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Gudang Jumlah harga (Rp) Apotek rajal

1 Acetazolamid 250 mg - Rp - -
2 Akarbose 100 mg 9,100 Rp 7,088,900 924
3 Akarbose 50 mg - Rp - -
4 Akilen tetes telinga - Rp - 3
5 Albendazol sirup - Rp - -
6 ALBUMIN 25% 100 ML 7 Rp 10,581,620 -
7 Alprazolam Tablet 0,5 mg 3,100 Rp 329,449 96
8 Alupurinol tablet 100 mg. 7,500 Rp 1,125,000 135
9 Ambroxol 30 mg tab 3,500 Rp 4,130,000 279
10 Ambroxol sirup - Rp - -
11 Amikasin 1 gr injrksi (Program TB RO ) - Rp - -
12 AMINOFLUID 1000 mL/Bfluid 32 Rp 208,000 -
13 Aminopilin Injeksi. 240 Rp 19,200 -
14 Amiodarone HCL Injeksi 50 mg/ml 12 Rp 104,400 -
15 Amitriptilin 300 Rp 60,000 15
16 Amlodipin 10 mg 10,800 Rp 1,598,400 525
17 Amlodipin 5 mg 12,500 Rp 875,000 540
18 Amoksilin + As. Kalvulanat tablet 450 Rp 2,709,450 18
Amoksilin + Asam Klavulanat Sirup
19 24 Rp 620,160 -
(Claneksi Sirup)
20 Amoksilin drop - Rp - -
21 Amoksilin kapsul 250 mg. - Rp - -
22 Amoxillin kapsul 500 mg 400 Rp 92,800 90
23 Antasida DOEN tab.kombinasi 2,300 Rp 165,600 84
24 Anti Hemoroid 900 Rp 2,740,500 6
25 Aqua Pro injeksi 1,080 Rp 3,088,800 36
26 Aripirazol 10 mg 400 Rp 9,211,400 6
27 Asam Askorbat (Vit.C) tab.50 mg. 1,200 Rp 114,000 15
Asam Mefenamat 500 mg
28 tablet salut selaput 12,700 Rp 1,346,200 300
29 Asam traneksamat inj 1,529 Rp 2,973,905 15
Asetil sistein 100 mg Sirup
30 (Fluimucil Sirup) - Rp - -
31 Asetil sistein 200 mg 8,760 Rp 8,094,240 147
32 Asiklovir 200 mg tab - Rp - -
33 Asiklovir 400 mg. tablet 650 Rp 230,750 99
34 Asiklovir salep 125 Rp 481,250 -
35 Atenolol 50 mg - Rp - -
36 Atorvastain Calcium tab 20 mg 450 Rp 900,000 285
37 Atorvastatin 10 mg Tablet - Rp - -
38 Atropin sulfat Injeksi 100 Rp 149,000 -
39 Avamys Spray 39 Rp 4,017,000 6
40 Azitromisin 500 mg 1,140 Rp 2,166,000 57
41 Azitromisin sirup kering 200 mg 208 Rp 8,923,200 -
42 Bayclin - Rp - -
43 Bedaquiline 100 mg (Program TB RO ) - Rp - -

44 Betametason + Neomisin Krim - Rp - -


(Benoson N Krim)
45 Betametason krim 0,1 % - Rp - -
46 Biosat ATS 20 Rp 2,619,980 -
47 Bisoprolol 5 mg - Rp - 162
48 Bricasma Injeksi (Terbutalin) 420 Rp 5,023,200 -
49 Bromheksin 8 mg - Rp - -
50 Bupivicain Injeksi (REGIVELL Injeksi) 20 Rp 1,320,000 6
51 Calcium Gluconat 120 Rp 1,447,440 -
52 candesartan 16 mg 19,920 Rp 82,409,040 336
53 Candesartan 8 mg tab 15,750 Rp 8,583,750 309
54 Carbazocrome inj 60 Rp 715,200 -
55 Ceftazidim injeksi 80 Rp 1,600,000 -
56 Ceftriaxon injeksi - Rp - -
57 Cendo Asthenof - Rp - -
58 Cendo Catarlent 15 ml 460 Rp 18,630,000 -
59 Cendo Cenfresh Eye Drop 675 Rp 31,117,500 -
60 Cendo floxa Eye Drop 260 Rp 10,478,000 3
61 Cendo Lyteers 350 Rp 8,662,500 9
62 Cendo mata pantocain 41 Rp 541,446 3
63 Cendo Mydriatil Tetes Mata 200 Rp 7,640,000 3
64 Cendo polydex - Rp - -
65 Cendo Statrol - Rp - -
66 Cendo timol 170 Rp 10,285,000 3
67 Cendo Tropin 0.5% 150 Rp 1,856,250 -
68 Cendo Xitrol Eye Drop 350 Rp 12,600,000 18
69 Cendo Xitrol salep mata 3,5 Gram 50 Rp 1,973,125 -
70 Cilostazol Tablet 100 mg (Pletaal 1,950 Rp 10,764,000 6
Tablet)
71 Citicolin inj 175 Rp 938,525 -
72 Clindamisin 300 mg 150 Rp 195,000 36
73 Clindamycin caps 150 mg 600 Rp 780,000 21
74 Clotrimazole (Dermifar Krim) - Rp - -
75 Combiven Inhaler 400 Rp 1,820,000 27
76 Coparcetin - Rp - -
77 Curcuma tab 3,600 Rp 4,759,200 171
78 Deksametason tablet 0,5 mg. 400 Rp 27,200 210
79 Delamanid 50 mg (Program TB RO ) 100 Rp 3,721,300 -
80 Depakote ER 250 mg 120 Rp 468,000 -
81 Depakote ER 500 mg - Rp - -
Dextrometrophan + Gliseril Guaiacolat
82 + Phenylpropanolamin HC + Chlo - Rp - -
heniramine Maleat Tab
83 Diazepam 5 mg tablet - Rp - 15
84 Diazepam Injeksi 20 Rp 34,700 3
85 Diazepam Rectal Tube 20 mg (STEOLID 1 65 Rp 1,144,765 -
86 Diazepam Rectal Tube 5 mg (STESOLID 5 140 Rp 2,305,725 -
87 Diazink tab - Rp - -
Digoksin injeksi 0,25 mg
88 (FARGOKSIN IV) 15 Rp 3,750 -
89 Digoksin tablet 0,25 mg. 200 Rp 19,400 -
90 Diltiazem 10 mg - Rp - -
91 Diphenhidramin injeksi 270 Rp 268,650 3
92 Dipsamol inhaler - Rp - -
93 Domperidon - Rp - 99
94 Domperidon 10 mg sirup - Rp - -
95 Domperidon drop - Rp - -
96 Donepezile 90 Rp 184,050 -
97 Doxycyclin kapsul 100 mg. 900 Rp 242,100 -
98 Epinefrin injeksi - Rp - 3
99 Eritromisin 500 mg tab 1,800 Rp 1,314,000 -
100 Etanol 70 % 1 liter - Rp - -
101 Ethambutol 400 mg (Program TB ) 50 Rp 24,700 -

102 Ethionamide 250 mg (Program TB RO ) 500 Rp 714,500 -


103 ethyl cloride 11 Rp 1,815,000 -
104 Euthyrox Tab - Rp - 12
105 fenitoin injeksi - Rp - -
106 Fenitoin Kapsul 200 Rp 121,000 -
107 Fentanyl Injeksi 100 mcg/2ml Injeks 255 Rp 10,965,000 6
108 Ferriz drop - Rp - -
109 Fitomenadion (Vit.K10 inj.10mg/ml01ml - Rp - 9
110 Flixotide - Rp - -
111 Flukonazole tab 80 Rp 1,800,000 3
112 Furosemid injeksi 400 Rp 1,505,600 39
113 Furosemid tab - Rp - 171
114 Gabapentin 100 mg 950 Rp 992,750 294
115 Gabapentin 300 mg tab 1,080 Rp 1,152,360 162
116 Garam Oralit 200 ml air 400 Rp 105,600 36
117 Gemfibrozil Kapsul 300 mg 4,000 Rp 1,472,000 66
118 Gentamisin Cream Kulit - Rp - 3
119 gentamisin injeksi 80 Rp 456,400 72
120 Glibenklamid 5 mg - Rp - -
121 Glikazid 80 mg 4,100 Rp 902,000 135
122 Glikuidon 30 Mg  5,900 Rp 6,342,500 144
123 glimepirid 2 mg - Rp - 39
124 Glukosa 40% 108 Rp 1,188,000 3
125 Glukose larutan infus 10 % steril 40 Rp 181,395 -
126 Glukose larutan infus 5 % steril 140 Rp 1,540,000 3
127 Haloperidol 50 mg injeksi - Rp - -
128 Haloperidol tablet 5 mg 400 Rp 24,000 30
129 Herbesser injeksi - Rp - -
130 Hidonac Injeksi 2.5 g 90 Rp 23,400,000 -
131 Hidroklorotiazide (HCT) tablet 25 mg. 2,000 Rp 300,000 -
132 Hidrokortison cr - Rp - -
133 Human Tetanus Immunoglobulin 1 ml 2 97 Rp 16,636,567 -
134 Hyoscine n Butil Bromide Injeksi 50 Rp 600,000 -
135 Hyosin N Butylbromide 10 mg 1,100 Rp 1,320,000 45
136 Ialuset plus - Rp - -
137 Ibuprofen tab 400 mg 4,900 Rp 2,028,600 234
138 Ibuprofen tablet 200 mg. - Rp - -
139 INH 100 mg (Program TB RO ) - Rp - -

140 INH 300 mg (Program TB RO ) - Rp - -

141 INH 300 mg (Program TB RO ) - Rp - -

142 Inhalasi Salbutamol Device (Salbulin) 64 Rp 2,007,872 -


143 Inhaler Ventolin 2,280 Rp 9,120,000 -
144 Inviclot 460 Rp 20,237,700 -
145 Iodin Povidone 1 L 30 Rp 1,950,000 -
146 Isoniazid 300 mg (Program TB RO ) - Rp - -

147 Isonoasid 300 mg (Program TB RO ) - Rp - -


148 Isosorbid injeksi 10 mg 150 Rp 4,701,750 3
149 Isosorbit Dinitrat tab sublingal 5 mg. 2,300 Rp 207,000 69
150 Kaen 1 B  100 Rp 2,196,200 9
151 Kaen 3 B  300 Rp 2,160,600 12
152 Kalium Diklofenak 50 mg 1,400 Rp 448,000 9
153 Kalsium Laktat (Kalk) tab.500 mg. - Rp - 294
154 Kaptopril 12,5 mg tablet - Rp - -
155 Kaptopril 25 mg tablet 2,900 Rp 136,300 369
156 Kidmin infus 7 Rp 322,616 -
157 Kloramfenikol 500 mg - Rp - -
158 Kloramfenikol Salep mata 38 Rp 71,478 3
159 Kloramfenikol tetes telinga - Rp - -
Klorfeniramin Maleat (CTM) tablet 4
160 mg. 1,000 Rp 30,000 201
161 Kodein 20 mg 100 Rp 93,000 54
162 Kotrimoksazol dewasa tablet 700 Rp 105,700 21
163 Kotrimoksazol suspensi 132 Rp 372,768 -
164 KSR 4,800 Rp 9,768,000 114
165 Lacto B - Rp - 93
166 Lactulac sirup 144 Rp 6,048,000 6
167 Lamivudine (3TC) 150mg (Program 180 Rp 318,240 -
HIV)
168 lansoprazol capsul 4,350 Rp 3,253,800 327
169 Lansoprazol injeksi 77 Rp 7,085,463 6
170 Lantus 610 Rp 54,900,000 27
171 Levemir Insulin - Rp - -
172 Levodopa + Benserazide kombinasi - Rp - 6
173 Levofloksasin tab 1,150 Rp 632,500 39
174 Levofloxacin infus 5mg/ml 360 Rp 6,914,160 12
175 Lidocain 2 % injeksi 1,300 Rp 1,090,700 21
Lidokain HCL0 Epinefrin Injeksi/amp 2
176 20 Rp 20,000 6
ml (PEHACAIN)

177 Linezolid 600 mg (Program TB RO ) - Rp - -


178 Loperamid tablet 1,800 Rp 535,846 9
179 Madopar tab/Levopar - Rp - -
180 Manitol infus 25 mL 20 Rp 680,000 -
181 Mecobalamin 500 mg 800 Rp 1,587,200 516
182 Meloksikam 15 mg - Rp - -
183 Meloxicam 15 mg - Rp - 99
184 Mersibion inj 10 Rp 57,490 6
185 Metamizole Injeksi 100 Rp 2,749,890 -
186 Metamizole Tablet 500 mg - Rp - -
187 Metformin 500 mg 44,800 Rp 4,480,000 360
188 Metformin tab 850 mg 1,900 Rp 564,300 30
189 Metil Ergometrin (METERGIN Injeksi) 25 Rp 6,500 15
190 Metil Prednisolon 125MG/ml INJ 250 Rp 5,500,000 -
191 Metil Prednisolon 4 mg 11,000 Rp 2,134,000 186
192 Metildopa tablet - Rp - 60
193 Metoklo ramid 10 mg tab 2,400 Rp 216,000 15
194 Metronidazol 500 mg ovula - Rp - -
195 Metronidazol tablet 500 mg. 3,100 Rp 412,300 90
196 metronidazole infus 40 Rp 324,400 6
197 Mgso4 infus - Rp - 3
198 Miconazole cream 24 Rp 94,608 -
199 Mineral Mix - Rp - -
200 Minosep Gargle 36 Rp 1,260,000 -
201 Misoprostol tab 630 Rp 3,150,000 21
202 Moxifloxacin 400 mg (Program TB RO ) - Rp - -
203 Mupirocin salep 12 Rp 633,600 -
204 NaCL 0.9%, 100 ml 600 Rp 4,290,000 66
205 NaCL 0.9%, 500 ml 1,760 Rp 23,232,000 36
206 Nalokson injeksi 0.4 mg - Rp - -
207 Natrium Bikarbonat tablet 4,300 Rp 4,300,000 300
208 Natrium Diklofenak 25 mg tab - Rp - -
209 Natrium Klorida 3% 40 Rp 1,200,000 3
210 Neurodex - Rp - -
Nevirapine (NVP) 200mg(Program
211 300 Rp 1,834,800 -
HIV )
212 Nifedipin 10 mg. tablet 22,200 Rp 3,907,200 180
213 Nikardipin injeksi 170 Rp 4,020,330 3
214 Nistatin 500.000 IU tablet salut - Rp - -
215 Nistatin drop 108 Rp 2,376,000 3
216 Nitrogliserin 5 mg - Rp - -
217 Nitrokaf retard 2.5 mg 300 Rp 570,000 273
218 Norepinefrine 1 mg/ml - Rp - 9
219 Novomix insulin - Rp - -
220 Novorapid insulin 1,200 Rp 104,400,000 57
221 - Rp - -
OAT Combivak (Program TB )
222 Obat Anti Tubercolosis Anak - Rp - -
(Program TB )
Obat Anti Tuberkolosis Kategori I
223 (Program TB SO ) 64 Rp 23,039,040 -

224 Obat Anti Tuberkolosis Kategori II - Rp - -


(Program TB )
225 OBH 235 Rp 1,175,000 -
226 Oksitosina injeksi 10 IU / ml01ml 3,900 Rp 4,676,100 69
227 Omeprazol 20 mg tab 2,800 Rp 448,000 252
228 Omeprazol injeksi 2,660 Rp 26,328,680 48
229 Ondansetron 4 mg Inj 8,085 Rp 9,435,195 75
230 Ondansetron 8 mg - Rp - 84
231 Parasetamol drop - Rp - -
232 Parasetamol infus 1,000 Rp 18,000,000 24
233 Parasetamol sirup 120 mg/ 5 ml 300 Rp 810,000 -
234 Parasetamol Supp 125 mg 756 Rp 9,450,000 15
235 Parasetamol suppos 250 mg 432 Rp 11,664,000 24
236 Parasetamol tablet 500 mg. 200 Rp 11,200 645
237 Pioglitazon 10,230 Rp 36,572,250 300
238 Pirazinamid 500 mg (Program TB ) - Rp - -
239 Prednison 5 mg 7,800 Rp 530,400 -
240 Procain Penisilline (Program TB RO ) - Rp - -

Pseudoefedrin HCL 15 mg +
241 Terfenadine 100 Rp 169,400 96
242 Ramipril 5 Mg Tab  13,100 Rp 3,209,500 354
243 Ranitidin 150 mg 4,500 Rp 540,000 81
244 Ranitidin injeksi 3,225 Rp 4,482,750 54
245 Ranivel sirup 10 Rp 484,000 -
246 Requip tab - Rp - -
247 Rifampisin 450 mg tab (Program TB ) - Rp - -
248 Ringer Laktat 460 Rp 3,289,000 78
249 Risperidone 2 mg 2,800 Rp 803,600 18
250 Salbutamol 2 mg - Rp - 150
251 Salbutamol 4 mg tab 2,800 Rp 316,400 111
252 Salisil Bedak 2 % - Rp - -
253 SANBE Baquinor 0.3% Tetes Mata 192 Rp 8,315,136 -
254 SANBE Forumen 28 Rp 590,205 -
255 SANBE Fukrisin ED 5 ml 48 Rp 3,696,000 -
256 SANBE Hyaloph Eye Drop - Rp - 3
257 SANBE Otilon tetes telinga 270 Rp 8,587,080 3
258 Sefadroksil 500 mg kapsul 8,700 Rp 4,437,000 114
259 Sefadroksil sirup 33 Rp 161,568 -
260 Sefiksim 100 mg 4,900 Rp 2,891,000 81
261 Sefiksim 100 mg sirup 250 Rp 1,332,500 -
262 Sefiksim 200 mg 7,900 Rp 19,671,000 171
263 Sefotaksim injeksi 770 Rp 4,235,000 15
264 Seftriakson injeksi 1,650 Rp 7,396,950 21
265 Seretide Diskus (50/500) 200 Rp 26,799,600 3
266 Sertralin 50 mg 820 Rp 1,607,200 9
267 Setirizin 10 mg sirup 550 Rp 3,575,000 -
268 Setirizin 10 mg tab 11,600 Rp 1,658,800 -
269 Sevodex 23 Rp 43,700,000 -
270 Simarc 2 mg 2,100 Rp 2,100,000 45
271 Simvastatin 20 mg 25,100 Rp 5,145,500 246
272 Siprofloksasin 2% Infus 48 Rp 600,000 3
273 Siprofloksasin 500 mg tablet 3,100 Rp 871,100 99
274 SNMC Injeksi - Rp - 3
275 Stesolid 10 mg - Rp - -
276 Stesolid 5 mg - Rp - -
277 Streptomycin 1 gr (Program TB ) 5 Rp 49,580 -
278 sukralfat tablet - Rp - -
279 Sulfadiazin krim 47 Rp 1,175,000 -
280 Tablet tambah darah kombinasi 4,400 Rp 277,200 339
TDF 300/3TC 300/DTG 50 (Program
281 HIV) 330 Rp 923,076 -

TDF/3TC/EFV(300/300/600) (Program
282 300 Rp 2,040,000 -
HIV)
283 Telmisartan 40 mg tab - Rp - -
284 Tenofovir (TDF) 300mg (Program HIV) 150 Rp 1,263,600 -

285 Teofilin tab 150 mg (BRONSOLVAN) - Rp - -


286 Terbutalin Sulfat 0,5mg/ml Injeksi - Rp - -
287 Thiamfenikol 500 - Rp - -
288 Tramadol 37,5 mg + Parasetamol caps 1,590 Rp 15,872,970 24
289 Tramadol inj 430 Rp 874,333 3
290 Trihexyphenidyl tab 1,200 Rp 128,400 54
291 Trilac (Triamcinolon) 8 Rp 474,304 -
292 Tuberculin PPD TEST 20 Rp 19,364,176 -
Urdafalk tab (URSODEOXYCHOLIC
293 ACID GENERIK) 2,850 Rp 6,463,800 3

294 Vaksin HB0 (Program VAKSIN) 213 Rp 4,451,700 3

295 Vaksin TD Single Use - Rp - -


(Program TB RO )
296 Valsartan 160 mg 5,730 Rp 6,876,000 45
297 Valsartan 80 mg - Rp - -
298 Vasacon 200 Rp 4,300,000 -
Vicilin SX serbuk injeksi (Ampisilin
299 Sulbactam) 30 Rp 1,314,300 15
300 Vitamin B Kompleks Tablet 19,600 Rp 2,254,000 246
301 Vitamin B6 - Rp - -
302 Vitamin B6 - Rp - -
303 Vitamin B6 10 mg 4,000 Rp 492,000 225
304 VITAMIN C INJEKSI 200 Rp 3,740,000 -
305 Vitamin D3 1000 iu 4,200 Rp 8,820,000 39
306 Vitamin Sirup anak (UNIVIT/TIALISIN) - Rp - -
307 Water Steril 1 L 12 Rp 133,644 3
308 Xylocain 10% Spray - Rp - -
309 Xylocain Jelly 2% 650 Rp 27,040,000 9
310 Zidovudin (Zdv) 100 mg (Program HIV) 150 Rp 265,200 -

311 Zidovudine (ZDV)/Lamivudine (3TC) 720 Rp 2,770,560 -


300/150mg (Program HIV)
312 Zinc Sirup 30 Rp 188,700 -
313 Abilify 15 mg (Aripriprazole) 60 3
314 Adalat Oros Tab 960 -
315 Allopurinol 300 mg 3,900 54
316 Ampicilin Inj 1,950 27
317 Antasida DOEN syr 240 -
318 ARDIUM - -
319 Aricept Evess (Donepezil 10mg) 1,540 -
320 Arixtra Inj 30 3
321 As. Valproat Sirup - -
322 Asam Folat tab 3,000 351
323 Asam Traneksamat 500 mg tab 8,300 186
324 Asering 500 ml 20 -
325 Atracurium Injeksi (Tramus Inj) 20 -
326 Attapulgite tablet 3,000 -
327 Betahistin 6 mg 1,100 -
328 Bisakodil tab 200 -
329 Bisoprolol 2.5 mg 8,000 99
330 CaCO3 13,710 66
331 Captopril 25 mg 2,900 354
332 Cefoperazone 120 -
333 Cendo Efrisel. 300 -
334 Cendo Siloxan 5 -
335 Cetadop inj (Dopamin) 60 3
336 Cetirizin Sirup 550 -
337 Cetirizin tab 14,400 -
338 Chloroquin 150 mg tablet 3,700 -
339 Chlorpromazin Tab 600 -
340 Citicolin tab. 120 -
341 Clobazam 10 mg - -
342 Clonazepam 2 mg tab 1,300 -
343 Clonidine tablet 0,15 mg - -
344 Clozapine 100 mg 450 -
345 Clozapine 25 mg 200 15
346 Concor 1,25 - -
347 Deksametason inj 700 -
348 Diltiazem tablet 30 mg 3,300 -
349 Dobutamin Inj 310 3
350 Beraprost (Dorner) tab 3,270 33

351 Dulcolax supp 5 mg - -

352 Efedrin Injeksi 50 mg 70 3


353 Eperison tablet - 180
354 Fenofibrate 100mg kap 5,650 219
355 Ferro-K Sirup 120 -
356 Fitomenadion tablet 10 mg 2,400 -
357 Flunarizine 10 mg tab - -
358 Fluoxetin Capsul 3,780 -
359 Gelofusin 10 -
360 Glimepirid 1 mg 1,500 -
361 Glimepirid 3 mg 10,000 -
362 Glimepiride 4 mg 11,000 -
363 Glucosamin Tab 300 -
364 Tamsolusin 300 45
365 Herbesser CD 100 mg 1,500 75
366 Hot In Cream DCL 1,000 -
367 HP PRO 120 -
368 Ibuprofen suspensi 20 -
369 KCL 7.46% 102 -
370 Ketamin Inj 90 -
371 Ketoconazol Tab - -
372 Ketokonazol Cr 84 -

373 Ketoprofen Supp 720 -

374 Ketorolac inj 30 mg 140 -


375 Klopidogrel 75 mg 9,000 408
376 Kolkisin tablet - -
377 Loratadine 10 mg 1,400 30
378 Meropenem Injeksi 135 -
379 Methosoprinol syr 10 -
380 Metil Ergometrin tab (Bledstop) 400 -
381 Metil Prednisolon 16 mg 3,000 99
382 Metoklopramid Injeksi 180 -
383 Meylon 156 -
384 Microlax 25 -
385 miniaspi 80mg 20,000 885
386 Multivitamin TABLET 8,200 -
387 Natrium Diklofenak 50 mg 100 -
388 Neostigmin inj 50 -
389 PK Serbuk 24 -
390 Pramifrol 0,375 MG tab - -
391 Propranolol 10 mg Tablet 7,100 -
392 Propranolol 40 mg 1,700 -
393 PTU tablet 100 mg 2,100 -
394 Pulmicort 0.25 Mg/ Ml  - 24
395 Ramipril 10 mg 60 -
396 Rebamipid. 8,200 90
397 Recofol 10 mg/ml 100 -
398 Rifampisin 600 mg tab 1,000 -
399 Rocuronium 10 mg/ml inj 5 -
400 Salbutamol 2 mg/5 ml Sirup 318 -
401 Seretide Diskus 50/250MCG. - -
402 Spironolakton 25 mg tab 3,200 -
403 Thrombopop Gel 7 -
404 Thiamzole 10 mg tab. 100 -
405 Triamsinolon inj 8 -
406 Carvedilol (Vbloc) 6,25 mg tab - -
Total 644,048 Rp 1,109,291,001

Direktur RSUD Cilincing


drg. Evi Marni Nasril. MKM
NIP. 197001291999032002
Stock Akhir Bulan Maret 2023

Jumlah harga (Rp) apotek ranap Jumlah harga (Rp) apotek paru Jumlah harga
(Rp)

Rp - - Rp - - Rp -
Rp 719,796 462 Rp 359,898 186 Rp 144,894
Rp - - Rp - - Rp -
Rp 105,000 - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 10,202 48 Rp 5,101 18 Rp 1,913
Rp 20,250 69 Rp 10,350 27 Rp 4,050
Rp 329,220 141 Rp 166,380 57 Rp 67,260
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 3,000 9 Rp 1,800 3 Rp 600
Rp 77,700 264 Rp 39,072 105 Rp 15,540
Rp 37,800 270 Rp 18,900 108 Rp 7,560
Rp 108,378 9 Rp 54,189 3 Rp 18,063
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 20,880 45 Rp 10,440 18 Rp 4,176
Rp 6,048 42 Rp 3,024 18 Rp 1,296
Rp 18,270 3 Rp 9,135 - Rp -
Rp 102,960 18 Rp 51,480 6 Rp 17,160
Rp 138,171 3 Rp 69,086 - Rp -
Rp 1,425 9 Rp 855 3 Rp 285
Rp 31,800 150 Rp 15,900 60 Rp 6,360
Rp 29,175 6 Rp 11,670 3 Rp 5,835
Rp - - Rp - - Rp -
Rp 135,828 75 Rp 69,300 30 Rp 27,720
Rp - - Rp - - Rp -
Rp 35,145 48 Rp 17,040 21 Rp 7,455
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 570,000 141 Rp 282,000 57 Rp 114,000
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 618,000 3 Rp 309,000 - Rp -
Rp 108,300 30 Rp 57,000 12 Rp 22,800
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -

Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 40,824 81 Rp 20,412 33 Rp 8,316
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 396,000 3 Rp 198,000 - Rp -
Rp - - Rp - - Rp -
Rp 1,390,032 168 Rp 695,016 66 Rp 273,042
Rp 168,405 153 Rp 83,385 63 Rp 34,335
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 120,900 - Rp - - Rp -
Rp 222,750 6 Rp 148,500 3 Rp 74,250
Rp 39,618 - Rp - - Rp -
Rp 114,600 - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 181,500 3 Rp 181,500 - Rp -
Rp - - Rp - - Rp -
Rp 648,000 9 Rp 324,000 3 Rp 108,000
Rp - - Rp - - Rp -
Rp 33,120 3 Rp 16,560 - Rp -
Rp - - Rp - - Rp -
Rp 46,800 18 Rp 23,400 6 Rp 7,800
Rp 27,300 9 Rp 11,700 3 Rp 3,900
Rp - - Rp - - Rp -
Rp 122,850 12 Rp 54,600 6 Rp 27,300
Rp - - Rp - - Rp -
Rp 226,062 84 Rp 111,048 33 Rp 43,626
Rp 14,280 105 Rp 7,140 42 Rp 2,856
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -

Rp - - Rp - - Rp -

Rp 1,710 9 Rp 1,026 3 Rp 342


Rp 5,205 - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 2,985 - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 11,682 51 Rp 6,018 21 Rp 2,478
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 4,404 - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -

Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 28,800 6 Rp 14,400 3 Rp 7,200
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 258,000 3 Rp 129,000 - Rp -
Rp - - Rp - - Rp -
Rp 58,500 6 Rp 39,000 3 Rp 19,500
Rp - - Rp - - Rp -
Rp 67,500 3 Rp 67,500 - Rp -
Rp 146,796 21 Rp 79,044 9 Rp 33,876
Rp 23,256 84 Rp 11,424 33 Rp 4,488
Rp 307,230 147 Rp 153,615 60 Rp 62,700
Rp 172,854 81 Rp 86,427 33 Rp 35,211
Rp 9,504 18 Rp 4,752 6 Rp 1,584
Rp 24,288 33 Rp 12,144 12 Rp 4,416
Rp 5,700 3 Rp 5,700 - Rp -
Rp 410,760 36 Rp 205,380 15 Rp 85,575
Rp - - Rp - - Rp -
Rp 29,700 69 Rp 15,180 27 Rp 5,940
Rp 154,800 72 Rp 77,400 30 Rp 32,250
Rp 8,073 21 Rp 4,347 9 Rp 1,863
Rp 33,000 - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 33,000 3 Rp 33,000 - Rp -
Rp - - Rp - - Rp -
Rp 1,800 15 Rp 900 6 Rp 360
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 54,000 24 Rp 28,800 9 Rp 10,800
Rp - - Rp - - Rp -
Rp 96,876 117 Rp 48,438 48 Rp 19,872
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -

Rp - - Rp - - Rp -

Rp - - Rp - - Rp -

Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -

Rp - - Rp - - Rp -
Rp 94,035 - Rp - - Rp -
Rp 6,210 36 Rp 3,240 15 Rp 1,350
Rp 197,658 3 Rp 65,886 3 Rp 65,886
Rp 86,424 6 Rp 43,212 3 Rp 21,606
Rp 2,880 6 Rp 1,920 3 Rp 960
Rp 18,522 147 Rp 9,261 60 Rp 3,780
Rp - - Rp - - Rp -
Rp 17,343 186 Rp 8,742 75 Rp 3,525
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 5,643 - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 6,030 99 Rp 2,970 39 Rp 1,170
Rp 50,220 27 Rp 25,110 12 Rp 11,160
Rp 3,171 9 Rp 1,359 3 Rp 453
Rp - - Rp - - Rp -
Rp 231,990 57 Rp 115,995 24 Rp 48,840
Rp 530,100 45 Rp 256,500 18 Rp 102,600
Rp 252,000 3 Rp 126,000 - Rp -
Rp - - Rp - - Rp -
Rp 244,596 165 Rp 123,420 66 Rp 49,368
Rp 552,114 3 Rp 276,057 - Rp -
Rp 2,430,000 12 Rp 1,080,000 6 Rp 540,000
Rp - - Rp - - Rp -
Rp 23,700 3 Rp 11,850 - Rp -
Rp 21,450 21 Rp 11,550 9 Rp 4,950
Rp 230,472 6 Rp 115,236 3 Rp 57,618
Rp 17,619 9 Rp 7,551 3 Rp 2,517
Rp 6,000 3 Rp 3,000 - Rp -

Rp - - Rp - - Rp -
Rp 2,679 6 Rp 1,786 3 Rp 893
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 1,023,744 258 Rp 511,872 102 Rp 202,368
Rp - - Rp - - Rp -
Rp 39,600 51 Rp 20,400 21 Rp 8,400
Rp 34,494 3 Rp 17,247 - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 36,000 180 Rp 18,000 72 Rp 7,200
Rp 8,910 15 Rp 4,455 6 Rp 1,782
Rp 3,900 9 Rp 2,340 3 Rp 780
Rp - - Rp - - Rp -
Rp 36,084 93 Rp 18,042 36 Rp 6,984
Rp 74,160 30 Rp 37,080 12 Rp 14,832
Rp 1,350 9 Rp 810 3 Rp 270
Rp - - Rp - - Rp -
Rp 11,970 45 Rp 5,985 18 Rp 2,394
Rp 48,660 3 Rp 24,330 - Rp -
Rp 3,978 3 Rp 3,978 - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 105,000 12 Rp 60,000 3 Rp 15,000
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 471,900 33 Rp 235,950 12 Rp 85,800
Rp 475,200 18 Rp 237,600 6 Rp 79,200
Rp - - Rp - - Rp -
Rp 300,000 150 Rp 150,000 60 Rp 60,000
Rp - - Rp - - Rp -
Rp 90,000 - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 31,680 90 Rp 15,840 36 Rp 6,336
Rp 70,947 - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 66,000 - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 518,700 138 Rp 262,200 54 Rp 102,600
Rp 56,700 3 Rp 18,900 3 Rp 18,900
Rp - - Rp - - Rp -
Rp 4,959,000 27 Rp 2,349,000 12 Rp 1,044,000
Rp - - Rp - - Rp -

Rp - - Rp - - Rp -

Rp - - Rp - - Rp -

Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 82,731 36 Rp 43,164 15 Rp 17,985
Rp 40,320 126 Rp 20,160 51 Rp 8,160
Rp 475,104 24 Rp 237,552 9 Rp 89,082
Rp 87,525 36 Rp 42,012 15 Rp 17,505
Rp 25,116 42 Rp 12,558 18 Rp 5,382
Rp - - Rp - - Rp -
Rp 432,000 12 Rp 216,000 6 Rp 108,000
Rp - - Rp - - Rp -
Rp 187,500 9 Rp 112,500 3 Rp 37,500
Rp 648,000 12 Rp 324,000 6 Rp 162,000
Rp 36,120 324 Rp 18,144 129 Rp 7,224
Rp 1,072,500 150 Rp 536,250 60 Rp 214,500
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -

Rp 162,624 48 Rp 81,312 18 Rp 30,492


Rp 86,730 177 Rp 43,365 72 Rp 17,640
Rp 9,720 39 Rp 4,680 15 Rp 1,800
Rp 75,060 27 Rp 37,530 12 Rp 16,680
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 557,700 39 Rp 278,850 15 Rp 107,250
Rp 5,166 9 Rp 2,583 3 Rp 861
Rp 9,900 75 Rp 4,950 30 Rp 1,980
Rp 12,543 54 Rp 6,102 21 Rp 2,373
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 144,273 - Rp - - Rp -
Rp 95,412 - Rp - - Rp -
Rp 58,140 57 Rp 29,070 24 Rp 12,240
Rp - - Rp - - Rp -
Rp 47,790 39 Rp 23,010 15 Rp 8,850
Rp - - Rp - - Rp -
Rp 425,790 84 Rp 209,160 33 Rp 82,170
Rp 82,500 9 Rp 49,500 3 Rp 16,500
Rp 94,143 9 Rp 40,347 3 Rp 13,449
Rp 401,994 - Rp - - Rp -
Rp 17,640 3 Rp 5,880 3 Rp 5,880
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 45,000 24 Rp 24,000 9 Rp 9,000
Rp 50,430 123 Rp 25,215 48 Rp 9,840
Rp 37,500 - Rp - - Rp -
Rp 27,819 51 Rp 14,331 21 Rp 5,901
Rp 315,000 - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 21,357 171 Rp 10,773 69 Rp 4,347
Rp - - Rp - - Rp -

Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -

Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 239,592 12 Rp 119,796 6 Rp 59,898
Rp 6,100 - Rp - - Rp -
Rp 5,778 27 Rp 2,889 12 Rp 1,284
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 6,804 3 Rp 6,804 - Rp -

Rp 62,700 3 Rp 62,700 - Rp -

Rp - - Rp - - Rp -
Rp 54,000 24 Rp 28,800 9 Rp 10,800
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 657,150 6 Rp 262,860 3 Rp 131,430
Rp 28,290 123 Rp 14,145 48 Rp 5,520
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 27,675 114 Rp 14,022 45 Rp 5,535
Rp - - Rp - - Rp -
Rp 81,900 21 Rp 44,100 9 Rp 18,900
Rp - - Rp - - Rp -
Rp 33,411 - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 374,400 3 Rp 124,800 3 Rp 124,800
Rp - - Rp - - Rp -

Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 67,509 - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 11,988 27 Rp 5,994 12 Rp 2,664
Rp 213,300 15 Rp 118,500 6 Rp 47,400
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 663,579 - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 42,120 174 Rp 20,880 69 Rp 8,280
Rp 306,528 93 Rp 153,264 36 Rp 59,328
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 12,078 51 Rp 6,222 21 Rp 2,562
Rp 32,670 33 Rp 16,335 12 Rp 5,940
Rp 38,940 177 Rp 19,470 72 Rp 7,920
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 11,088 - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 7,155 9 Rp 4,293 3 Rp 1,431
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 34,194 - Rp - - Rp -
Rp 98,967 15 Rp 44,985 6 Rp 17,994

Rp - - Rp - - Rp -

Rp 19,458 - Rp - - Rp -
Rp 113,580 90 Rp 56,790 36 Rp 22,716
Rp 108,405 108 Rp 53,460 45 Rp 22,275
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 196,020 24 Rp 104,544 9 Rp 39,204
Rp 359,475 39 Rp 186,927 15 Rp 71,895
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -

Rp - - Rp - - Rp -

Rp - - Rp - - Rp -
Rp 367,200 204 Rp 183,600 81 Rp 72,900
Rp - - Rp - - Rp -
Rp 3,270 15 Rp 1,635 6 Rp 654
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 49,995 51 Rp 25,755 21 Rp 10,605
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 201,780 444 Rp 101,232 177 Rp 40,356
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp 253,752 12 Rp 126,876 6 Rp 63,438
Rp - - Rp - - Rp -
Rp 99,000 45 Rp 49,500 18 Rp 19,800
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - - Rp - - Rp -
Rp - Rp - Rp -

Rp - Rp - Rp -
Rp - Rp - Rp -
apotek prb Jumlah harga Satuan Barang Harga Satuan Harga Satuan (Rp.)
(Rp) (Rp)

- Rp - TABLET Rp 4,394 Rp 4,394


279 Rp 217,341 TABLET Rp 779 Rp 779
- Rp - TABLET Rp 562 Rp 562
- Rp - BOTOL Rp 35,000 Rp 35,000
- Rp - BOTOL Rp 3,849 Rp 3,849
- Rp - TABLET Rp 1,511,660 Rp 1,511,660
30 Rp 3,188 TABLET Rp 106 Rp 106
42 Rp 6,300 TABLET Rp 150 Rp 150
84 Rp 99,120 TABLET Rp 1,180 Rp 1,180
- Rp - BOTOL Rp 5,200 Rp 5,200
- Rp - TABLET Rp 30,450 Rp 30,450
- Rp - TABLET Rp 6,500 Rp 6,500
- Rp - TABLET Rp 80 Rp 80
- Rp - AMPUL Rp 8,700 Rp 8,700
6 Rp 1,200 TABLET Rp 200 Rp 200
159 Rp 23,532 TABLET Rp 148 Rp 148
162 Rp 11,340 TABLET Rp 70 Rp 70
6 Rp 36,126 TABLET Rp 6,021 Rp 6,021
- Rp - BOTOL Rp 25,840 Rp 25,840
- Rp - BOTOL Rp 25,300 Rp 25,300
- Rp - KAPSUL Rp 195 Rp 195
27 Rp 6,264 KAPSUL Rp 232 Rp 232
27 Rp 1,944 TABLET Rp 72 Rp 72
3 Rp 9,135 TUBE Rp 3,045 Rp 3,045
12 Rp 34,320 AMPUL Rp 2,860 Rp 2,860
3 Rp 69,086 TABLET Rp 23,029 Rp 23,029
6 Rp 570 TABLET Rp 95 Rp 95
90 Rp 9,540 TABLET Rp 106 Rp 106
3 Rp 5,835 AMPUL Rp 1,945 Rp 1,945
- Rp - BOTOL Rp 68,000 Rp 68,000
45 Rp 41,580 KAPSUL Rp 924 Rp 924
- Rp - TABLET Rp 249 Rp 249
30 Rp 10,650 TABLET Rp 355 Rp 355
- Rp - TUBE Rp 3,850 Rp 3,850
- Rp - TABLET Rp 352 Rp 352
84 Rp 168,000 TABLET Rp 2,000 Rp 2,000
- Rp - TABLET Rp 1,100 Rp 1,100
- Rp - TABLET Rp 1,490 Rp 1,490
- Rp - BOTOL Rp 103,000 Rp 103,000
18 Rp 34,200 TABLET Rp 1,900 Rp 1,900
- Rp - BOTOL Rp 42,900 Rp 42,900
- Rp - BOTOL Rp 15,500 Rp 15,500
1 LITER
- Rp - TABLET Rp 34,300 Rp 34,300

- Rp - TUBE Rp 24,000 Rp 24,000


- Rp - TUBE Rp 2,650 Rp 2,650
- Rp - AMPUL Rp 130,999 Rp 130,999
48 Rp 12,096 TABLET Rp 252 Rp 252
- Rp - AMPUL Rp 11,960 Rp 11,960
- Rp - TABLET Rp 105 Rp 105
3 Rp 198,000 TABLET Rp 66,000 Rp 66,000
- Rp - AMPUL Rp 12,062 Rp 12,062
102 Rp 421,974 TABLET Rp 4,137 Rp 4,137
93 Rp 50,685 TABLET Rp 545 Rp 545
- Rp - TABLET Rp 11,920 Rp 11,920
- Rp - VIAL Rp 20,000 Rp 20,000
- Rp - VIAL Rp 8,420
- Rp - BOTOL 5 ML Rp 23,100 Rp 23,100
- Rp - BOTOL Rp 40,500 Rp 40,500
- Rp - BOTOL Rp 46,100 Rp 46,100
- Rp - BOTOL Rp 40,300 Rp 40,300
3 Rp 74,250 BOTOL 5 ML Rp 24,750 Rp 24,750
- Rp - BOTOL Rp 13,206 Rp 13,206
- Rp - BOTOL Rp 38,200 Rp 38,200
- Rp - BOTOL 5 ML Rp 39,325 Rp 39,325
- Rp - BOTOL 5 ML Rp 20,075 Rp 20,075
- Rp - BOTOL Rp 60,500 Rp 60,500
- Rp - BOTOL 5 ML Rp 12,375 Rp 12,375
6 Rp 216,000 BOTOL Rp 36,000 Rp 36,000
- Rp - TUBE Rp 39,463 Rp 39,463
3 Rp 16,560 TABLET Rp 5,520 Rp 5,520
- Rp - VIAL Rp 5,363 Rp 5,363
12 Rp 15,600 TABLET Rp 1,300 Rp 1,300
6 Rp 7,800 TABLET Rp 1,300 Rp 1,300
- Rp - TUBE Rp 5,280 Rp 5,280
9 Rp 40,950 AMPUL Rp 4,550 Rp 4,550
- Rp - TABLET Rp 400 Rp 400
51 Rp 67,422 TABLET Rp 1,322 Rp 1,322
63 Rp 4,284 TABLET Rp 68 Rp 68
- Rp - TABLET Rp 37,213 Rp 37,213
- Rp - KAPLET Rp 3,900 Rp 3,900
- Rp - KAPLET Rp 7,900 Rp 7,900

- Rp - TABLET Rp 433 Rp 433

6 Rp 684 TABLET Rp 114 Rp 114


- Rp - VIAL Rp 1,735 Rp 1,735
- Rp - TABLET Rp 17,612 Rp 17,612
- Rp - SUPP Rp 16,469 Rp 16,469
- Rp - TABLET Rp 474 Rp 474
- Rp - AMPUL Rp 250 Rp 250
- Rp - TABLET Rp 97 Rp 97
- Rp - TABLET Rp 4,460 Rp 4,460
- Rp - AMPUL Rp 995 Rp 995
- Rp - BOTOL Rp 41,250 Rp 41,250
30 Rp 3,540 TABLET Rp 118 Rp 118
- Rp - BOTOL Rp 3,000 Rp 3,000
- Rp - BOTOL Rp 12,500 Rp 12,500
- Rp - TABLET Rp 2,045 Rp 2,045
- Rp - KAPSUL Rp 269 Rp 269
- Rp - AMPUL Rp 1,468 Rp 1,468
- Rp - TABLET Rp 730 Rp 730
- Rp - BOTOL Rp 21,500 Rp 21,500
- Rp - TABLET Rp 494 Rp 494

- Rp - TABLET Rp 1,429 Rp 1,429


- Rp - BOTOL Rp 165,000 Rp 165,000
3 Rp 7,200 TABLET Rp 2,400 Rp 2,400
- Rp - AMPUL Rp 5,000 Rp 5,000
- Rp - KAPSUL Rp 605 Rp 605
3 Rp 129,000 VIAL Rp 43,000 Rp 43,000
- Rp - BOTOL Rp 33,000 Rp 33,000
3 Rp 19,500 VIAL Rp 6,500 Rp 6,500
- Rp - BUAH Rp 18,000 Rp 18,000
- Rp - TABLET Rp 22,500 Rp 22,500
12 Rp 45,168 AMPUL Rp 3,764 Rp 3,764
51 Rp 6,936 TABLET Rp 136 Rp 136
87 Rp 90,915 TABLET Rp 1,045 Rp 1,045
48 Rp 51,216 TABLET Rp 1,067 Rp 1,067
12 Rp 3,168 SACHET Rp 264 Rp 264
21 Rp 7,728 TABLET Rp 368 Rp 368
- Rp - TUBE Rp 1,900 Rp 1,900
21 Rp 119,805 AMPUL Rp 5,705 Rp 5,705
- Rp - TABLET Rp 190 Rp 190
42 Rp 9,240 TABLET Rp 220 Rp 220
45 Rp 48,375 TABLET Rp 1,075 Rp 1,075
12 Rp 2,484 TABLET Rp 207 Rp 207
- Rp - BOTOL Rp 11,000 Rp 11,000
500 ML
- Rp - TABLET Rp 4,535 Rp 4,535
- Rp - TABLET Rp 11,000 Rp 11,000
- Rp - AMPUL Rp 97,500 Rp 97,500
9 Rp 540 TABLET Rp 60 Rp 60
- Rp - AMPUL Rp 154,400 Rp 154,400
- Rp - TABLET Rp 260,000 Rp 260,000
- Rp - TABLET Rp 150 Rp 150
- Rp - TABLET Rp 3,500 Rp 3,500
- Rp - BUAH Rp 171,511 Rp 171,511
- Rp - VIAL Rp 12,000 Rp 12,000
15 Rp 18,000 TABLET Rp 1,200 Rp 1,200
- Rp - TUBE Rp 166,972 Rp 166,972
72 Rp 29,808 TABLET Rp 414 Rp 414
- Rp - TABLET Rp 105 Rp 105
- Rp - TABLET Rp 231 Rp 231

- Rp - TABLET Rp 173 Rp 173

- Rp - TABLET Rp 150 Rp 150

- Rp - RESPUL Rp 31,373 Rp 31,373


- Rp - AMPUL Rp 4,000 Rp 4,000
- Rp - TABLET Rp 43,995 Rp 43,995
- Rp - BOTOL Rp 65,000 Rp 65,000
- Rp - TABLET Rp 297 Rp 297

- Rp - TABLET Rp 150 Rp 150


- Rp - VIAL Rp 31,345 Rp 31,345
21 Rp 1,890 TABLET Rp 90 Rp 90
3 Rp 65,886 BOTOL Rp 21,962 Rp 21,962
3 Rp 21,606 BOTOL Rp 7,202 Rp 7,202
3 Rp 960 TABLET Rp 320 Rp 320
90 Rp 5,670 TABLET Rp 63 Rp 63
- Rp - TABLET Rp 62 Rp 62
111 Rp 5,217 TABLET Rp 47 Rp 47
- Rp - TABLET Rp 46,088 Rp 46,088
- Rp - KAPSUL Rp 1,048 Rp 1,048
- Rp - TUBE Rp 1,881 Rp 1,881
- Rp - BOTOL 5 ML Rp 4,700 Rp 4,700
60 Rp 1,800 TABLET Rp 30 Rp 30
18 Rp 16,740 TABLET Rp 930 Rp 930
6 Rp 906 TABLET Rp 151 Rp 151
- Rp - BOTOL Rp 2,824 Rp 2,824
36 Rp 73,260 TABLET Rp 2,035 Rp 2,035
27 Rp 153,900 KOTAK Rp 5,700 Rp 5,700
- Rp - TABLET Rp 42,000 Rp 42,000
- Rp - TABLET Rp 1,768 Rp 1,768
99 Rp 74,052 KAPSUL Rp 748 Rp 748
3 Rp 276,057 AMPUL Rp 92,019 Rp 92,019
9 Rp 810,000 PEN Rp 90,000 Rp 90,000
- Rp - PEN Rp 83,950 Rp 83,950
3 Rp 11,850 TABLET Rp 3,950 Rp 3,950
12 Rp 6,600 TABLET Rp 550 Rp 550
3 Rp 57,618 FLS Rp 19,206 Rp 19,206
6 Rp 5,034 TABLET Rp 839 Rp 839
3 Rp 3,000 AMPUL Rp 1,000 Rp 1,000

- Rp - TABLET Rp 11,828 Rp 11,828


3 Rp 893 TABLET Rp 298 Rp 298
- Rp - TABLET Rp 5,500 Rp 5,500
BOTOL
- Rp - 500 ML Rp 34,000 Rp 34,000
156 Rp 309,504 TABLET Rp 1,984 Rp 1,984
- Rp - TABLET Rp 450 Rp 450
30 Rp 12,000 TABLET Rp 400 Rp 400
- Rp - VIAL Rp 5,749 Rp 5,749
- Rp - AMPUL Rp 27,499 Rp 27,499
- Rp - TABLET Rp 385 Rp 385
108 Rp 10,800 TABLET Rp 100 Rp 100
9 Rp 2,673 TABLET Rp 297 Rp 297
6 Rp 1,560 TABLET Rp 260 Rp 260
- Rp - VIAL Rp 22,000 Rp 22,000
57 Rp 11,058 TABLET Rp 194 Rp 194
18 Rp 22,248 TABLET Rp 1,236 Rp 1,236
6 Rp 540 TABLET Rp 90 Rp 90
- Rp - SUPP Rp 160 Rp 160
27 Rp 3,591 TABLET Rp 133 Rp 133
3 Rp 24,330 TABLET Rp 8,110 Rp 8,110
- Rp - BOTOL Rp 1,326 Rp 1,326
- Rp - TUBE Rp 3,942 Rp 3,942
- Rp - SACHET Rp 2,805 Rp 2,805
- Rp - TABLET Rp 35,000 Rp 35,000
6 Rp 30,000 TABLET Rp 5,000 Rp 5,000
- Rp - TABLET Rp 4,303 Rp 4,303
- Rp - TUBE Rp 52,800 Rp 52,800
BOTOL
21 Rp 150,150 100 ML Rp 7,150 Rp 7,150
BOTOL
12 Rp 158,400 500 ML Rp 13,200 Rp 13,200
- Rp - AMPUL Rp 68,695 Rp 68,695
90 Rp 90,000 TABLET Rp 1,000 Rp 1,000
- Rp - TABLET Rp 123 Rp 123
- Rp - BOTOL Rp 30,000 Rp 30,000
500 ML
- Rp - TABLET Rp 525 Rp 525
- Rp - TABLET Rp 6,116 Rp 6,116
54 Rp 9,504 TABLET Rp 176 Rp 176
- Rp - AMPUL Rp 23,649 Rp 23,649
- Rp - TABLET Rp 915 Rp 915
- Rp - TABLET Rp 22,000 Rp 22,000
- Rp - TABLET Rp 1,560 Rp 1,560
81 Rp 153,900 TABLET Rp 1,900 Rp 1,900
3 Rp 18,900 AMPUL Rp 6,300 Rp 6,300
- Rp - PEN Rp 127,426 Rp 127,426
18 Rp 1,566,000 PEN Rp 87,000 Rp 87,000
- Rp - TABLET Rp 317,018 Rp 317,018

- Rp - PAKET Rp 214,985 Rp 214,985

- Rp - PAKET Rp 359,985 Rp 359,985

- Rp - PAKET Rp 1,199,985 Rp 1,199,985


- Rp - BOTOL Rp 5,000 Rp 5,000
21 Rp 25,179 TABLET Rp 1,199 Rp 1,199
75 Rp 12,000 KAPSUL Rp 160 Rp 160
15 Rp 148,470 AMPUL Rp 9,898 Rp 9,898
21 Rp 24,507 TABLET Rp 1,167 Rp 1,167
24 Rp 7,176 TABLET Rp 299 Rp 299
- Rp - TABLET Rp 8,000 Rp 8,000
9 Rp 162,000 BOTOL Rp 18,000 Rp 18,000
- Rp - BOTOL Rp 2,700
6 Rp 75,000 SUPP Rp 12,500 Rp 2,700
6 Rp 162,000 SUPP Rp 27,000 Rp 12,500
195 Rp 10,920 TABLET Rp 56 Rp 56
90 Rp 321,750 TABLET Rp 3,575 Rp 3,575
- Rp - TABLET Rp 222 Rp 222
- Rp - TABLET Rp 68 Rp 68
- Rp - VIAL Rp 28,000 Rp 28,000

30 Rp 50,820 TABLET Rp 1,694 Rp 1,694


108 Rp 26,460 TABLET Rp 245 Rp 245
24 Rp 2,880 TABLET Rp 120 Rp 120
15 Rp 20,850 AMPUL Rp 1,390 Rp 1,390
- Rp - BOTOL Rp 48,400 Rp 48,400
- Rp - TABLET Rp 7,200 Rp 7,200
- Rp - TABLET Rp 897 Rp 897
24 Rp 171,600 TABLET Rp 7,150 Rp 7,150
6 Rp 1,722 TABLET Rp 287 Rp 287
45 Rp 2,970 TABLET Rp 66 Rp 66
33 Rp 3,729 TABLET Rp 113 Rp 113
- Rp - ZAK Rp 1,025 Rp 1,025
- Rp - BOTOL Rp 43,308 Rp 43,308
- Rp - BOTOL Rp 21,079 Rp 21,079
- Rp - BOTOL Rp 77,000 Rp 77,000
- Rp - BOTOL 5 ML Rp 48,091 Rp 48,091
- Rp - BOTOL Rp 31,804 Rp 31,804
36 Rp 18,360 KAPSUL Rp 510 Rp 510
- Rp - BOTOL Rp 4,896 Rp 4,896
24 Rp 14,160 KAPSUL Rp 590 Rp 590
- Rp - BOTOL Rp 5,330 Rp 5,330
51 Rp 126,990 TABLET Rp 2,490 Rp 2,490
6 Rp 33,000 VIAL Rp 5,500 Rp 5,500
6 Rp 26,898 VIAL Rp 4,483 Rp 8,420
- Rp - BUAH Rp 133,998 Rp 133,998
3 Rp 5,880 TABLET Rp 1,960 Rp 1,960
- Rp - BOTOL Rp 6,500 Rp 6,500
- Rp - TABLET Rp 143 Rp 143
- Rp - TABLET Rp 1,900,000 Rp 1,900,000
15 Rp 15,000 TABLET Rp 1,000 Rp 1,000
75 Rp 15,375 TABLET Rp 205 Rp 205
- Rp - BOTOL Rp 12,500 Rp 12,500
30 Rp 8,430 KAPSUL Rp 281 Rp 281
- Rp - TABLET Rp 105,000 Rp 105,000
- Rp - TUBE Rp 16,748 Rp 16,748
- Rp - TUBE Rp 11,525 Rp 11,525
- Rp - TABLET Rp 9,916 Rp 9,916
- Rp - TABLET Rp 368 Rp 368
- Rp - TUBE Rp 25,000 Rp 25,000
102 Rp 6,426 TABLET Rp 63 Rp 63
- Rp - TABLET Rp 2,797 Rp 2,797

- Rp - TABLET Rp 6,800 Rp 6,800


- Rp - TABLET Rp 3,045 Rp 3,045
- Rp - TABLET Rp 8,424 Rp 8,424

- Rp - TABLET Rp 550 Rp 550


- Rp - AMPUL Rp 11,960 Rp 11,960
- Rp - TABLET Rp 832 Rp 832
6 Rp 59,898 TABLET Rp 9,983 Rp 9,983
- Rp - TABLET Rp 2,033 Rp 2,033
18 Rp 1,926 TABLET Rp 107 Rp 107
- Rp - VIAL Rp 59,288 Rp 59,288
- Rp - VIAL Rp 968,209 Rp 968,209
- Rp - TABLET Rp 2,268 Rp 2,268

- Rp - VIAL Rp 20,900 Rp 20,900

- Rp - AMPUL Rp 39,930 Rp 39,930


15 Rp 18,000 TABLET Rp 1,200 Rp 1,200
- Rp - TABLET Rp 2,833 Rp 2,833
- Rp - TABLET Rp 21,500 Rp 21,500
3 Rp 131,430 VIAL Rp 43,810 Rp 43,810
75 Rp 8,625 TABLET Rp 115 Rp 115
- Rp - TABLET Rp 222 Rp 222
- Rp - TABLET Rp 222 Rp 222
69 Rp 8,487 TABLET Rp 123 Rp 123
- Rp - AMPUL Rp 18,700 Rp 18,700
12 Rp 25,200 TABLET Rp 2,100 Rp 2,100
- Rp - BOTOL Rp 6,216 Rp 6,216
- Rp - KOLF Rp 11,137 Rp 11,137
- Rp - BOTOL Rp 177,216 Rp 177,216
3 Rp 124,800 TUBE Rp 41,600 Rp 41,600
- Rp - TABLET Rp 1,768 Rp 1,768

- Rp - TABLET Rp 3,848 Rp 3,848


- Rp - BOTOL Rp 6,290 Rp 6,290
- Rp - TABLET Rp 22,503 Rp 22,503
- Rp - TABLET Rp 3,986 Rp 3,986
18 Rp 3,996 TABLET Rp 222 Rp 222
9 Rp 71,100 VIAL Rp 7,900 Rp 7,900
- Rp - BOTOL Rp 1,590 Rp 1,590
- Rp - KAPSUL Rp 9,167 Rp 9,167
- Rp - TABLET Rp 6,888 Rp 6,888
- Rp - PCS Rp 221,193 Rp 221,193
- Rp - BOTOL Rp 15,800 Rp 15,800
105 Rp 12,600 TABLET Rp 120 Rp 120
57 Rp 93,936 TABLET Rp 1,648 Rp 1,648
- Rp - BOTOL Rp 8,798 Rp 8,798
- Rp - AMPUL Rp 23,976 Rp 23,976
- Rp - TABLET Rp 250 Rp 250
- Rp - TABLET Rp 89 Rp 89
- Rp - TABLET Rp 385 Rp 385
30 Rp 3,660 TABLET Rp 122 Rp 122
18 Rp 8,910 KAPSUL Rp 495 Rp 495
108 Rp 11,880 TABLET Rp 110 Rp 110
- Rp - VIAL Rp 7,170 Rp 7,170
- Rp - BOTOL Rp 16,081 Rp 16,081
- Rp - BOTOL Rp 55,124 Rp 55,124
- Rp - AMPUL Rp 3,696 Rp 3,696
- Rp - BOTOL Rp 2,089 Rp 2,089
- Rp - TABLET Rp 45 Rp 45
- Rp - TABLET Rp - Rp -
- Rp - TABLET Rp 253 Rp 253
- Rp - TABLET Rp 3,292 Rp 3,292
- Rp - TABLET Rp 776 Rp 776
- Rp - TABLET Rp 5,349 Rp 5,349
- Rp - TABLET Rp 146 Rp 146
- Rp - TABLET Rp 1,121 Rp 1,121
6 Rp 2,862 TABLET Rp 477 Rp 477
- Rp - TABLET Rp 1,922 Rp 1,922
- Rp - AMPUL Rp 923 Rp 923
- Rp - BOTOL Rp 121 Rp 121
- Rp - VIAL Rp 11,398 Rp 11,398
9 Rp 26,991 TABLET Rp 2,999 Rp 2,999

- Rp - SUPPOSITORIA Rp 5,084 Rp 5,084

- Rp - AMPUL Rp 6,486 Rp 6,486


54 Rp 34,074 TABLET Rp 631 Rp 631
66 Rp 32,670 TABLET Rp 495 Rp 495
- Rp - BOTOL Rp 26,950 Rp 26,950
- Rp - TABLET Rp 220 Rp 220
- Rp - TABLET Rp 760 Rp 760
- Rp - CAPSUL Rp 387 Rp 387
- Rp - BOTOL Rp 149,850 Rp 149,850
- Rp - TABLET Rp 93 Rp 93
- Rp - TABLET Rp 143 Rp 143
- Rp - TABLET Rp 183 Rp 183
- Rp - TABLET Rp 1,485 Rp 1,485
15 Rp 65,340 TABLET Rp 4,356 Rp 4,356
24 Rp 115,032 BOX Rp 4,793 Rp 4,793
- Rp - TUBE Rp 8,296 Rp 8,296
- Rp - CAPSUL Rp 8,787 Rp 8,787
- Rp - BOTOL Rp 3,800 Rp 3,800
- Rp - BOTOL Rp 3,223 Rp 3,223
- Rp - VIAL Rp 13,903 Rp 13,903
- Rp - TABLET Rp 270 Rp 270
- Rp - TUBE Rp 2,000 Rp 2,000

- Rp - SUPPOSITORIA Rp 2,016 Rp 2,016

- Rp - VIAL Rp 846 Rp 846


123 Rp 110,700 TABLET Rp 900 Rp 900
- Rp - Rp 2,000 Rp 2,000
9 Rp 981 TABLET Rp 109 Rp 109
- Rp - AMPUL Rp 45,900 Rp 45,900
- Rp - BOTOL Rp 55,000 Rp 55,000
- Rp - BOTOL Rp 227 Rp 227
30 Rp 15,150 Rp 505 Rp 505
- Rp - AMPUL Rp 6,600 Rp 6,600
- Rp - kolf Rp 6,749 Rp 6,749
- Rp - PCS Rp 20,812 Rp 20,812
267 Rp 60,876 TABLET Rp 228 Rp 228
- Rp - TABLET Rp 715 Rp 715
- Rp - TABLET Rp 99 Rp 99
- Rp - AMPUL Rp 7,050 Rp 7,050
- Rp - PCS Rp 6,100 Rp 6,100
- Rp - TABLET Rp 3,050 Rp 3,050
- Rp - TABLET Rp 40 Rp 40
- Rp - TABLET Rp 87 Rp 87
- Rp - TABLET Rp 847 Rp 847
9 Rp 95,157 PCS Rp 10,573 Rp 10,573
- Rp - TABLET Rp 710 Rp 710
27 Rp 29,700 TABLET Rp 1,100 Rp 1,100
- Rp - AMPUL Rp 79,087 Rp 79,087
- Rp - TABLET Rp 1,244 Rp 1,244
- Rp - AMPUL Rp 27,023 Rp 27,023
- Rp - BOTOL Rp 4,445 Rp 4,445
- Rp - BOX Rp 126,858 Rp 126,858
- Rp - TABLET Rp 192 Rp 192
- Rp - BOX Rp 40,000 Rp 40,000
- Rp - TABLET Rp 989 Rp 989
- Rp - VIAL Rp 37,345 Rp 37,345
- Rp - TABLET Rp 2,590 Rp 2,590
Rp - Rp 12,737,117

Rp -
Rp -
Apotik Rajal 0.5
Jumlah harga
(Rp) Jumlah harga Jumlah Jumlah Jumlah
I II III IV
(Rp) harga (Rp) harga (Rp) harga (Rp)
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0 0
Apotik Ranap 0.25
Total pemakain 1 Jumlah harga (Rp)
hari Jumlah Jumlah
I II III
harga (Rp) harga (Rp)
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0

0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0

0 0 Rp - 0 0 0 0 0

0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0

0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0

0 0 Rp - 0 0 0 0 0

0 0 Rp - 0 0 0 0 0

0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0

0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0

0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0

0 0 Rp - 0 0 0 0 0

0 0 Rp - 0 0 0 0 0

0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0

0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0

0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0

0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0

0 0 Rp - 0 0 0 0 0

0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0

0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
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0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
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0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0

0 0 Rp - 0 0 0 0 0

0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0

0 0 Rp - 0 0 0 0 0

0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
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0 0 Rp - 0 0 0 0 0
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0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 0 Rp - 0 0 0 0 0
0 Rp -

0 Rp -
0 Rp -
STOCK OPNAME BARANG PERSEDIAAN O
Per 31 April 2023

Distribusi gudang ke

Ranap 0.25
Total pemakain 1 Jumlah harga (Rp)
Jumlah Jumlah hari
IV I
harga (Rp) harga (Rp)
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0

0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0

0 0 0 0 0 Rp - 0

0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0

0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
0 0 0 0 0 Rp - 0
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0 0 0 0 0 Rp - 0

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0 Rp -

0 Rp -
0 Rp -
NAME BARANG PERSEDIAAN OBAT OBATAN
Per 31 April 2023

Apotik Paru 0.15


Total pemakain 1
Jumlah Jumlah Jumlah Jumlah hari
II III IV
harga (Rp) harga (Rp) harga (Rp) harga (Rp)
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0

0
0
Apotek PRB 0.1
Jumlah harga (Rp)
I Jumlah II Jumlah III Jumlah IV
harga (Rp) harga (Rp) harga (Rp)
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
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Rp - 0 0 0 0 0 0 0

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Rp - 0 0 0 0 0 0 0

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Rp - 0 0 0 0 0 0 0

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Rp - 0 0 0 0 0 0 0

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Rp - 0 0 0 0 0 0 0
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Rp - 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
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Rp - 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
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Rp - 0 0 0 0 0 0 0
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Rp - 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0
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Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0

Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
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Rp - 0 0 0 0 0 0 0
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Rp - 0 0 0 0 0 0 0
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Rp - 0 0 0 0 0 0 0
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Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
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Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
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Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp - 0 0 0 0 0 0 0
Rp -

Rp -
Rp -
Jumlah harga (Rp) Total Jumlah harga (Rp)
pemakain 1 Pengeluaran
Total
Jumlah hari
harga (Rp)
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -

0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -

0 0 0 Rp - - Rp -

0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -

0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -

0 0 0 Rp - - Rp -

0 0 0 Rp - - Rp -

0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -

0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -

0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -

0 0 0 Rp - - Rp -

0 0 0 Rp - - Rp -

0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -

0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -

0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -

0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -

0 0 0 Rp - - Rp -

0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -

0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -

0 0 0 Rp - - Rp -

0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -

0 0 0 Rp - - Rp -

0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 0 0 Rp - - Rp -
0 Rp -

0 Rp -
0 Rp -
Pemakain depo

Apotik Apotik Apotik


Rajal Jumlah harga (Rp) Ranap Jumlah harga (Rp) Parul
Total Total Total

0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0

0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0

0 Rp - 0 Rp - 0

0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0

0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0

0 Rp - 0 Rp - 0

0 Rp - 0 Rp - 0

0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0

0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0

0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0

0 Rp - 0 Rp - 0

0 Rp - 0 Rp - 0

0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0

0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0

0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0

0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0

0 Rp - 0 Rp - 0

0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0

0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0

0 Rp - 0 Rp - 0

0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0

0 Rp - 0 Rp - 0

0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
0 Rp - 0 Rp - 0
Rp - Rp -

Rp - Rp -
Rp - Rp -
emakain depo

Jumlah harga (Rp) Apotik PRB Jumlah harga (Rp) Gudang Jumlah harga
Total (Rp)

Rp - 0 Rp - - -
Rp - 0 Rp - 9,100 7,088,900
Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - 7 10,581,620
Rp - 0 Rp - 3,100 329,449
Rp - 0 Rp - 7,500 1,125,000
Rp - 0 Rp - 3,500 4,130,000
Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - 32 208,000
Rp - 0 Rp - 240 19,200
Rp - 0 Rp - 12 104,400
Rp - 0 Rp - 300 60,000
Rp - 0 Rp - 10,800 1,598,400
Rp - 0 Rp - 12,500 875,000
Rp - 0 Rp - 450 2,709,450
Rp - 0 Rp - 24 620,160
Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - 400 92,800
Rp - 0 Rp - 2,300 165,600
Rp - 0 Rp - 900 2,740,500
Rp - 0 Rp - 1,080 3,088,800
Rp - 0 Rp - 400 9,211,400
Rp - 0 Rp - 1,200 114,000
Rp - 0 Rp - 12,700 1,346,200
Rp - 0 Rp - 1,529 2,973,905
Rp - 0 Rp - - -
Rp - 0 Rp - 8,760 8,094,240
Rp - 0 Rp - - -
Rp - 0 Rp - 650 230,750
Rp - 0 Rp - 125 481,250
Rp - 0 Rp - - -
Rp - 0 Rp - 450 900,000
Rp - 0 Rp - - -
Rp - 0 Rp - 100 149,000
Rp - 0 Rp - 39 4,017,000
Rp - 0 Rp - 1,140 2,166,000
Rp - 0 Rp - 208 8,923,200
Rp - 0 Rp - - -
Rp - 0 Rp - - -

Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - 20 2,619,980
Rp - 0 Rp - - -
Rp - 0 Rp - 420 5,023,200
Rp - 0 Rp - - -
Rp - 0 Rp - 20 1,320,000
Rp - 0 Rp - 120 1,447,440
Rp - 0 Rp - 19,920 82,409,040
Rp - 0 Rp - 15,750 8,583,750
Rp - 0 Rp - 60 715,200
Rp - 0 Rp - 80 1,600,000
Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - 460 18,630,000
Rp - 0 Rp - 675 31,117,500
Rp - 0 Rp - 260 10,478,000
Rp - 0 Rp - 350 8,662,500
Rp - 0 Rp - 41 541,446
Rp - 0 Rp - 200 7,640,000
Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - 170 10,285,000
Rp - 0 Rp - 150 1,856,250
Rp - 0 Rp - 350 12,600,000
Rp - 0 Rp - 50 1,973,125
Rp - 0 Rp - 1,950 10,764,000
Rp - 0 Rp - 175 938,525
Rp - 0 Rp - 150 195,000
Rp - 0 Rp - 600 780,000
Rp - 0 Rp - - -
Rp - 0 Rp - 400 1,820,000
Rp - 0 Rp - - -
Rp - 0 Rp - 3,600 4,759,200
Rp - 0 Rp - 400 27,200
Rp - 0 Rp - 100 3,721,300
Rp - 0 Rp - 120 468,000
Rp - 0 Rp - - -

Rp - 0 Rp - - -

Rp - 0 Rp - - -
Rp - 0 Rp - 20 34,700
Rp - 0 Rp - 65 1,144,765
Rp - 0 Rp - 140 2,305,725
Rp - 0 Rp - - -
Rp - 0 Rp - 15 3,750
Rp - 0 Rp - 200 19,400
Rp - 0 Rp - - -
Rp - 0 Rp - 270 268,650
Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - 90 184,050
Rp - 0 Rp - 900 242,100
Rp - 0 Rp - - -
Rp - 0 Rp - 1,800 1,314,000
Rp - 0 Rp - - -
Rp - 0 Rp - 50 24,700

Rp - 0 Rp - 500 714,500
Rp - 0 Rp - 11 1,815,000
Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - 200 121,000
Rp - 0 Rp - 255 10,965,000
Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - 80 1,800,000
Rp - 0 Rp - 400 1,505,600
Rp - 0 Rp - - -
Rp - 0 Rp - 950 992,750
Rp - 0 Rp - 1,080 1,152,360
Rp - 0 Rp - 400 105,600
Rp - 0 Rp - 4,000 1,472,000
Rp - 0 Rp - - -
Rp - 0 Rp - 80 456,400
Rp - 0 Rp - - -
Rp - 0 Rp - 4,100 902,000
Rp - 0 Rp - 5,900 6,342,500
Rp - 0 Rp - - -
Rp - 0 Rp - 108 1,188,000
Rp - 0 Rp - 40 181,395
Rp - 0 Rp - 140 1,540,000
Rp - 0 Rp - - -
Rp - 0 Rp - 400 24,000
Rp - 0 Rp - - -
Rp - 0 Rp - 90 23,400,000
Rp - 0 Rp - 2,000 300,000
Rp - 0 Rp - - -
Rp - 0 Rp - 97 16,636,567
Rp - 0 Rp - 50 600,000
Rp - 0 Rp - 1,100 1,320,000
Rp - 0 Rp - - -
Rp - 0 Rp - 4,900 2,028,600
Rp - 0 Rp - - -
Rp - 0 Rp - - -

Rp - 0 Rp - - -

Rp - 0 Rp - - -

Rp - 0 Rp - 64 2,007,872
Rp - 0 Rp - 2,280 9,120,000
Rp - 0 Rp - 460 20,237,700
Rp - 0 Rp - 30 1,950,000
Rp - 0 Rp - - -

Rp - 0 Rp - - -
Rp - 0 Rp - 150 4,701,750
Rp - 0 Rp - 2,300 207,000
Rp - 0 Rp - 100 2,196,200
Rp - 0 Rp - 300 2,160,600
Rp - 0 Rp - 1,400 448,000
Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - 2,900 136,300
Rp - 0 Rp - 7 322,616
Rp - 0 Rp - - -
Rp - 0 Rp - 38 71,478
Rp - 0 Rp - - -
Rp - 0 Rp - 1,000 30,000
Rp - 0 Rp - 100 93,000
Rp - 0 Rp - 700 105,700
Rp - 0 Rp - 132 372,768
Rp - 0 Rp - 4,800 9,768,000
Rp - 0 Rp - - -
Rp - 0 Rp - 144 6,048,000
Rp - 0 Rp - 180 318,240
Rp - 0 Rp - 4,350 3,253,800
Rp - 0 Rp - 77 7,085,463
Rp - 0 Rp - 610 54,900,000
Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - 1,150 632,500
Rp - 0 Rp - 360 6,914,160
Rp - 0 Rp - 1,300 1,090,700
Rp - 0 Rp - 20 20,000

Rp - 0 Rp - - -
Rp - 0 Rp - 1,800 535,846
Rp - 0 Rp - - -
Rp - 0 Rp - 20 680,000
Rp - 0 Rp - 800 1,587,200
Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - 10 57,490
Rp - 0 Rp - 100 2,749,890
Rp - 0 Rp - - -
Rp - 0 Rp - 44,800 4,480,000
Rp - 0 Rp - 1,900 564,300
Rp - 0 Rp - 25 6,500
Rp - 0 Rp - 250 5,500,000
Rp - 0 Rp - 11,000 2,134,000
Rp - 0 Rp - - -
Rp - 0 Rp - 2,400 216,000
Rp - 0 Rp - - -
Rp - 0 Rp - 3,100 412,300
Rp - 0 Rp - 40 324,400
Rp - 0 Rp - - -
Rp - 0 Rp - 24 94,608
Rp - 0 Rp - - -
Rp - 0 Rp - 36 1,260,000
Rp - 0 Rp - 630 3,150,000
Rp - 0 Rp - - -
Rp - 0 Rp - 12 633,600
Rp - 0 Rp - 600 4,290,000
Rp - 0 Rp - 1,760 23,232,000
Rp - 0 Rp - - -
Rp - 0 Rp - 4,300 4,300,000
Rp - 0 Rp - - -
Rp - 0 Rp - 40 1,200,000
Rp - 0 Rp - - -
Rp - 0 Rp - 300 1,834,800
Rp - 0 Rp - 22,200 3,907,200
Rp - 0 Rp - 170 4,020,330
Rp - 0 Rp - - -
Rp - 0 Rp - 108 2,376,000
Rp - 0 Rp - - -
Rp - 0 Rp - 300 570,000
Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - 1,200 104,400,000
Rp - 0 Rp - - -

Rp - 0 Rp - - -

Rp - 0 Rp - 64 23,039,040

Rp - 0 Rp - - -
Rp - 0 Rp - 235 1,175,000
Rp - 0 Rp - 3,900 4,676,100
Rp - 0 Rp - 2,800 448,000
Rp - 0 Rp - 2,660 26,328,680
Rp - 0 Rp - 8,085 9,435,195
Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - 1,000 18,000,000
Rp - 0 Rp - 300 -
Rp - 0 Rp - 756 2,041,200
Rp - 0 Rp - 432 5,400,000
Rp - 0 Rp - 200 11,200
Rp - 0 Rp - 10,230 36,572,250
Rp - 0 Rp - - -
Rp - 0 Rp - 7,800 530,400
Rp - 0 Rp - - -

Rp - 0 Rp - 100 169,400
Rp - 0 Rp - 13,100 3,209,500
Rp - 0 Rp - 4,500 540,000
Rp - 0 Rp - 3,225 4,482,750
Rp - 0 Rp - 10 484,000
Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - 460 3,289,000
Rp - 0 Rp - 2,800 803,600
Rp - 0 Rp - - -
Rp - 0 Rp - 2,800 316,400
Rp - 0 Rp - - -
Rp - 0 Rp - 192 8,315,136
Rp - 0 Rp - 28 590,205
Rp - 0 Rp - 48 3,696,000
Rp - 0 Rp - - -
Rp - 0 Rp - 270 8,587,080
Rp - 0 Rp - 8,700 4,437,000
Rp - 0 Rp - 33 161,568
Rp - 0 Rp - 4,900 2,891,000
Rp - 0 Rp - 250 1,332,500
Rp - 0 Rp - 7,900 19,671,000
Rp - 0 Rp - 770 4,235,000
Rp - 0 Rp - 1,650 13,893,000
Rp - 0 Rp - 200 26,799,600
Rp - 0 Rp - 820 1,607,200
Rp - 0 Rp - 550 3,575,000
Rp - 0 Rp - 11,600 1,658,800
Rp - 0 Rp - 23 43,700,000
Rp - 0 Rp - 2,100 2,100,000
Rp - 0 Rp - 25,100 5,145,500
Rp - 0 Rp - 48 600,000
Rp - 0 Rp - 3,100 871,100
Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - 5 49,580
Rp - 0 Rp - - -
Rp - 0 Rp - 47 1,175,000
Rp - 0 Rp - 4,400 277,200
Rp - 0 Rp - 330 923,076

Rp - 0 Rp - 300 2,040,000
Rp - 0 Rp - - -
Rp - 0 Rp - 150 1,263,600

Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - 1,590 15,872,970
Rp - 0 Rp - 430 874,333
Rp - 0 Rp - 1,200 128,400
Rp - 0 Rp - 8 474,304
Rp - 0 Rp - 20 19,364,176
Rp - 0 Rp - 2,850 6,463,800

Rp - 0 Rp - 213 4,451,700

Rp - 0 Rp - - -
Rp - 0 Rp - 5,730 6,876,000
Rp - 0 Rp - - -
Rp - 0 Rp - 200 4,300,000
Rp - 0 Rp - 30 1,314,300
Rp - 0 Rp - 19,600 2,254,000
Rp - 0 Rp - - -
Rp - 0 Rp - - -
Rp - 0 Rp - 4,000 492,000
Rp - 0 Rp - 200 3,740,000
Rp - 0 Rp - 4,200 8,820,000
Rp - 0 Rp - - -
Rp - 0 Rp - 12 133,644
Rp - 0 Rp - - -
Rp - 0 Rp - 650 27,040,000
Rp - 0 Rp - 150 265,200

Rp - 0 Rp - 720 2,770,560
Rp - 0 Rp - 30 188,700
Rp - 0 Rp - 60 1,350,180
Rp - 0 Rp - 960 3,826,560
Rp - 0 Rp - 3,900 865,800
Rp - 0 Rp - 1,950 15,405,000
Rp - 0 Rp - 240 381,600
Rp - 0 Rp - - -
Rp - 0 Rp - 1,540 10,607,520
Rp - 0 Rp - 30 6,635,790
Rp - 0 Rp - - -
Rp - 0 Rp - 3,000 360,000
Rp - 0 Rp - 8,300 13,678,400
Rp - 0 Rp - 20 175,960
Rp - 0 Rp - 20 479,520
Rp - 0 Rp - 3,000 750,000
Rp - 0 Rp - 1,100 97,900
Rp - 0 Rp - 200 77,000
Rp - 0 Rp - 8,000 976,000
Rp - 0 Rp - 13,710 6,786,450
Rp - 0 Rp - 2,900 319,000
Rp - 0 Rp - 120 860,400
Rp - 0 Rp - 300 4,824,300
Rp - 0 Rp - 5 275,620
Rp - 0 Rp - 60 221,760
Rp - 0 Rp - 550 1,148,950
Rp - 0 Rp - 14,400 648,000
Rp - 0 Rp - 3,700 -
Rp - 0 Rp - 600 151,800
Rp - 0 Rp - 120 395,040
Rp - 0 Rp - - -
Rp - 0 Rp - 1,300 6,953,700
Rp - 0 Rp - - -
Rp - 0 Rp - 450 504,450
Rp - 0 Rp - 200 95,400
Rp - 0 Rp - - -
Rp - 0 Rp - 700 646,100
Rp - 0 Rp - 3,300 399,300
Rp - 0 Rp - 310 3,533,380
Rp - 0 Rp - 3,270 9,806,730

Rp - 0 Rp - - -

Rp - 0 Rp - 70 454,020
Rp - 0 Rp - - -
Rp - 0 Rp - 5,650 2,796,750
Rp - 0 Rp - 120 3,234,000
Rp - 0 Rp - 2,400 528,000
Rp - 0 Rp - - -
Rp - 0 Rp - 3,780 1,462,860
Rp - 0 Rp - 10 1,498,500
Rp - 0 Rp - 1,500 139,500
Rp - 0 Rp - 10,000 1,430,000
Rp - 0 Rp - 11,000 2,013,000
Rp - 0 Rp - 300 445,500
Rp - 0 Rp - 300 1,306,800
Rp - 0 Rp - 1,500 7,189,500
Rp - 0 Rp - 1,000 8,296,000
Rp - 0 Rp - 120 1,054,440
Rp - 0 Rp - 20 76,000
Rp - 0 Rp - 102 328,746
Rp - 0 Rp - 90 1,251,270
Rp - 0 Rp - - -
Rp - 0 Rp - 84 168,000

Rp - 0 Rp - 720 1,451,520

Rp - 0 Rp - 140 118,440
Rp - 0 Rp - 9,000 8,100,000
Rp - 0 Rp - - -
Rp - 0 Rp - 1,400 152,600
Rp - 0 Rp - 135 6,196,500
Rp - 0 Rp - 10 550,000
Rp - 0 Rp - 400 90,800
Rp - 0 Rp - 3,000 1,515,000
Rp - 0 Rp - 180 1,188,000
Rp - 0 Rp - 156 1,052,844
Rp - 0 Rp - 25 520,300
Rp - 0 Rp - 20,000 4,560,000
Rp - 0 Rp - 8,200 5,863,000
Rp - 0 Rp - 100 9,900
Rp - 0 Rp - 50 352,500
Rp - 0 Rp - 24 146,400
Rp - 0 Rp - - -
Rp - 0 Rp - 7,100 284,000
Rp - 0 Rp - 1,700 147,900
Rp - 0 Rp - 2,100 1,778,700
Rp - 0 Rp - - -
Rp - 0 Rp - 60 42,600
Rp - 0 Rp - 8,200 9,020,000
Rp - 0 Rp - 100 7,908,700
Rp - 0 Rp - 1,000 1,244,000
Rp - 0 Rp - 5 135,115
Rp - 0 Rp - 318 1,413,510
Rp - 0 Rp - - -
Rp - 0 Rp - 3,200 614,400
Rp - 0 Rp - 7 280,000
Rp - 0 Rp - 100 98,900
Rp - 0 Rp - 8 298,760
Rp - 0 Rp - - -
Rp - Rp - 644,048

Rp - Rp -
Rp - Rp -
Sisa Stok

Apotik Rajal Jumlah harga (Rp) Apotik Ranap Jumlah harga (Rp) Apotik Paru

- Rp - - Rp - -
924 Rp - 462 Rp - 186
- Rp - - Rp - -
3 Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
96 Rp - 48 Rp - 18
135 Rp - 69 Rp - 27
279 Rp - 141 Rp - 57
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
15 Rp - 9 Rp - 3
525 Rp - 264 Rp - 105
540 Rp - 270 Rp - 108
18 Rp - 9 Rp - 3
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
90 Rp - 45 Rp - 18
84 Rp - 42 Rp - 18
6 Rp - 3 Rp - -
36 Rp - 18 Rp - 6
6 Rp - 3 Rp - -
15 Rp - 9 Rp - 3
300 Rp - 150 Rp - 60
15 Rp - 6 Rp - 3
- Rp - - Rp - -
147 Rp - 75 Rp - 30
- Rp - - Rp - -
99 Rp - 48 Rp - 21
- Rp - - Rp - -
- Rp - - Rp - -
285 Rp - 141 Rp - 57
- Rp - - Rp - -
- Rp - - Rp - -
6 Rp - 3 Rp - -
57 Rp - 30 Rp - 12
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -

- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
162 Rp - 81 Rp - 33
- Rp - - Rp - -
- Rp - - Rp - -
6 Rp - 3 Rp - -
- Rp - - Rp - -
336 Rp - 168 Rp - 66
309 Rp - 153 Rp - 63
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
3 Rp - - Rp - -
9 Rp - 6 Rp - 3
3 Rp - - Rp - -
3 Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
3 Rp - 3 Rp - -
- Rp - - Rp - -
18 Rp - 9 Rp - 3
- Rp - - Rp - -
6 Rp - 3 Rp - -
- Rp - - Rp - -
36 Rp - 18 Rp - 6
21 Rp - 9 Rp - 3
- Rp - - Rp - -
27 Rp - 12 Rp - 6
- Rp - - Rp - -
171 Rp - 84 Rp - 33
210 Rp - 105 Rp - 42
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -

- Rp - - Rp - -

15 Rp - 9 Rp - 3
3 Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
3 Rp - - Rp - -
- Rp - - Rp - -
99 Rp - 51 Rp - 21
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
3 Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -

- Rp - - Rp - -
- Rp - - Rp - -
12 Rp - 6 Rp - 3
- Rp - - Rp - -
- Rp - - Rp - -
6 Rp - 3 Rp - -
- Rp - - Rp - -
9 Rp - 6 Rp - 3
- Rp - - Rp - -
3 Rp - 3 Rp - -
39 Rp - 21 Rp - 9
171 Rp - 84 Rp - 33
294 Rp - 147 Rp - 60
162 Rp - 81 Rp - 33
36 Rp - 18 Rp - 6
66 Rp - 33 Rp - 12
3 Rp - 3 Rp - -
72 Rp - 36 Rp - 15
- Rp - - Rp - -
135 Rp - 69 Rp - 27
144 Rp - 72 Rp - 30
39 Rp - 21 Rp - 9
3 Rp - - Rp - -
- Rp - - Rp - -
3 Rp - 3 Rp - -
- Rp - - Rp - -
30 Rp - 15 Rp - 6
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
45 Rp - 24 Rp - 9
- Rp - - Rp - -
234 Rp - 117 Rp - 48
- Rp - - Rp - -
- Rp - - Rp - -

- Rp - - Rp - -

- Rp - - Rp - -

- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -

- Rp - - Rp - -
3 Rp - - Rp - -
69 Rp - 36 Rp - 15
9 Rp - 3 Rp - 3
12 Rp - 6 Rp - 3
9 Rp - 6 Rp - 3
294 Rp - 147 Rp - 60
- Rp - - Rp - -
369 Rp - 186 Rp - 75
- Rp - - Rp - -
- Rp - - Rp - -
3 Rp - - Rp - -
- Rp - - Rp - -
201 Rp - 99 Rp - 39
54 Rp - 27 Rp - 12
21 Rp - 9 Rp - 3
- Rp - - Rp - -
114 Rp - 57 Rp - 24
93 Rp - 45 Rp - 18
6 Rp - 3 Rp - -
- Rp - - Rp - -
327 Rp - 165 Rp - 66
6 Rp - 3 Rp - -
27 Rp - 12 Rp - 6
- Rp - - Rp - -
6 Rp - 3 Rp - -
39 Rp - 21 Rp - 9
12 Rp - 6 Rp - 3
21 Rp - 9 Rp - 3
6 Rp - 3 Rp - -

- Rp - - Rp - -
9 Rp - 6 Rp - 3
- Rp - - Rp - -
- Rp - - Rp - -
516 Rp - 258 Rp - 102
- Rp - - Rp - -
99 Rp - 51 Rp - 21
6 Rp - 3 Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
360 Rp - 180 Rp - 72
30 Rp - 15 Rp - 6
15 Rp - 9 Rp - 3
- Rp - - Rp - -
186 Rp - 93 Rp - 36
60 Rp - 30 Rp - 12
15 Rp - 9 Rp - 3
- Rp - - Rp - -
90 Rp - 45 Rp - 18
6 Rp - 3 Rp - -
3 Rp - 3 Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
21 Rp - 12 Rp - 3
- Rp - - Rp - -
- Rp - - Rp - -
66 Rp - 33 Rp - 12
36 Rp - 18 Rp - 6
- Rp - - Rp - -
300 Rp - 150 Rp - 60
- Rp - - Rp - -
3 Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
180 Rp - 90 Rp - 36
3 Rp - - Rp - -
- Rp - - Rp - -
3 Rp - - Rp - -
- Rp - - Rp - -
273 Rp - 138 Rp - 54
9 Rp - 3 Rp - 3
- Rp - - Rp - -
57 Rp - 27 Rp - 12
- Rp - - Rp - -

- Rp - - Rp - -

- Rp - - Rp - -

- Rp - - Rp - -
- Rp - - Rp - -
69 Rp - 36 Rp - 15
252 Rp - 126 Rp - 51
48 Rp - 24 Rp - 9
75 Rp - 36 Rp - 15
84 Rp - 42 Rp - 18
- Rp - - Rp - -
24 Rp - 12 Rp - 6
- Rp - - Rp - -
15 Rp - 9 Rp - 3
24 Rp - 12 Rp - 6
645 Rp - 324 Rp - 129
300 Rp - 150 Rp - 60
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -

96 Rp - 48 Rp - 18
354 Rp - 177 Rp - 72
81 Rp - 39 Rp - 15
54 Rp - 27 Rp - 12
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
78 Rp - 39 Rp - 15
18 Rp - 9 Rp - 3
150 Rp - 75 Rp - 30
111 Rp - 54 Rp - 21
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
3 Rp - - Rp - -
3 Rp - - Rp - -
114 Rp - 57 Rp - 24
- Rp - - Rp - -
81 Rp - 39 Rp - 15
- Rp - - Rp - -
171 Rp - 84 Rp - 33
15 Rp - 9 Rp - 3
21 Rp - 9 Rp - 3
3 Rp - - Rp - -
9 Rp - 3 Rp - 3
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
45 Rp - 24 Rp - 9
246 Rp - 123 Rp - 48
3 Rp - - Rp - -
99 Rp - 51 Rp - 21
3 Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
339 Rp - 171 Rp - 69
- Rp - - Rp - -

- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -

- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
24 Rp - 12 Rp - 6
3 Rp - - Rp - -
54 Rp - 27 Rp - 12
- Rp - - Rp - -
- Rp - - Rp - -
3 Rp - 3 Rp - -

3 Rp - 3 Rp - -

- Rp - - Rp - -
45 Rp - 24 Rp - 9
- Rp - - Rp - -
- Rp - - Rp - -
15 Rp - 6 Rp - 3
246 Rp - 123 Rp - 48
- Rp - - Rp - -
- Rp - - Rp - -
225 Rp - 114 Rp - 45
- Rp - - Rp - -
39 Rp - 21 Rp - 9
- Rp - - Rp - -
3 Rp - - Rp - -
- Rp - - Rp - -
9 Rp - 3 Rp - 3
- Rp - - Rp - -

- Rp - - Rp - -
- Rp - - Rp - -
3 Rp - - Rp - -
- Rp - - Rp - -
54 Rp - 27 Rp - 12
27 Rp - 15 Rp - 6
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
3 Rp - - Rp - -
- Rp - - Rp - -
351 Rp - 174 Rp - 69
186 Rp - 93 Rp - 36
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
99 Rp - 51 Rp - 21
66 Rp - 33 Rp - 12
354 Rp - 177 Rp - 72
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
3 Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
15 Rp - 9 Rp - 3
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
3 Rp - - Rp - -
33 Rp - 15 Rp - 6

- Rp - - Rp - -

3 Rp - - Rp - -
180 Rp - 90 Rp - 36
219 Rp - 108 Rp - 45
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
45 Rp - 24 Rp - 9
75 Rp - 39 Rp - 15
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -

- Rp - - Rp - -

- Rp - - Rp - -
408 Rp - 204 Rp - 81
- Rp - - Rp - -
30 Rp - 15 Rp - 6
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
99 Rp - 51 Rp - 21
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
885 Rp - 444 Rp - 177
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
24 Rp - 12 Rp - 6
- Rp - - Rp - -
90 Rp - 45 Rp - 18
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -
- Rp - - Rp - -

Jakarta,31 Maret 2023


Pengurus Barang
Meri Febriani, A.Md
NIP.199302192020122015
sumber
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Jumlah harga (Rp) Apotik PRB

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Rp - 45 BLUD
Rp - - BLUD
Rp - 30 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 84 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 18 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - HIBAH
SUDINKES
Rp - -
BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 48 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 3 BLUD
Rp - - BLUD
Rp - 102 BLUD
Rp - 93 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 3 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 6 BLUD
Rp - - BLUD
Rp - 3
BLUD
Rp - - BLUD
Rp - 12 BLUD
Rp - 6 BLUD
Rp - - BLUD
Rp - 9 BLUD
Rp - - BLUD
Rp - 51 BLUD
Rp - 63 BLUD
Rp - - HIBAH
SUDINKES
Rp - - BLUD
Rp - - BLUD

Rp - -
BLUD
Rp - 6 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - -
BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 30 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - HIBAH
SUDINKES
Rp - - HIBAH
SUDINKES
Rp - - BLUD
Rp - 3 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 3
BLUD
Rp - - BLUD
Rp - 3 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 12 BLUD
Rp - 51 BLUD
Rp - 87 BLUD
Rp - 48 BLUD
Rp - 12 BLUD
Rp - 21 BLUD
Rp - - BLUD
Rp - 21 BLUD
Rp - - BLUD
Rp - 42 BLUD
Rp - 45 BLUD
Rp - 12 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 9 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - -
BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 15 BLUD
Rp - - BLUD
Rp - 72 BLUD
Rp - - BLUD
Rp - - HIBAH
SUDINKES
Rp - - HIBAH
SUDINKES
Rp - - HIBAH
SUDINKES
Rp - -
BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - HIBAH
SUDINKES
Rp - - HIBAH
SUDINKES
Rp - - BLUD
Rp - 21
BLUD
Rp - 3 BLUD
Rp - 3 BLUD
Rp - 3 BLUD
Rp - 90 BLUD
Rp - - BLUD
Rp - 111 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 60
BLUD
Rp - 18 BLUD
Rp - 6 BLUD
Rp - - BLUD
Rp - 36 BLUD
Rp - 27 BLUD
Rp - - BLUD
Rp - - HIBAH
SUDINKES
Rp - 99 BLUD
Rp - 3 BLUD
Rp - 9 BLUD
Rp - - BLUD
Rp - 3 BLUD
Rp - 12 BLUD
Rp - 3 BLUD
Rp - 6 BLUD
Rp - 3
BLUD
Rp - - HIBAH
SUDINKES
Rp - 3 BLUD
Rp - - BLUD
Rp - -
BLUD
Rp - 156 BLUD
Rp - - BLUD
Rp - 30 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 108 BLUD
Rp - 9 BLUD
Rp - 6 BLUD
Rp - - BLUD
Rp - 57 BLUD
Rp - 18 BLUD
Rp - 6 BLUD
Rp - - BLUD
Rp - 27 BLUD
Rp - 3 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 6 BLUD
Rp - - HIBAH
SUDINKES
Rp - - BLUD
Rp - 21 BLUD
Rp - 12 BLUD
Rp - - BLUD
Rp - 90 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - HIBAH
SUDINKES
Rp - 54 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 81 BLUD
Rp - 3 BLUD
Rp - - BLUD
Rp - 18 BLUD
Rp - - HIBAH
SUDINKES
Rp - - HIBAH
SUDINKES
Rp - - HIBAH
SUDINKES
Rp - - HIBAH
SUDINKES
Rp - - BLUD
Rp - 21 BLUD
Rp - 75 BLUD
Rp - 15 BLUD
Rp - 21 BLUD
Rp - 24 BLUD
Rp - - BLUD
Rp - 9 BLUD
Rp - - BLUD
Rp - 6 BLUD
Rp - 6 BLUD
Rp - 195 BLUD
Rp - 90 BLUD
Rp - - HIBAH
SUDINKES
Rp - - BLUD
Rp - - HIBAH
SUDINKES
Rp - 30
BLUD
Rp - 108 BLUD
Rp - 24 BLUD
Rp - 15 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - HIBAH
SUDINKES
Rp - 24 BLUD
Rp - 6 BLUD
Rp - 45 BLUD
Rp - 33 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 36 BLUD
Rp - - BLUD
Rp - 24 BLUD
Rp - - BLUD
Rp - 51 BLUD
Rp - 6 BLUD
Rp - 6 BLUD
Rp - - BLUD
Rp - 3 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 15 BLUD
Rp - 75 BLUD
Rp - - BLUD
Rp - 30 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - HIBAH
SUDINKES
Rp - - BLUD
Rp - - BLUD
Rp - 102 BLUD
Rp - - HIBAH
SUDINKES
Rp - - HIBAH
SUDINKES
Rp - - BLUD
Rp - - HIBAH
SUDINKES
Rp - -
BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 6 BLUD
Rp - - BLUD
Rp - 18 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - -
BLUD
Rp - - HIBAH
SUDINKES
Rp - - HIBAH
SUDINKES
Rp - 15 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 3
BLUD
Rp - 75 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 69 BLUD
Rp - - BLUD
Rp - 12 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 3 BLUD
Rp - - HIBAH
SUDINKES
Rp - - HIBAH
SUDINKES
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 18 BLUD
Rp - 9 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 105 BLUD
Rp - 57 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 30 BLUD
Rp - 18 BLUD
Rp - 108 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 6 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 9 BLUD

Rp - -
BLUD
Rp - - BLUD
Rp - 54 BLUD
Rp - 66 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 15 BLUD
Rp - 24 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD

Rp - -
BLUD
Rp - - BLUD
Rp - 123 BLUD
Rp - - BLUD
Rp - 9 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 30 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 267 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - 9 BLUD
Rp - - BLUD
Rp - 27 BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
Rp - - BLUD
PEMERINTAH PROVINSI DAERAH KHUSUS IBUKOTA JAKARTA
DINAS KESEHATAN
RUMAH SAKIT UMUM DAERAH CILINCING
Jalan Madya Kebantenan 1 Nomor 4, Cilincing. Telepon : 021 - 441 2889
Email : RSUDCilincing@gmail.com
JAKARTA
Kode Pos 14130

SURAT BUKTI BARANG KELUAR (SBBK)

Di berikan kepada
Nama/ NIP : Putri utami, Apt
Bagian : Apotek Rajal
Tanggal :

No Nama Barang Jumlah Harga


1 Acetazolamid 250 mg 0 0
2 Akarbose 100 mg 0 0
3 Akarbose 50 mg 0 0
4 Akilen tetes telinga 0 0
5 Albendazol sirup 0 0
6 ALBUMIN 25% 100 ML 0 0
7 Alprazolam Tablet 0,5 mg 0 0
8 Alupurinol tablet 100 mg. 0 0
9 Ambroxol 30 mg tab 0 0
10 Ambroxol sirup 0 0
Amikasin 1 gr injrksi (Program TB
11 0 0
RO )
12 AMINOFLUID 1000 mL/Bfluid 0 0
13 Aminopilin Injeksi. 0 0
14 Amiodarone HCL Injeksi 50 mg/ml 0 0
15 Amitriptilin 0 0
16 Amlodipin 10 mg 0 0
17 Amlodipin 5 mg 0 0
18 Amoksilin + As. Kalvulanat tablet 0 0
Amoksilin + Asam Klavulanat Sirup
19 0 0
(Claneksi Sirup)
20 Amoksilin drop 0 0
21 Amoksilin kapsul 250 mg. 0 0
22 Amoxillin kapsul 500 mg 0 0
23 Antasida DOEN tab.kombinasi 0 0
24 Anti Hemoroid 0 0
25 Aqua Pro injeksi 0 0
26 Aripirazol 10 mg 0 0
27 Asam Askorbat (Vit.C) tab.50 mg. 0 0
Asam Mefenamat 500 mg
28 0 0
tablet salut selaput
29 Asam traneksamat inj 0 0
Asetil sistein 100 mg Sirup
30 0 0
(Fluimucil Sirup)
31 Asetil sistein 200 mg 0 0
32 Asiklovir 200 mg tab 0 0
33 Asiklovir 400 mg. tablet 0 0
34 Asiklovir salep 0 0
35 Atenolol 50 mg 0 0
36 Atorvastain Calcium tab 20 mg 0 0
37 Atorvastatin 10 mg Tablet 0 0
38 Atropin sulfat Injeksi 0 0
39 Avamys Spray 0 0
40 Azitromisin 500 mg 0 0
41 Azitromisin sirup kering 200 mg 0 0
42 Bayclin 0 0
Bedaquiline 100 mg (Program TB
43 0 0
RO )
Betametason + Neomisin Krim
44 0 0
(Benoson N Krim)
45 Betametason krim 0,1 % 0 0
46 Biosat ATS 0 0
47 Bisoprolol 5 mg 0 0
48 Bricasma Injeksi (Terbutalin) 0 0
49 Bromheksin 8 mg 0 0
Bupivicain Injeksi (REGIVELL
50 0 0
Injeksi)
51 Calcium Gluconat 0 0
52 candesartan 16 mg 0 0
53 Candesartan 8 mg tab 0 0
54 Carbazocrome inj 0 0
55 Ceftazidim injeksi 0 0
56 Ceftriaxon injeksi 0 0
57 Cendo Asthenof 0 0
58 Cendo Catarlent 15 ml 0 0
59 Cendo Cenfresh Eye Drop 0 0
60 Cendo floxa Eye Drop 0 0
61 Cendo Lyteers 0 0
62 Cendo mata pantocain 0 0
63 Cendo Mydriatil Tetes Mata 0 0
64 Cendo polydex 0 0
65 Cendo Statrol 0 0
66 Cendo timol 0 0
67 Cendo Tropin 0.5% 0 0
68 Cendo Xitrol Eye Drop 0 0
69 Cendo Xitrol salep mata 3,5 Gram 0 0

Cilostazol Tablet 100 mg (Pletaal


70 0 0
Tablet)
71 Citicolin inj 0 0
72 Clindamisin 300 mg 0 0
73 Clindamycin caps 150 mg 0 0
74 Clotrimazole (Dermifar Krim) 0 0
75 Combiven Inhaler 0 0
76 Coparcetin 0 0
77 Curcuma tab 0 0
78 Deksametason tablet 0,5 mg. 0 0
79 Delamanid 50 mg (Program TB RO ) 0 0
80 Depakote ER 250 mg 0 0
81 Depakote ER 500 mg 0 0
Dextrometrophan + Gliseril
82 Guaiacolat + Phenylpropanolamin 0 0
HC + Chlo heniramine Maleat Tab
83 Diazepam 5 mg tablet 0 0
84 Diazepam Injeksi 0 0
Diazepam Rectal Tube 20 mg
85 0 0
(STEOLID 10)
Diazepam Rectal Tube 5 mg
86 0 0
(STESOLID 5)
87 Diazink tab 0 0
Digoksin injeksi 0,25 mg
88 0 0
(FARGOKSIN IV)
89 Digoksin tablet 0,25 mg. 0 0
90 Diltiazem 10 mg 0 0
91 Diphenhidramin injeksi 0 0
92 Dipsamol inhaler 0 0
93 Domperidon 0 0
94 Domperidon 10 mg sirup 0 0
95 Domperidon drop 0 0
96 Donepezile 0 0
97 Doxycyclin kapsul 100 mg. 0 0
98 Epinefrin injeksi 0 0
99 Eritromisin 500 mg tab 0 0
100 Etanol 70 % 1 liter 0 0
101 Ethambutol 400 mg (Program TB ) 0 0
Ethionamide 250 mg (Program TB
102 0 0
RO )
103 ethyl cloride 0 0
104 Euthyrox Tab 0 0
105 fenitoin injeksi 0 0
106 Fenitoin Kapsul 0 0
107 Fentanyl Injeksi 100 mcg/2ml Injeks 0 0
108 Ferriz drop 0 0
Fitomenadion (Vit.K10
109 0 0
inj.10mg/ml01ml
110 Flixotide 0 0
111 Flukonazole tab 0 0
112 Furosemid injeksi 0 0
113 Furosemid tab 0 0
114 Gabapentin 100 mg 0 0
115 Gabapentin 300 mg tab 0 0
116 Garam Oralit 200 ml air 0 0
117 Gemfibrozil Kapsul 300 mg 0 0
118 Gentamisin Cream Kulit 0 0
119 gentamisin injeksi 0 0
120 Glibenklamid 5 mg 0 0
121 Glikazid 80 mg 0 0
122 Glikuidon 30 Mg  0 0
123 glimepirid 2 mg 0 0
124 Glukosa 40% 0 0
125 Glukose larutan infus 10 % steril 0 0
126 Glukose larutan infus 5 % steril 0 0
127 Haloperidol 50 mg injeksi 0 0
128 Haloperidol tablet 5 mg 0 0
129 Herbesser injeksi 0 0
130 Hidonac Injeksi 2.5 g 0 0
Hidroklorotiazide (HCT) tablet 25
131 0 0
mg.
132 Hidrokortison cr 0 0
Human Tetanus Immunoglobulin 1
133 0 0
ml 250 IU (TETAGAM)
134 Hyoscine n Butil Bromide Injeksi 0 0
135 Hyosin N Butylbromide 10 mg 0 0
136 Ialuset plus 0 0
137 Ibuprofen tab 400 mg 0 0
138 Ibuprofen tablet 200 mg. 0 0
139 INH 100 mg (Program TB RO ) 0 0
140 INH 300 mg (Program TB RO ) 0 0
141 INH 300 mg (Program TB RO ) 0 0
Inhalasi Salbutamol Device
142 0 0
(Salbulin)
143 Inhaler Ventolin 0 0
144 Inviclot 0 0
145 Iodin Povidone 1 L 0 0
146 Isoniazid 300 mg (Program TB RO ) 0 0

147 Isonoasid 300 mg (Program TB RO ) 0 0


148 Isosorbid injeksi 10 mg 0 0
149 Isosorbit Dinitrat tab sublingal 5 mg. 0 0
150 Kaen 1 B  0 0
151 Kaen 3 B  0 0
152 Kalium Diklofenak 50 mg 0 0
153 Kalsium Laktat (Kalk) tab.500 mg. 0 0
154 Kaptopril 12,5 mg tablet 0 0
155 Kaptopril 25 mg tablet 0 0
156 Kidmin infus 0 0
157 Kloramfenikol 500 mg 0 0
158 Kloramfenikol Salep mata 0 0
159 Kloramfenikol tetes telinga 0 0
Klorfeniramin Maleat (CTM) tablet 4
160 0 0
mg.
161 Kodein 20 mg 0 0
162 Kotrimoksazol dewasa tablet 0 0
163 Kotrimoksazol suspensi 0 0
164 KSR 0 0
165 Lacto B 0 0
166 Lactulac sirup 0 0
Lamivudine (3TC) 150mg (Program
167 0 0
HIV)
168 lansoprazol capsul 0 0
169 Lansoprazol injeksi 0 0
170 Lantus 0 0
171 Levemir Insulin 0 0
172 Levodopa + Benserazide kombinasi 0 0
173 Levofloksasin tab 0 0
174 Levofloxacin infus 5mg/ml 0 0
175 Lidocain 2 % injeksi 0 0
Lidokain HCL0 Epinefrin Injeksi/amp
176 0 0
2 ml (PEHACAIN)

177 Linezolid 600 mg (Program TB RO ) 0 0


178 Loperamid tablet 0 0
179 Madopar tab/Levopar 0 0
180 Manitol infus 25 mL 0 0
181 Mecobalamin 500 mg 0 0
182 Meloksikam 15 mg 0 0
183 Meloxicam 15 mg 0 0
184 Mersibion inj 0 0
185 Metamizole Injeksi 0 0
186 Metamizole Tablet 500 mg 0 0
187 Metformin 500 mg 0 0
188 Metformin tab 850 mg 0 0
Metil Ergometrin (METERGIN
189 0 0
Injeksi)
190 Metil Prednisolon 125MG/ml INJ 0 0
191 Metil Prednisolon 4 mg 0 0
192 Metildopa tablet 0 0
193 Metoklo ramid 10 mg tab 0 0
194 Metronidazol 500 mg ovula 0 0
195 Metronidazol tablet 500 mg. 0 0
196 metronidazole infus 0 0
197 Mgso4 infus 0 0
198 Miconazole cream 0 0
199 Mineral Mix 0 0
200 Minosep Gargle 0 0
201 Misoprostol tab 0 0
Moxifloxacin 400 mg (Program TB
202 0 0
RO )
203 Mupirocin salep 0 0
204 NaCL 0.9%, 100 ml 0 0
205 NaCL 0.9%, 500 ml 0 0
206 Nalokson injeksi 0.4 mg 0 0
207 Natrium Bikarbonat tablet 0 0
208 Natrium Diklofenak 25 mg tab 0 0
209 Natrium Klorida 3% 0 0
210 Neurodex 0 0
Nevirapine (NVP) 200mg(Program
211 0 0
HIV )
212 Nifedipin 10 mg. tablet 0 0
213 Nikardipin injeksi 0 0
214 Nistatin 500.000 IU tablet salut 0 0
215 Nistatin drop 0 0
216 Nitrogliserin 5 mg 0 0
217 Nitrokaf retard 2.5 mg 0 0
218 Norepinefrine 1 mg/ml 0 0
219 Novomix insulin 0 0
220 Novorapid insulin 0 0
221 OAT Combivak (Program TB ) 0 0
Obat Anti Tubercolosis Anak
222 0 0
(Program TB )
Obat Anti Tuberkolosis Kategori I
223 0 0
(Program TB SO )
Obat Anti Tuberkolosis Kategori II
224 0 0
(Program TB )
225 OBH 0 0
226 Oksitosina injeksi 10 IU / ml01ml 0 0
227 Omeprazol 20 mg tab 0 0
228 Omeprazol injeksi 0 0
229 Ondansetron 4 mg Inj 0 0
230 Ondansetron 8 mg 0 0
231 Parasetamol drop 0 0
232 Parasetamol infus 0 0
233 Parasetamol sirup 120 mg/ 5 ml 0 0
234 Parasetamol Supp 125 mg 0 0
235 Parasetamol suppos 250 mg 0 0
236 Parasetamol tablet 500 mg. 0 0
237 Pioglitazon 0 0
238 Pirazinamid 500 mg (Program TB ) 0 0
239 Prednison 5 mg 0 0
Procain Penisilline (Program TB
240 0 0
RO )
Pseudoefedrin HCL 15 mg +
241 0 0
Terfenadine
242 Ramipril 5 Mg Tab  0 0
243 Ranitidin 150 mg 0 0
244 Ranitidin injeksi 0 0
245 Ranivel sirup 0 0
246 Requip tab 0 0
Rifampisin 450 mg tab (Program
247 0 0
TB )
248 Ringer Laktat 0 0
249 Risperidone 2 mg 0 0
250 Salbutamol 2 mg 0 0
251 Salbutamol 4 mg tab 0 0
252 Salisil Bedak 2 % 0 0
253 SANBE Baquinor 0.3% Tetes Mata 0 0
254 SANBE Forumen 0 0
255 SANBE Fukrisin ED 5 ml 0 0
256 SANBE Hyaloph Eye Drop 0 0
257 SANBE Otilon tetes telinga 0 0
258 Sefadroksil 500 mg kapsul 0 0
259 Sefadroksil sirup 0 0
260 Sefiksim 100 mg 0 0
261 Sefiksim 100 mg sirup 0 0
262 Sefiksim 200 mg 0 0
263 Sefotaksim injeksi 0 0
264 Seftriakson injeksi 0 0
265 Seretide Diskus (50/500) 0 0
266 Sertralin 50 mg 0 0
267 Setirizin 10 mg sirup 0 0
268 Setirizin 10 mg tab 0 0
269 Sevodex 0 0
270 Simarc 2 mg 0 0
271 Simvastatin 20 mg 0 0
272 Siprofloksasin 2% Infus 0 0
273 Siprofloksasin 500 mg tablet 0 0
274 SNMC Injeksi 0 0
275 Stesolid 10 mg 0 0
276 Stesolid 5 mg 0 0
277 Streptomycin 1 gr (Program TB ) 0 0
278 sukralfat tablet 0 0
279 Sulfadiazin krim 0 0
280 Tablet tambah darah kombinasi 0 0
TDF 300/3TC 300/DTG 50 (Program
281 0 0
HIV)
TDF/3TC/EFV(300/300/600)
282 0 0
(Program HIV)
283 Telmisartan 40 mg tab 0 0
Tenofovir (TDF) 300mg (Program
284 0 0
HIV)

285 Teofilin tab 150 mg (BRONSOLVAN) 0 0


286 Terbutalin Sulfat 0,5mg/ml Injeksi 0 0
287 Thiamfenikol 500 0 0

Tramadol 37,5 mg + Parasetamol


288 0 0
caps (ANALTRAM caps)

289 Tramadol inj 0 0


290 Trihexyphenidyl tab 0 0
291 Trilac (Triamcinolon) 0 0
292 Tuberculin PPD TEST 0 0

Urdafalk tab (URSODEOXYCHOLIC


293 0 0
ACID GENERIK)

294 Vaksin HB0 (Program VAKSIN) 0 0


Vaksin TD Single Use
295 0 0
(Program TB RO )
296 Valsartan 160 mg 0 0
297 Valsartan 80 mg 0 0
298 Vasacon 0 0
Vicilin SX serbuk injeksi (Ampisilin
299 0 0
Sulbactam)
300 Vitamin B Kompleks Tablet 0 0
301 Vitamin B6 0 0
302 Vitamin B6 0 0
303 Vitamin B6 10 mg 0 0
304 VITAMIN C INJEKSI 0 0
305 Vitamin D3 1000 iu 0 0
Vitamin Sirup anak
306 0 0
(UNIVIT/TIALISIN)
307 Water Steril 1 L 0 0
308 Xylocain 10% Spray 0 0
309 Xylocain Jelly 2% 0 0
Zidovudin (Zdv) 100 mg (Program
310 0 0
HIV)
Zidovudine (ZDV)/Lamivudine (3TC)
311 0 0
300/150mg (Program HIV)
312 Zinc Sirup 0 0
313 Abilify 15 mg (Aripriprazole) 0 0
314 Adalat Oros Tab 0 0
315 Allopurinol 300 mg 0 0
316 Ampicilin Inj 0 0
317 Antasida DOEN syr 0 0
318 ARDIUM 0 0
319 Aricept Evess (Donepezil 10mg) 0 0
320 Arixtra Inj 0 0
321 As. Valproat Sirup 0 0
322 Asam Folat tab 0 0
323 Asam Traneksamat 500 mg tab 0 0
324 Asering 500 ml 0 0
325 Atracurium Injeksi (Tramus Inj) 0 0
326 Attapulgite tablet 0 0
327 Betahistin 6 mg 0 0
328 Bisakodil tab 0 0
329 Bisoprolol 2.5 mg 0 0
330 CaCO3 0 0
331 Captopril 25 mg 0 0
332 Cefoperazone 0 0
333 Cendo Efrisel. 0 0
334 Cendo Siloxan 0 0
335 Cetadop inj (Dopamin) 0 0
336 Cetirizin Sirup 0 0
337 Cetirizin tab 0 0
338 Chloroquin 150 mg tablet 0 0
339 Chlorpromazin Tab 0 0
340 Citicolin tab. 0 0
341 Clobazam 10 mg 0 0
342 Clonazepam 2 mg tab 0 0
343 Clonidine tablet 0,15 mg 0 0
344 Clozapine 100 mg 0 0
345 Clozapine 25 mg 0 0
346 Concor 1,25 0 0
347 Deksametason inj 0 0
348 Diltiazem tablet 30 mg 0 0
349 Dobutamin Inj 0 0
350 Beraprost (Dorner) tab 0 0
351 Dulcolax supp 5 mg 0 0
352 Efedrin Injeksi 50 mg 0 0
353 Eperison tablet 0 0
354 Fenofibrate 100mg kap 0 0
355 Ferro-K Sirup 0 0
356 Fitomenadion tablet 10 mg 0 0
357 Flunarizine 10 mg tab 0 0
358 Fluoxetin Capsul 0 0
359 Gelofusin 0 0
360 Glimepirid 1 mg 0 0
361 Glimepirid 3 mg 0 0
362 Glimepiride 4 mg 0 0
363 Glucosamin Tab 0 0
364 Tamsolusin 0 0
365 Herbesser CD 100 mg 0 0
366 Hot In Cream DCL 0 0
367 HP PRO 0 0
368 Ibuprofen suspensi 0 0
369 KCL 7.46% 0 0
370 Ketamin Inj 0 0
371 Ketoconazol Tab 0 0
372 Ketokonazol Cr 0 0
373 Ketoprofen Supp 0 0
374 Ketorolac inj 30 mg 0 0
375 Klopidogrel 75 mg 0 0
376 Kolkisin tablet 0 0
377 Loratadine 10 mg 0 0
378 Meropenem Injeksi 0 0
379 Methosoprinol syr 0 0
380 Metil Ergometrin tab (Bledstop) 0 0
381 Metil Prednisolon 16 mg 0 0
382 Metoklopramid Injeksi 0 0
383 Meylon 0 0
384 Microlax 0 0
385 miniaspi 80mg 0 0
386 Multivitamin TABLET 0 0
387 Natrium Diklofenak 50 mg 0 0
388 Neostigmin inj 0 0
389 PK Serbuk 0 0
390 Pramifrol 0,375 MG tab 0 0
391 Propranolol 10 mg Tablet 0 0
392 Propranolol 40 mg 0 0
393 PTU tablet 100 mg 0 0
394 Pulmicort 0.25 Mg/ Ml  0 0
395 Ramipril 10 mg 0 0
396 Rebamipid. 0 0
397 Recofol 10 mg/ml 0 0
398 Rifampisin 600 mg tab 0 0
399 Rocuronium 10 mg/ml inj 0 0
400 Salbutamol 2 mg/5 ml Sirup 0 0
401 Seretide Diskus 50/250MCG. 0 0
402 Spironolakton 25 mg tab 0 0
403 Thrombopop Gel 0 0
404 Thiamzole 10 mg tab. 0 0
405 Triamsinolon inj 0 0
406 Carvedilol (Vbloc) 6,25 mg tab 0 0

Yang menyerahkan Yang menerima

Fezi kendri,Apt Putri Utami,Apt

PEMERINTAH PROVINSI DAERAH KHUSUS IBUKOTA JAKARTA


DINAS KESEHATAN
RUMAH SAKIT UMUM DAERAH CILINCING
Jalan Madya Kebantenan 1 Nomor 4, Cilincing. Telepon : 021 - 441 2889
Email : RSUDCilincing@gmail.com
JAKARTA
Kode Pos 14130

SURAT BUKTI BARANG KELUAR (SBBK)

Di berikan kepada
Nama/ NIP : Putri utami, Apt
Bagian : Apotek Rajal
Tanggal :

No Nama Barang Jumlah Harga


1 Acetazolamid 250 mg 0 0
2 Akarbose 100 mg 0 0
3 Akarbose 50 mg 0 0
4 Akilen tetes telinga 0 0
5 Albendazol sirup 0 0
6 ALBUMIN 25% 100 ML 0 0
7 Alprazolam Tablet 0,5 mg 0 0
8 Alupurinol tablet 100 mg. 0 0
9 Ambroxol 30 mg tab 0 0
10 Ambroxol sirup 0 0
Amikasin 1 gr injrksi (Program TB
11 0 0
RO )
12 AMINOFLUID 1000 mL/Bfluid 0 0
13 Aminopilin Injeksi. 0 0
14 Amiodarone HCL Injeksi 50 mg/ml 0 0
15 Amitriptilin 0 0
16 Amlodipin 10 mg 0 0
17 Amlodipin 5 mg 0 0
18 Amoksilin + As. Kalvulanat tablet 0 0
Amoksilin + Asam Klavulanat Sirup
19 0 0
(Claneksi Sirup)
20 Amoksilin drop 0 0
21 Amoksilin kapsul 250 mg. 0 0
22 Amoxillin kapsul 500 mg 0 0
23 Antasida DOEN tab.kombinasi 0 0
24 Anti Hemoroid 0 0
25 Aqua Pro injeksi 0 0
26 Aripirazol 10 mg 0 0
27 Asam Askorbat (Vit.C) tab.50 mg. 0 0
Asam Mefenamat 500 mg
28 0 0
tablet salut selaput
29 Asam traneksamat inj 0 0
Asetil sistein 100 mg Sirup
30 0 0
(Fluimucil Sirup)
31 Asetil sistein 200 mg 0 0
32 Asiklovir 200 mg tab 0 0
33 Asiklovir 400 mg. tablet 0 0
34 Asiklovir salep 0 0
35 Atenolol 50 mg 0 0
36 Atorvastain Calcium tab 20 mg 0 0
37 Atorvastatin 10 mg Tablet 0 0
38 Atropin sulfat Injeksi 0 0
39 Avamys Spray 0 0
40 Azitromisin 500 mg 0 0
41 Azitromisin sirup kering 200 mg 0 0
42 Bayclin 0 0
Bedaquiline 100 mg (Program TB
43 0 0
RO )
Betametason + Neomisin Krim
44 0 0
(Benoson N Krim)
45 Betametason krim 0,1 % 0 0
46 Biosat ATS 0 0
47 Bisoprolol 5 mg 0 0
48 Bricasma Injeksi (Terbutalin) 0 0
49 Bromheksin 8 mg 0 0
Bupivicain Injeksi (REGIVELL
50 0 0
Injeksi)
51 Calcium Gluconat 0 0
52 candesartan 16 mg 0 0
53 Candesartan 8 mg tab 0 0
54 Carbazocrome inj 0 0
55 Ceftazidim injeksi 0 0
56 Ceftriaxon injeksi 0 0
57 Cendo Asthenof 0 0
58 Cendo Catarlent 15 ml 0 0
59 Cendo Cenfresh Eye Drop 0 0
60 Cendo floxa Eye Drop 0 0
61 Cendo Lyteers 0 0
62 Cendo mata pantocain 0 0
63 Cendo Mydriatil Tetes Mata 0 0
64 Cendo polydex 0 0
65 Cendo Statrol 0 0
66 Cendo timol 0 0
67 Cendo Tropin 0.5% 0 0
68 Cendo Xitrol Eye Drop 0 0
69 Cendo Xitrol salep mata 3,5 Gram 0 0
Cilostazol Tablet 100 mg (Pletaal
70 0 0
Tablet)
71 Citicolin inj 0 0
72 Clindamisin 300 mg 0 0
73 Clindamycin caps 150 mg 0 0
74 Clotrimazole (Dermifar Krim) 0 0
75 Combiven Inhaler 0 0
76 Coparcetin 0 0
77 Curcuma tab 0 0
78 Deksametason tablet 0,5 mg. 0 0
79 Delamanid 50 mg (Program TB RO ) 0 0
80 Depakote ER 250 mg 0 0
81 Depakote ER 500 mg 0 0
Dextrometrophan + Gliseril
82 Guaiacolat + Phenylpropanolamin 0 0
HC + Chlo heniramine Maleat Tab
83 Diazepam 5 mg tablet 0 0
84 Diazepam Injeksi 0 0
Diazepam Rectal Tube 20 mg
85 0 0
(STEOLID 10)
Diazepam Rectal Tube 5 mg
86 0 0
(STESOLID 5)
87 Diazink tab 0 0
Digoksin injeksi 0,25 mg
88 0 0
(FARGOKSIN IV)
89 Digoksin tablet 0,25 mg. 0 0
90 Diltiazem 10 mg 0 0
91 Diphenhidramin injeksi 0 0
92 Dipsamol inhaler 0 0
93 Domperidon 0 0
94 Domperidon 10 mg sirup 0 0
95 Domperidon drop 0 0
96 Donepezile 0 0
97 Doxycyclin kapsul 100 mg. 0 0
98 Epinefrin injeksi 0 0
99 Eritromisin 500 mg tab 0 0
100 Etanol 70 % 1 liter 0 0
101 Ethambutol 400 mg (Program TB ) 0 0

Ethionamide 250 mg (Program TB


102 0 0
RO )
103 ethyl cloride 0 0
104 Euthyrox Tab 0 0
105 fenitoin injeksi 0 0
106 Fenitoin Kapsul 0 0
107 Fentanyl Injeksi 100 mcg/2ml Injeks 0 0
108 Ferriz drop 0 0
Fitomenadion (Vit.K10
109 0 0
inj.10mg/ml01ml
110 Flixotide 0 0
111 Flukonazole tab 0 0
112 Furosemid injeksi 0 0
113 Furosemid tab 0 0
114 Gabapentin 100 mg 0 0
115 Gabapentin 300 mg tab 0 0
116 Garam Oralit 200 ml air 0 0
117 Gemfibrozil Kapsul 300 mg 0 0
118 Gentamisin Cream Kulit 0 0
119 gentamisin injeksi 0 0
120 Glibenklamid 5 mg 0 0
121 Glikazid 80 mg 0 0
122 Glikuidon 30 Mg  0 0
123 glimepirid 2 mg 0 0
124 Glukosa 40% 0 0
125 Glukose larutan infus 10 % steril 0 0
126 Glukose larutan infus 5 % steril 0 0
127 Haloperidol 50 mg injeksi 0 0
128 Haloperidol tablet 5 mg 0 0
129 Herbesser injeksi 0 0
130 Hidonac Injeksi 2.5 g 0 0
Hidroklorotiazide (HCT) tablet 25
131 0 0
mg.
132 Hidrokortison cr 0 0
Human Tetanus Immunoglobulin 1
133 0 0
ml 250 IU (TETAGAM)
134 Hyoscine n Butil Bromide Injeksi 0 0
135 Hyosin N Butylbromide 10 mg 0 0
136 Ialuset plus 0 0
137 Ibuprofen tab 400 mg 0 0
138 Ibuprofen tablet 200 mg. 0 0
139 INH 100 mg (Program TB RO ) 0 0
140 INH 300 mg (Program TB RO ) 0 0
141 INH 300 mg (Program TB RO ) 0 0
Inhalasi Salbutamol Device
142 0 0
(Salbulin)
143 Inhaler Ventolin 0 0
144 Inviclot 0 0
145 Iodin Povidone 1 L 0 0
146 Isoniazid 300 mg (Program TB RO ) 0 0
147 Isonoasid 300 mg (Program TB RO ) 0 0
148 Isosorbid injeksi 10 mg 0 0
149 Isosorbit Dinitrat tab sublingal 5 mg. 0 0
150 Kaen 1 B  0 0
151 Kaen 3 B  0 0
152 Kalium Diklofenak 50 mg 0 0
153 Kalsium Laktat (Kalk) tab.500 mg. 0 0
154 Kaptopril 12,5 mg tablet 0 0
155 Kaptopril 25 mg tablet 0 0
156 Kidmin infus 0 0
157 Kloramfenikol 500 mg 0 0
158 Kloramfenikol Salep mata 0 0
159 Kloramfenikol tetes telinga 0 0
Klorfeniramin Maleat (CTM) tablet 4
160 0 0
mg.
161 Kodein 20 mg 0 0
162 Kotrimoksazol dewasa tablet 0 0
163 Kotrimoksazol suspensi 0 0
164 KSR 0 0
165 Lacto B 0 0
166 Lactulac sirup 0 0
Lamivudine (3TC) 150mg (Program
167 0 0
HIV)
168 lansoprazol capsul 0 0
169 Lansoprazol injeksi 0 0
170 Lantus 0 0
171 Levemir Insulin 0 0
172 Levodopa + Benserazide kombinasi 0 0
173 Levofloksasin tab 0 0
174 Levofloxacin infus 5mg/ml 0 0
175 Lidocain 2 % injeksi 0 0
Lidokain HCL0 Epinefrin Injeksi/amp
176 0 0
2 ml (PEHACAIN)

177 Linezolid 600 mg (Program TB RO ) 0 0


178 Loperamid tablet 0 0
179 Madopar tab/Levopar 0 0
180 Manitol infus 25 mL 0 0
181 Mecobalamin 500 mg 0 0
182 Meloksikam 15 mg 0 0
183 Meloxicam 15 mg 0 0
184 Mersibion inj 0 0
185 Metamizole Injeksi 0 0
186 Metamizole Tablet 500 mg 0 0
187 Metformin 500 mg 0 0
188 Metformin tab 850 mg 0 0
Metil Ergometrin (METERGIN
189 0 0
Injeksi)
190 Metil Prednisolon 125MG/ml INJ 0 0
191 Metil Prednisolon 4 mg 0 0
192 Metildopa tablet 0 0
193 Metoklo ramid 10 mg tab 0 0
194 Metronidazol 500 mg ovula 0 0
195 Metronidazol tablet 500 mg. 0 0
196 metronidazole infus 0 0
197 Mgso4 infus 0 0
198 Miconazole cream 0 0
199 Mineral Mix 0 0
200 Minosep Gargle 0 0
201 Misoprostol tab 0 0
Moxifloxacin 400 mg (Program TB
202 0 0
RO )
203 Mupirocin salep 0 0
204 NaCL 0.9%, 100 ml 0 0
205 NaCL 0.9%, 500 ml 0 0
206 Nalokson injeksi 0.4 mg 0 0
207 Natrium Bikarbonat tablet 0 0
208 Natrium Diklofenak 25 mg tab 0 0
209 Natrium Klorida 3% 0 0
210 Neurodex 0 0
Nevirapine (NVP) 200mg(Program
211 0 0
HIV )
212 Nifedipin 10 mg. tablet 0 0
213 Nikardipin injeksi 0 0
214 Nistatin 500.000 IU tablet salut 0 0
215 Nistatin drop 0 0
216 Nitrogliserin 5 mg 0 0
217 Nitrokaf retard 2.5 mg 0 0
218 Norepinefrine 1 mg/ml 0 0
219 Novomix insulin 0 0
220 Novorapid insulin 0 0
221 OAT Combivak (Program TB ) 0 0
Obat Anti Tubercolosis Anak
222 0 0
(Program TB )
Obat Anti Tuberkolosis Kategori I
223 0 0
(Program TB SO )
Obat Anti Tuberkolosis Kategori II
224 0 0
(Program TB )
225 OBH 0 0
226 Oksitosina injeksi 10 IU / ml01ml 0 0
227 Omeprazol 20 mg tab 0 0
228 Omeprazol injeksi 0 0
229 Ondansetron 4 mg Inj 0 0
230 Ondansetron 8 mg 0 0
231 Parasetamol drop 0 0
232 Parasetamol infus 0 0
233 Parasetamol sirup 120 mg/ 5 ml 0 0
234 Parasetamol Supp 125 mg 0 0
235 Parasetamol suppos 250 mg 0 0
236 Parasetamol tablet 500 mg. 0 0
237 Pioglitazon 0 0
238 Pirazinamid 500 mg (Program TB ) 0 0
239 Prednison 5 mg 0 0
Procain Penisilline (Program TB
240 0 0
RO )
Pseudoefedrin HCL 15 mg +
241 0 0
Terfenadine
242 Ramipril 5 Mg Tab  0 0
243 Ranitidin 150 mg 0 0
244 Ranitidin injeksi 0 0
245 Ranivel sirup 0 0
246 Requip tab 0 0
Rifampisin 450 mg tab (Program
247 0 0
TB )
248 Ringer Laktat 0 0
249 Risperidone 2 mg 0 0
250 Salbutamol 2 mg 0 0
251 Salbutamol 4 mg tab 0 0
252 Salisil Bedak 2 % 0 0
253 SANBE Baquinor 0.3% Tetes Mata 0 0
254 SANBE Forumen 0 0
255 SANBE Fukrisin ED 5 ml 0 0
256 SANBE Hyaloph Eye Drop 0 0
257 SANBE Otilon tetes telinga 0 0
258 Sefadroksil 500 mg kapsul 0 0
259 Sefadroksil sirup 0 0
260 Sefiksim 100 mg 0 0
261 Sefiksim 100 mg sirup 0 0
262 Sefiksim 200 mg 0 0
263 Sefotaksim injeksi 0 0
264 Seftriakson injeksi 0 0
265 Seretide Diskus (50/500) 0 0
266 Sertralin 50 mg 0 0
267 Setirizin 10 mg sirup 0 0
268 Setirizin 10 mg tab 0 0
269 Sevodex 0 0
270 Simarc 2 mg 0 0
271 Simvastatin 20 mg 0 0
272 Siprofloksasin 2% Infus 0 0
273 Siprofloksasin 500 mg tablet 0 0
274 SNMC Injeksi 0 0
275 Stesolid 10 mg 0 0
276 Stesolid 5 mg 0 0
277 Streptomycin 1 gr (Program TB ) 0 0
278 sukralfat tablet 0 0
279 Sulfadiazin krim 0 0
280 Tablet tambah darah kombinasi 0 0
TDF 300/3TC 300/DTG 50 (Program
281 0 0
HIV)
TDF/3TC/EFV(300/300/600)
282 0 0
(Program HIV)
283 Telmisartan 40 mg tab 0 0
Tenofovir (TDF) 300mg (Program
284 0 0
HIV)

285 Teofilin tab 150 mg (BRONSOLVAN) 0 0


286 Terbutalin Sulfat 0,5mg/ml Injeksi 0 0
287 Thiamfenikol 500 0 0

Tramadol 37,5 mg + Parasetamol


288 0 0
caps (ANALTRAM caps)

289 Tramadol inj 0 0


290 Trihexyphenidyl tab 0 0
291 Trilac (Triamcinolon) 0 0
292 Tuberculin PPD TEST 0 0

Urdafalk tab (URSODEOXYCHOLIC


293 0 0
ACID GENERIK)

294 Vaksin HB0 (Program VAKSIN) 0 0


Vaksin TD Single Use
295 0 0
(Program TB RO )
296 Valsartan 160 mg 0 0
297 Valsartan 80 mg 0 0
298 Vasacon 0 0
Vicilin SX serbuk injeksi (Ampisilin
299 0 0
Sulbactam)
300 Vitamin B Kompleks Tablet 0 0
301 Vitamin B6 0 0
302 Vitamin B6 0 0
303 Vitamin B6 10 mg 0 0
304 VITAMIN C INJEKSI 0 0
305 Vitamin D3 1000 iu 0 0
Vitamin Sirup anak
306 0 0
(UNIVIT/TIALISIN)
307 Water Steril 1 L 0 0
308 Xylocain 10% Spray 0 0
309 Xylocain Jelly 2% 0 0
Zidovudin (Zdv) 100 mg (Program
310 0 0
HIV)
Zidovudine (ZDV)/Lamivudine (3TC)
311 0 0
300/150mg (Program HIV)
312 Zinc Sirup 0 0
313 Abilify 15 mg (Aripriprazole) 0 0
314 Adalat Oros Tab 0 0
315 Allopurinol 300 mg 0 0
316 Ampicilin Inj 0 0
317 Antasida DOEN syr 0 0
318 ARDIUM 0 0
319 Aricept Evess (Donepezil 10mg) 0 0
320 Arixtra Inj 0 0
321 As. Valproat Sirup 0 0
322 Asam Folat tab 0 0
323 Asam Traneksamat 500 mg tab 0 0
324 Asering 500 ml 0 0
325 Atracurium Injeksi (Tramus Inj) 0 0
326 Attapulgite tablet 0 0
327 Betahistin 6 mg 0 0
328 Bisakodil tab 0 0
329 Bisoprolol 2.5 mg 0 0
330 CaCO3 0 0
331 Captopril 25 mg 0 0
332 Cefoperazone 0 0
333 Cendo Efrisel. 0 0
334 Cendo Siloxan 0 0
335 Cetadop inj (Dopamin) 0 0
336 Cetirizin Sirup 0 0
337 Cetirizin tab 0 0
338 Chloroquin 150 mg tablet 0 0
339 Chlorpromazin Tab 0 0
340 Citicolin tab. 0 0
341 Clobazam 10 mg 0 0
342 Clonazepam 2 mg tab 0 0
343 Clonidine tablet 0,15 mg 0 0
344 Clozapine 100 mg 0 0
345 Clozapine 25 mg 0 0
346 Concor 1,25 0 0
347 Deksametason inj 0 0
348 Diltiazem tablet 30 mg 0 0
349 Dobutamin Inj 0 0
350 Beraprost (Dorner) tab 0 0
351 Dulcolax supp 5 mg 0 0
352 Efedrin Injeksi 50 mg 0 0
353 Eperison tablet 0 0
354 Fenofibrate 100mg kap 0 0
355 Ferro-K Sirup 0 0
356 Fitomenadion tablet 10 mg 0 0
357 Flunarizine 10 mg tab 0 0
358 Fluoxetin Capsul 0 0
359 Gelofusin 0 0
360 Glimepirid 1 mg 0 0
361 Glimepirid 3 mg 0 0
362 Glimepiride 4 mg 0 0
363 Glucosamin Tab 0 0
364 Tamsolusin 0 0
365 Herbesser CD 100 mg 0 0
366 Hot In Cream DCL 0 0
367 HP PRO 0 0
368 Ibuprofen suspensi 0 0
369 KCL 7.46% 0 0
370 Ketamin Inj 0 0
371 Ketoconazol Tab 0 0
372 Ketokonazol Cr 0 0
373 Ketoprofen Supp 0 0
374 Ketorolac inj 30 mg 0 0
375 Klopidogrel 75 mg 0 0
376 Kolkisin tablet 0 0
377 Loratadine 10 mg 0 0
378 Meropenem Injeksi 0 0
379 Methosoprinol syr 0 0
380 Metil Ergometrin tab (Bledstop) 0 0
381 Metil Prednisolon 16 mg 0 0
382 Metoklopramid Injeksi 0 0
383 Meylon 0 0
384 Microlax 0 0
385 miniaspi 80mg 0 0
386 Multivitamin TABLET 0 0
387 Natrium Diklofenak 50 mg 0 0
388 Neostigmin inj 0 0
389 PK Serbuk 0 0
390 Pramifrol 0,375 MG tab 0 0
391 Propranolol 10 mg Tablet 0 0
392 Propranolol 40 mg 0 0
393 PTU tablet 100 mg 0 0
394 Pulmicort 0.25 Mg/ Ml  0 0
395 Ramipril 10 mg 0 0
396 Rebamipid. 0 0
397 Recofol 10 mg/ml 0 0
398 Rifampisin 600 mg tab 0 0
399 Rocuronium 10 mg/ml inj 0 0
400 Salbutamol 2 mg/5 ml Sirup 0 0
401 Seretide Diskus 50/250MCG. 0 0
402 Spironolakton 25 mg tab 0 0
403 Thrombopop Gel 0 0
404 Thiamzole 10 mg tab. 0 0
405 Triamsinolon inj 0 0
406 Carvedilol (Vbloc) 6,25 mg tab 0 0

Yang menyerahkan Yang menerima

Fezi kendri,Apt Putri Utami,Apt

PEMERINTAH PROVINSI DAERAH KHUSUS IBUKOTA JAKARTA


DINAS KESEHATAN
RUMAH SAKIT UMUM DAERAH CILINCING
Jalan Madya Kebantenan 1 Nomor 4, Cilincing. Telepon : 021 - 441 2889
Email : RSUDCilincing@gmail.com
JAKARTA
Kode Pos 14130

SURAT BUKTI BARANG KELUAR (SBBK)

Di berikan kepada
Nama/ NIP : Putri utami, Apt
Bagian : Apotek Rajal
Tanggal :

No Nama Barang Jumlah Harga


1 Acetazolamid 250 mg 0 0
2 Akarbose 100 mg 0 0
3 Akarbose 50 mg 0 0
4 Akilen tetes telinga 0 0
5 Albendazol sirup 0 0
6 ALBUMIN 25% 100 ML 0 0
7 Alprazolam Tablet 0,5 mg 0 0
8 Alupurinol tablet 100 mg. 0 0
9 Ambroxol 30 mg tab 0 0
10 Ambroxol sirup 0 0
Amikasin 1 gr injrksi (Program TB
11 0 0
RO )
12 AMINOFLUID 1000 mL/Bfluid 0 0
13 Aminopilin Injeksi. 0 0
14 Amiodarone HCL Injeksi 50 mg/ml 0 0
15 Amitriptilin 0 0
16 Amlodipin 10 mg 0 0
17 Amlodipin 5 mg 0 0
18 Amoksilin + As. Kalvulanat tablet 0 0
Amoksilin + Asam Klavulanat Sirup
19 0 0
(Claneksi Sirup)
20 Amoksilin drop 0 0
21 Amoksilin kapsul 250 mg. 0 0
22 Amoxillin kapsul 500 mg 0 0
23 Antasida DOEN tab.kombinasi 0 0
24 Anti Hemoroid 0 0
25 Aqua Pro injeksi 0 0
26 Aripirazol 10 mg 0 0
27 Asam Askorbat (Vit.C) tab.50 mg. 0 0
Asam Mefenamat 500 mg
28 0 0
tablet salut selaput
29 Asam traneksamat inj 0 0
Asetil sistein 100 mg Sirup
30 0 0
(Fluimucil Sirup)
31 Asetil sistein 200 mg 0 0
32 Asiklovir 200 mg tab 0 0
33 Asiklovir 400 mg. tablet 0 0
34 Asiklovir salep 0 0
35 Atenolol 50 mg 0 0
36 Atorvastain Calcium tab 20 mg 0 0
37 Atorvastatin 10 mg Tablet 0 0
38 Atropin sulfat Injeksi 0 0
39 Avamys Spray 0 0
40 Azitromisin 500 mg 0 0
41 Azitromisin sirup kering 200 mg 0 0
42 Bayclin 0 0
Bedaquiline 100 mg (Program TB
43 0 0
RO )
Betametason + Neomisin Krim
44 0 0
(Benoson N Krim)
45 Betametason krim 0,1 % 0 0
46 Biosat ATS 0 0
47 Bisoprolol 5 mg 0 0
48 Bricasma Injeksi (Terbutalin) 0 0
49 Bromheksin 8 mg 0 0
Bupivicain Injeksi (REGIVELL
50 0 0
Injeksi)
51 Calcium Gluconat 0 0
52 candesartan 16 mg 0 0
53 Candesartan 8 mg tab 0 0
54 Carbazocrome inj 0 0
55 Ceftazidim injeksi 0 0
56 Ceftriaxon injeksi 0 0
57 Cendo Asthenof 0 0
58 Cendo Catarlent 15 ml 0 0
59 Cendo Cenfresh Eye Drop 0 0
60 Cendo floxa Eye Drop 0 0
61 Cendo Lyteers 0 0
62 Cendo mata pantocain 0 0
63 Cendo Mydriatil Tetes Mata 0 0
64 Cendo polydex 0 0
65 Cendo Statrol 0 0
66 Cendo timol 0 0
67 Cendo Tropin 0.5% 0 0
68 Cendo Xitrol Eye Drop 0 0
69 Cendo Xitrol salep mata 3,5 Gram 0 0

Cilostazol Tablet 100 mg (Pletaal


70 0 0
Tablet)
71 Citicolin inj 0 0
72 Clindamisin 300 mg 0 0
73 Clindamycin caps 150 mg 0 0
74 Clotrimazole (Dermifar Krim) 0 0
75 Combiven Inhaler 0 0
76 Coparcetin 0 0
77 Curcuma tab 0 0
78 Deksametason tablet 0,5 mg. 0 0
79 Delamanid 50 mg (Program TB RO ) 0 0
80 Depakote ER 250 mg 0 0
81 Depakote ER 500 mg 0 0
Dextrometrophan + Gliseril
82 Guaiacolat + Phenylpropanolamin 0 0
HC + Chlo heniramine Maleat Tab
83 Diazepam 5 mg tablet 0 0
84 Diazepam Injeksi 0 0
Diazepam Rectal Tube 20 mg
85 0 0
(STEOLID 10)
Diazepam Rectal Tube 5 mg
86 0 0
(STESOLID 5)
87 Diazink tab 0 0
Digoksin injeksi 0,25 mg
88 0 0
(FARGOKSIN IV)
89 Digoksin tablet 0,25 mg. 0 0
90 Diltiazem 10 mg 0 0
91 Diphenhidramin injeksi 0 0
92 Dipsamol inhaler 0 0
93 Domperidon 0 0
94 Domperidon 10 mg sirup 0 0
95 Domperidon drop 0 0
96 Donepezile 0 0
97 Doxycyclin kapsul 100 mg. 0 0
98 Epinefrin injeksi 0 0
99 Eritromisin 500 mg tab 0 0
100 Etanol 70 % 1 liter 0 0
101 Ethambutol 400 mg (Program TB ) 0 0

Ethionamide 250 mg (Program TB


102 0 0
RO )
103 ethyl cloride 0 0
104 Euthyrox Tab 0 0
105 fenitoin injeksi 0 0
106 Fenitoin Kapsul 0 0
107 Fentanyl Injeksi 100 mcg/2ml Injeks 0 0
108 Ferriz drop 0 0
Fitomenadion (Vit.K10
109 0 0
inj.10mg/ml01ml
110 Flixotide 0 0
111 Flukonazole tab 0 0
112 Furosemid injeksi 0 0
113 Furosemid tab 0 0
114 Gabapentin 100 mg 0 0
115 Gabapentin 300 mg tab 0 0
116 Garam Oralit 200 ml air 0 0
117 Gemfibrozil Kapsul 300 mg 0 0
118 Gentamisin Cream Kulit 0 0
119 gentamisin injeksi 0 0
120 Glibenklamid 5 mg 0 0
121 Glikazid 80 mg 0 0
122 Glikuidon 30 Mg  0 0
123 glimepirid 2 mg 0 0
124 Glukosa 40% 0 0
125 Glukose larutan infus 10 % steril 0 0
126 Glukose larutan infus 5 % steril 0 0
127 Haloperidol 50 mg injeksi 0 0
128 Haloperidol tablet 5 mg 0 0
129 Herbesser injeksi 0 0
130 Hidonac Injeksi 2.5 g 0 0
Hidroklorotiazide (HCT) tablet 25
131 0 0
mg.
132 Hidrokortison cr 0 0
Human Tetanus Immunoglobulin 1
133 0 0
ml 250 IU (TETAGAM)
134 Hyoscine n Butil Bromide Injeksi 0 0
135 Hyosin N Butylbromide 10 mg 0 0
136 Ialuset plus 0 0
137 Ibuprofen tab 400 mg 0 0
138 Ibuprofen tablet 200 mg. 0 0
139 INH 100 mg (Program TB RO ) 0 0
140 INH 300 mg (Program TB RO ) 0 0
141 INH 300 mg (Program TB RO ) 0 0
Inhalasi Salbutamol Device
142 0 0
(Salbulin)
143 Inhaler Ventolin 0 0
144 Inviclot 0 0
145 Iodin Povidone 1 L 0 0
146 Isoniazid 300 mg (Program TB RO ) 0 0

147 Isonoasid 300 mg (Program TB RO ) 0 0


148 Isosorbid injeksi 10 mg 0 0
149 Isosorbit Dinitrat tab sublingal 5 mg. 0 0
150 Kaen 1 B  0 0
151 Kaen 3 B  0 0
152 Kalium Diklofenak 50 mg 0 0
153 Kalsium Laktat (Kalk) tab.500 mg. 0 0
154 Kaptopril 12,5 mg tablet 0 0
155 Kaptopril 25 mg tablet 0 0
156 Kidmin infus 0 0
157 Kloramfenikol 500 mg 0 0
158 Kloramfenikol Salep mata 0 0
159 Kloramfenikol tetes telinga 0 0
Klorfeniramin Maleat (CTM) tablet 4
160 0 0
mg.
161 Kodein 20 mg 0 0
162 Kotrimoksazol dewasa tablet 0 0
163 Kotrimoksazol suspensi 0 0
164 KSR 0 0
165 Lacto B 0 0
166 Lactulac sirup 0 0
Lamivudine (3TC) 150mg (Program
167 0 0
HIV)
168 lansoprazol capsul 0 0
169 Lansoprazol injeksi 0 0
170 Lantus 0 0
171 Levemir Insulin 0 0
172 Levodopa + Benserazide kombinasi 0 0
173 Levofloksasin tab 0 0
174 Levofloxacin infus 5mg/ml 0 0
175 Lidocain 2 % injeksi 0 0
Lidokain HCL0 Epinefrin Injeksi/amp
176 0 0
2 ml (PEHACAIN)

177 Linezolid 600 mg (Program TB RO ) 0 0


178 Loperamid tablet 0 0
179 Madopar tab/Levopar 0 0
180 Manitol infus 25 mL 0 0
181 Mecobalamin 500 mg 0 0
182 Meloksikam 15 mg 0 0
183 Meloxicam 15 mg 0 0
184 Mersibion inj 0 0
185 Metamizole Injeksi 0 0
186 Metamizole Tablet 500 mg 0 0
187 Metformin 500 mg 0 0
188 Metformin tab 850 mg 0 0
Metil Ergometrin (METERGIN
189 0 0
Injeksi)
190 Metil Prednisolon 125MG/ml INJ 0 0
191 Metil Prednisolon 4 mg 0 0
192 Metildopa tablet 0 0
193 Metoklo ramid 10 mg tab 0 0
194 Metronidazol 500 mg ovula 0 0
195 Metronidazol tablet 500 mg. 0 0
196 metronidazole infus 0 0
197 Mgso4 infus 0 0
198 Miconazole cream 0 0
199 Mineral Mix 0 0
200 Minosep Gargle 0 0
201 Misoprostol tab 0 0
Moxifloxacin 400 mg (Program TB
202 0 0
RO )
203 Mupirocin salep 0 0
204 NaCL 0.9%, 100 ml 0 0
205 NaCL 0.9%, 500 ml 0 0
206 Nalokson injeksi 0.4 mg 0 0
207 Natrium Bikarbonat tablet 0 0
208 Natrium Diklofenak 25 mg tab 0 0
209 Natrium Klorida 3% 0 0
210 Neurodex 0 0
Nevirapine (NVP) 200mg(Program
211 0 0
HIV )
212 Nifedipin 10 mg. tablet 0 0
213 Nikardipin injeksi 0 0
214 Nistatin 500.000 IU tablet salut 0 0
215 Nistatin drop 0 0
216 Nitrogliserin 5 mg 0 0
217 Nitrokaf retard 2.5 mg 0 0
218 Norepinefrine 1 mg/ml 0 0
219 Novomix insulin 0 0
220 Novorapid insulin 0 0
221 OAT Combivak (Program TB ) 0 0
Obat Anti Tubercolosis Anak
222 0 0
(Program TB )
Obat Anti Tuberkolosis Kategori I
223 0 0
(Program TB SO )
Obat Anti Tuberkolosis Kategori II
224 0 0
(Program TB )
225 OBH 0 0
226 Oksitosina injeksi 10 IU / ml01ml 0 0
227 Omeprazol 20 mg tab 0 0
228 Omeprazol injeksi 0 0
229 Ondansetron 4 mg Inj 0 0
230 Ondansetron 8 mg 0 0
231 Parasetamol drop 0 0
232 Parasetamol infus 0 0
233 Parasetamol sirup 120 mg/ 5 ml 0 0
234 Parasetamol Supp 125 mg 0 0
235 Parasetamol suppos 250 mg 0 0
236 Parasetamol tablet 500 mg. 0 0
237 Pioglitazon 0 0
238 Pirazinamid 500 mg (Program TB ) 0 0
239 Prednison 5 mg 0 0
Procain Penisilline (Program TB
240 0 0
RO )
Pseudoefedrin HCL 15 mg +
241 0 0
Terfenadine
242 Ramipril 5 Mg Tab  0 0
243 Ranitidin 150 mg 0 0
244 Ranitidin injeksi 0 0
245 Ranivel sirup 0 0
246 Requip tab 0 0
Rifampisin 450 mg tab (Program
247 0 0
TB )
248 Ringer Laktat 0 0
249 Risperidone 2 mg 0 0
250 Salbutamol 2 mg 0 0
251 Salbutamol 4 mg tab 0 0
252 Salisil Bedak 2 % 0 0
253 SANBE Baquinor 0.3% Tetes Mata 0 0
254 SANBE Forumen 0 0
255 SANBE Fukrisin ED 5 ml 0 0
256 SANBE Hyaloph Eye Drop 0 0
257 SANBE Otilon tetes telinga 0 0
258 Sefadroksil 500 mg kapsul 0 0
259 Sefadroksil sirup 0 0
260 Sefiksim 100 mg 0 0
261 Sefiksim 100 mg sirup 0 0
262 Sefiksim 200 mg 0 0
263 Sefotaksim injeksi 0 0
264 Seftriakson injeksi 0 0
265 Seretide Diskus (50/500) 0 0
266 Sertralin 50 mg 0 0
267 Setirizin 10 mg sirup 0 0
268 Setirizin 10 mg tab 0 0
269 Sevodex 0 0
270 Simarc 2 mg 0 0
271 Simvastatin 20 mg 0 0
272 Siprofloksasin 2% Infus 0 0
273 Siprofloksasin 500 mg tablet 0 0
274 SNMC Injeksi 0 0
275 Stesolid 10 mg 0 0
276 Stesolid 5 mg 0 0
277 Streptomycin 1 gr (Program TB ) 0 0
278 sukralfat tablet 0 0
279 Sulfadiazin krim 0 0
280 Tablet tambah darah kombinasi 0 0
TDF 300/3TC 300/DTG 50 (Program
281 0 0
HIV)
TDF/3TC/EFV(300/300/600)
282 0 0
(Program HIV)
283 Telmisartan 40 mg tab 0 0
Tenofovir (TDF) 300mg (Program
284 0 0
HIV)

285 Teofilin tab 150 mg (BRONSOLVAN) 0 0


286 Terbutalin Sulfat 0,5mg/ml Injeksi 0 0
287 Thiamfenikol 500 0 0

Tramadol 37,5 mg + Parasetamol


288 0 0
caps (ANALTRAM caps)

289 Tramadol inj 0 0


290 Trihexyphenidyl tab 0 0
291 Trilac (Triamcinolon) 0 0
292 Tuberculin PPD TEST 0 0

Urdafalk tab (URSODEOXYCHOLIC


293 0 0
ACID GENERIK)

294 Vaksin HB0 (Program VAKSIN) 0 0


Vaksin TD Single Use
295 0 0
(Program TB RO )
296 Valsartan 160 mg 0 0
297 Valsartan 80 mg 0 0
298 Vasacon 0 0
Vicilin SX serbuk injeksi (Ampisilin
299 0 0
Sulbactam)
300 Vitamin B Kompleks Tablet 0 0
301 Vitamin B6 0 0
302 Vitamin B6 0 0
303 Vitamin B6 10 mg 0 0
304 VITAMIN C INJEKSI 0 0
305 Vitamin D3 1000 iu 0 0
Vitamin Sirup anak
306 0 0
(UNIVIT/TIALISIN)
307 Water Steril 1 L 0 0
308 Xylocain 10% Spray 0 0
309 Xylocain Jelly 2% 0 0
Zidovudin (Zdv) 100 mg (Program
310 0 0
HIV)
Zidovudine (ZDV)/Lamivudine (3TC)
311 0 0
300/150mg (Program HIV)
312 Zinc Sirup 0 0
313 Abilify 15 mg (Aripriprazole) 0 0
314 Adalat Oros Tab 0 0
315 Allopurinol 300 mg 0 0
316 Ampicilin Inj 0 0
317 Antasida DOEN syr 0 0
318 ARDIUM 0 0
319 Aricept Evess (Donepezil 10mg) 0 0
320 Arixtra Inj 0 0
321 As. Valproat Sirup 0 0
322 Asam Folat tab 0 0
323 Asam Traneksamat 500 mg tab 0 0
324 Asering 500 ml 0 0
325 Atracurium Injeksi (Tramus Inj) 0 0
326 Attapulgite tablet 0 0
327 Betahistin 6 mg 0 0
328 Bisakodil tab 0 0
329 Bisoprolol 2.5 mg 0 0
330 CaCO3 0 0
331 Captopril 25 mg 0 0
332 Cefoperazone 0 0
333 Cendo Efrisel. 0 0
334 Cendo Siloxan 0 0
335 Cetadop inj (Dopamin) 0 0
336 Cetirizin Sirup 0 0
337 Cetirizin tab 0 0
338 Chloroquin 150 mg tablet 0 0
339 Chlorpromazin Tab 0 0
340 Citicolin tab. 0 0
341 Clobazam 10 mg 0 0
342 Clonazepam 2 mg tab 0 0
343 Clonidine tablet 0,15 mg 0 0
344 Clozapine 100 mg 0 0
345 Clozapine 25 mg 0 0
346 Concor 1,25 0 0
347 Deksametason inj 0 0
348 Diltiazem tablet 30 mg 0 0
349 Dobutamin Inj 0 0
350 Beraprost (Dorner) tab 0 0
351 Dulcolax supp 5 mg 0 0
352 Efedrin Injeksi 50 mg 0 0
353 Eperison tablet 0 0
354 Fenofibrate 100mg kap 0 0
355 Ferro-K Sirup 0 0
356 Fitomenadion tablet 10 mg 0 0
357 Flunarizine 10 mg tab 0 0
358 Fluoxetin Capsul 0 0
359 Gelofusin 0 0
360 Glimepirid 1 mg 0 0
361 Glimepirid 3 mg 0 0
362 Glimepiride 4 mg 0 0
363 Glucosamin Tab 0 0
364 Tamsolusin 0 0
365 Herbesser CD 100 mg 0 0
366 Hot In Cream DCL 0 0
367 HP PRO 0 0
368 Ibuprofen suspensi 0 0
369 KCL 7.46% 0 0
370 Ketamin Inj 0 0
371 Ketoconazol Tab 0 0
372 Ketokonazol Cr 0 0
373 Ketoprofen Supp 0 0
374 Ketorolac inj 30 mg 0 0
375 Klopidogrel 75 mg 0 0
376 Kolkisin tablet 0 0
377 Loratadine 10 mg 0 0
378 Meropenem Injeksi 0 0
379 Methosoprinol syr 0 0
380 Metil Ergometrin tab (Bledstop) 0 0
381 Metil Prednisolon 16 mg 0 0
382 Metoklopramid Injeksi 0 0
383 Meylon 0 0
384 Microlax 0 0
385 miniaspi 80mg 0 0
386 Multivitamin TABLET 0 0
387 Natrium Diklofenak 50 mg 0 0
388 Neostigmin inj 0 0
389 PK Serbuk 0 0
390 Pramifrol 0,375 MG tab 0 0
391 Propranolol 10 mg Tablet 0 0
392 Propranolol 40 mg 0 0
393 PTU tablet 100 mg 0 0
394 Pulmicort 0.25 Mg/ Ml  0 0
395 Ramipril 10 mg 0 0
396 Rebamipid. 0 0
397 Recofol 10 mg/ml 0 0
398 Rifampisin 600 mg tab 0 0
399 Rocuronium 10 mg/ml inj 0 0
400 Salbutamol 2 mg/5 ml Sirup 0 0
401 Seretide Diskus 50/250MCG. 0 0
402 Spironolakton 25 mg tab 0 0
403 Thrombopop Gel 0 0
404 Thiamzole 10 mg tab. 0 0
405 Triamsinolon inj 0 0
406 Carvedilol (Vbloc) 6,25 mg tab 0 0

Yang menyerahkan Yang menerima

Fezi kendri,Apt Putri Utami,Apt

PEMERINTAH PROVINSI DAERAH KHUSUS IBUKOTA JAKARTA


DINAS KESEHATAN
RUMAH SAKIT UMUM DAERAH CILINCING
Jalan Madya Kebantenan 1 Nomor 4, Cilincing. Telepon : 021 - 441 2889
Email : RSUDCilincing@gmail.com
JAKARTA
Kode Pos 14130

SURAT BUKTI BARANG KELUAR (SBBK)

Di berikan kepada
Nama/ NIP : Putri utami, Apt
Bagian : Apotek Rajal
Tanggal :

No Nama Barang Jumlah Harga


1 Acetazolamid 250 mg 0 0
2 Akarbose 100 mg 0 0
3 Akarbose 50 mg 0 0
4 Akilen tetes telinga 0 0
5 Albendazol sirup 0 0
6 ALBUMIN 25% 100 ML 0 0
7 Alprazolam Tablet 0,5 mg 0 0
8 Alupurinol tablet 100 mg. 0 0
9 Ambroxol 30 mg tab 0 0
10 Ambroxol sirup 0 0
Amikasin 1 gr injrksi (Program TB
11 0 0
RO )
12 AMINOFLUID 1000 mL/Bfluid 0 0
13 Aminopilin Injeksi. 0 0
14 Amiodarone HCL Injeksi 50 mg/ml 0 0
15 Amitriptilin 0 0
16 Amlodipin 10 mg 0 0
17 Amlodipin 5 mg 0 0
18 Amoksilin + As. Kalvulanat tablet 0 0
Amoksilin + Asam Klavulanat Sirup
19 0 0
(Claneksi Sirup)
20 Amoksilin drop 0 0
21 Amoksilin kapsul 250 mg. 0 0
22 Amoxillin kapsul 500 mg 0 0
23 Antasida DOEN tab.kombinasi 0 0
24 Anti Hemoroid 0 0
25 Aqua Pro injeksi 0 0
26 Aripirazol 10 mg 0 0
27 Asam Askorbat (Vit.C) tab.50 mg. 0 0
Asam Mefenamat 500 mg
28 0 0
tablet salut selaput
29 Asam traneksamat inj 0 0
Asetil sistein 100 mg Sirup
30 0 0
(Fluimucil Sirup)
31 Asetil sistein 200 mg 0 0
32 Asiklovir 200 mg tab 0 0
33 Asiklovir 400 mg. tablet 0 0
34 Asiklovir salep 0 0
35 Atenolol 50 mg 0 0
36 Atorvastain Calcium tab 20 mg 0 0
37 Atorvastatin 10 mg Tablet 0 0
38 Atropin sulfat Injeksi 0 0
39 Avamys Spray 0 0
40 Azitromisin 500 mg 0 0
41 Azitromisin sirup kering 200 mg 0 0
42 Bayclin 0 0
Bedaquiline 100 mg (Program TB
43 0 0
RO )
Betametason + Neomisin Krim
44 0 0
(Benoson N Krim)
45 Betametason krim 0,1 % 0 0
46 Biosat ATS 0 0
47 Bisoprolol 5 mg 0 0
48 Bricasma Injeksi (Terbutalin) 0 0
49 Bromheksin 8 mg 0 0
Bupivicain Injeksi (REGIVELL
50 0 0
Injeksi)
51 Calcium Gluconat 0 0
52 candesartan 16 mg 0 0
53 Candesartan 8 mg tab 0 0
54 Carbazocrome inj 0 0
55 Ceftazidim injeksi 0 0
56 Ceftriaxon injeksi 0 0
57 Cendo Asthenof 0 0
58 Cendo Catarlent 15 ml 0 0
59 Cendo Cenfresh Eye Drop 0 0
60 Cendo floxa Eye Drop 0 0
61 Cendo Lyteers 0 0
62 Cendo mata pantocain 0 0
63 Cendo Mydriatil Tetes Mata 0 0
64 Cendo polydex 0 0
65 Cendo Statrol 0 0
66 Cendo timol 0 0
67 Cendo Tropin 0.5% 0 0
68 Cendo Xitrol Eye Drop 0 0
69 Cendo Xitrol salep mata 3,5 Gram 0 0

Cilostazol Tablet 100 mg (Pletaal


70 0 0
Tablet)
71 Citicolin inj 0 0
72 Clindamisin 300 mg 0 0
73 Clindamycin caps 150 mg 0 0
74 Clotrimazole (Dermifar Krim) 0 0
75 Combiven Inhaler 0 0
76 Coparcetin 0 0
77 Curcuma tab 0 0
78 Deksametason tablet 0,5 mg. 0 0
79 Delamanid 50 mg (Program TB RO ) 0 0
80 Depakote ER 250 mg 0 0
81 Depakote ER 500 mg 0 0
Dextrometrophan + Gliseril
82 Guaiacolat + Phenylpropanolamin 0 0
HC + Chlo heniramine Maleat Tab
83 Diazepam 5 mg tablet 0 0
84 Diazepam Injeksi 0 0
Diazepam Rectal Tube 20 mg
85 0 0
(STEOLID 10)
Diazepam Rectal Tube 5 mg
86 0 0
(STESOLID 5)
87 Diazink tab 0 0
Digoksin injeksi 0,25 mg
88 0 0
(FARGOKSIN IV)
89 Digoksin tablet 0,25 mg. 0 0
90 Diltiazem 10 mg 0 0
91 Diphenhidramin injeksi 0 0
92 Dipsamol inhaler 0 0
93 Domperidon 0 0
94 Domperidon 10 mg sirup 0 0
95 Domperidon drop 0 0
96 Donepezile 0 0
97 Doxycyclin kapsul 100 mg. 0 0
98 Epinefrin injeksi 0 0
99 Eritromisin 500 mg tab 0 0
100 Etanol 70 % 1 liter 0 0
101 Ethambutol 400 mg (Program TB ) 0 0

Ethionamide 250 mg (Program TB


102 0 0
RO )
103 ethyl cloride 0 0
104 Euthyrox Tab 0 0
105 fenitoin injeksi 0 0
106 Fenitoin Kapsul 0 0
107 Fentanyl Injeksi 100 mcg/2ml Injeks 0 0
108 Ferriz drop 0 0
Fitomenadion (Vit.K10
109 0 0
inj.10mg/ml01ml
110 Flixotide 0 0
111 Flukonazole tab 0 0
112 Furosemid injeksi 0 0
113 Furosemid tab 0 0
114 Gabapentin 100 mg 0 0
115 Gabapentin 300 mg tab 0 0
116 Garam Oralit 200 ml air 0 0
117 Gemfibrozil Kapsul 300 mg 0 0
118 Gentamisin Cream Kulit 0 0
119 gentamisin injeksi 0 0
120 Glibenklamid 5 mg 0 0
121 Glikazid 80 mg 0 0
122 Glikuidon 30 Mg  0 0
123 glimepirid 2 mg 0 0
124 Glukosa 40% 0 0
125 Glukose larutan infus 10 % steril 0 0
126 Glukose larutan infus 5 % steril 0 0
127 Haloperidol 50 mg injeksi 0 0
128 Haloperidol tablet 5 mg 0 0
129 Herbesser injeksi 0 0
130 Hidonac Injeksi 2.5 g 0 0
Hidroklorotiazide (HCT) tablet 25
131 0 0
mg.
132 Hidrokortison cr 0 0
Human Tetanus Immunoglobulin 1
133 0 0
ml 250 IU (TETAGAM)
134 Hyoscine n Butil Bromide Injeksi 0 0
135 Hyosin N Butylbromide 10 mg 0 0
136 Ialuset plus 0 0
137 Ibuprofen tab 400 mg 0 0
138 Ibuprofen tablet 200 mg. 0 0
139 INH 100 mg (Program TB RO ) 0 0
140 INH 300 mg (Program TB RO ) 0 0
141 INH 300 mg (Program TB RO ) 0 0
Inhalasi Salbutamol Device
142 0 0
(Salbulin)
143 Inhaler Ventolin 0 0
144 Inviclot 0 0
145 Iodin Povidone 1 L 0 0
146 Isoniazid 300 mg (Program TB RO ) 0 0

147 Isonoasid 300 mg (Program TB RO ) 0 0


148 Isosorbid injeksi 10 mg 0 0
149 Isosorbit Dinitrat tab sublingal 5 mg. 0 0
150 Kaen 1 B  0 0
151 Kaen 3 B  0 0
152 Kalium Diklofenak 50 mg 0 0
153 Kalsium Laktat (Kalk) tab.500 mg. 0 0
154 Kaptopril 12,5 mg tablet 0 0
155 Kaptopril 25 mg tablet 0 0
156 Kidmin infus 0 0
157 Kloramfenikol 500 mg 0 0
158 Kloramfenikol Salep mata 0 0
159 Kloramfenikol tetes telinga 0 0
Klorfeniramin Maleat (CTM) tablet 4
160 0 0
mg.
161 Kodein 20 mg 0 0
162 Kotrimoksazol dewasa tablet 0 0
163 Kotrimoksazol suspensi 0 0
164 KSR 0 0
165 Lacto B 0 0
166 Lactulac sirup 0 0
Lamivudine (3TC) 150mg (Program
167 0 0
HIV)
168 lansoprazol capsul 0 0
169 Lansoprazol injeksi 0 0
170 Lantus 0 0
171 Levemir Insulin 0 0
172 Levodopa + Benserazide kombinasi 0 0
173 Levofloksasin tab 0 0
174 Levofloxacin infus 5mg/ml 0 0
175 Lidocain 2 % injeksi 0 0
Lidokain HCL0 Epinefrin Injeksi/amp
176 0 0
2 ml (PEHACAIN)

177 Linezolid 600 mg (Program TB RO ) 0 0


178 Loperamid tablet 0 0
179 Madopar tab/Levopar 0 0
180 Manitol infus 25 mL 0 0
181 Mecobalamin 500 mg 0 0
182 Meloksikam 15 mg 0 0
183 Meloxicam 15 mg 0 0
184 Mersibion inj 0 0
185 Metamizole Injeksi 0 0
186 Metamizole Tablet 500 mg 0 0
187 Metformin 500 mg 0 0
188 Metformin tab 850 mg 0 0
Metil Ergometrin (METERGIN
189 0 0
Injeksi)
190 Metil Prednisolon 125MG/ml INJ 0 0
191 Metil Prednisolon 4 mg 0 0
192 Metildopa tablet 0 0
193 Metoklo ramid 10 mg tab 0 0
194 Metronidazol 500 mg ovula 0 0
195 Metronidazol tablet 500 mg. 0 0
196 metronidazole infus 0 0
197 Mgso4 infus 0 0
198 Miconazole cream 0 0
199 Mineral Mix 0 0
200 Minosep Gargle 0 0
201 Misoprostol tab 0 0
Moxifloxacin 400 mg (Program TB
202 0 0
RO )
203 Mupirocin salep 0 0
204 NaCL 0.9%, 100 ml 0 0
205 NaCL 0.9%, 500 ml 0 0
206 Nalokson injeksi 0.4 mg 0 0
207 Natrium Bikarbonat tablet 0 0
208 Natrium Diklofenak 25 mg tab 0 0
209 Natrium Klorida 3% 0 0
210 Neurodex 0 0
Nevirapine (NVP) 200mg(Program
211 0 0
HIV )
212 Nifedipin 10 mg. tablet 0 0
213 Nikardipin injeksi 0 0
214 Nistatin 500.000 IU tablet salut 0 0
215 Nistatin drop 0 0
216 Nitrogliserin 5 mg 0 0
217 Nitrokaf retard 2.5 mg 0 0
218 Norepinefrine 1 mg/ml 0 0
219 Novomix insulin 0 0
220 Novorapid insulin 0 0
221 OAT Combivak (Program TB ) 0 0
Obat Anti Tubercolosis Anak
222 0 0
(Program TB )
Obat Anti Tuberkolosis Kategori I
223 0 0
(Program TB SO )
Obat Anti Tuberkolosis Kategori II
224 0 0
(Program TB )
225 OBH 0 0
226 Oksitosina injeksi 10 IU / ml01ml 0 0
227 Omeprazol 20 mg tab 0 0
228 Omeprazol injeksi 0 0
229 Ondansetron 4 mg Inj 0 0
230 Ondansetron 8 mg 0 0
231 Parasetamol drop 0 0
232 Parasetamol infus 0 0
233 Parasetamol sirup 120 mg/ 5 ml 0 0
234 Parasetamol Supp 125 mg 0 0
235 Parasetamol suppos 250 mg 0 0
236 Parasetamol tablet 500 mg. 0 0
237 Pioglitazon 0 0
238 Pirazinamid 500 mg (Program TB ) 0 0
239 Prednison 5 mg 0 0
Procain Penisilline (Program TB
240 0 0
RO )
Pseudoefedrin HCL 15 mg +
241 0 0
Terfenadine
242 Ramipril 5 Mg Tab  0 0
243 Ranitidin 150 mg 0 0
244 Ranitidin injeksi 0 0
245 Ranivel sirup 0 0
246 Requip tab 0 0
Rifampisin 450 mg tab (Program
247 0 0
TB )
248 Ringer Laktat 0 0
249 Risperidone 2 mg 0 0
250 Salbutamol 2 mg 0 0
251 Salbutamol 4 mg tab 0 0
252 Salisil Bedak 2 % 0 0
253 SANBE Baquinor 0.3% Tetes Mata 0 0
254 SANBE Forumen 0 0
255 SANBE Fukrisin ED 5 ml 0 0
256 SANBE Hyaloph Eye Drop 0 0
257 SANBE Otilon tetes telinga 0 0
258 Sefadroksil 500 mg kapsul 0 0
259 Sefadroksil sirup 0 0
260 Sefiksim 100 mg 0 0
261 Sefiksim 100 mg sirup 0 0
262 Sefiksim 200 mg 0 0
263 Sefotaksim injeksi 0 0
264 Seftriakson injeksi 0 0
265 Seretide Diskus (50/500) 0 0
266 Sertralin 50 mg 0 0
267 Setirizin 10 mg sirup 0 0
268 Setirizin 10 mg tab 0 0
269 Sevodex 0 0
270 Simarc 2 mg 0 0
271 Simvastatin 20 mg 0 0
272 Siprofloksasin 2% Infus 0 0
273 Siprofloksasin 500 mg tablet 0 0
274 SNMC Injeksi 0 0
275 Stesolid 10 mg 0 0
276 Stesolid 5 mg 0 0
277 Streptomycin 1 gr (Program TB ) 0 0
278 sukralfat tablet 0 0
279 Sulfadiazin krim 0 0
280 Tablet tambah darah kombinasi 0 0
TDF 300/3TC 300/DTG 50 (Program
281 0 0
HIV)
TDF/3TC/EFV(300/300/600)
282 0 0
(Program HIV)
283 Telmisartan 40 mg tab 0 0
Tenofovir (TDF) 300mg (Program
284 0 0
HIV)

285 Teofilin tab 150 mg (BRONSOLVAN) 0 0


286 Terbutalin Sulfat 0,5mg/ml Injeksi 0 0
287 Thiamfenikol 500 0 0

Tramadol 37,5 mg + Parasetamol


288 0 0
caps (ANALTRAM caps)

289 Tramadol inj 0 0


290 Trihexyphenidyl tab 0 0
291 Trilac (Triamcinolon) 0 0
292 Tuberculin PPD TEST 0 0

Urdafalk tab (URSODEOXYCHOLIC


293 0 0
ACID GENERIK)

294 Vaksin HB0 (Program VAKSIN) 0 0


Vaksin TD Single Use
295 0 0
(Program TB RO )
296 Valsartan 160 mg 0 0
297 Valsartan 80 mg 0 0
298 Vasacon 0 0
Vicilin SX serbuk injeksi (Ampisilin
299 0 0
Sulbactam)
300 Vitamin B Kompleks Tablet 0 0
301 Vitamin B6 0 0
302 Vitamin B6 0 0
303 Vitamin B6 10 mg 0 0
304 VITAMIN C INJEKSI 0 0
305 Vitamin D3 1000 iu 0 0
Vitamin Sirup anak
306 0 0
(UNIVIT/TIALISIN)
307 Water Steril 1 L 0 0
308 Xylocain 10% Spray 0 0
309 Xylocain Jelly 2% 0 0
Zidovudin (Zdv) 100 mg (Program
310 0 0
HIV)
Zidovudine (ZDV)/Lamivudine (3TC)
311 0 0
300/150mg (Program HIV)
312 Zinc Sirup 0 0
313 Abilify 15 mg (Aripriprazole) 0 0
314 Adalat Oros Tab 0 0
315 Allopurinol 300 mg 0 0
316 Ampicilin Inj 0 0
317 Antasida DOEN syr 0 0
318 ARDIUM 0 0
319 Aricept Evess (Donepezil 10mg) 0 0
320 Arixtra Inj 0 0
321 As. Valproat Sirup 0 0
322 Asam Folat tab 0 0
323 Asam Traneksamat 500 mg tab 0 0
324 Asering 500 ml 0 0
325 Atracurium Injeksi (Tramus Inj) 0 0
326 Attapulgite tablet 0 0
327 Betahistin 6 mg 0 0
328 Bisakodil tab 0 0
329 Bisoprolol 2.5 mg 0 0
330 CaCO3 0 0
331 Captopril 25 mg 0 0
332 Cefoperazone 0 0
333 Cendo Efrisel. 0 0
334 Cendo Siloxan 0 0
335 Cetadop inj (Dopamin) 0 0
336 Cetirizin Sirup 0 0
337 Cetirizin tab 0 0
338 Chloroquin 150 mg tablet 0 0
339 Chlorpromazin Tab 0 0
340 Citicolin tab. 0 0
341 Clobazam 10 mg 0 0
342 Clonazepam 2 mg tab 0 0
343 Clonidine tablet 0,15 mg 0 0
344 Clozapine 100 mg 0 0
345 Clozapine 25 mg 0 0
346 Concor 1,25 0 0
347 Deksametason inj 0 0
348 Diltiazem tablet 30 mg 0 0
349 Dobutamin Inj 0 0
350 Beraprost (Dorner) tab 0 0
351 Dulcolax supp 5 mg 0 0
352 Efedrin Injeksi 50 mg 0 0
353 Eperison tablet 0 0
354 Fenofibrate 100mg kap 0 0
355 Ferro-K Sirup 0 0
356 Fitomenadion tablet 10 mg 0 0
357 Flunarizine 10 mg tab 0 0
358 Fluoxetin Capsul 0 0
359 Gelofusin 0 0
360 Glimepirid 1 mg 0 0
361 Glimepirid 3 mg 0 0
362 Glimepiride 4 mg 0 0
363 Glucosamin Tab 0 0
364 Tamsolusin 0 0
365 Herbesser CD 100 mg 0 0
366 Hot In Cream DCL 0 0
367 HP PRO 0 0
368 Ibuprofen suspensi 0 0
369 KCL 7.46% 0 0
370 Ketamin Inj 0 0
371 Ketoconazol Tab 0 0
372 Ketokonazol Cr 0 0
373 Ketoprofen Supp 0 0
374 Ketorolac inj 30 mg 0 0
375 Klopidogrel 75 mg 0 0
376 Kolkisin tablet 0 0
377 Loratadine 10 mg 0 0
378 Meropenem Injeksi 0 0
379 Methosoprinol syr 0 0
380 Metil Ergometrin tab (Bledstop) 0 0
381 Metil Prednisolon 16 mg 0 0
382 Metoklopramid Injeksi 0 0
383 Meylon 0 0
384 Microlax 0 0
385 miniaspi 80mg 0 0
386 Multivitamin TABLET 0 0
387 Natrium Diklofenak 50 mg 0 0
388 Neostigmin inj 0 0
389 PK Serbuk 0 0
390 Pramifrol 0,375 MG tab 0 0
391 Propranolol 10 mg Tablet 0 0
392 Propranolol 40 mg 0 0
393 PTU tablet 100 mg 0 0
394 Pulmicort 0.25 Mg/ Ml  0 0
395 Ramipril 10 mg 0 0
396 Rebamipid. 0 0
397 Recofol 10 mg/ml 0 0
398 Rifampisin 600 mg tab 0 0
399 Rocuronium 10 mg/ml inj 0 0
400 Salbutamol 2 mg/5 ml Sirup 0 0
401 Seretide Diskus 50/250MCG. 0 0
402 Spironolakton 25 mg tab 0 0
403 Thrombopop Gel 0 0
404 Thiamzole 10 mg tab. 0 0
405 Triamsinolon inj 0 0
406 Carvedilol (Vbloc) 6,25 mg tab 0 0

Yang menyerahkan Yang menerima

Fezi kendri,Apt Putri Utami,Apt


JAKARTA

G
21 - 441 2889

s 14130

Keterangan
JAKARTA

G
21 - 441 2889
s 14130

Keterangan
JAKARTA

G
21 - 441 2889

s 14130
Keterangan
JAKARTA

G
21 - 441 2889

s 14130

Keterangan
PEMERINTAH PROVINSI DAERAH KHUSUS IBUKOTA JAKARTA
DINAS KESEHATAN
RUMAH SAKIT UMUM DAERAH CILINCING
Jalan Madya Kebantenan 1 Nomor 4, Cilincing. Telepon : 021 - 441 2889
Email : RSUDCilincing@gmail.com
JAKARTA
Kode Pos 14130

SURAT BUKTI BARANG KELUAR (SBBK)

Di berikan kepada
Nama/ NIP : Reinaldi Yudha, Apt
Bagian : Apotek Ranap
Tanggal :

No Nama Barang Jumlah Harga


1 Acetazolamid 250 mg 0 0
2 Akarbose 100 mg 0 0
3 Akarbose 50 mg 0 0
4 Akilen tetes telinga 0 0
5 Albendazol sirup 0 0
6 ALBUMIN 25% 100 ML 0 0
7 Alprazolam Tablet 0,5 mg 0 0
8 Alupurinol tablet 100 mg. 0 0
9 Ambroxol 30 mg tab 0 0
10 Ambroxol sirup 0 0
Amikasin 1 gr injrksi (Program TB
11 0 0
RO )
12 AMINOFLUID 1000 mL/Bfluid 0 0
13 Aminopilin Injeksi. 0 0
14 Amiodarone HCL Injeksi 50 mg/ml 0 0
15 Amitriptilin 0 0
16 Amlodipin 10 mg 0 0
17 Amlodipin 5 mg 0 0
18 Amoksilin + As. Kalvulanat tablet 0 0
Amoksilin + Asam Klavulanat Sirup
19 0 0
(Claneksi Sirup)
20 Amoksilin drop 0 0
21 Amoksilin kapsul 250 mg. 0 0
22 Amoxillin kapsul 500 mg 0 0
23 Antasida DOEN tab.kombinasi 0 0
24 Anti Hemoroid 0 0
25 Aqua Pro injeksi 0 0
26 Aripirazol 10 mg 0 0
27 Asam Askorbat (Vit.C) tab.50 mg. 0 0
Asam Mefenamat 500 mg
28 0 0
tablet salut selaput
29 Asam traneksamat inj 0 0
Asetil sistein 100 mg Sirup
30 0 0
(Fluimucil Sirup)
31 Asetil sistein 200 mg 0 0
32 Asiklovir 200 mg tab 0 0
33 Asiklovir 400 mg. tablet 0 0
34 Asiklovir salep 0 0
35 Atenolol 50 mg 0 0
36 Atorvastain Calcium tab 20 mg 0 0
37 Atorvastatin 10 mg Tablet 0 0
38 Atropin sulfat Injeksi 0 0
39 Avamys Spray 0 0
40 Azitromisin 500 mg 0 0
41 Azitromisin sirup kering 200 mg 0 0
42 Bayclin 0 0
Bedaquiline 100 mg (Program TB
43 0 0
RO )
Betametason + Neomisin Krim
44 0 0
(Benoson N Krim)
45 Betametason krim 0,1 % 0 0
46 Biosat ATS 0 0
47 Bisoprolol 5 mg 0 0
48 Bricasma Injeksi (Terbutalin) 0 0
49 Bromheksin 8 mg 0 0
Bupivicain Injeksi (REGIVELL
50 0 0
Injeksi)
51 Calcium Gluconat 0 0
52 candesartan 16 mg 0 0
53 Candesartan 8 mg tab 0 0
54 Carbazocrome inj 0 0
55 Ceftazidim injeksi 0 0
56 Ceftriaxon injeksi 0 0
57 Cendo Asthenof 0 0
58 Cendo Catarlent 15 ml 0 0
59 Cendo Cenfresh Eye Drop 0 0
60 Cendo floxa Eye Drop 0 0
61 Cendo Lyteers 0 0
62 Cendo mata pantocain 0 0
63 Cendo Mydriatil Tetes Mata 0 0
64 Cendo polydex 0 0
65 Cendo Statrol 0 0
66 Cendo timol 0 0
67 Cendo Tropin 0.5% 0 0
68 Cendo Xitrol Eye Drop 0 0
69 Cendo Xitrol salep mata 3,5 Gram 0 0

Cilostazol Tablet 100 mg (Pletaal


70 0 0
Tablet)
71 Citicolin inj 0 0
72 Clindamisin 300 mg 0 0
73 Clindamycin caps 150 mg 0 0
74 Clotrimazole (Dermifar Krim) 0 0
75 Combiven Inhaler 0 0
76 Coparcetin 0 0
77 Curcuma tab 0 0
78 Deksametason tablet 0,5 mg. 0 0
79 Delamanid 50 mg (Program TB RO ) 0 0
80 Depakote ER 250 mg 0 0
81 Depakote ER 500 mg 0 0
Dextrometrophan + Gliseril
82 Guaiacolat + Phenylpropanolamin 0 0
HC + Chlo heniramine Maleat Tab
83 Diazepam 5 mg tablet 0 0
84 Diazepam Injeksi 0 0
Diazepam Rectal Tube 20 mg
85 0 0
(STEOLID 10)
Diazepam Rectal Tube 5 mg
86 0 0
(STESOLID 5)
87 Diazink tab 0 0
Digoksin injeksi 0,25 mg
88 0 0
(FARGOKSIN IV)
89 Digoksin tablet 0,25 mg. 0 0
90 Diltiazem 10 mg 0 0
91 Diphenhidramin injeksi 0 0
92 Dipsamol inhaler 0 0
93 Domperidon 0 0
94 Domperidon 10 mg sirup 0 0
95 Domperidon drop 0 0
96 Donepezile 0 0
97 Doxycyclin kapsul 100 mg. 0 0
98 Epinefrin injeksi 0 0
99 Eritromisin 500 mg tab 0 0
100 Etanol 70 % 1 liter 0 0
101 Ethambutol 400 mg (Program TB ) 0 0
Ethionamide 250 mg (Program TB
102 0 0
RO )
103 ethyl cloride 0 0
104 Euthyrox Tab 0 0
105 fenitoin injeksi 0 0
106 Fenitoin Kapsul 0 0
107 Fentanyl Injeksi 100 mcg/2ml Injeks 0 0
108 Ferriz drop 0 0
Fitomenadion (Vit.K10
109 0 0
inj.10mg/ml01ml
110 Flixotide 0 0
111 Flukonazole tab 0 0
112 Furosemid injeksi 0 0
113 Furosemid tab 0 0
114 Gabapentin 100 mg 0 0
115 Gabapentin 300 mg tab 0 0
116 Garam Oralit 200 ml air 0 0
117 Gemfibrozil Kapsul 300 mg 0 0
118 Gentamisin Cream Kulit 0 0
119 gentamisin injeksi 0 0
120 Glibenklamid 5 mg 0 0
121 Glikazid 80 mg 0 0
122 Glikuidon 30 Mg  0 0
123 glimepirid 2 mg 0 0
124 Glukosa 40% 0 0
125 Glukose larutan infus 10 % steril 0 0
126 Glukose larutan infus 5 % steril 0 0
127 Haloperidol 50 mg injeksi 0 0
128 Haloperidol tablet 5 mg 0 0
129 Herbesser injeksi 0 0
130 Hidonac Injeksi 2.5 g 0 0
Hidroklorotiazide (HCT) tablet 25
131 0 0
mg.
132 Hidrokortison cr 0 0
Human Tetanus Immunoglobulin 1
133 0 0
ml 250 IU (TETAGAM)
134 Hyoscine n Butil Bromide Injeksi 0 0
135 Hyosin N Butylbromide 10 mg 0 0
136 Ialuset plus 0 0
137 Ibuprofen tab 400 mg 0 0
138 Ibuprofen tablet 200 mg. 0 0
139 INH 100 mg (Program TB RO ) 0 0
140 INH 300 mg (Program TB RO ) 0 0
141 INH 300 mg (Program TB RO ) 0 0
Inhalasi Salbutamol Device
142 0 0
(Salbulin)
143 Inhaler Ventolin 0 0
144 Inviclot 0 0
145 Iodin Povidone 1 L 0 0
146 Isoniazid 300 mg (Program TB RO ) 0 0

147 Isonoasid 300 mg (Program TB RO ) 0 0


148 Isosorbid injeksi 10 mg 0 0
149 Isosorbit Dinitrat tab sublingal 5 mg. 0 0
150 Kaen 1 B  0 0
151 Kaen 3 B  0 0
152 Kalium Diklofenak 50 mg 0 0
153 Kalsium Laktat (Kalk) tab.500 mg. 0 0
154 Kaptopril 12,5 mg tablet 0 0
155 Kaptopril 25 mg tablet 0 0
156 Kidmin infus 0 0
157 Kloramfenikol 500 mg 0 0
158 Kloramfenikol Salep mata 0 0
159 Kloramfenikol tetes telinga 0 0
Klorfeniramin Maleat (CTM) tablet 4
160 0 0
mg.
161 Kodein 20 mg 0 0
162 Kotrimoksazol dewasa tablet 0 0
163 Kotrimoksazol suspensi 0 0
164 KSR 0 0
165 Lacto B 0 0
166 Lactulac sirup 0 0
Lamivudine (3TC) 150mg (Program
167 0 0
HIV)
168 lansoprazol capsul 0 0
169 Lansoprazol injeksi 0 0
170 Lantus 0 0
171 Levemir Insulin 0 0
172 Levodopa + Benserazide kombinasi 0 0
173 Levofloksasin tab 0 0
174 Levofloxacin infus 5mg/ml 0 0
175 Lidocain 2 % injeksi 0 0
Lidokain HCL0 Epinefrin Injeksi/amp
176 0 0
2 ml (PEHACAIN)

177 Linezolid 600 mg (Program TB RO ) 0 0


178 Loperamid tablet 0 0
179 Madopar tab/Levopar 0 0
180 Manitol infus 25 mL 0 0
181 Mecobalamin 500 mg 0 0
182 Meloksikam 15 mg 0 0
183 Meloxicam 15 mg 0 0
184 Mersibion inj 0 0
185 Metamizole Injeksi 0 0
186 Metamizole Tablet 500 mg 0 0
187 Metformin 500 mg 0 0
188 Metformin tab 850 mg 0 0
Metil Ergometrin (METERGIN
189 0 0
Injeksi)
190 Metil Prednisolon 125MG/ml INJ 0 0
191 Metil Prednisolon 4 mg 0 0
192 Metildopa tablet 0 0
193 Metoklo ramid 10 mg tab 0 0
194 Metronidazol 500 mg ovula 0 0
195 Metronidazol tablet 500 mg. 0 0
196 metronidazole infus 0 0
197 Mgso4 infus 0 0
198 Miconazole cream 0 0
199 Mineral Mix 0 0
200 Minosep Gargle 0 0
201 Misoprostol tab 0 0
Moxifloxacin 400 mg (Program TB
202 0 0
RO )
203 Mupirocin salep 0 0
204 NaCL 0.9%, 100 ml 0 0
205 NaCL 0.9%, 500 ml 0 0
206 Nalokson injeksi 0.4 mg 0 0
207 Natrium Bikarbonat tablet 0 0
208 Natrium Diklofenak 25 mg tab 0 0
209 Natrium Klorida 3% 0 0
210 Neurodex 0 0
Nevirapine (NVP) 200mg(Program
211 0 0
HIV )
212 Nifedipin 10 mg. tablet 0 0
213 Nikardipin injeksi 0 0
214 Nistatin 500.000 IU tablet salut 0 0
215 Nistatin drop 0 0
216 Nitrogliserin 5 mg 0 0
217 Nitrokaf retard 2.5 mg 0 0
218 Norepinefrine 1 mg/ml 0 0
219 Novomix insulin 0 0
220 Novorapid insulin 0 0
221 OAT Combivak (Program TB ) 0 0
Obat Anti Tubercolosis Anak
222 0 0
(Program TB )
Obat Anti Tuberkolosis Kategori I
223 0 0
(Program TB SO )
Obat Anti Tuberkolosis Kategori II
224 0 0
(Program TB )
225 OBH 0 0
226 Oksitosina injeksi 10 IU / ml01ml 0 0
227 Omeprazol 20 mg tab 0 0
228 Omeprazol injeksi 0 0
229 Ondansetron 4 mg Inj 0 0
230 Ondansetron 8 mg 0 0
231 Parasetamol drop 0 0
232 Parasetamol infus 0 0
233 Parasetamol sirup 120 mg/ 5 ml 0 0
234 Parasetamol Supp 125 mg 0 0
235 Parasetamol suppos 250 mg 0 0
236 Parasetamol tablet 500 mg. 0 0
237 Pioglitazon 0 0
238 Pirazinamid 500 mg (Program TB ) 0 0
239 Prednison 5 mg 0 0
Procain Penisilline (Program TB
240 0 0
RO )
Pseudoefedrin HCL 15 mg +
241 0 0
Terfenadine
242 Ramipril 5 Mg Tab  0 0
243 Ranitidin 150 mg 0 0
244 Ranitidin injeksi 0 0
245 Ranivel sirup 0 0
246 Requip tab 0 0
Rifampisin 450 mg tab (Program
247 0 0
TB )
248 Ringer Laktat 0 0
249 Risperidone 2 mg 0 0
250 Salbutamol 2 mg 0 0
251 Salbutamol 4 mg tab 0 0
252 Salisil Bedak 2 % 0 0
253 SANBE Baquinor 0.3% Tetes Mata 0 0
254 SANBE Forumen 0 0
255 SANBE Fukrisin ED 5 ml 0 0
256 SANBE Hyaloph Eye Drop 0 0
257 SANBE Otilon tetes telinga 0 0
258 Sefadroksil 500 mg kapsul 0 0
259 Sefadroksil sirup 0 0
260 Sefiksim 100 mg 0 0
261 Sefiksim 100 mg sirup 0 0
262 Sefiksim 200 mg 0 0
263 Sefotaksim injeksi 0 0
264 Seftriakson injeksi 0 0
265 Seretide Diskus (50/500) 0 0
266 Sertralin 50 mg 0 0
267 Setirizin 10 mg sirup 0 0
268 Setirizin 10 mg tab 0 0
269 Sevodex 0 0
270 Simarc 2 mg 0 0
271 Simvastatin 20 mg 0 0
272 Siprofloksasin 2% Infus 0 0
273 Siprofloksasin 500 mg tablet 0 0
274 SNMC Injeksi 0 0
275 Stesolid 10 mg 0 0
276 Stesolid 5 mg 0 0
277 Streptomycin 1 gr (Program TB ) 0 0
278 sukralfat tablet 0 0
279 Sulfadiazin krim 0 0
280 Tablet tambah darah kombinasi 0 0
TDF 300/3TC 300/DTG 50 (Program
281 0 0
HIV)
TDF/3TC/EFV(300/300/600)
282 0 0
(Program HIV)
283 Telmisartan 40 mg tab 0 0
Tenofovir (TDF) 300mg (Program
284 0 0
HIV)

285 Teofilin tab 150 mg (BRONSOLVAN) 0 0


286 Terbutalin Sulfat 0,5mg/ml Injeksi 0 0
287 Thiamfenikol 500 0 0

Tramadol 37,5 mg + Parasetamol


288 0 0
caps (ANALTRAM caps)

289 Tramadol inj 0 0


290 Trihexyphenidyl tab 0 0
291 Trilac (Triamcinolon) 0 0
292 Tuberculin PPD TEST 0 0

Urdafalk tab (URSODEOXYCHOLIC


293 0 0
ACID GENERIK)

294 Vaksin HB0 (Program VAKSIN) 0 0


Vaksin TD Single Use
295 0 0
(Program TB RO )
296 Valsartan 160 mg 0 0
297 Valsartan 80 mg 0 0
298 Vasacon 0 0
Vicilin SX serbuk injeksi (Ampisilin
299 0 0
Sulbactam)
300 Vitamin B Kompleks Tablet 0 0
301 Vitamin B6 0 0
302 Vitamin B6 0 0
303 Vitamin B6 10 mg 0 0
304 VITAMIN C INJEKSI 0 0
305 Vitamin D3 1000 iu 0 0
Vitamin Sirup anak
306 0 0
(UNIVIT/TIALISIN)
307 Water Steril 1 L 0 0
308 Xylocain 10% Spray 0 0
309 Xylocain Jelly 2% 0 0
Zidovudin (Zdv) 100 mg (Program
310 0 0
HIV)
Zidovudine (ZDV)/Lamivudine (3TC)
311 0 0
300/150mg (Program HIV)
312 Zinc Sirup 0 0
313 Abilify 15 mg (Aripriprazole) 0 0
314 Adalat Oros Tab 0 0
315 Allopurinol 300 mg 0 0
316 Ampicilin Inj 0 0
317 Antasida DOEN syr 0 0
318 ARDIUM 0 0
319 Aricept Evess (Donepezil 10mg) 0 0
320 Arixtra Inj 0 0
321 As. Valproat Sirup 0 0
322 Asam Folat tab 0 0
323 Asam Traneksamat 500 mg tab 0 0
324 Asering 500 ml 0 0
325 Atracurium Injeksi (Tramus Inj) 0 0
326 Attapulgite tablet 0 0
327 Betahistin 6 mg 0 0
328 Bisakodil tab 0 0
329 Bisoprolol 2.5 mg 0 0
330 CaCO3 0 0
331 Captopril 25 mg 0 0
332 Cefoperazone 0 0
333 Cendo Efrisel. 0 0
334 Cendo Siloxan 0 0
335 Cetadop inj (Dopamin) 0 0
336 Cetirizin Sirup 0 0
337 Cetirizin tab 0 0
338 Chloroquin 150 mg tablet 0 0
339 Chlorpromazin Tab 0 0
340 Citicolin tab. 0 0
341 Clobazam 10 mg 0 0
342 Clonazepam 2 mg tab 0 0
343 Clonidine tablet 0,15 mg 0 0
344 Clozapine 100 mg 0 0
345 Clozapine 25 mg 0 0
346 Concor 1,25 0 0
347 Deksametason inj 0 0
348 Diltiazem tablet 30 mg 0 0
349 Dobutamin Inj 0 0
350 Beraprost (Dorner) tab 0 0
351 Dulcolax supp 5 mg 0 0
352 Efedrin Injeksi 50 mg 0 0
353 Eperison tablet 0 0
354 Fenofibrate 100mg kap 0 0
355 Ferro-K Sirup 0 0
356 Fitomenadion tablet 10 mg 0 0
357 Flunarizine 10 mg tab 0 0
358 Fluoxetin Capsul 0 0
359 Gelofusin 0 0
360 Glimepirid 1 mg 0 0
361 Glimepirid 3 mg 0 0
362 Glimepiride 4 mg 0 0
363 Glucosamin Tab 0 0
364 Tamsolusin 0 0
365 Herbesser CD 100 mg 0 0
366 Hot In Cream DCL 0 0
367 HP PRO 0 0
368 Ibuprofen suspensi 0 0
369 KCL 7.46% 0 0
370 Ketamin Inj 0 0
371 Ketoconazol Tab 0 0
372 Ketokonazol Cr 0 0
373 Ketoprofen Supp 0 0
374 Ketorolac inj 30 mg 0 0
375 Klopidogrel 75 mg 0 0
376 Kolkisin tablet 0 0
377 Loratadine 10 mg 0 0
378 Meropenem Injeksi 0 0
379 Methosoprinol syr 0 0
380 Metil Ergometrin tab (Bledstop) 0 0
381 Metil Prednisolon 16 mg 0 0
382 Metoklopramid Injeksi 0 0
383 Meylon 0 0
384 Microlax 0 0
385 miniaspi 80mg 0 0
386 Multivitamin TABLET 0 0
387 Natrium Diklofenak 50 mg 0 0
388 Neostigmin inj 0 0
389 PK Serbuk 0 0
390 Pramifrol 0,375 MG tab 0 0
391 Propranolol 10 mg Tablet 0 0
392 Propranolol 40 mg 0 0
393 PTU tablet 100 mg 0 0
394 Pulmicort 0.25 Mg/ Ml  0 0
395 Ramipril 10 mg 0 0
396 Rebamipid. 0 0
397 Recofol 10 mg/ml 0 0
398 Rifampisin 600 mg tab 0 0
399 Rocuronium 10 mg/ml inj 0 0
400 Salbutamol 2 mg/5 ml Sirup 0 0
401 Seretide Diskus 50/250MCG. 0 0
402 Spironolakton 25 mg tab 0 0
403 Thrombopop Gel 0 0
404 Thiamzole 10 mg tab. 0 0
405 Triamsinolon inj 0 0
406 Carvedilol (Vbloc) 6,25 mg tab 0 0

Yang menyerahkan Yang menerima

Fezi kendri,Apt Reinaldi Yudha, Apt

PEMERINTAH PROVINSI DAERAH KHUSUS IBUKOTA JAKARTA


DINAS KESEHATAN
RUMAH SAKIT UMUM DAERAH CILINCING
Jalan Madya Kebantenan 1 Nomor 4, Cilincing. Telepon : 021 - 441 2889
Email : RSUDCilincing@gmail.com
JAKARTA
Kode Pos 14130

SURAT BUKTI BARANG KELUAR (SBBK)

Di berikan kepada
Nama/ NIP : Reinaldi Yudha, Apt
Bagian : Apotek Ranap
Tanggal :

No Nama Barang Jumlah Harga


1 Acetazolamid 250 mg 0 0
2 Akarbose 100 mg 0 0
3 Akarbose 50 mg 0 0
4 Akilen tetes telinga 0 0
5 Albendazol sirup 0 0
6 ALBUMIN 25% 100 ML 0 0
7 Alprazolam Tablet 0,5 mg 0 0
8 Alupurinol tablet 100 mg. 0 0
9 Ambroxol 30 mg tab 0 0
10 Ambroxol sirup 0 0
Amikasin 1 gr injrksi (Program TB
11 0 0
RO )
12 AMINOFLUID 1000 mL/Bfluid 0 0
13 Aminopilin Injeksi. 0 0
14 Amiodarone HCL Injeksi 50 mg/ml 0 0
15 Amitriptilin 0 0
16 Amlodipin 10 mg 0 0
17 Amlodipin 5 mg 0 0
18 Amoksilin + As. Kalvulanat tablet 0 0
Amoksilin + Asam Klavulanat Sirup
19 0 0
(Claneksi Sirup)
20 Amoksilin drop 0 0
21 Amoksilin kapsul 250 mg. 0 0
22 Amoxillin kapsul 500 mg 0 0
23 Antasida DOEN tab.kombinasi 0 0
24 Anti Hemoroid 0 0
25 Aqua Pro injeksi 0 0
26 Aripirazol 10 mg 0 0
27 Asam Askorbat (Vit.C) tab.50 mg. 0 0
Asam Mefenamat 500 mg
28 0 0
tablet salut selaput
29 Asam traneksamat inj 0 0
Asetil sistein 100 mg Sirup
30 0 0
(Fluimucil Sirup)
31 Asetil sistein 200 mg 0 0
32 Asiklovir 200 mg tab 0 0
33 Asiklovir 400 mg. tablet 0 0
34 Asiklovir salep 0 0
35 Atenolol 50 mg 0 0
36 Atorvastain Calcium tab 20 mg 0 0
37 Atorvastatin 10 mg Tablet 0 0
38 Atropin sulfat Injeksi 0 0
39 Avamys Spray 0 0
40 Azitromisin 500 mg 0 0
41 Azitromisin sirup kering 200 mg 0 0
42 Bayclin 0 0
Bedaquiline 100 mg (Program TB
43 0 0
RO )
Betametason + Neomisin Krim
44 0 0
(Benoson N Krim)
45 Betametason krim 0,1 % 0 0
46 Biosat ATS 0 0
47 Bisoprolol 5 mg 0 0
48 Bricasma Injeksi (Terbutalin) 0 0
49 Bromheksin 8 mg 0 0
Bupivicain Injeksi (REGIVELL
50 0 0
Injeksi)
51 Calcium Gluconat 0 0
52 candesartan 16 mg 0 0
53 Candesartan 8 mg tab 0 0
54 Carbazocrome inj 0 0
55 Ceftazidim injeksi 0 0
56 Ceftriaxon injeksi 0 0
57 Cendo Asthenof 0 0
58 Cendo Catarlent 15 ml 0 0
59 Cendo Cenfresh Eye Drop 0 0
60 Cendo floxa Eye Drop 0 0
61 Cendo Lyteers 0 0
62 Cendo mata pantocain 0 0
63 Cendo Mydriatil Tetes Mata 0 0
64 Cendo polydex 0 0
65 Cendo Statrol 0 0
66 Cendo timol 0 0
67 Cendo Tropin 0.5% 0 0
68 Cendo Xitrol Eye Drop 0 0
69 Cendo Xitrol salep mata 3,5 Gram 0 0
Cilostazol Tablet 100 mg (Pletaal
70 0 0
Tablet)
71 Citicolin inj 0 0
72 Clindamisin 300 mg 0 0
73 Clindamycin caps 150 mg 0 0
74 Clotrimazole (Dermifar Krim) 0 0
75 Combiven Inhaler 0 0
76 Coparcetin 0 0
77 Curcuma tab 0 0
78 Deksametason tablet 0,5 mg. 0 0
79 Delamanid 50 mg (Program TB RO ) 0 0
80 Depakote ER 250 mg 0 0
81 Depakote ER 500 mg 0 0
Dextrometrophan + Gliseril
82 Guaiacolat + Phenylpropanolamin 0 0
HC + Chlo heniramine Maleat Tab
83 Diazepam 5 mg tablet 0 0
84 Diazepam Injeksi 0 0
Diazepam Rectal Tube 20 mg
85 0 0
(STEOLID 10)
Diazepam Rectal Tube 5 mg
86 0 0
(STESOLID 5)
87 Diazink tab 0 0
Digoksin injeksi 0,25 mg
88 0 0
(FARGOKSIN IV)
89 Digoksin tablet 0,25 mg. 0 0
90 Diltiazem 10 mg 0 0
91 Diphenhidramin injeksi 0 0
92 Dipsamol inhaler 0 0
93 Domperidon 0 0
94 Domperidon 10 mg sirup 0 0
95 Domperidon drop 0 0
96 Donepezile 0 0
97 Doxycyclin kapsul 100 mg. 0 0
98 Epinefrin injeksi 0 0
99 Eritromisin 500 mg tab 0 0
100 Etanol 70 % 1 liter 0 0
101 Ethambutol 400 mg (Program TB ) 0 0

Ethionamide 250 mg (Program TB


102 0 0
RO )
103 ethyl cloride 0 0
104 Euthyrox Tab 0 0
105 fenitoin injeksi 0 0
106 Fenitoin Kapsul 0 0
107 Fentanyl Injeksi 100 mcg/2ml Injeks 0 0
108 Ferriz drop 0 0
Fitomenadion (Vit.K10
109 0 0
inj.10mg/ml01ml
110 Flixotide 0 0
111 Flukonazole tab 0 0
112 Furosemid injeksi 0 0
113 Furosemid tab 0 0
114 Gabapentin 100 mg 0 0
115 Gabapentin 300 mg tab 0 0
116 Garam Oralit 200 ml air 0 0
117 Gemfibrozil Kapsul 300 mg 0 0
118 Gentamisin Cream Kulit 0 0
119 gentamisin injeksi 0 0
120 Glibenklamid 5 mg 0 0
121 Glikazid 80 mg 0 0
122 Glikuidon 30 Mg  0 0
123 glimepirid 2 mg 0 0
124 Glukosa 40% 0 0
125 Glukose larutan infus 10 % steril 0 0
126 Glukose larutan infus 5 % steril 0 0
127 Haloperidol 50 mg injeksi 0 0
128 Haloperidol tablet 5 mg 0 0
129 Herbesser injeksi 0 0
130 Hidonac Injeksi 2.5 g 0 0
Hidroklorotiazide (HCT) tablet 25
131 0 0
mg.
132 Hidrokortison cr 0 0
Human Tetanus Immunoglobulin 1
133 0 0
ml 250 IU (TETAGAM)
134 Hyoscine n Butil Bromide Injeksi 0 0
135 Hyosin N Butylbromide 10 mg 0 0
136 Ialuset plus 0 0
137 Ibuprofen tab 400 mg 0 0
138 Ibuprofen tablet 200 mg. 0 0
139 INH 100 mg (Program TB RO ) 0 0
140 INH 300 mg (Program TB RO ) 0 0
141 INH 300 mg (Program TB RO ) 0 0
Inhalasi Salbutamol Device
142 0 0
(Salbulin)
143 Inhaler Ventolin 0 0
144 Inviclot 0 0
145 Iodin Povidone 1 L 0 0
146 Isoniazid 300 mg (Program TB RO ) 0 0
147 Isonoasid 300 mg (Program TB RO ) 0 0
148 Isosorbid injeksi 10 mg 0 0
149 Isosorbit Dinitrat tab sublingal 5 mg. 0 0
150 Kaen 1 B  0 0
151 Kaen 3 B  0 0
152 Kalium Diklofenak 50 mg 0 0
153 Kalsium Laktat (Kalk) tab.500 mg. 0 0
154 Kaptopril 12,5 mg tablet 0 0
155 Kaptopril 25 mg tablet 0 0
156 Kidmin infus 0 0
157 Kloramfenikol 500 mg 0 0
158 Kloramfenikol Salep mata 0 0
159 Kloramfenikol tetes telinga 0 0
Klorfeniramin Maleat (CTM) tablet 4
160 0 0
mg.
161 Kodein 20 mg 0 0
162 Kotrimoksazol dewasa tablet 0 0
163 Kotrimoksazol suspensi 0 0
164 KSR 0 0
165 Lacto B 0 0
166 Lactulac sirup 0 0
Lamivudine (3TC) 150mg (Program
167 0 0
HIV)
168 lansoprazol capsul 0 0
169 Lansoprazol injeksi 0 0
170 Lantus 0 0
171 Levemir Insulin 0 0
172 Levodopa + Benserazide kombinasi 0 0
173 Levofloksasin tab 0 0
174 Levofloxacin infus 5mg/ml 0 0
175 Lidocain 2 % injeksi 0 0
Lidokain HCL0 Epinefrin Injeksi/amp
176 0 0
2 ml (PEHACAIN)

177 Linezolid 600 mg (Program TB RO ) 0 0


178 Loperamid tablet 0 0
179 Madopar tab/Levopar 0 0
180 Manitol infus 25 mL 0 0
181 Mecobalamin 500 mg 0 0
182 Meloksikam 15 mg 0 0
183 Meloxicam 15 mg 0 0
184 Mersibion inj 0 0
185 Metamizole Injeksi 0 0
186 Metamizole Tablet 500 mg 0 0
187 Metformin 500 mg 0 0
188 Metformin tab 850 mg 0 0
Metil Ergometrin (METERGIN
189 0 0
Injeksi)
190 Metil Prednisolon 125MG/ml INJ 0 0
191 Metil Prednisolon 4 mg 0 0
192 Metildopa tablet 0 0
193 Metoklo ramid 10 mg tab 0 0
194 Metronidazol 500 mg ovula 0 0
195 Metronidazol tablet 500 mg. 0 0
196 metronidazole infus 0 0
197 Mgso4 infus 0 0
198 Miconazole cream 0 0
199 Mineral Mix 0 0
200 Minosep Gargle 0 0
201 Misoprostol tab 0 0
Moxifloxacin 400 mg (Program TB
202 0 0
RO )
203 Mupirocin salep 0 0
204 NaCL 0.9%, 100 ml 0 0
205 NaCL 0.9%, 500 ml 0 0
206 Nalokson injeksi 0.4 mg 0 0
207 Natrium Bikarbonat tablet 0 0
208 Natrium Diklofenak 25 mg tab 0 0
209 Natrium Klorida 3% 0 0
210 Neurodex 0 0
Nevirapine (NVP) 200mg(Program
211 0 0
HIV )
212 Nifedipin 10 mg. tablet 0 0
213 Nikardipin injeksi 0 0
214 Nistatin 500.000 IU tablet salut 0 0
215 Nistatin drop 0 0
216 Nitrogliserin 5 mg 0 0
217 Nitrokaf retard 2.5 mg 0 0
218 Norepinefrine 1 mg/ml 0 0
219 Novomix insulin 0 0
220 Novorapid insulin 0 0
221 OAT Combivak (Program TB ) 0 0
Obat Anti Tubercolosis Anak
222 0 0
(Program TB )
Obat Anti Tuberkolosis Kategori I
223 0 0
(Program TB SO )
Obat Anti Tuberkolosis Kategori II
224 0 0
(Program TB )
225 OBH 0 0
226 Oksitosina injeksi 10 IU / ml01ml 0 0
227 Omeprazol 20 mg tab 0 0
228 Omeprazol injeksi 0 0
229 Ondansetron 4 mg Inj 0 0
230 Ondansetron 8 mg 0 0
231 Parasetamol drop 0 0
232 Parasetamol infus 0 0
233 Parasetamol sirup 120 mg/ 5 ml 0 0
234 Parasetamol Supp 125 mg 0 0
235 Parasetamol suppos 250 mg 0 0
236 Parasetamol tablet 500 mg. 0 0
237 Pioglitazon 0 0
238 Pirazinamid 500 mg (Program TB ) 0 0
239 Prednison 5 mg 0 0
Procain Penisilline (Program TB
240 0 0
RO )
Pseudoefedrin HCL 15 mg +
241 0 0
Terfenadine
242 Ramipril 5 Mg Tab  0 0
243 Ranitidin 150 mg 0 0
244 Ranitidin injeksi 0 0
245 Ranivel sirup 0 0
246 Requip tab 0 0
Rifampisin 450 mg tab (Program
247 0 0
TB )
248 Ringer Laktat 0 0
249 Risperidone 2 mg 0 0
250 Salbutamol 2 mg 0 0
251 Salbutamol 4 mg tab 0 0
252 Salisil Bedak 2 % 0 0
253 SANBE Baquinor 0.3% Tetes Mata 0 0
254 SANBE Forumen 0 0
255 SANBE Fukrisin ED 5 ml 0 0
256 SANBE Hyaloph Eye Drop 0 0
257 SANBE Otilon tetes telinga 0 0
258 Sefadroksil 500 mg kapsul 0 0
259 Sefadroksil sirup 0 0
260 Sefiksim 100 mg 0 0
261 Sefiksim 100 mg sirup 0 0
262 Sefiksim 200 mg 0 0
263 Sefotaksim injeksi 0 0
264 Seftriakson injeksi 0 0
265 Seretide Diskus (50/500) 0 0
266 Sertralin 50 mg 0 0
267 Setirizin 10 mg sirup 0 0
268 Setirizin 10 mg tab 0 0
269 Sevodex 0 0
270 Simarc 2 mg 0 0
271 Simvastatin 20 mg 0 0
272 Siprofloksasin 2% Infus 0 0
273 Siprofloksasin 500 mg tablet 0 0
274 SNMC Injeksi 0 0
275 Stesolid 10 mg 0 0
276 Stesolid 5 mg 0 0
277 Streptomycin 1 gr (Program TB ) 0 0
278 sukralfat tablet 0 0
279 Sulfadiazin krim 0 0
280 Tablet tambah darah kombinasi 0 0
TDF 300/3TC 300/DTG 50 (Program
281 0 0
HIV)
TDF/3TC/EFV(300/300/600)
282 0 0
(Program HIV)
283 Telmisartan 40 mg tab 0 0
Tenofovir (TDF) 300mg (Program
284 0 0
HIV)

285 Teofilin tab 150 mg (BRONSOLVAN) 0 0


286 Terbutalin Sulfat 0,5mg/ml Injeksi 0 0
287 Thiamfenikol 500 0 0

Tramadol 37,5 mg + Parasetamol


288 0 0
caps (ANALTRAM caps)

289 Tramadol inj 0 0


290 Trihexyphenidyl tab 0 0
291 Trilac (Triamcinolon) 0 0
292 Tuberculin PPD TEST 0 0

Urdafalk tab (URSODEOXYCHOLIC


293 0 0
ACID GENERIK)

294 Vaksin HB0 (Program VAKSIN) 0 0


Vaksin TD Single Use
295 0 0
(Program TB RO )
296 Valsartan 160 mg 0 0
297 Valsartan 80 mg 0 0
298 Vasacon 0 0
Vicilin SX serbuk injeksi (Ampisilin
299 0 0
Sulbactam)
300 Vitamin B Kompleks Tablet 0 0
301 Vitamin B6 0 0
302 Vitamin B6 0 0
303 Vitamin B6 10 mg 0 0
304 VITAMIN C INJEKSI 0 0
305 Vitamin D3 1000 iu 0 0
Vitamin Sirup anak
306 0 0
(UNIVIT/TIALISIN)
307 Water Steril 1 L 0 0
308 Xylocain 10% Spray 0 0
309 Xylocain Jelly 2% 0 0
Zidovudin (Zdv) 100 mg (Program
310 0 0
HIV)
Zidovudine (ZDV)/Lamivudine (3TC)
311 0 0
300/150mg (Program HIV)
312 Zinc Sirup 0 0
313 Abilify 15 mg (Aripriprazole) 0 0
314 Adalat Oros Tab 0 0
315 Allopurinol 300 mg 0 0
316 Ampicilin Inj 0 0
317 Antasida DOEN syr 0 0
318 ARDIUM 0 0
319 Aricept Evess (Donepezil 10mg) 0 0
320 Arixtra Inj 0 0
321 As. Valproat Sirup 0 0
322 Asam Folat tab 0 0
323 Asam Traneksamat 500 mg tab 0 0
324 Asering 500 ml 0 0
325 Atracurium Injeksi (Tramus Inj) 0 0
326 Attapulgite tablet 0 0
327 Betahistin 6 mg 0 0
328 Bisakodil tab 0 0
329 Bisoprolol 2.5 mg 0 0
330 CaCO3 0 0
331 Captopril 25 mg 0 0
332 Cefoperazone 0 0
333 Cendo Efrisel. 0 0
334 Cendo Siloxan 0 0
335 Cetadop inj (Dopamin) 0 0
336 Cetirizin Sirup 0 0
337 Cetirizin tab 0 0
338 Chloroquin 150 mg tablet 0 0
339 Chlorpromazin Tab 0 0
340 Citicolin tab. 0 0
341 Clobazam 10 mg 0 0
342 Clonazepam 2 mg tab 0 0
343 Clonidine tablet 0,15 mg 0 0
344 Clozapine 100 mg 0 0
345 Clozapine 25 mg 0 0
346 Concor 1,25 0 0
347 Deksametason inj 0 0
348 Diltiazem tablet 30 mg 0 0
349 Dobutamin Inj 0 0
350 Beraprost (Dorner) tab 0 0
351 Dulcolax supp 5 mg 0 0
352 Efedrin Injeksi 50 mg 0 0
353 Eperison tablet 0 0
354 Fenofibrate 100mg kap 0 0
355 Ferro-K Sirup 0 0
356 Fitomenadion tablet 10 mg 0 0
357 Flunarizine 10 mg tab 0 0
358 Fluoxetin Capsul 0 0
359 Gelofusin 0 0
360 Glimepirid 1 mg 0 0
361 Glimepirid 3 mg 0 0
362 Glimepiride 4 mg 0 0
363 Glucosamin Tab 0 0
364 Tamsolusin 0 0
365 Herbesser CD 100 mg 0 0
366 Hot In Cream DCL 0 0
367 HP PRO 0 0
368 Ibuprofen suspensi 0 0
369 KCL 7.46% 0 0
370 Ketamin Inj 0 0
371 Ketoconazol Tab 0 0
372 Ketokonazol Cr 0 0
373 Ketoprofen Supp 0 0
374 Ketorolac inj 30 mg 0 0
375 Klopidogrel 75 mg 0 0
376 Kolkisin tablet 0 0
377 Loratadine 10 mg 0 0
378 Meropenem Injeksi 0 0
379 Methosoprinol syr 0 0
380 Metil Ergometrin tab (Bledstop) 0 0
381 Metil Prednisolon 16 mg 0 0
382 Metoklopramid Injeksi 0 0
383 Meylon 0 0
384 Microlax 0 0
385 miniaspi 80mg 0 0
386 Multivitamin TABLET 0 0
387 Natrium Diklofenak 50 mg 0 0
388 Neostigmin inj 0 0
389 PK Serbuk 0 0
390 Pramifrol 0,375 MG tab 0 0
391 Propranolol 10 mg Tablet 0 0
392 Propranolol 40 mg 0 0
393 PTU tablet 100 mg 0 0
394 Pulmicort 0.25 Mg/ Ml  0 0
395 Ramipril 10 mg 0 0
396 Rebamipid. 0 0
397 Recofol 10 mg/ml 0 0
398 Rifampisin 600 mg tab 0 0
399 Rocuronium 10 mg/ml inj 0 0
400 Salbutamol 2 mg/5 ml Sirup 0 0
401 Seretide Diskus 50/250MCG. 0 0
402 Spironolakton 25 mg tab 0 0
403 Thrombopop Gel 0 0
404 Thiamzole 10 mg tab. 0 0
405 Triamsinolon inj 0 0
406 Carvedilol (Vbloc) 6,25 mg tab 0 0

Yang menyerahkan Yang menerima

Fezi kendri,Apt Reinaldi Yudha, Apt

PEMERINTAH PROVINSI DAERAH KHUSUS IBUKOTA JAKARTA


DINAS KESEHATAN
RUMAH SAKIT UMUM DAERAH CILINCING
Jalan Madya Kebantenan 1 Nomor 4, Cilincing. Telepon : 021 - 441 2889
Email : RSUDCilincing@gmail.com
JAKARTA
Kode Pos 14130

SURAT BUKTI BARANG KELUAR (SBBK)

Di berikan kepada
Nama/ NIP : Reinaldi Yudha, Apt
Bagian : Apotek Ranap
Tanggal :

No Nama Barang Jumlah Harga


1 Acetazolamid 250 mg 0 0
2 Akarbose 100 mg 0 0
3 Akarbose 50 mg 0 0
4 Akilen tetes telinga 0 0
5 Albendazol sirup 0 0
6 ALBUMIN 25% 100 ML 0 0
7 Alprazolam Tablet 0,5 mg 0 0
8 Alupurinol tablet 100 mg. 0 0
9 Ambroxol 30 mg tab 0 0
10 Ambroxol sirup 0 0
Amikasin 1 gr injrksi (Program TB
11 0 0
RO )
12 AMINOFLUID 1000 mL/Bfluid 0 0
13 Aminopilin Injeksi. 0 0
14 Amiodarone HCL Injeksi 50 mg/ml 0 0
15 Amitriptilin 0 0
16 Amlodipin 10 mg 0 0
17 Amlodipin 5 mg 0 0
18 Amoksilin + As. Kalvulanat tablet 0 0
Amoksilin + Asam Klavulanat Sirup
19 0 0
(Claneksi Sirup)
20 Amoksilin drop 0 0
21 Amoksilin kapsul 250 mg. 0 0
22 Amoxillin kapsul 500 mg 0 0
23 Antasida DOEN tab.kombinasi 0 0
24 Anti Hemoroid 0 0
25 Aqua Pro injeksi 0 0
26 Aripirazol 10 mg 0 0
27 Asam Askorbat (Vit.C) tab.50 mg. 0 0
Asam Mefenamat 500 mg
28 0 0
tablet salut selaput
29 Asam traneksamat inj 0 0
Asetil sistein 100 mg Sirup
30 0 0
(Fluimucil Sirup)
31 Asetil sistein 200 mg 0 0
32 Asiklovir 200 mg tab 0 0
33 Asiklovir 400 mg. tablet 0 0
34 Asiklovir salep 0 0
35 Atenolol 50 mg 0 0
36 Atorvastain Calcium tab 20 mg 0 0
37 Atorvastatin 10 mg Tablet 0 0
38 Atropin sulfat Injeksi 0 0
39 Avamys Spray 0 0
40 Azitromisin 500 mg 0 0
41 Azitromisin sirup kering 200 mg 0 0
42 Bayclin 0 0
Bedaquiline 100 mg (Program TB
43 0 0
RO )
Betametason + Neomisin Krim
44 0 0
(Benoson N Krim)
45 Betametason krim 0,1 % 0 0
46 Biosat ATS 0 0
47 Bisoprolol 5 mg 0 0
48 Bricasma Injeksi (Terbutalin) 0 0
49 Bromheksin 8 mg 0 0
Bupivicain Injeksi (REGIVELL
50 0 0
Injeksi)
51 Calcium Gluconat 0 0
52 candesartan 16 mg 0 0
53 Candesartan 8 mg tab 0 0
54 Carbazocrome inj 0 0
55 Ceftazidim injeksi 0 0
56 Ceftriaxon injeksi 0 0
57 Cendo Asthenof 0 0
58 Cendo Catarlent 15 ml 0 0
59 Cendo Cenfresh Eye Drop 0 0
60 Cendo floxa Eye Drop 0 0
61 Cendo Lyteers 0 0
62 Cendo mata pantocain 0 0
63 Cendo Mydriatil Tetes Mata 0 0
64 Cendo polydex 0 0
65 Cendo Statrol 0 0
66 Cendo timol 0 0
67 Cendo Tropin 0.5% 0 0
68 Cendo Xitrol Eye Drop 0 0
69 Cendo Xitrol salep mata 3,5 Gram 0 0

Cilostazol Tablet 100 mg (Pletaal


70 0 0
Tablet)
71 Citicolin inj 0 0
72 Clindamisin 300 mg 0 0
73 Clindamycin caps 150 mg 0 0
74 Clotrimazole (Dermifar Krim) 0 0
75 Combiven Inhaler 0 0
76 Coparcetin 0 0
77 Curcuma tab 0 0
78 Deksametason tablet 0,5 mg. 0 0
79 Delamanid 50 mg (Program TB RO ) 0 0
80 Depakote ER 250 mg 0 0
81 Depakote ER 500 mg 0 0
Dextrometrophan + Gliseril
82 Guaiacolat + Phenylpropanolamin 0 0
HC + Chlo heniramine Maleat Tab
83 Diazepam 5 mg tablet 0 0
84 Diazepam Injeksi 0 0
Diazepam Rectal Tube 20 mg
85 0 0
(STEOLID 10)
Diazepam Rectal Tube 5 mg
86 0 0
(STESOLID 5)
87 Diazink tab 0 0
Digoksin injeksi 0,25 mg
88 0 0
(FARGOKSIN IV)
89 Digoksin tablet 0,25 mg. 0 0
90 Diltiazem 10 mg 0 0
91 Diphenhidramin injeksi 0 0
92 Dipsamol inhaler 0 0
93 Domperidon 0 0
94 Domperidon 10 mg sirup 0 0
95 Domperidon drop 0 0
96 Donepezile 0 0
97 Doxycyclin kapsul 100 mg. 0 0
98 Epinefrin injeksi 0 0
99 Eritromisin 500 mg tab 0 0
100 Etanol 70 % 1 liter 0 0
101 Ethambutol 400 mg (Program TB ) 0 0

Ethionamide 250 mg (Program TB


102 0 0
RO )
103 ethyl cloride 0 0
104 Euthyrox Tab 0 0
105 fenitoin injeksi 0 0
106 Fenitoin Kapsul 0 0
107 Fentanyl Injeksi 100 mcg/2ml Injeks 0 0
108 Ferriz drop 0 0
Fitomenadion (Vit.K10
109 0 0
inj.10mg/ml01ml
110 Flixotide 0 0
111 Flukonazole tab 0 0
112 Furosemid injeksi 0 0
113 Furosemid tab 0 0
114 Gabapentin 100 mg 0 0
115 Gabapentin 300 mg tab 0 0
116 Garam Oralit 200 ml air 0 0
117 Gemfibrozil Kapsul 300 mg 0 0
118 Gentamisin Cream Kulit 0 0
119 gentamisin injeksi 0 0
120 Glibenklamid 5 mg 0 0
121 Glikazid 80 mg 0 0
122 Glikuidon 30 Mg  0 0
123 glimepirid 2 mg 0 0
124 Glukosa 40% 0 0
125 Glukose larutan infus 10 % steril 0 0
126 Glukose larutan infus 5 % steril 0 0
127 Haloperidol 50 mg injeksi 0 0
128 Haloperidol tablet 5 mg 0 0
129 Herbesser injeksi 0 0
130 Hidonac Injeksi 2.5 g 0 0
Hidroklorotiazide (HCT) tablet 25
131 0 0
mg.
132 Hidrokortison cr 0 0
Human Tetanus Immunoglobulin 1
133 0 0
ml 250 IU (TETAGAM)
134 Hyoscine n Butil Bromide Injeksi 0 0
135 Hyosin N Butylbromide 10 mg 0 0
136 Ialuset plus 0 0
137 Ibuprofen tab 400 mg 0 0
138 Ibuprofen tablet 200 mg. 0 0
139 INH 100 mg (Program TB RO ) 0 0
140 INH 300 mg (Program TB RO ) 0 0
141 INH 300 mg (Program TB RO ) 0 0
Inhalasi Salbutamol Device
142 0 0
(Salbulin)
143 Inhaler Ventolin 0 0
144 Inviclot 0 0
145 Iodin Povidone 1 L 0 0
146 Isoniazid 300 mg (Program TB RO ) 0 0

147 Isonoasid 300 mg (Program TB RO ) 0 0


148 Isosorbid injeksi 10 mg 0 0
149 Isosorbit Dinitrat tab sublingal 5 mg. 0 0
150 Kaen 1 B  0 0
151 Kaen 3 B  0 0
152 Kalium Diklofenak 50 mg 0 0
153 Kalsium Laktat (Kalk) tab.500 mg. 0 0
154 Kaptopril 12,5 mg tablet 0 0
155 Kaptopril 25 mg tablet 0 0
156 Kidmin infus 0 0
157 Kloramfenikol 500 mg 0 0
158 Kloramfenikol Salep mata 0 0
159 Kloramfenikol tetes telinga 0 0
Klorfeniramin Maleat (CTM) tablet 4
160 0 0
mg.
161 Kodein 20 mg 0 0
162 Kotrimoksazol dewasa tablet 0 0
163 Kotrimoksazol suspensi 0 0
164 KSR 0 0
165 Lacto B 0 0
166 Lactulac sirup 0 0
Lamivudine (3TC) 150mg (Program
167 0 0
HIV)
168 lansoprazol capsul 0 0
169 Lansoprazol injeksi 0 0
170 Lantus 0 0
171 Levemir Insulin 0 0
172 Levodopa + Benserazide kombinasi 0 0
173 Levofloksasin tab 0 0
174 Levofloxacin infus 5mg/ml 0 0
175 Lidocain 2 % injeksi 0 0
Lidokain HCL0 Epinefrin Injeksi/amp
176 0 0
2 ml (PEHACAIN)

177 Linezolid 600 mg (Program TB RO ) 0 0


178 Loperamid tablet 0 0
179 Madopar tab/Levopar 0 0
180 Manitol infus 25 mL 0 0
181 Mecobalamin 500 mg 0 0
182 Meloksikam 15 mg 0 0
183 Meloxicam 15 mg 0 0
184 Mersibion inj 0 0
185 Metamizole Injeksi 0 0
186 Metamizole Tablet 500 mg 0 0
187 Metformin 500 mg 0 0
188 Metformin tab 850 mg 0 0
Metil Ergometrin (METERGIN
189 0 0
Injeksi)
190 Metil Prednisolon 125MG/ml INJ 0 0
191 Metil Prednisolon 4 mg 0 0
192 Metildopa tablet 0 0
193 Metoklo ramid 10 mg tab 0 0
194 Metronidazol 500 mg ovula 0 0
195 Metronidazol tablet 500 mg. 0 0
196 metronidazole infus 0 0
197 Mgso4 infus 0 0
198 Miconazole cream 0 0
199 Mineral Mix 0 0
200 Minosep Gargle 0 0
201 Misoprostol tab 0 0
Moxifloxacin 400 mg (Program TB
202 0 0
RO )
203 Mupirocin salep 0 0
204 NaCL 0.9%, 100 ml 0 0
205 NaCL 0.9%, 500 ml 0 0
206 Nalokson injeksi 0.4 mg 0 0
207 Natrium Bikarbonat tablet 0 0
208 Natrium Diklofenak 25 mg tab 0 0
209 Natrium Klorida 3% 0 0
210 Neurodex 0 0
Nevirapine (NVP) 200mg(Program
211 0 0
HIV )
212 Nifedipin 10 mg. tablet 0 0
213 Nikardipin injeksi 0 0
214 Nistatin 500.000 IU tablet salut 0 0
215 Nistatin drop 0 0
216 Nitrogliserin 5 mg 0 0
217 Nitrokaf retard 2.5 mg 0 0
218 Norepinefrine 1 mg/ml 0 0
219 Novomix insulin 0 0
220 Novorapid insulin 0 0
221 OAT Combivak (Program TB ) 0 0
Obat Anti Tubercolosis Anak
222 0 0
(Program TB )
Obat Anti Tuberkolosis Kategori I
223 0 0
(Program TB SO )
Obat Anti Tuberkolosis Kategori II
224 0 0
(Program TB )
225 OBH 0 0
226 Oksitosina injeksi 10 IU / ml01ml 0 0
227 Omeprazol 20 mg tab 0 0
228 Omeprazol injeksi 0 0
229 Ondansetron 4 mg Inj 0 0
230 Ondansetron 8 mg 0 0
231 Parasetamol drop 0 0
232 Parasetamol infus 0 0
233 Parasetamol sirup 120 mg/ 5 ml 0 0
234 Parasetamol Supp 125 mg 0 0
235 Parasetamol suppos 250 mg 0 0
236 Parasetamol tablet 500 mg. 0 0
237 Pioglitazon 0 0
238 Pirazinamid 500 mg (Program TB ) 0 0
239 Prednison 5 mg 0 0
Procain Penisilline (Program TB
240 0 0
RO )
Pseudoefedrin HCL 15 mg +
241 0 0
Terfenadine
242 Ramipril 5 Mg Tab  0 0
243 Ranitidin 150 mg 0 0
244 Ranitidin injeksi 0 0
245 Ranivel sirup 0 0
246 Requip tab 0 0
Rifampisin 450 mg tab (Program
247 0 0
TB )
248 Ringer Laktat 0 0
249 Risperidone 2 mg 0 0
250 Salbutamol 2 mg 0 0
251 Salbutamol 4 mg tab 0 0
252 Salisil Bedak 2 % 0 0
253 SANBE Baquinor 0.3% Tetes Mata 0 0
254 SANBE Forumen 0 0
255 SANBE Fukrisin ED 5 ml 0 0
256 SANBE Hyaloph Eye Drop 0 0
257 SANBE Otilon tetes telinga 0 0
258 Sefadroksil 500 mg kapsul 0 0
259 Sefadroksil sirup 0 0
260 Sefiksim 100 mg 0 0
261 Sefiksim 100 mg sirup 0 0
262 Sefiksim 200 mg 0 0
263 Sefotaksim injeksi 0 0
264 Seftriakson injeksi 0 0
265 Seretide Diskus (50/500) 0 0
266 Sertralin 50 mg 0 0
267 Setirizin 10 mg sirup 0 0
268 Setirizin 10 mg tab 0 0
269 Sevodex 0 0
270 Simarc 2 mg 0 0
271 Simvastatin 20 mg 0 0
272 Siprofloksasin 2% Infus 0 0
273 Siprofloksasin 500 mg tablet 0 0
274 SNMC Injeksi 0 0
275 Stesolid 10 mg 0 0
276 Stesolid 5 mg 0 0
277 Streptomycin 1 gr (Program TB ) 0 0
278 sukralfat tablet 0 0
279 Sulfadiazin krim 0 0
280 Tablet tambah darah kombinasi 0 0
TDF 300/3TC 300/DTG 50 (Program
281 0 0
HIV)
TDF/3TC/EFV(300/300/600)
282 0 0
(Program HIV)
283 Telmisartan 40 mg tab 0 0
Tenofovir (TDF) 300mg (Program
284 0 0
HIV)

285 Teofilin tab 150 mg (BRONSOLVAN) 0 0


286 Terbutalin Sulfat 0,5mg/ml Injeksi 0 0
287 Thiamfenikol 500 0 0

Tramadol 37,5 mg + Parasetamol


288 0 0
caps (ANALTRAM caps)

289 Tramadol inj 0 0


290 Trihexyphenidyl tab 0 0
291 Trilac (Triamcinolon) 0 0
292 Tuberculin PPD TEST 0 0

Urdafalk tab (URSODEOXYCHOLIC


293 0 0
ACID GENERIK)

294 Vaksin HB0 (Program VAKSIN) 0 0


Vaksin TD Single Use
295 0 0
(Program TB RO )
296 Valsartan 160 mg 0 0
297 Valsartan 80 mg 0 0
298 Vasacon 0 0
Vicilin SX serbuk injeksi (Ampisilin
299 0 0
Sulbactam)
300 Vitamin B Kompleks Tablet 0 0
301 Vitamin B6 0 0
302 Vitamin B6 0 0
303 Vitamin B6 10 mg 0 0
304 VITAMIN C INJEKSI 0 0
305 Vitamin D3 1000 iu 0 0
Vitamin Sirup anak
306 0 0
(UNIVIT/TIALISIN)
307 Water Steril 1 L 0 0
308 Xylocain 10% Spray 0 0
309 Xylocain Jelly 2% 0 0
Zidovudin (Zdv) 100 mg (Program
310 0 0
HIV)
Zidovudine (ZDV)/Lamivudine (3TC)
311 0 0
300/150mg (Program HIV)
312 Zinc Sirup 0 0
313 Abilify 15 mg (Aripriprazole) 0 0
314 Adalat Oros Tab 0 0
315 Allopurinol 300 mg 0 0
316 Ampicilin Inj 0 0
317 Antasida DOEN syr 0 0
318 ARDIUM 0 0
319 Aricept Evess (Donepezil 10mg) 0 0
320 Arixtra Inj 0 0
321 As. Valproat Sirup 0 0
322 Asam Folat tab 0 0
323 Asam Traneksamat 500 mg tab 0 0
324 Asering 500 ml 0 0
325 Atracurium Injeksi (Tramus Inj) 0 0
326 Attapulgite tablet 0 0
327 Betahistin 6 mg 0 0
328 Bisakodil tab 0 0
329 Bisoprolol 2.5 mg 0 0
330 CaCO3 0 0
331 Captopril 25 mg 0 0
332 Cefoperazone 0 0
333 Cendo Efrisel. 0 0
334 Cendo Siloxan 0 0
335 Cetadop inj (Dopamin) 0 0
336 Cetirizin Sirup 0 0
337 Cetirizin tab 0 0
338 Chloroquin 150 mg tablet 0 0
339 Chlorpromazin Tab 0 0
340 Citicolin tab. 0 0
341 Clobazam 10 mg 0 0
342 Clonazepam 2 mg tab 0 0
343 Clonidine tablet 0,15 mg 0 0
344 Clozapine 100 mg 0 0
345 Clozapine 25 mg 0 0
346 Concor 1,25 0 0
347 Deksametason inj 0 0
348 Diltiazem tablet 30 mg 0 0
349 Dobutamin Inj 0 0
350 Beraprost (Dorner) tab 0 0
351 Dulcolax supp 5 mg 0 0
352 Efedrin Injeksi 50 mg 0 0
353 Eperison tablet 0 0
354 Fenofibrate 100mg kap 0 0
355 Ferro-K Sirup 0 0
356 Fitomenadion tablet 10 mg 0 0
357 Flunarizine 10 mg tab 0 0
358 Fluoxetin Capsul 0 0
359 Gelofusin 0 0
360 Glimepirid 1 mg 0 0
361 Glimepirid 3 mg 0 0
362 Glimepiride 4 mg 0 0
363 Glucosamin Tab 0 0
364 Tamsolusin 0 0
365 Herbesser CD 100 mg 0 0
366 Hot In Cream DCL 0 0
367 HP PRO 0 0
368 Ibuprofen suspensi 0 0
369 KCL 7.46% 0 0
370 Ketamin Inj 0 0
371 Ketoconazol Tab 0 0
372 Ketokonazol Cr 0 0
373 Ketoprofen Supp 0 0
374 Ketorolac inj 30 mg 0 0
375 Klopidogrel 75 mg 0 0
376 Kolkisin tablet 0 0
377 Loratadine 10 mg 0 0
378 Meropenem Injeksi 0 0
379 Methosoprinol syr 0 0
380 Metil Ergometrin tab (Bledstop) 0 0
381 Metil Prednisolon 16 mg 0 0
382 Metoklopramid Injeksi 0 0
383 Meylon 0 0
384 Microlax 0 0
385 miniaspi 80mg 0 0
386 Multivitamin TABLET 0 0
387 Natrium Diklofenak 50 mg 0 0
388 Neostigmin inj 0 0
389 PK Serbuk 0 0
390 Pramifrol 0,375 MG tab 0 0
391 Propranolol 10 mg Tablet 0 0
392 Propranolol 40 mg 0 0
393 PTU tablet 100 mg 0 0
394 Pulmicort 0.25 Mg/ Ml  0 0
395 Ramipril 10 mg 0 0
396 Rebamipid. 0 0
397 Recofol 10 mg/ml 0 0
398 Rifampisin 600 mg tab 0 0
399 Rocuronium 10 mg/ml inj 0 0
400 Salbutamol 2 mg/5 ml Sirup 0 0
401 Seretide Diskus 50/250MCG. 0 0
402 Spironolakton 25 mg tab 0 0
403 Thrombopop Gel 0 0
404 Thiamzole 10 mg tab. 0 0
405 Triamsinolon inj 0 0
406 Carvedilol (Vbloc) 6,25 mg tab 0 0

Yang menyerahkan Yang menerima

Fezi kendri,Apt Reinaldi Yudha, Apt

PEMERINTAH PROVINSI DAERAH KHUSUS IBUKOTA JAKARTA


DINAS KESEHATAN
RUMAH SAKIT UMUM DAERAH CILINCING
Jalan Madya Kebantenan 1 Nomor 4, Cilincing. Telepon : 021 - 441 2889
Email : RSUDCilincing@gmail.com
JAKARTA
Kode Pos 14130

SURAT BUKTI BARANG KELUAR (SBBK)

Di berikan kepada
Nama/ NIP : Reinaldi Yudha, Apt
Bagian : Apotek Ranap
Tanggal :

No Nama Barang Jumlah Harga


1 Acetazolamid 250 mg 0 0
2 Akarbose 100 mg 0 0
3 Akarbose 50 mg 0 0
4 Akilen tetes telinga 0 0
5 Albendazol sirup 0 0
6 ALBUMIN 25% 100 ML 0 0
7 Alprazolam Tablet 0,5 mg 0 0
8 Alupurinol tablet 100 mg. 0 0
9 Ambroxol 30 mg tab 0 0
10 Ambroxol sirup 0 0
Amikasin 1 gr injrksi (Program TB
11 0 0
RO )
12 AMINOFLUID 1000 mL/Bfluid 0 0
13 Aminopilin Injeksi. 0 0
14 Amiodarone HCL Injeksi 50 mg/ml 0 0
15 Amitriptilin 0 0
16 Amlodipin 10 mg 0 0
17 Amlodipin 5 mg 0 0
18 Amoksilin + As. Kalvulanat tablet 0 0
Amoksilin + Asam Klavulanat Sirup
19 0 0
(Claneksi Sirup)
20 Amoksilin drop 0 0
21 Amoksilin kapsul 250 mg. 0 0
22 Amoxillin kapsul 500 mg 0 0
23 Antasida DOEN tab.kombinasi 0 0
24 Anti Hemoroid 0 0
25 Aqua Pro injeksi 0 0
26 Aripirazol 10 mg 0 0
27 Asam Askorbat (Vit.C) tab.50 mg. 0 0
Asam Mefenamat 500 mg
28 0 0
tablet salut selaput
29 Asam traneksamat inj 0 0
Asetil sistein 100 mg Sirup
30 0 0
(Fluimucil Sirup)
31 Asetil sistein 200 mg 0 0
32 Asiklovir 200 mg tab 0 0
33 Asiklovir 400 mg. tablet 0 0
34 Asiklovir salep 0 0
35 Atenolol 50 mg 0 0
36 Atorvastain Calcium tab 20 mg 0 0
37 Atorvastatin 10 mg Tablet 0 0
38 Atropin sulfat Injeksi 0 0
39 Avamys Spray 0 0
40 Azitromisin 500 mg 0 0
41 Azitromisin sirup kering 200 mg 0 0
42 Bayclin 0 0
Bedaquiline 100 mg (Program TB
43 0 0
RO )
Betametason + Neomisin Krim
44 0 0
(Benoson N Krim)
45 Betametason krim 0,1 % 0 0
46 Biosat ATS 0 0
47 Bisoprolol 5 mg 0 0
48 Bricasma Injeksi (Terbutalin) 0 0
49 Bromheksin 8 mg 0 0
Bupivicain Injeksi (REGIVELL
50 0 0
Injeksi)
51 Calcium Gluconat 0 0
52 candesartan 16 mg 0 0
53 Candesartan 8 mg tab 0 0
54 Carbazocrome inj 0 0
55 Ceftazidim injeksi 0 0
56 Ceftriaxon injeksi 0 0
57 Cendo Asthenof 0 0
58 Cendo Catarlent 15 ml 0 0
59 Cendo Cenfresh Eye Drop 0 0
60 Cendo floxa Eye Drop 0 0
61 Cendo Lyteers 0 0
62 Cendo mata pantocain 0 0
63 Cendo Mydriatil Tetes Mata 0 0
64 Cendo polydex 0 0
65 Cendo Statrol 0 0
66 Cendo timol 0 0
67 Cendo Tropin 0.5% 0 0
68 Cendo Xitrol Eye Drop 0 0
69 Cendo Xitrol salep mata 3,5 Gram 0 0

Cilostazol Tablet 100 mg (Pletaal


70 0 0
Tablet)
71 Citicolin inj 0 0
72 Clindamisin 300 mg 0 0
73 Clindamycin caps 150 mg 0 0
74 Clotrimazole (Dermifar Krim) 0 0
75 Combiven Inhaler 0 0
76 Coparcetin 0 0
77 Curcuma tab 0 0
78 Deksametason tablet 0,5 mg. 0 0
79 Delamanid 50 mg (Program TB RO ) 0 0
80 Depakote ER 250 mg 0 0
81 Depakote ER 500 mg 0 0
Dextrometrophan + Gliseril
82 Guaiacolat + Phenylpropanolamin 0 0
HC + Chlo heniramine Maleat Tab
83 Diazepam 5 mg tablet 0 0
84 Diazepam Injeksi 0 0
Diazepam Rectal Tube 20 mg
85 0 0
(STEOLID 10)
Diazepam Rectal Tube 5 mg
86 0 0
(STESOLID 5)
87 Diazink tab 0 0
Digoksin injeksi 0,25 mg
88 0 0
(FARGOKSIN IV)
89 Digoksin tablet 0,25 mg. 0 0
90 Diltiazem 10 mg 0 0
91 Diphenhidramin injeksi 0 0
92 Dipsamol inhaler 0 0
93 Domperidon 0 0
94 Domperidon 10 mg sirup 0 0
95 Domperidon drop 0 0
96 Donepezile 0 0
97 Doxycyclin kapsul 100 mg. 0 0
98 Epinefrin injeksi 0 0
99 Eritromisin 500 mg tab 0 0
100 Etanol 70 % 1 liter 0 0
101 Ethambutol 400 mg (Program TB ) 0 0

Ethionamide 250 mg (Program TB


102 0 0
RO )
103 ethyl cloride 0 0
104 Euthyrox Tab 0 0
105 fenitoin injeksi 0 0
106 Fenitoin Kapsul 0 0
107 Fentanyl Injeksi 100 mcg/2ml Injeks 0 0
108 Ferriz drop 0 0
Fitomenadion (Vit.K10
109 0 0
inj.10mg/ml01ml
110 Flixotide 0 0
111 Flukonazole tab 0 0
112 Furosemid injeksi 0 0
113 Furosemid tab 0 0
114 Gabapentin 100 mg 0 0
115 Gabapentin 300 mg tab 0 0
116 Garam Oralit 200 ml air 0 0
117 Gemfibrozil Kapsul 300 mg 0 0
118 Gentamisin Cream Kulit 0 0
119 gentamisin injeksi 0 0
120 Glibenklamid 5 mg 0 0
121 Glikazid 80 mg 0 0
122 Glikuidon 30 Mg  0 0
123 glimepirid 2 mg 0 0
124 Glukosa 40% 0 0
125 Glukose larutan infus 10 % steril 0 0
126 Glukose larutan infus 5 % steril 0 0
127 Haloperidol 50 mg injeksi 0 0
128 Haloperidol tablet 5 mg 0 0
129 Herbesser injeksi 0 0
130 Hidonac Injeksi 2.5 g 0 0
Hidroklorotiazide (HCT) tablet 25
131 0 0
mg.
132 Hidrokortison cr 0 0
Human Tetanus Immunoglobulin 1
133 0 0
ml 250 IU (TETAGAM)
134 Hyoscine n Butil Bromide Injeksi 0 0
135 Hyosin N Butylbromide 10 mg 0 0
136 Ialuset plus 0 0
137 Ibuprofen tab 400 mg 0 0
138 Ibuprofen tablet 200 mg. 0 0
139 INH 100 mg (Program TB RO ) 0 0
140 INH 300 mg (Program TB RO ) 0 0
141 INH 300 mg (Program TB RO ) 0 0
Inhalasi Salbutamol Device
142 0 0
(Salbulin)
143 Inhaler Ventolin 0 0
144 Inviclot 0 0
145 Iodin Povidone 1 L 0 0
146 Isoniazid 300 mg (Program TB RO ) 0 0

147 Isonoasid 300 mg (Program TB RO ) 0 0


148 Isosorbid injeksi 10 mg 0 0
149 Isosorbit Dinitrat tab sublingal 5 mg. 0 0
150 Kaen 1 B  0 0
151 Kaen 3 B  0 0
152 Kalium Diklofenak 50 mg 0 0
153 Kalsium Laktat (Kalk) tab.500 mg. 0 0
154 Kaptopril 12,5 mg tablet 0 0
155 Kaptopril 25 mg tablet 0 0
156 Kidmin infus 0 0
157 Kloramfenikol 500 mg 0 0
158 Kloramfenikol Salep mata 0 0
159 Kloramfenikol tetes telinga 0 0
Klorfeniramin Maleat (CTM) tablet 4
160 0 0
mg.
161 Kodein 20 mg 0 0
162 Kotrimoksazol dewasa tablet 0 0
163 Kotrimoksazol suspensi 0 0
164 KSR 0 0
165 Lacto B 0 0
166 Lactulac sirup 0 0
Lamivudine (3TC) 150mg (Program
167 0 0
HIV)
168 lansoprazol capsul 0 0
169 Lansoprazol injeksi 0 0
170 Lantus 0 0
171 Levemir Insulin 0 0
172 Levodopa + Benserazide kombinasi 0 0
173 Levofloksasin tab 0 0
174 Levofloxacin infus 5mg/ml 0 0
175 Lidocain 2 % injeksi 0 0
Lidokain HCL0 Epinefrin Injeksi/amp
176 0 0
2 ml (PEHACAIN)

177 Linezolid 600 mg (Program TB RO ) 0 0


178 Loperamid tablet 0 0
179 Madopar tab/Levopar 0 0
180 Manitol infus 25 mL 0 0
181 Mecobalamin 500 mg 0 0
182 Meloksikam 15 mg 0 0
183 Meloxicam 15 mg 0 0
184 Mersibion inj 0 0
185 Metamizole Injeksi 0 0
186 Metamizole Tablet 500 mg 0 0
187 Metformin 500 mg 0 0
188 Metformin tab 850 mg 0 0
Metil Ergometrin (METERGIN
189 0 0
Injeksi)
190 Metil Prednisolon 125MG/ml INJ 0 0
191 Metil Prednisolon 4 mg 0 0
192 Metildopa tablet 0 0
193 Metoklo ramid 10 mg tab 0 0
194 Metronidazol 500 mg ovula 0 0
195 Metronidazol tablet 500 mg. 0 0
196 metronidazole infus 0 0
197 Mgso4 infus 0 0
198 Miconazole cream 0 0
199 Mineral Mix 0 0
200 Minosep Gargle 0 0
201 Misoprostol tab 0 0
Moxifloxacin 400 mg (Program TB
202 0 0
RO )
203 Mupirocin salep 0 0
204 NaCL 0.9%, 100 ml 0 0
205 NaCL 0.9%, 500 ml 0 0
206 Nalokson injeksi 0.4 mg 0 0
207 Natrium Bikarbonat tablet 0 0
208 Natrium Diklofenak 25 mg tab 0 0
209 Natrium Klorida 3% 0 0
210 Neurodex 0 0
Nevirapine (NVP) 200mg(Program
211 0 0
HIV )
212 Nifedipin 10 mg. tablet 0 0
213 Nikardipin injeksi 0 0
214 Nistatin 500.000 IU tablet salut 0 0
215 Nistatin drop 0 0
216 Nitrogliserin 5 mg 0 0
217 Nitrokaf retard 2.5 mg 0 0
218 Norepinefrine 1 mg/ml 0 0
219 Novomix insulin 0 0
220 Novorapid insulin 0 0
221 OAT Combivak (Program TB ) 0 0
Obat Anti Tubercolosis Anak
222 0 0
(Program TB )
Obat Anti Tuberkolosis Kategori I
223 0 0
(Program TB SO )
Obat Anti Tuberkolosis Kategori II
224 0 0
(Program TB )
225 OBH 0 0
226 Oksitosina injeksi 10 IU / ml01ml 0 0
227 Omeprazol 20 mg tab 0 0
228 Omeprazol injeksi 0 0
229 Ondansetron 4 mg Inj 0 0
230 Ondansetron 8 mg 0 0
231 Parasetamol drop 0 0
232 Parasetamol infus 0 0
233 Parasetamol sirup 120 mg/ 5 ml 0 0
234 Parasetamol Supp 125 mg 0 0
235 Parasetamol suppos 250 mg 0 0
236 Parasetamol tablet 500 mg. 0 0
237 Pioglitazon 0 0
238 Pirazinamid 500 mg (Program TB ) 0 0
239 Prednison 5 mg 0 0
Procain Penisilline (Program TB
240 0 0
RO )
Pseudoefedrin HCL 15 mg +
241 0 0
Terfenadine
242 Ramipril 5 Mg Tab  0 0
243 Ranitidin 150 mg 0 0
244 Ranitidin injeksi 0 0
245 Ranivel sirup 0 0
246 Requip tab 0 0
Rifampisin 450 mg tab (Program
247 0 0
TB )
248 Ringer Laktat 0 0
249 Risperidone 2 mg 0 0
250 Salbutamol 2 mg 0 0
251 Salbutamol 4 mg tab 0 0
252 Salisil Bedak 2 % 0 0
253 SANBE Baquinor 0.3% Tetes Mata 0 0
254 SANBE Forumen 0 0
255 SANBE Fukrisin ED 5 ml 0 0
256 SANBE Hyaloph Eye Drop 0 0
257 SANBE Otilon tetes telinga 0 0
258 Sefadroksil 500 mg kapsul 0 0
259 Sefadroksil sirup 0 0
260 Sefiksim 100 mg 0 0
261 Sefiksim 100 mg sirup 0 0
262 Sefiksim 200 mg 0 0
263 Sefotaksim injeksi 0 0
264 Seftriakson injeksi 0 0
265 Seretide Diskus (50/500) 0 0
266 Sertralin 50 mg 0 0
267 Setirizin 10 mg sirup 0 0
268 Setirizin 10 mg tab 0 0
269 Sevodex 0 0
270 Simarc 2 mg 0 0
271 Simvastatin 20 mg 0 0
272 Siprofloksasin 2% Infus 0 0
273 Siprofloksasin 500 mg tablet 0 0
274 SNMC Injeksi 0 0
275 Stesolid 10 mg 0 0
276 Stesolid 5 mg 0 0
277 Streptomycin 1 gr (Program TB ) 0 0
278 sukralfat tablet 0 0
279 Sulfadiazin krim 0 0
280 Tablet tambah darah kombinasi 0 0
TDF 300/3TC 300/DTG 50 (Program
281 0 0
HIV)
TDF/3TC/EFV(300/300/600)
282 0 0
(Program HIV)
283 Telmisartan 40 mg tab 0 0
Tenofovir (TDF) 300mg (Program
284 0 0
HIV)

285 Teofilin tab 150 mg (BRONSOLVAN) 0 0


286 Terbutalin Sulfat 0,5mg/ml Injeksi 0 0
287 Thiamfenikol 500 0 0

Tramadol 37,5 mg + Parasetamol


288 0 0
caps (ANALTRAM caps)

289 Tramadol inj 0 0


290 Trihexyphenidyl tab 0 0
291 Trilac (Triamcinolon) 0 0
292 Tuberculin PPD TEST 0 0

Urdafalk tab (URSODEOXYCHOLIC


293 0 0
ACID GENERIK)

294 Vaksin HB0 (Program VAKSIN) 0 0


Vaksin TD Single Use
295 0 0
(Program TB RO )
296 Valsartan 160 mg 0 0
297 Valsartan 80 mg 0 0
298 Vasacon 0 0
Vicilin SX serbuk injeksi (Ampisilin
299 0 0
Sulbactam)
300 Vitamin B Kompleks Tablet 0 0
301 Vitamin B6 0 0
302 Vitamin B6 0 0
303 Vitamin B6 10 mg 0 0
304 VITAMIN C INJEKSI 0 0
305 Vitamin D3 1000 iu 0 0
Vitamin Sirup anak
306 0 0
(UNIVIT/TIALISIN)
307 Water Steril 1 L 0 0
308 Xylocain 10% Spray 0 0
309 Xylocain Jelly 2% 0 0
Zidovudin (Zdv) 100 mg (Program
310 0 0
HIV)
Zidovudine (ZDV)/Lamivudine (3TC)
311 0 0
300/150mg (Program HIV)
312 Zinc Sirup 0 0
313 Abilify 15 mg (Aripriprazole) 0 0
314 Adalat Oros Tab 0 0
315 Allopurinol 300 mg 0 0
316 Ampicilin Inj 0 0
317 Antasida DOEN syr 0 0
318 ARDIUM 0 0
319 Aricept Evess (Donepezil 10mg) 0 0
320 Arixtra Inj 0 0
321 As. Valproat Sirup 0 0
322 Asam Folat tab 0 0
323 Asam Traneksamat 500 mg tab 0 0
324 Asering 500 ml 0 0
325 Atracurium Injeksi (Tramus Inj) 0 0
326 Attapulgite tablet 0 0
327 Betahistin 6 mg 0 0
328 Bisakodil tab 0 0
329 Bisoprolol 2.5 mg 0 0
330 CaCO3 0 0
331 Captopril 25 mg 0 0
332 Cefoperazone 0 0
333 Cendo Efrisel. 0 0
334 Cendo Siloxan 0 0
335 Cetadop inj (Dopamin) 0 0
336 Cetirizin Sirup 0 0
337 Cetirizin tab 0 0
338 Chloroquin 150 mg tablet 0 0
339 Chlorpromazin Tab 0 0
340 Citicolin tab. 0 0
341 Clobazam 10 mg 0 0
342 Clonazepam 2 mg tab 0 0
343 Clonidine tablet 0,15 mg 0 0
344 Clozapine 100 mg 0 0
345 Clozapine 25 mg 0 0
346 Concor 1,25 0 0
347 Deksametason inj 0 0
348 Diltiazem tablet 30 mg 0 0
349 Dobutamin Inj 0 0
350 Beraprost (Dorner) tab 0 0
351 Dulcolax supp 5 mg 0 0
352 Efedrin Injeksi 50 mg 0 0
353 Eperison tablet 0 0
354 Fenofibrate 100mg kap 0 0
355 Ferro-K Sirup 0 0
356 Fitomenadion tablet 10 mg 0 0
357 Flunarizine 10 mg tab 0 0
358 Fluoxetin Capsul 0 0
359 Gelofusin 0 0
360 Glimepirid 1 mg 0 0
361 Glimepirid 3 mg 0 0
362 Glimepiride 4 mg 0 0
363 Glucosamin Tab 0 0
364 Tamsolusin 0 0
365 Herbesser CD 100 mg 0 0
366 Hot In Cream DCL 0 0
367 HP PRO 0 0
368 Ibuprofen suspensi 0 0
369 KCL 7.46% 0 0
370 Ketamin Inj 0 0
371 Ketoconazol Tab 0 0
372 Ketokonazol Cr 0 0
373 Ketoprofen Supp 0 0
374 Ketorolac inj 30 mg 0 0
375 Klopidogrel 75 mg 0 0
376 Kolkisin tablet 0 0
377 Loratadine 10 mg 0 0
378 Meropenem Injeksi 0 0
379 Methosoprinol syr 0 0
380 Metil Ergometrin tab (Bledstop) 0 0
381 Metil Prednisolon 16 mg 0 0
382 Metoklopramid Injeksi 0 0
383 Meylon 0 0
384 Microlax 0 0
385 miniaspi 80mg 0 0
386 Multivitamin TABLET 0 0
387 Natrium Diklofenak 50 mg 0 0
388 Neostigmin inj 0 0
389 PK Serbuk 0 0
390 Pramifrol 0,375 MG tab 0 0
391 Propranolol 10 mg Tablet 0 0
392 Propranolol 40 mg 0 0
393 PTU tablet 100 mg 0 0
394 Pulmicort 0.25 Mg/ Ml  0 0
395 Ramipril 10 mg 0 0
396 Rebamipid. 0 0
397 Recofol 10 mg/ml 0 0
398 Rifampisin 600 mg tab 0 0
399 Rocuronium 10 mg/ml inj 0 0
400 Salbutamol 2 mg/5 ml Sirup 0 0
401 Seretide Diskus 50/250MCG. 0 0
402 Spironolakton 25 mg tab 0 0
403 Thrombopop Gel 0 0
404 Thiamzole 10 mg tab. 0 0
405 Triamsinolon inj 0 0
406 Carvedilol (Vbloc) 6,25 mg tab 0 0

Yang menyerahkan Yang menerima

Fezi kendri,Apt Reinaldi Yudha, Apt


JAKARTA

G
21 - 441 2889

s 14130

Keterangan
JAKARTA

G
21 - 441 2889
s 14130

Keterangan
JAKARTA

G
21 - 441 2889

s 14130
Keterangan
JAKARTA

G
21 - 441 2889

s 14130

Keterangan
PEMERINTAH PROVINSI DAERAH KHUSUS IBUKOTA JAKARTA
DINAS KESEHATAN
RUMAH SAKIT UMUM DAERAH CILINCING
Jalan Madya Kebantenan 1 Nomor 4, Cilincing. Telepon : 021 - 441 2889
Email : RSUDCilincing@gmail.com
JAKARTA
Kode Pos 14130

SURAT BUKTI BARANG KELUAR (SBBK)

Di berikan kepada
Nama/ NIP : Satria Kinayungan, Apt
Bagian : Apotek Paru
Tanggal :

No Nama Barang Jumlah Harga


1 Acetazolamid 250 mg 0 0
2 Akarbose 100 mg 0 0
3 Akarbose 50 mg 0 0
4 Akilen tetes telinga 0 0
5 Albendazol sirup 0 0
6 ALBUMIN 25% 100 ML 0 0
7 Alprazolam Tablet 0,5 mg 0 0
8 Alupurinol tablet 100 mg. 0 0
9 Ambroxol 30 mg tab 0 0
10 Ambroxol sirup 0 0
Amikasin 1 gr injrksi (Program TB
11 0 0
RO )
12 AMINOFLUID 1000 mL/Bfluid 0 0
13 Aminopilin Injeksi. 0 0
14 Amiodarone HCL Injeksi 50 mg/ml 0 0
15 Amitriptilin 0 0
16 Amlodipin 10 mg 0 0
17 Amlodipin 5 mg 0 0
18 Amoksilin + As. Kalvulanat tablet 0 0
Amoksilin + Asam Klavulanat Sirup
19 0 0
(Claneksi Sirup)
20 Amoksilin drop 0 0
21 Amoksilin kapsul 250 mg. 0 0
22 Amoxillin kapsul 500 mg 0 0
23 Antasida DOEN tab.kombinasi 0 0
24 Anti Hemoroid 0 0
25 Aqua Pro injeksi 0 0
26 Aripirazol 10 mg 0 0
27 Asam Askorbat (Vit.C) tab.50 mg. 0 0
Asam Mefenamat 500 mg
28 0 0
tablet salut selaput
29 Asam traneksamat inj 0 0
Asetil sistein 100 mg Sirup
30 0 0
(Fluimucil Sirup)
31 Asetil sistein 200 mg 0 0
32 Asiklovir 200 mg tab 0 0
33 Asiklovir 400 mg. tablet 0 0
34 Asiklovir salep 0 0
35 Atenolol 50 mg 0 0
36 Atorvastain Calcium tab 20 mg 0 0
37 Atorvastatin 10 mg Tablet 0 0
38 Atropin sulfat Injeksi 0 0
39 Avamys Spray 0 0
40 Azitromisin 500 mg 0 0
41 Azitromisin sirup kering 200 mg 0 0
42 Bayclin 0 0
Bedaquiline 100 mg (Program TB
43 0 0
RO )
Betametason + Neomisin Krim
44 0 0
(Benoson N Krim)
45 Betametason krim 0,1 % 0 0
46 Biosat ATS 0 0
47 Bisoprolol 5 mg 0 0
48 Bricasma Injeksi (Terbutalin) 0 0
49 Bromheksin 8 mg 0 0
Bupivicain Injeksi (REGIVELL
50 0 0
Injeksi)
51 Calcium Gluconat 0 0
52 candesartan 16 mg 0 0
53 Candesartan 8 mg tab 0 0
54 Carbazocrome inj 0 0
55 Ceftazidim injeksi 0 0
56 Ceftriaxon injeksi 0 0
57 Cendo Asthenof 0 0
58 Cendo Catarlent 15 ml 0 0
59 Cendo Cenfresh Eye Drop 0 0
60 Cendo floxa Eye Drop 0 0
61 Cendo Lyteers 0 0
62 Cendo mata pantocain 0 0
63 Cendo Mydriatil Tetes Mata 0 0
64 Cendo polydex 0 0
65 Cendo Statrol 0 0
66 Cendo timol 0 0
67 Cendo Tropin 0.5% 0 0
68 Cendo Xitrol Eye Drop 0 0
69 Cendo Xitrol salep mata 3,5 Gram 0 0

Cilostazol Tablet 100 mg (Pletaal


70 0 0
Tablet)
71 Citicolin inj 0 0
72 Clindamisin 300 mg 0 0
73 Clindamycin caps 150 mg 0 0
74 Clotrimazole (Dermifar Krim) 0 0
75 Combiven Inhaler 0 0
76 Coparcetin 0 0
77 Curcuma tab 0 0
78 Deksametason tablet 0,5 mg. 0 0
79 Delamanid 50 mg (Program TB RO ) 0 0
80 Depakote ER 250 mg 0 0
81 Depakote ER 500 mg 0 0
Dextrometrophan + Gliseril
82 Guaiacolat + Phenylpropanolamin 0 0
HC + Chlo heniramine Maleat Tab
83 Diazepam 5 mg tablet 0 0
84 Diazepam Injeksi 0 0
Diazepam Rectal Tube 20 mg
85 0 0
(STEOLID 10)
Diazepam Rectal Tube 5 mg
86 0 0
(STESOLID 5)
87 Diazink tab 0 0
Digoksin injeksi 0,25 mg
88 0 0
(FARGOKSIN IV)
89 Digoksin tablet 0,25 mg. 0 0
90 Diltiazem 10 mg 0 0
91 Diphenhidramin injeksi 0 0
92 Dipsamol inhaler 0 0
93 Domperidon 0 0
94 Domperidon 10 mg sirup 0 0
95 Domperidon drop 0 0
96 Donepezile 0 0
97 Doxycyclin kapsul 100 mg. 0 0
98 Epinefrin injeksi 0 0
99 Eritromisin 500 mg tab 0 0
100 Etanol 70 % 1 liter 0 0
101 Ethambutol 400 mg (Program TB ) 0 0
Ethionamide 250 mg (Program TB
102 0 0
RO )
103 ethyl cloride 0 0
104 Euthyrox Tab 0 0
105 fenitoin injeksi 0 0
106 Fenitoin Kapsul 0 0
107 Fentanyl Injeksi 100 mcg/2ml Injeks 0 0
108 Ferriz drop 0 0
Fitomenadion (Vit.K10
109 0 0
inj.10mg/ml01ml
110 Flixotide 0 0
111 Flukonazole tab 0 0
112 Furosemid injeksi 0 0
113 Furosemid tab 0 0
114 Gabapentin 100 mg 0 0
115 Gabapentin 300 mg tab 0 0
116 Garam Oralit 200 ml air 0 0
117 Gemfibrozil Kapsul 300 mg 0 0
118 Gentamisin Cream Kulit 0 0
119 gentamisin injeksi 0 0
120 Glibenklamid 5 mg 0 0
121 Glikazid 80 mg 0 0
122 Glikuidon 30 Mg  0 0
123 glimepirid 2 mg 0 0
124 Glukosa 40% 0 0
125 Glukose larutan infus 10 % steril 0 0
126 Glukose larutan infus 5 % steril 0 0
127 Haloperidol 50 mg injeksi 0 0
128 Haloperidol tablet 5 mg 0 0
129 Herbesser injeksi 0 0
130 Hidonac Injeksi 2.5 g 0 0
Hidroklorotiazide (HCT) tablet 25
131 0 0
mg.
132 Hidrokortison cr 0 0
Human Tetanus Immunoglobulin 1
133 0 0
ml 250 IU (TETAGAM)
134 Hyoscine n Butil Bromide Injeksi 0 0
135 Hyosin N Butylbromide 10 mg 0 0
136 Ialuset plus 0 0
137 Ibuprofen tab 400 mg 0 0
138 Ibuprofen tablet 200 mg. 0 0
139 INH 100 mg (Program TB RO ) 0 0
140 INH 300 mg (Program TB RO ) 0 0
141 INH 300 mg (Program TB RO ) 0 0
Inhalasi Salbutamol Device
142 0 0
(Salbulin)
143 Inhaler Ventolin 0 0
144 Inviclot 0 0
145 Iodin Povidone 1 L 0 0
146 Isoniazid 300 mg (Program TB RO ) 0 0

147 Isonoasid 300 mg (Program TB RO ) 0 0


148 Isosorbid injeksi 10 mg 0 0
149 Isosorbit Dinitrat tab sublingal 5 mg. 0 0
150 Kaen 1 B  0 0
151 Kaen 3 B  0 0
152 Kalium Diklofenak 50 mg 0 0
153 Kalsium Laktat (Kalk) tab.500 mg. 0 0
154 Kaptopril 12,5 mg tablet 0 0
155 Kaptopril 25 mg tablet 0 0
156 Kidmin infus 0 0
157 Kloramfenikol 500 mg 0 0
158 Kloramfenikol Salep mata 0 0
159 Kloramfenikol tetes telinga 0 0
Klorfeniramin Maleat (CTM) tablet 4
160 0 0
mg.
161 Kodein 20 mg 0 0
162 Kotrimoksazol dewasa tablet 0 0
163 Kotrimoksazol suspensi 0 0
164 KSR 0 0
165 Lacto B 0 0
166 Lactulac sirup 0 0
Lamivudine (3TC) 150mg (Program
167 0 0
HIV)
168 lansoprazol capsul 0 0
169 Lansoprazol injeksi 0 0
170 Lantus 0 0
171 Levemir Insulin 0 0
172 Levodopa + Benserazide kombinasi 0 0
173 Levofloksasin tab 0 0
174 Levofloxacin infus 5mg/ml 0 0
175 Lidocain 2 % injeksi 0 0
Lidokain HCL0 Epinefrin Injeksi/amp
176 0 0
2 ml (PEHACAIN)

177 Linezolid 600 mg (Program TB RO ) 0 0


178 Loperamid tablet 0 0
179 Madopar tab/Levopar 0 0
180 Manitol infus 25 mL 0 0
181 Mecobalamin 500 mg 0 0
182 Meloksikam 15 mg 0 0
183 Meloxicam 15 mg 0 0
184 Mersibion inj 0 0
185 Metamizole Injeksi 0 0
186 Metamizole Tablet 500 mg 0 0
187 Metformin 500 mg 0 0
188 Metformin tab 850 mg 0 0
Metil Ergometrin (METERGIN
189 0 0
Injeksi)
190 Metil Prednisolon 125MG/ml INJ 0 0
191 Metil Prednisolon 4 mg 0 0
192 Metildopa tablet 0 0
193 Metoklo ramid 10 mg tab 0 0
194 Metronidazol 500 mg ovula 0 0
195 Metronidazol tablet 500 mg. 0 0
196 metronidazole infus 0 0
197 Mgso4 infus 0 0
198 Miconazole cream 0 0
199 Mineral Mix 0 0
200 Minosep Gargle 0 0
201 Misoprostol tab 0 0
Moxifloxacin 400 mg (Program TB
202 0 0
RO )
203 Mupirocin salep 0 0
204 NaCL 0.9%, 100 ml 0 0
205 NaCL 0.9%, 500 ml 0 0
206 Nalokson injeksi 0.4 mg 0 0
207 Natrium Bikarbonat tablet 0 0
208 Natrium Diklofenak 25 mg tab 0 0
209 Natrium Klorida 3% 0 0
210 Neurodex 0 0
Nevirapine (NVP) 200mg(Program
211 0 0
HIV )
212 Nifedipin 10 mg. tablet 0 0
213 Nikardipin injeksi 0 0
214 Nistatin 500.000 IU tablet salut 0 0
215 Nistatin drop 0 0
216 Nitrogliserin 5 mg 0 0
217 Nitrokaf retard 2.5 mg 0 0
218 Norepinefrine 1 mg/ml 0 0
219 Novomix insulin 0 0
220 Novorapid insulin 0 0
221 OAT Combivak (Program TB ) 0 0
Obat Anti Tubercolosis Anak
222 0 0
(Program TB )
Obat Anti Tuberkolosis Kategori I
223 0 0
(Program TB SO )
Obat Anti Tuberkolosis Kategori II
224 0 0
(Program TB )
225 OBH 0 0
226 Oksitosina injeksi 10 IU / ml01ml 0 0
227 Omeprazol 20 mg tab 0 0
228 Omeprazol injeksi 0 0
229 Ondansetron 4 mg Inj 0 0
230 Ondansetron 8 mg 0 0
231 Parasetamol drop 0 0
232 Parasetamol infus 0 0
233 Parasetamol sirup 120 mg/ 5 ml 0 0
234 Parasetamol Supp 125 mg 0 0
235 Parasetamol suppos 250 mg 0 0
236 Parasetamol tablet 500 mg. 0 0
237 Pioglitazon 0 0
238 Pirazinamid 500 mg (Program TB ) 0 0
239 Prednison 5 mg 0 0
Procain Penisilline (Program TB
240 0 0
RO )
Pseudoefedrin HCL 15 mg +
241 0 0
Terfenadine
242 Ramipril 5 Mg Tab  0 0
243 Ranitidin 150 mg 0 0
244 Ranitidin injeksi 0 0
245 Ranivel sirup 0 0
246 Requip tab 0 0
Rifampisin 450 mg tab (Program
247 0 0
TB )
248 Ringer Laktat 0 0
249 Risperidone 2 mg 0 0
250 Salbutamol 2 mg 0 0
251 Salbutamol 4 mg tab 0 0
252 Salisil Bedak 2 % 0 0
253 SANBE Baquinor 0.3% Tetes Mata 0 0
254 SANBE Forumen 0 0
255 SANBE Fukrisin ED 5 ml 0 0
256 SANBE Hyaloph Eye Drop 0 0
257 SANBE Otilon tetes telinga 0 0
258 Sefadroksil 500 mg kapsul 0 0
259 Sefadroksil sirup 0 0
260 Sefiksim 100 mg 0 0
261 Sefiksim 100 mg sirup 0 0
262 Sefiksim 200 mg 0 0
263 Sefotaksim injeksi 0 0
264 Seftriakson injeksi 0 0
265 Seretide Diskus (50/500) 0 0
266 Sertralin 50 mg 0 0
267 Setirizin 10 mg sirup 0 0
268 Setirizin 10 mg tab 0 0
269 Sevodex 0 0
270 Simarc 2 mg 0 0
271 Simvastatin 20 mg 0 0
272 Siprofloksasin 2% Infus 0 0
273 Siprofloksasin 500 mg tablet 0 0
274 SNMC Injeksi 0 0
275 Stesolid 10 mg 0 0
276 Stesolid 5 mg 0 0
277 Streptomycin 1 gr (Program TB ) 0 0
278 sukralfat tablet 0 0
279 Sulfadiazin krim 0 0
280 Tablet tambah darah kombinasi 0 0
TDF 300/3TC 300/DTG 50 (Program
281 0 0
HIV)
TDF/3TC/EFV(300/300/600)
282 0 0
(Program HIV)
283 Telmisartan 40 mg tab 0 0
Tenofovir (TDF) 300mg (Program
284 0 0
HIV)

285 Teofilin tab 150 mg (BRONSOLVAN) 0 0


286 Terbutalin Sulfat 0,5mg/ml Injeksi 0 0
287 Thiamfenikol 500 0 0

Tramadol 37,5 mg + Parasetamol


288 0 0
caps (ANALTRAM caps)

289 Tramadol inj 0 0


290 Trihexyphenidyl tab 0 0
291 Trilac (Triamcinolon) 0 0
292 Tuberculin PPD TEST 0 0

Urdafalk tab (URSODEOXYCHOLIC


293 0 0
ACID GENERIK)

294 Vaksin HB0 (Program VAKSIN) 0 0


Vaksin TD Single Use
295 0 0
(Program TB RO )
296 Valsartan 160 mg 0 0
297 Valsartan 80 mg 0 0
298 Vasacon 0 0
Vicilin SX serbuk injeksi (Ampisilin
299 0 0
Sulbactam)
300 Vitamin B Kompleks Tablet 0 0
301 Vitamin B6 0 0
302 Vitamin B6 0 0
303 Vitamin B6 10 mg 0 0
304 VITAMIN C INJEKSI 0 0
305 Vitamin D3 1000 iu 0 0
Vitamin Sirup anak
306 0 0
(UNIVIT/TIALISIN)
307 Water Steril 1 L 0 0
308 Xylocain 10% Spray 0 0
309 Xylocain Jelly 2% 0 0
Zidovudin (Zdv) 100 mg (Program
310 0 0
HIV)
Zidovudine (ZDV)/Lamivudine (3TC)
311 0 0
300/150mg (Program HIV)
312 Zinc Sirup 0 0
313 Abilify 15 mg (Aripriprazole) 0 0
314 Adalat Oros Tab 0 0
315 Allopurinol 300 mg 0 0
316 Ampicilin Inj 0 0
317 Antasida DOEN syr 0 0
318 ARDIUM 0 0
319 Aricept Evess (Donepezil 10mg) 0 0
320 Arixtra Inj 0 0
321 As. Valproat Sirup 0 0
322 Asam Folat tab 0 0
323 Asam Traneksamat 500 mg tab 0 0
324 Asering 500 ml 0 0
325 Atracurium Injeksi (Tramus Inj) 0 0
326 Attapulgite tablet 0 0
327 Betahistin 6 mg 0 0
328 Bisakodil tab 0 0
329 Bisoprolol 2.5 mg 0 0
330 CaCO3 0 0
331 Captopril 25 mg 0 0
332 Cefoperazone 0 0
333 Cendo Efrisel. 0 0
334 Cendo Siloxan 0 0
335 Cetadop inj (Dopamin) 0 0
336 Cetirizin Sirup 0 0
337 Cetirizin tab 0 0
338 Chloroquin 150 mg tablet 0 0
339 Chlorpromazin Tab 0 0
340 Citicolin tab. 0 0
341 Clobazam 10 mg 0 0
342 Clonazepam 2 mg tab 0 0
343 Clonidine tablet 0,15 mg 0 0
344 Clozapine 100 mg 0 0
345 Clozapine 25 mg 0 0
346 Concor 1,25 0 0
347 Deksametason inj 0 0
348 Diltiazem tablet 30 mg 0 0
349 Dobutamin Inj 0 0
350 Beraprost (Dorner) tab 0 0
351 Dulcolax supp 5 mg 0 0
352 Efedrin Injeksi 50 mg 0 0
353 Eperison tablet 0 0
354 Fenofibrate 100mg kap 0 0
355 Ferro-K Sirup 0 0
356 Fitomenadion tablet 10 mg 0 0
357 Flunarizine 10 mg tab 0 0
358 Fluoxetin Capsul 0 0
359 Gelofusin 0 0
360 Glimepirid 1 mg 0 0
361 Glimepirid 3 mg 0 0
362 Glimepiride 4 mg 0 0
363 Glucosamin Tab 0 0
364 Tamsolusin 0 0
365 Herbesser CD 100 mg 0 0
366 Hot In Cream DCL 0 0
367 HP PRO 0 0
368 Ibuprofen suspensi 0 0
369 KCL 7.46% 0 0
370 Ketamin Inj 0 0
371 Ketoconazol Tab 0 0
372 Ketokonazol Cr 0 0
373 Ketoprofen Supp 0 0
374 Ketorolac inj 30 mg 0 0
375 Klopidogrel 75 mg 0 0
376 Kolkisin tablet 0 0
377 Loratadine 10 mg 0 0
378 Meropenem Injeksi 0 0
379 Methosoprinol syr 0 0
380 Metil Ergometrin tab (Bledstop) 0 0
381 Metil Prednisolon 16 mg 0 0
382 Metoklopramid Injeksi 0 0
383 Meylon 0 0
384 Microlax 0 0
385 miniaspi 80mg 0 0
386 Multivitamin TABLET 0 0
387 Natrium Diklofenak 50 mg 0 0
388 Neostigmin inj 0 0
389 PK Serbuk 0 0
390 Pramifrol 0,375 MG tab 0 0
391 Propranolol 10 mg Tablet 0 0
392 Propranolol 40 mg 0 0
393 PTU tablet 100 mg 0 0
394 Pulmicort 0.25 Mg/ Ml  0 0
395 Ramipril 10 mg 0 0
396 Rebamipid. 0 0
397 Recofol 10 mg/ml 0 0
398 Rifampisin 600 mg tab 0 0
399 Rocuronium 10 mg/ml inj 0 0
400 Salbutamol 2 mg/5 ml Sirup 0 0
401 Seretide Diskus 50/250MCG. 0 0
402 Spironolakton 25 mg tab 0 0
403 Thrombopop Gel 0 0
404 Thiamzole 10 mg tab. 0 0
405 Triamsinolon inj 0 0
406 Carvedilol (Vbloc) 6,25 mg tab 0 0

Yang menyerahkan Yang menerima

Fezi kendri,Apt Satria Kinayungan, Apt

PEMERINTAH PROVINSI DAERAH KHUSUS IBUKOTA JAKARTA


DINAS KESEHATAN
RUMAH SAKIT UMUM DAERAH CILINCING
Jalan Madya Kebantenan 1 Nomor 4, Cilincing. Telepon : 021 - 441 2889
Email : RSUDCilincing@gmail.com
JAKARTA
Kode Pos 14130

SURAT BUKTI BARANG KELUAR (SBBK)

Di berikan kepada
Nama/ NIP : Satria Kinayungan, Apt
Bagian : Apotek Paru
Tanggal :

No Nama Barang Jumlah Harga


1 Acetazolamid 250 mg 0 0
2 Akarbose 100 mg 0 0
3 Akarbose 50 mg 0 0
4 Akilen tetes telinga 0 0
5 Albendazol sirup 0 0
6 ALBUMIN 25% 100 ML 0 0
7 Alprazolam Tablet 0,5 mg 0 0
8 Alupurinol tablet 100 mg. 0 0
9 Ambroxol 30 mg tab 0 0
10 Ambroxol sirup 0 0
Amikasin 1 gr injrksi (Program TB
11 0 0
RO )
12 AMINOFLUID 1000 mL/Bfluid 0 0
13 Aminopilin Injeksi. 0 0
14 Amiodarone HCL Injeksi 50 mg/ml 0 0
15 Amitriptilin 0 0
16 Amlodipin 10 mg 0 0
17 Amlodipin 5 mg 0 0
18 Amoksilin + As. Kalvulanat tablet 0 0
Amoksilin + Asam Klavulanat Sirup
19 0 0
(Claneksi Sirup)
20 Amoksilin drop 0 0
21 Amoksilin kapsul 250 mg. 0 0
22 Amoxillin kapsul 500 mg 0 0
23 Antasida DOEN tab.kombinasi 0 0
24 Anti Hemoroid 0 0
25 Aqua Pro injeksi 0 0
26 Aripirazol 10 mg 0 0
27 Asam Askorbat (Vit.C) tab.50 mg. 0 0
Asam Mefenamat 500 mg
28 0 0
tablet salut selaput
29 Asam traneksamat inj 0 0
Asetil sistein 100 mg Sirup
30 0 0
(Fluimucil Sirup)
31 Asetil sistein 200 mg 0 0
32 Asiklovir 200 mg tab 0 0
33 Asiklovir 400 mg. tablet 0 0
34 Asiklovir salep 0 0
35 Atenolol 50 mg 0 0
36 Atorvastain Calcium tab 20 mg 0 0
37 Atorvastatin 10 mg Tablet 0 0
38 Atropin sulfat Injeksi 0 0
39 Avamys Spray 0 0
40 Azitromisin 500 mg 0 0
41 Azitromisin sirup kering 200 mg 0 0
42 Bayclin 0 0
Bedaquiline 100 mg (Program TB
43 0 0
RO )
Betametason + Neomisin Krim
44 0 0
(Benoson N Krim)
45 Betametason krim 0,1 % 0 0
46 Biosat ATS 0 0
47 Bisoprolol 5 mg 0 0
48 Bricasma Injeksi (Terbutalin) 0 0
49 Bromheksin 8 mg 0 0
Bupivicain Injeksi (REGIVELL
50 0 0
Injeksi)
51 Calcium Gluconat 0 0
52 candesartan 16 mg 0 0
53 Candesartan 8 mg tab 0 0
54 Carbazocrome inj 0 0
55 Ceftazidim injeksi 0 0
56 Ceftriaxon injeksi 0 0
57 Cendo Asthenof 0 0
58 Cendo Catarlent 15 ml 0 0
59 Cendo Cenfresh Eye Drop 0 0
60 Cendo floxa Eye Drop 0 0
61 Cendo Lyteers 0 0
62 Cendo mata pantocain 0 0
63 Cendo Mydriatil Tetes Mata 0 0
64 Cendo polydex 0 0
65 Cendo Statrol 0 0
66 Cendo timol 0 0
67 Cendo Tropin 0.5% 0 0
68 Cendo Xitrol Eye Drop 0 0
69 Cendo Xitrol salep mata 3,5 Gram 0 0
Cilostazol Tablet 100 mg (Pletaal
70 0 0
Tablet)
71 Citicolin inj 0 0
72 Clindamisin 300 mg 0 0
73 Clindamycin caps 150 mg 0 0
74 Clotrimazole (Dermifar Krim) 0 0
75 Combiven Inhaler 0 0
76 Coparcetin 0 0
77 Curcuma tab 0 0
78 Deksametason tablet 0,5 mg. 0 0
79 Delamanid 50 mg (Program TB RO ) 0 0
80 Depakote ER 250 mg 0 0
81 Depakote ER 500 mg 0 0
Dextrometrophan + Gliseril
82 Guaiacolat + Phenylpropanolamin 0 0
HC + Chlo heniramine Maleat Tab
83 Diazepam 5 mg tablet 0 0
84 Diazepam Injeksi 0 0
Diazepam Rectal Tube 20 mg
85 0 0
(STEOLID 10)
Diazepam Rectal Tube 5 mg
86 0 0
(STESOLID 5)
87 Diazink tab 0 0
Digoksin injeksi 0,25 mg
88 0 0
(FARGOKSIN IV)
89 Digoksin tablet 0,25 mg. 0 0
90 Diltiazem 10 mg 0 0
91 Diphenhidramin injeksi 0 0
92 Dipsamol inhaler 0 0
93 Domperidon 0 0
94 Domperidon 10 mg sirup 0 0
95 Domperidon drop 0 0
96 Donepezile 0 0
97 Doxycyclin kapsul 100 mg. 0 0
98 Epinefrin injeksi 0 0
99 Eritromisin 500 mg tab 0 0
100 Etanol 70 % 1 liter 0 0
101 Ethambutol 400 mg (Program TB ) 0 0

Ethionamide 250 mg (Program TB


102 0 0
RO )
103 ethyl cloride 0 0
104 Euthyrox Tab 0 0
105 fenitoin injeksi 0 0
106 Fenitoin Kapsul 0 0
107 Fentanyl Injeksi 100 mcg/2ml Injeks 0 0
108 Ferriz drop 0 0
Fitomenadion (Vit.K10
109 0 0
inj.10mg/ml01ml
110 Flixotide 0 0
111 Flukonazole tab 0 0
112 Furosemid injeksi 0 0
113 Furosemid tab 0 0
114 Gabapentin 100 mg 0 0
115 Gabapentin 300 mg tab 0 0
116 Garam Oralit 200 ml air 0 0
117 Gemfibrozil Kapsul 300 mg 0 0
118 Gentamisin Cream Kulit 0 0
119 gentamisin injeksi 0 0
120 Glibenklamid 5 mg 0 0
121 Glikazid 80 mg 0 0
122 Glikuidon 30 Mg  0 0
123 glimepirid 2 mg 0 0
124 Glukosa 40% 0 0
125 Glukose larutan infus 10 % steril 0 0
126 Glukose larutan infus 5 % steril 0 0
127 Haloperidol 50 mg injeksi 0 0
128 Haloperidol tablet 5 mg 0 0
129 Herbesser injeksi 0 0
130 Hidonac Injeksi 2.5 g 0 0
Hidroklorotiazide (HCT) tablet 25
131 0 0
mg.
132 Hidrokortison cr 0 0
Human Tetanus Immunoglobulin 1
133 0 0
ml 250 IU (TETAGAM)
134 Hyoscine n Butil Bromide Injeksi 0 0
135 Hyosin N Butylbromide 10 mg 0 0
136 Ialuset plus 0 0
137 Ibuprofen tab 400 mg 0 0
138 Ibuprofen tablet 200 mg. 0 0
139 INH 100 mg (Program TB RO ) 0 0
140 INH 300 mg (Program TB RO ) 0 0
141 INH 300 mg (Program TB RO ) 0 0
Inhalasi Salbutamol Device
142 0 0
(Salbulin)
143 Inhaler Ventolin 0 0
144 Inviclot 0 0
145 Iodin Povidone 1 L 0 0
146 Isoniazid 300 mg (Program TB RO ) 0 0
147 Isonoasid 300 mg (Program TB RO ) 0 0
148 Isosorbid injeksi 10 mg 0 0
149 Isosorbit Dinitrat tab sublingal 5 mg. 0 0
150 Kaen 1 B  0 0
151 Kaen 3 B  0 0
152 Kalium Diklofenak 50 mg 0 0
153 Kalsium Laktat (Kalk) tab.500 mg. 0 0
154 Kaptopril 12,5 mg tablet 0 0
155 Kaptopril 25 mg tablet 0 0
156 Kidmin infus 0 0
157 Kloramfenikol 500 mg 0 0
158 Kloramfenikol Salep mata 0 0
159 Kloramfenikol tetes telinga 0 0
Klorfeniramin Maleat (CTM) tablet 4
160 0 0
mg.
161 Kodein 20 mg 0 0
162 Kotrimoksazol dewasa tablet 0 0
163 Kotrimoksazol suspensi 0 0
164 KSR 0 0
165 Lacto B 0 0
166 Lactulac sirup 0 0
Lamivudine (3TC) 150mg (Program
167 0 0
HIV)
168 lansoprazol capsul 0 0
169 Lansoprazol injeksi 0 0
170 Lantus 0 0
171 Levemir Insulin 0 0
172 Levodopa + Benserazide kombinasi 0 0
173 Levofloksasin tab 0 0
174 Levofloxacin infus 5mg/ml 0 0
175 Lidocain 2 % injeksi 0 0
Lidokain HCL0 Epinefrin Injeksi/amp
176 0 0
2 ml (PEHACAIN)

177 Linezolid 600 mg (Program TB RO ) 0 0


178 Loperamid tablet 0 0
179 Madopar tab/Levopar 0 0
180 Manitol infus 25 mL 0 0
181 Mecobalamin 500 mg 0 0
182 Meloksikam 15 mg 0 0
183 Meloxicam 15 mg 0 0
184 Mersibion inj 0 0
185 Metamizole Injeksi 0 0
186 Metamizole Tablet 500 mg 0 0
187 Metformin 500 mg 0 0
188 Metformin tab 850 mg 0 0
Metil Ergometrin (METERGIN
189 0 0
Injeksi)
190 Metil Prednisolon 125MG/ml INJ 0 0
191 Metil Prednisolon 4 mg 0 0
192 Metildopa tablet 0 0
193 Metoklo ramid 10 mg tab 0 0
194 Metronidazol 500 mg ovula 0 0
195 Metronidazol tablet 500 mg. 0 0
196 metronidazole infus 0 0
197 Mgso4 infus 0 0
198 Miconazole cream 0 0
199 Mineral Mix 0 0
200 Minosep Gargle 0 0
201 Misoprostol tab 0 0
Moxifloxacin 400 mg (Program TB
202 0 0
RO )
203 Mupirocin salep 0 0
204 NaCL 0.9%, 100 ml 0 0
205 NaCL 0.9%, 500 ml 0 0
206 Nalokson injeksi 0.4 mg 0 0
207 Natrium Bikarbonat tablet 0 0
208 Natrium Diklofenak 25 mg tab 0 0
209 Natrium Klorida 3% 0 0
210 Neurodex 0 0
Nevirapine (NVP) 200mg(Program
211 0 0
HIV )
212 Nifedipin 10 mg. tablet 0 0
213 Nikardipin injeksi 0 0
214 Nistatin 500.000 IU tablet salut 0 0
215 Nistatin drop 0 0
216 Nitrogliserin 5 mg 0 0
217 Nitrokaf retard 2.5 mg 0 0
218 Norepinefrine 1 mg/ml 0 0
219 Novomix insulin 0 0
220 Novorapid insulin 0 0
221 OAT Combivak (Program TB ) 0 0
Obat Anti Tubercolosis Anak
222 0 0
(Program TB )
Obat Anti Tuberkolosis Kategori I
223 0 0
(Program TB SO )
Obat Anti Tuberkolosis Kategori II
224 0 0
(Program TB )
225 OBH 0 0
226 Oksitosina injeksi 10 IU / ml01ml 0 0
227 Omeprazol 20 mg tab 0 0
228 Omeprazol injeksi 0 0
229 Ondansetron 4 mg Inj 0 0
230 Ondansetron 8 mg 0 0
231 Parasetamol drop 0 0
232 Parasetamol infus 0 0
233 Parasetamol sirup 120 mg/ 5 ml 0 0
234 Parasetamol Supp 125 mg 0 0
235 Parasetamol suppos 250 mg 0 0
236 Parasetamol tablet 500 mg. 0 0
237 Pioglitazon 0 0
238 Pirazinamid 500 mg (Program TB ) 0 0
239 Prednison 5 mg 0 0
Procain Penisilline (Program TB
240 0 0
RO )
Pseudoefedrin HCL 15 mg +
241 0 0
Terfenadine
242 Ramipril 5 Mg Tab  0 0
243 Ranitidin 150 mg 0 0
244 Ranitidin injeksi 0 0
245 Ranivel sirup 0 0
246 Requip tab 0 0
Rifampisin 450 mg tab (Program
247 0 0
TB )
248 Ringer Laktat 0 0
249 Risperidone 2 mg 0 0
250 Salbutamol 2 mg 0 0
251 Salbutamol 4 mg tab 0 0
252 Salisil Bedak 2 % 0 0
253 SANBE Baquinor 0.3% Tetes Mata 0 0
254 SANBE Forumen 0 0
255 SANBE Fukrisin ED 5 ml 0 0
256 SANBE Hyaloph Eye Drop 0 0
257 SANBE Otilon tetes telinga 0 0
258 Sefadroksil 500 mg kapsul 0 0
259 Sefadroksil sirup 0 0
260 Sefiksim 100 mg 0 0
261 Sefiksim 100 mg sirup 0 0
262 Sefiksim 200 mg 0 0
263 Sefotaksim injeksi 0 0
264 Seftriakson injeksi 0 0
265 Seretide Diskus (50/500) 0 0
266 Sertralin 50 mg 0 0
267 Setirizin 10 mg sirup 0 0
268 Setirizin 10 mg tab 0 0
269 Sevodex 0 0
270 Simarc 2 mg 0 0
271 Simvastatin 20 mg 0 0
272 Siprofloksasin 2% Infus 0 0
273 Siprofloksasin 500 mg tablet 0 0
274 SNMC Injeksi 0 0
275 Stesolid 10 mg 0 0
276 Stesolid 5 mg 0 0
277 Streptomycin 1 gr (Program TB ) 0 0
278 sukralfat tablet 0 0
279 Sulfadiazin krim 0 0
280 Tablet tambah darah kombinasi 0 0
TDF 300/3TC 300/DTG 50 (Program
281 0 0
HIV)
TDF/3TC/EFV(300/300/600)
282 0 0
(Program HIV)
283 Telmisartan 40 mg tab 0 0
Tenofovir (TDF) 300mg (Program
284 0 0
HIV)

285 Teofilin tab 150 mg (BRONSOLVAN) 0 0


286 Terbutalin Sulfat 0,5mg/ml Injeksi 0 0
287 Thiamfenikol 500 0 0

Tramadol 37,5 mg + Parasetamol


288 0 0
caps (ANALTRAM caps)

289 Tramadol inj 0 0


290 Trihexyphenidyl tab 0 0
291 Trilac (Triamcinolon) 0 0
292 Tuberculin PPD TEST 0 0

Urdafalk tab (URSODEOXYCHOLIC


293 0 0
ACID GENERIK)

294 Vaksin HB0 (Program VAKSIN) 0 0


Vaksin TD Single Use
295 0 0
(Program TB RO )
296 Valsartan 160 mg 0 0
297 Valsartan 80 mg 0 0
298 Vasacon 0 0
Vicilin SX serbuk injeksi (Ampisilin
299 0 0
Sulbactam)
300 Vitamin B Kompleks Tablet 0 0
301 Vitamin B6 0 0
302 Vitamin B6 0 0
303 Vitamin B6 10 mg 0 0
304 VITAMIN C INJEKSI 0 0
305 Vitamin D3 1000 iu 0 0
Vitamin Sirup anak
306 0 0
(UNIVIT/TIALISIN)
307 Water Steril 1 L 0 0
308 Xylocain 10% Spray 0 0
309 Xylocain Jelly 2% 0 0
Zidovudin (Zdv) 100 mg (Program
310 0 0
HIV)
Zidovudine (ZDV)/Lamivudine (3TC)
311 0 0
300/150mg (Program HIV)
312 Zinc Sirup 0 0
313 Abilify 15 mg (Aripriprazole) 0 0
314 Adalat Oros Tab 0 0
315 Allopurinol 300 mg 0 0
316 Ampicilin Inj 0 0
317 Antasida DOEN syr 0 0
318 ARDIUM 0 0
319 Aricept Evess (Donepezil 10mg) 0 0
320 Arixtra Inj 0 0
321 As. Valproat Sirup 0 0
322 Asam Folat tab 0 0
323 Asam Traneksamat 500 mg tab 0 0
324 Asering 500 ml 0 0
325 Atracurium Injeksi (Tramus Inj) 0 0
326 Attapulgite tablet 0 0
327 Betahistin 6 mg 0 0
328 Bisakodil tab 0 0
329 Bisoprolol 2.5 mg 0 0
330 CaCO3 0 0
331 Captopril 25 mg 0 0
332 Cefoperazone 0 0
333 Cendo Efrisel. 0 0
334 Cendo Siloxan 0 0
335 Cetadop inj (Dopamin) 0 0
336 Cetirizin Sirup 0 0
337 Cetirizin tab 0 0
338 Chloroquin 150 mg tablet 0 0
339 Chlorpromazin Tab 0 0
340 Citicolin tab. 0 0
341 Clobazam 10 mg 0 0
342 Clonazepam 2 mg tab 0 0
343 Clonidine tablet 0,15 mg 0 0
344 Clozapine 100 mg 0 0
345 Clozapine 25 mg 0 0
346 Concor 1,25 0 0
347 Deksametason inj 0 0
348 Diltiazem tablet 30 mg 0 0
349 Dobutamin Inj 0 0
350 Beraprost (Dorner) tab 0 0
351 Dulcolax supp 5 mg 0 0
352 Efedrin Injeksi 50 mg 0 0
353 Eperison tablet 0 0
354 Fenofibrate 100mg kap 0 0
355 Ferro-K Sirup 0 0
356 Fitomenadion tablet 10 mg 0 0
357 Flunarizine 10 mg tab 0 0
358 Fluoxetin Capsul 0 0
359 Gelofusin 0 0
360 Glimepirid 1 mg 0 0
361 Glimepirid 3 mg 0 0
362 Glimepiride 4 mg 0 0
363 Glucosamin Tab 0 0
364 Tamsolusin 0 0
365 Herbesser CD 100 mg 0 0
366 Hot In Cream DCL 0 0
367 HP PRO 0 0
368 Ibuprofen suspensi 0 0
369 KCL 7.46% 0 0
370 Ketamin Inj 0 0
371 Ketoconazol Tab 0 0
372 Ketokonazol Cr 0 0
373 Ketoprofen Supp 0 0
374 Ketorolac inj 30 mg 0 0
375 Klopidogrel 75 mg 0 0
376 Kolkisin tablet 0 0
377 Loratadine 10 mg 0 0
378 Meropenem Injeksi 0 0
379 Methosoprinol syr 0 0
380 Metil Ergometrin tab (Bledstop) 0 0
381 Metil Prednisolon 16 mg 0 0
382 Metoklopramid Injeksi 0 0
383 Meylon 0 0
384 Microlax 0 0
385 miniaspi 80mg 0 0
386 Multivitamin TABLET 0 0
387 Natrium Diklofenak 50 mg 0 0
388 Neostigmin inj 0 0
389 PK Serbuk 0 0
390 Pramifrol 0,375 MG tab 0 0
391 Propranolol 10 mg Tablet 0 0
392 Propranolol 40 mg 0 0
393 PTU tablet 100 mg 0 0
394 Pulmicort 0.25 Mg/ Ml  0 0
395 Ramipril 10 mg 0 0
396 Rebamipid. 0 0
397 Recofol 10 mg/ml 0 0
398 Rifampisin 600 mg tab 0 0
399 Rocuronium 10 mg/ml inj 0 0
400 Salbutamol 2 mg/5 ml Sirup 0 0
401 Seretide Diskus 50/250MCG. 0 0
402 Spironolakton 25 mg tab 0 0
403 Thrombopop Gel 0 0
404 Thiamzole 10 mg tab. 0 0
405 Triamsinolon inj 0 0
406 Carvedilol (Vbloc) 6,25 mg tab 0 0

Yang menyerahkan Yang menerima

Fezi kendri,Apt Satria Kinayungan, Apt

PEMERINTAH PROVINSI DAERAH KHUSUS IBUKOTA JAKARTA


DINAS KESEHATAN
RUMAH SAKIT UMUM DAERAH CILINCING
Jalan Madya Kebantenan 1 Nomor 4, Cilincing. Telepon : 021 - 441 2889
Email : RSUDCilincing@gmail.com
JAKARTA
Kode Pos 14130

SURAT BUKTI BARANG KELUAR (SBBK)

Di berikan kepada
Nama/ NIP : Satria Kinayungan, Apt
Bagian : Apotek Paru
Tanggal :

No Nama Barang Jumlah Harga


1 Acetazolamid 250 mg 0 0
2 Akarbose 100 mg 0 0
3 Akarbose 50 mg 0 0
4 Akilen tetes telinga 0 0
5 Albendazol sirup 0 0
6 ALBUMIN 25% 100 ML 0 0
7 Alprazolam Tablet 0,5 mg 0 0
8 Alupurinol tablet 100 mg. 0 0
9 Ambroxol 30 mg tab 0 0
10 Ambroxol sirup 0 0
Amikasin 1 gr injrksi (Program TB
11 0 0
RO )
12 AMINOFLUID 1000 mL/Bfluid 0 0
13 Aminopilin Injeksi. 0 0
14 Amiodarone HCL Injeksi 50 mg/ml 0 0
15 Amitriptilin 0 0
16 Amlodipin 10 mg 0 0
17 Amlodipin 5 mg 0 0
18 Amoksilin + As. Kalvulanat tablet 0 0
Amoksilin + Asam Klavulanat Sirup
19 0 0
(Claneksi Sirup)
20 Amoksilin drop 0 0
21 Amoksilin kapsul 250 mg. 0 0
22 Amoxillin kapsul 500 mg 0 0
23 Antasida DOEN tab.kombinasi 0 0
24 Anti Hemoroid 0 0
25 Aqua Pro injeksi 0 0
26 Aripirazol 10 mg 0 0
27 Asam Askorbat (Vit.C) tab.50 mg. 0 0
Asam Mefenamat 500 mg
28 0 0
tablet salut selaput
29 Asam traneksamat inj 0 0
Asetil sistein 100 mg Sirup
30 0 0
(Fluimucil Sirup)
31 Asetil sistein 200 mg 0 0
32 Asiklovir 200 mg tab 0 0
33 Asiklovir 400 mg. tablet 0 0
34 Asiklovir salep 0 0
35 Atenolol 50 mg 0 0
36 Atorvastain Calcium tab 20 mg 0 0
37 Atorvastatin 10 mg Tablet 0 0
38 Atropin sulfat Injeksi 0 0
39 Avamys Spray 0 0
40 Azitromisin 500 mg 0 0
41 Azitromisin sirup kering 200 mg 0 0
42 Bayclin 0 0
Bedaquiline 100 mg (Program TB
43 0 0
RO )
Betametason + Neomisin Krim
44 0 0
(Benoson N Krim)
45 Betametason krim 0,1 % 0 0
46 Biosat ATS 0 0
47 Bisoprolol 5 mg 0 0
48 Bricasma Injeksi (Terbutalin) 0 0
49 Bromheksin 8 mg 0 0
Bupivicain Injeksi (REGIVELL
50 0 0
Injeksi)
51 Calcium Gluconat 0 0
52 candesartan 16 mg 0 0
53 Candesartan 8 mg tab 0 0
54 Carbazocrome inj 0 0
55 Ceftazidim injeksi 0 0
56 Ceftriaxon injeksi 0 0
57 Cendo Asthenof 0 0
58 Cendo Catarlent 15 ml 0 0
59 Cendo Cenfresh Eye Drop 0 0
60 Cendo floxa Eye Drop 0 0
61 Cendo Lyteers 0 0
62 Cendo mata pantocain 0 0
63 Cendo Mydriatil Tetes Mata 0 0
64 Cendo polydex 0 0
65 Cendo Statrol 0 0
66 Cendo timol 0 0
67 Cendo Tropin 0.5% 0 0
68 Cendo Xitrol Eye Drop 0 0
69 Cendo Xitrol salep mata 3,5 Gram 0 0

Cilostazol Tablet 100 mg (Pletaal


70 0 0
Tablet)
71 Citicolin inj 0 0
72 Clindamisin 300 mg 0 0
73 Clindamycin caps 150 mg 0 0
74 Clotrimazole (Dermifar Krim) 0 0
75 Combiven Inhaler 0 0
76 Coparcetin 0 0
77 Curcuma tab 0 0
78 Deksametason tablet 0,5 mg. 0 0
79 Delamanid 50 mg (Program TB RO ) 0 0
80 Depakote ER 250 mg 0 0
81 Depakote ER 500 mg 0 0
Dextrometrophan + Gliseril
82 Guaiacolat + Phenylpropanolamin 0 0
HC + Chlo heniramine Maleat Tab
83 Diazepam 5 mg tablet 0 0
84 Diazepam Injeksi 0 0
Diazepam Rectal Tube 20 mg
85 0 0
(STEOLID 10)
Diazepam Rectal Tube 5 mg
86 0 0
(STESOLID 5)
87 Diazink tab 0 0
Digoksin injeksi 0,25 mg
88 0 0
(FARGOKSIN IV)
89 Digoksin tablet 0,25 mg. 0 0
90 Diltiazem 10 mg 0 0
91 Diphenhidramin injeksi 0 0
92 Dipsamol inhaler 0 0
93 Domperidon 0 0
94 Domperidon 10 mg sirup 0 0
95 Domperidon drop 0 0
96 Donepezile 0 0
97 Doxycyclin kapsul 100 mg. 0 0
98 Epinefrin injeksi 0 0
99 Eritromisin 500 mg tab 0 0
100 Etanol 70 % 1 liter 0 0
101 Ethambutol 400 mg (Program TB ) 0 0

Ethionamide 250 mg (Program TB


102 0 0
RO )
103 ethyl cloride 0 0
104 Euthyrox Tab 0 0
105 fenitoin injeksi 0 0
106 Fenitoin Kapsul 0 0
107 Fentanyl Injeksi 100 mcg/2ml Injeks 0 0
108 Ferriz drop 0 0
Fitomenadion (Vit.K10
109 0 0
inj.10mg/ml01ml
110 Flixotide 0 0
111 Flukonazole tab 0 0
112 Furosemid injeksi 0 0
113 Furosemid tab 0 0
114 Gabapentin 100 mg 0 0
115 Gabapentin 300 mg tab 0 0
116 Garam Oralit 200 ml air 0 0
117 Gemfibrozil Kapsul 300 mg 0 0
118 Gentamisin Cream Kulit 0 0
119 gentamisin injeksi 0 0
120 Glibenklamid 5 mg 0 0
121 Glikazid 80 mg 0 0
122 Glikuidon 30 Mg  0 0
123 glimepirid 2 mg 0 0
124 Glukosa 40% 0 0
125 Glukose larutan infus 10 % steril 0 0
126 Glukose larutan infus 5 % steril 0 0
127 Haloperidol 50 mg injeksi 0 0
128 Haloperidol tablet 5 mg 0 0
129 Herbesser injeksi 0 0
130 Hidonac Injeksi 2.5 g 0 0
Hidroklorotiazide (HCT) tablet 25
131 0 0
mg.
132 Hidrokortison cr 0 0
Human Tetanus Immunoglobulin 1
133 0 0
ml 250 IU (TETAGAM)
134 Hyoscine n Butil Bromide Injeksi 0 0
135 Hyosin N Butylbromide 10 mg 0 0
136 Ialuset plus 0 0
137 Ibuprofen tab 400 mg 0 0
138 Ibuprofen tablet 200 mg. 0 0
139 INH 100 mg (Program TB RO ) 0 0
140 INH 300 mg (Program TB RO ) 0 0
141 INH 300 mg (Program TB RO ) 0 0
Inhalasi Salbutamol Device
142 0 0
(Salbulin)
143 Inhaler Ventolin 0 0
144 Inviclot 0 0
145 Iodin Povidone 1 L 0 0
146 Isoniazid 300 mg (Program TB RO ) 0 0

147 Isonoasid 300 mg (Program TB RO ) 0 0


148 Isosorbid injeksi 10 mg 0 0
149 Isosorbit Dinitrat tab sublingal 5 mg. 0 0
150 Kaen 1 B  0 0
151 Kaen 3 B  0 0
152 Kalium Diklofenak 50 mg 0 0
153 Kalsium Laktat (Kalk) tab.500 mg. 0 0
154 Kaptopril 12,5 mg tablet 0 0
155 Kaptopril 25 mg tablet 0 0
156 Kidmin infus 0 0
157 Kloramfenikol 500 mg 0 0
158 Kloramfenikol Salep mata 0 0
159 Kloramfenikol tetes telinga 0 0
Klorfeniramin Maleat (CTM) tablet 4
160 0 0
mg.
161 Kodein 20 mg 0 0
162 Kotrimoksazol dewasa tablet 0 0
163 Kotrimoksazol suspensi 0 0
164 KSR 0 0
165 Lacto B 0 0
166 Lactulac sirup 0 0
Lamivudine (3TC) 150mg (Program
167 0 0
HIV)
168 lansoprazol capsul 0 0
169 Lansoprazol injeksi 0 0
170 Lantus 0 0
171 Levemir Insulin 0 0
172 Levodopa + Benserazide kombinasi 0 0
173 Levofloksasin tab 0 0
174 Levofloxacin infus 5mg/ml 0 0
175 Lidocain 2 % injeksi 0 0
Lidokain HCL0 Epinefrin Injeksi/amp
176 0 0
2 ml (PEHACAIN)

177 Linezolid 600 mg (Program TB RO ) 0 0


178 Loperamid tablet 0 0
179 Madopar tab/Levopar 0 0
180 Manitol infus 25 mL 0 0
181 Mecobalamin 500 mg 0 0
182 Meloksikam 15 mg 0 0
183 Meloxicam 15 mg 0 0
184 Mersibion inj 0 0
185 Metamizole Injeksi 0 0
186 Metamizole Tablet 500 mg 0 0
187 Metformin 500 mg 0 0
188 Metformin tab 850 mg 0 0
Metil Ergometrin (METERGIN
189 0 0
Injeksi)
190 Metil Prednisolon 125MG/ml INJ 0 0
191 Metil Prednisolon 4 mg 0 0
192 Metildopa tablet 0 0
193 Metoklo ramid 10 mg tab 0 0
194 Metronidazol 500 mg ovula 0 0
195 Metronidazol tablet 500 mg. 0 0
196 metronidazole infus 0 0
197 Mgso4 infus 0 0
198 Miconazole cream 0 0
199 Mineral Mix 0 0
200 Minosep Gargle 0 0
201 Misoprostol tab 0 0
Moxifloxacin 400 mg (Program TB
202 0 0
RO )
203 Mupirocin salep 0 0
204 NaCL 0.9%, 100 ml 0 0
205 NaCL 0.9%, 500 ml 0 0
206 Nalokson injeksi 0.4 mg 0 0
207 Natrium Bikarbonat tablet 0 0
208 Natrium Diklofenak 25 mg tab 0 0
209 Natrium Klorida 3% 0 0
210 Neurodex 0 0
Nevirapine (NVP) 200mg(Program
211 0 0
HIV )
212 Nifedipin 10 mg. tablet 0 0
213 Nikardipin injeksi 0 0
214 Nistatin 500.000 IU tablet salut 0 0
215 Nistatin drop 0 0
216 Nitrogliserin 5 mg 0 0
217 Nitrokaf retard 2.5 mg 0 0
218 Norepinefrine 1 mg/ml 0 0
219 Novomix insulin 0 0
220 Novorapid insulin 0 0
221 OAT Combivak (Program TB ) 0 0
Obat Anti Tubercolosis Anak
222 0 0
(Program TB )
Obat Anti Tuberkolosis Kategori I
223 0 0
(Program TB SO )
Obat Anti Tuberkolosis Kategori II
224 0 0
(Program TB )
225 OBH 0 0
226 Oksitosina injeksi 10 IU / ml01ml 0 0
227 Omeprazol 20 mg tab 0 0
228 Omeprazol injeksi 0 0
229 Ondansetron 4 mg Inj 0 0
230 Ondansetron 8 mg 0 0
231 Parasetamol drop 0 0
232 Parasetamol infus 0 0
233 Parasetamol sirup 120 mg/ 5 ml 0 0
234 Parasetamol Supp 125 mg 0 0
235 Parasetamol suppos 250 mg 0 0
236 Parasetamol tablet 500 mg. 0 0
237 Pioglitazon 0 0
238 Pirazinamid 500 mg (Program TB ) 0 0
239 Prednison 5 mg 0 0
Procain Penisilline (Program TB
240 0 0
RO )
Pseudoefedrin HCL 15 mg +
241 0 0
Terfenadine
242 Ramipril 5 Mg Tab  0 0
243 Ranitidin 150 mg 0 0
244 Ranitidin injeksi 0 0
245 Ranivel sirup 0 0
246 Requip tab 0 0
Rifampisin 450 mg tab (Program
247 0 0
TB )
248 Ringer Laktat 0 0
249 Risperidone 2 mg 0 0
250 Salbutamol 2 mg 0 0
251 Salbutamol 4 mg tab 0 0
252 Salisil Bedak 2 % 0 0
253 SANBE Baquinor 0.3% Tetes Mata 0 0
254 SANBE Forumen 0 0
255 SANBE Fukrisin ED 5 ml 0 0
256 SANBE Hyaloph Eye Drop 0 0
257 SANBE Otilon tetes telinga 0 0
258 Sefadroksil 500 mg kapsul 0 0
259 Sefadroksil sirup 0 0
260 Sefiksim 100 mg 0 0
261 Sefiksim 100 mg sirup 0 0
262 Sefiksim 200 mg 0 0
263 Sefotaksim injeksi 0 0
264 Seftriakson injeksi 0 0
265 Seretide Diskus (50/500) 0 0
266 Sertralin 50 mg 0 0
267 Setirizin 10 mg sirup 0 0
268 Setirizin 10 mg tab 0 0
269 Sevodex 0 0
270 Simarc 2 mg 0 0
271 Simvastatin 20 mg 0 0
272 Siprofloksasin 2% Infus 0 0
273 Siprofloksasin 500 mg tablet 0 0
274 SNMC Injeksi 0 0
275 Stesolid 10 mg 0 0
276 Stesolid 5 mg 0 0
277 Streptomycin 1 gr (Program TB ) 0 0
278 sukralfat tablet 0 0
279 Sulfadiazin krim 0 0
280 Tablet tambah darah kombinasi 0 0
TDF 300/3TC 300/DTG 50 (Program
281 0 0
HIV)
TDF/3TC/EFV(300/300/600)
282 0 0
(Program HIV)
283 Telmisartan 40 mg tab 0 0
Tenofovir (TDF) 300mg (Program
284 0 0
HIV)

285 Teofilin tab 150 mg (BRONSOLVAN) 0 0


286 Terbutalin Sulfat 0,5mg/ml Injeksi 0 0
287 Thiamfenikol 500 0 0

Tramadol 37,5 mg + Parasetamol


288 0 0
caps (ANALTRAM caps)

289 Tramadol inj 0 0


290 Trihexyphenidyl tab 0 0
291 Trilac (Triamcinolon) 0 0
292 Tuberculin PPD TEST 0 0

Urdafalk tab (URSODEOXYCHOLIC


293 0 0
ACID GENERIK)

294 Vaksin HB0 (Program VAKSIN) 0 0


Vaksin TD Single Use
295 0 0
(Program TB RO )
296 Valsartan 160 mg 0 0
297 Valsartan 80 mg 0 0
298 Vasacon 0 0
Vicilin SX serbuk injeksi (Ampisilin
299 0 0
Sulbactam)
300 Vitamin B Kompleks Tablet 0 0
301 Vitamin B6 0 0
302 Vitamin B6 0 0
303 Vitamin B6 10 mg 0 0
304 VITAMIN C INJEKSI 0 0
305 Vitamin D3 1000 iu 0 0
Vitamin Sirup anak
306 0 0
(UNIVIT/TIALISIN)
307 Water Steril 1 L 0 0
308 Xylocain 10% Spray 0 0
309 Xylocain Jelly 2% 0 0
Zidovudin (Zdv) 100 mg (Program
310 0 0
HIV)
Zidovudine (ZDV)/Lamivudine (3TC)
311 0 0
300/150mg (Program HIV)
312 Zinc Sirup 0 0
313 Abilify 15 mg (Aripriprazole) 0 0
314 Adalat Oros Tab 0 0
315 Allopurinol 300 mg 0 0
316 Ampicilin Inj 0 0
317 Antasida DOEN syr 0 0
318 ARDIUM 0 0
319 Aricept Evess (Donepezil 10mg) 0 0
320 Arixtra Inj 0 0
321 As. Valproat Sirup 0 0
322 Asam Folat tab 0 0
323 Asam Traneksamat 500 mg tab 0 0
324 Asering 500 ml 0 0
325 Atracurium Injeksi (Tramus Inj) 0 0
326 Attapulgite tablet 0 0
327 Betahistin 6 mg 0 0
328 Bisakodil tab 0 0
329 Bisoprolol 2.5 mg 0 0
330 CaCO3 0 0
331 Captopril 25 mg 0 0
332 Cefoperazone 0 0
333 Cendo Efrisel. 0 0
334 Cendo Siloxan 0 0
335 Cetadop inj (Dopamin) 0 0
336 Cetirizin Sirup 0 0
337 Cetirizin tab 0 0
338 Chloroquin 150 mg tablet 0 0
339 Chlorpromazin Tab 0 0
340 Citicolin tab. 0 0
341 Clobazam 10 mg 0 0
342 Clonazepam 2 mg tab 0 0
343 Clonidine tablet 0,15 mg 0 0
344 Clozapine 100 mg 0 0
345 Clozapine 25 mg 0 0
346 Concor 1,25 0 0
347 Deksametason inj 0 0
348 Diltiazem tablet 30 mg 0 0
349 Dobutamin Inj 0 0
350 Beraprost (Dorner) tab 0 0
351 Dulcolax supp 5 mg 0 0
352 Efedrin Injeksi 50 mg 0 0
353 Eperison tablet 0 0
354 Fenofibrate 100mg kap 0 0
355 Ferro-K Sirup 0 0
356 Fitomenadion tablet 10 mg 0 0
357 Flunarizine 10 mg tab 0 0
358 Fluoxetin Capsul 0 0
359 Gelofusin 0 0
360 Glimepirid 1 mg 0 0
361 Glimepirid 3 mg 0 0
362 Glimepiride 4 mg 0 0
363 Glucosamin Tab 0 0
364 Tamsolusin 0 0
365 Herbesser CD 100 mg 0 0
366 Hot In Cream DCL 0 0
367 HP PRO 0 0
368 Ibuprofen suspensi 0 0
369 KCL 7.46% 0 0
370 Ketamin Inj 0 0
371 Ketoconazol Tab 0 0
372 Ketokonazol Cr 0 0
373 Ketoprofen Supp 0 0
374 Ketorolac inj 30 mg 0 0
375 Klopidogrel 75 mg 0 0
376 Kolkisin tablet 0 0
377 Loratadine 10 mg 0 0
378 Meropenem Injeksi 0 0
379 Methosoprinol syr 0 0
380 Metil Ergometrin tab (Bledstop) 0 0
381 Metil Prednisolon 16 mg 0 0
382 Metoklopramid Injeksi 0 0
383 Meylon 0 0
384 Microlax 0 0
385 miniaspi 80mg 0 0
386 Multivitamin TABLET 0 0
387 Natrium Diklofenak 50 mg 0 0
388 Neostigmin inj 0 0
389 PK Serbuk 0 0
390 Pramifrol 0,375 MG tab 0 0
391 Propranolol 10 mg Tablet 0 0
392 Propranolol 40 mg 0 0
393 PTU tablet 100 mg 0 0
394 Pulmicort 0.25 Mg/ Ml  0 0
395 Ramipril 10 mg 0 0
396 Rebamipid. 0 0
397 Recofol 10 mg/ml 0 0
398 Rifampisin 600 mg tab 0 0
399 Rocuronium 10 mg/ml inj 0 0
400 Salbutamol 2 mg/5 ml Sirup 0 0
401 Seretide Diskus 50/250MCG. 0 0
402 Spironolakton 25 mg tab 0 0
403 Thrombopop Gel 0 0
404 Thiamzole 10 mg tab. 0 0
405 Triamsinolon inj 0 0
406 Carvedilol (Vbloc) 6,25 mg tab 0 0

Yang menyerahkan Yang menerima

Fezi kendri,Apt Satria Kinayungan, Apt

PEMERINTAH PROVINSI DAERAH KHUSUS IBUKOTA JAKARTA


DINAS KESEHATAN
RUMAH SAKIT UMUM DAERAH CILINCING
Jalan Madya Kebantenan 1 Nomor 4, Cilincing. Telepon : 021 - 441 2889
Email : RSUDCilincing@gmail.com
JAKARTA
Kode Pos 14130

SURAT BUKTI BARANG KELUAR (SBBK)

Di berikan kepada
Nama/ NIP : Satria Kinayungan, Apt
Bagian : Apotek Paru
Tanggal :

No Nama Barang Jumlah Harga


1 Acetazolamid 250 mg 0 0
2 Akarbose 100 mg 0 0
3 Akarbose 50 mg 0 0
4 Akilen tetes telinga 0 0
5 Albendazol sirup 0 0
6 ALBUMIN 25% 100 ML 0 0
7 Alprazolam Tablet 0,5 mg 0 0
8 Alupurinol tablet 100 mg. 0 0
9 Ambroxol 30 mg tab 0 0
10 Ambroxol sirup 0 0
Amikasin 1 gr injrksi (Program TB
11 0 0
RO )
12 AMINOFLUID 1000 mL/Bfluid 0 0
13 Aminopilin Injeksi. 0 0
14 Amiodarone HCL Injeksi 50 mg/ml 0 0
15 Amitriptilin 0 0
16 Amlodipin 10 mg 0 0
17 Amlodipin 5 mg 0 0
18 Amoksilin + As. Kalvulanat tablet 0 0
Amoksilin + Asam Klavulanat Sirup
19 0 0
(Claneksi Sirup)
20 Amoksilin drop 0 0
21 Amoksilin kapsul 250 mg. 0 0
22 Amoxillin kapsul 500 mg 0 0
23 Antasida DOEN tab.kombinasi 0 0
24 Anti Hemoroid 0 0
25 Aqua Pro injeksi 0 0
26 Aripirazol 10 mg 0 0
27 Asam Askorbat (Vit.C) tab.50 mg. 0 0
Asam Mefenamat 500 mg
28 0 0
tablet salut selaput
29 Asam traneksamat inj 0 0
Asetil sistein 100 mg Sirup
30 0 0
(Fluimucil Sirup)
31 Asetil sistein 200 mg 0 0
32 Asiklovir 200 mg tab 0 0
33 Asiklovir 400 mg. tablet 0 0
34 Asiklovir salep 0 0
35 Atenolol 50 mg 0 0
36 Atorvastain Calcium tab 20 mg 0 0
37 Atorvastatin 10 mg Tablet 0 0
38 Atropin sulfat Injeksi 0 0
39 Avamys Spray 0 0
40 Azitromisin 500 mg 0 0
41 Azitromisin sirup kering 200 mg 0 0
42 Bayclin 0 0
Bedaquiline 100 mg (Program TB
43 0 0
RO )
Betametason + Neomisin Krim
44 0 0
(Benoson N Krim)
45 Betametason krim 0,1 % 0 0
46 Biosat ATS 0 0
47 Bisoprolol 5 mg 0 0
48 Bricasma Injeksi (Terbutalin) 0 0
49 Bromheksin 8 mg 0 0
Bupivicain Injeksi (REGIVELL
50 0 0
Injeksi)
51 Calcium Gluconat 0 0
52 candesartan 16 mg 0 0
53 Candesartan 8 mg tab 0 0
54 Carbazocrome inj 0 0
55 Ceftazidim injeksi 0 0
56 Ceftriaxon injeksi 0 0
57 Cendo Asthenof 0 0
58 Cendo Catarlent 15 ml 0 0
59 Cendo Cenfresh Eye Drop 0 0
60 Cendo floxa Eye Drop 0 0
61 Cendo Lyteers 0 0
62 Cendo mata pantocain 0 0
63 Cendo Mydriatil Tetes Mata 0 0
64 Cendo polydex 0 0
65 Cendo Statrol 0 0
66 Cendo timol 0 0
67 Cendo Tropin 0.5% 0 0
68 Cendo Xitrol Eye Drop 0 0
69 Cendo Xitrol salep mata 3,5 Gram 0 0

Cilostazol Tablet 100 mg (Pletaal


70 0 0
Tablet)
71 Citicolin inj 0 0
72 Clindamisin 300 mg 0 0
73 Clindamycin caps 150 mg 0 0
74 Clotrimazole (Dermifar Krim) 0 0
75 Combiven Inhaler 0 0
76 Coparcetin 0 0
77 Curcuma tab 0 0
78 Deksametason tablet 0,5 mg. 0 0
79 Delamanid 50 mg (Program TB RO ) 0 0
80 Depakote ER 250 mg 0 0
81 Depakote ER 500 mg 0 0
Dextrometrophan + Gliseril
82 Guaiacolat + Phenylpropanolamin 0 0
HC + Chlo heniramine Maleat Tab
83 Diazepam 5 mg tablet 0 0
84 Diazepam Injeksi 0 0
Diazepam Rectal Tube 20 mg
85 0 0
(STEOLID 10)
Diazepam Rectal Tube 5 mg
86 0 0
(STESOLID 5)
87 Diazink tab 0 0
Digoksin injeksi 0,25 mg
88 0 0
(FARGOKSIN IV)
89 Digoksin tablet 0,25 mg. 0 0
90 Diltiazem 10 mg 0 0
91 Diphenhidramin injeksi 0 0
92 Dipsamol inhaler 0 0
93 Domperidon 0 0
94 Domperidon 10 mg sirup 0 0
95 Domperidon drop 0 0
96 Donepezile 0 0
97 Doxycyclin kapsul 100 mg. 0 0
98 Epinefrin injeksi 0 0
99 Eritromisin 500 mg tab 0 0
100 Etanol 70 % 1 liter 0 0
101 Ethambutol 400 mg (Program TB ) 0 0

Ethionamide 250 mg (Program TB


102 0 0
RO )
103 ethyl cloride 0 0
104 Euthyrox Tab 0 0
105 fenitoin injeksi 0 0
106 Fenitoin Kapsul 0 0
107 Fentanyl Injeksi 100 mcg/2ml Injeks 0 0
108 Ferriz drop 0 0
Fitomenadion (Vit.K10
109 0 0
inj.10mg/ml01ml
110 Flixotide 0 0
111 Flukonazole tab 0 0
112 Furosemid injeksi 0 0
113 Furosemid tab 0 0
114 Gabapentin 100 mg 0 0
115 Gabapentin 300 mg tab 0 0
116 Garam Oralit 200 ml air 0 0
117 Gemfibrozil Kapsul 300 mg 0 0
118 Gentamisin Cream Kulit 0 0
119 gentamisin injeksi 0 0
120 Glibenklamid 5 mg 0 0
121 Glikazid 80 mg 0 0
122 Glikuidon 30 Mg  0 0
123 glimepirid 2 mg 0 0
124 Glukosa 40% 0 0
125 Glukose larutan infus 10 % steril 0 0
126 Glukose larutan infus 5 % steril 0 0
127 Haloperidol 50 mg injeksi 0 0
128 Haloperidol tablet 5 mg 0 0
129 Herbesser injeksi 0 0
130 Hidonac Injeksi 2.5 g 0 0
Hidroklorotiazide (HCT) tablet 25
131 0 0
mg.
132 Hidrokortison cr 0 0
Human Tetanus Immunoglobulin 1
133 0 0
ml 250 IU (TETAGAM)
134 Hyoscine n Butil Bromide Injeksi 0 0
135 Hyosin N Butylbromide 10 mg 0 0
136 Ialuset plus 0 0
137 Ibuprofen tab 400 mg 0 0
138 Ibuprofen tablet 200 mg. 0 0
139 INH 100 mg (Program TB RO ) 0 0
140 INH 300 mg (Program TB RO ) 0 0
141 INH 300 mg (Program TB RO ) 0 0
Inhalasi Salbutamol Device
142 0 0
(Salbulin)
143 Inhaler Ventolin 0 0
144 Inviclot 0 0
145 Iodin Povidone 1 L 0 0
146 Isoniazid 300 mg (Program TB RO ) 0 0

147 Isonoasid 300 mg (Program TB RO ) 0 0


148 Isosorbid injeksi 10 mg 0 0
149 Isosorbit Dinitrat tab sublingal 5 mg. 0 0
150 Kaen 1 B  0 0
151 Kaen 3 B  0 0
152 Kalium Diklofenak 50 mg 0 0
153 Kalsium Laktat (Kalk) tab.500 mg. 0 0
154 Kaptopril 12,5 mg tablet 0 0
155 Kaptopril 25 mg tablet 0 0
156 Kidmin infus 0 0
157 Kloramfenikol 500 mg 0 0
158 Kloramfenikol Salep mata 0 0
159 Kloramfenikol tetes telinga 0 0
Klorfeniramin Maleat (CTM) tablet 4
160 0 0
mg.
161 Kodein 20 mg 0 0
162 Kotrimoksazol dewasa tablet 0 0
163 Kotrimoksazol suspensi 0 0
164 KSR 0 0
165 Lacto B 0 0
166 Lactulac sirup 0 0
Lamivudine (3TC) 150mg (Program
167 0 0
HIV)
168 lansoprazol capsul 0 0
169 Lansoprazol injeksi 0 0
170 Lantus 0 0
171 Levemir Insulin 0 0
172 Levodopa + Benserazide kombinasi 0 0
173 Levofloksasin tab 0 0
174 Levofloxacin infus 5mg/ml 0 0
175 Lidocain 2 % injeksi 0 0
Lidokain HCL0 Epinefrin Injeksi/amp
176 0 0
2 ml (PEHACAIN)

177 Linezolid 600 mg (Program TB RO ) 0 0


178 Loperamid tablet 0 0
179 Madopar tab/Levopar 0 0
180 Manitol infus 25 mL 0 0
181 Mecobalamin 500 mg 0 0
182 Meloksikam 15 mg 0 0
183 Meloxicam 15 mg 0 0
184 Mersibion inj 0 0
185 Metamizole Injeksi 0 0
186 Metamizole Tablet 500 mg 0 0
187 Metformin 500 mg 0 0
188 Metformin tab 850 mg 0 0
Metil Ergometrin (METERGIN
189 0 0
Injeksi)
190 Metil Prednisolon 125MG/ml INJ 0 0
191 Metil Prednisolon 4 mg 0 0
192 Metildopa tablet 0 0
193 Metoklo ramid 10 mg tab 0 0
194 Metronidazol 500 mg ovula 0 0
195 Metronidazol tablet 500 mg. 0 0
196 metronidazole infus 0 0
197 Mgso4 infus 0 0
198 Miconazole cream 0 0
199 Mineral Mix 0 0
200 Minosep Gargle 0 0
201 Misoprostol tab 0 0
Moxifloxacin 400 mg (Program TB
202 0 0
RO )
203 Mupirocin salep 0 0
204 NaCL 0.9%, 100 ml 0 0
205 NaCL 0.9%, 500 ml 0 0
206 Nalokson injeksi 0.4 mg 0 0
207 Natrium Bikarbonat tablet 0 0
208 Natrium Diklofenak 25 mg tab 0 0
209 Natrium Klorida 3% 0 0
210 Neurodex 0 0
Nevirapine (NVP) 200mg(Program
211 0 0
HIV )
212 Nifedipin 10 mg. tablet 0 0
213 Nikardipin injeksi 0 0
214 Nistatin 500.000 IU tablet salut 0 0
215 Nistatin drop 0 0
216 Nitrogliserin 5 mg 0 0
217 Nitrokaf retard 2.5 mg 0 0
218 Norepinefrine 1 mg/ml 0 0
219 Novomix insulin 0 0
220 Novorapid insulin 0 0
221 OAT Combivak (Program TB ) 0 0
Obat Anti Tubercolosis Anak
222 0 0
(Program TB )
Obat Anti Tuberkolosis Kategori I
223 0 0
(Program TB SO )
Obat Anti Tuberkolosis Kategori II
224 0 0
(Program TB )
225 OBH 0 0
226 Oksitosina injeksi 10 IU / ml01ml 0 0
227 Omeprazol 20 mg tab 0 0
228 Omeprazol injeksi 0 0
229 Ondansetron 4 mg Inj 0 0
230 Ondansetron 8 mg 0 0
231 Parasetamol drop 0 0
232 Parasetamol infus 0 0
233 Parasetamol sirup 120 mg/ 5 ml 0 0
234 Parasetamol Supp 125 mg 0 0
235 Parasetamol suppos 250 mg 0 0
236 Parasetamol tablet 500 mg. 0 0
237 Pioglitazon 0 0
238 Pirazinamid 500 mg (Program TB ) 0 0
239 Prednison 5 mg 0 0
Procain Penisilline (Program TB
240 0 0
RO )
Pseudoefedrin HCL 15 mg +
241 0 0
Terfenadine
242 Ramipril 5 Mg Tab  0 0
243 Ranitidin 150 mg 0 0
244 Ranitidin injeksi 0 0
245 Ranivel sirup 0 0
246 Requip tab 0 0
Rifampisin 450 mg tab (Program
247 0 0
TB )
248 Ringer Laktat 0 0
249 Risperidone 2 mg 0 0
250 Salbutamol 2 mg 0 0
251 Salbutamol 4 mg tab 0 0
252 Salisil Bedak 2 % 0 0
253 SANBE Baquinor 0.3% Tetes Mata 0 0
254 SANBE Forumen 0 0
255 SANBE Fukrisin ED 5 ml 0 0
256 SANBE Hyaloph Eye Drop 0 0
257 SANBE Otilon tetes telinga 0 0
258 Sefadroksil 500 mg kapsul 0 0
259 Sefadroksil sirup 0 0
260 Sefiksim 100 mg 0 0
261 Sefiksim 100 mg sirup 0 0
262 Sefiksim 200 mg 0 0
263 Sefotaksim injeksi 0 0
264 Seftriakson injeksi 0 0
265 Seretide Diskus (50/500) 0 0
266 Sertralin 50 mg 0 0
267 Setirizin 10 mg sirup 0 0
268 Setirizin 10 mg tab 0 0
269 Sevodex 0 0
270 Simarc 2 mg 0 0
271 Simvastatin 20 mg 0 0
272 Siprofloksasin 2% Infus 0 0
273 Siprofloksasin 500 mg tablet 0 0
274 SNMC Injeksi 0 0
275 Stesolid 10 mg 0 0
276 Stesolid 5 mg 0 0
277 Streptomycin 1 gr (Program TB ) 0 0
278 sukralfat tablet 0 0
279 Sulfadiazin krim 0 0
280 Tablet tambah darah kombinasi 0 0
TDF 300/3TC 300/DTG 50 (Program
281 0 0
HIV)
TDF/3TC/EFV(300/300/600)
282 0 0
(Program HIV)
283 Telmisartan 40 mg tab 0 0
Tenofovir (TDF) 300mg (Program
284 0 0
HIV)

285 Teofilin tab 150 mg (BRONSOLVAN) 0 0


286 Terbutalin Sulfat 0,5mg/ml Injeksi 0 0
287 Thiamfenikol 500 0 0

Tramadol 37,5 mg + Parasetamol


288 0 0
caps (ANALTRAM caps)

289 Tramadol inj 0 0


290 Trihexyphenidyl tab 0 0
291 Trilac (Triamcinolon) 0 0
292 Tuberculin PPD TEST 0 0

Urdafalk tab (URSODEOXYCHOLIC


293 0 0
ACID GENERIK)

294 Vaksin HB0 (Program VAKSIN) 0 0


Vaksin TD Single Use
295 0 0
(Program TB RO )
296 Valsartan 160 mg 0 0
297 Valsartan 80 mg 0 0
298 Vasacon 0 0
Vicilin SX serbuk injeksi (Ampisilin
299 0 0
Sulbactam)
300 Vitamin B Kompleks Tablet 0 0
301 Vitamin B6 0 0
302 Vitamin B6 0 0
303 Vitamin B6 10 mg 0 0
304 VITAMIN C INJEKSI 0 0
305 Vitamin D3 1000 iu 0 0
Vitamin Sirup anak
306 0 0
(UNIVIT/TIALISIN)
307 Water Steril 1 L 0 0
308 Xylocain 10% Spray 0 0
309 Xylocain Jelly 2% 0 0
Zidovudin (Zdv) 100 mg (Program
310 0 0
HIV)
Zidovudine (ZDV)/Lamivudine (3TC)
311 0 0
300/150mg (Program HIV)
312 Zinc Sirup 0 0
313 Abilify 15 mg (Aripriprazole) 0 0
314 Adalat Oros Tab 0 0
315 Allopurinol 300 mg 0 0
316 Ampicilin Inj 0 0
317 Antasida DOEN syr 0 0
318 ARDIUM 0 0
319 Aricept Evess (Donepezil 10mg) 0 0
320 Arixtra Inj 0 0
321 As. Valproat Sirup 0 0
322 Asam Folat tab 0 0
323 Asam Traneksamat 500 mg tab 0 0
324 Asering 500 ml 0 0
325 Atracurium Injeksi (Tramus Inj) 0 0
326 Attapulgite tablet 0 0
327 Betahistin 6 mg 0 0
328 Bisakodil tab 0 0
329 Bisoprolol 2.5 mg 0 0
330 CaCO3 0 0
331 Captopril 25 mg 0 0
332 Cefoperazone 0 0
333 Cendo Efrisel. 0 0
334 Cendo Siloxan 0 0
335 Cetadop inj (Dopamin) 0 0
336 Cetirizin Sirup 0 0
337 Cetirizin tab 0 0
338 Chloroquin 150 mg tablet 0 0
339 Chlorpromazin Tab 0 0
340 Citicolin tab. 0 0
341 Clobazam 10 mg 0 0
342 Clonazepam 2 mg tab 0 0
343 Clonidine tablet 0,15 mg 0 0
344 Clozapine 100 mg 0 0
345 Clozapine 25 mg 0 0
346 Concor 1,25 0 0
347 Deksametason inj 0 0
348 Diltiazem tablet 30 mg 0 0
349 Dobutamin Inj 0 0
350 Beraprost (Dorner) tab 0 0
351 Dulcolax supp 5 mg 0 0
352 Efedrin Injeksi 50 mg 0 0
353 Eperison tablet 0 0
354 Fenofibrate 100mg kap 0 0
355 Ferro-K Sirup 0 0
356 Fitomenadion tablet 10 mg 0 0
357 Flunarizine 10 mg tab 0 0
358 Fluoxetin Capsul 0 0
359 Gelofusin 0 0
360 Glimepirid 1 mg 0 0
361 Glimepirid 3 mg 0 0
362 Glimepiride 4 mg 0 0
363 Glucosamin Tab 0 0
364 Tamsolusin 0 0
365 Herbesser CD 100 mg 0 0
366 Hot In Cream DCL 0 0
367 HP PRO 0 0
368 Ibuprofen suspensi 0 0
369 KCL 7.46% 0 0
370 Ketamin Inj 0 0
371 Ketoconazol Tab 0 0
372 Ketokonazol Cr 0 0
373 Ketoprofen Supp 0 0
374 Ketorolac inj 30 mg 0 0
375 Klopidogrel 75 mg 0 0
376 Kolkisin tablet 0 0
377 Loratadine 10 mg 0 0
378 Meropenem Injeksi 0 0
379 Methosoprinol syr 0 0
380 Metil Ergometrin tab (Bledstop) 0 0
381 Metil Prednisolon 16 mg 0 0
382 Metoklopramid Injeksi 0 0
383 Meylon 0 0
384 Microlax 0 0
385 miniaspi 80mg 0 0
386 Multivitamin TABLET 0 0
387 Natrium Diklofenak 50 mg 0 0
388 Neostigmin inj 0 0
389 PK Serbuk 0 0
390 Pramifrol 0,375 MG tab 0 0
391 Propranolol 10 mg Tablet 0 0
392 Propranolol 40 mg 0 0
393 PTU tablet 100 mg 0 0
394 Pulmicort 0.25 Mg/ Ml  0 0
395 Ramipril 10 mg 0 0
396 Rebamipid. 0 0
397 Recofol 10 mg/ml 0 0
398 Rifampisin 600 mg tab 0 0
399 Rocuronium 10 mg/ml inj 0 0
400 Salbutamol 2 mg/5 ml Sirup 0 0
401 Seretide Diskus 50/250MCG. 0 0
402 Spironolakton 25 mg tab 0 0
403 Thrombopop Gel 0 0
404 Thiamzole 10 mg tab. 0 0
405 Triamsinolon inj 0 0
406 Carvedilol (Vbloc) 6,25 mg tab 0 0

Yang menyerahkan Yang menerima

Fezi kendri,Apt Satria Kinayungan, Apt


JAKARTA

G
21 - 441 2889

s 14130

Keterangan
ayungan, Apt

JAKARTA

G
21 - 441 2889
s 14130

Keterangan
ayungan, Apt

JAKARTA

G
21 - 441 2889

s 14130
Keterangan
ayungan, Apt

JAKARTA

G
21 - 441 2889

s 14130

Keterangan
ayungan, Apt
PEMERINTAH PROVINSI DAERAH KHUSUS IBUKOTA JAKARTA
DINAS KESEHATAN
RUMAH SAKIT UMUM DAERAH CILINCING
Jalan Madya Kebantenan 1 Nomor 4, Cilincing. Telepon : 021 - 441 2889
Email : RSUDCilincing@gmail.com
JAKARTA
Kode Pos 14130

SURAT BUKTI BARANG KELUAR (SBBK)

Di berikan kepada
Nama/ NIP : Norman Dwiyanto, Apt
Bagian : Apotek PRB
Tanggal :

No Nama Barang Jumlah Harga


1 Acetazolamid 250 mg 0 0
2 Akarbose 100 mg 0 0
3 Akarbose 50 mg 0 0
4 Akilen tetes telinga 0 0
5 Albendazol sirup 0 0
6 ALBUMIN 25% 100 ML 0 0
7 Alprazolam Tablet 0,5 mg 0 0
8 Alupurinol tablet 100 mg. 0 0
9 Ambroxol 30 mg tab 0 0
10 Ambroxol sirup 0 0
Amikasin 1 gr injrksi (Program TB
11 0 0
RO )
12 AMINOFLUID 1000 mL/Bfluid 0 0
13 Aminopilin Injeksi. 0 0
14 Amiodarone HCL Injeksi 50 mg/ml 0 0
15 Amitriptilin 0 0
16 Amlodipin 10 mg 0 0
17 Amlodipin 5 mg 0 0
18 Amoksilin + As. Kalvulanat tablet 0 0
Amoksilin + Asam Klavulanat Sirup
19 0 0
(Claneksi Sirup)
20 Amoksilin drop 0 0
21 Amoksilin kapsul 250 mg. 0 0
22 Amoxillin kapsul 500 mg 0 0
23 Antasida DOEN tab.kombinasi 0 0
24 Anti Hemoroid 0 0
25 Aqua Pro injeksi 0 0
26 Aripirazol 10 mg 0 0
27 Asam Askorbat (Vit.C) tab.50 mg. 0 0
Asam Mefenamat 500 mg
28 0 0
tablet salut selaput
29 Asam traneksamat inj 0 0
Asetil sistein 100 mg Sirup
30 0 0
(Fluimucil Sirup)
31 Asetil sistein 200 mg 0 0
32 Asiklovir 200 mg tab 0 0
33 Asiklovir 400 mg. tablet 0 0
34 Asiklovir salep 0 0
35 Atenolol 50 mg 0 0
36 Atorvastain Calcium tab 20 mg 0 0
37 Atorvastatin 10 mg Tablet 0 0
38 Atropin sulfat Injeksi 0 0
39 Avamys Spray 0 0
40 Azitromisin 500 mg 0 0
41 Azitromisin sirup kering 200 mg 0 0
42 Bayclin 0 0
Bedaquiline 100 mg (Program TB
43 0 0
RO )
Betametason + Neomisin Krim
44 0 0
(Benoson N Krim)
45 Betametason krim 0,1 % 0 0
46 Biosat ATS 0 0
47 Bisoprolol 5 mg 0 0
48 Bricasma Injeksi (Terbutalin) 0 0
49 Bromheksin 8 mg 0 0
Bupivicain Injeksi (REGIVELL
50 0 0
Injeksi)
51 Calcium Gluconat 0 0
52 candesartan 16 mg 0 0
53 Candesartan 8 mg tab 0 0
54 Carbazocrome inj 0 0
55 Ceftazidim injeksi 0 0
56 Ceftriaxon injeksi 0 0
57 Cendo Asthenof 0 0
58 Cendo Catarlent 15 ml 0 0
59 Cendo Cenfresh Eye Drop 0 0
60 Cendo floxa Eye Drop 0 0
61 Cendo Lyteers 0 0
62 Cendo mata pantocain 0 0
63 Cendo Mydriatil Tetes Mata 0 0
64 Cendo polydex 0 0
65 Cendo Statrol 0 0
66 Cendo timol 0 0
67 Cendo Tropin 0.5% 0 0
68 Cendo Xitrol Eye Drop 0 0
69 Cendo Xitrol salep mata 3,5 Gram 0 0

Cilostazol Tablet 100 mg (Pletaal


70 0 0
Tablet)
71 Citicolin inj 0 0
72 Clindamisin 300 mg 0 0
73 Clindamycin caps 150 mg 0 0
74 Clotrimazole (Dermifar Krim) 0 0
75 Combiven Inhaler 0 0
76 Coparcetin 0 0
77 Curcuma tab 0 0
78 Deksametason tablet 0,5 mg. 0 0
79 Delamanid 50 mg (Program TB RO ) 0 0
80 Depakote ER 250 mg 0 0
81 Depakote ER 500 mg 0 0
Dextrometrophan + Gliseril
82 Guaiacolat + Phenylpropanolamin 0 0
HC + Chlo heniramine Maleat Tab
83 Diazepam 5 mg tablet 0 0
84 Diazepam Injeksi 0 0
Diazepam Rectal Tube 20 mg
85 0 0
(STEOLID 10)
Diazepam Rectal Tube 5 mg
86 0 0
(STESOLID 5)
87 Diazink tab 0 0
Digoksin injeksi 0,25 mg
88 0 0
(FARGOKSIN IV)
89 Digoksin tablet 0,25 mg. 0 0
90 Diltiazem 10 mg 0 0
91 Diphenhidramin injeksi 0 0
92 Dipsamol inhaler 0 0
93 Domperidon 0 0
94 Domperidon 10 mg sirup 0 0
95 Domperidon drop 0 0
96 Donepezile 0 0
97 Doxycyclin kapsul 100 mg. 0 0
98 Epinefrin injeksi 0 0
99 Eritromisin 500 mg tab 0 0
100 Etanol 70 % 1 liter 0 0
101 Ethambutol 400 mg (Program TB ) 0 0
Ethionamide 250 mg (Program TB
102 0 0
RO )
103 ethyl cloride 0 0
104 Euthyrox Tab 0 0
105 fenitoin injeksi 0 0
106 Fenitoin Kapsul 0 0
107 Fentanyl Injeksi 100 mcg/2ml Injeks 0 0
108 Ferriz drop 0 0
Fitomenadion (Vit.K10
109 0 0
inj.10mg/ml01ml
110 Flixotide 0 0
111 Flukonazole tab 0 0
112 Furosemid injeksi 0 0
113 Furosemid tab 0 0
114 Gabapentin 100 mg 0 0
115 Gabapentin 300 mg tab 0 0
116 Garam Oralit 200 ml air 0 0
117 Gemfibrozil Kapsul 300 mg 0 0
118 Gentamisin Cream Kulit 0 0
119 gentamisin injeksi 0 0
120 Glibenklamid 5 mg 0 0
121 Glikazid 80 mg 0 0
122 Glikuidon 30 Mg  0 0
123 glimepirid 2 mg 0 0
124 Glukosa 40% 0 0
125 Glukose larutan infus 10 % steril 0 0
126 Glukose larutan infus 5 % steril 0 0
127 Haloperidol 50 mg injeksi 0 0
128 Haloperidol tablet 5 mg 0 0
129 Herbesser injeksi 0 0
130 Hidonac Injeksi 2.5 g 0 0
Hidroklorotiazide (HCT) tablet 25
131 0 0
mg.
132 Hidrokortison cr 0 0
Human Tetanus Immunoglobulin 1
133 0 0
ml 250 IU (TETAGAM)
134 Hyoscine n Butil Bromide Injeksi 0 0
135 Hyosin N Butylbromide 10 mg 0 0
136 Ialuset plus 0 0
137 Ibuprofen tab 400 mg 0 0
138 Ibuprofen tablet 200 mg. 0 0
139 INH 100 mg (Program TB RO ) 0 0
140 INH 300 mg (Program TB RO ) 0 0
141 INH 300 mg (Program TB RO ) 0 0
Inhalasi Salbutamol Device
142 0 0
(Salbulin)
143 Inhaler Ventolin 0 0
144 Inviclot 0 0
145 Iodin Povidone 1 L 0 0
146 Isoniazid 300 mg (Program TB RO ) 0 0

147 Isonoasid 300 mg (Program TB RO ) 0 0


148 Isosorbid injeksi 10 mg 0 0
149 Isosorbit Dinitrat tab sublingal 5 mg. 0 0
150 Kaen 1 B  0 0
151 Kaen 3 B  0 0
152 Kalium Diklofenak 50 mg 0 0
153 Kalsium Laktat (Kalk) tab.500 mg. 0 0
154 Kaptopril 12,5 mg tablet 0 0
155 Kaptopril 25 mg tablet 0 0
156 Kidmin infus 0 0
157 Kloramfenikol 500 mg 0 0
158 Kloramfenikol Salep mata 0 0
159 Kloramfenikol tetes telinga 0 0
Klorfeniramin Maleat (CTM) tablet 4
160 0 0
mg.
161 Kodein 20 mg 0 0
162 Kotrimoksazol dewasa tablet 0 0
163 Kotrimoksazol suspensi 0 0
164 KSR 0 0
165 Lacto B 0 0
166 Lactulac sirup 0 0
Lamivudine (3TC) 150mg (Program
167 0 0
HIV)
168 lansoprazol capsul 0 0
169 Lansoprazol injeksi 0 0
170 Lantus 0 0
171 Levemir Insulin 0 0
172 Levodopa + Benserazide kombinasi 0 0
173 Levofloksasin tab 0 0
174 Levofloxacin infus 5mg/ml 0 0
175 Lidocain 2 % injeksi 0 0
Lidokain HCL0 Epinefrin Injeksi/amp
176 0 0
2 ml (PEHACAIN)

177 Linezolid 600 mg (Program TB RO ) 0 0


178 Loperamid tablet 0 0
179 Madopar tab/Levopar 0 0
180 Manitol infus 25 mL 0 0
181 Mecobalamin 500 mg 0 0
182 Meloksikam 15 mg 0 0
183 Meloxicam 15 mg 0 0
184 Mersibion inj 0 0
185 Metamizole Injeksi 0 0
186 Metamizole Tablet 500 mg 0 0
187 Metformin 500 mg 0 0
188 Metformin tab 850 mg 0 0
Metil Ergometrin (METERGIN
189 0 0
Injeksi)
190 Metil Prednisolon 125MG/ml INJ 0 0
191 Metil Prednisolon 4 mg 0 0
192 Metildopa tablet 0 0
193 Metoklo ramid 10 mg tab 0 0
194 Metronidazol 500 mg ovula 0 0
195 Metronidazol tablet 500 mg. 0 0
196 metronidazole infus 0 0
197 Mgso4 infus 0 0
198 Miconazole cream 0 0
199 Mineral Mix 0 0
200 Minosep Gargle 0 0
201 Misoprostol tab 0 0
Moxifloxacin 400 mg (Program TB
202 0 0
RO )
203 Mupirocin salep 0 0
204 NaCL 0.9%, 100 ml 0 0
205 NaCL 0.9%, 500 ml 0 0
206 Nalokson injeksi 0.4 mg 0 0
207 Natrium Bikarbonat tablet 0 0
208 Natrium Diklofenak 25 mg tab 0 0
209 Natrium Klorida 3% 0 0
210 Neurodex 0 0
Nevirapine (NVP) 200mg(Program
211 0 0
HIV )
212 Nifedipin 10 mg. tablet 0 0
213 Nikardipin injeksi 0 0
214 Nistatin 500.000 IU tablet salut 0 0
215 Nistatin drop 0 0
216 Nitrogliserin 5 mg 0 0
217 Nitrokaf retard 2.5 mg 0 0
218 Norepinefrine 1 mg/ml 0 0
219 Novomix insulin 0 0
220 Novorapid insulin 0 0
221 OAT Combivak (Program TB ) 0 0
Obat Anti Tubercolosis Anak
222 0 0
(Program TB )
Obat Anti Tuberkolosis Kategori I
223 0 0
(Program TB SO )
Obat Anti Tuberkolosis Kategori II
224 0 0
(Program TB )
225 OBH 0 0
226 Oksitosina injeksi 10 IU / ml01ml 0 0
227 Omeprazol 20 mg tab 0 0
228 Omeprazol injeksi 0 0
229 Ondansetron 4 mg Inj 0 0
230 Ondansetron 8 mg 0 0
231 Parasetamol drop 0 0
232 Parasetamol infus 0 0
233 Parasetamol sirup 120 mg/ 5 ml 0 0
234 Parasetamol Supp 125 mg 0 0
235 Parasetamol suppos 250 mg 0 0
236 Parasetamol tablet 500 mg. 0 0
237 Pioglitazon 0 0
238 Pirazinamid 500 mg (Program TB ) 0 0
239 Prednison 5 mg 0 0
Procain Penisilline (Program TB
240 0 0
RO )
Pseudoefedrin HCL 15 mg +
241 0 0
Terfenadine
242 Ramipril 5 Mg Tab  0 0
243 Ranitidin 150 mg 0 0
244 Ranitidin injeksi 0 0
245 Ranivel sirup 0 0
246 Requip tab 0 0
Rifampisin 450 mg tab (Program
247 0 0
TB )
248 Ringer Laktat 0 0
249 Risperidone 2 mg 0 0
250 Salbutamol 2 mg 0 0
251 Salbutamol 4 mg tab 0 0
252 Salisil Bedak 2 % 0 0
253 SANBE Baquinor 0.3% Tetes Mata 0 0
254 SANBE Forumen 0 0
255 SANBE Fukrisin ED 5 ml 0 0
256 SANBE Hyaloph Eye Drop 0 0
257 SANBE Otilon tetes telinga 0 0
258 Sefadroksil 500 mg kapsul 0 0
259 Sefadroksil sirup 0 0
260 Sefiksim 100 mg 0 0
261 Sefiksim 100 mg sirup 0 0
262 Sefiksim 200 mg 0 0
263 Sefotaksim injeksi 0 0
264 Seftriakson injeksi 0 0
265 Seretide Diskus (50/500) 0 0
266 Sertralin 50 mg 0 0
267 Setirizin 10 mg sirup 0 0
268 Setirizin 10 mg tab 0 0
269 Sevodex 0 0
270 Simarc 2 mg 0 0
271 Simvastatin 20 mg 0 0
272 Siprofloksasin 2% Infus 0 0
273 Siprofloksasin 500 mg tablet 0 0
274 SNMC Injeksi 0 0
275 Stesolid 10 mg 0 0
276 Stesolid 5 mg 0 0
277 Streptomycin 1 gr (Program TB ) 0 0
278 sukralfat tablet 0 0
279 Sulfadiazin krim 0 0
280 Tablet tambah darah kombinasi 0 0
TDF 300/3TC 300/DTG 50 (Program
281 0 0
HIV)
TDF/3TC/EFV(300/300/600)
282 0 0
(Program HIV)
283 Telmisartan 40 mg tab 0 0
Tenofovir (TDF) 300mg (Program
284 0 0
HIV)

285 Teofilin tab 150 mg (BRONSOLVAN) 0 0


286 Terbutalin Sulfat 0,5mg/ml Injeksi 0 0
287 Thiamfenikol 500 0 0

Tramadol 37,5 mg + Parasetamol


288 0 0
caps (ANALTRAM caps)

289 Tramadol inj 0 0


290 Trihexyphenidyl tab 0 0
291 Trilac (Triamcinolon) 0 0
292 Tuberculin PPD TEST 0 0

Urdafalk tab (URSODEOXYCHOLIC


293 0 0
ACID GENERIK)

294 Vaksin HB0 (Program VAKSIN) 0 0


Vaksin TD Single Use
295 0 0
(Program TB RO )
296 Valsartan 160 mg 0 0
297 Valsartan 80 mg 0 0
298 Vasacon 0 0
Vicilin SX serbuk injeksi (Ampisilin
299 0 0
Sulbactam)
300 Vitamin B Kompleks Tablet 0 0
301 Vitamin B6 0 0
302 Vitamin B6 0 0
303 Vitamin B6 10 mg 0 0
304 VITAMIN C INJEKSI 0 0
305 Vitamin D3 1000 iu 0 0
Vitamin Sirup anak
306 0 0
(UNIVIT/TIALISIN)
307 Water Steril 1 L 0 0
308 Xylocain 10% Spray 0 0
309 Xylocain Jelly 2% 0 0
Zidovudin (Zdv) 100 mg (Program
310 0 0
HIV)
Zidovudine (ZDV)/Lamivudine (3TC)
311 0 0
300/150mg (Program HIV)
312 Zinc Sirup 0 0
313 Abilify 15 mg (Aripriprazole) 0 0
314 Adalat Oros Tab 0 0
315 Allopurinol 300 mg 0 0
316 Ampicilin Inj 0 0
317 Antasida DOEN syr 0 0
318 ARDIUM 0 0
319 Aricept Evess (Donepezil 10mg) 0 0
320 Arixtra Inj 0 0
321 As. Valproat Sirup 0 0
322 Asam Folat tab 0 0
323 Asam Traneksamat 500 mg tab 0 0
324 Asering 500 ml 0 0
325 Atracurium Injeksi (Tramus Inj) 0 0
326 Attapulgite tablet 0 0
327 Betahistin 6 mg 0 0
328 Bisakodil tab 0 0
329 Bisoprolol 2.5 mg 0 0
330 CaCO3 0 0
331 Captopril 25 mg 0 0
332 Cefoperazone 0 0
333 Cendo Efrisel. 0 0
334 Cendo Siloxan 0 0
335 Cetadop inj (Dopamin) 0 0
336 Cetirizin Sirup 0 0
337 Cetirizin tab 0 0
338 Chloroquin 150 mg tablet 0 0
339 Chlorpromazin Tab 0 0
340 Citicolin tab. 0 0
341 Clobazam 10 mg 0 0
342 Clonazepam 2 mg tab 0 0
343 Clonidine tablet 0,15 mg 0 0
344 Clozapine 100 mg 0 0
345 Clozapine 25 mg 0 0
346 Concor 1,25 0 0
347 Deksametason inj 0 0
348 Diltiazem tablet 30 mg 0 0
349 Dobutamin Inj 0 0
350 Beraprost (Dorner) tab 0 0
351 Dulcolax supp 5 mg 0 0
352 Efedrin Injeksi 50 mg 0 0
353 Eperison tablet 0 0
354 Fenofibrate 100mg kap 0 0
355 Ferro-K Sirup 0 0
356 Fitomenadion tablet 10 mg 0 0
357 Flunarizine 10 mg tab 0 0
358 Fluoxetin Capsul 0 0
359 Gelofusin 0 0
360 Glimepirid 1 mg 0 0
361 Glimepirid 3 mg 0 0
362 Glimepiride 4 mg 0 0
363 Glucosamin Tab 0 0
364 Tamsolusin 0 0
365 Herbesser CD 100 mg 0 0
366 Hot In Cream DCL 0 0
367 HP PRO 0 0
368 Ibuprofen suspensi 0 0
369 KCL 7.46% 0 0
370 Ketamin Inj 0 0
371 Ketoconazol Tab 0 0
372 Ketokonazol Cr 0 0
373 Ketoprofen Supp 0 0
374 Ketorolac inj 30 mg 0 0
375 Klopidogrel 75 mg 0 0
376 Kolkisin tablet 0 0
377 Loratadine 10 mg 0 0
378 Meropenem Injeksi 0 0
379 Methosoprinol syr 0 0
380 Metil Ergometrin tab (Bledstop) 0 0
381 Metil Prednisolon 16 mg 0 0
382 Metoklopramid Injeksi 0 0
383 Meylon 0 0
384 Microlax 0 0
385 miniaspi 80mg 0 0
386 Multivitamin TABLET 0 0
387 Natrium Diklofenak 50 mg 0 0
388 Neostigmin inj 0 0
389 PK Serbuk 0 0
390 Pramifrol 0,375 MG tab 0 0
391 Propranolol 10 mg Tablet 0 0
392 Propranolol 40 mg 0 0
393 PTU tablet 100 mg 0 0
394 Pulmicort 0.25 Mg/ Ml  0 0
395 Ramipril 10 mg 0 0
396 Rebamipid. 0 0
397 Recofol 10 mg/ml 0 0
398 Rifampisin 600 mg tab 0 0
399 Rocuronium 10 mg/ml inj 0 0
400 Salbutamol 2 mg/5 ml Sirup 0 0
401 Seretide Diskus 50/250MCG. 0 0
402 Spironolakton 25 mg tab 0 0
403 Thrombopop Gel 0 0
404 Thiamzole 10 mg tab. 0 0
405 Triamsinolon inj 0 0
406 Carvedilol (Vbloc) 6,25 mg tab 0 0

Yang menyerahkan Yang menerima

Fezi kendri,Apt Satria Kinayungan, Apt

PEMERINTAH PROVINSI DAERAH KHUSUS IBUKOTA JAKARTA


DINAS KESEHATAN
RUMAH SAKIT UMUM DAERAH CILINCING
Jalan Madya Kebantenan 1 Nomor 4, Cilincing. Telepon : 021 - 441 2889
Email : RSUDCilincing@gmail.com
JAKARTA
Kode Pos 14130

SURAT BUKTI BARANG KELUAR (SBBK)

Di berikan kepada
Nama/ NIP : Norman Dwiyanto, Apt
Bagian : Apotek PRB
Tanggal :

No Nama Barang Jumlah Harga


1 Acetazolamid 250 mg 0 0
2 Akarbose 100 mg 0 0
3 Akarbose 50 mg 0 0
4 Akilen tetes telinga 0 0
5 Albendazol sirup 0 0
6 ALBUMIN 25% 100 ML 0 0
7 Alprazolam Tablet 0,5 mg 0 0
8 Alupurinol tablet 100 mg. 0 0
9 Ambroxol 30 mg tab 0 0
10 Ambroxol sirup 0 0
Amikasin 1 gr injrksi (Program TB
11 0 0
RO )
12 AMINOFLUID 1000 mL/Bfluid 0 0
13 Aminopilin Injeksi. 0 0
14 Amiodarone HCL Injeksi 50 mg/ml 0 0
15 Amitriptilin 0 0
16 Amlodipin 10 mg 0 0
17 Amlodipin 5 mg 0 0
18 Amoksilin + As. Kalvulanat tablet 0 0
Amoksilin + Asam Klavulanat Sirup
19 0 0
(Claneksi Sirup)
20 Amoksilin drop 0 0
21 Amoksilin kapsul 250 mg. 0 0
22 Amoxillin kapsul 500 mg 0 0
23 Antasida DOEN tab.kombinasi 0 0
24 Anti Hemoroid 0 0
25 Aqua Pro injeksi 0 0
26 Aripirazol 10 mg 0 0
27 Asam Askorbat (Vit.C) tab.50 mg. 0 0
Asam Mefenamat 500 mg
28 0 0
tablet salut selaput
29 Asam traneksamat inj 0 0
Asetil sistein 100 mg Sirup
30 0 0
(Fluimucil Sirup)
31 Asetil sistein 200 mg 0 0
32 Asiklovir 200 mg tab 0 0
33 Asiklovir 400 mg. tablet 0 0
34 Asiklovir salep 0 0
35 Atenolol 50 mg 0 0
36 Atorvastain Calcium tab 20 mg 0 0
37 Atorvastatin 10 mg Tablet 0 0
38 Atropin sulfat Injeksi 0 0
39 Avamys Spray 0 0
40 Azitromisin 500 mg 0 0
41 Azitromisin sirup kering 200 mg 0 0
42 Bayclin 0 0
Bedaquiline 100 mg (Program TB
43 0 0
RO )
Betametason + Neomisin Krim
44 0 0
(Benoson N Krim)
45 Betametason krim 0,1 % 0 0
46 Biosat ATS 0 0
47 Bisoprolol 5 mg 0 0
48 Bricasma Injeksi (Terbutalin) 0 0
49 Bromheksin 8 mg 0 0
Bupivicain Injeksi (REGIVELL
50 0 0
Injeksi)
51 Calcium Gluconat 0 0
52 candesartan 16 mg 0 0
53 Candesartan 8 mg tab 0 0
54 Carbazocrome inj 0 0
55 Ceftazidim injeksi 0 0
56 Ceftriaxon injeksi 0 0
57 Cendo Asthenof 0 0
58 Cendo Catarlent 15 ml 0 0
59 Cendo Cenfresh Eye Drop 0 0
60 Cendo floxa Eye Drop 0 0
61 Cendo Lyteers 0 0
62 Cendo mata pantocain 0 0
63 Cendo Mydriatil Tetes Mata 0 0
64 Cendo polydex 0 0
65 Cendo Statrol 0 0
66 Cendo timol 0 0
67 Cendo Tropin 0.5% 0 0
68 Cendo Xitrol Eye Drop 0 0
69 Cendo Xitrol salep mata 3,5 Gram 0 0
Cilostazol Tablet 100 mg (Pletaal
70 0 0
Tablet)
71 Citicolin inj 0 0
72 Clindamisin 300 mg 0 0
73 Clindamycin caps 150 mg 0 0
74 Clotrimazole (Dermifar Krim) 0 0
75 Combiven Inhaler 0 0
76 Coparcetin 0 0
77 Curcuma tab 0 0
78 Deksametason tablet 0,5 mg. 0 0
79 Delamanid 50 mg (Program TB RO ) 0 0
80 Depakote ER 250 mg 0 0
81 Depakote ER 500 mg 0 0
Dextrometrophan + Gliseril
82 Guaiacolat + Phenylpropanolamin 0 0
HC + Chlo heniramine Maleat Tab
83 Diazepam 5 mg tablet 0 0
84 Diazepam Injeksi 0 0
Diazepam Rectal Tube 20 mg
85 0 0
(STEOLID 10)
Diazepam Rectal Tube 5 mg
86 0 0
(STESOLID 5)
87 Diazink tab 0 0
Digoksin injeksi 0,25 mg
88 0 0
(FARGOKSIN IV)
89 Digoksin tablet 0,25 mg. 0 0
90 Diltiazem 10 mg 0 0
91 Diphenhidramin injeksi 0 0
92 Dipsamol inhaler 0 0
93 Domperidon 0 0
94 Domperidon 10 mg sirup 0 0
95 Domperidon drop 0 0
96 Donepezile 0 0
97 Doxycyclin kapsul 100 mg. 0 0
98 Epinefrin injeksi 0 0
99 Eritromisin 500 mg tab 0 0
100 Etanol 70 % 1 liter 0 0
101 Ethambutol 400 mg (Program TB ) 0 0

Ethionamide 250 mg (Program TB


102 0 0
RO )
103 ethyl cloride 0 0
104 Euthyrox Tab 0 0
105 fenitoin injeksi 0 0
106 Fenitoin Kapsul 0 0
107 Fentanyl Injeksi 100 mcg/2ml Injeks 0 0
108 Ferriz drop 0 0
Fitomenadion (Vit.K10
109 0 0
inj.10mg/ml01ml
110 Flixotide 0 0
111 Flukonazole tab 0 0
112 Furosemid injeksi 0 0
113 Furosemid tab 0 0
114 Gabapentin 100 mg 0 0
115 Gabapentin 300 mg tab 0 0
116 Garam Oralit 200 ml air 0 0
117 Gemfibrozil Kapsul 300 mg 0 0
118 Gentamisin Cream Kulit 0 0
119 gentamisin injeksi 0 0
120 Glibenklamid 5 mg 0 0
121 Glikazid 80 mg 0 0
122 Glikuidon 30 Mg  0 0
123 glimepirid 2 mg 0 0
124 Glukosa 40% 0 0
125 Glukose larutan infus 10 % steril 0 0
126 Glukose larutan infus 5 % steril 0 0
127 Haloperidol 50 mg injeksi 0 0
128 Haloperidol tablet 5 mg 0 0
129 Herbesser injeksi 0 0
130 Hidonac Injeksi 2.5 g 0 0
Hidroklorotiazide (HCT) tablet 25
131 0 0
mg.
132 Hidrokortison cr 0 0
Human Tetanus Immunoglobulin 1
133 0 0
ml 250 IU (TETAGAM)
134 Hyoscine n Butil Bromide Injeksi 0 0
135 Hyosin N Butylbromide 10 mg 0 0
136 Ialuset plus 0 0
137 Ibuprofen tab 400 mg 0 0
138 Ibuprofen tablet 200 mg. 0 0
139 INH 100 mg (Program TB RO ) 0 0
140 INH 300 mg (Program TB RO ) 0 0
141 INH 300 mg (Program TB RO ) 0 0
Inhalasi Salbutamol Device
142 0 0
(Salbulin)
143 Inhaler Ventolin 0 0
144 Inviclot 0 0
145 Iodin Povidone 1 L 0 0
146 Isoniazid 300 mg (Program TB RO ) 0 0
147 Isonoasid 300 mg (Program TB RO ) 0 0
148 Isosorbid injeksi 10 mg 0 0
149 Isosorbit Dinitrat tab sublingal 5 mg. 0 0
150 Kaen 1 B  0 0
151 Kaen 3 B  0 0
152 Kalium Diklofenak 50 mg 0 0
153 Kalsium Laktat (Kalk) tab.500 mg. 0 0
154 Kaptopril 12,5 mg tablet 0 0
155 Kaptopril 25 mg tablet 0 0
156 Kidmin infus 0 0
157 Kloramfenikol 500 mg 0 0
158 Kloramfenikol Salep mata 0 0
159 Kloramfenikol tetes telinga 0 0
Klorfeniramin Maleat (CTM) tablet 4
160 0 0
mg.
161 Kodein 20 mg 0 0
162 Kotrimoksazol dewasa tablet 0 0
163 Kotrimoksazol suspensi 0 0
164 KSR 0 0
165 Lacto B 0 0
166 Lactulac sirup 0 0
Lamivudine (3TC) 150mg (Program
167 0 0
HIV)
168 lansoprazol capsul 0 0
169 Lansoprazol injeksi 0 0
170 Lantus 0 0
171 Levemir Insulin 0 0
172 Levodopa + Benserazide kombinasi 0 0
173 Levofloksasin tab 0 0
174 Levofloxacin infus 5mg/ml 0 0
175 Lidocain 2 % injeksi 0 0
Lidokain HCL0 Epinefrin Injeksi/amp
176 0 0
2 ml (PEHACAIN)

177 Linezolid 600 mg (Program TB RO ) 0 0


178 Loperamid tablet 0 0
179 Madopar tab/Levopar 0 0
180 Manitol infus 25 mL 0 0
181 Mecobalamin 500 mg 0 0
182 Meloksikam 15 mg 0 0
183 Meloxicam 15 mg 0 0
184 Mersibion inj 0 0
185 Metamizole Injeksi 0 0
186 Metamizole Tablet 500 mg 0 0
187 Metformin 500 mg 0 0
188 Metformin tab 850 mg 0 0
Metil Ergometrin (METERGIN
189 0 0
Injeksi)
190 Metil Prednisolon 125MG/ml INJ 0 0
191 Metil Prednisolon 4 mg 0 0
192 Metildopa tablet 0 0
193 Metoklo ramid 10 mg tab 0 0
194 Metronidazol 500 mg ovula 0 0
195 Metronidazol tablet 500 mg. 0 0
196 metronidazole infus 0 0
197 Mgso4 infus 0 0
198 Miconazole cream 0 0
199 Mineral Mix 0 0
200 Minosep Gargle 0 0
201 Misoprostol tab 0 0
Moxifloxacin 400 mg (Program TB
202 0 0
RO )
203 Mupirocin salep 0 0
204 NaCL 0.9%, 100 ml 0 0
205 NaCL 0.9%, 500 ml 0 0
206 Nalokson injeksi 0.4 mg 0 0
207 Natrium Bikarbonat tablet 0 0
208 Natrium Diklofenak 25 mg tab 0 0
209 Natrium Klorida 3% 0 0
210 Neurodex 0 0
Nevirapine (NVP) 200mg(Program
211 0 0
HIV )
212 Nifedipin 10 mg. tablet 0 0
213 Nikardipin injeksi 0 0
214 Nistatin 500.000 IU tablet salut 0 0
215 Nistatin drop 0 0
216 Nitrogliserin 5 mg 0 0
217 Nitrokaf retard 2.5 mg 0 0
218 Norepinefrine 1 mg/ml 0 0
219 Novomix insulin 0 0
220 Novorapid insulin 0 0
221 OAT Combivak (Program TB ) 0 0
Obat Anti Tubercolosis Anak
222 0 0
(Program TB )
Obat Anti Tuberkolosis Kategori I
223 0 0
(Program TB SO )
Obat Anti Tuberkolosis Kategori II
224 0 0
(Program TB )
225 OBH 0 0
226 Oksitosina injeksi 10 IU / ml01ml 0 0
227 Omeprazol 20 mg tab 0 0
228 Omeprazol injeksi 0 0
229 Ondansetron 4 mg Inj 0 0
230 Ondansetron 8 mg 0 0
231 Parasetamol drop 0 0
232 Parasetamol infus 0 0
233 Parasetamol sirup 120 mg/ 5 ml 0 0
234 Parasetamol Supp 125 mg 0 0
235 Parasetamol suppos 250 mg 0 0
236 Parasetamol tablet 500 mg. 0 0
237 Pioglitazon 0 0
238 Pirazinamid 500 mg (Program TB ) 0 0
239 Prednison 5 mg 0 0
Procain Penisilline (Program TB
240 0 0
RO )
Pseudoefedrin HCL 15 mg +
241 0 0
Terfenadine
242 Ramipril 5 Mg Tab  0 0
243 Ranitidin 150 mg 0 0
244 Ranitidin injeksi 0 0
245 Ranivel sirup 0 0
246 Requip tab 0 0
Rifampisin 450 mg tab (Program
247 0 0
TB )
248 Ringer Laktat 0 0
249 Risperidone 2 mg 0 0
250 Salbutamol 2 mg 0 0
251 Salbutamol 4 mg tab 0 0
252 Salisil Bedak 2 % 0 0
253 SANBE Baquinor 0.3% Tetes Mata 0 0
254 SANBE Forumen 0 0
255 SANBE Fukrisin ED 5 ml 0 0
256 SANBE Hyaloph Eye Drop 0 0
257 SANBE Otilon tetes telinga 0 0
258 Sefadroksil 500 mg kapsul 0 0
259 Sefadroksil sirup 0 0
260 Sefiksim 100 mg 0 0
261 Sefiksim 100 mg sirup 0 0
262 Sefiksim 200 mg 0 0
263 Sefotaksim injeksi 0 0
264 Seftriakson injeksi 0 0
265 Seretide Diskus (50/500) 0 0
266 Sertralin 50 mg 0 0
267 Setirizin 10 mg sirup 0 0
268 Setirizin 10 mg tab 0 0
269 Sevodex 0 0
270 Simarc 2 mg 0 0
271 Simvastatin 20 mg 0 0
272 Siprofloksasin 2% Infus 0 0
273 Siprofloksasin 500 mg tablet 0 0
274 SNMC Injeksi 0 0
275 Stesolid 10 mg 0 0
276 Stesolid 5 mg 0 0
277 Streptomycin 1 gr (Program TB ) 0 0
278 sukralfat tablet 0 0
279 Sulfadiazin krim 0 0
280 Tablet tambah darah kombinasi 0 0
TDF 300/3TC 300/DTG 50 (Program
281 0 0
HIV)
TDF/3TC/EFV(300/300/600)
282 0 0
(Program HIV)
283 Telmisartan 40 mg tab 0 0
Tenofovir (TDF) 300mg (Program
284 0 0
HIV)

285 Teofilin tab 150 mg (BRONSOLVAN) 0 0


286 Terbutalin Sulfat 0,5mg/ml Injeksi 0 0
287 Thiamfenikol 500 0 0

Tramadol 37,5 mg + Parasetamol


288 0 0
caps (ANALTRAM caps)

289 Tramadol inj 0 0


290 Trihexyphenidyl tab 0 0
291 Trilac (Triamcinolon) 0 0
292 Tuberculin PPD TEST 0 0

Urdafalk tab (URSODEOXYCHOLIC


293 0 0
ACID GENERIK)

294 Vaksin HB0 (Program VAKSIN) 0 0


Vaksin TD Single Use
295 0 0
(Program TB RO )
296 Valsartan 160 mg 0 0
297 Valsartan 80 mg 0 0
298 Vasacon 0 0
Vicilin SX serbuk injeksi (Ampisilin
299 0 0
Sulbactam)
300 Vitamin B Kompleks Tablet 0 0
301 Vitamin B6 0 0
302 Vitamin B6 0 0
303 Vitamin B6 10 mg 0 0
304 VITAMIN C INJEKSI 0 0
305 Vitamin D3 1000 iu 0 0
Vitamin Sirup anak
306 0 0
(UNIVIT/TIALISIN)
307 Water Steril 1 L 0 0
308 Xylocain 10% Spray 0 0
309 Xylocain Jelly 2% 0 0
Zidovudin (Zdv) 100 mg (Program
310 0 0
HIV)
Zidovudine (ZDV)/Lamivudine (3TC)
311 0 0
300/150mg (Program HIV)
312 Zinc Sirup 0 0
313 Abilify 15 mg (Aripriprazole) 0 0
314 Adalat Oros Tab 0 0
315 Allopurinol 300 mg 0 0
316 Ampicilin Inj 0 0
317 Antasida DOEN syr 0 0
318 ARDIUM 0 0
319 Aricept Evess (Donepezil 10mg) 0 0
320 Arixtra Inj 0 0
321 As. Valproat Sirup 0 0
322 Asam Folat tab 0 0
323 Asam Traneksamat 500 mg tab 0 0
324 Asering 500 ml 0 0
325 Atracurium Injeksi (Tramus Inj) 0 0
326 Attapulgite tablet 0 0
327 Betahistin 6 mg 0 0
328 Bisakodil tab 0 0
329 Bisoprolol 2.5 mg 0 0
330 CaCO3 0 0
331 Captopril 25 mg 0 0
332 Cefoperazone 0 0
333 Cendo Efrisel. 0 0
334 Cendo Siloxan 0 0
335 Cetadop inj (Dopamin) 0 0
336 Cetirizin Sirup 0 0
337 Cetirizin tab 0 0
338 Chloroquin 150 mg tablet 0 0
339 Chlorpromazin Tab 0 0
340 Citicolin tab. 0 0
341 Clobazam 10 mg 0 0
342 Clonazepam 2 mg tab 0 0
343 Clonidine tablet 0,15 mg 0 0
344 Clozapine 100 mg 0 0
345 Clozapine 25 mg 0 0
346 Concor 1,25 0 0
347 Deksametason inj 0 0
348 Diltiazem tablet 30 mg 0 0
349 Dobutamin Inj 0 0
350 Beraprost (Dorner) tab 0 0
351 Dulcolax supp 5 mg 0 0
352 Efedrin Injeksi 50 mg 0 0
353 Eperison tablet 0 0
354 Fenofibrate 100mg kap 0 0
355 Ferro-K Sirup 0 0
356 Fitomenadion tablet 10 mg 0 0
357 Flunarizine 10 mg tab 0 0
358 Fluoxetin Capsul 0 0
359 Gelofusin 0 0
360 Glimepirid 1 mg 0 0
361 Glimepirid 3 mg 0 0
362 Glimepiride 4 mg 0 0
363 Glucosamin Tab 0 0
364 Tamsolusin 0 0
365 Herbesser CD 100 mg 0 0
366 Hot In Cream DCL 0 0
367 HP PRO 0 0
368 Ibuprofen suspensi 0 0
369 KCL 7.46% 0 0
370 Ketamin Inj 0 0
371 Ketoconazol Tab 0 0
372 Ketokonazol Cr 0 0
373 Ketoprofen Supp 0 0
374 Ketorolac inj 30 mg 0 0
375 Klopidogrel 75 mg 0 0
376 Kolkisin tablet 0 0
377 Loratadine 10 mg 0 0
378 Meropenem Injeksi 0 0
379 Methosoprinol syr 0 0
380 Metil Ergometrin tab (Bledstop) 0 0
381 Metil Prednisolon 16 mg 0 0
382 Metoklopramid Injeksi 0 0
383 Meylon 0 0
384 Microlax 0 0
385 miniaspi 80mg 0 0
386 Multivitamin TABLET 0 0
387 Natrium Diklofenak 50 mg 0 0
388 Neostigmin inj 0 0
389 PK Serbuk 0 0
390 Pramifrol 0,375 MG tab 0 0
391 Propranolol 10 mg Tablet 0 0
392 Propranolol 40 mg 0 0
393 PTU tablet 100 mg 0 0
394 Pulmicort 0.25 Mg/ Ml  0 0
395 Ramipril 10 mg 0 0
396 Rebamipid. 0 0
397 Recofol 10 mg/ml 0 0
398 Rifampisin 600 mg tab 0 0
399 Rocuronium 10 mg/ml inj 0 0
400 Salbutamol 2 mg/5 ml Sirup 0 0
401 Seretide Diskus 50/250MCG. 0 0
402 Spironolakton 25 mg tab 0 0
403 Thrombopop Gel 0 0
404 Thiamzole 10 mg tab. 0 0
405 Triamsinolon inj 0 0
406 Carvedilol (Vbloc) 6,25 mg tab 0 0

Yang menyerahkan Yang menerima

Fezi kendri,Apt Satria Kinayungan, Apt

PEMERINTAH PROVINSI DAERAH KHUSUS IBUKOTA JAKARTA


DINAS KESEHATAN
RUMAH SAKIT UMUM DAERAH CILINCING
Jalan Madya Kebantenan 1 Nomor 4, Cilincing. Telepon : 021 - 441 2889
Email : RSUDCilincing@gmail.com
JAKARTA
Kode Pos 14130

SURAT BUKTI BARANG KELUAR (SBBK)

Di berikan kepada
Nama/ NIP : Norman Dwiyanto, Apt
Bagian : Apotek PRB
Tanggal :

No Nama Barang Jumlah Harga


1 Acetazolamid 250 mg 0 0
2 Akarbose 100 mg 0 0
3 Akarbose 50 mg 0 0
4 Akilen tetes telinga 0 0
5 Albendazol sirup 0 0
6 ALBUMIN 25% 100 ML 0 0
7 Alprazolam Tablet 0,5 mg 0 0
8 Alupurinol tablet 100 mg. 0 0
9 Ambroxol 30 mg tab 0 0
10 Ambroxol sirup 0 0
Amikasin 1 gr injrksi (Program TB
11 0 0
RO )
12 AMINOFLUID 1000 mL/Bfluid 0 0
13 Aminopilin Injeksi. 0 0
14 Amiodarone HCL Injeksi 50 mg/ml 0 0
15 Amitriptilin 0 0
16 Amlodipin 10 mg 0 0
17 Amlodipin 5 mg 0 0
18 Amoksilin + As. Kalvulanat tablet 0 0
Amoksilin + Asam Klavulanat Sirup
19 0 0
(Claneksi Sirup)
20 Amoksilin drop 0 0
21 Amoksilin kapsul 250 mg. 0 0
22 Amoxillin kapsul 500 mg 0 0
23 Antasida DOEN tab.kombinasi 0 0
24 Anti Hemoroid 0 0
25 Aqua Pro injeksi 0 0
26 Aripirazol 10 mg 0 0
27 Asam Askorbat (Vit.C) tab.50 mg. 0 0
Asam Mefenamat 500 mg
28 0 0
tablet salut selaput
29 Asam traneksamat inj 0 0
Asetil sistein 100 mg Sirup
30 0 0
(Fluimucil Sirup)
31 Asetil sistein 200 mg 0 0
32 Asiklovir 200 mg tab 0 0
33 Asiklovir 400 mg. tablet 0 0
34 Asiklovir salep 0 0
35 Atenolol 50 mg 0 0
36 Atorvastain Calcium tab 20 mg 0 0
37 Atorvastatin 10 mg Tablet 0 0
38 Atropin sulfat Injeksi 0 0
39 Avamys Spray 0 0
40 Azitromisin 500 mg 0 0
41 Azitromisin sirup kering 200 mg 0 0
42 Bayclin 0 0
Bedaquiline 100 mg (Program TB
43 0 0
RO )
Betametason + Neomisin Krim
44 0 0
(Benoson N Krim)
45 Betametason krim 0,1 % 0 0
46 Biosat ATS 0 0
47 Bisoprolol 5 mg 0 0
48 Bricasma Injeksi (Terbutalin) 0 0
49 Bromheksin 8 mg 0 0
Bupivicain Injeksi (REGIVELL
50 0 0
Injeksi)
51 Calcium Gluconat 0 0
52 candesartan 16 mg 0 0
53 Candesartan 8 mg tab 0 0
54 Carbazocrome inj 0 0
55 Ceftazidim injeksi 0 0
56 Ceftriaxon injeksi 0 0
57 Cendo Asthenof 0 0
58 Cendo Catarlent 15 ml 0 0
59 Cendo Cenfresh Eye Drop 0 0
60 Cendo floxa Eye Drop 0 0
61 Cendo Lyteers 0 0
62 Cendo mata pantocain 0 0
63 Cendo Mydriatil Tetes Mata 0 0
64 Cendo polydex 0 0
65 Cendo Statrol 0 0
66 Cendo timol 0 0
67 Cendo Tropin 0.5% 0 0
68 Cendo Xitrol Eye Drop 0 0
69 Cendo Xitrol salep mata 3,5 Gram 0 0

Cilostazol Tablet 100 mg (Pletaal


70 0 0
Tablet)
71 Citicolin inj 0 0
72 Clindamisin 300 mg 0 0
73 Clindamycin caps 150 mg 0 0
74 Clotrimazole (Dermifar Krim) 0 0
75 Combiven Inhaler 0 0
76 Coparcetin 0 0
77 Curcuma tab 0 0
78 Deksametason tablet 0,5 mg. 0 0
79 Delamanid 50 mg (Program TB RO ) 0 0
80 Depakote ER 250 mg 0 0
81 Depakote ER 500 mg 0 0
Dextrometrophan + Gliseril
82 Guaiacolat + Phenylpropanolamin 0 0
HC + Chlo heniramine Maleat Tab
83 Diazepam 5 mg tablet 0 0
84 Diazepam Injeksi 0 0
Diazepam Rectal Tube 20 mg
85 0 0
(STEOLID 10)
Diazepam Rectal Tube 5 mg
86 0 0
(STESOLID 5)
87 Diazink tab 0 0
Digoksin injeksi 0,25 mg
88 0 0
(FARGOKSIN IV)
89 Digoksin tablet 0,25 mg. 0 0
90 Diltiazem 10 mg 0 0
91 Diphenhidramin injeksi 0 0
92 Dipsamol inhaler 0 0
93 Domperidon 0 0
94 Domperidon 10 mg sirup 0 0
95 Domperidon drop 0 0
96 Donepezile 0 0
97 Doxycyclin kapsul 100 mg. 0 0
98 Epinefrin injeksi 0 0
99 Eritromisin 500 mg tab 0 0
100 Etanol 70 % 1 liter 0 0
101 Ethambutol 400 mg (Program TB ) 0 0

Ethionamide 250 mg (Program TB


102 0 0
RO )
103 ethyl cloride 0 0
104 Euthyrox Tab 0 0
105 fenitoin injeksi 0 0
106 Fenitoin Kapsul 0 0
107 Fentanyl Injeksi 100 mcg/2ml Injeks 0 0
108 Ferriz drop 0 0
Fitomenadion (Vit.K10
109 0 0
inj.10mg/ml01ml
110 Flixotide 0 0
111 Flukonazole tab 0 0
112 Furosemid injeksi 0 0
113 Furosemid tab 0 0
114 Gabapentin 100 mg 0 0
115 Gabapentin 300 mg tab 0 0
116 Garam Oralit 200 ml air 0 0
117 Gemfibrozil Kapsul 300 mg 0 0
118 Gentamisin Cream Kulit 0 0
119 gentamisin injeksi 0 0
120 Glibenklamid 5 mg 0 0
121 Glikazid 80 mg 0 0
122 Glikuidon 30 Mg  0 0
123 glimepirid 2 mg 0 0
124 Glukosa 40% 0 0
125 Glukose larutan infus 10 % steril 0 0
126 Glukose larutan infus 5 % steril 0 0
127 Haloperidol 50 mg injeksi 0 0
128 Haloperidol tablet 5 mg 0 0
129 Herbesser injeksi 0 0
130 Hidonac Injeksi 2.5 g 0 0
Hidroklorotiazide (HCT) tablet 25
131 0 0
mg.
132 Hidrokortison cr 0 0
Human Tetanus Immunoglobulin 1
133 0 0
ml 250 IU (TETAGAM)
134 Hyoscine n Butil Bromide Injeksi 0 0
135 Hyosin N Butylbromide 10 mg 0 0
136 Ialuset plus 0 0
137 Ibuprofen tab 400 mg 0 0
138 Ibuprofen tablet 200 mg. 0 0
139 INH 100 mg (Program TB RO ) 0 0
140 INH 300 mg (Program TB RO ) 0 0
141 INH 300 mg (Program TB RO ) 0 0
Inhalasi Salbutamol Device
142 0 0
(Salbulin)
143 Inhaler Ventolin 0 0
144 Inviclot 0 0
145 Iodin Povidone 1 L 0 0
146 Isoniazid 300 mg (Program TB RO ) 0 0

147 Isonoasid 300 mg (Program TB RO ) 0 0


148 Isosorbid injeksi 10 mg 0 0
149 Isosorbit Dinitrat tab sublingal 5 mg. 0 0
150 Kaen 1 B  0 0
151 Kaen 3 B  0 0
152 Kalium Diklofenak 50 mg 0 0
153 Kalsium Laktat (Kalk) tab.500 mg. 0 0
154 Kaptopril 12,5 mg tablet 0 0
155 Kaptopril 25 mg tablet 0 0
156 Kidmin infus 0 0
157 Kloramfenikol 500 mg 0 0
158 Kloramfenikol Salep mata 0 0
159 Kloramfenikol tetes telinga 0 0
Klorfeniramin Maleat (CTM) tablet 4
160 0 0
mg.
161 Kodein 20 mg 0 0
162 Kotrimoksazol dewasa tablet 0 0
163 Kotrimoksazol suspensi 0 0
164 KSR 0 0
165 Lacto B 0 0
166 Lactulac sirup 0 0
Lamivudine (3TC) 150mg (Program
167 0 0
HIV)
168 lansoprazol capsul 0 0
169 Lansoprazol injeksi 0 0
170 Lantus 0 0
171 Levemir Insulin 0 0
172 Levodopa + Benserazide kombinasi 0 0
173 Levofloksasin tab 0 0
174 Levofloxacin infus 5mg/ml 0 0
175 Lidocain 2 % injeksi 0 0
Lidokain HCL0 Epinefrin Injeksi/amp
176 0 0
2 ml (PEHACAIN)

177 Linezolid 600 mg (Program TB RO ) 0 0


178 Loperamid tablet 0 0
179 Madopar tab/Levopar 0 0
180 Manitol infus 25 mL 0 0
181 Mecobalamin 500 mg 0 0
182 Meloksikam 15 mg 0 0
183 Meloxicam 15 mg 0 0
184 Mersibion inj 0 0
185 Metamizole Injeksi 0 0
186 Metamizole Tablet 500 mg 0 0
187 Metformin 500 mg 0 0
188 Metformin tab 850 mg 0 0
Metil Ergometrin (METERGIN
189 0 0
Injeksi)
190 Metil Prednisolon 125MG/ml INJ 0 0
191 Metil Prednisolon 4 mg 0 0
192 Metildopa tablet 0 0
193 Metoklo ramid 10 mg tab 0 0
194 Metronidazol 500 mg ovula 0 0
195 Metronidazol tablet 500 mg. 0 0
196 metronidazole infus 0 0
197 Mgso4 infus 0 0
198 Miconazole cream 0 0
199 Mineral Mix 0 0
200 Minosep Gargle 0 0
201 Misoprostol tab 0 0
Moxifloxacin 400 mg (Program TB
202 0 0
RO )
203 Mupirocin salep 0 0
204 NaCL 0.9%, 100 ml 0 0
205 NaCL 0.9%, 500 ml 0 0
206 Nalokson injeksi 0.4 mg 0 0
207 Natrium Bikarbonat tablet 0 0
208 Natrium Diklofenak 25 mg tab 0 0
209 Natrium Klorida 3% 0 0
210 Neurodex 0 0
Nevirapine (NVP) 200mg(Program
211 0 0
HIV )
212 Nifedipin 10 mg. tablet 0 0
213 Nikardipin injeksi 0 0
214 Nistatin 500.000 IU tablet salut 0 0
215 Nistatin drop 0 0
216 Nitrogliserin 5 mg 0 0
217 Nitrokaf retard 2.5 mg 0 0
218 Norepinefrine 1 mg/ml 0 0
219 Novomix insulin 0 0
220 Novorapid insulin 0 0
221 OAT Combivak (Program TB ) 0 0
Obat Anti Tubercolosis Anak
222 0 0
(Program TB )
Obat Anti Tuberkolosis Kategori I
223 0 0
(Program TB SO )
Obat Anti Tuberkolosis Kategori II
224 0 0
(Program TB )
225 OBH 0 0
226 Oksitosina injeksi 10 IU / ml01ml 0 0
227 Omeprazol 20 mg tab 0 0
228 Omeprazol injeksi 0 0
229 Ondansetron 4 mg Inj 0 0
230 Ondansetron 8 mg 0 0
231 Parasetamol drop 0 0
232 Parasetamol infus 0 0
233 Parasetamol sirup 120 mg/ 5 ml 0 0
234 Parasetamol Supp 125 mg 0 0
235 Parasetamol suppos 250 mg 0 0
236 Parasetamol tablet 500 mg. 0 0
237 Pioglitazon 0 0
238 Pirazinamid 500 mg (Program TB ) 0 0
239 Prednison 5 mg 0 0
Procain Penisilline (Program TB
240 0 0
RO )
Pseudoefedrin HCL 15 mg +
241 0 0
Terfenadine
242 Ramipril 5 Mg Tab  0 0
243 Ranitidin 150 mg 0 0
244 Ranitidin injeksi 0 0
245 Ranivel sirup 0 0
246 Requip tab 0 0
Rifampisin 450 mg tab (Program
247 0 0
TB )
248 Ringer Laktat 0 0
249 Risperidone 2 mg 0 0
250 Salbutamol 2 mg 0 0
251 Salbutamol 4 mg tab 0 0
252 Salisil Bedak 2 % 0 0
253 SANBE Baquinor 0.3% Tetes Mata 0 0
254 SANBE Forumen 0 0
255 SANBE Fukrisin ED 5 ml 0 0
256 SANBE Hyaloph Eye Drop 0 0
257 SANBE Otilon tetes telinga 0 0
258 Sefadroksil 500 mg kapsul 0 0
259 Sefadroksil sirup 0 0
260 Sefiksim 100 mg 0 0
261 Sefiksim 100 mg sirup 0 0
262 Sefiksim 200 mg 0 0
263 Sefotaksim injeksi 0 0
264 Seftriakson injeksi 0 0
265 Seretide Diskus (50/500) 0 0
266 Sertralin 50 mg 0 0
267 Setirizin 10 mg sirup 0 0
268 Setirizin 10 mg tab 0 0
269 Sevodex 0 0
270 Simarc 2 mg 0 0
271 Simvastatin 20 mg 0 0
272 Siprofloksasin 2% Infus 0 0
273 Siprofloksasin 500 mg tablet 0 0
274 SNMC Injeksi 0 0
275 Stesolid 10 mg 0 0
276 Stesolid 5 mg 0 0
277 Streptomycin 1 gr (Program TB ) 0 0
278 sukralfat tablet 0 0
279 Sulfadiazin krim 0 0
280 Tablet tambah darah kombinasi 0 0
TDF 300/3TC 300/DTG 50 (Program
281 0 0
HIV)
TDF/3TC/EFV(300/300/600)
282 0 0
(Program HIV)
283 Telmisartan 40 mg tab 0 0
Tenofovir (TDF) 300mg (Program
284 0 0
HIV)

285 Teofilin tab 150 mg (BRONSOLVAN) 0 0


286 Terbutalin Sulfat 0,5mg/ml Injeksi 0 0
287 Thiamfenikol 500 0 0

Tramadol 37,5 mg + Parasetamol


288 0 0
caps (ANALTRAM caps)

289 Tramadol inj 0 0


290 Trihexyphenidyl tab 0 0
291 Trilac (Triamcinolon) 0 0
292 Tuberculin PPD TEST 0 0

Urdafalk tab (URSODEOXYCHOLIC


293 0 0
ACID GENERIK)

294 Vaksin HB0 (Program VAKSIN) 0 0


Vaksin TD Single Use
295 0 0
(Program TB RO )
296 Valsartan 160 mg 0 0
297 Valsartan 80 mg 0 0
298 Vasacon 0 0
Vicilin SX serbuk injeksi (Ampisilin
299 0 0
Sulbactam)
300 Vitamin B Kompleks Tablet 0 0
301 Vitamin B6 0 0
302 Vitamin B6 0 0
303 Vitamin B6 10 mg 0 0
304 VITAMIN C INJEKSI 0 0
305 Vitamin D3 1000 iu 0 0
Vitamin Sirup anak
306 0 0
(UNIVIT/TIALISIN)
307 Water Steril 1 L 0 0
308 Xylocain 10% Spray 0 0
309 Xylocain Jelly 2% 0 0
Zidovudin (Zdv) 100 mg (Program
310 0 0
HIV)
Zidovudine (ZDV)/Lamivudine (3TC)
311 0 0
300/150mg (Program HIV)
312 Zinc Sirup 0 0
313 Abilify 15 mg (Aripriprazole) 0 0
314 Adalat Oros Tab 0 0
315 Allopurinol 300 mg 0 0
316 Ampicilin Inj 0 0
317 Antasida DOEN syr 0 0
318 ARDIUM 0 0
319 Aricept Evess (Donepezil 10mg) 0 0
320 Arixtra Inj 0 0
321 As. Valproat Sirup 0 0
322 Asam Folat tab 0 0
323 Asam Traneksamat 500 mg tab 0 0
324 Asering 500 ml 0 0
325 Atracurium Injeksi (Tramus Inj) 0 0
326 Attapulgite tablet 0 0
327 Betahistin 6 mg 0 0
328 Bisakodil tab 0 0
329 Bisoprolol 2.5 mg 0 0
330 CaCO3 0 0
331 Captopril 25 mg 0 0
332 Cefoperazone 0 0
333 Cendo Efrisel. 0 0
334 Cendo Siloxan 0 0
335 Cetadop inj (Dopamin) 0 0
336 Cetirizin Sirup 0 0
337 Cetirizin tab 0 0
338 Chloroquin 150 mg tablet 0 0
339 Chlorpromazin Tab 0 0
340 Citicolin tab. 0 0
341 Clobazam 10 mg 0 0
342 Clonazepam 2 mg tab 0 0
343 Clonidine tablet 0,15 mg 0 0
344 Clozapine 100 mg 0 0
345 Clozapine 25 mg 0 0
346 Concor 1,25 0 0
347 Deksametason inj 0 0
348 Diltiazem tablet 30 mg 0 0
349 Dobutamin Inj 0 0
350 Beraprost (Dorner) tab 0 0
351 Dulcolax supp 5 mg 0 0
352 Efedrin Injeksi 50 mg 0 0
353 Eperison tablet 0 0
354 Fenofibrate 100mg kap 0 0
355 Ferro-K Sirup 0 0
356 Fitomenadion tablet 10 mg 0 0
357 Flunarizine 10 mg tab 0 0
358 Fluoxetin Capsul 0 0
359 Gelofusin 0 0
360 Glimepirid 1 mg 0 0
361 Glimepirid 3 mg 0 0
362 Glimepiride 4 mg 0 0
363 Glucosamin Tab 0 0
364 Tamsolusin 0 0
365 Herbesser CD 100 mg 0 0
366 Hot In Cream DCL 0 0
367 HP PRO 0 0
368 Ibuprofen suspensi 0 0
369 KCL 7.46% 0 0
370 Ketamin Inj 0 0
371 Ketoconazol Tab 0 0
372 Ketokonazol Cr 0 0
373 Ketoprofen Supp 0 0
374 Ketorolac inj 30 mg 0 0
375 Klopidogrel 75 mg 0 0
376 Kolkisin tablet 0 0
377 Loratadine 10 mg 0 0
378 Meropenem Injeksi 0 0
379 Methosoprinol syr 0 0
380 Metil Ergometrin tab (Bledstop) 0 0
381 Metil Prednisolon 16 mg 0 0
382 Metoklopramid Injeksi 0 0
383 Meylon 0 0
384 Microlax 0 0
385 miniaspi 80mg 0 0
386 Multivitamin TABLET 0 0
387 Natrium Diklofenak 50 mg 0 0
388 Neostigmin inj 0 0
389 PK Serbuk 0 0
390 Pramifrol 0,375 MG tab 0 0
391 Propranolol 10 mg Tablet 0 0
392 Propranolol 40 mg 0 0
393 PTU tablet 100 mg 0 0
394 Pulmicort 0.25 Mg/ Ml  0 0
395 Ramipril 10 mg 0 0
396 Rebamipid. 0 0
397 Recofol 10 mg/ml 0 0
398 Rifampisin 600 mg tab 0 0
399 Rocuronium 10 mg/ml inj 0 0
400 Salbutamol 2 mg/5 ml Sirup 0 0
401 Seretide Diskus 50/250MCG. 0 0
402 Spironolakton 25 mg tab 0 0
403 Thrombopop Gel 0 0
404 Thiamzole 10 mg tab. 0 0
405 Triamsinolon inj 0 0
406 Carvedilol (Vbloc) 6,25 mg tab 0 0

Yang menyerahkan Yang menerima

Fezi kendri,Apt Satria Kinayungan, Apt

PEMERINTAH PROVINSI DAERAH KHUSUS IBUKOTA JAKARTA


DINAS KESEHATAN
RUMAH SAKIT UMUM DAERAH CILINCING
Jalan Madya Kebantenan 1 Nomor 4, Cilincing. Telepon : 021 - 441 2889
Email : RSUDCilincing@gmail.com
JAKARTA
Kode Pos 14130

SURAT BUKTI BARANG KELUAR (SBBK)

Di berikan kepada
Nama/ NIP : Norman Dwiyanto, Apt
Bagian : Apotek PRB
Tanggal :

No Nama Barang Jumlah Harga


1 Acetazolamid 250 mg 0 0
2 Akarbose 100 mg 0 0
3 Akarbose 50 mg 0 0
4 Akilen tetes telinga 0 0
5 Albendazol sirup 0 0
6 ALBUMIN 25% 100 ML 0 0
7 Alprazolam Tablet 0,5 mg 0 0
8 Alupurinol tablet 100 mg. 0 0
9 Ambroxol 30 mg tab 0 0
10 Ambroxol sirup 0 0
Amikasin 1 gr injrksi (Program TB
11 0 0
RO )
12 AMINOFLUID 1000 mL/Bfluid 0 0
13 Aminopilin Injeksi. 0 0
14 Amiodarone HCL Injeksi 50 mg/ml 0 0
15 Amitriptilin 0 0
16 Amlodipin 10 mg 0 0
17 Amlodipin 5 mg 0 0
18 Amoksilin + As. Kalvulanat tablet 0 0
Amoksilin + Asam Klavulanat Sirup
19 0 0
(Claneksi Sirup)
20 Amoksilin drop 0 0
21 Amoksilin kapsul 250 mg. 0 0
22 Amoxillin kapsul 500 mg 0 0
23 Antasida DOEN tab.kombinasi 0 0
24 Anti Hemoroid 0 0
25 Aqua Pro injeksi 0 0
26 Aripirazol 10 mg 0 0
27 Asam Askorbat (Vit.C) tab.50 mg. 0 0
Asam Mefenamat 500 mg
28 0 0
tablet salut selaput
29 Asam traneksamat inj 0 0
Asetil sistein 100 mg Sirup
30 0 0
(Fluimucil Sirup)
31 Asetil sistein 200 mg 0 0
32 Asiklovir 200 mg tab 0 0
33 Asiklovir 400 mg. tablet 0 0
34 Asiklovir salep 0 0
35 Atenolol 50 mg 0 0
36 Atorvastain Calcium tab 20 mg 0 0
37 Atorvastatin 10 mg Tablet 0 0
38 Atropin sulfat Injeksi 0 0
39 Avamys Spray 0 0
40 Azitromisin 500 mg 0 0
41 Azitromisin sirup kering 200 mg 0 0
42 Bayclin 0 0
Bedaquiline 100 mg (Program TB
43 0 0
RO )
Betametason + Neomisin Krim
44 0 0
(Benoson N Krim)
45 Betametason krim 0,1 % 0 0
46 Biosat ATS 0 0
47 Bisoprolol 5 mg 0 0
48 Bricasma Injeksi (Terbutalin) 0 0
49 Bromheksin 8 mg 0 0
Bupivicain Injeksi (REGIVELL
50 0 0
Injeksi)
51 Calcium Gluconat 0 0
52 candesartan 16 mg 0 0
53 Candesartan 8 mg tab 0 0
54 Carbazocrome inj 0 0
55 Ceftazidim injeksi 0 0
56 Ceftriaxon injeksi 0 0
57 Cendo Asthenof 0 0
58 Cendo Catarlent 15 ml 0 0
59 Cendo Cenfresh Eye Drop 0 0
60 Cendo floxa Eye Drop 0 0
61 Cendo Lyteers 0 0
62 Cendo mata pantocain 0 0
63 Cendo Mydriatil Tetes Mata 0 0
64 Cendo polydex 0 0
65 Cendo Statrol 0 0
66 Cendo timol 0 0
67 Cendo Tropin 0.5% 0 0
68 Cendo Xitrol Eye Drop 0 0
69 Cendo Xitrol salep mata 3,5 Gram 0 0

Cilostazol Tablet 100 mg (Pletaal


70 0 0
Tablet)
71 Citicolin inj 0 0
72 Clindamisin 300 mg 0 0
73 Clindamycin caps 150 mg 0 0
74 Clotrimazole (Dermifar Krim) 0 0
75 Combiven Inhaler 0 0
76 Coparcetin 0 0
77 Curcuma tab 0 0
78 Deksametason tablet 0,5 mg. 0 0
79 Delamanid 50 mg (Program TB RO ) 0 0
80 Depakote ER 250 mg 0 0
81 Depakote ER 500 mg 0 0
Dextrometrophan + Gliseril
82 Guaiacolat + Phenylpropanolamin 0 0
HC + Chlo heniramine Maleat Tab
83 Diazepam 5 mg tablet 0 0
84 Diazepam Injeksi 0 0
Diazepam Rectal Tube 20 mg
85 0 0
(STEOLID 10)
Diazepam Rectal Tube 5 mg
86 0 0
(STESOLID 5)
87 Diazink tab 0 0
Digoksin injeksi 0,25 mg
88 0 0
(FARGOKSIN IV)
89 Digoksin tablet 0,25 mg. 0 0
90 Diltiazem 10 mg 0 0
91 Diphenhidramin injeksi 0 0
92 Dipsamol inhaler 0 0
93 Domperidon 0 0
94 Domperidon 10 mg sirup 0 0
95 Domperidon drop 0 0
96 Donepezile 0 0
97 Doxycyclin kapsul 100 mg. 0 0
98 Epinefrin injeksi 0 0
99 Eritromisin 500 mg tab 0 0
100 Etanol 70 % 1 liter 0 0
101 Ethambutol 400 mg (Program TB ) 0 0

Ethionamide 250 mg (Program TB


102 0 0
RO )
103 ethyl cloride 0 0
104 Euthyrox Tab 0 0
105 fenitoin injeksi 0 0
106 Fenitoin Kapsul 0 0
107 Fentanyl Injeksi 100 mcg/2ml Injeks 0 0
108 Ferriz drop 0 0
Fitomenadion (Vit.K10
109 0 0
inj.10mg/ml01ml
110 Flixotide 0 0
111 Flukonazole tab 0 0
112 Furosemid injeksi 0 0
113 Furosemid tab 0 0
114 Gabapentin 100 mg 0 0
115 Gabapentin 300 mg tab 0 0
116 Garam Oralit 200 ml air 0 0
117 Gemfibrozil Kapsul 300 mg 0 0
118 Gentamisin Cream Kulit 0 0
119 gentamisin injeksi 0 0
120 Glibenklamid 5 mg 0 0
121 Glikazid 80 mg 0 0
122 Glikuidon 30 Mg  0 0
123 glimepirid 2 mg 0 0
124 Glukosa 40% 0 0
125 Glukose larutan infus 10 % steril 0 0
126 Glukose larutan infus 5 % steril 0 0
127 Haloperidol 50 mg injeksi 0 0
128 Haloperidol tablet 5 mg 0 0
129 Herbesser injeksi 0 0
130 Hidonac Injeksi 2.5 g 0 0
Hidroklorotiazide (HCT) tablet 25
131 0 0
mg.
132 Hidrokortison cr 0 0
Human Tetanus Immunoglobulin 1
133 0 0
ml 250 IU (TETAGAM)
134 Hyoscine n Butil Bromide Injeksi 0 0
135 Hyosin N Butylbromide 10 mg 0 0
136 Ialuset plus 0 0
137 Ibuprofen tab 400 mg 0 0
138 Ibuprofen tablet 200 mg. 0 0
139 INH 100 mg (Program TB RO ) 0 0
140 INH 300 mg (Program TB RO ) 0 0
141 INH 300 mg (Program TB RO ) 0 0
Inhalasi Salbutamol Device
142 0 0
(Salbulin)
143 Inhaler Ventolin 0 0
144 Inviclot 0 0
145 Iodin Povidone 1 L 0 0
146 Isoniazid 300 mg (Program TB RO ) 0 0

147 Isonoasid 300 mg (Program TB RO ) 0 0


148 Isosorbid injeksi 10 mg 0 0
149 Isosorbit Dinitrat tab sublingal 5 mg. 0 0
150 Kaen 1 B  0 0
151 Kaen 3 B  0 0
152 Kalium Diklofenak 50 mg 0 0
153 Kalsium Laktat (Kalk) tab.500 mg. 0 0
154 Kaptopril 12,5 mg tablet 0 0
155 Kaptopril 25 mg tablet 0 0
156 Kidmin infus 0 0
157 Kloramfenikol 500 mg 0 0
158 Kloramfenikol Salep mata 0 0
159 Kloramfenikol tetes telinga 0 0
Klorfeniramin Maleat (CTM) tablet 4
160 0 0
mg.
161 Kodein 20 mg 0 0
162 Kotrimoksazol dewasa tablet 0 0
163 Kotrimoksazol suspensi 0 0
164 KSR 0 0
165 Lacto B 0 0
166 Lactulac sirup 0 0
Lamivudine (3TC) 150mg (Program
167 0 0
HIV)
168 lansoprazol capsul 0 0
169 Lansoprazol injeksi 0 0
170 Lantus 0 0
171 Levemir Insulin 0 0
172 Levodopa + Benserazide kombinasi 0 0
173 Levofloksasin tab 0 0
174 Levofloxacin infus 5mg/ml 0 0
175 Lidocain 2 % injeksi 0 0
Lidokain HCL0 Epinefrin Injeksi/amp
176 0 0
2 ml (PEHACAIN)

177 Linezolid 600 mg (Program TB RO ) 0 0


178 Loperamid tablet 0 0
179 Madopar tab/Levopar 0 0
180 Manitol infus 25 mL 0 0
181 Mecobalamin 500 mg 0 0
182 Meloksikam 15 mg 0 0
183 Meloxicam 15 mg 0 0
184 Mersibion inj 0 0
185 Metamizole Injeksi 0 0
186 Metamizole Tablet 500 mg 0 0
187 Metformin 500 mg 0 0
188 Metformin tab 850 mg 0 0
Metil Ergometrin (METERGIN
189 0 0
Injeksi)
190 Metil Prednisolon 125MG/ml INJ 0 0
191 Metil Prednisolon 4 mg 0 0
192 Metildopa tablet 0 0
193 Metoklo ramid 10 mg tab 0 0
194 Metronidazol 500 mg ovula 0 0
195 Metronidazol tablet 500 mg. 0 0
196 metronidazole infus 0 0
197 Mgso4 infus 0 0
198 Miconazole cream 0 0
199 Mineral Mix 0 0
200 Minosep Gargle 0 0
201 Misoprostol tab 0 0
Moxifloxacin 400 mg (Program TB
202 0 0
RO )
203 Mupirocin salep 0 0
204 NaCL 0.9%, 100 ml 0 0
205 NaCL 0.9%, 500 ml 0 0
206 Nalokson injeksi 0.4 mg 0 0
207 Natrium Bikarbonat tablet 0 0
208 Natrium Diklofenak 25 mg tab 0 0
209 Natrium Klorida 3% 0 0
210 Neurodex 0 0
Nevirapine (NVP) 200mg(Program
211 0 0
HIV )
212 Nifedipin 10 mg. tablet 0 0
213 Nikardipin injeksi 0 0
214 Nistatin 500.000 IU tablet salut 0 0
215 Nistatin drop 0 0
216 Nitrogliserin 5 mg 0 0
217 Nitrokaf retard 2.5 mg 0 0
218 Norepinefrine 1 mg/ml 0 0
219 Novomix insulin 0 0
220 Novorapid insulin 0 0
221 OAT Combivak (Program TB ) 0 0
Obat Anti Tubercolosis Anak
222 0 0
(Program TB )
Obat Anti Tuberkolosis Kategori I
223 0 0
(Program TB SO )
Obat Anti Tuberkolosis Kategori II
224 0 0
(Program TB )
225 OBH 0 0
226 Oksitosina injeksi 10 IU / ml01ml 0 0
227 Omeprazol 20 mg tab 0 0
228 Omeprazol injeksi 0 0
229 Ondansetron 4 mg Inj 0 0
230 Ondansetron 8 mg 0 0
231 Parasetamol drop 0 0
232 Parasetamol infus 0 0
233 Parasetamol sirup 120 mg/ 5 ml 0 0
234 Parasetamol Supp 125 mg 0 0
235 Parasetamol suppos 250 mg 0 0
236 Parasetamol tablet 500 mg. 0 0
237 Pioglitazon 0 0
238 Pirazinamid 500 mg (Program TB ) 0 0
239 Prednison 5 mg 0 0
Procain Penisilline (Program TB
240 0 0
RO )
Pseudoefedrin HCL 15 mg +
241 0 0
Terfenadine
242 Ramipril 5 Mg Tab  0 0
243 Ranitidin 150 mg 0 0
244 Ranitidin injeksi 0 0
245 Ranivel sirup 0 0
246 Requip tab 0 0
Rifampisin 450 mg tab (Program
247 0 0
TB )
248 Ringer Laktat 0 0
249 Risperidone 2 mg 0 0
250 Salbutamol 2 mg 0 0
251 Salbutamol 4 mg tab 0 0
252 Salisil Bedak 2 % 0 0
253 SANBE Baquinor 0.3% Tetes Mata 0 0
254 SANBE Forumen 0 0
255 SANBE Fukrisin ED 5 ml 0 0
256 SANBE Hyaloph Eye Drop 0 0
257 SANBE Otilon tetes telinga 0 0
258 Sefadroksil 500 mg kapsul 0 0
259 Sefadroksil sirup 0 0
260 Sefiksim 100 mg 0 0
261 Sefiksim 100 mg sirup 0 0
262 Sefiksim 200 mg 0 0
263 Sefotaksim injeksi 0 0
264 Seftriakson injeksi 0 0
265 Seretide Diskus (50/500) 0 0
266 Sertralin 50 mg 0 0
267 Setirizin 10 mg sirup 0 0
268 Setirizin 10 mg tab 0 0
269 Sevodex 0 0
270 Simarc 2 mg 0 0
271 Simvastatin 20 mg 0 0
272 Siprofloksasin 2% Infus 0 0
273 Siprofloksasin 500 mg tablet 0 0
274 SNMC Injeksi 0 0
275 Stesolid 10 mg 0 0
276 Stesolid 5 mg 0 0
277 Streptomycin 1 gr (Program TB ) 0 0
278 sukralfat tablet 0 0
279 Sulfadiazin krim 0 0
280 Tablet tambah darah kombinasi 0 0
TDF 300/3TC 300/DTG 50 (Program
281 0 0
HIV)
TDF/3TC/EFV(300/300/600)
282 0 0
(Program HIV)
283 Telmisartan 40 mg tab 0 0
Tenofovir (TDF) 300mg (Program
284 0 0
HIV)

285 Teofilin tab 150 mg (BRONSOLVAN) 0 0


286 Terbutalin Sulfat 0,5mg/ml Injeksi 0 0
287 Thiamfenikol 500 0 0

Tramadol 37,5 mg + Parasetamol


288 0 0
caps (ANALTRAM caps)

289 Tramadol inj 0 0


290 Trihexyphenidyl tab 0 0
291 Trilac (Triamcinolon) 0 0
292 Tuberculin PPD TEST 0 0

Urdafalk tab (URSODEOXYCHOLIC


293 0 0
ACID GENERIK)

294 Vaksin HB0 (Program VAKSIN) 0 0


Vaksin TD Single Use
295 0 0
(Program TB RO )
296 Valsartan 160 mg 0 0
297 Valsartan 80 mg 0 0
298 Vasacon 0 0
Vicilin SX serbuk injeksi (Ampisilin
299 0 0
Sulbactam)
300 Vitamin B Kompleks Tablet 0 0
301 Vitamin B6 0 0
302 Vitamin B6 0 0
303 Vitamin B6 10 mg 0 0
304 VITAMIN C INJEKSI 0 0
305 Vitamin D3 1000 iu 0 0
Vitamin Sirup anak
306 0 0
(UNIVIT/TIALISIN)
307 Water Steril 1 L 0 0
308 Xylocain 10% Spray 0 0
309 Xylocain Jelly 2% 0 0
Zidovudin (Zdv) 100 mg (Program
310 0 0
HIV)
Zidovudine (ZDV)/Lamivudine (3TC)
311 0 0
300/150mg (Program HIV)
312 Zinc Sirup 0 0
313 Abilify 15 mg (Aripriprazole) 0 0
314 Adalat Oros Tab 0 0
315 Allopurinol 300 mg 0 0
316 Ampicilin Inj 0 0
317 Antasida DOEN syr 0 0
318 ARDIUM 0 0
319 Aricept Evess (Donepezil 10mg) 0 0
320 Arixtra Inj 0 0
321 As. Valproat Sirup 0 0
322 Asam Folat tab 0 0
323 Asam Traneksamat 500 mg tab 0 0
324 Asering 500 ml 0 0
325 Atracurium Injeksi (Tramus Inj) 0 0
326 Attapulgite tablet 0 0
327 Betahistin 6 mg 0 0
328 Bisakodil tab 0 0
329 Bisoprolol 2.5 mg 0 0
330 CaCO3 0 0
331 Captopril 25 mg 0 0
332 Cefoperazone 0 0
333 Cendo Efrisel. 0 0
334 Cendo Siloxan 0 0
335 Cetadop inj (Dopamin) 0 0
336 Cetirizin Sirup 0 0
337 Cetirizin tab 0 0
338 Chloroquin 150 mg tablet 0 0
339 Chlorpromazin Tab 0 0
340 Citicolin tab. 0 0
341 Clobazam 10 mg 0 0
342 Clonazepam 2 mg tab 0 0
343 Clonidine tablet 0,15 mg 0 0
344 Clozapine 100 mg 0 0
345 Clozapine 25 mg 0 0
346 Concor 1,25 0 0
347 Deksametason inj 0 0
348 Diltiazem tablet 30 mg 0 0
349 Dobutamin Inj 0 0
350 Beraprost (Dorner) tab 0 0
351 Dulcolax supp 5 mg 0 0
352 Efedrin Injeksi 50 mg 0 0
353 Eperison tablet 0 0
354 Fenofibrate 100mg kap 0 0
355 Ferro-K Sirup 0 0
356 Fitomenadion tablet 10 mg 0 0
357 Flunarizine 10 mg tab 0 0
358 Fluoxetin Capsul 0 0
359 Gelofusin 0 0
360 Glimepirid 1 mg 0 0
361 Glimepirid 3 mg 0 0
362 Glimepiride 4 mg 0 0
363 Glucosamin Tab 0 0
364 Tamsolusin 0 0
365 Herbesser CD 100 mg 0 0
366 Hot In Cream DCL 0 0
367 HP PRO 0 0
368 Ibuprofen suspensi 0 0
369 KCL 7.46% 0 0
370 Ketamin Inj 0 0
371 Ketoconazol Tab 0 0
372 Ketokonazol Cr 0 0
373 Ketoprofen Supp 0 0
374 Ketorolac inj 30 mg 0 0
375 Klopidogrel 75 mg 0 0
376 Kolkisin tablet 0 0
377 Loratadine 10 mg 0 0
378 Meropenem Injeksi 0 0
379 Methosoprinol syr 0 0
380 Metil Ergometrin tab (Bledstop) 0 0
381 Metil Prednisolon 16 mg 0 0
382 Metoklopramid Injeksi 0 0
383 Meylon 0 0
384 Microlax 0 0
385 miniaspi 80mg 0 0
386 Multivitamin TABLET 0 0
387 Natrium Diklofenak 50 mg 0 0
388 Neostigmin inj 0 0
389 PK Serbuk 0 0
390 Pramifrol 0,375 MG tab 0 0
391 Propranolol 10 mg Tablet 0 0
392 Propranolol 40 mg 0 0
393 PTU tablet 100 mg 0 0
394 Pulmicort 0.25 Mg/ Ml  0 0
395 Ramipril 10 mg 0 0
396 Rebamipid. 0 0
397 Recofol 10 mg/ml 0 0
398 Rifampisin 600 mg tab 0 0
399 Rocuronium 10 mg/ml inj 0 0
400 Salbutamol 2 mg/5 ml Sirup 0 0
401 Seretide Diskus 50/250MCG. 0 0
402 Spironolakton 25 mg tab 0 0
403 Thrombopop Gel 0 0
404 Thiamzole 10 mg tab. 0 0
405 Triamsinolon inj 0 0
406 Carvedilol (Vbloc) 6,25 mg tab 0 0

Yang menyerahkan Yang menerima

Fezi kendri,Apt Satria Kinayungan, Apt


JAKARTA

G
21 - 441 2889

s 14130

Keterangan
ayungan, Apt

JAKARTA

G
21 - 441 2889
s 14130

Keterangan
ayungan, Apt

JAKARTA

G
21 - 441 2889

s 14130
Keterangan
ayungan, Apt

JAKARTA

G
21 - 441 2889

s 14130

Keterangan
ayungan, Apt
PEMERINTAH PROVINSI DKI JAKARTA KARTU PERSEDIAAN OBAT / ALKES
DINAS KESEHATAN
RUMAH SAKIT UMUM DAERAH CILINCING
Jl. Madya Kebantenan No. 4, Cilincing, Telp. : 021-441 2889
Fax. : 021-44102889 Email: rsudcilincing@gmail.com, Jakarta 14130

Sumber Anggaran :
Nama Obat : Satuan :

PENAMBAHAN PENGELUARAN
ASAL PABRIK
TGL SISA PERSEDIAAN
JUMLAH No. D.O / BA JUMLAH NAMA FASILITAS No. BATCH / EXP. DATE

1 2 3 4 5 6 7

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