DINAS KESEHATAN KABUPATEN SU

UPTD PUSKESMAS RAWAT INAP

Jl. RAYA WADO

LAPORAN OBAT TERPADU

Nama SubUnit :
Nomor :
Tanggal :
Bulan :

Harga Stok Awal Penambahan

No Nama Obat Satuan
Satuan Jumlah Σ Harga Jumlah
1 2 3 4 5 6(5x4) 7
1 Acetyl Cysteine 200 mg Kapsul 382.00 -
2 Alat Suntik 0,05ml Buah 1,379.80 -
3 Alat Suntik Sekali Pakai 0.5 ml Pcs 1,249.45 -
4 Alat Suntik Sekali Pakai 1 ml Pcs 1,034.88 -
5 Alat Suntik Sekali Pakai 10 ml (Aximed) Buah 946.14 -
6 Alat Suntik Sekali Pakai 10 ml (Top Point) Buah 946.16 -
7 Alat Suntik Sekali Pakai 2,5 ml Pcs 662.29 -
8 Alat Suntik Sekali Pakai 20 ml Buah 1,525.12 -
9 Alat Suntik Sekali Pakai 3 ml Pcs 950.40 -
10 Alat Suntik Sekali Pakai 3 ml Pcs 662.00 -
11 Alat Suntik Sekali Pakai 3 ml Pcs 662.30 -
12 Alat Suntik Sekali Pakai 5 ml Pcs 787.97 -
13 Albendazol 400 mg Tablet 430.00 -
14 Alkohol Swab ( PT. Bio Axion Healthindo) Sase 116.04 -
15 Alkohol Swab CHG + 0,5 % (e-care) Pcs 200.00 -
16 Alopurinol tablet 100 mg Tablet 99.00 -
17 Alopurinol tablet 300 mg Tablet 210.00 -
18 Ambroxol Sirup Botol 3,970.00 -
19 Ambroxol Tablet 30 mg Tablet 148.50 -
20 Aminofilin Inj 24 mg/ml-10 ml Ampul 2,789.00 -
21 Aminofilin Tablet 200 mg Tablet 89.00 -
22 Amitriptilina HCl tablet salut 25 mg Tablet 167.00 -
23 Amlodipin tablet 10 mg Tablet 99.00 -
24 Amlodipin tablet 5 mg Tablet 75.00 -
25 Amoksilin 500 mg Kaplet 233.00 -
26 Amoksilin Kapsul 250 mg Kapsul 184.00 -
27 Amoksilin sirup kering 125 mg/5ml Botol 2,500.00 -
28 Amoksilin sirup kering 125 mg/5ml Botol 2,050.00 -
29 Amoksilin sirup kering forte 250 mg/5ml Botol 3,628.00 -
30 Ampisilin 1 gr inj Ampul 8,237.00 -
31 Ampisilin Kaplet 500 mg Kaplet 521,4
32 Ampisilin Serbuk Injeksi Vial 8,237.00 -
33 Antalgin(Metampiron) Tablet 500 mg Tablet 268.00 -
34 Antalgin(Metampiron) Tablet 500 mg Tablet 268.07 -
35 Antasida DOEN I tablet kombinasi Tablet 54.00 -
36 Antasida DOEN II suspensi kombinasi Botol 1,995.00 -
37 Anti hemoroid suppositorida Supp 3,167.00 -
38 Antifungi DOEN kombinasi : Pot 4,496.00 -
39 Antimigren DOEN/Ergotamin kafein Tablet 173.00 -
40 Antiseptik Hand Rub 5 lt Galon ### -
41 Antiseptik Hand Rub 500 ml Botol 60,800.00 -
42 Antiseptik Surgical Hand Scrub 5 lt Galon ### -
43 Antiseptik Surgical Hand Scrub 500 ml Botol 74,000.00 -
44 Aqua Pro Injeksi steril bebas pirogen- 20 ml Ampul 2,295.00 -
45 Aquadest steril -500 ml Botol 25,949.00 -
46 Asam Askorbat (VIT C) Tablet 50 mg (KF) Tablet 105.00 -
47 Asam folat tablet 0,4 mg Tablet 55.00 -
48 Asam Mefenamat 500 mg Tablet 103.00 -
49 Asering Botol 9,646.00 -
50 Asetosal tablet 80 mg Tablet 92.00 -
51 Asetosal tablet 80 mg Tablet 148.00 -
52 Asiklovir cr Tube 4,180.00 -
53 Asiklovir tab 200 mg Tablet 236.00 -
54 Asiklovir tab 400 mg Tablet 405.00 -
55 Atapulgit Tablet 136.00 -
56 Atorvastatin 10 mg Tablet 1,100.00 -
57 Atropin Sulfat injeksi 0,25 mg/ml-1 ml Ampul 1,595.00 -
58 Atropin Sulfat injeksi 0,25 mg/ml-1 ml Ampul 1,540.00 -
59 Azitromisin 500 mg Kaplet 1,888.00 -
60 Bedak Salisil serbuk 2 % Buah 2,585.00 -
61 Benzatin benzil penisilin 1,2 juta IU/Vial Vial 14,500.00 -
62 Betametason Krim 0.1 % Tube 1,430.00 -
63 Bisakodil Supp (Dulcolax) Supp 6,000.00 -
64 Bisturi no 10 Buah 767.00 -
65 Bloodseet Buah 11,550.00 -
66 Carpul (Articain & Adrenalin) Ampul 10,914.00 -
67 Catgut Chromic 2/0 100 m Roll ### -
68 Catgut Chromic 2/0 75C + Jarum 1/2 30 MR Roll 61,800.00 -
69 Catgut Chromic 3/0 75C + Jarum 1/2 22 MR Roll 22,500.00 -
70 Catgut Plain 2/0 70C + Jarum 1/2 36M R Roll 30,500.00 -
71 Catgut Plain 3/0 70C + Jarum 3/8 19M C Roll 29,583.33 -
72 Catgut/Benang Bedah No.2/0-3/0 dg jarum bed Roll 24,500.00 -
73 Cefiksim 100 mg Kapsul 803.00 -
74 Cetirizine Kapsul 90.00 -
75 Citoject Pcs ### -
76 Clorofenol (CHKM) Ples ### -
77 Deksametason inj 5 mg/ml-1 ml Ampul 1,097.00 -
78 Deksametason Tablet 0,5 mg Tablet 77.00 -
79 Devitalisasi Pasta (Non arsen) Botol ### -
80 Dextaco Tablet 394.00 -
81 Dextrofen Syrup 60 ml Botol 11,500.00 -
82 Difenhidramin inj 10 mg/ml Ampul 1,095.00 -
83 Digoksin tablet 0,25 mg Tablet 104.00 -
84 Dimenhidrinat tablet 50 mg Tablet 99.00 -
85 Doksisiklin 100 mg Kapsul 264.00 -
86 Domperidon Syrup Botol 2,700.00 -
87 Domperidon tablet 10 mg Tablet 85.00 -
88 Ekstrak Belladona tablet 10 mg Tablet 38.00 -
89 Eosin 2% 1x100 ml Botol ### -
90 Epinefrina(Adrenalin) inj i.v/s.k/i.m 1 mg/ml Ampul 1,408.00 -
91 Eritromisin 250 mg Tablet 546.00 -
92 Eritromisin 500 mg Tablet 750.00 -
93 Eritromisin sirup kering 200 mg/5 ml Botol 6,090.00 -
94 Etambutol Hcl tablet 250 mg Tablet 366.00 -
95 Etambutol Hcl Tablet 500 mg Tablet 451.00 -
96 Etambutol Hcl Tablet 500 mg Tablet 505.00 -
97 Etanol 70 %- 100 ml Botol 2,500.00 -
98 Etanol 70% - 1 L Botol 18,700.00 -
99 Etil Klorida semprot-100 ml Botol ### -
100 Eugenol Cairan Botol 18,824.00 -
101 Female Catheter no 16 Pcs 5,720.00 -
102 Female Catheter no 18 Pcs 5,720.00 -
103 Fenitoin Kapsul100 mg Kapsul 152.00 -
104 Fenoksimetil Penisilin tablet 250 mg Tablet 350.00 -
105 Fenoksimetil Penisilin tablet 500 mg Tablet 605.00 -
106 Fenol Gliserol Tetes telinga 10 % Botol 1,008.33 -
107 Film IV Dressing 6x7 P Pcs 2,200.00 -
108 Fitomenadion(Vit K1) inj 10 mg/ml-1ml Ampul 1,566.00 -
109 Fitomenadion(Vit K1) inj 2 mg/ml-1ml Ampul 3,682.00 -
110 Fitomenadion(Vit K1) tablet salut gula 10 mg Tablet 710.00 -
111 Fluconazol 150 mg kapsul 18,720.00 -
112 Folley Cathether 2 way no 20 Pcs 8,000.00 -
113 Folley Cathether no 16 Pcs 10,340.00 -
114 Folley Cathether no 18 Pcs 10,890.00 -
115 Folley Cathether no 18 Pcs 11,890.00 -
116 Furosemid tablet 40 mg Tablet 77.00 -
117 Garam Oralit 200 ml air Sachet 257.00 -
118 Garam Oralit 200 ml air Sachet 274.00 -
119 Gentamisin Inj 40 mg/ml Vial 5,900.00 -
120 Gentamycin Salep Kulit Tube 3,550.00 -
121 Gentamycin Salep Mata Tube 2,675.00 -
122 Gentamycin Tetes Mata Tube 4,232.00 -
123 Gentian violet larutan 1 %-10 ml Botol 3,000.00 -
124 Glas Lonomer Cement Set ### -
125 Glas Lonomer Cement Liquid Set ### -
126 Glibenklamid tablet 5 mg Tablet 119.00 -
127 Glimepiride tablet 1 mg Tablet 174.00 -
128 Gliseril Gyayakolat tablet 100 mg Tablet 128,81
129 Glukosa Larutan infus 10% steril-500 ml Botol 5,700.00 -
130 Glukosa Larutan infus 5% steril-500 ml Botol 7,363.00 -
131 Griseofulvin tablet 125 mg micronized Tablet 210.00 -
132 Haloperidol Injeksi (Lodomer) Ampul 6,250.00 -
133 Haloperidol Injeksi (Lodomer) Ampul 4,000.00 -
134 Haloperidol tablet 0,5 mg Tablet 55.00 -
135 Haloperidol tablet 1,5 mg Tablet 59.00 -
136 Haloperidol tablet 2 mg Tablet 84.00 -
137 Haloperidol tablet 5 mg Tablet 56.00 -
138 Hansaplast 2,5 cm x 4,5 m Roll 11,334.00 -
139 Hansaplast 7,5 cm x 4,5 m Roll 31,265.00 -
140 Hemafort Tablet 834.00 -
141 Hidrogen Peroksida 3% (H2O2) Botol 23,931.00 -
142 Hidroklortiazid (HCT) tablet 25 mg Tablet 155.00 -
143 Hidrokortison krim 2,5 % Tube 2,475.00 -
144 Ibuprofen sirup 100 mg/5 ml Botol 2,365.00 -
145 Ibuprofen tablet 200 mg Tablet 105.00 -
146 Ibuprofen tablet 400 mg Tablet 330.00 -
147 Infusion set anak Set 6,150.00 -
148 Infusion set anak Set 6,242.25 -
149 Infusion set dewasa Set 2,880.00 -
150 Infusion Set Dewasa Set 5,887.00 -
151 Isoniazida ( INH ) tablet 100 mg Tablet 72.00 -
152 Isoniazida ( INH ) tablet 100 mg Tablet 137.00 -
153 Isoniazida ( INH ) tablet 300 mg Tablet 173.00 -
154 Isosorbit 5 mg Tablet 89.00 -
155 IV Cateter 18 Buah 11,110.00 -
156 IV Cateter 20 Buah 11,110.00 -
157 IV Cateter 22 Buah 11,110.00 -
158 IV Cateter 24 Buah 11,110.00 -
159 IV Cateter no 26 wings & port Buah 6,600.00 -
160 IV Cateter with injection port 26 G Buah 13,332.00 -
161 Jarum Citojek No 16 Pcs 2,093.00 -
162 Jarum Jahit kulit No.12 Pcs 2,283.33 -
163 Jarum Jahit Otot No.12 Pcs 2,283.33 -
164 Kalium Permanganat Pot 8,700.00 -
165 Kalsium Glukonat injeksi i.v 10 % Ampul 10,351.00 -
166 Kalsium Hidroksida Pasta Set ### -
167 Kalsium laktat (Kalk) tablet 500 mg Tablet 59.00 -
168 Kapas pembalut/absorben 250 mg Buah 12,500.00 -
169 Kaptropil 12,5 mg Tablet 62.00 -
170 Kaptropil 25 mg Tablet 75.00 -
171 Karbamazepin tablet 200 mg Tablet 230.00 -
172 Karbogliserin Tetes Telinga Botol 2,590.00 -
173 Kasa hidrofil 36 m x 80 cm Roll ### -
174 Kasa hidrofile 3 yard x 10 cm/2,7 yardx10cm Buah 1,380.00 -
175 Kasa hidrofile 40 yard x 80 cm/36mx80cm Roll ### -
176 Kasa kompres 16x16 steril Buah 291,67
177 Kasa pembalut hidrofil 4 m x 10 cm Roll 1,493.50 -
178 Ketokonazol 200 mg Tablet 270.00 -
179 Ketokonazol Krim 2% Tube 2,518.00 -
180 Klindamisin 150 mg Tablet 759.00 -
181 Klindamisin 300 mg Tablet 578.00 -
182 Kloramfenikol kapsul 250 mg Kapsul 310.00 -
183 Kloramfenikol kapsul 250 mg Kapsul 547.00 -
184 Kloramfenikol salep kulit 2 % Tube 3,038.00 -
185 Kloramfenikol salep mata 1 % Tube 1,881.00 -
186 Kloramfenikol susp 125 ml Botol 5,015.00 -
187 Kloramfenikol tetes telinga 3 % Ples 11,044.00 -
188 Klorfenariamin maleat (CTM) tablet 4 mg Tablet 22.00 -
189 Klorine Botol 24,000.00 -
190 Klorpromazin 100 MG Tablet 147.00 -
191 Klorpromazin 25 mg Tablet 148.00 -
192 Klorpromazin injeksi 5 mg/ml-2ml Ampul 1,050.00 -
193 Kotrimoksazol anak Tablet 76.00 -
194 Kotrimoksazol Susp Botol 2,052.00 -
195 Kotrimoksazol Tablet 480 mg Tablet 133.00 -
196 Leucoplast 2,50 cm x 4,5 m Roll 12,675.00 -
197 Leucoplast 7,50 cm x 4,5 m Roll 37,371.00 -
198 Lidocain compositum inj kombinasi Ampul 1,152.00 -
199 Lidocain Injeksi 2% Ampul 1,144.00 -
200 Lidocain Jeli 2% Syringe 41,600.00 -
201 Lidokain Spray Oral 10%(Xylocaine spray) Botol ### -
202 Lisol Botol 41,000.00 -
203 Lodecon Forte Tablet 1,110.00 -
204 Loratadine 10 mg Tablet 131.00 -
205 Magnesium Sulfat Inj 20% Vial 3,200.00 -
206 Magnesium Sulfat Inj 40% Ampul 3,796.00 -
207 Masker Karet Buah 314.00 -
208 Masker Karet Buah 331.70 -
209 Masker Tali Buah 762.00 -
210 Metformin Tablet 96.00 -
211 Metildopa 250 mg / Dopamet Tablet 946.00 -
212 Metilergometrin Maleat Inj Ampul 2,959.00 -
213 Metilergometrin Maleat tab Tablet 210.00 -
214 Metilprednisolone 4 mg Tablet 143.00 -
215 Metoklopramide Inj Ampul 3,960.00 -
216 Metoklopramide Inj Ampul 3,395.00 -
217 Metronidazol Syrup Botol 3,950.00 -
218 Metronidazol tablet 250 mg Tablet 89.00 -
219 Metronidazol tablet 500 mg Tablet 124.00 -
220 Mikonazol krim 2% Tube 3,414.00 -
221 Mummying Pasta Botol ### -
222 Nasal Oxygen, O2 cannula size L/adult Pcs 4,000.00 -
223 Nasal Oxygen, O2 cannula size M Pcs 5,082.00 -
224 Nasal Oxygen, O2 cannula size S/infant Pcs 5,500.00 -
225 Nasal Oxygen, O2 cannula size XS Pcs 6,930.00 -
226 Natrium Bikarbonat tablet 500 mg Tablet 66.00 -
227 Natrium Diklofenak Tablet 137.00 -
228 Natrium Klorida Lar.infus 0,9 % steril Botol 6,840.00 -
229 Natrium Tiroksin Tablet 3,100.00 -
230 Nifedipin 10 mg Tablet 104.00 -
231 Nistatin Suspensi 100.000 IU/ml Botol 13,500.00 -
232 Nistatin tablet vaginal 100.000 IU/g Tablet 560.00 -
233 Nistatin tablet vaginal 500.000 IU/g Tablet 640.00 -
234 Norit Tablet 250.00 -
235 OAT Sisipan/FDC Sisipan Paket ### -
236 Obat antituberkolosis Kombipak Kat.I Dewasa Paket ### -
237 Obat antituberkulosis anak/FDC Anak Paket ### -
238 Obat antituberkulosis anak/FDC Anak Paket ### -
239 Obat antituberkulosis kategori 1/FDC 1 Paket ### -
240 Obat antituberkulosis kategori 1/FDC 1 Paket ### -
241 Obat antituberkulosis kategori 2/FDC 2 Paket ### -
242 Obat antituberkulosis kategori 2/FDC 2 Paket ### -
243 Obat Batuk Hitam (OBH) Cairan -100 ml Botol 2,800.00 -
244 OBH Nusantara Menthol Botol 9,647.00 -
245 OBH Plus Botol 10,600.00 -
246 Oksitetrasiklin HCl 1 % Salep mata Tube 2,500.00 -
247 Oksitetrasiklin HCl inj i.m 50 mg/ml-10 ml Vial 7,700.00 -
248 Oksitetrasiklin HCl Salep Kulit 3 % Tube 4,884.00 -
249 Oksitoksin inj 10 IU/ml- 1 ml Ampul 1,785.00 -
250 Oksitoksin inj 10 IU/ml- 1 ml Ampul 1,199.00 -
251 Omeprazol Kapsul 139.00 -
252 Omeprazol Injeksi Vial 9,898.00 -
253 Papaverin tab Tablet 640.00 -
254 Paraformaldehid Tablet 660.00 -
255 Parasetamol drop Botol 6,649.00 -
256 Parasetamol sirup 120 mg / 5ml Botol 1,107.00 -
257 Parasetamol tablet 500 mg Tablet 53.00 -
258 Parasetamol tablet 100 mg Tablet 92.00 -
259 Pehakain Ampul 3,000.00 -
260 Permetrin Krim 5% (Scabimite) Tube 7,200.00 -
261 Permetrin Krim 5% (Scabimite) Tube 11,825.00 -
262 PGA 2 75 C + Jarum 1/2 40 M Pcs 58,333.33 -
263 Piralent Inj Ampul 7,240.00 -
264 Pirantel Pamoat 125 mg Tablet 269.00 -
265 Pirazinamid 500 mg Tablet 237.00 -
266 Piridoksin HCl (Vit B6) tablet 10 mg Tablet 123.00 -
267 Piroxicam 10 mg Tablet 160.60 -
268 Plester 5 yard x 2 inch Roll 23,600.00 -
269 Plester 7,5 cm x 5 m Buah 30,000.00 -
270 Polypropylene 2/0 75C + Jarum 3/8 26m Pcs 24,500.00 -
271 Povidon Iodiada 10 %-30 ml Botol 2,900.00 -
272 Povidon Iodiada 10 %-300 ml Botol 16,500.00 -
273 Povidon Iodiada 10 %-60 ml Botol 4,620.00 -
274 Prednison tablet 5 mg Tablet 73.00 -
275 Probenesid 500 mg Tablet 1,755.00 -
276 Propanolol HCl tablet 10 mg Tablet 60.00 -
277 Propanolol HCl tablet 40 mg Tablet 81.00 -
278 Propiltiourasil tablet 100 mg Tablet 279.00 -
279 Ranitidin inj Ampul 1,155.00 -
280 Ranitidine 150 mg Tablet 112.00 -
281 Retinol (VIT A) Kapsul 100.000 IU Kapsul 288.00 -
282 Retinol (VIT A) Kapsul 200.000 IU Kapsul 517.00 -
283 Rifampisin kapsul 300 mg Kapsul 725.00 -
284 Rifampisin kapsul 450 mg Kapsul 868.00 -
285 Ringer Laktat Larutan Infus Steril Botol 7,150.00 -
286 Rivanol 300 ml Botol 3,400.00 -
287 Salbutamol tablet 2 mg Tablet 63.00 -
288 Salep 2-4 kombinasi : as.asal 2 % + Bel. 4 % Pot 2,621.00 -
289 Salisil Spiritus Botol 32,299.00 -
290 Sarung Tangan non steril no 6,5 Pasang 7,700.00 -
291 Sarung Tangan non steril no 7 Pasang 8,701.00 -
292 Sarung Tangan non steril no 7,5 Pasang 8,701.00 -
293 Sarung Tangan Obgyn steril Pasang 19,360.00 -
294 Sarung tangan steril no 6,5 Pasang 7,865.00 -
295 Sarung tangan steril no 7 Pasang 8,987.00 -
296 Sarung tangan steril no 7,5 Pasang 9,350.00 -
297 Scandonest Ampul 13,612.00 -
298 Seledril Tablet Tablet 823.33 -
299 Semen Seng Fosfat Serbuk Cairan Set ### -
300 Semillas non Woven Medical Tape Pcs 21,753.00 -
301 Sepadroxil 500 mg Tablet 478.00 -
302 Sepadroxil Syrup Kering 125 mg/5 ml Botol 4,185.00 -
303 Serum anti tetanus (ATS) / Biosat Ampul ### -
304 Serum anti tetanus (ATS) / Tetagam Ampul ### -
305 Serum antibisa ular Polivalen inj 5 ml (SABU) Ampul ### -
306 Silk 2/0 75 C + Jarum 1/2 30M R Sase 20,833.33 -
307 Silk 3/0 75 C + Jarum 1/2 17M R Sase 20,833.33 -
308 Silk 3/0 75 C + Jarum 3/8 26M C Sase 37,100.00 -
309 Silk Black 2/0 DS 24 MM Sase 23,300.00 -
310 Silk Black 2/0 HR 26 MM Sase 20,300.00 -
311 Silk Black 3/0 DS 24 MM Sase 22,400.00 -
312 Silk Black 3/0 HR 26 MM Sase 19,700.00 -
313 Silk Black PFM 2/0 100 m Roll ### -
314 Simvastatin tablet 10 mg Tablet 110.00 -
315 Simvastatin tablet 20 mg Tablet 205.00 -
316 Siprofloksasin 500 mg Tablet 500.00 -
317 Siprofloksasin 500 mg Tablet 770.00 -
318 Softanol antimicrobial 500 ml Botol 55,000.00 -
319 Softanol antimicrobial galon 5 liter Galon ### -
320 Softanol antimicrobial galon 5 liter Galon ### -
321 Solacort krim /Armacort Tube 8,200.00 -
322 Solafluz Botol 13,700.00 -
323 Soldextam Tablet 566.00 -
324 Solvitral Tablet 913.00 -
325 Spironolakton 25 mg Tablet 208.00 -
326 Streptomisin Inj Vial 5,200.00 -
327 Sulfasetamid Natrium Tetes mata 15 % Ples 15,180.00 -
328 Tablet Tambah darah kombinasi : Besi II Sulfa Tablet 353.00 -
329 Tablet Tambah darah kombinasi : Besi II Sulfa Tablet 350.00 -
330 Temporary Filling Material (Fermin) Botol ### -
331 Temporary Stopping Fletcher serbuk &cairan Set 37,000.00 -
332 Tetrakain HCl tetes mata 0,5 % Botol 11,500.00 -
333 Tetrasiklin Kapsul 250 mg Kapsul 166.00 -
334 Tetrasiklin Kapsul 500 mg Kapsul 303.00 -
335 Tiamin HCL (Vit B1) tablet 50 mg Tablet 85.00 -
336 Transfusion Set Set 7,860.00 -
337 Triheksifenidil HCl tablet 2 mg Tablet 85.00 -
338 Trikesol Formalin (TKF) Botol ### -
339 Trikesol Formalin (TKF) Botol ### -
340 Truvit Syr Botol 12,221.00 -
341 Umbilical cord klem steril Pcs 1,000.00 -
342 Urine Bag Pcs 4,202.00 -
343 Ventolin nebules Nebule 4,000.00 -
344 Viorex no rinse antimicrobial Galon ### -
345 Viorex no rinse antimicrobial Botol 65,340.00 -
346 Vitamin B 12 Injeksi Ampul 520.00 -
347 Vitamin B 12 tab Tablet 46.00 -
348 Vitamin B Kompleks tablet Tablet 89.00 -
349 Widabest Botol 10,293.00 -
350 Wing Nedle no 25 Tablet 5,749.00 -
351 Zink Tablet 524.00 -
352 Zink Tablet 508.00 -

-
OBAT PREKURSOR DAN PSIKOTROPIKA -
1 Diazepam inj 5 mg/ml-2 ml Ampul 1,735.00 -
2 Diazepam tablet 2 mg Tablet 86.00 -
3 Diazepam tablet 5 mg Tablet 109.00 -
4 Fenobarbital inj 50 mg/ml-2ml Ampul 1,300.00 -
5 Fenobarbital tablet 30 mg Tablet 165.00 -
6 Stesolid (Diazepam Rectal) Tube 12,573.00 -

Total (Rp) - Total (Rp)

Cat : Format/nama-nama obat jangan dirubah, Bila ada obat-obat yang tidak ada di format (obat lama) mohon di

MENGETAHUI
KEPALA UPTD PUSKESMAS WADO PETUGAS OBAT PUSKESMAS
 dr. Eka. Damayanti
NIP. 197509122005012008 Apt. Nurelawati, S.Si
NIP. 19841109 201903 2 006
EHATAN KABUPATEN SUMEDANG
SKESMAS RAWAT INAP WADO
Jl. RAYA WADO

PORAN OBAT TERPADU

Penambahan Persediaan Pengeluaran ED Sisa Stok

Ket
Σ Harga Jumlah Σ Harga Jumlah Σ Harga Jumlah Σ Harga Jumlah Σ Harga
8(7x4) 9(5+7) 10(9x4) 11 12(11x4) 13 14(13x4) 15 16(15x4)
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- Total (Rp) - Total (Rp) - Total (Rp) - Total (Rp) -

mat (obat lama) mohon dimasukan di kolom paling bawah sesudah nomor 352 (Zink)

OBAT PUSKESMAS PETUGAS OBAT POL/PP

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