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SISA STOK 2021

LIST OBAT 2021 (PASTE DI SINI) STOK AWAL 2022


2 WAY FOLEY CATHETER NO.16 0 0
2 WAY FOLEY CATHETER NO.18 0 0
2 WAY FOLEY CATHETER NO.20 0 0
ACETYLCYSTEINE CAPSULE 200 MG 0 0
ALABETIK TABLET 0 0
ALAT SUNTIK SEKALI PAKAI 1 ML 0 0
ALAT SUNTIK SEKALI PAKAI 10 ML 0 0
ALAT SUNTIK SEKALI PAKAI 20 ML 0 0
ALAT SUNTIK SEKALI PAKAI 3 ML 0 0
ALAT SUNTIK SEKALI PAKAI 5 ML 0
ALLOPURINOL TABLET 100 MG 0 0
ALPRAZOLAM 1 MG TABLET 0 0
AMBROXOL SIRUP 5MG/ML 0 0
AMBROXOL TABLET 30 MG 0 0
AMINOPHYLLINE INJEKSI 24 MG/ML 10 ML 0 0
AMINOPHYLLINE TABLET 200 MG 0 0
AMITRIPTYLLINE HCL TABLET 25 MG 0 0
AMLODIPINE TABLET 10 MG 0 0
AMLODIPINE TABLET 5 MG 0 0
AMOKSISILIN DRY SYRUP 125 MG/5 ML 60 ML 0 0
AMOKSISILIN TABLET 500 MG 0 0
AMOKSISILIN SERBUK INJEKSI 0 0
AMPICILLIN SERBUK INJEKSI 1.000 MG MG/VIAL 0
ANTALGIN 500 MG TABLET (METAMIZOL) 0 0
ANTASIDA DOEN TABLET KOMBINASI 0 0
ANTASIDA SUSPENSI 60 ML 0 0
ANTI BAKTERI DOEN SALEP KOMBINASI 5 GR 0 0
ANTI FUNGI DOEN SALEP KOMBINASI 30 GR 0 0
ANTI HAEMOROID DOEN KOMBINASI 0 0
ANTI INFLUENZA (EMFLU) KOMBINASI TAB 0 0
ANTI INFLUENZA (SOLAFLUZ) KOMBINASI SYRUP 0 0
ANTI MIGRAIN DOEN TABLET KOMBINASI 0 0
ANTI SPASMODIK INJEKSI (SPASHI) 0 0
ANTI SPASMODIK TABLET (DORMICOMP) 0 0
AQUA PRO INJEKSI STERIL BEBAS PIROGEN 20 ML 0 0
ASAM ASKORBAT ( VIT C ) TABLET 250 MG 0 0
ASAM ASKORBAT ( VIT C ) TABLET 50 MG 0 0
ASAM FOLAT 1MG TABLET 0 0
ASAM MEFENAMAT TABLET 500 MG 0 0
ASAM TRANEKSAMAT 100 MG/ML INJEKSI 0 0
ASAM TRANEKSAMAT 500 MG TABLET 0 0
ASAM VALPROAT 250 MG TABLET / DEPAKOTE ER 0 0
ASEPTAN 500CC + PUMP 0 0
ASEPTIC GEL 500CC + DISPENSER 0 0
ASERING (ASETAT RINGER) SOFT BAG 0 0
ASETOSAL TABLET 100 (80) MG 0 0
ASIKLOVIR KREAM 5 % 5 GR 0 0
ASIKLOVIR TABLET 400 MG 0 0
ATROPIN SULFAT INJEKSI 0,25 MG/ML 1 ML 0 0
ATTAPULGIT + PECTIN ( NEO DIASTOP ) TABLET 0
BETAHISTINMESILAT 6 MG TABLET 0 0
BETAMETHASONE CREAM 0,1 % 5 GR 0
BISAKODIL ( BICOLAX ) TABLET 5 MG 0 0
BISAKODIL SUPPOSITORIA 10 MG 0
BISAKODIL SUPPOSITORIA 5 MG 0 0
BISOPROLOL 2,5 MG TABLET (CONCOR) 0 0
BISOPROLOL 5 MG TABLET 0 0
BROMHEXINE SIRUP (HUSTAB) 0 0
CAT GUT NO.2/0 CHROMIC 0 0
CAT GUT NO.2/0-3/0 PLAIN 0 0
CITICHOLIN 250 MG/ML-2ML INJEKSI 0 0
COMBIVENT UDV INHALASI 0
DEKSAMETHASONE INJEKSI 5 MG/ML 1 ML 0
DEKSAMETHASONE TABLET 0,5 MG 0 0
DEVITALISASI PASTA ( NON ARSEN ) 0 0
DIAZEPAM INJEKSI 5 MG/ML 2 ML 0 0
DIAZEPAM LARUTAN RECTAL 5MG/ 2,5ML-STESOLID 0 0
DIAZEPAM TABLET 2 MG 0 0
DIAZEPAM TABLET 5 MG 0 0
DIFENHIDRAMINE HCL INJEKSI 10 MG/ML 1 ML 0 0
DIGOXIN TABLET 0,25 MG 0 0
DIMENHYDRINATE TABLET 50 MG 0 0
DOKSISIKLIN TABLET 100 MG 0 0
DOMPERIDON SUSPENSI 5MG/ML 0 0
DOMPERIDON TABLET 10 MG 0 0
EKSTRACT PLASENTA + NEOMYSIN SALEP 15 GR 0 0
EPINEFRIN (ADRENALIN) HCL INJ.0,1 % 1 ML 0 0
ERITROMISIN KAPSUL 250 MG 0 0
ERITROMISIN SIRUP KERING 200 MG/5ML 0 0
ERITROMISIN TABLET 500 MG 0 0
ETAKRIDIN ( RIVANOL ) LARUTAN 0,1 % 300 ML 0 0
ETANOL [ ALKOHOL ] 70 % 1000 ML 0 0
ETIL KLORIDA SEMPROT 100 ML 0 0
EUGENOL CAIRAN 10 ML 0 0
FENITOIN NATRIUM INJEKSI 50 MG/ML 2 ML 0 0
FENITOIN NATRIUM TABLET 100 MG 0 0
FENOBARBITAL INJEKSI 50 MG/ML 2 ML 0 0
FENOBARBITAL TABLET 30 MG 0 0
FENOL GLISEROL TETES TELINGA 10 % 5 ML 0 0
FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML 1 ML 0 0
FITOMENADION ( VIT K1 ) TABLET SALUT 10 MG 0 0
FITOMENADION INFANT INJ. 2MG/ML 0 0
FLUPHENASINE DEKANOAT INJEKSI 25 MG 1 ML 0 0
FUROSEMID INJEKSI 0 0
FUROSEMID TABLET 40 MG 0 0
GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 % 10 GR 0 0
GEMFIBROZIL 300 MG KAPSUL 0 0
GENTAMISIN SALEP KULIT 0,1 % 5 GR 0 0
GENTAMISIN SALEP MATA 0,3% 0
GENTAMISIN TETES MATA 0,3% 0 0
GLASS IONOMER CEMENT ( GC IX ) 0 0
GLIBENCLAMIDE TABLET 5 MG 0 0
GLICERIL GUAIACOLAT TABLET 100 MG 0 0
GLIMEPIRIDE 2 MG TABLET 0 0
GLUKOSA 40% DEXTROSE INJECTION U.S.P CAIRAN INJEKSI 0 0
GLUKOSA LARUTAN INFUS 10 % STERIL 0 0
GLUKOSA LARUTAN INFUS 5 % STERIL 0
GRISEOFULVIN TABLET 125 MG 0 0
HALOPERIDOL DEKANOAT INJ 50 MG 0 0
HALOPERIDOL INJ. 5 MG/ML (LODOMER) 0 0
HALOPERIDOL TABLET 1,5 MG 0 0
HALOPERIDOL 2 MG 0 0
HALOPERIDOL TABLET 5 MG 0 0
HEPARIN SODIUM 200 UI (THROMBOFLASH) 0 0
HES-HYDROXYETHYL STARCH 6 %/VOLUVEN INFUS 500 ML 0 0
HIDROCORTISONE CREAM 2,5 % 5 GR 0 0
I.V CATHETER NO.16 WITH INJECTION PORT 0 0
I.V CATHETER NO.18 WITH INJECTION PORT 0
I.V CATHETER NO.20 WITH INJECTION PORT 0 0
I.V CATHETER NO.22 WITH INJECTION PORT 0
I.V CATHETER NO.24 WITH INJECTION PORT 0 0
I.V CATHETER NO.26 WITH INJECTION PORT 0
IBUPROFEN SUSPENSI 100 MG/5 ML 60 ML 0 0
IBUPROFEN TABLET 400 MG 0 0
INFUSION SET ANAK 0 0
INFUSION SET DEWASA 0 0
ISOSORBIDE DINITRATE SUBLINGUAL 5 MG 0 0
KAEN 3B 0 0
KALIUM DIKLOFENAK 50 MG TABLET 0
KALSIUM GLUCONAS INJEKSI 100 MG/ML 10 ML 0 0
KALSIUM LAKTAT (KALK) TABLET 500 MG 0 0
KANTONG URINE DEWASA 0 0
KAOLIN PEKTIN (NOVADIAR) SUSPENSI 0 0
KAPAS PEMBALUT/ABSORBEN 250 GR 0 0
KAPTOPRIL TABLET 25 MG 0 0
KARBAMAZEPIN TABLET 200 MG 0 0
KARBAZOKHROME SODIUM SULFONATE INJEKSI 5 MG/ML 10 ML (SALDONA) 0 0
KASA KOMPRES 40/40 STERIL 0 0
KASA PEMBALUT HIDROFIL 16 X 16 CM STRIL 0 0
KASA PEMBALUT HIDROFIL 2 M X 80 CM 0 0
KASA PEMBALUT HIDROFIL 4 M X 10 CM 0 0
KASA PEMBALUT HIDROFIL 4 M X 5 CM 0 0
KASA STERIL (DARYAN TOLLE)YG DIRESAPI FRAMISETIN 0 0
KETOKONAZOLE TABLET 200 MG 0 0
KETOPROFEN 100 MG SUPPOSITORIA 0 0
KLINDAMISIN KAPSUL 150 MG 0 0
KLINDAMISIN KAPSUL 300 MG 0 0
KLOBAZAM 10 MG TABLET 0 0
KLORAMFENIKOL KAPSUL 500 MG 0 0
KLORAMFENIKOL SALEP KULIT 2 % 0 0
KLORAMFENIKOL SALEP MATA 1 % 0 0
KLORAMFENIKOL SUSPENSI 125 MG/5 ML 0 0
KLORAMFENIKOL TETES TELINGA 3 % 0 0
KLORFENIRAMINE MALEAT (CTM) TABLET 4 MG 0 0
KLORPROMAZIN HCL INJEKSI 25 MG/ML 1 ML 0 0
KLORPROMAZIN HCL TABLET 100 MG 0 0
KLOZAPIN 100 MG TABLET 0 0
KLOZAPIN 25 MG TABLET 0 0
KODEIN HCL TABLET 10 MG 0 0
KOTRIMOKSAZOL DEWASA TABLET 0 0
KOTRIMOKSAZOL SUSPENSI 60 ML 0
LEVOFLOXACIN TABLET 500 MG 0 0
LIDOCAIN 2% INJ 0 0
LIDOCAIN COMPOSITUM INJEKSI 2 ML 0 0
LISOL CONCENTRATE 1000 ML 0 0
LOPERAMIDE TABLET 2 MG 0 0
LORATADIN TABLET 10 MG 0 0
MAGNESIUM SULFAT INJEKSI (IV) 40 % 25 ML 0 0
MASKER KERTAS 3 PLY EAR LOOP 0 0
MASKER KERTAS 3 PLY TIE ON 0 0
MELOKSIKAM TABLET 7,5 MG 0 0
METAMIZOL (NORAGES) INJEKSI 500 MG/2ML 0 0
METFORMIN TABLET 500 MG 0 0
METILERGOMETRIN MALEAT INJEKSI 0,200 MG 1 ML 0
METILERGOMETRIN MALEAT TABLET 0,125 MG 0 0
METILPREDNISOLON TABLET 4 MG 0
METOKLOPRAMIDE 10 MG TABLET 0 0
METOKLOPRAMIDE 5 MG TABLET 0 0
METOKLOPROMIDE (SOTATIC) INJEKSI 5 MG/ML 2 ML 0
METOKLOPROMIDE SIRUP 0 0
METRONIDAZOL + NYSTATIN VAG. (PROVAGIN) INJEKSI 0 0
METRONIDAZOL TABLET 250 MG 0 0
METRONIDAZOL TABLET 500 MG 0 0
METRONIDAZOLE INFUS 5 MG/ML 100 ML 0 0
MIKONAZOL KREAM 10 GR 0 0
MINERAL MIX 0 0
MULTIVITAMIN (LYSOVIT ) SYRUP 100 ML 0 0
MULTIVITAMIN (MALTIRON PLUS) KOMBINASI TABLET 0 0
NATRIUM DIKLOFENAK TABLET 25 MG 0 0
NATRIUM DIKLOFENAK TABLET 50 MG 0 0
NATRIUM KLORIDA INFUS 0,9 % STERIL 0 0
NEUROTROPIK (IKANEURON) INJEKSI 0 0
NEUROTROPIK KOMBINASI (IKANEURON) TABLET 0 0
NIFEDIPINE TABLET 10 MG 0 0
NISTATIN TABLET 500.000 UI 0 0
NISTATIN VAGINAL TABLET 100.000 UI 0 0
NOREPINEPHRINE CAIRAN INJEKSI 0 0
OBAT BATUK HITAM (OBH) CAIRAN 100 ML 0 0
OKSIGEN NASAL CANNULA ADULT 0 0
OKSIGEN NASAL CANNULA INFANT 0 0
OKSITETRACYCLIN SALEP KULIT 3 % 5 GR 0 0
OKSITETRACYCLIN SALEP MATA 1 % 3,5 GR 0 0
OKSITOSIN INJEKSI 10 IU/ML 1 ML 0 0
OMEPRAZOLE TABLET 20 MG 0 0
ONDANSENTRON 4 MG/2 ML INJEKSI 0 0
PARACETAMOL SYRUP 120 MG/5 ML 60 ML 0 0
PARACETAMOL TABLET 500 MG 0 0
PARACETAMOL TETES 100 MG/ML 15 ML 0 0
PEHAVRAL TABLET 0 0
PERAK SULFADIAZIN KRIM 1 % 0 0
PERHYDROL [ H2O2 ] 3 % 800 ML 0 0
PIRACETAM TABLET 800 MG 0 0
PIRANTEL PAMOAT TABLET 0 0
PIRIDOKSIN HCL (VIT B6) TABLET 10 MG 0 0
PIROKSIKAM KAPSUL 10 MG 0 0
PLESTER 5 YARD X 2 INCI (LEUKOPLAST) 0
PREDNISON TABLET 5 MG 0 0
PROPANOLOL HCL TABLET 40 MG 0 0
PROPILTHIOURACIL TABLET 100 MG 0 0
RANITIDIN INJEKSI 25 MG/ ML 0 0
RESPERIDON 2 MG TABLET 0 0
RINGER LAKTATE LARUTAN INFUS STERIL 0 0
SALBUTAMOL TABLET 2 MG 0 0
SALBUTAMOL TABLET 4 MG 0 0
SALEP 2-4 KOMBINASI 30 GR 0 0
SALICYL BEDAK 2 % 0 0
SARUNG TANGAM NON STERIL L 0 0
SARUNG TANGAN NON STERIL M 0 0
SARUNG TANGAN NON STERIL S 0 0
SARUNG TANGAN STERIL NO 6 0 0
SARUNG TANGAN STERIL NO. 7,5 0 0
SARUNG TANGAN STERILE NO.6,5 0 0
SARUNG TANGAN STERILE NO.7 0 0
SEFADROKSIL KAPSUL 500 MG 0 0
SEFIKSIM KAPSUL 100 MG 0 0
SERUM ANTI BISA ULAR POLIVALEN INJ.5 ML (ABU I) 0 0
SERUM ANTI TETANUS INJEKSI 1.500 IU/AMP (ATS) 0 0
SETIRIZINE TABLET 10 MG 0 0
SIANOKOBALAMIN ( VIT B12 ) INJEKSI 500 MCG/ML 1 ML 0 0
SIANOKOBALAMIN ( VIT B12 ) TABLET 50 MCG 0 0
SILK (BENANG BEDAH SUTERA) NO.3/0 0 0
SIMETIDINE TABLET 200 MG 0 0
SIMVASTATIN TABLET 10 MG 0 0
SIPROFLOXACIN INFUS 2% 0 0
SIPROFLOXACIN TABLET 500 MG 0 0
SIPROHEPTADINE 4 MG TABLET (PRONICY) 0 0
SPONS GELATIN CUBICLES 1x1x1 CM 0 0
SULFADOKSIN TABLET 0 0
SULFASETAMID NATRIUM TETES MATA 15 % 5 ML 0 0
STIMUNO TAB (100) 0 0
STIMUNO TAB (30) 0 0
STIMUNO SYR 0 0
TABLET TAMBAH DARAH (DAK) 0 0
TEMPORARY CAVITY SEALER [TUMPATAN SEMENTARA] (CAVIT G) 0 0
TETRAKAIN HCL TETES MATA 5 ML 0 0
TETRASIKLIN HCL TABLET 500 MG 0 0
THIAMIN HCL (VIT B1) INJEKSI 100 MG/ML 1 ML 0 0
THIAMIN HCL MONONITRAT (VIT B1) TABLET 100 MG 0 0
THIAMIN HCL MONONITRAT (VIT B1) TABLET 50 MG 0
TRAMADOL INJEKSI 50 MG/ML 0 0
TRANFUSION SET ADULT WITH Y INJECTION 0 0
TRIAMSINOLON ACETONIDE (BUFACOMB) 1MG/GR SALEP 0 0
TRIFLOUPERASIN TABLET 5 MG 0 0
TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2 MG 0 0
VITAMIN B COMPLEX TABLET 0 0
YODIUM POVIDON LARUTAN 10 % 30 ML 0 0
YODIUM POVIDON LARUTAN 10% 60 ML 0 0
ZENTRA (TRIPROLIDINE|PSEUDOEPHEDRINE) 0 0
ZINK 20 MG TABLET 0 0
ZINK SYRUP 0 0
0
0
0
SISA STOK 2021
LIST OBAT PROGAM 2021 (PASTE DI SINI) STOK AWAL 2022
ALAT SUNTIK 0,05 ML (PROGRAM) 0
ALAT SUNTIK 0,5 ML (PROGRAM) 0
ALAT SUNTIK 5 ML (PROGRAM) 0
ALBENDAZOL TABLET 400 MG 0
AMPICILLIN SERBUK INJEKSI 1 G (KESGA) 0
CA GLUCONAS INJEKSI 10 Ml (KESGA) 0
DIAZEPAM CAIRAN INJEKSI 5 MG\/2ML (KESGA) 0
FITOMENADION INJECTION 2 MG\/ ML (KESGA) 0 0
GARAM ORALIT UNTUK 200 ML AIR 0 0
GENTAMICIN CAIRAN INJEKSI 40 MG/ML (KESGA) 0 0
IODINE TES 0 0
ISONIAZID TABLET 100 MG 0
ISONIAZID TABLET 300 MG 0 0
KOMBIPAK AZITHROMYCIN - CEFIXIME KOMBINASI 0
KOTRIMOKSASOL 480 TABLET KOMBINASI 0 0
KOTRIMOKSASOL 960 TABLET KOMBINASI 0
LEVOTHYROXINE ACTAVIS TABLET 100 MCG (KESGA) 0
LODOMER CAIRAN INJEKSI 5 MG/ML (HALOPERIDOL) 0
MDT COMBI - MB ADULT (RED) 0 0
MDT COMBI - MB CHILD (ORANGE) 0 0
MDT COMBI - PB ADULT (GREEN) 0 0
METILERGOMETRIN MALEAT INJECTION 0,200 MG (KESGA) 0 0
OBAT ANTI TUBERKULOSIS ANAK 0 0
OBAT ANTI TUBERKULOSIS KATAGORI 1 0 0
OBAT ANTI TUBERKULOSIS KATAGORI 2 0 0
OBAT ANTI TUBERKULOSIS KOMBIPAK KATEGORI I 0 0
OBAT HIV EFAVIRENZ 200 MG TABLET 0 0
OBAT HIV EFAVIRENZ 600 MG TABLET 0
OBAT HIV LAMIVUDIN 150 MG TABLET 0 0
OBAT HIV NEVIRAPINE (NVP) 200 MG TABLET 0 0
OBAT HIV TENOFOVIR 300 MG (TDF) 0 0
OBAT HIV TRIPLE FDC ANAK ZDV+3TC+NVP (60+30+50) 0 0
OBAT HIV TRIPLE FDC DEWASA TDC+3TC+EFV (300/300/600) 0 0
OBAT HIV ZIDOVUDINE 100 MG TABLET 0 0
OBAT HIV ZIDOVUDINE 300 MG + LAMIVUDIN 150 MG 0 0
OKSITETRASIKLIN SALEP MATA 1% (KESGA) 0 0
PIRIDOKSIN 25 MG TABLET (VIT B6) 0
REAGEN HIV (FOKUS) 0 0
REAGEN HIV (STANDART DIAGNOSTIC/SD) 0 0
REAGEN HIV (VIKIA) 0 0
REAGEN HIV DIAGNOSTAR HIV 1\/2 ONE STEP RAPID TEST 0
REAGEN HIV DIAGNOSTIC KIT FOR HIV (1+2) ANTIBODY (COLLOIDAL GOLD) 0 0
REAGEN SYPHILIS (TREPOCHECK) 0
REAGEN SYPHILIS RDT (FOKUS) 0 0
RETINOL ( VIT A ) KAPSUL 100.000 IU 0 0
RETINOL ( VIT A ) KAPSUL 200.000 IU 0 0
SAFETY BOX 0 0
SERUM ANTI DIFTERI CAIRAN INJEKSI 125 MG/ML 0 0
TABLET TAMBAH DARAH (PROGRAM) 0 0
ZINK TABLET DISPERSIBLE 20 MG (PROGRAM) 0 0
0
0
0
0
0
0
LIST OBAT 2022
2 WAY FOLEY CATHETER NO.16
2 WAY FOLEY CATHETER NO.18
2 WAY FOLEY CATHETER NO.20
ACETYLCYSTEINE CAPSULE 200 MG
ALAT SUNTIK SEKALI PAKAI 1 ML
ALAT SUNTIK SEKALI PAKAI 10 ML
ALAT SUNTIK SEKALI PAKAI 20 ML
ALAT SUNTIK SEKALI PAKAI 3 ML
ALAT SUNTIK SEKALI PAKAI 5 ML
ALKOHOL SWAB
ALLOPURINOL TABLET 100 MG
ALPRAZOLAM 1 MG TABLET
AMBROXOL SIRUP 5MG/ML
AMBROXOL TABLET 30 MG
AMINOPHYLLINE INJEKSI 24 MG/ML 10 ML
AMINOPHYLLINE TABLET 200 MG
AMITRIPTYLLINE HCL TABLET 25 MG
AMLODIPINE TABLET 10 MG
AMLODIPINE TABLET 5 MG
AMOKSISILIN DRY SYRUP 125 MG/5 ML 60 ML
AMOKSISILIN SERBUK INJEKSI 1000 MG
AMOKSISILIN TABLET 500 MG
AMOXCICILIN FORTE SYRUP KERING 250MG/5ML
AMPICILLIN SERBUK INJEKSI 1.000 MG MG/VIAL
ANTALGIN 500 MG TABLET (METAMIZOL)
ANTASIDA DOEN TABLET KOMBINASI
ANTASIDA SUSPENSI 60 ML
ANTI BAKTERI DOEN SALEP KOMBINASI 5 GR
ANTI FUNGI DOEN SALEP KOMBINASI 30 GR
ANTI HAEMOROID DOEN KOMBINASI
ANTI MIGRAIN DOEN TABLET KOMBINASI
ANTI SPASMODIK INJEKSI (SPASHI)
ANTI SPASMODIK TABLET (DORMICOMP)
AQUA PRO INJEKSI STERIL BEBAS PIROGEN 20 ML
ASAM ASKORBAT ( VIT C ) TABLET 250 MG
ASAM ASKORBAT ( VIT C ) TABLET 50 MG
ASAM FOLAT 1MG TABLET
ASAM MEFENAMAT TABLET 500 MG
ASAM TRANEKSAMAT 100 MG/ML INJEKSI
ASAM TRANEKSAMAT 500 MG TABLET
ASAM VALPROAT 250 MG TABLET / DEPAKOTE ER
ASEPTAN 500CC + PUMP
ASEPTIC GEL 500CC + DISPENSER
ASERING (ASETAT RINGER) SOFT BAG
ASETOSAL TABLET 100 (80) MG
ASIKLOVIR KREAM 5 % 5 GR
ASIKLOVIR TABLET 400 MG
ATROPIN SULFAT INJEKSI 0,25 MG/ML 1 ML
ATTAPULGIT + PECTIN TABLET
BETAHISTINE MESILAT 24 MG TABLET
BETAHISTINMESILAT 6 MG TABLET
BETAMETHASON CR 0.05% 20 GR
BETAMETHASONE CREAM 0,1 % 5 GR
BIONICOM ZINC TABLET
BISAKODIL SUPPOSITORIA 10 MG
BISAKODIL SUPPOSITORIA 5 MG
BISOPROLOL 2,5 MG TABLET (CONCOR)
BISOPROLOL 5 MG TABLET
CAT GUT NO. 3/0 CHROMIC
CAT GUT NO. 3/0 PLAIN
CITICHOLIN 250 MG/ML-2ML INJEKSI
CLONIDINE 0.15 MG TABLET
CLOPIDOGREL 75 MG
COMBIVENT UDV INHALASI
DEKSAMETHASONE INJEKSI 5 MG/ML 1 ML
DEKSAMETHASONE TABLET 0,5 MG
DEVITALISASI PASTA ( NON ARSEN )
DIAZEPAM INJEKSI 5 MG/ML 2 ML
DIAZEPAM LARUTAN RECTAL 5MG/ 2,5ML-STESOLID
DIAZEPAM TABLET 2 MG
DIAZEPAM TABLET 5 MG
DIFENHIDRAMINE HCL INJEKSI 10 MG/ML 1 ML
DIGOXIN TABLET 0,25 MG
DIMENHYDRINATE TABLET 50 MG
DOKSISIKLIN TABLET 100 MG
DOMPERIDON SUSPENSI 5MG/ML
DOMPERIDON TABLET 10 MG
EKSTRACT PLASENTA + NEOMYSIN SALEP 15 GR
EPINEFRIN (ADRENALIN) HCL INJ.0,1 % 1 ML
ERITROMISIN KAPSUL 250 MG
ERITROMISIN SIRUP KERING 200 MG/5ML
ERITROMISIN TABLET 500 MG
ETAKRIDIN ( RIVANOL ) LARUTAN 0,1 % 300 ML
ETANOL [ ALKOHOL ] 70 % 1000 ML
ETIL KLORIDA SEMPROT 100 ML
EUGENOL CAIRAN 10 ML
FENITOIN NATRIUM INJEKSI 50 MG/ML 2 ML
FENITOIN NATRIUM TABLET 100 MG
FENOBARBITAL INJEKSI 50 MG/ML 2 ML
FENOBARBITAL TABLET 30 MG
FENOL GLISEROL TETES TELINGA 10 % 5 ML
FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML 1 ML
FITOMENADION ( VIT K1 ) TABLET SALUT 10 MG
FITOMENADION INFANT INJ. 2MG/ML
FLUPHENASINE DEKANOAT INJEKSI 25 MG 1 ML
FUROSEMID INJEKSI 10 mg
FUROSEMID TABLET 40 MG
GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 % 10 GR
GARAM ORALIT
GEMFIBROZIL 300 MG KAPSUL
GENTAMISIN SALEP KULIT 0,1 % 5 GR
GENTAMISIN SALEP MATA 0,3%
GENTAMISIN TETES MATA 0,3%
GLASS IONOMER CEMENT ( GC IX )
GLIBENCLAMIDE TABLET 5 MG
GLICERIL GUAIACOLAT TABLET 100 MG
GLIMEPIRIDE 1 MG TABLET
GLIMEPIRIDE 2 MG TABLET
GLUKOSA 40% DEXTROSE INJECTION U.S.P CAIRAN INJEKSI
GLUKOSA LARUTAN INFUS 10 % STERIL
GLUKOSA LARUTAN INFUS 5 % STERIL
GRISEOFULVIN TABLET 125 MG
HALOPERIDOL 2 MG
HALOPERIDOL DEKANOAT INJ 50 MG
HALOPERIDOL INJ. 5 MG/ML (LODOMER)
HALOPERIDOL TABLET 1,5 MG
HALOPERIDOL TABLET 5 MG
HERBAKOF SYRUP 60ML
HES-HYDROXYETHYL STARCH 6 %/VOLUVEN INFUS 500 ML
HIDROCORTISON CR 1%
HIDROCORTISONE CREAM 2,5 % 5 GR
HYDROCHLORTHIAZIDE 25 MG
I.V CATHETER NO.16 WITH INJECTION PORT
I.V CATHETER NO.18 WITH INJECTION PORT
I.V CATHETER NO.20 WITH INJECTION PORT
I.V CATHETER NO.22 WITH INJECTION PORT
I.V CATHETER NO.24 WITH INJECTION PORT
I.V CATHETER NO.26 WITH INJECTION PORT
IBUPROFEN FORTE SYRUP 200MG/5ML
IBUPROFEN SUSPENSI 100 MG/5 ML 60 ML
IBUPROFEN TABLET 400 MG
INFUSION SET ANAK
INFUSION SET DEWASA
ISOSORBIDE DINITRATE SUBLINGUAL 5 MG
KAEN 3B
KALIUM DIKLOFENAK 50 MG TABLET
KALSIUM GLUCONAS INJEKSI 100 MG/ML 10 ML
KALSIUM LAKTAT (KALK) TABLET 500 MG
KANTONG URINE DEWASA
KAPAS PEMBALUT/ABSORBEN 250 GR
KAPTOPRIL TABLET 25 MG
KARBAMAZEPIN TABLET 200 MG
KASA KOMPRES 40/40 STERIL
KASA PEMBALUT HIDROFIL 16 X 16 CM STRIL
KASA PEMBALUT HIDROFIL 2 M X 80 CM
KASA PEMBALUT HIDROFIL 4 M X 10 CM
KASA PEMBALUT HIDROFIL 4 M X 5 CM
KASA STERIL (DARYAN TOLLE)YG DIRESAPI FRAMISETIN
KETOKONAZOLE TABLET 200 MG
KETOPROFEN 100 MG SUPPOSITORIA
KLINDAMISIN KAPSUL 150 MG
KLINDAMISIN KAPSUL 300 MG
KLOBAZAM 10 MG TABLET
KLORAMFENIKOL KAPSUL 500 MG
KLORAMFENIKOL SALEP KULIT 2 %
KLORAMFENIKOL SALEP MATA 1 %
KLORAMFENIKOL SUSPENSI 125 MG/5 ML
KLORAMFENIKOL TETES TELINGA 3 %
KLORFENIRAMINE MALEAT (CTM) TABLET 4 MG
KLORPROMAZIN HCL INJEKSI 25 MG/ML 1 ML
KLORPROMAZIN HCL INJEKSI 50 MG/ML 1 ML
KLORPROMAZIN HCL TABLET 100 MG
KLOZAPIN 100 MG TABLET
KLOZAPIN 25 MG TABLET
KODEIN HCL TABLET 10 MG
KOTRIMOKSAZOL DEWASA TABLET
KOTRIMOKSAZOL SUSPENSI 60 ML
LEVOFLOXACIN TABLET 500 MG
LIDOCAIN 2% INJ
LIDOCAIN COMPOSITUM INJEKSI 2 ML
LISOL CONCENTRATE 1000 ML
LOPERAMIDE TABLET 2 MG
LORATADIN TABLET 10 MG
LORAZEPAM 2 MG
MAGNESIUM SULFAT INJEKSI (IV) 40 % 25 ML
MASKER EARLOOP PLUS
MASKER KERTAS 3 PLY EAR LOOP
MASKER KERTAS 3 PLY TIE ON
MASKER N95
MELOKSIKAM TABLET 7,5 MG
METAMIZOL (NORAGES) INJEKSI 500 MG/2ML
METFORMIN TABLET 500 MG
METILERGOMETRIN MALEAT INJEKSI 0,200 MG 1 ML
METILERGOMETRIN MALEAT TABLET 0,125 MG
METILPREDNISOLON TABLET 4 MG
METOKLOPRAMIDE 10 MG TABLET
METOKLOPRAMIDE 5 MG TABLET
METOKLOPROMIDE (SOTATIC) INJEKSI 5 MG/ML 2 ML
METOKLOPROMIDE SIRUP
METRONIDAZOL + NYSTATIN VAG. (PROVAGIN) INJEKSI
METRONIDAZOL TABLET 250 MG
METRONIDAZOL TABLET 500 MG
METRONIDAZOLE INFUS 5 MG/ML 100 ML
MIKONAZOL KREAM 10 GR
MINERAL MIX
NATRIUM DIKLOFENAK TABLET 25 MG
NATRIUM DIKLOFENAK TABLET 50 MG
NATRIUM KLORIDA INFUS 0,9 % STERIL
NIFEDIPINE TABLET 10 MG
NISTATIN TABLET 500.000 UI
NISTATIN VAGINAL TABLET 100.000 UI
OBAT BATUK HITAM (OBH) CAIRAN 100 ML
OKSIGEN NASAL CANNULA ADULT
OKSIGEN NASAL CANNULA INFANT
OKSITETRACYCLIN SALEP KULIT 3 % 5 GR
OKSITETRACYCLIN SALEP MATA 1 % 3,5 GR
OKSITOSIN INJEKSI 10 IU/ML 1 ML
OMEPRAZOLE TABLET 20 MG
ONDANSENTRON 4 MG/2 ML INJEKSI
PARACETAMOL SYRUP 120 MG/5 ML 60 ML
PARACETAMOL TABLET 500 MG
PARACETAMOL TETES 100 MG/ML 15 ML
PEHAVRAL TABLET
PERAK SULFADIAZIN KRIM 1 %
PERHYDROL [ H2O2 ] 3 % 800 ML
PERMETHRINE 5% CR 15 GRAM
PIRACETAM TABLET 800 MG
PIRANTEL PAMOAT TABLET
PIRIDOKSIN HCL (VIT B6) TABLET 10 MG
PIROKSIKAM KAPSUL 10 MG
PLESTER 10 CM X 2 M
PREDNISON TABLET 5 MG
PROPRANOLOL HCL TABLET 40 MG
PROPILTHIOURACIL TABLET 100 MG
RANITIDIN INJEKSI 25 MG/ ML
RESPERIDON 2 MG TABLET
RINGER LAKTATE LARUTAN INFUS STERIL
SALBUTAMOL TABLET 2 MG
SALBUTAMOL TABLET 4 MG
SALEP 2-4 KOMBINASI 30 GR
SALICYL BEDAK 2 %
SARUNG TANGAM NON STERIL L
SARUNG TANGAN NON STERIL M
SARUNG TANGAN NON STERIL S
SARUNG TANGAN STERIL NO 6
SARUNG TANGAN STERIL NO. 7,5
SARUNG TANGAN STERILE NO.6,5
SARUNG TANGAN STERILE NO.7
SEFADROKSIL KAPSUL 500 MG
SEFIKSIM KAPSUL 100 MG
SERUM ANTI BISA ULAR POLIVALEN INJ.5 ML (ABU I)
SERUM ANTI TETANUS INJEKSI 1.500 IU/AMP (ATS)
SETIRIZINE TABLET 10 MG
SIANOKOBALAMIN ( VIT B12 ) INJEKSI 500 MCG/ML 1 ML
SIANOKOBALAMIN ( VIT B12 ) TABLET 50 MCG
SILK (BENANG BEDAH SUTERA) NO.3/0
SIMETIDINE TABLET 200 MG
SIMVASTATIN TABLET 10 MG
SIPROFLOXACIN INFUS 2%
SIPROFLOXACIN TABLET 500 MG
SPONS GELATIN CUBICLES 1x1x1 CM
STIMUNO SYR
STIMUNO TAB (100)
STIMUNO TAB (30)
SULFADOKSIN TABLET
SULFASETAMID NATRIUM TETES MATA 15 % 5 ML
TABLET TAMBAH DARAH (DAK)
TEMPORARY CAVITY SEALER [TUMPATAN SEMENTARA] (CAVIT G)
TETAGRAM 150 IU
TETRAKAIN HCL TETES MATA 5 ML
TETRASIKLIN HCL TABLET 500 MG
THIAMIN HCL (VIT B1) INJEKSI 100 MG/ML 1 ML
THIAMIN HCL MONONITRAT (VIT B1) TABLET 100 MG
THIAMIN HCL MONONITRAT (VIT B1) TABLET 50 MG
TRAMADOL INJEKSI 50 MG/ML
TRANFUSION SET ADULT WITH Y INJECTION
TRIFLOUPERASIN TABLET 5 MG
TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2 MG
VITAMIN B COMPLEX TABLET
YODIUM POVIDON LARUTAN 10 % 30 ML
YODIUM POVIDON LARUTAN 10% 60 ML
ZENTRA (TRIPROLIDINE|PSEUDOEPHEDRINE)
ZINK 20 MG TABLET
LIST OBAT PROGRAM 2022
AMITRIPTYLINE 25 MG
HALOPERIDOLE INJEKSI
HALOPERIDOLE 1,5 MG
HALOPERIDOLE 5 MG
LODOMER 2 MG
LODOMER 5 MG
TRIHEXYPHENIDYL 2 MG
ALAT SUNTIK 0,05 ML (PROGRAM)
ALAT SUNTIK 0,5 ML (PROGRAM)
ALAT SUNTIK 5 ML (PROGRAM)
ALBENDAZOL TABLET 400 MG
BENZATINE BENZYLPENICILLIN 2.400.000 IU
COTRIMOXAZOLE 800/160
DIETHYLCARBAMAZINE 100 MG
GARAM ORALIT UNTUK 200 ML AIR
HIV ABACAVIR TABLET 300 MG
HIV ACRIPTEGA (TDF 300 + 3TC 300 + DTG 50)
HIV DOLUTEGRAFIR 50 MG
HIV EFAFIRENZ 200 MG TABLET
HIV EFAFIRENZ 600 MG TABLET
HIV LAMIVUDIN 150 MG TABLET
HIV NEVIRAPINE 200 MG TABLET
HIV TENOFOVIR 300 MG
HIV TRIPLE FDC ANAK (ZIDOVUDIN 60MG+LAMIVUDIN 30MG+NEVIRAPINE 50MG)
HIV TRIPLE FDC DEWASA (TDC+3TC+EFV (300/300/600))
HIV ZIDOVUDINE 100 MG @60 KAPSUL
HIV ZIDOVUDINE 300 MG + LAMIVUDIN 150 MG
HIV ZIDOVUDINE SYRUP 240 ML
IODINE TES
ISONIAZID TABLET 100 MG
ISONIAZID TABLET 300 MG
KOMBIPAK AZITHROMYCIN - CEFIXIME KOMBINASI
MDT COMBI - MB ADULT (RED)
MDT COMBI - MB CHILD (ORANGE)
MDT COMBI - PB ADULT (GREEN)
OBAT ANTI TUBERKULOSIS ANAK
OBAT ANTI TUBERKULOSIS DOSIS HARIAN STOP TB KIT
OBAT ANTI TUBERKULOSIS KATEGORI 1
OBAT ANTI TUBERKULOSIS KATEGORI 2
OBAT ANTI TUBERKULOSIS KOMBIPAK KATEGORI I
PARACETAMOL 500 MG (P2)
PIRIDOKSIN 25 MG TABLET (VIT B6)
PYRIMETAMINE
REAGEN HIV (FOKUS)
REAGEN HIV (STANDART DIAGNOSTIC/SD)
REAGEN HIV (VIKIA)
REAGEN HIV DIAGNOSTAR HIV 1\/2 ONE STEP RAPID TEST
REAGEN HIV DIAGNOSTIC KIT FOR HIV (1+2) ANTIBODY (COLLOIDAL GOLD) V2 PAKET
REAGEN SYPHILIS (TREPOCHECK)
REAGEN SYPHILIS RDT (FOKUS)
RETINOL ( VIT A ) KAPSUL 100.000 IU
RETINOL ( VIT A ) KAPSUL 200.000 IU
SAFETY BOX
SERUM ANTI DIFTERI CAIRAN INJEKSI 125 MG/ML
TABLET TAMBAH DARAH (PROGRAM)
ZINK TABLET DISPERSIBLE 20 MG (PROGRAM)
SD BIOLINE Syphilis 3.0 One Step Syphilis Antibody Test
KEPALA PUSKESMAS :
PENGELOLA OBAT WILAYAH :
ENDAH ROSITANINGSIH, SE, MM NIP :
APRILLIA YUDHA A.S. NIP :
196912302010012002
199104082015022002
LPLPO Sumberingin Jan22

DINAS KESEHATAN KABUPATEN BLITAR


LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)
WILAYAH : SUMBERINGIN PELAPORAN BULA : JANUARI
PUSKESMAS : SANANKULON PERMINTAAN BULA: FEBRUARI
KECAMATAN : SANANKULON
KABUPATEN : BLITAR
PROVINSI : JAWA TIMUR

SISA STOK JUMLAH OBAT


NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN
GUDANG ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11

1 2 WAY FOLEY CATHETER NO.16 PCS 0 0 0

2 2 WAY FOLEY CATHETER NO.18 PCS 0 0 0

3 2 WAY FOLEY CATHETER NO.20 PCS 0 0 0

4 ACETYLCYSTEINE CAPSULE 200 MG CAPSULE 0 0 0

5 ALAT SUNTIK SEKALI PAKAI 1 ML PCS 0 0 0

6 ALAT SUNTIK SEKALI PAKAI 10 ML PCS 0 0 0

7 ALAT SUNTIK SEKALI PAKAI 20 ML PCS 0 0 0

8 ALAT SUNTIK SEKALI PAKAI 3 ML PCS 127 127 10 117

9 ALAT SUNTIK SEKALI PAKAI 5 ML PCS 43 43 23 20 50 60

10 ALKOHOL SWAB PCS 0 0 0 200

11 ALLOPURINOL TABLET 100 MG TABLET 0 0 0 100

12 ALPRAZOLAM 1 MG TABLET TABLET 0 0 0

13 AMBROXOL SIRUP 5MG/ML BOTOL 0 0 0 5

14 AMBROXOL TABLET 30 MG TABLET 0 0 0

15 AMINOPHYLLINE INJEKSI 24 MG/ML 10 ML AMPUL 0 0 0

16 AMINOPHYLLINE TABLET 200 MG TABLET 0 0 0

17 AMITRIPTYLLINE HCL TABLET 25 MG TABLET 0 0 0

18 AMLODIPINE TABLET 10 MG TABLET 116 200 316 180 136 200

19 AMLODIPINE TABLET 5 MG TABLET 0 0 0

20 AMOKSISILIN DRY SYRUP 125 MG/5 ML 60 ML BOTOL 0 0 0 5

21 AMOKSISILIN SERBUK INJEKSI 1000 MG VIAL 0 0 0

22 AMOKSISILIN TABLET 500 MG KAPLET 344 344 179 165 100 300

AMOXCICILIN FORTE SYRUP KERING


23 250MG/5ML BOTOL 0 0 0

24 AMPICILLIN SERBUK INJEKSI 1.000 MG MG/VIAL VIAL 0 0 0

25 ANTALGIN 500 MG TABLET (METAMIZOL) TABLET 0 0 0

26 ANTASIDA DOEN TABLET KOMBINASI TABLET 210 300 510 166 344 400 300

27 ANTASIDA SUSPENSI 60 ML BOTOL 0 0 0 5 5

28 ANTI BAKTERI DOEN SALEP KOMBINASI 5 GR POT 0 0 0

29 ANTI FUNGI DOEN SALEP KOMBINASI 30 GR POT 0 0 0 5

30 ANTI HAEMOROID DOEN KOMBINASI SUPP. 0 0 0

31 ANTI MIGRAIN DOEN TABLET KOMBINASI TABLET 0 0 0

32 ANTI SPASMODIK INJEKSI (SPASHI) AMPUL 0 0 0

33 ANTI SPASMODIK TABLET (DORMICOMP) TABLET 0 0 0

34 AQUA PRO INJEKSI STERIL BEBAS PIROGEN 20 BOTOL 0 0


ML 0

35 ASAM ASKORBAT ( VIT C ) TABLET 250 MG TABLET 0 0 0

36 ASAM ASKORBAT ( VIT C ) TABLET 50 MG TABLET 0 0 0

37 ASAM FOLAT 1MG TABLET TABLET 0 0 0

38 ASAM MEFENAMAT TABLET 500 MG TABLET 0 0 0

39 ASAM TRANEKSAMAT 100 MG/ML INJEKSI AMPUL 0 0 0

Page 18 of 203
LPLPO Sumberingin Jan22
SISA STOK JUMLAH OBAT
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN
GUDANG ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11

40 ASAM TRANEKSAMAT 500 MG TABLET TABLET 0 0 0

ASAM VALPROAT 250 MG TABLET / DEPAKOTE


41 TABLET 0 0 0
ER

42 ASEPTAN 500CC + PUMP BOTOL 0 0 0

43 ASEPTIC GEL 500CC + DISPENSER BOTOL 0 0 0

44 ASERING (ASETAT RINGER) SOFT BAG BOTOL 0 0 0

45 ASETOSAL TABLET 100 (80) MG TABLET 0 0 0

46 ASIKLOVIR KREAM 5 % 5 GR TUBE 3 3 3 2

47 ASIKLOVIR TABLET 400 MG TABLET 0 0 0 100

48 ATROPIN SULFAT INJEKSI 0,25 MG/ML 1 ML AMPUL 0 0 0

49 ATTAPULGIT + PECTIN TABLET TABLET 0 0 0

50 BETAHISTINE MESILAT 24 MG TABLET TABLET 0 0 0

51 BETAHISTINMESILAT 6 MG TABLET TABLET 0 0 0

52 BETAMETHASON CR 0.05% 20 GR TUBE 0 0 0

53 BETAMETHASONE CREAM 0,1 % 5 GR TUBE 0 0 0

54 BIONICOM ZINC TABLET TABLET 0 0 0

55 BISAKODIL SUPPOSITORIA 10 MG SUPP. 0 0 0

56 BISAKODIL SUPPOSITORIA 5 MG SUPP. 0 0 0

57 BISOPROLOL 2,5 MG TABLET (CONCOR) TABLET 0 0 0

58 BISOPROLOL 5 MG TABLET TABLET 0 0 0

59 CAT GUT NO. 3/0 CHROMIC PCS 0 0 0

60 CAT GUT NO. 3/0 PLAIN PCS 0 0 0

61 CITICHOLIN 250 MG/ML-2ML INJEKSI AMPUL 0 0 0

62 CLONIDINE 0.15 MG TABLET TABLET 0 0 0

63 CLOPIDOGREL 75 MG TABLET 0 0 0

64 COMBIVENT UDV INHALASI VIAL 0 0 0

65 DEKSAMETHASONE INJEKSI 5 MG/ML 1 ML AMPUL 0 0 0

66 DEKSAMETHASONE TABLET 0,5 MG TABLET 0 0 0

67 DEVITALISASI PASTA ( NON ARSEN ) POT 0 0 0

68 DIAZEPAM INJEKSI 5 MG/ML 2 ML AMPUL 0 0 0

DIAZEPAM LARUTAN RECTAL 5MG/ 2,5ML-


69 STESOLID TUBE 0 0 0

70 DIAZEPAM TABLET 2 MG TABLET 0 0 0

71 DIAZEPAM TABLET 5 MG TABLET 0 0 0

72 DIFENHIDRAMINE HCL INJEKSI 10 MG/ML 1 ML AMPUL 0 0 0

73 DIGOXIN TABLET 0,25 MG TABLET 0 0 0

74 DIMENHYDRINATE TABLET 50 MG TABLET 15 15 6 9

75 DOKSISIKLIN TABLET 100 MG KAPSUL 0 0 0

76 DOMPERIDON SUSPENSI 5MG/ML BOTOL 0 0 0

77 DOMPERIDON TABLET 10 MG TABLET 0 0 0

78 EKSTRACT PLASENTA + NEOMYSIN SALEP 15 GR TUBE 0 0 0

79 EPINEFRIN (ADRENALIN) HCL INJ.0,1 % 1 ML AMPUL 0 0 0

80 ERITROMISIN KAPSUL 250 MG KAPSUL 0 0 0

81 ERITROMISIN SIRUP KERING 200 MG/5ML BOTOL 0 0 0

82 ERITROMISIN TABLET 500 MG KAPSUL 0 0 0

Page 19 of 203
LPLPO Sumberingin Jan22
SISA STOK JUMLAH OBAT
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN
GUDANG ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11

83 ETAKRIDIN ( RIVANOL ) LARUTAN 0,1 % 300 ML BOTOL 1 1 1

84 ETANOL [ ALKOHOL ] 70 % 1000 ML BOTOL 1 1 1

85 ETIL KLORIDA SEMPROT 100 ML BOTOL 0 0 0

86 EUGENOL CAIRAN 10 ML BOTOL 0 0 0

87 FENITOIN NATRIUM INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0

88 FENITOIN NATRIUM TABLET 100 MG KAPSUL 0 0 0

89 FENOBARBITAL INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0

90 FENOBARBITAL TABLET 30 MG TABLET 0 0 0

91 FENOL GLISEROL TETES TELINGA 10 % 5 ML BOTOL 0 0 0

92 FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML 1 AMPUL 0 0


ML 0

93 FITOMENADION ( VIT K1 ) TABLET SALUT 10 MG TABLET 0 0 0

94 FITOMENADION INFANT INJ. 2MG/ML AMPUL 0 0 0

95 FLUPHENASINE DEKANOAT INJEKSI 25 MG 1 ML AMPUL 0 0 0

96 FUROSEMID INJEKSI 10 mg VIAL 0 0 0

97 FUROSEMID TABLET 40 MG TABLET 70 70 28 42

98 GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 % 10 TUBE 4 4 3 3


GR 1

99 GARAM ORALIT SACHET 117 117 15 102

100 GEMFIBROZIL 300 MG KAPSUL KAPSUL 0 0 0

101 GENTAMISIN SALEP KULIT 0,1 % 5 GR TUBE 0 0 0 5

102 GENTAMISIN SALEP MATA 0,3% TUBE 0 0 0

103 GENTAMISIN TETES MATA 0,3% BOTOL 0 0 0

104 GLASS IONOMER CEMENT ( GC IX ) BOTOL 0 0 0

105 GLIBENCLAMIDE TABLET 5 MG TABLET 30 200 230 25 205 200 300

106 GLICERIL GUAIACOLAT TABLET 100 MG TABLET 0 0 0

107 GLIMEPIRIDE 1 MG TABLET TABLET 0 0 0

108 GLIMEPIRIDE 2 MG TABLET TABLET 124 200 324 30 294 200 100

GLUKOSA 40% DEXTROSE INJECTION U.S.P


109 CAIRAN INJEKSI VIAL 0 0 0

110 GLUKOSA LARUTAN INFUS 10 % STERIL BOTOL 0 0 0

111 GLUKOSA LARUTAN INFUS 5 % STERIL BOTOL 0 0 0

112 GRISEOFULVIN TABLET 125 MG TABLET 0 0 0

113 HALOPERIDOL 2 MG TABLET 0 0 0

114 HALOPERIDOL DEKANOAT INJ 50 MG VIAL 0 0 0

115 HALOPERIDOL INJ. 5 MG/ML (LODOMER) AMPUL 0 0 0

116 HALOPERIDOL TABLET 1,5 MG TABLET 0 0 0

117 HALOPERIDOL TABLET 5 MG TABLET 0 0 0

118 HERBAKOF SYRUP 60ML BOTOL 0 0 0

119 HES-HYDROXYETHYL STARCH 6 %/VOLUVEN BOTOL 0 0


INFUS 500 ML 0

120 HIDROCORTISON CR 1% TUBE 0 0 0

121 HIDROCORTISONE CREAM 2,5 % 5 GR TUBE 0 0 0

122 HYDROCHLORTHIAZIDE 25 MG TABLET 0 0 0

123 I.V CATHETER NO.16 WITH INJECTION PORT PCS 0 0 0

124 I.V CATHETER NO.18 WITH INJECTION PORT PCS 0 0 0

125 I.V CATHETER NO.20 WITH INJECTION PORT PCS 0 0 0

Page 20 of 203
LPLPO Sumberingin Jan22
SISA STOK JUMLAH OBAT
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN
GUDANG ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11

126 I.V CATHETER NO.22 WITH INJECTION PORT PCS 0 0 0

127 I.V CATHETER NO.24 WITH INJECTION PORT PCS 0 0 0

128 I.V CATHETER NO.26 WITH INJECTION PORT PCS 0 0 0

129 IBUPROFEN FORTE SYRUP 200MG/5ML BOTOL 0 0 0

130 IBUPROFEN SUSPENSI 100 MG/5 ML 60 ML BOTOL 0 3 3 3 5 5

131 IBUPROFEN TABLET 400 MG TABLET 0 0 0 50

132 INFUSION SET ANAK PCS 0 0 0

133 INFUSION SET DEWASA PCS 0 0 0

134 ISOSORBIDE DINITRATE SUBLINGUAL 5 MG TABLET 0 0 0

135 KAEN 3B BOTOL 0 0 0

136 KALIUM DIKLOFENAK 50 MG TABLET TABLET 0 0 0

137 KALSIUM GLUCONAS INJEKSI 100 MG/ML 10 ML AMPUL 0 0 0

138 KALSIUM LAKTAT (KALK) TABLET 500 MG TABLET 192 300 492 239 253 600 200

139 KANTONG URINE DEWASA PCS 0 0 0

140 KAPAS PEMBALUT/ABSORBEN 250 GR BKS 0 0 0

141 KAPTOPRIL TABLET 25 MG TABLET 0 0 0

142 KARBAMAZEPIN TABLET 200 MG TABLET 0 0 0

143 KASA KOMPRES 40/40 STERIL BKS 0 0 0

144 KASA PEMBALUT HIDROFIL 16 X 16 CM STRIL ROL 1 3 4 4

145 KASA PEMBALUT HIDROFIL 2 M X 80 CM ROL 1 1 1

146 KASA PEMBALUT HIDROFIL 4 M X 10 CM ROL 0 0 0

147 KASA PEMBALUT HIDROFIL 4 M X 5 CM ROL 0 0 0

148 KASA STERIL (DARYAN TOLLE)YG DIRESAPI PCS 0 0


FRAMISETIN 0

149 KETOKONAZOLE TABLET 200 MG TABLET 0 0 0

150 KETOPROFEN 100 MG SUPPOSITORIA SUPP. 0 0 0

151 KLINDAMISIN KAPSUL 150 MG TABLET 0 0 0

152 KLINDAMISIN KAPSUL 300 MG KAPSUL 0 0 0

153 KLOBAZAM 10 MG TABLET TABLET 0 0 0

154 KLORAMFENIKOL KAPSUL 500 MG KAPSUL 0 0 0 100

155 KLORAMFENIKOL SALEP KULIT 2 % TUBE 0 0 0

156 KLORAMFENIKOL SALEP MATA 1 % TUBE 4 4 2 2

157 KLORAMFENIKOL SUSPENSI 125 MG/5 ML BOTOL 0 0 0

158 KLORAMFENIKOL TETES TELINGA 3 % BOTOL 0 0 0

159 KLORFENIRAMINE MALEAT (CTM) TABLET 4 TABLET 118 200 318 190 300 200
MG 128

160 KLORPROMAZIN HCL INJEKSI 25 MG/ML 1 ML AMPUL 0 0 0

161 KLORPROMAZIN HCL INJEKSI 50 MG/ML 1 ML AMPUL 0 0 0

162 KLORPROMAZIN HCL TABLET 100 MG TABLET 0 0 0

163 KLOZAPIN 100 MG TABLET TABLET 0 0 0

164 KLOZAPIN 25 MG TABLET TABLET 0 0 0

165 KODEIN HCL TABLET 10 MG TABLET 0 0 0

166 KOTRIMOKSAZOL DEWASA TABLET TABLET 0 0 0

167 KOTRIMOKSAZOL SUSPENSI 60 ML BOTOL 0 0 0

168 LEVOFLOXACIN TABLET 500 MG TABLET 0 0 0

Page 21 of 203
LPLPO Sumberingin Jan22
SISA STOK JUMLAH OBAT
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN
GUDANG ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11

169 LIDOCAIN 2% INJ AMPUL 0 0 0

170 LIDOCAIN COMPOSITUM INJEKSI 2 ML AMPUL 0 0 0

171 LISOL CONCENTRATE 1000 ML BOTOL 0 0 0

172 LOPERAMIDE TABLET 2 MG TABLET 0 0 0

173 LORATADIN TABLET 10 MG TABLET 50 50 50

174 LORAZEPAM 2 MG TABLET 0 0 0

175 MAGNESIUM SULFAT INJEKSI (IV) 40 % 25 ML AMPUL 0 0 0

176 MASKER EARLOOP PLUS PCS 0 0 0

177 MASKER KERTAS 3 PLY EAR LOOP PCS 0 0 0

178 MASKER KERTAS 3 PLY TIE ON PCS 0 0 0

179 MASKER N95 PCS 0 0 0

180 MELOKSIKAM TABLET 7,5 MG TABLET 0 0 0

181 METAMIZOL (NORAGES) INJEKSI 500 MG/2ML AMPUL 0 0 0

182 METFORMIN TABLET 500 MG TABLET 0 0 0

183 METILERGOMETRIN MALEAT INJEKSI 0,200 MG AMPUL 0 0


1 ML 0

184 METILERGOMETRIN MALEAT TABLET 0,125 MG TABLET 0 0 0

185 METILPREDNISOLON TABLET 4 MG TABLET 0 0 0

186 METOKLOPRAMIDE 10 MG TABLET TABLET 0 0 0

187 METOKLOPRAMIDE 5 MG TABLET TABLET 0 0 0

188 METOKLOPROMIDE (SOTATIC) INJEKSI 5 AMPUL 0 0


MG/ML 2 ML 0

189 METOKLOPROMIDE SIRUP BOTOL 0 0 0

190 METRONIDAZOL + NYSTATIN VAG. (PROVAGIN) VIAL 0 0


INJEKSI 0

191 METRONIDAZOL TABLET 250 MG TABLET 0 0 0 100

192 METRONIDAZOL TABLET 500 MG TABLET 0 0 0 100

193 METRONIDAZOLE INFUS 5 MG/ML 100 ML BOTOL 0 0 0

194 MIKONAZOL KREAM 10 GR TUBE 4 4 1 3 3 5

195 MINERAL MIX SACHET 0 0 0

196 NATRIUM DIKLOFENAK TABLET 25 MG TABLET 92 92 10 82 100

197 NATRIUM DIKLOFENAK TABLET 50 MG TABLET 0 0 0

198 NATRIUM KLORIDA INFUS 0,9 % STERIL BOTOL 0 0 0 1

199 NIFEDIPINE TABLET 10 MG TABLET 0 0 0

200 NISTATIN TABLET 500.000 UI TABLET 50 50 10 40

201 NISTATIN VAGINAL TABLET 100.000 UI VAGTAB 11 11 11

202 OBAT BATUK HITAM (OBH) CAIRAN 100 ML BOTOL 0 0 0 10

203 OKSIGEN NASAL CANNULA ADULT PCS 0 0 0

204 OKSIGEN NASAL CANNULA INFANT PCS 0 0 0

205 OKSITETRACYCLIN SALEP KULIT 3 % 5 GR TUBE 0 0 0

206 OKSITETRACYCLIN SALEP MATA 1 % 3,5 GR TUBE 3 3 1 2

207 OKSITOSIN INJEKSI 10 IU/ML 1 ML AMPUL 0 0 0

208 OMEPRAZOLE TABLET 20 MG KAPSUL 0 0 0

209 ONDANSENTRON 4 MG/2 ML INJEKSI AMPUL 0 0 0

210 PARACETAMOL SYRUP 120 MG/5 ML 60 ML BOTOL 0 3 3 2 1 10 5

211 PARACETAMOL TABLET 500 MG TABLET 0 0 0

Page 22 of 203
LPLPO Sumberingin Jan22
SISA STOK JUMLAH OBAT
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN
GUDANG ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11

212 PARACETAMOL TETES 100 MG/ML 15 ML BOTOL 0 0 0

213 PEHAVRAL TABLET TABLET 0 0 0

214 PERAK SULFADIAZIN KRIM 1 % TUBE 0 0 0

215 PERHYDROL [ H2O2 ] 3 % 800 ML BOTOL 1 1 1

216 PERMETHRINE 5% CR 15 GRAM TUBE 0 0 0

217 PIRACETAM TABLET 800 MG TABLET 0 0 0

218 PIRANTEL PAMOAT TABLET TABLET 0 0 0

219 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG TABLET 0 0 0

220 PIROKSIKAM KAPSUL 10 MG KAPSUL 0 0 0

221 PLESTER 10 CM X 2 M ROL 0 0 0

222 PREDNISON TABLET 5 MG TABLET 0 0 0

223 PROPRANOLOL HCL TABLET 40 MG TABLET 0 0 0

224 PROPILTHIOURACIL TABLET 100 MG TABLET 0 0 0

225 RANITIDIN INJEKSI 25 MG/ ML AMPUL 0 0 0

226 RESPERIDON 2 MG TABLET TABLET 0 0 0

227 RINGER LAKTATE LARUTAN INFUS STERIL BOTOL 0 0 0

228 SALBUTAMOL TABLET 2 MG TABLET 0 0 0 100

229 SALBUTAMOL TABLET 4 MG TABLET 0 0 0

230 SALEP 2-4 KOMBINASI 30 GR POT 2 2 2 5

231 SALICYL BEDAK 2 % KOTAK 0 0 0 10

232 SARUNG TANGAM NON STERIL L PCS 0 0 0

233 SARUNG TANGAN NON STERIL M PCS 85 200 285 117 168 200 200

234 SARUNG TANGAN NON STERIL S PCS 0 0 0 200 100

235 SARUNG TANGAN STERIL NO 6 PSG 0 0 0

236 SARUNG TANGAN STERIL NO. 7,5 PSG 0 0 0

237 SARUNG TANGAN STERILE NO.6,5 PSG 0 0 0

238 SARUNG TANGAN STERILE NO.7 PSG 1 1 1

239 SEFADROKSIL KAPSUL 500 MG KAPSUL 0 0 0

240 SEFIKSIM KAPSUL 100 MG KAPSUL 0 0 0

SERUM ANTI BISA ULAR POLIVALEN INJ.5 ML


241 (ABU I) VIAL 0 0 0

242 SERUM ANTI TETANUS INJEKSI 1.500 IU/AMP VIAL 0 0


(ATS) 0

243 SETIRIZINE TABLET 10 MG TABLET 40 40 16 24 50 100

244 SIANOKOBALAMIN ( VIT B12 ) INJEKSI 500 AMPUL 0 0 0


MCG/ML 1 ML

245 SIANOKOBALAMIN ( VIT B12 ) TABLET 50 MCG TABLET 200 200 6 194

246 SILK (BENANG BEDAH SUTERA) NO.3/0 PCS 0 0 0

247 SIMETIDINE TABLET 200 MG TABLET 0 0 0

248 SIMVASTATIN TABLET 10 MG TABLET 0 0 0 60

249 SIPROFLOXACIN INFUS 2% BOTOL 0 0 0

250 SIPROFLOXACIN TABLET 500 MG TABLET 0 0 0

251 SPONS GELATIN CUBICLES 1x1x1 CM PCS 0 0 0

252 STIMUNO SYR BOTOL 0 0 0

253 STIMUNO TAB (100) TABLET 0 0 0

254 STIMUNO TAB (30) BOTOL 0 0 0

Page 23 of 203
LPLPO Sumberingin Jan22
SISA STOK JUMLAH OBAT
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN
GUDANG ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11

255 SULFADOKSIN TABLET TABLET 0 0 0

SULFASETAMID NATRIUM TETES MATA 15 % 5


256 BOTOL 0 0 0
ML

257 TABLET TAMBAH DARAH TABLET 714 500 1,214 350 864 400 500

258 TEMPORARY CAVITY SEALER [TUMPATAN PCS 0 0


SEMENTARA] (CAVIT G) 0

259 TETAGRAM 150 IU AMPUL 0 0 0

260 TETRAKAIN HCL TETES MATA 5 ML BOTOL 0 0 0

261 TETRASIKLIN HCL TABLET 500 MG KAPSUL 0 0 0

262 THIAMIN HCL (VIT B1) INJEKSI 100 MG/ML 1 ML AMPUL 0 0 0

263 THIAMIN HCL MONONITRAT (VIT B1) TABLET 100 TABLET 0 0 500
MG 0

264 THIAMIN HCL MONONITRAT (VIT B1) TABLET 50 TABLET 0 0 500


MG 0

265 TRAMADOL INJEKSI 50 MG/ML AMPUL 0 0 0

266 TRANFUSION SET ADULT WITH Y INJECTION PCS 0 0 0

267 TRIFLOUPERASIN TABLET 5 MG TABLET 0 0 0

268 TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2 MG TABLET 0 0 0

269 VITAMIN B COMPLEX TABLET TABLET 158 158 158 0 300 100

270 YODIUM POVIDON LARUTAN 10 % 30 ML BOTOL 0 0 0

271 YODIUM POVIDON LARUTAN 10% 60 ML BOTOL 1 1 1

272 ZENTRA (TRIPROLIDINE|PSEUDOEPHEDRINE) TABLET 0 0 0

273 ZINK 20 MG TABLET TABLET 0 0 0

274 Hi-D 1000 CHOLECALCIFEROL TABLET 0 0 0

OBAT PROGRAM / HIBAH

1 AMITRIPTYLINE 25 MG TABLET 0 0 0

2 HALOPERIDOLE INJEKSI AMPUL 0 0 0

3 HALOPERIDOLE 1,5 MG TABLET 0 0 0

4 HALOPERIDOLE 5 MG TABLET 0 0 0

5 LODOMER 2 MG TABLET 0 0 0

6 LODOMER 5 MG TABLET 0 0 0

7 TRIHEXYPHENIDYL 2 MG TABLET 0 0 0

8 ALAT SUNTIK 0,05 ML (PROGRAM) PCS 0 0 0

9 ALAT SUNTIK 0,5 ML (PROGRAM) PCS 0 0 0

10 ALAT SUNTIK 5 ML (PROGRAM) PCS 0 0 0

11 ALBENDAZOL TABLET 400 MG TABLET 0 0 0

12 BENZATINE BENZYLPENICILLIN 2.400.000 IU VIAL 0 0 0

13 COTRIMOXAZOLE 800/160 TABLET 0 0 0

14 DIETHYLCARBAMAZINE 100 MG TABLET 0 0 0

15 GARAM ORALIT UNTUK 200 ML AIR SACHET 0 0 0 0

16 HIV ABACAVIR TABLET 300 MG BOTOL 0 0 0

17 HIV ACRIPTEGA (TDF 300 + 3TC 300 + DTG 50) BOTOL 0 0 0

18 HIV DOLUTEGRAFIR 50 MG BOTOL 0 0 0

19 HIV EFAFIRENZ 200 MG TABLET BOTOL 0 0 0

20 HIV EFAFIRENZ 600 MG TABLET BOTOL 0 0 0

21 HIV LAMIVUDIN 150 MG TABLET BOTOL 0 0 0

22 HIV NEVIRAPINE 200 MG TABLET BOTOL 0 0 0

Page 24 of 203
LPLPO Sumberingin Jan22
SISA STOK JUMLAH OBAT
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN
GUDANG ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11

23 HIV TENOFOVIR 300 MG BOTOL 0 0 0


HIV TRIPLE FDC ANAK (ZIDOVUDIN
24 BOTOL 0 0 0
60MG+LAMIVUDIN 30MG+NEVIRAPINE 50MG)
25 HIV TRIPLE FDC DEWASA (TDC+3TC+EFV BOTOL 0 0 0
(300/300/600))

26 HIV ZIDOVUDINE 100 MG @60 KAPSUL BOTOL 0 0 0

27 HIV ZIDOVUDINE 300 MG + LAMIVUDIN 150 MG BOTOL 0 0 0

28 HIV ZIDOVUDINE SYRUP 240 ML BOTOL 0 0 0

29 IODINE TES PCS 0 0 0

30 ISONIAZID TABLET 100 MG TABLET 0 0 0

31 ISONIAZID TABLET 300 MG TABLET 0 0 0

KOMBIPAK AZITHROMYCIN - CEFIXIME


32 TABLET 0 0 0
KOMBINASI

33 MDT COMBI - MB ADULT (RED) BLISTER 0 0 0

34 MDT COMBI - MB CHILD (ORANGE) BLISTER 0 0 0

35 MDT COMBI - PB ADULT (GREEN) BLISTER 0 0 0

36 OBAT ANTI TUBERKULOSIS ANAK PAKET 0 0 0

OBAT ANTI TUBERKULOSIS DOSIS HARIAN STOP


37 TB KIT PAKET 0 0 0

38 OBAT ANTI TUBERKULOSIS KATEGORI 1 PAKET 0 0 0

39 OBAT ANTI TUBERKULOSIS KATEGORI 2 PAKET 0 0 0

OBAT ANTI TUBERKULOSIS KOMBIPAK


40 KATEGORI I PAKET 0 0 0

41 PARACETAMOL 500 MG (P2) TABLET 0 0 0

42 PIRIDOKSIN 25 MG TABLET (VIT B6) TABLET 0 0 0

43 PYRIMETAMINE TABLET 0 0 0

44 REAGEN HIV (FOKUS) PCS 0 0 0

45 REAGEN HIV (STANDART DIAGNOSTIC/SD) PCS 0 0 0

46 REAGEN HIV (VIKIA) PCS 0 0 0

47 REAGEN HIV DIAGNOSTAR HIV 1\/2 ONE STEP PCS 0 0 0


RAPID TEST
REAGEN HIV DIAGNOSTIC KIT FOR HIV (1+2)
48 PCS 0 0 0
ANTIBODY (COLLOIDAL GOLD) V2 PAKET
49 REAGEN SYPHILIS (TREPOCHECK) PCS 0 0 0

50 REAGEN SYPHILIS RDT (FOKUS) PCS 0 0 0

51 RETINOL ( VIT A ) KAPSUL 100.000 IU KAPSUL 0 0 0

52 RETINOL ( VIT A ) KAPSUL 200.000 IU KAPSUL 0 0 0

53 SAFETY BOX PCS 0 0 0

54 SERUM ANTI DIFTERI CAIRAN INJEKSI 125 VIAL 0 0 0


MG/ML

55 TABLET TAMBAH DARAH (PROGRAM) TABLET 0 0 0

56 ZINK TABLET DISPERSIBLE 20 MG (PROGRAM) TABLET 0 0 0

57 ALBENDAZOLE SIRUP BOTOL 0 0 0

58 COTRIMOXAZOLE 400/80 TABLET 0 0 0

59 MINERAL MIX SACHET 0 0 0

60 SD BIOLINE Syphilis 3.0 One Step Syphilis PCS 0 0 0


Antibody Test

OBAT TAMBAHAN

1 ALKOHOL SWAB 0 0 100

2 ALLOPURINOL 0 0 100

3 AMLODIPINE 5MG (BLUD) 0 0 150

4 ANTISEPTIK GEL (DINKES) 1 1 1 0 2 1

5 APD VAKSIN 0 0

Page 25 of 203
LPLPO Sumberingin Jan22
SISA STOK JUMLAH OBAT
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN
GUDANG ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11

6 APRON (DINKES) 0 0

7 AQUA PRO INJEKSI (BLUD) 0 0

8 ASAM MEFENAMAT TABLET 500 MG (BLUD) 184 184 32 152

9 ASIKLOVIR TABLET 0 0

10 BETAMETHASONE SALEP KULIT (BLUD) 4 4 4 0 10

11 BIOPLACENTON (BLUD) 0 0 2

12 BISAKODIL TABLET 5 MG (BLUD) 0 0

13 CIPROFLOXACIN (BLUD) 0 0 100

14 CLINDAMISIN KAPS (BLUD) 0 0

15 DEKSAMETHASONE HARSEN TABLET 0,5 MG 200 200 12 188 100 300


((BLUD) )

16 DOMPERIDONE TABLET 10 MG ( (BLUD)) 100 100 100

17 EPINEFRIN INJEKSI (BLUD) 0 0

18 FENITOIN KAPS (BLUD) 0 0

19 FITOMENADION INJ (BLUD) 0 0

20 FITOMENADION TABLET (BLUD) 0 0

21 FUROSEMIDE TABLET 0 0

22 GEMFIBROZIL (BLUD) 0 0

23 GENOINT (BLUD) 1 1 1 0 5

24 GENTAMICIN TETES MATA (BLUD) 2 5 7 2 5 5

25 GENTIAN VIOLET LARUTAN 1 % (BLUD) 2 2 2

26 GLISERIL GUAIKOLAT/GUAIFENESIN BLUD 407 300 707 192 515 300

27 HIDROKORTISON CREAM KULIT (BLUD) 5 5 5 5

28 HYOSCINE BUTYLBROMIDE (ANTI SPASMODIK 0 0


BLUD)

29 HYPAFIX (BLUD) 0 0

30 INFUSET (BLUD) 0 0

31 IV CATHETER (BLUD) 0 0

32 KAPTOPRIL TABLET 12,5 MG (BLUD) 6 300 306 22 284 300 300

33 KLORAMFENIKOL SIRUP (BLUD) 0 0

34 KLORAMFENIKOL TETES TELINGA (BLUD) 3 5 8 3 5

35 KOTRIMOKSAZOL TAB (BLUD) 0 0

36 LOPERAMIDE TABLET 2 MG (BLUD) 0 0

37 MASKER (DINKES) 0 0

38 MASKER N9 0 0 0

39 METFORMIN (BLUD) 75 100 175 20 155 100

40 METILERGOMETRINE INJ (BLUD) 0 0

41 MULTIVITAMIN KOMB 0 0

42 NEW DIATABS (BLUD) 78 78 20 58

43 NIFEDIPINE TAB (BLUD) 0 0

44 NURSE CAP 0 0

45 OMEPRAZOLE 20MG 66 66 4 62

46 ONDANSETRONE INJEKSI (BLUD) 0 0

47 PARACETAMOL TABLET 500 MG (BLUD) 610 600 1,210 474 736 400 600

48 PEHAVRAL 0 0

Page 26 of 203
LPLPO Sumberingin Jan22
SISA STOK JUMLAH OBAT
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN
GUDANG ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11

49 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG (BLUD) 238 238 44 194

50 PIROXICAM 0 0

51 SALBUTAMOL TABLET 2 MG (BLUD) 35 35 8 27

52 SARUNG TANGAN OBGYN 0 0

53 SARUNG TANGAN OBGYN 0 0

54 SEFADROKSIL KAPSUL 500 MG (BLUD) 0 0

55 VGEL (BLUD) 0 0

56 VITAMIN C 50 MG (BLUD) 370 370 184 186 300 500

57 ZIVIT ZINC 60 60 6 54 90

58 ASETIL (DINKES) 0 0

59 DEXAMETHASONE (DINKES) 0 0

60 OBH (DINKES) 0 0

61 AMBROXOL

62 BATUK FLU SIRUP (ETAFLUSIN)

63 BATUK FLU TABLET (ETAFLUSIN)

64 BETADINE GARGLE

65 BUFACOMB SALEP

66 BUFACORT - N

67 DARYANTULLE

68 ETIL KLORIDA SPRAY

69 GLIBENCLAMIDE TABLET 5 MG

70 GLIMEPIRIDE 2 MG TABLET

71 KAOLIN PEKTIN SIRUP (NOVADIAR)

72 PIRACETAM KAPSUL

73 TIAMFENIKOL KAPSUL

74 VITAMIN ANAK SIRUP (SAMCOVIT)

75

76

77

78

79

80

Blitar , 02 February 2022


Mengetahui / Menyetujui
Yang Menerima, Yang Menyerahkan,
Kepala Puskesmas Petugas Petugas Pengelola Obat
SANANKULON Instalasi Farmasi Kabupaten Pustu/Polindes/Ponkesdes

ENDAH ROSITANINGSIH, SE, MM Apt. AINA MUJTAHIDA A, S.Farm. APRILLIA YUDHA A.S.
NIP. 196912302010012002 NIP : 198612188 11033 2 0004 NIP. 199104082015022002

Page 27 of 203
LPLPO Feb22

DINAS KESEHATAN KABUPATEN BLITAR


LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)
WILAYAH : SUMBERINGIN PELAPORAN BULAN : FEBRUARI
PUSKESMAS : SANANKULON PERMINTAAN BULAN: MARET
KECAMATAN : SANANKULON
KABUPATEN : BLITAR
PROVINSI : JAWA TIMUR

SISA STOK JUMLAH OBAT


NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

1 2 WAY FOLEY CATHETER NO.16 PCS 0 0 0

2 2 WAY FOLEY CATHETER NO.18 PCS 0 0 0

3 2 WAY FOLEY CATHETER NO.20 PCS 0 0 0

4 ACETYLCYSTEINE CAPSULE 200 MG CAPSULE 0 0 0

5 ALAT SUNTIK SEKALI PAKAI 1 ML PCS 0 0 0

6 ALAT SUNTIK SEKALI PAKAI 10 ML PCS 0 0 0

7 ALAT SUNTIK SEKALI PAKAI 20 ML PCS 0 0 0

8 ALAT SUNTIK SEKALI PAKAI 3 ML PCS 117 117 4 113

9 ALAT SUNTIK SEKALI PAKAI 5 ML PCS 20 60 80 2 78

10 ALKOHOL SWAB PCS 0 0 0

11 ALLOPURINOL TABLET 100 MG TABLET 0 0 0

12 ALPRAZOLAM 1 MG TABLET TABLET 0 0 0

13 AMBROXOL SIRUP 5MG/ML BOTOL 0 0 0

14 AMBROXOL TABLET 30 MG TABLET 0 0 0

15 AMINOPHYLLINE INJEKSI 24 MG/ML 10 ML AMPUL 0 0 0

16 AMINOPHYLLINE TABLET 200 MG TABLET 0 0 0

17 AMITRIPTYLLINE HCL TABLET 25 MG TABLET 0 0 0

18 AMLODIPINE TABLET 10 MG TABLET 136 136 136 0

19 AMLODIPINE TABLET 5 MG TABLET 0 0 0

20 AMOKSISILIN DRY SYRUP 125 MG/5 ML 60 ML BOTOL 0 0 0

21 AMOKSISILIN SERBUK INJEKSI 1000 MG VIAL 0 0 0

22 AMOKSISILIN TABLET 500 MG KAPLET 165 300 465 175 290 200 200

23 AMOXCICILIN FORTE SYRUP KERING BOTOL 0 0


250MG/5ML 0

24 AMPICILLIN SERBUK INJEKSI 1.000 MG VIAL 0 0


MG/VIAL 0

25 ANTALGIN 500 MG TABLET (METAMIZOL) TABLET 0 0 0

26 ANTASIDA DOEN TABLET KOMBINASI TABLET 344 300 644 186 458 200 300

27 ANTASIDA SUSPENSI 60 ML BOTOL 0 5 5 5

28 ANTI BAKTERI DOEN SALEP KOMBINASI 5 GR POT 0 0 0

29 ANTI FUNGI DOEN SALEP KOMBINASI 30 GR POT 0 5 5 5

30 ANTI HAEMOROID DOEN KOMBINASI SUPP. 0 0 0

31 ANTI MIGRAIN DOEN TABLET KOMBINASI TABLET 0 0 0

32 ANTI SPASMODIK INJEKSI (SPASHI) AMPUL 0 0 0

33 ANTI SPASMODIK TABLET (DORMICOMP) TABLET 0 0 0

AQUA PRO INJEKSI STERIL BEBAS PIROGEN 20


34 BOTOL 0 0 0
ML

35 ASAM ASKORBAT ( VIT C ) TABLET 250 MG TABLET 0 0 0

36 ASAM ASKORBAT ( VIT C ) TABLET 50 MG TABLET 0 0 0

37 ASAM FOLAT 1MG TABLET TABLET 0 0 0

38 ASAM MEFENAMAT TABLET 500 MG TABLET 0 0 0

39 ASAM TRANEKSAMAT 100 MG/ML INJEKSI AMPUL 0 0 0

Page 28 of 203
LPLPO Feb22
SISA STOK JUMLAH OBAT
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

40 ASAM TRANEKSAMAT 500 MG TABLET TABLET 0 0 0

41 ASAM VALPROAT 250 MG TABLET / TABLET 0 0


DEPAKOTE ER 0

42 ASEPTAN 500CC + PUMP BOTOL 0 0 0

43 ASEPTIC GEL 500CC + DISPENSER BOTOL 0 0 0

44 ASERING (ASETAT RINGER) SOFT BAG BOTOL 0 0 0

45 ASETOSAL TABLET 100 (80) MG TABLET 0 0 0

46 ASIKLOVIR KREAM 5 % 5 GR TUBE 3 3 0 3 5

47 ASIKLOVIR TABLET 400 MG TABLET 0 0 0

48 ATROPIN SULFAT INJEKSI 0,25 MG/ML 1 ML AMPUL 0 0 0

49 ATTAPULGIT + PECTIN TABLET TABLET 0 0 0

50 BETAHISTINE MESILAT 24 MG TABLET TABLET 0 0 0

51 BETAHISTINMESILAT 6 MG TABLET TABLET 0 0 0

52 BETAMETHASON CR 0.05% 20 GR TUBE 0 0 0

53 BETAMETHASONE CREAM 0,1 % 5 GR TUBE 0 0 0

54 BIONICOM ZINC TABLET TABLET 0 0 0

55 BISAKODIL SUPPOSITORIA 10 MG SUPP. 0 0 0

56 BISAKODIL SUPPOSITORIA 5 MG SUPP. 0 0 0

57 BISOPROLOL 2,5 MG TABLET (CONCOR) TABLET 0 0 0

58 BISOPROLOL 5 MG TABLET TABLET 0 0 0

59 CAT GUT NO. 3/0 CHROMIC PCS 0 0 0

60 CAT GUT NO. 3/0 PLAIN PCS 0 0 0

61 CITICHOLIN 250 MG/ML-2ML INJEKSI AMPUL 0 0 0

62 CLONIDINE 0.15 MG TABLET TABLET 0 0 0

63 CLOPIDOGREL 75 MG TABLET 0 0 0

64 COMBIVENT UDV INHALASI VIAL 0 0 0

65 DEKSAMETHASONE INJEKSI 5 MG/ML 1 ML AMPUL 0 0 0

66 DEKSAMETHASONE TABLET 0,5 MG TABLET 0 0 0

67 DEVITALISASI PASTA ( NON ARSEN ) POT 0 0 0

68 DIAZEPAM INJEKSI 5 MG/ML 2 ML AMPUL 0 0 0

69 DIAZEPAM LARUTAN RECTAL 5MG/ 2,5ML- TUBE 0 0


STESOLID 0

70 DIAZEPAM TABLET 2 MG TABLET 0 0 0

71 DIAZEPAM TABLET 5 MG TABLET 0 0 0

72 DIFENHIDRAMINE HCL INJEKSI 10 MG/ML 1 ML AMPUL 0 0 0

73 DIGOXIN TABLET 0,25 MG TABLET 0 0 0

74 DIMENHYDRINATE TABLET 50 MG TABLET 9 9 9

75 DOKSISIKLIN TABLET 100 MG KAPSUL 0 0 0

76 DOMPERIDON SUSPENSI 5MG/ML BOTOL 0 0 0

77 DOMPERIDON TABLET 10 MG TABLET 0 0 0

78 EKSTRACT PLASENTA + NEOMYSIN SALEP 15 TUBE 0 0


GR 0

79 EPINEFRIN (ADRENALIN) HCL INJ.0,1 % 1 ML AMPUL 0 0 0

80 ERITROMISIN KAPSUL 250 MG KAPSUL 0 0 0

81 ERITROMISIN SIRUP KERING 200 MG/5ML BOTOL 0 0 0

82 ERITROMISIN TABLET 500 MG KAPSUL 0 0 0

Page 29 of 203
LPLPO Feb22
SISA STOK JUMLAH OBAT
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

83 ETAKRIDIN ( RIVANOL ) LARUTAN 0,1 % 300 BOTOL 1 1 1


ML 0

84 ETANOL [ ALKOHOL ] 70 % 1000 ML BOTOL 1 1 1

85 ETIL KLORIDA SEMPROT 100 ML BOTOL 0 0 0

86 EUGENOL CAIRAN 10 ML BOTOL 0 0 0

87 FENITOIN NATRIUM INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0

88 FENITOIN NATRIUM TABLET 100 MG KAPSUL 0 0 0

89 FENOBARBITAL INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0

90 FENOBARBITAL TABLET 30 MG TABLET 0 0 0

91 FENOL GLISEROL TETES TELINGA 10 % 5 ML BOTOL 0 0 0

92 FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML 1 AMPUL 0 0


ML 0

93 FITOMENADION ( VIT K1 ) TABLET SALUT 10 TABLET 0 0


MG 0

94 FITOMENADION INFANT INJ. 2MG/ML AMPUL 0 0 0

95 FLUPHENASINE DEKANOAT INJEKSI 25 MG 1 AMPUL 0 0


ML 0

96 FUROSEMID INJEKSI 10 mg VIAL 0 0 0

97 FUROSEMID TABLET 40 MG TABLET 42 42 16 26 50 50

98 GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 % TUBE 1 1


10 GR 1

99 GARAM ORALIT SACHET 102 102 5 97

100 GEMFIBROZIL 300 MG KAPSUL KAPSUL 0 0 0

101 GENTAMISIN SALEP KULIT 0,1 % 5 GR TUBE 0 0 0

102 GENTAMISIN SALEP MATA 0,3% TUBE 0 0 0

103 GENTAMISIN TETES MATA 0,3% BOTOL 0 0 0

104 GLASS IONOMER CEMENT ( GC IX ) BOTOL 0 0 0

105 GLIBENCLAMIDE TABLET 5 MG TABLET 205 300 505 70 435

106 GLICERIL GUAIACOLAT TABLET 100 MG TABLET 0 0 0

107 GLIMEPIRIDE 1 MG TABLET TABLET 0 0 0

108 GLIMEPIRIDE 2 MG TABLET TABLET 294 100 394 20 374

109 GLUKOSA 40% DEXTROSE INJECTION U.S.P VIAL 0 0


CAIRAN INJEKSI 0

110 GLUKOSA LARUTAN INFUS 10 % STERIL BOTOL 0 0 0

111 GLUKOSA LARUTAN INFUS 5 % STERIL BOTOL 0 0 0

112 GRISEOFULVIN TABLET 125 MG TABLET 0 0 0

113 HALOPERIDOL 2 MG TABLET 0 0 0

114 HALOPERIDOL DEKANOAT INJ 50 MG VIAL 0 0 0

115 HALOPERIDOL INJ. 5 MG/ML (LODOMER) AMPUL 0 0 0

116 HALOPERIDOL TABLET 1,5 MG TABLET 0 0 0

117 HALOPERIDOL TABLET 5 MG TABLET 0 0 0

118 HERBAKOF SYRUP 60ML BOTOL 0 0 0

119 HES-HYDROXYETHYL STARCH 6 %/VOLUVEN BOTOL 0 0


INFUS 500 ML 0

120 HIDROCORTISON CR 1% TUBE 0 0 0

121 HIDROCORTISONE CREAM 2,5 % 5 GR TUBE 0 0 0

122 HYDROCHLORTHIAZIDE 25 MG TABLET 0 0 0

123 I.V CATHETER NO.16 WITH INJECTION PORT PCS 0 0 0

124 I.V CATHETER NO.18 WITH INJECTION PORT PCS 0 0 0

125 I.V CATHETER NO.20 WITH INJECTION PORT PCS 0 0 0

Page 30 of 203
LPLPO Feb22
SISA STOK JUMLAH OBAT
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

126 I.V CATHETER NO.22 WITH INJECTION PORT PCS 0 0 0

127 I.V CATHETER NO.24 WITH INJECTION PORT PCS 0 0 0

128 I.V CATHETER NO.26 WITH INJECTION PORT PCS 0 0 0

129 IBUPROFEN FORTE SYRUP 200MG/5ML BOTOL 0 0 0

130 IBUPROFEN SUSPENSI 100 MG/5 ML 60 ML BOTOL 3 5 8 3 5 5

131 IBUPROFEN TABLET 400 MG TABLET 0 0 0

132 INFUSION SET ANAK PCS 0 0 0

133 INFUSION SET DEWASA PCS 0 0 0

134 ISOSORBIDE DINITRATE SUBLINGUAL 5 MG TABLET 0 0 0

135 KAEN 3B BOTOL 0 0 0

136 KALIUM DIKLOFENAK 50 MG TABLET TABLET 0 0 0

KALSIUM GLUCONAS INJEKSI 100 MG/ML 10


137 AMPUL 0 0 0
ML

138 KALSIUM LAKTAT (KALK) TABLET 500 MG TABLET 253 200 453 275 178 600 400

139 KANTONG URINE DEWASA PCS 0 0 0

140 KAPAS PEMBALUT/ABSORBEN 250 GR BKS 0 0 0

141 KAPTOPRIL TABLET 25 MG TABLET 0 0 0

142 KARBAMAZEPIN TABLET 200 MG TABLET 0 0 0

143 KASA KOMPRES 40/40 STERIL BKS 0 0 0

144 KASA PEMBALUT HIDROFIL 16 X 16 CM STRIL ROL 4 4 1 3

145 KASA PEMBALUT HIDROFIL 2 M X 80 CM ROL 1 1 1

146 KASA PEMBALUT HIDROFIL 4 M X 10 CM ROL 0 0 0

147 KASA PEMBALUT HIDROFIL 4 M X 5 CM ROL 0 0 0

148 KASA STERIL (DARYAN TOLLE)YG DIRESAPI PCS 0 0


FRAMISETIN 0

149 KETOKONAZOLE TABLET 200 MG TABLET 0 0 0

150 KETOPROFEN 100 MG SUPPOSITORIA SUPP. 0 0 0

151 KLINDAMISIN KAPSUL 150 MG TABLET 0 0 0

152 KLINDAMISIN KAPSUL 300 MG KAPSUL 0 0 0

153 KLOBAZAM 10 MG TABLET TABLET 0 0 0

154 KLORAMFENIKOL KAPSUL 500 MG KAPSUL 0 0 0

155 KLORAMFENIKOL SALEP KULIT 2 % TUBE 0 0 0

156 KLORAMFENIKOL SALEP MATA 1 % TUBE 2 2 2

157 KLORAMFENIKOL SUSPENSI 125 MG/5 ML BOTOL 0 0 0

158 KLORAMFENIKOL TETES TELINGA 3 % BOTOL 0 0 0

159 KLORFENIRAMINE MALEAT (CTM) TABLET 4 TABLET 128 200 328 184 400
MG 144

160 KLORPROMAZIN HCL INJEKSI 25 MG/ML 1 ML AMPUL 0 0 0

161 KLORPROMAZIN HCL INJEKSI 50 MG/ML 1 ML AMPUL 0 0 0

162 KLORPROMAZIN HCL TABLET 100 MG TABLET 0 0 0

163 KLOZAPIN 100 MG TABLET TABLET 0 0 0

164 KLOZAPIN 25 MG TABLET TABLET 0 0 0

165 KODEIN HCL TABLET 10 MG TABLET 0 0 0

166 KOTRIMOKSAZOL DEWASA TABLET TABLET 0 0 0

167 KOTRIMOKSAZOL SUSPENSI 60 ML BOTOL 0 0 0

168 LEVOFLOXACIN TABLET 500 MG TABLET 0 0 0

Page 31 of 203
LPLPO Feb22
SISA STOK JUMLAH OBAT
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

169 LIDOCAIN 2% INJ AMPUL 0 0 0

170 LIDOCAIN COMPOSITUM INJEKSI 2 ML AMPUL 0 0 0

171 LISOL CONCENTRATE 1000 ML BOTOL 0 0 0

172 LOPERAMIDE TABLET 2 MG TABLET 0 0 0

173 LORATADIN TABLET 10 MG TABLET 50 50 50

174 LORAZEPAM 2 MG TABLET 0 0 0

175 MAGNESIUM SULFAT INJEKSI (IV) 40 % 25 ML AMPUL 0 0 0

176 MASKER EARLOOP PLUS PCS 0 0 0

177 MASKER KERTAS 3 PLY EAR LOOP PCS 0 0 0

178 MASKER KERTAS 3 PLY TIE ON PCS 0 0 0

179 MASKER N95 PCS 0 0 0

180 MELOKSIKAM TABLET 7,5 MG TABLET 0 0 0

181 METAMIZOL (NORAGES) INJEKSI 500 AMPUL 0 0


MG/2ML 0

182 METFORMIN TABLET 500 MG TABLET 0 0 0

METILERGOMETRIN MALEAT INJEKSI 0,200


183 MG 1 ML AMPUL 0 0 0

184 METILERGOMETRIN MALEAT TABLET 0,125 TABLET 0 0


MG 0

185 METILPREDNISOLON TABLET 4 MG TABLET 0 0 0

186 METOKLOPRAMIDE 10 MG TABLET TABLET 0 0 0

187 METOKLOPRAMIDE 5 MG TABLET TABLET 0 0 0

188 METOKLOPROMIDE (SOTATIC) INJEKSI 5 AMPUL 0 0


MG/ML 2 ML 0

189 METOKLOPROMIDE SIRUP BOTOL 0 0 0

190 METRONIDAZOL + NYSTATIN VAG. VIAL 0 0


(PROVAGIN) INJEKSI 0

191 METRONIDAZOL TABLET 250 MG TABLET 0 0 0

192 METRONIDAZOL TABLET 500 MG TABLET 0 0 0

193 METRONIDAZOLE INFUS 5 MG/ML 100 ML BOTOL 0 0 0

194 MIKONAZOL KREAM 10 GR TUBE 3 5 8 1 7

195 MINERAL MIX SACHET 0 0 0

196 NATRIUM DIKLOFENAK TABLET 25 MG TABLET 82 100 182 24 158 200 200

197 NATRIUM DIKLOFENAK TABLET 50 MG TABLET 0 0 0

198 NATRIUM KLORIDA INFUS 0,9 % STERIL BOTOL 0 1 1 1

199 NIFEDIPINE TABLET 10 MG TABLET 0 0 0

200 NISTATIN TABLET 500.000 UI TABLET 40 40 40

201 NISTATIN VAGINAL TABLET 100.000 UI VAGTAB 11 11 11

202 OBAT BATUK HITAM (OBH) CAIRAN 100 ML BOTOL 0 0 0

203 OKSIGEN NASAL CANNULA ADULT PCS 0 0 0

204 OKSIGEN NASAL CANNULA INFANT PCS 0 0 0

205 OKSITETRACYCLIN SALEP KULIT 3 % 5 GR TUBE 0 0 0

206 OKSITETRACYCLIN SALEP MATA 1 % 3,5 GR TUBE 2 2 2 0

207 OKSITOSIN INJEKSI 10 IU/ML 1 ML AMPUL 0 0 0

208 OMEPRAZOLE TABLET 20 MG KAPSUL 0 0 0

209 ONDANSENTRON 4 MG/2 ML INJEKSI AMPUL 0 0 0

210 PARACETAMOL SYRUP 120 MG/5 ML 60 ML BOTOL 1 5 6 6 5

211 PARACETAMOL TABLET 500 MG TABLET 0 0 0

Page 32 of 203
LPLPO Feb22
SISA STOK JUMLAH OBAT
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

212 PARACETAMOL TETES 100 MG/ML 15 ML BOTOL 0 0 0

213 PEHAVRAL TABLET TABLET 0 0 0

214 PERAK SULFADIAZIN KRIM 1 % TUBE 0 0 0

215 PERHYDROL [ H2O2 ] 3 % 800 ML BOTOL 1 1 1

216 PERMETHRINE 5% CR 15 GRAM TUBE 0 0 0

217 PIRACETAM TABLET 800 MG TABLET 0 0 0

218 PIRANTEL PAMOAT TABLET TABLET 0 0 0

219 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG TABLET 0 0 0

220 PIROKSIKAM KAPSUL 10 MG KAPSUL 0 0 0

221 PLESTER 10 CM X 2 M ROL 0 0 0

222 PREDNISON TABLET 5 MG TABLET 0 0 0

223 PROPRANOLOL HCL TABLET 40 MG TABLET 0 0 0

224 PROPILTHIOURACIL TABLET 100 MG TABLET 0 0 0

225 RANITIDIN INJEKSI 25 MG/ ML AMPUL 0 0 0

226 RESPERIDON 2 MG TABLET TABLET 0 0 0

227 RINGER LAKTATE LARUTAN INFUS STERIL BOTOL 0 0 0

228 SALBUTAMOL TABLET 2 MG TABLET 0 100 100 100

229 SALBUTAMOL TABLET 4 MG TABLET 0 0 0

230 SALEP 2-4 KOMBINASI 30 GR POT 2 5 7 2 5

231 SALICYL BEDAK 2 % KOTAK 0 0 0

232 SARUNG TANGAM NON STERIL L PCS 0 0 0

233 SARUNG TANGAN NON STERIL M PCS 168 200 368 168 200

234 SARUNG TANGAN NON STERIL S PCS 0 100 100 100 100 100

235 SARUNG TANGAN STERIL NO 6 PSG 0 0 0

236 SARUNG TANGAN STERIL NO. 7,5 PSG 0 0 0

237 SARUNG TANGAN STERILE NO.6,5 PSG 0 0 0

238 SARUNG TANGAN STERILE NO.7 PSG 1 1 1

239 SEFADROKSIL KAPSUL 500 MG KAPSUL 0 0 0

240 SEFIKSIM KAPSUL 100 MG KAPSUL 0 0 0

241 SERUM ANTI BISA ULAR POLIVALEN INJ.5 ML VIAL 0 0


(ABU I) 0

242 SERUM ANTI TETANUS INJEKSI 1.500 IU/AMP VIAL 0 0


(ATS) 0

243 SETIRIZINE TABLET 10 MG TABLET 24 100 124 24 100 100 100

244 SIANOKOBALAMIN ( VIT B12 ) INJEKSI 500 AMPUL 0 0 0


MCG/ML 1 ML

245 SIANOKOBALAMIN ( VIT B12 ) TABLET 50 MCG TABLET 194 194 116 78 100 200

246 SILK (BENANG BEDAH SUTERA) NO.3/0 PCS 0 0 0

247 SIMETIDINE TABLET 200 MG TABLET 0 0 0

248 SIMVASTATIN TABLET 10 MG TABLET 0 0 0

249 SIPROFLOXACIN INFUS 2% BOTOL 0 0 0

250 SIPROFLOXACIN TABLET 500 MG TABLET 0 0 0

251 SPONS GELATIN CUBICLES 1x1x1 CM PCS 0 0 0

252 STIMUNO SYR BOTOL 0 0 0

253 STIMUNO TAB (100) TABLET 0 0 0

254 STIMUNO TAB (30) BOTOL 0 0 0

Page 33 of 203
LPLPO Feb22
SISA STOK JUMLAH OBAT
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

255 SULFADOKSIN TABLET TABLET 0 0 0

256 SULFASETAMID NATRIUM TETES MATA 15 % BOTOL 0 0


5 ML 0

257 TABLET TAMBAH DARAH TABLET 864 500 1,364 420 944 400 400

258 TEMPORARY CAVITY SEALER [TUMPATAN PCS 0 0


SEMENTARA] (CAVIT G) 0

259 TETAGRAM 150 IU AMPUL 0 0 0

260 TETRAKAIN HCL TETES MATA 5 ML BOTOL 0 0 0

261 TETRASIKLIN HCL TABLET 500 MG KAPSUL 0 0 0

262 THIAMIN HCL (VIT B1) INJEKSI 100 MG/ML 1 ML AMPUL 0 0 0

THIAMIN HCL MONONITRAT (VIT B1) TABLET


263 TABLET 0 0 0
100 MG

264 THIAMIN HCL MONONITRAT (VIT B1) TABLET TABLET 0 0 300


50 MG 0

265 TRAMADOL INJEKSI 50 MG/ML AMPUL 0 0 0

266 TRANFUSION SET ADULT WITH Y INJECTION PCS 0 0 0

267 TRIFLOUPERASIN TABLET 5 MG TABLET 0 0 0

268 TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2 TABLET 0 0


MG 0

269 VITAMIN B COMPLEX TABLET TABLET 0 100 100 28 72 300 200

270 YODIUM POVIDON LARUTAN 10 % 30 ML BOTOL 0 0 0

271 YODIUM POVIDON LARUTAN 10% 60 ML BOTOL 1 1 1

272 ZENTRA (TRIPROLIDINE|PSEUDOEPHEDRINE) TABLET 0 0 0

273 ZINK 20 MG TABLET TABLET 0 0 0

274 Hi-D 1000 CHOLECALCIFEROL TABLET 0 0 0

OBAT PROGRAM / HIBAH

1 AMITRIPTYLINE 25 MG TABLET 0 0 0

2 HALOPERIDOLE INJEKSI AMPUL 0 0 0

3 HALOPERIDOLE 1,5 MG TABLET 0 0 0

4 HALOPERIDOLE 5 MG TABLET 0 0 0

5 LODOMER 2 MG TABLET 0 0 0

6 LODOMER 5 MG TABLET 0 0 0

7 TRIHEXYPHENIDYL 2 MG TABLET 0 0 0

8 ALAT SUNTIK 0,05 ML (PROGRAM) PCS 0 0 0

9 ALAT SUNTIK 0,5 ML (PROGRAM) PCS 0 0 0

10 ALAT SUNTIK 5 ML (PROGRAM) PCS 0 0 0

11 ALBENDAZOL TABLET 400 MG TABLET 0 0 0

12 BENZATINE BENZYLPENICILLIN 2.400.000 IU VIAL 0 0 0

13 COTRIMOXAZOLE 800/160 TABLET 0 0 0

14 DIETHYLCARBAMAZINE 100 MG TABLET 0 0 0

15 GARAM ORALIT UNTUK 200 ML AIR SACHET 0 0 0

16 HIV ABACAVIR TABLET 300 MG BOTOL 0 0 0

17 HIV ACRIPTEGA (TDF 300 + 3TC 300 + DTG 50) BOTOL 0 0 0

18 HIV DOLUTEGRAFIR 50 MG BOTOL 0 0 0

19 HIV EFAFIRENZ 200 MG TABLET BOTOL 0 0 0

20 HIV EFAFIRENZ 600 MG TABLET BOTOL 0 0 0

21 HIV LAMIVUDIN 150 MG TABLET BOTOL 0 0 0

22 HIV NEVIRAPINE 200 MG TABLET BOTOL 0 0 0

Page 34 of 203
LPLPO Feb22
SISA STOK JUMLAH OBAT
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

23 HIV TENOFOVIR 300 MG BOTOL 0 0 0


HIV TRIPLE FDC ANAK (ZIDOVUDIN
24 BOTOL 0 0 0
60MG+LAMIVUDIN 30MG+NEVIRAPINE 50MG)
25 HIV TRIPLE FDC DEWASA (TDC+3TC+EFV BOTOL 0 0 0
(300/300/600))

26 HIV ZIDOVUDINE 100 MG @60 KAPSUL BOTOL 0 0 0

27 HIV ZIDOVUDINE 300 MG + LAMIVUDIN 150 MG BOTOL 0 0 0

28 HIV ZIDOVUDINE SYRUP 240 ML BOTOL 0 0 0

29 IODINE TES PCS 0 0 0

30 ISONIAZID TABLET 100 MG TABLET 0 0 0

31 ISONIAZID TABLET 300 MG TABLET 0 0 0

32 KOMBIPAK AZITHROMYCIN - CEFIXIME TABLET 0 0 0


KOMBINASI

33 MDT COMBI - MB ADULT (RED) BLISTER 0 0 0

34 MDT COMBI - MB CHILD (ORANGE) BLISTER 0 0 0

35 MDT COMBI - PB ADULT (GREEN) BLISTER 0 0 0

36 OBAT ANTI TUBERKULOSIS ANAK PAKET 0 0 0

37 OBAT ANTI TUBERKULOSIS DOSIS HARIAN PAKET 0 0 0


STOP TB KIT

38 OBAT ANTI TUBERKULOSIS KATEGORI 1 PAKET 0 0 0

39 OBAT ANTI TUBERKULOSIS KATEGORI 2 PAKET 0 0 0

40 OBAT ANTI TUBERKULOSIS KOMBIPAK PAKET 0 0 0


KATEGORI I

41 PARACETAMOL 500 MG (P2) TABLET 0 0 0

42 PIRIDOKSIN 25 MG TABLET (VIT B6) TABLET 0 0 0

43 PYRIMETAMINE TABLET 0 0 0

44 REAGEN HIV (FOKUS) PCS 0 0 0

45 REAGEN HIV (STANDART DIAGNOSTIC/SD) PCS 0 0 0

46 REAGEN HIV (VIKIA) PCS 0 0 0

47 REAGEN HIV DIAGNOSTAR HIV 1\/2 ONE STEP PCS 0 0 0


RAPID TEST
48 REAGEN HIV DIAGNOSTIC KIT FOR HIV (1+2) PCS 0 0 0
ANTIBODY (COLLOIDAL GOLD) V2 PAKET
49 REAGEN SYPHILIS (TREPOCHECK) PCS 0 0 0

50 REAGEN SYPHILIS RDT (FOKUS) PCS 0 0 0

51 RETINOL ( VIT A ) KAPSUL 100.000 IU KAPSUL 0 0 0

52 RETINOL ( VIT A ) KAPSUL 200.000 IU KAPSUL 0 0 0

53 SAFETY BOX PCS 0 0 0

54 SERUM ANTI DIFTERI CAIRAN INJEKSI 125 VIAL 0 0 0


MG/ML

55 TABLET TAMBAH DARAH (PROGRAM) TABLET 0 0 0

56 ZINK TABLET DISPERSIBLE 20 MG (PROGRAM) TABLET 0 0 0

57 ALBENDAZOLE SIRUP BOTOL 0 0 0

58 COTRIMOXAZOLE 400/80 TABLET 0 0 0

59 MINERAL MIX SACHET 0 0 0

60 SD BIOLINE Syphilis 3.0 One Step Syphilis PCS 0 0 0


Antibody Test

OBAT TAMBAHAN

1 ALKOHOL SWAB 0 0 0 0

2 ALLOPURINOL 0 0 0 0

3 AMLODIPINE 5MG (BLUD) 0 0 150 150 150 100 300

4 ANTISEPTIK GEL (DINKES) 0 0 1 1 1 1 1

5 APD VAKSIN 0 0 0 0

Page 35 of 203
LPLPO Feb22
SISA STOK JUMLAH OBAT
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

6 APRON (DINKES) 0 0 0

7 AQUA PRO INJEKSI (BLUD) 0 0 0

8 ASAM MEFENAMAT TABLET 500 MG (BLUD) 152 152 26 126 200 200

9 ASIKLOVIR TABLET 0 0 0

10 BETAMETHASONE SALEP KULIT (BLUD) 0 0 0

11 BIOPLACENTON (BLUD) 0 0 0

12 BISAKODIL TABLET 5 MG (BLUD) 0 0 0

13 CIPROFLOXACIN (BLUD) 0 0 0

14 CLINDAMISIN KAPS (BLUD) 0 0 0

15 DEKSAMETHASONE HARSEN TABLET 0,5 MG 188 300 488 90 398


((BLUD) )

16 DOMPERIDONE TABLET 10 MG ( (BLUD)) 100 100 10 90

17 EPINEFRIN INJEKSI (BLUD) 0 0 0

18 FENITOIN KAPS (BLUD) 0 0 0

19 FITOMENADION INJ (BLUD) 0 0 0

20 FITOMENADION TABLET (BLUD) 0 0 0

21 FUROSEMIDE TABLET 0 0 0

22 GEMFIBROZIL (BLUD) 0 0 0

23 GENOINT (BLUD) 0 0 0

24 GENTAMICIN TETES MATA (BLUD) 5 5 10 1 9

25 GENTIAN VIOLET LARUTAN 1 % (BLUD) 2 2 2

26 GLISERIL GUAIKOLAT/GUAIFENESIN BLUD 515 300 815 239 576

27 HIDROKORTISON CREAM KULIT (BLUD) 5 5 10 3 7

28 HYOSCINE BUTYLBROMIDE (ANTI SPASMODIK 0 0 0


BLUD)

29 HYPAFIX (BLUD) 0 0 0

30 INFUSET (BLUD) 0 0 0

31 IV CATHETER (BLUD) 0 0 0

32 KAPTOPRIL TABLET 12,5 MG (BLUD) 284 300 584 50 534

33 KLORAMFENIKOL SIRUP (BLUD) 0 0 0

34 KLORAMFENIKOL TETES TELINGA (BLUD) 5 5 5

35 KOTRIMOKSAZOL TAB (BLUD) 0 0 0

36 LOPERAMIDE TABLET 2 MG (BLUD) 0 0 0

37 MASKER (DINKES) 0 0 0

38 MASKER N9 0 0 0

39 METFORMIN (BLUD) 155 100 255 42 213

40 METILERGOMETRINE INJ (BLUD) 0 0 0

41 MULTIVITAMIN KOMB 0 0 0

42 NEW DIATABS (BLUD) 58 58 6 52

43 NIFEDIPINE TAB (BLUD) 0 0 0

44 NURSE CAP 0 0 0

45 OMEPRAZOLE 20MG 62 62 10 52

46 ONDANSETRONE INJEKSI (BLUD) 0 0 0

47 PARACETAMOL TABLET 500 MG (BLUD) 736 600 1,336 498 838 500 500

48 PEHAVRAL 0 0 0

Page 36 of 203
LPLPO Feb22
SISA STOK JUMLAH OBAT
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

49 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG (BLUD) 194 194 106 88 200 200

50 PIROXICAM 0 0 0

51 SALBUTAMOL TABLET 2 MG (BLUD) 27 27 27

52 SARUNG TANGAN OBGYN 0 0 0

53 SARUNG TANGAN OBGYN 0 0 0

54 SEFADROKSIL KAPSUL 500 MG (BLUD) 0 0 0

55 VGEL (BLUD) 0 0 0

56 VITAMIN C 50 MG (BLUD) 186 500 686 127 559 300 300

57 ZIVIT ZINC 54 90 144 92 52 90 90

58 ASETIL (DINKES) 0 0 0

59 DEXAMETHASONE (DINKES) 0 0 0

60 OBH (DINKES) 0 0 0

61 AMBROXOL 0 0 0 300 500

62 BATUK FLU SIRUP (ETAFLUSIN) 0 0 90

63 BATUK FLU TABLET (ETAFLUSIN) 0 0

64 BETADINE GARGLE 0 0

65 BUFACOMB SALEP 0 0

66 BUFACORT - N

67 DARYANTULLE

68 ETIL KLORIDA SPRAY

69 GLIBENCLAMIDE TABLET 5 MG

70 GLIMEPIRIDE 2 MG TABLET

71 KAOLIN PEKTIN SIRUP (NOVADIAR)

72 PIRACETAM KAPSUL

73 TIAMFENIKOL KAPSUL

74 VITAMIN ANAK SIRUP (SAMCOVIT)

75

76

77

78

79

80

ENDAH ROSITANINGSIH, SE, MM Apt. AINA MUJTAHIDA A, S.Farm. APRILLIA YUDHA A.S.
NIP. 196912302010012002 NIP : 198612188 11033 2 0004 NIP. 199104082015022002

Page 37 of 203
LPLPO Sumberingin Mar22

DINAS KESEHATAN KABUPATEN BLITAR


LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)
WILAYAH : SUMBERINGIN PELAPORAN BU: MARET
PUSKESMAS : SANANKULON PERMINTAAN : APRIL
KECAMATAN : SANANKULON
KABUPATEN : BLITAR
PROVINSI : JAWA TIMUR

SISA STOK JUMLAH OBAT


NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

1 2 WAY FOLEY CATHETER NO.16 PCS 0 0 0

2 2 WAY FOLEY CATHETER NO.18 PCS 0 0 0

3 2 WAY FOLEY CATHETER NO.20 PCS 0 0 0

4 ACETYLCYSTEINE CAPSULE 200 MG CAPSULE 0 0 0

5 ALAT SUNTIK SEKALI PAKAI 1 ML PCS 0 0 0

6 ALAT SUNTIK SEKALI PAKAI 10 ML PCS 0 0 0

7 ALAT SUNTIK SEKALI PAKAI 20 ML PCS 0 0 0

8 ALAT SUNTIK SEKALI PAKAI 3 ML PCS 113 113 10 103

9 ALAT SUNTIK SEKALI PAKAI 5 ML PCS 78 78 1 77

10 ALKOHOL SWAB PCS 0 0 0

11 ALLOPURINOL TABLET 100 MG TABLET 0 0 0 100

12 ALPRAZOLAM 1 MG TABLET TABLET 0 0 0

13 AMBROXOL SIRUP 5MG/ML BOTOL 0 0 0

14 AMBROXOL TABLET 30 MG TABLET 0 0 0

15 AMINOPHYLLINE INJEKSI 24 MG/ML 10 ML AMPUL 0 0 0

16 AMINOPHYLLINE TABLET 200 MG TABLET 0 0 0

17 AMITRIPTYLLINE HCL TABLET 25 MG TABLET 0 0 0

18 AMLODIPINE TABLET 10 MG TABLET 0 0 0

19 AMLODIPINE TABLET 5 MG TABLET 0 0 0

20 AMOKSISILIN DRY SYRUP 125 MG/5 ML 60 ML BOTOL 0 0 0

21 AMOKSISILIN SERBUK INJEKSI 1000 MG VIAL 0 0 0

22 AMOKSISILIN TABLET 500 MG KAPLET 290 200 490 240 250 100

23 AMOXCICILIN FORTE SYRUP KERING BOTOL 0 0


250MG/5ML 0

24 AMPICILLIN SERBUK INJEKSI 1.000 MG VIAL 0 0


MG/VIAL 0

25 ANTALGIN 500 MG TABLET (METAMIZOL) TABLET 0 0 0

26 ANTASIDA DOEN TABLET KOMBINASI TABLET 458 300 758 167 591

27 ANTASIDA SUSPENSI 60 ML BOTOL 5 5 1 4

28 ANTI BAKTERI DOEN SALEP KOMBINASI 5 GR POT 0 0 0

29 ANTI FUNGI DOEN SALEP KOMBINASI 30 GR POT 5 5 5

30 ANTI HAEMOROID DOEN KOMBINASI SUPP. 0 0 0

31 ANTI MIGRAIN DOEN TABLET KOMBINASI TABLET 0 0 0

32 ANTI SPASMODIK INJEKSI (SPASHI) AMPUL 0 0 0

33 ANTI SPASMODIK TABLET (DORMICOMP) TABLET 0 0 0

AQUA PRO INJEKSI STERIL BEBAS PIROGEN 20


34 BOTOL 0 0 0
ML

35 ASAM ASKORBAT ( VIT C ) TABLET 250 MG TABLET 0 0 0

36 ASAM ASKORBAT ( VIT C ) TABLET 50 MG TABLET 0 0 0

37 ASAM FOLAT 1MG TABLET TABLET 0 0 0

38 ASAM MEFENAMAT TABLET 500 MG TABLET 0 0 0

39 ASAM TRANEKSAMAT 100 MG/ML INJEKSI AMPUL 0 0 0

Page 38 of 203
LPLPO Sumberingin Mar22

40 ASAM TRANEKSAMAT 500 MG TABLET TABLET 0 0 0

ASAM VALPROAT 250 MG TABLET /


41 TABLET 0 0 0
DEPAKOTE ER

42 ASEPTAN 500CC + PUMP BOTOL 0 0 0

43 ASEPTIC GEL 500CC + DISPENSER BOTOL 0 0 0

44 ASERING (ASETAT RINGER) SOFT BAG BOTOL 0 0 0

45 ASETOSAL TABLET 100 (80) MG TABLET 0 0 0

46 ASIKLOVIR KREAM 5 % 5 GR TUBE 0 0 0 10

47 ASIKLOVIR TABLET 400 MG TABLET 0 0 0 100

48 ATROPIN SULFAT INJEKSI 0,25 MG/ML 1 ML AMPUL 0 0 0

49 ATTAPULGIT + PECTIN TABLET TABLET 0 0 0

50 BETAHISTINE MESILAT 24 MG TABLET TABLET 0 0 0

51 BETAHISTINMESILAT 6 MG TABLET TABLET 0 0 0

52 BETAMETHASON CR 0.05% 20 GR TUBE 0 0 0 5

53 BETAMETHASONE CREAM 0,1 % 5 GR TUBE 0 0 0 5

54 BIONICOM ZINC TABLET TABLET 0 0 0

55 BISAKODIL SUPPOSITORIA 10 MG SUPP. 0 0 0

56 BISAKODIL SUPPOSITORIA 5 MG SUPP. 0 0 0

57 BISOPROLOL 2,5 MG TABLET (CONCOR) TABLET 0 0 0

58 BISOPROLOL 5 MG TABLET TABLET 0 0 0

59 CAT GUT NO. 3/0 CHROMIC PCS 0 0 0

60 CAT GUT NO. 3/0 PLAIN PCS 0 0 0

61 CITICHOLIN 250 MG/ML-2ML INJEKSI AMPUL 0 0 0

62 CLONIDINE 0.15 MG TABLET TABLET 0 0 0

63 CLOPIDOGREL 75 MG TABLET 0 0 0

64 COMBIVENT UDV INHALASI VIAL 0 0 0

65 DEKSAMETHASONE INJEKSI 5 MG/ML 1 ML AMPUL 0 0 0

66 DEKSAMETHASONE TABLET 0,5 MG TABLET 0 0 0

67 DEVITALISASI PASTA ( NON ARSEN ) POT 0 0 0

68 DIAZEPAM INJEKSI 5 MG/ML 2 ML AMPUL 0 0 0

DIAZEPAM LARUTAN RECTAL 5MG/ 2,5ML-


69 STESOLID TUBE 0 0 0

70 DIAZEPAM TABLET 2 MG TABLET 0 0 0

71 DIAZEPAM TABLET 5 MG TABLET 0 0 0

72 DIFENHIDRAMINE HCL INJEKSI 10 MG/ML 1 ML AMPUL 0 0 0

73 DIGOXIN TABLET 0,25 MG TABLET 0 0 0

74 DIMENHYDRINATE TABLET 50 MG TABLET 9 9 7 2

75 DOKSISIKLIN TABLET 100 MG KAPSUL 0 0 0

76 DOMPERIDON SUSPENSI 5MG/ML BOTOL 0 0 0

77 DOMPERIDON TABLET 10 MG TABLET 0 0 0

EKSTRACT PLASENTA + NEOMYSIN SALEP 15


78 TUBE 0 0 0
GR

79 EPINEFRIN (ADRENALIN) HCL INJ.0,1 % 1 ML AMPUL 0 0 0

80 ERITROMISIN KAPSUL 250 MG KAPSUL 0 0 0

81 ERITROMISIN SIRUP KERING 200 MG/5ML BOTOL 0 0 0

82 ERITROMISIN TABLET 500 MG KAPSUL 0 0 0

ETAKRIDIN ( RIVANOL ) LARUTAN 0,1 % 300


83 BOTOL 0 0 0
ML

Page 39 of 203
LPLPO Sumberingin Mar22

84 ETANOL [ ALKOHOL ] 70 % 1000 ML BOTOL 1 1 1

85 ETIL KLORIDA SEMPROT 100 ML BOTOL 0 0 0

86 EUGENOL CAIRAN 10 ML BOTOL 0 0 0

87 FENITOIN NATRIUM INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0

88 FENITOIN NATRIUM TABLET 100 MG KAPSUL 0 0 0

89 FENOBARBITAL INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0

90 FENOBARBITAL TABLET 30 MG TABLET 0 0 0

91 FENOL GLISEROL TETES TELINGA 10 % 5 ML BOTOL 0 0 0

FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML 1


92 AMPUL 0 0 0
ML
FITOMENADION ( VIT K1 ) TABLET SALUT 10
93 TABLET 0 0 0
MG

94 FITOMENADION INFANT INJ. 2MG/ML AMPUL 0 0 0

95 FLUPHENASINE DEKANOAT INJEKSI 25 MG 1 AMPUL 0 0


ML 0

96 FUROSEMID INJEKSI 10 mg VIAL 0 0 0

97 FUROSEMID TABLET 40 MG TABLET 26 50 76 76

98 GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 % TUBE 1 1


10 GR 1

99 GARAM ORALIT SACHET 97 97 33 64

100 GEMFIBROZIL 300 MG KAPSUL KAPSUL 0 0 0

101 GENTAMISIN SALEP KULIT 0,1 % 5 GR TUBE 0 0 0

102 GENTAMISIN SALEP MATA 0,3% TUBE 0 0 0

103 GENTAMISIN TETES MATA 0,3% BOTOL 0 0 0

104 GLASS IONOMER CEMENT ( GC IX ) BOTOL 0 0 0

105 GLIBENCLAMIDE TABLET 5 MG TABLET 435 435 145 290

106 GLICERIL GUAIACOLAT TABLET 100 MG TABLET 0 0 0

107 GLIMEPIRIDE 1 MG TABLET TABLET 0 0 0

108 GLIMEPIRIDE 2 MG TABLET TABLET 374 374 60 314

GLUKOSA 40% DEXTROSE INJECTION U.S.P


109 VIAL 0 0 0
CAIRAN INJEKSI

110 GLUKOSA LARUTAN INFUS 10 % STERIL BOTOL 0 0 0

111 GLUKOSA LARUTAN INFUS 5 % STERIL BOTOL 0 0 0

112 GRISEOFULVIN TABLET 125 MG TABLET 0 0 0

113 HALOPERIDOL 2 MG TABLET 0 0 0

114 HALOPERIDOL DEKANOAT INJ 50 MG VIAL 0 0 0

115 HALOPERIDOL INJ. 5 MG/ML (LODOMER) AMPUL 0 0 0

116 HALOPERIDOL TABLET 1,5 MG TABLET 0 0 0

117 HALOPERIDOL TABLET 5 MG TABLET 0 0 0

118 HERBAKOF SYRUP 60ML BOTOL 0 0 0

119 HES-HYDROXYETHYL STARCH 6 %/VOLUVEN BOTOL 0 0


INFUS 500 ML 0

120 HIDROCORTISON CR 1% TUBE 0 0 0

121 HIDROCORTISONE CREAM 2,5 % 5 GR TUBE 0 0 0

122 HYDROCHLORTHIAZIDE 25 MG TABLET 0 0 0

123 I.V CATHETER NO.16 WITH INJECTION PORT PCS 0 0 0

124 I.V CATHETER NO.18 WITH INJECTION PORT PCS 0 0 0

125 I.V CATHETER NO.20 WITH INJECTION PORT PCS 0 0 0

126 I.V CATHETER NO.22 WITH INJECTION PORT PCS 0 0 0

127 I.V CATHETER NO.24 WITH INJECTION PORT PCS 0 0 0

Page 40 of 203
LPLPO Sumberingin Mar22

128 I.V CATHETER NO.26 WITH INJECTION PORT PCS 0 0 0

129 IBUPROFEN FORTE SYRUP 200MG/5ML BOTOL 0 0 0

130 IBUPROFEN SUSPENSI 100 MG/5 ML 60 ML BOTOL 5 5 2 0 3 5

131 IBUPROFEN TABLET 400 MG TABLET 0 0 0 100

132 INFUSION SET ANAK PCS 0 0 0

133 INFUSION SET DEWASA PCS 0 0 0

134 ISOSORBIDE DINITRATE SUBLINGUAL 5 MG TABLET 0 0 0

135 KAEN 3B BOTOL 0 0 0

136 KALIUM DIKLOFENAK 50 MG TABLET TABLET 0 0 0

KALSIUM GLUCONAS INJEKSI 100 MG/ML 10


137 AMPUL 0 0 0
ML

138 KALSIUM LAKTAT (KALK) TABLET 500 MG TABLET 178 400 578 240 338 500 400

139 KANTONG URINE DEWASA PCS 0 0 0

140 KAPAS PEMBALUT/ABSORBEN 250 GR BKS 0 0 0

141 KAPTOPRIL TABLET 25 MG TABLET 0 0 0

142 KARBAMAZEPIN TABLET 200 MG TABLET 0 0 0

143 KASA KOMPRES 40/40 STERIL BKS 0 0 0

144 KASA PEMBALUT HIDROFIL 16 X 16 CM STRIL ROL 3 3 3

145 KASA PEMBALUT HIDROFIL 2 M X 80 CM ROL 1 1 1

146 KASA PEMBALUT HIDROFIL 4 M X 10 CM ROL 0 0 0

147 KASA PEMBALUT HIDROFIL 4 M X 5 CM ROL 0 0 0

KASA STERIL (DARYAN TOLLE)YG DIRESAPI


148 PCS 0 0 0
FRAMISETIN

149 KETOKONAZOLE TABLET 200 MG TABLET 0 0 0

150 KETOPROFEN 100 MG SUPPOSITORIA SUPP. 0 0 0

151 KLINDAMISIN KAPSUL 150 MG TABLET 0 0 0

152 KLINDAMISIN KAPSUL 300 MG KAPSUL 0 0 0

153 KLOBAZAM 10 MG TABLET TABLET 0 0 0

154 KLORAMFENIKOL KAPSUL 500 MG KAPSUL 0 0 0

155 KLORAMFENIKOL SALEP KULIT 2 % TUBE 0 0 0

156 KLORAMFENIKOL SALEP MATA 1 % TUBE 2 2 1 1

157 KLORAMFENIKOL SUSPENSI 125 MG/5 ML BOTOL 0 0 0

158 KLORAMFENIKOL TETES TELINGA 3 % BOTOL 0 0 0

159 KLORFENIRAMINE MALEAT (CTM) TABLET 4 TABLET 144 144 144 400
MG 0

160 KLORPROMAZIN HCL INJEKSI 25 MG/ML 1 ML AMPUL 0 0 0

161 KLORPROMAZIN HCL INJEKSI 50 MG/ML 1 ML AMPUL 0 0 0

162 KLORPROMAZIN HCL TABLET 100 MG TABLET 0 0 0

163 KLOZAPIN 100 MG TABLET TABLET 0 0 0

164 KLOZAPIN 25 MG TABLET TABLET 0 0 0

165 KODEIN HCL TABLET 10 MG TABLET 0 0 0

166 KOTRIMOKSAZOL DEWASA TABLET TABLET 0 0 0

167 KOTRIMOKSAZOL SUSPENSI 60 ML BOTOL 0 0 0

168 LEVOFLOXACIN TABLET 500 MG TABLET 0 0 0

169 LIDOCAIN 2% INJ AMPUL 0 0 0

170 LIDOCAIN COMPOSITUM INJEKSI 2 ML AMPUL 0 0 0

171 LISOL CONCENTRATE 1000 ML BOTOL 0 0 0

Page 41 of 203
LPLPO Sumberingin Mar22

172 LOPERAMIDE TABLET 2 MG TABLET 0 0 0

173 LORATADIN TABLET 10 MG TABLET 50 50 50 100

174 LORAZEPAM 2 MG TABLET 0 0 0

175 MAGNESIUM SULFAT INJEKSI (IV) 40 % 25 ML AMPUL 0 0 0

176 MASKER EARLOOP PLUS PCS 0 0 0

177 MASKER KERTAS 3 PLY EAR LOOP PCS 0 0 0

178 MASKER KERTAS 3 PLY TIE ON PCS 0 0 0

179 MASKER N95 PCS 0 0 0

180 MELOKSIKAM TABLET 7,5 MG TABLET 0 0 0

181 METAMIZOL (NORAGES) INJEKSI 500 MG/2ML AMPUL 0 0 0

182 METFORMIN TABLET 500 MG TABLET 0 0 0

183 METILERGOMETRIN MALEAT INJEKSI 0,200 AMPUL 0 0


MG 1 ML 0

184 METILERGOMETRIN MALEAT TABLET 0,125 TABLET 0 0


MG 0

185 METILPREDNISOLON TABLET 4 MG TABLET 0 0 0

186 METOKLOPRAMIDE 10 MG TABLET TABLET 0 0 0

187 METOKLOPRAMIDE 5 MG TABLET TABLET 0 0 0

188 METOKLOPROMIDE (SOTATIC) INJEKSI 5 AMPUL 0 0


MG/ML 2 ML 0

189 METOKLOPROMIDE SIRUP BOTOL 0 0 0

190 METRONIDAZOL + NYSTATIN VAG. VIAL 0 0


(PROVAGIN) INJEKSI 0

191 METRONIDAZOL TABLET 250 MG TABLET 0 0 0 100

192 METRONIDAZOL TABLET 500 MG TABLET 0 0 0

193 METRONIDAZOLE INFUS 5 MG/ML 100 ML BOTOL 0 0 0

194 MIKONAZOL KREAM 10 GR TUBE 7 7 1 6

195 MINERAL MIX SACHET 0 0 0

196 NATRIUM DIKLOFENAK TABLET 25 MG TABLET 158 200 358 28 330

197 NATRIUM DIKLOFENAK TABLET 50 MG TABLET 0 0 0

198 NATRIUM KLORIDA INFUS 0,9 % STERIL BOTOL 1 1 1

199 NIFEDIPINE TABLET 10 MG TABLET 0 0 0

200 NISTATIN TABLET 500.000 UI TABLET 40 40 40

201 NISTATIN VAGINAL TABLET 100.000 UI VAGTAB 11 11 11

202 OBAT BATUK HITAM (OBH) CAIRAN 100 ML BOTOL 0 0 0

203 OKSIGEN NASAL CANNULA ADULT PCS 0 0 0

204 OKSIGEN NASAL CANNULA INFANT PCS 0 0 0

205 OKSITETRACYCLIN SALEP KULIT 3 % 5 GR TUBE 0 0 0 10

206 OKSITETRACYCLIN SALEP MATA 1 % 3,5 GR TUBE 0 0 0

207 OKSITOSIN INJEKSI 10 IU/ML 1 ML AMPUL 0 0 0

208 OMEPRAZOLE TABLET 20 MG KAPSUL 0 0 0

209 ONDANSENTRON 4 MG/2 ML INJEKSI AMPUL 0 0 0

210 PARACETAMOL SYRUP 120 MG/5 ML 60 ML BOTOL 6 6 4 2 5 5

211 PARACETAMOL TABLET 500 MG TABLET 0 0 0

212 PARACETAMOL TETES 100 MG/ML 15 ML BOTOL 0 0 0

213 PEHAVRAL TABLET TABLET 0 0 0

214 PERAK SULFADIAZIN KRIM 1 % TUBE 0 0 0

215 PERHYDROL [ H2O2 ] 3 % 800 ML BOTOL 1 1 1

Page 42 of 203
LPLPO Sumberingin Mar22

216 PERMETHRINE 5% CR 15 GRAM TUBE 0 0 0

217 PIRACETAM TABLET 800 MG TABLET 0 0 0

218 PIRANTEL PAMOAT TABLET TABLET 0 0 0

219 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG TABLET 0 0 0

220 PIROKSIKAM KAPSUL 10 MG KAPSUL 0 0 0

221 PLESTER 10 CM X 2 M ROL 0 0 0

222 PREDNISON TABLET 5 MG TABLET 0 0 0

223 PROPRANOLOL HCL TABLET 40 MG TABLET 0 0 0

224 PROPILTHIOURACIL TABLET 100 MG TABLET 0 0 0

225 RANITIDIN INJEKSI 25 MG/ ML AMPUL 0 0 0

226 RESPERIDON 2 MG TABLET TABLET 0 0 0

227 RINGER LAKTATE LARUTAN INFUS STERIL BOTOL 0 0 0

228 SALBUTAMOL TABLET 2 MG TABLET 100 100 100

229 SALBUTAMOL TABLET 4 MG TABLET 0 0 0

230 SALEP 2-4 KOMBINASI 30 GR POT 5 5 5

231 SALICYL BEDAK 2 % KOTAK 0 0 0 10

232 SARUNG TANGAM NON STERIL L PCS 0 0 0

233 SARUNG TANGAN NON STERIL M PCS 200 200 58 142 100

234 SARUNG TANGAN NON STERIL S PCS 100 100 200 64 136 100 100

235 SARUNG TANGAN STERIL NO 6 PSG 0 0 0

236 SARUNG TANGAN STERIL NO. 7,5 PSG 0 0 0

237 SARUNG TANGAN STERILE NO.6,5 PSG 0 0 0

238 SARUNG TANGAN STERILE NO.7 PSG 1 1 1

239 SEFADROKSIL KAPSUL 500 MG KAPSUL 0 0 0

240 SEFIKSIM KAPSUL 100 MG KAPSUL 0 0 0

SERUM ANTI BISA ULAR POLIVALEN INJ.5 ML


241 VIAL 0 0 0
(ABU I)
SERUM ANTI TETANUS INJEKSI 1.500 IU/AMP
242 VIAL 0 0 0
(ATS)

243 SETIRIZINE TABLET 10 MG TABLET 100 100 200 66 134 200 100

SIANOKOBALAMIN ( VIT B12 ) INJEKSI 500


244 AMPUL 0 0 0
MCG/ML 1 ML

245 SIANOKOBALAMIN ( VIT B12 ) TABLET 50 MCG TABLET 78 200 278 62 216

246 SILK (BENANG BEDAH SUTERA) NO.3/0 PCS 0 0 0

247 SIMETIDINE TABLET 200 MG TABLET 0 0 0

248 SIMVASTATIN TABLET 10 MG TABLET 0 0 0

249 SIPROFLOXACIN INFUS 2% BOTOL 0 0 0

250 SIPROFLOXACIN TABLET 500 MG TABLET 0 0 0

251 SPONS GELATIN CUBICLES 1x1x1 CM PCS 0 0 0

252 STIMUNO SYR BOTOL 0 0 0

253 STIMUNO TAB (100) TABLET 0 0 0

254 STIMUNO TAB (30) BOTOL 0 0 0

255 SULFADOKSIN TABLET TABLET 0 0 0

SULFASETAMID NATRIUM TETES MATA 15 %


256 BOTOL 0 0 0
5 ML

257 TABLET TAMBAH DARAH TABLET 944 400 1,344 520 824 400 200

TEMPORARY CAVITY SEALER [TUMPATAN


258 PCS 0 0 0
SEMENTARA] (CAVIT G)

259 TETAGRAM 150 IU AMPUL 0 0 0

Page 43 of 203
LPLPO Sumberingin Mar22

260 TETRAKAIN HCL TETES MATA 5 ML BOTOL 0 0 0

261 TETRASIKLIN HCL TABLET 500 MG KAPSUL 0 0 0

262 THIAMIN HCL (VIT B1) INJEKSI 100 MG/ML 1 ML AMPUL 0 0 0 400

THIAMIN HCL MONONITRAT (VIT B1) TABLET


263 TABLET 0 0 0
100 MG
THIAMIN HCL MONONITRAT (VIT B1) TABLET
264 TABLET 0 0 0
50 MG

265 TRAMADOL INJEKSI 50 MG/ML AMPUL 0 0 0

266 TRANFUSION SET ADULT WITH Y INJECTION PCS 0 0 0

267 TRIFLOUPERASIN TABLET 5 MG TABLET 0 0 0

TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2


268 TABLET 0 0 0
MG

269 VITAMIN B COMPLEX TABLET TABLET 72 200 272 116 156 200

270 YODIUM POVIDON LARUTAN 10 % 30 ML BOTOL 0 0 0

271 YODIUM POVIDON LARUTAN 10% 60 ML BOTOL 1 1 1

272 ZENTRA (TRIPROLIDINE|PSEUDOEPHEDRINE) TABLET 0 0 0

273 ZINK 20 MG TABLET TABLET 0 0 0

274 Hi-D 1000 CHOLECALCIFEROL TABLET 0 0 0

OBAT PROGRAM / HIBAH

1 AMITRIPTYLINE 25 MG TABLET 0 0 0

2 HALOPERIDOLE INJEKSI AMPUL 0 0 0

3 HALOPERIDOLE 1,5 MG TABLET 0 0 0

4 HALOPERIDOLE 5 MG TABLET 0 0 0

5 LODOMER 2 MG TABLET 0 0 0

6 LODOMER 5 MG TABLET 0 0 0

7 TRIHEXYPHENIDYL 2 MG TABLET 0 0 0

8 ALAT SUNTIK 0,05 ML (PROGRAM) PCS 0 0 0

9 ALAT SUNTIK 0,5 ML (PROGRAM) PCS 0 0 0

10 ALAT SUNTIK 5 ML (PROGRAM) PCS 0 0 0

11 ALBENDAZOL TABLET 400 MG TABLET 0 0 0

12 BENZATINE BENZYLPENICILLIN 2.400.000 IU VIAL 0 0 0

13 COTRIMOXAZOLE 800/160 TABLET 0 0 0

14 DIETHYLCARBAMAZINE 100 MG TABLET 0 0 0

15 GARAM ORALIT UNTUK 200 ML AIR SACHET 0 0 0

16 HIV ABACAVIR TABLET 300 MG BOTOL 0 0 0

17 HIV ACRIPTEGA (TDF 300 + 3TC 300 + DTG 50) BOTOL 0 0 0

18 HIV DOLUTEGRAFIR 50 MG BOTOL 0 0 0

19 HIV EFAFIRENZ 200 MG TABLET BOTOL 0 0 0

20 HIV EFAFIRENZ 600 MG TABLET BOTOL 0 0 0

21 HIV LAMIVUDIN 150 MG TABLET BOTOL 0 0 0

22 HIV NEVIRAPINE 200 MG TABLET BOTOL 0 0 0

23 HIV TENOFOVIR 300 MG BOTOL 0 0 0


HIV TRIPLE FDC ANAK (ZIDOVUDIN
24 BOTOL 0 0 0
60MG+LAMIVUDIN 30MG+NEVIRAPINE 50MG)
HIV TRIPLE FDC DEWASA (TDC+3TC+EFV
25 BOTOL 0 0 0
(300/300/600))

26 HIV ZIDOVUDINE 100 MG @60 KAPSUL BOTOL 0 0 0

27 HIV ZIDOVUDINE 300 MG + LAMIVUDIN 150 MG BOTOL 0 0 0

28 HIV ZIDOVUDINE SYRUP 240 ML BOTOL 0 0 0

29 IODINE TES PCS 0 0 0

Page 44 of 203
LPLPO Sumberingin Mar22

30 ISONIAZID TABLET 100 MG TABLET 0 0 0

31 ISONIAZID TABLET 300 MG TABLET 0 0 0

KOMBIPAK AZITHROMYCIN - CEFIXIME


32 TABLET 0 0 0
KOMBINASI

33 MDT COMBI - MB ADULT (RED) BLISTER 0 0 0

34 MDT COMBI - MB CHILD (ORANGE) BLISTER 0 0 0

35 MDT COMBI - PB ADULT (GREEN) BLISTER 0 0 0

36 OBAT ANTI TUBERKULOSIS ANAK PAKET 0 0 0

OBAT ANTI TUBERKULOSIS DOSIS HARIAN


37 PAKET 0 0 0
STOP TB KIT

38 OBAT ANTI TUBERKULOSIS KATEGORI 1 PAKET 0 0 0

39 OBAT ANTI TUBERKULOSIS KATEGORI 2 PAKET 0 0 0

OBAT ANTI TUBERKULOSIS KOMBIPAK


40 KATEGORI I PAKET 0 0 0

41 PARACETAMOL 500 MG (P2) TABLET 0 0 0

42 PIRIDOKSIN 25 MG TABLET (VIT B6) TABLET 0 0 0

43 PYRIMETAMINE TABLET 0 0 0

44 REAGEN HIV (FOKUS) PCS 0 0 0

45 REAGEN HIV (STANDART DIAGNOSTIC/SD) PCS 0 0 0

46 REAGEN HIV (VIKIA) PCS 0 0 0

47 REAGEN HIV DIAGNOSTAR HIV 1\/2 ONE STEP PCS 0 0 0


RAPID TEST
REAGEN HIV DIAGNOSTIC KIT FOR HIV (1+2)
48 PCS 0 0 0
ANTIBODY (COLLOIDAL GOLD) V2 PAKET
49 REAGEN SYPHILIS (TREPOCHECK) PCS 0 0 0

50 REAGEN SYPHILIS RDT (FOKUS) PCS 0 0 0

51 RETINOL ( VIT A ) KAPSUL 100.000 IU KAPSUL 0 0 0

52 RETINOL ( VIT A ) KAPSUL 200.000 IU KAPSUL 0 0 0

53 SAFETY BOX PCS 0 0 0

SERUM ANTI DIFTERI CAIRAN INJEKSI 125


54 VIAL 0 0 0
MG/ML

55 TABLET TAMBAH DARAH (PROGRAM) TABLET 0 0 0

56 ZINK TABLET DISPERSIBLE 20 MG (PROGRAM) TABLET 0 0 0

57 ALBENDAZOLE SIRUP BOTOL 0 0 0

58 COTRIMOXAZOLE 400/80 TABLET 0 0 0

59 MINERAL MIX SACHET 0 0 0

SD BIOLINE Syphilis 3.0 One Step Syphilis


60 Antibody Test PCS 0 0 0

OBAT TAMBAHAN

1 ALKOHOL SWAB 0 0 0 0

2 ALLOPURINOL 0 0 0

3 AMLODIPINE 5MG (BLUD) 150 600 750 210 540

4 ANTISEPTIK GEL (DINKES) 1 1 2 1 1 1

5 APD VAKSIN 0 0 0

6 APRON (DINKES) 0 0 0

7 AQUA PRO INJEKSI (BLUD) 0 0 0

8 ASAM MEFENAMAT TABLET 500 MG (BLUD) 126 200 326 22 304

9 ASIKLOVIR TABLET 0 0 0

10 BETAMETHASONE SALEP KULIT (BLUD) 0 0 0

11 BIOPLACENTON (BLUD) 0 0 0

12 BISAKODIL TABLET 5 MG (BLUD) 0 0 0

13 CIPROFLOXACIN (BLUD) 0 0 0

Page 45 of 203
LPLPO Sumberingin Mar22

14 CLINDAMISIN KAPS (BLUD) 0 0 0

DEKSAMETHASONE HARSEN TABLET 0,5 MG


15 398 398 138 260 100 100
((BLUD) )

16 DOMPERIDONE TABLET 10 MG ( (BLUD)) 90 90 90

17 EPINEFRIN INJEKSI (BLUD) 0 0 0

18 FENITOIN KAPS (BLUD) 0 0 0

19 FITOMENADION INJ (BLUD) 0 0 0

20 FITOMENADION TABLET (BLUD) 0 0 0

21 FUROSEMIDE TABLET 0 0 0

22 GEMFIBROZIL (BLUD) 0 0 0

23 GENOINT (BLUD) 0 0 0

24 GENTAMICIN TETES MATA (BLUD) 9 9 2 7

25 GENTIAN VIOLET LARUTAN 1 % (BLUD) 2 2 2

26 GLISERIL GUAIKOLAT/GUAIFENESIN BLUD 576 576 168 408

27 HIDROKORTISON CREAM KULIT (BLUD) 7 7 7 0 10 10

28 HYOSCINE BUTYLBROMIDE (ANTI SPASMODIK 0 0 0


BLUD)

29 HYPAFIX (BLUD) 0 0 0

30 INFUSET (BLUD) 0 0 0

31 IV CATHETER (BLUD) 0 0 0

32 KAPTOPRIL TABLET 12,5 MG (BLUD) 534 534 26 508

33 KLORAMFENIKOL SIRUP (BLUD) 0 0 0

34 KLORAMFENIKOL TETES TELINGA (BLUD) 5 5 5

35 KOTRIMOKSAZOL TAB (BLUD) 0 0 0

36 LOPERAMIDE TABLET 2 MG (BLUD) 0 0 0

37 MASKER (DINKES) 0 0 0

38 MASKER N9 0 0 0

39 METFORMIN (BLUD) 213 213 58 155

40 METILERGOMETRINE INJ (BLUD) 0 0 0

41 MULTIVITAMIN KOMB 0 0 0

42 NEW DIATABS (BLUD) 52 52 28 24 100

43 NIFEDIPINE TAB (BLUD) 0 0 0

44 NURSE CAP 0 0 0

45 OMEPRAZOLE 20MG 52 52 52

46 ONDANSETRONE INJEKSI (BLUD) 0 0 0

47 PARACETAMOL TABLET 500 MG (BLUD) 838 500 1,338 413 925 200 200

48 PEHAVRAL 0 0 0

49 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG (BLUD) 88 200 288 88 200 200 200

50 PIROXICAM 0 0 0

51 SALBUTAMOL TABLET 2 MG (BLUD) 27 27 6 21

52 SARUNG TANGAN OBGYN 0 0 0

53 SARUNG TANGAN OBGYN 0 0 0

54 SEFADROKSIL KAPSUL 500 MG (BLUD) 0 0 0

55 VGEL (BLUD) 0 0 0

56 VITAMIN C 50 MG (BLUD) 559 300 859 211 648

57 ZIVIT ZINC 52 90 142 76 66 90

Page 46 of 203
LPLPO Sumberingin Mar22

58 ASETIL (DINKES) 0 0 0

59 DEXAMETHASONE (DINKES) 0 0 0

60 OBH (DINKES) 0 0 0

61 AMBROXOL 0 0 0

62 BATUK FLU SIRUP (ETAFLUSIN) 0 0 0

63 BATUK FLU TABLET (ETAFLUSIN) 0 0 0

64 BETADINE GARGLE 0 0 0

65 BUFACOMB SALEP 0 0 0

66 BUFACORT - N 0 0 0

67 DARYANTULLE 0 0 0

68 ETIL KLORIDA SPRAY 0 0 0

69 GLIBENCLAMIDE TABLET 5 MG 0 0 0

70 GLIMEPIRIDE 2 MG TABLET 0 0 0

71 KAOLIN PEKTIN SIRUP (NOVADIAR) 0 0 0

72 PIRACETAM KAPSUL 0 0 0

73 TIAMFENIKOL KAPSUL 0 0 0

74 VITAMIN ANAK SIRUP (SAMCOVIT) 0 0 0

75 0 0 0

76 0 0 0

77 0 0 0

78 0 0 0

79 0 0 0

80 0 0 0
Kepala Puskesmas Petugas Petugas Pengelola Obat
SANANKULON Instalasi Farmasi Kabupaten Pustu/Polindes/Ponkesdes

ENDAH ROSITANINGSIH, SE, MM Apt. AINA MUJTAHIDA A, S.Farm. APRILLIA YUDHA A.S.
NIP. 196912302010012002 NIP : 198612188 11033 2 0004 NIP. 199104082015022002

Page 47 of 203
DINAS KESEHATAN KABUPATEN BLITAR
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)
WILAYAH : SUMBERINGIN PELAPORAN BULAN : APRIL
PUSKESMAS : SANANKULON PERMINTAAN BULAN : MEI
KECAMATAN : SANANKULON
KABUPATEN : BLITAR
PROVINSI : JAWA TIMUR

SISA STOK JUMLAH


NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

1 2 WAY FOLEY CATHETER NO.16 PCS 0 0 0

2 2 WAY FOLEY CATHETER NO.18 PCS 0 0 0

3 2 WAY FOLEY CATHETER NO.20 PCS 0 0 0

4 ACETYLCYSTEINE CAPSULE 200 MG CAPSULE 0 0 0

5 ALAT SUNTIK SEKALI PAKAI 1 ML PCS 0 0 0

6 ALAT SUNTIK SEKALI PAKAI 10 ML PCS 0 0 0

7 ALAT SUNTIK SEKALI PAKAI 20 ML PCS 0 0 0

8 ALAT SUNTIK SEKALI PAKAI 3 ML PCS 103 103 7 96

9 ALAT SUNTIK SEKALI PAKAI 5 ML PCS 77 77 77

10 ALKOHOL SWAB PCS 0 0 0

11 ALLOPURINOL TABLET 100 MG TABLET 0 0 0 100

12 ALPRAZOLAM 1 MG TABLET TABLET 0 0 0

13 AMBROXOL SIRUP 5MG/ML BOTOL 0 0 0 5

14 AMBROXOL TABLET 30 MG TABLET 0 0 0

15 AMINOPHYLLINE INJEKSI 24 MG/ML 10 ML AMPUL 0 0 0

16 AMINOPHYLLINE TABLET 200 MG TABLET 0 0 0

17 AMITRIPTYLLINE HCL TABLET 25 MG TABLET 0 0 0

18 AMLODIPINE TABLET 10 MG TABLET 0 0 0

19 AMLODIPINE TABLET 5 MG TABLET 0 0 0

20 AMOKSISILIN DRY SYRUP 125 MG/5 ML 60 ML BOTOL 0 0 0

21 AMOKSISILIN SERBUK INJEKSI 1000 MG VIAL 0 0 0

22 AMOKSISILIN TABLET 500 MG KAPLET 250 100 350 209 141 300

AMOXCICILIN FORTE SYRUP KERING


23 250MG/5ML BOTOL 0 0 0

24 AMPICILLIN SERBUK INJEKSI 1.000 MG VIAL 0 0


MG/VIAL 0

25 ANTALGIN 500 MG TABLET (METAMIZOL) TABLET 0 0 0

26 ANTASIDA DOEN TABLET KOMBINASI TABLET 591 591 149 442 200

27 ANTASIDA SUSPENSI 60 ML BOTOL 4 4 4

28 ANTI BAKTERI DOEN SALEP KOMBINASI 5 GR POT 0 0 0

29 ANTI FUNGI DOEN SALEP KOMBINASI 30 GR POT 5 5 5

30 ANTI HAEMOROID DOEN KOMBINASI SUPP. 0 0 0

31 ANTI MIGRAIN DOEN TABLET KOMBINASI TABLET 0 0 0

32 ANTI SPASMODIK INJEKSI (SPASHI) AMPUL 0 0 0

33 ANTI SPASMODIK TABLET (DORMICOMP) TABLET 0 0 0

AQUA PRO INJEKSI STERIL BEBAS PIROGEN 20


34 BOTOL 0 0 0
ML

35 ASAM ASKORBAT ( VIT C ) TABLET 250 MG TABLET 0 0 0

36 ASAM ASKORBAT ( VIT C ) TABLET 50 MG TABLET 0 0 0

37 ASAM FOLAT 1MG TABLET TABLET 0 0 0

38 ASAM MEFENAMAT TABLET 500 MG TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

39 ASAM TRANEKSAMAT 100 MG/ML INJEKSI AMPUL 0 0 0

40 ASAM TRANEKSAMAT 500 MG TABLET TABLET 0 0 0

41 ASAM VALPROAT 250 MG TABLET / TABLET 0 0


DEPAKOTE ER 0

42 ASEPTAN 500CC + PUMP BOTOL 0 0 0

43 ASEPTIC GEL 500CC + DISPENSER BOTOL 0 0 0

44 ASERING (ASETAT RINGER) SOFT BAG BOTOL 0 0 0

45 ASETOSAL TABLET 100 (80) MG TABLET 0 0 0

46 ASIKLOVIR KREAM 5 % 5 GR TUBE 0 0 0 5

47 ASIKLOVIR TABLET 400 MG TABLET 0 0 0 100

48 ATROPIN SULFAT INJEKSI 0,25 MG/ML 1 ML AMPUL 0 0 0

49 ATTAPULGIT + PECTIN TABLET TABLET 0 0 0

50 BETAHISTINE MESILAT 24 MG TABLET TABLET 0 0 0

51 BETAHISTINMESILAT 6 MG TABLET TABLET 0 0 0

52 BETAMETHASON CR 0.05% 20 GR TUBE 0 5 5 2 3 10

53 BETAMETHASONE CREAM 0,1 % 5 GR TUBE 0 0 0

54 BIONICOM ZINC TABLET TABLET 0 0 0

55 BISAKODIL SUPPOSITORIA 10 MG SUPP. 0 0 0

56 BISAKODIL SUPPOSITORIA 5 MG SUPP. 0 0 0

57 BISOPROLOL 2,5 MG TABLET (CONCOR) TABLET 0 0 0

58 BISOPROLOL 5 MG TABLET TABLET 0 0 0

59 CAT GUT NO. 3/0 CHROMIC PCS 0 1 1 1

60 CAT GUT NO. 3/0 PLAIN PCS 0 1 1 1

61 CITICHOLIN 250 MG/ML-2ML INJEKSI AMPUL 0 0 0

62 CLONIDINE 0.15 MG TABLET TABLET 0 0 0

63 CLOPIDOGREL 75 MG TABLET 0 0 0

64 COMBIVENT UDV INHALASI VIAL 0 0 0

65 DEKSAMETHASONE INJEKSI 5 MG/ML 1 ML AMPUL 0 0 0

66 DEKSAMETHASONE TABLET 0,5 MG TABLET 0 0 0

67 DEVITALISASI PASTA ( NON ARSEN ) POT 0 0 0

68 DIAZEPAM INJEKSI 5 MG/ML 2 ML AMPUL 0 0 0

DIAZEPAM LARUTAN RECTAL 5MG/ 2,5ML-


69 TUBE 0 0 0
STESOLID

70 DIAZEPAM TABLET 2 MG TABLET 0 0 0

71 DIAZEPAM TABLET 5 MG TABLET 0 0 0

72 DIFENHIDRAMINE HCL INJEKSI 10 MG/ML 1 ML AMPUL 0 0 0

73 DIGOXIN TABLET 0,25 MG TABLET 0 0 0

74 DIMENHYDRINATE TABLET 50 MG TABLET 2 2 2 100

75 DOKSISIKLIN TABLET 100 MG KAPSUL 0 0 0

76 DOMPERIDON SUSPENSI 5MG/ML BOTOL 0 0 0

77 DOMPERIDON TABLET 10 MG TABLET 0 0 0

78 EKSTRACT PLASENTA + NEOMYSIN SALEP 15 TUBE 0 0


GR 0

79 EPINEFRIN (ADRENALIN) HCL INJ.0,1 % 1 ML AMPUL 0 0 0

80 ERITROMISIN KAPSUL 250 MG KAPSUL 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

81 ERITROMISIN SIRUP KERING 200 MG/5ML BOTOL 0 0 0

82 ERITROMISIN TABLET 500 MG KAPSUL 0 0 0

83 ETAKRIDIN ( RIVANOL ) LARUTAN 0,1 % 300 BOTOL 0 0


ML 0

84 ETANOL [ ALKOHOL ] 70 % 1000 ML BOTOL 1 1 0 1 1

85 ETIL KLORIDA SEMPROT 100 ML BOTOL 0 0 0

86 EUGENOL CAIRAN 10 ML BOTOL 0 0 0

87 FENITOIN NATRIUM INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0

88 FENITOIN NATRIUM TABLET 100 MG KAPSUL 0 0 0

89 FENOBARBITAL INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0

90 FENOBARBITAL TABLET 30 MG TABLET 0 0 0

91 FENOL GLISEROL TETES TELINGA 10 % 5 ML BOTOL 0 0 0

FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML 1


92 AMPUL 0 0 0
ML
FITOMENADION ( VIT K1 ) TABLET SALUT 10
93 TABLET 0 0 0
MG

94 FITOMENADION INFANT INJ. 2MG/ML AMPUL 0 0 0

FLUPHENASINE DEKANOAT INJEKSI 25 MG 1


95 AMPUL 0 0 0
ML

96 FUROSEMID INJEKSI 10 mg VIAL 0 0 0

97 FUROSEMID TABLET 40 MG TABLET 76 76 10 66 100

GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 %


98 10 GR TUBE 1 1 1 0 5

99 GARAM ORALIT SACHET 64 64 1 63

100 GEMFIBROZIL 300 MG KAPSUL KAPSUL 0 0 0

101 GENTAMISIN SALEP KULIT 0,1 % 5 GR TUBE 0 0 0

102 GENTAMISIN SALEP MATA 0,3% TUBE 0 0 0

103 GENTAMISIN TETES MATA 0,3% BOTOL 0 0 0

104 GLASS IONOMER CEMENT ( GC IX ) BOTOL 0 0 0

105 GLIBENCLAMIDE TABLET 5 MG TABLET 290 290 90 200

106 GLICERIL GUAIACOLAT TABLET 100 MG TABLET 0 0 0

107 GLIMEPIRIDE 1 MG TABLET TABLET 0 0 0

108 GLIMEPIRIDE 2 MG TABLET TABLET 314 314 46 268

GLUKOSA 40% DEXTROSE INJECTION U.S.P


109 VIAL 0 0 0
CAIRAN INJEKSI

110 GLUKOSA LARUTAN INFUS 10 % STERIL BOTOL 0 0 0

111 GLUKOSA LARUTAN INFUS 5 % STERIL BOTOL 0 0 0

112 GRISEOFULVIN TABLET 125 MG TABLET 0 0 0

113 HALOPERIDOL 2 MG TABLET 0 0 0

114 HALOPERIDOL DEKANOAT INJ 50 MG VIAL 0 0 0

115 HALOPERIDOL INJ. 5 MG/ML (LODOMER) AMPUL 0 0 0

116 HALOPERIDOL TABLET 1,5 MG TABLET 0 0 0

117 HALOPERIDOL TABLET 5 MG TABLET 0 0 0

118 HERBAKOF SYRUP 60ML BOTOL 0 0 0

119 HES-HYDROXYETHYL STARCH 6 %/VOLUVEN BOTOL 0 0


INFUS 500 ML 0

120 HIDROCORTISON CR 1% TUBE 0 0 0

121 HIDROCORTISONE CREAM 2,5 % 5 GR TUBE 0 0 0

122 HYDROCHLORTHIAZIDE 25 MG TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

123 I.V CATHETER NO.16 WITH INJECTION PORT PCS 0 0 0

124 I.V CATHETER NO.18 WITH INJECTION PORT PCS 0 0 0

125 I.V CATHETER NO.20 WITH INJECTION PORT PCS 0 0 0

126 I.V CATHETER NO.22 WITH INJECTION PORT PCS 0 0 0

127 I.V CATHETER NO.24 WITH INJECTION PORT PCS 0 0 0

128 I.V CATHETER NO.26 WITH INJECTION PORT PCS 0 0 0

129 IBUPROFEN FORTE SYRUP 200MG/5ML BOTOL 0 0 0

130 IBUPROFEN SUSPENSI 100 MG/5 ML 60 ML BOTOL 0 0 0

131 IBUPROFEN TABLET 400 MG TABLET 0 0 0 100

132 INFUSION SET ANAK PCS 0 0 0

133 INFUSION SET DEWASA PCS 0 0 0

134 ISOSORBIDE DINITRATE SUBLINGUAL 5 MG TABLET 0 0 0

135 KAEN 3B BOTOL 0 0 0

136 KALIUM DIKLOFENAK 50 MG TABLET TABLET 0 0 0

KALSIUM GLUCONAS INJEKSI 100 MG/ML 10


137 AMPUL 0 0 0
ML

138 KALSIUM LAKTAT (KALK) TABLET 500 MG TABLET 338 400 738 195 543 300

139 KANTONG URINE DEWASA PCS 0 0 0

140 KAPAS PEMBALUT/ABSORBEN 250 GR BKS 0 0 0

141 KAPTOPRIL TABLET 25 MG TABLET 0 0 0

142 KARBAMAZEPIN TABLET 200 MG TABLET 0 0 0

143 KASA KOMPRES 40/40 STERIL BKS 0 0 0

144 KASA PEMBALUT HIDROFIL 16 X 16 CM STRIL ROL 3 3 2 1 5

145 KASA PEMBALUT HIDROFIL 2 M X 80 CM ROL 1 1 1

146 KASA PEMBALUT HIDROFIL 4 M X 10 CM ROL 0 0 0

147 KASA PEMBALUT HIDROFIL 4 M X 5 CM ROL 0 0 0

148 KASA STERIL (DARYAN TOLLE)YG DIRESAPI PCS 0 0


FRAMISETIN 0

149 KETOKONAZOLE TABLET 200 MG TABLET 0 0 0

150 KETOPROFEN 100 MG SUPPOSITORIA SUPP. 0 0 0

151 KLINDAMISIN KAPSUL 150 MG TABLET 0 0 0

152 KLINDAMISIN KAPSUL 300 MG KAPSUL 0 0 0

153 KLOBAZAM 10 MG TABLET TABLET 0 0 0

154 KLORAMFENIKOL KAPSUL 500 MG KAPSUL 0 0 0

155 KLORAMFENIKOL SALEP KULIT 2 % TUBE 0 0 0

156 KLORAMFENIKOL SALEP MATA 1 % TUBE 1 1 1 3

157 KLORAMFENIKOL SUSPENSI 125 MG/5 ML BOTOL 0 0 0

158 KLORAMFENIKOL TETES TELINGA 3 % BOTOL 0 0 0

KLORFENIRAMINE MALEAT (CTM) TABLET 4


159 MG TABLET 0 0 0

160 KLORPROMAZIN HCL INJEKSI 25 MG/ML 1 ML AMPUL 0 0 0

161 KLORPROMAZIN HCL INJEKSI 50 MG/ML 1 ML AMPUL 0 0 0

162 KLORPROMAZIN HCL TABLET 100 MG TABLET 0 0 0

163 KLOZAPIN 100 MG TABLET TABLET 0 0 0

164 KLOZAPIN 25 MG TABLET TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

165 KODEIN HCL TABLET 10 MG TABLET 0 0 0

166 KOTRIMOKSAZOL DEWASA TABLET TABLET 0 0 0 100

167 KOTRIMOKSAZOL SUSPENSI 60 ML BOTOL 0 0 0

168 LEVOFLOXACIN TABLET 500 MG TABLET 0 0 0

169 LIDOCAIN 2% INJ AMPUL 0 0 0

170 LIDOCAIN COMPOSITUM INJEKSI 2 ML AMPUL 0 3 3 3

171 LISOL CONCENTRATE 1000 ML BOTOL 0 0 0

172 LOPERAMIDE TABLET 2 MG TABLET 0 0 0

173 LORATADIN TABLET 10 MG TABLET 50 100 150 16 134

174 LORAZEPAM 2 MG TABLET 0 0 0

175 MAGNESIUM SULFAT INJEKSI (IV) 40 % 25 ML AMPUL 0 0 0

176 MASKER EARLOOP PLUS PCS 0 0 0

177 MASKER KERTAS 3 PLY EAR LOOP PCS 0 0 0

178 MASKER KERTAS 3 PLY TIE ON PCS 0 0 0

179 MASKER N95 PCS 0 0 0

180 MELOKSIKAM TABLET 7,5 MG TABLET 0 0 0

181 METAMIZOL (NORAGES) INJEKSI 500 MG/2ML AMPUL 0 0 0

182 METFORMIN TABLET 500 MG TABLET 0 0 0

183 METILERGOMETRIN MALEAT INJEKSI 0,200 AMPUL 0 0


MG 1 ML 0

184 METILERGOMETRIN MALEAT TABLET 0,125 TABLET 0 0


MG 0

185 METILPREDNISOLON TABLET 4 MG TABLET 0 0 0

186 METOKLOPRAMIDE 10 MG TABLET TABLET 0 0 0

187 METOKLOPRAMIDE 5 MG TABLET TABLET 0 0 0

188 METOKLOPROMIDE (SOTATIC) INJEKSI 5 AMPUL 0 0


MG/ML 2 ML 0

189 METOKLOPROMIDE SIRUP BOTOL 0 0 0

190 METRONIDAZOL + NYSTATIN VAG. VIAL 0 0


(PROVAGIN) INJEKSI 0

191 METRONIDAZOL TABLET 250 MG TABLET 0 0 0 100

192 METRONIDAZOL TABLET 500 MG TABLET 0 0 0

193 METRONIDAZOLE INFUS 5 MG/ML 100 ML BOTOL 0 0 0

194 MIKONAZOL KREAM 10 GR TUBE 6 6 1 5

195 MINERAL MIX SACHET 0 0 0

196 NATRIUM DIKLOFENAK TABLET 25 MG TABLET 330 330 10 320

197 NATRIUM DIKLOFENAK TABLET 50 MG TABLET 0 0 0

198 NATRIUM KLORIDA INFUS 0,9 % STERIL BOTOL 1 1 1

199 NIFEDIPINE TABLET 10 MG TABLET 0 0 0

200 NISTATIN TABLET 500.000 UI TABLET 40 40 40

201 NISTATIN VAGINAL TABLET 100.000 UI VAGTAB 11 11 3 8

202 OBAT BATUK HITAM (OBH) CAIRAN 100 ML BOTOL 0 0 0 10

203 OKSIGEN NASAL CANNULA ADULT PCS 0 0 0

204 OKSIGEN NASAL CANNULA INFANT PCS 0 0 0

205 OKSITETRACYCLIN SALEP KULIT 3 % 5 GR TUBE 0 0 0 10

206 OKSITETRACYCLIN SALEP MATA 1 % 3,5 GR TUBE 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

207 OKSITOSIN INJEKSI 10 IU/ML 1 ML AMPUL 0 0 0

208 OMEPRAZOLE TABLET 20 MG KAPSUL 0 0 0

209 ONDANSENTRON 4 MG/2 ML INJEKSI AMPUL 0 0 0

210 PARACETAMOL SYRUP 120 MG/5 ML 60 ML BOTOL 2 5 7 3 4 5

211 PARACETAMOL TABLET 500 MG TABLET 0 0 0

212 PARACETAMOL TETES 100 MG/ML 15 ML BOTOL 0 0 0

213 PEHAVRAL TABLET TABLET 0 0 0

214 PERAK SULFADIAZIN KRIM 1 % TUBE 0 0 0 3

215 PERHYDROL [ H2O2 ] 3 % 800 ML BOTOL 1 1 1

216 PERMETHRINE 5% CR 15 GRAM TUBE 0 0 0

217 PIRACETAM TABLET 800 MG TABLET 0 0 0

218 PIRANTEL PAMOAT TABLET TABLET 0 0 0

219 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG TABLET 0 0 0

220 PIROKSIKAM KAPSUL 10 MG KAPSUL 0 0 0

221 PLESTER 10 CM X 2 M ROL 0 0 0

222 PREDNISON TABLET 5 MG TABLET 0 0 0

223 PROPRANOLOL HCL TABLET 40 MG TABLET 0 0 0

224 PROPILTHIOURACIL TABLET 100 MG TABLET 0 0 0

225 RANITIDIN INJEKSI 25 MG/ ML AMPUL 0 0 0

226 RESPERIDON 2 MG TABLET TABLET 0 0 0

227 RINGER LAKTATE LARUTAN INFUS STERIL BOTOL 0 0 0

228 SALBUTAMOL TABLET 2 MG TABLET 100 100 100

229 SALBUTAMOL TABLET 4 MG TABLET 0 0 0

230 SALEP 2-4 KOMBINASI 30 GR POT 5 5 5

231 SALICYL BEDAK 2 % KOTAK 0 0 0 10

232 SARUNG TANGAM NON STERIL L PCS 0 0 0

233 SARUNG TANGAN NON STERIL M PCS 142 100 242 212 30

234 SARUNG TANGAN NON STERIL S PCS 136 136 136 0 200

235 SARUNG TANGAN STERIL NO 6 PSG 0 0 0

236 SARUNG TANGAN STERIL NO. 7,5 PSG 0 0 0

237 SARUNG TANGAN STERILE NO.6,5 PSG 0 0 0

238 SARUNG TANGAN STERILE NO.7 PSG 1 1 1

239 SEFADROKSIL KAPSUL 500 MG KAPSUL 0 0 0

240 SEFIKSIM KAPSUL 100 MG KAPSUL 0 0 0

SERUM ANTI BISA ULAR POLIVALEN INJ.5 ML


241 VIAL 0 0 0
(ABU I)
SERUM ANTI TETANUS INJEKSI 1.500 IU/AMP
242 VIAL 0 0 0
(ATS)

243 SETIRIZINE TABLET 10 MG TABLET 134 100 234 179 55 300

244 SIANOKOBALAMIN ( VIT B12 ) INJEKSI 500 AMPUL 0 0 0


MCG/ML 1 ML

245 SIANOKOBALAMIN ( VIT B12 ) TABLET 50 MCG TABLET 216 216 216

246 SILK (BENANG BEDAH SUTERA) NO.3/0 PCS 0 1 1 1

247 SIMETIDINE TABLET 200 MG TABLET 0 0 0

248 SIMVASTATIN TABLET 10 MG TABLET 0 0 0 100


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

249 SIPROFLOXACIN INFUS 2% BOTOL 0 0 0

250 SIPROFLOXACIN TABLET 500 MG TABLET 0 0 0 100

251 SPONS GELATIN CUBICLES 1x1x1 CM PCS 0 0 0

252 STIMUNO SYR BOTOL 0 0 0

253 STIMUNO TAB (100) TABLET 0 0 0

254 STIMUNO TAB (30) BOTOL 0 0 0

255 SULFADOKSIN TABLET TABLET 0 0 0

SULFASETAMID NATRIUM TETES MATA 15 %


256 BOTOL 0 0 0
5 ML

257 TABLET TAMBAH DARAH TABLET 824 200 1,024 80 944

TEMPORARY CAVITY SEALER [TUMPATAN


258 PCS 0 0 0
SEMENTARA] (CAVIT G)

259 TETAGRAM 150 IU AMPUL 0 0 0

260 TETRAKAIN HCL TETES MATA 5 ML BOTOL 0 0 0

261 TETRASIKLIN HCL TABLET 500 MG KAPSUL 0 0 0

262 THIAMIN HCL (VIT B1) INJEKSI 100 MG/ML 1 ML AMPUL 0 0 0

THIAMIN HCL MONONITRAT (VIT B1) TABLET


263 TABLET 0 0 0 200
100 MG
THIAMIN HCL MONONITRAT (VIT B1) TABLET
264 TABLET 0 0 0
50 MG

265 TRAMADOL INJEKSI 50 MG/ML AMPUL 0 0 0

266 TRANFUSION SET ADULT WITH Y INJECTION PCS 0 0 0

267 TRIFLOUPERASIN TABLET 5 MG TABLET 0 0 0

268 TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2 TABLET 0 0


MG 0

269 VITAMIN B COMPLEX TABLET TABLET 156 200 356 63 293 200

270 YODIUM POVIDON LARUTAN 10 % 30 ML BOTOL 0 0 0

271 YODIUM POVIDON LARUTAN 10% 60 ML BOTOL 1 1 1

272 ZENTRA (TRIPROLIDINE|PSEUDOEPHEDRINE) TABLET 0 0 0

273 ZINK 20 MG TABLET TABLET 0 0 0

274 Hi-D 1000 CHOLECALCIFEROL TABLET 0 0 0

OBAT PROGRAM / HIBAH

1 AMITRIPTYLINE 25 MG TABLET 0 0 0

2 HALOPERIDOLE INJEKSI AMPUL 0 0 0

3 HALOPERIDOLE 1,5 MG TABLET 0 0 0

4 HALOPERIDOLE 5 MG TABLET 0 0 0

5 LODOMER 2 MG TABLET 0 0 0

6 LODOMER 5 MG TABLET 0 0 0

7 TRIHEXYPHENIDYL 2 MG TABLET 0 0 0

8 ALAT SUNTIK 0,05 ML (PROGRAM) PCS 0 0 0

9 ALAT SUNTIK 0,5 ML (PROGRAM) PCS 0 0 0

10 ALAT SUNTIK 5 ML (PROGRAM) PCS 0 0 0

11 ALBENDAZOL TABLET 400 MG TABLET 0 0 0

12 BENZATINE BENZYLPENICILLIN 2.400.000 IU VIAL 0 0 0

13 COTRIMOXAZOLE 800/160 TABLET 0 0 0

14 DIETHYLCARBAMAZINE 100 MG TABLET 0 0 0

15 GARAM ORALIT UNTUK 200 ML AIR SACHET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

16 HIV ABACAVIR TABLET 300 MG BOTOL 0 0 0

17 HIV ACRIPTEGA (TDF 300 + 3TC 300 + DTG 50) BOTOL 0 0 0

18 HIV DOLUTEGRAFIR 50 MG BOTOL 0 0 0

19 HIV EFAFIRENZ 200 MG TABLET BOTOL 0 0 0

20 HIV EFAFIRENZ 600 MG TABLET BOTOL 0 0 0

21 HIV LAMIVUDIN 150 MG TABLET BOTOL 0 0 0

22 HIV NEVIRAPINE 200 MG TABLET BOTOL 0 0 0

23 HIV TENOFOVIR 300 MG BOTOL 0 0 0


HIV TRIPLE FDC ANAK (ZIDOVUDIN
24 BOTOL 0 0 0
60MG+LAMIVUDIN 30MG+NEVIRAPINE 50MG)
HIV TRIPLE FDC DEWASA (TDC+3TC+EFV
25 BOTOL 0 0 0
(300/300/600))

26 HIV ZIDOVUDINE 100 MG @60 KAPSUL BOTOL 0 0 0

27 HIV ZIDOVUDINE 300 MG + LAMIVUDIN 150 MG BOTOL 0 0 0

28 HIV ZIDOVUDINE SYRUP 240 ML BOTOL 0 0 0

29 IODINE TES PCS 0 0 0

30 ISONIAZID TABLET 100 MG TABLET 0 0 0

31 ISONIAZID TABLET 300 MG TABLET 0 0 0

KOMBIPAK AZITHROMYCIN - CEFIXIME


32 TABLET 0 0 0
KOMBINASI

33 MDT COMBI - MB ADULT (RED) BLISTER 0 0 0

34 MDT COMBI - MB CHILD (ORANGE) BLISTER 0 0 0

35 MDT COMBI - PB ADULT (GREEN) BLISTER 0 0 0

36 OBAT ANTI TUBERKULOSIS ANAK PAKET 0 0 0

37 OBAT ANTI TUBERKULOSIS DOSIS HARIAN PAKET 0 0 0


STOP TB KIT

38 OBAT ANTI TUBERKULOSIS KATEGORI 1 PAKET 0 0 0

39 OBAT ANTI TUBERKULOSIS KATEGORI 2 PAKET 0 0 0

40 OBAT ANTI TUBERKULOSIS KOMBIPAK PAKET 0 0 0


KATEGORI I

41 PARACETAMOL 500 MG (P2) TABLET 0 0 0

42 PIRIDOKSIN 25 MG TABLET (VIT B6) TABLET 0 0 0

43 PYRIMETAMINE TABLET 0 0 0

44 REAGEN HIV (FOKUS) PCS 0 0 0

45 REAGEN HIV (STANDART DIAGNOSTIC/SD) PCS 0 0 0

46 REAGEN HIV (VIKIA) PCS 0 0 0

REAGEN HIV DIAGNOSTAR HIV 1\/2 ONE STEP


47 PCS 0 0 0
RAPID TEST
48 REAGEN HIV DIAGNOSTIC KIT FOR HIV (1+2) PCS 0 0 0
ANTIBODY (COLLOIDAL GOLD) V2 PAKET
49 REAGEN SYPHILIS (TREPOCHECK) PCS 0 0 0

50 REAGEN SYPHILIS RDT (FOKUS) PCS 0 0 0

51 RETINOL ( VIT A ) KAPSUL 100.000 IU KAPSUL 0 0 0

52 RETINOL ( VIT A ) KAPSUL 200.000 IU KAPSUL 0 0 0

53 SAFETY BOX PCS 0 0 0

SERUM ANTI DIFTERI CAIRAN INJEKSI 125


54 MG/ML VIAL 0 0 0

55 TABLET TAMBAH DARAH (PROGRAM) TABLET 0 0 0

56 ZINK TABLET DISPERSIBLE 20 MG (PROGRAM) TABLET 0 0 0

57 ALBENDAZOLE SIRUP BOTOL 0 0 0

58 COTRIMOXAZOLE 400/80 TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

59 MINERAL MIX SACHET 0 0 0

60 SD BIOLINE Syphilis 3.0 One Step Syphilis PCS 0 0 0


Antibody Test

OBAT TAMBAHAN

1 ALKOHOL SWAB 0 0 0 0

2 ALLOPURINOL 0 0 0 100

3 AMLODIPINE 5MG (BLUD) 540 540 128 412

4 ANTISEPTIK GEL (DINKES) 1 1 2 1 1

5 APD VAKSIN 0 0 0

6 APRON (DINKES) 0 0 0

7 AQUA PRO INJEKSI (BLUD) 0 0 0

8 ASAM MEFENAMAT TABLET 500 MG (BLUD) 304 304 80 224

9 ASIKLOVIR TABLET 0 0 0 100

10 BETAMETHASONE SALEP KULIT (BLUD) 0 0 0

11 BIOPLACENTON (BLUD) 0 0 0 3

12 BISAKODIL TABLET 5 MG (BLUD) 0 0 0

13 CIPROFLOXACIN (BLUD) 0 0 0 100

14 CLINDAMISIN KAPS (BLUD) 0 0 0

DEKSAMETHASONE HARSEN TABLET 0,5 MG


15 ((BLUD) ) 260 100 360 171 189 200

16 DOMPERIDONE TABLET 10 MG ( (BLUD)) 90 90 6 84

17 EPINEFRIN INJEKSI (BLUD) 0 0 0

18 FENITOIN KAPS (BLUD) 0 0 0

19 FITOMENADION INJ (BLUD) 0 0 0

20 FITOMENADION TABLET (BLUD) 0 0 0

21 FUROSEMIDE TABLET 0 0 0

22 GEMFIBROZIL (BLUD) 0 0 0

23 GENOINT (BLUD) 0 0 0

24 GENTAMICIN TETES MATA (BLUD) 7 7 1 6

25 GENTIAN VIOLET LARUTAN 1 % (BLUD) 2 2 2

26 GLISERIL GUAIKOLAT/GUAIFENESIN BLUD 408 408 121 287 200

27 HIDROKORTISON CREAM KULIT (BLUD) 0 10 10 1 9

HYOSCINE BUTYLBROMIDE (ANTI SPASMODIK


28 0 0 0
BLUD)

29 HYPAFIX (BLUD) 0 0 0

30 INFUSET (BLUD) 0 0 0

31 IV CATHETER (BLUD) 0 0 0

32 KAPTOPRIL TABLET 12,5 MG (BLUD) 508 508 44 464

33 KLORAMFENIKOL SIRUP (BLUD) 0 0 0

34 KLORAMFENIKOL TETES TELINGA (BLUD) 5 5 2 3

35 KOTRIMOKSAZOL TAB (BLUD) 0 0 0 100

36 LOPERAMIDE TABLET 2 MG (BLUD) 0 0 0

37 MASKER (DINKES) 0 0 0

38 MASKER N9 0 0 0

39 METFORMIN (BLUD) 155 155 30 125 100


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

40 METILERGOMETRINE INJ (BLUD) 0 0 0

41 MULTIVITAMIN KOMB 0 0 0

42 NEW DIATABS (BLUD) 24 24 24 100

43 NIFEDIPINE TAB (BLUD) 0 0 0

44 NURSE CAP 0 0 0

45 OMEPRAZOLE 20MG 52 52 17 35 100

46 ONDANSETRONE INJEKSI (BLUD) 0 0 0

47 PARACETAMOL TABLET 500 MG (BLUD) 925 200 1,125 358 767 200

48 PEHAVRAL 0 0 0

49 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG (BLUD) 200 200 400 111 289 200

50 PIROXICAM 0 0 0

51 SALBUTAMOL TABLET 2 MG (BLUD) 21 21 21

52 SARUNG TANGAN OBGYN 0 0 0

53 SARUNG TANGAN OBGYN 0 0 0

54 SEFADROKSIL KAPSUL 500 MG (BLUD) 0 0 0 100

55 VGEL (BLUD) 0 0 0

56 VITAMIN C 50 MG (BLUD) 648 648 79 569

57 ZIVIT ZINC 66 90 156 6 150

58 ASETIL (DINKES) 0 0 0

59 DEXAMETHASONE (DINKES) 0 0 0

60 OBH (DINKES) 0 0 0

61 AMBROXOL 0 0 0

62 BATUK FLU SIRUP (ETAFLUSIN) 0 0 0

63 BATUK FLU TABLET (ETAFLUSIN) 0 0 0

64 BETADINE GARGLE 0 0 0

65 BUFACOMB SALEP 0 0 0

66 BUFACORT - N 0 0 0

67 DARYANTULLE 0 0 0

68 ETIL KLORIDA SPRAY 0 0 0

69 GLIBENCLAMIDE TABLET 5 MG 0 0 0

70 GLIMEPIRIDE 2 MG TABLET 0 0 0

71 KAOLIN PEKTIN SIRUP (NOVADIAR) 0 0 0

72 PIRACETAM KAPSUL 0 0 0

73 TIAMFENIKOL KAPSUL 0 0 0

74 VITAMIN ANAK SIRUP (SAMCOVIT) 0 0 0

75 0 0 0

76 0 0 0

77 0 0 0

78 0 0 0

79 0 0 0

80 0 0 0

Blitar , 04 May 2022


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12
Mengetahui / Menyetujui
Yang Menerima, Yang Menyerahkan,
Kepala Puskesmas Petugas Petugas Pengelola Obat
SANANKULON Instalasi Farmasi Kabupaten Pustu/Polindes/Ponkesdes

ENDAH ROSITANINGSIH, SE, MM Apt. AINA MUJTAHIDA A, S.Farm. APRILLIA YUDHA A.S.
NIP. 196912302010012002 NIP : 198612188 11033 2 0004 NIP. 199104082015022002
DINAS KESEHATAN KABUPATEN BLITAR
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)
WILAYAH : SUMBERINGIN PELAPORAN BULAN : MEI
PUSKESMAS : SANANKULON PERMINTAAN BULAN : JUNI
KECAMATAN : SANANKULON
KABUPATEN : BLITAR
PROVINSI : JAWA TIMUR

SISA STOK JUMLAH


NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

1 2 WAY FOLEY CATHETER NO.16 PCS 0 0 0 0

2 2 WAY FOLEY CATHETER NO.18 PCS 0 0 0 0

3 2 WAY FOLEY CATHETER NO.20 PCS 0 0 0 0

4 ACETYLCYSTEINE CAPSULE 200 MG CAPSULE 0 0 0 0

5 ALAT SUNTIK SEKALI PAKAI 1 ML PCS 0 0 0 0

6 ALAT SUNTIK SEKALI PAKAI 10 ML PCS 0 0 0 0

7 ALAT SUNTIK SEKALI PAKAI 20 ML PCS 0 0 0 0

8 ALAT SUNTIK SEKALI PAKAI 3 ML PCS 96 96 8 88

9 ALAT SUNTIK SEKALI PAKAI 5 ML PCS 77 77 0 77

10 ALKOHOL SWAB PCS 0 0 0 0

11 ALLOPURINOL TABLET 100 MG TABLET 0 0 0 0

12 ALPRAZOLAM 1 MG TABLET TABLET 0 0 0 0

13 AMBROXOL SIRUP 5MG/ML BOTOL 0 0 0 0

14 AMBROXOL TABLET 30 MG TABLET 0 0 0 0

15 AMINOPHYLLINE INJEKSI 24 MG/ML 10 ML AMPUL 0 0 0 0

16 AMINOPHYLLINE TABLET 200 MG TABLET 0 0 0 0

17 AMITRIPTYLLINE HCL TABLET 25 MG TABLET 0 0 0 0

18 AMLODIPINE TABLET 10 MG TABLET 0 100 100 60 40

19 AMLODIPINE TABLET 5 MG TABLET 0 0 0 0

20 AMOKSISILIN DRY SYRUP 125 MG/5 ML 60 ML BOTOL 0 0 0 0

21 AMOKSISILIN SERBUK INJEKSI 1000 MG VIAL 0 0 0 0

22 AMOKSISILIN TABLET 500 MG KAPLET 141 100 241 124 117

AMOXCICILIN FORTE SYRUP KERING


23 250MG/5ML BOTOL 0 0 0 0

24 AMPICILLIN SERBUK INJEKSI 1.000 MG VIAL 0 0 0


MG/VIAL 0

25 ANTALGIN 500 MG TABLET (METAMIZOL) TABLET 0 0 0 0

26 ANTASIDA DOEN TABLET KOMBINASI TABLET 442 442 90 352

27 ANTASIDA SUSPENSI 60 ML BOTOL 4 4 1 3

28 ANTI BAKTERI DOEN SALEP KOMBINASI 5 GR POT 0 0 0 0

29 ANTI FUNGI DOEN SALEP KOMBINASI 30 GR POT 5 5 0 5

30 ANTI HAEMOROID DOEN KOMBINASI SUPP. 0 0 0 0

31 ANTI MIGRAIN DOEN TABLET KOMBINASI TABLET 0 0 0 0

32 ANTI SPASMODIK INJEKSI (SPASHI) AMPUL 0 0 0 0

33 ANTI SPASMODIK TABLET (DORMICOMP) TABLET 0 0 0 0

AQUA PRO INJEKSI STERIL BEBAS PIROGEN 20


34 BOTOL 0 0 0 0
ML

35 ASAM ASKORBAT ( VIT C ) TABLET 250 MG TABLET 0 0 0 0

36 ASAM ASKORBAT ( VIT C ) TABLET 50 MG TABLET 0 0 0 0

37 ASAM FOLAT 1MG TABLET TABLET 0 0 0 0

38 ASAM MEFENAMAT TABLET 500 MG TABLET 0 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

39 ASAM TRANEKSAMAT 100 MG/ML INJEKSI AMPUL 0 0 0 0

40 ASAM TRANEKSAMAT 500 MG TABLET TABLET 0 0 0 0

41 ASAM VALPROAT 250 MG TABLET / TABLET 0 0 0


DEPAKOTE ER 0

42 ASEPTAN 500CC + PUMP BOTOL 0 0 0 0

43 ASEPTIC GEL 500CC + DISPENSER BOTOL 0 0 0 0

44 ASERING (ASETAT RINGER) SOFT BAG BOTOL 0 0 0 0

45 ASETOSAL TABLET 100 (80) MG TABLET 0 0 0 0

46 ASIKLOVIR KREAM 5 % 5 GR TUBE 0 0 0 0

47 ASIKLOVIR TABLET 400 MG TABLET 0 0 0 0

48 ATROPIN SULFAT INJEKSI 0,25 MG/ML 1 ML AMPUL 0 0 0 0

49 ATTAPULGIT + PECTIN TABLET TABLET 0 0 0 0

50 BETAHISTINE MESILAT 24 MG TABLET TABLET 0 0 0 0

51 BETAHISTINMESILAT 6 MG TABLET TABLET 0 0 0 0

52 BETAMETHASON CR 0.05% 20 GR TUBE 3 3 0 3

53 BETAMETHASONE CREAM 0,1 % 5 GR TUBE 0 0 0 0

54 BIONICOM ZINC TABLET TABLET 0 0 0 0

55 BISAKODIL SUPPOSITORIA 10 MG SUPP. 0 0 0 0

56 BISAKODIL SUPPOSITORIA 5 MG SUPP. 0 0 0 0

57 BISOPROLOL 2,5 MG TABLET (CONCOR) TABLET 0 0 0 0

58 BISOPROLOL 5 MG TABLET TABLET 0 0 0 0

59 CAT GUT NO. 3/0 CHROMIC PCS 1 1 0 1

60 CAT GUT NO. 3/0 PLAIN PCS 1 1 0 1

61 CITICHOLIN 250 MG/ML-2ML INJEKSI AMPUL 0 0 0 0

62 CLONIDINE 0.15 MG TABLET TABLET 0 0 0 0

63 CLOPIDOGREL 75 MG TABLET 0 0 0 0

64 COMBIVENT UDV INHALASI VIAL 0 0 0 0

65 DEKSAMETHASONE INJEKSI 5 MG/ML 1 ML AMPUL 0 0 0 0

66 DEKSAMETHASONE TABLET 0,5 MG TABLET 0 0 0 0

67 DEVITALISASI PASTA ( NON ARSEN ) POT 0 0 0 0

68 DIAZEPAM INJEKSI 5 MG/ML 2 ML AMPUL 0 0 0 0

DIAZEPAM LARUTAN RECTAL 5MG/ 2,5ML-


69 TUBE 0 0 0 0
STESOLID

70 DIAZEPAM TABLET 2 MG TABLET 0 0 0 0

71 DIAZEPAM TABLET 5 MG TABLET 0 0 0 0

72 DIFENHIDRAMINE HCL INJEKSI 10 MG/ML 1 ML AMPUL 0 0 0 0

73 DIGOXIN TABLET 0,25 MG TABLET 0 0 0 0

74 DIMENHYDRINATE TABLET 50 MG TABLET 2 2 2 0

75 DOKSISIKLIN TABLET 100 MG KAPSUL 0 0 0 0

76 DOMPERIDON SUSPENSI 5MG/ML BOTOL 0 0 0 0

77 DOMPERIDON TABLET 10 MG TABLET 0 0 0 0

78 EKSTRACT PLASENTA + NEOMYSIN SALEP 15 TUBE 0 0 0


GR 0

79 EPINEFRIN (ADRENALIN) HCL INJ.0,1 % 1 ML AMPUL 0 0 0 0

80 ERITROMISIN KAPSUL 250 MG KAPSUL 0 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

81 ERITROMISIN SIRUP KERING 200 MG/5ML BOTOL 0 0 0 0

82 ERITROMISIN TABLET 500 MG KAPSUL 0 0 0 0

83 ETAKRIDIN ( RIVANOL ) LARUTAN 0,1 % 300 BOTOL 0 0 0 0


ML 0

84 ETANOL [ ALKOHOL ] 70 % 1000 ML BOTOL 0 0 0 0

85 ETIL KLORIDA SEMPROT 100 ML BOTOL 0 0 0 0

86 EUGENOL CAIRAN 10 ML BOTOL 0 0 0 0

87 FENITOIN NATRIUM INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0 0

88 FENITOIN NATRIUM TABLET 100 MG KAPSUL 0 0 0 0

89 FENOBARBITAL INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0 0

90 FENOBARBITAL TABLET 30 MG TABLET 0 0 0 0

91 FENOL GLISEROL TETES TELINGA 10 % 5 ML BOTOL 0 0 0 0

FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML 1


92 AMPUL 0 0 0 0
ML
FITOMENADION ( VIT K1 ) TABLET SALUT 10
93 TABLET 0 0 0 0
MG

94 FITOMENADION INFANT INJ. 2MG/ML AMPUL 0 0 0 0

FLUPHENASINE DEKANOAT INJEKSI 25 MG 1


95 AMPUL 0 0 0 0
ML

96 FUROSEMID INJEKSI 10 mg VIAL 0 0 0 0

97 FUROSEMID TABLET 40 MG TABLET 66 66 0 66

GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 %


98 10 GR TUBE 0 3 3 0 3

99 GARAM ORALIT SACHET 63 63 0 63

100 GEMFIBROZIL 300 MG KAPSUL KAPSUL 0 0 0 0

101 GENTAMISIN SALEP KULIT 0,1 % 5 GR TUBE 0 0 0 0

102 GENTAMISIN SALEP MATA 0,3% TUBE 0 5 5 3 2

103 GENTAMISIN TETES MATA 0,3% BOTOL 0 0 0 0

104 GLASS IONOMER CEMENT ( GC IX ) BOTOL 0 0 0 0

105 GLIBENCLAMIDE TABLET 5 MG TABLET 200 200 0 0 200

106 GLICERIL GUAIACOLAT TABLET 100 MG TABLET 0 0 0 0

107 GLIMEPIRIDE 1 MG TABLET TABLET 0 0 0 0

108 GLIMEPIRIDE 2 MG TABLET TABLET 268 268 64 204

GLUKOSA 40% DEXTROSE INJECTION U.S.P


109 VIAL 0 0 0 0
CAIRAN INJEKSI

110 GLUKOSA LARUTAN INFUS 10 % STERIL BOTOL 0 0 0 0

111 GLUKOSA LARUTAN INFUS 5 % STERIL BOTOL 0 0 0 0

112 GRISEOFULVIN TABLET 125 MG TABLET 0 0 0 0

113 HALOPERIDOL 2 MG TABLET 0 0 0 0

114 HALOPERIDOL DEKANOAT INJ 50 MG VIAL 0 0 0 0

115 HALOPERIDOL INJ. 5 MG/ML (LODOMER) AMPUL 0 0 0 0

116 HALOPERIDOL TABLET 1,5 MG TABLET 0 0 0 0

117 HALOPERIDOL TABLET 5 MG TABLET 0 0 0 0

118 HERBAKOF SYRUP 60ML BOTOL 0 0 0 0

119 HES-HYDROXYETHYL STARCH 6 %/VOLUVEN BOTOL 0 0 0


INFUS 500 ML 0

120 HIDROCORTISON CR 1% TUBE 0 0 0 0

121 HIDROCORTISONE CREAM 2,5 % 5 GR TUBE 0 0 0 0

122 HYDROCHLORTHIAZIDE 25 MG TABLET 0 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

123 I.V CATHETER NO.16 WITH INJECTION PORT PCS 0 0 0 0

124 I.V CATHETER NO.18 WITH INJECTION PORT PCS 0 0 0 0

125 I.V CATHETER NO.20 WITH INJECTION PORT PCS 0 0 0 0

126 I.V CATHETER NO.22 WITH INJECTION PORT PCS 0 0 0 0

127 I.V CATHETER NO.24 WITH INJECTION PORT PCS 0 0 0 0

128 I.V CATHETER NO.26 WITH INJECTION PORT PCS 0 0 0 0

129 IBUPROFEN FORTE SYRUP 200MG/5ML BOTOL 0 0 0 0

130 IBUPROFEN SUSPENSI 100 MG/5 ML 60 ML BOTOL 0 0 0 0

131 IBUPROFEN TABLET 400 MG TABLET 0 0 0 0

132 INFUSION SET ANAK PCS 0 0 0 0

133 INFUSION SET DEWASA PCS 0 1 1 1 0

134 ISOSORBIDE DINITRATE SUBLINGUAL 5 MG TABLET 0 0 0 0

135 KAEN 3B BOTOL 0 0 0 0

136 KALIUM DIKLOFENAK 50 MG TABLET TABLET 0 0 0 0

KALSIUM GLUCONAS INJEKSI 100 MG/ML 10


137 AMPUL 0 0 0 0
ML

138 KALSIUM LAKTAT (KALK) TABLET 500 MG TABLET 543 300 843 208 635

139 KANTONG URINE DEWASA PCS 0 0 0 0

140 KAPAS PEMBALUT/ABSORBEN 250 GR BKS 0 0 0 0

141 KAPTOPRIL TABLET 25 MG TABLET 0 0 0 0

142 KARBAMAZEPIN TABLET 200 MG TABLET 0 0 0 0

143 KASA KOMPRES 40/40 STERIL BKS 0 5 5 0 5

144 KASA PEMBALUT HIDROFIL 16 X 16 CM STRIL ROL 1 2 3 0 3

145 KASA PEMBALUT HIDROFIL 2 M X 80 CM ROL 1 1 2 0 2

146 KASA PEMBALUT HIDROFIL 4 M X 10 CM ROL 0 0 0 0

147 KASA PEMBALUT HIDROFIL 4 M X 5 CM ROL 0 10 10 0 10

148 KASA STERIL (DARYAN TOLLE)YG DIRESAPI PCS 0 0 0


FRAMISETIN 0

149 KETOKONAZOLE TABLET 200 MG TABLET 0 0 0 0

150 KETOPROFEN 100 MG SUPPOSITORIA SUPP. 0 0 0 0

151 KLINDAMISIN KAPSUL 150 MG TABLET 0 0 0 0

152 KLINDAMISIN KAPSUL 300 MG KAPSUL 0 0 0 0

153 KLOBAZAM 10 MG TABLET TABLET 0 0 0 0

154 KLORAMFENIKOL KAPSUL 500 MG KAPSUL 0 0 0 0

155 KLORAMFENIKOL SALEP KULIT 2 % TUBE 0 0 0 0

156 KLORAMFENIKOL SALEP MATA 1 % TUBE 1 1 1 0

157 KLORAMFENIKOL SUSPENSI 125 MG/5 ML BOTOL 0 0 0 0

158 KLORAMFENIKOL TETES TELINGA 3 % BOTOL 0 0 0 0

KLORFENIRAMINE MALEAT (CTM) TABLET 4


159 MG TABLET 0 0 0 0

160 KLORPROMAZIN HCL INJEKSI 25 MG/ML 1 ML AMPUL 0 0 0 0

161 KLORPROMAZIN HCL INJEKSI 50 MG/ML 1 ML AMPUL 0 0 0 0

162 KLORPROMAZIN HCL TABLET 100 MG TABLET 0 0 0 0

163 KLOZAPIN 100 MG TABLET TABLET 0 0 0 0

164 KLOZAPIN 25 MG TABLET TABLET 0 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

165 KODEIN HCL TABLET 10 MG TABLET 0 0 0 0

166 KOTRIMOKSAZOL DEWASA TABLET TABLET 0 0 0 0

167 KOTRIMOKSAZOL SUSPENSI 60 ML BOTOL 0 0 0 0

168 LEVOFLOXACIN TABLET 500 MG TABLET 0 0 0 0

169 LIDOCAIN 2% INJ AMPUL 0 0 0 0

170 LIDOCAIN COMPOSITUM INJEKSI 2 ML AMPUL 3 3 0 3

171 LISOL CONCENTRATE 1000 ML BOTOL 0 0 0 0

172 LOPERAMIDE TABLET 2 MG TABLET 0 0 0 0

173 LORATADIN TABLET 10 MG TABLET 134 134 10 124

174 LORAZEPAM 2 MG TABLET 0 0 0 0

175 MAGNESIUM SULFAT INJEKSI (IV) 40 % 25 ML AMPUL 0 0 0 0

176 MASKER EARLOOP PLUS PCS 0 0 0 0

177 MASKER KERTAS 3 PLY EAR LOOP PCS 0 0 0 0

178 MASKER KERTAS 3 PLY TIE ON PCS 0 0 0 0

179 MASKER N95 PCS 0 0 0 0

180 MELOKSIKAM TABLET 7,5 MG TABLET 0 0 0 0

181 METAMIZOL (NORAGES) INJEKSI 500 MG/2ML AMPUL 0 0 0 0

182 METFORMIN TABLET 500 MG TABLET 0 100 100 0 100

183 METILERGOMETRIN MALEAT INJEKSI 0,200 AMPUL 0 0 0


MG 1 ML 0

184 METILERGOMETRIN MALEAT TABLET 0,125 TABLET 0 0 0


MG 0

185 METILPREDNISOLON TABLET 4 MG TABLET 0 0 0 0

186 METOKLOPRAMIDE 10 MG TABLET TABLET 0 0 0 0

187 METOKLOPRAMIDE 5 MG TABLET TABLET 0 0 0 0

188 METOKLOPROMIDE (SOTATIC) INJEKSI 5 AMPUL 0 0 0


MG/ML 2 ML 0

189 METOKLOPROMIDE SIRUP BOTOL 0 0 0 0

190 METRONIDAZOL + NYSTATIN VAG. VIAL 0 0 0


(PROVAGIN) INJEKSI 0

191 METRONIDAZOL TABLET 250 MG TABLET 0 0 0 0

192 METRONIDAZOL TABLET 500 MG TABLET 0 0 0 0

193 METRONIDAZOLE INFUS 5 MG/ML 100 ML BOTOL 0 0 0 0

194 MIKONAZOL KREAM 10 GR TUBE 5 5 2 3

195 MINERAL MIX SACHET 0 0 0 0

196 NATRIUM DIKLOFENAK TABLET 25 MG TABLET 320 320 6 314

197 NATRIUM DIKLOFENAK TABLET 50 MG TABLET 0 0 0 0

198 NATRIUM KLORIDA INFUS 0,9 % STERIL BOTOL 1 2 3 0 3

199 NIFEDIPINE TABLET 10 MG TABLET 0 0 0 0

200 NISTATIN TABLET 500.000 UI TABLET 40 40 3 37

201 NISTATIN VAGINAL TABLET 100.000 UI VAGTAB 8 8 0 8

202 OBAT BATUK HITAM (OBH) CAIRAN 100 ML BOTOL 0 0 0 0

203 OKSIGEN NASAL CANNULA ADULT PCS 0 0 0 0

204 OKSIGEN NASAL CANNULA INFANT PCS 0 0 0 0

205 OKSITETRACYCLIN SALEP KULIT 3 % 5 GR TUBE 0 0 0 0

206 OKSITETRACYCLIN SALEP MATA 1 % 3,5 GR TUBE 0 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

207 OKSITOSIN INJEKSI 10 IU/ML 1 ML AMPUL 0 0 0 0

208 OMEPRAZOLE TABLET 20 MG KAPSUL 0 0 0 0

209 ONDANSENTRON 4 MG/2 ML INJEKSI AMPUL 0 0 0 0

210 PARACETAMOL SYRUP 120 MG/5 ML 60 ML BOTOL 4 5 9 9 0

211 PARACETAMOL TABLET 500 MG TABLET 0 0 0 0

212 PARACETAMOL TETES 100 MG/ML 15 ML BOTOL 0 0 0 0

213 PEHAVRAL TABLET TABLET 0 0 0 0

214 PERAK SULFADIAZIN KRIM 1 % TUBE 0 0 0 0

215 PERHYDROL [ H2O2 ] 3 % 800 ML BOTOL 1 1 0 0 1

216 PERMETHRINE 5% CR 15 GRAM TUBE 0 0 0 0

217 PIRACETAM TABLET 800 MG TABLET 0 0 0 0

218 PIRANTEL PAMOAT TABLET TABLET 0 0 0 0

219 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG TABLET 0 0 0 0

220 PIROKSIKAM KAPSUL 10 MG KAPSUL 0 0 0 0

221 PLESTER 10 CM X 2 M ROL 0 0 0 0

222 PREDNISON TABLET 5 MG TABLET 0 0 0 0

223 PROPRANOLOL HCL TABLET 40 MG TABLET 0 0 0 0

224 PROPILTHIOURACIL TABLET 100 MG TABLET 0 0 0 0

225 RANITIDIN INJEKSI 25 MG/ ML AMPUL 0 0 0 0

226 RESPERIDON 2 MG TABLET TABLET 0 0 0 0

227 RINGER LAKTATE LARUTAN INFUS STERIL BOTOL 0 0 0 0

228 SALBUTAMOL TABLET 2 MG TABLET 100 100 0 100

229 SALBUTAMOL TABLET 4 MG TABLET 0 0 0 0

230 SALEP 2-4 KOMBINASI 30 GR POT 5 5 1 4

231 SALICYL BEDAK 2 % KOTAK 0 0 0 0

232 SARUNG TANGAM NON STERIL L PCS 0 0 0 0

233 SARUNG TANGAN NON STERIL M PCS 30 100 130 20 110

234 SARUNG TANGAN NON STERIL S PCS 0 0 0 0

235 SARUNG TANGAN STERIL NO 6 PSG 0 0 0 0

236 SARUNG TANGAN STERIL NO. 7,5 PSG 0 0 0 0

237 SARUNG TANGAN STERILE NO.6,5 PSG 0 0 0 0

238 SARUNG TANGAN STERILE NO.7 PSG 1 2 3 0 3

239 SEFADROKSIL KAPSUL 500 MG KAPSUL 0 0 0 0

240 SEFIKSIM KAPSUL 100 MG KAPSUL 0 0 0 0

SERUM ANTI BISA ULAR POLIVALEN INJ.5 ML


241 VIAL 0 0 0 0
(ABU I)
SERUM ANTI TETANUS INJEKSI 1.500 IU/AMP
242 VIAL 0 0 0 0
(ATS)

243 SETIRIZINE TABLET 10 MG TABLET 55 50 105 91 14

244 SIANOKOBALAMIN ( VIT B12 ) INJEKSI 500 AMPUL 0 0 0 0


MCG/ML 1 ML

245 SIANOKOBALAMIN ( VIT B12 ) TABLET 50 MCG TABLET 216 216 0 216

246 SILK (BENANG BEDAH SUTERA) NO.3/0 PCS 1 1 0 1

247 SIMETIDINE TABLET 200 MG TABLET 0 0 0 0

248 SIMVASTATIN TABLET 10 MG TABLET 0 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

249 SIPROFLOXACIN INFUS 2% BOTOL 0 0 0 0

250 SIPROFLOXACIN TABLET 500 MG TABLET 0 0 0 0

251 SPONS GELATIN CUBICLES 1x1x1 CM PCS 0 0 0 0

252 STIMUNO SYR BOTOL 0 0 0 0

253 STIMUNO TAB (100) TABLET 0 0 0 0

254 STIMUNO TAB (30) BOTOL 0 0 0 0

255 SULFADOKSIN TABLET TABLET 0 0 0 0

SULFASETAMID NATRIUM TETES MATA 15 %


256 BOTOL 0 0 0 0
5 ML

257 TABLET TAMBAH DARAH TABLET 944 500 1,444 331 1,113

TEMPORARY CAVITY SEALER [TUMPATAN


258 PCS 0 0 0 0
SEMENTARA] (CAVIT G)

259 TETAGRAM 150 IU AMPUL 0 0 0 0

260 TETRAKAIN HCL TETES MATA 5 ML BOTOL 0 0 0 0

261 TETRASIKLIN HCL TABLET 500 MG KAPSUL 0 0 0 0

262 THIAMIN HCL (VIT B1) INJEKSI 100 MG/ML 1 ML AMPUL 0 0 0 0

THIAMIN HCL MONONITRAT (VIT B1) TABLET


263 TABLET 0 0 0 0
100 MG
THIAMIN HCL MONONITRAT (VIT B1) TABLET
264 TABLET 0 0 0 0
50 MG

265 TRAMADOL INJEKSI 50 MG/ML AMPUL 0 0 0 0

266 TRANFUSION SET ADULT WITH Y INJECTION PCS 0 0 0 0

267 TRIFLOUPERASIN TABLET 5 MG TABLET 0 0 0 0

268 TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2 TABLET 0 0 0


MG 0

269 VITAMIN B COMPLEX TABLET TABLET 293 50 343 98 245

270 YODIUM POVIDON LARUTAN 10 % 30 ML BOTOL 0 0 0 0

271 YODIUM POVIDON LARUTAN 10% 60 ML BOTOL 1 1 0 0 1

272 ZENTRA (TRIPROLIDINE|PSEUDOEPHEDRINE) TABLET 0 0 0 0

273 ZINK 20 MG TABLET TABLET 0 100 100 0 100

274 Hi-D 1000 CHOLECALCIFEROL TABLET 0 0 0 0

OBAT PROGRAM / HIBAH

1 AMITRIPTYLINE 25 MG TABLET 0 0 0 0

2 HALOPERIDOLE INJEKSI AMPUL 0 0 0 0

3 HALOPERIDOLE 1,5 MG TABLET 0 0 0 0

4 HALOPERIDOLE 5 MG TABLET 0 0 0 0

5 LODOMER 2 MG TABLET 0 0 0 0

6 LODOMER 5 MG TABLET 0 0 0 0

7 TRIHEXYPHENIDYL 2 MG TABLET 0 0 0 0

8 ALAT SUNTIK 0,05 ML (PROGRAM) PCS 0 0 0 0

9 ALAT SUNTIK 0,5 ML (PROGRAM) PCS 0 0 0 0

10 ALAT SUNTIK 5 ML (PROGRAM) PCS 0 0 0 0

11 ALBENDAZOL TABLET 400 MG TABLET 0 0 0 0

12 BENZATINE BENZYLPENICILLIN 2.400.000 IU VIAL 0 0 0 0

13 COTRIMOXAZOLE 800/160 TABLET 0 0 0 0

14 DIETHYLCARBAMAZINE 100 MG TABLET 0 0 0 0

15 GARAM ORALIT UNTUK 200 ML AIR SACHET 0 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

16 HIV ABACAVIR TABLET 300 MG BOTOL 0 0 0 0

17 HIV ACRIPTEGA (TDF 300 + 3TC 300 + DTG 50) BOTOL 0 0 0 0

18 HIV DOLUTEGRAFIR 50 MG BOTOL 0 0 0 0

19 HIV EFAFIRENZ 200 MG TABLET BOTOL 0 0 0 0

20 HIV EFAFIRENZ 600 MG TABLET BOTOL 0 0 0 0

21 HIV LAMIVUDIN 150 MG TABLET BOTOL 0 0 0 0

22 HIV NEVIRAPINE 200 MG TABLET BOTOL 0 0 0 0

23 HIV TENOFOVIR 300 MG BOTOL 0 0 0 0


HIV TRIPLE FDC ANAK (ZIDOVUDIN
24 BOTOL 0 0 0 0
60MG+LAMIVUDIN 30MG+NEVIRAPINE 50MG)
HIV TRIPLE FDC DEWASA (TDC+3TC+EFV
25 BOTOL 0 0 0 0
(300/300/600))

26 HIV ZIDOVUDINE 100 MG @60 KAPSUL BOTOL 0 0 0 0

27 HIV ZIDOVUDINE 300 MG + LAMIVUDIN 150 MG BOTOL 0 0 0 0

28 HIV ZIDOVUDINE SYRUP 240 ML BOTOL 0 0 0 0

29 IODINE TES PCS 0 0 0 0

30 ISONIAZID TABLET 100 MG TABLET 0 0 0 0

31 ISONIAZID TABLET 300 MG TABLET 0 0 0 0

KOMBIPAK AZITHROMYCIN - CEFIXIME


32 TABLET 0 0 0 0
KOMBINASI

33 MDT COMBI - MB ADULT (RED) BLISTER 0 0 0 0

34 MDT COMBI - MB CHILD (ORANGE) BLISTER 0 0 0 0

35 MDT COMBI - PB ADULT (GREEN) BLISTER 0 0 0 0

36 OBAT ANTI TUBERKULOSIS ANAK PAKET 0 0 0 0

37 OBAT ANTI TUBERKULOSIS DOSIS HARIAN PAKET 0 0 0 0


STOP TB KIT

38 OBAT ANTI TUBERKULOSIS KATEGORI 1 PAKET 0 0 0 0

39 OBAT ANTI TUBERKULOSIS KATEGORI 2 PAKET 0 0 0 0

40 OBAT ANTI TUBERKULOSIS KOMBIPAK PAKET 0 0 0 0


KATEGORI I

41 PARACETAMOL 500 MG (P2) TABLET 0 0 0 0

42 PIRIDOKSIN 25 MG TABLET (VIT B6) TABLET 0 0 0 0

43 PYRIMETAMINE TABLET 0 0 0 0

44 REAGEN HIV (FOKUS) PCS 0 0 0 0

45 REAGEN HIV (STANDART DIAGNOSTIC/SD) PCS 0 0 0 0

46 REAGEN HIV (VIKIA) PCS 0 0 0 0

REAGEN HIV DIAGNOSTAR HIV 1\/2 ONE STEP


47 PCS 0 0 0 0
RAPID TEST
48 REAGEN HIV DIAGNOSTIC KIT FOR HIV (1+2) PCS 0 0 0 0
ANTIBODY (COLLOIDAL GOLD) V2 PAKET
49 REAGEN SYPHILIS (TREPOCHECK) PCS 0 0 0 0

50 REAGEN SYPHILIS RDT (FOKUS) PCS 0 0 0 0

51 RETINOL ( VIT A ) KAPSUL 100.000 IU KAPSUL 0 0 0 0

52 RETINOL ( VIT A ) KAPSUL 200.000 IU KAPSUL 0 0 0 0

53 SAFETY BOX PCS 0 0 0 0

SERUM ANTI DIFTERI CAIRAN INJEKSI 125


54 MG/ML VIAL 0 0 0 0

55 TABLET TAMBAH DARAH (PROGRAM) TABLET 0 0 0 0

56 ZINK TABLET DISPERSIBLE 20 MG (PROGRAM) TABLET 0 0 0 0

57 ALBENDAZOLE SIRUP BOTOL 0 0 0 0

58 COTRIMOXAZOLE 400/80 TABLET 0 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

59 MINERAL MIX SACHET 0 0 0 0

60 SD BIOLINE Syphilis 3.0 One Step Syphilis PCS 0 0 0 0


Antibody Test

OBAT TAMBAHAN

1 ALKOHOL SWAB 0 0 0 0 0

2 ALLOPURINOL 0 100 100 0 100

3 AMLODIPINE 5MG (BLUD) 412 412 74 338

4 ANTISEPTIK GEL (DINKES) 1 1 1 0

5 APD VAKSIN 0 0 0 0

6 APRON (DINKES) 0 0 0 0

7 AQUA PRO INJEKSI (BLUD) 0 0 0 0

8 ASAM MEFENAMAT TABLET 500 MG (BLUD) 224 100 324 40 284

9 ASIKLOVIR TABLET 0 50 50 4 46

10 BETAMETHASONE SALEP KULIT (BLUD) 0 0 0 0

11 BIOPLACENTON (BLUD) 0 2 2 0 2

12 BISAKODIL TABLET 5 MG (BLUD) 0 0 0 0

13 CIPROFLOXACIN (BLUD) 0 0 0 0

14 CLINDAMISIN KAPS (BLUD) 0 0 0 0

DEKSAMETHASONE HARSEN TABLET 0,5 MG


15 ((BLUD) ) 189 200 389 131 258

16 DOMPERIDONE TABLET 10 MG ( (BLUD)) 84 50 134 22 112

17 EPINEFRIN INJEKSI (BLUD) 0 0 0 0

18 FENITOIN KAPS (BLUD) 0 0 0 0

19 FITOMENADION INJ (BLUD) 0 0 0 0

20 FITOMENADION TABLET (BLUD) 0 0 0 0

21 FUROSEMIDE TABLET 0 0 0 0

22 GEMFIBROZIL (BLUD) 0 100 100 12 88

23 GENOINT (BLUD) 0 0 0 0

24 GENTAMICIN TETES MATA (BLUD) 6 6 6 0

25 GENTIAN VIOLET LARUTAN 1 % (BLUD) 2 2 0 2

26 GLISERIL GUAIKOLAT/GUAIFENESIN BLUD 287 287 83 204

27 HIDROKORTISON CREAM KULIT (BLUD) 9 9 2 7

HYOSCINE BUTYLBROMIDE (ANTI SPASMODIK


28 0 100 100 0 100
BLUD)

29 HYPAFIX (BLUD) 0 0 0 0

30 INFUSET (BLUD) 0 0 0 0

31 IV CATHETER (BLUD) 0 0 0 0

32 KAPTOPRIL TABLET 12,5 MG (BLUD) 464 464 10 454

33 KLORAMFENIKOL SIRUP (BLUD) 0 0 0 0

34 KLORAMFENIKOL TETES TELINGA (BLUD) 3 5 8 0 8

35 KOTRIMOKSAZOL TAB (BLUD) 0 0 0 0

36 LOPERAMIDE TABLET 2 MG (BLUD) 0 0 0 0

37 MASKER (DINKES) 0 0 0 0

38 MASKER N9 0 0 0 0

39 METFORMIN (BLUD) 125 125 80 45


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

40 METILERGOMETRINE INJ (BLUD) 0 0 0 0

41 MULTIVITAMIN KOMB 0 0 0 0

42 NEW DIATABS (BLUD) 24 24 0 24

43 NIFEDIPINE TAB (BLUD) 0 0 0 0

44 NURSE CAP 0 0 0 0

45 OMEPRAZOLE 20MG 35 100 135 33 102

46 ONDANSETRONE INJEKSI (BLUD) 0 0 0 0

47 PARACETAMOL TABLET 500 MG (BLUD) 767 500 1,267 356 911

48 PEHAVRAL 0 0 0 0

49 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG (BLUD) 289 289 20 269

50 PIROXICAM 0 0 0 0

51 SALBUTAMOL TABLET 2 MG (BLUD) 21 21 0 21

52 SARUNG TANGAN OBGYN 0 0 0 0

53 SARUNG TANGAN OBGYN 0 0 0 0

54 SEFADROKSIL KAPSUL 500 MG (BLUD) 0 0 0 0

55 VGEL (BLUD) 0 0 0 0

56 VITAMIN C 50 MG (BLUD) 569 569 113 456

57 ZIVIT ZINC 150 150 36 114

58 ASETIL (DINKES) 0 0 0 0

59 DEXAMETHASONE (DINKES) 0 0 0 0

60 OBH (DINKES) 0 5 5 0 5

61 AMBROXOL 0 0 0

62 BATUK FLU SIRUP (ETAFLUSIN) 0 0 0

63 BATUK FLU TABLET (ETAFLUSIN) 0 0 0

64 BETADINE GARGLE 0 0 0

65 BUFACOMB SALEP 0 0 0

66 BUFACORT - N 0 0 0

67 DARYANTULLE 0 0 0

68 ETIL KLORIDA SPRAY 0 0 0

69 GLIBENCLAMIDE TABLET 5 MG 0 0 0

70 GLIMEPIRIDE 2 MG TABLET 0 0 0

71 KAOLIN PEKTIN SIRUP (NOVADIAR) 0 0 0

72 PIRACETAM KAPSUL 0 0 0

73 TIAMFENIKOL KAPSUL 0 0 0

74 VITAMIN ANAK SIRUP (SAMCOVIT) 0 0 0

75 0 0 0

76 0 0 0

77 0 0 0

78 0 0 0

79 0 0 0

80 0 0 0

Blitar , 02 June 2022


Mengetahui / Menyetujui
Yang Menerima, Yang Menyerahkan,
Kepala Puskesmas Petugas Petugas Pengelola Obat
SANANKULON Instalasi Farmasi Kabupaten Pustu/Polindes/Ponkesdes
SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

ENDAH ROSITANINGSIH, SE, MM Apt. AINA MUJTAHIDA A, S.Farm. APRILLIA YUDHA A.S.
NIP. 196912302010012002 NIP : 198612188 11033 2 0004 NIP. 199104082015022002
DINAS KESEHATAN KABUPATEN BLITAR
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)
WILAYAH : SUMBERINGIN PELAPORAN BULAN : JUNI
PUSKESMAS : SANANKULON PERMINTAAN BULAN : JULI
KECAMATAN : SANANKULON
KABUPATEN : BLITAR
PROVINSI : JAWA TIMUR

SISA STOK JUMLAH


NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

1 2 WAY FOLEY CATHETER NO.16 PCS 0 0 0 0

2 2 WAY FOLEY CATHETER NO.18 PCS 0 0 0 0

3 2 WAY FOLEY CATHETER NO.20 PCS 0 0 0 0

4 ACETYLCYSTEINE CAPSULE 200 MG CAPSULE 0 60 60 6 54

5 ALAT SUNTIK SEKALI PAKAI 1 ML PCS 0 0 0 0

6 ALAT SUNTIK SEKALI PAKAI 10 ML PCS 0 0 0 0

7 ALAT SUNTIK SEKALI PAKAI 20 ML PCS 0 0 0 0

8 ALAT SUNTIK SEKALI PAKAI 3 ML PCS 88 88 38 50

9 ALAT SUNTIK SEKALI PAKAI 5 ML PCS 77 77 0 77

10 ALKOHOL SWAB PCS 0 0 0 0

11 ALLOPURINOL TABLET 100 MG TABLET 0 0 0 0

12 ALPRAZOLAM 1 MG TABLET TABLET 0 0 0 0

13 AMBROXOL SIRUP 5MG/ML BOTOL 0 0 0 0

14 AMBROXOL TABLET 30 MG TABLET 0 0 0 0

15 AMINOPHYLLINE INJEKSI 24 MG/ML 10 ML AMPUL 0 0 0 0

16 AMINOPHYLLINE TABLET 200 MG TABLET 0 0 0 0

17 AMITRIPTYLLINE HCL TABLET 25 MG TABLET 0 0 0 0

18 AMLODIPINE TABLET 10 MG TABLET 40 40 40 0

19 AMLODIPINE TABLET 5 MG TABLET 0 0 0 0

20 AMOKSISILIN DRY SYRUP 125 MG/5 ML 60 ML BOTOL 0 0 0 0

21 AMOKSISILIN SERBUK INJEKSI 1000 MG VIAL 0 0 0 0

22 AMOKSISILIN TABLET 500 MG KAPLET 117 200 317 176 132 9

AMOXCICILIN FORTE SYRUP KERING


23 250MG/5ML BOTOL 0 0 0 0

24 AMPICILLIN SERBUK INJEKSI 1.000 MG VIAL 0 0 0


MG/VIAL 0

25 ANTALGIN 500 MG TABLET (METAMIZOL) TABLET 0 0 0 0

26 ANTASIDA DOEN TABLET KOMBINASI TABLET 352 352 262 90

27 ANTASIDA SUSPENSI 60 ML BOTOL 3 3 0 3

28 ANTI BAKTERI DOEN SALEP KOMBINASI 5 GR POT 0 0 0 0

29 ANTI FUNGI DOEN SALEP KOMBINASI 30 GR POT 5 5 1 4

30 ANTI HAEMOROID DOEN KOMBINASI SUPP. 0 0 0 0

31 ANTI MIGRAIN DOEN TABLET KOMBINASI TABLET 0 0 0 0

32 ANTI SPASMODIK INJEKSI (SPASHI) AMPUL 0 0 0 0

33 ANTI SPASMODIK TABLET (DORMICOMP) TABLET 0 0 0 0

AQUA PRO INJEKSI STERIL BEBAS PIROGEN 20


34 BOTOL 0 0 0 0
ML

35 ASAM ASKORBAT ( VIT C ) TABLET 250 MG TABLET 0 0 0 0

36 ASAM ASKORBAT ( VIT C ) TABLET 50 MG TABLET 0 0 0 0

37 ASAM FOLAT 1MG TABLET TABLET 0 0 0 0

38 ASAM MEFENAMAT TABLET 500 MG TABLET 0 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

39 ASAM TRANEKSAMAT 100 MG/ML INJEKSI AMPUL 0 0 0 0

40 ASAM TRANEKSAMAT 500 MG TABLET TABLET 0 0 0 0

41 ASAM VALPROAT 250 MG TABLET / TABLET 0 0 0


DEPAKOTE ER 0

42 ASEPTAN 500CC + PUMP BOTOL 0 0 0 0

43 ASEPTIC GEL 500CC + DISPENSER BOTOL 0 0 0 0

44 ASERING (ASETAT RINGER) SOFT BAG BOTOL 0 0 0 0

45 ASETOSAL TABLET 100 (80) MG TABLET 0 0 0 0

46 ASIKLOVIR KREAM 5 % 5 GR TUBE 0 0 0 0

47 ASIKLOVIR TABLET 400 MG TABLET 0 0 0 0

48 ATROPIN SULFAT INJEKSI 0,25 MG/ML 1 ML AMPUL 0 0 0 0

49 ATTAPULGIT + PECTIN TABLET TABLET 0 0 0 0

50 BETAHISTINE MESILAT 24 MG TABLET TABLET 0 0 0 0

51 BETAHISTINMESILAT 6 MG TABLET TABLET 0 0 0 0

52 BETAMETHASON CR 0.05% 20 GR TUBE 3 3 2 1

53 BETAMETHASONE CREAM 0,1 % 5 GR TUBE 0 0 0 0

54 BIONICOM ZINC TABLET TABLET 0 0 0 0

55 BISAKODIL SUPPOSITORIA 10 MG SUPP. 0 0 0 0

56 BISAKODIL SUPPOSITORIA 5 MG SUPP. 0 0 0 0

57 BISOPROLOL 2,5 MG TABLET (CONCOR) TABLET 0 0 0 0

58 BISOPROLOL 5 MG TABLET TABLET 0 0 0 0

59 CAT GUT NO. 3/0 CHROMIC PCS 1 1 0 1

60 CAT GUT NO. 3/0 PLAIN PCS 1 1 0 1

61 CITICHOLIN 250 MG/ML-2ML INJEKSI AMPUL 0 0 0 0

62 CLONIDINE 0.15 MG TABLET TABLET 0 0 0 0

63 CLOPIDOGREL 75 MG TABLET 0 0 0 0

64 COMBIVENT UDV INHALASI VIAL 0 0 0 0

65 DEKSAMETHASONE INJEKSI 5 MG/ML 1 ML AMPUL 0 0 0 0

66 DEKSAMETHASONE TABLET 0,5 MG TABLET 0 0 0 0

67 DEVITALISASI PASTA ( NON ARSEN ) POT 0 0 0 0

68 DIAZEPAM INJEKSI 5 MG/ML 2 ML AMPUL 0 0 0 0

DIAZEPAM LARUTAN RECTAL 5MG/ 2,5ML-


69 TUBE 0 0 0 0
STESOLID

70 DIAZEPAM TABLET 2 MG TABLET 0 0 0 0

71 DIAZEPAM TABLET 5 MG TABLET 0 0 0 0

72 DIFENHIDRAMINE HCL INJEKSI 10 MG/ML 1 ML AMPUL 0 0 0 0

73 DIGOXIN TABLET 0,25 MG TABLET 0 0 0 0

74 DIMENHYDRINATE TABLET 50 MG TABLET 0 0 0 0

75 DOKSISIKLIN TABLET 100 MG KAPSUL 0 0 0 0

76 DOMPERIDON SUSPENSI 5MG/ML BOTOL 0 0 0 0

77 DOMPERIDON TABLET 10 MG TABLET 0 0 0 0

78 EKSTRACT PLASENTA + NEOMYSIN SALEP 15 TUBE 0 0 0


GR 0

79 EPINEFRIN (ADRENALIN) HCL INJ.0,1 % 1 ML AMPUL 0 0 0 0

80 ERITROMISIN KAPSUL 250 MG KAPSUL 0 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

81 ERITROMISIN SIRUP KERING 200 MG/5ML BOTOL 0 0 0 0

82 ERITROMISIN TABLET 500 MG KAPSUL 0 0 0 0

83 ETAKRIDIN ( RIVANOL ) LARUTAN 0,1 % 300 BOTOL 0 0 0


ML 0

84 ETANOL [ ALKOHOL ] 70 % 1000 ML BOTOL 0 0 0 0

85 ETIL KLORIDA SEMPROT 100 ML BOTOL 0 0 0 0

86 EUGENOL CAIRAN 10 ML BOTOL 0 0 0 0

87 FENITOIN NATRIUM INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0 0

88 FENITOIN NATRIUM TABLET 100 MG KAPSUL 0 0 0 0

89 FENOBARBITAL INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0 0

90 FENOBARBITAL TABLET 30 MG TABLET 0 0 0 0

91 FENOL GLISEROL TETES TELINGA 10 % 5 ML BOTOL 0 2 2 0 2

FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML 1


92 AMPUL 0 0 0 0
ML
FITOMENADION ( VIT K1 ) TABLET SALUT 10
93 TABLET 0 0 0 0
MG

94 FITOMENADION INFANT INJ. 2MG/ML AMPUL 0 0 0 0

FLUPHENASINE DEKANOAT INJEKSI 25 MG 1


95 AMPUL 0 0 0 0
ML

96 FUROSEMID INJEKSI 10 mg VIAL 0 0 0 0

97 FUROSEMID TABLET 40 MG TABLET 66 66 0 66

GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 %


98 10 GR TUBE 3 3 1 2

99 GARAM ORALIT SACHET 63 100 163 5 95 63

100 GEMFIBROZIL 300 MG KAPSUL KAPSUL 0 0 0 0

101 GENTAMISIN SALEP KULIT 0,1 % 5 GR TUBE 0 0 0 0

102 GENTAMISIN SALEP MATA 0,3% TUBE 2 5 7 7 0

103 GENTAMISIN TETES MATA 0,3% BOTOL 0 0 0

104 GLASS IONOMER CEMENT ( GC IX ) BOTOL 0 0 0 0

105 GLIBENCLAMIDE TABLET 5 MG TABLET 0 0 0 0

106 GLICERIL GUAIACOLAT TABLET 100 MG TABLET 0 0 0 0

107 GLIMEPIRIDE 1 MG TABLET TABLET 0 0 0 0

108 GLIMEPIRIDE 2 MG TABLET TABLET 204 204 26 178

GLUKOSA 40% DEXTROSE INJECTION U.S.P


109 VIAL 0 0 0 0
CAIRAN INJEKSI

110 GLUKOSA LARUTAN INFUS 10 % STERIL BOTOL 0 0 0 0

111 GLUKOSA LARUTAN INFUS 5 % STERIL BOTOL 0 0 0 0

112 GRISEOFULVIN TABLET 125 MG TABLET 0 0 0 0

113 HALOPERIDOL 2 MG TABLET 0 0 0 0

114 HALOPERIDOL DEKANOAT INJ 50 MG VIAL 0 0 0 0

115 HALOPERIDOL INJ. 5 MG/ML (LODOMER) AMPUL 0 0 0 0

116 HALOPERIDOL TABLET 1,5 MG TABLET 0 0 0 0

117 HALOPERIDOL TABLET 5 MG TABLET 0 0 0 0

118 HERBAKOF SYRUP 60ML BOTOL 0 0 0 0

119 HES-HYDROXYETHYL STARCH 6 %/VOLUVEN BOTOL 0 0 0


INFUS 500 ML 0

120 HIDROCORTISON CR 1% TUBE 0 0 0 0

121 HIDROCORTISONE CREAM 2,5 % 5 GR TUBE 0 0 0 0

122 HYDROCHLORTHIAZIDE 25 MG TABLET 0 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

123 I.V CATHETER NO.16 WITH INJECTION PORT PCS 0 0 0 0

124 I.V CATHETER NO.18 WITH INJECTION PORT PCS 0 0 0 0

125 I.V CATHETER NO.20 WITH INJECTION PORT PCS 0 0 0 0

126 I.V CATHETER NO.22 WITH INJECTION PORT PCS 0 0 0 0

127 I.V CATHETER NO.24 WITH INJECTION PORT PCS 0 0 0 0

128 I.V CATHETER NO.26 WITH INJECTION PORT PCS 0 0 0 0

129 IBUPROFEN FORTE SYRUP 200MG/5ML BOTOL 0 0 0 0

130 IBUPROFEN SUSPENSI 100 MG/5 ML 60 ML BOTOL 0 0 0 0

131 IBUPROFEN TABLET 400 MG TABLET 0 0 0 0

132 INFUSION SET ANAK PCS 0 0 0 0

133 INFUSION SET DEWASA PCS 0 0 0 0

134 ISOSORBIDE DINITRATE SUBLINGUAL 5 MG TABLET 0 0 0 0

135 KAEN 3B BOTOL 0 0 0 0

136 KALIUM DIKLOFENAK 50 MG TABLET TABLET 0 0 0 0

KALSIUM GLUCONAS INJEKSI 100 MG/ML 10


137 AMPUL 0 0 0 0
ML

138 KALSIUM LAKTAT (KALK) TABLET 500 MG TABLET 635 635 365 270

139 KANTONG URINE DEWASA PCS 0 0 0 0

140 KAPAS PEMBALUT/ABSORBEN 250 GR BKS 0 0 0 0

141 KAPTOPRIL TABLET 25 MG TABLET 0 0 0 0

142 KARBAMAZEPIN TABLET 200 MG TABLET 0 0 0 0

143 KASA KOMPRES 40/40 STERIL BKS 5 5 2 3

144 KASA PEMBALUT HIDROFIL 16 X 16 CM STRIL ROL 3 3 0 3

145 KASA PEMBALUT HIDROFIL 2 M X 80 CM ROL 2 2 0 2

146 KASA PEMBALUT HIDROFIL 4 M X 10 CM ROL 0 0 0 0

147 KASA PEMBALUT HIDROFIL 4 M X 5 CM ROL 10 10 0 10

148 KASA STERIL (DARYAN TOLLE)YG DIRESAPI PCS 0 0 0


FRAMISETIN 0

149 KETOKONAZOLE TABLET 200 MG TABLET 0 0 0 0

150 KETOPROFEN 100 MG SUPPOSITORIA SUPP. 0 0 0 0

151 KLINDAMISIN KAPSUL 150 MG TABLET 0 0 0 0

152 KLINDAMISIN KAPSUL 300 MG KAPSUL 0 0 0 0

153 KLOBAZAM 10 MG TABLET TABLET 0 0 0 0

154 KLORAMFENIKOL KAPSUL 500 MG KAPSUL 0 0 0 0

155 KLORAMFENIKOL SALEP KULIT 2 % TUBE 0 0 0 0

156 KLORAMFENIKOL SALEP MATA 1 % TUBE 0 0 0 0

157 KLORAMFENIKOL SUSPENSI 125 MG/5 ML BOTOL 0 0 0 0

158 KLORAMFENIKOL TETES TELINGA 3 % BOTOL 0 0 0 0

KLORFENIRAMINE MALEAT (CTM) TABLET 4


159 MG TABLET 0 0 0 0

160 KLORPROMAZIN HCL INJEKSI 25 MG/ML 1 ML AMPUL 0 0 0 0

161 KLORPROMAZIN HCL INJEKSI 50 MG/ML 1 ML AMPUL 0 0 0 0

162 KLORPROMAZIN HCL TABLET 100 MG TABLET 0 0 0 0

163 KLOZAPIN 100 MG TABLET TABLET 0 0 0 0

164 KLOZAPIN 25 MG TABLET TABLET 0 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

165 KODEIN HCL TABLET 10 MG TABLET 0 0 0 0

166 KOTRIMOKSAZOL DEWASA TABLET TABLET 0 0 0 0

167 KOTRIMOKSAZOL SUSPENSI 60 ML BOTOL 0 0 0 0

168 LEVOFLOXACIN TABLET 500 MG TABLET 0 0 0 0

169 LIDOCAIN 2% INJ AMPUL 0 0 0 0

170 LIDOCAIN COMPOSITUM INJEKSI 2 ML AMPUL 3 3 0 3

171 LISOL CONCENTRATE 1000 ML BOTOL 0 0 0 0

172 LOPERAMIDE TABLET 2 MG TABLET 0 0 0 0

173 LORATADIN TABLET 10 MG TABLET 124 124 42 82

174 LORAZEPAM 2 MG TABLET 0 0 0 0

175 MAGNESIUM SULFAT INJEKSI (IV) 40 % 25 ML AMPUL 0 0 0 0

176 MASKER EARLOOP PLUS PCS 0 0 0 0

177 MASKER KERTAS 3 PLY EAR LOOP PCS 0 0 0 0

178 MASKER KERTAS 3 PLY TIE ON PCS 0 0 0 0

179 MASKER N95 PCS 0 0 0 0

180 MELOKSIKAM TABLET 7,5 MG TABLET 0 0 0 0

181 METAMIZOL (NORAGES) INJEKSI 500 MG/2ML AMPUL 0 0 0 0

182 METFORMIN TABLET 500 MG TABLET 100 100 5 95

183 METILERGOMETRIN MALEAT INJEKSI 0,200 AMPUL 0 0 0


MG 1 ML 0

184 METILERGOMETRIN MALEAT TABLET 0,125 TABLET 0 0 0


MG 0

185 METILPREDNISOLON TABLET 4 MG TABLET 0 0 0 0

186 METOKLOPRAMIDE 10 MG TABLET TABLET 0 0 0 0

187 METOKLOPRAMIDE 5 MG TABLET TABLET 0 0 0 0

188 METOKLOPROMIDE (SOTATIC) INJEKSI 5 AMPUL 0 0 0


MG/ML 2 ML 0

189 METOKLOPROMIDE SIRUP BOTOL 0 0 0 0

190 METRONIDAZOL + NYSTATIN VAG. VIAL 0 0 0


(PROVAGIN) INJEKSI 0

191 METRONIDAZOL TABLET 250 MG TABLET 0 0 0 0

192 METRONIDAZOL TABLET 500 MG TABLET 0 0 0 0

193 METRONIDAZOLE INFUS 5 MG/ML 100 ML BOTOL 0 0 0 0

194 MIKONAZOL KREAM 10 GR TUBE 3 3 1 2

195 MINERAL MIX SACHET 0 0 0 0

196 NATRIUM DIKLOFENAK TABLET 25 MG TABLET 314 314 44 270

197 NATRIUM DIKLOFENAK TABLET 50 MG TABLET 0 0 0 0

198 NATRIUM KLORIDA INFUS 0,9 % STERIL BOTOL 3 3 1 2

199 NIFEDIPINE TABLET 10 MG TABLET 0 0 0 0

200 NISTATIN TABLET 500.000 UI TABLET 37 37 6 31

201 NISTATIN VAGINAL TABLET 100.000 UI VAGTAB 8 8 0 8

202 OBAT BATUK HITAM (OBH) CAIRAN 100 ML BOTOL 0 0 0 0

203 OKSIGEN NASAL CANNULA ADULT PCS 0 0 0 0

204 OKSIGEN NASAL CANNULA INFANT PCS 0 0 0 0

205 OKSITETRACYCLIN SALEP KULIT 3 % 5 GR TUBE 0 0 0 0

206 OKSITETRACYCLIN SALEP MATA 1 % 3,5 GR TUBE 0 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

207 OKSITOSIN INJEKSI 10 IU/ML 1 ML AMPUL 0 0 0 0

208 OMEPRAZOLE TABLET 20 MG KAPSUL 0 0 0 0

209 ONDANSENTRON 4 MG/2 ML INJEKSI AMPUL 0 0 0 0

210 PARACETAMOL SYRUP 120 MG/5 ML 60 ML BOTOL 0 20 20 4 16

211 PARACETAMOL TABLET 500 MG TABLET 0 300 300 300

212 PARACETAMOL TETES 100 MG/ML 15 ML BOTOL 0 0 0 0

213 PEHAVRAL TABLET TABLET 0 0 0 0

214 PERAK SULFADIAZIN KRIM 1 % TUBE 0 0 0 0

215 PERHYDROL [ H2O2 ] 3 % 800 ML BOTOL 0 0 0 0

216 PERMETHRINE 5% CR 15 GRAM TUBE 0 0 0 0

217 PIRACETAM TABLET 800 MG TABLET 0 0 0 0

218 PIRANTEL PAMOAT TABLET TABLET 0 0 0 0

219 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG TABLET 0 0 0 0

220 PIROKSIKAM KAPSUL 10 MG KAPSUL 0 0 0 0

221 PLESTER 10 CM X 2 M ROL 0 0 0 0

222 PREDNISON TABLET 5 MG TABLET 0 0 0 0

223 PROPRANOLOL HCL TABLET 40 MG TABLET 0 0 0 0

224 PROPILTHIOURACIL TABLET 100 MG TABLET 0 0 0 0

225 RANITIDIN INJEKSI 25 MG/ ML AMPUL 0 0 0 0

226 RESPERIDON 2 MG TABLET TABLET 0 0 0 0

227 RINGER LAKTATE LARUTAN INFUS STERIL BOTOL 0 0 0 0

228 SALBUTAMOL TABLET 2 MG TABLET 100 100 0 100

229 SALBUTAMOL TABLET 4 MG TABLET 0 0 0 0

230 SALEP 2-4 KOMBINASI 30 GR POT 4 4 0 4

231 SALICYL BEDAK 2 % KOTAK 0 0 0 0

232 SARUNG TANGAM NON STERIL L PCS 0 0 0 0

233 SARUNG TANGAN NON STERIL M PCS 110 110 41 69

234 SARUNG TANGAN NON STERIL S PCS 0 0 0 0

235 SARUNG TANGAN STERIL NO 6 PSG 0 0 0 0

236 SARUNG TANGAN STERIL NO. 7,5 PSG 0 0 0 0

237 SARUNG TANGAN STERILE NO.6,5 PSG 0 0 0 0

238 SARUNG TANGAN STERILE NO.7 PSG 3 3 0 3

239 SEFADROKSIL KAPSUL 500 MG KAPSUL 0 0 0 0

240 SEFIKSIM KAPSUL 100 MG KAPSUL 0 0 0 0

SERUM ANTI BISA ULAR POLIVALEN INJ.5 ML


241 VIAL 0 0 0 0
(ABU I)
SERUM ANTI TETANUS INJEKSI 1.500 IU/AMP
242 VIAL 0 0 0 0
(ATS)

243 SETIRIZINE TABLET 10 MG TABLET 14 100 114 102 12

244 SIANOKOBALAMIN ( VIT B12 ) INJEKSI 500 AMPUL 0 0 0 0


MCG/ML 1 ML

245 SIANOKOBALAMIN ( VIT B12 ) TABLET 50 MCG TABLET 216 216 14 202

246 SILK (BENANG BEDAH SUTERA) NO.3/0 PCS 1 1 0 1

247 SIMETIDINE TABLET 200 MG TABLET 0 0 0 0

248 SIMVASTATIN TABLET 10 MG TABLET 0 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

249 SIPROFLOXACIN INFUS 2% BOTOL 0 0 0 0

250 SIPROFLOXACIN TABLET 500 MG TABLET 0 0 0 0

251 SPONS GELATIN CUBICLES 1x1x1 CM PCS 0 0 0 0

252 STIMUNO SYR BOTOL 0 0 0 0

253 STIMUNO TAB (100) TABLET 0 0 0 0

254 STIMUNO TAB (30) BOTOL 0 0 0 0

255 SULFADOKSIN TABLET TABLET 0 0 0 0

SULFASETAMID NATRIUM TETES MATA 15 %


256 BOTOL 0 0 0 0
5 ML

257 TABLET TAMBAH DARAH TABLET 1,113 1,113 461 652

TEMPORARY CAVITY SEALER [TUMPATAN


258 PCS 0 0 0 0
SEMENTARA] (CAVIT G)

259 TETAGRAM 150 IU AMPUL 0 0 0 0

260 TETRAKAIN HCL TETES MATA 5 ML BOTOL 0 0 0 0

261 TETRASIKLIN HCL TABLET 500 MG KAPSUL 0 0 0 0

262 THIAMIN HCL (VIT B1) INJEKSI 100 MG/ML 1 ML AMPUL 0 0 0 0

THIAMIN HCL MONONITRAT (VIT B1) TABLET


263 TABLET 0 0 0 0
100 MG
THIAMIN HCL MONONITRAT (VIT B1) TABLET
264 TABLET 0 0 0 0
50 MG

265 TRAMADOL INJEKSI 50 MG/ML AMPUL 0 0 0 0

266 TRANFUSION SET ADULT WITH Y INJECTION PCS 0 0 0 0

267 TRIFLOUPERASIN TABLET 5 MG TABLET 0 0 0 0

268 TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2 TABLET 0 0 0


MG 0

269 VITAMIN B COMPLEX TABLET TABLET 245 245 165 80

270 YODIUM POVIDON LARUTAN 10 % 30 ML BOTOL 0 0 0 0

271 YODIUM POVIDON LARUTAN 10% 60 ML BOTOL 0 0 0 0

272 ZENTRA (TRIPROLIDINE|PSEUDOEPHEDRINE) TABLET 0 0 0 0

273 ZINK 20 MG TABLET TABLET 100 100 0 100

274 Hi-D 1000 CHOLECALCIFEROL TABLET 0 0 0 0

OBAT PROGRAM / HIBAH

1 AMITRIPTYLINE 25 MG TABLET 0 0 0

2 HALOPERIDOLE INJEKSI AMPUL 0 0 0

3 HALOPERIDOLE 1,5 MG TABLET 0 0 0

4 HALOPERIDOLE 5 MG TABLET 0 0 0

5 LODOMER 2 MG TABLET 0 0 0

6 LODOMER 5 MG TABLET 0 0 0

7 TRIHEXYPHENIDYL 2 MG TABLET 0 0 0

8 ALAT SUNTIK 0,05 ML (PROGRAM) PCS 0 0 0

9 ALAT SUNTIK 0,5 ML (PROGRAM) PCS 0 0 0

10 ALAT SUNTIK 5 ML (PROGRAM) PCS 0 0 0

11 ALBENDAZOL TABLET 400 MG TABLET 0 0 0

12 BENZATINE BENZYLPENICILLIN 2.400.000 IU VIAL 0 0 0

13 COTRIMOXAZOLE 800/160 TABLET 0 0 0

14 DIETHYLCARBAMAZINE 100 MG TABLET 0 0 0

15 GARAM ORALIT UNTUK 200 ML AIR SACHET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

16 HIV ABACAVIR TABLET 300 MG BOTOL 0 0 0

17 HIV ACRIPTEGA (TDF 300 + 3TC 300 + DTG 50) BOTOL 0 0 0

18 HIV DOLUTEGRAFIR 50 MG BOTOL 0 0 0

19 HIV EFAFIRENZ 200 MG TABLET BOTOL 0 0 0

20 HIV EFAFIRENZ 600 MG TABLET BOTOL 0 0 0

21 HIV LAMIVUDIN 150 MG TABLET BOTOL 0 0 0

22 HIV NEVIRAPINE 200 MG TABLET BOTOL 0 0 0

23 HIV TENOFOVIR 300 MG BOTOL 0 0 0


HIV TRIPLE FDC ANAK (ZIDOVUDIN
24 BOTOL 0 0 0
60MG+LAMIVUDIN 30MG+NEVIRAPINE 50MG)
HIV TRIPLE FDC DEWASA (TDC+3TC+EFV
25 BOTOL 0 0 0
(300/300/600))

26 HIV ZIDOVUDINE 100 MG @60 KAPSUL BOTOL 0 0 0

27 HIV ZIDOVUDINE 300 MG + LAMIVUDIN 150 MG BOTOL 0 0 0

28 HIV ZIDOVUDINE SYRUP 240 ML BOTOL 0 0 0

29 IODINE TES PCS 0 0 0

30 ISONIAZID TABLET 100 MG TABLET 0 0 0

31 ISONIAZID TABLET 300 MG TABLET 0 0 0

KOMBIPAK AZITHROMYCIN - CEFIXIME


32 TABLET 0 0 0
KOMBINASI

33 MDT COMBI - MB ADULT (RED) BLISTER 0 0 0

34 MDT COMBI - MB CHILD (ORANGE) BLISTER 0 0 0

35 MDT COMBI - PB ADULT (GREEN) BLISTER 0 0 0

36 OBAT ANTI TUBERKULOSIS ANAK PAKET 0 0 0

37 OBAT ANTI TUBERKULOSIS DOSIS HARIAN PAKET 0 0 0


STOP TB KIT

38 OBAT ANTI TUBERKULOSIS KATEGORI 1 PAKET 0 0 0

39 OBAT ANTI TUBERKULOSIS KATEGORI 2 PAKET 0 0 0

40 OBAT ANTI TUBERKULOSIS KOMBIPAK PAKET 0 0 0


KATEGORI I

41 PARACETAMOL 500 MG (P2) TABLET 0 0 0

42 PIRIDOKSIN 25 MG TABLET (VIT B6) TABLET 0 0 0

43 PYRIMETAMINE TABLET 0 0 0

44 REAGEN HIV (FOKUS) PCS 0 0 0

45 REAGEN HIV (STANDART DIAGNOSTIC/SD) PCS 0 0 0

46 REAGEN HIV (VIKIA) PCS 0 0 0

REAGEN HIV DIAGNOSTAR HIV 1\/2 ONE STEP


47 PCS 0 0 0
RAPID TEST
48 REAGEN HIV DIAGNOSTIC KIT FOR HIV (1+2) PCS 0 0 0
ANTIBODY (COLLOIDAL GOLD) V2 PAKET
49 REAGEN SYPHILIS (TREPOCHECK) PCS 0 0 0

50 REAGEN SYPHILIS RDT (FOKUS) PCS 0 0 0

51 RETINOL ( VIT A ) KAPSUL 100.000 IU KAPSUL 0 0 0

52 RETINOL ( VIT A ) KAPSUL 200.000 IU KAPSUL 0 0 0

53 SAFETY BOX PCS 0 0 0

SERUM ANTI DIFTERI CAIRAN INJEKSI 125


54 MG/ML VIAL 0 0 0

55 TABLET TAMBAH DARAH (PROGRAM) TABLET 0 0 0

56 ZINK TABLET DISPERSIBLE 20 MG (PROGRAM) TABLET 0 0 0

57 ALBENDAZOLE SIRUP BOTOL 0 0 0

58 COTRIMOXAZOLE 400/80 TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

59 MINERAL MIX SACHET 0 0 0

60 SD BIOLINE Syphilis 3.0 One Step Syphilis PCS 0 0 0


Antibody Test

OBAT TAMBAHAN

1 ALKOHOL SWAB 0 0 0 0 0

2 ALLOPURINOL 100 100 36 64

3 AMLODIPINE 5MG (BLUD) 338 338 30 308

4 ANTISEPTIK GEL (DINKES) 0 0 0 0

5 APD VAKSIN 0 0 0 0

6 APRON (DINKES) 0 0 0 0

7 AQUA PRO INJEKSI (BLUD) 0 0 0 0

8 ASAM MEFENAMAT TABLET 500 MG (BLUD) 284 284 72 212

9 ASIKLOVIR TABLET 46 46 0 46

10 BETAMETHASONE SALEP KULIT (BLUD) 0 0 0 0

11 BIOPLACENTON (BLUD) 2 2 1 1

12 BISAKODIL TABLET 5 MG (BLUD) 0 0 0 0

13 CIPROFLOXACIN (BLUD) 0 0 0 0

14 CLINDAMISIN KAPS (BLUD) 0 0 0 0

DEKSAMETHASONE HARSEN TABLET 0,5 MG


15 ((BLUD) ) 258 258 258 0

16 DOMPERIDONE TABLET 10 MG ( (BLUD)) 112 112 51 61

17 EPINEFRIN INJEKSI (BLUD) 0 0 0 0

18 FENITOIN KAPS (BLUD) 0 0 0 0

19 FITOMENADION INJ (BLUD) 0 0 0 0

20 FITOMENADION TABLET (BLUD) 0 0 0 0

21 FUROSEMIDE TABLET 0 0 0 0

22 GEMFIBROZIL (BLUD) 88 88 36 52

23 GENOINT (BLUD) 0 0 0 0

24 GENTAMICIN TETES MATA (BLUD) 0 5 5 5 0

25 GENTIAN VIOLET LARUTAN 1 % (BLUD) 2 2 0 2

26 GLISERIL GUAIKOLAT/GUAIFENESIN BLUD 204 204 168 36

27 HIDROKORTISON CREAM KULIT (BLUD) 7 7 2 5

HYOSCINE BUTYLBROMIDE (ANTI SPASMODIK


28 100 100 0 100
BLUD)

29 HYPAFIX (BLUD) 0 0 0 0

30 INFUSET (BLUD) 0 0 0 0

31 IV CATHETER (BLUD) 0 0 0 0

32 KAPTOPRIL TABLET 12,5 MG (BLUD) 454 454 6 448

33 KLORAMFENIKOL SIRUP (BLUD) 0 0 0 0

34 KLORAMFENIKOL TETES TELINGA (BLUD) 8 8 0 8

35 KOTRIMOKSAZOL TAB (BLUD) 0 100 100 0 100

36 LOPERAMIDE TABLET 2 MG (BLUD) 0 0 0 0

37 MASKER (DINKES) 0 0 0 0

38 MASKER N9 0 0 0 0

39 METFORMIN (BLUD) 45 45 45 0
SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

40 METILERGOMETRINE INJ (BLUD) 0 0 0 0

41 MULTIVITAMIN KOMB 0 0 0 0

42 NEW DIATABS (BLUD) 24 24 20 4

43 NIFEDIPINE TAB (BLUD) 0 0 0 0

44 NURSE CAP 0 0 0 0

45 OMEPRAZOLE 20MG 102 102 20 82

46 ONDANSETRONE INJEKSI (BLUD) 0 0 0 0

47 PARACETAMOL TABLET 500 MG (BLUD) 911 911 577 334

48 PEHAVRAL 0 0 0 0

49 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG (BLUD) 269 269 2 267

50 PIROXICAM 0 0 0 0

51 SALBUTAMOL TABLET 2 MG (BLUD) 21 21 0 21

52 SARUNG TANGAN OBGYN 0 0 0 0

53 SARUNG TANGAN OBGYN 0 0 0 0

54 SEFADROKSIL KAPSUL 500 MG (BLUD) 0 0 0 0

55 VGEL (BLUD) 0 0 0 0

56 VITAMIN C 50 MG (BLUD) 456 456 83 373

57 ZIVIT ZINC 114 114 34 80

58 ASETIL (DINKES) 0 0 0 0

59 DEXAMETHASONE (DINKES) 0 0 0 0

60 OBH (DINKES) 5 5 1 4

61 AMBROXOL 0 0 0

62 BATUK FLU SIRUP (ETAFLUSIN) 0 0 0

63 BATUK FLU TABLET (ETAFLUSIN) 0 0 0

64 BETADINE GARGLE 0 0 0

65 BUFACOMB SALEP 0 0 0

66 BUFACORT - N 0 0 0

67 DARYANTULLE 0 0 0

68 ETIL KLORIDA SPRAY 0 0 0

69 GLIBENCLAMIDE TABLET 5 MG 0 0 0

70 GLIMEPIRIDE 2 MG TABLET 0 0 0

71 KAOLIN PEKTIN SIRUP (NOVADIAR) 0 0 0

72 PIRACETAM KAPSUL 0 0 0

73 TIAMFENIKOL KAPSUL 0 0 0

74 VITAMIN ANAK SIRUP (SAMCOVIT) 0 0 0

75 0 0 0

76 0 0 0

77 0 0 0

78 0 0 0

79 0 0 0

80 0 0 0

Blitar , 01 July 2022


Mengetahui / Menyetujui
Yang Menerima, Yang Menyerahkan,
Kepala Puskesmas Petugas Petugas Pengelola Obat
SANANKULON Instalasi Farmasi Kabupaten Pustu/Polindes/Ponkesdes
SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

ENDAH ROSITANINGSIH, SE, MM Apt. AINA MUJTAHIDA A, S.Farm. APRILLIA YUDHA A.S.
NIP. 196912302010012002 NIP : 198612188 11033 2 0004 NIP. 199104082015022002
-59

141
DINAS KESEHATAN KABUPATEN BLITAR
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)
WILAYAH : SUMBERINGIN PELAPORAN BULAN : JULI
PUSKESMAS : SANANKULON PERMINTAAN BULAN : AGUSTUS
KECAMATAN : SANANKULON
KABUPATEN : BLITAR
PROVINSI : JAWA TIMUR

SISA STOK JUMLAH


NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

1 2 WAY FOLEY CATHETER NO.16 PCS 0 0 0 0

2 2 WAY FOLEY CATHETER NO.18 PCS 0 0 0 0

3 2 WAY FOLEY CATHETER NO.20 PCS 0 0 0 0

4 ACETYLCYSTEINE CAPSULE 200 MG CAPSULE 54 54 14 40

5 ALAT SUNTIK SEKALI PAKAI 1 ML PCS 0 0 0 0

6 ALAT SUNTIK SEKALI PAKAI 10 ML PCS 0 0 0 0

7 ALAT SUNTIK SEKALI PAKAI 20 ML PCS 0 0 0 0

8 ALAT SUNTIK SEKALI PAKAI 3 ML PCS 50 50 10 40

9 ALAT SUNTIK SEKALI PAKAI 5 ML PCS 77 77 7 70

10 ALKOHOL SWAB PCS 0 0 0 0

11 ALLOPURINOL TABLET 100 MG TABLET 0 0 0 0

12 ALPRAZOLAM 1 MG TABLET TABLET 0 0 0 0

13 AMBROXOL SIRUP 5MG/ML BOTOL 0 0 0 0

14 AMBROXOL TABLET 30 MG TABLET 0 0 0 0

15 AMINOPHYLLINE INJEKSI 24 MG/ML 10 ML AMPUL 0 0 0 0

16 AMINOPHYLLINE TABLET 200 MG TABLET 0 0 0 0

17 AMITRIPTYLLINE HCL TABLET 25 MG TABLET 0 0 0 0

18 AMLODIPINE TABLET 10 MG TABLET 0 0 0 0

19 AMLODIPINE TABLET 5 MG TABLET 0 0 0 0

20 AMOKSISILIN DRY SYRUP 125 MG/5 ML 60 ML BOTOL 0 0 0 0

21 AMOKSISILIN SERBUK INJEKSI 1000 MG VIAL 0 0 0 0

22 AMOKSISILIN TABLET 500 MG KAPLET 132 200 332 68 264

AMOXCICILIN FORTE SYRUP KERING


23 250MG/5ML BOTOL 0 0 0 0

24 AMPICILLIN SERBUK INJEKSI 1.000 MG VIAL 0 0 0


MG/VIAL 0

25 ANTALGIN 500 MG TABLET (METAMIZOL) TABLET 0 0 0 0

26 ANTASIDA DOEN TABLET KOMBINASI TABLET 90 200 290 85 205

27 ANTASIDA SUSPENSI 60 ML BOTOL 3 3 3 0

28 ANTI BAKTERI DOEN SALEP KOMBINASI 5 GR POT 0 0 0 0

29 ANTI FUNGI DOEN SALEP KOMBINASI 30 GR POT 4 4 0 4

30 ANTI HAEMOROID DOEN KOMBINASI SUPP. 0 0 0 0

31 ANTI MIGRAIN DOEN TABLET KOMBINASI TABLET 0 0 0 0

32 ANTI SPASMODIK INJEKSI (SPASHI) AMPUL 0 0 0 0

33 ANTI SPASMODIK TABLET (DORMICOMP) TABLET 0 0 0 0

AQUA PRO INJEKSI STERIL BEBAS PIROGEN 20


34 BOTOL 0 0 0 0
ML

35 ASAM ASKORBAT ( VIT C ) TABLET 250 MG TABLET 0 0 0 0

36 ASAM ASKORBAT ( VIT C ) TABLET 50 MG TABLET 0 0 0 0

37 ASAM FOLAT 1MG TABLET TABLET 0 0 0 0

38 ASAM MEFENAMAT TABLET 500 MG TABLET 0 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

39 ASAM TRANEKSAMAT 100 MG/ML INJEKSI AMPUL 0 0 0 0

40 ASAM TRANEKSAMAT 500 MG TABLET TABLET 0 0 0 0

41 ASAM VALPROAT 250 MG TABLET / TABLET 0 0 0


DEPAKOTE ER 0

42 ASEPTAN 500CC + PUMP BOTOL 0 0 0 0

43 ASEPTIC GEL 500CC + DISPENSER BOTOL 0 0 0 0

44 ASERING (ASETAT RINGER) SOFT BAG BOTOL 0 0 0 0

45 ASETOSAL TABLET 100 (80) MG TABLET 0 0 0 0

46 ASIKLOVIR KREAM 5 % 5 GR TUBE 0 0 0 0

47 ASIKLOVIR TABLET 400 MG TABLET 0 0 0 0

48 ATROPIN SULFAT INJEKSI 0,25 MG/ML 1 ML AMPUL 0 0 0 0

49 ATTAPULGIT + PECTIN TABLET TABLET 0 0 0 0

50 BETAHISTINE MESILAT 24 MG TABLET TABLET 0 0 0 0

51 BETAHISTINMESILAT 6 MG TABLET TABLET 0 0 0 0

52 BETAMETHASON CR 0.05% 20 GR TUBE 1 1 1 0

53 BETAMETHASONE CREAM 0,1 % 5 GR TUBE 0 0 0 0

54 BIONICOM ZINC TABLET TABLET 0 0 0 0

55 BISAKODIL SUPPOSITORIA 10 MG SUPP. 0 0 0 0

56 BISAKODIL SUPPOSITORIA 5 MG SUPP. 0 0 0 0

57 BISOPROLOL 2,5 MG TABLET (CONCOR) TABLET 0 0 0 0

58 BISOPROLOL 5 MG TABLET TABLET 0 0 0 0

59 CAT GUT NO. 3/0 CHROMIC PCS 1 1 0 1

60 CAT GUT NO. 3/0 PLAIN PCS 1 1 0 1

61 CITICHOLIN 250 MG/ML-2ML INJEKSI AMPUL 0 0 0 0

62 CLONIDINE 0.15 MG TABLET TABLET 0 0 0 0

63 CLOPIDOGREL 75 MG TABLET 0 0 0 0

64 COMBIVENT UDV INHALASI VIAL 0 0 0 0

65 DEKSAMETHASONE INJEKSI 5 MG/ML 1 ML AMPUL 0 0 0 0

66 DEKSAMETHASONE TABLET 0,5 MG TABLET 0 0 0 0

67 DEVITALISASI PASTA ( NON ARSEN ) POT 0 0 0 0

68 DIAZEPAM INJEKSI 5 MG/ML 2 ML AMPUL 0 0 0 0

DIAZEPAM LARUTAN RECTAL 5MG/ 2,5ML-


69 TUBE 0 0 0 0
STESOLID

70 DIAZEPAM TABLET 2 MG TABLET 0 0 0 0

71 DIAZEPAM TABLET 5 MG TABLET 0 0 0 0

72 DIFENHIDRAMINE HCL INJEKSI 10 MG/ML 1 ML AMPUL 0 0 0 0

73 DIGOXIN TABLET 0,25 MG TABLET 0 0 0 0

74 DIMENHYDRINATE TABLET 50 MG TABLET 0 0 0 0

75 DOKSISIKLIN TABLET 100 MG KAPSUL 0 0 0 0

76 DOMPERIDON SUSPENSI 5MG/ML BOTOL 0 5 5 1 4

77 DOMPERIDON TABLET 10 MG TABLET 0 0 0 0

78 EKSTRACT PLASENTA + NEOMYSIN SALEP 15 TUBE 0 0 0


GR 0

79 EPINEFRIN (ADRENALIN) HCL INJ.0,1 % 1 ML AMPUL 0 0 0 0

80 ERITROMISIN KAPSUL 250 MG KAPSUL 0 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

81 ERITROMISIN SIRUP KERING 200 MG/5ML BOTOL 0 0 0 0

82 ERITROMISIN TABLET 500 MG KAPSUL 0 0 0 0

83 ETAKRIDIN ( RIVANOL ) LARUTAN 0,1 % 300 BOTOL 0 0 0


ML 0

84 ETANOL [ ALKOHOL ] 70 % 1000 ML BOTOL 0 0 0 0

85 ETIL KLORIDA SEMPROT 100 ML BOTOL 0 0 0 0

86 EUGENOL CAIRAN 10 ML BOTOL 0 0 0 0

87 FENITOIN NATRIUM INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0 0

88 FENITOIN NATRIUM TABLET 100 MG KAPSUL 0 0 0 0

89 FENOBARBITAL INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0 0

90 FENOBARBITAL TABLET 30 MG TABLET 0 0 0 0

91 FENOL GLISEROL TETES TELINGA 10 % 5 ML BOTOL 2 2 0 2

FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML 1


92 AMPUL 0 0 0 0
ML
FITOMENADION ( VIT K1 ) TABLET SALUT 10
93 TABLET 0 0 0 0
MG

94 FITOMENADION INFANT INJ. 2MG/ML AMPUL 0 0 0 0

FLUPHENASINE DEKANOAT INJEKSI 25 MG 1


95 AMPUL 0 0 0 0
ML

96 FUROSEMID INJEKSI 10 mg VIAL 0 0 0 0

97 FUROSEMID TABLET 40 MG TABLET 66 66 0 66

GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 %


98 10 GR TUBE 2 2 1 1

99 GARAM ORALIT SACHET 95 95 3 92

100 GEMFIBROZIL 300 MG KAPSUL KAPSUL 0 0 0 0

101 GENTAMISIN SALEP KULIT 0,1 % 5 GR TUBE 0 0 0 0

102 GENTAMISIN SALEP MATA 0,3% TUBE 0 10 10 1 9

103 GENTAMISIN TETES MATA 0,3% BOTOL 0 0 0 0

104 GLASS IONOMER CEMENT ( GC IX ) BOTOL 0 0 0 0

105 GLIBENCLAMIDE TABLET 5 MG TABLET 0 0 0 0

106 GLICERIL GUAIACOLAT TABLET 100 MG TABLET 0 0 0 0

107 GLIMEPIRIDE 1 MG TABLET TABLET 0 0 0 0

108 GLIMEPIRIDE 2 MG TABLET TABLET 178 178 0 178

GLUKOSA 40% DEXTROSE INJECTION U.S.P


109 VIAL 0 0 0 0
CAIRAN INJEKSI

110 GLUKOSA LARUTAN INFUS 10 % STERIL BOTOL 0 0 0 0

111 GLUKOSA LARUTAN INFUS 5 % STERIL BOTOL 0 0 0 0

112 GRISEOFULVIN TABLET 125 MG TABLET 0 0 0 0

113 HALOPERIDOL 2 MG TABLET 0 0 0 0

114 HALOPERIDOL DEKANOAT INJ 50 MG VIAL 0 0 0 0

115 HALOPERIDOL INJ. 5 MG/ML (LODOMER) AMPUL 0 0 0 0

116 HALOPERIDOL TABLET 1,5 MG TABLET 0 0 0 0

117 HALOPERIDOL TABLET 5 MG TABLET 0 0 0 0

118 HERBAKOF SYRUP 60ML BOTOL 0 10 10 1 9

119 HES-HYDROXYETHYL STARCH 6 %/VOLUVEN BOTOL 0 0 0


INFUS 500 ML 0

120 HIDROCORTISON CR 1% TUBE 0 0 0 0

121 HIDROCORTISONE CREAM 2,5 % 5 GR TUBE 0 0 0 0

122 HYDROCHLORTHIAZIDE 25 MG TABLET 0 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

123 I.V CATHETER NO.16 WITH INJECTION PORT PCS 0 0 0 0

124 I.V CATHETER NO.18 WITH INJECTION PORT PCS 0 0 0 0

125 I.V CATHETER NO.20 WITH INJECTION PORT PCS 0 0 0 0

126 I.V CATHETER NO.22 WITH INJECTION PORT PCS 0 0 0 0

127 I.V CATHETER NO.24 WITH INJECTION PORT PCS 0 0 0 0

128 I.V CATHETER NO.26 WITH INJECTION PORT PCS 0 0 0 0

129 IBUPROFEN FORTE SYRUP 200MG/5ML BOTOL 0 0 0 0

130 IBUPROFEN SUSPENSI 100 MG/5 ML 60 ML BOTOL 0 5 5 1 4

131 IBUPROFEN TABLET 400 MG TABLET 0 0 0 0

132 INFUSION SET ANAK PCS 0 0 0 0

133 INFUSION SET DEWASA PCS 0 0 0 0

134 ISOSORBIDE DINITRATE SUBLINGUAL 5 MG TABLET 0 0 0 0

135 KAEN 3B BOTOL 0 0 0 0

136 KALIUM DIKLOFENAK 50 MG TABLET TABLET 0 0 0 0

KALSIUM GLUCONAS INJEKSI 100 MG/ML 10


137 AMPUL 0 0 0 0
ML

138 KALSIUM LAKTAT (KALK) TABLET 500 MG TABLET 270 300 570 450 120

139 KANTONG URINE DEWASA PCS 0 0 0 0

140 KAPAS PEMBALUT/ABSORBEN 250 GR BKS 0 0 0 0

141 KAPTOPRIL TABLET 25 MG TABLET 0 0 0 0

142 KARBAMAZEPIN TABLET 200 MG TABLET 0 0 0 0

143 KASA KOMPRES 40/40 STERIL BKS 3 3 0 3

144 KASA PEMBALUT HIDROFIL 16 X 16 CM STRIL ROL 3 3 0 3

145 KASA PEMBALUT HIDROFIL 2 M X 80 CM ROL 2 2 0 2

146 KASA PEMBALUT HIDROFIL 4 M X 10 CM ROL 0 0 0 0

147 KASA PEMBALUT HIDROFIL 4 M X 5 CM ROL 10 10 0 10

148 KASA STERIL (DARYAN TOLLE)YG DIRESAPI PCS 0 0 0


FRAMISETIN 0

149 KETOKONAZOLE TABLET 200 MG TABLET 0 0 0 0

150 KETOPROFEN 100 MG SUPPOSITORIA SUPP. 0 0 0 0

151 KLINDAMISIN KAPSUL 150 MG TABLET 0 0 0 0

152 KLINDAMISIN KAPSUL 300 MG KAPSUL 0 0 0 0

153 KLOBAZAM 10 MG TABLET TABLET 0 0 0 0

154 KLORAMFENIKOL KAPSUL 500 MG KAPSUL 0 0 0 0

155 KLORAMFENIKOL SALEP KULIT 2 % TUBE 0 0 0 0

156 KLORAMFENIKOL SALEP MATA 1 % TUBE 0 0 0 0

157 KLORAMFENIKOL SUSPENSI 125 MG/5 ML BOTOL 0 0 0 0

158 KLORAMFENIKOL TETES TELINGA 3 % BOTOL 0 0 0 0

KLORFENIRAMINE MALEAT (CTM) TABLET 4


159 MG TABLET 0 0 0 0

160 KLORPROMAZIN HCL INJEKSI 25 MG/ML 1 ML AMPUL 0 0 0 0

161 KLORPROMAZIN HCL INJEKSI 50 MG/ML 1 ML AMPUL 0 0 0 0

162 KLORPROMAZIN HCL TABLET 100 MG TABLET 0 0 0 0

163 KLOZAPIN 100 MG TABLET TABLET 0 0 0 0

164 KLOZAPIN 25 MG TABLET TABLET 0 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

165 KODEIN HCL TABLET 10 MG TABLET 0 0 0 0

166 KOTRIMOKSAZOL DEWASA TABLET TABLET 0 0 0 0

167 KOTRIMOKSAZOL SUSPENSI 60 ML BOTOL 0 0 0 0

168 LEVOFLOXACIN TABLET 500 MG TABLET 0 0 0 0

169 LIDOCAIN 2% INJ AMPUL 0 0 0 0

170 LIDOCAIN COMPOSITUM INJEKSI 2 ML AMPUL 3 3 0 3

171 LISOL CONCENTRATE 1000 ML BOTOL 0 0 0 0

172 LOPERAMIDE TABLET 2 MG TABLET 0 0 0 0

173 LORATADIN TABLET 10 MG TABLET 82 82 38 44

174 LORAZEPAM 2 MG TABLET 0 0 0 0

175 MAGNESIUM SULFAT INJEKSI (IV) 40 % 25 ML AMPUL 0 0 0 0

176 MASKER EARLOOP PLUS PCS 0 0 0 0

177 MASKER KERTAS 3 PLY EAR LOOP PCS 0 0 0 0

178 MASKER KERTAS 3 PLY TIE ON PCS 0 0 0 0

179 MASKER N95 PCS 0 0 0 0

180 MELOKSIKAM TABLET 7,5 MG TABLET 0 0 0 0

181 METAMIZOL (NORAGES) INJEKSI 500 MG/2ML AMPUL 0 0 0 0

182 METFORMIN TABLET 500 MG TABLET 95 95 20 75

183 METILERGOMETRIN MALEAT INJEKSI 0,200 AMPUL 0 0 0


MG 1 ML 0

184 METILERGOMETRIN MALEAT TABLET 0,125 TABLET 0 0 0


MG 0

185 METILPREDNISOLON TABLET 4 MG TABLET 0 0 0 0

186 METOKLOPRAMIDE 10 MG TABLET TABLET 0 0 0 0

187 METOKLOPRAMIDE 5 MG TABLET TABLET 0 0 0 0

188 METOKLOPROMIDE (SOTATIC) INJEKSI 5 AMPUL 0 0 0


MG/ML 2 ML 0

189 METOKLOPROMIDE SIRUP BOTOL 0 0 0 0

190 METRONIDAZOL + NYSTATIN VAG. VIAL 0 0 0


(PROVAGIN) INJEKSI 0

191 METRONIDAZOL TABLET 250 MG TABLET 0 0 0 0

192 METRONIDAZOL TABLET 500 MG TABLET 0 0 0 0

193 METRONIDAZOLE INFUS 5 MG/ML 100 ML BOTOL 0 0 0 0

194 MIKONAZOL KREAM 10 GR TUBE 2 5 7 2 5

195 MINERAL MIX SACHET 0 0 0 0

196 NATRIUM DIKLOFENAK TABLET 25 MG TABLET 270 100 370 36 334

197 NATRIUM DIKLOFENAK TABLET 50 MG TABLET 0 0 0 0

198 NATRIUM KLORIDA INFUS 0,9 % STERIL BOTOL 2 2 1 1

199 NIFEDIPINE TABLET 10 MG TABLET 0 0 0 0

200 NISTATIN TABLET 500.000 UI TABLET 31 31 0 31

201 NISTATIN VAGINAL TABLET 100.000 UI VAGTAB 8 8 0 8

202 OBAT BATUK HITAM (OBH) CAIRAN 100 ML BOTOL 0 0 0 0

203 OKSIGEN NASAL CANNULA ADULT PCS 0 0 0 0

204 OKSIGEN NASAL CANNULA INFANT PCS 0 0 0 0

205 OKSITETRACYCLIN SALEP KULIT 3 % 5 GR TUBE 0 0 0 0

206 OKSITETRACYCLIN SALEP MATA 1 % 3,5 GR TUBE 0 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

207 OKSITOSIN INJEKSI 10 IU/ML 1 ML AMPUL 0 0 0 0

208 OMEPRAZOLE TABLET 20 MG KAPSUL 0 0 0 0

209 ONDANSENTRON 4 MG/2 ML INJEKSI AMPUL 0 0 0 0

210 PARACETAMOL SYRUP 120 MG/5 ML 60 ML BOTOL 16 16 5 11

211 PARACETAMOL TABLET 500 MG TABLET 300 300 0 300

212 PARACETAMOL TETES 100 MG/ML 15 ML BOTOL 0 0 0 0

213 PEHAVRAL TABLET TABLET 0 0 0 0

214 PERAK SULFADIAZIN KRIM 1 % TUBE 0 0 0 0

215 PERHYDROL [ H2O2 ] 3 % 800 ML BOTOL 0 0 0 0

216 PERMETHRINE 5% CR 15 GRAM TUBE 0 5 5 0 5

217 PIRACETAM TABLET 800 MG TABLET 0 0 0 0

218 PIRANTEL PAMOAT TABLET TABLET 0 0 0 0

219 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG TABLET 0 0 0 0

220 PIROKSIKAM KAPSUL 10 MG KAPSUL 0 0 0 0

221 PLESTER 10 CM X 2 M ROL 0 0 0 0

222 PREDNISON TABLET 5 MG TABLET 0 0 0 0

223 PROPRANOLOL HCL TABLET 40 MG TABLET 0 0 0 0

224 PROPILTHIOURACIL TABLET 100 MG TABLET 0 0 0 0

225 RANITIDIN INJEKSI 25 MG/ ML AMPUL 0 0 0 0

226 RESPERIDON 2 MG TABLET TABLET 0 0 0 0

227 RINGER LAKTATE LARUTAN INFUS STERIL BOTOL 0 0 0 0

228 SALBUTAMOL TABLET 2 MG TABLET 100 100 0 100

229 SALBUTAMOL TABLET 4 MG TABLET 0 0 0 0

230 SALEP 2-4 KOMBINASI 30 GR POT 4 4 0 4

231 SALICYL BEDAK 2 % KOTAK 0 0 0 0

232 SARUNG TANGAM NON STERIL L PCS 0 0 0 0

233 SARUNG TANGAN NON STERIL M PCS 69 200 269 50 219

234 SARUNG TANGAN NON STERIL S PCS 0 0 0 0

235 SARUNG TANGAN STERIL NO 6 PSG 0 0 0 0

236 SARUNG TANGAN STERIL NO. 7,5 PSG 0 0 0 0

237 SARUNG TANGAN STERILE NO.6,5 PSG 0 0 0 0

238 SARUNG TANGAN STERILE NO.7 PSG 3 3 0 3

239 SEFADROKSIL KAPSUL 500 MG KAPSUL 0 0 0 0

240 SEFIKSIM KAPSUL 100 MG KAPSUL 0 0 0 0

SERUM ANTI BISA ULAR POLIVALEN INJ.5 ML


241 VIAL 0 0 0 0
(ABU I)
SERUM ANTI TETANUS INJEKSI 1.500 IU/AMP
242 VIAL 0 0 0 0
(ATS)

243 SETIRIZINE TABLET 10 MG TABLET 12 12 12 0

244 SIANOKOBALAMIN ( VIT B12 ) INJEKSI 500 AMPUL 0 0 0 0


MCG/ML 1 ML

245 SIANOKOBALAMIN ( VIT B12 ) TABLET 50 MCG TABLET 202 202 0 202

246 SILK (BENANG BEDAH SUTERA) NO.3/0 PCS 1 1 0 1

247 SIMETIDINE TABLET 200 MG TABLET 0 0 0 0

248 SIMVASTATIN TABLET 10 MG TABLET 0 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

249 SIPROFLOXACIN INFUS 2% BOTOL 0 0 0 0

250 SIPROFLOXACIN TABLET 500 MG TABLET 0 0 0 0

251 SPONS GELATIN CUBICLES 1x1x1 CM PCS 0 0 0 0

252 STIMUNO SYR BOTOL 0 0 0 0

253 STIMUNO TAB (100) TABLET 0 0 0 0

254 STIMUNO TAB (30) BOTOL 0 0 0 0

255 SULFADOKSIN TABLET TABLET 0 0 0 0

SULFASETAMID NATRIUM TETES MATA 15 %


256 BOTOL 0 0 0 0
5 ML

257 TABLET TAMBAH DARAH TABLET 652 652 472 180

TEMPORARY CAVITY SEALER [TUMPATAN


258 PCS 0 0 0 0
SEMENTARA] (CAVIT G)

259 TETAGRAM 150 IU AMPUL 0 0 0 0

260 TETRAKAIN HCL TETES MATA 5 ML BOTOL 0 0 0 0

261 TETRASIKLIN HCL TABLET 500 MG KAPSUL 0 0 0 0

262 THIAMIN HCL (VIT B1) INJEKSI 100 MG/ML 1 ML AMPUL 0 0 0 0

THIAMIN HCL MONONITRAT (VIT B1) TABLET


263 TABLET 0 0 0 0
100 MG
THIAMIN HCL MONONITRAT (VIT B1) TABLET
264 TABLET 0 0 0 0
50 MG

265 TRAMADOL INJEKSI 50 MG/ML AMPUL 0 0 0 0

266 TRANFUSION SET ADULT WITH Y INJECTION PCS 0 0 0 0

267 TRIFLOUPERASIN TABLET 5 MG TABLET 0 0 0 0

268 TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2 TABLET 0 0 0


MG 0

269 VITAMIN B COMPLEX TABLET TABLET 80 80 59 21

270 YODIUM POVIDON LARUTAN 10 % 30 ML BOTOL 0 0 0 0

271 YODIUM POVIDON LARUTAN 10% 60 ML BOTOL 0 0 0 0

272 ZENTRA (TRIPROLIDINE|PSEUDOEPHEDRINE) TABLET 0 0 0 0

273 ZINK 20 MG TABLET TABLET 100 100 0 100

274 Hi-D 1000 CHOLECALCIFEROL TABLET 0 0 0 0

OBAT PROGRAM / HIBAH

1 AMITRIPTYLINE 25 MG TABLET 0 0 0

2 HALOPERIDOLE INJEKSI AMPUL 0 0 0

3 HALOPERIDOLE 1,5 MG TABLET 0 0 0

4 HALOPERIDOLE 5 MG TABLET 0 0 0

5 LODOMER 2 MG TABLET 0 0 0

6 LODOMER 5 MG TABLET 0 0 0

7 TRIHEXYPHENIDYL 2 MG TABLET 0 0 0

8 ALAT SUNTIK 0,05 ML (PROGRAM) PCS 0 0 0

9 ALAT SUNTIK 0,5 ML (PROGRAM) PCS 0 0 0

10 ALAT SUNTIK 5 ML (PROGRAM) PCS 0 0 0

11 ALBENDAZOL TABLET 400 MG TABLET 0 0 0

12 BENZATINE BENZYLPENICILLIN 2.400.000 IU VIAL 0 0 0

13 COTRIMOXAZOLE 800/160 TABLET 0 0 0

14 DIETHYLCARBAMAZINE 100 MG TABLET 0 0 0

15 GARAM ORALIT UNTUK 200 ML AIR SACHET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

16 HIV ABACAVIR TABLET 300 MG BOTOL 0 0 0

17 HIV ACRIPTEGA (TDF 300 + 3TC 300 + DTG 50) BOTOL 0 0 0

18 HIV DOLUTEGRAFIR 50 MG BOTOL 0 0 0

19 HIV EFAFIRENZ 200 MG TABLET BOTOL 0 0 0

20 HIV EFAFIRENZ 600 MG TABLET BOTOL 0 0 0

21 HIV LAMIVUDIN 150 MG TABLET BOTOL 0 0 0

22 HIV NEVIRAPINE 200 MG TABLET BOTOL 0 0 0

23 HIV TENOFOVIR 300 MG BOTOL 0 0 0


HIV TRIPLE FDC ANAK (ZIDOVUDIN
24 BOTOL 0 0 0
60MG+LAMIVUDIN 30MG+NEVIRAPINE 50MG)
HIV TRIPLE FDC DEWASA (TDC+3TC+EFV
25 BOTOL 0 0 0
(300/300/600))

26 HIV ZIDOVUDINE 100 MG @60 KAPSUL BOTOL 0 0 0

27 HIV ZIDOVUDINE 300 MG + LAMIVUDIN 150 MG BOTOL 0 0 0

28 HIV ZIDOVUDINE SYRUP 240 ML BOTOL 0 0 0

29 IODINE TES PCS 0 0 0

30 ISONIAZID TABLET 100 MG TABLET 0 0 0

31 ISONIAZID TABLET 300 MG TABLET 0 0 0

KOMBIPAK AZITHROMYCIN - CEFIXIME


32 TABLET 0 0 0
KOMBINASI

33 MDT COMBI - MB ADULT (RED) BLISTER 0 0 0

34 MDT COMBI - MB CHILD (ORANGE) BLISTER 0 0 0

35 MDT COMBI - PB ADULT (GREEN) BLISTER 0 0 0

36 OBAT ANTI TUBERKULOSIS ANAK PAKET 0 0 0

37 OBAT ANTI TUBERKULOSIS DOSIS HARIAN PAKET 0 0 0


STOP TB KIT

38 OBAT ANTI TUBERKULOSIS KATEGORI 1 PAKET 0 0 0

39 OBAT ANTI TUBERKULOSIS KATEGORI 2 PAKET 0 0 0

40 OBAT ANTI TUBERKULOSIS KOMBIPAK PAKET 0 0 0


KATEGORI I

41 PARACETAMOL 500 MG (P2) TABLET 0 0 0

42 PIRIDOKSIN 25 MG TABLET (VIT B6) TABLET 0 0 0

43 PYRIMETAMINE TABLET 0 0 0

44 REAGEN HIV (FOKUS) PCS 0 0 0

45 REAGEN HIV (STANDART DIAGNOSTIC/SD) PCS 0 0 0

46 REAGEN HIV (VIKIA) PCS 0 0 0

REAGEN HIV DIAGNOSTAR HIV 1\/2 ONE STEP


47 PCS 0 0 0
RAPID TEST
48 REAGEN HIV DIAGNOSTIC KIT FOR HIV (1+2) PCS 0 0 0
ANTIBODY (COLLOIDAL GOLD) V2 PAKET
49 REAGEN SYPHILIS (TREPOCHECK) PCS 0 0 0

50 REAGEN SYPHILIS RDT (FOKUS) PCS 0 0 0

51 RETINOL ( VIT A ) KAPSUL 100.000 IU KAPSUL 0 0 0

52 RETINOL ( VIT A ) KAPSUL 200.000 IU KAPSUL 0 0 0

53 SAFETY BOX PCS 0 0 0

SERUM ANTI DIFTERI CAIRAN INJEKSI 125


54 MG/ML VIAL 0 0 0

55 TABLET TAMBAH DARAH (PROGRAM) TABLET 0 0 0

56 ZINK TABLET DISPERSIBLE 20 MG (PROGRAM) TABLET 0 0 0

57 ALBENDAZOLE SIRUP BOTOL 0 0 0

58 COTRIMOXAZOLE 400/80 TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

59 MINERAL MIX SACHET 0 0 0

60 SD BIOLINE Syphilis 3.0 One Step Syphilis PCS 0 0 0


Antibody Test

OBAT TAMBAHAN

1 ALKOHOL SWAB 0 0 0 0

2 ALLOPURINOL 64 64 10 54

3 AMLODIPINE 5MG (BLUD) 308 308 45 263

4 ANTISEPTIK GEL (DINKES) 0 1 1 1 0

5 APD VAKSIN 0 0 0

6 APRON (DINKES) 0 0 0

7 AQUA PRO INJEKSI (BLUD) 0 0 0

8 ASAM MEFENAMAT TABLET 500 MG (BLUD) 212 100 312 19 293

9 ASIKLOVIR TABLET 46 46 46

10 BETAMETHASONE SALEP KULIT (BLUD) 0 0 0

11 BIOPLACENTON (BLUD) 1 1 1

12 BISAKODIL TABLET 5 MG (BLUD) 0 0 0

13 CIPROFLOXACIN (BLUD) 0 0 0

14 CLINDAMISIN KAPS (BLUD) 0 0 0

DEKSAMETHASONE HARSEN TABLET 0,5 MG


15 ((BLUD) ) 0 300 300 126 174

16 DOMPERIDONE TABLET 10 MG ( (BLUD)) 61 61 47 14

17 EPINEFRIN INJEKSI (BLUD) 0 0 0

18 FENITOIN KAPS (BLUD) 0 0 0

19 FITOMENADION INJ (BLUD) 0 0 0

20 FITOMENADION TABLET (BLUD) 0 0 0

21 FUROSEMIDE TABLET 0 0 0

22 GEMFIBROZIL (BLUD) 52 52 10 42

23 GENOINT (BLUD) 0 0 0

24 GENTAMICIN TETES MATA (BLUD) 0 5 5 1 4

25 GENTIAN VIOLET LARUTAN 1 % (BLUD) 2 2 2

26 GLISERIL GUAIKOLAT/GUAIFENESIN BLUD 36 200 236 83 153

27 HIDROKORTISON CREAM KULIT (BLUD) 5 5 5 0

HYOSCINE BUTYLBROMIDE (ANTI SPASMODIK


28 100 100 100
BLUD)

29 HYPAFIX (BLUD) 0 0 0

30 INFUSET (BLUD) 0 0 0

31 IV CATHETER (BLUD) 0 0 0

32 KAPTOPRIL TABLET 12,5 MG (BLUD) 448 448 448

33 KLORAMFENIKOL SIRUP (BLUD) 0 0 0

34 KLORAMFENIKOL TETES TELINGA (BLUD) 8 8 8

35 KOTRIMOKSAZOL TAB (BLUD) 100 100 100

36 LOPERAMIDE TABLET 2 MG (BLUD) 0 0 0

37 MASKER (DINKES) 0 0 0

38 MASKER N9 0 0 0

39 METFORMIN (BLUD) 0 0 0
SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

40 METILERGOMETRINE INJ (BLUD) 0 0 0

41 MULTIVITAMIN KOMB 0 0 0

42 NEW DIATABS (BLUD) 4 4 4

43 NIFEDIPINE TAB (BLUD) 0 0 0

44 NURSE CAP 0 0 0

45 OMEPRAZOLE 20MG 82 100 182 10 172

46 ONDANSETRONE INJEKSI (BLUD) 0 0 0

47 PARACETAMOL TABLET 500 MG (BLUD) 334 334 270 64

48 PEHAVRAL 0 0 0

49 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG (BLUD) 267 267 56 211

50 PIROXICAM 0 0 0

51 SALBUTAMOL TABLET 2 MG (BLUD) 21 21 21

52 SARUNG TANGAN OBGYN 0 0 0

53 SARUNG TANGAN OBGYN 0 0 0

54 SEFADROKSIL KAPSUL 500 MG (BLUD) 0 0 0

55 VGEL (BLUD) 0 1 1 1 0

56 VITAMIN C 50 MG (BLUD) 373 373 55 318

57 ZIVIT ZINC 80 80 63 17

58 ASETIL (DINKES) 0 0 0

59 DEXAMETHASONE (DINKES) 0 0 0

60 OBH (DINKES) 4 4 3 1

61 AMBROXOL 0 0 0

62 BATUK FLU SIRUP (ETAFLUSIN) 0 0 0

63 BATUK FLU TABLET (ETAFLUSIN) 0 0 0

64 BETADINE GARGLE 0 0 0

65 BUFACOMB SALEP 0 0 0

66 BUFACORT - N 0 0 0

67 DARYANTULLE 0 0 0

68 ETIL KLORIDA SPRAY 0 0 0

69 GLIBENCLAMIDE TABLET 5 MG 0 0 0

70 GLIMEPIRIDE 2 MG TABLET 0 0 0

71 KAOLIN PEKTIN SIRUP (NOVADIAR) 0 0 0

72 PIRACETAM KAPSUL 0 0 0

73 TIAMFENIKOL KAPSUL 0 0 0

74 VITAMIN ANAK SIRUP (SAMCOVIT) 0 0 0

75 0 0 0

76 0 0 0

77 0 0 0

78 0 0 0

79 0 0 0

80 0 0 0

Blitar , 01 August 2022


Mengetahui / Menyetujui
Yang Menerima, Yang Menyerahkan,
Kepala Puskesmas Petugas Petugas Pengelola Obat
SANANKULON Instalasi Farmasi Kabupaten Pustu/Polindes/Ponkesdes
SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

ENDAH ROSITANINGSIH, SE, MM Apt. AINA MUJTAHIDA A, S.Farm. DANIK YUNITA SARI,Amd.Kep
NIP. 196912302010012002 NIP : 198612188 11033 2 0004 NIP. 198,506,142,022,212,000
DINAS KESEHATAN KABUPATEN BLITAR
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)
WILAYAH : SUMBERINGIN PELAPORAN BULAN : AGUSTUS
PUSKESMAS : SANANKULON PERMINTAAN BULAN : SEPTEMBER
KECAMATAN : SANANKULON
KABUPATEN : BLITAR
PROVINSI : JAWA TIMUR

SISA STOK JUMLAH


NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

1 2 WAY FOLEY CATHETER NO.16 PCS 0 0 0

2 2 WAY FOLEY CATHETER NO.18 PCS 0 0 0

3 2 WAY FOLEY CATHETER NO.20 PCS 0 0 0

4 ACETYLCYSTEINE CAPSULE 200 MG CAPSULE 40 40 4 36

5 ALAT SUNTIK SEKALI PAKAI 1 ML PCS 0 0 0

6 ALAT SUNTIK SEKALI PAKAI 10 ML PCS 0 0 0

7 ALAT SUNTIK SEKALI PAKAI 20 ML PCS 0 0 0

8 ALAT SUNTIK SEKALI PAKAI 3 ML PCS 40 40 7 33

9 ALAT SUNTIK SEKALI PAKAI 5 ML PCS 70 70 5 65

10 ALKOHOL SWAB PCS 0 0 0

11 ALLOPURINOL TABLET 100 MG TABLET 0 0 0

12 ALPRAZOLAM 1 MG TABLET TABLET 0 0 0

13 AMBROXOL SIRUP 5MG/ML BOTOL 0 0 0

14 AMBROXOL TABLET 30 MG TABLET 0 0 0

15 AMINOPHYLLINE INJEKSI 24 MG/ML 10 ML AMPUL 0 0 0

16 AMINOPHYLLINE TABLET 200 MG TABLET 0 0 0

17 AMITRIPTYLLINE HCL TABLET 25 MG TABLET 0 0 0

18 AMLODIPINE TABLET 10 MG TABLET 0 0 0

19 AMLODIPINE TABLET 5 MG TABLET 0 0 0

20 AMOKSISILIN DRY SYRUP 125 MG/5 ML 60 ML BOTOL 0 0 0

21 AMOKSISILIN SERBUK INJEKSI 1000 MG VIAL 0 0 0

22 AMOKSISILIN TABLET 500 MG KAPLET 264 400 664 251 413

AMOXCICILIN FORTE SYRUP KERING


23 250MG/5ML BOTOL 0 0 0

24 AMPICILLIN SERBUK INJEKSI 1.000 MG VIAL 0 0


MG/VIAL 0

25 ANTALGIN 500 MG TABLET (METAMIZOL) TABLET 0 0 0

26 ANTASIDA DOEN TABLET KOMBINASI TABLET 205 700 905 111 794

27 ANTASIDA SUSPENSI 60 ML BOTOL 0 15 15 7 8

28 ANTI BAKTERI DOEN SALEP KOMBINASI 5 GR POT 0 0 0

29 ANTI FUNGI DOEN SALEP KOMBINASI 30 GR POT 4 4 0 4

30 ANTI HAEMOROID DOEN KOMBINASI SUPP. 0 0 0

31 ANTI MIGRAIN DOEN TABLET KOMBINASI TABLET 0 0 0

32 ANTI SPASMODIK INJEKSI (SPASHI) AMPUL 0 0 0

33 ANTI SPASMODIK TABLET (DORMICOMP) TABLET 0 0 0

AQUA PRO INJEKSI STERIL BEBAS PIROGEN 20


34 BOTOL 0 0 0
ML

35 ASAM ASKORBAT ( VIT C ) TABLET 250 MG TABLET 0 0 0

36 ASAM ASKORBAT ( VIT C ) TABLET 50 MG TABLET 0 0 0

37 ASAM FOLAT 1MG TABLET TABLET 0 0 0

38 ASAM MEFENAMAT TABLET 500 MG TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

39 ASAM TRANEKSAMAT 100 MG/ML INJEKSI AMPUL 0 0 0

40 ASAM TRANEKSAMAT 500 MG TABLET TABLET 0 0 0

41 ASAM VALPROAT 250 MG TABLET / TABLET 0 0


DEPAKOTE ER 0

42 ASEPTAN 500CC + PUMP BOTOL 0 0 0

43 ASEPTIC GEL 500CC + DISPENSER BOTOL 0 0 0

44 ASERING (ASETAT RINGER) SOFT BAG BOTOL 0 0 0

45 ASETOSAL TABLET 100 (80) MG TABLET 0 0 0

46 ASIKLOVIR KREAM 5 % 5 GR TUBE 0 0 0

47 ASIKLOVIR TABLET 400 MG TABLET 0 0 0

48 ATROPIN SULFAT INJEKSI 0,25 MG/ML 1 ML AMPUL 0 0 0

49 ATTAPULGIT + PECTIN TABLET TABLET 0 0 0

50 BETAHISTINE MESILAT 24 MG TABLET TABLET 0 0 0

51 BETAHISTINMESILAT 6 MG TABLET TABLET 0 0 0

52 BETAMETHASON CR 0.05% 20 GR TUBE 0 5 5 1 4

53 BETAMETHASONE CREAM 0,1 % 5 GR TUBE 0 0 0

54 BIONICOM ZINC TABLET TABLET 0 0 0 0 0

55 BISAKODIL SUPPOSITORIA 10 MG SUPP. 0 0 0

56 BISAKODIL SUPPOSITORIA 5 MG SUPP. 0 0 0

57 BISOPROLOL 2,5 MG TABLET (CONCOR) TABLET 0 0 0

58 BISOPROLOL 5 MG TABLET TABLET 0 0 0

59 CAT GUT NO. 3/0 CHROMIC PCS 1 1 0 1

60 CAT GUT NO. 3/0 PLAIN PCS 1 1 0 1

61 CITICHOLIN 250 MG/ML-2ML INJEKSI AMPUL 0 0 0

62 CLONIDINE 0.15 MG TABLET TABLET 0 0 0

63 CLOPIDOGREL 75 MG TABLET 0 0 0

64 COMBIVENT UDV INHALASI VIAL 0 0 0

65 DEKSAMETHASONE INJEKSI 5 MG/ML 1 ML AMPUL 0 0 0

66 DEKSAMETHASONE TABLET 0,5 MG TABLET 0 0 0

67 DEVITALISASI PASTA ( NON ARSEN ) POT 0 0 0

68 DIAZEPAM INJEKSI 5 MG/ML 2 ML AMPUL 0 0 0

DIAZEPAM LARUTAN RECTAL 5MG/ 2,5ML-


69 TUBE 0 0 0
STESOLID

70 DIAZEPAM TABLET 2 MG TABLET 0 0 0

71 DIAZEPAM TABLET 5 MG TABLET 0 0 0

72 DIFENHIDRAMINE HCL INJEKSI 10 MG/ML 1 ML AMPUL 0 0 0

73 DIGOXIN TABLET 0,25 MG TABLET 0 0 0

74 DIMENHYDRINATE TABLET 50 MG TABLET 0 0 0

75 DOKSISIKLIN TABLET 100 MG KAPSUL 0 0 0

76 DOMPERIDON SUSPENSI 5MG/ML BOTOL 4 10 14 2 12

77 DOMPERIDON TABLET 10 MG TABLET 0 100 100 34 66

78 EKSTRACT PLASENTA + NEOMYSIN SALEP 15 TUBE 0 0


GR 0

79 EPINEFRIN (ADRENALIN) HCL INJ.0,1 % 1 ML AMPUL 0 0 0

80 ERITROMISIN KAPSUL 250 MG KAPSUL 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

81 ERITROMISIN SIRUP KERING 200 MG/5ML BOTOL 0 0 0

82 ERITROMISIN TABLET 500 MG KAPSUL 0 0 0

83 ETAKRIDIN ( RIVANOL ) LARUTAN 0,1 % 300 BOTOL 0 0


ML 0

84 ETANOL [ ALKOHOL ] 70 % 1000 ML BOTOL 0 0 0

85 ETIL KLORIDA SEMPROT 100 ML BOTOL 0 0 0

86 EUGENOL CAIRAN 10 ML BOTOL 0 0 0

87 FENITOIN NATRIUM INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0

88 FENITOIN NATRIUM TABLET 100 MG KAPSUL 0 0 0

89 FENOBARBITAL INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0

90 FENOBARBITAL TABLET 30 MG TABLET 0 0 0

91 FENOL GLISEROL TETES TELINGA 10 % 5 ML BOTOL 2 2 0 2

FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML 1


92 AMPUL 0 0 0
ML
FITOMENADION ( VIT K1 ) TABLET SALUT 10
93 TABLET 0 0 0
MG

94 FITOMENADION INFANT INJ. 2MG/ML AMPUL 0 0 0

FLUPHENASINE DEKANOAT INJEKSI 25 MG 1


95 AMPUL 0 0 0
ML

96 FUROSEMID INJEKSI 10 mg VIAL 0 0 0

97 FUROSEMID TABLET 40 MG TABLET 66 66 0 66

GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 %


98 10 GR TUBE 1 1 0 1

99 GARAM ORALIT SACHET 92 92 4 88

100 GEMFIBROZIL 300 MG KAPSUL KAPSUL 0 0 0

101 GENTAMISIN SALEP KULIT 0,1 % 5 GR TUBE 0 0 0

102 GENTAMISIN SALEP MATA 0,3% TUBE 9 9 2 7

103 GENTAMISIN TETES MATA 0,3% BOTOL 0 0 0

104 GLASS IONOMER CEMENT ( GC IX ) BOTOL 0 0 0

105 GLIBENCLAMIDE TABLET 5 MG TABLET 0 0 0

106 GLICERIL GUAIACOLAT TABLET 100 MG TABLET 0 0 0

107 GLIMEPIRIDE 1 MG TABLET TABLET 0 0 0

108 GLIMEPIRIDE 2 MG TABLET TABLET 178 178 170 8

GLUKOSA 40% DEXTROSE INJECTION U.S.P


109 VIAL 0 0 0
CAIRAN INJEKSI

110 GLUKOSA LARUTAN INFUS 10 % STERIL BOTOL 0 0 0

111 GLUKOSA LARUTAN INFUS 5 % STERIL BOTOL 0 0 0

112 GRISEOFULVIN TABLET 125 MG TABLET 0 0 0

113 HALOPERIDOL 2 MG TABLET 0 0 0

114 HALOPERIDOL DEKANOAT INJ 50 MG VIAL 0 0 0

115 HALOPERIDOL INJ. 5 MG/ML (LODOMER) AMPUL 0 0 0

116 HALOPERIDOL TABLET 1,5 MG TABLET 0 0 0

117 HALOPERIDOL TABLET 5 MG TABLET 0 0 0

118 HERBAKOF SYRUP 60ML BOTOL 9 10 19 13 6

119 HES-HYDROXYETHYL STARCH 6 %/VOLUVEN BOTOL 0 0


INFUS 500 ML 0

120 HIDROCORTISON CR 1% TUBE 0 0 0

121 HIDROCORTISONE CREAM 2,5 % 5 GR TUBE 0 5 5 2 3

122 HYDROCHLORTHIAZIDE 25 MG TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

123 I.V CATHETER NO.16 WITH INJECTION PORT PCS 0 0 0

124 I.V CATHETER NO.18 WITH INJECTION PORT PCS 0 0 0

125 I.V CATHETER NO.20 WITH INJECTION PORT PCS 0 0 0

126 I.V CATHETER NO.22 WITH INJECTION PORT PCS 0 0 0

127 I.V CATHETER NO.24 WITH INJECTION PORT PCS 0 0 0

128 I.V CATHETER NO.26 WITH INJECTION PORT PCS 0 0 0

129 IBUPROFEN FORTE SYRUP 200MG/5ML BOTOL 0 0 0

130 IBUPROFEN SUSPENSI 100 MG/5 ML 60 ML BOTOL 4 4 3 1

131 IBUPROFEN TABLET 400 MG TABLET 0 0 0

132 INFUSION SET ANAK PCS 0 0 0

133 INFUSION SET DEWASA PCS 0 0 0

134 ISOSORBIDE DINITRATE SUBLINGUAL 5 MG TABLET 0 0 0

135 KAEN 3B BOTOL 0 0 0

136 KALIUM DIKLOFENAK 50 MG TABLET TABLET 0 0 0

KALSIUM GLUCONAS INJEKSI 100 MG/ML 10


137 AMPUL 0 0 0
ML

138 KALSIUM LAKTAT (KALK) TABLET 500 MG TABLET 120 900 1,020 636 384

139 KANTONG URINE DEWASA PCS 0 0 0

140 KAPAS PEMBALUT/ABSORBEN 250 GR BKS 0 0 0

141 KAPTOPRIL TABLET 25 MG TABLET 0 0 0

142 KARBAMAZEPIN TABLET 200 MG TABLET 0 0 0

143 KASA KOMPRES 40/40 STERIL BKS 3 3 1 2

144 KASA PEMBALUT HIDROFIL 16 X 16 CM STRIL ROL 3 3 0 3

145 KASA PEMBALUT HIDROFIL 2 M X 80 CM ROL 2 2 0 2

146 KASA PEMBALUT HIDROFIL 4 M X 10 CM ROL 0 0 0

147 KASA PEMBALUT HIDROFIL 4 M X 5 CM ROL 10 10 0 10

148 KASA STERIL (DARYAN TOLLE)YG DIRESAPI PCS 0 0


FRAMISETIN 0

149 KETOKONAZOLE TABLET 200 MG TABLET 0 0 0

150 KETOPROFEN 100 MG SUPPOSITORIA SUPP. 0 0 0

151 KLINDAMISIN KAPSUL 150 MG TABLET 0 0 0

152 KLINDAMISIN KAPSUL 300 MG KAPSUL 0 0 0

153 KLOBAZAM 10 MG TABLET TABLET 0 0 0

154 KLORAMFENIKOL KAPSUL 500 MG KAPSUL 0 0 0

155 KLORAMFENIKOL SALEP KULIT 2 % TUBE 0 0 0

156 KLORAMFENIKOL SALEP MATA 1 % TUBE 0 0 0

157 KLORAMFENIKOL SUSPENSI 125 MG/5 ML BOTOL 0 0 0

158 KLORAMFENIKOL TETES TELINGA 3 % BOTOL 0 0 0

KLORFENIRAMINE MALEAT (CTM) TABLET 4


159 MG TABLET 0 0 0

160 KLORPROMAZIN HCL INJEKSI 25 MG/ML 1 ML AMPUL 0 0 0

161 KLORPROMAZIN HCL INJEKSI 50 MG/ML 1 ML AMPUL 0 0 0

162 KLORPROMAZIN HCL TABLET 100 MG TABLET 0 0 0

163 KLOZAPIN 100 MG TABLET TABLET 0 0 0

164 KLOZAPIN 25 MG TABLET TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

165 KODEIN HCL TABLET 10 MG TABLET 0 0 0

166 KOTRIMOKSAZOL DEWASA TABLET TABLET 0 0 0

167 KOTRIMOKSAZOL SUSPENSI 60 ML BOTOL 0 0 0

168 LEVOFLOXACIN TABLET 500 MG TABLET 0 0 0

169 LIDOCAIN 2% INJ AMPUL 0 0 0

170 LIDOCAIN COMPOSITUM INJEKSI 2 ML AMPUL 3 3 0 3

171 LISOL CONCENTRATE 1000 ML BOTOL 0 0 0

172 LOPERAMIDE TABLET 2 MG TABLET 0 0 0

173 LORATADIN TABLET 10 MG TABLET 44 44 0 44

174 LORAZEPAM 2 MG TABLET 0 0 0

175 MAGNESIUM SULFAT INJEKSI (IV) 40 % 25 ML AMPUL 0 0 0

176 MASKER EARLOOP PLUS PCS 0 0 0

177 MASKER KERTAS 3 PLY EAR LOOP PCS 0 0 0

178 MASKER KERTAS 3 PLY TIE ON PCS 0 0 0

179 MASKER N95 PCS 0 0 0

180 MELOKSIKAM TABLET 7,5 MG TABLET 0 0 0

181 METAMIZOL (NORAGES) INJEKSI 500 MG/2ML AMPUL 0 0 0

182 METFORMIN TABLET 500 MG TABLET 75 75 10 65

183 METILERGOMETRIN MALEAT INJEKSI 0,200 AMPUL 0 0


MG 1 ML 0

184 METILERGOMETRIN MALEAT TABLET 0,125 TABLET 0 0


MG 0

185 METILPREDNISOLON TABLET 4 MG TABLET 0 0 0

186 METOKLOPRAMIDE 10 MG TABLET TABLET 0 0 0

187 METOKLOPRAMIDE 5 MG TABLET TABLET 0 0 0

188 METOKLOPROMIDE (SOTATIC) INJEKSI 5 AMPUL 0 0


MG/ML 2 ML 0

189 METOKLOPROMIDE SIRUP BOTOL 0 0 0

190 METRONIDAZOL + NYSTATIN VAG. VIAL 0 0


(PROVAGIN) INJEKSI 0

191 METRONIDAZOL TABLET 250 MG TABLET 0 0 0

192 METRONIDAZOL TABLET 500 MG TABLET 0 0 0

193 METRONIDAZOLE INFUS 5 MG/ML 100 ML BOTOL 0 0 0

194 MIKONAZOL KREAM 10 GR TUBE 5 5 2 3

195 MINERAL MIX SACHET 0 0 0

196 NATRIUM DIKLOFENAK TABLET 25 MG TABLET 334 334 64 270

197 NATRIUM DIKLOFENAK TABLET 50 MG TABLET 0 0 0

198 NATRIUM KLORIDA INFUS 0,9 % STERIL BOTOL 1 1 0 1

199 NIFEDIPINE TABLET 10 MG TABLET 0 0 0

200 NISTATIN TABLET 500.000 UI TABLET 31 31 4 0 27

201 NISTATIN VAGINAL TABLET 100.000 UI VAGTAB 8 8 0 8

202 OBAT BATUK HITAM (OBH) CAIRAN 100 ML BOTOL 0 0 0

203 OKSIGEN NASAL CANNULA ADULT PCS 0 0 0

204 OKSIGEN NASAL CANNULA INFANT PCS 0 0 0

205 OKSITETRACYCLIN SALEP KULIT 3 % 5 GR TUBE 0 0 0

206 OKSITETRACYCLIN SALEP MATA 1 % 3,5 GR TUBE 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

207 OKSITOSIN INJEKSI 10 IU/ML 1 ML AMPUL 0 0 0

208 OMEPRAZOLE TABLET 20 MG KAPSUL 0 0 0

209 ONDANSENTRON 4 MG/2 ML INJEKSI AMPUL 0 0 0

210 PARACETAMOL SYRUP 120 MG/5 ML 60 ML BOTOL 11 11 11 0

211 PARACETAMOL TABLET 500 MG TABLET 300 600 900 410 490

212 PARACETAMOL TETES 100 MG/ML 15 ML BOTOL 0 0 0

213 PEHAVRAL TABLET TABLET 0 0 0

214 PERAK SULFADIAZIN KRIM 1 % TUBE 0 0 0

215 PERHYDROL [ H2O2 ] 3 % 800 ML BOTOL 0 0 0

216 PERMETHRINE 5% CR 15 GRAM TUBE 5 5 5

217 PIRACETAM TABLET 800 MG TABLET 0 0 0

218 PIRANTEL PAMOAT TABLET TABLET 0 0 0

219 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG TABLET 0 0 0

220 PIROKSIKAM KAPSUL 10 MG KAPSUL 0 0 0

221 PLESTER 10 CM X 2 M ROL 0 0 0

222 PREDNISON TABLET 5 MG TABLET 0 0 0

223 PROPRANOLOL HCL TABLET 40 MG TABLET 0 0 0

224 PROPILTHIOURACIL TABLET 100 MG TABLET 0 0 0

225 RANITIDIN INJEKSI 25 MG/ ML AMPUL 0 0 0

226 RESPERIDON 2 MG TABLET TABLET 0 0 0

227 RINGER LAKTATE LARUTAN INFUS STERIL BOTOL 0 0 0

228 SALBUTAMOL TABLET 2 MG TABLET 100 100 0 100

229 SALBUTAMOL TABLET 4 MG TABLET 0 0 0

230 SALEP 2-4 KOMBINASI 30 GR POT 4 4 1 3

231 SALICYL BEDAK 2 % KOTAK 0 0 0

232 SARUNG TANGAM NON STERIL L PCS 0 0 0

233 SARUNG TANGAN NON STERIL M PCS 219 219 58 161

234 SARUNG TANGAN NON STERIL S PCS 0 0 0

235 SARUNG TANGAN STERIL NO 6 PSG 0 0 0

236 SARUNG TANGAN STERIL NO. 7,5 PSG 0 0 0

237 SARUNG TANGAN STERILE NO.6,5 PSG 0 0 0

238 SARUNG TANGAN STERILE NO.7 PSG 3 3 0 3

239 SEFADROKSIL KAPSUL 500 MG KAPSUL 0 0 0

240 SEFIKSIM KAPSUL 100 MG KAPSUL 0 0 0

SERUM ANTI BISA ULAR POLIVALEN INJ.5 ML


241 VIAL 0 0 0
(ABU I)
SERUM ANTI TETANUS INJEKSI 1.500 IU/AMP
242 VIAL 0 0 0
(ATS)

243 SETIRIZINE TABLET 10 MG TABLET 0 150 150 110 40

244 SIANOKOBALAMIN ( VIT B12 ) INJEKSI 500 AMPUL 0 0 0


MCG/ML 1 ML

245 SIANOKOBALAMIN ( VIT B12 ) TABLET 50 MCG TABLET 202 202 12 190

246 SILK (BENANG BEDAH SUTERA) NO.3/0 PCS 1 1 0 1

247 SIMETIDINE TABLET 200 MG TABLET 0 0 0

248 SIMVASTATIN TABLET 10 MG TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

249 SIPROFLOXACIN INFUS 2% BOTOL 0 0 0

250 SIPROFLOXACIN TABLET 500 MG TABLET 0 0 0

251 SPONS GELATIN CUBICLES 1x1x1 CM PCS 0 0 0

252 STIMUNO SYR BOTOL 0 0 0

253 STIMUNO TAB (100) TABLET 0 0 0

254 STIMUNO TAB (30) BOTOL 0 0 0

255 SULFADOKSIN TABLET TABLET 0 0 0

SULFASETAMID NATRIUM TETES MATA 15 %


256 BOTOL 0 0 0
5 ML

257 TABLET TAMBAH DARAH TABLET 180 0 180 180 0

TEMPORARY CAVITY SEALER [TUMPATAN


258 PCS 0 0 0
SEMENTARA] (CAVIT G)

259 TETAGRAM 150 IU AMPUL 0 0 0

260 TETRAKAIN HCL TETES MATA 5 ML BOTOL 0 0 0

261 TETRASIKLIN HCL TABLET 500 MG KAPSUL 0 0 0

262 THIAMIN HCL (VIT B1) INJEKSI 100 MG/ML 1 ML AMPUL 0 0 0

THIAMIN HCL MONONITRAT (VIT B1) TABLET


263 TABLET 0 0 0
100 MG
THIAMIN HCL MONONITRAT (VIT B1) TABLET
264 TABLET 0 0 0
50 MG

265 TRAMADOL INJEKSI 50 MG/ML AMPUL 0 0 0

266 TRANFUSION SET ADULT WITH Y INJECTION PCS 0 0 0

267 TRIFLOUPERASIN TABLET 5 MG TABLET 0 0 0

268 TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2 TABLET 0 0


MG 0

269 VITAMIN B COMPLEX TABLET TABLET 21 21 21 0

270 YODIUM POVIDON LARUTAN 10 % 30 ML BOTOL 0 0 0

271 YODIUM POVIDON LARUTAN 10% 60 ML BOTOL 0 0 0

272 ZENTRA (TRIPROLIDINE|PSEUDOEPHEDRINE) TABLET 0 0 0

273 ZINK 20 MG TABLET TABLET 100 100 0 100

274 Hi-D 1000 CHOLECALCIFEROL TABLET 0 0 0

OBAT PROGRAM / HIBAH

1 AMITRIPTYLINE 25 MG TABLET 0 0 0

2 HALOPERIDOLE INJEKSI AMPUL 0 0 0

3 HALOPERIDOLE 1,5 MG TABLET 0 0 0

4 HALOPERIDOLE 5 MG TABLET 0 0 0

5 LODOMER 2 MG TABLET 0 0 0

6 LODOMER 5 MG TABLET 0 0 0

7 TRIHEXYPHENIDYL 2 MG TABLET 0 0 0

8 ALAT SUNTIK 0,05 ML (PROGRAM) PCS 0 0 0

9 ALAT SUNTIK 0,5 ML (PROGRAM) PCS 0 0 0

10 ALAT SUNTIK 5 ML (PROGRAM) PCS 0 0 0

11 ALBENDAZOL TABLET 400 MG TABLET 0 0 0

12 BENZATINE BENZYLPENICILLIN 2.400.000 IU VIAL 0 0 0

13 COTRIMOXAZOLE 800/160 TABLET 0 0 0

14 DIETHYLCARBAMAZINE 100 MG TABLET 0 0 0

15 GARAM ORALIT UNTUK 200 ML AIR SACHET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

16 HIV ABACAVIR TABLET 300 MG BOTOL 0 0 0

17 HIV ACRIPTEGA (TDF 300 + 3TC 300 + DTG 50) BOTOL 0 0 0

18 HIV DOLUTEGRAFIR 50 MG BOTOL 0 0 0

19 HIV EFAFIRENZ 200 MG TABLET BOTOL 0 0 0

20 HIV EFAFIRENZ 600 MG TABLET BOTOL 0 0 0

21 HIV LAMIVUDIN 150 MG TABLET BOTOL 0 0 0

22 HIV NEVIRAPINE 200 MG TABLET BOTOL 0 0 0

23 HIV TENOFOVIR 300 MG BOTOL 0 0 0


HIV TRIPLE FDC ANAK (ZIDOVUDIN
24 BOTOL 0 0 0
60MG+LAMIVUDIN 30MG+NEVIRAPINE 50MG)
HIV TRIPLE FDC DEWASA (TDC+3TC+EFV
25 BOTOL 0 0 0
(300/300/600))

26 HIV ZIDOVUDINE 100 MG @60 KAPSUL BOTOL 0 0 0

27 HIV ZIDOVUDINE 300 MG + LAMIVUDIN 150 MG BOTOL 0 0 0

28 HIV ZIDOVUDINE SYRUP 240 ML BOTOL 0 0 0

29 IODINE TES PCS 0 0 0

30 ISONIAZID TABLET 100 MG TABLET 0 0 0

31 ISONIAZID TABLET 300 MG TABLET 0 0 0

KOMBIPAK AZITHROMYCIN - CEFIXIME


32 TABLET 0 0 0
KOMBINASI

33 MDT COMBI - MB ADULT (RED) BLISTER 0 0 0

34 MDT COMBI - MB CHILD (ORANGE) BLISTER 0 0 0

35 MDT COMBI - PB ADULT (GREEN) BLISTER 0 0 0

36 OBAT ANTI TUBERKULOSIS ANAK PAKET 0 0 0

37 OBAT ANTI TUBERKULOSIS DOSIS HARIAN PAKET 0 0 0


STOP TB KIT

38 OBAT ANTI TUBERKULOSIS KATEGORI 1 PAKET 0 0 0

39 OBAT ANTI TUBERKULOSIS KATEGORI 2 PAKET 0 0 0

40 OBAT ANTI TUBERKULOSIS KOMBIPAK PAKET 0 0 0


KATEGORI I

41 PARACETAMOL 500 MG (P2) TABLET 0 0 0

42 PIRIDOKSIN 25 MG TABLET (VIT B6) TABLET 0 0 0

43 PYRIMETAMINE TABLET 0 0 0

44 REAGEN HIV (FOKUS) PCS 0 0 0

45 REAGEN HIV (STANDART DIAGNOSTIC/SD) PCS 0 0 0

46 REAGEN HIV (VIKIA) PCS 0 0 0

REAGEN HIV DIAGNOSTAR HIV 1\/2 ONE STEP


47 PCS 0 0 0
RAPID TEST
48 REAGEN HIV DIAGNOSTIC KIT FOR HIV (1+2) PCS 0 0 0
ANTIBODY (COLLOIDAL GOLD) V2 PAKET
49 REAGEN SYPHILIS (TREPOCHECK) PCS 0 0 0

50 REAGEN SYPHILIS RDT (FOKUS) PCS 0 0 0

51 RETINOL ( VIT A ) KAPSUL 100.000 IU KAPSUL 0 0 0

52 RETINOL ( VIT A ) KAPSUL 200.000 IU KAPSUL 0 0 0

53 SAFETY BOX PCS 0 0 0

SERUM ANTI DIFTERI CAIRAN INJEKSI 125


54 MG/ML VIAL 0 0 0

55 TABLET TAMBAH DARAH (PROGRAM) TABLET 0 0 0

56 ZINK TABLET DISPERSIBLE 20 MG (PROGRAM) TABLET 0 0 0

57 ALBENDAZOLE SIRUP BOTOL 0 0 0

58 COTRIMOXAZOLE 400/80 TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

59 MINERAL MIX SACHET 0 0 0

60 SD BIOLINE Syphilis 3.0 One Step Syphilis PCS 0 0 0


Antibody Test

OBAT TAMBAHAN

1 ALKOHOL SWAB 0 0 0 0

2 ALLOPURINOL 54 54 44 10

3 AMLODIPINE 5MG (BLUD) 263 263 83 180

4 ANTISEPTIK GEL (DINKES) 0 1 1 1 0

5 APD VAKSIN 0 0 0

6 APRON (DINKES) 0 0 0

7 AQUA PRO INJEKSI (BLUD) 0 0 0

8 ASAM MEFENAMAT TABLET 500 MG (BLUD) 293 293 40 253

9 ASIKLOVIR TABLET 46 46 6 40

10 BETAMETHASONE SALEP KULIT (BLUD) 0 0 0

11 BIOPLACENTON (BLUD) 1 1 0 1

12 BISAKODIL TABLET 5 MG (BLUD) 0 0 0

13 CIPROFLOXACIN (BLUD) 0 0 0

14 CLINDAMISIN KAPS (BLUD) 0 0 0

DEKSAMETHASONE HARSEN TABLET 0,5 MG


15 ((BLUD) ) 174 200 374 184 190

16 DOMPERIDONE TABLET 10 MG ( (BLUD)) 14 14 14 0

17 EPINEFRIN INJEKSI (BLUD) 0 0 0

18 FENITOIN KAPS (BLUD) 0 0 0

19 FITOMENADION INJ (BLUD) 0 0 0

20 FITOMENADION TABLET (BLUD) 0 0 0

21 FUROSEMIDE TABLET 0 0 0

22 GEMFIBROZIL (BLUD) 42 42 13 29

23 GENOINT (BLUD) 0 5 5 2 3

24 GENTAMICIN TETES MATA (BLUD) 4 4 0 4

25 GENTIAN VIOLET LARUTAN 1 % (BLUD) 2 2 0 2

26 GLISERIL GUAIKOLAT/GUAIFENESIN BLUD 153 300 453 124 329

27 HIDROKORTISON CREAM KULIT (BLUD) 0 0 0

HYOSCINE BUTYLBROMIDE (ANTI SPASMODIK


28 100 100 20 80
BLUD)

29 HYPAFIX (BLUD) 0 0 0

30 INFUSET (BLUD) 0 0 0

31 IV CATHETER (BLUD) 0 0 0

32 KAPTOPRIL TABLET 12,5 MG (BLUD) 448 448 0 448

33 KLORAMFENIKOL SIRUP (BLUD) 0 0 0

34 KLORAMFENIKOL TETES TELINGA (BLUD) 8 8 1 7

35 KOTRIMOKSAZOL TAB (BLUD) 100 100 0 100

36 LOPERAMIDE TABLET 2 MG (BLUD) 0 0 0

37 MASKER (DINKES) 0 0 0

38 MASKER N9 0 0 0

39 METFORMIN (BLUD) 0 0 0
SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

40 METILERGOMETRINE INJ (BLUD) 0 0 0

41 MULTIVITAMIN KOMB 0 0 0

42 NEW DIATABS (BLUD) 4 4 0 4

43 NIFEDIPINE TAB (BLUD) 0 0 0

44 NURSE CAP 0 0 0

45 OMEPRAZOLE 20MG 172 172 9 163

46 ONDANSETRONE INJEKSI (BLUD) 0 0 0

47 PARACETAMOL TABLET 500 MG (BLUD) 64 64 64 0

48 PEHAVRAL 0 0 0

49 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG (BLUD) 211 211 23 188

50 PIROXICAM 0 0 0

51 SALBUTAMOL TABLET 2 MG (BLUD) 21 21 12 9

52 SARUNG TANGAN OBGYN 0 0 0

53 SARUNG TANGAN OBGYN 0 0 0

54 SEFADROKSIL KAPSUL 500 MG (BLUD) 0 0 0

55 VGEL (BLUD) 0 0 0

56 VITAMIN C 50 MG (BLUD) 318 500 818 218 600

57 ZIVIT ZINC 17 150 167 17 150

58 ASETIL (DINKES) 0 0 0

59 DEXAMETHASONE (DINKES) 0 0 0

60 OBH (DINKES) 1 20 21 13 8

61 AMBROXOL 0 100 100 23 77

62 BATUK FLU SIRUP (ETAFLUSIN) 0 10 10 9 1

63 BATUK FLU TABLET (ETAFLUSIN) 0 0 0

64 BETADINE GARGLE 0 0 0

65 BUFACOMB SALEP 0 0 0

66 BUFACORT - N 0 2 2 1 1

67 DARYANTULLE 0 0 0

68 ETIL KLORIDA SPRAY 0 0 0

69 GLIBENCLAMIDE TABLET 5 MG 0 0 0

70 GLIMEPIRIDE 2 MG TABLET 0 0 0

71 KAOLIN PEKTIN SIRUP (NOVADIAR) 0 5 5 0 5

72 PIRACETAM KAPSUL 0 0 0

73 TIAMFENIKOL KAPSUL 0 0 0

74 VITAMIN ANAK SIRUP (SAMCOVIT) 0 10 10 10 0

75 0 0 0

76 0 0 0

77 0 0 0

78 0 0 0

79 0 0 0

80 0 0 0

Blitar , 01 September 2022


Mengetahui / Menyetujui
Yang Menerima, Yang Menyerahkan,
Kepala Puskesmas Petugas Petugas Pengelola Obat
SANANKULON Instalasi Farmasi Kabupaten Pustu/Polindes/Ponkesdes
SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

ENDAH ROSITANINGSIH, SE, MM Apt. AINA MUJTAHIDA A, S.Farm. DANIK YUNITA SARI,Amd.Kep
NIP. 196912302010012002 NIP : 198612188 11033 2 0004 NIP. 198,506,142,022,212,000
DINAS KESEHATAN KABUPATEN BLITAR
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)
WILAYAH : SUMBERINGEN PELAPORAN BULAN : SEPTEMBER
PUSKESMAS : SANANKULON PERMINTAAN BULAN : OKTOBER
KECAMATAN : SANANKULON
KABUPATEN : BLITAR
PROVINSI : JAWA TIMUR

SISA STOK JUMLAH


NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

1 2 WAY FOLEY CATHETER NO.16 PCS 0 0 0

2 2 WAY FOLEY CATHETER NO.18 PCS 0 0 0

3 2 WAY FOLEY CATHETER NO.20 PCS 0 0 0

4 ACETYLCYSTEINE CAPSULE 200 MG CAPSULE 36 36 10 26

5 ALAT SUNTIK SEKALI PAKAI 1 ML PCS 0 0 0

6 ALAT SUNTIK SEKALI PAKAI 10 ML PCS 0 0 0

7 ALAT SUNTIK SEKALI PAKAI 20 ML PCS 0 0 0

8 ALAT SUNTIK SEKALI PAKAI 3 ML PCS 33 33 10 23

9 ALAT SUNTIK SEKALI PAKAI 5 ML PCS 65 65 5 60

10 ALKOHOL SWAB PCS 0 0 0

11 ALLOPURINOL TABLET 100 MG TABLET 0 0 0

12 ALPRAZOLAM 1 MG TABLET TABLET 0 0 0

13 AMBROXOL SIRUP 5MG/ML BOTOL 0 0 0

14 AMBROXOL TABLET 30 MG TABLET 0 0 0

15 AMINOPHYLLINE INJEKSI 24 MG/ML 10 ML AMPUL 0 0 0

16 AMINOPHYLLINE TABLET 200 MG TABLET 0 0 0

17 AMITRIPTYLLINE HCL TABLET 25 MG TABLET 0 0 0

18 AMLODIPINE TABLET 10 MG TABLET 0 0 0

19 AMLODIPINE TABLET 5 MG TABLET 0 0 0

20 AMOKSISILIN DRY SYRUP 125 MG/5 ML 60 ML BOTOL 0 0 0

21 AMOKSISILIN SERBUK INJEKSI 1000 MG VIAL 0 0 0

22 AMOKSISILIN TABLET 500 MG KAPLET 413 413 243 170

AMOXCICILIN FORTE SYRUP KERING


23 250MG/5ML BOTOL 0 0 0

24 AMPICILLIN SERBUK INJEKSI 1.000 MG VIAL 0 0


MG/VIAL 0

25 ANTALGIN 500 MG TABLET (METAMIZOL) TABLET 0 0 0

26 ANTASIDA DOEN TABLET KOMBINASI TABLET 794 794 166 628

27 ANTASIDA SUSPENSI 60 ML BOTOL 8 10 18 7 11

28 ANTI BAKTERI DOEN SALEP KOMBINASI 5 GR POT 0 0 0

29 ANTI FUNGI DOEN SALEP KOMBINASI 30 GR POT 4 4 2 2

30 ANTI HAEMOROID DOEN KOMBINASI SUPP. 0 0 0

31 ANTI MIGRAIN DOEN TABLET KOMBINASI TABLET 0 0 0

32 ANTI SPASMODIK INJEKSI (SPASHI) AMPUL 0 0 0

33 ANTI SPASMODIK TABLET (DORMICOMP) TABLET 0 0 0

AQUA PRO INJEKSI STERIL BEBAS PIROGEN 20


34 BOTOL 0 0 0
ML

35 ASAM ASKORBAT ( VIT C ) TABLET 250 MG TABLET 0 0 0

36 ASAM ASKORBAT ( VIT C ) TABLET 50 MG TABLET 0 0 0

37 ASAM FOLAT 1MG TABLET TABLET 0 0 0

38 ASAM MEFENAMAT TABLET 500 MG TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

39 ASAM TRANEKSAMAT 100 MG/ML INJEKSI AMPUL 0 0 0

40 ASAM TRANEKSAMAT 500 MG TABLET TABLET 0 0 0

41 ASAM VALPROAT 250 MG TABLET / TABLET 0 0


DEPAKOTE ER 0

42 ASEPTAN 500CC + PUMP BOTOL 0 0 0

43 ASEPTIC GEL 500CC + DISPENSER BOTOL 0 0 0

44 ASERING (ASETAT RINGER) SOFT BAG BOTOL 0 0 0

45 ASETOSAL TABLET 100 (80) MG TABLET 0 0 0

46 ASIKLOVIR KREAM 5 % 5 GR TUBE 0 0 0

47 ASIKLOVIR TABLET 400 MG TABLET 0 0 0

48 ATROPIN SULFAT INJEKSI 0,25 MG/ML 1 ML AMPUL 0 0 0

49 ATTAPULGIT + PECTIN TABLET TABLET 0 0 0

50 BETAHISTINE MESILAT 24 MG TABLET TABLET 0 0 0

51 BETAHISTINMESILAT 6 MG TABLET TABLET 0 0 0

52 BETAMETHASON CR 0.05% 20 GR TUBE 4 4 4

53 BETAMETHASONE CREAM 0,1 % 5 GR TUBE 0 0 0

54 BIONICOM ZINC TABLET TABLET 0 0 0

55 BISAKODIL SUPPOSITORIA 10 MG SUPP. 0 0 0

56 BISAKODIL SUPPOSITORIA 5 MG SUPP. 0 0 0

57 BISOPROLOL 2,5 MG TABLET (CONCOR) TABLET 0 0 0

58 BISOPROLOL 5 MG TABLET TABLET 0 0 0

59 CAT GUT NO. 3/0 CHROMIC PCS 1 1 1

60 CAT GUT NO. 3/0 PLAIN PCS 1 1 1

61 CITICHOLIN 250 MG/ML-2ML INJEKSI AMPUL 0 0 0

62 CLONIDINE 0.15 MG TABLET TABLET 0 0 0

63 CLOPIDOGREL 75 MG TABLET 0 0 0

64 COMBIVENT UDV INHALASI VIAL 0 0 0

65 DEKSAMETHASONE INJEKSI 5 MG/ML 1 ML AMPUL 0 0 0

66 DEKSAMETHASONE TABLET 0,5 MG TABLET 0 0 0

67 DEVITALISASI PASTA ( NON ARSEN ) POT 0 0 0

68 DIAZEPAM INJEKSI 5 MG/ML 2 ML AMPUL 0 0 0

DIAZEPAM LARUTAN RECTAL 5MG/ 2,5ML-


69 TUBE 0 0 0
STESOLID

70 DIAZEPAM TABLET 2 MG TABLET 0 0 0

71 DIAZEPAM TABLET 5 MG TABLET 0 0 0

72 DIFENHIDRAMINE HCL INJEKSI 10 MG/ML 1 ML AMPUL 0 0 0

73 DIGOXIN TABLET 0,25 MG TABLET 0 0 0

74 DIMENHYDRINATE TABLET 50 MG TABLET 0 0 0

75 DOKSISIKLIN TABLET 100 MG KAPSUL 0 0 0

76 DOMPERIDON SUSPENSI 5MG/ML BOTOL 12 12 3 9

77 DOMPERIDON TABLET 10 MG TABLET 66 66 48 18

78 EKSTRACT PLASENTA + NEOMYSIN SALEP 15 TUBE 0 0


GR 0

79 EPINEFRIN (ADRENALIN) HCL INJ.0,1 % 1 ML AMPUL 0 0 0

80 ERITROMISIN KAPSUL 250 MG KAPSUL 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

81 ERITROMISIN SIRUP KERING 200 MG/5ML BOTOL 0 0 0

82 ERITROMISIN TABLET 500 MG KAPSUL 0 0 0

83 ETAKRIDIN ( RIVANOL ) LARUTAN 0,1 % 300 BOTOL 0 0


ML 0

84 ETANOL [ ALKOHOL ] 70 % 1000 ML BOTOL 0 0 0

85 ETIL KLORIDA SEMPROT 100 ML BOTOL 0 0 0

86 EUGENOL CAIRAN 10 ML BOTOL 0 0 0

87 FENITOIN NATRIUM INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0

88 FENITOIN NATRIUM TABLET 100 MG KAPSUL 0 0 0

89 FENOBARBITAL INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0

90 FENOBARBITAL TABLET 30 MG TABLET 0 0 0

91 FENOL GLISEROL TETES TELINGA 10 % 5 ML BOTOL 2 2 2

FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML 1


92 AMPUL 0 0 0
ML
FITOMENADION ( VIT K1 ) TABLET SALUT 10
93 TABLET 0 0 0
MG

94 FITOMENADION INFANT INJ. 2MG/ML AMPUL 0 0 0

FLUPHENASINE DEKANOAT INJEKSI 25 MG 1


95 AMPUL 0 0 0
ML

96 FUROSEMID INJEKSI 10 mg VIAL 0 0 0

97 FUROSEMID TABLET 40 MG TABLET 66 66 66

GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 %


98 10 GR TUBE 1 1 1

99 GARAM ORALIT SACHET 88 88 18 70

100 GEMFIBROZIL 300 MG KAPSUL KAPSUL 0 0 0

101 GENTAMISIN SALEP KULIT 0,1 % 5 GR TUBE 0 0 0

102 GENTAMISIN SALEP MATA 0,3% TUBE 7 7 4 3

103 GENTAMISIN TETES MATA 0,3% BOTOL 0 0 0

104 GLASS IONOMER CEMENT ( GC IX ) BOTOL 0 0 0

105 GLIBENCLAMIDE TABLET 5 MG TABLET 0 0 0

106 GLICERIL GUAIACOLAT TABLET 100 MG TABLET 0 0 0

107 GLIMEPIRIDE 1 MG TABLET TABLET 0 0 0

108 GLIMEPIRIDE 2 MG TABLET TABLET 8 8 8

GLUKOSA 40% DEXTROSE INJECTION U.S.P


109 VIAL 0 0 0
CAIRAN INJEKSI

110 GLUKOSA LARUTAN INFUS 10 % STERIL BOTOL 0 0 0

111 GLUKOSA LARUTAN INFUS 5 % STERIL BOTOL 0 0 0

112 GRISEOFULVIN TABLET 125 MG TABLET 0 0 0

113 HALOPERIDOL 2 MG TABLET 0 0 0

114 HALOPERIDOL DEKANOAT INJ 50 MG VIAL 0 0 0

115 HALOPERIDOL INJ. 5 MG/ML (LODOMER) AMPUL 0 0 0

116 HALOPERIDOL TABLET 1,5 MG TABLET 0 0 0

117 HALOPERIDOL TABLET 5 MG TABLET 0 0 0

118 HERBAKOF SYRUP 60ML BOTOL 6 5 11 2 9

119 HES-HYDROXYETHYL STARCH 6 %/VOLUVEN BOTOL 0 0


INFUS 500 ML 0

120 HIDROCORTISON CR 1% TUBE 0 0 0

121 HIDROCORTISONE CREAM 2,5 % 5 GR TUBE 3 5 8 3 5

122 HYDROCHLORTHIAZIDE 25 MG TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

123 I.V CATHETER NO.16 WITH INJECTION PORT PCS 0 0 0

124 I.V CATHETER NO.18 WITH INJECTION PORT PCS 0 0 0

125 I.V CATHETER NO.20 WITH INJECTION PORT PCS 0 0 0

126 I.V CATHETER NO.22 WITH INJECTION PORT PCS 0 0 0

127 I.V CATHETER NO.24 WITH INJECTION PORT PCS 0 0 0

128 I.V CATHETER NO.26 WITH INJECTION PORT PCS 0 0 0

129 IBUPROFEN FORTE SYRUP 200MG/5ML BOTOL 0 0 0

130 IBUPROFEN SUSPENSI 100 MG/5 ML 60 ML BOTOL 1 5 6 4 2

131 IBUPROFEN TABLET 400 MG TABLET 0 0 0

132 INFUSION SET ANAK PCS 0 0 0

133 INFUSION SET DEWASA PCS 0 0 0

134 ISOSORBIDE DINITRATE SUBLINGUAL 5 MG TABLET 0 0 0

135 KAEN 3B BOTOL 0 0 0

136 KALIUM DIKLOFENAK 50 MG TABLET TABLET 0 0 0

KALSIUM GLUCONAS INJEKSI 100 MG/ML 10


137 AMPUL 0 0 0
ML

138 KALSIUM LAKTAT (KALK) TABLET 500 MG TABLET 384 600 984 724 260

139 KANTONG URINE DEWASA PCS 0 0 0

140 KAPAS PEMBALUT/ABSORBEN 250 GR BKS 0 0 0

141 KAPTOPRIL TABLET 25 MG TABLET 0 0 0

142 KARBAMAZEPIN TABLET 200 MG TABLET 0 0 0

143 KASA KOMPRES 40/40 STERIL BKS 2 2 2

144 KASA PEMBALUT HIDROFIL 16 X 16 CM STRIL ROL 3 3 3

145 KASA PEMBALUT HIDROFIL 2 M X 80 CM ROL 2 2 2

146 KASA PEMBALUT HIDROFIL 4 M X 10 CM ROL 0 0 0

147 KASA PEMBALUT HIDROFIL 4 M X 5 CM ROL 10 10 10

148 KASA STERIL (DARYAN TOLLE)YG DIRESAPI PCS 0 0


FRAMISETIN 0

149 KETOKONAZOLE TABLET 200 MG TABLET 0 0 0

150 KETOPROFEN 100 MG SUPPOSITORIA SUPP. 0 0 0

151 KLINDAMISIN KAPSUL 150 MG TABLET 0 0 0

152 KLINDAMISIN KAPSUL 300 MG KAPSUL 0 0 0

153 KLOBAZAM 10 MG TABLET TABLET 0 0 0

154 KLORAMFENIKOL KAPSUL 500 MG KAPSUL 0 0 0

155 KLORAMFENIKOL SALEP KULIT 2 % TUBE 0 0 0

156 KLORAMFENIKOL SALEP MATA 1 % TUBE 0 0 0

157 KLORAMFENIKOL SUSPENSI 125 MG/5 ML BOTOL 0 0 0

158 KLORAMFENIKOL TETES TELINGA 3 % BOTOL 0 0 0

KLORFENIRAMINE MALEAT (CTM) TABLET 4


159 MG TABLET 0 0 0

160 KLORPROMAZIN HCL INJEKSI 25 MG/ML 1 ML AMPUL 0 0 0

161 KLORPROMAZIN HCL INJEKSI 50 MG/ML 1 ML AMPUL 0 0 0

162 KLORPROMAZIN HCL TABLET 100 MG TABLET 0 0 0

163 KLOZAPIN 100 MG TABLET TABLET 0 0 0

164 KLOZAPIN 25 MG TABLET TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

165 KODEIN HCL TABLET 10 MG TABLET 0 0 0

166 KOTRIMOKSAZOL DEWASA TABLET TABLET 0 0 0

167 KOTRIMOKSAZOL SUSPENSI 60 ML BOTOL 0 0 0

168 LEVOFLOXACIN TABLET 500 MG TABLET 0 0 0

169 LIDOCAIN 2% INJ AMPUL 0 0 0

170 LIDOCAIN COMPOSITUM INJEKSI 2 ML AMPUL 3 3 3

171 LISOL CONCENTRATE 1000 ML BOTOL 0 0 0

172 LOPERAMIDE TABLET 2 MG TABLET 0 0 0

173 LORATADIN TABLET 10 MG TABLET 44 44 20 24

174 LORAZEPAM 2 MG TABLET 0 0 0

175 MAGNESIUM SULFAT INJEKSI (IV) 40 % 25 ML AMPUL 0 0 0

176 MASKER EARLOOP PLUS PCS 0 0 0

177 MASKER KERTAS 3 PLY EAR LOOP PCS 0 0 0

178 MASKER KERTAS 3 PLY TIE ON PCS 0 0 0

179 MASKER N95 PCS 0 0 0

180 MELOKSIKAM TABLET 7,5 MG TABLET 0 0 0

181 METAMIZOL (NORAGES) INJEKSI 500 MG/2ML AMPUL 0 0 0

182 METFORMIN TABLET 500 MG TABLET 65 65 30 35

183 METILERGOMETRIN MALEAT INJEKSI 0,200 AMPUL 0 0


MG 1 ML 0

184 METILERGOMETRIN MALEAT TABLET 0,125 TABLET 0 0


MG 0

185 METILPREDNISOLON TABLET 4 MG TABLET 0 0 0

186 METOKLOPRAMIDE 10 MG TABLET TABLET 0 0 0

187 METOKLOPRAMIDE 5 MG TABLET TABLET 0 0 0

188 METOKLOPROMIDE (SOTATIC) INJEKSI 5 AMPUL 0 0


MG/ML 2 ML 0

189 METOKLOPROMIDE SIRUP BOTOL 0 0 0

190 METRONIDAZOL + NYSTATIN VAG. VIAL 0 0


(PROVAGIN) INJEKSI 0

191 METRONIDAZOL TABLET 250 MG TABLET 0 0 0

192 METRONIDAZOL TABLET 500 MG TABLET 0 0 0

193 METRONIDAZOLE INFUS 5 MG/ML 100 ML BOTOL 0 0 0

194 MIKONAZOL KREAM 10 GR TUBE 3 5 8 7 1

195 MINERAL MIX SACHET 0 0 0

196 NATRIUM DIKLOFENAK TABLET 25 MG TABLET 270 270 60 210

197 NATRIUM DIKLOFENAK TABLET 50 MG TABLET 0 0 0

198 NATRIUM KLORIDA INFUS 0,9 % STERIL BOTOL 1 1 1

199 NIFEDIPINE TABLET 10 MG TABLET 0 0 0

200 NISTATIN TABLET 500.000 UI TABLET 0 0 0

201 NISTATIN VAGINAL TABLET 100.000 UI VAGTAB 8 8 8

202 OBAT BATUK HITAM (OBH) CAIRAN 100 ML BOTOL 0 0 0

203 OKSIGEN NASAL CANNULA ADULT PCS 0 0 0

204 OKSIGEN NASAL CANNULA INFANT PCS 0 0 0

205 OKSITETRACYCLIN SALEP KULIT 3 % 5 GR TUBE 0 0 0

206 OKSITETRACYCLIN SALEP MATA 1 % 3,5 GR TUBE 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

207 OKSITOSIN INJEKSI 10 IU/ML 1 ML AMPUL 0 0 0

208 OMEPRAZOLE TABLET 20 MG KAPSUL 0 0 0

209 ONDANSENTRON 4 MG/2 ML INJEKSI AMPUL 0 0 0

210 PARACETAMOL SYRUP 120 MG/5 ML 60 ML BOTOL 0 5 5 5

211 PARACETAMOL TABLET 500 MG TABLET 490 600 1,090 570 520

212 PARACETAMOL TETES 100 MG/ML 15 ML BOTOL 0 3 3 3

213 PEHAVRAL TABLET TABLET 0 0 0

214 PERAK SULFADIAZIN KRIM 1 % TUBE 0 0 0

215 PERHYDROL [ H2O2 ] 3 % 800 ML BOTOL 0 0 0

216 PERMETHRINE 5% CR 15 GRAM TUBE 5 5 4 1

217 PIRACETAM TABLET 800 MG TABLET 0 0 0

218 PIRANTEL PAMOAT TABLET TABLET 0 0 0

219 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG TABLET 0 0 0

220 PIROKSIKAM KAPSUL 10 MG KAPSUL 0 0 0

221 PLESTER 10 CM X 2 M ROL 0 0 0

222 PREDNISON TABLET 5 MG TABLET 0 100 100 16 84

223 PROPRANOLOL HCL TABLET 40 MG TABLET 0 0 0

224 PROPILTHIOURACIL TABLET 100 MG TABLET 0 0 0

225 RANITIDIN INJEKSI 25 MG/ ML AMPUL 0 0 0

226 RESPERIDON 2 MG TABLET TABLET 0 0 0

227 RINGER LAKTATE LARUTAN INFUS STERIL BOTOL 0 0 0

228 SALBUTAMOL TABLET 2 MG TABLET 100 100 34 66

229 SALBUTAMOL TABLET 4 MG TABLET 0 0 0

230 SALEP 2-4 KOMBINASI 30 GR POT 3 3 1 2

231 SALICYL BEDAK 2 % KOTAK 0 0 0

232 SARUNG TANGAM NON STERIL L PCS 0 0 0

233 SARUNG TANGAN NON STERIL M PCS 161 161 50 111

234 SARUNG TANGAN NON STERIL S PCS 0 0 0

235 SARUNG TANGAN STERIL NO 6 PSG 0 0 0

236 SARUNG TANGAN STERIL NO. 7,5 PSG 0 0 0

237 SARUNG TANGAN STERILE NO.6,5 PSG 0 0 0

238 SARUNG TANGAN STERILE NO.7 PSG 3 3 3

239 SEFADROKSIL KAPSUL 500 MG KAPSUL 0 0 0

240 SEFIKSIM KAPSUL 100 MG KAPSUL 0 0 0

SERUM ANTI BISA ULAR POLIVALEN INJ.5 ML


241 VIAL 0 0 0
(ABU I)
SERUM ANTI TETANUS INJEKSI 1.500 IU/AMP
242 VIAL 0 0 0
(ATS)

243 SETIRIZINE TABLET 10 MG TABLET 40 40 40 0

244 SIANOKOBALAMIN ( VIT B12 ) INJEKSI 500 AMPUL 0 0 0


MCG/ML 1 ML

245 SIANOKOBALAMIN ( VIT B12 ) TABLET 50 MCG TABLET 190 190 78 112

246 SILK (BENANG BEDAH SUTERA) NO.3/0 PCS 1 1 1

247 SIMETIDINE TABLET 200 MG TABLET 0 0 0

248 SIMVASTATIN TABLET 10 MG TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

249 SIPROFLOXACIN INFUS 2% BOTOL 0 0 0

250 SIPROFLOXACIN TABLET 500 MG TABLET 0 0 0

251 SPONS GELATIN CUBICLES 1x1x1 CM PCS 0 0 0

252 STIMUNO SYR BOTOL 0 0 0

253 STIMUNO TAB (100) TABLET 0 0 0

254 STIMUNO TAB (30) BOTOL 0 0 0

255 SULFADOKSIN TABLET TABLET 0 0 0

SULFASETAMID NATRIUM TETES MATA 15 %


256 BOTOL 0 0 0
5 ML

257 TABLET TAMBAH DARAH TABLET 0 600 600 431 169

TEMPORARY CAVITY SEALER [TUMPATAN


258 PCS 0 0 0
SEMENTARA] (CAVIT G)

259 TETAGRAM 150 IU AMPUL 0 0 0

260 TETRAKAIN HCL TETES MATA 5 ML BOTOL 0 0 0

261 TETRASIKLIN HCL TABLET 500 MG KAPSUL 0 0 0

262 THIAMIN HCL (VIT B1) INJEKSI 100 MG/ML 1 ML AMPUL 0 0 0

THIAMIN HCL MONONITRAT (VIT B1) TABLET


263 TABLET 0 0 0
100 MG
THIAMIN HCL MONONITRAT (VIT B1) TABLET
264 TABLET 0 0 0
50 MG

265 TRAMADOL INJEKSI 50 MG/ML AMPUL 0 0 0

266 TRANFUSION SET ADULT WITH Y INJECTION PCS 0 0 0

267 TRIFLOUPERASIN TABLET 5 MG TABLET 0 0 0

268 TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2 TABLET 0 0


MG 0

269 VITAMIN B COMPLEX TABLET TABLET 0 0 0

270 YODIUM POVIDON LARUTAN 10 % 30 ML BOTOL 0 0 0

271 YODIUM POVIDON LARUTAN 10% 60 ML BOTOL 0 0 0

272 ZENTRA (TRIPROLIDINE|PSEUDOEPHEDRINE) TABLET 0 100 100 10 90

273 ZINK 20 MG TABLET TABLET 100 100 100

274 Hi-D 1000 CHOLECALCIFEROL TABLET 0 0 0

OBAT PROGRAM / HIBAH

1 AMITRIPTYLINE 25 MG TABLET 0 0 0

2 HALOPERIDOLE INJEKSI AMPUL 0 0 0

3 HALOPERIDOLE 1,5 MG TABLET 0 0 0

4 HALOPERIDOLE 5 MG TABLET 0 0 0

5 LODOMER 2 MG TABLET 0 0 0

6 LODOMER 5 MG TABLET 0 0 0

7 TRIHEXYPHENIDYL 2 MG TABLET 0 0 0

8 ALAT SUNTIK 0,05 ML (PROGRAM) PCS 0 0 0

9 ALAT SUNTIK 0,5 ML (PROGRAM) PCS 0 0 0

10 ALAT SUNTIK 5 ML (PROGRAM) PCS 0 0 0

11 ALBENDAZOL TABLET 400 MG TABLET 0 0 0

12 BENZATINE BENZYLPENICILLIN 2.400.000 IU VIAL 0 0 0

13 COTRIMOXAZOLE 800/160 TABLET 0 0 0

14 DIETHYLCARBAMAZINE 100 MG TABLET 0 0 0

15 GARAM ORALIT UNTUK 200 ML AIR SACHET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

16 HIV ABACAVIR TABLET 300 MG BOTOL 0 0 0

17 HIV ACRIPTEGA (TDF 300 + 3TC 300 + DTG 50) BOTOL 0 0 0

18 HIV DOLUTEGRAFIR 50 MG BOTOL 0 0 0

19 HIV EFAFIRENZ 200 MG TABLET BOTOL 0 0 0

20 HIV EFAFIRENZ 600 MG TABLET BOTOL 0 0 0

21 HIV LAMIVUDIN 150 MG TABLET BOTOL 0 0 0

22 HIV NEVIRAPINE 200 MG TABLET BOTOL 0 0 0

23 HIV TENOFOVIR 300 MG BOTOL 0 0 0


HIV TRIPLE FDC ANAK (ZIDOVUDIN
24 BOTOL 0 0 0
60MG+LAMIVUDIN 30MG+NEVIRAPINE 50MG)
HIV TRIPLE FDC DEWASA (TDC+3TC+EFV
25 BOTOL 0 0 0
(300/300/600))

26 HIV ZIDOVUDINE 100 MG @60 KAPSUL BOTOL 0 0 0

27 HIV ZIDOVUDINE 300 MG + LAMIVUDIN 150 MG BOTOL 0 0 0

28 HIV ZIDOVUDINE SYRUP 240 ML BOTOL 0 0 0

29 IODINE TES PCS 0 0 0

30 ISONIAZID TABLET 100 MG TABLET 0 0 0

31 ISONIAZID TABLET 300 MG TABLET 0 0 0

KOMBIPAK AZITHROMYCIN - CEFIXIME


32 TABLET 0 0 0
KOMBINASI

33 MDT COMBI - MB ADULT (RED) BLISTER 0 0 0

34 MDT COMBI - MB CHILD (ORANGE) BLISTER 0 0 0

35 MDT COMBI - PB ADULT (GREEN) BLISTER 0 0 0

36 OBAT ANTI TUBERKULOSIS ANAK PAKET 0 0 0

37 OBAT ANTI TUBERKULOSIS DOSIS HARIAN PAKET 0 0 0


STOP TB KIT

38 OBAT ANTI TUBERKULOSIS KATEGORI 1 PAKET 0 0 0

39 OBAT ANTI TUBERKULOSIS KATEGORI 2 PAKET 0 0 0

40 OBAT ANTI TUBERKULOSIS KOMBIPAK PAKET 0 0 0


KATEGORI I

41 PARACETAMOL 500 MG (P2) TABLET 0 0 0

42 PIRIDOKSIN 25 MG TABLET (VIT B6) TABLET 0 0 0

43 PYRIMETAMINE TABLET 0 0 0

44 REAGEN HIV (FOKUS) PCS 0 0 0

45 REAGEN HIV (STANDART DIAGNOSTIC/SD) PCS 0 0 0

46 REAGEN HIV (VIKIA) PCS 0 0 0

REAGEN HIV DIAGNOSTAR HIV 1\/2 ONE STEP


47 PCS 0 0 0
RAPID TEST
48 REAGEN HIV DIAGNOSTIC KIT FOR HIV (1+2) PCS 0 0 0
ANTIBODY (COLLOIDAL GOLD) V2 PAKET
49 REAGEN SYPHILIS (TREPOCHECK) PCS 0 0 0

50 REAGEN SYPHILIS RDT (FOKUS) PCS 0 0 0

51 RETINOL ( VIT A ) KAPSUL 100.000 IU KAPSUL 0 0 0

52 RETINOL ( VIT A ) KAPSUL 200.000 IU KAPSUL 0 0 0

53 SAFETY BOX PCS 0 0 0

SERUM ANTI DIFTERI CAIRAN INJEKSI 125


54 MG/ML VIAL 0 0 0

55 TABLET TAMBAH DARAH (PROGRAM) TABLET 0 0 0

56 ZINK TABLET DISPERSIBLE 20 MG (PROGRAM) TABLET 0 0 0

57 ALBENDAZOLE SIRUP BOTOL 0 0 0

58 COTRIMOXAZOLE 400/80 TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

59 MINERAL MIX SACHET 0 0 0

60 SD BIOLINE Syphilis 3.0 One Step Syphilis PCS 0 0 0


Antibody Test

OBAT TAMBAHAN

1 ALKOHOL SWAB 0 0 0 0

2 ALLOPURINOL 10 10 10

3 AMLODIPINE 5MG (BLUD) 180 180 21 159

4 ANTISEPTIK GEL (DINKES) 0 1 1 1

5 APD VAKSIN 0 0 0

6 APRON (DINKES) 0 0 0

7 AQUA PRO INJEKSI (BLUD) 0 0 0

8 ASAM MEFENAMAT TABLET 500 MG (BLUD) 253 253 52 201

9 ASIKLOVIR TABLET 40 40 9 31

10 BETAMETHASONE SALEP KULIT (BLUD) 0 0 0

11 BIOPLACENTON (BLUD) 1 1 1

12 BISAKODIL TABLET 5 MG (BLUD) 0 0 0

13 CIPROFLOXACIN (BLUD) 0 0 0

14 CLINDAMISIN KAPS (BLUD) 0 0 0

DEKSAMETHASONE HARSEN TABLET 0,5 MG


15 ((BLUD) ) 190 300 490 250 240

16 DOMPERIDONE TABLET 10 MG ( (BLUD)) 0 0 0

17 EPINEFRIN INJEKSI (BLUD) 0 0 0

18 FENITOIN KAPS (BLUD) 0 0 0

19 FITOMENADION INJ (BLUD) 0 0 0

20 FITOMENADION TABLET (BLUD) 0 0 0

21 FUROSEMIDE TABLET 0 0 0

22 GEMFIBROZIL (BLUD) 29 29 29

23 GENOINT (BLUD) 3 10 13 13

24 GENTAMICIN TETES MATA (BLUD) 4 3 7 5 2

25 GENTIAN VIOLET LARUTAN 1 % (BLUD) 2 2 2

26 GLISERIL GUAIKOLAT/GUAIFENESIN BLUD 329 300 629 109 520

27 HIDROKORTISON CREAM KULIT (BLUD) 0 0 0

HYOSCINE BUTYLBROMIDE (ANTI SPASMODIK


28 80 80 80
BLUD)

29 HYPAFIX (BLUD) 0 0 0

30 INFUSET (BLUD) 0 0 0

31 IV CATHETER (BLUD) 0 0 0

32 KAPTOPRIL TABLET 12,5 MG (BLUD) 448 448 448

33 KLORAMFENIKOL SIRUP (BLUD) 0 0 0

34 KLORAMFENIKOL TETES TELINGA (BLUD) 7 7 7

35 KOTRIMOKSAZOL TAB (BLUD) 100 100 12 88

36 LOPERAMIDE TABLET 2 MG (BLUD) 0 0 0

37 MASKER (DINKES) 0 0 0

38 MASKER N9 0 0 0

39 METFORMIN (BLUD) 0 0 0
SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

40 METILERGOMETRINE INJ (BLUD) 0 0 0

41 MULTIVITAMIN KOMB 0 0 0

42 NEW DIATABS (BLUD) 4 4 4 0

43 NIFEDIPINE TAB (BLUD) 0 0 0

44 NURSE CAP 0 0 0

45 OMEPRAZOLE 20MG 163 163 9 154

46 ONDANSETRONE INJEKSI (BLUD) 0 0 0

47 PARACETAMOL TABLET 500 MG (BLUD) 0 0 0

48 PEHAVRAL 0 0 0

49 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG (BLUD) 188 188 10 178

50 PIROXICAM 0 0 0

51 SALBUTAMOL TABLET 2 MG (BLUD) 9 9 9 0

52 SARUNG TANGAN OBGYN 0 0 0

53 SARUNG TANGAN OBGYN 0 0 0

54 SEFADROKSIL KAPSUL 500 MG (BLUD) 0 0 0

55 VGEL (BLUD) 0 0 0

56 VITAMIN C 50 MG (BLUD) 600 600 200 400

57 ZIVIT ZINC 150 150 100 50

58 ASETIL (DINKES) 0 0 0

59 DEXAMETHASONE (DINKES) 0 0 0

60 OBH (DINKES) 8 5 13 11 2

61 AMBROXOL 77 300 377 77 300

62 BATUK FLU SIRUP (ETAFLUSIN) 1 5 6 6 0

63 BATUK FLU TABLET (ETAFLUSIN) 0 0 0

64 BETADINE GARGLE 0 0 0

65 BUFACOMB SALEP 0 0 0

66 BUFACORT - N 1 3 4 4

67 DARYANTULLE 0 0 0

68 ETIL KLORIDA SPRAY 0 0 0

69 GLIBENCLAMIDE TABLET 5 MG 0 0 0

70 GLIMEPIRIDE 2 MG TABLET 0 0 0

71 KAOLIN PEKTIN SIRUP (NOVADIAR) 5 5 1 4

72 PIRACETAM KAPSUL 0 0 0

73 TIAMFENIKOL KAPSUL 0 0 0

74 VITAMIN ANAK SIRUP (SAMCOVIT) 0 5 5 5 0

75 ANTIHEMOROID/BORRAGINOL (BLUD) 0 0 0

76 ASAM TRANEKSAMAT (BLUD) 0 0 0

77 ASETILSISTEIN (BLUD) 0 0 0

78 ASETOSAL TABLET 100 (80) MG (BLUD) 0 0 0

79 ASIKLOVIR SALEP KULIT (BLUD) 0 0 0

80 BEDAK SALISIL (BLUD) 0 0 0

81 BETAHISTIN TABLET (BLUD) 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

82 CTM (BLUD) 0 0 0

83 GLIMEPIRID 1 MG (BLUD) 0 0 0

84 GLUKOSA INFUS (BLUD) 0 0 0

85 ISDN (BLUD) 0 0 0

86 METILPREDNISOLON TABLET 4 MG (BLUD) 0 0 0

87 METRONIDAZOL (BLUD) 0 0 0

88 OKSITETRASIKLIN SALEP KULIT (BLUD) 0 0 0

89 POVIDONE IODINE 60ML (BLUD) 0 0 0

90 RANITIDIN TABLET (BLUD) 0 0 0

91 SETERIZIN TABLET (BLUD) 0 0 0

92 VITAMIN B KOMPLEKS (BLUD) 0 0 0

93 VITAMIN B1 (BLUD) 0 0 0

94 0 0 0

95 0 0 0

96 0 0 0

97 0 0 0

98 0 0 0

99 0 0 0

100 0 0 0

Blitar , 03 October 2022


Mengetahui / Menyetujui
Yang Menerima, Yang Menyerahkan,
Kepala Puskesmas Petugas Petugas Pengelola Obat
SANANKULON Instalasi Farmasi Kabupaten Pustu/Polindes/Ponkesdes

ENDAH ROSITANINGSIH, SE, MM Apt. AINA MUJTAHIDA A, S.Farm. DANIK YUNITA SARI,Amd.Kep
NIP. 196912302010012002 NIP : 198612188 11033 2 0004 NIP. 198,506,142,022,212,000
DINAS KESEHATAN KABUPATEN BLITAR
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)
WILAYAH : SUMBERINGIN PELAPORAN BULAN : OKTOBER
PUSKESMAS : SANANKULON PERMINTAAN BULAN : NOVEMBER
KECAMATAN : SANANKULON
KABUPATEN : BLITAR
PROVINSI : JAWA TIMUR

SISA STOK JUMLAH


NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

1 2 WAY FOLEY CATHETER NO.16 PCS 0 0 0

2 2 WAY FOLEY CATHETER NO.18 PCS 0 0 0

3 2 WAY FOLEY CATHETER NO.20 PCS 0 0 0

4 ACETYLCYSTEINE CAPSULE 200 MG CAPSULE 26 26 8 18

5 ALAT SUNTIK SEKALI PAKAI 1 ML PCS 0 0 0

6 ALAT SUNTIK SEKALI PAKAI 10 ML PCS 0 0 0

7 ALAT SUNTIK SEKALI PAKAI 20 ML PCS 0 0 0

8 ALAT SUNTIK SEKALI PAKAI 3 ML PCS 23 23 10 13

9 ALAT SUNTIK SEKALI PAKAI 5 ML PCS 60 60 5 55

10 ALKOHOL SWAB PCS 0 0 0

11 ALLOPURINOL TABLET 100 MG TABLET 0 0 0

12 ALPRAZOLAM 1 MG TABLET TABLET 0 0 0

13 AMBROXOL SIRUP 5MG/ML BOTOL 0 0 0

14 AMBROXOL TABLET 30 MG TABLET 0 0 0

15 AMINOPHYLLINE INJEKSI 24 MG/ML 10 ML AMPUL 0 0 0

16 AMINOPHYLLINE TABLET 200 MG TABLET 0 0 0

17 AMITRIPTYLLINE HCL TABLET 25 MG TABLET 0 0 0

18 AMLODIPINE TABLET 10 MG TABLET 0 100 100 6 94

19 AMLODIPINE TABLET 5 MG TABLET 0 0 0

20 AMOKSISILIN DRY SYRUP 125 MG/5 ML 60 ML BOTOL 0 0 0

21 AMOKSISILIN SERBUK INJEKSI 1000 MG VIAL 0 0 0

22 AMOKSISILIN TABLET 500 MG KAPLET 170 170 160 10

AMOXCICILIN FORTE SYRUP KERING


23 BOTOL 0 0 0
250MG/5ML
AMPICILLIN SERBUK INJEKSI 1.000 MG
24 VIAL 0 0 0
MG/VIAL

25 ANTALGIN 500 MG TABLET (METAMIZOL) TABLET 0 0 0

26 ANTASIDA DOEN TABLET KOMBINASI TABLET 628 200 828 114 714

27 ANTASIDA SUSPENSI 60 ML BOTOL 11 10 21 7 14

28 ANTI BAKTERI DOEN SALEP KOMBINASI 5 GR POT 0 0 0

29 ANTI FUNGI DOEN SALEP KOMBINASI 30 GR POT 2 2 2

30 ANTI HAEMOROID DOEN KOMBINASI SUPP. 0 0 0

31 ANTI MIGRAIN DOEN TABLET KOMBINASI TABLET 0 0 0

32 ANTI SPASMODIK INJEKSI (SPASHI) AMPUL 0 0 0

33 ANTI SPASMODIK TABLET (DORMICOMP) TABLET 0 0 0

34 AQUA PRO INJEKSI STERIL BEBAS PIROGEN 20 BOTOL 0 0


ML 0

35 ASAM ASKORBAT ( VIT C ) TABLET 250 MG TABLET 0 0 0

36 ASAM ASKORBAT ( VIT C ) TABLET 50 MG TABLET 0 0 0

37 ASAM FOLAT 1MG TABLET TABLET 0 0 0

38 ASAM MEFENAMAT TABLET 500 MG TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

39 ASAM TRANEKSAMAT 100 MG/ML INJEKSI AMPUL 0 0 0

40 ASAM TRANEKSAMAT 500 MG TABLET TABLET 0 0 0

ASAM VALPROAT 250 MG TABLET /


41 TABLET 0 0 0
DEPAKOTE ER

42 ASEPTAN 500CC + PUMP BOTOL 0 0 0

43 ASEPTIC GEL 500CC + DISPENSER BOTOL 0 0 0

44 ASERING (ASETAT RINGER) SOFT BAG BOTOL 0 0 0

45 ASETOSAL TABLET 100 (80) MG TABLET 0 0 0

46 ASIKLOVIR KREAM 5 % 5 GR TUBE 0 0 0

47 ASIKLOVIR TABLET 400 MG TABLET 0 0 0

48 ATROPIN SULFAT INJEKSI 0,25 MG/ML 1 ML AMPUL 0 0 0

49 ATTAPULGIT + PECTIN TABLET TABLET 0 0 0

50 BETAHISTINE MESILAT 24 MG TABLET TABLET 0 0 0

51 BETAHISTINMESILAT 6 MG TABLET TABLET 0 0 0

52 BETAMETHASON CR 0.05% 20 GR TUBE 4 4 1 3

53 BETAMETHASONE CREAM 0,1 % 5 GR TUBE 0 0 0

54 BIONICOM ZINC TABLET TABLET 0 0 0

55 BISAKODIL SUPPOSITORIA 10 MG SUPP. 0 0 0

56 BISAKODIL SUPPOSITORIA 5 MG SUPP. 0 0 0

57 BISOPROLOL 2,5 MG TABLET (CONCOR) TABLET 0 0 0

58 BISOPROLOL 5 MG TABLET TABLET 0 0 0

59 CAT GUT NO. 3/0 CHROMIC PCS 1 1 1

60 CAT GUT NO. 3/0 PLAIN PCS 1 1 1

61 CITICHOLIN 250 MG/ML-2ML INJEKSI AMPUL 0 0 0

62 CLONIDINE 0.15 MG TABLET TABLET 0 0 0

63 CLOPIDOGREL 75 MG TABLET 0 0 0

64 COMBIVENT UDV INHALASI VIAL 0 0 0

65 DEKSAMETHASONE INJEKSI 5 MG/ML 1 ML AMPUL 0 0 0

66 DEKSAMETHASONE TABLET 0,5 MG TABLET 0 0 0

67 DEVITALISASI PASTA ( NON ARSEN ) POT 0 0 0

68 DIAZEPAM INJEKSI 5 MG/ML 2 ML AMPUL 0 0 0

69 DIAZEPAM LARUTAN RECTAL 5MG/ 2,5ML- TUBE 0 0


STESOLID 0

70 DIAZEPAM TABLET 2 MG TABLET 0 0 0

71 DIAZEPAM TABLET 5 MG TABLET 0 0 0

72 DIFENHIDRAMINE HCL INJEKSI 10 MG/ML 1 ML AMPUL 0 0 0

73 DIGOXIN TABLET 0,25 MG TABLET 0 0 0

74 DIMENHYDRINATE TABLET 50 MG TABLET 0 0 0

75 DOKSISIKLIN TABLET 100 MG KAPSUL 0 0 0

76 DOMPERIDON SUSPENSI 5MG/ML BOTOL 9 9 2 7

77 DOMPERIDON TABLET 10 MG TABLET 18 18 18 0

EKSTRACT PLASENTA + NEOMYSIN SALEP 15


78 TUBE 0 0 0
GR

79 EPINEFRIN (ADRENALIN) HCL INJ.0,1 % 1 ML AMPUL 0 0 0

80 ERITROMISIN KAPSUL 250 MG KAPSUL 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

81 ERITROMISIN SIRUP KERING 200 MG/5ML BOTOL 0 0 0

82 ERITROMISIN TABLET 500 MG KAPSUL 0 0 0

ETAKRIDIN ( RIVANOL ) LARUTAN 0,1 % 300


83 BOTOL 0 0 0
ML

84 ETANOL [ ALKOHOL ] 70 % 1000 ML BOTOL 0 0 0

85 ETIL KLORIDA SEMPROT 100 ML BOTOL 0 0 0

86 EUGENOL CAIRAN 10 ML BOTOL 0 0 0

87 FENITOIN NATRIUM INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0

88 FENITOIN NATRIUM TABLET 100 MG KAPSUL 0 0 0

89 FENOBARBITAL INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0

90 FENOBARBITAL TABLET 30 MG TABLET 0 0 0

91 FENOL GLISEROL TETES TELINGA 10 % 5 ML BOTOL 2 2 2

92 FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML 1 AMPUL 0 0


ML 0

93 FITOMENADION ( VIT K1 ) TABLET SALUT 10 TABLET 0 0


MG 0

94 FITOMENADION INFANT INJ. 2MG/ML AMPUL 0 0 0

95 FLUPHENASINE DEKANOAT INJEKSI 25 MG 1 AMPUL 0 0


ML 0

96 FUROSEMID INJEKSI 10 mg VIAL 0 0 0

97 FUROSEMID TABLET 40 MG TABLET 66 66 66 0

98 GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 % TUBE 1 3 4


10 GR 4

99 GARAM ORALIT SACHET 70 70 12 58

100 GEMFIBROZIL 300 MG KAPSUL KAPSUL 0 0 0

101 GENTAMISIN SALEP KULIT 0,1 % 5 GR TUBE 0 0 0

102 GENTAMISIN SALEP MATA 0,3% TUBE 3 5 8 2 6

103 GENTAMISIN TETES MATA 0,3% BOTOL 0 5 5 5

104 GLASS IONOMER CEMENT ( GC IX ) BOTOL 0 0 0

105 GLIBENCLAMIDE TABLET 5 MG TABLET 0 0 0

106 GLICERIL GUAIACOLAT TABLET 100 MG TABLET 0 0 0

107 GLIMEPIRIDE 1 MG TABLET TABLET 0 0 0

108 GLIMEPIRIDE 2 MG TABLET TABLET 8 8 8

GLUKOSA 40% DEXTROSE INJECTION U.S.P


109 CAIRAN INJEKSI VIAL 0 0 0

110 GLUKOSA LARUTAN INFUS 10 % STERIL BOTOL 0 0 0

111 GLUKOSA LARUTAN INFUS 5 % STERIL BOTOL 0 0 0

112 GRISEOFULVIN TABLET 125 MG TABLET 0 0 0

113 HALOPERIDOL 2 MG TABLET 0 0 0

114 HALOPERIDOL DEKANOAT INJ 50 MG VIAL 0 0 0

115 HALOPERIDOL INJ. 5 MG/ML (LODOMER) AMPUL 0 0 0

116 HALOPERIDOL TABLET 1,5 MG TABLET 0 0 0

117 HALOPERIDOL TABLET 5 MG TABLET 0 0 0

118 HERBAKOF SYRUP 60ML BOTOL 9 5 14 14

HES-HYDROXYETHYL STARCH 6 %/VOLUVEN


119 BOTOL 0 0 0
INFUS 500 ML

120 HIDROCORTISON CR 1% TUBE 0 0 0

121 HIDROCORTISONE CREAM 2,5 % 5 GR TUBE 5 5 5 0

122 HYDROCHLORTHIAZIDE 25 MG TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

123 I.V CATHETER NO.16 WITH INJECTION PORT PCS 0 0 0

124 I.V CATHETER NO.18 WITH INJECTION PORT PCS 0 0 0

125 I.V CATHETER NO.20 WITH INJECTION PORT PCS 0 0 0

126 I.V CATHETER NO.22 WITH INJECTION PORT PCS 0 0 0

127 I.V CATHETER NO.24 WITH INJECTION PORT PCS 0 0 0

128 I.V CATHETER NO.26 WITH INJECTION PORT PCS 0 0 0

129 IBUPROFEN FORTE SYRUP 200MG/5ML BOTOL 0 0 0

130 IBUPROFEN SUSPENSI 100 MG/5 ML 60 ML BOTOL 2 10 12 3 9

131 IBUPROFEN TABLET 400 MG TABLET 0 0 0

132 INFUSION SET ANAK PCS 0 0 0

133 INFUSION SET DEWASA PCS 0 0 0

134 ISOSORBIDE DINITRATE SUBLINGUAL 5 MG TABLET 0 0 0

135 KAEN 3B BOTOL 0 0 0

136 KALIUM DIKLOFENAK 50 MG TABLET TABLET 0 0 0

137 KALSIUM GLUCONAS INJEKSI 100 MG/ML 10 AMPUL 0 0


ML 0

138 KALSIUM LAKTAT (KALK) TABLET 500 MG TABLET 260 500 760 340 420

139 KANTONG URINE DEWASA PCS 0 0 0

140 KAPAS PEMBALUT/ABSORBEN 250 GR BKS 0 0 0

141 KAPTOPRIL TABLET 25 MG TABLET 0 0 0

142 KARBAMAZEPIN TABLET 200 MG TABLET 0 0 0

143 KASA KOMPRES 40/40 STERIL BKS 2 2 2

144 KASA PEMBALUT HIDROFIL 16 X 16 CM STRIL ROL 3 3 3

145 KASA PEMBALUT HIDROFIL 2 M X 80 CM ROL 2 2 2

146 KASA PEMBALUT HIDROFIL 4 M X 10 CM ROL 0 0 0

147 KASA PEMBALUT HIDROFIL 4 M X 5 CM ROL 10 10 10

KASA STERIL (DARYAN TOLLE)YG DIRESAPI


148 PCS 0 0 0
FRAMISETIN

149 KETOKONAZOLE TABLET 200 MG TABLET 0 0 0

150 KETOPROFEN 100 MG SUPPOSITORIA SUPP. 0 0 0

151 KLINDAMISIN KAPSUL 150 MG TABLET 0 0 0

152 KLINDAMISIN KAPSUL 300 MG KAPSUL 0 0 0

153 KLOBAZAM 10 MG TABLET TABLET 0 0 0

154 KLORAMFENIKOL KAPSUL 500 MG KAPSUL 0 0 0

155 KLORAMFENIKOL SALEP KULIT 2 % TUBE 0 0 0

156 KLORAMFENIKOL SALEP MATA 1 % TUBE 0 0 0

157 KLORAMFENIKOL SUSPENSI 125 MG/5 ML BOTOL 0 0 0

158 KLORAMFENIKOL TETES TELINGA 3 % BOTOL 0 0 0

159 KLORFENIRAMINE MALEAT (CTM) TABLET 4 TABLET 0 0


MG 0

160 KLORPROMAZIN HCL INJEKSI 25 MG/ML 1 ML AMPUL 0 0 0

161 KLORPROMAZIN HCL INJEKSI 50 MG/ML 1 ML AMPUL 0 0 0

162 KLORPROMAZIN HCL TABLET 100 MG TABLET 0 0 0

163 KLOZAPIN 100 MG TABLET TABLET 0 0 0

164 KLOZAPIN 25 MG TABLET TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

165 KODEIN HCL TABLET 10 MG TABLET 0 0 0

166 KOTRIMOKSAZOL DEWASA TABLET TABLET 0 0 0

167 KOTRIMOKSAZOL SUSPENSI 60 ML BOTOL 0 0 0

168 LEVOFLOXACIN TABLET 500 MG TABLET 0 0 0

169 LIDOCAIN 2% INJ AMPUL 0 0 0

170 LIDOCAIN COMPOSITUM INJEKSI 2 ML AMPUL 3 3 3

171 LISOL CONCENTRATE 1000 ML BOTOL 0 0 0

172 LOPERAMIDE TABLET 2 MG TABLET 0 0 0

173 LORATADIN TABLET 10 MG TABLET 24 24 14 10

174 LORAZEPAM 2 MG TABLET 0 0 0

175 MAGNESIUM SULFAT INJEKSI (IV) 40 % 25 ML AMPUL 0 0 0

176 MASKER EARLOOP PLUS PCS 0 0 0

177 MASKER KERTAS 3 PLY EAR LOOP PCS 0 0 0

178 MASKER KERTAS 3 PLY TIE ON PCS 0 0 0

179 MASKER N95 PCS 0 0 0

180 MELOKSIKAM TABLET 7,5 MG TABLET 0 0 0

181 METAMIZOL (NORAGES) INJEKSI 500 MG/2ML AMPUL 0 0 0

182 METFORMIN TABLET 500 MG TABLET 35 35 35

METILERGOMETRIN MALEAT INJEKSI 0,200


183 AMPUL 0 0 0
MG 1 ML
METILERGOMETRIN MALEAT TABLET 0,125
184 TABLET 0 0 0
MG

185 METILPREDNISOLON TABLET 4 MG TABLET 0 0 0

186 METOKLOPRAMIDE 10 MG TABLET TABLET 0 0 0

187 METOKLOPRAMIDE 5 MG TABLET TABLET 0 0 0

METOKLOPROMIDE (SOTATIC) INJEKSI 5


188 AMPUL 0 0 0
MG/ML 2 ML

189 METOKLOPROMIDE SIRUP BOTOL 0 0 0

METRONIDAZOL + NYSTATIN VAG.


190 VIAL 0 0 0
(PROVAGIN) INJEKSI

191 METRONIDAZOL TABLET 250 MG TABLET 0 0 0

192 METRONIDAZOL TABLET 500 MG TABLET 0 0 0

193 METRONIDAZOLE INFUS 5 MG/ML 100 ML BOTOL 0 0 0

194 MIKONAZOL KREAM 10 GR TUBE 1 1 1

195 MINERAL MIX SACHET 0 0 0

196 NATRIUM DIKLOFENAK TABLET 25 MG TABLET 210 210 100 110

197 NATRIUM DIKLOFENAK TABLET 50 MG TABLET 0 0 0

198 NATRIUM KLORIDA INFUS 0,9 % STERIL BOTOL 1 1 1

199 NIFEDIPINE TABLET 10 MG TABLET 0 0 0

200 NISTATIN TABLET 500.000 UI TABLET 0 0 0

201 NISTATIN VAGINAL TABLET 100.000 UI VAGTAB 8 8 0 8

202 OBAT BATUK HITAM (OBH) CAIRAN 100 ML BOTOL 0 0 0

203 OKSIGEN NASAL CANNULA ADULT PCS 0 0 0

204 OKSIGEN NASAL CANNULA INFANT PCS 0 0 0

205 OKSITETRACYCLIN SALEP KULIT 3 % 5 GR TUBE 0 0 0

206 OKSITETRACYCLIN SALEP MATA 1 % 3,5 GR TUBE 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

207 OKSITOSIN INJEKSI 10 IU/ML 1 ML AMPUL 0 0 0

208 OMEPRAZOLE TABLET 20 MG KAPSUL 0 0 0

209 ONDANSENTRON 4 MG/2 ML INJEKSI AMPUL 0 0 0

210 PARACETAMOL SYRUP 120 MG/5 ML 60 ML BOTOL 5 5 3 2

211 PARACETAMOL TABLET 500 MG TABLET 520 500 1,020 440 580

212 PARACETAMOL TETES 100 MG/ML 15 ML BOTOL 3 3 3

213 PEHAVRAL TABLET TABLET 0 0 0

214 PERAK SULFADIAZIN KRIM 1 % TUBE 0 0 0

215 PERHYDROL [ H2O2 ] 3 % 800 ML BOTOL 0 0 0

216 PERMETHRINE 5% CR 15 GRAM TUBE 1 3 4 4

217 PIRACETAM TABLET 800 MG TABLET 0 0 0

218 PIRANTEL PAMOAT TABLET TABLET 0 0 0

219 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG TABLET 0 0 0

220 PIROKSIKAM KAPSUL 10 MG KAPSUL 0 0 0

221 PLESTER 10 CM X 2 M ROL 0 0 0

222 PREDNISON TABLET 5 MG TABLET 84 84 84

223 PROPRANOLOL HCL TABLET 40 MG TABLET 0 0 0

224 PROPILTHIOURACIL TABLET 100 MG TABLET 0 0 0

225 RANITIDIN INJEKSI 25 MG/ ML AMPUL 0 0 0

226 RESPERIDON 2 MG TABLET TABLET 0 0 0

227 RINGER LAKTATE LARUTAN INFUS STERIL BOTOL 0 0 0

228 SALBUTAMOL TABLET 2 MG TABLET 66 66 66

229 SALBUTAMOL TABLET 4 MG TABLET 0 0 0

230 SALEP 2-4 KOMBINASI 30 GR POT 2 2 2

231 SALICYL BEDAK 2 % KOTAK 0 0 0

232 SARUNG TANGAM NON STERIL L PCS 0 0 0

233 SARUNG TANGAN NON STERIL M PCS 111 111 55 56

234 SARUNG TANGAN NON STERIL S PCS 0 0 0

235 SARUNG TANGAN STERIL NO 6 PSG 0 0 0

236 SARUNG TANGAN STERIL NO. 7,5 PSG 0 0 0

237 SARUNG TANGAN STERILE NO.6,5 PSG 0 0 0

238 SARUNG TANGAN STERILE NO.7 PSG 3 3 3

239 SEFADROKSIL KAPSUL 500 MG KAPSUL 0 0 0

240 SEFIKSIM KAPSUL 100 MG KAPSUL 0 0 0

241 SERUM ANTI BISA ULAR POLIVALEN INJ.5 ML VIAL 0 0


(ABU I) 0

242 SERUM ANTI TETANUS INJEKSI 1.500 IU/AMP VIAL 0 0


(ATS) 0

243 SETIRIZINE TABLET 10 MG TABLET 0 0 0

SIANOKOBALAMIN ( VIT B12 ) INJEKSI 500


244 AMPUL 0 0 0
MCG/ML 1 ML

245 SIANOKOBALAMIN ( VIT B12 ) TABLET 50 MCG TABLET 112 112 112

246 SILK (BENANG BEDAH SUTERA) NO.3/0 PCS 1 1 1

247 SIMETIDINE TABLET 200 MG TABLET 0 0 0

248 SIMVASTATIN TABLET 10 MG TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

249 SIPROFLOXACIN INFUS 2% BOTOL 0 0 0

250 SIPROFLOXACIN TABLET 500 MG TABLET 0 0 0

251 SPONS GELATIN CUBICLES 1x1x1 CM PCS 0 0 0

252 STIMUNO SYR BOTOL 0 0 0

253 STIMUNO TAB (100) TABLET 0 0 0

254 STIMUNO TAB (30) BOTOL 0 0 0

255 SULFADOKSIN TABLET TABLET 0 0 0

SULFASETAMID NATRIUM TETES MATA 15 %


256 BOTOL 0 0 0
5 ML

257 TABLET TAMBAH DARAH TABLET 169 169 169 0

TEMPORARY CAVITY SEALER [TUMPATAN


258 SEMENTARA] (CAVIT G) PCS 0 0 0

259 TETAGRAM 150 IU AMPUL 0 0 0

260 TETRAKAIN HCL TETES MATA 5 ML BOTOL 0 0 0

261 TETRASIKLIN HCL TABLET 500 MG KAPSUL 0 0 0

262 THIAMIN HCL (VIT B1) INJEKSI 100 MG/ML 1 ML AMPUL 0 0 0

263 THIAMIN HCL MONONITRAT (VIT B1) TABLET TABLET 0 0


100 MG 0

264 THIAMIN HCL MONONITRAT (VIT B1) TABLET TABLET 0 0


50 MG 0

265 TRAMADOL INJEKSI 50 MG/ML AMPUL 0 0 0

266 TRANFUSION SET ADULT WITH Y INJECTION PCS 0 0 0

267 TRIFLOUPERASIN TABLET 5 MG TABLET 0 0 0

TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2


268 TABLET 0 0 0
MG

269 VITAMIN B COMPLEX TABLET TABLET 0 0 0

270 YODIUM POVIDON LARUTAN 10 % 30 ML BOTOL 0 0 0

271 YODIUM POVIDON LARUTAN 10% 60 ML BOTOL 0 0 0

272 ZENTRA (TRIPROLIDINE|PSEUDOEPHEDRINE) TABLET 90 90 90

273 ZINK 20 MG TABLET TABLET 100 100 100

274 Hi-D 1000 CHOLECALCIFEROL TABLET 0 0 0

OBAT PROGRAM / HIBAH

1 AMITRIPTYLINE 25 MG TABLET 0 0 0

2 HALOPERIDOLE INJEKSI AMPUL 0 0 0

3 HALOPERIDOLE 1,5 MG TABLET 0 0 0

4 HALOPERIDOLE 5 MG TABLET 0 0 0

5 LODOMER 2 MG TABLET 0 0 0

6 LODOMER 5 MG TABLET 0 0 0

7 TRIHEXYPHENIDYL 2 MG TABLET 0 0 0

8 ALAT SUNTIK 0,05 ML (PROGRAM) PCS 0 0 0

9 ALAT SUNTIK 0,5 ML (PROGRAM) PCS 0 0 0

10 ALAT SUNTIK 5 ML (PROGRAM) PCS 0 0 0

11 ALBENDAZOL TABLET 400 MG TABLET 0 0 0

12 BENZATINE BENZYLPENICILLIN 2.400.000 IU VIAL 0 0 0

13 COTRIMOXAZOLE 800/160 TABLET 0 0 0

14 DIETHYLCARBAMAZINE 100 MG TABLET 0 0 0

15 GARAM ORALIT UNTUK 200 ML AIR SACHET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

16 HIV ABACAVIR TABLET 300 MG BOTOL 0 0 0

17 HIV ACRIPTEGA (TDF 300 + 3TC 300 + DTG 50) BOTOL 0 0 0

18 HIV DOLUTEGRAFIR 50 MG BOTOL 0 0 0

19 HIV EFAFIRENZ 200 MG TABLET BOTOL 0 0 0

20 HIV EFAFIRENZ 600 MG TABLET BOTOL 0 0 0

21 HIV LAMIVUDIN 150 MG TABLET BOTOL 0 0 0

22 HIV NEVIRAPINE 200 MG TABLET BOTOL 0 0 0

23 HIV TENOFOVIR 300 MG BOTOL 0 0 0

24 HIV TRIPLE FDC ANAK (ZIDOVUDIN BOTOL 0 0 0


60MG+LAMIVUDIN 30MG+NEVIRAPINE 50MG)
25 HIV TRIPLE FDC DEWASA (TDC+3TC+EFV BOTOL 0 0 0
(300/300/600))

26 HIV ZIDOVUDINE 100 MG @60 KAPSUL BOTOL 0 0 0

27 HIV ZIDOVUDINE 300 MG + LAMIVUDIN 150 MG BOTOL 0 0 0

28 HIV ZIDOVUDINE SYRUP 240 ML BOTOL 0 0 0

29 IODINE TES PCS 0 0 0

30 ISONIAZID TABLET 100 MG TABLET 0 0 0

31 ISONIAZID TABLET 300 MG TABLET 0 0 0

KOMBIPAK AZITHROMYCIN - CEFIXIME


32 TABLET 0 0 0
KOMBINASI

33 MDT COMBI - MB ADULT (RED) BLISTER 0 0 0

34 MDT COMBI - MB CHILD (ORANGE) BLISTER 0 0 0

35 MDT COMBI - PB ADULT (GREEN) BLISTER 0 0 0

36 OBAT ANTI TUBERKULOSIS ANAK PAKET 0 0 0

OBAT ANTI TUBERKULOSIS DOSIS HARIAN


37 STOP TB KIT PAKET 0 0 0

38 OBAT ANTI TUBERKULOSIS KATEGORI 1 PAKET 0 0 0

39 OBAT ANTI TUBERKULOSIS KATEGORI 2 PAKET 0 0 0

40 OBAT ANTI TUBERKULOSIS KOMBIPAK PAKET 0 0 0


KATEGORI I

41 PARACETAMOL 500 MG (P2) TABLET 0 0 0

42 PIRIDOKSIN 25 MG TABLET (VIT B6) TABLET 0 0 0

43 PYRIMETAMINE TABLET 0 0 0

44 REAGEN HIV (FOKUS) PCS 0 0 0

45 REAGEN HIV (STANDART DIAGNOSTIC/SD) PCS 0 0 0

46 REAGEN HIV (VIKIA) PCS 0 0 0

REAGEN HIV DIAGNOSTAR HIV 1\/2 ONE STEP


47 PCS 0 0 0
RAPID TEST
48 REAGEN HIV DIAGNOSTIC KIT FOR HIV (1+2) PCS 0 0 0
ANTIBODY (COLLOIDAL GOLD) V2 PAKET
49 REAGEN SYPHILIS (TREPOCHECK) PCS 0 0 0

50 REAGEN SYPHILIS RDT (FOKUS) PCS 0 0 0

51 RETINOL ( VIT A ) KAPSUL 100.000 IU KAPSUL 0 0 0

52 RETINOL ( VIT A ) KAPSUL 200.000 IU KAPSUL 0 0 0

53 SAFETY BOX PCS 0 0 0

54 SERUM ANTI DIFTERI CAIRAN INJEKSI 125 VIAL 0 0 0


MG/ML

55 TABLET TAMBAH DARAH (PROGRAM) TABLET 0 0 0

56 ZINK TABLET DISPERSIBLE 20 MG (PROGRAM) TABLET 0 0 0

57 ALBENDAZOLE SIRUP BOTOL 0 0 0

58 COTRIMOXAZOLE 400/80 TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

59 MINERAL MIX SACHET 0 0 0

SD BIOLINE Syphilis 3.0 One Step Syphilis


60 PCS 0 0 0
Antibody Test

OBAT TAMBAHAN

1 ALKOHOL SWAB 0 0 0 0

2 ALLOPURINOL 10 10 10 0

3 AMLODIPINE 5MG (BLUD) 159 159 75 84

4 ANTISEPTIK GEL (DINKES) 1 1 1

5 APD VAKSIN 0 0 0

6 APRON (DINKES) 0 0 0

7 AQUA PRO INJEKSI (BLUD) 0 0 0

8 ASAM MEFENAMAT TABLET 500 MG (BLUD) 201 100 301 16 285

9 ASIKLOVIR TABLET 31 31 6 25

10 BETAMETHASONE SALEP KULIT (BLUD) 0 0 0

11 BIOPLACENTON (BLUD) 1 1 1

12 BISAKODIL TABLET 5 MG (BLUD) 0 0 0

13 CIPROFLOXACIN (BLUD) 0 0 0

14 CLINDAMISIN KAPS (BLUD) 0 0 0

15 DEKSAMETHASONE HARSEN TABLET 0,5 MG 240 200 440 190 250


((BLUD) )

16 DOMPERIDONE TABLET 10 MG ( (BLUD)) 0 0 0

17 EPINEFRIN INJEKSI (BLUD) 0 0 0

18 FENITOIN KAPS (BLUD) 0 0 0

19 FITOMENADION INJ (BLUD) 0 0 0

20 FITOMENADION TABLET (BLUD) 0 0 0

21 FUROSEMIDE TABLET 0 0 0

22 GEMFIBROZIL (BLUD) 29 29 13 16

23 GENOINT (BLUD) 13 13 2 11

24 GENTAMICIN TETES MATA (BLUD) 2 2 1 1

25 GENTIAN VIOLET LARUTAN 1 % (BLUD) 2 2 2

26 GLISERIL GUAIKOLAT/GUAIFENESIN BLUD 520 200 720 60 660

27 HIDROKORTISON CREAM KULIT (BLUD) 0 0 0

28 HYOSCINE BUTYLBROMIDE (ANTI SPASMODIK 80 80 80


BLUD)

29 HYPAFIX (BLUD) 0 0 0

30 INFUSET (BLUD) 0 0 0

31 IV CATHETER (BLUD) 0 0 0

32 KAPTOPRIL TABLET 12,5 MG (BLUD) 448 448 10 438

33 KLORAMFENIKOL SIRUP (BLUD) 0 0 0

34 KLORAMFENIKOL TETES TELINGA (BLUD) 7 7 7

35 KOTRIMOKSAZOL TAB (BLUD) 88 88 88

36 LOPERAMIDE TABLET 2 MG (BLUD) 0 0 0

37 MASKER (DINKES) 0 0 0

38 MASKER N9 0 0 0

39 METFORMIN (BLUD) 0 0 0
SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

40 METILERGOMETRINE INJ (BLUD) 0 0 0

41 MULTIVITAMIN KOMB 0 0 0

42 NEW DIATABS (BLUD) 0 0 0

43 NIFEDIPINE TAB (BLUD) 0 0 0

44 NURSE CAP 0 0 0

45 OMEPRAZOLE 20MG 154 154 8 146

46 ONDANSETRONE INJEKSI (BLUD) 0 0 0

47 PARACETAMOL TABLET 500 MG (BLUD) 0 0 0

48 PEHAVRAL 0 0 0

49 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG (BLUD) 178 178 18 160

50 PIROXICAM 0 0 0

51 SALBUTAMOL TABLET 2 MG (BLUD) 0 0 0

52 SARUNG TANGAN OBGYN 0 0 0

53 SARUNG TANGAN OBGYN 0 0 0

54 SEFADROKSIL KAPSUL 500 MG (BLUD) 0 0 0

55 VGEL (BLUD) 0 0 0

56 VITAMIN C 50 MG (BLUD) 400 300 700 450 250

57 ZIVIT ZINC 50 50 10 40

58 ASETIL (DINKES) 0 0 0

59 DEXAMETHASONE (DINKES) 0 0 0

60 OBH (DINKES) 2 3 5 5 0

61 AMBROXOL 300 200 500 30 470

62 BATUK FLU SIRUP (ETAFLUSIN) 0 5 5 2 3

63 BATUK FLU TABLET (ETAFLUSIN) 0 200 200 200

64 BETADINE GARGLE 0 0 0

65 BUFACOMB SALEP 0 0 0

66 BUFACORT - N 4 4 1 3

67 DARYANTULLE 0 0 0

68 ETIL KLORIDA SPRAY 0 0 0

69 GLIBENCLAMIDE TABLET 5 MG 0 0 0

70 GLIMEPIRIDE 2 MG TABLET 0 0 0

71 KAOLIN PEKTIN SIRUP (NOVADIAR) 4 4 1 3

72 PIRACETAM KAPSUL 0 0 0

73 TIAMFENIKOL KAPSUL 0 0 0

74 VITAMIN ANAK SIRUP (SAMCOVIT) 0 5 5 2 3

75 ANTIHEMOROID/BORRAGINOL (BLUD) 0 0 0

76 ASAM TRANEKSAMAT (BLUD) 0 0 0

77 ASETILSISTEIN (BLUD) 0 0 0

78 ASETOSAL TABLET 100 (80) MG (BLUD) 0 0 0

79 ASIKLOVIR SALEP KULIT (BLUD) 0 3 3 3

80 BEDAK SALISIL (BLUD) 0 5 5 5

81 BETAHISTIN TABLET (BLUD) 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

82 CTM (BLUD) 0 288 288 26 262

83 GLIMEPIRID 1 MG (BLUD) 0 0 0

84 GLUKOSA INFUS (BLUD) 0 0 0

85 ISDN (BLUD) 0 0 0

86 METILPREDNISOLON TABLET 4 MG (BLUD) 0 0 0

87 METRONIDAZOL (BLUD) 0 0 0

88 OKSITETRASIKLIN SALEP KULIT (BLUD) 0 0 0

89 POVIDONE IODINE 60ML (BLUD) 0 0 0

90 RANITIDIN TABLET (BLUD) 0 0 0

91 SETERIZIN TABLET (BLUD) 0 200 200 28 172

92 VITAMIN B KOMPLEKS (BLUD) 0 300 300 75 225

93 VITAMIN B1 (BLUD) 0 300 300 35 265

94 0 0 0

95 0 0 0

96 0 0 0

97 0 0 0

98 0 0 0

99 0 0 0

100 0 0 0

Blitar , 03 October 2022


Mengetahui / Menyetujui
Yang Menerima, Yang Menyerahkan,
Kepala Puskesmas Petugas Petugas Pengelola Obat
SANANKULON Instalasi Farmasi Kabupaten Pustu/Polindes/Ponkesdes

ENDAH ROSITANINGSIH, SE, MM Apt. AINA MUJTAHIDA A, S.Farm. DANIK YUNITA SARI,Amd.Kep
NIP. 196912302010012002 NIP : 198612188 11033 2 0004 NIP. 198,506,142,022,212,000
DINAS KESEHATAN KABUPATEN BLITAR
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)
WILAYAH : SUMBERINGIN PELAPORAN BULAN : NOVEMBER
PUSKESMAS : SANANKULON PERMINTAAN BULAN : DESEMBER
KECAMATAN : SANANKULON
KABUPATEN : BLITAR
PROVINSI : JAWA TIMUR

SISA STOK JUMLAH


NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

1 2 WAY FOLEY CATHETER NO.16 PCS 0 0 0

2 2 WAY FOLEY CATHETER NO.18 PCS 0 0 0

3 2 WAY FOLEY CATHETER NO.20 PCS 0 0 0

4 ACETYLCYSTEINE CAPSULE 200 MG CAPSULE 18 18 18

5 ALAT SUNTIK SEKALI PAKAI 1 ML PCS 0 0 0

6 ALAT SUNTIK SEKALI PAKAI 10 ML PCS 0 0 0

7 ALAT SUNTIK SEKALI PAKAI 20 ML PCS 0 0 0

8 ALAT SUNTIK SEKALI PAKAI 3 ML PCS 13 13 13

9 ALAT SUNTIK SEKALI PAKAI 5 ML PCS 55 55 55

10 ALKOHOL SWAB PCS 0 0 0

11 ALLOPURINOL TABLET 100 MG TABLET 0 0 0

12 ALPRAZOLAM 1 MG TABLET TABLET 0 0 0

13 AMBROXOL SIRUP 5MG/ML BOTOL 0 0 0

14 AMBROXOL TABLET 30 MG TABLET 0 0 0

15 AMINOPHYLLINE INJEKSI 24 MG/ML 10 ML AMPUL 0 0 0

16 AMINOPHYLLINE TABLET 200 MG TABLET 0 0 0

17 AMITRIPTYLLINE HCL TABLET 25 MG TABLET 0 0 0

18 AMLODIPINE TABLET 10 MG TABLET 94 94 94

19 AMLODIPINE TABLET 5 MG TABLET 0 0 0

20 AMOKSISILIN DRY SYRUP 125 MG/5 ML 60 ML BOTOL 0 0 0

21 AMOKSISILIN SERBUK INJEKSI 1000 MG VIAL 0 0 0

22 AMOKSISILIN TABLET 500 MG KAPLET 10 10 10

AMOXCICILIN FORTE SYRUP KERING


23 BOTOL 0 0 0
250MG/5ML
AMPICILLIN SERBUK INJEKSI 1.000 MG
24 VIAL 0 0 0
MG/VIAL

25 ANTALGIN 500 MG TABLET (METAMIZOL) TABLET 0 0 0

26 ANTASIDA DOEN TABLET KOMBINASI TABLET 714 714 714

27 ANTASIDA SUSPENSI 60 ML BOTOL 14 14 14

28 ANTI BAKTERI DOEN SALEP KOMBINASI 5 GR POT 0 0 0

29 ANTI FUNGI DOEN SALEP KOMBINASI 30 GR POT 2 2 2

30 ANTI HAEMOROID DOEN KOMBINASI SUPP. 0 0 0

31 ANTI MIGRAIN DOEN TABLET KOMBINASI TABLET 0 0 0

32 ANTI SPASMODIK INJEKSI (SPASHI) AMPUL 0 0 0

33 ANTI SPASMODIK TABLET (DORMICOMP) TABLET 0 0 0

34 AQUA PRO INJEKSI STERIL BEBAS PIROGEN 20 BOTOL 0 0


ML 0

35 ASAM ASKORBAT ( VIT C ) TABLET 250 MG TABLET 0 0 0

36 ASAM ASKORBAT ( VIT C ) TABLET 50 MG TABLET 0 0 0

37 ASAM FOLAT 1MG TABLET TABLET 0 0 0

38 ASAM MEFENAMAT TABLET 500 MG TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

39 ASAM TRANEKSAMAT 100 MG/ML INJEKSI AMPUL 0 0 0

40 ASAM TRANEKSAMAT 500 MG TABLET TABLET 0 0 0

ASAM VALPROAT 250 MG TABLET /


41 TABLET 0 0 0
DEPAKOTE ER

42 ASEPTAN 500CC + PUMP BOTOL 0 0 0

43 ASEPTIC GEL 500CC + DISPENSER BOTOL 0 0 0

44 ASERING (ASETAT RINGER) SOFT BAG BOTOL 0 0 0

45 ASETOSAL TABLET 100 (80) MG TABLET 0 0 0

46 ASIKLOVIR KREAM 5 % 5 GR TUBE 0 0 0

47 ASIKLOVIR TABLET 400 MG TABLET 0 0 0

48 ATROPIN SULFAT INJEKSI 0,25 MG/ML 1 ML AMPUL 0 0 0

49 ATTAPULGIT + PECTIN TABLET TABLET 0 0 0

50 BETAHISTINE MESILAT 24 MG TABLET TABLET 0 0 0

51 BETAHISTINMESILAT 6 MG TABLET TABLET 0 0 0

52 BETAMETHASON CR 0.05% 20 GR TUBE 3 3 3

53 BETAMETHASONE CREAM 0,1 % 5 GR TUBE 0 0 0

54 BIONICOM ZINC TABLET TABLET 0 0 0

55 BISAKODIL SUPPOSITORIA 10 MG SUPP. 0 0 0

56 BISAKODIL SUPPOSITORIA 5 MG SUPP. 0 0 0

57 BISOPROLOL 2,5 MG TABLET (CONCOR) TABLET 0 0 0

58 BISOPROLOL 5 MG TABLET TABLET 0 0 0

59 CAT GUT NO. 3/0 CHROMIC PCS 1 1 1

60 CAT GUT NO. 3/0 PLAIN PCS 1 1 1

61 CITICHOLIN 250 MG/ML-2ML INJEKSI AMPUL 0 0 0

62 CLONIDINE 0.15 MG TABLET TABLET 0 0 0

63 CLOPIDOGREL 75 MG TABLET 0 0 0

64 COMBIVENT UDV INHALASI VIAL 0 0 0

65 DEKSAMETHASONE INJEKSI 5 MG/ML 1 ML AMPUL 0 0 0

66 DEKSAMETHASONE TABLET 0,5 MG TABLET 0 0 0

67 DEVITALISASI PASTA ( NON ARSEN ) POT 0 0 0

68 DIAZEPAM INJEKSI 5 MG/ML 2 ML AMPUL 0 0 0

69 DIAZEPAM LARUTAN RECTAL 5MG/ 2,5ML- TUBE 0 0


STESOLID 0

70 DIAZEPAM TABLET 2 MG TABLET 0 0 0

71 DIAZEPAM TABLET 5 MG TABLET 0 0 0

72 DIFENHIDRAMINE HCL INJEKSI 10 MG/ML 1 ML AMPUL 0 0 0

73 DIGOXIN TABLET 0,25 MG TABLET 0 0 0

74 DIMENHYDRINATE TABLET 50 MG TABLET 0 0 0

75 DOKSISIKLIN TABLET 100 MG KAPSUL 0 0 0

76 DOMPERIDON SUSPENSI 5MG/ML BOTOL 7 7 7

77 DOMPERIDON TABLET 10 MG TABLET 0 0 0

EKSTRACT PLASENTA + NEOMYSIN SALEP 15


78 TUBE 0 0 0
GR

79 EPINEFRIN (ADRENALIN) HCL INJ.0,1 % 1 ML AMPUL 0 0 0

80 ERITROMISIN KAPSUL 250 MG KAPSUL 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

81 ERITROMISIN SIRUP KERING 200 MG/5ML BOTOL 0 0 0

82 ERITROMISIN TABLET 500 MG KAPSUL 0 0 0

ETAKRIDIN ( RIVANOL ) LARUTAN 0,1 % 300


83 BOTOL 0 0 0
ML

84 ETANOL [ ALKOHOL ] 70 % 1000 ML BOTOL 0 0 0

85 ETIL KLORIDA SEMPROT 100 ML BOTOL 0 0 0

86 EUGENOL CAIRAN 10 ML BOTOL 0 0 0

87 FENITOIN NATRIUM INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0

88 FENITOIN NATRIUM TABLET 100 MG KAPSUL 0 0 0

89 FENOBARBITAL INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0

90 FENOBARBITAL TABLET 30 MG TABLET 0 0 0

91 FENOL GLISEROL TETES TELINGA 10 % 5 ML BOTOL 2 2 2

92 FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML 1 AMPUL 0 0


ML 0

93 FITOMENADION ( VIT K1 ) TABLET SALUT 10 TABLET 0 0


MG 0

94 FITOMENADION INFANT INJ. 2MG/ML AMPUL 0 0 0

95 FLUPHENASINE DEKANOAT INJEKSI 25 MG 1 AMPUL 0 0


ML 0

96 FUROSEMID INJEKSI 10 mg VIAL 0 0 0

97 FUROSEMID TABLET 40 MG TABLET 0 0 0

98 GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 % TUBE 4 4


10 GR 4

99 GARAM ORALIT SACHET 58 58 58

100 GEMFIBROZIL 300 MG KAPSUL KAPSUL 0 0 0

101 GENTAMISIN SALEP KULIT 0,1 % 5 GR TUBE 0 0 0

102 GENTAMISIN SALEP MATA 0,3% TUBE 6 6 6

103 GENTAMISIN TETES MATA 0,3% BOTOL 5 5 5

104 GLASS IONOMER CEMENT ( GC IX ) BOTOL 0 0 0

105 GLIBENCLAMIDE TABLET 5 MG TABLET 0 0 0

106 GLICERIL GUAIACOLAT TABLET 100 MG TABLET 0 0 0

107 GLIMEPIRIDE 1 MG TABLET TABLET 0 0 0

108 GLIMEPIRIDE 2 MG TABLET TABLET 8 8 8

GLUKOSA 40% DEXTROSE INJECTION U.S.P


109 CAIRAN INJEKSI VIAL 0 0 0

110 GLUKOSA LARUTAN INFUS 10 % STERIL BOTOL 0 0 0

111 GLUKOSA LARUTAN INFUS 5 % STERIL BOTOL 0 0 0

112 GRISEOFULVIN TABLET 125 MG TABLET 0 0 0

113 HALOPERIDOL 2 MG TABLET 0 0 0

114 HALOPERIDOL DEKANOAT INJ 50 MG VIAL 0 0 0

115 HALOPERIDOL INJ. 5 MG/ML (LODOMER) AMPUL 0 0 0

116 HALOPERIDOL TABLET 1,5 MG TABLET 0 0 0

117 HALOPERIDOL TABLET 5 MG TABLET 0 0 0

118 HERBAKOF SYRUP 60ML BOTOL 14 14 14

HES-HYDROXYETHYL STARCH 6 %/VOLUVEN


119 BOTOL 0 0 0
INFUS 500 ML

120 HIDROCORTISON CR 1% TUBE 0 0 0

121 HIDROCORTISONE CREAM 2,5 % 5 GR TUBE 0 0 0

122 HYDROCHLORTHIAZIDE 25 MG TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

123 I.V CATHETER NO.16 WITH INJECTION PORT PCS 0 0 0

124 I.V CATHETER NO.18 WITH INJECTION PORT PCS 0 0 0

125 I.V CATHETER NO.20 WITH INJECTION PORT PCS 0 0 0

126 I.V CATHETER NO.22 WITH INJECTION PORT PCS 0 0 0

127 I.V CATHETER NO.24 WITH INJECTION PORT PCS 0 0 0

128 I.V CATHETER NO.26 WITH INJECTION PORT PCS 0 0 0

129 IBUPROFEN FORTE SYRUP 200MG/5ML BOTOL 0 0 0

130 IBUPROFEN SUSPENSI 100 MG/5 ML 60 ML BOTOL 9 9 9

131 IBUPROFEN TABLET 400 MG TABLET 0 0 0

132 INFUSION SET ANAK PCS 0 0 0

133 INFUSION SET DEWASA PCS 0 0 0

134 ISOSORBIDE DINITRATE SUBLINGUAL 5 MG TABLET 0 0 0

135 KAEN 3B BOTOL 0 0 0

136 KALIUM DIKLOFENAK 50 MG TABLET TABLET 0 0 0

137 KALSIUM GLUCONAS INJEKSI 100 MG/ML 10 AMPUL 0 0


ML 0

138 KALSIUM LAKTAT (KALK) TABLET 500 MG TABLET 420 420 420

139 KANTONG URINE DEWASA PCS 0 0 0

140 KAPAS PEMBALUT/ABSORBEN 250 GR BKS 0 0 0

141 KAPTOPRIL TABLET 25 MG TABLET 0 0 0

142 KARBAMAZEPIN TABLET 200 MG TABLET 0 0 0

143 KASA KOMPRES 40/40 STERIL BKS 2 2 2

144 KASA PEMBALUT HIDROFIL 16 X 16 CM STRIL ROL 3 3 3

145 KASA PEMBALUT HIDROFIL 2 M X 80 CM ROL 2 2 2

146 KASA PEMBALUT HIDROFIL 4 M X 10 CM ROL 0 0 0

147 KASA PEMBALUT HIDROFIL 4 M X 5 CM ROL 10 10 10

KASA STERIL (DARYAN TOLLE)YG DIRESAPI


148 PCS 0 0 0
FRAMISETIN

149 KETOKONAZOLE TABLET 200 MG TABLET 0 0 0

150 KETOPROFEN 100 MG SUPPOSITORIA SUPP. 0 0 0

151 KLINDAMISIN KAPSUL 150 MG TABLET 0 0 0

152 KLINDAMISIN KAPSUL 300 MG KAPSUL 0 0 0

153 KLOBAZAM 10 MG TABLET TABLET 0 0 0

154 KLORAMFENIKOL KAPSUL 500 MG KAPSUL 0 0 0

155 KLORAMFENIKOL SALEP KULIT 2 % TUBE 0 0 0

156 KLORAMFENIKOL SALEP MATA 1 % TUBE 0 0 0

157 KLORAMFENIKOL SUSPENSI 125 MG/5 ML BOTOL 0 0 0

158 KLORAMFENIKOL TETES TELINGA 3 % BOTOL 0 0 0

159 KLORFENIRAMINE MALEAT (CTM) TABLET 4 TABLET 0 0


MG 0

160 KLORPROMAZIN HCL INJEKSI 25 MG/ML 1 ML AMPUL 0 0 0

161 KLORPROMAZIN HCL INJEKSI 50 MG/ML 1 ML AMPUL 0 0 0

162 KLORPROMAZIN HCL TABLET 100 MG TABLET 0 0 0

163 KLOZAPIN 100 MG TABLET TABLET 0 0 0

164 KLOZAPIN 25 MG TABLET TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

165 KODEIN HCL TABLET 10 MG TABLET 0 0 0

166 KOTRIMOKSAZOL DEWASA TABLET TABLET 0 0 0

167 KOTRIMOKSAZOL SUSPENSI 60 ML BOTOL 0 0 0

168 LEVOFLOXACIN TABLET 500 MG TABLET 0 0 0

169 LIDOCAIN 2% INJ AMPUL 0 0 0

170 LIDOCAIN COMPOSITUM INJEKSI 2 ML AMPUL 3 3 3

171 LISOL CONCENTRATE 1000 ML BOTOL 0 0 0

172 LOPERAMIDE TABLET 2 MG TABLET 0 0 0

173 LORATADIN TABLET 10 MG TABLET 10 10 10

174 LORAZEPAM 2 MG TABLET 0 0 0

175 MAGNESIUM SULFAT INJEKSI (IV) 40 % 25 ML AMPUL 0 0 0

176 MASKER EARLOOP PLUS PCS 0 0 0

177 MASKER KERTAS 3 PLY EAR LOOP PCS 0 0 0

178 MASKER KERTAS 3 PLY TIE ON PCS 0 0 0

179 MASKER N95 PCS 0 0 0

180 MELOKSIKAM TABLET 7,5 MG TABLET 0 0 0

181 METAMIZOL (NORAGES) INJEKSI 500 MG/2ML AMPUL 0 0 0

182 METFORMIN TABLET 500 MG TABLET 35 35 35

METILERGOMETRIN MALEAT INJEKSI 0,200


183 AMPUL 0 0 0
MG 1 ML
METILERGOMETRIN MALEAT TABLET 0,125
184 TABLET 0 0 0
MG

185 METILPREDNISOLON TABLET 4 MG TABLET 0 0 0

186 METOKLOPRAMIDE 10 MG TABLET TABLET 0 0 0

187 METOKLOPRAMIDE 5 MG TABLET TABLET 0 0 0

METOKLOPROMIDE (SOTATIC) INJEKSI 5


188 AMPUL 0 0 0
MG/ML 2 ML

189 METOKLOPROMIDE SIRUP BOTOL 0 0 0

METRONIDAZOL + NYSTATIN VAG.


190 VIAL 0 0 0
(PROVAGIN) INJEKSI

191 METRONIDAZOL TABLET 250 MG TABLET 0 0 0

192 METRONIDAZOL TABLET 500 MG TABLET 0 0 0

193 METRONIDAZOLE INFUS 5 MG/ML 100 ML BOTOL 0 0 0

194 MIKONAZOL KREAM 10 GR TUBE 1 1 1

195 MINERAL MIX SACHET 0 0 0

196 NATRIUM DIKLOFENAK TABLET 25 MG TABLET 110 110 110

197 NATRIUM DIKLOFENAK TABLET 50 MG TABLET 0 0 0

198 NATRIUM KLORIDA INFUS 0,9 % STERIL BOTOL 1 1 1

199 NIFEDIPINE TABLET 10 MG TABLET 0 0 0

200 NISTATIN TABLET 500.000 UI TABLET 0 0 0

201 NISTATIN VAGINAL TABLET 100.000 UI VAGTAB 0 0 0

202 OBAT BATUK HITAM (OBH) CAIRAN 100 ML BOTOL 0 0 0

203 OKSIGEN NASAL CANNULA ADULT PCS 0 0 0

204 OKSIGEN NASAL CANNULA INFANT PCS 0 0 0

205 OKSITETRACYCLIN SALEP KULIT 3 % 5 GR TUBE 0 0 0

206 OKSITETRACYCLIN SALEP MATA 1 % 3,5 GR TUBE 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

207 OKSITOSIN INJEKSI 10 IU/ML 1 ML AMPUL 0 0 0

208 OMEPRAZOLE TABLET 20 MG KAPSUL 0 0 0

209 ONDANSENTRON 4 MG/2 ML INJEKSI AMPUL 0 0 0

210 PARACETAMOL SYRUP 120 MG/5 ML 60 ML BOTOL 2 2 2

211 PARACETAMOL TABLET 500 MG TABLET 580 580 580

212 PARACETAMOL TETES 100 MG/ML 15 ML BOTOL 3 3 3

213 PEHAVRAL TABLET TABLET 0 0 0

214 PERAK SULFADIAZIN KRIM 1 % TUBE 0 0 0

215 PERHYDROL [ H2O2 ] 3 % 800 ML BOTOL 0 0 0

216 PERMETHRINE 5% CR 15 GRAM TUBE 4 4 4

217 PIRACETAM TABLET 800 MG TABLET 0 0 0

218 PIRANTEL PAMOAT TABLET TABLET 0 0 0

219 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG TABLET 0 0 0

220 PIROKSIKAM KAPSUL 10 MG KAPSUL 0 0 0

221 PLESTER 10 CM X 2 M ROL 0 0 0

222 PREDNISON TABLET 5 MG TABLET 84 84 84

223 PROPRANOLOL HCL TABLET 40 MG TABLET 0 0 0

224 PROPILTHIOURACIL TABLET 100 MG TABLET 0 0 0

225 RANITIDIN INJEKSI 25 MG/ ML AMPUL 0 0 0

226 RESPERIDON 2 MG TABLET TABLET 0 0 0

227 RINGER LAKTATE LARUTAN INFUS STERIL BOTOL 0 0 0

228 SALBUTAMOL TABLET 2 MG TABLET 66 66 66

229 SALBUTAMOL TABLET 4 MG TABLET 0 0 0

230 SALEP 2-4 KOMBINASI 30 GR POT 2 2 2

231 SALICYL BEDAK 2 % KOTAK 0 0 0

232 SARUNG TANGAM NON STERIL L PCS 0 0 0

233 SARUNG TANGAN NON STERIL M PCS 56 56 56

234 SARUNG TANGAN NON STERIL S PCS 0 0 0

235 SARUNG TANGAN STERIL NO 6 PSG 0 0 0

236 SARUNG TANGAN STERIL NO. 7,5 PSG 0 0 0

237 SARUNG TANGAN STERILE NO.6,5 PSG 0 0 0

238 SARUNG TANGAN STERILE NO.7 PSG 3 3 3

239 SEFADROKSIL KAPSUL 500 MG KAPSUL 0 0 0

240 SEFIKSIM KAPSUL 100 MG KAPSUL 0 0 0

241 SERUM ANTI BISA ULAR POLIVALEN INJ.5 ML VIAL 0 0


(ABU I) 0

242 SERUM ANTI TETANUS INJEKSI 1.500 IU/AMP VIAL 0 0


(ATS) 0

243 SETIRIZINE TABLET 10 MG TABLET 0 0 0

SIANOKOBALAMIN ( VIT B12 ) INJEKSI 500


244 AMPUL 0 0 0
MCG/ML 1 ML

245 SIANOKOBALAMIN ( VIT B12 ) TABLET 50 MCG TABLET 112 112 112

246 SILK (BENANG BEDAH SUTERA) NO.3/0 PCS 1 1 1

247 SIMETIDINE TABLET 200 MG TABLET 0 0 0

248 SIMVASTATIN TABLET 10 MG TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

249 SIPROFLOXACIN INFUS 2% BOTOL 0 0 0

250 SIPROFLOXACIN TABLET 500 MG TABLET 0 0 0

251 SPONS GELATIN CUBICLES 1x1x1 CM PCS 0 0 0

252 STIMUNO SYR BOTOL 0 0 0

253 STIMUNO TAB (100) TABLET 0 0 0

254 STIMUNO TAB (30) BOTOL 0 0 0

255 SULFADOKSIN TABLET TABLET 0 0 0

SULFASETAMID NATRIUM TETES MATA 15 %


256 BOTOL 0 0 0
5 ML

257 TABLET TAMBAH DARAH TABLET 0 0 0

TEMPORARY CAVITY SEALER [TUMPATAN


258 SEMENTARA] (CAVIT G) PCS 0 0 0

259 TETAGRAM 150 IU AMPUL 0 0 0

260 TETRAKAIN HCL TETES MATA 5 ML BOTOL 0 0 0

261 TETRASIKLIN HCL TABLET 500 MG KAPSUL 0 0 0

262 THIAMIN HCL (VIT B1) INJEKSI 100 MG/ML 1 ML AMPUL 0 0 0

263 THIAMIN HCL MONONITRAT (VIT B1) TABLET TABLET 0 0


100 MG 0

264 THIAMIN HCL MONONITRAT (VIT B1) TABLET TABLET 0 0


50 MG 0

265 TRAMADOL INJEKSI 50 MG/ML AMPUL 0 0 0

266 TRANFUSION SET ADULT WITH Y INJECTION PCS 0 0 0

267 TRIFLOUPERASIN TABLET 5 MG TABLET 0 0 0

TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2


268 TABLET 0 0 0
MG

269 VITAMIN B COMPLEX TABLET TABLET 0 0 0

270 YODIUM POVIDON LARUTAN 10 % 30 ML BOTOL 0 0 0

271 YODIUM POVIDON LARUTAN 10% 60 ML BOTOL 0 0 0

272 ZENTRA (TRIPROLIDINE|PSEUDOEPHEDRINE) TABLET 90 90 90

273 ZINK 20 MG TABLET TABLET 100 100 100

274 Hi-D 1000 CHOLECALCIFEROL TABLET 0 0 0

OBAT PROGRAM / HIBAH

1 AMITRIPTYLINE 25 MG TABLET 0 0 0

2 HALOPERIDOLE INJEKSI AMPUL 0 0 0

3 HALOPERIDOLE 1,5 MG TABLET 0 0 0

4 HALOPERIDOLE 5 MG TABLET 0 0 0

5 LODOMER 2 MG TABLET 0 0 0

6 LODOMER 5 MG TABLET 0 0 0

7 TRIHEXYPHENIDYL 2 MG TABLET 0 0 0

8 ALAT SUNTIK 0,05 ML (PROGRAM) PCS 0 0 0

9 ALAT SUNTIK 0,5 ML (PROGRAM) PCS 0 0 0

10 ALAT SUNTIK 5 ML (PROGRAM) PCS 0 0 0

11 ALBENDAZOL TABLET 400 MG TABLET 0 0 0

12 BENZATINE BENZYLPENICILLIN 2.400.000 IU VIAL 0 0 0

13 COTRIMOXAZOLE 800/160 TABLET 0 0 0

14 DIETHYLCARBAMAZINE 100 MG TABLET 0 0 0

15 GARAM ORALIT UNTUK 200 ML AIR SACHET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

16 HIV ABACAVIR TABLET 300 MG BOTOL 0 0 0

17 HIV ACRIPTEGA (TDF 300 + 3TC 300 + DTG 50) BOTOL 0 0 0

18 HIV DOLUTEGRAFIR 50 MG BOTOL 0 0 0

19 HIV EFAFIRENZ 200 MG TABLET BOTOL 0 0 0

20 HIV EFAFIRENZ 600 MG TABLET BOTOL 0 0 0

21 HIV LAMIVUDIN 150 MG TABLET BOTOL 0 0 0

22 HIV NEVIRAPINE 200 MG TABLET BOTOL 0 0 0

23 HIV TENOFOVIR 300 MG BOTOL 0 0 0

24 HIV TRIPLE FDC ANAK (ZIDOVUDIN BOTOL 0 0 0


60MG+LAMIVUDIN 30MG+NEVIRAPINE 50MG)
25 HIV TRIPLE FDC DEWASA (TDC+3TC+EFV BOTOL 0 0 0
(300/300/600))

26 HIV ZIDOVUDINE 100 MG @60 KAPSUL BOTOL 0 0 0

27 HIV ZIDOVUDINE 300 MG + LAMIVUDIN 150 MG BOTOL 0 0 0

28 HIV ZIDOVUDINE SYRUP 240 ML BOTOL 0 0 0

29 IODINE TES PCS 0 0 0

30 ISONIAZID TABLET 100 MG TABLET 0 0 0

31 ISONIAZID TABLET 300 MG TABLET 0 0 0

KOMBIPAK AZITHROMYCIN - CEFIXIME


32 TABLET 0 0 0
KOMBINASI

33 MDT COMBI - MB ADULT (RED) BLISTER 0 0 0

34 MDT COMBI - MB CHILD (ORANGE) BLISTER 0 0 0

35 MDT COMBI - PB ADULT (GREEN) BLISTER 0 0 0

36 OBAT ANTI TUBERKULOSIS ANAK PAKET 0 0 0

OBAT ANTI TUBERKULOSIS DOSIS HARIAN


37 STOP TB KIT PAKET 0 0 0

38 OBAT ANTI TUBERKULOSIS KATEGORI 1 PAKET 0 0 0

39 OBAT ANTI TUBERKULOSIS KATEGORI 2 PAKET 0 0 0

40 OBAT ANTI TUBERKULOSIS KOMBIPAK PAKET 0 0 0


KATEGORI I

41 PARACETAMOL 500 MG (P2) TABLET 0 0 0

42 PIRIDOKSIN 25 MG TABLET (VIT B6) TABLET 0 0 0

43 PYRIMETAMINE TABLET 0 0 0

44 REAGEN HIV (FOKUS) PCS 0 0 0

45 REAGEN HIV (STANDART DIAGNOSTIC/SD) PCS 0 0 0

46 REAGEN HIV (VIKIA) PCS 0 0 0

REAGEN HIV DIAGNOSTAR HIV 1\/2 ONE STEP


47 PCS 0 0 0
RAPID TEST
48 REAGEN HIV DIAGNOSTIC KIT FOR HIV (1+2) PCS 0 0 0
ANTIBODY (COLLOIDAL GOLD) V2 PAKET
49 REAGEN SYPHILIS (TREPOCHECK) PCS 0 0 0

50 REAGEN SYPHILIS RDT (FOKUS) PCS 0 0 0

51 RETINOL ( VIT A ) KAPSUL 100.000 IU KAPSUL 0 0 0

52 RETINOL ( VIT A ) KAPSUL 200.000 IU KAPSUL 0 0 0

53 SAFETY BOX PCS 0 0 0

54 SERUM ANTI DIFTERI CAIRAN INJEKSI 125 VIAL 0 0 0


MG/ML

55 TABLET TAMBAH DARAH (PROGRAM) TABLET 0 0 0

56 ZINK TABLET DISPERSIBLE 20 MG (PROGRAM) TABLET 0 0 0

57 ALBENDAZOLE SIRUP BOTOL 0 0 0

58 COTRIMOXAZOLE 400/80 TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

59 MINERAL MIX SACHET 0 0 0

SD BIOLINE Syphilis 3.0 One Step Syphilis


60 PCS 0 0 0
Antibody Test

OBAT TAMBAHAN

1 ALKOHOL SWAB 0 0 0 0

2 ALLOPURINOL 0 0 0

3 AMLODIPINE 5MG (BLUD) 84 84 84

4 ANTISEPTIK GEL (DINKES) 1 1 1

5 APD VAKSIN 0 0 0

6 APRON (DINKES) 0 0 0

7 AQUA PRO INJEKSI (BLUD) 0 0 0

8 ASAM MEFENAMAT TABLET 500 MG (BLUD) 285 285 285

9 ASIKLOVIR TABLET 25 25 25

10 BETAMETHASONE SALEP KULIT (BLUD) 0 0 0

11 BIOPLACENTON (BLUD) 1 1 1

12 BISAKODIL TABLET 5 MG (BLUD) 0 0 0

13 CIPROFLOXACIN (BLUD) 0 0 0

14 CLINDAMISIN KAPS (BLUD) 0 0 0

15 DEKSAMETHASONE HARSEN TABLET 0,5 MG 250 250 250


((BLUD) )

16 DOMPERIDONE TABLET 10 MG ( (BLUD)) 0 0 0

17 EPINEFRIN INJEKSI (BLUD) 0 0 0

18 FENITOIN KAPS (BLUD) 0 0 0

19 FITOMENADION INJ (BLUD) 0 0 0

20 FITOMENADION TABLET (BLUD) 0 0 0

21 FUROSEMIDE TABLET 0 0 0

22 GEMFIBROZIL (BLUD) 16 16 16

23 GENOINT (BLUD) 11 11 11

24 GENTAMICIN TETES MATA (BLUD) 1 1 1

25 GENTIAN VIOLET LARUTAN 1 % (BLUD) 2 2 2

26 GLISERIL GUAIKOLAT/GUAIFENESIN BLUD 660 660 660

27 HIDROKORTISON CREAM KULIT (BLUD) 0 0 0

28 HYOSCINE BUTYLBROMIDE (ANTI SPASMODIK 80 80 80


BLUD)

29 HYPAFIX (BLUD) 0 0 0

30 INFUSET (BLUD) 0 0 0

31 IV CATHETER (BLUD) 0 0 0

32 KAPTOPRIL TABLET 12,5 MG (BLUD) 438 438 438

33 KLORAMFENIKOL SIRUP (BLUD) 0 0 0

34 KLORAMFENIKOL TETES TELINGA (BLUD) 7 7 7

35 KOTRIMOKSAZOL TAB (BLUD) 88 88 88

36 LOPERAMIDE TABLET 2 MG (BLUD) 0 0 0

37 MASKER (DINKES) 0 0 0

38 MASKER N9 0 0 0

39 METFORMIN (BLUD) 0 0 0
SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

40 METILERGOMETRINE INJ (BLUD) 0 0 0

41 MULTIVITAMIN KOMB 0 0 0

42 NEW DIATABS (BLUD) 0 0 0

43 NIFEDIPINE TAB (BLUD) 0 0 0

44 NURSE CAP 0 0 0

45 OMEPRAZOLE 20MG 146 146 146

46 ONDANSETRONE INJEKSI (BLUD) 0 0 0

47 PARACETAMOL TABLET 500 MG (BLUD) 0 0 0

48 PEHAVRAL 0 0 0

49 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG (BLUD) 160 160 160

50 PIROXICAM 0 0 0

51 SALBUTAMOL TABLET 2 MG (BLUD) 0 0 0

52 SARUNG TANGAN OBGYN 0 0 0

53 SARUNG TANGAN OBGYN 0 0 0

54 SEFADROKSIL KAPSUL 500 MG (BLUD) 0 0 0

55 VGEL (BLUD) 0 0 0

56 VITAMIN C 50 MG (BLUD) 250 250 250

57 ZIVIT ZINC 40 40 40

58 ASETIL (DINKES) 0 0 0

59 DEXAMETHASONE (DINKES) 0 0 0

60 OBH (DINKES) 0 0 0

61 AMBROXOL 470 470 470

62 BATUK FLU SIRUP (ETAFLUSIN) 3 3 3

63 BATUK FLU TABLET (ETAFLUSIN) 200 200 200

64 BETADINE GARGLE 0 0 0

65 BUFACOMB SALEP 0 0 0

66 BUFACORT - N 3 3 3

67 DARYANTULLE 0 0 0

68 ETIL KLORIDA SPRAY 0 0 0

69 GLIBENCLAMIDE TABLET 5 MG 0 0 0

70 GLIMEPIRIDE 2 MG TABLET 0 0 0

71 KAOLIN PEKTIN SIRUP (NOVADIAR) 3 3 3

72 PIRACETAM KAPSUL 0 0 0

73 TIAMFENIKOL KAPSUL 0 0 0

74 VITAMIN ANAK SIRUP (SAMCOVIT) 3 3 3

75 ANTIHEMOROID/BORRAGINOL (BLUD) 0 0 0

76 ASAM TRANEKSAMAT (BLUD) 0 0 0

77 ASETILSISTEIN (BLUD) 0 0 0

78 ASETOSAL TABLET 100 (80) MG (BLUD) 0 0 0

79 ASIKLOVIR SALEP KULIT (BLUD) 3 3 3

80 BEDAK SALISIL (BLUD) 5 5 5

81 BETAHISTIN TABLET (BLUD) 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

82 CTM (BLUD) 262 262 262

83 GLIMEPIRID 1 MG (BLUD) 0 0 0

84 GLUKOSA INFUS (BLUD) 0 0 0

85 ISDN (BLUD) 0 0 0

86 METILPREDNISOLON TABLET 4 MG (BLUD) 0 0 0

87 METRONIDAZOL (BLUD) 0 0 0

88 OKSITETRASIKLIN SALEP KULIT (BLUD) 0 0 0

89 POVIDONE IODINE 60ML (BLUD) 0 0 0

90 RANITIDIN TABLET (BLUD) 0 0 0

91 SETERIZIN TABLET (BLUD) 172 172 172

92 VITAMIN B KOMPLEKS (BLUD) 225 225 225

93 VITAMIN B1 (BLUD) 265 265 265

94 0 0 0

95 0 0 0

96 0 0 0

97 0 0 0

98 0 0 0

99 0 0 0

100 0 0 0

Blitar , 03 October 2022


Mengetahui / Menyetujui
Yang Menerima, Yang Menyerahkan,
Kepala Puskesmas Petugas Petugas Pengelola Obat
SANANKULON Instalasi Farmasi Kabupaten Pustu/Polindes/Ponkesdes

ENDAH ROSITANINGSIH, SE, MM Apt. AINA MUJTAHIDA A, S.Farm. DANIK YUNITA SARI,Amd.Kep
NIP. 196912302010012002 NIP : 198612188 11033 2 0004 NIP. 198,506,142,022,212,000
DINAS KESEHATAN KABUPATEN BLITAR
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)
WILAYAH : SUMBERINGIN PELAPORAN BULAN : DESEMBER
PUSKESMAS : SANANKULON PERMINTAAN BULAN : JANUARI
KECAMATAN : SANANKULON
KABUPATEN : BLITAR
PROVINSI : JAWA TIMUR

SISA STOK JUMLAH


NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

1 2 WAY FOLEY CATHETER NO.16 PCS 0 0 0

2 2 WAY FOLEY CATHETER NO.18 PCS 0 0 0

3 2 WAY FOLEY CATHETER NO.20 PCS 0 0 0

4 ACETYLCYSTEINE CAPSULE 200 MG CAPSULE 18 18 18

5 ALAT SUNTIK SEKALI PAKAI 1 ML PCS 0 0 0

6 ALAT SUNTIK SEKALI PAKAI 10 ML PCS 0 0 0

7 ALAT SUNTIK SEKALI PAKAI 20 ML PCS 0 0 0

8 ALAT SUNTIK SEKALI PAKAI 3 ML PCS 13 13 13

9 ALAT SUNTIK SEKALI PAKAI 5 ML PCS 55 55 55

10 ALKOHOL SWAB PCS 0 0 0

11 ALLOPURINOL TABLET 100 MG TABLET 0 0 0

12 ALPRAZOLAM 1 MG TABLET TABLET 0 0 0

13 AMBROXOL SIRUP 5MG/ML BOTOL 0 0 0

14 AMBROXOL TABLET 30 MG TABLET 0 0 0

15 AMINOPHYLLINE INJEKSI 24 MG/ML 10 ML AMPUL 0 0 0

16 AMINOPHYLLINE TABLET 200 MG TABLET 0 0 0

17 AMITRIPTYLLINE HCL TABLET 25 MG TABLET 0 0 0

18 AMLODIPINE TABLET 10 MG TABLET 94 94 94

19 AMLODIPINE TABLET 5 MG TABLET 0 0 0

20 AMOKSISILIN DRY SYRUP 125 MG/5 ML 60 ML BOTOL 0 0 0

21 AMOKSISILIN SERBUK INJEKSI 1000 MG VIAL 0 0 0

22 AMOKSISILIN TABLET 500 MG KAPLET 10 10 10

AMOXCICILIN FORTE SYRUP KERING


23 BOTOL 0 0 0
250MG/5ML
AMPICILLIN SERBUK INJEKSI 1.000 MG
24 VIAL 0 0 0
MG/VIAL

25 ANTALGIN 500 MG TABLET (METAMIZOL) TABLET 0 0 0

26 ANTASIDA DOEN TABLET KOMBINASI TABLET 714 714 714

27 ANTASIDA SUSPENSI 60 ML BOTOL 14 14 14

28 ANTI BAKTERI DOEN SALEP KOMBINASI 5 GR POT 0 0 0

29 ANTI FUNGI DOEN SALEP KOMBINASI 30 GR POT 2 2 2

30 ANTI HAEMOROID DOEN KOMBINASI SUPP. 0 0 0

31 ANTI MIGRAIN DOEN TABLET KOMBINASI TABLET 0 0 0

32 ANTI SPASMODIK INJEKSI (SPASHI) AMPUL 0 0 0

33 ANTI SPASMODIK TABLET (DORMICOMP) TABLET 0 0 0

34 AQUA PRO INJEKSI STERIL BEBAS PIROGEN 20 BOTOL 0 0


ML 0

35 ASAM ASKORBAT ( VIT C ) TABLET 250 MG TABLET 0 0 0

36 ASAM ASKORBAT ( VIT C ) TABLET 50 MG TABLET 0 0 0

37 ASAM FOLAT 1MG TABLET TABLET 0 0 0

38 ASAM MEFENAMAT TABLET 500 MG TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

39 ASAM TRANEKSAMAT 100 MG/ML INJEKSI AMPUL 0 0 0

40 ASAM TRANEKSAMAT 500 MG TABLET TABLET 0 0 0

ASAM VALPROAT 250 MG TABLET /


41 TABLET 0 0 0
DEPAKOTE ER

42 ASEPTAN 500CC + PUMP BOTOL 0 0 0

43 ASEPTIC GEL 500CC + DISPENSER BOTOL 0 0 0

44 ASERING (ASETAT RINGER) SOFT BAG BOTOL 0 0 0

45 ASETOSAL TABLET 100 (80) MG TABLET 0 0 0

46 ASIKLOVIR KREAM 5 % 5 GR TUBE 0 0 0

47 ASIKLOVIR TABLET 400 MG TABLET 0 0 0

48 ATROPIN SULFAT INJEKSI 0,25 MG/ML 1 ML AMPUL 0 0 0

49 ATTAPULGIT + PECTIN TABLET TABLET 0 0 0

50 BETAHISTINE MESILAT 24 MG TABLET TABLET 0 0 0

51 BETAHISTINMESILAT 6 MG TABLET TABLET 0 0 0

52 BETAMETHASON CR 0.05% 20 GR TUBE 3 3 3

53 BETAMETHASONE CREAM 0,1 % 5 GR TUBE 0 0 0

54 BIONICOM ZINC TABLET TABLET 0 0 0

55 BISAKODIL SUPPOSITORIA 10 MG SUPP. 0 0 0

56 BISAKODIL SUPPOSITORIA 5 MG SUPP. 0 0 0

57 BISOPROLOL 2,5 MG TABLET (CONCOR) TABLET 0 0 0

58 BISOPROLOL 5 MG TABLET TABLET 0 0 0

59 CAT GUT NO. 3/0 CHROMIC PCS 1 1 1

60 CAT GUT NO. 3/0 PLAIN PCS 1 1 1

61 CITICHOLIN 250 MG/ML-2ML INJEKSI AMPUL 0 0 0

62 CLONIDINE 0.15 MG TABLET TABLET 0 0 0

63 CLOPIDOGREL 75 MG TABLET 0 0 0

64 COMBIVENT UDV INHALASI VIAL 0 0 0

65 DEKSAMETHASONE INJEKSI 5 MG/ML 1 ML AMPUL 0 0 0

66 DEKSAMETHASONE TABLET 0,5 MG TABLET 0 0 0

67 DEVITALISASI PASTA ( NON ARSEN ) POT 0 0 0

68 DIAZEPAM INJEKSI 5 MG/ML 2 ML AMPUL 0 0 0

69 DIAZEPAM LARUTAN RECTAL 5MG/ 2,5ML- TUBE 0 0


STESOLID 0

70 DIAZEPAM TABLET 2 MG TABLET 0 0 0

71 DIAZEPAM TABLET 5 MG TABLET 0 0 0

72 DIFENHIDRAMINE HCL INJEKSI 10 MG/ML 1 ML AMPUL 0 0 0

73 DIGOXIN TABLET 0,25 MG TABLET 0 0 0

74 DIMENHYDRINATE TABLET 50 MG TABLET 0 0 0

75 DOKSISIKLIN TABLET 100 MG KAPSUL 0 0 0

76 DOMPERIDON SUSPENSI 5MG/ML BOTOL 7 7 7

77 DOMPERIDON TABLET 10 MG TABLET 0 0 0

EKSTRACT PLASENTA + NEOMYSIN SALEP 15


78 TUBE 0 0 0
GR

79 EPINEFRIN (ADRENALIN) HCL INJ.0,1 % 1 ML AMPUL 0 0 0

80 ERITROMISIN KAPSUL 250 MG KAPSUL 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

81 ERITROMISIN SIRUP KERING 200 MG/5ML BOTOL 0 0 0

82 ERITROMISIN TABLET 500 MG KAPSUL 0 0 0

ETAKRIDIN ( RIVANOL ) LARUTAN 0,1 % 300


83 BOTOL 0 0 0
ML

84 ETANOL [ ALKOHOL ] 70 % 1000 ML BOTOL 0 0 0

85 ETIL KLORIDA SEMPROT 100 ML BOTOL 0 0 0

86 EUGENOL CAIRAN 10 ML BOTOL 0 0 0

87 FENITOIN NATRIUM INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0

88 FENITOIN NATRIUM TABLET 100 MG KAPSUL 0 0 0

89 FENOBARBITAL INJEKSI 50 MG/ML 2 ML AMPUL 0 0 0

90 FENOBARBITAL TABLET 30 MG TABLET 0 0 0

91 FENOL GLISEROL TETES TELINGA 10 % 5 ML BOTOL 2 2 2

92 FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML 1 AMPUL 0 0


ML 0

93 FITOMENADION ( VIT K1 ) TABLET SALUT 10 TABLET 0 0


MG 0

94 FITOMENADION INFANT INJ. 2MG/ML AMPUL 0 0 0

95 FLUPHENASINE DEKANOAT INJEKSI 25 MG 1 AMPUL 0 0


ML 0

96 FUROSEMID INJEKSI 10 mg VIAL 0 0 0

97 FUROSEMID TABLET 40 MG TABLET 0 0 0

98 GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 % TUBE 4 4


10 GR 4

99 GARAM ORALIT SACHET 58 58 58

100 GEMFIBROZIL 300 MG KAPSUL KAPSUL 0 0 0

101 GENTAMISIN SALEP KULIT 0,1 % 5 GR TUBE 0 0 0

102 GENTAMISIN SALEP MATA 0,3% TUBE 6 6 6

103 GENTAMISIN TETES MATA 0,3% BOTOL 5 5 5

104 GLASS IONOMER CEMENT ( GC IX ) BOTOL 0 0 0

105 GLIBENCLAMIDE TABLET 5 MG TABLET 0 0 0

106 GLICERIL GUAIACOLAT TABLET 100 MG TABLET 0 0 0

107 GLIMEPIRIDE 1 MG TABLET TABLET 0 0 0

108 GLIMEPIRIDE 2 MG TABLET TABLET 8 8 8

GLUKOSA 40% DEXTROSE INJECTION U.S.P


109 CAIRAN INJEKSI VIAL 0 0 0

110 GLUKOSA LARUTAN INFUS 10 % STERIL BOTOL 0 0 0

111 GLUKOSA LARUTAN INFUS 5 % STERIL BOTOL 0 0 0

112 GRISEOFULVIN TABLET 125 MG TABLET 0 0 0

113 HALOPERIDOL 2 MG TABLET 0 0 0

114 HALOPERIDOL DEKANOAT INJ 50 MG VIAL 0 0 0

115 HALOPERIDOL INJ. 5 MG/ML (LODOMER) AMPUL 0 0 0

116 HALOPERIDOL TABLET 1,5 MG TABLET 0 0 0

117 HALOPERIDOL TABLET 5 MG TABLET 0 0 0

118 HERBAKOF SYRUP 60ML BOTOL 14 14 14

HES-HYDROXYETHYL STARCH 6 %/VOLUVEN


119 BOTOL 0 0 0
INFUS 500 ML

120 HIDROCORTISON CR 1% TUBE 0 0 0

121 HIDROCORTISONE CREAM 2,5 % 5 GR TUBE 0 0 0

122 HYDROCHLORTHIAZIDE 25 MG TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

123 I.V CATHETER NO.16 WITH INJECTION PORT PCS 0 0 0

124 I.V CATHETER NO.18 WITH INJECTION PORT PCS 0 0 0

125 I.V CATHETER NO.20 WITH INJECTION PORT PCS 0 0 0

126 I.V CATHETER NO.22 WITH INJECTION PORT PCS 0 0 0

127 I.V CATHETER NO.24 WITH INJECTION PORT PCS 0 0 0

128 I.V CATHETER NO.26 WITH INJECTION PORT PCS 0 0 0

129 IBUPROFEN FORTE SYRUP 200MG/5ML BOTOL 0 0 0

130 IBUPROFEN SUSPENSI 100 MG/5 ML 60 ML BOTOL 9 9 9

131 IBUPROFEN TABLET 400 MG TABLET 0 0 0

132 INFUSION SET ANAK PCS 0 0 0

133 INFUSION SET DEWASA PCS 0 0 0

134 ISOSORBIDE DINITRATE SUBLINGUAL 5 MG TABLET 0 0 0

135 KAEN 3B BOTOL 0 0 0

136 KALIUM DIKLOFENAK 50 MG TABLET TABLET 0 0 0

137 KALSIUM GLUCONAS INJEKSI 100 MG/ML 10 AMPUL 0 0


ML 0

138 KALSIUM LAKTAT (KALK) TABLET 500 MG TABLET 420 420 420

139 KANTONG URINE DEWASA PCS 0 0 0

140 KAPAS PEMBALUT/ABSORBEN 250 GR BKS 0 0 0

141 KAPTOPRIL TABLET 25 MG TABLET 0 0 0

142 KARBAMAZEPIN TABLET 200 MG TABLET 0 0 0

143 KASA KOMPRES 40/40 STERIL BKS 2 2 2

144 KASA PEMBALUT HIDROFIL 16 X 16 CM STRIL ROL 3 3 3

145 KASA PEMBALUT HIDROFIL 2 M X 80 CM ROL 2 2 2

146 KASA PEMBALUT HIDROFIL 4 M X 10 CM ROL 0 0 0

147 KASA PEMBALUT HIDROFIL 4 M X 5 CM ROL 10 10 10

KASA STERIL (DARYAN TOLLE)YG DIRESAPI


148 PCS 0 0 0
FRAMISETIN

149 KETOKONAZOLE TABLET 200 MG TABLET 0 0 0

150 KETOPROFEN 100 MG SUPPOSITORIA SUPP. 0 0 0

151 KLINDAMISIN KAPSUL 150 MG TABLET 0 0 0

152 KLINDAMISIN KAPSUL 300 MG KAPSUL 0 0 0

153 KLOBAZAM 10 MG TABLET TABLET 0 0 0

154 KLORAMFENIKOL KAPSUL 500 MG KAPSUL 0 0 0

155 KLORAMFENIKOL SALEP KULIT 2 % TUBE 0 0 0

156 KLORAMFENIKOL SALEP MATA 1 % TUBE 0 0 0

157 KLORAMFENIKOL SUSPENSI 125 MG/5 ML BOTOL 0 0 0

158 KLORAMFENIKOL TETES TELINGA 3 % BOTOL 0 0 0

159 KLORFENIRAMINE MALEAT (CTM) TABLET 4 TABLET 0 0


MG 0

160 KLORPROMAZIN HCL INJEKSI 25 MG/ML 1 ML AMPUL 0 0 0

161 KLORPROMAZIN HCL INJEKSI 50 MG/ML 1 ML AMPUL 0 0 0

162 KLORPROMAZIN HCL TABLET 100 MG TABLET 0 0 0

163 KLOZAPIN 100 MG TABLET TABLET 0 0 0

164 KLOZAPIN 25 MG TABLET TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

165 KODEIN HCL TABLET 10 MG TABLET 0 0 0

166 KOTRIMOKSAZOL DEWASA TABLET TABLET 0 0 0

167 KOTRIMOKSAZOL SUSPENSI 60 ML BOTOL 0 0 0

168 LEVOFLOXACIN TABLET 500 MG TABLET 0 0 0

169 LIDOCAIN 2% INJ AMPUL 0 0 0

170 LIDOCAIN COMPOSITUM INJEKSI 2 ML AMPUL 3 3 3

171 LISOL CONCENTRATE 1000 ML BOTOL 0 0 0

172 LOPERAMIDE TABLET 2 MG TABLET 0 0 0

173 LORATADIN TABLET 10 MG TABLET 10 10 10

174 LORAZEPAM 2 MG TABLET 0 0 0

175 MAGNESIUM SULFAT INJEKSI (IV) 40 % 25 ML AMPUL 0 0 0

176 MASKER EARLOOP PLUS PCS 0 0 0

177 MASKER KERTAS 3 PLY EAR LOOP PCS 0 0 0

178 MASKER KERTAS 3 PLY TIE ON PCS 0 0 0

179 MASKER N95 PCS 0 0 0

180 MELOKSIKAM TABLET 7,5 MG TABLET 0 0 0

181 METAMIZOL (NORAGES) INJEKSI 500 MG/2ML AMPUL 0 0 0

182 METFORMIN TABLET 500 MG TABLET 35 35 35

METILERGOMETRIN MALEAT INJEKSI 0,200


183 AMPUL 0 0 0
MG 1 ML
METILERGOMETRIN MALEAT TABLET 0,125
184 TABLET 0 0 0
MG

185 METILPREDNISOLON TABLET 4 MG TABLET 0 0 0

186 METOKLOPRAMIDE 10 MG TABLET TABLET 0 0 0

187 METOKLOPRAMIDE 5 MG TABLET TABLET 0 0 0

METOKLOPROMIDE (SOTATIC) INJEKSI 5


188 AMPUL 0 0 0
MG/ML 2 ML

189 METOKLOPROMIDE SIRUP BOTOL 0 0 0

METRONIDAZOL + NYSTATIN VAG.


190 VIAL 0 0 0
(PROVAGIN) INJEKSI

191 METRONIDAZOL TABLET 250 MG TABLET 0 0 0

192 METRONIDAZOL TABLET 500 MG TABLET 0 0 0

193 METRONIDAZOLE INFUS 5 MG/ML 100 ML BOTOL 0 0 0

194 MIKONAZOL KREAM 10 GR TUBE 1 1 1

195 MINERAL MIX SACHET 0 0 0

196 NATRIUM DIKLOFENAK TABLET 25 MG TABLET 110 110 110

197 NATRIUM DIKLOFENAK TABLET 50 MG TABLET 0 0 0

198 NATRIUM KLORIDA INFUS 0,9 % STERIL BOTOL 1 1 1

199 NIFEDIPINE TABLET 10 MG TABLET 0 0 0

200 NISTATIN TABLET 500.000 UI TABLET 0 0 0

201 NISTATIN VAGINAL TABLET 100.000 UI VAGTAB 0 0 0

202 OBAT BATUK HITAM (OBH) CAIRAN 100 ML BOTOL 0 0 0

203 OKSIGEN NASAL CANNULA ADULT PCS 0 0 0

204 OKSIGEN NASAL CANNULA INFANT PCS 0 0 0

205 OKSITETRACYCLIN SALEP KULIT 3 % 5 GR TUBE 0 0 0

206 OKSITETRACYCLIN SALEP MATA 1 % 3,5 GR TUBE 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

207 OKSITOSIN INJEKSI 10 IU/ML 1 ML AMPUL 0 0 0

208 OMEPRAZOLE TABLET 20 MG KAPSUL 0 0 0

209 ONDANSENTRON 4 MG/2 ML INJEKSI AMPUL 0 0 0

210 PARACETAMOL SYRUP 120 MG/5 ML 60 ML BOTOL 2 2 2

211 PARACETAMOL TABLET 500 MG TABLET 580 580 580

212 PARACETAMOL TETES 100 MG/ML 15 ML BOTOL 3 3 3

213 PEHAVRAL TABLET TABLET 0 0 0

214 PERAK SULFADIAZIN KRIM 1 % TUBE 0 0 0

215 PERHYDROL [ H2O2 ] 3 % 800 ML BOTOL 0 0 0

216 PERMETHRINE 5% CR 15 GRAM TUBE 4 4 4

217 PIRACETAM TABLET 800 MG TABLET 0 0 0

218 PIRANTEL PAMOAT TABLET TABLET 0 0 0

219 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG TABLET 0 0 0

220 PIROKSIKAM KAPSUL 10 MG KAPSUL 0 0 0

221 PLESTER 10 CM X 2 M ROL 0 0 0

222 PREDNISON TABLET 5 MG TABLET 84 84 84

223 PROPRANOLOL HCL TABLET 40 MG TABLET 0 0 0

224 PROPILTHIOURACIL TABLET 100 MG TABLET 0 0 0

225 RANITIDIN INJEKSI 25 MG/ ML AMPUL 0 0 0

226 RESPERIDON 2 MG TABLET TABLET 0 0 0

227 RINGER LAKTATE LARUTAN INFUS STERIL BOTOL 0 0 0

228 SALBUTAMOL TABLET 2 MG TABLET 66 66 66

229 SALBUTAMOL TABLET 4 MG TABLET 0 0 0

230 SALEP 2-4 KOMBINASI 30 GR POT 2 2 2

231 SALICYL BEDAK 2 % KOTAK 0 0 0

232 SARUNG TANGAM NON STERIL L PCS 0 0 0

233 SARUNG TANGAN NON STERIL M PCS 56 56 56

234 SARUNG TANGAN NON STERIL S PCS 0 0 0

235 SARUNG TANGAN STERIL NO 6 PSG 0 0 0

236 SARUNG TANGAN STERIL NO. 7,5 PSG 0 0 0

237 SARUNG TANGAN STERILE NO.6,5 PSG 0 0 0

238 SARUNG TANGAN STERILE NO.7 PSG 3 3 3

239 SEFADROKSIL KAPSUL 500 MG KAPSUL 0 0 0

240 SEFIKSIM KAPSUL 100 MG KAPSUL 0 0 0

241 SERUM ANTI BISA ULAR POLIVALEN INJ.5 ML VIAL 0 0


(ABU I) 0

242 SERUM ANTI TETANUS INJEKSI 1.500 IU/AMP VIAL 0 0


(ATS) 0

243 SETIRIZINE TABLET 10 MG TABLET 0 0 0

SIANOKOBALAMIN ( VIT B12 ) INJEKSI 500


244 AMPUL 0 0 0
MCG/ML 1 ML

245 SIANOKOBALAMIN ( VIT B12 ) TABLET 50 MCG TABLET 112 112 112

246 SILK (BENANG BEDAH SUTERA) NO.3/0 PCS 1 1 1

247 SIMETIDINE TABLET 200 MG TABLET 0 0 0

248 SIMVASTATIN TABLET 10 MG TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

249 SIPROFLOXACIN INFUS 2% BOTOL 0 0 0

250 SIPROFLOXACIN TABLET 500 MG TABLET 0 0 0

251 SPONS GELATIN CUBICLES 1x1x1 CM PCS 0 0 0

252 STIMUNO SYR BOTOL 0 0 0

253 STIMUNO TAB (100) TABLET 0 0 0

254 STIMUNO TAB (30) BOTOL 0 0 0

255 SULFADOKSIN TABLET TABLET 0 0 0

SULFASETAMID NATRIUM TETES MATA 15 %


256 BOTOL 0 0 0
5 ML

257 TABLET TAMBAH DARAH TABLET 0 0 0

TEMPORARY CAVITY SEALER [TUMPATAN


258 SEMENTARA] (CAVIT G) PCS 0 0 0

259 TETAGRAM 150 IU AMPUL 0 0 0

260 TETRAKAIN HCL TETES MATA 5 ML BOTOL 0 0 0

261 TETRASIKLIN HCL TABLET 500 MG KAPSUL 0 0 0

262 THIAMIN HCL (VIT B1) INJEKSI 100 MG/ML 1 ML AMPUL 0 0 0

263 THIAMIN HCL MONONITRAT (VIT B1) TABLET TABLET 0 0


100 MG 0

264 THIAMIN HCL MONONITRAT (VIT B1) TABLET TABLET 0 0


50 MG 0

265 TRAMADOL INJEKSI 50 MG/ML AMPUL 0 0 0

266 TRANFUSION SET ADULT WITH Y INJECTION PCS 0 0 0

267 TRIFLOUPERASIN TABLET 5 MG TABLET 0 0 0

TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2


268 TABLET 0 0 0
MG

269 VITAMIN B COMPLEX TABLET TABLET 0 0 0

270 YODIUM POVIDON LARUTAN 10 % 30 ML BOTOL 0 0 0

271 YODIUM POVIDON LARUTAN 10% 60 ML BOTOL 0 0 0

272 ZENTRA (TRIPROLIDINE|PSEUDOEPHEDRINE) TABLET 90 90 90

273 ZINK 20 MG TABLET TABLET 100 100 100

274 Hi-D 1000 CHOLECALCIFEROL TABLET 0 0 0

OBAT PROGRAM / HIBAH

1 AMITRIPTYLINE 25 MG TABLET 0 0 0

2 HALOPERIDOLE INJEKSI AMPUL 0 0 0

3 HALOPERIDOLE 1,5 MG TABLET 0 0 0

4 HALOPERIDOLE 5 MG TABLET 0 0 0

5 LODOMER 2 MG TABLET 0 0 0

6 LODOMER 5 MG TABLET 0 0 0

7 TRIHEXYPHENIDYL 2 MG TABLET 0 0 0

8 ALAT SUNTIK 0,05 ML (PROGRAM) PCS 0 0 0

9 ALAT SUNTIK 0,5 ML (PROGRAM) PCS 0 0 0

10 ALAT SUNTIK 5 ML (PROGRAM) PCS 0 0 0

11 ALBENDAZOL TABLET 400 MG TABLET 0 0 0

12 BENZATINE BENZYLPENICILLIN 2.400.000 IU VIAL 0 0 0

13 COTRIMOXAZOLE 800/160 TABLET 0 0 0

14 DIETHYLCARBAMAZINE 100 MG TABLET 0 0 0

15 GARAM ORALIT UNTUK 200 ML AIR SACHET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

16 HIV ABACAVIR TABLET 300 MG BOTOL 0 0 0

17 HIV ACRIPTEGA (TDF 300 + 3TC 300 + DTG 50) BOTOL 0 0 0

18 HIV DOLUTEGRAFIR 50 MG BOTOL 0 0 0

19 HIV EFAFIRENZ 200 MG TABLET BOTOL 0 0 0

20 HIV EFAFIRENZ 600 MG TABLET BOTOL 0 0 0

21 HIV LAMIVUDIN 150 MG TABLET BOTOL 0 0 0

22 HIV NEVIRAPINE 200 MG TABLET BOTOL 0 0 0

23 HIV TENOFOVIR 300 MG BOTOL 0 0 0

24 HIV TRIPLE FDC ANAK (ZIDOVUDIN BOTOL 0 0 0


60MG+LAMIVUDIN 30MG+NEVIRAPINE 50MG)
25 HIV TRIPLE FDC DEWASA (TDC+3TC+EFV BOTOL 0 0 0
(300/300/600))

26 HIV ZIDOVUDINE 100 MG @60 KAPSUL BOTOL 0 0 0

27 HIV ZIDOVUDINE 300 MG + LAMIVUDIN 150 MG BOTOL 0 0 0

28 HIV ZIDOVUDINE SYRUP 240 ML BOTOL 0 0 0

29 IODINE TES PCS 0 0 0

30 ISONIAZID TABLET 100 MG TABLET 0 0 0

31 ISONIAZID TABLET 300 MG TABLET 0 0 0

KOMBIPAK AZITHROMYCIN - CEFIXIME


32 TABLET 0 0 0
KOMBINASI

33 MDT COMBI - MB ADULT (RED) BLISTER 0 0 0

34 MDT COMBI - MB CHILD (ORANGE) BLISTER 0 0 0

35 MDT COMBI - PB ADULT (GREEN) BLISTER 0 0 0

36 OBAT ANTI TUBERKULOSIS ANAK PAKET 0 0 0

OBAT ANTI TUBERKULOSIS DOSIS HARIAN


37 STOP TB KIT PAKET 0 0 0

38 OBAT ANTI TUBERKULOSIS KATEGORI 1 PAKET 0 0 0

39 OBAT ANTI TUBERKULOSIS KATEGORI 2 PAKET 0 0 0

40 OBAT ANTI TUBERKULOSIS KOMBIPAK PAKET 0 0 0


KATEGORI I

41 PARACETAMOL 500 MG (P2) TABLET 0 0 0

42 PIRIDOKSIN 25 MG TABLET (VIT B6) TABLET 0 0 0

43 PYRIMETAMINE TABLET 0 0 0

44 REAGEN HIV (FOKUS) PCS 0 0 0

45 REAGEN HIV (STANDART DIAGNOSTIC/SD) PCS 0 0 0

46 REAGEN HIV (VIKIA) PCS 0 0 0

REAGEN HIV DIAGNOSTAR HIV 1\/2 ONE STEP


47 PCS 0 0 0
RAPID TEST
48 REAGEN HIV DIAGNOSTIC KIT FOR HIV (1+2) PCS 0 0 0
ANTIBODY (COLLOIDAL GOLD) V2 PAKET
49 REAGEN SYPHILIS (TREPOCHECK) PCS 0 0 0

50 REAGEN SYPHILIS RDT (FOKUS) PCS 0 0 0

51 RETINOL ( VIT A ) KAPSUL 100.000 IU KAPSUL 0 0 0

52 RETINOL ( VIT A ) KAPSUL 200.000 IU KAPSUL 0 0 0

53 SAFETY BOX PCS 0 0 0

54 SERUM ANTI DIFTERI CAIRAN INJEKSI 125 VIAL 0 0 0


MG/ML

55 TABLET TAMBAH DARAH (PROGRAM) TABLET 0 0 0

56 ZINK TABLET DISPERSIBLE 20 MG (PROGRAM) TABLET 0 0 0

57 ALBENDAZOLE SIRUP BOTOL 0 0 0

58 COTRIMOXAZOLE 400/80 TABLET 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

59 MINERAL MIX SACHET 0 0 0

SD BIOLINE Syphilis 3.0 One Step Syphilis


60 PCS 0 0 0
Antibody Test

OBAT TAMBAHAN

1 ALKOHOL SWAB 0 0 0 0

2 ALLOPURINOL 0 0 0

3 AMLODIPINE 5MG (BLUD) 84 84 84

4 ANTISEPTIK GEL (DINKES) 1 1 1

5 APD VAKSIN 0 0 0

6 APRON (DINKES) 0 0 0

7 AQUA PRO INJEKSI (BLUD) 0 0 0

8 ASAM MEFENAMAT TABLET 500 MG (BLUD) 285 285 285

9 ASIKLOVIR TABLET 25 25 25

10 BETAMETHASONE SALEP KULIT (BLUD) 0 0 0

11 BIOPLACENTON (BLUD) 1 1 1

12 BISAKODIL TABLET 5 MG (BLUD) 0 0 0

13 CIPROFLOXACIN (BLUD) 0 0 0

14 CLINDAMISIN KAPS (BLUD) 0 0 0

15 DEKSAMETHASONE HARSEN TABLET 0,5 MG 250 250 250


((BLUD) )

16 DOMPERIDONE TABLET 10 MG ( (BLUD)) 0 0 0

17 EPINEFRIN INJEKSI (BLUD) 0 0 0

18 FENITOIN KAPS (BLUD) 0 0 0

19 FITOMENADION INJ (BLUD) 0 0 0

20 FITOMENADION TABLET (BLUD) 0 0 0

21 FUROSEMIDE TABLET 0 0 0

22 GEMFIBROZIL (BLUD) 16 16 16

23 GENOINT (BLUD) 11 11 11

24 GENTAMICIN TETES MATA (BLUD) 1 1 1

25 GENTIAN VIOLET LARUTAN 1 % (BLUD) 2 2 2

26 GLISERIL GUAIKOLAT/GUAIFENESIN BLUD 660 660 660

27 HIDROKORTISON CREAM KULIT (BLUD) 0 0 0

28 HYOSCINE BUTYLBROMIDE (ANTI SPASMODIK 80 80 80


BLUD)

29 HYPAFIX (BLUD) 0 0 0

30 INFUSET (BLUD) 0 0 0

31 IV CATHETER (BLUD) 0 0 0

32 KAPTOPRIL TABLET 12,5 MG (BLUD) 438 438 438

33 KLORAMFENIKOL SIRUP (BLUD) 0 0 0

34 KLORAMFENIKOL TETES TELINGA (BLUD) 7 7 7

35 KOTRIMOKSAZOL TAB (BLUD) 88 88 88

36 LOPERAMIDE TABLET 2 MG (BLUD) 0 0 0

37 MASKER (DINKES) 0 0 0

38 MASKER N9 0 0 0

39 METFORMIN (BLUD) 0 0 0
SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

40 METILERGOMETRINE INJ (BLUD) 0 0 0

41 MULTIVITAMIN KOMB 0 0 0

42 NEW DIATABS (BLUD) 0 0 0

43 NIFEDIPINE TAB (BLUD) 0 0 0

44 NURSE CAP 0 0 0

45 OMEPRAZOLE 20MG 146 146 146

46 ONDANSETRONE INJEKSI (BLUD) 0 0 0

47 PARACETAMOL TABLET 500 MG (BLUD) 0 0 0

48 PEHAVRAL 0 0 0

49 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG (BLUD) 160 160 160

50 PIROXICAM 0 0 0

51 SALBUTAMOL TABLET 2 MG (BLUD) 0 0 0

52 SARUNG TANGAN OBGYN 0 0 0

53 SARUNG TANGAN OBGYN 0 0 0

54 SEFADROKSIL KAPSUL 500 MG (BLUD) 0 0 0

55 VGEL (BLUD) 0 0 0

56 VITAMIN C 50 MG (BLUD) 250 250 250

57 ZIVIT ZINC 40 40 40

58 ASETIL (DINKES) 0 0 0

59 DEXAMETHASONE (DINKES) 0 0 0

60 OBH (DINKES) 0 0 0

61 AMBROXOL 470 470 470

62 BATUK FLU SIRUP (ETAFLUSIN) 3 3 3

63 BATUK FLU TABLET (ETAFLUSIN) 200 200 200

64 BETADINE GARGLE 0 0 0

65 BUFACOMB SALEP 0 0 0

66 BUFACORT - N 3 3 3

67 DARYANTULLE 0 0 0

68 ETIL KLORIDA SPRAY 0 0 0

69 GLIBENCLAMIDE TABLET 5 MG 0 0 0

70 GLIMEPIRIDE 2 MG TABLET 0 0 0

71 KAOLIN PEKTIN SIRUP (NOVADIAR) 3 3 3

72 PIRACETAM KAPSUL 0 0 0

73 TIAMFENIKOL KAPSUL 0 0 0

74 VITAMIN ANAK SIRUP (SAMCOVIT) 3 3 3

75 ANTIHEMOROID/BORRAGINOL (BLUD) 0 0 0

76 ASAM TRANEKSAMAT (BLUD) 0 0 0

77 ASETILSISTEIN (BLUD) 0 0 0

78 ASETOSAL TABLET 100 (80) MG (BLUD) 0 0 0

79 ASIKLOVIR SALEP KULIT (BLUD) 3 3 3

80 BEDAK SALISIL (BLUD) 5 5 5

81 BETAHISTIN TABLET (BLUD) 0 0 0


SISA STOK JUMLAH
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN STOK IFK
GUDANG OBAT ED
1 2 3 4 5 6 = 4+5 7 8 = (6-7)-10 9 10 11 12

82 CTM (BLUD) 262 262 262

83 GLIMEPIRID 1 MG (BLUD) 0 0 0

84 GLUKOSA INFUS (BLUD) 0 0 0

85 ISDN (BLUD) 0 0 0

86 METILPREDNISOLON TABLET 4 MG (BLUD) 0 0 0

87 METRONIDAZOL (BLUD) 0 0 0

88 OKSITETRASIKLIN SALEP KULIT (BLUD) 0 0 0

89 POVIDONE IODINE 60ML (BLUD) 0 0 0

90 RANITIDIN TABLET (BLUD) 0 0 0

91 SETERIZIN TABLET (BLUD) 172 172 172

92 VITAMIN B KOMPLEKS (BLUD) 225 225 225

93 VITAMIN B1 (BLUD) 265 265 265

94 0 0 0

95 0 0 0

96 0 0 0

97 0 0 0

98 0 0 0

99 0 0 0

100 0 0 0

Blitar , 03 October 2022


Mengetahui / Menyetujui
Yang Menerima, Yang Menyerahkan,
Kepala Puskesmas Petugas Petugas Pengelola Obat
SANANKULON Instalasi Farmasi Kabupaten Pustu/Polindes/Ponkesdes

ENDAH ROSITANINGSIH, SE, MM Apt. AINA MUJTAHIDA A, S.Farm. DANIK YUNITA SARI,Amd.Kep
NIP. 196912302010012002 NIP : 198612188 11033 2 0004 NIP. 198,506,142,022,212,000
DINAS KESEHATAN KABUPATEN BLITAR
SUMBERINGIN 2022
PEMASUKAN
JAN FEB MAR APR MEI
NO NAMA OBAT STOK AWAL

1 2 WAY FOLEY CATHETER NO.16 0 0 0 0 0 0


2 2 WAY FOLEY CATHETER NO.18 0 0 0 0 0 0
3 2 WAY FOLEY CATHETER NO.20 0 0 0 0 0 0
4 ACETYLCYSTEINE CAPSULE 200 MG 0 0 0 0 0 0
5 ALAT SUNTIK SEKALI PAKAI 1 ML 0 0 0 0 0 0
6 ALAT SUNTIK SEKALI PAKAI 10 ML 0 0 0 0 0 0
7 ALAT SUNTIK SEKALI PAKAI 20 ML 0 0 0 0 0 0
8 ALAT SUNTIK SEKALI PAKAI 3 ML 127 0 0 0 0 0
9 ALAT SUNTIK SEKALI PAKAI 5 ML 43 0 60 0 0 0
10 ALKOHOL SWAB 0 0 0 0 0 0
11 ALLOPURINOL TABLET 100 MG 0 0 0 0 0 0
12 ALPRAZOLAM 1 MG TABLET 0 0 0 0 0 0
13 AMBROXOL SIRUP 5MG/ML 0 0 0 0 0 0
14 AMBROXOL TABLET 30 MG 0 0 0 0 0 0
15 AMINOPHYLLINE INJEKSI 24 MG/ML 10 ML 0 0 0 0 0 0
16 AMINOPHYLLINE TABLET 200 MG 0 0 0 0 0 0
17 AMITRIPTYLLINE HCL TABLET 25 MG 0 0 0 0 0 0
18 AMLODIPINE TABLET 10 MG 116 200 0 0 0 100
19 AMLODIPINE TABLET 5 MG 0 0 0 0 0 0
AMOKSISILIN DRY SYRUP 125 MG/5 ML 60
20 0 0 0 0 0 0
ML
21 AMOKSISILIN SERBUK INJEKSI 1000 MG 0 0 0 0 0 0
22 AMOKSISILIN TABLET 500 MG 344 0 300 200 100 100
AMOXCICILIN FORTE SYRUP KERING
23 0 0 0 0 0 0
250MG/5ML
AMPICILLIN SERBUK INJEKSI 1.000 MG
24 0 0 0 0 0 0
MG/VIAL
25 ANTALGIN 500 MG TABLET (METAMIZOL) 0 0 0 0 0 0
26 ANTASIDA DOEN TABLET KOMBINASI 210 300 300 300 0 0
27 ANTASIDA SUSPENSI 60 ML 0 0 5 0 0 0
28 ANTI BAKTERI DOEN SALEP KOMBINASI 5 0 0 0 0 0 0
GR
ANTI FUNGI DOEN SALEP KOMBINASI 30
29 0 0 5 0 0 0
GR
30 ANTI HAEMOROID DOEN KOMBINASI 0 0 0 0 0 0
31 ANTI MIGRAIN DOEN TABLET KOMBINASI 0 0 0 0 0 0
32 ANTI SPASMODIK INJEKSI (SPASHI) 0 0 0 0 0 0
33 ANTI SPASMODIK TABLET (DORMICOMP) 0 0 0 0 0 0
34 AQUA PRO INJEKSI STERIL BEBAS PIROGEN 0 0 0 0 0 0
20 ML
35 ASAM ASKORBAT ( VIT C ) TABLET 250 MG 0 0 0 0 0 0
36 ASAM ASKORBAT ( VIT C ) TABLET 50 MG 0 0 0 0 0 0
37 ASAM FOLAT 1MG TABLET 0 0 0 0 0 0
38 ASAM MEFENAMAT TABLET 500 MG 0 0 0 0 0 0
39 ASAM TRANEKSAMAT 100 MG/ML INJEKSI 0 0 0 0 0 0
40 ASAM TRANEKSAMAT 500 MG TABLET 0 0 0 0 0 0
41 ASAM VALPROAT 250 MG TABLET / 0 0 0 0 0 0
DEPAKOTE ER
42 ASEPTAN 500CC + PUMP 0 0 0 0 0 0
43 ASEPTIC GEL 500CC + DISPENSER 0 0 0 0 0 0
44 ASERING (ASETAT RINGER) SOFT BAG 0 0 0 0 0 0
45 ASETOSAL TABLET 100 (80) MG 0 0 0 0 0 0
46 ASIKLOVIR KREAM 5 % 5 GR 3 0 0 0 0 0
47 ASIKLOVIR TABLET 400 MG 0 0 0 0 0 0
ATROPIN SULFAT INJEKSI 0,25 MG/ML 1
48 ML 0 0 0 0 0 0
49 ATTAPULGIT + PECTIN TABLET 0 0 0 0 0 0
50 BETAHISTINE MESILAT 24 MG TABLET 0 0 0 0 0 0
51 BETAHISTINMESILAT 6 MG TABLET 0 0 0 0 0 0
52 BETAMETHASON CR 0.05% 20 GR 0 0 0 0 5 0
53 BETAMETHASONE CREAM 0,1 % 5 GR 0 0 0 0 0 0
54 BIONICOM ZINC TABLET 0 0 0 0 0 0
55 BISAKODIL SUPPOSITORIA 10 MG 0 0 0 0 0 0
56 BISAKODIL SUPPOSITORIA 5 MG 0 0 0 0 0 0
57 BISOPROLOL 2,5 MG TABLET (CONCOR) 0 0 0 0 0 0
58 BISOPROLOL 5 MG TABLET 0 0 0 0 0 0
59 CAT GUT NO. 3/0 CHROMIC 0 0 0 0 1 0
60 CAT GUT NO. 3/0 PLAIN 0 0 0 0 1 0
61 CITICHOLIN 250 MG/ML-2ML INJEKSI 0 0 0 0 0 0
62 CLONIDINE 0.15 MG TABLET 0 0 0 0 0 0
63 CLOPIDOGREL 75 MG 0 0 0 0 0 0
64 COMBIVENT UDV INHALASI 0 0 0 0 0 0
65 DEKSAMETHASONE INJEKSI 5 MG/ML 1 ML 0 0 0 0 0 0
66 DEKSAMETHASONE TABLET 0,5 MG 0 0 0 0 0 0
67 DEVITALISASI PASTA ( NON ARSEN ) 0 0 0 0 0 0
68 DIAZEPAM INJEKSI 5 MG/ML 2 ML 0 0 0 0 0 0
DIAZEPAM LARUTAN RECTAL 5MG/
69 0 0 0 0 0 0
2,5ML-STESOLID
70 DIAZEPAM TABLET 2 MG 0 0 0 0 0 0
71 DIAZEPAM TABLET 5 MG 0 0 0 0 0 0
DIFENHIDRAMINE HCL INJEKSI 10 MG/ML 1
72 0 0 0 0 0 0
ML
73 DIGOXIN TABLET 0,25 MG 0 0 0 0 0 0
74 DIMENHYDRINATE TABLET 50 MG 15 0 0 0 0 0
75 DOKSISIKLIN TABLET 100 MG 0 0 0 0 0 0
76 DOMPERIDON SUSPENSI 5MG/ML 0 0 0 0 0 0
77 DOMPERIDON TABLET 10 MG 0 0 0 0 0 0
EKSTRACT PLASENTA + NEOMYSIN SALEP
78 15 GR 0 0 0 0 0 0
79 EPINEFRIN (ADRENALIN) HCL INJ.0,1 % 1 ML 0 0 0 0 0 0
80 ERITROMISIN KAPSUL 250 MG 0 0 0 0 0 0
81 ERITROMISIN SIRUP KERING 200 MG/5ML 0 0 0 0 0 0
82 ERITROMISIN TABLET 500 MG 0 0 0 0 0 0
ETAKRIDIN ( RIVANOL ) LARUTAN 0,1 % 300
83 ML 1 0 0 0 0 0
84 ETANOL [ ALKOHOL ] 70 % 1000 ML 1 0 0 0 0 0
85 ETIL KLORIDA SEMPROT 100 ML 0 0 0 0 0 0
86 EUGENOL CAIRAN 10 ML 0 0 0 0 0 0
87 FENITOIN NATRIUM INJEKSI 50 MG/ML 2 0 0 0 0 0 0
ML
88 FENITOIN NATRIUM TABLET 100 MG 0 0 0 0 0 0
89 FENOBARBITAL INJEKSI 50 MG/ML 2 ML 0 0 0 0 0 0
90 FENOBARBITAL TABLET 30 MG 0 0 0 0 0 0
91 FENOL GLISEROL TETES TELINGA 10 % 5 0 0 0 0 0 0
ML
FITOMENADION ( VIT K1 ) INJEKSI 10
92 0 0 0 0 0 0
MG/ML 1 ML
FITOMENADION ( VIT K1 ) TABLET SALUT
93 0 0 0 0 0 0
10 MG
94 FITOMENADION INFANT INJ. 2MG/ML 0 0 0 0 0 0
FLUPHENASINE DEKANOAT INJEKSI 25 MG
95 0 0 0 0 0 0
1 ML
96 FUROSEMID INJEKSI 10 mg 0 0 0 0 0 0
97 FUROSEMID TABLET 40 MG 70 0 0 50 0 0
GAMEKSAN (SCABICID)/PERMETRIN KRIM 1
98 4 0 0 0 0 3
% 10 GR
99 GARAM ORALIT 117 0 0 0 0 0
100 GEMFIBROZIL 300 MG KAPSUL 0 0 0 0 0 0
101 GENTAMISIN SALEP KULIT 0,1 % 5 GR 0 0 0 0 0 0
102 GENTAMISIN SALEP MATA 0,3% 0 0 0 0 0 5
103 GENTAMISIN TETES MATA 0,3% 0 0 0 0 0 0
104 GLASS IONOMER CEMENT ( GC IX ) 0 0 0 0 0 0
105 GLIBENCLAMIDE TABLET 5 MG 30 200 300 0 0 0
106 GLICERIL GUAIACOLAT TABLET 100 MG 0 0 0 0 0 0
107 GLIMEPIRIDE 1 MG TABLET 0 0 0 0 0 0
108 GLIMEPIRIDE 2 MG TABLET 124 200 100 0 0 0
GLUKOSA 40% DEXTROSE INJECTION
109 0 0 0 0 0 0
U.S.P CAIRAN INJEKSI
110 GLUKOSA LARUTAN INFUS 10 % STERIL 0 0 0 0 0 0
111 GLUKOSA LARUTAN INFUS 5 % STERIL 0 0 0 0 0 0
112 GRISEOFULVIN TABLET 125 MG 0 0 0 0 0 0
113 HALOPERIDOL 2 MG 0 0 0 0 0 0
114 HALOPERIDOL DEKANOAT INJ 50 MG 0 0 0 0 0 0
115 HALOPERIDOL INJ. 5 MG/ML (LODOMER) 0 0 0 0 0 0
116 HALOPERIDOL TABLET 1,5 MG 0 0 0 0 0 0
117 HALOPERIDOL TABLET 5 MG 0 0 0 0 0 0
118 HERBAKOF SYRUP 60ML 0 0 0 0 0 0
119 HES-HYDROXYETHYL STARCH 6 0 0 0 0 0 0
%/VOLUVEN INFUS 500 ML
120 HIDROCORTISON CR 1% 0 0 0 0 0 0
121 HIDROCORTISONE CREAM 2,5 % 5 GR 0 0 0 0 0 0
122 HYDROCHLORTHIAZIDE 25 MG 0 0 0 0 0 0
123 I.V CATHETER NO.16 WITH INJECTION 0 0 0 0 0 0
PORT
I.V CATHETER NO.18 WITH INJECTION
124 0 0 0 0 0 0
PORT
I.V CATHETER NO.20 WITH INJECTION
125 0 0 0 0 0 0
PORT
I.V CATHETER NO.22 WITH INJECTION
126 0 0 0 0 0 0
PORT
I.V CATHETER NO.24 WITH INJECTION
127 PORT 0 0 0 0 0 0
I.V CATHETER NO.26 WITH INJECTION
128 0 0 0 0 0 0
PORT
129 IBUPROFEN FORTE SYRUP 200MG/5ML 0 0 0 0 0 0
130 IBUPROFEN SUSPENSI 100 MG/5 ML 60 ML 0 3 5 0 0 0
131 IBUPROFEN TABLET 400 MG 0 0 0 0 0 0
132 INFUSION SET ANAK 0 0 0 0 0 0
133 INFUSION SET DEWASA 0 0 0 0 0 1
134 ISOSORBIDE DINITRATE SUBLINGUAL 5 MG 0 0 0 0 0 0
135 KAEN 3B 0 0 0 0 0 0
136 KALIUM DIKLOFENAK 50 MG TABLET 0 0 0 0 0 0
KALSIUM GLUCONAS INJEKSI 100 MG/ML 10
137 0 0 0 0 0 0
ML
138 KALSIUM LAKTAT (KALK) TABLET 500 MG 192 300 200 400 400 300
139 KANTONG URINE DEWASA 0 0 0 0 0 0
140 KAPAS PEMBALUT/ABSORBEN 250 GR 0 0 0 0 0 0
141 KAPTOPRIL TABLET 25 MG 0 0 0 0 0 0
142 KARBAMAZEPIN TABLET 200 MG 0 0 0 0 0 0
143 KASA KOMPRES 40/40 STERIL 0 0 0 0 0 5
KASA PEMBALUT HIDROFIL 16 X 16 CM
144 STRIL 1 3 0 0 0 2
145 KASA PEMBALUT HIDROFIL 2 M X 80 CM 1 0 0 0 0 1
146 KASA PEMBALUT HIDROFIL 4 M X 10 CM 0 0 0 0 0 0
147 KASA PEMBALUT HIDROFIL 4 M X 5 CM 0 0 0 0 0 10
KASA STERIL (DARYAN TOLLE)YG DIRESAPI
148 0 0 0 0 0 0
FRAMISETIN
149 KETOKONAZOLE TABLET 200 MG 0 0 0 0 0 0
150 KETOPROFEN 100 MG SUPPOSITORIA 0 0 0 0 0 0
151 KLINDAMISIN KAPSUL 150 MG 0 0 0 0 0 0
152 KLINDAMISIN KAPSUL 300 MG 0 0 0 0 0 0
153 KLOBAZAM 10 MG TABLET 0 0 0 0 0 0
154 KLORAMFENIKOL KAPSUL 500 MG 0 0 0 0 0 0
155 KLORAMFENIKOL SALEP KULIT 2 % 0 0 0 0 0 0
156 KLORAMFENIKOL SALEP MATA 1 % 4 0 0 0 0 0
157 KLORAMFENIKOL SUSPENSI 125 MG/5 ML 0 0 0 0 0 0
158 KLORAMFENIKOL TETES TELINGA 3 % 0 0 0 0 0 0
159 KLORFENIRAMINE MALEAT (CTM) TABLET 118 200 200 0 0 0
4 MG
KLORPROMAZIN HCL INJEKSI 25 MG/ML 1
160 0 0 0 0 0 0
ML
KLORPROMAZIN HCL INJEKSI 50 MG/ML 1
161 0 0 0 0 0 0
ML
162 KLORPROMAZIN HCL TABLET 100 MG 0 0 0 0 0 0
163 KLOZAPIN 100 MG TABLET 0 0 0 0 0 0
164 KLOZAPIN 25 MG TABLET 0 0 0 0 0 0
165 KODEIN HCL TABLET 10 MG 0 0 0 0 0 0
166 KOTRIMOKSAZOL DEWASA TABLET 0 0 0 0 0 0
167 KOTRIMOKSAZOL SUSPENSI 60 ML 0 0 0 0 0 0
168 LEVOFLOXACIN TABLET 500 MG 0 0 0 0 0 0
169 LIDOCAIN 2% INJ 0 0 0 0 0 0
170 LIDOCAIN COMPOSITUM INJEKSI 2 ML 0 0 0 0 3 0
171 LISOL CONCENTRATE 1000 ML 0 0 0 0 0 0
172 LOPERAMIDE TABLET 2 MG 0 0 0 0 0 0
173 LORATADIN TABLET 10 MG 50 0 0 0 100 0
174 LORAZEPAM 2 MG 0 0 0 0 0 0
175 MAGNESIUM SULFAT INJEKSI (IV) 40 % 25 0 0 0 0 0 0
ML
176 MASKER EARLOOP PLUS 0 0 0 0 0 0
177 MASKER KERTAS 3 PLY EAR LOOP 0 0 0 0 0 0
178 MASKER KERTAS 3 PLY TIE ON 0 0 0 0 0 0
179 MASKER N95 0 0 0 0 0 0
180 MELOKSIKAM TABLET 7,5 MG 0 0 0 0 0 0
METAMIZOL (NORAGES) INJEKSI 500
181 0 0 0 0 0 0
MG/2ML
182 METFORMIN TABLET 500 MG 0 0 0 0 0 100
METILERGOMETRIN MALEAT INJEKSI
183 0,200 MG 1 ML 0 0 0 0 0 0
METILERGOMETRIN MALEAT TABLET
184 0 0 0 0 0 0
0,125 MG
185 METILPREDNISOLON TABLET 4 MG 0 0 0 0 0 0
186 METOKLOPRAMIDE 10 MG TABLET 0 0 0 0 0 0
187 METOKLOPRAMIDE 5 MG TABLET 0 0 0 0 0 0
METOKLOPROMIDE (SOTATIC) INJEKSI 5
188 0 0 0 0 0 0
MG/ML 2 ML
189 METOKLOPROMIDE SIRUP 0 0 0 0 0 0
METRONIDAZOL + NYSTATIN VAG.
190 (PROVAGIN) INJEKSI 0 0 0 0 0 0
191 METRONIDAZOL TABLET 250 MG 0 0 0 0 0 0
192 METRONIDAZOL TABLET 500 MG 0 0 0 0 0 0
193 METRONIDAZOLE INFUS 5 MG/ML 100 ML 0 0 0 0 0 0
194 MIKONAZOL KREAM 10 GR 4 0 5 0 0 0
195 MINERAL MIX 0 0 0 0 0 0
196 NATRIUM DIKLOFENAK TABLET 25 MG 92 0 100 200 0 0
197 NATRIUM DIKLOFENAK TABLET 50 MG 0 0 0 0 0 0
198 NATRIUM KLORIDA INFUS 0,9 % STERIL 0 0 1 0 0 2
199 NIFEDIPINE TABLET 10 MG 0 0 0 0 0 0
200 NISTATIN TABLET 500.000 UI 50 0 0 0 0 0
201 NISTATIN VAGINAL TABLET 100.000 UI 11 0 0 0 0 0
202 OBAT BATUK HITAM (OBH) CAIRAN 100 ML 0 0 0 0 0 0
203 OKSIGEN NASAL CANNULA ADULT 0 0 0 0 0 0
204 OKSIGEN NASAL CANNULA INFANT 0 0 0 0 0 0
205 OKSITETRACYCLIN SALEP KULIT 3 % 5 GR 0 0 0 0 0 0
OKSITETRACYCLIN SALEP MATA 1 % 3,5
206 GR 3 0 0 0 0 0
207 OKSITOSIN INJEKSI 10 IU/ML 1 ML 0 0 0 0 0 0
208 OMEPRAZOLE TABLET 20 MG 0 0 0 0 0 0
209 ONDANSENTRON 4 MG/2 ML INJEKSI 0 0 0 0 0 0
210 PARACETAMOL SYRUP 120 MG/5 ML 60 ML 0 3 5 0 5 5
211 PARACETAMOL TABLET 500 MG 0 0 0 0 0 0
212 PARACETAMOL TETES 100 MG/ML 15 ML 0 0 0 0 0 0
213 PEHAVRAL TABLET 0 0 0 0 0 0
214 PERAK SULFADIAZIN KRIM 1 % 0 0 0 0 0 0
215 PERHYDROL [ H2O2 ] 3 % 800 ML 1 0 0 0 0 0
216 PERMETHRINE 5% CR 15 GRAM 0 0 0 0 0 0
217 PIRACETAM TABLET 800 MG 0 0 0 0 0 0
218 PIRANTEL PAMOAT TABLET 0 0 0 0 0 0
219 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG 0 0 0 0 0 0
220 PIROKSIKAM KAPSUL 10 MG 0 0 0 0 0 0
221 PLESTER 10 CM X 2 M 0 0 0 0 0 0
222 PREDNISON TABLET 5 MG 0 0 0 0 0 0
223 PROPRANOLOL HCL TABLET 40 MG 0 0 0 0 0 0
224 PROPILTHIOURACIL TABLET 100 MG 0 0 0 0 0 0
225 RANITIDIN INJEKSI 25 MG/ ML 0 0 0 0 0 0
226 RESPERIDON 2 MG TABLET 0 0 0 0 0 0
227 RINGER LAKTATE LARUTAN INFUS STERIL 0 0 0 0 0 0
228 SALBUTAMOL TABLET 2 MG 0 0 100 0 0 0
229 SALBUTAMOL TABLET 4 MG 0 0 0 0 0 0
230 SALEP 2-4 KOMBINASI 30 GR 2 0 5 0 0 0
231 SALICYL BEDAK 2 % 0 0 0 0 0 0
232 SARUNG TANGAM NON STERIL L 0 0 0 0 0 0
233 SARUNG TANGAN NON STERIL M 85 200 200 0 100 100
234 SARUNG TANGAN NON STERIL S 0 0 100 100 0 0
235 SARUNG TANGAN STERIL NO 6 0 0 0 0 0 0
236 SARUNG TANGAN STERIL NO. 7,5 0 0 0 0 0 0
237 SARUNG TANGAN STERILE NO.6,5 0 0 0 0 0 0
238 SARUNG TANGAN STERILE NO.7 1 0 0 0 0 2
239 SEFADROKSIL KAPSUL 500 MG 0 0 0 0 0 0
240 SEFIKSIM KAPSUL 100 MG 0 0 0 0 0 0
SERUM ANTI BISA ULAR POLIVALEN INJ.5
241 0 0 0 0 0 0
ML (ABUANTI
SERUM I) TETANUS INJEKSI 1.500
242 0 0 0 0 0 0
IU/AMP (ATS)
243 SETIRIZINE TABLET 10 MG 40 0 100 100 100 50
SIANOKOBALAMIN ( VIT B12 ) INJEKSI 500
244 0 0 0 0 0 0
MCG/ML 1 ML
SIANOKOBALAMIN ( VIT B12 ) TABLET 50
245 MCG 200 0 0 200 0 0
246 SILK (BENANG BEDAH SUTERA) NO.3/0 0 0 0 0 1 0
247 SIMETIDINE TABLET 200 MG 0 0 0 0 0 0
248 SIMVASTATIN TABLET 10 MG 0 0 0 0 0 0
249 SIPROFLOXACIN INFUS 2% 0 0 0 0 0 0
250 SIPROFLOXACIN TABLET 500 MG 0 0 0 0 0 0
251 SPONS GELATIN CUBICLES 1x1x1 CM 0 0 0 0 0 0
252 STIMUNO SYR 0 0 0 0 0 0
253 STIMUNO TAB (100) 0 0 0 0 0 0
254 STIMUNO TAB (30) 0 0 0 0 0 0
255 SULFADOKSIN TABLET 0 0 0 0 0 0
SULFASETAMID NATRIUM TETES MATA 15
256 % 5 ML 0 0 0 0 0 0
257 TABLET TAMBAH DARAH 714 500 500 400 200 500
258 TEMPORARY CAVITY SEALER [TUMPATAN 0 0 0 0 0 0
SEMENTARA] (CAVIT G)
259 TETAGRAM 150 IU 0 0 0 0 0 0
260 TETRAKAIN HCL TETES MATA 5 ML 0 0 0 0 0 0
261 TETRASIKLIN HCL TABLET 500 MG 0 0 0 0 0 0
THIAMIN HCL (VIT B1) INJEKSI 100 MG/ML 1
262 ML 0 0 0 0 0 0
THIAMIN HCL MONONITRAT (VIT B1)
263 0 0 0 0 0 0
TABLET 100
THIAMIN HCLMGMONONITRAT (VIT B1)
264 0 0 0 0 0 0
TABLET 50 MG
265 TRAMADOL INJEKSI 50 MG/ML 0 0 0 0 0 0
TRANFUSION SET ADULT WITH Y
266 0 0 0 0 0 0
INJECTION
267 TRIFLOUPERASIN TABLET 5 MG 0 0 0 0 0 0
TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2
268 MG 0 0 0 0 0 0
269 VITAMIN B COMPLEX TABLET 158 0 100 200 200 50
270 YODIUM POVIDON LARUTAN 10 % 30 ML 0 0 0 0 0 0
271 YODIUM POVIDON LARUTAN 10% 60 ML 1 0 0 0 0 0
ZENTRA (TRIPROLIDINE|
272 0 0 0 0 0 0
PSEUDOEPHEDRINE)
273 ZINK 20 MG TABLET 0 0 0 0 0 100
274 Hi-D 1000 CHOLECALCIFEROL 0 0 0 0 0 0
OBAT PROGRAM / HIBAH
1 AMITRIPTYLINE 25 MG 0 0 0 0 0 0
2 HALOPERIDOLE INJEKSI 0 0 0 0 0 0
3 HALOPERIDOLE 1,5 MG 0 0 0 0 0 0
4 HALOPERIDOLE 5 MG 0 0 0 0 0 0
5 LODOMER 2 MG 0 0 0 0 0 0
6 LODOMER 5 MG 0 0 0 0 0 0
7 TRIHEXYPHENIDYL 2 MG 0 0 0 0 0 0
8 ALAT SUNTIK 0,05 ML (PROGRAM) 0 0 0 0 0 0
9 ALAT SUNTIK 0,5 ML (PROGRAM) 0 0 0 0 0 0
10 ALAT SUNTIK 5 ML (PROGRAM) 0 0 0 0 0 0
11 ALBENDAZOL TABLET 400 MG 0 0 0 0 0 0
BENZATINE BENZYLPENICILLIN 2.400.000
12 0 0 0 0 0 0
IU
13 COTRIMOXAZOLE 800/160 0 0 0 0 0 0
14 DIETHYLCARBAMAZINE 100 MG 0 0 0 0 0 0
15 GARAM ORALIT UNTUK 200 ML AIR 0 0 0 0 0 0
16 HIV ABACAVIR TABLET 300 MG 0 0 0 0 0 0
17 HIV ACRIPTEGA (TDF 300 + 3TC 300 + DTG 0 0 0 0 0 0
50)
18 HIV DOLUTEGRAFIR 50 MG 0 0 0 0 0 0
19 HIV EFAFIRENZ 200 MG TABLET 0 0 0 0 0 0
20 HIV EFAFIRENZ 600 MG TABLET 0 0 0 0 0 0
21 HIV LAMIVUDIN 150 MG TABLET 0 0 0 0 0 0
22 HIV NEVIRAPINE 200 MG TABLET 0 0 0 0 0 0
23 HIV
HIV TENOFOVIR 300 MG
TRIPLE FDC ANAK (ZIDOVUDIN 0 0 0 0 0 0
24 60MG+LAMIVUDIN 30MG+NEVIRAPINE 0 0 0 0 0 0
HIV TRIPLE FDC DEWASA (TDC+3TC+EFV
50MG)
25 (300/300/600)) 0 0 0 0 0 0
26 HIV ZIDOVUDINE 100 MG @60 KAPSUL 0 0 0 0 0 0
27 HIV ZIDOVUDINE 300 MG + LAMIVUDIN 150 0 0 0 0 0 0
MG
28 HIV ZIDOVUDINE SYRUP 240 ML 0 0 0 0 0 0
29 IODINE TES 0 0 0 0 0 0
30 ISONIAZID TABLET 100 MG 0 0 0 0 0 0
31 ISONIAZID TABLET 300 MG 0 0 0 0 0 0
KOMBIPAK AZITHROMYCIN - CEFIXIME
32 0 0 0 0 0 0
KOMBINASI
33 MDT COMBI - MB ADULT (RED) 0 0 0 0 0 0
34 MDT COMBI - MB CHILD (ORANGE) 0 0 0 0 0 0
35 MDT COMBI - PB ADULT (GREEN) 0 0 0 0 0 0
36 OBAT ANTI TUBERKULOSIS ANAK 0 0 0 0 0 0
OBAT ANTI TUBERKULOSIS DOSIS HARIAN
37 STOP TB KIT 0 0 0 0 0 0
38 OBAT ANTI TUBERKULOSIS KATEGORI 1 0 0 0 0 0 0
39 OBAT ANTI TUBERKULOSIS KATEGORI 2 0 0 0 0 0 0
40 OBAT ANTI TUBERKULOSIS KOMBIPAK 0 0 0 0 0 0
KATEGORI I
41 PARACETAMOL 500 MG (P2) 0 0 0 0 0 0
42 PIRIDOKSIN 25 MG TABLET (VIT B6) 0 0 0 0 0 0
43 PYRIMETAMINE 0 0 0 0 0 0
44 REAGEN HIV (FOKUS) 0 0 0 0 0 0
45 REAGEN HIV (STANDART DIAGNOSTIC/SD) 0 0 0 0 0 0
46 REAGEN HIV (VIKIA) 0 0 0 0 0 0
47 REAGEN HIV DIAGNOSTAR HIV 1\/2 ONE 0 0 0 0 0 0
REAGEN
STEP RAPIDHIVTEST
DIAGNOSTIC KIT FOR HIV
48 (1+2) ANTIBODY (COLLOIDAL GOLD) V2 0 0 0 0 0 0
49 PAKET
REAGEN SYPHILIS (TREPOCHECK) 0 0 0 0 0 0
50 REAGEN SYPHILIS RDT (FOKUS) 0 0 0 0 0 0
51 RETINOL ( VIT A ) KAPSUL 100.000 IU 0 0 0 0 0 0
52 RETINOL ( VIT A ) KAPSUL 200.000 IU 0 0 0 0 0 0
53 SAFETY BOX 0 0 0 0 0 0
SERUM ANTI DIFTERI CAIRAN INJEKSI 125
54 MG/ML 0 0 0 0 0 0
55 TABLET TAMBAH DARAH (PROGRAM) 0 0 0 0 0 0
56 ZINK TABLET DISPERSIBLE 20 MG 0 0 0 0 0 0
(PROGRAM)
57 ALBENDAZOLE SIRUP 0 0 0 0 0 0
58 COTRIMOXAZOLE 400/80 0 0 0 0 0 0
59 MINERAL MIX 0 0 0 0 0 0
SD BIOLINE Syphilis 3.0 One Step Syphilis
60 Antibody Test 0 0 0 0 0 0
OBAT TAMBAHAN
1 ALKOHOL SWAB 0 0 0 0 0 0
2 ALLOPURINOL 0 0 0 0 0 100
3 AMLODIPINE 5MG (BLUD) 0 0 150 600 0 0
4 ANTISEPTIK GEL (DINKES) 1 0 1 1 1 0
5 APD VAKSIN 0 0 0 0 0 0
6 APRON (DINKES) 0 0 0 0 0 0
7 AQUA PRO INJEKSI (BLUD) 0 0 0 0 0 0
ASAM MEFENAMAT TABLET 500 MG
8 184 0 0 200 0 100
(BLUD)
9 ASIKLOVIR TABLET 0 0 0 0 0 50
10 BETAMETHASONE SALEP KULIT (BLUD) 4 0 0 0 0 0
11 BIOPLACENTON (BLUD) 0 0 0 0 0 2
12 BISAKODIL TABLET 5 MG (BLUD) 0 0 0 0 0 0
13 CIPROFLOXACIN (BLUD) 0 0 0 0 0 0
14 CLINDAMISIN KAPS (BLUD) 0 0 0 0 0 0
DEKSAMETHASONE HARSEN TABLET 0,5
15 MG ((BLUD) ) 0 200 300 0 100 200
16 DOMPERIDONE TABLET 10 MG ( (BLUD)) 0 100 0 0 0 50
17 EPINEFRIN INJEKSI (BLUD) 0 0 0 0 0 0
18 FENITOIN KAPS (BLUD) 0 0 0 0 0 0
19 FITOMENADION INJ (BLUD) 0 0 0 0 0 0
20 FITOMENADION TABLET (BLUD) 0 0 0 0 0 0
21 FUROSEMIDE TABLET 0 0 0 0 0 0
22 GEMFIBROZIL (BLUD) 0 0 0 0 0 100
23 GENOINT (BLUD) 1 0 0 0 0 0
24 GENTAMICIN TETES MATA (BLUD) 2 5 5 0 0 0
25 GENTIAN VIOLET LARUTAN 1 % (BLUD) 2 0 0 0 0 0
26 GLISERIL GUAIKOLAT/GUAIFENESIN BLUD 407 300 300 0 0 0
27 HIDROKORTISON CREAM KULIT (BLUD) 5 0 5 0 10 0
28 HYOSCINE BUTYLBROMIDE (ANTI 0 0 0 0 0 100
SPASMODIK BLUD)
29 HYPAFIX (BLUD) 0 0 0 0 0 0
30 INFUSET (BLUD) 0 0 0 0 0 0
31 IV CATHETER (BLUD) 0 0 0 0 0 0
32 KAPTOPRIL TABLET 12,5 MG (BLUD) 6 300 300 0 0 0
33 KLORAMFENIKOL SIRUP (BLUD) 0 0 0 0 0 0
34 KLORAMFENIKOL TETES TELINGA (BLUD) 3 5 0 0 0 5
35 KOTRIMOKSAZOL TAB (BLUD) 0 0 0 0 0 0
36 LOPERAMIDE TABLET 2 MG (BLUD) 0 0 0 0 0 0
37 MASKER (DINKES) 0 0 0 0 0 0
38 MASKER N9 0 0 0 0 0 0
39 METFORMIN (BLUD) 75 100 100 0 0 0
40 METILERGOMETRINE INJ (BLUD) 0 0 0 0 0 0
41 MULTIVITAMIN KOMB 0 0 0 0 0 0
42 NEW DIATABS (BLUD) 78 0 0 0 0 0
43 NIFEDIPINE TAB (BLUD) 0 0 0 0 0 0
44 NURSE CAP 0 0 0 0 0 0
45 OMEPRAZOLE 20MG 66 0 0 0 0 100
46 ONDANSETRONE INJEKSI (BLUD) 0 0 0 0 0 0
47 PARACETAMOL TABLET 500 MG (BLUD) 610 600 600 500 200 500
48 PEHAVRAL 0 0 0 0 0 0
PIRIDOKSIN HCL (VIT B6) TABLET 10 MG
49 (BLUD) 238 0 0 200 200 0
50 PIROXICAM 0 0 0 0 0 0
51 SALBUTAMOL TABLET 2 MG (BLUD) 35 0 0 0 0 0
52 SARUNG TANGAN OBGYN 0 0 0 0 0 0
53 SARUNG TANGAN OBGYN 0 0 0 0 0 0
54 SEFADROKSIL KAPSUL 500 MG (BLUD) 0 0 0 0 0 0
55 VGEL (BLUD) 0 0 0 0 0 0
56 VITAMIN C 50 MG (BLUD) 370 0 500 300 0 0
57 ZIVIT ZINC 0 60 90 90 90 0
58 ASETIL (DINKES) 0 0 0 0 0 0
59 DEXAMETHASONE (DINKES) 0 0 0 0 0 0
60 OBH (DINKES) 0 0 0 0 0 5
61 AMBROXOL 0 0 0 0 0
62 BATUK FLU SIRUP (ETAFLUSIN) 0 0 0 0 0
63 BATUK FLU TABLET (ETAFLUSIN) 0 0 0 0 0
64 BETADINE GARGLE 0 0 0 0 0
65 BUFACOMB SALEP 0 0 0 0 0
66 BUFACORT - N 0 0 0 0 0
67 DARYANTULLE 0 0 0 0 0
68 ETIL KLORIDA SPRAY 0 0 0 0 0
69 GLIBENCLAMIDE TABLET 5 MG 0 0 0 0 0
70 GLIMEPIRIDE 2 MG TABLET 0 0 0 0 0
71 KAOLIN PEKTIN SIRUP (NOVADIAR) 0 0 0 0 0
72 PIRACETAM KAPSUL 0 0 0 0 0
73 TIAMFENIKOL KAPSUL 0 0 0 0 0
74 VITAMIN ANAK SIRUP (SAMCOVIT) 0 0 0 0 0
75 ANTIHEMOROID/BORRAGINOL (BLUD) 0 0 0 0 0
76 ASAM TRANEKSAMAT (BLUD) 0 0 0 0 0
77 ASETILSISTEIN (BLUD) 0 0 0 0 0
78 ASETOSAL TABLET 100 (80) MG (BLUD) 0 0 0 0 0
79 ASIKLOVIR SALEP KULIT (BLUD) 0 0 0 0 0
80 BEDAK SALISIL (BLUD) 0 0 0 0 0
81 BETAHISTIN TABLET (BLUD) 0 0 0 0 0
82 CTM (BLUD) 0 0 0 0 0
83 GLIMEPIRID 1 MG (BLUD) 0 0 0 0 0
84 GLUKOSA INFUS (BLUD) 0 0 0 0 0
85 ISDN (BLUD) 0 0 0 0 0
86 METILPREDNISOLON TABLET 4 MG (BLUD) 0 0 0 0 0
87 METRONIDAZOL (BLUD) 0 0 0 0 0
88 OKSITETRASIKLIN SALEP KULIT (BLUD) 0 0 0 0 0
89 POVIDONE IODINE 60ML (BLUD) 0 0 0 0 0
90 RANITIDIN TABLET (BLUD) 0 0 0 0 0
91 SETERIZIN TABLET (BLUD) 0 0 0 0 0
92 VITAMIN B KOMPLEKS (BLUD) 0 0 0 0 0
93 VITAMIN B1 (BLUD) 0 0 0 0 0
VITAMIN
94 0 0 0 0 0
B1 (BLUD)
95 0 0 0 0 0 0
96 0 0 0 0 0
97 0 0 0 0 0
98 0 0 0 0 0
99 0 0 0 0 0
100 0 0 0 0 0
kartu stok
JUNI JULI AGUST SEPT OKT NOV DES TOTAL JAN FEB MAR APR MEI

16 JAN 22
22 FEB23/03/2022
22 20/04/22 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
60 0 0 0 0 0 0 60 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 60 0 60 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 100 100 0 500 200 0 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
200 200 400 0 0 0 0 1,500 0 300 200 100 100
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 200 700 0 200 200 0 2,200 300 300 300 0 0
0 0 15 10 10 10 0 50 0 5 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 5 0 5 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 5 0 0 0 0 10 0 0 0 5 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 1 0 0 0 1 0
0 0 0 0 0 0 0 1 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 5 10 0 0 0 0 15 0 0 0 0 0
0 0 100 0 0 0 0 100 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 2 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 50 0 0 50 0 0
0 0 0 0 3 3 0 9 0 0 0 0 3
100 0 0 0 0 0 0 100 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
5 10 0 0 5 5 0 30 0 0 0 0 5
0 0 0 0 5 5 0 10 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 500 200 300 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 300 200 100 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 10 5 5 5 0 35 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 5 5 0 0 0 10 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 5 10 10 0 38 3 5 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 1 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 300 900 600 500 500 0 4,400 300 200 400 400 300
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 5 0 0 0 0 5
0 0 0 0 0 0 0 5 3 0 0 0 2
0 0 0 0 0 0 0 1 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 10 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 400 200 200 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 3 0 0 0 3 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 100 0 0 0 100 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 100 0 0 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 5 0 0 0 15 0 5 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 100 0 0 0 0 0 400 0 100 200 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 3 0 1 0 0 2
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
20 0 0 5 0 0 0 43 3 5 0 5 5
300 0 600 600 500 500 0 2,500 0 0 0 0 0
0 0 0 3 0 0 0 3 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 3 3 0 11 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 100 0 0 0 100 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 100 0 100 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 5 0 5 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 200 0 0 0 0 0 800 200 200 0 100 100
0 0 0 0 0 0 0 200 0 100 100 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 2 0 0 0 0 2
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
100 0 150 0 0 0 0 600 0 100 100 100 50
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 200 0 0 200 0 0
0 0 0 0 0 0 0 1 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 600 0 0 0 2,700 500 500 400 200 500
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 550 0 100 200 200 50
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 100 0 0 0 100 0 0 0 0 0
0 0 0 0 0 0 0 100 0 0 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 100 0 0 0 0 100
0 0 0 0 0 0 0 750 0 150 600 0 0
0 1 1 1 0 0 0 6 0 1 1 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 100 0 0 100 100 0 600 0 0 200 0 100
0 0 0 0 0 0 0 50 0 0 0 0 50
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 2 0 0 0 0 2
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 300 200 300 200 200 0 2,000 200 300 0 100 200
0 0 0 0 0 0 0 150 100 0 0 0 50
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 100 0 0 0 0 100
0 0 5 10 0 0 0 15 0 0 0 0 0
5 5 0 3 0 0 0 23 5 5 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 200 300 300 200 200 0 1,800 300 300 0 0 0
0 0 0 0 0 0 0 15 0 5 0 10 0
0 0 0 0 0 0 0 100 0 0 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 600 300 300 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 10 5 0 0 0 5
100 0 0 0 0 0 0 100 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 200 100 100 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 100 0 0 0 0 0 200 0 0 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 2,400 600 600 500 200 500
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 400 0 0 200 200 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 1 0 0 0 0 0 1 0 0 0 0 0
0 0 500 0 300 300 0 1,900 0 500 300 0 0
0 0 150 0 0 0 0 480 60 90 90 90 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 20 5 3 3 0 36 0 0 0 0 5
0 0 100 300 200 200 0 800 0 0 0 0 0
0 0 10 5 5 5 0 25 0 0 0 0 0
0 0 0 0 200 200 0 400 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 2 3 0 0 0 5 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 5 0 0 0 0 5 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 10 5 5 5 0 25 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 3 3 0 6 0 0 0 0 0
0 0 0 0 5 5 0 10 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 288 288 0 576 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 200 200 0 400 0 0 0 0 0
0 0 0 0 300 300 0 600 0 0 0 0 0
0 0 0 0 300 300 0 600 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
PAKAI
JUNI JULI AGUST SEPT OKT NOV DES TOTAL B/S JAN FEB MAR

10 JUNI 22
8 JULI
5+26
22 AGUST 09/09/2022
22222 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
60 0 0 0 0 0 0 60 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 10 4 10
0 0 0 0 0 0 0 60 1 23 2 1
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 300 0 180 136 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
200 200 400 0 0 0 0 1,500 1 179 175 240
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 200 700 0 0 0 0 1,800 0 166 186 167
0 0 15 10 0 0 0 30 0 0 0 1
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 5 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 5 0 0 0 0 10 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 6 0 7
0 0 0 0 0 0 0 0 1 0 0 0
0 5 10 0 0 0 0 15 1 0 0 0
0 0 100 0 0 0 0 100 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
2 0 0 0 0 0 0 2 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 50 1 28 16 0
0 0 0 0 0 0 0 3 0 3 0 0
100 0 0 0 0 0 0 100 1 15 5 33
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
5 10 0 0 0 0 0 20 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 500 1 25 70 145
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 300 1 30 20 60
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 10 10 5 0 0 0 25 0 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 5 5 0 0 0 10 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 5 0 5 0 0 0 18 0 0 3 2
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 300 900 600 0 0 0 3,400 0 239 275 240
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 5 1 0 0 0
0 0 0 0 0 0 0 5 1 0 1 0
0 0 0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 10 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 2 0 1
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 400 1 190 184 144
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 3 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 100 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 100 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 5 0 5 0 0 0 15 1 1 1 1
0 0 0 0 0 0 0 0 1 0 0 0
0 100 0 0 0 0 0 400 1 10 24 28
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 3 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 10 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 1 2 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
20 0 0 5 0 0 0 43 1 2 0 4
300 0 600 600 0 0 0 1,500 0 0 0 0
0 0 0 3 0 0 0 3 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 5 0 0 0 0 0 5 0 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 100 0 0 0 100 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 100 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 5 1 0 2 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 200 0 0 0 0 0 800 1 117 168 58
0 0 0 0 0 0 0 200 1 0 0 64
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 2 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
100 0 150 0 0 0 0 600 1 16 24 66
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 200 1 6 116 62
0 0 0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 600 0 0 0 2,700 1 350 420 520
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 550 1 158 28 116
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 100 0 0 0 100 1 0 0 0
0 0 0 0 0 0 0 100 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 100 1 0 0 0
0 0 0 0 0 0 0 750 1 0 0 210
0 1 1 1 0 0 0 6 1 1 0 1
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 100 0 0 0 0 0 400 0 32 26 22
0 0 0 0 0 0 0 50 1 0 0 0
0 0 0 0 0 0 0 0 1 4 0 0
0 0 0 0 0 0 0 2 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 300 200 300 0 0 0 1,600 0 12 90 138
0 0 0 0 0 0 0 150 1 0 10 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 100 1 0 0 0
0 0 5 10 0 0 0 15 1 1 0 0
5 5 0 3 0 0 0 23 1 2 1 2
0 0 0 0 0 0 0 0 1 0 0 0
0 200 300 300 0 0 0 1,400 0 192 239 168
0 0 0 0 0 0 0 15 1 0 3 7
0 0 0 0 0 0 0 100 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 600 1 22 50 26
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 10 1 3 0 0
100 0 0 0 0 0 0 100 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 200 1 20 42 58
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 20 6 28
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 100 0 0 0 0 0 200 1 4 10 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 2,400 1 474 498 413
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 400 1 44 106 88
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 8 0 6
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 1 0 0 0 0 0 1 1 0 0 0
0 0 500 0 0 0 0 1,300 0 184 127 211
0 0 150 0 0 0 0 480 1 6 92 76
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 20 5 0 0 0 30 0 0 0 0
0 0 100 300 0 0 0 400 0 0 0 0
0 0 10 5 0 0 0 15 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 2 3 0 0 0 5 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 5 0 0 0 0 5 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 10 5 0 0 0 15 0 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 1
SISA
APR MEI JUNI JULI AGUST SEPT OKT NOV DES TOTAL JAN FEB MAR

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 6 14 4 10 8 0 0 42 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
7 8 38 10 7 10 10 0 0 114 117 113 103
0 0 0 7 5 5 5 0 0 48 20 78 77
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 60 40 0 0 0 6 0 0 422 136 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
209 124 176 68 251 243 160 0 0 1,825 165 290 250
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
149 90 262 85 111 166 114 0 0 1,496 344 458 591
0 1 0 3 7 7 7 0 0 26 0 5 4
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 1 0 0 2 0 0 0 3 0 5 5
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 3 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 2 1 1 0 1 0 0 7 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 2 0 0 0 0 0 0 0 15 9 9 2
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 2 3 2 0 0 8 0 0 0
0 0 0 0 34 48 18 0 0 100 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 1 0 0
0 0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
10 0 0 0 0 0 66 0 0 120 42 26 76
1 0 1 1 0 0 0 0 0 6 1 1 1
1 0 5 3 4 18 12 0 0 96 102 97 64
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 3 7 1 2 4 2 0 0 19 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
90 0 0 0 0 0 0 0 0 330 205 435 290
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
46 64 26 0 170 0 0 0 0 416 294 374 314
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 13 2 0 0 0 16 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 2 3 5 0 0 10 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 3 4 3 0 0 16 3 5 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 1 0 0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
195 208 365 450 636 724 340 0 0 3,672 253 178 338
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 2 0 1 0 0 0 0 3 0 0 0
2 0 0 0 0 0 0 0 0 3 4 3 3
0 0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 1 0 0 0 0 0 0 0 4 2 2 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 518 128 144 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
16 10 42 38 0 20 14 0 0 140 50 50 50
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 5 20 10 30 0 0 0 65 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
1 2 1 2 2 7 0 0 0 18 3 7 6
0 0 0 0 0 0 0 0 0 0 0 0 0
10 6 44 36 64 60 100 0 0 382 82 158 330
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 1 1 0 0 0 0 0 2 0 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 3 6 0 4 0 0 0 0 23 40 40 40
3 0 0 0 0 0 0 0 0 3 11 11 11
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 3 2 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
3 9 4 5 11 0 3 0 0 41 1 6 2
0 0 0 0 410 570 440 0 0 1,420 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0
ED
APR MEI JUNI JULI AGUST SEPT OKT NOV DES RUMUS B/S JAN

0 0 0 0 0 0 0 0 0 0 1 0
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0 0 0 0 0 0 0 0 0 0 1 0
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4,172 0
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0 1
16 1
0 1
0 1
0 1
0 1
0 1
34 1
0 1
5 1
0 1
0 1
829 1
200 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
640 1
0 1
288 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
3,414 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
708 1
0 1
1 0
10 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
100 1
666 1
6 1
0 1
0 1
0 1
499 0
25 1
4 1
1 1
0 1
0 1
0 1
1,750 0
150 1
0 1
0 1
0 1
0 1
0 1
84 1
5 1
24 1
0 1
1,547 0
20 1
20 1
0 1
0 1
0 1
168 1
0 1
6 1
12 1
0 1
0 1
0 1
275 1
0 1
0 1
78 1
0 1
0 1
120 1
0 1
3,010 1
0 1
478 1
0 1
35 1
0 1
0 1
0 1
1 1
2,020 0
440 1
0 1
0 1
36 0

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