Pengeluaran Gudang Bulan Maret

NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
A OBAT GENERIK
A1 Acetosal 80 mg tab Tablet 0
A2 ACT tab Tablet 0
A3 Albendasol Tablet 0
A4 Allopurinol 100 mg tab Tablet 0
A5 Aminofilin inj. Ampul 0
A6 Aminofilin tab 200 mg Tablet 0
A7 Amitriptilin tab 25 mg Tablet 0
A8 Amlodipin 5mg Tablet 0
A9 Amoksisilin injeksi Vial 0
A10 Amoksisilin kab 500 mg Tablet 0
A11 Amoksisilin Sirup 125 mg Botol 0
A12 Ampisilin injeksi 1 gram Vial 0
A13 Antalgin injeksi Ampul 0
A14 Antalgin tab 500 mg Tablet 0
A15 Antasida Doen tab Tablet 200
A16 Antasida sirup Botol 0
A17 Anti Bacteri Doen salep kulit Tube 0
A18 Anti Hemoroid suppo Suppo 0
A19 Antifungi Kombinasi salep kulit Pot 0
A20 Artemeter inj 80 mg Ktk 6 amp 0
A21 Artesunate Inj ktk 8 amp 0
ARV FDC Dewasa : Tenofovir 300mg +
A22 Tablet 0
Lamivudine 300mg + Efavirenz 600mg
A23 Asam Askorbat tab 50 mg tab Tablet 0
A24 Asam Mefenamat kap 500 mg Kaplet 0
A25 Asam Amino Infus 500 cc Bag 500 cc 0
A26 Asetilsistein 200 mg Tablet 0
A27 Asiklovir salep kulit Tube 0
A28 Asiklovir tab 200 mg Tablet 0
A30 Atropin Sulfas inj Ampul 0
A31 Attapulgit ( Anti Diare Tablet ) Tablet 0
A32 Benzatin Benzyl Penisilin Inj 2,4jt UI Flacon 0
A33 Besi II Sulfat Tablet + asam folat Tablet 0
NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
A34 Betahistin mesilat tab Tablet 0
A35 Betamethason salep kulit Tube 0
A36 Bisakodil tab Tablet 0
A37 Cefixime Azithromycin 1000 mg Paket 0
A38 Clindamycin 150 mg Dus 0
A39 Deksametason inj Ampul 0
A40 Deksametason tab 0,5 mg Tablet 600
A41 Diazepam inj. 5mg/2ml Ampul 0
A42 Diazepam rectal Tube 0
A43 Diazepam tab 2 mg Tablet 0
A44 Difenhydramin HCl inj Ampul 0
A45 Digoxin tab 0,25 mg Tablet 0
Dihydro Artemisin 40mg + Piperaquin
A46 Tablet 0
320mg ( DHP ) MERSI
A47 Dimenhydrinat tab Tablet 0
A48 Doksisiklin 100 Tablet 0
A49 Domperidon suspensi Botol 0
A50 Domperidon tab 10 mg Tablet 0
A51 Efavirenz 200 mg Tablet 0
A53 Efinefrin ( Adrenalin inj ) Ampul 0
A54 Erytromicin kap 500 mg Kapsul 0
A55 Erytromicin sirup Botol 0
A56 Etakridin Lakt. ( Rivanol ) Botol 0
A57 Fenitoin Na. kap 100 mg Kapsul 0
A58 Fenobarbital inj 50mg/ml Ampul 0
A59 Fenobarbital tab30 mg Tablet 0
A60 Fenol Gliserol Botol 0
A61 Fitomenadion inj Ampul 0
A62 Fitomenadion tab 10 mg Tablet 0
Dus @ 10
A63 Fluoconazol 150 mg 0
Kap
A64 Furosemide tab 40 mg Tablet 0
A65 Furosemide injeksi Ampul 0
A66 Garam Oralit 200ml Sak 0
A67 Gentamicin tetes mata 0,3 % Botol 0
A68 Gentamicin injeksi Ampul 0
A69 Gentamisin salep kulit Tube 0
A70 Gentian Violet Botol 0
A71 Glibenklamide tab 5 mg Tablet 0
A72 Glimepiride 1 mg Tablet 0
NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
A73 Gliseril guaiakolat tab Tablet 400
A74 Glukonas kalsikus Ampul 0
A75 Glukose 5 % larutan infus Flabot 0
A76 Griseofulvin tab 125 mg Tablet 0
A77 Haloperidol tab 0,5 mg Tablet 0
A79 Hidrokhlorotiazide (HCT) tab 25 mg Tablet 0
A80 Hidrokortison salep kulit Tube 0
A81 Hiosine-N- butilbromide tablet 10 mg Tablet 0
A82 Ibuprofen tab 200 mg Tablet 0
A84 Isoniazide tab ( INH ) Tablet 0
A85 Isosorbid Dinitrat Tablet 0
A86 Kalium Diklofenak 25 mg Tablet 0
A88 Kalsium Laktat tab 500 mg Tablet 0
A89 Kaptopril tab 25 mg Tablet 0
A90 Karbamazepin tab 200 mg Tablet 0
A91 Ketokonazole 200 mg Tablet 0
A92 Ketokonazole krim tube 0
A93 Ketoprofen inj Ampul 0
A94 Kinina Dihydroklorid inj Ampul 0
A95 Kinina HCl. Tab Tablet 0
A96 Klobazam tab Tablet 0
A97 Klonidin tab Tablet 0
A98 Klorafeniramin ( CTM ) tab Tablet 1,000
A99 Kloramfenikol salep mata 1 % Tube 0
A100 Kloramfenikol sirup Botol 0
A101 Kloramfenikol tetes mata 0,5 % Tube 0
A102 Kloramfenikol tetes telinga Kapsul 0
A103 Kloramfenikol kap 250 mg Botol 0
A104 Klorokuin tab 150 mg Tablet 0
A105 Klorpromasin injeksi Ampul 0
A106 Klorpromasin tab 25 mg Tablet 0
A107 Kotrimoksazol suspensi Botol 0
A108 Kotrimoksazol tab 120 mg Tablet 0
A110 Lamivudine (3TC) 150 mg Tablet 0
A111 Lidokain comp injeksi Ampul 0
A112 Loperamid Tablet 0
NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
Lopinavir 200 mg, Ritonavir ( LPV/r ) 50
A113 Tablet 0
mg ( ALUVIA )
A114 Mebendazol tab100 mg Tablet 0
A115 Metformin 500 Tablet 0
A116 Methoklopramide injeksi Ampul 0
A117 Methoklopramide sirup Botol 0
A118 Methoklopramide tab10 mg Tablet 0
A119 Metilergomet injeksi 0,2 mg Ampul 0
A120 Metilergomet tab 0,125 mg Tablet 0
A121 Metilprednisolon 4 Tablet 0
A122 Metronidazol tab 500 mg Tablet 0
A123 MgSO4 20 % Vial 0
A125 Mineral mix Sak 0
A126 Myconazol salep kulit Tube 0
A127 Na tiroksin Tablet 0
A128 Na. Bic. Tab 500 mg Tablet 0
A129 Na. Cl. Infus Flabot 0
A130 Natrium Dikofenak 50 Tablet 0
A131 Nevirapine 200 mg Tablet 0
A132 Nifedipin Tablet 0
A133 O A T Anak Paket 0
A134 O A T - FDC anak Paket 0
A135 O A T - FDC kat 1 & 3 Paket 0
A136 O A T - FDC kat 2 Paket 0
A137 O A T - FDC sisipan Paket 0
A138 O A T Katagori - 1 Paket 0
A141 O A T Sisipan Paket 0
A142 Obat Batuk Hitam sirup Botol 0
A143 Oksitetrasiklin salep kulit 3 % Tube 0
A144 Oksitetrasiklin salep mata Tube 0
A145 Oksitetrasiklin 50mg/ml inj Flacon 0
A146 Oksitocin 10mg/ml inj Ampul 0
A147 Omeprazol kaps Kapsul 0
A148 Oseltamivir Kapsul Kapsul 0
A149 Paket Kusta MB Anak Blister 0
A150 Paket Kusta MB Dewasa Blister 0
A151 Paket Kusta PB Anak Blister 0
A152 Paket Kusta PB Dewasa Blister 0
NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
A153 Parasetamol Drops Botol 0
A154 Parasetamol sirup Botol 10
A155 Parasetamol tab 500 mg Tablet 1,200
A156 Piracetam 400 Kapsul 0
A157 Piridoksin tab 10 mg Tablet 0
A158 Piroksikam tab 10 mg Kapsul 0
A159 Povidon Iodium 10% 30 ml Botol 0
A161 Prednison tab 5 mg Tablet 0
A162 Primakuin tab 15 mg Tablet 0
A163 Proc. Pen. 3 juta inj Vial 0
A164 Prokain Benzil Penisilin Vial 0
A165 Propanolol tab 40 mg Tablet 0
A166 Propylthioracil ( PTU ) tab 100 mg Tablet 0
A167 Pyrantel tab 125 mg Tablet 0
A168 Ranitidine 150 mg Tablet 0
A169 Ranitidine inj ampul 0
A170 Retinol 100.000 iu Kab Btl @50 0
A172 Ringer Asetat Infus Flabot 0
A173 Ringer Laktat Infus Flabot 0
A174 Salbutamol Cairan ih 0,1% Nebule 0
A175 Salbutamol tab 2 mg Tablet 0
A176 Salep 2 - 4 kombinasi Pot 0
A177 Salysil bedak 2 % Botol 0
A178 Sefadroksil 500 cps Kapsul 0
A179 Sefotaxim 1g inj Vial 0
A180 Seftriaxon inj Vial 0
A181 Serum ABU 5 ml inj. Flacon 0
A182 Serum ATS 1.500 iu inj Ampul 0
A183 Setirizin 10 mg Tablet 0
A184 Setirizin Sirup Botol 0
A185 Sianokobalamin inj ( Vit. B12 ) inj Ampul 0
A186 Sianokobalamin tab ( Vit. B12 ) tab Tablet 300
A187 Simetidin tab Tablet 0
A188 Simvastatin 10 Tablet 0
A189 Siprofloxacin tab 500 mg Tablet 0
A190 Sulfacetamid tetes mata Botol 0
A191 Tenofovir (TDF) 300 mg Tablet 0
A192 Tenofovir 300 mg + Emtricitabine 200 mg Tablet 0
NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
A193 Tiamfenikol kap 500 mg Kapsul 0
A194 Tiamin HCl / B1 injeksi 100mg /ml Ampul 0
A195 Tiamin HCl / B1 tab 100 mg Tablet 0
A196 Tiamin HCl / B1 Tab 50 mg Tablet 200
A197 Triheksifenidil tab 2 mg Tablet 0
A198 Vitamin B Komplek tab Tablet 100
A199 Zidovudine Tablet 0
Zidovudine + Lamivudine ( 300 mg / 150
A200 Tablet 0
mg )
A201 Zink Tablet 0
0
B OBAT KOMBINASI 0
B1 Antasida + Simetikon Tablet 0
B2 Antasida + simetikon sirup Botol 0
B3 Anti Diare kombinasi sirup ( Anak ) Botol 0
B4 Anti Hemorhoid kapsul Kapsul 0
B5 Anti Hipertensi Herbal Kapsul 0
Anti radang topikal mengandung
B6 Tube 0
triamsinolon acetonide 1 mg
B7 Anti spasmodik inj / spasi inj Ampul 0
B8 Asam Askorbat tab 500 + Vitamin Tablet 0
B9 Betamethason + Antibiotik salep kulit Tube 0
B10 D 1/2NS Flabot 0
B11 Flunarizin 5 mg Tablet 0
B12 Kombinasi Lutein 6 mg, Ekstrak buah Kapsul
0
Bilberry 80 mg
B13 Methyl Cobalamin 500 Kapsul 0
B14 Minyak kayu putih Botol 0
B15 Minyak telon Botol 0
B16 Multivitamin sirup ( Anak ) Botol 0
B17 Multivitamin tab ( Dewasa ) Tablet 0
B18 Peluruh Batu Ginjal Botol 0
B19 Salep Luka Bakar Tube 0
B20 Sirup Flu dan Batuk Kombinasi Botol 0
B21 Tablet Tambah Darah + Vitamin Tablet 0
B22 Vitamin Neurotropik inj Ampul 0
0
C OBAT GIGI 0
C1 Air raksa dental use Botol 0
C2 Bahan bonding botol 0
C3 Bahan Etsa botol 0
C4 Devitalisasi Pasta Botol 0
C5 Etil Klorida semprot Botol 0
NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
C6 Eugenol sol Pot 0
C7 Flour tablet Tablet 0
C8 Glass Ionomer Cement ( Fuji IX ) Pot 0
C9 Glass Ionomer Cement ( Fuji VII ) Pot 0
C10 Kalsium hydroksi pasta dos 0
C11 Komposit Tube 0
C12 Lidokain Spray Botol 0
C13 Monokror Kamfer Menthol ( CHKM ) Pot 0
C14 Mumiying Pasta Biji 0
C15 Semen Seng Fosfat p+liq Botol 0
C16 Silver Amalgam Botol 0
C17 Spons Gelatin Cubices Dos 0
C18 Temp+Stopp Fletc p+liq Set 0
C19 Trikresol Formalin ( TKF ) Botol 0
C20 Yodium Gliserin Cc 0
0 0 0 0
D PERBEKES 0 0
D1 ADS 0,05 ml Biji 0
D3 ADS 5 ml Biji 0
D4 Alat suntik 1 ml Biji 0
D5 Alat suntik 2,5 ml / 3ml Biji 0
D6 Alat Suntik 5 ml Biji 0
D7 Anti Septik Handrub Box@10 0
D8 Antiseptik Botol 5 liter 0
D9 Aqua Pro injeksi Flacon 0
D10 Cat Gut Roll 0
D11 Cotton Aplikator Buah 0
D12 Etanol 70 % Botol 0
D13 Expert Check Kit Unit 0
D14 Hand Scoen Biji 0
D15 Hand Scoen Steril Pasang 0
D16 Infus Set anak Biji 0
D17 Infus Set dewasa Biji 0
D18 IV Cateter No. 18 Biji 0
D19 IV Cateter No. 20 ( Dewasa ) Biji 0
D21 IV Cateter No. 24 ( Anak ) Biji 0
D22 IV Dresing Biji 0
D23 Jarum Bengkok / Jahit Biji 0
NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
D24 Jarum Suntik Biji 0
D25 Kapas Adsorben 250 gr Roll 0
D26 Kasa panjang 40 yard x 80 cm Roll 0
D27 Kasa Pemb Hydro 4 m x 15 cm Roll 0
D28 Kasa Steril 16 x 16 ( 16 lmb ) Dos 0
D29 Kasa steril mengand:Framasetin 10% Biji 0
D30 Lisol Botol 0
D31 Masker Biji 0
D32 Masker N 95 Biji 0
D33 Masker N 95 + Aura Biji 0
D34 Masker Nebulizer Biji 0
D35 Mess Biji 0
D36 Plester 5 yardx2inch Roll 0
D37 Poly Cateter No. 14 Biji 0
D40 Pot dahak Biji 0
D41 Rotator Buah 0
D42 Safeglove PF Pasang 0
D43 Safety box Buah 0
D44 Selang oksigen anak Biji 0
D45 Selang Oksigen dws Biji 0
D46 Silk Biji 0
D47 Urine Bag Biji 0
0
E LABORATORIUM 0
E1 Box Slide Box 0
E2 HbsAg test Biji 0
E3 Iodium Test Botol 0
E4 KOH 10% Botol 0
E5 Larutan Asam Klorida 1 % Botol 0
E6 Lugol Botol 100 ml 0
E7 Methylen Blue 0.3% Botol 0
E8 NaCl 0.9% Botol 0
E9 Obyek glass set 0
E10 Oksigen m3 0
E11 pH Paper Cat 9555 Merck Roll 0
E12 Rapid Tes HIV Ke-1 Test 0
NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
E15 Rapid Tes Shipilis ( SD ) Test 0
E16 RDT Anti HCV ( Hepatitis C ) Test 0
E17 RDT DBD Combo ( NS1 + IgG/IgM ) Test 0
E18 RDT Leptospirosis Test 0
E19 RDT Malaria Test 0
E20 Reagen Zn Botol 0
E21 TCM Cartridge Xpert MTB/Rif Buah 0
E22 Urine Test Biji 0
E23 Xylol Botol 0
0 0 0
F VAKSIN 0 0
F1 BCG + Pelarut Ampul 0
F2 Campak + Pelarut Vial 0
F3 DPT-HB-Hib Vial 0
F4 DT Vial 0
Syringe @
F5 HBIG ( Hiperhep-B ) 0
0,5 ml
F6 HEP.B (PID) / HB 0 Buah 0
F7 MR Vial 0
F8 Polio bOPV + Dropper Vial 0
F9 Polio IPV Vial 0
F10 Td Vial 0
F11 TT Vial 0
F12 Vaksin Anti Rabies ( VAR ) Vial 0
0
G TAMBAHAN 0
G5 Masker N95 - BFE Tipe Cone Kecil ( 3M 1Biji 0
G9 Amoksisilin Sirup 250 mg Botol 0
G10 Metronidazol Infus 5mg Bottol 0
G14 Albendasol Suspensi 200mg/5ml Botol 0
G15 Kloramfenikol kap 500 mg Kapsul 0
G16 Azithromycin 500mg Tablet 0
G17 Coverall Suit / Hazmat Buah 0
G18 Face Sheild Buah 0
G19 Kacamata Goggle Buah 0
G20 Masker Kain Buah 0
G24 Stimuno Tablet 0
G25 Handsanitiser Botol 0
G26 Gawn Biji 0
G28 Tutup Kepala Biji 0
G29 Hand Sanitizer Galon Jerigen 0
NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
G32 Masker KN 95 Biji 0
G36 Kantong Jenazah Unit 0
G43 Apron Medis Biji 0
G44 Nurse Cup Biji 0
G46 Imunos Tablet 0
G56 Alkohol Swab Box 0
G57 Plesterin Bulat Non Woven Box 0
G61 Face Sheild Anak Buah 0
G62 Rapit Test Covid-19 Antigen Test 0
G63 Vitamin C 500mg Tablet 0
G72 Stimuno Syrup Botol 0
G73 Blood Transfusion Set Biji 0
G74 Sarung Tangan Obgyn Pasang 0
G78 Favipiravir tablet 200mg Tablet 0
G81 Diisinfektan Botol 0
G89 Vitamin D Tablet 1000 IU Tablet 0
G90 Piroksikam tab 20 mg Kapsul 0
G93 Simvastatin 20 Tablet 0
G128 Oste Kaplet 0
G129 Kotrimoksazol Forte Tablet 0
G162 Oxymeter Unit 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
0
0
0
0
0
0
0
0
0
0
0 0
0
0
0
0
0
0
0
0 2
0
0
0
Jumlah Kunjungan Resep Bayar
Rawat Jalan
Rawat Inap
UGD
Jumlah
Sragen, 31 Maret 2015
Mengetahui / menyetujui Yang Meminta Yang Menerima
Kepala Dinas Kesehatan Kepala UPTD Puskesmas Petugas Puskesmas
Kabupaten Sragen
dr. M. Farid Anshori, MM. dr. Endah Riswandari Siti Fatimah

NIP.19580826 198711 1 001 NIP.19751225 200701 2NIP.19700617
013 199203 2 007
NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
24 25 26 27 28 29 30 31 jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
200
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
24 25 26 27 28 29 30 31 jumlah
0
0
0
0
0
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
24 25 26 27 28 29 30 31 jumlah
400
0
0
0
0
0
0
0
0
0
100
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1,000
0
0
0
0
0
0
0
0
0
0
0
0
0
0
24 25 26 27 28 29 30 31 jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
24 25 26 27 28 29 30 31 jumlah
0
10
1,200
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
300
0
0
0
0
0
0
24 25 26 27 28 29 30 31 jumlah
0
0
0
200
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
24 25 26 27 28 29 30 31 jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
24 25 26 27 28 29 30 31 jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
24 25 26 27 28 29 30 31 jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
24 25 26 27 28 29 30 31 jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
24 25 26 27 28 29 30 31 jumlah
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A OBAT GENERIK
A2 ACT tab Tablet 0
A22 Tablet 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A46 Tablet 0
320mg ( DHP ) MERSI
Dus @ 10
Kap
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A98 Klorafeniramin ( CTM ) tab Tablet 100
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A113 Tablet 0
mg ( ALUVIA )
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A155 Parasetamol tab 500 mg Tablet 100
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A200 Tablet 0
mg )
A201 Zink Tablet 0
0
B OBAT KOMBINASI 0
B6 Tube 0
0
Bilberry 80 mg
0
C OBAT GIGI 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
C11 Komposit Tube 0
0 0 0 0
D PERBEKES 0 0
D3 ADS 5 ml Biji 0
D10 Cat Gut Roll 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
D30 Lisol Botol 0
D31 Masker Biji 20
D35 Mess Biji 0
D41 Rotator Buah 0
D46 Silk Biji 0
0
E LABORATORIUM 0
E1 Box Slide Box 0
E4 KOH 10% Botol 0
E10 Oksigen m3 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
E23 Xylol Botol 0
0 0 0
F VAKSIN 0 0
F4 DT Vial 0
Syringe @
0,5 ml
F7 MR Vial 0
F9 Polio IPV Vial 0
F10 Td Vial 0
F11 TT Vial 0
0
G TAMBAHAN 0
G26 Gawn Biji 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
G46 Imunos Tablet 0
G128 Oste Kaplet 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
BPJS
Jumlah Kunjungan Resep Bayar Gratis Saraswati
Jumlah
Askes & JPS
Rawat Jalan
Rawat Inap
UGD
Jumlah
Mengetahui / menyetujui Yang Menyerahkan Yang Meminta Yang Menerima
Kepala Dinas Kesehatan Kepala UPTD Instalasi Farmasi
Kepala UPTD Puskesmas Petugas Puskesmas
Kabupaten Sragen Kabupaten Sragen
dr. M. Farid Anshori, MM. Dra.Endang Purwanti,M.Kes,Apt

dr. Endah Riswandari Siti Fatimah
NIP.19580826 198711 1 001 NIP.19590828 199203 2 002
NIP.19751225 200701 2 013
NIP.19700617 199203 2 007
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 jumlah
0
0
0
0
0
0
0
0
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
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
50
0
0
0
0
0
0
0
0
0
100
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 jumlah
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
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 jumlah
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
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 jumlah
0
0
0
0
0
0
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
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 jumlah
0
0
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
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 jumlah
2
NO SATUAN Stok Awal 1 2 3 4 5 6 7 8 9 10 11
A OBAT GENERIK
A2 ACT tab Tablet 0
A15 Antasida Doen tab Tablet 0 500
A22 Tablet 0
A23 Asam Askorbat tab 50 mg tab Tablet 0 0
A31 Attapulgit ( Anti Diare Tablet ) Tablet 4 20
A40 Deksametason tab 0,5 mg Tablet 0 500
A46 Tablet 0
320mg ( DHP ) MERSI
Dus @ 10
Kap
A67 Gentamicin tetes mata 0,3 % Botol 0 0
A73 Gliseril guaiakolat tab Tablet 0 500
A80 Hidrokortison salep kulit Tube 0 0
A83 Ibuprofen tab 400 mg Tablet 0 0
A98 Klorafeniramin ( CTM ) tab Tablet 0 800
A113 Tablet 0
mg ( ALUVIA )
A155 Parasetamol tab 500 mg Tablet 0 800
A161 Prednison tab 5 mg Tablet 0 300
A200 Tablet 0
mg )
A201 Zink Tablet 0
0
B OBAT KOMBINASI 0
B3 Anti Diare kombinasi sirup ( Anak ) Botol 5 0
B6 Tube 0
0
Bilberry 80 mg
0
C OBAT GIGI 0
C11 Komposit Tube 0
0 0 0 0
D PERBEKES 0 0
D3 ADS 5 ml Biji 0
D5 Alat suntik 2,5 ml / 3ml Biji 20 0
D10 Cat Gut Roll 0
D30 Lisol Botol 0
D31 Masker Biji 0
D35 Mess Biji 0
D41 Rotator Buah 0
D46 Silk Biji 0
0
E LABORATORIUM 0
E1 Box Slide Box 0
E4 KOH 10% Botol 0
E10 Oksigen m3 0
E23 Xylol Botol 0
0 0 0
F VAKSIN 0 0
F4 DT Vial 0
Syringe @
0,5 ml
F7 MR Vial 0
F9 Polio IPV Vial 0
F10 Td Vial 0
F11 TT Vial 0
0
G TAMBAHAN 0
G26 Gawn Biji 0
G46 Imunos Tablet 0
G56 Alkohol Swab Box 1 0
G128 Oste Kaplet 0
BPJS
Jumlah
Askes & JPS
Rawat Jalan
Rawat Inap
UGD
Jumlah
Srag
Mengetahui / menyetujui Yang Menyerahkan Yang Meminta
Kepala UPTD Puskesmas
dr. M. Farid Anshori, MM. Dra.Endang Purwanti,M.Kes,Apt dr. Endah Riswandari

NIP.19580826 198711 1 001 NIP.19590828 199203 2 002
NIP.19751225 200701 2NIP.197
013
12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
500
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
20
0
0
12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 jumlah
0
0
0
0
0
0
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
12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 jumlah
500
0
0
0
0
0
0
0
0
100
0
0
0
0
0
100
0
0
0
0
0
0
0
0
0
800
0
0
0
1
0
0
0
0
0
0
0
0
0
0
12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 jumlah
0
0
800
0
0
0
0
0
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
200
0
0
0
0
0
0
12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 jumlah
0
0
0
300
0
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
12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 jumlah

Yang Menerima
Siti Fatimah
NIP.19751225 200701 2NIP.19700617
013 199203 2 007
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A OBAT GENERIK
A2 ACT tab Tablet 0
A22 Tablet 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A46 Tablet 0
320mg ( DHP ) MERSI
Dus @ 10
Kap
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A113 Tablet 0
mg ( ALUVIA )
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A200 Tablet 0
mg )
A201 Zink Tablet 0
0
B OBAT KOMBINASI 0
B6 Tube 0
0
Bilberry 80 mg
0
C OBAT GIGI 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
C11 Komposit Tube 0
0 0 0 0
D PERBEKES 0 0
D3 ADS 5 ml Biji 0
D10 Cat Gut Roll 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
D30 Lisol Botol 0
D31 Masker Biji 0
D35 Mess Biji 0
D41 Rotator Buah 0
D46 Silk Biji 0
0
E LABORATORIUM 0
E1 Box Slide Box 0
E4 KOH 10% Botol 0
E10 Oksigen m3 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
E23 Xylol Botol 0
0 0 0
F VAKSIN 0 0
F4 DT Vial 0
Syringe @
0,5 ml
F7 MR Vial 0
F9 Polio IPV Vial 0
F10 Td Vial 0
F11 TT Vial 0
0
G TAMBAHAN 0
G26 Gawn Biji 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
G46 Imunos Tablet 0
G128 Oste Kaplet 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
BPJS
Jumlah
Askes & JPS
Rawat Jalan
Rawat Inap
UGD
Jumlah
dr. M. Farid Anshori, MM. Dra.Endang Purwanti,M.Kes,Aptdr. Endah Riswandari Siti Fatimah
NIP.19580826 198711 1 001 NIP.19590828 199203 2 002
NIP.19751225 200701 2 013
NIP.19700617 199203 2 007
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
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
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
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
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
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
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
2
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A OBAT GENERIK
A2 ACT tab Tablet 0
A22 Tablet 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A46 Tablet 0
320mg ( DHP ) MERSI
Dus @ 10
Kap
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A113 Tablet 0
mg ( ALUVIA )
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A200 Tablet 0
mg )
A201 Zink Tablet 0
0
B OBAT KOMBINASI 0
B6 Tube 0
0
Bilberry 80 mg
0
C OBAT GIGI 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
C11 Komposit Tube 0
0 0 0 0
D PERBEKES 0 0
D3 ADS 5 ml Biji 0
D10 Cat Gut Roll 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
D30 Lisol Botol 0
D31 Masker Biji 20
D35 Mess Biji 0
D41 Rotator Buah 0
D46 Silk Biji 0
0
E LABORATORIUM 0
E1 Box Slide Box 0
E4 KOH 10% Botol 0
E10 Oksigen m3 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
E23 Xylol Botol 0
0 0 0
F VAKSIN 0 0
F4 DT Vial 0
Syringe @
0,5 ml
F7 MR Vial 0
F9 Polio IPV Vial 0
F10 Td Vial 0
F11 TT Vial 0
0
G TAMBAHAN 0
G26 Gawn Biji 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
G46 Imunos Tablet 0
G128 Oste Kaplet 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
BPJS
Jumlah
Askes & JPS
Rawat Jalan
Rawat Inap
UGD
Jumlah

NIP.19580826 198711 1 001 NIP.19590828 199203 2NIP.19751225
002 200701 2NIP.19700617
013 199203 2 007
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
50
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
100
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
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
2
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
50
0
0
0
0
0
0
0
0
0
0
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
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
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
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
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
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
5
0
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
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
2
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
A OBAT GENERIK
A1 Acetosal 80 mg tab Tablet
A2 ACT tab Tablet
A3 Albendasol Tablet
A4 Allopurinol 100 mg tab Tablet
A5 Aminofilin inj. Ampul
A6 Aminofilin tab 200 mg Tablet
A7 Amitriptilin tab 25 mg Tablet
A8 Amlodipin 5mg Tablet
A9 Amoksisilin injeksi Vial
A10 Amoksisilin kab 500 mg Tablet
A11 Amoksisilin Sirup 125 mg Botol
A12 Ampisilin injeksi 1 gram Vial
A13 Antalgin injeksi Ampul
A14 Antalgin tab 500 mg Tablet
A15 Antasida Doen tab Tablet
A16 Antasida sirup Botol
A17 Anti Bacteri Doen salep kulit Tube
A18 Anti Hemoroid suppo Suppo
A19 Antifungi Kombinasi salep kulit Pot
A20 Artemeter inj 80 mg Ktk 6 amp
A21 Artesunate Inj ktk 8 amp
A22 Tablet
A23 Asam Askorbat tab 50 mg tab Tablet
A24 Asam Mefenamat kap 500 mg Kaplet
A25 Asam Amino Infus 500 cc Bag 500 cc
A26 Asetilsistein 200 mg Tablet
A27 Asiklovir salep kulit Tube
A28 Asiklovir tab 200 mg Tablet
A29 Asiklovir tab 400 mg Tablet
A30 Atropin Sulfas inj Ampul
A31 Attapulgit ( Anti Diare Tablet ) Tablet
A32 Benzatin Benzyl Penisilin Inj 2,4jt UI Flacon
A33 Besi II Sulfat Tablet + asam folat Tablet
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
A34 Betahistin mesilat tab Tablet
A35 Betamethason salep kulit Tube
A36 Bisakodil tab Tablet
A37 Cefixime Azithromycin 1000 mg Paket
A38 Clindamycin 150 mg Dus
A39 Deksametason inj Ampul
A40 Deksametason tab 0,5 mg Tablet
A41 Diazepam inj. 5mg/2ml Ampul
A42 Diazepam rectal Tube
A43 Diazepam tab 2 mg Tablet
A44 Difenhydramin HCl inj Ampul
A45 Digoxin tab 0,25 mg Tablet
A46 Tablet
320mg ( DHP ) MERSI
A47 Dimenhydrinat tab Tablet
A48 Doksisiklin 100 Tablet
A49 Domperidon suspensi Botol
A50 Domperidon tab 10 mg Tablet
A51 Efavirenz 200 mg Tablet
A52 Efavirenz 600 mg Tablet
A53 Efinefrin ( Adrenalin inj ) Ampul
A54 Erytromicin kap 500 mg Kapsul
A55 Erytromicin sirup Botol
A56 Etakridin Lakt. ( Rivanol ) Botol
A57 Fenitoin Na. kap 100 mg Kapsul
A58 Fenobarbital inj 50mg/ml Ampul
A59 Fenobarbital tab30 mg Tablet
A60 Fenol Gliserol Botol
A61 Fitomenadion inj Ampul
A62 Fitomenadion tab 10 mg Tablet
Dus @ 10
A63 Fluoconazol 150 mg
Kap
A64 Furosemide tab 40 mg Tablet
A65 Furosemide injeksi Ampul
A66 Garam Oralit 200ml Sak
A67 Gentamicin tetes mata 0,3 % Botol
A68 Gentamicin injeksi Ampul
A69 Gentamisin salep kulit Tube
A70 Gentian Violet Botol
A71 Glibenklamide tab 5 mg Tablet
A72 Glimepiride 1 mg Tablet
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
A73 Gliseril guaiakolat tab Tablet
A74 Glukonas kalsikus Ampul
A75 Glukose 5 % larutan infus Flabot
A76 Griseofulvin tab 125 mg Tablet
A77 Haloperidol tab 0,5 mg Tablet
A78 Haloperidol tab 1,5 mg Tablet
A79 Hidrokhlorotiazide (HCT) tab 25 mg Tablet
A80 Hidrokortison salep kulit Tube
A81 Hiosine-N- butilbromide tablet 10 mg Tablet
A82 Ibuprofen tab 200 mg Tablet
A83 Ibuprofen tab 400 mg Tablet
A84 Isoniazide tab ( INH ) Tablet
A85 Isosorbid Dinitrat Tablet
A86 Kalium Diklofenak 25 mg Tablet
A87 Kalium Diklofenak 50 mg Tablet
A88 Kalsium Laktat tab 500 mg Tablet
A89 Kaptopril tab 25 mg Tablet
A90 Karbamazepin tab 200 mg Tablet
A91 Ketokonazole 200 mg Tablet
A92 Ketokonazole krim tube
A93 Ketoprofen inj Ampul
A94 Kinina Dihydroklorid inj Ampul
A95 Kinina HCl. Tab Tablet
A96 Klobazam tab Tablet
A97 Klonidin tab Tablet
A98 Klorafeniramin ( CTM ) tab Tablet
A99 Kloramfenikol salep mata 1 % Tube
A100 Kloramfenikol sirup Botol
A101 Kloramfenikol tetes mata 0,5 % Tube
A102 Kloramfenikol tetes telinga Kapsul
A103 Kloramfenikol kap 250 mg Botol
A104 Klorokuin tab 150 mg Tablet
A105 Klorpromasin injeksi Ampul
A106 Klorpromasin tab 25 mg Tablet
A107 Kotrimoksazol suspensi Botol
A108 Kotrimoksazol tab 120 mg Tablet
A109 Kotrimoksazol tab 480 mg Tablet
A110 Lamivudine (3TC) 150 mg Tablet
A111 Lidokain comp injeksi Ampul
A112 Loperamid Tablet
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
A113 Tablet
mg ( ALUVIA )
A114 Mebendazol tab100 mg Tablet
A115 Metformin 500 Tablet
A116 Methoklopramide injeksi Ampul
A117 Methoklopramide sirup Botol
A118 Methoklopramide tab10 mg Tablet
A119 Metilergomet injeksi 0,2 mg Ampul
A120 Metilergomet tab 0,125 mg Tablet
A121 Metilprednisolon 4 Tablet
A122 Metronidazol tab 500 mg Tablet
A123 MgSO4 20 % Vial
A124 MgSO4 40 % Vial
A125 Mineral mix Sak
A126 Myconazol salep kulit Tube
A127 Na tiroksin Tablet
A128 Na. Bic. Tab 500 mg Tablet
A129 Na. Cl. Infus Flabot
A130 Natrium Dikofenak 50 Tablet
A131 Nevirapine 200 mg Tablet
A132 Nifedipin Tablet
A133 O A T Anak Paket
A134 O A T - FDC anak Paket
A135 O A T - FDC kat 1 & 3 Paket
A136 O A T - FDC kat 2 Paket
A137 O A T - FDC sisipan Paket
A138 O A T Katagori - 1 Paket
A141 O A T Sisipan Paket
A142 Obat Batuk Hitam sirup Botol
A143 Oksitetrasiklin salep kulit 3 % Tube
A144 Oksitetrasiklin salep mata Tube
A145 Oksitetrasiklin 50mg/ml inj Flacon
A146 Oksitocin 10mg/ml inj Ampul
A147 Omeprazol kaps Kapsul
A148 Oseltamivir Kapsul Kapsul
A149 Paket Kusta MB Anak Blister
A150 Paket Kusta MB Dewasa Blister
A151 Paket Kusta PB Anak Blister
A152 Paket Kusta PB Dewasa Blister
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
A153 Parasetamol Drops Botol
A154 Parasetamol sirup Botol
A155 Parasetamol tab 500 mg Tablet
A156 Piracetam 400 Kapsul
A157 Piridoksin tab 10 mg Tablet
A158 Piroksikam tab 10 mg Kapsul
A159 Povidon Iodium 10% 30 ml Botol
A160 Povidon Iodium 10% 300 ml Botol
A161 Prednison tab 5 mg Tablet
A162 Primakuin tab 15 mg Tablet
A163 Proc. Pen. 3 juta inj Vial
A164 Prokain Benzil Penisilin Vial
A165 Propanolol tab 40 mg Tablet
A166 Propylthioracil ( PTU ) tab 100 mg Tablet
A167 Pyrantel tab 125 mg Tablet
A168 Ranitidine 150 mg Tablet
A169 Ranitidine inj ampul
A170 Retinol 100.000 iu Kab Btl @50
A171 Retinol 200.000 iu Kab Btl @50
A172 Ringer Asetat Infus Flabot
A173 Ringer Laktat Infus Flabot
A174 Salbutamol Cairan ih 0,1% Nebule
A175 Salbutamol tab 2 mg Tablet
A176 Salep 2 - 4 kombinasi Pot
A177 Salysil bedak 2 % Botol
A178 Sefadroksil 500 cps Kapsul
A179 Sefotaxim 1g inj Vial
A180 Seftriaxon inj Vial
A181 Serum ABU 5 ml inj. Flacon
A182 Serum ATS 1.500 iu inj Ampul
A183 Setirizin 10 mg Tablet
A184 Setirizin Sirup Botol
A185 Sianokobalamin inj ( Vit. B12 ) inj Ampul
A186 Sianokobalamin tab ( Vit. B12 ) tab Tablet
A187 Simetidin tab Tablet
A188 Simvastatin 10 Tablet
A189 Siprofloxacin tab 500 mg Tablet
A190 Sulfacetamid tetes mata Botol
A191 Tenofovir (TDF) 300 mg Tablet
A192 Tenofovir 300 mg + Emtricitabine 200 mg Tablet
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
A193 Tiamfenikol kap 500 mg Kapsul
A194 Tiamin HCl / B1 injeksi 100mg /ml Ampul
A195 Tiamin HCl / B1 tab 100 mg Tablet
A196 Tiamin HCl / B1 Tab 50 mg Tablet
A197 Triheksifenidil tab 2 mg Tablet
A198 Vitamin B Komplek tab Tablet
A199 Zidovudine Tablet
A200 Tablet
mg )
A201 Zink Tablet
B OBAT KOMBINASI
B1 Antasida + Simetikon Tablet
B2 Antasida + simetikon sirup Botol
B3 Anti Diare kombinasi sirup ( Anak ) Botol
B4 Anti Hemorhoid kapsul Kapsul
B5 Anti Hipertensi Herbal Kapsul
B6 Tube
B7 Anti spasmodik inj / spasi inj Ampul
B8 Asam Askorbat tab 500 + Vitamin Tablet
B9 Betamethason + Antibiotik salep kulit Tube
B10 D 1/2NS Flabot
B11 Flunarizin 5 mg Tablet
Bilberry 80 mg
B13 Methyl Cobalamin 500 Kapsul
B14 Minyak kayu putih Botol
B15 Minyak telon Botol
B16 Multivitamin sirup ( Anak ) Botol
B17 Multivitamin tab ( Dewasa ) Tablet
B18 Peluruh Batu Ginjal Botol
B19 Salep Luka Bakar Tube
B20 Sirup Flu dan Batuk Kombinasi Botol
B21 Tablet Tambah Darah + Vitamin Tablet
B22 Vitamin Neurotropik inj Ampul
C OBAT GIGI
C1 Air raksa dental use Botol
C2 Bahan bonding botol
C3 Bahan Etsa botol
C4 Devitalisasi Pasta Botol
C5 Etil Klorida semprot Botol
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
C6 Eugenol sol Pot
C7 Flour tablet Tablet
C8 Glass Ionomer Cement ( Fuji IX ) Pot
C9 Glass Ionomer Cement ( Fuji VII ) Pot
C10 Kalsium hydroksi pasta dos
C11 Komposit Tube
C12 Lidokain Spray Botol
C13 Monokror Kamfer Menthol ( CHKM ) Pot
C14 Mumiying Pasta Biji
C15 Semen Seng Fosfat p+liq Botol
C16 Silver Amalgam Botol
C17 Spons Gelatin Cubices Dos
C18 Temp+Stopp Fletc p+liq Set
C19 Trikresol Formalin ( TKF ) Botol
C20 Yodium Gliserin Cc
0 0 0
D PERBEKES 0
D1 ADS 0,05 ml Biji
D2 ADS 0,5 ml Biji
D3 ADS 5 ml Biji
D4 Alat suntik 1 ml Biji
D5 Alat suntik 2,5 ml / 3ml Biji
D6 Alat Suntik 5 ml Biji
D7 Anti Septik Handrub Box@10
D8 Antiseptik Botol 5 liter
D9 Aqua Pro injeksi Flacon
D10 Cat Gut Roll
D11 Cotton Aplikator Buah
D12 Etanol 70 % Botol
D13 Expert Check Kit Unit
D14 Hand Scoen Biji
D15 Hand Scoen Steril Pasang
D16 Infus Set anak Biji
D17 Infus Set dewasa Biji
D18 IV Cateter No. 18 Biji
D19 IV Cateter No. 20 ( Dewasa ) Biji
D20 IV Cateter No. 22 ( Dewasa ) Biji
D21 IV Cateter No. 24 ( Anak ) Biji
D22 IV Dresing Biji
D23 Jarum Bengkok / Jahit Biji
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
D24 Jarum Suntik Biji
D25 Kapas Adsorben 250 gr Roll
D26 Kasa panjang 40 yard x 80 cm Roll
D27 Kasa Pemb Hydro 4 m x 15 cm Roll
D28 Kasa Steril 16 x 16 ( 16 lmb ) Dos
D29 Kasa steril mengand:Framasetin 10% Biji
D30 Lisol Botol
D31 Masker Biji
D32 Masker N 95 Biji
D33 Masker N 95 + Aura Biji
D34 Masker Nebulizer Biji
D35 Mess Biji
D36 Plester 5 yardx2inch Roll
D37 Poly Cateter No. 14 Biji
D40 Pot dahak Biji
D41 Rotator Buah
D42 Safeglove PF Pasang
D43 Safety box Buah
D44 Selang oksigen anak Biji
D45 Selang Oksigen dws Biji
D46 Silk Biji
D47 Urine Bag Biji
E LABORATORIUM
E1 Box Slide Box
E2 HbsAg test Biji
E3 Iodium Test Botol
E4 KOH 10% Botol
E5 Larutan Asam Klorida 1 % Botol
E6 Lugol Botol 100 ml
E7 Methylen Blue 0.3% Botol
E8 NaCl 0.9% Botol
E9 Obyek glass set
E10 Oksigen m3
E11 pH Paper Cat 9555 Merck Roll
E12 Rapid Tes HIV Ke-1 Test
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
E15 Rapid Tes Shipilis ( SD ) Test
E16 RDT Anti HCV ( Hepatitis C ) Test
E17 RDT DBD Combo ( NS1 + IgG/IgM ) Test
E18 RDT Leptospirosis Test
E19 RDT Malaria Test
E20 Reagen Zn Botol
E21 TCM Cartridge Xpert MTB/Rif Buah
E22 Urine Test Biji
E23 Xylol Botol
0 0
F VAKSIN 0
F1 BCG + Pelarut Ampul
F2 Campak + Pelarut Vial
F3 DPT-HB-Hib Vial
F4 DT Vial
Syringe @
F5 HBIG ( Hiperhep-B )
0,5 ml
F6 HEP.B (PID) / HB 0 Buah
F7 MR Vial
F8 Polio bOPV + Dropper Vial
F9 Polio IPV Vial
F10 Td Vial
F11 TT Vial
F12 Vaksin Anti Rabies ( VAR ) Vial
G TAMBAHAN
G5 Masker N95 - BFE Tipe Cone Kecil ( 3M 1Biji
G9 Amoksisilin Sirup 250 mg Botol
G10 Metronidazol Infus 5mg Bottol
G14 Albendasol Suspensi 200mg/5ml Botol
G15 Kloramfenikol kap 500 mg Kapsul
G16 Azithromycin 500mg Tablet
G17 Coverall Suit / Hazmat Buah
G18 Face Sheild Buah
G19 Kacamata Goggle Buah
G20 Masker Kain Buah
G24 Stimuno Tablet
G25 Handsanitiser Botol
G26 Gawn Biji
G28 Tutup Kepala Biji
G29 Hand Sanitizer Galon Jerigen
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
G32 Masker KN 95 Biji
G36 Kantong Jenazah Unit
G43 Apron Medis Biji
G44 Nurse Cup Biji
G46 Imunos Tablet
G56 Alkohol Swab Box
G57 Tutup Kepala Box
G61 Face Sheild Anak Buah
G62 Rapit Test Covid-19 Antigen Test
G63 Vitamin C 500mg Tablet
G72 Stimuno Syrup Botol
G73 Blood Transfusion Set Biji
G74 Sarung Tangan Obgyn Pasang

G78 Favipiravir tablet 200mg Tablet
G81 Diisinfektan Botol

G89 Vitamin D Tablet 1000 IU Tablet
G90 Piroksikam tab 20 mg Kapsul
G93 Simvastatin 20 Tablet
G128 Oste Kaplet
G129 Kotrimoksazol Forte Tablet
G162 Oxymeter Unit
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
BPJS
Jumlah
Askes & JPS
Rawat Jalan
Rawat Inap
UGD
Jumlah

NIP.19580826 198711 1 001 NIP.19590828 199203 2NIP.19751225
002 200701 2NIP.19700617
013 199203 2 007
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
2
NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
A OBAT GENERIK
A2 ACT tab Tablet 0
A22 Tablet 0
NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
A46 Tablet 0
320mg ( DHP ) MERSI
Dus @ 10
Kap
NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
A113 Tablet 0
mg ( ALUVIA )
NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
A200 Tablet 0
mg )
A201 Zink Tablet 0
0
B OBAT KOMBINASI 0
B6 Tube 0
0
Bilberry 80 mg
0
C OBAT GIGI 0
NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
C11 Komposit Tube 0
0 0 0 0
D PERBEKES 0 0
D3 ADS 5 ml Biji 0
D10 Cat Gut Roll 0
NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
D30 Lisol Botol 0
D31 Masker Biji 0
D35 Mess Biji 0
D41 Rotator Buah 0
D46 Silk Biji 0
0
E LABORATORIUM 0
E1 Box Slide Box 0
E4 KOH 10% Botol 0
E10 Oksigen m3 0
NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
E23 Xylol Botol 0
0 0 0
F VAKSIN 0 0
F4 DT Vial 0
Syringe @
0,5 ml
F7 MR Vial 0
F9 Polio IPV Vial 0
F10 Td Vial 0
F11 TT Vial 0
0
G TAMBAHAN 0
G26 Gawn Biji 0
NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
G46 Imunos Tablet 0
G128 Oste Kaplet 0
NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
Rawat Jalan
Rawat Inap
UGD
Jumlah
Mengetahui / menyetujui Yang Meminta Yang Menerima
Kepala Dinas Kesehatan Kepala UPTD Puskesmas Petugas Puskesmas
Kabupaten Sragen
dr. M. Farid Anshori, MM. dr. Endah Riswandari Siti Fatimah

NIP.19580826 198711 1 001 NIP.19751225 200701 2 013
NIP.19700617 199203 2 007
NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
100
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
200
24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
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
24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
24 25 26 27 28 29 30 31 Jumlah
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
24 25 26 27 28 29 30 31 Jumlah
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
24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
240
0
0
0
0
0
24 25 26 27 28 29 30 31 Jumlah
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A OBAT GENERIK
A2 ACT tab Tablet 0
A22 Tablet 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A46 Tablet 0
320mg ( DHP ) MERSI
Dus @ 10
Kap
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A113 Tablet 0
mg ( ALUVIA )
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A200 Tablet 0
mg )
A201 Zink Tablet 0
0
B OBAT KOMBINASI 0
B6 Tube 0
0
Bilberry 80 mg
0
C OBAT GIGI 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
C11 Komposit Tube 0
0 0 0 0
D PERBEKES 0 0
D3 ADS 5 ml Biji 0
D10 Cat Gut Roll 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
D30 Lisol Botol 0
D31 Masker Biji 0
D35 Mess Biji 0
D41 Rotator Buah 0
D46 Silk Biji 0
0
E LABORATORIUM 0
E1 Box Slide Box 0
E4 KOH 10% Botol 0
E10 Oksigen m3 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
E23 Xylol Botol 0
0 0 0
F VAKSIN 0 0
F4 DT Vial 0
Syringe @
0,5 ml
F7 MR Vial 0
F9 Polio IPV Vial 0
F10 Td Vial 0
F11 TT Vial 0
0
G TAMBAHAN 0
G26 Gawn Biji 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
G46 Imunos Tablet 0
G128 Oste Kaplet 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
BPJS
Jumlah
Askes & JPS
Rawat Jalan
Rawat Inap
UGD
Jumlah
NIP.19580826 198711 1 001 NIP.19590828 199203 2 002
NIP.19751225 200701 2 013
NIP.19700617 199203 2 007
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
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
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
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
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
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
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
2
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A OBAT GENERIK
A2 ACT tab Tablet 0
A22 Tablet 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A46 Tablet 0
320mg ( DHP ) MERSI
Dus @ 10
Kap
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A113 Tablet 0
mg ( ALUVIA )
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A200 Tablet 0
mg )
A201 Zink Tablet 0
0
B OBAT KOMBINASI 0
B6 Tube 0
0
Bilberry 80 mg
0
C OBAT GIGI 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
C11 Komposit Tube 0
0 0 0 0
D PERBEKES 0 0
D3 ADS 5 ml Biji 0
D10 Cat Gut Roll 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
D30 Lisol Botol 0
D31 Masker Biji 20
D35 Mess Biji 0
D41 Rotator Buah 0
D46 Silk Biji 0
0
E LABORATORIUM 0
E1 Box Slide Box 0
E4 KOH 10% Botol 0
E10 Oksigen m3 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
E23 Xylol Botol 0
0 0 0
F VAKSIN 0 0
F4 DT Vial 0
Syringe @
0,5 ml
F7 MR Vial 0
F9 Polio IPV Vial 0
F10 Td Vial 0
F11 TT Vial 0
0
G TAMBAHAN 0
G26 Gawn Biji 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
G46 Imunos Tablet 0
G128 Oste Kaplet 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
BPJS
Jumlah
Askes & JPS
Rawat Jalan
Rawat Inap
UGD
Jumlah

NIP.19580826 198711 1 001 NIP.19590828 199203 2 002
NIP.19751225 200701 2 013
NIP.19700617 199203 2 007
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
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
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
100
0
0
0
0
0
0
0
0
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
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
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
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
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
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
2
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A OBAT GENERIK
A2 ACT tab Tablet 0
A22 Tablet 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A46 Tablet 0
320mg ( DHP ) MERSI
Dus @ 10
Kap
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A113 Tablet 0
mg ( ALUVIA )
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A200 Tablet 0
mg )
A201 Zink Tablet 0
0
B OBAT KOMBINASI 0
B6 Tube 0
0
Bilberry 80 mg
0
C OBAT GIGI 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
C11 Komposit Tube 0
0 0 0 0
D PERBEKES 0 0
D3 ADS 5 ml Biji 0
D10 Cat Gut Roll 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
D30 Lisol Botol 0
D31 Masker Biji 0
D35 Mess Biji 0
D41 Rotator Buah 0
D46 Silk Biji 0
0
E LABORATORIUM 0
E1 Box Slide Box 0
E4 KOH 10% Botol 0
E10 Oksigen m3 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
E23 Xylol Botol 0
0 0 0
F VAKSIN 0 0
F4 DT Vial 0
Syringe @
0,5 ml
F7 MR Vial 0
F9 Polio IPV Vial 0
F10 Td Vial 0
F11 TT Vial 0
0
G TAMBAHAN 0
G26 Gawn Biji 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
G46 Imunos Tablet 0
G128 Oste Kaplet 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
BPJS
Jumlah
Askes & JPS
Rawat Jalan
Rawat Inap
UGD
Jumlah
NIP.19580826 198711 1 001 NIP.19590828 199203 2 002
NIP.19751225 200701 2 013
NIP.19700617 199203 2 007
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
50
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
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
100
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
2
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
A OBAT GENERIK
A2 ACT tab Tablet 0
A22 Tablet 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
A46 Tablet 0
320mg ( DHP ) MERSI
Dus @ 10
Kap
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
A113 Tablet 0
mg ( ALUVIA )
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
A200 Tablet 0
mg )
A201 Zink Tablet 0
0
B OBAT KOMBINASI 0
B6 Tube 0
0
Bilberry 80 mg
0
C OBAT GIGI 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
C11 Komposit Tube 0
0 0 0 0
D PERBEKES 0 0
D3 ADS 5 ml Biji 0
D10 Cat Gut Roll 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
D30 Lisol Botol 0
D31 Masker Biji 0
D35 Mess Biji 0
D41 Rotator Buah 0
D46 Silk Biji 0
0
E LABORATORIUM 0
E1 Box Slide Box 0
E4 KOH 10% Botol 0
E10 Oksigen m3 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
E23 Xylol Botol 0
0 0 0
F VAKSIN 0 0
F4 DT Vial 0
Syringe @
0,5 ml
F7 MR Vial 0
F9 Polio IPV Vial 0
F10 Td Vial 0
F11 TT Vial 0
0
G TAMBAHAN 0
G26 Gawn Biji 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
G46 Imunos Tablet 0
G128 Oste Kaplet 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
BPJS
Jumlah
Askes & JPS
Rawat Jalan
Rawat Inap
UGD
Jumlah

NIP.19580826 198711 1 001 NIP.19590828 199203 2NIP.19751225
002 200701 2NIP.19700617
013 199203 2 007
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
2
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
A OBAT GENERIK
A2 ACT tab Tablet 0
A22 Tablet 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
A46 Tablet 0
320mg ( DHP ) MERSI
Dus @ 10
Kap
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
A113 Tablet 0
mg ( ALUVIA )
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
A200 Tablet 0
mg )
A201 Zink Tablet 0
0
B OBAT KOMBINASI 0
B6 Tube 0
0
Bilberry 80 mg
0
C OBAT GIGI 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
C11 Komposit Tube 0
0 0 0 0
D PERBEKES 0 0
D3 ADS 5 ml Biji 0
D10 Cat Gut Roll 5
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
D30 Lisol Botol 0
D31 Masker Biji 0
D35 Mess Biji 0
D41 Rotator Buah 0
D46 Silk Biji 0
0
E LABORATORIUM 0
E1 Box Slide Box 0
E4 KOH 10% Botol 0
E10 Oksigen m3 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
E23 Xylol Botol 0
0 0 0
F VAKSIN 0 0
F4 DT Vial 0
Syringe @
0,5 ml
F7 MR Vial 0
F9 Polio IPV Vial 0
F10 Td Vial 0
F11 TT Vial 0
0
G TAMBAHAN 0
G26 Gawn Biji 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
G46 Imunos Tablet 0
G128 Oste Kaplet 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
BPJS
Jumlah
Askes & JPS
Rawat Jalan
Rawat Inap
UGD
Jumlah

NIP.19580826 198711 1 001 NIP.19590828 199203 2NIP.19751225
002 200701 2NIP.19700617
013 199203 2 007
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
90
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
90
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
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
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
90
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
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
5
0
0
0
0
0
0
5
0
0
3
3
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
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
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
2
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
A OBAT GENERIK
A2 ACT tab Tablet 0
A22 Tablet 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
A46 Tablet 0
320mg ( DHP ) MERSI
Dus @ 10
Kap
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
A113 Tablet 0
mg ( ALUVIA )
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
A200 Tablet 0
mg )
A201 Zink Tablet 0
0
B OBAT KOMBINASI 0
B6 Tube 0
0
Bilberry 80 mg
0
C OBAT GIGI 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
C11 Komposit Tube 0
0 0 0 0
D PERBEKES 0 0
D3 ADS 5 ml Biji 0
D10 Cat Gut Roll 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
D30 Lisol Botol 0
D31 Masker Biji 0
D35 Mess Biji 0
D41 Rotator Buah 0
D46 Silk Biji 0
0
E LABORATORIUM 0
E1 Box Slide Box 0
E4 KOH 10% Botol 0
E10 Oksigen m3 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
E23 Xylol Botol 0
0 0 0
F VAKSIN 0 0
F4 DT Vial 0
Syringe @
0,5 ml
F7 MR Vial 0
F9 Polio IPV Vial 0
F10 Td Vial 0
F11 TT Vial 0
0
G TAMBAHAN 0
G26 Gawn Biji 0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
G46 Imunos Tablet 0
G128 Oste Kaplet 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
BPJS
Jumlah
Askes & JPS
Rawat Jalan
Rawat Inap
UGD
Jumlah

NIP.19580826 198711 1 001 NIP.19590828 199203 2NIP.19751225
002 200701 2NIP.19700617
013 199203 2 007
NO SATUAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
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 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah
NIP.19700617 199203 2 007

NO SATUAN Penerimaan penerimaan banjir
A OBAT GENERIK tgl 7
A2 ACT tab Tablet 0
A10 Amoksisilin kab 500 mg Tablet 2,000
A15 Antasida Doen tab Tablet 2,000 2,000

A22 Tablet 0

A24 Asam Mefenamat kap 500 mg Kaplet 1,000
A31 Attapulgit ( Anti Diare Tablet ) Tablet 500 2,000
A40 Deksametason tab 0,5 mg Tablet 1,000 3,000
A46 Tablet 0
320mg ( DHP ) MERSI
Dus @ 10
Kap
A72 Glimepiride 1 mg Tablet 1,000
A73 Gliseril guaiakolat tab Tablet 2,000 3,000
A82 Ibuprofen tab 200 mg Tablet 0 1,000
A88 Kalsium Laktat tab 500 mg Tablet 2,000
A98 Klorafeniramin ( CTM ) tab Tablet 5,000 5,000
A113 Tablet 0
mg ( ALUVIA )
A154 Parasetamol sirup Botol 0 100
A155 Parasetamol tab 500 mg Tablet 5,000 5,000
A161 Prednison tab 5 mg Tablet 2,000
A186 Sianokobalamin tab ( Vit. B12 ) tab Tablet 0 3,000
A196 Tiamin HCl / B1 Tab 50 mg Tablet 1,000 5,000
A198 Vitamin B Komplek tab Tablet 2,000 5,000
A200 Tablet 0
mg )
A201 Zink Tablet 0
0
B OBAT KOMBINASI 0
B6 Tube 0
Bilberry 80 mg 0
0
C OBAT GIGI 0
C11 Komposit Tube 0
0 0 0 0
D PERBEKES 0 0
D3 ADS 5 ml Biji 0
D10 Cat Gut Roll 0
D14 Hand Scoen Biji 1,000
D30 Lisol Botol 0
D31 Masker Biji 0
D35 Mess Biji 0
D41 Rotator Buah 0
D46 Silk Biji 24
0
E LABORATORIUM 0
E1 Box Slide Box 0
E4 KOH 10% Botol 0
E10 Oksigen m3 0
E23 Xylol Botol 0
0 0 0
F VAKSIN 0 0
F4 DT Vial 0
Syringe @
0,5 ml
F7 MR Vial 0
F9 Polio IPV Vial 0
F10 Td Vial 0
F11 TT Vial 0
0
G TAMBAHAN 0
G26 Gawn Biji 0
G46 Imunos Tablet 0
G128 Oste Kaplet 0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Rawat Jalan
Rawat Inap
UGD
Jumlah
Mengetahui / menyetujui
Kepala Dinas Kesehatan
Kabupaten Sragen
dr. M. Farid Anshori, MM.

NIP.19580826 198711 1 001
jumlah 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
0
0
0
0
0
0
0
300
0
2,000
0
0
0
0
4,000
0
0
0
0
0
0
0
1,000
0
0
0
0
0
0
2,500
0
0
300
0
0
0
0
0
4,000
0
5
0
0
0
0
0
0
0
0
0
0
0
500
0
0
0
0
0
0
30
0
0
0
0
0
0
0
0
0
0
1,000
5,000
0
0
0
0
0
0
0
0
1,000
0
0
0
0
0
2,000
0
0
0
0
0
0
0
0
0
10,000
0
0
25
0
0
0
0
0
0
0
0
0
0
0
0
0
800
0
0
0
0
0
0
500
0
0
0
0
0
0
20
200
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
100
10,000
0
0
0
0
0
2,000
0
0
0
0
0
0
0
0
0
0
0
40
0
100
0
0
0
0
0
5
0
0
0
0
3,000
0
0
0
0
0
0
0
0
0
6,000
0
7,000
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
0
0
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
0
0
0
1,000
0
0
0
0
0
50
0
0
0
0
5
0
0
20
0
0
0
0
0
0
0
10
0
0
0
0
0
0
0
0
0
24
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
0
0
0
0
0
0
0
0
0
0
100
0
BPJS
Gratis Saraswati
Jumlah
Askes & JPS

Yang Menyerahkan Yang Meminta Yang Menerima
Kepala UPTD Instalasi Farmasi
Kabupaten Sragen
Dra.Endang Purwanti,M.Kes,Apt
NIP.19590828 199203 2NIP.19751225
002 200701 2NIP.19700617
013 199203 2 007
19 20 21 22 23 24 25 26 27 28 29 30 31 Jumlah sisa
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 300
0 0
0 2,000
0 0
0 0
0 0
0 0
0 2,000
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 1,000
0 0
0 0
0 0
0 0
0 0
0 0
0 500
0 0
0 0
0 300
0 0
0 0
0 0
0 0
0 0
0 1,000
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
0 500
0 0
0 0
0 0
0 0
0 0
0 0
0 30
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 1,000
0 2,000
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 2,000
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 5,000
0 0
0 0
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
0 800
0 0
0 0
0 0
0 0
0 0
0 0
0 500
0 0
0 0
0 0
0 0
0 0
0 0
0 20
0 200
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 5,000
0 0
0 0
0 0
0 0
0 0
0 2,000
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 40
0 0
0 100
0 0
0 0
0 0
0 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 1,000
0 0
0 2,000
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 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 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 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 0
0 0
0 0
0 0
0 0
0 0
0 1,000
0 0
0 0
0 0
0 0
0 0
0 50
0 0
0 0
0 0
0 0
0 5
0 0
0 0
0 20
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 10
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 24
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 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 0
0 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

Pengeluaran Gudang Bulan Maret

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NO SATUAN 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23

Jumlah Kunjungan Resep Bayar

dr. M. Farid Anshori, MM. dr. Endah Riswandari Siti Fatimah

dr. M. Farid Anshori, MM. Dra.Endang Purwanti,M.Kes,Apt

dr. M. Farid Anshori, MM. Dra.Endang Purwanti,M.Kes,Apt dr. Endah Riswandari

Sragen, 31 Maret 2015

dr. M. Farid Anshori, MM. Dra.Endang Purwanti,M.Kes,Apt

G74 Sarung Tangan Obgyn Pasang

G81 Diisinfektan Botol

dr. M. Farid Anshori, MM. Dra.Endang Purwanti,M.Kes,Apt

Jumlah Kunjungan Resep Bayar

dr. M. Farid Anshori, MM. dr. Endah Riswandari Siti Fatimah

dr. M. Farid Anshori, MM. Dra.Endang Purwanti,M.Kes,Apt

dr. M. Farid Anshori, MM. Dra.Endang Purwanti,M.Kes,Apt

dr. M. Farid Anshori, MM. Dra.Endang Purwanti,M.Kes,Apt

dr. M. Farid Anshori, MM. Dra.Endang Purwanti,M.Kes,Apt

Sragen, 31 Maret 2015

NIP.19700617 199203 2 007

ARV FDC Dewasa : Tenofovir 300mg +

A23 Asam Askorbat tab 50 mg tab Tablet 0

G129 Kotrimoksazol Forte Tablet 100

G162 Oxymeter Unit 0

Jumlah Kunjungan Resep Bayar

dr. M. Farid Anshori, MM.

Sragen, 31 Maret 2015

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