LAPORAN MUTASI OBAT DAN BAHAN MEDIS HABIS PAKAI (BMHP)

DINAS KASEHATAN KABUPATEN HALMAHERA TENGAH

PUSKESMAS : : Banemo BULAN : SEPTEMBER
KODE PUSKESMAS : P8202044201 TAHUN : 2020
KECAMATAN : Patani Barat
JUMLAH PUSTU/POLINDES :3
PENGELUARAN
JMLH
NO SATUAN STOK PENERI KETERSE PUSKESM PESANT PUSTU PENGEL SISA PKM
URUT NAMA OBAT KEMASAN AWAL MAAN DIAAN APOTEK UGD/ PUSTU PUSTU ED
LAINNYA AS REN SIBENPOPO MOREALA BOBANE UARAN
KELILING JAYA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Obat-Obatan
1 Aciclovir 200 mg Tablet 1600 0 1600 0 0 0 0 100 0 0 100 1500
2 Aciclovir 400 mg Tablet 350 0 350 0 0 0 0 0 0 0 0 350
3 Aciclovir Krim Tube 59 0 59 0 0 0 0 0 0 0 0 59
4 Aciclovir Salep Mata Tube
5 Adidryl injeksi-15 ml/ Recodril Vial 20 0 20 0 0 0 0 0 0 0 0 20
6 Adimidon Injeksi-15 ml/ Benodon Vial 0 10 10 0 0 0 0 0 0 0 0 10
7 Albendazol 400 mg Tablet 1850 0 1850 0 0 0 0 0 0 0 0 1850
8 Allopurinol 100 mg Tablet
9 Alprazolam 0,5 mg Tablet 303 0 303 15 0 0 0 0 0 0 15 288
10 Alprazolam 1 mg Tablet
11 Ambroxol 30 mg Tablet 0 1000 1000 0 0 0 0 0 0 0 0 1000
12 Ambroxol Sirup Botol 5 0 5 5 0 0 0 0 0 0 5 0
13 Aminofilin 200 mg Tablet 1100 0 1100 0 0 0 0 0 0 0 0 1100
14 Aminofilin Injeksi-24 mg/ml 10 ml Ampul 30 0 30 0 0 0 0 0 0 0 0 30
15 Amoxisilin 250 mg Kapsul
16 Amoxisilin 500 mg Tablet 1500 3000 4500 600 0 0 0 100 0 100 800 3700
17 Amoxisilin Syr 125 mg/5 ml Botol 37 0 37 2 0 0 0 3 0 5 10 27
18 Amoxisilin Syr 250 mg/ 5 ml Botol 95 0 95 15 0 0 0 0 0 0 15 80
19 Ampicilin 250 mg kaplet
20 Ampisilin 500 mg Tablet 700 0 700 0 0 0 0 100 0 200 300 400
21 Ampisilin Injeksi Vial 18 0 18 0 0 0 0 0 0 0 0 18
22 Ampislin Syr 125 mg/5 ml Botol 30 0 30 0 0 0 0 5 0 0 5 25
 PENGELUARAN
JMLH
NO SATUAN STOK PENERI KETERSE PUSKESM PESANT PUSTU PENGEL SISA PKM
URUT NAMA OBAT KEMASAN AWAL MAAN DIAAN APOTEK UGD/ PUSTU PUSTU ED
LAINNYA AS REN SIBENPOPO MOREALA BOBANE UARAN
KELILING JAYA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
23 Amlodipin 5 Mg Tablet 1600 0 1600 0 0 0 0 0 0 0 0 1600
24 Antalgin 500 mg Tablet
25 Antalgin Injeksi 250 mg/ml-2 ml Ampul
26 Antasida Doen Tablet 2300 0 2300 0 0 0 0 100 0 100 200 2100
27 Antasida Syr Botol 68 0 68 0 0 0 0 0 0 0 0 68
28 Anti Fungi Doen Kombinasi Pot 48 0 48 0 0 0 0 0 0 0 0 48
29 Anti Haemoroid Doen Kombinasi Supp
30 Artesunate Tablet
31 Artesunate inj Vial
32 Asam Ascorbat (Vit C ) 50 mg Tablet 1700 2000 3700 900 0 0 0 100 0 100 1100 2600
33 Asam Ascorbat (Vit C ) 250 mg Tablet
34 Asam Folat Tablet 0 1000 1000 0 0 0 0 0 0 0 0 1000
35 Asam Mefenamat 250 mg Tablet
36 Asam Mefenamat 500 mg Tablet 1900 0 1900 400 0 0 0 200 0 200 800 1100
37 Asam Tranexamat Tablet
38 Asam Tranexamat Injeksi Ampul
39 Asetosal 100 mg Tablet
40 Asetosal 500 mg Tablet
41 Atropin Sulfat Injeksi 0.25 mg/ml-1ml Ampul
42 Atropin Sulfat Tetes Mata 0.5 %-5 ml Botol
43 Atorvastatin 10 mg Tablet 0 2000 2000 0 0 0 0 0 0 0 0 2000 1100 ED 04/20
44 Aqua Pro Injeksi Steril-20 ml Ampul
45 Azitromycin Tablet 380 0 380 0 0 0 0 0 0 0 0 380
46 Bacitracyn-Polimixyn Tube
47 Betammetason Krim 0.1%-5 gram Tube
48 Betahistin Mesylate Tablet
49 Bioplacenton Jely Tube 6 0 6 0 0 0 0 0 0 0 0 6
50 Buscopan Injeksi Ampul 10 0 10 0 0 0 0 0 0 0 0 10
51 Calcii Gluconas Ampul
52 Captopril 12.5 mg Tablet 200 2000 2200 200 0 0 0 0 0 0 200 2000
53 Captopril 25 mg Tablet 500 0 500 0 0 0 0 0 0 0 0 500
 PENGELUARAN
JMLH
NO SATUAN STOK PENERI KETERSE PUSKESM PESANT PUSTU PENGEL SISA PKM
URUT NAMA OBAT KEMASAN AWAL MAAN DIAAN APOTEK UGD/ PUSTU PUSTU ED
LAINNYA AS REN SIBENPOPO MOREALA BOBANE UARAN
KELILING JAYA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
54 Caviplex Sirup Botol
55 Cefadroxil 250 mg Tablet
56 Cefadroxil 500 mg Tablet 1900 0 1900 0 0 0 0 0 0 0 0 1900
57 Cefadroxyl sirup 125 mg Botol 49 0 49 0 0 0 0 0 0 0 0 49
58 Cefadroxyl Sirup 250 mg Botol 45 0 45 0 0 0 0 0 0 0 0 45
59 Cefixime 200 mg Tablet
60 Cefixime Sirup 100 mg Botol
61 Cefotaxim Injeksi Vial
62 Ceftriaxone Injeksi Vial 60 0 60 0 0 0 0 0 0 0 0 60 60 ED 09/20
63 Cetirizine Sirup Botol 64 0 64 28 0 0 0 0 0 0 28 36
64 Cimetidine 200 mg Tablet 0 1000 1000 0 0 0 0 0 0 0 0 1000
65 Clindamycin 150 Mg Tablet 900 0 900 0 0 0 0 0 0 0 0 900
66 Clindamycin 300 Mg Tablet 900 0 900 0 0 0 0 0 0 0 0 900
67 Colchicine Tablet
68 Curcuma Suspensi Botol
69 Deksametasone 0.5 mg Tablet 1900 0 1900 0 0 0 0 100 0 100 200 1700
70 Deksametasone Injeksi 5 mg/ml-1 ml Ampul 200 0 200 0 0 0 0 0 0 0 0 200 100 ED 09/20
71 Dermasolon Tube
72 Dexocort Tube
73 DHP Frimal Tablet 40 0 40 0 0 0 0 0 0 0 0 40
74 Diazepam 2 mg Tablet
75 Diazepam 5 mg Tablet 500 0 500 5 0 0 0 0 0 0 5 495
76 Diazepam Injeksi 5 mg/ml-2 ml/ stesoli Ampul
77 Difenhidramin HCL Injeksi 10 mg/ml-1 Ampul 30 0 30 0 0 0 0 0 0 0 0 30
78 Diltiazem Tablet
79 Doksisiklin 100 mg Tablet 600 0 600 0 0 0 0 0 0 0 0 600
80 Domperidon Tablet 500 2000 2500 200 0 0 0 0 0 0 200 2300
81 Domperidon Sirup Botol 20 20 40 7 0 0 0 0 0 0 7 33
82 Dulcolax 5 mg Tablet Tablet 210 0 210 0 0 0 0 0 0 0 0 210
83 Dulcolax Supositoria 5 mg anak Tablet
84 Dulcolax Supositoria 10 mg Dewasa Supp
 PENGELUARAN
JMLH
NO SATUAN STOK PENERI KETERSE PUSKESM PESANT PUSTU PENGEL SISA PKM
URUT NAMA OBAT KEMASAN AWAL MAAN DIAAN APOTEK UGD/ PUSTU PUSTU ED
LAINNYA AS REN SIBENPOPO MOREALA BOBANE UARAN
KELILING JAYA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
85 Efedrin HCL 25 mg Tablet
86 Ephineprine HCL Injeksi 0.1% -1 ml Ampul 100 100 200 0 0 0 0 0 0 0 0 200
87 Eritromisin 250 mg Kapsul
88 Eritromisin 500 mg Kaplet 1700 0 1700 0 0 0 0 0 0 0 0 1700
89 Eritromisin Syr Kering 200 mg/ml-60 m Botol 115 0 115 0 0 0 0 0 0 0 0 115
90 Ethambutol 250 mg Tablet
91 Ethambutol 500 mg Tablet
92 Fenilbutason 200 mg Tablet
93 Fenobarbital 30 mg Tablet
94 Fenobarbital 100 mg Tablet
95 Fenobarbital Injeksi 50 mg/ml-2 ml Ampul
96 Fitomenadion ( Vit K ) 10 mg Tablet 0 1000 1000 0 0 0 0 0 0 0 0 1000
97 Fitomenadion ( Vit K ) Injeksi -1 ml Ampul 90 60 150 0 0 0 0 0 0 0 0 150
98 Furosemide 40 mg Tablet 2000 0 2000 0 0 0 0 0 0 0 0 2000
99 Furosemide Injeksi Ampul
100 Gameksan Emulsi 1%-100 ml Botol
101 Garam Oralit 200 ml air Sachet 200 0 200 0 0 0 0 0 0 0 0 200
102 Gentamicin Injeksi Ampul
103 Gentamicin salep Kulit Tube 30 20 50 20 0 0 0 0 0 0 20 30
104 Gentamicin Tetes Mata Botol 24 0 24 24 0 0 0 0 0 0 24 0
105 Gentien Violet Larutan 1 % -10 ml Botol 24 0 24 0 0 0 0 0 0 0 0 24
106 Glibenklamide 5 mg Tablet 700 0 700 0 0 0 0 0 0 0 0 700 20 ED 09/20
107 Glimepiride 1 mg Tablet
108 Glimepiride 2 mg Tablet 800 0 800 0 0 0 0 0 0 0 0 800
109 Gliseril Guaicolate 100 mg Tablet 0 1000 1000 0 0 0 0 0 0 0 0 1000
110 Gliserin 100 ml Botol
111 Gliserin 1000 ml Tablet
112 Glukosa Injeksi 40 % Steril 25 ml Tablet
113 Glukosa Infus 5 % Steril -500 ml Tablet 210 0 210 10 0 0 0 0 0 0 10 200
114 Glukosa Infus 10 % Steril -500 ml Pot 80 0 80 0 0 0 0 0 0 0 0 80
115 Graxine Tablet
 PENGELUARAN
JMLH
NO SATUAN STOK PENERI KETERSE PUSKESM PESANT PUSTU PENGEL SISA PKM
URUT NAMA OBAT KEMASAN AWAL MAAN DIAAN APOTEK UGD/ PUSTU PUSTU ED
LAINNYA AS REN SIBENPOPO MOREALA BOBANE UARAN
KELILING JAYA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
116 Griseofulvin 125 mg Tablet 0 2000 2000 0 0 0 0 0 0 0 0 2000
117 Haloperidol 0.5 mg Tablet
118 Haloperidol 1.5 mg Tablet
119 Haloperidol 5 mg Tablet
120 Haloperidol Injeksi Ampul
121 Hidroklosiasid (HCT )25 mg Tablet
122 Hidrokortison Krim 2.5 %-5 gram Tube
123 Ibuprofen sirup Botol 43 0 43 6 0 0 0 0 0 0 6 37
124 Ibuprofen 200 mg Tablet
125 Ibuprofen 400 mg Kapsul
126 Isoniasid (INH) 100 mg Tube
127 Isoniasid (INH) 300 mg Botol
128 Isosorbid Dinitrat Sublingual Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
129 Kalium Permangnat Serbuk 5 mg Tablet
130 Kalsium Laktat 500 mg Tablet 800 0 800 400 0 0 0 100 0 100 600 200
131 Karbamazepin 200 mg Vial 150 100 250 100 0 0 0 0 0 0 100 150
132 Ketoconazole 200 mg Tablet Tablet 700 0 700 0 0 0 0 0 0 0 0 700
133 Ketoconazole Krim Tablet 20 50 70 20 0 0 0 0 0 0 20 50
134 Ketorolac Injeksi Ampul
135 Kinna ( Quinine )222 mg Tablet
136 Klorampenikol 250 mg Tablet 1900 0 1900 0 0 0 0 0 0 0 0 1900
137 Klorampenikol Salep Mata 1% Tube 134 0 134 0 0 0 0 0 0 0 0 134
138 Klorampenikol Sirup Botol 0 50 50 0 0 0 0 0 0 0 0 50
139 Klorampenikol Tetes Telinga Botol 8 15 23 2 0 0 0 0 0 0 2 21
140 Klorampeniramin Maleat (CTM ) 4 mg Tablet 0 5000 5000 0 0 0 0 0 0 0 0 5000
141 Kloroquin 150 mg Tablet
142 Kloroquin 250 mg Tablet
143 Kloroquin Injeksi-15 ml Ampul
144 Klorpromazin HCL 25 mg Tablet
145 Klorpromazin HCL 100 mg Tablet
146 Klorpromazin HCL Injeksi 5 mg/ml-2 ml Ampul
 PENGELUARAN
JMLH
NO SATUAN STOK PENERI KETERSE PUSKESM PESANT PUSTU PENGEL SISA PKM
URUT NAMA OBAT KEMASAN AWAL MAAN DIAAN APOTEK UGD/ PUSTU PUSTU ED
LAINNYA AS REN SIBENPOPO MOREALA BOBANE UARAN
KELILING JAYA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
147 Klorpromazin HCL Injeksi 25 mg/ml-1 m Ampul
148 Klorpropamid 100 mg Tablet
149 Kodein fosfat HCL 10 mg Tablet
150 Kotrimoksazole Suspensi 60 ml Botol 84 0 84 5 0 0 0 0 0 0 5 79
151 Kotrimoksazole 120 mg Pediatrik Tablet
152 Kotrimoksazole 480 mg Dewasa Tablet 1100 0 1100 0 0 0 0 0 0 100 100 1000
153 Kotrimoxazole Forte 960 mg Tablet
154 Larutan Irigasi Botol
155 Lansoprazole 30 mg Tablet 2300 0 2300 0 0 0 0 0 0 0 0 2300
156 Levopar Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
157 Lidokain Injeksi 2 %-2 ml Ampul 300 0 300 0 0 0 0 0 0 0 0 300
158 Lidokain Injeksi Compositum Ampul
159 Loperamid 2 Mg Tablet 900 0 900 0 0 0 0 0 0 0 0 900
160 Lorazepam tablet Tablet 300 0 300 0 0 0 0 0 0 0 0 300
161 Mebendazol Syr 100 mg/5 ml-30 ml Botol
162 Meloxicam 7,5 Mg Tablet 450 0 450 0 0 0 0 0 0 0 0 450
163 Meloxicam 15 Mg Tablet 350 0 350 0 0 0 0 0 0 0 0 350
164 Metilergomertin Maleat 0.125 mg Tablet
165 Metilergomertin Maleat Inj 0.200 mg/ml-1 Ampul
166 Metoclopramide Tablet 1700 0 1700 0 0 0 0 0 0 0 0 1700
167 Metoclopramide Drops Botol 26 0 26 6 0 0 0 0 0 0 6 20
168 Metoclopramide Sirup Botol
169 Metoclorpamide Injeksi Ampul 20 0 20 0 0 0 0 0 0 0 0 20
170 Metronidazole 500 mg Tablet 1100 0 1100 0 0 0 0 0 0 0 0 1100
171 Metronidazole Sirup Botol
172 Methylprednisolon 4 Mg Tablet 5400 0 5400 0 0 0 0 0 0 0 0 5400
173 Methylprednisolon 8 Mg Tablet 2500 0 2500 0 0 0 0 0 0 0 0 2500
174 Methylprednisolon 16 Mg Tablet
175 Methylprednisolon Injeksi 125 Mg Ampul
176 Methylprednisolon Injeksi 500 mg Ampul
177 Metformin 500 Mg Tablet
 PENGELUARAN
JMLH
NO SATUAN STOK PENERI KETERSE PUSKESM PESANT PUSTU PENGEL SISA PKM
URUT NAMA OBAT KEMASAN AWAL MAAN DIAAN APOTEK UGD/ PUSTU PUSTU ED
LAINNYA AS REN SIBENPOPO MOREALA BOBANE UARAN
KELILING JAYA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
178 MgSO4 20 % Flacon 28 0 28 0 0 0 0 0 0 0 0 28
179 MgSO4 40 % Flacon
180 Miconazole Zalf Tube 24 0 24 24 0 0 0 0 0 0 24 0
181 Microdiol strip
182 Mineral Mix Sachet 339 0 339 0 0 0 0 0 0 0 0 339 80 ED 09/20
183 Natrium Diclofenak 25 mg Tablet 1000 0 1000 200 0 0 0 0 0 100 300 700
184 Natrium Diclofenak 50 mg Tablet 0 1000 1000 0 0 0 0 0 0 0 0 1000
185 Natrium Fenitoin Injeksi 50mg/ml Ampul
186 Natrium Klorida Infus 0.9 % Steril 500 Botol 40 0 40 18 0 0 0 0 0 0 18 22
187 New Diatabs/ New Antides Tablet
188 Nifedipin 10 mg Tablet
189 Nistatin tablet 500.000 IU Tablet 400 0 400 0 0 0 0 0 0 0 0 400
190 Nistatin tablet Vaginal 100.000 IU Supp
191 Obat Anti Tuberkulosis Kategori 1 Dew Paket
192 Obat Anti Tuberkulosis Kategori 2 Dew Paket
193 Obat Anti Tuberkulosis Kategori 3 Dew Paket
194 Obat Anti Tuberkulosis Kategori Anak Paket
195 Obat Anti Tuberkulosis Sisipan Paket
196 Obat Batuk Hitam Syr 100 ml Botol 30 0 30 16 0 0 0 5 0 0 21 9
197 Obat Batuk Putih Syr 100 ml Botol
198 Oksitetrasiklin HCL Injeksi 50 mg/ml-10 Vial
199 Oksitetrasiklin HCL Salep Kulit 3 %-5 g Tube
200 Oksitetrasiklin HCL Salep Mata 1 %-3.5 Tube 0 25 25 0 0 0 0 0 0 0 0 25
201 Oksitosin Injeksi 10 IU/ml-8 ml Vial 2 30 32 0 2 0 0 0 0 0 2 30
202 Omeprazole Tablet 5760 0 5760 150 0 0 0 60 0 60 270 5490
203 Omeprazole Injeksi Vial
204 Ondansetron Injeksi Ampul
205 Papaverin 40 mg Tablet 3000 0 3000 0 0 0 0 0 0 0 0 3000
206 Papaverin Injeksi 40 mg/ml-8 ml Ampul
207 Parasetamol Drops Vial 19 0 19 10 0 0 0 0 0 0 10 9
208 Parasetamol 500 mg Tablet 6600 0 6600 300 0 0 0 100 0 200 600 6000
 PENGELUARAN
JMLH
NO SATUAN STOK PENERI KETERSE PUSKESM PESANT PUSTU PENGEL SISA PKM
URUT NAMA OBAT KEMASAN AWAL MAAN DIAAN APOTEK UGD/ PUSTU PUSTU ED
LAINNYA AS REN SIBENPOPO MOREALA BOBANE UARAN
KELILING JAYA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
209 Paracetamol Injeksi Botol 28 0 28 0 4 0 0 0 0 0 4 24
210 Parasetamol Syr 60 ml Botol 7 20 27 7 0 0 0 0 0 0 7 20
211 Pethidin HCL Injeksi 50 mg/ml-2 ml Ampul
212 Phenol Gliserol Botol
213 Piracetam 400 Mg Tablet
214 Piracetam 800 Mg Tablet 900 0 900 0 0 0 0 0 0 0 0 900 900 ED 09/20
215 Piracetam Injeksi 5 ml Ampul
216 Piracetam Injeksi 15 ml Ampul
217 Pirazinamide Tablet
218 Pirantel Pamoat 125 mg Tablet 400 0 400 0 0 0 0 0 0 0 0 400
219 Pirantel Pamoat Sirup Botol
220 Piroxicam 10 mg Tablet 1500 0 1500 0 0 0 0 100 0 100 200 1300
221 Piroxicam 20 mg Tablet 800 1000 1800 600 0 0 0 0 0 0 600 1200
222 Pirodoksine HCL (B 6 ) 10 mg Tablet 3000 0 3000 100 0 0 0 100 0 100 300 2700
223 Prednison 5 mg Tablet 700 0 700 0 200 0 0 200 0 0 400 300
224 Primaquin 15 mg Tablet 100 0 100 0 0 0 0 0 0 0 0 100
225 Prokain Benzil Penisilin Vial
226 Propranolol HCL 10 mg Tablet 0 500 500 0 0 0 0 0 0 0 0 500
227 Propranolol HCL 40 mg Tablet
228 Propiltiuracil (PTU) Tablet
229 Ranitidine 150 mg Tablet 10300 0 10300 600 0 0 0 100 0 100 800 9500 9500 ED 09/20
230 Ranitidine Injeksi 50 mg/ml-2ml Ampul 20 30 50 20 0 0 0 0 0 0 20 30
231 Reserpin 0.10 mg Tablet
232 Reserpin 0.25 mg Tablet
233 Retinol ( VIT A )6.000 IU Tablet
234 Retinol ( VIT A )25.000 IU Tablet
235 Retinol ( VIT A )50.000 IU Tablet
236 Retinol ( VIT A )100.000 IU Tablet 500 0 500 0 0 0 0 0 0 0 0 500
237 Retinol ( VIT A )200.000 IU Tablet 0 500 500 0 0 0 0 0 0 0 0 500
238 Ringer Laktat Larutan Infus Steril-500 m Botol 26 0 26 6 0 0 0 0 0 0 6 20
239 Ringer Laktat Larutan Infus Steril-1000 Botol 0 20 20 0 0 0 0 0 0 0 0 20
 PENGELUARAN
JMLH
NO SATUAN STOK PENERI KETERSE PUSKESM PESANT PUSTU PENGEL SISA PKM
URUT NAMA OBAT KEMASAN AWAL MAAN DIAAN APOTEK UGD/ PUSTU PUSTU ED
LAINNYA AS REN SIBENPOPO MOREALA BOBANE UARAN
KELILING JAYA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
240 Risperidone 2 mg Tablet
241 Salbutamol 2 mg Tablet 4700 0 4700 100 0 0 0 100 0 0 200 4500
242 Salbutamol 4 mg Tablet 1800 0 1800 100 0 0 0 0 0 0 100 1700
243 Salbutamol sirup Botol
244 Salep Ichtyol 30 gram Pot 72 0 72 0 0 0 0 0 0 0 0 72
245 Salep Levetran Pot
246 Salep Scabisid Tube
247 Salicyl Bedak 2 %-50 gram Dos 42 0 42 0 0 0 0 0 0 0 0 42
248 Salicyl Spritus 10 % -25 ml Botol 25 0 25 0 0 0 0 0 0 0 0 25 25 ED 09/20
249 Salep 2-4 Botol 21 48 69 21 0 0 0 0 0 0 21 48
250 Sianocobalamin( VIT B 12 ) 50 mg Tablet 6000 0 6000 0 0 0 0 0 0 200 200 5800
251 Sianocobalalamin ( VIT B 12 ) 500 mg/m Ampul 300 0 300 0 0 0 0 0 0 0 0 300
252 Sianocobalalamin ( VIT B 12 ) 500 mg/ Vial
253 Simvastatin 10 mg Tablet 750 0 750 0 0 0 0 60 0 60 120 630
254 Simvastatin 20 mg Tablet 390 0 390 0 0 0 0 0 0 0 0 390
255 Siprofloksacin 250 mg Tablet
256 Siprofloksacin 500 mg Tablet 0 1000 1000 0 0 0 0 0 0 0 0 1000
257 Sodium Bicaronat Tablet 0 1000 1000 0 0 0 0 0 0 0 0 1000
258 Streptomicin Injeksi 1 gram Vial
259 Streptomicin Injeksi 1.5 gram Vial
260 Sulfadoxin Pirimenthamin 525 mg Tablet
261 Sulfacetamid Sodium Tetes mata Botol
262 Tablet Tambah Darah (SF ) Tablet 22260 0 22260 360 0 0 0 100 0 100 560 21700 19700 ED 09/20
263 Tetrakain HCL Tetes Mata 0.5 %-5 ml Botol
264 Tetrasiklin HCL 250 mg Kapsul
265 Tetrasiklin HCL 500 mg Kapsul
266 Theophylline Tablet
267 Thiamin HCL ( B 1 ) 50 mg Tablet 21000 0 21000 0 0 0 0 0 0 200 200 20800
268 Thiamin HCL ( B 1 ) Injeksi - 1 ml Ampul 1170 0 1170 0 0 0 0 0 0 0 0 1170
269 Thiamin HCL ( B 1 ) Injeksi-15 ml Vial
270 Tramadol 50 mg Tablet
 PENGELUARAN
JMLH
NO SATUAN STOK PENERI KETERSE PUSKESM PESANT PUSTU PENGEL SISA PKM
URUT NAMA OBAT KEMASAN AWAL MAAN DIAAN APOTEK UGD/ PUSTU PUSTU ED
LAINNYA AS REN SIBENPOPO MOREALA BOBANE UARAN
KELILING JAYA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
271 Tramadol Injeksi Ampul 45 0 45 5 0 0 0 0 0 0 5 40
272 Triheksipenidil Hidroklorida 2 mg Tablet 650 250 900 30 0 0 0 0 0 0 30 870 620 ED 09/20
273 Ventolin Inhaler Botol
274 Verapamil 80 mg Tablet
275 Vitamin B Kompleks Tablet 1490 0 1490 0 0 0 0 0 0 200 200 1290
276 Vitamin B Kompleks Injeksi -15 ml Vial
277 Vitamin B 6 Tablet 3000 0 3000 100 0 0 0 100 0 100 300 2700
278 Vitamin B 6 Injeksi Ampul 0 100 100 0 0 0 0 0 0 0 0 100
279 Vitamin K4 Tablet
280 Wida KDN 1 Botol
281 Wida KN 1 Botol
282 Zink Tablet 500 0 500 200 0 0 0 0 0 0 200 300

BMHP
1 3 way Pcs 0 10 10 0 0 0 0 0 0 0 0 10
2 Abocath No.18 Pcs 138 0 138 0 0 0 0 0 0 0 0 138
3 Abocath No.20 Pcs
4 Abocath No.22 Pcs 49 0 49 0 0 0 0 0 0 0 0 49
5 Abocath No.24 Pcs 47 0 47 7 0 0 0 0 0 0 7 40
6 Abocath No.26 Pcs 0 27 27 0 0 0 0 0 0 0 0 27
7 Alkohol 100 ml Botol
8 Alkohol 300 ml Botol 4 0 4 0 0 0 0 0 0 0 0 4 4 ED 09/20
9 Alkohol 1000 ml Botol 0 2 2 0 0 0 0 0 0 0 0 3
10 Alkohol Swab Box 2 0 2 0 0 0 0 0 0 0 0 2
11 Bisturi (Pisau Bedah )No.10 Biji 200 0 200 0 0 0 0 0 0 0 0 200
12 Bisturi (Pisau Bedah )No.11 Biji 100 0 100 0 0 0 0 0 0 0 0 100
13 Bisturi (Pisau Bedah )No.12 Biji 100 0 100 0 0 0 0 0 0 0 0 100
14 Bisturi (Pisau Bedah )No.20 Biji 200 0 200 0 0 0 0 0 0 0 0 200
15 Bisturi (Pisau Bedah )No.21 Biji 200 0 200 0 0 0 0 0 0 0 0 200
16 Bisturi (Pisau Bedah )No.22 Biji 100 0 100 0 0 0 0 0 0 0 0 100
17 Bisturi (Pisau Bedah )No.23 Biji 100 0 100 0 0 0 0 0 0 0 0 100
 PENGELUARAN
JMLH
NO SATUAN STOK PENERI KETERSE PUSKESM PESANT PUSTU PENGEL SISA PKM
URUT NAMA OBAT KEMASAN AWAL MAAN DIAAN APOTEK UGD/ PUSTU PUSTU ED
LAINNYA AS REN SIBENPOPO MOREALA BOBANE UARAN
KELILING JAYA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
18 Bisturi (Pisau Bedah )No.24 Biji
19 Blood Lancet Box 3 0 3 0 0 0 0 0 0 0 0 3
20 Catgut/Benang Bedah Chromic No.2/0 Box 0 2 2 0 0 0 0 0 0 0 0 2
21 Catqut/Benang Bedah Chromic 3/0 Box 0 2 2 0 0 0 0 0 0 0 0 2
22 Catqut/Benang Bedah Plain 2/0 Box
23 Catqut/Benang Bedah Plain 3/0 Box 0 2 2 0 0 0 0 0 0 0 0 2
24 Cutisorb Pcs 0 25 25 0 0 0 0 0 0 0 0 25
25 Disposible 1 ml Pcs 400 0 400 100 0 0 0 0 0 0 100 300
26 Disposible 2.5 ml Pcs
27 Disposible 3 ml Pcs 100 300 400 0 0 0 0 0 0 0 0 400
28 Disposible 5 ml Pcs 100 0 100 0 0 0 0 0 0 0 0 100
29 Disposible 10 ml Pcs 200 0 200 0 0 0 0 0 0 0 0 200
30 Disposible 20 ml Pcs 0 100 100 0 0 0 0 0 0 0 0 100
31 Elastis Perban 7,5 X 4,55 Pcs
32 Elastis Perban 10 X 4,55 Pcs
33 Etil Klorida Semprot 100 ml Botol 1 2 3 0 0 0 0 0 0 0 0 3
34 Foley Catheter No. 06 PCS 0 10 10 0 0 0 0 0 0 0 0 10
35 Foley Catheter No. 08 PCS 0 10 10 0 0 0 0 0 0 0 0 10
36 Foley Catheter No. 10 PCS 0 10 10 0 0 0 0 0 0 0 0 10
37 Foley Catheter No. 12 PCS 0 10 10 0 0 0 0 0 0 0 0 10
38 Foley Catheter No. 14 PCS 0 10 10 0 0 0 0 0 0 0 0 10
39 Foley Catheter No. 16 PCS
40 Foley Catheter No. 18 PCS 19 10 29 0 0 0 0 0 0 0 0 29
41 Foley Catheter No. 20 PCS 10 0 10 0 0 0 0 0 0 0 0 10
42 Foley Catheter No. 22 PCS 20 0 20 0 0 0 0 0 0 0 0 20
43 Foley Catheter No. 24 PCS 19 0 19 0 0 0 0 0 0 0 0 19
44 Formalin Botol
45 Giemza Botol
46 H2O2 Botol
47 Handscoon Obgyn pasang 40 50 90 0 0 0 0 0 0 0 0 90
48 Hand Scoen (Sarung Tangan ) Uk. XS box
 PENGELUARAN
JMLH
NO SATUAN STOK PENERI KETERSE PUSKESM PESANT PUSTU PENGEL SISA PKM
URUT NAMA OBAT KEMASAN AWAL MAAN DIAAN APOTEK UGD/ PUSTU PUSTU ED
LAINNYA AS REN SIBENPOPO MOREALA BOBANE UARAN
KELILING JAYA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
49 Hand Scoen ( Sarung Tangan )Uk. S box 14 0 14 0 1 0 0 0 0 0 1 13
50 Hand Scoen ( Sarung Tangan )Uk. M box 8 0 8 1 4 0 0 0 0 0 5 3
51 Hand Scoen ( Sarung Tangan )Uk. L box 9 0 9 1 1 0 0 0 0 0 2 7
52 Hand Scoen Steril (Sarung Tangan ) No. Pasang 90 0 90 0 0 0 0 10 0 10 20 70
53 Hand Scoen Steril ( Sarung Tangan )No. Pasang 0 50 50 0 0 0 0 0 0 0 0 50
54 Hand Scoen Steril ( Sarung Tangan )No. Pasang 86 0 86 10 33 0 0 10 0 10 63 23
55 Hand Scoen Steril ( Sarung Tangan )No. Pasang 150 0 150 0 0 0 0 0 0 0 0 150
56 Hand Scoen Steril ( Sarung Tangan )No. Pasang 150 0 150 0 0 0 0 0 0 0 0 150
57 HCL 0,1 N Botol
58 Infuset Anak Pcs 69 0 69 2 0 0 0 0 0 0 2 67
59 Infuset Dewasa Pcs 48 0 48 2 0 0 0 0 0 0 2 46
60 Kapas Pembalut/ Absorben 250 gram Rol
61 Kapas Pembalut/ Absorben 1000 gram Rol
62 Kasa Hidrofil 80 cm X 2 m Lembar
63 Kasa Hidrofil Pembalut 3 cm X 4 m Rol
64 Kasa Hidrofil Pembalut 6 cm X 4 m Rol
65 Kasa Hidrofil Pembalut 15 cm X 4 m Rol 158 0 158 0 45 0 0 0 0 0 45 113
66 Kasa Hidrofil Pembalut 80 cm X 4 m Rol
67 Kasa Kompres Steril 16 cm X 16 cm Rol
68 Kasa Kompres Steril 40 cm X 80 cm Rol
69 Leukomed Pcs
70 Masker Box 9 0 9 2 2 0 0 0 0 0 4 5
71 Masker Hijab Box
72 Masker Nebulizer Anak Pcs
73 Masker Nebulizer Dewasa Pcs 10 0 10 2 0 0 0 0 0 0 2 8
74 Masker Oksigen Dewasa Pcs 22 0 22 1 0 0 0 0 0 0 1 21
75 Micropore Pcs
76 Oksigen Nasal Kanul (Bayi) Pcs 5 0 5 0 0 0 0 0 0 0 0 5
77 Oksigen Nasal Kanul (Anak) Pcs 5 0 5 0 0 0 0 0 0 0 0 5
78 Oksigen Nasal Kanul (Dewasa) Pcs 3 0 3 1 0 0 0 0 0 0 1 2
79 Plaster 1,25 cm X 4,5 Yards Rol
 PENGELUARAN
JMLH
NO SATUAN STOK PENERI KETERSE PUSKESM PESANT PUSTU PENGEL SISA PKM
URUT NAMA OBAT KEMASAN AWAL MAAN DIAAN APOTEK UGD/ PUSTU PUSTU ED
LAINNYA AS REN SIBENPOPO MOREALA BOBANE UARAN
KELILING JAYA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
80 Plaster 2,5 cm X 4,5 Yards Rol 0 2 2 0 0 0 0 0 0 0 0 2
81 Plaster 5 cm X 4,5 Yards Rol 0 2 2 0 0 0 0 0 0 0 0 2
82 Plaster 7.5 cm X 4,5 yards Rol 7 0 7 2 0 0 0 0 0 0 2 5
83 Polifix 5 cm X 1 m Box 50 0 50 2 0 0 0 0 0 0 2 48
84 Polifix 5 cm X 5 m Box
85 Polifix 10 cm X 5 m Box
86 Policlean Botol
87 Poliwash Botol
88 Pot Dahak Botol
89 Povidon Iodion 10 %-60 ml Botol 9 0 9 1 1 0 0 1 0 1 4 5
90 Povidon Iodion 10 %-300 ml Botol 5 0 5 1 1 0 0 0 0 0 2 3
91 Povidon Iodion 10 %-1000 ml Botol
92 Rak Tabung Pcs
93 RDT Frambusia Box
94 RDT HIV Box 0 1 1 0 0 0 0 0 0 0 0 1
95 RDT Hepatitis Sachet
96 RDT Malaria Box
97 Reagen TB Paket 0 1 1 0 0 0 0 0 0 0 0 1
98 Rivanol Larutan 0.1% -100 ml Botol
99 Rivanol Larutan 0.1 % -300 ml Botol 24 0 24 0 2 0 0 0 0 0 2 22
100 Sabun Asepso Pcs
101 Silk Benang Bedah No.0/0 Box 0 2 2 0 0 0 0 0 0 0 0 2
102 Silk Benang Bedah No.1/0 Box
103 Silk Benang Bedah No.2/0 Box 1 2 3 0 0 0 0 0 0 0 0 3
104 Silk Benang Bedah No.3/0 Box 2 2 4 0 0 0 0 0 0 0 0 4
105 Silk Benang Bedah No.4/0 Box 0 2 2 0 0 0 0 0 0 0 0 2
106 Silk Benang Bedah No.5/0 Box 0 2 2 0 0 0 0 0 0 0 0 2
107 Silk Benang Bedah No.6/0 Box 0 2 2 0 0 0 0 0 0 0 0 2
108 Slide Box
109 Suction Catheter Pcs
110 Stik Asam Urat Box 2 0 2 0 0 0 0 0 0 0 0 2
 PENGELUARAN
JMLH
NO SATUAN STOK PENERI KETERSE PUSKESM PESANT PUSTU PENGEL SISA PKM
URUT NAMA OBAT KEMASAN AWAL MAAN DIAAN APOTEK UGD/ PUSTU PUSTU ED
LAINNYA AS REN SIBENPOPO MOREALA BOBANE UARAN
KELILING JAYA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
111 Stik Glukosa Box
112 Stik Kolesterol Box
113 Stik Hemoglobin Box 4 0 4 1 0 0 0 0 0 0 1 3
114 Stik Urinalisa Test Box 50 0 50 1 0 0 0 0 0 0 1 49
115 Tabung Reaksi Pcs
116 Tes Kehamilan Pcs 300 0 300 100 0 0 0 0 0 0 100 200
117 Transfusion Set Pcs
118 Ultrasonic Gel Botol
119 Under Pad Pcs
120 Urine Bag Pcs 20 0 20 0 0 0 0 0 0 0 0 20

BMHP Gigi
1 Caviton 30 gram
Glass Ionomer Cement Type II + Paper
2 Pad
Glass Ionomer Cement Type IX +
3 Paper Pad
4 Composit A2
5 Composit A3
6 Etsa
7 Bonding
8 Mikro Brush
9 Chlor Etyl
Devitec (Devitalizing Paste Arsenic
10 Free) 7 gram
11 Alveogyl
12 Intro Kit
13 Chresopen
14 Paper Point

Vaksin
 PENGELUARAN
JMLH
NO SATUAN STOK PENERI KETERSE PUSKESM PESANT PUSTU PENGEL SISA PKM
URUT NAMA OBAT KEMASAN AWAL MAAN DIAAN APOTEK UGD/ PUSTU PUSTU ED
LAINNYA AS REN SIBENPOPO MOREALA BOBANE UARAN
KELILING JAYA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
1 ADS 0,05 ml PCS
2 ADS 0,5 ml PCS
3 ADS 5 ml PCS
4 BCG Ampul
5 CAMPAK Vial
6 DPT-HB-HIB Vial
7 DT Vial
8 HB Uniject Vial
9 HbB 1 ml PCS
10 IPV Vial
11 MR Vial
12 Polio Vial
13 Td Vial
14 Serum Anti Bisa Ular (ABU) Vial
15 serum Anti Tetanus (ATS) Ampul
16 S.Box 2,5 ltr
17 S.Box 5 ltr
18 Vaksin Rabies

Obat-Obatan
283 Allopurinol 300 mg tablet 1800 0 1800 200 0 0 0 0 0 0 200 1600
284 Amlodipine 10 mg tablet 0 500 500 0 0 0 0 0 0 0 0 500
285 Diethylcarbamazine citrate 100 mg tablet 1500 0 1500 0 0 0 0 0 0 0 0 1500
286 Dimenhidrinate 50 mg tablet 900 0 900 200 0 0 0 0 0 0 200 700
287 Gentamisin Salep Mata tube 20 0 20 0 0 0 0 0 0 0 0 20
288 Loratadin 10 mg tablet
289 Metamizole Injeksi ampul 100 0 100 0 0 0 0 0 0 0 0 100
290 Metronidazole 250 mg tablet
291 Ventolin Nebules 2,5 mg pcs 10 20 30 10 0 0 0 0 0 0 10 20
292 Cetirizine tab 10 mg tablet 1500 0 1500 400 0 0 0 0 0 0 400 1100
293 methamizole tab tablet 5300 0 5300 0 0 0 0 0 0 100 100 5200
 PENGELUARAN
JMLH
NO SATUAN STOK PENERI KETERSE PUSKESM PESANT PUSTU PENGEL SISA PKM
URUT NAMA OBAT KEMASAN AWAL MAAN DIAAN APOTEK UGD/ PUSTU PUSTU ED
LAINNYA AS REN SIBENPOPO MOREALA BOBANE UARAN
KELILING JAYA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
294 nifedipne 20 mg tablet 355 0 355 0 0 0 0 0 0 0 0 355
295 kloramphenikol salep kulit tube 74 0 74 0 0 0 0 0 0 0 0 74
BMHP
121 Antiseptik Gel botol 33 0 33 3 0 0 0 0 0 0 3 30
122 Kasa Hidrofil Steril 16/16 pcs 65 20 85 25 0 0 0 0 0 0 25 60
123 Oxygen Mask Anak pcs 6 0 6 1 0 0 0 0 0 0 1 5
124 Reagen Siphylis AB pcs
125 Reagen Siphylis BD pcs
126 Sabun Anti Bakteri botol 4 0 4 2 0 0 0 0 0 0 2 2
127 HBSaG pcs
128 Surgical Gown M pcs 3 0 3 2 0 0 0 0 0 0 2 1
129 Wing Needle pcs
130 Baju Coverall PCS 30 0 30 0 0 0 0 0 0 0 0 30
131 Thermogun PCS 1 0 1 0 0 0 0 0 0 0 0 1
132 Masker N95 PCS 180 0 180 0 0 0 0 0 0 0 0 180
133 Rapid Tes Covid-19 PCS 5 0 5 0 5 0 0 0 0 0 5 0
134 masker hijab (skineer) pcs 2 10 12 1 0 0 0 0 0 0 1 11
135 MASKER PCS Bantuan
136 Papsmer Kit pcs 10 0 10 0 0 0 0 0 0 0 0 10
137 plester non woven Roll 5cmx5m box 0 20 20 0 0 0 0 0 0 0 0 20

Mengetahui/Menyetujui Yang Menyerahkan Yang Meminta Yang Menerima

Kepala Dinas Kesehatan Petugas GFK Kepala UPTD Puskesmas Petugas Pengelola Obat UPTD Puskesmas
Kabupaten Halmahera Tengah Rawat Inap Banemo Rawat Inap Banemo

Rusman Djafar, SKM Resky Yuliandany, Amd.Farm.

Nip. Nip. Nip. 19740306 199403 1 004 NIP.19951105 201903 2 007
 LAPORAN MUTASI OBAT DAN BAHAN MEDIS HABIS PAKAI (BMHP)
DINAS KASEHATAN KABUPATEN HALMAHERA TENGAH
PUSKESMAS : : Banemo BULAN : OKTOBER
KODE PUSKESMAS : P8202044201 TAHUN : 2020
KECAMATAN : Patani Barat
JUMLAH PUSTU/POLINDES :3
PENGELUARAN

SATUAN STOK PENERI JMLH

NO KETERSED
URUT NAMA OBAT KEMASAN AWAL MAAN IAAN UGD/
PUSKES
PUSTU PUSTU
PUSTU PENGELU SISA PKM ED
APOTEK MAS PESANTREN BOBANE ARAN
LAINNYA SIBENPOPO MOREALA
KELILING JAYA

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Obat-Obatan
1 Aciclovir 200 mg Tablet 1500 0 1500 0 0 0 0 0 0 0 0 1500
2 Aciclovir 400 mg Tablet 350 0 350 0 0 0 0 0 0 0 0 350
3 Aciclovir Krim Tube 59 0 59 0 0 0 0 0 0 0 0 59 59 ED 10/20
4 Aciclovir Salep Mata Tube
5 Adidryl injeksi-15 ml/ Recodril Vial 20 0 20 0 0 0 0 0 0 0 0 20
6 Adimidon Injeksi-15 ml/ Benodon Vial 10 0 10 0 0 0 0 0 0 0 0 10
7 Albendazol 400 mg Tablet 1850 0 1850 0 0 0 0 0 0 0 0 1850
8 Allopurinol 100 mg Tablet 0
9 Alprazolam 0,5 mg Tablet 288 0 288 18 0 0 0 0 0 0 18 270
10 Alprazolam 1 mg Tablet
11 Ambroxol 30 mg Tablet 1000 0 1000 0 0 0 0 100 0 0 100 900
12 Ambroxol Sirup Botol
13 Aminofilin 200 mg Tablet 1100 0 1100 0 0 0 0 0 0 0 0 1100 1100 ED 10/20
14 Aminofilin Injeksi-24 mg/ml 10 ml Ampul 30 0 30 0 0 0 0 0 0 0 0 30
15 Amoxisilin 250 mg Kapsul
16 Amoxisilin 500 mg Tablet 3700 0 3700 300 0 0 0 100 100 0 500 3200 400 ED 10/20
17 Amoxisilin Syr 125 mg/5 ml Botol 27 0 27 5 0 0 0 0 10 0 15 12
18 Amoxisilin Syr 250 mg/ 5 ml Botol 80 0 80 6 0 0 0 0 0 0 6 74
19 Ampicilin 250 mg kaplet
20 Ampisilin 500 mg Tablet 400 0 400 0 0 0 0 100 200 0 300 100
21 Ampisilin Injeksi Vial 18 0 18 0 0 0 0 0 0 0 0 18
22 Ampislin Syr 125 mg/5 ml Botol 25 0 25 0 0 0 0 0 0 0 0 25
23 Amlodipin 5 Mg Tablet 1600 0 1600 0 0 0 0 0 0 0 0 1600
24 Antalgin 500 mg Tablet
25 Antalgin Injeksi 250 mg/ml-2 ml Ampul
26 Antasida Doen Tablet 2100 0 2100 0 0 0 0 0 200 0 200 1900
27 Antasida Syr Botol 68 0 68 5 0 0 0 0 0 0 5 63
28 Anti Fungi Doen Kombinasi Pot 48 0 48 0 0 0 0 0 0 0 0 48
29 Anti Haemoroid Doen Kombinasi Supp
30 Artesunate Tablet
31 Artesunate inj Vial
32 Asam Ascorbat (Vit C ) 50 mg Tablet 2600 0 2600 1200 0 0 0 0 0 0 1200 1400
33 Asam Ascorbat (Vit C ) 250 mg Tablet
34 Asam Folat Tablet 1000 0 1000 200 0 0 0 0 0 0 200 800
35 Asam Mefenamat 250 mg Tablet
36 Asam Mefenamat 500 mg Tablet 1100 0 1100 300 0 0 0 100 200 0 600 500
37 Asam Tranexamat Tablet
38 Asam Tranexamat Injeksi Ampul
39 Asetosal 100 mg Tablet
40 Asetosal 500 mg Tablet
41 Atropin Sulfat Injeksi 0.25 mg/ml-1ml Ampul
42 Atropin Sulfat Tetes Mata 0.5 %-5 ml Botol
43 Atorvastatin 10 mg Tablet 2000 0 2000 100 0 0 0 0 0 0 100 1900 1100 ED 04/20
44 Aqua Pro Injeksi Steril-20 ml Ampul
45 Azitromycin Tablet 380 0 380 0 0 0 0 0 0 0 0 380 380 ED 10/20
46 Bacitracyn-Polimixyn Tube
47 Betammetason Krim 0.1%-5 gram Tube
48 Betahistin Mesylate Tablet
49 Bioplacenton Jely Tube 6 0 6 0 0 0 0 0 0 0 0 6
50 Buscopan Injeksi Ampul 10 0 10 0 0 0 0 0 0 0 0 10
51 Calcii Gluconas Ampul
52 Captopril 12.5 mg Tablet 2000 0 2000 400 0 0 0 0 0 0 400 1600
53 Captopril 25 mg Tablet 500 0 500 0 0 0 0 0 0 0 0 500
54 Caviplex Sirup Botol
55 Cefadroxil 250 mg Tablet
56 Cefadroxil 500 mg Tablet 1900 0 1900 0 0 0 0 0 0 0 0 1900
57 Cefadroxyl sirup 125 mg Botol 49 0 49 3 0 0 0 0 0 0 3 46
58 Cefadroxyl Sirup 250 mg Botol 45 0 45 3 0 0 0 0 0 0 3 42
59 Cefixime 200 mg Tablet
60 Cefixime Sirup 100 mg Botol
61 Cefotaxim Injeksi Vial
62 Ceftriaxone Injeksi Vial 0 0 0 0 0 0 0 0 0 0 0 0
63 Cetirizine Sirup Botol 36 0 36 25 0 0 0 0 0 0 25 11
64 Cimetidine 200 mg Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
65 Clindamycin 150 Mg Tablet 900 0 900 0 0 0 0 0 0 0 0 900
66 Clindamycin 300 Mg Tablet 900 0 900 0 0 0 0 0 0 0 0 900
67 Colchicine Tablet
68 Curcuma Suspensi Botol
69 Deksametasone 0.5 mg Tablet 1700 0 1700 0 0 0 0 100 100 0 200 1500
70 Deksametasone Injeksi 5 mg/ml-1 ml Ampul 100 0 100 80 0 0 0 10 10 0 100 0
71 Dermasolon Tube
72 Dexocort Tube
73 DHP Frimal Tablet 40 0 40 0 0 0 0 0 0 0 0 40
74 Diazepam 2 mg Tablet
75 Diazepam 5 mg Tablet 495 0 495 4 0 0 0 0 0 0 4 491
76 Diazepam Injeksi 5 mg/ml-2 ml/ stesol Ampul
77 Difenhidramin HCL Injeksi 10 mg/ml-1 Ampul 30 0 30 0 0 0 0 0 0 0 0 30
78 Diltiazem Tablet
79 Doksisiklin 100 mg Tablet 600 0 600 0 0 0 0 0 0 0 0 600 600 ED 10/20
80 Domperidon Tablet 2300 0 2300 0 0 0 0 0 0 0 0 2300
81 Domperidon Sirup Botol 33 0 33 0 0 0 0 0 0 0 0 33
82 Dulcolax 5 mg Tablet Tablet 210 0 210 0 0 0 0 0 0 0 0 210
83 Dulcolax Supositoria 5 mg anak Tablet
84 Dulcolax Supositoria 10 mg Dewasa Supp
85 Efedrin HCL 25 mg Tablet
86 Ephineprine HCL Injeksi 0.1% -1 ml Ampul 200 0 200 0 0 0 0 0 0 0 0 200
87 Eritromisin 250 mg Kapsul
88 Eritromisin 500 mg Kaplet 1700 0 1700 0 0 0 0 0 0 0 0 1700
89 Eritromisin Syr Kering 200 mg/ml-60 m Botol 115 0 115 0 0 0 0 0 0 0 0 115
90 Ethambutol 250 mg Tablet
91 Ethambutol 500 mg Tablet
92 Fenilbutason 200 mg Tablet
93 Fenobarbital 30 mg Tablet
94 Fenobarbital 100 mg Tablet
 95 Fenobarbital Injeksi 50 mg/ml-2 ml Ampul
96 Fitomenadion ( Vit K ) 10 mg Tablet 1000 0 1000 100 0 0 0 0 0 0 100 900
97 Fitomenadion ( Vit K ) Injeksi -1 ml Ampul 150 0 150 0 0 0 0 0 0 0 0 150 90 ED 10/20
98 Furosemide 40 mg Tablet 2000 0 2000 0 0 0 0 0 0 0 0 2000
99 Furosemide Injeksi Ampul
100 Gameksan Emulsi 1%-100 ml Botol
101 Garam Oralit 200 ml air Sachet 200 0 200 0 0 0 0 0 0 0 0 200
102 Gentamicin Injeksi Ampul
103 Gentamicin salep Kulit Tube 30 0 30 20 0 0 0 0 0 0 20 10
104 Gentamicin Tetes Mata Botol
105 Gentien Violet Larutan 1 % -10 ml Botol 24 0 24 0 0 0 0 4 2 0 6 18
106 Glibenklamide 5 mg Tablet 500 0 500 0 0 0 0 0 0 0 0 500
107 Glimepiride 1 mg Tablet
108 Glimepiride 2 mg Tablet 800 0 800 0 0 0 0 0 0 0 0 800
109 Gliseril Guaicolate 100 mg Tablet 1000 0 1000 100 0 0 0 50 50 0 200 800
110 Gliserin 100 ml Botol
111 Gliserin 1000 ml Tablet
112 Glukosa Injeksi 40 % Steril 25 ml Tablet
113 Glukosa Infus 5 % Steril -500 ml Tablet 200 0 200 0 0 0 0 0 0 0 0 200
114 Glukosa Infus 10 % Steril -500 ml Pot 80 0 80 0 0 0 0 0 0 0 0 80
115 Graxine Tablet
116 Griseofulvin 125 mg Tablet 2000 0 2000 0 0 0 0 0 0 0 0 2000
117 Haloperidol 0.5 mg Tablet
118 Haloperidol 1.5 mg Tablet
119 Haloperidol 5 mg Tablet
120 Haloperidol Injeksi Ampul
121 Hidroklosiasid (HCT )25 mg Tablet
122 Hidrokortison Krim 2.5 %-5 gram Tube
123 Ibuprofen sirup Botol 37 0 37 0 0 0 0 0 0 0 0 37
124 Ibuprofen 200 mg Tablet
125 Ibuprofen 400 mg Kapsul
126 Isoniasid (INH) 100 mg Tube
127 Isoniasid (INH) 300 mg Botol
128 Isosorbid Dinitrat Sublingual Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
129 Kalium Permangnat Serbuk 5 mg Tablet
130 Kalsium Laktat 500 mg Tablet 200 0 200 100 0 0 0 0 100 0 200 0
 131 Karbamazepin 200 mg Vial 150 0 150 150 0 0 0 0 0 0 150 0
132 Ketoconazole 200 mg Tablet Tablet 700 0 700 200 0 0 0 0 0 0 200 500
133 Ketoconazole Krim Tablet 50 0 50 40 0 0 0 5 5 0 50 0
134 Ketorolac Injeksi Ampul
135 Kinna ( Quinine )222 mg Tablet
136 Klorampenikol 250 mg Tablet 1900 0 1900 0 0 0 0 0 0 0 0 1900
137 Klorampenikol Salep Mata 1% Tube 134 0 134 0 0 0 0 0 0 0 0 134
138 Klorampenikol Sirup Botol 50 0 50 0 0 0 0 0 0 0 0 50
139 Klorampenikol Tetes Telinga Botol 21 0 21 0 0 0 0 0 0 0 0 21
1000 Klorampeniramin Maleat (CTM ) 4 mg Tablet 5000 0 5000 800 0 0 0 200 0 0 1000 4000
141 Kloroquin 150 mg Tablet
142 Kloroquin 250 mg Tablet
143 Kloroquin Injeksi-15 ml Ampul
144 Klorpromazin HCL 25 mg Tablet
145 Klorpromazin HCL 100 mg Tablet
146 Klorpromazin HCL Injeksi 5 mg/ml-2 m Ampul
147 Klorpromazin HCL Injeksi 25 mg/ml-1 Ampul
148 Klorpropamid 100 mg Tablet
149 Kodein fosfat HCL 10 mg Tablet
150 Kotrimoksazole Suspensi 60 ml Botol 79 0 79 0 0 0 0 0 0 0 0 79
151 Kotrimoksazole 120 mg Pediatrik Tablet
152 Kotrimoksazole 480 mg Dewasa Tablet 1000 0 1000 0 0 0 0 0 100 0 100 900
153 Kotrimoxazole Forte 960 mg Tablet
154 Larutan Irigasi Botol
155 Lansoprazole 30 mg Tablet 2300 0 2300 0 0 0 0 0 0 0 0 2300
156 Levopar Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
157 Lidokain Injeksi 2 %-2 ml Ampul 300 0 300 80 0 0 0 10 10 0 100 200
158 Lidokain Injeksi Compositum Ampul
159 Loperamid 2 Mg Tablet 900 0 900 0 0 0 0 0 0 0 0 900
160 Lorazepam tablet Tablet 300 0 300 0 0 0 0 0 0 0 0 300
161 Mebendazol Syr 100 mg/5 ml-30 ml Botol
162 Meloxicam 7,5 Mg Tablet 450 0 450 0 0 0 0 0 0 0 0 450
163 Meloxicam 15 Mg Tablet 350 0 350 0 0 0 0 0 0 0 0 350
164 Metilergomertin Maleat 0.125 mg Tablet
165 Metilergomertin Maleat Inj 0.200 mg/ml- Ampul
166 Metoclopramide Tablet 1700 0 1700 0 0 0 0 0 0 0 0 1700
167 Metoclopramide Drops Botol 20 0 20 0 0 0 0 0 0 0 0 20
168 Metoclopramide Sirup Botol
169 Metoclorpamide Injeksi Ampul 20 0 20 0 0 0 0 0 0 0 0 20
170 Metronidazole 500 mg Tablet 1100 0 1100 200 0 0 0 0 100 0 300 800
171 Metronidazole Sirup Botol
172 Methylprednisolon 4 Mg Tablet 5400 0 5400 0 0 0 0 0 0 0 0 5400
173 Methylprednisolon 8 Mg Tablet 2500 0 2500 0 0 0 0 0 0 0 0 2500
174 Methylprednisolon 16 Mg Tablet
175 Methylprednisolon Injeksi 125 Mg Ampul
176 Methylprednisolon Injeksi 500 mg Ampul
177 Metformin 500 Mg Tablet
178 MgSO4 20 % Flacon 28 0 28 0 0 0 0 0 0 0 0 28 20 ED 10/20
179 MgSO4 40 % Flacon
180 Miconazole Zalf Tube
181 Microdiol strip
182 Mineral Mix Sachet 259 0 259 0 0 0 0 0 0 0 0 259
183 Natrium Diclofenak 25 mg Tablet 700 0 700 0 0 0 0 0 0 0 0 700
184 Natrium Diclofenak 50 mg Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
185 Natrium Fenitoin Injeksi 50mg/ml Ampul
186 Natrium Klorida Infus 0.9 % Steril 500 Botol 22 40 62 20 0 0 0 0 0 0 20 42
187 New Diatabs/ New Antides Tablet
188 Nifedipin 10 mg Tablet
189 Nistatin tablet 500.000 IU Tablet 400 0 400 0 0 0 0 0 0 0 0 400
190 Nistatin tablet Vaginal 100.000 IU Supp
191 Obat Anti Tuberkulosis Kategori 1 De Paket
192 Obat Anti Tuberkulosis Kategori 2 De Paket
193 Obat Anti Tuberkulosis Kategori 3 De Paket
194 Obat Anti Tuberkulosis Kategori Anak Paket
195 Obat Anti Tuberkulosis Sisipan Paket
196 Obat Batuk Hitam Syr 100 ml Botol 9 0 9 9 0 0 0 0 0 0 9 0
197 Obat Batuk Putih Syr 100 ml Botol
198 Oksitetrasiklin HCL Injeksi 50 mg/ml-1 Vial
199 Oksitetrasiklin HCL Salep Kulit 3 %-5 Tube
200 Oksitetrasiklin HCL Salep Mata 1 %-3. Tube 25 0 25 22 0 0 0 3 0 0 25 0
201 Oksitosin Injeksi 10 IU/ml-8 ml Vial 30 0 30 0 0 0 0 0 0 0 0 30
202 Omeprazole Tablet 5490 0 5490 930 0 0 0 0 0 0 930 4560
203 Omeprazole Injeksi Vial
204 Ondansetron Injeksi Ampul
205 Papaverin 40 mg Tablet 3000 0 3000 0 0 0 0 0 1000 0 1000 2000
206 Papaverin Injeksi 40 mg/ml-8 ml Ampul
207 Parasetamol Drops Vial 9 0 9 0 0 0 0 0 0 0 0 9
208 Parasetamol 500 mg Tablet 6000 0 6000 400 0 0 0 100 200 0 700 5300
209 Paracetamol Injeksi Botol 24 0 24 0 0 0 0 0 0 0 0 24
210 Parasetamol Syr 60 ml Botol 20 0 20 13 0 0 0 0 0 0 13 7
211 Pethidin HCL Injeksi 50 mg/ml-2 ml Ampul
212 Phenol Gliserol Botol
213 Piracetam 400 Mg Tablet
214 Piracetam 800 Mg Tablet
215 Piracetam Injeksi 5 ml Ampul
216 Piracetam Injeksi 15 ml Ampul
217 Pirazinamide Tablet
218 Pirantel Pamoat 125 mg Tablet 400 0 400 0 0 0 0 0 0 0 0 400
219 Pirantel Pamoat Sirup Botol
220 Piroxicam 10 mg Tablet 1300 0 1300 0 0 0 0 0 200 0 200 1100
221 Piroxicam 20 mg Tablet 1200 0 1200 600 0 0 0 0 0 0 600 600
222 Pirodoksine HCL (B 6 ) 10 mg Tablet 2700 0 2700 0 0 0 0 100 200 0 300 2400
223 Prednison 5 mg Tablet 300 0 300 200 0 0 0 0 0 0 200 100
224 Primaquin 15 mg Tablet 100 0 100 0 0 0 0 0 0 0 0 100
225 Prokain Benzil Penisilin Vial
226 Propranolol HCL 10 mg Tablet 500 0 500 0 0 0 0 0 0 0 0 500
227 Propranolol HCL 40 mg Tablet
228 Propiltiuracil (PTU) Tablet
229 Ranitidine 150 mg Tablet
230 Ranitidine Injeksi 50 mg/ml-2ml Ampul 30 0 30 0 0 0 0 0 0 0 0 30
231 Reserpin 0.10 mg Tablet
232 Reserpin 0.25 mg Tablet
233 Retinol ( VIT A )6.000 IU Tablet
234 Retinol ( VIT A )25.000 IU Tablet
235 Retinol ( VIT A )50.000 IU Tablet
236 Retinol ( VIT A )100.000 IU Tablet 500 0 500 0 0 0 0 0 0 0 0 500 500 ED 10/20
237 Retinol ( VIT A )200.000 IU Tablet 500 0 500 0 0 0 0 0 0 0 0 500
238 Ringer Laktat Larutan Infus Steril-500 Botol 20 0 20 0 0 0 0 0 0 0 0 20
239 Ringer Laktat Larutan Infus Steril-100 Botol 20 0 20 0 0 0 0 0 0 0 0 20
240 Risperidone 2 mg Tablet
241 Salbutamol 2 mg Tablet 4500 0 4500 0 0 0 0 0 0 0 0 4500 4500 ED 10/20
242 Salbutamol 4 mg Tablet 1700 0 1700 0 0 0 0 0 0 0 0 1700
243 Salbutamol sirup Botol
244 Salep Ichtyol 30 gram Pot 24 0 24 0 0 0 0 0 0 0 0 24
245 Salep Levetran Pot
246 Salep Scabisid Tube
247 Salicyl Bedak 2 %-50 gram Dos 42 0 42 5 0 0 0 0 0 0 5 37 37 ED 10/20
248 Salicyl Spritus 10 % -25 ml Botol
249 Salep 2-4 Botol 48 0 48 0 0 0 0 0 0 0 0 48
250 Sianocobalamin( VIT B 12 ) 50 mg Tablet 5800 0 5800 0 0 0 0 0 0 0 0 5800
251 Sianocobalalamin ( VIT B 12 ) 500 mg/ Ampul 300 0 300 0 0 0 0 0 0 0 0 300
252 Sianocobalalamin ( VIT B 12 ) 500 mg/ Vial
253 Simvastatin 10 mg Tablet 630 0 630 0 0 0 0 0 60 0 60 570
254 Simvastatin 20 mg Tablet 390 0 390 0 0 0 0 0 0 0 0 390
255 Siprofloksacin 250 mg Tablet
256 Siprofloksacin 500 mg Tablet 1000 0 1000 200 0 0 0 0 0 0 200 800
257 Sodium Bicaronat Tablet 1000 0 1000 100 0 0 0 0 0 0 100 900
258 Streptomicin Injeksi 1 gram Vial
259 Streptomicin Injeksi 1.5 gram Vial
260 Sulfadoxin Pirimenthamin 525 mg Tablet
261 Sulfacetamid Sodium Tetes mata Botol
262 Tablet Tambah Darah (SF ) Tablet 2000 0 2000 750 0 0 0 120 180 0 1050 950
263 Tetrakain HCL Tetes Mata 0.5 %-5 ml Botol
264 Tetrasiklin HCL 250 mg Kapsul
265 Tetrasiklin HCL 500 mg Kapsul
266 Theophylline Tablet
267 Thiamin HCL ( B 1 ) 50 mg Tablet 20800 0 20800 0 0 0 0 0 0 0 0 20800
268 Thiamin HCL ( B 1 ) Injeksi - 1 ml Ampul 1170 0 1170 0 0 0 0 0 0 0 0 1170
269 Thiamin HCL ( B 1 ) Injeksi-15 ml Vial
270 Tramadol 50 mg Tablet
271 Tramadol Injeksi Ampul 40 0 40 0 0 0 0 0 0 0 0 40
272 Triheksipenidil Hidroklorida 2 mg Tablet 250 0 250 40 0 0 0 0 0 0 40 210
273 Ventolin Inhaler Botol
274 Verapamil 80 mg Tablet
275 Vitamin B Kompleks Tablet 1290 0 1290 0 0 0 0 0 0 0 0 1290
276 Vitamin B Kompleks Injeksi -15 ml Vial
277 Vitamin B 6 Tablet 2700 0 2700 0 0 0 0 100 200 0 300 2400
278 Vitamin B 6 Injeksi Ampul 100 0 100 0 0 0 0 0 0 0 0 100
279 Vitamin K4 Tablet
280 Wida KDN 1 Botol
281 Wida KN 1 Botol
282 Zink Tablet 300 0 300 0 0 0 0 0 0 0 0 300

BMHP
1 3 way Pcs 10 0 10 0 0 0 0 0 0 0 0 10
2 Abocath No.18 Pcs 138 0 138 0 0 0 0 0 0 0 0 138
3 Abocath No.20 Pcs
4 Abocath No.22 Pcs 49 0 49 0 0 0 0 0 0 0 0 49
5 Abocath No.24 Pcs 40 0 40 3 0 0 0 0 0 0 3 37
6 Abocath No.26 Pcs 27 0 27 0 0 0 0 0 0 0 0 27
7 Alkohol 100 ml Botol
8 Alkohol 300 ml Botol
9 Alkohol 1000 ml Botol 2 0 2 0 0 0 0 0 0 0 0 2
10 Alkohol Swab Box 2 0 2 0 0 0 0 0 0 0 0 2
11 Bisturi (Pisau Bedah )No.10 Biji 200 0 200 0 0 0 0 0 0 0 0 200
12 Bisturi (Pisau Bedah )No.11 Biji 100 0 100 0 0 0 0 0 0 0 0 100
13 Bisturi (Pisau Bedah )No.12 Biji 100 0 100 0 0 0 0 0 0 0 0 100
14 Bisturi (Pisau Bedah )No.20 Biji 200 0 200 0 0 0 0 0 0 0 0 200
15 Bisturi (Pisau Bedah )No.21 Biji 200 0 200 0 0 0 0 0 0 0 0 200
16 Bisturi (Pisau Bedah )No.22 Biji 100 0 100 0 0 0 0 0 0 0 0 100
17 Bisturi (Pisau Bedah )No.23 Biji 100 0 100 0 0 0 0 0 0 0 0 100
18 Bisturi (Pisau Bedah )No.24 Biji
19 Blood Lancet Box 3 0 3 0 0 0 0 0 0 0 0 3
20 Catgut/Benang Bedah Chromic No.2/0 Box 2 0 2 0 0 0 0 0 0 0 0 2
21 Catqut/Benang Bedah Chromic 3/0 Box 2 0 2 0 0 0 0 0 0 0 0 2
22 Catqut/Benang Bedah Plain 2/0 Box
23 Catqut/Benang Bedah Plain 3/0 Box 2 0 2 0 0 0 0 0 0 0 0 2
24 Cutisorb Pcs 25 0 25 1 0 0 0 0 0 0 1 24
25 Disposible 1 ml Pcs 300 0 300 0 0 0 0 0 0 0 0 300
26 Disposible 2.5 ml Pcs
27 Disposible 3 ml Pcs 400 0 400 70 0 0 0 15 15 0 100 300
28 Disposible 5 ml Pcs 100 0 100 0 0 0 0 0 0 0 0 100
29 Disposible 10 ml Pcs 200 0 200 0 0 0 0 0 0 0 0 200
30 Disposible 20 ml Pcs 100 0 100 0 0 0 0 0 0 0 0 100
31 Elastis Perban 7,5 X 4,55 Pcs
32 Elastis Perban 10 X 4,55 Pcs
33 Etil Klorida Semprot 100 ml Botol 3 0 3 0 0 0 0 0 0 0 0 3
34 Foley Catheter No. 06 PCS 10 0 10 0 0 0 0 0 0 0 0 10
35 Foley Catheter No. 08 PCS 10 0 10 0 0 0 0 0 0 0 0 10
36 Foley Catheter No. 10 PCS 10 0 10 0 0 0 0 0 0 0 0 10
37 Foley Catheter No. 12 PCS 10 0 10 0 0 0 0 0 0 0 0 10
38 Foley Catheter No. 14 PCS 10 0 10 0 0 0 0 0 0 0 0 10
39 Foley Catheter No. 16 PCS
40 Foley Catheter No. 18 PCS 29 0 29 0 0 0 0 0 0 0 0 29
41 Foley Catheter No. 20 PCS 10 0 10 0 0 0 0 0 0 0 0 10
42 Foley Catheter No. 22 PCS 20 0 20 0 0 0 0 0 0 0 0 20
43 Foley Catheter No. 24 PCS 19 0 19 0 0 0 0 0 0 0 0 19
44 Formalin Botol
45 Giemza Botol
46 H2O2 Botol
47 Handscoon Obgyn pasang 90 0 90 0 0 0 0 0 0 0 0 90
48 Hand Scoen (Sarung Tangan ) Uk. XS box
49 Hand Scoen ( Sarung Tangan )Uk. S box 13 0 13 1 0 0 0 0 0 0 1 12
50 Hand Scoen ( Sarung Tangan )Uk. M box 3 0 3 3 0 0 0 0 0 0 3 0
51 Hand Scoen ( Sarung Tangan )Uk. L box 7 0 7 1 1 0 0 0 0 0 2 5
52 Hand Scoen Steril (Sarung Tangan ) No Pasang 70 0 70 5 5 0 0 0 0 0 10 60
53 Hand Scoen Steril ( Sarung Tangan )No Pasang 50 0 50 16 10 0 0 0 0 0 26 24
54 Hand Scoen Steril ( Sarung Tangan )No Pasang 23 0 23 10 0 0 0 0 0 0 10 13
55 Hand Scoen Steril ( Sarung Tangan )No Pasang 150 0 150 3 0 0 0 0 0 0 3 147
56 Hand Scoen Steril ( Sarung Tangan )No Pasang 150 0 150 0 0 0 0 0 0 0 0 150
57 HCL 0,1 N Botol
58 Infuset Anak Pcs 67 0 67 1 0 0 0 0 0 0 1 66
59 Infuset Dewasa Pcs 46 0 46 0 0 0 0 0 0 0 0 46
60 Kapas Pembalut/ Absorben 250 gram Rol
61 Kapas Pembalut/ Absorben 1000 gram Rol
62 Kasa Hidrofil 80 cm X 2 m Lembar
63 Kasa Hidrofil Pembalut 3 cm X 4 m Rol
64 Kasa Hidrofil Pembalut 6 cm X 4 m Rol
65 Kasa Hidrofil Pembalut 15 cm X 4 m Rol 113 0 113 15 0 0 0 0 0 0 15 98
66 Kasa Hidrofil Pembalut 80 cm X 4 m Rol
67 Kasa Kompres Steril 16 cm X 16 cm Rol
68 Kasa Kompres Steril 40 cm X 80 cm Rol
69 Leukomed Pcs
70 Masker Box 5 0 5 2 0 0 0 0 0 0 2 3
71 Masker Hijab Box
72 Masker Nebulizer Anak Pcs
73 Masker Nebulizer Dewasa Pcs 8 0 8 3 0 0 0 0 0 0 3 5
74 Masker Oksigen Dewasa Pcs 21 0 21 1 0 0 0 0 0 0 1 20
75 Micropore Pcs
76 Oksigen Nasal Kanul (Bayi) Pcs 5 0 5 1 0 0 0 0 0 0 1 4
77 Oksigen Nasal Kanul (Anak) Pcs 5 0 5 0 0 0 0 0 0 0 0 5
78 Oksigen Nasal Kanul (Dewasa) Pcs 2 0 2 1 0 0 0 0 0 0 1 1
79 Plaster 1,25 cm X 4,5 Yards Rol
80 Plaster 2,5 cm X 4,5 Yards Rol 2 0 2 0 0 0 0 0 0 0 0 2
81 Plaster 5 cm X 4,5 Yards Rol 2 0 2 0 0 0 0 0 0 0 0 2
82 Plaster 7.5 cm X 4,5 yards Rol 5 0 5 0 0 0 0 0 0 0 0 5
83 Polifix 5 cm X 1 m Box 48 0 48 0 0 0 0 0 0 0 0 48
84 Polifix 5 cm X 5 m Box
85 Polifix 10 cm X 5 m Box
86 Policlean Botol
87 Poliwash Botol
88 Pot Dahak Botol
89 Povidon Iodion 10 %-60 ml Botol 5 0 5 1 0 0 0 2 0 0 3 2
90 Povidon Iodion 10 %-300 ml Botol 3 0 3 1 0 0 0 0 0 0 1 2
91 Povidon Iodion 10 %-1000 ml Botol
92 Rak Tabung Pcs
93 RDT Frambusia Box
94 RDT HIV PCS 25 0 25 11 0 0 0 0 0 0 11 14
95 RDT Hepatitis Sachet
96 RDT Malaria Box
97 Reagen TB Paket 1 0 1 1 0 0 0 0 0 0 1 0
98 Rivanol Larutan 0.1% -100 ml Botol
 99 Rivanol Larutan 0.1 % -300 ml Botol 22 0 22 0 0 0 0 0 0 0 0 22
100 Sabun Asepso Pcs
101 Silk Benang Bedah No.0/0 Box 2 0 2 1 0 0 0 0 0 0 1 1
102 Silk Benang Bedah No.1/0 Box
103 Silk Benang Bedah No.2/0 Box 3 0 3 0 0 0 0 0 0 0 0 3
104 Silk Benang Bedah No.3/0 Box 4 0 4 0 0 0 0 0 0 0 0 4
105 Silk Benang Bedah No.4/0 Box 2 0 2 0 0 0 0 0 0 0 0 2
106 Silk Benang Bedah No.5/0 Box 2 0 2 0 1 0 0 0 0 0 1 1
107 Silk Benang Bedah No.6/0 Box 2 0 2 0 0 0 0 0 0 0 0 2
108 Slide Box
109 Suction Catheter Pcs
110 Stik Asam Urat Box 2 0 2 0 0 0 0 0 0 0 0 2
111 Stik Glukosa Box
112 Stik Kolesterol Box
113 Stik Hemoglobin Box 3 0 3 1 0 0 0 0 0 0 1 2
114 Stik Urinalisa Test Box 49 0 49 0 0 0 0 0 0 0 0 49
115 Tabung Reaksi Pcs
116 Tes Kehamilan Pcs 200 0 200 80 0 0 0 10 10 0 100 100
117 Transfusion Set Pcs
118 Ultrasonic Gel Botol
119 Under Pad Pcs
120 Urine Bag Pcs 20 0 20 0 0 0 0 0 0 0 0 20

BMHP Gigi
1 Caviton 30 gram
Glass Ionomer Cement Type II +
2 Paper Pad
Glass Ionomer Cement Type IX +
3 Paper Pad
4 Composit A2
5 Composit A3
6 Etsa
7 Bonding
8 Mikro Brush
9 Chlor Etyl
 Devitec (Devitalizing Paste Arsenic
10 Free) 7 gram
11 Alveogyl
12 Intro Kit
13 Chresopen
14 Paper Point

Vaksin
1 ADS 0,05 ml PCS
2 ADS 0,5 ml PCS
3 ADS 5 ml PCS
4 BCG Ampul
5 CAMPAK Vial
6 DPT-HB-HIB Vial
7 DT Vial
8 HB Uniject Vial
9 HbB 1 ml PCS
10 IPV Vial
11 MR Vial
12 Polio Vial
13 Td Vial
14 Serum Anti Bisa Ular (ABU) Vial
15 serum Anti Tetanus (ATS) Ampul
16 S.Box 2,5 ltr
17 S.Box 5 ltr
18 Vaksin Rabies

Obat-Obatan
283 Allopurinol 300 mg tablet 1600 0 1600 0 0 0 0 0 0 0 0 1600
284 Amlodipine 10 mg tablet 500 0 500 250 0 0 0 0 0 0 250 250
285 Diethylcarbamazine citrate 100 mg tablet 1500 0 1500 0 0 0 0 0 0 0 0 1500
286 Dimenhidrinate 50 mg tablet 700 0 700 300 0 0 0 0 0 0 300 400
287 Gentamisin Salep Mata tube 20 0 20 0 0 0 0 0 0 0 0 20
288 Loratadin 10 mg tablet
289 Metamizole Injeksi ampul 100 0 100 0 0 0 0 0 0 0 0 100
290 Metronidazole 250 mg tablet
291 Ventolin Nebules 2,5 mg pcs 20 0 20 20 0 0 0 0 0 0 20 0
292 Cetirizine tab 10 mg tablet 1100 0 1100 300 0 0 0 0 0 0 300 800
293 methamizole tab tablet 5200 0 5200 0 0 0 0 0 200 0 200 5000
294 nifedipne 20 mg tablet 355 0 355 0 0 0 0 0 0 0 0 355
295 kloramphenikol salep kulit tube 74 0 74 0 0 0 0 0 0 0 0 74
BMHP
121 Antiseptik Gel botol 30 0 30 1 0 0 0 0 0 0 1 29
122 Kasa Hidrofil Steril 16/16 pcs 60 0 60 20 0 0 0 0 0 0 20 40
123 Oxygen Mask Anak pcs 5 0 5 0 0 0 0 0 0 0 0 5
124 Reagen Siphylis AB pcs
125 Reagen Siphylis BD pcs
126 Sabun Anti Bakteri botol 2 0 2 1 0 0 0 0 0 0 1 1
127 HBSaG pcs
128 Surgical Gown M pcs 1 0 1 0 0 0 0 0 0 0 0 1
129 Wing Needle pcs
130 Baju Coverall PCS 30 0 30 0 0 0 0 0 0 0 0 30
131 Thermogun PCS 1 0 1 0 0 0 0 0 0 0 0 1
132 Masker N95 PCS 180 0 180 0 0 0 0 0 0 0 0 180
133 Rapid Tes Covid-19 PCS
134 masker hijab (skineer) pcs 11 0 11 1 1 0 0 0 0 0 2 9
135 MASKER PCS Bantuan
136 Papsmer Kit pcs 10 0 10 0 0 0 0 0 0 0 0 10
137 plester non woven Roll 5cmx5m box 20 0 20 0 0 0 0 0 0 0 0 20

Mengetahui/Menyetujui Yang Menyerahkan Yang Meminta Yang Menerima

Kepala Dinas Kesehatan Petugas GFK Kepala UPTD Puskesmas Petugas Pengelola Obat UPTD Puskesmas
Kabupaten Halmahera Tengah Rawat Inap Banemo Rawat Inap Banemo

Rusman Djafar, SKM Resky Yuliandany, Amd.Farm.

Nip. Nip. Nip. 19740306 199403 1 004 NIP.19951105 201903 2 007
0/20
0/20
 LAPORAN MUTASI OBAT DAN BAHAN MEDIS HABIS PAKAI (BMHP)
DINAS KASEHATAN KABUPATEN HALMAHERA TENGAH
PUSKESMAS : : Banemo BULAN : NOVEMBER
KODE PUSKESMAS : P8202044201 TAHUN : 2020
KECAMATAN : Patani Barat
JUMLAH PUSTU/POLINDES :3
PENGELUARAN
SATUAN JMLH
NO
NAMA OBAT KEMASA STOK PENERI KETERSE
DIAAN APOTEK UGD/
PUSKES
PESANTR PUSTU
PUSTU PUSTU PENGELUA SISA
ED
URUT
N AWAL MAAN MAS MOREAL BOBANE RAN
PKM
LAINNYA EN SIBENPOPO
KELILING A JAYA

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Obat-Obatan
1 Aciclovir 200 mg Tablet 1500 0 1500 0 0 0 0 100 0 0 100 1400
2 Aciclovir 400 mg Tablet 350 0 350 100 0 0 0 0 0 0 100 250
3 Aciclovir Krim Tube
4 Aciclovir Salep Mata Tube
5 Adidryl injeksi-15 ml/ Recodril Vial 20 0 20 0 0 0 0 0 0 0 0 20
6 Adimidon Injeksi-15 ml/ Benodon Vial 10 0 10 10 0 0 0 0 0 0 10 0
7 Albendazol 400 mg Tablet 1850 0 1850 0 0 0 0 0 0 0 0 1850
8 Allopurinol 100 mg Tablet 0 2000 2000 0 0 0 0 0 0 100 100 1900
9 Alprazolam 0,5 mg Tablet 270 0 270 27 0 0 0 0 0 0 27 243
10 Alprazolam 1 mg Tablet
11 Ambroxol 30 mg Tablet 900 0 900 300 0 0 0 100 200 100 700 200
12 Ambroxol Sirup Botol
13 Aminofilin 200 mg Tablet 0 0 0 0 0 0 0 0 0 0 0
14 Aminofilin Injeksi-24 mg/ml 10 ml Ampul 30 0 30 0 0 0 0 0 0 0 0 30
15 Amoxisilin 250 mg Kapsul
16 Amoxisilin 500 mg Tablet 2800 1000 3800 600 0 0 0 100 200 200 1100 2700
17 Amoxisilin Syr 125 mg/5 ml Botol 12 0 12 0 0 0 0 5 0 5 10 2
18 Amoxisilin Syr 250 mg/ 5 ml Botol 74 0 74 0 0 0 0 0 0 0 0 74
19 Ampicilin 250 mg kaplet
20 Ampisilin 500 mg Tablet 100 1000 1100 100 0 0 0 0 100 0 200 900
21 Ampisilin Injeksi Vial 18 0 18 0 0 0 0 0 0 0 0 18
22 Ampislin Syr 125 mg/5 ml Botol 25 0 25 0 0 0 0 3 0 0 3 22
23 Amlodipin 5 Mg Tablet 1600 0 1600 0 0 0 0 0 0 0 0 1600
24 Antalgin 500 mg Tablet
25 Antalgin Injeksi 250 mg/ml-2 ml Ampul
26 Antasida Doen Tablet 1900 0 1900 200 0 0 0 100 0 100 400 1500
27 Antasida Syr Botol 63 0 63 17 0 0 0 5 0 0 22 41
28 Anti Fungi Doen Kombinasi Pot 48 0 48 0 0 0 0 0 0 0 0 48
29 Anti Haemoroid Doen Kombinasi Supp
30 Artesunate Tablet
31 Artesunate inj Vial
32 Asam Ascorbat (Vit C ) 50 mg Tablet 1400 0 1400 1100 0 0 0 100 200 0 1400 0
33 Asam Ascorbat (Vit C ) 250 mg Tablet
34 Asam Folat Tablet 800 0 800 600 0 0 0 0 200 0 800 0
35 Asam Mefenamat 250 mg Tablet
36 Asam Mefenamat 500 mg Tablet 500 5000 5500 600 0 0 0 100 0 200 900 4600
37 Asam Tranexamat Tablet
38 Asam Tranexamat Injeksi Ampul
39 Asetosal 100 mg Tablet
40 Asetosal 500 mg Tablet
41 Atropin Sulfat Injeksi 0.25 mg/ml-1ml Ampul
42 Atropin Sulfat Tetes Mata 0.5 %-5 ml Botol
43 Atorvastatin 10 mg Tablet 800 0 800 0 0 0 0 0 0 0 0 800
44 Aqua Pro Injeksi Steril-20 ml Ampul
45 Azitromycin Tablet
46 Bacitracyn-Polimixyn Tube
47 Betammetason Krim 0.1%-5 gram Tube 0 25 25 25 0 0 0 0 0 0 25 0
48 Betahistin Mesylate Tablet
49 Bioplacenton Jely Tube 6 0 6 0 0 0 0 0 0 0 0 6
50 Buscopan Injeksi Ampul 10 0 10 0 0 0 0 0 0 0 0 10
51 Calcii Gluconas Ampul
52 Captopril 12.5 mg Tablet 1600 1000 2600 600 0 0 0 100 0 200 900 1700
53 Captopril 25 mg Tablet 500 0 500 200 0 0 0 0 0 0 200 300
54 Caviplex Sirup Botol
55 Cefadroxil 250 mg Tablet
56 Cefadroxil 500 mg Tablet 1900 0 1900 300 0 0 0 0 0 100 400 1500
57 Cefadroxyl sirup 125 mg Botol 46 0 46 1 0 0 0 0 0 0 1 45
58 Cefadroxyl Sirup 250 mg Botol 42 0 42 1 0 0 0 0 0 0 1 41
59 Cefixime 200 mg Tablet
60 Cefixime Sirup 100 mg Botol
61 Cefotaxim Injeksi Vial
62 Ceftriaxone Injeksi Vial
63 Cetirizine Sirup Botol 11 100 111 14 0 0 0 0 0 0 14 97
64 Cimetidine 200 mg Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
65 Clindamycin 150 Mg Tablet 900 0 900 0 0 0 0 0 0 0 0 900
66 Clindamycin 300 Mg Tablet 900 0 900 0 0 0 0 0 0 0 0 900
67 Colchicine Tablet
68 Curcuma Suspensi Botol
69 Deksametasone 0.5 mg Tablet 1500 0 1500 0 0 0 0 100 300 100 500 1000
70 Deksametasone Injeksi 5 mg/ml-1 ml Ampul 0 100 100 0 0 0 0 0 0 0 0 100
71 Dermasolon Tube 0 24 24 24 0 0 0 0 0 24 0
72 Dexocort Tube
73 DHP Frimal Tablet 40 0 40 0 0 0 0 0 0 0 0 40
74 Diazepam 2 mg Tablet
75 Diazepam 5 mg Tablet 491 0 491 0 0 0 0 0 0 0 0 491
76 Diazepam Injeksi 5 mg/ml-2 ml/ steso Ampul
77 Difenhidramin HCL Injeksi 10 mg/ml- Ampul 30 0 30 0 0 0 0 0 0 0 0 30
78 Diltiazem Tablet
79 Doksisiklin 100 mg Tablet
80 Domperidon Tablet 2300 0 2300 100 0 0 0 0 0 100 200 2100
81 Domperidon Sirup Botol 33 0 33 4 0 0 0 0 0 0 4 29
82 Dulcolax 5 mg Tablet Tablet 210 0 210 20 0 0 0 0 0 0 20 190
 83 Dulcolax Supositoria 5 mg anak Tablet
84 Dulcolax Supositoria 10 mg Dewasa Supp
85 Efedrin HCL 25 mg Tablet
86 Ephineprine HCL Injeksi 0.1% -1 ml Ampul 200 0 200 0 0 0 0 0 0 0 0 200
87 Eritromisin 250 mg Kapsul
88 Eritromisin 500 mg Kaplet 1700 0 1700 0 0 0 0 0 0 0 0 1700
89 Eritromisin Syr Kering 200 mg/ml-60 Botol 115 0 115 0 0 0 0 0 0 0 0 115
90 Ethambutol 250 mg Tablet
91 Ethambutol 500 mg Tablet
92 Fenilbutason 200 mg Tablet
93 Fenobarbital 30 mg Tablet
94 Fenobarbital 100 mg Tablet
95 Fenobarbital Injeksi 50 mg/ml-2 ml Ampul
96 Fitomenadion ( Vit K ) 10 mg Tablet 900 0 900 0 0 0 0 100 0 0 100 800
97 Fitomenadion ( Vit K ) Injeksi -1 ml Ampul 60 0 60 60 0 0 0 0 0 0 60 0
98 Furosemide 40 mg Tablet 2000 0 2000 0 0 0 0 0 0 0 0 2000
99 Furosemide Injeksi Ampul
100 Gameksan Emulsi 1%-100 ml Botol
101 Garam Oralit 200 ml air Sachet 200 0 200 0 0 0 0 0 0 0 0 200
102 Gentamicin Injeksi Ampul
103 Gentamicin salep Kulit Tube 10 20 30 20 0 0 0 0 0 0 20 10
104 Gentamicin Tetes Mata Botol
105 Gentien Violet Larutan 1 % -10 ml Botol 18 24 42 10 0 0 0 5 3 0 18 24
106 Glibenklamide 5 mg Tablet 500 0 500 100 0 0 0 0 0 0 100 400
107 Glimepiride 1 mg Tablet
108 Glimepiride 2 mg Tablet 800 0 800 50 0 0 0 0 0 0 50 750
109 Gliseril Guaicolate 100 mg Tablet 800 0 800 600 0 0 0 0 200 0 800 0
110 Gliserin 100 ml Botol
111 Gliserin 1000 ml Tablet
112 Glukosa Injeksi 40 % Steril 25 ml Tablet
113 Glukosa Infus 5 % Steril -500 ml Tablet 200 0 200 0 0 0 0 0 0 0 0 200
114 Glukosa Infus 10 % Steril -500 ml Pot 80 0 80 0 0 0 0 0 0 0 0 80
 115 Graxine Tablet
116 Griseofulvin 125 mg Tablet 2000 0 2000 200 0 0 0 100 0 100 400 1600
117 Haloperidol 0.5 mg Tablet
118 Haloperidol 1.5 mg Tablet
119 Haloperidol 5 mg Tablet
120 Haloperidol Injeksi Ampul
121 Hidroklosiasid (HCT )25 mg Tablet
122 Hidrokortison Krim 2.5 %-5 gram Tube 0 48 48 24 0 0 0 0 0 0 24 24
123 Ibuprofen sirup Botol 37 0 37 0 0 0 0 0 0 0 0 37
124 Ibuprofen 200 mg Tablet 0 1000 1000 300 0 0 0 0 0 100 400 600
125 Ibuprofen 400 mg Kapsul
126 Isoniasid (INH) 100 mg Tube
127 Isoniasid (INH) 300 mg Botol
128 Isosorbid Dinitrat Sublingual Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
129 Kalium Permangnat Serbuk 5 mg Tablet
130 Kalsium Laktat 500 mg Tablet 0 1000 1000 200 0 0 0 0 0 0 200 800
131 Karbamazepin 200 mg Vial 0 200 200 100 0 0 0 0 0 0 100 100
132 Ketoconazole 200 mg Tablet Tablet 500 0 500 0 0 0 0 0 0 50 50 450
133 Ketoconazole Krim Tablet 0 50 50 25 0 0 0 0 0 0 25 25
134 Ketorolac Injeksi Ampul
135 Kinna ( Quinine )222 mg Tablet
136 Klorampenikol 250 mg Tablet 1900 0 1900 0 0 0 0 0 0 0 0 1900
137 Klorampenikol Salep Mata 1% Tube 134 0 134 0 0 0 0 0 0 0 0 134
138 Klorampenikol Sirup Botol 50 0 50 0 0 0 0 0 0 0 0 50
139 Klorampenikol Tetes Telinga Botol 21 0 21 11 0 0 0 0 2 0 13 8
1000 Klorampeniramin Maleat (CTM ) 4 mg Tablet 4000 0 4000 0 0 0 0 0 300 0 300 3700
141 Kloroquin 150 mg Tablet
142 Kloroquin 250 mg Tablet
143 Kloroquin Injeksi-15 ml Ampul
144 Klorpromazin HCL 25 mg Tablet
145 Klorpromazin HCL 100 mg Tablet
146 Klorpromazin HCL Injeksi 5 mg/ml-2 mAmpul
147 Klorpromazin HCL Injeksi 25 mg/ml-1 Ampul
148 Klorpropamid 100 mg Tablet
149 Kodein fosfat HCL 10 mg Tablet
150 Kotrimoksazole Suspensi 60 ml Botol 79 0 79 4 0 0 0 0 0 0 4 75
151 Kotrimoksazole 120 mg Pediatrik Tablet
152 Kotrimoksazole 480 mg Dewasa Tablet 900 0 900 0 0 0 0 100 0 0 100 800
153 Kotrimoxazole Forte 960 mg Tablet
154 Larutan Irigasi Botol
155 Lansoprazole 30 mg Tablet 2300 0 2300 50 0 0 0 0 0 0 50 2250
156 Levopar Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
157 Lidokain Injeksi 2 %-2 ml Ampul 200 0 200 0 0 0 0 0 0 0 0 200
158 Lidokain Injeksi Compositum Ampul
159 Loperamid 2 Mg Tablet 900 0 900 0 0 0 0 0 0 0 0 900
160 Lorazepam tablet Tablet 300 0 300 0 0 0 0 0 0 0 0 300
161 Mebendazol Syr 100 mg/5 ml-30 ml Botol
162 Meloxicam 7,5 Mg Tablet 450 0 450 0 0 0 0 0 0 0 0 450
163 Meloxicam 15 Mg Tablet 350 0 350 0 0 0 0 0 0 0 0 350
164 Metilergomertin Maleat 0.125 mg Tablet
165 Metilergomertin Maleat Inj 0.200 mg/ml- Ampul
166 Metoclopramide Tablet 1700 0 1700 0 0 0 0 0 0 0 0 1700
167 Metoclopramide Drops Botol 20 0 20 3 0 0 0 0 0 0 3 17
168 Metoclopramide Sirup Botol
169 Metoclorpamide Injeksi Ampul 20 10 30 0 0 0 0 0 0 0 0 30
170 Metronidazole 500 mg Tablet 800 0 800 0 0 0 0 0 0 0 0 800
171 Metronidazole Sirup Botol
172 Methylprednisolon 4 Mg Tablet 5400 0 5400 0 0 0 0 0 0 100 100 5300
173 Methylprednisolon 8 Mg Tablet 2500 0 2500 0 0 0 0 0 0 0 0 2500
174 Methylprednisolon 16 Mg Tablet
175 Methylprednisolon Injeksi 125 Mg Ampul
176 Methylprednisolon Injeksi 500 mg Ampul
177 Metformin 500 Mg Tablet
178 MgSO4 20 % Flacon 8 0 8 0 0 0 0 0 0 0 0 8 8 ED 11/20
179 MgSO4 40 % Flacon
180 Miconazole Zalf Tube 0 24 24 24 0 0 0 0 0 0 24 0
181 Microdiol strip
182 Mineral Mix Sachet 259 0 259 0 0 0 0 0 0 0 0 259 259 ED 10/20
183 Natrium Diclofenak 25 mg Tablet 700 0 700 100 0 0 0 0 0 0 100 600
184 Natrium Diclofenak 50 mg Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
185 Natrium Fenitoin Injeksi 50mg/ml Ampul
186 Natrium Klorida Infus 0.9 % Steril 500 Botol 42 60 102 20 0 0 0 0 0 0 20 82
187 New Diatabs/ New Antides Tablet
188 Nifedipin 10 mg Tablet
189 Nistatin tablet 500.000 IU Tablet 400 0 400 0 0 0 0 0 0 0 0 400
190 Nistatin tablet Vaginal 100.000 IU Supp
191 Obat Anti Tuberkulosis Kategori 1 De Paket
192 Obat Anti Tuberkulosis Kategori 2 De Paket
193 Obat Anti Tuberkulosis Kategori 3 De Paket
194 Obat Anti Tuberkulosis Kategori Anak Paket
195 Obat Anti Tuberkulosis Sisipan Paket
196 Obat Batuk Hitam Syr 100 ml Botol 0 30 30 15 0 0 0 0 0 0 15 15
197 Obat Batuk Putih Syr 100 ml Botol
198 Oksitetrasiklin HCL Injeksi 50 mg/ml- Vial
199 Oksitetrasiklin HCL Salep Kulit 3 %-5 Tube
200 Oksitetrasiklin HCL Salep Mata 1 %-3 Tube
201 Oksitosin Injeksi 10 IU/ml-8 ml Vial 30 0 30 6 0 0 0 0 0 0 6 24
202 Omeprazole Tablet 4560 0 4560 720 0 0 0 0 0 0 720 3840
203 Omeprazole Injeksi Vial 0 10 10 0 0 0 0 0 0 0 0 10
204 Ondansetron Injeksi Ampul
205 Papaverin 40 mg Tablet 2000 0 2000 0 0 0 0 0 0 0 0 2000
206 Papaverin Injeksi 40 mg/ml-8 ml Ampul
207 Parasetamol Drops Vial 9 96 105 0 0 0 0 0 0 0 0 105
208 Parasetamol 500 mg Tablet 5300 2000 7300 700 0 0 0 100 0 200 1000 6300 4700 ED 10/20

209 Paracetamol Injeksi Botol 24 0 24 0 0 0 0 0 0 0 0 24

210 Parasetamol Syr 60 ml Botol 7 20 27 15 0 0 0 0 0 0 15 12
211 Pethidin HCL Injeksi 50 mg/ml-2 ml Ampul
212 Phenol Gliserol Botol
213 Piracetam 400 Mg Tablet
214 Piracetam 800 Mg Tablet
215 Piracetam Injeksi 5 ml Ampul
216 Piracetam Injeksi 15 ml Ampul
217 Pirazinamide Tablet
218 Pirantel Pamoat 125 mg Tablet 400 0 400 0 0 0 0 0 0 0 0 400
219 Pirantel Pamoat Sirup Botol
220 Piroxicam 10 mg Tablet 1100 0 1100 0 0 0 0 0 0 0 0 1100 1100 ED 10/20

221 Piroxicam 20 mg Tablet 600 0 600 500 0 0 0 100 0 0 600 0

222 Pirodoksine HCL (B 6 ) 10 mg Tablet 2400 0 2400 1700 0 0 0 100 100 0 1900 500
223 Prednison 5 mg Tablet 100 2000 2100 0 0 0 0 100 0 100 200 1900
224 Primaquin 15 mg Tablet 100 0 100 0 0 0 0 0 0 0 0 100
225 Prokain Benzil Penisilin Vial
226 Propranolol HCL 10 mg Tablet 500 0 500 0 0 0 0 0 0 0 0 500
227 Propranolol HCL 40 mg Tablet
228 Propiltiuracil (PTU) Tablet
229 Ranitidine 150 mg Tablet 0 2000 2000 300 0 0 0 0 0 0 300 1700
230 Ranitidine Injeksi 50 mg/ml-2ml Ampul 30 30 60 20 0 0 0 0 0 0 20 40
231 Reserpin 0.10 mg Tablet
232 Reserpin 0.25 mg Tablet
233 Retinol ( VIT A )6.000 IU Tablet
234 Retinol ( VIT A )25.000 IU Tablet
235 Retinol ( VIT A )50.000 IU Tablet
236 Retinol ( VIT A )100.000 IU Tablet 0 500 500 0 0 0 0 0 0 0 0 500
237 Retinol ( VIT A )200.000 IU Tablet 500 0 500 50 0 0 0 0 0 0 50 450
238 Ringer Laktat Larutan Infus Steril-500 Botol 20 0 20 20 0 0 0 0 0 0 20 0
239 Ringer Laktat Larutan Infus Steril-100 Botol 20 0 20 0 0 0 0 0 0 0 0 20
240 Risperidone 2 mg Tablet
241 Salbutamol 2 mg Tablet 0 2000 2000 200 0 0 0 0 0 0 200 1800
242 Salbutamol 4 mg Tablet 1700 0 1700 100 0 0 0 100 0 0 200 1500
243 Salbutamol sirup Botol
244 Salep Ichtyol 30 gram Pot 24 0 24 0 0 0 0 0 0 0 0 24
245 Salep Levetran Pot
246 Salep Scabisid Tube
247 Salicyl Bedak 2 %-50 gram Dos
248 Salicyl Spritus 10 % -25 ml Botol
249 Salep 2-4 Botol 48 0 48 0 0 0 0 0 0 0 0 48
250 Sianocobalamin( VIT B 12 ) 50 mg Tablet 5800 0 5800 1900 0 0 0 0 0 200 2100 3700
251 Sianocobalalamin ( VIT B 12 ) 500 mg Ampul 300 100 400 0 0 0 0 0 0 0 0 400
252 Sianocobalalamin ( VIT B 12 ) 500 mg Vial
253 Simvastatin 10 mg Tablet 570 0 570 30 0 0 0 90 60 0 180 390
254 Simvastatin 20 mg Tablet 390 0 390 250 0 0 0 0 0 0 250 140
255 Siprofloksacin 250 mg Tablet
256 Siprofloksacin 500 mg Tablet 800 0 800 0 0 0 0 0 100 100 200 600
257 Sodium Bicaronat Tablet 900 0 900 0 0 0 0 0 0 0 0 900
258 Streptomicin Injeksi 1 gram Vial
259 Streptomicin Injeksi 1.5 gram Vial
260 Sulfadoxin Pirimenthamin 525 mg Tablet
261 Sulfacetamid Sodium Tetes mata Botol
262 Tablet Tambah Darah (SF ) Tablet 950 0 950 0 0 0 0 0 0 0 0 950
263 Tetrakain HCL Tetes Mata 0.5 %-5 ml Botol
264 Tetrasiklin HCL 250 mg Kapsul
265 Tetrasiklin HCL 500 mg Kapsul
266 Theophylline Tablet
267 Thiamin HCL ( B 1 ) 50 mg Tablet 20800 0 20800 1500 0 0 0 0 0 200 1700 19100
268 Thiamin HCL ( B 1 ) Injeksi - 1 ml Ampul 1170 0 1170 0 0 0 0 0 0 0 0 1170
269 Thiamin HCL ( B 1 ) Injeksi-15 ml Vial
270 Tramadol 50 mg Tablet
271 Tramadol Injeksi Ampul 40 0 40 5 0 0 0 0 0 0 5 35
272 Triheksipenidil Hidroklorida 2 mg Tablet 210 250 460 20 0 0 0 0 0 0 20 440
273 Ventolin Inhaler Botol
274 Verapamil 80 mg Tablet
275 Vitamin B Kompleks Tablet 1290 0 1290 200 0 0 0 100 0 0 300 990
276 Vitamin B Kompleks Injeksi -15 ml Vial
277 Vitamin B 6 Tablet 2400 0 2400 1700 0 0 0 100 100 0 1900 500
278 Vitamin B 6 Injeksi Ampul 100 0 100 0 0 0 0 0 0 0 0 100
279 Vitamin K4 Tablet
280 Wida KDN 1 Botol
281 Wida KN 1 Botol
282 Zink Tablet 300 0 300 100 0 0 0 0 0 0 100 200

BMHP
1 3 way Pcs 10 0 10 2 0 0 0 0 0 0 2 8
2 Abocath No.18 Pcs 138 0 138 0 0 0 0 0 0 0 0 138
3 Abocath No.20 Pcs
4 Abocath No.22 Pcs 49 0 49 1 0 0 0 0 0 0 1 48
5 Abocath No.24 Pcs 37 0 37 5 0 0 0 0 0 0 5 32
6 Abocath No.26 Pcs 27 0 27 0 0 0 0 0 0 0 0 27
7 Alkohol 100 ml Botol
8 Alkohol 300 ml Botol
9 Alkohol 1000 ml Botol 2 0 2 0 0 0 0 0 0 0 0 2
10 Alkohol Swab Box 2 0 2 0 0 0 0 0 0 0 0 2
11 Bisturi (Pisau Bedah )No.10 Biji 200 0 200 0 0 0 0 0 0 0 0 200
12 Bisturi (Pisau Bedah )No.11 Biji 100 0 100 0 0 0 0 0 0 0 0 100
13 Bisturi (Pisau Bedah )No.12 Biji 100 0 100 0 0 0 0 0 0 0 0 100
14 Bisturi (Pisau Bedah )No.20 Biji 200 0 200 0 0 0 0 0 0 0 0 200
15 Bisturi (Pisau Bedah )No.21 Biji 200 0 200 0 0 0 0 0 0 0 0 200
16 Bisturi (Pisau Bedah )No.22 Biji 100 0 100 0 0 0 0 0 0 0 0 100
17 Bisturi (Pisau Bedah )No.23 Biji 100 0 100 0 0 0 0 0 0 0 0 100
18 Bisturi (Pisau Bedah )No.24 Biji
19 Blood Lancet Box 3 0 3 2 0 0 0 0 0 0 2 1
20 Catgut/Benang Bedah Chromic No.2/ Box 2 0 2 0 0 0 0 0 0 0 0 2
21 Catqut/Benang Bedah Chromic 3/0 Box 2 0 2 0 0 0 0 0 0 0 0 2
22 Catqut/Benang Bedah Plain 2/0 Box
23 Catqut/Benang Bedah Plain 3/0 Box 2 0 2 0 0 0 0 0 0 0 0 2
24 Cutisorb Pcs 24 0 24 0 0 0 0 0 0 0 0 24
25 Disposible 1 ml Pcs 300 0 300 0 0 0 0 0 0 0 0 300
26 Disposible 2.5 ml Pcs
27 Disposible 3 ml Pcs 300 0 300 30 20 0 0 20 20 10 100 200
28 Disposible 5 ml Pcs 100 0 100 0 0 0 0 0 0 0 0 100
29 Disposible 10 ml Pcs 200 0 200 0 0 0 0 0 0 0 0 200
30 Disposible 20 ml Pcs 100 0 100 0 0 0 0 0 0 0 0 100
31 Elastis Perban 7,5 X 4,55 Pcs
32 Elastis Perban 10 X 4,55 Pcs
33 Etil Klorida Semprot 100 ml Botol 3 0 3 0 0 0 0 0 0 0 0 3
34 Foley Catheter No. 06 PCS 10 0 10 0 0 0 0 0 0 0 0 10
35 Foley Catheter No. 08 PCS 10 0 10 0 0 0 0 0 0 0 0 10
36 Foley Catheter No. 10 PCS 10 0 10 0 0 0 0 0 0 0 0 10
37 Foley Catheter No. 12 PCS 10 0 10 0 0 0 0 0 0 0 0 10
38 Foley Catheter No. 14 PCS 10 0 10 0 0 0 0 0 0 0 0 10
39 Foley Catheter No. 16 PCS
40 Foley Catheter No. 18 PCS 29 0 29 0 0 0 0 0 0 0 0 29
41 Foley Catheter No. 20 PCS 10 0 10 0 0 0 0 0 0 0 0 10
42 Foley Catheter No. 22 PCS 20 0 20 0 0 0 0 0 0 0 0 20
43 Foley Catheter No. 24 PCS 19 0 19 0 0 0 0 0 0 0 0 19
44 Formalin Botol
45 Giemza Botol
46 H2O2 Botol
47 Handscoon Obgyn pasang 90 0 90 5 0 0 0 0 0 0 5 85
48 Hand Scoen (Sarung Tangan ) Uk. XS box
49 Hand Scoen ( Sarung Tangan )Uk. S box 12 0 12 3 0 0 0 0 1 0 4 8
50 Hand Scoen ( Sarung Tangan )Uk. M box
51 Hand Scoen ( Sarung Tangan )Uk. L box 5 0 5 3 0 0 0 0 0 0 3 2
52 Hand Scoen Steril (Sarung Tangan ) N Pasang 60 0 60 26 0 0 0 0 0 0 26 34
53 Hand Scoen Steril ( Sarung Tangan )NoPasang 24 0 24 19 0 0 0 0 0 0 19 5
54 Hand Scoen Steril ( Sarung Tangan )N Pasang 13 100 113 15 0 0 0 0 0 0 15 98
55 Hand Scoen Steril ( Sarung Tangan )NoPasang 147 0 147 12 0 0 0 0 0 0 12 135
56 Hand Scoen Steril ( Sarung Tangan )N Pasang 150 0 150 0 0 0 0 0 0 0 0 150
57 HCL 0,1 N Botol
58 Infuset Anak Pcs 66 0 66 0 0 0 0 0 0 0 0 66
59 Infuset Dewasa Pcs 46 0 46 0 0 0 0 0 0 0 0 46
60 Kapas Pembalut/ Absorben 250 gram Rol
61 Kapas Pembalut/ Absorben 1000 gra Rol
62 Kasa Hidrofil 80 cm X 2 m Lembar
63 Kasa Hidrofil Pembalut 3 cm X 4 m Rol
64 Kasa Hidrofil Pembalut 6 cm X 4 m Rol
65 Kasa Hidrofil Pembalut 15 cm X 4 m Rol 98 0 98 25 0 0 0 5 5 5 40 58
66 Kasa Hidrofil Pembalut 80 cm X 4 m Rol
67 Kasa Kompres Steril 16 cm X 16 cm Rol
68 Kasa Kompres Steril 40 cm X 80 cm Rol
69 Leukomed Pcs
70 Masker Box 3 0 3 3 0 0 0 0 0 0 3 0
71 Masker Hijab Box
72 Masker Nebulizer Anak Pcs
73 Masker Nebulizer Dewasa Pcs 5 0 5 0 0 0 0 0 0 0 0 5
74 Masker Oksigen Dewasa Pcs 20 0 20 0 0 0 0 0 0 0 0 20
75 Micropore Pcs
76 Oksigen Nasal Kanul (Bayi) Pcs 4 0 4 0 0 0 0 0 0 0 0 4
77 Oksigen Nasal Kanul (Anak) Pcs 5 0 5 0 0 0 0 0 0 0 0 5
78 Oksigen Nasal Kanul (Dewasa) Pcs 1 0 1 0 0 0 0 0 0 0 0 1
79 Plaster 1,25 cm X 4,5 Yards Rol
80 Plaster 2,5 cm X 4,5 Yards Rol 2 0 2 0 0 0 0 0 0 0 0 2
81 Plaster 5 cm X 4,5 Yards Rol 2 0 2 0 0 0 0 0 0 1 1 1
82 Plaster 7.5 cm X 4,5 yards Rol 5 0 5 1 0 0 0 0 0 0 1 4
83 Polifix 5 cm X 1 m Box 48 0 48 0 0 0 0 0 0 0 0 48
84 Polifix 5 cm X 5 m Box
85 Polifix 10 cm X 5 m Box
86 Policlean Botol
 87 Poliwash Botol
88 Pot Dahak Botol
89 Povidon Iodion 10 %-60 ml Botol 2 0 2 0 0 0 0 2 0 0 2 0
90 Povidon Iodion 10 %-300 ml Botol 2 5 7 3 0 0 0 0 0 1 4 3
91 Povidon Iodion 10 %-1000 ml Botol
92 Rak Tabung Pcs
93 RDT Frambusia Box
94 RDT HIV PCS 14 0 14 2 0 0 0 0 0 0 2 12
95 RDT Hepatitis Sachet
96 RDT Malaria Box
97 Reagen TB Paket
98 Rivanol Larutan 0.1% -100 ml Botol
99 Rivanol Larutan 0.1 % -300 ml Botol 22 0 22 1 0 0 0 1 0 0 2 20
100 Sabun Asepso Pcs
101 Silk Benang Bedah No.0/0 Box 1 0 1 0 0 0 0 0 0 0 0 1
102 Silk Benang Bedah No.1/0 Box
103 Silk Benang Bedah No.2/0 Box 3 0 3 0 0 0 0 0 0 0 0 3
104 Silk Benang Bedah No.3/0 Box 4 0 4 0 0 0 0 0 0 0 0 4
105 Silk Benang Bedah No.4/0 Box 2 0 2 0 0 0 0 0 0 0 0 2
106 Silk Benang Bedah No.5/0 Box 1 0 1 0 0 0 0 0 0 0 0 1
107 Silk Benang Bedah No.6/0 Box 2 0 2 0 0 0 0 0 0 0 0 2
108 Slide Box
109 Suction Catheter Pcs
110 Stik Asam Urat Box 2 0 2 1 0 0 0 0 0 0 1 1
111 Stik Glukosa Box
112 Stik Kolesterol Box
113 Stik Hemoglobin Box 2 0 2 0 0 0 0 0 0 0 0 2
114 Stik Urinalisa Test Box 49 0 49 10 0 0 0 0 0 0 10 39
115 Tabung Reaksi Pcs
116 Tes Kehamilan Pcs 100 0 100 0 0 0 0 0 0 0 0 100
117 Transfusion Set Pcs
118 Ultrasonic Gel Botol
119 Under Pad Pcs
120 Urine Bag Pcs 20 0 20 0 0 0 0 0 0 0 0 20

BMHP Gigi
1 Caviton 30 gram
Glass Ionomer Cement Type II +
2 Paper Pad
Glass Ionomer Cement Type IX +
3 Paper Pad
4 Composit A2
5 Composit A3
6 Etsa
7 Bonding
8 Mikro Brush
9 Chlor Etyl
Devitec (Devitalizing Paste Arsenic
10 Free) 7 gram
11 Alveogyl
12 Intro Kit
13 Chresopen
14 Paper Point

Vaksin
1 ADS 0,05 ml PCS
2 ADS 0,5 ml PCS
3 ADS 5 ml PCS
4 BCG Ampul
5 CAMPAK Vial
6 DPT-HB-HIB Vial
7 DT Vial
8 HB Uniject Vial
9 HbB 1 ml PCS
10 IPV Vial
11 MR Vial
12 Polio Vial
13 Td Vial
14 Serum Anti Bisa Ular (ABU) Vial
15 serum Anti Tetanus (ATS) Ampul
16 S.Box 2,5 ltr
17 S.Box 5 ltr
18 Vaksin Rabies

Obat-Obatan
283 Allopurinol 300 mg tablet 1600 0 1600 400 0 0 0 100 200 0 700 900
284 Amlodipine 10 mg tablet 250 1000 1250 250 0 0 0 0 0 0 250 1000
285 Diethylcarbamazine citrate 100 mg tablet 1500 0 1500 0 0 0 0 0 0 0 0 1500
286 Dimenhidrinate 50 mg tablet 400 500 900 300 0 0 0 0 0 0 300 600
287 Gentamisin Salep Mata tube 20 0 20 0 0 0 0 0 0 0 0 20
288 Loratadin 10 mg tablet
289 Metamizole Injeksi ampul 100 0 100 0 0 0 0 0 0 0 0 100
290 Metronidazole 250 mg tablet 0
291 Ventolin Nebules 2,5 mg pcs 0 20 20 20 0 0 0 0 0 0 20 0
292 Cetirizine tab 10 mg tablet 800 0 800 600 0 0 0 0 0 0 600 200
293 methamizole tab tablet 5000 0 5000 0 0 0 0 100 0 200 300 4700
294 nifedipne 20 mg tablet 355 0 355 0 0 0 0 0 0 0 0 355
295 kloramphenikol salep kulit tube 74 0 74 27 0 0 0 0 0 0 27 47
BMHP
121 Antiseptik Gel botol 29 3 32 3 0 0 0 1 0 0 4 28
122 Kasa Hidrofil Steril 16/16 pcs 40 0 40 22 0 0 0 5 5 5 37 3
123 Oxygen Mask Anak pcs 5 0 5 0 0 0 0 0 0 0 0 5
124 Reagen Siphylis AB pcs
125 Reagen Siphylis BD pcs
126 Sabun Anti Bakteri botol 1 3 4 2 0 0 0 0 0 0 2 2
127 HBSaG pcs
128 Surgical Gown M pcs 1 10 11 1 0 0 0 0 0 0 1 10
129 Wing Needle pcs
130 Baju Coverall PCS 30 0 30 0 0 0 0 0 0 0 0 30
131 Thermogun PCS 1 0 1 0 0 0 0 0 0 0 0 1
132 Masker N95 PCS 180 0 180 3 0 0 0 0 0 0 3 177
133 Rapid Tes Covid-19 PCS
134 masker hijab (skineer) pcs 9 0 9 3 0 0 0 0 0 0 3 6
135 MASKER PCS Bantuan
136 Papsmer Kit pcs 10 0 10 0 0 0 0 0 0 0 0 10
137 plester non woven Roll 5cmx5m box 20 0 20 0 0 0 0 1 1 1 3 17

Mengetahui/Menyetujui Yang Menyerahkan Yang Meminta Yang Menerima

Kepala Dinas Kesehatan Petugas GFK Kepala UPTD Puskesmas Petugas Pengelola Obat UPTD Puskesmas
Kabupaten Halmahera Tengah Rawat Inap Banemo Rawat Inap Banemo

Rusman Djafar, SKM Resky Yuliandany, Amd.Farm.

Nip. Nip. Nip. 19740306 199403 1 004 NIP.19951105 201903 2 007
8 ED 11/20
259 ED 10/20

4700 ED 10/20
1100 ED 10/20
 LAPORAN MUTASI OBAT DAN BAHAN MEDIS HABIS PAKAI (BMHP)
DINAS KASEHATAN KABUPATEN HALMAHERA TENGAH
PUSKESMAS : : Banemo BULAN : DESEMBER
KODE PUSKESMAS : P8202044201 TAHUN : 2020
KECAMATAN : Patani Barat
JUMLAH PUSTU/POLINDES :3
PENGELUARAN
SATUAN STOK PENERI JMLH
NO KETERSEDIA
URUT NAMA OBAT KEMASAN AWAL MAAN AN UGD/
PUSKESM
PESANT PUSTU PUSTU
PUSTU PENGELUAR SISA PKM ED
APOTEK AS BOBANE AN
LAINNYA REN SIBENPOPO MOREALA
KELILING JAYA

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Obat-Obatan
1 Aciclovir 200 mg Tablet 1400 0 1400 0 0 0 0 0 0 0 0 1400
2 Aciclovir 400 mg Tablet 250 0 250 0 0 0 0 0 0 0 0 250
3 Aciclovir Krim Tube
4 Aciclovir Salep Mata Tube
5 Adidryl injeksi-15 ml/ Recodril Vial 20 0 20 0 0 0 0 0 0 0 0 20
6 Adimidon Injeksi-15 ml/ Benodon Vial
7 Albendazol 400 mg Tablet 1850 0 1850 700 0 0 0 0 0 0 700 1150
8 Allopurinol 100 mg Tablet 1900 0 1900 0 0 0 0 0 0 0 0 1900
9 Alprazolam 0,5 mg Tablet 243 0 243 0 0 0 0 0 0 0 0 243 243 ED 12/20
10 Alprazolam 1 mg Tablet
11 Ambroxol 30 mg Tablet 200 0 200 200 0 0 0 0 0 0 200 0
12 Ambroxol Sirup Botol
13 Aminofilin 200 mg Tablet
14 Aminofilin Injeksi-24 mg/ml 10 ml Ampul 30 0 30 0 0 0 0 0 0 0 0 30
15 Amoxisilin 250 mg Kapsul 0 3000 3000 0 0 0 0 0 0 0 0 3000
16 Amoxisilin 500 mg Tablet 2700 0 2700 300 0 0 0 0 0 0 300 2400
17 Amoxisilin Syr 125 mg/5 ml Botol 2 0 2 0 0 0 0 0 0 0 0 2
18 Amoxisilin Syr 250 mg/ 5 ml Botol 74 0 74 6 0 0 0 0 0 0 6 68
19 Ampicilin 250 mg kaplet
20 Ampisilin 500 mg Tablet 900 1500 2400 0 0 0 0 0 0 0 0 2400
21 Ampisilin Injeksi Vial
22 Ampislin Syr 125 mg/5 ml Botol 22 0 22 0 0 0 0 0 0 0 0 22
23 Amlodipin 5 Mg Tablet 1600 0 1600 0 0 0 0 0 0 0 0 1600
24 Antalgin 500 mg Tablet 0 1500 1500 0 0 0 0 0 0 0 0 1500
25 Antalgin Injeksi 250 mg/ml-2 ml Ampul
26 Antasida Doen Tablet 1500 0 1500 0 0 0 0 0 0 0 0 1500
27 Antasida Syr Botol 41 20 61 5 0 0 0 0 0 0 5 56
28 Anti Fungi Doen Kombinasi Pot 48 0 48 0 0 0 0 0 0 0 0 48
29 Anti Haemoroid Doen Kombinasi Supp
30 Artesunate Tablet
31 Artesunate inj Vial
32 Asam Ascorbat (Vit C ) 50 mg Tablet 0 2000 2000 0 0 0 0 0 0 0 0 2000
33 Asam Ascorbat (Vit C ) 250 mg Tablet
34 Asam Folat Tablet 0 1000 1000 0 0 0 0 0 0 0 0 1000
35 Asam Mefenamat 250 mg Tablet
36 Asam Mefenamat 500 mg Tablet 4600 0 4600 200 0 0 0 0 0 0 200 4400
37 Asam Tranexamat Tablet
38 Asam Tranexamat Injeksi Ampul
39 Asetosal 100 mg Tablet
40 Asetosal 500 mg Tablet
41 Atropin Sulfat Injeksi 0.25 mg/ml-1ml Ampul
42 Atropin Sulfat Tetes Mata 0.5 %-5 ml Botol
43 Atorvastatin 10 mg Tablet 800 1000 1800 0 0 0 0 0 0 0 0 1800
44 Aqua Pro Injeksi Steril-20 ml Ampul
45 Azitromycin Tablet
46 Bacitracyn-Polimixyn Tube
47 Betammetason Krim 0.1%-5 gram Tube 0 25 25 0 0 0 0 0 0 0 0 25
48 Betahistin Mesylate Tablet
49 Bioplacenton Jely Tube 6 6 12 0 0 0 0 0 0 0 0 12
50 Buscopan Injeksi Ampul 10 0 10 0 0 0 0 0 0 0 0 10
51 Calcii Gluconas Ampul
52 Captopril 12.5 mg Tablet 1700 0 1700 200 0 0 0 0 0 0 200 1500
53 Captopril 25 mg Tablet 300 2000 2300 0 0 0 0 0 0 0 0 2300
54 Caviplex Sirup Botol
55 Cefadroxil 250 mg Tablet
56 Cefadroxil 500 mg Tablet 1500 0 1500 0 0 0 0 0 0 0 0 1500
57 Cefadroxyl sirup 125 mg Botol 45 0 45 0 0 0 0 0 0 0 0 45
58 Cefadroxyl Sirup 250 mg Botol 41 0 41 0 0 0 0 0 0 0 0 41
59 Cefixime 200 mg Tablet
60 Cefixime Sirup 100 mg Botol
61 Cefotaxim Injeksi Vial
62 Ceftriaxone Injeksi Vial
63 Cetirizine Sirup Botol 97 0 97 12 0 0 0 0 0 0 12 85
64 Cimetidine 200 mg Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
65 Clindamycin 150 Mg Tablet 900 0 900 0 0 0 0 0 0 0 0 900
66 Clindamycin 300 Mg Tablet 900 2000 2900 0 0 0 0 0 0 0 0 2900
67 Colchicine Tablet 0 450 450 0 0 0 0 0 0 0 0 450
68 Curcuma Suspensi Botol
69 Deksametasone 0.5 mg Tablet 1000 2000 3000 100 0 0 0 0 0 0 100 2900
70 Deksametasone Injeksi 5 mg/ml-1 ml Ampul 100 0 100 0 0 0 0 0 0 0 0 100
71 Dermasolon Tube 0 12 12 0 0 0 0 0 0 0 0 12
72 Dexocort Tube
73 DHP Frimal Tablet 40 0 40 0 0 0 0 0 0 0 0 40
74 Diazepam 2 mg Tablet
75 Diazepam 5 mg Tablet 491 0 491 0 0 0 0 0 0 0 0 491
76 Diazepam Injeksi 5 mg/ml-2 ml/ stesolid Ampul 0 20 20 0 0 0 0 0 0 0 0 20
77 Difenhidramin HCL Injeksi 10 mg/ml-1 ml Ampul 30 0 30 0 0 0 0 0 0 0 0 30
78 Diltiazem Tablet 0 1000 1000 0 0 0 0 0 0 0 0 1000
79 Doksisiklin 100 mg Tablet
80 Domperidon Tablet 2100 2000 4100 0 0 0 0 0 0 0 0 4100
81 Domperidon Sirup Botol 29 0 29 0 0 0 0 0 0 0 0 29
82 Dulcolax 5 mg Tablet Tablet 190 0 190 0 0 0 0 0 0 0 0 190 190 ED 20/12
83 Dulcolax Supositoria 5 mg anak Tablet
84 Dulcolax Supositoria 10 mg Dewasa Supp
85 Efedrin HCL 25 mg Tablet
86 Ephineprine HCL Injeksi 0.1% -1 ml Ampul 200 0 200 0 0 0 0 0 0 0 0 200
 87 Eritromisin 250 mg Kapsul 0 2000 2000 0 0 0 0 0 0 0 0 2000
88 Eritromisin 500 mg Kaplet 1700 0 1700 0 0 0 0 0 0 0 0 1700
89 Eritromisin Syr Kering 200 mg/ml-60 ml Botol 115 0 115 0 0 0 0 0 0 0 0 115 115 ED 12/20
90 Ethambutol 250 mg Tablet
91 Ethambutol 500 mg Tablet
92 Fenilbutason 200 mg Tablet
93 Fenobarbital 30 mg Tablet
94 Fenobarbital 100 mg Tablet
95 Fenobarbital Injeksi 50 mg/ml-2 ml Ampul
96 Fitomenadion ( Vit K ) 10 mg Tablet 800 0 800 0 0 0 0 0 0 0 0 800
97 Fitomenadion ( Vit K ) Injeksi -1 ml Ampul 0 90 90 0 0 0 0 0 0 0 0 90
98 Furosemide 40 mg Tablet 2000 0 2000 0 0 0 0 0 0 0 0 2000
99 Furosemide Injeksi Ampul
100 Gameksan Emulsi 1%-100 ml Botol
101 Garam Oralit 200 ml air Sachet 200 200 400 0 0 0 0 0 0 0 0 400
102 Gentamicin Injeksi Ampul
103 Gentamicin salep Kulit Tube 10 0 10 10 0 0 0 0 0 0 10 0
104 Gentamicin Tetes Mata Botol 0 48 48 0 0 0 0 0 0 0 0 48
105 Gentien Violet Larutan 1 % -10 ml Botol 24 0 24 0 0 0 0 0 0 0 0 24
106 Glibenklamide 5 mg Tablet 400 2000 2400 0 0 0 0 0 0 0 0 2400
107 Glimepiride 1 mg Tablet
108 Glimepiride 2 mg Tablet 750 1000 1750 0 0 0 0 0 0 0 0 1750
109 Gliseril Guaicolate 100 mg Tablet
110 Gliserin 100 ml Botol
111 Gliserin 1000 ml Tablet
112 Glukosa Injeksi 40 % Steril 25 ml Tablet
113 Glukosa Infus 5 % Steril -500 ml Tablet 200 0 200 0 0 0 0 0 0 0 0 200
114 Glukosa Infus 10 % Steril -500 ml Pot 80 0 80 0 0 0 0 0 0 0 0 80
115 Graxine Tablet
116 Griseofulvin 125 mg Tablet 1600 3000 4600 0 0 0 0 0 0 0 0 4600
117 Haloperidol 0.5 mg Tablet
118 Haloperidol 1.5 mg Tablet
119 Haloperidol 5 mg Tablet
120 Haloperidol Injeksi Ampul
121 Hidroklosiasid (HCT )25 mg Tablet
122 Hidrokortison Krim 2.5 %-5 gram Tube 24 48 72 0 0 0 0 0 0 0 0 72
123 Ibuprofen sirup Botol 37 0 37 0 0 0 0 0 0 0 0 37
124 Ibuprofen 200 mg Tablet 600 2000 2600 300 0 0 0 0 0 0 300 2300
125 Ibuprofen 400 mg Kapsul 0 2000 2000 0 0 0 0 0 0 0 0 2000
126 Isoniasid (INH) 100 mg Tube
127 Isoniasid (INH) 300 mg Botol
128 Isosorbid Dinitrat Sublingual Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
129 Kalium Permangnat Serbuk 5 mg Tablet
130 Kalsium Laktat 500 mg Tablet 800 0 800 400 0 0 0 0 0 0 400 400
131 Karbamazepin 200 mg Vial 100 0 100 0 0 0 0 0 0 0 0 100
132 Ketoconazole 200 mg Tablet Tablet 450 1500 1950 0 0 0 0 0 0 0 0 1950
133 Ketoconazole Krim Tablet 25 50 75 6 0 0 0 0 0 0 6 69
134 Ketorolac Injeksi Ampul
135 Kinna ( Quinine )222 mg Tablet
136 Klorampenikol 250 mg Tablet 1900 0 1900 0 0 0 0 0 0 0 0 1900
137 Klorampenikol Salep Mata 1% Tube 134 0 134 0 0 0 0 0 0 0 0 134
138 Klorampenikol Sirup Botol 50 0 50 0 0 0 0 0 0 0 0 50
139 Klorampenikol Tetes Telinga Botol 8 20 28 8 0 0 0 0 0 0 8 20
140 Klorampeniramin Maleat (CTM ) 4 mg Tablet 3700 0 3700 0 0 0 0 0 0 0 0 3700
141 Kloroquin 150 mg Tablet
142 Kloroquin 250 mg Tablet
143 Kloroquin Injeksi-15 ml Ampul
144 Klorpromazin HCL 25 mg Tablet
145 Klorpromazin HCL 100 mg Tablet
146 Klorpromazin HCL Injeksi 5 mg/ml-2 ml Ampul
147 Klorpromazin HCL Injeksi 25 mg/ml-1 ml Ampul
148 Klorpropamid 100 mg Tablet
149 Kodein fosfat HCL 10 mg Tablet
150 Kotrimoksazole Suspensi 60 ml Botol 75 0 75 4 0 0 0 0 0 0 4 71
151 Kotrimoksazole 120 mg Pediatrik Tablet
152 Kotrimoksazole 480 mg Dewasa Tablet 800 2000 2800 100 0 0 0 0 0 0 100 2700
153 Kotrimoxazole Forte 960 mg Tablet
154 Larutan Irigasi Botol
155 Lansoprazole 30 mg Tablet 2250 0 2250 0 0 0 0 0 0 0 0 2250
156 Levopar Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
157 Lidokain Injeksi 2 %-2 ml Ampul 200 0 200 0 0 0 0 0 0 0 0 200
158 Lidokain Injeksi Compositum Ampul
159 Loperamid 2 Mg Tablet 900 0 900 0 0 0 0 0 0 0 0 900 900 ED 12/20
160 Lorazepam tablet Tablet 300 0 300 0 0 0 0 0 0 0 0 300
161 Mebendazol Syr 100 mg/5 ml-30 ml Botol
162 Meloxicam 7,5 Mg Tablet 450 0 450 0 0 0 0 0 0 0 0 450
163 Meloxicam 15 Mg Tablet 350 0 350 0 0 0 0 0 0 0 0 350
164 Metilergomertin Maleat 0.125 mg Tablet 0 1000 1000 0 0 0 0 0 0 0 0 1000
165 Metilergomertin Maleat Inj 0.200 mg/ml-1 m Ampul 0 200 200 0 0 0 0 0 0 0 0 200
166 Metoclopramide Tablet 1700 0 1700 0 0 0 0 0 0 0 0 1700
167 Metoclopramide Drops Botol 17 0 17 5 0 0 0 0 0 0 5 12
168 Metoclopramide Sirup Botol
169 Metoclorpamide Injeksi Ampul 30 0 30 0 0 0 0 0 0 0 0 30
170 Metronidazole 500 mg Tablet 800 0 800 0 0 0 0 0 0 0 0 800
171 Metronidazole Sirup Botol
172 Methylprednisolon 4 Mg Tablet 5300 0 5300 0 0 0 0 0 0 0 0 5300
173 Methylprednisolon 8 Mg Tablet 2500 0 2500 0 0 0 0 0 0 0 0 2500
174 Methylprednisolon 16 Mg Tablet
175 Methylprednisolon Injeksi 125 Mg Ampul 0 30 30 0 0 0 0 0 0 0 0 30
176 Methylprednisolon Injeksi 500 mg Ampul
177 Metformin 500 Mg Tablet 0 1000 1000 0 0 0 0 0 0 0 0 1000
178 MgSO4 20 % Flacon 0 18 18 0 0 0 0 0 0 0 0 18
179 MgSO4 40 % Flacon 0 18 18 0 0 0 0 0 0 0 0 18
180 Miconazole Zalf Tube 0 24 24 0 0 0 0 0 0 0 0 24
181 Microdiol strip
182 Mineral Mix Sachet 0 400 400 0 0 0 0 0 0 0 0 400
183 Natrium Diclofenak 25 mg Tablet 600 0 600 200 0 0 0 0 0 0 200 400
184 Natrium Diclofenak 50 mg Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
185 Natrium Fenitoin Injeksi 50mg/ml Ampul
186 Natrium Klorida Infus 0.9 % Steril 500 ml Botol 82 0 82 5 0 0 0 0 0 0 5 77
187 New Diatabs/ New Antides Tablet 0 1000 1000 0 0 0 0 0 0 0 0 1000
188 Nifedipin 10 mg Tablet
189 Nistatin tablet 500.000 IU Tablet 400 0 400 0 0 0 0 0 0 0 0 400
190 Nistatin tablet Vaginal 100.000 IU Supp
191 Obat Anti Tuberkulosis Kategori 1 Dewas Paket
192 Obat Anti Tuberkulosis Kategori 2 Dewas Paket
193 Obat Anti Tuberkulosis Kategori 3 Dewas Paket
194 Obat Anti Tuberkulosis Kategori Anak Paket
195 Obat Anti Tuberkulosis Sisipan Paket
196 Obat Batuk Hitam Syr 100 ml Botol 15 0 15 15 0 0 0 0 0 0 15 0
197 Obat Batuk Putih Syr 100 ml Botol
198 Oksitetrasiklin HCL Injeksi 50 mg/ml-10 m Vial
199 Oksitetrasiklin HCL Salep Kulit 3 %-5 gra Tube
200 Oksitetrasiklin HCL Salep Mata 1 %-3.5 g Tube 0 48 48 0 0 0 0 0 0 0 0 48
201 Oksitosin Injeksi 10 IU/ml-8 ml Vial 24 0 24 0 0 0 0 0 0 0 0 24
202 Omeprazole Tablet 3840 0 3840 420 0 0 0 0 0 0 420 3420
203 Omeprazole Injeksi Vial 10 10 20 0 0 0 0 0 0 0 0 20
204 Ondansetron Injeksi Ampul
205 Papaverin 40 mg Tablet 2000 0 2000 0 0 0 0 0 0 0 0 2000 2000 ED 12/20
206 Papaverin Injeksi 40 mg/ml-8 ml Ampul
207 Parasetamol Drops Vial 105 0 105 3 0 0 0 0 0 0 3 102
208 Parasetamol 500 mg Tablet 1600 0 1600 300 0 0 0 0 0 0 300 1300
209 Paracetamol Injeksi Botol 24 0 24 11 0 0 0 0 0 0 11 13
210 Parasetamol Syr 60 ml Botol 12 200 212 12 0 0 0 0 0 0 12 200
211 Pethidin HCL Injeksi 50 mg/ml-2 ml Ampul
212 Phenol Gliserol Botol
213 Piracetam 400 Mg Tablet
214 Piracetam 800 Mg Tablet 0 1000 1000 0 0 0 0 0 0 0 0 1000
215 Piracetam Injeksi 5 ml Ampul
216 Piracetam Injeksi 15 ml Ampul
217 Pirazinamide Tablet
218 Pirantel Pamoat 125 mg Tablet 400 0 400 0 0 0 0 0 0 0 0 400
219 Pirantel Pamoat Sirup Botol
220 Piroxicam 10 mg Tablet
221 Piroxicam 20 mg Tablet
222 Pirodoksine HCL (B 6 ) 10 mg Tablet 500 0 500 0 0 0 0 0 0 0 0 500
223 Prednison 5 mg Tablet 1900 0 1900 0 0 0 0 0 0 0 0 1900
224 Primaquin 15 mg Tablet 100 0 100 0 0 0 0 0 0 0 0 100
225 Prokain Benzil Penisilin Vial
226 Propranolol HCL 10 mg Tablet 500 0 500 0 0 0 0 0 0 0 0 500
227 Propranolol HCL 40 mg Tablet
228 Propiltiuracil (PTU) Tablet
229 Ranitidine 150 mg Tablet 1700 0 1700 200 0 0 0 0 0 0 200 1500
230 Ranitidine Injeksi 50 mg/ml-2ml Ampul 40 0 40 20 0 0 0 0 0 0 20 20
231 Reserpin 0.10 mg Tablet
232 Reserpin 0.25 mg Tablet
233 Retinol ( VIT A )6.000 IU Tablet
234 Retinol ( VIT A )25.000 IU Tablet
235 Retinol ( VIT A )50.000 IU Tablet
236 Retinol ( VIT A )100.000 IU Tablet 500 0 500 0 0 0 0 0 0 0 0 500
237 Retinol ( VIT A )200.000 IU Tablet 450 0 450 0 0 0 0 0 0 0 0 450
238 Ringer Laktat Larutan Infus Steril-500 ml Botol 0 200 200 0 0 0 0 0 0 0 0 200
239 Ringer Laktat Larutan Infus Steril-1000 ml Botol 20 0 20 0 0 0 0 0 0 0 0 20
240 Risperidone 2 mg Tablet
241 Salbutamol 2 mg Tablet 1800 0 1800 0 0 0 0 0 0 0 0 1800
242 Salbutamol 4 mg Tablet 1500 0 1500 0 0 0 0 0 0 0 0 1500
243 Salbutamol sirup Botol
244 Salep Ichtyol 30 gram Pot 24 0 24 3 0 0 0 0 0 0 3 21
245 Salep Levetran Pot
246 Salep Scabisid Tube
247 Salicyl Bedak 2 %-50 gram Dos
248 Salicyl Spritus 10 % -25 ml Botol
249 Salep 2-4 Botol 48 0 48 0 0 0 0 0 0 0 0 48
250 Sianocobalamin( VIT B 12 ) 50 mg Tablet 3700 0 3700 100 0 0 0 0 0 0 100 3600
251 Sianocobalalamin ( VIT B 12 ) 500 mg/ml- Ampul 400 0 400 0 0 0 0 0 0 0 0 400
252 Sianocobalalamin ( VIT B 12 ) 500 mg/ml Vial
253 Simvastatin 10 mg Tablet 390 0 390 0 0 0 0 0 0 0 0 390
254 Simvastatin 20 mg Tablet 140 2500 2640 0 0 0 0 0 0 0 0 2640
255 Siprofloksacin 250 mg Tablet
256 Siprofloksacin 500 mg Tablet 600 0 600 0 0 0 0 0 0 0 0 600
257 Sodium Bicaronat Tablet 900 0 900 0 0 0 0 0 0 0 0 900
258 Streptomicin Injeksi 1 gram Vial
259 Streptomicin Injeksi 1.5 gram Vial
260 Sulfadoxin Pirimenthamin 525 mg Tablet
261 Sulfacetamid Sodium Tetes mata Botol
262 Tablet Tambah Darah (SF ) Tablet 950 4320 5270 950 0 0 0 0 0 0 950 4320
263 Tetrakain HCL Tetes Mata 0.5 %-5 ml Botol
264 Tetrasiklin HCL 250 mg Kapsul 0 2000 2000 0 0 0 0 0 0 0 0 2000
265 Tetrasiklin HCL 500 mg Kapsul 0 2000 2000 0 0 0 0 0 0 0 0 2000
266 Theophylline Tablet 0 1000 1000 0 0 0 0 0 0 0 0 1000
267 Thiamin HCL ( B 1 ) 50 mg Tablet 19100 0 19100 0 0 0 0 0 0 0 0 19100
268 Thiamin HCL ( B 1 ) Injeksi - 1 ml Ampul 1170 0 1170 0 0 0 0 0 0 0 0 1170
269 Thiamin HCL ( B 1 ) Injeksi-15 ml Vial
270 Tramadol 50 mg Tablet
271 Tramadol Injeksi Ampul 35 0 35 0 0 0 0 0 0 0 0 35
272 Triheksipenidil Hidroklorida 2 mg Tablet 440 40 480 80 0 0 0 0 0 0 80 400
273 Ventolin Inhaler Botol
274 Verapamil 80 mg Tablet 0 1000 1000 0 0 0 0 0 0 0 0 1000
275 Vitamin B Kompleks Tablet 990 0 990 0 0 0 0 0 0 0 0 990
276 Vitamin B Kompleks Injeksi -15 ml Vial
277 Vitamin B 6 Tablet 500 0 500 0 0 0 0 0 0 0 0 500
278 Vitamin B 6 Injeksi Ampul 100 0 100 100 0 0 0 0 0 0 100 0
279 Vitamin K4 Tablet
280 Wida KDN 1 Botol 0 20 20 0 0 0 0 0 0 0 0 20
281 Wida KN 1 Botol 0 20 20 0 0 0 0 0 0 0 0 20
282 Zink Tablet 200 2000 2200 200 0 0 0 0 0 0 200 2000

BMHP
 1 3 way Pcs 8 0 8 0 0 0 0 0 0 0 0 8
2 Abocath No.18 Pcs 138 0 138 0 0 0 0 0 0 0 0 138
3 Abocath No.20 Pcs
4 Abocath No.22 Pcs 48 0 48 2 0 0 0 0 0 0 2 46
5 Abocath No.24 Pcs 32 0 32 6 0 0 0 0 0 0 6 26
6 Abocath No.26 Pcs 27 0 27 0 0 0 0 0 0 0 0 27
7 Alkohol 100 ml Botol
8 Alkohol 300 ml Botol
9 Alkohol 1000 ml Botol 2 5 7 0 0 0 0 0 0 0 0 7
10 Alkohol Swab Box 2 0 2 0 0 0 0 0 0 0 0 2
11 Bisturi (Pisau Bedah )No.10 Biji 200 0 200 0 0 0 0 0 0 0 0 200
12 Bisturi (Pisau Bedah )No.11 Biji 100 0 100 0 0 0 0 0 0 0 0 100
13 Bisturi (Pisau Bedah )No.12 Biji 100 0 100 0 0 0 0 0 0 0 0 100
14 Bisturi (Pisau Bedah )No.20 Biji 200 0 200 0 0 0 0 0 0 0 0 200
15 Bisturi (Pisau Bedah )No.21 Biji 200 0 200 0 0 0 0 0 0 0 0 200
16 Bisturi (Pisau Bedah )No.22 Biji 100 0 100 0 0 0 0 0 0 0 0 100
17 Bisturi (Pisau Bedah )No.23 Biji 100 0 100 0 0 0 0 0 0 0 0 100
18 Bisturi (Pisau Bedah )No.24 Biji
19 Blood Lancet Box 1 0 1 0 0 0 0 0 0 0 0 1
20 Catgut/Benang Bedah Chromic No.2/0 Box 2 0 2 0 0 0 0 0 0 0 0 2
21 Catqut/Benang Bedah Chromic 3/0 Box 2 0 2 0 0 0 0 0 0 0 0 2
22 Catqut/Benang Bedah Plain 2/0 Box
23 Catqut/Benang Bedah Plain 3/0 Box 2 0 2 0 0 0 0 0 0 0 0 2
24 Cutisorb Pcs 24 0 24 0 0 0 0 0 0 0 0 24
25 Disposible 1 ml Pcs 300 0 300 0 0 0 0 0 0 0 0 300
26 Disposible 2.5 ml Pcs
27 Disposible 3 ml Pcs 200 3 203 0 0 0 0 0 0 0 0 203
28 Disposible 5 ml Pcs 100 0 100 0 0 0 0 0 0 0 0 100
29 Disposible 10 ml Pcs 200 0 200 100 0 0 0 0 0 0 100 100
30 Disposible 20 ml Pcs 100 0 100 0 0 0 0 0 0 0 0 100
31 Elastis Perban 7,5 X 4,55 Rol 0 1 1 0 0 0 0 0 0 0 0 1
32 Elastis Perban 10 X 4,55 Rol 0 1 1 0 0 0 0 0 0 0 0 1
33 Etil Klorida Semprot 100 ml Botol 3 0 3 0 0 0 0 0 0 0 0 3 3 ED 12/20
34 Foley Catheter No. 06 PCS 10 0 10 0 0 0 0 0 0 0 0 10
35 Foley Catheter No. 08 PCS 10 0 10 0 0 0 0 0 0 0 0 10
36 Foley Catheter No. 10 PCS 10 0 10 0 0 0 0 0 0 0 0 10
37 Foley Catheter No. 12 PCS 10 0 10 0 0 0 0 0 0 0 0 10
38 Foley Catheter No. 14 PCS 10 0 10 0 0 0 0 0 0 0 0 10
39 Foley Catheter No. 16 PCS
40 Foley Catheter No. 18 PCS 29 0 29 0 0 0 0 0 0 0 0 29
41 Foley Catheter No. 20 PCS 10 0 10 0 0 0 0 0 0 0 0 10
42 Foley Catheter No. 22 PCS 20 0 20 0 0 0 0 0 0 0 0 20
43 Foley Catheter No. 24 PCS 19 0 19 0 0 0 0 0 0 0 0 19
44 Formalin Botol
45 Giemza Botol
46 H2O2 Botol 0 5 5 0 0 0 0 0 0 0 0 5
47 Handscoon Obgyn pasang 85 50 135 0 0 0 0 0 0 0 0 135
48 Hand Scoen (Sarung Tangan ) Uk. XS box
49 Hand Scoen ( Sarung Tangan )Uk. S box 8 5 13 1 0 0 0 0 0 0 1 12
50 Hand Scoen ( Sarung Tangan )Uk. M box 0 5 5 0 0 0 0 0 0 0 0 5
51 Hand Scoen ( Sarung Tangan )Uk. L box 2 5 7 2 0 0 0 0 0 0 2 5
52 Hand Scoen Steril (Sarung Tangan ) No.6 Pasang 34 0 34 6 0 0 0 0 0 0 6 28
53 Hand Scoen Steril ( Sarung Tangan )No. 6 Pasang 5 50 55 5 0 0 0 0 0 0 5 50
54 Hand Scoen Steril ( Sarung Tangan )No. 7 Pasang 98 0 98 0 0 0 0 0 0 0 0 98
55 Hand Scoen Steril ( Sarung Tangan )No. 7 Pasang 135 0 135 3 0 0 0 0 0 0 3 132
56 Hand Scoen Steril ( Sarung Tangan )No. 8 Pasang 150 0 150 0 0 0 0 0 0 0 0 150
57 HCL 0,1 N Botol 0 5 5 0 0 0 0 0 0 0 0 5
58 Infuset Anak Pcs 110 0 110 11 0 0 0 0 0 0 11 99
59 Infuset Dewasa Pcs 2 50 52 2 0 0 0 0 0 0 2 50
60 Kapas Pembalut/ Absorben 250 gram Rol
61 Kapas Pembalut/ Absorben 1000 gram Rol
62 Kasa Hidrofil 80 cm X 2 m Lembar
63 Kasa Hidrofil Pembalut 3 cm X 4 m Rol
64 Kasa Hidrofil Pembalut 6 cm X 4 m Rol
65 Kasa Hidrofil Pembalut 15 cm X 4 m Rol 58 0 58 50 0 0 0 0 0 0 50 8
66 Kasa Hidrofil Pembalut 80 cm X 4 m Rol
67 Kasa Kompres Steril 16 cm X 16 cm Rol
68 Kasa Kompres Steril 40 cm X 80 cm Rol
69 Leukomed Pcs
70 Masker Box
71 Masker Hijab Box
72 Masker Nebulizer Anak Pcs
73 Masker Nebulizer Dewasa Pcs 5 0 5 0 0 0 0 0 0 0 0 5
74 Masker Oksigen Dewasa Pcs 20 0 20 0 0 0 0 0 0 0 0 20
75 Micropore Pcs
76 Oksigen Nasal Kanul (Bayi) Pcs 4 0 4 0 0 0 0 0 0 0 0 4
77 Oksigen Nasal Kanul (Anak) Pcs 5 0 5 0 0 0 0 0 0 0 0 5
78 Oksigen Nasal Kanul (Dewasa) Pcs 1 0 1 0 0 0 0 0 0 0 0 1
79 Plaster 1,25 cm X 4,5 Yards Rol
80 Plaster 2,5 cm X 4,5 Yards Rol 2 0 2 0 0 0 0 0 0 0 0 2
81 Plaster 5 cm X 4,5 Yards Rol 1 5 6 1 0 0 0 0 0 0 1 5
82 Plaster 7.5 cm X 4,5 yards Rol 4 0 4 1 0 0 0 0 0 0 1 3
83 Polifix 5 cm X 1 m Box 48 0 48 0 0 0 0 0 0 0 0 48
84 Polifix 5 cm X 5 m Box
85 Polifix 10 cm X 5 m Box
86 Policlean Botol
87 Poliwash Botol
88 Pot Dahak Botol
89 Povidon Iodion 10 %-60 ml Botol
90 Povidon Iodion 10 %-300 ml Botol 3 0 3 2 0 0 0 0 0 0 2 1
91 Povidon Iodion 10 %-1000 ml Botol
92 Rak Tabung Pcs
93 RDT Frambusia Box
94 RDT HIV PCS 12 0 12 1 0 0 0 0 0 0 1 11
95 RDT Hepatitis Sachet
96 RDT Malaria Box
97 Reagen TB Paket
98 Rivanol Larutan 0.1% -100 ml Botol
99 Rivanol Larutan 0.1 % -300 ml Botol 20 0 20 3 0 0 0 0 0 0 3 17
100 Sabun Asepso Pcs
101 Silk Benang Bedah No.0/0 Box 1 0 1 0 0 0 0 0 0 0 0 1
102 Silk Benang Bedah No.1/0 Box
103 Silk Benang Bedah No.2/0 Box 3 0 3 0 0 0 0 0 0 0 0 3
104 Silk Benang Bedah No.3/0 Box 4 0 4 0 0 0 0 0 0 0 0 4
105 Silk Benang Bedah No.4/0 Box 2 0 2 0 0 0 0 0 0 0 0 2
106 Silk Benang Bedah No.5/0 Box 1 0 1 0 0 0 0 0 0 0 0 1
107 Silk Benang Bedah No.6/0 Box 2 0 2 0 0 0 0 0 0 0 0 2
108 Slide Box
109 Suction Catheter Pcs
110 Stik Asam Urat Box 1 0 1 0 0 0 0 0 0 0 0 1
111 Stik Glukosa Box
112 Stik Kolesterol Box
113 Stik Hemoglobin Box 2 0 2 0 0 0 0 0 0 0 0 2
114 Stik Urinalisa Test Box 39 0 39 0 0 0 0 0 0 0 0 39
115 Tabung Reaksi Pcs
116 Tes Kehamilan Pcs 100 0 100 100 0 0 0 0 0 0 100 0
117 Transfusion Set Pcs
118 Ultrasonic Gel Botol
119 Under Pad Pcs
120 Urine Bag Pcs 20 0 20 0 0 0 0 0 0 0 0 20

BMHP Gigi
1 Caviton 30 gram
Glass Ionomer Cement Type II + Paper
2 Pad
Glass Ionomer Cement Type IX + Paper
3 Pad
4 Composit A2
5 Composit A3
6 Etsa
7 Bonding
8 Mikro Brush
 9 Chlor Etyl
Devitec (Devitalizing Paste Arsenic Free)
10 7 gram
11 Alveogyl
12 Intro Kit
13 Chresopen
14 Paper Point

Vaksin
1 ADS 0,05 ml PCS
2 ADS 0,5 ml PCS
3 ADS 5 ml PCS
4 BCG Ampul
5 CAMPAK Vial
6 DPT-HB-HIB Vial
7 DT Vial
8 HB Uniject Vial
9 HbB 1 ml PCS
10 IPV Vial
11 MR Vial
12 Polio Vial
13 Td Vial
14 Serum Anti Bisa Ular (ABU) Vial
15 serum Anti Tetanus (ATS) Ampul
16 S.Box 2,5 ltr
17 S.Box 5 ltr
18 Vaksin Rabies

Obat-Obatan
283 Allopurinol 300 mg tablet 900 0 900 0 0 0 0 0 0 0 0 900
284 Amlodipine 10 mg tablet 1000 1500 2500 200 0 0 0 0 0 0 200 2300
285 Diethylcarbamazine citrate 100 mg tablet 1500 0 1500 0 0 0 0 0 0 0 0 1500
286 Dimenhidrinate 50 mg tablet 600 0 600 100 0 0 0 0 0 0 100 500
287 Gentamisin Salep Mata tube 20 0 20 0 0 0 0 0 0 0 0 20
288 Loratadin 10 mg tablet
289 Metamizole Injeksi ampul 100 0 100 0 0 0 0 0 0 0 0 100
290 Metronidazole 250 mg tablet
291 Ventolin Nebules 2,5 mg pcs
292 Cetirizine tab 10 mg tablet 200 0 200 0 0 0 0 0 0 0 0 200
293 methamizole tab tablet 4700 0 4700 0 0 0 0 0 0 0 0 4700
294 nifedipne 20 mg tablet 355 0 355 0 0 0 0 0 0 0 0 355
295 kloramphenikol salep kulit tube 47 120 167 10 0 0 0 0 0 0 10 157
BMHP
121 Antiseptik Gel botol 28 0 28 1 0 0 0 0 0 0 1 27
122 Kasa Hidrofil Steril 16/16 pcs 3 50 53 3 0 0 0 0 0 0 3 50
123 Oxygen Mask Anak pcs 5 0 5 0 0 0 0 0 0 0 0 5
124 Reagen Siphylis AB pcs
125 Reagen Siphylis BD pcs
126 Sabun Anti Bakteri botol 2 0 2 2 0 0 0 0 0 0 2 0
127 HBSaG pcs
128 Surgical Gown M pcs 10 0 10 0 0 0 0 0 0 0 0 10
129 Wing Needle pcs
130 Baju Coverall PCS 30 0 30 0 0 0 0 0 0 0 0 30
131 Thermogun PCS 1 0 1 0 0 0 0 0 0 0 0 1
132 Masker N95 PCS 177 0 177 2 0 0 0 0 0 0 2 175
133 Rapid Tes Covid-19 PCS
134 masker hijab (skineer) pcs 6 0 6 3 0 0 0 0 0 0 3 3
135 MASKER PCS Bantuan
136 Papsmer Kit pcs 10 0 10 0 0 0 0 0 0 0 0 10
137 plester non woven Roll 5cmx5m box 17 0 17 2 0 0 0 0 0 0 2 15
138 leukoplast 1.5 cm x 5 cm rol 0 10 10 0 0 0 0 0 0 0 0 10

Mengetahui/Menyetujui Yang Menyerahkan Yang Meminta Yang Menerima

Kepala Dinas Kesehatan Petugas GFK Kepala UPTD Puskesmas Petugas Pengelola Obat UPTD Puskesmas
Kabupaten Halmahera Tengah Rawat Inap Banemo Rawat Inap Banemo
 Rusman Djafar, SKM Resky Yuliandany, Amd.Farm.
Nip. Nip. Nip. 19740306 199403 1 004 NIP.19951105 201903 2 007
 LAPORAN MUTASI OBAT DAN BAHAN MEDIS HABIS PAKAI (BMHP)
DINAS KASEHATAN KABUPATEN HALMAHERA TENGAH
PUSKESMAS : : Banemo BULAN : JANUARI
KODE PUSKESMAS : P8202044201 TAHUN : 2021
KECAMATAN : Patani Barat
JUMLAH PUSTU/POLINDES :3
PENGELUARAN
SATUAN STOK PENERI JMLH
NO KETERSEDIA
URUT NAMA OBAT KEMASAN AWAL MAAN AN UGD/ PUSKESMA PUSTU PUSTU
PUSTU PENGELUAR
APOTEK PESANTREN BOBANE AN
LAINNYA S KELILING SIBENPOPO MOREALA
JAYA

1 2 3 4 5 6 7 8 9 10 11 12 13 14
Obat-Obatan
1 Aciclovir 200 mg Tablet 1400 0 1400 0 0 0 0 0 0 0 0
2 Aciclovir 400 mg Tablet 250 0 250 0 0 0 0 0 0 0 0
3 Aciclovir Krim Tube
4 Aciclovir Salep Mata Tube
5 Adidryl injeksi-15 ml/ Recodril Vial 20 0 20 0 0 0 0 0 0 0 0
6 Adimidon Injeksi-15 ml/ Benodon Vial
7 Albendazol 400 mg Tablet 1150 0 1150 0 0 0 0 0 0 0 0
8 Allopurinol 100 mg Tablet 1900 0 1900 0 0 0 0 0 0 0 0
9 Alprazolam 0,5 mg Tablet
10 Alprazolam 1 mg Tablet
11 Ambroxol 30 mg Tablet
12 Ambroxol Sirup Botol
13 Aminofilin 200 mg Tablet
14 Aminofilin Injeksi-24 mg/ml 10 ml Ampul 30 0 30 0 0 0 0 0 0 0 0
15 Amoxisilin 250 mg Kapsul 3000 0 3000 0 0 0 0 0 0 0 0
16 Amoxisilin 500 mg Tablet 2400 0 2400 400 0 0 0 0 0 0 400
17 Amoxisilin Syr 125 mg/5 ml Botol 2 60 62 0 0 0 0 0 0 0 0
18 Amoxisilin Syr 250 mg/ 5 ml Botol 68 0 68 0 0 0 0 0 0 0 0
19 Ampicilin 250 mg kaplet
20 Ampisilin 500 mg Tablet 2400 0 2400 0 0 0 0 0 0 0 0
21 Ampisilin Injeksi Vial
22 Ampislin Syr 125 mg/5 ml Botol 22 0 22 0 0 0 0 0 0 0 0
23 Amlodipin 5 Mg Tablet 1600 0 1600 0 0 0 0 0 0 0 0
24 Antalgin 500 mg Tablet 1500 0 1500 0 0 0 0 0 0 0 0
25 Antalgin Injeksi 250 mg/ml-2 ml Ampul
26 Antasida Doen Tablet 1500 0 1500 0 0 0 0 0 0 0 0
27 Antasida Syr Botol 56 0 56 10 0 0 0 0 0 0 10
28 Anti Fungi Doen Kombinasi Pot 48 0 48 0 0 0 0 0 0 0 0
29 Anti Haemoroid Doen Kombinasi Supp
30 Artesunate Tablet
31 Artesunate inj Vial
32 Asam Ascorbat (Vit C ) 50 mg Tablet 2000 0 2000 200 0 0 0 0 0 0 200
33 Asam Ascorbat (Vit C ) 250 mg Tablet
34 Asam Folat Tablet 1000 0 1000 200 0 0 0 0 0 0 200
35 Asam Mefenamat 250 mg Tablet
36 Asam Mefenamat 500 mg Tablet 4400 0 4400 600 0 0 0 0 0 0 600
37 Asam Tranexamat Tablet 0 100 100 0 0 0 0 0 0 0 0
38 Asam Tranexamat Injeksi Ampul 0 10 10 0 0 0 0 0 0 0 0
39 Asetosal 100 mg Tablet
40 Asetosal 500 mg Tablet
41 Atropin Sulfat Injeksi 0.25 mg/ml-1ml Ampul
42 Atropin Sulfat Tetes Mata 0.5 %-5 ml Botol
43 Atorvastatin 10 mg Tablet 1800 0 1800 100 0 0 0 0 0 0 100
44 Aqua Pro Injeksi Steril-20 ml Ampul
45 Azitromycin Tablet
46 Bacitracyn-Polimixyn Tube
47 Betammetason Krim 0.1%-5 gram Tube 25 0 25 25 0 0 0 0 0 0 25
48 Betahistin Mesylate Tablet
49 Bioplacenton Jely Tube 12 0 12 6 0 0 0 0 0 0 6
50 Buscopan Injeksi Ampul 10 0 10 0 0 0 0 0 0 0 0
51 Calcii Gluconas Ampul
52 Captopril 12.5 mg Tablet 1500 0 1500 400 0 0 0 0 0 0 400
53 Captopril 25 mg Tablet 2300 0 2300 0 0 0 0 0 0 0 0
54 Caviplex Sirup Botol
55 Cefadroxil 250 mg Tablet
56 Cefadroxil 500 mg Tablet 1500 0 1500 0 0 0 0 0 0 0 0
57 Cefadroxyl sirup 125 mg Botol 45 0 45 5 0 0 0 0 0 0 5
58 Cefadroxyl Sirup 250 mg Botol 41 0 41 5 0 0 0 0 0 0 5
59 Cefixime 200 mg Tablet
60 Cefixime Sirup 100 mg Botol
61 Cefotaxim Injeksi Vial
62 Ceftriaxone Injeksi Vial
63 Cetirizine Sirup Botol 85 0 85 0 0 0 0 0 0 0 0
64 Cimetidine 200 mg Tablet 1000 0 1000 0 0 0 0 0 0 0 0
65 Clindamycin 150 Mg Tablet 900 0 900 0 0 0 0 0 0 0 0
66 Clindamycin 300 Mg Tablet 2900 0 2900 0 0 0 0 0 0 0 0
67 Colchicine Tablet 450 0 450 0 0 0 0 0 0 0 0
68 Curcuma Suspensi Botol
69 Deksametasone 0.5 mg Tablet 2900 0 2900 100 0 0 0 0 0 0 100
70 Deksametasone Injeksi 5 mg/ml-1 ml Ampul 100 0 100 0 0 0 0 0 0 0 0
71 Dermasolon Tube 12 0 12 12 0 0 0 0 0 0 12
72 Dexocort Tube
73 DHP Frimal Tablet 40 0 40 0 0 0 0 0 0 0 0
74 Diazepam 2 mg Tablet
75 Diazepam 5 mg Tablet 491 0 491 5 0 0 0 0 0 0 5
76 Diazepam Injeksi 5 mg/ml-2 ml/ stesol Ampul 20 0 20 0 0 0 0 0 0 0 0
77 Difenhidramin HCL Injeksi 10 mg/ml-1 Ampul 30 0 30 0 0 0 0 0 0 0 0
78 Diltiazem Tablet 1000 0 1000 0 0 0 0 0 0 0 0
79 Doksisiklin 100 mg Tablet
80 Domperidon Tablet 4100 0 4100 0 0 0 0 0 0 0 0
81 Domperidon Sirup Botol 29 0 29 6 0 0 0 0 0 0 6
82 Dulcolax 5 mg Tablet Tablet 0 200 200 0 0 0 0 0 0 0 0
83 Dulcolax Supositoria 5 mg anak Tablet 0 12 12 0 0 0 0 0 0 0 0
84 Dulcolax Supositoria 10 mg Dewasa Supp
85 Efedrin HCL 25 mg Tablet
86 Ephineprine HCL Injeksi 0.1% -1 ml Ampul 200 0 200 0 0 0 0 0 0 0 0
87 Eritromisin 250 mg Kapsul 2000 0 2000 0 0 0 0 0 0 0 0
88 Eritromisin 500 mg Kaplet 1700 0 1700 0 0 0 0 0 0 0 0
89 Eritromisin Syr Kering 200 mg/ml-60 m Botol
90 Ethambutol 250 mg Tablet
91 Ethambutol 500 mg Tablet
92 Fenilbutason 200 mg Tablet
93 Fenobarbital 30 mg Tablet
94 Fenobarbital 100 mg Tablet
95 Fenobarbital Injeksi 50 mg/ml-2 ml Ampul
 96 Fitomenadion ( Vit K ) 10 mg Tablet 800 0 800 0 0 0 0 0 0 0 0
97 Fitomenadion ( Vit K ) Injeksi -1 ml Ampul 90 0 90 0 0 0 0 0 0 0 0
98 Furosemide 40 mg Tablet 2000 0 2000 0 0 0 0 0 0 0 0
99 Furosemide Injeksi Ampul
100 Gameksan Emulsi 1%-100 ml Botol
101 Garam Oralit 200 ml air Sachet 400 0 400 0 0 0 0 0 0 0 0
102 Gentamicin Injeksi Ampul
103 Gentamicin salep Kulit Tube
104 Gentamicin Tetes Mata Botol 48 0 48 0 0 0 0 0 0 0 0
105 Gentien Violet Larutan 1 % -10 ml Botol 24 0 24 0 0 0 0 0 0 0 0
106 Glibenklamide 5 mg Tablet 2400 0 2400 0 0 0 0 0 0 0 0
107 Glimepiride 1 mg Tablet
108 Glimepiride 2 mg Tablet 1750 0 1750 0 0 0 0 0 0 0 0
109 Gliseril Guaicolate 100 mg Tablet
110 Gliserin 100 ml Botol
111 Gliserin 1000 ml Tablet
112 Glukosa Injeksi 40 % Steril 25 ml Tablet
113 Glukosa Infus 5 % Steril -500 ml Tablet 200 0 200 0 0 0 0 0 0 0 0
114 Glukosa Infus 10 % Steril -500 ml Pot 80 0 80 0 0 0 0 0 0 0 0
115 Graxine Tablet
116 Griseofulvin 125 mg Tablet 4600 0 4600 0 0 0 0 0 0 0 0
117 Haloperidol 0.5 mg Tablet
118 Haloperidol 1.5 mg Tablet
119 Haloperidol 5 mg Tablet
120 Haloperidol Injeksi Ampul
121 Hidroklosiasid (HCT )25 mg Tablet
122 Hidrokortison Krim 2.5 %-5 gram Tube 72 0 72 24 0 0 0 0 0 0 24
123 Ibuprofen sirup Botol 37 0 37 0 0 0 0 0 0 0 0
124 Ibuprofen 200 mg Tablet 2300 0 2300 0 0 0 0 0 0 0 0
125 Ibuprofen 400 mg Kapsul 2000 0 2000 100 0 0 0 0 0 0 100
126 Isoniasid (INH) 100 mg Tube
127 Isoniasid (INH) 300 mg Botol
128 Isosorbid Dinitrat Sublingual Tablet 1000 0 1000 0 0 0 0 0 0 0 0
129 Kalium Permangnat Serbuk 5 mg Tablet
130 Kalsium Laktat 500 mg Tablet 400 0 400 300 0 0 0 0 0 0 300
131 Karbamazepin 200 mg Vial 100 0 100 100 0 0 0 0 0 0 100
132 Ketoconazole 200 mg Tablet Tablet 1950 0 1950 200 0 0 0 0 0 0 200
133 Ketoconazole Krim Tablet 69 0 69 5 0 0 0 0 0 0 5
134 Ketorolac Injeksi Ampul
135 Kinna ( Quinine )222 mg Tablet
136 Klorampenikol 250 mg Tablet 1900 0 1900 0 0 0 0 0 0 0 0
137 Klorampenikol Salep Mata 1% Tube 134 0 134 0 0 0 0 0 0 0 0
138 Klorampenikol Sirup Botol 50 0 50 0 0 0 0 0 0 0 0
139 Klorampenikol Tetes Telinga Botol 20 0 20 2 0 0 0 0 0 0 2
140 Klorampeniramin Maleat (CTM ) 4 mg Tablet 3700 0 3700 1000 0 0 0 0 0 0 1000
141 Kloroquin 150 mg Tablet
142 Kloroquin 250 mg Tablet
143 Kloroquin Injeksi-15 ml Ampul
144 Klorpromazin HCL 25 mg Tablet
145 Klorpromazin HCL 100 mg Tablet
146 Klorpromazin HCL Injeksi 5 mg/ml-2 m Ampul
147 Klorpromazin HCL Injeksi 25 mg/ml-1 Ampul
148 Klorpropamid 100 mg Tablet
149 Kodein fosfat HCL 10 mg Tablet
150 Kotrimoksazole Suspensi 60 ml Botol 71 30 101 10 0 0 0 0 0 0 10
151 Kotrimoksazole 120 mg Pediatrik Tablet
152 Kotrimoksazole 480 mg Dewasa Tablet 2700 0 2700 100 0 0 0 0 0 0 100
153 Kotrimoxazole Forte 960 mg Tablet
154 Larutan Irigasi Botol
155 Lansoprazole 30 mg Tablet 2250 0 2250 0 0 0 0 0 0 0 0
156 Levopar Tablet 1000 0 1000 0 0 0 0 0 0 0 0
157 Lidokain Injeksi 2 %-2 ml Ampul 200 0 200 0 0 0 0 0 0 0 0
158 Lidokain Injeksi Compositum Ampul
159 Loperamid 2 Mg Tablet
160 Lorazepam tablet Tablet 300 0 300 0 0 0 0 0 0 0 0
161 Mebendazol Syr 100 mg/5 ml-30 ml Botol
162 Meloxicam 7,5 Mg Tablet 450 0 450 0 0 0 0 0 0 0 0
163 Meloxicam 15 Mg Tablet 350 0 350 0 0 0 0 0 0 0 0
164 Metilergomertin Maleat 0.125 mg Tablet 1000 0 1000 0 0 0 0 0 0 0 0
165 Metilergomertin Maleat Inj 0.200 mg/ml-1 Ampul 200 0 200 0 0 0 0 0 0 0 0
166 Metoclopramide Tablet 1700 0 1700 0 0 0 0 0 0 0 0
167 Metoclopramide Drops Botol 12 0 12 0 0 0 0 0 0 0 0
168 Metoclopramide Sirup Botol
169 Metoclorpamide Injeksi Ampul 30 20 50 10 0 0 0 0 0 0 10
170 Metronidazole 500 mg Tablet 800 0 800 0 0 0 0 0 0 0 0
171 Metronidazole Sirup Botol
172 Methylprednisolon 4 Mg Tablet 5300 0 5300 100 0 0 0 0 0 0 100
173 Methylprednisolon 8 Mg Tablet 2500 0 2500 0 0 0 0 0 0 0 0
174 Methylprednisolon 16 Mg Tablet
175 Methylprednisolon Injeksi 125 Mg Ampul 30 0 30 0 0 0 0 0 0 0 0
176 Methylprednisolon Injeksi 500 mg Ampul
177 Metformin 500 Mg Tablet 1000 0 1000 0 0 0 0 0 0 0 0
178 MgSO4 20 % Flacon 18 0 18 0 0 0 0 0 0 0 0
179 MgSO4 40 % Flacon 18 0 18 0 0 0 0 0 0 0 0
180 Miconazole Zalf Tube 24 0 24 0 0 0 0 0 0 0 0
181 Microdiol strip
182 Mineral Mix Sachet 400 0 400 0 0 0 0 0 0 0 0
183 Natrium Diclofenak 25 mg Tablet 400 0 400 0 0 0 0 0 0 0 0
184 Natrium Diclofenak 50 mg Tablet 1000 0 1000 0 0 0 0 0 0 0 0
185 Natrium Fenitoin Injeksi 50mg/ml Ampul
186 Natrium Klorida Infus 0.9 % Steril 500 Botol 77 60 137 26 0 0 0 0 0 0 26
187 New Diatabs/ New Antides Tablet 1000 0 1000 100 0 0 0 0 0 0 100
188 Nifedipin 10 mg Tablet
189 Nistatin tablet 500.000 IU Tablet 400 0 400 0 0 0 0 0 0 0 0
190 Nistatin tablet Vaginal 100.000 IU Supp
191 Obat Anti Tuberkulosis Kategori 1 Dew Paket
192 Obat Anti Tuberkulosis Kategori 2 Dew Paket
193 Obat Anti Tuberkulosis Kategori 3 Dew Paket
194 Obat Anti Tuberkulosis Kategori Anak Paket
195 Obat Anti Tuberkulosis Sisipan Paket
196 Obat Batuk Hitam Syr 100 ml Botol 0 30 30 0 0 0 0 0 0 0 0
197 Obat Batuk Putih Syr 100 ml Botol
198 Oksitetrasiklin HCL Injeksi 50 mg/ml-1 Vial
199 Oksitetrasiklin HCL Salep Kulit 3 %-5 g Tube
200 Oksitetrasiklin HCL Salep Mata 1 %-3. Tube 48 0 48 0 0 0 0 0 0 0 0
201 Oksitosin Injeksi 10 IU/ml-8 ml Vial 24 0 24 4 0 0 0 0 0 0 4
202 Omeprazole Tablet 3420 0 3420 300 0 0 0 0 0 0 300
203 Omeprazole Injeksi Vial 20 0 20 0 0 0 0 0 0 0 0
204 Ondansetron Injeksi Ampul
205 Papaverin 40 mg Tablet
206 Papaverin Injeksi 40 mg/ml-8 ml Ampul
207 Parasetamol Drops Vial 102 0 102 12 0 0 0 0 0 0 12
208 Parasetamol 500 mg Tablet 1300 0 1300 400 0 0 0 0 0 0 400
209 Paracetamol Injeksi Botol 13 24 37 2 0 0 0 0 0 0 2
210 Parasetamol Syr 60 ml Botol 200 0 200 10 0 0 0 0 0 0 10
211 Pethidin HCL Injeksi 50 mg/ml-2 ml Ampul
212 Phenol Gliserol Botol
213 Piracetam 400 Mg Tablet
214 Piracetam 800 Mg Tablet 1000 0 1000 0 0 0 0 0 0 0 0
215 Piracetam Injeksi 5 ml Ampul
216 Piracetam Injeksi 15 ml Ampul
217 Pirazinamide Tablet
218 Pirantel Pamoat 125 mg Tablet 400 0 400 0 0 0 0 0 0 0 0
219 Pirantel Pamoat Sirup Botol
220 Piroxicam 10 mg Tablet
221 Piroxicam 20 mg Tablet 0 2000 2000 0 0 0 0 0 0 0 0
222 Pirodoksine HCL (B 6 ) 10 mg Tablet 500 0 500 0 0 0 0 0 0 0 0
223 Prednison 5 mg Tablet 1900 0 1900 100 0 0 0 0 0 0 100
224 Primaquin 15 mg Tablet 100 0 100 0 0 0 0 0 0 0 0
225 Prokain Benzil Penisilin Vial
226 Propranolol HCL 10 mg Tablet 500 0 500 0 0 0 0 0 0 0 0
227 Propranolol HCL 40 mg Tablet
228 Propiltiuracil (PTU) Tablet
229 Ranitidine 150 mg Tablet 1500 0 1500 100 0 0 0 0 0 0 100
230 Ranitidine Injeksi 50 mg/ml-2ml Ampul 20 30 50 10 0 0 0 0 0 0 10
231 Reserpin 0.10 mg Tablet
232 Reserpin 0.25 mg Tablet
233 Retinol ( VIT A )6.000 IU Tablet
234 Retinol ( VIT A )25.000 IU Tablet
235 Retinol ( VIT A )50.000 IU Tablet
236 Retinol ( VIT A )100.000 IU Tablet 500 0 500 0 0 0 0 0 0 0 0
237 Retinol ( VIT A )200.000 IU Tablet 450 0 450 0 0 0 0 0 0 0 0
238 Ringer Laktat Larutan Infus Steril-500 Botol 200 0 200 0 0 0 0 0 0 0 0
239 Ringer Laktat Larutan Infus Steril-1000 Botol 20 0 20 0 0 0 0 0 0 0 0
240 Risperidone 2 mg Tablet
241 Salbutamol 2 mg Tablet 1800 0 1800 100 0 0 0 0 0 0 100
242 Salbutamol 4 mg Tablet 1500 0 1500 0 0 0 0 0 0 0 0
243 Salbutamol sirup Botol
244 Salep Ichtyol 30 gram Pot 21 0 21 0 0 0 0 0 0 0 0
245 Salep Levetran Pot
246 Salep Scabisid Tube
247 Salicyl Bedak 2 %-50 gram Dos
248 Salicyl Spritus 10 % -25 ml Botol
249 Salep 2-4 Botol 48 0 48 0 0 0 0 0 0 0 0
250 Sianocobalamin( VIT B 12 ) 50 mg Tablet 3600 0 3600 400 0 0 0 0 0 0 400
251 Sianocobalalamin ( VIT B 12 ) 500 mg/ Ampul 400 0 400 0 0 0 0 0 0 0 0
252 Sianocobalalamin ( VIT B 12 ) 500 mg/ Vial
253 Simvastatin 10 mg Tablet 390 0 390 0 0 0 0 0 0 0 0
254 Simvastatin 20 mg Tablet 2640 0 2640 0 0 0 0 0 0 0 0
255 Siprofloksacin 250 mg Tablet
256 Siprofloksacin 500 mg Tablet 600 0 600 0 0 0 0 0 0 0 0
257 Sodium Bicaronat Tablet 900 0 900 0 0 0 0 0 0 0 0
258 Streptomicin Injeksi 1 gram Vial
259 Streptomicin Injeksi 1.5 gram Vial
260 Sulfadoxin Pirimenthamin 525 mg Tablet
261 Sulfacetamid Sodium Tetes mata Botol
262 Tablet Tambah Darah (SF ) Tablet 4320 0 4320 500 0 0 0 0 0 0 500
263 Tetrakain HCL Tetes Mata 0.5 %-5 ml Botol
264 Tetrasiklin HCL 250 mg Kapsul 2000 0 2000 0 0 0 0 0 0 0 0
265 Tetrasiklin HCL 500 mg Kapsul 2000 0 2000 0 0 0 0 0 0 0 0
266 Theophylline Tablet 1000 0 1000 0 0 0 0 0 0 0 0
267 Thiamin HCL ( B 1 ) 50 mg Tablet 19100 0 19100 200 0 0 0 0 0 0 200
268 Thiamin HCL ( B 1 ) Injeksi - 1 ml Ampul 1170 0 1170 0 0 0 0 0 0 0 0
269 Thiamin HCL ( B 1 ) Injeksi-15 ml Vial
270 Tramadol 50 mg Tablet
271 Tramadol Injeksi Ampul 35 0 35 0 0 0 0 0 0 0 0
272 Triheksipenidil Hidroklorida 2 mg Tablet 400 0 400 20 0 0 0 0 0 0 20
273 Ventolin Inhaler Botol
274 Verapamil 80 mg Tablet 1000 0 1000 0 0 0 0 0 0 0 0
275 Vitamin B Kompleks Tablet 990 0 990 400 0 0 0 0 0 0 400
276 Vitamin B Kompleks Injeksi -15 ml Vial
277 Vitamin B 6 Tablet 500 0 500 0 0 0 0 0 0 0 0
278 Vitamin B 6 Injeksi Ampul 0 100 100 0 0 0 0 0 0 0 0
279 Vitamin K4 Tablet
280 Wida KDN 1 Botol 20 0 20 0 0 0 0 0 0 0 0
281 Wida KN 1 Botol 20 0 20 0 0 0 0 0 0 0 0
282 Zink Tablet 2000 0 2000 200 0 0 0 0 0 0 200

BMHP
1 3 way Pcs 8 0 8 0 0 0 0 0 0 0 0
2 Abocath No.18 Pcs 138 0 138 3 0 0 0 0 0 0 3
3 Abocath No.20 Pcs
4 Abocath No.22 Pcs 46 0 46 10 0 0 0 0 0 0 10
5 Abocath No.24 Pcs 26 0 26 10 0 0 0 0 0 0 10
6 Abocath No.26 Pcs 27 0 27 0 0 0 0 0 0 0 0
7 Alkohol 100 ml Botol
8 Alkohol 300 ml Botol
9 Alkohol 1000 ml Botol 7 0 7 1 0 0 0 0 0 0 1
10 Alkohol Swab Box 2 0 2 0 0 0 0 0 0 0 0
11 Bisturi (Pisau Bedah )No.10 Biji 200 0 200 0 0 0 0 0 0 0 0
12 Bisturi (Pisau Bedah )No.11 Biji 100 0 100 0 0 0 0 0 0 0 0
13 Bisturi (Pisau Bedah )No.12 Biji 100 0 100 0 0 0 0 0 0 0 0
14 Bisturi (Pisau Bedah )No.20 Biji 200 0 200 0 0 0 0 0 0 0 0
15 Bisturi (Pisau Bedah )No.21 Biji 200 0 200 0 0 0 0 0 0 0 0
16 Bisturi (Pisau Bedah )No.22 Biji 100 0 100 0 0 0 0 0 0 0 0
17 Bisturi (Pisau Bedah )No.23 Biji 100 0 100 0 0 0 0 0 0 0 0
18 Bisturi (Pisau Bedah )No.24 Biji
19 Blood Lancet Box 1 0 1 0 0 0 0 0 0 0 0
20 Catgut/Benang Bedah Chromic No.2/0 Box 2 0 2 0 0 0 0 0 0 0 0
21 Catqut/Benang Bedah Chromic 3/0 Box 2 0 2 0 0 0 0 0 0 0 0
22 Catqut/Benang Bedah Plain 2/0 Box
23 Catqut/Benang Bedah Plain 3/0 Box 2 0 2 0 0 0 0 0 0 0 0
24 Cutisorb Pcs 24 0 24 0 0 0 0 0 0 0 0
25 Disposible 1 ml Pcs 300 0 300 0 0 0 0 0 0 0 0
26 Disposible 2.5 ml Pcs
27 Disposible 3 ml Pcs 203 0 203 0 0 0 0 0 0 0 0
28 Disposible 5 ml Pcs 100 0 100 0 0 0 0 0 0 0 0
29 Disposible 10 ml Pcs 100 0 100 0 0 0 0 0 0 0 0
30 Disposible 20 ml Pcs 100 0 100 0 0 0 0 0 0 0 0
31 Elastis Perban 7,5 X 4,55 Rol 1 0 1 0 0 0 0 0 0 0 0
32 Elastis Perban 10 X 4,55 Rol 1 0 1 0 0 0 0 0 0 0 0
33 Etil Klorida Semprot 100 ml Botol
34 Foley Catheter No. 06 PCS 10 0 10 0 0 0 0 0 0 0 0
35 Foley Catheter No. 08 PCS 10 0 10 0 0 0 0 0 0 0 0
36 Foley Catheter No. 10 PCS 10 0 10 0 0 0 0 0 0 0 0
37 Foley Catheter No. 12 PCS 10 0 10 0 0 0 0 0 0 0 0
38 Foley Catheter No. 14 PCS 10 0 10 0 0 0 0 0 0 0 0
39 Foley Catheter No. 16 PCS
40 Foley Catheter No. 18 PCS 29 0 29 0 0 0 0 0 0 0 0
41 Foley Catheter No. 20 PCS 10 0 10 1 0 0 0 0 0 0 1
42 Foley Catheter No. 22 PCS 20 0 20 0 0 0 0 0 0 0 0
43 Foley Catheter No. 24 PCS 19 0 19 0 0 0 0 0 0 0 0
44 Formalin Botol
45 Giemza Botol
46 H2O2 Botol 5 0 5 1 0 0 0 0 0 0 1
47 Handscoon Obgyn pasang 135 0 135 2 0 0 0 0 0 0 2
48 Hand Scoen (Sarung Tangan ) Uk. XS box
49 Hand Scoen ( Sarung Tangan )Uk. S box 12 0 12 3 0 0 0 0 0 0 3
50 Hand Scoen ( Sarung Tangan )Uk. M box 5 0 5 0 0 0 0 0 0 0 0
51 Hand Scoen ( Sarung Tangan )Uk. L box 5 0 5 1 0 0 0 0 0 0 1
52 Hand Scoen Steril (Sarung Tangan ) No Pasang 28 0 28 4 0 0 0 0 0 0 4
53 Hand Scoen Steril ( Sarung Tangan )No. Pasang 50 0 50 3 0 0 0 0 0 0 3
54 Hand Scoen Steril ( Sarung Tangan )No. Pasang 98 0 98 1 0 0 0 0 0 0 1
55 Hand Scoen Steril ( Sarung Tangan )No. Pasang 132 0 132 10 0 0 0 0 0 0 10
56 Hand Scoen Steril ( Sarung Tangan )No. Pasang 150 0 150 0 0 0 0 0 0 0 0
57 HCL 0,1 N Botol 5 0 5 0 0 0 0 0 0 0 0
58 Infuset Anak Pcs 99 0 99 0 0 0 0 0 0 0 0
59 Infuset Dewasa Pcs 50 0 50 0 0 0 0 0 0 0 0
60 Kapas Pembalut/ Absorben 250 gram Rol
61 Kapas Pembalut/ Absorben 1000 gram Rol
62 Kasa Hidrofil 80 cm X 2 m Lembar
63 Kasa Hidrofil Pembalut 3 cm X 4 m Rol
64 Kasa Hidrofil Pembalut 6 cm X 4 m Rol
65 Kasa Hidrofil Pembalut 15 cm X 4 m Rol 8 0 8 8 0 0 0 0 0 0 8
66 Kasa Hidrofil Pembalut 80 cm X 4 m Rol
67 Kasa Kompres Steril 16 cm X 16 cm Rol
68 Kasa Kompres Steril 40 cm X 80 cm Rol
69 Leukomed Pcs
70 Masker Box 0 20 20 0 0 0 0 0 0 0 0
71 Masker Hijab Box
72 Masker Nebulizer Anak Pcs
73 Masker Nebulizer Dewasa Pcs 5 0 5 0 0 0 0 0 0 0 0
74 Masker Oksigen Dewasa Pcs 20 0 20 0 0 0 0 0 0 0 0
75 Micropore Pcs
76 Oksigen Nasal Kanul (Bayi) Pcs 4 0 4 1 0 0 0 0 0 0 1
77 Oksigen Nasal Kanul (Anak) Pcs 5 0 5 2 0 0 0 0 0 0 2
78 Oksigen Nasal Kanul (Dewasa) Pcs 1 0 1 1 0 0 0 0 0 0 1
79 Plaster 1,25 cm X 4,5 Yards Rol
80 Plaster 2,5 cm X 4,5 Yards Rol 2 0 2 0 0 0 0 0 0 0 0
81 Plaster 5 cm X 4,5 Yards Rol 5 0 5 0 0 0 0 0 0 0 0
82 Plaster 7.5 cm X 4,5 yards Rol 3 0 3 0 0 0 0 0 0 0 0
83 Polifix 5 cm X 1 m Box 48 0 48 0 0 0 0 0 0 0 0
84 Polifix 5 cm X 5 m Box
85 Polifix 10 cm X 5 m Box
86 Policlean Botol
87 Poliwash Botol
88 Pot Dahak Botol
89 Povidon Iodion 10 %-60 ml Botol
90 Povidon Iodion 10 %-300 ml Botol 1 0 1 1 0 0 0 0 0 0 1
91 Povidon Iodion 10 %-1000 ml Botol
92 Rak Tabung Pcs
93 RDT Frambusia Box
94 RDT HIV PCS 11 0 11 0 0 0 0 0 0 0 0
95 RDT Hepatitis Sachet
96 RDT Malaria Box
97 Reagen TB Paket
98 Rivanol Larutan 0.1% -100 ml Botol
99 Rivanol Larutan 0.1 % -300 ml Botol 17 0 17 0 0 0 0 0 0 0 0
100 Sabun Asepso Pcs
101 Silk Benang Bedah No.0/0 Box 1 0 1 0 0 0 0 0 0 0 0
102 Silk Benang Bedah No.1/0 Box
103 Silk Benang Bedah No.2/0 Box 3 0 3 0 0 0 0 0 0 0 0
104 Silk Benang Bedah No.3/0 Box 4 0 4 0 0 0 0 0 0 0 0
105 Silk Benang Bedah No.4/0 Box 2 0 2 0 0 0 0 0 0 0 0
106 Silk Benang Bedah No.5/0 Box 1 0 1 0 0 0 0 0 0 0 0
107 Silk Benang Bedah No.6/0 Box 2 0 2 0 0 0 0 0 0 0 0
108 Slide Box
109 Suction Catheter Pcs
110 Stik Asam Urat Box 1 0 1 0 0 0 0 0 0 0 0
111 Stik Glukosa Box 0 1 1 0 0 0 0 0 0 0 0
112 Stik Kolesterol Box
113 Stik Hemoglobin Box 2 0 2 0 0 0 0 0 0 0 0
114 Stik Urinalisa Test Box 39 0 39 0 0 0 0 0 0 0 0
115 Tabung Reaksi Pcs
116 Tes Kehamilan Pcs 0 100 100 0 0 0 0 0 0 0 0
117 Transfusion Set Pcs
118 Ultrasonic Gel Botol
119 Under Pad Pcs
120 Urine Bag Pcs 20 0 20 0 0 0 0 0 0 0 0

BMHP Gigi
1 Caviton 30 gram
Glass Ionomer Cement Type II +
2 Paper Pad
Glass Ionomer Cement Type IX +
3 Paper Pad
4 Composit A2
5 Composit A3
6 Etsa
7 Bonding
8 Mikro Brush
9 Chlor Etyl
 Devitec (Devitalizing Paste Arsenic
10 Free) 7 gram
11 Alveogyl
12 Intro Kit
13 Chresopen
14 Paper Point

Vaksin
1 ADS 0,05 ml PCS
2 ADS 0,5 ml PCS
3 ADS 5 ml PCS
4 BCG Ampul
5 CAMPAK Vial
6 DPT-HB-HIB Vial
7 DT Vial
8 HB Uniject Vial
9 HbB 1 ml PCS
10 IPV Vial
11 MR Vial
12 Polio Vial
13 Td Vial
14 Serum Anti Bisa Ular (ABU) Vial
15 serum Anti Tetanus (ATS) Ampul
16 S.Box 2,5 ltr
17 S.Box 5 ltr
18 Vaksin Rabies

Obat-Obatan
283 Allopurinol 300 mg tablet 900 0 900 0 0 0 0 0 0 0 0
284 Amlodipine 10 mg tablet 2300 0 2300 200 0 0 0 0 0 0 200
285 Diethylcarbamazine citrate 100 mg tablet 1500 0 1500 0 0 0 0 0 0 0 0
286 Dimenhidrinate 50 mg tablet 500 0 500 200 0 0 0 0 0 0 200
287 Gentamisin Salep Mata tube 20 0 20 0 0 0 0 0 0 0 0
288 Loratadin 10 mg tablet
289 Metamizole Injeksi ampul 100 0 100 0 0 0 0 0 0 0 0
290 Metronidazole 250 mg tablet
291 Ventolin Nebules 2,5 mg pcs
292 Cetirizine tab 10 mg tablet 200 1000 1200 200 0 0 0 0 0 0 200
293 methamizole tab tablet 4700 0 4700 0 0 0 0 0 0 0 0
294 nifedipne 20 mg tablet 355 0 355 0 0 0 0 0 0 0 0
295 kloramphenikol salep kulit tube 157 0 157 28 0 0 0 0 0 0 28
BMHP
121 Antiseptik Gel botol 27 0 27 3 0 0 0 0 0 0 3
122 Kasa Hidrofil Steril 16/16 pcs 50 0 50 10 0 0 0 0 0 0 10
123 Oxygen Mask Anak pcs 5 0 5 0 0 0 0 0 0 0 0
124 Reagen Siphylis AB pcs
125 Reagen Siphylis BD pcs
126 Sabun Anti Bakteri botol
127 HBSaG pcs
128 Surgical Gown M pcs 10 0 10 0 0 0 0 0 0 0 0
129 Wing Needle pcs
130 Baju Coverall PCS 30 0 30 0 0 0 0 0 0 0 0
131 Thermogun PCS 1 0 1 0 0 0 0 0 0 0 0
132 Masker N95 PCS 175 0 175 0 0 0 0 0 0 0 0
133 Rapid Tes Covid-19 PCS
134 masker hijab (skineer) pcs 3 0 3 3 0 0 0 0 0 0 3
135 MASKER PCS
136 Papsmer Kit pcs 10 0 10 0 0 0 0 0 0 0 0
137 plester non woven Roll 5cmx5m box 15 0 15 0 0 0 0 0 0 0 0
138 leukoplast 1.5 cm x 5 cm rol 10 0 10 0 0 0 0 0 0 0 0

Mengetahui/Menyetujui Yang Menyerahkan Yang Meminta Yang Menerima

Kepala Dinas Kesehatan Petugas GFK Kepala UPTD Puskesmas Petugas Pengelola Obat UPTD Puskesmas
Kabupaten Halmahera Tengah Rawat Inap Banemo Rawat Inap Banemo

Rusman Djafar, SKM Resky Yuliandany, Amd.Farm.

Nip. Nip. Nip. 19740306 199403 1 004 NIP.19951105 201903 2 007
SISA PKM ED

15 16

1400
250

20

1150
1900

30
3000
2000
62
68

2400

22
1600
1500

1500
46
48

1800

800

3800
100
10

1700

6
10

1100
2300

1500
40
36
 85
1000
900
2900
450

2800
100
0

40

486
20
30
1000

4100
23
200
12

200 200 ED 01/21

2000
1700
 800
90
2000

400

48
24
2400

1750

200
80

4600

48
37
2300
1900

1000

100
0
1750
64

1900
134 134 ED 01/21
50
18
2700

91

2600

2250
1000
200

300

450
350
1000
200
1700
12
 40
800

5200
2500

30

1000
18
18
24

400
400
1000

111
900

400

30

48 48 ED 01/21
20
3120
20
 90
900
35
190

1000

400

2000
500
1800
100

500

1400
40 10 ED 01/21

500
450
200
20
1700
1500

21

48
3200
400

390
2640

600
900

3820

2000
2000
1000
18900
1170

35
380

1000
590
500
100

20
20
1800

8
135

36
16
27

6
2
200
100
100
200
200
100
100

1
2
2

2
24
300

203
100
100
100
1
1

10
10
10
10
10

29
9
20
19

4
133

9
5
4
24
47
97
122
150
5
99
50
0

20

5
20

3
3
0

2
5
3
48

11

17
1

3
4
2
1
2

1
1

2
39

100

20
 900
2100
1500
300
20

100
 1000
4700
355
129

24
40
5

10

30
1
175

0
Bantuan
10
15
10

Yang Menerima
gelola Obat UPTD Puskesmas
awat Inap Banemo

Yuliandany, Amd.Farm.
19951105 201903 2 007
 LAPORAN MUTASI OBAT DAN BAHAN MEDIS HABIS PAKAI (BMHP)
DINAS KASEHATAN KABUPATEN HALMAHERA TENGAH
PUSKESMAS : : Banemo BULAN : FEBRUARI
KODE PUSKESMAS : P8202044201 TAHUN : 2021
KECAMATAN : Patani Barat
JUMLAH PUSTU/POLINDES :3
PENGELUARAN
SATUAN JMLH
NO
NAMA OBAT KEMASA STOK PENERI KETERSE
DIAAN APOTEK UGD/
PUSKES
PESANT PUSTU PUSTU
PUSTU PENGELU SISA PKM ED
URUT
N AWAL MAAN MAS BOBANE ARAN
LAINNYA REN SIBENPOPO MOREALA
KELILING JAYA

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Obat-Obatan
1 Aciclovir 200 mg Tablet 1400 0 1400 0 0 0 0 0 0 0 0 1400
2 Aciclovir 400 mg Tablet 250 0 250 0 0 0 0 0 0 0 0 250
3 Aciclovir Krim Tube
4 Aciclovir Salep Mata Tube
5 Adidryl injeksi-15 ml/ Recodril Vial 20 0 20 0 0 0 0 0 0 0 0 20
6 Adimidon Injeksi-15 ml/ Benodon Vial
7 Albendazol 400 mg Tablet 1150 0 1150 0 0 0 0 0 0 0 0 1150 ED 800 02/21
8 Allopurinol 100 mg Tablet 1900 0 1900 100 0 0 0 0 100 0 200 1700
9 Alprazolam 0,5 mg Tablet
10 Alprazolam 1 mg Tablet
11 Ambroxol 30 mg Tablet
12 Ambroxol Sirup Botol
13 Aminofilin 200 mg Tablet
14 Aminofilin Injeksi-24 mg/ml 10 ml Ampul 30 0 30 0 0 0 0 0 0 0 0 30
15 Amoxisilin 250 mg Kapsul 3000 1000 4000 100 0 0 0 0 200 0 300 3700
16 Amoxisilin 500 mg Tablet 2000 0 2000 100 0 0 0 0 0 0 100 1900
17 Amoxisilin Syr 125 mg/5 ml Botol 62 60 122 2 0 0 0 0 5 0 7 115
18 Amoxisilin Syr 250 mg/ 5 ml Botol 68 0 68 0 0 0 0 0 0 0 0 68
19 Ampicilin 250 mg kaplet
20 Ampisilin 500 mg Tablet 2400 0 2400 0 0 0 0 0 200 0 200 2200
21 Ampisilin Injeksi Vial
22 Ampislin Syr 125 mg/5 ml Botol 22 0 22 2 0 0 0 0 0 0 2 20
23 Amlodipin 5 Mg Tablet 1600 0 1600 0 0 0 0 0 0 0 0 1600
24 Antalgin 500 mg Tablet 1500 0 1500 0 0 0 0 0 0 0 0 1500
25 Antalgin Injeksi 250 mg/ml-2 ml Ampul
26 Antasida Doen Tablet 1500 0 1500 0 0 0 0 0 0 0 0 1500
27 Antasida Syr Botol 46 0 46 8 0 0 0 0 0 0 8 38
28 Anti Fungi Doen Kombinasi Pot 48 0 48 0 0 0 0 0 0 0 0 48
29 Anti Haemoroid Doen Kombinasi Supp
30 Artesunate Tablet
31 Artesunate inj Vial
32 Asam Ascorbat (Vit C ) 50 mg Tablet 1800 0 1800 1400 0 0 0 0 0 0 1400 400
33 Asam Ascorbat (Vit C ) 250 mg Tablet
34 Asam Folat Tablet 800 0 800 200 0 0 0 0 100 0 300 500
35 Asam Mefenamat 250 mg Tablet
36 Asam Mefenamat 500 mg Tablet 3800 0 3800 300 0 0 0 0 200 0 500 3300
37 Asam Tranexamat Tablet 100 0 100 100 0 0 0 0 0 0 100 0
38 Asam Tranexamat Injeksi Ampul 10 0 10 10 0 0 0 0 0 0 10 0
39 Asetosal 100 mg Tablet
40 Asetosal 500 mg Tablet
41 Atropin Sulfat Injeksi 0.25 mg/ml-1ml Ampul
42 Atropin Sulfat Tetes Mata 0.5 %-5 ml Botol
43 Atorvastatin 10 mg Tablet 1700 0 1700 0 0 0 0 0 0 0 0 1700 1700 ED 2/21
44 Aqua Pro Injeksi Steril-20 ml Ampul
45 Azitromycin Tablet
46 Bacitracyn-Polimixyn Tube
47 Betammetason Krim 0.1%-5 gram Tube
48 Betahistin Mesylate Tablet
49 Bioplacenton Jely Tube 6 0 6 0 0 0 0 0 0 0 0 6
50 Buscopan Injeksi Ampul 10 0 10 0 0 0 0 0 0 0 0 10 10 ED 02/21
51 Calcii Gluconas Ampul
52 Captopril 12.5 mg Tablet 1100 0 1100 500 0 0 0 0 0 0 500 600
53 Captopril 25 mg Tablet 2300 0 2300 0 0 0 0 0 0 0 0 2300
54 Caviplex Sirup Botol
55 Cefadroxil 250 mg Tablet
56 Cefadroxil 500 mg Tablet 1500 0 1500 200 0 0 0 0 0 0 200 1300
57 Cefadroxyl sirup 125 mg Botol 40 0 40 15 0 0 0 0 0 0 15 25
58 Cefadroxyl Sirup 250 mg Botol 36 0 36 10 0 0 0 0 0 0 10 26
59 Cefixime 200 mg Tablet
60 Cefixime Sirup 100 mg Botol
61 Cefotaxim Injeksi Vial
62 Ceftriaxone Injeksi Vial
63 Cetirizine Sirup Botol 85 0 85 22 0 0 0 0 0 0 22 63
64 Cimetidine 200 mg Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
65 Clindamycin 150 Mg Tablet 900 0 900 0 0 0 0 0 0 0 0 900
66 Clindamycin 300 Mg Tablet 2900 0 2900 0 0 0 0 0 0 0 0 2900
67 Colchicine Tablet 450 0 450 0 0 0 0 0 0 0 0 450
68 Curcuma Suspensi Botol
69 Deksametasone 0.5 mg Tablet 2800 0 2800 0 0 0 0 0 200 0 200 2600
70 Deksametasone Injeksi 5 mg/ml-1 ml Ampul 100 0 100 0 0 0 0 0 0 0 0 100
71 Dermasolon Tube
72 Dexocort Tube
73 DHP Frimal Tablet 40 0 40 0 0 0 0 0 0 0 0 40
74 Diazepam 2 mg Tablet
75 Diazepam 5 mg Tablet 486 0 486 0 0 0 0 0 0 0 0 486
76 Diazepam Injeksi 5 mg/ml-2 ml/ stesoli Ampul 20 0 20 0 0 0 0 0 0 0 0 20
77 Difenhidramin HCL Injeksi 10 mg/ml-1 Ampul 30 0 30 0 0 0 0 0 0 0 0 30
78 Diltiazem Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
79 Doksisiklin 100 mg Tablet
80 Domperidon Tablet 4100 0 4100 200 0 0 0 0 100 0 300 3800
81 Domperidon Sirup Botol 23 0 23 4 0 0 0 0 0 0 4 19
82 Dulcolax 5 mg Tablet Tablet 200 0 200 60 0 0 0 0 0 0 60 140
 83 Dulcolax Supositoria 5 mg anak Tablet 12 0 12 0 0 0 0 0 0 0 0 12
84 Dulcolax Supositoria 10 mg Dewasa Supp
85 Efedrin HCL 25 mg Tablet
86 Ephineprine HCL Injeksi 0.1% -1 ml Ampul
87 Eritromisin 250 mg Kapsul 2000 0 2000 0 0 0 0 0 0 0 0 2000
88 Eritromisin 500 mg Kaplet 1700 0 1700 0 0 0 0 0 0 0 0 1700
89 Eritromisin Syr Kering 200 mg/ml-60 ml Botol
90 Ethambutol 250 mg Tablet
91 Ethambutol 500 mg Tablet
92 Fenilbutason 200 mg Tablet
93 Fenobarbital 30 mg Tablet
94 Fenobarbital 100 mg Tablet
95 Fenobarbital Injeksi 50 mg/ml-2 ml Ampul
96 Fitomenadion ( Vit K ) 10 mg Tablet 800 0 800 0 0 0 0 0 0 0 0 800
97 Fitomenadion ( Vit K ) Injeksi -1 ml Ampul 90 0 90 0 0 0 0 0 0 0 0 90
98 Furosemide 40 mg Tablet 2000 0 2000 0 0 0 0 0 0 0 0 2000
99 Furosemide Injeksi Ampul
100 Gameksan Emulsi 1%-100 ml Botol
101 Garam Oralit 200 ml air Sachet 400 0 400 100 0 0 0 0 0 0 100 300
102 Gentamicin Injeksi Ampul
103 Gentamicin salep Kulit Tube
104 Gentamicin Tetes Mata Botol 48 0 48 24 0 0 0 0 0 0 24 24
105 Gentien Violet Larutan 1 % -10 ml Botol 24 0 24 0 0 0 0 0 0 0 0 24
106 Glibenklamide 5 mg Tablet 2400 0 2400 0 0 0 0 0 0 0 0 2400
107 Glimepiride 1 mg Tablet
108 Glimepiride 2 mg Tablet 1750 0 1750 0 0 0 0 0 0 0 0 1750
109 Gliseril Guaicolate 100 mg Tablet
110 Gliserin 100 ml Botol
111 Gliserin 1000 ml Tablet
112 Glukosa Injeksi 40 % Steril 25 ml Tablet
113 Glukosa Infus 5 % Steril -500 ml Tablet 200 0 200 0 0 0 0 0 0 0 0 200 200 ED 2/21
114 Glukosa Infus 10 % Steril -500 ml Pot 80 0 80 0 0 0 0 0 0 0 0 80
115 Graxine Tablet
116 Griseofulvin 125 mg Tablet 4600 0 4600 0 0 0 0 0 0 0 0 4600
117 Haloperidol 0.5 mg Tablet
118 Haloperidol 1.5 mg Tablet
119 Haloperidol 5 mg Tablet
120 Haloperidol Injeksi Ampul
121 Hidroklosiasid (HCT )25 mg Tablet
122 Hidrokortison Krim 2.5 %-5 gram Tube 48 0 48 48 0 0 0 0 0 0 48 0
123 Ibuprofen sirup Botol 37 0 37 3 0 0 0 0 0 0 3 34
124 Ibuprofen 200 mg Tablet 2300 0 2300 200 0 0 0 0 0 0 200 2100
125 Ibuprofen 400 mg Kapsul 1900 0 1900 400 0 0 0 0 0 0 400 1500
126 Isoniasid (INH) 100 mg Tube
127 Isoniasid (INH) 300 mg Botol
128 Isosorbid Dinitrat Sublingual Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
129 Kalium Permangnat Serbuk 5 mg Tablet
130 Kalsium Laktat 500 mg Tablet 100 1000 1100 100 0 0 0 0 0 0 100 1000
131 Karbamazepin 200 mg Vial
132 Ketoconazole 200 mg Tablet Tablet 1750 0 1750 100 0 0 0 0 0 0 100 1650
133 Ketoconazole Krim Tablet 64 0 64 24 0 0 0 0 0 0 24 40
134 Ketorolac Injeksi Ampul
135 Kinna ( Quinine )222 mg Tablet
136 Klorampenikol 250 mg Tablet 1900 0 1900 0 0 0 0 0 0 0 0 1900
137 Klorampenikol Salep Mata 1% Tube 100 0 100 0 0 0 0 0 0 0 0 100
138 Klorampenikol Sirup Botol 50 0 50 0 0 0 0 0 0 0 0 50
139 Klorampenikol Tetes Telinga Botol 18 10 28 7 0 0 0 0 0 0 7 21
140 Klorampeniramin Maleat (CTM ) 4 mg Tablet 2700 0 2700 0 0 0 0 0 0 0 0 2700
141 Kloroquin 150 mg Tablet
142 Kloroquin 250 mg Tablet
143 Kloroquin Injeksi-15 ml Ampul
144 Klorpromazin HCL 25 mg Tablet
145 Klorpromazin HCL 100 mg Tablet
146 Klorpromazin HCL Injeksi 5 mg/ml-2 ml Ampul
147 Klorpromazin HCL Injeksi 25 mg/ml-1 m Ampul
148 Klorpropamid 100 mg Tablet
149 Kodein fosfat HCL 10 mg Tablet
150 Kotrimoksazole Suspensi 60 ml Botol 91 0 91 10 0 0 0 0 0 0 10 81
151 Kotrimoksazole 120 mg Pediatrik Tablet
152 Kotrimoksazole 480 mg Dewasa Tablet 2600 0 2600 0 0 0 0 0 0 0 0 2600
153 Kotrimoxazole Forte 960 mg Tablet
154 Larutan Irigasi Botol
155 Lansoprazole 30 mg Tablet 2250 0 2250 0 0 0 0 0 0 0 0 2250
156 Levopar Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
157 Lidokain Injeksi 2 %-2 ml Ampul 200 0 200 20 0 0 0 0 0 0 20 180
158 Lidokain Injeksi Compositum Ampul
159 Loperamid 2 Mg Tablet
160 Lorazepam tablet Tablet 300 0 300 0 0 0 0 0 0 0 0 300
161 Mebendazol Syr 100 mg/5 ml-30 ml Botol
162 Meloxicam 7,5 Mg Tablet 450 0 450 0 0 0 0 0 0 0 0 450
163 Meloxicam 15 Mg Tablet 350 0 350 150 0 0 0 0 0 0 150 200
164 Metilergomertin Maleat 0.125 mg Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
165 Metilergomertin Maleat Inj 0.200 mg/ml-1 Ampul 200 0 200 0 0 0 0 0 0 0 0 200
166 Metoclopramide Tablet 1700 0 1700 0 0 0 0 0 0 0 0 1700
167 Metoclopramide Drops Botol 12 0 12 2 0 0 0 0 0 0 2 10
168 Metoclopramide Sirup Botol
169 Metoclorpamide Injeksi Ampul 40 0 40 20 0 0 0 0 0 0 20 20
170 Metronidazole 500 mg Tablet 800 0 800 100 0 0 0 0 0 0 100 700
171 Metronidazole Sirup Botol
172 Methylprednisolon 4 Mg Tablet 5200 0 5200 200 0 0 0 0 0 0 200 5000
173 Methylprednisolon 8 Mg Tablet 2500 0 2500 0 0 0 0 0 0 0 0 2500
174 Methylprednisolon 16 Mg Tablet
175 Methylprednisolon Injeksi 125 Mg Ampul 30 0 30 0 0 0 0 0 0 0 0 30
176 Methylprednisolon Injeksi 500 mg Ampul
177 Metformin 500 Mg Tablet 1000 0 1000 200 0 0 0 0 0 0 200 800
178 MgSO4 20 % Flacon 18 0 18 0 0 0 0 0 0 0 0 18
179 MgSO4 40 % Flacon 18 0 18 0 0 0 0 0 0 0 0 18
180 Miconazole Zalf Tube 24 0 24 24 0 0 0 0 0 0 24 0
181 Microdiol strip
182 Mineral Mix Sachet 400 0 400 0 0 0 0 0 0 0 0 400
183 Natrium Diclofenak 25 mg Tablet 400 0 400 400 0 0 0 0 0 0 400 0
184 Natrium Diclofenak 50 mg Tablet 1000 0 1000 300 0 0 0 0 0 0 300 700
185 Natrium Fenitoin Injeksi 50mg/ml Ampul
186 Natrium Klorida Infus 0.9 % Steril 500 m Botol 111 0 111 71 0 0 0 0 0 0 71 40
187 New Diatabs/ New Antides Tablet 900 0 900 100 0 0 0 0 0 0 100 800
188 Nifedipin 10 mg Tablet
189 Nistatin tablet 500.000 IU Tablet 400 0 400 0 0 0 0 0 0 0 0 400
190 Nistatin tablet Vaginal 100.000 IU Supp
191 Obat Anti Tuberkulosis Kategori 1 Dew Paket
192 Obat Anti Tuberkulosis Kategori 2 Dew Paket
193 Obat Anti Tuberkulosis Kategori 3 Dew Paket
194 Obat Anti Tuberkulosis Kategori Anak Paket
195 Obat Anti Tuberkulosis Sisipan Paket
196 Obat Batuk Hitam Syr 100 ml Botol 30 0 30 30 0 0 0 0 0 0 30 0
197 Obat Batuk Putih Syr 100 ml Botol
198 Oksitetrasiklin HCL Injeksi 50 mg/ml-10 Vial
199 Oksitetrasiklin HCL Salep Kulit 3 %-5 gr Tube
200 Oksitetrasiklin HCL Salep Mata 1 %-3.5 Tube
201 Oksitosin Injeksi 10 IU/ml-8 ml Vial 20 0 20 7 0 0 0 0 0 0 7 13
202 Omeprazole Tablet 3120 2910 6030 390 0 0 0 0 0 0 390 5640
203 Omeprazole Injeksi Vial 20 0 20 10 0 0 0 0 0 0 10 10
204 Ondansetron Injeksi Ampul
205 Papaverin 40 mg Tablet
206 Papaverin Injeksi 40 mg/ml-8 ml Ampul
207 Parasetamol Drops Vial 90 0 90 15 0 0 0 0 5 0 20 70
208 Parasetamol 500 mg Tablet 900 0 900 500 0 0 0 0 100 0 600 300
209 Paracetamol Injeksi Botol 35 0 35 8 0 0 0 0 0 0 8 27
210 Parasetamol Syr 60 ml Botol 190 0 190 60 0 0 0 0 10 0 70 120
211 Pethidin HCL Injeksi 50 mg/ml-2 ml Ampul
212 Phenol Gliserol Botol
213 Piracetam 400 Mg Tablet
214 Piracetam 800 Mg Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
215 Piracetam Injeksi 5 ml Ampul
216 Piracetam Injeksi 15 ml Ampul
217 Pirazinamide Tablet
218 Pirantel Pamoat 125 mg Tablet 400 0 400 0 0 0 0 0 0 0 0 400
219 Pirantel Pamoat Sirup Botol
220 Piroxicam 10 mg Tablet
221 Piroxicam 20 mg Tablet 500 0 500 200 0 0 0 0 0 0 200 300
222 Pirodoksine HCL (B 6 ) 10 mg Tablet 500 0 500 0 0 0 0 0 0 0 0 500
223 Prednison 5 mg Tablet 1800 0 1800 0 0 0 0 0 0 0 0 1800
224 Primaquin 15 mg Tablet 100 0 100 0 0 0 0 0 0 0 0 100
225 Prokain Benzil Penisilin Vial
226 Propranolol HCL 10 mg Tablet 500 0 500 0 0 0 0 0 0 0 0 500 500 ED 2/21

227 Propranolol HCL 40 mg Tablet

228 Propiltiuracil (PTU) Tablet
229 Ranitidine 150 mg Tablet 1400 0 1400 900 0 0 0 0 0 0 900 500
230 Ranitidine Injeksi 50 mg/ml-2ml Ampul 30 0 30 30 0 0 0 0 0 0 30 0
231 Reserpin 0.10 mg Tablet
232 Reserpin 0.25 mg Tablet
233 Retinol ( VIT A )6.000 IU Tablet
234 Retinol ( VIT A )25.000 IU Tablet
235 Retinol ( VIT A )50.000 IU Tablet
236 Retinol ( VIT A )100.000 IU Tablet 500 0 500 250 0 0 0 0 0 0 250 250
237 Retinol ( VIT A )200.000 IU Tablet 450 0 450 250 0 0 0 0 0 0 250 200 200 ED 2/21
238 Ringer Laktat Larutan Infus Steril-500 m Botol 20 0 20 11 0 0 0 0 0 0 11 9
239 Ringer Laktat Larutan Infus Steril-1000 Botol 20 0 20 3 0 0 0 0 0 0 3 17
240 Risperidone 2 mg Tablet
241 Salbutamol 2 mg Tablet 1700 0 1700 200 0 0 0 0 0 0 200 1500
242 Salbutamol 4 mg Tablet 1500 0 1500 0 0 0 0 0 0 0 0 1500
243 Salbutamol sirup Botol
244 Salep Ichtyol 30 gram Pot 21 0 21 21 0 0 0 0 0 0 21 0
245 Salep Levetran Pot
246 Salep Scabisid Tube
247 Salicyl Bedak 2 %-50 gram Dos
248 Salicyl Spritus 10 % -25 ml Botol
249 Salep 2-4 Botol 48 0 48 0 0 0 0 0 0 0 0 48
250 Sianocobalamin( VIT B 12 ) 50 mg Tablet 3200 0 3200 200 0 0 0 0 0 0 200 3000
251 Sianocobalalamin ( VIT B 12 ) 500 mg/m Ampul 400 0 400 0 0 0 0 0 0 0 0 400
252 Sianocobalalamin ( VIT B 12 ) 500 mg/m Vial
253 Simvastatin 10 mg Tablet 390 0 390 0 0 0 0 0 30 0 30 360
254 Simvastatin 20 mg Tablet 2640 0 2640 0 0 0 0 0 0 0 0 2640
255 Siprofloksacin 250 mg Tablet
256 Siprofloksacin 500 mg Tablet 600 0 600 0 0 0 0 0 100 0 100 500
257 Sodium Bicaronat Tablet 900 0 900 0 0 0 0 0 0 0 0 900
258 Streptomicin Injeksi 1 gram Vial
259 Streptomicin Injeksi 1.5 gram Vial
260 Sulfadoxin Pirimenthamin 525 mg Tablet
261 Sulfacetamid Sodium Tetes mata Botol
262 Tablet Tambah Darah (SF ) Tablet 3820 0 3820 270 0 0 0 0 90 0 360 3460
263 Tetrakain HCL Tetes Mata 0.5 %-5 ml Botol
264 Tetrasiklin HCL 250 mg Kapsul 2000 0 2000 0 0 0 0 0 0 0 0 2000
265 Tetrasiklin HCL 500 mg Kapsul 2000 0 2000 0 0 0 0 0 0 0 0 2000
266 Theophylline Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
267 Thiamin HCL ( B 1 ) 50 mg Tablet 18900 0 18900 0 0 0 0 0 0 0 0 18900
268 Thiamin HCL ( B 1 ) Injeksi - 1 ml Ampul 1170 0 1170 0 0 0 0 0 0 0 0 1170
269 Thiamin HCL ( B 1 ) Injeksi-15 ml Vial
270 Tramadol 50 mg Tablet
271 Tramadol Injeksi Ampul 35 0 35 0 0 0 0 0 0 0 0 35 30 ED 02/21
272 Triheksipenidil Hidroklorida 2 mg Tablet 380 0 380 20 0 0 0 0 0 0 20 360
273 Ventolin Inhaler Botol
274 Verapamil 80 mg Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
275 Vitamin B Kompleks Tablet 590 0 590 300 0 0 0 0 0 0 300 290
276 Vitamin B Kompleks Injeksi -15 ml Vial
277 Vitamin B 6 Tablet 500 0 500 0 0 0 0 0 0 0 0 500
278 Vitamin B 6 Injeksi Ampul 100 0 100 0 0 0 0 0 0 0 0 100
279 Vitamin K4 Tablet
280 Wida KDN 1 Botol 20 0 20 0 0 0 0 0 0 0 0 20
281 Wida KN 1 Botol 20 0 20 0 0 0 0 0 0 0 0 20
282 Zink Tablet 1800 0 1800 0 0 0 0 0 0 0 0 1800

BMHP
1 3 way Pcs 8 0 8 0 0 0 0 0 0 0 0 8
2 Abocath No.18 Pcs 135 0 135 1 0 0 0 0 0 0 1 134
3 Abocath No.20 Pcs 0 20 20 0 0 0 0 0 0 0 0 20
4 Abocath No.22 Pcs 36 0 36 29 0 0 0 0 0 0 29 7
5 Abocath No.24 Pcs 16 20 36 14 0 0 0 0 0 0 14 22
6 Abocath No.26 Pcs 27 0 27 0 0 0 0 0 0 0 0 27
7 Alkohol 100 ml Botol
8 Alkohol 300 ml Botol
9 Alkohol 1000 ml Botol 6 0 6 4 0 0 0 0 0 0 4 2
10 Alkohol Swab Box 2 0 2 0 0 0 0 0 0 0 0 2
11 Bisturi (Pisau Bedah )No.10 Biji 200 0 200 0 0 0 0 0 0 0 0 200
12 Bisturi (Pisau Bedah )No.11 Biji 100 0 100 0 0 0 0 0 0 0 0 100
13 Bisturi (Pisau Bedah )No.12 Biji 100 0 100 0 0 0 0 0 0 0 0 100
14 Bisturi (Pisau Bedah )No.20 Biji 200 0 200 0 0 0 0 0 0 0 0 200
15 Bisturi (Pisau Bedah )No.21 Biji 200 0 200 0 0 0 0 0 0 0 0 200
16 Bisturi (Pisau Bedah )No.22 Biji 100 0 100 0 0 0 0 0 0 0 0 100
17 Bisturi (Pisau Bedah )No.23 Biji 100 0 100 0 0 0 0 0 0 0 0 100
18 Bisturi (Pisau Bedah )No.24 Biji
19 Blood Lancet Box 1 1 2 1 0 0 0 0 0 0 1 1
20 Catgut/Benang Bedah Chromic No.2/0 Box 2 0 2 0 0 0 0 0 0 0 0 2
21 Catqut/Benang Bedah Chromic 3/0 Box 2 0 2 1 0 0 0 0 0 0 1 1
22 Catqut/Benang Bedah Plain 2/0 Box
23 Catqut/Benang Bedah Plain 3/0 Box 2 0 2 0 0 0 0 0 0 0 0 2
24 Cutisorb Pcs 24 0 24 0 0 0 0 0 0 0 0 24
25 Disposible 1 ml Pcs 300 0 300 0 0 0 0 0 0 0 0 300
26 Disposible 2.5 ml Pcs
27 Disposible 3 ml Pcs 203 0 203 103 0 0 0 0 0 0 103 100
28 Disposible 5 ml Pcs 100 0 100 100 0 0 0 0 0 0 100 0
29 Disposible 10 ml Pcs 100 0 100 0 0 0 0 0 0 0 0 100
30 Disposible 20 ml Pcs 100 0 100 0 0 0 0 0 0 0 0 100
31 Elastis Perban 7,5 X 4,55 Rol 1 0 1 0 0 0 0 0 0 0 0 1
32 Elastis Perban 10 X 4,55 Rol 1 0 1 0 0 0 0 0 0 0 0 1
33 Etil Klorida Semprot 100 ml Botol 0 1 1 0 0 0 0 0 0 0
34 Foley Catheter No. 06 PCS 10 0 10 0 0 0 0 0 0 0 0 10
35 Foley Catheter No. 08 PCS 10 0 10 0 0 0 0 0 0 0 0 10
36 Foley Catheter No. 10 PCS 10 0 10 0 0 0 0 0 0 0 0 10
37 Foley Catheter No. 12 PCS 10 0 10 0 0 0 0 0 0 0 0 10
38 Foley Catheter No. 14 PCS 10 0 10 0 0 0 0 0 0 0 0 10
39 Foley Catheter No. 16 PCS
40 Foley Catheter No. 18 PCS 29 0 29 0 0 0 0 0 0 0 0 29
41 Foley Catheter No. 20 PCS 9 0 9 0 0 0 0 0 0 0 0 9
42 Foley Catheter No. 22 PCS 20 0 20 0 0 0 0 0 0 0 0 20
43 Foley Catheter No. 24 PCS 19 0 19 0 0 0 0 0 0 0 0 19
44 Formalin Botol
45 Giemza Botol
46 H2O2 Botol 4 0 4 0 0 0 0 0 0 0 0 4
47 Handscoon Obgyn pasang 133 0 133 0 0 0 0 0 0 0 0 133
48 Hand Scoen (Sarung Tangan ) Uk. XS box
49 Hand Scoen ( Sarung Tangan )Uk. S box 9 0 9 2 0 0 0 0 0 0 2 7
50 Hand Scoen ( Sarung Tangan )Uk. M box 5 0 5 2 0 0 0 0 0 0 2 3
51 Hand Scoen ( Sarung Tangan )Uk. L box 4 0 4 1 0 0 0 0 0 0 1 3
52 Hand Scoen Steril (Sarung Tangan ) No. Pasang 24 0 24 14 0 0 0 0 0 0 14 10
53 Hand Scoen Steril ( Sarung Tangan )No. Pasang 47 0 47 0 0 0 0 0 0 0 0 47
54 Hand Scoen Steril ( Sarung Tangan )No. Pasang 97 0 97 20 0 0 0 0 0 0 20 77
55 Hand Scoen Steril ( Sarung Tangan )No. Pasang 122 0 122 12 0 0 0 0 0 0 12 110
56 Hand Scoen Steril ( Sarung Tangan )No. Pasang 150 0 150 0 0 0 0 0 0 0 0 150
57 HCL 0,1 N Botol 5 0 5 0 0 0 0 0 0 0 0 5
58 Infuset Anak Pcs 99 0 99 5 0 0 0 0 0 0 5 94
59 Infuset Dewasa Pcs 50 0 50 36 0 0 0 0 0 0 36 14
60 Kapas Pembalut/ Absorben 250 gram Rol
61 Kapas Pembalut/ Absorben 1000 gram Rol
62 Kasa Hidrofil 80 cm X 2 m Lembar
63 Kasa Hidrofil Pembalut 3 cm X 4 m Rol
64 Kasa Hidrofil Pembalut 6 cm X 4 m Rol
65 Kasa Hidrofil Pembalut 15 cm X 4 m Rol
66 Kasa Hidrofil Pembalut 80 cm X 4 m Rol
67 Kasa Kompres Steril 16 cm X 16 cm Rol
68 Kasa Kompres Steril 40 cm X 80 cm Rol
69 Leukomed Pcs
70 Masker Box 20 0 20 5 0 0 0 0 0 0 5 15
71 Masker Hijab Box
72 Masker Nebulizer Anak Pcs
73 Masker Nebulizer Dewasa Pcs 5 0 5 5 0 0 0 0 0 0 5 0
74 Masker Oksigen Dewasa Pcs 20 0 20 10 0 0 0 0 0 0 10 10
75 Micropore Pcs
76 Oksigen Nasal Kanul (Bayi) Pcs 3 0 3 3 0 0 0 0 0 0 3 0
77 Oksigen Nasal Kanul (Anak) Pcs 3 0 3 3 0 0 0 0 0 0 3 0
78 Oksigen Nasal Kanul (Dewasa) Pcs
79 Plaster 1,25 cm X 4,5 Yards Rol
80 Plaster 2,5 cm X 4,5 Yards Rol 2 0 2 0 0 0 0 0 0 0 0 2
81 Plaster 5 cm X 4,5 Yards Rol 5 0 5 1 0 0 0 0 0 0 1 4
82 Plaster 7.5 cm X 4,5 yards Rol 3 0 3 0 0 0 0 0 0 0 0 3
83 Polifix 5 cm X 1 m Box 48 0 48 0 0 0 0 0 0 0 0 48
84 Polifix 5 cm X 5 m Box
85 Polifix 10 cm X 5 m Box
86 Policlean Botol
 87 Poliwash Botol
88 Pot Dahak Botol
89 Povidon Iodion 10 %-60 ml Botol
90 Povidon Iodion 10 %-300 ml Botol 0 5 5 0 0 0 0 0 0 0 0 5
91 Povidon Iodion 10 %-1000 ml Botol
92 Rak Tabung Pcs
93 RDT Frambusia Box
94 RDT HIV PCS 11 0 11 0 0 0 0 0 0 0 0 11
95 RDT Hepatitis Sachet
96 RDT Malaria Box
97 Reagen TB Paket
98 Rivanol Larutan 0.1% -100 ml Botol
99 Rivanol Larutan 0.1 % -300 ml Botol 17 0 17 1 0 0 0 0 0 0 1 16
100 Sabun Asepso Pcs
101 Silk Benang Bedah No.0/0 Box 1 0 1 0 0 0 0 0 0 0 0 1
102 Silk Benang Bedah No.1/0 Box
103 Silk Benang Bedah No.2/0 Box 3 0 3 0 0 0 0 0 0 0 0 3
104 Silk Benang Bedah No.3/0 Box 4 0 4 0 0 0 0 0 0 0 0 4
105 Silk Benang Bedah No.4/0 Box 2 0 2 0 0 0 0 0 0 0 0 2
106 Silk Benang Bedah No.5/0 Box 1 0 1 0 0 0 0 0 0 0 0 1
107 Silk Benang Bedah No.6/0 Box 2 0 2 1 0 0 0 0 0 0 1 1
108 Slide Box
109 Suction Catheter Pcs
110 Stik Asam Urat Box 1 0 1 1 0 0 0 0 0 0 1 0
111 Stik Glukosa Box 1 0 1 1 0 0 0 0 0 0 1 0
112 Stik Kolesterol Box
113 Stik Hemoglobin Box 2 0 2 0 0 0 0 0 0 0 0 2
114 Stik Urinalisa Test Box 39 0 39 0 0 0 0 0 0 0 0 39
115 Tabung Reaksi Pcs
116 Tes Kehamilan Pcs 100 100 200 100 0 0 0 0 0 0 100 100
117 Transfusion Set Pcs
118 Ultrasonic Gel Botol
119 Under Pad Pcs
120 Urine Bag Pcs 20 0 20 0 0 0 0 0 0 0 0 20

BMHP Gigi
1 Caviton
Glass 30 gram
Ionomer Cement Type II + Paper
2 Pad
Glass Ionomer Cement Type IX +
3 Paper Pad
4 Composit A2
5 Composit A3
6 Etsa
7 Bonding
8 Mikro Brush
9 Chlor Etyl
Devitec (Devitalizing Paste Arsenic
10 Free) 7 gram
11 Alveogyl
12 Intro Kit
13 Chresopen
14 Paper Point

Vaksin
1 ADS 0,05 ml PCS
2 ADS 0,5 ml PCS
3 ADS 5 ml PCS
4 BCG Ampul
5 CAMPAK Vial
6 DPT-HB-HIB Vial
7 DT Vial
8 HB Uniject Vial
9 HbB 1 ml PCS
10 IPV Vial
11 MR Vial
12 Polio Vial
13 Td Vial
14 Serum Anti Bisa Ular (ABU) Vial
15 serum Anti Tetanus (ATS) Ampul
16 S.Box 2,5 ltr
17 S.Box 5 ltr
18 Vaksin Rabies

Obat-Obatan
283 Allopurinol 300 mg tablet 900 0 900 0 0 0 0 0 0 0 0 900 200 ED 2/21
284 Amlodipine 10 mg tablet 2100 0 2100 0 0 0 0 0 0 0 0 2100
285 Diethylcarbamazine citrate 100 mg tablet 1500 0 1500 0 0 0 0 0 0 0 0 1500
286 Dimenhidrinate 50 mg tablet 300 500 800 200 0 0 0 0 0 0 200 600
287 Gentamisin Salep Mata tube 20 0 20 0 0 0 0 0 0 0 0 20
288 Loratadin 10 mg tablet
289 Metamizole Injeksi ampul 100 0 100 0 0 0 0 0 0 0 0 100
290 Metronidazole 250 mg tablet
291 Ventolin Nebules 2,5 mg pcs
292 Cetirizine tab 10 mg tablet 1000 2000 3000 700 0 0 0 0 0 0 700 2300
293 methamizole tab tablet 4700 0 4700 0 0 0 0 0 200 0 200 4500
294 nifedipne 20 mg tablet 355 0 355 0 0 0 0 0 0 0 0 355
295 kloramphenikol salep kulit tube 129 0 129 0 0 0 0 0 0 0 0 129
BMHP
121 Antiseptik Gel botol 24 0 24 2 0 0 0 0 0 0 2 22
122 Kasa Hidrofil Steril 16/16 pcs 40 0 40 40 0 0 0 0 0 0 40 0
123 Oxygen Mask Anak pcs 5 0 5 0 0 0 0 0 0 0 0 5
124 Reagen Siphylis AB pcs
125 Reagen Siphylis BD pcs
126 Sabun Anti Bakteri botol
127 HBSaG pcs
128 Surgical Gown M pcs 10 0 10 0 0 0 0 0 0 0 0 10
129 Wing Needle pcs
130 Baju Coverall PCS 30 0 30 0 0 0 0 0 0 0 0 30
131 Thermogun PCS 1 0 1 0 0 0 0 0 0 0 0 1
132 Masker N95 PCS 175 0 175 0 0 0 0 0 0 0 0 175
133 Rapid Tes Covid-19 PCS
134 masker hijab (skineer) pcs
135 MASKER PCS 0 7 7 7 0 0 0 0 0 0 7 0 PROGRAM
136 Papsmer Kit pcs 10 0 10 0 0 0 0 0 0 0 0 10
137 plester non woven Roll 5cmx5m box 15 0 15 5 0 0 0 0 0 0 5 10
138 leukoplast 1.5 cm x 5 cm rol 10 0 10 0 0 0 0 0 0 0 0 10

Mengetahui/Menyetujui Yang Menyerahkan Yang Meminta Yang Menerima

Kepala Dinas Kesehatan Petugas GFK Kepala UPTD Puskesmas Petugas Pengelola Obat UPTD Puskesmas
Kabupaten Halmahera Tengah Rawat Inap Banemo Rawat Inap Banemo

Rusman Djafar, SKM Resky Yuliandany, Amd.Farm.

Nip. Nip. Nip. 19740306 199403 1 004 NIP.19951105 201903 2 007
 LAPORAN MUTASI OBAT DAN BAHAN MEDIS HABIS PAKAI (BMHP)
DINAS KASEHATAN KABUPATEN HALMAHERA TENGAH
PUSKESMAS : : Banemo BULAN : MARET
KODE PUSKESMAS : P8202044201 TAHUN : 2021
KECAMATAN : Patani Barat

JUMLAH PUSTU/POLINDES :3
PENGELUARAN
SATUAN STOK PENERI KETERSED JMLH
NO
URUT NAMA OBAT KEMASAN AWAL MAAN IAAN APOTEK UGD/ PUSKESM PESANT PUSTU PUSTU
PUSTU PENGELUA SISA PKM ED
AS BOBANE RAN
LAINNYA REN SIBENPOPO MOREALA
KELILING JAYA

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Obat-Obatan
1 Aciclovir 200 mg Tablet 1400 0 1400 0 0 0 0 0 0 0 0 1400
2 Aciclovir 400 mg Tablet 250 0 250 0 0 0 0 0 0 0 0 250
3 Aciclovir Krim Tube
4 Aciclovir Salep Mata Tube
5 Adidryl injeksi-15 ml/ Recodril Vial 20 0 20 0 0 0 0 0 0 0 0 20
6 Adimidon Injeksi-15 ml/ Benodon Vial
7 Albendazol 400 mg Tablet 350 0 350 0 0 0 0 0 0 0 0 350
8 Allopurinol 100 mg Tablet 1700 0 1700 0 0 0 0 0 100 0 100 1600
9 Alprazolam 0,5 mg Tablet
10 Alprazolam 1 mg Tablet
11 Ambroxol 30 mg Tablet
12 Ambroxol Sirup Botol
13 Aminofilin 200 mg Tablet
14 Aminofilin Injeksi-24 mg/ml 10 ml Ampul 30 0 30 0 0 0 0 0 0 0 0 30
15 Amoxisilin 250 mg Kapsul 3700 0 3700 0 0 0 0 0 200 200 400 3300
16 Amoxisilin 500 mg Tablet 1900 0 1900 500 0 0 0 0 0 0 500 1400
17 Amoxisilin Syr 125 mg/5 ml Botol 115 0 115 13 0 0 0 0 0 0 13 102
18 Amoxisilin Syr 250 mg/ 5 ml Botol 68 120 188 5 0 0 0 0 0 0 5 183
19 Ampicilin 250 mg kaplet
20 Ampisilin 500 mg Tablet 2200 0 2200 200 0 0 0 0 200 0 400 1800
21 Ampisilin Injeksi Vial
22 Ampislin Syr 125 mg/5 ml Botol 20 0 20 3 0 0 0 0 0 0 3 17
23 Amlodipin 5 Mg Tablet 1600 0 1600 0 0 0 0 0 0 0 0 1600
24 Antalgin 500 mg Tablet 1500 0 1500 100 0 0 0 0 100 0 200 1300
25 Antalgin Injeksi 250 mg/ml-2 ml Ampul
26 Antasida Doen Tablet 1500 0 1500 0 0 0 0 0 0 0 0 1500
27 Antasida Syr Botol 38 0 38 38 0 0 0 0 0 0 38 0
28 Anti Fungi Doen Kombinasi Pot 48 0 48 24 0 0 0 0 0 0 24 24
29 Anti Haemoroid Doen Kombinasi Supp
30 Artesunate Tablet
31 Artesunate inj Vial
32 Asam Ascorbat (Vit C ) 50 mg Tablet 400 2000 2400 900 0 0 0 0 0 0 900 1500
33 Asam Ascorbat (Vit C ) 250 mg Tablet
34 Asam Folat Tablet 500 1000 1500 500 0 0 0 0 100 0 600 900
35 Asam Mefenamat 250 mg Tablet
36 Asam Mefenamat 500 mg Tablet 3300 0 3300 1100 0 0 0 0 200 0 1300 2000
37 Asam Tranexamat Tablet 0 100 100 0 0 0 0 0 0 0 0 100
38 Asam Tranexamat Injeksi Ampul
39 Asetosal 100 mg Tablet
40 Asetosal 500 mg Tablet
41 Atropin Sulfat Injeksi 0.25 mg/ml-1ml Ampul
42 Atropin Sulfat Tetes Mata 0.5 %-5 ml Botol
43 Atorvastatin 10 mg Tablet
44 Aqua Pro Injeksi Steril-20 ml Ampul
45 Azitromycin Tablet
46 Bacitracyn-Polimixyn Tube
47 Betammetason Krim 0.1%-5 gram Tube 0 50 50 50 0 0 0 0 0 0 50 0
48 Betahistin Mesylate Tablet
49 Bioplacenton Jely Tube 6 0 6 0 0 0 0 0 0 0 0 6
50 Buscopan Injeksi Ampul
51 Calcii Gluconas Ampul
52 Captopril 12.5 mg Tablet 600 0 600 500 0 0 0 0 0 0 500 100
53 Captopril 25 mg Tablet 2300 0 2300 200 0 0 0 0 0 0 200 2100
54 Caviplex Sirup Botol
55 Cefadroxil 250 mg Tablet
56 Cefadroxil 500 mg Tablet 1300 0 1300 600 0 0 0 0 100 0 700 600
57 Cefadroxyl sirup 125 mg Botol 25 0 25 6 0 0 0 0 0 0 6 19
58 Cefadroxyl Sirup 250 mg Botol 26 100 126 5 0 0 0 0 0 0 5 121
59 Cefixime 200 mg Tablet
60 Cefixime Sirup 100 mg Botol
61 Cefotaxim Injeksi Vial
62 Ceftriaxone Injeksi Vial
63 Cetirizine Sirup Botol 63 100 163 10 0 0 0 0 0 0 10 153
64 Cimetidine 200 mg Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
65 Clindamycin 150 Mg Tablet 900 0 900 0 0 0 0 0 0 0 0 900
66 Clindamycin 300 Mg Tablet 2900 0 2900 0 0 0 0 0 0 0 0 2900
67 Colchicine Tablet 450 0 450 110 0 0 0 0 0 0 110 340
68 Curcuma Suspensi Botol
69 Deksametasone 0.5 mg Tablet 2600 0 2600 400 0 0 0 0 100 0 500 2100
70 Deksametasone Injeksi 5 mg/ml-1 ml Ampul 100 0 100 0 0 0 0 0 0 0 0 100
71 Dermasolon Tube 0 7 7 7 0 0 0 0 0 0 7 0
72 Dexocort Tube
73 DHP Frimal Tablet 40 0 40 0 0 0 0 0 0 0 0 40 40 ED 3/21
74 Diazepam 2 mg Tablet
75 Diazepam 5 mg Tablet 486 0 486 0 0 0 0 0 0 0 0 486
76 Diazepam Injeksi 5 mg/ml-2 ml/ stesolid Ampul 20 0 20 0 0 0 0 0 0 0 0 20
77 Difenhidramin HCL Injeksi 10 mg/ml-1 ml Ampul 30 0 30 0 0 0 0 0 0 0 0 30
78 Diltiazem Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
79 Doksisiklin 100 mg Tablet
80 Domperidon Tablet 3800 0 3800 400 0 0 0 0 0 0 400 3400
81 Domperidon Sirup Botol 19 0 19 7 0 0 0 0 0 0 7 12
82 Dulcolax 5 mg Tablet Tablet 140 0 140 0 0 0 0 0 20 0 20 120
83 Dulcolax Supositoria 5 mg anak Tablet 12 0 12 3 0 0 0 0 0 0 3 9
84 Dulcolax Supositoria 10 mg Dewasa Supp
85 Efedrin HCL 25 mg Tablet
86 Ephineprine HCL Injeksi 0.1% -1 ml Ampul
87 Eritromisin 250 mg Kapsul 2000 0 2000 0 0 0 0 0 0 0 0 2000
88 Eritromisin 500 mg Kaplet 1700 0 1700 0 0 0 0 0 0 0 0 1700
89 Eritromisin Syr Kering 200 mg/ml-60 ml Botol
90 Ethambutol 250 mg Tablet
91 Ethambutol 500 mg Tablet
92 Fenilbutason 200 mg Tablet
93 Fenobarbital 30 mg Tablet
94 Fenobarbital 100 mg Tablet
95 Fenobarbital Injeksi 50 mg/ml-2 ml Ampul
96 Fitomenadion ( Vit K ) 10 mg Tablet 800 0 800 0 0 0 0 0 0 0 0 800
97 Fitomenadion ( Vit K ) Injeksi -1 ml Ampul 90 0 90 0 0 0 0 0 0 0 0 90
98 Furosemide 40 mg Tablet 2000 0 2000 0 0 0 0 0 0 0 0 2000
99 Furosemide Injeksi Ampul
100 Gameksan Emulsi 1%-100 ml Botol
101 Garam Oralit 200 ml air Sachet 300 100 400 100 0 0 0 0 0 0 100 300
102 Gentamicin Injeksi Ampul
103 Gentamicin salep Kulit Tube
104 Gentamicin Tetes Mata Botol 24 48 72 0 0 0 0 0 0 0 0 72
105 Gentien Violet Larutan 1 % -10 ml Botol 24 0 24 0 0 0 0 0 0 0 0 24
106 Glibenklamide 5 mg Tablet 2400 0 2400 0 0 0 0 0 0 0 0 2400
107 Glimepiride 1 mg Tablet
108 Glimepiride 2 mg Tablet 1750 0 1750 0 0 0 0 0 0 0 0 1750
109 Gliseril Guaicolate 100 mg Tablet
110 Gliserin 100 ml Botol
111 Gliserin 1000 ml Tablet
112 Glukosa Injeksi 40 % Steril 25 ml Tablet
113 Glukosa Infus 5 % Steril -500 ml Tablet
114 Glukosa Infus 10 % Steril -500 ml Pot 80 0 80 0 0 0 0 0 0 0 0 80
115 Graxine Tablet
116 Griseofulvin 125 mg Tablet 4600 0 4600 100 0 0 0 0 100 0 200 4400
117 Haloperidol 0.5 mg Tablet
118 Haloperidol 1.5 mg Tablet
119 Haloperidol 5 mg Tablet
120 Haloperidol Injeksi Ampul
121 Hidroklosiasid (HCT )25 mg Tablet
122 Hidrokortison Krim 2.5 %-5 gram Tube
123 Ibuprofen sirup Botol 34 0 34 0 0 0 0 0 0 0 0 34
124 Ibuprofen 200 mg Tablet 2100 0 2100 900 0 0 0 0 0 0 900 1200
125 Ibuprofen 400 mg Kapsul 1500 0 1500 500 0 0 0 0 0 0 500 1000
126 Isoniasid (INH) 100 mg Tube
127 Isoniasid (INH) 300 mg Botol
128 Isosorbid Dinitrat Sublingual Tablet 1000 0 1000 100 0 0 0 0 0 0 100 900
129 Kalium Permangnat Serbuk 5 mg Tablet
130 Kalsium Laktat 500 mg Tablet 1000 0 1000 600 0 0 0 0 100 100 800 200
131 Karbamazepin 200 mg Vial 0 300 300 15 0 0 0 0 0 0 15 285
132 Ketoconazole 200 mg Tablet Tablet 1650 0 1650 100 0 0 0 0 100 0 200 1450
133 Ketoconazole Krim Tablet 40 0 40 0 0 0 0 0 0 0 0 40
134 Ketorolac Injeksi Ampul
135 Kinna ( Quinine )222 mg Tablet
136 Klorampenikol 250 mg Tablet 1900 0 1900 0 0 0 0 0 0 0 0 1900
137 Klorampenikol Salep Mata 1% Tube 100 0 100 0 0 0 0 0 0 0 0 100 100 ED 03/21
138 Klorampenikol Sirup Botol 50 50 100 0 0 0 0 0 0 0 0 100
139 Klorampenikol Tetes Telinga Botol 21 0 21 13 0 0 0 0 1 0 14 7
140 Klorampeniramin Maleat (CTM ) 4 mg Tablet 2700 0 2700 500 0 0 0 0 100 100 700 2000
141 Kloroquin 150 mg Tablet
142 Kloroquin 250 mg Tablet
143 Kloroquin Injeksi-15 ml Ampul
144 Klorpromazin HCL 25 mg Tablet
145 Klorpromazin HCL 100 mg Tablet
146 Klorpromazin HCL Injeksi 5 mg/ml-2 ml Ampul
147 Klorpromazin HCL Injeksi 25 mg/ml-1 ml Ampul
148 Klorpropamid 100 mg Tablet
149 Kodein fosfat HCL 10 mg Tablet
150 Kotrimoksazole Suspensi 60 ml Botol 81 0 81 10 0 0 0 0 0 0 10 71
151 Kotrimoksazole 120 mg Pediatrik Tablet
152 Kotrimoksazole 480 mg Dewasa Tablet 2600 0 2600 0 0 0 0 0 100 0 100 2500
153 Kotrimoxazole Forte 960 mg Tablet
154 Larutan Irigasi Botol
155 Lansoprazole 30 mg Tablet 2250 0 2250 0 0 0 0 0 0 0 0 2250
156 Levopar Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
157 Lidokain Injeksi 2 %-2 ml Ampul 180 0 180 0 0 0 0 0 0 0 0 180 180 ED 3/21
158 Lidokain Injeksi Compositum Ampul
159 Loperamid 2 Mg Tablet
160 Lorazepam tablet Tablet 300 0 300 0 0 0 0 0 0 0 0 300
161 Mebendazol Syr 100 mg/5 ml-30 ml Botol
162 Meloxicam 7,5 Mg Tablet 450 0 450 0 0 0 0 0 0 0 0 450
163 Meloxicam 15 Mg Tablet 200 0 200 0 0 0 0 0 0 0 0 200
164 Metilergomertin Maleat 0.125 mg Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
165 Metilergomertin Maleat Inj 0.200 mg/ml-1 m Ampul 200 0 200 0 0 0 0 0 0 0 0 200
166 Metoclopramide Tablet 1700 0 1700 100 0 0 0 0 0 0 100 1600
167 Metoclopramide Drops Botol 10 0 10 10 0 0 0 0 0 0 10 0
168 Metoclopramide Sirup Botol
169 Metoclorpamide Injeksi Ampul 20 0 20 20 0 0 0 0 0 0 20 0
170 Metronidazole 500 mg Tablet 700 0 700 100 0 0 0 0 100 0 200 500
171 Metronidazole Sirup Botol
172 Methylprednisolon 4 Mg Tablet 5000 0 5000 200 0 0 0 0 0 0 200 4800
173 Methylprednisolon 8 Mg Tablet 2500 0 2500 0 0 0 0 0 0 0 0 2500
174 Methylprednisolon 16 Mg Tablet
175 Methylprednisolon Injeksi 125 Mg Ampul 30 0 30 0 0 0 0 0 0 0 0 30
176 Methylprednisolon Injeksi 500 mg Ampul
177 Metformin 500 Mg Tablet 800 0 800 200 0 0 0 0 0 0 200 600
178 MgSO4 20 % Flacon 18 0 18 0 0 0 0 0 0 0 0 18
179 MgSO4 40 % Flacon 18 0 18 0 0 0 0 0 0 0 0 18
180 Miconazole Zalf Tube 0 48 48 0 0 0 0 0 0 0 0 48
181 Microdiol strip
182 Mineral Mix Sachet 400 0 400 0 0 0 0 0 0 0 0 400
183 Natrium Diclofenak 25 mg Tablet
184 Natrium Diclofenak 50 mg Tablet 700 500 1200 300 0 0 0 0 0 0 300 900
185 Natrium Fenitoin Injeksi 50mg/ml Ampul
186 Natrium Klorida Infus 0.9 % Steril 500 ml Botol 40 100 140 53 0 0 0 0 0 0 53 87
187 New Diatabs/ New Antides Tablet 800 0 800 200 0 0 0 0 0 0 200 600
188 Nifedipin 10 mg Tablet
189 Nistatin tablet 500.000 IU Tablet 400 0 400 0 0 0 0 0 0 0 0 400
190 Nistatin tablet Vaginal 100.000 IU Supp
191 Obat Anti Tuberkulosis Kategori 1 Dewas Paket
192 Obat Anti Tuberkulosis Kategori 2 Dewas Paket
193 Obat Anti Tuberkulosis Kategori 3 Dewas Paket
194 Obat Anti Tuberkulosis Kategori Anak Paket
195 Obat Anti Tuberkulosis Sisipan Paket
196 Obat Batuk Hitam Syr 100 ml Botol 0 50 50 20 0 0 0 0 2 0 22 28
197 Obat Batuk Putih Syr 100 ml Botol
198 Oksitetrasiklin HCL Injeksi 50 mg/ml-10 m Vial
199 Oksitetrasiklin HCL Salep Kulit 3 %-5 gra Tube
200 Oksitetrasiklin HCL Salep Mata 1 %-3.5 g Tube 0 50 50 0 0 0 0 0 0 0 0 50
201 Oksitosin Injeksi 10 IU/ml-8 ml Vial 13 100 113 10 0 0 0 0 0 0 10 103
202 Omeprazole Tablet 5640 0 5640 510 0 0 0 0 120 150 780 4860
203 Omeprazole Injeksi Vial 10 10 20 20 0 0 0 0 0 0 20 0
204 Ondansetron Injeksi Ampul
205 Papaverin 40 mg Tablet
206 Papaverin Injeksi 40 mg/ml-8 ml Ampul
207 Parasetamol Drops Vial 70 0 70 10 0 0 0 0 0 0 10 60
208 Parasetamol 500 mg Tablet 300 1000 1300 600 0 0 0 0 0 0 600 700
209 Paracetamol Injeksi Botol 27 0 27 19 0 0 0 0 0 0 19 8
210 Parasetamol Syr 60 ml Botol 120 100 220 25 0 0 0 0 0 0 25 195
211 Pethidin HCL Injeksi 50 mg/ml-2 ml Ampul
212 Phenol Gliserol Botol
213 Piracetam 400 Mg Tablet
214 Piracetam 800 Mg Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
215 Piracetam Injeksi 5 ml Ampul
216 Piracetam Injeksi 15 ml Ampul
217 Pirazinamide Tablet
218 Pirantel Pamoat 125 mg Tablet 400 0 400 0 0 0 0 0 100 0 100 300
219 Pirantel Pamoat Sirup Botol
220 Piroxicam 10 mg Tablet
221 Piroxicam 20 mg Tablet 300 0 300 0 0 0 0 0 0 0 0 300 300 ED 03/21

222 Pirodoksine HCL (B 6 ) 10 mg Tablet 500 0 500 400 0 0 0 0 0 100 500 0

223 Prednison 5 mg Tablet 1800 0 1800 0 0 0 0 0 0 0 0 1800
224 Primaquin 15 mg Tablet 100 0 100 0 0 0 0 0 0 0 0 100
225 Prokain Benzil Penisilin Vial
226 Propranolol HCL 10 mg Tablet
227 Propranolol HCL 40 mg Tablet
228 Propiltiuracil (PTU) Tablet
229 Ranitidine 150 mg Tablet 500 1000 1500 600 0 0 0 0 100 0 700 800
230 Ranitidine Injeksi 50 mg/ml-2ml Ampul 0 30 30 30 0 0 0 0 0 0 30 0
231 Reserpin 0.10 mg Tablet
232 Reserpin 0.25 mg Tablet
233 Retinol ( VIT A )6.000 IU Tablet
234 Retinol ( VIT A )25.000 IU Tablet
235 Retinol ( VIT A )50.000 IU Tablet
236 Retinol ( VIT A )100.000 IU Tablet 250 500 750 0 0 0 0 0 0 0 0 750
237 Retinol ( VIT A )200.000 IU Tablet 0 500 500 0 0 0 0 0 0 0 0 500
238 Ringer Laktat Larutan Infus Steril-500 ml Botol 9 80 89 20 0 0 0 0 0 0 20 69
239 Ringer Laktat Larutan Infus Steril-1000 m Botol 17 0 17 5 0 0 0 0 0 0 5 12
240 Risperidone 2 mg Tablet
241 Salbutamol 2 mg Tablet 1500 2000 3500 200 0 0 0 0 0 0 200 3300
242 Salbutamol 4 mg Tablet 1500 0 1500 300 0 0 0 0 0 0 300 1200
243 Salbutamol sirup Botol
244 Salep Ichtyol 30 gram Pot 0 24 24 0 0 0 0 0 0 0 0 24
245 Salep Levetran Pot
246 Salep Scabisid Tube
247 Salicyl Bedak 2 %-50 gram Dos
248 Salicyl Spritus 10 % -25 ml Botol
249 Salep 2-4 Botol 48 0 48 24 0 0 0 0 0 0 24 24
250 Sianocobalamin( VIT B 12 ) 50 mg Tablet 3000 0 3000 200 0 0 0 0 200 0 400 2600
251 Sianocobalalamin ( VIT B 12 ) 500 mg/ml- Ampul 400 0 400 200 0 0 0 0 0 0 200 200
252 Sianocobalalamin ( VIT B 12 ) 500 mg/ml Vial
253 Simvastatin 10 mg Tablet 360 0 360 0 0 0 0 0 0 0 0 360
254 Simvastatin 20 mg Tablet 2640 1500 4140 240 0 0 0 0 0 0 240 3900
255 Siprofloksacin 250 mg Tablet
256 Siprofloksacin 500 mg Tablet 500 0 500 0 0 0 0 0 100 0 100 400 400 ED 3/21
257 Sodium Bicaronat Tablet 900 0 900 0 0 0 0 0 0 0 0 900
258 Streptomicin Injeksi 1 gram Vial
259 Streptomicin Injeksi 1.5 gram Vial
260 Sulfadoxin Pirimenthamin 525 mg Tablet
261 Sulfacetamid Sodium Tetes mata Botol
262 Tablet Tambah Darah (SF ) Tablet 3460 0 3460 350 0 0 0 0 210 150 710 2750
263 Tetrakain HCL Tetes Mata 0.5 %-5 ml Botol
264 Tetrasiklin HCL 250 mg Kapsul 2000 0 2000 0 0 0 0 0 0 0 0 2000
265 Tetrasiklin HCL 500 mg Kapsul 2000 0 2000 0 0 0 0 0 0 0 0 2000
266 Theophylline Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
267 Thiamin HCL ( B 1 ) 50 mg Tablet 18900 0 18900 0 0 0 0 0 0 0 0 18900
268 Thiamin HCL ( B 1 ) Injeksi - 1 ml Ampul 1170 0 1170 0 0 0 0 0 0 0 0 1170
269 Thiamin HCL ( B 1 ) Injeksi-15 ml Vial
270 Tramadol 50 mg Tablet
271 Tramadol Injeksi Ampul
272 Triheksipenidil Hidroklorida 2 mg Tablet 360 0 360 20 0 0 0 0 0 0 20 340
273 Ventolin Inhaler Botol
274 Verapamil 80 mg Tablet 1000 0 1000 0 0 0 0 0 0 0 0 1000
275 Vitamin B Kompleks Tablet 290 0 290 90 0 0 0 0 100 100 290 0
276 Vitamin B Kompleks Injeksi -15 ml Vial
277 Vitamin B 6 Tablet 500 0 500 400 0 0 0 0 0 100 500 0
278 Vitamin B 6 Injeksi Ampul 100 200 300 100 0 0 0 0 0 0 100 200
279 Vitamin K4 Tablet
280 Wida KDN 1 Botol 20 0 20 0 0 0 0 0 0 0 0 20
281 Wida KN 1 Botol 20 20 40 0 0 0 0 0 0 0 0 40
282 Zink Tablet 1800 0 1800 300 0 0 0 0 0 100 400 1400

BMHP
1 3 way Pcs 8 0 8 0 0 0 0 0 0 0 0 8
2 Abocath No.18 Pcs 134 0 134 14 0 0 0 0 0 0 14 120
3 Abocath No.20 Pcs 20 50 70 20 0 0 0 0 0 0 20 50
4 Abocath No.22 Pcs 7 25 32 32 0 0 0 0 0 0 32 0
5 Abocath No.24 Pcs 22 50 72 2 0 0 0 0 0 0 2 70
6 Abocath No.26 Pcs 27 0 27 8 0 0 0 0 0 0 8 19
7 Alkohol 100 ml Botol
8 Alkohol 300 ml Botol
 9 Alkohol 1000 ml Botol 2 2 4 2 0 0 0 0 0 0 2 2
10 Alkohol Swab Box 2 0 2 0 0 0 0 0 0 0 0 2
11 Bisturi (Pisau Bedah )No.10 Biji 200 0 200 0 0 0 0 0 0 0 0 200
12 Bisturi (Pisau Bedah )No.11 Biji 100 0 100 0 0 0 0 0 0 0 0 100
13 Bisturi (Pisau Bedah )No.12 Biji 100 0 100 0 0 0 0 0 0 0 0 100
14 Bisturi (Pisau Bedah )No.20 Biji 200 0 200 0 0 0 0 0 0 0 0 200
15 Bisturi (Pisau Bedah )No.21 Biji 200 0 200 0 0 0 0 0 0 0 0 200
16 Bisturi (Pisau Bedah )No.22 Biji 100 0 100 0 0 0 0 0 0 0 0 100
17 Bisturi (Pisau Bedah )No.23 Biji 100 0 100 0 0 0 0 0 0 0 0 100
18 Bisturi (Pisau Bedah )No.24 Biji
19 Blood Lancet Box 1 2 3 1 0 0 0 0 0 0 1 2
20 Catgut/Benang Bedah Chromic No.2/0 Box 2 0 2 1 0 0 0 0 0 0 1 1
21 Catqut/Benang Bedah Chromic 3/0 Box 1 0 1 0 0 0 0 0 0 0 0 1
22 Catqut/Benang Bedah Plain 2/0 Box
23 Catqut/Benang Bedah Plain 3/0 Box 2 0 2 0 0 0 0 0 0 0 0 2
24 Cutisorb Pcs 24 0 24 10 0 0 0 0 0 0 10 14
25 Disposible 1 ml Pcs 300 0 300 0 0 0 0 0 0 0 0 300
26 Disposible 2.5 ml Pcs
27 Disposible 3 ml Pcs 100 200 300 200 0 0 0 0 0 0 200 100
28 Disposible 5 ml Pcs 0 200 200 0 0 0 0 0 0 0 0 200
29 Disposible 10 ml Pcs 100 0 100 0 0 0 0 0 0 0 0 100
30 Disposible 20 ml Pcs 100 0 100 0 0 0 0 0 0 0 0 100
31 Elastis Perban 7,5 X 4,55 Rol 1 0 1 0 0 0 0 0 0 0 0 1
32 Elastis Perban 10 X 4,55 Rol 1 0 1 0 0 0 0 0 0 0 0 1
33 Etil Klorida Semprot 100 ml Botol 1 0 1 0 0 0 0 0 0 0 0 1
34 Foley Catheter No. 06 PCS 10 0 10 0 0 0 0 0 0 0 0 10
35 Foley Catheter No. 08 PCS 10 0 10 0 0 0 0 0 0 0 0 10
36 Foley Catheter No. 10 PCS 10 0 10 0 0 0 0 0 0 0 0 10
37 Foley Catheter No. 12 PCS 10 0 10 0 0 0 0 0 0 0 0 10
38 Foley Catheter No. 14 PCS 10 0 10 0 0 0 0 0 0 0 0 10
39 Foley Catheter No. 16 PCS
40 Foley Catheter No. 18 PCS 29 0 29 2 0 0 0 0 0 0 2 27
41 Foley Catheter No. 20 PCS 9 0 9 0 0 0 0 0 0 0 0 9
42 Foley Catheter No. 22 PCS 20 0 20 0 0 0 0 0 0 0 0 20
43 Foley Catheter No. 24 PCS 19 0 19 0 0 0 0 0 0 0 0 19
44 Formalin Botol
45 Giemza Botol
46 H2O2 Botol 4 0 4 3 0 0 0 0 0 0 3 1
47 Handscoon Obgyn pasang 133 50 183 15 0 0 0 0 0 0 15 168
48 Hand Scoen (Sarung Tangan ) Uk. XS box
49 Hand Scoen ( Sarung Tangan )Uk. S box 7 3 10 7 0 0 0 0 0 0 7 3
50 Hand Scoen ( Sarung Tangan )Uk. M box 3 5 8 5 0 0 0 0 0 0 5 3
51 Hand Scoen ( Sarung Tangan )Uk. L box 3 3 6 2 0 0 0 0 0 0 2 4
52 Hand Scoen Steril (Sarung Tangan ) No.6 Pasang 10 0 10 5 0 0 0 0 5 0 10 0
53 Hand Scoen Steril ( Sarung Tangan )No. 6 Pasang 47 100 147 38 0 0 0 0 5 0 43 104
54 Hand Scoen Steril ( Sarung Tangan )No. 7 Pasang 77 0 77 21 0 0 0 0 0 0 21 56
55 Hand Scoen Steril ( Sarung Tangan )No. 7 Pasang 110 0 110 5 0 0 0 0 0 0 5 105
56 Hand Scoen Steril ( Sarung Tangan )No. 8 Pasang 150 0 150 3 0 0 0 0 0 0 3 147
57 HCL 0,1 N Botol 5 0 5 0 0 0 0 0 0 0 0 5
58 Infuset Anak Pcs 94 0 94 3 0 0 0 0 0 0 3 91
59 Infuset Dewasa Pcs 14 30 44 10 0 0 0 0 0 0 10 34
60 Kapas Pembalut/ Absorben 250 gram Rol
61 Kapas Pembalut/ Absorben 1000 gram Rol
62 Kasa Hidrofil 80 cm X 2 m Lembar
63 Kasa Hidrofil Pembalut 3 cm X 4 m Rol
64 Kasa Hidrofil Pembalut 6 cm X 4 m Rol
65 Kasa Hidrofil Pembalut 15 cm X 4 m Rol
66 Kasa Hidrofil Pembalut 80 cm X 4 m Rol
67 Kasa Kompres Steril 16 cm X 16 cm Rol
68 Kasa Kompres Steril 40 cm X 80 cm Rol
69 Leukomed Pcs
70 Masker Box 15 20 35 12 0 0 0 0 0 0 12 23
71 Masker Hijab Box
72 Masker Nebulizer Anak Pcs 0 5 5 1 0 0 0 0 0 0 1 4
73 Masker Nebulizer Dewasa Pcs 0 5 5 2 0 0 0 0 0 0 2 3
74 Masker Oksigen Dewasa Pcs 10 0 10 1 0 0 0 0 0 0 1 9
75 Micropore Pcs
76 Oksigen Nasal Kanul (Bayi) Pcs 0 5 5 0 0 0 0 0 0 0 0 5
77 Oksigen Nasal Kanul (Anak) Pcs 0 10 10 0 0 0 0 0 0 0 0 10
78 Oksigen Nasal Kanul (Dewasa) Pcs 0 11 11 0 0 0 0 0 0 0 0 11
79 Plaster 1,25 cm X 4,5 Yards Rol
80 Plaster 2,5 cm X 4,5 Yards Rol 2 0 2 1 0 0 0 0 0 0 1 1
81 Plaster 5 cm X 4,5 Yards Rol 4 0 4 1 0 0 0 0 0 0 1 3
82 Plaster 7.5 cm X 4,5 yards Rol 3 0 3 1 0 0 0 0 0 0 1 2
83 Polifix 5 cm X 1 m Box 48 0 48 5 0 0 0 0 0 0 5 43
84 Polifix 5 cm X 5 m Box
85 Polifix 10 cm X 5 m Box
86 Policlean Botol
87 Poliwash Botol
88 Pot Dahak Botol 0 60 60 60 0 0 0 0 0 0 60 0
89 Povidon Iodion 10 %-60 ml Botol
90 Povidon Iodion 10 %-300 ml Botol 5 0 5 3 0 0 0 0 0 1 4 1
91 Povidon Iodion 10 %-1000 ml Botol
92 Rak Tabung Pcs
93 RDT Frambusia Box
94 RDT HIV PCS 11 0 11 5 0 0 0 0 0 0 5 6
95 RDT Hepatitis Sachet
96 RDT Malaria Box
97 Reagen TB Paket 0 1 1 1 0 0 0 0 0 0 1 0
98 Rivanol Larutan 0.1% -100 ml Botol
99 Rivanol Larutan 0.1 % -300 ml Botol 16 0 16 3 0 0 0 0 0 0 3 13
100 Sabun Asepso Pcs
101 Silk Benang Bedah No.0/0 Box 1 0 1 0 0 0 0 0 0 0 0 1
102 Silk Benang Bedah No.1/0 Box
103 Silk Benang Bedah No.2/0 Box 3 0 3 0 0 0 0 0 0 0 0 3
104 Silk Benang Bedah No.3/0 Box 4 0 4 0 0 0 0 0 0 0 0 4
105 Silk Benang Bedah No.4/0 Box 2 0 2 0 0 0 0 0 0 0 0 2
106 Silk Benang Bedah No.5/0 Box 1 0 1 0 0 0 0 0 0 0 0 1
107 Silk Benang Bedah No.6/0 Box 1 0 1 0 0 0 0 0 0 0 0 1
108 Slide Box
109 Suction Catheter Pcs
110 Stik Asam Urat Box
111 Stik Glukosa Box
112 Stik Kolesterol Box
113 Stik Hemoglobin Box 2 0 2 2 0 0 0 0 0 0 2 0
114 Stik Urinalisa Test Box 39 0 39 0 0 0 0 0 0 0 0 39
115 Tabung Reaksi Pcs
116 Tes Kehamilan Pcs 100 0 100 0 0 0 0 0 0 0 0 100
117 Transfusion Set Pcs
118 Ultrasonic Gel Botol
119 Under Pad Pcs
120 Urine Bag Pcs 20 0 20 3 0 0 0 0 0 0 3 17

BMHP Gigi
1 Caviton 30 gram

Glass Ionomer Cement Type II + Paper

2 Pad
Glass Ionomer Cement Type IX + Paper
3 Pad
4 Composit A2
5 Composit A3
6 Etsa
7 Bonding
8 Mikro Brush
9 Chlor Etyl

Devitec (Devitalizing Paste Arsenic Free)

10 7 gram
11 Alveogyl
12 Intro Kit
13 Chresopen
14 Paper Point

Vaksin
 1 ADS 0,05 ml PCS
2 ADS 0,5 ml PCS
3 ADS 5 ml PCS
4 BCG Ampul
5 CAMPAK Vial
6 DPT-HB-HIB Vial
7 DT Vial
8 HB Uniject Vial
9 HbB 1 ml PCS
10 IPV Vial
11 MR Vial
12 Polio Vial
13 Td Vial
14 Serum Anti Bisa Ular (ABU) Vial
15 serum Anti Tetanus (ATS) Ampul
16 S.Box 2,5 ltr
17 S.Box 5 ltr
18 Vaksin Rabies

Obat-Obatan
283 Allopurinol 300 mg tablet 700 0 700 100 0 0 0 0 0 0 100 600
284 Amlodipine 10 mg tablet 2100 0 2100 300 0 0 0 0 0 0 300 1800
285 Diethylcarbamazine citrate 100 mg tablet 1500 0 1500 0 0 0 0 0 0 0 0 1500
286 Dimenhidrinate 50 mg tablet 600 0 600 300 0 0 0 0 0 0 300 300
287 Gentamisin Salep Mata tube 20 0 20 0 0 0 0 0 0 0 0 20
288 Loratadin 10 mg tablet
289 Metamizole Injeksi ampul 100 0 100 0 0 0 0 0 0 0 0 100
290 Metronidazole 250 mg tablet
291 Ventolin Nebules 2,5 mg pcs
292 Cetirizine tab 10 mg tablet 2300 0 2300 300 0 0 0 0 0 0 300 2000
293 methamizole tab tablet 4500 0 4500 0 0 0 0 0 0 0 0 4500 3300 ED 03/21
294 nifedipne 20 mg tablet 355 0 355 0 0 0 0 0 0 0 0 355
295 kloramphenikol salep kulit tube 129 0 129 24 0 0 0 0 0 0 24 105
BMHP
121 Antiseptik Gel botol 22 0 22 6 0 0 0 0 0 0 6 16
122 Kasa Hidrofil Steril 16/16 pcs 0 50 50 10 0 0 0 0 0 0 10 40
123 Oxygen Mask Anak pcs 5 5 10 0 0 0 0 0 0 0 0 10
124 Reagen Siphylis AB pcs
125 Reagen Siphylis BD pcs
126 Sabun Anti Bakteri botol 0 3 3 2 0 0 0 0 0 0 2 1
127 HBSaG pcs
128 Surgical Gown M pcs 10 0 10 2 0 0 0 0 0 0 2 8
129 Wing Needle pcs
130 Baju Coverall PCS 30 0 30 0 0 0 0 0 0 0 0 30
131 Thermogun PCS 1 0 1 0 0 0 0 0 0 0 0 1
132 Masker N95 PCS 175 0 175 0 0 0 0 0 0 0 0 175
133 Rapid Tes Covid-19 PCS
134 masker hijab (skineer) pcs
135 MASKER PCS PROGRAM
136 Papsmer Kit pcs 10 0 10 0 0 0 0 0 0 0 0 10
137 plester non woven Roll 5cmx5m box 10 0 10 2 0 0 0 0 0 0 2 8
138 leukoplast 1.5 cm x 5 cm rol 10 0 10 2 0 0 0 0 0 0 2 8

Mengetahui/Menyetujui Yang Menyerahkan Yang Meminta Yang Menerima

Kepala Dinas Kesehatan Petugas GFK Kepala UPTD Puskesmas Petugas Pengelola Obat UPTD Puskesmas
Kabupaten Halmahera Tengah Rawat Inap Banemo Rawat Inap Banemo

Rusman Djafar, SKM Resky Yuliandany, Amd.Farm.

Nip. Nip. Nip. 19740306 199403 1 004 NIP.19951105 201903 2 007
287 Gentamisin Salep Mata tube 20 0 20 0 0 0 0 0 0 0 0 20
288 Loratadin 10 mg tablet
289 Metamizole Injeksi ampul 100 0 100 0 0 0 0 0 0 0 0 100
290 Metronidazole 250 mg tablet
291 Ventolin Nebules 2,5 mg pcs
292 Cetirizine tab 10 mg tablet 2000 0 2000 200 0 0 0 0 0 0 200 1800
293 methamizole tab tablet 1200 0 1200 100 0 0 0 0 0 0 100 1100
294 nifedipne 20 mg tablet 355 0 355 0 0 0 0 0 0 0 0 355
295 kloramphenikol salep kulit tube 105 0 105 24 0 0 0 0 0 0 24 81
BMHP
121 Antiseptik Gel botol 16 0 16 6 0 0 0 0 0 0 6 10
122 Kasa Hidrofil Steril 16/16 pcs 40 0 40 20 0 0 0 0 0 0 20 20
123 Oxygen Mask Anak pcs 10 0 10 0 0 0 0 0 0 0 0 10
124 Reagen Siphylis AB pcs
125 Reagen Siphylis BD pcs
126 Sabun Anti Bakteri botol 1 0 1 1 0 0 0 0 0 0 1 0
127 HBSaG pcs
128 Surgical Gown M pcs 8 0 8 0 0 0 0 0 0 0 0 8
129 Wing Needle pcs
130 Baju Coverall PCS 30 0 30 0 0 0 0 0 0 0 0 30
131 Thermogun PCS 1 0 1 0 0 0 0 0 0 0 0 1
132 Masker N95 PCS 175 0 175 0 0 0 0 0 0 0 0 175
133 Rapid Tes Covid-19 PCS
134 masker hijab (skineer) pcs
135 MASKER PCS PROGRAM
136 Papsmer Kit pcs 10 0 10 0 0 0 0 0 0 0 0 10
137 plester non woven Roll 5cmx5m box 8 0 8 0 0 0 0 0 0 0 0 8
138 leukoplast 1.5 cm x 5 cm rol 8 0 8 0 0 0 0 0 0 0 0 8

Mengetahui/Menyetujui Yang Menyerahkan Yang Meminta Yang Menerima

Kepala Dinas Kesehatan Petugas GFK Kepala UPTD Puskesmas Petugas Pengelola Obat UPTD Puskesmas
Kabupaten Halmahera Tengah Rawat Inap Banemo Rawat Inap Banemo
 Rusman Djafar, SKM Resky Yuliandany, Amd.Farm.
Nip. Nip. Nip. 19740306 199403 1 004 NIP.19951105 201903 2 007