PEMERINTAH KABUPATEN JAYAPURA

DINAS KESEHATAN
UPTD. PUSKESMAS RAVENIRARA
DISTRIK RAVENIRARA
Alamat : DESA YONGSU DESOYO
===========================================================================
Daftar Permintaan Obat dan Bahan Medis Habis Pakai (BMHP)

SISA PEMAKAIAN
NO NAMA OBAT / BHP SATUAN PERMINTAAN
STOK RATA-RATA
1 Dispo 2,5 cc pcs 30 200
2 Dispo 1 cc 0 50
3 handscon Non Steril M Box 400 300
4 Kasa Steril paket 16 20
5 Kasa Hidrofil 4 x 8 Pcs 0 5
6 Plester Rol Rol 3 4
7 RDT Malaria Pcs 0 500
8 Plastik Obat paket 1000 1000
Acyclovir Cream Tube 0 30
9 Amlodipin Tablet 500 300
10 Amoxicilin 125 mg/5 ml Syr 18 40
11 Amoxicilin 500 mg Tablet 670 1000
12 Antalgin 500 mg Tablet 350 300
13 Asam Mefenamat 500 mg Tablet 313 1000
14 Becarbon Tablet Tablet 0 50
15 Cotrimoxasole 240 mg/5 ml Syr 0 50
16 Cotrimoxasole 480 mg Tablet 230 500
17 Dexametason 0,5 mg Tablet 734 800
18 DHP Tablet 450 450
19 Domperidone 10 mg Tablet 184 300
20 Fenol Gliserol tetes Telinga Botol 21 25
21 Gentamicin Salf Luka Tube 10 50
22 Griseofulfun 125 mg Tablet 420 800
23 Guafenisin 100 mg Tablet 659 500
24 Ibuprofen 200 mg Tablet 0 800
25 Kalcium Lactat 500 mg Tablet 0 400
26 KLoramfenicol Tetes Mata Tube 15 25
27 Multivitamin Pyvaton Tablet 201 500
28 Natrium Diklofenak 25 mg Tablet 642 1000
29 Oralit Sach 80 100
30 Paracetamol 500 Tablet 960 500
31 Piroxicam 20 mg Tablet 760 200
32 Paket OAT Dewasa Kat 1 Tablet 0 2
33 Salbutamol 4 Mg Tablet 400 200
34 Salicilk Bedak Tube 0 50
35 Simvastatin 10 mg Tablet 413 700
36 Hanzenitaizer botol 2 1
37 Tespec Kehamilan pcs 10 25
38 Furosemid 40 mg Tablet 0 200
39 Lisol Pembersih Botol 0 3
40
41
42
43
44
45
46
47

Ravenirara,04 Januari 2023

Penanggung Jawab Farmasi Kepala Puskesmas

(Januar Gautama Amd.Farm) ( Cipta K.Sijabat,SKM )

NIP. 19890426 201104 1 001
 PEMERINTAH KABUPATEN JAYAPURA
DINAS KESEHATAN
UPTD. PUSKESMAS RAVENIRARA
DISTRIK RAVENIRARA
Alamat : DESA YONGSU DESOYO
============================================================================
Daftar Permintaan Obat dan Bahan Medis Habis Pakai (BMHP)

SISA PEMAKAIAN
NO NAMA OBAT / BHP SATUAN
STOK RATA-RATA
1 Plester Rol Rol 4
2 RDT Malaria Pcs 0
3 Plastik Obat paket 1000
4 Acyclovir Cream Tube 0
5 Albendazol 400 mg Tablet 93
6 Amlodipin Tablet 413
7 Amoxicilin 500 mg Tablet 830
8 Asam Mefenamat 500 mg Tablet 718
9 Dexametason 0,5 mg Tablet 734
10 DHP Tablet 0
11 Gentamicin Salf Luka Tube 10
12 Griseofulfun 125 mg Tablet 613
13 Guafenisin 100 mg Tablet 944
14 Ibuprofen 200 mg Tablet 400
15 Kalcium Lactat 500 mg Tablet 370
16 Oralit Sach 80
17 oxitocin Amp Ampul 0
18 Paracetamol 500 Tablet 752
19 Piroxicam 20 mg Tablet 640
20 Rifampentine Box 0
21 Salicilk Bedak Tube 0
22 sianocobalamin (B12) Amp Ampul 12
23 Simvastatin 10 mg Tablet 413
24 Vit A 100.000 (Biru) Tablet 0
25 Vit A 200.000 (merah) Tablet 0
26 Hanzenitaizer botol 2
27 Tespec Kehamilan pcs 10
28
29
30
31
32
33
34
35

Ravenirara,03 Februari 2023

Penanggung Jawab Farmasi Kepala Puskesmas

(Januar Gautama Amd.Farm) ( Cipta K.Sijabat,SKM )

NIP. 19890426 201104 1 001

Ravenirara, 02 Desember 2020

Penanggung Jawab Farmasi Kepala Puskesmas

(Januar Gautama Amd.Farm) ( Cipta K.Sijabat,SKM )

NIP. 19890426 201104 1 001
=======================
BMHP)

PERMINTAAN
2
500
1000 Primaquin 15 mg Tablet 700
30
200
200
800
200
800
700
50
300
400
300
200
100
10
500
200
1 Box
50
100
700
50
300
1
25
rara,03 Februari 2023
ala Puskesmas

K.Sijabat,SKM )
890426 201104 1 001

ara, 02 Desember 2020

ala Puskesmas

K.Sijabat,SKM )
890426 201104 1 001
760
 PEMERINTAH KABUPATEN JAYAPURA
DINAS KESEHATAN
UPTD. PUSKESMAS RAVENIRARA
DISTRIK RAVENIRARA
Alamat : DESA YONGSU DESOYO
================================================================================
Daftar Permintaan Obat dan Bahan Medis Habis Pakai (BMHP)

SISA PEMAKAIAN
NO NAMA OBAT / BHP SATUAN PERMINTAAN
STOK RATA-RATA
1 Plester Rol Rol 0 2
2 RDT Malaria Pcs 0 700
Masker Karet Pcs 68
3 Plastik Obat paket 1234 1000
4 Acyclovir Cream Tube 0 30
5 Amlodipin Tablet 124 400
6 Amoxicilin 500 mg Tablet 312 800
Allupurinol 100 mg Tablet 346 1000
7 Asam Mefenamat 500 mg Tablet 200 600
8 Dexametason 0,5 mg Tablet 234 700
9 DHP Tablet 0 1350
10 Gentamicin Salf Luka Tube 0 50
11 Griseofulfun 125 mg Tablet 320 300
12 Guafenisin 100 mg Tablet 621 400
13 Ibuprofen 200 mg Tablet 213 300
14 Kalcium Lactat 500 mg Tablet 421 200
15 Natrium diklovenak Tablet 568 800
Multivitamin Pivaton Tablet 134 800
16 Oralit Sach 34 100
17 Paracetamol 500 Tablet 326 500
18 Piroxicam 20 mg Tablet 342 200
Primquin Tablet 235 1200
19 Salicilk Bedak Tube 0 50
20 sianocobalamin (B12) Amp Ampul 45 100
21 Simvastatin 10 mg Tablet 213 700
22
23
24
25
26
27
28
29
logistik Malaria Untuk Kader Malaria

Ravenirara,10 Maret 2023

Penanggung Jawab Farmasi Kepala Puskesmas

(Januar Gautama Amd.Farm) ( Cipta K.Sijabat,SKM )

NIP. 19890426 201104 1 001
 PEMERINTAH KABUPATEN JAYAPURA
DINAS KESEHATAN
UPTD. PUSKESMAS RAVENIRARA
DISTRIK RAVENIRARA
Alamat : DESA YONGSU DESOYO
================================================================================
Daftar Permintaan Obat dan Bahan Medis Habis Pakai (BMHP)

SISA PEMAKAIAN
NO NAMA OBAT / BHP SATUAN PERMINTAAN
STOK RATA-RATA
1 Plester Rol Rol 1 5
2 RDT Malaria Pcs 800
3 Plastik Obat paket 700 2000
4 kasa Steril pcs 11 30
5 Pot Dahak pcs 13 30
6 Ambroxol 30 mg Tablet 0 1000
7 Amlodipin Tablet 650 300
8 Amoxicilin 125 mg/5 ml Botol 0 100
9 Amoxicilin 500 mg Tablet 763 1000
10 Allupurinol 100 mg Tablet 780 700
11 Ascorbid Acid (Vit C) 50 mg Tablet 125 800
12 Dexametason 0,5 mg Tablet 800 600
13 DHP Tablet 900
14 Fluconasole 150 mg Tablet 0 50
15 Gentamicin Salf Luka Tube 0 50
16 Griseofulfun 125 mg Tablet 450 300
17 Guafenisin 100 mg Tablet 334 1000
18 Ibuprofen 200 mg Tablet 220 1000
19 Natrium diklovenak Tablet 612 800
20 Multivitamin Pivaton Tablet 450 800
21 Nistatin Drops Botol 0 30
22 Nifedipin Tablet 0 100

23
Obat Batuk Hitam(OBH) Botol 0 20
24 Paracetamol 500 Tablet 1240 500
25 Piroxicam 20 mg Tablet 0 200
26 Primquin Tablet 172 1000
27 Salicilk Bedak Tube 0 50
28 sianocobalamin (B12) Amp Ampul 30 100
29 Simvastatin 10 mg Tablet 0 700
30
31
32
33
34
35
36
37
logistik Malaria Untuk Kader Malaria

Ravenirara,01 Mei 2023

Penanggung Jawab Farmasi Kepala Puskesmas
(Januar Gautama Amd.Farm) ( Cipta K.Sijabat,SKM )
NIP. 19890426 201104 1 001
 DINAS KESEHATAN
UPTD. PUSKESMAS RAVENIRARA
DISTRIK RAVENIRARA
Alamat : DESA YONGSU DESOYO
============================================================================
Daftar Permintaan Obat dan Bahan Medis Habis Pakai (BMHP)

SISA PEMAKAIAN
NO NAMA OBAT / BHP SATUAN
STOK RATA-RATA
1 Plester Rol Rol 3
2 Plastik Obat paket 1000
3 kasa Steril pcs 11
4 Kertas Puyer lembar 0
5 Amlodipin Tablet 312
6 Amoxicilin 500 mg Tablet 537
7 Amytriphilin 25 mg Tablet 0
8 Allupurinol 100 mg Tablet 540
9 Gentamicin Salf Luka Tube 0
10 Griseofulfun 125 mg Tablet 150
11 Guafenisin 100 mg Tablet 650
12 Ibuprofen 200 mg Tablet 220
13 Natrium diklovenak Tablet 240
Obat Kusta Dewasa 0
14 Multivitamin Pivaton Tablet 300
15 Paracetamol 500 Tablet 780
16 Piroxicam 20 mg Tablet 0
17 Simvastatin 10 mg Tablet 340
18
19
20
21
22
23
24
25

Ravenirara,14 Juli 2023

Penanggung Jawab Farmasi Kepala Puskesmas
(Januar Gautama Amd.Farm) ( Cipta K.Sijabat,SKM )
NIP. 19890426 201104 1 001

Ravenirara, 02 Desember 2020

Penanggung Jawab Farmasi Kepala Puskesmas

(Januar Gautama Amd.Farm) ( Cipta K.Sijabat,SKM )

NIP. 19890426 201104 1 001
=======================
BMHP)

PERMINTAAN
2
500
30
50
200
1000
200
400
50
300
700
1000
800
1 Paket
500
800
500
300

aa

rara,14 Juli 2023

ala Puskesmas
K.Sijabat,SKM )
890426 201104 1 001

ara, 02 Desember 2020

ala Puskesmas

K.Sijabat,SKM )
890426 201104 1 001
 PEMERINTAH KABUPATEN JAYAPURA
DINAS KESEHATAN
UPTD. PUSKESMAS RAVENIRARA
DISTRIK RAVENIRARA
Alamat : DESA YONGSU DESOYO
============================================================================
Daftar Permintaan Obat dan Bahan Medis Habis Pakai (BMHP)

SISA PEMAKAIAN
NO NAMA OBAT / BHP SATUAN
STOK RATA-RATA
1 RDT Malaria Pcs 5
2 DHP Tablet 27
3 Primquin Tablet 50
logistik Malaria Untuk PKM Dan Kader Malaria & Program MBS
logistik RDT Untuk Pemakaian 3 Bulan

Ravenirara,14 Juli 2023

Penanggung Jawab Farmasi Kepala Puskesmas

(Januar Gautama Amd.Farm) ( Cipta K.Sijabat,SKM )

NIP. 19890426 201104 1 001

Ravenirara, 02 Desember 2020

Penanggung Jawab Farmasi Kepala Puskesmas

(Januar Gautama Amd.Farm) ( Cipta K.Sijabat,SKM )

NIP. 19890426 201104 1 001
=======================
BMHP)

PERMINTAAN
3900
1350
1000

rara,14 Juli 2023

ala Puskesmas

K.Sijabat,SKM )
890426 201104 1 001

ara, 02 Desember 2020

ala Puskesmas

K.Sijabat,SKM )
890426 201104 1 001
 PEMERINTAH KABUPATEN JAYAPURA
DINAS KESEHATAN
UPTD. PUSKESMAS RAVENIRARA
DISTRIK RAVENIRARA
Alamat : DESA YONGSU DESOYO
==============================================================================
Daftar Permintaan Obat dan Bahan Medis Habis Pakai (BMHP)

SISA PEMAKAIAN
NO NAMA OBAT / BHP SATUAN PERMINTAAN
STOK RATA-RATA
1 disposibe 1 cc PCS 0 100
2 disposibe 2,5 cc pcs 54 200
3 dispo 5 cc PCS 0 100
4 Alkohol Swab PCS 0 1000
5 Aquaades Injeksi vial 4 10
6 Hanscond uk M pcs 0 800
7 Kapas 250 gr PCS 1 2
8 Kertas Puyer lembar 0 20
9 Plester Rol Rol 1 2
10 Allupurinol 100 mg Tablet 400 1000
11 Amlodipin Tablet 124 400
Amoxicilin 500 mg Tablet 400 1200
12 Ambroxol 30 mg Tablet 240 1000
13 Albendasol 400 mg Tablet 20 600
14 Asam Mefenamat 500 mg Tablet 200 1000
15 Cefadroxil 500 mg capsul 20 800
16 Cetrizine 10 mg Tablet 30 1000
17 CTM 4 mg Tablet 0 1000
18 Dexametason 0,5 mg Tablet 642 1000
19 Gentamicin Salf Luka Tube 30 50
20 Griseofulfun 125 mg Tablet 320 300
21 Guafenisin 100 mg Tablet 2100 1000
22 INH 100 mg Tablet 0 500
23 Kalcium Lactat 500 mg Tablet 421 500
24 Lefofloxacin 500 mg Tablet 0 100
25 Loratadine 10 mg Tablet 0 1000
26 Natrium diklovenak Tablet 50 1000
27 Metronidazol 500 mg Tablet 200 500
28 Multivitamin Pivaton Tablet 700 500
29 Oralit Sach 34 100
30 Paracetamol 500 Tablet 800 1500
31 simvasstatin 10 mg Tablet 600 1000
32 Vit c 50 mg Tablet 100 1000
33 Vit B1 Tablet 250 1000
34 Vit B6 Tablet 0 500
35 Mantoux test Tuberkulin Tablet 0 2
36 RDT Sipilis PCS 0 50
37 RDT HIV PCS 0 50
38 HBSAG PCS 0 50
39 RDT FRAMBUSIA PCS 0 50
40 Benzatin Penisilin Box 0 1
41
42
43

Ravenirara,3 Agustus 2023

Penanggung Jawab Farmasi Kepala Puskesmas
 PEMERINTAH KABUPATEN JAYAPURA
DINAS KESEHATAN
UPTD. PUSKESMAS RAVENIRARA
DISTRIK RAVENIRARA
Alamat : DESA YONGSU DESOYO
============================================================================
Daftar Permintaan Obat dan Bahan Medis Habis Pakai (BMHP)

SISA PEMAKAIAN
NO NAMA OBAT / BHP SATUAN
STOK RATA-RATA
1 disposibe 1 cc PCS 100
2 disposibe 2,5 cc pcs 200
3 Alkohol Swab PCS 700
4 Aquaades Injeksi vial 10
5 Condom (KB) PCS 0
6 Lubricen (KB) PCS 0
7 Hanscond uk M pcs 600
8 Hanscoon Steril PCS 4
9 Kapas 250 gr PCS 1
10 Plester Rol Rol 1
11 Allupurinol 100 mg Tablet 710
12 Amlodipin Tablet 500
13 Amoxicilin 500 mg Tablet 630
14 Ambroxol 30 mg Tablet 240
15 Aminophilin apm 0
16 Aminophilin Tablet 0
17 Antasida Doen Tablet 0
18 Asam Mefenamat 500 mg Tablet 750
19 Bacitracin Zalf Tube 19
20 Cairan NACL 500 Infus 3
21 Cefadroxil 500 mg capsul 200
22 Cetrizine 10 mg Tablet Bulan lalu belum di ambil
23 Ciprofloxacin 500 Tablet 0
24 Clindamicin 300 m Tablet 50
25 CTM 4 mg Tablet 456
26 Dexamethason Amp Amp 4
27 Dexametason 0,5 mg Tablet 642
28 D40 Inf 0
29 Dopamin Amp 0
30 Gentamicin Salf Luka Tube 30
31 Griseofulfun 125 mg Tablet 320
32 Guafenisin 100 mg Tablet 1200
33 INH 100 mg Tablet 0
34 Ithicol Salf Bisul Tube 2
35 Kalcium Lactat 500 mg Tablet 500
36 Lefofloxacin 500 mg Tablet 0
37 Loratadine 10 mg Tablet 200
38 Natrium diklovenak Tablet 10
39 Metronidazol 500 mg Tablet 100
40 Multivitamin Pivaton Tablet 340
41 Mineral Mix Sach 0
42 NACL 100 Infus 0
43 Oralit Sach 34
44 Paracetamol 500 Tablet 1230
45 Pehacain / Lidocain Amp 4
46 simvasstatin 10 mg Tablet 600
47 Streptomicin Amp 0
48 Tespec Kehamilan PCS 25
49 Vit B Complex Tablet 0
50 Vit c 50 mg Tablet 400
51 Vit B1 Tablet 730
52 Vit B6 Tablet 300
53 Mantoux test Tuberkulin Tablet 2
54 Ziheld Nelsen PCS 0
55 RDT FRAMBUSIA PCS 0
56 Benzatin Penisilin PCS 10
57
58
59

Ravenirara,5 September 2023

Penanggung Jawab Farmasi Kepala Puskesmas

(Januar Gautama Amd.Farm) ( Cipta K.Sijabat,SKM )

NIP. 19890426 201104 1 001
 Ravenirara, 02 Desember 2020
Penanggung Jawab Farmasi Kepala Puskesmas

(Januar Gautama Amd.Farm) ( Cipta K.Sijabat,SKM )

NIP. 19890426 201104 1 001
=======================
BMHP)

PERMINTAAN

100
200
500
10
100
100
400
50
2
3
1000
700
1000
1000
10
300
1000
800
25
20
200
1000
100
100
1000
50
1000
10
10
50
300
 500
400
30
200
100
700
700
300
300
300
30
100
500
50
1000
10
50
800
1000
700
500
2
1
50
10

rara,5 September 2023

ala Puskesmas

K.Sijabat,SKM )
890426 201104 1 001
ara, 02 Desember 2020
ala Puskesmas

K.Sijabat,SKM )
890426 201104 1 001
 PEMERINTAH KABUPATEN JAYAPURA
DINAS KESEHATAN
UPTD. PUSKESMAS RAVENIRARA
DISTRIK RAVENIRARA
Alamat : DESA YONGSU DESOYO
============================================================================
Daftar Permintaan Obat dan Bahan Medis Habis Pakai (BMHP) Program Malaria

SISA PEMAKAIAN
NO NAMA OBAT / BHP SATUAN
STOK RATA-RATA
3 Primquin Tablet 500
logistik Malaria Untuk PKM Dan Kader Malaria & Program MBS

Ravenirara,5 September 2023

Penanggung Jawab Farmasi Kepala Puskesmas

(Januar Gautama Amd.Farm) ( Cipta K.Sijabat,SKM )

NIP. 19890426 201104 1 001

Ravenirara, 02 Desember 2020

Penanggung Jawab Farmasi Kepala Puskesmas

(Januar Gautama Amd.Farm) ( Cipta K.Sijabat,SKM )

NIP. 19890426 201104 1 001
=======================
rogram Malaria

PERMINTAAN
1000

rara,5 September 2023

ala Puskesmas

K.Sijabat,SKM )
890426 201104 1 001

ara, 02 Desember 2020

ala Puskesmas

K.Sijabat,SKM )
890426 201104 1 001
 PEMERINTAH KABUPATEN JAYAPURA
DINAS KESEHATAN
UPTD. PUSKESMAS RAVENIRARA
DISTRIK RAVENIRARA
Alamat : DESA YONGSU DESOYO
============================================================================
Daftar Permintaan Obat dan Bahan Medis Habis Pakai (BMHP)

SISA PEMAKAIAN
NO NAMA OBAT / BHP SATUAN
STOK RATA-RATA
1 Antiseptik Gel PCS 1
2 Bisturi pcs 8
3 Catgut (Benang Bedah ) PCS 2
4 Plastik Klip Obat Pcs 1000
5 Plester Rol PCS 4
6 Aciclovir Cream Tube 12
7 Allupurinol 100 mg Tablet 1200
8 Ambroxol 30 mg Tablet 700
9 Amoxicilin 500 mg Tablet 1800
10 Amoxicilin syr 125 mg/5ml Botol 9
11 Asam Mefenamat 500 mg Tablet 920
12 Antipulgate Tablet 122
13 Bacitracin Zalf Tablet 24
14 Ambroxol 30 mg Tablet 240
15 Antasida Doen Tablet 0
16 Asam Mefenamat 500 mg Tablet 750
17 Bacitracin Zalf Tube 19
18 Betametasone Cream Tube 0
19 Cefadroxil 500 mg Caps 100
20 Cetrizine 10 mg Tablet 500
21 Captopril 25 mg Tablet 50
22 Dexametason 0,5 mg Tablet 1600
23 Domperidon 10 mg Tablet 60
24 Etanol 70% Botol 1
25 Erytromicin 500 mg Tablet 0
26 FDC Dewasa Paket 0
27 FDC Anak Paket 0
28 Hidrocortisone Cream Tube 2
29 INH 100 mg Tablet 0
30 Ithicol Salf Bisul Tube 0
31 Ketokonassole Tablet 30
32 Lidocain Amp 20
33 Loratadine 10 mg Tablet 650
34 Natrium diklovenak Tablet 360
35 Methil Prednisolon 4 mg Tablet 0
36 Miconasole Cream Tube 6
37 NACL 100 Infus 0
38 Oksitertra Salf Mata Tube 14
39 Paracetamol 500 Tablet 1400
40 Paracetamol Drops Botol 20
41 Piroxicam 20 mg Tablet 0
42 Salbutamol Amp 110
43 Salp 24 Tube 1
44 Zink 20 mg Tablet 0
45
46
47
48
49
50
51
52
53
54

Ravenirara,5 Oktober 2023

Penanggung Jawab Farmasi Kepala Puskesmas

(Januar Gautama Amd.Farm) ( Cipta K.Sijabat,SKM )

NIP. 19890426 201104 1 001
=======================
BMHP)

PERMINTAAN

3
30
40
1000
1
30
800
800
600
50
600
200
25
1000
1000
800
25
50
300
1000
500
400
800
4
500
1
1
50
1080
50
500
30
400
 500
600
30
30
50
600
20
800
400
25
800

rara,5 Oktober 2023

ala Puskesmas

K.Sijabat,SKM )
890426 201104 1 001