Lplpo PKM Hila Bulan Oktober Tahun 2022

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)
PUSKESMAS PERAWATAN HILA
BULAN : JANUARI
TAHUN : 2022
SATUAN
BULAN JANUARI
NO NAMA BARANG
STOK PENERIMAAN PER- PE- SISA PER-
AWAL DAK JKN TOTAL SEDIAAN MAKAIAN STOK MINTAAN
TABLET
1 Alopurinol 100 mg Tablet 2,300 0 2,300 0 2,300

2 Alprazolam 0,25 mg Tablet 0 0 0 0 0
4 Alprazolam 1 mg Tablet 0 0 0 0 0
5 Ambroksol 30 mg Tablet 0 0 0 0 0
Aminofilin 150 mg (Decafil
6 150)
Tablet 0 0 0 0
0
7 Aminofilin 200 mg Tablet 0 0 0 0 0
8 Amitriptilin 25 mg Tablet 0 0 0 0 0
9 Amlodipin 10 mg Tablet 0 0 0 0 0
10 Amlodipin 5 mg Tablet 1,300 0 1,300 600 700
11 Amoksisilin 250 mg Tablet 0 0 0 0 0
12 Amoksisilin 500 mg Tablet 12,800 0 12,800 2000 10,800
13 Antasida Tablet Kunyah Tablet 14,700 0 14,700 1000 13,700
Asam Asetilsalisilat 100 mg
14 (Asetosal) Tablet 0 0 0 0
0
15 (Miniaspi) Tablet 0 0 0 0
0
16 Asam Folat 1 mg Tablet 800 0 800 0 800
17 Asam Mefenamat 500 mg Tablet 12,700 0 12,700 800 11,900
Asam Pipemidat 400mg
18 (Urinter) Tablet 0 0 0 0
0
19 Asiklovir 200 mg Tablet 100 0 100 100 0
21 Atenolol 100 mg (Betablok) Tablet 0 0 0 0

0
22 Betahistin 6 mg Tablet 210 0 210 60 150
23 Bisoprolol tab 5mg Tablet 0 0 0 0 0
24 Deksametason 0,5 mg Tablet 0 0 0 0 0
25 Demacolin tab Tablet 0 0 0 0 0
26 Diazepam 2 mg Tablet 110 0 110 22 88
28 Dietilkarbamazin 100mg Tablet 0 0 0 0 0
29 Digoksin 0,25 mg Tablet 0 0 0 0 0
30 Dimenhidrinat 50 mg Tablet 0 0 0 0 0
31 Doksisiklin 100 mg Kapsul 0 0 0 0 0
32 Domperidon 10mg Tablet 0 0 0 0 0
33 Efedrin Hcl tab 25 mg Tablet 0 0 0 0 0
Ergotamin 1 mg + Kafein
34 50 mg Tablet 0 0 0 0
0
35 Eritromisin 250 mg Kapsul 100 0 100 0 100
36 Eritromisin500 mg Kapsul 0 0 0 0 0
37 Fenitoin 100 mg Kapsul 100 0 100 0 100
38 Fenitoin 30 mg Tablet 0 0 0 0 0
39 Fenobarbital 30 mg Tablet 5 0 5 0 5
40 Furosemid 40 mg Tablet 4,800 0 4,800 4800 0
41 Glibenklamid 2,5 mg Tablet 0 0 0 0 0
42 Glibenklamid 5 mg Tablet 11,000 0 11,000 0 11,000
Gliklazid tab lepas lambat

43 30 mg (Diamicron) Tablet 0 0 0 0
0

0
45 Glimepirid 1 mg Tablet 400 0 400 400 0
48 Glimipirid tablet 4mg Tablet 0 0 0 0 0
49 Griseofulvin 125 mg Tablet 200 0 200 200 0
51 Guaifenisin / GG Tablet 20,200 0 20,200 500 19,700
52 Haloperidol 0,5 mg Tablet 0 0 0 0 0
Haloperidol 2 mg
54 (Lodomer 2) Tablet 0 0 0 0
0
55 Haloperidol 5 mg Tablet 0 0 0 0 0
56 Hidroklortiazid 25 mg Tablet 1,100 0 1,100 0 1,100
57 Ibuprofen 200 mg Tablet 0 0 0 0 0
59 Isoniazid 300 mg Tablet 100 0 100 0 100
60 Isosorbid Dinitrat 5 mg Tablet 0 0 0 0 0
Kalium Klorida 600mg (KSR
61 600mg) Tablet 0 0 0 0
0
62 Kalsitriol (Oscal) Tablet 0 0 0 0 0
Kalsium Karbonat 500mg
63 (Calprosis-D) Tablet 0 0 0 0
0
64 Kalsium Laktat 500 mg Tablet 200 0 200 100 100
65 Kandesartan 8 mg Tablet 30 0 30 30 0
66 Kaptopril 12,5 mg Tablet 8,000 0 8,000 500 7,500
67 Kaptopril 25 mg Tablet 0 0 0 0 0
68 Karbamazepin 200 mg Tablet 100 0 100 0 100
69 Ketokonazol 200 mg Tablet 0 0 0 0 0
70 Kloramfenikol 250mg Kapsul 200 0 200 0 200
Kloramfenikol 500 mg
71 (Chloramex) Kapsul 0 0 0 0
0
72 Klorfeniramin 4 mg (CTM) Tablet 30,300 0 30,300 29,500
800
73 Klorpromazin 100 mg Tablet 0 0 0 0 0
74 Klopidogrel 300 mg Tablet 0 0 0 0 0
76 Klindamisin 300 mg Tablet 0 0 0 0 0
77 Kodein 10 mg Tablet 0 0 0 0 0
80 Kotrimoksazol 400/80mg Tablet 0 0 0 0 0
81 Levofloksasin 500mg Tablet 0 0 0 0 0
Levotiroksin (Euthyrox 50
82 mg) Tablet 0 0 0 0
0
83 Lansoprazol 30 mg Tablet 0 0 0 0 0
84 Loratadin 10 mg Tablet 0 0 0 0 0
85 Lorazepam 2mg Tablet 0 0 0 0 0
Medroksi Progesteron
86 Asetat 10mg (Provera Tablet 0 0 0 0
10mg) 0
87 Asetat 100 mg (Provera Tablet 0 0 0 0
100mg) 0
88 Meloksikam 15mg tab Tablet 0 0 0 0 0
89 Metformin 500 mg Tablet 0 0 0 0 0
Metildopa 250 mg
91 (Dopamet) Tablet 0 0 0 0
0
Metilergometrin tab 0,125
92 mg Tablet 0 0 0 0
0
93 Metilprednisolon 16 mg Tablet 0 0 0 0 0
95 Metoklopramid 10 mg Tablet 700 0 700 0 700
96 Metronidazol 250 mg Tablet 0 0 0 0 0
98 N-Asetil Sistein 200 mg Tablet 0 0 0 0 0
99 Natrium diklofenak 25mg Tablet 0 0 0 0

0
0
101 Neo Diaform tab Tablet 0 0 0 0 0
102 Nifedipin 20 mg Tablet 0 0 0 0 0
104 Nistatin Vaginal 100.000IU Tablet 155 0 155 155

0
0
106 Noretisterone 5mg Tablet 0 0 0 0 0
107 Ofloksasin 200 mg Tablet 50 0 50 0 50
109 Omeprazol 20 mg Kapsul 0 0 0 0 0
110 Ondansetron 4 mg Tablet 0 0 0 0 0
112 Parasetamol 500 mg Tablet 0 0 0 0 0
113 Pil KB Oral Kombinasi siklus 0 0 0 0 0
114 Pirantel Pamoat 125 mg Tablet 360 0 360 0 360
Pirantel Pamoat 250 mg
115 (Pantrin) Tablet 0 0 0 0
0
116 Piroksikam 20 mg tab Tablet 0 0 0 0 0
117 Prednison 5 mg Tablet 0 0 0 0 0
118 Propranolol 10 mg Tablet 0 0 0 0 0
120 Ranitidin 150 mg Tablet 300 0 300 300 0
121 Risperidon 1 mg Tablet 0 0 0 0 0
Rivaroksaban 20 mg
122 (Xarelto 20) Tablet 0 0 0 0
0
123 Salbutamol 4mg Tablet 0 0 0 0 0
124 Salbutamol 2mg Tablet 1,900 0 1,900 300 1,600
125 Sefadroksil 500 mg Kapsul 0 0 0 0 0
126 Sefiksim 200 mg Tablet 0 0 0 0 0
127 Setirizin 10 mg Tablet 0 0 0 0 0
128 Simetidin 200mg Tablet 0 0 0 0 0
129 Simvastatin 10 mg Tablet 0 0 0 0 0
130 Simvastatin 20 mg Tablet 1,050 0 1,050 200 850
131 Siprofloksasin 500 mg Tablet 0 0 0 0 0
132 Spironolakton 100 mg Tablet 0 0 0 0 0
Teofilin 150 mg
134 (Bronsolvan) Tablet 380 0 380 380
0
135 Tetrasiklin 500 mg Kapsul 0 0 0 0 0
Tiamizol 10 mg (Thyrozol,
137 Antityroid) Tablet 0 0 0 0
0
138 Triheksifenidil 2mg Tablet 0 0 0 0 0
139 Trifluoperazine 5 mg 0 0 0 0 0
140 Vitamin B kompleks Tablet 2,700 0 2,700 900 1,800
141 Vitamin B1 (Tiamin) 50mg Tablet 7,600 0 7,600 7,100

500
Vitamin B6 (Piridoksin) 10
142 mg Tablet 4,800 0 4,800 4,200
600
Vitamin B12
143 (Sianokobalamin) 50mcg Tablet 700 0 700 700
0
Vitamin C (Asam Askorbat)
144 50mg Tablet 700 0 700 0
700
Vitamin K1 (Fitomenadion)
145 10 mg Tablet 0 0 0 0
0
146 Zink tablet disperse 20 mg Tablet 3,300 0 3,300 3,000
300
SIRUP
147 Ambroksol Sirup Botol 0 0 0 0 0
Amoksisilin Sirup 125
148 mg/5mL Botol 0 0 0 0
0
Amoksisilin Sirup Forte 250
149 mg/5mL Botol 0 0 0 0
0
150 Antasida Suspensi Botol 0 0 0 0 0
151 Domperidon drop 5mg/mL Botol 0 0 0 0

0
Domperidon Sirup
152 5mg/5mL Botol 0 0 0 0
0
Eritromisin Sirup Kering
153 200mg/5mL Botol 0 0 0 0
0
Ibuprofen Suspensi
154 100mg/5 mL Botol 0 0 0 0
0
Ibuprofen Suspensi
155 200mg/5 mL Botol 0 0 0 0
0
156 Kloramfenikol Suspensi Botol 0 0 0 0 0
Kotrimoksazol Suspensi
157 200/40mg Botol 0 0 0 0
0
Laktulosa Sirup
158 3,335g/5mL Botol 0 0 0 0
0
Metoklopramid Sirup
159 5mg/5mL (Lexapram) Botol 0 0 0 0
0
Metoclopramid 10mL
160 (Gavistal) Drops Botol 0 0 0 0
0
Metronidazol Suspensi
161 125mg/5mL Botol 13 0 13 10
3
162 Nistatin Drops 100.000 IU Botol 0 0 0 0
0
Parasetamol Drop
163 100mg/mL Botol 0 0 0 0
0
Parasetamol Sirup
164 120mg/5mL Botol 40 0 40 18
22
Pirantel Pamoat Susp
165 125mg/5mL Botol 3 0 3 3
0
166 Salbutamol Sirup 2mg/5mL Botol 0 0 0 0
0
Sefadroksil Sirup
167 125mg/5mL Botol 32 0 32 7
25
168 Sefiksim Sirup 100mg/5mL Botol 15 0 15 0
15
169 Setirizin Sirup 5mg/5mL Botol 0 0 0 0 0
Sukralfat Suspensi
170 500mg/5mL Botol 0 0 0 0
0
171 Zink Pro 10 mg/mL Botol 0 0 0 0 0
172 Zink syrup 20 mg/5 mL Botol 0 0 0 0 0
SALEP/ INJEKSI/ SUPPO/
CAIRAN INFUS
Antibakteri Doen
173 Bacitracin - Polimiksin Tube 0 0 0 0
0
174 Air Untuk Injeksi 25 ml Flac 190 0 190 30 160
Albumin 25%-100ml
175 (Octalbin 25%) Botol 0 0 0 0
0
Albumin 5%-250 ml
0
Albumin Serum inj. 20%
177 100 mL (Biotest) Botol 0 0 0 0
0
178 Aminofilin inj 24 mg/mL Ampul 0 0 0 0 0
179 Amiodaron inj. 50mg/mL Ampul 0 0 0
180 Antifungi salep Tube 24 0 24 0 24
Antihemoroid Suppositoria Suppo
181 2 gr 70 0 70 70
0
Asam Traneksamat inj. 100 Ampul
182 mg/mL 0 0 0 0
0
Asam Traneksamat inj.
183 50mg/mL Ampul 10 0 10 10
0
184 Asiklovir krim 5% Tube 0 0 0 0 0
185 Asiklovir SM 3% (Lacyvir) Tube 0 0 0 0 0
186 Atropin inj 0,25 mg/mL Ampul 0 0 0 0 0
187 Bedak Salisil 2% Pot 0 0 0 0 0
Benzatin Penisilin 1,2 jt
188 IU/mL Vial 0 0 0 0
0
189 IU/mL Vial 0 0 0 0
0
Betametason 0,05%
190 (Skizon 5 gr) Tube 0 0 0 0
0
191 Betametason Krim 0,1% Tube 0 0 0 0 0
Betametason Dipropionat
192 Krim 0,05% Tube 0 0 0 0
0
Bisakodil Supp 10 mg
193 (Dulcolax) Suppo 5 0 5 5
0
Bisakodil Supp 5 mg
1
195 Citikolin inj Ampul 0 0 0 0 0
196 Deksametason inj 5mg/mL Ampul 100 0 100 90

10
197 Desoksimetason 0,25% Tube 9 0 9 0 9
Desoksimetason 0,25%
198 (Dexocort krim) Tube 0 0 0 0
0
199 Diazepam inj 5 mg Rectal 5 0 5 0 5
Diazepam Enema 10
200 mg/2,5mL (Stesolid10mg) Rectal 0 0 0 0
0
Diazepam Enema 5 mg/2,5 Ampul
201 mL (Stesolid 5mg) 0 0 0 0
0
202 Difenhidramin inj Ampul 0 0 0 0
10mg/mL 0
Dobutamin HCl 250 mg/5
203 ml (50mg/mL) Ampul 0 0 0 0
0
Dobutamin-Hameln inj.
204 12,5 mg/mL Ampul 0 0 0 0
0
205 Dopamin HCl inj. 4mg/mL Ampul 0 0 0 0
0
206 Efedrin inj 50 mg/mL Ampul 0 0 0 0 0
Epinefrin inj. 0,1% -
207 1mg/mL Ampul 0 0 0 0
0
208 Esomeprazol serb inj 40mg Vial 0 0 0 0
0
209 Eugenol cairan Botol 0 0 0 0 0
210 Etil klorida spray Botol 0 0 0 0 0
211 Fenitoin inj. 50 mg/mL Ampul 0 0 0 0 0
212 Fenobarbital inj. 50mg/mL Ampul 0 0 0 0

0
Fenoterol Cairan Ih 0,1%
213 (Berotec Solution) Vial 0 0 0 0
0
214 Fentanil inj 0,0785mg Ampul 0 0 0 0 0
Flusinolon asetonid salep

215 0,025% (Dermasolon) Tube 0 0 0 0
0
216 Furosemid inj 10 mg/mL Ampul 0 0 0 0 0
217 Gentamisin SM 0,3% Tube 0 0 0 0 0
218 Gentamisin inj Ampul 0 0 0 0 0
219 Glukosa 5% larutan infus Botol 53 0 53 53

0
0
221 Human Albumin 5% 50ml Botol 0 0 0 0 0
222 Hidrokortison krim 2,5% Tube 39 0 39 0 39
223 Hidrokortison Krim 1% Tube 7 0 7 7
Hepatitis B Imunoglobulin
224 220 IU/mL (HyperHep Flac 0 0 0 0
0,5ml) 0
Insulin Long Acting
225 100IU/mL (Levemir) Pen 0 0 0 0
0
Insulin Rapid Acting
226 100IU/mL (Novorapid) Pen 0 0 0 0
0
Ipratropium Br aerosol
227 0,025% 20 mcg/puff Botol 0 0 0 0
(Atrovent) 0
Ipratropium Br inhalasi 0,5
228 mg (Combivent) Botol 0 0 0 0
0
229 KA EN 1B, larutan infus Flac 0 0 0 0 0
230 KA EN 3A, larutan infus Flac 0 0 0 0 0
231 KAEN 3B larutan infus Flac 0 0 0 0 0
232 KAEN MG, Larutan Infus Flac 0 0 0 0 0
233 Kalium Klorida (KCL) Inj. Flac 0 0 0 0 0
234 Kalsium Glukonat inj. 10% Ampul 3 0 3 3

0
Kloramfenikol Salep 2%
235 (Bufacetin) Tube 3 0 3 0
3
Kloramfenikol Salep Mata
236 1% Tube 62 0 62 38
24
237 Kloramfenikol Salep Kulit Tube 0 0 0 0
0
Klonidin inj150 mcg/mL
238 (Catapres) Ampul 0 0 0 0
0
Karbogliserin tetes telinga
239 10% (Fenol Gliserol) Botol 0 0 0 0
0
240 Ketokonazol krim 2% Tube 11 0 11 5 6
Ketoprofen Sup 100 mg
241 (Protofen) Suppo 0 0 0 0
0
242 Ketorolak inj. 30 mg/mL Ampul 0 0 0 0 0
243 Lansoprazole 30mg inj Vial 0 0 0 0 0
244 Lidocain inj 2% Ampul 100 0 100 0 100
245 Lidokain inj 2% + Epinefrin Ampul 70 0 70 30

40
246 Manitol, cairan infus Flac 0 0 0 0 0
247 Asetat 150mg/3mL inj. Vial 0 0 0 0
(Deponeo) 0
248 Meropenem 0,5 g Vial 0 0 0 0 0
249 Metilergometrin inj. Ampul 0 0 0 0 0
Metilprednisolon inj.
250 500mg Vial 0 0 0 0
0
Metilprednisolon serb inj
251 125 mg Vial 0 0 0 0
0
Metronidazol infus
252 5mg/mL Botol 4 0 4 4
0
253 Mikonazol krim 2% Tube 66 0 66 24 42
254 NaCl 0,9%, larutan infus Flac 80 0 80 60

20
255 Neurobion inj Ampul 0 0 0 0 0
256 Nikardipin Inj. 1mg/mL Ampul 0 0 0 0 0
Oksimetazolin tetes hidung
257 (Iliadin 0,05%) Botol 0 0 0 0
0
258 Oksitetrasiklin SM 1% Tube 86 0 86 24 62
259 Ondansetron inj. 4mg Ampul 100 0 100 100 0
260 Omeprazol inj. 40mg Ampul 0 0 0 0 0
261 Oksitosin inj 10 IU/mL Ampul 0 0 0 0 0
Parasetamol infus 10
262 mg/mL Botol 0 0 0 0
0
263 Perak Sulfadiazin Krim Tube 2 0 2 0 2
264 Ranitidin inj 25 mg/mL Ampul 60 0 60 30 30
265 Ringer Lactat, larutan infus Flac 0 0 0 0 0
Salbutamol aerosol 100
266 mcg (Salbulin) Botol 0 0 0 0
0
267 Salep 2-4 Pot 34 0 34 0 34
268 Sefotaksim inj. 1000 mg Vial 0 0 0 0 0
269 Seftriakson inj. 1000 mg Vial 0 0 0 0 0
270 Sefuroksim inj Vial 0 0 0 0 0
271 Siprofloksasin inf. 2mg/mL Botol 0 0 0 0

0
272 Streptomisin inj 1 gr Vial 0 0 0 0 0
273 Tramadol inj. 50 mg/mL Ampul 0 0 0 0 0
274 Vaksin Rabies (Verorab) Vial 0 0 0 0 0
Vitamin B12
275 (Sianokobalamin) inj. Ampul 200 0 200 200
500mcg/mL 0
Vitamin B6 (Piridoksin) inj.
276 100mg Ampul 100 0 100 100
0
277 Zyprexa / Olanzapine 10mg Vial 0 0 0 0
0
PERBEKALAN KESEHATAN
1 Abbocath no. 18 Pcs 640 0 640 0 640
2 Abbocath no. 20 Pcs 232 0 232 25 207
3 Abbocath no. 22 Pcs 125 0 125 25 100
4 Abbocath no. 24 Pcs 150 0 150 9 141
5 Abbocath no. 26 Pcs 33 0 33 33 0
6 Alkohol 70% 1 liter Botol 108 0 108 3 105
7 Alkohol 70% 300ml Botol 0 0 0 0 0
8 Alkohol Peroxida 500ml Botol 10 0 10 7
3
9 Alkohol Swab Pcs 1,900 0 1,900 1080 820
10 Arm Sling L Pcs 19 0 19 9 10
11 Arm Sling M Pcs 18 0 18 3 15
12 Arm Sling S Pcs 18 0 18 0 18
13 Aseptik 500 cc + dispenser Botol 14 0 14 11

3
14 Autoclick Lancing Device Pcs 0 0 0 0 0
15 Blood Lancet Pcs 4,400 0 4,400 200 4,200
16 Blood Transfusion Set Pcs 0 0 0 0 0
17 Catgut no 2/0 Pcs 0 0 0 0 0
18 Catgut no 3/0 Pcs 0 0 0 0 0
Catgut Chromic 0, 75 cm,
19 40mm CG278 Pcs 0 0 0 0
0
20 36mm CG228 Pcs 0 0 0 0
0
21 45 mm CG209 Pcs 0 0 0 0
0
Catgut Chromic 2/0, 37cm,
22 90 mm CG315 Pcs 0 0 0 0
0
23 26 mm CG296 Pcs 5 0 5 0
5
24 Catgut Chromic 3/0 Pcs 0 0 0 0 0
Catgut Chromic 3/0, 24
25 mm, 75 cm CG342 Pcs 0 0 0 0
0
26 mm, 75 cm CG344 Pcs 0 0 0 0
0
27 mm, 75 cm CG366 Pcs 0 0 0 0
0
28 mm, 75 cm CG372 Pcs 0 0 0 0
0
Catgut Plain 0, 30 mm, 75
29 cm PG132 Pcs 0 0 0 0
0
Catgut Plain 1, 90 cm,
30 1/2mayo, 30 mm PG114 Pcs 0 0 0 0
0
31 Catgut Plain 2/0 HR 20mm Pcs 0 0 0 0
0
Catgut Plain 2/0, 24 mm,
32 75 cm gabler Pcs 0 0 0 0
0
33 75 cm PG142 Pcs 0 0 0 0
0
34 75 cm PG146 Pcs 0 0 0 0
0
35 Catgut Plain 3/0 Pcs 0 0 0 0 0
36 Catgut Plain 3/0 DS 19mm Pcs 0 0 0 0

0
0
38 75 cm PG168-1 Pcs 0 0 0 0
0
39 75 cm PG174 Pcs 0 0 0 0
0
40 Catgut Plain 4/0, DS 16mm Pcs 0 0 0 0
0
41 Cervical Collar Pcs 8 0 8 0 8
42 Colostomy bag Pcs 0 0 0 0 0
43 Dermavix S IV Pcs 0 0 0 0 0
44 Dermavix T 10 x 15 cm Pcs 0 0 0 0 0
47 Dermavix t 5 x 7 cm Pcs 25 0 25 5 20
48 Ecodine 1 liter Botol 0 0 0 0 0
49 Feeding Tube 5FR 100 cm Pcs 0 0 0 0 0
51 Fetal Doppler Pcs 0 0 0 0 0
Foley Catheter 2 way no.
52 12 (Urocare) Pcs 0 0 0 0
0
53 14 (Urocare) Pcs 0 0 0 0
0
54 16 (Urocare) Pcs 13 0 13 13
0
55 18 (Urocare) Pcs 22 0 22 12
10
56 20 (Urocare) Pcs 0 0 0 0
0
57 22 (Urocare) Pcs 3 0 3 3
0
58 24 (Urocare) Pcs 5 0 5 5
0
59 Foley Catheter 3 way no 20 Pcs 0 0 0 0
0
0
0
62 Foley Catheter no. FR16 Pcs 0 0 0 0 0
63 Foley Catheter no. FR18 Pcs 0 0 0 0
0
Foley Catheter Ped 2 no.
64 10 Pcs 2 0 2 2
0
65 Foley Catheter Ped 2 no. 6 Pcs 0 0 0 0
0
0
Handscum (Surgical
67 Gloves) No. 6,5 Pasang 0 0 0 0
0
Handscum (Surgical
68 Gloves) No.7 Pasang 0 0 0 0
0
Handscum (Surgical
0
70 Handsanitizer Botol 0 0 0 0 0
71 Infus Set Anak Pcs 49 0 49 0 49
72 Infus set Dewasa Pcs 50 0 50 40 10
73 Jet Nebuliser Mask Anak Pcs 4 0 4 1

3
74 Jet Nebuliser Mask Dewasa Pcs 5 0 5 5
0
75 Kapas 100 g Roll 0 0 0 0 0
76 Kapas 500 gram Roll 5 0 5 1 4
77 Kapas Pembalut 1000gr Roll 3 0 3 3

0
78 Kapas pembalut 250 gr Roll 0 0 0 0 0
79 Kasa Hidrofil 4m x 10cm Roll 35 0 35 0 35
81 Kasa Hidrofil 4m x 5cm Roll 130 0 130 100

30
2
83 Kasa Hidrofil Steril 16x16 Pcs 1,400 0 1,400 500
900
84 Kasa Steril 10 x 10 cm Roll 0 0 0 0 0
85 Leukoplast 2,5 x 4,5 Roll 37 0 37 0 37
87 Lysol 1 L Botol 4 0 4 0 4
88 Masker N95 Pcs 0 0 0 0 0
89 Masker Surgical (One Med) Pcs 300 0 300 0

300
90 Masker Surgical 3 Ply Pcs 0 0 0 0 0
Maxter Exam Non Powder
91 L Pasang 0 0 0 0
0
92 M Pasang 0 0 0 0
0
93 S Pasang 0 0 0 0
0
94 XS Pasang 0 0 0 0
0
Norta Catheter 2 Way Ch
95 14/200 Pcs 0 0 0 0
0
96 16/200 Pcs 0 0 0 0
0
97 18/200 Pcs 0 0 0 0
0
98 20/200 Pcs 0 0 0 0
0
99 22/100 Pcs 0 0 0 0
0
100 24/100 Pcs 0 0 0 0
0
Norta Catheter ped 2 Way
101 Ch 10 Pcs 0 0 0 0
0
102 Ch 6 Pcs 0 0 0 0
0
103 Nurse Cup 0 0 0 0 0
104 Oxyflow Anak Pcs 0 0 0 0 0
105 Oxyflow Dewasa Pcs 0 0 0 0 0
106 Plesterin Bulat Pcs 1,850 0 1,850 500 1,350
107 Plesterin Elastis Pcs 0 0 0 0 0
108 Plesterin Elastis Jumbo Pcs 9,200 0 9,200 300 8,900
Plesterin Non Woven 10
109 cm x 5 m Roll 29 0 29 29
0
110 cm x 5 m Roll 0 0 0 0
0
Plesterin Non Woven 5 cm
111 x 5 m Roll 20 0 20 20
0
112 Pot Dahak Pcs 820 0 820 30 790
113 Povidon Iodine 10% 60ml Botol 0 0 0 0

0
114 Povidon Iodine 300 ml Botol 0 0 0 0 0
Provein 2/0 26 mm, 75 cm
116 PV830 Pcs 1 0 1 1
0
117 PV856 Pcs 1 0 1 0
1
118 PV888 Pcs 0 0 0 0
0
119 PV894 Pcs 0 0 0 0
0
120 Rivanol 300 cc Botol 0 0 0 0 0
121 Safe Glove Surgical 6 ½ Pasang 0 0 0 0 0
122 Safe Glove Surgical 7 Pasang 0 0 0 0 0
125 Sarung Tangan Obgyn Pasang 68 0 68 0 68
126 Shoe Cover Pasang 59 0 59 0 59
Silk Black 2/0, 25 mm, 75
127 cm BS636 Pcs 0 0 0 0
0
128 cm BS640-1 Pcs 7 0 7 4
3
129 Silk Black 3/0 HR 30mm Pcs 0 0 0 0 0
130 Silk Black 3/0 HR 20mm Pcs 0 0 0 0

0
131 cm BS668 Pcs 0 0 0 0
0
Silk Black 3/0, 75cm, 19
132 mm BS656-1 Pcs 7 0 7 4
3
133 cm BS695 Pcs 0 0 0 0
0
134 Silk Braided 2/0 Pcs 0 0 0 0 0
Silk Braided Black 3/0 HR
136 30 mm Pcs 0 0 0 0
0
Softpad 60 x 90 cm non
137 steril Pcs 830 0 830 730
100
138 Spoit 0,5 ml Pcs 200 0 200 0 200
139 Spoit 1 ml Pcs 770 0 770 50 720
140 Spoit 10 ml Pcs 200 0 200 0 200
141 Spoit 2,5 ml Pcs 670 0 670 0 670
142 Spoit 20 ml Pcs 0 0 0 0 0
143 Spoit 3 ml Pcs 750 0 750 100 650
144 Spoit 5 ml Pcs 560 0 560 0 560
145 Spoit 50 ml Pcs 0 0 0 0 0
146 Suction Catheter FR 10 Pcs 1 0 1 0 1
151 Surgical Mask 3 Ply Earloop Pcs 0 0 0 0

0
152 U Pad Steril 60 x 90 cm Pcs 0 0 0 0 0
153 Ultrasonic Gel 250 ml Botol 0 0 0 0 0
154 Ultra One Tes Kehamilan Pcs 0 0 0 0 0
155 Uniflex 10 cm x 4,5 cm Roll 1 0 1 0 1
157 Uniflex 7,5 cm x 4,5 cm Roll 3 0 3 1 2
Onemed Umbilical Cord

158 klem (Penjepit Tali Pusar) Pcs 0 0 0 0
0
159 Urine Bag Pcs 5 0 5 0 5
160 Wing Needle no. 21 G Pcs 10 0 10 0 10
161 Autocheck Stick Urid acid Pcs 0 0 0 0

0
Autocheck Stick Gula
162 Darah Pcs 0 0 0 0
0
163 Autocheck Stick Kolesterol Pcs 0 0 0 0
0
PROGRAM TB
1 OAT Paduan Kategori I Paket 2 0 2 0 2
2 OAT Kategori I Paket 9 0 9 0 9
3 OAT Kategori II Paket 0 0 0 0 0
4 OAT Kategori Anak Paket 0 0 0 0 0
5 Pot Dahak Pot 820 0 820 30 790
6 Reagen Paket 8 0 8 0 8
7 Slide Pcs 0 0 0 0 0
8 TCM Catridge (TB) Paket 0 0 0 0 0
PROGRAM KECACINGAN
1 Albendazole tab Tablet 0 0 0 0 0
2 Albendazol Syr Botol 0 0 0 0 0
3 DEC Tablet 0 0 0 0 0
PROGRAM DIARE
1 Oralit Sach 4,800 0 4,800 0 4,800
2 Zink 20 mg Tablet 3,300 0 3,300 300 3,000
PROGRAM MALARIA 0 0
1 Artesunat inj Ampul 0 0 0 0 0
2 DHP Primal Tablet 45 0 45 9 36
3 Kina (Quinin) tab Tablet 0 0 0 0 0
4 Primaquin Tablet 31 0 31 0 31
5 RDT Malaria Teskit 0 0 0 0 0
PROGRAM HIV
1 Mikropipet 10 UL Pcs 1 0 1 0 1
PROGRAM IMUNISASI
1 Vaksin BCG Vial 0 0 0 0
2 Vaksin Campak Rubella Vial 0 0 0 0
3 Vaksin DPT-HB-HIB Vial 0 0 0 0
4 Vaksin DT Vial 0 0 0 0
5 Vaksin HB0 Vial 0 0 0 0
6 Vaksin Polio Vial 0 0 0 0
7 Vaksin Polio injeksi Vial 0 0 0 0
8 Vaksin TD Vial 0 0 0 0
9 Solosot 0,05 Pcs 0 0 0 0
10 Solosot 0,5 ml Pcs 0 0 0 0
11 Solosot 5 ml Pcs 0 0 0 0
12 Safety Box Pcs 0 0 0 0
PROGRAM GIZI
1 Mineral Mix Sach 0 0 0 0
2 Tablet Tambah Darah Tablet 35,940 0 35,940 3660 32,280
3 Vitamin A 100000 IU Kapsul 400 0 400 0 400
4 Vitamin A 200000 IU Kapsul 2,500 0 2,500 0 2,500
PROGRAM KIA
1 Ampisillin 1000 mg Inj Ampul 0 0 0 0 0
2 Fenobarbital Injeksi Ampul 0 0 0 0 0
3 Fitomenadion Injeksi Ampul 270 0 270 5 265
4 Kalsium Glukonat Inj Ampul 0 0 0 0 0
5 MgSO4 40% Injeksi Flac 0 0 0 0 0
6 Oxytetrasiklin 1% SM Tube 86 0 86 24 62
PROGRAM COVID-19
1 Vitamin C 500 mg Tablet 1,415 0 1,415 45 1,370
2 Multivitamin Zink Tablet 1,320 0 1,320 55 1,265
3 Alkohol Swab Pcs 0 2,400 2,400 2,400 1500 900
4 ADS 0,5 ml Pcs 0 0 0 0
5 ADS 0,3 ml Pcs 0 2,400 2,400 2,400 900 1,500
6 ADS 3 ml Pcs 0 0 0 0
7 APD Set Set 0 0 0 0
8 NaCl 0,9% Flac 0 0 0 0
TAMBAHAN
1 Benechek pcs 0 0 0 0 0
2 Masker Kain Putih pcs 0 0 0 0 0
3 Virochek HBSAg pcs 0 0 0 0 0
4 Trepocheck (sifilis) pcs 0 0 0 0 0
5 Stik HIV pcs 0 0 0 0 0
6 Sepatu Covid19 (Provinsi) pcs 0 0 0 0

0
7 Masker N95 (Provinsi) pcs 0 0 0 0 0
Kaca Helm Covid19
8 (Provinsi)
pcs 0 0 0 0
0
9 Helm Covid19 (Provinsi) pcs 0 0 0 0 0
10 Indec Covid (Provinsi) pcs 0 0 0 0 0
Baju Hazmat L, XL
11 (Provinsi) pcs 0 0 0 0
0
12 Baju Hazmat M (Provinsi) pcs 0 0 0 0
0
Masker Bedah Karet
0
14 Vaculab (Provinsi) pcs 100 0 100 0 100
15 Aseptic Gel (Perhubungan) Botol 0 0 0 0

0
16 Stick pan pcs 0 0 0 0 0
17 Urinal Male pcs 0 0 0 0 0
18 Urinal Female pcs 0 0 0 0 0
19 Timbangan Bayi pcs 0 0 0 0 0
20 Lodia Tablet 0 0 0 0
21 Revital Syp sirup 0 0 0 0
22 Gentamicin SK Slp 0 0 0 0
23 Biocombin Inj 0 0 0 0
24 Sohobion Tablet 0 0 0 0
25 Pentolin 0 0 0 0
26 curcuma force Tablet 0 0 0 0
27 cavit D3 kapsul 1000 IU kapsul 0 0 0 0
28 ramvit c 500mg Tablet 0 0 0 0
29 caviplex 0 0 0
30 0 0 0
0
UMUM
ASKES JUMLAH
JUMLAH KUNJUNGAN RESEP BAYAR TDK BAYAR
0
Petugas Pengelola Obat

Mengetahui,
Pimpinan Puskesmas
(Sisara Wakang S. KM) (Sumiati Kausaha. S.Kep Ns)

NIP. 19670303199103 2 010 NIP. 197909182010012014
MINTAAN OBAT (LPLPO)

BULAN JANUARI
KET.
(Sumiati Kausaha. S.Kep Ns)

NIP. 197909182010012014
BULAN : FEBRUARI
TAHUN : 2022
SATUAN
BULAN FEBRUARI
NO NAMA BARANG
TABLET
1 Alopurinol 100 mg Tablet 2,300 0 2,300 500 1,800 3000

5 Ambroksol 30 mg Tablet 0 0 0 0 0 5000
6 150)
Tablet 0 0 0 0
0
7 Aminofilin 200 mg Tablet 0 0 0 0 0 500
9 Amlodipin 10 mg Tablet 0 0 0 0 0 3000
11 Amoksisilin 250 mg Tablet 0 0 0 0 0 5000
12 Amoksisilin 500 mg Tablet 10,800 0 10,800 1600 9,200 10000
13 Antasida Tablet Kunyah Tablet 13,700 0 13,700 1000 12,700 8000
0
0
0
19 Asiklovir 200 mg Tablet 0 0 0 0 0 1000
20 Asiklovir 400 mg Tablet 0 0 0 0 0 1000
0
22 Betahistin 6 mg Tablet 150 0 150 30 120 300
24 Deksametason 0,5 mg Tablet 0 0 0 0 0 5000
25 Demacolin tab Tablet 0 0 0 0 0 7000
26 Diazepam 2 mg Tablet 88 0 88 5 83 100
30 Dimenhidrinat 50 mg Tablet 0 0 0 0 0 1000
32 Domperidon 10mg Tablet 0 0 0 0 0 1500
34 50 mg Tablet 0 0 0 0
0 300
40 Furosemid 40 mg Tablet 0 0 0 0 0 500

0

0
49 Griseofulvin 125 mg Tablet 0 0 0 0 0 1000
Haloperidol 2 mg
0
57 Ibuprofen 200 mg Tablet 0 0 0 0 0 5000
58 Ibuprofen 400 mg Tablet 0 0 0 0 0 10000
61 600mg) Tablet 0 0 0 0
0
0
64 Kalsium Laktat 500 mg Tablet 100 0 100 100 0 5000
0
800
82 mg) Tablet 0 0 0 0
0
83 Lansoprazol 30 mg Tablet 0 0 0 0 0 3000
84 Loratadin 10 mg Tablet 0 0 0 0 0 2000
10mg) 0
100mg) 0
89 Metformin 500 mg Tablet 0 0 0 0 0 3000
90 Metformin 850 mg Tablet 0 0 0 0 0 2000
Metildopa 250 mg
0
0
93 Metilprednisolon 16 mg Tablet 0 0 0 0 0 3000
94 Metilprednisolon 4 mg Tablet 0 0 0 0 0 2000
97 Metronidazol 500 mg Tablet 0 0 0 0 0 2000
98 N-Asetil Sistein 200 mg Tablet 0 0 0 0 0 2000
0 10000
0 8000
102 Nifedipin 20 mg Tablet 0 0 0 0 0 1000

0
0
109 Omeprazol 20 mg Kapsul 0 0 0 0 0 8000
110 Ondansetron 4 mg Tablet 0 0 0 0 0 1000
112 Parasetamol 500 mg Tablet 0 0 0 0 0 15000
113 Pil KB Oral Kombinasi siklus 0 0 0 0 0 1000
0
116 Piroksikam 20 mg tab Tablet 0 0 0 0 0 5000
117 Prednison 5 mg Tablet 0 0 0 0 0 8000
118 Propranolol 10 mg Tablet 0 0 0 0
120 Ranitidin 150 mg Tablet 0 0 0 0 0 2000
Rivaroksaban 20 mg
0
125 Sefadroksil 500 mg Kapsul 0 0 0 0 0 5000
126 Sefiksim 200 mg Tablet 0 0 0 0 0 3000
127 Setirizin 10 mg Tablet 0 0 0 0 0 2000
128 Simetidin 200mg Tablet 0 0 0 0 0 1000
129 Simvastatin 10 mg Tablet 0 0 0 0 0 3000
131 Siprofloksasin 500 mg Tablet 0 0 0 0 0 2000
Teofilin 150 mg
0
0
140 Vitamin B kompleks Tablet 1,800 0 1,800 800 1,000 10000
300
142 mg Tablet 4,200 0 4,200 3,100
1100
Vitamin B12
0
144 50mg Tablet 0 0 0 0
0 15000
145 10 mg Tablet 0 0 0 0
0 200
0
SIRUP
147 Ambroksol Sirup Botol 0 0 0 0 0 100
148 mg/5mL Botol 0 0 0 0
0 100
149 mg/5mL Botol 0 0 0 0
0 100

0
Domperidon Sirup
152 5mg/5mL Botol 0 0 0 0
0 100
153 200mg/5mL Botol 0 0 0 0
0
Ibuprofen Suspensi
154 100mg/5 mL Botol 0 0 0 0
0 100
Ibuprofen Suspensi
155 200mg/5 mL Botol 0 0 0 0
0
156 Kloramfenikol Suspensi Botol 0 0 0 0
0 20
157 200/40mg Botol 0 0 0 0
0 100
Laktulosa Sirup
158 3,335g/5mL Botol 0 0 0 0
0 20
Metoklopramid Sirup
0
Metoclopramid 10mL
0
161 125mg/5mL Botol 10 0 10 10
0
0
Parasetamol Drop
163 100mg/mL Botol 0 0 0 0
0 50
Parasetamol Sirup
164 120mg/5mL Botol 18 0 18 0
18 200
165 125mg/5mL Botol 3 0 3 3
0
0
Sefadroksil Sirup
167 125mg/5mL Botol 7 0 7 0
7 50
0 50
169 Setirizin Sirup 5mg/5mL Botol 0 0 0 0 0 50
Sukralfat Suspensi
170 500mg/5mL Botol 0 0 0 0
0 50
171 Zink Pro 10 mg/mL Botol 0 0 0 0 0 20
172 Zink syrup 20 mg/5 mL Botol 0 0 0 0 0 50
CAIRAN INFUS
Antibakteri Doen
0 100
174 Air Untuk Injeksi 25 ml Flac 160 0 160 10 150 20
Albumin 25%-100ml
0
Albumin 5%-250 ml
0
0
179 Amiodaron inj. 50mg/mL Ampul 0 0 0 0 0
181 2 gr 70 0 70 70
0
182 mg/mL 0 0 0 0
0
183 50mg/mL Ampul 10 0 10 10
0
184 Asiklovir krim 5% Tube 0 0 0 0 0 50
186 Atropin inj 0,25 mg/mL Ampul 0 0 0 0 0 30
188 IU/mL Vial 0 0 0 0
0
189 IU/mL Vial 0 0 0 0
0
Betametason 0,05%
0
191 Betametason Krim 0,1% Tube 0 0 0 0 0 100
192 Krim 0,05% Tube 0 0 0 0
0
3
Bisakodil Supp 5 mg
0

10
0
Diazepam Enema 10
0
0
10mg/mL 0 25
203 ml (50mg/mL) Ampul 0 0 0 0
0
204 12,5 mg/mL Ampul 0 0 0 0
0
0
206 Efedrin inj 50 mg/mL Ampul 0 0 0 0 0 5
207 1mg/mL Ampul 0 0 0 0
0
0
210 Etil klorida spray Botol 0 0 0 0 0 5

0
0

215 0,025% (Dermasolon) Tube 0 0 0 0
0
217 Gentamisin SM 0,3% Tube 0 0 0 0 0 50

0
0
222 Hidrokortison krim 2,5% Tube 39 0 39 39 0 100
0,5ml) 0
Insulin Long Acting
0
0
227 0,025% 20 mcg/puff Botol 0 0 0 0
(Atrovent) 0
0

0
0
236 1% Tube 38 0 38 38
0
0
0
0
0

0
246 Manitol, cairan infus Flac 0 0 0 0
(Deponeo) 0
250 500mg Vial 0 0 0 0
0
251 125 mg Vial 0 0 0 0
0
Metronidazol infus
252 5mg/mL Botol 4 0 4 4
0

0
257 (Iliadin 0,05%) Botol 0 0 0 0
0
262 mg/mL Botol 0 0 0 0
0 20
265 Ringer Lactat, larutan infus Flac 0 0 0 0 0 500
0
267 Salep 2-4 Pot 34 0 34 0 34

0
Vitamin B12
500mcg/mL 100
276 100mg Ampul 100 0 100 100
0
0
1 Abbocath no. 18 Pcs 640 0 640 0 640
2 Abbocath no. 20 Pcs 207 0 207 10 197 200
3 Abbocath no. 22 Pcs 100 0 100 10 90 200
4 Abbocath no. 24 Pcs 141 0 141 10 131
5 Abbocath no. 26 Pcs 0 0 0 0 0 200
7 Alkohol 70% 300ml Botol 0 0 0 0

0
8 Alkohol Peroxida 500ml Botol 7 0 7 0 7
9 Alkohol Swab Pcs 820 0 820 600 220 5000
10 Arm Sling L Pcs 10 0 10 0 10
11 Arm Sling M Pcs 15 0 15 0 15
12 Arm Sling S Pcs 18 0 18 0 18

0
15 Blood Lancet Pcs 4,200 0 4,200 0 4,200
17 Catgut no 2/0 Pcs 0 0 0 0 0 300
18 Catgut no 3/0 Pcs 0 0 0 0 0 300
19 40mm CG278 Pcs 0 0 0 0
0 300
20 36mm CG228 Pcs 0 0 0 0
0 500
21 45 mm CG209 Pcs 0 0 0 0
0 500
22 90 mm CG315 Pcs 0 0 0 0
0
23 26 mm CG296 Pcs 0 0 0 0
0 300
25 mm, 75 cm CG342 Pcs 0 0 0 0
0
26 mm, 75 cm CG344 Pcs 0 0 0 0
0 500
27 mm, 75 cm CG366 Pcs 0 0 0 0
0
28 mm, 75 cm CG372 Pcs 0 0 0 0
0
29 cm PG132 Pcs 0 0 0 0
0
30 1/2mayo, 30 mm PG114 Pcs 0 0 0 0
0
0
0
33 75 cm PG142 Pcs 0 0 0 0
0 500
34 75 cm PG146 Pcs 0 0 0 0
0
35 Catgut Plain 3/0 Pcs 0 0 0 0 0 500
0
0
38 75 cm PG168-1 Pcs 0 0 0 0
0 500
39 75 cm PG174 Pcs 0 0 0 0
0
0
52 12 (Urocare) Pcs 0 0 0 0
0
53 14 (Urocare) Pcs 0 0 0 0
0
54 16 (Urocare) Pcs 13 0 13 10
3
55 18 (Urocare) Pcs 12 0 12 10
2
56 20 (Urocare) Pcs 0 0 0 0
0
57 22 (Urocare) Pcs 3 0 3 3
0
58 24 (Urocare) Pcs 5 0 5 5
0
0
0
0
0
64 10 Pcs 2 0 2 2
0
0
0
Handscum (Surgical
0 500
Handscum (Surgical
0 500
Handscum (Surgical
0 500
71 Infus Set Anak Pcs 49 0 49 0 49 300
72 Infus set Dewasa Pcs 10 0 10 0
10 500
73 Jet Nebuliser Mask Anak Pcs 1 0 1 0 1

0
75 Kapas 100 g Roll 0 0 0 0 0
76 Kapas 500 gram Roll 4 0 4 4

0
77 Kapas Pembalut 1000gr Roll 3 0 3 0 3
79 Kasa Hidrofil 4m x 10cm Roll 35 0 35 0 35 100
0 100

0
83 Kasa Hidrofil Steril 16x16 Pcs 500 0 500 244
256 1000
87 Lysol 1 L Botol 4 0 4 0 4
88 Masker N95 Pcs 0 0 0 0 0 700
0 1000
91 L Pasang 0 0 0 0
0 1000
92 M Pasang 0 0 0 0
0 2000
93 S Pasang 0 0 0 0
0 1000
0
95 14/200 Pcs 0 0 0 0
0
96 16/200 Pcs 0 0 0 0
0
97 18/200 Pcs 0 0 0 0
0
98 20/200 Pcs 0 0 0 0
0
99 22/100 Pcs 0 0 0 0
0
100 24/100 Pcs 0 0 0 0
0
101 Ch 10 Pcs 0 0 0 0
0
102 Ch 6 Pcs 0 0 0 0
0
103 Nurse Cup 0 0 0 0 0
106 Plesterin Bulat Pcs 1,350 0 1,350 350 1,000
109 cm x 5 m Roll 29 0 29 29
0
110 cm x 5 m Roll 0 0 0 0
0
111 x 5 m Roll 20 0 20 20
0
112 Pot Dahak Pcs 790 0 790 0 790

0
114 Povidon Iodine 300 ml Botol 0 0 0 0 0 10
116 PV830 Pcs 1 0 1 1
0
117 PV856 Pcs 0 0 0 0
0
118 PV888 Pcs 0 0 0 0
0
119 PV894 Pcs 0 0 0 0
0
120 Rivanol 300 cc Botol 0 0 0 0 0 5
122 Safe Glove Surgical 7 Pasang 0 0 0 0 0 500
123 Safe Glove Surgical 7 ½ Pasang 0 0 0 0 0 500
124 Safe Glove Surgical 8 Pasang 0 0 0 0 0 500
127 cm BS636 Pcs 0 0 0 0
0
128 cm BS640-1 Pcs 4 0 4 4
0
0 100
131 cm BS668 Pcs 0 0 0 0
0
132 mm BS656-1 Pcs 4 0 4 4
0 100
133 cm BS695 Pcs 0 0 0 0
0
134 Silk Braided 2/0 Pcs 0 0 0 0 0 50
135 Silk Braided 3/0 Pcs 0 0 0 0 0 50
136 30 mm Pcs 0 0 0 0
0
137 steril Pcs 730 0 730 670
60
138 Spoit 0,5 ml Pcs 200 0 200 0 200
139 Spoit 1 ml Pcs 720 0 720 0 720
140 Spoit 10 ml Pcs 200 0 200 50 150
141 Spoit 2,5 ml Pcs 670 0 670 100 570
142 Spoit 20 ml Pcs 0 0 0 0 0
143 Spoit 3 ml Pcs 650 0 650 50 600
144 Spoit 5 ml Pcs 560 0 560 60 500
145 Spoit 50 ml Pcs 0 0 0 0 0

0 1000

0

0
162 Darah Pcs 0 0 0 0
0
0
PROGRAM TB
1 OAT Paduan Kategori I Paket 2 0 2 2
3 OAT Kategori II Paket 0 0 0 0
4 OAT Kategori Anak Paket 0 0 0 0
5 Pot Dahak Pot 790 0 790 790
6 Reagen Paket 8 0 8 8
7 Slide Pcs 0 0 0 0
8 TCM Catridge (TB) Paket 0 0 0 0
PROGRAM KECACINGAN
1 Albendazole tab Tablet 0 0 0 0
2 Albendazol Syr Botol 0 0 0 0
3 DEC Tablet 0 0 0 0
PROGRAM DIARE
1 Oralit Sach 4,800 0 4,800 4,800
2 Zink 20 mg Tablet 3,000 0 3,000 3,000
PROGRAM MALARIA
1 Artesunat inj Ampul 0 0 0 0
3 Kina (Quinin) tab Tablet 0 0 0 0
5 RDT Malaria Teskit 0 0 0 0
PROGRAM HIV
1 Mikropipet 10 UL Pcs 1 0 1 1
PROGRAM IMUNISASI
9 Solosot 0,05 Pcs 0 0 0 0
PROGRAM GIZI
2 Tablet Tambah Darah Tablet 32,280 0 32,280 32,280
3 Vitamin A 100000 IU Kapsul 400 0 400 400
4 Vitamin A 200000 IU Kapsul 2,500 0 2,500 2,500
PROGRAM KIA
1 Ampisillin 1000 mg Inj Ampul 0 0 0 0
2 Fenobarbital Injeksi Ampul 0 0 0 0
3 Fitomenadion Injeksi Ampul 265 0 265 265
4 Kalsium Glukonat Inj Ampul 0 0 0 0
5 MgSO4 40% Injeksi Flac 0 0 0 0
6 Oxytetrasiklin 1% SM Tube 62 0 62 62
PROGRAM COVID-19
1 Vitamin C 500 mg Tablet 1,370 0 1,370 1,370
2 Multivitamin Zink Tablet 1,265 0 1,265 1,265
3 Alkohol Swab Pcs 900 0 0 900 715 185 2000
4 ADS 0,5 ml Pcs 0 0 0 0 1600
5 ADS 0,3 ml Pcs 1,500 0 0 1,500 375 1,125 1600
6 ADS 3 ml Pcs 0 0 0 0 500
8 NaCl 0,9% Flac 0 0 0 0
TAMBAHAN
1 Benechek pcs 0 0 0 0
2 Masker Kain Putih pcs 0 0 0 0
3 Virochek HBSAg pcs 0 0 0 0
4 Trepocheck (sifilis) pcs 0 0 0 0
5 Stik HIV pcs 0 0 0 0
7 Masker N95 (Provinsi) pcs 0 0 0 0

Kaca Helm Covid19
8 (Provinsi)
pcs 0 0 0 0
9 Helm Covid19 (Provinsi) pcs 0 0 0 0

10 Indec Covid (Provinsi) pcs 0 0 0 0
Baju Hazmat L, XL
Masker Bedah Karet

14 Vaculab (Provinsi) pcs 100 0 100 100
16 Stick pan pcs 0 0 0 0

17 Urinal Male pcs 0 0 0 0
18 Urinal Female pcs 0 0 0 0
19 Timbangan Bayi pcs 0 0 0 0
25 Pentolin 0 0 0 0 0
29 caviplex 0 0 0 0 0
30 0 0 0 0 0 0
UMUM
ASKES JUMLAH
0

Mengetahui,
Pimpinan Puskesmas

NIP. 19670303199103 2 010 NIP. 197909182010012014

BULAN FEBRUARI
KET.

NIP. 197909182010012014
BULAN : MARET
TAHUN : 2022
PUSKESMAS …................................................
SATUAN
BULAN MARET
NO NAMA BARANG
TABLET

6 150)
Tablet 0 0 0 0
0
0
0
0

0
34 50 mg Tablet 0 0 0 0
0
40 Furosemid 40 mg Tablet 0 0 0 0 0

0

0
Haloperidol 2 mg
0
61 600mg) Tablet 0 0 0 0
0
0
0
700
82 mg) Tablet 0 0 0 0
0
10mg) 0
100mg) 0
Metildopa 250 mg
0
0

0
0

155 ED.3.33
0
112 Parasetamol 500 mg Tablet 0 0 0 0 0
0
117 Prednison 5 mg Tablet 0 0 0 0 0
Rivaroksaban 20 mg
0
123 Salbutamol 4mg Tablet 0 0 0 0
127 Setirizin 10 mg Tablet 0 0 0 0 0
Teofilin 150 mg
0
0
140 Vitamin B kompleks Tablet 1,000 0 1,000 1000 0

200
142 mg Tablet 3,100 0 3,100 2,800
300
Vitamin B12
0
144 50mg Tablet 0 0 0 0
0
145 10 mg Tablet 0 0 0 0
0
200
SIRUP
148 mg/5mL Botol 0 0 0 0
0
149 mg/5mL Botol 0 0 0 0
0

0
Domperidon Sirup
152 5mg/5mL Botol 0 0 0 0
0
153 200mg/5mL Botol 0 0 0 0
0
Ibuprofen Suspensi
154 100mg/5 mL Botol 0 0 0 0
0
Ibuprofen Suspensi
155 200mg/5 mL Botol 0 0 0 0
0
0
157 200/40mg Botol 0 0 0 0
0
Laktulosa Sirup
158 3,335g/5mL Botol 0 0 0 0
0
Metoklopramid Sirup
0
Metoclopramid 10mL
0
161 125mg/5mL Botol 10 0 10 0
10
0
Parasetamol Drop
163 100mg/mL Botol 0 0 0 0
0
Parasetamol Sirup
164 120mg/5mL Botol 0 0 0 0
0
165 125mg/5mL Botol 3 0 3 3
0
0
Sefadroksil Sirup
167 125mg/5mL Botol 0 0 0 0
0
0
Sukralfat Suspensi
170 500mg/5mL Botol 0 0 0 0
0
CAIRAN INFUS
Antibakteri Doen
0
Albumin 25%-100ml
0
Albumin 5%-250 ml
0
0
181 2 gr 70 0 70 70
0
182 mg/mL 0 0 0 0
0
183 50mg/mL Ampul 10 0 10 10
0
188 IU/mL Vial 0 0 0 0
0
189 IU/mL Vial 0 0 0 0
0
Betametason 0,05%
0
192 Krim 0,05% Tube 0 0 0 0
0
0
Bisakodil Supp 5 mg
0

20
0
Diazepam Enema 10
0
0
10mg/mL 0
203 ml (50mg/mL) Ampul 0 0 0 0
0
204 12,5 mg/mL Ampul 0 0 0 0
0
0
207 1mg/mL Ampul 0 0 0 0
0
0

0
0

215 0,025% (Dermasolon) Tube 0 0 0 0
0

0
0
223 Hidrokortison Krim 1% Tube 7 0 7 0 7
0,5ml) 0
Insulin Long Acting
0
0
227 0,025% 20 mcg/puff Botol 0 0 0 0
(Atrovent) 0
0

0
0
236 1% Tube 38 0 38 0
38
0
0
0
0

0
(Deponeo) 0
250 500mg Vial 0 0 0 0
0
251 125 mg Vial 0 0 0 0
0
Metronidazol infus
252 5mg/mL Botol 4 0 4 3
1

0
257 (Iliadin 0,05%) Botol 0 0 0 0
0
262 mg/mL Botol 0 0 0 0
0
0
267 Salep 2-4 Pot 34 0 34 10 24

0
Vitamin B12
500mcg/mL 0
276 100mg Ampul 100 0 100 100
0
0
1 Abbocath no. 18 Pcs 640 0 640 0 640
2 Abbocath no. 20 Pcs 197 0 197 0 197
3 Abbocath no. 22 Pcs 90 0 90 0 90
4 Abbocath no. 24 Pcs 131 0 131 0 131
5 Abbocath no. 26 Pcs 0 0 0 0 0

0
9 Alkohol Swab Pcs 220 0 220 220 0
10 Arm Sling L Pcs 10 0 10 0 10
11 Arm Sling M Pcs 15 0 15 0 15
12 Arm Sling S Pcs 18 0 18 0 18

3
15 Blood Lancet Pcs 4,200 0 4,200 200 4,000
17 Catgut no 2/0 Pcs 0 0 0 0 0
18 Catgut no 3/0 Pcs 0 0 0 0 0
19 40mm CG278 Pcs 0 0 0 0
0
20 36mm CG228 Pcs 0 0 0 0
0
21 45 mm CG209 Pcs 0 0 0 0
0
22 90 mm CG315 Pcs 0 0 0 0
0
23 26 mm CG296 Pcs 0 0 0 0
0
25 mm, 75 cm CG342 Pcs 0 0 0 0
0
26 mm, 75 cm CG344 Pcs 0 0 0 0
0
27 mm, 75 cm CG366 Pcs 0 0 0 0
0
28 mm, 75 cm CG372 Pcs 0 0 0 0
0
29 cm PG132 Pcs 0 0 0 0
0
30 1/2mayo, 30 mm PG114 Pcs 0 0 0 0
0
0
0
33 75 cm PG142 Pcs 0 0 0 0
0
34 75 cm PG146 Pcs 0 0 0 0
0

0
0
38 75 cm PG168-1 Pcs 0 0 0 0
0
39 75 cm PG174 Pcs 0 0 0 0
0
0
52 12 (Urocare) Pcs 0 0 0 0
0
53 14 (Urocare) Pcs 0 0 0 0
0
54 16 (Urocare) Pcs 10 0 10 8
2
55 18 (Urocare) Pcs 10 0 10 10
0
56 20 (Urocare) Pcs 0 0 0 0
0
57 22 (Urocare) Pcs 3 0 3 3
0
58 24 (Urocare) Pcs 5 0 5 5
0
0
0
0
0
64 10 Pcs 2 0 2 2
0
0
0
Handscum (Surgical
0
Handscum (Surgical
0
Handscum (Surgical
0

0

0
75 Kapas 100 g Roll 0 0 0 0 0

0

30

0
192
87 Lysol 1 L Botol 4 0 4 0 4
88 Masker N95 Pcs 0 0 0 0 0

0
91 L Pasang 0 0 0 0
0
92 M Pasang 0 0 0 0
0
93 S Pasang 0 0 0 0
0
0
95 14/200 Pcs 0 0 0 0
0
96 16/200 Pcs 0 0 0 0
0
97 18/200 Pcs 0 0 0 0
0
98 20/200 Pcs 0 0 0 0
0
99 22/100 Pcs 0 0 0 0
0
100 24/100 Pcs 0 0 0 0
0
101 Ch 10 Pcs 0 0 0 0
0
102 Ch 6 Pcs 0 0 0 0
0
103 Nurse Cup 0 0 0 0 0
106 Plesterin Bulat Pcs 1,000 0 1,000 550 450
109 cm x 5 m Roll 29 0 29 29
0
110 cm x 5 m Roll 0 0 0 0
0
111 x 5 m Roll 20 0 20 20
0
112 Pot Dahak Pcs 790 0 790 0 790

0
116 PV830 Pcs 1 0 1 1
0
117 PV856 Pcs 0 0 0 0
0
118 PV888 Pcs 0 0 0 0
0
119 PV894 Pcs 0 0 0 0
0
127 cm BS636 Pcs 0 0 0 0
0
128 cm BS640-1 Pcs 4 0 4 2
2
0
131 cm BS668 Pcs 0 0 0 0
0
132 mm BS656-1 Pcs 4 0 4 2
2
133 cm BS695 Pcs 0 0 0 0
0
136 30 mm Pcs 0 0 0 0
0
137 steril Pcs 670 0 670 550
120
138 Spoit 0,5 ml Pcs 200 0 200 0 200
139 Spoit 1 ml Pcs 720 0 720 0 720
140 Spoit 10 ml Pcs 150 0 150 0 150
141 Spoit 2,5 ml Pcs 570 0 570 25 545
142 Spoit 20 ml Pcs 0 0 0 0 0
143 Spoit 3 ml Pcs 600 0 600 150 450
144 Spoit 5 ml Pcs 500 0 500 0 500
145 Spoit 50 ml Pcs 0 0 0 0 0

0

158 klem (Penjepit Tali Pusar) Pcs 0 300 300 300 200
100

0
162 Darah Pcs 0 0 0 0
0
0
PROGRAM TB
5 Pot Dahak Pot 790 0 790 20 770
7 Slide Pcs 0 0 0 0 0
PROGRAM KECACINGAN
PROGRAM DIARE
1 Oralit Sach 4,800 0 4,800 300 4,500
2 Zink 20 mg Tablet 3,000 0 3,000 200 2,800
PROGRAM MALARIA
PROGRAM HIV
PROGRAM IMUNISASI
1 Vaksin BCG Vial 0 0 0 0 0
2 Vaksin Campak Rubella Vial 0 0 0 0 0
3 Vaksin DPT-HB-HIB Vial 0 0 0 0 0
4 Vaksin DT Vial 0 0 0 0 0
5 Vaksin HB0 Vial 0 0 0 0 0
6 Vaksin Polio Vial 0 0 0 0 0
7 Vaksin Polio injeksi Vial 0 0 0 0 0
8 Vaksin TD Vial 0 0 0 0 0
9 Solosot 0,05 Pcs 0 0 0 0 0
10 Solosot 0,5 ml Pcs 0 0 0 0 0
11 Solosot 5 ml Pcs 0 0 0 0 0
12 Safety Box Pcs 0 0 0 0 0
PROGRAM GIZI
1 Mineral Mix Sach 0 0 0 0 0
4 Vitamin A 200000 IU Kapsul 2,500 2,200 2,200 4,700 4700 0
PROGRAM KIA
PROGRAM COVID-19
4 ADS 0,5 ml Pcs 0 0 0 0 0
5 ADS 0,3 ml Pcs 1,125 0 1,125 0 1,125
6 ADS 3 ml Pcs 0 0 0 0 0
7 APD Set Set 0 0 0 0 0
8 NaCl 0,9% Flac 0 0 0 0 0
TAMBAHAN

0
Kaca Helm Covid19
8 (Provinsi)
pcs 0 0 0 0
0
Baju Hazmat L, XL
0
0
Masker Bedah Karet
0

0
20 Lodia Tablet 0 0 0 0 0
21 Revital Syp sirup 0 0 0 0 0
22 Gentamicin SK Slp 0 0 0 0 0
23 Biocombin Inj 0 0 0 0 0
24 Sohobion Tablet 0 0 0 0 0
25 Pentolin 0 0 0 0 0 0
26 curcuma force Tablet 0 0 0 0 0
27 cavit D3 kapsul 1000 IU kapsul 0 0 0 0 0
28 ramvit c 500mg Tablet 0 0 0 0 0
29 caviplex 0 0 0 0 0 0
30 0 0 0 0 0 0 0
UMUM
ASKES JUMLAH
75 354 364 793

Mengetahui,
Pimpinan Puskesmas

NIP. 19670303199103 2 010 NIP. 197909182010012014
PUSKESMAS …................................................
BULAN MARET
KET.

NIP. 197909182010012014
BULAN : APRIL
TAHUN : 2022
PUSKESMAS …................................................
SATUAN
BULAN APRIL
NO NAMA BARANG
TABLET

5 Ambroksol 30 mg Tablet 0 1,000 1,000 1,000 100 900
6 150)
Tablet 0 0 0 0
0
0
0
0

0
24 Deksametason 0,5 mg Tablet 0 1,000 1,000 1,000 100 900
34 50 mg Tablet 0 0 0 0
0

0

0
Haloperidol 2 mg
0
58 Ibuprofen 400 mg Tablet 0 3,000 3,000 3,000 100 2,900
61 600mg) Tablet 0 0 0 0
0
0
65 Kandesartan 8 mg Tablet 0 600 600 600 0 600
0
800
76 Klindamisin 300 mg Tablet 0 700 700 700 100 600
80 Kotrimoksazol 400/80mg Tablet 0 200 200 200 0 200
82 mg) Tablet 0 0 0 0
0
10mg) 0
100mg) 0
89 Metformin 500 mg Tablet 0 2,000 2,000 2,000 100 1,900
Metildopa 250 mg
0
0
93 Metilprednisolon 16 mg Tablet 0 0 0 0
94 Metilprednisolon 4 mg Tablet 0 1,000 1,000 1,000 100 900
96 Metronidazol 250 mg Tablet 0 0 0 0
100 Natrium diklofenak 50mg Tablet 0 4,000 4,000 4,000 3,800

200

0
109 Omeprazol 20 mg Kapsul 0 1,400 1,400 1,400 120 1,280
112 Parasetamol 500 mg Tablet 0 10,000 10,000 10,000 200 9,800
0
117 Prednison 5 mg Tablet 0 5,000 5,000 5,000 0 5,000
119 Propranolol 40 mg Tablet 100 100 100 200 0 200
120 Ranitidin 150 mg Tablet 0 1,000 1,000 1,000 100 900
Rivaroksaban 20 mg
0
125 Sefadroksil 500 mg Kapsul 0 1,000 1,000 1,000 100 900
Teofilin 150 mg
0
0
140 Vitamin B kompleks Tablet 0 0 0 0 0

400
142 mg Tablet 2,800 0 2,800 2,600
200
Vitamin B12
500
144 50mg Tablet 0 10,000 10,000 10,000 9,600
400
145 10 mg Tablet 0 0 0 0
0
0
SIRUP
148 mg/5mL Botol 0 12 12 12 0
12
149 mg/5mL Botol 0 0 0 0
0
150 Antasida Suspensi Botol 0 100 100 100 10 90
151 Domperidon drop 5mg/mL Botol 0 0 0 0 0

0
Domperidon Sirup
152 5mg/5mL Botol 0 30 30 30 20
10
153 200mg/5mL Botol 0 0 0 0
0
Ibuprofen Suspensi
154 100mg/5 mL Botol 0 0 0 0
0
Ibuprofen Suspensi
155 200mg/5 mL Botol 0 0 0 0
0
0
157 200/40mg Botol 0 50 50 50 50
0
Laktulosa Sirup
158 3,335g/5mL Botol 0 0 0 0
0
Metoklopramid Sirup
0
Metoclopramid 10mL
0
161 125mg/5mL Botol 0 10 10 10 10
0
0
Parasetamol Drop
163 100mg/mL Botol 0 0 0 0
0
Parasetamol Sirup
164 120mg/5mL Botol 0 0 0 0
0
165 125mg/5mL Botol 3 0 3 3
0
0
Sefadroksil Sirup
167 125mg/5mL Botol 0 50 50 50 45
5
0
Sukralfat Suspensi
170 500mg/5mL Botol 0 0 0 0
0
172 Zink syrup 20 mg/5 mL Botol 0 50 50 50 5 45
CAIRAN INFUS
Antibakteri Doen
0
Albumin 25%-100ml
0
Albumin 5%-250 ml
0
0
181 2 gr 70 0 70 70
0
182 mg/mL 0 0 0 0
0
183 50mg/mL Ampul 10 0 10 8
2
188 IU/mL Vial 0 0 0 0
0
189 IU/mL Vial 0 0 0 0
0
Betametason 0,05%
0
192 Krim 0,05% Tube 0 0 0 0
0
2
Bisakodil Supp 5 mg
0

15
0
199 Diazepam inj 5 mg Rectal 5 0 5 5 0 ednov21
Diazepam Enema 10
0
0
10mg/mL 0
203 ml (50mg/mL) Ampul 0 0 0 0
0
204 12,5 mg/mL Ampul 0 0 0 0
0
0
207 1mg/mL Ampul 0 0 0 0
0
0
211 Fenitoin inj. 50 mg/mL Ampul 0 8 8 8 8 0 edmar22

0
0

215 0,025% (Dermasolon) Tube 0 0 0 0
0

0
0
0,5ml) 0
Insulin Long Acting
0
0
227 0,025% 20 mcg/puff Botol 0 0 0 0
(Atrovent) 0
0

0
0
236 1% Tube 0 0 0 0
0
0
0
0
0
242 Ketorolak inj. 30 mg/mL Ampul 0 100 100 100 5 95

0
(Deponeo) 0
249 Metilergometrin inj. Ampul 0 100 100 100 0 100
250 500mg Vial 0 0 0 0
0
251 125 mg Vial 0 0 0 0
0
Metronidazol infus
252 5mg/mL Botol 3 0 3 3
0

20
257 (Iliadin 0,05%) Botol 0 0 0 0
0
259 Ondansetron inj. 4mg Ampul 0 50 50 50 5 45
261 Oksitosin inj 10 IU/mL Ampul 0 100 100 100 0 100
262 mg/mL Botol 0 5 5 5 1
4
264 Ranitidin inj 25 mg/mL Ampul 10 100 100 110 15 95
0
267 Salep 2-4 Pot 24 0 24 0 24
268 Sefotaksim inj. 1000 mg Vial 0 20 20 20 2 18
269 Seftriakson inj. 1000 mg Vial 0 20 20 20 2 18
270 Sefuroksim inj Vial 0 0 0 0

0
Vitamin B12
500mcg/mL 0
276 100mg Ampul 100 0 100 0
100 ed.Jan 22
0
1 Abbocath no. 18 Pcs 640 0 640 15 625
2 Abbocath no. 20 Pcs 197 0 197 0 197
3 Abbocath no. 22 Pcs 90 0 90 0 90
4 Abbocath no. 24 Pcs 131 0 131 0 131
5 Abbocath no. 26 Pcs 0 0 0 0 0

0
10 Arm Sling L Pcs 10 0 10 0 10
11 Arm Sling M Pcs 15 0 15 0 15
12 Arm Sling S Pcs 18 0 18 0 18

0
15 Blood Lancet Pcs 4,000 0 4,000 200 3,800
17 Catgut no 2/0 Pcs 0 0 0 0 0
18 Catgut no 3/0 Pcs 0 0 0 0 0
19 40mm CG278 Pcs 0 0 0 0
0
20 36mm CG228 Pcs 0 0 0 0
0
21 45 mm CG209 Pcs 0 0 0 0
0
22 90 mm CG315 Pcs 0 0 0 0
0
23 26 mm CG296 Pcs 0 0 0 0
0
25 mm, 75 cm CG342 Pcs 0 0 0 0
0
26 mm, 75 cm CG344 Pcs 0 0 0 0
0
27 mm, 75 cm CG366 Pcs 0 0 0 0
0
28 mm, 75 cm CG372 Pcs 0 0 0 0
0
29 cm PG132 Pcs 0 0 0 0
0
30 1/2mayo, 30 mm PG114 Pcs 0 0 0 0
0
0
0
33 75 cm PG142 Pcs 0 0 0 0
0
34 75 cm PG146 Pcs 0 0 0 0
0

0
0
38 75 cm PG168-1 Pcs 0 0 0 0
0
39 75 cm PG174 Pcs 0 0 0 0
0
0
52 12 (Urocare) Pcs 0 0 0 0
0
53 14 (Urocare) Pcs 0 0 0 0
0
54 16 (Urocare) Pcs 8 0 8 6
2
55 18 (Urocare) Pcs 10 0 10 10
0
56 20 (Urocare) Pcs 0 0 0 0
0
57 22 (Urocare) Pcs 3 0 3 3
0
58 24 (Urocare) Pcs 5 0 5 5
0
0
0
0
0
64 10 Pcs 2 0 2 2
0
0
0
Handscum (Surgical
0
Handscum (Surgical
0
Handscum (Surgical
0

0

0
75 Kapas 100 g Roll 0 0 0 0 0

0

20

1
36
87 Lysol 1 L Botol 4 0 4 2 2
88 Masker N95 Pcs 0 0 0 0 0

0
91 L Pasang 0 0 0 0
0
92 M Pasang 0 0 0 0
0
93 S Pasang 0 0 0 0
0
0
95 14/200 Pcs 0 0 0 0
0
96 16/200 Pcs 0 0 0 0
0
97 18/200 Pcs 0 0 0 0
0
98 20/200 Pcs 0 0 0 0
0
99 22/100 Pcs 0 0 0 0
0
100 24/100 Pcs 0 0 0 0
0
101 Ch 10 Pcs 0 0 0 0
0
102 Ch 6 Pcs 0 0 0 0
0
103 Nurse Cup 0 0 0 0 0
106 Plesterin Bulat Pcs 450 0 450 200 250
109 cm x 5 m Roll 29 0 29 29
0
110 cm x 5 m Roll 0 0 0 0
0
111 x 5 m Roll 20 0 20 20
0
112 Pot Dahak Pcs 790 0 790 10 780

0
116 PV830 Pcs 1 0 1 1
0
117 PV856 Pcs 0 0 0 0
0
118 PV888 Pcs 0 0 0 0
0
119 PV894 Pcs 0 0 0 0
0
127 cm BS636 Pcs 0 0 0 0
0
128 cm BS640-1 Pcs 2 0 2 2
0
0
131 cm BS668 Pcs 0 0 0 0
0
132 mm BS656-1 Pcs 2 0 2 2
0
133 cm BS695 Pcs 0 0 0 0
0
136 30 mm Pcs 0 0 0 0
0
137 steril Pcs 550 0 550 490
60
138 Spoit 0,5 ml Pcs 200 0 200 0 200
139 Spoit 1 ml Pcs 720 0 720 100 620
140 Spoit 10 ml Pcs 150 0 150 0 150
141 Spoit 2,5 ml Pcs 545 0 545 100 445
142 Spoit 20 ml Pcs 0 0 0 0 0
143 Spoit 3 ml Pcs 450 0 450 100 350
144 Spoit 5 ml Pcs 500 0 500 100 400
145 Spoit 50 ml Pcs 0 0 0 0 0

0
154 Ultra One Tes Kehamilan Pcs 0 50 50 50 2 48

0

0
162 Darah Pcs 0 0 0 0
0
0
PROGRAM TB
5 Pot Dahak Pot 770 0 770 10 760
7 Slide Pcs 0 0 0 0 0
PROGRAM KECACINGAN
PROGRAM DIARE
1 Oralit Sach 4,500 0 4,500 300 4,200
2 Zink 20 mg Tablet 2,800 0 2,800 0 2,800
PROGRAM MALARIA
PROGRAM HIV
PROGRAM IMUNISASI
9 Solosot 0,05 Pcs 0 0 0 0 0
10 Solosot 0,5 ml Pcs 0 0 0 0 0
PROGRAM GIZI
PROGRAM KIA
PROGRAM COVID-19
4 ADS 0,5 ml Pcs 0 0 0 0 0
5 ADS 0,3 ml Pcs 1,125 0 1,125 0 1,125
6 ADS 3 ml Pcs 0 0 0 0 0
7 APD Set Set 0 0 0 0 0
8 NaCl 0,9% Flac 0 0 0 0 0
TAMBAHAN

0
Kaca Helm Covid19
8 (Provinsi)
pcs 0 0 0 0
0
Baju Hazmat L, XL
0
0
Masker Bedah Karet
0

0
20 Lodia Tablet 0 600 600 600 20 580
22 Gentamicin SK Slp 0 50 50 50 29 21
25 Pentolin 0 0 60 60 60 5 55
29 caviplex 0 0 0 0 0 0
30 0 0 0 0 0 0 0
UMUM
ASKES JUMLAH
0

Mengetahui,
Pimpinan Puskesmas

NIP. 19670303199103 2 010 NIP. 197909182010012014
PUSKESMAS …................................................
BULAN APRIL
KET.

NIP. 197909182010012014
PUSKESMAS PUSKESMAS PERAWATAN HILA
BULAN : MEI
TAHUN : 2022
SATUAN
BULAN MEI
NO NAMA BARANG
TABLET
1 Alopurinol 100 mg Tablet 1,300 1,000 1,000 2,300 200 2,100

5 Ambroksol 30 mg Tablet 900 500 500 1,400 400 1,000
6 150)
Tablet 0 0 0 0
0
12 Amoksisilin 500 mg Tablet 6,800 2,000 2,000 8,800 1300 7,500
13 Antasida Tablet Kunyah Tablet 11,000 2,000 2,000 13,000 900 12,100
0
0
0

0
24 Deksametason 0,5 mg Tablet 900 1,000 1,000 1,900 500 1,400
26 Diazepam 2 mg Tablet 49 100 100 149 17 132
34 50 mg Tablet 0 0 0 0
0

0

0
Haloperidol 2 mg
0
58 Ibuprofen 400 mg Tablet 2,900 3,000 3,000 5,900 300 5,600
61 600mg) Tablet 0 0 0 0
0
0
64 Kalsium Laktat 500 mg Tablet 0 2,000 2,000 2,000 0 2,000
0
900
82 mg) Tablet 0 0 0 0
0
10mg) 0
100mg) 0
89 Metformin 500 mg Tablet 1,900 1,000 1,000 2,900 300 2,600
Metildopa 250 mg
0
0
94 Metilprednisolon 4 mg Tablet 900 2,000 2,000 2,900 500 2,400

0
100 Natrium diklofenak 50mg Tablet 3,800 300 500 800 4,600 4,000
600

0
0
109 Omeprazol 20 mg Kapsul 1,280 600 600 1,880 500 1,380
112 Parasetamol 500 mg Tablet 9,800 200 6,000 6,200 16,000 700 15,300
0
117 Prednison 5 mg Tablet 5,000 2,000 2,000 7,000 300 6,700
120 Ranitidin 150 mg Tablet 900 200 200 1,100 300 800
Rivaroksaban 20 mg
0
125 Sefadroksil 500 mg Kapsul 900 200 200 1,100 300 800
127 Setirizin 10 mg Tablet 240 1,500 1,500 1,740 300 1,440
Teofilin 150 mg
0
0
140 Vitamin B kompleks Tablet 0 2,000 2,000 2,000 0 2,000

500
142 mg Tablet 2,600 0 2,600 2,400
200
Vitamin B12
0
144 50mg Tablet 9,600 300 300 9,900 9,400
500
145 10 mg Tablet 0 0 0 0
0
0
SIRUP 0
148 mg/5mL Botol 0 100 100 100 70
30
149 mg/5mL Botol 0 0 0 0
0

0
Domperidon Sirup
152 5mg/5mL Botol 20 20 20 40 25
15
153 200mg/5mL Botol 0 0 0 0
0
Ibuprofen Suspensi
154 100mg/5 mL Botol 0 0 0 0
0
Ibuprofen Suspensi
155 200mg/5 mL Botol 0 0 0 0
0
0
157 200/40mg Botol 50 0 50 30
20
Laktulosa Sirup
158 3,335g/5mL Botol 0 0 0 0
0
Metoklopramid Sirup
0
Metoclopramid 10mL
0
161 125mg/5mL Botol 10 0 10 10
0
0
Parasetamol Drop
163 100mg/mL Botol 0 0 0 0
0
Parasetamol Sirup
164 120mg/5mL Botol 0 50 50 50 50
0
165 125mg/5mL Botol 3 0 3 3
0
0
Sefadroksil Sirup
167 125mg/5mL Botol 45 20 20 65 48
17
0
Sukralfat Suspensi
170 500mg/5mL Botol 0 0 0 0
0
CAIRAN INFUS
Antibakteri Doen
0
174 Air Untuk Injeksi 25 ml Flac 150 20 20 170 0 170
Albumin 25%-100ml
0
Albumin 5%-250 ml
0
0
181 2 gr 70 0 70 50
20
182 mg/mL 0 0 0 0
0
183 50mg/mL Ampul 8 0 8 8
0
188 IU/mL Vial 0 0 0 0
0
189 IU/mL Vial 0 0 0 0
0
Betametason 0,05%
0
192 Krim 0,05% Tube 0 0 0 0
0
0
Bisakodil Supp 5 mg
0

0
198 (Dexocort krim) Tube 0 50 50 50 30
20
Diazepam Enema 10
0
0
10mg/mL 0
203 ml (50mg/mL) Ampul 0 0 0 0
0
204 12,5 mg/mL Ampul 0 0 0 0
0
0
207 1mg/mL Ampul 0 0 0 0
0
0

0
0

215 0,025% (Dermasolon) Tube 0 0 0 0
0

0
0
222 Hidrokortison krim 2,5% Tube 0 24 24 24 24 0
0,5ml) 0
Insulin Long Acting
0
0
227 0,025% 20 mcg/puff Botol 0 0 0 0
(Atrovent) 0
0

3
0
236 1% Tube 0 50 50 50 25
25
0
0
0
240 Ketokonazol krim 2% Tube 0 50 50 50 20 30
0

0
(Deponeo) 0
250 500mg Vial 0 0 0 0
0
251 125 mg Vial 0 0 0 0
0
Metronidazol infus
252 5mg/mL Botol 3 0 3 3
0

20
257 (Iliadin 0,05%) Botol 0 0 0 0
0
259 Ondansetron inj. 4mg Ampul 45 100 100 145 10 135
262 mg/mL Botol 1 0 1 0
1
0
267 Salep 2-4 Pot 24 0 24 24 0

0
Vitamin B12
500mcg/mL 100
276 100mg Ampul 0 0 0 0
0
0
1 Abbocath no. 18 Pcs 625 10 10 635 48 587
2 Abbocath no. 20 Pcs 197 200 17 217 414 20 394
3 Abbocath no. 22 Pcs 90 200 18 218 308 10 298
4 Abbocath no. 24 Pcs 131 10 10 141 20 121
5 Abbocath no. 26 Pcs 0 200 120 320 320 20 300
6 Alkohol 70% 1 liter Botol 96 10 10 106 5 101

0
9 Alkohol Swab Pcs 0 1,000 3,300 4,300 4,300 300 4,000
10 Arm Sling L Pcs 10 5 5 15 0 15
11 Arm Sling M Pcs 15 0 15 3 12
12 Arm Sling S Pcs 18 0 18 0 18
13 Aseptik 500 cc + dispenser Botol 8 3 3 11 9

2
15 Blood Lancet Pcs 3,800 0 3,800 0 3,800
17 Catgut no 2/0 Pcs 0 0 0 0 0
18 Catgut no 3/0 Pcs 0 0 0 0 0
19 40mm CG278 Pcs 0 0 0 0
0
20 36mm CG228 Pcs 0 0 0 0
0
21 45 mm CG209 Pcs 0 0 0 0
0
22 90 mm CG315 Pcs 0 0 0 0
0
23 26 mm CG296 Pcs 0 0 0 0
0
25 mm, 75 cm CG342 Pcs 0 24 24 24 0
24
26 mm, 75 cm CG344 Pcs 0 0 0 0
0
27 mm, 75 cm CG366 Pcs 0 0 0 0
0
28 mm, 75 cm CG372 Pcs 0 0 0 0
0
29 cm PG132 Pcs 0 0 0 0
0
30 1/2mayo, 30 mm PG114 Pcs 0 0 0 0
0
0
0
33 75 cm PG142 Pcs 0 0 0 0
0
34 75 cm PG146 Pcs 0 0 0 0
0

0
0
38 75 cm PG168-1 Pcs 0 0 0 0
0
39 75 cm PG174 Pcs 0 480 480 480 456
24

42 Colostomy bag Pcs 0 0 0 0
43 Dermavix S IV Pcs 0 0 0 0
44 Dermavix T 10 x 15 cm Pcs 0 50 50 50 0 50
47 Dermavix t 5 x 7 cm Pcs 20 125 125 145 3 142
52 12 (Urocare) Pcs 0 0 0 0
0
53 14 (Urocare) Pcs 0 0 0 0
0
54 16 (Urocare) Pcs 6 0 6 4
2
55 18 (Urocare) Pcs 10 0 10 8
2
56 20 (Urocare) Pcs 0 0 0 0
0
57 22 (Urocare) Pcs 3 20 20 23 21
2
58 24 (Urocare) Pcs 5 0 5 5
0
0
0
0
0
64 10 Pcs 2 0 2 2
0
0
0
Handscum (Surgical
0
Handscum (Surgical
0
Handscum (Surgical
0
71 Infus Set Anak Pcs 39 50 10 60 99 10 89
72 Infus set Dewasa Pcs 0 50 30 80 80 60

20

0
75 Kapas 100 g Roll 0 0 0 0 0

1

0

2
83 Kasa Hidrofil Steril 16x16 Pcs 16 160 200 360 376 260
116
84 Kasa Steril 10 x 10 cm Roll 0 50 50 50 0 50
87 Lysol 1 L Botol 2 0 2 2 0
88 Masker N95 Pcs 0 40 40 40 10 30
89 Masker Surgical (One Med) Pcs 0 250 250 250 150

100
90 Masker Surgical 3 Ply Pcs 0 500 500 1,000 1,000 300 700
91 L Pasang 0 0 0 0
0
92 M Pasang 0 0 0 0
0
93 S Pasang 0 0 0 0
0
0
95 14/200 Pcs 0 0 0 0
0
96 16/200 Pcs 0 0 0 0
0
97 18/200 Pcs 0 0 0 0
0
98 20/200 Pcs 0 0 0 0
0
99 22/100 Pcs 0 0 0 0
0
100 24/100 Pcs 0 0 0 0
0
101 Ch 10 Pcs 0 0 0 0
0
102 Ch 6 Pcs 0 0 0 0
0
103 Nurse Cup 0 0 0 0 0
107 Plesterin Elastis Pcs 0 0 0 0
109 cm x 5 m Roll 29 5 5 34 34
0
110 cm x 5 m Roll 0 0 0 0
0
111 x 5 m Roll 20 5 5 25 20
5
112 Pot Dahak Pcs 780 0 780 20 760

0
116 PV830 Pcs 1 0 1 1
0
117 PV856 Pcs 0 0 0 0
0
118 PV888 Pcs 0 0 0 0
0
119 PV894 Pcs 0 0 0 0
0
120 Rivanol 300 cc Botol 0 13 13 13 2 11
127 cm BS636 Pcs 0 0 0 0
0
128 cm BS640-1 Pcs 2 0 2 0
2
0
131 cm BS668 Pcs 0 0 0 0
0
132 mm BS656-1 Pcs 2 360 360 362 336
26
133 cm BS695 Pcs 0 0 0 0
0
136 30 mm Pcs 0 0 0 0
0
137 steril Pcs 490 50 50 540 390
150
138 Spoit 0,5 ml Pcs 200 0 200 0 200
139 Spoit 1 ml Pcs 620 0 620 100 520
140 Spoit 10 ml Pcs 150 100 100 250 100 150
141 Spoit 2,5 ml Pcs 445 0 445 20 425
142 Spoit 20 ml Pcs 0 0 0 0 0
143 Spoit 3 ml Pcs 350 300 300 650 100 550
144 Spoit 5 ml Pcs 400 200 200 600 215 385
145 Spoit 50 ml Pcs 0 0 0 0
147 Suction Catheter FR 14 Pcs 0 0 0 0

0

25
159 Urine Bag Pcs 4 12 12 16 2 14
161 Autocheck Stick Urid acid Pcs 0 8 8 8 6

2
162 Darah Pcs 0 9 9 9 7
2
163 Autocheck Stick Kolesterol Pcs 0 10 10 10 7
3
PROGRAM TB
5 Pot Dahak Pot 760 0 760 0 760
7 Slide Pcs 0 0 0 0 0
PROGRAM KECACINGAN
PROGRAM DIARE
1 Oralit Sach 4,200 0 4,200 200 4,000
2 Zink 20 mg Tablet 2,800 0 2,800 0 2,800
PROGRAM MALARIA
PROGRAM HIV
PROGRAM IMUNISASI
9 Solosot 0,05 Pcs 0 0 0 0 0
10 Solosot 0,5 ml Pcs 0 0 0 0 0
PROGRAM GIZI
PROGRAM KIA
PROGRAM COVID-19
4 ADS 0,5 ml Pcs 0 0 0 0 0
5 ADS 0,3 ml Pcs 1,125 0 1,125 0 1,125
6 ADS 3 ml Pcs 0 0 0 0 0
7 APD Set Set 0 0 0 0 0
8 NaCl 0,9% Flac 0 0 0 0 0
TAMBAHAN

0
Kaca Helm Covid19
8 (Provinsi)
pcs 0 0 0 0
0
Baju Hazmat L, XL
0
0
Masker Bedah Karet
0

0
20 Lodia Tablet 580 0 580 180 400
21 Revital Syp sirup 0 20 20 20 5 15
23 Biocombin Inj 0 100 100 100 20 80
24 Sohobion Tablet 0 300 300 300 100 200
25 Pentolin 0 55 20 20 75 20 55
29 caviplex 0 0 0 0 0 0
30 0 0 0 0 0 0 0
UMUM
ASKES JUMLAH
90 306 258 654

Mengetahui,
Pimpinan Puskesmas

NIP. 19670303199103 2 010 NIP. 197909182010012014
A

BULAN MEI
KET.

NIP. 197909182010012014
BULAN : JUNI
TAHUN : 2022
SATUAN
BULAN JUNI
NO NAMA BARANG
TABLET

5 Ambroksol 30 mg Tablet 1,000 0 1,000 400 600
6 150)
Tablet 0 0 0 0
0
0
0
0

0
24 Deksametason 0,5 mg Tablet 1,400 0 1,400 400 1,000
34 50 mg Tablet 0 0 0 0
0

0

0
Haloperidol 2 mg
0
58 Ibuprofen 400 mg Tablet 5,600 0 5,600 500 5,100
61 600mg) Tablet 0 0 0 0
0
0
64 Kalsium Laktat 500 mg Tablet 2,000 0 2,000 400 1,600
0
1800
82 mg) Tablet 0 0 0 0
0
10mg) 0
100mg) 0
89 Metformin 500 mg Tablet 2,600 0 2,600 300 2,300
Metildopa 250 mg
0
0
94 Metilprednisolon 4 mg Tablet 2,400 0 2,400 400 2,000

0
100 Natrium diklofenak 50mg Tablet 4,000 0 4,000 3,600
400

0
0
109 Omeprazol 20 mg Kapsul 1,380 0 1,380 240 1,140
112 Parasetamol 500 mg Tablet 15,300 0 15,300 1300 14,000
0
117 Prednison 5 mg Tablet 6,700 0 6,700 600 6,100
Rivaroksaban 20 mg
0
127 Setirizin 10 mg Tablet 1,440 0 1,440 360 1,080
Teofilin 150 mg
0
0
140 Vitamin B kompleks Tablet 2,000 0 2,000 800 1,200

600
142 mg Tablet 2,400 0 2,400 1,600
800
Vitamin B12
0
144 50mg Tablet 9,400 0 9,400 8,600
800
145 10 mg Tablet 0 0 0 0
0
0
SIRUP
148 mg/5mL Botol 70 0 70 50
20
149 mg/5mL Botol 0 0 0 0
0

0
Domperidon Sirup
152 5mg/5mL Botol 25 0 25 15
10
153 200mg/5mL Botol 0 0 0 0
0
Ibuprofen Suspensi
154 100mg/5 mL Botol 0 0 0 0
0
Ibuprofen Suspensi
155 200mg/5 mL Botol 0 0 0 0
0
0
157 200/40mg Botol 30 0 30 20
10
Laktulosa Sirup
158 3,335g/5mL Botol 0 0 0 0
0
Metoklopramid Sirup
0
Metoclopramid 10mL
0
161 125mg/5mL Botol 10 0 10 10
0
0
Parasetamol Drop
163 100mg/mL Botol 0 0 0 0
0
Parasetamol Sirup
164 120mg/5mL Botol 50 0 50 40
10
165 125mg/5mL Botol 3 0 3 3
0
0
Sefadroksil Sirup
167 125mg/5mL Botol 48 0 48 28
20
0
Sukralfat Suspensi
170 500mg/5mL Botol 0 0 0 0
0
CAIRAN INFUS
Antibakteri Doen
0
Albumin 25%-100ml
0
Albumin 5%-250 ml
0
0
181 2 gr 50 0 50 7
43
182 mg/mL 0 0 0 0
0
183 50mg/mL Ampul 8 0 8 8
0
188 IU/mL Vial 0 0 0 0
0
189 IU/mL Vial 0 0 0 0
0
Betametason 0,05%
0
192 Krim 0,05% Tube 0 0 0 0
0
0
Bisakodil Supp 5 mg
0

10
0
Diazepam Enema 10
0
0
10mg/mL 0
203 ml (50mg/mL) Ampul 0 0 0 0
0
204 12,5 mg/mL Ampul 0 0 0 0
0
0
207 1mg/mL Ampul 0 0 0 0
0
0

0
0

215 0,025% (Dermasolon) Tube 0 0 0 0
0

0
0
0,5ml) 0
Insulin Long Acting
0
227 0,025% 20 mcg/puff Botol 0 0 0 0
(Atrovent) 0
0

0
0
236 1% Tube 25 0 25 25
0
0
0
0
0

30
(Deponeo) 0
250 500mg Vial 0 0 0 0
0
251 125 mg Vial 0 0 0 0
0
Metronidazol infus
252 5mg/mL Botol 3 0 3 3
0

0
257 (Iliadin 0,05%) Botol 0 0 0 0
0
262 mg/mL Botol 0 0 0 0
0
0
267 Salep 2-4 Pot 0 0 0 0 0

0
Vitamin B12
500mcg/mL 0
276 100mg Ampul 0 0 0 0
0
0
1 Abbocath no. 18 Pcs 587 0 587 10 577
2 Abbocath no. 20 Pcs 394 0 394 37 357
3 Abbocath no. 22 Pcs 298 0 298 20 278
4 Abbocath no. 24 Pcs 121 0 121 0 121
5 Abbocath no. 26 Pcs 300 0 300 20 280

0
9 Alkohol Swab Pcs 4,000 0 4,000 600 3,400
10 Arm Sling L Pcs 15 0 15 0 15
11 Arm Sling M Pcs 12 0 12 0 12
12 Arm Sling S Pcs 18 0 18 0 18

3
15 Blood Lancet Pcs 3,800 0 3,800 200 3,600
17 Catgut no 2/0 Pcs 0 0 0 0 0
18 Catgut no 3/0 Pcs 0 0 0 0 0
19 40mm CG278 Pcs 0 0 0 0
0
20 36mm CG228 Pcs 0 0 0 0
0
21 45 mm CG209 Pcs 0 0 0 0
0
22 90 mm CG315 Pcs 0 0 0 0
0
23 26 mm CG296 Pcs 0 0 0 0
0
25 mm, 75 cm CG342 Pcs 0 0 0 0
0
26 mm, 75 cm CG344 Pcs 0 0 0 0
0
27 mm, 75 cm CG366 Pcs 0 0 0 0
0
28 mm, 75 cm CG372 Pcs 0 0 0 0
0
29 cm PG132 Pcs 0 0 0 0
0
30 1/2mayo, 30 mm PG114 Pcs 0 0 0 0
0
0
0
33 75 cm PG142 Pcs 0 0 0 0
0
34 75 cm PG146 Pcs 0 0 0 0
0

0
0
38 75 cm PG168-1 Pcs 0 0 0 0
0
39 75 cm PG174 Pcs 456 0 456 456
0
0
52 12 (Urocare) Pcs 0 0 0 0
0
53 14 (Urocare) Pcs 0 0 0 0
0
54 16 (Urocare) Pcs 4 0 4 4
0
55 18 (Urocare) Pcs 8 0 8 5
3
56 20 (Urocare) Pcs 0 0 0 0
0
57 22 (Urocare) Pcs 21 0 21 21
0
58 24 (Urocare) Pcs 5 0 5 5
0
0
0
0
0
64 10 Pcs 2 0 2 2
0
0
0
Handscum (Surgical
0
Handscum (Surgical
0
Handscum (Surgical
0

0

0
75 Kapas 100 g Roll 0 0 0 0 0

0

100

0
44
87 Lysol 1 L Botol 0 0 0 0 0
88 Masker N95 Pcs 30 0 30 0 30

0
91 L Pasang 0 0 0 0
0
92 M Pasang 0 0 0 0
0
93 S Pasang 0 0 0 0
0
0
95 14/200 Pcs 0 0 0 0
0
96 16/200 Pcs 0 0 0 0
0
97 18/200 Pcs 0 0 0 0
0
98 20/200 Pcs 0 0 0 0
0
99 22/100 Pcs 0 0 0 0
0
100 24/100 Pcs 0 0 0 0
0
101 Ch 10 Pcs 0 0 0 0
0
102 Ch 6 Pcs 0 0 0 0
0
103 Nurse Cup 0 0 0 0 0
109 cm x 5 m Roll 34 0 34 34
0
110 cm x 5 m Roll 0 0 0 0
0
111 x 5 m Roll 20 0 20 20
0
112 Pot Dahak Pcs 760 0 760 0 760

0
114 Povidon Iodine 300 ml Botol 10 0 10 10
116 PV830 Pcs 1 0 1 1
0
117 PV856 Pcs 0 0 0 0
0
118 PV888 Pcs 0 0 0 0
0
119 PV894 Pcs 0 0 0 0
0
120 Rivanol 300 cc Botol 11 0 11 3 8
127 cm BS636 Pcs 0 0 0 0
0
128 cm BS640-1 Pcs 0 0 0 0
0
0
131 cm BS668 Pcs 0 0 0 0
0
132 mm BS656-1 Pcs 336 0 336 336
0
133 cm BS695 Pcs 0 0 0 0
0
136 30 mm Pcs 0 0 0 0
0
137 steril Pcs 390 0 390 340
50
138 Spoit 0,5 ml Pcs 200 0 200 0 200
139 Spoit 1 ml Pcs 520 0 520 0 520
140 Spoit 10 ml Pcs 150 0 150 0 150
141 Spoit 2,5 ml Pcs 425 0 425 0 425
142 Spoit 20 ml Pcs 0 0 0 0 0
143 Spoit 3 ml Pcs 550 0 550 100 450
144 Spoit 5 ml Pcs 385 0 385 100 285
145 Spoit 50 ml Pcs 0 0 0 0 0

0

0
159 Urine Bag Pcs 14 0 14 2 12

1
162 Darah Pcs 7 0 7 6
1
4
PROGRAM TB
2 OAT Kategori I Paket 3 16 16 19 5 14
4 OAT Kategori Anak Paket 0 5 5 5 0 5
5 Pot Dahak Pot 760 0 760 0 760
7 Slide Pcs 0 0 0 0 0
PROGRAM KECACINGAN
PROGRAM DIARE
1 Oralit Sach 4,000 0 4,000 300 3,700
2 Zink 20 mg Tablet 2,800 0 2,800 0 2,800
PROGRAM MALARIA
PROGRAM HIV
PROGRAM IMUNISASI
9 Solosot 0,05 Pcs 0 0 0 0 0
10 Solosot 0,5 ml Pcs 0 0 0 0 0
PROGRAM GIZI
PROGRAM KIA
PROGRAM COVID-19
4 ADS 0,5 ml Pcs 0 0 0 0 0
5 ADS 0,3 ml Pcs 1,125 0 1,125 0 1,125
6 ADS 3 ml Pcs 0 0 0 0 0
7 APD Set Set 0 0 0 0 0
8 NaCl 0,9% Flac 0 0 0 0 0
TAMBAHAN

0
Kaca Helm Covid19
8 (Provinsi)
pcs 0 0 0 0
0
Baju Hazmat L, XL
0
0
Masker Bedah Karet
0

0
20 Lodia Tablet 400 0 400 180 220
25 Pentolin 0 55 0 55 55
29 caviplex 0 0 0 0 0
30 0 0 0 0 0 0
UMUM
ASKES JUMLAH
74 322 336 732

Mengetahui,
Pimpinan Puskesmas

NIP. 19670303199103 2 010 NIP. 197909182010012014

BULAN JUNI
KET.

NIP. 197909182010012014
BULAN : JULI
TAHUN : 2022
SATUAN
BULAN JULI
NO NAMA BARANG
TABLET

5 Ambroksol 30 mg Tablet 600 500 500 1,100 1100 0
6 150)
Tablet 0 0 0 0
0
12 Amoksisilin 500 mg Tablet 5,700 4,000 4,000 9,700 5700 4,000 0
0
0
0

0
24 Deksametason 0,5 mg Tablet 1,000 1,000 1,000 2,000 800 1,200
29 Digoksin 0,25 mg Tablet 0 0 0 0
34 50 mg Tablet 0 0 0 0
0

0

0
Haloperidol 2 mg
0
58 Ibuprofen 400 mg Tablet 5,100 500 500 5,600 1500 4,100
61 600mg) Tablet 0 0 0 0
0
0
0
1500
82 mg) Tablet 0 0 0 0
0
10mg) 0
100mg) 0
Metildopa 250 mg
0
0
94 Metilprednisolon 4 mg Tablet 2,000 500 500 2,500 1000 1,500

0
100 Natrium diklofenak 50mg Tablet 3,600 450 450 4,050 2,350
1700
101 Neo Diaform tab Tablet 0 0 0 3 -3

0
0
109 Omeprazol 20 mg Kapsul 1,140 600 600 1,740 720 1,020
112 Parasetamol 500 mg Tablet 14,000 2,500 2,500 16,500 1200 15,300
0
117 Prednison 5 mg Tablet 6,100 2,000 2,000 8,100 2000 6,100
Rivaroksaban 20 mg
0
124 Salbutamol 2mg Tablet 1,000 0 1,000 500 500
125 Sefadroksil 500 mg Kapsul 500 200 200 700 500 200
127 Setirizin 10 mg Tablet 1,080 1,500 1,500 2,580 600 1,980
Teofilin 150 mg
180
0
140 Vitamin B kompleks Tablet 1,200 0 1,200 900 300

500
142 mg Tablet 1,600 0 1,600 1,100
500
Vitamin B12
0
144 50mg Tablet 8,600 0 8,600 6,400
2200
145 10 mg Tablet 0 0 0 0
0
300
SIRUP 0 0 0 0 0
148 mg/5mL Botol 50 100 100 150 120
30
149 mg/5mL Botol 0 0 0 0
0

0
Domperidon Sirup
152 5mg/5mL Botol 15 20 20 35 25
10
153 200mg/5mL Botol 0 0 0 0
0
Ibuprofen Suspensi
154 100mg/5 mL Botol 0 0 0 0
0
Ibuprofen Suspensi
155 200mg/5 mL Botol 0 0 0 0
0
0
157 200/40mg Botol 20 0 20 0
20
Laktulosa Sirup
158 3,335g/5mL Botol 0 0 0 0
0
Metoklopramid Sirup
0
Metoclopramid 10mL
0
161 125mg/5mL Botol 10 0 10 0
10
0
Parasetamol Drop
163 100mg/mL Botol 0 0 0 0
0
Parasetamol Sirup
164 120mg/5mL Botol 40 0 40 40
0
165 125mg/5mL Botol 3 0 3 0
3
0
Sefadroksil Sirup
167 125mg/5mL Botol 28 0 28 9
19
0
Sukralfat Suspensi
170 500mg/5mL Botol 0 0 0 0
0
CAIRAN INFUS 0 0 0 0
0
Antibakteri Doen
0
Albumin 25%-100ml
0
Albumin 5%-250 ml
0
0
181 2 gr 7 0 7 7
0
182 mg/mL 0 0 0 0
0
183 50mg/mL Ampul 8 0 8 8
0
188 IU/mL Vial 0 0 0 0
0
189 IU/mL Vial 0 0 0 0
0
Betametason 0,05%
0
192 Krim 0,05% Tube 0 0 0 0
0
193 (Dulcolax) Suppo 0 25 25 25 25
0
Bisakodil Supp 5 mg
194 (Dulcolax) Suppo 0 18 18 18 14
4

15
10
Diazepam Enema 10
0
0
10mg/mL 0
203 ml (50mg/mL) Ampul 0 0 0 0
0
204 12,5 mg/mL Ampul 0 0 0 0
0
0
207 1mg/mL Ampul 0 0 0 0
0
0

0
0

215 0,025% (Dermasolon) Tube 0 0 0 0
0

0
0
0,5ml) 0
Insulin Long Acting
0
0
227 0,025% 20 mcg/puff Botol 0 0 0 0
(Atrovent) 0
0

0
0
236 1% Tube 25 0 25 10
15
0
0
0
0

0
(Deponeo) 0
250 500mg Vial 0 0 0 0
0
251 125 mg Vial 0 0 0 0
0
Metronidazol infus
252 5mg/mL Botol 3 0 3 1
2

20
257 (Iliadin 0,05%) Botol 0 0 0 0
0
262 mg/mL Botol 0 20 20 20 10
10
0
267 Salep 2-4 Pot 0 0 0 0 0
268 Sefotaksim inj. 1000 mg Vial 10 40 40 50 5 45

0
Vitamin B12
500mcg/mL 0
276 100mg Ampul 0 0 0 0
0
0
0 0 0 0 0
PERBEKALAN KESEHATAN 0 0 0 0 0
1 Abbocath no. 18 Pcs 577 0 577 0 577
2 Abbocath no. 20 Pcs 357 0 357 42 315
3 Abbocath no. 22 Pcs 278 0 278 38 240
4 Abbocath no. 24 Pcs 121 0 121 10 111
5 Abbocath no. 26 Pcs 280 0 280 80 200

0
9 Alkohol Swab Pcs 3,400 0 3,400 1000 2,400
10 Arm Sling L Pcs 15 0 15 0 15
11 Arm Sling M Pcs 12 0 12 0 12
12 Arm Sling S Pcs 18 0 18 0 18

6
15 Blood Lancet Pcs 3,600 0 3,600 200 3,400
17 Catgut no 2/0 Pcs 0 0 0 0 0
18 Catgut no 3/0 Pcs 0 0 0 0 0
19 40mm CG278 Pcs 0 0 0 0
0
20 36mm CG228 Pcs 0 0 0 0
0
21 45 mm CG209 Pcs 0 0 0 0
0
22 90 mm CG315 Pcs 0 0 0 0
0
23 26 mm CG296 Pcs 0 0 0 0
0
25 mm, 75 cm CG342 Pcs 0 0 0 0
0
26 mm, 75 cm CG344 Pcs 0 0 0 0
0
27 mm, 75 cm CG366 Pcs 0 0 0 0
0
28 mm, 75 cm CG372 Pcs 0 0 0 0
0
29 cm PG132 Pcs 0 0 0 0
0
30 1/2mayo, 30 mm PG114 Pcs 0 0 0 0
0
0
0
33 75 cm PG142 Pcs 0 0 0 0
0
34 75 cm PG146 Pcs 0 0 0 0
0

0
0
38 75 cm PG168-1 Pcs 0 0 0 0
0
39 75 cm PG174 Pcs 456 0 456 384
72
0
52 12 (Urocare) Pcs 0 0 0 0
0
53 14 (Urocare) Pcs 0 0 0 0
0
54 16 (Urocare) Pcs 4 0 4 4
0
55 18 (Urocare) Pcs 5 0 5 3
2
56 20 (Urocare) Pcs 0 0 0 0
0
57 22 (Urocare) Pcs 21 0 21 13
8
58 24 (Urocare) Pcs 5 0 5 5
0
0
0
0
0
64 10 Pcs 2 0 2 2
0
0
0
Handscum (Surgical
0
Handscum (Surgical
0
Handscum (Surgical
0

60

0
75 Kapas 100 g Roll 0 0 0 0 0

1

0

0
112
84 Kasa Steril 10 x 10 cm Roll 0 0 0 0
87 Lysol 1 L Botol 0 0 0 0 0
88 Masker N95 Pcs 30 0 30 30 0

150
91 L Pasang 0 0 0 0
0
92 M Pasang 0 0 0 0
0
93 S Pasang 0 0 0 0
0
0
95 14/200 Pcs 0 0 0 0
0
96 16/200 Pcs 0 0 0 0
0
97 18/200 Pcs 0 0 0 0
0
98 20/200 Pcs 0 0 0 0
0
99 22/100 Pcs 0 0 0 0
0
100 24/100 Pcs 0 0 0 0
0
101 Ch 10 Pcs 0 0 0 0
0
102 Ch 6 Pcs 0 0 0 0
0
103 Nurse Cup 0 0 0 0 0
109 cm x 5 m Roll 34 0 34 29
5
110 cm x 5 m Roll 0 0 0 0
0
111 x 5 m Roll 20 0 20 20
0
112 Pot Dahak Pcs 760 0 760 20 740

0
116 PV830 Pcs 1 0 1 1
0
117 PV856 Pcs 0 0 0 0
0
118 PV888 Pcs 0 0 0 0
0
119 PV894 Pcs 0 0 0 0
0
127 cm BS636 Pcs 0 0 0 0
0
128 cm BS640-1 Pcs 0 0 0 0
0
0
131 cm BS668 Pcs 0 0 0 0
0
132 mm BS656-1 Pcs 336 0 336 288
48
133 cm BS695 Pcs 0 0 0 0
0
136 30 mm Pcs 0 0 0 0
0
137 steril Pcs 340 0 340 240
100
138 Spoit 0,5 ml Pcs 200 0 200 0 200
139 Spoit 1 ml Pcs 520 0 520 100 420
140 Spoit 10 ml Pcs 150 0 150 0 150
141 Spoit 2,5 ml Pcs 425 0 425 0 425
142 Spoit 20 ml Pcs 0 0 0 0 0
143 Spoit 3 ml Pcs 450 0 450 350 100
144 Spoit 5 ml Pcs 285 0 285 100 185
145 Spoit 50 ml Pcs 0 0 0 0 0

0
152 U Pad Steril 60 x 90 cm Pcs 0 0 0 0

0
159 Urine Bag Pcs 12 0 12 8 4

3
162 Darah Pcs 6 0 6 3
3
3
0 0 0 0
PROGRAM TB 0 0 0 0
5 Pot Dahak Pot 760 0 760 40 720
7 Slide Pcs 0 0 0 0 0
PROGRAM KECACINGAN 0 0 0 0 0
PROGRAM DIARE 0 0 0 0 0
1 Oralit Sach 3,700 0 3,700 0 3,700
2 Zink 20 mg Tablet 2,800 0 2,800 300 2,500
PROGRAM MALARIA 0 0 0 0 0
PROGRAM HIV 0 0 0 0 0
PROGRAM IMUNISASI 0 0 0 0 0
9 Solosot 0,05 Pcs 0 0 0 0 0
10 Solosot 0,5 ml Pcs 0 0 0 0 0
PROGRAM GIZI 0 0 0 0
PROGRAM KIA 0 0 0 0 0
PROGRAM COVID-19 0 0 0 0 0
4 ADS 0,5 ml Pcs 0 0 0 0 0
5 ADS 0,3 ml Pcs 1,125 0 1,125 0 1,125
6 ADS 3 ml Pcs 0 0 0 0 0
7 APD Set Set 0 0 0 0 0
8 NaCl 0,9% Flac 0 0 0 0 0
TAMBAHAN 0 0 0 0 0
5 Stik HIV pcs 0 175 175 175 2 173

0
Kaca Helm Covid19
8 (Provinsi)
pcs 0 0 0 0
0
Baju Hazmat L, XL
0
0
Masker Bedah Karet
0

0
20 Lodia Tablet 220 500 500 720 420 300
23 Biocombin Inj 60 20 20 80 30 50
24 Sohobion Tablet 150 100 100 250 150 100
25 Pentolin 0 55 20 20 75 25 50
29 caviplex 0 0 500 500 500 300 200
30 0 0 0 0 0 0 0
UMUM
ASKES JUMLAH
114 271 400 785

Mengetahui,
Pimpinan Puskesmas

NIP. 19670303199103 2 010 NIP. 197909182010012014

BULAN JULI
KET.

NIP. 197909182010012014
BULAN : AGUSTUS
TAHUN : 2022
SATUAN
BULAN AGUSTUS
NO NAMA BARANG
KET.
TABLET
1 Alopurinol 100 mg Tablet 1,000 0 1,000 700 300

6 Aminofilin 150 mg (Decafil Tablet 0 0 0 0

150) 0
12 Amoksisilin 500 mg Tablet 4,000 2,600 2,600 6,600 2400 4,200
14 Asam Asetilsalisilat 100 mg Tablet 0 0 0 0

(Asetosal) 0
15 Asam Asetilsalisilat 80 mg Tablet 0 0 0 0
(Miniaspi) 0
18 Asam Pipemidat 400mg Tablet 0 0 0 0

(Urinter) 0

0
24 Deksametason 0,5 mg Tablet 1,200 0 1,200 800 400
34 Ergotamin 1 mg + Kafein Tablet 0 0 0 0

50 mg 0
43 Gliklazid tab lepas lambat Tablet 0 0 0 0

30 mg (Diamicron)
0
44 Gliklazid tab lepas lambat Tablet 0 0 0 0

60 mg (Diamicron)
0
54 Haloperidol 2 mg Tablet 0 0 0 0
(Lodomer 2) 0
58 Ibuprofen 400 mg Tablet 4,100 2,500 2,500 6,600 1600 5,000
61 Kalium Klorida 600mg (KSR Tablet 0 0 0 0

600mg) 0
63 Kalsium Karbonat 500mg Tablet 0 0 0 0

(Calprosis-D) 0
71 Kloramfenikol 500 mg Kapsul 0 0 0 0

(Chloramex) 0
2400
82 Levotiroksin (Euthyrox 50 Tablet 0 0 0 0

mg) 0
10mg) 0
100mg) 0
91 Metildopa 250 mg Tablet 0 0 0 0

(Dopamet) 0
92 Metilergometrin tab 0,125 Tablet 0 0 0 0
mg 0
94 Metilprednisolon 4 mg Tablet 1,500 1,500 1,500 3,000 1400 1,600
97 Metronidazol 500 mg Tablet 500 500 500 1,000 500 500

0
100 Natrium diklofenak 50mg Tablet 2,350 0 2,350 550
1800
101 Neo Diaform tab Tablet -3 0 -3 -3

0
0
109 Omeprazol 20 mg Kapsul 1,020 0 1,020 720 300
115 Pirantel Pamoat 250 mg Tablet 0 0 0 0

(Pantrin) 0
122 Rivaroksaban 20 mg Tablet 0 0 0 0

(Xarelto 20) 0
127 Setirizin 10 mg Tablet 1,980 0 1,980 390 1,590
134 Teofilin 150 mg Tablet 200 0 200 200

(Bronsolvan) 0
137 Tiamizol 10 mg (Thyrozol, Tablet 0 0 0 0

Antityroid) 0

500
142 Vitamin B6 (Piridoksin) 10 Tablet 1,100 0 1,100 200
mg 900
143 Vitamin B12 Tablet 200 0 200 0
(Sianokobalamin) 50mcg 200
144 Vitamin C (Asam Askorbat) Tablet 6,400 0 6,400 4,200
50mg 2200
145 Vitamin K1 (Fitomenadion) Tablet 0 0 0 0
10 mg 0
0
SIRUP
148 Amoksisilin Sirup 125 Botol 120 0 120 100

mg/5mL 20
149 Amoksisilin Sirup Forte 250 Botol 0 0 0 0
mg/5mL 0

0
152 Domperidon Sirup Botol 25 0 25 25
5mg/5mL 0
153 Eritromisin Sirup Kering Botol 0 0 0 0
200mg/5mL 0
154 Ibuprofen Suspensi Botol 0 0 0 0
100mg/5 mL 0
155 Ibuprofen Suspensi Botol 0 0 0 0
200mg/5 mL 0
0
157 Kotrimoksazol Suspensi Botol 0 0 0 0
200/40mg 0
158 Laktulosa Sirup Botol 0 0 0 0
3,335g/5mL 0
159 Metoklopramid Sirup Botol 0 0 0 0
5mg/5mL (Lexapram) 0
160 Metoclopramid 10mL Botol 0 0 0 0
(Gavistal) Drops 0
161 Metronidazol Suspensi Botol 0 0 0 0
125mg/5mL 0
0
163 Parasetamol Drop Botol 0 0 0 0
100mg/mL 0
164 Parasetamol Sirup Botol 40 0 40 30
120mg/5mL 10
165 Pirantel Pamoat Susp Botol 0 0 0 0
125mg/5mL 0
0
167 Sefadroksil Sirup Botol 9 0 9 0
125mg/5mL 9
0
170 Sukralfat Suspensi Botol 0 0 0 0

500mg/5mL 0
CAIRAN INFUS
173 Antibakteri Doen Tube 0 0 0 0

Bacitracin - Polimiksin 0
175 Albumin 25%-100ml Botol 0 0 0 0

(Octalbin 25%) 0
176 Albumin 5%-250 ml Botol 0 0 0 0
(Octalbin 5%) 0
177 Albumin Serum inj. 20% Botol 0 0 0 0
100 mL (Biotest) 0
181 Antihemoroid Suppositoria Suppo 7 0 7 0

2 gr 7
182 Asam Traneksamat inj. 100 Ampul 0 0 0 0
mg/mL 0
183 Asam Traneksamat inj. Ampul 8 0 8 0
50mg/mL 8
188 Benzatin Penisilin 1,2 jt Vial 0 0 0 0

IU/mL 0
189 Benzatin Penisilin 2,4 jt Vial 0 0 0 0
IU/mL 0
190 Betametason 0,05% Tube 0 0 0 0
(Skizon 5 gr) 0
192 Betametason Dipropionat Tube 0 0 0 0

Krim 0,05% 0
193 Bisakodil Supp 10 mg Suppo 25 0 25 18
(Dulcolax) 7
194 Bisakodil Supp 5 mg Suppo 14 0 14 14
(Dulcolax) 0
198 Desoksimetason 0,25% Tube 20 0 20 0

(Dexocort krim) 20
200 Diazepam Enema 10 Rectal 0 0 0 0

mg/2,5mL (Stesolid10mg) 0
201 Diazepam Enema 5 mg/2,5 Ampul 0 0 0 0
mL (Stesolid 5mg) 0
202 Difenhidramin inj 10mg/mL Ampul 0 0 0 0
0
203 Dobutamin HCl 250 mg/5 Ampul 0 0 0 0
ml (50mg/mL) 0
204 Dobutamin-Hameln inj. Ampul 0 0 0 0
12,5 mg/mL 0
0
207 Epinefrin inj. 0,1% - Ampul 0 0 0 0

1mg/mL 0
0

0
213 Fenoterol Cairan Ih 0,1% Vial 0 0 0 0
(Berotec Solution) 0
215 Flusinolon asetonid salep Tube 0 0 0 0

0,025% (Dermasolon)
0
217 Gentamisin SM 0,3% Tube 30 0 30 30
219 Glukosa 5% larutan infus Botol 53 50 50 103 43

60
0
0,5ml) 0
225 Insulin Long Acting Pen 0 0 0 0
100IU/mL (Levemir) 0
226 Insulin Rapid Acting Pen 0 0 0 0
100IU/mL (Novorapid) 0
227 0,025% 20 mcg/puff Botol 0 0 0 0
(Atrovent) 0
228 Ipratropium Br inhalasi 0,5 Botol 0 0 0 0
mg (Combivent) 0

0
235 Kloramfenikol Salep 2% Tube 0 0 0 0
(Bufacetin) 0
236 Kloramfenikol Salep Mata Tube 10 0 10 0
1% 10
0
238 Klonidin inj150 mcg/mL Ampul 0 0 0 0
(Catapres) 0
239 Karbogliserin tetes telinga Botol 0 0 0 0
10% (Fenol Gliserol) 0
241 Ketoprofen Sup 100 mg Suppo 0 0 0 0

(Protofen) 0

0
(Deponeo) 0
250 Metilprednisolon inj. Vial 0 0 0 0
500mg 0
251 Metilprednisolon serb inj Vial 0 0 0 0
125 mg 0
252 Metronidazol infus Botol 1 0 1 1
5mg/mL 0

0
257 Oksimetazolin tetes hidung Botol 0 0 0 0

(Iliadin 0,05%) 0
262 Parasetamol infus 10 Botol 10 0 10 0

mg/mL 10
266 Salbutamol aerosol 100 Botol 0 0 0 0

mcg (Salbulin) 0
267 Salep 2-4 Pot 0 0 0 0 0

0
Vitamin B12
500mcg/mL 0
276 Vitamin B6 (Piridoksin) inj. Ampul 0 0 0 0
100mg 0
0
1 Abbocath no. 18 Pcs 577 0 577 5 572
2 Abbocath no. 20 Pcs 315 0 315 3 312
3 Abbocath no. 22 Pcs 240 0 240 30 210
4 Abbocath no. 24 Pcs 111 0 111 30 81
5 Abbocath no. 26 Pcs 200 0 200 65 135

0
9 Alkohol Swab Pcs 2,400 0 2,400 1100 1,300
10 Arm Sling L Pcs 15 0 15 5 10
11 Arm Sling M Pcs 12 0 12 0 12
12 Arm Sling S Pcs 18 0 18 0 18

0
15 Blood Lancet Pcs 3,400 0 3,400 200 3,200
17 Catgut no 2/0 Pcs 0 0 0 0 0
18 Catgut no 3/0 Pcs 0 0 0 0 0
19 Catgut Chromic 0, 75 cm, Pcs 0 0 0 0

40mm CG278 0
36mm CG228 0
45 mm CG209 0
22 Catgut Chromic 2/0, 37cm, Pcs 0 0 0 0
90 mm CG315 0
23 Catgut Chromic 2/0, 75cm, Pcs 0 0 0 0
26 mm CG296 0
25 Catgut Chromic 3/0, 24 Pcs 0 0 0 0

mm, 75 cm CG342 0
mm, 75 cm CG344 0
mm, 75 cm CG366 0
mm, 75 cm CG372 0
29 Catgut Plain 0, 30 mm, 75 Pcs 0 0 0 0
cm PG132 0
30 Catgut Plain 1, 90 cm, Pcs 0 0 0 0
1/2mayo, 30 mm PG114 0
0
32 Catgut Plain 2/0, 24 mm, Pcs 0 0 0 0
75 cm gabler 0
75 cm PG142 0
75 cm PG146 0

0
0
75 cm PG168-1 0
75 cm PG174 48
0
52 Foley Catheter 2 way no. Pcs 0 0 0 0

12 (Urocare) 0
14 (Urocare) 0
16 (Urocare) 0
18 (Urocare) 0
20 (Urocare) 0
22 (Urocare) 0
24 (Urocare) 5
0
0
0
0
64 Foley Catheter Ped 2 no. Pcs 2 0 2 2

10 0
0
0
67 Handscum (Surgical Pasang 0 0 0 0
Gloves) No. 6,5 0
Gloves) No.7 0
Gloves) No. 7,5 0

0

0
75 Kapas 100 g Roll 0 0 0 0 0

0

0

0
104
87 Lysol 1 L Botol 0 0 0 0 0
88 Masker N95 Pcs 0 0 0 0 0

0
91 Maxter Exam Non Powder Pasang 0 0 0 0

L 0
M 0
S 0
XS 0
95 Norta Catheter 2 Way Ch Pcs 0 0 0 0
14/200 0
16/200 0
18/200 0
20/200 0
22/100 0
24/100 0
101 Norta Catheter ped 2 Way Pcs 0 0 0 0
Ch 10 0
102 Norta Catheter ped 2 Way Pcs 0 0 0 0
Ch 6 0
103 Nurse Cup 0 0 0 0 0
106 Plesterin Bulat Pcs 50 0 50 50
109 Plesterin Non Woven 10 Roll 29 0 29 29

cm x 5 m 0
110 Plesterin Non Woven 15 Roll 0 0 0 0
cm x 5 m 0
111 Plesterin Non Woven 5 cm Roll 20 0 20 20
x5m 0
112 Pot Dahak Pcs 740 0 740 20 720

0
116 Provein 2/0 26 mm, 75 cm Pcs 1 0 1 0

PV830 1
117 Provein 3/0 26 mm, 75 cm Pcs 0 0 0 0
PV856 0
118 Provein 5/0 18 mm, 45 cm Pcs 0 0 0 0
PV888 0
119 Provein 6/0 13 mm, 45 cm Pcs 0 0 0 0
PV894 0
127 Silk Black 2/0, 25 mm, 75 Pcs 0 0 0 0

cm BS636 0
128 Silk Black 2/0, 30 mm, 75 Pcs 0 0 0 0
cm BS640-1 0
0
131 Silk Black 3/0, 26 mm, 75 Pcs 0 0 0 0

cm BS668 0
132 Silk Black 3/0, 75cm, 19 Pcs 288 0 288 240
mm BS656-1 48
133 Silk Black 5/0, 13 mm, 45 Pcs 0 0 0 0
cm BS695 0
136 Silk Braided Black 3/0 HR Pcs 0 0 0 0

30 mm 0
137 Softpad 60 x 90 cm non Pcs 240 0 240 240
steril 0
138 Spoit 0,5 ml Pcs 200 0 200 0 200
139 Spoit 1 ml Pcs 420 0 420 0 420
140 Spoit 10 ml Pcs 150 0 150 0 150
141 Spoit 2,5 ml Pcs 425 0 425 0 425
142 Spoit 20 ml Pcs 0 0 0 0 0
143 Spoit 3 ml Pcs 100 0 100 100 0
144 Spoit 5 ml Pcs 185 0 185 0 185
145 Spoit 50 ml Pcs 0 0 0 0 0

0
158 Onemed Umbilical Cord Pcs 200 0 200 200

klem (Penjepit Tali Pusar)
0

2
162 Autocheck Stick Gula Pcs 3 0 3 1
Darah 2
0
PROGRAM TB
5 Pot Dahak Pot 720 0 720 0 720
7 Slide Pcs 0 0 0 0 0
PROGRAM KECACINGAN
PROGRAM DIARE
1 Oralit Sach 3,700 0 3,700 0 3,700
2 Zink 20 mg Tablet 2,500 0 2,500 0 2,500
PROGRAM MALARIA
PROGRAM HIV
PROGRAM IMUNISASI
2 Vaksin Campak Rubella Vial 0 48 48 48 0 48
3 Vaksin DPT-HB-HIB Vial 0 101 101 101 0 101
4 Vaksin DT Vial 0 70 70 70 7 63
5 Vaksin HB0 Vial 0 100 100 100 0 100
6 Vaksin Polio Vial 0 50 50 50 5 45
7 Vaksin Polio injeksi Vial 0 20 20 20 0 20
9 Solosot 0,05 Pcs 0 0 0 0
PROGRAM GIZI
PROGRAM KIA
PROGRAM COVID-19
4 ADS 0,5 ml Pcs 0 0 0 0 0
5 ADS 0,3 ml Pcs 1,125 0 1,125 0 1,125
6 ADS 3 ml Pcs 0 0 0 0 0
7 APD Set Set 0 0 0 0 0
8 NaCl 0,9% Flac 0 0 0 0 0
TAMBAHAN
5 Stik HIV pcs 173 0 173 9 164

0
8 Kaca Helm Covid19 pcs 0 0 0 0

(Provinsi) 0
11 Baju Hazmat L, XL pcs 0 0 0 0

(Provinsi) 0
0
13 Masker Bedah Karet pcs 0 0 0 0
(Provinsi) 0

0
20 Lodia Tablet 300 0 300 300 0
24 Sohobion Tablet 100 200 200 300 200 100
25 Pentolin 0 50 0 50 30 20
29 caviplex 0 200 2,000 2,000 2,200 700 1,500
30 0 0 0 0 0 0
UMUM
ASKES JUMLAH
137 304 335 776

Mengetahui,
Pimpinan Puskesmas

NIP. 19670303199103 2 010 NIP. 197909182010012014
PUSKESMAS ….........................................
BULAN : SEPTEMBER
TAHUN : 2022
PUSKESMAS …................................................
SATUAN
BULAN SEPTEMBER
NO NAMA BARANG
TABLET
1 Alopurinol 100 mg Tablet 300 0 300 300 0

6 150)
Tablet 0 0 0 0
0
0
0
0

0
34 50 mg Tablet 0 0 0 0
0

0

0
Haloperidol 2 mg
0
56 Hidroklortiazid 25 mg Tablet 1,100 0 1,100 500 600
61 600mg) Tablet 0 0 0 0
0
0
0
3100
82 mg) Tablet 0 0 0 0
0
10mg) 0
100mg) 0
Metildopa 250 mg
0
0
94 Metilprednisolon 4 mg Tablet 1,600 0 1,600 600 1,000

0
550

0
0
112 Parasetamol 500 mg Tablet 15,400 0 15,400 2000 13,400
0
Rivaroksaban 20 mg
0
127 Setirizin 10 mg Tablet 1,590 0 1,590 1020 570
Teofilin 150 mg
0
0

500
142 mg Tablet 200 0 200 0
200
Vitamin B12
0
144 50mg Tablet 4,200 0 4,200 2,700
1500
145 10 mg Tablet 0 0 0 0
0
0
SIRUP
148 mg/5mL Botol 100 0 100 55
45
149 mg/5mL Botol 0 0 0 0
0

0
Domperidon Sirup
152 5mg/5mL Botol 25 0 25 0
25
153 200mg/5mL Botol 0 0 0 0
0
Ibuprofen Suspensi
154 100mg/5 mL Botol 0 0 0 0
0
Ibuprofen Suspensi
155 200mg/5 mL Botol 0 0 0 0
0
0
157 200/40mg Botol 0 0 0 0
0
Laktulosa Sirup
158 3,335g/5mL Botol 0 0 0 0
0
Metoklopramid Sirup
0
Metoclopramid 10mL
0
161 125mg/5mL Botol 0 0 0 0
0
0
Parasetamol Drop
163 100mg/mL Botol 0 0 0 0
0
Parasetamol Sirup
164 120mg/5mL Botol 30 0 30 20
10
165 125mg/5mL Botol 0 0 0 0
0
0
Sefadroksil Sirup
167 125mg/5mL Botol 0 0 0 0
0
0
Sukralfat Suspensi
170 500mg/5mL Botol 0 0 0 0
0
CAIRAN INFUS
Antibakteri Doen
0
Albumin 25%-100ml
0
Albumin 5%-250 ml
0
0
181 2 gr 0 0 0 0
0
182 mg/mL 0 0 0 0
0
183 50mg/mL Ampul 0 0 0 0
0
188 IU/mL Vial 0 0 0 0
0
189 IU/mL Vial 0 0 0 0
0
Betametason 0,05%
0
192 Krim 0,05% Tube 0 0 0 0
0
5
Bisakodil Supp 5 mg
5

20
0
Diazepam Enema 10
0
0
10mg/mL 0
203 ml (50mg/mL) Ampul 0 0 0 0
0
204 12,5 mg/mL Ampul 0 0 0 0
0
0
207 1mg/mL Ampul 0 0 0 0
0
0

0
0

215 0,025% (Dermasolon) Tube 0 0 0 0
0

0
0
0,5ml) 0
Insulin Long Acting
0
0
227 0,025% 20 mcg/puff Botol 0 0 0 0
(Atrovent) 0
0

0
0
236 1% Tube 0 0 0 0
0
0
0
0
0

0
(Deponeo) 0
250 500mg Vial 0 0 0 0
0
251 125 mg Vial 0 0 0 0
0
Metronidazol infus
252 5mg/mL Botol 1 0 1 1
0

0
257 (Iliadin 0,05%) Botol 0 0 0 0
0
262 mg/mL Botol 0 0 0 0
0
0
267 Salep 2-4 Pot 0 0 0 0 0

0
Vitamin B12
500mcg/mL 0
276 100mg Ampul 0 0 0 0
0
0
1 Abbocath no. 18 Pcs 572 0 572 15 557
2 Abbocath no. 20 Pcs 312 0 312 25 287
3 Abbocath no. 22 Pcs 210 0 210 20 190
4 Abbocath no. 24 Pcs 81 0 81 10 71
5 Abbocath no. 26 Pcs 135 0 135 10 125

0
9 Alkohol Swab Pcs 1,300 0 1,300 800 500
10 Arm Sling L Pcs 10 0 10 0 10
11 Arm Sling M Pcs 12 0 12 0 12
12 Arm Sling S Pcs 18 0 18 0 18

0
15 Blood Lancet Pcs 3,200 0 3,200 200 3,000
17 Catgut no 2/0 Pcs 0 0 0 0 0
18 Catgut no 3/0 Pcs 0 0 0 0 0
19 40mm CG278 Pcs 0 0 0 0
0
20 36mm CG228 Pcs 0 0 0 0
0
21 45 mm CG209 Pcs 0 0 0 0
0
22 90 mm CG315 Pcs 0 0 0 0
0
23 26 mm CG296 Pcs 0 0 0 0
0
25 mm, 75 cm CG342 Pcs 0 0 0 0
0
26 mm, 75 cm CG344 Pcs 0 0 0 0
0
27 mm, 75 cm CG366 Pcs 0 0 0 0
0
28 mm, 75 cm CG372 Pcs 0 0 0 0
0
29 cm PG132 Pcs 0 0 0 0
0
30 1/2mayo, 30 mm PG114 Pcs 0 0 0 0
0
0
0
33 75 cm PG142 Pcs 0 0 0 0
0
34 75 cm PG146 Pcs 0 0 0 0
0

0
0
38 75 cm PG168-1 Pcs 0 0 0 0
0
39 75 cm PG174 Pcs 336 0 336 288
48
0
52 12 (Urocare) Pcs 0 0 0 0
0
53 14 (Urocare) Pcs 0 0 0 0
0
54 16 (Urocare) Pcs 4 0 4 3
1
55 18 (Urocare) Pcs 3 0 3 2
1
56 20 (Urocare) Pcs 0 0 0 0
0
57 22 (Urocare) Pcs 13 0 13 13
0
58 24 (Urocare) Pcs 0 0 0 0
0
0
0
0
0
64 10 Pcs 2 0 2 2
0
0
0
Handscum (Surgical
0
Handscum (Surgical
0
Handscum (Surgical
0

0

0
75 Kapas 100 g Roll 0 0 0 0 0

2

30

0
0
87 Lysol 1 L Botol 0 0 0 0 0
88 Masker N95 Pcs 0 0 0 0 0

0
91 L Pasang 0 0 0 0
0
92 M Pasang 0 0 0 0
0
93 S Pasang 0 0 0 0
0
0
95 14/200 Pcs 0 0 0 0
0
96 16/200 Pcs 0 0 0 0
0
97 18/200 Pcs 0 0 0 0
0
98 20/200 Pcs 0 0 0 0
0
99 22/100 Pcs 0 0 0 0
0
100 24/100 Pcs 0 0 0 0
0
101 Ch 10 Pcs 0 0 0 0
0
102 Ch 6 Pcs 0 0 0 0
0
103 Nurse Cup 0 0 0 0 0
109 cm x 5 m Roll 29 0 29 29
0
110 cm x 5 m Roll 0 0 0 0
0
111 x 5 m Roll 20 0 20 20
0
112 Pot Dahak Pcs 720 0 720 30 690

0
116 PV830 Pcs 0 0 0 0
0
117 PV856 Pcs 0 0 0 0
0
118 PV888 Pcs 0 0 0 0
0
119 PV894 Pcs 0 0 0 0
0
127 cm BS636 Pcs 0 0 0 0
0
128 cm BS640-1 Pcs 0 0 0 0
0
0
131 cm BS668 Pcs 0 0 0 0
0
132 mm BS656-1 Pcs 240 0 240 192
48
133 cm BS695 Pcs 0 0 0 0
0
136 30 mm Pcs 0 0 0 0
0
137 steril Pcs 240 0 240 140
100
138 Spoit 0,5 ml Pcs 200 0 200 0 200
139 Spoit 1 ml Pcs 420 0 420 100 320
140 Spoit 10 ml Pcs 150 0 150 0 150
141 Spoit 2,5 ml Pcs 425 0 425 100 325
142 Spoit 20 ml Pcs 0 0 0 0 0
143 Spoit 3 ml Pcs 0 0 0 0 0
144 Spoit 5 ml Pcs 185 0 185 0 185
145 Spoit 50 ml Pcs 0 0 0 0 0

0

0

0
162 Darah Pcs 1 0 1 1
0
0
PROGRAM TB
5 Pot Dahak Pot 720 0 720 30 690
7 Slide Pcs 0 0 0 0 0
PROGRAM KECACINGAN
1 Albendazole tab Tablet 0 3,600 3,600 3,600 0 3,600
PROGRAM DIARE
1 Oralit Sach 3,700 0 3,700 300 3,400
2 Zink 20 mg Tablet 2,500 0 2,500 0 2,500
PROGRAM MALARIA
5 RDT Malaria Teskit 0 30 30 30 0 30
PROGRAM HIV
PROGRAM IMUNISASI
5 Vaksin HB0 Vial 100 0 100 0 100
9 Solosot 0,05 Pcs 0 300 300 300 0 300
10 Solosot 0,5 ml Pcs 0 2,000 2,000 2,000 0 2,000
11 Solosot 5 ml Pcs 0 100 100 100 0 100
PROGRAM GIZI
PROGRAM KIA
PROGRAM COVID-19
1 Vitamin C 500 mg Tablet 1,370 0 1,370 1000 370
2 Multivitamin Zink Tablet 1,265 0 1,265 1265 0
4 ADS 0,5 ml Pcs 0 0 0 0 0
5 ADS 0,3 ml Pcs 1,125 0 1,125 0 1,125
6 ADS 3 ml Pcs 0 0 0 0 0
7 APD Set Set 0 0 0 0 0
8 NaCl 0,9% Flac 0 0 0 0 0
TAMBAHAN
5 Stik HIV pcs 164 0 164 139 25

0
Kaca Helm Covid19
8 (Provinsi)
pcs 0 0 0 0
0
Baju Hazmat L, XL
0
0
Masker Bedah Karet
0

0
25 Pentolin 0 20 0 20 10 10
29 caviplex 0 1,500 0 1,500 1,500
30 0 0 0 0 0 0
UMUM
ASKES JUMLAH
98 327 406 831

Mengetahui,
Pimpinan Puskesmas
(………………………………………….) (………………………………………….)
NIP. NIP.
PUSKESMAS …................................................
BULAN SEPTEMBER
KET.
(………………………………………….)
NIP.
PUSKESMAS ….........................................
BULAN : OKTOBER
TAHUN : 2022
PUSKESMAS …................................................
SATUAN
BULAN OKTOBER
NO NAMA BARANG
TABLET
1 Alopurinol 100 mg Tablet 0 4,000 4,000 4,000 1100 2,900

5 Ambroksol 30 mg Tablet 0 2,000 2,000 2,000 800 1,200
6 150)
Tablet 0 0 0 0
0
10 Amlodipin 5 mg Tablet 0 500 250 750 750 300 450
12 Amoksisilin 500 mg Tablet 2,100 18,000 5,000 23,000 25,100 3600 21,500
13 Antasida Tablet Kunyah Tablet 7,500 20,000 20,000 27,500 1800 25,700
15 (Miniaspi) Tablet 0 7,000 7,000 7,000 6,800
200
16 Asam Folat 1 mg Tablet 0 3,000 3,000 3,000 100 2,900
17 Asam Mefenamat 500 mg Tablet 4,200 26,000 26,000 30,200 4800 25,400
0

0
29 Digoksin 0,25 mg Tablet 0 300 300 300 0 300
34 50 mg Tablet 0 0 0 0
0
39 Fenobarbital 30 mg Tablet 5 100 100 105 0 105
40 Furosemid 40 mg Tablet 0 600 200 800 800 0 800
42 Glibenklamid 5 mg Tablet 7,500 200 200 7,700 500 7,200

0

0
46 Glimepirid 2 mg Tablet 350 1,200 1,200 1,550 0 1,550
49 Griseofulvin 125 mg Tablet 0 400 200 600 600 0 600
51 Guaifenisin / GG Tablet 10,800 1,500 500 2,000 12,800 2700 10,100
Haloperidol 2 mg
0
56 Hidroklortiazid 25 mg Tablet 600 0 600 0 600
61 600mg) Tablet 0 0 0 0
0
0
64 Kalsium Laktat 500 mg Tablet 1,100 0 1,100 200 900
66 Kaptopril 12,5 mg Tablet 3,800 700 700 4,500 1200 3,300
67 Kaptopril 25 mg Tablet 0 200 200 200 0 200
68 Karbamazepin 200 mg Tablet 100 100 100 200 0 200
69 Ketokonazol 200 mg Tablet 0 2,400 2,400 2,400 200 2,200
0
72 Klorfeniramin 4 mg (CTM) Tablet 17,500 15,000 15,000 32,500 28,200
4300
75 Klopidogrel 75 mg Tablet 0 90 90 90 20 70
80 Kotrimoksazol 400/80mg Tablet 0 7,000 7,000 7,000 100 6,900
82 mg) Tablet 0 0 0 0
0
84 Loratadin 10 mg Tablet 0 2,000 2,000 2,000 200 1,800
10mg) 0
100mg) 0
Metildopa 250 mg
0
92 mg Tablet 0 300 300 300 300
0
94 Metilprednisolon 4 mg Tablet 1,000 3,700 3,700 4,700 1000 3,700
95 Metoklopramid 10 mg Tablet 500 300 300 800 0 800
97 Metronidazol 500 mg Tablet 300 2,000 2,000 2,300 200 2,100
98 N-Asetil Sistein 200 mg Tablet 0 300 300 300 100 200
99 Natrium diklofenak 25mg Tablet 0 2,200 200 2,400 2,400 2,000

400
0
101 Neo Diaform tab Tablet -3 0 -3 0 -3

0
0
109 Omeprazol 20 mg Kapsul 0 3,000 60 3,060 3,060 60 3,000
0
117 Prednison 5 mg Tablet 4,700 200 200 4,900 1500 3,400
120 Ranitidin 150 mg Tablet 0 100 100 100 0 100
Rivaroksaban 20 mg
0
124 Salbutamol 2mg Tablet 200 1,000 200 1,200 1,400 400 1,000
129 Simvastatin 10 mg Tablet 0 3,000 3,000 3,000 500 2,500
130 Simvastatin 20 mg Tablet 0 4,100 150 4,250 4,250 0 4,250
Teofilin 150 mg
0
0
139 Trifluoperazine 5 mg 0 100 100 100 0 100
141 Vitamin B1 (Tiamin) 50mg Tablet 3,600 1,000 1,000 4,600 4,300
300
142 mg Tablet 0 2,500 2,500 2,500 2,500
0
Vitamin B12
143 (Sianokobalamin) 50mcg Tablet 0 2,000 2,000 2,000 2,000
0
144 50mg Tablet 2,700 6,600 6,600 9,300 7,100
2200
145 10 mg Tablet 0 0 0 0

200
SIRUP
148 mg/5mL Botol 55 100 100 155 130
25
149 mg/5mL Botol 0 0 0 0

0
Domperidon Sirup
152 5mg/5mL Botol 0 20 25 45 45 40
5
153 200mg/5mL Botol 0 0 0 0
0
Ibuprofen Suspensi
154 100mg/5 mL Botol 0 0 0 0
0
Ibuprofen Suspensi
155 200mg/5 mL Botol 0 50 50 50 40
10
0
157 200/40mg Botol 0 0 0 0
0
Laktulosa Sirup
158 3,335g/5mL Botol 0 0 0 0
0
Metoklopramid Sirup
0
Metoclopramid 10mL
0
161 125mg/5mL Botol 0 30 30 30 30
0
0
Parasetamol Drop
163 100mg/mL Botol 0 0 0 0
0
Parasetamol Sirup
164 120mg/5mL Botol 20 60 100 160 180 160
20
165 125mg/5mL Botol 0 0 0 0
0
0
Sefadroksil Sirup
167 125mg/5mL Botol 0 0 0 0
0
0
Sukralfat Suspensi
170 500mg/5mL Botol 0 0 0 0
0
CAIRAN INFUS
Antibakteri Doen
0
Albumin 25%-100ml
0
Albumin 5%-250 ml
0
0
181 2 gr 0 0 0 0
0
182 mg/mL 0 0 0 0
0
183 50mg/mL Ampul 0 0 0 0
0
188 IU/mL Vial 0 0 0 0
0
189 IU/mL Vial 0 0 0 0
0
Betametason 0,05%
0
191 Betametason Krim 0,1% Tube 0 30 30 30 0 30
192 Krim 0,05% Tube 0 0 0 0
0
0
Bisakodil Supp 5 mg
0

0
0
Diazepam Enema 10
0
0
202 Difenhidramin inj Ampul 0 20 20 20 20
10mg/mL 0
203 ml (50mg/mL) Ampul 0 0 0 0
0
204 12,5 mg/mL Ampul 0 0 0 0
0
0
207 1mg/mL Ampul 0 0 0 0
0
0

0
0

215 0,025% (Dermasolon) Tube 0 4 4 4 4
0

0
0
222 Hidrokortison krim 2,5% Tube 0 96 240 336 336 0 336
0,5ml) 0
Insulin Long Acting
0
0
227 0,025% 20 mcg/puff Botol 0 0 0 0
(Atrovent) 0
0

0
235 (Bufacetin) Tube 0 48 48 48 48
0
236 1% Tube 0 0 0 0
0
0
0
0
0
244 Lidocain inj 2% Ampul 0 200 200 200 10 190
245 Lidokain inj 2% + Epinefrin Ampul 0 30 30 30 30

0
(Deponeo) 0
248 Meropenem 0,5 g Vial 0 0 0 0
250 500mg Vial 0 0 0 0
0
251 125 mg Vial 0 0 0 0
0
Metronidazol infus
252 5mg/mL Botol 1 0 1 1
0
253 Mikonazol krim 2% Tube 0 24 24 24 24 0
254 NaCl 0,9%, larutan infus Flac 0 100 100 100 90

10
257 (Iliadin 0,05%) Botol 0 0 0 0
0
262 mg/mL Botol 0 0 0 0
0
265 Ringer Lactat, larutan infus Flac 0 100 100 100 10 90
0
267 Salep 2-4 Pot 0 192 192 192 0 192

0
Vitamin B12
275 (Sianokobalamin) inj. Ampul 0 300 300 300 300
500mcg/mL 0
276 100mg Ampul 0 0 0 0
0
0
1 Abbocath no. 18 Pcs 557 0 557 0 557
2 Abbocath no. 20 Pcs 287 100 100 387 12 375
3 Abbocath no. 22 Pcs 190 100 100 290 47 243
4 Abbocath no. 24 Pcs 71 0 71 5 66
5 Abbocath no. 26 Pcs 125 0 125 10 115
7 Alkohol 70% 300ml Botol 0 10 10 10 10

0
9 Alkohol Swab Pcs 500 1,900 1,900 2,400 300 2,100
10 Arm Sling L Pcs 10 0 10 0 10
11 Arm Sling M Pcs 12 0 12 0 12
12 Arm Sling S Pcs 18 0 18 0 18

0
15 Blood Lancet Pcs 3,000 500 500 3,500 200 3,300
17 Catgut no 2/0 Pcs 0 0 0 0 0
18 Catgut no 3/0 Pcs 0 0 0 0 0
19 40mm CG278 Pcs 0 1 1 1 0
1
20 36mm CG228 Pcs 0 1 1 1 0
1
21 45 mm CG209 Pcs 0 1 1 1 0
1
22 90 mm CG315 Pcs 0 0 0 0
0
23 26 mm CG296 Pcs 0 3 3 3 0
3
25 mm, 75 cm CG342 Pcs 0 0 0 0
0
26 mm, 75 cm CG344 Pcs 0 0 0 0
0
27 mm, 75 cm CG366 Pcs 0 0 0 0
0
28 mm, 75 cm CG372 Pcs 0 0 0 0
0
29 cm PG132 Pcs 0 0 0 0
0
30 1/2mayo, 30 mm PG114 Pcs 0 0 0 0
0
0
32 75 cm gabler Pcs 0 1 1 1 0
1
33 75 cm PG142 Pcs 0 0 0 0
0
34 75 cm PG146 Pcs 0 0 0 0
0

0
0
38 75 cm PG168-1 Pcs 0 0 0 0
0
39 75 cm PG174 Pcs 288 0 288 288
0
0
41 Cervical Collar Pcs 6 2 2 8 0 8
47 Dermavix t 5 x 7 cm Pcs 77 25 25 102 0 102
50 Feeding Tube 8FR 100 cm Pcs 0 10 10 10 0 10
52 12 (Urocare) Pcs 0 0 0 0
0
53 14 (Urocare) Pcs 0 0 0 0
0
54 16 (Urocare) Pcs 3 5 5 8 5
3
55 18 (Urocare) Pcs 2 5 5 7 7
0
56 20 (Urocare) Pcs 0 0 0 0
0
57 22 (Urocare) Pcs 13 0 13 13
0
58 24 (Urocare) Pcs 0 0 0 0
0
0
0
0
0
64 10 Pcs 2 0 2 2
0
0
0
Handscum (Surgical
67 Gloves) No. 6,5 Pasang 0 50 50 50 50
0
Handscum (Surgical
68 Gloves) No.7 Pasang 0 50 50 50 50
0
Handscum (Surgical
69 Gloves) No. 7,5 Pasang 0 50 50 50 50
0
71 Infus Set Anak Pcs 64 15 15 79 13 66
72 Infus set Dewasa Pcs 0 25 25 25 25

0
73 Jet Nebuliser Mask Anak Pcs 0 1 1 1 0 1
74 Jet Nebuliser Mask Dewasa Pcs 5 1 1 6 6

0
75 Kapas 100 g Roll 0 0 0 0 0

0
77 Kapas Pembalut 1000gr Roll 0 3 3 3 2 1
78 Kapas pembalut 250 gr Roll 0 2 2 2 1 1

25

0
83 Kasa Hidrofil Steril 16x16 Pcs 0 918 918 918 918
0
85 Leukoplast 2,5 x 4,5 Roll 15 37 37 52 0 52
87 Lysol 1 L Botol 0 0 0 0 0
88 Masker N95 Pcs 0 110 110 110 0 110

0
90 Masker Surgical 3 Ply Pcs 0 1,520 1,520 1,520 500 1,020
91 L Pasang 0 300 300 300 300
0
92 M Pasang 0 300 300 300 300
0
93 S Pasang 0 100 100 100 100
0
0
95 14/200 Pcs 0 0 0 0
0
96 16/200 Pcs 0 0 0 0
0
97 18/200 Pcs 0 0 0 0
0
98 20/200 Pcs 0 0 0 0
0
99 22/100 Pcs 0 0 0 0
0
100 24/100 Pcs 0 0 0 0
0
101 Ch 10 Pcs 0 0 0 0
0
102 Ch 6 Pcs 0 0 0 0
0
103 Nurse Cup 0 200 200 200 0 200
104 Oxyflow Anak Pcs 0 3 3 3 0 3
105 Oxyflow Dewasa Pcs 0 4 4 4 0 4
106 Plesterin Bulat Pcs 50 600 600 650 0 650
107 Plesterin Elastis Pcs 0 2,400 2,400 2,400 0 2,400
108 Plesterin Elastis Jumbo Pcs 5,500 1,200 1,200 6,700 500 6,200
109 cm x 5 m Roll 29 0 29 29
0
110 cm x 5 m Roll 0 0 0 0
0
111 x 5 m Roll 20 3 3 23 20
3
112 Pot Dahak Pcs 690 0 690 30 660

0
116 PV830 Pcs 0 0 0 0
0
117 PV856 Pcs 0 0 0 0
0
118 PV888 Pcs 0 0 0 0
0
119 PV894 Pcs 0 0 0 0
0
120 Rivanol 300 cc Botol 0 24 24 24 0 24
125 Sarung Tangan Obgyn Pasang 59 6 6 65 5 60
126 Shoe Cover Pasang 59 5 5 64 0 64
127 cm BS636 Pcs 0 0 0 0
0
128 cm BS640-1 Pcs 0 0 0 0
0
0
131 cm BS668 Pcs 0 0 0 0
0
132 mm BS656-1 Pcs 192 0 192 144
48
133 cm BS695 Pcs 0 0 0 0
0
134 Silk Braided 2/0 Pcs 0 7 7 7 0 7
135 Silk Braided 3/0 Pcs 0 7 7 7 0 7
136 30 mm Pcs 0 0 0 0
0
137 steril Pcs 140 200 200 340 300
40
138 Spoit 0,5 ml Pcs 200 0 200 0 200
139 Spoit 1 ml Pcs 320 100 100 420 100 320
140 Spoit 10 ml Pcs 150 100 100 250 50 200
141 Spoit 2,5 ml Pcs 325 0 325 25 300
142 Spoit 20 ml Pcs 0 25 25 25 0 25
143 Spoit 3 ml Pcs 0 300 300 300 0 300
144 Spoit 5 ml Pcs 185 100 100 285 285 0
145 Spoit 50 ml Pcs 0 15 15 15 0 15

0
155 Uniflex 10 cm x 4,5 cm Roll 0 1 1 1 0 1
156 Uniflex 15 cm x 4,5 cm Roll 0 1 1 1 0 1
157 Uniflex 7,5 cm x 4,5 cm Roll 1 1 1 2 0 2

0
159 Urine Bag Pcs 4 10 10 14 0 14

0
162 Darah Pcs 1 0 1 1
0
0
PROGRAM TB
2 OAT Kategori I Paket 3 18 18 21 6 15
5 Pot Dahak Pot 690 0 690 30 660
7 Slide Pcs 0 0 0 0 0
PROGRAM KECACINGAN
1 Albendazole tab Tablet 3,600 0 3,600 3600 0
PROGRAM DIARE
1 Oralit Sach 3,400 0 3,400 50 3,350
2 Zink 20 mg Tablet 2,500 0 2,500 200 2,300
PROGRAM MALARIA
PROGRAM HIV
PROGRAM IMUNISASI
5 Vaksin HB0 Vial 100 0 100 20 80
9 Solosot 0,05 Pcs 300 0 300 13 287
10 Solosot 0,5 ml Pcs 2,000 0 2,000 641 1,359
11 Solosot 5 ml Pcs 100 0 100 14 86
PROGRAM GIZI
2 Tablet Tambah Darah Tablet 17,194 3,930 3,930 21,124 3546 17,578
PROGRAM KIA
PROGRAM COVID-19
1 Vitamin C 500 mg Tablet 370 0 370 370 0
2 Multivitamin Zink Tablet 0 0 0 0 0
4 ADS 0,5 ml Pcs 0 0 0 0 0
5 ADS 0,3 ml Pcs 1,125 0 1,125 0 1,125
6 ADS 3 ml Pcs 0 0 0 0 0
7 APD Set Set 0 0 0 0 0
8 NaCl 0,9% Flac 0 0 0 0 0
TAMBAHAN
5 Stik HIV pcs 25 0 25 0 25

0
Kaca Helm Covid19
8 (Provinsi)
pcs 0 0 0 0
0
Baju Hazmat L, XL
0
0
Masker Bedah Karet
0
15 Aseptic Gel (Perhubungan) Botol 0 5 5 5 5

0
25 Pentolin 0 10 0 10 0 10
26 curcuma force Tablet 0 960 960 960 200 760
27 cavit D3 kapsul 1000 IU kapsul 0 900 900 900 0 900
28 ramvit c 500mg Tablet 0 3,000 3,000 3,000 0 3,000
29 caviplex 0 1,500 0 1,500 400 1,100
30 0 0 0 0 0 0
UMUM
ASKES JUMLAH
180 301 400 881

Mengetahui,
Pimpinan Puskesmas

NIP. 19670303199103 2 010 NIP. 197909182010012014
PUSKESMAS …................................................
BULAN OKTOBER
KET.

NIP. 197909182010012014
PUSKESMAS ….........................................
BULAN : NOVEMBER
TAHUN : 2022
PUSKESMAS …................................................
SATUAN
BULAN NOVEMBER
NO NAMA BARANG
TABLET
1 Alopurinol 100 mg Tablet 2,900 0 2,900 2,900

2 Alprazolam 0,25 mg Tablet 0 0 0 0
4 Alprazolam 1 mg Tablet 0 0 0 0
5 Ambroksol 30 mg Tablet 1,200 0 1,200 1,200
6 150)
Tablet 0 0 0 0
7 Aminofilin 200 mg Tablet 200 0 200 200

8 Amitriptilin 25 mg Tablet 0 0 0 0
9 Amlodipin 10 mg Tablet 0 0 0 0
11 Amoksisilin 250 mg Tablet 0 0 0 0
12 Amoksisilin 500 mg Tablet 21,500 0 21,500 21,500
13 Antasida Tablet Kunyah Tablet 25,700 0 25,700 25,700
15 (Miniaspi) Tablet 6,800 0 6,800 6,800
16 Asam Folat 1 mg Tablet 2,900 0 2,900 2,900

17 Asam Mefenamat 500 mg Tablet 25,400 0 25,400 25,400
19 Asiklovir 200 mg Tablet 0 0 0 0

22 Betahistin 6 mg Tablet 150 0 150 150

23 Bisoprolol tab 5mg Tablet 0 0 0 0
24 Deksametason 0,5 mg Tablet 0 0 0 0
25 Demacolin tab Tablet 0 0 0 0
26 Diazepam 2 mg Tablet 57 0 57 57
28 Dietilkarbamazin 100mg Tablet 0 0 0 0
30 Dimenhidrinat 50 mg Tablet 0 0 0 0
31 Doksisiklin 100 mg Kapsul 0 0 0 0
32 Domperidon 10mg Tablet 200 0 200 200
33 Efedrin Hcl tab 25 mg Tablet 0 0 0 0
34 50 mg Tablet 0 0 0 0
35 Eritromisin 250 mg Kapsul 0 0 0 0

36 Eritromisin500 mg Kapsul 0 0 0 0
37 Fenitoin 100 mg Kapsul 0 0 0 0
38 Fenitoin 30 mg Tablet 0 0 0 0
39 Fenobarbital 30 mg Tablet 105 0 105 105
40 Furosemid 40 mg Tablet 800 0 800 800
41 Glibenklamid 2,5 mg Tablet 0 0 0 0
42 Glibenklamid 5 mg Tablet 7,200 0 7,200 7,200


45 Glimepirid 1 mg Tablet 0 0 0 0
46 Glimepirid 2 mg Tablet 1,550 0 1,550 1,550
48 Glimipirid tablet 4mg Tablet 0 0 0 0
49 Griseofulvin 125 mg Tablet 600 0 600 600
51 Guaifenisin / GG Tablet 10,100 0 10,100 10,100
52 Haloperidol 0,5 mg Tablet 0 0 0 0
Haloperidol 2 mg
56 Hidroklortiazid 25 mg Tablet 600 0 600 600
57 Ibuprofen 200 mg Tablet 0 0 0 0
58 Ibuprofen 400 mg Tablet 2,800 0 2,800 2,800
59 Isoniazid 300 mg Tablet 0 0 0 0
60 Isosorbid Dinitrat 5 mg Tablet 0 0 0 0
61 600mg) Tablet 0 0 0 0
62 Kalsitriol (Oscal) Tablet 0 0 0 0

64 Kalsium Laktat 500 mg Tablet 900 0 900 900

65 Kandesartan 8 mg Tablet 70 0 70 70
66 Kaptopril 12,5 mg Tablet 3,300 0 3,300 3,300
67 Kaptopril 25 mg Tablet 200 0 200 200
68 Karbamazepin 200 mg Tablet 200 0 200 200
69 Ketokonazol 200 mg Tablet 2,200 0 2,200 2,200
70 Kloramfenikol 250mg Kapsul 0 0 0 0
73 Klorpromazin 100 mg Tablet 0 0 0 0

74 Klopidogrel 300 mg Tablet 0 0 0 0
76 Klindamisin 300 mg Tablet 0 0 0 0
77 Kodein 10 mg Tablet 0 0 0 0
80 Kotrimoksazol 400/80mg Tablet 6,900 0 6,900 6,900
81 Levofloksasin 500mg Tablet 0 0 0 0
82 mg) Tablet 0 0 0 0
83 Lansoprazol 30 mg Tablet 0 0 0 0
84 Loratadin 10 mg Tablet 1,800 0 1,800 1,800
85 Lorazepam 2mg Tablet 0 0 0 0
10mg)
100mg)
88 Meloksikam 15mg tab Tablet 0 0 0 0
89 Metformin 500 mg Tablet 3,200 0 3,200 3,200
90 Metformin 850 mg Tablet 0 0 0 0
Metildopa 250 mg

92 mg Tablet 300 0 300 300
94 Metilprednisolon 4 mg Tablet 3,700 0 3,700 3,700
95 Metoklopramid 10 mg Tablet 800 0 800 800
97 Metronidazol 500 mg Tablet 2,100 0 2,100 2,100
98 N-Asetil Sistein 200 mg Tablet 200 0 200 200

102 Nifedipin 20 mg Tablet 0 0 0 0
106 Noretisterone 5mg Tablet 0 0 0 0

107 Ofloksasin 200 mg Tablet 0 0 0 0
109 Omeprazol 20 mg Kapsul 3,000 0 3,000 3,000
110 Ondansetron 4 mg Tablet 0 0 0 0
112 Parasetamol 500 mg Tablet 13,800 0 13,800 13,800
113 Pil KB Oral Kombinasi siklus 0 0 0 0
116 Piroksikam 20 mg tab Tablet 0 0 0 0

117 Prednison 5 mg Tablet 3,400 0 3,400 3,400
120 Ranitidin 150 mg Tablet 100 0 100 100
121 Risperidon 1 mg Tablet 0 0 0 0
Rivaroksaban 20 mg

124 Salbutamol 2mg Tablet 1,000 0 1,000 1,000
125 Sefadroksil 500 mg Kapsul 0 0 0 0
126 Sefiksim 200 mg Tablet 0 0 0 0
127 Setirizin 10 mg Tablet 200 0 200 200
128 Simetidin 200mg Tablet 0 0 0 0
129 Simvastatin 10 mg Tablet 2,500 0 2,500 2,500
131 Siprofloksasin 500 mg Tablet 0 0 0 0
132 Spironolakton 100 mg Tablet 0 0 0 0
Teofilin 150 mg
135 Tetrasiklin 500 mg Kapsul 0 0 0 0

138 Triheksifenidil 2mg Tablet 0 0 0 0

139 Trifluoperazine 5 mg 100 0 100 100
140 Vitamin B kompleks Tablet 0 0 0 0
142 mg Tablet 2,500 0 2,500 2,500
Vitamin B12
143 (Sianokobalamin) 50mcg Tablet 2,000 0 2,000 2,000

144 50mg Tablet 7,100 0 7,100 7,100
145 10 mg Tablet 0 0 0 0

SIRUP
147 Ambroksol Sirup Botol 0 0 0 0
148 mg/5mL Botol 130 0 130 130

149 mg/5mL Botol 0 0 0 0
150 Antasida Suspensi Botol 100 0 100 100
Domperidon Sirup
152 5mg/5mL Botol 40 0 40 40

153 200mg/5mL Botol 0 0 0 0
Ibuprofen Suspensi
154 100mg/5 mL Botol 0 0 0 0
Ibuprofen Suspensi
155 200mg/5 mL Botol 40 0 40 40
157 200/40mg Botol 0 0 0 0
Laktulosa Sirup
158 3,335g/5mL Botol 0 0 0 0
Metoklopramid Sirup
Metoclopramid 10mL
161 125mg/5mL Botol 30 0 30 30
Parasetamol Drop
163 100mg/mL Botol 0 0 0 0
Parasetamol Sirup
164 120mg/5mL Botol 160 0 160 160

165 125mg/5mL Botol 0 0 0 0
Sefadroksil Sirup
167 125mg/5mL Botol 0 0 0 0
169 Setirizin Sirup 5mg/5mL Botol 0 0 0 0

Sukralfat Suspensi
170 500mg/5mL Botol 0 0 0 0
171 Zink Pro 10 mg/mL Botol 0 0 0 0

172 Zink syrup 20 mg/5 mL Botol 0 0 0 0
CAIRAN INFUS
Antibakteri Doen
174 Air Untuk Injeksi 25 ml Flac 0 0 0 0

Albumin 25%-100ml
Albumin 5%-250 ml

178 Aminofilin inj 24 mg/mL Ampul 0 0 0 0

179 Amiodaron inj. 50mg/mL Ampul 0 0 0 0
180 Antifungi salep Tube 24 0 24 24
181 2 gr 0 0 0 0

182 mg/mL 0 0 0 0

183 50mg/mL Ampul 0 0 0 0
184 Asiklovir krim 5% Tube 0 0 0 0

185 Asiklovir SM 3% (Lacyvir) Tube 0 0 0 0
186 Atropin inj 0,25 mg/mL Ampul 0 0 0 0
187 Bedak Salisil 2% Pot 0 0 0 0
188 IU/mL Vial 0 0 0 0

189 IU/mL Vial 0 0 0 0
Betametason 0,05%
191 Betametason Krim 0,1% Tube 30 0 30 30

192 Krim 0,05% Tube 0 0 0 0
Bisakodil Supp 5 mg
195 Citikolin inj Ampul 0 0 0 0

199 Diazepam inj 5 mg Rectal 0 0 0 0

Diazepam Enema 10


10mg/mL
203 ml (50mg/mL) Ampul 0 0 0 0
204 12,5 mg/mL Ampul 0 0 0 0
206 Efedrin inj 50 mg/mL Ampul 0 0 0 0

207 1mg/mL Ampul 0 0 0 0
209 Eugenol cairan Botol 0 0 0 0

210 Etil klorida spray Botol 0 0 0 0
211 Fenitoin inj. 50 mg/mL Ampul 0 0 0 0

214 Fentanil inj 0,0785mg Ampul 0 0 0 0

215 0,025% (Dermasolon) Tube 4 0 4 4
216 Furosemid inj 10 mg/mL Ampul 0 0 0 0

218 Gentamisin inj Ampul 0 0 0 0
221 Human Albumin 5% 50ml Botol 0 0 0 0

222 Hidrokortison krim 2,5% Tube 336 0 336 336
0,5ml)
Insulin Long Acting

227 0,025% 20 mcg/puff Botol 0 0 0 0
(Atrovent)
229 KA EN 1B, larutan infus Flac 0 0 0 0

230 KA EN 3A, larutan infus Flac 0 0 0 0
231 KAEN 3B larutan infus Flac 0 0 0 0
232 KAEN MG, Larutan Infus Flac 0 0 0 0
233 Kalium Klorida (KCL) Inj. Flac 0 0 0 0

236 1% Tube 0 0 0 0


240 Ketokonazol krim 2% Tube 0 0 0 0

242 Ketorolak inj. 30 mg/mL Ampul 50 0 50 50

243 Lansoprazole 30mg inj Vial 0 0 0 0
244 Lidocain inj 2% Ampul 190 0 190 190

(Deponeo)
249 Metilergometrin inj. Ampul 70 0 70 70
250 500mg Vial 0 0 0 0

251 125 mg Vial 0 0 0 0
Metronidazol infus
252 5mg/mL Botol 1 0 1 1
253 Mikonazol krim 2% Tube 0 0 0 0
255 Neurobion inj Ampul 0 0 0 0

256 Nikardipin Inj. 1mg/mL Ampul 0 0 0 0
257 (Iliadin 0,05%) Botol 0 0 0 0
258 Oksitetrasiklin SM 1% Tube 0 0 0 0

259 Ondansetron inj. 4mg Ampul 15 0 15 15
260 Omeprazol inj. 40mg Ampul 0 0 0 0
261 Oksitosin inj 10 IU/mL Ampul 65 0 65 65
262 mg/mL Botol 0 0 0 0
263 Perak Sulfadiazin Krim Tube 2 0 2 2

264 Ranitidin inj 25 mg/mL Ampul 15 0 15 15
265 Ringer Lactat, larutan infus Flac 90 0 90 90
267 Salep 2-4 Pot 192 0 192 192

268 Sefotaksim inj. 1000 mg Vial 30 0 30 30
269 Seftriakson inj. 1000 mg Vial 48 0 48 48
272 Streptomisin inj 1 gr Vial 0 0 0 0

273 Tramadol inj. 50 mg/mL Ampul 0 0 0 0
274 Vaksin Rabies (Verorab) Vial 0 0 0 0
Vitamin B12
500mcg/mL
276 100mg Ampul 0 0 0 0
1 Abbocath no. 18 Pcs 557 0 557 557
2 Abbocath no. 20 Pcs 375 0 375 375
3 Abbocath no. 22 Pcs 243 0 243 243
4 Abbocath no. 24 Pcs 66 0 66 66
5 Abbocath no. 26 Pcs 115 0 115 115
6 Alkohol 70% 1 liter Botol 67 0 67 67
7 Alkohol 70% 300ml Botol 10 0 10 10

9 Alkohol Swab Pcs 2,100 0 2,100 2,100
10 Arm Sling L Pcs 10 0 10 10
11 Arm Sling M Pcs 12 0 12 12
12 Arm Sling S Pcs 18 0 18 18
14 Autoclick Lancing Device Pcs 0 0 0 0

15 Blood Lancet Pcs 3,300 0 3,300 3,300
16 Blood Transfusion Set Pcs 0 0 0 0
17 Catgut no 2/0 Pcs 0 0 0 0
18 Catgut no 3/0 Pcs 0 0 0 0
19 40mm CG278 Pcs 0 0 0 0

20 36mm CG228 Pcs 0 0 0 0

21 45 mm CG209 Pcs 0 0 0 0

22 90 mm CG315 Pcs 0 0 0 0

23 26 mm CG296 Pcs 0 0 0 0
24 Catgut Chromic 3/0 Pcs 0 0 0 0

25 mm, 75 cm CG342 Pcs 0 0 0 0

26 mm, 75 cm CG344 Pcs 0 0 0 0

27 mm, 75 cm CG366 Pcs 0 0 0 0

28 mm, 75 cm CG372 Pcs 0 0 0 0

29 cm PG132 Pcs 0 0 0 0

30 1/2mayo, 30 mm PG114 Pcs 0 0 0 0


33 75 cm PG142 Pcs 0 0 0 0

34 75 cm PG146 Pcs 0 0 0 0
35 Catgut Plain 3/0 Pcs 0 0 0 0

38 75 cm PG168-1 Pcs 0 0 0 0

39 75 cm PG174 Pcs 288 0 288 288
41 Cervical Collar Pcs 8 0 8 8

44 Dermavix T 10 x 15 cm Pcs 30 0 30 30
47 Dermavix t 5 x 7 cm Pcs 102 0 102 102
48 Ecodine 1 liter Botol 0 0 0 0
49 Feeding Tube 5FR 100 cm Pcs 0 0 0 0
51 Fetal Doppler Pcs 0 0 0 0
52 12 (Urocare) Pcs 0 0 0 0

53 14 (Urocare) Pcs 0 0 0 0

54 16 (Urocare) Pcs 5 0 5 5

55 18 (Urocare) Pcs 7 0 7 7

56 20 (Urocare) Pcs 0 0 0 0

57 22 (Urocare) Pcs 13 0 13 13

58 24 (Urocare) Pcs 0 0 0 0

64 10 Pcs 2 0 2 2
Handscum (Surgical
67 Gloves) No. 6,5 Pasang 50 0 50 50
Handscum (Surgical
Handscum (Surgical
69 Gloves) No. 7,5 Pasang 50 0 50 50
70 Handsanitizer Botol 0 0 0 0
71 Infus Set Anak Pcs 66 0 66 66
75 Kapas 100 g Roll 0 0 0 0

78 Kapas pembalut 250 gr Roll 1 0 1 1

85 Leukoplast 2,5 x 4,5 Roll 52 0 52 52
87 Lysol 1 L Botol 0 0 0 0
88 Masker N95 Pcs 110 0 110 110
90 Masker Surgical 3 Ply Pcs 1,020 0 1,020 1,020

91 L Pasang 300 0 300 300

92 M Pasang 300 0 300 300

93 S Pasang 100 0 100 100


95 14/200 Pcs 0 0 0 0

96 16/200 Pcs 0 0 0 0

97 18/200 Pcs 0 0 0 0

98 20/200 Pcs 0 0 0 0

99 22/100 Pcs 0 0 0 0

100 24/100 Pcs 0 0 0 0

101 Ch 10 Pcs 0 0 0 0

102 Ch 6 Pcs 0 0 0 0
103 Nurse Cup 200 0 200 200

104 Oxyflow Anak Pcs 3 0 3 3
105 Oxyflow Dewasa Pcs 4 0 4 4
107 Plesterin Elastis Pcs 2,400 0 2,400 2,400
108 Plesterin Elastis Jumbo Pcs 6,200 0 6,200 6,200
109 cm x 5 m Roll 29 0 29 29

110 cm x 5 m Roll 0 0 0 0

111 x 5 m Roll 20 0 20 20
112 Pot Dahak Pcs 660 0 660 660

116 PV830 Pcs 0 0 0 0

117 PV856 Pcs 0 0 0 0
118 PV888 Pcs 0 0 0 0

119 PV894 Pcs 0 0 0 0
120 Rivanol 300 cc Botol 24 0 24 24

121 Safe Glove Surgical 6 ½ Pasang 0 0 0 0
122 Safe Glove Surgical 7 Pasang 0 0 0 0
125 Sarung Tangan Obgyn Pasang 60 0 60 60
126 Shoe Cover Pasang 64 0 64 64
127 cm BS636 Pcs 0 0 0 0

128 cm BS640-1 Pcs 0 0 0 0

131 cm BS668 Pcs 0 0 0 0

132 mm BS656-1 Pcs 144 0 144 144

133 cm BS695 Pcs 0 0 0 0
134 Silk Braided 2/0 Pcs 7 0 7 7

136 30 mm Pcs 0 0 0 0
137 steril Pcs 300 0 300 300
138 Spoit 0,5 ml Pcs 200 0 200 200

139 Spoit 1 ml Pcs 320 0 320 320
140 Spoit 10 ml Pcs 200 0 200 200
141 Spoit 2,5 ml Pcs 300 0 300 300
142 Spoit 20 ml Pcs 25 0 25 25
143 Spoit 3 ml Pcs 300 0 300 300
144 Spoit 5 ml Pcs 0 0 0 0
145 Spoit 50 ml Pcs 15 0 15 15

153 Ultrasonic Gel 250 ml Botol 0 0 0 0
154 Ultra One Tes Kehamilan Pcs 118 0 118 118
155 Uniflex 10 cm x 4,5 cm Roll 1 0 1 1
157 Uniflex 7,5 cm x 4,5 cm Roll 2 0 2 2

159 Urine Bag Pcs 14 0 14 14

160 Wing Needle no. 21 G Pcs 10 0 10 10

162 Darah Pcs 1 0 1 1
PROGRAM TB
2 OAT Kategori I Paket 15 0 15 15
5 Pot Dahak Pot 660 0 660 660
7 Slide Pcs 0 0 0 0
PROGRAM KECACINGAN
PROGRAM DIARE
1 Oralit Sach 3,350 0 3,350 3,350
2 Zink 20 mg Tablet 2,300 0 2,300 2,300
PROGRAM MALARIA
2 DHP Primal Tablet 0 0 0 0
4 Primaquin Tablet 0 0 0 0
PROGRAM HIV
PROGRAM IMUNISASI
9 Solosot 0,05 Pcs 287 0 287 287
10 Solosot 0,5 ml Pcs 1,359 0 1,359 1,359
PROGRAM GIZI
PROGRAM KIA
PROGRAM COVID-19
1 Vitamin C 500 mg Tablet 0 0 0 0
2 Multivitamin Zink Tablet 0 0 0 0
3 Alkohol Swab Pcs 0 0 0 0
4 ADS 0,5 ml Pcs 0 0 0 0
5 ADS 0,3 ml Pcs 1,125 0 1,125 1,125
6 ADS 3 ml Pcs 0 0 0 0
8 NaCl 0,9% Flac 0 0 0 0
TAMBAHAN

Kaca Helm Covid19
8 (Provinsi)
pcs 0 0 0 0

Baju Hazmat L, XL
Masker Bedah Karet


25 Pentolin 0 10 0 10 10
28 ramvit c 500mg Tablet 3,000 0 3,000 3,000
29 caviplex 0 1,100 0 1,100 1,100
30 0 0 0 0 0 0
UMUM
ASKES JUMLAH
0

Mengetahui,
Pimpinan Puskesmas
(………………………………………….) (………………………………………….)
NIP. NIP.
PUSKESMAS …................................................
BULAN NOVEMBER
KET.
(………………………………………….)
NIP.
PUSKESMAS ….........................................
BULAN : DESEMBER
TAHUN : 2022
PUSKESMAS …................................................
SATUAN
BULAN DESEMBER
NO NAMA BARANG
TABLET
1 Alopurinol 100 mg Tablet 2,900 0 2,900 2,900

4 Alprazolam 1 mg Tablet 0 0 0 0
5 Ambroksol 30 mg Tablet 1,200 0 1,200 1,200
6 150)
Tablet 0 0 0 0
7 Aminofilin 200 mg Tablet 200 0 200 200

8 Amitriptilin 25 mg Tablet 0 0 0 0
11 Amoksisilin 250 mg Tablet 0 0 0 0
12 Amoksisilin 500 mg Tablet 21,500 0 21,500 21,500
13 Antasida Tablet Kunyah Tablet 25,700 0 25,700 25,700
15 (Miniaspi) Tablet 6,800 0 6,800 6,800
16 Asam Folat 1 mg Tablet 2,900 0 2,900 2,900

17 Asam Mefenamat 500 mg Tablet 25,400 0 25,400 25,400

22 Betahistin 6 mg Tablet 150 0 150 150

23 Bisoprolol tab 5mg Tablet 0 0 0 0
24 Deksametason 0,5 mg Tablet 0 0 0 0
25 Demacolin tab Tablet 0 0 0 0
28 Dietilkarbamazin 100mg Tablet 0 0 0 0
30 Dimenhidrinat 50 mg Tablet 0 0 0 0
31 Doksisiklin 100 mg Kapsul 0 0 0 0
32 Domperidon 10mg Tablet 200 0 200 200
33 Efedrin Hcl tab 25 mg Tablet 0 0 0 0
34 50 mg Tablet 0 0 0 0
35 Eritromisin 250 mg Kapsul 0 0 0 0

36 Eritromisin500 mg Kapsul 0 0 0 0
37 Fenitoin 100 mg Kapsul 0 0 0 0
38 Fenitoin 30 mg Tablet 0 0 0 0
39 Fenobarbital 30 mg Tablet 105 0 105 105
40 Furosemid 40 mg Tablet 800 0 800 800
41 Glibenklamid 2,5 mg Tablet 0 0 0 0
42 Glibenklamid 5 mg Tablet 7,200 0 7,200 7,200


46 Glimepirid 2 mg Tablet 1,550 0 1,550 1,550
48 Glimipirid tablet 4mg Tablet 0 0 0 0
51 Guaifenisin / GG Tablet 10,100 0 10,100 10,100
Haloperidol 2 mg
56 Hidroklortiazid 25 mg Tablet 600 0 600 600
57 Ibuprofen 200 mg Tablet 0 0 0 0
58 Ibuprofen 400 mg Tablet 2,800 0 2,800 2,800
59 Isoniazid 300 mg Tablet 0 0 0 0
60 Isosorbid Dinitrat 5 mg Tablet 0 0 0 0
61 600mg) Tablet 0 0 0 0
62 Kalsitriol (Oscal) Tablet 0 0 0 0

64 Kalsium Laktat 500 mg Tablet 900 0 900 900

65 Kandesartan 8 mg Tablet 70 0 70 70
66 Kaptopril 12,5 mg Tablet 3,300 0 3,300 3,300
67 Kaptopril 25 mg Tablet 200 0 200 200
68 Karbamazepin 200 mg Tablet 200 0 200 200
69 Ketokonazol 200 mg Tablet 2,200 0 2,200 2,200
70 Kloramfenikol 250mg Kapsul 0 0 0 0
73 Klorpromazin 100 mg Tablet 0 0 0 0

76 Klindamisin 300 mg Tablet 0 0 0 0
80 Kotrimoksazol 400/80mg Tablet 6,900 0 6,900 6,900
81 Levofloksasin 500mg Tablet 0 0 0 0
82 mg) Tablet 0 0 0 0
83 Lansoprazol 30 mg Tablet 0 0 0 0
84 Loratadin 10 mg Tablet 1,800 0 1,800 1,800
85 Lorazepam 2mg Tablet 0 0 0 0
10mg)
100mg)
88 Meloksikam 15mg tab Tablet 0 0 0 0
89 Metformin 500 mg Tablet 3,200 0 3,200 3,200
90 Metformin 850 mg Tablet 0 0 0 0
Metildopa 250 mg

92 mg Tablet 300 0 300 300
94 Metilprednisolon 4 mg Tablet 3,700 0 3,700 3,700
95 Metoklopramid 10 mg Tablet 800 0 800 800
97 Metronidazol 500 mg Tablet 2,100 0 2,100 2,100
98 N-Asetil Sistein 200 mg Tablet 200 0 200 200

106 Noretisterone 5mg Tablet 0 0 0 0

109 Omeprazol 20 mg Kapsul 3,000 0 3,000 3,000
112 Parasetamol 500 mg Tablet 13,800 0 13,800 13,800
113 Pil KB Oral Kombinasi siklus 0 0 0 0
116 Piroksikam 20 mg tab Tablet 0 0 0 0

117 Prednison 5 mg Tablet 3,400 0 3,400 3,400
120 Ranitidin 150 mg Tablet 100 0 100 100
121 Risperidon 1 mg Tablet 0 0 0 0
Rivaroksaban 20 mg

124 Salbutamol 2mg Tablet 1,000 0 1,000 1,000
125 Sefadroksil 500 mg Kapsul 0 0 0 0
126 Sefiksim 200 mg Tablet 0 0 0 0
127 Setirizin 10 mg Tablet 200 0 200 200
128 Simetidin 200mg Tablet 0 0 0 0
131 Siprofloksasin 500 mg Tablet 0 0 0 0
Teofilin 150 mg

138 Triheksifenidil 2mg Tablet 0 0 0 0

139 Trifluoperazine 5 mg 100 0 100 100
140 Vitamin B kompleks Tablet 0 0 0 0
142 mg Tablet 2,500 0 2,500 2,500
Vitamin B12
143 (Sianokobalamin) 50mcg Tablet 2,000 0 2,000 2,000

144 50mg Tablet 7,100 0 7,100 7,100
145 10 mg Tablet 0 0 0 0

SIRUP
147 Ambroksol Sirup Botol 0 0 0 0
148 mg/5mL Botol 130 0 130 130

149 mg/5mL Botol 0 0 0 0
150 Antasida Suspensi Botol 100 0 100 100
Domperidon Sirup
152 5mg/5mL Botol 40 0 40 40

153 200mg/5mL Botol 0 0 0 0
Ibuprofen Suspensi
154 100mg/5 mL Botol 0 0 0 0
Ibuprofen Suspensi
155 200mg/5 mL Botol 40 0 40 40
157 200/40mg Botol 0 0 0 0
Laktulosa Sirup
158 3,335g/5mL Botol 0 0 0 0
Metoklopramid Sirup
Metoclopramid 10mL
161 125mg/5mL Botol 30 0 30 30
Parasetamol Drop
163 100mg/mL Botol 0 0 0 0
Parasetamol Sirup
164 120mg/5mL Botol 160 0 160 160

165 125mg/5mL Botol 0 0 0 0
Sefadroksil Sirup
167 125mg/5mL Botol 0 0 0 0
169 Setirizin Sirup 5mg/5mL Botol 0 0 0 0

Sukralfat Suspensi
170 500mg/5mL Botol 0 0 0 0
171 Zink Pro 10 mg/mL Botol 0 0 0 0

172 Zink syrup 20 mg/5 mL Botol 0 0 0 0
CAIRAN INFUS
Antibakteri Doen
174 Air Untuk Injeksi 25 ml Flac 0 0 0 0

Albumin 25%-100ml
Albumin 5%-250 ml

178 Aminofilin inj 24 mg/mL Ampul 0 0 0 0

179 Amiodaron inj. 50mg/mL Ampul 0 0 0 0
180 Antifungi salep Tube 24 0 24 24
181 2 gr 0 0 0 0

182 mg/mL 0 0 0 0

183 50mg/mL Ampul 0 0 0 0
184 Asiklovir krim 5% Tube 0 0 0 0

185 Asiklovir SM 3% (Lacyvir) Tube 0 0 0 0
186 Atropin inj 0,25 mg/mL Ampul 0 0 0 0
187 Bedak Salisil 2% Pot 0 0 0 0
188 IU/mL Vial 0 0 0 0

189 IU/mL Vial 0 0 0 0
Betametason 0,05%
191 Betametason Krim 0,1% Tube 30 0 30 30

192 Krim 0,05% Tube 0 0 0 0
Bisakodil Supp 5 mg
195 Citikolin inj Ampul 0 0 0 0

199 Diazepam inj 5 mg Rectal 0 0 0 0

Diazepam Enema 10


10mg/mL
203 ml (50mg/mL) Ampul 0 0 0 0
204 12,5 mg/mL Ampul 0 0 0 0
206 Efedrin inj 50 mg/mL Ampul 0 0 0 0

207 1mg/mL Ampul 0 0 0 0
209 Eugenol cairan Botol 0 0 0 0

210 Etil klorida spray Botol 0 0 0 0
211 Fenitoin inj. 50 mg/mL Ampul 0 0 0 0

214 Fentanil inj 0,0785mg Ampul 0 0 0 0

215 0,025% (Dermasolon) Tube 4 0 4 4
216 Furosemid inj 10 mg/mL Ampul 0 0 0 0

218 Gentamisin inj Ampul 0 0 0 0
221 Human Albumin 5% 50ml Botol 0 0 0 0

222 Hidrokortison krim 2,5% Tube 336 0 336 336
0,5ml)
Insulin Long Acting

227 0,025% 20 mcg/puff Botol 0 0 0 0
(Atrovent)
229 KA EN 1B, larutan infus Flac 0 0 0 0

230 KA EN 3A, larutan infus Flac 0 0 0 0
231 KAEN 3B larutan infus Flac 0 0 0 0
232 KAEN MG, Larutan Infus Flac 0 0 0 0
233 Kalium Klorida (KCL) Inj. Flac 0 0 0 0

236 1% Tube 0 0 0 0


240 Ketokonazol krim 2% Tube 0 0 0 0

242 Ketorolak inj. 30 mg/mL Ampul 50 0 50 50

243 Lansoprazole 30mg inj Vial 0 0 0 0
244 Lidocain inj 2% Ampul 190 0 190 190

(Deponeo)
249 Metilergometrin inj. Ampul 70 0 70 70
250 500mg Vial 0 0 0 0

251 125 mg Vial 0 0 0 0
Metronidazol infus
252 5mg/mL Botol 1 0 1 1
253 Mikonazol krim 2% Tube 0 0 0 0
255 Neurobion inj Ampul 0 0 0 0

256 Nikardipin Inj. 1mg/mL Ampul 0 0 0 0
257 (Iliadin 0,05%) Botol 0 0 0 0
258 Oksitetrasiklin SM 1% Tube 0 0 0 0

259 Ondansetron inj. 4mg Ampul 15 0 15 15
260 Omeprazol inj. 40mg Ampul 0 0 0 0
261 Oksitosin inj 10 IU/mL Ampul 65 0 65 65
262 mg/mL Botol 0 0 0 0
263 Perak Sulfadiazin Krim Tube 2 0 2 2

264 Ranitidin inj 25 mg/mL Ampul 15 0 15 15
265 Ringer Lactat, larutan infus Flac 90 0 90 90
267 Salep 2-4 Pot 192 0 192 192

268 Sefotaksim inj. 1000 mg Vial 30 0 30 30
269 Seftriakson inj. 1000 mg Vial 48 0 48 48
272 Streptomisin inj 1 gr Vial 0 0 0 0

273 Tramadol inj. 50 mg/mL Ampul 0 0 0 0
274 Vaksin Rabies (Verorab) Vial 0 0 0 0
Vitamin B12
500mcg/mL
276 100mg Ampul 0 0 0 0
1 Abbocath no. 18 Pcs 557 0 557 557
2 Abbocath no. 20 Pcs 375 0 375 375
3 Abbocath no. 22 Pcs 243 0 243 243
4 Abbocath no. 24 Pcs 66 0 66 66
5 Abbocath no. 26 Pcs 115 0 115 115
6 Alkohol 70% 1 liter Botol 67 0 67 67
7 Alkohol 70% 300ml Botol 10 0 10 10

9 Alkohol Swab Pcs 2,100 0 2,100 2,100
10 Arm Sling L Pcs 10 0 10 10
11 Arm Sling M Pcs 12 0 12 12
12 Arm Sling S Pcs 18 0 18 18
14 Autoclick Lancing Device Pcs 0 0 0 0

15 Blood Lancet Pcs 3,300 0 3,300 3,300
16 Blood Transfusion Set Pcs 0 0 0 0
17 Catgut no 2/0 Pcs 0 0 0 0
18 Catgut no 3/0 Pcs 0 0 0 0
19 40mm CG278 Pcs 0 0 0 0

20 36mm CG228 Pcs 0 0 0 0

21 45 mm CG209 Pcs 0 0 0 0

22 90 mm CG315 Pcs 0 0 0 0

23 26 mm CG296 Pcs 0 0 0 0
24 Catgut Chromic 3/0 Pcs 0 0 0 0

25 mm, 75 cm CG342 Pcs 0 0 0 0

26 mm, 75 cm CG344 Pcs 0 0 0 0

27 mm, 75 cm CG366 Pcs 0 0 0 0

28 mm, 75 cm CG372 Pcs 0 0 0 0

29 cm PG132 Pcs 0 0 0 0

30 1/2mayo, 30 mm PG114 Pcs 0 0 0 0


33 75 cm PG142 Pcs 0 0 0 0

34 75 cm PG146 Pcs 0 0 0 0
35 Catgut Plain 3/0 Pcs 0 0 0 0

38 75 cm PG168-1 Pcs 0 0 0 0

39 75 cm PG174 Pcs 288 0 288 288
41 Cervical Collar Pcs 8 0 8 8

47 Dermavix t 5 x 7 cm Pcs 102 0 102 102
48 Ecodine 1 liter Botol 0 0 0 0
51 Fetal Doppler Pcs 0 0 0 0
52 12 (Urocare) Pcs 0 0 0 0

53 14 (Urocare) Pcs 0 0 0 0

54 16 (Urocare) Pcs 5 0 5 5

55 18 (Urocare) Pcs 7 0 7 7

56 20 (Urocare) Pcs 0 0 0 0

57 22 (Urocare) Pcs 13 0 13 13

58 24 (Urocare) Pcs 0 0 0 0

64 10 Pcs 2 0 2 2
Handscum (Surgical
67 Gloves) No. 6,5 Pasang 50 0 50 50
Handscum (Surgical
Handscum (Surgical
69 Gloves) No. 7,5 Pasang 50 0 50 50
70 Handsanitizer Botol 0 0 0 0
71 Infus Set Anak Pcs 66 0 66 66
75 Kapas 100 g Roll 0 0 0 0

78 Kapas pembalut 250 gr Roll 1 0 1 1

87 Lysol 1 L Botol 0 0 0 0
88 Masker N95 Pcs 110 0 110 110
90 Masker Surgical 3 Ply Pcs 1,020 0 1,020 1,020

91 L Pasang 300 0 300 300

92 M Pasang 300 0 300 300

93 S Pasang 100 0 100 100


95 14/200 Pcs 0 0 0 0

96 16/200 Pcs 0 0 0 0

97 18/200 Pcs 0 0 0 0

98 20/200 Pcs 0 0 0 0

99 22/100 Pcs 0 0 0 0

100 24/100 Pcs 0 0 0 0

101 Ch 10 Pcs 0 0 0 0

102 Ch 6 Pcs 0 0 0 0
103 Nurse Cup 200 0 200 200

104 Oxyflow Anak Pcs 3 0 3 3
105 Oxyflow Dewasa Pcs 4 0 4 4
107 Plesterin Elastis Pcs 2,400 0 2,400 2,400
108 Plesterin Elastis Jumbo Pcs 6,200 0 6,200 6,200
109 cm x 5 m Roll 29 0 29 29

110 cm x 5 m Roll 0 0 0 0

111 x 5 m Roll 20 0 20 20
112 Pot Dahak Pcs 660 0 660 660

116 PV830 Pcs 0 0 0 0

117 PV856 Pcs 0 0 0 0
118 PV888 Pcs 0 0 0 0

119 PV894 Pcs 0 0 0 0
120 Rivanol 300 cc Botol 24 0 24 24

125 Sarung Tangan Obgyn Pasang 60 0 60 60
126 Shoe Cover Pasang 64 0 64 64
127 cm BS636 Pcs 0 0 0 0

128 cm BS640-1 Pcs 0 0 0 0

131 cm BS668 Pcs 0 0 0 0

132 mm BS656-1 Pcs 144 0 144 144

133 cm BS695 Pcs 0 0 0 0

136 30 mm Pcs 0 0 0 0
137 steril Pcs 300 0 300 300
138 Spoit 0,5 ml Pcs 200 0 200 200

139 Spoit 1 ml Pcs 320 0 320 320
140 Spoit 10 ml Pcs 200 0 200 200
141 Spoit 2,5 ml Pcs 300 0 300 300
142 Spoit 20 ml Pcs 25 0 25 25
143 Spoit 3 ml Pcs 300 0 300 300
144 Spoit 5 ml Pcs 0 0 0 0
145 Spoit 50 ml Pcs 15 0 15 15

153 Ultrasonic Gel 250 ml Botol 0 0 0 0
154 Ultra One Tes Kehamilan Pcs 118 0 118 118
157 Uniflex 7,5 cm x 4,5 cm Roll 2 0 2 2

159 Urine Bag Pcs 14 0 14 14

160 Wing Needle no. 21 G Pcs 10 0 10 10

162 Darah Pcs 1 0 1 1
PROGRAM TB
2 OAT Kategori I Paket 15 0 15 15
5 Pot Dahak Pot 660 0 660 660
7 Slide Pcs 0 0 0 0
PROGRAM KECACINGAN
PROGRAM DIARE
1 Oralit Sach 3,350 0 3,350 3,350
2 Zink 20 mg Tablet 2,300 0 2,300 2,300
PROGRAM MALARIA
2 DHP Primal Tablet 0 0 0 0
4 Primaquin Tablet 0 0 0 0
PROGRAM HIV
PROGRAM IMUNISASI
9 Solosot 0,05 Pcs 287 0 287 287
10 Solosot 0,5 ml Pcs 1,359 0 1,359 1,359
PROGRAM GIZI
PROGRAM KIA
PROGRAM COVID-19
1 Vitamin C 500 mg Tablet 0 0 0 0
2 Multivitamin Zink Tablet 0 0 0 0
3 Alkohol Swab Pcs 0 0 0 0
4 ADS 0,5 ml Pcs 0 0 0 0
5 ADS 0,3 ml Pcs 1,125 0 1,125 1,125
6 ADS 3 ml Pcs 0 0 0 0
8 NaCl 0,9% Flac 0 0 0 0
TAMBAHAN

Kaca Helm Covid19
8 (Provinsi)
pcs 0 0 0 0

Baju Hazmat L, XL
Masker Bedah Karet


25 Pentolin 0 10 0 10 10
28 ramvit c 500mg Tablet 3,000 0 3,000 3,000
29 caviplex 0 1,100 0 1,100 1,100
30 0 0 0 0 0 0
UMUM
ASKES JUMLAH
0

Mengetahui,
Pimpinan Puskesmas
(………………………………………….) (………………………………………….)
NIP. NIP.
PUSKESMAS …................................................
BULAN DESEMBER
KET.
(………………………………………….)
NIP.

Lplpo PKM Hila Bulan Oktober Tahun 2022

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Lplpo PKM Hila Bulan Oktober Tahun 2022

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LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

PUSKESMAS PERAWATAN HILA

PUSKESMAS PERAWATAN HILA

1 Alopurinol 100 mg Tablet 2,300 0 2,300 0 2,300

21 Atenolol 100 mg (Betablok) Tablet 0 0 0 0

Gliklazid tab lepas lambat

Gliklazid tab lepas lambat

99 Natrium diklofenak 25mg Tablet 0 0 0 0

104 Nistatin Vaginal 100.000IU Tablet 155 0 155 155

141 Vitamin B1 (Tiamin) 50mg Tablet 7,600 0 7,600 7,100

151 Domperidon drop 5mg/mL Botol 0 0 0 0

196 Deksametason inj 5mg/mL Ampul 100 0 100 90

212 Fenobarbital inj. 50mg/mL Ampul 0 0 0 0

Flusinolon asetonid salep

219 Glukosa 5% larutan infus Botol 53 0 53 53

234 Kalsium Glukonat inj. 10% Ampul 3 0 3 3

245 Lidokain inj 2% + Epinefrin Ampul 70 0 70 30

254 NaCl 0,9%, larutan infus Flac 80 0 80 60

271 Siprofloksasin inf. 2mg/mL Botol 0 0 0 0

13 Aseptik 500 cc + dispenser Botol 14 0 14 11

36 Catgut Plain 3/0 DS 19mm Pcs 0 0 0 0

73 Jet Nebuliser Mask Anak Pcs 4 0 4 1

77 Kapas Pembalut 1000gr Roll 3 0 3 3

81 Kasa Hidrofil 4m x 5cm Roll 130 0 130 100

89 Masker Surgical (One Med) Pcs 300 0 300 0

113 Povidon Iodine 10% 60ml Botol 0 0 0 0

130 Silk Black 3/0 HR 20mm Pcs 0 0 0 0

151 Surgical Mask 3 Ply Earloop Pcs 0 0 0 0

Onemed Umbilical Cord

161 Autocheck Stick Urid acid Pcs 0 0 0 0

6 Sepatu Covid19 (Provinsi) pcs 0 0 0 0

15 Aseptic Gel (Perhubungan) Botol 0 0 0 0

Petugas Pengelola Obat

(Sisara Wakang S. KM) (Sumiati Kausaha. S.Kep Ns)

PUSKESMAS PERAWATAN HILA

(Sumiati Kausaha. S.Kep Ns)

PUSKESMAS PERAWATAN HILA

1 Alopurinol 100 mg Tablet 2,300 0 2,300 500 1,800 3000

Gliklazid tab lepas lambat

Gliklazid tab lepas lambat

104 Nistatin Vaginal 100.000IU Tablet 155 0 155 155

151 Domperidon drop 5mg/mL Botol 0 0 0 0

196 Deksametason inj 5mg/mL Ampul 90 0 90 80

212 Fenobarbital inj. 50mg/mL Ampul 0 0 0 0

Flusinolon asetonid salep

219 Glukosa 5% larutan infus Botol 53 0 53 53

234 Kalsium Glukonat inj. 10% Ampul 3 0 3 3

245 Lidokain inj 2% + Epinefrin Ampul 30 0 30 30

254 NaCl 0,9%, larutan infus Flac 60 0 60 60

271 Siprofloksasin inf. 2mg/mL Botol 0 0 0 0

7 Alkohol 70% 300ml Botol 0 0 0 0

13 Aseptik 500 cc + dispenser Botol 11 0 11 11

74 Jet Nebuliser Mask Dewasa Pcs 5 0 5 5

76 Kapas 500 gram Roll 4 0 4 4

82 Kasa Hidrofil 40m x 80cm Roll 4 0 4 4

113 Povidon Iodine 10% 60ml Botol 0 0 0 0

151 Surgical Mask 3 Ply Earloop Pcs 0 0 0 0

Onemed Umbilical Cord

161 Autocheck Stick Urid acid Pcs 0 0 0 0

6 Sepatu Covid19 (Provinsi) pcs 0 0 0 0

7 Masker N95 (Provinsi) pcs 0 0 0 0

9 Helm Covid19 (Provinsi) pcs 0 0 0 0

12 Baju Hazmat M (Provinsi) pcs 0 0 0 0