LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

(LPLPO)

KODE PUSKESMAS :
PUSKESMAS : KIRURU
DISTRIK : TELUK ETNA
KABUPATEN : KAIMANA BULAN DESEMBER
PROPINSI : PAPUA BARAT TAHUN 2018

STOK PENERI- PERSE- PEMA- SISA STOK PERMIN- PEMBERIAN KET

NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK OPT TAAN APBN APBD II ASKES JML
1 2 3 4 5 6 7 8 9 10 11 12 13 15 16
1 Acyclovir krim 5 % tube 5 gram 50 0 50 0 50 0
2 Acyclovir tablet 200 mg tablet 600 0 600 0 600 0
3 Acyclovir tablet 400 mg tablet 450 0 450 0 450 500
4 Albendazol tablet 400 mg tablet 0 0 0 0 0 0
5 Alopurinol tablet 100 mg tablet 0 3000 3000 0 3000 2000
30 Altran / Asam Mefenamat 500 mg tablet 0 0 0 0 0 0
6 Ambroxol sirup 15 mg/ml btl 60 ml 37 0 37 37 0 0
7 Ambroxol tablet 30 mg tablet 800 0 800 0 800 0
10 Aminofilin tablet 100 mg tablet 0 0 0 0 0 0
11 Aminofilina injeksi 24 mg/ml - 10 ml ampul 122 0 122 0 122 0
8 Amlodipin tablet 10 mg tablet 900 0 900 300 600 0
9 Amlodipin tablet 5 mg tablet 0 0 0 0 0 0
13 Amoksisilin kaplet 500 mg kaplet 4600 10000 14600 300 14300 0
12 Amoksisilin sirup kering 125 mg/5 ml Botol 60 ml 105 0 105 1 104 100
14 Ampicillin injeksi ampul 7 0 7 0 7 0
15 Ampicillin Tablet tablet 100 2000 2100 0 2100 0
16 Antalgin (Metampiron) tablet 500 mg tablet 0 2000 2000 0 2000 0
17 Antalgin injeksi 250 mg/ml - 2 ml ampul 70 150 220 0 220 0
18 Antasida DOEN SYR Botol 60 ml 0 0 0 0 0 0
19 Antasida DOEN tab botol/1000 0 0 0 0 0 0
20 Antasida DOEN tab ktk/100 300 2000 2300 300 2000 0
 Anti Bakteri DOEN salep kombinasi:
21 Basitrasin 500 IU/g + Polimiksin 10.000 IU/g tube 5 g 0
0 0 0 0 0
22 Anti Hemoroid Superhoid supositoria supp 78 0 78 0 78 0
24 Antifungi DOEN Pot 30 gram 168 0 168 0 168 0

23 Antifungi DOEN (Whitefield) salep kombinasi Pot 30 gram 0

0 0 0 0 0
26 Aqua pro Injeksi steril, bebas pirogen botol 0 0 0 0 0 0
25 Artesunate injeksi 8 ampul/kotak 24 0 24 0 24 0
27 Asam Askorbat (Vit C) tablet 50 mg tablet 6300 7000 13300 300 13000 0
28 Asam Folat / Profolat tablet 1200 2000 3200 0 3200 0
29 Asam mefenamat 500 mg tablet 0 0 0 0 0 0
33 Asam Traneksamat 500 mg tablet 200 0 200 0 200 0
34 Asam traneksamat inj ampul 40 0 40 0 40 0
31 Asetosal 100 mg tablet 0 0 0 0 0 500
32 Asetosal 500 mg tablet 0 0 0 0 0 500
37 Benzatin Benzi Penisillin 2,4 juta iu/vial vial 0 0 0 0 0 0
36 Benzatin Benzil Penisillin 1,2 juta iu/vial vial 8 0 8 0 8 0
38 Betahistin tablet tablet 60 0 60 30 30 900
39 Betametason krim 0.1% tube 5 gram 174 0 174 0 174 0
42 Bimatracin tablet 0 0 0 0 0 0
40 Bioplacenton jelly tube 15 gram 4 30 34 0 34 36
35 Bronkis tablet 200 5000 5200 100 5100 2000
41 Burnazin salep tube 35 g 0 0 0 0 0 0
43 Byolisin syp botol/60 ml 0 0 0 0 0 0
44 Caviplex tablet ktk/100 0 2000 2000 0 2000 5000
47 Cefixime 200 mg tablet 0 0 0 0 0 0
58 Cetirizine 10 mg kapsul 0 0 0 0 0 0
45 Chinine antipirin injeksi 2 ml ampul 0 0 0 0 0 0
46 Cimetidin tablet 200mg tablet 300 0 300 0 300 0
48 Clindamicyn 150 mg tablet 0 0 0 0 0 0
49 Clindamicyn 300 mg tablet 0 0 0 0 0 0
56 Combantrin syrup botol 10 ml 0 0 0 0 0 0
50 Combi Pack Azytro tablet 0 0 0 0 0 0
51 Combi Pack Azytro + Ceffixime tablet 0 0 0 0 0 0
52 Combi pack Paket Kusta Anak MB paket 0 0 0 0 0 0
54 Combi pack Paket Kusta Anak PB Paket 0 0 0 0 0 0
53 Combi pack Paket Kusta Dewasa MB Paket/ 6 Strip 0 0 0 0 0 0
55 Combi Pack Paket Kusta Dewasa PB Paket 0 0 0 0 0 0
57 Curcuma tablet 0 0 0 0 0 100
59 Daneuron tablet 0 1000 1000 0 1000 2000
69 Decacetine ( Chlorampenicol TTM ) btl 56 0 56 0 56 0
60 Deksametason injeksi 5 mg/ml - 1 ml ampul 271 0 271 0 271 0
61 Deksametason tablet 0,5 mg ktk/100 3400 5000 8400 0 8400 0
62 Difenhidramin HCl injeksi 10 mg/ml-1 ml ktk/30 ampul 60 0 60 0 60 0
63 Digoksin tablet 0,25 mg tablet 0 0 0 0 0 0
65 Domperidon sirup 5 mg/5 ml Botol 60 ml 316 0 316 316 0 100
64 Domperidon tablet 10 mg tablet 600 0 600 100 500 0
66 Doxyciclin kapsul 100 mg kapsul 0 0 0 0 0 0
67 Dulcolax Suppositoria 10 mg supp 0 0 0 0 0 0
68 Dulcolax Suppositoria 5 mg supp 0 0 0 0 0 100
70 Efedrin HCl tablet 25 mg btl/250 0 0 0 0 0 0
71 Epineprin inj 0 ,1 %(adrenalin) ampul 60 0 60 0 60 0
82 Ergotamine Caffeine Tablet 0 1000 1000 0 1000 0
72 Eritromicin sirop kering 200 mgl / 5ml Botol 60 ml 14 0 14 0 14 0
76 Erlamycetin Salp Mata tube 3 0 3 0 3 0
75 Erlamycetin tetes telinga 1% tube 0 72 72 0 72 0
83 Erphazone ( Phenylbutazone 200 mg ) btl/1000 0 0 0 0 0 0
73 Erytromicin kapsul 250 mg kapsul 0 0 0 0 0 0
74 Erytromicin kapsul 500 mg kapsul 600 0 600 0 600 0
80 Etakridin ( Rivanol ) larutan 0,1% Botol 300 ml 9 0 9 1 8 0
77 Etanol ( alkohol ) 70% botol 100 ml 0 15 15 0 15 0
78 Etanol ( alkohol ) 70% Botol 300 ml 0 0 0 0 0 0
79 Etanol ( alkohol ) 70% botol 1000 ml 0 5 5 0 5 0
81 Ethambutol tablet 250mg tablet 0 0 0 0 0 0
84 Ethambutol tablet 500mg tablet 0 0 0 0 0 0
85 Farmalat (Nifedipin) tablet 10 mg tablet 0 0 0 0 0 0
86 faxiden 20 mg tab tablet 0 1000 1000 0 1000 0
87 Fenilbutalson tablet 200 mg Btl/1000 0 0 0 0 0 0
88 Fenilbutalson tablet 200 mg ktk/150 0 0 0 0 0 0
89 Fenol Gliserol tetes telinga 10% botol 5 ml 0 120 120 0 120 0
91 Fermia ktk/100 0 0 0 0 0 1000
90 Ferrous Sulphate tablet 300 mg tablet 0 0 0 0 0 1000
92 Fitomenadion (Vit.K1) inj 10 mg/ml - 1 ml ampul 109 0 109 0 109 0
93 Fitomenadion (Vit.K1) tab salut gula 10 mg tablet 0 0 0 0 0 0
95 Fluconazole tablet 0 0 0 0 0 500
94 Furosemid tablet 0,5 mg tablet 100 0 100 0 100 0
96 Garam Oralit untuk 200 ml air sachet 800 0 800 0 800 500
97 Gemfibrosil kapsul 300 Mg kapsul 0 0 0 0 0 0
98 Gemfibrosil kapsul 600 Mg kapsul 300 0 300 0 300 0
100 gentalex salep kulit 0,1 % ktk/10 tube 0 36 36 0 36 72
99 Gentamicin inj 80mg/2ml ampul 50 0 50 0 50 0
101 Gentamicin salep kulit 0,1 % ktk/ 10 tube 40 0 40 0 40 300
102 Gentian Violet larutan 1 % Botol 10 ml 72 48 120 0 120 0
118 Gitarmin ( Asam Mefenamat 500 mg ) tablet 100 0 100 0 100 1000
109 Gitri sirup Botol 60 ml 0 0 0 0 0 0
104 Glibenklamid tablet 5 mg tablet 0 0 0 0 0 0
103 Glikos (Metformin 500 mg) tablet 800 0 800 100 700 0
105 Gliseril Guaiakolat tablet 100 mg tablet 800 5000 5800 200 5600 0
116 Gludepatic 500 mg tablet 400 0 400 0 400 0
106 Glukosa larutan infus 5 % steril Botol 500 ml 132 0 132 7 125 0
115 Gradilex 2 mg / Loperamid tablet 4900 0 4900 0 4900 0
113 Grafazole 500 mg tablet 0 0 0 0 0 0
117 Graseric 150 mg tablet 0 0 0 0 0 0
114 Gravalin 2 mg / Salbutamol 2 mg tablet 2500 0 2500 500 2000 2000
112 Gravask 10 mg tablet 60 0 60 0 60 0
110 Gravask 5 mg tablet 0 0 0 0 0 0
111 Gricin 500 mg tablet 600 0 600 0 600 0
107 Griseofulvin tablet 125 mg tablet 3400 0 3400 1000 2400 1000
108 Griseofulvin tablet 500 mg tablet 2500 0 2500 0 2500 2000
119 Hidroklorotiazid (HCT) tablet 25 mg tablet 300 0 300 100 200 0
120 Hidrokortison krim 2,5 % tube 5 g 72 0 72 0 72 0
122 Holimox Syp ( Amox Syp) btl / 60 ml 0 100 100 0 100 0
121 Hustab tablet 0 3600 3600 0 3600 3600
127 Ibuprofen Syp btl 5 ml 0 0 0 0 0 0
125 Ibuprofen tablet 200 mg tablet 1300 2000 3300 500 2800 0
126 Ibuprofen tablet 400 mg tablet 0 1000 1000 0 1000 0
128 Ichtiyol Salf pot 12 24 36 12 24 72
123 Ifison ( Prednisone ) tablet 0 0 0 0 0 0
129 Infantrim forte tablet 480 mg tablet 1400 0 1400 0 1400 0
133 Irgapan tablet 500 500 1000 0 1000 0
130 Isoniazid ( INH ) 100 mg tablet 0 0 0 0 0 0
131 Isoniazid ( INH ) 300 mg tablet 300 0 300 0 300 0
132 Isosorbid Dinitrat tablet sublingual 5 mg tablet 300 0 300 0 300 500
124 Itrasal Syp btl 5 ml 0 0 0 0 0 0
137 Kalium diklofenak tablet tablet 0 0 0 0 0 0
138 Kalsium Laktat (Kalk) tablet 500 mg ktk/100 0 0 0 0 0 0
139 Kalsium Laktat (Kalk) tablet 500 mg Btl/1000 6000 0 6000 1000 5000 0
140 Kanamicin inj 1 gram/vial vial 0 0 0 0 0 0
141 Kaptopril tablet 12,5 mg tablet 500 2000 2500 0 2500 0
142 Kaptopril tablet 25 mg tablet 700 2000 2700 0 2700 0
156 Katitra (Tertracycline) Kapsul 500 mg kapsul 0 0 0 0 0 0
134 Kemoren 50 mg tablet 0 0 0 0 0 0
143 Ketokonazol salep 2% tube 10 gram 100 0 100 100 0 500
144 Ketokonazol tablet 200 mg tablet 1500 0 1500 0 1500 0
145 Kina tablet salut gula ktk/24x12 0 0 0 0 0 0
146 Kloramfenikol kapsul 250 mg kapsul 0 0 0 0 0 0
148 Kloramfenikol salep kulit tube 5 mg 0 0 0 0 0 0
147 Kloramfenikol tetes telinga 3 % botol 5 ml 10 0 10 3 7 0
149 Klorampenicol salep mata 1 % tube 5 g 0 0 0 0 0 0
150 Klorampenicol tetes mata 0.5% (Reco) botol 5 ml 0 0 0 0 0 0
151 Klorfeniramin Maleat (CTM) tablet 4 mg tablet 0 5000 5000 0 5000 0
153 Kloroquine tablet 250mg tablet 400 0 400 0 400 0
152 Klorquine tablet 150 mg tablet 0 0 0 0 0 0
135 Kokodin 10 % Btl/1000 ml 0 0 0 0 0 0
136 Kokodin 10 % Btl/300 ml 0 0 0 0 0 0
155 Kokotra (Tetracycline) kapsul 250 mg kapsul 0 0 0 0 0 0
Komb Pirimetamin 25 mg + Sulfadoxin 500 mg
154 tablet
0 0 0 0 0 2000
Kotrimoksazol susp kombinasi :
157 sulfametaksazol 200 mg + trimetropim 40mg/ 5 botol 60 ml
ml 290 0 290 40 250 0

Kotrimoksazol tablet kombonasi :

158 tablet
sulfametaksazole 400 mg + Trimetropim 80 mg
500 5000 5500 0 5500 0
159 Kotrimoksazol tablet pediatrik 120 mg tablet 0 0 0 0 0 0
160 Kuinin Dihidroklorida injeksi 25% - 2 ml ampul 0 0 0 0 0 0
162 Levofloksasin 500 mg tablet 0 0 0 0 0 0
167 Licopec Kaplet 0 0 0 0 0 0

Lidokain komp. Injeksi, Kombinasi : lidokain HCl

163 ampul
2% + epinefrin 1 : 80.000- 2ml
30 0 30 0 30 0
161 Lifadrox DS Syp Btl/60 ml 0 0 0 0 0 0
168 Lisol Concentrate Botol 1000 ml 0 0 0 0 0 0
165 Lodia 2 mg tablet 0 0 0 0 0 0
164 Loperamide 2 mg tablet 0 0 0 0 0 0
166 Loratadine tablet 100 mg tablet 2800 2500 5300 0 5300 0
169 Mebendazol tablet 100 mg tablet 0 0 0 0 0 0
178 Metformin 500 mg tablet 0 0 0 0 0 0
173 Methilergometrin Maleat tab.salut 0,125 tablet 1300 0 1300 0 1300 0
170 Methylprednisolone tablet 16 mg tablet 0 0 0 0 0 0
172 Methylprednisolone tablet 4 mg tablet 0 0 0 0 0 500
171 Methylprednisolone tablet 8 mg tablet 0 0 0 0 0 0
175 Metronidazol tablet 250 mg tablet 0 0 0 0 0 0
176 Metronidazol tablet 500 mg tablet 1700 0 1700 0 1700 2000
177 Miconasole 2 % krim tube 10 gram 0 72 72 0 72 100
Myomergin
174 Ampul 28 28 28
(Metilergometrin Maleat inj 0,200 mg-1 ml) 0 0 0
181 Natrium diklofenak 25 mg tablet 0 0 0 0 0 0
180 Natrium diklofenak 50 mg tablet 0 0 0 0 0 0
186 Natrium Klorida larutan infus 0,9 % steril botol 500 ml 53 0 53 0 53 100
187 Neurobion 5000 injeksi 3 ml Ampl/Psng 5 20 25 0 25 200
182 nifedipin tablet tablet 1600 0 1600 0 1600 0
188 Nistatin tablet salut gula 500.000 IU tablet 0 0 0 0 0 1000
189 Nistatin tablet vaginal 100.000 IU tablet 0 0 0 0 0 1000
179 Norpid 10 mg ( Simvastatin 10 mg ) tablet 0 0 0 0 0 0
190 Novabion kapsul 0 0 0 0 0 1000
183 Novadiar Syr btl 60 ml 0 0 0 0 0 0
185 Novadium tablet 0 0 0 0 0 0
184 Novamag Syp btl 60 ml 275 0 275 0 275 200
191 nuvopec 15 mg/ml Botol 60 ml 0 100 100 0 100 0
192 nuvopec tablet 30 mg tablet 0 3000 3000 0 3000 0
193 Obat anti Malaria (DHP) ktk/9 0 0 0 0 0 100
194 Obat Batuk Hitam ( O.B.H. ) cairan Botol 100 ml 132 0 132 0 132 100
197 Obat OAT Kategori I Anak Paket 0 0 0 0 0
195 Obat OAT Kategori I Dewasa paket 0 0 0 0 0
196 Obat OAT Kategori II Paket 0 0 0 0 0
198 Obimin Dos/30 210 0 210 0 210 300
201 Oksitetrasiklin HCl salep kulit 3 % tube 5 g 0 0 0 0 0 0
202 Oksitetrasiklin HCl salep mata 1 % tube 5 g 0 0 0 0 0 0
203 Oksitosin injeksi 10 IU/ml - 1 ml ampul 0 0 0 0 0 0
199 Omegdiar sirup btl 60 ml 0 0 0 0 0 0
200 Omeprasole kapsul 20 mg kapsul 1590 0 1590 0 1590 3000
205 Papaverin injeksi 40 mg / ml vial 0 0 0 0 0 0
206 Papaverin tablet 40 mg tablet 1000 0 1000 0 1000 0
207 Parasetamol sirup 120 mg/5 ml Botol 60 ml 371 300 671 5 666 0
208 Parasetamol tablet 500 mg ktk/100 4400 12800 17200 1400 15800 0
209 Pehacaine injeksi ampul 25 0 25 5 20 0
210 Piracetam tablet 400 mg tablet 0 0 0 0 0 0
211 Piracetam tablet 800 mg tablet 0 0 0 0 0 0
213 Pirantel Syp Botol 60 ml 25 0 25 0 25 0
212 Pirantel tablet 125 mg tablet 0 2000 2000 0 2000 0
214 Pirazinamide tablet 500 mg tablet 0 0 0 0 0 0
215 Piridoksin HCl (Vit.B6) tablet 10 mg tablet 1000 7000 8000 900 7100 0
216 Piroxicam tablet 10 mg tablet 100 0 100 100 0 0
217 Piroxicam tablet 20 mg tablet 100 0 100 0 100 0
218 Povidon Iodida 10 % Botol 30 ml 0 0 0 0 0 50
219 Povidon Iodida 10 % Botol 60 ml 1 0 1 0 1 20
220 Povidon Iodida 10 % Botol 300 ml 0 0 0 0 0 0
221 Povidon Iodida 10 % Botol 1000 ml 0 0 0 0 0 0
222 Prednison tablet 5 mg tablet 4100 7000 11100 400 10700 0
228 Prenamia tablet 0 0 0 0 0 0
223 Primakuin tablet 15 mg tablet 200 0 200 0 200 0
224 Procain Benzill Penicillin Inj. 3 juta IU vial 0 0 0 0 0 0
226 Propanolol HCL tablet 10 mg tablet 0 0 0 0 0 0
225 Propanolol HCL tablet 40 mg tablet 0 0 0 0 0 0
227 Propilititiurasil tablet 100 mg tablet 0 0 0 0 0 0
204 Pytogin injeksi 10 IU/ml - 1 ml ampul 0 0 0 0 0 0
229 Quinine tablet 222 mg Btl/1000 0 0 0 0 0 0
230 Quinine tablet 222 mg ktk/60 400 0 400 0 400 0
237 Ramolit sachet 0 0 0 0 0 200
231 Ranitidin tablet 150 mg tablet 3400 6000 9400 400 9000 0
232 Ranitidine injeksi 25 mg/ml - 2ml ampul 130 0 130 0 130 0
233 Rifampicin kapsul 300 mg kapsul 0 0 0 0 0 0
234 Rifampicin tablet 450 mg tablet 0 0 0 0 0 0
235 Rifampicin tablet 600 mg tablet 0 0 0 0 0 0
Ringer Laktat larutan infus steril (Produk lokal)
236 botol 500 ml 126 126 125
0 1 0
238 Salbutamol tablet 2 mg tablet 0 0 0 0 0 0
239 Salbutamol tablet 4 mg tablet 3100 0 3100 0 3100 0
Salep 2-4 , Kombinasi:
240 Pot 30 gram 14 134 134
As Salisilat 2% + Belerang Endap 4% 120 0 0
241 Salisil Bedak 2 % pot 50 gram 78 0 78 0 78 0
245 Sefadroksil kapsul 500 mg tablet 0 0 0 0 0 1000
242 Sefadroksil sirup 125mg/5ml btl 60 ml 130 0 130 0 130 0
243 sefotaxim serbuk injeksi 1 gram/vial 2 vial/kotak 10 0 10 0 10 0
244 seftriaxon serbuk injeksi 1 gram/ vial 2 vial/kotak 0 0 0 0 0 0
252 Selespurin (Allopurinol 100 mg ) tablet 100 0 100 0 100 0
246 Sianokobalamin (Vit.B12) 50 mcg Btl/1000 0 0 0 0 0 0
247 Sianokobalamin (Vit.B12) 50 mcg Ktk/100 3600 2500 6100 0 6100 0
Sianokobalamin (Vit.B12) injeksi 500 mcg-ml
248 ampul 300 300 300
0 0 0
249 Simvastatin tablet 10 mg tablet 550 5000 5550 0 5550 0
250 Simvastatin tablet 20 mg tablet 0 0 0 0 0 0
251 Siprofloksasin tablet 500mg tablet 1100 0 1100 0 1100 0
253 Tablet tambah darah + as folat tablet 1200 5600 6800 0 6800 0
254 Tetrasiklin HCl kapsul 250 mg kapsul 0 0 0 0 0 0
255 Tetrasiklin HCl kapsul 500 mg kapsul 0 0 0 0 0 0
256 Thiamfenicol 500 mg tablet 0 0 0 0 0 0
257 Tiamin HCl (Vit.B1) injeksi 100 mg/ml-1 ml ampul 173 0 173 0 173 0
258 Tiamin HCl / Mononitrat (Vit.B1) tab.50 mg tablet 1100 0 1100 0 1100 0
259 Tuzalos tablet tablet 0 0 0 0 0 1000
260 Ultrasonic gell btl 250 gram 3 0 3 0 3 0
261 Ultravita Multivitamin tablet 0 0 0 0 0
262 Univit Syp btl 60 ml 0 20 20 0 20 100
263 Vitamin A 100.000iu kapsul 400 0 400 50 350 500
264 Vitamin A 200.000iu kapsul 500 0 500 50 450 500
265 Vitamin B Kompleks tablet tablet 6200 0 6200 0 6200 0
266 Zinc tablet tablet 100 0 100 100 0 5000
0 0 0
Alat Kesehatan 0 0 0
1 Abocath No. 18 set 122 0 122 0 122 0
2 Abocath No. 20 set 0 0 0 0 0 0
3 Abocath No. 22 set 142 0 142 0 142 0
4 Abocath No. 24 100 set/kotak 85 0 85 40 45 0
5 Abocath No. 26 100 set/kot 0 0 0 0 0 0
6 Alat suntik sekali pakai 0,5 ml 100 set/kot 200 0 200 0 200 100
7 Alat suntik sekali pakai 1 ml 100 set/kotak 200 0 200 0 200 100
12 Alat suntik sekali pakai 10 ml 100 set/kotak 100 0 100 0 100 100
8 Alat suntik sekali pakai 2,5 ml 100 set/kotak 0 0 0 0 0 100
9 Alat suntik sekali pakai 3 ml 100 set/kotak 300 500 800 0 800 100
10 Alat suntik sekali pakai 5 ml 100 set/kotak 174 0 174 0 174 100
11 Alat suntik sekali pakai 50 ml 100 set/kotak 200 0 200 0 200 0
13 Alkohol Swab Kotak 300 0 300 0 300 500
14 Bisturi no 10 set 50 0 50 0 50 50
15 Bisturi no 11 set 0 0 0 0 0 50
16 Blood lancet set 160 0 160 0 160 0
18 Catgut / Benang Bedah chrom 3/0 matrix 3 buah 72 0 72 0 72 0
17 Catgut / Benang Bedah No. 4/0 buah 0 0 0 0 0 0
19 Catgut/Benang Bedah No.2/0 buah 0 0 0 0 0 0
20 Cotton Swab buah 0 0 0 0 0 0
21 Cover glass buah 50 0 50 0 50 0
22 Digital Thermometer buah 0 0 0 0 0 5
23 Etil Klorida spray botol 100 ml 1 0 1 0 1 2
24 feeding tube 8 FR x 120 cm buah 40 0 40 0 0
25 Foley catheter no 12 buah 10 0 10 0 10 0
26 Foley catheter no 14 buah 70 0 70 0 70 0
27 Foley catheter no 16 buah 21 0 21 0 21 0
28 Foley catheter no 18 buah 0 0 0 0 0 0
29 Foley catheter no 20 buah 0 0 0 0 0 0
39 Haemometer / Hb Sahli set 2 0 2 0 2 0
37 Hand Gloves (sarung tangan) tanpa bedak Kotak 59 0 59 0 59 0
34 Handscond obgyn ktk/50 26 0 26 0 26 0
32 Handscond Maxter L ktk/50 psg 500 0 500 0 500 0
31 Handscond Maxter M ktk/50 psg 200 0 200 0 200 0
30 Handscond Maxter S ktk/50 psg 212 0 212 0 212 0
33 Handscond Steril pasang 24 0 24 0 24 0
38 Hidrogen peroksida 3 % Botol 1000ml 1 2 3 0 3 0
40 Infusion set anak kantong 37 0 37 0 37 50
41 Infusion set dewasa kantong 3 0 3 0 3 50
45 kapas berlemak 500 gram rol 7 0 7 0 7 0
49 Kapas Pembalut / Absorben 250 gram Rol 2 0 2 0 2 0
42 kapas pembalut 100 gram rol 1 0 1 0 1 0
51 Kapas pembalut 1000 gram rol 1 0 1 0 1 0
44 kapas pembalut 50 gram rol 4 0 4 0 4 0
43 kapas pembalutr 250 gram rol 18 0 18 0 18 0
46 kapas putih 100 gram rol 3 0 3 0 3 0
47 kapas putih 250 gram rol 21 0 21 0 21 0
48 kapas putih 50 gram rol 31 0 31 0 31 0
50 Kapas putih 500 gram rol 1 0 0 0 0 0
59 Kartu golongan darah ktk/100 0 0 0 0 0 0
52 Kasa hidrofil 2 yard x 80 cm Rol 0 0 0 0 0 0
53 Kasa Hidrofil DRC 40 yard x 80 cm rol 6 0 6 0 6 0
54 Kasa Kompres 40/40 steril Bungkus 61 0 61 0 61 0
55 Kasa Pembalut Hidrofil 2,7 cm x 15 cm Rol 100 0 100 0 100 0
57 Kasa Pembalut Hidrofil 4 m x 15 cm Rol 5 0 5 0 5 0
58 Kasa steril 16x16 rol 3 0 3 0 3
56 Kassa Verban 3 cm x 15 cm Rol 0 0 0 0 0 5
61 Kertas Perkamen lembar/rim 0 0 0 0 0 0
62 Kertas Puyer Press pcs 0 0 0 0 0 0
60 Kertas saring lembar 0 0 0 0 0 0
64 Kondom sutra pcs 0 0 0 0 0 50
63 KY Jelly tube 0 0 0 0 0 0
65 Masker hijau ktk/50 100 200 300 0 300 500
68 Medicine paket set 0 0 0 0 0 0
67 Micropipette 5 - 50µl Unit 0 0 0 0 0 0
66 Mortir + Stempel set 0 0 0 0 0 0
69 Oksigen Set Unit 0 0 0 0 0 0
70 Oneclean Botol 1000 ml 0 0 0 0 0 0
71 Oneclean botol 500 ml 2 0 2 0 2 0
72 Pembalut Gips (Gypsona 6 inchi x 3 yard) rol 11 0 11 0 11 0
73 Penjepit tali pusat set 277 0 277 0 277 0
79 pH Paper 3,8-5,4 ktk 0 0 0 0 0 0
78 Pipet Westergren buah 0 0 0 0 0 0
74 Plastik obat ( ukuran Besar ) lembar 0 0 0 0 0 0
75 Plastik obat ( ukuran Kecil ) lembar 0 0 0 0 0 0
76 Plester 5 cm x 4,5 m rol 6 0 6 0 6 0
77 Plester 5 cm x 5 m rol 5 0 5 0 5 0
80 Pot sputum buah 0 100 100 0 100 0
84 Rak tabung reaksi buah 0 0 0 0 0 0
85 Rak westergren/LED buah 0 0 0 0 0 0
81 Rapid 1 (oncoprobe) ktk/50 0 0 0 0 0 0
82 Rapid 2 (Advanced) ktk/100 0 0 0 0 0 0
83 Rapid 3 (Vikia) ktk/25 0 0 0 0 0 0
36 sarung tangan free Powder ukuran L 100 psg/ktk 200 0 200 0 200 500
35 sarung tangan free Powder ukuran M 100 psg/ktk 400 0 400 0 400 500
97 Sikat tabung (Korok Tabung) buah 0 0 0 0 0 0
95 Slide box pcs 0 0 0 0 0 0
94 Slide/objek glass Ktk/72 0 0 0 0 0 0
96 Spiritus cair buah 0 0 0 0 0 0
86 surgical suture with needle (Plain Catgut) pcs 24 0 24 0 24 0
87 surgical suture with needle (silk Braided) pcs 36 0 36 0 36 0
88 suture needle GT 10 12pcs/bks 24 0 24 0 24 0
89 suture needle GT 11 12pcs/bks 24 0 24 0 24 0
90 suture needle GT 12 12pcs/bks 24 0 24 0 24 0
91 suture needle GT 13 12pcs/bks 24 0 24 0 24 0
93 suture needle GT 6 12pcs/bks 24 0 24 0 24 0
92 suture needle GT 7 12pcs/bks 22 0 22 0 22 0
98 Tabung Sahli (HB Sahli) set 0 0 0 0 0 0
100 Tabung Sentrifuse buah 0 0 0 0 0 0
101 Tabung Serologi buah 0 0 0 0 0 0
99 Tabung Westergreen buah 0 0 0 0 0 0
114 Tensi Digital dan Stetoskop Kit 0 0 0 0 0 0
102 Test Kehamilan pcs 0 0 0 0 0 0
104 Torniket anak rol 0 0 0 0 0 0
103 Torniket dewasa set 0 0 0 0 0 0
105 Tromol, SS set 0 0 0 0 0 0
107 Ultrafix 10 cm x 1 cm ktk/25 0 0 0 0 0 0
106 Ultrafix 5 cm x 1 cm ktk/10 2 0 2 0 2 0
108 Urinalisa (Strip Urine Expert) set 0 0 0 0 0 0
109 Urinalisis (Mission Expert) Btl 0 0 0 0 0 0
110 Urine bag 2000 ml set 15 0 15 0 15 0
113 Usilakit (posyandu Lansia) kit 0 0 0 0 0 0
111 Vaselin album btl 1 liter 0 0 0 0 0 0
112 Yellow Tips ( 5µ / 10µ /25 µ ) ktk 0 0 0 0 0 0
0 0
Reagen 0 0 0 0
1 Asam Alkohol botol 0 0 0 0 0 0
2 Asam chlorida HCl 0,1 N botol 0 0 0 0 0 0
3 Combour tes Urine botol 0 0 0 0 0 0
5 EDTA cair botol 0 0 0 0 0 0
4 Emersi oil botol 100 ml 0 0 0 0 0 0
7 Etanol asam 3% botol 100 ml 0 0 0 0 0 0
6 Eter Alkohol botol 100 ml 0 0 0 0 0 0
8 Glemsa botol 0 0 0 0 0 0
37 HCL 0,1 N botol 0 0 0 0 0 0
9 Hexagon Sypillis Kotak/20 0 0 0 0 0 0
11 Karbol fuksin botol 500 ml 0 0 0 0 0 0
10 KOH 10% botol 0 0 0 0 0 0
13 Metanol btl / 500 ml 0 0 0 0 0 0
14 Metanol btl / 1000 ml 1 0 1 0 1 0
12 Metylen Blue botol 0 0 0 0 0 0
15 Na.Citrat 3,8% botol 0 0 0 0 0 0
25 Reagen ALT / GPT Kotak 0 0 0 0 0 0
16 Reagen Anti D Golongan Darah set 0 0 0 0 0 0
27 Reagen Antigen AO.S.Paratyphii Kotak 0 0 0 0 0 0
29 Reagen Antigen BO.S.Parathypii Kotak 0 0 0 0 0 0
26 Reagen Antigen H.S.Typhii Kit 0 0 0 0 0 0
28 Reagen Antigen O.S.Parathypii Kotak 0 0 0 0 0 0
20 Reagen Asam urat Kotak 0 0 0 0 0 0
24 Reagen AST / GOT Kotak 0 0 0 0 0 0
18 Reagen BTA set 0 0 0 0 0 0
22 Reagen Cholesterol Kotak 0 0 0 0 0 0
21 Reagen GDS Kotak 0 0 0 0 0 0
17 Reagen Golongan Darah Kit 0 0 0 0 0 0
19 Reagen RPR Sypilis kotak/100 0 0 0 0 0 0
23 Reagen Trigliserida Kotak 0 0 0 0 0 0
38 reagen Zield Nelsen 0
30 SD HIV set 0 0 0 0 0 0
31 SD Syphilis 3.0 set 100 0 100 0 100 0
34 Stik Asam urat Botol/25 0 0 0 0 0 0
33 Stik Glucosa nesco Botol/25 0 0 0 0 0 0
32 Stik Kolesterol nesco Botol/10 0 0 0 0 0 0
35 Tes RDT Malaria Kotak/10 150 0 150 0 150 0
36 Xylol botol 0 0 0 0 0 0

Mengetahui, Kiruru, 16 Januari 2019

Kepala Puskesmas Kaimana Yang Meminta,
Petugas Pengelola Obat

Fransiska C.Balatando,S.Farm,Apt
Basri La hisa, Amk.
Nip. 197602142001111001
 PUSAT KESEHATAN MASYARAKAT KIRURU
REKAPITULASI PENGGUNAAN OBAT PSIKOTROPIKA PUSKESMAS KIRURU

BULAN Desember
TAHUN 2018

STOK JUMLAH
PERSEDI PEMAKAI
NO. NAMA OBAT SATUAN PENERIM
AWAL AAN AN
AAN
1 Diazepam 2 mg Botol/1000 tablet 0 0 0 0
2 Diazepam injeksi 5 mg/ml - 2ml Kotak/30 ampul 0 0 0 0
3 Haloperidol tablet 100 mg tablet 0 0 0 0
4 Phenobarbital 30 mg tablet 0 0 0 0
5 Phenobarbital injeksi Kotak/30 ampul 0 0 0 0
6 Klorpromazin HCL tablet 100 mg Tablet 0 0 0 0
7 Klorpromazin HCL injeksi 5 mg/ml-2 ml Ampul 0 0 0 0
8 Stesolid rectal Tube 0 0 0 0

Mengetahui
Kepala Puskesmas Kiruru, 17 Januari 20

Pengelola Obat Pusk

Basri La hisa, Amk. Fransiska Celsia Bala

Nip. 197602142001111001 Nip.-
RU
ESMAS KIRURU

SISA
PERMINT
STOK AAN

0 0
0 0
0 0
0 100
0 30
0 0
0 0
0 10

Kiruru, 17 Januari 2019

Pengelola Obat Puskesmas

Fransiska Celsia Balatando,S.Farm,Apt

 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

KODE PUSKESMAS :
PUSKESMAS : KIRURU
DISTRIK : TELUK ETNA
KABUPATEN : KAIMANA BULAN JANUARI
PROPINSI : PAPUA BARAT TAHUN 2019

STOK PENERI- PERSE- PEMA- SISA STOK PERMIN- PEMBERIAN KET

NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK OPT TAAN APBN APBD II ASKES JML
1 2 3 4 5 6 7 8 9 10 11 12 13 15 16
1 Acyclovir krim 5 % tube 5 gram 50 0 50 0 50 0
2 Acyclovir tablet 200 mg tablet 600 0 600 0 600 0
3 Acyclovir tablet 400 mg tablet 450 0 450 0 450 0
4 Albendazol tablet 400 mg tablet 0 0 0 0 0 0
5 Alopurinol tablet 100 mg tablet 3000 0 3000 0 3000 0
6 Altran (Asam mefenamat 500 mg) tablet 0 0 0 0 0 0
7 Ambroxol sirup 15 mg/ml btl 60 ml 0 0 0 0 0 0
8 Ambroxol tablet 30 mg tablet 800 0 800 200 600 500
9 Aminofilin tablet 100 mg tablet 0 0 0 0 0 0
10 Aminofilina injeksi 24 mg/ml - 10 ml ampul 122 0 122 0 122 0
11 Amlodipin tablet 10 mg tablet 600 0 600 0 600 0
12 Amlodipin tablet 5 mg tablet 0 0 0 0 0 0
13 Amoksisilin kaplet 500 mg kaplet 14300 0 14300 7200 7100 0
14 Amoksisilin sirup kering 125 mg/5 ml Botol 60 ml 104 0 104 65 39 100
15 Ampicillin injeksi ampul 7 0 7 0 7 0
16 Ampicillin Tablet tablet 2100 0 2100 900 1200 0
17 Antalgin (Metampiron) tablet 500 mg tablet 2000 0 2000 1800 200 2000
18 Antalgin injeksi 250 mg/ml - 2 ml ampul 220 0 220 0 220 0
19 Antasida DOEN SYR Botol 60 ml 0 0 0 0 0 0
20 Antasida DOEN tab botol/1000 0 0 0 0 0 0
21 Antasida DOEN tab ktk/100 2000 0 2000 500 1500 500
 Anti Bakteri DOEN salep kombinasi:
22 Basitrasin 500 IU/g + Polimiksin 10.000 IU/g tube 5 g 0
0 0 0 0 0
23 Anti Hemoroid Superhoid supositoria supp 78 0 78 12 66 36
24 Antifungi DOEN Pot 30 gram 168 0 168 0 168 0

25 Antifungi DOEN (Whitefield) salep kombinasi Pot 30 gram 0

0 0 0 0 0
26 Aqua pro Injeksi steril, bebas pirogen botol 0 0 0 0 0 0
27 Artesunate injeksi 8 ampul/kotak 24 0 24 0 24 0
28 Asam Askorbat (Vit C) tablet 50 mg tablet 13000 0 13000 1400 11600 0
29 Asam Folat / Profolat tablet 3200 0 3200 500 2700 0
30 Asam Mefenamat 500 mg tablet 0 1000 1000 0 1000 0
31 Asam Traneksamat 500 mg tablet 200 0 200 0 200 0
32 Asam traneksamat inj ampul 40 0 40 20 20 0
33 Asetosal 100 mg tablet 0 0 0 0 0 0
34 Asetosal 500 mg tablet 0 0 0 0 0 0
35 Benzatin Benzi Penisillin 2,4 juta iu/vial vial 0 0 0 0 0 0
36 Benzatin Benzil Penisillin 1,2 juta iu/vial vial 8 0 8 0 8 0
37 Betahistin tablet tablet 30 900 930 0 930 0
38 Betametason krim 0.1% tube 5 gram 174 0 174 0 174 0
39 Bimatracin tablet 0 0 0 0 0 0
40 Bioplacenton jelly tube 15 gram 34 0 34 10 24 36
41 Bronkis tablet 5100 0 5100 2500 2600 2000
42 Burnazin salep tube 35 g 0 0 0 0 0 100
43 Byolisin syp botol/60 ml 0 0 0 0 0 100
44 Caviplex tablet ktk/100 2000 0 2000 1800 200 5000
45 Cefford FORTE (Sefadroksil kapsul 500 mg) tablet 0 1000 1000 0 1000 0
46 Cefixime 200 mg tablet 0 0 0 0 0 0
47 Cetirizine 10 mg kapsul 0 0 0 0 0 0
48 Chinine antipirin injeksi 2 ml ampul 0 0 0 0 0 0
49 Cimetidin tablet 200mg tablet 300 0 300 0 300 0
50 Clindamicyn 150 mg tablet 0 0 0 0 0 0
51 Clindamicyn 300 mg tablet 0 0 0 0 0 0
52 Combantrin syrup botol 10 ml 0 0 0 0 0 0
53 Combi Pack Azytro tablet 0 0 0 0 0 0
54 Combi Pack Azytro + Ceffixime tablet 0 0 0 0 0 0
55 Combi pack Paket Kusta Anak MB paket 0 0 0 0 0 0
56 Combi pack Paket Kusta Anak PB Paket 0 0 0 0 0 0
57 Combi pack Paket Kusta Dewasa MB Paket/ 6 Strip 0 0 0 0 0 0
58 Combi Pack Paket Kusta Dewasa PB Paket 0 0 0 0 0 0
59 Curcuma tablet 0 0 0 0 0 0
60 Daneuron tablet 1000 0 1000 900 100 0
61 Decacetine ( Chlorampenicol TTM ) btl 56 0 56 21 35 0
62 Deksametason injeksi 5 mg/ml - 1 ml ampul 271 0 271 0 271 0
63 Deksametason tablet 0,5 mg ktk/100 8400 0 8400 1200 7200 0
64 Difenhidramin HCl injeksi 10 mg/ml-1 ml ktk/30 ampul 60 0 60 0 60 0
65 Digoksin tablet 0,25 mg tablet 0 0 0 0 0 0
66 Domperidon sirup 5 mg/5 ml Botol 60 ml 0 100 100 0 100 0
67 Domperidon tablet 10 mg tablet 500 0 500 0 500 0
68 Doxyciclin kapsul 100 mg kapsul 0 0 0 0 0 0
69 Dulcolax Suppositoria 10 mg supp 0 0 0 0 0 100
70 Dulcolax Suppositoria 5 mg supp 0 0 0 0 0 100
71 Efedrin HCl tablet 25 mg btl/250 0 0 0 0 0 1000
72 Epineprin inj 0 ,1 %(adrenalin) ampul 60 0 60 3 57 0
73 Ergotamine Caffeine Tablet 1000 0 1000 100 900 0
74 Eritromicin sirop kering 200 mgl / 5ml Botol 60 ml 14 0 14 2 12 0
75 Erlamycetin Salp Mata tube 3 0 3 0 3 0
76 Erlamycetin tetes telinga 1% tube 72 0 72 11 61 0
77 Erphazone ( Phenylbutazone 200 mg ) btl/1000 0 0 0 0 0 0
78 Erytromicin kapsul 250 mg kapsul 0 0 0 0 0 0
79 Erytromicin kapsul 500 mg kapsul 600 0 600 200 400 0
80 Etakridin ( Rivanol ) larutan 0,1% Botol 300 ml 8 8 16 0 16 0
81 Etanol ( alkohol ) 70% botol 100 ml 15 0 15 0 15 0
82 Etanol ( alkohol ) 70% Botol 300 ml 0 0 0 0 0 0
83 Etanol ( alkohol ) 70% botol 1000 ml 5 0 5 0 5 0
84 Ethambutol tablet 250mg tablet 0 0 0 0 0 0
85 Ethambutol tablet 500mg tablet 0 0 0 0 0 0
86 Farmalat (Nifedipin) tablet 10 mg tablet 0 0 0 0 0 0
87 faxiden 20 mg tab tablet 1000 0 1000 400 600 1000
88 Fenilbutalson tablet 200 mg Btl/1000 0 0 0 0 0 0
89 Fenilbutalson tablet 200 mg ktk/150 0 0 0 0 0 0
90 Fenol Gliserol tetes telinga 10% botol 5 ml 120 0 120 0 120 0
91 Fermia ktk/100 0 0 0 0 0 0
92 Ferrous Sulphate tablet 300 mg tablet 0 0 0 0 0 0
93 Fitomenadion (Vit.K1) inj 10 mg/ml - 1 ml ampul 109 0 109 0 109 0
94 Fitomenadion (Vit.K1) tab salut gula 10 mg tablet 0 0 0 0 0 0
95 Fluconazole tablet 0 0 0 0 0 0
96 Furosemid tablet 0,5 mg tablet 100 0 100 0 100 0
97 Garam Oralit untuk 200 ml air sachet 800 500 1300 0 1300 0
98 Gemfibrosil kapsul 300 Mg kapsul 0 0 0 0 0 0
99 Gemfibrosil kapsul 600 Mg kapsul 300 0 300 0 300 0
100 gentalex salep kulit 0,1 % ktk/10 tube 36 120 156 16 140 0
101 Gentamicin inj 80mg/2ml ampul 50 0 50 0 50 0
102 Gentamicin salep kulit 0,1 % ktk/ 10 tube 40 0 40 30 10 300
103 Gentian Violet larutan 1 % Botol 10 ml 120 0 120 0 120 0
104 Gitarmin ( Asam Mefenamat 500 mg ) tablet 100 0 100 0 100 500
105 Gitri sirup Botol 60 ml 0 0 0 0 0 0
106 Glibenklamid tablet 5 mg tablet 0 0 0 0 0 0
107 Glikos (Metformin 500 mg) tablet 700 0 700 100 600 0
108 Gliseril Guaiakolat tablet 100 mg tablet 5600 0 5600 0 5600 0
109 Gludepatic 500 mg tablet 400 0 400 0 400 0
110 Glukosa larutan infus 5 % steril Botol 500 ml 125 0 125 0 125 0
111 Gradilex 2 mg / Loperamid tablet 4900 0 4900 1700 3200 0
112 Grafazole 500 mg tablet 0 0 0 0 0 0
113 Graseric 150 mg tablet 0 0 0 0 0 0
114 Gravalin 2 mg / Salbutamol 2 mg tablet 2000 0 2000 0 2000 0
115 Gravask 10 mg tablet 60 0 60 0 60 0
116 Gravask 5 mg tablet 0 0 0 0 0 0
117 Gricin 500 mg tablet 600 0 600 200 400 0
118 Griseofulvin tablet 125 mg tablet 2400 0 2400 0 2400 0
119 Griseofulvin tablet 500 mg tablet 2500 0 2500 300 2200 0
120 Hidroklorotiazid (HCT) tablet 25 mg tablet 200 0 200 0 200 0
121 Hidrokortison krim 2,5 % tube 5 g 72 0 72 0 72 0
122 Holimox Syp ( Amox Syp) btl / 60 ml 100 0 100 21 79 0
123 Hustab tablet 3600 0 3600 1000 2600 7200
124 Ibuprofen Syp btl 5 ml 0 0 0 0 0 0
125 Ibuprofen tablet 200 mg tablet 2800 0 2800 500 2300 0
126 Ibuprofen tablet 400 mg tablet 10000 0 10000 5000 5000 0
127 Ichtiyol Salf pot 24 24 48 24 24 24
128 Ifison ( Prednisone ) tablet 0 0 0 0 0 0
129 Infantrim forte tablet 480 mg tablet 1400 0 1400 0 1400 0
130 Irgapan tablet 1000 0 1000 0 1000 0
131 Isoniazid ( INH ) 100 mg tablet 0 0 0 0 0 0
132 Isoniazid ( INH ) 300 mg tablet 300 0 300 0 300 0
133 Isosorbid Dinitrat tablet sublingual 5 mg tablet 300 500 800 100 700 0
134 Itrasal Syp btl 5 ml 0 0 0 0 0 0
135 Kalium diklofenak tablet tablet 0 0 0 0 0 0
136 Kalsium Laktat (Kalk) tablet 500 mg ktk/100 0 0 0 0 0 0
137 Kalsium Laktat (Kalk) tablet 500 mg Btl/1000 5000 0 5000 1000 4000 0
138 Kanamicin inj 1 gram/vial vial 0 0 0 0 0 0
139 Kaptopril tablet 12,5 mg tablet 2500 0 2500 700 1800 0
140 Kaptopril tablet 25 mg tablet 2700 0 2700 300 2400 0
141 Katitra (Tertracycline) Kapsul 500 mg kapsul 0 0 0 0 0 0
142 Kemoren 50 mg tablet 0 0 0 0 0 0
143 Ketokonazol salep 2% tube 10 gram 0 48 48 0 48 0
144 Ketokonazol tablet 200 mg tablet 1500 0 1500 0 1500 0
145 Kina tablet salut gula ktk/24x12 0 0 0 0 0 0
146 Kloramfenikol kapsul 250 mg kapsul 0 0 0 0 0 0
147 Kloramfenikol salep kulit tube 5 mg 0 0 0 0 0 0
148 Kloramfenikol tetes telinga 3 % botol 5 ml 7 0 7 7 0 0
149 Klorampenicol salep mata 1 % tube 5 g 0 0 0 0 0 0
150 Klorampenicol tetes mata 0.5% (Reco) botol 5 ml 0 0 0 0 0 0
151 Klorfeniramin Maleat (CTM) tablet 4 mg tablet 5000 0 5000 400 4600 0
152 Kloroquine tablet 250mg tablet 400 0 400 0 400 0
153 Klorquine tablet 150 mg tablet 0 0 0 0 0 0
154 Kokodin 10 % Btl/1000 ml 0 0 0 0 0 2
155 Kokodin 10 % Btl/300 ml 0 0 0 0 0 5
156 Kokotra (Tetracycline) kapsul 250 mg kapsul 0 0 0 0 0 0
Komb Pirimetamin 25 mg + Sulfadoxin 500 mg
157 tablet
0 1000 1000 0 1000 0
Kotrimoksazol susp kombinasi :
158 sulfametaksazol 200 mg + trimetropim 40mg/ 5 botol 60 ml
ml 250 0 250 5 245 0

Kotrimoksazol tablet kombonasi :

159 tablet
sulfametaksazole 400 mg + Trimetropim 80 mg
5500 0 5500 300 5200 0
160 Kotrimoksazol tablet pediatrik 120 mg tablet 0 0 0 0 0 0
161 Kuinin Dihidroklorida injeksi 25% - 2 ml ampul 0 0 0 0 0 0
162 Levofloksasin 500 mg tablet 0 0 0 0 0 0
163 Licopec Kaplet 0 0 0 0 0 0

Lidokain komp. Injeksi, Kombinasi : lidokain HCl

164 ampul
2% + epinefrin 1 : 80.000- 2ml
30 0 30 0 30 0
165 Lifadrox DS Syp Btl/60 ml 0 0 0 0 0 0
166 Lisol Concentrate Botol 1000 ml 0 0 0 0 0 0
167 Lodia 2 mg tablet 0 0 0 0 0 0
168 Loperamide 2 mg tablet 0 0 0 0 0 0
169 Loratadine tablet 100 mg tablet 5300 0 5300 700 4600 0
170 Mebendazol tablet 100 mg tablet 0 0 0 0 0 0
171 Metformin 500 mg tablet 0 0 0 0 0 0
172 Methilergometrin Maleat tab.salut 0,125 tablet 1300 0 1300 100 1200 0
173 Methylprednisolone tablet 16 mg tablet 0 0 0 0 0 0
174 Methylprednisolone tablet 4 mg tablet 0 0 0 0 0 500
175 Methylprednisolone tablet 8 mg tablet 0 0 0 0 0 0
176 Metronidazol tablet 250 mg tablet 0 0 0 0 0 0
177 Metronidazol tablet 500 mg tablet 1700 0 1700 100 1600 0
178 Miconasole 2 % krim tube 10 gram 72 0 72 0 72 0
Myomergin
179 Ampul 28 28 28
(Metilergometrin Maleat inj 0,200 mg-1 ml) 0 0 0
180 Natrium diklofenak 25 mg tablet 0 0 0 0 0 0
181 Natrium diklofenak 50 mg tablet 0 0 0 0 0 0
182 Natrium Klorida larutan infus 0,9 % steril botol 500 ml 53 0 53 0 53 0
183 Neurobion 5000 injeksi 3 ml Ampl/Psng 25 0 25 7 18 200
184 nifedipin tablet tablet 1600 0 1600 0 1600 0
185 Nistatin tablet salut gula 500.000 IU tablet 0 0 0 0 0 500
186 Nistatin tablet vaginal 100.000 IU tablet 0 0 0 0 0 500
187 Norpid 10 mg ( Simvastatin 10 mg ) tablet 0 0 0 0 0 0
188 Novabion kapsul 0 1000 1000 0 1000 0
189 Novadiar Syr btl 60 ml 0 0 0 0 0 0
190 Novadium tablet 0 0 0 0 0 0
191 Novamag Syp btl 60 ml 275 0 275 0 275 0
192 nuvopec 15 mg/ml Botol 60 ml 100 0 100 5 95 0
193 nuvopec tablet 30 mg tablet 3000 0 3000 0 3000 0
194 Obat anti Malaria (DHP) ktk/9 0 90 90 0 90 300
195 Obat Batuk Hitam ( O.B.H. ) cairan Botol 100 ml 132 0 132 0 132 0
196 Obat OAT Kategori I Anak Paket 0 0 0 0 0 5
197 Obat OAT Kategori I Dewasa paket 0 0 0 0 0 5
198 Obat OAT Kategori II Paket 0 0 0 0 0 5
199 Obimin Dos/30 210 0 210 0 210 900
200 Oksitetrasiklin HCl salep kulit 3 % tube 5 g 0 0 0 0 0 0
201 Oksitetrasiklin HCl salep mata 1 % tube 5 g 0 0 0 0 0 0
202 Oksitosin injeksi 10 IU/ml - 1 ml ampul 0 0 0 0 0 0
203 Omegdiar sirup btl 60 ml 0 0 0 0 0 0
204 Omeprasole kapsul 20 mg kapsul 1590 0 1590 0 1590 0
205 Papaverin injeksi 40 mg / ml vial 0 0 0 0 0 0
206 Papaverin tablet 40 mg tablet 1000 0 1000 0 1000 0
207 Parasetamol sirup 120 mg/5 ml Botol 60 ml 666 0 666 96 570 0
208 Parasetamol tablet 500 mg ktk/100 15800 0 15800 1800 14000 0
209 Pehacaine injeksi ampul 20 0 20 10 10 0
210 Piracetam tablet 400 mg tablet 0 0 0 0 0 0
211 Piracetam tablet 800 mg tablet 0 0 0 0 0 0
212 Pirantel Syp Botol 60 ml 25 0 25 0 25 0
213 Pirantel tablet 125 mg tablet 2000 0 2000 200 1800 0
214 Pirazinamide tablet 500 mg tablet 0 0 0 0 0 0
215 Piridoksin HCl (Vit.B6) tablet 10 mg tablet 7100 0 7100 0 7100 0
216 Piroxicam tablet 10 mg tablet 0 0 0 0 0 500
217 Piroxicam tablet 20 mg tablet 100 0 100 0 100 0
218 Povidon Iodida 10 % Botol 30 ml 0 50 50 0 50 0
219 Povidon Iodida 10 % Botol 60 ml 1 10 11 0 11 0
220 Povidon Iodida 10 % Botol 300 ml 0 0 0 0 0 2
221 Povidon Iodida 10 % Botol 1000 ml 0 0 0 0 0 0
222 Prednison tablet 5 mg tablet 10700 0 10700 1100 9600 0
223 Prenamia tablet 0 0 0 0 0 0
224 Primakuin tablet 15 mg tablet 200 0 200 0 200 0
225 Procain Benzill Penicillin Inj. 3 juta IU vial 0 0 0 0 0 0
226 Propanolol HCL tablet 10 mg tablet 0 0 0 0 0 0
227 Propanolol HCL tablet 40 mg tablet 0 0 0 0 0 0
228 Propilititiurasil tablet 100 mg tablet 0 0 0 0 0 0
229 Pytogin injeksi 10 IU/ml - 1 ml ampul 0 0 0 0 0 100
230 Quinine tablet 222 mg Btl/1000 0 0 0 0 0 0
231 Quinine tablet 222 mg ktk/60 400 0 400 0 400 0
232 Ramolit sachet 0 0 0 0 0 0
233 Ranitidin tablet 150 mg tablet 9000 0 9000 900 8100 0
234 Ranitidine injeksi 25 mg/ml - 2ml ampul 130 0 130 10 120 0
235 Rifampicin kapsul 300 mg kapsul 0 0 0 0 0 0
236 Rifampicin tablet 450 mg tablet 0 0 0 0 0 0
237 Rifampicin tablet 600 mg tablet 0 0 0 0 0 0
Ringer Laktat larutan infus steril (Produk lokal)
238 botol 500 ml 125 125 125
0 0 0
239 Salbutamol tablet 2 mg tablet 0 0 0 0 0 0
240 Salbutamol tablet 4 mg tablet 3100 0 3100 100 3000 0
Salep 2-4 , Kombinasi:
241 Pot 30 gram 134 134 134
As Salisilat 2% + Belerang Endap 4% 0 0 0
242 Salisil Bedak 2 % pot 50 gram 78 0 78 20 58 0
243 Sefadroksil sirup 125mg/5ml btl 60 ml 130 0 130 13 117 0
244 sefotaxim serbuk injeksi 1 gram/vial 2 vial/kotak 10 0 10 0 10 0
245 seftriaxon serbuk injeksi 1 gram/ vial 2 vial/kotak 0 0 0 0 0 10
246 Selespurin (Allopurinol 100 mg ) tablet 100 0 100 100 0 0
247 Sianokobalamin (Vit.B12) 50 mcg Btl/1000 0 0 0 0 0 0
248 Sianokobalamin (Vit.B12) 50 mcg Ktk/100 6100 0 6100 1000 5100 0
Sianokobalamin (Vit.B12) injeksi 500 mcg-ml
249 ampul 300 300 300
0 0 0
250 Simvastatin tablet 10 mg tablet 5550 0 5550 2580 2970 0
251 Simvastatin tablet 20 mg tablet 0 0 0 0 0 0
252 Siprofloksasin tablet 500mg tablet 1100 0 1100 700 400 0
253 Tablet tambah darah + as folat tablet 6800 0 6800 1090 5710 0
254 Tetrasiklin HCl kapsul 250 mg kapsul 0 0 0 0 0 0
255 Tetrasiklin HCl kapsul 500 mg kapsul 0 0 0 0 0 0
256 Thiamfenicol 500 mg tablet 0 0 0 0 0 0
257 Tiamin HCl (Vit.B1) injeksi 100 mg/ml-1 ml ampul 173 0 173 0 173 0
258 Tiamin HCl / Mononitrat (Vit.B1) tab.50 mg tablet 1100 0 1100 0 1100 0
259 Tuzalos tablet tablet 0 0 0 0 0 1000
260 Ultrasonic gell btl 250 gram 3 0 3 0 3 5
261 Ultravita Multivitamin tablet 0 0 0 0 0
262 Univit Syp btl 60 ml 20 102 122 16 106 0
263 Vitamin A 100.000iu kapsul 350 0 350 0 350 0
264 Vitamin A 200.000iu kapsul 450 500 950 50 900 0
265 Vitamin B Kompleks tablet tablet 6200 0 6200 1900 4300 0
266 Zinc tablet tablet 0 2000 2000 0 2000 1000
0 0 0
Alat Kesehatan 0 0 0
1 Abocath No. 18 set 122 0 122 0 122 0
2 Abocath No. 20 set 0 0 0 0 0 0
3 Abocath No. 22 set 142 0 142 0 142 0
4 Abocath No. 24 100 set/kotak 85 0 85 0 85 0
5 Abocath No. 26 100 set/kot 0 0 0 0 0 0
6 Alat suntik sekali pakai 0,5 ml 100 set/kot 200 100 300 100 200 0
7 Alat suntik sekali pakai 1 ml 100 set/kotak 200 100 300 0 300 0
8 Alat suntik sekali pakai 10 ml 100 set/kotak 100 0 100 0 100 0
9 Alat suntik sekali pakai 2,5 ml 100 set/kotak 0 200 200 0 200 0
10 Alat suntik sekali pakai 3 ml 100 set/kotak 300 0 300 0 300 0
11 Alat suntik sekali pakai 5 ml 100 set/kotak 174 100 274 0 274 0
12 Alat suntik sekali pakai 50 ml 100 set/kotak 200 0 200 0 200 0
13 Alkohol Swab Kotak 300 500 800 200 600 0
14 Bisturi no 10 set 50 0 50 0 50 50
15 Bisturi no 11 set 0 0 0 0 0 50
16 Blood lancet set 160 0 160 0 160 0
17 Catgut / Benang Bedah chrom 3/0 matrix 3 buah 72 0 72 0 72 0
18 Catgut / Benang Bedah No. 4/0 buah 0 0 0 0 0 0
19 Catgut/Benang Bedah No.2/0 buah 0 0 0 0 0 0
20 Cotton Swab buah 0 0 0 0 0 0
21 Cover glass buah 50 0 50 0 50 0
22 Digital Thermometer buah 0 0 0 0 0 0
23 Etil Klorida spray botol 100 ml 1 1 2 0 2 0
24 feeding tube 8 FR x 120 cm buah 40 0 40 0 0
25 Foley catheter no 12 buah 10 0 10 0 10 0
26 Foley catheter no 14 buah 70 0 70 0 70 0
27 Foley catheter no 16 buah 21 0 21 0 21 0
28 Foley catheter no 18 buah 0 0 0 0 0 0
29 Foley catheter no 20 buah 0 0 0 0 0 0
30 Haemometer / Hb Sahli set 2 0 2 0 2 0
31 Hand Gloves (sarung tangan) tanpa bedak Kotak 59 0 59 0 59 0
32 Handscond obgyn ktk/50 26 0 26 0 26 0
33 Handscond Maxter L ktk/50 psg 500 0 500 0 500 0
34 Handscond Maxter M ktk/50 psg 200 0 200 0 200 0
35 Handscond Maxter S ktk/50 psg 212 0 212 0 212 0
36 Handscond Steril pasang 24 0 24 0 24 0
37 Hidrogen peroksida 3 % Botol 1000ml 1 0 1 0 1 0
38 Infusion set anak kantong 37 50 87 0 87 0
39 Infusion set dewasa kantong 3 50 53 0 53 0
40 kapas berlemak 500 gram rol 7 0 7 0 7 0
41 Kapas Pembalut / Absorben 250 gram Rol 2 0 2 0 2 0
42 kapas pembalut 100 gram rol 1 0 1 0 1 0
43 Kapas pembalut 1000 gram rol 1 0 1 0 1 0
44 kapas pembalut 50 gram rol 4 0 4 0 4 0
45 kapas pembalutr 250 gram rol 18 0 18 0 18 0
46 kapas putih 100 gram rol 3 0 3 0 3 0
47 kapas putih 250 gram rol 21 0 21 0 21 0
48 kapas putih 50 gram rol 31 0 31 0 31 0
49 Kapas putih 500 gram rol 1 0 0 0 0 0
50 Kartu golongan darah ktk/100 0 0 0 0 0 0
51 Kasa hidrofil 2 yard x 80 cm Rol 0 0 0 0 0 0
52 Kasa Hidrofil DRC 40 yard x 80 cm rol 6 0 6 3 3 6
53 Kasa Kompres 40/40 steril Bungkus 61 0 61 0 61 100
54 Kasa Pembalut Hidrofil 2,7 cm x 15 cm Rol 100 0 100 0 100 0
55 Kasa Pembalut Hidrofil 4 m x 15 cm Rol 5 0 5 0 5 0
56 Kasa steril 16x16 rol 3 0 3 0 3 5
57 Kassa Verban 3 cm x 15 cm Rol 0 0 0 0 0 5
58 Kertas Perkamen lembar/rim 0 0 0 0 0 0
59 Kertas Puyer Press pcs 0 0 0 0 0 0
60 Kertas saring lembar 0 0 0 0 0 0
61 Kondom sutra pcs 0 0 0 0 0 50
62 KY Jelly tube 0 0 0 0 0 0
63 Masker hijau ktk/50 100 0 100 100 0 500
64 Medicine paket set 0 0 0 0 0 0
65 Micropipette 5 - 50µl Unit 0 0 0 0 0 0
66 Mortir + Stempel set 0 0 0 0 0 0
67 Oksigen Set Unit 0 0 0 0 0 0
68 Oneclean Botol 1000 ml 0 0 0 0 0 0
69 Oneclean botol 500 ml 2 0 2 0 2 0
70 Pembalut Gips (Gypsona 6 inchi x 3 yard) rol 11 0 11 0 11 0
71 Penjepit tali pusat set 277 0 277 0 277 0
72 pH Paper 3,8-5,4 ktk 0 0 0 0 0 0
73 Pipet Westergren buah 0 0 0 0 0 0
74 Plastik obat ( ukuran Besar ) lembar 0 0 0 0 0 500
75 Plastik obat ( ukuran Kecil ) lembar 0 0 0 0 0 0
76 Plester 5 cm x 4,5 m rol 6 0 6 0 6 0
77 Plester 5 cm x 5 m rol 5 0 5 0 5 0
78 Pot sputum buah 0 0 0 0 0 0
79 Rak tabung reaksi buah 0 0 0 0 0 0
80 Rak westergren/LED buah 0 0 0 0 0 0
81 Rapid 1 (oncoprobe) ktk/50 0 0 0 0 0 0
82 Rapid 2 (Advanced) ktk/100 0 0 0 0 0 0
83 Rapid 3 (Vikia) ktk/25 0 0 0 0 0 0
84 sarung tangan free Powder ukuran L 100 psg/ktk 200 0 200 100 100 500
85 sarung tangan free Powder ukuran M 100 psg/ktk 400 0 400 200 200 500
86 Sikat tabung (Korok Tabung) buah 0 0 0 0 0 0
87 Slide box pcs 0 0 0 0 0 0
88 Slide/objek glass Ktk/72 0 0 0 0 0 0
89 Spiritus cair buah 0 0 0 0 0 0
90 surgical suture with needle (Plain Catgut) pcs 24 0 24 0 24 0
91 surgical suture with needle (silk Braided) pcs 36 0 36 0 36 0
92 suture needle GT 10 12pcs/bks 24 0 24 0 24 0
93 suture needle GT 11 12pcs/bks 24 0 24 0 24 0
94 suture needle GT 12 12pcs/bks 24 0 24 0 24 0
95 suture needle GT 13 12pcs/bks 24 0 24 0 24 0
96 suture needle GT 6 12pcs/bks 24 0 24 0 24 0
97 suture needle GT 7 12pcs/bks 22 0 22 0 22 0
98 Tabung Sahli (HB Sahli) set 0 0 0 0 0 0
99 Tabung Sentrifuse buah 0 0 0 0 0 0
100 Tabung Serologi buah 0 0 0 0 0 0
101 Tabung Westergreen buah 0 0 0 0 0 0
102 Tensi Digital dan Stetoskop Kit 0 0 0 0 0 0
103 Test Kehamilan pcs 0 0 0 0 0 0
104 Torniket anak rol 0 0 0 0 0 0
105 Torniket dewasa set 0 0 0 0 0 0
106 Tromol, SS set 0 0 0 0 0 0
107 Ultrafix 10 cm x 1 cm ktk/25 0 0 0 0 0 0
108 Ultrafix 5 cm x 1 cm ktk/10 2 0 2 0 2 0
109 Urinalisa (Strip Urine Expert) set 0 0 0 0 0 0
110 Urinalisis (Mission Expert) Btl 0 0 0 0 0 0
111 Urine bag 2000 ml set 15 0 15 0 15 0
112 Usilakit (posyandu Lansia) kit 0 0 0 0 0 0
113 Vaselin album btl 1 liter 0 0 0 0 0 0
114 Yellow Tips ( 5µ / 10µ /25 µ ) ktk 0 0 0 0 0 0
0 0 0
Reagen 0 0 0 0
1 Asam Alkohol botol 0 0 0 0 0 0
2 Asam chlorida HCl 0,1 N botol 0 0 0 0 0 0
3 Combour tes Urine botol 0 0 0 0 0 0
4 EDTA cair botol 0 0 0 0 0 0
5 Emersi oil botol 100 ml 0 0 0 0 0 0
6 Etanol asam 3% botol 100 ml 0 0 0 0 0 0
7 Eter Alkohol botol 100 ml 0 0 0 0 0 0
8 Glemsa botol 0 0 0 0 0 0
9 HCL 0,1 N botol 0 0 0 0 0 0
10 Hexagon Sypillis Kotak/20 0 0 0 0 0 0
11 Karbol fuksin botol 500 ml 0 0 0 0 0 0
12 KOH 10% botol 0 0 0 0 0 0
13 Metanol btl / 500 ml 0 0 0 0 0 0
14 Metanol btl / 1000 ml 1 0 1 0 1 0
15 Metylen Blue botol 0 0 0 0 0 0
16 Na.Citrat 3,8% botol 0 0 0 0 0 0
17 Reagen ALT / GPT Kotak 0 0 0 0 0 0
18 Reagen Anti D Golongan Darah set 0 0 0 0 0 0
19 Reagen Antigen AO.S.Paratyphii Kotak 0 0 0 0 0 0
20 Reagen Antigen BO.S.Parathypii Kotak 0 0 0 0 0 0
21 Reagen Antigen H.S.Typhii Kit 0 0 0 0 0 0
22 Reagen Antigen O.S.Parathypii Kotak 0 0 0 0 0 0
23 Reagen Asam urat Kotak 0 0 0 0 0 0
24 Reagen AST / GOT Kotak 0 0 0 0 0 0
25 Reagen BTA set 0 0 0 0 0 0
26 Reagen Cholesterol Kotak 0 0 0 0 0 0
27 Reagen GDS Kotak 0 0 0 0 0 0
28 Reagen Golongan Darah Kit 0 0 0 0 0 0
29 Reagen RPR Sypilis kotak/100 0 0 0 0 0 0
30 Reagen Trigliserida Kotak 0 0 0 0 0 0
31 reagen Zield Nelsen pakel 0 0 0 0 0 5
32 SD HIV set 0 0 0 0 0 5
33 SD Syphilis 3.0 set 100 0 100 0 100 0
34 Stik Asam urat Botol/25 0 0 0 0 0 500
35 Stik Glucosa nesco Botol/25 0 0 0 0 0 500
36 Stik Kolesterol nesco Botol/10 0 0 0 0 0 500
37 Tes RDT Malaria Kotak/10 150 0 150 0 150 0
38 Xylol botol 0 0 0 0 0 0

Mengetahui, Kiruru, 4 Februari 2019

Kepala Puskesmas Kaimana Yang Meminta,
Petugas Pengelola Obat

Fransiska C.Balatando,S.Farm,Apt
Basri La hisa, Amk.
Nip. 197602142001111001

``
 PUSAT KESEHATAN MASYARAKAT KIRURU
REKAPITULASI PENGGUNAAN OBAT PSIKOTROPIKA PUSKESMAS KIRURU

BULAN Januari
TAHUN 2019

STOK JUMLAH
PERSEDI PEMAKAI
NO. NAMA OBAT SATUAN PENERIM
AWAL AAN AN
AAN
1 Diazepam 2 mg Botol/1000 tablet 0 0 0 0
2 Diazepam injeksi 5 mg/ml - 2ml Kotak/30 ampul 0 0 0 0
3 Haloperidol tablet 100 mg tablet 0 0 0 0
4 Phenobarbital 30 mg tablet 0 0 0 0
5 Phenobarbital injeksi Kotak/30 ampul 0 0 0 0
6 Klorpromazin HCL tablet 100 mg Tablet 0 0 0 0
7 Klorpromazin HCL injeksi 5 mg/ml-2 ml Ampul 0 0 0 0
8 Stesolid rectal Tube 0 0 0 0

Mengetahui
Kepala Puskesmas Kiruru, 4 februari 20

Pengelola Obat Pusk

Basri La hisa, Amk. Fransiska Celsia Bala

Nip. 197602142001111001 Nip.-
RU
ESMAS KIRURU

SISA
PERMINT
STOK AAN

0 100
0 0
0 0
0 0
0 0
0 0
0 0
0 10

Kiruru, 4 februari 2019

Pengelola Obat Puskesmas

Fransiska Celsia Balatando,S.Farm,Apt

 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

KODE PUSKESMAS :
PUSKESMAS : KIRURU
DISTRIK : TELUK ETNA
KABUPATEN : KAIMANA BULAN FEBRUARI
PROPINSI : PAPUA BARAT TAHUN 2019

STOK PENERI- PERSE- PEMA- SISA STOK PERMIN- PEMBERIAN KET

NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK OPTMUM TAAN APBN APBD II ASKES JML
1 2 3 4 5 6 7 8 9 10 11 12 13 15 16
1 Acyclovir krim 5 % tube 5 gram 50 0 50 0 50 0
2 Acyclovir tablet 200 mg tablet 600 0 600 0 600 0
3 Acyclovir tablet 400 mg tablet 450 0 450 0 450 0
4 Albendazol tablet 400 mg tablet 0 0 0 0 0 0
5 Alopurinol tablet 100 mg tablet 3000 0 3000 2000 1000 3000
6 Altran (Asam mefenamat 500 mg) tablet 0 0 0 0 0 2000
7 Ambroxol sirup 15 mg/ml btl 60 ml 0 0 0 0 0 200
8 Ambroxol tablet 30 mg tablet 600 0 600 500 100 2000
9 Aminofilin tablet 100 mg tablet 0 0 0 0 0 0
10 Aminofilina injeksi 24 mg/ml - 10 ml ampul 122 0 122 0 122 0
11 Amlodipin tablet 10 mg tablet 600 0 600 0 600 0
12 Amlodipin tablet 5 mg tablet 0 0 0 0 0 0
13 Amoksisilin kaplet 500 mg kaplet 7100 0 7100 2000 5100 0
14 Amoksisilin sirup kering 125 mg/5 ml Botol 60 ml 39 0 39 39 0 200
15 Ampicillin injeksi ampul 7 0 7 0 7 0
16 Ampicillin Tablet tablet 1200 0 1200 500 700 500
17 Antalgin (Metampiron) tablet 500 mg tablet 200 1000 1200 500 700 500
18 Antalgin injeksi 250 mg/ml - 2 ml ampul 220 0 220 0 220 0
19 Antasida DOEN SYR Botol 60 ml 0 0 0 0 0 0
20 Antasida DOEN tab botol/1000 0 0 0 0 0 0
21 Antasida DOEN tab ktk/100 1500 3000 4500 4000 500 5000
 Anti Bakteri DOEN salep kombinasi:
22 Basitrasin 500 IU/g + Polimiksin 10.000 IU/g tube 5 g
0 0 0 0 0 0
23 Anti Hemoroid Superhoid supositoria supp 66 0 66 24 42 24
Anti hemoroid suppositoria supp 0 30 30 0 30 0
24 Antifungi DOEN Pot 30 gram 168 0 168 24 144 0

25 Antifungi DOEN (Whitefield) salep kombinasi Pot 30 gram

0 0 0 0 0 0
26 Aqua pro Injeksi steril, bebas pirogen botol 0 0 0 0 0 0
27 Artesunate injeksi 8 ampul/kotak 24 0 24 0 24 0
28 Asam Askorbat (Vit C) tablet 50 mg tablet 11600 0 11600 5000 6600 5000
29 Asam Folat / Profolat tablet 2700 0 2700 500 2200 0
30 Asam Mefenamat 500 mg tablet 1000 0 1000 300 700 500
31 Asam Traneksamat 500 mg tablet 200 0 200 0 200 0
32 Asam traneksamat inj ampul 20 0 20 0 20 0
33 Asetosal 100 mg tablet 0 0 0 0 0 0
34 Asetosal 500 mg tablet 0 0 0 0 0 0
35 Benzatin Benzi Penisillin 2,4 juta iu/vial vial 0 0 0 0 0 0
36 Benzatin Benzil Penisillin 1,2 juta iu/vial vial 8 0 8 0 8 0
37 Betahistin tablet tablet 930 0 930 60 870 0
38 Betametason krim 0.1% tube 5 gram 174 0 174 74 100 0
39 Bimatracin tablet 0 0 0 0 0 0
40 Bioplacenton jelly tube 15 gram 24 24 48 28 20 48
41 Bronkis tablet 2600 0 2600 1800 800 3000
42 Burnazin salep tube 35 g 0 0 0 0 0 0
43 Byolisin syp botol/60 ml 0 0 0 0 0 0
44 Caviplex tablet ktk/100 200 2000 2200 2200 0 5000
45 Cefford FORTE (Sefadroksil kapsul 500 mg) tablet 1000 0 1000 0 1000 1000
46 Cefixime 200 mg tablet 0 0 0 0 0 0
47 Cetirizine 10 mg kapsul 0 0 0 0 0 0
48 Chinine antipirin injeksi 2 ml ampul 0 0 0 0 0 0
49 Cimetidin tablet 200mg tablet 300 0 300 100 200 500
50 Clindamicyn 150 mg tablet 0 0 0 0 0 0
51 Clindamicyn 300 mg tablet 0 0 0 0 0 0
52 Combantrin syrup botol 10 ml 0 0 0 0 0 0
53 Combi Pack Azytro tablet 0 0 0 0 0 0
54 Combi Pack Azytro + Ceffixime tablet 0 0 0 0 0 0
55 Combi pack Paket Kusta Anak MB paket 0 0 0 0 0 0
56 Combi pack Paket Kusta Anak PB Paket 0 0 0 0 0 0
57 Combi pack Paket Kusta Dewasa MB Paket/ 6 Strip 0 0 0 0 0 0
58 Combi Pack Paket Kusta Dewasa PB Paket 0 0 0 0 0 0
59 Curcuma tablet 0 0 0 0 0 0
60 Daneuron tablet 100 0 100 100 0 500
61 Decacetine ( Chlorampenicol TTM ) btl 35 0 35 19 16 0
62 Deksametason injeksi 5 mg/ml - 1 ml ampul 271 0 271 0 271 0
63 Deksametason tablet 0,5 mg ktk/100 7200 0 7200 1400 5800 0
64 Difenhidramin HCl injeksi 10 mg/ml-1 ml ktk/30 ampul 60 0 60 0 60 0
65 Digoksin tablet 0,25 mg tablet 0 0 0 0 0 0
66 Domperidon sirup 5 mg/5 ml Botol 60 ml 100 0 100 0 100 0
67 Domperidon tablet 10 mg tablet 500 0 500 200 300 500
68 Doxyciclin kapsul 100 mg kapsul 0 0 0 0 0 0
69 Dulcolax Suppositoria 10 mg supp 0 0 0 0 0 0
70 Dulcolax Suppositoria 5 mg supp 0 0 0 0 0 0
71 Efedrin HCl tablet 25 mg btl/250 0 0 0 0 0 0
72 Epineprin inj 0 ,1 %(adrenalin) ampul 57 0 57 0 57 0
73 Ergotamine Caffeine Tablet 900 0 900 100 800 0
74 Eritromicin sirop kering 200 mgl / 5ml Botol 60 ml 12 0 12 3 9 0
75 Erlamycetin Salp Mata tube 3 0 3 0 3 0
76 Erlamycetin tetes telinga 1% tube 61 0 61 0 61 0
77 Erphazone ( Phenylbutazone 200 mg ) btl/1000 0 0 0 0 0 0
78 Erytromicin kapsul 250 mg kapsul 0 0 0 0 0 0
79 Erytromicin kapsul 500 mg kapsul 400 0 400 100 300 500
80 Etakridin ( Rivanol ) larutan 0,1% Botol 300 ml 16 0 16 0 16 0
81 Etanol ( alkohol ) 70% botol 100 ml 15 0 15 9 6 10
82 Etanol ( alkohol ) 70% Botol 300 ml 0 0 0 0 0 0
83 Etanol ( alkohol ) 70% botol 1000 ml 5 0 5 1 4 0
84 Ethambutol tablet 250mg tablet 0 0 0 0 0 0
85 Ethambutol tablet 500mg tablet 0 0 0 0 0 0
86 Farmalat (Nifedipin) tablet 10 mg tablet 0 0 0 0 0 0
87 faxiden 20 mg tab tablet 600 1000 1600 500 1100 0
88 Fenilbutalson tablet 200 mg Btl/1000 0 0 0 0 0 0
89 Fenilbutalson tablet 200 mg ktk/150 0 0 0 0 0 0
90 Fenol Gliserol tetes telinga 10% botol 5 ml 120 0 120 0 120 0
91 Fermia ktk/100 0 0 0 0 0 0
92 Ferrous Sulphate tablet 300 mg tablet 0 0 0 0 0 0
93 Fitomenadion (Vit.K1) inj 10 mg/ml - 1 ml ampul 109 0 109 0 109 0
94 Fitomenadion (Vit.K1) tab salut gula 10 mg tablet 0 0 0 0 0 0
95 Fluconazole tablet 0 0 0 0 0 0
96 Furosemid tablet 0,5 mg tablet 100 0 100 100 0 100
97 Garam Oralit untuk 200 ml air sachet 1300 0 1300 300 1000 0
98 Gemfibrosil kapsul 300 Mg kapsul 0 0 0 0 0 0
99 Gemfibrosil kapsul 600 Mg kapsul 300 0 300 0 300 0
100 gentalex salep kulit 0,1 % ktk/10 tube 140 0 140 80 60 300
101 Gentamicin inj 80mg/2ml ampul 50 0 50 0 50 0
102 Gentamicin salep kulit 0,1 % ktk/ 10 tube 10 0 10 10 0 200
103 Gentian Violet larutan 1 % Botol 10 ml 120 0 120 20 100 0
104 Gitarmin ( Asam Mefenamat 500 mg ) tablet 100 0 100 0 100 0
105 Gitri sirup Botol 60 ml 0 0 0 0 0 0
106 Glibenklamid tablet 5 mg tablet 0 0 0 0 0 0
107 Glikos (Metformin 500 mg) tablet 600 0 600 0 600 0
108 Gliseril Guaiakolat tablet 100 mg tablet 5600 0 5600 300 5300 0
109 Gludepatic 500 mg tablet 400 0 400 0 400 0
110 Glukosa larutan infus 5 % steril Botol 500 ml 125 0 125 0 125 0
111 Gradilex 2 mg / Loperamid tablet 3200 0 3200 1000 2200 1000
112 Grafazole 500 mg tablet 0 0 0 0 0 0
113 Graseric 150 mg tablet 0 0 0 0 0 0
114 Gravalin 2 mg / Salbutamol 2 mg tablet 2000 0 2000 500 1500 1000
115 Gravask 10 mg tablet 60 0 60 0 60 0
116 Gravask 5 mg tablet 0 0 0 0 0 0
117 Gricin 500 mg tablet 400 0 400 400 0 2000
118 Griseofulvin tablet 125 mg tablet 2400 0 2400 300 2100 500
119 Griseofulvin tablet 500 mg tablet 2200 0 2200 500 1700 500
120 Hidroklorotiazid (HCT) tablet 25 mg tablet 200 0 200 0 200 0
121 Hidrokortison krim 2,5 % tube 5 g 72 0 72 23 49 48
122 Holimox Syp ( Amox Syp) btl / 60 ml 79 0 79 50 29 200
123 Hustab tablet 2600 3600 6200 4700 1500 3000
124 Ibuprofen Syp btl 5 ml 0 0 0 0 0 0
125 Ibuprofen tablet 200 mg tablet 2300 0 2300 900 1400 2000
126 Ibuprofen tablet 400 mg tablet 5000 0 5000 0 5000 0
127 Ichtiyol Salf pot 24 24 48 24 24 48
128 Ifison ( Prednisone ) tablet 0 0 0 0 0 0
129 Infantrim forte tablet 480 mg tablet 1400 0 1400 0 1400 0
130 Irgapan tablet 1000 0 1000 1000 0 3000
131 Isoniazid ( INH ) 100 mg tablet 0 0 0 0 0 0
132 Isoniazid ( INH ) 300 mg tablet 300 0 300 0 300 0
133 Isosorbid Dinitrat tablet sublingual 5 mg tablet 700 0 700 0 700 0
134 Itrasal Syp btl 5 ml 0 0 0 0 0 0
135 Kalium diklofenak tablet tablet 0 0 0 0 0 0
136 Kalsium Laktat (Kalk) tablet 500 mg ktk/100 0 0 0 0 0 0
137 Kalsium Laktat (Kalk) tablet 500 mg Btl/1000 4000 0 4000 0 4000 0
138 Kanamicin inj 1 gram/vial vial 0 0 0 0 0 0
139 Kaptopril tablet 12,5 mg tablet 1800 0 1800 800 1000 500
140 Kaptopril tablet 25 mg tablet 2400 0 2400 2000 400 1000
141 Katitra (Tertracycline) Kapsul 500 mg kapsul 0 0 0 0 0 0
142 Kemoren 50 mg tablet 0 0 0 0 0 0
143 Ketokonazol salep 2% tube 10 gram 48 0 48 37 11 48
144 Ketokonazol tablet 200 mg tablet 1500 0 1500 800 700 1000
145 Kina tablet salut gula ktk/24x12 0 0 0 0 0 0
146 Kloramfenikol kapsul 250 mg kapsul 0 0 0 0 0 0
147 Kloramfenikol salep kulit tube 5 mg 0 0 0 0 0 0
148 Kloramfenikol tetes telinga 3 % botol 5 ml 0 0 0 0 0 0
149 Klorampenicol salep mata 1 % tube 5 g 0 0 0 0 0 0
150 Klorampenicol tetes mata 0.5% (Reco) botol 5 ml 0 0 0 0 0 0
151 Klorfeniramin Maleat (CTM) tablet 4 mg tablet 4600 0 4600 2000 2600 3000
152 Kloroquine tablet 250mg tablet 400 0 400 0 400 0
153 Klorquine tablet 150 mg tablet 0 0 0 0 0 0
154 Kokodin 10 % Btl/1000 ml 0 0 0 0 0 0
155 Kokodin 10 % Btl/300 ml 0 0 0 0 0 0
156 Kokotra (Tetracycline) kapsul 250 mg kapsul 0 0 0 0 0 0
Komb Pirimetamin 25 mg + Sulfadoxin 500 mg
157 tablet
1000 0 1000 0 1000 0
Kotrimoksazol susp kombinasi :
158 sulfametaksazol 200 mg + trimetropim 40mg/ 5 botol 60 ml
ml 245 0 245 0 245 0

Kotrimoksazol tablet kombonasi :

159 tablet
sulfametaksazole 400 mg + Trimetropim 80 mg
5200 0 5200 0 5200 0
160 Kotrimoksazol tablet pediatrik 120 mg tablet 0 0 0 0 0 0
161 Kuinin Dihidroklorida injeksi 25% - 2 ml ampul 0 0 0 0 0 0
162 Levofloksasin 500 mg tablet 0 0 0 0 0 0
163 Licopec Kaplet 0 0 0 0 0 0

Lidokain komp. Injeksi, Kombinasi : lidokain HCl

164 ampul
2% + epinefrin 1 : 80.000- 2ml
30 0 30 0 30 0
165 Lifadrox DS Syp Btl/60 ml 0 0 0 0 0 0
166 Lisol Concentrate Botol 1000 ml 0 0 0 0 0 0
167 Lodia 2 mg tablet 0 0 0 0 0 0
168 Loperamide 2 mg tablet 0 0 0 0 0 0
169 Loratadine tablet 100 mg tablet 4600 0 4600 0 4600 0
170 Mebendazol tablet 100 mg tablet 0 0 0 0 0 0
171 Metformin 500 mg tablet 0 0 0 0 0 0
172 Methilergometrin Maleat tab.salut 0,125 tablet 1200 0 1200 0 1200 0
173 Methylprednisolone tablet 16 mg tablet 0 0 0 0 0 0
174 Methylprednisolone tablet 4 mg tablet 0 0 0 0 0 0
175 Methylprednisolone tablet 8 mg tablet 0 0 0 0 0 0
176 Metronidazol tablet 250 mg tablet 0 0 0 0 0 0
177 Metronidazol tablet 500 mg tablet 1600 0 1600 0 1600 0
178 Miconasole 2 % krim tube 10 gram 72 0 72 28 44 48
 Myomergin
179 Ampul 28 28
(Metilergometrin Maleat inj 0,200 mg-1 ml) 28 0 0 0
180 Natrium diklofenak 25 mg tablet 0 0 0 0 0 0
181 Natrium diklofenak 50 mg tablet 0 0 0 0 0 0
182 Natrium Klorida larutan infus 0,9 % steril botol 500 ml 53 0 53 0 53 0
183 Neurobion 5000 injeksi 3 ml Ampl/Psng 18 40 58 0 58 0
184 nifedipin tablet tablet 1600 0 1600 0 1600 0
185 Nistatin tablet salut gula 500.000 IU tablet 0 0 0 0 0 0
186 Nistatin tablet vaginal 100.000 IU tablet 0 0 0 0 0 0
187 Norpid 10 mg ( Simvastatin 10 mg ) tablet 0 0 0 0 0 0
188 Novabion kapsul 1000 0 1000 1000 0 3000
189 Novadiar Syr btl 60 ml 0 0 0 0 0 0
190 Novadium tablet 0 0 0 0 0 0
191 Novamag Syp btl 60 ml 275 0 275 198 77 300
192 nuvopec 15 mg/ml Botol 60 ml 95 0 95 62 33 100
193 nuvopec tablet 30 mg tablet 3000 0 3000 1000 2000 500
194 Obat anti Malaria (DHP) ktk/9 90 0 90 0 90 0
195 Obat Batuk Hitam ( O.B.H. ) cairan Botol 100 ml 132 0 132 72 60 100
196 Obat OAT Kategori I Anak Paket 0 0 0 0 0 0
197 Obat OAT Kategori I Dewasa paket 0 0 0 0 0 0
198 Obat OAT Kategori II Paket 0 0 0 0 0 0
199 Obimin Dos/30 210 0 210 120 90 900
200 Oksitetrasiklin HCl salep kulit 3 % tube 5 g 0 0 0 0 0 0
201 Oksitetrasiklin HCl salep mata 1 % tube 5 g 0 0 0 0 0 0
202 Oksitosin injeksi 10 IU/ml - 1 ml ampul 0 0 0 0 0 0
203 Omegdiar sirup btl 60 ml 0 0 0 0 0 0
204 Omeprasole kapsul 20 mg kapsul 1590 0 1590 0 1590 0
205 Papaverin injeksi 40 mg / ml vial 0 0 0 0 0 0
206 Papaverin tablet 40 mg tablet 1000 0 1000 0 1000 0
207 Parasetamol sirup 120 mg/5 ml Botol 60 ml 570 0 570 256 314 0
208 Parasetamol tablet 500 mg ktk/100 14000 0 14000 5100 8900 0
209 Pehacaine injeksi ampul 10 0 10 0 10 0
210 Piracetam tablet 400 mg tablet 0 0 0 0 0 0
211 Piracetam tablet 800 mg tablet 0 0 0 0 0 0
212 Pirantel Syp Botol 60 ml 25 0 25 0 25 0
213 Pirantel tablet 125 mg tablet 1800 0 1800 0 1800 0
214 Pirazinamide tablet 500 mg tablet 0 0 0 0 0 0
215 Piridoksin HCl (Vit.B6) tablet 10 mg tablet 7100 0 7100 2100 5000 0
216 Piroxicam tablet 10 mg tablet 0 0 0 0 0 0
217 Piroxicam tablet 20 mg tablet 100 0 100 100 0 500
218 Povidon Iodida 10 % Botol 30 ml 50 0 50 30 20 100
219 Povidon Iodida 10 % Botol 60 ml 11 0 11 5 6 5
220 Povidon Iodida 10 % Botol 300 ml 0 0 0 0 0 0
221 Povidon Iodida 10 % Botol 1000 ml 0 0 0 0 0 0
222 Prednison tablet 5 mg tablet 9600 0 9600 2000 7600 2000
223 Prenamia tablet 0 0 0 0 0 0
224 Primakuin tablet 15 mg tablet 200 0 200 0 200 0
225 Procain Benzill Penicillin Inj. 3 juta IU vial 0 0 0 0 0 0
226 Propanolol HCL tablet 10 mg tablet 0 0 0 0 0 0
227 Propanolol HCL tablet 40 mg tablet 0 0 0 0 0 0
228 Propilititiurasil tablet 100 mg tablet 0 0 0 0 0 0
229 Pytogin injeksi 10 IU/ml - 1 ml ampul 0 100 100 12 88 0
230 Quinine tablet 222 mg Btl/1000 0 0 0 0 0 0
231 Quinine tablet 222 mg ktk/60 400 0 400 0 400 0
232 Ramolit sachet 0 0 0 0 0 0
233 Ranitidin tablet 150 mg tablet 8100 0 8100 2000 6100 1000
234 Ranitidine injeksi 25 mg/ml - 2ml ampul 120 0 120 0 120 0
235 Rifampicin kapsul 300 mg kapsul 0 0 0 0 0 0
236 Rifampicin tablet 450 mg tablet 0 0 0 0 0 0
237 Rifampicin tablet 600 mg tablet 0 0 0 0 0 0
Ringer Laktat larutan infus steril (Produk lokal)
238 botol 500 ml 125 125
125 0 0 0
239 Salbutamol tablet 2 mg tablet 0 0 0 0 0 0
240 Salbutamol tablet 4 mg tablet 3000 0 3000 1678 1322 1000
Salep 2-4 , Kombinasi:
241 Pot 30 gram 134 134
As Salisilat 2% + Belerang Endap 4% 134 0 0 0
242 Salisil Bedak 2 % pot 50 gram 58 0 58 0 58 0
243 Sefadroksil sirup 125mg/5ml btl 60 ml 117 0 117 0 117 0
244 sefotaxim serbuk injeksi 1 gram/vial 2 vial/kotak 10 0 10 0 10 0
245 seftriaxon serbuk injeksi 1 gram/ vial 2 vial/kotak 0 0 0 0 0 0
246 Selespurin (Allopurinol 100 mg ) tablet 0 0 0 0 0 0
247 Sianokobalamin (Vit.B12) 50 mcg Btl/1000 0 0 0 0 0 0
248 Sianokobalamin (Vit.B12) 50 mcg Ktk/100 5100 0 5100 0 5100 0
Sianokobalamin (Vit.B12) injeksi 500 mcg-ml
249 ampul 300 300
300 0 0 0
250 Simvastatin tablet 10 mg tablet 2970 0 2970 0 2970 0
251 Simvastatin tablet 20 mg tablet 0 0 0 0 0 0
252 Siprofloksasin tablet 500mg tablet 400 0 400 0 400 0
253 Tablet tambah darah + as folat tablet 5710 0 5710 0 5710 0
254 Tetrasiklin HCl kapsul 250 mg kapsul 0 0 0 0 0 0
255 Tetrasiklin HCl kapsul 500 mg kapsul 0 0 0 0 0 0
256 Thiamfenicol 500 mg tablet 0 0 0 0 0 0
257 Tiamin HCl (Vit.B1) injeksi 100 mg/ml-1 ml ampul 173 0 173 0 173 0
258 Tiamin HCl / Mononitrat (Vit.B1) tab.50 mg tablet 1100 0 1100 0 1100 0
259 Tuzalos tablet tablet 0 0 0 0 0 0
260 Ultrasonic gell btl 250 gram 3 3 6 0 6 0
261 Ultravita Multivitamin tablet 0 0 0 0 0 0
262 Univit Syp btl 60 ml 106 0 106 58 48 200
263 Vitamin A 100.000iu kapsul 350 0 350 0 350 0
264 Vitamin A 200.000iu kapsul 900 0 900 0 900 0
265 Vitamin B Kompleks tablet tablet 4300 0 4300 0 4300 0
266 Zinc tablet tablet 2000 2000 4000 2100 1900 3000

Alat Kesehatan
1 Abocath No. 18 set 122 0 122 0 122 0
2 Abocath No. 20 set 0 0 0 0 0 0
3 Abocath No. 22 set 142 0 142 0 142 0
4 Abocath No. 24 100 set/kotak 85 0 85 0 85 0
5 Abocath No. 26 100 set/kot 0 0 0 0 0 0
6 Alat suntik sekali pakai 0,5 ml 100 set/kot 200 0 200 0 200 0
7 Alat suntik sekali pakai 1 ml 100 set/kotak 300 0 300 0 300 0
8 Alat suntik sekali pakai 10 ml 100 set/kotak 100 0 100 0 100 0
9 Alat suntik sekali pakai 2,5 ml 100 set/kotak 200 0 200 0 200 0
10 Alat suntik sekali pakai 3 ml 100 set/kotak 300 0 300 0 300 0
11 Alat suntik sekali pakai 5 ml 100 set/kotak 274 0 274 0 274 0
12 Alat suntik sekali pakai 50 ml 100 set/kotak 200 0 200 0 200 0
13 Alkohol Swab Kotak 600 0 600 0 600 0
14 Bisturi no 10 set 50 0 50 0 50 50
15 Bisturi no 11 set 0 0 0 0 0 50
16 Blood lancet set 160 0 160 0 160 0
17 Catgut / Benang Bedah chrom 3/0 matrix 3 buah 72 0 72 0 72 0
18 Catgut / Benang Bedah No. 4/0 buah 0 0 0 0 0 0
19 Catgut/Benang Bedah No.2/0 buah 0 0 0 0 0 0
20 Cotton Swab buah 0 0 0 0 0 0
21 Cover glass buah 50 0 50 0 50 0
22 Digital Thermometer buah 0 0 0 0 0 0
23 Etil Klorida spray botol 100 ml 2 0 2 0 2 0
24 feeding tube 8 FR x 120 cm buah 0 0 40 0 0 0
25 Foley catheter no 12 buah 10 0 10 0 10 0
26 Foley catheter no 14 buah 70 0 70 0 70 0
27 Foley catheter no 16 buah 21 0 21 0 21 0
28 Foley catheter no 18 buah 0 0 0 0 0 0
29 Foley catheter no 20 buah 0 0 0 0 0 0
30 Haemometer / Hb Sahli set 2 0 2 0 2 0
31 Hand Gloves (sarung tangan) tanpa bedak Kotak 59 0 59 0 59 0
32 Handscond obgyn ktk/50 26 0 26 0 26 0
33 Handscond Maxter L ktk/50 psg 500 300 800 0 800 0
34 Handscond Maxter M ktk/50 psg 200 300 500 0 500 0
35 Handscond Maxter S ktk/50 psg 212 0 212 0 212 0
36 Handscond Steril pasang 24 0 24 0 24 0
37 Hidrogen peroksida 3 % Botol 1000ml 1 0 1 0 1 0
38 Infusion set anak kantong 87 0 87 0 87 0
39 Infusion set dewasa kantong 53 0 53 0 53 0
40 kapas berlemak 500 gram rol 7 0 7 0 7 0
41 Kapas Pembalut / Absorben 250 gram Rol 2 0 2 0 2 0
42 kapas pembalut 100 gram rol 1 0 1 0 1 0
43 Kapas pembalut 1000 gram rol 1 0 1 0 1 0
44 kapas pembalut 50 gram rol 4 0 4 0 4 0
45 kapas pembalutr 250 gram rol 18 0 18 0 18 0
46 kapas putih 100 gram rol 3 0 3 0 3 0
47 kapas putih 250 gram rol 21 0 21 0 21 0
48 kapas putih 50 gram rol 31 0 31 0 31 0
49 Kapas putih 500 gram rol 0 0 0 0 0 0
50 Kartu golongan darah ktk/100 0 0 0 0 0 0
51 Kasa hidrofil 2 yard x 80 cm Rol 0 0 0 0 0 0
52 Kasa Hidrofil DRC 40 yard x 80 cm rol 3 4 7 0 7 6
53 Kasa Kompres 40/40 steril Bungkus 61 0 61 0 61 100
54 Kasa Pembalut Hidrofil 2,7 cm x 15 cm Rol 100 0 100 0 100 0
55 Kasa Pembalut Hidrofil 4 m x 15 cm Rol 5 0 5 0 5 0
56 Kasa steril 16x16 rol 3 20 23 0 23 5
57 Kassa Verban 3 cm x 15 cm Rol 0 50 50 0 50 5
58 Kertas Perkamen lembar/rim 0 0 0 0 0 0
59 Kertas Puyer Press pcs 0 0 0 0 0 0
60 Kertas saring lembar 0 0 0 0 0 0
61 Kondom KTK/3 0 36 36 0 36 50
62 KY Jelly tube 0 0 0 0 0 0
63 Masker hijau ktk/50 200 0 200 0 200 500
64 Medicine paket set 0 0 0 0 0 0
65 Micropipette 5 - 50µl Unit 0 0 0 0 0 0
66 Mortir + Stempel set 0 0 0 0 0 0
67 Oksigen Set Unit 0 0 0 0 0 0
68 Oneclean Botol 1000 ml 0 0 0 0 0 0
69 Oneclean botol 500 ml 2 0 2 0 2 0
70 Pembalut Gips (Gypsona 6 inchi x 3 yard) rol 11 0 11 0 11 0
71 Penjepit tali pusat set 277 0 277 0 277 0
72 pH Paper 3,8-5,4 ktk 0 0 0 0 0 0
73 Pipet Westergren buah 0 0 0 0 0 0
74 Plastik obat ( ukuran Besar ) lembar 0 0 0 0 0 500
75 Plastik obat ( ukuran Kecil ) lembar 0 2000 2000 0 2000 0
76 Plester 5 cm x 4,5 m rol 6 0 6 0 6 0
77 Plester 5 cm x 5 m rol 5 0 5 0 5 0
78 Pot sputum buah 0 0 0 0 0 0
79 Rak tabung reaksi buah 0 0 0 0 0 0
80 Rak westergren/LED buah 0 0 0 0 0 0
81 Rapid 1 (oncoprobe) ktk/50 0 0 0 0 0 0
82 Rapid 2 (Advanced) ktk/100 0 0 0 0 0 0
83 Rapid 3 (Vikia) ktk/25 0 0 0 0 0 0
84 sarung tangan free Powder ukuran L 100 psg/ktk 100 0 100 0 100 500
85 sarung tangan free Powder ukuran M 100 psg/ktk 200 0 200 0 200 500
86 Sikat tabung (Korok Tabung) buah 0 0 0 0 0 0
87 Slide box pcs 0 0 0 0 0 0
88 Slide/objek glass Ktk/72 0 0 0 0 0 0
89 Spiritus cair buah 0 0 0 0 0 0
90 surgical suture with needle (Plain Catgut) pcs 24 0 24 0 24 0
91 surgical suture with needle (silk Braided) pcs 36 0 36 0 36 0
92 suture needle GT 10 12pcs/bks 24 0 24 0 24 0
93 suture needle GT 11 12pcs/bks 24 0 24 0 24 0
94 suture needle GT 12 12pcs/bks 24 0 24 0 24 0
95 suture needle GT 13 12pcs/bks 24 0 24 0 24 0
96 suture needle GT 6 12pcs/bks 24 0 24 0 24 0
97 suture needle GT 7 12pcs/bks 22 0 22 0 22 0
98 Tabung Sahli (HB Sahli) set 0 0 0 0 0 0
99 Tabung Sentrifuse buah 0 0 0 0 0 0
100 Tabung Serologi buah 0 0 0 0 0 0
101 Tabung Westergreen buah 0 0 0 0 0 0
102 Tensi Digital dan Stetoskop Kit 0 0 0 0 0 0
103 Test Kehamilan pcs 0 0 0 0 0 0
104 Torniket anak rol 0 0 0 0 0 0
105 Torniket dewasa set 0 0 0 0 0 0
106 Tromol, SS set 0 0 0 0 0 0
107 Ultrafix 10 cm x 1 cm ktk/25 0 0 0 0 0 0
108 Ultrafix 5 cm x 1 cm ktk/10 2 0 2 0 2 0
109 Urinalisa (Strip Urine Expert) set 0 0 0 0 0 0
110 Urinalisis (Mission Expert) Btl 0 0 0 0 0 0
111 Urine bag 2000 ml set 15 0 15 0 15 0
112 Usilakit (posyandu Lansia) kit 0 0 0 0 0 0
113 Vaselin album btl 1 liter 0 0 0 0 0 0
114 Yellow Tips ( 5µ / 10µ /25 µ ) ktk 0 0 0 0 0 0
0 0 0
Reagen 0 0 0
1 Asam Alkohol botol 0 0 0 0 0 0
2 Asam chlorida HCl 0,1 N botol 0 0 0 0 0 0
3 Combour tes Urine botol 0 0 0 0 0 0
4 EDTA cair botol 0 0 0 0 0 0
5 Emersi oil botol 100 ml 0 0 0 0 0 0
6 Etanol asam 3% botol 100 ml 0 0 0 0 0 0
7 Eter Alkohol botol 100 ml 0 0 0 0 0 0
8 Glemsa botol 0 0 0 0 0 0
9 HCL 0,1 N botol 0 0 0 0 0 0
10 Hexagon Sypillis Kotak/20 0 0 0 0 0 0
11 Karbol fuksin botol 500 ml 0 0 0 0 0 0
12 KOH 10% botol 0 0 0 0 0 0
13 Metanol btl / 500 ml 0 0 0 0 0 0
14 Metanol btl / 1000 ml 1 0 1 0 1 0
15 Metylen Blue botol 0 0 0 0 0 0
16 Na.Citrat 3,8% botol 0 0 0 0 0 0
17 Reagen ALT / GPT Kotak 0 0 0 0 0 0
18 Reagen Anti D Golongan Darah set 0 0 0 0 0 0
19 Reagen Antigen AO.S.Paratyphii Kotak 0 0 0 0 0 0
20 Reagen Antigen BO.S.Parathypii Kotak 0 0 0 0 0 0
21 Reagen Antigen H.S.Typhii Kit 0 0 0 0 0 0
22 Reagen Antigen O.S.Parathypii Kotak 0 0 0 0 0 0
23 Reagen Asam urat Kotak 0 0 0 0 0 0
24 Reagen AST / GOT Kotak 0 0 0 0 0 0
25 Reagen BTA set 0 0 0 0 0 0
26 Reagen Cholesterol Kotak 0 0 0 0 0 0
27 Reagen GDS Kotak 0 0 0 0 0 0
28 Reagen Golongan Darah Kit 0 0 0 0 0 0
29 Reagen RPR Sypilis kotak/100 0 0 0 0 0 0
30 Reagen Trigliserida Kotak 0 0 0 0 0 0
31 reagen Zield Nelsen KIT 0 2 2 0 2 5
32 SD HIV set 0 100 100 0 100 5
33 SD Syphilis 3.0 set 100 0 100 0 100 0
34 Stik Asam urat Botol/25 0 100 100 0 100 500
35 Stik Glucosa nesco Botol/25 0 100 100 0 100 500
36 Stik Kolesterol nesco Botol/10 0 0 0 0 0 500
37 Tes RDT Malaria Kotak/10 0 0 0 0 0
38 Xylol botol 0 0 0 0 0

Mengetahui, Kiruru, 4 Maret 2019

Kepala Puskesmas Kaimana Yang Meminta,
Petugas Pengelola Obat

Fransiska C.Balatando,S.Farm,Apt
Basri La hisa, Amk.
Nip. 197602142001111001
``
 PUSAT KESEHATAN MASYARAKAT KIRURU
REKAPITULASI PENGGUNAAN OBAT PSIKOTROPIKA PUSKESMAS KIRURU

BULAN Februari
TAHUN 2019

STOK JUMLAH
PERSEDI PEMAKAI
NO. NAMA OBAT SATUAN PENERIM
AWAL AAN AN
AAN
1 Diazepam 2 mg Botol/1000 tablet 0 0 0 0
2 Diazepam injeksi 5 mg/ml - 2ml Kotak/30 ampul 0 0 0 0
3 Haloperidol tablet 100 mg tablet 0 0 0 0
4 Phenobarbital 30 mg tablet 0 0 0 0
5 Phenobarbital injeksi Kotak/30 ampul 0 0 0 0
6 Klorpromazin HCL tablet 100 mg Tablet 0 0 0 0
7 Klorpromazin HCL injeksi 5 mg/ml-2 ml Ampul 0 0 0 0
8 Stesolid rectal Tube 0 0 0 0

Mengetahui
Kepala Puskesmas Kiruru, 4 Maret 2019

Pengelola Obat Pusk

Basri La hisa, Amk. Fransiska Celsia Bala

Nip. 197602142001111001 Nip.-
RU
ESMAS KIRURU

SISA
PERMINT
STOK AAN

0 100
0 0
0 0
0 0
0 0
0 0
0 0
0 10

Kiruru, 4 Maret 2019

Pengelola Obat Puskesmas

Fransiska Celsia Balatando,S.Farm,Apt

 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

KODE PUSKESMAS :
PUSKESMAS : KIRURU
DISTRIK : TELUK ETNA
KABUPATEN : KAIMANA BULAN MARET
PROPINSI : PAPUA BARAT TAHUN 2019

STOK PENERI- PERSE- PEMA- SISA STOK PERMIN- PEMBERIAN KET

NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK OPTMUM TAAN APBN APBD II ASKES JML
1 2 3 4 5 6 7 8 9 10 11 12 13 15 16
1 Acyclovir krim 5 % tube 5 gram 50 0 50 0 50 0
2 Acyclovir tablet 200 mg tablet 600 0 600 200 400 0
3 Acyclovir tablet 400 mg tablet 450 0 450 50 400 0
4 Albendazol tablet 400 mg tablet 0 0 0 0 0 0
5 Alopurinol tablet 100 mg tablet 1000 0 1000 0 1000 0
6 Altran (Asam mefenamat 500 mg) tablet 0 0 0 0 0 0
7 Ambroxol sirup 15 mg/ml btl 60 ml 0 0 0 0 0 0
8 Ambroxol tablet 30 mg tablet 100 0 100 0 100 0
9 Aminofilin tablet 100 mg tablet 0 0 0 0 0 0
10 Aminofilina injeksi 24 mg/ml - 10 ml ampul 122 0 122 0 122 0
11 Amlodipin tablet 10 mg tablet 600 0 600 115 485 0
12 Amlodipin tablet 5 mg tablet 0 0 0 0 0 0
13 Amoksisilin kaplet 500 mg kaplet 5100 0 5100 200 4900 0
14 Amoksisilin sirup kering 125 mg/5 ml Botol 60 ml 0 0 0 0 0 0
15 Ampicillin injeksi ampul 7 0 7 4 3 0
16 Ampicillin Tablet tablet 700 0 700 200 500 0
17 Antalgin (Metampiron) tablet 500 mg tablet 700 0 700 100 600 0
18 Antalgin injeksi 250 mg/ml - 2 ml ampul 220 0 220 30 190 0
19 Antasida DOEN SYR Botol 60 ml 0 0 0 0 0 0
20 Antasida DOEN tab botol/1000 0 0 0 0 0 0
21 Antasida DOEN tab ktk/100 500 0 500 0 500 0
 Anti Bakteri DOEN salep kombinasi:
22 Basitrasin 500 IU/g + Polimiksin 10.000 IU/g tube 5 g 0 0 0 0 0 0

23 Anti Hemoroid Superhoid supositoria supp 42 0 42 7 35 0

Anti hemoroid suppositoria supp 30 0 30 15 15 0
24 Antifungi DOEN Pot 30 gram 144 0 144 25 119 0

25 Antifungi DOEN (Whitefield) salep kombinasi Pot 30 gram 40 0 40 0 40 0

26 Aqua pro Injeksi steril, bebas pirogen botol 0 0 0 0 0 0

27 Artesunate injeksi 8 ampul/kotak 24 0 24 0 24 0
28 Asam Askorbat (Vit C) tablet 50 mg tablet 6600 0 6600 500 6100 0
29 Asam Folat / Profolat tablet 2200 0 2200 100 2100 0
30 Asam Mefenamat 500 mg tablet 700 0 700 300 400 0
31 Asam Traneksamat 500 mg tablet 200 0 200 0 200 0
32 Asam traneksamat inj ampul 20 0 20 0 20 0
33 Asetosal 100 mg tablet 0 0 0 0 0 0
34 Asetosal 500 mg tablet 0 0 0 0 0 0
35 Benzatin Benzi Penisillin 2,4 juta iu/vial vial 0 0 0 0 0 0
36 Benzatin Benzil Penisillin 1,2 juta iu/vial vial 8 0 8 4 4 0
37 Betahistin tablet tablet 870 0 870 320 550 0
38 Betametason krim 0.1% tube 5 gram 100 0 100 10 90 0
39 Bimatracin tablet 0 0 0 0 0 0
40 Bioplacenton jelly tube 15 gram 20 0 20 0 20 0
41 Bronkis tablet 800 0 800 400 400 0
42 Burnazin salep tube 35 g 0 0 0 0 0 0
43 Byolisin syp botol/60 ml 0 0 0 0 0 0
44 Caviplex tablet ktk/100 0 0 0 0 0 0
45 Cefford FORTE (Sefadroksil kapsul 500 mg) tablet 1000 0 1000 500 500 0
46 Cefixime 200 mg tablet 0 0 0 0 0 0
47 Cetirizine 10 mg kapsul 0 0 0 0 0 0
48 Chinine antipirin injeksi 2 ml ampul 0 0 0 0 0 0
49 Cimetidin tablet 200mg tablet 200 0 200 100 100 0
50 Clindamicyn 150 mg tablet 0 0 0 0 0 0
51 Clindamicyn 300 mg tablet 0 0 0 0 0 0
52 Combantrin syrup botol 10 ml 0 0 0 0 0 0
53 Combi Pack Azytro tablet 0 0 0 0 0 0
54 Combi Pack Azytro + Ceffixime tablet 0 0 0 0 0 0
55 Combi pack Paket Kusta Anak MB paket 0 0 0 0 0 0
56 Combi pack Paket Kusta Anak PB Paket 0 0 0 0 0 0
57 Combi pack Paket Kusta Dewasa MB Paket/ 6 Strip 0 0 0 0 0 0
58 Combi Pack Paket Kusta Dewasa PB Paket 0 0 0 0 0 0
59 Curcuma tablet 0 0 0 0 0 0
60 Daneuron tablet 0 0 0 0 0 0
61 Decacetine ( Chlorampenicol TTM ) btl 16 0 16 6 10 0
62 Deksametason injeksi 5 mg/ml - 1 ml ampul 271 0 271 9 262 0
63 Deksametason tablet 0,5 mg ktk/100 5800 0 5800 2100 3700 0
64 Difenhidramin HCl injeksi 10 mg/ml-1 ml ktk/30 ampul 60 0 60 40 20 0
65 Digoksin tablet 0,25 mg tablet 0 0 0 0 0 0
66 Domperidon sirup 5 mg/5 ml Botol 60 ml 100 0 100 0 100 0
67 Domperidon tablet 10 mg tablet 300 0 300 100 200 0
68 Doxyciclin kapsul 100 mg kapsul 0 0 0 0 0 0
69 Dulcolax Suppositoria 10 mg supp 0 0 0 0 0 0
70 Dulcolax Suppositoria 5 mg supp 0 0 0 0 0 0
71 Efedrin HCl tablet 25 mg btl/250 0 0 0 0 0 0
72 Epineprin inj 0 ,1 %(adrenalin) ampul 57 0 57 30 27 0
73 Ergotamine Caffeine Tablet 800 0 800 0 800 0
74 Eritromicin sirop kering 200 mgl / 5ml Botol 60 ml 9 0 9 0 9 0
75 Erlamycetin Salp Mata tube 3 0 3 0 3 0
76 Erlamycetin tetes telinga 1% tube 61 0 61 0 61 0
77 Erphazone ( Phenylbutazone 200 mg ) btl/1000 0 0 0 0 0 0
78 Erytromicin kapsul 250 mg kapsul 0 0 0 0 0 0
79 Erytromicin kapsul 500 mg kapsul 300 0 300 0 300 0
80 Etakridin ( Rivanol ) larutan 0,1% Botol 300 ml 16 0 16 10 6 0
81 Etanol ( alkohol ) 70% botol 100 ml 6 0 6 0 6 0
82 Etanol ( alkohol ) 70% Botol 300 ml 0 0 0 0 0 0
83 Etanol ( alkohol ) 70% botol 1000 ml 4 0 4 0 4 0
84 Ethambutol tablet 250mg tablet 0 0 0 0 0 0
85 Ethambutol tablet 500mg tablet 0 0 0 0 0 0
86 Farmalat (Nifedipin) tablet 10 mg tablet 0 0 0 0 0 0
87 faxiden 20 mg tab tablet 1100 0 1100 300 800 0
88 Fenilbutalson tablet 200 mg Btl/1000 0 0 0 0 0 0
89 Fenilbutalson tablet 200 mg ktk/150 0 0 0 0 0 0
90 Fenol Gliserol tetes telinga 10% botol 5 ml 120 0 120 10 110 0
91 Fermia ktk/100 0 0 0 0 0 0
92 Ferrous Sulphate tablet 300 mg tablet 0 0 0 0 0 0
93 Fitomenadion (Vit.K1) inj 10 mg/ml - 1 ml ampul 109 0 109 0 109 0
94 Fitomenadion (Vit.K1) tab salut gula 10 mg tablet 0 0 0 0 0 0
95 Fluconazole tablet 0 0 0 0 0 0
96 Furosemid tablet 0,5 mg tablet 0 0 0 0 0 0
97 Garam Oralit untuk 200 ml air sachet 1000 0 1000 0 1000 0
98 Gemfibrosil kapsul 300 Mg kapsul 0 0 0 0 0 0
99 Gemfibrosil kapsul 600 Mg kapsul 300 0 300 0 300 0
100 gentalex salep kulit 0,1 % ktk/10 tube 60 0 60 0 60 0
101 Gentamicin inj 80mg/2ml ampul 50 0 50 0 50 0
102 Gentamicin salep kulit 0,1 % ktk/ 10 tube 0 0 0 0 0 0
103 Gentian Violet larutan 1 % Botol 10 ml 0 0 0 0 0 0
104 Gitarmin ( Asam Mefenamat 500 mg ) tablet 0 0 0 0 0 0
105 Gitri sirup Botol 60 ml 0 0 0 0 0 0
106 Glibenklamid tablet 5 mg tablet 0 0 0 0 0 0
107 Glikos (Metformin 500 mg) tablet 600 0 600 0 600 0
108 Gliseril Guaiakolat tablet 100 mg tablet 5300 0 5300 1800 3500 0
109 Gludepatic 500 mg tablet 400 0 400 0 400 0
110 Glukosa larutan infus 5 % steril Botol 500 ml 125 0 125 20 105 0
111 Gradilex 2 mg / Loperamid tablet 2200 0 2200 0 2200 0
112 Grafazole 500 mg tablet 0 0 0 0 0 0
113 Graseric 150 mg tablet 0 0 0 0 0 0
114 Gravalin 2 mg / Salbutamol 2 mg tablet 1500 0 1500 0 1500 0
115 Gravask 10 mg tablet 60 0 60 30 30 0
116 Gravask 5 mg tablet 0 0 0 0 0 0
117 Gricin 500 mg tablet 0 0 0 0 0 0
118 Griseofulvin tablet 125 mg tablet 2100 0 2100 0 2100 0
119 Griseofulvin tablet 500 mg tablet 1700 0 1700 300 1400 0
120 Hidroklorotiazid (HCT) tablet 25 mg tablet 200 0 200 0 200 0
121 Hidrokortison krim 2,5 % tube 5 g 49 0 49 0 49 0
122 Holimox Syp ( Amox Syp) btl / 60 ml 29 0 29 4 25 0
123 Hustab tablet 1500 0 1500 300 1200 0
124 Ibuprofen Syp btl 5 ml 0 0 0 0 0 0
125 Ibuprofen tablet 200 mg tablet 1400 0 1400 200 1200 0
126 Ibuprofen tablet 400 mg tablet 5000 0 5000 1000 4000 0
127 Ichtiyol Salf pot 24 0 24 0 24 0
128 Ifison ( Prednisone ) tablet 0 0 0 0 0 0
129 Infantrim forte tablet 480 mg tablet 1400 0 1400 100 1300 0
130 Irgapan tablet 0 0 0 0 0 0
131 Isoniazid ( INH ) 100 mg tablet 0 0 0 0 0 0
132 Isoniazid ( INH ) 300 mg tablet 300 0 300 0 300 0
133 Isosorbid Dinitrat tablet sublingual 5 mg tablet 700 0 700 0 700 0
134 Itrasal Syp btl 5 ml 0 0 0 0 0 0
135 Kalium diklofenak tablet tablet 0 0 0 0 0 0
136 Kalsium Laktat (Kalk) tablet 500 mg ktk/100 0 0 0 0 0 0
137 Kalsium Laktat (Kalk) tablet 500 mg Btl/1000 4000 0 4000 1000 3000 0
138 Kanamicin inj 1 gram/vial vial 0 0 0 0 0 0
139 Kaptopril tablet 12,5 mg tablet 1000 0 1000 400 600 0
140 Kaptopril tablet 25 mg tablet 400 0 400 0 400 0
141 Katitra (Tertracycline) Kapsul 500 mg kapsul 0 0 0 0 0 0
142 Kemoren 50 mg tablet 0 0 0 0 0 0
143 Ketokonazol salep 2% tube 10 gram 11 0 11 0 11 0
144 Ketokonazol tablet 200 mg tablet 700 0 700 0 700 0
145 Kina tablet salut gula ktk/24x12 0 0 0 0 0 0
146 Kloramfenikol kapsul 250 mg kapsul 0 0 0 0 0 0
147 Kloramfenikol salep kulit tube 5 mg 0 0 0 0 0 0
148 Kloramfenikol tetes telinga 3 % botol 5 ml 0 0 0 0 0 0
149 Klorampenicol salep mata 1 % tube 5 g 0 0 0 0 0 0
150 Klorampenicol tetes mata 0.5% (Reco) botol 5 ml 0 0 0 0 0 0
151 Klorfeniramin Maleat (CTM) tablet 4 mg tablet 2600 0 2600 1000 1600 0
152 Kloroquine tablet 250mg tablet 400 0 400 0 400 0
153 Klorquine tablet 150 mg tablet 0 0 0 0 0 0
154 Kokodin 10 % Btl/1000 ml 0 0 0 0 0 0
155 Kokodin 10 % Btl/300 ml 0 0 0 0 0 0
156 Kokotra (Tetracycline) kapsul 250 mg kapsul 0 0 0 0 0 0
Komb Pirimetamin 25 mg + Sulfadoxin 500 mg
157 tablet 1000 0 1000 0 1000 0

Kotrimoksazol susp kombinasi :

158 sulfametaksazol 200 mg + trimetropim 40mg/ 5 botol 60 ml 245 0 245 0 245 0
ml

Kotrimoksazol tablet kombonasi :

159 tablet 5200 0 5200 1000 4200 0
sulfametaksazole 400 mg + Trimetropim 80 mg

160 Kotrimoksazol tablet pediatrik 120 mg tablet 0 0 0 0 0 0

161 Kuinin Dihidroklorida injeksi 25% - 2 ml ampul 0 0 0 0 0 0
162 Levofloksasin 500 mg tablet 0 0 0 0 0 0
163 Licopec Kaplet 0 0 0 0 0 0

Lidokain komp. Injeksi, Kombinasi : lidokain HCl

164 ampul 30 0 30 10 20 0
2% + epinefrin 1 : 80.000- 2ml

165 Lifadrox DS Syp Btl/60 ml 0 0 0 0 0 0

166 Lisol Concentrate Botol 1000 ml 0 0 0 0 0 0
167 Lodia 2 mg tablet 0 0 0 0 0 0
168 Loperamide 2 mg tablet 0 0 0 0 0 0
169 Loratadine tablet 100 mg tablet 4600 0 4600 1400 3200 0
170 Mebendazol tablet 100 mg tablet 0 0 0 0 0 0
171 Metformin 500 mg tablet 0 0 0 0 0 0
172 Methilergometrin Maleat tab.salut 0,125 tablet 1200 0 1200 0 1200 0
173 Methylprednisolone tablet 16 mg tablet 0 0 0 0 0 0
174 Methylprednisolone tablet 4 mg tablet 0 0 0 0 0 0
175 Methylprednisolone tablet 8 mg tablet 0 0 0 0 0 0
176 Metronidazol tablet 250 mg tablet 0 0 0 0 0 0
177 Metronidazol tablet 500 mg tablet 1600 0 1600 200 1400 0
178 Miconasole 2 % krim tube 10 gram 44 0 44 0 44 0
 Myomergin
179 Ampul 28 0 28 0 28 0
(Metilergometrin Maleat inj 0,200 mg-1 ml)
180 Natrium diklofenak 25 mg tablet 0 0 0 0 0 0
181 Natrium diklofenak 50 mg tablet 0 0 0 0 0 0
182 Natrium Klorida larutan infus 0,9 % steril botol 500 ml 53 0 53 5 48 0
183 Neurobion 5000 injeksi 3 ml Ampl/Psng 58 0 58 0 58 0
184 nifedipin tablet tablet 1600 0 1600 0 1600 0
185 Nistatin tablet salut gula 500.000 IU tablet 0 0 0 0 0 0
186 Nistatin tablet vaginal 100.000 IU tablet 0 0 0 0 0 0
187 Norpid 10 mg ( Simvastatin 10 mg ) tablet 0 0 0 0 0 0
188 Novabion kapsul 0 0 0 0 0 0
189 Novadiar Syr btl 60 ml 0 0 0 0 0 0
190 Novadium tablet 0 0 0 0 0 0
191 Novamag Syp btl 60 ml 77 0 77 0 77 0
192 nuvopec 15 mg/ml Botol 60 ml 33 0 33 2 31 0
193 nuvopec tablet 30 mg tablet 2000 0 2000 300 1700 0
194 Obat anti Malaria (DHP) ktk/9 90 0 90 0 90 0
195 Obat Batuk Hitam ( O.B.H. ) cairan Botol 100 ml 60 0 60 0 60 0
196 Obat OAT Kategori I Anak Paket 0 0 0 0 0 0
197 Obat OAT Kategori I Dewasa paket 0 0 0 0 0 0
198 Obat OAT Kategori II Paket 0 0 0 0 0 0
199 Obimin Dos/30 90 0 90 0 90 0
200 Oksitetrasiklin HCl salep kulit 3 % tube 5 g 0 0 0 0 0 0
201 Oksitetrasiklin HCl salep mata 1 % tube 5 g 0 0 0 0 0 0
202 Oksitosin injeksi 10 IU/ml - 1 ml ampul 0 0 0 0 0 0
203 Omegdiar sirup btl 60 ml 0 0 0 0 0 0
204 Omeprasole kapsul 20 mg kapsul 1590 0 1590 390 1200 0
205 Papaverin injeksi 40 mg / ml vial 0 0 0 0 0 0
206 Papaverin tablet 40 mg tablet 1000 0 1000 0 1000 0
207 Parasetamol sirup 120 mg/5 ml Botol 60 ml 314 0 314 4 310 0
208 Parasetamol tablet 500 mg ktk/100 8900 0 8900 500 8400 0
209 Pehacaine injeksi ampul 10 0 10 0 10 0
210 Piracetam tablet 400 mg tablet 0 0 0 0 0 0
211 Piracetam tablet 800 mg tablet 0 0 0 0 0 0
212 Pirantel Syp Botol 60 ml 25 0 25 0 25 0
213 Pirantel tablet 125 mg tablet 1800 0 1800 500 1300 0
214 Pirazinamide tablet 500 mg tablet 0 0 0 0 0 0
215 Piridoksin HCl (Vit.B6) tablet 10 mg tablet 5000 0 5000 0 5000 0
216 Piroxicam tablet 10 mg tablet 0 0 0 0 0 0
217 Piroxicam tablet 20 mg tablet 0 0 0 0 0 0
218 Povidon Iodida 10 % Botol 30 ml 20 0 20 0 20 0
219 Povidon Iodida 10 % Botol 60 ml 6 0 6 2 4 0
220 Povidon Iodida 10 % Botol 300 ml 0 0 0 0 0 0
221 Povidon Iodida 10 % Botol 1000 ml 0 0 0 0 0 0
222 Prednison tablet 5 mg tablet 7600 0 7600 1800 5800 0
223 Prenamia tablet 0 0 0 0 0 0
224 Primakuin tablet 15 mg tablet 200 0 200 0 200 0
225 Procain Benzill Penicillin Inj. 3 juta IU vial 0 0 0 0 0 0
226 Propanolol HCL tablet 10 mg tablet 0 0 0 0 0 0
227 Propanolol HCL tablet 40 mg tablet 0 0 0 0 0 0
228 Propilititiurasil tablet 100 mg tablet 0 0 0 0 0 0
229 Pytogin injeksi 10 IU/ml - 1 ml ampul 88 0 88 5 83 0
230 Quinine tablet 222 mg Btl/1000 0 0 0 0 0 0
231 Quinine tablet 222 mg ktk/60 400 0 400 100 300 0
232 Ramolit sachet 0 0 0 0 0 0
233 Ranitidin tablet 150 mg tablet 6100 0 6100 500 5600 0
234 Ranitidine injeksi 25 mg/ml - 2ml ampul 120 0 120 10 110 0
235 Rifampicin kapsul 300 mg kapsul 0 0 0 0 0 0
236 Rifampicin tablet 450 mg tablet 0 0 0 0 0 0
237 Rifampicin tablet 600 mg tablet 0 0 0 0 0 0
Ringer Laktat larutan infus steril (Produk lokal)
238 botol 500 ml 125 0 125 20 105 0

239 Salbutamol tablet 2 mg tablet 0 0 0 0 0 0

240 Salbutamol tablet 4 mg tablet 1322 0 1322 22 1300 0
Salep 2-4 , Kombinasi:
241 Pot 30 gram 134 0 134 0 134 0
As Salisilat 2% + Belerang Endap 4%
242 Salisil Bedak 2 % pot 50 gram 58 0 58 17 41 0
243 Sefadroksil sirup 125mg/5ml btl 60 ml 117 0 117 7 110 0
244 sefotaxim serbuk injeksi 1 gram/vial 2 vial/kotak 10 0 10 0 10 0
245 seftriaxon serbuk injeksi 1 gram/ vial 2 vial/kotak 0 0 0 0 0 0
246 Selespurin (Allopurinol 100 mg ) tablet 0 0 0 0 0 0
247 Sianokobalamin (Vit.B12) 50 mcg Btl/1000 0 0 0 0 0 0
248 Sianokobalamin (Vit.B12) 50 mcg Ktk/100 5100 0 5100 1000 4100 0
Sianokobalamin (Vit.B12) injeksi 500 mcg-ml
249 ampul 300 0 300 0 300 0

250 Simvastatin tablet 10 mg tablet 2970 0 2970 570 2400 0

251 Simvastatin tablet 20 mg tablet 0 0 0 0 0 0
252 Siprofloksasin tablet 500mg tablet 400 0 400 150 250 0
253 Tablet tambah darah + as folat tablet 5710 0 5710 2000 3710 0
254 Tetrasiklin HCl kapsul 250 mg kapsul 0 0 0 0 0 0
255 Tetrasiklin HCl kapsul 500 mg kapsul 0 0 0 0 0 0
256 Thiamfenicol 500 mg tablet 0 0 0 0 0 0
257 Tiamin HCl (Vit.B1) injeksi 100 mg/ml-1 ml ampul 173 0 173 1 172 0
258 Tiamin HCl / Mononitrat (Vit.B1) tab.50 mg tablet 1100 0 1100 300 800 0
259 Tuzalos tablet tablet 0 0 0 0 0 0
260 Ultrasonic gell btl 250 gram 6 0 6 0 6 0
261 Ultravita Multivitamin tablet 0 0 0 0 0 0
262 Univit Syp btl 60 ml 48 0 48 0 48 0
263 Vitamin A 100.000iu kapsul 350 0 350 0 350 0
264 Vitamin A 200.000iu kapsul 900 0 900 100 800 0
265 Vitamin B Kompleks tablet tablet 4300 0 4300 0 4300 0
266 Zinc tablet tablet 1900 0 1900 600 1300 0

Alat Kesehatan 0
1 Abocath No. 18 set 122 0 122 0 122 0
2 Abocath No. 20 set 0 0 0 0 0 0
3 Abocath No. 22 set 142 0 142 0 142 0
4 Abocath No. 24 100 set/kotak 85 0 85 0 85 0
5 Abocath No. 26 100 set/kot 0 0 0 0 0 0
6 Alat suntik sekali pakai 0,5 ml 100 set/kot 200 0 200 0 200 0
7 Alat suntik sekali pakai 1 ml 100 set/kotak 300 0 300 0 300 0
8 Alat suntik sekali pakai 10 ml 100 set/kotak 100 0 100 0 100 0
9 Alat suntik sekali pakai 2,5 ml 100 set/kotak 200 0 200 0 200 0
10 Alat suntik sekali pakai 3 ml 100 set/kotak 300 0 300 0 300 0
11 Alat suntik sekali pakai 5 ml 100 set/kotak 274 0 274 0 274 0
12 Alat suntik sekali pakai 50 ml 100 set/kotak 200 0 200 0 200 0
13 Alkohol Swab Kotak 600 0 600 0 600 0
14 Bisturi no 10 set 50 0 50 0 50 0
15 Bisturi no 11 set 0 0 0 0 0 0
16 Blood lancet set 160 0 160 0 160 0
17 Catgut / Benang Bedah chrom 3/0 matrix 3 buah 72 0 72 0 72 0
18 Catgut / Benang Bedah No. 4/0 buah 0 0 0 0 0 0
19 Catgut/Benang Bedah No.2/0 buah 0 0 0 0 0 0
20 Cotton Swab buah 0 0 0 0 0 0
21 Cover glass buah 50 0 50 0 50 0
22 Digital Thermometer buah 0 0 0 0 0 0
23 Etil Klorida spray botol 100 ml 2 0 2 0 2 0
24 feeding tube 8 FR x 120 cm buah 0 0 40 0 0 0
25 Foley catheter no 12 buah 10 0 10 0 10 0
26 Foley catheter no 14 buah 70 0 70 0 70 0
27 Foley catheter no 16 buah 21 0 21 0 21 0
28 Foley catheter no 18 buah 0 0 0 0 0 0
29 Foley catheter no 20 buah 0 0 0 0 0 0
30 Haemometer / Hb Sahli set 2 0 2 0 2 0
31 Hand Gloves (sarung tangan) tanpa bedak Kotak 59 0 59 30 29 0
32 Handscond obgyn ktk/50 26 0 26 16 10 0
33 Handscond Maxter L ktk/50 psg 800 0 800 400 400 0
34 Handscond Maxter M ktk/50 psg 500 0 500 300 200 0
35 Handscond Maxter S ktk/50 psg 212 0 212 112 100 0
36 Handscond Steril pasang 24 0 24 0 24 0
37 Hidrogen peroksida 3 % Botol 1000ml 1 0 1 0 1 0
38 Infusion set anak kantong 87 0 87 20 67 0
39 Infusion set dewasa kantong 53 0 53 2 51 0
40 kapas berlemak 500 gram rol 7 0 7 0 7 0
41 Kapas Pembalut / Absorben 250 gram Rol 2 0 2 0 2 0
42 kapas pembalut 100 gram rol 1 0 1 0 1 0
43 Kapas pembalut 1000 gram rol 1 0 1 0 1 0
44 kapas pembalut 50 gram rol 4 0 4 0 4 0
45 kapas pembalutr 250 gram rol 18 0 18 0 18 0
46 kapas putih 100 gram rol 3 0 3 0 3 0
47 kapas putih 250 gram rol 21 0 21 0 21 0
48 kapas putih 50 gram rol 31 0 31 0 31 0
49 Kapas putih 500 gram rol 0 0 0 0 0 0
50 Kartu golongan darah ktk/100 0 0 0 0 0 0
51 Kasa hidrofil 2 yard x 80 cm Rol 0 0 0 0 0 0
52 Kasa Hidrofil DRC 40 yard x 80 cm rol 7 0 7 1 6 0
53 Kasa Kompres 40/40 steril Bungkus 61 0 61 21 40 0
54 Kasa Pembalut Hidrofil 2,7 cm x 15 cm Rol 100 0 100 52 48 0
55 Kasa Pembalut Hidrofil 4 m x 15 cm Rol 5 0 5 0 5 0
56 Kasa steril 16x16 rol 23 0 23 0 23 0
57 Kassa Verban 3 cm x 15 cm Rol 50 0 50 0 50 0
58 Kertas Perkamen lembar/rim 0 0 0 0 0 0
59 Kertas Puyer Press pcs 0 0 0 0 0 0
60 Kertas saring lembar 0 0 0 0 0 0
61 Kondom KTK/3 36 0 36 0 36 0
62 KY Jelly tube 0 0 0 0 0 0
63 Masker hijau ktk/50 200 0 200 0 200 0
64 Medicine paket set 0 0 0 0 0 0
65 Micropipette 5 - 50µl Unit 0 0 0 0 0 0
66 Mortir + Stempel set 0 0 0 0 0 0
67 Oksigen Set Unit 0 0 0 0 0 0
68 Oneclean Botol 1000 ml 0 0 0 0 0 0
69 Oneclean botol 500 ml 2 0 2 0 2 0
70 Pembalut Gips (Gypsona 6 inchi x 3 yard) rol 11 0 11 0 11 0
71 Penjepit tali pusat set 277 0 277 0 277 0
72 pH Paper 3,8-5,4 ktk 0 0 0 0 0 0
73 Pipet Westergren buah 0 0 0 0 0 0
74 Plastik obat ( ukuran Besar ) lembar 0 0 0 0 0 0
75 Plastik obat ( ukuran Kecil ) lembar 2000 0 2000 0 2000 0
76 Plester 5 cm x 4,5 m rol 6 0 6 3 3 0
77 Plester 5 cm x 5 m rol 5 0 5 2 3 0
78 Pot sputum buah 0 0 0 0 0 0
79 Rak tabung reaksi buah 0 0 0 0 0 0
80 Rak westergren/LED buah 0 0 0 0 0 0
81 Rapid 1 (oncoprobe) ktk/50 0 0 0 0 0 0
82 Rapid 2 (Advanced) ktk/100 0 0 0 0 0 0
83 Rapid 3 (Vikia) ktk/25 0 0 0 0 0 0
84 sarung tangan free Powder ukuran L 100 psg/ktk 100 0 100 0 100 0
85 sarung tangan free Powder ukuran M 100 psg/ktk 200 0 200 0 200 0
86 Sikat tabung (Korok Tabung) buah 0 0 0 0 0 0
87 Slide box pcs 0 0 0 0 0 0
88 Slide/objek glass Ktk/72 0 0 0 0 0 0
89 Spiritus cair buah 0 0 0 0 0 0
90 surgical suture with needle (Plain Catgut) pcs 24 0 24 0 24 0
91 surgical suture with needle (silk Braided) pcs 36 0 36 0 36 0
92 suture needle GT 10 12pcs/bks 24 0 24 0 24 0
93 suture needle GT 11 12pcs/bks 24 0 24 0 24 0
94 suture needle GT 12 12pcs/bks 24 0 24 0 24 0
95 suture needle GT 13 12pcs/bks 24 0 24 0 24 0
96 suture needle GT 6 12pcs/bks 24 0 24 0 24 0
97 suture needle GT 7 12pcs/bks 22 0 22 0 22 0
98 Tabung Sahli (HB Sahli) set 0 0 0 0 0 0
99 Tabung Sentrifuse buah 0 0 0 0 0 0
100 Tabung Serologi buah 0 0 0 0 0 0
101 Tabung Westergreen buah 0 0 0 0 0 0
102 Tensi Digital dan Stetoskop Kit 0 0 0 0 0 0
103 Test Kehamilan pcs 0 0 0 0 0 0
104 Torniket anak rol 0 0 0 0 0 0
105 Torniket dewasa set 0 0 0 0 0 0
106 Tromol, SS set 0 0 0 0 0 0
107 Ultrafix 10 cm x 1 cm ktk/25 0 0 0 0 0 0
108 Ultrafix 5 cm x 1 cm ktk/10 0 0 0 0 0 0
109 Urinalisa (Strip Urine Expert) set 0 0 0 0 0 0
110 Urinalisis (Mission Expert) Btl 0 0 0 0 0 0
111 Urine bag 2000 ml set 15 0 15 0 15 0
112 Usilakit (posyandu Lansia) kit 0 0 0 0 0 0
113 Vaselin album btl 1 liter 0 0 0 0 0 0
114 Yellow Tips ( 5µ / 10µ /25 µ ) ktk 0 0 0 0 0 0

Reagen
1 Asam Alkohol botol 0 0 0 0 0 0
2 Asam chlorida HCl 0,1 N botol 0 0 0 0 0 0
3 Combour tes Urine botol 0 0 0 0 0 0
4 EDTA cair botol 0 0 0 0 0 0
5 Emersi oil botol 100 ml 0 0 0 0 0 0
6 Etanol asam 3% botol 100 ml 0 0 0 0 0 0
7 Eter Alkohol botol 100 ml 0 0 0 0 0 0
8 Glemsa botol 0 0 0 0 0 0
9 HCL 0,1 N botol 0 0 0 0 0 0
10 Hexagon Sypillis Kotak/20 0 0 0 0 0 0
11 Karbol fuksin botol 500 ml 0 0 0 0 0 0
12 KOH 10% botol 0 0 0 0 0 0
13 Metanol btl / 500 ml 0 0 0 0 0 0
14 Metanol btl / 1000 ml 1 0 1 0 1 0
15 Metylen Blue botol 0 0 0 0 0 0
16 Na.Citrat 3,8% botol 0 0 0 0 0 0
17 Reagen ALT / GPT Kotak 0 0 0 0 0 0
18 Reagen Anti D Golongan Darah set 0 0 0 0 0 0
19 Reagen Antigen AO.S.Paratyphii Kotak 0 0 0 0 0 0
20 Reagen Antigen BO.S.Parathypii Kotak 0 0 0 0 0 0
21 Reagen Antigen H.S.Typhii Kit 0 0 0 0 0 0
22 Reagen Antigen O.S.Parathypii Kotak 0 0 0 0 0 0
23 Reagen Asam urat Kotak 0 0 0 0 0 0
24 Reagen AST / GOT Kotak 0 0 0 0 0 0
25 Reagen BTA set 0 0 0 0 0 0
26 Reagen Cholesterol Kotak 0 0 0 0 0 0
27 Reagen GDS Kotak 0 0 0 0 0 0
28 Reagen Golongan Darah Kit 0 0 0 0 0 0
29 Reagen RPR Sypilis kotak/100 0 0 0 0 0 0
30 Reagen Trigliserida Kotak 0 0 0 0 0
31 reagen Zield Nelsen KIT 2 0 2 0 2 0
32 SD HIV set 100 0 100 0 100 0
33 SD Syphilis 3.0 set 100 0 100 0 100 0
34 Stik Asam urat Botol/25 100 0 100 0 100 0
35 Stik Glucosa nesco Botol/25 100 0 100 0 100 0
36 Stik Kolesterol nesco Botol/10 0 0 0 0 0 0
37 Tes RDT Malaria Kotak/10 0 0 0 0 0 0
38 Xylol botol 0 0 0 0 0 0

Mengetahui, Kiruru, 5 April 2019

Kepala Puskesmas Kaimana Yang Meminta,
Petugas Pengelola Obat

Fransiska C.Balatando,S.Farm,Apt
Basri La hisa, Amk.
Nip. 197602142001111001
``
 PUSAT KESEHATAN MASYARAKAT KIRURU
REKAPITULASI PENGGUNAAN OBAT PSIKOTROPIKA PUSKESMAS KIRURU

BULAN Maret
TAHUN 2019

STOK JUMLAH
PERSEDI PEMAKAI
NO. NAMA OBAT SATUAN PENERIM
AWAL AAN AN
AAN
1 Diazepam 2 mg Botol/1000 tablet 0 0 0 0
2 Diazepam injeksi 5 mg/ml - 2ml Kotak/30 ampul 0 0 0 0
3 Haloperidol tablet 100 mg tablet 0 0 0 0
4 Phenobarbital 30 mg tablet 0 0 0 0
5 Phenobarbital injeksi Kotak/30 ampul 0 0 0 0
6 Klorpromazin HCL tablet 100 mg Tablet 0 0 0 0
7 Klorpromazin HCL injeksi 5 mg/ml-2 ml Ampul 0 0 0 0
8 Stesolid rectal Tube 0 0 0 0

Mengetahui
Kepala Puskesmas Kiruru, 5 April 2019

Pengelola Obat Pusk

Basri La hisa, Amk. Fransiska Celsia Bala

Nip. 197602142001111001 Nip.-
RU
ESMAS KIRURU

SISA
PERMINT
STOK AAN

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

Kiruru, 5 April 2019

Pengelola Obat Puskesmas

Fransiska Celsia Balatando,S.Farm,Apt

 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

KODE PUSKESMAS :
PUSKESMAS : KIRURU
DISTRIK : TELUK ETNA
KABUPATEN : KAIMANA BULAN APRIL
PROPINSI : PAPUA BARAT TAHUN 2019

STOK PENERI- PERSE- PEMA- SISA STOK PERMIN- PEMBERIAN KET

NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK OPTMUM TAAN APBN APBD II ASKES JML
1 2 3 4 5 6 7 8 9 10 11 12 13 15 16
1 Acyclovir krim 5 % tube 5 gram 50 0 50 0 50 200
2 Acyclovir tablet 200 mg tablet 400 0 400 200 200 500
3 Acyclovir tablet 400 mg tablet 400 0 400 100 300 500
4 Albendazol tablet 400 mg tablet 0 0 0 0 0 1000
5 Alopurinol tablet 100 mg tablet 1000 0 1000 0 1000 0
6 Altran (Asam mefenamat 500 mg) tablet 0 0 0 0 0 3000
7 Ambroxol sirup 15 mg/ml btl 60 ml 0 0 0 0 0 200
8 Ambroxol tablet 30 mg tablet 100 0 100 0 100 2000
9 Aminofilin tablet 100 mg tablet 0 0 0 0 0 0
10 Aminofilina injeksi 24 mg/ml - 10 ml ampul 122 0 122 0 122 0
11 Amlodipin tablet 10 mg tablet 485 0 485 100 385 300
12 Amlodipin tablet 5 mg tablet 0 0 0 0 0 300
13 Amoksisilin kaplet 500 mg kaplet 4900 0 4900 600 4300 0
14 Amoksisilin sirup kering 125 mg/5 ml Botol 60 ml 0 0 0 0 0 200
15 Ampicillin injeksi ampul 3 0 3 3 0 10
16 Ampicillin Tablet tablet 500 0 500 200 300 500
17 Antalgin (Metampiron) tablet 500 mg tablet 600 0 600 100 500 2000
18 Antalgin injeksi 250 mg/ml - 2 ml ampul 190 0 190 10 180 0
19 Antasida DOEN SYR Botol 60 ml 0 0 0 0 0 500
20 Antasida DOEN tab botol/1000 0 0 0 0 0 0
21 Antasida DOEN tab ktk/100 500 0 500 0 500 1000
 Anti Bakteri DOEN salep kombinasi:
22 Basitrasin 500 IU/g + Polimiksin 10.000 IU/g tube 5 g
0 0 0 0 0 0
23 Anti Hemoroid Superhoid supositoria supp 35 0 35 15 20 48
Anti hemoroid suppositoria supp 15 0 15 0 15 48
24 Antifungi DOEN Pot 30 gram 119 0 119 29 90 0

25 Antifungi DOEN (Whitefield) salep kombinasi Pot 30 gram

40 0 40 0 40 0
26 Aqua pro Injeksi steril, bebas pirogen botol 0 0 0 0 0 100
27 Artesunate injeksi 8 ampul/kotak 24 0 24 0 24 0
28 Asam Askorbat (Vit C) tablet 50 mg tablet 6100 0 6100 200 5900 0
29 Asam Folat / Profolat tablet 2100 0 2100 0 2100 1000
30 Asam Mefenamat 500 mg tablet 400 0 400 400 0 3000
31 Asam Traneksamat 500 mg tablet 200 0 200 0 200 0
32 Asam traneksamat inj ampul 20 0 20 0 20 0
33 Asetosal 100 mg tablet 0 0 0 0 0 500
34 Asetosal 500 mg tablet 0 0 0 0 0 500
35 Benzatin Benzi Penisillin 2,4 juta iu/vial vial 0 0 0 0 0 0
36 Benzatin Benzil Penisillin 1,2 juta iu/vial vial 4 0 4 4 0 16
37 Betahistin tablet tablet 550 0 550 230 320 300
38 Betametason krim 0.1% tube 5 gram 90 0 90 10 80 100
39 Bimatracin tablet 0 0 0 0 0 0
40 Bioplacenton jelly tube 15 gram 20 0 20 0 20 100
41 Bronkis tablet 400 0 400 400 0 5000
42 Burnazin salep tube 35 g 0 0 0 0 0 0
43 Byolisin syp botol/60 ml 0 0 0 0 0 100
44 Caviplex tablet ktk/100 0 0 0 0 0 5000
45 Cefford FORTE (Sefadroksil kapsul 500 mg) tablet 500 0 500 500 0 500
46 Cefixime 200 mg tablet 0 0 0 0 0 1000
47 Cetirizine 10 mg kapsul 0 0 0 0 0 500
48 Chinine antipirin injeksi 2 ml ampul 0 0 0 0 0 0
49 Cimetidin tablet 200mg tablet 100 0 100 0 100 0
50 Clindamicyn 150 mg tablet 0 0 0 0 0 0
51 Clindamicyn 300 mg tablet 0 0 0 0 0 0
52 Combantrin syrup botol 10 ml 0 0 0 0 0 100
53 Combi Pack Azytro tablet 0 0 0 0 0 0
54 Combi Pack Azytro + Ceffixime tablet 0 0 0 0 0 0
55 Combi pack Paket Kusta Anak MB paket 0 0 0 0 0 0
56 Combi pack Paket Kusta Anak MB Paket 0 0 0 0 0 0
57 Combi pack Paket Kusta Dewasa MB Paket/ 6 Strip 0 0 0 0 0 0
58 Combi Pack Paket Kusta Dewasa PB Paket 0 0 0 0 0 0
59 Curcuma tablet 0 0 0 0 0 100
60 Daneuron tablet 0 0 0 0 0 500
61 Decacetine ( Chlorampenicol TTM ) btl 10 0 10 10 0 0
62 Deksametason injeksi 5 mg/ml - 1 ml ampul 262 0 262 12 250 0
63 Deksametason tablet 0,5 mg ktk/100 3700 0 3700 1100 2600 1000
64 Difenhidramin HCl injeksi 10 mg/ml-1 ml ktk/30 ampul 20 0 20 20 0 0
65 Digoksin tablet 0,25 mg tablet 0 0 0 0 0 500
66 Domperidon sirup 5 mg/5 ml Botol 60 ml 100 0 100 2 98 0
67 Domperidon tablet 10 mg tablet 200 0 200 200 0 0
68 Doxyciclin kapsul 100 mg kapsul 0 0 0 0 0 0
69 Dulcolax Suppositoria 10 mg supp 0 0 0 0 0 500
70 Dulcolax Suppositoria 5 mg supp 0 0 0 0 0 500
71 Efedrin HCl tablet 25 mg btl/250 0 0 0 0 0 1000
72 Epineprin inj 0 ,1 %(adrenalin) ampul 27 0 27 27 0 0
73 Ergotamine Caffeine Tablet 800 0 800 0 800 0
74 Eritromicin sirop kering 200 mgl / 5ml Botol 60 ml 9 0 9 3 6 0
75 Erlamycetin Salp Mata tube 3 0 3 0 3 0
76 Erlamycetin tetes telinga 1% tube 61 0 61 0 61 0
77 Erphazone ( Phenylbutazone 200 mg ) btl/1000 0 0 0 0 0 0
78 Erytromicin kapsul 250 mg kapsul 0 0 0 0 0 0
79 Erytromicin kapsul 500 mg kapsul 300 0 300 100 200 500
80 Etakridin ( Rivanol ) larutan 0,1% Botol 300 ml 6 0 6 6 0 0
81 Etanol ( alkohol ) 70% botol 100 ml 6 0 6 2 4 10
82 Etanol ( alkohol ) 70% Botol 300 ml 0 0 0 0 0 5
83 Etanol ( alkohol ) 70% botol 1000 ml 4 0 4 0 4 0
84 Ethambutol tablet 250mg tablet 0 0 0 0 0 0
85 Ethambutol tablet 500mg tablet 0 0 0 0 0 0
86 Farmalat (Nifedipin) tablet 10 mg tablet 0 0 0 0 0 100
87 faxiden 20 mg tab tablet 800 0 800 200 600 2000
88 Fenilbutalson tablet 200 mg Btl/1000 0 0 0 0 0 500
89 Fenilbutalson tablet 200 mg ktk/150 0 0 0 0 0 0
90 Fenol Gliserol tetes telinga 10% botol 5 ml 110 0 110 10 100 0
91 Fermia ktk/100 0 0 0 0 0 3000
92 Ferrous Sulphate tablet 300 mg tablet 0 0 0 0 0 500
93 Fitomenadion (Vit.K1) inj 10 mg/ml - 1 ml ampul 109 0 109 0 109 0
94 Fitomenadion (Vit.K1) tab salut gula 10 mg tablet 0 0 0 0 0 0
95 Fluconazole tablet 0 0 0 0 0 0
96 Furosemid tablet 0,5 mg tablet 0 0 0 0 0 0
97 Garam Oralit untuk 200 ml air sachet 1000 0 1000 100 900 500
98 Gemfibrosil kapsul 300 Mg kapsul 0 0 0 0 0 500
99 Gemfibrosil kapsul 600 Mg kapsul 300 0 300 100 200 500
100 gentalex salep kulit 0,1 % ktk/10 tube 60 0 60 0 60 300
101 Gentamicin inj 80mg/2ml ampul 50 0 50 0 50 0
102 Gentamicin salep kulit 0,1 % ktk/ 10 tube 0 0 0 0 0 500
103 Gentian Violet larutan 1 % Botol 10 ml 0 0 0 0 0 0
104 Gitarmin ( Asam Mefenamat 500 mg ) tablet 0 0 0 0 0 1000
105 Gitri sirup Botol 60 ml 0 0 0 0 0 0
106 Glibenklamid tablet 5 mg tablet 0 0 0 0 0 0
107 Glikos (Metformin 500 mg) tablet 600 0 600 300 300 0
108 Gliseril Guaiakolat tablet 100 mg tablet 3500 0 3500 1000 2500 2000
109 Gludepatic 500 mg tablet 400 0 400 0 400 0
110 Glukosa larutan infus 5 % steril Botol 500 ml 105 0 105 15 90 100
111 Gradilex 2 mg / Loperamid tablet 2200 0 2200 0 2200 500
112 Grafazole 500 mg tablet 0 0 0 0 0
113 Graseric 150 mg tablet 0 0 0 0 0 0
114 Gravalin 2 mg / Salbutamol 2 mg tablet 1500 0 1500 0 1500 1000
115 Gravask 10 mg tablet 30 0 30 30 0 0
116 Gravask 5 mg tablet 0 0 0 0 0 0
117 Gricin 500 mg tablet 0 0 0 0 0 1000
118 Griseofulvin tablet 125 mg tablet 2100 0 2100 0 2100 500
119 Griseofulvin tablet 500 mg tablet 1400 0 1400 400 1000 2000
120 Hidroklorotiazid (HCT) tablet 25 mg tablet 200 0 200 0 200 0
121 Hidrokortison krim 2,5 % tube 5 g 49 0 49 0 49 100
122 Holimox Syp ( Amox Syp) btl / 60 ml 25 0 25 5 20 200
123 Hustab tablet 1200 0 1200 0 1200 3000
124 Ibuprofen Syp btl 5 ml 0 0 0 0 0 0
125 Ibuprofen tablet 200 mg tablet 1200 0 1200 200 1000 0
126 Ibuprofen tablet 400 mg tablet 4000 0 4000 1000 3000 0
127 Ichtiyol Salf pot 24 0 24 0 24 48
128 Ifison ( Prednisone ) tablet 0 0 0 0 0 0
129 Infantrim forte tablet 480 mg tablet 1300 0 1300 100 1200 0
130 Irgapan tablet 0 0 0 0 0 0
131 Isoniazid ( INH ) 100 mg tablet 0 0 0 0 0 0
132 Isoniazid ( INH ) 300 mg tablet 300 0 300 0 300 0
133 Isosorbid Dinitrat tablet sublingual 5 mg tablet 700 0 700 100 600 500
134 Itrasal Syp btl 5 ml 0 0 0 0 0 0
135 Kalium diklofenak tablet tablet 0 0 0 0 0 0
136 Kalsium Laktat (Kalk) tablet 500 mg ktk/100 0 0 0 0 0
137 Kalsium Laktat (Kalk) tablet 500 mg Btl/1000 3000 0 3000 1000 2000 0
138 Kanamicin inj 1 gram/vial vial 0 0 0 0 0
139 Kaptopril tablet 12,5 mg tablet 600 0 600 200 400 1000
140 Kaptopril tablet 25 mg tablet 400 0 400 0 400 1000
141 Katitra (Tertracycline) Kapsul 500 mg kapsul 0 0 0 0 0 0
142 Kemoren 50 mg tablet 0 0 0 0 0 0
143 Ketokonazol salep 2% tube 10 gram 11 0 11 0 11 200
144 Ketokonazol tablet 200 mg tablet 700 0 700 0 700 500
145 Kina tablet salut gula ktk/24x12 0 0 0 0 0 0
146 Kloramfenikol kapsul 250 mg kapsul 0 0 0 0 0 0
147 Kloramfenikol salep kulit tube 5 mg 0 0 0 0 0 0
148 Kloramfenikol tetes telinga 3 % botol 5 ml 0 0 0 0 0 50
149 Klorampenicol salep mata 1 % tube 5 g 0 0 0 0 0 0
150 Klorampenicol tetes mata 0.5% (Reco) botol 5 ml 0 0 0 0 0 0
151 Klorfeniramin Maleat (CTM) tablet 4 mg tablet 1600 0 1600 700 900 5000
152 Kloroquine tablet 250mg tablet 400 0 400 0 400 500
153 Klorquine tablet 150 mg tablet 0 0 0 0 0 0
154 Kokodin 10 % Btl/1000 ml 0 0 0 0 0 10
155 Kokodin 10 % Btl/300 ml 0 0 0 0 0 0
156 Kokotra (Tetracycline) kapsul 250 mg kapsul 0 0 0 0 0 0
Komb Pirimetamin 25 mg + Sulfadoxin 500 mg
157 tablet
1000 0 1000 0 1000 0
Kotrimoksazol susp kombinasi :
158 sulfametaksazol 200 mg + trimetropim 40mg/ 5 botol 60 ml
ml 245 0 245 0 245 0

Kotrimoksazol tablet kombonasi :

159 tablet
sulfametaksazole 400 mg + Trimetropim 80 mg
4200 0 4200 1000 3200 0
160 Kotrimoksazol tablet pediatrik 120 mg tablet 0 0 0 0 0 0
161 Kuinin Dihidroklorida injeksi 25% - 2 ml ampul 0 0 0 0 0 0
162 Levofloksasin 500 mg tablet 0 0 0 0 0 0
163 Licopec Kaplet 0 0 0 0 0 0

Lidokain komp. Injeksi, Kombinasi : lidokain HCl

164 ampul
2% + epinefrin 1 : 80.000- 2ml
20 0 20 10 10 100
165 Lifadrox DS Syp Btl/60 ml 0 0 0 0 0 0
166 Lisol Concentrate Botol 1000 ml 0 0 0 0 0 0
167 Lodia 2 mg tablet 0 0 0 0 0 0
168 Loperamide 2 mg tablet 0 0 0 0 0 1000
169 Loratadine tablet 100 mg tablet 3200 0 3200 1000 2200 0
170 Mebendazol tablet 100 mg tablet 0 0 0 0 0 200
171 Metformin 500 mg tablet 0 0 0 0 0 0
172 Methilergometrin Maleat tab.salut 0,125 tablet 1200 0 1200 0 1200 0
173 Methylprednisolone tablet 16 mg tablet 0 0 0 0 0 0
174 Methylprednisolone tablet 4 mg tablet 0 0 0 0 0 500
175 Methylprednisolone tablet 8 mg tablet 0 0 0 0 0 0
176 Metronidazol tablet 250 mg tablet 0 0 0 0 0 0
177 Metronidazol tablet 500 mg tablet 1400 0 1400 100 1300 500
178 Miconasole 2 % krim tube 10 gram 44 0 44 0 44 200
 Myomergin
179 Ampul 28 28 0 28
(Metilergometrin Maleat inj 0,200 mg-1 ml) 0 0
180 Natrium diklofenak 25 mg tablet 0 0 0 0 0 500
181 Natrium diklofenak 50 mg tablet 0 0 0 0 0 500
182 Natrium Klorida larutan infus 0,9 % steril botol 500 ml 48 0 48 6 42 100
183 Neurobion 5000 injeksi 3 ml Ampl/Psng 58 0 58 0 58 100
184 nifedipin tablet tablet 1600 0 1600 0 1600 0
185 Nistatin tablet salut gula 500.000 IU tablet 0 0 0 0 0 500
186 Nistatin tablet vaginal 100.000 IU tablet 0 0 0 0 0 500
187 Norpid 10 mg ( Simvastatin 10 mg ) tablet 0 0 0 0 0 0
188 Novabion kapsul 0 0 0 0 0 1000
189 Novadiar Syr btl 60 ml 0 0 0 0 0 0
190 Novadium tablet 0 0 0 0 0 0
191 Novamag Syp btl 60 ml 77 0 77 0 77 100
192 nuvopec 15 mg/ml Botol 60 ml 31 0 31 1 30 300
193 nuvopec tablet 30 mg tablet 1700 0 1700 200 1500 1000
194 Obat anti Malaria (DHP) ktk/9 90 0 90 0 90 0
195 Obat Batuk Hitam ( O.B.H. ) cairan Botol 100 ml 60 0 60 0 60 100
196 Obat OAT Kategori I Anak Paket 0 0 0 0 0 0
197 Obat OAT Kategori I Dewasa paket 0 0 0 0 0 0
198 Obat OAT Kategori II Paket 0 0 0 0 0 0
199 Obimin Dos/30 90 0 90 90 0 900
200 Oksitetrasiklin HCl salep kulit 3 % tube 5 g 0 0 0 0 0 0
201 Oksitetrasiklin HCl salep mata 1 % tube 5 g 0 0 0 0 0 0
202 Oksitosin injeksi 10 IU/ml - 1 ml ampul 0 0 0 0 0 0
203 Omegdiar sirup btl 60 ml 0 0 0 0 0 0
204 Omeprasole kapsul 20 mg kapsul 1200 0 1200 450 750 3000
205 Papaverin injeksi 40 mg / ml vial 0 0 0 0 0 0
206 Papaverin tablet 40 mg tablet 1000 0 1000 0 1000 0
207 Parasetamol sirup 120 mg/5 ml Botol 60 ml 310 0 310 20 290 0
208 Parasetamol tablet 500 mg ktk/100 8400 0 8400 1500 6900 0
209 Pehacaine injeksi ampul 10 0 10 0 10 0
210 Piracetam tablet 400 mg tablet 0 0 0 0 0 0
211 Piracetam tablet 800 mg tablet 0 0 0 0 0 0
212 Pirantel Syp Botol 60 ml 25 0 25 0 25 0
213 Pirantel tablet 125 mg tablet 1300 0 1300 500 800 0
214 Pirazinamide tablet 500 mg tablet 0 0 0 0 0 0
215 Piridoksin HCl (Vit.B6) tablet 10 mg tablet 5000 0 5000 0 5000 0
216 Piroxicam tablet 10 mg tablet 0 0 0 0 0 500
217 Piroxicam tablet 20 mg tablet 0 0 0 0 0 0
218 Povidon Iodida 10 % Botol 30 ml 20 0 20 0 20 200
219 Povidon Iodida 10 % Botol 60 ml 4 0 4 4 0 5
220 Povidon Iodida 10 % Botol 300 ml 0 0 0 0 0 1
221 Povidon Iodida 10 % Botol 1000 ml 0 0 0 0 0 0
222 Prednison tablet 5 mg tablet 5800 0 5800 900 4900 0
223 Prenamia tablet 0 0 0 0 0 0
224 Primakuin tablet 15 mg tablet 200 0 200 100 100 0
225 Procain Benzill Penicillin Inj. 3 juta IU vial 0 0 0 0 0 0
226 Propanolol HCL tablet 10 mg tablet 0 0 0 0 0 0
227 Propanolol HCL tablet 40 mg tablet 0 0 0 0 0 0
228 Propilititiurasil tablet 100 mg tablet 0 0 0 0 0 0
229 Pytogin injeksi 10 IU/ml - 1 ml ampul 83 0 83 3 80 0
230 Quinine tablet 222 mg Btl/1000 0 0 0 0 0 0
231 Quinine tablet 222 mg ktk/60 300 0 300 100 200 0
232 Ramolit sachet 0 0 0 0 0 0
233 Ranitidin tablet 150 mg tablet 5600 0 5600 500 5100 0
234 Ranitidine injeksi 25 mg/ml - 2ml ampul 110 0 110 30 80 0
235 Rifampicin kapsul 300 mg kapsul 0 0 0 0 0 0
236 Rifampicin tablet 450 mg tablet 0 0 0 0 0 0
237 Rifampicin tablet 600 mg tablet 0 0 0 0 0 0
Ringer Laktat larutan infus steril (Produk lokal)
238 botol 500 ml 105 105 25 80
0 0
239 Salbutamol tablet 2 mg tablet 0 0 0 0 0 0
240 Salbutamol tablet 4 mg tablet 1300 0 1300 0 1300 1000
Salep 2-4 , Kombinasi:
241 Pot 30 gram 134 134 0 134
As Salisilat 2% + Belerang Endap 4% 0 0
242 Salisil Bedak 2 % pot 50 gram 41 0 41 12 29 100
243 Sefadroksil sirup 125mg/5ml btl 60 ml 110 0 110 12 98 0
244 sefotaxim serbuk injeksi 1 gram/vial 2 vial/kotak 10 0 10 0 10 0
245 seftriaxon serbuk injeksi 1 gram/ vial 2 vial/kotak 0 0 0 0 0 10
246 Selespurin (Allopurinol 100 mg ) tablet 0 0 0 0 0 0
247 Sianokobalamin (Vit.B12) 50 mcg Btl/1000 0 0 0 0 0 0
248 Sianokobalamin (Vit.B12) 50 mcg Ktk/100 4100 0 4100 1100 3000 0
Sianokobalamin (Vit.B12) injeksi 500 mcg-ml
249 ampul 300 300 0 300
0 0
250 Simvastatin tablet 10 mg tablet 2400 0 2400 900 1500 0
251 Simvastatin tablet 20 mg tablet 0 0 0 0 0 0
252 Siprofloksasin tablet 500mg tablet 2500 0 2500 200 2300 0
253 Tablet tambah darah + as folat tablet 3710 0 3710 1100 2610 1000
254 Tetrasiklin HCl kapsul 250 mg kapsul 0 0 0 0 0 0
255 Tetrasiklin HCl kapsul 500 mg kapsul 0 0 0 0 0 0
256 Thiamfenicol 500 mg tablet 0 0 0 0 0 0
257 Tiamin HCl (Vit.B1) injeksi 100 mg/ml-1 ml ampul 172 0 172 3 169 0
258 Tiamin HCl / Mononitrat (Vit.B1) tab.50 mg tablet 800 0 800 200 600 0
259 Tuzalos tablet tablet 0 0 0 0 0 3000
260 Ultrasonic gell btl 250 gram 6 0 6 0 6 0
261 Ultravita Multivitamin tablet 0 0 0 0 0 0
262 Univit Syp btl 60 ml 48 0 48 0 48 100
263 Vitamin A 100.000iu kapsul 350 0 350 50 300 500
264 Vitamin A 200.000iu kapsul 800 0 800 200 600 500
265 Vitamin B Kompleks tablet tablet 4300 0 4300 0 4300 0
266 Zinc tablet tablet 1300 0 1300 1000 300 5000

Alat Kesehatan 0 0
1 Abocath No. 18 set 122 0 122 0 122 0
2 Abocath No. 20 set 0 0 0 0 0 0
3 Abocath No. 22 set 142 0 142 0 142 0
4 Abocath No. 24 100 set/kotak 85 0 85 0 85 0
5 Abocath No. 26 100 set/kot 0 0 0 0 0 0
6 Alat suntik sekali pakai 0,5 ml 100 set/kot 200 0 200 0 200 0
7 Alat suntik sekali pakai 1 ml 100 set/kotak 300 0 300 0 300 0
8 Alat suntik sekali pakai 10 ml 100 set/kotak 100 0 100 0 100 0
9 Alat suntik sekali pakai 2,5 ml 100 set/kotak 200 0 200 0 200 0
10 Alat suntik sekali pakai 3 ml 100 set/kotak 300 0 300 0 300 0
11 Alat suntik sekali pakai 5 ml 100 set/kotak 274 0 274 0 274 0
12 Alat suntik sekali pakai 50 ml 100 set/kotak 200 0 200 100 100 100
13 Alkohol Swab Kotak 600 0 600 300 300 200
14 Bisturi no 10 set 50 0 50 0 50 0
15 Bisturi no 11 set 0 0 0 0 0 0
16 Blood lancet set 160 0 160 0 160 0
17 Catgut / Benang Bedah chrom 3/0 matrix 3 buah 72 0 72 0 72 0
18 Catgut / Benang Bedah No. 4/0 buah 0 0 0 0 0 0
19 Catgut/Benang Bedah No.2/0 buah 0 0 0 0 0 0
20 Cotton Swab buah 0 0 0 0 0 0
21 Cover glass buah 50 0 50 0 50 0
22 Digital Thermometer buah 0 0 0 0 0 5
23 Etil Klorida spray botol 100 ml 2 0 2 0 2 0
24 feeding tube 8 FR x 120 cm buah 0 0 40 0 0 0
25 Foley catheter no 12 buah 10 0 10 0 10 0
26 Foley catheter no 14 buah 70 0 70 0 70 0
27 Foley catheter no 16 buah 21 0 21 0 21 0
28 Foley catheter no 18 buah 0 0 0 0 0 0
29 Foley catheter no 20 buah 0 0 0 0 0 0
30 Haemometer / Hb Sahli set 2 0 2 0 2 0
31 Hand Gloves (sarung tangan) tanpa bedak Kotak 29 0 29 22 7 0
32 Handscond obgyn ktk/50 10 0 10 3 7 0
33 Handscond Maxter L ktk/50 psg 400 0 400 200 200 300
34 Handscond Maxter M ktk/50 psg 200 0 200 200 0 300
35 Handscond Maxter S ktk/50 psg 100 0 100 100 0 300
36 Handscond Steril pasang 24 0 24 0 24 300
37 Hidrogen peroksida 3 % Botol 1000ml 1 0 1 0 1 0
38 Infusion set anak kantong 67 0 67 12 55 0
39 Infusion set dewasa kantong 51 0 51 6 45 0
40 kapas berlemak 500 gram rol 7 0 7 0 7 0
41 Kapas Pembalut / Absorben 250 gram Rol 2 0 2 0 2 0
42 kapas pembalut 100 gram rol 1 0 1 0 1 0
43 Kapas pembalut 1000 gram rol 1 0 1 0 1 0
44 kapas pembalut 50 gram rol 4 0 4 0 4 0
45 kapas pembalutr 250 gram rol 18 0 18 0 18 0
46 kapas putih 100 gram rol 3 0 3 0 3 0
47 kapas putih 250 gram rol 2 0 2 0 2 0
48 kapas putih 50 gram rol 31 0 31 0 31 0
49 Kapas putih 500 gram rol 0 0 0 0 0 0
50 Kartu golongan darah ktk/100 0 0 0 0 0 100
51 Kasa hidrofil 2 yard x 80 cm Rol 0 0 0 0 0 5
52 Kasa Hidrofil DRC 40 yard x 80 cm rol 6 0 6 4 2 5
53 Kasa Kompres 40/40 steril Bungkus 40 0 40 30 10 0
54 Kasa Pembalut Hidrofil 2,7 cm x 15 cm Rol 48 0 48 44 4 0
55 Kasa Pembalut Hidrofil 4 m x 15 cm Rol 5 0 5 0 5 0
56 Kasa steril 16x16 rol 23 0 23 0 23 100
57 Kassa Verban 3 cm x 15 cm Rol 50 0 50 0 50 0
58 Kertas Perkamen lembar/rim 0 0 0 0 0 100
59 Kertas Puyer Press pcs 0 0 0 0 0 0
60 Kertas saring lembar 0 0 0 0 0 0
61 Kondom KTK/3 36 0 36 0 36 50
62 KY Jelly tube 0 0 0 0 0 0
63 Masker hijau ktk/50 200 0 200 50 150 500
64 Medicine paket set 0 0 0 0 0 0
65 Micropipette 5 - 50µl Unit 0 0 0 0 0 0
66 Mortir + Stempel set 0 0 0 0 0 0
67 Oksigen Set Unit 0 0 0 0 0 0
68 Oneclean Botol 1000 ml 0 0 0 0 0 0
69 Oneclean botol 500 ml 2 0 2 0 2 0
70 Pembalut Gips (Gypsona 6 inchi x 3 yard) rol 11 0 11 0 11 0
71 Penjepit tali pusat set 277 0 277 0 277 0
72 pH Paper 3,8-5,4 ktk 0 0 0 0 0 0
73 Pipet Westergren buah 0 0 0 0 0 0
74 Plastik obat ( ukuran Besar ) lembar 0 0 0 0 0 3000
75 Plastik obat ( ukuran Kecil ) lembar 2000 0 2000 1000 1000 0
76 Plester 5 cm x 4,5 m rol 3 0 3 3 0 5
77 Plester 5 cm x 5 m rol 3 0 3 3 0 5
78 Pot sputum buah 0 0 0 0 0 0
79 Rak tabung reaksi buah 0 0 0 0 0 0
80 Rak westergren/LED buah 0 0 0 0 0 0
81 Rapid 1 (oncoprobe) ktk/50 0 0 0 0 0 0
82 Rapid 2 (Advanced) ktk/100 0 0 0 0 0 0
83 Rapid 3 (Vikia) ktk/25 0 0 0 0 0 0
84 sarung tangan free Powder ukuran L 100 psg/ktk 100 0 100 0 100 0
85 sarung tangan free Powder ukuran M 100 psg/ktk 200 0 200 0 200 0
86 Sikat tabung (Korok Tabung) buah 0 0 0 0 0 0
87 Slide box pcs 0 0 0 0 0 0
88 Slide/objek glass Ktk/72 0 0 0 0 0 0
89 Spiritus cair buah 0 0 0 0 0 0
90 surgical suture with needle (Plain Catgut) pcs 24 0 24 0 24 0
91 surgical suture with needle (silk Braided) pcs 36 0 36 0 36 0
92 suture needle GT 10 12pcs/bks 24 0 24 0 24 0
93 suture needle GT 11 12pcs/bks 24 0 24 0 24 0
94 suture needle GT 12 12pcs/bks 24 0 24 0 24 0
95 suture needle GT 13 12pcs/bks 24 0 24 0 24 0
96 suture needle GT 6 12pcs/bks 24 0 24 0 24 0
97 suture needle GT 7 12pcs/bks 22 0 22 0 22 0
98 Tabung Sahli (HB Sahli) set 0 0 0 0 0 0
99 Tabung Sentrifuse buah 0 0 0 0 0 0
100 Tabung Serologi buah 0 0 0 0 0 0
101 Tabung Westergreen buah 0 0 0 0 0 0
102 Tensi Digital dan Stetoskop Kit 0 0 0 0 0 0
103 Test Kehamilan pcs 0 0 0 0 0 100
104 Torniket anak rol 0 0 0 0 0 0
105 Torniket dewasa set 0 0 0 0 0 0
106 Tromol, SS set 0 0 0 0 0 0
107 Ultrafix 10 cm x 1 cm ktk/25 0 0 0 0 0 0
108 Ultrafix 5 cm x 1 cm ktk/10 0 0 0 0 0 0
109 Urinalisa (Strip Urine Expert) set 0 0 0 0 0 0
110 Urinalisis (Mission Expert) Btl 0 0 0 0 0 0
111 Urine bag 2000 ml set 15 0 15 0 15 0
112 Usilakit (posyandu Lansia) kit 0 0 0 0 0 0
113 Vaselin album btl 1 liter 0 0 0 0 0 0
114 Yellow Tips ( 5µ / 10µ /25 µ ) ktk 0 0 0 0 0 0

Reagen
1 Asam Alkohol botol 0 0 0 0 0 0
2 Asam chlorida HCl 0,1 N botol 0 0 0 0 0 0
3 Combour tes Urine botol 0 0 0 0 0 0
4 EDTA cair botol 0 0 0 0 0 0
5 Emersi oil botol 100 ml 0 0 0 0 0 0
6 Etanol asam 3% botol 100 ml 0 0 0 0 0 0
7 Eter Alkohol botol 100 ml 0 0 0 0 0 0
8 Glemsa botol 0 0 0 0 0 0
9 HCL 0,1 N botol 0 0 0 0 0 0
10 Hexagon Sypillis Kotak/20 0 0 0 0 0 0
11 Karbol fuksin botol 500 ml 0 0 0 0 0 0
12 KOH 10% botol 0 0 0 0 0 0
13 Metanol btl / 500 ml 0 0 0 0 0 0
14 Metanol btl / 1000 ml 1 0 1 0 1 0
15 Metylen Blue botol 0 0 0 0 0 0
16 Na.Citrat 3,8% botol 0 0 0 0 0 0
17 Reagen ALT / GPT Kotak 0 0 0 0 0 0
18 Reagen Anti D Golongan Darah set 0 0 0 0 0 0
19 Reagen Antigen AO.S.Paratyphii Kotak 0 0 0 0 0 0
20 Reagen Antigen BO.S.Parathypii Kotak 0 0 0 0 0 0
21 Reagen Antigen H.S.Typhii Kit 0 0 0 0 0 0
22 Reagen Antigen O.S.Parathypii Kotak 0 0 0 0 0 0
23 Reagen Asam urat Kotak 0 0 0 0 0 0
24 Reagen AST / GOT Kotak 0 0 0 0 0 0
25 Reagen BTA set 0 0 0 0 0 0
26 Reagen Cholesterol Kotak 0 0 0 0 0 0
27 Reagen GDS Kotak 0 0 0 0 0 0
28 Reagen Golongan Darah Kit 0 0 0 0 0 0
29 Reagen RPR Sypilis kotak/100 0 0 0 0 0 0
30 Reagen Trigliserida Kotak 0 0 0 0 0 0
31 reagen Zield Nelsen KIT 2 0 2 0 2 0
32 SD HIV set 100 0 100 0 100 0
33 SD Syphilis 3.0 set 100 0 100 0 100 0
34 Stik Asam urat Botol/25 100 0 100 0 100 0
35 Stik Glucosa nesco Botol/25 100 0 100 0 100 0
36 Stik Kolesterol nesco Botol/10 0 0 0 0 0 0
37 Tes RDT Malaria Kotak/10 0 0 0 0 0 0
38 Xylol botol 0 0 0 0 0 0

Mengetahui, Kiruru, 7 mei 2019

Kepala Puskesmas Kaimana Yang Meminta,
Petugas Pengelola Obat

Fransiska C.Balatando,S.Farm,Apt
Basri La hisa, Amk.
Nip. 197602142001111001
``
 PUSAT KESEHATAN MASYARAKAT KIRURU
REKAPITULASI PENGGUNAAN OBAT PSIKOTROPIKA PUSKESMAS KIRURU

BULAN April
TAHUN 2019

STOK JUMLAH
PERSEDI PEMAKAI
NO. NAMA OBAT SATUAN PENERIM
AWAL AAN AN
AAN
1 Diazepam 2 mg Botol/1000 tablet 0 0 0 0
2 Diazepam injeksi 5 mg/ml - 2ml Kotak/30 ampul 0 0 0 0
3 Haloperidol tablet 100 mg tablet 0 0 0 0
4 Phenobarbital 30 mg tablet 0 0 0 0
5 Phenobarbital injeksi Kotak/30 ampul 0 0 0 0
6 Klorpromazin HCL tablet 100 mg Tablet 0 0 0 0
7 Klorpromazin HCL injeksi 5 mg/ml-2 ml Ampul 0 0 0 0
8 Stesolid rectal Tube 0 0 0 0

Mengetahui
Kepala Puskesmas Kiruru, 7 Mei 2019

Pengelola Obat Pusk

Basri La hisa, Amk. Fransiska Celsia Bala

Nip. 197602142001111001 Nip.-
RU
ESMAS KIRURU

SISA
PERMINT
STOK AAN

0 100
0 0
0 0
0 0
0 0
0 0
0 0
0 10

Kiruru, 7 Mei 2019

Pengelola Obat Puskesmas

Fransiska Celsia Balatando,S.Farm,Apt

 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

KODE PUSKESMAS :
PUSKESMAS : KIRURU
DISTRIK : TELUK ETNA
KABUPATEN : KAIMANA BULAN MEI
PROPINSI : PAPUA BARAT TAHUN 2019

STOK PENERI- PERSE- PEMA- SISA STOK PERMIN- PEMBERIAN KET

NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK OPTMUM TAAN APBN APBD II ASKES JML
1 2 3 4 5 6 7 8 9 10 11 12 13 15 16
1 Acyclovir krim 5 % tube 5 gram 50 0 50 0 50 0
2 Acyclovir tablet 200 mg tablet 200 0 200 0 200 0
3 Acyclovir tablet 400 mg tablet 300 0 300 0 300 0
4 Albendazol tablet 400 mg tablet 0 0 0 0 0 0
5 Alopurinol tablet 100 mg tablet 1000 0 1000 0 1000 0
6 Altran (Asam mefenamat 500 mg) tablet 0 0 0 0 0 0
7 Ambroxol sirup 15 mg/ml btl 60 ml 0 0 0 0 0 0
8 Ambroxol tablet 30 mg tablet 100 0 100 100 0 0
9 Aminofilin tablet 100 mg tablet 0 0 0 0 0 0
10 Aminofilina injeksi 24 mg/ml - 10 ml ampul 122 0 122 0 122 0
11 Amlodipin tablet 10 mg tablet 385 300 685 0 685 0
12 Amlodipin tablet 5 mg tablet 0 250 250 0 250 0
13 Amoksisilin kaplet 500 mg kaplet 4300 0 4300 2300 2000 0
14 Amoksisilin sirup kering 125 mg/5 ml Botol 60 ml 0 0 0 0 0 0
15 Ampicillin injeksi ampul 0 0 0 0 0 0
16 Ampicillin Tablet tablet 300 2000 2300 0 2300 0
17 Antalgin (Metampiron) tablet 500 mg tablet 500 0 500 200 300 0
18 Antalgin injeksi 250 mg/ml - 2 ml ampul 180 0 180 20 160 0
19 Antasida DOEN SYR Botol 60 ml 0 0 0 0 0 0
20 Antasida DOEN tab botol/1000 0 0 0 0 0 0
21 Antasida DOEN tab ktk/100 500 0 500 0 500 0
 Anti Bakteri DOEN salep kombinasi:
22 Basitrasin 500 IU/g + Polimiksin 10.000 IU/g tube 5 g
0 0 0 0 0 0
23 Anti Hemoroid Superhoid supositoria supp 20 0 20 0 20 0
24 Anti hemoroid suppositoria supp 15 0 15 6 9 0
25 Antifungi DOEN Pot 30 gram 90 0 90 12 78 0

26 Antifungi DOEN (Whitefield) salep kombinasi Pot 30 gram

40 0 40 20 20 0
27 Aqua pro Injeksi steril, bebas pirogen botol 0 18 18 0 18 0
28 Artesunate injeksi 8 ampul/kotak 24 0 24 0 24 0
29 Asam Askorbat (Vit C) tablet 50 mg tablet 5900 0 5900 500 5400 0
30 Asam Folat / Profolat tablet 2100 0 2100 0 2100 0
31 Asam Mefenamat 500 mg tablet 0 1000 1000 0 1000 0
32 Asam Traneksamat 500 mg tablet 200 0 200 100 100 0
33 Asam traneksamat inj ampul 20 0 20 10 10 0
34 Asetosal 100 mg tablet 0 0 0 0 0 0
35 Asetosal 500 mg tablet 0 0 0 0 0 0
36 Benzatin Benzi Penisillin 2,4 juta iu/vial vial 0 0 0 0 0 0
37 Benzatin Benzil Penisillin 1,2 juta iu/vial vial 0 0 0 0 0 0
38 Betahistin tablet tablet 320 300 620 0 620 0
39 Betametason krim 0.1% tube 5 gram 80 0 80 40 40 0
40 Bimatracin tablet 0 0 0 0 0 0
41 Bioplacenton jelly tube 15 gram 20 0 20 10 10 0
42 Bronkis tablet 0 3000 3000 1500 1500 0
43 Burnazin salep tube 35 g 0 0 0 0 0 0
44 Byolisin syp botol/60 ml 0 0 0 0 0 0
45 Caviplex tablet ktk/100 0 0 0 0 0 0
46 Cefford FORTE (Sefadroksil kapsul 500 mg) tablet 0 0 0 0 0 0
47 Cefixime 200 mg tablet 0 0 0 0 0 0
48 Cetirizine 10 mg kapsul 0 0 0 0 0 0
49 Chinine antipirin injeksi 2 ml ampul 0 0 0 0 0 0
50 Cimetidin tablet 200mg tablet 0 0 0 0 0 0
51 Clindamicyn 150 mg tablet 0 0 0 0 0 0
52 Clindamicyn 300 mg tablet 0 0 0 0 0 0
53 Combantrin syrup botol 10 ml 0 10 10 0 10 0
54 Combi Pack Azytro tablet 0 0 0 0 0 0
55 Combi Pack Azytro + Ceffixime tablet 0 0 0 0 0 0
56 Combi pack Paket Kusta Anak MB paket 0 0 0 0 0 0
57 Combi pack Paket Kusta Anak MB Paket 0 0 0 0 0 0
58 Combi pack Paket Kusta Dewasa MB Paket/ 6 Strip 0 0 0 0 0 0
59 Combi Pack Paket Kusta Dewasa PB Paket 0 0 0 0 0 0
60 Curcuma tablet 0 0 0 0 0 0
61 Daneuron tablet 0 3000 3000 1500 1500 0
62 Decacetine ( Chlorampenicol TTM ) btl 0 0 0 0 0 0
63 Deksametason injeksi 5 mg/ml - 1 ml ampul 250 0 250 0 250 0
64 Deksametason tablet 0,5 mg ktk/100 2600 16500 19100 10000 9100 0
65 Difenhidramin HCl injeksi 10 mg/ml-1 ml ktk/30 ampul 0 0 0 0 0 0
66 Digoksin tablet 0,25 mg tablet 0 0 0 0 0 0
67 Domperidon sirup 5 mg/5 ml Botol 60 ml 98 0 98 0 98 0
68 Domperidon tablet 10 mg tablet 0 2000 2000 300 1700 0
69 Doxyciclin kapsul 100 mg kapsul 0 0 0 0 0 0
70 Dulcolax Suppositoria 10 mg supp 0 0 0 0 0 0
71 Dulcolax Suppositoria 5 mg supp 0 0 0 0 0 0
72 Efedrin HCl tablet 25 mg btl/250 0 0 0 0 0 0
73 Epineprin inj 0 ,1 %(adrenalin) ampul 0 0 0 0 0 0
74 Ergotamine Caffeine Tablet 800 0 800 100 700 0
75 Eritromicin sirop kering 200 mgl / 5ml Botol 60 ml 6 0 6 1 5 0
76 Erlamycetin Salp Mata tube 3 0 3 0 3 0
77 Erlamycetin tetes telinga 1% tube 61 0 61 0 61 0
78 Erphazone ( Phenylbutazone 200 mg ) btl/1000 0 0 0 0 0 0
79 Erytromicin kapsul 250 mg kapsul 0 0 0 0 0 0
80 Erytromicin kapsul 500 mg kapsul 200 0 200 100 100 0
81 etabion tab tablet 0 1000 1000 500 500
82 Etakridin ( Rivanol ) larutan 0,1% Botol 300 ml 0 0 0 0 0 0
83 Etanol ( alkohol ) 70% botol 100 ml 4 12 16 0 16 0
84 Etanol ( alkohol ) 70% Botol 300 ml 0 0 0 0 0 0
85 Etanol ( alkohol ) 70% botol 1000 ml 4 0 4 1 3 0
86 Ethambutol tablet 250mg tablet 0 0 0 0 0 0
87 Ethambutol tablet 500mg tablet 0 0 0 0 0 0
88 Farmalat (Nifedipin) tablet 10 mg tablet 0 0 0 0 0 0
89 faxiden 20 mg tab tablet 600 0 600 300 300 0
90 Fenilbutalson tablet 200 mg Btl/1000 0 0 0 0 0 0
91 Fenilbutalson tablet 200 mg ktk/150 0 0 0 0 0 0
92 Fenol Gliserol tetes telinga 10% botol 5 ml 100 0 100 50 50 0
93 Fermia ktk/100 0 0 0 0 0 0
94 Ferrous Sulphate tablet 300 mg tablet 0 0 0 0 0 0
95 Fitomenadion (Vit.K1) inj 10 mg/ml - 1 ml ampul 109 0 109 9 100 0
96 Fitomenadion (Vit.K1) tab salut gula 10 mg tablet 0 0 0 0 0 0
97 Fluconazole tablet 0 0 0 0 0 0
98 Furosemid tablet 0,5 mg tablet 0 0 0 0 0 0
99 Garam Oralit untuk 200 ml air sachet 900 0 900 100 800 0
100 Gemfibrosil kapsul 300 Mg kapsul 0 0 0 0 0 0
101 Gemfibrosil kapsul 600 Mg kapsul 200 0 200 0 200 0
102 gentalex salep kulit 0,1 % ktk/10 tube 60 0 60 20 40 0
103 Gentamicin inj 80mg/2ml ampul 50 0 50 0 50 0
104 Gentamicin salep kulit 0,1 % ktk/ 10 tube 0 0 0 0 0 0
105 Gentian Violet larutan 1 % Botol 10 ml 0 0 0 0 0 0
106 Gitarmin ( Asam Mefenamat 500 mg ) tablet 0 0 0 0 0 0
107 Gitri sirup Botol 60 ml 0 0 0 0 0 0
108 Glibenklamid tablet 5 mg tablet 0 0 0 0 0 0
109 Glikos (Metformin 500 mg) tablet 300 0 300 0 300 0
110 Gliseril Guaiakolat tablet 100 mg tablet 2500 0 2500 500 2000 0
111 Gludepatic 500 mg tablet 400 0 400 200 200 0
112 Glukosa larutan infus 5 % steril Botol 500 ml 90 0 90 0 90 0
113 Gradilex 2 mg / Loperamid tablet 2200 0 2200 0 2200 0
114 Grafazole 500 mg tablet 0 0 0 0 0 0
115 Graseric 150 mg tablet 0 0 0 0 0 0
116 Gravalin 2 mg / Salbutamol 2 mg tablet 1500 0 1500 200 1300 0
117 Gravask 10 mg tablet 0 0 0 0 0 0
118 Gravask 5 mg tablet 0 0 0 0 0 0
119 Gricin 500 mg tablet 0 2000 2000 0 2000 0
120 Griseofulvin tablet 125 mg tablet 2100 0 2100 100 2000 0
121 Griseofulvin tablet 500 mg tablet 1000 0 1000 0 1000 0
122 Hidroklorotiazid (HCT) tablet 25 mg tablet 200 0 200 0 200 0
123 Hidrokortison krim 2,5 % tube 5 g 49 0 49 20 29 0
124 Holimox Syp ( Amox Syp) btl / 60 ml 20 0 20 10 10 0
125 Hustab tablet 1200 4200 5400 3000 2400 0
126 Ibuprofen Syp btl 5 ml 0 0 0 0 0 0
127 Ibuprofen tablet 200 mg tablet 1000 0 1000 500 500 0
128 Ibuprofen tablet 400 mg tablet 3000 0 3000 0 3000 0
129 Ichtiyol Salf pot 24 0 24 0 24 0
130 Ifison ( Prednisone ) tablet 0 0 0 0 0 0
131 Infantrim forte tablet 480 mg tablet 1200 0 1200 0 1200 0
132 Irgapan tablet 0 1000 1000 300 700 0
133 Isoniazid ( INH ) 100 mg tablet 0 0 0 0 0 0
134 Isoniazid ( INH ) 300 mg tablet 300 0 300 0 300 0
135 Isosorbid Dinitrat tablet sublingual 5 mg tablet 600 0 600 100 500 0
136 Itrasal Syp btl 5 ml 0 0 0 0 0 0
137 Kalium diklofenak tablet tablet 0 0 0 0 0 0
138 Kalsium Laktat (Kalk) tablet 500 mg ktk/100 0 0 0 0 0 0
139 Kalsium Laktat (Kalk) tablet 500 mg Btl/1000 2000 0 2000 0 2000 0
140 Kanamicin inj 1 gram/vial vial 0 0 0 0 0 0
141 Kaptopril tablet 12,5 mg tablet 400 3000 3400 200 3200 0
142 Kaptopril tablet 25 mg tablet 400 2000 2400 1000 1400 0
143 Katitra (Tertracycline) Kapsul 500 mg kapsul 0 0 0 0 0 0
144 Kemoren 50 mg tablet 0 0 0 0 0 0
145 Ketokonazol salep 2% tube 10 gram 11 0 11 0 11 0
146 Ketokonazol tablet 200 mg tablet 700 1000 1700 600 1100 0
147 Kina tablet salut gula ktk/24x12 0 0 0 0 0 0
148 Kloramfenikol kapsul 250 mg kapsul 0 0 0 0 0 0
149 Kloramfenikol salep kulit tube 5 mg 0 0 0 0 0 0
150 Kloramfenikol tetes telinga 3 % botol 5 ml 0 0 0 0 0 0
151 Klorampenicol salep mata 1 % tube 5 g 0 0 0 0 0 0
152 Klorampenicol tetes mata 0.5% (Reco) botol 5 ml 0 0 0 0 0 0
153 Klorfeniramin Maleat (CTM) tablet 4 mg tablet 900 3500 4400 1500 2900 0
154 Kloroquine tablet 250mg tablet 400 0 400 200 200 0
155 Klorquine tablet 150 mg tablet 0 0 0 0 0 0
156 Kokodin 10 % Btl/1000 ml 0 0 0 0 0 0
157 Kokodin 10 % Btl/300 ml 0 0 0 0 0 0
158 Kokotra (Tetracycline) kapsul 250 mg kapsul 0 0 0 0 0 0
Komb Pirimetamin 25 mg + Sulfadoxin 500 mg
159 tablet
1000 0 1000 0 1000 0
Kotrimoksazol susp kombinasi :
160 sulfametaksazol 200 mg + trimetropim 40mg/ 5 botol 60 ml
ml 245 0 245 0 245 0

Kotrimoksazol tablet kombonasi :

161 tablet
sulfametaksazole 400 mg + Trimetropim 80 mg
3200 0 3200 0 3200 0
162 Kotrimoksazol tablet pediatrik 120 mg tablet 0 0 0 0 0 0
163 Kuinin Dihidroklorida injeksi 25% - 2 ml ampul 0 0 0 0 0 0
164 Levofloksasin 500 mg tablet 0 0 0 0 0 0
165 Licopec Kaplet 0 0 0 0 0 0

Lidokain komp. Injeksi, Kombinasi : lidokain HCl

166 ampul
2% + epinefrin 1 : 80.000- 2ml
10 60 70 0 70 0
167 Lifadrox DS Syp Btl/60 ml 0 0 0 0 0 0
168 Lisol Concentrate Botol 1000 ml 0 0 0 0 0 0
169 Lodia 2 mg tablet 0 0 0 0 0 0
170 Loperamide 2 mg tablet 0 1800 1800 200 1600 0
171 Loratadine tablet 100 mg tablet 2200 0 2200 0 2200 0
172 Mebendazol tablet 100 mg tablet 0 0 0 0 0 0
173 Metformin 500 mg tablet 0 0 0 0 0 0
174 Methilergometrin Maleat tab.salut 0,125 tablet 1200 0 1200 100 1100 0
175 Methylprednisolone tablet 16 mg tablet 0 0 0 0 0 0
176 Methylprednisolone tablet 4 mg tablet 0 0 0 0 0 0
177 Methylprednisolone tablet 8 mg tablet 0 0 0 0 0 0
178 Metronidazol tablet 250 mg tablet 0 0 0 0 0 0
179 Metronidazol tablet 500 mg tablet 1300 0 1300 300 1000 0
180 Miconasole 2 % krim tube 10 gram 44 0 44 10 34 0
Myomergin
181 Ampul 28 28 28
(Metilergometrin Maleat inj 0,200 mg-1 ml) 0 0 0
182 Natrium diklofenak 25 mg tablet 0 0 0 0 0 0
183 Natrium diklofenak 50 mg tablet 0 500 500 0 500 0
184 Natrium Klorida larutan infus 0,9 % steril botol 500 ml 42 40 82 20 62 0
185 Neurobion 5000 injeksi 3 ml Ampl/Psng 58 0 58 20 38 0
186 nifedipin tablet tablet 1600 600 2200 1000 1200 0
187 Nistatin tablet salut gula 500.000 IU tablet 0 0 0 0 0 0
188 Nistatin tablet vaginal 100.000 IU tablet 0 0 0 0 0 0
189 Norpid 10 mg ( Simvastatin 10 mg ) tablet 0 0 0 0 0 0
190 Novabion kapsul 0 0 0 0 0 0
191 Novadiar Syr btl 60 ml 0 0 0 0 0 0
192 Novadium tablet 0 0 0 0 0 0
193 Novamag Syp btl 60 ml 77 0 77 0 77 0
194 nuvopec 15 mg/ml Botol 60 ml 30 0 30 20 10 0
195 nuvopec tablet 30 mg tablet 1500 2000 3500 2000 1500 0
196 Obat anti Malaria (DHP) ktk/9 90 0 90 0 90 0
197 Obat Batuk Hitam ( O.B.H. ) cairan Botol 100 ml 60 0 60 15 45 0
198 Obat OAT Kategori I Anak Paket 0 0 0 0 0 0
199 Obat OAT Kategori I Dewasa paket 0 0 0 0 0 0
200 Obat OAT Kategori II Paket 0 0 0 0 0 0
201 Obimin Dos/30 0 0 0 0 0 0
202 Oksitetrasiklin HCl salep kulit 3 % tube 5 g 0 0 0 0 0 0
203 Oksitetrasiklin HCl salep mata 1 % tube 5 g 0 0 0 0 0 0
204 Oksitosin injeksi 10 IU/ml - 1 ml ampul 0 0 0 0 0 0
205 Omegdiar sirup btl 60 ml 0 0 0 0 0 0
206 Omeprasole kapsul 20 mg kapsul 750 600 1350 900 450 0
207 Papaverin injeksi 40 mg / ml vial 0 0 0 0 0 0
208 Papaverin tablet 40 mg tablet 1000 0 1000 0 1000 0
209 Parasetamol sirup 120 mg/5 ml Botol 60 ml 290 0 290 50 240 0
210 Parasetamol tablet 500 mg ktk/100 6900 0 6900 3000 3900 0
211 Pehacaine injeksi ampul 10 0 10 0 10 0
212 Piracetam tablet 400 mg tablet 0 0 0 0 0 0
213 Piracetam tablet 800 mg tablet 0 0 0 0 0 0
214 Pirantel Syp Botol 60 ml 25 0 25 0 25 0
215 Pirantel tablet 125 mg tablet 800 0 800 0 800 0
216 Pirazinamide tablet 500 mg tablet 0 0 0 0 0 0
217 Piridoksin HCl (Vit.B6) tablet 10 mg tablet 5000 0 5000 3000 2000 0
218 Piroxicam tablet 10 mg tablet 0 0 0 0 0 0
219 Piroxicam tablet 20 mg tablet 0 0 0 0 0 0
220 Povidon Iodida 10 % Botol 30 ml 20 0 20 10 10 0
221 Povidon Iodida 10 % Botol 60 ml 0 0 0 0 0 0
222 Povidon Iodida 10 % Botol 300 ml 0 0 0 0 0 0
223 Povidon Iodida 10 % Botol 1000 ml 0 0 0 0 0 0
224 Prednison tablet 5 mg tablet 4900 2000 6900 500 6400 0
225 Prenamia tablet 0 0 0 0 0 0
226 Primakuin tablet 15 mg tablet 100 0 100 0 100 0
227 Procain Benzill Penicillin Inj. 3 juta IU vial 0 0 0 0 0 0
228 Propanolol HCL tablet 10 mg tablet 0 0 0 0 0 0
229 Propanolol HCL tablet 40 mg tablet 0 0 0 0 0 0
230 Propilititiurasil tablet 100 mg tablet 0 0 0 0 0 0
231 Pytogin injeksi 10 IU/ml - 1 ml ampul 80 0 80 20 60 0
232 Quinine tablet 222 mg Btl/1000 0 0 0 0 0 0
233 Quinine tablet 222 mg ktk/60 200 0 200 100 100 0
234 Ramolit sachet 0 0 0 0 0 0
235 Ranitidin tablet 150 mg tablet 5100 0 5100 100 5000 0
236 Ranitidine injeksi 25 mg/ml - 2ml ampul 80 0 80 0 80 0
237 Rifampicin kapsul 300 mg kapsul 0 0 0 0 0 0
238 Rifampicin tablet 450 mg tablet 0 0 0 0 0 0
239 Rifampicin tablet 600 mg tablet 0 0 0 0 0 0
Ringer Laktat larutan infus steril (Produk lokal)
240 botol 500 ml 80 80 80
0 0 0
241 Salbutamol tablet 2 mg tablet 0 0 0 0 0 0
242 Salbutamol tablet 4 mg tablet 1300 0 1300 500 800 0
Salep 2-4 , Kombinasi:
243 Pot 30 gram 134 134 125
As Salisilat 2% + Belerang Endap 4% 0 9 0
244 Salisil Bedak 2 % pot 50 gram 29 100 129 50 79 0
245 Sefadroksil sirup 125mg/5ml btl 60 ml 98 0 98 0 98 0
246 Sefadroksil tab 500 mg tablet 0 2000 2000 800 1200 0
247 sefotaxim serbuk injeksi 1 gram/vial 2 vial/kotak 10 0 10 0 10 0
248 seftriaxon serbuk injeksi 1 gram/ vial 2 vial/kotak 0 0 0 0 0 0
249 Selespurin (Allopurinol 100 mg ) tablet 0 0 0 0 0 0
250 Sianokobalamin (Vit.B12) 50 mcg Btl/1000 0 0 0 0 0 0
251 Sianokobalamin (Vit.B12) 50 mcg Ktk/100 3000 0 3000 2000 1000 0
Sianokobalamin (Vit.B12) injeksi 500 mcg-ml
252 ampul 300 300 200
0 100 0
253 Simvastatin tablet 10 mg tablet 1500 0 1500 0 1500 0
254 Simvastatin tablet 20 mg tablet 0 0 0 0 0 0
255 Siprofloksasin tablet 500mg tablet 2300 0 2300 1000 1300 0
256 Tablet tambah darah + as folat tablet 2510 2200 4710 510 4200 0
257 Tetrasiklin HCl kapsul 250 mg kapsul 0 0 0 0 0 0
258 Tetrasiklin HCl kapsul 500 mg kapsul 0 0 0 0 0 0
259 Thiamfenicol 500 mg tablet 0 0 0 0 0 0
260 Tiamin HCl (Vit.B1) injeksi 100 mg/ml-1 ml ampul 169 0 169 0 169 0
261 Tiamin HCl / Mononitrat (Vit.B1) tab.50 mg tablet 600 0 600 0 600 0
262 Tuzalos tablet tablet 0 0 0 0 0 0
263 Ultrasonic gell btl 250 gram 6 0 6 0 6 0
264 Ultravita Multivitamin tablet 0 0 0 0 0 0
265 Univit Syp btl 60 ml 48 0 48 0 48 0
266 Vitamin A 100.000iu kapsul 300 350 650 0 650 0
267 Vitamin A 200.000iu kapsul 600 500 1100 0 1100 0
268 Vitamin B Kompleks tablet tablet 4300 0 4300 1200 3100 0
269 Zinc tablet tablet 300 0 300 100 200 0
0
Alat Kesehatan 0
1 Abocath No. 18 set 122 0 122 0 122 0
2 Abocath No. 20 set 0 0 0 0 0 0
3 Abocath No. 22 set 142 0 142 0 142 0
4 Abocath No. 24 100 set/kotak 85 0 85 0 85 0
5 Abocath No. 26 100 set/kot 0 0 0 0 0 0
6 Alat suntik sekali pakai 0,5 ml 100 set/kot 200 0 200 100 100 0
7 Alat suntik sekali pakai 1 ml 100 set/kotak 300 0 300 100 200 0
8 Alat suntik sekali pakai 10 ml 100 set/kotak 100 0 100 0 100 0
9 Alat suntik sekali pakai 2,5 ml 100 set/kotak 200 0 200 0 200 0
10 Alat suntik sekali pakai 3 ml 100 set/kotak 300 0 300 0 300 0
11 Alat suntik sekali pakai 5 ml 100 set/kotak 274 0 274 0 274 0
12 Alat suntik sekali pakai 50 ml 100 set/kotak 100 0 100 0 100 0
13 Alkohol Swab Kotak 300 0 300 200 100 0
14 Bisturi no 10 set 50 0 50 0 50 0
15 Bisturi no 11 set 0 0 0 0 0 0
16 Blood lancet set 160 0 160 0 160 0
17 Catgut / Benang Bedah chrom 3/0 matrix 3 buah 72 0 72 0 72 0
18 Catgut / Benang Bedah No. 4/0 buah 0 0 0 0 0 0
19 Catgut/Benang Bedah No.2/0 buah 0 0 0 0 0 0
20 Cotton Swab buah 0 0 0 0 0 0
21 Cover glass buah 50 0 50 0 50 0
22 Digital Thermometer buah 0 0 0 0 0 0
23 Etil Klorida spray botol 100 ml 2 0 2 0 2 0
24 feeding tube 8 FR x 120 cm buah 0 0 40 0 0 0
25 Foley catheter no 12 buah 10 0 10 0 10 0
26 Foley catheter no 14 buah 70 0 70 0 70 0
27 Foley catheter no 16 buah 21 0 21 0 21 0
28 Foley catheter no 18 buah 0 0 0 0 0 0
29 Foley catheter no 20 buah 0 0 0 0 0 0
30 Haemometer / Hb Sahli set 2 0 2 0 2 0
31 Hand Gloves (sarung tangan) tanpa bedak Kotak 7 0 7 0 7 0
32 Handscond obgyn ktk/50 7 0 7 0 7 0
33 Handscond Maxter L ktk/50 psg 200 1400 1600 500 1100 0
34 Handscond Maxter M ktk/50 psg 0 500 500 200 300 0
35 Handscond Maxter S ktk/50 psg 0 0 0 0 0 0
36 Handscond Steril pasang 24 0 24 20 4 0
37 Hidrogen peroksida 3 % Botol 1000ml 1 0 1 0 1 0
38 Infusion set anak kantong 55 0 55 0 55 0
39 Infusion set dewasa kantong 45 0 45 0 45 0
40 kapas berlemak 500 gram rol 7 0 7 1 6 0
41 Kapas Pembalut / Absorben 250 gram Rol 2 0 2 0 2 0
42 kapas pembalut 100 gram rol 1 0 1 0 1 0
43 Kapas pembalut 1000 gram rol 1 0 1 0 1 0
44 kapas pembalut 50 gram rol 4 0 4 0 4 0
45 kapas pembalutr 250 gram rol 18 0 18 0 18 0
46 kapas putih 100 gram rol 3 0 3 0 3 0
47 kapas putih 250 gram rol 2 0 2 0 2 0
48 kapas putih 50 gram rol 31 0 31 0 31 0
49 Kapas putih 500 gram rol 0 0 0 0 0 0
50 Kartu golongan darah ktk/100 0 0 0 0 0 0
51 Kasa hidrofil 2 yard x 80 cm Rol 0 0 0 0 0 0
52 Kasa Hidrofil DRC 40 yard x 80 cm rol 2 2 4 2 2 0
53 Kasa Kompres 40/40 steril Bungkus 10 0 10 0 10 0
54 Kasa Pembalut Hidrofil 2,7 cm x 15 cm Rol 4 0 4 0 4 0
55 Kasa Pembalut Hidrofil 4 m x 15 cm Rol 5 0 5 0 5 0
56 Kasa steril 16x16 rol 23 0 23 0 23 0
57 Kassa Verban 3 cm x 15 cm Rol 50 0 50 0 50 0
58 Kertas Perkamen lembar/rim 0 1 1 0 1 0
59 Kertas Puyer Press pcs 0 0 0 0 0 0
60 Kertas saring lembar 0 0 0 0 0 0
61 Kondom KTK/3 36 0 36 0 36 0
62 KY Jelly tube 0 0 0 0 0 0
63 Masker hijau ktk/50 150 150 300 100 200 0
64 Medicine paket set 0 0 0 0 0 0
65 Micropipette 5 - 50µl Unit 0 0 0 0 0 0
66 Mortir + Stempel set 0 0 0 0 0 0
67 Oksigen Set Unit 0 0 0 0 0 0
68 Oneclean Botol 1000 ml 0 0 0 0 0 0
69 Oneclean botol 500 ml 2 0 2 0 2 0
70 Pembalut Gips (Gypsona 6 inchi x 3 yard) rol 11 0 11 0 11 0
71 Penjepit tali pusat set 277 0 277 0 277 0
72 pH Paper 3,8-5,4 ktk 0 0 0 0 0 0
73 Pipet Westergren buah 0 0 0 0 0 0
74 Plastik obat ( ukuran Besar ) lembar 0 0 0 0 0 0
75 Plastik obat ( ukuran Kecil ) lembar 1000 1000 2000 500 1500 0
76 Plester 5 cm x 4,5 m rol 0 18 18 4 14 0
77 Plester 5 cm x 5 m rol 0 0 0 0 0 0
78 Pot sputum buah 0 0 0 0 0 0
79 Rak tabung reaksi buah 0 0 0 0 0 0
80 Rak westergren/LED buah 0 0 0 0 0 0
81 Rapid 1 (oncoprobe) ktk/50 0 0 0 0 0 0
82 Rapid 2 (Advanced) ktk/100 0 0 0 0 0 0
83 Rapid 3 (Vikia) ktk/25 0 0 0 0 0 0
84 sarung tangan free Powder ukuran L 100 psg/ktk 100 0 100 50 50 0
85 sarung tangan free Powder ukuran M 100 psg/ktk 200 0 200 100 100 0
86 Sikat tabung (Korok Tabung) buah 0 0 0 0 0 0
87 Slide box pcs 0 0 0 0 0 0
88 Slide/objek glass Ktk/72 0 0 0 0 0 0
89 Spiritus cair buah 0 0 0 0 0 0
90 surgical suture with needle (Plain Catgut) pcs 24 0 24 12 12 0
91 surgical suture with needle (silk Braided) pcs 36 0 36 12 24 0
92 suture needle GT 10 12pcs/bks 24 0 24 12 12 0
93 suture needle GT 11 12pcs/bks 24 0 24 12 12 0
94 suture needle GT 12 12pcs/bks 24 0 24 12 12 0
95 suture needle GT 13 12pcs/bks 24 0 24 12 12 0
96 suture needle GT 6 12pcs/bks 24 0 24 12 12 0
97 suture needle GT 7 12pcs/bks 22 0 22 10 12 0
98 Tabung Sahli (HB Sahli) set 0 0 0 0 0 0
99 Tabung Sentrifuse buah 0 0 0 0 0 0
100 Tabung Serologi buah 0 0 0 0 0 0
101 Tabung Westergreen buah 0 0 0 0 0 0
102 Tensi Digital dan Stetoskop Kit 0 0 0 0 0 0
103 Test Kehamilan pcs 0 100 100 0 100 0
104 Torniket anak rol 0 0 0 0 0 0
105 Torniket dewasa set 0 0 0 0 0 0
106 Tromol, SS set 0 0 0 0 0 0
107 Ultrafix 10 cm x 1 cm ktk/25 0 0 0 0 0 0
108 Ultrafix 5 cm x 1 cm ktk/10 0 0 0 0 0 0
109 Urinalisa (Strip Urine Expert) set 0 0 0 0 0 0
110 Urinalisis (Mission Expert) Btl 0 0 0 0 0 0
111 Urine bag 2000 ml set 15 0 15 0 15 0
112 Usilakit (posyandu Lansia) kit 0 0 0 0 0 0
113 Vaselin album btl 1 liter 0 0 0 0 0 0
114 Yellow Tips ( 5µ / 10µ /25 µ ) ktk 0 0 0 0 0 0
0
0
Reagen 0
1 Asam Alkohol botol 0 0 0 0 0 0
2 Asam chlorida HCl 0,1 N botol 0 0 0 0 0 0
3 Combour tes Urine botol 0 0 0 0 0 0
4 EDTA cair botol 0 0 0 0 0 0
5 Emersi oil botol 100 ml 0 0 0 0 0 0
6 Etanol asam 3% botol 100 ml 0 0 0 0 0 0
7 Eter Alkohol botol 100 ml 0 0 0 0 0 0
8 Glemsa botol 0 0 0 0 0 0
9 HCL 0,1 N botol 0 0 0 0 0 0
10 Hexagon Sypillis Kotak/20 0 0 0 0 0 0
11 Karbol fuksin botol 500 ml 0 0 0 0 0 0
12 KOH 10% botol 0 0 0 0 0 0
13 Metanol btl / 500 ml 0 0 0 0 0 0
14 Metanol btl / 1000 ml 1 0 1 0 1 0
15 Metylen Blue botol 0 0 0 0 0 0
16 Na.Citrat 3,8% botol 0 0 0 0 0 0
17 Reagen ALT / GPT Kotak 0 0 0 0 0 0
18 Reagen Anti D Golongan Darah set 0 0 0 0 0 0
19 Reagen Antigen AO.S.Paratyphii Kotak 0 0 0 0 0 0
20 Reagen Antigen BO.S.Parathypii Kotak 0 0 0 0 0 0
21 Reagen Antigen H.S.Typhii Kit 0 0 0 0 0 0
22 Reagen Antigen O.S.Parathypii Kotak 0 0 0 0 0 0
23 Reagen Asam urat Kotak 0 0 0 0 0 0
24 Reagen AST / GOT Kotak 0 0 0 0 0 0
25 Reagen BTA set 0 0 0 0 0 0
26 Reagen Cholesterol Kotak 0 0 0 0 0 0
27 Reagen GDS Kotak 0 0 0 0 0
28 Reagen Golongan Darah Kit 0 0 0 0 0 0
29 Reagen RPR Sypilis kotak/100 0 0 0 0 0 0
30 Reagen Trigliserida Kotak 0 0 0 0 0 0
31 reagen Zield Nelsen KIT 2 0 2 0 2 0
32 SD HIV set 100 0 100 0 100 0
33 SD Syphilis 3.0 set 100 0 100 0 100 0
34 Stik Asam urat Botol/25 100 50 150 50 100 0
35 Stik Glucosa nesco Botol/25 100 50 150 50 100 0
36 Stik Kolesterol nesco Botol/10 0 0 0 0 0 0
37 Tes RDT Malaria Kotak/10 0 0 0 0 0 0
38 Xylol botol 0 0 0 0 0 0

Mengetahui, Kiruru, 5 Juni 2019

Kepala Puskesmas Kaimana Yang Meminta,
Petugas Pengelola Obat

Fransiska C.Balatando,S.Farm,Apt
Basri La hisa, Amk.
Nip. 197602142001111001
``
 PUSAT KESEHATAN MASYARAKAT KIRURU
REKAPITULASI PENGGUNAAN OBAT PSIKOTROPIKA PUSKESMAS KIRURU

BULAN Mei
TAHUN 2019

STOK JUMLAH
PERSEDI PEMAKAI
NO. NAMA OBAT SATUAN PENERIM
AWAL AAN AN
AAN
1 Diazepam 2 mg Botol/1000 tablet 0 0 0 0
2 Diazepam injeksi 5 mg/ml - 2ml Kotak/30 ampul 0 0 0 0
3 Haloperidol tablet 100 mg tablet 0 0 0 0
4 Phenobarbital 30 mg tablet 0 0 0 0
5 Phenobarbital injeksi Kotak/30 ampul 0 0 0 0
6 Klorpromazin HCL tablet 100 mg Tablet 0 0 0 0
7 Klorpromazin HCL injeksi 5 mg/ml-2 ml Ampul 0 0 0 0
8 Stesolid rectal Tube 0 0 0 0

Mengetahui
Kepala Puskesmas Kiruru, 5 Juni 2019

Pengelola Obat Pusk

Basri La hisa, Amk. Fransiska Celsia Bala

Nip. 197602142001111001 Nip.-
RU
ESMAS KIRURU

SISA
PERMINT
STOK AAN

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

Kiruru, 5 Juni 2019

Pengelola Obat Puskesmas

Fransiska Celsia Balatando,S.Farm,Apt

 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

KODE PUSKESMAS :
PUSKESMAS : KIRURU
DISTRIK : TELUK ETNA
KABUPATEN : KAIMANA BULAN JUNI
PROPINSI : PAPUA BARAT TAHUN 2019

STOK PENERI- PERSE- PEMA- SISA STOK PERMIN- PEMBERIAN KET

NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK OPTMUM TAAN APBN APBD II ASKES JML
1 2 3 4 5 6 7 8 9 10 11 12 13 15 16
1 Acyclovir krim 5 % tube 5 gram 50 0 50 0 50 200
2 Acyclovir tablet 200 mg tablet 200 0 200 100 100 500
3 Acyclovir tablet 400 mg tablet 300 0 300 150 150 500
4 Albendazol tablet 400 mg tablet 0 0 0 0 0 0
5 Alopurinol tablet 100 mg tablet 1000 0 1000 0 1000 3000
6 Altran (Asam mefenamat 500 mg) tablet 0 0 0 0 0 5000
7 Ambroxol sirup 15 mg/ml btl 60 ml 0 0 0 0 0 500
8 Ambroxol tablet 30 mg tablet 0 0 0 0 0 5000
9 Aminofilin tablet 100 mg tablet 0 0 0 0 0
10 Aminofilina injeksi 24 mg/ml - 10 ml ampul 122 0 122 0 122 0
11 Amlodipin tablet 10 mg tablet 685 0 685 0 685 0
12 Amlodipin tablet 5 mg tablet 250 0 250 0 250 0
13 Amoksisilin kaplet 500 mg kaplet 2000 0 2000 1900 100 10000
14 Amoksisilin sirup kering 125 mg/5 ml Botol 60 ml 0 0 0 0 0 500
15 Ampicillin injeksi ampul 0 0 0 0 0 10
16 Ampicillin Tablet tablet 2300 0 2300 1400 900 500
17 Antalgin (Metampiron) tablet 500 mg tablet 300 0 300 300 0 5000
18 Antalgin injeksi 250 mg/ml - 2 ml ampul 160 0 160 40 120 30
19 Antasida DOEN SYR Botol 60 ml 0 0 0 0 0 500
20 Antasida DOEN tab botol/1000 0 0 0 0 0 0
21 Antasida DOEN tab ktk/100 500 0 500 0 500 5000
 Anti Bakteri DOEN salep kombinasi:
22 Basitrasin 500 IU/g + Polimiksin 10.000 IU/g tube 5 g
0 0 0 0 0 0
23 Anti Hemoroid Superhoid supositoria supp 20 0 20 0 20 48
24 Anti hemoroid suppositoria supp 9 0 9 9 0 48
25 Antifungi DOEN Pot 30 gram 78 0 78 6 72 0

26 Antifungi DOEN (Whitefield) salep kombinasi Pot 30 gram

20 0 20 20 0 0
27 Aqua pro Injeksi steril, bebas pirogen botol 18 0 18 0 18 20
28 Artesunate injeksi 8 ampul/kotak 24 0 24 0 24 0
29 Asam Askorbat (Vit C) tablet 50 mg tablet 5400 0 5400 1000 4400 5000
30 Asam Folat / Profolat tablet 2100 0 2100 0 2100 0
31 Asam Mefenamat 500 mg tablet 1000 0 1000 0 1000 5000
32 Asam Traneksamat 500 mg tablet 100 0 100 100 0 0
33 Asam traneksamat inj ampul 10 0 10 10 0 0
34 Asetosal 100 mg tablet 0 0 0 0 0 0
35 Asetosal 500 mg tablet 0 0 0 0 0 1000
36 Benzatin Benzi Penisillin 2,4 juta iu/vial vial 0 0 0 0 0 100
37 Benzatin Benzil Penisillin 1,2 juta iu/vial vial 0 0 0 0 0 100
38 Betahistin tablet tablet 620 0 620 0 620 0
39 Betametason krim 0.1% tube 5 gram 40 0 40 40 0 300
40 Bimatracin tablet 0 0 0 0 0 0
41 Bioplacenton jelly tube 15 gram 10 0 10 10 0 100
42 Bronkis tablet 1500 0 1500 800 700 5000
43 Burnazin salep tube 35 g 0 0 0 0 0 200
44 Byolisin syp botol/60 ml 0 0 0 0 0 300
45 Caviplex tablet ktk/100 0 0 0 0 0 10000
46 Cefford FORTE (Sefadroksil kapsul 500 mg) tablet 0 0 0 0 0 500
47 Cefixime 200 mg tablet 0 0 0 0 0 0
48 Cetirizine 10 mg kapsul 0 0 0 0 0 0
49 Chinine antipirin injeksi 2 ml ampul 0 0 0 0 0 0
50 Cimetidin tablet 200mg tablet 0 0 0 0 0 0
51 Clindamicyn 150 mg tablet 0 0 0 0 0 0
52 Clindamicyn 300 mg tablet 0 0 0 0 0 1000
53 Combantrin syrup botol 10 ml 10 0 10 2 8 0
54 Combi Pack Azytro tablet 0 0 0 0 0 0
55 Combi Pack Azytro + Ceffixime tablet 0 0 0 0 0 0
56 Combi pack Paket Kusta Anak MB paket 0 0 0 0 0 0
57 Combi pack Paket Kusta Anak MB Paket 0 0 0 0 0 0
58 Combi pack Paket Kusta Dewasa MB Paket/ 6 Strip 0 0 0 0 0 0
59 Combi Pack Paket Kusta Dewasa PB Paket 0 0 0 0 0 0
60 Curcuma tablet 0 0 0 0 0 0
61 Daneuron tablet 1500 0 1500 900 600 3000
62 Decacetine ( Chlorampenicol TTM ) btl 0 0 0 0 0 0
63 Deksametason injeksi 5 mg/ml - 1 ml ampul 250 0 250 0 250 0
64 Deksametason tablet 0,5 mg ktk/100 9100 0 9100 3100 6000 5000
65 Difenhidramin HCl injeksi 10 mg/ml-1 ml ktk/30 ampul 0 0 0 0 0 30
66 Digoksin tablet 0,25 mg tablet 0 0 0 0 0 0
67 Domperidon sirup 5 mg/5 ml Botol 60 ml 98 0 98 0 98 0
68 Domperidon tablet 10 mg tablet 1700 0 1700 200 1500 0
69 Doxyciclin kapsul 100 mg kapsul 0 0 0 0 0 0
70 Dulcolax Suppositoria 10 mg supp 0 0 0 0 0 500
71 Dulcolax Suppositoria 5 mg supp 0 0 0 0 0 500
72 Efedrin HCl tablet 25 mg btl/250 0 0 0 0 0 0
73 Epineprin inj 0 ,1 %(adrenalin) ampul 0 0 0 0 0 30
74 Ergotamine Caffeine Tablet 700 0 700 0 700 0
75 Eritromicin sirop kering 200 mgl / 5ml Botol 60 ml 5 0 5 3 2 10
76 Erlamycetin Salp Mata tube 3 0 3 1 2 0
77 Erlamycetin tetes telinga 1% tube 61 0 61 0 61 0
78 Erphazone ( Phenylbutazone 200 mg ) btl/1000 0 0 0 0 0 2000
79 Erytromicin kapsul 250 mg kapsul 0 0 0 0 0 0
80 Erytromicin kapsul 500 mg kapsul 100 0 100 0 100 0
81 etabion tab tablet 500 0 500 500 0 5000
82 Etakridin ( Rivanol ) larutan 0,1% Botol 30ml 0 0 0 0 0 100
83 Etanol ( alkohol ) 70% botol 100 ml 16 0 16 0 16 0
84 Etanol ( alkohol ) 70% Botol 300 ml 0 0 0 0 0 0
85 Etanol ( alkohol ) 70% botol 1000 ml 3 0 3 1 2 0
86 Ethambutol tablet 250mg tablet 0 0 0 0 0 0
87 Ethambutol tablet 500mg tablet 0 0 0 0 0 0
88 Farmalat (Nifedipin) tablet 10 mg tablet 0 0 0 0 0 0
89 faxiden 20 mg tab tablet 300 0 300 300 0 5000
90 Fenilbutalson tablet 200 mg Btl/1000 0 0 0 0 0 0
91 Fenilbutalson tablet 200 mg ktk/150 0 0 0 0 0 0
92 Fenol Gliserol tetes telinga 10% botol 5 ml 50 0 50 50 0 100
93 Fermia ktk/100 0 0 0 0 0 5000
94 Ferrous Sulphate tablet 300 mg tablet 0 0 0 0 0 0
95 Fitomenadion (Vit.K1) inj 10 mg/ml - 1 ml ampul 100 0 100 0 100 0
96 Fitomenadion (Vit.K1) tab salut gula 10 mg tablet 0 0 0 0 0 0
97 Fluconazole tablet 0 0 0 0 0 2000
98 Furosemid tablet 0,5 mg tablet 0 0 0 0 0 0
99 Garam Oralit untuk 200 ml air sachet 800 0 800 0 800 500
100 Gemfibrosil kapsul 300 Mg kapsul 0 0 0 0 0 0
101 Gemfibrosil kapsul 600 Mg kapsul 200 0 200 0 200 300
102 gentalex salep kulit 0,1 % ktk/10 tube 40 0 40 30 10 500
103 Gentamicin inj 80mg/2ml ampul 50 0 50 0 50 500
104 Gentamicin salep kulit 0,1 % ktk/ 10 tube 0 0 0 0 0 0
105 Gentian Violet larutan 1 % Botol 10 ml 0 0 0 0 0 0
106 Gitarmin ( Asam Mefenamat 500 mg ) tablet 0 0 0 0 0 2000
107 Gitri sirup Botol 60 ml 0 0 0 0 0 0
108 Glibenklamid tablet 5 mg tablet 0 0 0 0 0 0
109 Glikos (Metformin 500 mg) tablet 300 0 300 0 300 0
110 Gliseril Guaiakolat tablet 100 mg tablet 2000 0 2000 400 1600 5000
111 Gludepatic 500 mg tablet 200 0 200 100 100 0
112 Glukosa larutan infus 5 % steril Botol 500 ml 90 0 90 0 90 0
113 Gradilex 2 mg / Loperamid tablet 2200 0 2200 0 2200 3000
114 Grafazole 500 mg tablet 0 0 0 0 0 5000
115 Graseric 150 mg tablet 0 0 0 0 0 2000
116 Gravalin 2 mg / Salbutamol 2 mg tablet 1300 0 1300 400 900 5000
117 Gravask 10 mg tablet 0 0 0 0 0 0
118 Gravask 5 mg tablet 0 0 0 0 0 0
119 Gricin 500 mg tablet 2000 0 2000 0 2000 3000
120 Griseofulvin tablet 125 mg tablet 2000 0 2000 0 2000 2000
121 Griseofulvin tablet 500 mg tablet 1000 0 1000 0 1000 2000
122 Hidroklorotiazid (HCT) tablet 25 mg tablet 200 0 200 0 200 0
123 Hidrokortison krim 2,5 % tube 5 g 29 0 29 29 0 100
124 Holimox Syp ( Amox Syp) btl / 60 ml 10 0 10 8 2 500
125 Hustab tablet 2400 0 2400 600 1800 5000
126 Ibuprofen Syp btl 5 ml 0 0 0 0 0 0
127 Ibuprofen tablet 200 mg tablet 500 0 500 500 0 0
128 Ibuprofen tablet 400 mg tablet 3000 0 3000 0 3000 0
129 Ichtiyol Salf pot 24 0 24 0 24 96
130 Ifison ( Prednisone ) tablet 0 0 0 0 0 0
131 Infantrim forte tablet 480 mg tablet 1200 0 1200 0 1200 0
132 Irgapan tablet 700 0 700 200 500 3000
133 Isoniazid ( INH ) 100 mg tablet 0 0 0 0 0 0
134 Isoniazid ( INH ) 300 mg tablet 300 0 300 300 0 0
135 Isosorbid Dinitrat tablet sublingual 5 mg tablet 500 0 500 0 500 500
136 Itrasal Syp btl 5 ml 0 0 0 0 0 0
137 Kalium diklofenak tablet tablet 0 0 0 0 0 0
138 Kalsium Laktat (Kalk) tablet 500 mg ktk/100 0 0 0 0 0 0
139 Kalsium Laktat (Kalk) tablet 500 mg Btl/1000 2000 0 2000 0 2000 0
140 Kanamicin inj 1 gram/vial vial 0 0 0 0 0 0
141 Kaptopril tablet 12,5 mg tablet 3200 0 3200 300 2900 500
142 Kaptopril tablet 25 mg tablet 1400 0 1400 500 900 500
143 Katitra (Tertracycline) Kapsul 500 mg kapsul 0 0 0 0 0 0
144 Kemoren 50 mg tablet 0 0 0 0 0 1000
145 Ketokonazol salep 2% tube 10 gram 11 0 11 0 11 300
146 Ketokonazol tablet 200 mg tablet 1100 0 1100 200 900 2000
147 Kina tablet salut gula ktk/24x12 0 0 0 0 0 0
148 Kloramfenikol kapsul 250 mg kapsul 0 0 0 0 0 0
149 Kloramfenikol salep kulit tube 5 mg 0 0 0 0 0 0
150 Kloramfenikol tetes telinga 3 % botol 5 ml 0 0 0 0 0 0
151 Klorampenicol salep mata 1 % tube 5 g 0 0 0 0 0 0
152 Klorampenicol tetes mata 0.5% (Reco) botol 5 ml 0 0 0 0 0 0
153 Klorfeniramin Maleat (CTM) tablet 4 mg tablet 2900 0 2900 200 2700 5000
154 Kloroquine tablet 250mg tablet 200 0 200 200 0 1000
155 Klorquine tablet 150 mg tablet 0 0 0 0 0 0
156 Kokodin 10 % Btl/1000 ml 0 0 0 0 0 5
157 Kokodin 10 % Btl/300 ml 0 0 0 0 0 5
158 Kokotra (Tetracycline) kapsul 250 mg kapsul 0 0 0 0 0 0
Komb Pirimetamin 25 mg + Sulfadoxin 500 mg
159 tablet
1000 0 1000 0 1000 0
Kotrimoksazol susp kombinasi :
160 sulfametaksazol 200 mg + trimetropim 40mg/ 5 botol 60 ml
ml 245 0 245 0 245 0

Kotrimoksazol tablet kombonasi :

161 tablet
sulfametaksazole 400 mg + Trimetropim 80 mg
3200 0 3200 0 3200 0
162 Kotrimoksazol tablet pediatrik 120 mg tablet 0 0 0 0 0 0
163 Kuinin Dihidroklorida injeksi 25% - 2 ml ampul 0 0 0 0 0 0
164 Levofloksasin 500 mg tablet 0 0 0 0 0 0
165 Licopec Kaplet 0 0 0 0 0 0

Lidokain komp. Injeksi, Kombinasi : lidokain HCl

166 ampul
2% + epinefrin 1 : 80.000- 2ml
70 0 70 0 70 0
167 Lifadrox DS Syp Btl/60 ml 0 0 0 0 0 0
168 Lisol Concentrate Botol 1000 ml 0 0 0 0 0 0
169 Lodia 2 mg tablet 0 0 0 0 0 0
170 Loperamide 2 mg tablet 1600 0 1600 100 1500 2000
171 Loratadine tablet 100 mg tablet 2200 0 2200 0 2200 3000
172 Mebendazol tablet 100 mg tablet 0 0 0 0 0 0
173 Metformin 500 mg tablet 0 0 0 0 0 500
174 Methilergometrin Maleat tab.salut 0,125 tablet 1100 0 1100 0 1100 0
175 Methylprednisolone tablet 16 mg tablet 0 0 0 0 0 500
176 Methylprednisolone tablet 4 mg tablet 0 0 0 0 0 0
177 Methylprednisolone tablet 8 mg tablet 0 0 0 0 0 0
178 Metronidazol tablet 250 mg tablet 0 0 0 0 0 0
179 Metronidazol tablet 500 mg tablet 1000 0 1000 300 700 2000
180 Miconasole 2 % krim tube 10 gram 34 0 34 10 24 200
Myomergin
181 Ampul 28 28 28
(Metilergometrin Maleat inj 0,200 mg-1 ml) 0 0 0
182 Natrium diklofenak 25 mg tablet 0 0 0 0 0 0
183 Natrium diklofenak 50 mg tablet 500 0 500 0 500 2000
184 Natrium Klorida larutan infus 0,9 % steril botol 500 ml 62 0 62 15 47 0
185 Neurobion 5000 injeksi 3 ml Ampl/Psng 38 0 38 7 31 200
186 nifedipin tablet tablet 1200 0 1200 300 900 0
187 Nistatin tablet salut gula 500.000 IU tablet 0 0 0 0 0 2000
188 Nistatin tablet vaginal 100.000 IU tablet 0 0 0 0 0 2000
189 Norpid 10 mg ( Simvastatin 10 mg ) tablet 0 0 0 0 0 0
190 Novabion kapsul 0 0 0 0 0 3000
191 Novadiar Syr btl 60 ml 0 0 0 0 0 100
192 Novadium tablet 0 0 0 0 0 100
193 Novamag Syp btl 60 ml 77 0 77 0 77 300
194 nuvopec 15 mg/ml Botol 60 ml 10 0 10 10 0 300
195 nuvopec tablet 30 mg tablet 1500 0 1500 500 1000 3000
196 Obat anti Malaria (DHP) ktk/9 90 0 90 0 90 300
197 Obat Batuk Hitam ( O.B.H. ) cairan Botol 100 ml 45 0 45 28 17 300
198 Obat OAT Kategori I Anak Paket 0 0 0 0 0 0
199 Obat OAT Kategori I Dewasa paket 0 0 0 0 0 0
200 Obat OAT Kategori II Paket 0 0 0 0 0 0
201 Obimin Dos/30 0 0 0 0 0 0
202 Oksitetrasiklin HCl salep kulit 3 % tube 5 g 0 0 0 0 0 0
203 Oksitetrasiklin HCl salep mata 1 % tube 5 g 0 0 0 0 0 0
204 Oksitosin injeksi 10 IU/ml - 1 ml ampul 0 0 0 0 0 0
205 Omegdiar sirup btl 60 ml 0 0 0 0 0 0
206 Omeprasole kapsul 20 mg kapsul 450 0 450 210 240 3000
207 Papaverin injeksi 40 mg / ml vial 0 0 0 0 0 0
208 Papaverin tablet 40 mg tablet 1000 0 1000 0 1000 2000
209 Parasetamol sirup 120 mg/5 ml Botol 60 ml 240 0 240 15 225 500
210 Parasetamol tablet 500 mg ktk/100 3900 0 3900 2300 1600 10000
211 Pehacaine injeksi ampul 10 0 10 0 10 0
212 Piracetam tablet 400 mg tablet 0 0 0 0 0 0
213 Piracetam tablet 800 mg tablet 0 0 0 0 0 0
214 Pirantel Syp Botol 60 ml 25 0 25 0 25 0
215 Pirantel tablet 125 mg tablet 800 0 800 0 800 0
216 Pirazinamide tablet 500 mg tablet 0 0 0 0 0 0
217 Piridoksin HCl (Vit.B6) tablet 10 mg tablet 2000 0 2000 2000 0 3000
218 Piroxicam tablet 10 mg tablet 0 0 0 0 0 5000
219 Piroxicam tablet 20 mg tablet 0 0 0 0 0 5000
220 Povidon Iodida 10 % Botol 30 ml 10 0 10 10 0 100
221 Povidon Iodida 10 % Botol 60 ml 0 0 0 0 0 5
222 Povidon Iodida 10 % Botol 300 ml 0 0 0 0 0 5
223 Povidon Iodida 10 % Botol 1000 ml 0 0 0 0 0 0
224 Prednison tablet 5 mg tablet 6400 0 6400 1000 5400 0
225 Prenamia tablet 0 0 0 0 0 500
226 Primakuin tablet 15 mg tablet 100 0 100 0 100 1000
227 Procain Benzill Penicillin Inj. 3 juta IU vial 0 0 0 0 0 300
228 Propanolol HCL tablet 10 mg tablet 0 0 0 0 0 0
229 Propanolol HCL tablet 40 mg tablet 0 0 0 0 0 0
230 Propilititiurasil tablet 100 mg tablet 0 0 0 0 0 0
231 Pytogin injeksi 10 IU/ml - 1 ml ampul 60 0 60 0 60 0
232 Quinine tablet 222 mg Btl/1000 0 0 0 0 0 0
233 Quinine tablet 222 mg ktk/60 100 0 100 40 60 500
234 Ramolit sachet 0 0 0 0 0 0
235 Ranitidin tablet 150 mg tablet 5000 0 5000 0 5000 2000
236 Ranitidine injeksi 25 mg/ml - 2ml ampul 80 0 80 0 80 200
237 Rifampicin kapsul 300 mg kapsul 0 0 0 0 0 0
238 Rifampicin tablet 450 mg tablet 0 0 0 0 0 0
239 Rifampicin tablet 600 mg tablet 0 0 0 0 0 0
Ringer Laktat larutan infus steril (Produk lokal)
240 botol 500 ml 80 80 80
0 0 0
241 Salbutamol tablet 2 mg tablet 0 0 0 0 0 5000
242 Salbutamol tablet 4 mg tablet 800 0 800 200 600 3000
Salep 2-4 , Kombinasi:
243 Pot 30 gram 125 125 120
As Salisilat 2% + Belerang Endap 4% 0 5 0
244 Salisil Bedak 2 % pot 50 gram 79 0 79 19 60 100
245 Sefadroksil sirup 125mg/5ml btl 60 ml 98 0 98 0 98 100
246 Sefadroksil tab 500 mg tablet 1200 0 1200 600 600 3000
247 sefotaxim serbuk injeksi 1 gram/vial 2 vial/kotak 10 0 10 0 10 0
248 seftriaxon serbuk injeksi 1 gram/ vial 2 vial/kotak 0 0 0 0 0 10
249 Selespurin (Allopurinol 100 mg ) tablet 0 0 0 0 0 0
250 Sianokobalamin (Vit.B12) 50 mcg Btl/1000 0 0 0 0 0 0
251 Sianokobalamin (Vit.B12) 50 mcg Ktk/100 1000 0 1000 600 400 3000
Sianokobalamin (Vit.B12) injeksi 500 mcg-ml
252 ampul 200 200 100
0 100 100
253 Simvastatin tablet 10 mg tablet 1500 0 1500 0 1500 0
254 Simvastatin tablet 20 mg tablet 0 0 0 0 0 0
255 Siprofloksasin tablet 500mg tablet 1300 0 1300 1000 300 2000
256 Tablet tambah darah + as folat tablet 4200 0 4200 2000 2200 5000
257 Tetrasiklin HCl kapsul 250 mg kapsul 0 0 0 0 0 0
258 Tetrasiklin HCl kapsul 500 mg kapsul 0 0 0 0 0 0
259 Thiamfenicol 500 mg tablet 0 0 0 0 0 0
260 Tiamin HCl (Vit.B1) injeksi 100 mg/ml-1 ml ampul 169 0 169 0 169 0
261 Tiamin HCl / Mononitrat (Vit.B1) tab.50 mg tablet 600 0 600 0 600 0
262 Tuzalos tablet tablet 0 0 0 0 0 5000
263 Ultrasonic gell btl 250 gram 6 0 6 0 6 0
264 Ultravita Multivitamin tablet 0 0 0 0 0 0
265 Univit Syp btl 60 ml 48 0 48 0 48 300
266 Vitamin A 100.000iu kapsul 650 0 650 0 650 0
267 Vitamin A 200.000iu kapsul 1100 0 1100 0 1100 0
268 Vitamin B Kompleks tablet tablet 3100 0 3100 500 2600 0
269 Zinc tablet tablet 200 0 200 200 0 10000
0 0
Alat Kesehatan 0 0
1 Abocath No. 18 set 122 0 122 0 122 0
2 Abocath No. 20 set 0 0 0 0 0 0
3 Abocath No. 22 set 142 0 142 0 142 0
4 Abocath No. 24 100 set/kotak 85 0 85 0 85 0
5 Abocath No. 26 100 set/kot 0 0 0 0 0 0
6 Alat suntik sekali pakai 0,5 ml 100 set/kot 100 0 100 0 100 100
7 Alat suntik sekali pakai 1 ml 100 set/kotak 200 0 200 0 200 100
8 Alat suntik sekali pakai 10 ml 100 set/kotak 100 0 100 0 100 100
9 Alat suntik sekali pakai 2,5 ml 100 set/kotak 200 0 200 0 200 100
10 Alat suntik sekali pakai 3 ml 100 set/kotak 300 0 300 0 300 100
11 Alat suntik sekali pakai 5 ml 100 set/kotak 274 0 274 0 274 100
12 Alat suntik sekali pakai 50 ml 100 set/kotak 100 0 100 100 0 100
13 Alkohol Swab Kotak 100 0 100 100 0 500
14 Bisturi no 10 set 50 0 50 0 50 0
15 Bisturi no 11 set 0 0 0 0 0 0
16 Blood lancet set 160 0 160 0 160 0
17 Catgut / Benang Bedah chrom 3/0 matrix 3 buah 72 0 72 0 72 0
18 Catgut / Benang Bedah No. 4/0 buah 0 0 0 0 0 0
19 Catgut/Benang Bedah No.2/0 buah 0 0 0 0 0 0
20 Cotton Swab buah 0 0 0 0 0 0
21 Cover glass buah 50 0 50 0 50 0
22 Digital Thermometer buah 0 0 0 0 0 0
23 Etil Klorida spray botol 100 ml 2 0 2 0 2 0
24 feeding tube 8 FR x 120 cm buah 0 0 40 0 0 0
25 Foley catheter no 12 buah 10 0 10 10 0 100
26 Foley catheter no 14 buah 70 0 70 70 0 100
27 Foley catheter no 16 buah 21 0 21 0 21 100
28 Foley catheter no 18 buah 0 0 0 0 0 100
29 Foley catheter no 20 buah 0 0 0 0 0 100
30 Haemometer / Hb Sahli set 2 0 2 0 2 0
31 Hand Gloves (sarung tangan) tanpa bedak Kotak 7 0 7 0 7 0
32 Handscond obgyn ktk/50 7 0 7 0 7 0
33 Handscond Maxter L ktk/50 psg 1100 0 1100 700 400 500
34 Handscond Maxter M ktk/50 psg 300 0 300 300 0 500
35 Handscond Maxter S ktk/50 psg 0 0 0 0 0 500
36 Handscond Steril pasang 4 0 4 1 3 0
37 Hidrogen peroksida 3 % Botol 1000ml 1 0 1 0 1 0
38 Infusion set anak kantong 55 0 55 0 55 100
39 Infusion set dewasa kantong 45 0 45 0 45 100
40 kapas berlemak 500 gram rol 6 0 6 1 5 0
41 Kapas Pembalut / Absorben 250 gram Rol 2 0 2 0 2 0
42 kapas pembalut 100 gram rol 1 0 1 0 1 0
43 Kapas pembalut 1000 gram rol 1 0 1 0 1 0
44 kapas pembalut 50 gram rol 4 0 4 0 4 0
45 kapas pembalutr 250 gram rol 18 0 18 0 18 0
46 kapas putih 100 gram rol 3 0 3 0 3 0
47 kapas putih 250 gram rol 2 0 2 0 2 0
48 kapas putih 50 gram rol 31 0 31 0 31 0
49 Kapas putih 500 gram rol 0 0 0 0 0 0
50 Kartu golongan darah ktk/100 0 0 0 0 0 0
51 Kasa hidrofil 2 yard x 80 cm Rol 0 0 0 0 0 0
52 Kasa Hidrofil DRC 40 yard x 80 cm rol 2 0 2 2 0 5
53 Kasa Kompres 40/40 steril Bungkus 10 0 10 0 10 100
54 Kasa Pembalut Hidrofil 2,7 cm x 15 cm Rol 4 0 4 0 4 3
55 Kasa Pembalut Hidrofil 4 m x 15 cm Rol 5 0 5 0 5 5
56 Kasa steril 16x16 rol 23 0 23 0 23 50
57 Kassa Verban 3 cm x 15 cm Rol 50 0 50 0 50 20
58 Kertas Perkamen lembar/rim 1 0 1 0 1 0
59 Kertas Puyer Press pcs 0 0 0 0 0 0
60 Kertas saring lembar 0 0 0 0 0 0
61 Kondom KTK/3 36 0 36 0 36 100
62 KY Jelly tube 0 0 0 0 0 0
63 Masker hijau ktk/50 200 0 200 100 100 500
64 Medicine paket set 0 0 0 0 0 0
65 Micropipette 5 - 50µl Unit 0 0 0 0 0 0
66 Mortir + Stempel set 0 0 0 0 0 0
67 Oksigen Set Unit 0 0 0 0 0 0
68 Oneclean Botol 1000 ml 0 0 0 0 0 0
69 Oneclean botol 500 ml 2 0 2 0 2 0
70 Pembalut Gips (Gypsona 6 inchi x 3 yard) rol 11 0 11 0 11 0
71 Penjepit tali pusat set 277 0 277 0 277 0
72 pH Paper 3,8-5,4 ktk 0 0 0 0 0 0
73 Pipet Westergren buah 0 0 0 0 0 0
74 Plastik obat ( ukuran Besar ) lembar 0 0 0 0 0 0
75 Plastik obat ( ukuran Kecil ) lembar 1500 0 1500 1000 500 0
76 Plester 5 cm x 4,5 m rol 14 0 14 4 10 0
77 Plester 5 cm x 5 m rol 0 0 0 0 0 0
78 Pot sputum buah 0 0 0 0 0 0
79 Rak tabung reaksi buah 0 0 0 0 0 0
80 Rak westergren/LED buah 0 0 0 0 0 0
81 Rapid 1 (oncoprobe) ktk/50 0 0 0 0 0 0
82 Rapid 2 (Advanced) ktk/100 0 0 0 0 0 0
83 Rapid 3 (Vikia) ktk/25 0 0 0 0 0 0
84 sarung tangan free Powder ukuran L 100 psg/ktk 50 0 50 25 25 500
85 sarung tangan free Powder ukuran M 100 psg/ktk 100 0 100 100 0 500
86 Sikat tabung (Korok Tabung) buah 0 0 0 0 0 0
87 Slide box pcs 0 0 0 0 0 0
88 Slide/objek glass Ktk/72 0 0 0 0 0 0
89 Spiritus cair buah 0 0 0 0 0 0
90 surgical suture with needle (Plain Catgut) pcs 12 0 12 12 0 0
91 surgical suture with needle (silk Braided) pcs 24 0 24 24 0 0
92 suture needle GT 10 12pcs/bks 12 0 12 12 0 24
93 suture needle GT 11 12pcs/bks 12 0 12 12 0 24
94 suture needle GT 12 12pcs/bks 12 0 12 12 0 24
95 suture needle GT 13 12pcs/bks 12 0 12 12 0 24
96 suture needle GT 6 12pcs/bks 12 0 12 12 0 24
97 suture needle GT 7 12pcs/bks 12 0 12 12 0 24
98 Tabung Sahli (HB Sahli) set 0 0 0 0 0 0
99 Tabung Sentrifuse buah 0 0 0 0 0 0
100 Tabung Serologi buah 0 0 0 0 0 0
101 Tabung Westergreen buah 0 0 0 0 0 0
102 Tensi Digital dan Stetoskop Kit 0 0 0 0 0 0
103 Test Kehamilan pcs 100 0 100 0 100 300
104 Torniket anak rol 0 0 0 0 0 0
105 Torniket dewasa set 0 0 0 0 0 0
106 Tromol, SS set 0 0 0 0 0 0
107 Ultrafix 10 cm x 1 cm ktk/25 0 0 0 0 0 10
108 Ultrafix 5 cm x 1 cm ktk/10 0 0 0 0 0 10
109 Urinalisa (Strip Urine Expert) set 0 0 0 0 0 0
110 Urinalisis (Mission Expert) Btl 0 0 0 0 0 0
111 Urine bag 2000 ml set 15 0 15 1 14 100
112 Usilakit (posyandu Lansia) kit 0 0 0 0 0 0
113 Vaselin album btl 1 liter 0 0 0 0 0 0
114 Yellow Tips ( 5µ / 10µ /25 µ ) ktk 0 0 0 0 0 0
0
0
Reagen 0 0
1 Asam Alkohol botol 0 0 0 0 0 0
2 Asam chlorida HCl 0,1 N botol 0 0 0 0 0 0
3 Combour tes Urine botol 0 0 0 0 0 0
4 EDTA cair botol 0 0 0 0 0 1
5 Emersi oil botol 100 ml 0 0 0 0 0 0
6 Etanol asam 3% botol 100 ml 0 0 0 0 0 0
7 Eter Alkohol botol 100 ml 0 0 0 0 0 0
8 Glemsa botol 0 0 0 0 0 1
9 HCL 0,1 N botol 0 0 0 0 0 0
10 Hexagon Sypillis Kotak/20 0 0 0 0 0 200
11 Karbol fuksin botol 500 ml 0 0 0 0 0 0
12 KOH 10% botol 0 0 0 0 0 0
13 Metanol btl / 500 ml 0 0 0 0 0 0
14 Metanol btl / 1000 ml 1 0 1 0 1 0
15 Metylen Blue botol 0 0 0 0 0 0
16 Na.Citrat 3,8% botol 0 0 0 0 0 0
17 Reagen ALT / GPT Kotak 0 0 0 0 0 0
18 Reagen Anti D Golongan Darah set 0 0 0 0 0 2
19 Reagen Antigen AO.S.Paratyphii Kotak 0 0 0 0 0 2
20 Reagen Antigen BO.S.Parathypii Kotak 0 0 0 0 0 2
21 Reagen Antigen H.S.Typhii Kit 0 0 0 0 0 2
22 Reagen Antigen O.S.Parathypii Kotak 0 0 0 0 0 2
23 Reagen Asam urat Kotak 0 0 0 0 0 2
24 Reagen AST / GOT Kotak 0 0 0 0 0 2
25 Reagen BTA set 0 0 0 0 0 2
26 Reagen Cholesterol Kotak 0 0 0 0 0 2
27 Reagen GDS Kotak 0 0 0 0 0 2
28 Reagen Golongan Darah Kit 0 0 0 0 0 2
29 Reagen RPR Sypilis kotak/100 0 0 0 0 0 2
30 Reagen Trigliserida Kotak 0 0 0 0 0 2
31 reagen Zield Nelsen KIT 2 0 2 0 2 0
32 SD HIV set 100 0 100 0 100 200
33 SD Syphilis 3.0 set 100 0 100 0 100 200
34 Stik Asam urat Botol/25 100 0 100 50 50 0
35 Stik Glucosa nesco Botol/25 100 0 100 0 100 0
36 Stik Kolesterol nesco Botol/10 0 0 0 0 0 0
37 Tes RDT Malaria Kotak/10 0 0 0 0 0 100
38 Xylol botol 0 0 0 0 0 0

Mengetahui, Kiruru, 9 July 2019

Kepala Puskesmas Kaimana Yang Meminta,
Petugas Pengelola Obat

Fransiska C.Balatando,S.Farm,Apt
Basri La hisa, Amk.
Nip. 197602142001111001
``
 PUSAT KESEHATAN MASYARAKAT KIRURU
REKAPITULASI PENGGUNAAN OBAT PSIKOTROPIKA PUSKESMAS KIRURU

BULAN Juni
TAHUN 2019

STOK JUMLAH
PERSEDI PEMAKAI
NO. NAMA OBAT SATUAN PENERIM
AWAL AAN AN
AAN
1 Diazepam 2 mg Botol/1000 tablet 0 0 0 0
2 Diazepam injeksi 5 mg/ml - 2ml Kotak/30 ampul 0 0 0 0
3 Haloperidol tablet 100 mg tablet 0 0 0 0
4 Phenobarbital 30 mg tablet 0 0 0 0
5 Phenobarbital injeksi Kotak/30 ampul 0 0 0 0
6 Klorpromazin HCL tablet 100 mg Tablet 0 0 0 0
7 Klorpromazin HCL injeksi 5 mg/ml-2 ml Ampul 0 0 0 0
8 Stesolid rectal Tube 0 0 0 0

Mengetahui
Kepala Puskesmas Kiruru, 9 July 2019

Pengelola Obat Pusk

Basri La hisa, Amk. Fransiska Celsia Bala

Nip. 197602142001111001 Nip.-
RU
ESMAS KIRURU

SISA
PERMINT
STOK AAN

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

Kiruru, 9 July 2019

Pengelola Obat Puskesmas

Fransiska Celsia Balatando,S.Farm,Apt