LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO )

PUSKESMAS SUNGAI SEMBILAN

Puskesmas : SUNGAI SEMBILAN Pelaporan bulan/periode: NOVEMBER Dokumen Nomor Tanggal

Kecamatan: SUNGAI SEMBILAN Permintaan bulan/periode: Dinkes Kab/Kota
Kab/Kota : DUMAI IFK Kab/Kota
Propinsi :RIAU Puskesmas

PEMBERIAN
STOK STOK
NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK
OPT.
PERMINTAAN PKPS- LAIN- @
AWAL ASKES APBD I APBD II
BBM
PROGRAM
LAIN
JUMLAH

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
1 Albendazol tablet 400 mg tablet 850 850 120 730 Rp 313.00
2 Alopurinol tablet 100 mg tablet 860 1000 1860 330 1530 Rp 93.00
3 Aminofilin tablet 200 mg tablet 0 0 0 0 Rp 82.00
4 Aminofilin injeksi 24 mg ampul 0 25 25 0 25 Rp 3,349.00
5 Amitriptilin HCl tablet salut 25 mg tablet 900 900 0 900 Rp 150.00
6 Amoksisilin kapsul 250 mg kapsul 2210 5000 7210 3410 3800 Rp 201.00
7 Amoksisilin sirup kering 125 mg/5 ml botol 21 450 471 215 256 Rp 2,150.00
8 Ampisilin kaplet 500 mg kaplet 425 500 925 245 680 Rp 590.00
9 Ampisilina sirup kering 125 mg/5ml botol 0 0 0 0 Rp 6,830.00
10 Antalgin (Metampiron) tablet 500 mg tablet 858 500 1358 458 900 Rp 230.00
11 Antasida DOEN tablet 400 mg tablet 7220 10000 17220 6310 10910 Rp 63.00
12 Anti Haemorroid DOEN Kombinasi suppos 40 100 140 10 130 Rp 3,197.00
13 Antifungi DOEN Kombinasi salep pot 5 24 29 9 20 Rp 4,366.00
14 Antimigren DOEN Kombinasi tablet (Ergo tablet 0 0 0 0 Rp 107.94
15 Antiparkinson DOEN tablet kombinasi tablet 0 0 0 0 Rp -
16 Aqua pro Injeksi steril, bebas pirogen ampul 5 5 0 5 Rp 2,750.00
17 Aquadest steril botol 3 3 0 3 Rp 27,600.00
18 Asam Askorbat (Vit.C) tablet 100 mg tablet 0 0 0 0 Rp 54.00
19 Asam Askorbat (Vit C) tablet 50 mg tablet 760 20000 20760 5998 14762 Rp 109.00
20 Asetosal tablet 100 mg tablet 0 100 100 0 100 Rp 134.00
21 Asetosal tablet 500 mg tablet 0 0 0 0 Rp -
22 Asetosal 80 mg ( Miniaspi ) tablet 0 100 100 0 100 Rp 118.00
23 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 30 30 0 30 Rp 1,672.00
24 Betametason krim 0.1% tube 0 100 100 72 28 Rp 1,407.00
25 Deksametason injeksi 5 mg/ml - 1 ml ampul 101 101 34 67 Rp 1,600.00
26 Deksametason tablet 0,5 mg tablet 1040 10000 11040 4520 6520 Rp 46.00
27 Diazepam injeksi 5mg/ml-2 ml ampul 0 0 0 Rp -
28 Diazepam tablet 2 mg tablet 100 500 600 100 500 Rp 50.04
29 Diazepam tablet 5 mg tablet 0 0 0 0 Rp 122.00
30 Difenhidramin HCl injeksi 10 mg/ml - 1 m ampul 35 60 95 25 70 Rp 1,236.00
31 Digoksin tablet 0,25 mg tablet 600 600 0 600 Rp 106.00
32 Efedrin HCl tablet 25 mg tablet 0 0 0 0 Rp 52.00
33 Epinefrina HCl/Bitartrat injeksi 0,1% - 1 m ampul 50 50 0 50 Rp 2,354.00
34 Etakridin ( Rivanol ) larutan 0,1% botol 10 10 4 6 Rp 3,300.00
35 Fenitoin Natrium kapsul 30 mg kapsul 0 0 0 0 Rp -
36 Fenitoin Natrium kapsul 100 mg kapsul 300 300 0 300 Rp 140.00
37 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 28 28 28 Rp 2,068.00
38 Fenobarbital tablet 30 mg tablet 800 800 280 520 Rp 48.83
39 Fenobarbital tablet 100 mg tablet 0 0 0 Rp -
40 Fenol Gliserol tetes telinga 10% botol 30 30 20 10 Rp 2,500.00
41 Fitomenadion (Vit.K1) inj. 10 mg/ml - 1 m ampul 55 55 15 40 Rp 3,728.00
42 Fitomenadion (Vit.K1) tablet salut 10 mg tablet 1096 1096 144 952 Rp 730.00
43 Fluor tablet 0,5mg tablet 0 0 0 0 Rp -
44 Furosemid tablet 40 mg tablet 200 200 0 200 Rp 94.00
45 Garam Oralit untuk 200 ml air kantong 590 3800 4390 350 4040 Rp 269.00
46 Glibenklamid tablet 5 mg tablet 920 5000 5920 2880 3040 Rp 125.00
47 Gliseril Guayakolat tablet 100 mg tablet 1225 1600 2825 1620 1205 Rp 110.00
48 Glukosa larutan infus 5 % steril botol 35 500 535 210 325 Rp 6,900.00
49 Glukosa larutan infus 10 % steril botol 0 0 0 0 Rp -
50 Glukosa larutan infus 40 % steril ampul 0 0 0 0 Rp -
51 Griseofulvin tablet 125 mg, Micronized tablet 0 500 500 140 360 Rp 230.00
52 Haloperidol tablet 0,5 mg tablet 0 0 0 Rp 62.00
53 Haloperidol tablet 1,5 mg tablet 1650 2000 3650 270 3380 Rp 71.00
54 Haloperidol tablet 2 mg tablet 0 2000 2000 0 2000 Rp 112.00
55 Haloperidol tablet 5 mg tablet 830 830 0 830 Rp 94.00
56 Haloperidol Inj. 5 mg ( Lodomer Inj ) ampul 0 0 0 0 Rp 5,072.00
57 Hidroklorotiazid (HCT) tablet 25 mg tablet 570 570 0 570 Rp 156.00
58 Hidrokortison krim 2,5 % tube 92 92 184 155 29 Rp 2,650.00
59 Ibuprofen tablet 200 mg tablet 0 1000 1000 320 680 Rp 108.00
60 Ibuprofen tablet 400 mg tablet 1080 5000 6080 1850 4230 Rp 130.00
61 Isosorbid Dinitrat tablet (farsorbid) subli tablet 0 200 200 0 200 Rp 198.00
62 Isosorbid Dinitrat tablet sublingual 5 mg tablet 100 100 0 100 Rp 91.00
63 Isoniazid 300 mg tablet 0 500 500 0 500 Rp 173.00
64 Isoniazid 100 mg tablet 0 500 500 0 500 Rp 75.00
65 Kalsium Laktat (Kalk) tablet 500 mg tablet 0 16800 16800 4880 11920 Rp 66.00
66 Karbamazepin tablet 200 mg tablet 0 200 200 0 200 Rp 280.00
67 Kloramfenikol kapsul 250 mg kapsul 290 2000 2290 410 1880 Rp 262.00
68 Kloramfenikol kapsul 500 mg kapsul 0 1000 1000 260 740 Rp 1,056.00
69 Kloramfenikol salep mata 1 % tube 0 112 112 75 37 Rp 1,800.00
70 Kloramfenikol tetes telinga 3 % botol 0 0 0 Rp 1,679.00
71 Kloramfenikol Salep Kulit tube 0 111 111 10 101 Rp 3,223.00
72 Klorfeniramin Maleat (CTM) tablet 4 mg tablet 1532 20000 21532 8342 13190 Rp 43.00
73 Klorpromazin HCl injeksi 5 mg/ml - 2 ml ampul 0 0 0 Rp 1,483.00
74 Klorpromazin HCl tablet salut 25 mg tablet 0 1000 1000 0 1000 Rp 155.00
75 Klorpromazin HCl tablet salut 100 mg tablet 968 3000 3968 165 3803 Rp 171.00
76 Kodein HCl tablet 10 mg tablet 284 284 0 284 Rp 575.00
77 Kotrimoksazol Adult tablet 480 mg tablet 1660 1660 260 1400 Rp 154.00
78 Kotrimoksazol Pediatrik tablet 120 mg tablet 0 0 0 Rp 6,000.00
79 Kotrimoksazol suspensi 240 mg/5ml botol 52 150 202 40 162 Rp 2,183.00
80 Lidokain Komp. injeksi - 2 ml ampul 88 150 238 110 128 Rp 1,937.00
81 Lidokain injeksi - 2 ml ampul 0 100 100 0 100 Rp 870.00
82 Magnesium Sulfat injeksi (IV) 20% - 25 m vial 0 10 10 0 10 Rp 3,200.00
83 Magnesium Sulfat injeksi (IV) 40% - 25 m vial 0 10 10 0 10 Rp 3,650.00
84 Mebendazol tablet 100 mg tablet 0 0 0 Rp 239.00
85 Metilergometrin Maleat inj. 0,200 mg-1 ml ampul 20 100 120 10 110 Rp 2,684.00
86 Metilergometrin Maleat tablet salut 0,125 tablet 1305 1000 2305 1415 890 Rp 162.00
87 Natrium Bikarbonat tablet 500 mg tablet 875 875 875 Rp 43.00
88 Natrium Klorida larutan infus 0,9% steril botol 36 300 336 180 156 Rp 6,410.00
89 Nistatin tablet vaginal 100.000 IU/g tablet 43 43 20 23 Rp 549.00
90 Nistatin tablet 500.000 IU/g tablet 0 0 0 Rp 782.00
91 Obat Batuk Hitam ( O.B.H. ) cairan botol 95 50 145 105 40 Rp 9,000.00
92 Oksitetrasiklin HCl salep 3% tube 65 65 65 0 Rp 1,606.00
93 Oksitetrasiklin HCl salep mata 1% tube 0 0 0 Rp 2,402.00
94 Oksitosin injeksi 10 IU/ml - 1 ml ampul 40 200 240 85 155 Rp 1,900.00
95 Parasetamol sirup 120 mg/5ml botol 105 200 305 102 203 Rp 1,119.00
96 Parasetamol tablet 100 mg tablet 0 0 0 0 Rp 32.96
97 Parasetamol tablet 500 mg tablet 3777 30000 33777 12880 20897 Rp 57.00
98 Pirantel tablet 125 mg tablet 179 200 379 0 379 Rp 308.00
99 Piridoksin HCl (Vit.B6) tablet 10 mg tablet 1090 1090 80 1010 Rp 124.00
100 Primaquin tablet 15 mg tablet 0 0 0 Rp 235.00
101 Prednison tablet 5 mg tablet 0 0 0 Rp 98.00
102 Propiltiourasil tablet 100 mg tablet 100 100 0 100 Rp 292.00
103 Propranolol HCl tablet 10 mg tablet 400 400 400 Rp 66.00
104 Ringer Laktat larutan infus steril botol 49 500 549 210 339 Rp 7,150.00
105 Salbutamol tablet 2 mg tablet 1950 1950 480 1470 Rp 67.00
106 Salep 2-4 , Kombinasi pot 30 48 78 10 68 Rp 2,554.00
107 Salisil Bedak 2 % botol 53 100 153 44 109 Rp 1,046.00
108 Serum Anti Bisa Ular Polivalen inj. 5ml (ABU I) vial 1 1 0 1 Rp 745,950.00
109 Serum Anti Difteri Injeksi 20.000 IU/vial (ADS) vial 0 0 0 Rp -
110 Serum Anti Tetanus Injeksi 1.500 IU/ampul (ATS) ampul 2 2 0 2 Rp 200,000.00
111 Serum Anti Tetanus Injeksi 20.000 IU/vial (ATS) vial 0 0 0 Rp -
112 Sianokobalamin (Vit.B12) inj. 500mcg/ml ampul 30 30 8 22 Rp 1,168.00
113 Streptomycin injeksi 1 g vial 0 0 0 Rp 5,250.00
114 Tablet Tambah Darah kombinasi tablet 1400 11200 12600 3100 9500 Rp 53.00
115 Tetrasiklin HCl kapsul 500 mg kapsul 0 300 300 0 300 Rp 319.00
116 Tiamin HCl (Vit.B1) injeksi 100 mg/ml-1 ampul 25 25 0 25 Rp 700.00
117 Tiamin HCl (Vit.B1) tablet 100 mg tablet 0 \ Rp 116.64
118 Tiamin HCl (Vit.B1) tablet 50 mg tablet 3064 10000 13064 3250 9814 Rp 89.00
119 Tetagam Injeksi Ampul 0 0 0 Rp 170,000.00
120 Triheksifenidil Hidroklorida tablet 2 mg tablet 710 1000 1710 270 1440 Rp 92.00
121 Vitamin B-Kompleks tablet tablet 2759 20000 22759 9100 13659 Rp 121.00
122 Yodium Povidon 10% 30 ml botol 8 10 18 6 12 Rp 3,190.00
123 Yodium Povidon 10% 300 ml botol 4 10 14 4 10 Rp 14,771.00

1 Acyclovir cream tube 0 0 0 0 Rp 3,753.00

2 Acyclovir tablet 200 mg tablet 950 950 240 710 Rp 261.00
3 Acyclovir tablet 400 mg tablet 1076 1076 450 626 Rp 360.00
4 Alprazolam tablet 0,25 mg tablet 0 0 0 Rp 410.00
5 Ambroxol sirup botol 0 0 0 Rp 5,120.00
6 Ambroxol tablet 30 mg tablet 1045 5000 6045 2270 3775 Rp 194.00
7 Amlodipin tablet 10 mg tablet 1107 900 2007 660 1347 Rp 160.00
8 Amlodipin tablet 5 mg tablet 400 3900 4300 1520 2780 Rp 88.00
9 Amoksisilin kapsul 500 mg kapsul 6141 20000 26141 10860 15281 Rp 233.00
10 Amoksisilin sirup 250 mg botol 0 300 300 66 234 Rp 4,128.00
11 Amoxicillin + As.Clavulanat (Co-Amoksik tablet 0 0 0 Rp 6,878.80
12 Ampicillin injeksi 1 gr vial 0 0 0 Rp -
13 Antasida sirup botol 102 300 402 133 269 Rp 2,065.00
14 Asam Mefenamat tablet 500 mg tablet 1720 10000 11720 3308 8412 Rp 112.00
15 Azitromicin kapsul 500 mg kapsul 0 0 0 Rp 1,900.00
16 Betahistin Mesilat tablet 6 mg tablet 0 900 900 350 550 Rp 162.00
17 Benzatin benzil penisillin 2,4 jt iu vial 0 0 0 Rp 15,225.00
18 benzatin bensil penisillin 1,2 jt iu vial 0 0 0 Rp 11,235.00
19 Bisoprolol tablet 5 mg tablet 120 120 0 120 Rp 363.00
20 Calsium Gluconas injeksi ampul 0 0 0 Rp 9,955.00
21 Captopril tablet 12,5 mg tablet 690 5000 5690 1440 4250 Rp 63.00
22 Captopril tablet 25 mg tablet 420 5000 5420 2010 3410 Rp 71.00
23 Captopril tablet 50 mg tablet 0 0 0 Rp 131.00
24 Cefadroxil kapsul 500mg kapsul 339 500 839 210 629 Rp 534.00
25 Cefadroxil sirup 125 mg/5 ml botol 60 120 180 60 120 Rp 4,586.00
26 Cefadroxil sirup 250 mg/5 ml botol 60 120 180 50 130 Rp 5,711.00
27 Cefixim syrup botol 0 0 0 Rp -
28 Cefixim kapsul 100 mg kapsul 255 255 55 200 Rp 626.00
29 Cefotaxim injeksi 1,0 gram vial 25 50 75 25 50 Rp 5,635.00
30 Ceftriaxone injeksi vial 0 0 0 Rp 3,500.00
31 Cetirizin tablet 10 mg tablet 1085 2000 3085 930 2155 Rp 145.00
32 Cimetidin tablet 200 mg tablet 290 290 90 200 Rp 175.00
33 Ciprofloxacin tablet 500 mg tablet 433 1500 1933 820 1113 Rp 289.00
34 Clobazam tablet tablet 0 0 0 Rp 1,010.00
35 Clozapine tablet 25 mg tablet 0 100 100 0 100 Rp 1,550.00
36 Dikloxacillin tablet 125 mg tablet 0 0 0 Rp 239.22
37 Diltiazem tablet 30 mg tablet 0 100 100 0 100 Rp 127.00
38 Dimenhydrinate tablet 50 mg tablet 220 220 50 170 Rp 104.00
39 Doksisiklin tablet 100mg tablet 0 0 0 Rp 282.00
40 Domperidon tablet 10 mg tablet 700 700 420 280 Rp 118.00
41 Erythromycin kapsul 250 mg kapsul 508 2000 2508 100 2408 Rp 594.00
42 Erythromycin kapsul 500 mg kapsul 0 0 0 Rp 751.00
43 Erythromycin sirup botol 64 64 39 25 Rp 6,867.00
44 Famotidin tablet 20 mg tablet 0 0 0 Rp 170.00
45 Famotidin tablet 40 mg tablet 0 0 0 Rp 270.00
46 Flukonazole kapsul 50 mg kapsul 0 0 0 Rp 4,862.00
47 Flukonazole kapsul 150 mg kapsul 0 0 0 Rp 18,900.00
48 Furosemid injeksi ampul 50 50 0 50 Rp 1,920.00
49 Flufenazin injeksi ( sikzonoat ) ampul 0 0 0 Rp 57,500.00
50 Gentamicin Salep Kulit 1 % tube 0 0 0 Rp 2,298.00
51 Gentamicin injeksi 40 mg /2 ml ampul 0 0 0 Rp 3,568.00
52 Gentamicin tetes mata 0,3% botol 28 28 10 18 Rp 4,200.00
53 Gentamicin salep mata tube 0 0 0 Rp 2,830.00
54 Gentian Violet 1 % botol 0 48 48 6 42 Rp 960.00
55 Glimepiride tablet 1 mg tablet 0 0 0 Rp 220.00
56 Glimepiride tablet 2 mg tablet 0 0 0 Rp 290.00
57 Kalium Diklofenak tablet 25 mg tablet 0 0 0 Rp 410.38
58 Kalium Diklofenak tablet 50 mg tablet 0 0 0 Rp 1,099.00
59 Kalium Permanganat (PK Kristal) botol 7 7 7 Rp 5,000.00
60 Ketokonazol cream tube 6 6 6 0 Rp 2,547.00
61 Ketokonazol tablet 200 mg tablet 0 0 0 Rp 390.60
62 Ketoprofen tablet 50 mg tablet 0 0 0 Rp -
63 Klindamicin kapsul 150 mg kapsul 1080 1080 310 770 Rp 379.00
64 Klindamicin kapsul 300 mg kapsul 555 555 110 445 Rp 630.00
65 Kloramfenikol sirup botol 53 53 8 45 Rp 3,978.00
66 Lansoprazole kapsul 30 mg kapsul 170 1200 1370 420 950 Rp 334.00
67 Levofloksasin tablet 500 mg tablet 0 0 0 Rp 554.00
68 Loperamid tablet tablet 745 745 250 495 Rp 87.00
69 Meloksicam tablet 15 mg tablet 0 0 0 Rp 1,800.00
70 Meloksicam tablet 7,5 mg tablet 0 0 0 Rp 1,060.00
71 Metformin tablet 500 mg tablet 0 5000 5000 2600 2400 Rp 115.00
72 Metil prednisolon tablet 4 mg tablet 0 0 0 Rp 210.00
73 Metil prednisolon tablet 8 mg tablet 720 1000 1720 420 1300 Rp 316.00
74 Metoklopramid injeksi ampul 0 0 0 Rp 1,000.00
75 Metoklopramid tablet tablet 700 3000 3700 1040 2660 Rp 120.00
76 Metronidazol tablet 250 mg tablet 0 1000 1000 0 1000 Rp 96.00
77 Metronidazol tablet 500 mg tablet 508 1000 1508 558 950 Rp 133.00
78 Miconazol cream tube 96 96 60 36 Rp 3,410.00
79 Mineral mix sachet 0 0 0
80 Natr.Diklofenak tablet 25 mg tablet 1959 2800 4759 1560 3199 Rp 157.00
81 Natr.Diklofenak tablet 50 mg tablet 905 2900 3805 1280 2525 Rp 160.00
82 Nifedipin tablet tablet 1080 1080 0 1080 Rp 110.00
83 Ofloxacin kapsul 200 mg kapsul 0 0 0 Rp 365.00
84 Omeprazole kapsul 20 mg kapsul 0 0 0 Rp 164.00
85 Obat Anti Tuberkulosis (OAT) FDC Kateg paket 0 0 0 Rp 225,735.00
86 Papaverin tablet 40 mg tablet 0 0 0 Rp 185.00
87 Parasetamol Drops botol 0 0 0 Rp 5,460.00
88 Piroxicam tablet 20 mg tablet 0 4680 4680 1200 3480 Rp 243.00
89 Ranitidin injeksi ampul 42 40 82 22 60 Rp 1,440.00
90 Ranitidin tablet 150 mg tablet 0 0 0 Rp 135.00
91 Risperidon tablet 1 mg tablet 0 0 0 Rp 439.00
92 Risperidon tablet 2 mg tablet 0 0 0 Rp 495.00
93 Risperidon tablet 3 mg tablet 300 300 0 300 Rp 792.00
94 Salbutamol tablet 4 mg tablet 0 0 0 Rp 83.00
95 Simvastatin tablet 10 mg tablet 270 270 0 270 Rp 174.00
96 Simvastatin tablet 20 mg tablet 93 4000 4093 600 3493 Rp 252.00
97 Thiamfenicol kapsul 500 mg kapsul 0 0 0 Rp 770.00
98 Tramadol injeksi 50 mg/ml ampul 0 0 0 Rp 1,890.00
99 Tramadol tablet 50 mg tablet 750 750 750 0 Rp 510.00
100 Tranexamic acid 5% Injeksi ampul 0 0 0 Rp 2,536.00
101 Trifluoperazine tablet 5 mg tablet 0 0 0 Rp 305.00
102 Zink Dispersible tablet tablet 1557 2000 3557 610 2947 Rp 540.00
103 Zink ID 10 mg /5 ml syrup botol 35 35 35 0 Rp 15,729.00

1 Albothyl Concentrat botol 4 4 0 4 Rp 43,950.00

2 Adver kapsul kapsul 0 0 0 Rp 605.00
3 Bactricid Forte tablet tablet 0 0 0 Rp 750.00
4 Becefort sirup botol 0 0 0 Rp 27,458.00
5 Becefort tablet tablet 0 0 0 Rp 1,851.00
6 Bekarbon (Norit) tablet tablet 0 0 0 Rp 115.00
7 Beneuron tablet tablet 0 0 0 Rp 982.67
8 Betafort sirup botol 0 0 0 Rp -
9 Betason-N cream tube 0 0 0 Rp 12,450.00
10 Benoson - N tube 0 30 30 30 0 Rp 21,280.00
11 Bioneuron tablet tablet 0 0 0 Rp 982.67
12 Bioplacenton jelly tube 7 7 2 5 Rp 19,450.00
13 Bioplacenton tulle lembar 4 4 1 3 Rp 10,950.00
14 Bionic sirup botol 20 150 170 60 110 Rp 19,580.00
15 Burnazin cream 500 gr pot 1 1 0 1 Rp 356,200.00
16 Cendo Xitrol e.d botol 3 11 14 7 7 Rp 27,850.00
17 Chloramphecort cream tube 0 0 0 Rp 15,700.00
18 Combivent Nebulizer ampul 0 0 0 Rp 4,995.00
19 Corpacetin kaplet kaplet 540 540 540 0 Rp 850.00
20 Dasabion tablet tablet 0 0 0 Rp 981.25
21 Dulcolax supp.10 mg supp 28 28 0 28 Rp 5,800.00
22 Dulcolax supp.5 mg supp 29 29 0 29 Rp 4,990.00
23 Dulcolax tablet 5 mg tablet 0 0 0 Rp 1,173.00
24 Enzymfort tablet tablet 0 0 0 Rp 613.47
25 Freshcare kotak 0 0 0 Rp 17,500.00
26 Haldol Decanoas inj. (Long Acting) ampul 0 0 0 Rp 97,500.00
27 Hemafort tablet tablet 350 350 0 350 Rp 1,000.00
28 Inamid tablet tablet 560 560 60 500 Rp 423.00
29 Isotic Clearens tetes mata botol 13 13 0 13 Rp 10,000.00
30 Isotic Neolyson tetes mata botol 0 0 0 Rp 37,000.00
31 Kanamycin injeksi 1 gr vial 10 10 0 10 Rp 12,500.00
32 Kanamycin injeksi 2 gr vial 0 0 0 Rp 20,160.00
33 Kontrasepsi (Depo) injeksi vial 0 0 0 Rp 7,000.00
34 Lacbon tablet tablet 0 0 0 Rp 1,824.00
35 Livron B Plex tab tablet 310 1800 2110 410 1700 Rp 285.00
36 Laxana boks 0 1 1 1 0 Rp 1,000.00
37 Miratrim forte tab tablet 220 220 220 0 Rp 1,365.00
38 Miraneuro tablet 0 0 0 Rp 1,200.00
39 Neuromed tablet tablet 0 0 0 Rp 2,900.00
40 Neo- Diaform tab tablet 0 0 0 Rp 140.00
41 Neurovit-E tablet tablet 0 0 0 Rp 1,085.00
42 Nodiar tablet tablet 0 0 0 Rp 1,219.00
43 Novakid-Plus sirup botol 0 0 0 Rp 13,345.00
44 Noza tablet tablet 0 0 0 Rp 735.00
45 OBH Indo Plus sirup botol 0 336 336 55 281 Rp 12,100.00
46 Pehatrim Forte tablet tablet 0 0 0 Rp 870.00
47 Pehavral tablet tablet 890 2000 2890 1820 1070 Rp 990.00
48 Plasminex tab tablet 0 0 0 Rp 2,970.00
49 Prolysin sirup botol 0 0 0 Rp 24,498.00
50 Proris Suppos supp 47 47 11 36 Rp 6,250.00
51 Panvit c tablet 210 1000 1210 340 870 Rp 1,220.00
52 Rohto tetes mata botol 0 0 0 Rp 10,000.00
53 Scabicid cream pot 0 0 0 Rp 22,700.00
54 Siobion kaps kapsul 0 0 0 Rp 1,274.00
55 Stesolid Rectal 10 mg supp 25 25 0 25 Rp 17,600.00
56 Stesolid Rectal 5 mg supp 24 24 0 24 Rp 12,155.00
57 Supraflu tablet tablet 0 0 0 Rp 948.00
58 Tuzalos kapsul kapsul 0 0 0 Rp 948.00
59 Ventolin Nebulizer ampul 0 0 0 Rp 4,000.00
60 Verorab 0.5 ml ( Vaksin ) ampul 0 0 0 Rp 211,600.00

Laboratorium :
1 Asam Klorida 0,1 N botol 0 1 1 1 0 Rp 50,000.00
2 ALT (GPT) kit 0 0 0 Rp 895,000.00
3 AST(GOT) kit 0 0 0 Rp 895,000.00
4 Aluminium kit 0 0 0 Rp 4,900,000.00
5 Asam Asetat btl 0 0 0 Rp 50,000.00
6 Aquadest liter 0 0 0 Rp 13,000.00
7 Borax test kit kit 0 0 0 Rp 3,375,000.00
8 Bola Hisap pcs 0 0 0 Rp 112,000.00
9 Bros tabung reaksi pcs 0 0 0 Rp 7,600.00
10 Baterai PH Meter pcs 0 0 0 Rp 15,000.00
11 Baterai Spektro pcs 0 0 0 Rp 6,150,000.00
12 BGLB 500 gr botol 0 0 0 Rp 1,850,000.00
13 Benang Rami rol 0 0 0 Rp 44,000.00
14 Buret Coklat pcs 0 0 0 Rp 2,380,000.00
15 Cholesterol PAP SL (6x100 ml) box 0 0 0 Rp 3,100,000.00
16 Chloride kit 0 0 0 Rp 5,700,000.00
17 Cleanser - ZN 244 1 liter botol 0 0 0 Rp 1,380,000.00
18 Cleaning kit botol 0 0 0 Rp 5,180,000.00
19 Concentrat Cleanser botol 0 4 4 4 0 Rp 2,365,000.00
20 Con.diff normal 16 Parameter ( Hematologi Tube 0 0 0 Rp 1,900,000.00
21 Control - N botol 0 0 0 Rp 1,575,000.00
22 Cyan Haemoglobin botol 0 0 0 Rp 68,000.00
23 Charger Spektro pcs 0 0 0 Rp 2,160,000.00
24 Diluent ZN 244 20 liter botol 0 0 0 Rp 2,425,000.00
25 Dual Pack Lyse + Diluen set 0 0 0 Rp 4,080,000.00
26 EZ Cleanser botol 0 0 0 Rp 1,342,390.00
27 Erlenmeyer 250 ml pcs 0 0 0 Rp 76,500.00
28 Formalin test kit 0 0 0 Rp 6,875,000.00
29 Flouride kit 0 0 0 Rp 7,100,000.00
30 Glucose PAP SL (6x100 ml) ktk 0 0 0 Rp 1,400,000.00
31 Gelas Ukur 500 ml pcs 0 0 0 Rp 425,000.00
32 Gunting Kecil pcs 0 0 0 Rp 5,000.00
33 iron kit 0 0 0 Rp 5,950,000.00
34 iodine test btl 0 0 0 Rp 5,500.00
35 Karet Gelang kg 0 0 0 Rp 50,000.00
36 Larutan Alkohol 96% botol 8 8 8 Rp 37,000.00
37 Larutan Asam Asetat 6% botol 0 1 1 1 0 Rp 50,000.00
38 Larutan Benedict botol 0 1 1 1 0 Rp 43,750.00
39 Larutan Edta 10% botol 0 1 1 1 0 Rp 320,000.00
40 Larutan Eosin 2% botol 0 1 1 1 0 Rp 379,000.00
41 Larutan Etanol Asam botol 0 1 1 1 0 Rp 73,000.00
42 Larutan Fuksin botol 0 1 1 1 0 Rp 173,000.00
43 Larutan Giemsa Stain botol 0 1 1 1 0 Rp 410,000.00
44 Larutan H2O2 botol 0 1 1 1 0 Rp 50,000.00
45 Larutan Hayem botol 0 1 1 1 0 Rp 80,000.00
46 Larutan Imersion Oil botol 0 1 1 1 0 Rp 318,750.00
47 Larutan Iodium botol 0 1 1 1 0 Rp 158,000.00
48 Larutan Karbol Fuksin botol 0 1 1 1 0 Rp 116,350.00
49 Larutan KOH 10% botol 0 1 1 1 0 Rp 37,500.00
50 Larutan Metilen Biru botol 0 1 1 1 0 Rp 112,000.00
51 Larutan Na.Sitrat botol 0 1 1 1 0 Rp 7,500.00
52 Larutan NaCl 0,86% botol 0 1 1 1 0 Rp 40,000.00
53 Larutan Reesecher botol 0 1 1 1 0 Rp 12,000.00
54 Larutan Serum Gol.Darah set 0 1 1 1 0 Rp 900,000.00
55 Larutan Turk botol 0 1 1 1 0 Rp 43,000.00
56 Larutan Widal Type H/O set 0 1 1 1 0 Rp 283,000.00
57 Larutan Xylen botol 0 1 1 1 0 Rp 218,000.00
58 Lyse ZN 244 500ml box 0 0 0 Rp 1,380,000.00
59 Lidi kapas / Dacron kotak 0 0 0 Rp 400,000.00
60 Larutan Kalibrasi PH 4,0 botol 0 0 0 Rp 720,000.00
61 Larutan Kalibrasi PH 7,0 botol 0 0 0 Rp 715,000.00
62 Larutan Kalibrasi PH 10.0 botol 0 0 0 Rp 1,800,000.00
63 Lactosa Broth 500 gr botol 0 0 0 Rp 1,275,000.00
64 Metanol botol 0 1 1 1 0 Rp 125,000.00
65 Manganese kit 0 0 0 Rp 5,800,000.00
66 Nitrat kit 0 0 0 Rp 8,200,000.00
67 Nitrit kit 0 0 0 Rp 6,750,000.00
68 PH meter pcs 0 0 0 Rp 2,280,000.00
69 Rinse botol 0 0 0 Rp 2,951,200.00
70 Rectangular cells Quartz 10 mm botol 0 0 0 Rp 7,986,600.00
71 Rohdamin test kit 0 0 0 Rp 4,300,000.00
72 Reagen HIV I ( Oncoprobe ) ktk 0 0 0 Rp 3,720,000.00
73 Reagen HIV II ( Intec ) ktk 0 0 0 Rp 4,880,000.00
74 Sphyllis Diagnostic Rapid Test box 0 0 0 Rp 600,000.00
75 Spiritus Bakar botol 0 2 2 2 0 Rp 32,500.00
76 Sulfat kit 0 0 0 Rp 3,500,000.00
77 Triglycerid box 0 0 0 Rp 4,900,000.00
78 Tabung Durham pcs 0 0 0 Rp 5,900.00
79 Tabung Serum bngks 0 0 0 Rp 480,000.00
80 Tabung Reaksi pcs 0 0 0 Rp 13,000.00
81 Timbangan Digital pcs 0 0 0 Rp 620,000.00
82 Uric Acid Mono SL (6x50 ml) box 0 0 0 Rp 3,230,000.00
83 Univ. Indikator PH 0-14 kit 0 0 0 Rp 356,000.00

Obat Gigi :
1 Alvogil kotak 0 1 1 1 0 Rp 225,000.00
2 Boonding botol 0 1 1 1 0 Rp 450,000.00
3 Calsium Hydroxide/Hydcal kotak 0 0 0 Rp 235,000.00
4 Cresophen botol 0 0 0 Rp 385,000.00
5 Dentine Conditioner kotak 0 0 0 Rp 182,800.00
6 Devitec kotak 0 0 0 Rp 385,000.00
7 Etching botol 0 0 0 Rp 348,000.00
8 Etil Klorida semprot botol 4 4 4 Rp 123,000.00
9 Eugenol cairan botol 0 0 0 Rp 19,005.00
10 Glass Ionomer Cement Anterior kotak 0 1 1 1 0 Rp 946,000.00
11 Glass Ionomer Cement Art kotak 0 1 1 1 0 Rp 765,000.00
12 Glass Ionomer Cement Posterior kotak 0 1 1 1 0 Rp 878,000.00
13 Kavit kotak 0 0 0 Rp 183,000.00
14 Ketricin kotak 0 0 0 Rp 57,750.00
15 MonoKlorKamferMentol Cairan (CHKM) botol 0 0 0 Rp 83,600.00
16 Occo botol 0 0 0 Rp 127,500.00
17 Retin Composit/Solare kotak 0 0 0 Rp 460,000.00
18 Scandonest 3% carpule 0 0 0 Rp 10,140.00
19 Semen Seng Fosfat serbuk dan cairan botol 0 0 0 Rp 255,000.00
20 Spons Gelatin Cubicles 1 x 1 x 1 cm kotak 0 0 0 Rp 120,000.00
21 Zinc Oxide Cement kotak 0 0 0 Rp 550,000.00
22 Xylocain 2% jelly pcs 0 0 0 Rp 40,000.00

1 Aesculap No. 11 ( Pisau Operasi ) pcs 10 10 2 8 Rp 3,150.00

2 Aesculap No. 15 ( Pisau Operasi ) pcs 13 4 17 4 13 Rp 3,150.00
3 Aesculap No. 20 ( Pisau Operasi ) pcs 8 8 2 6 Rp 3,150.00
4 Aesculap No. 21 ( Pisau Operasi ) pcs 5 5 2 3 Rp 3,150.00
5 Alat suntik sekali pakai 1 ml set 310 1000 1310 150 1160 Rp 711.63
6 Alat suntik sekali pakai 2,5 ml set 200 2000 2200 400 1800 Rp 717.76
7 Alat suntik sekali pakai 3 ml set 0 3000 3000 500 2500 Rp 717.76
8 Alat suntik sekali pakai 5 ml set 450 450 100 350 Rp 853.96
9 Alat suntik sekali pakai 10 ml set 0 0 0 Rp 1,174.75
10 Alkohol Swab kotak 0 20 20 20 0 Rp 11,000.00
11 Alkacid botol 0 1 1 1 0 Rp 2,972,970.00
12 Blood Lancet pcs 0 300 300 300 0 Rp 16,022.60
13 Catgut Chromic No. 2/0 (75 cm) set 43 43 10 33 Rp 18,040.00
14 Catgut Chromic No.3/0 (75 cm) set 38 38 8 30 Rp 23,625.00
15 Catgut Chromic No.2/0 (90 cm) box 0 0 0 Rp 433,000.00
16 Catgut Plain No. 2/0 (75 cm) set 35 35 10 25 Rp 7,090.83
17 Catgut Plain No.3/0 (75 cm) set 45 45 10 35 Rp 7,090.83
18 Catgut Chromic No.1/0 - 75 meter rol 0 0 0 Rp 1,695,000.00
19 Catgut Chromic No.2/0 - 100 meter rol 0 1 1 0 1 Rp 1,875,950.00
20 Catgut Chromic No.3/0 - 100 meter rol 0 1 1 0 1 Rp 1,837,600.00
21 Catgut Plain No.2/0 - 75 meter rol 0 0 0 Rp 1,037,000.00
22 Cotton Aplikator pak 0 0 0 Rp 359,600.00
23 Deck Glass pcs 0 300 300 300 0 Rp 1,384.00
24 Duk Bolong Small drapers pcs 0 5 5 5 0 Rp 82,500.00
25 Elastis bandage 10cm X 4,57m (no.4) rol 0 0 0 Rp 36,300.00
26 Elastis bandage 15cm X 4,57m (no.6) rol 0 0 0 Rp 46,101.00
27 Elastis bandage 7,5cm X 4,57m (no.3) rol 0 0 0 Rp 30,613.00
28 Etanol 70% botol 3 30 33 10 23 Rp 27,500.00
29 Feeding Tube No.12 pcs 0 0 0 Rp 21,300.00
30 Feeding Tube No.16 pcs 0 0 0 Rp 21,300.00
31 Feeding Tube No.3.5 pcs 0 0 0 Rp 18,450.00
32 Feeding Tube No.5 pcs 0 0 0 Rp 18,450.00
33 Feeding Tube No.8 pcs 0 0 0 Rp 18,450.00
34 Foley Catheter 2 way 12 Fr pcs 0 0 0 Rp 18,271.00
35 Foley Catheter 2 way 14 Fr pcs 0 0 0 Rp 8,317.00
36 Foley Catheter 2 way 16 Fr pcs 0 5 5 5 0 Rp 8,317.00
37 Foley Catheter 2 way 18 Fr pcs 0 5 5 5 0 Rp 8,317.00
38 Glukose Test Tip pcs 0 0 0 Rp 7,450.00
39 Handschoen non steril L pasang 100 200 300 100 200 Rp 661.00
40 Handschoen non steril M pasang 100 200 300 100 200 Rp 661.00
41 Handrub 500 ml botol 0 0 0 Rp 63,850.00
42 Handrub 5 L galon 0 0 0 Rp 672,800.00
43 Handscrub 500 ml botol 4 10 14 8 6 Rp 77,700.00
44 Handscrub 5 L galon 1 1 0 1 Rp 673,800.00
45 Hypafix 15 cm x 5 m rol 6 6 12 4 8 Rp 85,971.00
46 Hypafix 5 cm x 5 m rol 6 5 11 3 8 Rp 27,000.00
47 Infusion set Anak set 55 21 76 20 56 Rp 6,765.00
48 Infusion set Dewasa set 0 300 300 100 200 Rp 5,990.00
49 IV Catheter No. 18 set 35 199 234 80 154 Rp 13,894.00
50 IV Catheter No. 20 set 30 210 240 120 120 Rp 13,894.00
51 IV Catheter No. 22 set 15 239 254 120 134 Rp 13,894.00
52 IV Catheter No. 24 set 23 339 362 150 212 Rp 13,894.00
53 Isolasi Steril pcs 0 0 0 Rp 625,000.00
54 Jarum Infiltrasi / Needle Citojet ktk 0 0 0 Rp 227,500.00
55 Jarum Jahit (Bedah) No. 10 lsn 3 3 3 Rp 43,000.00
56 Jarum Jahit (Bedah) No. 11 lsn 3 3 3 Rp 43,000.00
57 Jarum Jahit (Bedah) No. 12 lsn 3 3 3 Rp 43,000.00
58 Jarum Jahit (Bedah) No. 13 lsn 1 1 1 Rp 43,000.00
59 Jarum Jahit (Bedah) No. 14 lsn 3 3 3 Rp 43,000.00
60 Jarum Jahit (Bedah) No. 9 lsn 4 4 4 Rp 43,000.00
61 Jarum Jahit Segitiga No.G 12 lsn 1 1 1 Rp 43,000.00
62 Jarum Jahit Segitiga No.G 14 lsn 0 0 0 Rp 43,000.00
63 Jarum Otot pcs 0 0 0 Rp 416.66
64 Jarum Tabung Edta/ Vacutainer box 0 0 0 Rp 380,000.00
65 Kapas 100 gram rol 5 20 25 10 15 Rp 6,000.00
66 Kapas Pembalut/Absorbent 250 gram rol 6 20 26 12 14 Rp 13,750.00
67 Kasa 40 x 80 rol 0 10 10 2 8 Rp 115,500.00
68 Kasa Pembalut Hidrofil 4 m x 15 cm rol 12 50 62 22 40 Rp 2,310.00
69 Kasa steril 16 x 16 rol 31 20 51 25 26 Rp 8,800.00
70 Kertas EKG rol 0 0 0 Rp 131,000.00
71 Kertas Saring lembar 0 0 0 Rp 3,000.00
72 Kertas PH lembar 0 0 0 Rp 44,000.00
73 Lancet ktk 0 0 0 Rp 59,000.00
74 Lisol, mengandung Kresol tersabun 50% botol 3 3 6 2 4 Rp 45,100.00
75 Masker 3fly pcs 360 5000 5360 2100 3260 Rp 605.00
76 Masker 3fly (Bedah) pcs 0 2000 2000 800 1200 Rp 440.00
77 Mini Blood Glukose Reader set 0 0 0 Rp 965,000.00
78 Multi Check GCU 3 in 1 set 0 0 0 Rp 529,081.00
79 Nassal oxygen M pcs 0 0 0 Rp 10,285.00
80 Nassal oxygen L pcs 0 0 0 Rp 10,285.00
81 Needle G.23 pcs 0 0 0 Rp 800.00
82 Object Glass ktk 0 2 2 2 0 Rp 19,400.00
83 Oxycan fortable 500 cc btl 0 0 0
84 oxygen Mask dewasa pcs 0 0 0 Rp 26,015.00
85 oxygen Mask anak pcs 0 0 0 Rp 26,015.00
86 Pemeriksaan Asam Urat ktk 0 10 10 10 0 Rp 150,000.00
87 Pemeriksaan Cholesterol ktk 0 10 10 10 0 Rp 281,000.00
88 Pemeriksaan Glukosa ktk 0 10 10 10 0 Rp 150,000.00
89 Pemeriksaan HB ktk 0 0 0 Rp 230,000.00
90 Pipet Tetes Panjang pcs 0 0 0 Rp 3,990.00
91 Pipet Tetes Pendek pcs 0 0 0 Rp 2,500.00
92 Planotest ktk 0 0 0 Rp 106,645.00
93 Plester 1,25 x 4,5 (kecil) rol 0 0 0 Rp 11,250.00
94 Plester 5 yards x 2 inch rol 4 4 4 0 Rp 16,692.50
95 Plester 1 inch rol 2 2 2 0 Rp 8,583.33
96 Plester 0,5 inch rol 0 0 0 Rp 5,125.00
97 Poliaid Sol 1 liter botol 0 0 0 Rp 79,375.00
98 Plastik Sampah Medis 42 Bks 0 0 0 Rp 4,025.00
99 Plastik Sampah Medis 35 Bks 0 0 0 Rp 40,300.00
100 Plastik Larvasida Bks 0 0 0 Rp 20,000.00
101 PGA 3/0 75 - cm ( benang jahit ) box 0 0 0 Rp 309,000.00
102 PGA 2/0 75 - cm ( benang jahit ) box 0 0 0 Rp 301,700.00
103 Polypropilene ( PPL ) benang jahit box 0 0 0 Rp 280,000.00
104 Silk No. 2/0 - 75 cm set 53 53 10 43 Rp 15,750.00
105 Silk No. 3/0 - 75 cm set 52 52 10 42 Rp 15,750.00
106 Silk No. 2/0 - 100 meter rol 0 1 1 0 1 Rp 752,220.00
107 Silk No. 3/0 - 100 meter rol 0 1 1 0 1 Rp 689,340.00
108 Slim Seher/Extractor Muccus pcs 0 0 0 Rp 7,744.00
109 Surgical Gloves No. 6,5 pasang 70 100 170 50 120 Rp 7,255.00
110 Surgical Gloves No. 7 pasang 77 100 177 52 125 Rp 7,255.00
111 Surgical Gloves No. 7,5 pasang 50 100 150 50 100 Rp 7,255.00
112 Surgical Gloves No. 8 pasang 77 50 127 27 100 Rp 7,255.00
113 Tabung Edta box 0 0 0 Rp 169,092.00
114 Umbilical Cord Klem Roll 25 25 10 15 Rp 3,100.00
115 Urinalisa Strip Ktk 0 0 0 Rp 8,500.00
116 Tas Sample pcs 0 0 0 Rp 300,000.00
117 Ultrasonic Gel botol 0 15 15 2 13 Rp 13,843.00
118 Umbilical Cord Klem pcs 0 0 0 Rp 3,025.00
119 Urinalisa Strip pcs 0 0 0 Rp 6,500.00
120 Urine bag pcs 0 0 0 Rp 4,719.00

UMUM
TIDAK BPJS JUMLAH
Jumlah kunjungan pasien BAYAR
BAYAR
1,873 885 2758
Jumlah resep ( R/ ) 6233
Jumlah resep generik ( R/ ) 6015
 Mengetahui/Menyetujui Yang Menyerahkan, Yang Meminta, Yang Menerima,
An. Kepala Dinas Kesehatan Kota Dumai Penanggung Jawab IFK Kota Dumai Kepala Puskesmas Petugas Puskesmas
Kabid. SDK,

MAINI ASNA,SKM.M.Si SARINA ULY,S.Farm,Apt dr. EKA VIORA EFFENDI YAYAK SUHANA S.Far, Apt
NIP. 19680529 198903 2 002 NIP.19790826 201001 2 016 NIP.19830826 200904 1 001 NIP.19800926201001 1 008
 NILAI KET

19 20
Rp 228,490.00
Rp 142,290.00
Rp -
Rp 83,725.00
Rp 135,000.00
Rp 763,800.00
Rp 550,400.00
Rp 401,200.00
Rp -
Rp 207,000.00
Rp 687,330.00
Rp 415,610.00
Rp 87,320.00
Rp -
Rp -
Rp 13,750.00
Rp 82,800.00
Rp -
Rp 1,609,058.00
Rp 13,400.00
Rp -
Rp 11,800.00
Rp 50,160.00
Rp 39,396.00
Rp 107,200.00
Rp 299,920.00
Rp -
Rp 25,020.00
Rp -
Rp 86,520.00
Rp 63,600.00
Rp -
Rp 117,700.00
Rp 19,800.00
Rp -
Rp 42,000.00
Rp 57,904.00
Rp 25,391.60
Rp -
Rp 25,000.00
Rp 149,120.00
Rp 694,960.00
Rp -
Rp 18,800.00
Rp 1,086,760.00
Rp 380,000.00
Rp 132,550.00
Rp 2,242,500.00
Rp -
Rp -
Rp 82,800.00
Rp -
Rp 239,980.00
Rp 224,000.00
Rp 78,020.00
Rp -
Rp 88,920.00
Rp 76,850.00
Rp 73,440.00
Rp 549,900.00
Rp 39,600.00
Rp 9,100.00
Rp 86,500.00
Rp 37,500.00
Rp 786,720.00
Rp 56,000.00
Rp 492,560.00
Rp 781,440.00
Rp 66,600.00
Rp -
Rp 325,523.00
Rp 567,170.00
Rp -
Rp 155,000.00
Rp 650,313.00
Rp 163,300.00
Rp 215,600.00
Rp -
Rp 353,646.00
Rp 247,936.00
Rp 87,000.00
Rp 32,000.00
Rp 36,500.00
Rp -
Rp 295,240.00
Rp 144,180.00
Rp 37,625.00
Rp 999,960.00
Rp 12,627.00
Rp -
Rp 360,000.00
Rp -
Rp -
Rp 294,500.00
Rp 227,157.00
Rp -
Rp 1,191,129.00
Rp 116,732.00
Rp 125,240.00
Rp -
Rp -
Rp 29,200.00
Rp 26,400.00
Rp 2,423,850.00
Rp 98,490.00
Rp 173,672.00
Rp 114,014.00
Rp 745,950.00
Rp -
Rp 400,000.00
Rp -
Rp 25,696.00
Rp -
Rp 503,500.00
Rp 95,700.00
Rp 17,500.00
#VALUE!
Rp 873,446.00
Rp -

Rp 1,652,739.00
Rp 38,280.00
Rp 147,710.00
Rp -
Rp -
Rp 185,310.00
Rp 225,360.00
Rp -
Rp -
Rp 732,350.00
Rp 215,520.00
Rp 244,640.00
Rp 3,560,473.00
Rp 965,952.00
Rp -
Rp -
Rp 555,485.00
Rp 942,144.00
Rp -
Rp 89,100.00
Rp -
Rp -
Rp 43,560.00
Rp -
Rp 267,750.00
Rp 242,110.00
Rp -
Rp 335,886.00
Rp 550,320.00
Rp 742,430.00
Rp -
Rp 125,200.00
Rp 281,750.00
Rp -
Rp 312,475.00
Rp 35,000.00
Rp 321,657.00
Rp -
Rp 155,000.00
Rp -
Rp 12,700.00
Rp 17,680.00
Rp -
Rp 33,040.00
Rp 1,430,352.00
Rp -
Rp 171,675.00
Rp -
Rp -
Rp -
Rp -
Rp 96,000.00
Rp -
Rp -
Rp -
Rp 75,600.00
Rp -
Rp 40,320.00
Rp -
Rp -
Rp -
Rp -
Rp 35,000.00
Rp -
Rp -
Rp -
Rp 291,830.00
Rp 280,350.00
Rp 179,010.00
Rp 317,300.00
Rp -
Rp 43,065.00
Rp -
Rp -
Rp 276,000.00
Rp -
Rp 410,800.00
Rp -
Rp 319,200.00
Rp 96,000.00
Rp 126,350.00
Rp 122,760.00
Rp -
Rp 502,243.00
Rp 404,000.00
Rp 118,800.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 845,640.00
Rp 86,400.00
Rp -
Rp -
Rp -
Rp 237,600.00
Rp -
Rp 46,980.00
Rp 880,236.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,591,380.00
Rp -
Rp -
Rp -
Rp 175,800.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 97,250.00
Rp 32,850.00
Rp 2,153,800.00
Rp 356,200.00
Rp 194,950.00
Rp -
Rp -
Rp -
Rp -
Rp 162,400.00
Rp 144,710.00
Rp -
Rp -
Rp -
Rp -
Rp 350,000.00
Rp 211,500.00
Rp 130,000.00
Rp -
Rp 125,000.00
Rp -
Rp -
Rp -
Rp 484,500.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 3,400,100.00
Rp -
Rp 1,059,300.00
Rp -
Rp -
Rp 225,000.00
Rp 1,061,400.00
Rp -
Rp -
Rp -
Rp 440,000.00
Rp 291,720.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 296,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 492,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 25,200.00
Rp 40,950.00
Rp 18,900.00
Rp 9,450.00
Rp 825,490.80
Rp 1,291,968.00
Rp 1,794,400.00
Rp 298,886.00
Rp -
Rp -
Rp -
Rp -
Rp 595,320.00
Rp 708,750.00
Rp -
Rp 177,270.75
Rp 248,179.05
Rp -
Rp 1,875,950.00
Rp 1,837,600.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 632,500.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 132,200.00
Rp 132,200.00
Rp -
Rp -
Rp 466,200.00
Rp 673,800.00
Rp 687,768.00
Rp 216,000.00
Rp 378,840.00
Rp 1,198,000.00
Rp 2,139,676.00
Rp 1,667,280.00
Rp 1,861,796.00
Rp 2,945,528.00
Rp -
Rp -
Rp 129,000.00
Rp 129,000.00
Rp 129,000.00
Rp 43,000.00
Rp 129,000.00
Rp 172,000.00
Rp 43,000.00
Rp -
Rp -
Rp -
Rp 90,000.00
Rp 192,500.00
Rp 924,000.00
Rp 92,400.00
Rp 228,800.00
Rp -
Rp -
Rp -
Rp -
Rp 180,400.00
Rp 1,972,300.00
Rp 528,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 677,250.00
Rp 661,500.00
Rp 752,220.00
Rp 689,340.00
Rp -
Rp 870,600.00
Rp 906,875.00
Rp 725,500.00
Rp 725,500.00
Rp -
Rp 46,500.00
Rp -
Rp -
Rp 179,959.00
Rp -
Rp -
Rp -
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO )
PUSKESMAS SUNGAI SEMBILAN

Puskesmas : SUNGAI SEMBILAN Pelaporan bulan/periode: DESEMBER 2017 Dokumen Nomor Tanggal
Kecamatan: SUNGAI SEMBILAN Permintaan bulan/periode: Dinkes Kab/Kota
Kab/Kota : DUMAI IFK Kab/Kota
Propinsi :RIAU Puskesmas

PEMBERIAN
STOK STOK
NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK
OPT.
PERMINTAAN PKPS- LAIN- @
AWAL ASKES APBD I APBD II
BBM
PROGRAM
LAIN
JUMLAH

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
1 Albendazol tablet 400 mg tablet 730 730 10 720 Rp 313.00
2 Alopurinol tablet 100 mg tablet 1530 1530 150 1380 Rp 93.00
3 Aminofilin tablet 200 mg tablet 0 0 0 Rp 82.00
4 Aminofilin injeksi 24 mg ampul 25 25 3 22 Rp 3,349.00
5 Amitriptilin HCl tablet salut 25 mg tablet 900 900 220 680 Rp 150.00
6 Amoksisilin kapsul 250 mg kapsul 3800 3800 450 3350 5000 Rp 201.00
7 Amoksisilin sirup kering 125 mg/5 ml botol 256 256 88 168 300 Rp 2,150.00
8 Ampisilin kaplet 500 mg kaplet 680 680 680 0 1000 Rp 590.00
9 Ampisilina sirup kering 125 mg/5ml botol 0 0 0 200 Rp 6,830.00
10 Antalgin (Metampiron) tablet 500 mg tablet 900 900 0 900 Rp 230.00
11 Antasida DOEN tablet 400 mg tablet 10910 10910 850 10060 10000 Rp 63.00
12 Anti Haemorroid DOEN Kombinasi suppos 130 130 20 110 Rp 3,197.00
13 Antifungi DOEN Kombinasi salep pot 20 20 20 48 Rp 4,366.00
14 Antimigren DOEN Kombinasi tablet (Ergo tablet 0 0 0 Rp 107.94
15 Antiparkinson DOEN tablet kombinasi tablet 0 0 0 Rp -
16 Aqua pro Injeksi steril, bebas pirogen ampul 5 5 5 Rp 2,750.00
17 Aquadest steril botol 3 3 3 Rp 27,600.00
18 Asam Askorbat (Vit.C) tablet 100 mg tablet 0 0 0 Rp 54.00
19 Asam Askorbat (Vit C) tablet 50 mg tablet 14762 14762 510 14252 Rp 109.00
20 Asetosal tablet 100 mg tablet 100 100 0 100 Rp 134.00
21 Asetosal tablet 500 mg tablet 0 0 0 Rp -
22 Asetosal 80 mg ( Miniaspi ) tablet 100 100 0 100 Rp 118.00
23 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 30 30 0 30 Rp 1,672.00
24 Betametason krim 0.1% tube 28 28 28 0 200 Rp 1,407.00
25 Deksametason injeksi 5 mg/ml - 1 ml ampul 67 67 0 67 Rp 1,600.00
26 Deksametason tablet 0,5 mg tablet 6520 6520 6520 10000 Rp 46.00
27 Diazepam injeksi 5mg/ml-2 ml ampul 0 0 0 Rp -
28 Diazepam tablet 2 mg tablet 500 500 100 400 Rp 50.04
29 Diazepam tablet 5 mg tablet 0 0 0 Rp 122.00
30 Difenhidramin HCl injeksi 10 mg/ml - 1 m ampul 70 70 0 70 Rp 1,236.00
31 Digoksin tablet 0,25 mg tablet 600 600 0 600 Rp 106.00
32 Efedrin HCl tablet 25 mg tablet 0 0 0 Rp 52.00
33 Epinefrina HCl/Bitartrat injeksi 0,1% - 1 m ampul 50 50 0 50 Rp 2,354.00
34 Etakridin ( Rivanol ) larutan 0,1% botol 6 6 1 5 20 Rp 3,300.00
35 Fenitoin Natrium kapsul 30 mg kapsul 0 0 0 Rp -
36 Fenitoin Natrium kapsul 100 mg kapsul 300 300 300 0 Rp 140.00
37 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 28 28 8 20 Rp 2,068.00
38 Fenobarbital tablet 30 mg tablet 520 520 20 500 Rp 48.83
39 Fenobarbital tablet 100 mg tablet 0 0 0 Rp -
40 Fenol Gliserol tetes telinga 10% botol 10 10 10 0 Rp 2,500.00
41 Fitomenadion (Vit.K1) inj. 10 mg/ml - 1 m ampul 40 40 2 38 120 Rp 3,728.00
42 Fitomenadion (Vit.K1) tablet salut 10 mg tablet 952 952 52 900 Rp 730.00
43 Fluor tablet 0,5mg tablet 0 0 0 Rp -
44 Furosemid tablet 40 mg tablet 200 200 0 200 Rp 94.00
45 Garam Oralit untuk 200 ml air kantong 4040 4040 650 3390 Rp 269.00
46 Glibenklamid tablet 5 mg tablet 3040 3040 410 2630 10000 Rp 125.00
47 Gliseril Guayakolat tablet 100 mg tablet 1205 1205 1205 0 20000 Rp 110.00
48 Glukosa larutan infus 5 % steril botol 325 325 90 235 200 Rp 6,900.00
49 Glukosa larutan infus 10 % steril botol 0 0 0 Rp -
50 Glukosa larutan infus 40 % steril ampul 0 0 0 Rp -
51 Griseofulvin tablet 125 mg, Micronized tablet 360 360 80 280 5000 Rp 230.00
52 Haloperidol tablet 0,5 mg tablet 0 0 0 Rp 62.00
53 Haloperidol tablet 1,5 mg tablet 3380 3380 135 3245 Rp 71.00
54 Haloperidol tablet 2 mg tablet 2000 2000 0 2000 Rp 112.00
55 Haloperidol tablet 5 mg tablet 830 830 0 830 Rp 94.00
56 Haloperidol Inj. 5 mg ( Lodomer Inj ) ampul 0 0 0 Rp 5,072.00
57 Hidroklorotiazid (HCT) tablet 25 mg tablet 570 570 70 500 Rp 156.00
58 Hidrokortison krim 2,5 % tube 29 29 29 192 Rp 2,650.00
59 Ibuprofen tablet 200 mg tablet 680 680 680 0 1000 Rp 108.00
60 Ibuprofen tablet 400 mg tablet 4230 4230 210 4020 5000 Rp 130.00
61 Isosorbid Dinitrat tablet (farsorbid) subli tablet 200 200 200 0 Rp 198.00
62 Isosorbid Dinitrat tablet sublingual 5 mg tablet 100 100 0 100 Rp 91.00
63 Isoniazid 300 mg tablet 500 500 500 0 Rp 173.00
64 Isoniazid 100 mg tablet 500 500 500 0 Rp 75.00
65 Kalsium Laktat (Kalk) tablet 500 mg tablet 11920 11920 710 11210 Rp 66.00
66 Karbamazepin tablet 200 mg tablet 200 200 0 200 Rp 280.00
67 Kloramfenikol kapsul 250 mg kapsul 1880 1880 80 1800 Rp 262.00
68 Kloramfenikol kapsul 500 mg kapsul 740 740 0 740 2000 Rp 1,056.00
69 Kloramfenikol salep mata 1 % tube 37 37 14 23 Rp 1,800.00
70 Kloramfenikol tetes telinga 3 % botol 0 0 0 50 Rp 1,679.00
71 Kloramfenikol Salep Kulit tube 101 101 53 48 100 Rp 3,223.00
72 Klorfeniramin Maleat (CTM) tablet 4 mg tablet 13190 13190 3050 10140 20000 Rp 43.00
73 Klorpromazin HCl injeksi 5 mg/ml - 2 ml ampul 0 0 0 Rp 1,483.00
74 Klorpromazin HCl tablet salut 25 mg tablet 1000 1000 0 1000 Rp 155.00
75 Klorpromazin HCl tablet salut 100 mg tablet 3803 3803 111 3692 Rp 171.00
76 Kodein HCl tablet 10 mg tablet 284 284 10 274 Rp 575.00
77 Kotrimoksazol Adult tablet 480 mg tablet 1400 1400 0 1400 Rp 154.00
78 Kotrimoksazol Pediatrik tablet 120 mg tablet 0 0 0 Rp 6,000.00
79 Kotrimoksazol suspensi 240 mg/5ml botol 162 162 10 152 Rp 2,183.00
80 Lidokain Komp. injeksi - 2 ml ampul 128 128 28 100 Rp 1,937.00
81 Lidokain injeksi - 2 ml ampul 100 100 67 33 100 Rp 870.00
82 Magnesium Sulfat injeksi (IV) 20% - 25 m vial 10 10 0 10 Rp 3,200.00
83 Magnesium Sulfat injeksi (IV) 40% - 25 m vial 10 10 0 10 Rp 3,650.00
84 Mebendazol tablet 100 mg tablet 0 0 0 Rp 239.00
85 Metilergometrin Maleat inj. 0,200 mg-1 ml ampul 110 110 0 110 Rp 2,684.00
86 Metilergometrin Maleat tablet salut 0,125 tablet 890 890 430 460 3000 Rp 162.00
87 Natrium Bikarbonat tablet 500 mg tablet 875 875 50 825 Rp 43.00
88 Natrium Klorida larutan infus 0,9% steril botol 156 156 40 116 200 Rp 6,410.00
89 Nistatin tablet vaginal 100.000 IU/g tablet 23 23 23 0 100 Rp 549.00
90 Nistatin tablet 500.000 IU/g tablet 0 0 0 Rp 782.00
91 Obat Batuk Hitam ( O.B.H. ) cairan botol 40 40 40 0 200 Rp 9,000.00
92 Oksitetrasiklin HCl salep 3% tube 0 0 0 200 Rp 1,606.00
93 Oksitetrasiklin HCl salep mata 1% tube 0 0 0 100 Rp 2,402.00
94 Oksitosin injeksi 10 IU/ml - 1 ml ampul 155 155 46 109 Rp 1,900.00
95 Parasetamol sirup 120 mg/5ml botol 203 203 80 123 100 Rp 1,119.00
96 Parasetamol tablet 100 mg tablet 0 0 0 Rp 32.96
97 Parasetamol tablet 500 mg tablet 20897 20897 5837 15060 30000 Rp 57.00
98 Pirantel tablet 125 mg tablet 379 379 19 360 Rp 308.00
99 Piridoksin HCl (Vit.B6) tablet 10 mg tablet 1010 1010 10 1000 2000 Rp 124.00
100 Primaquin tablet 15 mg tablet 0 0 0 Rp 235.00
101 Prednison tablet 5 mg tablet 0 0 0 10000 Rp 98.00
102 Propiltiourasil tablet 100 mg tablet 100 100 100 0 Rp 292.00
103 Propranolol HCl tablet 10 mg tablet 400 400 0 400 Rp 66.00
104 Ringer Laktat larutan infus steril botol 339 339 110 229 200 Rp 7,150.00
105 Salbutamol tablet 2 mg tablet 1470 1470 70 1400 2000 Rp 67.00
106 Salep 2-4 , Kombinasi pot 68 60 50 10 96 Rp 2,554.00
107 Salisil Bedak 2 % botol 109 109 5 104 Rp 1,046.00
108 Serum Anti Bisa Ular Polivalen inj. 5ml (ABU I) vial 1 1 0 1 Rp 745,950.00
109 Serum Anti Difteri Injeksi 20.000 IU/vial (ADS) vial 0 0 0 Rp -
110 Serum Anti Tetanus Injeksi 1.500 IU/ampul (ATS) ampul 2 2 0 2 Rp 200,000.00
111 Serum Anti Tetanus Injeksi 20.000 IU/vial (ATS) vial 0 0 0 Rp -
112 Sianokobalamin (Vit.B12) inj. 500mcg/ml ampul 22 22 22 0 200 Rp 1,168.00
113 Streptomycin injeksi 1 g vial 0 0 0 Rp 5,250.00
114 Tablet Tambah Darah kombinasi tablet 9500 9500 5450 4050 5000 Rp 53.00
115 Tetrasiklin HCl kapsul 500 mg kapsul 300 300 0 300 Rp 319.00
116 Tiamin HCl (Vit.B1) injeksi 100 mg/ml-1 ampul 25 25 0 25 Rp 700.00
117 Tiamin HCl (Vit.B1) tablet 100 mg tablet 0 \ Rp 116.64
118 Tiamin HCl (Vit.B1) tablet 50 mg tablet 9814 9814 8720 1094 8000 Rp 89.00
119 Tetagam Injeksi Ampul 0 0 0 Rp 170,000.00
120 Triheksifenidil Hidroklorida tablet 2 mg tablet 1440 1440 216 1224 Rp 92.00
121 Vitamin B-Kompleks tablet tablet 13659 13659 1500 12159 20000 Rp 121.00
122 Yodium Povidon 10% 30 ml botol 12 12 0 12 20 Rp 3,190.00
123 Yodium Povidon 10% 300 ml botol 10 10 3 7 10 Rp 14,771.00

1 Acyclovir cream tube 0 0 0 100 Rp 3,753.00

2 Acyclovir tablet 200 mg tablet 710 710 0 710 Rp 261.00
3 Acyclovir tablet 400 mg tablet 626 626 100 526 Rp 360.00
4 Alprazolam tablet 0,25 mg tablet 0 0 0 Rp 410.00
5 Ambroxol sirup botol 0 0 0 200 Rp 5,120.00
6 Ambroxol tablet 30 mg tablet 3775 3775 110 3665 5000 Rp 194.00
7 Amlodipin tablet 10 mg tablet 1347 1347 120 1227 1000 Rp 160.00
8 Amlodipin tablet 5 mg tablet 2780 2780 1820 960 2000 Rp 88.00
9 Amoksisilin kapsul 500 mg kapsul 15281 15281 5100 10181 10000 Rp 233.00
10 Amoksisilin sirup 250 mg botol 234 234 34 200 Rp 4,128.00
11 Amoxicillin + As.Clavulanat (Co-Amoksik tablet 0 0 0 Rp 6,878.80
12 Ampicillin injeksi 1 gr vial 0 0 0 Rp -
13 Antasida sirup botol 269 269 19 250 100 Rp 2,065.00
14 Asam Mefenamat tablet 500 mg tablet 8412 8412 1400 7012 10000 Rp 112.00
15 Azitromicin kapsul 500 mg kapsul 0 0 0 Rp 1,900.00
16 Betahistin Mesilat tablet 6 mg tablet 550 550 0 550 Rp 162.00
17 Benzatin benzil penisillin 2,4 jt iu vial 0 0 0 Rp 15,225.00
18 benzatin bensil penisillin 1,2 jt iu vial 0 0 0 Rp 11,235.00
19 Bisoprolol tablet 5 mg tablet 120 120 120 Rp 363.00
20 Calsium Gluconas injeksi ampul 0 0 0 Rp 9,955.00
21 Captopril tablet 12,5 mg tablet 4250 4250 220 4030 Rp 63.00
22 Captopril tablet 25 mg tablet 3410 3410 340 3070 Rp 71.00
23 Captopril tablet 50 mg tablet 0 0 0 Rp 131.00
24 Cefadroxil kapsul 500mg kapsul 629 629 400 229 2000 Rp 534.00
25 Cefadroxil sirup 125 mg/5 ml botol 120 120 20 100 Rp 4,586.00
26 Cefadroxil sirup 250 mg/5 ml botol 130 130 30 100 Rp 5,711.00
27 Cefixim syrup botol 0 0 0 Rp -
28 Cefixim kapsul 100 mg kapsul 200 200 80 120 Rp 626.00
29 Cefotaxim injeksi 1,0 gram vial 50 50 0 50 Rp 5,635.00
30 Ceftriaxone injeksi vial 0 0 0 Rp 3,500.00
31 Cetirizin tablet 10 mg tablet 2155 2155 155 2000 Rp 145.00
32 Cimetidin tablet 200 mg tablet 200 200 200 0 5000 Rp 175.00
33 Ciprofloxacin tablet 500 mg tablet 1113 1113 0 1113 3000 Rp 289.00
34 Clobazam tablet tablet 0 0 0 Rp 1,010.00
35 Clozapine tablet 25 mg tablet 100 100 0 100 Rp 1,550.00
36 Dikloxacillin tablet 125 mg tablet 0 0 0 Rp 239.22
37 Diltiazem tablet 30 mg tablet 100 100 0 100 Rp 127.00
38 Dimenhydrinate tablet 50 mg tablet 170 170 170 0 Rp 104.00
39 Doksisiklin tablet 100mg tablet 0 0 0 Rp 282.00
40 Domperidon tablet 10 mg tablet 280 280 0 280 5000 Rp 118.00
41 Erythromycin kapsul 250 mg kapsul 2408 2408 0 2408 Rp 594.00
42 Erythromycin kapsul 500 mg kapsul 0 0 0 Rp 751.00
43 Erythromycin sirup botol 25 25 25 0 100 Rp 6,867.00
44 Famotidin tablet 20 mg tablet 0 0 0 Rp 170.00
45 Famotidin tablet 40 mg tablet 0 0 0 Rp 270.00
46 Flukonazole kapsul 50 mg kapsul 0 0 0 Rp 4,862.00
47 Flukonazole kapsul 150 mg kapsul 0 0 0 Rp 18,900.00
48 Furosemid injeksi ampul 50 50 25 25 Rp 1,920.00
49 Flufenazin injeksi ( sikzonoat ) ampul 0 0 0 Rp 57,500.00
50 Gentamicin Salep Kulit 1 % tube 0 0 0 200 Rp 2,298.00
51 Gentamicin injeksi 40 mg /2 ml ampul 0 0 0 Rp 3,568.00
52 Gentamicin tetes mata 0,3% botol 18 18 8 10 200 Rp 4,200.00
53 Gentamicin salep mata tube 0 0 0 100 Rp 2,830.00
54 Gentian Violet 1 % botol 42 42 42 0 50 Rp 960.00
55 Glimepiride tablet 1 mg tablet 0 0 0 Rp 220.00
56 Glimepiride tablet 2 mg tablet 0 0 0 Rp 290.00
57 Kalium Diklofenak tablet 25 mg tablet 0 0 0 2000 Rp 410.38
58 Kalium Diklofenak tablet 50 mg tablet 0 0 0 2000 Rp 1,099.00
59 Kalium Permanganat (PK Kristal) botol 7 7 7 Rp 5,000.00
60 Ketokonazol cream tube 0 0 0 200 Rp 2,547.00
61 Ketokonazol tablet 200 mg tablet 0 0 0 2000 Rp 390.60
62 Ketoprofen tablet 50 mg tablet 0 0 0 Rp -
63 Klindamicin kapsul 150 mg kapsul 770 770 0 770 3000 Rp 379.00
64 Klindamicin kapsul 300 mg kapsul 445 445 0 445 3000 Rp 630.00
65 Kloramfenikol sirup botol 45 45 0 45 100 Rp 3,978.00
66 Lansoprazole kapsul 30 mg kapsul 950 950 50 900 2000000 Rp 334.00
67 Levofloksasin tablet 500 mg tablet 0 0 0 Rp 554.00
68 Loperamid tablet tablet 495 495 0 495 1000 Rp 87.00
69 Meloksicam tablet 15 mg tablet 0 0 0 2000 Rp 1,800.00
70 Meloksicam tablet 7,5 mg tablet 0 0 0 5000 Rp 1,060.00
71 Metformin tablet 500 mg tablet 2400 2400 0 2400 5000 Rp 115.00
72 Metil prednisolon tablet 4 mg tablet 0 0 0 2000 Rp 210.00
73 Metil prednisolon tablet 8 mg tablet 1300 1300 180 1120 Rp 316.00
74 Metoklopramid injeksi ampul 0 0 0 50 Rp 1,000.00
75 Metoklopramid tablet tablet 2660 2660 160 2500 2000 Rp 120.00
76 Metronidazol tablet 250 mg tablet 1000 1000 200 800 Rp 96.00
77 Metronidazol tablet 500 mg tablet 950 950 150 800 2000 Rp 133.00
78 Miconazol cream tube 36 36 36 0 Rp 3,410.00
79 Mineral mix sachet 0 0 0
80 Natr.Diklofenak tablet 25 mg tablet 3199 3199 189 3010 2000 Rp 157.00
81 Natr.Diklofenak tablet 50 mg tablet 2525 2525 1425 1100 Rp 160.00
82 Nifedipin tablet tablet 1080 1080 0 1080 2000 Rp 110.00
83 Ofloxacin kapsul 200 mg kapsul 0 0 0 Rp 365.00
84 Omeprazole kapsul 20 mg kapsul 0 0 0 Rp 164.00
85 Obat Anti Tuberkulosis (OAT) FDC Kateg paket 0 0 0 Rp 225,735.00
86 Papaverin tablet 40 mg tablet 0 0 0 Rp 185.00
87 Parasetamol Drops botol 0 0 0 Rp 5,460.00
88 Piroxicam tablet 20 mg tablet 3480 3480 240 3240 Rp 243.00
89 Ranitidin injeksi ampul 60 60 0 60 200 Rp 1,440.00
90 Ranitidin tablet 150 mg tablet 0 0 0 5000 Rp 135.00
91 Risperidon tablet 1 mg tablet 0 0 0 Rp 439.00
92 Risperidon tablet 2 mg tablet 0 0 0 Rp 495.00
93 Risperidon tablet 3 mg tablet 300 300 0 300 Rp 792.00
94 Salbutamol tablet 4 mg tablet 1000 1000 0 1000 Rp 83.00
95 Simvastatin tablet 10 mg tablet 270 270 270 0 1000 Rp 174.00
96 Simvastatin tablet 20 mg tablet 3493 3493 93 3400 Rp 252.00
97 Thiamfenicol kapsul 500 mg kapsul 0 0 0 2000 Rp 770.00
98 Tramadol injeksi 50 mg/ml ampul 0 0 0 Rp 1,890.00
99 Tramadol tablet 50 mg tablet 0 0 0 Rp 510.00
100 Tranexamic acid 5% Injeksi ampul 0 0 0 Rp 2,536.00
101 Trifluoperazine tablet 5 mg tablet 0 0 0 Rp 305.00
102 Zink Dispersible tablet tablet 2947 2947 542 2405 2000 Rp 540.00
103 Zink ID 10 mg /5 ml syrup botol 0 0 0 200 Rp 15,729.00

1 Albothyl Concentrat botol 4 4 0 4 10 Rp 43,950.00

2 Adver kapsul kapsul 0 0 0 Rp 605.00
3 Bactricid Forte tablet tablet 0 0 0 Rp 750.00
4 Becefort sirup botol 0 0 0 200 Rp 27,458.00
5 Becefort tablet tablet 0 0 0 2000 Rp 1,851.00
6 Bekarbon (Norit) tablet tablet 0 0 0 Rp 115.00
7 Beneuron tablet tablet 0 0 0 Rp 982.67
8 Betafort sirup botol 0 0 0 Rp -
9 Betason-N cream tube 0 0 0 200 Rp 12,450.00
10 Benoson - N tube 0 0 0 200 Rp 21,280.00
11 Bioneuron tablet tablet 0 0 0 2000 Rp 982.67
12 Bioplacenton jelly tube 5 5 1 4 10 Rp 19,450.00
13 Bioplacenton tulle lembar 3 3 1 2 Rp 10,950.00
14 Bionic sirup botol 110 110 1 109 200 Rp 19,580.00
15 Burnazin cream 500 gr pot 1 1 0 1 Rp 356,200.00
16 Cendo Xitrol e.d botol 7 7 4 3 10 Rp 27,850.00
17 Chloramphecort cream tube 0 0 0 Rp 15,700.00
18 Combivent Nebulizer ampul 0 0 0 50 Rp 4,995.00
19 Corpacetin kaplet kaplet 0 0 0 2000 Rp 850.00
20 Dasabion tablet tablet 0 0 0 Rp 981.25
21 Dulcolax supp.10 mg supp 28 28 28 0 50 Rp 5,800.00
22 Dulcolax supp.5 mg supp 29 29 12 17 Rp 4,990.00
23 Dulcolax tablet 5 mg tablet 0 0 0 Rp 1,173.00
24 Enzymfort tablet tablet 0 0 0 Rp 613.47
25 Freshcare kotak 0 0 0 Rp 17,500.00
26 Haldol Decanoas inj. (Long Acting) ampul 0 0 0 Rp 97,500.00
27 Hemafort tablet tablet 350 350 50 300 2000 Rp 1,000.00
28 Inamid tablet tablet 500 500 200 300 Rp 423.00
29 Isotic Clearens tetes mata botol 13 13 0 13 Rp 10,000.00
30 Isotic Neolyson tetes mata botol 0 0 0 Rp 37,000.00
31 Kanamycin injeksi 1 gr vial 10 10 0 10 Rp 12,500.00
32 Kanamycin injeksi 2 gr vial 0 0 0 Rp 20,160.00
33 Kontrasepsi (Depo) injeksi vial 0 0 0 Rp 7,000.00
34 Lacbon tablet tablet 0 0 0 2000 Rp 1,824.00
35 Livron B Plex tab tablet 1700 1700 700 1000 2000 Rp 285.00
36 Laxana boks 0 0 0 Rp 1,000.00
37 Miratrim forte tab tablet 600 600 0 600 Rp 1,365.00
38 Miraneuro tablet 0 0 0 Rp 1,200.00
39 Neuromed tablet tablet 0 0 0 Rp 2,900.00
40 Neo- Diaform tab tablet 0 0 0 Rp 140.00
41 Neurovit-E tablet tablet 0 0 0 3000 Rp 1,085.00
42 Nodiar tablet tablet 0 0 0 2000 Rp 1,219.00
43 Novakid-Plus sirup botol 0 0 0 Rp 13,345.00
44 Noza tablet tablet 0 0 0 2000 Rp 735.00
45 OBH Indo Plus sirup botol 281 281 137 144 200 Rp 12,100.00
46 Pehatrim Forte tablet tablet 0 0 0 Rp 870.00
47 Pehavral tablet tablet 1070 1070 70 1000 3000 Rp 990.00
48 Plasminex tab tablet 0 0 0 Rp 2,970.00
49 Prolysin sirup botol 0 0 0 200 Rp 24,498.00
50 Proris Suppos supp 36 36 0 36 Rp 6,250.00
51 Panvit c tablet 870 870 370 500 2000 Rp 1,220.00
52 Rohto tetes mata botol 0 0 0 50 Rp 10,000.00
53 Scabicid cream pot 0 0 0 100 Rp 22,700.00
54 Siobion kaps kapsul 0 0 0 Rp 1,274.00
55 Stesolid Rectal 10 mg supp 25 25 0 25 Rp 17,600.00
56 Stesolid Rectal 5 mg supp 24 24 0 24 Rp 12,155.00
57 Supraflu tablet tablet 0 0 0 Rp 948.00
58 Tuzalos kapsul kapsul 0 0 0 200 Rp 948.00
59 Ventolin Nebulizer ampul 0 0 0 100 Rp 4,000.00
60 Verorab 0.5 ml ( Vaksin ) ampul 0 0 0 Rp 211,600.00

Laboratorium :
1 Asam Klorida 0,1 N botol 0 0 0 Rp 50,000.00
2 ALT (GPT) kit 0 0 0 Rp 895,000.00
3 AST(GOT) kit 0 0 0 Rp 895,000.00
4 Aluminium kit 0 0 0 Rp 4,900,000.00
5 Asam Asetat btl 0 0 0 Rp 50,000.00
6 Aquadest liter 0 0 0 Rp 13,000.00
7 Borax test kit kit 0 0 0 Rp 3,375,000.00
8 Bola Hisap pcs 0 0 0 Rp 112,000.00
9 Bros tabung reaksi pcs 0 0 0 Rp 7,600.00
10 Baterai PH Meter pcs 0 0 0 Rp 15,000.00
11 Baterai Spektro pcs 0 0 0 Rp 6,150,000.00
12 BGLB 500 gr botol 0 0 0 Rp 1,850,000.00
13 Benang Rami rol 0 0 0 Rp 44,000.00
14 Buret Coklat pcs 0 0 0 Rp 2,380,000.00
15 Cholesterol PAP SL (6x100 ml) box 0 0 0 Rp 3,100,000.00
16 Chloride kit 0 0 0 Rp 5,700,000.00
17 Cleanser - ZN 244 1 liter botol 0 0 0 Rp 1,380,000.00
18 Cleaning kit botol 0 0 0 Rp 5,180,000.00
19 Concentrat Cleanser botol 0 0 0 Rp 2,365,000.00
20 Con.diff normal 16 Parameter ( Hematologi Tube 0 0 0 Rp 1,900,000.00
21 Control - N botol 0 0 0 Rp 1,575,000.00
22 Cyan Haemoglobin botol 0 0 0 Rp 68,000.00
23 Charger Spektro pcs 0 0 0 Rp 2,160,000.00
24 Diluent ZN 244 20 liter botol 0 0 0 Rp 2,425,000.00
25 Dual Pack Lyse + Diluen set 0 0 0 Rp 4,080,000.00
26 EZ Cleanser botol 0 0 0 Rp 1,342,390.00
27 Erlenmeyer 250 ml pcs 0 0 0 Rp 76,500.00
28 Formalin test kit 0 0 0 Rp 6,875,000.00
29 Flouride kit 0 0 0 Rp 7,100,000.00
30 Glucose PAP SL (6x100 ml) ktk 0 0 0 Rp 1,400,000.00
31 Gelas Ukur 500 ml pcs 0 0 0 Rp 425,000.00
32 Gunting Kecil pcs 0 0 0 Rp 5,000.00
33 iron kit 0 0 0 Rp 5,950,000.00
34 iodine test btl 0 0 0 Rp 5,500.00
35 Karet Gelang kg 0 0 0 Rp 50,000.00
36 Larutan Alkohol 96% botol 8 8 8 Rp 37,000.00
37 Larutan Asam Asetat 6% botol 0 0 0 Rp 50,000.00
38 Larutan Benedict botol 0 0 0 Rp 43,750.00
39 Larutan Edta 10% botol 0 0 0 Rp 320,000.00
40 Larutan Eosin 2% botol 0 0 0 Rp 379,000.00
41 Larutan Etanol Asam botol 0 0 0 Rp 73,000.00
42 Larutan Fuksin botol 0 0 0 Rp 173,000.00
43 Larutan Giemsa Stain botol 0 0 0 Rp 410,000.00
44 Larutan H2O2 botol 0 0 0 Rp 50,000.00
45 Larutan Hayem botol 0 0 0 Rp 80,000.00
46 Larutan Imersion Oil botol 0 0 0 Rp 318,750.00
47 Larutan Iodium botol 0 0 0 Rp 158,000.00
48 Larutan Karbol Fuksin botol 0 0 0 Rp 116,350.00
49 Larutan KOH 10% botol 0 0 0 Rp 37,500.00
50 Larutan Metilen Biru botol 0 0 0 Rp 112,000.00
51 Larutan Na.Sitrat botol 0 0 0 Rp 7,500.00
52 Larutan NaCl 0,86% botol 0 0 0 Rp 40,000.00
53 Larutan Reesecher botol 0 0 0 Rp 12,000.00
54 Larutan Serum Gol.Darah set 0 0 0 Rp 900,000.00
55 Larutan Turk botol 0 0 0 Rp 43,000.00
56 Larutan Widal Type H/O set 0 0 0 Rp 283,000.00
57 Larutan Xylen botol 0 0 0 Rp 218,000.00
58 Lyse ZN 244 500ml box 0 0 0 Rp 1,380,000.00
59 Lidi kapas / Dacron kotak 0 0 0 Rp 400,000.00
60 Larutan Kalibrasi PH 4,0 botol 0 0 0 Rp 720,000.00
61 Larutan Kalibrasi PH 7,0 botol 0 0 0 Rp 715,000.00
62 Larutan Kalibrasi PH 10.0 botol 0 0 0 Rp 1,800,000.00
63 Lactosa Broth 500 gr botol 0 0 0 Rp 1,275,000.00
64 Metanol botol 0 0 0 Rp 125,000.00
65 Manganese kit 0 0 0 Rp 5,800,000.00
66 Nitrat kit 0 0 0 Rp 8,200,000.00
67 Nitrit kit 0 0 0 Rp 6,750,000.00
68 PH meter pcs 0 0 0 Rp 2,280,000.00
69 Rinse botol 0 0 0 Rp 2,951,200.00
70 Rectangular cells Quartz 10 mm botol 0 0 0 Rp 7,986,600.00
71 Rohdamin test kit 0 0 0 Rp 4,300,000.00
72 Reagen HIV I ( Oncoprobe ) ktk 0 0 0 Rp 3,720,000.00
73 Reagen HIV II ( Intec ) ktk 0 0 0 Rp 4,880,000.00
74 Sphyllis Diagnostic Rapid Test box 0 0 0 Rp 600,000.00
75 Spiritus Bakar botol 0 0 0 Rp 32,500.00
76 Sulfat kit 0 0 0 Rp 3,500,000.00
77 Triglycerid box 0 0 0 Rp 4,900,000.00
78 Tabung Durham pcs 0 0 0 Rp 5,900.00
79 Tabung Serum bngks 0 0 0 Rp 480,000.00
80 Tabung Reaksi pcs 0 0 0 Rp 13,000.00
81 Timbangan Digital pcs 0 0 0 Rp 620,000.00
82 Uric Acid Mono SL (6x50 ml) box 0 0 0 Rp 3,230,000.00
83 Univ. Indikator PH 0-14 kit 0 0 0 Rp 356,000.00

Obat Gigi :
1 Alvogil kotak 0 0 0 Rp 225,000.00
2 Boonding botol 0 0 0 Rp 450,000.00
3 Calsium Hydroxide/Hydcal kotak 0 0 0 Rp 235,000.00
4 Cresophen botol 0 0 0 Rp 385,000.00
5 Dentine Conditioner kotak 0 0 0 Rp 182,800.00
6 Devitec kotak 0 0 0 Rp 385,000.00
7 Etching botol 0 0 0 Rp 348,000.00
8 Etil Klorida semprot botol 4 4 4 Rp 123,000.00
9 Eugenol cairan botol 0 0 0 Rp 19,005.00
10 Glass Ionomer Cement Anterior kotak 0 0 0 Rp 946,000.00
11 Glass Ionomer Cement Art kotak 0 0 0 Rp 765,000.00
12 Glass Ionomer Cement Posterior kotak 0 0 0 Rp 878,000.00
13 Kavit kotak 0 0 0 Rp 183,000.00
14 Ketricin kotak 0 0 0 Rp 57,750.00
15 MonoKlorKamferMentol Cairan (CHKM) botol 0 0 0 Rp 83,600.00
16 Occo botol 0 0 0 Rp 127,500.00
17 Retin Composit/Solare kotak 0 0 0 Rp 460,000.00
18 Scandonest 3% carpule 0 0 0 Rp 10,140.00
19 Semen Seng Fosfat serbuk dan cairan botol 0 0 0 Rp 255,000.00
20 Spons Gelatin Cubicles 1 x 1 x 1 cm kotak 0 0 0 Rp 120,000.00
21 Zinc Oxide Cement kotak 0 0 0 Rp 550,000.00
22 Xylocain 2% jelly pcs 0 0 0 Rp 40,000.00

1 Aesculap No. 11 ( Pisau Operasi ) pcs 8 8 2 6 20 Rp 3,150.00

2 Aesculap No. 15 ( Pisau Operasi ) pcs 13 13 5 8 20 Rp 3,150.00
3 Aesculap No. 20 ( Pisau Operasi ) pcs 6 6 2 4 20 Rp 3,150.00
4 Aesculap No. 21 ( Pisau Operasi ) pcs 3 3 1 2 20 Rp 3,150.00
5 Alat suntik sekali pakai 1 ml set 1160 1160 0 1160 Rp 711.63
6 Alat suntik sekali pakai 2,5 ml set 1800 1800 800 1000 500 Rp 717.76
7 Alat suntik sekali pakai 3 ml set 2500 2500 1300 1200 500 Rp 717.76
8 Alat suntik sekali pakai 5 ml set 350 350 50 300 500 Rp 853.96
9 Alat suntik sekali pakai 10 ml set 0 0 0 Rp 1,174.75
10 Alkohol Swab kotak 0 0 0 Rp 11,000.00
11 Alkacid botol 0 0 0 Rp 2,972,970.00
12 Blood Lancet pcs 0 0 0 Rp 16,022.60
13 Catgut Chromic No. 2/0 (75 cm) set 33 33 3 30 Rp 18,040.00
14 Catgut Chromic No.3/0 (75 cm) set 30 30 5 25 Rp 23,625.00
15 Catgut Chromic No.2/0 (90 cm) box 0 0 0 Rp 433,000.00
16 Catgut Plain No. 2/0 (75 cm) set 25 25 5 20 Rp 7,090.83
17 Catgut Plain No.3/0 (75 cm) set 35 35 5 30 Rp 7,090.83
18 Catgut Chromic No.1/0 - 75 meter rol 0 0 0 Rp 1,695,000.00
19 Catgut Chromic No.2/0 - 100 meter rol 1 1 1 0 Rp 1,875,950.00
20 Catgut Chromic No.3/0 - 100 meter rol 1 1 1 0 Rp 1,837,600.00
21 Catgut Plain No.2/0 - 75 meter rol 0 0 0 Rp 1,037,000.00
22 Cotton Aplikator pak 0 0 0 Rp 359,600.00
23 Deck Glass pcs 0 0 0 Rp 1,384.00
24 Duk Bolong Small drapers pcs 0 0 0 Rp 82,500.00
25 Elastis bandage 10cm X 4,57m (no.4) rol 0 0 0 Rp 36,300.00
26 Elastis bandage 15cm X 4,57m (no.6) rol 0 0 0 Rp 46,101.00
27 Elastis bandage 7,5cm X 4,57m (no.3) rol 0 0 0 Rp 30,613.00
28 Etanol 70% botol 23 23 10 13 20 Rp 27,500.00
29 Feeding Tube No.12 pcs 0 0 0 Rp 21,300.00
30 Feeding Tube No.16 pcs 0 0 0 Rp 21,300.00
31 Feeding Tube No.3.5 pcs 0 0 0 Rp 18,450.00
32 Feeding Tube No.5 pcs 0 0 0 Rp 18,450.00
33 Feeding Tube No.8 pcs 0 0 0 Rp 18,450.00
34 Foley Catheter 2 way 12 Fr pcs 0 0 0 Rp 18,271.00
35 Foley Catheter 2 way 14 Fr pcs 0 0 0 Rp 8,317.00
36 Foley Catheter 2 way 16 Fr pcs 0 0 0 Rp 8,317.00
37 Foley Catheter 2 way 18 Fr pcs 0 0 0 Rp 8,317.00
38 Glukose Test Tip pcs 0 0 0 Rp 7,450.00
39 Handschoen non steril L pasang 200 200 100 100 500 Rp 661.00
40 Handschoen non steril M pasang 200 200 0 200 500 Rp 661.00
41 Handrub 500 ml botol 0 0 0 Rp 63,850.00
42 Handrub 5 L galon 0 0 0 Rp 672,800.00
43 Handscrub 500 ml botol 6 6 2 4 10 Rp 77,700.00
44 Handscrub 5 L galon 1 1 0 1 3 Rp 673,800.00
45 Hypafix 15 cm x 5 m rol 8 8 2 6 10 Rp 85,971.00
46 Hypafix 5 cm x 5 m rol 8 8 2 6 10 Rp 27,000.00
47 Infusion set Anak set 56 56 16 40 200 Rp 6,765.00
48 Infusion set Dewasa set 200 200 100 100 400 Rp 5,990.00
49 IV Catheter No. 18 set 154 154 4 150 Rp 13,894.00
50 IV Catheter No. 20 set 120 120 10 110 Rp 13,894.00
51 IV Catheter No. 22 set 134 134 14 120 Rp 13,894.00
52 IV Catheter No. 24 set 212 212 12 200 Rp 13,894.00
53 Isolasi Steril pcs 0 0 0 Rp 625,000.00
54 Jarum Infiltrasi / Needle Citojet ktk 0 0 0 Rp 227,500.00
55 Jarum Jahit (Bedah) No. 10 lsn 3 3 0 3 Rp 43,000.00
56 Jarum Jahit (Bedah) No. 11 lsn 3 3 0 3 Rp 43,000.00
57 Jarum Jahit (Bedah) No. 12 lsn 3 3 0 3 Rp 43,000.00
58 Jarum Jahit (Bedah) No. 13 lsn 1 1 0 1 Rp 43,000.00
59 Jarum Jahit (Bedah) No. 14 lsn 3 3 0 3 Rp 43,000.00
60 Jarum Jahit (Bedah) No. 9 lsn 4 4 0 4 Rp 43,000.00
61 Jarum Jahit Segitiga No.G 12 lsn 1 1 0 1 Rp 43,000.00
62 Jarum Jahit Segitiga No.G 14 lsn 0 0 0 Rp 43,000.00
63 Jarum Otot pcs 0 0 0 Rp 416.66
64 Jarum Tabung Edta/ Vacutainer box 0 0 0 Rp 380,000.00
65 Kapas 100 gram rol 15 15 5 10 10 Rp 6,000.00
66 Kapas Pembalut/Absorbent 250 gram rol 14 14 4 10 10 Rp 13,750.00
67 Kasa 40 x 80 rol 8 8 8 0 20 Rp 115,500.00
68 Kasa Pembalut Hidrofil 4 m x 15 cm rol 40 40 20 20 20 Rp 2,310.00
69 Kasa steril 16 x 16 rol 26 26 16 10 50 Rp 8,800.00
70 Kertas EKG rol 0 0 0 Rp 131,000.00
71 Kertas Saring lembar 0 0 0 Rp 3,000.00
72 Kertas PH lembar 0 0 0 Rp 44,000.00
73 Lancet ktk 0 0 0 Rp 59,000.00
74 Lisol, mengandung Kresol tersabun 50% botol 4 4 0 4 10 Rp 45,100.00
75 Masker 3fly pcs 3260 3260 1400 1860 Rp 605.00
76 Masker 3fly (Bedah) pcs 1200 1200 200 1000 Rp 440.00
77 Mini Blood Glukose Reader set 0 0 0 Rp 965,000.00
78 Multi Check GCU 3 in 1 set 0 0 0 Rp 529,081.00
79 Nassal oxygen M pcs 0 0 0 Rp 10,285.00
80 Nassal oxygen L pcs 0 0 0 Rp 10,285.00
81 Needle G.23 pcs 0 0 0 Rp 800.00
82 Object Glass ktk 0 0 0 Rp 19,400.00
83 Oxycan fortable 500 cc btl 0 0 0
84 oxygen Mask dewasa pcs 0 0 0 Rp 26,015.00
85 oxygen Mask anak pcs 0 0 0 Rp 26,015.00
86 Pemeriksaan Asam Urat ktk 0 0 0 Rp 150,000.00
87 Pemeriksaan Cholesterol ktk 0 0 0 Rp 281,000.00
88 Pemeriksaan Glukosa ktk 0 0 0 Rp 150,000.00
89 Pemeriksaan HB ktk 0 0 0 Rp 230,000.00
90 Pipet Tetes Panjang pcs 0 0 0 Rp 3,990.00
91 Pipet Tetes Pendek pcs 0 0 0 Rp 2,500.00
92 Planotest ktk 0 0 0 Rp 106,645.00
93 Plester 1,25 x 4,5 (kecil) rol 0 0 0 Rp 11,250.00
94 Plester 5 yards x 2 inch rol 0 0 0 Rp 16,692.50
95 Plester 1 inch rol 0 0 0 Rp 8,583.33
96 Plester 0,5 inch rol 0 0 0 Rp 5,125.00
97 Poliaid Sol 1 liter botol 0 0 0 Rp 79,375.00
98 Plastik Sampah Medis 42 Bks 0 0 0 Rp 4,025.00
99 Plastik Sampah Medis 35 Bks 0 0 0 Rp 40,300.00
100 Plastik Larvasida Bks 0 0 0 Rp 20,000.00
101 PGA 3/0 75 - cm ( benang jahit ) box 0 0 0 Rp 309,000.00
102 PGA 2/0 75 - cm ( benang jahit ) box 0 0 0 Rp 301,700.00
103 Polypropilene ( PPL ) benang jahit box 0 0 0 Rp 280,000.00
104 Silk No. 2/0 - 75 cm set 43 43 7 36 Rp 15,750.00
105 Silk No. 3/0 - 75 cm set 42 42 12 30 Rp 15,750.00
106 Silk No. 2/0 - 100 meter rol 1 1 1 0 Rp 752,220.00
107 Silk No. 3/0 - 100 meter rol 1 1 1 0 Rp 689,340.00
108 Slim Seher/Extractor Muccus pcs 0 0 0 Rp 7,744.00
109 Surgical Gloves No. 6,5 pasang 120 120 10 110 100 Rp 7,255.00
110 Surgical Gloves No. 7 pasang 125 125 25 100 100 Rp 7,255.00
111 Surgical Gloves No. 7,5 pasang 100 100 20 80 150 Rp 7,255.00
112 Surgical Gloves No. 8 pasang 100 100 10 90 100 Rp 7,255.00
113 Tabung Edta box 0 0 0 Rp 169,092.00
114 Umbilical Cord Klem Roll 15 15 0 15 50 Rp 3,100.00
115 Urinalisa Strip Ktk 0 0 0 Rp 8,500.00
116 Tas Sample pcs 0 0 0 Rp 300,000.00
117 Ultrasonic Gel botol 13 13 2 11 Rp 13,843.00
118 Umbilical Cord Klem pcs 0 0 0 Rp 3,025.00
119 Urinalisa Strip pcs 0 0 0 Rp 6,500.00
120 Urine bag pcs 0 0 0 Rp 4,719.00

UMUM
TIDAK BPJS JUMLAH
Jumlah kunjungan pasien BAYAR
BAYAR

Jumlah resep ( R/ )
Jumlah resep generik ( R/ )
 Mengetahui/Menyetujui Yang Menyerahkan, Yang Meminta, Yang Menerima,
An. Kepala Dinas Kesehatan Kota Dumai Penanggung Jawab IFK Kota Dumai Kepala Puskesmas Petugas Puskesmas
Kabid. SDK,

MAINI ASNA,SKM.M.Si SARINA ULY,S.Farm,Apt dr. EKA VIORA EFFENDI YAYAK SUHANA S.Far, Apt
NIP. 19680529 198903 2 002 NIP.19790826 201001 2 016 NIP.19830826 200904 1 001 NIP.19800926201001 1 008
 NILAI KET

19 20
Rp 225,360.00
Rp 128,340.00
Rp -
Rp 73,678.00
Rp 102,000.00
Rp 673,350.00
Rp 361,200.00
Rp -
Rp -
Rp 207,000.00
Rp 633,780.00
Rp 351,670.00
Rp 87,320.00
Rp -
Rp -
Rp 13,750.00
Rp 82,800.00
Rp -
Rp 1,553,468.00
Rp 13,400.00
Rp -
Rp 11,800.00
Rp 50,160.00
Rp -
Rp 107,200.00
Rp 299,920.00
Rp -
Rp 20,016.00
Rp -
Rp 86,520.00
Rp 63,600.00
Rp -
Rp 117,700.00
Rp 16,500.00
Rp -
Rp -
Rp 41,360.00
Rp 24,415.00
Rp -
Rp -
Rp 141,664.00
Rp 657,000.00
Rp -
Rp 18,800.00
Rp 911,910.00
Rp 328,750.00
Rp -
Rp 1,621,500.00
Rp -
Rp -
Rp 64,400.00
Rp -
Rp 230,395.00
Rp 224,000.00
Rp 78,020.00
Rp -
Rp 78,000.00
Rp 76,850.00
Rp -
Rp 522,600.00
Rp -
Rp 9,100.00
Rp -
Rp -
Rp 739,860.00
Rp 56,000.00
Rp 471,600.00
Rp 781,440.00
Rp 41,400.00
Rp -
Rp 154,704.00
Rp 436,020.00
Rp -
Rp 155,000.00
Rp 631,332.00
Rp 157,550.00
Rp 215,600.00
Rp -
Rp 331,816.00
Rp 193,700.00
Rp 28,710.00
Rp 32,000.00
Rp 36,500.00
Rp -
Rp 295,240.00
Rp 74,520.00
Rp 35,475.00
Rp 743,560.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 207,100.00
Rp 137,637.00
Rp -
Rp 858,420.00
Rp 110,880.00
Rp 124,000.00
Rp -
Rp -
Rp -
Rp 26,400.00
Rp 1,637,350.00
Rp 93,800.00
Rp 25,540.00
Rp 108,784.00
Rp 745,950.00
Rp -
Rp 400,000.00
Rp -
Rp -
Rp -
Rp 214,650.00
Rp 95,700.00
Rp 17,500.00
 #VALUE!
Rp 97,366.00
Rp -

Rp 1,471,239.00
Rp 38,280.00
Rp 103,397.00
Rp -
Rp -
Rp 185,310.00
Rp 189,360.00
Rp -
Rp -
Rp 711,010.00
Rp 196,320.00
Rp 84,480.00
Rp 2,372,173.00
Rp 825,600.00
Rp -
Rp -
Rp 516,250.00
Rp 785,344.00
Rp -
Rp 89,100.00
Rp -
Rp -
Rp 43,560.00
Rp -
Rp 253,890.00
Rp 217,970.00
Rp -
Rp 122,286.00
Rp 458,600.00
Rp 571,100.00
Rp -
Rp 75,120.00
Rp 281,750.00
Rp -
Rp 290,000.00
Rp -
Rp 321,657.00
Rp -
Rp 155,000.00
Rp -
Rp 12,700.00
Rp -
Rp -
Rp 33,040.00
Rp 1,430,352.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 48,000.00
Rp -
Rp -
Rp -
Rp 42,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 35,000.00
Rp -
Rp -
Rp -
Rp 291,830.00
Rp 280,350.00
Rp 179,010.00
Rp 300,600.00
Rp -
Rp 43,065.00
Rp -
Rp -
Rp 276,000.00
Rp -
Rp 353,920.00
Rp -
Rp 300,000.00
Rp 76,800.00
Rp 106,400.00
Rp -
Rp -
Rp 472,570.00
Rp 176,000.00
Rp 118,800.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 787,320.00
Rp 86,400.00
Rp -
Rp -
Rp -
Rp 237,600.00
Rp 83,000.00
Rp -
Rp 856,800.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,298,700.00
Rp -
Rp -
Rp -
Rp 175,800.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 77,800.00
Rp 21,900.00
Rp 2,134,220.00
Rp 356,200.00
Rp 83,550.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 84,830.00
Rp -
Rp -
Rp -
Rp -
Rp 300,000.00
Rp 126,900.00
Rp 130,000.00
Rp -
Rp 125,000.00
Rp -
Rp -
Rp -
Rp 285,000.00
Rp -
Rp 819,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,742,400.00
Rp -
Rp 990,000.00
Rp -
Rp -
Rp 225,000.00
Rp 610,000.00
Rp -
Rp -
Rp -
Rp 440,000.00
Rp 291,720.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 296,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 492,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 18,900.00
Rp 25,200.00
Rp 12,600.00
Rp 6,300.00
Rp 825,490.80
Rp 717,760.00
Rp 861,312.00
Rp 256,188.00
Rp -
Rp -
Rp -
Rp -
Rp 541,200.00
Rp 590,625.00
Rp -
Rp 141,816.60
Rp 212,724.90
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 357,500.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 66,100.00
Rp 132,200.00
Rp -
Rp -
Rp 310,800.00
Rp 673,800.00
Rp 515,826.00
Rp 162,000.00
Rp 270,600.00
Rp 599,000.00
Rp 2,084,100.00
Rp 1,528,340.00
Rp 1,667,280.00
Rp 2,778,800.00
Rp -
Rp -
Rp 129,000.00
Rp 129,000.00
Rp 129,000.00
Rp 43,000.00
Rp 129,000.00
Rp 172,000.00
Rp 43,000.00
Rp -
Rp -
Rp -
Rp 60,000.00
Rp 137,500.00
Rp -
Rp 46,200.00
Rp 88,000.00
Rp -
Rp -
Rp -
Rp -
Rp 180,400.00
Rp 1,125,300.00
Rp 440,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 567,000.00
Rp 472,500.00
Rp -
Rp -
Rp -
Rp 798,050.00
Rp 725,500.00
Rp 580,400.00
Rp 652,950.00
Rp -
Rp 46,500.00
Rp -
Rp -
Rp 152,273.00
Rp -
Rp -
Rp -
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO )
PUSKESMAS SUNGAI SEMBILAN

Puskesmas : SUNGAI SEMBILAN Pelaporan bulan/periode: MEI 218 Dokumen Nomor Tanggal
Kecamatan: SUNGAI SEMBILAN Permintaan bulan/periode: JUNI 2018 Dinkes Kab/Kota
Kab/Kota : DUMAI IFK Kab/Kota
Propinsi :RIAU Puskesmas

STOK STOK
NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK
OPT.
PERMINTAAN
AWAL
1 2 3 4 5 6 7 8 9 10
1 Albendazol tablet 400 mg tablet 156 156 156
2 Alopurinol tablet 100 mg tablet 180 125
3 Aminofilin tablet 200 mg tablet
4 Aminofilin injeksi 24 mg ampul 3 3
5 Amitriptilin HCl tablet salut 25 mg tablet
6 Amoksisilin kapsul 250 mg kapsul 200 200 400
7 Amoksisilin sirup kering 125 mg/5 ml botol 4 20 24
8 Ampisilin kaplet 500 mg kaplet
9 Ampisilina sirup kering 125 mg/5ml botol 4
10 Antalgin (Metampiron) tablet 500 mg tablet 300 300
11 Antasida DOEN tablet 400 mg tablet 1000 1000
12 Anti Haemorroid DOEN Kombinasi suppos 20 20
13 Antifungi DOEN Kombinasi salep pot 19 19
14 Antimigren DOEN Kombinasi tablet (Ergot-K tablet
15 Antiparkinson DOEN tablet kombinasi tablet
16 Aqua pro Injeksi steril, bebas pirogen ampul 6 6
17 Aquadest steril botol
18 Asam Askorbat (Vit.C) tablet 100 mg tablet
19 Asam Askorbat (Vit C) tablet 50 mg tablet 600 400 1000
20 Asetosal tablet 100 mg tablet
21 Asetosal tablet 500 mg tablet
22 Asetosal 80 mg ( Miniaspi ) tablet
23 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul
24 Betametason krim 0.1% tube 22 22
25 Deksametason injeksi 5 mg/ml - 1 ml ampul 2 12 14
26 Deksametason tablet 0,5 mg tablet 200 500 700
27 Diazepam injeksi 5mg/ml-2 ml ampul
28 Diazepam tablet 2 mg tablet
29 Diazepam tablet 5 mg tablet
30 Difenhidramin HCl injeksi 10 mg/ml - 1 ml ampul 30 30
31 Digoksin tablet 0,25 mg tablet 100 100
32 Efedrin HCl tablet 25 mg tablet
33 Epinefrina HCl/Bitartrat injeksi 0,1% - 1 ml ampul 20 20
34 Etakridin ( Rivanol ) larutan 0,1% botol
35 Fenitoin Natrium kapsul 30 mg kapsul
36 Fenitoin Natrium kapsul 100 mg kapsul
37 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 5 5
38 Fenobarbital tablet 30 mg tablet
39 Fenobarbital tablet 100 mg tablet 150 150
40 Fenol Gliserol tetes telinga 10% botol
41 Fitomenadion (Vit.K1) inj. 10 mg/ml - 1 ml ampul 38 38
42 Fitomenadion (Vit.K1) tablet salut 10 mg tablet 600 600
43 Fluor tablet 0,5mg tablet
44 Furosemid tablet 40 mg tablet 0
45 Garam Oralit untuk 200 ml air kantong 250 250
46 Glibenklamid tablet 5 mg tablet 100 100
47 Gliseril Guayakolat tablet 100 mg tablet
48 Glukosa larutan infus 5 % steril botol 28 80 108
49 Glukosa larutan infus 10 % steril botol
50 Glukosa larutan infus 40 % steril ampul
51 Griseofulvin tablet 125 mg, Micronized tablet 200 200 400
52 Haloperidol tablet 0,5 mg tablet 47 47
53 Haloperidol tablet 1,5 mg tablet
54 Haloperidol tablet 2 mg tablet
55 Haloperidol tablet 5 mg tablet
56 Haloperidol Inj. 5 mg ( Lodomer Inj ) ampul
57 Hidroklorotiazid (HCT) tablet 25 mg tablet 200
58 Hidrokortison krim 2,5 % tube 9
59 Ibuprofen tablet 200 mg tablet
60 Ibuprofen tablet 400 mg tablet 700 300 1000
61 Isosorbid Dinitrat tablet (farsorbid) sublingu tablet
62 Isosorbid Dinitrat tablet sublingual 5 mg tablet
63 Isoniazid 300 mg tablet
64 Isoniazid 100 mg tablet
65 Kalsium Laktat (Kalk) tablet 500 mg tablet 100 300 400
66 Karbamazepin tablet 200 mg tablet
67 Kloramfenikol kapsul 250 mg kapsul 700 700
68 Kloramfenikol kapsul 500 mg kapsul 100 100
69 Kloramfenikol salep mata 1 % tube
70 Kloramfenikol tetes telinga 3 % botol
71 Kloramfenikol Salep Kulit tube
72 Klorfeniramin Maleat (CTM) tablet 4 mg tablet 360 1000 1360
73 Klorpromazin HCl injeksi 5 mg/ml - 2 ml ampul
74 Klorpromazin HCl tablet salut 25 mg tablet 0
75 Klorpromazin HCl tablet salut 100 mg tablet 0
76 Kodein HCl tablet 10 mg tablet 0
77 Kotrimoksazol Adult tablet 480 mg tablet 400 400
78 Kotrimoksazol Pediatrik tablet 120 mg tablet
79 Kotrimoksazol suspensi 240 mg/5ml botol 30 30
80 Lidokain Komp. injeksi - 2 ml ampul 0
81 Lidokain injeksi - 2 ml ampul 8 39 45
82 Magnesium Sulfat injeksi (IV) 20% - 25 ml vial 8 8
83 Magnesium Sulfat injeksi (IV) 40% - 25 ml vial 7 7
84 Mebendazol tablet 100 mg tablet
85 Metilergometrin Maleat inj. 0,200 mg-1 ml ampul 40 40
86 Metilergometrin Maleat tablet salut 0,125mg tablet 100 200 300
87 Natrium Bikarbonat tablet 500 mg tablet 0
88 Natrium Klorida larutan infus 0,9% steril botol 17 80 97
89 Nistatin tablet vaginal 100.000 IU/g tablet 0
90 Nistatin tablet 500.000 IU/g tablet
91 Obat Batuk Hitam ( O.B.H. ) cairan botol 0
92 Oksitetrasiklin HCl salep 3% tube 21 21
93 Oksitetrasiklin HCl salep mata 1% tube 0
94 Oksitosin injeksi 10 IU/ml - 1 ml ampul 22 22
95 Parasetamol sirup 120 mg/5ml botol 6 20 26
96 Parasetamol tablet 100 mg tablet
97 Parasetamol tablet 500 mg tablet 30 1000 1030
98 Pirantel tablet 125 mg tablet 56 56
99 Piridoksin HCl (Vit.B6) tablet 10 mg tablet 300 300
100 Primaquin tablet 15 mg tablet
101 Prednison tablet 5 mg tablet 100 400 500
102 Propiltiourasil tablet 100 mg tablet
103 Propranolol HCl tablet 10 mg tablet
104 Ringer Laktat larutan infus steril botol 8 95 103
105 Salbutamol tablet 2 mg tablet 100 300 400
106 Salep 2-4 , Kombinasi pot 16 16
107 Salisil Bedak 2 % botol 0
108 Serum Anti Bisa Ular Polivalen inj. 5ml (ABU I) vial 0
109 Serum Anti Difteri Injeksi 20.000 IU/vial (ADS) vial 0
110 Serum Anti Tetanus Injeksi 1.500 IU/ampul (ATS) ampul 0
111 Serum Anti Tetanus Injeksi 20.000 IU/vial (ATS) vial 0
112 Sianokobalamin (Vit.B12) inj. 500mcg/ml - 1 ampul 15 20 35
113 Streptomycin injeksi 1 g vial
114 Tablet Tambah Darah kombinasi tablet 200 1000 1200
115 Tetrasiklin HCl kapsul 500 mg kapsul 0
116 Tiamin HCl (Vit.B1) injeksi 100 mg/ml-1 ml ampul 0
117 Tiamin HCl (Vit.B1) tablet 100 mg tablet 100 100
118 Tiamin HCl (Vit.B1) tablet 50 mg tablet 0
119 Tetagam Injeksi Ampul 4 4
120 Triheksifenidil Hidroklorida tablet 2 mg tablet 0
121 Vitamin B-Kompleks tablet tablet 200 1000 1200
122 Yodium Povidon 10% 30 ml botol 5 5
123 Yodium Povidon 10% 300 ml botol 1 1

1 Acyclovir cream tube

2 Acyclovir tablet 200 mg tablet 200 200
3 Acyclovir tablet 400 mg tablet 200 200
4 Alprazolam tablet 0,25 mg tablet
5 Ambroxol sirup botol
6 Ambroxol tablet 30 mg tablet 100 500 600
7 Amlodipin tablet 10 mg tablet 100 100
8 Amlodipin tablet 5 mg tablet 200 150 350
9 Amoksisilin kapsul 500 mg kapsul 1000 1000
10 Amoksisilin sirup 250 mg botol 14 14
11 Amoxicillin + As.Clavulanat (Co-Amoksiklav tablet
12 Ampicillin injeksi 1 gr vial
13 Antasida sirup botol 20 20
14 Asam Mefenamat tablet 500 mg tablet 500 500
15 Azitromicin kapsul 500 mg kapsul
16 Betahistin Mesilat tablet 6 mg tablet 0
17 Benzatin benzil penisillin 2,4 jt iu vial
18 benzatin bensil penisillin 1,2 jt iu vial 16 16
19 Bisoprolol tablet 5 mg tablet 0
20 Calsium Gluconas injeksi ampul 51 51
21 Captopril tablet 12,5 mg tablet 200 200 400
22 Captopril tablet 25 mg tablet 100 200 300
23 Captopril tablet 50 mg tablet 0 0
24 Cefadroxil kapsul 500mg kapsul 100 200 300
25 Cefadroxil sirup 125 mg/5 ml botol 8 8
26 Cefadroxil sirup 250 mg/5 ml botol 10 10
27 Cefixim syrup botol
28 Cefixim kapsul 100 mg kapsul 140 140
29 Cefotaxim injeksi 1,0 gram vial 42 42
30 Ceftriaxone injeksi vial
31 Cetirizin tablet 10 mg tablet 0 0
32 Cimetidin tablet 200 mg tablet 100 200 300
33 Ciprofloxacin tablet 500 mg tablet 300 500
34 Clobazam tablet tablet 22 22
35 Clozapine tablet 25 mg tablet 10 22
36 Dikloxacillin tablet 125 mg tablet
37 Diltiazem tablet 30 mg tablet 0
38 Dimenhydrinate tablet 50 mg tablet 100 100
39 Doksisiklin tablet 100mg tablet 0 0
40 Domperidon tablet 10 mg tablet 200 200
41 Erythromycin kapsul 250 mg kapsul 0 0
42 Erythromycin kapsul 500 mg kapsul 0 0
43 Erythromycin sirup botol 16 16
44 Famotidin tablet 20 mg tablet 0 0
45 Famotidin tablet 40 mg tablet 0 0
46 Flukonazole kapsul 50 mg kapsul 0 0
47 Flukonazole kapsul 150 mg kapsul 0 0
48 Furosemid injeksi ampul 25 25
49 Flufenazin injeksi ( sikzonoat ) ampul 0
50 Gentamicin Salep Kulit 1 % tube 0
51 Gentamicin injeksi 40 mg /2 ml ampul 0
52 Gentamicin tetes mata 0,3% botol 0
53 Gentamicin salep mata tube 31 31
54 Gentian Violet 1 % botol 22 22
55 Glimepiride tablet 1 mg tablet 100 100
56 Glimepiride tablet 2 mg tablet 55 55
57 Kalium Diklofenak tablet 25 mg tablet
58 Kalium Diklofenak tablet 50 mg tablet
59 Kalium Permanganat (PK Kristal) botol
60 Ketokonazol cream tube 0
61 Ketokonazol tablet 200 mg tablet
62 Ketoprofen tablet 50 mg tablet
63 Klindamicin kapsul 150 mg kapsul 0
64 Klindamicin kapsul 300 mg kapsul 0
65 Kloramfenikol sirup botol 0
66 Lansoprazole kapsul 30 mg kapsul 0
67 Levofloksasin tablet 500 mg tablet
68 Loperamid tablet tablet 50 50
69 Meloksicam tablet 15 mg tablet
70 Meloksicam tablet 7,5 mg tablet
71 Metformin tablet 500 mg tablet 0
72 Metil prednisolon tablet 4 mg tablet 200 200
73 Metil prednisolon tablet 8 mg tablet 200 200
74 Metoklopramid injeksi ampul 0
75 Metoklopramid tablet tablet 200 200
76 Metronidazol tablet 250 mg tablet 105 105
77 Metronidazol tablet 500 mg tablet 200 200
78 Miconazol cream tube 20
79 Mineral mix sachet
80 Natr.Diklofenak tablet 25 mg tablet 200 200
81 Natr.Diklofenak tablet 50 mg tablet 200 200
82 Nifedipin tablet tablet 200 200
83 Ofloxacin kapsul 200 mg kapsul
84 Omeprazole kapsul 20 mg kapsul
85 Obat Anti Tuberkulosis (OAT) FDC Kategori paket
86 Papaverin tablet 40 mg tablet 480 480
87 Parasetamol Drops botol
88 Piroxicam tablet 20 mg tablet 400 400
89 Ranitidin injeksi ampul 18 10 28
90 Ranitidin tablet 150 mg tablet
91 Risperidon tablet 1 mg tablet
92 Risperidon tablet 2 mg tablet
93 Risperidon tablet 3 mg tablet 28
94 Salbutamol tablet 4 mg tablet 100 200 300
95 Simvastatin tablet 10 mg tablet
96 Simvastatin tablet 20 mg tablet 178 178
97 Thiamfenicol kapsul 500 mg kapsul
98 Tramadol injeksi 50 mg/ml ampul
99 Tramadol tablet 50 mg tablet
100 Tranexamic acid 5% Injeksi ampul 4 4
101 Trifluoperazine tablet 5 mg tablet
102 Zink Dispersible tablet tablet 97 500 597
103 Zink ID 10 mg /5 ml syrup botol

1 Albothyl Concentrat botol

2 Adver kapsul kapsul
3 Bactricid Forte tablet tablet
4 Becefort sirup botol
5 Becefort tablet tablet
6 Bekarbon (Norit) tablet tablet
7 Beneuron tablet tablet
8 Betafort sirup botol
9 Betason-N cream tube
10 Benoson - N tube
11 Bioneuron tablet tablet
12 Bioplacenton jelly tube
13 Bioplacenton tulle lembar
14 Bionic sirup botol 6 10 26
15 Burnazin cream 500 gr pot
16 Cendo Xitrol e.d botol
17 Chloramphecort cream tube
18 Combivent Nebulizer ampul 10 10
19 Coparcetin kaplet kaplet
20 Dasabion tablet tablet
21 Dulcolax supp.10 mg supp
22 Dulcolax supp.5 mg supp
23 Dulcolax tablet 5 mg tablet
24 Enzymfort tablet tablet
25 Freshcare kotak
26 Haldol Decanoas inj. (Long Acting) ampul
27 Hemafort tablet tablet 55 200 255
28 Inamid tablet tablet
29 Isotic Clearens tetes mata botol
30 Isotic Neolyson tetes mata botol
31 Kanamycin injeksi 1 gr vial
32 Kanamycin injeksi 2 gr vial
33 Kontrasepsi (Depo) injeksi vial
34 Lacbon tablet tablet
35 Livron B Plex tab tablet
36 Laxana boks
37 Miratrim forte tab tablet 100 100
38 Miraneuro tablet
39 Neuromed tablet tablet
40 Neo- Diaform tab tablet
41 Neurovit-E tablet tablet
42 Nodiar tablet tablet
43 Novakid-Plus sirup botol
44 Noza tablet tablet
45 OBH Indo Plus sirup botol 7 10 18
46 Pehatrim Forte tablet tablet
47 Pehavral tablet tablet
48 Plasminex tab tablet
49 Prolysin sirup botol
50 Proris Suppos supp
51 Panvit c tablet 100 200 300
52 Rohto tetes mata botol
53 Scabicid cream pot
54 Siobion kaps kapsul
55 Stesolid Rectal 10 mg supp
56 Stesolid Rectal 5 mg supp
57 Supraflu tablet tablet
58 Tuzalos kapsul kapsul
59 Ventolin Nebulizer ampul
60 Verorab 0.5 ml ( Vaksin ) ampul
61 infantrim forte tablet

1 Aesculap No. 11 ( Pisau Operasi ) pcs

2 Aesculap No. 15 ( Pisau Operasi ) pcs
3 Aesculap No. 20 ( Pisau Operasi ) pcs
4 Aesculap No. 21 ( Pisau Operasi ) pcs
5 Alat suntik sekali pakai 1 ml set
6 Alat suntik sekali pakai 2,5 ml set 100 100 200
7 Alat suntik sekali pakai 3 ml set
8 Alat suntik sekali pakai 5 ml set 100
9 Alat suntik sekali pakai 10 ml set
10 Alkohol Swab kotak
11 Alkacid botol
12 Blood Lancet pcs
13 Catgut Chromic No. 2/0 (75 cm) set
14 Catgut Chromic No.3/0 (75 cm) set 15 15
15 Catgut Chromic No.2/0 (90 cm) box 24 24
16 Catgut Plain No. 2/0 (75 cm) set
17 Catgut Plain No.3/0 (75 cm) set
18 Catgut Chromic No.1/0 - 75 meter rol
19 Catgut Chromic No.2/0 - 100 meter rol
20 Catgut Chromic No.3/0 - 100 meter rol
21 Catgut Plain No.2/0 - 75 meter rol
22 Cotton Aplikator pak
23 Deck Glass pcs
24 Duk Bolong Small drapers pcs
25 Elastis bandage 10cm X 4,57m (no.4) rol
26 Elastis bandage 15cm X 4,57m (no.6) rol
27 Elastis bandage 7,5cm X 4,57m (no.3) rol
28 Etanol 70% botol 1 1
29 Feeding Tube No.12 pcs
30 Feeding Tube No.16 pcs
31 Feeding Tube No.3.5 pcs
32 Feeding Tube No.5 pcs
33 Feeding Tube No.8 pcs
34 Foley Catheter 2 way 12 Fr pcs
35 Foley Catheter 2 way 14 Fr pcs
36 Foley Catheter 2 way 16 Fr pcs
37 Foley Catheter 2 way 18 Fr pcs
38 Glukose Test Tip pcs
39 Handschoen non steril L pasang 100 100 100 0
40 Handschoen non steril M pasang 100 100 100 0
41 Handrub 500 ml botol
42 Handrub 5 L galon
43 Handscrub 500 ml botol
44 Handscrub 5 L galon
45 Hypafix 15 cm x 5 m rol 1 1
46 Hypafix 5 cm x 5 m rol 2 2
47 Infusion set Anak set 7 60 67
48 Infusion set Dewasa set 40 40 80
49 IV Catheter No. 18 set 62 62 5 57
50 IV Catheter No. 20 set 50 50
51 IV Catheter No. 22 set 50 50
52 IV Catheter No. 24 set 50 50
53 Isolasi Steril pcs
54 Jarum Infiltrasi / Needle Citojet ktk
55 Jarum Jahit (Bedah) No. 10 lsn 8 8
56 Jarum Jahit (Bedah) No. 11 lsn 6 6
57 Jarum Jahit (Bedah) No. 12 lsn 8 8
58 Jarum Jahit (Bedah) No. 13 lsn
59 Jarum Jahit (Bedah) No. 14 lsn 5 5
60 Jarum Jahit (Bedah) No. 9 lsn 7 7
61 Jarum Jahit Segitiga No.G 12 lsn
62 Jarum Jahit Segitiga No.G 14 lsn
63 Jarum Otot pcs
64 Jarum Tabung Edta/ Vacutainer box
65 Kapas 100 gram rol 2 2 1 1
66 Kapas Pembalut/Absorbent 250 gram rol
67 Kasa 40 x 80 rol 2 2 1 1
68 Kasa Pembalut Hidrofil 4 m x 15 cm rol
69 Kasa steril 16 x 16 rol 5 5 5 0
70 Kertas EKG rol
71 Kertas Saring lembar
72 Kertas PH lembar
73 Lancet ktk
74 Lisol, mengandung Kresol tersabun 50% botol
75 Masker 3fly pcs 100 100 100 0
76 Masker 3fly (Bedah) pcs
77 Mini Blood Glukose Reader set
78 Multi Check GCU 3 in 1 set
79 Nassal oxygen M pcs
80 Nassal oxygen L pcs
81 Needle G.23 pcs
82 Object Glass ktk
83 Oxycan fortable 500 cc btl
84 oxygen Mask dewasa pcs
85 oxygen Mask anak pcs
86 Pemeriksaan Asam Urat ktk
87 Pemeriksaan Cholesterol ktk
88 Pemeriksaan Glukosa ktk
89 Pemeriksaan HB ktk
90 Pipet Tetes Panjang pcs
91 Pipet Tetes Pendek pcs
92 Planotest ktk
93 Plester 1,25 x 4,5 (kecil) rol
94 Plester 5 yards x 2 inch rol
95 Plester 1 inch rol
96 Plester 0,5 inch rol
97 Poliaid Sol 1 liter botol
98 Plastik Sampah Medis 42 Bks
99 Plastik Sampah Medis 35 Bks
100 Plastik Larvasida Bks
101 PGA 3/0 75 - cm ( benang jahit ) box
102 PGA 2/0 75 - cm ( benang jahit ) box
103 Polypropilene ( PPL ) benang jahit box
104 Silk No. 2/0 - 75 cm set 12 12
105 Silk No. 3/0 - 75 cm set
106 Silk No. 2/0 - 100 meter rol
107 Silk No. 3/0 - 100 meter rol
108 Slim Seher/Extractor Muccus pcs
109 Surgical Gloves No. 6,5 pasang
110 Surgical Gloves No. 7 pasang
111 Surgical Gloves No. 7,5 pasang
112 Surgical Gloves No. 8 pasang
113 Tabung Edta box
114 Umbilical Cord Klem Roll
115 Urinalisa Strip Ktk
116 Tas Sample pcs
117 Ultrasonic Gel botol
118 Urine bag pcs

0 0
UMUM
TIDAK BPJS JUMLAH
Jumlah kunjungan pasien BAYAR
BAYAR

Jumlah resep ( R/ )
Jumlah resep generik ( R/ )

Mengetahui/Menyetujui Yang Menyerahkan,

KEPALA RUANGAN IGD Penanggung jawab Apotek IGD

ELVITRIA AGUSTINA, Amd.Keb MUHAMMAD BAHRUL ULUM,Amd.Farm

19860830200904 2 002
Albendazol tablet 400 mg tablet
Alopurinol tablet 100 mg tablet
Aminofilin tablet 200 mg tablet
Aminofilin injeksi 24 mg ampul
Amitriptilin HCl tablet salut 25 mg tablet
Amoksisilin kapsul 250 mg kapsul
Amoksisilin sirup kering 125 mg/5 ml botol
Ampisilin kaplet 500 mg kaplet
Ampisilina sirup kering 125 mg/5ml botol
Antalgin (Metampiron) tablet 500 mg tablet
Antasida DOEN tablet 400 mg tablet
Anti Haemorroid DOEN Kombinasi suppos
Antifungi DOEN Kombinasi salep pot
Antimigren DOEN Kombinasi tablet (Ergot-Kofein) tablet
Antiparkinson DOEN tablet kombinasi tablet
Aqua pro Injeksi steril, bebas pirogen ampul
Aquadest steril botol
Asam Askorbat (Vit.C) tablet 100 mg tablet
Asam Askorbat (Vit C) tablet 50 mg tablet
Asetosal tablet 100 mg tablet
Asetosal tablet 500 mg tablet
Asetosal 80 mg ( Miniaspi ) tablet
Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul
Betametason krim 0.1% tube
Deksametason injeksi 5 mg/ml - 1 ml ampul
Deksametason tablet 0,5 mg tablet
Diazepam injeksi 5mg/ml-2 ml ampul
Diazepam tablet 2 mg tablet
Diazepam tablet 5 mg tablet
Difenhidramin HCl injeksi 10 mg/ml - 1 ml ampul
Digoksin tablet 0,25 mg tablet
Efedrin HCl tablet 25 mg tablet
Epinefrina HCl/Bitartrat injeksi 0,1% - 1 ml ampul
Etakridin ( Rivanol ) larutan 0,1% botol
Fenitoin Natrium kapsul 30 mg kapsul
Fenitoin Natrium kapsul 100 mg kapsul
Fenobarbital injeksi 50 mg/ml - 2 ml ampul
Fenobarbital tablet 30 mg tablet
Fenobarbital tablet 100 mg tablet
Fenol Gliserol tetes telinga 10% botol
Fitomenadion (Vit.K1) inj. 10 mg/ml - 1 ml ampul
Fitomenadion (Vit.K1) tablet salut 10 mg tablet
Fluor tablet 0,5mg tablet
Furosemid tablet 40 mg tablet
Garam Oralit untuk 200 ml air kantong
Glibenklamid tablet 5 mg tablet
Gliseril Guayakolat tablet 100 mg tablet
Glukosa larutan infus 5 % steril botol
Glukosa larutan infus 10 % steril botol
Glukosa larutan infus 40 % steril ampul
Griseofulvin tablet 125 mg, Micronized tablet
Haloperidol tablet 0,5 mg tablet
Haloperidol tablet 1,5 mg tablet
Haloperidol tablet 2 mg tablet
Haloperidol tablet 5 mg tablet
Haloperidol Inj. 5 mg ( Lodomer Inj ) ampul
Hidroklorotiazid (HCT) tablet 25 mg tablet
Hidrokortison krim 2,5 % tube
Ibuprofen tablet 200 mg tablet
Ibuprofen tablet 400 mg tablet
Isosorbid Dinitrat tablet (farsorbid) sublingual 10 mg tablet
Isosorbid Dinitrat tablet sublingual 5 mg tablet
Isoniazid 300 mg tablet
Isoniazid 100 mg tablet
Kalsium Laktat (Kalk) tablet 500 mg tablet
Karbamazepin tablet 200 mg tablet
Kloramfenikol kapsul 250 mg kapsul
Kloramfenikol kapsul 500 mg kapsul
Kloramfenikol salep mata 1 % tube
Kloramfenikol tetes telinga 3 % botol
Kloramfenikol Salep Kulit tube
Klorfeniramin Maleat (CTM) tablet 4 mg tablet
Klorpromazin HCl injeksi 5 mg/ml - 2 ml ampul
Klorpromazin HCl tablet salut 25 mg tablet
Klorpromazin HCl tablet salut 100 mg tablet
Kodein HCl tablet 10 mg tablet
Kotrimoksazol Adult tablet 480 mg tablet
Kotrimoksazol Pediatrik tablet 120 mg tablet
Kotrimoksazol suspensi 240 mg/5ml botol
Lidokain Komp. injeksi - 2 ml ampul
Lidokain injeksi - 2 ml ampul
Magnesium Sulfat injeksi (IV) 20% - 25 ml vial
Magnesium Sulfat injeksi (IV) 40% - 25 ml vial
Mebendazol tablet 100 mg tablet
Metilergometrin Maleat inj. 0,200 mg-1 ml ampul
Metilergometrin Maleat tablet salut 0,125mg tablet
Natrium Bikarbonat tablet 500 mg tablet
Natrium Klorida larutan infus 0,9% steril botol
Nistatin tablet vaginal 100.000 IU/g tablet
Nistatin tablet 500.000 IU/g tablet
Obat Batuk Hitam ( O.B.H. ) cairan botol
Oksitetrasiklin HCl salep 3% tube
Oksitetrasiklin HCl salep mata 1% tube
Oksitosin injeksi 10 IU/ml - 1 ml ampul
Parasetamol sirup 120 mg/5ml botol
Parasetamol tablet 100 mg tablet
Parasetamol tablet 500 mg tablet
Pirantel tablet 125 mg tablet
Piridoksin HCl (Vit.B6) tablet 10 mg tablet
Primaquin tablet 15 mg tablet
Prednison tablet 5 mg tablet
Propiltiourasil tablet 100 mg tablet
Propranolol HCl tablet 10 mg tablet
Ringer Laktat larutan infus steril botol
Salbutamol tablet 2 mg tablet
Salep 2-4 , Kombinasi pot
Salisil Bedak 2 % botol
Serum Anti Bisa Ular Polivalen inj. 5ml (ABU I) vial
Serum Anti Difteri Injeksi 20.000 IU/vial (ADS) vial
Serum Anti Tetanus Injeksi 1.500 IU/ampul (ATS) ampul
Serum Anti Tetanus Injeksi 20.000 IU/vial (ATS) vial
Sianokobalamin (Vit.B12) inj. 500mcg/ml - 1ml ampul
Streptomycin injeksi 1 g vial
Tablet Tambah Darah kombinasi tablet
Tetrasiklin HCl kapsul 500 mg kapsul
Tiamin HCl (Vit.B1) injeksi 100 mg/ml-1 ml ampul
Tiamin HCl (Vit.B1) tablet 100 mg tablet
Tiamin HCl (Vit.B1) tablet 50 mg tablet
Tetagam Injeksi Ampul
Triheksifenidil Hidroklorida tablet 2 mg tablet
Vitamin B-Kompleks tablet tablet
Yodium Povidon 10% 30 ml botol
Yodium Povidon 10% 300 ml botol

Acyclovir cream tube

Acyclovir tablet 200 mg tablet
Acyclovir tablet 400 mg tablet
Alprazolam tablet 0,25 mg tablet
Ambroxol sirup botol
Ambroxol tablet 30 mg tablet
Amlodipin tablet 10 mg tablet
Amlodipin tablet 5 mg tablet
Amoksisilin kapsul 500 mg kapsul
Amoksisilin sirup 250 mg botol
Amoxicillin + As.Clavulanat (Co-Amoksiklav) tablet
Ampicillin injeksi 1 gr vial
Antasida sirup botol
Asam Mefenamat tablet 500 mg tablet
Azitromicin kapsul 500 mg kapsul
Betahistin Mesilat tablet 6 mg tablet
Benzatin benzil penisillin 2,4 jt iu vial
benzatin bensil penisillin 1,2 jt iu vial
Bisoprolol tablet 5 mg tablet
Calsium Gluconas injeksi ampul
Captopril tablet 12,5 mg tablet
Captopril tablet 25 mg tablet
Captopril tablet 50 mg tablet
Cefadroxil kapsul 500mg kapsul
Cefadroxil sirup 125 mg/5 ml botol
Cefadroxil sirup 250 mg/5 ml botol
Cefixim syrup botol
Cefixim kapsul 100 mg kapsul
Cefotaxim injeksi 1,0 gram vial
Ceftriaxone injeksi vial
Cetirizin tablet 10 mg tablet
Cimetidin tablet 200 mg tablet
Ciprofloxacin tablet 500 mg tablet
Clobazam tablet tablet
Clozapine tablet 25 mg tablet
Dikloxacillin tablet 125 mg tablet
Diltiazem tablet 30 mg tablet
Dimenhydrinate tablet 50 mg tablet
Doksisiklin tablet 100mg tablet
Domperidon tablet 10 mg tablet
Erythromycin kapsul 250 mg kapsul
Erythromycin kapsul 500 mg kapsul
Erythromycin sirup botol
Famotidin tablet 20 mg tablet
Famotidin tablet 40 mg tablet
Flukonazole kapsul 50 mg kapsul
Flukonazole kapsul 150 mg kapsul
Furosemid injeksi ampul
Flufenazin injeksi ( sikzonoat ) ampul
Gentamicin Salep Kulit 1 % tube
Gentamicin injeksi 40 mg /2 ml ampul
Gentamicin tetes mata 0,3% botol
Gentamicin salep mata tube
Gentian Violet 1 % botol
Glimepiride tablet 1 mg tablet
Glimepiride tablet 2 mg tablet
Kalium Diklofenak tablet 25 mg tablet
Kalium Diklofenak tablet 50 mg tablet
Kalium Permanganat (PK Kristal) botol
Ketokonazol cream tube
Ketokonazol tablet 200 mg tablet
Ketoprofen tablet 50 mg tablet
Klindamicin kapsul 150 mg kapsul
Klindamicin kapsul 300 mg kapsul
Kloramfenikol sirup botol
Lansoprazole kapsul 30 mg kapsul
Levofloksasin tablet 500 mg tablet
Loperamid tablet tablet
Meloksicam tablet 15 mg tablet
Meloksicam tablet 7,5 mg tablet
Metformin tablet 500 mg tablet
Metil prednisolon tablet 4 mg tablet
Metil prednisolon tablet 8 mg tablet
Metoklopramid injeksi ampul
Metoklopramid tablet tablet
Metronidazol tablet 250 mg tablet
Metronidazol tablet 500 mg tablet
Miconazol cream tube
Mineral mix sachet
Natr.Diklofenak tablet 25 mg tablet
Natr.Diklofenak tablet 50 mg tablet
Nifedipin tablet tablet
Ofloxacin kapsul 200 mg kapsul
Omeprazole kapsul 20 mg kapsul
Obat Anti Tuberkulosis (OAT) FDC Kategori Anak paket
Papaverin tablet 40 mg tablet
Parasetamol Drops botol
Piroxicam tablet 20 mg tablet
Ranitidin injeksi ampul
Ranitidin tablet 150 mg tablet
Risperidon tablet 1 mg tablet
Risperidon tablet 2 mg tablet
Risperidon tablet 3 mg tablet
Salbutamol tablet 4 mg tablet
Simvastatin tablet 10 mg tablet
Simvastatin tablet 20 mg tablet
Thiamfenicol kapsul 500 mg kapsul
Tramadol injeksi 50 mg/ml ampul
Tramadol tablet 50 mg tablet
Tranexamic acid 5% Injeksi ampul
Trifluoperazine tablet 5 mg tablet
Zink Dispersible tablet tablet
Zink ID 10 mg /5 ml syrup botol

Albothyl Concentrat botol

Adver kapsul kapsul
Bactricid Forte tablet tablet
Becefort sirup botol
Becefort tablet tablet
Bekarbon (Norit) tablet tablet
Beneuron tablet tablet
Betafort sirup botol
Betason-N cream tube
Benoson - N tube
Bioneuron tablet tablet
Bioplacenton jelly tube
Bioplacenton tulle lembar
Bionic sirup botol
Burnazin cream 500 gr pot
Cendo Xitrol e.d botol
Chloramphecort cream tube
Combivent Nebulizer ampul
Corpacetin kaplet kaplet
Dasabion tablet tablet
Dulcolax supp.10 mg supp
Dulcolax supp.5 mg supp
Dulcolax tablet 5 mg tablet
Enzymfort tablet tablet
Freshcare kotak
Haldol Decanoas inj. (Long Acting) ampul
Hemafort tablet tablet
Inamid tablet tablet
Isotic Clearens tetes mata botol
Isotic Neolyson tetes mata botol
Kanamycin injeksi 1 gr vial
Kanamycin injeksi 2 gr vial
Kontrasepsi (Depo) injeksi vial
Lacbon tablet tablet
Livron B Plex tab tablet
Laxana boks
Miratrim forte tab tablet
Miraneuro tablet
Neuromed tablet tablet
Neo- Diaform tab tablet
Neurovit-E tablet tablet
Nodiar tablet tablet
Novakid-Plus sirup botol
Noza tablet tablet
OBH Indo Plus sirup botol
Pehatrim Forte tablet tablet
Pehavral tablet tablet
Plasminex tab tablet
Prolysin sirup botol
Proris Suppos supp
Panvit c tablet
Rohto tetes mata botol
Scabicid cream pot
Siobion kaps kapsul
Stesolid Rectal 10 mg supp
Stesolid Rectal 5 mg supp
Supraflu tablet tablet
Tuzalos kapsul kapsul
Ventolin Nebulizer ampul
Verorab 0.5 ml ( Vaksin ) ampul

Laboratorium :
Asam Klorida 0,1 N botol
ALT (GPT) kit
AST(GOT) kit
Aluminium kit
Asam Asetat btl
Aquadest liter
Borax test kit kit
Bola Hisap pcs
Bros tabung reaksi pcs
Baterai PH Meter pcs
Baterai Spektro pcs
BGLB 500 gr botol
Benang Rami rol
Buret Coklat pcs
Cholesterol PAP SL (6x100 ml) box
Chloride kit
Cleanser - ZN 244 1 liter botol
Cleaning kit botol
Concentrat Cleanser botol
Con.diff normal 16 Parameter ( Hematologi ) Tube
Control - N botol
Cyan Haemoglobin botol
Charger Spektro pcs
Diluent ZN 244 20 liter botol
Dual Pack Lyse + Diluen set
EZ Cleanser botol
Erlenmeyer 250 ml pcs
Formalin test kit
Flouride kit
Glucose PAP SL (6x100 ml) ktk
Gelas Ukur 500 ml pcs
Gunting Kecil pcs
iron kit
iodine test btl
Karet Gelang kg
Larutan Alkohol 96% botol
Larutan Asam Asetat 6% botol
Larutan Benedict botol
Larutan Edta 10% botol
Larutan Eosin 2% botol
Larutan Etanol Asam botol
Larutan Fuksin botol
Larutan Giemsa Stain botol
Larutan H2O2 botol
Larutan Hayem botol
Larutan Imersion Oil botol
Larutan Iodium botol
Larutan Karbol Fuksin botol
Larutan KOH 10% botol
Larutan Metilen Biru botol
Larutan Na.Sitrat botol
Larutan NaCl 0,86% botol
Larutan Reesecher botol
Larutan Serum Gol.Darah set
Larutan Turk botol
Larutan Widal Type H/O set
Larutan Xylen botol
Lyse ZN 244 500ml box
Lidi kapas / Dacron kotak
Larutan Kalibrasi PH 4,0 botol
Larutan Kalibrasi PH 7,0 botol
Larutan Kalibrasi PH 10.0 botol
Lactosa Broth 500 gr botol
Metanol botol
Manganese kit
Nitrat kit
Nitrit kit
PH meter pcs
Rinse botol
Rectangular cells Quartz 10 mm botol
Rohdamin test kit
Reagen HIV I ( Oncoprobe ) ktk
Reagen HIV II ( Intec ) ktk
Sphyllis Diagnostic Rapid Test box
Spiritus Bakar botol
Sulfat kit
Triglycerid box
Tabung Durham pcs
Tabung Serum bngks
Tabung Reaksi pcs
Timbangan Digital pcs
Uric Acid Mono SL (6x50 ml) box
Univ. Indikator PH 0-14 kit

Obat Gigi :
Alvogil kotak
Boonding botol
Calsium Hydroxide/Hydcal kotak
Cresophen botol
Dentine Conditioner kotak
Devitec kotak
Etching botol
Etil Klorida semprot botol
Eugenol cairan botol
Glass Ionomer Cement Anterior kotak
Glass Ionomer Cement Art kotak
Glass Ionomer Cement Posterior kotak
Kavit kotak
Ketricin kotak
MonoKlorKamferMentol Cairan (CHKM) botol
Occo botol
Retin Composit/Solare kotak
Scandonest 3% carpule
Semen Seng Fosfat serbuk dan cairan botol
Spons Gelatin Cubicles 1 x 1 x 1 cm kotak
Zinc Oxide Cement kotak
Xylocain 2% jelly pcs

Aesculap No. 11 ( Pisau Operasi ) pcs

Aesculap No. 15 ( Pisau Operasi ) pcs
Aesculap No. 20 ( Pisau Operasi ) pcs
Aesculap No. 21 ( Pisau Operasi ) pcs
Alat suntik sekali pakai 1 ml set
Alat suntik sekali pakai 2,5 ml set
Alat suntik sekali pakai 3 ml set
Alat suntik sekali pakai 5 ml set
Alat suntik sekali pakai 10 ml set
Alkohol Swab kotak
Alkacid botol
Blood Lancet pcs
Catgut Chromic No. 2/0 (75 cm) set
Catgut Chromic No.3/0 (75 cm) set
Catgut Chromic No.2/0 (90 cm) box
Catgut Plain No. 2/0 (75 cm) set
Catgut Plain No.3/0 (75 cm) set
Catgut Chromic No.1/0 - 75 meter rol
Catgut Chromic No.2/0 - 100 meter rol
Catgut Chromic No.3/0 - 100 meter rol
Catgut Plain No.2/0 - 75 meter rol
Cotton Aplikator pak
Deck Glass pcs
Duk Bolong Small drapers pcs
Elastis bandage 10cm X 4,57m (no.4) rol
Elastis bandage 15cm X 4,57m (no.6) rol
Elastis bandage 7,5cm X 4,57m (no.3) rol
Etanol 70% botol
Feeding Tube No.12 pcs
Feeding Tube No.16 pcs
Feeding Tube No.3.5 pcs
Feeding Tube No.5 pcs
Feeding Tube No.8 pcs
Foley Catheter 2 way 12 Fr pcs
Foley Catheter 2 way 14 Fr pcs
Foley Catheter 2 way 16 Fr pcs
Foley Catheter 2 way 18 Fr pcs
Glukose Test Tip pcs
Handschoen non steril L pasang
Handschoen non steril M pasang
Handrub 500 ml botol
Handrub 5 L galon
Handscrub 500 ml botol
Handscrub 5 L galon
Hypafix 15 cm x 5 m rol
Hypafix 5 cm x 5 m rol
Infusion set Anak set
Infusion set Dewasa set
IV Catheter No. 18 set
IV Catheter No. 20 set
IV Catheter No. 22 set
IV Catheter No. 24 set
Isolasi Steril pcs
Jarum Infiltrasi / Needle Citojet ktk
Jarum Jahit (Bedah) No. 10 lsn
Jarum Jahit (Bedah) No. 11 lsn
Jarum Jahit (Bedah) No. 12 lsn
Jarum Jahit (Bedah) No. 13 lsn
Jarum Jahit (Bedah) No. 14 lsn
Jarum Jahit (Bedah) No. 9 lsn
Jarum Jahit Segitiga No.G 12 lsn
Jarum Jahit Segitiga No.G 14 lsn
Jarum Otot pcs
Jarum Tabung Edta/ Vacutainer box
Kapas 100 gram rol
Kapas Pembalut/Absorbent 250 gram rol
Kasa 40 x 80 rol
Kasa Pembalut Hidrofil 4 m x 15 cm rol
Kasa steril 16 x 16 kotak
Kertas EKG rol
Kertas Saring lembar
Kertas PH lembar
Lancet ktk
Lisol, mengandung Kresol tersabun 50% botol
Masker 3fly pcs
Masker 3fly (Bedah) pcs
Mini Blood Glukose Reader set
Multi Check GCU 3 in 1 set
Nassal oxygen M pcs
Nassal oxygen L pcs
Needle G.23 pcs
Object Glass ktk
Oxycan fortable 500 cc btl
oxygen Mask dewasa pcs
oxygen Mask anak pcs
Pemeriksaan Asam Urat ktk
Pemeriksaan Cholesterol ktk
Pemeriksaan Glukosa ktk
Pemeriksaan HB ktk
Pipet Tetes Panjang pcs
Pipet Tetes Pendek pcs
Planotest ktk
Plester 1,25 x 4,5 (kecil) rol
Plester 5 yards x 2 inch rol
Plester 1 inch rol
Plester 0,5 inch rol
Poliaid Sol 1 liter botol
Plastik Sampah Medis 42 Bks
Plastik Sampah Medis 35 Bks
Plastik Larvasida Bks
PGA 3/0 75 - cm ( benang jahit ) box
PGA 2/0 75 - cm ( benang jahit ) box
Polypropilene ( PPL ) benang jahit box
Silk No. 2/0 - 75 cm set
Silk No. 3/0 - 75 cm set
Silk No. 2/0 - 100 meter rol
Silk No. 3/0 - 100 meter rol
Slim Seher/Extractor Muccus pcs
Surgical Gloves No. 6,5 pasang
Surgical Gloves No. 7 pasang
Surgical Gloves No. 7,5 pasang
Surgical Gloves No. 8 pasang
Tabung Edta box
96 Roll
97 Ktk
Tas Sample pcs
Ultrasonic Gel botol
Umbilical Cord Klem pcs
Urinalisa Strip pcs
Urine bag pcs