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LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) OBAT PROGRAM UNIT KOTA PROVINSI NO. 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39
: : AMBON : MALUKU NAMA OBAT
SATUAN
2 3 OBAT GIZI / KIA Albendazol tab Asam traneksamat inj. amp CA.Glukonas inj amp Oksitosin inj. amp Oksitetrasiklin SM tube MgSO4 inj amp Pyrantel 125 mg tab Retinol 100.000 IU (Vit A) tab Retinol 200.000 IU (Vit A) tab Tablet tambah darah komb tab Vitamin K inj. 2 mg/ml amp Vitamin K inj. 10 mg/ml amp OBAT TB PARU OAT FDC Anak paket OAT FDC kat 1 paket OAT FDC kat 2 paket OAT FDC Sisipan paket VAKSIN DASAR DAN RABIES Vaksin rabies ampul Vaksin HB ampul Vaksin BCG ampul Vaksin DPT-HB-HIB ampul Vaksin Polio ampul Vaksin Campak ampul Vaksin IPV ampul Vaksin MR ampul Vaksin DT ampul Vaksin TD ampul OBAT / RAPID TES PROGRAM IMS/HIV Nistatin 100.000 IU tablet Benzatine Benzil Penicilin inj vial Combipak : Azithro + Sefiksim strip Aqua Pro Injeksi vial Asiklovir 400 Mg tablet Rapid tes Syphilis strip Rapid Tes 1/2 HIV strip OBAT PROGRAM MALARIA Primaquin tablet DHP
KECAMATAN BULAN TAHUN STOCK AWAL 4
PENERI MAAN 5
PERSE DIAAN 6=4+5
PEMAKAI AN 7
: : : STOCK AKHIR 8=6-7
PERMINTAAN 9
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0
Mengetahui / Menyetujui Kepala Puskesmas
0 0 0 0 0 0 Ambon, ……………………..2019 Yang Meminta/Melapor Pengelola Obat
( …………………………….. ) NIP :
( …………………………………..) NIP :
ver 1.0.2012
KET 10
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) UNIT KOTA PROVINSI NO
: : AMBON : MALUKU NAMA OBAT
1
1
2
Acetylstein kapsul 200 mg
SEDIAAN
STOK AWAL
3
4
Kaps
PENERIMAAN PERSEDIAAN PEMAKAIAN 5
6 =4 +5
7
0
RUSAK/ KADALUARSA 8
KECAMATAN BULAN TAHUN SISA STOK
: : : STOK OPTIMUM
9 = 6 - (7+8)
10
0
PERMINTAAN KET 11
0
13
0
2
Albendazol 400 mg
Tab
0
0
0
0
3
Allopurinol tab 100 mg
Tab
0
0
0
0
4 5
Allopurinol tab 300 mg Alprazolam 0,25 mg
Tab Tab
0 0
0 0
0 0
0 0
6
Alprazolam 1 mg
Tab
0
0
0
0
7
Ambroksol 30 mg
Tab
0
0
0
0
Aminophilin inj
Amp
8
0
0
0
0
9
Aminophilin tab 200 mg
Tab
0
0
0
0
10
Amlodipin 10 mg
Tab
0
0
0
0
11
Amlodipin 5 mg
12
Amoksisilin 250 mg
13
Amoksisilin 500 mg
14
Amoksisilin Syr Kering 125 mg/5ml
15
Amoksisilin Sirup Forte
16
Anaton Tablet
17 18
Anaton Sirup
Tab
0
0
0
0
Tab
0
0
0
0
Tab
0
0
0
0
Btl
0
0
0
0
Btl
0
0
0
0
Tab
0
0
0
0
Btl
0 0
0
0
0
Btl
0
0
0
0
Tab
Anti Bakteri Doen (Bacitrasin Salep)
Tube
0
0
0
0
Anti Fungi Salep
Pot
0
0
0
0
Anti Hemoroid Suppositoria
Suppo
0
0
0
0
Antasida Tablet
22 23 24
0
0
0
Amp
0
0
0
Tab
Antalgin Injeksi Antasida Sirup
21
0
0
Antalgin tab 500 mg
19 20
0
0
0
25
Anti Migren Komb
Tab
0
0
0
0
26
AquaPro Injeksi steril
Vial
0
0
0
0
27 28
Arkine Asam Askorbat (Vit C) tablet 50 mg
Tab Tab
0 0
0 0
0 0
0 0
29
Asam Askorbat (Vit C) tablet 250 mg
Tab
0
0
0
0
30
Asam Mefenamat 500 mg
Tab
0
0
0
0
Asam Traneksamat inj
Amp
31
0
0
0
0
32
Asam Folat
Tab
0
0
0
0
33
Asetosal 100 mg
Tab
0
0
0
0
34
Asiklovir 200 mg
Tab
0
0
0
0
35
Asiklovir 400 mg
Tab
0
0
0
0
36
Asiklovir cream
Tube
0
0
0
0
37 38
Atorvastatin 20 mg
Tab
Atropin Injeksi 0.25 mg/ml
Amp
0 0
0 0
0 0
0 0
39
Azytromicyn tab
Tab
0
0
0
0
40
Benzatin Benzil Injeksi
Vial
0
0
0
0
41
Betadine Solution - 60 ml
Btl
0
0
0
0
42
Betadine Solution - 1000 ml
Btl
0
0
0
0
43
Besi II Sulfat (Tablet tambah darah)
Tab
0
0
0
0
Betahistin Mesilat 6 mg
Tab
45
Betametason Cream
Tube
0
0
0
0
46
44
Bisakodil 5 mg
Tab
0
0
0
0
47 48
Buscopan Buscopan 10 mg Tab
Tab Tab
0
0 0
0
0 0
0
0 0
0
0 0
49
Buscopan Plus
Tab
0
0
0
0
50
Buscopan Injeksi
Amp
0
0
0
0
Calcium Gluconate Injeksi
Amp
51
0
0
0
0
52
Carbamazepin tablet 200mg
Tab
0
0
0
0
53
Caviplex tablet
Tab
0
0
0
0
54
Caviplex Sirup
55
Caviplex Drops
56
CD Asthenof Tetes Mata MD 0.6 ml
57 58
CD Augenthonic Tetes Mata MD 0,6ml CD Carpine 1% Tetes Mata
59
CD Catarlent Tetes Mata
60
CD Catarlent Tetes Mata MD 0.6ml
61
CD Efrisel 10% Tetes Mata
62
CD Fenicol 0.25% Tetes Mata
63
CD Floxa Tetes Mata MD 0.6 ml
64
CD Genta 0.3% Tetes Mata
65
CD Lyteers Tetes Mata
66
CD Lyteers Tetes Mata MD 0.6 ml
67 68
CD Mydriatil 0.5% Tetes Mata CD Pantocaine 0.5% Tetes Mata
Btl
0
0
0
0
Btl
0
0
0
0
Strip
0
0
0
0
Strip Btl
0 0
0 0
0 0
0 0
Btl
0
0
0
0
Strip
0
0
0
0
Btl
0
0
0
0
Btl
0
0
0
0
Strip
0
0
0
0
Btl
0
0
0
0
Btl
0
0
0
0
Strip
0
0
0
0
Btl Btl
0 0
0 0
0 0
0 0
69
CD Pantocaine 2% Tetes Mata
Btl
0
0
0
0
70
CD Polydek Tetes Mata
Btl
0
0
0
0
71
CD Timol 0.5% Tetes Mata
Btl
0
0
0
0
72
CD Tropin 0.5% Tetes Mata
Btl
0
0
0
0
73
CD Xitrol Salep Mata
Tube
0
0
0
0
CD Xitrol Tetes Mata MD 0.6 ml
Strip
74
0
0
0
0
75
CD Xitrol Tetes Mata
Btl
0
0
0
0
76
Cetrizin 10 mg
Tab
0
0
0
0
Chloramex/Kloramfenicol 500 mg
Tab
78
Citicolin Injeksi
Amp
0
0
0
0
79
77
Ciprofloksasin 500 mg
Tab
0
0
0
0
80 81
Clyndamisin 300 mg Combivent UDV 0.5 mg
Kaps Vial
0
0 0
0
0 0
0
0 0
0
0 0
82
Colcitine
Tab
0
0
0
0
83
Daryantulle
Lembar
0
0
0
0
84
Demacolin Tablet
Tab
0
0
0
0
85
Dexametason 0,5 mg tab
Tab
0
0
0
0
86
Dexametason injeksi 5 mg/ml - 1ml
Amp
0
0
0
0
87
Diazepam 2 mg tab
Tab
0
0
0
0
88
Diazepam Injeksi
Amp
0
0
0
0
89
Difenhidramin Inj. 10 mg/ml- 1ml
Amp
0
0
0
0
90 91
Digoksin 0.25 mg Diltiazem HCl
Tab Tab
0 0
0 0
0 0
0 0
92
Dimenhidrinat 50 mg
Tab
0
0
0
0
93
Doksisiklin kapsl 100 mg
Kaps
0
0
0
0
Domperidon 10 mg
Tab
94
0
0
0
0
95
Domperidone Sirup
Btl
0
0
0
0
96
Domperidon Tetes 5 mg/ml
Btl
0
0
0
0
97
Dores
Tab
0
0
0
0
98
Dulcolax Suppo 5 mg
Suppo
0
0
0
0
99
Dulcolax Suppo 10 mg
Suppo
0
0
0
0
100 Efedrin HCl 25mg/Bromifar
Tab
101 Epinephrine Injeksi 0.1%
Amp
0 0
0 0
0 0
0 0
102 Erytromicine 250 mg
Tab
0
0
0
0
103 Erytromicine 500 mg
Tab
0
0
0
0
104 Erytromicine Sirup Kering
Btl
0
0
0
0
105 Etanol 70 % - 60 ml
Btl
0
0
0
0
106 Etanol 70 % - 100 ml
Btl
0
0
0
0
107 Etanol 70 % - 300 ml
Btl
0
0
0
0
108 Etanol 70 % - 1000 ml
Btl
0
0
0
0
109 Fenobarbital tab. 30 mg
Tab
0
0
0
0
110 Fenol Gliserol Tetes Telinga
Btl
0
0
0
0
0
0
0
0
0
0
0
0
0
Tab Tab
0
0
Amp Amp
114 Fluconazole 150 mg
0
0
111 Fitomenadion Inj 2 mg 112 Fitomenadion Inj 10 mg 113 Fitomenadion 10 mg Tablet
0
0
0
115 Furosemid 40 mg tab
Tab
0
0
0
0
116 Furosemid inj
Amp
0
0
0
0
117 Garam Oralit 118 Genoint/Gentamisin Tetes Mata
Sase
0
0
0
0
Btl
0
0
0
0
119 Gentamisin inj
Amp
0
0
0
0
120 Gentamisin Salep Kulit
Tube
121 Gentian Violet 1%
Btl
0 0
0 0
0 0
0 0
122 Glibenklamid tablet 5 mg
Tab
0
0
0
0
123 Gliseril Guayakolat tablet 100 mg/Guaifenesin
Tab
0
0
0
0
124 Glimepirid 1 mg
Tab
0
0
0
0
125 Glukosa Infus 10 % steril
Btl
0
0
0
0
126 Glukosa Infus 5 % steril
Btl
0
0
0
0
127 Griseovulfin 125 mg
Tab
0
0
0
0
128 Haloperidol tablet 1,5 mg
Tab
0
0
0
0
129 Hidroklortiaside (HCT) tablet 25 mg
Tab
0
0
0
0
130 Hidrokortison cream 2,5 %
Tube
131 H2O2 Cairan
Btl
0 0
0 0
0 0
0 0
132 Ibuprofen 200 mg
Tab
0
0
0
0
133 Ibuprofen 400 mg
Tab
0
0
0
0
134 Ibuprofen suspensi
Btl
0
0
0
0
135 Interzinc Sirup
Btl
0
0
0
0
136 Isonat
Tab
0
0
0
0
137 Isosorbid dinitrat sub lingual 5 mg
Tab
0
0
0
0
138 KAEN 3B infus
Btl
0
0
0
0
139 Kalsium Laktat (kalk) tab 500 mg
Tab
0
0
0
0
140 Kaptopril 25 mg 141 Kaptopril 50 mg
Tab Tab
0 0
0 0
0 0
0 0
142 Ketokonasole 200 mg
Tab
0
0
0
0
143 Ketokonazole Krim
Tube
0
0
0
0
144 Ketorolac Injeksi
Amp
0
0
0
0
145 Klorampenicol 250 mg
Kaps
0
0
0
0
146 Klorampenicol Salep Mata
Tube
0
0
0
0
147 Klorampenikol susp 125 mg/ 5 ml
Btl
0
0
0
0
148 Klorampenikol Tetes Telinga
Btl
0
0
0
0
149 Klorfeniramin maleat (CTM) tab 4 mg
Tab
0
0
0
0
150 Klorpromazin HCl tablet salut 25 mg
Tab
0
0
0
0
151 Kodein Fosfat tab 10 mg
Tab
0
0
0
0
152 Kodein Fosfat tab 15 mg
Tab
0
0
0
0
153 Kombipak (Azyt-Cefix)
Paket
154 Komb. Injeksi Depot G
Vial
0 0
0 0
0 0
0 0
155 Kotrimoksazol Suspensi
Btl
0
0
0
0
156 Kotrimoksazol 480 mg
Tab
0
0
0
0
157 Kotrimoksazol 120 mg
Tab
0
0
0
0
158 Laxamet 200 mg
Tab
0
0
0
0
159 Lexavit Tab
Tab
0
0
0
0
160 Lidokain injeksi
Amp
0
0
0
0
161 Lisol - 1000 ml
Btl
0
0
0
0
162 Livitan Sirup
Btl
0
0
0
0
163 Lodomer 2 mg 164 Loperamid 2 mg
Tab Tab
0 0
0 0
0 0
0 0
165 Loratadin 10mg
Tab
0
0
0
0
166 Magnesium Sulfat (MgSO4) 20
Vial
0
0
0
0
167 Magnesium Sulfat (MgSO4) 40
Amp
168 Mersibion Injeksi
Amp
0
0
0
0
169 Metaneuron
Tab
0
0
0
0
170 Metformin HCl 500 mg
Tab
0
0
0
0
0
0
0
0
171 Metformin HCl 850 mg
Tab
0
0
0
0
172 Metilergometrin maleat injeksi
Amp
0
0
0
0
173 Metilprednisolon 4 mg 174 Metilprednisolon 8 mg
Tab Tab
0 0
0 0
0 0
0 0
175 Metoklopramide 10 mg
Tab
0
0
0
0
176 Metrodinasole tab 250 mg
Tab
0
0
0
0
177 Metrodinasole tab 500 mg
Tab
0
0
0
0
178 Mikonasole Krim
Tube
0
0
0
0
179 Mikrodial (Pil KB)
Strip
0
0
0
0
180 Miniaspi 80 mg
Tab
0
0
0
0
181 Molaneuron
Tab
0
0
0
0
182 Natrium Diklofenak tab 50 mg
Tab
0
0
0
0
183 Natrium klorida lar.Infus 0,9 % steril 184 Neuraxon Tablet
Btl Tab
0 0
0 0
0 0
0 0
185 Neurodex
Tab
0
0
0
0
186 Neurobion 5000 mg tab
Tab
0
0
0
0
187 New Antides
Tab
0
0
0
0
188 New Baby Cough Sirup
Btl
0
0
0
0
189 Nifedipin tab 10 mg
Tab
0
0
0
0
190 Nistatin 500.000 IU
Tab
0
0
0
0
191 Nistatin 100.000 IU
Tab
0
0
0
0
192 Noza
Tab
0
0
0
0
193 OAT I FDC 194 Obat Anti Tuberkulosis Kat. II
Paket Paket
0 0
0 0
0 0
0 0
195 Obat Anti Tuberkulosis Kat. Anak
Paket
0
0
0
0
196 Obat FDC Anak
Paket
0
0
0
0
197 OBH Combi Anak
Btl
0
0
0
0
198 OBH Itra
Btl
0
0
0
0
199 Oksitetrasiklin HCl inj 50 mg/ml-10 ml
Vial
0
0
0
0
200 Oksitetrasiklin HCl Salep mata
Tube
201 Oksitosin inj 10 IU/ml-1ml
Amp
0
0
0
0
202 Omeprazole 20 mg
Kaps
0
0
0
0
0
Amp Vial Tab
0
0
0
0
Btl
0
0
0
0
Btl
0
0
0
0
0
203 Ondansentron inj 204 Oxibiotic Injeksi 205 Papaverin 40 mg
0
0
0
206 Parasetamol Drops 207 Parasetamol Syrup 120 mg/ 5 ml
0
0
0
0
0 0
0
208 Parasetamol 500 mg
Tab
0
0
0
0
209 Pehacain inj
Amp
0
0
0
0
210 Pharmaton Formula
Tab
0
0
0
0
211 Piracetam 400 mg
Tab
0
0
0
0
212 Piracetam Injeksi
Amp
0
0
0
0
213 Piroksikam 10 mg
Tab
214 Piroksikam 20 mg
Tab
0 0
0 0
0 0
0 0
215 Povidon iodida 10 % - 30 ml
Btl
0
0
0
0
216 Povidon iodida 10 % - 60 ml
Btl
0
0
0
0
217 Povidon iodida 10 % - 300 ml 218 Povidon iodida 10 % - 1000 ml 219 Prednison tablet 5 mg
Btl
0
0
0
0
Btl
0
0
0
0
Tab
220 Primakuin
Tab
221 Probenid 500 mg 222 Propranolol HCl 40 mg 223 Propil tiouracil tablet 100 mg 224 Pyrantel tab 125 mg 225 Pyrantel Sirup
0 0
0 0
0 0
0 0
Tab
0
0
0
0
Tab
0
0
0
0
Tab
0
0
0
0
Tab
0
0
0
0
Btl
0
0
0
0
226 Pyridoxin 10 mg (vit.B6) tablet
Tab
227 Ranitidin inj
Amp
0
0
0
0
228 Ranitidin tablet 150 mg
Tab
0
0
0
0
229 Resperidon 2 mg
Tab
0
0
0
0
0
Softkaps Softkaps
0
0
0
0
Kap
0
0
0
0
Btl
0
0
0
0
230 Retinol 100.000 IU
233 Ringer lactat lar.infus
0
0
231 Retinol 200.000 IU 232 Rimfampicin 450 mg
0
0
0
0
0
234 Rivanol larutan 0,1 %
Btl
0
0
0
0
235 Salbutamol 4 mg tab
Tab
0
0
0
0
236 Salep 2-4
Pot
0
0
0
0
237 Salicyl bedak 2 %
Ktk
0
0
0
0
238 Sefadroksil 500 mg
Tab
0
0
0
0
239 Sefadroksil Sirup
Btl
0
0
0
0
240 Sefiksim 100mg
Kaps
0
0
0
0
241 Sefiksim Azitromisin
Paket
0
0
0
0
242 Sefotaksim inj
Vial
0
0
0
0
0
0
0
0
0
0
0
0
0
Tab Tab
0
0
Vial Amp
246 Simvastatin tab 10 mg
0
0
243 Seftriakson inj 244 Sianokobalamin ( Vit.B12) Injeksi 245 Simetidin 200 mg
0
0
0
247 Simvastatin tab 20 mg
Tab
0
0
0
0
248 Spironolactone 100 mg
Tab
0
0
0
0
249 Stesolid supp
Tube
250 Sulfadiazine Krim
Tube
0
0
0
0
251 Tamofen 10 mg
Tab
0
0
0
0
252 Teosal
Tab
0
0
0
0
0
Kaps Amp
0
0
0
0
Tab
0
0
0
0
0
0
0
0
253 Tetraciklin HCL kap 500 mg 254 Thiamin HCL injeksi
Tab
0
0
255 Thiamin HCL/Mononitrat (Vit. B1) tab 50 mg 256 Thyrax
0
0
0
0
0
257 Triheksifenidil Tablet 2 mg
Tab
0
0
0
0
258 Valisanbe Tablet 2 mg
Tab
0
0
0
0
259 Valisanbe Tablet 5 mg
Tab
0
0
0
0
260 Vaksin Verorab/Rabies
Vial
0
0
0
0
261 Vaksin BCG
Vial
0
0
0
0
262 Vitamin B compleks tab
Tab
0
0
0
0
0
0
0
Btl
0
0
0
0
266 Zink Tablet
0
0
Tab Tab
267 Zink Sirup
0
0
263 Vitamin B 12 Tablet 264 Wibrom 265 Zinkid Sirup
0
Tab
0
0
0
0
Btl
0
0
0
0
OBAT GIGI 268 Calsium Hidroksida Pasta 269 Caviton
Tube Ktk
0 0
0 0
0 0
0 0
270 Clorfenol Khamfer Menthol (CHKM)
Btl
0
0
0
0
271 Devitalisasi Pasta (non arsen)
Btl
0
0
0
0
272 Ethyl kloride semprot
Btl
0
0
0
0
273 Eugenol Cairan
Btl
0
0
0
0
274 Glass Ionomer Cement
Btl
0
0
0
0
275 Mummifying pasta
Btl/ktk
276 Semen Seng fosfat serbuk dan cairan 277 Xylocain Spray
ALAT KESEHATAN
278 Alat Suntik Sekali Pakai 0.05 ml
0
0
0
0
Btl/ Set
0
0
0
0
Btl
0
0
0
0
Pcs
0
0
0
0
279 Alat Suntik Sekali Pakai 0.5 ml
Pcs
0
0
0
0
280 Alat Suntik sekali pakai 1 ml
Pcs
0
0
0
0
281 Alat suntik sekali pakai 3ml
Pcs
0
0
0
0
282 Alat suntik sekali pakai 5 ml
Pcs
0
0
0
0
283 Alkohol Swab
Pcs
0
0
0
0
284 Aseptic Gel 500cc + Dispenser 285 Blood Lancet
Btl Pcs
0 0
0 0
0 0
0 0
286 Blood Transfusi Set
Pcs
0
0
0
0
287 Catgut Cromic No. 3/0
Pcs
0
0
0
0
288 Catgut Cromic No. 2/0
Pcs
0
0
0
0
289 Catgut Plain No. 3/0
Pcs
0
0
0
0
290 Catgut Plain No. 2/0
Pcs
0
0
0
0
291 Cover Glass
Pcs
0
0
0
0
292 Cuticell 10 x 10 cm
Pcs
0
0
0
0
293 Fixomul
Rol
0
0
0
0
294 Folley Cateter No. 16
Set
295 Folley Cateter No. 18
Pcs
0 0
0 0
0 0
0 0
296 HCl 0.1N
Btl
0
0
0
0
297 Infusion set anak
Set
0
0
0
0
298 Infusion set dewasa
Set
0
0
0
0
299 IV Cateter No. 20 G
Pcs
0
0
0
0
300 IV Cateter No. 22 G
Pcs
0
0
0
0
301 IV Cateter No. 24 G
Pcs
302 Jelly 82 gram
Tube
0
0
0
0
303 Kapas 250 gr
Bks
0
0
0
0
304 Kapas 500 gr
Bks
305 Kapas 1000 gr 306 Kasa Hydrofil steril 16 x 16 cm 307 Kasa Hydrofil steril 10 x 10 cm 308 Kasa Hydrofil steril 5 x 5 cm
0
0
0
0
0
0
0
0
Bks
0
0
0
0
Lembar
0
0
0
0
Rol Rol
0 0
0 0
0 0
0 0
309 Kasa Pembalut Hydrofil 4 x 3 cm
Rol
0
0
0
0
310 Kasa Pembalut Hydrofil 4 x 5cm
Rol
0
0
0
0
311 Kasa Pembalut Hydrofil 4 x 10 cm
Rol
0
0
0
0
312 Kasa Pembalut Hydrofil 4 x 15cm
Rol
0
0
0
0
313 Kasa Pembalut Hydrofil 40 x 80 yard
Rol
0
0
0
0
314 Klip Obat 8 x 15 cm
Pcs
0
0
0
0
315 Klip Obat 10 x 15 cm
Pcs
0
0
0
0
316 Klip Obat 5 x 8 cm
Pcs
0
0
0
0
317 Klip Obat 6 x 10 cm
Pcs
0
0
0
0
0
0
0
0
0
0
0
0
0
Rol Pcs
0
0
Buah Buah
321 Maxter Exam Non Powder L
0
0
318 Masker Nebulizer Anak 319 Masker Nebulizer Dewasa 320 Leukoplast 1625H
0
0
0
322 Maxter Exam Non Powder M
Pcs
0
0
0
0
323 Maxter Exam Non Powder S
Pcs
0
0
0
0
324 My Jelly 82 gram
Tube
0
0
0
0
325 Nurce Cap
Pcs
0
0
0
0
326 Object Glass
Pcs
0
0
0
0
327 One Scrub 500 cc + Dispenser 328 One scrub 5 L
Btl Galon
0 0
0 0
0 0
0 0
329 Safa Gloves No. 6
Pasang
0
0
0
0
330 Safa Gloves No. 7
Pasang
0
0
0
0
331 Safa Gloves No. 7,5
Pasang
332 Safa Gloves No. 8
Pasang
0
0
0
0
333 Safety Box
Buah
0
0
0
0
0
334 Sarung Tangan Obgyn
Pasang
0
0
0
0
0
0
0
335 Silk 2/0
Pcs
0
0
0
0
336 Silk 3/0
Pcs
0
0
0
0
337 Stera Syringe 10cc
Pcs
338 Surgical Blades No 11
Pcs
0 0
0 0
0 0
0 0
339 Surgical Blades No 12
Pcs
0
0
0
0
340 Surgical Mask Earloop Plus
Pcs
0
0
0
0
341 Surgical Mask Earloop
Pcs
0
0
0
0
342 Surgical Mask With Visor
Pcs
0
0
0
0
343 Surgical Mask Tie On
Pcs
0
0
0
0
344 Surgical Grown Spulance
Pcs
0
0
0
0
345 Surgical Gown Non Woven
Pcs
0
0
0
0
346 Test Glukosa
Stik
0
0
0
0
347 Test Uric Acid
Stik
348 Test Hemoglobin
Stik
0 0
0 0
0 0
0 0
349 Test Kolesterol
Stik
0
0
0
0
350 Ultra/Ultraone Tes Hamil
Pcs
0
0
0
0
351 Urine Bag Steril 352 USG Jelly 250 ml
OBAT BPJS
Pcs
0
0
0
0
Btl
0
0
0
0
353 Alpara
Tab
354 Ambeven
Kaps
0 0
0 0
0 0
0 0
355 Ambroksol Suspensi
Btl
0
0
0
0
356 Aminophylin 100 mg
Tab
0
0
0
0
357 Amoxsan Drop
Btl
0
0
0
0
358 Analsik
Tab
0
0
0
0
359 Andalan I
Vial
0
0
0
0
360 Andalan II
Vial
361 Andalan III
Vial
0
0
0
0
362 Asam Traneksamat 500 mg
Tab
0
0
0
0
363 Askamex 364 Aspilet Thrombo
Tab Tab
0
0 0
0
0 0
0
0 0
0
0 0
365 Atofar 20 mg
Tab
0
0
0
0
366 Avil 25 mg
Tab
0
0
0
0
367 B Com. C
Tab
0
0
0
0
368 Baby Cough Sirup
Btl
0
0
0
0
369 Batugin Sirup 120 ml
Btl
0
0
0
0
370 Batugin Sirup 300 ml
Btl
0
0
0
0
371 Betadine Salep
Tube
0
0
0
0
372 Betason-N Cream 5 gr
Tube
0
0
0
0
373 Biolysin Sirup 374 Bioplacenton Jelly 375 Bisolvon Sirup 376 Bisolvon Solution 50 ml 377 Bisolvon
Btl
0
0
0
0
Tube
0
0
0
0
Btl
0
0
0
0
Btl Tab
0 0
0 0
0 0
0 0
378 Bisoprolol
Tab
0
0
0
0
379 Bodrex
Tab
0
0
0
0
380 Buffect Sirup
Btl
0
0
0
0
381 Canderin 8 mg
Tab
0
0
0
0
382 Candersartan 16 mg
Tab
0
0
0
0
383 Candersartan 8 mg
Tab
0
0
0
0
384 Cardio Aspirin
Tab
0
0
0
0
385 Cataflam 25 mg
Tab
0
0
0
0
386 Cataflam 50 mg
Tab
0
0
0
0
0
0
0
0
0
0
0
0
0
Btl Btl
0
0
Tab Tab
390 Cendo Cortihist 5 cc
0
0
387 Cataflam tab 12,5 mg 388 Cefixim tab 200 mg 389 Cendo Cenfresh
0
0
0
391 Cendohyaluph EyeDrop
Btl
0
0
0
0
392 Cetrizine Drops
Btl
0
0
0
0
393 Cetrizine Sirup 60 ml
Btl
394 Clindamicin 150 mg
Kaps
0
0
0
0
395 Clopidogrel
Tab
0
0
0
0
396 Costil Sirup 397 Counterpain Cream
Btl Tube
0
0 0
0
0 0
0
0 0
0
0 0
398 Curcuma Plus Sirup
Btl
0
0
0
0
399 Curcuma Sirup
Btl
0
0
0
0
400 Curcuma
Tab
0
0
0
0
401 Curvit Sirup
Btl
0
0
0
0
402 Decadryl Eksp
Btl
0
0
0
0
403 Dexanta Sirup
Btl
404 Dextafen
Kaps
0
0
0
0
405 Dietylcarbamazepin
Tab
0
0
0
0
406 Duramycin 407 Efiline
Tab Tab
0
0 0
0
0 0
0
0 0
0
0 0
408 Elkana Sirup
Btl
0
0
0
0
409 Enervon - C
Tab
0
0
0
0
410 Epexol Drops
Btl
411 Epsonal
Tab
0
0
0
0
412 Erlamycetin Ear Drop
Btl
0
0
0
0
413 Erlamycetin Plus Salep Mata
Tube
0
0
0
0
0
0
0
0
414 Erlamycetin Plus Tetes Telinga
Btl
0
0
0
0
415 Erphafilin
Tab
0
0
0
0
416 Esperson Cream
Tube
0
0
0
0
0
0
0
0
0
0
0
0
0
Btl Tab
0
0
Btl Kaps
420 Fervital
0
0
417 Estin Drops 418 Fasidol 500 mg 419 Fasidol Drops
0
0
0
421 FG Troches
Tab
0
0
0
0
422 Flutamol Plus
Tab
0
0
0
0
423 Flutamol Sirup
Btl
0
0
0
0
424 Flutamol
Tab
0
0
0
0
425 Gabapentin 300 mg
Tab
0
0
0
0
426 Gamexan
Tube
427 Genoint Salep Kulit
Tube
0 0
0 0
0 0
0 0
428 Glaucon
Tab
0
0
0
0
429 Glimepiride 2 mg
Tab
0
0
0
0
430 Glimepiride tab 3 mg
Tab
431 Griseofulvin 500 mg
Tab
0
0
0
0
432 H2 O2 3% 800 ml
Btl
0
0
0
0
433 Haloperidol tab 2 mg
Tab
0
0
0
0
0
0
0
0
434 Haloperidol tablet 0,5 mg
Tab
0
0
0
0
435 Hervis Eye Oint
Tube
0
0
0
0
Btl
0
0
0
0
436 Hufagrip Flu Sirup
437 Hufagrip Sirup 438 Ichtiol Salep 439 Ifison tab
Btl
0
0
0
0
Pot
0
0
0
0
Tab
440 Imboost Force Caplet 441 Imboost Force Sirup 442 Imboost Kids Sirup 443 Imboost Syrup
0
Kap
446 Imudator
0
0
0
0 0
0 0
Btl
0
0
0
0
Btl
0
0
0
0
Btl
444 Imboost 445 Imudator Sirup
0
0
0
0
Tab
0
0
0
0
Btl
0
0
0
0
Tab
0
0
0
0
447 Imunvit Plus
Kaps
0
0
0
0
448 Inerson Salep 15 gram
Tube
0
0
0
0
449 Inpepsa Sirup
Btl
450 Intunal - F
0
Tab
0
0
0
0 0
0 0
451 Intunal Sirup
Btl
0
0
0
0
452 Intunal
Tab
0
0
0
0
453 Irgapan tab 200 mg
Tab
0
0
0
0
454 Izoniasid ( INH ) 100 mg
Tab
0
0
0
0
455 Izoniasid ( INH ) 300 mg
Tab
0
0
0
0
456 Kalium Diklofenak 25 mg
Tab
0
0
0
0
457 Kalium Diklofenak 50 mg
Tab
0
0
0
0
458 Kanamycin 1 GK injeksi
Vial
0
0
0
0
459 Kaptopril 12,5 mg
Tab
0
0
0
0
460 Klorpromazin 25 mg
Tab
0
0
0
0
461 Lacto - B
Sase
0
0
0
0
462 Lando 300 mg
Tab
463 Lansoprazole
Kaps
0
0
0
0
0 0
0 0
464 Leukoplast 7,5 x 4,5
Rol
0
0
0
0
465 Levofloxacin
Tab
0
0
0
0
466 Little Ulysin 100 ml
Btl
0
0
0
0
467 Livron B Plex
Tab
0
0
0
0
468 Lodia
Tab
0
0
0
0
469 Lycalvit Sirup
Btl
0
0
0
0
470 Matovit
Tab
0
0
0
0
471 Matrix tab 1 mg
Tab
0
0
0
0
472 Mefinal 500 mg
Tab
473 Megabal
Kaps
0
0
0
0
0 0
0 0
474 Meloxicam 15 mg
Tab
0
0
0
0
475 Meloxicam 7.5 mg
Tab
0
0
0
0
476 Merislon 12 mg
Tab
0
0
0
0
477 Merislon 6 mg
Tab
0
0
0
0
478 Mertigo
Tab
0
0
0
0
479 Mesol 4 mg
Tab
0
0
0
0
480 Mesol 8 mg
Tab
0
0
0
0
481 Methylcobal 500 mg
Tab
0
0
0
0
482 Metoklopramide 5 mg
Tab
483 Microlax
Tube
484 Mixagrip Flu & Batuk
Tab
0
0
0
0
485 Mucera Drops
Btl
0
0
0
0
0
0
0
0
0
0
0
0
Btl
0
0
0
0
0
0
0
0
Btl Tab Btl
0
0
486 Mucera Sirup 487 Mucohexin / Wibron 488 Mucopect Sirup 489 Mucos Drops 20 ml
0
0 0
0
0
0
490 Mylanta Sirup 50 ml
Btl
0
0
0
0
491 Natabion
Tab
0
0
0
0
492 Natrium Diklofenak tab 25 mg 493 Nebacetin Powder
Tab
0
Btl
0
0
0
0 0
0 0
494 Neo Kaolana Sirup
Btl
0
0
0
0
495 Neuralgin tab
Tab
0
0
0
0
496 Neurobion 5000 injeksi
Amp
0
0
0
0
497 Neurobion Putih
Tab
0
0
0
0
498 Neurohax
Tab
0
0
0
0
499 Neurosanbe 5000
Tab
500 Neurosanbe Inj
Amp
0
0
0
0
501 New Diatab
Tab
0
0
0
0
502 Nonflamin
0
Kaps
503 Obat Batuk Ibu Dan Anak 75 ml
0
0
Btl
0
0
0
0
0 0
0
0 0
504 Oksaderm Salep Kulit
Tube
0
0
0
0
505 Ondansentron 5 mg
Tab
0
0
0
0
506 Ondansentron 8 mg
Tab
0
0
0
0
507 Opthalgon 5 ml
Btl
0
0
0
0
508 Osteor
Kaps
0
0
0
0
509 Otopain Tetes Telinga
Btl
510 Oxytetra Salep Kulit 5 gr 511 Pamol Drops
0
0
0
0
Tube
0
0
0
0
Btl
0
0
0
0
512 Paratusin
Tab
513 Phenitoin Sodium 100 mg
Tab
0
0
0
0
0 0
0 0
514 Pimacolin Sirup
Btl
0
0
0
0
515 Pimtrakol Sirup
Btl
0
0
0
0
516 Piracetam 1200 mg
Tab
517 Piracetam 800 mg
0
0
0
0
Tab
0
0
0
0
518 Pirexin Supp 160 mg
Suppo
0
0
0
0
519 Pirexin Supp 80 mg
Suppo
0
0
0
0
520 Polysilane Sirup
Btl
0
0
0
0
521 Propepsa Sirup
Btl
0
0
0
0
522 Proris Sirup
Btl
523 Protocin Liquid
0
Btl
0
0
0
0 0
0 0
524 Protogenta 5 ml
Btl
0
0
0
0
525 Pyrazinamide 500 mg
Tab
0
0
0
0
526 Pytramic 500 mg
Tab
0
0
0
0
527 Redoxon Eff Zinc
Tab
0
0
0
0
528 Regumen
Tab
0
0
0
0
529 Renadinac 25 mg
Tab
0
0
0
0
530 Rhinofed
Tab
0
0
0
0
531 Rhinos
Kaps
0
0
0
0
532 Rhinos Drops
Btl
0
0
0
0
533 Rhinos Junior Sirup
Btl
0
0
0
0
534 Risperidone 2 mg
Tab
0
0
0
0
535 Sagestam Cream 10 gr
Tube
536 Salbulin CFC ( Inhaler )
0
Btl
0
0
0
0 0
0 0
537 Salbutamol tab 2 mg
Tab
0
0
0
0
538 San - B Plex
Tab
0
0
0
0
539 Sanadryl DMP Syr
Btl
0
0
0
0
540 Sanadryl Exp Sirup
Btl
0
0
0
0
541 San-B Plex Drops
Btl
0
0
0
0
542 Sanmol 500 mg
Tab
0
0
0
0
543 Sanmol Drops
Btl
0
0
0
0
544 Sanmol Sirup
Btl
0
0
0
0
545 Scabimite Cream 10 gr
Tube
0
0
0
0
0
0
Tab
0
0
0
0
Tab
0
0
0
0
0
Tube Tube
549 Scopamin
0
0
546 Scabimite Cream 30 gr 547 Scabimite Cream 5 gr 548 Scopamin Plus
0
0
0
550 Scopma Plus
Tab
0
0
0
0
551 Selviplex
Tab
0
0
0
0
552 Siloxan EyeDrop 5 ml
Btl
553 Simcobal 500 mg
Kaps
0
0
0
0
554 Simdrol 4 mg
Tab
0
0
0
0
555 Simprofen 25 mg
0
Tab
0
0
0
0
0
0
0
0
Btl
0
0
0
0
0
0
0
0
Tab Tab Kaps
0
0
556 Sohobion 5000 557 Starbion 558 Stimuno Sirup 559 Supertin
0
0
0
0
0
560 Suprafit
Kaps
0
0
0
0
561 Thrombopop Gel
Tube
0
0
0
0
562 Tobradex 5 ml
Btl
0
0
0
0
563 Tobroson 5 ml
Btl
0
0
0
0
564 Tranec 500 mg
Tab
0
0
0
0
565 Transamin
Tab
566 Univit Plus Lysin
0
Btl
0
0
0
0 0
0 0
567 Univit Sirup
Btl
0
0
0
0
568 Vasacon A Eye Drop
Btl
0
0
0
0
569 Vasacon A. 15 ml
Btl
0
0
0
0
570 Ventolin Nebuleser 2,5 mg
Btl
0
0
0
0
571 Vernacel Eye Drop
Btl
0
0
0
0
572 Vertigosan
Tab
0
0
0
0
573 Vicolsin Sirup
Btl
0
0
0
0
574 Vit B. Complex Injeksi
Vial
0
0
0
0
575 Vitrolenta Eye Drop
Btl
576 Voltaren Emulgel 1% 10 gr
0
Tube
0
0
0
0 0
0 0
577 Vomistop Sirup
Btl
0
0
0
0
578 Vomitas Sirup
Btl
0
0
0
0
579 Zecaneron 580 Zircum Kids Sirup
OBAT TAMBAHAN
Kaps
0
0
0
0
Btl
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
BPJS
0
0
0
0
0
0
0
0 0
0 0
0 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
JUMLAH
JAMKESMAS
Mengetahui / Menyetujui
Yang Meminta/Melapor
Pimpinan Puskesmas
Penanggung jawab farmasi Puskesmas
( …………………………………..)
( ………………………………... )
NIP :
0
0 0 0
UM UM
0
0 0
0
GRATIS/KTP
0
0 0 0
BAYAR
0 0
0 0
0
JUMLAH KUNJUNGAN RESEP BULAN….................
0 0
0 0
NIP :
PEMERINTAH KOTA AMBON DINAS KESEHATAN Jl. Imam Bonjol, Ambon Telp 352029-353152
LAPORAN PENGGUNAAN SEDIAAN JADI PSIKOTROPIKA PUSKESMAS ALAMAT TELP KAB/ KODYA
NO 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14
: ……………………………………………… : ……………………………………………… : ……………………………………………… : ………………………………………………
NAMA SEDIAAN JADI 2 Amitriptilin tablet salut 25 mg Carbamazepine Chlorpromazin HCl tablet salut 100 mg Chlorpromazin HCl tablet salut 25mg Diazepam 2 mg tab Diazepam 5 mg tab Diazepam inj. Diazepam supp. Haloperidol tablet 1.5 mg Haloperidol tablet 5 mg Phenobarbital inj. Phenobarbital tablet 30 mg Proneuron Triheksifenidil hidroksida Tab
Mengetahui, Kepala Puskesmas
BULAN TAHUN
SATUAN
SALDO AWAL
PEMASUKAN JUMLAH
3 tab tab tab tab tab tab amp supp tab tab amp tab tab tab
4
5
: …………………………………………… : ……………………………………………
PENGGUNAAN JUMLAH
SALDO AKHIR
6
7
KETERANGAN 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Ambon, ……………………..2019 Apoteker Penanggungjawab
( NIP:
)
( NIP:
)
PEMERINTAH KOTA AMBON DINAS KESEHATAN Jl. Imam Bonjol, Ambon Telp 352029-353152
LAPORAN PENGGUNAAN SEDIAAN JADI NARKOTIKA PUSKESMAS ALAMAT TELP KAB/ KODYA
: ……………………………………………… : ……………………………………………… : ……………………………………………… : ………………………………………………
NO
NAMA SEDIAAN JADI
1
2
1
Codein 10 mg
BULAN TAHUN
PERSEDIAAN SATUAN AWAL BULAN TANGGAL 3 Tablet
4
5
PENAMBAHAN DARI GUDANG FARMASI KOTA 6
JUMLAH PENGGUNAAN JUMLAH KESELURUHAN JUMLAH (4+7) 7 8 9 0
N-22 : …………………………………………… : ……………………………………………
PERSEDIAAN AKHIR BULAN (8-9) 10
KETERANGAN 11
0
Satuan: Tablet, Kapsul, Vial, Ampul, dll Mengetahui, Kepala Puskesmas
Ambon, ……………………..2019 Pengelola Obat Puskesmas Passo
Formulir Pelaporan Obat
FORM PEMANTAUAN KETERSEDIAAN OBAT DAN VAKSIN INDIKATOR DI PUSKESMAS
PERIODE PELAPORAN NAMA PUSKESMAS PROVINSI NO HP
NO
: : : :
NAMA OBAT
1
ALAMAT PENANGGUNG JAWAB FARMASI EMAIL
BENTUK
KETERSEDIAAN
JUMLAH
SEDIAAN
ADA/TIDAK
SISA STOK
3
4
5
2
1
Albendasole
Tablet
2
Amoxicillin 500 mg
Tablet
3
Amoxicillin Sirup
Sirup
4
Dexsamethason
Tablet
5
Diazepam 5 mg/ml
Injeksi
6
Epinefrin (Adrenalin) 0.1% (sebagai HCl)
Injeksi
7
Fitomenadion (Vitamin K)
Injeksi
8
Furosemide 40 mg
Tablet
9
Garam Oralit
Serbuk
10 Glibenklamid
Tablet
11 Kaptopril
Tablet
12 Magnesium sulfat 20%
Injeksi
13 Metilergometrin Maleat 0,200 mg - 1 ml
Injeksi
14 Obat Anti Tuberkulosis Dewasa
Tablet
15 Oksitosin
Injeksi
16 Parasetamol 500 mg
Tablet
17 Tablet Tambah Darah
Tablet
18 Vaksin BCG
Injeksi
19 Vaksin TT
Injeksi
20 Vaksin DPT/DPT-HB/DPT-HB-Hib
Injeksi
: : :
KET
6
Keterangan : Kolom Ketersediaan (4) : * * Diisi dengan angka 1 jika obat tersebut tersedia untuk pelayanan * Diisi dengan angka 0 jika obat tersebut tidak tersedia untuk pelayanan * Kolom Jumlah Sisa Stok (5) : diisi jumlah stok terakhir obat di puskesmas pada periode pelaporan Ambon, ……………………………………………… Mengetahui, Kepala Puskesmas …………………………………………
………………………………………………………… NIP :
Penanggung Jawab Farmasi
………………………………………………………. NIP :
LEMBAR PERENCANAAN KEBUTUHAN OBAT SARANA PELAYANAN KESEHATAN DASAR UNIT PERENCANA KOTA PROVINSI
: PUSKESMAS PASSO : AMBON : MALUKU
KECAMATAN : BAGUALA KEBUTUHAN T : TAHUN 2020
NO
NAMA OBAT
SEDIAAN
STOK per 3112-2018
PEMAKAIAN JAN-DES 2018
1
2
3
4
5
RATA2 OBAT PEMAKAIAN EXP/RUSAK OBAT/ BULAN JAN-DES 2018 6
7
(=KOL 5-kol7):12
KEKOSONGAN OBAT (jumlah kebutuhan bulan kosong)
KEBUTUHAN 8
9
(=kolom 6x18)-kol.4+kol.9
(kalo tjd kosong obat)
1
Acetylstein kapsul 200 mg
Kaps
0
1204
2
Albendazol 400 mg
Tab
0
6990
582
2300
3
Allopurinol tab 100 mg
Tab
2213
5427
452
5928
4
Allopurinol tab 300 mg
Tab
0
0
5
Alprazolam 0,25 mg
Tab
0
0
6
Alprazolam 1 mg
Tab
0
0
7
Ambroksol 30 mg
Tab
0
3500
292
5250
8
Aminophilin inj
Amp
14
11
1
3
9
Aminophilin tab 200 mg
Tab
11
10
Amlodipin 10 mg
Tab
4840
2331
194
11
Amlodipin 5 mg
Tab
3980
3811
318
12
Amoksisilin 250 mg
Tab
848
3119
260
3831
13
Amoksisilin 500 mg
Tab
8961
13792
1149
11727
14
Amoksisilin Syr Kering 125 mg/5ml
Btl
491
357
23
15
Amoksisilin Sirup Forte
Btl
0
56
5
16
Anaton Tablet
Tab
3590
410
34
17
Anaton Sirup
Btl
90
150
13
135
18
Antalgin tab 500 mg
Tab
14
4812
401
7204
19
Antalgin Injeksi
Amp
0
0
20
Antasida Sirup
Btl
90
65
5
21
Antasida Tablet
Tab
2128
18222
1510
22
Anti Bakteri Doen (Bacitrasin Salep)
Tube
85
115
10
23
Anti Fungi Salep
Pot
3
0
0
24
Anti Hemoroid Suppositoria
Suppo
15
155
10
25
Anti Migren Komb
Tab
100
100
8
26
AquaPro Injeksi steril
Vial
0
60
3
27
Arkine
Tab
28
Asam Askorbat (Vit C) tablet 50 mg
Tab
2808
29
Asam Askorbat (Vit C) tablet 250 mg
Tab
18000
0
0
30
Asam Mefenamat 500 mg
Tab
18816
11098
917
31
Asam Traneksamat inj
Amp
32
Asam Folat
Tab
33
Asetosal 100 mg
34
Asiklovir 200 mg
35 36 37 38
11
10469
0 1737
81 84
8 100
88 40
3277
158 50
20
60
200
56174
0 39521
25055
0
100
0
0 120
30
100
8
Tab
0
200
17
Tab
1153
995
58
Asiklovir 400 mg
Tab
995
805
67
213
Asiklovir cream
Tube
53
72
6
55
Atorvastatin 20 mg
Tab
30
0
0
Atropin Injeksi 0.25 mg/ml
Amp
39
Azytromicyn tab
Tab
370
125
10
40
Benzatin Benzil Injeksi
Vial
0
119
10
41
Betadine Solution - 60 ml
Btl
42
Betadine Solution - 1000 ml
Btl
43
Besi II Sulfat (Tablet tambah darah)
Tab
44
Betahistin Mesilat 6 mg
Tab
0
90
8
135
45
Betametason Cream
Tube
187
537
45
619
46
Bisakodil 5 mg
Tab
150
60
5
47
Buscopan
Tab
0
230
19
345
48
Buscopan 10 mg Tab
Tab
0
0
49
Buscopan Plus
Tab
246
154
13
50
Buscopan Injeksi
Amp
10
51
Calcium Gluconate Injeksi
Amp
52
Carbamazepin tablet 200mg
Tab
200
0
53
Caviplex tablet
Tab
0
2500
208
3750
54
Caviplex Sirup
Btl
0
369
31
554
55
Caviplex Drops
Btl
0
89
7
134
56
CD Asthenof Tetes Mata MD 0.6 ml (ONLY BALAI MA
Strip
0
0
57
CD Augenthonic Tetes Mata MD 0,6ml (ONLY BALAI
Strip
0
0
58
CD Carpine 1% Tetes Mata (ONLY BALAI MATA)
Btl
0
0
59
CD Catarlent Tetes Mata (ONLY BALAI MATA)
60
CD Catarlent Tetes Mata MD 0.6ml (ONLY BALAI MA
61
CD Efrisel 10% Tetes Mata (ONLY BALAI MATA)
300 300
0
0 179 3
0 7884
14516
0 56400
0 0
0 200
Btl
0
0
Strip
0
0
Btl
0
0
NO
NAMA OBAT
SEDIAAN
STOK per 3112-2018
PEMAKAIAN JAN-DES 2018
1
2
3
4
5
RATA2 OBAT PEMAKAIAN EXP/RUSAK OBAT/ BULAN JAN-DES 2018 6
7
(=KOL 5-kol7):12
62
CD Fenicol 0.25% Tetes Mata (ONLY BALAI MATA)
63
CD Floxa Tetes Mata MD 0.6 ml (ONLY BALAI MATA)
64
CD Genta 0.3% Tetes Mata (ONLY BALAI MATA)
65
CD Lyteers Tetes Mata (ONLY BALAI MATA)
66
CD Lyteers Tetes Mata MD 0.6 ml (ONLY BALAI MATA
67 68
KEKOSONGAN OBAT (jumlah kebutuhan bulan kosong)
KEBUTUHAN 8
9
(=kolom 6x18)-kol.4+kol.9
(kalo tjd kosong obat)
Btl
0
0
Strip
0
0
Btl
0
0
Btl
0
0
Strip
0
0
CD Mydriatil 0.5% Tetes Mata (ONLY BALAI MATA)
Btl
0
0
CD Pantocaine 0.5% Tetes Mata (ONLY BALAI MATA)
Btl
0
0
69
CD Pantocaine 2% Tetes Mata (ONLY BALAI MATA)
Btl
0
0
70
CD Polydek Tetes Mata (ONLY BALAI MATA)
Btl
0
0
71
CD Timol 0.5% Tetes Mata (ONLY BALAI MATA)
Btl
0
0
72
CD Tropin 0.5% Tetes Mata (ONLY BALAI MATA)
Btl
0
0
73
CD Xitrol Salep Mata (ONLY BALAI MATA)
Tube
0
0
74
CD Xitrol Tetes Mata MD 0.6 ml (ONLY BALAI MATA)
Strip
0
0
75
CD Xitrol Tetes Mata (ONLY BALAI MATA)
Btl
76
Cetrizin 10 mg
Tab
77
Chloramex/Kloramfenicol 500 mg
Tab
78
Citicolin Injeksi
Amp
79
Ciprofloksasin 500 mg
Tab
80
Clyndamisin 300 mg
81
Combivent UDV 0.5 mg
82
Colcitine
83
Daryantulle
84
Demacolin Tablet
Tab
1900
7450
621
9275
85
Dexametason 0,5 mg tab
Tab
7902
25017
2085
29624
86
Dexametason injeksi 5 mg/ml - 1ml
Amp
200
200
10
87
Diazepam 2 mg tab
Tab
81
219
18
88
Diazepam Injeksi
Amp
30
0
0
89
Difenhidramin Inj. 10 mg/ml- 1ml
Amp
60
23
2
90
Digoksin 0.25 mg
Tab
0
20
91
Diltiazem HCl
Tab
0
0
92
Dimenhidrinat 50 mg
Tab
100
0
0
93
Doksisiklin kapsl 100 mg
Kaps
200
6900
425
94
Domperidon 10 mg
Tab
970
537
45
95
Domperidone Sirup
Btl
51
199
17
248
96
Domperidon Tetes 5 mg/ml
Btl
0
0
97
Dores
0
0
98
Dulcolax Suppo 5 mg
Suppo
1
7
99
Dulcolax Suppo 10 mg
Suppo
100 Efedrin HCl 25mg/Bromifar
Tab
101 Epinephrine Injeksi 0.1% 102 Erytromicine 250 mg
0 0
540
0 300
0
0
1620
2918
243
2757
Kaps
0
1233
103
Vial
50
110
9
0
10
Tab Lembar
Tab 2
6
1850 6
Amp
15
15
Tab
848
103 Erytromicine 500 mg
Tab
568
104 Erytromicine Sirup Kering
Btl
105 Etanol 70 % - 60 ml
Btl
106 Etanol 70 % - 100 ml
Btl
107 Etanol 70 % - 300 ml
Btl
9
108 Etanol 70 % - 1000 ml
Btl
8
109 Fenobarbital tab. 30 mg
Tab
400
106
0
0
1
15
85 248
400 200 1800
0 1961
7450
0 5000
1
8 32
300
5 15
3232 0
0
0
0
0 0
0
1
15
0
Btl
20
0
0
111 Fitomenadion Inj 2 mg
Amp
0
60
5
112 Fitomenadion Inj 10 mg
Amp
40
20
50
113 Fitomenadion 10 mg Tablet
Tab
208
0
317
114 Fluconazole 150 mg
Tab
115 Furosemid 40 mg tab
Tab
350
350
116 Furosemid inj
Amp
0
0
117 Garam Oralit
Sase
900
900
118 Genoint/Gentamisin Tetes Mata
360
100
0
110 Fenol Gliserol Tetes Telinga
20
90
0
0
29
175 25
67
100
300
Btl
2
0
119 Gentamisin inj
Amp
0
3
0
5
120 Gentamisin Salep Kulit
108
Tube
50
105
9
121 Gentian Violet 1%
Btl
2
23
2
33
122 Glibenklamid tablet 5 mg
Tab
44
1956
163
2890
123 Gliseril Guayakolat tablet 100 mg/Guaifenesin
Tab
4444
23056
1921
30140
124 Glimepirid 1 mg
Tab
2100
800
67
125 Glukosa Infus 10 % steril
Btl
18
2
0
126 Glukosa Infus 5 % steril
Btl
14
4
0
NO
NAMA OBAT
SEDIAAN
STOK per 3112-2018
PEMAKAIAN JAN-DES 2018
1
2
3
4
5
RATA2 OBAT PEMAKAIAN EXP/RUSAK OBAT/ BULAN JAN-DES 2018 6
7
(=KOL 5-kol7):12
127 Griseovulfin 125 mg
Tab
235
1447
128 Haloperidol tablet 1,5 mg
Tab
129 Hidroklortiaside (HCT) tablet 25 mg
Tab
100
0
0
130 Hidrokortison cream 2,5 %
Tube
534
316
26
KEKOSONGAN OBAT (jumlah kebutuhan bulan kosong)
KEBUTUHAN 8
9
(=kolom 6x18)-kol.4+kol.9
(kalo tjd kosong obat)
121
1936
0
0
131 H2O2 Cairan
Btl
0
0
132 Ibuprofen 200 mg
Tab
0
2436
203
3654
133 Ibuprofen 400 mg
Tab
0
7000
583
10500
134 Ibuprofen suspensi
Btl
190
56
5
135 Interzinc Sirup
Btl
0
28
2
136 Isonat
Tab
75
25
2
137 Isosorbid dinitrat sub lingual 5 mg
Tab
0
0
138 KAEN 3B infus
Btl
139 Kalsium Laktat (kalk) tab 500 mg
Tab
3855
15395
140 Kaptopril 25 mg
Tab
6572
528
141 Kaptopril 50 mg
Tab
142 Ketokonasole 200 mg
Tab
0
200
143 Ketokonazole Krim
Tube
36
26
144 Ketorolac Injeksi
Amp
145 Klorampenicol 250 mg
Kaps
0
146 Klorampenicol Salep Mata
Tube
42 0
0
0
1283
19238 3600
0
0 800
2
3
0
0
400
33
600
44
56
5
40
147 Klorampenikol susp 125 mg/ 5 ml
Btl
0
0
148 Klorampenikol Tetes Telinga
Btl
16
91
8
121
149 Klorfeniramin maleat (CTM) tab 4 mg
Tab
11983
25557
2130
26353
150 Klorpromazin HCl tablet salut 25 mg
Tab
0
0
151 Kodein Fosfat tab 10 mg
Tab
152 Kodein Fosfat tab 15 mg
Tab
92
8
1 0
153 Kombipak (Azyt-Cefix)
Paket
25
0
0
154 Komb. Injeksi Depot G
Vial
0
20
2
0 30
155 Kotrimoksazol Suspensi
Btl
87
91
8
50
156 Kotrimoksazol 480 mg
Tab
2783
4755
396
4350
157 Kotrimoksazol 120 mg
Tab
0
0
158 Laxamet 200 mg
Tab
0
0
159 Lexavit Tab
Tab
300
2200
183
3000
160 Lidokain injeksi
Amp
63
128
2
161 Lisol - 1000 ml
Btl
13
17
1
100 13
162 Livitan Sirup
Btl
163 Lodomer 2 mg
Tab
0
0
0
164 Loperamid 2 mg
Tab
190
160
13
50
165 Loratadin 10mg
Tab
0
400
33
600
166 Magnesium Sulfat (MgSO4) 20
Vial
20
3
167 Magnesium Sulfat (MgSO4) 40
Amp
0
0
168 Mersibion Injeksi
Amp
0
0
169 Metaneuron
Tab
0
0
170 Metformin HCl 500 mg
Tab
171 Metformin HCl 850 mg
Tab
172 Metilergometrin maleat injeksi
Amp
173 Metilprednisolon 4 mg
Tab
800
67
174 Metilprednisolon 8 mg
Tab
1301
37
3
175 Metoklopramide 10 mg
Tab
371
110
9
176 Metrodinasole tab 250 mg
Tab
333
157
13
3930
0 200
20
3700
6000 0
0
0
0 200 1200
177 Metrodinasole tab 500 mg
Tab
0
300
178 Mikonasole Krim
Tube
193
264
22
400 203
179 Mikrodial (Pil KB)
Strip
174
126
11
15
180 Miniaspi 80 mg
Tab
80
20
2
181 Molaneuron
Tab
0
300
25
450
182 Natrium Diklofenak tab 50 mg
Tab
4
7192
599
10784
183 Natrium klorida lar.Infus 0,9 % steril
Btl
20
9
1
184 Neuraxon Tablet
Tab
185 Neurodex
Tab
186 Neurobion 5000 mg tab
Tab
0
187 New Antides
Tab
894
0 500
0
0
0
42
750
0
188 New Baby Cough Sirup
Btl
189 Nifedipin tab 10 mg
Tab
890
472
0 710
0
190 Nistatin 500.000 IU
Tab
0
200
700
191 Nistatin 100.000 IU
Tab
0
100
400
NO
NAMA OBAT
SEDIAAN
STOK per 3112-2018
PEMAKAIAN JAN-DES 2018
1
2
3
4
5
RATA2 OBAT PEMAKAIAN EXP/RUSAK OBAT/ BULAN JAN-DES 2018 6
7
(=KOL 5-kol7):12
192 Noza
KEKOSONGAN OBAT (jumlah kebutuhan bulan kosong)
KEBUTUHAN 8
9
(=kolom 6x18)-kol.4+kol.9
(kalo tjd kosong obat)
Tab
88
12
1
193 OAT I FDC
Paket
4
72
6
104
194 Obat Anti Tuberkulosis Kat. II
Paket
0
0
195 Obat Anti Tuberkulosis Kat. Anak
Paket
0
6
196 Obat FDC Anak
Paket
0
0
0
4
197 OBH Combi Anak
Btl
14
82
198 OBH Itra
Btl
0
120
7
109
199 Oksitetrasiklin HCl inj 50 mg/ml-10 ml
Vial
40
0
0
200 Oksitetrasiklin HCl Salep mata
Tube
29
152
11
201 Oksitosin inj 10 IU/ml-1ml
Amp
0
0
202 Omeprazole 20 mg
Kaps
0
1230
103
1845
203 Ondansentron inj
Amp
5
0
0
204 Oxibiotic Injeksi
Vial
205 Papaverin 40 mg
Tab
206 Parasetamol Drops
Btl
207 Parasetamol Syrup 120 mg/ 5 ml
Btl
528
208 Parasetamol 500 mg
Tab
209 Pehacain inj
Amp
210 Pharmaton Formula
Tab
211 Piracetam 400 mg
Tab
212 Piracetam Injeksi
Amp
213 Piroksikam 10 mg
320 25
0 0
0
162
0 1000
0
0
712
59
540
8626
24074
2006
27485
100
20
2
50
0 0
0
Tab
0
2240
187
3360
214 Piroksikam 20 mg
Tab
9119
3681
307
215 Povidon iodida 10 % - 30 ml
Btl
4
5
0
4
216 Povidon iodida 10 % - 60 ml
Btl
0
6
1
9
217 Povidon iodida 10 % - 300 ml
Btl
6
8
1
218 Povidon iodida 10 % - 1000 ml
Btl
1
1
0
219 Prednison tablet 5 mg
Tab
9593
2646
220 Primakuin
Tab
221 Probenid 500 mg
Tab
222 Propranolol HCl 40 mg
Tab
223 Propil tiouracil tablet 100 mg
Tab
810
190
224 Pyrantel tab 125 mg
Tab
1993
467
14
225 Pyrantel Sirup
Btl
18
1
0
226 Pyridoxin 10 mg (vit.B6) tablet
Tab
628
7522
627
227 Ranitidin inj
Amp
102
24
228 Ranitidin tablet 150 mg
Tab
0
2050
229 Resperidon 2 mg
Tab
230 Retinol 100.000 IU
Softkaps
231 Retinol 200.000 IU
Softkaps
0
0 50
6 1 19489
0 80
0
0 0
0
800
0 200 300 10655 50
171
3075
0
0
67
1200
0
0
232 Rimfampicin 450 mg
Kap
200
0
233 Ringer lactat lar.infus
Btl
12
8
1
234 Rivanol larutan 0,1 %
Btl
12
3
0
235 Salbutamol 4 mg tab
Tab
690
504
42
680
236 Salep 2-4
Pot
76
45
4
#VALUE!
237 Salicyl bedak 2 %
Ktk
100
174
15
161
238 Sefadroksil 500 mg
Tab
1540
239 Sefadroksil Sirup
Btl
240 Sefiksim 100mg
Kaps
450
241 Sefiksim Azitromisin
Paket
10
0
0 0
0
0 0
0
242 Sefotaksim inj
Vial
0
0
243 Seftriakson inj
Vial
0
0
244 Sianokobalamin ( Vit.B12) Injeksi
Amp
96
0
245 Simetidin 200 mg
Tab
1962
0
246 Simvastatin tab 10 mg
Tab
2010
1800
150
690
247 Simvastatin tab 20 mg
Tab
678
2582
215
3195
248 Spironolactone 100 mg
Tab
100
0
249 Stesolid supp
Tube
250 Sulfadiazine Krim
Tube
251 Tamofen 10 mg
Tab
252 Teosal
Tab
253 Tetraciklin HCL kap 500 mg 254 Thiamin HCL injeksi
2 0
4
1
0
400
Kaps
0
1000
67
Amp
0.93
0
0
255 Thiamin HCL/Mononitrat (Vit. B1) tab 50 mg
Tab
0
29302
256 Thyrax
Tab
0
0 0
0 540 200
1200
37500 0
0
NO
NAMA OBAT
SEDIAAN
STOK per 3112-2018
PEMAKAIAN JAN-DES 2018
1
2
3
4
5
RATA2 OBAT PEMAKAIAN EXP/RUSAK OBAT/ BULAN JAN-DES 2018 6
7
(=KOL 5-kol7):12
KEKOSONGAN OBAT (jumlah kebutuhan bulan kosong)
KEBUTUHAN 8
9
(=kolom 6x18)-kol.4+kol.9
(kalo tjd kosong obat)
257 Triheksifenidil Tablet 2 mg
Tab
0
0
258 Valisanbe Tablet 2 mg
Tab
0
0
259 Valisanbe Tablet 5 mg
Tab
0
0
260 Vaksin Verorab/Rabies
Vial
0
0
261 Vaksin BCG
Vial
0
0
262 Vitamin B compleks tab
Tab
4550
48392
4033
68038
263 Vitamin B 12 Tablet
Tab
0
300
25
450
264 Wibrom
Tab
3725
375
31
265 Zinkid Sirup
Btl
266 Zink Tablet
Tab
0
267 Zink Sirup
Btl
50
1265
0
0
105
1898
0
OBAT GIGI 268 Calsium Hidroksida Pasta
Tube
2
0
3
0
0
269 Caviton
Ktk
270 Clorfenol Khamfer Menthol (CHKM)
Btl
271 Devitalisasi Pasta (non arsen)
Btl
272 Ethyl kloride semprot
Btl
273 Eugenol Cairan
Btl
5
2
0
274 Glass Ionomer Cement
1
0
0 0
0
0
0
Btl
4
1
0
275 Mummifying pasta
Btl/ktk
2
3
0
3
276 Semen Seng fosfat serbuk dan cairan
Btl/ Set
0
0
Btl
0
0
277 Xylocain Spray ALAT KESEHATAN 278 Alat Suntik Sekali Pakai 0.05 ml
Pcs
3000
300
25
279 Alat Suntik Sekali Pakai 0.5 ml
Pcs
3200
280 Alat Suntik sekali pakai 1 ml
Pcs
1285
500
42
281 Alat suntik sekali pakai 3ml 282 Alat suntik sekali pakai 5 ml
Pcs
1249
1051
88
328
Pcs
780
720
60
300
283 Alkohol Swab
Pcs
460
1240
103
1400
284 Aseptic Gel 500cc + Dispenser
Btl
11
11
1
6
285 Blood Lancet
Pcs
150
350
29
375
286 Blood Transfusi Set
Pcs
0
0
287 Catgut Cromic No. 3/0
Pcs
0
0
288 Catgut Cromic No. 2/0
Pcs
0
0
289 Catgut Plain No. 3/0
Pcs
20
290 Catgut Plain No. 2/0
Pcs
5
19
2
24
291 Cover Glass
Pcs
0
1000
83
1500
292 Cuticell 10 x 10 cm
Pcs
85
45
4
293 Fixomul
Rol
2
1
0
294 Folley Cateter No. 16
Set
0
0
295 Folley Cateter No. 18
Pcs
0
0
296 HCl 0.1N
Btl
0
2
0
3
297 Infusion set anak
Set
4
6
1
5
298 Infusion set dewasa
Set
4
6
1
5
299 IV Cateter No. 20 G
Pcs
1
0
2
300 IV Cateter No. 22 G
Pcs
0
0
301 IV Cateter No. 24 G
0
5
0
Pcs
0
0
302 Jelly 82 gram
Tube
0
0
303 Kapas 250 gr
Bks
3
8
1
9
304 Kapas 500 gr
Bks
10
6
1
305 Kapas 1000 gr
Bks
5
2
0
160
300
25
290
Rol
0
0
308 Kasa Hydrofil steril 5 x 5 cm
Rol
0
0
309 Kasa Pembalut Hydrofil 4 x 3 cm
Rol
0
300
25
450
310 Kasa Pembalut Hydrofil 4 x 5cm
Rol
20
140
12
190
311 Kasa Pembalut Hydrofil 4 x 10 cm
Rol
270
134
11
312 Kasa Pembalut Hydrofil 4 x 15cm
Rol
570
130
11
6
1
306 Kasa Hydrofil steril 16 x 16 cm
Lembar
307 Kasa Hydrofil steril 10 x 10 cm
313 Kasa Pembalut Hydrofil 40 x 80 yard
Rol
5
314 Klip Obat 8 x 15 cm
Pcs
3000
4
315 Klip Obat 10 x 15 cm
Pcs
1400
3600
300
4000
316 Klip Obat 5 x 8 cm
Pcs
0
0
317 Klip Obat 6 x 10 cm
Pcs
11055
445
37
0
318 Masker Nebulizer Anak
Buah
2
0
0
319 Masker Nebulizer Dewasa
Buah
2
0
0
NO
NAMA OBAT
SEDIAAN
STOK per 3112-2018
PEMAKAIAN JAN-DES 2018
1
2
3
4
5
RATA2 OBAT PEMAKAIAN EXP/RUSAK OBAT/ BULAN JAN-DES 2018 6
7
(=KOL 5-kol7):12
KEKOSONGAN OBAT (jumlah kebutuhan bulan kosong)
KEBUTUHAN 8
9
(=kolom 6x18)-kol.4+kol.9
(kalo tjd kosong obat)
320 Leukoplast 1625H
Rol
29
11
1
321 Maxter Exam Non Powder L
Pcs
700
800
67
500
322 Maxter Exam Non Powder M
Pcs
0
400
33
600
323 Maxter Exam Non Powder S
Pcs
0
0
Tube
0
0
325 Nurce Cap
Pcs
0
0
326 Object Glass
Pcs
0
0
327 One Scrub 500 cc + Dispenser
Btl
1
7
0
0
324 My Jelly 82 gram
328 One scrub 5 L
Galon
329 Safa Gloves No. 6
Pasang
330 Safa Gloves No. 7
Pasang
331 Safa Gloves No. 7,5 332 Safa Gloves No. 8 333 Safety Box
7
9
0
0
8
150
Pasang
0
0
Pasang
0
0
Buah
0
1
23
Pasang
0
0
335 Silk 2/0
Pcs
0
0
336 Silk 3/0
Pcs
337 Stera Syringe 10cc
Pcs
338 Surgical Blades No 11
Pcs
500
0
339 Surgical Blades No 12
Pcs
152
0
340 Surgical Mask Earloop Plus
Pcs
5000
1650
138
341 Surgical Mask Earloop
Pcs
0
1400
117
2100
342 Surgical Mask With Visor
Pcs
0
0
343 Surgical Mask Tie On
Pcs
0
0
344 Surgical Grown Spulance
Pcs
0
0
345 Surgical Gown Non Woven
Pcs
0
0
346 Test Glukosa
Stik
0
175
15
263
347 Test Uric Acid
Stik
70
30
3
348 Test Hemoglobin
Stik
100
0
0
349 Test Kolesterol
Stik
30
40
3
350 Ultra/Ultraone Tes Hamil
Pcs
250
43
4
351 Urine Bag Steril
Pcs
352 USG Jelly 250 ml
Btl
1
7
334 Sarung Tangan Obgyn
0
100
15
36
0 0
BPJS
0
30
0
0
1
10
0
0
353 Alpara
Tab
0
0
354 Ambeven
Kaps
0
0
355 Ambroksol Suspensi
Btl
0
0
356 Aminophylin 100 mg
Tab
0
0
357 Amoxsan Drop
Btl
0
0
358 Analsik
Tab
100
1650
359 Andalan I
Vial
0
0
360 Andalan II
Vial
0
0
361 Andalan III
Vial
0
0
362 Asam Traneksamat 500 mg
Tab
0
0
363 Askamex
Tab
0
0
364 Aspilet Thrombo
Tab
0
0
365 Atofar 20 mg
Tab
0
0
366 Avil 25 mg
Tab
0
0
367 B Com. C
Tab
0
0
368 Baby Cough Sirup
Btl
9
156
369 Batugin Sirup 120 ml
Btl
0
0
370 Batugin Sirup 300 ml
Btl
0
371 Betadine Salep
Tube
372 Betason-N Cream 5 gr
Tube
373 Biolysin Sirup 374 Bioplacenton Jelly
141
0
0
1194
104
2
Btl Tube
20
12
0
0 2
0
0
0
0
0
1
375 Bisolvon Sirup
Btl
0
0
376 Bisolvon Solution 50 ml
Btl
0
0
377 Bisolvon
Tab
0
0
378 Bisoprolol
Tab
0
0
379 Bodrex
Tab
6
60
48
72
380 Buffect Sirup
Btl
0
0
381 Canderin 8 mg
Tab
0
0
382 Candersartan 16 mg
Tab
0
0
383 Candersartan 8 mg
Tab
0
0
NO
NAMA OBAT
SEDIAAN
STOK per 3112-2018
PEMAKAIAN JAN-DES 2018
1
2
3
4
5
RATA2 OBAT PEMAKAIAN EXP/RUSAK OBAT/ BULAN JAN-DES 2018 6
7
(=KOL 5-kol7):12
KEKOSONGAN OBAT (jumlah kebutuhan bulan kosong)
KEBUTUHAN 8
9
(=kolom 6x18)-kol.4+kol.9
(kalo tjd kosong obat)
384 Cardio Aspirin
Tab
0
0
385 Cataflam 25 mg
Tab
0
0
386 Cataflam 50 mg
Tab
0
0
387 Cataflam tab 12,5 mg
Tab
0
0
388 Cefixim tab 200 mg
Tab
0
0
389 Cendo Cenfresh
Btl
0
0
390 Cendo Cortihist 5 cc
Btl
0
0
391 Cendohyaluph EyeDrop
Btl
0
0
392 Cetrizine Drops
Btl
0
0
393 Cetrizine Sirup 60 ml
Btl
0
0
394 Clindamicin 150 mg
Kaps
0
0
395 Clopidogrel
Tab
0
0
396 Costil Sirup
Btl
3
2
27
397 Counterpain Cream
Tube
0
2
0
3
398 Curcuma Plus Sirup
Btl
0
200
17
300
399 Curcuma Sirup
Btl
0
0
400 Curcuma
Tab
0
0
401 Curvit Sirup
Btl
0
0
402 Decadryl Eksp
Btl
0
0
403 Dexanta Sirup
Btl
0
0
404 Dextafen
Kaps
0
0
405 Dietylcarbamazepin
Tab
0
0
406 Duramycin
Tab
0
0
407 Efiline
Tab
0
0
408 Elkana Sirup
Btl
0
0
409 Enervon - C
Tab
0
0
410 Epexol Drops
Btl
0
0
411 Epsonal
Tab
0
0
412 Erlamycetin Ear Drop
20
Btl
0
0
413 Erlamycetin Plus Salep Mata
Tube
0
0
414 Erlamycetin Plus Tetes Telinga
Btl
0
0
415 Erphafilin
Tab
0
0
416 Esperson Cream
Tube
0
0
1
5
Kaps
0
0
419 Fasidol Drops
Btl
0
0
420 Fervital
Tab
0
0
421 FG Troches
Tab
0
0
422 Flutamol Plus
Tab
0
0
423 Flutamol Sirup
Btl
0
0
424 Flutamol
Tab
0
0
425 Gabapentin 300 mg
Tab
0
0
426 Gamexan
Tube
0
0
427 Genoint Salep Kulit
Tube
4
69
428 Glaucon
Tab
0
0
429 Glimepiride 2 mg
Tab
0
0
430 Glimepiride tab 3 mg
Tab
0
0
431 Griseofulvin 500 mg
Tab
0
0
432 H2 O2 3% 800 ml
Btl
0
0
433 Haloperidol tab 2 mg
Tab
0
0
434 Haloperidol tablet 0,5 mg
Tab
0
0
435 Hervis Eye Oint
Tube
0
0
417 Estin Drops 418 Fasidol 500 mg
Btl
436 Hufagrip Flu Sirup
Btl
437 Hufagrip Sirup
Btl
4
0
15 1
6
46
9 9
1 0
0
438 Ichtiol Salep
Pot
1
13
439 Ifison tab
Tab
0
0
440 Imboost Force Caplet
Kap
0
0
441 Imboost Force Sirup
Btl
0
0
442 Imboost Kids Sirup
Btl
0
0
443 Imboost Syrup
Btl
0
0
444 Imboost
Tab
0
0
445 Imudator Sirup
Btl
0
0
446 Imudator
Tab
0
0
447 Imunvit Plus
Kaps
0
0
448 Inerson Salep 15 gram
Tube
0
0
NO
NAMA OBAT
SEDIAAN
STOK per 3112-2018
PEMAKAIAN JAN-DES 2018
1
2
3
4
5
RATA2 OBAT PEMAKAIAN EXP/RUSAK OBAT/ BULAN JAN-DES 2018 6
7
(=KOL 5-kol7):12
0
KEKOSONGAN OBAT (jumlah kebutuhan bulan kosong)
KEBUTUHAN 8
9
(=kolom 6x18)-kol.4+kol.9
(kalo tjd kosong obat)
449 Inpepsa Sirup
Btl
450 Intunal - F
Tab
451 Intunal Sirup
Btl
0
0
452 Intunal
Tab
0
0
453 Irgapan tab 200 mg
Tab
0
0
454 Izoniasid ( INH ) 100 mg
Tab
0
0
455 Izoniasid ( INH ) 300 mg
Tab
0
0
456 Kalium Diklofenak 25 mg
Tab
0
0
457 Kalium Diklofenak 50 mg
Tab
0
0
458 Kanamycin 1 GK injeksi
Vial
0
0
459 Kaptopril 12,5 mg
Tab
0
0
460 Klorpromazin 25 mg
Tab
0
0
461 Lacto - B
Sase
0
0
462 Lando 300 mg
Tab
0
0
463 Lansoprazole
Kaps
0
0
464 Leukoplast 7,5 x 4,5
Rol
0
0
465 Levofloxacin
Tab
0
0
466 Little Ulysin 100 ml
Btl
0
0
467 Livron B Plex
Tab
0
0
468 Lodia
Tab
0
0
469 Lycalvit Sirup
Btl
0
0
470 Matovit
Tab
0
0
471 Matrix tab 1 mg
Tab
0
0
472 Mefinal 500 mg
Tab
0
0
473 Megabal
Kaps
0
0
474 Meloxicam 15 mg
Tab
0
0
475 Meloxicam 7.5 mg
Tab
0
0
476 Merislon 12 mg
Tab
0
0
477 Merislon 6 mg
Tab
0
0
478 Mertigo
Tab
0
0
479 Mesol 4 mg
Tab
0
0
480 Mesol 8 mg
Tab
0
0
481 Methylcobal 500 mg
Tab
0
0
482 Metoklopramide 5 mg
Tab
0
0
483 Microlax
Tube
0
0
484 Mixagrip Flu & Batuk
Tab
0
0
485 Mucera Drops
Btl
4540
1060
13
0
88
0
486 Mucera Sirup
Btl
0
0
487 Mucohexin / Wibron
Tab
0
0
488 Mucopect Sirup
Btl
0
0
489 Mucos Drops 20 ml
Btl
0
0
490 Mylanta Sirup 50 ml
Btl
0
0
491 Natabion
Tab
0
0
492 Natrium Diklofenak tab 25 mg
Tab
0
0
493 Nebacetin Powder
Btl
0
0
494 Neo Kaolana Sirup
Btl
0
0
495 Neuralgin tab
Tab
0
0
496 Neurobion 5000 injeksi
Amp
0
0
497 Neurobion Putih
Tab
0
0
498 Neurohax
Tab
43
771
0
514
499 Neurosanbe 5000
Tab
0
0
500 Neurosanbe Inj
Amp
0
0
501 New Diatab
Tab
0
0
502 Nonflamin
Kaps
0
0
503 Obat Batuk Ibu Dan Anak 75 ml
Btl
0
0
504 Oksaderm Salep Kulit
Tube
0
0
505 Ondansentron 5 mg
Tab
0
0
506 Ondansentron 8 mg
Tab
0
0
507 Opthalgon 5 ml 508 Osteor 509 Otopain Tetes Telinga 510 Oxytetra Salep Kulit 5 gr
Btl
0
0
Kaps
0
0
Btl
0
0
Tube
0
0
511 Pamol Drops
Btl
0
0
512 Paratusin
Tab
0
0
513 Phenitoin Sodium 100 mg
Tab
0
0
NO
NAMA OBAT
SEDIAAN
STOK per 3112-2018
PEMAKAIAN JAN-DES 2018
1
2
3
4
5
RATA2 OBAT PEMAKAIAN EXP/RUSAK OBAT/ BULAN JAN-DES 2018 6
7
(=KOL 5-kol7):12
514 Pimacolin Sirup
Btl
0
230
KEKOSONGAN OBAT (jumlah kebutuhan bulan kosong)
KEBUTUHAN 8
9
(=kolom 6x18)-kol.4+kol.9
(kalo tjd kosong obat)
19
345
515 Pimtrakol Sirup
Btl
0
0
516 Piracetam 1200 mg
Tab
0
0
517 Piracetam 800 mg
Tab
0
0
518 Pirexin Supp 160 mg
Suppo
0
0
519 Pirexin Supp 80 mg
Suppo
0
0
520 Polysilane Sirup
Btl
0
0
521 Propepsa Sirup
Btl
0
0
522 Proris Sirup
Btl
0
0
523 Protocin Liquid
Btl
0
0
524 Protogenta 5 ml
Btl
0
0
525 Pyrazinamide 500 mg
Tab
0
0
526 Pytramic 500 mg
Tab
0
0
527 Redoxon Eff Zinc
Tab
0
0
528 Regumen
Tab
0
0
529 Renadinac 25 mg
Tab
0
0
530 Rhinofed
Tab
0
0
531 Rhinos
Kaps
0
0
532 Rhinos Drops
Btl
0
0
533 Rhinos Junior Sirup
Btl
0
0
534 Risperidone 2 mg
Tab
535 Sagestam Cream 10 gr
Tube
0
31
0
0
3
47
536 Salbulin CFC ( Inhaler )
Btl
0
0
537 Salbutamol tab 2 mg
Tab
0
0
538 San - B Plex
Tab
0
0
539 Sanadryl DMP Syr
Btl
0
0
540 Sanadryl Exp Sirup
Btl
0
0
541 San-B Plex Drops
Btl
542 Sanmol 500 mg
Tab
0
0
543 Sanmol Drops
Btl
0
0
544 Sanmol Sirup
Btl
0
0
545 Scabimite Cream 10 gr
Tube
0
0
546 Scabimite Cream 30 gr
Tube
0
0
547 Scabimite Cream 5 gr
Tube
0
0
548 Scopamin Plus
Tab
0
0
549 Scopamin
Tab
550 Scopma Plus
Tab
551 Selviplex 552 Siloxan EyeDrop 5 ml
30
0
0
0
15
168
Tab
0
0
Btl
0
0
553 Simcobal 500 mg
Kaps
0
0
554 Simdrol 4 mg
Tab
0
0
555 Simprofen 25 mg
Tab
0
0
556 Sohobion 5000
Tab
500
0
0
557 Starbion
Tab
0
1710
143
2565
558 Stimuno Sirup
Btl
0
0
Kaps
0
0
0
0
0
5
559 Supertin 560 Suprafit
Kaps
561 Thrombopop Gel
Tube
95
0
175
3
562 Tobradex 5 ml
Btl
0
0
563 Tobroson 5 ml
Btl
0
0
564 Tranec 500 mg
Tab
0
0
565 Transamin
Tab
0
0
566 Univit Plus Lysin
Btl
0
0
567 Univit Sirup
Btl
0
0
568 Vasacon A Eye Drop
Btl
0
0
569 Vasacon A. 15 ml
Btl
0
570 Ventolin Nebuleser 2,5 mg
Btl
571 Vernacel Eye Drop
Btl
0
0
572 Vertigosan
Tab
0
0
573 Vicolsin Sirup
Btl
0
0
574 Vit B. Complex Injeksi
Vial
0
0
575 Vitrolenta Eye Drop
0
7
0 22
Btl
0
0
Tube
0
0
577 Vomistop Sirup
Btl
0
0
578 Vomitas Sirup
Btl
0
0
576 Voltaren Emulgel 1% 10 gr
NO
NAMA OBAT
SEDIAAN
STOK per 3112-2018
PEMAKAIAN JAN-DES 2018
1
2
3
4
5
RATA2 OBAT PEMAKAIAN EXP/RUSAK OBAT/ BULAN JAN-DES 2018 6
7
(=KOL 5-kol7):12
579 Zecaneron
Kaps
580 Zircum Kids Sirup
1500
Btl
KEKOSONGAN OBAT (jumlah kebutuhan bulan kosong)
KEBUTUHAN 8
9
(=kolom 6x18)-kol.4+kol.9
(kalo tjd kosong obat)
0
71
4
0
TAMBAHAN
0 TAB
PLESTER 12,5 X 5 M
ROLL
0
10
1
15
DEPO 3 BULAN
BTL
0
60
5
90
ZINK SUPLEMEN KAPS
KAPS
0
6
1
9
VIT B12
TAB
0
1000
83
1500
FITOMENADION K4
TAB
0
300
25
450
Dexanta
TAB
0
0
DIAFORM
TAB
0
150
btl
0
250
21
Safe glove no. 6
pasang
36
14
1
Safe glove no. 7
pasang
200
50
4
safe glove no. 7,5
pasang
40
10
1
safe glove no. 8
pasang
100
50
4
Novakid sirup
100
0
AMITRIPTILLIN
0
180 500 375
Sangobion
Ktk/250tab
0
2400
200
3600
Simvastatin 20mg
ktk/100 tab
0
1100
92
1650
Curcuma plus syrup
0
Btl 60ml
Combivent 2.5 ml UDV
ktk/20amp
Ranitidin inj
ktk/25 amp
Ambroxol 30 mg
ktk/100tab
50
3 0
0
11114
10886
907
5215 4
btl
4
5
0
ktk/10suppo
4
0
0
Protocin liquid inj
ktk/10 amp
3
0
0
Allopurinol tab 300 mg
ktk/100 tab
0
800
67
Gentamicin 0,1 % SK
ktk/ 10
720
0
0
3
7
1
Betadine vag+ alat 100 ml Pyrexin 160mg
Paket OAT Kat 1
paket
Ibuprofen 400 mg
ktk/100 tab
2862
138
12
Ranitidin
ktk/100 tab
1635
138
12
btl 60 ml
4
16
1
Cataflam 50 mg
ktk/50 tab
150
0
Ceterizine tab 10mg
ktk/30 tab
392
0
Gentamisin Salep Kulit
tube
150
0
Betametason Cream 1 %
tube
60
0
Cerini drops
Minidose xitrol
strip/5 amp
5
Caviplex tablet
ktk/100 tab
3000
Clindamycin 300 mg
ktk/50 tab ampul
Prokain Benzyl Penicillin
0
50
20
1200 8
20
0 1000
83
200
0
0
10
20
2
20
5124
427
10
Thiamin HCl tab
ktk/100 tab
7676
Simvastatin 20 mg
ktk/30 tab
600
Zircum Kids Sirup
btl
0 0
Mucos drops
btl
MiKonazole krim
tube
50
0
Salbulin CFC
pcs
3
0
Cendo genta TM
btl
3
0
Depo progestin injeksi
ampul
2
Sohobion tan 5000mg
ktk/100 tab
0
0
zecaneuron kaplet
ktk/100 tab
0
0
Ottopan drops
btl
Curvit sirup
btl
Gentian Violet 1 %
btl
Analsik tablet OBH Combi madu
4
0
13
0
1
21
9
2
8
0
1
ktk/100 tab
100
btl
0
0
1
10
0
0
0
Estin drops 10ml
btl
0
0
Bedak Salisil 2 %
pcs
0
0
UMUM TOTAL JUMLAH KUNJUNGAN RESEP 2018
BAYAR 3626
GRATIS/KTP
1691
BPJS
JUMLAH
5621
10938
JAMKESMAS
Mengetahui / Menyetujui
Pembuat Perencanaan,
Kepala Puskesmas Passo
Penanggung jawab Farmasi,
NO
NAMA OBAT
SEDIAAN
STOK per 3112-2018
PEMAKAIAN JAN-DES 2018
1
2
3
4
5
RATA2 OBAT PEMAKAIAN EXP/RUSAK OBAT/ BULAN JAN-DES 2018 6 (=KOL 5-kol7):12
drg.Bernadeth.M.N.Marlessy NIP : 197812282009042002
7
KEBUTUHAN
KEKOSONGAN OBAT (jumlah kebutuhan bulan kosong)
8
9
(=kolom 6x18)-kol.4+kol.9
(kalo tjd kosong obat)
Trifena P. Mosse. S.Farm., Apt NIP: 19880914 201504 2 001
FORMULIR MONITORING INDIKATOR PERESEPAN Puskesmas
: ……………………………………….
Bulan Tahun
Tgl
No
Nama
Umur
Diagnosis
Jumlah item
Antibiotik Ya / Ti
Injeksi Ya / Ti
Jumlah Gen
1
2
3
4
5
6
7
8
9
1
2 3 1
2
3
1
2
3
1
2
2
3
1
2
3
1
2
3
1
2
3
1
1
2
3
1
2
3
1
2
3
n=
n=
n=
Total 1302 Rata-Rata 1302 Persentase 1302 Total 0102 Rata-Rata 0102 Persentase 0102 Total 21 Rata-Rata21 Persentase 21
A
B
C
D
E
F
G
H
A
B
C
D
E
F
G
H
A
B
C
D
E
F
G
H
SEPAN : …………………….. : ……………………..
a. b. c. d. a. b. c. d. a. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a.
Nama Obat
Dosis
Jumlah Obat
10
11
12
b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a.
b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. Keterangan : n = Jumlah Pasien A = Jumlah Item Obat B = Jumlah Pasien Yang mendapatkan Antibiotik C = Jumlah Pasien Yang Mendapatkan Injeksi D = Jumlah Generik E = A/n F = B/n x 100% G = C/n x 100%
H = D/A x 100%
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
EMAIL
[email protected]
waehoka kayu putih Poka Arbes Ht.Kecil Tawiri urimessing waihaong tiahahu BALAI MATA amahusu karpan nania halong airsalobar belso rijali kilang hutumuri latuhalat benteng lateri passo
[email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected]
xx
xx xx
xx xx
[email protected] xx
[email protected] [email protected]
xx
KEBUTUHAN OBAT DAN PERBEKALAN KESEHATAN PENGADAAN SECARA E-PURCHASING (PAKET 1) KOTA AMBON TAHUN 2019
NO
NAMA OBAT
SEDIAAN
RENCANA KEBUTUHAN
1
2
3
4
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34
AMINOPHYLLINE INJEKSI 25 MG/ML AMLODIPINE TABLET 10 MG AMLODIPINE TABLET 5 MG AMOXYCILLIN TABLET 250 MG AMOXYCILLIN TABLET 500 MG ANTACIDA SIRUP 400 MG/5 ML ANTACIDA TABLET ASCORBIC ACID (VITAMIN C) TABLET 250 MG ASCORBIC ACID (VITAMIN C) TABLET 50 MG BETAMETHASONE SALEP 0.1% BISACODYL (DULCOLAX) SUPPO 10 MG BISACODYL (DULCOLAX) SUPPO 5 MG CALCIUM GLUCONAS INJ CARBAMAZEPINE TABLET 200 MG CEFADROXIL TABLET MG CHLORAMPHENICOL EYE OINT CHLORPHENIRAMINE TABLET 4 MG CIPROFLOXACIN TABLET 500 MG CLINDAMYCIN TABLET 300 MG COLCHICINE TABLET 0.5 MG CYANOCOBALAMIN INJEKSI DEXAMETHASONE INJEKSI 5 MG/ML DEXAMETHASONE TABLET 0.5 MG DICLOFENAC SODIUM TABLET 50 MG (NATRIUM DIKLOFENAK) DOMPERIDONE SIRUP 5 MG/5 ML DOMPERIDONE TABLET 10 MG EPINEPHRINE INJEKSI 1 MG/ML ERYTHROMYCIN TABLET 500 MG FUROSEMIDE INJEKSI 10 MG/ML GENTAMYCIN INJEKSI 40 MG/ML HYDROCORTISONE SALEP 2.5 % IBUPROFEN SIRUP 100 MG/5 ML IBUPROFEN TABLET 200 MG IBUPROFEN TABLET 400 MG
AMPUL TABLET TABLET TABLET TABLET BOTOL TABLET TABLET TABLET TUBE SUPP SUPP TABLET TABLET TUBE TABLET TABLET TABLET TABLET AMPUL AMPUL TABLET TABLET BOTOL TABLET AMPUL TABLET AMPUL AMPUL TUBE BOTOL TABLET TABLET
300 ### 60,000 ### 59,000 ### 30,000 ### 200,000 ### 3500 ### 180000 ### 200000 ### 300000 ### 3300 ### 300 ### 300 ### 750 6000 ### 60000 ### 2000 ### 160000 ### 35500 ### 7400 ### 2500 ### 1200 ### 1000 ### 500000 ### 100000 ### 4000 ### 26000 ### 1600 ### 4800 ### 1500 ### 600 ### 3880 ### 3750 ### 110000 ### 300000 ###
T O T A L
35 36 37 38 39 40 41 42 43 44 45 46 47 48
KETOCONAZOLE SALEP 2% KETOROLAC INJEKSI 30 MG/ML LOPERAMIDE TABLET 2 MG LORATADINE TABLET 10 MG MAGNESIUM SULPHATE INJEKSI 20 % (MGS04) METFORMIN TABLET 500 MG METHYLPREDNISOLONE TABLET 8 MG METRONIDAZOLE TABLET 500 MG MICONAZOLE SALEP 2% NIFEDIPINE TABLET 10 MG NYSTATIN TABLET 50000 IU OMEPRAZOLE TABLET 20 MG PARACETAMOL DROPS 100 MG/ML PARACETAMOL SIRUP 120 MG/5 ML
TUBE AMPUL TABLET TABLET AMPUL TABLET TABLET TABLET TUBE TABLET TABLET TABLET BOTOL BOTOL
1500 ### 1000 ### 6000 ### 19500 ### 500 ### 130000 ### 30000 ### 23600 ### 2400 ### 10000 ### 1000 ### 60000 ### 1000 ### 17100 ###
###
NO 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73
NAMA OBAT
SEDIAAN
PHYTOMENADIONE (VITAMIN K) INJEKSI 2 MG/ML (FITOMENADIO PHYTOMENADIONE (VITAMIN K) TABLET 10 MG (FITOMENADION PYRIDOXINE TABLET 10 MG SALICYLIC ACID SERBUK 2% SPIRONOLACTONE TABLET 100 MG ALAT SUNTIK 0.05 CC ALAT SUNTIK 0.5 CC ALAT SUNTIK 1 CC ALAT SUNTIK 3 CC ALAT SUNTIK 5 CC THIAMINE (VITAMIN B1) TABLET 50 MG Ambroksol tablet 30 mg Amoksisilin Syr Kering 125mg/5ml Amoksisilin Sirup Forte Anti Bakteri Doen (Bacitrasin Salep) Anti fungi DOEN komb.As. Benzoat 6 % + as.Salisilat 3% Anti Hemoroid Suppositoria Antimigren tab AquaPro Injeksi steril Asam Folat Asam Mefenamat 500 mg Asam Traneksamat inj Asiklovir cream Besi II Sulfat (Tablet tambah darah) Betahistin Mesilat 6mg
AMPUL TABLET TABLET SERBUK TABLET
PCS PCS PCS TABLET TABLET BOTOL BOTOL TUBE POT SUPP TABLET Vial TABLET TABLET AMPUL TUBE TABLET TABLET
RENCANA KEBUTUHAN ### 3000 ### 3000 ### 130500 ### 2500 ### 1500 ### 12000 ### 5000 ### 12500 ### 15000 ### 5000 ### 437400 ### 60000 ### 4000 ### 1000 ### 5000 ### 84.00 ### 840.00 ### 700.00 ### 700.00 ### 3,000.00 ### 225,900.00 ### 3000 ### 3500 ### 1,556,400.00 ### 2,000.00 ###
74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101
Citicolin inj Combivent UDV 2.5mg Diazepam 2 mg tab Diltiazem HCl Etanol 70 % - 100 ML Fenol gliserol TT 10% Furosemid 40 mg tab Garam Oralit 200 ml Gentamisin Salep Kulit Gentamisin Sulfat Tetes mata Gentian Violet 1 % - 10 ML Glibenklamid tablet 5 mg Gliseril Guayakolat tablet 100 mg Glimepiride 2 mg tab Griseovulfin tablet 125 mg micronized Haloperidol tablet 1,5 mg Hidroklortiaside (HCT) tablet 25 mg Kalsium Laktat (kalk) tab 500 mg Klorampenicol kapsul 250 mg Klorampenicol SM Kotrimoksazol 480mg Mertigo tab Oksitetrasiklin HCl inj 50 mg/ml-10 ml Oksitetrasiklin HCl Salep mata Ondansentron inj Parasetamol tablet 500 mg Pil Kb Oral Komb Piracetam 400mg
AMPUL Vial TABLET TABLET BOTOL BOTOL TABLET SACHET TUBE BOTOL BOTOL TABLET TABLET TABLET TABLET TABLET TABLET TABLET KAPSUL TUBE TABLET TABLET Vial TUBE AMPUL TABLET STRIP TABLET
500.00 ### 2,000.00 ### 9,000.00 ### 2,000.00 ### 200.00 ### 700 ### 3000 ### 6000 ### 4000 ### 800.00 ### 300.00 ### 20,000.00 ### 51,500.00 ### 30000 ### 10000 ### 1200 ### 2000 ### 250000 ### 5000 ### 2000 ### 24000 ### 1000 ### 240.00 ### 1,800.00 ### 300.00 ### 400000 ### 3,000.00 ### 2,000.00 ###
###
NO 102 103 104 105 106 107 108 109 110 111 112
NAMA OBAT Piracetam inj Piroksikam 20 mg Prednison tablet 5 mg Prokain Benzyl Penicillin Propil tiouracil tablet 100 mg Propranolol HCl tab 40 mg Ranitidin inj Ranitidin tablet 150 mg Retinol 100.000 IU Retinol 200.000 IU Ringer lactat lar.infus
SEDIAAN AMPUL TABLET TABLET Vial TABLET TABLET AMPUL TABLET KAPSUL KAPSUL BOTOL
RENCANA KEBUTUHAN ### 10.00 ### 30,000.00 ### 10,000.00 ### 200.00 ### 3,000.00 ### 3,000.00 ### 2,000.00 ### 25,000.00 ### 10000### 5,800.00 ### 4000 ###
113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128
Rivanol larutan 0,1 % - 300 ML Salep 2-4 Komb: As. Salisilat 2% + Belerang Endap 4% Sefadroksil 500 mg Sefiksim 400mg + Azytromisin 1000mg Sefotaksim inj 1g Seftriakson inj 1g Simetidin 200 mg Simvastatin tab 10 mg Stesolid supp Tetraciklin HCL kap 500 mg Thiamin HCL injeksi Triheksilfenidil Hidroklorida tablet 2 mg Vitamin B compleks tab Vaksin Rabies Rapidtest HIV 1-2 Rapidtest Syphilis
BOTOL POT TABLET PAKET Vial Vial TABLET TABLET TUBE KAPSUL AMPUL TABLET TABLET AMPUL caset caset
150.00 ### 1,600.00 ### 150,000.00 ### 100.00 ### 1,000.00 ### 1,000.00 ### 20,000.00 ### 55,020.00 ### 100.00 ### 5,000.00 ### 700.00 ### 1,500.00 ### 280,000.00 1,100.00 6,000.00 5,000.00
PPK Pengadaan Obat dan Perbekes Dinas Kesehatan Kota Ambon,
H.Kotalewala,S.Si,Apt.MPH NIP.19730914 199903 1004
