Lplpo Pakisaji Feb 19.xlsx
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LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) DINAS KESEHATAN KABUPATEN MALANG PROPINSI JAWA TIMUR KODE PUSKESMAS
: 35 07 21 01
PUSKESMAS
: PAKISAJI : PAKISAJI : MALANG : JAWA TIMUR
KECAMATAN KABUPATEN PROPINSI
NO
NAMA OBAT
SATUAN
02 02
DOKUMEN PERBEKALAN FARMASI PELAPORAN BULAN / PERIODE
: FEBRUARI
2019
PERMINTAAN BULAN / PERIODE
:MARET
2019
Nomor Tanggal
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG
PEMBERIAN JKN
OBAT GENERIK 1 Albendazol 400 mg 2 Alopurinol 100 mg 4 Ambroxol 30 mg 5 Aminofilina 200 mg 6 Amlodipin 5 mg 7 Amlodipin 10 mg 8 Amoksilin 250 mg 9 Amoksilin 500 mg 10 Antalgin 500 mg 11 Antasida (MgOH 200mg+AlOH 200mg) 13 Asam Askorbat ( Vit C ) 50 mg 14 Asam Askorbat ( Vit C ) 250 mg 15 Asam folat 1 mg 16 Asam mefenamat 500 mg 17 Asam Traneksamat 500 mg 18 Asetosal 100 mg 19 Asetylcysteine 200 mg 20 Asiklovir 400mg 21 Azithromycin 500 mg
TABLET TABLET TABLET TABLET TABLET TABLET KAPSUL KAPLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET KAPSUL TABLET
0 3,520 3,842 0 297 13,000 3,941 9,700 10,640 0 11,450 3,788 203 3,460 5,388 987 2,703 6,336 4,239 319
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 3,520 3,842 0 297 13,000 3,941 9,700 10,640 0 11,450 3,788 203 3,460 5,388 987 2,703 6,336 4,239 319
0 0 311 0 26 2,127 1,843 327 3,832 0 4,601 868 0 10 4,184 273 2,202 741 213 0
0 3,520 3,531 0 271 10,873 2,098 9,373 6,808 0 6,849 2,920 203 3,450 1,204 714 501 5,595 4,026 319
0 3,490 1,700 0 0 8,670 1,200 7,400 4,300 0 4,400 1,500 0 0 0 450 0 4,700 2,950 300
1,000 5,000
12,000 10,000 10,000 5,000 5,000 10,000 1,000
: :
KET.
PROGRAM BANTUAN
### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
NO 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 43 44 45 46 47 48 49 50 51 52 53
NAMA OBAT Betahistin mesilat 5 mg Cefadroxil 500 mg Cefixim Cetirizin 10mg Deksametason 0,5 mg Digoksin 0,25 mg Dimenhidrinat tablet 50mg Doksisiklin 100mg Domperidon tablet 10 mg Eritromisin 500mg Fitomenadion (Vit K1) 10mg Furosemid 40 mg Glibenklamid 5 mg Glimepiride tablet 2 mg Gliseril Guaiakolat 100 mg Griseofulvin 125 mg Hidroklorotiazid (HCT) 25 mg Hyosin N Butilbromida 10mg Ibuprofen 200 mg Ibuprofen 400 mg Isosorbid Dinitrat sublingual 5 mg Kalsium Laktat (Kalk) 500 mg Kaptopril 12,5 mg Kaptopril 25 mg Ketokonazol 200mg tablet Klindamisin kapsul 150 mg Klindamisin kapsul 300 mg Klopidogrel Kloramfenikol kapsul 250 mg Kloramfenikol kapsul 500 mg Klorfeniramin Maleat (CTM) 4 mg
SATUAN TABLET TABLET KAPSUL TABLET TABLET TABLET TABLET KAPSUL TABLET TABLET KAPLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET KAPSUL TABLET KAPSUL TABLET TABLET
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG 3,492 6,025 375 3,327 16,246 3,069 2,092 220 2,613 1,247 3,281 1,922 15,116 10,528 780 2,686 3,247 4,242 242 18 1,862 7,791 6,152 18,669 730 2,186 0 270 70 4,643 15,348
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
3,492 6,025 375 3,327 16,246 3,069 2,092 220 2,613 1,247 3,281 1,922 15,116 10,528 780 2,686 3,247 4,242 242 18 1,862 7,791 6,152 18,669 730 2,186 0 270 70 4,643 15,348
411 1,062 10 293 2,940 55 185 0 391 621 686 163 1,858 1,547 130 10 195 297 81 0 27 1,356 764 1,427 0 333 0 0 0 608 3,481
3,081 4,963 365 3,034 13,306 3,014 1,907 220 2,222 626 2,595 1,759 13,258 8,981 650 2,676 3,052 3,945 161 18 1,835 6,435 5,388 17,242 730 1,853 0 270 70 4,035 11,867
1,420 3,900 0 2,540 12,400 2,200 1,000 0 800 0 1,000 1,100 10,600 8,050 0 1,400 1,400 3,500 0 0 500 4,400 4,200 15,500 550 1,250 0 0 0 2,300 10,200
2,000
3,000 5,000 3,000 2,000
10,000
5,000 10,000 1,000
1,000 3,000 3,000 2,000 10,000
PEMBERIAN
KET. ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
NO
NAMA OBAT
SATUAN
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG
dewasa kombinasi : 54 Kotrimoksazol Sulfametoksazol400mg+Trimetoprim80mg
TABLET
5,667
0
55 56 57 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83
TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET
1,360 70 3,856 0 29,889 500 1,890 2,077 1,502 5,996 15,347 1,024 226 6,818 147 16,628 270 40 546 2,388 1,473 302 7,240 4,701 3,403 7,408 7,349 300
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
Levofloksasin 500 mg Loperamide 2 mg Loratadin tablet 10 mg Meloksikam tablet 7,5 mg Metformin 500mg tablet Methylsoprinol Metil Prednisolon 4 mg Metilergometrin Maleat 0,125 mg Metoklopramid 5mg Metronidazol 500mg Natrium Diklofenac 50 mg Nifedipin 10 mg tablet Nistatin tablet vaginal 100.000 IU/g Omeprazole 20mg Ondansetron 4 mg Parasetamol 500 mg Pirantel 125 mg Pirasetam 800 mg tablet Piridoksin HCL (Vit B6) tablet 10 mg Prednison tablet 5 mg Propanolol HCL tablet 10 mg Propiltiourasil tablet 100 mg Ranitidin tablet 150 mg Salbutamol tablet 2 mg Salbutamol tablet 4 mg Simvastatin 10 mg Siprofloksazin tablet 500 mg Spironolacton
443 5,667 1,360 70 3,856 0 29,889 500 1,890 2,077 1,502 5,996 15,347 1,024 226 6,818 147 16,628 270 40 546 2,388 1,473 302 7,240 4,701 3,403 7,408 7,349 300
200 0 385 0 2,065 0 470 100 399 207 2,173 184 20 395 111 10,171 0 0 126 1,706 29 0 1,492 1,099 50 492 318 0
PEMBERIAN
KET.
3,700 5,224 1,160 70 3,471 0 27,824 500 1,420 1,977 1,103 5,789 13,174 840 206 6,423 36 6,457 270 40 420 682 1,444 302 5,748 3,602 3,353 6,916 7,031 300
400 0 3,200 0 25,400 500 0 700 0 4,000 11,340 0 60 5,580 0 4,000 100 0 0 0 900 200 4,000 2,000 2,700 5,420 5,100 300
2,000 2,000 5,000
2,000 2,000 5,000
5,000
3,000 20,000 5,000 10,000 5,000
5,000 2,000
### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
SATUAN
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG
Tambah Darah Kombinasi : Besi sulfat 84 Tablet 200mg+Asam folat 0,25mg
TABLET
126,577
0
85 86 87 88 89 90
TABLET TABLET TABLET KAPSUL KAPSUL KAPSUL TABLET TABLET
VIAL VIAL AMPUL AMPUL BOTOL VIAL AMPUL AMPUL AMPUL
202 760 100 3,430 10,416 7,376 0 0 34 350 285 18 0 564 513 27 149 100 345
0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0
komp injeksi,Kombinasi:Lidokain 107 Lidokain HCl2%+Epinefrin1:80000-2ml
AMPUL
660
100
108 Magnesium sulfat injeksi (IV) 20 % - 25 ml 109 Magnesium sulfat injeksi (IV) 40 % - 25 ml 110 Metilergometrin Maleat inj. 0,200mg-1ml
AMPUL AMPUL VIAL
13 18 100
0 0 100
111 Metoklopramid inj. 5mg / ml
AMPUL
27
0
112 Oksitosin injeksi 10 IU/ml - 1 ml 113 Omeprazole 40 mg inj.
BOTOL BOTOL
38 169
200 0
NO
b. 92 93 94 96 97 98 99 100 101 103 104 105
NAMA OBAT
Tetrasiklin HCL kapsul 250 mg Tetrasiklin HCL kapsul 500 mg Thiamfenikol 500mg kapsul Tiamin HCL (VitB1) 50 mg Vitamin B Kompleks Zinc 10 mg Injeksi Aminofilina 24 mg/ml - 10 ml Amoksisilin 1000mg Ampisillin im/iv 1000mg/ml Aqua pro injeksi, bebas pirogen Atropin sulfat 0,25mg/ml-1 ml Ceftriaxone 1 gr injeksi Deksametason injeksi 5 mg/ml-1ml Difenhidramin HCL Inj 10mg/ml-1 ml Epinefrin injeksi Fitomenadion (Vit K1)inj 10mg/ml-1ml Furosemid injeksi Gentamisin injeksi
126,577 202 760 100 3,430 10,416 7,376 0 0 34 350 405 18 0 564 513 27 149 100 345
26,878 0 0 10 900 2,775 1,518 0 0 34 88 203 0 0 99 25 4 20 8 71
99,699 202 760 90 2,530 7,641 5,858 0 0 0 262 202 18 0 465 488 23 129 92 274
80 760 13 18 200 27 238 169
1 1 9 27 13 22
95,040 0 700 0 1,000 6,100 4,300 0 0 0 210 124 15 0 345 316 9 52 50 235 494
680 12 17 191 0 225 147
5,000 5,000 10,000 5,000 100 500 500 500 100 20 100 100 200
PEMBERIAN
KET. ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
300
4 2 142
10 10 100
0
1,000
193 80
100 500
### ### ### ### ### ### ###
NO 114 115 117 118
NAMA OBAT Ondansetron injeksi Piracetam injeksi 1 gr / 5 ml Ranitidin injeksi 25mg/2ml Sefotaksim injeksi 1 gram
SATUAN
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG
AMPUL AMPUL AMPUL VIAL
628 0 1,089 262
0 0 0 0
119 Sianokobalamin(VitB12)inj.500mcg/ml-1ml
AMPUL
119
0
120 Tiamin HCl (Vit.B1) injeksi 100 mg/ml-1 ml
BOTOL
53
0
BOTOL AMPUL
92 0
0 0
VIAL
71
0
Asiklovir krim 5% Bacitracin SK Betametason krim 0,1 % Gentamisin 0,3 % salep mata Gentamisin 0,1 % salep kulit Hidrokortison krim 2,5 % Kloramfenikol 1 % salep mata Kloramfenikol 2 % salep kulit Miconazol cream 2 % Oksitetrasiklin HCL 1 % salep mata Oksitetrasiklin HCL 3 % salep kulit
AMPUL VIAL AMPUL AMPUL POT TUBE TUBE TUBE TUBE TUBE
30 196 254 7 0 220 1 67 179 245 0
0 0 0 0 0 0 0 0 0 0 0
2-4 Komb: As salisilat2%+Belerang 134 Salep endap4%
TUBE
58
0
TUBE TUBE TUBE TUBE TUBE POT
81 0 4,192 134 0 465
0 0 0 0 0 0
121 Tranexamat Acid Inj. 250 mg/5 ml c. Salep 122 Antifungi (As. Benzoat6%+As. salisilat 3%) 123 124 125 126 127 128 129 130 131 132 133
135 d. 136 137 e. 138
Sulfadiazine Silver Cream Serbuk Garam oralit untuk 200 ml air Salisil Bedak 2 % Sirup Amoksilin 125mg/5ml
628 0 1,089 262 119 53 92 0 71 30 196 254 7 0 220 1 67 179 245 0 58 81 0 4,192 134 0 465
100 0 345 39 0 7 18 0 12 11 0 16 0 0 47 1 3 13 7 0 1 5 0 582 19 0 82
528 0 744 223 119 46 74 0 59 19 196 238 7 0 173 0 64 166 238 0 57 76 0 3,610 115 0 383
515 0 738 60
200 200
0
300
0
200
500
60 0 30
PEMBERIAN
KET. ### ### ### ### ### ### ### ### ###
0 170 200 0 0 129 0 0 96 179 0
120
28
48
52 0 2,700 57 0 286
3,000 200
120 120 120 120
120
120
### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
NO
NAMA OBAT
SATUAN
syr (MgOH 200mg/5ml+AlOH 139 Antasida 200mg/5ml) 140 141 142 143 144 145
Cefadroxil Syr Cetirizin syr Dextrofen Eritromisin sirup Ibuprofen suspensi 100mg/5ml Kloramfenikol suspensi 125mg/5ml
Suspensi komb: Sulfametoksazol 146 Kotrimoksazol 200mg+Trimetoprim40mg/5ml 147 Metronidazole Suspensi 148 Obat Batuk Hitam ( O B H ) cairan 149 Parasetamol drop 100mg/ml btl @ 15ml 150 Parasetamol sirup 120mg/5ml d. Tetes 152 Fenol Gliserol tetes telinga 10 % 153 Gentamisin tetes mata 0.3% 154 Gentian violet larutan 1 % 155 Karbo Glycerin 156 Kloramfenikol tetes mata 157 Kloramfenikol tetes telinga 3 % 158 Litrol TM/ Cendo Xitrol TM 159 Pantocain TM 160 Sulfasetamid Natrium tetes mata 15 % ALKES DAN CAIRAN LUAR 161 Alat suntik sekali pakai 01 ml 162 Alat suntik sekali pakai 03 ml 163 Alat suntik sekali pakai 05 ml 164 Alat suntik sekali pakai 10 ml 165 Alat suntik sekali pakai 20 ml
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG 2,345
0
VIAL BOTOL BOTOL
0 37 114 27 38 906
0 0 0 0 0 0
BOTOL
403
0
BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL
165 38 109 1,292 0 143 123 8 0 0 19 4 2 4 0 3,697 10,430 2,941 772 388
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
SACHET POT
BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL SET SET SET
2,345 0 37 114 27 38 906
227 0 2 34 1 14 75
2,118 0 35 80 26 24 831
19 403 165 38 109 1,292 0 143 123 8 0 0 19 4 2 4 0 3,697 10,430 2,941 772 388
3 3 24 145 0 15 2 0 0 0 12 0 1 0 0 238 1,682 718 86 7
2,032 0 23 44 0 0 755
200 50 200 120 300
PEMBERIAN
KET. ### ### ### ### ### ### ###
323 384 162 35 85 1,147 0 128 121 8 0 0 7 4 1 4 0 3,459 8,748 2,223 686 381
129 0 41 1,032 0 76 118 0 0 0 0 0 0 0 0 3,014 8,035 1,815 599 364
500 200
120 100 120 120 120
120
2,000
### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG
NO
NAMA OBAT
SATUAN
166 167 168 169 170 171 172
Alat suntik sekali pakai 50 ml Alkacide Alkazyme Alkohol Swab Anti Hemoroid (Bismut subgallat150mg+Heksak Antiseptic Cairan/ Poli Clean 500 ml Blood Tranfusion set
SET BOTOL BOTOL BOTOL PCS SACHET SACHET
100 6 7 4 162 20 173
0 5 5 0 0 0 0
LEMBAR
253
0
142 15 90 16 4 44 92 100 67 99 830 0 10,580 390 0 232 445 362 314 163 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0
173 Catgut chromic/benang bedah No. 2/0-3/0 174 175 176 177 178 179 180 181 182 183 184 185 186 189 191 192 193 194 195 196 197 198
Catgut plain/benang bedah No. 2/0-3/0 Catheter Gel (MY Gel/Aqua Gel) Cavilon Daryantulle Etanol 70 % 100 ml Etanol 70 % 1000 ml Female Cath.16 Female Cath.18 Foley Catheter no.16 Foley Catheter no.18 Glucose Protein Tes Hanschoen Non Steril (S) Hanschoen Non Steril (M) Hanschoen Steril No. 7 Hanschoen Steril Obgyn I.V. Catheter No 18 I.V. Catheter No 20 I.V. Catheter No 22 I.V. Catheter No 24 I.V. Catheter No 26 ID Band (gelang pasien) Anak Biru ID Band (gelang pasien) Anak Pink
BOTOL BOTOL PCS PCS KOTAK PCS PCS PCS PCS PCS PCS PCS PCS ROL ROL PAK BOTOL PCS PCS PCS PCS PCS
100 11 12 4 162 20 173 253 142 15 90 16 4 44 92 100 67 99 830 0 10,580 490 0 232 445 362 314 163 2 2
0 0 0 2 29 4 26 24 5 0 0 1 0 0 0 0 21 28 6 0 3,264 52 0 19 77 114 40 4 0 0
100 11 12 2 133 16 147 229 137 15 90 15 4 44 92 100 46 71 824 0 7,316 438 0 213 368 248 274 159 2 2
100 7 11 0 0 15 130
5 50 200
201
120
116 14 90 0 0 26 75 92 22 53 810 0 6,100 388 0 188 334 226 245 140 1 1
120
300 20
50 50 2,000 6,000 200 100 200 300 100 2 2
PEMBERIAN
KET. ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
NO 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 221 222 223 224 225 226 227 228 229 230
NAMA OBAT ID Band (gelang pasien) Dewasa Biru ID Band (gelang pasien) Dewasa Kuning ID Band (gelang pasien) Dewasa Pink Infusion set anak Infusion set dewasa Inplant Kit Iodium Test IUD Kit Kantong mayat Kapas Pembalut / Absorben 250 gr Kasa Pembalut 2 m x 80 cm Kasa Pembalut 4 x 80 yard Kasa Pembalut Hidrofil 4 m x 3 cm Kasa Pembalut Hidrofil 4 m x 5 cm Kasa Pembalut Hidrofil 4 m x 15 cm Kasa Steril Khlorin Leukoplast 2,5 cm x 4,5 m Leukoplast 5 cm x 4,5 m Leukoplast 7,5 cm x 4,5 m Masker Hijab Masker Tali Masker N 95 Masker Nebulazer Anak Masker Nebulazer Dewasa Masker NRBM Anak Masker NRBM Dewasa Mucus Extractor Nasal Canul Bayi Nasal Canul Anak Nasal Canul Dewasa
SATUAN BOTOL PCS ROL PCS BOTOL SACHET PAK PCS PCS BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL TABLET TUBE SUPP SUPP TUBE TUBE BOTOL TABLET
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG 5 1 5 211 56 2 12 1 17 47 263 26 14 854 502 130 10 20 0 260 5,950 9,816 2 33 115 73 66 100 110 55 77
0 0 0 0 300 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
5 1 5 211 356 2 12 1 17 47 263 26 14 854 502 130 10 20 0 260 5,950 9,816 2 33 115 73 66 100 110 55 77
0 0 0 24 112 0 0 0 0 7 11 6 0 33 64 21 1 5 0 19 49 1,046 0 0 5 0 3 10 0 14 14
5 1 5 187 244 2 12 1 17 40 252 20 14 821 438 109 9 15 0 241 5,901 8,770 2 33 110 73 63 90 110 41 63
5 1 4 164 192 2 12 1 17 24 206 13 0 738 358 87 4 13 0 228 5,650 8,200 2 28 107 71 61 90 103 33 48
2 200 400
20 20 500 500 500 300 3 100 100 100
50
100 100
PEMBERIAN
KET. ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
NO
NAMA OBAT
236 NGT No.16 237 One Med H₂- O₂ 3 % 238 One Med Surgical Blade/ Mess 239 Plasterin 240 Plester 5 yards x 2 inch 241 Plester infus 242 Poli Wash 500 ml 243 Poli Wash 5 Liter 244 Rivanol larutan 0,1 % 300ml 245 Safety box 246 Silk ( Benang Bedah Sutera ) No. 3/0 247 Spalk 248 Steri Strip 249 Styrofoam 250 Styrofoam Tali 252 Suction Cath.No.14 257 Tensocrape 10 cm 258 Ultrasonic Gel (USG Gel) 259 Umbilical Clem (Klem Tali Pusat) 260 Underpad 261 Urine Bag 262 Yodium Povidon larutan 10 % 30 ml 263 Yodium Povidon larutan 10 % 300 ml 264 Yodium Povidon larutan 10 % 1 L ml INFUS 267 Asering Larutan infus 268 Glukosa larutan infus 5 % steril 269 Glukosa larutan infus 10 % steril 270 Glukosa larutan infus 40 % steril 271 KAEN 3B 272 Metronidazol infus
SATUAN TABLET BIJI AMPUL AMPUL TABLET BOTOL BIJI AMPUL TUBE TABLET PCS TABLET TABLET BOTOL BOTOL PCS PCS PCS PCS PCS PCS PCS PCS PCS PCS PCS PCS PCS SACHET
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG 10 2 117 4,382 6 1,255 2 18 8 72 122 4 1 5 1 16 20 4 2 534 307 75 15 13 0 105 366 33 2 65 0
50 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 780 0 0 0 300 0
60 2 117 4,382 6 1,355 2 18 8 72 122 4 1 5 1 16 20 4 2 534 307 75 15 14 0 885 366 33 2 365 0
0 0 2 779 0 147 0 0 0 25 18 0 0 0 0 0 0 0 0 61 12 8 0 1 0 358 10 11 0 62 0
60 2 115 3,603 6 1,208 2 18 8 47 104 4 1 5 1 16 20 4 2 473 295 67 15 13 0 527 356 22 2 303 0
58 0 0 3,000 0 1,001 1 17 4 36 83 4 1 5 1 16 20 4 2 429 271 60 7 9 0 482 320 18 0 280 0
100 120
200 20 50 200
PEMBERIAN
KET. ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
NO
NAMA OBAT
273 Natrium Klorida larutan infus 0,9 % steril 274 Paracetamol Infus 275 Ringer Lactate infus steril OBAT PATEN 276 Adalat Oros 277 Aptil 278 Bisakodil suppositoria anak 5 mg 279 Bisakodil suppositoria dewasa 10 mg 280 Bravoderm 281 Bufacomb 282 Calporosis 283 Combivent 284 Demacolin 285 Lactodia 286 Laxadin sirup 287 Metamizole injeksi 500 mg 288 Microlax 289 Multivitamin inj. 5000 mcg 290 Multivitamin syr 291 Multivitamin tablet 292 Noza/ Flurin 293 Obat Batuk Anak sirup 294 296 297 298 e. 303 304 314
Paracetamol Rectal Permetrin/ Scabicid krim 5% Puralex Spasminal Gigi Etil Klorida semprot (Lidocain Spray) Eugenol cairan Retinol ( Vit A ) kapsul 100.000 IU
SATUAN TABLET
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG
BOTOL BOTOL BOTOL BOTOL TUBE BOTOL TUBE BOTOL BOTOL
338 0 371 0 2,836 21 22 138 2 1 3,701 163 0 3 71 320 0 353 17 1,300 4,000
500 0 1,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
BOTOL
5
0
BOTOL PAKET KAPSUL KAPSUL AMPUL KAPSUL AMPUL TABLET
0 234 4,455 35 0 62 1 14
0 0 0 0 0 0 0 0
TABLET TUBE TABLET TABLET TUBE TABLET TABLET TABLET
838 0 1,371 0 2,836 21 22 138 2 1 3,701 163 0 3 71 320 0 353 17 1,300 4,000 5 0 234 4,455 35 0 62 1 14
255 0 289 0 274 0 0 8 0 0 855 70 0 0 10 16 0 127 0 0 2,156 0 0 17 324 0 0 0 0 14
583 0 1,082 0 2,562 21 22 130 2 1 2,846 93 0 3 61 304 0 226 17 1,300 1,844 5 0 217 4,131 35 0 62 1 0
556 0 1,034 0 2,250 20 22 128 0 0 1,080 66 0 0 33 280 0 169 0 400 1,500 0 0 113 3,350 0 0 61 0 0
200 200
120 120 200 5,000
200 300 300 5,000 5,000 200
5,000
PEMBERIAN
KET. ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
NO 315 g. 316 317 318 319 321 322 323 325 326 327 328 330 331 k. 346 347 348 350 351 352 n. 370 372 373 374 377 379 381 KB
NAMA OBAT Retinol ( Vit A ) kapsul 200.000 IU Jiwa Alprazolam Amitriptilin HCL 25 mg Clozapin tab Fenitoin Natrium 100 mg Haloperidol 1,5 mg Haloperidol 5 mg Karbamazepin 200 mg Klorpromazin HCL tablet salut 25 mg Klorpromazin HCL tablet salut 100 mg Lodomer 5mg/ml inj Risperidone 2mg Trifluoperazin tablet 5 mg Triheksifenidil Hidroklorida tab 2 mg Psikotropik & Narkotik Diazepam 2 mg Diazepam 5 mg Diazepam injeksi 5 mg/ml - 2 ml Kodein tablet 10 mg Stesolid rectal supp 5 mg Stesolid rectal supp 10 mg TB Paru Isoniazid (INH) 100mg Obat Antituberkulosis Anak Obat Antituberkulosis kategori 1 ( FDC ) Obat Antituberkulosis kategori 2 ( FDC ) Slide Sputum pot Ziehl nelseen
SATUAN VIAL VIAL TABLET PCS KAPSUL TABLET PCS TABLET PCS SET KAPSUL PAKET PAKET TABLET AMPUL TABLET TABLET TABLET BIJI TABLET PAKET PAKET PAKET PAK BIJI PAKET
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG 113 0 100 621 1,260 500 157 0 100 5 0 36 1,383 2,065 713 0 0 0 60 889 0 0 0 857 0 12 0 8 268 13 0
0 0 0 300 0 0 1,000 1,000 0 0 1,000 0 0 0 1,000 0 0 0 0 200 0 0 0 0 4 24 1 10 200 5 0
113 0 100 921 1,260 500 1,157 1,000 100 5 1,000 36 1,383 2,065 1,713 0 0 0 60 1,089 0 0 0 857 4 36 1 18 468 18 0
113 0 0 31 31 0 374 146 0 0 263 0 613 413 735 0 0 0 0 437 0 0 0 17 0 4 1 1 160 1 0
0 0 100 890 1,229 500 783 854 100 5 737 36 770 1,652 978 0 0 0 60 652 0 0 0 840 4 32 0 17 308 17 0
0 0 100 800 1,000 300 500 700 100 0 700 24 700 1,500 900 0 0 0 60 400 0 0 0 800 4 32 0 15 266 16 0
200 1,000 1,000
1,000 1,000 500 1,000 500 500 500 20 20
PEMBERIAN
KET. ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
NAMA OBAT
NO 382 383 384 385 386 387
Depo kombinasi Indoplant IUD COPER T kondom Pil. Kombinasi Spuit 3 cc (KB)
SATUAN
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG 226 30 75 10 10 340
vial set set set tab set
0 100 0 0 0 100
226 130 75 10 10 440
20 6 3 0 0 42
PEMBERIAN
140 66 59 10 0 320
206 124 72 10 10 398
KET. ### ### ### ### ### ### TOTAL
UMUM
JUMLAH KUNJUNGAN
RAWAT JALAN RAWAT INAP
1,624
A/n KA. DINAS KESEHATAN Ka. UPTD PERBEKALAN FARMALKES
TIDAK BAYAR
150
RAWAT JALAN
351
BPJS
RAWAT INAP
0
RAWAT JALAN
JUMLAH
RAWAT INAP
1,466
RAWAT JALAN RAWAT INAP
150
3,441
300
PETUGAS
MENGETAHUI
MALANG, 25 FEBRUARI 2019
UPTD PERBEKALAN FARMALKES
Plt. KEPALA UPT PUSKESMAS
PETUGAS PENGELOLA OBAT
drg. DEWI AMINAH
DEDI DARMAWAN
NIP: 19720607 200501 2 008
NIP: 19831127 200904 1 002
02
: 35 07 21 01
PUSKESMAS
: PAKISAJI : PAKISAJI : MALANG : JAWA TIMUR
KECAMATAN KABUPATEN PROPINSI
NO
NAMA OBAT
SATUAN
02 02
DOKUMEN PERBEKALAN FARMASI PELAPORAN BULAN / PERIODE
: FEBRUARI
2019
PERMINTAAN BULAN / PERIODE
:MARET
2019
Nomor Tanggal
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG
PEMBERIAN JKN
OBAT GENERIK 1 Albendazol 400 mg 2 Alopurinol 100 mg 4 Ambroxol 30 mg 5 Aminofilina 200 mg 6 Amlodipin 5 mg 7 Amlodipin 10 mg 8 Amoksilin 250 mg 9 Amoksilin 500 mg 10 Antalgin 500 mg 11 Antasida (MgOH 200mg+AlOH 200mg) 13 Asam Askorbat ( Vit C ) 50 mg 14 Asam Askorbat ( Vit C ) 250 mg 15 Asam folat 1 mg 16 Asam mefenamat 500 mg 17 Asam Traneksamat 500 mg 18 Asetosal 100 mg 19 Asetylcysteine 200 mg 20 Asiklovir 400mg 21 Azithromycin 500 mg
TABLET TABLET TABLET TABLET TABLET TABLET KAPSUL KAPLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET KAPSUL TABLET
0 3,520 3,842 0 297 13,000 3,941 9,700 10,640 0 11,450 3,788 203 3,460 5,388 987 2,703 6,336 4,239 319
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 3,520 3,842 0 297 13,000 3,941 9,700 10,640 0 11,450 3,788 203 3,460 5,388 987 2,703 6,336 4,239 319
0 0 311 0 26 2,127 1,843 327 3,832 0 4,601 868 0 10 4,184 273 2,202 741 213 0
0 3,520 3,531 0 271 10,873 2,098 9,373 6,808 0 6,849 2,920 203 3,450 1,204 714 501 5,595 4,026 319
0 3,490 1,700 0 0 8,670 1,200 7,400 4,300 0 4,400 1,500 0 0 0 450 0 4,700 2,950 300
1,000 5,000
12,000 10,000 10,000 5,000 5,000 10,000 1,000
: :
KET.
PROGRAM BANTUAN
### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
NO 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 43 44 45 46 47 48 49 50 51 52 53
NAMA OBAT Betahistin mesilat 5 mg Cefadroxil 500 mg Cefixim Cetirizin 10mg Deksametason 0,5 mg Digoksin 0,25 mg Dimenhidrinat tablet 50mg Doksisiklin 100mg Domperidon tablet 10 mg Eritromisin 500mg Fitomenadion (Vit K1) 10mg Furosemid 40 mg Glibenklamid 5 mg Glimepiride tablet 2 mg Gliseril Guaiakolat 100 mg Griseofulvin 125 mg Hidroklorotiazid (HCT) 25 mg Hyosin N Butilbromida 10mg Ibuprofen 200 mg Ibuprofen 400 mg Isosorbid Dinitrat sublingual 5 mg Kalsium Laktat (Kalk) 500 mg Kaptopril 12,5 mg Kaptopril 25 mg Ketokonazol 200mg tablet Klindamisin kapsul 150 mg Klindamisin kapsul 300 mg Klopidogrel Kloramfenikol kapsul 250 mg Kloramfenikol kapsul 500 mg Klorfeniramin Maleat (CTM) 4 mg
SATUAN TABLET TABLET KAPSUL TABLET TABLET TABLET TABLET KAPSUL TABLET TABLET KAPLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET KAPSUL TABLET KAPSUL TABLET TABLET
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG 3,492 6,025 375 3,327 16,246 3,069 2,092 220 2,613 1,247 3,281 1,922 15,116 10,528 780 2,686 3,247 4,242 242 18 1,862 7,791 6,152 18,669 730 2,186 0 270 70 4,643 15,348
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
3,492 6,025 375 3,327 16,246 3,069 2,092 220 2,613 1,247 3,281 1,922 15,116 10,528 780 2,686 3,247 4,242 242 18 1,862 7,791 6,152 18,669 730 2,186 0 270 70 4,643 15,348
411 1,062 10 293 2,940 55 185 0 391 621 686 163 1,858 1,547 130 10 195 297 81 0 27 1,356 764 1,427 0 333 0 0 0 608 3,481
3,081 4,963 365 3,034 13,306 3,014 1,907 220 2,222 626 2,595 1,759 13,258 8,981 650 2,676 3,052 3,945 161 18 1,835 6,435 5,388 17,242 730 1,853 0 270 70 4,035 11,867
1,420 3,900 0 2,540 12,400 2,200 1,000 0 800 0 1,000 1,100 10,600 8,050 0 1,400 1,400 3,500 0 0 500 4,400 4,200 15,500 550 1,250 0 0 0 2,300 10,200
2,000
3,000 5,000 3,000 2,000
10,000
5,000 10,000 1,000
1,000 3,000 3,000 2,000 10,000
PEMBERIAN
KET. ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
NO
NAMA OBAT
SATUAN
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG
dewasa kombinasi : 54 Kotrimoksazol Sulfametoksazol400mg+Trimetoprim80mg
TABLET
5,667
0
55 56 57 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83
TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET
1,360 70 3,856 0 29,889 500 1,890 2,077 1,502 5,996 15,347 1,024 226 6,818 147 16,628 270 40 546 2,388 1,473 302 7,240 4,701 3,403 7,408 7,349 300
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
Levofloksasin 500 mg Loperamide 2 mg Loratadin tablet 10 mg Meloksikam tablet 7,5 mg Metformin 500mg tablet Methylsoprinol Metil Prednisolon 4 mg Metilergometrin Maleat 0,125 mg Metoklopramid 5mg Metronidazol 500mg Natrium Diklofenac 50 mg Nifedipin 10 mg tablet Nistatin tablet vaginal 100.000 IU/g Omeprazole 20mg Ondansetron 4 mg Parasetamol 500 mg Pirantel 125 mg Pirasetam 800 mg tablet Piridoksin HCL (Vit B6) tablet 10 mg Prednison tablet 5 mg Propanolol HCL tablet 10 mg Propiltiourasil tablet 100 mg Ranitidin tablet 150 mg Salbutamol tablet 2 mg Salbutamol tablet 4 mg Simvastatin 10 mg Siprofloksazin tablet 500 mg Spironolacton
443 5,667 1,360 70 3,856 0 29,889 500 1,890 2,077 1,502 5,996 15,347 1,024 226 6,818 147 16,628 270 40 546 2,388 1,473 302 7,240 4,701 3,403 7,408 7,349 300
200 0 385 0 2,065 0 470 100 399 207 2,173 184 20 395 111 10,171 0 0 126 1,706 29 0 1,492 1,099 50 492 318 0
PEMBERIAN
KET.
3,700 5,224 1,160 70 3,471 0 27,824 500 1,420 1,977 1,103 5,789 13,174 840 206 6,423 36 6,457 270 40 420 682 1,444 302 5,748 3,602 3,353 6,916 7,031 300
400 0 3,200 0 25,400 500 0 700 0 4,000 11,340 0 60 5,580 0 4,000 100 0 0 0 900 200 4,000 2,000 2,700 5,420 5,100 300
2,000 2,000 5,000
2,000 2,000 5,000
5,000
3,000 20,000 5,000 10,000 5,000
5,000 2,000
### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
SATUAN
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG
Tambah Darah Kombinasi : Besi sulfat 84 Tablet 200mg+Asam folat 0,25mg
TABLET
126,577
0
85 86 87 88 89 90
TABLET TABLET TABLET KAPSUL KAPSUL KAPSUL TABLET TABLET
VIAL VIAL AMPUL AMPUL BOTOL VIAL AMPUL AMPUL AMPUL
202 760 100 3,430 10,416 7,376 0 0 34 350 285 18 0 564 513 27 149 100 345
0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0
komp injeksi,Kombinasi:Lidokain 107 Lidokain HCl2%+Epinefrin1:80000-2ml
AMPUL
660
100
108 Magnesium sulfat injeksi (IV) 20 % - 25 ml 109 Magnesium sulfat injeksi (IV) 40 % - 25 ml 110 Metilergometrin Maleat inj. 0,200mg-1ml
AMPUL AMPUL VIAL
13 18 100
0 0 100
111 Metoklopramid inj. 5mg / ml
AMPUL
27
0
112 Oksitosin injeksi 10 IU/ml - 1 ml 113 Omeprazole 40 mg inj.
BOTOL BOTOL
38 169
200 0
NO
b. 92 93 94 96 97 98 99 100 101 103 104 105
NAMA OBAT
Tetrasiklin HCL kapsul 250 mg Tetrasiklin HCL kapsul 500 mg Thiamfenikol 500mg kapsul Tiamin HCL (VitB1) 50 mg Vitamin B Kompleks Zinc 10 mg Injeksi Aminofilina 24 mg/ml - 10 ml Amoksisilin 1000mg Ampisillin im/iv 1000mg/ml Aqua pro injeksi, bebas pirogen Atropin sulfat 0,25mg/ml-1 ml Ceftriaxone 1 gr injeksi Deksametason injeksi 5 mg/ml-1ml Difenhidramin HCL Inj 10mg/ml-1 ml Epinefrin injeksi Fitomenadion (Vit K1)inj 10mg/ml-1ml Furosemid injeksi Gentamisin injeksi
126,577 202 760 100 3,430 10,416 7,376 0 0 34 350 405 18 0 564 513 27 149 100 345
26,878 0 0 10 900 2,775 1,518 0 0 34 88 203 0 0 99 25 4 20 8 71
99,699 202 760 90 2,530 7,641 5,858 0 0 0 262 202 18 0 465 488 23 129 92 274
80 760 13 18 200 27 238 169
1 1 9 27 13 22
95,040 0 700 0 1,000 6,100 4,300 0 0 0 210 124 15 0 345 316 9 52 50 235 494
680 12 17 191 0 225 147
5,000 5,000 10,000 5,000 100 500 500 500 100 20 100 100 200
PEMBERIAN
KET. ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
300
4 2 142
10 10 100
0
1,000
193 80
100 500
### ### ### ### ### ### ###
NO 114 115 117 118
NAMA OBAT Ondansetron injeksi Piracetam injeksi 1 gr / 5 ml Ranitidin injeksi 25mg/2ml Sefotaksim injeksi 1 gram
SATUAN
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG
AMPUL AMPUL AMPUL VIAL
628 0 1,089 262
0 0 0 0
119 Sianokobalamin(VitB12)inj.500mcg/ml-1ml
AMPUL
119
0
120 Tiamin HCl (Vit.B1) injeksi 100 mg/ml-1 ml
BOTOL
53
0
BOTOL AMPUL
92 0
0 0
VIAL
71
0
Asiklovir krim 5% Bacitracin SK Betametason krim 0,1 % Gentamisin 0,3 % salep mata Gentamisin 0,1 % salep kulit Hidrokortison krim 2,5 % Kloramfenikol 1 % salep mata Kloramfenikol 2 % salep kulit Miconazol cream 2 % Oksitetrasiklin HCL 1 % salep mata Oksitetrasiklin HCL 3 % salep kulit
AMPUL VIAL AMPUL AMPUL POT TUBE TUBE TUBE TUBE TUBE
30 196 254 7 0 220 1 67 179 245 0
0 0 0 0 0 0 0 0 0 0 0
2-4 Komb: As salisilat2%+Belerang 134 Salep endap4%
TUBE
58
0
TUBE TUBE TUBE TUBE TUBE POT
81 0 4,192 134 0 465
0 0 0 0 0 0
121 Tranexamat Acid Inj. 250 mg/5 ml c. Salep 122 Antifungi (As. Benzoat6%+As. salisilat 3%) 123 124 125 126 127 128 129 130 131 132 133
135 d. 136 137 e. 138
Sulfadiazine Silver Cream Serbuk Garam oralit untuk 200 ml air Salisil Bedak 2 % Sirup Amoksilin 125mg/5ml
628 0 1,089 262 119 53 92 0 71 30 196 254 7 0 220 1 67 179 245 0 58 81 0 4,192 134 0 465
100 0 345 39 0 7 18 0 12 11 0 16 0 0 47 1 3 13 7 0 1 5 0 582 19 0 82
528 0 744 223 119 46 74 0 59 19 196 238 7 0 173 0 64 166 238 0 57 76 0 3,610 115 0 383
515 0 738 60
200 200
0
300
0
200
500
60 0 30
PEMBERIAN
KET. ### ### ### ### ### ### ### ### ###
0 170 200 0 0 129 0 0 96 179 0
120
28
48
52 0 2,700 57 0 286
3,000 200
120 120 120 120
120
120
### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
NO
NAMA OBAT
SATUAN
syr (MgOH 200mg/5ml+AlOH 139 Antasida 200mg/5ml) 140 141 142 143 144 145
Cefadroxil Syr Cetirizin syr Dextrofen Eritromisin sirup Ibuprofen suspensi 100mg/5ml Kloramfenikol suspensi 125mg/5ml
Suspensi komb: Sulfametoksazol 146 Kotrimoksazol 200mg+Trimetoprim40mg/5ml 147 Metronidazole Suspensi 148 Obat Batuk Hitam ( O B H ) cairan 149 Parasetamol drop 100mg/ml btl @ 15ml 150 Parasetamol sirup 120mg/5ml d. Tetes 152 Fenol Gliserol tetes telinga 10 % 153 Gentamisin tetes mata 0.3% 154 Gentian violet larutan 1 % 155 Karbo Glycerin 156 Kloramfenikol tetes mata 157 Kloramfenikol tetes telinga 3 % 158 Litrol TM/ Cendo Xitrol TM 159 Pantocain TM 160 Sulfasetamid Natrium tetes mata 15 % ALKES DAN CAIRAN LUAR 161 Alat suntik sekali pakai 01 ml 162 Alat suntik sekali pakai 03 ml 163 Alat suntik sekali pakai 05 ml 164 Alat suntik sekali pakai 10 ml 165 Alat suntik sekali pakai 20 ml
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG 2,345
0
VIAL BOTOL BOTOL
0 37 114 27 38 906
0 0 0 0 0 0
BOTOL
403
0
BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL
165 38 109 1,292 0 143 123 8 0 0 19 4 2 4 0 3,697 10,430 2,941 772 388
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
SACHET POT
BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL SET SET SET
2,345 0 37 114 27 38 906
227 0 2 34 1 14 75
2,118 0 35 80 26 24 831
19 403 165 38 109 1,292 0 143 123 8 0 0 19 4 2 4 0 3,697 10,430 2,941 772 388
3 3 24 145 0 15 2 0 0 0 12 0 1 0 0 238 1,682 718 86 7
2,032 0 23 44 0 0 755
200 50 200 120 300
PEMBERIAN
KET. ### ### ### ### ### ### ###
323 384 162 35 85 1,147 0 128 121 8 0 0 7 4 1 4 0 3,459 8,748 2,223 686 381
129 0 41 1,032 0 76 118 0 0 0 0 0 0 0 0 3,014 8,035 1,815 599 364
500 200
120 100 120 120 120
120
2,000
### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG
NO
NAMA OBAT
SATUAN
166 167 168 169 170 171 172
Alat suntik sekali pakai 50 ml Alkacide Alkazyme Alkohol Swab Anti Hemoroid (Bismut subgallat150mg+Heksak Antiseptic Cairan/ Poli Clean 500 ml Blood Tranfusion set
SET BOTOL BOTOL BOTOL PCS SACHET SACHET
100 6 7 4 162 20 173
0 5 5 0 0 0 0
LEMBAR
253
0
142 15 90 16 4 44 92 100 67 99 830 0 10,580 390 0 232 445 362 314 163 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0
173 Catgut chromic/benang bedah No. 2/0-3/0 174 175 176 177 178 179 180 181 182 183 184 185 186 189 191 192 193 194 195 196 197 198
Catgut plain/benang bedah No. 2/0-3/0 Catheter Gel (MY Gel/Aqua Gel) Cavilon Daryantulle Etanol 70 % 100 ml Etanol 70 % 1000 ml Female Cath.16 Female Cath.18 Foley Catheter no.16 Foley Catheter no.18 Glucose Protein Tes Hanschoen Non Steril (S) Hanschoen Non Steril (M) Hanschoen Steril No. 7 Hanschoen Steril Obgyn I.V. Catheter No 18 I.V. Catheter No 20 I.V. Catheter No 22 I.V. Catheter No 24 I.V. Catheter No 26 ID Band (gelang pasien) Anak Biru ID Band (gelang pasien) Anak Pink
BOTOL BOTOL PCS PCS KOTAK PCS PCS PCS PCS PCS PCS PCS PCS ROL ROL PAK BOTOL PCS PCS PCS PCS PCS
100 11 12 4 162 20 173 253 142 15 90 16 4 44 92 100 67 99 830 0 10,580 490 0 232 445 362 314 163 2 2
0 0 0 2 29 4 26 24 5 0 0 1 0 0 0 0 21 28 6 0 3,264 52 0 19 77 114 40 4 0 0
100 11 12 2 133 16 147 229 137 15 90 15 4 44 92 100 46 71 824 0 7,316 438 0 213 368 248 274 159 2 2
100 7 11 0 0 15 130
5 50 200
201
120
116 14 90 0 0 26 75 92 22 53 810 0 6,100 388 0 188 334 226 245 140 1 1
120
300 20
50 50 2,000 6,000 200 100 200 300 100 2 2
PEMBERIAN
KET. ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
NO 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 221 222 223 224 225 226 227 228 229 230
NAMA OBAT ID Band (gelang pasien) Dewasa Biru ID Band (gelang pasien) Dewasa Kuning ID Band (gelang pasien) Dewasa Pink Infusion set anak Infusion set dewasa Inplant Kit Iodium Test IUD Kit Kantong mayat Kapas Pembalut / Absorben 250 gr Kasa Pembalut 2 m x 80 cm Kasa Pembalut 4 x 80 yard Kasa Pembalut Hidrofil 4 m x 3 cm Kasa Pembalut Hidrofil 4 m x 5 cm Kasa Pembalut Hidrofil 4 m x 15 cm Kasa Steril Khlorin Leukoplast 2,5 cm x 4,5 m Leukoplast 5 cm x 4,5 m Leukoplast 7,5 cm x 4,5 m Masker Hijab Masker Tali Masker N 95 Masker Nebulazer Anak Masker Nebulazer Dewasa Masker NRBM Anak Masker NRBM Dewasa Mucus Extractor Nasal Canul Bayi Nasal Canul Anak Nasal Canul Dewasa
SATUAN BOTOL PCS ROL PCS BOTOL SACHET PAK PCS PCS BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL BOTOL TABLET TUBE SUPP SUPP TUBE TUBE BOTOL TABLET
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG 5 1 5 211 56 2 12 1 17 47 263 26 14 854 502 130 10 20 0 260 5,950 9,816 2 33 115 73 66 100 110 55 77
0 0 0 0 300 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
5 1 5 211 356 2 12 1 17 47 263 26 14 854 502 130 10 20 0 260 5,950 9,816 2 33 115 73 66 100 110 55 77
0 0 0 24 112 0 0 0 0 7 11 6 0 33 64 21 1 5 0 19 49 1,046 0 0 5 0 3 10 0 14 14
5 1 5 187 244 2 12 1 17 40 252 20 14 821 438 109 9 15 0 241 5,901 8,770 2 33 110 73 63 90 110 41 63
5 1 4 164 192 2 12 1 17 24 206 13 0 738 358 87 4 13 0 228 5,650 8,200 2 28 107 71 61 90 103 33 48
2 200 400
20 20 500 500 500 300 3 100 100 100
50
100 100
PEMBERIAN
KET. ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
NO
NAMA OBAT
236 NGT No.16 237 One Med H₂- O₂ 3 % 238 One Med Surgical Blade/ Mess 239 Plasterin 240 Plester 5 yards x 2 inch 241 Plester infus 242 Poli Wash 500 ml 243 Poli Wash 5 Liter 244 Rivanol larutan 0,1 % 300ml 245 Safety box 246 Silk ( Benang Bedah Sutera ) No. 3/0 247 Spalk 248 Steri Strip 249 Styrofoam 250 Styrofoam Tali 252 Suction Cath.No.14 257 Tensocrape 10 cm 258 Ultrasonic Gel (USG Gel) 259 Umbilical Clem (Klem Tali Pusat) 260 Underpad 261 Urine Bag 262 Yodium Povidon larutan 10 % 30 ml 263 Yodium Povidon larutan 10 % 300 ml 264 Yodium Povidon larutan 10 % 1 L ml INFUS 267 Asering Larutan infus 268 Glukosa larutan infus 5 % steril 269 Glukosa larutan infus 10 % steril 270 Glukosa larutan infus 40 % steril 271 KAEN 3B 272 Metronidazol infus
SATUAN TABLET BIJI AMPUL AMPUL TABLET BOTOL BIJI AMPUL TUBE TABLET PCS TABLET TABLET BOTOL BOTOL PCS PCS PCS PCS PCS PCS PCS PCS PCS PCS PCS PCS PCS SACHET
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG 10 2 117 4,382 6 1,255 2 18 8 72 122 4 1 5 1 16 20 4 2 534 307 75 15 13 0 105 366 33 2 65 0
50 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 780 0 0 0 300 0
60 2 117 4,382 6 1,355 2 18 8 72 122 4 1 5 1 16 20 4 2 534 307 75 15 14 0 885 366 33 2 365 0
0 0 2 779 0 147 0 0 0 25 18 0 0 0 0 0 0 0 0 61 12 8 0 1 0 358 10 11 0 62 0
60 2 115 3,603 6 1,208 2 18 8 47 104 4 1 5 1 16 20 4 2 473 295 67 15 13 0 527 356 22 2 303 0
58 0 0 3,000 0 1,001 1 17 4 36 83 4 1 5 1 16 20 4 2 429 271 60 7 9 0 482 320 18 0 280 0
100 120
200 20 50 200
PEMBERIAN
KET. ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
NO
NAMA OBAT
273 Natrium Klorida larutan infus 0,9 % steril 274 Paracetamol Infus 275 Ringer Lactate infus steril OBAT PATEN 276 Adalat Oros 277 Aptil 278 Bisakodil suppositoria anak 5 mg 279 Bisakodil suppositoria dewasa 10 mg 280 Bravoderm 281 Bufacomb 282 Calporosis 283 Combivent 284 Demacolin 285 Lactodia 286 Laxadin sirup 287 Metamizole injeksi 500 mg 288 Microlax 289 Multivitamin inj. 5000 mcg 290 Multivitamin syr 291 Multivitamin tablet 292 Noza/ Flurin 293 Obat Batuk Anak sirup 294 296 297 298 e. 303 304 314
Paracetamol Rectal Permetrin/ Scabicid krim 5% Puralex Spasminal Gigi Etil Klorida semprot (Lidocain Spray) Eugenol cairan Retinol ( Vit A ) kapsul 100.000 IU
SATUAN TABLET
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG
BOTOL BOTOL BOTOL BOTOL TUBE BOTOL TUBE BOTOL BOTOL
338 0 371 0 2,836 21 22 138 2 1 3,701 163 0 3 71 320 0 353 17 1,300 4,000
500 0 1,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
BOTOL
5
0
BOTOL PAKET KAPSUL KAPSUL AMPUL KAPSUL AMPUL TABLET
0 234 4,455 35 0 62 1 14
0 0 0 0 0 0 0 0
TABLET TUBE TABLET TABLET TUBE TABLET TABLET TABLET
838 0 1,371 0 2,836 21 22 138 2 1 3,701 163 0 3 71 320 0 353 17 1,300 4,000 5 0 234 4,455 35 0 62 1 14
255 0 289 0 274 0 0 8 0 0 855 70 0 0 10 16 0 127 0 0 2,156 0 0 17 324 0 0 0 0 14
583 0 1,082 0 2,562 21 22 130 2 1 2,846 93 0 3 61 304 0 226 17 1,300 1,844 5 0 217 4,131 35 0 62 1 0
556 0 1,034 0 2,250 20 22 128 0 0 1,080 66 0 0 33 280 0 169 0 400 1,500 0 0 113 3,350 0 0 61 0 0
200 200
120 120 200 5,000
200 300 300 5,000 5,000 200
5,000
PEMBERIAN
KET. ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
NO 315 g. 316 317 318 319 321 322 323 325 326 327 328 330 331 k. 346 347 348 350 351 352 n. 370 372 373 374 377 379 381 KB
NAMA OBAT Retinol ( Vit A ) kapsul 200.000 IU Jiwa Alprazolam Amitriptilin HCL 25 mg Clozapin tab Fenitoin Natrium 100 mg Haloperidol 1,5 mg Haloperidol 5 mg Karbamazepin 200 mg Klorpromazin HCL tablet salut 25 mg Klorpromazin HCL tablet salut 100 mg Lodomer 5mg/ml inj Risperidone 2mg Trifluoperazin tablet 5 mg Triheksifenidil Hidroklorida tab 2 mg Psikotropik & Narkotik Diazepam 2 mg Diazepam 5 mg Diazepam injeksi 5 mg/ml - 2 ml Kodein tablet 10 mg Stesolid rectal supp 5 mg Stesolid rectal supp 10 mg TB Paru Isoniazid (INH) 100mg Obat Antituberkulosis Anak Obat Antituberkulosis kategori 1 ( FDC ) Obat Antituberkulosis kategori 2 ( FDC ) Slide Sputum pot Ziehl nelseen
SATUAN VIAL VIAL TABLET PCS KAPSUL TABLET PCS TABLET PCS SET KAPSUL PAKET PAKET TABLET AMPUL TABLET TABLET TABLET BIJI TABLET PAKET PAKET PAKET PAK BIJI PAKET
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG 113 0 100 621 1,260 500 157 0 100 5 0 36 1,383 2,065 713 0 0 0 60 889 0 0 0 857 0 12 0 8 268 13 0
0 0 0 300 0 0 1,000 1,000 0 0 1,000 0 0 0 1,000 0 0 0 0 200 0 0 0 0 4 24 1 10 200 5 0
113 0 100 921 1,260 500 1,157 1,000 100 5 1,000 36 1,383 2,065 1,713 0 0 0 60 1,089 0 0 0 857 4 36 1 18 468 18 0
113 0 0 31 31 0 374 146 0 0 263 0 613 413 735 0 0 0 0 437 0 0 0 17 0 4 1 1 160 1 0
0 0 100 890 1,229 500 783 854 100 5 737 36 770 1,652 978 0 0 0 60 652 0 0 0 840 4 32 0 17 308 17 0
0 0 100 800 1,000 300 500 700 100 0 700 24 700 1,500 900 0 0 0 60 400 0 0 0 800 4 32 0 15 266 16 0
200 1,000 1,000
1,000 1,000 500 1,000 500 500 500 20 20
PEMBERIAN
KET. ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
NAMA OBAT
NO 382 383 384 385 386 387
Depo kombinasi Indoplant IUD COPER T kondom Pil. Kombinasi Spuit 3 cc (KB)
SATUAN
STOCK PENERIM PERSEDIA PEMAKA SISA RIIL SISA PERMINT AAN AAN AWAL AN IAN GUDANG 226 30 75 10 10 340
vial set set set tab set
0 100 0 0 0 100
226 130 75 10 10 440
20 6 3 0 0 42
PEMBERIAN
140 66 59 10 0 320
206 124 72 10 10 398
KET. ### ### ### ### ### ### TOTAL
UMUM
JUMLAH KUNJUNGAN
RAWAT JALAN RAWAT INAP
1,624
A/n KA. DINAS KESEHATAN Ka. UPTD PERBEKALAN FARMALKES
TIDAK BAYAR
150
RAWAT JALAN
351
BPJS
RAWAT INAP
0
RAWAT JALAN
JUMLAH
RAWAT INAP
1,466
RAWAT JALAN RAWAT INAP
150
3,441
300
PETUGAS
MENGETAHUI
MALANG, 25 FEBRUARI 2019
UPTD PERBEKALAN FARMALKES
Plt. KEPALA UPT PUSKESMAS
PETUGAS PENGELOLA OBAT
drg. DEWI AMINAH
DEDI DARMAWAN
NIP: 19720607 200501 2 008
NIP: 19831127 200904 1 002
02
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