LEMBAR PEMBERIAN OBAT DAN BAHAN MEDIS HABIS PAKAI (BMHP)

GUDANG FARMASI DINAS KESEHATAN KABUPATEN MAMUJU

NOMOR : /GFK/XII/2021/DINKES

PEMBERIAN TOTAL
HARGA SATUAN JUMLAH HARGA
NO NAMA OBAT/BMHP SATUAN KET
PKD DKP/PROGRAM LAIN-LAIN PEMBERIAN (Rp) (Rp)

1 2 3 4 5 6 7 8 9 11
1 Acyclovir tab 200 mg Tablet - 236 -

Acyclovir tab 200 mg Tablet - 534 -

Acyclovir tab 400 mg Tablet - 473 -

2 Acyclovir tab 400 mg Tablet - 470 -

Accugence Blood Glukosa Box - 284,127.7 -

Accugence Blood Uric Acid Box - 140,779.92 -

Adhesive Wound Strip 5 cm X 5 m (Plester) Roll - 25,520 -

3 Alat Suntik Sekali Pakai 1 ml (Stera) Pieces - 715 -

Alat Suntik Sekali Pakai 1 ml Pieces - 808.675 -

Alat Suntik Sekali Pakai 3 ml Pieces - 815.6375 -

4 Alat Suntik Sekali Pakai 3 ml Pieces - 957 -

Alat Suntik Sekali Pakai 3 ml Pieces - 750 -

5 Alat Suntik Sekali Pakai 5 ml Pieces - 1,348 -

Alat Suntik Sekali Pakai 5 ml Pieces - 970.4125 -

Allopurinol 100 mg Tablet - 95 -

6 Allopurinol 100 mg Tablet - 108 -

Allopurinol 300 mg Tablet - 210 -

7 Aminophyllin 200 mg tab Tablet - 104 -

8 Aminophyllin 24 mg/ml Injeksi Ampul - 2,878 -

9 Aminophyllin Injeksi Ampul - 8,218 -

10 Amlodipin tablet 5 mg Tablet - 85 -

10 Amlodipin tablet 5 mg Tablet - 59 -

11 Amlodipin tablet 10 mg Tablet - 106 -

11 Amlodipin tablet 10 mg Tablet - 76 -

12 Amoxicillin 500 mg Tablet - 269 -

12 Amoxicillin 500 mg Tablet - 241 -

13 Amoxicillin Sirup 125 mg/5 ml Botol - 2,070 -

14 Antasida Tab Tablet - 61 -

14 Antasida Tab Tablet - 54 -

15 Antacida suspensi btl /60 ml - 2,290 -

15 Antacida suspensi btl /60 ml - 1,767 -

16 Antihaemorrid Supp Supp/2 g - 3,800 -

Antihaemorrid Supp Supp/2 g - 3,265 -

17 Antimigrain : ergotamine + coffeine tablet - 208 -

18 Antiseptik hand rub 500 ml (Henclin 2%) Botol - 52,750 -

18 Antiseptik hand rub 500 ml Botol - 68,525.5 -

19 Aqua Pro Injeksi 25 ml Btl/25 ml - 2,860 -

19 Aqua Pro Injeksi 25 ml Btl/25 ml - 2,650 -

20 Aquasonic Gel 250 ml Botol - 55,000 -

21 Asam Asetilsasilisilat tab 80 mg Tablet - 108 -

22 Asam Askorbat tab 50 mg Tablet - 126 -

Asam Askorbat tab 50 mg Tablet - 50 -

23 Asam Askorbat tab 250 mg Tablet - 132 -

Asam Folat Tab. 1 mg Tablet - 63 -

24 Asam Mefenamat tab 500 mg Tablet - 106 -

25 Asam Mefenamat tab 500 mg Tablet - 298.1 -

25 Asam Mefenamat tab 500 mg Tablet - 128 -

26 Asering Infus Btl/500 ml - 9,646 -

27 Atapulgit tab 600 mg Tablet - 330 -

28 Atropin sulfat Injeksi 0,25 mg/ml Ampul - 1,958 -

28 Atropin sulfat Injeksi 0,25 mg/ml Ampul - 1,718 -

29 Bedak Salisil Pot - 3,355 -

 Bedak Salisil Pot - 2,167 -

30 Betahistin 6 mg Tablet - 119 -

31 Betametason 0,1% krim Tube - 1,494 -

32 Bisturi No. 10 Pcs - 940 -

Blood Lancet Box - 17,576.66666 -

33 Captopril 12,5 mg Tablet - 73 -

Captopril 25 mg Tablet - 75 -

34 Captopril 25 mg tablet - 137.5 -

35 Carbamazepin tab 200 mg Tablet - 252 -

35 Carbamazepin tab 200 mg Tablet - 225 -

Catgut Chromic 2/0 HR 30 MM Pcs - 12,549.578375 -

36 Catgut Chromic 2/0 HR 30 MM Pcs - 33,788 -

37 Catgut Chromic 3/0 HR 30 MM Pcs - 33,788 -

38 Catgut Chromic 3/0 HR 30 MM Pcs - 39,206.966 -

39 Cefadroxil 500 mg Tablet - 935 -

40 Ciprofloxacin tab 500 mg Tablet - 660 -

41 Dexamethasone 0,5 mg tablet Tablet - 165 -

Dexamethasone Injeksi Ampul - 1,012 -

42 Dexamethasone Injeksi Ampul - 1,278 -

Diazepam 2 mg Tablet - 77 -

43 Diazepam 2 mg Tablet - 86 -

44 Diazepam 5 mg Tablet - 119 -

44 Diazepam 5 mg Tablet - 108 -

45 Diazepam Injeksi Ampul - 2,010 -

Diazepam Injeksi Ampul - 1,545 -

Difenhidramin Injeksi 10 mg/ml Ampul - 902 -

46 Difenhidramin Injeksi 10 mg/ml Ampul - 1,404 -

47 Digoxin tablet 0,25 mg Tablet - 104 -

48 Diltiazem tab 30 mg Tablet - 142 -

Diltiazem tab 30 mg Tablet - 140 -

49 Dimenhidrinat tab 50 mg Tablet - 110 -

50 Domperidon tablet 10 mg Tablet - 96 -

50 Domperidon tablet 10 mg Tablet - 77 -

51 Efinefrin Injeksi 0,1% Ampul - 2,904 -

52 Efinefrin Injeksi 0,1% Ampul - 2,068 -

53 Eritromisin kapsul 250 mg Tablet - 711 -

54 Eritromisin kapsul 500 mg Capsul - 1,250 -

Eritromisin Syrup Botol - 7,761 -

55 Etylchlorida semprot Btl/100 - 192,500 -

Ethanol 70 % 1.000 ml Botol - 37,639 -

Expert MTB/RIF Assay KIT Set - 254,650 -

56 Fenobarbital tab 30 mg Tablet - 205 -

Fenobarbital tab 30 mg Tablet - 162.672 -

57 Fitomenadion 10 mg Tablet - 912 -

57 Fitomenadion 10 mg Tablet - 847 -

58 Fitomenadion (Vit. K1) Injeksi 2 mg/ml Ampul - 1,595 -

58 Fitomenadion (Vit. K1) Injeksi 10 mg/ml Ampul - 4,000 -

Furosemide Tablet 40 mg Tablet - 281 -

Gentamicin Salep Mata (Genoint) 0.3 % Tube - 9,317 -

59 Gentamicin sulfat TM 0,3% Btl/ 5 ml - 5,098 -

Glibenklamid tab 5 mg Tablet - 95 -

60 Glibenklamid tab 5 mg Tablet - 100 -

Glimepiride 2 mg Tablet - 560 -

61 Glimepiride 2 mg Tablet - 207 -

Glukosa 10 % Botol - 7,200 -

Glukosa 5 % Botol - 6,627 -

62 Griseofulvin 125 mg Tablet - 247 -

62 Griseofulvin 125 mg Tablet - 220 -

63 Haloperidol tab 0,5 mg Tablet - 55 -

64 Haloperidol tab 1,5 mg Tablet - 59 -

65 Hidroklorothiazid (HCT) tab Tablet - 186 -

Hidroklorothiazid (HCT) tab Tablet - 149 -

66 Hidrokortison Cream 2,5% Tube - 2,556 -

67 Hiosina butilbromida tab 10 mg Tablet - 1,397 -

68 Hypafix 5 cm x 5 m Roll - 41,100 -

68 Hypafix 5 cm x 5 m Roll - 90,000 -

69 Ibuprofen 200 mg Tablet - 324.5 -

Ibuprofen 200 mg Tablet - 235 -

Ibuprofen 400 mg Tablet - 365 -

70 Ibuprofen 400 mg Tablet - 396 -

Infus Set Dewasa Pieces - 3,679.00 -

Infus Set Dewasa Pieces - 9,900.00 -

71 Infus Set Dewasa Pieces - 3,744.39 -

72 Infusion set anak Pcs - 3,939.09 -

72 Infusion set anak Pcs - 3,679 -

73 Infusion set makro Pcs - 3,875 -

74 Isosorbide Dinitrate tab 5 mg Tablet - 352 -

75 IV Canula 18 G Pcs - 9,250 -

76 IV Canula 18 G Pieces - 9,260 -

77 IV Canula 20 G Pieces - 9,260 -

77 IV Canula 20 G Pieces - 8,790 -

78 IV Canula 22 G Pieces - 5,460 -

79 IV Canula 22 G Pieces - 9,260 -

80 IV Canula 24 G Pcs - 5,811 -

81 IV Canula 24 G Pieces - 9,260 -

82 Jarum Jahit bedah No. 9 Bungkus - 2,000 -

83 Jarum Jahit bedah No. 11 Bungkus - 2,000 -

84 Jarum Jahit bedah No. 12 Bungkus - 2,000 -

85 Ka-en 3B Larutan infus botol - 11,314 -

Kalsium Laktat 500 mg Tablet - 60 -

86 Kapas 250 gram Roll - 29,900 -

Karbogliserin Tetes Telinga (Fenol Gliserol

87 btl/ 5 ml - 2,764 -
10%)
Karbogliserin Tetes Telinga (Fenol Gliserol
87 btl/ 5 ml - 3,300 -
10%)

Kasa Hidrofil Lipat 40 X 40 cm Pieces - 2,755 -

88 Kasa Kompres 40 x 40 cm Pieces - 1,493.25 -

89 Kasa Roll 3,6 x 15 cm Roll - 4,251.25 -

90 Kasa Roll 3,6 x 5 cm Roll - 1,215.5 -

91 Kasa Roll Panjang 40 Y x 80 cm Roll - 156,600 -

91 Kasa Roll Panjang 40 Y x 80 cm Roll - 164,784 -

92 Kasa Steril 16 x 16 cm Box - 8,294 -

92 Kasa Steril 16 x 16 cm Box - 17,004.8 -

93 Ketoconazole 200 mg Tablet - 317 -

Ketoconazole 200 mg Tablet - 270 -

94 Khlorpheniramin Maleat 4 mg (CTM) Tablet - 27 -

CTM 23

95 Kloramfenikol caps 250 mg Kapsul - 825 -

96 Kloramfenikol Salep kulit 2% Tube - 3,645 -

97 Kloramfenikol Tetes Telinga Botol/5 ml - 10,406 -

98 Kotrimoxazole 480 mg Tablet - 129 -

99 Kotrimoxazole 480 mg Tablet - 138 -

100 Kotrimoxazole Suspensi Botol - 2,257 -

Leukoplast (Plester ) Roll - 29,651.5992 -

101 Lidocain HCl Compositum Injeksi Ampul - 1,380 -

101 Lidocain HCl Compositum Injeksi Ampul - 924 -

102 Lidocain HCl injeksi 2% Ampul - 1,378 -

Lisol Botol - 33,000 -

103 Loperamid tablet Tablet - 100 -

Loperamid tablet Tablet - 83 -

104 Loratadine Tablet 10 mg Tab - 121 -

Masker Bedah Earloop Pieces - 1,296 -

Masker Bedah Hijab Pieces - 1,368 -

104 Masker Bedah Pieces - 1,375 -

Masker N95 Box - 551,030 -

105 Metformin 850 mg Tablet - 179 -

Metformin 500 mg Tablet - 86 -

106 Methylprednisolon 4 mg Tablet - 153 -

107 Metoklorpropamide Injeksi Ampul - 4,752 -

107 Metoklorpropamide Injeksi Ampul - 1,992 -

108 Metoklorpropamide tab 10 mg Tablet - 93 -

Metoklorpropamide tab 5 mg Tablet - 118 -

109 Metronidazole 500 mg Tablet - 286 -

110 Metylergometrin Maleat tab. Tablet - 270 -

111 Metylergometrin Maleat Inj Ampul - 3,553 -

112 Miconazole krim Tube - 4,097 -

112 Miconazole krim Tube - 2,090 -

Mission HB Strip Box - 476,682 -

Mission Ultra Total Cholesterol Box - 625,000 -

113 N-Asetil Sistein 200 mg Tablet - 460 -

114 Natrium Diklofenak 25 mg Tablet - 126 -

115 Natrium Diklofenak 50 mg Tablet - 156 -

Natrium Diklofenak 50 mg Tablet - 118 -

116 Natrium Klorida Inf 0,9% Btl/ 500 ml - 6,840 -

Natrium Klorida Inf 0,9% Btl/ 500 ml - 6,900 -

Nifedipine 10 mg tablet Tablet - 204 -

117 Nifedipine 10 mg tablet Tablet - 120 -

118 Nistatin Tab. Vag 100.000 UI Tablet vag - 720 -

118 Nistatin Tab. Vag 100.000 UI Tablet vag - 550 -

119 Nistatin Tab. Vag 500.000 UI Tablet - 1,014 -

119 Nistatin Tab. Vag 500.000 UI Tablet - 957 -

Nurse Cap Merk Golden Glove Box - 53,245 -

Nurse/Medical Cap Pcs - 773.3333 -

120 Omeprazole capsul 20 mg Kapsul - 528 -

121 Omeprazole Injeksi Vial - 11,868 -

Oxytetracycline Salep Mata Tube - 3,850 -

122 Oxytocin Inj 10 mg/ml Ampul - 1,287 -

Parasetamol tablet 500 mg Tablet - 216 -

123 Parasetamol tablet 500 mg Tablet - 209 -

124 Paracetamol syrup Btl/ 60 ml - 4,235 -

124 Paracetamol syrup Btl/ 60 ml - 1,160 -

125 Plester 5 cm x 5 m Roll - 28,500 -

126 Prednison tablet 5 mg Tablet - 79 -

126 Prednison tablet 5 mg Tablet - 78 -

Prednison tablet 5 mg Tablet - 78 -

127 Propanolol 10 mg Tablet - 66 -

128 Propiltiuourasil (PTU) Tablet - 1,017.5 -

Propiltiuourasil (PTU) Tablet - 462.0 -

Rapid Antigen (Egens) Test - 60,800.0 -

129 Reagen Golda Botol - 454,300 -

130 Ringer Laktat Infus Btl/ 500 ml - 7,630 -

Ringer Laktat Infus Btl/ 500 ml - 7,703 -

131 Salbutamol tab 4 mg Tablet - 198 -

 Salep 2-4 Pot - 2,539 -

132 Salep Antifungi 30 gram Pot - 5,757 -

133 Sarung Tangan S Box - 207,000 -

133 Sarung Tangan S Box - 178,526.315789 -

Sarung Tangan S Merk Golden Box - 156,463.333 -

Sarung Tangan M Merk Golden Box - 156,463.333 -

134 Sarung Tangan M Box - 207,000 -

134 Sarung Tangan M Box - 178,526.315789 -

134 Sarung Tangan L Box - 178,526.315789 -

Sarung Tangan L Merk Golden Box - 156,463.333 -

Sarung Tangan L Box - 207,000.000000 -

136 Sarung Tangan Steril No. 6,5 Pasang - 6,595 -

Sarung Tangan Steril No. 6,5 Pasang - 8,635 -

136 Sarung Tangan Steril No. 6,5 Pasang - 12,102.173913 -

Sarung Tangan Steril No. 6,5 Merk Golden Pasang - 25,412.3076 -

Sarung Tangan Steril No. 7 Merk Golden Pasang - 25,412.3076 -

135 Sarung tangan steril 7 Pcs - 6,305.0833 -

Sarung tangan steril 7 Pcs - 8,635 -

137 Sarung Tangan Steril no. 7 Pieces - 7,918.4242 -

137 Sarung Tangan Steril no. 7 Pieces - 12,102.173913 -

Sarung Tangan Steril no. 7,5 Pasang - 8,635 -

138 Sarung Tangan Steril no. 7,5 Pasang - 6,595 -

138 Sarung Tangan Steril no. 7,5 Pasang - 12,102.173913 -

Sarung Tangan Steril No. 8 Merk Golden Pasang - 25,412.3076 -

139 Sianocobalamin (Vit. B12) tablet 500 mcg Tablet - 47 -

140 Sianocobalamin (Vit. B12) Injeksi 500 mcg Ampul - 1,267 -

141 Silk Black 2/0 HR 30 MM Pcs - 21,007 -

142 Silk Black 3/0 HR 30 MM Pcs - 20,436 -

143 Silk no. 2/0 30 mm Pieces - 21,882 -

Silk no. 3/0 30 mm Pieces - 698,520,585 -

144 Silk no. 3/0 30 mm Pieces - 21,311 -

145 Simvastatin 10 mg Tablet - 117 -

Simvastatin 20 mg Tablet - 165 -

146 Simvastatin 20 mg Tablet - 247 -

147 Strip Asam Urat Botol - 149,820 -

148 Strip Glukosa Botol - 149,820 -

149 Strip Kolestrol Botol - 226,600 -

150 Thiamin 50 mg Tablet - 98 -

151 Vitamin B Complex tab Tablet - 141 -

VTM/Dacron SWAB Pcs - 43,100 -

Yodium 300 ml Botol - 22,831

152 Yodium 300 ml Botol - 24,150 -

TOTAL -

Yang Menerima, Mamuju,

Puskesmas Yang Membuat,

SYARIFUDDIN, Amd. Far

........................................................ Mengetahui : NIP. 19880712 201503 1 004
NIP.
Plt Kepala Gudang Farmasi Kab. Mamuju

FATMAWATI, S.Si.,Apt
NIP. 19810807 201503 2 003
 LEMBAR PEMBERIAN OBAT DAN BAHAN MEDIS HABIS PAKAI (BMHP)
GUDANG FARMASI DINAS KESEHATAN KABUPATEN MAMUJU
NOMOR : /GFK/XII/2021/DINKES

PEMBERIAN TOTAL HARGA SATUAN JUMLAH HARGA

NO NAMA OBAT/BMHP SATUAN KET
PKD DKP/PROGRAM LAIN-LAIN PEMBERIAN (Rp) (Rp)
1 2 3 4 5 6 7 8 9 11

1 Advokasi Kit Kit - 310,500 -

2 Albendazol tablet 400 mg Tablet - 271.14 -

3 Albendazol tablet 400 mg Tablet - 1,041.975 -

4 Albendazol tablet 400 mg Tablet - 283 -

5 Ampicillin Injeksi Vial - 8,237 -

5 Artesunat Injeksi Vial - 53,350 -

5 Artesunat Injeksi Vial - 62,500 -

6 Bedaquiline Tablet - 34,802.127 -

7 Benner Unit - 486,500 -

8 Betamethasone krim 0,1% Tube - 1,430 -

8 Blood Lancet Kotak - 35,135 -

9 Buku Atlas Buah - 55,000 -

Buku Kader Filariasis Mengenali dan

10 Buku - 30,600 -
Mencegah Penyakit Kaki Gajah

11 Buku Register POPM Filariasis Buku - 24,650 -

12 Buku Saku Malaria Pieces - 16,450 -

Buku Saku Perawatan Mandiri Kasus

13 Buku - 14,800 -
Kronis Filariasis

14 Calcium Gluconas Inj Ampul - 10,350 -

Calcium Gluconas Inj Ampul - 10,351 -

15 Calcium Lactat 500 mg Tablet - 64 -

16 Catrtridge Paket - 224,254 -

17 Catrtridge Paket - 258,172 -

Catrtridge Paket - 256,327 -

18 Clofazimin/Lamprene 100 mg Tablet - 8,384 -

19 CTM 4 mg Tablet - 23 -

20 DBS Collection Kit Kit - 356,953 -

21 DEC 100 mg Tablet - 202.065 -

22 DEC 100 mg Tablet - 215.91 -

23 DHP (Malaria) Tablet - 2,166 -

24 DHP (Malaria) Tablet - 2,134 -

25 Diazepam Injeksi Ampul - 2,010 -

25 Doksisiklin 100 mg Tablet - 280 -

26 Etambutol 400 mg Tablet - 427 -

27 Etambutol 400 mg Tablet - 444 -

28 Ethionamide 250 mg Tablet - 1,387 -

Fenobarbital injeksi Ampul - 2,380 -

 Fitomenadion injeksi 2 mg/ml Ampul - 1,595 -

Fitomenadion injeksi 10 mg/ml Ampul - 7,400 -

29 Format Bercak dan Koreng Rim - 65,000 -

30 Garam Oralit Sachet - 275 -

Garam Oralit Sachet - 293 -

31 Giemsa 100 ml Botol - 513,000 -

31 Giemsa 100 ml Botol - 875,065 -

Haloperidol Tab. 5 mg Tablet - 60 -

32 Holder (Vacuntainer) Pieces - -

32 Immersion Oil Botol - 1,123,065 -

33 INH 300 mg Tablet - 304 -

34 INH 300 mg Tablet - 291 -

34 Insektisida Botol - 622,500 -

35 Invermectin Tablet - -

36 Kaca Slide/ Microscope Slide Pieces - 327 -

37 Kanamycin Sulfat Inj Vial - 17,074 -

38 Kit Advokasi POPM IDA Kit - 378,000 -

39 Kit Belkaga IDA Kit - 248,000 -

40 Kit POPM Filariasis Kit - 49,500 -

41 Kombipak Kategori 1 Paket - 317,018 -

42 Kondom Pieces - 358 -

42 Lab Kit Paket - 1,016,565 -

43 Levofloxacin 250 mg Tablet - 721 -

Levofloxacin 250 mg Tablet - 493 -

44 Masker Bedah (TB) Box/50 - 22,200 -

44 Masker Bedah (HIV) Pieces - 2,290 -

45 Masker N-95 Pieces - -

46 Masker N-95 (TB) Pieces - 23,472 -

47 MDT MB Adult Strip - 36,579 -

48 MDT MB Adult Strip - 41,240 -

49 MDT MB Child Strip - 22,794 -

50 MDT MB Child Strip - 25,870 -

51 Metronidazole Infus Botol - 8,250 -

MgSO4 20% injeksi Vial - 4,300 -

MgSO4 40% injeksi Flacon - 4,900 -

Mineral Mix Sachet - 2,981 -

52 Moxifloxacin 400 mg (Moximed) Tablet - 22,500 -

53 Moxifloxacin 400 mg (Staxom) Tablet - 4,303 -

54 Natrium Klorida 0,9% inf 500 ml Botol - 6,840 -

55 Nevirapine tablet Tablet - 2,940 -

56 O A T Kategori 1 Paket - 498,565 -

57 O A T Kategori 1 Paket - 585 -

O A T Dosis Harian Paket - 409,461 -

58 O A T Kategori Anak Paket - 297,747 -

59 OAT Kategori 2 Paket - 1,384,977 -

Oxytetracycline Salep Mata Tube - 3,850

60 Oxytetracycline Salep Mata Tube - 2,500 -

61 Oxytetracycline Salep Mata Tube - 2,668 -

Oxytocin injeksi Ampul - 1,287 -

Oxytocin injeksi Ampul - 1,498 -

Panduan POPM Filariasis dengan

62 Buku - 29,095 -
Regimen Invermectin DEC, Albendazole

Paracetamol 500 mg Tablet - 131 -

63 PAS-Na 5,52 gram Sachet - 19,777 -

64 Poster Algoritma buah - 5,500 -

65 Pot Dahak Pcs - 2,968 -

66 Pot Dahak Pcs - 2,429 -

Prednison 5 mg Tablet - 79 -

67 Primaquin Tablet Tablet - 253 -

67 Primaquin Tablet Tablet - 242 -

68 Pyrazinamide 500 mg Tablet - 319 -

69 Pyrazinamide 500 mg Tablet - 340 -

70 Pyridoxyn 100 mg (Vitamin B6) Tablet - 561 -

71 Quinine tablet Tablet - 836 -

72 Rapid HIV 1 (Bioline) Test - -

73 Rapid HIV Bioline SD 1 Test - 11,975 -

Rapid 1 RDT HIV Test - 8,692 -

74 Rapid Test 3 Fokus Test - - -

75 Rapid Test Shipillis Trepocher Test - 9,300 -

76 RDT Combo Test - 15,520 -

77 Reagen ZN Paket - 285,571 -

78 Reagen ZN Paket - -

78 Reagen ZN Paket - 215,384 -

79 Retinol 100.000 UI Tablet - 371 -

79 Retinol 100.000 UI Tablet - 297 -

80 Retinol 200.000 UI Tablet - 664 -

81 Risperidore 2 mg Tablet - 287 -

82 Sarung Tangan M Pieces - 496 -

83 Sarung Tangan M (HIV) Pieces - -

84 Sarung Tangan L Pieces - 496 -

85 Sarung Tangan Non Steril Pieces - 400 -

85 Slide Box Kotak - 327 -

86 Slide Frosted/Mikroskop Pieces - 319 -

87 Slide Mikroskop Pieces - 278 -

88 Spoit 0,05 ml Pieces - 1,518 -

89 Spoit 0,05 ml Pieces - 1,460 -

90 Spoit 0,5 ml Pieces - 1,200 -

91 Spoit 5 ml Pieces - 1,500 -

92 Spoit 5 ml Pieces - 1,439 -

93 Tablet Tambah Darah Tablet - 427 -

93 Tablet Tambah Darah Tablet - 260 -

TriFluoperazine HCL 5 mg Tablet - 287 -

94 Triheksipenidil 2 mg Tablet - 91 -

Tuberculin Test Vial - 625,800 -

95 Vaksin BCG Vial - 60,140 -

96 Vaksin BCG + pelarut vial - 56,360 -

97 Vaksin Campak + Rubella (MR) vial - 151,150 -

98 Vaksin DPT-HB-Hib Vial - 76,620 -

99 Vaksin DT Vial - 17,450 -

100 Vaksin HB0 Vial - 23,270 -

101 Vaksin IPV Vial - 144,540 -

102 Vaksin Polio (60pv) Vial - 19,350 -

103 Vaksin Td Vial - 15,450 -

104 Vitamin B1 Tablet Tablet - 95 -

105 Vitamin B1 Tablet Tablet - 98 -

Yodium 300 ml Botol - 18,000 -

106 Zinc 20 mg Tablet - 631 -

TOTAL -

Mamuju,
Yang Menerima,
Penanggungjawab,
Puskesmas

SRI INTAN MARTHEN, S. Si

Mengetahui : NIP. 19720410 201212 2 003
........................................................
NIP.
Plt Kepala Gudang Farmasi Kab. Mamuju

FATMAWATI, S.Si.,Apt
NIP. 19810807 201503 2 003