LAPORAN PEMAKAIAN DAN PERMINTAAN OBAT BULAN MEI

PUSKESMAS :
KECAMATAN :
WILAYAH :
KOTA : BANDUNG
Bulan : April-Mei 2018
Stok Pemeriaan
No Jenis Barang Satuan Stok Awal Penerimaan Persediaan Pemakaian Stok Akhir Permintaan
Optimum
APBD APBD I APBN
1 2 3 4 5 6 7 8 9 10 11 12 13
LIFE SAVING
1 Atropin Inj. Im/Iv/s.k.0,25 mg/ml-1ml Ampul 0 0 0 0
2 Epinefrin HCL Inj Ampul 0 0 0 0
3 Kalsium Glukonat inj 100 mg / ml Ampul 0 0 0 0
4 Mg Sulfat Inj 40 % - IV/10 vial Ampul 0 0 0 0
5 Oksitosin Inj 10 lU/ml 1 ml Ampul 0 0 0 0
6 Diazepam Lar Rektal 10 mg/ml Tube 0 0 0 0

ANTIINFEKSI
7 ACT ( arthesunat ) Tablet 0 0 0 0 0
8 Acyclovir tab 400 mg Tablet 0 0 0 0 0
9 Albendazol 400 mg Tablet 346 346 2 344 4
10 Albendazol susp 200 mg/5 ml Botol 0 0 0 0 0
11 Amoksilin Kap. 250 mg Kapsul 0 0 0 0 0
12 Amoksilin Kap.500 mg Tablet 0 500 500 0 500 0
13 Amoksilin syr kering 125 mg/ ml Botol 0 0 0 0 0
14 Amoksilin syr kering 250 mg/ ml Botol 0 0 0 0 0
15 Amoksisilin Drops 100 mg/ml Botol 0 0 0 0 0
16 Azitromisin 500 mg Kaplet 0 0 0 0 0
17 Benzatin Benzil P 2,4 Vial 0 0 0 0 0
18 Cefixim tab 100 mg Tablet 0 0 0 0 0
19 Ciprofloxacin 500 mg Tablet 0 0 0 0 0
20 Dietilkarbamazin Tablet 0 0 0 0 0
21 Doxyciclin 100 mg Tablet 0 0 0 0 0
22 Erytromicin 250 mg Tablet 0 0 0 0 0
23 Ethambutol 250 mg Tablet 0 0 0 0 0
24 Flukonazol kaps 50 mg Capsul 0 0 0 0 0
25 Gentamisin 40 mg / 2ml inj Ampul 0 0 0 0 0
26 Griseofulvin125 mg Tablet 0 0 0 0 0
27 Isoniazide 100 mg Tablet 0 0 0 0 0
28 Isoniazide 300 mg Tablet 0 0 0 0 0
29 Ketoconazole 200 mg Tablet 74 74 31 43 62
30 Klindamisin 150 mg Capsul 205 205 10 195 20
31 Klindamisin 300 mg Capsul 158 100 258 54 204 108
32 Kloramfenikol 250 mg capsul Capsul 0 0 0 0 0
33 Kloramfenikol 500 mg capsul Capsul 0 0 0 0 0
34 Kloramfenikol susp 125 mg / 5 ml Botol 29 29 5 24 10
35 Kombipak IMS Kotak 0 0 0 0 0
36 Kotrimoksazol Adult 480 mg Tablet 0 300 300 0 300 0
37 Kotrimoksazol Suspensi 240 mg/5 ml Botol 63 50 113 3 110 6
38 Metronidazol 250 mg Tablet 0 0 0 0 0
39 Metronidazol 500 mg Tablet 699 699 154 545 308
40 Natrium Tiroksin Tablet 0 0 0 0 0
41 Nistatin 100.000 IU/g tablet vagina Tablet 121 121 11 110 22
42 Nistatin susp 100.000 UI / ml Botol 6 6 2 4 4
43 Obat Anti TBC Anak FDC Paket 0 0 0 0 0
44 Obat Anti TBC Kat I FDC Paket 0 0 0 0 0
45 Obat Anti TBC Kat II FDC Paket 0 0 0 0 0
46 Obat Anti TBC Kombipak Paket 0 0 0 0 0
47 Pyrantel Pamoat 125 mg Tablet 0 0 0 0 0
48 Pyrazinamide 500 mg Tablet 0 0 0 0 0
49 Pyrimethamine 25 mg Tablet 0 0 0 0 0
50 Rifampicin 300 mg Tablet 0 0 0 0 0
51 Rifampicin 450 mg Tablet 0 0 0 0 0
52 Rifampicin 600 mg Tablet 0 0 0 0 0
53 Sefadroxil kapsul 500 mg Capsul 0 0 0 0 0
54 Sefadroxil syr kering 125 mg/ml Botol 0 0 0 0 0
55 Streptomicin Inj. Ampul 0 0 0 0 0
56 Tetracyclin 250 mg Tablet 0 0 0 0 0
57 Thiamphenicol caplet Tablet 0 0 0 0 0

SALURAN PERNAPASAN
58 Ambroxol Syrup 15 mg Botol 0 0 0 0 0
59 Ambroxol tab 30 mg Tablet 0 0 0 0 0
60 Aminopilina 200 mg Tablet 0 0 0 0 0
61 Gliseril Guayakolat 100 mg (GG) Tablet 0 0 0 0 0
62 Komb : Ipatropium Br 0.5 mg, salbutamol 2,5 Vial 0 10 10 0 10 0
63 N-asetil sistein (NAC) kaps 200 mg Kapsul 408 408 174 234 348
64 Obat batuk anak (OBP,Daganak) Botol 0 0 0 0 0
65 Obat Batuk Anak Syrup Botol 0 0 0 0 0
66 Obat batuk flu syrup (Alphara,Babycough) Botol 0 0 0 0 0
67 Obat Batuk Flu Tablet (Flunax) Tablet 0 0 0 0 0
68 Obat batuk hitam (OBH) Botol 0 0 0 0 0
69 Salbutamol 2 mg Tablet 140 140 4 136 8
70 Salbutamol 2.5 mg nebules Vial 0 0 0 0 0
71 Sanadryl DMP Syr Botol 0 0 0 0 0
72 Sanadryl Exp Syr Botol 0 0 0 0 0
Bromheksin 0 0 0 0

ANALGETIK,ANTIPIRETIK,ANTIINFLAMASI,AINS
73 Antimigren Tablet 0 0 0 0 0
74 Asam Mefenamat 500 mg Tablet 0 0 0 0
75 Betahistine mysilat 6 mg Tablet 0 0 0 0 0
76 Etil Klorida Semprot 100 ml Botol 0 0 0 0
77 Ibupropen 200 mg Tablet 0 0 0 0 0
78 Ibuprofen 400 mg Tablet 0 0 0 0 0
79 Ibuprofen sirup 200 mg/ 5 ml Botol 17 17 1 16 2
80 Lidokain inj 2 % (infltr/p.v) Ampul 0 0 0 0 0
81 Na.Diklofenak 50 mg Tablet 0 0 0 0 0
82 Parasetamol tts 60 mg / 0.6 ml Botol 0 0 0 0 0
83 Parasetamol 500 mg Tablet 2982 1000 3982 3308 674 6616
84 Parasetamol syr 120 mg/5 ml 60 ml Botol 197 100 297 144 153 288
85 Piroksikam 10 mg Tablet 0 0 0 0 0
86 Proris supp suppositoria 0 0 0 0 0
87 Asam Asetl Salisilat 0 0 0 0 0
88 Meloxicam 0 0 0 0 0

SISTEM PENCERNAAN
89 Antasida DOEN Tablet 2358 200 2558 524 2034 1048
90 Antasida DOEN susp Botol 0 50 50 10 40 20
91 Antihemoroid suppositoria Supp 0 0 0 0 0
92 Atapulgit tab 600 mg Tablet 300 300 300 0 600
93 Bisakodil sup 5 mg Supp 15 15 3 12 6
94 Bisakodil 5 mg Tablet 0 0 0 0 0
95 Dimenhidrinat tab 50 mg Tablet 0 0 0 0 0
 96 Domperidon 10 mg Tablet 0 0 0 0 0
97 Domperidon sirup 5 mg/5 ml Botol 0 0 0 0 0
98 Garam Oralit 200 ml Sase 222 100 322 112 210 224
99 Hiosina Butilbromida 10 mg Tablet 200 200 200 0 400
100 Karbo Adsorben 250 mg Tablet 0 0 0 0 0
101 Metoklopramide sirup 5 mg/ml Botol 0 0 0 0 0
102 Natrium Bicarbonat 500 mg Tablet 0 0 0 0 0
103 Komb Kaolin 550 mg + pektin 20 mg Tablet 0 0 0 0 0
104 Omeprazol 20 mg Capsul 0 0 0 0 0
105 Omeprazol inj 40 mg / 10 ml Ampul 0 0 0 0 0
106 Ranitidin tab 150 mg Tablet 562 300 862 662 200 1324
107 Zinc dispersibel Tablet 115 200 315 0 315 0
Ondansetron Tablet 60 60 0 60 0

JANTUNG DAN PEMBULUH DARAH

108 Amlodipine 5 mg Tablet 250 300 550 250 300 500
109 Amlodipin 10 mg Tablet 485 485 165 320 330
110 Atenolol 50 mg Tablet 0 0 0 0 0
111 Captopril 12,5 mg Tablet 265 265 30 235 60
112 Captopril 25 mg Tablet 124 124 24 100 48
113 Digoksin 0,25 mg Tablet 0 0 0 0 0
114 Diltiazem 30 mg Tablet 0 0 0 0 0
115 Furosemid 40 mg Tablet 0 100 100 0 100 0
116 Hidrokortiazid HCT tab 25 mg Tablet 0 0 0 0 0
117 Isosorbid Dinitrat 5 mg tablet Tablet 0 0 0 0 0
118 Metyldopa tab 250 mg Tablet 0 0 0 0 0
119 Nifedipin tab 10 mg Tablet 0 0 0 0 0
120 Reserpin 0,25 mg Tablet 0 0 0 0 0
121 Spironolakton 25 mg Tablet 146 146 0 146 0

OBAT MATA
122 Klorampenicol S.M 1 % Tube 24 24 48 24 24 48
123 Koramfenikol TM 1 % Botol 0 0 0 0 0
124 Cendo Eye Fresh Tube 0 0 0 0 0

OBAT KULIT
125 Acyclovir cream 5 % Tube 5 10 15 0 15 0
126 Anti Bacteri DOEN SK Tube 0 0 0 0 0
127 Antifungi SK Pot 16 8 24 0 24 0
128 Basitrasin Polimiksin SK Tube 16 16 2 14 4
129 Bedak Salisil serbuk 2 % Dus 52 52 36 16 72
130 Betametason Crem 0,1 % Tube 105 25 130 26 104 52
131 Gentamycin SK Tube 0 0 0 0 0
132 Hidrokortison Crem 2,5 % Tube 25 24 49 13 36 26
133 Hydrocortison 1 % Tube 0 0 0 0 0
134 Ichtyol Sk Pot 5 5 2 3 4
135 Ketokonazol krim 2% Tube 38 25 63 5 58 10
136 Kloramfenikol SK 2% Tube 56 24 80 15 65 30
137 Mikonazol krim 2% Tube 65 10 75 6 69 12
138 Neocental Gel Tube 0 0 0 0 0
139 Neomisin dan Basitrasin SK Tube 0 0 0 0 0
140 Perak Sulfadiazin krim 1% Tube 8 8 8 0 16
141 Permetrin Krim 5 % Tube 60 60 0 60 0
142 Salep 2-4 Pot 21 24 45 4 41 8

VITAMIN DAN MINERAL

143 Asam Askorbat (Vit C) tab 50 mg Tablet 0 300 300 0 300 0
144 Asam Askorbat (Vit C) tab 250 mg Tablet 305 300 605 390 215 780
145 Asam Folat 1 mg Tablet 0 0 0 0 0
146 Kalsium laktat (kalk) tab 500 mg Tablet 300 300 600 200 400 400
147 Multivitamin dan Mineral Tablet 0 0 0 0 0
148 Mineral Mix Sase 0 0 0 0 0
149 Piridoksin HCL (B6) 10 mg tablet Tablet 0 300 300 200 100 400
150 Retinol (Vit. A) 100,000 IU Kap Lunak Capsul 0 0 0 0 0
151 Retinol (Vit. A) 200,000 IU Kap Lunak Capsul 3434 3434 5 3429 10
152 Sianokobalamin (Vitamin B12) tab 50 mcg Tablet 530 1000 1530 630 900 1260
153 Tablet Tambah Darah/FE Tablet 80818 80818 6068 74750 12136
154 Thiamin HCL (B1) 50 mg Tablet 2328 300 2628 182 2446 364
155 Vit. B. Complex Tablet 1450 500 1950 850 1100 1700
156 Vit. Syrup Anak 60 ml Botol 0 0 0 0 0

DARAH,AS URAT,KOLESTEROL
157 Alopurinol 100 mg Tablet 370 370 70 300 140
158 Fitomenadion /Vit K 10 mg Tablet 50 100 150 0 150 0
159 Fitomenadion /Vit K Inj 2 mg/ml Ampul 0 0 0 0 0
160 Gemfibrozil 300 mg Tablet 0 0 0 0 0
161 Metilergometrin Maleat 0,125 mg Tablet 24 24 10 14 20
162 Metilergometrin Maleat 0,200 mg 1ml inj Ampul 0 0 0 0 0
163 Simvastatin 10 mg Tablet 0 0 0 0 0

MULUT,THT
169 Borax Glicerin Botol 0 0 0 0 0
170 Fenol Glicerol Tetes Telinga 10 % Botol 0 0 0 0 0
171 Gentian Violet Lart 1 % 10 ml Botol 0 0 0 0 0
172 Kloramfenikol tetes Telinga 3 % 10 ml Botol 0 0 0 0 0
173 Oksimetazolin tts hidung 0,025% Botol 2 2 0 2 0

ALERGI,KORTIKOSTEROID
179 Deksametason 0,5 mg tablet Tablet 1642 800 2442 296 2146 592
180 Deksametason inj 5 mg / ml (i.v / i.m) Ampul 0 0 0 0 0
181 Difenhidramin inj 10 mg / ml (i.v / i.m) Ampul 0 0 0 0 0
182 Klorfeniramin Maleat/CTM 4 mg Tablet 1610 800 2410 662 1748 1324
183 Loratadine Tab 10 mg Tablet 0 0 0 0 0
184 Methilprednisolon 4 mg Tablet 0 0 0 0 0
185 Prednison 5 mg Tablet 0 0 0 0 0
186 Setirizin sir 5 mg / 5 ml Botol 0 0 0 0 0
187 Setrizin tablet Tablet 0 0 0 0 0

HORMON
188 Glibenklamid 5 mg tablet Tablet 0 0 0 0 0
189 Propiltiourasil tab 100 mg (PTU) Tablet 0 0 0 0 0
190 Metformin tab 500 mg Tablet 197 400 597 197 400 394
191 Glimepiride tablet Tablet 0 0 0 0 0

ANTISEPTIK,DISINFEKTAN
192 Alkohol Swab Buah 0 0 0 0 0
193 Chlorin 10 % Liter 1 1 1 0
194 Etakridin 0,1 % Rivanol 300 ml Botol 0 0 0 0
195 Etanol 70 % 100 ml Botol 4 4 4 0
196 Etanol 70 % 1000 ml Botol 2 2 2 0
197 Framisetin sulfat tulle 1% Lembar 0 0 0 0
198 Hand Rub Liter 1 1 1 0
199 Kaporit 60% Kg 0 0 0 0
200 Kaporit 60% Tablet 0 0 0 0
201 Kalium Permanganat (PK) 5 gram Botol 0 0 0 0
202 Lisol 50 % 1000 ml Botol 53 53 53 0
203 Polikresulen 10 ml Botol 0 0 0 0
204 Povidon Iodin lar 10 mg/ml Botol 30 ml 0 0 0 0
205 Povidon Iodin lar 10 mg/ml Botol 300 ml 0 0 0 0
206 Proclean 1 L Botol 0 0 0 0 0

INFUS,LAR STERIL
207 Aqua pro inj steril 20 ml Vial 10 10 10 0
208 Glukosa Lar infus 5 % steril 500 ml Labu 2 2 2 0
209 Natrium Klorida Larutan Infus 0,9 % Labu 0 0 0 0
210 Ringer Laktat Larutan Infus Steril Labu 0 0 0 0
211 Aqua Bidestilata Liter 0 0 0 0

NARKOTIKA, PSIKOTROPIKA & KESEHATAN JIWA

212 Amitriptilin tab sal 25 mg Tablet 0 0 0 0
213 Diazepam 2 mg tablet Tablet 0 0 0 0
214 Fenobarbital tab 30 mg Tablet 0 0 0 0
215 Haloperidol tab 1.5 mg Tablet 0 0 0 0
216 Karbamazepin tab 200 mg Tablet 0 0 0 0
217 Klorpromazin tab sal 25 mg Sallet 0 0 0 0
218 Kodein HCL 10 mg Tablet 0 0 0 0
219 Risperidon tab 2 mg Sallet 0 0 0 0

REAGENT HIV
220 Rapid Test HIV ( Oncoprobe ) Test 0 0 0 0
221 Rapid Test HIV ( Intec ) Test 0 0 0 0
222 Rapid Test HIV ( Biomeriux ) Test 0 0 0 0
223 SD HIV Test 0 0 0 0
224 Open CD 4 Test 0 0 0 0
225 Kontrol CD 4 kitt 0 0 0 0
0 0 0
REAGENT IMS 0 0 0 0
223 TPHA Sypillis (Hexagon) Test 0 0 0 0
224 TPHA Sypillis (SD) Test 0 0 0 0
225 RPR Antigen/ Trust Test 0 0 0 0
226 Pewarnaan gram Kit 0 0 0 0
0 0 0
REAGEN TB 0 0 0 0
227 Reagent ZN Kit 0 0 0 0
228 PPD / Test Mantoux Vial 0 0 0 0
229 Oli Imersi Botol 0 0 0 0
0 0 0
0 0 0
ALAT & BAHAN GIGI 0 0 0
230 Air Raksa Fls 0 0 0 0
231 Alvogil Fls 0 0 0 0
232 Amalgam Fls 0 0 0 0
233 Arkansas Stone Fls 0 0 0 0
234 Articulating paper (kertas warna penanda oklusLembar 0 0 0 0
235 Bahan tumpatan sementara (Temporary Fletche Pot 0 0 0 0
236 Boor jet Fressure Buah 0 0 0 0
237 Boor jet inverted Buah 0 0 0 0
238 Boor jet round Buah 0 0 0 0
239 Boor low fressure Buah 0 0 0 0
240 Boor low inverted Buah 0 0 0 0
241 Boor low round Buah 0 0 0 0
242 Boor Stone Buah 0 0 0 0
243 CaOH with Iodoform 1 syringe 2,2 g Botol 0 0 0 0
244 Celluloid Strip Lembar 0 0 0 0
245 Cement Zn Phospat Powder & Liquid Set 0 0 0 0
246 Devitalisasi Pasta (arsenik) Fls 0 0 0 0
247 Devitalisasi Pasta (Non arsen) 0 0 0 0
248 Disclossing Tablet 0 0 0 0
249 Eugenol Fls 0 0 0 0
250 Formokresol Btl 0 0 0 0
251 Glass Ionomer ART (Atraumatic Restorative TreaBuah 0 0 0 0
252 Glass Ionomer ART (Atraumatic Restorative TreBuah 0 0 0 0
253 H2O2 Botol 0 0 0 0
254 Kalsium Hidroksida Pasta (CaOH) Tube 0 0 0 0
255 Klorfenol Kamfer Mentol (CHKM) Fls 0 0 0 0
256 Komb : Artikaine HCl 4% + Epinefrin 1 : 100.0 cartridge kaca 0 0 0 0
257 Komb : Deksametason asetat 0,1%, Thymol 5%Fls 0 0 0 0
258 Komb : Lidokain HCl 2% + Epinefrin 1 : 80.000Ampul 0 0 0 0
259 Komb : Mepivakaine HCl 2 % + Epinefrin 1:100cartridge kaca 0 0 0 0
260 Komposit Resin Fls 0 0 0 0
261 Matrix Band Roll 0 0 0 0
262 Panasray Buah 1 1 1 0
263 Pasta Gigi Buah 6 8 14 14 0
264 Pasta Pengisi Saluran Akar Fls 0 0 0 0
265 Pembersih noda gigi (TSR/OCO) Buah 0 0 0 0
266 Rockel Fls 0 0 0 0
267 Savlon Liter 0 0 0 0
268 Slaber Buah 0 0 0 0
269 Spongostan Buah 0 0 0 0
270 Tampon Segitiga Bks 0 0 0 0
271 Tissue gulung Buah 0 0 0 0 0
272 Vaseline Pot 15gr 0 0 0 0
0 0 0
0 0 0
ALKES HABIS PAKAI 0 0 0
273 Abbocat No. 18 Buah 0 0 0 0
274 Abbocat No. 20 Buah 0 0 0 0
275 Abbocat No. 22 Buah 0 0 0 0
276 Abbocat No. 24 Buah 0 0 0 0
277 Abbocat No. 26 Buah 0 0 0 0
278 Alat Suntik 1 ml Buah 100 100 100 0
279 Alat Suntik 3 ml Buah 500 500 500 0
280 Alat Suntik 5 ml Buah 0 0 0 0
281 Alat Suntik 10 ml Buah 0 0 0 0
282 Alat Suntik 20 ml Buah 0 0 0 0
283 Bisturi Buah 0 0 0 0
284 Blood Lancet Buah 0 0 0 0
285 Cat Gut Chromic/Benang Bedah No. 3.2 Buah 0 0 0 0
286 Cat Gut Plain/Benang Bedah No. 3.2 Buah 0 0 0 0
287 Endotrakeal No 3 Buah 0 0 0 0
288 Endotrakeal No 3.5 Buah 0 0 0 0
289 Endotrakeal No 4 Buah 0 0 0 0
290 Foley Kateter No 18 Buah 0 0 0 0
291 Foley Kateter No 20 Buah 0 0 0 0
292 Hecting Nald Buah 1 1 1 0
293 Infuset anak Buah 0 0 0 0
294 Infuset dewasa Buah 0 0 0 0
295 Iodina Test Botol 1 1 1 0
296 Jarum Cytojek Buah 100 100 100 0
297 Jarum vacutainer Buah 0 0 0 0
298 Kateter penghisap lendir No 8 Buah 0 0 0 0
299 Kateter penghisap lendir No 10 Buah 0 0 0 0
300 Kaca Mulut Buah 0 0 0 0
301 Kaca Penutup / Dek glass Kotak 100 0 0 0 0
302 Kantong Jenazah Buah 0 0 0 0
303 Kapas Pembalut Absorben 250 g Bks 2 2 2 0
304 Kassa Kompres 40 x 40 steril Bks 2 2 2 0
305 Kassa Pembalut 2 m x 80 cm Bks 24 24 24 0
306 Kassa pembalut Hidrofil 4 cm x 15 cm Roll 0 0 0 0
307 Kassa pembalut Hidrofil 4 cm x 3 cm Roll 0 0 0 0
308 Kertas Perkamen Bks 0 0 0 0
309 Kondom buah 0 0 0 0
310 Masker Lembar 0 50 50 50 0 100
311 Masker N.95 Buah 0 0 0 0
312 Masker Oksigen dewasa Buah 0 0 0 0
313 Masker Oksigen Anak Buah 1 1 1 0
314 Oksigen can Buah 0 0 0 0
315 Plastic Bandages Kotak 0 0 0 0
316 Plester Roll 2 2 2 0
317 Plester kertas Roll 0 0 0 0
318 Peneng Bayi Buah 0 0 0 0
319 Perban elastis Roll 0 0 0 0
320 Pot Sputum Buah 0 0 0 0
321 RTD Malaria Box 0 0 0 0
322 Rotator Unit 0 0 0 0
323 Slide Box 0 0 0 0
324 Sarung tangan Steril Psng 100 100 100 0
325 Sarung Tangan Non Steril Psng 100 100 100 0
326 Sarung Tangan Panjang ginekolog Psng 0 0 0 0
327 Sarung Tangan Karet Tebal Buah 0 0 0 0
328 Selang oksigen Anak Buah 0 0 0 0
329 Selang oksigen dewasa Buah 0 0 0 0
330 Sendok Obat Buah 0 0 0 0
331 Silk Buah 0 0 0 0
332 Spalk 30 cm pasang 0 0 0 0
333 Three way stop cock Buah 0 0 0 0
334 Tip pipet kuning Pak 0 0 0 0
335 Tongue Spatel Kayu Buah 0 0 0 0
336 Urine Bag Buah 0 0 0 0
337 Ultrasound gel 250 cc Botol 0 0 0 0
338 Umbilical Cord Clam Biru Buah 0 0 0 0
339 Vacutainer/Tabung spesimen darah + tutup Buah 0 0 0 0
340 Wing Needle no.27 G Buah 0 0 0 0
341 ADS 0,5 ml 0 0 0 0
0 0 0
CETAKAN DAN EMBALAGE 0 0 0
342 Buku Resep Buku 0 0 0 0
343 Berita Acara Serah Terima Barang Buku 0 0 0 0
344 Etiket Obat putih Lembar 0 0 0 0
345 Buku Harian Buku 0 0 0 0
346 Kartu stok Barang ( Gudang) Lembar 0 0 0 0
347 Kartu Persediaan Barang (Gudang) Lembar 0 0 0 0
348 LPLPO Buku 0 0 0 0
0 0 0
EMBALAGE 0 0 0
349 K.Obat Plastik 8 x 13 x 05 Kg 0 0 0 0
350 Kantong Obat Plastik 20 x 15 x 0.5 Kg 0 0 0 0
351 Kantong Obat Plastik 20 x 30 x 0.5 Kg 0 0 0 0
352 Kantong kresek Putih Pak 0 0 0 0
0 0 0
Obat-obatan Program HIV AIDS 0 0 0
353 Abacavir 300 mg (ABC) Botol 60 tablet 0 0 0 0
354 Efavirenz 600 mg (EFV) Botol 30 tablet 0 0 0 0
355 Lamivudine 150 mg (3TC) Botol 60 tablet 0 0 0 0
356 Neviraphine 200 mg (NVP) Botol 60 tablet 0 0 0 0
357 Tenovir 300 mg (TDF) + Lamivudine 300 mg (3TBotol 30 tablet 0 0 0 0
358 Tenovofir 300 mg (TDF) Botol 30 tablet 0 0 0 0
359 Tenovir 300 mg (TDF) + Emtricitabine 200 mg Botol 30 tablet 0 0 0 0
360 Zidovudine 60 mg (ZDV)+ Lamivudine 30 mg (3Botol 60 tablet 0 0 0 0
361 Zidovudine 300 mg (ZDV)+ Lamivudine 150 mgBotol 60 tablet 0 0 0 0
362 Lovinapir 200 mg + Ronavir 50 mg Botol 120 tablet 0 0 0 0
363 DBS Collection Kit Test 0 0 0 0
364 Zidovudine 50 mg/ ml Botol 0 0 0 0
0 0 0
Obat - Obatan Program Hepatitis 0 0 0
365 Ribavirin 200 mg (Rebetol) Kapsul 0 0 0 0
366 Simeprevir 150 mg (Olysio) Kapsul 0 0 0 0
367 Sofosbufir 400 mg (Myhep) Kapsul 0 0 0 0
368 HCV Viral Load Test 0 0 0 0
369 RDD Anti HCV Test 0 0 0 0
370 Reagent Rapid Test HBSAG Test 0 0 0 0
371 Hepatitis B Immunoglobulin Syringe 0 0 0 0
372 Daclastavir 60 mg Botol 0 0 0 0
373 Daclastavir 30 mg Botol 0 0 0 0
374 Dehidroartemisin + Piperaquine (DHP) Tablet 0 0 0 0
375 RDT Malaria Test 0 0 0 0
376 Primakuin 15 mg Tablet 0 0 0 0
377 Artesunat inj. 60 mg Ampul 0 0 0 0
0 0 0
0 0 0
Logistik DBD 0 0 0
378 Insektisida Liter 0 0 0 0
379 BTI Botol 30 ml 0 0 0 0
380 Jumantik Paket 0 0 0 0
381 NS1 Tes 0 0 0 0
382 RDT IGM Tes 0 0 0 0
383 RDT Combo Tes 0 0 0 0
384 APD Buah 0 0 0 0
385 Mesin Foging Swan Fog SF 88 Unit 0 0 0 0
386 Larvasida Abate Kg 0 0 0 0

KUNJUNGAN JUMLAH R/ GENERIK R/ NON GENERIK JUMLAH

PASIEN KUNJUNGA
UMUM BPJS UMUM BPJS UMUM BPJS PENULISAN R/
N
BALITA 143 64 207 296 148 0 0 444
ANAK 104 41 145 228 89 0 0 317
DEWASA 565 477 1042 1395 1137 0 0 2532
JUMLAH 812 582 1394 1919 1374 0 0 3293

Mengetahui, Yang menyerahkan, Yang menerima Yang melaporkan,

Kepala UPT Puskesmas Pengelola Obat UPT Puskesmas Kepala Puskesmas
Arcamanik Arcamanik
 LAPORAN PEMAKAIAN DAN PERMINTAAN OBAT BULAN APRIL
PUSKESMAS :
KECAMATAN :
WILAYAH :
KOTA : BANDUNG
Bulan : Maret-April
Stok Pemeriaan
No Jenis Barang Satuan Stok Awal Penerimaan Persediaan Pemakaian Stok Akhir Permintaan
Optimum
APBD APBD I APBN
1 2 3 4 5 6 7 8 9 10 11 12 13
LIFE SAVING
1 Atropin Inj. Im/Iv/s.k.0,25 mg/ml-1ml Ampul 0 0 0 0
2 Epinefrin HCL Inj Ampul 0 0 0 0
3 Kalsium Glukonat inj 100 mg / ml Ampul 0 0 0 0
4 Mg Sulfat Inj 40 % - IV/10 vial Ampul 0 0 0 0
5 Oksitosin Inj 10 lU/ml 1 ml Ampul 0 0 0 0
6 Diazepam Lar Rektal 10 mg/ml Tube 0 0 0 0

ANTIINFEKSI
7 ACT ( arthesunat ) Tablet 0 0 0 0 0
8 Acyclovir tab 400 mg Tablet 0 0 0 0 0
9 Albendazol 400 mg Tablet 346 346 0 346 0
10 Albendazol susp 200 mg/5 ml Botol 0 0 0 0 0
11 Amoksilin Kap. 250 mg Kapsul 0 0 0 0 0
12 Amoksilin Kap.500 mg Tablet 0 0 0 0 0
13 Amoksilin syr kering 125 mg/ ml Botol 0 0 0 0 0
14 Amoksilin syr kering 250 mg/ ml Botol 0 0 0 0 0
15 Amoksisilin Drops 100 mg/ml Botol 0 0 0 0 0
16 Azitromisin 500 mg Kaplet 0 0 0 0 0
17 Benzatin Benzil P 2,4 Vial 0 0 0 0 0
18 Cefixim tab 100 mg Tablet 0 0 0 0 0
19 Ciprofloxacin 500 mg Tablet 92 92 92 0 184
20 Dietilkarbamazin Tablet 0 0 0 0 0
21 Doxyciclin 100 mg Tablet 0 0 0 0 0
22 Erytromicin 250 mg Tablet 0 0 0 0 0
23 Ethambutol 250 mg Tablet 0 0 0 0 0
24 Flukonazol kaps 50 mg Capsul 0 0 0 0 0
25 Gentamisin 40 mg / 2ml inj Ampul 0 0 0 0 0
26 Griseofulvin125 mg Tablet 0 0 0 0 0
27 Isoniazide 100 mg Tablet 0 0 0 0 0
28 Isoniazide 300 mg Tablet 0 0 0 0 0
29 Ketoconazole 200 mg Tablet 92 92 18 74 36
30 Klindamisin 150 mg Capsul 215 215 10 205 20
31 Klindamisin 300 mg Capsul 290 290 132 158 264
32 Kloramfenikol 250 mg capsul Capsul 0 0 0 0 0
33 Kloramfenikol 500 mg capsul Capsul 0 0 0 0 0
34 Kloramfenikol susp 125 mg / 5 ml Botol 29 29 0 29 0
35 Kombipak IMS Kotak 0 0 0 0 0
36 Kotrimoksazol Adult 480 mg Tablet 38 38 38 0 76
37 Kotrimoksazol Suspensi 240 mg/5 ml Botol 53 20 73 10 63 20
38 Metronidazol 250 mg Tablet 0 0 0 0 0
39 Metronidazol 500 mg Tablet 699 699 0 699 0
40 Natrium Tiroksin Tablet 0 0 0 0 0
41 Nistatin 100.000 IU/g tablet vagina Tablet 121 121 0 121 0
42 Nistatin susp 100.000 UI / ml Botol 7 7 1 6 2
43 Obat Anti TBC Anak FDC Paket 0 0 0 0 0
44 Obat Anti TBC Kat I FDC Paket 0 0 0 0 0
45 Obat Anti TBC Kat II FDC Paket 0 0 0 0 0
46 Obat Anti TBC Kombipak Paket 0 0 0 0 0
47 Pyrantel Pamoat 125 mg Tablet 0 0 0 0 0
48 Pyrazinamide 500 mg Tablet 0 0 0 0 0
49 Pyrimethamine 25 mg Tablet 0 0 0 0 0
50 Rifampicin 300 mg Tablet 0 0 0 0 0
51 Rifampicin 450 mg Tablet 0 0 0 0 0
52 Rifampicin 600 mg Tablet 0 0 0 0 0
53 Sefadroxil kapsul 500 mg Capsul 0 0 0 0 0
54 Sefadroxil syr kering 125 mg/ml Botol 0 0 0 0 0
55 Streptomicin Inj. Ampul 0 0 0 0 0
56 Tetracyclin 250 mg Tablet 0 0 0 0 0
57 Thiamphenicol caplet Tablet 0 0 0 0 0

SALURAN PERNAPASAN
58 Ambroxol Syrup 15 mg Botol 49 10 59 59 0 118
59 Ambroxol tab 30 mg Tablet 0 0 0 0 0
60 Aminopilina 200 mg Tablet 0 0 0 0 0
61 Gliseril Guayakolat 100 mg (GG) Tablet 0 0 0 0 0
62 Komb : Ipatropium Br 0.5 mg, salbutamol 2,5 Vial 0 0 0 0 0
63 N-asetil sistein (NAC) kaps 200 mg Kapsul 445 445 37 408 74
64 Obat batuk anak (OBP,Daganak) Botol 0 0 0 0 0
65 Obat Batuk Anak Syrup Botol 0 0 0 0 0
66 Obat batuk flu syrup (Alphara,Babycough) Botol 0 0 0 0 0
67 Obat Batuk Flu Tablet (Flunax) Tablet 0 0 0 0 0
68 Obat batuk hitam (OBH) Botol 0 0 0 0 0
69 Salbutamol 2 mg Tablet 140 140 0 140 0
70 Salbutamol 2.5 mg nebules Vial 0 0 0 0 0
71 Sanadryl DMP Syr Botol 0 0 0 0 0
72 Sanadryl Exp Syr Botol 0 0 0 0 0
Bromheksin 0 0 0

ANALGETIK,ANTIPIRETIK,ANTIINFLAMASI,AINS
73 Antimigren Tablet 0 0 0 0 0
74 Asam Mefenamat 500 mg Tablet 0 0 0
75 Betahistine mysilat 6 mg Tablet 0 0 0 0 0
76 Etil Klorida Semprot 100 ml Botol 0 0 0
77 Ibupropen 200 mg Tablet 0 0 0 0 0
78 Ibuprofen 400 mg Tablet 0 0 0 0 0
79 Ibuprofen sirup 200 mg/ 5 ml Botol 19 19 2 17 4
80 Lidokain inj 2 % (infltr/p.v) Ampul 0 0 0 0 0
81 Na.Diklofenak 50 mg Tablet 0 0 0 0 0
82 Parasetamol tts 60 mg / 0.6 ml Botol 0 0 0 0 0
83 Parasetamol 500 mg Tablet 4594 1000 5594 2612 2982 5224
84 Parasetamol syr 120 mg/5 ml 60 ml Botol 200 100 300 103 197 206
85 Piroksikam 10 mg Tablet 0 0 0 0 0
86 Proris supp suppositoria 0 0 0 0 0
87 Asam Asetl Salisilat 0 0 0 0 0
88 Meloxicam 0 0 0 0 0

SISTEM PENCERNAAN
89 Antasida DOEN Tablet 2511 300 2811 453 2358 906
90 Antasida DOEN susp Botol 11 50 61 61 0 122
91 Antihemoroid suppositoria Supp 10 10 10 0 20
92 Atapulgit tab 600 mg Tablet 300 300 0 300 0
93 Bisakodil sup 5 mg Supp 16 16 1 15 2
94 Bisakodil 5 mg Tablet 0 0 0 0 0
95 Dimenhidrinat tab 50 mg Tablet 0 0 0 0 0
96 Domperidon 10 mg Tablet 0 0 0 0 0
97 Domperidon sirup 5 mg/5 ml Botol 0 0 0 0 0
98 Garam Oralit 200 ml Sase 505 100 605 383 222 766
99 Hiosina Butilbromida 10 mg Tablet 0 200 200 0 200 0
100 Karbo Adsorben 250 mg Tablet 0 0 0 0 0
101 Metoklopramide sirup 5 mg/ml Botol 0 0 0 0 0
102 Natrium Bicarbonat 500 mg Tablet 0 0 0 0 0
103 Komb Kaolin 550 mg + pektin 20 mg Tablet 0 0 0 0 0
104 Omeprazol 20 mg Capsul 0 0 0 0
105 Omeprazol inj 40 mg / 10 ml Ampul 0 0 0 0 0
106 Ranitidin tab 150 mg Tablet 735 300 1035 473 562 946
107 Zinc dispersibel Tablet 170 100 270 155 115 310
Ondansetron Tablet 60 60 60

JANTUNG DAN PEMBULUH DARAH

108 Amlodipine 5 mg Tablet 560 250 810 560 250 1120
109 Amlodipin 10 mg Tablet 765 765 280 485 560
110 Atenolol 50 mg Tablet 0 0 0 0 0
111 Captopril 12,5 mg Tablet 375 375 110 265 220
112 Captopril 25 mg Tablet 207 207 83 124 166
113 Digoksin 0,25 mg Tablet 0 0 0 0 0
114 Diltiazem 30 mg Tablet 0 0 0 0 0
115 Furosemid 40 mg Tablet 0 0 0 0 0
116 Hidrokortiazid HCT tab 25 mg Tablet 0 0 0 0 0
117 Isosorbid Dinitrat 5 mg tablet Tablet 0 0 0 0 0
118 Metyldopa tab 250 mg Tablet 0 0 0 0 0
119 Nifedipin tab 10 mg Tablet 0 0 0 0 0
120 Reserpin 0,25 mg Tablet 0 0 0 0 0
121 Spironolakton 25 mg Tablet 146 146 0 146 0

OBAT MATA
122 Klorampenicol S.M 1 % Tube 12 24 36 12 24 24
123 Koramfenikol TM 1 % Botol 0 0 0 0 0
124 Cendo Eye Fresh Tube 0 0 0 0 0

OBAT KULIT
125 Acyclovir cream 5 % Tube 10 10 5 5 10
126 Anti Bacteri DOEN SK Tube 0 0 0 0 0
127 Antifungi SK Pot 11 6 17 1 16 2
128 Basitrasin Polimiksin SK Tube 20 20 4 16 8
129 Bedak Salisil serbuk 2 % Dus 10 50 60 8 52 16
130 Betametason Crem 0,1 % Tube 88 25 113 8 105 16
131 Gentamycin SK Tube 0 0 0 0 0
132 Hidrokortison Crem 2,5 % Tube 61 10 71 46 25 92
133 Hydrocortison 1 % Tube 0 0 0 0 0
134 Ichtyol Sk Pot 5 5 0 5 0
135 Ketokonazol krim 2% Tube 16 25 41 3 38 6
136 Kloramfenikol SK 2% Tube 41 24 65 9 56 18
137 Mikonazol krim 2% Tube 59 10 69 4 65 8
138 Neocental Gel Tube 0 0 0 0 0
139 Neomisin dan Basitrasin SK Tube 0 0 0 0 0
140 Perak Sulfadiazin krim 1% Tube 10 10 2 8 4
141 Permetrin Krim 5 % Tube 74 74 14 60 28
142 Salep 2-4 Pot 9 14 23 2 21 4
0 0
VITAMIN DAN MINERAL 0 0
143 Asam Askorbat (Vit C) tab 50 mg Tablet 445 445 445 0 890
144 Asam Askorbat (Vit C) tab 250 mg Tablet 305 305 0 305 0
145 Asam Folat 1 mg Tablet 0 0 0 0 0
146 Kalsium laktat (kalk) tab 500 mg Tablet 370 300 670 370 300 740
147 Multivitamin dan Mineral Tablet 0 0 0 0 0
148 Mineral Mix Sase 0 0 0 0 0
149 Piridoksin HCL (B6) 10 mg tablet Tablet 0 0 0 0 0
150 Retinol (Vit. A) 100,000 IU Kap Lunak Capsul 0 0 0 0 0
151 Retinol (Vit. A) 200,000 IU Kap Lunak Capsul 3435 3435 1 3434 2
152 Sianokobalamin (Vitamin B12) tab 50 mcg Tablet 802 500 1302 772 530 1544
153 Tablet Tambah Darah/FE Tablet 81790 81790 972 80818 1944
154 Thiamin HCL (B1) 50 mg Tablet 2453 200 2653 325 2328 650
155 Vit. B. Complex Tablet 1776 400 2176 726 1450 1452
156 Vit. Syrup Anak 60 ml Botol 0 0 0 0 0
0 0
0 0
DARAH,AS URAT,KOLESTEROL 0 0
157 Alopurinol 100 mg Tablet 300 100 400 30 370 60
158 Fitomenadion /Vit K 10 mg Tablet 0 50 50 0 50 0
159 Fitomenadion /Vit K Inj 2 mg/ml Ampul 0 0 0 0 0
160 Gemfibrozil 300 mg Tablet 0 0 0 0 0
161 Metilergometrin Maleat 0,125 mg Tablet 24 24 0 24 0
162 Metilergometrin Maleat 0,200 mg 1ml inj Ampul 0 0 0 0 0
163 Simvastatin 10 mg Tablet 0 0 0 0 0
0 0 0
0 0 0
MULUT,THT 0 0 0
169 Borax Glicerin Botol 0 0 0 0 0
170 Fenol Glicerol Tetes Telinga 10 % Botol 1 1 1 0 2
171 Gentian Violet Lart 1 % 10 ml Botol 0 0 0 0 0
172 Kloramfenikol tetes Telinga 3 % 10 ml Botol 0 0 0 0 0
173 Oksimetazolin tts hidung 0,025% Botol 0 2 2 0 2 0

ALERGI,KORTIKOSTEROID
179 Deksametason 0,5 mg tablet Tablet 1310 600 1910 268 1642 536
180 Deksametason inj 5 mg / ml (i.v / i.m) Ampul 0 0 0 0 0
181 Difenhidramin inj 10 mg / ml (i.v / i.m) Ampul 0 0 0 0 0
182 Klorfeniramin Maleat/CTM 4 mg Tablet 2417 2417 807 1610 1614
183 Loratadine Tab 10 mg Tablet 0 0 0 0 0
184 Methilprednisolon 4 mg Tablet 0 0 0 0 0
185 Prednison 5 mg Tablet 0 0 0 0 0
186 Setirizin sir 5 mg / 5 ml Botol 0 0 0 0 0
187 Setrizin tablet Tablet 0 0 0 0 0

HORMON
188 Glibenklamid 5 mg tablet Tablet 0 0 0 0 0
189 Propiltiourasil tab 100 mg (PTU) Tablet 0 0 0 0 0
190 Metformin tab 500 mg Tablet 540 540 343 197 686
191 Glimepiride tablet Tablet 0 0 0 0 0

ANTISEPTIK,DISINFEKTAN
192 Alkohol Swab Buah 0 0 0 0 0
193 Chlorin 10 % Liter 2 2 1 1 2
194 Etakridin 0,1 % Rivanol 300 ml Botol 0 0 0 0
195 Etanol 70 % 100 ml Botol 8 8 4 4 8
196 Etanol 70 % 1000 ml Botol 3 3 1 2 2
197 Framisetin sulfat tulle 1% Lembar 1 1 1 0 2
198 Hand Rub Liter 1 1 1 0
199 Kaporit 60% Kg 0 0 0 0
200 Kaporit 60% Tablet 0 0 0 0
201 Kalium Permanganat (PK) 5 gram Botol 0 0 0 0
202 Lisol 50 % 1000 ml Botol 22 31 53 53 0
203 Polikresulen 10 ml Botol 0 0 0 0
204 Povidon Iodin lar 10 mg/ml Botol 30 ml 4 4 4 0 8
205 Povidon Iodin lar 10 mg/ml Botol 300 ml 0 0 0 0
206 Proclean 1 L Botol 0 0 0 0

INFUS,LAR STERIL
207 Aqua pro inj steril 20 ml Vial 10 10 10 0
208 Glukosa Lar infus 5 % steril 500 ml Labu 3 3 1 2 2
209 Natrium Klorida Larutan Infus 0,9 % Labu 2 2 2 0 4
210 Ringer Laktat Larutan Infus Steril Labu 3 3 3 0 6
211 Aqua Bidestilata Liter 0 0 0 0
0 0
0 0
NARKOTIKA, PSIKOTROPIKA & KESEHATAN JIWA 0 0
212 Amitriptilin tab sal 25 mg Tablet 0 0 0 0
213 Diazepam 2 mg tablet Tablet 13 13 13 0 26
214 Fenobarbital tab 30 mg Tablet 0 0 0 0
215 Haloperidol tab 1.5 mg Tablet 0 0 0 0
216 Karbamazepin tab 200 mg Tablet 0 0 0 0
217 Klorpromazin tab sal 25 mg Sallet 0 0 0 0
218 Kodein HCL 10 mg Tablet 0 0 0 0
219 Risperidon tab 2 mg Sallet 0 0 0 0
0 0
0 0
REAGENT HIV 0 0
220 Rapid Test HIV ( Oncoprobe ) Test 0 0 0 0
221 Rapid Test HIV ( Intec ) Test 0 0 0 0
222 Rapid Test HIV ( Biomeriux ) Test 0 0 0 0
223 SD HIV Test 0 0 0 0
224 Open CD 4 Test 0 0 0 0
225 Kontrol CD 4 kitt 0 0 0 0
0 0
REAGENT IMS 0 0 0 0
223 TPHA Sypillis (Hexagon) Test 0 0 0 0
224 TPHA Sypillis (SD) Test 0 0 0 0
225 RPR Antigen/ Trust Test 0 0 0 0
226 Pewarnaan gram Kit 0 0 0 0
0 0
REAGEN TB 0 0 0 0
227 Reagent ZN Kit 0 0 0 0
228 PPD / Test Mantoux Vial 0 0 0 0
229 Oli Imersi Botol 0 0 0 0
0 0
0 0
ALAT & BAHAN GIGI 0 0
230 Air Raksa Fls 0 0 0 0
231 Alvogil Fls 0 0 0 0
232 Amalgam Fls 0 0 0 0
233 Arkansas Stone Fls 0 0 0 0
234 Articulating paper (kertas warna penanda oklusLembar 0 0 0 0
235 Bahan tumpatan sementara (Temporary FletchePot 0 0 0 0
236 Boor jet Fressure Buah 0 0 0 0
237 Boor jet inverted Buah 0 0 0 0
238 Boor jet round Buah 0 0 0 0
239 Boor low fressure Buah 0 0 0 0
240 Boor low inverted Buah 0 0 0 0
241 Boor low round Buah 0 0 0 0
242 Boor Stone Buah 0 0 0 0
243 CaOH with Iodoform 1 syringe 2,2 g Botol 0 0 0 0
244 Celluloid Strip Lembar 0 0 0 0
245 Cement Zn Phospat Powder & Liquid Set 0 0 0 0
246 Devitalisasi Pasta (arsenik) Fls 0 0 0 0
247 Devitalisasi Pasta (Non arsen) 0 0 0 0
248 Disclossing Tablet 0 0 0 0
249 Eugenol Fls 0 0 0 0
250 Formokresol Btl 0 0 0 0
251 Glass Ionomer ART (Atraumatic Restorative TreaBuah 0 0 0 0
252 Glass Ionomer ART (Atraumatic Restorative TreaBuah 0 0 0 0
253 H2O2 Botol 0 0 0 0
254 Kalsium Hidroksida Pasta (CaOH) Tube 0 0 0 0
255 Klorfenol Kamfer Mentol (CHKM) Fls 0 0 0 0
256 Komb : Artikaine HCl 4% + Epinefrin 1 : 100.0 cartridge kaca 0 0 0 0
257 Komb : Deksametason asetat 0,1%, Thymol 5%,Fls 0 0 0 0
258 Komb : Lidokain HCl 2% + Epinefrin 1 : 80.000 Ampul 0 0 0 0
259 Komb : Mepivakaine HCl 2 % + Epinefrin 1:100cartridge kaca 0 0 0 0
260 Komposit Resin Fls 0 0 0 0
261 Matrix Band Roll 0 0 0 0
262 Panasray Buah 1 1 1 0
263 Pasta Gigi Buah 6 6 6 0
264 Pasta Pengisi Saluran Akar Fls 0 0 0 0
265 Pembersih noda gigi (TSR/OCO) Buah 0 0 0 0
266 Rockel Fls 0 0 0 0
267 Savlon Liter 0 0 0 0
268 Slaber Buah 0 0 0 0
269 Spongostan Buah 0 0 0 0
270 Tampon Segitiga Bks 0 0 0 0
271 Tissue gulung Buah 0 0 0 0
272 Vaseline Pot 15gr 0 0 0 0
0 0
0 0
ALKES HABIS PAKAI 0 0
273 Abbocat No. 18 Buah 0 0 0 0
274 Abbocat No. 20 Buah 0 0 0 0
275 Abbocat No. 22 Buah 0 0 0 0
276 Abbocat No. 24 Buah 0 0 0 0
277 Abbocat No. 26 Buah 0 0 0 0
278 Alat Suntik 1 ml Buah 100 100 100 0
279 Alat Suntik 3 ml Buah 600 600 100 500 200
280 Alat Suntik 5 ml Buah 0 0 0 0
281 Alat Suntik 10 ml Buah 0 0 0 0
282 Alat Suntik 20 ml Buah 0 0 0 0
283 Bisturi Buah 0 0 0 0
284 Blood Lancet Buah 0 0 0 0
285 Cat Gut Chromic/Benang Bedah No. 3.2 Buah 0 0 0 0
286 Cat Gut Plain/Benang Bedah No. 3.2 Buah 0 0 0 0
287 Endotrakeal No 3 Buah 0 0 0 0
288 Endotrakeal No 3.5 Buah 0 0 0 0
289 Endotrakeal No 4 Buah 0 0 0 0
290 Foley Kateter No 18 Buah 0 0 0 0
291 Foley Kateter No 20 Buah 0 0 0 0
292 Hecting Nald Buah 1 1 1 0
293 Infuset anak Buah 0 0 0 0
294 Infuset dewasa Buah 0 0 0 0
295 Iodina Test Botol 1 1 1 0
296 Jarum Cytojek Buah 100 100 100 0
297 Jarum vacutainer Buah 0 0 0 0
298 Kateter penghisap lendir No 8 Buah 0 0 0 0
299 Kateter penghisap lendir No 10 Buah 0 0 0 0
300 Kaca Mulut Buah 0 0 0 0
301 Kaca Penutup / Dek glass Kotak 100 0 0 0 0
302 Kantong Jenazah Buah 0 0 0 0
303 Kapas Pembalut Absorben 250 g Bks 3 3 1 2 2
304 Kassa Kompres 40 x 40 steril Bks 5 5 3 2 6
305 Kassa Pembalut 2 m x 80 cm Bks 24 24 24 0
306 Kassa pembalut Hidrofil 4 cm x 15 cm Roll 0 0 0 0
307 Kassa pembalut Hidrofil 4 cm x 3 cm Roll 0 0 0 0
308 Kertas Perkamen Bks 0 0 0 0
309 Kondom buah 0 0 0 0
310 Masker Lembar 0 0 0 0
311 Masker N.95 Buah 0 0 0 0
312 Masker Oksigen dewasa Buah 0 0 0 0
313 Masker Oksigen Anak Buah 1 1 1 0
314 Oksigen can Buah 0 0 0 0
315 Plastic Bandages Kotak 0 0 0 0
316 Plester Roll 4 4 2 2 4
317 Plester kertas Roll 2 2 2 0 4
318 Peneng Bayi Buah 0 0 0 0
319 Perban elastis Roll 0 0 0 0
320 Pot Sputum Buah 0 0 0 0
321 RTD Malaria Box 0 0 0 0
322 Rotator Unit 0 0 0 0
323 Slide Box 0 0 0 0
324 Sarung tangan Steril Psng 100 100 100 0
325 Sarung Tangan Non Steril Psng 100 100 100 0
326 Sarung Tangan Panjang ginekolog Psng 0 0 0 0
327 Sarung Tangan Karet Tebal Buah 0 0 0 0
328 Selang oksigen Anak Buah 0 0 0 0
329 Selang oksigen dewasa Buah 0 0 0 0
330 Sendok Obat Buah 0 0 0 0
331 Silk Buah 1 1 1 0 2
332 Spalk 30 cm pasang 0 0 0 0
333 Three way stop cock Buah 0 0 0 0
334 Tip pipet kuning Pak 0 0 0 0
335 Tongue Spatel Kayu Buah 0 0 0 0
336 Urine Bag Buah 0 0 0 0
337 Ultrasound gel 250 cc Botol 0 0 0 0
338 Umbilical Cord Clam Biru Buah 0 0 0 0
339 Vacutainer/Tabung spesimen darah + tutup Buah 0 0 0 0
340 Wing Needle no.27 G Buah 0 0 0 0
341 ADS 0,5 ml 0 0 0 0
0 0
CETAKAN DAN EMBALAGE 0 0
342 Buku Resep Buku 0 0 0 0
343 Berita Acara Serah Terima Barang Buku 0 0 0 0
344 Etiket Obat putih Lembar 0 0 0 0
345 Buku Harian Buku 0 0 0 0
346 Kartu stok Barang ( Gudang) Lembar 0 0 0 0
347 Kartu Persediaan Barang (Gudang) Lembar 0 0 0 0
348 LPLPO Buku 0 0 0 0
0 0
EMBALAGE 0 0
349 K.Obat Plastik 8 x 13 x 05 Kg 0 0 0 0
350 Kantong Obat Plastik 20 x 15 x 0.5 Kg 0 0 0 0
351 Kantong Obat Plastik 20 x 30 x 0.5 Kg 0 0 0 0
352 Kantong kresek Putih Pak 0 0 0 0
0 0
Obat-obatan Program HIV AIDS 0 0
353 Abacavir 300 mg (ABC) Botol 60 tablet 0 0 0 0
354 Efavirenz 600 mg (EFV) Botol 30 tablet 0 0 0 0
355 Lamivudine 150 mg (3TC) Botol 60 tablet 0 0 0 0
356 Neviraphine 200 mg (NVP) Botol 60 tablet 0 0 0 0
357 Tenovir 300 mg (TDF) + Lamivudine 300 mg (3TBotol 30 tablet 0 0 0 0
358 Tenovofir 300 mg (TDF) Botol 30 tablet 0 0 0 0
359 Tenovir 300 mg (TDF) + Emtricitabine 200 mg ( Botol 30 tablet 0 0 0 0
360 Zidovudine 60 mg (ZDV)+ Lamivudine 30 mg (3Botol 60 tablet 0 0 0 0
361 Zidovudine 300 mg (ZDV)+ Lamivudine 150 mgBotol 60 tablet 0 0 0 0
362 Lovinapir 200 mg + Ronavir 50 mg Botol 120 tablet 0 0 0 0
363 DBS Collection Kit Test 0 0 0 0
364 Zidovudine 50 mg/ ml Botol 0 0 0 0
0 0
Obat - Obatan Program Hepatitis 0 0
365 Ribavirin 200 mg (Rebetol) Kapsul 0 0 0 0
366 Simeprevir 150 mg (Olysio) Kapsul 0 0 0 0
367 Sofosbufir 400 mg (Myhep) Kapsul 0 0 0 0
368 HCV Viral Load Test 0 0 0 0
369 RDD Anti HCV Test 0 0 0 0
370 Reagent Rapid Test HBSAG Test 0 0 0 0
371 Hepatitis B Immunoglobulin Syringe 0 0 0 0
372 Daclastavir 60 mg Botol 0 0 0 0
373 Daclastavir 30 mg Botol 0 0 0 0
374 Dehidroartemisin + Piperaquine (DHP) Tablet 0 0 0 0
375 RDT Malaria Test 0 0 0 0
376 Primakuin 15 mg Tablet 0 0 0 0
377 Artesunat inj. 60 mg Ampul 0 0 0 0
0 0
0 0
Logistik DBD 0 0
378 Insektisida Liter 0 0 0 0
379 BTI Botol 30 ml 0 0 0 0
380 Jumantik Paket 0 0 0 0
381 NS1 Tes 0 0 0 0
382 RDT IGM Tes 0 0 0 0
383 RDT Combo Tes 0 0 0 0
384 APD Buah 0 0 0 0
385 Mesin Foging Swan Fog SF 88 Unit 0 0 0 0
386 Larvasida Abate Kg 0 0 0 0
 KUNJUNGAN JUMLAH R/ GENERIK R/ NON GENERIK JUMLAH
PASIEN KUNJUNGA
UMUM BPJS UMUM BPJS UMUM BPJS PENULISAN R/
N
BALITA 160 41 201 316 48 0 0 364
ANAK 97 54 151 221 101 0 0 322
DEWASA 428 404 832 983 948 0 0 1931
JUMLAH 685 499 1184 1520 1097 0 0 2617

Mengetahui, Yang menyerahkan, Yang menerima Yang melaporkan,

Kepala UPT Puskesmas Pengelola Obat UPT Puskesmas Kepala Puskesmas
Arcamanik Arcamanik
 LAPORAN PEMAKAIAN DAN PERMINTAAN OBAT BULAN MARET
PUSKESMAS :
KECAMATAN
WILAYAH :
KOTA : BANDUNG
Bulan : Februari-Maret
Stok Pemeriaan
No Jenis Barang Satuan Stok Awal Penerimaan Persediaan Pemakaian Stok Akhir Permintaan
Optimum
APBD APBD I APBN
1 2 3 4 5 6 7 8 9 10 11 12 13
LIFE SAVING
1 Atropin Inj. Im/Iv/s.k.0,25 mg/ml-1ml Ampul 0 0 0 0
2 Epinefrin HCL Inj Ampul 0 0 0 0
3 Kalsium Glukonat inj 100 mg / ml Ampul 0 0 0 0
4 Mg Sulfat Inj 40 % - IV/10 vial Ampul 0 0 0 0
5 Oksitosin Inj 10 lU/ml 1 ml Ampul 0 0 0 0
6 Diazepam Lar Rektal 10 mg/ml Tube 0 0 0 0

ANTIINFEKSI
7 ACT ( arthesunat ) Tablet 0 0 0 0 0
8 Acyclovir tab 400 mg Tablet 0 0 0 0
9 Albendazol 400 mg Tablet 332 332 2 330 4
10 Albendazol susp 200 mg/5 ml Botol 0 0 0 0 0
11 Amoksilin Kap. 250 mg Kapsul 0 0 0 0 0
12 Amoksilin Kap.500 mg Tablet 0 0 0 0 0
13 Amoksilin syr kering 125 mg/ ml Botol 0 0 0 0 0
14 Amoksilin syr kering 250 mg/ ml Botol 0 0 0 0 0
15 Amoksisilin Drops 100 mg/ml Botol 0 0 0 0 0
16 Azitromisin 500 mg Kaplet 0 0 0 0 0
17 Benzatin Benzil P 2,4 Vial 0 0 0 0 0
18 Cefixim tab 100 mg Tablet 0 0 0 0 0
19 Ciprofloxacin 500 mg Tablet 200 200 108 92 216 300
20 Dietilkarbamazin Tablet 0 0 0 0 0
21 Doxyciclin 100 mg Tablet 0 0 0 0 0
22 Erytromicin 250 mg Tablet 0 0 0 0 0
23 Ethambutol 250 mg Tablet 0 0 0 0 0
24 Flukonazol kaps 50 mg Capsul 0 0 0 0 0
25 Gentamisin 40 mg / 2ml inj Ampul 0 0 0 0 0
26 Griseofulvin125 mg Tablet 0 0 0 0 0
27 Isoniazide 100 mg Tablet 0 0 0 0 0
28 Isoniazide 300 mg Tablet 0 0 0 0 0
29 Ketoconazole 200 mg Tablet 148 148 56 92 112 100
30 Klindamisin 150 mg Capsul 215 215 0 215 0
31 Klindamisin 300 mg Capsul 340 340 50 290 100
32 Kloramfenikol 250 mg capsul Capsul 0 0 0 0
33 Kloramfenikol 500 mg capsul Capsul 0 0 0 0 0
34 Kloramfenikol susp 125 mg / 5 ml Botol 29 29 0 29 0
35 Kombipak IMS Kotak 0 0 0 0 0
36 Kotrimoksazol Adult 480 mg Tablet 68 68 30 38 60
37 Kotrimoksazol Suspensi 240 mg/5 ml Botol 58 58 5 53 10
38 Metronidazol 250 mg Tablet 10 10 10 0 20
39 Metronidazol 500 mg Tablet 424 300 724 125 599 250
40 Natrium Tiroksin Tablet 0 0 0 0 0
41 Nistatin 100.000 IU/g tablet vagina Tablet 121 121 0 121 0
42 Nistatin susp 100.000 UI / ml Botol 8 8 1 7 2
43 Obat Anti TBC Anak FDC Paket 0 0 0 0 0
44 Obat Anti TBC Kat I FDC Paket 0 0 0 0 0
45 Obat Anti TBC Kat II FDC Paket 0 0 0 0 0
46 Obat Anti TBC Kombipak Paket 0 0 0 0 0
47 Pyrantel Pamoat 125 mg Tablet 0 0 0 0 0
48 Pyrazinamide 500 mg Tablet 0 0 0 0 0
49 Pyrimethamine 25 mg Tablet 0 0 0 0 0
50 Rifampicin 300 mg Tablet 0 0 0 0 0
51 Rifampicin 450 mg Tablet 0 0 0 0 0
52 Rifampicin 600 mg Tablet 0 0 0 0 0
53 Sefadroxil kapsul 500 mg Capsul 0 0 0 0 0
54 Sefadroxil syr kering 125 mg/ml Botol 0 0 0 0 0
55 Streptomicin Inj. Ampul 0 0 0 0 0
56 Tetracyclin 250 mg Tablet 0 0 0 0 0
57 Thiamphenicol caplet Tablet 0 0 0 0 0

SALURAN PERNAPASAN
58 Ambroxol Syrup 15 mg Botol 36 70 106 57 49 114 100
59 Ambroxol tab 30 mg Tablet 0 0 0 0
60 Aminopilina 200 mg Tablet 0 0 0 0 0
61 Gliseril Guayakolat 100 mg (GG) Tablet 0 0 0 0
62 Komb : Ipatropium Br 0.5 mg, salbutamol 2,5 Vial 0 0 0 0 0
63 N-asetil sistein (NAC) kaps 200 mg Kapsul 509 509 64 445 128
64 Obat batuk anak (OBP,Daganak) Botol 0 0 0 0 0
65 Obat Batuk Anak Syrup Botol 0 0 0 0 0
66 Obat batuk flu syrup (Alphara,Babycough) Botol 0 0 0 0
67 Obat Batuk Flu Tablet (Flunax) Tablet 0 0 0 0
68 Obat batuk hitam (OBH) Botol 0 0 0 0
69 Salbutamol 2 mg Tablet 100 30 130 30 100 60
70 Salbutamol 2.5 mg nebules Vial 0 0 0 0 0
71 Sanadryl DMP Syr Botol 0 0 0 0 0
72 Sanadryl Exp Syr Botol 0 0 0 0 0

ANALGETIK,ANTIPIRETIK,ANTIINFLAMASI,AINS
73 Antimigren Tablet 0 0 0 0 0
74 Asam Mefenamat 500 mg Tablet
75 Betahistine mysilat 6 mg Tablet 90 90 90 0 180
76 Etil Klorida Semprot 100 ml Botol 0 2
77 Ibupropen 200 mg Tablet 0 0 0 0 0
78 Ibuprofen 400 mg Tablet 0 0 0 0
79 Ibuprofen sirup 200 mg/ 5 ml Botol 28 28 9 19 18 20
80 Lidokain inj 2 % (infltr/p.v) Ampul 0 0 0 0
81 Na.Diklofenak 50 mg Tablet 0 0 0 0
82 Parasetamol tts 60 mg / 0.6 ml Botol 0 0 0 0
83 Parasetamol 500 mg Tablet 6026 1000 7026 2432 4594 4864 2000
84 Parasetamol syr 120 mg/5 ml 60 ml Botol 100 100 200 200 0
85 Piroksikam 10 mg Tablet 0 0 0 0 0
86 Proris supp suppositoria 0 0 0 0 0
87 Asam Asetl Salisilat 0 0 0 0 0
88 Meloxicam 0 0 0 0 0

SISTEM PENCERNAAN
89 Antasida DOEN Tablet 2750 2750 239 2511 478
90 Antasida DOEN susp Botol 50 40 90 79 11 158 100
91 Antihemoroid suppositoria Supp 23 23 13 10 26 30
92 Atapulgit tab 600 mg Tablet 300 250 550 250 300 500 300
93 Bisakodil sup 5 mg Supp 18 18 2 16 4
94 Bisakodil 5 mg Tablet 0 0 0 0
95 Dimenhidrinat tab 50 mg Tablet 0 0 0 0 0
96 Domperidon 10 mg Tablet 0 0 0 0 300
97 Domperidon sirup 5 mg/5 ml Botol 0 0 0 0 0
98 Garam Oralit 200 ml Sase 668 668 163 505 326
99 Hiosina Butilbromida 10 mg Tablet 50 50 50 0 100 100
100 Karbo Adsorben 250 mg Tablet 0 0 0 0 0
101 Metoklopramide sirup 5 mg/ml Botol 0 0 0 0 0
102 Natrium Bicarbonat 500 mg Tablet 0 0 0 0
103 Komb Kaolin 550 mg + pektin 20 mg Tablet 0 0 0 0 0
104 Omeprazol 20 mg Capsul 0 0 0 0
105 Omeprazol inj 40 mg / 10 ml Ampul 0 0 0 0 0
106 Ranitidin tab 150 mg Tablet 1323 1323 588 735 1176 1000
107 Zinc dispersibel Tablet 190 200 390 220 170 440 500

JANTUNG DAN PEMBULUH DARAH

108 Amlodipine 5 mg Tablet 1500 1500 940 560 1880 1000
109 Amlodipin 10 mg Tablet 750 750 515 235 1030 1000
110 Atenolol 50 mg Tablet 0 0 0 0 0
111 Captopril 12,5 mg Tablet 310 100 410 25 375 50
112 Captopril 25 mg Tablet 200 100 300 93 207 186
113 Digoksin 0,25 mg Tablet 0 0 0 0 0
114 Diltiazem 30 mg Tablet 0 0 0 0 0
115 Furosemid 40 mg Tablet 0 0 0 0
116 Hidrokortiazid HCT tab 25 mg Tablet 0 0 0 0 0
117 Isosorbid Dinitrat 5 mg tablet Tablet 0 0 0 0 0
118 Metyldopa tab 250 mg Tablet 0 0 0 0 0
119 Nifedipin tab 10 mg Tablet 0 0 0 0 0
120 Reserpin 0,25 mg Tablet 0 0 0 0 0
121 Spironolakton 25 mg Tablet 146 146 0 146 0

OBAT MATA
122 Klorampenicol S.M 1 % Tube 15 12 27 15 12 30
123 Koramfenikol TM 1 % Botol 0 0 0 0
124 Cendo Eye Fresh Tube 0 0 0 0
 OBAT KULIT
125 Acyclovir cream 5 % Tube 24 24 14 10 28 50
126 Anti Bacteri DOEN SK Tube 0 0 0 0
127 Antifungi SK Pot 14 14 3 11 6
128 Basitrasin Polimiksin SK Tube 0 10 10 4 6 8
129 Bedak Salisil serbuk 2 % Dus 0 10 10 10 0 30
130 Betametason Crem 0,1 % Tube 113 113 25 88 50
131 Gentamycin SK Tube 0 0 0 0 0
132 Hidrokortison Crem 2,5 % Tube 72 16 88 27 61 54
133 Hydrocortison 1 % Tube 0 0 0 0 0
134 Ichtyol Sk Pot 4 4 0 4 0
135 Ketokonazol krim 2% Tube 0 0 0 0
136 Kloramfenikol SK 2% Tube 48 15 63 27 36 54
137 Mikonazol krim 2% Tube 53 10 63 4 59 8
138 Neocental Gel Tube 0 0 0 0 0
139 Neomisin dan Basitrasin SK Tube 0 0 0 0 0
140 Perak Sulfadiazin krim 1% Tube 10 10 0 10 0
141 Permetrin Krim 5 % Tube 86 86 12 74 24
142 Salep 2-4 Pot 2 10 12 3 9 6

VITAMIN DAN MINERAL

143 Asam Askorbat (Vit C) tab 50 mg Tablet 500 200 700 255 445 510 1500
144 Asam Askorbat (Vit C) tab 250 mg Tablet 206 200 406 115 291 230
145 Asam Folat 1 mg Tablet 0 0 0 0 0
146 Kalsium laktat (kalk) tab 500 mg Tablet 995 995 625 370 1250 1000
147 Multivitamin dan Mineral Tablet 0 0 0 0
148 Mineral Mix Sase 0 0 0 0
149 Piridoksin HCL (B6) 10 mg tablet Tablet 0 0 0 0
150 Retinol (Vit. A) 100,000 IU Kap Lunak Capsul 350 350 350 0 700
151 Retinol (Vit. A) 200,000 IU Kap Lunak Capsul 6690 6690 3255 3435 6510
152 Sianokobalamin (Vitamin B12) tab 50 mcg Tablet 186 1000 1186 452 734 904 1500
153 Tablet Tambah Darah/FE Tablet 82795 82795 1005 81790 2010
154 Thiamin HCL (B1) 50 mg Tablet 2507 2507 176 2331 352
155 Vit. B. Complex Tablet 2253 600 2853 1086 1767 2172 1000
156 Vit. Syrup Anak 60 ml Botol 0 0 0 0

DARAH,AS URAT,KOLESTEROL
157 Alopurinol 100 mg Tablet 254 100 354 54 300 108
158 Fitomenadion /Vit K 10 mg Tablet 0 0 0 0
159 Fitomenadion /Vit K Inj 2 mg/ml Ampul 0 0 0 0 0
160 Gemfibrozil 300 mg Tablet 0 0 0 0 0
161 Metilergometrin Maleat 0,125 mg Tablet 24 24 0 24 0
162 Metilergometrin Maleat 0,200 mg 1ml inj Ampul 0 0 0 0 0
163 Simvastatin 10 mg Tablet 0 0 0 0

MULUT,THT
169 Borax Glicerin Botol 0 0 0 0
170 Fenol Glicerol Tetes Telinga 10 % Botol 1 1 1 0
171 Gentian Violet Lart 1 % 10 ml Botol 0 0 0 0
172 Kloramfenikol tetes Telinga 3 % 10 ml Botol 0 0 0 0
173 Oksimetazolin tts hidung 0,025% Botol 0 0 0 0

ALERGI,KORTIKOSTEROID
179 Deksametason 0,5 mg tablet Tablet 1000 200 1200 259 941 518
180 Deksametason inj 5 mg / ml (i.v / i.m) Ampul 0 0 0 0 0
181 Difenhidramin inj 10 mg / ml (i.v / i.m) Ampul 0 0 0 0 0
182 Klorfeniramin Maleat/CTM 4 mg Tablet 2035 1000 3035 618 2417 1236
183 Loratadine Tab 10 mg Tablet 14 14 14 0 28 200
184 Methilprednisolon 4 mg Tablet 0 0 0 0 0
185 Prednison 5 mg Tablet 0 0 0 0 0
186 Setirizin sir 5 mg / 5 ml Botol 0 0 0 0
187 Setrizin tablet Tablet 0 0 0 0

HORMON
188 Glibenklamid 5 mg tablet Tablet 145 145 145 0 290
189 Propiltiourasil tab 100 mg (PTU) Tablet 0 0 0 0 0
190 Metformin tab 500 mg Tablet 888 888 348 540 696
191 Glimepiride tablet Tablet 0 0 0 0 0

ANTISEPTIK,DISINFEKTAN
192 Alkohol Swab Buah 0 0 0 0
193 Chlorin 10 % Liter 2 2 2 0
194 Etakridin 0,1 % Rivanol 300 ml Botol 0 0 0 0
195 Etanol 70 % 100 ml Botol 3 5 8 8 0
196 Etanol 70 % 1000 ml Botol 3 3 3 0
197 Framisetin sulfat tulle 1% Lembar 1 1 1 0
198 Hand Rub Liter 0 0 0 0
199 Kaporit 60% Kg 0 0 0 0
200 Kaporit 60% Tablet 0 0 0 0
201 Kalium Permanganat (PK) 5 gram Botol 0 0 0 0 10
202 Lisol 50 % 1000 ml Botol 22 22 22 0
203 Polikresulen 10 ml Botol 0 0 0 0
204 Povidon Iodin lar 10 mg/ml Botol 30 ml 4 4 4 0
205 Povidon Iodin lar 10 mg/ml Botol 300 ml 0 0 0 0
206 Proclean 1 L Botol 0 0 0 0

INFUS,LAR STERIL
207 Aqua pro inj steril 20 ml Vial 10 10 10 0
208 Glukosa Lar infus 5 % steril 500 ml Labu 3 3 3 0
209 Natrium Klorida Larutan Infus 0,9 % Labu 2 2 2 0
210 Ringer Laktat Larutan Infus Steril Labu 3 3 3 0
211 Aqua Bidestilata Liter 0 0 0 0

NARKOTIKA, PSIKOTROPIKA & KESEHATAN JIWA

212 Amitriptilin tab sal 25 mg Tablet 0 0 0 0
213 Diazepam 2 mg tablet Tablet 13 13 13 0
214 Fenobarbital tab 30 mg Tablet 0 0 0 0
215 Haloperidol tab 1.5 mg Tablet 0 0 0 0
216 Karbamazepin tab 200 mg Tablet 0 0 0 0
217 Klorpromazin tab sal 25 mg Sallet 0 0 0 0
218 Kodein HCL 10 mg Tablet 0 0 0 0
219 Risperidon tab 2 mg Sallet 0 0 0 0

REAGENT HIV
220 Rapid Test HIV ( Oncoprobe ) Test 0 0 0 0
221 Rapid Test HIV ( Intec ) Test 0 0 0 0
222 Rapid Test HIV ( Biomeriux ) Test 0 0 0 0
223 SD HIV Test 0 0 0 0
224 Open CD 4 Test 0 0 0 0
225 Kontrol CD 4 kitt 0 0 0 0

REAGENT IMS 0 0 0 0
223 TPHA Sypillis (Hexagon) Test 0 0 0 0
224 TPHA Sypillis (SD) Test 0 0 0 0
225 RPR Antigen/ Trust Test 0 0 0 0
226 Pewarnaan gram Kit 0 0 0 0

REAGEN TB 0 0 0 0
227 Reagent ZN Kit 0 0 0 0
228 PPD / Test Mantoux Vial 0 0 0 0
229 Oli Imersi Botol 0 0 0 0

ALAT & BAHAN GIGI

230 Air Raksa Fls 0 0 0 0
231 Alvogil Fls 0 0 0 0
232 Amalgam Fls 0 0 0 0
233 Arkansas Stone Fls 0 0 0 0
234 Articulating paper (kertas warna penanda oklusLembar 0 0 0 0
235 Bahan tumpatan sementara (Temporary FletchePot 0 0 0 0
236 Boor jet Fressure Buah 0 0 0 0
237 Boor jet inverted Buah 0 0 0 0
238 Boor jet round Buah 0 0 0 0
239 Boor low fressure Buah 0 0 0 0
240 Boor low inverted Buah 0 0 0 0
241 Boor low round Buah 0 0 0 0
242 Boor Stone Buah 0 0 0 0
243 CaOH with Iodoform 1 syringe 2,2 g Botol 0 0 0 0
244 Celluloid Strip Lembar 0 0 0 0
245 Cement Zn Phospat Powder & Liquid Set 0 0 0 0
246 Devitalisasi Pasta (arsenik) Fls 0 0 0 0
247 Devitalisasi Pasta (Non arsen) 0 0 0 0
248 Disclossing Tablet 0 0 0 0
249 Eugenol Fls 0 0 0 0
250 Formokresol Btl 0 0 0 0
251 Glass Ionomer ART (Atraumatic Restorative TreaBuah 0 0 0 0
252 Glass Ionomer ART (Atraumatic Restorative TreaBuah 0 0 0 0
253 H2O2 Botol 0 0 0 0
254 Kalsium Hidroksida Pasta (CaOH) Tube 0 0 0 0
255 Klorfenol Kamfer Mentol (CHKM) Fls 0 0 0 0
256 Komb : Artikaine HCl 4% + Epinefrin 1 : 100.0 cartridge kaca 0 0 0 0
257 Komb : Deksametason asetat 0,1%, Thymol 5%,Fls 0 0 0 0
258 Komb : Lidokain HCl 2% + Epinefrin 1 : 80.000 Ampul 0 0 0 0
259 Komb : Mepivakaine HCl 2 % + Epinefrin 1:100cartridge kaca 0 0 0 0
260 Komposit Resin Fls 0 0 0 0
261 Matrix Band Roll 0 0 0 0
262 Panasray Buah 1 1 1 0
263 Pasta Gigi Buah 6 6 6 0
264 Pasta Pengisi Saluran Akar Fls 0 0 0 0
265 Pembersih noda gigi (TSR/OCO) Buah 0 0 0 0
266 Rockel Fls 0 0 0 0
267 Savlon Liter 0 0 0 0
268 Slaber Buah 0 0 0 0
269 Spongostan Buah 0 0 0 0
270 Tampon Segitiga Bks 0 0 0 0
271 Tissue gulung Buah 0 0 0 0
272 Vaseline Pot 15gr 0 0 0 0

ALKES HABIS PAKAI

273 Abbocat No. 18 Buah 0 0 0 0
274 Abbocat No. 20 Buah 0 0 0 0
275 Abbocat No. 22 Buah 0 0 0 0
276 Abbocat No. 24 Buah 0 0 0 0
277 Abbocat No. 26 Buah 0 0 0 0
278 Alat Suntik 1 ml Buah 100 100 100 0
279 Alat Suntik 3 ml Buah 600 600 600 0
280 Alat Suntik 5 ml Buah 0 0 0 0
281 Alat Suntik 10 ml Buah 0 0 0 0
282 Alat Suntik 20 ml Buah 0 0 0 0
283 Bisturi Buah 0 0 0 0
284 Blood Lancet Buah 0 0 0 0
285 Cat Gut Chromic/Benang Bedah No. 3.2 Buah 0 0 0 0
286 Cat Gut Plain/Benang Bedah No. 3.2 Buah 0 0 0 0
287 Endotrakeal No 3 Buah 0 0 0 0
288 Endotrakeal No 3.5 Buah 0 0 0 0
289 Endotrakeal No 4 Buah 0 0 0 0
290 Foley Kateter No 18 Buah 0 0 0 0
291 Foley Kateter No 20 Buah 0 0 0 0
292 Hecting Nald Buah 1 1 1 0
293 Infuset anak Buah 0 0 0 0
294 Infuset dewasa Buah 0 0 0 0
295 Iodina Test Botol 1 1 1 0
296 Jarum Cytojek Buah 100 100 100 0
297 Jarum vacutainer Buah 0 0 0 0
298 Kateter penghisap lendir No 8 Buah 0 0 0 0
299 Kateter penghisap lendir No 10 Buah 0 0 0 0
300 Kaca Mulut Buah 0 0 0 0
301 Kaca Penutup / Dek glass Kotak 100 0 0 0 0
302 Kantong Jenazah Buah 0 0 0 0
303 Kapas Pembalut Absorben 250 g Bks 3 3 3 0
304 Kassa Kompres 40 x 40 steril Bks 5 5 5 0
305 Kassa Pembalut 2 m x 80 cm Bks 24 24 24 0
306 Kassa pembalut Hidrofil 4 cm x 15 cm Roll 0 0 0 0
307 Kassa pembalut Hidrofil 4 cm x 3 cm Roll 0 0 0 0
308 Kertas Perkamen Bks 0 0 0 0
309 Kondom buah 0 0 0 0
310 Masker Lembar 0 0 0 0
311 Masker N.95 Buah 0 0 0 0
312 Masker Oksigen dewasa Buah 0 0 0 0
313 Masker Oksigen Anak Buah 1 1 1 0
314 Oksigen can Buah 0 0 0 0
315 Plastic Bandages Kotak 0 0 0 0
316 Plester Roll 4 4 4 0
317 Plester kertas Roll 2 2 2 0
318 Peneng Bayi Buah 0 0 0 0
319 Perban elastis Roll 0 0 0 0
320 Pot Sputum Buah 0 0 0 0
321 RTD Malaria Box 0 0 0 0
322 Rotator Unit 0 0 0 0
323 Slide Box 0 0 0 0
324 Sarung tangan Steril Psng 100 100 100 0
325 Sarung Tangan Non Steril Psng 100 100 100 0
326 Sarung Tangan Panjang ginekolog Psng 0 0 0 0
327 Sarung Tangan Karet Tebal Buah 0 0 0 0
328 Selang oksigen Anak Buah 0 0 0 0
329 Selang oksigen dewasa Buah 0 0 0 0
330 Sendok Obat Buah 0 0 0 0
331 Silk Buah 1 1 1 0
332 Spalk 30 cm pasang 0 0 0 0
333 Three way stop cock Buah 0 0 0 0
334 Tip pipet kuning Pak 0 0 0 0
335 Tongue Spatel Kayu Buah 0 0 0 0
336 Urine Bag Buah 0 0 0 0
337 Ultrasound gel 250 cc Botol 0 0 0 0
338 Umbilical Cord Clam Biru Buah 0 0 0 0
339 Vacutainer/Tabung spesimen darah + tutup Buah 0 0 0 0
340 Wing Needle no.27 G Buah 0 0 0 0
341 ADS 0,5 ml 0 0 0 0

CETAKAN DAN EMBALAGE

342 Buku Resep Buku 0 0 0 0
343 Berita Acara Serah Terima Barang Buku 0 0 0 0
344 Etiket Obat putih Lembar 0 0 0 0
345 Buku Harian Buku 0 0 0 0
346 Kartu stok Barang ( Gudang) Lembar 0 0 0 0
347 Kartu Persediaan Barang (Gudang) Lembar 0 0 0 0
348 LPLPO Buku 0 0 0 0

EMBALAGE
349 K.Obat Plastik 8 x 13 x 05 Kg 0 0 0 0
350 Kantong Obat Plastik 20 x 15 x 0.5 Kg 0 0 0 0
351 Kantong Obat Plastik 20 x 30 x 0.5 Kg 0 0 0 0
352 Kantong kresek Putih Pak 0 0 0 0

Obat-obatan Program HIV AIDS

353 Abacavir 300 mg (ABC) Botol 60 tablet 0 0 0 0
354 Efavirenz 600 mg (EFV) Botol 30 tablet 0 0 0 0
355 Lamivudine 150 mg (3TC) Botol 60 tablet 0 0 0 0
356 Neviraphine 200 mg (NVP) Botol 60 tablet 0 0 0 0
357 Tenovir 300 mg (TDF) + Lamivudine 300 mg (3TBotol 30 tablet 0 0 0 0
358 Tenovofir 300 mg (TDF) Botol 30 tablet 0 0 0 0
359 Tenovir 300 mg (TDF) + Emtricitabine 200 mg ( Botol 30 tablet 0 0 0 0
360 Zidovudine 60 mg (ZDV)+ Lamivudine 30 mg (3Botol 60 tablet 0 0 0 0
361 Zidovudine 300 mg (ZDV)+ Lamivudine 150 mgBotol 60 tablet 0 0 0 0
362 Lovinapir 200 mg + Ronavir 50 mg Botol 120 tablet 0 0 0 0
363 DBS Collection Kit Test 0 0 0 0
364 Zidovudine 50 mg/ ml Botol 0 0 0 0

Obat - Obatan Program Hepatitis

365 Ribavirin 200 mg (Rebetol) Kapsul 0 0 0 0
366 Simeprevir 150 mg (Olysio) Kapsul 0 0 0 0
367 Sofosbufir 400 mg (Myhep) Kapsul 0 0 0 0
368 HCV Viral Load Test 0 0 0 0
369 RDD Anti HCV Test 0 0 0 0
370 Reagent Rapid Test HBSAG Test 0 0 0 0
371 Hepatitis B Immunoglobulin Syringe 0 0 0 0
372 Daclastavir 60 mg Botol 0 0 0 0
373 Daclastavir 30 mg Botol 0 0 0 0
374 Dehidroartemisin + Piperaquine (DHP) Tablet 0 0 0 0
375 RDT Malaria Test 0 0 0 0
376 Primakuin 15 mg Tablet 0 0 0 0
377 Artesunat inj. 60 mg Ampul 0 0 0 0

Logistik DBD
378 Insektisida Liter 0 0 0 0
379 BTI Botol 30 ml 0 0 0 0
380 Jumantik Paket 0 0 0 0
381 NS1 Tes 0 0 0 0
382 RDT IGM Tes 0 0 0 0
383 RDT Combo Tes 0 0 0 0
384 APD Buah 0 0 0 0
385 Mesin Foging Swan Fog SF 88 Unit 0 0 0 0
386 Larvasida Abate Kg 0 0 0 0
 KUNJUNGAN JUMLAH R/ GENERIK R/ NON GENERIK JUMLAH
PASIEN KUNJUNGA
UMUM BPJS UMUM BPJS UMUM BPJS PENULISAN R/
N
BALITA 193 35 228 339 51 0 0 390
ANAK 96 46 142 234 113 0 0 347
DEWASA 540 407 947 1315 1028 0 0 2343
JUMLAH 829 475 1317 1888 1192 0 0 3080

Mengetahui, Yang menyerahkan, Yang menerima Yang melaporkan,

Kepala Seksi Farbekes Pemegang Barang Khusus Obat Kepala Puskesmas

-------------------------------- ----------------------------------
NIP. NIP.
 LAPORAN PEMAKAIAN DAN PERMINTAAN OBAT BULAN FEBRUARI
PUSKESMAS :
KECAMATAN :
WILAYAH :
KOTA : BANDUNG
Bulan : Januari - Februari
Stok Pemeriaan
No Jenis Barang Satuan Stok Awal Penerimaan Persediaan Pemakaian Stok Akhir Permintaan
Optimum
APBD APBD I APBN
1 2 3 4 5 6 7 8 9 10 11 12 13
LIFE SAVING
1 Atropin Inj. Im/Iv/s.k.0,25 mg/ml-1ml Ampul 0 0 0 0
2 Epinefrin HCL Inj Ampul 0 0 0 0
3 Kalsium Glukonat inj 100 mg / ml Ampul 0 0 0 0
4 Mg Sulfat Inj 40 % - IV/10 vial Ampul 0 0 0 0
5 Oksitosin Inj 10 lU/ml 1 ml Ampul 0 0 0 0
6 Diazepam Lar Rektal 10 mg/ml Tube 0 0 0 0

ANTIINFEKSI
7 ACT ( arthesunat ) Tablet 0 0 0 0 0 0
8 Acyclovir tab 400 mg Tablet 0 0 0 0 0 0
9 Albendazol 400 mg Tablet 334 334 2 332 4 0
10 Albendazol susp 200 mg/5 ml Botol 0 0 0 0 0 0
11 Amoksilin Kap. 250 mg Kapsul 0 0 0 0 0 0
12 Amoksilin Kap.500 mg Tablet 400 1100 1500 1500 0 3000 3000
13 Amoksilin syr kering 125 mg/ ml Botol 0 0 0 0 0 0
14 Amoksilin syr kering 250 mg/ ml Botol 0 0 0 0 0 0
15 Amoksisilin Drops 100 mg/ml Botol 0 0 0 0 0
16 Azitromisin 500 mg Kaplet 0 0 0 0 0
17 Benzatin Benzil P 2,4 Vial 0 0 0 0 0
18 Cefixim tab 100 mg Tablet 10 10 10 0 0
19 Ciprofloxacin 500 mg Tablet 372 372 172 200 344 200
20 Dietilkarbamazin Tablet 0 0 0 0 0
21 Doxyciclin 100 mg Tablet 0 0 0 0 0
22 Erytromicin 250 mg Tablet 0 0 0 0 0
23 Ethambutol 250 mg Tablet 0 0 0 0 0
24 Flukonazol kaps 50 mg Capsul 0 0 0 0 0
25 Gentamisin 40 mg / 2ml inj Ampul 0 0 0 0 0
26 Griseofulvin125 mg Tablet 0 0 0 0 0
27 Isoniazide 100 mg Tablet 0 0 0 0 0
28 Isoniazide 300 mg Tablet 0 0 0 0 0
29 Ketoconazole 200 mg Tablet 188 188 40 148 80 50
30 Klindamisin 150 mg Capsul 225 225 60 165 120 0
31 Klindamisin 300 mg Capsul 134 150 284 40 244 80 0
32 Kloramfenikol 250 mg capsul Capsul 0 0 0 0 0 0
33 Kloramfenikol 500 mg capsul Capsul 0 0 0 0 0 0
34 Kloramfenikol susp 125 mg / 5 ml Botol 30 30 1 29 2 0
35 Kombipak IMS Kotak 0 0 0 0 0 0
36 Kotrimoksazol Adult 480 mg Tablet 128 128 60 68 120 100
37 Kotrimoksazol Suspensi 240 mg/5 ml Botol 10 50 60 2 58 4 0
38 Metronidazol 250 mg Tablet 25 25 15 10 30 100
39 Metronidazol 500 mg Tablet 770 770 346 424 692 300
40 Natrium Tiroksin Tablet 0 0 0 0 0 0
41 Nistatin 100.000 IU/g tablet vagina Tablet 127 127 6 121 12 0
42 Nistatin susp 100.000 UI / ml Botol 5 5 10 2 8 4 0
43 Obat Anti TBC Anak FDC Paket 0 0 0 0 0
44 Obat Anti TBC Kat I FDC Paket 0 0 0 0 0
45 Obat Anti TBC Kat II FDC Paket 0 0 0 0 0
46 Obat Anti TBC Kombipak Paket 0 0 0 0 0
47 Pyrantel Pamoat 125 mg Tablet 0 0 0 0 0
48 Pyrazinamide 500 mg Tablet 0 0 0 0 0
49 Pyrimethamine 25 mg Tablet 0 0 0 0 0
50 Rifampicin 300 mg Tablet 0 0 0 0 0
51 Rifampicin 450 mg Tablet 0 0 0 0 0
52 Rifampicin 600 mg Tablet 0 0 0 0 0
53 Sefadroxil kapsul 500 mg Capsul 0 0 0 0 0
54 Sefadroxil syr kering 125 mg/ml Botol 0 0 0 0 0
55 Streptomicin Inj. Ampul 0 0 0 0 0
56 Tetracyclin 250 mg Tablet 0 0 0 0 0
57 Thiamphenicol caplet Tablet 0 0 0 0 0

SALURAN PERNAPASAN
58 Ambroxol Syrup 15 mg Botol 0 50 50 14 36 28 100
59 Ambroxol tab 30 mg Tablet 0 0 0 0 0 0
60 Aminopilina 200 mg Tablet 0 0 0 0 0
61 Gliseril Guayakolat 100 mg (GG) Tablet 0 0 0 0 0 0
62 Komb : Ipatropium Br 0.5 mg, salbutamol 2,5 Vial 0 0 0 0 0
63 N-asetil sistein (NAC) kaps 200 mg Kapsul 329 180 509 509 0 0
64 Obat batuk anak (OBP,Daganak) Botol 0 0 0 0 0
65 Obat Batuk Anak Syrup Botol 0 0 0 0 0
66 Obat batuk flu syrup (Alphara,Babycough) Botol 0 0 0 0 0 0
67 Obat Batuk Flu Tablet (Flunax) Tablet 0 0 0 0 0
68 Obat batuk hitam (OBH) Botol 0 0 0 0 0
69 Salbutamol 2 mg Tablet 15 100 115 15 100 30 0
70 Salbutamol 2.5 mg nebules Vial 0 0 0 0 0
71 Sanadryl DMP Syr Botol 0 0 0 0 0
72 Sanadryl Exp Syr Botol 0 0 0 0 0

ANALGETIK,ANTIPIRETIK,ANTIINFLAMASI,AINS
73 Antimigren Tablet 0 0 0 0 0
74 Asam Mefenamat 500 mg Tablet
75 Betahistine mysilat 6 mg Tablet 0 90 90 0 90 0 0
76 Etil Klorida Semprot 100 ml Botol
77 Ibupropen 200 mg Tablet 0 0 0 0 0
78 Ibuprofen 400 mg Tablet 0 0 0 0 0
79 Ibuprofen sirup 200 mg/ 5 ml Botol 0 30 30 2 28 4 0
80 Lidokain inj 2 % (infltr/p.v) Ampul 0 0 0 0 0
81 Na.Diklofenak 50 mg Tablet 360 360 360 0 720 1000
82 Parasetamol tts 60 mg / 0.6 ml Botol 0 0 0 0 0
83 Parasetamol 500 mg Tablet 4514 4000 8514 2488 6026 4976 1000
84 Parasetamol syr 120 mg/5 ml 60 ml Botol 126 100 226 126 100 252 150
85 Piroksikam 10 mg Tablet 0 0 0 0 0
86 Proris supp suppositoria 0 0 0 0 0
87 Asam Asetl Salisilat 0 0 0 0
88 Meloxicam 0 0 0 0

SISTEM PENCERNAAN
89 Antasida DOEN Tablet 1361 1700 3061 311 2750 622 0
90 Antasida DOEN susp Botol 0 50 50 50 0 100
91 Antihemoroid suppositoria Supp 40 40 17 23 34 20
92 Atapulgit tab 600 mg Tablet 300 300 0 300 0 0
93 Bisakodil sup 5 mg Supp 14 6 20 2 18 4 6
94 Bisakodil 5 mg Tablet 0 0 0 0 0
95 Dimenhidrinat tab 50 mg Tablet 0 0 0 0 0
96 Domperidon 10 mg Tablet 24 24 24 0 48 0
97 Domperidon sirup 5 mg/5 ml Botol 0 0 0 0 0
98 Garam Oralit 200 ml Sase 305 500 805 137 668 274 200
99 Hiosina Butilbromida 10 mg Tablet 0 100 100 50 50 100 50
100 Karbo Adsorben 250 mg Tablet 0 0 0 0 0
101 Metoklopramide sirup 5 mg/ml Botol 0 0 0 0 0
102 Natrium Bicarbonat 500 mg Tablet 0 0 0 0 0
103 Komb Kaolin 550 mg + pektin 20 mg Tablet 0 0 0 0 0
104 Omeprazol 20 mg Capsul 0 0 0 0 0
105 Omeprazol inj 40 mg / 10 ml Ampul 0 0 0 0 0
106 Ranitidin tab 150 mg Tablet 1500 200 1700 377 1323 754 0
107 Zinc dispersibel Tablet 240 100 340 150 190 300 300

JANTUNG DAN PEMBULUH DARAH

108 Amlodipine 5 mg Tablet 0 1500 1500 1500 0 1000
109 Amlodipin 10 mg Tablet 905 905 155 750 310 1000
110 Atenolol 50 mg Tablet 0 0 0 0 0
111 Captopril 12,5 mg Tablet 310 310 310 0 0
112 Captopril 25 mg Tablet 0 200 200 200 0 0
113 Digoksin 0,25 mg Tablet 0 0 0 0 0
114 Diltiazem 30 mg Tablet 0 0 0 0 0
115 Furosemid 40 mg Tablet 0 0 0 0 0
116 Hidrokortiazid HCT tab 25 mg Tablet 0 0 0 0 0
117 Isosorbid Dinitrat 5 mg tablet Tablet 0 0 0 0 0
118 Metyldopa tab 250 mg Tablet 0 0 0 0 0
119 Nifedipin tab 10 mg Tablet 0 0 0 0 0
120 Reserpin 0,25 mg Tablet 0 0 0 0 0
121 Spironolakton 25 mg Tablet 146 146 0 146 0 0

OBAT MATA
122 Klorampenicol S.M 1 % Tube 34 34 19 15 38 24
123 Koramfenikol TM 1 % Botol 0 0 0 0 0
124 Cendo Eye Fresh Tube 0 0 0 0 0
 OBAT KULIT
125 Acyclovir cream 5 % Tube 0 25 25 1 24 2 24
126 Anti Bacteri DOEN SK Tube 23 23 8 15 16 12
127 Antifungi SK Pot 3 12 15 1 14 2 0
128 Basitrasin Polimiksin SK Tube 0 0 0 0 0
129 Bedak Salisil serbuk 2 % Dus 15 15 15 0 30 50
130 Betametason Crem 0,1 % Tube 83 50 133 20 113 40 0
131 Gentamycin SK Tube 0 0 0 0 0
132 Hidrokortison Crem 2,5 % Tube 98 98 26 72 52 0
133 Hydrocortison 1 % Tube 0 0 0 0 0
134 Ichtyol Sk Pot 5 5 1 4 2 0
135 Ketokonazol krim 2% Tube 0 0 0 0 0
136 Kloramfenikol SK 2% Tube 78 78 30 48 60 24
137 Mikonazol krim 2% Tube 62 62 9 53 18 24
138 Neocental Gel Tube 0 0 0 0 0
139 Neomisin dan Basitrasin SK Tube 0 0 0 0 0
140 Perak Sulfadiazin krim 1% Tube 0 10 10 10 0 0
141 Permetrin Krim 5 % Tube 93 93 7 86 14 0
142 Salep 2-4 Pot 14 14 12 2 24 12

VITAMIN DAN MINERAL

143 Asam Askorbat (Vit C) tab 50 mg Tablet 0 500 500 0 500 0 500
144 Asam Askorbat (Vit C) tab 250 mg Tablet 567 567 361 206 722 500
145 Asam Folat 1 mg Tablet 0 0 0 0 0
146 Kalsium laktat (kalk) tab 500 mg Tablet 248 1300 1548 553 995 1106 300
147 Multivitamin dan Mineral Tablet 0 0 0 0 0
148 Mineral Mix Sase 0 0 0 0 0
149 Piridoksin HCL (B6) 10 mg tablet Tablet 0 0 0 0 0
150 Retinol (Vit. A) 100,000 IU Kap Lunak Capsul 0 350 350 0 350 0 0
151 Retinol (Vit. A) 200,000 IU Kap Lunak Capsul 3240 3450 6690 0 6690 0 0
152 Sianokobalamin (Vitamin B12) tab 50 mcg Tablet 792 500 1292 1106 186 2212 2000
153 Tablet Tambah Darah/FE Tablet 83910 83910 1115 82795 2230 0
154 Thiamin HCL (B1) 50 mg Tablet 1737 1000 2737 230 2507 460 0
155 Vit. B. Complex Tablet 983 2000 2983 730 2253 1460 500
156 Vit. Syrup Anak 60 ml Botol 0 0 0 0 0

DARAH,AS URAT,KOLESTEROL
157 Alopurinol 100 mg Tablet 340 340 86 254 172 0
158 Fitomenadion /Vit K 10 mg Tablet 0 0 0 0 0
159 Fitomenadion /Vit K Inj 2 mg/ml Ampul 0 0 0 0 0
160 Gemfibrozil 300 mg Tablet 0 0 0 0 0
161 Metilergometrin Maleat 0,125 mg Tablet 24 24 24 0 0
162 Metilergometrin Maleat 0,200 mg 1ml inj Ampul 0 0 0 0 0
163 Simvastatin 10 mg Tablet 0 0 0 0 0

MULUT,THT
169 Borax Glicerin Botol 0 0 0 0 0
170 Fenol Glicerol Tetes Telinga 10 % Botol 6 6 5 1 10 12
171 Gentian Violet Lart 1 % 10 ml Botol 0 0 0 0 0
172 Kloramfenikol tetes Telinga 3 % 10 ml Botol 0 0 0 0 0
173 Oksimetazolin tts hidung 0,025% Botol 0 0 0 0 0

ALERGI,KORTIKOSTEROID
179 Deksametason 0,5 mg tablet Tablet 131 1000 1131 131 1000 262 300
180 Deksametason inj 5 mg / ml (i.v / i.m) Ampul 0 0 0 0 0
181 Difenhidramin inj 10 mg / ml (i.v / i.m) Ampul 0 0 0 0 0
182 Klorfeniramin Maleat/CTM 4 mg Tablet 516 2400 2916 881 2035 1762 300
183 Loratadine Tab 10 mg Tablet 0 150 150 136 14 272 300
184 Methilprednisolon 4 mg Tablet 0 0 0 0 0
185 Prednison 5 mg Tablet 0 0 0 0 0
186 Setirizin sir 5 mg / 5 ml Botol 0 0 0 0 0
187 Setrizin tablet Tablet 0 0 0 0 0

HORMON
188 Glibenklamid 5 mg tablet Tablet 130 100 230 85 145 170 100
189 Propiltiourasil tab 100 mg (PTU) Tablet 0 0 0 0 0
190 Metformin tab 500 mg Tablet 543 500 1043 155 888 310 0
191 Glimepiride tablet Tablet 0 0 0 0 0

ANTISEPTIK,DISINFEKTAN
192 Alkohol Swab Buah 0 0 0 0 0
193 Chlorin 10 % Liter 2 2 2 0 0
194 Etakridin 0,1 % Rivanol 300 ml Botol 0 0 0 0 0
195 Etanol 70 % 100 ml Botol 5 5 2 3 4 5
196 Etanol 70 % 1000 ml Botol 3 3 3 0 0
197 Framisetin sulfat tulle 1% Lembar 1 1 1 0 0
198 Hand Rub Liter 0 0 0 0 0
199 Kaporit 60% Kg 0 0 0 0 0
200 Kaporit 60% Tablet 0 0 0 0 0
201 Kalium Permanganat (PK) 5 gram Botol 0 0 0 0 0
202 Lisol 50 % 1000 ml Botol 22 22 22 0 0
203 Polikresulen 10 ml Botol 0 0 0 0 0
204 Povidon Iodin lar 10 mg/ml Botol 30 ml 4 4 4 0 0
205 Povidon Iodin lar 10 mg/ml Botol 300 ml 0 0 0 0 0
206 Proclean 1 L Botol 0 0 0 0 0

INFUS,LAR STERIL
207 Aqua pro inj steril 20 ml Vial 0 10 10 10 0 0
208 Glukosa Lar infus 5 % steril 500 ml Labu 3 3 3 0 0
209 Natrium Klorida Larutan Infus 0,9 % Labu 2 2 2 0 0
210 Ringer Laktat Larutan Infus Steril Labu 3 3 3 0 2
211 Aqua Bidestilata Liter 0 0 0 0 0

NARKOTIKA, PSIKOTROPIKA & KESEHATAN JIWA

212 Amitriptilin tab sal 25 mg Tablet 0 0 0 0 0
213 Diazepam 2 mg tablet Tablet 13 13 13 0 0
214 Fenobarbital tab 30 mg Tablet 0 0 0 0 0
215 Haloperidol tab 1.5 mg Tablet 0 0 0 0 0
216 Karbamazepin tab 200 mg Tablet 0 0 0 0 0
217 Klorpromazin tab sal 25 mg Sallet 0 0 0 0 0
218 Kodein HCL 10 mg Tablet 0 0 0 0 0
219 Risperidon tab 2 mg Sallet 0 0 0 0 0

REAGENT HIV
220 Rapid Test HIV ( Oncoprobe ) Test 0 0 0 0 0
221 Rapid Test HIV ( Intec ) Test 0 0 0 0 0
222 Rapid Test HIV ( Biomeriux ) Test 0 0 0 0 0
223 SD HIV Test 0 0 0 0 0
224 Open CD 4 Test 0 0 0 0 0
225 Kontrol CD 4 kitt 0 0 0 0 0

REAGENT IMS 0 0 0 0
223 TPHA Sypillis (Hexagon) Test 0 0 0 0 0
224 TPHA Sypillis (SD) Test 0 0 0 0 0
225 RPR Antigen/ Trust Test 0 0 0 0 0
226 Pewarnaan gram Kit 0 0 0 0 0

REAGEN TB 0 0 0 0
227 Reagent ZN Kit 0 0 0 0 0
228 PPD / Test Mantoux Vial 0 0 0 0 0
229 Oli Imersi Botol 0 0 0 0 0

ALAT & BAHAN GIGI

230 Air Raksa Fls 0 0 0 0 0
231 Alvogil Fls 0 0 0 0 0
232 Amalgam Fls 0 0 0 0 0
233 Arkansas Stone Fls 0 0 0 0 0
234 Articulating paper (kertas warna penanda oklusLembar 0 0 0 0 0
235 Bahan tumpatan sementara (Temporary FletchePot 0 0 0 0 0
236 Boor jet Fressure Buah 0 0 0 0 0
237 Boor jet inverted Buah 0 0 0 0 0
238 Boor jet round Buah 0 0 0 0 0
239 Boor low fressure Buah 0 0 0 0 0
240 Boor low inverted Buah 0 0 0 0 0
241 Boor low round Buah 0 0 0 0 0
242 Boor Stone Buah 0 0 0 0 0
243 CaOH with Iodoform 1 syringe 2,2 g Botol 0 0 0 0 0
244 Celluloid Strip Lembar 0 0 0 0 0
245 Cement Zn Phospat Powder & Liquid Set 0 0 0 0 0
246 Devitalisasi Pasta (arsenik) Fls 0 0 0 0 0
247 Devitalisasi Pasta (Non arsen) 0 0 0 0 0
248 Disclossing Tablet 0 0 0 0 0
249 Eugenol Fls 0 0 0 0 0
250 Formokresol Btl 0 0 0 0 0
251 Glass Ionomer ART (Atraumatic Restorative TreaBuah 0 0 0 0 0
252 Glass Ionomer ART (Atraumatic Restorative TreaBuah 0 0 0 0 0
253 H2O2 Botol 0 0 0 0 0
254 Kalsium Hidroksida Pasta (CaOH) Tube 0 0 0 0 0
255 Klorfenol Kamfer Mentol (CHKM) Fls 0 0 0 0 0
256 Komb : Artikaine HCl 4% + Epinefrin 1 : 100.0 cartridge kaca 0 0 0 0 0
257 Komb : Deksametason asetat 0,1%, Thymol 5%,Fls 0 0 0 0 0
258 Komb : Lidokain HCl 2% + Epinefrin 1 : 80.000 Ampul 0 0 0 0 0
259 Komb : Mepivakaine HCl 2 % + Epinefrin 1:100cartridge kaca 0 0 0 0 0
260 Komposit Resin Fls 0 0 0 0 0
261 Matrix Band Roll 0 0 0 0 0
262 Panasray Buah 1 1 1 0 0
263 Pasta Gigi Buah 6 6 6 0 0
264 Pasta Pengisi Saluran Akar Fls 0 0 0 0 0
265 Pembersih noda gigi (TSR/OCO) Buah 0 0 0 0 0
266 Rockel Fls 0 0 0 0 0
267 Savlon Liter 0 0 0 0 0
268 Slaber Buah 0 0 0 0 0
269 Spongostan Buah 0 0 0 0 0
270 Tampon Segitiga Bks 0 0 0 0 0
271 Tissue gulung Buah 0 0 0 0 0
272 Vaseline Pot 15gr 0 0 0 0 0

ALKES HABIS PAKAI

273 Abbocat No. 18 Buah 0 0 0 0 0
274 Abbocat No. 20 Buah 0 0 0 0 0
275 Abbocat No. 22 Buah 0 0 0 0 0
276 Abbocat No. 24 Buah 0 0 0 0 0
277 Abbocat No. 26 Buah 0 0 0 0 0
278 Alat Suntik 1 ml Buah 100 100 100 0 0
279 Alat Suntik 3 ml Buah 600 600 600 0 0
280 Alat Suntik 5 ml Buah 0 0 0 0 200
281 Alat Suntik 10 ml Buah 0 0 0 0 0
282 Alat Suntik 20 ml Buah 0 0 0 0 0
283 Bisturi Buah 0 0 0 0 0
284 Blood Lancet Buah 0 0 0 0 0
285 Cat Gut Chromic/Benang Bedah No. 3.2 Buah 0 0 0 0 0
286 Cat Gut Plain/Benang Bedah No. 3.2 Buah 0 0 0 0 0
287 Endotrakeal No 3 Buah 0 0 0 0 0
288 Endotrakeal No 3.5 Buah 0 0 0 0 0
289 Endotrakeal No 4 Buah 0 0 0 0 0
290 Foley Kateter No 18 Buah 0 0 0 0 0
291 Foley Kateter No 20 Buah 0 0 0 0 0
292 Hecting Nald Buah 1 1 1 0 0
293 Infuset anak Buah 0 0 0 0 0
294 Infuset dewasa Buah 0 0 0 0 0
295 Iodina Test Botol 1 1 1 0 0
296 Jarum Cytojek Buah 100 100 100 0 0
297 Jarum vacutainer Buah 0 0 0 0 0
298 Kateter penghisap lendir No 8 Buah 0 0 0 0 0
299 Kateter penghisap lendir No 10 Buah 0 0 0 0 0
300 Kaca Mulut Buah 0 0 0 0 0
301 Kaca Penutup / Dek glass Kotak 100 0 0 0 0 0
302 Kantong Jenazah Buah 0 0 0 0 0
303 Kapas Pembalut Absorben 250 g Bks 3 3 3 0 0
304 Kassa Kompres 40 x 40 steril Bks 5 5 5 0 0
305 Kassa Pembalut 2 m x 80 cm Bks 16 15 31 7 24 14 0
306 Kassa pembalut Hidrofil 4 cm x 15 cm Roll 0 0 0 0 0
307 Kassa pembalut Hidrofil 4 cm x 3 cm Roll 0 0 0 0 0
308 Kertas Perkamen Bks 0 0 0 0 0
309 Kondom buah 0 0 0 0 0
310 Masker Lembar 0 0 0 0 0
311 Masker N.95 Buah 0 0 0 0 0
312 Masker Oksigen dewasa Buah 0 0 0 0 0
313 Masker Oksigen Anak Buah 1 1 1 0 0
314 Oksigen can Buah 0 0 0 0 0
315 Plastic Bandages Kotak 0 0 0 0 0
316 Plester Roll 4 4 4 0 0
317 Plester kertas Roll 2 2 2 0 0
318 Peneng Bayi Buah 0 0 0 0 0
319 Perban elastis Roll 0 0 0 0 0
320 Pot Sputum Buah 0 0 0 0 0
321 RTD Malaria Box 0 0 0 0 0
322 Rotator Unit 0 0 0 0 0
323 Slide Box 0 0 0 0 0
324 Sarung tangan Steril Psng 100 100 100 0 0
325 Sarung Tangan Non Steril Psng 0 100 100 100 0 0
326 Sarung Tangan Panjang ginekolog Psng 0 0 0 0 0
327 Sarung Tangan Karet Tebal Buah 0 0 0 0 0
328 Selang oksigen Anak Buah 0 0 0 0 0
329 Selang oksigen dewasa Buah 0 0 0 0 0
330 Sendok Obat Buah 0 0 0 0 0
331 Silk Buah 1 1 1 0 0
332 Spalk 30 cm pasang 0 0 0 0 0
333 Three way stop cock Buah 0 0 0 0 0
334 Tip pipet kuning Pak 0 0 0 0 0
335 Tongue Spatel Kayu Buah 0 0 0 0 0
336 Urine Bag Buah 0 0 0 0 0
337 Ultrasound gel 250 cc Botol 0 0 0 0 0
338 Umbilical Cord Clam Biru Buah 0 0 0 0 0
339 Vacutainer/Tabung spesimen darah + tutup Buah 0 0 0 0 0
340 Wing Needle no.27 G Buah 0 0 0 0 0
341 ADS 0,5 ml 0 0 0 0 0

CETAKAN DAN EMBALAGE

342 Buku Resep Buku 0 0 0 0
343 Berita Acara Serah Terima Barang Buku 0 0 0 0
344 Etiket Obat putih Lembar 0 0 0 0
345 Buku Harian Buku 0 0 0 0
346 Kartu stok Barang ( Gudang) Lembar 0 0 0 0
347 Kartu Persediaan Barang (Gudang) Lembar 0 0 0 0
348 LPLPO Buku 0 0 0 0

EMBALAGE
349 K.Obat Plastik 8 x 13 x 05 Kg 0 0 0 0
350 Kantong Obat Plastik 20 x 15 x 0.5 Kg 0 0 0 0
351 Kantong Obat Plastik 20 x 30 x 0.5 Kg 0 0 0 0
352 Kantong kresek Putih Pak 0 0 0 0

Obat-obatan Program HIV AIDS

353 Abacavir 300 mg (ABC) Botol 60 tablet 0 0 0 0
354 Efavirenz 600 mg (EFV) Botol 30 tablet 0 0 0 0
355 Lamivudine 150 mg (3TC) Botol 60 tablet 0 0 0 0
356 Neviraphine 200 mg (NVP) Botol 60 tablet 0 0 0 0
357 Tenovir 300 mg (TDF) + Lamivudine 300 mg (3TBotol 30 tablet 0 0 0 0
358 Tenovofir 300 mg (TDF) Botol 30 tablet 0 0 0 0
359 Tenovir 300 mg (TDF) + Emtricitabine 200 mg ( Botol 30 tablet 0 0 0 0
360 Zidovudine 60 mg (ZDV)+ Lamivudine 30 mg (3Botol 60 tablet 0 0 0 0
361 Zidovudine 300 mg (ZDV)+ Lamivudine 150 mgBotol 60 tablet 0 0 0 0
362 Lovinapir 200 mg + Ronavir 50 mg Botol 120 tablet 0 0 0 0
363 DBS Collection Kit Test 0 0 0 0
364 Zidovudine 50 mg/ ml Botol 0 0 0 0

Obat - Obatan Program Hepatitis

365 Ribavirin 200 mg (Rebetol) Kapsul 0 0 0 0
366 Simeprevir 150 mg (Olysio) Kapsul 0 0 0 0
367 Sofosbufir 400 mg (Myhep) Kapsul 0 0 0 0
368 HCV Viral Load Test 0 0 0 0
369 RDD Anti HCV Test 0 0 0 0
370 Reagent Rapid Test HBSAG Test 0 0 0 0
371 Hepatitis B Immunoglobulin Syringe 0 0 0 0
372 Daclastavir 60 mg Botol 0 0 0 0
373 Daclastavir 30 mg Botol 0 0 0 0
374 Dehidroartemisin + Piperaquine (DHP) Tablet 0 0 0 0
375 RDT Malaria Test 0 0 0 0
376 Primakuin 15 mg Tablet 0 0 0 0
377 Artesunat inj. 60 mg Ampul 0 0 0 0

Logistik DBD
378 Insektisida Liter 0 0 0 0
379 BTI Botol 30 ml 0 0 0 0
380 Jumantik Paket 0 0 0 0
381 NS1 Tes 0 0 0 0
382 RDT IGM Tes 0 0 0 0
383 RDT Combo Tes 0 0 0 0
384 APD Buah 0 0 0 0
385 Mesin Foging Swan Fog SF 88 Unit 0 0 0 0
386 Larvasida Abate Kg 0 0 0 0
 KUNJUNGAN JUMLAH R/ GENERIK R/ NON GENERIK JUMLAH
PASIEN KUNJUNGA
UMUM BPJS UMUM BPJS UMUM BPJS PENULISAN R/
N
BALITA 193 15 208 334 27 0 0 361
ANAK 97 47 144 205 98 0 0 303
DEWASA 578 413 991 1343 964 0 0 2307
JUMLAH 868 475 1343 1882 1089 0 0 2971

Mengetahui, Yang menyerahkan, Yang menerima Yang melaporkan,

Kepala Seksi Farbekes Pemegang Barang Khusus Obat Kepala Puskesmas

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