PEMERINTAH PROVINSI DAERAH KHUSUS IBUKOTA JAKARTA

DINAS KESEHATAN
PUSAT PELAYANAN KESEHATAN PEGAWAI
Jl. KEBON SIRIH NO.18, BLOK H LANTAI 13 - JAKARTA PUSAT

No. Dokumen : PPKP/ CM-LB15/ TU/ JAN/ 2017 No. Revisi : 03

SATPELKES : Mobil Klinik Balai Kota

Sisa Stock
No Nama Obat Satuan Komposisi Expired Date Desember 2018 Stok Awal Penerimaan

1 Acarbose 100mg tablet Acarbose 100mg 0 0

2 Acarbose 50mg tablet Acarbose 100mg Jun-20 800
3 Acyclovir 400 mg tablet Asiklovir 400 mg Mar-20 4500
4 Allopurinol 100 mg tablet Alopurinol tab 100 mg Aug-20 17600
5 Allopurinol 300 mg tablet Alopurinol tab 300 mg Mar-20 8160
6 Alprazolam 0,5 mg tablet Alprazolam 0,5 mg 0 0
7 Alprazolam 1 mg/ Zolastin 1 mg tablet Alprazolam 1 mg 0 0
8 Amaropo Plus tablet -karoten 6 Mg, Vitamin C 100 Mg, Vitamin E 25 Mg, Likopen 5 0 50.0
Mg. 0
9 Amaryl M 1/250 mg tablet Glimepirid Tab 1 Mg, Metformin HCl 250 mg Jul-19 210
10 Ambroxol 30mg tablet Ambroxol 30mg Jul-20 1150
11 Amiodaron tab 200 mg tablet Amiodaron tab 200 mg
12 Aminoral tablet (A-ketoisoleusine) Garam Kalsium 67 mg, (A-Ketoleucine) 0
Garam Kalsium 101 Mg, (A-Ketophenylalanin) Garam Kalsium
59 Mg, (A-ketovaline) Garam Kalsium 86 Mg, L-Tryptophan 23
Mg, L- Threonin 53 Mg, L - Histidin 38 Mg, L-Tyrosin 30 mg, L-
Lysine Acetat 105 mg, Kalsium per kaplet 50 mg

0
13 Aminofilin 150 mg tablet Aminofilin 150 mg
14 Amlodipin 10 mg tablet Amlodipin 10 mg 0 0 200.0
15 Amlodipin 5 mg tablet Amlodipin 5 mg Apr-20 63700
16 Amoksisilin 500 mg kapsul Amoksisilin 500 mg Jan-22 31100 200.0
17 Amitriptilin tab sal 25 ng tablet Amitriptilin tab sal 25 ng Aug-21 500
18 Analsik tablet Methampyrone 500mg, Diazepam 2mg 0 0
19 Antalgin 500 mg tablet Metamizol Sodium 0 0
20 Antasida tablet Antasida Mar-20 21100
21 Arcoxia 90 mg tablet Etoricoxib 90 mg Oct-19 50
22 Arcoxia 120 mg tablet Etoricoxib 120 mg
23 Armovit kapsul Royal jelly,Lyophilled 0
gingsengPowder,vitA,E,D,B1,B2,B6,B12,Ca Panthotenate,Folic
Acid,Mg,K,Ca,Fe 0
24 Asam asetilsalisilat 100 mg/ Acetosal 100mg tablet Asam asetilsalisilat 100 mg 0 0
25 Asam asetilsalisilat 80 mg/ Miniaspi 80mg tablet Asam asetilsalisilat 80 mg Aug-20 10450
26 Asam Folat 1 mg Tablet Asam Folat 1 mg Jun-20 7200
27 Asam mefenamat 500 mg tablet Asam mefenamat 500mg Sep-20 13000 200.0
28 Asam Pipemidat kaps 400 mg Asam Pipemidsat kaps 400 mg
29 Asam Traneksamat 500 mg tablet Asam Traneksamat 500 mg May-21 500
30 Asam Ursodeoksikolat kaps 250 mg / Urdahex tablet Asam Ursodeoksikolat kaps 250 mg 0 0
31 Atapulgit 600 mg / Neo Diagon / New Antides tablet Activated attapulgite 600 mg. Aug-22 12700 100.0
32 Atorvastatin 10 mg tablet Atorvastatin 10 mg Jan-21 4290
33 Atorvastatin 20 mg tablet Atorvastatin 20mg Apr-20 0
34 Azitromisin 500 mg tablet Azitromisin Dihidrat Mar-22 340
35 Batugin Elixir 120ml botol Ekstrak Daun Strobilanthes crispus yang setara dengan serbuk Aug-21
daun kering 0,3 gram, Ekstrak Daun Sonchus arvensis yang
setara dengan serbuk daun kering 3 gram 26
36 Berryvision tablet Ekstyrak Kering Bilberry 80Mg, Retinol 1600 Iu, Vit E 40Mg, Nov-20
Betacaroten 5Mg,Pigment Blue &Red 1280
37 Betahistin Mesilate 6 mg tablet Betahistin Mesilate 6 mg Sep-19 4940
38 Biocurliv tablet Ekstrak Curcuma longa rhizome (curcuminoid complex
95%/Bio-Curcumin/BCM-95) 150 mg, silymarin phytosome 35
mg, ekstrak Schizandrae fructus 135 mg, Liquiritae radix 135 mg, 01/08/2020 - 03/
choline bitartrate 150 mg, vitamin B6 2 mg
1110
39 Bisakodil Tab Salut 5 mg/ Dulcolax tablet Bisakodil Tab Salut 5 mg 0 0
40 Bisoprolol 1,25 mg tablet Bisoprolol 1,25 mg
41 Bisoprolol 2,5 mg / Concor 2,5 mg tablet Bisoprolol 2,5 mg Jul-21 5500
42 Bisoprolol 5mg tablet Bisoprolol 5mg Aug-20 4050
43 Bromhexin 8 mg / Novaheksin 8mg tablet Bromhexin 8 mg Oct-20 9500
44 Candesartan 16mg tablet Candesartan 16mg Mar-20 3270
45 Candesartan 8 mg tablet Candesartan 8 mg Apr-20 2400
46 Captopril 12,5 mg tablet Captopril 12,5 mg Oct-21 6780 200.0
47 Captopril 25 mg tablet Captopril 25 mg May-21 12200
48 Cefadroxil 500 mg kapsul Cefadroxil 500 mg 01/09/2019 - 30-07-2020 20400
49 Cefixim 100mg tablet Cefixim 100mg 0 0
50 Celebrex 200mg tablet Celecoxib 200mg 0 0
51 Cephaleksin 500mg kapsul Cephaleksin 500mg 0 0
52 Cetirizin 10 mg kapsul Cetirizin 10 mg Mar-20 5800 260.0
53 Chlorpeniramini M tablet Chlorpeniramini M 0 0
54 Ciprofloxacin 500mg tablet Ciprofloxacin 500mg Oct-20 24000
55 Cisapride 5mg / Guarposid 5mg tablet Cisapride 5mg 0 0
56 Clidinium Br 2.5 Mg, Chlordiazepoxide 5 Mg/ Braxidin/ Clixid tablet Clidinium Br 2.5 Mg, Chlordiazepoxide 5 Mg. 0 0
57 Clonidin 0,15 mg tablet Mar-23 0
58 Clopidogrel 75mg tablet Clopidogrel 75mg Sep-19 5160
59 Co-En Q10 Kapsul 0 0
60 Comtusy botol Guaifenesin, oxomemazine 0 0
61 Cotrimoksazole 960 mg tablet Cotrimoksazole Apr-22 6900
62 Desogestrel / Desiret 75 mg Dus Desogestrel 75 mg Jul-19 18
63 Dexamethasone 0,5 mg tablet Dexamethasone 0,5 mg Mar-20 20100
64 Dextral Forte tablet Dextromethorphan HBr 10 mg, glyceryl guaiacolate 50 mg, Oct-21
phenylpropanolamine HCl 12.5 mg, chlorpheniramine maleate 1
mg 56780
 65 Dextral Syrup botol Dextromethorphan HBr 10 mg, glyceryl guaiacolate 50 mg, Oct-20 48.0
phenylpropanolamine HCl 12.5 mg, chlorpheniramine maleate 1
mg, volume 100 ml 7475
66 Diazepam 2 mg tablet Diazepam 2 mg 0 0
67 Diazepam 5 mg tablet Diazepam 5 mg 0 0
68 Digoksin 0,25 mg tablet Digoksin 0,25 mg Sep-20 3200
69 Diltiazem 30 mg tablet Diltiazem 30 mg Mar-23 200
70 Diosmin 450 mg, hesperidin 50 mg tablet / Ardium 500 mg tablet Diosmin 450 mg, hesperidin 50 mg tablet Jan-22 -45
71 Doksisiklin Kapsul 100 mg kapsul Doksisiklin Kapsul 100 mg Mar-20 6000
72 Domperidone 10 mg tablet Domperidone 10 mg Mar-20 14300
73 Domperidone syrup 5mg/ml botol Domperidone syrup 5mg/ml 0
0
74 Dumocalcin Calcium Hydrogen Phosphate 333,34 Mg, Tri Calcium Citrate 0
tablet 666,66 Mg, Vitamin D3 400 Si 0
75 Ekstrak ginkgo biloba dari daun kering (50:1) 40 mg, standardized at 9.6 mg tablet Ekstrak ginkgo biloba dari daun kering (50:1) 40 mg, Mar-22
ginkgoflavone glycisides / Tebokan Forte standardized at 9.6 mg ginkgoflavone glycisides -10
76 Enervon C tablet Vit B1 50Mg, B2 25Mg, B6 10Mg, B12 5Mcg, Vit C 500Mg, 0
Niacinamid 50Mg, Ca Pantotenate 20Mg 0
77 Eperison 50 mg tablet Eperison 50 mg May-20 3350
78 Ergokalsiferol (vitamin D2) kaps 50.000 UI / D-Vit tablet Ergokalsiferol (vitamin D2) kaps 50.000 UI / D-Vit Jun-20 0
79 Ergotamine tablet Ergotamine Caffein 1mg - 50 mg 0 0
80 Caffein 1mgkaps
Eritromisin - 50500
mg mg kapsul Eritromisin kaps 500 mg Nov-21 450
81 F G Throcess tablet Fradiomisin Sulfat 2,5 mg, Gramisidin-S HCl 1 mg tablet 0 0
82 Fenofibrat 100 mg kapsul Febofibrat 100 mg Aug-19 0
83 Fenofibrat 300 mg kapsul Fenofibrat 300 mg
84 Fludane tablet Paracetamol 500mg, Phenylpropanolamine HCl 12,5mg, 0
chlorpheniramine maleate 2mg 0
85 Flumarizin tablet Flunarizin 5 mg 0 0
86 Furosemid 40 mg tablet Furosemid 40 mg Aug-21 3400
87 Gabapentin kaps 100 mg kapsul Gabapentin kaps 100 mg
88 Gemfibrozil 300mg kapsul Gemfibrozil 300mg Apr-21 12104
89 Glibenclamide 5 mg tablet Glibenclamide 5 mg Aug-23 9300
90 Glimepiride 1 mg tablet Glimepiride 1 mg Jan-21 600
91 Glimepiride 2 mg tablet Glimepiride 2 mg Jul-21 13600
92 Glimepiride 3 mg tablet Glimepiride 3 mg 0 0
93 Gliquidone 30mg tablet Gliquidone 30mg Jul-20 500
94 Gliseril Trinitrat 2,5 mg / Nitrokaf Retard tablet Gliseril Trinitrat 2,5 mg Apr-20 1000
95 Glucosamin 50 mg, Condroitin 400mg, Vit C 50mg tablet Glucosamin 50 mg, Condroitin 400mg, Vit C 50mg 0 0
96 Glucosamine HCL 500mg, Condroitin sulfate 400mg/ Fitbon Plus tablet Glucosamine HCL 500mg, Condroitin sulfate 400mg Aug-19 2874
97 Griseofulvin 125 mg tablet Griseofulvin 125 mg Jun-20 500
98 Griseofulvin 500 mg tablet Griseofulvin 500 mg Oct-20 400
99 Haloperidol 5 mg tablet Haloperidol 5 mg 0 0
100 Hiosina butilbromida tab 10 mg / Scopma tablet Hiosina butilbromida tab 10 mg Apr-20 4200
101 Horvita G tablet Royal jelly,Lyophilled 200.0
gingsengPowder,vitA,E,D,B1,B2,B6,B12,Ca Panthotenate,Folic Dec-21
Acid,Mg,K,Ca,Fe 45800
102 Hp pro kapsul Fructus schizandrae extract siccum 7,5mg 0 0
103 Hidroklortiazid tab 12,5 mg tablet Hidroklortiazid tab 12,5 mg Oct-22 0
104 Hidroklortiazid tab 25 mg tablet Hidroklortiazid tab 25 mg
105 Ibuprofen 200 mg tablet Ibuprofen 200 mg 0 0
106 Ibuprofen 400 mg tablet Ibuprofen 400 mg Jul-22 5600
107 Imboost Force tablet Imboost Force May-21
108 Imulan kapsul Imulan 0 0
109 Imunos tablet Echinacea purpurea, zinc picolinate, selenium, natrium
askorbat
110 Isoprinosine tablet Isoprinosine 0 0
111 Isosorbide Dinitrat 5 mg tablet Isosorbide Dinitrat 5 mg 0 0
112 Ivabradin 5 mg/ Coralan 5 mg tablet Ivabradin Jun-20 392
113 Janumet 50/1000 tablet Metfformin1000mg, Sitagliptin 50 mg Sep-19 224
114 Januvia 100mg tablet Sitagliptin 100 mg Jan-20 196
115 Kalium Diklofenak 50 mg / Merflam tablet Kalium Diklofenak 50 mg
116 Kalsium Laktat (kalk) tab 500 mg tablet Kalsium Laktat (kalk) tab 500 mg Oct-19 6900
117 Karbamazepin Tab 200 mg tablet Karbamazepin Tab 200 mg 0 0
118 Ketokonazol 200 mg tablet Ketokonazol 200 mg Sep-21 3800
119 Ketosteril tablet Ketosteril Apr-21 600
120 Klindamisin 300 mg kapsul Klindamisin 300 mg Aug-20 1900 50.0
121 Klonazepam kaps 2 mg tablet Klonazepam kaps 2 mg
122 Kloramfenikol kaps 500 mg tablet Kloramfenikol kaps 500 mg
123 Klorpromazin tab sal 100 mg tablet Klorpromazin tab sal 100 mg
124 Kodein tab 10 mg tablet Kodein tab 10 mg
125 KSR tablet Kalium klorida SR May-21 0
126 Lamata tablet Mar-19 240
127 Lamivudin 150mg tablet Lamivudin 150mg 0 0
128 Lanzoprazole 30 mg kapsul Lanzoprazole 30 mg 0 0
129 Levofloxacin 500 mg tablet Levofloxacin 500 mg 0 0
130 Levotiroksin tab 100 mcg tablet Levotiroksin tab 100 mcg
131 Lincomycin 500 mg capsul Lincomycin 500 mg 0 0
132 Listerine botol Timol 0,01 %, Eukaliptol 0,02 %, Metil Salisilat 0,02 %, Alkohol 0
18,54 %, Anetol 0,004 %, Pluronik 0,5 %, Asam Benzoat 0,15 %,
Minyak Permen 0,02 %, Minyak Spearmint 0,02 %.
0
133 Livron B. Plex tablet Vitamin B1 Hcl 15 Mg, Vitamin B2 0,25 Mg, Vitamin B6 Hcl 0
0,25 Mg, Vitamin B12 500 Mcg, Vitamin C 12,5 Mg, Kalsium
Pantotenat 1,5 Mg, Nikotinamida 10 Mg, Asam Folat 0,5 Mg,
Besi (Ii) Glukonat 7,5 Mg, Tembaga Sulfat 0,65 Mg

0
134 Loperamide 2 mg tablet Loperamide 2 mg 0 0
135 Loratadine 10 mg tablet Loratadine 10 mg Jul-21 18600
136 Lyrica tablet Pregabalin 0 0
137 Magnesium hidroksida + Aluminium hidroksida + Dimethyl Polisiloxane/
tablet
Magnesium hidroksida + Aluminium hidroksida + Dimethyl
Sep-20
200.0
dimeticone / Magasida Polisiloxane/ dimeticone 13100
138 Magtral Forte Susp 120ml botol Al Hidroksida Dried Gel Usp 200Mg, Mg Hidroksidausp200Mg, 0
Simethicone50Mg 0
139 Mebendazole 500 mg tablet Mebendazole 500 mg
140 Mecobalamin 500 mg/ Oxicobal 500 mg kapsul Mecobalamin Aug-20 22500 100.0
141 Medroksi progesteron asetat tab 10 mg tablet Medroksi progesteron asetat tab 10 mg
142 Meloxicam 15 mg tablet Meloxicam 15 mg Apr-23 12000
143 Meloxicam 7,5 mg tablet Meloxicam 7,5 mg 0 0
144 Metformin 500 mg tablet Metformin 500 mg Jul-20 28300 200.0
145 Metformin 850 mg tablet Metformin 850 mg Oct-19 500
146 Methampyron 500mg, vit B1 50mg, vit B6 100mg, vit B12 100mcg tablet Methampyron 500mg, vit B1 50mg, vit B6 100mg, vit B12
100mcg
147 Methylprednisolon 4mg tablet Methylprednisolon 4mg 0 0
148 Metoklopramide Tab 5 Mg/ Primperan tablet Metoklopramide Tab 5 Mg Apr-20 90
149 Metronidazole 500 mg tablet Metronidazole 500 mg 0 0
150 Natrium Diklofenac 25 mg tablet Natrium Diklofenac 25 mg May-23 10750 200.0
151 Natrium Diklofenac 50 mg tablet Natrium Diklofenac 50 mg Nov-20 13100
152 Neosanmag tablet Famothidine 10 Mg, Ca Carbonat 800 mg, Mg (OH)2 165 mg 0
0
153 Nephrolit tablet Ekstrak Folium Orthosiphon Stamineus 18Mg, Ekstrak Folium 0
Strobilanthus Crispus 16 Mg, Ekstrak Folium Sonchus Arvensis
24Mg, Ekstrak Folium Phyllantus Niruri 2,4Mg, Vit B 6 5 Mg,
Asam Folat 200 Mcg.
0
154 OBH rasa jeruk nipis botol OBH Oct-20 6 6.0
155 Ofloxacin 200 mg tablet Ofloxacin 200 mg 0 0
156 Omeprazole 20 mg kapsul Omeprazole 20 mg Oct-21 360 90.0
157 Ondansentron 8 mg
158 Garam Oralit Kombinasi / Pharolit sach Tiap bungkus mengandung Natrium klorida 0,52 g; Kalium Oct-21
klorida 0,30 g; Trinatrium sitrat dihidrat 0,58 g; Glukosa anhidrat
2,7 g 605
159 Pantoprazole 20 mg kapsul Pantoprazole 20 mg Dec-19 0
160 Parasetamol 500 mg tablet Parasetamol 500 mg Apr-20 33400
161 Parasetamol 500mg, vit B6 100 mg, vit B150 mg, vit B12 100 mcg tablet Parasetamol 500mg, vit B6 100 mg, vit B150 mg, vit B12 100
mcg
162 Piracetam 1200 mg tablet Piracetam 1200 mg 0 0
163 Piracetam 800 mg tablet Piracetam 800 mg 0 0
164 Pirantel Pamoat 125 mg tablet Pirantel Pamoat 125 mg
165 Piroxicam 10 mg tablet Piroxicam 10 mg 0 0
166 Piroxicam 20 mg / Grazeo tablet Piroxicam 20 mg Sep-20 90
167 Prednison 5 mg tablet Prednison 5 mg 0 0
168 Pronalges CR kapsul Ketoprofen 0 0
169 Propanolol 40 mg tablet Propanolol 40 mg Mar-21 800
170 Pseudoephedrine Hcl 30 mg, Triprolidine 2,5 mg tab tablet Pseudoephedrine Hcl 30 mg, Triprolidine 2,5 mg tab 0 0
171 Pseudoefedrin 30 mg, Terfenadine 40 mg/ Rhinofed tablet Pseudoefedrin 30 mg, Terfenadine 40 mg 01/03/2020 / 01-09-2020 67400
172 Ramipril 2,5mg tablet Ramipril 2,5mg
173 Ramipril 5mg tablet Ramipril 5mg Mar-20 500
174 Ramipril 10mg tablet Ramipril 10mg Aug-19 0
175 Ranitidine 150 mg tablet Ranitidine 150 mg 08-21 & 05-20 29200
176 Risperidon tab sal 2 mg tablet Risperidon tab sal 2 mg
177 Salbutamol 4mg tablet Salbutamol 4mg Mar-22 2100
178 Samcobion tablet 0,2 mg, Copper sulfate 0,2 mg, Vit C 50 mg, folic acid 1 mg, Vit 0
B 12 7,5 mcg, sorbitol 25 mg 0
179 Sanaflu tablet Parasetamol 500 mg, Fenilpropanolamin 15 mg Apr-21 0
180 Sangobion kapsul Fe Gluconate 250 mg, Manganese sulfat 0,2 mg, Copper sulfate 0
0,2 mg, Vit C 50 mg, folic acid 1 mg, Vit B 12 7,5 mcg, sorbitol
25 mg 0
181 Simvastatin 10 mg tablet Simvastatin 10 mg Jul-20 36990
182 Simvastatin 20 mg tablet Simvastatin 20 mg Apr-20 30
183 Sitikolin 500 mg tablet Sitikolin 500 mg May-23 700
184 Spasminal tablet Metampiron, ekstrak beladona, papaverin hidroklorida Jun-20 650 70.0
185 Spiramycin 500mg kapsul Spiramycin 500mg 0 0
186 Spironolacton 25 mg tablet Spironolacton 25 mg Nov-19 2900
187 Strocain tablet Polymigel 400 mg 0 0
188 Sukralfat Susp 500 ml Botol Sukralfat Susp 500 ml Apr-20 1010
189 Tablet Tambah Darah / Fermia tablet Kombinasi Besi III sulfat 200mg + Asam folat 0,25mg May-21 5700
190 Tamsulosin tab 0,2 mg tablet Tamsulosin tab 0,2 mg
191 Teofilin tab 150 mg/ Bronsolvan tablet Teofilin 150mg 0 0
192 Tramadol 37,5 mg, Parasetamol 325 mg / Zephanal kapsul Tramadol 37,5 mg, Parasetamol 325 mg 0 0
193 Valsartan 80mg tablet Valsartan 80mg Feb-20 8580
194 Verapamil 80 mg tablet Verapamil 80 mg Feb-23 0
195 Vitamin B Comp tablet Dec-20 790
196 Vitamin B1 (tiamin tab 50 mg ) tablet Vitamin B1 (tiamin tab 50 mg ) Oct-20 13
197 Vitamin B6 (piridoksin tab 10 mg) tablet Vitamin B6 (piridoksin tab 10 mg)
198 Vitamin B12 (sianokobalamin tab 50 mcg) tablet Vitamin B12 (sianokobalamin tab 50 mcg) May-23 1600
199 Vitamin B1 100 mg, vitamin B6 100 mg, vtamin B12 5000ug tablet Vitamin B1 100 mg, vitamin B6 100 mg, vtamin B12 5000ug
200 Vitamin B1 100 mg, vitamin B6 200 mg, vitamin B12 200 mcg / Neurobion tablet Vitamin B1 100 mg, vitamin B6 200 mg, vitamin B12 200 mcg Jan-20
5000
201 Warfarin 1mg tablet Warfarin Na 1mg Jan-19 120
202 Warfarin Na 2 mg / Notisil 2 mg tablet Warfarin Na 2 mg Mar-20 600
203 Xepazym tablet Amylase, Dimeticone, Lipase, Protease 0 0
204
205
206
207
208
209
210
211
212
213
Injeksi
1 Adona inj ampul Carbazochrome RETURN 0
2 Aminofilin Injeksi ampul Aminofilin 24 mg/ ml May-19 69
3 Analog Insulin Fast Acting / Novoravid Inj 100IU/ML Pen Analog Insulin Fast Acting / Novoravid Inj 100IU/ML Aug-20 50
4 Analog Insulin Intermediate acting / Novomix Inj 100 IU/Ml Pen Analog Insulin Intermediate acting / Novomix Inj 100 IU/Ml Feb-20 50
5 Analog Insulin Long Acting / Lantus Inj 100 IU ML Pen Analog Insulin Long Acting / Lantus Inj 100 IU ML Feb-21 122
6 Aqua Pro Injeksi 25 ML ampul Mar-21 65
 7 Asam Traneksamat Inj 50 mg/ ml ampul Asam Traneksamat Inj 50 mg/ ml
8 Atropin Sulfat 0,25 mg / ml ampul Atropin Sulfat 0,25 mg / ml Jun-19 169
9 Buscopan Injeksi ampul Hiosina butilbromida tab 10 mg Jan-19 25
10 Cairan infus Dextrose 5 % botol Feb-20 6
11 Cairan infus NaCl 0,9 % botol Aug-19 175
12 Cairan infus RL 500ml botol Apr-20 38
13 Decamidon Injeksi Vial Dec-99 0
14 Deksametason Injeksi ampul Deksametason 5 mg/ ml Feb-20 42
15 Diazepam 5 mg Injeksi ampul Diazepam 5 mg/ ml Dec-99 0
16 Difenhidramin 10mg/ml Injeksi ampul Difenhidramin 10mg/ml Injeksi Sep-19 32
17 Epinefrin (Adrenalin) inj 1 mg/ml ampul Epinefrin (Adrenalin) inj 1 mg/ml May-20 155
18 Furosemide 10mg ampul Furosemid 10mg/ml Aug-20 0
19 Lidocain 2% ampul Lidocain Hidroklorida Feb-22 21
20 lidokain hcl 2% + epinefrin 1 : 80.000 inj 2 ml ampul idokain hcl 2% + epinefrin 1 : 80.000 Dec-20 1
21 Novalgin Injeksi ampul Metampiron/ Metamizole Na Dec-99 0
22 Omeprazole 40mg injeksi ampul Omeprazole 20 mg Mar-20 5
23 Ondansentron 8mg inj ampul May-21 10
Prevenar Injeksi Pneumococcal polysaccharide conjugated vaccine (13-valent, adsorbed).
24 ampul Dec-99 0
25 Ranitidin Inj ampul Apr-21 10
26 Triamcinolon / Trilac ampul Triamcinolone Jun-20 26
27 Vaksin Flu Dewasa/ Ainfluvac influvac Vial Vaksin Influenza (split virion) diinaktivasi. Dec-99 0
Vaksin Servix/ Gardasil Injeksi ampul Quadrivalent human papillomavirus (types 6, 11, 16, 18)
28 recombinant vaccine. Dec-99 0
29 Vaksin Tetanus / Tetagam Syringe Human Tetanus Imunoglobulin Aug-20 10
30 Vitamin C Injeksi/ Extrace Injeksi Ampul Ascorbic acid / asam askorbat Jan-20 70
Vitamin B1 100 mg, Vitamin B6 100 mg, Vitamin B12 5,000 mcg / Vitamin B1 100 mg, Vitamin B6 100 mg, Vitamin B12 5,000 mcg
31 Mersibion Inj ampul / Mersibion Inj Feb-20 67
32 Vitamin K Injeksi / Neo K ampul phytonadione 2 mg Dec-99 0
33
34
35
36
37
38
39
40
41
Obat Luar
1 Antifungi Salep pot Asam Benzoat 6%, Asam Salisilat 3% Dec-99 0
2 Asam Retinoat 0,1 % / Niotinex tube Asam Retinoat 0,1 % Nov-19 33
3 Asiklovir Krim tube Acyclovir cream May-21 19
4 Atropin tts mata 1% / Cendo Tropin 1 % flacon Atropin Sulfat Apr-21 163
5 Avamys Nasal Spray
6 Baby oil 200ml botol Mineral Oil Dec-99 0
7 Bacitracin Polymixin B Zalf Kulit tube Basitrasin 500 UI/g, Polimiksin B 10000 UI/g Oct-22 200
 8 Bedak Salisil Serbuk 2 % pot Bedak Salisil Serbuk 2 % Oct-20 1932 3.0
9 Betametason cream tube Betametason cream Aug-20 182 40.0
10 Betamethason 1mg/ml / Betham Flacon Betametason 1mg/ ml Jun-19 74
11 Bioplacenton Gel Tube Placenta extract 10%. Neomycin sulfate 0,5% Sep-18 0
Borraginol N Lithospermi Radix Wxtr benzocaine, dibucaine Hcl,
Supp diphenhyramine Hcl,cetrimide
12 Dec-99 0
13 perak sulfadiazin 10 mg/ Burnazin 35 gr tube perak sulfadiazin 10 mg Aug-18 0
14 Caladin Lotion botol Calamine 5%, zinc oxide 10%, diphenhydramine HCI 2% Dec-99 0
15 Caladin powder botol Calamine 5%, zinc oxide 10%, diphenhydramine HCI 2% Dec-99 0
16 Carbo glycerin 10 % botol Carbo glycerin 10 % NO ED 9
17 carboxymethylcellulose sodium 5 mg Flacon Cenfres 5 ml Dec-99 0 12.0
Cendo Augentonic Flacon vitamin A palmitate 1000 IU, zinc sulfate 0,2 mg dan
18 phenylephrine HCl 1 mg Dec-99 0
19 Cendo Hyalub Minidose Sodium Hyaluronate 1,00 mg Dec-99 0
Combivent per 2,5 ml unit dosis vial:
Vial Ipratropium Br 0,5 mg Jun-19
20 Salbutamol sulphate 2,5 mg 31
21 Decacetin Tetes Mata Flacon Chloramphenicol 5 mg Sep-20 0 2.0
22 Desoximethasone 0,25 % tube Desoximethasone 0,25 % Jun-20 80
dexamethasone 1 mg, neomycin sulfate 3,5 mg dan polymyxin B sulfate Flacon dexamethasone 1 mg, neomycin sulfate 3,5 mg dan polymyxin B Oct-19 4.0
23 10.000 SI/ Isotic Neolyson sulfate 10.000 SI 30
dexamethasone 1 mg, neomycin sulfate 3,5 mg dan polymyxin B sulfate Flacon dexamethasone 1 mg, neomycin sulfate 3,5 mg dan polymyxin B
10.000 SI/ Aletrol tetes mata May-20 990
24 sulfate 10.000 SI
25 dexamethasone, neomycin sulfate, polymyxin B sulfate tube dexamethasone, neomycin sulfate, polymyxin B sulfate Dec-99 0
26 Elocon Cream 10 gr tube Momemtason Dec-99 0
27 Fladystin Supp metronidazole 500 mg, nystatin 100,000 iu. Dec-99 0
28 Flagyl Supp Metronidazol 500 mg Dec-99 0
29 Flagystatin Ovula Ovula metronidazole 500 mg, nystatin 100,000 IU. Dec-99 0
30 Flamar Tetes Mata Flacon Natrium Diklofenak Aug-19 18 2.0
31 Framisetin Sulfat Tulle 1% Framisetin Sulfat Tulle 1%
32 Fluicinolon 5 g / Synarcus 5 g Tube Fluicinolon Sep-21 50
33 Flumetholon tetes mata / Cendo Posop Minidose Fluorometholone 0,1 % Nov-20 50
34 Forumen TetesTelinga Flacon Natrium Dokusat Mar-20 94
35 Gentalex cr 5 gr tube Gentamicin Aug-19 177 12.0 2.0
36 Gentamycin salep kulit tube Gentamicin Dec-99 0
37 Gentamisin salep mata 1% tube Gentamycin 1% 5 ml Apr-22 192
38 Gentamisin salep mata 0,3% tube Gentamisin salep mata 0,3%
39 Gentamisin tetes mata 0,3% Flacon Gentamicin Jun-21 176
40 Hialid 5ml flacon Natrium hyaluronat 0,1 % Dec-99 0
41 Hydrocortison 2,5 mg tube Hydrocortison 2, mg May-22 55
42 Oksimetazoline 0,050 % Iliadin botol Oxymetazoline HCl Mar-20 142
43 Oksimetazoline 0,025 % Oksimetazoline 0,025 %
44 Ipratropium 20 mcg / Atropent botol Ipratropium 20 mcg Aug-20 2
45 Kary uni tts mata flacon pirenoxine 0.05 mg Dec-99 0
46 Ketokonazol SS 2% / Fungasol SS 2% botol Ketokonazol SS 2% Apr-20 35
47 Ketokonazole 2% cream tube Ketokonazol Apr-22 339 3.0 10.0
48 Ketoprofen Gel/ Profenid gel tube Ketoprofen Dec-99 0
49 Ketoprofen Sup 100 mg Ketoprofen Sup 100 mg
50 Kloramfenikol tetes telinga 3% Kloramfenikol tetes telinga 3%
51 Kloramfenikol tetes mata/ Reco Eye Drop Botol Kloramfenikol Dec-99 0
52 Latanoprost tetes mata 0,005%
53 Levofloxacin tetes mata / Optiflox tetes mata 5 mg/ml May-21 456
54 Levofloxacin tetes telinga
55 Lidokain gel 2 % Lidokain gel 2 %
56 Lidokain spray oral 10 %
Methyl salicylate 102 mg, menthol 54.4 mg, eugenol 13.6 mg. Methyl salicylate 102 mg, menthol 54.4 mg, eugenol 13.6 mg.
57
58 Metronidazol ovula 500 mg Ovula
59 Metronidazol sup 500 mg Suppos
60 Mikonazol krim 2% Tube
61 Minosep kumur Botol Klorheksidin glukonat 0,2% Dec-99 0
62 Molexdin 180 ml botol Povidon Iodine Gargle Dec-99 0
63 Mometason furoat krim 0,1% tube Mometason 10gr Apr-20 23 3.0
64 Natrium Fusidat krim 20 mg/ g
65 Natrium hyaluronat gel Natrium hyaluronat gel
66 Nistatin Ovula tablet Nystatin Ovula Dec-99 0
67 Nistatin tab vaginal 100,000 UI
68 Ofloksasin tetes telinga 3 % /Akilen Flacon Aug-20 176
69 Otopain ear drop
70 Permetrin Krim 5 % tube Permetrin Krim 5 %
71 Phenol gliserol pot Phenol Jun-20 30
72 Pilokarpin tetes mata 2 % Pilokarpin tetes mata 2 %
73 Piroksikam Gel/ Infeld Gel tube Piroksikam 15 mg gel 05-20 / 05-20 / 07-20 / 04-22 1665 10.0
74 PK kristal pot Kalium permanganat NO ED 26
75 Povidon Iodine 30 cc botol Povidon Iodine 30 cc Dec-99 0
76 Povidon Iodine 100 cc Gargle botol Povidone iodine 1% Jan-21 6
77 Pronalges supp Supp Ketoprofen Aug-18 0
78 Salep 2-4 pot Asam Salisilat 2%, Sulfur 4% Jul-20 7
Scabicid tube
79 Gameksan (gama benzen heksaklorida) 10 mgAsam Usnat (Usnic Acid)Dec-99
10 mg 0
80 Tarivid tetes mata botol Ofloxacin Dec-99 0
81 Thrombophob gel tube Heparin Sodium Aug-20 33 3.0
82 Timolol tetes mata 0,5% Timolol tetes mata 0,5%
83 Tobramisin tetes mata 0.3% + Deksametason 1 mg / Cendo Tobrosan Flacon Tobramisin tetes mata 0.3% + Deksametason 1 mg Oct-20 46
Total Care botol Timol 0,01%, Eukaliptol 0,02%, Metil Salisilat 0,02%, Alkohol Nov-20 0
18,54 %, Anetol 0,004%, Pluronik 0,5%, Asam Benzoat 0,15%,
Minyak Permen 0,02%, Minyak Spearmint 0,02%
84
85 Travoprost 0,004% / Travatan 0,004% Flacon Travoprost 0,004% Apr-19 14
86 triamsinolon asetonida 1 mg tube triamsinolon asetonida 1 mg
87 Urea krim 10% / Carmed 10 % tube Urea Krim 10 % May-21 40
88 Ventolin inhaler Inhalasi Salbutamol Dec-99 0
89 Ventolin Nebules nebul Salbutamol Dec-99 0
90
91
92
93
94
95
96
97
98
99
Bahan Gigi
1 Acrylic reducer buah 0 0
2 Alginat pack Nov-20 6
3 Arsenic paste pot Dec-99 0
4 Artikulating paper pack no ed 28
5 Blade steril buah Jun-21 636
6 Bonding gel tube Apr-20 6
7 Bur Poles Akrilic (Pink) Buah Dec-99 0
8 Bur Poles low white Buah Dec-99 0
9 Bur Poles speed white Buah no ed 10
10 Bur Preparasi gold buah Dec-99 0
11 Bur tulang fissure buah Dec-99 0
12 Bur tulang round buah no ed 3
13 Burjet High Speed Fissure buah no ed 4
14 Burjet High Speed Inverted buah no ed 4
15 Burjet High Speed Pointed buah no ed 6
16 Burjet High Speed Round buah no ed 374
17 Burjet High Speed Tapered buah no ed 4
18 Calcium Hydroxide Buah Feb-19 57
19 Calsium Gel Plus IOD pack Apr-20 2
20 Carpule needle/ Disposable buah Jul-20 37
21 Dental
CavitonNeedle
/ Tumpatan Sementara box Dec-19 188
22 Celuloid strip pack no ed 40
23 Cotton Roll Buah no ed 424
24 Cresophene pot Dec-99 0
25 Dental Diagnostik Set Set no ed 3
26 Dental floss buah no ed 701
27 Devitalisasi / Pulp X set May-21 39
28 Doble Impresion Light set Dec-99 0
29 Doble Impresion Putty set Dec-99 0
30 EDTA Gel Box Dec-99 0
31 Endo Acces Bur FG 1 - PC set No Ed 1
32 Endomethasone n Box Dec-99 0
33 Endoseal buah Mar-19 5
34 Etching gel buah Dec-99 0
35 Etching Liquid tube Jun-19 25
36 Eugenol box May-21 8
37 F 400 buah Dec-99 0
38 File no 15-40 set Dec-99 0
39 File no 45-80 set Dec-99 0
40 Fletcher pot no ed 0
 Formokresol
41 Fuji I buah Jan-20 1
42 Fuji II buah Jan-19 4
43 Fuji IX A2 buah May-19 5
44 Fuji IX A3 buah Mar-19 26
45 Fuji IX A3,5 buah Dec-99 0
46 Gutaperca Protaper Next pack Aug-20 15
47 Gutaperca Wave One pack Oct-20 5
48 Gutta point 15 - 40 set Mar-20 1
49 Gutta point 45 - 80 set Dec-99 0
50 Guttap Protapper pack Aug-20 37
51 Handle Kaca Mulut Pcs no ed 10
52 Hemosvon / Curaspoon set Oct-20 168
53 Jarum Extirpasi buah Dec-99 0
54 Kaca mulut buah no ed 0
55 Kefac Molar pack Dec-99 0
56 K-File M-Acces 21 mm 008 set No Ed 7
57 K-File M-Acces 21 mm 010 set no ed 7
58 K-File M-Acces 21 mm 015 set No Ed 1
59 K-File M-Acces 25 mm 008 set No Ed 7
60 K-File M-Acces 25 mm 010 set No Ed 0
61 K-File M-Acces 25 mm 015 set No Ed 2
62 Klorheksidin 0,2% / Periokin Spray Botol Nov-20 8
Klorfenol kamfer mentol (CHKM)
63 Komposite A2 buah Apr-20 17
64 Komposite A3 buah Oct-19 12
65 Komposite A3,5 buah Mar-19 24
66 Ledermix Paste tube Dec-99 0
67 Mata Scaler Pcs Dec-99 0
68 Matrik reguler buah no ed 1
69 Mercury (Hg) botol Dec-99 0
70 Moldano Buah Dec-99 0
71 Oxyfreshdental gargle botol Dec-99 0
72 Oxyfreshdental gel tube Dec-99 0
73 Palodent V3 Intro Kit Set no ed 1
74 Panaspray botol no ed 1
75 Paper point 15 - 40 set no ed 64
76 Paper point 45 - 80 set no ed 81
77 Polybib pack no ed 110
78 Protaper 21 mm pack Dec-99 0
79 Protaper 25 mm pack Dec-99 0
80 Respatorium buah no ed 24
81 Rubber Poles besar (Abu-abu) Buah Dec-99 0
82 Scandonest 3 % buah Dec-99 0
83 SDR (Bulk Fill Material) pack Dec-99 0
84 Semen Resin Relyx pack Dec-99 0
85 Semen sementara buah Dec-99 0
86 Sendok Cetak set Dec-99 0
 87 Shower cup buah Dec-99 0
88 Siler AH Plus pack Dec-99 0
89 Soft Acrilic Box Dec-99 0
90 Spreder Hands Instrumen buah no ed 3
91 Suction tip pack no ed 429
92 Tang Gigi buah no ed 4
93 Tempat Bur buah no ed 15
94 Ties ( Metronidazole ) Syringe Dec-99 0
95 TKF Buah Dec-99 0
96 Topical anestesi gel pot Dec-99 0
97 Trimmer stone buah Dec-99 0
98 Wax lembaran set no ed 4
99 Xylestesin ampul Dec-99 0
100
101
102
103
104
105
106
107
108
109
Alat Kesehatan Habis Pakai
1 2 way foley catheter no 16 buah Dec-99 0
2 2 way foley catheter no 18 buah Dec-99 0
3 Adhesive 3 cm
4 adhesive 5 cm
5 Alkohol 70 % liter Oct-20 154
6 Alkohol 96 % liter Dec-99 0
7 Alkohol Swab Box May-21 180
8 Aquadest Otsuka liter Dec-99 0
9 Arm sling box no ed 20
10 Asam Urat Stik Humases @50 kit Mar-20 72
11 Balon tensimeter buah no ed 5
12 BD Vacutainer No 21 GA Buah Dec-99 0
13 Bidai buah Dec-99 0
14 Blue tips pack no ed 135
15 Buku Ishihara buah Dec-99 0
16 Canul O2 buah Dec-99 0
17 Catgut plain dan Jarum 3/0 buah Dec-99 0
18 Cholesterol for Accutrend @25 kit Mar-19 0
19 Chromic Catgut Buah May-20 452
20 Citobrush buah no ed 2561
21 Combur Test M box Dec-99 0
22 Daryantule Lembar Apr-21 90
23 Deck glass pack Apr-21 1
24 Dettol solution botol Dec-99 0
25 Disp Syringe 10 ml buah Sep-22 888
26 Disp Syringe 20 ml buah Aug-18 128
27 Disp. Syringe 1 ml buah Aug-22 -1
28 Disp. Syringe 3 ml buah Feb-19 53
29 Disp. Syringe 5 ml buah Sep-22 -15
30 Dispenser Cotton Roll buah Dec-99 0
31 Duck bolong buah no ed 2
32 Duck rapat buah Dec-99 0
33 Elektroda disposible Pouch Dec-99 0
34 Erba Cleaner botol Nov-18 7
35 Erba Diluent-diff botol Dec-99 0
36 Erba lyse-diff botol Sep-18 7
37 Etil klorida semprot 100 ml Botol Aug-20 16
38 Extran 2500 ml botol Dec-99 0
39 Extran 500 ml botol Dec-99 0
40 Film Panoramic UPT 210 BL roll Dec-99 20
41 FilM X- Ray DVB 8x10 IN (20x25cm) Dus Apr-20 20
42 Fixomull 5 cm pcs Nov-21 33
43 Gel EKG drigen Jan-22 26
44 Glucose Stick Humases @50 kit Jun-20 276
45 Golongan Darah Set May-19 2
46 H2O2 3 % liter Jun-20 214
47 Hammer Reflex pack Dec-99 0
48 Hypapix roll Dec-99 0
49 Infus set Buah Mar-22 96
50 iv cateter no 20 buah Feb-22 66
51 iv cateter no 22 buah Sep-21 43
52 Kantong plastik 25/15 x 25 buah no ed 52200
53 Kapas Buah Oct-21 51
54 Kassa Steril Pack Jan-20 446
55 Kertas EKG 50MM x 30MT C-110 TIPE 050R30-H01 roll no ed 20
56 Kertas EKG Alpha 1000 pack no ed 219
57 Kertas Spirometri Box no ed 3
58 Kertas treatmil pack no ed 303
59 Klip plastik 10 x 15 buah no ed 13000
60 Klip plastik 12 x 20 buah no ed 53800
61 Klip plastik 7 x 10 buah no ed 32600
62 Klip plastik 8,7 x 13 buah no ed 8395
63 Lancette kit Nov-20 42
64 Manset tensimeter Buah Dec-99 0
65 Masker disposible karet box no ed 44
66 Masker disposible tali (50pc) box Dec-99 0
Revisi : 03 TANGGAL Berlaku : 02 Januari 2017
LAPORAN BULAN
PERMINTAAN BULAN
Pemakaian
Persediaan
RL RD KLB JML
- -
- -
- -
- -
- -
- -
- -
50.0 50.0 50.0 100.0
- -
- -
- -
- -
- -
200.0 200.0 50.0 250.0
- -
200.0 50.0 100.0 150.0
- -
- -
- -
- -
- -
- -
- -
- -
- -
:
: Februari 2019
Sisa Stok Stok Optimum Permintaan
- -
- -
- -
- -
- -
- -
- -
(50.0) 120.0
- -
- -
- -
- -
- -
(50.0) 300.0
- -
50.0 180.0
- -
- -
- -
- -
- -
- -
- -
- -
- -
Stok Minimal
- -
- -
- -
- -
- -
- -
- -
170.0 10.0
- -
- -
- -
- -
- -
350.0 25.0
- -
130.0 15.0
- -
- -
- -
- -
- -
- -
- -
- -
- -
 - - - - - -
200.0 100.0 100.0 200.0 - 240.0 240.0 20.0
- - - - - -
- - - - - -
- - - - - -
100.0 30.0 70.0 100.0 - 120.0 120.0 10.0
- - - - - -
- - - - - -
- - - - - -

- - - - - -

- 50.0 50.0 (50.0) 60.0 110.0 5.0

- - - - - -

- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
200.0 50.0 90.0 140.0 60.0 168.0 108.0 14.0
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
260.0 120.0 50.0 170.0 90.0 204.0 114.0 17.0
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- 50.0 50.0 (50.0) 60.0 110.0 5.0
- - - - - -
- - - - - -

- - - - - -
 48.0 12.0 15.0 27.0 21.0 32.4 11.4 2.7
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -

- - - - - -

- - - - - -

- - - - - -

- - - - - -
- 50.0 50.0 (50.0) 60.0 110.0 5.0
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -

- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- 50.0 50.0 (50.0) 60.0 110.0 5.0

200.0 50.0 100.0 150.0 50.0 180.0 130.0 15.0

- - - - - -
 - - - - - -
- - - - - -
- 50.0 50.0 (50.0) 60.0 110.0 5.0
- - - - - -
- - - - - -
- - - - - -

- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -

- - - - - -
- - - - - -
- - - - - -
- - - - - -
50.0 70.0 70.0 (20.0) 84.0 104.0 7.0
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -

- - - - - -

- 50.0 50.0 (50.0) 60.0 110.0 5.0

- - - - - -
- - - - - -
- - - - - -

200.0 100.0 100.0 200.0 - 240.0 240.0 20.0

- - - - - -
- - - - - -
100.0 50.0 50.0 100.0 - 120.0 120.0 10.0
- - - - - -
- - - - - -
- - - - - -
200.0 100.0 50.0 150.0 50.0 180.0 130.0 15.0
- - - - - -

- - - - - -
- - - - - -
- - - - - -
200.0 100.0 100.0 200.0 - 240.0 240.0 20.0
- 50.0 50.0 (50.0) 60.0 110.0 5.0

- - - - - -

- - - - - -
6.0 2.0 3.0 5.0 1.0 6.0 5.0 0.5
- - - - - -
90.0 90.0 100.0 190.0 (100.0) 228.0 328.0 19.0
- - - - - -

- - - - - -
- - - - - -
- 50.0 50.0 (50.0) 60.0 110.0 5.0

- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- 50.0 50.0 (50.0) 60.0 110.0 5.0
- - - - - -
- - - - - -
- - - - - -
- 50.0 50.0 (50.0) 60.0 110.0 5.0
- - - - - -
- 50.0 50.0 (50.0) 60.0 110.0 5.0
 - - - - - -
- - - - - -

- - - - - -
- - - - - -
- - - - - -
- - - - - -
70.0 20.0 70.0 90.0 (20.0) 108.0 128.0 9.0
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- 50.0 50.0 (50.0) 60.0 110.0 5.0
- - - - - -
- - - - - -
- - - - - -
- - - - - -

- 100.0 100.0 (100.0) 120.0 220.0 10.0

- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -

- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- 3.0 3.0 (3.0) 3.6 6.6 0.3
- - - - - -
- - - - - -
- - - - - -
- - - - - -

- - - - - -
- - - - - -
- - - - - -
- - - - - -

- - - - - -
- - - - - -
- - - - - -

- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
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- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
 3.0 6.0 6.0 (3.0) 7.2 10.2 0.6
40.0 10.0 15.0 25.0 15.0 30.0 15.0 2.5
- - - - - -
- - - - - -

- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
3.0 3.0

- - - - - -
- - - - - -

- - - - - -
2.0 3.0 3.0 (1.0) 3.6 4.6 0.3
- - - - - -

4.0 1.0 2.0 3.0 1.0 3.6 2.6 0.3

- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
2.0 2.0 2.0 - 2.4 2.4 0.2
- - - - - -
- - - - - -
- - - - - -
- - - - - -
14.0 8.0 5.0 13.0 1.0 15.6 14.6 1.3
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
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13.0 5.0 5.0 10.0 3.0 12.0 9.0 1.0
- - - - - -
- - - - - -
 - - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -

- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
3.0 2.0 5.0 7.0 (4.0) 8.4 12.4 0.7
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
10.0 5.0 5.0 10.0 - 12.0 12.0 1.0
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -

- - - - - -
- - - - - -
3.0 3.0 3.0 - 3.6 3.6 0.3
- - - - - -
- - - - - -

- 5.0 5.0 (5.0) 6.0 11.0 0.5

- - - - - -

- - - - - -
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- 100 100.0 (100.0) 120.0 220.0 10.0
- 100 100.0 (100.0) 120.0 220.0 10.0
- 100 100.0 (100.0) 120.0 220.0 10.0
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