Harian Februari

BUKU HARIAN R. FARMASI BULAN FEBRUARI 2019 TANGGAL ………………………………………….
No Nama Obat Satuan Pemakaian Obat Resep ke-

Jumlah 1
1 Albendazol Tablet 400 mg Tablet -
2 Alopurinol Tablet 100 mg Tablet -
3 Aminofilin Inj 24 mg/ml-10 ml Ampul -
4 Aminofilin Tablet 200 mg Tablet -
5 Amitriptilina HCl Tablet salut 25 mg Tablet -
6 Amlodipin Tablet 5 mg Tablet -
7 Amoksisilin Kaplet 500 mg Kaplet 90 5
8 Amoksisilin Sirup Kering 125 mg/5 ml Botol 5 3
9 Antasida DOEN I Tablet Kunyah Tablet 30 10
10 Antasida II Suspensi 60 ml Botol 1 1
11 Anti Hemmoroid DOEN Supp 5 5
12 Antibakteri DOEN Tube 1 1
13 Antifungi DOEN kombinasi Pot -
14 Antimigren DOEN Tablet -
15 Aqua Pro Inj steril bebas pirogen- 20 ml Vial -
16 ARV: Efavirenz 600 mg Tablet -
17 ARV: Lamivudine 150 mg Tablet -
18 ARV: Lovinapir 200 mg Ronavir Tablet -
19 ARV: Nevirapine 200 mg Tube -
20 ARV: TDF(300) + 3TC(300) + EFV(600) Tablet -
21 ARV: Tenofovir 300 mg Tablet -
22 ARV: Zdvdn(60) + Lmvdn(30) + Nvrpn(50) Ampul -
23 ARV: Zidovudine(300) + Lamivudine(150) Tablet -
24 Asam Asetilsalisilat Tablet 80 mg (Asetosal) Vial -
25 Asam Askorbat (VIT C) Tablet 50 mg Tube 10 10
26 Asam Folat Tablet 0,4 mg Tablet -
27 Asam Mefenamat kaplet 500 mg Paket 10 10
28 Asiklovir Krim 5%/5g Ampul -
29 Asiklovir Tablet 400 mg Tablet -
30 Atapulgit Tablet 600 mg Tablet 10 10
31 Atropin Sulfat Inj 0,25 mg/ml Botol -
32 Azithromisin Tablet 500 mg Botol -
33 Benzatin Benzil Penisilin Inj 2,4 juta IU/vial Vial -
34 Betahistin Tablet 6 mg Ampul -
35 Betametason Krim 0.1 % tube 1 1
36 Bisoprolol Tablet 5 mg tube -
37 Bromheksin Tablet 8 mg Tablet -
38 Clobazam Tablet 10 mg Ampul -
39 Clozapine Tablet 25 mg Tablet -
40 Dehidroartemisin 40 mg + Piperaquin 320 mg Tablet -
41 Deksametason Inj 5 mg/ml-1 ml Tablet 5 5
42 Deksametason Tablet 0,5 mg Botol 45 5
43 Dekstrometorfan Tablet kombinasi Tablet 60 10
44 Dektrometorfan Sirup kombinasi Botol 5 5
45 Devitalisasi Pasta Ampul -
46 Dextrose Inj 40% Kapsul -
47 Diazepam Inj 5 mg/ml-2 ml Botol -
48 Diazepam Rectal 5 mg/2,5 ml Botol -
49 Diazepam Tablet 2 mg Botol -
50 Difenhidramin Inj 10 mg/ml Botol 5 5
51 Digoksin Tablet 0,25 mg Botol -
52 Dimenhidrinat Tablet 50 mg Kapsul -
53 Doksisilin Tablet 100 mg Tablet -
54 Domperidon Suspensi 5mg/5ml Tablet -
55 Domperidon Tablet 10 mg Tablet -
56 Endometason Ampul -
57 Epinefrina HCl/Bitartrat (Adrenalin) Inj 0,1 % Tablet -
58 Eritromisin Kapsul 250 mg Ampul -
59 Eritromisin Kapsul 500 mg Botol -
60 Eritromisin Sirup 200 mg/5 ml Tablet -
61 Etakridin Larutan 0,1 % Sachet -
62 Etanol 70 %- 1000 ml Vial -
63 Etil Klorida Spray Tube -
64 Eugenol Cairan Botol -
65 Fenitoin Natrium Kapsul 100 mg Botol -
66 Fenobarbital Tablet 30 mg Tablet -
67 Fenoksimetil Penisilin Tablet 500 mg Tablet -
68 Fitomenadion (Vit K1) Tablet Salut Gula 10 mg Fls -
69 Fitomenadion(Vit K1) Inj 2 mg/ml Tablet -
70 Fluconazol Tablet 150 mg Tablet -
71 Flufenazin Inj im 25 mg/ml (Sikzonoate) Tablet -
72 Formokresol Cair Tube -
73 Furosemid Tablet 40 mg Tablet -
74 Garam Oralit I Serbuk Set 10 10
75 Gentamisin Inj 40 mg/ml (Sulfat) Tablet -
76 Gentamisin Salep Kulit 0,1% Tablet -
77 Glass Ionomer Cement Tablet -
78 Glibenklamid Tablet 5 mg Ampul -
79 Gliseril Guaiakolat Tablet 100 mg Botol 35 5
80 Glukosa Larutan Infus 5% steril Tablet -
81 Griseofulvin Tablet 125 mg Micronized Tablet -
82 Haloperidol 5 mg Tablet -
83 Haloperidol Dekanoat Inj 50 mg/ml Botol -
84 Haloperidol Inj 5 mg/ml Tablet -
85 Haloperidol Tablet 1,5 mg Tablet -
86 Hidrokortison Krim 2,5 % Ampul -
87 Hiosina butilbromida tab 10 mg Tablet -
88 Human Tetanus Imunoglobulin Im 250UI (Tetagam) Tablet -
89 Ibuprofen Tablet 400 mg Kapsul -
90 Isoniazid Tablet 100 mg Kapsul -
91 Isosorbid Dinitrat Tablet Sublingual 5 mg Tube -
92 Kalsium glukonat inj 100 mg/ml Tube -
93 Kalsium hidroksida pasta Botol -
94 Kalsium Laktat (Kalk) Tablet 500 mg Botol -
95 Kaptropil Tablet 25 mg Tube -
96 Karbamazepin Tablet 200 mg Tablet -
97 Karbogliserin Tetes Telinga 10 % Tablet -
98 Karbon aktif tab 0,5 mg Botol -
99 Ketokonazol Tablet 200 mg Tablet -
100 Ketoprofen Supp 100 mg Ampul -
101 Kina Inj 26 % 2 ml Botol -
102 Kina Tablet 222 mg Tablet -
103 Klindanmisin Tablet 300 mg Ampul -
104 Kloramfenikol Kapsul 250 mg Ampul -
105 Kloramfenikol Kapsul 500 mg Blister -
106 Kloramfenikol Salep Kulit 2% Blister -
107 Kloramfenikol Salep Mata 1 % Tablet -
108 Kloramfenikol Sirup 125 mg/5 ml Ampul -
109 Kloramfenikol Tetes Mata 0.5% Tablet -
110 Kloramfenikol Tetes telinga 3 % Tablet -
111 Klorfenarimin Maleat (CTM) Tablet 4 mg Tablet 30 5
112 Klorpropmazin HCl Tablet salut 100 mg Tube -
113 Kotrimoksazol Susp:Sulf 200+Trim 40 mg/5 ml Sachet 5 5
114 Kotrimoksazol Tab Dws:Sulf 400+Trim 80 mg Botol -
115 Lidokain Inj Komp : Lidokain %+ Epinefrin 1 : 80000-2 Botol -
116 Lidokain Jelly 2 % Kaplet -
117 Lidokain Spray 10 % Kapsul -
118 Lisol Tablet -
119 Loratadin Tablet 10 mg Tablet 5 5
120 Magnesium sulfat Inj (IV) 20 % Botol -
121 Magnesium sulfat Inj (IV) 40 % Fls -
122 MB Anak Tablet -
123 MB Dewasa Tablet -
124 Metformin HCl Tablet 500 mg Tablet -
125 Metildopa Tablet 250 mg Paket -
126 Metilergomatrin Maleat Inj 0,200 mg Paket -
127 Metilergometrin Maleat (Metilergometrin) Tablet Salut paket -
128 Metilprednisolon Tablet 4 mg Paket 20 10
129 Metronidazol Tablet 500 mg paket -
130 Mikonazol Krim/Salep 2% Botol -
131 Mineral Mix Tube -
132 Monoklorkamfer mentol cairan Tube -
133 Multivitamin + DHA + Lysin Sirup Ampul 2 2
134 Multivitamin + Mineral Kaplet Kapsul -
135 N-asetil sistein kaps 200 mg Ampul -
136 Natrium Bikarbonat Tablet 500 mg Botol -
137 Natrium Diklofenak Tablet 50 mg Tablet -
138 Natrium Hipoklorit 3% Blister -
139 Natrium Klorida Larutan Infus 0,9% Blister -
140 Natrium Tiroksin Tablet 100 µg Tube -
141 Nipedipin Tablet 10 mg Tablet -
142 Nistatin Tablet Salut Gula 500.000 IU/g Botol -
143 Nistatin Tablet Vaginal 100.000 IU/g Botol -
144 OAT FDC Katagori 1 Tablet -
146 OAT FDC Kategori Anak Tablet -
147 OAT FDC Kategori Sisipan Tablet -
148 OAT Kombipak Kat I Ampul -
149 Obat Batuk Hitam (OBH) Cairan Tablet 6 1
150 Oksitosin Inj 10 IU/ml- 1 ml Tablet -
151 Omeprazol Kapsul 20 mg Kapsul -
152 Ondansetron Inj 4 mg/2 ml Kapsul -
153 Parasetamol Sirup 120 mg / 5ml Fls 7 2
154 Parasetamol Tablet 500 mg Ampul 90 10
155 PB Anak Tablet -
156 PB Dewasa Pot -
157 Permetrin 5% Krim (Scabimite) Kotak -
158 Phenolphtalein, Paraffin Liquidum, Gliserin Sirup (Laxad Botol -
159 Piridoksin HCl (Vit B6) Tablet 10 mg Kapsul 20 10
160 Pirimetamin Tablet 25 mg Paket -
161 Polikresulen (Albotyl) Botol 5 ml Vial -
162 Povidon Iodida 10 %-30 ml Vial -
163 Povidon Iodida 10 %-300 ml Botol -
164 Prednison Tablet 5 mg Ampul -
165 Primakuin Tablet 15 mg Vial -
166 Prokain Benzilpenisilin Serb Inj 3 juta UI/vial (i.m.) Ampul -
167 Propanolol HCl Tablet 40 mg Tablet -
168 Propiltiourasil Tablet 100 mg Kaplet -
169 Ranitidin Inj 25 mg/ml Tablet -
170 Ranitidin Tablet 150 mg Botol 22 6
171 Retinol (Vit A) Kapsul 100.000 IU Kapsul -
172 Retinol (VIT A) Kapsul 200.000 IU Ampul -
173 Ringer Laktat Larutan Infus Steril Tablet -
174 Risperidon Tablet 2 mg Tablet -
175 Salbutamol Nebu 2,5 mg/2,5 ml NaCl Set -
176 Salbutamol Tablet 4 mg Set -
177 Salep 2-4 kombinasi : as.asal 2 % + Bel. 4 % Vial 2 1
178 Salisil Bedak 2 % Vial -
179 Sefadroksil Sirup 125 mg/5 ml Set -
180 Sefadroxil Kapsul 500 mg Vial 5 5
181 Sefiksime 200 mg + Azitromisin 500 mg Vial -
182 Sefotaksim Inj 1 g Vial -
183 Seftriaxon Inj 1 g Paket -
184 Semen seng fosfat serbuk cairan Vial -
185 Serum Anti Difteri (ADS) Vial -
186 Serum anti tetanus Inj 1500 IU/vial (ATS) Set -
187 Serum antibisa ular Polivalen Inj 5 ml (SABU) I Set -
188 Setirizin Sirup 5 mg/5 ml Set -
189 Sianokobalamin (Vit B12 ) Inj 500 mcg/ml Vial -
190 Simvastatin Tablet 10 mg Tablet -
191 Siprofloksasin (HCl) Tablet 500 mg Tablet -
- Tablet Tambah Darah (Camabion) 0 -
192 Tablet Tambah Darah Kombinasi Buah -
193 Temporary Restorative Material Buah -
194 Tetrasiklin Kapsul 500 mg Buah 6 3
195 Tiamin HCL (Vit B1) Tablet 50 mg Set -
196 Triheksifenidil HCl Tablet 2 mg Set -
197 Vaksin BCG + Pelarut Set -
198 Vaksin DPT-Hb-Hib Buah -
199 Vaksin DT Buah -
200 Vaksin Hb-0 Buah -
201 Vaksin IPV 10 ds Buah -
202 Vaksin IPV 5 ds Set -
203 Vaksin Measles Rubella (MR) Set -
204 Vaksin Meningitis Buah -
205 Vaksin Papillomavirus (HPV) Buah -
206 Vaksin Pneumococcus Buah -
207 Vaksin Polio 10 ds bopv + Penetes Buah -
208 Vaksin Rabies Vero Kantong -
209 Vaksin Td Kantong -
210 Vitamin B Kompleks Tablet Set -
211 Zinc Tablet 20 mg Set -
212 BAHAN HABIS PAKAI Set -
213 ADS 0.05 ml Set -
214 ADS 0.5 ml Buah -
215 ADS 5 ml Buah -
216 Alat Suntik Sekali Pakai 1ml Buah -
217 Alat Suntik Sekali Pakai 3 ml Buah -
218 Alat Suntik Sekali Pakai 5 ml Roll -
219 Alkohol Swab Roll -
220 Bisturi Lembar -
221 Blood set Roll -
222 Catgut/Benang Bedah No.2/0 dengan jarum bedah Roll -
224 Folley Catheter No.18 Buah -
225 Infusion set anak Buah -
226 Infusion set dewasa Buah -
227 IV Catheter No.18 Buah -
228 IV Catheter No.20 Roll -
229 IV Catheter No.22 Lembar -
231 Jarum kulit Lembar -
232 Jarum otot Buah -
233 Kaca Slide Buah -
234 Kantung mayat Buah -
235 Kapas Pembalut/absorben 250 mg Buah -
236 Kasa Hidrofil 2x80 Buah -
237 Kasa Hidrofil Steril 16 X 16 Set -
238 Kasa Pembalut Hidrofil 4 X 10 cm Set -
239 Kasa Pembalut hidrofil 4 x 5 cm Set -
240 Kassa Pembalut elastic 4 inchi Buah -
241 Masker Tie on Set -
242 Masker N-95 Buah -
243 Plester 5 yard x 2 inch Buah -
244 Polybag Medis Buah -
245 Polybag Nonmedis Buah -
246 Polybag Ramah Lingkungan Buah -
- Pot Dahak 0 -
247 Safety box Tablet -
248 Sarung Tangan Non Steril Uk.S Kg -
249 Sarung Tangan Non Steril Uk.M Sachet -
250 Sarung Tangan Non Steril Uk.L Sachet -
- Sarung Tangan Steril No.6 0 -
251 Sarung Tangan Steril No.6,5 Set -
252 Sarung Tangan Steril No.7 Set -
253 Sendok Obat Bedah Sutera) No.2/0 Dengan Jarum
Silk (Benang Set -
254 Bedah Kotak -
255 Urin Bag Kotak -
256 REAGEN Botol -
257 Cybow 10 Reagent Strip Botol -
258 Golongan darah anti A - 10 ml Botol -
259 Golongan darah anti A-B - 10 ml Botol -
260 Golongan darah anti B - 10 ml Botol -
261 Humasens Plus Sachet -
262 Humasens Plus Strip Uric Acid Sachet -
263 Humasens Strip Glucose Sachet -
264 Humasens Strip Kolesterol Sachet -
265 Iodin test Sachet -
266 Larutan Asam Asetat 6% 100 ml Sachet -
267 Larutan Benedict 100 ml Sachet -
268 Larutan EDTA 10 % 100 ml Sachet -
269 Larutan HCl 0,1 N 100 ml Sachet -
- Larutan Natrium Citrat 3,13 % 0 -
270 Larutan Rees Ecker 100 ml Tablet -
271 Larutan Turk 100 ml Botol -
- Larutan Ziehl Neelsen 0 -
- Rapid HIV 1/2 Device 0 -
- Rapid HIV 2 Fokus 0 -
- Rapid HIV Biomedika 0 -
- Rapid HIV Biomeriux 0 -
- Rapid HIV Intec 0 -
- Rapid HIV Oncoprobe 0 -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- Rapid Syphilis SD 0 -
- Reagen CD4 kontrol 0 -
- Reagen CD4 tipe 1 (Alere Pima CD4) 0 -
- RPR Syphilis 0 -
- Salmonella Thyphi H - 5 ml 0 -
- Salmonella Thyphi O - 5 ml 0 -
- Test Kehamilan 0 -
- LAIN-LAIN 0 -
- penobarbital injk 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
- Nipedipin 10 mg 0 -
- Lidocain Jelly 2 % 0 -
- Lidocain Spray 10 % 0 -
- Betahistin 6 mg 0 -
- DBS collection kit 0 -
- Phenolphtalein, paraffin liquidum, gliserin syr (laxadin syr) 0 -
- Polikresulen ( Albotyl) 5 ml 0 -
- Haloperidol inj 5 mg/ml 0 -
- Haloperidol dekanoat inj 50 mg/ml 0 -
- Clozapine 25 mg 0 -
Clobazam 10 mg
Larutan Rees Ecker 100 ml
Larutan Natrium Citrat 3 - 13 %
Larutan Turk 100 ml
Larutan EDTA 10 % 100 ml
Antifdifteri
Pirimethamin
Amoksisilin forte sirup Kering 250 mg/5 ml
Amoksisilin Kaplet 250 mg
Antalgin (Metampiron) Tablet 500 mg
Benechek Plus Uric tes strip 25
Benechek Plus glucosa test srip 50
Benechek Plus total Cholesterol strip 10
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
Metronidazol tablet 250 mg
metylprednison 8 mg
Omeprazol inj
Piracetam Tablet 1200 mg
Salbutamol 2mg
Tiamfenikol Kapsul 500 mg
Tramadol Inj 50 mg/ml
Tramadol Kapsul 50 mg
Vaksin TT
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
10 10 5 10 10 10 10 10 10
1 1
10 10
10 10 10 10
50
10 10 10
5 10 10
10
5
3 1 1
10 5 10 10 5 10 10 10 10
10
6 10
1
3
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
BUKU HARIAN R. FARMASI BULAN ………………………………………………….. TANGGAL ………………………………………….
Jumlah 1
6 Amlodipin Tablet 5 mg Tablet 5 5
9 Antasida DOEN I Tablet Kunyah Tablet -
10 Antasida II Suspensi 60 ml Botol -
11 Anti Hemmoroid DOEN Supp -
25 Asam Askorbat (VIT C) Tablet 50 mg Tube -
30 Atapulgit Tablet 600 mg Tablet -
35 Betametason Krim 0.1 % tube -
41 Deksametason Inj 5 mg/ml-1 ml Tablet -
42 Deksametason Tablet 0,5 mg Botol -
43 Dekstrometorfan Tablet kombinasi Tablet -
44 Dektrometorfan Sirup kombinasi Botol -
50 Difenhidramin Inj 10 mg/ml Botol -
74 Garam Oralit I Serbuk Set -
89 Ibuprofen Tablet 400 mg Kapsul 10 10
95 Kaptropil Tablet 25 mg Tube 10 10
109 Kloramfenikol Tetes Mata 0.5% Tablet 1 1
118 Lisol Tablet -
128 Metilprednisolon Tablet 4 mg Paket -
130 Mikonazol Krim/Salep 2% Botol 1 1
133 Multivitamin + DHA + Lysin Sirup Ampul -
149 Obat Batuk Hitam (OBH) Cairan Tablet -
156 PB Dewasa Pot -
177 Salep 2-4 kombinasi : as.asal 2 % + Bel. 4 % Vial -
180 Sefadroxil Kapsul 500 mg Vial -
194 Tetrasiklin Kapsul 500 mg Buah -
195 Tiamin HCL (Vit B1) Tablet 50 mg Set 30 10
211 Zinc Tablet 20 mg Set 10 10
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
1
2 2
2 2 10
1
1 1 1 1
10 10
10 10
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
7 Amoksisilin Kaplet 500 mg Kaplet -
8 Amoksisilin Sirup Kering 125 mg/5 ml Botol -
12 Antibakteri DOEN Tube -
27 Asam Mefenamat kaplet 500 mg Paket -
79 Gliseril Guaiakolat Tablet 100 mg Botol -
111 Klorfenarimin Maleat (CTM) Tablet 4 mg Tablet -
113 Kotrimoksazol Susp:Sulf 200+Trim 40 mg/5 ml Sachet -
118 Lisol Tablet -
119 Loratadin Tablet 10 mg Tablet -
153 Parasetamol Sirup 120 mg / 5ml Fls -
154 Parasetamol Tablet 500 mg Ampul -
156 PB Dewasa Pot -
159 Piridoksin HCl (Vit B6) Tablet 10 mg Kapsul -
170 Ranitidin Tablet 150 mg Botol -
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
26 Asam Folat Tablet 0,4 mg Tablet 10 10
37 Bromheksin Tablet 8 mg Tablet 10 10
94 Kalsium Laktat (Kalk) Tablet 500 mg Botol 30 10
113 Kotrimoksazol Susp:Sulf 200+Trim 40 mg/5 ml Botol -
114 Kotrimoksazol Tab Dws:Sulf 400+Trim 80 mg Tablet 10 10
118 Lisol Tablet -
124 Metformin HCl Tablet 500 mg Tablet 10 10
134 Multivitamin + Mineral Kaplet Kapsul 10 10
152 Ondansetron Inj 4 mg/2 ml Kapsul 14 4
156 PB Dewasa Pot -
157 Permetrin 5% Krim (Scabimite) Kotak 1 1
169 Ranitidin Inj 25 mg/ml Tablet 23 4
191 Siprofloksasin (HCl) Tablet 500 mg Tablet 10 10
192 Tablet Tambah Darah Kombinasi Buah 30 30
210 Vitamin B Kompleks Tablet Set 10 10
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
217 Alat Suntik Sekali Pakai 3 ml Buah 20 20
228 IV Catheter No.20 Roll 6 6
229 IV Catheter No.22 Lembar 6 6
231 Jarum kulit Lembar 4 4
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak 4 4
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
10 10 10 10 6 10 10 10
1 1
10 10
5 3
4 10
10 10 10
2 10
10 10
10 10
5
10 3 4 2 10
10
10
1 2 1 1 1
10 10 10 10 10 10
10
4 15
10 10 10 10 10
10
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
118 Lisol Tablet -
156 PB Dewasa Pot -
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
- Clobazam 10 mg
- Larutan Rees Ecker 100 ml
- Larutan Natrium Citrat 3 - 13 %
- Larutan Turk 100 ml
- Larutan EDTA 10 % 100 ml
- Antifdifteri
- Pirimethamin
- Amoksisilin forte sirup Kering 250 mg/5 ml
- Amoksisilin Kaplet 250 mg
- Antalgin (Metampiron) Tablet 500 mg
- Benechek Plus Uric tes strip 25
- Benechek Plus glucosa test srip 50
- Benechek Plus total Cholesterol strip 10
- Etanol 70 %- 100 ml
- HB Stik Accon
- HCT Tablet 25 mg
- Lidokain Inj 2%
- Metronidazol sirup
- Metronidazol tablet 250 mg
- metylprednison 8 mg
- Omeprazol inj
- Piracetam Tablet 1200 mg
- Salbutamol 2mg
- Tiamfenikol Kapsul 500 mg
- Tramadol Inj 50 mg/ml
- Tramadol Kapsul 50 mg
- Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
76 Gentamisin Salep Kulit 0,1% Tablet 2 1
118 Lisol Tablet -
156 PB Dewasa Pot -
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
10
10 10 10 10
10
10
1
10
1
1 1 1 1
10 10 10 10 10
10 10
10 10 10
10
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Supp
Jumlah 1
6 Amlodipin Tablet 5 mg Tablet 10 10
118 Lisol Tablet -
156 PB Dewasa Pot -
178 Salisil Bedak 2 % Vial 1 1
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
10 10 10
1
10 10
10 10
6 10
5
10
5 10 10 10 10 10
10
10 10 100 10 10 10 10 10 10
10 10
10 10
10
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
118 Lisol Tablet -
156 PB Dewasa Pot -
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
118 Lisol Tablet -
156 PB Dewasa Pot -
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
118 Lisol Tablet -
127 Metilergometrin Maleat (Metilergometrin) Tablet Salut paket 10 10
137 Natrium Diklofenak Tablet 50 mg Tablet 30 10
151 Omeprazol Kapsul 20 mg Kapsul 10 10
156 PB Dewasa Pot -
177 Salep 2-4 kombinasi : as.asal 2 % + Bel. 4 % Vial 1
188 Setirizin Sirup 5 mg/5 ml Set 2 1
194 Tetrasiklin Kapsul 500 mg Buah 10
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
10 10 10 10
1
10 10
1
10
10 10
1 1
10 6
10 5
10 10
1 1
1 1 1 1
10 20 20 10 10 10 10 10 10 10
10 10 10
6 10 10 10 10 10 10 6
1
1
10 10
10
10 10 10
10 10
12 13 14 15 16 17 18 19 20 21
10 10
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
26 Asam Folat Tablet 0,4 mg Tablet 1,000 1,000
34 Betahistin Tablet 6 mg Ampul 10 10
65 Fenitoin Natrium Kapsul 100 mg Botol 30 30
68 Fitomenadion (Vit K1) Tablet Salut Gula 10 mg Fls 10 10
114 Kotrimoksazol Tab Dws:Sulf 400+Trim 80 mg Botol 10 10
118 Lisol Tablet -
126 Metilergomatrin Maleat Inj 0,200 mg Paket 10 10
127 Metilergometrin Maleat (Metilergometrin) Tablet Salut paket 10 10
156 PB Dewasa Pot -
163 Povidon Iodida 10 %-300 ml Botol 1 1
164 Prednison Tablet 5 mg Ampul 10 10
179 Sefadroksil Sirup 125 mg/5 ml Set 1 1
190 Simvastatin Tablet 10 mg Tablet 10 10
192 Tablet Tambah Darah Kombinasi Buah 1,000 1,000
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
10 10 10 10
1
1
10
5
10
1
1
1 1 1 1 1
10 10 10 10 10 10 10 10
10 10 10
10
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
69 Fitomenadion(Vit K1) Inj 2 mg/ml Tablet 2 2
118 Lisol Tablet -
132 Monoklorkamfer mentol cairan Tube 1 1
133 Multivitamin + DHA + Lysin Sirup Ampul 1
156 PB Dewasa Pot -
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
243 Plester 5 yard x 2 inch Buah 1 1
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
6
1 1 1 1 1 1
10 10 3
10 3 10
10 10
1
10
1 1
1 1 1 1 1 1 1 1
19 10 10 10 10 6
10 10
10
10 10
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
52 Dimenhidrinat Tablet 50 mg Kapsul 10 10
55 Domperidon Tablet 10 mg Tablet 6 6
86 Hidrokortison Krim 2,5 % Ampul 1 1
118 Lisol Tablet -
129 Metronidazol Tablet 500 mg paket 10 10
136 Natrium Bikarbonat Tablet 500 mg Botol 10 10
156 PB Dewasa Pot -
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
224 Folley Catheter No.18 Buah 1
225 Infusion set anak Buah 5 5
- Pot Dahak 0 -
248 Sarung Tangan Non Steril Uk.S Kg 100 100
Silk (Benang Set -
254 Bedah Kotak -
255 Urin Bag Kotak 2
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
10 10
10
10
3 10
10
10
10
1 1
10
10
1 1 1
10 10 6 10
10 10 10
10
10
1
1 1
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
13 Antifungi DOEN kombinasi Pot 1 1
54 Domperidon Suspensi 5mg/5ml Tablet 1 1
68 Fitomenadion (Vit K1) Tablet Salut Gula 10 mg Fls 10 10
118 Lisol Tablet -
149 Obat Batuk Hitam (OBH) Cairan Tablet 1
156 PB Dewasa Pot -
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
10 10 10 10
10
10 10
1
10
1
10 10 10 10 10 10 10
10 10 10
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
106 Kloramfenikol Salep Kulit 2% Blister 1 1
107 Kloramfenikol Salep Mata 1 % Tablet 1 1
118 Lisol Tablet -
156 PB Dewasa Pot -
173 Ringer Laktat Larutan Infus Steril Tablet 3 3
176 Salbutamol Tablet 4 mg Set 20 10
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
226 Infusion set dewasa Buah 1 1
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
10 10 10 10 10
5
10
10 10
10
10
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
115 Lidokain Inj Komp : Lidokain %+ Epinefrin 1 : 80000-2 Botol 5 5
118 Lisol Tablet -
156 PB Dewasa Pot -
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
1
10
6
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
55 Domperidon Tablet 10 mg Tablet 1
118 Lisol Tablet -
156 PB Dewasa Pot -
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
10 10 10 10 5 10
10 10
1 1
10
10 10
1
5 10 10
1
10
10
2 1 1 1
10
1 1 1 1 1
10 10 10 10 10 10 10 10
10 6 10 10
10 2 10 10 20
10 10
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
118 Lisol Tablet -
156 PB Dewasa Pot -
174 Risperidon Tablet 2 mg Tablet 28 14
196 Triheksifenidil HCl Tablet 2 mg Set 14 7
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
10 10 10 10 10 10 10 10 10 10
1 1 1 1 1
10 10
10
10 10
10 10
10 10 10
10
10
10 10 10 10 10 10
10
1
1 1 1 1 1 1 1
10 10 10 20 10 10 10 10 10 10
15
10 10 10 10
14
7
10 10 10
12 13 14 15 16 17 18 19 20 21
10
10 10 10 10 10
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
118 Lisol Tablet -
136 Natrium Bikarbonat Tablet 500 mg Botol 10 10
156 PB Dewasa Pot -
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
10 10 10 10 10 10 10 10
10 10 10 10 10
10 10
10 10
10 10 10
1 1
1 1
10 10 10 10 10 10 10 10 10 10
10 10
10
1 1
10
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
9 Antasida DOEN I Tablet Kunyah Tablet 1,060 1,000
28 Asiklovir Krim 5%/5g Ampul 10 10
54 Domperidon Suspensi 5mg/5ml Tablet 5 5
61 Etakridin Larutan 0,1 % Sachet 1 1
62 Etanol 70 %- 1000 ml Vial 1 1
69 Fitomenadion(Vit K1) Inj 2 mg/ml Tablet 10 10
110 Kloramfenikol Tetes telinga 3 % Tablet 7 7
118 Lisol Tablet -
139 Natrium Klorida Larutan Infus 0,9% Blister 7 7
151 Omeprazol Kapsul 20 mg Kapsul 90 90
156 PB Dewasa Pot -
179 Sefadroksil Sirup 125 mg/5 ml Set 10 10
190 Simvastatin Tablet 10 mg Tablet 60 60
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
220 Bisturi Lembar 2 2
222 Catgut/Benang Bedah No.2/0 dengan jarum bedah Roll 5 5
237 Kasa Hidrofil Steril 16 X 16 Set 3 3
238 Kasa Pembalut Hidrofil 4 X 10 cm Set 10 10
- Pot Dahak 0 -
248 Sarung Tangan Non Steril Uk.S Kg 100 100
Silk (Benang Set -
254 Bedah Kotak 6 6
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
10 10 10 10 10
1 1 1 1 1
10 10 10 10 10 10
1
10 10
1 1
10 10 10
1
10
10 10
10 10
1 1
5 10 10 10
1 1
10 10
10 10 10
1
1 1 1 1 1
10 10 10 10 10 10 10 10 10 10
10 10 10
10
10 10 10
12 13 14 15 16 17 18 19 20 21
10
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
118 Lisol Tablet -
156 PB Dewasa Pot -
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
118 Lisol Tablet -
156 PB Dewasa Pot -
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
200
10 400
1 5
200
10 200
10
1 1 1
10 10 10 10 10 10 400
10
10
10
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
118 Lisol Tablet -
156 PB Dewasa Pot -
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
1 Albendazol Tablet 400 mg Tablet 1 1
15 Aqua Pro Inj steril bebas pirogen- 20 ml Vial 10 10
24 Asam Asetilsalisilat Tablet 80 mg (Asetosal) Vial 10 10
51 Digoksin Tablet 0,25 mg Botol 10 10
61 Etakridin Larutan 0,1 % Sachet 2 1
62 Etanol 70 %- 1000 ml Vial 1 1
73 Furosemid Tablet 40 mg Tablet 10 10
118 Lisol Tablet -
125 Metildopa Tablet 250 mg Paket 10 10
129 Metronidazol Tablet 500 mg paket 10 10
150 Oksitosin Inj 10 IU/ml- 1 ml Tablet 1 1
156 PB Dewasa Pot -
175 Salbutamol Nebu 2,5 mg/2,5 ml NaCl Set 2 2
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
216 Alat Suntik Sekali Pakai 1ml Buah 10 10
218 Alat Suntik Sekali Pakai 5 ml Roll 20 20
219 Alkohol Swab Roll 100 100
225 Infusion set anak Buah 5 5
237 Kasa Hidrofil Steril 16 X 16 Set 10 10
238 Kasa Pembalut Hidrofil 4 X 10 cm Set 10 10
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak 2 2
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
10 20 10 20 10 10 10 10 10 10
1 1 1 1
10
1 1 2
10 10 10
10 10
1 1 1
3 3 10
10 10
1 1 1 1 1 1 1 1
10 3 10 20 20 20 10 10 10 6
10
10 10 6 10 10 10 10
1
1 1 1 1 1 1
5 5 5
1 1 1 1 1 1 2 1
20 20 20 20 20 20 20 20 20 20
15 10 10 10
10 10
5 8
10 20 6 10 10 10 10 6 10
20
1 1
1
10 10 10 10 10
10
20
10
12 13 14 15 16 17 18 19 20 21
10 10 5
10 6 10 10 10 10 10 10 10 10
10 10 10 10 10 10 10 10 10 10
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
118 Lisol Tablet -
156 PB Dewasa Pot -
163 Povidon Iodida 10 %-300 ml Botol 1
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
237 Kasa Hidrofil Steril 16 X 16 Set 1
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
10 10 10 10
1 1 1
10 10
10 10 10
1
10 10 10 10
5
1 1
10
1 1 1 1
10 10 10 10 10 10 10 10 10 10
10 10 10
10
1
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
49 Diazepam Tablet 2 mg Botol 10 5
105 Kloramfenikol Kapsul 500 mg Blister 10 10
118 Lisol Tablet -
129 Metronidazol Tablet 500 mg paket 10
156 PB Dewasa Pot -
174 Risperidon Tablet 2 mg Tablet 28 14
178 Salisil Bedak 2 % Vial 1
196 Triheksifenidil HCl Tablet 2 mg Set 14 7
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
10 10 10 10 10 10
10
1 1
10 10
5
1
10 10 10
10
10
10 10 10 10 10
10 10 10
14
1
10
7
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
10 Antasida II Suspensi 60 ml Botol 1
15 Aqua Pro Inj steril bebas pirogen- 20 ml Vial 10 10
35 Betametason Krim 0.1 % tube 5
44 Dektrometorfan Sirup kombinasi Botol 2
79 Gliseril Guaiakolat Tablet 100 mg Botol 20
86 Hidrokortison Krim 2,5 % Ampul 1
89 Ibuprofen Tablet 400 mg Kapsul 10
99 Ketokonazol Tablet 200 mg Tablet 10
112 Klorpropmazin HCl Tablet salut 100 mg Tube 10 10
115 Lidokain Inj Komp : Lidokain %+ Epinefrin 1 : 80000-2 Botol 10 10
118 Lisol Tablet -
128 Metilprednisolon Tablet 4 mg Paket 10
137 Natrium Diklofenak Tablet 50 mg Tablet 10
141 Nipedipin Tablet 10 mg Tablet 10 10
149 Obat Batuk Hitam (OBH) Cairan Tablet 1
156 PB Dewasa Pot -
159 Piridoksin HCl (Vit B6) Tablet 10 mg Kapsul 10
170 Ranitidin Tablet 150 mg Botol 30
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
216 Alat Suntik Sekali Pakai 1ml Buah 20 20
218 Alat Suntik Sekali Pakai 5 ml Roll 30 30
242 Masker N-95 Buah 100 100
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
10 10 10
1 1 1
10 5 10
1
5
1 1
10 10
1
10
10
10 5 10 10
10
1 1
10
1 1 1
10 5 10 10
10
10 10 10
10 10 10
12 13 14 15 16 17 18 19 20 21
10 10 10 10
1
10 10
1
10 10 10 10 10
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
118 Lisol Tablet -
156 PB Dewasa Pot -
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
118 Lisol Tablet -
156 PB Dewasa Pot -
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
Jumlah 1
118 Lisol Tablet -
156 PB Dewasa Pot -
213 ADS 0.05 ml Set -
215 ADS 5 ml Buah -
- Pot Dahak 0 -
Silk (Benang Set -
254 Bedah Kotak -
256 REAGEN Botol -
- Larutan Ziehl Neelsen Tablet -
- Rapid HIV 1/2 Device Tablet -
- Rapid HIV 2 Fokus Tablet -
- Rapid HIV Biomedika botol -
- Rapid HIV Biomeriux Tablet -
- Rapid HIV Intec Tablet -
- Rapid HIV SD 0 -
- Rapid Malaria 0 -
- RPR Syphilis 0 -
- LAIN-LAIN 0 -
- piracetam 800 0 -
- lidokain 2% 0 -
Clobazam 10 mg
Larutan Turk 100 ml
Antifdifteri
Pirimethamin
Etanol 70 %- 100 ml
HB Stik Accon
HCT Tablet 25 mg
Lidokain Inj 2%
Metronidazol sirup
metylprednison 8 mg
Omeprazol inj
Salbutamol 2mg
Vaksin TT
………………………………………….
n Obat Resep ke-
2 3 4 5 6 7 8 9 10 11
12 13 14 15 16 17 18 19 20 21
22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41
42 43 44 45 46 47 48 49 50 51
52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71
72 73 74 75 76 77 78 79 80 81
82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111
112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131
132 133 134 135 136 137 138 139 140 141
142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161
162 163 164 165 166 167 168 169 170 171
172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191
192 193 194 195 196 197 198 199 200 201
202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221
222 223 224 225 226 227 228 229 230 231
232 233 234 235 236 237 238 239 240 241
242 243 244 245
BUKU HARIAN R. FARMASI BULAN …………………………………………………...
No Nama Obat
JML 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
1
Albendazol Tablet 400 mg 1 - - - - - - - - - - - - - - - - - - - - - - - - 1 - - - - -
2
Alopurinol Tablet 100 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3
Aminofilin Inj 24 mg/ml-10 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4
Aminofilin Tablet 200 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5
Amitriptilina HCl Tablet salut 25 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6
Amlodipin Tablet 5 mg 15 - 5 - - - - - 10 - - - - - - - - - - - - - - - - - - - - - -
7
Amoksisilin Kaplet 500 mg 2,062 90 10 - 86 - 20 70 40 - - 50 50 16 30 50 60 - 65 120 90 650 - 210 - 155 50 70 80 - -
8
Amoksisilin Sirup Kering 125 mg/5 ml 87 5 2 - 3 - 1 4 2 - - 2 2 7 - 1 - 1 1 6 1 35 - - - 5 4 - 5 - -
9
Antasida DOEN I Tablet Kunyah 1,935 30 - - 30 - 50 40 30 - - 30 10 - 10 20 10 - 30 30 60 1,060 - 420 - 20 - 20 35 - -
10
Antasida II Suspensi 60 ml 35 1 - - - - 1 1 - - - 2 2 - - - 10 2 3 - - 2 - 1 - 5 1 3 1 - -
11
Anti Hemmoroid DOEN 5 5 - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
12
Antibakteri DOEN 5 1 2 - - - - - - - - - - 1 - - - - - - - - - - - 1 - - - - -
13
Antifungi DOEN kombinasi 3 - - - - - - - - - - - - - - 1 - - - 1 - - - - - 1 - - - - -
14
Antimigren DOEN - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
15
Aqua Pro Inj steril bebas pirogen- 20 ml 20 - - - - - - - - - - - - - - - - - - - - - - - - 10 - - 10 - -
16
ARV: Efavirenz 600 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
17
ARV: Lamivudine 150 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
18
ARV: Lovinapir 200 mg Ronavir - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
19
ARV: Nevirapine 200 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
20
ARV: TDF(300) + 3TC(300) + EFV(600) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
21
ARV: Tenofovir 300 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
22
ARV: Zdvdn(60) + Lmvdn(30) + Nvrpn(50) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
23
ARV: Zidovudine(300) + Lamivudine(150) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
24
Asam Asetilsalisilat Tablet 80 mg (Asetosal) 10 - - - - - - - - - - - - - - - - - - - - - - - - 10 - - - - -
25
Asam Askorbat (VIT C) Tablet 50 mg 436 10 - - 13 - 10 10 - - - - - 10 - - - - 20 20 10 320 - - - 3 10 - - - -
26
Asam Folat Tablet 0,4 mg 1,070 - - - 10 - - - - - - - 1,000 10 10 - - - 10 - 10 10 - - - - 10 - - - -
27
Asam Mefenamat kaplet 500 mg 474 10 10 - 24 - 10 20 30 - - - 10 10 10 30 - - - - 10 10 - 200 - 40 10 30 10 - -
28
Asiklovir Krim 5%/5g 10 - - - - - - - - - - - - - - - - - - - - 10 - - - - - - - - -
29
Asiklovir Tablet 400 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
30
Atapulgit Tablet 600 mg 30 10 - - - - - - - - - - - - - - - - - 10 - - - - - 10 - - - - -
31
Atropin Sulfat Inj 0,25 mg/ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
32
Azithromisin Tablet 500 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
33
Benzatin Benzil Penisilin Inj 2,4 juta IU/vial - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
34
Betahistin Tablet 6 mg 70 - - - - - - 10 - - - - 10 - 20 10 - - - - 10 - - - - - - - 10 - -
35
Betametason Krim 0.1 % 83 1 - - 1 - 11 10 10 - - 1 - - 1 2 1 - 1 1 1 27 - 7 - 2 1 - 5 - -
36
Bisoprolol Tablet 5 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
37
Bromheksin Tablet 8 mg 265 - - - 10 - - - - - - 20 - - - - 15 - 10 - - 200 - - - 10 - - - - -
38
Clobazam Tablet 10 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
39
Clozapine Tablet 25 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
40
Dehidroartemisin 40 mg + Piperaquin 320 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
41
Deksametason Inj 5 mg/ml-1 ml 60 5 - - 10 - 10 - - - - - - - 5 - - - - - - - - - - 20 - - 10 - -
42
Deksametason Tablet 0,5 mg 417 45 - - 32 - 20 60 26 - - 10 5 33 - - 10 - 30 30 30 40 - - - 30 10 6 - - -
43
Dekstrometorfan Tablet kombinasi 120 60 - - 10 - - - - - - - - 10 20 10 - - - - - 10 - - - - - - - - -
44
Dektrometorfan Sirup kombinasi 20 5 - - - - - 1 - - - - 1 - - 1 1 - 1 1 - 2 - - - 4 1 - 2 - -
45
Devitalisasi Pasta - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
46
Dextrose Inj 40% - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
47
Diazepam Inj 5 mg/ml-2 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
48
Diazepam Rectal 5 mg/2,5 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
49
Diazepam Tablet 2 mg 10 - - - - - - - - - - - - - - - - - - - - - - - - - - 10 - - -
50
Difenhidramin Inj 10 mg/ml 14 5 - - 8 - - - - - - - - - - - - - - 1 - - - - - - - - - - -
51
Digoksin Tablet 0,25 mg 10 - - - - - - - - - - - - - - - - - - - - - - - - 10 - - - - -
52
Dimenhidrinat Tablet 50 mg 10 - - - - - - - - - - - - - 10 - - - - - - - - - - - - - - - -
53
Doksisilin Tablet 100 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
54
Domperidon Suspensi 5mg/5ml 6 - - - - - - - - - - - - - - 1 - - - - - 5 - - - - - - - - -
55
Domperidon Tablet 10 mg 47 - - - - - - - - - - - - - 6 - - - 1 - - 10 - - - - 30 - - - -
56
Endometason - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
57
Epinefrina HCl/Bitartrat (Adrenalin) Inj 0,1 % - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
58
Eritromisin Kapsul 250 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
59
Eritromisin Kapsul 500 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
60
Eritromisin Sirup 200 mg/5 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
61
Etakridin Larutan 0,1 % 4 - - - - - - 1 - - - - - - - - - - - - - 1 - - - 2 - - - - -
62
Etanol 70 %- 1000 ml 2 - - - - - - - - - - - - - - - - - - - - 1 - - - 1 - - - - -
63
Etil Klorida Spray - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
64
Eugenol Cairan - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
65
Fenitoin Natrium Kapsul 100 mg 30 - - - - - - - - - - - 30 - - - - - - - - - - - - - - - - - -
66
Fenobarbital Tablet 30 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
67
Fenoksimetil Penisilin Tablet 500 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
68
Fitomenadion (Vit K1) Tablet Salut Gula 10 mg 20 - - - - - - - - - - - 10 - - 10 - - - - - - - - - - - - - - -
69
Fitomenadion(Vit K1) Inj 2 mg/ml 12 - - - - - - - - - - - - 2 - - - - - - - 10 - - - - - - - - -
70
Fluconazol Tablet 150 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
71
Flufenazin Inj im 25 mg/ml (Sikzonoate) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
72
Formokresol Cair - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
73 Furosemid Tablet 40 mg
10 - - - - - - - - - - - - - - - - - - - - - - - - 10 - - - - -
74
Garam Oralit I Serbuk 236 10 - - 5 - - 6 10 - - - 20 - - - - - 30 25 - 110 - - - 10 - - 10 - -
75
Gentamisin Inj 40 mg/ml (Sulfat) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
76
Gentamisin Salep Kulit 0,1% 8 - - - - - 2 - - - - 1 - 1 - - - - 2 - - 1 - - - - 1 - - - -
77
Glass Ionomer Cement - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
78 Glibenklamid Tablet 5 mg
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
79
Gliseril Guaiakolat Tablet 100 mg 941 35 6 - 15 - 10 30 10 - - - 10 33 23 10 - - 10 40 10 420 - 200 - 19 40 - 20 - -
80
Glukosa Larutan Infus 5% steril - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
81
Griseofulvin Tablet 125 mg Micronized - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
82
Haloperidol 5 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
83
Haloperidol Dekanoat Inj 50 mg/ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
84
Haloperidol Inj 5 mg/ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
85
Haloperidol Tablet 1,5 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
86
Hidrokortison Krim 2,5 % 10 - - - - - - - - - - - - - 1 - - - - - - - - 5 - 1 1 1 1 - -
87
Hiosina butilbromida tab 10 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
88
Human Tetanus Imunoglobulin Im 250UI (Tetagam) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
89
Ibuprofen Tablet 400 mg 256 - 10 - 30 - - 30 - - - 30 - 10 20 10 - - 20 20 30 10 - - - 26 - - 10 - -
90
Isoniazid Tablet 100 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
91
Isosorbid Dinitrat Tablet Sublingual 5 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
92
Kalsium glukonat inj 100 mg/ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
93
Kalsium hidroksida pasta - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
94
Kalsium Laktat (Kalk) Tablet 500 mg 100 - - - 30 - - - 20 - - 10 - - 10 20 - - - - - - - - - - 10 - - - -
95
Kaptropil Tablet 25 mg 574 - 10 - 11 - - 13 10 - - - 10 10 20 10 - - 20 20 - 220 - 210 - 10 - - - - -
96
Karbamazepin Tablet 200 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
97
Karbogliserin Tetes Telinga 10 % - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
98
Karbon aktif tab 0,5 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
99
Ketokonazol Tablet 200 mg 10 - - - - - - - - - - - - - - - - - - - - - - - - - - - 10 - -
100
Ketoprofen Supp 100 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
101
Kina Inj 26 % 2 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
102
Kina Tablet 222 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
103
Klindanmisin Tablet 300 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
104
Kloramfenikol Kapsul 250 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
105
Kloramfenikol Kapsul 500 mg 10 - - - - - - - - - - - - - - - - - - - - - - - - - - 10 - - -
106
Kloramfenikol Salep Kulit 2% 23 - - - - - - - - - - - - - - - 1 - - 2 - 8 - 1 - 9 - - 2 - -
107
Kloramfenikol Salep Mata 1 % 18 - - - - - - 1 - - - - - - - - 1 - 1 3 - 10 - - - - 2 - - - -
108
Kloramfenikol Sirup 125 mg/5 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
109
Kloramfenikol Tetes Mata 0.5% 32 - 1 - 1 - - 1 - - - 3 - - - - 1 - - 2 2 3 - 6 - - 10 - 2 - -
110
Kloramfenikol Tetes telinga 3 % 19 - - - - - - - - - - - - - - - - - - - - 7 - - - - - 2 10 - -
111
Klorfenarimin Maleat (CTM) Tablet 4 mg 1,202 30 24 - 39 - 20 39 65 - - 26 15 30 13 10 20 3 10 70 40 185 - 220 - 218 50 10 65 - -
112
Klorpropmazin HCl Tablet salut 100 mg 10 - - - - - - - - - - - - - - - - - - - - - - - - - - - 10 - -
113
Kotrimoksazol Susp:Sulf 200+Trim 40 mg/5 ml 39 5 2 - - - 1 - 1 - - - 2 1 3 1 - - 6 1 - 11 - - - 1 1 1 2 - -
114
Kotrimoksazol Tab Dws:Sulf 400+Trim 80 mg 282 - - - 10 - - - - - - - 10 10 - - - - - 20 - 220 - - - 12 - - - - -
115
Lidokain Inj Komp:Lidokain %+ Epinefrin 1 : 80000-2 ml 15 - - - - - - - - - - - - - - - - 5 - - - - - - - - - - 10 - -
116
Lidokain Jelly 2 % - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
117 Lidokain Spray 10 %
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
118
Lisol - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
119
Loratadin Tablet 10 mg 136 5 1 - 20 - - - - - - 25 - - 20 20 - - - - 15 10 - - - 10 - - 10 - -
120
Magnesium sulfat Inj (IV) 20 % - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
121
Magnesium sulfat Inj (IV) 40 % - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
122
MB Anak - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
123
MB Dewasa - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
124
Metformin HCl Tablet 500 mg 50 - - - 10 - - - - - - 20 - - - - - - - - - - - - - 20 - - - - -
125
Metildopa Tablet 250 mg 10 - - - - - - - - - - - - - - - - - - - - - - - - 10 - - - - -
126
Metilergomatrin Maleat Inj 0,200 mg 10 - - - - - - - - - - - 10 - - - - - - - - - - - - - - - - - -
127
Metilergometrin Maleat Tablet Salut 0,125 mg 20 - - - - - - - - - - 10 10 - - - - - - - - - - - - - - - - - -
128
Metilprednisolon Tablet 4 mg 544 20 - - - - - 20 20 - - 10 - 6 - - 10 - 20 10 42 230 - 20 - 76 10 40 10 - -
129
Metronidazol Tablet 500 mg 30 - - - - - - - - - - - - - 10 - - - - - - - - - - 10 - 10 - - -
130
Mikonazol Krim/Salep 2% 30 - 1 - - - - - 1 - - - - - - 1 - - - 1 - 12 - - - 11 - - 3 - -
131
Mineral Mix - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
132
Monoklorkamfer mentol cairan 1 - - - - - - - - - - - - 1 - - - - - - - - - - - - - - - - -
133
Multivitamin + DHA + Lysin Sirup 24 2 - - - - 2 - 1 - - 1 2 1 - - - - 1 - 1 11 - - - - 1 1 - - -
134
Multivitamin + Mineral Kaplet 135 - - - 10 - - 20 - - - - - 20 20 - 10 - 10 - - - - 10 - - 15 20 - - -
135
N-asetil sistein kaps 200 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
136
Natrium Bikarbonat Tablet 500 mg 20 - - - - - - - - - - - - - 10 - - - - - 10 - - - - - - - - - -
137
Natrium Diklofenak Tablet 50 mg 290 - - - - - - 10 - - - 30 10 10 10 - - - 10 - - 200 - - - - - - 10 - -
138
Natrium Hipoklorit 3% - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
139
Natrium Klorida Larutan Infus 0,9% 7 - - - - - - - - - - - - - - - - - - - - 7 - - - - - - - - -
140
Natrium Tiroksin Tablet 100 µg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
141
Nipedipin Tablet 10 mg 10 - - - - - - - - - - - - - - - - - - - - - - - - - - - 10 - -
142
Nistatin Tablet Salut Gula 500.000 IU/g - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
143
Nistatin Tablet Vaginal 100.000 IU/g - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
144
OAT FDC Katagori 1 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
145
OAT FDC Katagori 2 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
146
OAT FDC Kategori Anak - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
147
OAT FDC Kategori Sisipan - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
148
OAT Kombipak Kat I - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
149
Obat Batuk Hitam (OBH) Cairan 51 6 - - 1 - 2 1 - - - 3 2 3 - 1 - - - 2 3 11 - 4 - 7 3 1 1 - -
150
Oksitosin Inj 10 IU/ml- 1 ml 1 - - - - - - - - - - - - - - - - - - - - - - - - 1 - - - - -
151
Omeprazol Kapsul 20 mg 110 - - - - - - 10 - - - 10 - - - - - - - - - 90 - - - - - - - - -
152
Ondansetron Inj 4 mg/2 ml 99 - - - 14 - - - - - - - - - - - - - - - - - - - - 35 30 10 10 - -
153
Parasetamol Sirup 120 mg / 5ml 116 7 5 - 7 - 5 4 1 - - 5 6 9 4 - - - 6 8 3 25 - - - 10 5 1 5 - -
154
Parasetamol Tablet 500 mg 3,356 90 30 - 70 - 60 100 190 - - 150 90 75 46 80 30 20 90 170 110 910 - 470 - 310 110 60 95 - -
155
PB Anak - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
156
PB Dewasa - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
157
Permetrin 5% Krim (Scabimite) 23 - - - 1 - - - 10 - - 1 - 1 1 - - - 1 1 - 5 - - - 1 - - 1 - -
158
Gliserin Sirup (Laxadin syr) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
159
Piridoksin HCl (Vit B6) Tablet 10 mg 610 20 5 - 20 - 30 10 - - - 40 - 10 10 10 - - - 25 30 300 - 20 - 60 10 - 10 - -
160
Pirimetamin Tablet 25 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
161
Polikresulen (Albotyl) Botol 5 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
162
Povidon Iodida 10 %-30 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
163
Povidon Iodida 10 %-300 ml 4 - - - - - - - - - - - 1 - - - - - - - - 1 - - - - 1 1 - - -
164
Prednison Tablet 5 mg 180 - - - - - - - - - - - 10 30 - - - - 10 - - 100 - - - 30 - - - - -
165
Primakuin Tablet 15 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
166
Prokain Benzilpenisilin Serb Inj 3 juta UI/vial (i.m.) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
167
Propanolol HCl Tablet 40 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
168
Propiltiourasil Tablet 100 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
169
Ranitidin Inj 25 mg/ml 101 - - - 23 - 10 - - - - - - 10 - - - - - - - - - - - 18 20 10 10 - -
170
Ranitidin Tablet 150 mg 1,056 22 10 - 56 - 40 10 30 - - 82 40 - 36 40 - 12 46 50 20 330 - 20 - 102 40 40 30 - -
171
Retinol (Vit A) Kapsul 100.000 IU - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
172
Retinol (VIT A) Kapsul 200.000 IU - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
173
Ringer Laktat Larutan Infus Steril 53 - - - - - - - - - - - - - - - 3 - - - - - - - - 40 - - 10 - -
174
Risperidon Tablet 2 mg 56 - - - - - - - - - - - - - - - - - - 28 - - - - - - - 28 - - -
175
Salbutamol Nebu 2,5 mg/2,5 ml NaCl 2 - - - - - - - - - - - - - - - - - - - - - - - - 2 - - - - -
176
Salbutamol Tablet 4 mg 50 - - - - - - - - - - - - - - - 20 - 10 - - 20 - - - - - - - - -
177
Salep 2-4 kombinasi : as.asal 2 % + Bel. 4 % 22 2 - - - - - - - - - 1 - - - - - 1 1 1 - 12 - - - 3 1 - - - -
178
Salisil Bedak 2 % 12 - - - - - - - 1 - - 2 - - 1 - - - - 1 3 1 - - - 2 - 1 - - -
179
Sefadroksil Sirup 125 mg/5 ml 11 - - - - - - - - - - - 1 - - - - - - - - 10 - - - - - - - - -
180
Sefadroxil Kapsul 500 mg 125 5 - - - - 10 40 30 - - - - - - - - - - - - - - 20 - 10 - 10 - - -
181
Sefiksime 200 mg + Azitromisin 500 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
182
Sefotaksim Inj 1 g - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
183
Seftriaxon Inj 1 g - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
184
Semen seng fosfat serbuk cairan - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
185
Serum Anti Difteri (ADS) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
186
Serum anti tetanus Inj 1500 IU/vial (ATS) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
187
Serum antibisa ular Polivalen Inj 5 ml (SABU) I - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
188
Setirizin Sirup 5 mg/5 ml 4 - - - - - - - - - - 2 - - 1 - - - 1 - - - - - - - - - - - -
189
Sianokobalamin (Vit B12 ) Inj 500 mcg/ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
190
Simvastatin Tablet 10 mg 70 - - - - - - - - - - - 10 - - - - - - - - 60 - - - - - - - - -
191
Siprofloksasin (HCl) Tablet 500 mg 10 - - - 10 - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Tablet Tambah Darah (Camabion) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
192
Tablet Tambah Darah Kombinasi 1,200 - - - 30 - - 30 10 - - 30 1,000 - 20 10 - - 10 - 10 10 - 10 - - 10 20 - - -
193
Temporary Restorative Material - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
194
Tetrasiklin Kapsul 500 mg 122 6 - - - - - - - - - 10 - - - - - 3 - 3 - 100 - - - - - - - - -
195
Tiamin HCL (Vit B1) Tablet 50 mg 662 - 30 - 20 - 20 30 20 - - 40 10 20 20 10 - - 62 10 20 230 - 10 - 60 - 10 40 - -
196
Triheksifenidil HCl Tablet 2 mg 28 - - - - - - - - - - - - - - - - - - 14 - - - - - - - 14 - - -
197
Vaksin BCG + Pelarut - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
198
Vaksin DPT-Hb-Hib - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
199
Vaksin DT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
200
Vaksin Hb-0 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
201
Vaksin IPV 10 ds - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
202
Vaksin IPV 5 ds - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
203
Vaksin Measles Rubella (MR) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
204
Vaksin Meningitis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
205
Vaksin Papillomavirus (HPV) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
206
Vaksin Pneumococcus - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
207
Vaksin Polio 10 ds bopv + Penetes - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
208
Vaksin Rabies Vero - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
209
Vaksin Td - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
210
Vitamin B Kompleks Tablet 940 - - - 10 - 10 10 - - - 30 20 30 10 10 20 - - 40 10 500 - 200 - 20 20 - - - -
211
Zinc Tablet 20 mg 75 - 10 - - - - 5 10 - - - 10 - - - - - 30 - - - - - - - - - 10 - -
212
BAHAN HABIS PAKAI - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
213
ADS 0.05 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
214
ADS 0.5 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
215
ADS 5 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
216
Alat Suntik Sekali Pakai 1ml 30 - - - - - - - - - - - - - - - - - - - - - - - - 10 - - 20 - -
217
Alat Suntik Sekali Pakai 3 ml 130 - - - 20 - - - - - - - - - - - - 10 - - - - - - - 40 30 - 30 - -
218
Alat Suntik Sekali Pakai 5 ml 50 - - - - - - - - - - - - - - - - - - - - - - - - 20 - - 30 - -
219
Alkohol Swab 100 - - - - - - - - - - - - - - - - - - - - - - - - 100 - - - - -
220
Bisturi 2 - - - - - - - - - - - - - - - - - - - - 2 - - - - - - - - -
221
Blood set - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
222
Catgut/Benang Bedah No.2/0 dengan jarum bedah 8 - - - - - - - - - - - - - - - - - - - - 5 - - - - 3 - - - -
223
Catgut/Benang Bedah No.3/0 dengan jarum bedah 3 - - - - - - - - - - - - - - - - - - - - - - - - - 3 - - - -
224
Folley Catheter No.18 1 - - - - - - - - - - - - - 1 - - - - - - - - - - - - - - - -
225
Infusion set anak 10 - - - - - - - - - - - - - 5 - - - - - - - - - - 5 - - - - -
226
Infusion set dewasa 16 - - - - - - - - - - - - - - - 1 - - - - 2 - - - 10 - - 3 - -
227
IV Catheter No.18 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
228
IV Catheter No.20 28 - - - 6 - - - - - - - - - - - 1 - - - - 4 - - - 12 - 5 - - -
229
IV Catheter No.22 14 - - - 6 - - - - - - - - - - - 1 - - - - - - - - 2 - 5 - - -
230
IV Catheter No.24 17 - - - 5 - - - - - - - - - - - - - - - - 5 - - - 2 - 5 - - -
231
Jarum kulit 4 - - - 4 - - - - - - - - - - - - - - - - - - - - - - - - - -
232
Jarum otot - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
233
Kaca Slide - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
234
Kantung mayat - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
235
Kapas Pembalut/absorben 250 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
236
Kasa Hidrofil 2x80 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
237
Kasa Hidrofil Steril 16 X 16 14 - - - - - - - - - - - - - - - - - - - - 3 - - - 10 1 - - - -
238
Kasa Pembalut Hidrofil 4 X 10 cm 20 - - - - - - - - - - - - - - - - - - - - 10 - - - 10 - - - - -
239
Kasa Pembalut hidrofil 4 x 5 cm - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
240
Kassa Pembalut elastic 4 inchi - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
241
Masker Tie on - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
242
Masker N-95 100 - - - - - - - - - - - - - - - - - - - - - - - - - - - 100 - -
243
Plester 5 yard x 2 inch 3 - - - - - - - - - - - - 1 - - - - - - - 1 - - - 1 - - - - -
244
Polybag Medis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
245
Polybag Nonmedis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
246
Polybag Ramah Lingkungan - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Pot Dahak - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
247
Safety box - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
248
Sarung Tangan Non Steril Uk.S 200 - - - - - - - - - - - - - 100 - - - - - - 100 - - - - - - - - -
249
Sarung Tangan Non Steril Uk.M - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
250
Sarung Tangan Non Steril Uk.L - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Sarung Tangan Steril No.6 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
251
Sarung Tangan Steril No.6,5 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
252
Sarung Tangan Steril No.7 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
253
Sendok Obat - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
254
Silk (Benang Bedah Sutera) No.2/0 12 - - - 4 - - - - - - - - - - - - - - - - 6 - - - 2 - - - - -
255
Urin Bag 2 - - - - - - - - - - - - - 2 - - - - - - - - - - - - - - - -
256
REAGEN - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
257
Cybow 10 Reagent Strip - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
258
Golongan darah anti A - 10 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
259
Golongan darah anti A-B - 10 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
260
Golongan darah anti B - 10 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
261
Humasens Plus - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
262
Humasens Plus Strip Uric Acid - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
263
Humasens Strip Glucose - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
264
Humasens Strip Kolesterol - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
265
Iodin test - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
266
Larutan Asam Asetat 6% 100 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
267
Larutan Benedict 100 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
268
Larutan EDTA 10 % 100 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
269
Larutan HCl 0,1 N 100 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Larutan Natrium Citrat 3,13 % - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
270
Larutan Rees Ecker 100 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
271
Larutan Turk 100 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Larutan Ziehl Neelsen - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Rapid HIV 1/2 Device - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Rapid HIV 2 Fokus - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Rapid HIV Biomedika - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Rapid HIV Biomeriux - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Rapid HIV Intec - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Rapid HIV Oncoprobe - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Rapid HIV SD - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Rapid Malaria - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Rapid Syphilis SD - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Reagen CD4 kontrol - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Reagen CD4 tipe 1 (Alere Pima CD4) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
RPR Syphilis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Salmonella Thyphi H - 5 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Salmonella Thyphi O - 5 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Test Kehamilan - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
LAIN-LAIN - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
penobarbital injk - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
piracetam 800 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
lidokain 2% - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Salmonella Thyphi H - 5 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Salmonella Thyphi O - 5 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Nipedipin 10 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Lidocain Jelly 2 % - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Lidocain Spray 10 % - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Betahistin 6 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
DBS collection kit - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
G+B253liserin syr (laxadin syr) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Polikresulen ( Albotyl) 5 ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Haloperidol inj 5 mg/ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Haloperidol dekanoat inj 50 mg/ml - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-
Clozapine 25 mg - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
31
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LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSKESMAS
Lembar Putih : Dinkes Kabupaten
Lembar Biru/Hijau : UPTD FAMM
Lembar Kuning : Puskesmas
PUSKESMAS : SILIWANGI DOKUMEN NOMOR TANGGAL

KECAMATAN : PELAPORAN BULAN/PERIODE : JUNI 2012 DINKES KAB/KOTA
KAB/KOTA : GARUT PERMINTAAN BULAN/PERIODE : JULI 2012 DBMB
PROPINSI : JAWA BARAT PUSKESMAS
NO. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR KEKOSONGAN STOK OPTIMUM PERMINTAAN
ALAT KESEHATAN
1 Alat Suntik Sekali Pakai 1ml SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
2 ALAT SUNTIK SEKALI PAKAI 2.5 ML/3 ML SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
3 Alat Suntik Sekali Pakai 5 ml SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
4 Blood set SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
5 Bisturi SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
6 Catgut/Benang Bedah No.3/0 SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
7 Catgut/Benang Bedah No.2/0 ROL #REF! 0 #REF! 0 #REF! 0 0 #REF!
8 Folley catheter SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
9 Infusion set anak SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
10 Infusion set dewasa SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
11 Jarum cutting (Otot) SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
12 Jarum tapper (kulit) SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
13 IV Catheter No.18 SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
17 Kapas pembalut/absorben 250 mg BUNGKUS #REF! 0 #REF! 0 #REF! 0 0 #REF!
18 Kasa Hidrofil Steril 16 X 16 ROL #REF! 0 #REF! 0 #REF! 0 0 #REF!
19 Kasa pembalut elastic 4 inchi ROL #REF! 0 #REF! 0 #REF! 0 0 #REF!
20 Kasa pembalut Hidrofil 4 X 10 cm ROL #REF! 0 #REF! 0 #REF! 0 0 #REF!
21 Kasa pembalut hidrofil 4 x 5 cm ROL #REF! 0 #REF! 0 #REF! 0 0 #REF!
22 Masker SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
23 Plester 5 yard x 2 inch ROL #REF! 0 #REF! 0 #REF! 0 0 #REF!
24 sarung Tangan non steril SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
25 Sarung Tangan Steril SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
26 SILK (BENANG BEDAH SUTRA) NO.3/0 DENGAN JARUM BEDAH SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
27 Urin Bag SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
28 Wing Needle SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANAFILAKSIS
29 Deksametason inj 5 mg/ml-1 ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
30 Deksametason Tablet 0.5 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
31 Difenhidramin inj 10 mg/ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
32 Epinefrina HCl/Bitartrat (Adrenalin) inj 0.1 %-1ml Ampul #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANALGETIKA ANTIPIRETIK & ANTIINFLAMASI NON STEROID
33 Antalgin (Metampiron) Tablet 500 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
34 Antalgin Injeksi 250 mg/ml-2ml TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
35 Asam Mefenamat 500 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
36 Asetosal Tablet 100 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
37 Ibuprofen tablet 400 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
38 Ketoprofen Inj Ampul #REF! 0 #REF! 0 #REF! 0 0 #REF!
39 Natrium Diklofenac 50 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
40 Parasetamol sirup 120 mg/5 ml BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
41 Parasetamol tablet 100 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
42 Parasetamol tablet 500 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
43 Tramadol Injeksi 50 mg/ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
44 Tramadol Kapsul 50 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANESTESI LOKAL
45 ETIL KLORIDA SEMPROT - 100 ML BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
46 Lidokain inj Komp:Lidokain % + Epinefrin 1 : 80000-2ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTELMINTIK
47 Albendazol 400 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
48 Pirantel tablet 125 TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIALERGI
49 KLORFENIRAMIN MALEAT (CTM) TABLET 4 MG TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIAMUBA
50 Metronidazol tablet 500 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIASMA
51 Aminofilin Inj 24 mg/ml-10 ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
52 Aminofilin Tablet 200 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
53 Efedrin HCl tablet 25 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
54 Salbutamol tablet 2 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
55 Salbutamol tablet 4 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
56 Salbutamol 2.5 mg/2.5 ml NaCl AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIBAKTERI
57 Amoksilin Kapsul 500 mg KAPLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
58 Amoksilin sirup kering 125 mg/ml BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
59 Ampisilin inj Im/IV 1000 mg/ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
60 Antibakteri DOEN TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
61 Benzatin Benzil Penisilin Inj 2.4 juta IU/vial VIAL #REF! 0 #REF! 0 #REF! 0 0 #REF!
62 Ciprofloksasin 500 mg KAPLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
63 Doksisilin 100 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
64 Erytromycin 250 mg KAPSUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
65 Fenoksimetil Penisilin tablet 500 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
66 Gentamisin Injeksi 80 mg/2 ml (sebagai sulfat) BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
67 Gentamisin Sulfat Tetes Mata 0.3% 5ML AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
68 Gentamycin S.K TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
69 Kloramfenikol kapsul 250 mg KAPSUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
70 Kloramfenikol Salep Kulit 2% TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
71 Kloramfenikol salep mata 1 % TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
72 Kloramfenikol Suspensi 125 mg/5 ml BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
73 Kloramfenikol tetes telinga 3 % BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
74 Kotrimoksazol Susp:Sulf 200+Trim 40 mg/5 ml BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
75 Kotrimoksazol Tab Dws:Sulf 400+Trim 80 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
76 Kotrimoksazol Tab Ped:Sulf 100 + Trim 20 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
77 Oksitetrasiklin HCl 1 % Salep mata TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
78 Oksitetrasiklin HCl inj i.m 50 mg/ml-10 ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
79 Oksitetrasiklin HCl Salep 3 % TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
80 Prokain Benzil Penisillin 3 juta IU / vial inj VIAL #REF! 0 #REF! 0 #REF! 0 0 #REF!
81 Sefadroxil Kapsul 500 mg KAPSUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
82 Sefotaksim Serbuk Injeksi 1 g/vial VIAL #REF! 0 #REF! 0 #REF! 0 0 #REF!
83 Seftriaxon Serbuk Injeksi 1 g/vial VIAL #REF! 0 #REF! 0 #REF! 0 0 #REF!
84 Sulfasetamid Natrium Tetes mata 15 % BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
85 Tetrasiklin Kapsul 250 mg KAPSUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
86 Tetrasiklin Kapsul 500 mg KAPSUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
87 Tiamfenikol Kapsul 500 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIDIABETES
88 Glibenklamid tablet 5 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
89 Metformin 500 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIDIARE
90 Attapulgite + pektin TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
91 Zinc Tablet TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIDOT
92 Atropin Sulfat injeksi 0.25 mg/ml-1 ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIEMETIKA
93 Dimenhidrinat Tablet 50 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
94 domperidon suspensi 5 mg/5ml BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
95 Domperidon Tablet 10 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
96 Metoklorpropamid Injeksi 5 mg/ml Ampul #REF! 0 #REF! 0 #REF! 0 0 #REF!
97 Metoklorpropamid Tablet 10 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIEPILEPTIK
98 Fenitoin Natrium kapsul 30 mg KAPSUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
99 Fenitoin Kapsul 100 mg KAPSUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
100 Karbamazepin tablet 200 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIFUNGI
101 Antifungi DOEN kombinasi POT #REF! 0 #REF! 0 #REF! 0 0 #REF!
102 Griseofulvin tablet 125 mg micronized TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
103 Ketokonazol Tablet 200 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
104 MICONAZOL SK 2% TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
105 Nistatin tablet salut gula 500.000 IU / G TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
106 Nistatin tablet vaginal 100.000 IU / g TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIHEMOROID
107 Anti Hemmoroid DOEN SUPP TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIHIPERASIDITAS
108 Antasida DOEN TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
109 Antasida II Suspensi 60 ml BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
110 Omeprazol Capsul 20 mg KAPSUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
111 Ranitidin 150 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
112 Ranitidin Injeksi 25 mg/ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIHIPERLIPID
113 Simvastatin 10 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
114 Simvastatin 20 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIHIPERTENSI
115 Captropil 25 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
116 Nifedipin 10 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIINFLAMASI KORTIKOSTEROID
117 Betametason Krim 0.1 % TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
118 Hidrokortison krim 2.5 % TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
119 Prednison tablet 5 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIMALARIA
120 Arterakina TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
121 Klorokuin tablet 150 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
122 Kuinin dihidroklorida inj 25 %-2 ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
123 Primakuin tablet 15 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIMIGREN
124 Antimigren DOEN TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIPARKINSON
125 Triheksifenidil HCl tablet 2 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIPIRAI
126 Alopurinol tablet 100 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTISEPTIK & DESINFEKTAN
127 ETAKRIDIN (RIVANOL) LARUTAN 0.1 %-300 ML BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
128 ETANOL 70 % - 1000 ML BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
129 Fenol Gliserol Tetes telinga 10 % BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
130 Gentian violet larutan 1 %-10 ml BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
131 Kaporit KG #REF! 0 #REF! 0 #REF! 0 0 #REF!
132 Lisol - Mengandung kresol tersabun 50%-1000 ml BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
133 Paraformaldehid tablet 1 gram TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
134 Pine oil 7 % + benzyl chlorophenol 0.6 % BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
135 Povidon Iodida 10 % - 30 ml BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
136 Povidon Iodida 10 % - 300 ml BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
137 Salisil Bedak 2 % - 50 gram KOTAK #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTISKABIES
138 Lindane 1% + Usnic acid 1% TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
139 Salep 2-4 kombinasi : as.asal 2 % + Bel. 4 % POT #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTISPASMODIK
140 Hyoscine-n-butilbromide Tablet 10 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTITIROID
141 PROPILPROTOURASIL TABLET 100 MG TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTITUSIF
142 DEKSTROMETORFAN SIRUP 10 MG/5 ML - 60 ML BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
143 Dekstrometorfan tablet 15 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIVIRAL
144 Asiklovir Krim 5%/5g TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
145 Asiklovir Tablet 400 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
CAIRAN EKLEKTROLIT & NUTRISI
146 Garam Oralit 200 ml air SACHET #REF! 0 #REF! 0 #REF! 0 0 #REF!
147 GLUKOSA LARUTAN INFUS 5 % STERIL-500 ML BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
148 Kalsium Laktat (Kalk) tablet 500 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
149 Natrium Klorida Lar.infus 0.9 % steril BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
150 Ringer Laktat Larutan Infus Steril BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
DIURETIK
151 Furosemid tablet 40 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
152 Hidroklotiazid (HCT) tablet 25 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
EKSPEKTORANS & TOKOLITIK
153 Bromheksin Tablet 8 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
154 Gliseril Guayakolat tablet 100 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
155 Obat batuk Hitam (OBH) Cairan - 100 ml BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
GIGI DAN MULUT
156 Devitalisasi Pasta (Non arsen) BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
157 Eugenol Cairan BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
158 Glass Ionomer Cement (GC IX) SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
159 Kalsium hidroksida pasta TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
160 Monoklor Kamfer mentol cairan BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
161 Mummifying Pasta BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
162 Semen seng fosfat serbuk cairan BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
163 Temporary Stopping Fletcher (Fletcher) SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
HEMOSTATIK
164 Fitomenadion(Vit K1) inj 2 mg/ml-1ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
165 FITOMENADION (VIT K1) INJ 10 MG/ML - 1 ML AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
166 FITOMENADION (VIT K1) TABLET SALUT GULA 10 MG TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
HIPNOTIK
167 Fenobarbital tablet 30 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
168 Fenobarbital Inj 50 mg/2ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
KARDIOVASKULER
169 Digoksin tablet 0.25 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
170 ISOSORBID DINITRAT TABLET SUBLINGUAL 5 MG TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
171 Propanolol HCl tablet 40 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
KEBIDANAN
172 Magnesium sulfat inj (IV) 20 %-25 ml VIAL #REF! 0 #REF! 0 #REF! 0 0 #REF!
173 Magnesium sulfat inj(IV) 40 % VIAL #REF! 0 #REF! 0 #REF! 0 0 #REF!
174 Metilergometrin maleat inj 0.200 mg - ml Ampul #REF! 0 #REF! 0 #REF! 0 0 #REF!
175 Metilergometrin maleat tab salut 0.125 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
176 Oksitoksin Inj 10 IU/ml - 1 ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
LAIN-LAIN
177 Aqua Pro Injeksi steril bebas pirogen - 20 ml VIAL #REF! 0 #REF! 0 #REF! 0 0 #REF!
178 Iodin Test BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
NEUROLEPTIK (TRANKUILIZER MINOR)
179 Amitriptilina HCl tablet salut 25 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
180 DIAZEPAM INJ 5 MG / ML - 2ML AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
181 Diazepam Rectal 5 mg/2.5 ml SUPP #REF! 0 #REF! 0 #REF! 0 0 #REF!
182 Diazepam tablet 2 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
NOOTROPIK
183 Piracetam Injeksi 1g/5mg AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
184 Piracetam Tablet 400 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
PSIKOSIS
185 Haloperidol tablet 1.5 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
186 Klorpropmazin HCl inj 5 mg/ml - 2 ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
187 Klorpropmazin HCl tablet salut 100 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
188 Klorpropmazin HCl tablet salut 25 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
189 Resperidon 2 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
VAKSIN & SERUM
190 Serum anti bisa ular Polivalen inj 5 ml (SABU) 1 VIAL #REF! 0 #REF! 0 #REF! 0 0 #REF!
191 Serum anti tetanus inj 1500 IU/vial (ATS) VIAL #REF! 0 #REF! 0 #REF! 0 0 #REF!
192 Serum anti tetanus inj 20.000 IU / vial (ATS) VIAL #REF! 0 #REF! 0 #REF! 0 0 #REF!
193 Serum antidifteri inj 20.000 IU / vial (ADS) VIAL #REF! 0 #REF! 0 #REF! 0 0 #REF!
194 Vaksin Rabies Vero KURR #REF! 0 #REF! 0 #REF! 0 0 #REF!
VITAMIN & MINERAL
195 Asam Askorbat (VIT C) Tablet 50 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
196 Iodiol kapsul KAPSUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
197 Mineral Mix SACHET #REF! 0 #REF! 0 #REF! 0 0 #REF!
198 Multivitamin + DHA + Lysin BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
199 Multivitamin + Mineral TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
200 Piridoksin HCl (Vit B6) tablet 10 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
201 Retinol (VIT A) 200.000 IU KAPSUL LUNAK #REF! 0 #REF! 0 #REF! 0 0 #REF!
202 Retinol tab 100.000 IU KAPSUL LUNAK #REF! 0 #REF! 0 #REF! 0 0 #REF!
203 Sianokobalamin (Vit B 12) inj 500 mcg/ml-1ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
204 Tablet Tambah darah kombinasi : Besi II Sulfat 200 mg + Asam folat TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
205 Tiamin HCL (Vit B1) inj 100 mg/ml - 1ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
206 Tiamin HCL (Vit B1) tablet 50 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
207 Vitamin B Kompleks tablet TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
208 Vit B1 100 mg, Vit B6 100 mg, Vit B12 100 mcg AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
Vitamin A 417 mcg, Vit B1 0.5 mg, Vit B2 0.5 mg, Vit B3 5 mg, Vit
209
B6 0.5 mg, Vit B12 1 mg, Vit D3 5 mg, Vit E 6 mg, Vit K 20 mcg, Vit
TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
C 30 mg, As. Folat 150 mcg, as Pantotenat 3 mg, Yodium 50 mcg,
Zat besi (Fe) 10 mg, Seng (Zn) 5 mg, Selenium (Se) 20 mcg
(TABURIA)
UMUM ASKES JAMKESMAS JAMKESDA JAMPERSAL JUMLAH
RAWAT JALAN
KUNJUNGAN RESEP
R/ (ITEM OBAT)
KUNJUNGAN PASIEN
RAWAT INAP
KUNJUNGAN RESEP
R/ (ITEM OBAT)
KUNJUNGAN PASIEN
Garut,
Mengetahui, Yang Melaporkan,
Kepala Puskesmas Pengelola Obat Puskesmas
….…………………………… ……………………………..
NIP. NIP.
NO NAMA OBAT KELOMPOK FARMAKOLOGI
1 Alopurinol Tablet 100 mg ANTIPIRAI

2 Albendazol Tablet 400 mg ANTELMINTIK
3 Aminofilin Inj 24 mg/ml-10 ml ANTIASMA
4 Aminofilin Tablet 200 mg ANTIASMA
5 Amitriptilina HCl Tablet salut 25 mg OBAT PSIKOSIS
6 Amlodipin Tablet 5 mg ANTIHIPERTENSI
7 Amoksisilin Kaplet 500 mg ANTIBAKTERI
8 Amoksisilin Sirup Kering 125 mg/5 ml ANTIBAKTERI
9 Antasida DOEN I Tablet Kunyah ANTIULKUS
10 Antasida II Suspensi 60 ml ANTIULKUS
11 Anti Hemmoroid DOEN ANTIHEMOROID
12 Antibakteri DOEN ANTIBAKTERI KULIT, Mata, TELINGA
13 Antifungi DOEN kombinasi ANTIFUNGI KULIT
14 Antimigren DOEN ANTIMIGREN
15 Aqua Pro Inj steril bebas pirogen- 20 ml LAIN-LAIN
16 Asam Asetilsalisilat Tablet 80 mg (Asetosal) ANTIAGREGASI PLATELET
17 Asam Askorbat (VIT C) Tablet 50 mg VITAMIN dan MINERAL
18 Asam Mefenamat kaplet 500 mg ANALGESIK NON NARKOTIK
19 Asiklovir Krim 5%/5g ANTIVIRUS
20 Asiklovir Tablet 400 mg ANTIVIRUS
21 Atapulgit Tablet 600 mg OBAT untuk DIARE
22 Atropin Sulfat Inj 0,25 mg/ml ANTIDOT dan OBAT LAIN untuk KERACU
23 Azithromisin Tablet 500 mg IMS
24 Benzatin Benzil Penisilin Inj 2,4 juta IU/vial ANTIBAKTERI
25 Betametason Krim 0.1 % ANTIINFLAMASI dan ANTIPRURITUS
26 Bromheksin Tablet 8 mg EKSPEKTORAN dan MUKOLITIK
27 Dehidroartemisin 40 mg + Piperaquin 320 mg ANTIMALARIA
28 Deksametason Inj 5 mg/ml-1 ml ANTIALERGI dan OBAT ANAFILAKSIS
29 Deksametason Tablet 0,5 mg ANTIALERGI dan OBAT ANAFILAKSIS
30 Dekstrometorfan Tablet kombinasi ANTITUSIF DAN DEKONGESTAN
31 Dektrometorfan Sirup kombinasi ANTITUSIF DAN DEKONGESTAN
32 Devitalisasi Pasta OBAT GIGI
33 Dextrose Inj 40% ELEKTROLIT
34 Diazepam Inj 5 mg/ml-2 ml OBAT PSIKOSIS
35 Diazepam Rectal 10 mg/2,5 ml OBAT PSIKOSIS
36 Diazepam Rectal 5 mg/2,5 ml OBAT PSIKOSIS
37 Diazepam Tablet 2 mg OBAT PSIKOSIS
38 Difenhidramin Inj 10 mg/ml ANTIALERGI dan OBAT ANAFILAKSIS
39 Digoksin Tablet 0,25 mg ANTIARITMIA
40 Dimenhidrinat Tablet 50 mg ANTIEMETIK
41 Doksisilin Tablet 100 mg ANTIMALARIA
42 Domperidon Suspensi 5mg/5ml ANTIEMETIK
43 Domperidon Tablet 10 mg ANTIEMETIK
44 Endometason OBAT GIGI
45 Epinefrina HCl/Bitartrat (Adrenalin) Inj 0,1 % OBAT untuk SYOK
46 Eritromisin Kapsul 250 mg ANTIBAKTERI
47 Eritromisin Sirup 250 mg/5 ml ANTIBAKTERI
48 Etakridin Larutan 0,1 % LAIN-LAIN
49 Etanol 70 %- 1000 ml DESINFEKTAN
50 Etil Klorida Spray ANASTETIK
51 Eugenol Cairan OBAT GIGI
52 Fenitoin Natrium Kapsul 100 mg OBAT PSIKOSIS
53 Fenobarbital Tablet 30 mg OBAT PSIKOSIS
54 Fenoksimetil Penisilin Tablet 500 mg ANTIBAKTERI
55 Fitomenadion (Vit K1) Tablet Salut Gula 10 mg OBAT yang MEMPENGARUHI KOAGULAS
56 Fitomenadion(Vit K1) Inj 2 mg/ml OBAT yang MEMPENGARUHI KOAGULAS
57 Fluconazol Tablet 150 mg IMS
58 Flufenazin Inj im 25 mg/ml (Sikzonoate) OBAT PSIKOSIS
59 Formokresol Cair OBAT GIGI
60 Furosemid Tablet 40 mg DIURETIK
61 Garam Oralit I Serbuk OBAT untuk DIARE
62 Gentamisin Inj 40 mg/ml (Sulfat) ANTIBAKTERI
63 Gentamisin Salep Kulit 0,1% ANTIBAKTERI KULIT, Mata, TELINGA
64 Gentian Violet Larutan 1 %-10 ml ANTISEPTIK
65 Glass Ionomer Cement OBAT GIGI
66 Glibenklamid Tablet 5 mg ANTIDIABETES
67 Gliseril Guaiakolat Tablet 100 mg EKSPEKTORAN dan MUKOLITIK
68 Glukosa Larutan Infus 5% steril ELEKTROLIT
69 Griseofulvin Tablet 125 mg Micronized ANTIFUNGI
70 Haloperidol 5 mg OBAT PSIKOSIS
71 Haloperidol Tablet 1,5 mg OBAT PSIKOSIS
72 Hidrokortison Krim 2,5 % ANTIINFLAMASI dan ANTIPRURITUS
73 Hiosina butilbromida tab 10 mg
74 Human Tetanus Imunoglobulin Im 250UI (Teta VAKSIN dan SERUM
75 Ibuprofen Tablet 400 mg ANALGESIK NON NARKOTIK
76 Isoniazid Tablet 100 mg ANTITUBERKULOSIS
77 Isosorbid Dinitrat Tablet Sublingual 5 mg ANTIANGINA
78 Kalsium glukonat inj 100 mg/ml
79 Kalsium hidroksida pasta OBAT GIGI
80 Kalsium Laktat (Kalk) Tablet 500 mg VITAMIN dan MINERAL
81 Kaptropil Tablet 25 mg ANTIHIPERTENSI
82 Karbamazepin Tablet 200 mg OBAT PSIKOSIS
83 Karbogliserin Tetes Telinga 10 % OBAT untuk TELINGA
84 Karbon Aktif Tablet ANTIDOT dan OBAT LAIN untuk KERACU
85 Ketokonazol Tablet 200 mg ANTIFUNGI
86 Kina Inj 26 % 2 ml ANTIMALARIA
87 Kina Tablet 222 mg ANTIMALARIA
88 Klindanmisin Tablet 300 mg IMS
89 Kloramfenikol Kapsul 250 mg ANTIBAKTERI
90 Kloramfenikol Kapsul 500 mg ANTIBAKTERI
91 Kloramfenikol Salep Kulit 2% ANTIBAKTERI KULIT, Mata, TELINGA
92 Kloramfenikol Salep Mata 1 % ANTIBAKTERI KULIT, Mata, TELINGA
93 Kloramfenikol Sirup 125 mg/5 ml ANTIBAKTERI
94 Kloramfenikol Tetes Mata 0.5% ANTIBAKTERI KULIT, Mata, TELINGA
95 Kloramfenikol Tetes telinga 3 % ANTIBAKTERI KULIT, Mata, TELINGA
96 Klorfenarimin Maleat (CTM) Tablet 4 mg ANTIALERGI dan OBAT ANAFILAKSIS
97 Klorpropmazin HCl Tablet salut 100 mg OBAT PSIKOSIS
98 Kotrimoksazol Susp:Sulf 200+Trim 40 mg/5 mlANTIBAKTERI
99 Kotrimoksazol Tab Dws:Sulf 400+Trim 80 mg ANTIBAKTERI
Lidokain Inj Komp : Lidokain %+ Epinefrin
100 1 : 80000-2 ml ANASTETIK
101 Lisol DESINFEKTAN
102 Loratadin Tablet 10 mg ANTIALERGI dan OBAT ANAFILAKSIS
103 Magnesium sulfat Inj (IV) 20 % ANTIEPILEPSI-ANTIKONVULSAN
104 Magnesium sulfat Inj (IV) 40 % ANTIEPILEPSI-ANTIKONVULSAN
105 MB Anak ANTILEPRA
106 MB Dewasa ANTILEPRA
107 Metformin HCl Tablet 500 mg ANTIDIABETES
108 Metilergomatrin Maleat Inj 0,200 mg OKSITOSIK
Metilergometrin Maleat (Metilergometrin)
109 Tablet Salut 0,125 mg OKSITOSIK
110 Metilprednisolon Tablet 4 mg ANTIALERGI dan OBAT ANAFILAKSIS
111 Metronidazol Tablet 500 mg ANTIBAKTERI
112 Mikonazol Krim/Salep 2% ANTIFUNGI KULIT
113 Mineral Mix SUPLEMEN GIZI
114 Monoklorkamfer mentol cairan OBAT GIGI
115 Multivitamin + DHA + Lysin VITAMIN dan MINERAL
116 Multivitamin + Mineral VITAMIN dan MINERAL
117 N-asetil sistein kaps 200 mg
118 Natrium Bikarbonat Tablet 500 mg ANTIDOT dan OBAT LAIN untuk KERACU
119 Natrium Diklofenak Tablet 50 mg ANALGESIK NON NARKOTIK
120 Natrium Hipoklorit 3% OBAT GIGI
121 Natrium Klorida Larutan Infus 0,9% ELEKTROLIT
122 Natrium Tiroksin Tablet 100 µg ANTITIROID
123 Nistatin Tablet Salut Gula 500.000 IU/g ANTIFUNGI
124 Nistatin Tablet Vaginal 100.000 IU/g ANTIFUNGI
125 OAT FDC Katagori 1 ANTITUBERKULOSIS
126 OAT FDC Katagori 2 ANTITUBERKULOSIS
127 OAT FDC Kategori Anak ANTITUBERKULOSIS
128 OAT FDC Kategori Sisipan ANTITUBERKULOSIS
129 OAT Kombipak Kat I ANTITUBERKULOSIS
130 Obat Batuk Hitam (OBH) Cairan EKSPEKTORAN dan MUKOLITIK
131 Oksitetrasiklin HCl 1 % Salep Mata ANTIBAKTERI KULIT, Mata, TELINGA
132 Oksitetrasiklin HCl Salep Kulit 3 % ANTIBAKTERI KULIT, Mata, TELINGA
133 Oksitoksin in 10 IU/ml- 1 ml OKSITOSIK
134 Omeprazol Kapsul 20 mg ANTIULKUS
135 Ondansetron Inj 4 mg/2 ml ANTIEMETIK
136 Parasetamol Sirup 120 mg / 5ml ANALGESIK NON NARKOTIK
137 Parasetamol Tablet 500 mg ANALGESIK NON NARKOTIK
138 PB Anak ANTILEPRA
139 PB Dewasa ANTILEPRA
140 Permetrin 5% Krim (Scabimite) ANTISKABIES
141 Piridoksin HCl (Vit B6) Tablet 10 mg VITAMIN dan MINERAL
142 Povidon Iodida 10 %-30 ml ANTISEPTIK
143 Povidon Iodida 10 %-300 ml ANTISEPTIK
144 Prednison Tablet 5 mg ANTIALERGI dan OBAT ANAFILAKSIS
145 Primakuin Tablet 15 mg ANTIMALARIA
146 Propanolol HCl Tablet 40 mg ANTIARITMIA
147 Propiltiourasil Tablet 100 mg ANTITIROID
148 Ranitidin Inj 25 mg/ml ANTIULKUS
149 Ranitidin Tablet 150 mg ANTIULKUS
150 Resperidon 2 mg OBAT PSIKOSIS
151 Retinol (Vit A) Kapsul 100.000 IU VITAMIN dan MINERAL
152 Retinol (VIT A) Kapsul 200.000 IU VITAMIN dan MINERAL
153 Ringer Laktat Larutan Infus Steril ELEKTROLIT
154 Salbutamol 2,5 mg/2,5 ml NaCl ANTIASMA
155 Salbutamol Tablet 4 mg ANTIASMA
156 Salep 2-4 kombinasi : as.asal 2 % + Bel. 4 % ANTISKABIES
157 Salisil Bedak 2 % LAIN-LAIN
158 Sefadroksil Sirup 125 mg/5 ml ANTIBAKTERI
159 Sefadroxil Kapsul 500 mg ANTIBAKTERI
160 Sefiksime 200 mg + Azitromisin 500 mg IMS
161 Sefotaksim Inj 1 g ANTIBAKTERI
162 Seftriaxon Inj 1 g ANTIBAKTERI
163 Semen seng fosfat serbuk cairan OBAT GIGI
164 Serum anti tetanus Inj 1500 IU/vial (ATS) VAKSIN dan SERUM
165 Serum antibisa ular Polivalen Inj 5 ml (SABU) VAKSIN dan SERUM
166 Sianokobalamin (Vit B12 ) Inj 500 mcg/ml VITAMIN dan MINERAL
167 Simvastatin Tablet 10 mg ANTIHIPERLIPIDEMIA
168 Siprofloksasin (HCl) Tablet 500 mg ANTIBAKTERI
169 Tablet Tambah Darah Kombinasi ANTIANEMI
170 Temporary Restorative Material OBAT GIGI
171 Tetrasiklin Kapsul 500 mg ANTIBAKTERI
172 Tiamin HCL (Vit B1) Inj 100 mg/ml-1ml VITAMIN dan MINERAL
173 Tiamin HCL (Vit B1) Tablet 50 mg VITAMIN dan MINERAL
174 Triheksifenidil HCl Tablet 2 mg OBAT PSIKOSIS
175 Vaksin BCG + Pelarut VAKSIN dan SERUM
176 Vaksin Campak + Pelarut VAKSIN dan SERUM
177 Vaksin DPT-Hb-Hib VAKSIN dan SERUM
178 Vaksin DT VAKSIN dan SERUM
179 Vaksin Hb-0 VAKSIN dan SERUM
180 Vaksin IPV 10 ds VAKSIN dan SERUM
181 Vaksin IPV 5 ds VAKSIN dan SERUM
182 Vaksin Measles Rubella (MR) VAKSIN dan SERUM
183 Vaksin Meningitis VAKSIN dan SERUM
184 Vaksin Papillomavirus (HPV) VAKSIN dan SERUM
185 Vaksin Pneumococcus VAKSIN dan SERUM
186 Vaksin Polio 10 ds + Penetes VAKSIN dan SERUM
187 Vaksin Polio 5 ds + Penetes VAKSIN dan SERUM
188 Vaksin Rabies Vero VAKSIN dan SERUM
189 Vaksin Td VAKSIN dan SERUM
190 Vitamin B Kompleks Tablet VITAMIN dan MINERAL
191 Zinc Tablet 20 mg OBAT untuk DIARE
ALKES HABIS PAKAI
192 ADS 0.05 ml BAHAN HABIS PAKAI
193 ADS 0.5 ml BAHAN HABIS PAKAI
194 ADS 5 ml BAHAN HABIS PAKAI
195 Alat Suntik Sekali Pakai 1ml BAHAN HABIS PAKAI
196 Alat Suntik Sekali Pakai 2,5 ml / 3 ml BAHAN HABIS PAKAI
197 Alat Suntik Sekali Pakai 5 ml BAHAN HABIS PAKAI
198 Alkohol Swab BAHAN HABIS PAKAI
199 Bisturi BAHAN HABIS PAKAI
200 Blood Lancet BAHAN HABIS PAKAI
201 Blood set BAHAN HABIS PAKAI
Catgut/Benang Bedah No.2/0 dengan jarum
202 bedah BAHAN HABIS PAKAI
Catgut/Benang Bedah No.3/0 dengan jarum
203 bedah BAHAN HABIS PAKAI
204 Cover Glass BAHAN HABIS PAKAI
205 Cry tube BAHAN HABIS PAKAI
206 Folley Catheter BAHAN HABIS PAKAI
207 Holder BAHAN HABIS PAKAI
208 Infusion set anak BAHAN HABIS PAKAI
209 Infusion set dewasa BAHAN HABIS PAKAI
210 IV Catheter No.18 BAHAN HABIS PAKAI
214 Jarum kulit BAHAN HABIS PAKAI
215 Jarum otot BAHAN HABIS PAKAI
216 Kaca Slide BAHAN HABIS PAKAI
217 Kantung mayat BAHAN HABIS PAKAI
218 Kapas Pembalut/absorben 250 mg BAHAN HABIS PAKAI
219 Kasa Hidrofil 2x80 BAHAN HABIS PAKAI
220 Kasa Hidrofil Steril 16 X 16 BAHAN HABIS PAKAI
221 Kasa Pembalut Hidrofil 4 X 10 cm BAHAN HABIS PAKAI
222 Kasa Pembalut hidrofil 4 x 5 cm BAHAN HABIS PAKAI
223 Kassa Pembalut elastic 4 inchi BAHAN HABIS PAKAI
224 Masker Tie on BAHAN HABIS PAKAI
225 Masker N-95 BAHAN HABIS PAKAI
226 Mikropipet 15-200 µl BAHAN HABIS PAKAI
227 PH Paper BAHAN HABIS PAKAI
228 Plester 5 yard x 2 inch BAHAN HABIS PAKAI
229 Polybag Medis BAHAN HABIS PAKAI
230 Polybag Nonmedis BAHAN HABIS PAKAI
231 Polybag Ramah Lingkungan BAHAN HABIS PAKAI
232 Pot Dahak BAHAN HABIS PAKAI
233 Safety box BAHAN HABIS PAKAI
234 Sarung Tangan Non Steril Uk.S BAHAN HABIS PAKAI
235 Sarung Tangan Non Steril Uk.M BAHAN HABIS PAKAI
236 Sarung Tangan Non Steril Uk.L BAHAN HABIS PAKAI
237 Sarung Tangan Steril No.6 BAHAN HABIS PAKAI
238 Sarung Tangan Steril No.6,5 BAHAN HABIS PAKAI
239 Sarung Tangan Steril No.7 BAHAN HABIS PAKAI
240 Sendok Obat BAHAN HABIS PAKAI
Silk (Benang Bedah Sutera) No.2/0 Dengan
241 Jarum Bedah BAHAN HABIS PAKAI
242 Tabung Vacutainer BAHAN HABIS PAKAI
243 Test Pack BAHAN HABIS PAKAI
244 Urin Bag BAHAN HABIS PAKAI
245 Vintip 60 BAHAN HABIS PAKAI
246 Vintip 61 BAHAN HABIS PAKAI
KESLING
247 Desinfektan tablet KESLING
248 Kaporit KESLING
249 PAC KESLING
250 Penjernih air cepat KESLING
REAGEN
251 Cybow 10 Reagent Strip REAGEN
252 Golongan Darah Anti A - B REAGEN
253 Humasens Plus REAGEN
254 Humasens Plus Strip Uric Acid REAGEN
255 Humasens Strip Glucose REAGEN
256 Iodin test REAGEN
257 Larutan Asam Asetat 6% 100 ml REAGEN
258 Larutan Benedict 100 ml REAGEN
259 Larutan HCl 0,1 N 100 ml REAGEN
260 Larutan Ziehl Neelsen REAGEN
261 Rapid Test Biomedika HIV REAGEN
262 Rapid Test Biomeriux HIV REAGEN
263 Rapid Test Intec HIV REAGEN
264 Rapid Test Malaria REAGEN
265 Rapid Test Oncoprobe HIV REAGEN
266 Rapid Test SD HIV REAGEN
267 Rapid Test SD Syphilis REAGEN
268 Rapid Test Syphilis REAGEN
269 RPR Syphilis REAGEN
LAIN-LAIN
270 Dekstrometorfan Tablet 15 mg
271 Dektrometorfan Sirup 10 mg/5 ml
Bagendit BGT
Pembangunan PBG
Kersamenak KSM
Siliwangi SLW
Pasundan PSD
Cilawu CLW
Bojongloa BJL
Karangmulya KRY
Karangpawitan KRP
Cempaka CPK
Cilimus CLM
Bayongbong BYB
Sukamulya SKY
Garawangsa GRW
Wanaraja WNR
Cimaragas CMG
Cipanas CPN
Sukaraja SKJ
Leles LLS
Lembang LMB
Guntur GTR
Mekarwangi MKW
Sukakarya SKK
Cisurupan CSR
Pakuwon PKW
Kadungora KDR
Rancasalak RCS
Karangsari KRS
Cikajang CKJ
Sukahurip SKP
Samarang SMR
Padaawas PDA
Gadog GDG
Maripari MRP
Cibatu CBT
Sukamerang SKM
Tarogong TRG
Sukasenang SKS
Bagendit BGT
Leuwigoong LWG
Citeras CTR
Malangbong MLB
Sukawening SKW
Sukamukti SKT
Karangtengah KRT
Cibiuk CBK
Limbangan LBG
Selaawi SLI
Haurpanggung HRP
BANJARWANGI BJW
BUNGBULANG BBL
CIBALONG CBL
CIHURIP CHP
CIMARI CMR
CISEWU CSW
MAROKO MRK
MEKARMUKTI MKM
PAMEUNGPEUK PMP
SINDANGRATU SDR
CIKELET CKT
CISANDAAN CSD
CISOMPET CSP
PAMULIHAN PML
PEUNDEUY PDY
SINGAJAYA SGJ
SUKARAME SKR
TALEGONG TLG
TEGALGEDE TGD
BULAN TAHUN INI

1 JANUARI 2017
2 FEBRUARI 2017
3 MARET 2017
4 APRIL 2017
5 MEI 2017
6 JUNI 2017
7 JULI 2017
8 AGUSTUS 2017
9 SEPTEMBER 2017
10 OKTOBER 2017
11 NOPEMBER 2017
12 DESEMBER 2017
JANUARI 2018
FEBRUARI 2018
HARGA
KEMASAN
SATUAN
Tablet 86.00
Tablet 1,356.00
Ampul 3,822.00
Tablet 90.00
Tablet 143.00
Tablet 187.00
Kaplet 272.00
Botol 2,445.00
Tablet 75.00
Botol 2,100.00
Supp 3,045.00
Tube
Pot 4,158.00
Tablet 135.00
Vial 2,030.00
Tablet 114.00
Tablet 104.00
Tablet 106.00
Tube 3,300.00
Tablet 345.00
Tablet 145.00
Ampul 1,672.00
Tablet 4,500.00
Vial 13,400.00
Tube 1,520.00
Tablet 132.00
Paket 32,101.00
Ampul 1,500.00
Tablet 44.00
Tablet 825.00
Botol 11,550.00
Botol 506,000.00
Vial
Ampul 4,180.00
tube 16,748.00
tube 11,525.00
Tablet 45.00
Ampul 1,054.00
Tablet 97.00
Tablet 104.00
Tablet 270.00
Botol 3,333.00
Tablet 118.00
Botol 660,000.00
Ampul 8,100.00
Kapsul 566.00
Botol
Botol 2,550.00
Botol 21,500.00
Botol 99,000.00
Botol 18,100.00
Kapsul 154.00
Tablet 135.00
Tablet 510.00
Tablet 634.00
Ampul 3,417.00
Tablet 2,000.00
Ampul 55,000.00
Botol 71,500.00
Tablet 85.00
Sachet 264.00
Vial 3,399.00
Tube 2,420.00
Botol
Botol 605,000.00
Tablet 104.50
Tablet 38.50
Fls 6,900.00
Tablet 219.00
Tablet 75.00
Tablet 66.00
Tube 2,798.00
Tablet 1,500.00
Set 170,000.00
Tablet 127.00
Tablet 137.00
Tablet 88.00
Ampul 9,955.00
Botol 137,500.00
Tablet 70.00
Tablet 80.00
Tablet 270.00
Botol 2,042.00
Tablet
Tablet 300.00
Ampul 6,200.00
Tablet 670.00
Tablet 553.00
Kapsul 273.74
Kapsul 1,007.00
Tube 3,091.00
Tube 1,600.00
Botol 3,955.00
Botol 7,150.00
Tube 6,160.00
Tablet 51.00
Tablet 162.00
Botol 2,145.00
Tablet 151.00
Ampul 1,845.00
Botol 41,000.00
Tablet 154.00
Ampul 6,050.00
Ampul 3,650.00
Blister 19,800.00
Blister 27,852.00
Tablet 112.50
Ampul 2,750.00
Tablet 154.00
Tablet 205.00
Tablet 160.00
Tube 3,000.00
Sachet -
Botol 88,000.00
Botol 10,230.00
Kaplet 935.00
Kapsul 426.00
Tablet 38.50
Tablet 200.00
Botol 71,500.00
Fls 6,410.00
Tablet -
Tablet 640.00
Tablet 523.00
Paket 359,900.00
Paket 1,199,985.00
paket 214,985.00
Paket 160,000.00
paket 288,200.00
Botol 4,235.00
Tube 2,772.00
Tube 1,870.00
Ampul 1,900.00
Kapsul 211.00
Ampul 1,650.00
Botol 1,438.00
Tablet 89.00
Blister 8,712.00
Blister 8,712.00
Tube 12,155.00
Tablet 118.00
Botol 2,163.00
Botol 14,203.00
Tablet 96.00
Tablet 224.00
Tablet 60.00
Tablet 319.00
Ampul 1,140.00
Tablet 120.00
Tablet 495.00
Kapsul 284.00
Kapsul 459.00
Fls 7,150.00
Ampul 6,600.00
Tablet 83.00
Pot 2,000.00
Kotak 1,250.00
Botol 4,746.00
Kapsul 510.00
Paket 33,000.00
Vial 4,000.00
Vial 8,360.00
Botol 170,500.00
Ampul 126,500.00
Vial 473,000.00
Ampul 1,078.00
Tablet 131.00
Kaplet 281.00
Tablet 50.00
Botol 165,000.00
Kapsul 300.00
Ampul 767.00
Tablet 86.00
Tablet 88.00
Set 59,950.00
Set 28,204.00
Vial 76,285.00
Vial 17,798.00
Set 20,900.00
Vial
Vial 14,498.00
Vial
Paket 198,000.00
Vial
Vial
Set
Set 19,954.00
Set 78,500.00
Vial 16,500.00
Tablet 115.00
Tablet 473.00
Buah 1,995.00
Buah 1,195.00
Buah 1,640.00
Set 650.00
Set 650.00
Set 750.00
Buah 2,350.00
Buah 770.00
Buah
Buah 3,600.00
Set 5,583.33
Set 5,583.33
Buah
Buah 750.00
Buah 8,000.00
Buah 925.00
Kantong 5,100.00
Kantong 6,435.00
Set 6,000.00
Set 6,000.00
Set 6,000.00
Set 6,000.00
Buah 2,291.67
Buah 2,291.67
Buah 19,700
Buah 170,000
Roll 12,500.00
Roll 7,700.00
Lembar 362.50
Roll 1,500.00
Roll 750.00
Roll 14,630.00
Buah 330.00
Buah 7,810.00
Buah 1,020.83
Buah 235,000.00
Roll 35,532.00
Lembar 300.00
Lembar 220.00
Lembar 250.00
Buah 5,890.00
Buah 18,625.00
Buah 356.20
Buah 356.20
Buah 356.20
Set 4,180.00
Set 4,180.00
Set 4,180.00
Buah 170.50
Set 3,055.56
Buah 6,908.00
Buah
Buah 3,000.00
Buah 773.00
Buah 980.00
Tablet 500.00
Kg 20,000
Sachet 5,000.00
Sachet 5,000.00
-
Set 133,750.00
Set
Set 805,950.00
Kotak 548,300.00
Kotak 249,800.00
Botol 5,806.00
Botol
Botol
Botol
Botol 276,500
Sachet 35,000.00
Sachet 22,475.00
Sachet 22,358.00
Sachet 27,710.00
Sachet 24,495.00
Sachet 22,330.00
Sachet 27,710.00
Sachet 22,385.00
Sachet 22,385.00
-
Tablet 110.00
Botol 2,865.00
Puskesmas Bagendit
Puskesmas Pembangunan
Puskesmas Kersamenak
Puskesmas Siliwangi
Puskesmas Pasundan
Puskesmas Cilawu
Puskesmas Bojongloa
Puskesmas Karangmulya
Puskesmas Karangpawitan
Puskesmas Cempaka
Puskesmas Cilimus
Puskesmas Bayongbong
Puskesmas Sukamulya
Puskesmas Garawangsa
Puskesmas Wanaraja
Puskesmas Cimaragas
Puskesmas Cipanas
Puskesmas Sukaraja
Puskesmas Leles
Puskesmas Lembang
Puskesmas Guntur
Puskesmas Mekarwangi
Puskesmas Sukakarya
Puskesmas Cisurupan
Puskesmas Pakuwon
Puskesmas Kadungora
Puskesmas Rancasalak
Puskesmas Karangsari
Puskesmas Cikajang
Puskesmas Sukahurip
Puskesmas Samarang
Puskesmas Padaawas
Puskesmas Gadog
Puskesmas Maripari
Puskesmas Cibatu
Puskesmas Sukamerang
Puskesmas Tarogong
Puskesmas Sukasenang
Puskesmas Bagendit
Puskesmas Leuwigoong
Puskesmas Citeras
Puskesmas Malangbong
Puskesmas Sukawening
Puskesmas Sukamukti
Puskesmas Karangtengah
Puskesmas Cibiuk
Puskesmas Limbangan
Puskesmas Selaawi
Puskesmas Haurpanggung
Puskesmas BANJARWANGI
Puskesmas BUNGBULANG
Puskesmas CIBALONG
Puskesmas CIHURIP
Puskesmas CIMARI
Puskesmas CISEWU
Puskesmas MAROKO
Puskesmas MEKARMUKTI
Puskesmas PAMEUNGPEUK
Puskesmas SINDANGRATU
Puskesmas CIKELET
Puskesmas CISANDAAN
Puskesmas CISOMPET
Puskesmas PAMULIHAN
Puskesmas PEUNDEUY
Puskesmas SINGAJAYA
Puskesmas SUKARAME
Puskesmas TALEGONG
Puskesmas TEGALGEDE
TAHUN DEPAN
2018
2018
2018
2018
2018
2018
2018
2018
2018
2018
2018
2018
2019
2019

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BUKU HARIAN R. FARMASI BULAN FEBRUARI 2019 TANGGAL ………………………………………….

No Nama Obat Satuan Pemakaian Obat Resep ke-

PUSKESMAS : SILIWANGI DOKUMEN NOMOR TANGGAL

UMUM ASKES JAMKESMAS JAMKESDA JAMPERSAL JUMLAH

1 Alopurinol Tablet 100 mg ANTIPIRAI

BULAN TAHUN INI

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