Lpo 08

(LP - LPO)
PUSKESMAS : NIMASI BULAN AGUSTUS

KECAMATAN : BIKOMI TENGAH TAHUN 2019
KABUPATEN : TIMOR TENGAH UTARA
SATUAN HARGA STOCK PERMINT ED OBAT PERSEDIA ED OBAT PEMAKAI SISA PERMINT PEMBERI
NO NAMA OBAT KEMASAN SATUAN Rp. AWAL AAN TERIMA BARU AN LAMA AN STOCK AAN AN KET
I. ANALGETIKA/ANTIPIRETIKA/ANTI INFLAMASI NONSTEROID/ANTIPIRAI

1 Antalgin/ Metamizol Tablet 238 -
2 metamizol 500 mg Tablet 231
3 Allupurinol 100 Mg Tablet Tablet 206.00 200 200 Nov-19 100 100 200
4 Antalgin/metampiron Inj 250 Mg/Ml -2 Ml Ampul 489 -
5 Asam Mefenamad 500 Mg Caplet Caplet 120 -
6 Asetosal 100 Mg Tablet Tablet 71 -
7 Asetosal 500 Mg Tablet Tablet 120 -
8 Ibuprofen 200 Mg Tablet Tablet 121 1500 1500
9 Ibuprofen 400 Mg Tablet Tablet 143 1500 1500
10 Kalium Diklofenak 50 Mg Tablet Tablet 990 500
11 Natrium Diklofenak 50 Mg Tablet Tablet 164 750 500 1,250 Oct-20 750 500 500
12 Parasetamol 100 Mg Tablet Tablet 72
13 Parasetamol 100 Mg Tablet Tablet 71,50 300 500
14 Parasetamol 500 Mg Tablet Tablet 120 800 1500 1,500 2,300 Mar-21 2300 - 2500
15 Parasetamol Syrup 120 Mg/5Ml Btl/60 Ml 3,455 60 15 75 Nov-21 42 33 30
16 BABY COUGH SYR Btl/60 Ml 5,500 51 51 Aug-21 31 20 50
17 Piroxicam 10 Mg Capsul Capsul 121 100
II ANESTETIK
1 Lidokain Injeksi Ampul 1,529 43 43 Oct-69 33 10 50
2 Xylocain Injeksi Vial
III ANTIALERGI &OBAT UNTUK ANAFILAKSIS
1 Dexamethason 0,5 Mg Tablet Tablet 54 800 1000 800 Apr-20 500 300 1000
2 Dexamethason injeksi 5Mg/Ml-1ml Ampul 1,897 7 7 Aug-19 7 - 20 ED
3 Diphenhidramin HCl Inj.10Mg/Ml-1Ml Ampul 1321` 60
4 Epinefrine / Adrenalin Injeksi Ampul 9,720 20 20 20 - 20 Rusak
NO NAMA OBAT TERIMA KET
KEMASAN SATUAN Rp. AWAL AAN BARU AN LAMA AN STOCK AAN AN
5 Klorfeniramin Maleat (CTM) 4 Mg Tablet Tablet 48.000 700 1000 1,500 2,200 Aug-20 500 1,700 0
6 Loratadin Tablet 10 Mg Tablet 160 2,150 1,000 3,150 Oct-21 550 2,600 0
7 Prednison 5 Mg Tablet Tablet 154 1000
IV ANTIDOT &OBAT LAIN UTK KERACUNAN
1 Atropin Sulfat 0,5 Mg Tablet Tablet 31
2 Atropin Sulfat Inj.0,25 Mg/Ml -1 Ml Ampul 1,038 5 5 Oct-20 5
3 Natrium Carbonat Tablet Tablet 17.16
4 Natrium Thiosulfat Ampul 3,240
V ANTIEPILEPSI
1 Carbamazepine 200 Mg /BAMGETOL Tablet 1,980 100 100 Mar-21 100
2 Diazepam 2 Mg Tablet Tablet 24
3 Diazepam SUPPOSITORIA SUPP
4 Diazepam 5Mg/Ml - 2Ml Injeksi Ampul 2,842 10 Apr-20 10 Feb-20 10
5 Fenobarbital 100 Mg Tablet Tablet 178
6 Fenobarbital 30 Mg Tablet Tablet 178,38 100 100 Oct-20
7 Fenobarbital Injeksi 50Mg /Ml-2Ml Ampul 214 5 5 Dec-19 5
VI ANTIBAKTERI
1 Amoxicilline 250 Mg Capsul Capsul 212 1,300 1,300 Apr-20 600 700
2 Amoxicilline 500 Mg Capsul Capsul 245 - 1500 2,000 2,000 Sep-20 1000 1,000
3 Amoxicilyn 125 Mg/5Ml Syrup Kering Btl/60Ml 2,350 57 57 Mar-20 9 48
4 Ampicilline 125 Mg/5 Ml Syrup Kering Btl/60Ml 5,700
5 Ampicilline 1 Gram Injeksi Vial 13,800
6 Benzatin Bensil Penisilin 1,200,000 IU Inj Vial 11,760
7 Chloramphenicol 250 Mg Capsul Capsul 1,254 - 100
8 Ciprofloksacin 500 Mg Capsul ( sebagai HCl ) Capsul 324 100
9 Cotrimoksazole 120 Mg Tablet Tablet 60 100
10 Cotrimoksazole 480 Mg Tablet Tablet 166 1,100 1,100 Nov-20 100 1,000
11 Cotrimoksazole Suspensi Btl/60 ml 2,590 82 82 Aug-19 82 - 30 ED
12 Doxycicline 100 Mg Tablet Tablet 251 100 100 May-20 100
13 Erytromycin 500 Mg Capsul Capsul 1,116 100
14 Gentamycin 40 Mg/Ml Injeksi Ampul 4,079
15 Kanamisin Injeksi Vial 539

16 Metronidasol 250 Mg Tablet Tablet 106 200 200 Jul-21 100 100 300
17 Metronidasol 500 Mg Tablet Tablet 151 200 200 Nov-20 100 100 300
18 Metronidazole Infus 500mg Botol 35,400
19 Oksitetrasikline HCl I.M.50Mg/Ml Inj Vial 13,750 6 6 Jun-21 6
20 Prokain Bensil Penisilin 3 Juta IU Inj Vial 10,770 5 5 Jun-20 5
21 Sefadroksil 250 Mg Capsul Capsul 795 800 200 1,000 Apr-20 1,000
22 Sefadroksil 500 Mg Capsul Capsul 840
23 Sefadroksil Syrup Btl/100 Ml 4,581 17 17 Mar-20 5 12
24 Sefotaksim 1 Gram Injeksi Vial 10,414
25 Seftriakson 1 Gram Injeksi Vial 11,459
26 Streptomycin Injeksi Vial 2,194
27 Tetrasiklin 250 Mg Capsul Capsul 179
28 Thiamfenikol 500 Mg Capsul Capsul 491
VII ANTHELMENTIKA
1 Albendazole 400 Mg Tablet Tablet 549 200 200 May-21 200
2 albendasolel Syrup 100mg/5ml Botol 13,800 3 3 May-20 1 2
3 Mebendasol Tablet Tablet 169
4 Pirantel Pamoat 125 Mg Tablet Tablet 274 200 200 200 May-21 200
VIII ANTI TUBERKULOSIS
1 Isoniazida 100 Mg Tablet Tablet 30
2 Kombipak I Paket 345,840
3 Obat TB FDC Kategori I + III Paket 409,075 1 2 2 3 Mar-20 2 1 3
4 Obat TB FDC Kategori II Paket 1,200,000
5 Obat TB Kategori Anak Paket 215,000 1 Mar-20 1 Feb-20 1
6 Obat TB Kategori Komb. II Sisipan Paket 160,000
7 Rifampisin 600 Mg Kapsul Kapsul 844
IX ANTI FUNGI
1 Griseofulvin 125 Mg Tablet Tablet 369 300 300 Apr-20 300
2 Nistatin 500,000 IU/g Tablet Salut Tablet 932 100 100 Oct-19 100
3 Nistatin 100,000 IU/g Tablet Vaginal Tablet 347 80 80 May-21 80
4 Ketokonasol Cream Tube 2,893 10 20 25 35 Jan-22 15 20 20

5 Miconazole Cream Tube 10 Gr 4,060 11 24 24 35 Apr-21 11 24
6 Ketokonasol 200 Mg Tablet Tablet 330 250 0 200 450 Feb-22 100 350
X ANTI MALARIA
1 DHP FIRMAL ktk/9tab Ktk/9 tab 31,482 5 5 Apr-20 5
2 Artesdiaquine / Arsuamoon Tablet Ktk/3 blister 39,600
@. 8 tab
3 Artesunate Injeksi Ampul 17,100

4 Arthemeter Injeksi Ampul 17,843
5 Primakuine 15 Mg Tablet Tablet 82 76 76 Apr-21 76
6 Quinine 200 Mg Tablet Tablet 373
7 Quinine Dihidroklorida Inj.25%-2Ml Ampul 3,139
XI ANTITUSIVA / EXPEKTORAN
1 Ambroxol 30 Mg Tablet Tablet 165 - 2000 2000
2 Dextral Tablet 495 - 600 600 600 Jul-23 450 150 900
3 AMBROXOL SYR Btl/60 Ml 2,880
4 Gliseril Guayakolat 100 Mg Tablet Tablet 57,20
5 Kodein Fosfat 10 Mg Tablet Tablet 685 100 100 Jun-22 100
6 Obat Batuk Hitam ( OBH ) Cairan Btl/100 Ml 2,970 20 20 40 Aug-21 10 30 50
XII ANTI ASTHMA
1 Aminophyllin 200 Mg Tablet Tablet 178,20 300 300 May-20 300
2 Aminophyllin 24 Mg/Ml-10 Ml Inj Ampul 3,349 5 5 May-21 5
3 Efedrin HCl 25 Mg Tablet Tablet 25 100
4 Salbutamol 2 Mg Tablet Tablet 84 100 200 300 Jul-21 100 100
5 Salbutamol 4 Mg Tablet Tablet 95 300 300 Jul-21 100 200
6 Atrovent Buah 2 2 Oct-19 2
XIII ANTASIDA / ANTI ULKUS
1 Antasida DOEN Tablet Tablet 252,70 - 1500 1500
2 Antasida Suspensi Btl/60 Ml 6,000 9 20 20 29 Nov-20 29 - 50
3 Cimetidin 200 Mg Tablet Tablet 87
4 Omeprazol 20 Mg Capsul Capsul 190 480 240 240 Apr-21 240 - 240
5 Ranitidine 150 Mg Tablet Tablet 121 1000 1,000 1,000 Aug-20 200 800 500
6 Ranitidine Injeksi 25 Mg/2 Ml Ampul 3,084 20 20 Oct-20 20 JKN"19
XIV OBAT KARDIOVASKULER
1 Amiloride 5 Mg Tablet Tablet 106
2 Amlodipin 10 Mg Tablet Tablet 99 250 250 Jan-23 250 - 300
3 Amlodipin 5 Mg Tablet Tablet 83 350 350 Jan-24 100 250 250
4 Digoksin 0,25 Mg Tablet Tablet 119
5 Furosemide 40 Mg Tablet Tablet 94 400 400 Nov-20 400
6 Hidroklortiazida 25 Mg Tablet Tablet 78 100 100 Aug-20 100
7 Isosorbid Dinitrat 5 Mg Tablet Tablet 107
8 Kaptopril 12,5 Mg Tablet Tablet 76 - 1500 700 700 Mar-23 700 700
9 Kaptopril 25 Mg Tablet Tablet 82
10 Nifedipin 10 Mg Tablet Tablet 140 100 100 Jan-22 100
11 Propranolol HCl 40 Mg Tablet Tablet 90
12 Reserpin 0,10 Mg Tablet Tablet 38
13 Reserpine 0,25 Mg Tablet Tablet 66
14 Spironolakton 25 Mg Tablet Tablet 400
XV OBAT GIGI
1 Air Raksa Dental Use Botol
2 Devitalisasi Pasta (Non Arsen) Botol 468,000
3 Eugenol Cairan Btl/10 Ml 20,000
4 Glass Ionomer Cement ART Kotak 474,000
5 Kalsium Hidroksida Pasta Ktk/2 Tube 290,400
6 Klorfenol Kamfer Menthol (CHKM) Btl 10 Ml 66,000
7 Mummifyng Pasta / Iodoform Botol 211,200
8 Semen Seng Fosfat Serbuk + Cairan Botol 112,200
9 Silver Amalgam Botol
10 Spons Gelatin Botol
11 Temporary Stopping Fletcher Botol 40,800
SATUAN HARGA STOK PERMINT ED OBAT PERSEDIA ED OBAT PEMAKAI SISA PERMINT PEMBERI
KEMASAN SATUAN Rp. AWAL AAN BARU AN LAMA AN STOK AAN AN
XVI LARUTAN ELEKTROLIT,NUTRISI, DLL

1 Aqua Pro Injeksi Steril Vial 8,910 3 3 Jan-21 3 - 10
2 Aquadest Steril Btl25Ml 9 9 Apr-21 9 - 10
3 Garam Oralit 200Ml Sachet 296 100 500 500 600 Nov-19 100 500
4 Glukosa 10% Larutan Infus Flacon 6,840 20 20 Dec-19 20
5 Glukosa 5% Larutan Infus Flacon 6,240 11 20 20 Apr-21 31 May-20 31
6 Natrium Klorida Lar.Infus 0,9% Steril Btl 500Ml 6,410 9 20 40 49 Apr-21 8 41
7 Ringer Laktat Larutan Infus Steril Botol/500 7,150 22 22 Oct-20 14 8 20
ml
XVII ANTIMIGRAIN
1 Ergotamin Cofein Tablet Tablet 162 100 100
XVIII DISINFEKTAN & ANTISEPTIK
1 Etakridin (Rivanol) Larutan 0,1% Btl 100ml 3,330 5 5 Sep-21 5 - 3
2 Ethanol 70 % Btl/1.000 Ml 25,408 1 1 Oct-20 1 - 2
3 Ethanol 70 % Btl/100 Ml 4,928 3 5 12 May-21 15 Nov-20 8 7 10

4 kalium permanganat serbuk Pot 5,610 5 5 Sep-22 5
5 Lisol Btl 1000Ml 56,580 1 1 1
6 Paraformaldehid Tablet Tablet 76
7 Povidon Iodida 10 % Btl 300Ml 23,100 2 5 3 5 Sep-20 3 2 3
8 Povidon Iodida 10 % Btl/30 Ml 6,050 5 5
9 Povidon Iodida 10 % Btl/60 Ml 7,532 5 5 5 5 - 5
10 Povidon Iodida 10 % Btl/1000 Ml 6,710 1 1 Sep-20 1 - 3
XIX OBAT TOPIKAL / KULIT

1 Basitrasin salf Tube 3,658 12 12 Sep-21 6 6 24
2 Antifungi DOEN Komb.(Salep 3-6%) Pot 1,385 10 10 Jun-22 4 6 5
3 Betametason 0,1% Cream Tube 1,444 33 33 Apr-20 3 30
4 Borax Gliserin Cairan 5 % Btl/10 Ml 4,550 8 8 Jul-20 8
5 Gentamycin Salep Kulit Tube 5 Gr 3,300 30 30 Jul-22 30 - 50
6 Gentian Violet Larutan 1% Btl 10 Ml 2,970 10 24 34 May-22 9 25
7 PERMETRIN Zalf Tube 2 2 May-20 2
8 Gliserol Btl/1.000 Ml -
9 Hidrokortison Cream 2,5% Tube 3,047 32 24 Jan-22 56 May-20 8 48

10 Icthyol Salep Pot 15 Gr 4,092 24 24 Aug-21 24
11 Levertran Salep Pot 15 Gr 8,910 24 24 Sep-19 24
12 Oxytetrasiklin HCl Salep Kulit 3% Tube 2,420 25 25 50 Nov-20 11 39
13 Salep 2 - 4 % Pot 3,040
14 Salicyl Spiritus 10 % Btl/30 Ml 7,480 24
15 Salicyl Talkum 2% Dos 1,165 3 15 15 18 Sep-21 12 6 12
XX OBAT MATA
1 Chloramfenikol Salep Mata 1% Tube/5 Gr 1,990 24 24 48 Apr-20 13 35
2 Chloramphenicol TM 1 % Botol 8,030 6 12 6 Jan-20 6 - 12
3 Oksitetrasikline HCl Salep Mata 1% Tube 2,600 4 12 25 29 Feb-21
4 Sulfacetamide TM Btl/5 Ml 4,134
XXI OBAT TELINGA
1 Chloramfenikol Tetes Telinga 3% Btl/10 Ml 8,030 9 12 9 Jul-21 6 3 12
2 Fenol Gliserol TT Botol 925
3 Karbogliserin Tetes Telinga 10 % Btl 2,450
XXII OKSITOSIK & RELAKSAN UTERUS
1 Methilergometrin Maleat Inj.0,200Mg-1Ml Ampul 2,684 100 100 Sep-19 100
2 Methilergometrin Maleat Tab.Salut 0,125Mg Tablet 259 100 100 Sep-20 100
3 Oksitosin Injeksi Ampul 1,900 99 Jun-20 99 Oct-19 3 96
XXIII VITAMIN / OBAT ROBORANTIA
1 Asam Folat 400mg Tablet 74 200 300 300 Jan-22 200 100 500
2 Asam Askorbat 50 Mg Tablet ( Vit. C ) Tablet 130 600 2500 2,500 3,100 Feb-22 1600 1,500 1000
3 Besi II Sulfat + Asam Folat Tablet 444 6,900 0 6,900 Aug-19 6900 - 5000
4 Fitomenadion 10Mg Tabl.Salut Gula ( Vit. K ) Tablet 950 100 100 Oct-21 100
5 Fitomenadion Inj.10Mg/Ml-1Ml ( Vit. K ) Ampul 10,230 14 14 Nov-20 4 10 30
6 Vitamin B12 tablet tablet 1,116 200 500 200 Jul-20 200 500
7 Kalsium Laktate 500 Mg Tablet Tablet 75 2,000 2,000 Apr-22 700 1,300 1000
8 Little U syr anak Btl/100 Ml 7,920 10 50 30 40 Jun-21 32 8 50
9 Iodine Test BOTOL 8,030 - 6 6 Apr-20 6

10 Piridoksin HCl 10 Mg Tablet ( Vit. B 6 ) Tablet 164 200 500 500 700 Oct-21 100 600
11 Retinol 100,000 IU / Vit. A Capsul (Biru) Capsul 355 500 500 Apr-20 50 450
12 Retinol 200,000 IU / Vit. A Capsul (Merah) Capsul 648 550 550 May-20 300 250
13 Vit. B 12 inj. Ampul 1,421 26 26 Apr-22 26
14 Thiamin HCl 100mg/ml-1ml Injeksi Ampul 2,200 32 32 Nov-20 32
15 Thiamin HCl/Mononitrat 50 mg Tablet Tablet 84 - 1000 1000
16 SOFERO KAPSS KAPSUL 440 700 2000 - 700 May-20 700 - 2500
17 Vitamin B Complex Tablet Tablet 144 700 1500 1,500 2,200 Mar-20 1,700 500 1500
XXIV OBAT OBAT LAIN (PROG: KUSTA,KECACINGAN,KIA,DLL)
1 Diethilcarbamazine Sitrat Tablet Tablet 136
2 Klorpromazin HCl 25 mg/ml/-1ml Inj Ampul 451
3 Klorpromazin HCl 5 mg/ml/-2ml Inj Ampul 502
4 Klorpromazin HCl Salut 100 Mg Tab Tablet 190
5 Klorpromazin HCl Salut 25 Mg Tab Tablet 29
6 MgSO4 ( IV ) 20 % - 25 Ml Injeksi Vial 1,848 1 1 Apr-20 1 - 10
7 MgSO4 ( IV ) 40 % - 25 Ml Injeksi Vial 2,337 1 1 Aug-19 1 - 10
8 MgSO4 Serbuk 30 gram Sachet 1,650 4 4 Aug-20 4
9 MB Anak Strip
10 MB Dewasa Strip 31,760
11 AZITROMISIN Tablet 1,888 970 970 Sep-21 970
12 PB Dewasa Strip
13 kalsium gluconas inj ampul 9,955 2 2 Aug-21 2
XXV OBAT ANTI DIARE, ANTIMUNTAH,ANTISPASMODIK,GGN SAL CERNA
1 Domperidon 10 Mg Tablet Tablet 144 100 100 Nov-20 100 - 200
2 Ekstrak Belladon 10 Mg Tablet Tablet 21 200 200
3 Karbo Adsorben ( Bekarbon ) Tablet Tablet 33
4 Loperamide 2 Mg Tablet Tablet 107 200 200
5 Metoclopropamide 10 Mg Tablet Tablet 120 100 100 Aug-20 100
6 Metoclopropamide Injeksi Ampul 4,950 5 5 Feb-20 5
7 Papaverine 40 Mg Tablet Tablet 297 100 100 Aug-20 100

8 Papaverine Injeksi Ampul 636
9 Zink 20 Mg/5 Ml Syrup Btl/60 Ml 17,976 15 15 Jun-21 7 8 10
10 Zink Dispersibel 20 Mg Tablet Tablet 644 700 700 May-21 250 450 500
XXVI OBAT ANTI VIRUS / HERPES
1 Acyclovir 400 Mg Tablet Tablet 400 100 100 Sep-21 100 - 500
2 Acyclovir Cream Tube 2,997 2 2 Oct-19 2 - 12
XXVII OBAT ANTI HEMOROID/WASIR
1 Anti Hemorroid DOEN Komb. Supp 2,400
XXVIII OBAT ANTI DEPRESAN,ANTIPSIKOSIS,PARKINSON,DIABETES MELITUS,HIPERTIROID,ANTIHIPOTIROID
1 Amitriptilin 25 Mg Tablet Tablet 111
2 Glibenklamide 5 Mg Tablet Tablet 70 -
3 Glimepiride 1 Mg Tablet Tablet 318 50 50 Feb-21 50
4 Glimepiride 2 Mg Tablet Tablet 230 250 250 Jul-21 250
5 Haloperidol 5 Mg Tablet Tablet 69 30 500 30 30 - 500
6 Levotiroksin Ktk/28 -
Tablet
7 Metformin HCl 500 Mg Tablet Tablet 138 -
8 Propiltiorasil 100 Mg Tablet Tablet 348 200 200 Jun-22 200
9 Simvastatin 10 Mg Tablet Tablet 117 - 500 240 240 Apr-21 210 30 300
10 Triheksifenidil Hidroklorida 2Mg Tablet Tablet 103 280 280 Sep-20 260 20 300
XXIX KONTRASEPSI
1 Susuk KB II- 3 Tahun Sachet -
2 Obat Suntik KB 3 BULAN Vial -
3 Pil KB Strip -
XXX VAKSIN
1 ATS/BCG Vial 54,500 11 10 21 Dec-19 17
2 CAMPAK/MR Vial 25,640 60 60 Feb-20 29
3 DPT-HB Pentabio Vial 70,232 12 10 22 May-20 8 10
4 DT Vial 15,500
5 HEPATITIS B ADS (PID) 1 dosis Vial 20,900
6 HEPATITIS B(0-7)hari Uniject 19,000 25 25 Sep-19 20
TERIMA
NO NAMA OBAT KET
7 POLIO Botol 19,954 4 10 14 Mar-20 3 20

8 SERUM ANTI BISA ULAR (ABU) Vial 229,000
9 TT/td Vial 15,000 24 24 Oct-19 22
10 PELARUT CAMPAK/MR Ampul 142 10 10 Jul-21 10
11 pipet dos - 20 -
12 ipv Ampul 137,810 6 5 10 16 Apr-20 10
13 pelarut BCG 1ML Ampul 50,000 12 12 Aug-21 12
XXXI BAHAN MEDIS HABIS PAKAI / PERBEKALAN KESEHATAN
1 Alat Suntik Sekali Pakai 0,05 Ml Buah 1,995 30 200 200 230 May-20 30 200
2 Alat Suntik Sekali Pakai 0,5 Ml Buah 1,345 96 200 200 296 May-20 233 63
3 Alat Suntik Sekali Pakai 1 Ml Buah 897 100 100 Nov-19 100
4 Alat Suntik Sekali Pakai 10 Ml Buah 100 100 100
5 Alat Suntik Sekali Pakai 2,5 Ml Buah 897 200 200 Jun-20 85 115
6 Alat Suntik Sekali Pakai 3 Ml Buah 3,516
7 Alat Suntik Sekali Pakai 5 Ml Buah 897 114 114 Jun-20 51 63
8 Blades FG 15 Buah 3,600 10 10 10 - 10
9 Blades FG 20 Buah 3,600 10 10 10 - 10
10 Cat Gut No.2/0 - 3/0 Sachet 7,705 28 28 Oct-19 24 4 24
11 Feeding Tube 5FR 40cm Sachet 9,570 2 2 2
12 Feeding Tube 8 FR 40 cm Sachet 15,717 2 2 2
13 Foley Catheter ped FG 8 Pcs 41,400 1 1 1
14 Female Catheter FG 16 Pcs 12,500
15 Foley Catheter 2 Way 3 cc FG 12 Pcs 10,000 5 5 5
19 Folley Catheter 2 Way 3cc FG 14 Pcs 10,194 10 10 10
20 Folley Catheter 2 Way 3cc FG 16 Pcs 10,194 10 10 10
21 Hecting Set Set 335,000
22 Infus Set Anak Set 4,416 18 18 Apr-21 4 14 10
23 Infus Set Dewasa Set 4,416 22 22 Apr-21 10 12 10
TERIMA
NO NAMA OBAT KET
24 IV Catheter No.18 G Pcs 6,306 - 20 20

25 IV Catheter No.20 G Pcs 6,306 10 10 Apr-21 2 8 10
26 IV Catheter No.22 G Pcs 6,306 10 10 May-22 3 7 10
27 IV Catheter No.24 G Pcs 6,306 14 14 Apr-21 14
28 Feeding Tube FR 5 40 cm set 9,570 2 2 2
29 Feeding Tube FR 8 40 cm set 9,570 2 2 2
30 Kapas Berlemak 500 Gram Bungkus 18,750 1 1 1
31 Kapas Pembalut 250 Gram Bungkus 17,250 - - 2
32 Kasa 10 Cm Roll
33 Kasa 2 M x 80 Cm Rol 10,071 21 21 10 11
34 Kasa 3x5 Cm Roll 794 13 13 7 6 20
35 Kasa 40 M x 80 Cm Roll 144,900 2 2 2 - 2
36 Kasa 16 M x 16 Cm Kotak 8,004 18 18 Sep-19 6 12
37 Kasa Kompres 40/40 Steril Bungkus 2,208
38 Kasa Pembalut Hidrofil 4 M x 15 Cm Rol 894 22 22 2 20
39 Kasa Pembalut Hidrofil 4 M x5Cm Rol 1,092 9 9 5 4 20
40 Kertas Perkamen Rimm 14999,60 - -
41 Masker Display 3 Play Set 925 30 200 150 180 150 30 200
42 plester roll kain 5x450 cm ROLL 18968,75 1 1 1
43 Nelaton Catheter FG 16 Pcs 15,000
SPALAK -
45 Pembalut Gips Rol 39,000
TERIMA
NAMA BMHP / PERBEKALAN KESEHATAN / SATUAN HARGA STOK PERMINT ED OBAT PERSEDI ED OBAT PEMAKAI SISA PERMINT PEMBERI
NO KET
REAGENTIA & ALAT LAB KES KEMASAN SATUAN Rp. AWAL AAN BARU AAN LAMA AN STOK AAN AN
46 Plester 2,5X450CM Rol 10323,75 1 1 1 -

47 Sachet Obat Klips Buah 17,999 - 5 5 5 2 3
48 Stomach Tube No.12/NGT pCS 9,680 2 2 2
49 Silk/Benang Bedah Sutera No.3/0 Sachet 4,688 36 36 Jul-20 1 36
50 Stomach Tube No. 16 / NGT Pcs 9,680 4 4 4
51 Stomach Tube No. 18 / NGT Pcs 9,680 4 4 4
52 Suction Catheter FG 10 Pcs 5,431 4 4 4
53 Suction Catheter FG 12 Pcs 5,431 4 4 4
54 Surgical Glove Non Steril No.7 1/2/ L Pcs 1,399 - 200 100 100 100 - 200
55 Surgical Glove Non Steril No.7/ M Pcs 1,399 - 200 100 100 100 - 200
56 Surgical Glove Steril No. 7 1/2 Pcs 5,016 100 100 Apr-21 100
57 Surgical Glove Steril No.6 1/2 Pcs 5,016 131 131 Apr-21 113 18
58 Surgical Glove Steril No.7 Pcs 5,016 81 100 181 Apr-21 131 50
59 Surgical Glove NON Steril uk,S Pcs 1,339 85 85 85 - 100
60 Urine Bag Steril Buah 4,824 6 6 Nov-19 6
61 Wing Needle No. 21 G Set 1,156 5 5 5
62 Wing Needle No.23 G Pcs 994 5 5 5
63 Wing Needle No.25 G Pcs 1,156 5 5 5
64 Wing Needle No.27 G Pcs 1,156 5 5 5
XXXII REAGENTIA & ALAT LABORATORIUM KESEHATAN
1 Alkohol swab 2 play Box/200 34,800 2 2 2
2 E Care Alkohol swab & CHG 0,5 % Box/100 20,664 1 1 1
3 Anti Sera ABO ( A,B,AB,O ) Set 428,725 1 1 1
4 E CARE ANTISEPTIK Hand Rub 10 btl@500ml btl 63,840 5 5 5
5 E Care film IV Dresing 67 (6x7cm) Box/100 231,000 1 1 1
6 Batang Pengaduk Kaca Kecil Buah 4,000
7 Bilirubin Direct Kit 1,036,364
8 Bilirubin Total Kit 1,036,364
9 Blood Lancet Feather isi 200 buah/box Buah 432 400 400 100 300
10 Botol Sample Air Bakteriologis Buah 86,000
11 BUN ( Human ) Kit/2x100 647,727
Ml
12 Burner Complite Aladin Buah 7,100,000
13 Cawan Porselin Buah 17,000
14 Cholesterol Human Kit 1,518,000
15 Cleansing & Desinfectant Set 2,150,000
16 Combur Tes ( Cybow )100 ml Kit 525,000 1 1 1
TERIMA
NO KET
REAGENTIA & ALAT LAB KES KEMASAN SATUAN Rp. AWAL AAN BARU AAN LAMA AN STOK AAN AN
17 Dipstik Sachet 5,271 190 190 Oct-19 1,909

18 EP. TIPS Standar 2200 Blue Pak/500 388,636
19 EP. TIPS Standar 2200 Yeloww Pak/500 431,818
20 Formalin Test Set 512,820
21 Glukosa 10260 Human Kit 496,591
22 Hand Held Unit 1,200
23 HB Sahli ( Marwa ) Set 110,000 2 2 2
24 HBsAg ( Stik ) Ktk/50 Tes 12,870
25 HCG Test Set 2425,75
26 HDL ( Human ) Kit 518,182
27 Hygrometer Unit
28 hexagon shipilis tes Test 26,889 140 140 Sep-19 80 60 ED
29 Iodine Test Test 1,980
30 Jas Lab Buah 85,000
31 Kertas Lensa 50 lembar/buku Buku/50 95000 75 75 50
32 Kertas Saring Lembar 34,000 1 1 1
33 Klinipette Multi Chanel 100 - 1.000 Ml Set 13,000
34 Kreatinin Btl/100 ml 582,955
35 Lab Kit Kit 901,274 1 1 1
36 Snellen Test Card pcs 15,172 2 2 2
37 Lampu Spiritus Buah 89,000
38 Larutan / Reagen Ziel Nelsenn Set 259,091
39 Larutan Aceton Alkohol Btl/100 ml 73,409
40 Larutan Anisol Btl 100 Ml 90,300
41 Larutan Asam Sulfosalisilat 20 % Btl/100 ml 273,000 1 1 1
42 Larutan Buffer Pro Giemsa Btl/500 Ml 136,500
43 Larutan Eosin 2% Btl/100 Ml 176,225 1 1 1
44 Larutan Extran Netral/Flow Cell Btl/500 Ml 467,500
45 Larutan Giemsa Stain Btl/100 Ml 356,250
TERIMA
NO REAGENTIA & ALAT LAB KES KEMASAN SATUAN Rp. AWAL AAN BARU AAN LAMA AN STOK AAN AN KET
46 Larutan Giemsa Stain Btl/100 Ml 356,250 1 1 1

47 Larutan H2O2 3 % Btl/1000 ml 133,980
48 Larutan Hayem Btl/100 ml 64,773

49 Larutan HCL 0,1 N Btl/100 Ml 13,728 2 2 2
50 Larutan KOH Btl/100 Ml 23,100
51 Larutan Lugol Btl/100 ml 158,182
52 Larutan Methanol Btl 100 Ml 40,000
53 Larutan Natrium Citrat Btl/100 ml 157,000
54 Larutan Oil Imersi Btl/500 Ml 3,261,720
55 Larutan Turk Btl 100 Ml 23,750 1 1 1
56 LDL ( Human ) Kit 561,364
57 Buah
58 Lensmatic Compas Unit
59 Microscope Binokuler Unit
60 Obyek Glass /Slide Dos/72 14,509 2 2 1 1
61 PHB Ph Meter Type 03 Unit 4,925,250
62 ONEMED DETECTO HBS Ag Hepatitis B Sashet 5,060 50 50 50
63 One Med Female Cateter no,12 steril pcs 6,050 2 2 2
64 Oxiflow Nassal Oxigen Anak pcs 6,600 5 5 5
65 Oxiflow Nassal Oxigen Bayi pcs 6,600 5 5 5
66 Oxygen Mask With Nebulizer (L ) PCS 19,488 2 2 2
67 Oxygen Mask With Nebulizer (M ) PCS 19,488 2 2 2
68 Oxygen Mask With Nebulizer (S ) PCS 19,488 2 2 2
69 Reagen HBs Ag Buah 6,040,000
70 Reagen Hemoglobin Buah 215,909
71 TES HIV/AIDS Sashet/50 15,260 180 180 Oct-19 80 100
72 Serum Vial Buah 4,950
TERIMA
NAMA REAGENTIA & ALAT LAB KES / ALAT SATUAN HARGA STOK PERMINT ED OBAT PERSEDI ED OBAT PEMAKAI SISA PERMINT PEMBERI
NO. KEDOKTERAN KEMASAN SATUAN Rp. AWAL AAN BARU AAN LAMA AN STOK AAN AN KET
73 Anios Gel 85 500 ml Botol 102,500 2 2 2

74 Indroreagen EDTA 10%(1X100)ml Botol 74,100 1 1 1
75 Indroreagen Hemoglobin C (1X500 )ml Botol 87,850 1 1 1
76 Safety Box 5 ml pcs 19,644 5 5 5 - 50
77 Sputum Pot Pot 12,000 100 100 20 80
78 Bioplacenton Tulle 10x10 ktk/10 109,200 1 1 1
79 Besmed Guedel Airway Dispo 100 mm pcs 15,717 2 2 2
82 Test HIV / AIDS Imonocom Dos/50 Tes 2,159,091
83 Test HIV / AIDS Quick Check Dos/50 Tes 2,159,091
84 Test HIV / AIDS SD Bioline HIV 1/2.3.0 Dos/30 Tes 2,159,091
85 Tissue Roll Roll 5,500 2 2 2 1 2
86 Torniquuet Buah 38,500
87 Total Protein Kit 561,000
88 Trigliserida Human Kit 820,455
89 Uric Acid Human Kit 647,727
90 Urin Analizer System Unit 48,900,000
91 Urinometer Buah 227,274
92 Widal Tes Set 971,000
93 water one botol 19,448
XXXIII ALAT KEDOKTERAN
1 Leukomed T Plus 8x15cm pcs 22,000 5 5 5
2 onestep solution 500ml botol 34,320
3 Under Pad pcs 5,203 10 10 10
4 Plester Non Woven 15x5cm Roll 86,900 5 5 3 2 3
5 Plester Non Woven5x5cm Roll 29,700 2 2 2 - 3
6 Verban Elastis''3'' Roll 19,500 5 5 2 3
7 Verban Elastis "4" Roll 25,000 3 3 3
8 Jelly Doopler Tube 25,000 1 1 1 - 2
9 Jelly Doopler 82gram tube 36,937 1 1 1 - 2
TERIMA
NO. KET
KEDOKTERAN KEMASAN SATUAN Rp. AWAL AAN BARU AAN LAMA AN STOK AAN AN
10 Waslap pcs 20,000 2

11 Wayson Med Semilas Transpar 6x7 pcs 4608,33 5 5 5
12 Three way stop cook wiyh tube 10cm pcs 4,485 20 20 20
15 Aximed Airflow Tube ETT with cuff no.6 pcs 32,670 2 2 2
16 Aximed Airflow Tube ETT with cuff no.7 pcs 30,855 2 2 2
17 Aximed Airflow Tube with cuff no.7,5 pcs 32,670 2 2 2
18 Guedel Airway 40 mm Disp Steril Saschet 15,717 1 1 1
19 Guedel Airway 70 mm Disp Steril Saschet 15,717 1 1 1
20 Verban Elastis 3" Roll 19,500
21 Umbilical cord klem steril Pcs 1,625 84 84 3 81
22 Dsposible bed sheet Pcs 6,050
23 Particulate Respirator Buah
24 Partus Set Set 1,326,492
25 cutticcll 10 cmx10 cm saschet 5,198 14 14 14
26 Pispot Laki Buah 350,000
27 Pispot Wanita Buah 350,000
28 cutticcll 10 cmx40 cm saschet 14,689
29 cuka dixi Btl 9,800
30 OXYMETRI Buah
31 REGULATOR OXIGEN Buah
32 TABUNG OKSIGEN Buah
33 NGT Buah 2 2 2
34 Stetoscope Unit 350,000
35 Stetoskop Pinard Unit 60,000
36 TENSIMETER DIGITAL Buah
37 Tensimeter Air Raksa Unit 1,260,000
38 Thermometer Axiler Buah 21,000
39 Thermometer Rectal Buah 21,000
40 Thermomether Unit 10,230
TERIMA
NO. KET
KEDOKTERAN KEMASAN SATUAN Rp. AWAL AAN BARU AAN LAMA AN STOK AAN AN
41 Timbangan Badan Bayi Unit -

42 Timbangan Berdiri Buah 1,960,000 -
43 Tromol Has Besar Buah 890,000 -
44 Tromol Has Sedang Buah 540,000
45 Muccus Extractor (Pengisap lendir bayi) set 8,800 2 2 2
46 BUKU KIA BUAH 188 188 34 154
JUMLAH KUNJUNGAN PUSKESMAS :
UMUM BAYAR 145

ASKES 4
GAKIN 292
DLL 71
JUMLAH TOTAL 512
Mengetahui / Menyetujui : Yang menyerahkan Yang Meminta Yang Menerima

Kepala Dinas Kesehatan Kabupaten Petugas UPTD Gudang Farmasi Kabupaten Kepala Puskesmas Nimasi Pengelola Obat Puskesmas Nimasi
Timor Tengah Utara Timor Tengah Utara
ANSELMUS SENGKOEN,S.Si BONEVASIA M.M. LAKE,A.Md,Farm

NIP. NIP. NIP.19800825 200212 1 009 NRPK.24.7.0505055
PUSKESMAS : NIMASI
KECAMATAN : BIKOMI TENGAH
NO. NAMA OBAT SATUAN HARGA

KEMASAN SATUAN
Rp.
1 Antalgin/Metampiron 500 Mg Tablet/ Metamizol Tablet 238
3 Allupurinol 100 Mg Tablet Tablet 206.00
4 Antalgin/metampiron Inj 250 Mg/Ml -2 Ml Ampul 489
5 Asam Mefenamad 500 Mg Caplet Caplet 120
6 Asetosal 100 Mg Tablet Tablet 71
8 Ibuprofen 200 Mg Tablet Tablet 121
10 Kalium Diklofenak 50 Mg Tablet Tablet 990
11 Natrium Diklofenak 50 Mg Tablet Tablet 162
13 Parasetamol 100 Mg Tablet Tablet 71,50
15 Parasetamol Syrup 120 Mg/5Ml Btl/60 Ml 1,252
16 BABY COUGH SYR Btl/60 Ml 5,500
17 Piroxicam 10 Mg Capsul Capsul 121
II ANESTETIK
1 Lidokain Injeksi Ampul 1,026
1 Dexamethason 0,5 Mg Tablet Tablet 54
2 Dexamethason injeksi 5Mg/Ml-1ml Ampul 1,897
3 Diphenhidramin HCl Inj.10Mg/Ml-1Ml Ampul 1,260
4 Epinefrine / Adrenalin Injeksi Ampul 9,720
5 Klorfeniramin Maleat (CTM) 4 Mg Tablet Tablet 48.000
6 Loratadin Tablet 10 Mg Tablet 172
7 Prednison 5 Mg Tablet Tablet 154
2 Atropin Sulfat Inj.0,25 Mg/Ml -1 Ml Ampul 1,038
V ANTIEPILEPSI
1 Carbamazepine 200 Mg Tablet Tablet 198
4 Diazepam 5Mg/Ml - 2Ml Injeksi Ampul 2,842
6 Fenobarbital 30 Mg Tablet Tablet 178,38
7 Fenobarbital Injeksi 50Mg /Ml-2Ml Ampul 214

KEMASAN SATUAN
Rp.
VI ANTIBAKTERI
1 Amoxicilline 250 Mg Capsul Capsul 212
3 Amoxicilyn 125 Mg/5Ml Syrup Kering Btl/60Ml 2,350
6 Benzatin Bensil Penisilin 1,200,000 IU Injeksi Vial 11,760
7 Chloramphenicol/CHLORAMEX 250 Mg Capsul Capsul 1,254
8 Ciprofloksacin 500 Mg Capsul ( sebagai HCl ) Capsul 324
9 Cotrimoksazole 120 Mg Tablet Tablet 60
11 Cotrimoksazole Suspensi Btl/60 ml 2,439
12 Doxycicline 100 Mg Tablet Tablet 251
13 Erytromycin 500 Mg Capsul Capsul 1,116
16 Metronidasol 250 Mg Tablet Tablet 106
19 Oksitetrasikline HCl I.M.50Mg/Ml Injeksi Vial 13,750
20 Prokain Bensil Penisilin 3 Juta IU Injeksi Vial 10,770
23 Sefadroksil Syrup Btl/100 Ml 4,581
VII ANTHELMENTIKA
1 Albendazole 400 Mg Tablet Tablet 549
2 albendasolel Syrup 100mg/5ml Botol 13,800
4 Pirantel Pamoat 125 Mg Tablet Tablet 274
3 Obat TB FDC Kategori I + III Paket 486,683
5 Obat TB Kategori Anak Paket 215,000
IX ANTI FUNGI
1 Griseofulvin 125 Mg Tablet Tablet 369
2 Nistatin 500,000 IU/g Tablet Salut Tablet 932
3 Nistatin 100,000 IU/g Tablet Vaginal Tablet 347
4 Ketokonasol Cream Tube 2,893
5 Miconazole Cream Tube 10 Gr 4,060
6 Ketokonasol 200 Mg Tablet Tablet 330

KEMASAN SATUAN
Rp.
X ANTI MALARIA
1 DHP FIRMAL ktk/9tab Ktk/9 tab 31,482
2 Artesdiaquine / Arsuamoon Tablet Ktk/3blister@8tab 39,600
5 Primakuine 15 Mg Tablet Tablet 82
1 Ambroxol 30 Mg Tablet Tablet 165
2 Dextral Tablet 495
5 Kodein Fosfat 10 Mg Tablet Tablet 31
6 Obat Batuk Hitam ( OBH ) Cairan Btl/100 Ml 2,970
XII ANTI ASTHMA
1 Aminophyllin 200 Mg Tablet Tablet 178,20
2 Aminophyllin 24 Mg/Ml-10 Ml Injeksi Ampul 3,349
3 Efedrin HCl 25 Mg Tablet Tablet 25
4 Salbutamol 2 Mg Tablet Tablet 84
6 Atrovent Buah
1 Antasida DOEN Tablet Tablet 252,70
2 Antasida Suspensi Btl/60 Ml 6,000
4 Omeprazol 20 Mg Capsul Capsul 240
5 Ranitidine 150 Mg Tablet Tablet 121
6 Ranitidine Injeksi 25 Mg/2 Ml Ampul 3,084
2 Amlodipin 10 Mg Tablet Tablet 391
5 Furosemide 40 Mg Tablet Tablet 141
6 Hidroklortiazida 25 Mg Tablet Tablet 78
8 Kaptopril 12,5 Mg Tablet Tablet 76
10 Nifedipin 10 Mg Tablet Tablet 140

KEMASAN SATUAN
Rp.
XV OBAT GIGI
11 Temporary Stopping Fletcher Serb+Cairan Botol 40,800
1 Aqua Pro Injeksi Steril Vial 8,910
2 Aquadest Steril Btl 100Ml 48,840
3 Garam Oralit 200Ml Sachet 296
4 Glukosa 10% Larutan Infus Flacon 6,840
6 Natrium Klorida Lar.Infus 0,9% Steril Btl 500Ml 7,150
7 Ringer Laktat Larutan Infus Steril Botol/500ml 7,150
XVII ANTIMIGRAIN
1 Anti Migrain DOEN Komb. Ergotamin Cofein Tablet Tablet 162
1 Etakridin (Rivanol) Larutan 0,1% Btl 300ml 3,330
2 Ethanol 70 % Btl/1.000 Ml 25,408
3 Ethanol 70 % Btl/100 Ml 4,928
4 kalium permanganat serbuk Pot 5,610
5 Lisol mengandung Kresol Tersabun 50% Btl 1000Ml 56,580
7 Povidon Iodida 10 % Btl 300Ml 23,100
8 Povidon Iodida 10 % Btl/30 Ml 6,050
1 Anti Bakteri DOEN Salep Komb.(Basitrasin) Tube 3,658
2 Antifungi DOEN Komb.(Salep 3-6%) Pot 1,385
3 Betametason 0,1% Cream sebagai valerat Tube 1,444
4 Borax Gliserin Cairan 5 % Btl/10 Ml 4,550
5 Gentamycin Salep Kulit Tube 5 Gr 3,300
6 Gentian Violet Larutan 1% Btl 10 Ml 2,970
7 PERMETRIN Zalf Tube
9 Hidrokortison Cream 2,5% Tube 3,047
10 Icthyol Salep Pot 15 Gram 4,092
11 Levertran Salep Pot 15 Gram 8,910
12 Oxytetrasiklin HCl Salep Kulit 3% Tube 2,420
13 Salep 2 - 4 % Pot 3,040
14 Salicyl Spiritus 10 % Btl/30 Ml 7,480
15 Salicyl Talkum 2% Dos 1,165

KEMASAN SATUAN
Rp.
XX OBAT MATA
1 Chloramfenikol Salep Mata 1% Tube/5 Gr 1,990
2 Chloramphenicol TM 1 % Botol 8,030
3 Oksitetrasikline HCl Salep Mata 1% Tube 2,600
XXI OBAT TELINGA
1 Chloramfenikol Tetes Telinga 3% Btl/10 Ml 8,030
1 Methilergometrin Maleat Inj.0,200Mg-1Ml Ampul 2,684
2 Methilergometrin Maleat Tab.Salut 0,125Mg Tablet 259
3 Oksitosin Injeksi Ampul 1,900
1 Asam Folat 400mg Tablet 74
2 Asam Askorbat 50 Mg Tablet ( Vit. C ) Tablet 130
3 Besi II Sulfat + Asam Folat (SF/Tablet Tambah Darah Komb) Tablet 444
4 Fitomenadion 10Mg Tabl.Salut Gula ( Vit. K ) Tablet 866
5 Fitomenadion Inj.10Mg/Ml-1Ml ( Vit. K ) Ampul 10,230
6 Iodiol Capsul Lunak Capsul 1,116
7 Kalsium Laktate 500 Mg Tablet Tablet 75
8 Little U syr anak Btl/100 Ml 7,920
9 Mineral Mix Sachet 2,970
10 Piridoksin HCl 10 Mg Tablet ( Vit. B 6 ) Tablet 144
11 Retinol 100,000 IU / Vit. A Capsul (Biru) Capsul 306
12 Retinol 200,000 IU / Vit. A Capsul (Merah) Capsul 402
13 Sianokobalamine 500mcg/ml-1ml Injeksi ( Vit. B 12 ) Ampul 624
14 Thiamin HCl 100mg/ml-1ml Injeksi ( Vit. B 1 ) Ampul 2,200
15 Thiamin HCl/Mononitrat 50 mg Tablet ( Vit. B1 ) Tablet 84
16 NOVABION/SOFERO KAPSS KAPSUL 444
17 Vitamin B Complex Tablet Tablet 144
2 Klorpromazin HCl 25 mg/ml/-1ml Injeksi Ampul 451
4 Klorpromazin HCl Salut 100 Mg Tablet Tablet 190
6 Magnesium Sulfat / MgSO4 ( IV ) 20 % - 25 Ml Injeksi Vial 1,848
8 Magnesium Sulfat / MgSO4 Serbuk 30 gram Sachet 1,650
9 MB Anak Strip
10 MB Dewasa Strip
11 PB Anak Strip
12 PB Dewasa Strip
13 kalsium gluconas inj ampul 9,955
NO. NAMA OBAT / VAKSIN SATUAN HARGA

KEMASAN SATUAN
Rp.
1 Domperidon 10 Mg Tablet Tablet 144
2 Ekstrak Belladon 10 Mg Tablet Tablet 21
4 Loperamide 2 Mg Tablet Tablet 107
5 Metoclopropamide 10 Mg Tablet Tablet 120
6 Metoclopropamide Injeksi Ampul 4,950
7 Papaverine 40 Mg Tablet Tablet 297
9 Zink 20 Mg/5 Ml Syrup Btl/60 Ml 17,976
10 Zink Dispersibel 20 Mg Tablet Tablet 644
1 Acyclovir 400 Mg Tablet Tablet 400
2 Acyclovir Cream Tube 2,997
2 Glibenklamide 5 Mg Tablet Tablet 70
3 Glimepiride 1 Mg Tablet Tablet 318
5 Haloperidol 0,5 Mg Tablet Tablet 71
6 Levotiroksin Ktk/28Tablet -
7 Metformin HCl 500 Mg Tablet Tablet 138
8 Propiltiorasil 100 Mg Tablet Tablet 348
9 Simvastatin 10 Mg Tablet Tablet 198
10 Triheksifenidil Hidroklorida 2Mg Tablet Tablet 49
XXIX KONTRASEPSI
3 Pil KB Strip -
XXX VAKSIN
1 ATS/BCG Vial 54,500
2 CAMPAK Vial 25,640
3 DPT-HB Pentabio Vial 70,232
4 DT Vial 15,500
6 HEPATITIS B(0-7)hari Uniject -
7 POLIO Botol 19,954
9 TT/td Vial 15,000
10 PELARUT CAMPAK Ampul
11 pipet dos
12 ipv Ampul 137,810
13 pelarut BCG 1ML Ampul 50,000
NO. NAMA BAHAN MEDIS HABIS PAKAI / SATUAN HARGA
PERBEKALAN KESEHATAN KEMASAN SATUAN
Rp.
1 Alat Suntik Sekali Pakai 0,05 Ml Buah 1,995
8 Blades FG 15 Buah 3,600
10 Cat Gut No.2/0 - 3/0 Sachet 4344,71
11 Feeding Tube Tube 100cm FG 6 Pcs 48,840
13 Foley Catheter ped FG 8 Pcs 41,400
15 Foley Catheter 2 Way 3 cc FG 12 Pcs 10,000
19 Folley Catheter 2 Way 3cc FG 14 Pcs 10,194
22 Infus Set Anak Set 4,416
23 Infus Set Dewasa Set 3662,50
24 IV Catheter No.18 G Pcs 6306,25
28 Kaca Mulut Buah 43,000
29 Kain Spray Putih 140 x 490 Cm Buah 198,500
30 Kapas Berlemak 500 Gram Bungkus 18,750
31 Kapas Pembalut 250 Gram Bungkus 15,625
32 Kasa 10 Cm Roll
33 Kasa 2 M x 80 Cm Rol 10,071
34 Kasa 3,6 M x 10 Cm Roll
35 Kasa 40 M x 80 Cm Roll 144,500
36 Kasa 16 M x 16 Cm Kotak 2,210
38 Kasa Pembalut Hidrofil 4 M x 15 Cm Rol 2,898
39 Kasa Pembalut Hidrofil 4 M x 3 Cm Rol 364
40 Kertas Perkamen Rimm 14999,60
41 Masker Display 3 Play Set 924,82
42 plester roll kain 5x450 cm ROLL 18968,75
SPALAK -
NO. NAMA BMHP / PERBEKALAN KESEHATAN / SATUAN HARGA

REAGENTIA & ALAT LAB KES KEMASAN SATUAN
Rp.
46 Plester 2,5X450CM Rol 10323,75
47 Sachet Obat Klips Buah 17999,3
48 Sarung Tangan Obgyn Panjang Pcs 18,500
49 Silk/Benang Bedah Sutera No.3/0 Sachet 4687,67
50 Stomach Tube No. 16 / NGT Pcs 4,545
52 Suction Catheter FG 10 Pcs 4,545
54 Surgical Glove Non Steril No.7 1/2/ L Pcs 1,399
55 Surgical Glove Non Steril No.7/ M Pcs 1399,20
56 Surgical Glove Steril No. 7 1/2 Pcs 5,100
57 Surgical Glove Steril No.6 1/2 Pcs 5,100
58 Surgical Glove Steril No.7 Pcs 5,016
59 Surgical Glove NON Steril uk,S Pcs 1,339
60 Urine Bag Steril Buah 4,800
61 Wing Needle No. 21 G Set 6,924
62 Wing Needle No.23 G Pcs 6,924
1 Albumin Kit 389,400
2 Anti HBs Buah 2,159
3 Anti Sera ABO ( A,B,AB,O ) Set 582,955
4 Aquadest On Steril Jerigen 107,200
5 Batang Pengaduk Kaca 30 Cm Buah 5,000
9 Blood Lancet Feather isi 200 buah/box Buah 432
11 BUN ( Human ) Kit/2x100 Ml 647,727
12 Burner Complite Aladin ( spare part unit RCW 50 EK ) Buah 7,100,000
16 Combur Tes ( Cybow ) Kit 611,000
17 Dipstik Sachet 5,271
23 HB Sahli ( Assisten ) Set 100,000
26 HDL ( Human ) Kit 518,182
NO. NAMA BMHP / PERBEKALAN KESEHATAN / SATUAN HARGA

Rp.
27 Hygrometer Unit
28 hexagon shipilis tes Test 26,889
31 Kertas Lensa 50 lembar/buku Buku/50 5000
32 Kertas Saring Lembar 1,000
35 Lab Kit Kit
36 Lactosa Broth Btl 1,950,000
41 Larutan Asam Sulfosalisilat 20 % Btl/100 ml 391,000
43 Larutan Eosin 2% Btl/100 Ml 217,000
46 Larutan Giemsa Stain Btl/500 Ml 1,303,000
47 Larutan H2O2 3 % Btl/1000 ml 133,980
49 Larutan HCL 0,1 N Btl/250 Ml 32,000
55 Larutan Turk Btl 100 Ml 92,000
56 LDL ( Human ) Kit 561,364
57 Lensa Obyek 40 x Buah 475,000
60 Obyek Glass /Slide Dos/72 14,509
62 Pipet Pasteur Buah 23,925
63 Pipet Tetes Kaca Panjang Buah 300
64 Pipet Tetes Kaca Pendek Buah 92
65 Rak Pengecatan TB (Beton) Set 125,227
66 Rak Tabung Reaksi Kayu Buah 4,400
67 Rak Tabung Reaksi Stainlees Steel Buah 23,800
68 Reagen Brilla/ Bouillon (BGLB) Set 2,775,000
71 TES HIV/AIDS Sashet/50 15,260
NO. NAMA REAGENTIA & ALAT LAB KES / SATUAN HARGA

ALAT KEDOKTERAN KEMASAN SATUAN
Rp.
73 SGOT Kit 734,091
74 SGPT Kit 734,091
75 Slide Box Buah 10,000
76 Spare Spart Mikroskop Unit
77 Sputum Pot Pot 12,000
78 Tabung Durham Buah 170,000
79 Tabung Khan 12 x 75mm Buah 2,100
80 Tabung Reaksi 16mm x 150mm Buah 1,428
81 Tabung Reaksi Bertutup Karet 10 Ml Buah 50,000
85 Tissue Roll Roll 5,500
90 Urin Analizer System Unit 48,900,000
1 Alat ukur panjang bayi Buah 375,000
2 Autoklaf Buah 25,275,000
3 Bak Instrumen Buah 240,000
4 Bedside Cabinet Buah 4,750,000
5 Bidan Kit Kit 1,950,000
6 Celemek Plastik Buah 50,000
7 Cunan Tampon Buah 728,000
8 Jelly Doopler Tube 36,937
9 ECG 3 Chanel Set 41,500,000
10 Infusion Standar Buah 1,350,000
11 Instrumen Bak Buah 240,000
12 Klem Ovum Buah 1,104,000
13 Korentang Buah 230,000
14 Lampu Sorot Buah 6,900,000
15 Mangkok Plasenta Buah 67,000
16 Meja Mayo Buah 5,120,000
17 NEBULIZER Buah
18 Minor Surgery Set Set 8,250,000
19 Mortir + Stanper Set 60,000
21 Umbilical cord klem steril Pcs 1,380
NO. NAMA ALAT KEDOKTERAN SATUAN HARGA

KEMASAN SATUAN
Rp.
30 OXYMETRI Buah
33 NGT Buah 1
41 Timbangan Badan Bayi Unit
42 Timbangan Berdiri / Weirghing Marchind Buah 1,960,000
43 Tromol Has Besar Buah 890,000
45 Vaccuum Extractor Manual Buah 4,111,000
Pirantel Pamoat syrup Botol 263
stok awal JANUARI FEBRUARI MARET
PENERIMAAN PENGELUARAN PENERIMAAN PENGELUARAN PENERIMAAN
RTIROID,ANTIHIPOTIROID
MARET APRIL MEI JUNI
PENGELUARAN PENERIMAAN PENGELUARAN PENERIMAAN PENGELUARAN PENERIMAAN
JUNI
PENGELUARAN
JUNI
PENGELUARAN
JUNI
PENGELUARAN
JUNI
PENGELUARAN
JUNI
PENGELUARAN
JUNI
PENGELUARAN
JUNI
PENGELUARAN
JUNI
PENGELUARAN
JUNI
PENGELUARAN
JUNI
PENGELUARAN
JUNI
PENGELUARAN
PUSKESMAS : NIMASI
KECAMATAN : BIKOMI TENGAH
NO. NAMA OBAT SATUANHARGA stok awal

KEMASANSATUAN
Rp.
1 Antalgin/Metampiron 500 Mg Tablet/ Metamizol Tablet 238
3 Allupurinol 100 Mg Tablet Tablet 206.00
4 Antalgin/metampiron Inj 250 Mg/Ml -2 Ml Ampul 489
5 Asam Mefenamad 500 Mg Caplet Caplet 120
10 Kalium Diklofenak 50 Mg Tablet Tablet 990
11 Natrium Diklofenak 50 Mg Tablet Tablet 162
13 Parasetamol 100 Mg Tablet Tablet 71,50
15 Parasetamol Syrup 120 Mg/5Ml Btl/60 Ml 1,252
16 BABY COUGH SYR Btl/60 Ml 5,500
17 Piroxicam 10 Mg Capsul Capsul 121
II ANESTETIK
1 Lidokain Injeksi Ampul 1,026
1 Dexamethason 0,5 Mg Tablet Tablet 54
2 Dexamethason injeksi 5Mg/Ml-1ml Ampul 1,897
3 Diphenhidramin HCl Inj.10Mg/Ml-1Ml Ampul 1,260
4 Epinefrine / Adrenalin Injeksi Ampul 9,720
5 Klorfeniramin Maleat (CTM) 4 Mg Tablet Tablet 48.000
6 Loratadin Tablet 10 Mg Tablet 172
7 Prednison 5 Mg Tablet Tablet 154
2 Atropin Sulfat Inj.0,25 Mg/Ml -1 Ml Ampul 1,038
V ANTIEPILEPSI
1 Carbamazepine 200 Mg Tablet Tablet 198
4 Diazepam 5Mg/Ml - 2Ml Injeksi Ampul 2,842
6 Fenobarbital 30 Mg Tablet Tablet 178,38
7 Fenobarbital Injeksi 50Mg /Ml-2Ml Ampul 214
NO. NAMA OBAT SATUAN HARGA stok awal

KEMASAN SATUAN
Rp.
VI ANTIBAKTERI
3 Amoxicilyn 125 Mg/5Ml Syrup Kering Btl/60Ml 2,350
6 Benzatin Bensil Penisilin 1,200,000 IU Injeksi Vial 11,760
7 Chloramphenicol/CHLORAMEX 250 Mg Capsul Capsul 1,254
8 Ciprofloksacin 500 Mg Capsul ( sebagai HCl ) Capsul 324
11 Cotrimoksazole Suspensi Btl/60 ml 2,439
12 Doxycicline 100 Mg Tablet Tablet 251
13 Erytromycin 500 Mg Capsul Capsul 1,116
19 Oksitetrasikline HCl I.M.50Mg/Ml Injeksi Vial 13,750
20 Prokain Bensil Penisilin 3 Juta IU Injeksi Vial 10,770
23 Sefadroksil Syrup Btl/100 Ml 4,581
VII ANTHELMENTIKA
1 Albendazole 400 Mg Tablet Tablet 549
2 albendasolel Syrup 100mg/5ml Botol 13,800
4 Pirantel Pamoat 125 Mg Tablet Tablet 274
3 Obat TB FDC Kategori I + III Paket 486,683
5 Obat TB Kategori Anak Paket 215,000
IX ANTI FUNGI
1 Griseofulvin 125 Mg Tablet Tablet 369
2 Nistatin 500,000 IU/g Tablet Salut Tablet 932
3 Nistatin 100,000 IU/g Tablet Vaginal Tablet 347
4 Ketokonasol Cream Tube 2,893
5 Miconazole Cream Tube 10 Gr 4,060
6 Ketokonasol 200 Mg Tablet Tablet 330

KEMASAN SATUAN
Rp.
X ANTI MALARIA
1 DHP FIRMAL ktk/9tab Ktk/9 tab 31,482
2 Artesdiaquine / Arsuamoon Tablet Ktk/3blister@8tab 39,600
5 Primakuine 15 Mg Tablet Tablet 82
1 Ambroxol 30 Mg Tablet Tablet 165
2 Dextral Tablet 495
5 Kodein Fosfat 10 Mg Tablet Tablet 31
6 Obat Batuk Hitam ( OBH ) Cairan Btl/100 Ml 2,970
XII ANTI ASTHMA
1 Aminophyllin 200 Mg Tablet Tablet 178,20
2 Aminophyllin 24 Mg/Ml-10 Ml Injeksi Ampul 3,349
3 Efedrin HCl 25 Mg Tablet Tablet 25
6 Atrovent Buah
1 Antasida DOEN Tablet Tablet 252,70
2 Antasida Suspensi Btl/60 Ml 6,000
4 Omeprazol 20 Mg Capsul Capsul 240
5 Ranitidine 150 Mg Tablet Tablet 121
6 Ranitidine Injeksi 25 Mg/2 Ml Ampul 3,084
5 Furosemide 40 Mg Tablet Tablet 141
6 Hidroklortiazida 25 Mg Tablet Tablet 78
8 Kaptopril 12,5 Mg Tablet Tablet 76
10 Nifedipin 10 Mg Tablet Tablet 140

KEMASAN SATUAN
Rp.
XV OBAT GIGI
11 Temporary Stopping Fletcher Serb+Cairan Botol 40,800
1 Aqua Pro Injeksi Steril Vial 8,910
2 Aquadest Steril Btl 100Ml 48,840
3 Garam Oralit 200Ml Sachet 296
6 Natrium Klorida Lar.Infus 0,9% Steril Btl 500Ml 7,150
7 Ringer Laktat Larutan Infus Steril Botol/500ml 7,150
XVII ANTIMIGRAIN
1 Anti Migrain DOEN Komb. Ergotamin Cofein Tablet Tablet 162
1 Etakridin (Rivanol) Larutan 0,1% Btl 300ml 3,330
2 Ethanol 70 % Btl/1.000 Ml 25,408
3 Ethanol 70 % Btl/100 Ml 4,928
4 kalium permanganat serbuk Pot 5,610
5 Lisol mengandung Kresol Tersabun 50% Btl 1000Ml 56,580
7 Povidon Iodida 10 % Btl 300Ml 23,100
1 Anti Bakteri DOEN Salep Komb.(Basitrasin) Tube 3,658
2 Antifungi DOEN Komb.(Salep 3-6%) Pot 1,385
3 Betametason 0,1% Cream sebagai valerat Tube 1,444
4 Borax Gliserin Cairan 5 % Btl/10 Ml 4,550
5 Gentamycin Salep Kulit Tube 5 Gr 3,300
6 Gentian Violet Larutan 1% Btl 10 Ml 2,970
7 PERMETRIN Zalf Tube
9 Hidrokortison Cream 2,5% Tube 3,047
10 Icthyol Salep Pot 15 Gram 4,092
11 Levertran Salep Pot 15 Gram 8,910
12 Oxytetrasiklin HCl Salep Kulit 3% Tube 2,420
13 Salep 2 - 4 % Pot 3,040
14 Salicyl Spiritus 10 % Btl/30 Ml 7,480
15 Salicyl Talkum 2% Dos 1,165

KEMASAN SATUAN
Rp.
XX OBAT MATA
1 Chloramfenikol Salep Mata 1% Tube/5 Gr 1,990
2 Chloramphenicol TM 1 % Botol 8,030
3 Oksitetrasikline HCl Salep Mata 1% Tube 2,600
XXI OBAT TELINGA
1 Chloramfenikol Tetes Telinga 3% Btl/10 Ml 8,030
1 Methilergometrin Maleat Inj.0,200Mg-1Ml Ampul 2,684
2 Methilergometrin Maleat Tab.Salut 0,125Mg Tablet 259
3 Oksitosin Injeksi Ampul 1,900
1 Asam Folat 400mg Tablet 74
2 Asam Askorbat 50 Mg Tablet ( Vit. C ) Tablet 130
3 Besi II Sulfat + Asam Folat (SF/Tablet Tambah Darah Komb) Tablet 444
4 Fitomenadion 10Mg Tabl.Salut Gula ( Vit. K ) Tablet 866
5 Fitomenadion Inj.10Mg/Ml-1Ml ( Vit. K ) Ampul 10,230
6 Iodiol Capsul Lunak Capsul 1,116
7 Kalsium Laktate 500 Mg Tablet Tablet 75
8 Little U syr anak Btl/100 Ml 7,920
9 Mineral Mix Sachet 2,970
10 Piridoksin HCl 10 Mg Tablet ( Vit. B 6 ) Tablet 144
11 Retinol 100,000 IU / Vit. A Capsul (Biru) Capsul 306
12 Retinol 200,000 IU / Vit. A Capsul (Merah) Capsul 402
13 Sianokobalamine 500mcg/ml-1ml Injeksi ( Vit. B 12 ) Ampul 624
14 Thiamin HCl 100mg/ml-1ml Injeksi ( Vit. B 1 ) Ampul 2,200
15 Thiamin HCl/Mononitrat 50 mg Tablet ( Vit. B1 ) Tablet 84
16 NOVABION/SOFERO KAPSS KAPSUL 444
17 Vitamin B Complex Tablet Tablet 144
8 Magnesium Sulfat / MgSO4 Serbuk 30 gram Sachet 1,650
9 MB Anak Strip
10 MB Dewasa Strip
11 PB Anak Strip
12 PB Dewasa Strip
13 kalsium gluconas inj ampul 9,955
NO. NAMA OBAT / VAKSIN SATUAN HARGA stok awal

KEMASAN SATUAN
Rp.
1 Domperidon 10 Mg Tablet Tablet 144
2 Ekstrak Belladon 10 Mg Tablet Tablet 21
4 Loperamide 2 Mg Tablet Tablet 107
5 Metoclopropamide 10 Mg Tablet Tablet 120
6 Metoclopropamide Injeksi Ampul 4,950
7 Papaverine 40 Mg Tablet Tablet 297
9 Zink 20 Mg/5 Ml Syrup Btl/60 Ml 17,976
10 Zink Dispersibel 20 Mg Tablet Tablet 644
1 Acyclovir 400 Mg Tablet Tablet 400
2 Acyclovir Cream Tube 2,997
2 Glibenklamide 5 Mg Tablet Tablet 70
5 Haloperidol 0,5 Mg Tablet Tablet 71
6 Levotiroksin Ktk/28Tablet -
7 Metformin HCl 500 Mg Tablet Tablet 138
8 Propiltiorasil 100 Mg Tablet Tablet 348
9 Simvastatin 10 Mg Tablet Tablet 198
10 Triheksifenidil Hidroklorida 2Mg Tablet Tablet 49
XXIX KONTRASEPSI
3 Pil KB Strip -
XXX VAKSIN
1 ATS/BCG Vial 54,500
2 CAMPAK Vial 25,640
3 DPT-HB Pentabio Vial 70,232
4 DT Vial 15,500
6 HEPATITIS B(0-7)hari Uniject -
7 POLIO Botol 19,954
9 TT/td Vial 15,000
10 PELARUT CAMPAK Ampul
11 pipet dos
12 ipv Ampul 137,810
13 pelarut BCG 1ML Ampul 50,000
NO. NAMA BAHAN MEDIS HABIS PAKAI / SATUAN HARGA stok awal
PERBEKALAN KESEHATAN KEMASAN SATUAN
Rp.
10 Cat Gut No.2/0 - 3/0 Sachet 4344,71
13 Foley Catheter ped FG 8 Pcs 41,400
22 Infus Set Anak Set 4,416
23 Infus Set Dewasa Set 3662,50
28 Kaca Mulut Buah 43,000
29 Kain Spray Putih 140 x 490 Cm Buah 198,500
30 Kapas Berlemak 500 Gram Bungkus 18,750
31 Kapas Pembalut 250 Gram Bungkus 15,625
32 Kasa 10 Cm Roll
33 Kasa 2 M x 80 Cm Rol 10,071
34 Kasa 3,6 M x 10 Cm Roll
35 Kasa 40 M x 80 Cm Roll 144,500
36 Kasa 16 M x 16 Cm Kotak 2,210
38 Kasa Pembalut Hidrofil 4 M x 15 Cm Rol 2,898
39 Kasa Pembalut Hidrofil 4 M x 3 Cm Rol 364
40 Kertas Perkamen Rimm 14999,60
41 Masker Display 3 Play Set 924,82
42 plester roll kain 5x450 cm ROLL 18968,75
SPALAK -
NO. NAMA BMHP / PERBEKALAN KESEHATAN / SATUAN HARGA stok awal

Rp.
46 Plester 2,5X450CM Rol 10323,75
47 Sachet Obat Klips Buah 17999,3
48 Sarung Tangan Obgyn Panjang Pcs 18,500
49 Silk/Benang Bedah Sutera No.3/0 Sachet 4687,67
54 Surgical Glove Non Steril No.7 1/2/ L Pcs 1,399
55 Surgical Glove Non Steril No.7/ M Pcs 1399,20
56 Surgical Glove Steril No. 7 1/2 Pcs 5,100
57 Surgical Glove Steril No.6 1/2 Pcs 5,100
58 Surgical Glove Steril No.7 Pcs 5,016
59 Surgical Glove NON Steril uk,S Pcs 1,339
60 Urine Bag Steril Buah 4,800
61 Wing Needle No. 21 G Set 6,924
1 Albumin Kit 389,400
2 Anti HBs Buah 2,159
3 Anti Sera ABO ( A,B,AB,O ) Set 582,955
4 Aquadest On Steril Jerigen 107,200
5 Batang Pengaduk Kaca 30 Cm Buah 5,000
9 Blood Lancet Feather isi 200 buah/box Buah 432
11 BUN ( Human ) Kit/2x100 Ml 647,727
12 Burner Complite Aladin ( spare part unit RCW 50 EK ) Buah 7,100,000
16 Combur Tes ( Cybow ) Kit 611,000
17 Dipstik Sachet 5,271
23 HB Sahli ( Assisten ) Set 100,000
26 HDL ( Human ) Kit 518,182
NO. NAMA BMHP / PERBEKALAN KESEHATAN / SATUAN HARGA stok awal

Rp.
27 Hygrometer Unit
28 hexagon shipilis tes Test 26,889
31 Kertas Lensa 50 lembar/buku Buku/50 5000
32 Kertas Saring Lembar 1,000
35 Lab Kit Kit
36 Lactosa Broth Btl 1,950,000
41 Larutan Asam Sulfosalisilat 20 % Btl/100 ml 391,000
43 Larutan Eosin 2% Btl/100 Ml 217,000
46 Larutan Giemsa Stain Btl/500 Ml 1,303,000
47 Larutan H2O2 3 % Btl/1000 ml 133,980
49 Larutan HCL 0,1 N Btl/250 Ml 32,000
55 Larutan Turk Btl 100 Ml 92,000
56 LDL ( Human ) Kit 561,364
57 Lensa Obyek 40 x Buah 475,000
60 Obyek Glass /Slide Dos/72 14,509
62 Pipet Pasteur Buah 23,925
63 Pipet Tetes Kaca Panjang Buah 300
64 Pipet Tetes Kaca Pendek Buah 92
65 Rak Pengecatan TB (Beton) Set 125,227
66 Rak Tabung Reaksi Kayu Buah 4,400
67 Rak Tabung Reaksi Stainlees Steel Buah 23,800
68 Reagen Brilla/ Bouillon (BGLB) Set 2,775,000
71 TES HIV/AIDS Sashet/50 15,260
NO. NAMA REAGENTIA & ALAT LAB KES / SATUAN HARGA stok awal
ALAT KEDOKTERAN KEMASAN SATUAN
Rp.
73 SGOT Kit 734,091
74 SGPT Kit 734,091
75 Slide Box Buah 10,000
76 Spare Spart Mikroskop Unit
77 Sputum Pot Pot 12,000
78 Tabung Durham Buah 170,000
79 Tabung Khan 12 x 75mm Buah 2,100
80 Tabung Reaksi 16mm x 150mm Buah 1,428
81 Tabung Reaksi Bertutup Karet 10 Ml Buah 50,000
85 Tissue Roll Roll 5,500
90 Urin Analizer System Unit ###
1 Alat ukur panjang bayi Buah 375,000
2 Autoklaf Buah ###
3 Bak Instrumen Buah 240,000
4 Bedside Cabinet Buah 4,750,000
5 Bidan Kit Kit 1,950,000
6 Celemek Plastik Buah 50,000
7 Cunan Tampon Buah 728,000
8 Jelly Doopler Tube 36,937
9 ECG 3 Chanel Set ###
10 Infusion Standar Buah 1,350,000
11 Instrumen Bak Buah 240,000
12 Klem Ovum Buah 1,104,000
13 Korentang Buah 230,000
14 Lampu Sorot Buah 6,900,000
15 Mangkok Plasenta Buah 67,000
16 Meja Mayo Buah 5,120,000
17 NEBULIZER Buah
18 Minor Surgery Set Set 8,250,000
19 Mortir + Stanper Set 60,000
21 Umbilical cord klem steril Pcs 1,380
NO. NAMA ALAT KEDOKTERAN SATUAN HARGA stok awal

KEMASAN SATUAN
Rp.
30 OXYMETRI Buah
33 NGT Buah 1
41 Timbangan Badan Bayi Unit
42 Timbangan Berdiri / Weirghing Marchind Buah 1,960,000
43 Tromol Has Besar Buah 890,000
45 Vaccuum Extractor Manual Buah 4,111,000
Pirantel Pamoat syrup Botol 263
JULI AGUSTUS SEPTEMBER
PENERIMAAN PENGELUARAN PENERIMAAN PENGELUARAN PENERIMAAN PENGELUARAN
TIROID,ANTIHIPOTIROID
OKTOBER NOVEMBER DESEMBER

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PUSKESMAS : NIMASI BULAN AGUSTUS

I. ANALGETIKA/ANTIPIRETIKA/ANTI INFLAMASI NONSTEROID/ANTIPIRAI

15 Kanamisin Injeksi Vial 539

4 Ketokonasol Cream Tube 2,893 10 20 25 35 Jan-22 15 20 20

3 Artesunate Injeksi Ampul 17,100

XVI LARUTAN ELEKTROLIT,NUTRISI, DLL

3 Ethanol 70 % Btl/100 Ml 4,928 3 5 12 May-21 15 Nov-20 8 7 10

XIX OBAT TOPIKAL / KULIT

9 Hidrokortison Cream 2,5% Tube 3,047 32 24 Jan-22 56 May-20 8 48

9 Iodine Test BOTOL 8,030 - 6 6 Apr-20 6

7 Papaverine 40 Mg Tablet Tablet 297 100 100 Aug-20 100

7 POLIO Botol 19,954 4 10 14 Mar-20 3 20

24 IV Catheter No.18 G Pcs 6,306 - 20 20

46 Plester 2,5X450CM Rol 10323,75 1 1 1 -

17 Dipstik Sachet 5,271 190 190 Oct-19 1,909

46 Larutan Giemsa Stain Btl/100 Ml 356,250 1 1 1

48 Larutan Hayem Btl/100 ml 64,773

73 Anios Gel 85 500 ml Botol 102,500 2 2 2

10 Waslap pcs 20,000 2

41 Timbangan Badan Bayi Unit -

JUMLAH KUNJUNGAN PUSKESMAS :

UMUM BAYAR 145

Mengetahui / Menyetujui : Yang menyerahkan Yang Meminta Yang Menerima

ANSELMUS SENGKOEN,S.Si BONEVASIA M.M. LAKE,A.Md,Farm

NO. NAMA OBAT SATUAN HARGA

NO. NAMA OBAT SATUAN HARGA

NO. NAMA OBAT SATUAN HARGA

NO. NAMA OBAT SATUAN HARGA

NO. NAMA OBAT SATUAN HARGA

NO. NAMA OBAT / VAKSIN SATUAN HARGA

NO. NAMA BMHP / PERBEKALAN KESEHATAN / SATUAN HARGA

NO. NAMA BMHP / PERBEKALAN KESEHATAN / SATUAN HARGA

NO. NAMA REAGENTIA & ALAT LAB KES / SATUAN HARGA

NO. NAMA ALAT KEDOKTERAN SATUAN HARGA

NO. NAMA OBAT SATUANHARGA stok awal

NO. NAMA OBAT SATUAN HARGA stok awal

NO. NAMA OBAT SATUAN HARGA stok awal

NO. NAMA OBAT SATUAN HARGA stok awal

NO. NAMA OBAT SATUAN HARGA stok awal

NO. NAMA OBAT / VAKSIN SATUAN HARGA stok awal

NO. NAMA BMHP / PERBEKALAN KESEHATAN / SATUAN HARGA stok awal

NO. NAMA BMHP / PERBEKALAN KESEHATAN / SATUAN HARGA stok awal

NO. NAMA ALAT KEDOKTERAN SATUAN HARGA stok awal

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