PUSTU

NO KODE NAMA OBAT KET

PERAPAKAN
1 2 3 4 9 10
OBAT GENERIK
1 Albendazol tablet 400 mg
2 Alopurinol tablet 100 mg
3 Alprazolam 0.5 mg
4 Ambroxol sirup 15 mg/ml
5 Ambroxol tablet 30 mg
6 Aminofilina injeksi 24 mg/ml - 10 ml
7 Aminofilina tablet 200 mg
8 Amlodipin 5 mg
9 Amoksisilin kapsul 250 mg
10 Amoksisilin + as. Klavulanat 625 mg
11 Amoksisilin kapsul 500 mg
12 Amoksisilin sirup kering 125 mg/5 ml
13 Amoksisilin sirup kering forte 250 mg/5 ml
14 Ampisilin caplet 500 mg
15 Ampisilin sirup kering 125 mg/5 ml
16 Antalgin injeksi 250 mg/ml - 2 ml
17 Antasida DOEN suspensi
Antasida DOEN tablet kunyah,kombinasi :Mg-hidroksida 200
18
mg + Al.Hidroksida.200 mg
Anti Bakteri DOEN salep kombinasi:Basitrasilin 500 IU/g +
19
Polimiksin 1000 UI/g
Antifungi DOEN kombinasi :Asam Benzoat 6 % + Asam
20 Salisilat 3 %
Anti Hemoroid DOEN kombinasi : Bismuth subgalat 150
21 mg + Heksaklorofen 2,5 mg

22 Anti Malaria ( DHP)

Antimigren DOEN tablet kombinasi : Ergotamin Tartrat 1 mg
23
+ Kofein 50 mg
24 Aqua pro Injeksi steril, bebas pirogen
25 ARCO
26 Artesunate injeksi,vial 60 ml
27 Asetosal tablet 100 mg
28 Asetosal tablet 500 mg
29 Asam Askorbat (Vit C) tablet 50 mg
30 Asam Mefenamat 500 mg
31 Asam Trenaksamat 500 mg
32 Asam Trenaksamat Injeksi
33 Asiklovir krim 5 %
34 Asiklovir tablet 400 mg
35 Attapulgite
Besi II Sulfat 200 mg + Asam Folat 0,25 mg (Tablet
36 Tambah Darah Kombinasi)
37 Betametason krim 0,1 o/o
38 Bisacodil Supp
39 Bisaprolol Fumarat 5 mg
40 Cetrizine syr
41 Cetirizine tablet 10 mg
42 DMP Kombinasi Sirup
43 DMP Kombinasi Tablet
44 Deksametason injeksi 5 mg/ml - 1 ml
45 Deksametason tablet 0,5 mg
46 Diazepam injeksi 5 mg/ml - 2 ml
47 Diazepam tablet 2 mg
48 Difenhidramin HCl inj 10 mg/ml - 1 ml
49 Digoksin tablet 0,25 mg
50 Doksisiklin tab 100 mg
51 Domperidon
52 Domperidon Syrup
53 Epinefrin HCl( Adrenalina) Injeksi 0,1 %
54 Eritromisin 500 mg
55 Eritromisin sirup 200 mg/ 5ml
56 Etakridin ( Rivanol ) larutan 0,1 o/o
57 Etanol ( Alkohol ) 70 o/o 100 ml
58 Etil Klorida semprot
59 Eugenol cairan
60 Famotidin 20 mg
61 Fenobarbital injeksi 50 mg/ml - 2 ml
62 Fenobarbital tablet 30 mg
63 Fenol Gliserol tetes telinga 10 o/o
64 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 ml
 PUSTU
NO KODE NAMA OBAT KET
PERAPAKAN
1 2 3 4 9 10
65 Fitomenodion (Vit.K1) tablet salut gula 10 mg
66 Furosemid tablet 40 mg
67 Garam Oralit serbuk,kombinasi
68 Gentamicin Sk
69 Gentamicin TM 0,3 %
70 Gemfibrozil 300 mg
71 Gentian violet 1 o/o
72 Glass Ionomer Cement (GC IX)
73 Glibenclamid tablet 5 mg
74 Gliclazide 80 mg
75 Glimepiride 2 mg
76 Gliseril Guaiakolat tablet 100 mg
77 Glukosa larutan infus 10 o/o
78 Glukosa larutan infus 5 o/o
79 Griseofulvin tablet 125 mg, micronized
80 Hidroklorotiazid (HCT) tablet 25 mg
81 Hidrokortison krim 2,5 o/o
82 Hyoscine N - Buthylbromida
83 Ibuprofen tablet 200 mg
84 Ibuprofen tablet 400 mg
85 Isosorbit Dinitrat tablet sublingual 5 mg
86 Kalium Permanganat serbuk
87 Kalsium Laktat (Kalk) tablet 500 mg
88 Kaptopril 25 mg
89 Karbamazepin tablet 200 mg
90 Ketokonazol krim 2%
91 Ketokonazol tablet 200 mg
92 Klindamisin 300 mg
93 Kloramfenikol kapsul 250 mg
94 Kloramfenikol salep mata 1 %(ERLA)
95 Kloramfenikol suspensi 125 mg/ml
96 Kloramfenikol tetes mata 0,5 /ERLA
97 Kloramfenikol tetes telinga 3 %
98 Klorfeniramin Maleat ( CTM ) tablet 4 mg
99 Klorokuin tablet 150 mg
100 Klorpromazin HCI Tablet salut 100 mg
Kotrimoksazol Suspensi kombinasi : Sulfametoksazol 200
101 mg + Trimetoprim 40 mg/ 5 ml
Kotrimoksazol DOEN I (Dewasa) kombinasi :
102
Sulfametoksazol 400 mg + Trimetoprim 80 mg
Kotrimoksazol DOEN ( FORTE ) kombinasi :Sulfametoksazol
103
800 mg + Trimetoprim 160 mg
104 Kuinin (Kina) Tablet 200 mg
Lidokain Komp.injeksi, Kombinasi : Lidokain HCL 12 % +
105
Epinefrin 1 : 80.000 - 2 ml ( Pehacaine )
106 Loperamide
107 Magnesium Sulfat Inj (IV) 40 %
108 Mebendazol tablet 100 mg
109 Metil prednisolon tab 4 mg
110 Metilergametrin (Maleat) tablet salut 0,125 mg
111 Metilergametrin Maleat inj 0,200 mg - 1 ml
112 Metoclopramide 10 mg tablet
113 Metoclopramide sirup 5 mg/ml
114 Metilergametrin Maleat inj 0,200 mg - 1 ml
115 Metformin 400 mg
116 Metronidazole Sirup
117 Metronidazol tablet 250 mg
118 Metronidazol tablet 500 mg
119 Miconazole krim 2% (Nitrat)
120 Natrium Bikarbonat tablet 500 mg
121 Natrim Diklofenak 50 mg tab
122 Natrium Klorida larutan infus 0,9 % Steril
123 Nifedipin tablet 10 mg
124 Nystatin Syr
125 Nistatin tablet salut 500.000 UI/g
126 Nistatin vaginal tablet 100.000 UI/g
127 OAT FDC Kategori 1 Dewasa
128 OAT FDC Kategori 2 Dewasa
129 OAT FDC Kategori Sisipan Dewasa
130 OAT FDC Kategori Anak
131 Obat Batuk Hitam ( O.B.H )
132 Ofloksasin tab 400 mg
133 Oksitetrasiklin HCI salep kulit 3 %
 PUSTU
NO KODE NAMA OBAT KET
PERAPAKAN
1 2 3 4 9 10
134 Oksitetrasiklin HCI salep mata 1 %
135 Oksitosin injeksi 10 IU / ml - ml
136 Omeprazole kapsul
137 Papaverin Injeksi 40 mg/ml
138 Papaverin tab 40 mg
139 Paracetamol drop
140 Parasetamol sirup 120 mg / 5 ml
141 Parasetamol tablet 100 mg
142 Parasetamol tablet 500 mg
143 Pirantel tablet 125 mg
144 Piridoksin HCI (Vit. B6 ) tablet 10 mg
145 Piroksikam 20 mg
146 Povidon lodida larutan 10 %
147 Prazikuantel tablet 600 mg
148 Prednison tablet 5 mg
149 Primakuin tablet 15 mg
150 Prokain Benzil Penisilin injeksi 3 juta IU/Vial
151 Propranolol HCI tablet 10 mg
152 Proiltiourasil tablet 100 mg
153 Ranitidin tablet 150 mg
154 Ranitidin Injeksi 25 mg/ml
155 Retinol ( Vitamin A ) 100.000 IU kapsul lunak
156 Retinol ( Vitamin A ) 200.000 IU kapsul lunak
157 Ringer laktat larutan infus
158 Salbutamol Syr
159 Salbutamol tablet 2 mg (4 mg)
Salep 2 - 4, Kombinasi :
160
Asam Salisilat 2 % + Belerang Endap 4 %
161 Salisil Bedak 2 %
162 Sefadroksil sirup kering 125 mg/5ml
163 Sefadroksil kapsul 500 mg
164 Sefiksim Tablet
165 Sefiksim Syrup
166 Sefotaksim Injeksi 1 g
167 Sianocobalamin (Vit.B12) tablet 50 mg
168 Sianokobalamin (Vit.B12) injeksi 500 mcg/ml - 1ml
169 Simetidin tab
170 Simvastatin tab
171 Siprofloksasin tablet 500 mg
172 Sukralfat
173 Tetrasiklin HCI Kapsul 500 mg
174 Theoplylline
175 Thiamphenicol 500 mg
176 Tiamin HCI ( Vit.B1 injeksi 100 mg/ml - 1 ml )
177 Tiamin HCI/Mononitrat (Vit.B1) tablet 50 mg
178 Tiopental Natrium serb inj. 1000 mg/amp
179 Tramadol tablet 50 mg
180 Triheksifenidil tablet 2 mg
181 Vitamin B Kompleks tablet
182 Zink Sirup
183 Zink 20 mg

ALAT KESEHATAN
1 IV Catheter G 20
2 IV Catheter G 22
3 IV Catheter G 24
4 Alat suntik sekali pakai 0,5 ml
5 Alat suntik sekali pakai 1 ml

6 Alat suntik sekali pakai 3 ml

7 Alat suntik sekali pakai 5 ml

Catgut / Benang bedah No. 2/0 dengan jarum bedah

8
Catgut / Benang bedah No. 3/0 dengan jarum
9 bedah(Cromic)
10 Handschoon ( Sarung Tangan )
11 Infusion set dewasa (Macro)
12 Kapas pembalut / Absorben 250 gram
13 Kasa Steril 16 X 16
14 Kasa Pembalut Hidrofil 4 m x 10 cm
15 Kasa Pembalut Hidrofil 18cm x 22 cm
16 Kasa Pembalut 36 m x 80 cm
 PUSTU
NO KODE NAMA OBAT KET
PERAPAKAN
1 2 3 4 9 10
17 Needle 23 G
18 Needle 24 G
19 Plester 5 yards x 2 inch
20 Silk (Benang Bedah Sutera) No.3/0 dgn jarum bedah
21 Urine Bag
22 Wing Needle No 23 G
23 Wing Needle No 27 G
24 Masker
LARUTAN REAGEN
1 Anisol
2 Asam Klorida 0,1 N
3 Eter Anestetik
4 Immersion oil
5 Larutan Benedict
6 Larutan Eosin 2 %
7 Larutan Etanol Asam
8 Larutan Giemsa Stain
9 Larutan Karbol Fuksin
10 Larutan Metanol
11 Larutan Metilen Biru
12 Larutan Truk
13 Lisol, mengandung Kresol tersabun 50 %
14 Semen seng Fosfat serbuk dan cairan
15 Ziehl Nelsen

1 Spuit 0,5 ml
2 Diethilcarbamazepin
3 Vitamin Ibu Hamil (Samcobion)
4 Kloramphenicol 500 mg
5 Vitamin Syr(tema Posyandu)

6 Catgut / Benang bedah No. 3/0 dengan jarum bedah(Plain)

7 UnderPad
8 Alkohol Pred (sweb)
9 Klem Tali Pusat
10 Sofratule
11 Tes Kehamilan
12 Sukralfat Syr
13 Scabimit
14 Anti Diare
15 HIV Tes
16 Glucoprotein Tes
17 Lidocaine Murni
18 Hand Scoen Steril
19 Spuit 0,05 ml
20 Tes Gula Darah
21 Tes Kolesterol
22 Tes Asam Urat
23 Mamavita
24 Vitamin Remaja ( Samcobion )
25 Blood Lancet
26 Jelly Dopler
27 Piracetam
28 Fenitoin
29 Loratadin
30 Spuit 20 ml
31 Anti-A Monoclonal Golongan Darah (Vial 10 ml) Vial 10 ml
32 Anti-A,B Monoclonal Golongan Darah (Vial 10 ml) Vial 10 ml
33 Anti-B Monoclonal Golongan Darah (Vial 10 ml) Vial 10 ml
34 Anti-D Duoclone Golongan Darah (Vial 10 ml) Vial 10 ml
35 Bethahistin 6 mg
36 Azitromisin tablet 500 mg
37 FARNORMIN - Atenolol 50 mg
38 Gabapentin 300 mg
39 KALIPAR - Kalium aspartat tab 300 mg
40 Kandesartan tab 8 mg
41 Lisinopril tablet/kapsul/kaplet 5 mg
42 Ondansetron tablet/kapsul/kaplet 4 mg
43 Valsartan tab 80 mg
44 FEMALE CATHETER, no. 18
45 Dulcolak supp 5 mg ( Pedriatrik )
46 Clopidogrel Bisulfate 75 mg
47 Lactulosa
48 Spironolacton
49 Spuit 50 ml
 PUSTU
NO KODE NAMA OBAT KET
PERAPAKAN
1 2 3 4 9 10
50 Gentamicin Injeksi
51 Calsii Gluconas
52 Diazepam Rectal 10 mg ( Stesolid 10 mg)
53
54
55
BLUD
1 Amoxicilin 500 mg
2 Antacida
3 Asam Mefenamat 500 mg
4 Asam Traneksamat 500 mg
5 Bedak Salisil
6 Bethahistin Maleat
7 GG
8 Ibuprofen 400 mg
9 Kaolin + Pectin (Omegdiar)
10 Kaptopril 25 mg
11 Pehacaine inj
12 Simvastatin 10 mg
13 Zink
14 Ambroxol 30 mg
15 CTM
16 Glibenclamid
17 Cefadroxil 500 mg
18 Amoxicilin DS 125 ( Sulfenox)
19 Ambroxol Syr
20 Omegdiar Syrup
21 Amlodipin 5 mg
22 Nifedipin
23 Kotrimoxazole Forte
24 Vitamin B Complex
25 Acetosal 100 mg
26 Piroxicam 20 mg
27 Oxitetasiklin Salep Kulit
28 Quantidex
29 Metronidazole 500 mg
30 Na Diclofenac 50 mg
31 Vitamin C ( Asam Ascobat)
32 Metformin 500 mg
33 Dexamethasone 0,5 mg
34 Allopurinol 100 mg
35 Paracetamol Syr
36 Ciprofloxacin 500 mg
37 Ibuprofen 200 mg
38 Methylprednisolon 4 mg
39 Kloramphenicol TM ( Erlamicetin TM)
40 Ranitidine
41 Thiamphenicol 500 mg ( Thiamex 500 mg )
42 Kloramphenicol 250 mg ( Novachor 250 mg)
43 Omprazole 30 mg
44 Hidrokortison 2,5 %
45 Kalsium Lactat
46 Salbuamol 4 mg ( Bronsolvan )
47 Acyclovir 200 mg
48 Antalgin (Metamizol Sodium )
49 Paracetamol 500 mg
VITAMIN DAN MINERAL
1 Multivitamin Tablet ( Omegavit )
2 Multivitamin Syrup ( Tyalisin )
3 Multivitamin ( Neurofa)
PERBEKALAN KESEHATAN
1 Hand Scoen Steril ( 7 )
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
PUSKESMAS
KODE PUSKESMAS :
PUSKESMAS : PEMANGKAT
KECAMATAN : PEMANGKAT PELAPORAN BULAN / PERIODE : DESEMBER 2016
KAB / KOTA : SAMBAS PERMINTAAN BULAN / PERIODE : JANUARI 2017

KLS STOK PENERI- PERSE- PEMA- SISA STOK PERMIN- PEMBERIAN

NO KODE NAMA OBAT SATUAN KET
TER AWAL MAAN DIAAN KAIAN STOK OPT TAAN INPRES ASKES APBD LAIN JML
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
OBAT GENERIK
1 Albendazol tablet 400 mg Tab 0 0 0 0 0
2 Alopurinol tablet 100 mg Tab 0 0 0 0 0
3 Alprazolam 0.5 mg Tab 0 0 0 0 0
4 Ambroxol sirup 15 mg/ml Btl 0 0 0 0 0
5 Ambroxol tablet 30 mg Tab 0 0 0 0 0
6 Aminofilina injeksi 24 mg/ml - 10 ml Amp 0 0 0 0 0
7 Aminofilina tablet 200 mg Tab 0 0 0 0 0
8 Amlodipin 5 mg Kap 0 0 0 0 0
9 Amoksisilin kapsul 250 mg Kap 0 0 0 0 0
10 Amoksisilin + as. Klavulanat 625 mg Kapt 0 0 0 0 0
11 Amoksisilin kapsul 500 mg Kap 0 0 0 0 0
12 Amoksisilin sirup kering 125 mg/5 ml Btl 0 0 0 0 0
13 Amoksisilin sirup kering forte 250 mg/5 ml Btl 0 0 0 0 0
14 Ampisilin caplet 500 mg Kap 0 0 0 0 0
15 Ampisilin sirup kering 125 mg/5 ml Btl 0 0 0 0 0
16 Antalgin injeksi 250 mg/ml - 2 ml Amp 0 0 0 0 0
17 Antasida DOEN suspensi Btl 0 0 0 0 0
Antasida DOEN tablet kunyah,kombinasi :Mg-hidroksida
18 Tab 0 0 0 0
200 mg + Al.Hidroksida.200 mg 0
Anti Bakteri DOEN salep kombinasi:Basitrasilin 500 IU/g
19 Tub 0 0 0 0
+ Polimiksin 1000 UI/g 0
Antifungi DOEN kombinasi :Asam Benzoat 6 % + Asam
20 Salisilat 3 % Pot 0 0 0 0
0
Anti Hemoroid DOEN kombinasi : Bismuth subgalat 150
21 mg + Heksaklorofen 2,5 mg Fcs 0 0 0 0
0
22 Anti Malaria ( DHP) Tab 0 0 0 0 0
Antimigren DOEN tablet kombinasi : Ergotamin Tartrat 1
23 Tab 0 0 0 0
mg + Kofein 50 mg 0
24 Aqua pro Injeksi steril, bebas pirogen Flc 0 0 0 0 0
25 ARCO Flc 0 0 0 0 0
26 Artesunate injeksi,vial 60 ml Amp 0 0 0 0 0
27 Asetosal tablet 100 mg Tab 0 0 0 0 0
28 Asetosal tablet 500 mg Tab 0 0 0 0 0
29 Asam Askorbat (Vit C) tablet 50 mg Tab 0 0 0 0 0
30 Asam Mefenamat 500 mg Tab 0 0 0 0 0
31 Asam Trenaksamat 500 mg Tab 0 0 0 0 0
32 Asam Trenaksamat Injeksi Amp 0 0 0 0 0
33 Asiklovir krim 5 % Tube 0 0 0 0 0
34 Asiklovir tablet 400 mg Tab 0 0 0 0 0
35 Attapulgite Tab 0 0 0 0 0
Besi II Sulfat 200 mg + Asam Folat 0,25 mg (Tablet
36 Tambah Darah Kombinasi) Tab 0 0 0 0
0
37 Betametason krim 0,1 o/o Tube 0 0 0 0 0
38 Bisacodil Supp Supp 0 0 0 0 0
39 Bisaprolol Fumarat 5 mg Tab 0 0 0 0 0
40 Cetrizine syr Btl 0 0 0 0 0
41 Cetirizine tablet 10 mg Tab 0 0 0 0 0
42 DMP Kombinasi Sirup Syr 0 0 0 0 0
43 DMP Kombinasi Tablet Tab 0 0 0 0 0
44 Deksametason injeksi 5 mg/ml - 1 ml Amp 0 0 0 0 0
45 Deksametason tablet 0,5 mg Tab 0 0 0 0 0
46 Diazepam injeksi 5 mg/ml - 2 ml Amp 0 0 0 0 0
47 Diazepam tablet 2 mg Tab 0 0 0 0 0
48 Difenhidramin HCl inj 10 mg/ml - 1 ml Amp 0 0 0 0 0
49 Digoksin tablet 0,25 mg Tab 0 0 0 0 0
50 Doksisiklin tab 100 mg Kaps 0 0 0 0 0
51 Domperidon Tab 0 0 0 0 0
52 Domperidon Syrup Btl 0 0 0 0 0
53 Epinefrin HCl( Adrenalina) Injeksi 0,1 % Tab 0 0 0 0 0
54 Eritromisin 500 mg Kaps 0 0 0 0 0
55 Eritromisin sirup 200 mg/ 5ml Btl 0 0 0 0 0
56 Etakridin ( Rivanol ) larutan 0,1 o/o Btl 0 0 0 0 0
57 Etanol ( Alkohol ) 70 o/o 100 ml Btl 0 0 0 0 0
58 Etil Klorida semprot Btl 0 0 0 0 0
59 Eugenol cairan Btl 0 0 0 0 0
60 Famotidin 20 mg Tab 0 0 0 0 0
61 Fenobarbital injeksi 50 mg/ml - 2 ml Amp 0 0 0 0 0
62 Fenobarbital tablet 30 mg Tab 0 0 0 0 0
63 Fenol Gliserol tetes telinga 10 o/o Btl 0 0 0 0 0
64 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 ml Tab 0 0 0 0 0
65 Fitomenodion (Vit.K1) tablet salut gula 10 mg Tab 0 0 0 0 0
66 Furosemid tablet 40 mg Tab 0 0 0 0 0
67 Garam Oralit serbuk,kombinasi Sach 0 0 0 0 0
68 Gentamicin Sk Tube 0 0 0 0 0
69 Gentamicin TM 0,3 % Btl 0 0 0 0 0
70 Gemfibrozil 300 mg Btl 0 0 0 0 0 1.6
 71 Gentian violet 1 o/o Btl 0 0 0 0 0
72 Glass Ionomer Cement (GC IX) Tab 0 0 0 0 0
73 Glibenclamid tablet 5 mg Tab 0 0 0 0 0
74 Gliclazide 80 mg Flc 0 0 0 0 0
75 Glimepiride 2 mg Flc 0 0 0 0 0
76 Gliseril Guaiakolat tablet 100 mg Tab 0 0 0 0 0
77 Glukosa larutan infus 10 o/o Btl 0 0 0 0 0
78 Glukosa larutan infus 5 o/o Btl 0 0 0 0 0
79 Griseofulvin tablet 125 mg, micronized Tab 0 0 0 0 0
80 Hidroklorotiazid (HCT) tablet 25 mg Tab 0 0 0 0 0
81 Hidrokortison krim 2,5 o/o Tube 0 0 0 0 0
82 Hyoscine N - Buthylbromida Tab 0 0 0 0 0
83 Ibuprofen tablet 200 mg Tab 0 0 0 0 0
84 Ibuprofen tablet 400 mg Tub 0 0 0 0 0
85 Isosorbit Dinitrat tablet sublingual 5 mg Tab 0 0 0 0 0
86 Kalium Permanganat serbuk Tab 0 0 0 0 0
87 Kalsium Laktat (Kalk) tablet 500 mg Tab 0 0 0 0 0
88 Kaptopril 25 mg Tab 0 0 0 0 0
89 Karbamazepin tablet 200 mg Pot 0 0 0 0 0
90 Ketokonazol krim 2% Tab 0 0 0 0 0
91 Ketokonazol tablet 200 mg Tab 0 0 0 0 0
92 Klindamisin 300 mg Tab 0 0 0 0 0
93 Kloramfenikol kapsul 250 mg Tub 0 0 0 0 0
94 Kloramfenikol salep mata 1 %(ERLA) Tab 0 0 0 0 0
95 Kloramfenikol suspensi 125 mg/ml Kap 0 0 0 0 0
96 Kloramfenikol tetes mata 0,5 /ERLA Kap 0 0 0 0 0
97 Kloramfenikol tetes telinga 3 % Tub 0 0 0 0 0
98 Klorfeniramin Maleat ( CTM ) tablet 4 mg Btl 0 0 0 0 0
99 Klorokuin tablet 150 mg Btl 0 0 0 0 0
100 Klorpromazin HCI Tablet salut 100 mg Tab 0 0 0 0 0
Kotrimoksazol Suspensi kombinasi : Sulfametoksazol 200
101 mg + Trimetoprim 40 mg/ 5 ml 0 0 0 0
Tab 0
Kotrimoksazol DOEN I (Dewasa) kombinasi :
102 Btl 0 0 0 0
Sulfametoksazol 400 mg + Trimetoprim 80 mg 0
Kotrimoksazol DOEN ( FORTE ) kombinasi
103 Tab 0 0 0 0
:Sulfametoksazol 800 mg + Trimetoprim 160 mg 0
104 Kuinin (Kina) Tablet 200 mg Tab 0 0 0 0 0
Lidokain Komp.injeksi, Kombinasi : Lidokain HCL 12 % +
105 Amp 0 0 0 0
Epinefrin 1 : 80.000 - 2 ml ( Pehacaine ) 0
106 Loperamide Tab 0 0 0 0 0
107 Magnesium Sulfat Inj (IV) 40 % Flc 0 0 0 0 0
108 Mebendazol tablet 100 mg Tab 0 0 0 0 0
109 Metil prednisolon tab 4 mg Tab 0 0 0 0 0
110 Metilergametrin (Maleat) tablet salut 0,125 mg Tab 0 0 0 0 0
111 Metilergametrin Maleat inj 0,200 mg - 1 ml Amp 0 0 0 0 0
112 Metoclopramide 10 mg tablet Tab 0 0 0 0 0
113 Metoclopramide sirup 5 mg/ml Btl 0 0 0 0 0
114 Metilergametrin Maleat inj 0,200 mg - 1 ml Tab 0 0 0 0 0
115 Metformin 400 mg Tab 0 0 0 0 0
116 Metronidazole Sirup Btl 0 0 0 0 0
117 Metronidazol tablet 250 mg Tab 0 0 0 0 0
118 Metronidazol tablet 500 mg Tab 0 0 0 0 0
119 Miconazole krim 2% (Nitrat) Tub 0 0 0 0 0
120 Natrium Bikarbonat tablet 500 mg Tab 0 0 0 0 0
121 Natrim Diklofenak 50 mg tab Tab 0 0 0 0 0
122 Natrium Klorida larutan infus 0,9 % Steril Btl 0 0 0 0 0
123 Nifedipin tablet 10 mg Tab 0 0 0 0 0
124 Nystatin Syr Tab 0 0 0 0 0
125 Nistatin tablet salut 500.000 UI/g Tab 0 0 0 0 0
126 Nistatin vaginal tablet 100.000 UI/g Tab 0 0 0 0 0
127 OAT FDC Kategori 1 Dewasa Pkt 0 0 0 0 0
128 OAT FDC Kategori 2 Dewasa Pkt 0 0 0 0 0
129 OAT FDC Kategori Sisipan Dewasa Pkt 0 0 0 0 0
130 OAT FDC Kategori Anak Pkt 0 0 0 0 0
131 Obat Batuk Hitam ( O.B.H ) Btl 0 0 0 0 0
132 Ofloksasin tab 400 mg Tab 0 0 0 0 0
133 Oksitetrasiklin HCI salep kulit 3 % Flc 0 0 0 0 0
134 Oksitetrasiklin HCI salep mata 1 % Tub 0 0 0 0 0
135 Oksitosin injeksi 10 IU / ml - ml Tub 0 0 0 0 0
136 Omeprazole kapsul Amp 0 0 0 0 0
137 Papaverin Injeksi 40 mg/ml Kap 0 0 0 0 0
138 Papaverin tab 40 mg Amp 0 0 0 0 0
139 Paracetamol drop Tab 0 0 0 0 0
140 Parasetamol sirup 120 mg / 5 ml Btl 0 0 0 0 0
141 Parasetamol tablet 100 mg Tab 0 0 0 0 0
142 Parasetamol tablet 500 mg Btl 0 0 0 0 0
143 Pirantel tablet 125 mg Tab 0 0 0 0 0
144 Piridoksin HCI (Vit. B6 ) tablet 10 mg Tab 0 0 0 0 0
145 Piroksikam 20 mg Tab 0 0 0 0 0
146 Povidon lodida larutan 10 % Btl 0 0 0 0 0
147 Prazikuantel tablet 600 mg Tab 0 0 0 0 0
148 Prednison tablet 5 mg Tab 0 0 0 0 0
149 Primakuin tablet 15 mg Tab 0 0 0 0 0
150 Prokain Benzil Penisilin injeksi 3 juta IU/Vial Flc 0 0 0 0 0
151 Propranolol HCI tablet 10 mg Tab 0 0 0 0 0
152 Proiltiourasil tablet 100 mg Tab 0 0 0 0 0
153 Ranitidin tablet 150 mg Tab 0 0 0 0 0
154 Ranitidin Injeksi 25 mg/ml Amp 0 0 0 0 0
155 Retinol ( Vitamin A ) 100.000 IU kapsul lunak Kap 0 0 0 0 0
156 Retinol ( Vitamin A ) 200.000 IU kapsul lunak Kap 0 0 0 0 0
157 Ringer laktat larutan infus Btl 0 0 0 0 0
158 Salbutamol Syr Btl 0 0 0 0 0
159 Salbutamol tablet 2 mg Tab 0 0 0 0 0
Salep 2 - 4, Kombinasi :
160 0 0 0 0
Asam Salisilat 2 % + Belerang Endap 4 % Pot 0
161 Salisil Bedak 2 % Bks 0 0 0 0 0
162 Sefadroksil sirup kering 125 mg/5ml Btl 0 0 0 0 0
163 Sefadroksil kapsul 500 mg Kap 0 0 0 0 0
164 Sefiksim Tablet Kap 0 0 0 0 0
165 Sefiksim Syrup Btl 0 0 0 0 0
166 Sefotaksim Injeksi 1 g Amp 0 0 0 0 0
167 Sianocobalamin (Vit.B12) tablet 50 mg Tab 0 0 0 0 0
168 Sianokobalamin (Vit.B12) injeksi 500 mcg/ml - 1ml Tab 0 0 0 0 0
169 Simetidin tab Tab 0 0 0 0 0
170 Simvastatin tab Tab 0 0 0 0 0
171 Siprofloksasin tablet 500 mg Tab 0 0 0 0 0
172 Sukralfat Kap 0 0 0 0 0
173 Tetrasiklin HCI Kapsul 500 mg Kap 0 0 0 0 0
174 Theoplylline Kap 0 0 0 0 0
175 Thiamphenicol 500 mg Amp 0 0 0 0 0
176 Tiamin HCI ( Vit.B1 injeksi 100 mg/ml - 1 ml ) Tab 0 0 0 0 0
177 Tiamin HCI/Mononitrat (Vit.B1) tablet 50 mg Btl 0 0 0 0 0
178 Tiopental Natrium serb inj. 1000 mg/amp Amp 0 0 0 0 0
179 Tramadol tablet 50 mg Tab 0 0 0 0 0
180 Triheksifenidil tablet 2 mg Tab 0 0 0 0 0
181 Vitamin B Kompleks tablet Tab 0 0 0 0 0
182 Zink Sirup Btl 0 0 0 0 0
183 Zink 20 mg Tab 0 0 0 0 0
0 0 0 0
ALAT KESEHATAN 0 0 0 0
1 IV Catheter G 20 Pcs 0 0 0 0 0
2 IV Catheter G 22 Psc 0 0 0 0 0
3 IV Catheter G 24 Pcs 0 0 0 0 0
4 Alat suntik sekali pakai 0,5 ml Pcs 0 0 0 0 0
5 Alat suntik sekali pakai 1 ml Pcs 0 0 0 0 0

6 Alat suntik sekali pakai 3 ml Pcs 0 0 0 0 0

7 Alat suntik sekali pakai 5 ml Pcs 0 0 0 0 0
8 Catgut / Benang bedah No. 2/0 dengan jarum bedah Pcs 0 0 0 0 0
Catgut / Benang bedah No. 3/0 dengan jarum
0 0 0 0
9 bedah(Cromic) Pcs 0
10 Handschoon ( Sarung Tangan ) Pcs 0 0 0 0 0
11 Infusion set dewasa (Macro) Set 0 0 0 0 0
12 Kapas pembalut / Absorben 250 gram Pcs 0 0 0 0 0
13 Kasa Steril 16 X 16 Pcs 0 0 0 0 0
14 Kasa Pembalut Hidrofil 4 m x 10 cm Pcs 0 0 0 0 0
15 Kasa Pembalut Hidrofil 18cm x 22 cm Pcs 0 0 0 0 0
16 Kasa Pembalut 36 m x 80 cm Pcs 0 0 0 0 0
17 Needle 23 G Pcs 0 0 0 0 0
18 Needle 24 G Pcs 0 0 0 0 0
19 Plester 5 yards x 2 inch Pcs 0 0 0 0 0
20 Silk (Benang Bedah Sutera) No.3/0 dgn jarum bedah Pcs 0 0 0 0 0
21 Urine Bag Pcs 0 0 0 0 0
22 Wing Needle No 23 G Pcs 0 0 0 0 0
23 Wing Needle No 27 G Pcs 0 0 0 0 0
24 Masker Box 0 0 0 0 0
25 Spuit 0,05 ml Err:509 Err:509 Err:509 0 Err:509
26 Tes Gula Darah Err:509 Err:509 Err:509 0 Err:509
27 Tes Kolesterol Err:509 Err:509 Err:509 0 Err:509
28 Tes Asam Urat Err:509 Err:509 Err:509 0 Err:509
29 Mamavita Err:509 Err:509 Err:509 0 Err:509
30 Vitamin Remaja ( Samcobion ) Err:509 Err:509 Err:509 0 Err:509
31 Blood Lancet Err:509 Err:509 Err:509 0 Err:509
32 Jelly Dopler Err:509 Err:509 Err:509 0 Err:509
33 Piracetam Err:509 Err:509 Err:509 0 Err:509
34 Fenitoin Err:509 Err:509 Err:509 0 Err:509
35 Loratadin Err:509 Err:509 Err:509 0 Err:509
Vial 10
36 Anti-A Monoclonal Golongan Darah (Vial 10 ml) Err:509 0 0 0 0
ml10
Vial
37 Anti-A,B Monoclonal Golongan Darah (Vial 10 ml) Err:509 0 0 0 0
ml10
Vial
38 Anti-B Monoclonal Golongan Darah (Vial 10 ml) Err:509 0 0 0 0
ml10
Vial
39 Anti-D Duoclone Golongan Darah (Vial 10 ml) Err:509 0 0 0 0
ml
40 Spuit 20 ml Err:509 0 0
LARUTAN REAGEN 0 0 0 0
1 Anisol Btl 0 0 0 0 0
2 Asam Klorida 0,1 N Btl 0 0 0 0 0
3 Eter Anestetik Btl 0 0 0 0 0
4 Immersion oil Btl 0 0 0 0 0
5 Larutan Benedict Btl 0 0 0 0 0
6 Larutan Eosin 2 % Btl 0 0 0 0 0
7 Larutan Etanol Asam Btl 0 0 0 0 0
8 Larutan Giemsa Stain Btl 0 0 0 0 0
9 Larutan Karbol Fuksin Btl 0 0 0 0 0
10 Larutan Metanol Btl 0 0 0 0 0
11 Larutan Metilen Biru Btl 0 0 0 0 0
12 Larutan Truk Btl 0 0 0 0 0
13 Lisol, mengandung Kresol tersabun 50 % Btl 0 0 0 0 0
14 Semen seng Fosfat serbuk dan cairan Btl 0 0 0 0 0
15 Ziehl Nelsen Btl 0 0 0 0 0
BLUD 0 0 0 0
1 Spuit 0,5 ml 0 0 0 0 0
2 Diethilcarbamazepin 0 0 0 0 0
3 Vitamin Ibu Hamil (Samcobion) 0 0 0 0 0
4 Kloramphenicol 500 mg 0 0 0 0 0
5 Vitamin Syr(tema Posyandu) 0 0 0 0 0
Catgut / Benang bedah No. 3/0 dengan jarum
6 0 0 0 0
bedah(Plain) 0
7 UnderPad 0 0 0 0 0
8 Alkohol Pred Pad 0 0 0 0 0
9 Klem Tali Pusat 0 0 0 0 0
10 Sofratule 0 0 0 0 0
11 Tes Kehamilan 0 0 0 0 0
12 Sukralfat Syr 0 0 0 0 0
13 Scabimit 0 0 0 0 0
14 Anti Diare 0 0 0 0 0
15 HIV Tes 0 0 0 0 0
16 Glucoprotein Tes 0 0 0 0 0
17 Lidocaine Murni 0 0 0 0 0
18 Hand Scoen Steril 0 0 0 0 0
19 Amoxicilin 500 mg botol 0 0 0 0 0
20 Antacida tablet 0 0 0 0 0
21 Asam Mefenamat 500 mg tablet 0 0 0 0 0
22 Asam Traneksamat 500 mg tablet 0 0 0 0 0
23 Bedak Salisil tablet 0 0 0 0 0
24 Bethahistin Maleat tablet 0 0 0 0 0
25 GG tablet 0 0 0 0 0
26 Ibuprofen 400 mg tablet 0 0 0 0 0
27 Kaolin + Pectin (Omegdiar) tablet 0 0 0 0 0
28 Kaptopril 25 mg tablet 0 0 0 0 0
29 Pehacaine inj botol 0 0 0 0 0
30 Simvastatin 10 mg botol 0 0 0 0 0
31 Zink tablet 0 0 0 0 0
32 Ambroxol 30 mg tablet 0 0 0 0 0
33 CTM tablet 0 0 0 0 0
34 Glibenclamid tablet 0 0 0 0 0
35 Cefadroxil 500 mg Kapsul 0 0 0 0 0
36 Amoxicilin DS 125 ( Sulfenox) Btl 0 0 0 0 0
37 Ambroxol Syr Btl 0 0 0 0 0
38 Omegdiar Syrup Syr 0 0 0 0 0
39 Amlodipin 5 mg tablet 0 0 0 0 0
40 Nifedipin tablet 0 0 0 0 0
41 Kotrimoxazole Forte tablet 0 0 0 0 0
42 Vitamin B Complex tablet 0 0 0 0 0
43 Acetosal 100 mg tablet 0 0 0 0 0
44 Piroxicam 20 mg tablet 0 0 0 0 0
45 Oxitetasiklin Salep Kulit Tube 0 0 0 0 0
46 Quantidex tablet 0 0 0 0 0
47 Metronidazole 500 mg tablet 0 0 0 0 0
48 Na Diclofenac 50 mg tablet 0 0 0 0 0
49 Vitamin C ( Asam Ascobat) tablet 0 0 0 0 0
50 Metformin 500 mg tablet 0 0 0 0 0
51 Dexamethasone 0,5 mg tablet 0 0 0 0 0
52 Allopurinol 100 mg tablet 0 0 0 0 0
53 Paracetamol Syr botol 0 0 0 0 0
54 Ciprofloxacin 500 mg 0 0 0 0 0
55 Ibuprofen 200 mg 0 0 0 0 0
56 Methylprednisolon 4 mg 0 0 0 0 0
57 Kloramphenicol TM ( Erlamicetin TM) 0 0 0 0 0
58 Ranitidine 0 0 0 0 0
59 Thiamphenicol 500 mg ( Thiamex 500 mg ) 0 0 0 0 0
60 Kloramphenicol 250 mg ( Novachor 250 mg) 0 0 0 0 0
61 Omprazole 30 mg 0 0 0 0 0
62 Hidrokortison 2,5 % 0 0 0 0 0
63 Kalsium Lactat 0 0 0 0 0
64 Salbuamol 4 mg ( Bronsolvan ) 0 0 0 0 0
65 Acyclovir 200 mg 0 0 0 0 0
66 Antalgin (Metamizol Sodium ) 0 0 0 0 0
67 Paracetamol 500 mg 0 0 0 0 0
VITAMIN DAN MINERAL 0 0 0 0
1 Multivitamin Tablet ( Omegavit ) 0 0 0 0 0
2 Multivitamin Syrup ( Tyalisin ) 0 0 0 0 0
3 Multivitamin ( Neurofa) 0 0 0 0 0

PERBEKALAN KESEHATAN 0 0 0 0
1 Hand Scoen Steril ( 7 ) 0 0 0 0 0

UMUM
ASKES JUMLAH
JUMLAH KUNJUNGAN RESEP BAYAR TIDAK BAYAR

JPS
JPKM
Mengetahui / menyetujui Yang Menyerahkan Yang Menerima/Melapor
Kadinkes Kab.Sambas Kepala IFK Kab. Sambas a/n.Kepala Puskesmas

(
(..) dr.Hj. MIRA RAHMAWATI
Nip.19690926 200604 2 004