PEMERIN

Komplek Gelangga

LAPORAN PEMAK

Puskesmas : CISOLOK
Kecamatan : CISOLOK
Kab/Kota : SUKABUMI
Provinsi : JAWA BARAT

No Nama Obat Satuan Stok Awal Penerimaan

OBAT
1 Alopurinol tablet 100 mg TAB 3000
2 Aloclair plus gel TAB 0
3 Amitriptilin HCl tablet salut 25 mg TAB 0
4 Amlodipin 5 mg TAB 6000
5 Amoksisilin kaplet 500 mg TAB 20000
6 Amoksisilin kapsul 250 mg KAPSUL 10000
7 Amoksisilin sirup kering 125 mg/5 ml BOTOL 600
8 Amoksisilin sirup kering Forte 250 mg/5 ml BOTOL 100
9 ampisilin inj IM/IV 1000 mg/ml AMPUL 0
10 Antalgin (Metampiron) tablet 500 mg TAB 10000
11 Antasida Suspensi 60 ml BOTOL 250
12 Antasida DOEN tablet kombinasi TAB 15000
13 Anti Bakteri DOEN salep kombinasi TUBE 0
14 Anti fungi DOEN komb sk TUBE 36
15 Anti Hemoroid DOEN kombinasi TAB 50
16 Antimigren DOEN kombinasi TAB 0
17 Antiparkinson DOEN TAB 0
18 Arimidex 1 mg- Anastrozole 1 mg AMPUL 0
19 Artesunat serb inj 60 mg/ml AMPUL 0
20 artesunat tablet (ACT) TAB 0
21 Asam Asetil Salisilat (Asetosal) tablet 80 mg TAB 0
22 Asam Askorbat (Vit.C) tablet 50 mg TAB 4000
23 asam folat tablet 1 mg TAB 200
24 Asam mefenamat 500 mg TAB 5000
25 Asam Mefenamat Kapsul 250 mg KAPSUL 0
26 Asiklovir Krim 5%/5g TUBE 160
27 Asiklovir tablet 200 mg TAB 0
28 Asiklovir Tablet 400 mg TAB 1000
29 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml AMPUL 15
30 Atropin Sulfat tablet 0,5 mg TAB 0
31 Attalpugite tab 600 mg TAB 3000
32 Benzatin Benzil Penisilin inj.1.2 juta IU/vial VIAL 0
33 Berotec MDI-Fenoterol Aerosol 100 mcg/dosis TAB 0
34 betahistin maleat TAB 2000
35 Betametason krim 0,1% - 5 gr TUBE 200
36 Bisakodil Supp 10 mg TAB 20
37 Captopril 12,5 mg TAB 5000
38 Captopril tablet 25 mg TAB 0
39 Ciprofloksasin 500 mg tablet TAB 2000
40 Deksametason injeksi 5 mg/ml - 1 ml AMPUL 100
41 Deksametason tablet 0,5 mg TAB 6000
42 Diazepam lar rektal 5mg/2,5ml BOTOL 15
43 Diazepam tablet 5 mg TAB 500
44 Dietilkarbamazin sitrat tablet 100 mg TAB 5000
45 Difenhidramin HCl injeksi 10 mg/ml - 1 ml AMPUL 120
46 Digoksin tablet 0,25 mg TAB 0
47 Doksisiklin kaps 100 mg TAB 500
48 Domperidon Syrup BOTOL 100
49 Domperidon tablet 10 mg TAB 1000
50 Epinefrina (adrenalin) injeksi 0,1% - 1 ml AMPUL 60
51 Erytromycin 250 mg TAB 0
52 Erytromycin syr 200mg/5 ml BOTOL 20
53 Etambutol HCl tablet 250 mg TAB 0
54 Eugenol cairan BOTOL 0
55 Fenitoin Na kaps 100 mg TAB 0
56 Fenobarbital injeksi 50 mg/ml - 2 ml AMPUL 0
57 Fenobarbital tablet 30 mg TAB 2000
58 Fenofibrat kaps 100 mg TAB 0
59 Fenoksimetil Penisilina tablet 250 mg TAB 0
60 Fenoksimetil Penisilina tablet 500 mg TAB 0
61 Fitomenadion (Vit.K1) tablet salut 10 mg TAB 5000
62 Furosemid tablet 40 mg TAB 1000
63 Garam oralit 200 ml air SACET 1000
64 Gentamisin injeksi 40 mg/ml AMPUL 20
65 gentamisin tetes mata TUBE 48
66 Glibenklamid tablet 5 mg TAB 4000
67 gliseril guaiacolat syrup BOTOL 100
68 Gliseril Guayakolat tablet 100 mg TAB 20000
69 Glivec- Imatinib tab 100 mg TAB 0
70 Griseofulvin tablet 125 mg, micronized TAB 1000
 71 Haloperidol 0,5 mg tablet TAB 0
72 Haloperidol 1,5 mg tablet TAB 0
73 Haloperidol 5 mg TAB 1000
74 Hidroklorotiazid (HCT) tablet 25 mg TAB 1000
75 Hidrokortison krim 2,5 % TUBE 250
76 Ibuprofen tablet 200 mg TAB 2000
77 Ibuprofen tablet 400 mg TAB 5000
78 Isoniazid tablet 100 mg TAB 0
79 Isoniazid tablet 300 mg TAB 0
80 Isosorbid Dinitrat 5 mg tablet sublingual TAB 0
81 Kalsium alginate gel BOTOL 0
82 Kalsium Glukonat Inj 100 mg/ml AMPUL 0
83 Karbamazepin tablet 200 mg TAB 1000
84 Karbogliserin Tetes Telinga 10% TUBE 75
85 Ketokonazol krim 2 % TUBE 100
86 Ketokonazol Tablet 200 mg TAB 500
87 Klindamicin 300 mg TAB 1000
88 Klopidogrel tab 75 mg TAB 0
89 Kloramfenikol kapsul 500 mg KAPSUL 1500
90 Kloramfenikol salep kulit 2% (bufacetin) TUBE 100
91 Kloramfenikol Salep Mata 1% - 3,5 gr TUBE 100
92 Kloramfenikol Tetes Telinga 3% - 5 ml TUBE 0
93 Klorfeniramin Maleat (CTM) tablet 4 mg TAB 250000
94 Klorpromazin HCL tablet 100 mg TAB 10
95 Klorpromazin inj. 25 mg/ml AMPUL 0
96 Kodein HCl tablet 10 mg TAB 500
97 Kotrimoksazol forte tablet TAB 2000
98 Kotrimoksazol suspensi kombinasi BOTOL 250
99 Kuinin (Kina) tablet 200 mg TAB 0
100 Kuinin dihidroklorida inj 25 %-2 ml AMPUL 0
101 Lansoprazol 30 Mg KAPSUL 2000
102 Levemir-Analog insulin long acting inj 100 UI/ml AMPUL 0
103 Lidokain inj. 2% AMPUL 400
104 Lidokain komp. injeksi kombinasi AMPUL 400
105 Loratadin tab 10 mg BOTOL 0
106 Magnesium Sulfat injeksi (IV) 40% - 25 ml AMPUL 0
107 Mebendazol tablet 100 mg TAB 150
108 Metformin tab 500 mg TAB 1000
109 metil dopa tab 250 mg TAB 0
110 Metilergometrin Maleat injeksi 0,200 mg - 1ml AMPUL 50
111 Metilergometrin Maleat tablet salut 0,125 mg TAB 1000
112 Metilprednisolon tablet TAB 2000
113 Metoklorpropamid tablet 5 mg TAB 200
114 Metronidazol sir 125 mg/5 ml BOTOL 25
115 Metronidazol tablet 250 mg TAB 1000
116 Metronidazol tablet 500 mg TAB 500
117 Miconazol SK TUBE 50
118 Multivitamin sirup BOTOL 100
119 Multivitamin Tablet Dewasa TAB 3000
120 Natrium Bikarbonat tablet 500 mg TAB 4000
121 Natrium Diklofenac 25 mg TAB 2000
122 Nifedifin tablet 10 mg TAB 2000
123 Nistatin 100.000 IU/gram tablet vaginal TAB 0
124 Nistatin tablet salut gula 500.000 IU/g TAB 500
125 Novorapid-Analog insulin rapid acting inj 100 UI/ml AMPUL 0
126 OAT FDC Anak TAB 0
127 OAT FDC Kategori 1 TAB 0
128 Obat Batuk Hitam (OBH) cairan - 100 ml BOTOL 600
129 Oksitetrasiklin HCl salep 3% - 5 gram TUBE 120
130 Oksitosin injeksi 10 IU/ml - 1 ml AMPUL 450
131 Omeprazol caps 20 mg KAPSUL 2000
132 Ondansentron tab 8 mg TAB 1000
133 parasetamol drop BOTOL 75
134 Parasetamol kaplet 500 mg TAB 15000
135 Parasetamol sirup BOTOL 800
136 Permetrin krim 5 % TUBE 10
137 Phtomenadion injeksi 2 mg/ml AMPUL 180
138 Pirantel Pamoat tablet 125 mg TAB 150
139 Pirazinamid tablet 500 mg TAB 0
140 Piridoksin HCl (Vit.B6) tablet 10 mg TAB 4000
141 Prednison tablet 5 mg TAB 2000
142 Probiokid AMPUL 0
143 Propiltiourasil tablet 100 mg TAB 750
144 Propranolol HCl tablet 10 mg TAB 0
145 Ranitidin Injeksi 25 mg/ml AMPUL 120
146 Ranitidin tablet 150 mg TAB 6000
147 Retinol (Vit.A) 100.000 IU kapsul KAPSUL 0
148 Retinol (Vit.A) 200.000 IU kapsul KAPSUL 0
149 Rifampisin kapsul 300 mg KAPSUL 0
150 Rifampisin kapsul 450 mg KAPSUL 100
151 Rifampisin kapsul 600 mg KAPSUL 0
152 Salbutamol Cairan ih 0,1% AMPUL 50
153 Salbutamol tablet 4 mg TAB 1000
154 Salep 2 - 4 kombinasi TUBE 96
155 Salisil Bedak 2% - 50 gram KOTAK 100
156 Sefadroksil Kapsul 500 mg KAPSUL 1000
157 Sefadroksil Syrup 250 mg BOTOL 50
158 Sefiksim kapsul 100 mg KAPSUL 500
159 Setirizin kap 10 mg KAPSUL 1000
160 Setirizin sir 5 mg/ 5 ml BOTOL 10
161 Sianokobalamin (Vitamin B12) 50 mg TAB 1000
162 Simvastatin 20 mg TAB 750
163 Symbicort 80/4.5 mcg- Budesonide Formoterol 80/4.5 AMPUL 0
164 Teofilin tab 150 mg TAB 500
165 Tetrasiklin HCl kapsul 250 mg KAPSUL 2000
166 Tetrasiklin HCl kapsul 500 mg KAPSUL 0
167 Tiamin HCl/Mononitrat (Vit.B1) tablet 50 mg TAB 2000
168 Triheksifenidil HCl 2 mg tablet TAB 750
169 Vitamin B komplek tablet TAB 4000
170 Zink syrup 20 mg/5 ml BOTOL 100
171 zink tablet disp 20 mg TAB 2000
OBAT GIGI 0 0
1 Devitalisasi pasta (Non Arsen) PASTA 1
2 Etil Klorida Semprot - 100 ml BOTOL 10
3 Eugenol cairan - 10 ml BOTOL 0
4 Fluor tablet 0,5 mg TAB 0
5 Formokresol Cairan BOTOL 0
6 Gentian Violet larutan 1% - 10 ml BOTOL 0
7 Glass Ionomer Cement (GC IX) BOTOL 1
8 Kalsium Hidroksida Pasta PASTA 1
9 Monoklorkamfer Mentol cairan (CHKM) 0 1
10 Mummifying Pasta 0 1
11 Polikresulen cairan 0 0
12 Semen Seng Fosfat serbuk dan cairan 0 1
13 Spons Gelatin Cubicles 1 x 1 x 1 cm 0 1
14 Temporary Stopping Fletcher serbuk & cairan 0 1
15 Lidokain gel 0 0
16 Trikresol Formalin (TKF) cairan - 10 ml 0 1
BHP 0 0
1 Alat suntik sekali pakai 3 ml PCS 750
2 Alat suntik sekali pakai 5 ml PCS 0
3 autodisable no 0,05 ml PCS 0
4 autodisable no. 0,5 ml PCS 0
5 bloodset PCS 0
6 Catgut Chromic 2/0 + jarum 1/2 HR 26 mm PCS 36
7 Catgut Chromic 3/0 + jarum 1/2 HR 26 mm PCS 36
8 Folley Catheter 2 WAY no 16 PCS 0
9 Folley Catheter 2 way no 18 PCS 0
10 Handscoon Non Steril 0 0
Ukuran S BOX 2
Ukuran M BOX 2
Ukuran L BOX 2
11 Handscoon steril 0 0
Ukuran 6.5 PCS 200
Ukuran 7.0 PCS 200
 Ukuran 7.5 PCS 200
12 Infusion set anak PCS 0
13 Infusion set dewasa PCS 40
14 IV Catheter G - 18 PCS 50
15 IV Catheter G - 20 PCS 100
16 IV Catheter G - 22 PCS 25
17 Kapas berlemak 250 gr ROL 5
18 Kasa hidrofil 16x16 (steril) BOX 50
19 Kasa Kompres 40/40 steril BOX 0
20 Kasa Pembalut 2 m x 80 cm ROLL 0
21 kasa pembalut hydrofil 36 m x 80 cm ROLL 3
22 Silk 2/0 + jarum 1/2 GT 35 mm PCS 36
23 Silk 3/0 + jarum 1/2 GT 35 mm PCS 36
24 Masker BOX 0
25 Plester ROLL 10
26 Urine bag PCS 0
27 ECG/USG jelly 82gr 0 10
28 ID Patient Adult/Dewasa Biru 0 0
29 ID Patient Adult/Dewasa Pink 0 0
30 Polifix 5 cm x 1 m 0 0
31 Policrepe Pembalut Elastis 7,5 cm x 4,55 m ROLL 0
32 Cuticell Classic 10 cm x 10 cm 0 5
DESINFECTAN 0 0
1 Antiseptik Hand Scrub BOTOL 5
2 Rivanol larutan 0,1% - 330 cc BOTOL 5
3 Alkohol 70% - 1000 ml BOTOL 10
4 Alkohol Swab BOK 4
5 Lisol 1 liter BOTOL 5
6 Gel untuk cateter TUBE 5
7 Povidon Iodida 60 ml BOTOL 6
8 Povidon Iodida 500 ml BOTOL 10
CAIRAN 0 0
1 Air untuk injeksi (Aqua pro injeksi) 20 ml VIAL 0
2 Natrium Klorida lart.infus 0,9% steril - 500 ml BOTOL 60
3 Ringer Laktat larutan infus steril - 500 ml BOTOL 180
REAGENT 0 0
1 Gliserin - 100 ml BOTOL 0
2 GLOKOSA LARUTAN INFUS 5% BOTOL 60
3 DIAZEPAM INJEKSI 5 MG AMPU[ 30
4 DIAZEPAM TAB 2 MG TAB 0
5 EPREDIN HCL TAB 25 MG TAB 1000
6 KALSIUM LAKTAS (KALK) TAB 1500
7 KASA 4X5 CM ROLL 200
8 NOVOROMID AMPUL 0
9 GLUKOSA 10% BOTOL 0
10 GLUKOSA 40% BOTOL 0
11 Alat Suntik 1 ml 0 300
12 0 0 0
13 0 0 0
14 0 0 0
15 0 0 0
16 0 0 0
17 0 0 0

Umum
Jumlah Kunjungan Resep Askes
Bayar Tidak Bayar

Yang meminta
Kepala Puskesmas,

NIP
 PEMERINTAH KABUPATEN SUKABUMI
DINAS KESEHATAN
Komplek Gelanggang Pemuda Cisaat telp (0266 ) 222061
SUKABUMI 43155

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

PUSKESMAS :

Pelaporan Bulan/ Periode : Dokumen

Permintaan Bulan/ Periode : Dinkes Kab/Kota
GFK Kab/Kota
Puskesmas

Stok Pemberian
Persediaan Pemakaian Stok Akhir Optinum Permintaan BPJS APBD I APBD II Program

3000 3000
0 0
0 0
6000 6000
20000 20000
10000 10000
600 600
100 100
0 0
10000 10000
250 250
15000 15000
0 0
36 36
50 50
0 0
0 0
0 0
0 0
0 0
0 0
4000 4000
200 200
5000 5000
0 0
 160 160
0 0
1000 1000
15 15
0 0
3000 3000
0 0
0 0
2000 2000
200 200
20 20
5000 5000
0 0
2000 2000
100 100
6000 6000
15 15
500 500
5000 5000
120 120
0 0
500 500
100 100
1000 1000
60 60
0 0
20 20
0 0
0 0
0 0
0 0
2000 2000
0 0
0 0
0 0
5000 5000
1000 1000
1000 1000
20 20
48 48
4000 4000
100 100
20000 20000
0 0
1000 1000
 0 0
0 0
1000 1000
1000 1000
250 250
2000 2000
5000 5000
0 0
0 0
0 0
0 0
0 0
1000 1000
75 75
100 100
500 500
1000 1000
0 0
1500 1500
100 100
100 100
0 0
250000 250000
10 10
0 0
500 500
2000 2000
250 250
0 0
0 0
2000 2000
0 0
400 400
400 400
0 0
0 0
150 150
1000 1000
0 0
50 50
1000 1000
2000 2000
200 200
25 25
1000 1000
 500 500
50 50
100 100
3000 3000
4000 4000
2000 2000
2000 2000
0 0
500 500
0 0
0 0
0 0
600 600
120 120
450 450
2000 2000
1000 1000
75 75
15000 15000
800 800
10 10
180 180
150 150
0 0
4000 4000
2000 2000
0 0
750 750
0 0
120 120
6000 6000
0 0
0 0
0 0
100 100
0 0
50 50
1000 1000
96 96
100 100
1000 1000
50 50
500 500
1000 1000
10 10
1000 1000
750 750
0 0
500 500
2000 2000
0 0
2000 2000
750 750
4000 4000
100 100
2000 2000
0 0
1 1
10 10
0 0
0 0
0 0
0 0
1 1
1 1
1 1
1 1
0 0
1 1
1 1
1 1
0 0
1 1
0 0
750 750
0 0
0 0
0 0
0 0
36 36
36 36
0 0
0 0
0 0
2 2
2 2
2 2
0 0
200 200
200 200
 200 200
0 0
40 40
50 50
100 100
25 25
5 5
50 50
0 0
0 0
3 3
36 36
36 36
0 0
10 10
0 0
10 10
0 0
0 0
0 0
0 0
5 5
0 0
5 5
5 5
10 10
4 4
5 5
5 5
6 6
10 10
0 0
0 0
60 60
180 180
0 0
0 0
60 60
30 30
0 0
1000 1000
1500 1500
200 200
0 0
0 0
 0 0
300 300
0 0
0 0
0 0
0 0
0 0
0 0

Jumlah

Yang menerima
Petugas Pengelola Obat,

NIP
Dokumen Nomor
Dinkes Kab/Kota
GFK Kab/Kota
Puskesmas

Jumlah
Lain-lain
NAMA-NAMA OBAT STOCK AKHIR
BULAN APRILI 2017

PUSKESMAS : CISOLOK
KECAMATAN : CISOLOK
KABUPATEN : SUKABUMI

NAMA, BENTUK DAN KADAR

No OBAT/PERBEKALAN Satuan Stok awal Pemasukan Pemakaian
KESEHATAN/VAKSIN/REAGENT
1 Alopurinol tablet 100 mg TAB 3000 0 0
2 Aloclair plus gel TAB 0 0 0
3 Amitriptilin HCl tablet salut 25 mg TAB 0 0 0
4 Amlodipin 5 mg TAB 6000 0 0
5 Amoksisilin kaplet 500 mg TAB 20000 0 0
6 Amoksisilin kapsul 250 mg KAPSUL 10000 0 0
7 Amoksisilin sirup kering 125 mg/5 ml BOTOL 600 0 0
8 Amoksisilin sirup kering Forte 250 mg/5 ml BOTOL 100 0 0
9 ampisilin inj IM/IV 1000 mg/ml AMPUL 0 0 0
10 Antalgin (Metampiron) tablet 500 mg TAB 10000 0 0
11 Antasida Suspensi 60 ml BOTOL 250 0 0
12 Antasida DOEN tablet kombinasi TAB 15000 0 0
13 Anti Bakteri DOEN salep kombinasi TUBE 0 0 0
14 Anti fungi DOEN komb sk TUBE 36 0 0
15 Anti Hemoroid DOEN kombinasi TAB 50 0 0
16 Antimigren DOEN kombinasi TAB 0 0 0
17 Antiparkinson DOEN TAB 0 0 0
18 Arimidex 1 mg- Anastrozole 1 mg AMPUL 0 0 0
19 Artesunat serb inj 60 mg/ml AMPUL 0 0 0
20 artesunat tablet (ACT) TAB 0 0 0
21 Asam Asetil Salisilat (Asetosal) tablet 80 mg TAB 0 0 0
22 Asam Askorbat (Vit.C) tablet 50 mg TAB 4000 0 0
23 asam folat tablet 1 mg TAB 200 0 0
24 Asam mefenamat 500 mg TAB 5000 0 0
25 Asam Mefenamat Kapsul 250 mg KAPSUL 0 0 0
26 Asiklovir Krim 5%/5g TUBE 160 0 0
27 Asiklovir tablet 200 mg TAB 0 0 0
28 Asiklovir Tablet 400 mg TAB 1000 0 0
29 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml AMPUL 15 0 0
30 Atropin Sulfat tablet 0,5 mg TAB 0 0 0
31 Attalpugite tab 600 mg TAB 3000 0 0
32 Benzatin Benzil Penisilin inj.1.2 juta IU/vial VIAL 0 0 0
33 Berotec MDI-Fenoterol Aerosol 100 mcg/dosis TAB 0 0 0
34 betahistin maleat TAB 2000 0 0
35 Betametason krim 0,1% - 5 gr TUBE 200 0 0
36 Bisakodil Supp 10 mg TAB 20 0 0
37 Captopril 12,5 mg TAB 5000 0 0
38 Captopril tablet 25 mg TAB 0 0 0
39 Ciprofloksasin 500 mg tablet TAB 2000 0 0
40 Deksametason injeksi 5 mg/ml - 1 ml AMPUL 100 0 0
41 Deksametason tablet 0,5 mg TAB 6000 0 0
42 Diazepam lar rektal 5mg/2,5ml BOTOL 15 0 0
43 Diazepam tablet 5 mg TAB 500 0 0
44 Dietilkarbamazin sitrat tablet 100 mg TAB 5000 0 0
45 Difenhidramin HCl injeksi 10 mg/ml - 1 ml AMPUL 120 0 0
46 Digoksin tablet 0,25 mg TAB 0 0 0
47 Doksisiklin kaps 100 mg TAB 500 0 0
48 Domperidon Syrup BOTOL 100 0 0
49 Domperidon tablet 10 mg TAB 1000 0 0
50 Epinefrina (adrenalin) injeksi 0,1% - 1 ml AMPUL 60 0 0
51 Erytromycin 250 mg TAB 0 0 0
52 Erytromycin syr 200mg/5 ml BOTOL 20 0 0
53 Etambutol HCl tablet 250 mg TAB 0 0 0
54 Eugenol cairan BOTOL 0 0 0
55 Fenitoin Na kaps 100 mg TAB 0 0 0
56 Fenobarbital injeksi 50 mg/ml - 2 ml AMPUL 0 0 0
57 Fenobarbital tablet 30 mg TAB 2000 0 0
58 Fenofibrat kaps 100 mg TAB 0 0 0
59 Fenoksimetil Penisilina tablet 250 mg TAB 0 0 0
60 Fenoksimetil Penisilina tablet 500 mg TAB 0 0 0
61 Fitomenadion (Vit.K1) tablet salut 10 mg TAB 5000 0 0
62 Furosemid tablet 40 mg TAB 1000 0 0
63 Garam oralit 200 ml air SACET 1000 0 0
64 Gentamisin injeksi 40 mg/ml AMPUL 20 0 0
65 gentamisin tetes mata TUBE 48 0 0
66 Glibenklamid tablet 5 mg TAB 4000 0 0
67 gliseril guaiacolat syrup BOTOL 100 0 0
68 Gliseril Guayakolat tablet 100 mg TAB 20000 0 0
69 Glivec- Imatinib tab 100 mg TAB 0 0 0
70 Griseofulvin tablet 125 mg, micronized TAB 1000 0 0
71 Haloperidol 0,5 mg tablet TAB 0 0 0
72 Haloperidol 1,5 mg tablet TAB 0 0 0
73 Haloperidol 5 mg TAB 1000 0 0
74 Hidroklorotiazid (HCT) tablet 25 mg TAB 1000 0 0
75 Hidrokortison krim 2,5 % TUBE 250 0 0
76 Ibuprofen tablet 200 mg TAB 2000 0 0
77 Ibuprofen tablet 400 mg TAB 5000 0 0
78 Isoniazid tablet 100 mg TAB 0 0 0
79 Isoniazid tablet 300 mg TAB 0 0 0
80 Isosorbid Dinitrat 5 mg tablet sublingual TAB 0 0 0
 81 Kalsium alginate gel BOTOL 0 0 0
82 Kalsium Glukonat Inj 100 mg/ml AMPUL 0 0 0
83 Karbamazepin tablet 200 mg TAB 1000 0 0
84 Karbogliserin Tetes Telinga 10% TUBE 75 0 0
85 Ketokonazol krim 2 % TUBE 100 0 0
86 Ketokonazol Tablet 200 mg TAB 500 0 0
87 Klindamicin 300 mg TAB 1000 0 0
88 Klopidogrel tab 75 mg TAB 0 0 0
89 Kloramfenikol kapsul 500 mg KAPSUL 1500 0 0
90 Kloramfenikol salep kulit 2% (bufacetin) TUBE 100 0 0
91 Kloramfenikol Salep Mata 1% - 3,5 gr TUBE 100 0 0
92 Kloramfenikol Tetes Telinga 3% - 5 ml TUBE 0 0 0
93 Klorfeniramin Maleat (CTM) tablet 4 mg TAB 250000 0 0
94 Klorpromazin HCL tablet 100 mg TAB 10 0 0
95 Klorpromazin inj. 25 mg/ml AMPUL 0 0 0
96 Kodein HCl tablet 10 mg TAB 500 0 0
97 Kotrimoksazol forte tablet TAB 2000 0 0
98 Kotrimoksazol suspensi kombinasi BOTOL 250 0 0
99 Kuinin (Kina) tablet 200 mg TAB 0 0 0
100 Kuinin dihidroklorida inj 25 %-2 ml AMPUL 0 0 0
101 Lansoprazol 30 Mg KAPSUL 2000 0 0
102 Levemir-Analog insulin long acting inj 100 UI/ml AMPUL 0 0 0
103 Lidokain inj. 2% AMPUL 400 0 0
104 Lidokain komp. injeksi kombinasi AMPUL 400 0 0
105 Loratadin tab 10 mg BOTOL 0 0 0
106 Magnesium Sulfat injeksi (IV) 40% - 25 ml AMPUL 0 0 0
107 Mebendazol tablet 100 mg TAB 150 0 0
108 Metformin tab 500 mg TAB 1000 0 0
109 metil dopa tab 250 mg TAB 0 0 0
110 Metilergometrin Maleat injeksi 0,200 mg - 1ml AMPUL 50 0 0
111 Metilergometrin Maleat tablet salut 0,125 mg TAB 1000 0 0
112 Metilprednisolon tablet TAB 2000 0 0
113 Metoklorpropamid tablet 5 mg TAB 200 0 0
114 Metronidazol sir 125 mg/5 ml BOTOL 25 0 0
115 Metronidazol tablet 250 mg TAB 1000 0 0
116 Metronidazol tablet 500 mg TAB 500 0 0
117 Miconazol SK TUBE 50 0 0
118 Multivitamin sirup BOTOL 100 0 0
119 Multivitamin Tablet Dewasa TAB 3000 0 0
120 Natrium Bikarbonat tablet 500 mg TAB 4000 0 0
121 Natrium Diklofenac 25 mg TAB 2000 0 0
122 Nifedifin tablet 10 mg TAB 2000 0 0
123 Nistatin 100.000 IU/gram tablet vaginal TAB 0 0 0
124 Nistatin tablet salut gula 500.000 IU/g TAB 500 0 0
125 Novorapid-Analog insulin rapid acting inj 100 UI/ AMPUL 0 0 0
126 OAT FDC Anak TAB 0 0 0
127 OAT FDC Kategori 1 TAB 0 0 0
128 Obat Batuk Hitam (OBH) cairan - 100 ml BOTOL 600 0 0
129 Oksitetrasiklin HCl salep 3% - 5 gram TUBE 120 0 0
130 Oksitosin injeksi 10 IU/ml - 1 ml AMPUL 450 0 0
131 Omeprazol caps 20 mg KAPSUL 2000 0 0
132 Ondansentron tab 8 mg TAB 1000 0 0
133 parasetamol drop BOTOL 75 0 0
134 Parasetamol kaplet 500 mg TAB 15000 0 0
135 Parasetamol sirup BOTOL 800 0 0
136 Permetrin krim 5 % TUBE 10 0 0
137 Phtomenadion injeksi 2 mg/ml AMPUL 180 0 0
138 Pirantel Pamoat tablet 125 mg TAB 150 0 0
139 Pirazinamid tablet 500 mg TAB 0 0 0
140 Piridoksin HCl (Vit.B6) tablet 10 mg TAB 4000 0 0
141 Prednison tablet 5 mg TAB 2000 0 0
142 Probiokid AMPUL 0 0 0
143 Propiltiourasil tablet 100 mg TAB 750 0 0
144 Propranolol HCl tablet 10 mg TAB 0 0 0
145 Ranitidin Injeksi 25 mg/ml AMPUL 120 0 0
146 Ranitidin tablet 150 mg TAB 6000 0 0
147 Retinol (Vit.A) 100.000 IU kapsul KAPSUL 0 0 0
148 Retinol (Vit.A) 200.000 IU kapsul KAPSUL 0 0 0
149 Rifampisin kapsul 300 mg KAPSUL 0 0 0
150 Rifampisin kapsul 450 mg KAPSUL 100 0 0
151 Rifampisin kapsul 600 mg KAPSUL 0 0 0
152 Salbutamol Cairan ih 0,1% AMPUL 50 0 0
153 Salbutamol tablet 4 mg TAB 1000 0 0
154 Salep 2 - 4 kombinasi TUBE 96 0 0
155 Salisil Bedak 2% - 50 gram KOTAK 100 0 0
156 Sefadroksil Kapsul 500 mg KAPSUL 1000 0 0
157 Sefadroksil Syrup 250 mg BOTOL 50 0 0
158 Sefiksim kapsul 100 mg KAPSUL 500 0 0
159 Setirizin kap 10 mg KAPSUL 1000 0 0
160 Setirizin sir 5 mg/ 5 ml BOTOL 10 0 0
161 Sianokobalamin (Vitamin B12) 50 mg TAB 1000 0 0
162 Simvastatin 20 mg TAB 750 0 0
163 Symbicort 80/4.5 mcg- Budesonide Formoterol 8AMPUL 0 0 0
164 Teofilin tab 150 mg TAB 500 0 0
165 Tetrasiklin HCl kapsul 250 mg KAPSUL 2000 0 0
166 Tetrasiklin HCl kapsul 500 mg KAPSUL 0 0 0
167 Tiamin HCl/Mononitrat (Vit.B1) tablet 50 mg TAB 2000 0 0
168 Triheksifenidil HCl 2 mg tablet TAB 750 0 0
169 Vitamin B komplek tablet TAB 4000 0 0
170 Zink syrup 20 mg/5 ml BOTOL 100 0 0
171 zink tablet disp 20 mg TAB 2000 0 0
OBAT GIGI 0 0 0
1 Devitalisasi pasta (Non Arsen) PASTA 1 0 0
2 Etil Klorida Semprot - 100 ml BOTOL 10 0 0
3 Eugenol cairan - 10 ml BOTOL 0 0 0
4 Fluor tablet 0,5 mg TAB 0 0 0
5 Formokresol Cairan BOTOL 0 0 0
6 Gentian Violet larutan 1% - 10 ml BOTOL 0 0 0
7 Glass Ionomer Cement (GC IX) BOTOL 1 0 0
8 Kalsium Hidroksida Pasta PASTA 1 0 0
9 Monoklorkamfer Mentol cairan (CHKM) 1 0 0
10 Mummifying Pasta 1 0 0
11 Polikresulen cairan 0 0 0
12 Semen Seng Fosfat serbuk dan cairan 1 0 0
13 Spons Gelatin Cubicles 1 x 1 x 1 cm 1 0 0
14 Temporary Stopping Fletcher serbuk & cairan 1 0 0
15 Lidokain gel 0 0 0
16 Trikresol Formalin (TKF) cairan - 10 ml 1 0 0
BHP 0 0 0
1 Alat suntik sekali pakai 3 ml PCS 750 0 0
2 Alat suntik sekali pakai 5 ml PCS 0 0 0
3 autodisable no 0,05 ml PCS 0 0 0
4 autodisable no. 0,5 ml PCS 0 0 0
5 bloodset PCS 0 0 0
6 Catgut Chromic 2/0 + jarum 1/2 HR 26 mm PCS 36 0 0
7 Catgut Chromic 3/0 + jarum 1/2 HR 26 mm PCS 36 0 0
8 Folley Catheter 2 WAY no 16 PCS 0 0 0
9 Folley Catheter 2 way no 18 PCS 0 0 0
10 Handscoon Non Steril 0 0 0
Ukuran S BOX 2 0 0
Ukuran M BOX 2 0 0
Ukuran L BOX 2 0 0
11 Handscoon steril 0 0 0
Ukuran 6.5 PCS 200 0 0
Ukuran 7.0 PCS 200 0 0
Ukuran 7.5 PCS 200 0 0
12 Infusion set anak PCS 0 0 0
13 Infusion set dewasa PCS 40 0 0
14 IV Catheter G - 18 PCS 50 0 0
15 IV Catheter G - 20 PCS 100 0 0
16 IV Catheter G - 22 PCS 25 0 0
17 Kapas berlemak 250 gr ROL 5 0 0
18 Kasa hidrofil 16x16 (steril) BOX 50 0 0
19 Kasa Kompres 40/40 steril BOX 0 0 0
20 Kasa Pembalut 2 m x 80 cm ROLL 0 0 0
21 kasa pembalut hydrofil 36 m x 80 cm ROLL 3 0 0
22 Silk 2/0 + jarum 1/2 GT 35 mm PCS 36 0 0
23 Silk 3/0 + jarum 1/2 GT 35 mm PCS 36 0 0
24 Masker BOX 0 0 0
25 Plester ROLL 10 0 0
26 Urine bag PCS 0 0 0
27 ECG/USG jelly 82gr 10 0 0
28 ID Patient Adult/Dewasa Biru 0 0 0
29 ID Patient Adult/Dewasa Pink 0 0 0
30 Polifix 5 cm x 1 m 0 0 0
31 Policrepe Pembalut Elastis 7,5 cm x 4,55 m ROLL 0 0 0
32 Cuticell Classic 10 cm x 10 cm 5 0 0
DESINFECTAN 0 0 0
1 Antiseptik Hand Scrub BOTOL 5 0 0
2 Rivanol larutan 0,1% - 330 cc BOTOL 5 0 0
3 Alkohol 70% - 1000 ml BOTOL 10 0 0
4 Alkohol Swab BOK 4 0 0
5 Lisol 1 liter BOTOL 5 0 0
6 Gel untuk cateter TUBE 5 0 0
7 Povidon Iodida 60 ml BOTOL 6 0 0
8 Povidon Iodida 500 ml BOTOL 10 0 0
CAIRAN 0 0 0
1 Air untuk injeksi (Aqua pro injeksi) 20 ml VIAL 0 0 0
2 Natrium Klorida lart.infus 0,9% steril - 500 ml BOTOL 60 0 0
3 Ringer Laktat larutan infus steril - 500 ml BOTOL 180 0 0
REAGENT 0 0 0
1 Gliserin - 100 ml BOTOL 0 0 0
2 GLOKOSA LARUTAN INFUS 5% BOTOL 60 0 0
3 DIAZEPAM INJEKSI 5 MG AMPU[ 30 0 0
4 DIAZEPAM TAB 2 MG TAB 0 0 0
5 EPREDIN HCL TAB 25 MG TAB 1000 0 0
6 KALSIUM LAKTAS (KALK) TAB 1500 0 0
7 KASA 4X5 CM ROLL 200 0 0
8 NOVOROMID AMPUL 0 0 0
9 GLUKOSA 10% BOTOL 0 0 0
10 GLUKOSA 40% BOTOL 0 0 0
11 Alat Suntik 1 ml 300 0 0
12 0 0 0 0
13 0 0 0 0
14 0 0 0 0
15 0 0 0 0
16 0 0 0 0
17 0 0 0 0
Mengetahui, Sukabumi, 04 Februari 2017
Kepala PKM Cisolok Petugas pengelola obat
dr. M. Saleh Nenden Halimah
NIP. 196206192006041002 NIP.197102091996012001
 Stok Akhir
Desember 2016

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