PEMERINTAH DAERAH KOTA CIREBON

PUSKESMAS PEGAMBIRAN
LAPORAN PENERIMAAN DAN PENGELUARAN OBAT
Periode 01 Dec 2020 s.d. 31 Dec 2020

Jumlah Sisa
No Kode Nama Obat Sat Stock Awal Penerimaan Pemakaian Ket
Persediaan Stock
1 1003 Alat Suntik 3 ml Buah 0.00 300.00 300.00 0.00 300.00

2 2105 Albendazol Suspensi 200 mg / 5 ml Botol 3.00 0.00 3.00 0.00 3.00

3 2001 Albendazol tablet 400 mg Tablet 6.00 0.00 6.00 2.00 4.00

4 1005 Alopurinol tablet 100 mg Tablet 1,428.00 0.00 1,428.00 204.00 1,224.00

5 2002 Ambroxol sirup 15 mg/ml- 60 ml Botol 120.00 150.00 270.00 143.00 127.00

6 1007 Amitriptilin tablet 25 mg Tablet 105.00 200.00 305.00 90.00 215.00

7 2085 Amlodipin tablet 5 mg Tablet 2,970.00 2,100.00 5,070.00 4,465.00 605.00

8 1009 Amoksisilin kaplet 500 mg Kaplet 2,742.00 2,000.00 4,742.00 3,794.00 948.00

9 2095 Antasida DOEN I tablet kunyah ( Blister ) Tablet 4,304.00 1,000.00 5,304.00 1,284.00 4,020.00

10 2007 Antasida DOEN II suspensi 60 ml Botol 155.00 100.00 255.00 53.00 202.00

11 1018 Antifungi DOEN Pot 53.00 0.00 53.00 2.00 51.00

12 1019 Antimigren DOEN Tablet 84.00 0.00 84.00 0.00 84.00

Aqua pro injeksi steril bebas pirogen 20
13 1021 Ampul 20.00 0.00 20.00 0.00 20.00
ml

14 2107 Asam Askorbat (Vitamin C) tablet 50 mg Tablet 4,464.00 3,000.00 7,464.00 2,932.00 4,532.00
(blister)
Asam Mefenamat tablet salut selaput
15 2009 Tablet 1,756.00 0.00 1,756.00 936.00 820.00
500 mg
16 2010 Asiklovir krim 5%- 5 g Tube 55.00 0.00 55.00 9.00 46.00

17 2012 Asiklovir tablet 400 mg Tablet 660.00 0.00 660.00 130.00 530.00

18 2120 Azitromisin 500 mg Kapsul 0.00 70.00 70.00 60.00 10.00

19 1033 Betametason krim 0,1% Tube 33.00 50.00 83.00 58.00 25.00

20 3124 Coverall Set 0.00 100.00 100.00 0.00 100.00

21 1036 Deksametason injeksi i.v. 5 mg/ml Ampul 26.00 0.00 26.00 16.00 10.00

22 3043 Diazepam Rektal 5 mg/tube (stesolid) Tube 7.00 0.00 7.00 2.00 5.00

23 1043 Diazepam tablet 2 mg Tablet 205.00 0.00 205.00 49.00 156.00

24 2086 Dimenhidrinat tablet 50 mg Tablet 22.00 200.00 222.00 98.00 124.00

25 2015 Domperidon suspensi 5 mg/5 ml- 60 ml Botol 204.00 0.00 204.00 8.00 196.00

26 2016 Domperidon tablet 10 mg Tablet 652.00 0.00 652.00 381.00 271.00

27 5009 Dropper Polio Buah 10.00 0.00 10.00 0.00 10.00

Epinefrin (Adrenalin) injeksi 0,1% (HCl) 1
28 1050 ml Ampul 18.00 0.00 18.00 7.00 11.00

29 2170 Eritromisn 250 mg kapsul Kapsul 920.00 0.00 920.00 0.00 920.00

30 2140 Fe Fumarat + As. Folat 0.4 mg tablet Tablet 31,655.00 0.00 31,655.00 3,285.00 28,370.00

31 1067 Fitomenadion (Vit.K1) tablet salut gula Tablet 140.00 0.00 140.00 0.00 140.00
10 mg
32 1071 Garam Oralit Sachet 163.00 200.00 363.00 323.00 40.00

33 2025 Gentamisin salep kulit 0,1% Tube 225.00 0.00 225.00 118.00 107.00

34 2026 Gentamisin sulfat TM 0,3% 5 ml Botol 54.00 0.00 54.00 20.00 34.00

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 Jumlah Sisa
No Kode Nama Obat Sat Stock Awal Penerimaan Pemakaian Ket
Persediaan Stock
35 3012 Gliseril Guaiakolat sirup Botol 127.00 0.00 127.00 64.00 63.00

36 2139 Guafenesin Tablet 100 mg Tablet 8,622.00 0.00 8,622.00 0.00 8,622.00

37 2028 Haloperidol tablet 5 mg Tablet 440.00 200.00 640.00 375.00 265.00

38 3019 Hand Shoen Steril 7, 7 1/2 Pasang 100.00 0.00 100.00 0.00 100.00

39 2162 Hepatitis B Immunoglobulin Buah 1.00 0.00 1.00 0.00 1.00

40 1085 Hidroklorotiazida tablet 25 mg Tablet 230.00 0.00 230.00 16.00 214.00

Ipratropium Bromida + Salbutamol
41 2142 Sulfat Vial 70.00 0.00 70.00 60.00 10.00

42 1098 Kalsium Laktat (Kalk) tablet 500 mg Tablet 3,698.00 2,000.00 5,698.00 3,193.00 2,505.00

43 1100 Kapas Pembalut 250 g Roll 3.00 0.00 3.00 0.00 3.00

44 3028 Kasa Steril 16 x 16 cm Pcs 208.00 0.00 208.00 0.00 208.00

45 2034 Ketokonazol tablet 200 mg Tablet 25.00 200.00 225.00 35.00 190.00

46 2101 Klindamisin kapsul 150 mg Kapsul 220.00 0.00 220.00 80.00 140.00

47 1108 Kloramfenikol kapsul 250 mg Kapsul 200.00 0.00 200.00 0.00 200.00

48 1109 Kloramfenikol salep mata 1% Tube 43.00 0.00 43.00 15.00 28.00

49 1110 Kloramfenikol tetes telinga 3% Botol 18.00 30.00 48.00 11.00 37.00
Klorfeniramina Maleat (CTM) tablet 4
50 2103 Tablet 8,051.00 0.00 8,051.00 3,839.00 4,212.00
mg
51 2157 Klorpromazin tablet salut 100 mg Tablet 305.00 0.00 305.00 135.00 170.00

52 1121 Kotrimoksazol suspensi 60 ml Botol 81.00 0.00 81.00 29.00 52.00

53 1134 Lidocain Comp Ampul 60.00 0.00 60.00 0.00 60.00

54 2113 Loratadin tablet 10 mg Tablet 1,760.00 0.00 1,760.00 260.00 1,500.00

55 4007 MB Adult Blister 5.00 0.00 5.00 5.00 0.00

56 2042 Metformin HCl tablet 500 mg Tablet 4,069.00 0.00 4,069.00 3,889.00 180.00

57 2193 Multivitamin Kaplet Kaplet 0.00 440.00 440.00 440.00 0.00

58 2145 Multivitamin Sirup Botol 17.00 100.00 117.00 14.00 103.00

59 2141 N - Asetil Sistein Tablet Tablet 6,834.00 0.00 6,834.00 859.00 5,975.00

60 3196 Nasal Oxigen Cannula Pcs 0.00 1.00 1.00 0.00 1.00

61 1147 Natrium Bikarbonat tablet 500 mg Tablet 200.00 0.00 200.00 0.00 200.00

62 2048 Natrium Diklofenak tablet 50 mg Tablet 651.00 0.00 651.00 619.00 32.00

63 1149 Natrium Klorida larutan infus 0,9% 500 Botol 4.00 4.00 8.00 1.00 7.00
ml
64 3081 Nifedipin Tablet Oros Tablet 60.00 0.00 60.00 50.00 10.00

65 3034 Nistatin Drop 12 ml, 100.000 UI/ml Botol 21.00 0.00 21.00 5.00 16.00

66 1151 Nistatin vaginal tablet 100.000 IU/g Tablet 63.00 0.00 63.00 5.00 58.00

67 1153 OAT FDC Kategori 1 dewasa Paket 2.00 1.00 3.00 1.00 2.00

68 1155 OAT FDC Kategori Anak Paket 2.00 0.00 2.00 2.00 0.00

69 3073 Obat Batuk Pilek sirup Botol 17.00 0.00 17.00 7.00 10.00

70 1162 Oksitosin injeksi 10 mg IU/ml - 1 ml Ampul 4.00 0.00 4.00 0.00 4.00

71 2171 Oseltamivir Kapsul Kapsul 0.00 195.00 195.00 195.00 0.00

72 3193 Oximeter Pcs 0.00 2.00 2.00 0.00 2.00

73 1163 Papaverin tablet 40 mg Tablet 484.00 0.00 484.00 220.00 264.00

74 1164 Parasetamol sirup 120 mg/5 ml- 60 ml Botol 512.00 0.00 512.00 74.00 438.00

75 2055 Parasetamol tablet 500 mg ( Blister ) Tablet 7,826.00 0.00 7,826.00 5,361.00 2,465.00

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 Jumlah Sisa
No Kode Nama Obat Sat Stock Awal Penerimaan Pemakaian Ket
Persediaan Stock
76 5011 Pelarut BCG Ampul 10.00 5.00 15.00 7.00 8.00

77 5010 Pelarut Measles Rubella (MR) Ampul 6.00 0.00 6.00 0.00 6.00

78 3071 Perak Sulfadiazin krim 1 % Tube 6.00 0.00 6.00 3.00 3.00

79 1175 Piridoksin (Vitamin B6) tablet 10 mg Tablet 4,040.00 0.00 4,040.00 1,673.00 2,367.00
(HCl)
80 2060 Piroksikam tablet 20 mg Tablet 1,046.00 0.00 1,046.00 602.00 444.00

81 1180 Povidon Iodida larutan 10% 300 ml Botol 4.00 0.00 4.00 1.00 3.00

82 2104 Prednison tablet 5 mg (blister) Tablet 970.00 0.00 970.00 272.00 698.00

83 2064 Ranitidin tablet 150 mg Tablet 1,868.00 0.00 1,868.00 658.00 1,210.00

84 3079 Rapid 2 HIV Fokus Test 50.00 0.00 50.00 0.00 50.00

85 3078 Rapid Tes HIV Kit 1 Test 200.00 0.00 200.00 0.00 200.00

86 3080 Rapid Tes HIV Kit 3 Test 25.00 0.00 25.00 0.00 25.00

87 2182 Rapid Test Corona Test 0.00 50.00 50.00 0.00 50.00

88 3084 Rapid test Syphilis Test 250.00 0.00 250.00 0.00 250.00

89 3141 Refill Hand Sanitizer 1000 ml Botol 1.00 0.00 1.00 0.00 1.00
Ringer Laktat larutan infus 500 ml 500
90 1194 Botol 0.00 20.00 20.00 0.00 20.00
ml
91 3065 Risperidon tablet 2 mg Tablet 620.00 200.00 820.00 135.00 685.00

92 1195 Salbutamol tablet 2 mg (sebagai sulfat) Tablet 455.00 0.00 455.00 231.00 224.00

93 1196 Salep 2-4 Pot 4.00 24.00 28.00 17.00 11.00

94 2070 Sefadroksil sirup kering 125 mg/5 ml - 60 Botol 96.00 0.00 96.00 20.00 76.00
ml
95 2115 Setirizin Sirup 5 mg/ 5 ml Botol 0.00 100.00 100.00 0.00 100.00

96 2075 Sianokobalamin (Vitamin B12) tablet 50 Tablet 1,846.00 1,000.00 2,846.00 1,315.00 1,531.00
mcg
97 2077 Simvastatin tablet 10 mg Tablet 5,955.00 0.00 5,955.00 3,435.00 2,520.00

98 3202 Tabung Oksigen Lengkap Pcs 0.00 1.00 1.00 0.00 1.00

99 3045 Tiamfenikol Dry Sirup : 125 mg/5 ml 60 Botol 43.00 0.00 43.00 0.00 43.00
ml

100 1223 Tiamin (Vitamin B1) tablet 50 mg Tablet 6,648.00 0.00 6,648.00 1,020.00 5,628.00
(HCl/Nitrat)
101 1225 Triheksifenidil 2 mg Tablet 440.00 300.00 740.00 300.00 440.00

102 5001 Vaksin BCG Vial 10.00 5.00 15.00 7.00 8.00

103 5002 Vaksin DPT-HB/Hib Vial 12.00 20.00 32.00 23.00 9.00

104 5004 Vaksin HB Uniject Sachet 8.00 15.00 23.00 20.00 3.00

105 5005 Vaksin Measles Rubella (MR) Vial 10.00 10.00 20.00 12.00 8.00

106 5006 Vaksin Polio (bOPV) Vial 10.00 15.00 25.00 17.00 8.00

107 5007 Vaksin Polio IPV Vial 5.00 30.00 35.00 10.00 25.00

108 5008 Vaksin TD Vial 12.00 0.00 12.00 0.00 12.00

109 3160 Virus Transpot Medium (VTM) Set 273.00 0.00 273.00 0.00 273.00

110 2117 Vitamin B Kompleks tablet (blister) Tablet 4,423.00 0.00 4,423.00 4,356.00 67.00

111 2200 Vitamin D 1000 UI Tablet 0.00 220.00 220.00 220.00 0.00

112 2199 Vitamin E 300 UI Kapsul 0.00 220.00 220.00 220.00 0.00

113 2084 Zinc tablet 20 mg Tablet 200.00 200.00 400.00 240.00 160.00

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 Mengetahui, CIREBON, 31 Dec 2020
KEPALA UPT PUSKESMAS PEGAMBIRAN Apoteker

dr. Ahmad Subhi Taufiequrrohman Fitrie Widiastuti, S. Farm, Apt.

NIP. 19720608 200604 1 014 NIP. 19890508 201903 2 008

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