Lplpo 2017

DINAS KESEHATAN KOTA PALEMBANG
REKAP PERSEDIAAN AKHIR BLUD PUSKESMAS

PER 31 DESEMBER 2016
APBD Kota Palembang HIBAH (BANTUAN)

OBAT KB
Nama BLUD APBN APBD PROPINSI
No. BKKBN
Puskesmas OBAT MP-ASI KARCIS OBAT ATK
PIN VAKSIN
MP-ASI MP-ASI OBAT HIV dll
NASIONAL PROGRAM
1 2 3 5 6 7 8 9 10 11 12 13
1 MAKRAYU 112,035,284.00 - 1,522,350.00 10,586,770.00 97,158,000.00 - - 7,602,298.00 - 8,268,400.00 438,000.00
2 GANDUS 90,311,882.00 - 179,100.00 8,099,728.00 54,420,000.00 - - 11,129,230.00 1,594,304.00 7,954,268.00 -
3 1 ULU 109,748,885.00 8,026,500.00 905,450.00 2,179,280.00 40,945,500.00 - 6,084,000.00 705,595.00 - - -
4 4 ULU 119,626,733.00 - 975,100.00 2,787,873.00 31,284,000.00 - 8,001,000.00 3,527,590.00 - 12,228,941.00 6,999,434.00
5 7 ULU 57,939,757.00 6,590,400.00 955,200.00 4,584,860.00 5,312,700.00 - - 1,456,004.00 - 17,334,180.00 3,553,679.00
6 PEMBINA 83,620,349.00 9,148,500.00 407,950.00 1,151,400.00 23,349,000.00 - 13,137,000.00 8,789,499.00 - 170,790.00 -
7 OPI 73,202,996.00 4,234,500.00 109,450.00 1,020,279.00 33,396,750.00 - - 3,887,136.00 - - -
8 KERAMASAN 66,406,605.00 - 238,800.00 4,042,340.00 - - - 6,261,750.00 - 72,000.00 771,100.00
9 KERTAPATI 55,927,555.00 2,289,600.00 229,450.00 2,364,434.00 24,887,000.00 - - 404,250.00 - - 1,550,000.00
10 NAGA SWIDAK 51,841,813.00 2,608,500.00 925,350.00 1,782,155.00 52,119,000.00 - - 7,879,432.00 - - -
11 TAMAN BACAAN 80,130,316.00 3,532,500.00 89,550.00 397,440.00 140,309,250.00 - 17,463,000.00 3,935,305.00 - 607,008.00 -
12 PLAJU 78,275,814.00 - 1,154,200.00 4,078,568.00 - - 16,258,500.00 10,512,810.00 - 24,738,831.00 -
13 KAMPUS 105,690,408.00 6,346,500.00 616,900.00 3,407,170.00 33,966,000.00 - 1,363,500.00 4,710,266.00 43,882.00 48,269.76 -
14 PAKJO 99,498,746.00 1,899,000.00 328,350.00 1,681,420.00 49,027,500.00 - - 3,128,708.00 - - 1,208,000.00
15 PADANG SELASA 109,423,369.00 4,503,000.00 368,150.00 3,743,100.00 114,606,000.00 - - 6,624,662.00 - - 1,200.00
16 SEI BAUNG 59,321,825.00 6,400,500.00 1,233,800.00 2,632,318.00 47,493,750.00 - - 8,585,220.00 - - 6,707,211.00
17 23 ILIR 72,253,998.00 873,600.00 238,800.00 1,600,154.00 1,586,650.00 - 1,586,650.00 1,659,526.00 28,806,170.00 - 13,500.00
18 MERDEKA 80,530,840.00 - 2,567,100.00 3,823,932.00 17,658,000.00 - - 917,983.00 1,188,040.00 4,342,718.00 1,119,100.00
19 ARIODILLAH 55,999,705.00 - 288,550.00 1,279,004.00 15,266,475.00 - - 9,891,782.00 - 2,082,925.00 981,764.00
20 DEMPO 40,879,059.00 11,736,600.00 835,800.00 532,000.00 30,728,250.00 - - 4,545,574.00 20,918,960.00 - -
21 TALANG RATU 124,782,095.00 - 338,300.00 4,812,472.00 26,731,200.00 - 1,039,050.00 802,626.00 - 2,313,181.00 -
22 BASUKI RAHMAT 54,639,210.00 - 746,250.00 2,196,200.00 17,775,000.00 - - 13,918,730.00 - 425,594.00 -
23 SEKIP 84,883,706.00 - 557,200.00 3,216,616.00 21,093,000.00 - - 15,432,123.00 - 15,183,244.00 -
24 5 ILIR 83,038,859.00 3,570,000.00 1,393,000.00 104,000.00 52,225,200.00 - - 6,082,997.00 - - 104,000.00
25 11 ILIR 143,250,967.00 - 467,650.00 1,244,374.00 9,807,750.00 - - 7,303,786.00 - 564,531.00 537,000.00
26 BOOM BARU 93,546,609.00 22,599,000.00 437,800.00 933,060.00 2,620,800.00 - 2,214,000.00 11,748,045.00 - - 1,895,434.00
27 KENTEN 85,550,390.00 - 288,550.00 3,328,463.00 - - - 12,069,680.00 - 26,824,165.00 94,500.00
28 SABOKINGKING 40,274,831.00 2,385,000.00 59,700.00 - 41,949,000.00 - - 8,683,510.00 - 349,800.00 260,900.00
29 BUKIT SANGKAL 51,876,834.50 - 139,300.00 590,035.00 32,523,750.00 - - 1,296,768.00 - - -
30 KALIDONI 80,146,786.00 - 676,600.00 1,773,905.00 5,451,000.00 - 6,056,100.00 6,744,518.00 - - -
31 SEI SELINCAH 83,376,796.00 - 487,550.00 343,149.00 25,122,000.00 - 11,772,000.00 5,647,290.00 - - -
32 MULTI WAHANA 117,026,700.00 - 477,600.00 8,678,320.00 70,193,400.00 - - 7,966,277.00 - 1,371,460.00 -
33 SEMATANG BORANG 55,565,850.00 8,442,000.00 597,000.00 - 31,556,250.00 - 1,886,250.00 2,325,730.00 - 12,064,490.00 2,816,611.00
34 SOSIAL 197,805,159.00 - 1,363,150.00 8,396,217.00 29,034,000.00 - 8,682,750.00 45,245,651.00 - 0.00 366,000.00
35 SUKARAME 52,129,406.00 - 1,084,550.00 3,915,568.00 18,888,000.00 - 8,682,750.00 15,283,928.00 469,600.00 1,378,942.00 160,000.00
36 TALANG BETUTU 56,453,009.00 - 537,300.00 665,956.00 44,964,000.00 - - 7,708,800.00 753,140.00 - 20,000.00
37 PUNTI KAYU 25,298,982.00 - 368,150.00 - 17,582,100.00 - 8,129,250.00 1,576,762.00 - - 676,200.00
38 ALANG ALANG LEBAR 99,482,245.00 5,527,850.00 1,094,500.00 1,836,500.00 11,687,500.00 - 10,588,600.00 8,264,554.00 - - 28,050.00
39 KARYA JAYA 66,703,341.00 4,939,200.00 189,050.00 1,888,038.00 19,966,200.00 - - 4,879,479.00 - - 1,707,399.00
TOTAL 3,198,497,714.50 115,652,750.00 25,472,600.00 105,697,098.00 1,292,683,975.00 - 122,944,400.00 289,135,874.00 53,774,096.00 138,323,737.76 32,009,082.00
BLUD
BHP Saldo Akhir

BHP BHP BHP ALAT
CETAKAN KANTONG
MEDIS+LABOR KEBERSIHAN LISTRIK
OBAT
14 15 16 17 18 19
- - - - - 237,611,102.00
- - - - - 173,688,512.00
- - - - - 168,595,210.00
- 10,547,200.00 1,224,377.00 - - 197,202,248.00
- 1,468,734.00 1,151,443.00 - - 100,346,957.00
1,025,000.00 - - - - 140,799,488.00
- - - - 115,851,111.00
2,750,000.00 645,000.00 - - - 81,187,595.00
660,000.00 774,730.00 - - - 89,087,019.00
- - - - - 117,156,250.00
633,400.00 - - - - 247,097,769.00
2,490,000.00 - - - - 137,508,723.00
- 963,000.00 973,000.00 - - 158,128,895.76
545,000.00 - 39,000.00 - - 157,355,724.00
- 2,500,800.00 99,000.00 - - 241,869,281.00
1,115,000.00 6,326,600.00 4,644,620.00 - - 144,460,844.00
- - 114,000.00 - - 108,733,048.00
- 868,408.00 424,400.00 - - 113,440,521.00
- - 67,460.00 - - 85,857,665.00
- - - - - 110,176,243.00
- - - - - 160,818,924.00
120,000.00 - - - - 89,820,984.00
- - - - - 140,365,889.00
555,000.00 212,000.00 57,000.00 - - 147,342,056.00
- - - - - 163,176,058.00
1,560,000.00 - 1,238,300.00 - 380,000.00 139,173,048.00
- 600,000.00 274,600.00 - - 129,030,348.00
- 1,615,500.00 859,300.00 - - 96,437,541.00
- - - - - 86,426,687.50
- - - - - 100,848,909.00
- - - - - 126,748,785.00
- - - - - 205,713,757.00
- - - - - 115,254,181.00
- 1,600,000.00 - - - 292,492,927.00
240,000.00 - - - - 102,232,744.00
- 909,000.00 107,500.00 - - 112,118,705.00
- - 280,500.00 - - 53,911,944.00
4,780,000.00 50,000.00 151,081.00 - - 143,490,880.00
136,875.00 - - 72,000.00 - 100,481,582.00
16,610,275.00 29,080,972.00 11,705,581.00 72,000.00 380,000.00 5,432,040,155.26
Plt. Kepala Dinas Kesehatan
dr. Hj. Letizia, M.Kes

NIP. 19640214 1991032002
LAPORAN PEMAKAIAN DAN PEMAKAIAN OBAT PKD, OBAT TRADISIONAL, REAGENT LABORATORIUM (APBD Kota)
HARGA
N0 NAMA OBAT SATUAN STOCK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOCK STOCK OPTIMAL PERMINTAAN PEMBERIAN
SATUAN (Rp)
OBAT PKD g=e+f I=g-h

1 Alat suntik 2,5 ml/3 ml 957 Set 479 479 82 397
2 Alat suntik 5 ml 1,348 Set 2,585 2,585 24 2,561
3 Albendazole 400 mg 350 tablet 0 0
4 Alkohol Swab 34,100 kotak 2 2 2
5 Acetosal (Miniaspi 80 mg),100mg 122 tablet 2,806 2,806 285 2,521
6 Acetylcystein 200 mg 866 tablet 666 666 666 0
7 Alopurinol 100 mg 93 tablet 4,657 4,657 400 4,257
8 Alopurinol 300 mg 215 tablet 601 601 115 486
9 Ambroxol sirup 15 mg/ml 3,600 botol 0 0
10 Aminofilin 200 mg 82 tablet 487 487 20 467
11 Amlodipin tab 5 mg 105 tablet 13,787 13,787 1,732 12,055
12 Amlodipin tab 10 mg 160 tablet 8,233 8,233 663 7,570
13 Amoksisilin syrup 125 mg/ 5ml 2,500 botol 727 727 182 545
14 Amoksisilin dry syrup 250 mg/ 5ml 4,212 botol 0 0
15 Amoksisilin 250 mg 201 kapsul 3,424 3,424 554 2,870
16 Amoksisilin 500 mg 270 kaplet 30,250 30,250 6,950 23,300
17 Amoksisilin+as klavulanat 625mg tab 4,777 tablet 0 0
18 Antasida doen tablet 63 tablet 6,237 6,237 1,890 4,347
19 Antasida doen suspensi 2,117 botol 906 906 61 845
20 Antibakteri salep kombinasi (Bevalex) 11,300 tube 240 240 240 0
21 Antifungi doen kombinasi ( white field ) 4,366 tube 158 158 15 143
22 Anti Migran (Ergotamin Coffein) 142 tablet 0 0
23 Amitriptilin tablet salut 25 mg 117 tablet 500 500 500
24 Asam Askorbat 50 mg 109 tablet 13,536 13,536 598 12,938
25 Asam Mefenamat 500 mg 112 tablet 41,326 41,326 2,691 38,635
26 Asiklovir krim 5% 2,988 tube 1 1 1 0
27 Asiklovir 200 239 tablet 1,000 1,000
28 Asikovir 400 345 tablet 879 879 366 513
29 Asam folat 0,4 mg 93 tablet 746 746 61 685
30 Attapulgite (Pularex 630 mg) 210 tablet 592 592 86 506
31 Articulating paper 202,000 kotak 4 4 1 3
32 Betametson krem 0,1 % 1,520 tube 485 485 102 383
33 Bisakodil supp 5 mg anak 4,990 suppos 54 54 4 50
34 Bisakodil tab 5 mg 1,235 tablet 0 0
35 Betahistin Mesilate 162 tablet 4,923 4,923 395 4,528
36 Burnazin cream 24,150 tube 75 75 2 73
37 BD Syringe Soloshot mini 0,05ml 165,550 kotak 13 13 13
39 Composite 423,500 botol 0 0
40 Cat gut 22,599 saset 0 0
41 Ciprofloxacin 500 mg 289 tablet 3,102 3,102 1,232 1,870
42 Cetrizine 10 mg 145 tablet 6,946 6,946 1,264 5,682
43 Cetrizine syr 5 mg 8,399 botol 133 133 1 132
44 Clobazam 10 mg tab 900 tablet 443 443 196 247
45 Carbamazepin 200 mg 280 tablet 0 0
46 Cooper T (380A) 17,710 unit 16 16 16
47 Calamed lotion 14,300 botol 30 30 2 28
48 Caviton White 154,000 botol 2 2 2
49 Cimetidin 200mg 115 kapsul 0 0
50 Chlorfenolkamfermentol (CHKM) 77,000 botol 0 0
51 Dexamethason inj 5 mg/ml 1,659 ampl 100 100 100
52 Dexamethason tabl 0,5 mg 46 tablet 18,281 18,281 1,976 16,305
53 Devitalisasi pasta 319,000 botol 2 2 2 0
HARGA
N0 NAMA OBAT SATUAN STOCK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOCK STOCK OPTIMAL PERMINTAAN PEMBERIAN
SATUAN (Rp)
54 Diazepam inj 2,486 ampl 25 25 16 9

55 Diazepam 2 mg tablet 28 tablet 0 0
57 Digoxin 0,25 mg tablet 100 tablet 0 0
58 Diltiazem 30 mg 134 tablet 0 0
59 Diphenhydramin inj 10 mg 1,100 ampl 85 85 85
60 Domperidon suspensi 5mg/5ml 3,410 botol 0 0
61 Domperidon 10 mg 170 tablet 602 602 61 541
62 Doksisiklin kapsul 100 mg 285 kapsul 1,110 1,110 20 1,090
63 Etakridin ( Rivanol ) larutan 0,1 % 2,650 botol 172 172 37 135
64 Etanol 70 % @ 100 ml 2,575 botol 25 25 25
65 Ethyl klorida spray 150,000 botol 7 7 2 5
66 Eugenol 19,005 botol 5 5 5
67 Eritromycin syr kering 200mg/5ml 7,893 botol 240 240 2 238
68 Erythromisin kap 250 mg 594 kapsul 1,000 1,000 1,000
69 Erythromisin kap 500 mg 751 kapsul 1,944 1,944 218 1,726
70 Epineprine 0,1 % Inj (Adrenalin) 2,354 ampl 0 0
71 Fitomenadion / vit k 10 mg 660 tablet 2,986 2,986 328 2,658
72 Fitomenadion Injeksi 2mg/ml 3,582 ampl 0 0
73 Fenol Glyserol 10 % TT 2,500 botol 95 95 8 87
74 Ferro Fumarat + As. Folat (Hemafort) 835 tablet 0 0
75 Furosemide 40 mg 81 tablet 2,052 2,052 112 1,940
76 Flagyl suppos 0,5 gr 3,220 buah 58 58 58
77 Garam oralit 269 saset 1,006 1,006 821 185
78 Gentamisin salep mata 0,3 % 2,830 tube 38 38 2 36
79 Gentamisin sulfat Ttm 0,3 % 4,200 botol 208 208 88 120
80 Gentamisin salep kulit (Gentalex) 3,080 tube 120 120 22 98
81 Gemfibrozil 300 mg 303 tablet 2,230 2,230 206 2,024
82 Glasionomer semen 779,000 botol 15 15 8 7
83 Glimepiride 1 mg 265 tablet 0 0
85 Griseofulvin 230 tablet 0 0
86 Gliseril Guaiakolat 53 tablet 0 0
87 Glukosa lart. Infus 5 % 6,900 botol 35 35 35
89 Glibenklamid 5 mg 95 tablet 0 0
90 Haloperidol 1,5 mg 72 tablet 655 655 655
91 Haloperidol 5 mg 100 tablet 577 577 577
92 Handscoon Steril 7,5 6,595 sachset 239 239 2 237
93 Handscoon non-steril 37,044 kotak 4 4 4
94 H C T 25 mg 156 tablet 0 0
95 Hidrokortison 2.5 % krim 2,798 tube 209 209 24 185
96 Iliadin drop (Obat tetes hidung) 28,928 botol 30 30 1 29
97 Ibuprofen 200 mg 116 tablet 0 0
98 Ibuprofen 400 mg 153 tablet 3,197 3,197 1,642 1,555
99 Ibuprofen 100 mg/5ml 3,674 botol 0 0
100 Infus Set Dewasa 5,445 Set 0 0
101 Isosorbid dinitrat 5 mg 93 tablet 844 844 96 748
102 Kalsium laktat 66 tablet 5,236 5,236 2,945 2,291
103 Kapas 250 grm 12,800 rol 0 0
104 Kasa steril 40 x 40 cm 1,550 rol 0 0
105 Kasa steril 16 x 16 cm 5,950 rol 256 256 1 255
106 Kasa 4x15 2,150 rol 170 170 170
107 Kaptopril 25 mg 89 tablet 6,296 6,296 1,346 4,950
108 Kaptopril 12,5 mg 62 tablet 6,801 6,801 642 6,159
109 Ketokenazol cream 2,569 tube 95 95 1 94
110 Ketokenazol tab 200 mg 310 tablet 1,299 1,299 423 876
111 Khloramfenikol 250 mg 500 kaps 0 0
112 Khloramfenikol salep mata 1,600 tube 144 144 116 28
113 Kloramfenikol TT (Reco TT 3%) 6,040 botol 28 28 28 0
114 Klorfeson cream 7,148 tube 0 0
115 Klindamisin 300 mg 630 kapsul 0 0
116 Klorfeniramine maleat (CTM) 43 tablet 0 0
117 Kodein 10 mg tab 525 tablet 0 0
118 Kotrimoksazol syrup 2,183 botol 312 312 88 224
119 Kotrimoksazol tablet dewasa 154 tablet 7,186 7,186 1,298 5,888
120 Kotrimoksazol 120 mg 75 tablet 0 0
121 Kalsium Hidroksida Pasta 467,500 botol 0 0
122 Klorpromazin 100 mg 148 tablet 1,185 1,185 1,185
123 Lanzoprazol kapsul 30 mg 473 kapsul 1,489 1,489 614 875
124 Loratadin 10 mg 139 tablet 2,004 2,004 183 1,821
125 Loperamid tablet 2 mg 92 tablet 300 300 10 290
126 Lidokain HCl inj 2% 2ml 879 ampl 184 184 184
127 Lidokain inj 2% + Efinefrin 2ml komb 1,937 ampl 0 0
128 Leukoplast 2,5cm x 4,5cm 12,076 roll 0 0
129 Lysol 43,000 botol 0 0
130 Multivitamin Anti Anemia (Livron B-plex) 240 tablet 0 0
131 Magnesium Sulfat Inj IV 20%-25ml 3,200 vial 0 0
132 Magnesium Sulfat Inj IV 40%-25ml 3,650 vial 20 20 20
133 Masker 22,880 kotak 10 10 10
134 Meloksikam 15 mg 1,185 tablet 182 182 30 152
135 Metformin HCl tab 500 mg 115 tablet 19,326 19,326 1,160 18,166
136 Metformin 850 mg 215 tablet 0 0
137 Metilergometrin tab 0.125 mg 162 tablet 0 0
138 Metilergometrin inj 0.2 mg/1ml 2,684 ampl 0 0
139 Metilprednisolon tab 4 mg 210 tablet 1,412 1,412 326 1,086
140 Metronidazol 250 mg 113 tablet 2,407 2,407 177 2,230
141 Metronidazol 500 mg 164 tablet 935 935 218 717
142 Metochlopramide 5 mg tablet 105 tablet 149 149 149
143 Mikonazol krem 3,000 tube 133 133 59 74
144 Molex flu kaplet 397 tablet 3,000 3,000 342 2,658
145 Molex flu syrup 60ml 6,710 botol 665 665 28 637
146 Natrium diklofenac 25 mg 157 tablet 5,600 5,600 461 5,139
147 Natrium diklofenac 50 mg 185 tablet 1,230 1,230 880 350
148 Natrium Klorida lart infus 6,410 botol 57 57 6 51
149 Nistatin 100 000 UI tab vaginal 504 tablet 54 54 33 21
150 Nipedipin tablet 10 mg 110 tablet 633 633 438 195
151 Obat Suntik K.B I / Andalan Harmonis 6,624 vial 0 0
152 Omeprazol kap 20 mg 216 kapsul 1,355 1,355 105 1,250
153 Oxytocin inj 10iu 1,900 ampul 0 0
154 Oksitetrasiklin 3% salep kulit 1,640 tube 0 0
155 OBH Molex syrup 60ml 5,500 botol 434 434 100 334
156 Parasetamol syrup 1,119 botol 892 892 357 535
157 Parasetamol drop 5,460 botol 424 424 123 301
158 Parasetamol 500 mg 57 tablet 0 0
159 Papaverin 40 mg 209 tablet 0 0
160 Pirantel Suspensi 125 mg/ 5ml 8,728 botol 0 0
161 Pirantel 125 mg tablet 308 tablet 1,497 1,497 40 1,457
162 Piridoksin (Vit.B6) tab 10 mg 124 tablet 17,839 17,839 1,382 16,457
163 Plester 5 x 2 2,000 rol 34 34 1 33
164 Propilthiourasil ( PTU ) 292 tablet 0 0
165 Propanolol 10 mg 66 tablet 997 997 997
166 Piroksikam 10 mg 132 tablet 0 0
168 Phenobarbital 30 mg 66 tablet 970 970 970
169 Phenobarbital inj 1,890 ampl 0 0
170 Prednison 5 mg 66 tablet 2,135 2,135 221 1,914
171 Quinin 200 mg 704 tablet 960 960 960
172 Ranitidin 150 mg 126 tablet 2,290 2,290 1,960 330
173 Ringerlaktat larutan infus 7,150 botol 36 36 36
174 Retinol 100.000 IU 298 kapsul 0 0
176 Salbutamol 2 mg 62 tablet 947 947 452 495
178 Salisyl talk 2% 1,250 sachet 178 178 83 95
179 Salep -24 2,554 pot 115 115 24 91
180 Scabimite Cream 5% 12,155 tube 10 10 10
181 Safety box 16,501 piece 0 0
182 Sefadroksil sirup kering 125 mg/5ml 4,485 botol 0 0
183 Semenseng fospat 137,500 botol 0 0
184 Silk 3.0 dgn jarum bedah 3,139 sachet 64 64 16 48
185 Simvastatin tab 10 mg 133 tablet 1,640 1,640 585 1,055
186 Sianokobalamin ( Vit B12 ) tablet 57 tablet 6,970 6,970 3,159 3,811
187 Serum Anti Tetanus (ATS) 1500 u/ Tetagam.P 170,000 vial 16 16 5 11
188 Superhoid suppos (Anti Hemoroid) 3,197 kotak 180 180 180
189 Solare Anterior/Pasterior 341,500 botol 0 0
190 Spironolakton 25 mg 320 tablet 767 767 35 732
191 Stesolid rectal 5 mg 12,159 tube 5 5 5
192 Tetrasiklin 250 mg 154 kapsul 0 0
193 Tetrasiklin 500 mg 319 kapsul 109 109 109 0
194 Temporarystopping (Flecher) P+L 319,000 botol 0 0
195 Thiamin tablet ( Vit B1 ) 50 mg 89 tablet 10,000 10,000 851 9,149
196 Triheksifenidil 2 mg 92 tablet 910 910 30 880
197 Tablet Tambah Darah Neo 400 tablet 4,923 4,923 4,923 0
198 Vitamin Bkomplek 121 tablet 16,031 16,031 6,390 9,641
199 Ventolin rotacaps 450 kapsul 0 0
200 Ventolin rotahaler 6,550 buah 0 0
201 Ventolin Nebules 2,5mg 6,930 ampul 40 40 40
202 Vitamin dan Mineral (Vitalex) 440 kapsul 8,000 8,000 598 7,402
203 Wing Needle 25G 1,400 buah 100 100 8 92
204 Yodium Povidon 30 ml 2,250 botol 100 100 14 86
205 Yodium Povidon 60 ml 6,298 botol 0 0
206 Yodium Povidon 300 ml 14,771 botol 7 7 7
207 Zinkid 10mg/5ml 15,729 botol 241 241 46 195
208 Zink tablet 20 mg 497 kaplet 0 0
OBAT TRADISIONAL 0
1 Aloeina 60,000 botol 0 0
2 Albumas 500mg 179,300 kapsul 0 0
3 Andrographis Herbs 39,000 botol 0 0
4 Arthricaps 40,000 botol 0 0
5 Bioimmune 60 ml 33,000 botol 0 0
6 Carlic Herbs 39,000 botol 0 0
7 Gastricaps 40,000 botol 0 0
8 Gen-C 97,000 botol 0 0
9 Herba Vomitz 49,500 tablet 0 0
10 Hemorogard 46,572 kapsul 90 90 60 30
11 Imboost 90,750 tablet 0 0
12 Jamsi 100ml 88,000 botol 0 0
13 Morindae Herbs 39,000 botol 0 0
14 Nigella Extract 40,000 botol 0 0
15 Netemp 214,500 kapsul 0 0
16 New pro uric 53,625 kapsul 0 0
17 Ocugard 141,838 kapsul 0 0
18 Prolipid 51,563 kapsul 0 0
19 Silex syrup 35,651 botol 0 0
20 Tensigard 63,800 kotak 9 9 9
21 Vincoblastcaps 43,000 botol 0 0
22 Fituno 124,893 dus 2 2 2
23 Enkasari 17,010 botol 5 5 5
24 Lacbon 143,000 dus 1 1 1
25 Batugin Elixir 20,351 botol 2 2 2
26 Asifit 61,500 dus 55 55 55
27 Toxilite 25,916 Kotak 1 1 1
28 Herbakof Syrup 60ml 12,100 botol 0 0
30 Stimuno Syrup 19,646 botol 5 7 7
31 Stimuno Forte 22,363 kotak 1 1 1
32 Herba Vomitz 4,703 strip 4 Tab 5 50 50
PUSKESMAS MAKRAYU
MUTASI PERSEDIAAN OBAT PROGRAM DARI PROPINSI (via Gudang Farmasi)
TAHUN 2017
HARGA
N0 NAMA OBAT SATUAN STOCK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOCK STOCK OPTIMAL PERMINTAAN PENERIMAAN
SATUAN (Rp)
HARGA
N0 NAMA OBAT SATUAN STOCK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOCK STOCK OPTIMAL PERMINTAAN PENERIMAAN
SATUAN (Rp)
PROGRAM PROPINSI (Via Gudang Farmasi) g = e+f I=g-h

1 Ampisilin inj 4,300 vial 0 0
2 Albendazole 400 mg 16,470 tablet 148 148 148 0
3 Box Slide 19,700 kotak 0 0
4 Ca Gluconas inj 10% 9,955 ampul 0 0
5 Diazepam inj 2,461 ampul 0 0
6 Diaethyl Kabamazim 101 tablet 0 0
7 Fe2SO4 1,290 sachet 0 0
8 Gentamisin inj 80 mg/2ml 3,259 ampul 0 0
9 Gentamisin inj 40 mg/ml 3,244 ampul 0 0
10 Garam oralit 297 sachet 0 0
11 Lab. Kit Filariasis 0 paket 0 0
12 MgSO4 (Magnesium Sulfat) injeksi 20% 5,500 kolf 0 0
13 MgSO4 (Magnesium Sulfat) injeksi 40% 3,650 ampul 0 0
14 Methyl Ergometrin Maleat injeksi 0,2mg 2,684 ampul 0 0
15 Natrium Tiroksin (Euthyrox) 100 1,694 tablet 0 0
16 OAT FDC Kat I 359,990 paket 65 65 65 0
17 OAT FDC Kat II 1,259,985 paket 3 3 3 0
18 OAT FDC Kat Anak 225,740 paket 0 0
19 Combipack Kat I 302,605 kotak 0 0
20 Obat Anti Malaria 43,288 kotak 0 0
22 Prosted Slide (Objek Glass) 19,700 kotak 0 0
23 Procain Benzil Penicillin inj 7,549 vial 0 0
24 Phytomenadion inj 1,644 ampul 0 0
25 Phenobarbital inj 1,890 ampul 0 0
26 Pot Sputum 2,950 buah 0 0
27 Pot Sputum 4,200 buah 281 281 281 0
28 Reagens TB Zialh Neelsen 276,600 paket 0 0
29 Vitamin A 100.000 IU 298 capsul 252 252 252 0
31 Bidan Kit 0 kit 0 0
32 Mineral Mix 98,000 kotak 0 0
33 Zink 20 mg tab 497 tablet 5,420 5,420 5,420 0
34 Antalgin tablet 116 tablet 400 400 400 0
35 Asiklovir 5% cream 3,700 tube 0 0
36 Broxal Elixir 20,100 botol 0 0
37 Candesartan 8mg/Biopres 3,255 tablet 0 0
38 Cecyl 3,288 tablet 100 100 100 0
39 Concor 2,5 746 tablet 100 100 100 0
40 FG Troches tablet 0 0
41 Fludane Plus Kaplet 1,065 tablet 50 50 50 0
42 Meloksikam 15 mg 1,358 tablet 0 0
43 Neo Diastop 1,382 tablet 200 200 200 0
44 Osteor Kaplet 6,923 tablet 30 30 30 0
45 Paracetamol 500 mg 84 tablet 0 0
46 Pehacain injeksi 3,580 ampul 100 100 100 0
47 Pehavral 804 tablet 245 245 245 0
0 0
JUMLAH II
-
Mengetahui
KabidPimpinan Puskesmas .......................
Hj. Sr_____________________
PenataNIP.
KET
2
KET
KET
KET
LAPORAN PEMAKAIAN DAN PEMAKAIAN OBAT PKD, OBAT TRADISIONAL(APBD Kota)
PUSKESMAS : MAKRAYU
KOTA : PALEMBANG
PROVINSI : SUMATERA SELATAN
HARGA
N0 NAMA OBAT SATUAN STOCK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN
SATUAN (Rp)
OBAT PKD g =e + f
1 Alat suntik 2,5 ml/3 ml 957 Set 397 1,000 1,397 43
2 Alat suntik 5 ml 1,348 Set 2,561 2,561 25
4 Alkohol Swab 34,100 kotak 2 2
5 Acetosal (Miniaspi 80 mg),100mg 122 tablet 2,521 2,521 110
6 Acetylcystein 200 mg 866 tablet 0 0
7 Alopurinol 100 mg 93 tablet 4,257 2,000 6,257 750
8 Alopurinol 300 mg 215 tablet 486 500 986
9 Ambroxol sirup 15 mg/ml 3,600 botol 0 300 300 19
10 Aminofilin 200 mg 82 tablet 467 467 53
11 Amlodipin tab 5 mg 105 tablet 12,055 12,055 2,090
12 Amlodipin tab 10 mg 160 tablet 7,570 7,570 617
13 Amoksisilin syrup 125 mg/ 5ml 2,500 botol 545 480 1,025 266
15 Amoksisilin 250 mg 201 kapsul 2,870 2,870 572
18 Antasida doen tablet 63 tablet 4,347 4,347 2,800
19 Antasida doen suspensi 2,117 botol 845 500 1,345 161
20 Antibakteri salep kombinasi (Bevalex) 11,300 tube 0 240 240
21 Antifungi doen kombinasi ( white field ) 4,366 tube 143 143 16
23 Amitriptilin tablet salut 25 mg 117 tablet 500 500
24 Asam Askorbat 50 mg 109 tablet 12,938 12,938 2,035
25 Asam Mefenamat 500 mg 112 tablet 38,635 38,635 3,696
27 Asiklovir 200 239 tablet 1,000 1,000 220
28 Asikovir 400 345 tablet 513 1,000 1,513 343
29 Asam folat 0,4 mg 93 tablet 685 685 30
30 Attapulgite (Pularex 630 mg) 210 tablet 506 506 27
31 Articulating paper 202,000 kotak 3 3
33 Bisakodil supp 5 mg anak 4,990 suppos 50 50
34 Bisakodil tab 5 mg 1,235 tablet 0 200 200 12
35 Betahistin Mesilate 162 tablet 4,528 3,000 7,528 651
36 Burnazin cream 24,150 tube 73 73 9
37 BD Syringe Soloshot mini 0,05ml 165,550 kotak 13 13
HARGA
SATUAN (Rp)

39 Composite 423,500 botol 0 2 2 1
42 Cetrizine 10 mg 145 tablet 5,682 5,682 1,148
43 Cetrizine syr 5 mg 8,399 botol 132 132 83
46 Cooper T (380A) 17,710 unit 16 16
47 Calamed lotion 14,300 botol 28 28
50 Chlorfenolkamfermentol (CHKM) 77,000 botol 0 2 2 1
51 Dexamethason inj 5 mg/ml 1,659 ampl 100 100
52 Dexamethason tabl 0,5 mg 46 tablet 16,305 16,305 2,358
54 Diazepam inj 2,486 ampl 9 9
59 Diphenhydramin inj 10 mg 1,100 ampl 85 85
61 Domperidon 10 mg 170 tablet 541 541 113
62 Doksisiklin kapsul 100 mg 285 kapsul 1,090 1,090 10
64 Etanol 70 % @ 100 ml 2,575 botol 25 25 6
67 Eritromycin syr kering 200mg/5ml 7,893 botol 238 238 30
68 Erythromisin kap 250 mg 594 kapsul 1,000 1,000 131
69 Erythromisin kap 500 mg 751 kapsul 1,726 1,726 155
71 Fitomenadion / vit k 10 mg 660 tablet 2,658 2,658 61
75 Furosemide 40 mg 81 tablet 1,940 500 2,440 24
76 Flagyl suppos 0,5 gr 3,220 buah 58 58
77 Garam oralit 269 saset 185 3,600 3,785 796
78 Gentamisin salep mata 0,3 % 2,830 tube 36 36
80 Gentamisin salep kulit (Gentalex) 3,080 tube 98 72 170
81 Gemfibrozil 300 mg 303 tablet 2,024 2,024 148
HARGA
SATUAN (Rp)
HARGA
SATUAN (Rp)
82 Glasionomer semen 779,000 botol 7 7

86 Gliseril Guaiakolat 53 tablet 0 20,000 20,000 5,280
87 Glukosa lart. Infus 5 % 6,900 botol 35 35
89 Glibenklamid 5 mg 95 tablet 0 3,000 3,000 305
90 Haloperidol 1,5 mg 72 tablet 655 655 60
91 Haloperidol 5 mg 100 tablet 577 577
92 Handscoon Steril 7,5 6,595 sachset 237 237 26
93 Handscoon non-steril 37,044 kotak 4 4
94 H C T 25 mg 156 tablet 0 0
96 Iliadin drop (Obat tetes hidung) 28,928 botol 29 29
101 Isosorbid dinitrat 5 mg 93 tablet 748 300 1,048 80
103 Kapas 250 grm 12,800 rol 0 0
105 Kasa steril 16 x 16 cm 5,950 rol 255 255 7
106 Kasa 4x15 2,150 rol 170 170 11
107 Kaptopril 25 mg 89 tablet 4,950 5,000 9,950 915
108 Kaptopril 12,5 mg 62 tablet 6,159 6,159 1,285
110 Ketokenazol tab 200 mg 310 tablet 876 1,000 1,876 570
111 Khloramfenikol 250 mg 500 kaps 0 1,200 1,200
113 Kloramfenikol TT (Reco TT 3%) 6,040 botol 0 0
116 Klorfeniramine maleat (CTM) 43 tablet 0 39,600 39,600 6,145
118 Kotrimoksazol syrup 2,183 botol 224 224 102
119 Kotrimoksazol tablet dewasa 154 tablet 5,888 5,888 1,200
122 Klorpromazin 100 mg 148 tablet 1,185 1,185 1,085
123 Lanzoprazol kapsul 30 mg 473 kapsul 875 1,000 1,875 746
124 Loratadin 10 mg 139 tablet 1,821 1,821 179
125 Loperamid tablet 2 mg 92 tablet 290 290
HARGA
SATUAN (Rp)

129 Lysol 43,000 botol 0 0
130 Multivitamin Anti Anemia (Livron B-plex) 240 tablet 0 2,000 2,000
133 Masker 22,880 kotak 10 10
134 Meloksikam 15 mg 1,185 tablet 152 3,200 3,352 85
135 Metformin HCl tab 500 mg 115 tablet 18,166 18,166 1,240
139 Metilprednisolon tab 4 mg 210 tablet 1,086 1,000 2,086 364
140 Metronidazol 250 mg 113 tablet 2,230 2,230 156
141 Metronidazol 500 mg 164 tablet 717 1,000 1,717 130
142 Metochlopramide 5 mg tablet 105 tablet 149 149
144 Molex flu kaplet 397 tablet 2,658 1,500 4,158 754
145 Molex flu syrup 60ml 6,710 botol 637 637 31
146 Natrium diklofenac 25 mg 157 tablet 5,139 5,139 1,563
147 Natrium diklofenac 50 mg 185 tablet 350 350 350
149 Nistatin 100 000 UI tab vaginal 504 tablet 21 21 21
150 Nipedipin tablet 10 mg 110 tablet 195 195 195
151 Obat Suntik K.B I / Andalan Harmonis 6,624 vial 0 60 60
152 Omeprazol kap 20 mg 216 kapsul 1,250 1,200 2,450 405
154 Oksitetrasiklin 3% salep kulit 1,640 tube 0 150 150
156 Parasetamol syrup 1,119 botol 535 500 1,035 363
157 Parasetamol drop 5,460 botol 301 301 95
158 Parasetamol 500 mg 57 tablet 0 33,600 33,600 5,986
159 Papaverin 40 mg 209 tablet 0 1,000 1,000 4
161 Pirantel 125 mg tablet 308 tablet 1,457 1,457 18
162 Piridoksin (Vit.B6) tab 10 mg 124 tablet 16,457 16,457 4,217
163 Plester 5 x 2 2,000 rol 33 33 2
164 Propilthiourasil ( PTU ) 292 tablet 0 1,000 1,000
165 Propanolol 10 mg 66 tablet 997 997
166 Piroksikam 10 mg 132 tablet 0 3,000 3,000
168 Phenobarbital 30 mg 66 tablet 970 970
HARGA
SATUAN (Rp)
HARGA
SATUAN (Rp)
170 Prednison 5 mg 66 tablet 1,914 1,914 77

171 Quinin 200 mg 704 tablet 960 960
172 Ranitidin 150 mg 126 tablet 330 3,000 3,330 1,966
176 Salbutamol 2 mg 62 tablet 495 2,000 2,495 345
177 Salbutamol 4 mg 95 tablet 144 2,000 2,144 306
179 Salep -24 2,554 pot 91 91 15
180 Scabimite Cream 5% 12,155 tube 10 10 20 10
182 Sefadroksil sirup kering 125 mg/5ml 4,485 botol 0 120 120
183 Semenseng fospat 137,500 botol 0 2 2 1
184 Silk 3.0 dgn jarum bedah 3,139 sachet 48 48
185 Simvastatin tab 10 mg 133 tablet 1,055 3,000 4,055 795
188 Superhoid suppos (Anti Hemoroid) 3,197 kotak 180 180 14
190 Spironolakton 25 mg 320 tablet 732 732 17
191 Stesolid rectal 5 mg 12,159 tube 5 5
193 Tetrasiklin 500 mg 319 kapsul 0 2,000 2,000 144
194 Temporarystopping (Flecher) P+L 319,000 botol 0 2 2
195 Thiamin tablet ( Vit B1 ) 50 mg 89 tablet 9,149 5,000 14,149 1,428
196 Triheksifenidil 2 mg 92 tablet 880 880 70
197 Tablet Tambah Darah Neo 400 tablet 0 5,600 5,600 265
201 Ventolin Nebules 2,5mg 6,930 ampul 40 40
202 Vitamin dan Mineral (Vitalex) 440 kapsul 7,402 7,402 1,270
203 Wing Needle 25G 1,400 buah 92 92
207 Zinkid 10mg/5ml 15,729 botol 195 195 75
HARGA
SATUAN (Rp)

8 Gen-C 97,000 botol 0 0
10 Hemorogard 46,572 kapsul 30 30
12 Jamsi 100ml 88,000 botol 0 0
20 Tensigard 63,800 kotak 9 9
22 Fituno 124,893 dus 2 2
23 Enkasari 17,010 botol 5 5
24 Lacbon 143,000 dus 1 1
25 Batugin Elixir 20,351 botol 2 2
26 Asifit 61,500 dus 55 55 55
27 Toxilite 25,916 Kotak 1 1
30 Stimuno Syrup 19,646 botol 7 7
31 Stimuno Forte 22,363 kotak 1 1
32 Herba Vomitz 4,703 strip 4 Tab 50 50
PUSKESMAS MAKRAYU
TAHUN 2017
HARGA
SATUAN (Rp)
PROGRAM PROPINSI (Via Gudang Farmasi) g=e+f

2 Albendazole 400 mg 16,470 tablet 0 0
16 OAT FDC Kat I 359,990 paket 0 0
17 OAT FDC Kat II 1,259,985 paket 0 0
27 Pot Sputum 4,200 buah 0 200 200
29 Vitamin A 100.000 IU 298 capsul 0 0
33 Zink 20 mg tab 497 tablet 0 3,000 3,000
34 Antalgin tablet 116 tablet 0 0
38 Cecyl 3,288 tablet 0 0
39 Concor 2,5 746 tablet 0 0
HARGA
SATUAN (Rp)
41 Fludane Plus Kaplet 1,065 tablet 0 0
43 Neo Diastop 1,382 tablet 0 0
44 Osteor Kaplet 6,923 tablet 0 0
46 Pehacain injeksi 3,580 ampul 0 0
47 Pehavral 804 tablet 0 0
Kabid Sumber Daya Kesehatan
UMUM BPJS
PUSKESMAS MAKRAYU 1440 1394
PUSTU 30 ILIR 807 85
Hj. Sri PUSTI 32 ILIR 545 35
PUSTU KEMANG MANIS 360 50
JUMLAH 3,545 1678
LAPORAN KETERSEDIAAN VAKSIN

PUSKESMAS : BULAN :
KOTA : TAHUN :
PROVINSI :
PERSEDIAAN
NO
NAMA VAKSN ADA TIDAK ADA
1 BCG
2 TT/ TD
3 DPT
Yang Menyerahkan Mengetahui

Gudang Farmasi Kepala Puskesmas Makrayu
Tien Atika Setiawati S Si. Apt Dr. Hj. Novia Diana Roza, M. kes
NIP. 19741014512009032001 NIP. 196212121989102001
SIONAL(APBD Kota)
BULAN : JANUARI
TAHUN : 2017
NO :
1
STOCK
SISA STOCK PERMINTAAN PEMBERIAN KET
OPTIMAL
I = g- h
1,354
2,536
0
2
2,411
0
5,507
986
281
414
9,965
6,953
759
0
2,298
26,925
0
1,547
1,184
240
127
0
500
10,903
34,939
188
780
1,170
655
479
3
533
50
188
6,877
64
13
2
STOCK
OPTIMAL
91
1
0
5,734
4,534
49
367
0
16
28
3
0
1
100
13,947
1
9
0
0
0
0
85
0
428
1,080
194
19
13
4
208
869
1,571
0
2,597
0
167
0
2,416
58
2,989
36
228
170
1,876
3
STOCK
OPTIMAL
STOCK
OPTIMAL
7
0
0
0
14,720
35
6
2,695
595
577
211
4
0
375
29
0
9,406
0
0
968
9,601
0
0
248
159
9,035
4,874
181
1,306
1,200
99
0
0
0
33,455
0
122
4,688
0
0
100 ED: 1022
1,129
1,642
290
STOCK
OPTIMAL
183
0
0
0
2,000
0
0
10
3,267
16,926
0
0
0
1,722
2,074
1,587
149
241
3,404
606
3,576
0
68
0
0
60
2,045
0
150
574
672
206
27,614
996
0
1,439
12,240
31
1,000
997
3,000
0
970
0
STOCK
OPTIMAL
STOCK
OPTIMAL
1,837
960
1,364
35
0
0
2,150
1,838
308
76
10
0
120
1
48
3,260
15,682
19
166
0
715
5
0
1,856
2
12,721
810
5,335
23,620
0
0
40
6,132
92
0
0
9
120
0
6
STOCK
OPTIMAL
0
0
0
0
0
0
0
0
0
30
0
0
0
0
0
0
0
0
0
9
0
2
5
1
2
0
1
0
0
7
1
50
udang Farmasi)
STOCK
OPTIMAL
I=g-h
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
200
0
0
0
0
0
3,000
0
0
0
0
0
0
STOCK
OPTIMAL
0
0
0
0
0
0
0
0
Palembang,
Yang Menerima
Petugas Puskesmas
Septiyawati, AMF
NIP. 198609082011012005
PUSKESMAS : MAKRAYU
KOTA : PALEMBANG
HARGA
N0 SATUAN STOCK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOCK
SATUAN (Rp)
OBAT PKD g =e + f I = g- h
1 Alat suntik 2,5 ml/3 ml 957 Set 1,354 1,354 125 1,229
3 Albendazole 400 mg 350 tablet 0 0 0
6 Acetylcystein 200 mg 866 tablet 0 0 0
14 Amoksisilin dry syrup 250 mg/ 5ml 4,212 botol 0 0 0
15 Amoksisilin 250 mg 201 kapsul 2,298 2,298 1,234 1,064
17 Amoksisilin+as klavulanat 625mg tab 4,777 tablet 0 0 0
18 Antasida doen tablet 63 tablet 1,547 1,547 1,547 0
19 Antasida doen suspensi 2,117 botol 1,184 1,184 195 989
22 Anti Migran (Ergotamin Coffein) 142 tablet 0 0 0
23 Amitriptilin tablet salut 25 mg 117 tablet 500 500 60 440
24 Asam Askorbat 50 mg 109 tablet 10,903 10,903 1,370 9,533
27 Asiklovir 200 239 tablet 780 780 215 565
28 Asikovir 400 345 tablet 1,170 1,170 323 847
31 Articulating paper 202,000 kotak 3 3 3
38 BD Syringe Soloshot mini 0,5ml 165,550 kotak 91 91 2 89
HARGA
SATUAN (Rp)
39 Composite 423,500 botol 1 1 1

40 Cat gut 22,599 saset 0 0 0
45 Carbamazepin 200 mg 280 tablet 0 0 0
46 Cooper T (380A) 17,710 unit 16 16 16
47 Calamed lotion 14,300 botol 28 28 28
48 Caviton White 154,000 botol 3 3 1 2
49 Cimetidin 200mg 115 kapsul 0 0 0
50 Chlorfenolkamfermentol (CHKM) 77,000 botol 1 1 1
53 Devitalisasi pasta 319,000 botol 1 1 1
54 Diazepam inj 2,486 ampl 9 9 9
55 Diazepam 2 mg tablet 28 tablet 0 0 0
57 Digoxin 0,25 mg tablet 100 tablet 0 0 0
58 Diltiazem 30 mg 134 tablet 0 0 0
60 Domperidon suspensi 5mg/5ml 3,410 botol 0 0 0
64 Etanol 70 % @ 100 ml 2,575 botol 19 19 8 11
66 Eugenol 19,005 botol 4 4 1 3
68 Erythromisin kap 250 mg 594 kapsul 869 869 163 706
69 Erythromisin kap 500 mg 751 kapsul 1,571 1,571 591 980
70 Epineprine 0,1 % Inj (Adrenalin) 2,354 ampl 0 0 0
72 Fitomenadion Injeksi 2mg/ml 3,582 ampl 0 0 0
74 Ferro Fumarat + As. Folat (Hemafort) 835 tablet 0 0 0
77 Garam oralit 269 saset 2,989 2,989 612 2,377
78 Gentamisin salep mata 0,3 % 2,830 tube 36 36 36
HARGA
SATUAN (Rp)
83 Glimepiride 1 mg 265 tablet 0 0 0

85 Griseofulvin 230 tablet 0 0 0
86 Gliseril Guaiakolat 53 tablet 14,720 14,720 6,770 7,950
89 Glibenklamid 5 mg 95 tablet 2,695 2,695 150 2,545
90 Haloperidol 1,5 mg 72 tablet 595 595 121 474
94 H C T 25 mg 156 tablet 0 0 0
97 Ibuprofen 200 mg 116 tablet 0 0 0
99 Ibuprofen 100 mg/5ml 3,674 botol 0 0 0
100 Infus Set Dewasa 5,445 Set 0 0 0
103 Kapas 250 grm 12,800 rol 0 0 0
106 Kasa 4x15 2,150 rol 159 159 4 155
107 Kaptopril 25 mg 89 tablet 9,035 9,035 795 8,240
108 Kaptopril 12,5 mg 62 tablet 4,874 4,874 1,803 3,071
110 Ketokenazol tab 200 mg 310 tablet 1,306 1,306 435 871
111 Khloramfenikol 250 mg 500 kaps 1,200 1,200 12 1,188
113 Kloramfenikol TT (Reco TT 3%) 6,040 botol 0 0 0
114 Klorfeson cream 7,148 tube 0 0 0
115 Klindamisin 300 mg 630 kapsul 0 0 0
116 Klorfeniramine maleat (CTM) 43 tablet 33,455 33,455 7,187 26,268
117 Kodein 10 mg tab 525 tablet 0 0 0
120 Kotrimoksazol 120 mg 75 tablet 0 0 0
121 Kalsium Hidroksida Pasta 467,500 botol 0 0 0
122 Klorpromazin 100 mg 148 tablet 100 100 100 0
123 Lanzoprazol kapsul 30 mg 473 kapsul 1,129 1,129 719 410
126 Lidokain HCl inj 2% 2ml 879 ampl 183 183 5 178
HARGA
SATUAN (Rp)
127 Lidokain inj 2% + Efinefrin 2ml komb 1,937 ampl 0 0 0

128 Leukoplast 2,5cm x 4,5cm 12,076 roll 0 0 0
129 Lysol 43,000 botol 0 0 0
130 Multivitamin Anti Anemia (Livron B-plex) 240 tablet 2,000 2,000 2,000
133 Masker 22,880 kotak 10 10 10
134 Meloksikam 15 mg 1,185 tablet 3,267 3,267 426 2,841
135 Metformin HCl tab 500 mg 115 tablet 16,926 16,926 990 15,936
136 Metformin 850 mg 215 tablet 0 0 0
137 Metilergometrin tab 0.125 mg 162 tablet 0 0 0
138 Metilergometrin inj 0.2 mg/1ml 2,684 ampl 0 0 0
139 Metilprednisolon tab 4 mg 210 tablet 1,722 1,722 638 1,084
141 Metronidazol 500 mg 164 tablet 1,587 1,587 595 992
144 Molex flu kaplet 397 tablet 3,404 3,404 1,036 2,368
146 Natrium diklofenac 25 mg 157 tablet 3,576 3,576 1,164 2,412
151 Obat Suntik K.B I / Andalan Harmonis 6,624 vial 60 60 20 40
153 Oxytocin inj 10iu 1,900 ampul 0 0 0
158 Parasetamol 500 mg 57 tablet 27,614 27,614 8,480 19,134
159 Papaverin 40 mg 209 tablet 996 996 84 912
160 Pirantel Suspensi 125 mg/ 5ml 8,728 botol 0 0 0
163 Plester 5 x 2 2,000 rol 31 31 2 29
164 Propilthiourasil ( PTU ) 292 tablet 1,000 1,000 1,000
166 Piroksikam 10 mg 132 tablet 3,000 3,000 120 2,880
167 Piroksikam 20 mg 176 tablet 0 0 0
168 Phenobarbital 30 mg 66 tablet 970 970 3 967
169 Phenobarbital inj 1,890 ampl 0 0 0
HARGA
SATUAN (Rp)
HARGA
SATUAN (Rp)
171 Quinin 200 mg 704 tablet 960 960 960

172 Ranitidin 150 mg 126 tablet 1,364 1,364 1,364 0
174 Retinol 100.000 IU 298 kapsul 0 0 0
176 Salbutamol 2 mg 62 tablet 2,150 2,150 348 1,802
179 Salep -24 2,554 pot 76 76 26 50
181 Safety box 16,501 piece 0 0 0
182 Sefadroksil sirup kering 125 mg/5ml 4,485 botol 120 120 2 118
183 Semenseng fospat 137,500 botol 1 1 1
188 Superhoid suppos (Anti Hemoroid) 3,197 kotak 166 166 5 161
189 Solare Anterior/Pasterior 341,500 botol 0 0 0
192 Tetrasiklin 250 mg 154 kapsul 0 0 0
30 Tetrasiklin 500 mg 319 kapsul 1,856 1,856 54 1,802
`1`` Temporarystopping (Flecher) P+L 319,000 botol 2 2 2
195 Thiamin tablet ( Vit B1 ) 50 mg 89 tablet 12,721 12,721 800 11,921
197 Tablet Tambah Darah Neo 400 tablet 5,335 5,335 235 5,100
199 Ventolin rotacaps 450 kapsul 0 0 0
200 Ventolin rotahaler 6,550 buah 0 0 0
201 Ventolin Nebules 2,5mg 6,930 ampul 40 40 8 32
202 Vitamin dan Mineral (Vitalex) 440 kapsul 6,132 6,132 1,282 4,850
203 Wing Needle 25G 1,400 buah 92 92 92
208 Zink tablet 20 mg 497 kaplet 0 0 0
HARGA
SATUAN (Rp)
OBAT TRADISIONAL
1 Aloeina 60,000 botol 0 0 0
2 Albumas 500mg 179,300 kapsul 0 0 0
3 Andrographis Herbs 39,000 botol 0 0 0
4 Arthricaps 40,000 botol 0 0 0
5 Bioimmune 60 ml 33,000 botol 0 0 0
6 Carlic Herbs 39,000 botol 0 0 0
7 Gastricaps 40,000 botol 0 0 0
8 Gen-C 97,000 botol 0 0 0
9 Herba Vomitz 49,500 tablet 0 0 0
10 Hemorogard 46,572 kapsul 30 30 30
11 Imboost 90,750 tablet 0 0 0
12 Jamsi 100ml 88,000 botol 0 0 0
13 Morindae Herbs 39,000 botol 0 0 0
14 Nigella Extract 40,000 botol 0 0 0
15 Netemp 214,500 kapsul 0 0 0
16 New pro uric 53,625 kapsul 0 0 0
17 Ocugard 141,838 kapsul 0 0 0
18 Prolipid 51,563 kapsul 0 0 0
19 Silex syrup 35,651 botol 0 0 0
21 Vincoblastcaps 43,000 botol 0 0 0
22 Fituno 124,893 dus 2 2 2
24 Lacbon 143,000 dus 1 1 1
26 Asifit 61,500 dus 0 0 0
28 Herbakof Syrup 60ml 12,100 botol 0 0 0
31 Stimuno Forte 22,363 kotak 1 1 1 0
PUSKESMAS MAKRAYU
PERSEDIAAN OBAT PROGRAM DARI PROPINSI (via Gudang Farmasi)
TAHUN 2017
HARGA
N0 NAMA OBAT SATUAN STOCK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOCK
SATUAN (Rp)
PROGRAM PROPINSI (Via Gudang Farmasi) g=e+f I=g-h

1 Ampisilin inj 4,300 vial 0 0 0
2 Albendazole 400 mg 16,470 tablet 0 0 0
3 Box Slide 19,700 kotak 0 0 0
4 Ca Gluconas inj 10% 9,955 ampul 0 0 0
5 Diazepam inj 2,461 ampul 0 0 0
6 Diaethyl Kabamazim 101 tablet 0 0 0
7 Fe2SO4 1,290 sachet 0 0 0
8 Gentamisin inj 80 mg/2ml 3,259 ampul 0 0 0
9 Gentamisin inj 40 mg/ml 3,244 ampul 0 0 0
10 Garam oralit 297 sachet 0 0 0
11 Lab. Kit Filariasis 0 paket 0 0 0
12 MgSO4 (Magnesium Sulfat) injeksi 20% 5,500 kolf 0 0 0
13 MgSO4 (Magnesium Sulfat) injeksi 40% 3,650 ampul 0 0 0
14 Methyl Ergometrin Maleat injeksi 0,2mg 2,684 ampul 0 0 0
15 Natrium Tiroksin (Euthyrox) 100 1,694 tablet 0 0 0
16 OAT FDC Kat I 359,990 paket 0 0 0
17 OAT FDC Kat II 1,259,985 paket 0 0 0
18 OAT FDC Kat Anak 225,740 paket 0 0 0
19 Combipack Kat I 302,605 kotak 0 0 0
20 Obat Anti Malaria 43,288 kotak 0 0 0
22 Prosted Slide (Objek Glass) 19,700 kotak 0 0 0
23 Procain Benzil Penicillin inj 7,549 vial 0 0 0
24 Phytomenadion inj 1,644 ampul 0 0 0
25 Phenobarbital inj 1,890 ampul 0 0 0
26 Pot Sputum 2,950 buah 0 0 0
27 Pot Sputum 4,200 buah 200 200 61 139
28 Reagens TB Zialh Neelsen 276,600 paket 0 0 0
29 Vitamin A 100.000 IU 298 capsul 0 0 0
31 Bidan Kit 0 kit 0 0 0
32 Mineral Mix 98,000 kotak 0 0 0
33 Zink 20 mg tab 497 tablet 3,000 3,000 3,000
34 Antalgin tablet 116 tablet 0 0 0
35 Asiklovir 5% cream 3,700 tube 0 0 0
36 Broxal Elixir 20,100 botol 0 0 0
37 Candesartan 8mg/Biopres 3,255 tablet 0 0 0
38 Cecyl 3,288 tablet 0 0 0
39 Concor 2,5 746 tablet 0 0 0
HARGA
SATUAN (Rp)
40 FG Troches tablet 0 0 0
41 Fludane Plus Kaplet 1,065 tablet 0 0 0
42 Meloksikam 15 mg 1,358 tablet 0 0 0
43 Neo Diastop 1,382 tablet 0 0 0
44 Osteor Kaplet 6,923 tablet 0 0 0
45 Paracetamol 500 mg 84 tablet 0 0 0
46 Pehacain injeksi 3,580 ampul 0 0 0
47 Pehavral 804 tablet 0 0 0
UMUM BPJS
Hj. S PUSTI 32 ILIR 508 31
JUMLAH 3,413 1641

PUSKESMAS : BULAN : Februari
KOTA : TAHUN : 2107
PROVINSI :
PERSEDIAAN
NO
1 BCG
2 TT/ TD
3 DPT

NIP. 19741014512009032001 NIP. 196212121989102001
NAL(APBD Kota)
BULAN : FEBRUARI
TAHUN : 2017
NO :
STOCK
PERMINTAAN PEMBERIAN KET
OPTIMAL
STOCK
OPTIMAL
STOCK
OPTIMAL
STOCK
OPTIMAL
STOCK
OPTIMAL
STOCK
OPTIMAL
STOCK
OPTIMAL
Farmasi)
STOCK
OPTIMAL
STOCK
OPTIMAL
Palembang,
Yang Menerima
Petugas Puskesmas
Septiyawati, AMF
NIP. 198609082011012005
PUSKESMAS : MAKRAYU
KOTA : PALEMBANG
HARGA
SATUAN (Rp)
1 Alat suntik 2,5 ml/3 ml 957 Set 1,229 1,229 230 999
15 Amoksisilin 250 mg 201 kapsul 1,064 1,064 854 210
18 Antasida doen tablet 63 tablet 0 0 0
28 Asikovir 400 345 tablet 847 847 268 579
HARGA
SATUAN (Rp)

40 Cat gut 22,599 saset 0 0 0
46 Cooper T (380A) 17,710 unit 16 16 16
61 Domperidon 10 mg 170 tablet 286 1,000 1,286 475 811
62 Doksisiklin kapsul 100 mg 285 kapsul 1,070 1,070 320 750
64 Etanol 70 % @ 100 ml 2,575 botol 11 11 1 10
65 Ethyl klorida spray 150,000 botol 11 11 11
82 Glasionomer semen 779,000 botol 0 0 0
HARGA
SATUAN (Rp)

85 Griseofulvin 230 tablet 0 0 0
86 Gliseril Guaiakolat 53 tablet 7,950 7,950 7,393 557
91 Haloperidol 5 mg 100 tablet 577 577 30 547
94 H C T 25 mg 156 tablet 0 0 0
96 Iliadin drop (Obat tetes hidung) 28,928 botol 25 25 25
99 Ibuprofen 100 mg/5ml 3,674 botol 0 0 0
103 Kapas 250 grm 12,800 rol 0 0 0
106 Kasa 4x15 2,150 rol 155 155 155
110 Ketokenazol tab 200 mg 310 tablet 871 871 520 351
115 Klindamisin 300 mg 630 kapsul 0 0 0
119 Kotrimoksazol tablet dewasa 154 tablet 3,411 3,411 910 2,501
122 Klorpromazin 100 mg 148 tablet 0 0 0
123 Lanzoprazol kapsul 30 mg 473 kapsul 410 410 410 0
125 Loperamid tablet 2 mg 92 tablet 272 272 272
HARGA
SATUAN (Rp)

129 Lysol 43,000 botol 0 0 0
133 Masker 22,880 kotak 10 10 10
139 Metilprednisolon tab 4 mg 210 tablet 1,084 1,084 786 298
144 Molex flu kaplet 397 tablet 2,368 2,368 1,275 1,093
154 Oksitetrasiklin 3% salep kulit 1,640 tube 150 150 4 146
161 Pirantel 125 mg tablet 308 tablet 1,353 1,353 1,353
163 Plester 5 x 2 2,000 rol 29 29 29
HARGA
SATUAN (Rp)
HARGA
SATUAN (Rp)
171 Quinin 200 mg 704 tablet 960 960 960

172 Ranitidin 150 mg 126 tablet 0 0 0
179 Salep -24 2,554 pot 50 50 29 21
191 Stesolid rectal 5 mg 12,159 tube 5 5 2 3
HARGA
SATUAN (Rp)
OBAT TRADISIONAL
8 Gen-C 97,000 botol 0 0 0
12 Jamsi 100ml 88,000 botol 0 0 0
22 Fituno 124,893 dus 2 2 1 1
24 Lacbon 143,000 dus 1 1 1
26 Asifit 61,500 dus 0 0 0
30 Stimuno Syrup 19,646 botol 7 7 1 6
PUSKESMAS MAKRAYU
TAHUN 2017
HARGA
SATUAN (Rp)

7 Fe2SO4 1,290 sachet 0 0 0
27 Pot Sputum 4,200 buah 139 139 139
jju
jum
UMUM BPJS
Hj. Sr PUSTI 32 ILIR 503 32
JUMLAH 3,932 1819

PUSKESMAS : BULAN : MARET
KOTA : TAHUN : 2017
PROVINSI :
PERSEDIAAN
NO
1 BCG
2 TT/ TD
3 DPT
NIP. 19741014512009032001 NIP. 196212121989102001
ONAL(APBD Kota)
BULAN : MARET
TAHUN 2017
NO :
STOCK
OPTIMAL
STOCK
OPTIMAL
STOCK
OPTIMAL
STOCK
OPTIMAL
STOCK
OPTIMAL
STOCK
OPTIMAL
STOCK
OPTIMAL
ang Farmasi)
STOCK
OPTIMAL
Palembang, April 2017
Yang Menerima
Petugas Puskesmas
Septiyawati, AMF
NIP. 198609082011012005
PUSKESMAS : MAKRAYU
KOTA : PALEMBANG
HARGA
SATUAN (Rp)
7 Alopurinol 100 mg 93 tablet 4,107 1,000 5,107 335 4,772
11 Amlodipin tab 5 mg 105 tablet 5,155 7,200 12,355 3,390 8,965
13 Amoksisilin syrup 125 mg/ 5ml 2,500 botol 370 960 1,330 195 1,135
15 Amoksisilin 250 mg 201 kapsul 210 210 210 0
18 Antasida doen tablet 63 tablet 0 10,000 10,000 3,240 6,760
19 Antasida doen suspensi 2,117 botol 703 500 1,203 172 1,031
20 Antibakteri salep kombinasi (Bevalex) 11,300 tube 0 240 240 39 201
24 Asam Askorbat 50 mg 109 tablet 8,352 5,000 13,352 1,709 11,643
25 Asam Mefenamat 500 mg 112 tablet 28,369 8,000 36,369 3,708 32,661
26 Asiklovir krim 5% 2,988 tube 149 100 249 21 228
28 Asikovir 400 345 tablet 579 579 350 229
32 Betametson krem 0,1 % 1,520 tube 287 300 587 134 453
34 Bisakodil tab 5 mg 1,235 tablet 91 200 291 43 248
35 Betahistin Mesilate 162 tablet 5,213 1,200 6,413 1,181 5,232
HARGA
SATUAN (Rp)

40 Cat gut 22,599 saset 0 0 0
41 Ciprofloxacin 500 mg 289 tablet 2,596 5,000 7,596 1,620 5,976
42 Cetrizine 10 mg 145 tablet 1,366 1,366 1,366 0
44 Clobazam 10 mg tab 900 tablet 0 0 0
46 Cooper T (380A) 17,710 unit 16 16 16
51 Dexamethason inj 5 mg/ml 1,659 ampl 100 100 100 0
52 Dexamethason tabl 0,5 mg 46 tablet 8,607 10,000 18,607 2,495 16,112
62 Doksisiklin kapsul 100 mg 285 kapsul 750 750 90 660
63 Etakridin ( Rivanol ) larutan 0,1 % 2,650 botol 107 96 203 48 155
64 Etanol 70 % @ 100 ml 2,575 botol 10 10 4 6
67 Eritromycin syr kering 200mg/5ml 7,893 botol 163 163 163
68 Erythromisin kap 250 mg 594 kapsul 387 1,000 1,387 132 1,255
73 Fenol Glyserol 10 % TT 2,500 botol 137 48 185 10 175
79 Gentamisin sulfat Ttm 0,3 % 4,200 botol 158 120 278 25 253
81 Gemfibrozil 300 mg 303 tablet 1,114 1,114 168 946
HARGA
SATUAN (Rp)

85 Griseofulvin 230 tablet 0 1,000 1,000 1,000
86 Gliseril Guaiakolat 53 tablet 557 20,000 20,557 7,526 13,031
87 Glukosa lart. Infus 5 % 6,900 botol 35 35 1 34
94 H C T 25 mg 156 tablet 0 0 0
95 Hidrokortison 2.5 % krim 2,798 tube 223 120 343 36 307
98 Ibuprofen 400 mg 153 tablet 3,654 7,000 10,654 2,183 8,471
99 Ibuprofen 100 mg/5ml 3,674 botol 0 300 300 3 297
102 Kalsium laktat 66 tablet 3,681 10,000 13,681 2,135 11,546
103 Kapas 250 grm 12,800 rol 0 5 5 1 4
106 Kasa 4x15 2,150 rol 155 155 6 149
107 Kaptopril 25 mg 89 tablet 7,099 5,000 12,099 1,025 11,074
108 Kaptopril 12,5 mg 62 tablet 1,709 6,000 7,709 1,165 6,544
115 Klindamisin 300 mg 630 kapsul 0 1,000 1,000 1,000
116 Klorfeniramine maleat (CTM) 43 tablet 20,022 10,000 30,022 5,270 24,752
118 Kotrimoksazol syrup 2,183 botol 0 300 300 35 265
119 Kotrimoksazol tablet dewasa 154 tablet 2,501 5,000 7,501 1,148 6,353
123 Lanzoprazol kapsul 30 mg 473 kapsul 0 0 0
HARGA
SATUAN (Rp)

129 Lysol 43,000 botol 0 0 0
131 Magnesium Sulfat Inj IV 20%-25ml 3,200 vial 0 2 2 2
133 Masker 22,880 kotak 10 10 1 9
134 Meloksikam 15 mg 1,185 tablet 2,433 2,000 4,433 278 4,155
135 Metformin HCl tab 500 mg 115 tablet 14,631 14,631 935 13,696
137 Metilergometrin tab 0.125 mg 162 tablet 0 500 500 500
138 Metilergometrin inj 0.2 mg/1ml 2,684 ampl 0 2 2 2
139 Metilprednisolon tab 4 mg 210 tablet 298 298 298 0
143 Mikonazol krem 3,000 tube 83 120 203 74 129
144 Molex flu kaplet 397 tablet 1,093 3,000 4,093 568 3,525
145 Molex flu syrup 60ml 6,710 botol 416 480 896 95 801
146 Natrium diklofenac 25 mg 157 tablet 1,392 2,800 4,192 773 3,419
152 Omeprazol kap 20 mg 216 kapsul 1,185 3,000 4,185 960 3,225
155 OBH Molex syrup 60ml 5,500 botol 118 720 838 181 657
156 Parasetamol syrup 1,119 botol 0 1,000 1,000 345 655
158 Parasetamol 500 mg 57 tablet 9,602 33,600 43,202 10,400 32,802
159 Papaverin 40 mg 209 tablet 700 1,000 1,700 500 1,200
161 Pirantel 125 mg tablet 308 tablet 1,353 100 1,453 18 1,435
163 Plester 5 x 2 2,000 rol 29 29 2 27
HARGA
SATUAN (Rp)
HARGA
SATUAN (Rp)
171 Quinin 200 mg 704 tablet 960 960 960

173 Ringerlaktat larutan infus 7,150 botol 35 35 1 34
176 Salbutamol 2 mg 62 tablet 1,146 1,146 608 538
178 Salisyl talk 2% 1,250 sachet 167 200 367 90 277
179 Salep -24 2,554 pot 21 21 21 0
180 Scabimite Cream 5% 12,155 tube 0 10 10 5 5
184 Silk 3.0 dgn jarum bedah 3,139 sachet 38 36 74 2 72
185 Simvastatin tab 10 mg 133 tablet 2,205 2,100 4,305 660 3,645
186 Sianokobalamin ( Vit B12 ) tablet 57 tablet 8,726 10,000 18,726 3,852 14,874
195 Thiamin tablet ( Vit B1 ) 50 mg 89 tablet 10,669 5,000 15,669 1,453 14,216
197 Tablet Tambah Darah Neo 400 tablet 4,560 3,000 7,560 645 6,915
202 Vitamin dan Mineral (Vitalex) 440 kapsul 3,403 4,000 7,403 765 6,638
207 Zinkid 10mg/5ml 15,729 botol 35 120 155 65 90
HARGA
SATUAN (Rp)
OBAT TRADISIONAL
8 Gen-C 97,000 botol 0 0 0
12 Jamsi 100ml 88,000 botol 0 0 0
22 Fituno 124,893 dus 1 1 1
24 Lacbon 143,000 dus 1 1 1
26 Asifit 61,500 dus 0 0 0
PUSKESMAS MAKRAYU
TAHUN 2017
HARGA
SATUAN (Rp)

7 Fe2SO4 1,290 sachet 0 0 0
21 Oxytocin inj 10iu 1,900 ampul 0 2 2 2
24 Phytomenadion inj 1,644 ampul 0 90 90 90
27 Pot Sputum 4,200 buah 139 139 139
29 Vitamin A 100.000 IU 298 capsul 0 4,500 4,500 4,500
30 Vitamin A 200.000 IU 519 capsul 0 5,000 5,000 5,000
HARGA
SATUAN (Rp)
UMUM BPJS
Hj. S PUSTI 32 ILIR 523 35
JUMLAH 3,908 1719

PUSKESMAS : BULAN : AFRIL
KOTA : TAHUN : 2017
PROVINSI :
PERSEDIAAN
NO
1 BCG
2 TT/ TD
3 DPT

NIP. 19741014512009032001 NIP. 196212121989102001
NAL(APBD Kota)
BULAN : APRIL
TAHUN : 2017
NO :
STOCK
OPTIMAL
STOCK
OPTIMAL
STOCK
OPTIMAL
STOCK
OPTIMAL
STOCK
OPTIMAL
STOCK
OPTIMAL
STOCK
OPTIMAL
ng Farmasi)
STOCK
OPTIMAL
STOCK
OPTIMAL
Palembang,
Yang Menerima
Petugas Puskesmas
Septiyawati, AMF
NIP. 198609082011012005
PUSKESMAS : MAKRAYU BULAN : MEI

KOTA : PALEMBANG TAHUN : 2017
PROVINSI : SUMATERA SELATAN NO :
HARGA STOCK
N0 SATUAN STOCK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOCK PERMINTAAN
SATUAN (Rp) OPTIMAL
1 Alat suntik 2,5 ml/3 ml 957 Set 975 975 975
2 Alat suntik 5 ml 1,348 Set 2,401 2,401 2,401
5 Acetosal (Miniaspi 80 mg),100mg 122 tablet 1,385 1,385 870 515
7 Alopurinol 100 mg 93 tablet 4,772 4,772 1,472 3,300
12 Amlodipin tab 10 mg 160 tablet 6,613 6,613 6,613
13 Amoksisilin syrup 125 mg/ 5ml 2,500 botol 1,135 1,135 392 743
15 Amoksisilin 250 mg 201 kapsul 0 0 0
18 Antasida doen tablet 63 tablet 6,760 6,760 6,760
19 Antasida doen suspensi 2,117 botol 1,031 1,031 507 524
21 Antifungi doen kombinasi ( white field ) 4,366 tube 64 64 64
24 Asam Askorbat 50 mg 109 tablet 11,643 11,643 233 11,410
27 Asiklovir 200 239 tablet 0 0 0
28 Asikovir 400 345 tablet 229 229 229
30 Attapulgite (Pularex 630 mg) 210 tablet 159 159 159
36 Burnazin cream 24,150 tube 60 60 60
HARGA STOCK
SATUAN (Rp) OPTIMAL

40 Cat gut 22,599 saset 0 0 0
41 Ciprofloxacin 500 mg 289 tablet 5,976 5,976 5,976
42 Cetrizine 10 mg 145 tablet 0 0 0 5,000
44 Clobazam 10 mg tab 900 tablet 0 0 0
46 Cooper T (380A) 17,710 unit 16 16 16
59 Diphenhydramin inj 10 mg 1,100 ampl 85 85 85 0
61 Domperidon 10 mg 170 tablet 618 618 618
62 Doksisiklin kapsul 100 mg 285 kapsul 660 660 660
63 Etakridin ( Rivanol ) larutan 0,1 % 2,650 botol 155 155 155
64 Etanol 70 % @ 100 ml 2,575 botol 6 6 6
68 Erythromisin kap 250 mg 594 kapsul 1,255 1,255 695 560
73 Fenol Glyserol 10 % TT 2,500 botol 175 175 175
75 Furosemide 40 mg 81 tablet 2,198 2,198 2,198
77 Garam oralit 269 saset 1,396 1,396 1,396
HARGA STOCK
SATUAN (Rp) OPTIMAL
HARGA STOCK
SATUAN (Rp) OPTIMAL

81 Gempibrozil 300 mg 303 tablet 946 946 886 60
85 Griseofulvin 230 tablet 1,000 1,000 300 700
89 Glibenklamid 5 mg 95 tablet 2,185 2,185 2,185
94 H C T 25 mg 156 tablet 0 0 0
99 Ibuprofen 100 mg/5ml 3,674 botol 297 297 8 289
101 Isosorbid dinitrat 5 mg 93 tablet 464 464 464
102 Kalsium laktat 66 tablet 11,546 11,546 41 11,505
103 Kapas 250 grm 12,800 rol 4 4 4
106 Kasa 4x15 2,150 rol 149 149 9 140
107 Kaptopril 25 mg 89 tablet 11,074 11,074 11,074
108 Kaptopril 12,5 mg 62 tablet 6,544 6,544 6,544
110 Ketokenazol tab 200 mg 310 tablet 0 0 0
111 Khloramfenikol 250 mg 500 kaps 1,128 1,128 507 621
112 Khloramfenikol salep mata 1,600 tube 25 25 25
115 Klindamisin 300 mg 630 kapsul 1,000 1,000 90 910
116 Klorfeniramine maleat (CTM) 43 tablet 24,752 24,752 24,752
119 Kotrimoksazol tablet dewasa 154 tablet 6,353 6,353 6,353
HARGA STOCK
SATUAN (Rp) OPTIMAL

125 Loperamide 2 mg 92 tablet 262 262 20 242
129 Lysol 43,000 botol 0 0 0
133 Masker 22,880 kotak 9 9 2 7
134 Meloksikam 15 mg 1,185 tablet 4,155 4,155 1,360 2,795
139 Metilprednisolon tab 4 mg 210 tablet 0 0 0
141 Metronidazol 500 mg 164 tablet 397 397 397
152 Omeprazol kap 20 mg 216 kapsul 3,225 3,225 1,090 2,135
159 Papaverin 40 mg 209 tablet 1,200 1,200 1,200
162 Piridoksin (Vit.B6) tab 10 mg 124 tablet 5,177 5,177 5,177
163 Plester 5 x 2 2,000 rol 27 27 27
HARGA STOCK
SATUAN (Rp) OPTIMAL
HARGA STOCK
SATUAN (Rp) OPTIMAL

169 Phenobarbital inj 1890 ampul 0 0 0
170 Prednison 5 mg 66 tablet 1,000 1,000 1,000
171 Quinin 200 mg 704 tablet 960 960 960
176 Salbutamol 2 mg 62 tablet 538 538 538
177 Salbutamol 4 mg 95 tablet 1,092 1,092 1,092
179 Salep -24 2,554 pot 0 0 0
`1`` Temporarystopping (Flecher) P+L 319,000 botol 2 2 1 1
197 Tablet Tambah Darah Neo 400 tablet 6,915 6,915 1,645 5,270
198 Vitamin Bkomplek 121 tablet 2,867 2,867 2,867
HARGA STOCK
SATUAN (Rp) OPTIMAL
206 Yodium povidon 300 ml 14771 botol 8 8 8

207 Zinkid 10mg/5ml 15,729 botol 90 90 90
HARGA STOCK
SATUAN (Rp) OPTIMAL
OBAT TRADISIONAL
8 Gen-C 97,000 botol 0 0 0
12 Jamsi 100ml 88,000 botol 0 0 0
22 Fituno 124,893 dus 1 1 1
24 Lacbon 143,000 dus 1 1 1
26 Asifit 61,500 dus 0 0 0
PUSKESMAS MAKRAYU
TAHUN 2017
HARGA STOCK
N0 NAMA OBAT SATUAN STOCK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOCK PERMINTAAN
SATUAN (Rp) OPTIMAL

7 Fe2SO4 1,290 sachet 0 0 0
27 Pot Sputum 4,200 buah 139 139 139
29 Vitamin A 100.000 IU 298 capsul 4,500 4,500 4,500
HARGA STOCK
SATUAN (Rp) OPTIMAL


UMUM BPJS
JUMLAH 3,763 1747

PUSKESMAS : BULAN : MEI
KOTA : TAHUN : 2017
PROVINSI :
PERSEDIAAN
NO
1 BCG Ö
2 TT/ TD Ö
3 DPT Ö

NIP. 19741014512009032001 NIP. 196212121989102001
1
PEMBERIAN KET
2
PEMBERIAN KET
3
PEMBERIAN KET
PEMBERIAN KET
4
PEMBERIAN KET
5
PEMBERIAN KET
PEMBERIAN KET
6
PEMBERIAN KET
PEMBERIAN KET
PEMBERIAN KET
8
PEMBERIAN KET
Palembang, 5 Juni 2017
Yang Menerima
Petugas Puskesmas
Septiyawati, AMF
NIP. 198609082011012005
PUSKESMAS : MAKRAYU
KOTA : PALEMBANG
HARGA
SATUAN (Rp)
3 Albendazole 400 mg 350 tablet 0 0 0 0
4 Alkohol Swab 34,100 kotak 2 2 0 2
5 Acetosal (Miniaspi 80 mg),100mg 122 tablet 515 515 110 405
14 Amoksisilin dry syrup 250 mg/ 5ml 4,212 botol 0 0 0 0
17 Amoksisilin+as klavulanat 625mg tab 4,777 tablet 0 0 0 0
22 Anti Migran (Ergotamin Coffein) 142 tablet 0 0 0 0
28 Asikovir 400 345 tablet 229 229 180 49
40 Cat gut 22,599 saset 0 0 0 0
42 Cetrizine 10 mg 145 tablet 0 0 0 0
45 Carbamazepin 200 mg 280 tablet 0 0 0 0
46 Cooper T (380A) 17,710 unit 16 16 0 16
49 Cimetidin 200mg 115 kapsul 0 0 0 0
55 Diazepam 2 mg tablet 28 tablet 0 0 0 0
57 Digoxin 0,25 mg tablet 100 tablet 0 0 0 0
58 Diltiazem 30 mg 134 tablet 0 0 0 0
60 Domperidon suspensi 5mg/5ml 3,410 botol 0 0 0 0
62 Doksisiklin kapsul 100 mg 285 kapsul 660 660 40 620
64 Etanol 70 % @ 100 ml 2,575 botol 6 6 4 2
66 Eugenol 19,005 botol 3 3 0 3
70 Epineprine 0,1 % Inj (Adrenalin) 2,354 ampl 0 0 0 0
72 Fitomenadion Injeksi 2mg/ml 3,582 ampl 0 0 0 0
74 Ferro Fumarat + As. Folat (Hemafort) 835 tablet 0 0 0 0
76 Flagyl suppos 0,5 gr 3,220 buah 58 58 6 52
77 Garam oralit 269 saset 1,396 1,396 504 892
81 Gemfibrozil 300 mg 303 tablet 60 60 60 0
83 Glimepiride 1 mg 265 tablet 0 0 0 0
85 Griseofulvin 230 tablet 700 700 20 680
93 Handscoon non-steril 37,044 kotak 4 4 0 4
94 H C T 25 mg 156 tablet 0 0 0 0
97 Ibuprofen 200 mg 116 tablet 0 0 0 0
100 Infus Set Dewasa 5,445 Set 0 0 0 0
103 Kapas 250 grm 12,800 rol 4 4 0 4
106 Kasa 4x15 2,150 rol 140 140 25 115
107 Kaptopril 25 mg 89 tablet 11,074 11,074 990 10,084
111 Khloramfenikol 250 mg 500 kaps 621 621 74 547
114 Klorfeson cream 7,148 tube 0 0 0 0
115 Klindamisin 300 mg 630 kapsul 910 910 910 0
117 Kodein 10 mg tab 525 tablet 0 0 0 0
119 Kotrimoksazol tablet dewasa 154 tablet 6,353 6,353 818 5,535
120 Kotrimoksazol 120 mg 75 tablet 0 0 0 0
121 Kalsium Hidroksida Pasta 467,500 botol 0 0 0 0
127 Lidokain inj 2% + Efinefrin 2ml komb 1,937 ampl 0 0 0 0
128 Leukoplast 2,5cm x 4,5cm 12,076 roll 0 0 0 0
129 Lysol 43,000 botol 0 0 0 0
130 Multivitamin Anti Anemia (Livron B-plex) 240 tablet 2,000 2,000 0 2,000
133 Masker 22,880 kotak 7 7 3 4
136 Metformin 850 mg 215 tablet 0 0 0 0
142 Metochlopramide 5 mg tablet 105 tablet 149 149 0 149
146 Natrium diklofenac 25 mg 157 tablet 1,611 1,611 525 1,086
147 Natrium diklofenac 50 mg 185 tablet 0 0 0 0
159 Papaverin 40 mg 209 tablet 1,200 1,200 230 970
160 Pirantel Suspensi 125 mg/ 5ml 8,728 botol 0 0 0 0
163 Plester 5 x 2 2,000 rol 27 27 7 20
164 Propilthiourasil ( PTU ) 292 tablet 1,000 1,000 0 1,000
165 Propanolol 10 mg 66 tablet 997 997 0 997
167 Piroksikam 20 mg 176 tablet 0 0 0 0
169 Phenobarbital inj 1,890 ampl 0 0 0 0
171 Quinin 200 mg 704 tablet 960 960 0 960
172 Ranitidin 150 mg 126 tablet 0 0 0 0
174 Retinol 100.000 IU 298 kapsul 0 0 0 0
177 Salbutamol 4 mg 95 tablet 1,092 1,092 175 917
179 Salep -24 2,554 pot 0 0 0 0
181 Safety box 16,501 piece 0 0 0 0
189 Solare Anterior/Pasterior 341,500 botol 0 0 0 0
193 Tetrasiklin 500 mg 319 kapsul 1,288 1,288 480 808
194 Temporarystopping (Flecher) P+L 319,000 botol 1 1 0 1
198 Vitamin Bkomplek 121 tablet 2,867 2,867 2,867 0
199 Ventolin rotacaps 450 kapsul 0 0 0 0
200 Ventolin rotahaler 6,550 buah 0 0 0 0
202 Vitamin dan Mineral (Vitalex) 440 kapsul 4,880 4,880 635 4,245
208 Zink tablet 20 mg 497 kaplet 0 0 0 0
OBAT TRADISIONAL
8 Gen-C 97,000 botol 0 0 0
12 Jamsi 100ml 88,000 botol 0 0 0
22 Fituno 124,893 dus 1 1 1
24 Lacbon 143,000 dus 1 1 1
26 Asifit 61,500 dus 0 0 0
PUSKESMAS MAKRAYU
TAHUN 2017
HARGA
SATUAN (Rp)

7 Fe2SO4 1,290 sachet 0 0 0
27 Pot Sputum 4,200 buah 139 139 75 64
33 Zink 20 mg tab 497 tablet 3,000 3,000 1,000 2,000
UMUM BPJS
JUMLAH 3525 957

PUSKESMAS : BULAN :JUNI
KOTA : TAHUN :2017
PROVINSI :
PERSEDIAAN
NO
NAMA VAKSN
NO
1 BCG Ö
2 TT/ TD Ö
3 DPT Ö

NIP. 19741014512009032001 NIP. 196212121989102001
NAL(APBD Kota)
BULAN :JUNI
TAHUN :2017
NO :
STOCK
OPTIMAL
5
1,000
3,000
3,000
8,000
5,000
600
20,000
5,000
500
480
240
10,000
240
5,000
5,000
1,000
1,000
250
50
200
5,000
15,000
500
1,000
50
15,000
3,000
1,000
20
3,000
5,000
240
500
240
240
480
5,000
20,000
1,000
1,000
240
10,000
500
2,000
150
5,000
3,000
500
500
500
1,000
20,000
5,000
2,000
6,000
100
5,000
3,000
480
10,000
360
10,000
10,000
5,000
500
1,000
500
33,600
5,000
3,000
10,000
2,000
2,000
300
100
100
300
3,000
20,000
10
2,000
1,000
5,000
1,000
20,000
20
5,000
100
300
1,000
300
300
10
ng Farmasi)
STOCK
OPTIMAL
32
2
200
500
500
1,000
500
100
Palembang, 6 Juli 2017
Yang Menerima
Petugas Puskesmas
Septiyawati, AMF
NIP. 198609082011012005
PUSKESMAS : MAKRAYU
KOTA : PALEMBANG
HARGA
SATUAN (Rp)
3 Albendazole 400 mg 350 tablet 0 0 0 0
4 Alkohol Swab 34,100 kotak 2 5 7 1 6
5 Acetosal (Miniaspi 80 mg),100mg 122 tablet 405 1,000 1,405 280 1,125
7 Alopurinol 100 mg 93 tablet 2,955 3,000 5,955 315 5,640
11 Amlodipin tab 5 mg 105 tablet 3,400 3,400 3,300 100
13 Amoksisilin syrup 125 mg/ 5ml 2,500 botol 487 180 667 204 463
14 Amoksisilin dry syrup 250 mg/ 5ml 4,212 botol 0 0 0 0
16 Amoksisilin 500 mg 270 kaplet 1,645 1,645 1,645 0
17 Amoksisilin+as klavulanat 625mg tab 4,777 tablet 0 0 0 0
18 Antasida doen tablet 63 tablet 4,040 5,000 9,040 2,740 6,300
19 Antasida doen suspensi 2,117 botol 268 500 768 218 550
22 Anti Migran (Ergotamin Coffein) 142 tablet 0 0 0 0
27 Asiklovir 200 239 tablet 0 1,000 1,000 60 940
28 Asikovir 400 345 tablet 49 5,000 5,049 170 4,879
30 Attapulgite (Pularex 630 mg) 210 tablet 101 1,000 1,101 102 999
40 Cat gut 22,599 saset 0 0 0 0
HARGA
SATUAN (Rp)
42 Cetrizine 10 mg 145 tablet 0 9,000 9,000 870 8,130

43 Cetrizine syr 5 mg 8,399 botol 0 120 120 23 97
45 Carbamazepin 200 mg 280 tablet 0 0 0 0
46 Cooper T (380A) 17,710 unit 16 16 0 16
49 Cimetidin 200mg 115 kapsul 0 0 0 0
53 Devitalisasi pasta 319,000 botol 1 1 2 2 0
57 Digoxin 0,25 mg tablet 100 tablet 0 0 0 0
58 Diltiazem 30 mg 134 tablet 0 0 0 0
60 Domperidon suspensi 5mg/5ml 3,410 botol 0 0 0 0
61 Domperidon 10 mg 170 tablet 483 3,000 3,483 133 3,350
62 Doksisiklin kapsul 100 mg 285 kapsul 620 1,000 1,620 20 1,600
64 Etanol 70 % @ 100 ml 2,575 botol 2 2 2 0
65 Ethyl klorida spray 150,000 botol 5 20 25 6 19
66 Eugenol 19,005 botol 3 3 0 3
74 Ferro Fumarat + As. Folat (Hemafort) 835 tablet 0 2,000 2,000 0 2,000
77 Garam oralit 269 saset 892 1,200 2,092 445 1,647
81 Gemfibrozil 300 mg 303 tablet 0 0 0 0
86 Gliseril Guaiakolat 53 tablet 1,740 1,740 1,740 0
HARGA
SATUAN (Rp)

94 H C T 25 mg 156 tablet 0 0 0 0
97 Ibuprofen 200 mg 116 tablet 0 0 0 0
98 Ibuprofen 400 mg 153 tablet 1,212 1,212 1,212 0
100 Infus Set Dewasa 5,445 Set 0 0 0 0
103 Kapas 250 grm 12,800 rol 4 4 1 3
106 Kasa 4x15 2,150 rol 115 115 10 105
108 Kaptopril 12,5 mg 62 tablet 5,204 5,204 905 4,299
111 Khloramfenikol 250 mg 500 kaps 547 3,600 4,147 157 3,990
115 Klindamisin 300 mg 630 kapsul 0 1,000 1,000 123 877
117 Kodein 10 mg tab 525 tablet 0 0 0 0
120 Kotrimoksazol 120 mg 75 tablet 0 0 0 0
121 Kalsium Hidroksida Pasta 467,500 botol 0 0 0 0
124 Loratadin 10 mg 139 tablet 1,055 2,000 3,055 195 2,860
128 Leukoplast 2,5cm x 4,5cm 12,076 roll 0 0 0 0
129 Lysol 43,000 botol 0 0 0 0
130 Multivitamin Anti Anemia (Livron B-plex) 240 tablet 2,000 2,000 4,000 15 3,985
133 Masker 22,880 kotak 4 1 5 3 2
135 Metformin HCl tab 500 mg 115 tablet 11,285 5,000 16,285 1,420 14,865
136 Metformin 850 mg 215 tablet 0 0 0 0
HARGA
SATUAN (Rp)
140 Metronidazol 250 mg 113 tablet 1,075 1,075 150 925

142 Metochlopramide 5 mg tablet 105 tablet 149 149 0 149
146 Natrium diklofenac 25 mg 157 tablet 1,086 5,600 6,686 1,626 5,060
147 Natrium diklofenac 50 mg 185 tablet 0 0 0 0
152 Omeprazol kap 20 mg 216 kapsul 1,290 6,000 7,290 1,050 6,240
162 Piridoksin (Vit.B6) tab 10 mg 124 tablet 3,672 7,000 10,672 1,810 8,862
163 Plester 5 x 2 2,000 rol 20 20 0 20
164 Propilthiourasil ( PTU ) 292 tablet 1,000 1,000 0 1,000
165 Propanolol 10 mg 66 tablet 997 997 0 997
166 Piroksikam 10 mg 132 tablet 2,470 3,000 5,470 126 5,344
167 Piroksikam 20 mg 176 tablet 0 0 0 0
169 Phenobarbital inj 1,890 ampl 0 0 0 0
170 Prednison 5 mg 66 tablet 1,000 1,000 85 915
171 Quinin 200 mg 704 tablet 960 960 0 960
172 Ranitidin 150 mg 126 tablet 0 10,000 10,000 284 9,716
179 Salep -24 2,554 pot 0 0 0 0
181 Safety box 16,501 piece 0 100 100 0 100
182 Sefadroksil sirup kering 125 mg/5ml 4,485 botol 50 300 350 21 329
185 Simvastatin tab 10 mg 133 tablet 1,910 6,900 8,810 880 7,930
HARGA
SATUAN (Rp)
189 Solare Anterior/Pasterior 341,500 botol 0 0 0 0

194 Temporarystopping (Flecher) P+L 319,000 botol 1 1 0 1
195 Thiamin tablet ( Vit B1 ) 50 mg 89 tablet 7,840 10,000 17,840 1,570 16,270
198 Vitamin Bkomplek 121 tablet 0 0 0 0
199 Ventolin rotacaps 450 kapsul 0 0 0 0
200 Ventolin rotahaler 6,550 buah 0 0 0 0
202 Vitamin dan Mineral (Vitalex) 440 kapsul 4,245 12,000 16,245 890 15,355
205 Yodium Povidon 60 ml 6,298 botol 0 96 96 0 96
206 Yodium Povidon 300 ml 14,771 botol 0 15 15 4 11
208 Zink tablet 20 mg 497 kaplet 0 0 0 0
HARGA
SATUAN (Rp)
OBAT TRADISIONAL
8 Gen-C 97,000 botol 0 0 0
12 Jamsi 100ml 88,000 botol 0 0 0
22 Fituno 124,893 dus 1 1 1
24 Lacbon 143,000 dus 1 1 1
26 Asifit 61,500 dus 0 0 0
32 Herba Vomitz 4,703 strip 4 Tab 50 50 50 0
PUSKESMAS MAKRAYU
TAHUN 2017
HARGA
SATUAN (Rp)

2 Albendazole 400 mg 16,470 tablet 0 11,400 11,400 11,400
7 Fe2SO4 1,290 sachet 0 0 0
16 OAT FDC Kat I 359,990 paket 16 32 48 3 45
27 Pot Sputum 4,200 buah 64 200 264 264
29 Vitamin A 100.000 IU 298 capsul 4,500 4,500 4,000 500
30 Vitamin A 200.000 IU 519 capsul 5,000 5,000 4,700 300
33 Zink 20 mg tab 497 tablet 2,000 2,000 430 1,570
HARGA
SATUAN (Rp)

UMUM BPJS
JUMLAH 3662 1960

PUSKESMAS : BULAN : JULI
KOTA : TAHUN : 2017
PROVINSI :
PERSEDIAAN
NO
1 BCG Ö
2 TT/ TD Ö
3 DPT Ö

NIP. 19741014512009032001 NIP. 196212121989102001
NAL(APBD Kota)
BULAN :JULI
TAHUN :2017
NO :
STOCK
OPTIMAL
STOCK
OPTIMAL
STOCK
OPTIMAL
STOCK
OPTIMAL
STOCK
OPTIMAL
NAL(APBD Kota)
STOCK
OPTIMAL
ng Farmasi)
STOCK
OPTIMAL
STOCK
OPTIMAL
Palembang, 2 Agustus 2017
Yang Menerima
Petugas Puskesmas
Septiyawati, AMF
NIP. 198609082011012005
PUSKESMAS : MAKRAYU BULAN :AGUSTUS

KOTA : PALEMBANG TAHUN :2017
HARGA STOCK
SATUAN (Rp) OPTIMAL
5 Acetosal (Miniaspi 80 mg),100mg 122 tablet 1,125 1,125 380 745
8 Alopurinol 300 mg 215 tablet 560 560 560
9 Ambroxol sirup 15 mg/ml 3,600 botol 0 0 0
11 Amlodipin tab 5 mg 105 tablet 100 100 100 0
15 Amoksisilin 250 mg 201 kapsul 0 0 0
16 Amoksisilin 500 mg 270 kaplet 0 10,000 10,000 600 9,400
26 Asiklovir krim 5% 2,988 tube 0 0 0
27 Asiklovir 200 239 tablet 940 500 1,440 220 1,220
28 Asikovir 400 345 tablet 4,879 2,000 6,879 222 6,657
29 Asam folat 0,4 mg 93 tablet 10 3,000 3,010 5 3,005
HARGA STOCK
SATUAN (Rp) OPTIMAL

40 Cat gut 22,599 saset 0 0 0
44 Clobazam 10 mg tab 900 tablet 0 500 500 61 439
46 Cooper T (380A) 17,710 unit 16 16 16
61 Domperidon 10 mg 170 tablet 3,350 3,350 318 3,032
64 Etanol 70 % @ 100 ml 2,575 botol 0 9 9 6 3
HARGA STOCK
SATUAN (Rp) OPTIMAL
68 Erythromisin kap 250 mg 594 kapsul 46 46 46

70 Epineprine 0,1 % Inj (Adrenalin) 2,354 ampl 0 30 30 30 0
74 Ferro Fumarat + As. Folat (Hemafort) 835 tablet 2,000 2,000 2,000
75 Furosemide 40 mg 81 tablet 1,886 3,000 4,886 123 4,763
81 Gemfibrozil 300 mg 303 tablet 0 0 0
86 Gliseril Guaiakolat 53 tablet 0 0 0
93 Handscoon non-steril 37,044 kotak 1 20 21 2 19
94 H C T 25 mg 156 tablet 0 0 0
97 Ibuprofen 200 mg 116 tablet 0 1,000 1,000 100 900
103 Kapas 250 grm 12,800 rol 3 3 3
HARGA STOCK
SATUAN (Rp) OPTIMAL

106 Kasa 4x15 2,150 rol 105 105 5 100
110 Ketokenazol tab 200 mg 310 tablet 0 0 0
112 Khloramfenikol salep mata 1,600 tube 0 0 0
115 Klindamisin 300 mg 630 kapsul 877 877 477 400
129 Lysol 43,000 botol 0 5 5 5
133 Masker 22,880 kotak 2 30 32 1 31
139 Metilprednisolon tab 4 mg 210 tablet 0 1,500 1,500 230 1,270
HARGA STOCK
SATUAN (Rp) OPTIMAL

143 Mikonazol krem 3,000 tube 0 0 0
144 Molex flu kaplet 397 tablet 1,630 1,630 958 672
147 Natrium diklofenac 50 mg 185 tablet 0 2,800 2,800 2,800
150 Nipedipin tablet 10 mg 110 tablet 0 2,000 2,000 10 1,990
155 OBH Molex syrup 60ml 5,500 botol 0 0 0
163 Plester 5 x 2 2,000 rol 20 20 1 19
164 Propilthiourasil ( PTU ) 292 tablet 1,000 1,000 1,000 0
166 Piroksikam 10 mg 132 tablet 5,344 5,344 5,344
170 Prednison 5 mg 66 tablet 915 915 175 740
171 Quinin 200 mg 704 tablet 960 960 960
172 Ranitidin 150 mg 126 tablet 9,716 9,716 384 9,332
176 Salbutamol 2 mg 62 tablet 0 1,000 1,000 864 136
178 Salisyl talk 2% 1,250 sachet 0 0 0
HARGA STOCK
SATUAN (Rp) OPTIMAL
179 Salep -24 2,554 pot 0 0 0

180 Scabimite Cream 5% 12,155 tube 0 0 0
181 Safety box 16,501 piece 100 12 112 112
185 Simvastatin tab 10 mg 133 tablet 7,930 7,930 1,200 6,730
187 Serum Anti Tetanus (ATS) 1500 u/ Tetagam.P 170,000 vial 3 20 23 4 19
197 Tablet Tambah Darah Neo 400 tablet 4,680 4,680 2,430 2,250
198 Vitamin Bkomplek 121 tablet 0 0 0
209 Bisoprolol 5 mg 2,169 tablet 0 2,000 2,000 20 1,980
210 Risperidon 3,206 tablet 0 300 300 300
211 Etanol 70 % 1 L 34,788 botol 0 10 10 10
HARGA STOCK
SATUAN (Rp) OPTIMAL
OBAT TRADISIONAL
8 Gen-C 97,000 botol 0 0 0
12 Jamsi 100ml 88,000 botol 0 0 0
22 Fituno 124,893 dus 1 1 1
24 Lacbon 143,000 dus 1 1 1
26 Asifit 61,500 dus 0 0 0
32 Herba Vomitz 4,703 strip 4 Tab 50 50 50 0
PUSKESMAS MAKRAYU
TAHUN 2017
HARGA STOCK
SATUAN (Rp) OPTIMAL

2 Albendazole 400 mg 16,470 tablet 11,400 11,400 11,400
7 Fe2SO4 1,290 sachet 0 0 0
27 Pot Sputum 4,200 buah 264 264 25 239
HARGA STOCK
SATUAN (Rp) OPTIMAL
33 Zink 20 mg tab 497 tablet 1,570 1,570 530 1,040

UMUM BPJS
PUSTU 35 ILIR 530 0
JUMLAH 4075 1680
PUSKESMAS : BULAN : AGUSTUS
KOTA : TAHUN : 2017
PROVINSI :
PERSEDIAAN
NO
1 BCG Ö
2 TT/ TD Ö
3 DPT Ö
Yang Menyerahkan Mengetahui Palembang, 4 Septe

Gudang Farmasi Kepala Puskesmas Makrayu Yang Menerima
Petugas Puskesmas
Tien Atika Setiawati S Si. Apt Dr. Hj. Novia Diana Roza, M. kes Septiyawati, AMF
NIP. 19741014512009032001 NIP. 196212121989102001 NIP. 198609082011
PEMBERIAN KET
PEMBERIAN KET
PEMBERIAN KET
PEMBERIAN KET
PEMBERIAN KET
PEMBERIAN KET
PEMBERIAN KET
PEMBERIAN KET
PEMBERIAN KET
ng, 4 September 2017
nerima
Puskesmas
ati, AMF
09082011012005
PUSKESMAS : MAKRAYU BULAN :SEPTEMBER

HARGA STOCK
SATUAN (Rp) OPTIMAL
3 Albendazole 400 mg 350 tablet 0 0 0 3,000
5 Acetosal (Miniaspi 80 mg),100mg 122 tablet 745 745 315 430 2,000
7 Alopurinol 100 mg 93 tablet 5,140 5,140 490 4,650 3,000
8 Alopurinol 300 mg 215 tablet 560 560 70 490 3,000
9 Ambroxol sirup 15 mg/ml 3,600 botol 0 0 0
10 Aminofilin 200 mg 82 tablet 104 104 80 24 1,000
11 Amlodipin tab 5 mg 105 tablet 0 0 0 9,000
13 Amoksisilin syrup 125 mg/ 5ml 2,500 botol 196 120 316 312 4 600
15 Amoksisilin 250 mg 201 kapsul 0 0 0 6,000
16 Amoksisilin 500 mg 270 kaplet 9,400 9,400 5,505 3,895 20,000
18 Antasida doen tablet 63 tablet 2,690 2,690 2,350 340 10,000
24 Asam Askorbat 50 mg 109 tablet 3,915 3,915 3,845 70 10,000
27 Asiklovir 200 239 tablet 1,220 1,220 125 1,095 5,000
28 Asikovir 400 345 tablet 6,657 6,657 579 6,078 5,000
29 Asam folat 0,4 mg 93 tablet 3,005 3,005 135 2,870 1,000
30 Attapulgite (Pularex 630 mg) 210 tablet 887 887 66 821 1,000
HARGA STOCK
SATUAN (Rp) OPTIMAL

35 Betahistin Mesilate 162 tablet 2,304 2,304 654 1,650 1,000
40 Cat gut 22,599 saset 0 0 0
42 Cetrizine 10 mg 145 tablet 6,864 6,864 1,589 5,275 10,000
44 Clobazam 10 mg tab 900 tablet 439 439 69 370 300
46 Cooper T (380A) 17,710 unit 16 16 16
61 Domperidon 10 mg 170 tablet 3,032 3,032 72 2,960 3,000
62 Doksisiklin kapsul 100 mg 285 kapsul 1,520 1,520 1,520
64 Etanol 70 % @ 100 ml 2,575 botol 3 3 2 1 20
HARGA STOCK
SATUAN (Rp) OPTIMAL
68 Erythromisin kap 250 mg 594 kapsul 46 46 46 0 3,000

69 Erythromisin kap 500 mg 751 kapsul 50 50 50 0 3,000
71 Fitomenadion / vit k 10 mg 660 tablet 1,803 1,803 76 1,727 500
74 Ferro Fumarat + As. Folat (Hemafort) 835 tablet 2,000 2,000 250 1,750
76 Flagyl suppos 0,5 gr 3,220 buah 37 37 7 30 50
77 Garam oralit 269 saset 1,001 1,001 599 402 1,000
78 Gentamisin salep mata 0,3 % 2,830 tube 25 25 8 17 240
81 Gemfibrozil 300 mg 303 tablet 0 0 0 5,000
85 Griseofulvin 230 tablet 320 320 100 220 1,000
86 Gliseril Guaiakolat 53 tablet 0 0 0 20,000
89 Glibenklamid 5 mg 95 tablet 1,455 1,455 1,455 500
90 Haloperidol 1,5 mg 72 tablet 90 90 10 80 1,000
91 Haloperidol 5 mg 100 tablet 260 260 90 170 1,000
94 H C T 25 mg 156 tablet 0 0 0
97 Ibuprofen 200 mg 116 tablet 900 3,000 3,900 1,144 2,756 2,000
98 Ibuprofen 400 mg 153 tablet 0 0 0 5,000
101 Isosorbid dinitrat 5 mg 93 tablet 248 248 89 159 2,000
102 Kalsium laktat 66 tablet 2,700 2,700 2,700 0 6,000
103 Kapas 250 grm 12,800 rol 3 3 3 0 20
HARGA STOCK
SATUAN (Rp) OPTIMAL

106 Kasa 4x15 2,150 rol 100 100 1 99 10
108 Kaptopril 12,5 mg 62 tablet 3,154 3,154 1,455 1,699 5,000
109 Ketokenazol cream 2,569 tube 13 13 13 0 250
110 Ketokenazol tab 200 mg 310 tablet 0 0 0 5,000
111 Khloramfenikol 250 mg 500 kaps 3,782 3,782 150 3,632 1,000
115 Klindamisin 300 mg 630 kapsul 400 400 400 0 1,000
116 Klorfeniramine maleat (CTM) 43 tablet 5,630 5,630 4,873 757 10,000
119 Kotrimoksazol tablet dewasa 154 tablet 7,959 7,959 958 7,001 5,000
125 Loperamid tablet 2 mg 92 tablet 160 160 50 110 100
126 Lidokain HCl inj 2% 2ml 879 ampl 0 60 60 11 49 40
129 Lysol 43,000 botol 5 5 5
133 Masker 22,880 kotak 31 31 1 30
139 Metilprednisolon tab 4 mg 210 tablet 1,270 1,270 372 898 3,000
140 Metronidazol 250 mg 113 tablet 563 563 488 75 3,000
141 Metronidazol 500 mg 164 tablet 0 0 0 3,000
HARGA STOCK
SATUAN (Rp) OPTIMAL

144 Molex flu kaplet 397 tablet 672 672 672 0 10,000
147 Natrium diklofenac 50 mg 185 tablet 2,800 2,800 760 2,040 5,000
150 Nipedipin tablet 10 mg 110 tablet 1,990 1,990 10 1,980 1,000
154 Oksitetrasiklin 3% salep kulit 1,640 tube 96 96 19 77 240
159 Papaverin 40 mg 209 tablet 590 590 220 370 500
163 Plester 5 x 2 2,000 rol 19 19 2 17
164 Propilthiourasil ( PTU ) 292 tablet 0 0 0
166 Piroksikam 10 mg 132 tablet 5,344 5,344 220 5,124 5,000
171 Quinin 200 mg 704 tablet 960 960 960
172 Ranitidin 150 mg 126 tablet 9,332 9,332 282 9,050
176 Salbutamol 2 mg 62 tablet 136 136 136 0 2,000
177 Salbutamol 4 mg 95 tablet 682 682 270 412 2,000
178 Salisyl talk 2% 1,250 sachet 0 400 400 35 365
HARGA STOCK
SATUAN (Rp) OPTIMAL
179 Salep -24 2,554 pot 0 0 0 240

181 Safety box 16,501 piece 112 112 1 111
182 Sefadroksil sirup kering 125 mg/5ml 4,485 botol 282 282 91 191 120
185 Simvastatin tab 10 mg 133 tablet 6,730 6,730 1,445 5,285 3,000
190 Spironolakton 25 mg 320 tablet 0 0 0 2,000
192 Tetrasiklin 250 mg 154 kapsul 0 0 0 1,000
196 Triheksifenidil 2 mg 92 tablet 160 160 100 60 5,000
197 Tablet Tambah Darah Neo (Fe) 400 tablet 2,250 2,250 1,780 470 3,000
198 Vitamin Bkomplek 121 tablet 0 28,200 28,200 1,160 27,040
202 Vitamin dan Mineral (Vitalex) 440 kapsul 11,325 11,325 2,270 9,055 5,000
209 Bisoprolol 5 mg 2,169 tablet 1,980 1,980 20 1,960
210 Risperidon 3,206 tablet 300 300 140 160
211 Etanol 70 % 1 L 34,788 botol 10 10 10
HARGA STOCK
SATUAN (Rp) OPTIMAL
OBAT TRADISIONAL
8 Gen-C 97,000 botol 0 0 0
10 Hemorogard 46,572 kapsul 0 0 0 1,000
11 Imboost 90,750 tablet 0 0 0 300
12 Jamsi 100ml 88,000 botol 0 0 0
22 Fituno 124,893 dus 1 1 1
24 Lacbon 143,000 dus 1 1 1
26 Asifit 61,500 dus 0 0 0
28 Herbakof Syrup 60ml 12,100 botol 0 0 0 300
31 Stimuno Forte 22,363 kotak 0 0 0 10
PUSKESMAS MAKRAYU
TAHUN 2017
HARGA STOCK
SATUAN (Rp) OPTIMAL

2 Albendazole 400 mg 16,470 tablet 11,400 11,400 9,400 2,000
7 Fe2SO4 1,290 sachet 0 0 0
27 Pot Sputum 4,200 buah 239 239 45 194 200
HARGA STOCK
SATUAN (Rp) OPTIMAL
33 Zink 20 mg tab 497 tablet 1,040 1,040 695 345

36 Broxal Elixir 20,100 botol 0 0 0 500
39 Concor 2,5 746 tablet 0 0 0 500
40 FG Troches tablet 0 0 0 500
41 Fludane Plus Kaplet 1,065 tablet 0 0 0 500
48 Gentian Violet 3,000 botol 0 0 0 100
49 widal botol 0 0 0 1 Paket
50 pewarna ziehl neelsen 100mL botol 0 0 0 2
50 Spiritus botol 0 0 0 2
UMUM BPJS
JUMLAH 3588 2228
PUSKESMAS : BULAN : SEPTEMBER
KOTA : TAHUN : 2017
PROVINSI :
PERSEDIAAN
NO
1 BCG Ö
2 TT/ TD Ö
3 DPT Ö
Yang Menyerahkan Mengetahui Palembang, 2 Oktob

Petugas Puskesmas
NIP. 19741014512009032001 NIP. 196212121989102001 NIP. 198609082011
PEMBERIAN KET
PEMBERIAN KET
PEMBERIAN KET
PEMBERIAN KET
PEMBERIAN KET
PEMBERIAN KET
PEMBERIAN KET
PEMBERIAN KET
PEMBERIAN KET
ng, 2 Oktober 2017
nerima
Puskesmas
ati, AMF
09082011012005
PUSKESMAS : MAKRAYU BULAN :OKTOBER

HARGA STOCK
SATUAN (Rp) OPTIMAL
1 Alat suntik 2,5 ml/3 ml 957 Set 480 140 620 20 600
2 Alat suntik 5 ml 1,348 Set 2,200 900 3,100 3,100
5 Acetosal (Miniaspi 80 mg),100mg 122 tablet 430 2,000 2,430 240 2,190
7 Alopurinol 100 mg 93 tablet 4,650 3,000 7,650 1,240 6,410
10 Ambroxol tab 30 mg 635 tablet 0 0 0 1,000
11 Aminofilin 200 mg 82 tablet 24 1,000 1,024 194 830
12 Amlodipin tab 5 mg 105 tablet 0 0 0 10,000
14 Amoksisilin syrup 125 mg/ 5ml 2,500 botol 4 600 604 200 404 500
16 Amoksisilin 250 mg 201 kapsul 0 6,000 6,000 1,150 4,850
17 Amoksisilin 500 mg 270 kaplet 3,895 20,000 23,895 5,172 18,723
19 Antasida doen tablet 63 tablet 340 16,800 17,140 3,960 13,180
21 Antibakteri salep kombinasi (Bevalex) 11,300 tube 91 120 211 125 86 240
22 Antifungi doen kombinasi ( white field ) 4,366 tube 0 240 240 52 188
24 Amitriptilin tablet salut 25 mg 117 tablet 0 0 0 1,000
25 Asam Askorbat 50 mg 109 tablet 70 14,000 14,070 3,395 10,675
27 Asiklovir krim 5% 2,988 tube 0 24 24 11 13 500
28 Asiklovir 200 239 tablet 1,095 2,000 3,095 29 3,066
29 Asikovir 400 345 tablet 6,078 2,000 8,078 1,820 6,258
30 Asam folat 0,4 mg 93 tablet 2,870 1,000 3,870 3,450 420
HARGA STOCK
SATUAN (Rp) OPTIMAL
31 Attapulgite (Pularex 630 mg) 210 tablet 821 1,000 1,821 1,821
33 Betametson krem 0,1 % 1,520 tube 76 250 326 137 189 240
34 Bisakodil supp 5 mg anak 4,990 suppos 103 48 151 7 144
36 Betahistin Mesilate 162 tablet 1,650 1,200 2,850 766 2,084
39 BD Syringe Soloshot mini 0,5ml 165,550 kotak 83 7,517 7,600 7,600
41 Cat gut 22,599 saset 0 0 0 10
43 Cetrizine 10 mg 145 tablet 5,275 2,250 7,525 462 7,063
45 Clobazam 10 mg tab 900 tablet 370 300 670 92 578 500
47 Cooper T (380A) 17,710 unit 16 16 16
62 Domperidon 10 mg 170 tablet 2,960 1,500 4,460 239 4,221
63 Doksisiklin kapsul 100 mg 285 kapsul 1,520 150 1,670 1,670
64 Etakridin ( Rivanol ) larutan 0,1 % 2,650 botol 77 77 19 58 240
65 Etanol 70 % @ 100 ml 2,575 botol 1 1 1
HARGA STOCK
SATUAN (Rp) OPTIMAL
68 Eritromycin syr kering 200mg/5ml 7,893 botol 0 120 120 1 119

72 Fitomenadion / vit k 10 mg 660 tablet 1,727 500 2,227 167 2,060
75 Ferro Fumarat + As. Folat (Hemafort) 835 tablet 1,750 1,750 660 1,090
77 Flagyl suppos 0,5 gr 3,220 buah 30 50 80 3 77
78 Garam oralit 269 saset 402 1,000 1,402 0 1,402
82 Gemfibrozil 300 mg 303 tablet 0 0 0 3,000
86 Griseofulvin 230 tablet 220 1,000 1,220 440 780
87 Gliseril Guaiakolat 53 tablet 0 0 0 20,000
90 Glibenklamid 5 mg 95 tablet 1,455 500 1,955 430 1,525
91 Haloperidol 1,5 mg 72 tablet 80 1,000 1,080 50 1,030
92 Haloperidol 5 mg 100 tablet 170 1,000 1,170 70 1,100
95 H C T 25 mg 156 tablet 0 0 0
98 Ibuprofen 200 mg 116 tablet 2,756 2,756 1,384 1,372 5,000
99 Ibuprofen 400 mg 153 tablet 0 0 0 5,000
102 Isosorbid dinitrat 5 mg 93 tablet 159 2,000 2,159 44 2,115
103 Kalsium laktat 66 tablet 0 6,000 6,000 1,760 4,240
104 Kapas 250 grm 12,800 rol 0 20 20 20
HARGA STOCK
SATUAN (Rp) OPTIMAL

107 Kasa 4x15 2,150 rol 99 10 109 109
109 Kaptopril 12,5 mg 62 tablet 1,699 6,000 7,699 119 7,580
110 Ketokenazol cream 2,569 tube 0 80 80 15 65 300
111 Ketokenazol tab 200 mg 310 tablet 0 2,000 2,000 830 1,170
112 Khloramfenikol 250 mg 500 kaps 3,632 1,200 4,832 1,122 3,710
113 Khloramfenikol salep mata 1,600 tube 0 240 240 110 130
116 Klindamisin 300 mg 630 kapsul 0 1,000 1,000 0 1,000
117 Klorfeniramine maleat (CTM) 43 tablet 757 26,728 27,485 6,321 21,164
127 Lidokain HCl inj 2% 2ml 879 ampl 49 49 34 15 100
130 Lysol 43,000 botol 5 5 5
134 Masker 22,880 kotak 30 30 6 24
135 Meloksikam 15 mg 1,185 tablet 1,825 1,825 0 1,825 3,000
140 Metilprednisolon tab 4 mg 210 tablet 898 3,000 3,898 180 3,718
HARGA STOCK
SATUAN (Rp) OPTIMAL

144 Mikonazol krem 3,000 tube 0 0 0
145 Molex flu kaplet 397 tablet 0 0 0
146 Molex flu syrup 60ml 6,710 botol 0 0 0
149 Natrium Klorida lart infus 6,410 botol 46 46 46
151 Nipedipin tablet 10 mg 110 tablet 1,980 1,000 2,980 50 2,930
156 OBH syrup 60ml 5,500 botol 0 0 0 500
157 Parasetamol syrup 1,119 botol 480 300 780 457 323 500
164 Plester 5 x 2 2,000 rol 17 17 17
165 Propilthiourasil ( PTU ) 292 tablet 0 0 0
167 Piroksikam 10 mg 132 tablet 5,124 3,000 8,124 950 7,174
172 Quinin 200 mg 704 tablet 960 960 960
173 Ranitidin 150 mg 126 tablet 9,050 9,050 1,670 7,380
177 Salbutamol 2 mg 62 tablet 0 2,000 2,000 120 1,880
HARGA STOCK
SATUAN (Rp) OPTIMAL

180 Salep -24 2,554 pot 0 0 0 0
182 Safety box 16,501 piece 111 111 111
185 Silk 3.0 dgn jarum bedah 3,139 sachet 60 60 60
186 Simvastatin tab 10 mg 133 tablet 5,285 3,000 8,285 1,985 6,300
189 Superhoid suppos (Anti Hemoroid) 3,197 kotak 153 153 46 107 300
192 Stesolid rectal 5 mg 12,159 tube 3 5 8 1 7
193 Tiamfenikol kap 500 1,200 kapsul 810 810 810
197 Triheksifenidil 2 mg 92 tablet 60 5,000 5,060 100 4,960
198 Tablet Tambah Darah Neo 400 tablet 470 470 470 0
202 Ventolin Nebules 2,5mg 6,930 ampul 7 20 27 8 19
203 Vitamin dan Mineral (Vitalex) 440 kapsul 9,055 4,000 13,055 5,255 7,800
210 Bisoprolol 5 mg 2,169 tablet 1,980 1,980 54 1,926
211 Risperidon 3,206 tablet 160 160 70 90 500
212 Etanol 70 % 1 L 34,788 botol 10 5 15 3 12
213 Sefadroksil tab 500 mg 451 tablet 0 2,000 2,000 696 1,304
214 Betadine salep 7,039 botol 0 24 24 24
215 Kloramfenikol TM (Decacetine) 3,500 botol 0 100 100 20 80
OBAT TRADISIONAL
8 Gen-C 97,000 botol 0 0 0
12 Jamsi 100ml 88,000 botol 0 0 0
22 Fituno 124,893 dus 1 1 1
24 Lacbon 143,000 dus 1 1 1
26 Asifit 61,500 dus 0 0 0
PUSKESMAS MAKRAYU
TAHUN 2017
HARGA STOCK
SATUAN (Rp) OPTIMAL

2 Albendazole 400 mg 16,470 tablet 2,000 3,000 5,000 128 4,872
7 Fe2SO4 1,290 sachet 0 0 0
27 Pot Sputum 4,200 buah 194 500 694 55 639
HARGA STOCK
SATUAN (Rp) OPTIMAL
33 Zink 20 mg tab 497 tablet 345 345 345

48 Gentian Violet 3,000 botol 0 0 0 100
49 Tablet Tambah Darah Neo 400 tablet 0 10,600 10,600 1,240 9,360
UMUM BPJS
JUMLAH 4133 1884

PUSKESMAS : BULAN :OKTOBER
KOTA : TAHUN :2017
PROVINSI :
PERSEDIAAN
NO
1 BCG Ö
2 TT/ TD Ö
3 DPT Ö
Yang Menyerahkan Mengetahui Palembang, 3 Novemb

Petugas Puskesmas
NIP. 19741014512009032001 NIP. 196212121989102001 NIP. 198609082011012
PEMBERIAN KET
PEMBERIAN KET
PEMBERIAN KET
PEMBERIAN KET
PEMBERIAN KET
PEMBERIAN KET
PEMBERIAN KET
PEMBERIAN KET
g, 3 November 2017
erima
uskesmas
i, AMF
9082011012005
N0 APOTIK GUDANG PENERIMAAN
OBAT PKD
1 Alat suntik 2,5 ml/3 ml
2 Alat suntik 5 ml
3 Albendazole 400 mg
4 Alkohol Swab
5 Acetosal (Miniaspi 80 mg),100mg
6 Acetylcystein 200 mg
7 Alopurinol 100 mg
8 Alopurinol 300 mg
9 Ambroxol sirup 15 mg/ml
10 Ambroxol tab 30 mg
11 Aminofilin 200 mg
12 Amlodipin tab 5 mg
13 Amlodipin tab 10 mg
14 Amoksisilin syrup 125 mg/ 5ml
15 Amoksisilin dry syrup 250 mg/ 5ml
16 Amoksisilin 250 mg
17 Amoksisilin 500 mg
18 Amoksisilin+as klavulanat 625mg tab
19 Antasida doen tablet
20 Antasida doen suspensi
21 Antibakteri salep kombinasi (Bevalex)
22 Antifungi doen kombinasi ( white field )
23 Anti Migran (Ergotamin Coffein)
24 Amitriptilin tablet salut 25 mg
25 Asam Askorbat 50 mg
26 Asam Mefenamat 500 mg
27 Asiklovir krim 5%
28 Asiklovir 200
29 Asikovir 400
30 Asam folat 0,4 mg
31 Attapulgite (Pularex 630 mg)
32 Articulating paper
33 Betametson krem 0,1 %
34 Bisakodil supp 5 mg anak
35 Bisakodil tab 5 mg
36 Betahistin Mesilate
37 Burnazin cream
38 BD Syringe Soloshot mini 0,05ml
39 BD Syringe Soloshot mini 0,5ml
40 Composite
41 Cat gut
42 Ciprofloxacin 500 mg
43 Cetrizine 10 mg
44 Cetrizine syr 5 mg
45 Clobazam 10 mg tab
46 Carbamazepin 200 mg
47 Cooper T (380A)
48 Calamed lotion
49 Caviton White
50 Cimetidin 200mg
51 Chlorfenolkamfermentol (CHKM)
52 Dexamethason inj 5 mg/ml
53 Dexamethason tabl 0,5 mg
54 Devitalisasi pasta
55 Diazepam inj
56 Diazepam 2 mg tablet
57 Diazepam 5 mg tablet
58 Digoxin 0,25 mg tablet
59 Diltiazem 30 mg
60 Diphenhydramin inj 10 mg
61 Domperidon suspensi 5mg/5ml
62 Domperidon 10 mg
63 Doksisiklin kapsul 100 mg
64 Etakridin ( Rivanol ) larutan 0,1 %
65 Etanol 70 % @ 100 ml
66 Ethyl klorida spray
67 Eugenol
68 Eritromycin syr kering 200mg/5ml
69 Erythromisin kap 250 mg
70 Erythromisin kap 500 mg
71 Epineprine 0,1 % Inj (Adrenalin)
72 Fitomenadion / vit k 10 mg
73 Fitomenadion Injeksi 2mg/ml
74 Fenol Glyserol 10 % TT
75 Ferro Fumarat + As. Folat (Hemafort)
76 Furosemide 40 mg
77 Flagyl suppos 0,5 gr
78 Garam oralit
79 Gentamisin salep mata 0,3 %
80 Gentamisin sulfat Ttm 0,3 %
81 Gentamisin salep kulit (Gentalex)
82 Gemfibrozil 300 mg
83 Glasionomer semen
84 Glimepiride 1 mg
85 Glimepiride 2 mg
86 Griseofulvin
87 Gliseril Guaiakolat
88 Glukosa lart. Infus 5 %
89 Glukosa lart. Infus 10 %
90 Glibenklamid 5 mg
91 Haloperidol 1,5 mg
92 Haloperidol 5 mg
93 Handscoon Steril 7,5
94 Handscoon non-steril
95 H C T 25 mg
96 Hidrokortison 2.5 % krim
97 Iliadin drop (Obat tetes hidung)
98 Ibuprofen 200 mg
99 Ibuprofen 400 mg
100 Ibuprofen 100 mg/5ml
101 Infus Set Dewasa
102 Isosorbid dinitrat 5 mg
103 Kalsium laktat
104 Kapas 250 grm
105 Kasa steril 40 x 40 cm
106 Kasa steril 16 x 16 cm
107 Kasa 4x15

108 Kaptopril 25 mg
109 Kaptopril 12,5 mg
110 Ketokenazol cream
111 Ketokenazol tab 200 mg
112 Khloramfenikol 250 mg
113 Khloramfenikol salep mata
114 Kloramfenikol TT (Reco TT 3%)
115 Klorfeson cream
116 Klindamisin 300 mg
117 Klorfeniramine maleat (CTM)
118 Kodein 10 mg tab
119 Kotrimoksazol syrup
120 Kotrimoksazol tablet dewasa
121 Kotrimoksazol 120 mg
122 Kalsium Hidroksida Pasta
123 Klorpromazin 100 mg
124 Lanzoprazol kapsul 30 mg
125 Loratadin 10 mg
126 Loperamid tablet 2 mg
127 Lidokain HCl inj 2% 2ml
128 Lidokain inj 2% + Efinefrin 2ml komb
129 Leukoplast 2,5cm x 4,5cm
130 Lysol
131 Multivitamin Anti Anemia (Livron B-plex)
132 Magnesium Sulfat Inj IV 20%-25ml
133 Magnesium Sulfat Inj IV 40%-25ml
134 Masker
135 Meloksikam 15 mg
136 Metformin HCl tab 500 mg
137 Metformin 850 mg
138 Metilergometrin tab 0.125 mg
139 Metilergometrin inj 0.2 mg/1ml
140 Metilprednisolon tab 4 mg
141 Metronidazol 250 mg
142 Metronidazol 500 mg
143 Metochlopramide 5 mg tablet
144 Mikonazol krem
145 Molex flu kaplet
146 Molex flu syrup 60ml
147 Natrium diklofenac 25 mg
148 Natrium diklofenac 50 mg
149 Natrium Klorida lart infus
150 Nistatin 100 000 UI tab vaginal
151 Nipedipin tablet 10 mg
152 Obat Suntik K.B I / Andalan Harmonis
153 Omeprazol kap 20 mg
154 Oxytocin inj 10iu
155 Oksitetrasiklin 3% salep kulit
156 OBH syrup 60ml
157 Parasetamol syrup
158 Parasetamol drop
159 Parasetamol 500 mg
160 Papaverin 40 mg
161 Pirantel Suspensi 125 mg/ 5ml

162 Pirantel 125 mg tablet
163 Piridoksin (Vit.B6) tab 10 mg
164 Plester 5 x 2
165 Propilthiourasil ( PTU )
166 Propanolol 10 mg
167 Piroksikam 10 mg
168 Piroksikam 20 mg
169 Phenobarbital 30 mg
170 Phenobarbital inj
171 Prednison 5 mg
172 Quinin 200 mg
173 Ranitidin 150 mg
174 Ringerlaktat larutan infus
175 Retinol 100.000 IU
176 Retinol 200.000 IU
177 Salbutamol 2 mg
178 Salbutamol 4 mg
179 Salisyl talk 2%
180 Salep -24
181 Scabimite Cream 5%
182 Safety box
183 Sefadroksil sirup kering 125 mg/5ml
184 Semenseng fospat
185 Silk 3.0 dgn jarum bedah
186 Simvastatin tab 10 mg
187 Sianokobalamin ( Vit B12 ) tablet
188 Serum Anti Tetanus (ATS) 1500 u/ Tetagam.P
189 Superhoid suppos (Anti Hemoroid)
190 Solare Anterior/Pasterior
191 Spironolakton 25 mg
192 Stesolid rectal 5 mg
193 Tiamfenikol kap 500
194 Tetrasiklin 500 mg
195 Temporarystopping (Flecher) P+L
196 Thiamin tablet ( Vit B1 ) 50 mg
197 Triheksifenidil 2 mg
198 Tablet Tambah Darah Neo
199 Vitamin Bkomplek
200 Ventolin rotacaps
201 Ventolin rotahaler
202 Ventolin Nebules 2,5mg
203 Vitamin dan Mineral (Vitalex)
204 Wing Needle 25G
205 Bacitracin Antibakteri salep
206 Yodium Povidon 60 ml
207 Yodium Povidon 300 ml
208 Zinkid 10mg/5ml
209 Zink tablet 20 mg
210 Bisoprolol 5 mg
211 Risperidon
212 Etanol 70 % 1 L
213 Sefadroksil tab 500 mg
214 Betadine salep
215 Kloramfenikol TM (Decacetine)

OBAT TRADISIONAL
1 Aloeina
2 Albumas 500mg
3 Andrographis Herbs
4 Arthricaps
5 Bioimmune 60 ml
6 Carlic Herbs
7 Gastricaps
8 Gen-C
9 Herba Vomitz
10 Hemorogard
11 Imboost
12 Jamsi 100ml
13 Morindae Herbs
14 Nigella Extract
15 Netemp
16 New pro uric
17 Ocugard
18 Prolipid
19 Silex syrup
20 Tensigard
21 Vincoblastcaps
22 Fituno
23 Enkasari
24 Lacbon
25 Batugin Elixir
26 Asifit
27 Toxilite
28 Herbakof Syrup 60ml
29 Herbakof Syrup 100ml
30 Stimuno Syrup
31 Stimuno Forte
32 Herba Vomitz
UMUM BPJS
PKM MAKRAYU MIALGIA
PUSTU 30 ILIR ISPA
PUSTU 32 ILIR DIARE
PUSTU 35 ILIR
PUSTU KEMANG MANIS
N0 NAMA OBAT APOTIK GUDANG PEMBERIAN
PROGRAM PROPINSI (Via Gudang Farmasi)

1 Ampisilin inj
2 Albendazole 400 mg
3 Box Slide
4 Ca Gluconas inj 10%
5 Diazepam inj
6 Diaethyl Kabamazim
7 Fe2SO4
8 Gentamisin inj 80 mg/2ml
9 Gentamisin inj 40 mg/ml
10 Garam oralit
11 Lab. Kit Filariasis
12 MgSO4 (Magnesium Sulfat) injeksi 20%
13 MgSO4 (Magnesium Sulfat) injeksi 40%
14 Methyl Ergometrin Maleat injeksi 0,2mg
15 Natrium Tiroksin (Euthyrox) 100
16 OAT FDC Kat I
17 OAT FDC Kat II
18 OAT FDC Kat Anak
19 Combipack Kat I
20 Obat Anti Malaria
21 Oxytocin inj 10iu
22 Prosted Slide (Objek Glass)
23 Procain Benzil Penicillin inj
24 Phytomenadion inj
25 Phenobarbital inj
26 Pot Sputum
27 Pot Sputum
28 Reagens TB Zialh Neelsen
29 Vitamin A 100.000 IU
30 Vitamin A 200.000 IU
31 Bidan Kit
32 Mineral Mix
33 Zink 20 mg tab
34 Antalgin tablet
35 Asiklovir 5% cream
36
Broxal Elixir
37 Candesartan 8mg/Biopres
38 Cecyl
39 Concor 2,5
40 FG Troches
41 Fludane Plus Kaplet
42 Meloksikam 15 mg
43 Neo Diastop
44 Osteor Kaplet
45 Paracetamol 500 mg
46 Pehacain injeksi
47 Pehavral
48 Gentian Violet
49 Tablet Tambah Darah Neo
PERSEDIAAN
PERSEDIAAN
PERSEDIAAN
PERSEDIAAN
PERSEDIAAN
PUSKESMAS : MAKRAYU BULAN :

KOTA : PALEMBANG TAHUN :
HARGA STOCK
SATUAN (Rp) OPTIMAL
1 Alat suntik 2,5 ml/3 ml 957 Set 0 0
2 Alat suntik 5 ml 1,348 Set 0 0
4 Alkohol Swab 34,100 kotak 0 0
5 Acetosal (Miniaspi 80 mg),100mg 122 tablet 0 0
6 Acetylcystein 200 mg 866 tablet 0 0
7 Alopurinol 100 mg 93 tablet 0 0
8 Alopurinol 300 mg 215 tablet 0 0
9 Ambroxol sirup 15 mg/ml 3,600 botol 0 0
10 Aminofilin 200 mg 82 tablet 0 0
11 Amlodipin tab 5 mg 105 tablet 0 0
12 Amlodipin tab 10 mg 160 tablet 0 0
13 Amoksisilin syrup 125 mg/ 5ml 2,500 botol 0 0
15 Amoksisilin 250 mg 201 kapsul 0 0
16 Amoksisilin 500 mg 270 kaplet 0 0
18 Antasida doen tablet 63 tablet 0 0
19 Antasida doen suspensi 2,117 botol 0 0
20 Antibakteri salep kombinasi (Bevalex) 11,300 tube 0 0
21 Antifungi doen kombinasi ( white field ) 4,366 tube 0 0
23 Amitriptilin tablet salut 25 mg 117 tablet 0 0
24 Asam Askorbat 50 mg 109 tablet 0 0
25 Asam Mefenamat 500 mg 112 tablet 0 0
26 Asiklovir krim 5% 2,988 tube 0 0
27 Asiklovir 200 239 tablet 0 0
28 Asikovir 400 345 tablet 0 0
29 Asam folat 0,4 mg 93 tablet 0 0
30 Attapulgite (Pularex 630 mg) 210 tablet 0 0
31 Articulating paper 202,000 kotak 0 0
32 Betametson krem 0,1 % 1,520 tube 0 0
33 Bisakodil supp 5 mg anak 4,990 suppos 0 0
34 Bisakodil tab 5 mg 1,235 tablet 0 0
35 Betahistin Mesilate 162 tablet 0 0
36 Burnazin cream 24,150 tube 0 0
39 Composite 423,500 botol 0 0
41 Ciprofloxacin 500 mg 289 tablet 0 0
42 Cetrizine 10 mg 145 tablet 0 0
43 Cetrizine syr 5 mg 8,399 botol 0 0
44 Clobazam 10 mg tab 900 tablet 0 0
46 Cooper T (380A) 17,710 unit 0 0
47 Calamed lotion 14,300 botol 0 0
48 Caviton White 154,000 botol 0 0
50 Chlorfenolkamfermentol (CHKM) 77,000 botol 0 0
51 Dexamethason inj 5 mg/ml 1,659 ampl 0 0
52 Dexamethason tabl 0,5 mg 46 tablet 0 0
53 Devitalisasi pasta 319,000 botol 0 0
54 Diazepam inj 2,486 ampl 0 0
59 Diphenhydramin inj 10 mg 1,100 ampl 0 0
61 Domperidon 10 mg 170 tablet 0 0
62 Doksisiklin kapsul 100 mg 285 kapsul 0 0
63 Etakridin ( Rivanol ) larutan 0,1 % 2,650 botol 0 0
64 Etanol 70 % @ 100 ml 2,575 botol 0 0
65 Ethyl klorida spray 150,000 botol 0 0
66 Eugenol 19,005 botol 0 0
67 Eritromycin syr kering 200mg/5ml 7,893 botol 0 0
68 Erythromisin kap 250 mg 594 kapsul 0 0
69 Erythromisin kap 500 mg 751 kapsul 0 0
71 Fitomenadion / vit k 10 mg 660 tablet 0 0
73 Fenol Glyserol 10 % TT 2,500 botol 0 0
75 Furosemide 40 mg 81 tablet 0 0
76 Flagyl suppos 0,5 gr 3,220 buah 0 0
77 Garam oralit 269 saset 0 0
78 Gentamisin salep mata 0,3 % 2,830 tube 0 0
79 Gentamisin sulfat Ttm 0,3 % 4,200 botol 0 0
80 Gentamisin salep kulit (Gentalex) 3,080 tube 0 0
81 Gemfibrozil 300 mg 303 tablet 0 0
82 Glasionomer semen 779,000 botol 0 0
86 Gliseril Guaiakolat 53 tablet 0 0
89 Glibenklamid 5 mg 95 tablet 0 0
90 Haloperidol 1,5 mg 72 tablet 0 0
91 Haloperidol 5 mg 100 tablet 0 0
92 Handscoon Steril 7,5 6,595 sachset 0 0
93 Handscoon non-steril 37,044 kotak 0 0
94 H C T 25 mg 156 tablet 0 0
95 Hidrokortison 2.5 % krim 2,798 tube 0 0
96 Iliadin drop (Obat tetes hidung) 28,928 botol 0 0
101 Isosorbid dinitrat 5 mg 93 tablet 0 0
102 Kalsium laktat 66 tablet 0 0
103 Kapas 250 grm 12,800 rol 0 0
106 Kasa 4x15 2,150 rol 0 0
107 Kaptopril 25 mg 89 tablet 0 0
108 Kaptopril 12,5 mg 62 tablet 0 0
109 Ketokenazol cream 2,569 tube 0 0
110 Ketokenazol tab 200 mg 310 tablet 0 0
111 Khloramfenikol 250 mg 500 kaps 0 0
112 Khloramfenikol salep mata 1,600 tube 0 0
113 Kloramfenikol TT (Reco TT 3%) 6,040 botol 0 0
116 Klorfeniramine maleat (CTM) 43 tablet 0 0
118 Kotrimoksazol syrup 2,183 botol 0 0
119 Kotrimoksazol tablet dewasa 154 tablet 0 0
122 Klorpromazin 100 mg 148 tablet 0 0
123 Lanzoprazol kapsul 30 mg 473 kapsul 0 0
124 Loratadin 10 mg 139 tablet 0 0
125 Loperamid tablet 2 mg 92 tablet 0 0
126 Lidokain HCl inj 2% 2ml 879 ampl 0 0
129 Lysol 43,000 botol 0 0
130 Multivitamin Anti Anemia (Livron B-plex) 240 tablet 0 0
133 Masker 22,880 kotak 0 0
135 Metformin HCl tab 500 mg 115 tablet 0 0
139 Metilprednisolon tab 4 mg 210 tablet 0 0
140 Metronidazol 250 mg 113 tablet 0 0
141 Metronidazol 500 mg 164 tablet 0 0
142 Metochlopramide 5 mg tablet 105 tablet 0 0
143 Mikonazol krem 3,000 tube 0 0
144 Molex flu kaplet 397 tablet 0 0
145 Molex flu syrup 60ml 6,710 botol 0 0
146 Natrium diklofenac 25 mg 157 tablet 0 0
147 Natrium diklofenac 50 mg 185 tablet 0 0
148 Natrium Klorida lart infus 6,410 botol 0 0
149 Nistatin 100 000 UI tab vaginal 504 tablet 0 0
150 Nipedipin tablet 10 mg 110 tablet 0 0
151 Obat Suntik K.B I / Andalan Harmonis 6,624 vial 0 0
152 Omeprazol kap 20 mg 216 kapsul 0 0
154 Oksitetrasiklin 3% salep kulit 1,640 tube 0 0
155 OBH Molex syrup 60ml 5,500 botol 0 0
156 Parasetamol syrup 1,119 botol 0 0
157 Parasetamol drop 5,460 botol 0 0
158 Parasetamol 500 mg 57 tablet 0 0
159 Papaverin 40 mg 209 tablet 0 0
161 Pirantel 125 mg tablet 308 tablet 0 0
162 Piridoksin (Vit.B6) tab 10 mg 124 tablet 0 0
163 Plester 5 x 2 2,000 rol 0 0
164 Propilthiourasil ( PTU ) 292 tablet 0 0
165 Propanolol 10 mg 66 tablet 0 0
168 Phenobarbital 30 mg 66 tablet 0 0
170 Prednison 5 mg 66 tablet 0 0
171 Quinin 200 mg 704 tablet 0 0
172 Ranitidin 150 mg 126 tablet 0 0
173 Ringerlaktat larutan infus 7,150 botol 0 0
176 Salbutamol 2 mg 62 tablet 0 0
177 Salbutamol 4 mg 95 tablet 0 0
178 Salisyl talk 2% 1,250 sachet 0 0
179 Salep -24 2,554 pot 0 0
180 Scabimite Cream 5% 12,155 tube 0 0
182 Sefadroksil sirup kering 125 mg/5ml 4,485 botol 0 0
183 Semenseng fospat 137,500 botol 0 0
184 Silk 3.0 dgn jarum bedah 3,139 sachet 0 0
185 Simvastatin tab 10 mg 133 tablet 0 0
186 Sianokobalamin ( Vit B12 ) tablet 57 tablet 0 0
187 Serum Anti Tetanus (ATS) 1500 u/ Tetagam.P 170,000 vial 0 0
188 Superhoid suppos (Anti Hemoroid) 3,197 kotak 0 0
190 Spironolakton 25 mg 320 tablet 0 0
191 Stesolid rectal 5 mg 12,159 tube 0 0
`1``Temporarystopping (Flecher) P+L 319,000 botol 0 0
195 Thiamin tablet ( Vit B1 ) 50 mg 89 tablet 0 0
196 Triheksifenidil 2 mg 92 tablet 0 0
197 Tablet Tambah Darah Neo 400 tablet 0 0
198 Vitamin Bkomplek 121 tablet 0 0
201 Ventolin Nebules 2,5mg 6,930 ampul 0 0
202 Vitamin dan Mineral (Vitalex) 440 kapsul 0 0
203 Wing Needle 25G 1,400 buah 0 0
207 Zinkid 10mg/5ml 15,729 botol 0 0
OBAT TRADISIONAL
8 Gen-C 97,000 botol 0 0
10 Hemorogard 46,572 kapsul 0 0
12 Jamsi 100ml 88,000 botol 0 0
20 Tensigard 63,800 kotak 0 0
22 Fituno 124,893 dus 0 0
23 Enkasari 17,010 botol 0 0
24 Lacbon 143,000 dus 0 0
25 Batugin Elixir 20,351 botol 0 0
26 Asifit 61,500 dus 0 0
27 Toxilite 25,916 Kotak 0 0
30 Stimuno Syrup 19,646 botol 0 0
31 Stimuno Forte 22,363 kotak 0 0
32 Herba Vomitz 4,703 strip 4 Tab 0 0
PUSKESMAS MAKRAYU
TAHUN 2017
HARGA STOCK
SATUAN (Rp) OPTIMAL

2 Albendazole 400 mg 16,470 tablet 0 0
16 OAT FDC Kat I 359,990 paket 0 0
17 OAT FDC Kat II 1,259,985 paket 0 0
33 Zink 20 mg tab 497 tablet 0 0
34 Antalgin tablet 116 tablet 0 0
38 Cecyl 3,288 tablet 0 0
39 Concor 2,5 746 tablet 0 0
41 Fludane Plus Kaplet 1,065 tablet 0 0
43 Neo Diastop 1,382 tablet 0 0
44 Osteor Kaplet 6,923 tablet 0 0
46 Pehacain injeksi 3,580 ampul 0 0
47 Pehavral 804 tablet 0 0
UMUM BPJS
PUSKESMAS MAKRAYU
PUSTU 30 ILIR
Hj. SrPUSTI 32 ILIR
PUSTU 35 ILIR
PUSTU KEMANG MANIS
JUMLAH

PUSKESMAS : BULAN :
KOTA : TAHUN :
PROVINSI :
PERSEDIAAN
NO
1 BCG
2 TT/ TD
3 DPT

NIP. 19741014512009032001 NIP. 196212121989102001
PEMBERIAN KET
PEMBERIAN KET
Palembang,
Yang Menerima
Petugas Puskesmas
Septiyawati, AMF
NIP. 198609082011012005
LAPORAN PEMAKAIAN DAN PERMINTAAN OBAT ( LPLPO)
PUSKESMAS PEMBANTU 30 ILIR
BULAN :
TAHUN:
STOCK SISA
N0 SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN
AWAL STOCK
UMUM BPJS TOTAL
1 Alat suntik 0,5ml kotak
2 Alat sunti 2,5 / 3 ml set
3 Alat suntik 5 ml Set
4 Albendazole 400 mg tablet
5 Acetosal (Miniaspi 80 mg),100mg tablet
6 Alopurinol 100 mg tablet
8 Aminofilin 200 mg tablet
9 Amlodipin tab 5 mg tablet
11 Amoksisilin syrup 125 mg/ 5ml botol
12 Amoksisilin 250 mg kapsul
13 Amoksisilin 500 mg kaplet
14 Antasida doen tablet tablet
15 Antasida doen suspensi botol
16 Antibakteri salep kombinasi (Bevalex) tube
17 Antifungi doen kombinasi ( white field ) tube
18 Asam Askorbat 50 mg tablet
19 Asam Mefenamat 500 mg tablet
20 Asiklovir krim 5% tube
21 Asiklovir 200 tablet
22 Asikovir 400 tablet
23 Asam folat 0,4 mg tablet
24 Attapulgite (Pularex 630 mg) tablet
25 Betametson krem 0,1 % tube
26 Betahistin Mesilate tablet
27 Borax gliceryn tube
28 Burnazin tube
29 Ciprofloxacin 500 mg tablet
30 Cetrizine 10 mg tablet
31 Cetrizine syr 5 mg botol
32 Dexamethason tabl 0,5 mg tablet
33 Domperidon 10 mg tablet
34 Doksisiklin kapsul 100 mg kapsul

BULAN :
TAHUN:
STOCK SISA
AWAL STOCK
UMUM BPJS TOTAL
35 Etakridin ( Rivanol ) larutan 0,1 % botol
36 Etanol 70 % @ 100 ml botol
37 Eritromycin syr kering 200mg/5ml botol
38 Erythromisin kap 250 mg kapsul
40 Fitomenadion / vit k 10 mg tablet
41 Fenol Glyserol 10 % TT botol
42 Ferro Fumarat + As. Folat (Hemafort) tablet
43 Furosemide 40 mg tablet
44 Garam oralit saset
45 Gentamisin salep mata 0,3 % tube
46 Gentamisin sulfat Ttm 0,3 % botol
47 Gentamisin salep kulit (Gentalex) tube
48 Gemfibrozil 300 mg tablet
49 Griseofulvin tablet
50 Gliseril Guaiakolat/ guaifenisin tablet
51 Glibenklamid 5 mg tablet
52 Hidrokortison 2.5 % krim tube
53 Ibuprofen 400 mg tablet
54 Ibuprofen 100 mg/5ml botol
55 Isosorbid dinitrat 5 mg tablet
56 Kalsium laktat tablet
57 Kasa steril 16 x 16 cm rol
58 Kaptopril 12,5 mg tablet
59 Kaptopril 25mg tablet
60 kassa pcs
61 Ketokenazol cream tube
62 Ketokenazol tab 200 mg tablet
63 Khloramfenikol 250 mg kaps
64 Khloramfenikol salep mata tube
65 Kloramfenikol TT (Reco TT 3%) botol
66 Klindamisin 300 mg kapsul
67 Klorfeniramine maleat (CTM) tablet

BULAN :
TAHUN:
STOCK SISA
AWAL STOCK
UMUM BPJS TOTAL
68 Kotrimoksazol syrup botol
69 Kotrimoksazol tablet dewasa tablet
70 Loratadin 10 mg tablet
71 Loperamid tablet 2 mg tablet
72 Multivitamin Anti Anemia (Livron B-plex) tablet
73 Masker kotak
74 Meloksikam 15 mg tablet
75 Metformin HCl tab 500 mg tablet
76 Metilergometrin tab 0.125 mg tablet
77 Metilprednisolon tab 4 mg tablet
78 Metronidazol 250 mg tablet
80 Metochlopramide 5 mg tablet tablet
81 Mikonazol krem tube
82 Natrium diklofenac 25 mg tablet
84 Nistatin 100 000 UI tab vaginal tablet
85 Nipedipin tablet 10 mg tablet
86 Omeprazol kap 20 mg kapsul
87 OBH Molex syrup 60ml botol
88 Parasetamol syrup botol
89 Parasetamol drop botol
90 Parasetamol 500 mg tablet
91 Papaverin 40 mg tablet
92 Piridoksin (Vit.B6) tab 10 mg tablet
93 Propilthiourasil ( PTU ) tablet
94 Propanolol 10 mg tablet
95 Piroksikam 10 mg tablet
96 pyrantel 125 tablet
97 Prednison 5 mg tablet
98 Ranitidin 150 mg tablet
99 Salbutamol 2 mg tablet
101 Salisyl talk 2% sachet

BULAN :
TAHUN:
STOCK SISA
AWAL STOCK
UMUM BPJS TOTAL

102 Salep -24 pot
103 Sefadroksil sirup kering 125 mg/5ml botol
104 Simvastatin 10 mg tablet
105 Sianokobalamin ( Vit B12 ) tablet tablet
106 Tetrasiklin 250 mg kapsul
108 Thiamin tablet ( Vit B1 ) 50 mg tablet
109 Tablet Tambah Darah Neo tablet
110 Vitamin Bkomplek tablet
111 Vitamin dan Mineral (Vitalex) kapsul
112 Yodium Povidon 30 ml botol
115 Zinkid 10mg/5ml botol
116 Zink tablet 20 mg kaplet
117 Basitracin cream tube
118
119
120
121
122
123
JUMLAH KUNJUNGAN PASIEN UMUM BPJS

PUSTU 30 ILIR
Mengetahui Yang Menyerahkan, Palembang,
Pimpinan Pustu 30 ILIR Petugas Farmasi Puskesmas Yang Menerima,
Widayat Septyawat, AMF Widayat

NIP : 196809161912032010 NIP:198609082011-12005 NIP : 196809161912032010
Palembang,
Yang Menerima,
NIP : 196809161912032010
BULAN :
TAHUN:
STOCK
N0 SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOCK
AWAL
UMUM BPJS TOTAL


BULAN :
TAHUN:
STOCK
AWAL
UMUM BPJS TOTAL


BULAN :
TAHUN:
STOCK
AWAL
UMUM BPJS TOTAL

70 Masker kotak
99 Salep -24 pot
BULAN :
TAHUN:
STOCK
AWAL
UMUM BPJS TOTAL

115
116
117
118
119
120
121
122
123
124

PUSTU 32 ILIR
widayat Septyawat, AMF widayat

NIP : 196809161912032013 NIP:198609082011-12005 NIP : 196809161912032013
Palembang,
Yang Menerima,
NIP : 196809161912032013
BULAN :
TAHUN:
STOCK SISA
AWAL STOCK
UMUM BPJS TOTAL


BULAN :
TAHUN:
STOCK SISA
AWAL STOCK
UMUM BPJS TOTAL


BULAN :
TAHUN:
STOCK SISA
AWAL STOCK
UMUM BPJS TOTAL

70 Masker kotak
99 Salep -24 pot

BULAN :
TAHUN:
STOCK SISA
AWAL STOCK
UMUM BPJS TOTAL

115
116
117
118
119
120
121
122
123
124

PUSTU 35 ILIR
Ade Novarini, SST Septyawat, AMF Ade Novarini, SST

NIP : 198105052009022003 NIP:198609082011-12005 NIP : 198105052009022003
Palembang,
Yang Menerima,
Ade Novarini, SST

NIP : 198105052009022003
PUSKESMAS PEMBANTU KEMANG MANIS
BULAN :
TAHUN:
STOCK SISA
N0 NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN
AWAL STOCK
UMUM BPJS TOTAL

Borax gliceryn tube
Burnazim cream tube

BULAN :
TAHUN:
STOCK SISA
AWAL STOCK
UMUM BPJS TOTAL

Kasa steril 16 x 16 cm psc
62 Kloramfenikol TT botol

BULAN :
TAHUN:
STOCK SISA
AWAL STOCK
UMUM BPJS TOTAL

70 Masker kotak
99 Salep -24 pot
BULAN :
TAHUN:
STOCK SISA
AWAL STOCK
UMUM BPJS TOTAL

115
116
117
118
119
120
121
122
123
124
PUSTU KEMANG MANIS

Pimpinan Pustu Kemang Manis Petugas Farmasi Puskesmas Yang Menerima,
Suryat Septyawat, AMF Suryat

NIP : 196405051984012001 NIP:198609082011-12005 NIP : 196405051984012001
Palembang,
Yang Menerima,
NIP : 196405051984012001

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DINAS KESEHATAN KOTA PALEMBANG

REKAP PERSEDIAAN AKHIR BLUD PUSKESMAS

APBD Kota Palembang HIBAH (BANTUAN)

BHP Saldo Akhir

Plt. Kepala Dinas Kesehatan

dr. Hj. Letizia, M.Kes

OBAT PKD g=e+f I=g-h

54 Diazepam inj 2,486 ampl 25 25 16 9

PROGRAM PROPINSI (Via Gudang Farmasi) g = e+f I=g-h

38 BD Syringe Soloshot mini 0,5ml 165,550 kotak 91 91

82 Glasionomer semen 779,000 botol 7 7

126 Lidokain HCl inj 2% 2ml 879 ampl 184 184 1

170 Prednison 5 mg 66 tablet 1,914 1,914 77

1 Aloeina 60,000 botol 0 0

PROGRAM PROPINSI (Via Gudang Farmasi) g=e+f

Kabid Sumber Daya Kesehatan

LAPORAN KETERSEDIAAN VAKSIN

Yang Menyerahkan Mengetahui

39 Composite 423,500 botol 1 1 1

83 Glimepiride 1 mg 265 tablet 0 0 0

127 Lidokain inj 2% + Efinefrin 2ml komb 1,937 ampl 0 0 0

171 Quinin 200 mg 704 tablet 960 960 960

PROGRAM PROPINSI (Via Gudang Farmasi) g=e+f I=g-h

LAPORAN KETERSEDIAAN VAKSIN

Yang Menyerahkan Mengetahui

39 Composite 423,500 botol 1 1 1

83 Glimepiride 1 mg 265 tablet 0 0 0

127 Lidokain inj 2% + Efinefrin 2ml komb 1,937 ampl 0 0 0

171 Quinin 200 mg 704 tablet 960 960 960

PROGRAM PROPINSI (Via Gudang Farmasi) g=e+f I=g-h

LAPORAN KETERSEDIAAN VAKSIN

39 Composite 423,500 botol 1 1 1

83 Glimepiride 1 mg 265 tablet 0 0 0

127 Lidokain inj 2% + Efinefrin 2ml komb 1,937 ampl 0 0 0

171 Quinin 200 mg 704 tablet 960 960 960

PROGRAM PROPINSI (Via Gudang Farmasi) g=e+f I=g-h

Kabid Sumber Daya Kesehatan

LAPORAN KETERSEDIAAN VAKSIN

Yang Menyerahkan Mengetahui

PUSKESMAS : MAKRAYU BULAN : MEI

38 BD Syringe Soloshot mini 0,5ml 165,550 kotak 87 87 4 83

80 Gentamisin salep kulit (Gentalex) 3,080 tube 71 71 46 25

122 Klorpromazin 100 mg 148 tablet 0 0 0

164 Propilthiourasil ( PTU ) 292 tablet 1,000 1,000 1,000

206 Yodium povidon 300 ml 14771 botol 8 8 8

PROGRAM PROPINSI (Via Gudang Farmasi) g=e+f I=g-h

36 Broxal Elixir 20,100 botol 0 0 0

Kabid Sumber Daya Kesehatan

LAPORAN KETERSEDIAAN VAKSIN

Yang Menyerahkan Mengetahui

PROGRAM PROPINSI (Via Gudang Farmasi) g=e+f I=g-h

Kabid Sumber Daya Kesehatan

LAPORAN KETERSEDIAAN VAKSIN

Yang Menyerahkan Mengetahui

42 Cetrizine 10 mg 145 tablet 0 9,000 9,000 870 8,130

91 Haloperidol 5 mg 100 tablet 387 387 70 317

140 Metronidazol 250 mg 113 tablet 1,075 1,075 150 925

189 Solare Anterior/Pasterior 341,500 botol 0 0 0 0