LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OB

PUSKESMAS

NO NAMA OBAT Satuan STOK awal PENERI PERSE PEMA

an Jan MAAN DIAAN KAIAN
1 Abocat N0.18/ IV CATH set 10 - 10 1
2 Abocat N0.20/ IV CATH set - - - -
3 Abocat N0.22 / IV CATH set 10 - 10 -
4 Abocat N0.24 / IV CATH set 17 - 17 -
5 Accutren Stik Kholesterol kit - - - -
6 Accutren Stik Glukosa kit - - - -
7 Accu chek kit - - - -
8 Acyclovir krim tube 130 100 230 229
9 Acyclovir 200 mg tablet 1,510 - 1,510 421
10 Acyclovir 400 mg tablet 2,165 - 2,165 1,927
11 Air raksa dental use botol - - - -
12 Alat suntik 1 ml set 200 - 200 42
13 Alat suntik 2,5 ml/3 ml set 867 - 867 254
14 Alat suntik 5 ml set 285 - 285 39
15 Albendazol 400 mg tab tablet 200 - 200 2
16 Albothyl/Aptil botol 6 50 56 39
17 Alluporinol tab 100 mg tablet 869 4,000 4,869 2,939
18 Alprazolam 0,5 mg tablet - 500 500 30
19 Ambroxol 30 mg tablet 3,815 4,000 7,815 10,746
20 Ambroxol sirup botol 270 100 370 370
21 Aminofilin tab 200 mg tablet 1,482 - 1,482 970
22 Aminofilin inj. 24 mg/ml ampul - - - -
23 Amitriptilin tab 25 mg tablet 146 - 146 86
24 Amoksisilin tab 250 mg kapsul 1,081 1,200 2,281 1,996
25 Amoksisilin cap 500 mg kapsul 13,935 11,600 25,535 18,015
26 Amoksisilin+asam klavunat tablet - - - -
27 Amoksisilin syr kering 125 mg botol 233 380 613 460
28 Amoksisilin syr kering 250 mg botol 136 - 136 26
NO NAMA OBAT Satuan SISA #VALUE! PERSE #VALUE!
an STOK #VALUE! DIAAN #VALUE!
29 Amlodipin besilat 5 mg - 3,000 3,000 3,461
30 Amlodipin besilat 10 mg tablet 7,230 - 7,230 7,230
31 Antalgin tab 500 mg tablet - - - -
32 Antasida tab doen tablet 7,573 13,000 20,573 24,166
33 Antasida doen suspensi botol - 300 300 170
34 Analog Insulin rapid acting inj 100UI/ml solostar - - - -
35 Anastesi lokal gigi untuk citojet catridge 72 - 72 72
36 anastesi lokal gigi untuk tensi tinggi buah 30 - 30 30
37 Anti bakteri/Basitrasin tube 222 300 522 369
38 Anti bakteri untuk luka bakar/Neocenta tube 202 - 202 21
39 Anti fungi doen salep pot - - - -
40 Anti fungi sirup botol - - - -
41 Anti inflamasi & antipruiritik lotio/Calamec botol - - - -
42 Anti hemoroid supp komb supp 56 260 316 174
43 Anti migrain tab komb tablet 273 - 273 163
44 Antiparkinson tablet kombinasi - - - -
45 Antiseptik cuci tangan tanpa bilas botol 68 - 68 28
46 Anti Tetanus 250 IU ampul 20 - 20 4
47 Antitusif sirup/Dekstrofen sir botol - - - -
48 Aqua pro inj steril 20 bebas pirogen ampul 4 10 14 -
49 Aqua dest steril 500 ml botol - - - -
50 Asam askorbat tab 50 mg tablet 19,603 14,000 33,603 31,890
51 Asam Folat 1 mg tablet 3,700 2,000 5,700 3,969
52 Asam klorida 0,1 N botol - - - -
53 Asam mefenamat tab 500 mg kaplet 5,000 - 5,000 6,254
54 Asam sulfosalisilat 20 % botol - - - -
55 Asam Traneksamat 500 mg/Clonex tablet - - - -
56 Asetosal 80 mg/ Miniaspi tablet 625 200 825 710
57 Asetosal 100 mg tab tablet - - - -
58 Attapulgite (Pularex) tablet 583 - 583 583
59 Atropin sulfat inj 0,25 mg ampul - - - -
NO NAMA OBAT Satuan SISA #VALUE! PERSE #VALUE!
an STOK #VALUE! DIAAN #VALUE!
60 Atropin sulfat tab 0,5 mg tablet - - - -
61 Azitromisin tablet 500 mg tablet 175 - 175 7
62 Bahan Tambalan sementara (Dentorit) pot - - - -
63 Bahan Tambahan Ligt Curing (sinar) ktk 3 - 3 -
64 Bahan pengisi saluran akar kotak 3 - 3 2
65 Bahan Perawatan saluran akar ktk 4 - 4 1
66 Besi syr botol - - - -
67 Betahistin mesilat 6 mg tablet - 600 600 40
68 Betametason krim 0,1 % tube 155 100 255 177
69 Billirubin Direct ktk - - - -
70 Billirubin Total ktk - - - -
71 Bisakodil 5 mg tablet/dulcolax/Laxana tablet 1,024 200 1,224 443
72 Bisakodil suppos 10 mg suppos 18 - 18 18
73 Bisoprolol 5 mg tablet 720 1,000 1,720 596
74 Bisturi no, 11 buah 100 - 100 1
75 Bisturi no, 15 buah 100 - 100 9
76 Bonding Komposite + etching btl 3 - 3 1
77 Bor Gigi set - - - -
78 Captopril tab 25 mg tablet 4,617 10,000 14,617 9,886
79 Captopril tab 12,5 mg tablet 3,795 - 3,795 3,167
80 Catgut No.2/0 sacc 84 - 84 14
81 Catgut No.3/0 sacc 78 - 78 2
82 Cetirizin tab tablet 6,457 3,600 10,057 12,429
83 Cetirizin Syrup botol 87 - 87 87
84 Cimetidin tab 200 mg tablet - - - -
85 Ciprofloxacin tab 500 mg tablet 5,260 - 5,260 3,065
86 Ciprofloxacin tab 250 mg tablet - - - -
87 Clobazam 10 mg tablet 365 - 365 18
88 Clopidogrel tablet 215 - 215 215
89 Creatinin + Standar ktk - - - -
90 Curcuma tab tablet - - - -
NO NAMA OBAT Satuan SISA #VALUE! PERSE #VALUE!
an STOK #VALUE! DIAAN #VALUE!
91 Dentorit/bahan tambalan sementara btl 5 - 5 5
92 Depakene sirup botol 15 - 15 15
93 Devitalisasi pasta pot 1 - 1 1
94 Dexametason inj 5 mg ampul 97 - 97 50
95 Dexametason tab 0,5 mg tablet 8,407 10,000 18,407 15,221
96 Dextrometorfan Hbr syr botol - - - -
97 Dextrometorfan Hbr tab 15 mg tablet 2,800 - 2,800 2,800
98 Diazepam inj 5 mg / ml ampul - - - 35
99 Diazepam 2 mg tab tablet 825 - 825 266
100 Diazepam 5 mg tab tablet - - - -
101 Digoxin tab 0,25 mg tablet 462 - 462 195
102 Diltiazem 30 mg tablet 535 - 535 -
103 Dimenhidrinat tab tablet 290 200 490 787
104 Diphenhidramin Hcl inj ampul - - - -
105 Dirgogesteron 10 mg tablet tablet 200 - 200 -
106 Doksisiklin 100 mg tablet 100 - 100 -
107 Domperidone 10 mg tablet 400 1,000 1,400 1,339
108 Domperidone sirup 5 mg/5 ml sirup 161 100 261 175
109 Domperidon tetes 5 mg/ml botol - - - -
110 Efedrin Hcl 25 mg tablet - - - -
111 Efinefrin Hcl inj 1 mg/ml ampul 36 20 56 16
112 Eperison HCl 50 mg tablet 90 - 90 90
113 Ergokalsiferol tablet - - - -
114 Erytromycin cap 250 mg kapsul - - - -
115 Erytromycin cap 500 mg kapsul 370 1,900 2,270 1,551
116 Erytromycin syr kering 200 mg/5 ml botol 106 100 206 17
117 Etakridin (Rivanol) botol 23 10 33 32
118 Etambutol Hcl tab 250 mg tablet - - - -
119 Etambutol hcl tab 500 mg tablet 100 - 100 1
120 Etanol 70 % 1 l botol - - - -
121 Etanol 100 ml botol 85 - 85 31
NO NAMA OBAT Satuan SISA #VALUE! PERSE #VALUE!
an STOK #VALUE! DIAAN #VALUE!
122 Etil klorida semprot botol 28 - 28 15
123 Etching botol - - - -
124 Eugenol cairan botol 8 - 8 -
125 Extrac beladon tab 10 mg tablet - - - -
126 Famotidine 20 mg tablet - - - -
127 Famotidine 40 mg tablet - - - -
128 Fenitoin Na cap 30 mg kapsul - - - -
129 Fenitoin Na cap 100 mg kapsul 355 700 1,055 948
130 Fenobarbital inj 50 mg ampul - - - -
131 Fenobarbital tab 30 mg tablet 1,862 - 1,862 449
132 Fenofibrat kapsul 100 mg tablet - - - -
133 Fenol gliserol tts telinga botol 107 24 131 48
134 Filler ktk 3 - 3 3
135 Fitomenadion tab 10 mg botol 586 - 586 255
136 Fitomenadion inj 10 mg ampul 29 - 29 9
137 Flukonazol 150 mg tablet 67 - 67 17
138 Fluoksetin 20 mg tab/Courage tablet - - - -
139 Flunarizin tab 5 mg tablet - - - -
140 Flunarizin tab 10 mg/ Sinral tablet - - - -
141 Fluor tab 0,5 mg tablet - - - -
142 Flusinolon asetonid krim 0,025 % tube - - - -
143 Folley catete 2 way no.14 set 2 - 2 -
144 Folley catete 2 way no.16 set 2 - 2 -
145 Folley catete 2 way no.18 set - - - -
146 Formalin tab tablet - - - -
147 Furosemid tab 40 mg tablet 520 - 520 404
148 Ganin tab/gabapentin tablet 90 - 90 50
149 Garam oralit 200 ml bungkus 942 2,400 3,342 1,830
150 Gemfibrozil 300 mg tablet tablet 240 - 240 -
151 Gentamisin injeksi 40 mg/ml ampul - - - -
152 Gentamisin salep kulit 1% tube 77 - 77 77
NO NAMA OBAT Satuan SISA #VALUE! PERSE #VALUE!
an STOK #VALUE! DIAAN #VALUE!
153 Gentamisin salep mata 0,3% tube 113 48 161 137
154 Gentamisin Sulfat tetes mata 0,3% botol 18 54 72 54
155 Gentian Violet botol 23 96 119 60
156 Glass lanomer cement set 9 - 9 9
157 Glibenklamid tab 5 mg tablet 1,055 4,000 5,055 4,120
158 Glikazid 80 mg tablet 485 300 785 235
159 Glimepirid tab 1 mg tablet 1,115 500 1,615 1,480
160 Glimepirid tab 2 mg tablet 2,010 950 2,960 2,960
161 Gliseril guayacolat tab 100 mg tablet 9,689 11,000 20,689 14,727
162 Gliseril Trinitrat sublingual 0,5 mg tablet - - - -
163 Gliserin btl 100ml - - - -
164 Glucose 40 % 25 ml botol - - - -
165 Glucosa lart inf 10 % botol - - - -
166 Glucosa lart inf 5 % botol - - - -
167 Glucose + Standar ktk - - - -
168 GIG Fuji IX botol 4 - 4 -
169 GOT ktk - - - -
170 GPT ktk - - - -
171 Gravinon tab tablet 70 - 70 30
172 Griseofulvin 125 mg tab tablet 2,970 - 2,970 625
173 Hemorogard tablet - - - -
174 Haloperidol tab 0,5 mg tablet - - - -
175 Haloperidol tab 1,5 mg tablet 745 - 745 378
176 Handschoen no 8 set - - - -
177 Handschoen steril No.7,5 set 40 - 40 -
178 Handschoen steril No.7 set 269 - 269 14
179 Handschoen non steril 7,5 set 1,167 - 1,167 238
180 Handschoen non steril 7 pcs 950 - 950 924
181 Hebi scrub botol - - - -
182 Hidroklorotiazid tab 25 mg tablet 140 200 340 145
183 Hidrokortison krim 2,5% tube 306 120 426 575
NO NAMA OBAT Satuan SISA #VALUE! PERSE #VALUE!
an STOK #VALUE! DIAAN #VALUE!
184 Hiosin-n-butilbromida 10 mg/Scopma tablet 954 - 954 402
185 Hyosin Injeksi ampul 76 - 76 -
186 Hustab tablet tablet 5,085 - 5,085 3,945
187 Hustab sirup botol - - - -
188 Ibuprofen tab 200 mg tablet 655 - 655 637
189 Ibuprofen tab 400 mg tablet 1,214 10,000 11,214 6,875
190 Ibuprofen sirup 200 mg/5 ml botol 93 - 93 93
191 Incidal OD tab tablet - - - -
192 Infusion set anak set 10 - 10 -
193 Infusion set dewasa set 10 - 10 -
194 Irbesartan 150 mg tablet tablet 580 2,500 3,080 2,605
195 Isoniazid tab 300 mg tablet 933 - 933 102
196 Isosukprin tablet 20 mg tablet - - - -
197 Isosorbit dinitrat tab 5 mg tablet 120 300 420 261
198 Jarum Kulit No.9 buah - - - -
199 Jarum Kulit No.10 buah - - - -
200 Jarum Kulit No.11 buah - - - -
201 Jarum Kulit No.12 buah - - - -
202 Jarum Kulit No.13 buah - - - -
203 Jarum Kulit No.14 buah - - - -
204 Jarum extirpasi ktk/12 2 - 2 2
205 Kalium Klorida 600 mg tablet tablet - - - -
206 Kalium permanganat serbuk pot - - - -
207 Kalium Slow Release (KSR) tablet 214 - 214 3
208 Kalsium lactat tab 500 mg tablet 5,152 16,000 21,152 14,453
209 Kapas pembalut 250 gram rol 119 - 119 16
210 Kapas berlemak 500 gram rol - - - -
211 Karbamazepin tab 200 mg tablet 860 - 860 30
212 Karbogliserin tetes telinga 10 % botol - - - -
213 Kasa elastis rol - - - -
214 Kasa kompres 40/40 rol 161 - 161 161
NO NAMA OBAT Satuan SISA #VALUE! PERSE #VALUE!
an STOK #VALUE! DIAAN #VALUE!
215 Kasa pembalut 2x80 rol 17 - 17 4
216 Kasa pembalut hidro 4x10 rol 279 - 279 129
217 Kasa pembalut hidro 4x3 rol - - - -
218 Kasa steril 16 x 16 rol - - - 5
219 Kasa hidrofil 40 x 80 cm rol - - - -
220 Kasa 18 x 22 kotak - - - -
221 Katekonazole 200 mg tablet 768 400 1,168 1,008
222 Katekonazole krim 2 % tube 94 192 286 179
223 Ketamin injeksi 100 mg/ml ampul - - - -
224 Ketolorac injeksi 30 mg/ml ampul - - - -
225 KY jelly tube - - - -
226 Klindamycin 150 mg kapsul 500 700 1,200 818
227 Kloramfenikol cap 250 mg kapsul 353 - 353 141
228 Kloramfenicol SM 1 % tube - 24 24 24
229 Klomifen sitrat 50 mg tablet - - - -
230 Kloramfenicol tts telinga 3 % tube - - - -
231 Kloramfenicol tts mata botol - - - -
232 Kloramfenicol syr botol - - - -
233 Klorfeniramin maleat tab 4 mg tablet 15,197 10,500 25,697 14,631
234 Kloroquin 150 mg tab tablet - - - -
235 Klorpromazin Hcl tab 100 mg tablet 75 - 75 45
236 Klorpromazin Hcl tab 25 mg tablet - - - -
237 Kodein 10 mg tablet 65 - 65 95
238 Kolesterol + Standar ktk - - - -
239 Kotrimoksazol ped tab 120 mg tablet - - - -
240 Kotrimoksazol suspensi kombinasi botol 204 - 204 101
241 Kotrimoksazol Doen tab 480 mg tablet 170 200 370 190
242 Lactobasilus acidofilus (Lacto-B) sacc - - - -
243 Lansoprazol tablet 170 1,660 1,830 2,243
244 Lar.mengandung karbohidrat,elektrolit botol - - - -
245 Lart.asam asetat 100 ml botol - - - -
NO NAMA OBAT Satuan SISA #VALUE! PERSE #VALUE!
 an STOK #VALUE! DIAAN #VALUE!
246 Lart.Benedict botol - - - -
247 Lart.Carbol fulcin botol - - - -
248 Lart.Eosin 2 % botol - - - -
249 Lart.Etanol asam botol - - - -
250 Lart .Gabbet botol - - - -
251 Lart.Giemsa Stain botol - - - -
252 Lart.Kihyoun botol - - - -
253 Lart.Metilen biru botol - - - -
254 Lart.Na.Citrat 3,8 % botol - - - -
255 Lart.turk botol - - - -
256 Lart.Yodium 1 % botol - - - -
257 Lart.Yodium 2 % botol - - - -
258 Levofloksasin tab 500 tablet 120 - 120 30
259 Lidocain inj 2 % ampul 477 - 477 28
260 Lidokain jeli 2 % syrg - - - -
261 Lidocain comp inj 2 %/Pehacain ampul 459 140 599 309
262 Lisinopril tablet 10 mg tablet - - - -
263 Lisol botol - - - -
264 Livron B Plek/Dasabion tablet 210 - 210 210
265 Loperamid 2 mg tablet tablet 1,870 500 2,370 712
266 Loratadin 10 mg tablet tablet 161 600 761 266
267 Lysmin syr botol - - - -
268 Magnesium Sulfat inj 40 % ampul - - - -
269 Masker set 2,903 - 2,903 633
270 Mecobalamin 500 mcg/Oxicobal tablet - 1,000 1,000 450
271 Meloxicam 15 mg tab tablet 920 - 920 520
272 Mebendazol tab 100 mg tablet - - - -
273 Metakreosol kondensat botol - - - -
274 Metampiron (Neurodial) tab tablet - - - -
275 Metanol botol - - - -
276 Metformin 500 mg tablet 6,720 9,500 16,220 18,710
NO NAMA OBAT Satuan SISA #VALUE! PERSE #VALUE!
an STOK #VALUE! DIAAN #VALUE!
277 Metformin 850 mg tablet 650 - 650 650
278 Metil dopa 250 mg tablet tablet 235 - 235 35
279 Metil ergometrin maleat tab tablet 130 - 130 100
280 Metil ergometrin injeksi ampul - - - -
281 Metil prednisolon 4 mg tablet 900 5,900 6,800 5,849
282 Metoklopramid Hcl 10 mg tablet - - - -
283 Metronidazol tab 500 mg tablet 420 1,300 1,720 1,253
284 Metronidazol tab 250 mg tablet 100 - 100 100
285 Metronidazol supp 500 mg supp 207 - 207 10
286 Metronidazol larutan infus 5 mg/ml tablet - - - -
287 Miconazol krim 2 % tube - 408 408 314
288 Mometason furoat krim 0,1% tube 79 - 79 17
289 Monoklor kamfer mentol cair botol 11 - 11 11
290 Multivitamin sirup / Lytacur/biovitan botol 60 ml - 12 12 12
291 Mummiying pasta botol 2 - 2 2
292 Na.bikarbonat tab 500 mg tablet 5,080 1,000 6,080 2,490
293 Na.klorida inf 0.9 % botol 24 - 24 23
294 Natrium fusidat salep 20 mg/g(Fucilex) tube 17 100 117 38
295 Neddle carpule pcs 404 - 404 59
296 Naso Gastric Tube (NGT) N0. 18 set - - - -
297 Na.tiosulfat inj 25 % 10 ml botol - - - -
298 Natrium diklofenat 25 mg tablet - - - -
299 Natrium diklofenat 50 mg tablet 3,240 4,800 8,040 10,252
300 Neurovit E/neurotropik vit/Bioron tablet 323 500 823 373
301 Nifedipin tab tablet 506 - 506 78
302 Nistatin drops/Cazetin botol - - - -
303 Nistatin tab vag 100.000 tablet 210 - 210 85
304 Nistatin tab gula 500.000 tablet - - - -
305 Noretisteron tablet 5 mg tablet - - - -
306 Noza tablet 5,966 - 5,966 4,511
307 OAT anak paket 2 - 2 2
NO NAMA OBAT Satuan SISA #VALUE! PERSE #VALUE!
an STOK #VALUE! DIAAN #VALUE!
308 OAT kategori I paket 7 8 15 14
309 OAT kategori II paket 7 - 7 7
310 OAT sisipan paket - - - -
311 Obat batuk hitam (obh) botol 498 120 618 618
312 Obat batuk hitam (obh) plus botol - - - -
313 Occo btl 1 - 1 -
314 Ofloxacin 400 mg tablet - - - -
315 Oksimetazolin tetes hidung 0,025% botol 22 - 22 -
316 Oksitosin injeksi ampul - - - -
317 Oksitetrasiklin Hcl 3% tube 84 50 134 81
318 Oksitetrasiklin Hcl SM 1 % tube 96 - 96 47
319 Oksitocin inj ampul - - - -
320 Omeprazol 20 mg tablet 2,072 4,110 6,182 6,182
321 Omeprazol injeksi 40 mg/10 ml ampul 5 - 5 5
322 Ondansetron injeksi 4 mg/2 ml ampul 40 - 40 5
323 Ondansetron tablet 4 mg tablet 210 - 210 99
324 Papaverin 40 mg tablet 236 - 236 121
325 Papaverin 40 mg/ml ampul - - - -
326 Parasetamol drop botol 114 335 449 198
327 Parasetamol suppos supp 76 - 76 30
328 Paracetamol syr 125 mg/5ml botol 302 300 602 652
329 Paracetamol tab 500 mg tablet 12,734 20,000 32,734 34,234
330 Pehavral tablet - 10,800 10,800 8,717
331 Pembalut Gips 3 (7,5 cm) roll - - - -
332 Permetrin krim 5% tube - - - -
333 Petidin inj ampul - - - -
334 Piracetam 400 mg tablet 755 - 755 65
335 Piracetam 800 mg tablet - - - -
336 Piracetam inj ampul - - - -
337 Pirantel pamoat tab 125 mg tablet 928 - 928 195
338 Pirantel sirup 125mg/5ml botol 55 - 55 55
NO NAMA OBAT Satuan SISA #VALUE! PERSE #VALUE!
an STOK #VALUE! DIAAN #VALUE!
339 Pirazinamid tab tablet 606 - 606 9
340 Piridoxin Hcl tab 10 mg tablet 5,542 - 5,542 4,342
341 Piroksikam tab 10 mg tablet 1,730 1,200 2,930 1,303
342 Piroksikam tab 20 mg tablet - - - -
343 Plastik klip 10 x 7 bungkus - - - -
344 Plester 5 Yard x 2 inch roll - - - -
345 Plester berpori/Hypafix pcs 29 - 29 7
346 Plester kertas hipoalergenik 1 inchi pcs 34 24 58 10
347 Polikresulen cairan botol - - - -
348 Porimokresol botol - - - -
349 Pravastatin 20 mg tablet 390 200 590 500
350 Prednison tab 5 mg tablet 2,318 - 2,318 1,401
351 Primakuin tab 15 mg tablet - - - -
352 Prokain Penisilin G 3 juta inj ampul - - - -
353 Propanolol Hcl tab 10 mg tablet - - - -
354 Propanolol Hcl tab 40 mg tablet 999 - 999 424
355 Propiltiourasil tab 100 mg tablet 905 - 905 220
356 Protein Total + Standar ktk - - - -
357 Ranitidin tab tablet 5,197 - 5,197 5,107
358 Ranitidin injeksi 25 mg/2 ml ampul 59 - 59 19
359 Reagen drabkin set - - - -
360 Reagen gol darah A,B,AB,O set - - - -
361 Reagen PP test ktk - - - -
362 Reagen Sodium Bicarbonat btl - - - -
363 Reagen Uric acid TBHA kit - - - -
364 Reamer ktk/6 3 - 3 1
365 Rees Ecker btl - - - -
366 Retinol (Vit A) caps 200.000 IU tablet 481 2,550 3,031 4,732
367 Retinol (Vit A) caps 100.000 IU tablet 194 400 594 698
368 Rifampicin cap 600 mg tablet - - - -
369 Rifampicin cap 300 mg tablet 515 - 515 -
NO NAMA OBAT Satuan SISA #VALUE! PERSE #VALUE!
an STOK #VALUE! DIAAN #VALUE!
370 Rifampisin cap 450 mg tablet 139 - 139 16
371 Ringer laktat Botol 18 - 18 5
372 Salap 2 - 4 komb pot 48 - 48 17
373 Salbutamol tab 2 mg tablet 605 3,000 3,605 2,793
374 Salbutamol tab 4 mg 855 - 855 155
375 Salbutamol inhalasi/aerosol 100 mcg/ds - - - -
376 Salisil bedak 2 % bungkus 109 100 209 181
377 Scabimit cream tube 50 - 50 21
378 Sefadroxil 500 mg kapsul 1,320 3,000 4,320 5,180
379 Sefadroxil sirker botol 48 48 96 83
380 Sefixime tablet 100 mg tablet 330 - 330 226
381 Sefixime sirup kering 100 mg/5ml - - - -
382 Sefotaksim tablet - - - -
383 Sefotaxim injeksi 1,0 g vial - - - -
384 Sianokobalamin inj ampul - - - -
385 Silk N0.3/0 sacc 2 - 2 2
386 Silver Amalgam serbuk botol - - - -
387 Simvastatin tab 10 mg tablet 1,034 6,720 7,754 8,574
388 Simvastatin 20 mg tablet 340 500 840 840
389 Spiranolacton 25 mg tablet 90 - 90 90
390 Spiritus 500 ml botol - - - -
391 Spongelatin buah - - - -
392 Stesolid rectal tube 78 - 78 3
393 Stimuno tablet tablet - - - -
394 Stimuno sirup botol - - - -
395 Tab. tambah darah komb tablet - 8,539 8,539 5,759
396 Temporary stopping fletcher set - - - -
397 Tamsulosin tablet SR 0,4 mg tablet - - - -
398 Theofilin 300 mg tablet tablet - - - -
399 Tetrahidrozolin tetes mata/Ailin botol 56 - 56 35
400 Tetrasiklin Hcl cap 250 mg capsul - - - -
NAMA OBAT Satuan SISA #VALUE! PERSE #VALUE!
an STOK #VALUE! DIAAN #VALUE!
401 Tetrasiklin Hcl cap 500 mg capsul - - - -
402 Tetrakain HCl tetes mata 0,5% botol 4 - 4 4
403 Thiamin Hcl tab 50 mg tablet 9,174 19,000 28,174 22,236
404 Thiamin Hcl inj ampul - - - -
405 Tramadol 50 mg tablet 240 - 240 102
406 Triheksipenidil tablet - 1,000 1,000 154
407 Trikresol formalin cairan botol - - - -
408 Tripolidine HCl, Pseudoefedrin HCl sirup botol - - - -
409 Urine bag set - - - -
410 Valproat tablet SR 250 mg tablet - - - -
411 Ventolin nebuliser ampul 59 - 59 30
412 Vitamin B komplek tab tablet 4,758 7,000 11,758 13,231
413 Vit D3 aktif (Kolkatriol) kapsul - - - -
414 Wing nedle No.21 set - - - -
415 Wing nedle No.23 set - - - -
416 Wing nedle No.25 set - - - -
417 Wing nedle No.27 set - - - -
418 Xylol botol - - - -
419 Yodium povidon lart.10% 30 ml botol 52 - 52 6
420 Yodium povidon lart.10% 300 ml botol 15 - 15 3
421 Zink tablet dispersible 20 mg tablet 1,044 3,500 4,544 2,647
422 Zinc Sirup 20 mg/5 botol 45 - 45 45
423 Zinc drops 10 mg/ml botol 25 - 25 8
424 Anvomer tablet 201 120 321 305
425 Asifit tablet - - - -
426 Farmaton kapsul - - - -
427 Geriavita tablet - 150 150 -
428 Natavit tablet - - - -
429 Osteotin tablet - - - -
430 Toxilite tablet - - - -
431 Tuzalos tablet 70 200 270 270
NO NAMA OBAT Satuan SISA #VALUE! PERSE #VALUE!
an STOK #VALUE! DIAAN #VALUE!
432 Megatic Emulgel tube - - - -
433 Hico Gel tube - - - -
434 Truvit Sirup botol - - - -
435 Simbicort inhaler set - 10 10 2
436 Pulmicort nebulizer ampul 40 20 60 10
437 Adver tablet - - - -
438 Asetilsistein tablet tablet 200 400 600 30
439 Bisolvon extra sirup botol - - - -
440 FG Troches tablet - - - -
441 Alkohol Swab kotak 34 - 34 7
442 Becefort tablet tablet 654 - 654 654
443 Benzatin benzil penisillin ampul 5 - 5 -
444 Isotic neolyson botol 10 - 10 4
445 Salbutamol sirup botol 98 - 98 59
446 Wood pepermint ekspektoran sirup botol - - - -
447 Accucheck Performa box 36 - 36 27
448 Strip Asam Urat box 18 - 18 10
449 Strip Hb box 8 - 8 6
450 Accucheck safe Pro T-Pro (lancet) box 15 - 15 -
451 Reagen gol darah A,B,AB,O box 1 - 1 1
452 Strip Accu Cholesterol box 18 - 18 -
453 Bahan resin komposite kotak 1 - 1 -
454 Semen seng fosfat set 1 - 1 -
455 Pepper Poin set 1 - 1 -
456 Mata bur set 1 - 1 -
457 Nald Hecting segitiga no.11 lusin 3 - 3 -
458 Dariantule kotak/10 1 - 1 -
459 Spalk unit 1 - 1 -
460 Doek lobang 30 cm X 30 cm pcs 10 - 10 1
461 H2O2 3% botol 2 - 2 1
462 Yodium Povidon 60 ml botol - 48 48 6
463 Kotrimoksazol 960 mg tablet - 1,000 1,000 -
464 Obat Anti Malaria (Dihidroartemisin Piperaquin) - 45 45 9
465 Bionemi tablet - 500 -

Menyetujui Yang Menyerahkan

Kepala Dinas Kesehatan Kota Pekanbaru Kepala UPTD Instalasi Farmasi

Drg. HELDA SURYANI MUNIR, M.Kes

NIP.19700608 200212 2 003
N LEMBAR PERMINTAAN OBAT
PUSKESMAS : SAIL BULAN : SEPTEMBER
TAHUN : 2017
SISA STOK PERMIN PEMBERIAN
STOK OPT TAAN INPRES ASKES APBD LAIN JML KET
9 (9)
- 0
10 (10)
17 (17)
- 0
- 0
- 0
1 195
1,089 (1,009)
238 500
- 0
158 (138)
613 (431)
246 200
198 (194)
17 50
1,930 (50)
470 (410)
(2,931) 11,937
- 300
512 (162)
- 0
60 100
285 815
7,520 3,182
- 0
153 100
110 (104)
SISA STOK PERMIN PEMBERIAN
STOK OPT TAAN INPRES ASKES APBD LAIN JML KET
(461) 3,000
- 3,000
- 0
(3,593) 21,145
130 300
- 0
- 0
- 0
153 131
181 (177)
- 0
- 0
- 0
142 (80)
110 (38)
- 0
40 (40)
16 (16)
 - 200
14 (14)
- 0
1,713 20,235
1,731 (1,097)
- 0
(1,254) 6,026
- 0
- 0
115 135
- 0
- 0
- 0
SISA STOK PERMIN PEMBERIAN
STOK OPT TAAN INPRES ASKES APBD LAIN JML KET
- 0
168 (154)
- 0
3 (3)
1 1
3 (3)
- 0
560 (480)
78 (14)
- 0
- 0
781 (535)
- 0
1,124 (644)
99 (99)
91 (87)
2 (2)
- 0
4,731 2,500
628 1,000
70 (68)
76 (72)
(2,372) 2,500
- 0
- 0
2,195 (425)
- 0
347 (347)
- 200
- 0
- 500
SISA STOK PERMIN PEMBERIAN
STOK OPT TAAN INPRES ASKES APBD LAIN JML KET
- 0
- 0
- 2
47 53
3,186 9,078
 - 0
- 0
(35) 105
559 (383)
- 0
267 (267)
535 (535)
(297) 905
- 0
200 (200)
100 100
61 1,165
86 150
- 0
- 0
40 (40)
- 40
- 0
- 0
719 863
189 (171)
1 9
- 0
99 (99)
- 0
54 (52)
SISA STOK PERMIN PEMBERIAN
STOK OPT TAAN INPRES ASKES APBD LAIN JML KET
13 (1)
- 0
8 (8)
- 0
- 0
- 0
- 0
107 313
- 0
1,413 (1,073)
- 0
83 50
- 0
331 (241)
20 (20)
50 (50)
- 0
- 0
- 500
- 0
- 0
2 (2)
2 (2)
- 0
- 0
 116 96
40 100
1,512 196
240 (240)
- 0
- 200
SISA STOK PERMIN PEMBERIAN
STOK OPT TAAN INPRES ASKES APBD LAIN JML KET
24 150
18 100
59 100
- 0
935 2,000
550 (450)
135 5,000
- 5,000
5,962 12,000
- 0
- 0
- 0
- 0
- 0
- 0
4 (4)
- 0
- 0
40 (40)
2,345 (2,065)
- 0
- 0
367 133
- 0
40 (40)
255 (233)
929 (787)
26 134
- 0
195 33
(149) 633
SISA STOK PERMIN PEMBERIAN
STOK OPT TAAN INPRES ASKES APBD LAIN JML KET
552 (256)
76 (76)
1,140 3,120
- 200
18 1,000
4,339 1,000
- 0
- 0
10 (10)
10 (10)
475 (475)
831 (801)
 - 0
159 43
- 0
- 0
- 0
- 0
- 0
- 0
- 0
- 0
- 0
211 (211)
6,699 971
103 (99)
- 0
830 (810)
- 0
- 0
- 0
SISA STOK PERMIN PEMBERIAN
STOK OPT TAAN INPRES ASKES APBD LAIN JML KET
13 (5)
150 (126)
- 0
(5) 15
- 0
- 0
160 130
107 (11)
- 0
- 0
- 0
382 500
212 (212)
- 100
- 0
- 100
- 100
- 0
11,066 5,000
- 0
30 0
- 0
(30) 150
- 0
- 0
103 9
180 (80)
- 0
(413) 1,839
- 0
- 0
SISA STOK PERMIN PEMBERIAN
STOK OPT TAAN INPRES ASKES APBD LAIN JML KET
- 0
- 0
- 0
- 0
- 0
- 0
- 0
- 0
- 0
- 0
- 0
- 0
90 (90)
449 (421)
- 0
290 (110)
- 0
- 0
- 0
1,658 (696)
495 (245)
- 0
- 0
2,270 (1,930)
550 1,000
400 200
- 0
- 0
- 0
- 0
(2,490) 14,090
SISA STOK PERMIN PEMBERIAN
STOK OPT TAAN INPRES ASKES APBD LAIN JML KET
- 500
200 (200)
30 (30)
- 0
951 2,057
- 0
467 500
- 0
197 (177)
- 0
94 150
62 (60)
- 0
- 0
- 0
3,590 (3,200)
1 7
79 (69)
345 (315)
 - 0
- 0
- 0
(2,212) 8,832
450 (350)
428 (404)
- 0
125 (115)
- 0
- 0
1,455 2,500
- 1
SISA STOK PERMIN PEMBERIAN
STOK OPT TAAN INPRES ASKES APBD LAIN JML KET
1 6
- 1
- 0
- 300
- 200
1 (1)
- 0
22 (22)
- 0
53 (35)
49 (37)
- 0
- 500
- 0
35 (35)
111 (111)
115 (55)
- 0
251 (83)
46 (46)
(50) 350
(1,500) 20,000
2,083 3,893
- 0
- 0
- 0
690 100
- 0
- 0
733 (673)
- 50
SISA STOK PERMIN PEMBERIAN
STOK OPT TAAN INPRES ASKES APBD LAIN JML KET
597 (597)
1,200 1,280
1,627 (1,221)
- 200
- 0
- 0
 22 (16)
48 (48)
- 0
- 0
90 500
917 (677)
- 0
- 0
- 100
575 200
685 (655)
- 0
90 3,000
40 (24)
- 0
- 0
- 0
- 0
- 0
2 (2)
- 0
(1,701) 5,785
(104) 704
- 0
515 (515)
SISA STOK PERMIN PEMBERIAN
STOK OPT TAAN INPRES ASKES APBD LAIN JML KET
123 (93)
13 (13)
31 24
812 1,000
700 (700)
- 0
28 90
29 (21)
(860) 4,470
13 50
104 206
- 0
- 0
- 0
- 0
- 0
- 0
(820) 5,710
- 1,000
- 0
- 0
- 0
75 10
- 1,000
- 1,000
2,780 3,090
 - 0
- 0
- 0
21 50
- 0
SISA STOK PERMIN PEMBERIAN
STOK OPT TAAN INPRES ASKES APBD LAIN JML KET
- 0
- 0
5,938 5,000
- 0
138 (134)
846 (706)
- 0
- 0
- 0
- 0
29 (27)
(1,473) 3,000
- 0
- 0
- 0
- 0
- 0
- 0
46 (44)
12 (10)
1,897 1,000
- 0
17 (15)
16 124
- 0
- 0
150 (150)
- 0
- 0
- 0
- 400
SISA STOK PERMIN PEMBERIAN
STOK OPT TAAN INPRES ASKES APBD LAIN JML KET
- 0
- 0
- 0
8 (4)
50 (50)
- 0
570 (570)
- 0
- 0
27 (27)
- 0
5 (5)
6 (6)
 39 1
- 0
9 (9)
8 (8)
2 (2)
15 (15)
- 0
18 (18)
1 (1)
1 (1)
1 (1)
1 (1)
3 (3)
1 (1)
1 (1)
9 (9)
1 (1)
42 (42)
1,000 (1,000)
36 (18)
0

Yang Melapor Yang Menerima

Kepala BLUD Puskesmas Sail Petugas Puskesmas

JENNY SUSANTRI, S.Farm, Apt

NIP.19811031 200501 2 006
Paracetamol tab 500 mg 34234
Asam askorbat tab 50 mg 31890
Antasida tab doen 24166
Thiamin Hcl tab 50 mg 22236
Metformin 500 mg 18710
Amoksisilin cap 500 mg 18015
Dexametason tab 0,5 mg 15221
Gliseril guayacolat tab 100 mg 14727
Klorfeniramin maleat tab 4 mg 14631
Kalsium lactat tab 500 mg 14453
Vitamin B komplek tab 13231
Cetirizin tab 12429
Ambroxol 30 mg 10746
Natrium diklofenat 50 mg 10252
Captopril tab 25 mg 9886
Pehavral 8717
Simvastatin tab 10 mg 8574
Amlodipin besilat 10 mg 7230
Ibuprofen tab 400 mg 6875
Asam mefenamat tab 500 mg 6254
Omeprazol 20 mg 6182
Metil prednisolon 4 mg 5849
Tab. tambah darah komb 5759
Sefadroxil 500 mg 5180
Ranitidin tab 5107
Retinol (Vit A) caps 200.000 IU 4732
Noza 4511
Piridoxin Hcl tab 10 mg 4342
Glibenklamid tab 5 mg 4120
Asam Folat 1 mg 3969
Hustab tablet 3945
Amlodipin besilat 5 mg 3461
Captopril tab 12,5 mg 3167
Ciprofloxacin tab 500 mg 3065
Glimepirid tab 2 mg 2960
Alluporinol tab 100 mg 2939
Dextrometorfan Hbr tab 15 mg 2800
Salbutamol tab 2 mg 2793
Zink tablet dispersible 20 mg 2647
Irbesartan 150 mg tablet 2605
Na.bikarbonat tab 500 mg 2490
Lansoprazol 2243
Amoksisilin tab 250 mg 1996
Acyclovir 400 mg 1927
Garam oralit 200 ml 1830
Erytromycin cap 500 mg 1551
Glimepirid tab 1 mg 1480
Prednison tab 5 mg 1401
Domperidone 10 mg 1339
Piroksikam tab 10 mg 1303
Metronidazol tab 500 mg 1253
Katekonazole 200 mg 1008
Aminofilin tab 200 mg 970
Fenitoin Na cap 100 mg 948
Handschoen non steril 7 924
Simvastatin 20 mg 840
Klindamycin 150 mg 818
Dimenhidrinat tab 787
Loperamid 2 mg tablet 712
Asetosal 80 mg/ Miniaspi 710
Retinol (Vit A) caps 100.000 IU 698
Becefort tablet 654
Paracetamol syr 125 mg/5ml 652
Metformin 850 mg 650
Ibuprofen tab 200 mg 637
Masker 633
Griseofulvin 125 mg tab 625
Obat batuk hitam (obh) 618
Bisoprolol 5 mg 596
Attapulgite (Pularex) 583
Hidrokortison krim 2,5% 575
Meloxicam 15 mg tab 520
Pravastatin 20 mg 500
Amoksisilin syr kering 125 mg 460
Mecobalamin 500 mcg/Oxicobal 450
Fenobarbital tab 30 mg 449
Bisakodil 5 mg tablet/dulcolax/Lax 443
Propanolol Hcl tab 40 mg 424
Acyclovir 200 mg 421
Furosemid tab 40 mg 404
Hiosin-n-butilbromida 10 mg/Scop 402
Haloperidol tab 1,5 mg 378
Neurovit E/neurotropik vit/Bioron 373
Ambroxol sirup 370
Anti bakteri/Basitrasin 369
Miconazol krim 2 % 314
Lidocain comp inj 2 %/Pehacain 309
Anvomer 305
Tuzalos 270
Diazepam 2 mg tab 266
Loratadin 10 mg tablet 266
Isosorbit dinitrat tab 5 mg 261
Fitomenadion tab 10 mg 255
Alat suntik 2,5 ml/3 ml 254
Handschoen non steril 7,5 238
Glikazid 80 mg 235
Acyclovir krim 229
Sefixime tablet 100 mg 226
Propiltiourasil tab 100 mg 220
Clopidogrel 215
Livron B Plek/Dasabion 210
Parasetamol drop 198
Digoxin tab 0,25 mg 195
Pirantel pamoat tab 125 mg 195
Kotrimoksazol Doen tab 480 mg 190
Salisil bedak 2 % 181
Katekonazole krim 2 % 179
Betametason krim 0,1 % 177
Domperidone sirup 5 mg/5 ml 175
Anti hemoroid supp komb 174
Antasida doen suspensi 170
Anti migrain tab komb 163
Kasa kompres 40/40 161
Salbutamol tab 4 mg 155
Triheksipenidil 154
Hidroklorotiazid tab 25 mg 145
Kloramfenikol cap 250 mg 141
Gentamisin salep mata 0,3% 137
Kasa pembalut hidro 4x10 129
Papaverin 40 mg 121
Isoniazid tab 300 mg 102
Tramadol 50 mg 102
Kotrimoksazol suspensi kombinasi 101
Metil ergometrin maleat tab 100
Metronidazol tab 250 mg 100
Ondansetron tablet 4 mg 99
Kodein 10 mg 95
Ibuprofen sirup 200 mg/5 ml 93
Eperison HCl 50 mg 90
Spiranolacton 25 mg 90
Cetirizin Syrup 87
Amitriptilin tab 25 mg 86
Nistatin tab vag 100.000 85
Sefadroxil sirker 83
Oksitetrasiklin Hcl 3% 81
Nifedipin tab 78
Gentamisin salep kulit 1% 77
Anastesi lokal gigi untuk citojet 72
Piracetam 400 mg 65
Gentian Violet 60
Neddle carpule 59
Salbutamol sirup 59
Pirantel sirup 125mg/5ml 55
Gentamisin Sulfat tetes mata 0,3% 54
Dexametason inj 5 mg 50
Ganin tab/gabapentin 50
Fenol gliserol tts telinga 48
Oksitetrasiklin Hcl SM 1 % 47
Klorpromazin Hcl tab 100 mg 45
Zinc Sirup 20 mg/5 45
Alat suntik 1 ml 42
Betahistin mesilat 6 mg 40
Alat suntik 5 ml 39
Albothyl/Aptil 39
Natrium fusidat salep 20 mg/g(Fuci 38
Diazepam inj 5 mg / ml 35
Metil dopa 250 mg tablet 35
Tetrahidrozolin tetes mata/Ailin 35
Etakridin (Rivanol) 32
Etanol 100 ml 31
Alprazolam 0,5 mg 30
anastesi lokal gigi untuk tensi tingg 30
Gravinon tab 30
Karbamazepin tab 200 mg 30
Levofloksasin tab 500 30
Parasetamol suppos 30
Ventolin nebuliser 30
Asetilsistein tablet 30
Antiseptik cuci tangan tanpa bilas 28
Lidocain inj 2 % 28
Accucheck Performa 27
Amoksisilin syr kering 250 mg 26
Kloramfenicol SM 1 % 24
Na.klorida inf 0.9 % 23
Anti bakteri untuk luka bakar/Neoc 21
Scabimit cream 21
Ranitidin injeksi 25 mg/2 ml 19
Bisakodil suppos 10 mg 18
Clobazam 10 mg 18
Erytromycin syr kering 200 mg/5 m 17
Flukonazol 150 mg 17
Mometason furoat krim 0,1% 17
Salap 2 - 4 komb 17
Efinefrin Hcl inj 1 mg/ml 16
Kapas pembalut 250 gram 16
Rifampisin cap 450 mg 16
Depakene sirup 15
Etil klorida semprot 15
Catgut No.2/0 14
Handschoen steril No.7 14
OAT kategori I 14
Multivitamin sirup / Lytacur/biovita 12
Monoklor kamfer mentol cair 11
Metronidazol supp 500 mg 10
Plester kertas hipoalergenik 1 inch 10
Pulmicort nebulizer 10
Strip Asam Urat 10
Bisturi no, 15 9
Fitomenadion inj 10 mg 9
Glass lanomer cement 9
Pirazinamid tab 9
Obat Anti Malaria (Dihidroartemisi 9
Zinc drops 10 mg/ml 8
Azitromisin tablet 500 mg 7
OAT kategori II 7
Plester berpori/Hypafix 7
Alkohol Swab 7
Yodium povidon lart.10% 30 ml 6
Strip Hb 6
Yodium Povidon 60 ml 6
Dentorit/bahan tambalan sementar 5
Kasa steril 16 x 16 5
Omeprazol injeksi 40 mg/10 ml 5
Ondansetron injeksi 4 mg/2 ml 5
Ringer laktat 5
Anti Tetanus 250 IU 4
Kasa pembalut 2x80 4
Tetrakain HCl tetes mata 0,5% 4
Isotic neolyson 4
Filler 3
Kalium Slow Release (KSR) 3
Stesolid rectal 3
Yodium povidon lart.10% 300 ml 3
Albendazol 400 mg tab 2
Bahan pengisi saluran akar 2
Catgut No.3/0 2
Jarum extirpasi 2
Mummiying pasta 2
OAT anak 2
Silk N0.3/0 2
Simbicort inhaler 2
Abocat N0.18/ IV CATH 1
Bahan Perawatan saluran akar 1
Bisturi no, 11 1
Bonding Komposite + etching 1
Devitalisasi pasta 1
Etambutol hcl tab 500 mg 1
Reamer 1
Reagen gol darah A,B,AB,O 1
Doek lobang 30 cm X 30 cm 1
H2O2 3% 1
Abocat N0.20/ IV CATH 0
Abocat N0.22 / IV CATH 0
Abocat N0.24 / IV CATH 0
Accutren Stik Kholesterol 0
Accutren Stik Glukosa 0
Accu chek 0
Air raksa dental use 0
Aminofilin inj. 24 mg/ml 0
Amoksisilin+asam klavunat 0
Antalgin tab 500 mg 0
Analog Insulin rapid acting inj 100 0
Anti fungi doen salep 0
Anti fungi sirup 0
Anti inflamasi & antipruiritik lotio/ 0
Antiparkinson tablet kombinasi 0
Antitusif sirup/Dekstrofen sir 0
Aqua pro inj steril 20 bebas piroge 0
Aqua dest steril 500 ml 0
Asam klorida 0,1 N 0
Asam sulfosalisilat 20 % 0
Asam Traneksamat 500 mg/Clone 0
Asetosal 100 mg tab 0
Atropin sulfat inj 0,25 mg 0
Atropin sulfat tab 0,5 mg 0
Bahan Tambalan sementara (Dentor 0
Bahan Tambahan Ligt Curing (sina 0
Besi syr 0
Billirubin Direct 0
Billirubin Total 0
Bor Gigi 0
Cimetidin tab 200 mg 0
Ciprofloxacin tab 250 mg 0
Creatinin + Standar 0
Curcuma tab 0
Dextrometorfan Hbr syr 0
Diazepam 5 mg tab 0
Diltiazem 30 mg 0
Diphenhidramin Hcl inj 0
Dirgogesteron 10 mg tablet 0
Doksisiklin 100 mg 0
Domperidon tetes 5 mg/ml 0
Efedrin Hcl 25 mg 0
Ergokalsiferol 0
Erytromycin cap 250 mg 0
Etambutol Hcl tab 250 mg 0
Etanol 70 % 1 l 0
Etching 0
Eugenol cairan 0
Extrac beladon tab 10 mg 0
Famotidine 20 mg 0
Famotidine 40 mg 0
Fenitoin Na cap 30 mg 0
Fenobarbital inj 50 mg 0
Fenofibrat kapsul 100 mg 0
Fluoksetin 20 mg tab/Courage 0
Flunarizin tab 5 mg 0
Flunarizin tab 10 mg/ Sinral 0
Fluor tab 0,5 mg 0
Flusinolon asetonid krim 0,025 % 0
Folley catete 2 way no.14 0
Folley catete 2 way no.16 0
Folley catete 2 way no.18 0
Formalin tab 0
Gemfibrozil 300 mg tablet 0
Gentamisin injeksi 40 mg/ml 0
Gliseril Trinitrat sublingual 0,5 mg 0
Gliserin 0
Glucose 40 % 25 ml 0
Glucosa lart inf 10 % 0
Glucosa lart inf 5 % 0
Glucose + Standar 0
GIG Fuji IX 0
GOT 0
GPT 0
Hemorogard 0
Haloperidol tab 0,5 mg 0
Handschoen no 8 0
Handschoen steril No.7,5 0
Hebi scrub 0
Hyosin Injeksi 0
Hustab sirup 0
Incidal OD tab 0
Infusion set anak 0
Infusion set dewasa 0
Isosukprin tablet 20 mg 0
Jarum Kulit No.9 0
Jarum Kulit No.10 0
Jarum Kulit No.11 0
Jarum Kulit No.12 0
Jarum Kulit No.13 0
Jarum Kulit No.14 0
Kalium Klorida 600 mg tablet 0
Kalium permanganat serbuk 0
Kapas berlemak 500 gram 0
Karbogliserin tetes telinga 10 % 0
Kasa elastis 0
Kasa pembalut hidro 4x3 0
Kasa hidrofil 40 x 80 cm 0
Kasa 18 x 22 0
Ketamin injeksi 100 mg/ml 0
Ketolorac injeksi 30 mg/ml 0
KY jelly 0
Klomifen sitrat 50 mg 0
Kloramfenicol tts telinga 3 % 0
Kloramfenicol tts mata 0
Kloramfenicol syr 0
Kloroquin 150 mg tab 0
Klorpromazin Hcl tab 25 mg 0
Kolesterol + Standar 0
Kotrimoksazol ped tab 120 mg 0
Lactobasilus acidofilus (Lacto-B) 0
Lar.mengandung karbohidrat,elektro 0
Lart.asam asetat 100 ml 0
Lart.Benedict 0
Lart.Carbol fulcin 0
Lart.Eosin 2 % 0
Lart.Etanol asam 0
Lart .Gabbet 0
Lart.Giemsa Stain 0
Lart.Kihyoun 0
Lart.Metilen biru 0
Lart.Na.Citrat 3,8 % 0
Lart.turk 0
Lart.Yodium 1 % 0
Lart.Yodium 2 % 0
Lidokain jeli 2 % 0
Lisinopril tablet 10 mg 0
Lisol 0
Lysmin syr 0
Magnesium Sulfat inj 40 % 0
Mebendazol tab 100 mg 0
Metakreosol kondensat 0
Metampiron (Neurodial) tab 0
Metanol 0
Metil ergometrin injeksi 0
Metoklopramid Hcl 10 mg 0
Metronidazol larutan infus 5 mg/ml 0
Naso Gastric Tube (NGT) N0. 18 0
Na.tiosulfat inj 25 % 10 ml 0
Natrium diklofenat 25 mg 0
Nistatin drops/Cazetin 0
Nistatin tab gula 500.000 0
Noretisteron tablet 5 mg 0
OAT sisipan 0
Obat batuk hitam (obh) plus 0
Occo 0
Ofloxacin 400 mg 0
Oksimetazolin tetes hidung 0,025 0
Oksitosin injeksi 0
Oksitocin inj 0
Papaverin 40 mg/ml 0
Pembalut Gips 3 (7,5 cm) 0
Permetrin krim 5% 0
Petidin inj 0
Piracetam 800 mg 0
Piracetam inj 0
Piroksikam tab 20 mg 0
Plastik klip 10 x 7 0
Plester 5 Yard x 2 inch 0
Polikresulen cairan 0
Porimokresol 0
Primakuin tab 15 mg 0
Prokain Penisilin G 3 juta inj 0
Propanolol Hcl tab 10 mg 0
Protein Total + Standar 0
Reagen drabkin 0
Reagen gol darah A,B,AB,O 0
Reagen PP test 0
Reagen Sodium Bicarbonat 0
Reagen Uric acid TBHA 0
Rees Ecker 0
Rifampicin cap 600 mg 0
Rifampicin cap 300 mg 0
Salbutamol inhalasi/aerosol 100 m 0
Sefixime sirup kering 100 mg/5ml 0
Sefotaksim tablet 0
Sefotaxim injeksi 1,0 g 0
Sianokobalamin inj 0
Silver Amalgam serbuk 0
Spiritus 500 ml 0
Spongelatin 0
Stimuno tablet 0
Stimuno sirup 0
Temporary stopping fletcher 0
Tamsulosin tablet SR 0,4 mg 0
Theofilin 300 mg tablet 0
Tetrasiklin Hcl cap 250 mg 0
Tetrasiklin Hcl cap 500 mg 0
Thiamin Hcl inj 0
Trikresol formalin cairan 0
Tripolidine HCl, Pseudoefedrin HCl 0
Urine bag 0
Valproat tablet SR 250 mg 0
Vit D3 aktif (Kolkatriol) 0
Wing nedle No.21 0
Wing nedle No.23 0
Wing nedle No.25 0
Wing nedle No.27 0
Xylol 0
Asifit 0
Farmaton 0
Geriavita 0
Natavit 0
Osteotin 0
Toxilite 0
Megatic Emulgel 0
Hico Gel 0
Truvit Sirup 0
Adver 0
Bisolvon extra sirup 0
FG Troches 0
Benzatin benzil penisillin 0
Wood pepermint ekspektoran sirup 0
Accucheck safe Pro T-Pro (lancet) 0
Strip Accu Cholesterol 0
Bahan resin komposite 0
Semen seng fosfat 0
Pepper Poin 0
Mata bur 0
Nald Hecting segitiga no.11 0
Dariantule 0
Spalk 0
Kotrimoksazol 960 mg 0
Bionemi 0
 PEMANTAUAN PENULISAN RESEP OBAT GENERIK DI PUSKESMAS DA
PUSKESMAS SAIL
Puskesmas : SAIL
Dinas Kab/Kota : PEKANBARU
TRIWULAN/THN : I - III/ 2017

JUMLAH R/OBAT
LEMBAR BPJS
UMUM
ASKES(PNS,TNI,POLRI) JAMKESMAS MANDIRI
% R/ % R/ % R/
TOTAL TOTAL R/ OBAT TOTAL TOTAL R/ OBAT TOTAL TOTAL R/ OBAT TOTAL TOTAL R/
BULAN RESEP R/ OBAT GENERIK R/ OBAT GENERIK R/ OBAT GENERIK R/ OBAT
GENERIK TERHADAP GENERIK TERHADAP GENERIK TERHADAP GENERIK
(UMUM, TOTAL R/ TOTAL R/ TOTAL R/
BPJS
JAMKESDA

1 2 3 4 5 6 7 8 9 10 11 12 13

TW I 5148 6834 6479 94.96 3942 3662 92.89 2010 1901 94.45 1649 1509

TW II 4305 5492 5234 95.30226 3705 3473 93.73819 1673 1588 94.91931 1286 1185

TW III 4598 6135 5837 95.08 4053 3723 91.88 1444 1389 96.16 1368 1271

TOTAL 14051 18461 17550 95.11 11700 10858 92.83 5127 4878 95.18 4303 3965
 DI PUSKESMAS DAN JARINGANNYA
AIL

JUMLAH
TOTAL R/ TOTAL R/ % R/ OBAT
JAMKESDA
MANDIRI
% R/ % R/
OBAT TOTAL TOTAL R/ OBAT OBAT GENERIK
GENERIK R/ OBAT GENERIK (UMUM (UMUM (UMUM
TERHADAP GENERIK TERHADAP BPJS BPJS BPJS
TOTAL R/ TOTAL R/ JAMKESDA JAMKESDA JAMKESDA

(3+6+9+12+15) (4+7+10+13+16)

14 15 16 17 18 19 20

91.37 770 731 95.15 15205 14282 93.93

92.14619 686 652 95.04373 12842 12132 94.39

92.91 577 542 93.74 13577 12762 94.00

92.14 2033 1925 94.64 41624 39176 94.10

 JUMLAH
LEMBAR
UMUM

TOTAL R/
BULAN RESEP OBAT
GENERIK
TOTAL R/

JUMLAh
1 pkm pst 1 pst 2 2 pkm pst 1 pst 3 3 pkm pst 1 pst 2 4
Juli 1316 116 75 1507 1793 213 51 2057 1659 213 110 1982
Agus 1342 106 97 1545 1926 224 47 2197 1790 224 87 2101
Sep 1324 136 86 1546 1592 256 33 1881 1465 256 33 1754
TOTAL 4598 6135 5837

Suryani AN
NIP. 19660723 198603 2 003
 R/OBAT
BPJS
ASKES(PNS,TNI,POLRI) JAMKESMAS
% R/ % R/
OBAT TOTAL TOTAL R/ OBAT TOTAL TOTAL R/
GENERIK R/ OBAT GENERIK R/ OBAT
TERHADAP GENERIK TERHADAP GENERIK
TOTAL R/ TOTAL R/

5 6 pkm pst 1 pst2 7 pkm pst1 pst2 8 9 pkm pst1 pst2 10 pkm pst1
96.35 1270 1231 33 6 1177 1137 33 7 92.68 611 393 206 12 584 358 206
95.63 1229 1215 12 2 1124 1107 12 5 91.46 460 351 81 28 452 315 81
93.25 1554 1533 16 5 1422 1401 16 5 91.51 373 245 103 25 353 225 103
95.08 4053 3723 91.88 1444 1389
 R/OBAT
PJS
JAMKESDA
SMAS MANDIRI
% R/ % R/
TOTAL R/ OBAT TOTAL TOTAL R/ OBAT TOTAL TOTAL R/
OBAT GENERIK R/ OBAT GENERIK R/ OBAT
GENERIK TERHADAP GENERIK TERHADAP GENERIK
TOTAL R/ TOTAL R/

pst2 11 12 pkm pst1 pst2 13 pkm pst1 pst2 14 15 pkm pst1 pst2 16
20 95.58 473 438 32 3 431 392 32 7 91.12 209 206 0 3 201
56 98.26 457 421 29 7 441 395 29 17 96.50 201 199 2 0 189
25 94.64 438 415 18 5 399 376 18 5 91.10 167 154 13 0 152
96.16 1368 1271 92.91 577 542
 JUMLAH
TOTAL R/ TOTAL R/ % R/ OBAT
JAMKESDA

% R/
TOTAL R/ OBAT OBAT GENERIK
OBAT GENERIK (UMUM (UMUM (UMUM
GENERIK TERHADAP BPJS BPJS BPJS
TOTAL R/ JAMKESDA JAMKESDA JAMKESDA

(3+6+9+12+15)
(4+7+10+13+16)

pkm pst1 pst2 17 18 19 20

194 0 7 96.17225 4620 4375 94.70
187 2 0 94.02985 4544 4307 94.78
139 13 0 91.01796 4413 4080 92.45
93.74 13577 12762 93.98