RUMAH SAKIT WIRA BHAKTI MATARAM

INSTALASI FARMASI

DAFTAR PENGADAAN OBAT TH. 2018-2019

NO NAMA BARANG SATUAN JUMLAH

1 2 3 4
1 AA 7715 Sheets Irrigating Vectis pcs 1
2 Abilify discmelt 10 mg Tab 500
3 Acarbose tab 50 mg tab 1000
4 Acetylcisteine 200 mg vial 43
5 Acetylsisteine 200 mg tab tab 2000
6 Acyclovir 400 mg tab 1000
7 Ahlstrom reliance 440&310 120 cm box 1
8 Alco Drops Botol 96
9 Allopurinol 100 mg tab 500
10 Alpentin 100 mg tab 1500
11 Alprazolam 0,5 mg tab 2200
12 Alprazolam 1 mg tab 2500
13 Ambroxol 30 mg tab 17500
14 Ambroxol Syrup botol 100
15 Aminofilin tab tab 500
16 Amlodipin 10 mg tab tab 6500
17 Amlodipin 5 mg Tab 5900
18 Amoxan 500 mg kaps tab 300
19 Amoxan Drops fles 5
20 Amoxicillin 500 mg tab 0
21 Amoxicillin SK OGB syr 60 ml btl 125
22 Ampicillin inj vial 100
23 Anacetin syr Btl 16
24 Analsik tab tab 1000
25 Analtram tab 600
26 Ancla Forte Dry Syrup botol 40
27 Antasida Doen tab 9200
28 Antasida Doen susp Btl 120
29 Antihaemoroid supp supp 120
30 Antimo tab tab 720
31 Apialys syr btl 14
32 Appalens 20.00 pcs 180
33 Appalens IOL model 101 power 10 pcs 4
34 Appalens IOL model 101 power 20.50 pcs 12
35 Appavisc 2 ml pcs 150
36 Appron 50 micron pcs 25
37 Apron 25 micron pcs 150
38 Apialys Drops vial 10
39 Arinia tab 2000
40 Arkine kapl Tab 10000
41 Asam Mefenamat Tab 18900
42 Asam valproat 250 mg/5 ml syr btl 300
43 Aspilet tab 2700
44 Assucryl violet 4/0 pcs 36
45 Atorvastatin calcium tab 20 mg tab 150
46 Atracurium 25 mg ampul 10
47 Aurolab Nylon Suture 8-0 pcs 1
48 Avesco 20 mg biji 600
49 Azithromycin dihydrate Tab 62
 2
NO NAMA BARANG SATUAN JUMLAH
1 2 3 4
50 Baby cough syr btl 50
51 Bamgetol Tab 9500
52 Baquinor Forte Cap Kapsul 100
53 Benzolac gel 5% gram-gel tube Tube 1
54 Benzolac-CL gel Tube 1
55 Berry Vision Dispersibel Tab Tab 1000
56 Betamethasone cr Tube 49
57 Bio ATP tab 100
58 Biocolagenta kapsul 250
59 Biosanbe kapsul 600
60 Biosat ATS 1500 IU amp 20
61 Biosave ABU vial 2
62 Bisoprolol 5 mg tab 610
63 Bisoprolol fumarat 2.5 mg tab 150
64 Bledstop tab 1000
65 Bledstop inj vial 200
66 Blood lancet 26G OM box 5
67 Blue label with indicator rol 1
68 Brainact 500 ampul 5
69 Brainact oral tab 30
70 Breathy drops btl 5
71 Bucain Inj amp 50
72 Bufacomb i.o.b tube 10
73 Calcium lactate 500 mg tab 2000
74 Candesartan cilexetil 16 mg tab 1900
75 Capsul kosong No 00 zak 10
76 Capsul kosong No 1 zak 10
77 Carbhacol pcs 10
78 Caviplex tab 15000
79 Caviplex syr Btl 265
80 Cd Asthenof btl botol 196
81 Cd Eyefresh plus md pcs 120
82 Cd Xitrol Salep Mata tube 30
83 CD. Cenfresh Minidose strip 1341
84 CD. Eyefresh Minidose strip 940
85 CD. Lyteers Minidose strip 1157
86 Cefadroxil 125 syrup botol 96
87 Cefadroxil 500 mg tab Tab 7700
88 Cefila dry syr btl 20
89 Cefixime 100 mg tab 7700
90 Cefixime Dry Syrup botol 100
91 Cefixime kapsul 200 mg biji 6400
92 Cefoperazone vial 950
93 Cefotaxime inj Vial 2310
94 Ceftriaxone inj vial 1000
95 Cefxon inj Vial 135
96 Cendo Efrisel 10% ED btl 5
97 Cendo Floxa pcs 410
98 Cendo Genta 0,3% 5 ml btl 18
99 Cendo Glaoplus MD pcs 200
100 Cendo LFX MD pcs 100
101 Cendo Mydriatil pcs 11

3
NO NAMA BARANG SATUAN JUMLAH
1 2 3 4
102 Cendo Pantocain 2% ED btl 24
103 Cendo Polydex MD pcs 100
104 Cendo Protagenta MD pcs 400
105 Cendo Timol 0.5% Btl 26
106 Cendo Timolol Maleat 0.25% 5 cc pcs 50
107 Cendo Tobroson MD pcs 90
108 Cendo Tonor 0,5% MD pcs 130
109 Cendo Vasacon MD pcs 100
110 Cendo Vitrolenta Eye Drop botol 20
111 Cendo Xytrol MD pcs 1085
112 Cepraz inj Vial 200
113 Cetirizine 10 mg biji 5600
114 Cetirizine HCl syr botol 100
115 Channa 500 mg kapsul 750
116 Chloramfenicol SM tube 24
117 Chlorpromazine 25 mg biji 300
118 Chromic Catgut 3/0 Cutting pcs 204
119 Ciprofloxacin Infus botol 16
120 Citicoline 500 mg tab tab 150
121 Clindamycin 300 mg tab 700
122 Clofritis 10 mg tab tab 300
123 Clopidogrel 75 mg tab 300
124 Clozapine 100 mg tab 500
125 Clozapine tab 25 mg tab 500
126 Coblue pcs 70
127 Colidium kaplet tab 1000
128 Couter bovie Pcs 9
129 Cresotin Liquid II Tehnodent Pcs 2
130 Criax inj Vial 60
131 CTG paper 151x25 Endo roll 1
132 CTM 4 mg tab Tab 1440
133 Curvit 60 ml syr Btl 25
134 Cyclo progynova supp 10
135 Cyclofem inj Vial 20
136 Demacolin tab 3000
137 Deolit Tab 900
138 Depakene syr 250 mg/5 ml btl 5
139 Depram 10 mg tab 90
140 Desoximetasone 0,25 cream 300
141 Dexamethasone tab 4000
142 dexamethasone inj amp 1300
143 Dexketoprofen tab 3900
144 dexketoprofen 50 mg ampul 200
145 Dextral tab 1500
146 Dextral syr Btl 30
147 Diane box 1
148 Diphenhydramin HCl inj amp 600
149 Divalproex Kap tab 6600
150 Domavit Tab 480
151 Domperidon syr btl 500
152 Domperidone 10 mg tab tab 20500
153 Dop Mata pcs 10

4
NO NAMA BARANG SATUAN JUMLAH
1 2 3 4
154 Dopepsa btl 100
155 Douderm gel 15 tube 60
156 Dulcolax supp supp 100
157 Dumin Rectal 125 mg supp 5
158 Duphaston 10 mg tab 20
159 Ecosol NaCl 100 ml botol 140
160 Elite cement mini pack 1135/30 g Box 1
161 Elizac 20 mg capc caps 210
162 Epinephrine Inj ampul 600
163 Ergotamine coffeine tab 100
164 Erysanbe Dry Syr botol 3
165 Erythromycin 250 mg tab 500
166 Esola inj box 500
167 Ethyl chloride spray botol 2
168 Euthyrox 50 mcg tab 200
169 Fargetik tab Tab 6000
170 Farizol kapsul kapsul 1000
171 Fenofibrate 300 mg kapsul 270
172 Fermia SC tab 2200
173 Fiopraz inj Vial 20
174 Flamar Emugel 20 gr tube 10
175 Flamicort 10 mg Vial 5
176 Flucadex tab 1000
177 Fluconazole inf btl 6
178 Flunarizine 5 mg tablet biji 500
179 Flutias inhaler botol 20
180 Folaplus caplet Tab 1000
181 Folavicap tab 1000
182 Folavit 400 mg Tablet biji 2000
183 Fortanest 5 mg/5 ml inj ampul 50
184 Forumen ear dop botol 5
185 Frimania 200 mg tab 500
186 Frimania 400 mg tab biji 300
187 Fucilex cr tube 300
188 Fukuda denshi op-119 TE Roll 6
189 Furamin inj amp 25
190 Furosemid 40 mg tab 1000
191 Fusycom 5 gr tube 10
192 Futrolit botol 24
193 Gastrinal HD susp Btl 180
194 Genoint eye oint 0.3% tube 10
195 Gentamycin cream tube 300
196 Gentamycin inj ampul 20
197 Giflox Tetes Mata pcs 100
198 Gitas inj ampul 680
199 Gitas Plus tab 3500
200 Glauseta tab tab 1000
201 Glimepiride 4 mg tab 2500
202 Glove size S box 20
203 Glucodex tab Tab 100
204 Glucosamin 250 mg tab 2400
205 glukosa 10 % botol 100

5
NO NAMA BARANG SATUAN JUMLAH
1 2 3 4
206 Glukosa 5 % botol 100
207 Grafamic biji 2000
208 Guaifinesin 100 mg/ GG tab 2000
209 Harnal ocas tab 90
210 Hufabion tab 500
211 Hydrocortison 1% cream Tube 10
212 Hydrocortison 2.5% cream Tube 265
213 Hydromal fles 48
214 Hystolan tab tab 100
215 Ibuprofen 400 mg tab 18200
216 Ikadryl syr Btl 38
217 Imodiar 2 mg tab 500
218 Imundo Kap tab 2600
219 Imunos kapl tab 2200
220 Imunos syr btl 20
221 Infusan D5 1/2 NS botol 240
222 Infusan D5 1/4 NS botol 240
223 Infusan NS botol 3,820
224 Infusan RL botol 10,968
225 Interhistin tab 100
226 KA-EN 1B fles 20
227 KA-EN 3B botol 160
228 Kalxetin 10 mg kapsul 1350
229 Kalxetin 20 mg kapsul 750
230 Kapas 250 g roll 5
231 Kapsul Kosong pcs 10
232 Kapsul Kosong pcs 11000
233 Kassa Sterile isi 16 OM box 100
234 Kenalog 5 gr tube 5
235 Kertas puyer pack 20
236 Ketoconazole 200 mg tab 1250
237 Ketokonazol crm tube 62
238 Ketomed cr Tube 3
239 Ketomed gel Tube 1
240 Ketomed SS Tube 21
241 Ketorolac 30 inj ampul 1456
242 Ketorolac inj 10 mg/ml amp 100
243 Klip 8,7x13 bks 128
244 Klip obat pack 25
245 Klip obat 7x10 pack 10
246 KSR 600 mg tab 1000
247 KTM vial 10
248 Kutoin ampul 10
249 Lactrin kaps kaps 200
250 Lactulax syr Btl 21
251 Lansoprazole 30 mg tab 5000
252 Lapicef drop Btl 8
253 Lapixime inj vial 250
254 Lasal nebu amp 400
255 Lasalcom vial 300
256 Lasmalin 100 mg kaps tab 900
257 Laxadine Emulsi botol 100

6
NO NAMA BARANG SATUAN JUMLAH
1 2 3 4
258 L-Bio caps tab 750
259 L-Bio sach tab 1050
260 L-Cisin biji 240
261 Leparson tab tab 1500
262 Leukoplas 7.5x4.5M Roll 10
263 Levemir Flexpen pcs 100
264 Levfloxacin 500 mg kaplet 500
265 Levofloxacin 500 mg inf Btl 650
266 Lidocain inj ampul 500
267 Lidodex 5% Inj Vial 150
268 Livron B Plex tab 12000
269 Lodia 2 mg Tablet Biji 500
270 Lodomer 5 mg tab 1000
271 Loratadin tab tab 100
272 Mecobalamin 500 mcg Tab 1000
273 Mefinal 500 mg Kapsul Biji 2000
274 Meloxicam 15 mg tab 200
275 Meloxicam 7.5 mg tab 8000
276 Meprovent inh amp 50
277 Meptin Inhalation sol 0.3 ml ampul 28
278 Meptin inhalation sol 0.5 ml amp 140
279 Meptin swinghaler Unit 5
280 Merlopam 0.5 mg tab tab 3200
281 Merlopam 2 mg tab 4300
282 Metaneuron tab tab 300
283 Metformin 500 mg kapsul 13200
284 Metformin 850 mg tab 200
285 Methylprednisolon 8 mg tab 4200
286 Methylprednisolone 125 inj ampul 84
287 Metronidazole 500 mg tab 2000
288 Metronidazole 500 mg infus botol 500
289 Miconazole 2% cr tube 480
290 Micro brush svenska Box 1
291 Microlax Tube 40
292 Misotab tab tab 1000
293 Molesco 10 mg biji 300
294 Molesco 5 mg biji 300
295 Myco-Z cr tube 5
296 Na Phenytoin inj amp 10
297 Natrium Diklofenak 25 mg tab 5500
298 Natrium Diklofenak 50 mg tab 6300
299 Neo gynoxa ovula Ovula 10
300 Neurobion 5000 Inj ampul 40
301 Neurohax tab 1000
302 New Diatab biji 2500
303 Nicardipine 10 mg inj vial 10
304 Nobor tab 90
305 Norages inj amp 600
306 Norages syr Btl 40
307 Norephineprine Ampul 15
308 Norvom Kapsul kapsul 1000
309 Novomix-30 flexpen pcs 75

7
NO NAMA BARANG SATUAN JUMLAH
1 2 3 4
310 Novorapid flexpen pcs 150
311 Nystatin drop Btl 20
312 OBH itrasal syr Btl 60
313 ODR Drops 4 mg botol 8
314 Olanzapine 5 mg tab 150
315 Omeprazole 20 mg tab 7,290
316 Omeprazole 40 mg inj vial 100
317 Omeyus caps caps 320
318 Ondancentron 4 mg tab 4000
319 Ondancentron 8 mg tablet biji 3300
320 Ondansetron 8 mg inj ampul 540
321 Ondansetron inj 4 mg Amp 1440
322 Opilax syr btl 50
323 Optalvit syr botol 5
324 Oralit pcs 2500
325 Osfit filco tab 1200
326 Otopain ear drop Btl 15
327 Otsu manitol botol 20
328 Otsu Salin 3 botol 20
329 Otsu Water botol 3000
330 Pamol 125 mg supp Supp 384
331 Pamol 250 mg supp Supp 384
332 Pantoprazole vial 210
333 Paracetamol 1 g/100 ml infus botol 1350
334 Paracetamol 500 mg kaplet 25400
335 Paracetamol syr btl 200
336 Paratusin Tab 2000
337 Pepzol Inj vial 100
338 Persidal 2 mg tab 200
339 Phenobarbital 30 mg tab 200
340 Phenytoin caps Tab 3000
341 Phytomenadion 10 mg inj amp 30
342 Pil KB Andalan box 30
343 Pimtracol Lemon syr botol 45
344 Pioglitazone 15 mg tab biji 300
345 Pioglitazone 30 mg tab 2100
346 Piracetam 1 g inj ampul 50
347 Piracetam 3 g ampul 100
348 PK 5 gr vial 168
349 Plester film island 25x10 Winner Pcs 200
350 Plesterin Bulat pcs 1600
351 Pletaal biji 450
352 Polifix 10cm x 5 m Roll 72
353 Pot Salep 12.5 gr pcs 5
354 Pot Salep 30 gr pcs 4
355 Pouches flat 20 cm roll 1
356 Pouches flat reels 150mmx200m roll 1
357 Pouches flat reels 300mmx200m roll 1
358 Prednison 5 mg Tab 6100
359 Pregabalin 75 mg kapsul 900
360 Premilene 5/0 pcs 5
361 Proanes inj ampul 150

8
NO NAMA BARANG SATUAN JUMLAH
1 2 3 4
362 Procur Plus tab 1000
363 Prohepar kapsul 390
364 Prohiper 10 mg tab 600
365 Prokasa 40 yx80 cm Roll 20
366 pronalges supp Supp 10
367 Prontosan gel tube 2
368 Propranolol 10 mg tab 800
369 Propranolol 40 mg tab 500
370 Propylthiouracil 100 mg tab 300
371 Prothyra 10 mg Tube 120
372 Pulp X Devitalizer 6 gr Denpo Pcs 1
373 Quaramol inf fles 5
374 Quetvell 100 mg tab 780
375 Quetvell 200 mg tab 1020
376 Quetvell tab 25 mg Tab 600
377 Ranitidine inj ampul 720
378 Ranitidine tablet biji 5000
379 Regivell amp 25
380 Regumen tab 300
381 Renadinac 50 mg Tab 2000
382 Renalof 325 mg kapsul 90
383 Retivit kaplet 2000
384 Rinclo 75 mg tab 300
385 Rindobion Tab 5,100
386 Rindomam Tab 480
387 Rinofer tab 2880
388 Risperidone 1 mg tab 1350
389 Risperidone 2 mg tab 3000
390 Sagestam Inj Ampul 1200
391 Salbutamol 2 mg tab 200
392 Salbutamol 4 mg tab 500
393 Salfenal Forte 400 mg tab 2000
394 Saliva ejector for single use svenska Pack 1
395 San B Plex Drops Botol 24
396 Sanbe Hest botol 145
397 Sangobion baby drop botol 13
398 Sangobion kids 100 ml btl 10
399 Sangobion vita-tonik syr Btl 3
400 Sanmol drop botol 24
401 Sanmol Syrup Botol 48
402 Sansulin Dispopen pcs 50
403 Santocyn Inj ampul 3000
404 Scabimite cr 10 g Tube 20
405 Scabimite cr 30 g Tube 60
406 Scacid Krim tube 85
407 Scopamin tab 500
408 Scopamin Inj ampul 25
409 Serlof tab tab 60
410 Sertraline HCl tab tab 5000
411 Sevoflurane Baxter botol 2
412 Sharpoint Nylon Suture 10-0 pcs 12
413 Sikzonoate inj amp 5

9
NO NAMA BARANG SATUAN JUMLAH
1 2 3 4
414 Sodasorb standard 5 L botol 2
415 Solasic kap tab 2000
416 Spasminal 10 mg tab 200
417 Spironolactone 25 mg tab 300
418 Stelosi 5 mg tab 3800
419 Sterilization roll pcs 2
420 Stesolid 5 Mg tube 25
421 Stesolid 10 mg tube 25
422 Sumagesic tab Tab 1500
423 Tablet tambah darah biji 300
424 Tas besar putih natural Pcs 50
425 Tas kecil putih natural Pcs 50
426 Tas tanggung putih natural Pcs 50
427 Teosal tab 500
428 Test Kehamilan Om pcs 50
429 Tetracyclin 500 mg tab 100
430 Thyrozol 10 mg tab 600
431 Thyrozol 5 mg tab 400
432 TKF/Tricresolformalina 10 ml Pcs 2
433 Tobroson MD pcs 100
434 Tofedex Inj ampul 400
435 Tofedex tab tab 1500
436 Tomaag Kaplet biji 2000
437 Tranexamic acid inj 500 mg ampul 800
438 Tramus 1% inj 50
439 Tranexamid acid inj 250 mg amp 500
440 Tremenza tab tab 2000
441 Triamcinolone 4 mg tab 200
442 Trifacalc tab tab 1000
443 T-SILK 2-0 RB pcs 36
444 Tuzalos kapl tab 500
445 Uni Bebi Cough Syrup botol 50
446 Unique 2.0 mm pcs 57
447 Unique 2.75 mm pcs 65
448 Unique Knifes 15 pcs 6
449 Urinter kapsul 100
450 Ursodeoxycholic acid tab tab 300
 451 Vagistin ovula ovula 20
452 Valisanbe 2 mg tab 1000
453 Valisanbe 5 mg tab 2000
454 Valisanbe Inj vial 40
455 Valsartan 160 mg tab 1650
456 Valsartan 80 mg tab 1470
457 Vaseline swab 10x10 pcs 100
458 Ventolin neb Amp 240
459 Vip Albumin sach 30
460 Vip Albumin kapsul 900
461 Vipachol kapsul 30
462 Vit A IPI tab Tab 1000
463 Vitacid cr 0,025% Tube 3
464 Vitacid cr 0,05% Tube 2
465 Vitacid cr 0,1% Tube 2

10
NO NAMA BARANG SATUAN JUMLAH
1 2 3 4
466 Vitamin B tab 2000
467 Wida D5-1/2 NS 500 ml btl 100
468 Widoxil caps 500 mg Tab 100
469 Write On ID For Adult pcs 5
470 XT REST SYR 3 pcs 5
471 Yarizine syr Btl 291
472 Yaz box 2
473 Zenirex syr Btl 50
474 Zircum KID Syrup botol 151

Mataram, Januari 2020

Kainstalasi Farmasi,

Novia Dewi, S.Farm., Apt.

Kapten Ckm (K) NRP 11080100571183

TIM VERIFIKASI :
1. Bidang Personil I. Nengah Ratna Wijaya Ttd…...................
Kapten Ckm NRP 21960286620775
2. Bidang Logistik & Materiil Novia Dewi S. Farm.Apt Ttd…..................
Kapten Ckm ( K ) NRP 11080100571183
3. Bidang Keuangan Sanup Ttd…...................
Lettu Ckm NRP 21970236700177

Yang Menyerahkan Yang Menerima

dr. Soleh Sp.S dr. Yudi Akbar Manurung Sp.B

Mayor Ckm NRP 11070042260179 Kapten Ckm NRP 11080087051179

Mengetahui
Kepala Denkesyah Mataram
Dw Ngk Gd Widiatnyana S. Kep, Ners, M.M. Kes
Letnan Kolonel Ckm NRP 11950009461170
RUMAH SAKIT WIRA BHAKTI MATARAM
INSTALASI FARMASI

LAPORAN STOK OPNAME PER 31 DESEMBER 2019

NO NAMA BARANG SATUAN JUMLAH

1 2 3 4
1 AA 7715 Sheets Irrigating Vectis pcs 0
2 Abilify discmelt 10 mg Tab 361
3 Abilify discmelt 15 mg tab 110
4 Acarbose tab 50 mg tab 656
5 Acetylcisteine 200 mg vial 8
6 Acetylsisteine 200 mg tab tab 1295
7 Acyclovir 200 mg tab 373
8 Acyclovir 400 mg tab 753
9 Acyclovir cr tube 39
10 Adalat Oros tab tab 112
11 Ahlstrom reliance 440&310 120 cm box 0
12 Albapure 20% btl 6
13 Albendazole tab tab 25
14 Albuminar 25% btl 3
15 Alco Drops Botol 72
16 Allopurinol 100 mg tab 960
17 Allopurinol 300 mg tab 422
18 Alpentin 100 mg tab 773
19 Alprazolam 0,5 mg tab 0
20 Alprazolam 1 mg tab 1579
21 Ambroxol 30 mg tab 0
22 Ambroxol Syrup botol 95
23 Aminofilin inj amp 40
24 Aminofilin tab tab 500
25 Amlodipin 10 mg tab tab 2929
26 Amlodipin 5 mg Tab 1872
27 Amoxan 500 mg kaps tab 425
28 Amoxan Drops fles 3
29 Amoxicillin 500 mg tab 4048
30 Amoxicillin SK OGB syr 60 ml btl 120
31 Amoxicillin drop btl 11
32 Ampicillin inj vial 78
33 Ampicillin 500 mg tab tab 420
34 Anacetin syr Btl 0
35 Analsik tab tab 1000
36 Analtram tab
37 Ancefa syr btl 9
38 Ancla tab tab 45
39 Ancla Forte Dry Syrup botol 14
40 Antalgin tab tab 816
41 Antasida Doen tab 4814
42 Antasida Doen susp Btl 0
43 Antihaemoroid supp supp 8
44 Antimo tab tab 710
45 Apialys syr btl 3
46 Apialys drop btl 6
47 Appalens 20.00 pcs 11
48 Appalens IOL model 101 power 10 pcs 4
49 Appalens IOL model 101 power 20.50 pcs 0
 2
NO NAMA BARANG SATUAN JUMLAH
1 2 3 4
50 Appavisc 2 ml pcs 41
51 Appron 50 micron pcs 0
52 Apron 25 micron pcs 0
53 Apialys Drops vial 0
54 Arinia tab 1411
55 Arkine kapl Tab 1939
56 Asam Mefenamat Tab 2744
57 Asam Tranexamat 500 mg Tab 1900
58 Asam valproat 250 mg/5 ml syr btl 233
59 Aspilet tab 256
60 Assucryl violet 4/0 pcs 0
61 Ataroc syr btl 2
62 Atorvastatin calcium tab 20 mg tab 398
63 Atracurium 25 mg ampul 0
64 Aurolab Nylon Suture 8-0 pcs 8
65 Avesco 20 mg biji 600
66 Azithromycin dihydrate Tab 17
67 Baby cough syr btl 3
68 Bamgetol Tab 4954
69 Baquinor Forte Cap Kapsul 100
70 Benzolac gel 5% gram-gel tube Tube 1
71 Benzolac-CL gel Tube 1
72 Berry Vision Dispersibel Tab Tab 910
73 Betahistine 6 mg tab 1502
74 Betamethasone cr Tube 21
75 Betason cr Tube 30
76 Bio ATP tab 80
77 Biocolagenta kapsul 0
78 Biocombin inj amp 1533
79 Biosanbe kapsul 280
80 Biosat ATS 1500 IU amp 0
81 Biosave ABU vial 2
82 Biothicol syr btl 6
83 Biothicol Forte syr btl 4
84 Bisacodil tab tab 25
85 Bisoprolol 5 mg tab 304
86 Bisoprolol fumarat 2.5 mg tab 119
87 Bledstop tab 911
88 Bledstop inj vial 76
89 Blood lancet 26G OM box 0
90 Blue label with indicator rol 0
91 Borraginol S supp supp 16
92 Brainact 500 ampul 11
93 Brainact oral tab 30
94 Breathy drops btl 3
95 Bucain Inj amp 22
96 Bufacomb i.o.b tube 10
97 Calcium lactate 500 mg tab 2000
98 Candesartan cilexetil 8 mg tab 467
99 Candesartan cilexetil 16 mg tab 1432
100 Capsul kosong No 00 zak 0
101 Capsul kosong No 1 zak 0

3
NO NAMA BARANG SATUAN JUMLAH
1 2 3 4
102 Carbhacol pcs 13
103 Caviplex tab 827
104 Caviplex syr Btl 29
105 Cd Asthenof btl botol 0
106 Cd Eyefresh plus md pcs 146
107 Cd Xitrol Salep Mata tube 0
108 CD. Cenfresh Minidose strip 241
109 CD. Eyefresh Minidose strip 292
110 Cendo Lyteers ED btl 21
111 CD. Lyteers Minidose strip 0
112 Cebactam inj vial 22
113 Cefadroxil 125 syrup botol 259
114 Cefadroxil 500 mg tab Tab 7165
115 Cefat 500 mg tab 370
116 Cefila dry syr btl 11
117 Cefim inj vial 40
118 Cefixime 100 mg tab 4624
119 Cefixime Dry Syrup botol 210
120 Cefixime kapsul 200 mg biji 3415
121 Cefoperazone vial 107
122 Cefotaxime inj Vial 1438
123 Ceftriaxone inj vial 1011
124 Cefxon inj Vial 168
125 Cendo Caprina 1% ED btl 3
126 Cendo Catarlent MD pcs 234
127 Cendo Cendrid MD pcs 25
128 Cendo CMC 2% ED btl 0
129 Cendo Conjuncto ED btl 10
130 Cendo Conver 2% MD pcs 83
131 Cendo Efrisel 10% ED btl 4
132 Cendo Floxa pcs 86
133 Cendo Genta 0,3% 5 ml btl 0
134 Cendo Glaoplus MD pcs 173
135 Cendo Homatro 2% MD pcs 5
136 Cendo Idoxuridine MD pcs 75
137 Cendo Lentikular MD pcs 40
138 Cendo LFX MD pcs 27
139 Cendo Lubrican btl 0
140 Cendo Mycetin EO tube 5
141 Cendo Mycos MD pcs 100
142 Cendo Mydriatil pcs 4
143 Cendo Noncort MD pcs 56
144 Cendo Oculenta gel tube 6
145 Cendo P-Pred MD pcs 71
146 Cendo Pantocain 2% ED btl 16
147 Cendo Phitalmic EO tube 5
148 Cendo Polydex MD pcs 100
149 Cendo Polypred MD pcs 80
150 Cendo Polynel MD pcs 0
151 Cendo Posop MD pcs 105
152 Cendo Protagenta MD pcs 248
153 Cendo Statrol MD pcs 89

4
NO NAMA BARANG SATUAN JUMLAH
1 2 3 4
154 Cendo Timol 0,25% MD pcs 101
155 Cendo Timol 0.5% Btl 0
156 Cendo Timolol Maleat 0.25% 5 cc pcs 38
157 Cendo Tobro MD pcs 0
158 Cendo Tobroson MD pcs 0
159 Cendo Tonor 0,5% MD pcs 130
160 Cendo Tropin 0,5% MD pcs 80
161 Cendo Vasacon MD pcs 52
162 Cendo Vasacon-A MD pcs 0
163 Cendo Vision MD pcs 100
164 Cendo Vitrolenta Eye Drop botol 2
165 Cendo Xytrol MD pcs 0
166 Cepraz inj Vial 153
167 Cernevit inj vial 46
168 Cetirizine 10 mg biji 0
169 Cetirizine HCl syr botol 33
170 Channa 500 mg kapsul 154
171 Chloramfecort cr tube 34
172 Chloramfecort H sk tube 50
173 Chloramfenicol 250 mg caps 39
174 Chloramfenicol SM tube 0
175 Chlorpromazine 25 mg biji 164
176 Chlorpromazine 100 mg tab 698
177 Chromic Catgut 3/0 Cutting pcs 0
178 Cinolon cr tube 5
179 Ciprofloxacin 500 mg tab 2564
180 Ciprofloxacin Infus botol 66
181 Citicoline 250 mg inj amp 827
182 Citicoline 500 mg inj amp 316
183 Citicoline 500 mg tab tab 134
184 Cliad tab tab 30
185 Clindamycin 300 mg tab 115
186 Clobazam 10 mg tab 707
187 Clofritis 10 mg tab tab 42
188 Clopidogrel 75 mg tab 441
189 Clozapine 100 mg tab 343
190 Clozapine tab 25 mg tab 309
191 Coblue pcs 35
192 Colidium kaplet tab 540
193 Colsancetine caps caps 90
194 Combivent Amp 0
195 Comtusi syr btl 1
196 Cotrimoksasol tab tab 608
197 Cotrimoksasol syr btl 57
198 Couter bovie Pcs 5
199 Cravox tab 10
200 Cresotin Liquid II Tehnodent Pcs 0
201 Criax inj Vial 67
202 CTG paper 151x25 Endo roll 0
203 CTM 4 mg tab Tab 188
204 Curvit 60 ml syr Btl 0
205 Cyclo progynova supp 6

5
NO NAMA BARANG SATUAN JUMLAH
1 2 3 4
206 Cyclofem inj Vial 7
207 Demacolin tab 1192
208 Deolit Tab 0
209 Depakene syr 250 mg/5 ml btl 0
210 Depoprogestin inj Vial 7
211 Depram 10 mg tab 0
212 Desoximetasone 0,25 cream 122
213 Dexamethasone tab 3733
214 dexamethasone inj amp 1054
215 Dexketoprofen tab 389
216 dexketoprofen 50 mg ampul 209
217 Dexteem tab tab 167
218 Dextral tab 217
219 Dextral syr Btl 0
220 Diane box 1
221 Diazepam 2 mg tab 28
222 Digoxin 0.25 tab tab 296
223 Diltiazem 30 mg tab 109
224 Diphenhydramin HCl inj amp 269
225 Diphenhydramin HCl inj Vial 61
226 Divalproex Kap tab 2540
227 Dobutamin inj amp 22
228 Domavit Tab 426
229 Domperidon syr btl 356
230 Domperidone 10 mg tab tab 17917
231 Donepezil tab tab 38
232 Dopamet tab 847
233 Dop Mata pcs 10
234 Dopepsa btl 162
235 Doxicycline 100 mg tab 494
236 Douderm gel 15 tube 36
237 Dulcolax supp supp 28
238 Dumin Rectal 125 mg supp 0
239 Dumin rectal 250 mg supp 2
240 Duphaston 10 mg tab 10
241 Duvadilan tab tab 26
242 Ecosol NaCl 100 ml botol 15
243 Eflagen 25 mg tab 50
244 Eflagen 50 mg tab 250
245 Elkana tab tab 379
246 Elite cement mini pack 1135/30 g Box 0
247 Elizac 20 mg capc caps 0
248 Eperisone HCl tab tab 1045
249 Ephedrin HCl inj amp 17
250 Epinephrine Inj ampul 90
251 Eprinoc tab tab 89
252 Ergotamine coffeine tab 26
253 Erysanbe Dry Syr botol 0
254 Erythromycin 250 mg tab 384
255 Esola inj box 110
256 Ethyl chloride spray botol 1
257 Euthyrox 50 mcg tab 93

6
NO NAMA BARANG SATUAN JUMLAH
1 2 3 4
258 Fargetik tab Tab 0
259 Fargoxin tab tab 55
260 Farizol kapsul kapsul 0
261 Fastor 20 mg tab 117
262 Fenofibrate 150 mg kapsul 192
263 Fenofibrate 300 mg kapsul 390
264 Fermia SC tab 116
265 Fiopraz inj Vial 17
266 Flamar Emugel 20 gr tube 0
267 Flamicort 10 mg Vial 4
268 Flucadex tab 111
269 Fluconazole inf btl 4
270 Fluconazole tab tab 181
271 Flunarizine 5 mg tablet biji 293
272 Flunarizine 10 mg tab 307
273 Flutias inhaler botol 1
274 Folaplus caplet Tab 431
275 Folavicap tab 3876
276 Folavit 400 mg Tablet biji 0
277 Formyco tab tab 23
278 Formyco cr tube 12
279 Fortanest 5 mg/5 ml inj ampul 113
280 Forumen ear dop botol 0
281 Frimania 200 mg tab 0
282 Frimania 400 mg tab biji 0
283 Fucilex cr tube 0
284 Fukuda denshi op-119 TE Roll 0
285 Furamin inj amp 16
286 Furosemid 40 mg tab 673
287 Furosemid inj amp 187
288 Fusycom 5 gr tube 7
289 Futrolit botol 191
290 Gabapentin 300 mg tab 1859
291 Gastridin inj amp 0
292 Gastrinal HD susp Btl 28
293 Gemfibrozil caps caps 375
294 Genoint eye oint 0.3% tube 10
295 Gentamycin cream tube 101
296 Gentamycin inj ampul 0
297 Gerdilium tab tab 0
298 Giflox Tetes Mata pcs 64
299 Gitas inj ampul 364
300 Gitas Plus tab 1614
301 Glauseta tab tab 918
302 Glibenclamide 5 mg tab 2105
303 Glimepiride 1 mg Tab 879
304 Glimepiride 2 mg tab 1785
305 Glimepiride 3 mg tab 826
306 Glimepiride 4 mg tab 1692
307 Glove size S box 0
308 Glucodex tab Tab 100
309 Glucosamin 250 mg tab 1859

7
NO NAMA BARANG SATUAN JUMLAH
1 2 3 4
310 glukosa 10 % botol 18
311 Glukosa 5 % botol 12
312 Grafamic biji 0
313 Griseofulvin 125 mg tab 1000
314 Guaifinesin 100 mg/ GG tab 987
315 Harnal ocas tab 16
316 Herbesser 100 mg tab 23
317 Hufabion tab 0
318 Hydrocortison 1% cream Tube 0
319 Hydrocortison 2.5% cream Tube 393
320 Hydromal fles 253
321 Hystolan tab tab 68
322 Ibuprofen 400 mg tab 14488
323 Ibuprofen syr btl 401
324 Ikadryl syr Btl 0
325 Imodiar 2 mg tab 0
326 Imundo Kap tab 30
327 Imunos kapl tab 751
328 Imunos syr btl 13
329 Inflesco tab tab 421
330 Infusan D5 1/2 NS botol 264
331 Infusan D5 1/4 NS botol 165
332 Infusan NS botol 220
333 Infusan RL botol 900
334 Infusan Ring As botol 83
335 Interhistin tab 631
336 Invomit 4 mg inj amp 9
337 Irbesartan tab tab 50
338 Isosorbit Dinitrat tab 50
339 Isosorbit Dinitrat inj amp 10
340 KA-EN 1B fles 21
341 KA-EN 3B botol 112
342 Kalnex 250 mg tab 12
343 Kalxetin 10 mg kapsul 645
344 Kalxetin 20 mg kapsul 1003
345 Kapas 250 g roll 0
346 Kapsul Kosong pcs 0
347 Kapsul Kosong pcs 0
348 Kassa Sterile isi 16 OM box 0
349 Kenalog 5 gr tube 0
350 Kertas puyer pack 0
351 Ketoconazole 200 mg tab 595
352 Ketokonazol crm tube 43
353 Ketomed cr Tube 3
354 Ketomed gel Tube 1
355 Ketomed SS Tube 19
356 Ketorolac 30 inj ampul 1112
357 Ketorolac inj 10 mg/ml amp 111
358 Klip 8,7x13 bks 0
359 Klip obat pack 0
360 Klip obat 7x10 pack 0
361 KSR 600 mg tab 734

8
NO NAMA BARANG SATUAN JUMLAH
1 2 3 4
362 KTM vial 5
363 Kutoin ampul 0
364 Lactrin kaps kaps 234
365 Lactulax syr Btl 0
366 Lameson 4 mg tab 60
367 Lameson 8 mg tab 100
368 Lameson 16 mg tab 70
369 Lansoprazole 30 mg tab 2304
370 Lapibal tab tab 662
371 Lapibal inj amp 17
372 Lapicef drop Btl 5
373 Lapicef tab caps 100
374 Lapixime inj vial 162
375 Lasal nebu amp 191
376 Lasalcom vial 93
377 Lasgan caps caps 2
378 Lasmalin 100 mg kaps tab 277
379 Laxadine Emulsi botol 31
380 L-Bio caps tab 630
381 L-Bio sach tab 570
382 L-Cisin biji 241
383 Leparson tab tab 413
384 Leukoplas 7.5x4.5M Roll 10
385 Levemir Flexpen pcs 83
386 Levfloxacin 500 mg kaplet 421
387 Levofloxacin 500 mg inf Btl 508
388 Levofloxacin 750 mg inf Btl 105
389 Lidocain inj ampul 274
390 Lidodex 5% Inj Vial 179
391 Lisinopril 5 mg tab 384
392 Livron B Plex tab 7808
393 Lodia 2 mg Tablet Biji 0
394 Lodomer 5 mg tab 653
395 Loratadin tab tab 90
396 Mecobalamin 500 mcg Tab 794
397 Mecobalamin inj amp 192
398 Mefinal 500 mg Kapsul Biji 578
399 Meloxicam 15 mg tab 1605
400 Meloxicam 7.5 mg tab 4035
401 Meprovent inh amp 50
402 Meptin Inhalation sol 0.3 ml ampul 138
403 Meptin inhalation sol 0.5 ml amp 168
404 Meptin swinghaler Unit 3
405 Merlopam 0.5 mg tab tab 996
406 Merlopam 2 mg tab 949
407 Meropenem inj 1 g vial 19
408 Mertigo tab tab 150
409 Metamizole tab tab 404
410 Metaneuron tab tab 0
411 Metformin 500 mg kapsul 10477
412 Metformin 850 mg tab 144
413 Methylprednisolon 4 mg tab 298

9
NO NAMA BARANG SATUAN JUMLAH
1 2 3 4
414 Methylprednisolon 8 mg tab 1764
415 Methylprednisolon 16 mg tab 0
416 Methylprednisolone 125 inj ampul 60
417 Metocloperamide inj amp 164
418 Metronidazole 500 mg tab 1310
419 Metronidazole 500 mg infus botol 250
420 Miconazole 2% cr tube 280
421 Micro brush svenska Box 0
422 Microlax Tube 14
423 Misotab tab tab 1000
424 Molacort 0,5 mg tab 139
425 Molesco 10 mg biji 929
426 Molesco 5 mg biji 257
427 Mometasone cr tube 100
428 Moxifloxacin infus Btl 5
429 MST 10 mg tab 60
430 Myco-Z cr tube 5
431 Mycoral cr tube 2
432 Myonal tab tab 20
433 Myonep tab tab 303
434 Na Phenytoin inj amp 8
435 Naquacol tab tab 60
436 Natrium Diklofenak 25 mg tab 8074
437 Natrium Diklofenak 50 mg tab 15169
438 Neo gynoxa ovula Ovula 10
439 Neo Napacin tab 24
440 Neurobion 5000 Inj ampul 0
441 Neurohax tab 0
442 New Diatab biji 698
443 Nicardipine 10 mg inj vial 15
444 Nifedipin 10 mg tab tab 627
445 Nitrokaf tab 200
446 Nobor tab 90
447 Nocid tab 200
448 Norages inj amp 626
449 Norages syr Btl 13
450 Norephineprine Ampul 13
451 Norvom Kapsul kapsul 933
452 Notisil 2 mg tab 170
453 Novomix-30 flexpen pcs 42
454 Novorapid flexpen pcs 85
455 Nystatin drop Btl 0
456 OBH itrasal syr Btl 0
457 ODR Drops 4 mg botol 2
458 Ofloxacin 200 mg tab 50
459 Ofloxacin 400 mg tab 50
460 Olanzapine 5 mg tab 0
461 Olanzapine 10 mg tab 190
462 Omeprazole 20 mg tab 851
463 Omeprazole 40 mg inj vial 109
464 Omeyus caps caps 0
465 Ondancentron 4 mg tab 0

10
NO NAMA BARANG SATUAN JUMLAH
1 2 3 4
466 Ondancentron 8 mg tablet biji 2243
467 Ondansetron 8 mg inj ampul 624
468 Ondansetron inj 4 mg Amp 887
469 Opilax syr btl 2
470 Optalvit syr botol 5
471 Oralit pcs 607
472 Osfit filco tab 455
473 Otopain ear drop Btl 2
474 Otsu manitol botol 20
475 Otsu Salin 3 botol 19
476 Otsu Water botol 1684
477 Oxytetrasiklin SK tube 37
478 Oxytetrasiklin SM tube 5
479 Pamol 125 mg supp Supp 51
480 Pamol 250 mg supp Supp 126
481 Pantoprazole vial 96
482 Paracetamol 1 g/100 ml infus botol 322
483 Paracetamol 500 mg kaplet 2219
484 Paracetamol syr btl 142
485 Paratusin Tab 1261
486 Pedialyte buble gumm Btl 5
487 Pedialyte sol Btl 3
488 Pepzol Inj vial 4
489 Persidal 2 mg tab 148
490 Pethidin HCl inj amp 129
491 Phenobarbital 30 mg tab 0
492 Phenytoin caps Tab 1074
493 Phytomenadion 10 mg inj amp 9
494 Pil KB Andalan box 28
495 Pimtracol Lemon syr botol 17
496 Pioglitazone 15 mg tab biji 515
497 Pioglitazone 30 mg tab 465
498 Piracetam 1 g inj ampul 84
499 Piracetam 3 g ampul 60
500 Piroxicam 10 mg tab 480
501 Piroxicam 20 mg tab 40
502 PK 5 gr vial 42
503 Plasminex tab tab 200
504 Plavesco 75 mg tab 0
505 Plester film island 25x10 Winner Pcs 0
506 Plesterin Bulat pcs 0
507 Pletaal biji 317
508 Polifix 10cm x 5 m Roll 0
509 Pot Salep 12.5 gr pcs 0
510 Pot Salep 30 gr pcs 0
511 Pouches flat 20 cm roll 0
512 Pouches flat reels 150mmx200m roll 0
513 Pouches flat reels 300mmx200m roll 0
514 Prednison 5 mg Tab 2363
515 Pregabalin 75 mg kapsul 81
516 Premilene 5/0 pcs 0
517 Proanes inj ampul 132

11
NO NAMA BARANG SATUAN JUMLAH
1 2 3 4
518 Procur Plus tab 85
519 Prohepar kapsul 200
520 Prohiper 10 mg tab 485
521 Prokasa 40 yx80 cm Roll 0
522 pronalges supp Supp 0
523 Prontosan gel tube 2
524 Propranolol 10 mg tab 635
525 Propranolol 40 mg tab 597
526 Propylthiouracil 100 mg tab 405
527 Prothyra 10 mg Tube 68
528 Pulp X Devitalizer 6 gr Denpo Pcs 0
529 Quaramol inf fles 0
530 Quetvell 100 mg tab 62
531 Quetvell 200 mg tab 517
532 Quetvell tab 25 mg Tab 387
533 Ramipril 2.5 mg tab 128
534 Ramipril 5 mg tab 49
535 Ranitidine inj ampul 1760
536 Ranitidine tablet biji 0
537 Regivell amp 0
538 Regumen tab 197
539 Renadinac 50 mg Tab 0
540 Renalof 325 mg kapsul 40
541 Retivit kaplet 0
542 Rifampicin 300 mg tab 6
543 Rinclo 75 mg tab 0
544 Rindobion Tab 670
545 Rindomam Tab 220
546 Rinofer tab 313
547 Risperidone 1 mg tab 1415
548 Risperidone 2 mg tab 1032
549 Risperidone 3 mg tab 1873
550 Rovator 20 mg tab 45
551 Sagestam Inj Ampul 481
552 Salbutamol 2 mg tab 1691
553 Salbutamol 4 mg tab 3097
554 Salfenal Forte 400 mg tab 0
555 Saliva ejector for single use svenska Pack 0
556 San B Plex Drops Botol 18
557 Sanbe Hest botol 339
558 Sangobion baby drop botol 3
559 Sangobion kids 100 ml btl 0
560 Sangobion vita-tonik syr Btl 0
561 Sanmol drop botol 8
562 Sanmol Syrup Botol 0
563 Sanmol tab tab 98
564 Sanprima tab tab 225
565 Sanprima Forte tab tab 207
566 Sansulin Dispopen pcs 0
567 Santocyn Inj ampul 805
568 Scabimite cr 10 g Tube 0
569 Scabimite cr 30 g Tube 20

12
NO NAMA BARANG SATUAN JUMLAH
1 2 3 4
570 Scacid Krim tube 80
571 Scopamin tab 0
572 Scopamin Inj ampul 0
573 Serlof tab tab 0
574 Sertraline HCl tab tab 4208
575 Sevoflurane Baxter botol 0
576 Sharpoint Nylon Suture 10-0 pcs 3
577 Sikzonoate inj amp 1
578 Simvastatin 10 mg tab 766
579 Simvastatin 20 mg tab 1831
580 Sodasorb standard 5 L botol 0
581 Solasic kap tab 0
582 Spasminal 10 mg tab 0
583 Spironolactone 25 mg tab 156
584 Sporetik 100 mg caps 75
585 Stelosi 5 mg tab 3800
586 Sterilization roll pcs 0
587 Stesolid 5 Mg tube 12
588 Stesolid 10 mg tube 23
589 Streptomycin sulfate inj amp 10
590 Sumagesic tab Tab 313
591 Tablet tambah darah biji 1413
592 Tas besar putih natural Pcs 0
593 Tas kecil putih natural Pcs 0
594 Tas tanggung putih natural Pcs 0
595 Tebokan tab 90
596 Teosal tab 0
597 Test Kehamilan Om pcs 35
598 Tetracyclin 500 mg tab 39
599 Thiamphenicol 500 mg caps 105
600 Thiamphenicol syr 2
601 Thyrozol 10 mg tab 378
602 Thyrozol 5 mg tab 470
603 Tiriz tab tab 10
604 Tiriz drop btl 6
605 Tizanidine tab 9
606 TKF/Tricresolformalina 10 ml Pcs 0
607 Tobroson MD pcs 0
608 Tofedex Inj ampul 0
609 Tofedex tab tab 1271
610 Tomaag Kaplet biji 1175
611 Topazol inj vial 0
612 Tranexamic acid inj 500 mg ampul 337
613 Tramus 1% inj 28
614 Tranexamid acid inj 250 mg amp 434
615 Tremenza tab tab 1733
616 Triamcinolone 4 mg tab 502
617 Trifacalc tab tab 151
618 T-SILK 2-0 RB pcs 0
619 Tuzalos kapl tab 403
620 Uni Bebi Cough Syrup botol 0

13
NO NAMA BARANG SATUAN JUMLAH
1 2 3 4
621 Unique 2.0 mm pcs 8
622 Unique 2.75 mm pcs 14
623 Unique Knifes 15 pcs 6
624 Uresic tab 79
625 Urinter kapsul 128
626 Ursodeoxycholic acid tab tab 219
627 Vagistin ovula ovula 0
628 Valisanbe 2 mg tab 980
629 Valisanbe 5 mg tab 1757
630 Valisanbe Inj vial 15
631 Valpi syr btl 3
632 Valsartan 160 mg tab 1390
633 Valsartan 80 mg tab 1113
634 Vaseline swab 10x10 pcs 0
635 Velutine inj vial 8
636 Ventolin neb Amp 0
637 Vip Albumin sach 5
638 Vip Albumin kapsul 186
639 Vipachol kapsul 30
640 Vit A IPI tab Tab 278
641 Vitacid cr 0,025% Tube 3
642 Vitacid cr 0,05% Tube 1
643 Vitacid cr 0,1% Tube 2
644 Vitadion inj amp 187
645 Vitamin B tab 0
646 Vitamin C tab 706
647 Voltaren 50 mg tab 13
648 Vosedon tab tab 346
649 Wida D5-1/2 NS 500 ml btl 44
 650 Wida KDN-1 btl 1
651 Widoxil caps 500 mg Tab 100
652 Write On ID For Adult pcs 0
653 XT REST SYR 3 pcs 0
654 Yarizine syr Btl 131
655 Yaz box 2
656 Zenirex syr Btl 5
657 Zinc tab tab 952
658 Zircum KID Strup botol 71

Mataram, Januari 2020

Kainstalasi Farmasi,

Novia Dewi, S.Farm., Apt.

Kapten Ckm (K) NRP 11080100571183

TIM VERIFIKASI :
1. Bidang Personil I. Nengah Ratna Wijaya Ttd…...................
Kapten Ckm NRP 21960286620775
2. Bidang Logistik & Materiil Novia Dewi S. Farm.Apt Ttd…..................
Kapten Ckm ( K ) NRP 11080100571183
3. Bidang Keuangan Sanup Ttd….................
Lettu Ckm NRP 21970236700177

Yang Menyerahkan Yang Menerima

dr. Soleh Sp.S dr. Yudi Akbar Manurung Sp.B

Mayor Ckm NRP 11070042260179 Kapten Ckm NRP 11080087051179

Mengetahui
Kepala Denkesyah Mataram

Dw Ngk Gd Widiatnyana S. Kep, Ners, M.M. Kes

Letnan Kolonel Ckm NRP 11950009461170