Unit Penerima : PUSKESMAS MADIUN Bulan : Oct

Kecamatan : Madiun Tahun : 2022

Kabupaten : Madiun
Provinsi : Jawa Timur
No Nama Satuan Awal Masuk Pesediaan Keluar Saldo Permintaan Pemberian Keterangan
1 ACETYLCYSTEINE TABLET 200 MG KAPSUL 5,189 0 5,189 0 5,189 0 0
2 ACYCLOVIR TABLET 400 MG TABLET 350 300 650 0 650 0 0
3 ALAT SUNTIK SEKALI PAKAI 0,5 ML PCS 12,765 0 12,765 0 12,765 0 0
4 ALAT SUNTIK SEKALI PAKAI 0.3 ML PCS 3,550 0 3,550 0 3,550 0 0
5 ALAT SUNTIK SEKALI PAKAI 1 ML PCS 0 100 100 0 100 0 0
6 ALAT SUNTIK SEKALI PAKAI 3 ML PCS 115 0 115 0 115 0 0
7 ALAT SUNTIK SEKALI PAKAI 5 ML PCS 0 100 100 0 100 0 0
8 ALBENDAZOLE TABLET 400 MG TABLET 1,073 0 1,073 0 1,073 0 0
9 ALKOHOL 70% 1 LITER BOTOL 130 0 130 1 129 0 0
10 ALKOHOL SWAB PCS 100 2,000 2,100 0 2,100 0 0
11 ALLOPURINOL TABLET 100 MG TABLET 597 1,000 1,597 10 1,587 0 0
12 ALLOPURINOL TABLET 300 MG TABLET 2,035 0 2,035 160 1,875 0 0
13 AMINOPHYLLINE INJEKSI 24 MG/ML AMPUL 10 0 10 0 10 0 0
14 AMITRIPTYLINE TABLET 25 MG TABLET 100 0 100 0 100 0 0
15 AMLODIPINE TABLET 10 MG TABLET 3,401 1,500 4,901 1,075 3,826 1,000 1,000
16 AMLODIPINE TABLET 5 MG TABLET 3,383 900 4,283 1,400 2,883 900 900
17 AMOXYCILLIN SIRUP 125 MG/5 ML BOTOL 22 0 22 5 17 0 0
18 AMOXYCILLIN TABLET 500 MG TABLET 5,233 1,000 6,233 784 5,449 1,000 1,000
19 AMPICILLIN INJEKSI 1 G/VIAL VIAL 0 0 0 0 0 10 10
20 ANTACIDA TABLET 400 MG TABLET 2,219 3,000 5,219 305 4,914 2,000 2,000
21 ANTIFUNGI: ASAM SALICYLICUM 30 MG, ASAM BENZOICUM 60 MG POT 24 0 24 0 24 0 0
22 ANTIHEMOROID DOEN SUPPOSITORIA 2 gr SUPPO 42 0 42 10 32 0 0
23 APRON FILM WHITE PCS 40 0 40 0 40 0 0
24 AQUA PRO INJEKSI 25 ML VIAL 131 110 241 0 241 0 0
25 ASAM MEFENAMAT TABLET 500 MG TABLET 3,622 500 4,122 690 3,432 5,000 5,000
26 ASAM TRANEKSAMAT INJEKSI (50MG/ML)/(250MG/5ML) AMPUL 0 0 0 0 0 10 10
27 ASCORBIC ACID (VITAMIN C) TABLET 250 MG TABLET 22,193 0 22,193 521 21,672 0 0
28 ASCORBIC ACID (VITAMIN C) TABLET 50 MG TABLET 9,465 4,000 13,465 489 12,976 0 0
29 ASCORBIC ACID (VITAMIN C) TABLET 500 MG TABLET 1,060 0 1,060 10 1,050 0 0
30 ASEPTIC GEL 1 LITER BOTOL 2 0 2 0 2 0 0
31 ASEPTIC GEL 5 Lt GALON 38 0 38 0 38 0 0
32 ASEPTIC GEL 500 CC BOTOL 36 0 36 0 36 0 0
33 ATROPINE SULPHATE INJEKSI 0.25 MG/ML AMPUL 30 0 30 0 30 0 0
34 ATTAPULGITE 630 MG / PULAREX TABLET 856 0 856 47 809 0 0
35 BAJU APD (DISPOSABLE PROTECTIVE COVER ALL)/HAZMAT PCS 317 0 317 0 317 0 0
36 BEDAK SALISIL SERBUK 2 % KOTAK 110 0 110 1 109 0 0
37 BETAHISTINE TABLET 6 MG TABLET 60 1,500 1,560 131 1,429 0 0
38 BISACODYL SUPPOSITORIA 10 MG SUPPO 41 0 41 0 41 0 0
39 BLOOD LANCET PCS 100 0 100 0 100 1,500 1,500
40 BUBUK TABUR GIZI SACHET 1,650 0 1,650 0 1,650 0 0
41 CALCIUM LACTATE TABLET 500 MG TABLET 4,070 1,000 5,070 686 4,384 0 0
42 CAPTOPRIL TABLET 12.5 MG TABLET 1,325 1,000 2,325 25 2,300 0 0
43 CEFADROXIL TABLET 500 MG KAPSUL 275 0 275 35 240 0 0
44 CHLORAMPHENICOL KAPSUL 250 MG KAPSUL 875 0 875 0 875 0 0
45 CHLORAMPHENICOL SALEP KULIT 2% (BUFACETIN SK 15 GR) TUBE 89 48 137 12 125 0 0
46 CHLORPHENIRAMINE MALEAT TABLET 4 MG (CTM) TABLET 7,100 1,000 8,100 1,119 6,981 2,000 2,000
47 CHLORPROMAZINE TABLET 25 MG (CPZ 25 MG) TABLET 2,780 1,500 4,280 555 3,725 0 0
48 Cholesterol (total) test system KOTAK 50 0 50 0 50 0 0
49 CHROMIC CATGUT WITH NEEDLE SURGICAL SUTURES 3/0 PCS 35 0 35 0 35 0 0
50 CLOZAPINE TABLET 25 MG TABLET 180 0 180 30 150 0 0
51 CODEINE TABLET 10 MG TABLET 630 0 630 15 615 0 0
52 COTRIMOXAZOLE (DOEN I DEWASA) : Sulfametoxazole 400 mg + Trimetoprim 80 mg TABLET 1,564 2,000 3,564 22 3,542 0 0
tablet
53 COTRIMOXAZOLE SUSPENSI KOMBINASI: SULFAMETOXAZOLE 200 MG + BOTOL 125 0 125 13 112 0 0
TRIMETROPIN 40 MG/5 ML
54 COVID-19 Ag TEST KIT 0 60 60 0 60 0 0
55 COVID-19 ANTIBODY IgM/IgG RAPID TEST PCS 3 0 3 0 3 0 0
56 CURCUMA 20 MG TABLET TABLET 950 0 950 0 950 0 0
57 DBS kit EID KIT 1 0 1 0 1 0 0
58 DEXAMETHASONE 0.5 MG TABLET TABLET 0 5,000 5,000 0 5,000 0 0
59 DEXAMETHASONE INJEKSI 5 MG/ML AMPUL 50 0 50 0 50 0 0
60 DIAZEPAM RECTAL 5MG / STESOLID (5/BOX) TUBE 5 0 5 0 5 0 0
61 DIAZEPAM TABLET 5 MG TABLET 40 0 40 0 40 0 0
62 DIPHENHYDRAMINE INJEKSI 10 MG/ML AMPUL 71 30 101 0 101 0 0
63 DOMPERIDONE TABLET 10 MG TABLET 735 0 735 0 735 0 0
64 DT VACCINE VIAL 0 22 22 0 22 0 0
65 EPINEPHRINE INJEKSI 1 MG/ML (i.v./s.k./i.m.) AMPUL 11 0 11 0 11 0 0
66 ERGOTAMINE TARTRATE|CAFFEINE TABLET (ANTI MIGRAIN) TABLET 284 100 384 20 364 0 0
67 Etanol 70% 1000 ml BOTOL 3 0 3 0 3 0 0
68 ETHYL CHLORIDE SPRAY BOTOL 4 0 4 1 3 3 3
69 EXAMINATION GLOVES SIZE L (HANDSCOON NON STERIL FREE POWDER L) PCS 1,000 0 1,000 0 1,000 0 0
70 EXAMINATION GLOVES SIZE S ( HANDSCOON NON STERIL FREE POWDER S) PCS 100 0 100 0 100 0 0
71 FACE SHIELD PCS 38 0 38 0 38 0 0
72 FAVIPIRAVIR 200 MG TABLET TABLET 680 0 680 0 680 0 0
73 Fenitoin injeksi 50mg/ml AMPUL 0 0 0 0 0 0 0
74 FITOMENADION (VIT. K) INJEKSI 10 MG/ML AMPUL 30 30 60 0 60 30 30
75 FITOMENADION (VIT. K1) 10 MG TABLET SALUT GULA TABLET 457 0 457 10 447 0 0
76 FITOMENADION (VITAMIN K) INJEKSI 2 MG/ML AMPUL 3 0 3 0 3 0 0
77 FLUPHENAZINE DECANOATE INJEKSI 25 MG/ML (i.m.)/SIKZONOATE AMPUL 20 0 20 0 20 0 0
78 FRAMYCETIN SULFATE TULE LEMBAR 27 20 47 0 47 0 0
79 FUROSEMIDE TABLET 40 MG TABLET 667 0 667 0 667 0 0
80 Garam Oralit Kombinasi Serbuk (200 ml air) SACHET 550 0 550 32 518 0 0
81 GENEXPERT MTB/RIF CARTRIDGE KIT 850 0 850 0 850 100 0 TB
82 GENTAMYCIN CAIRAN INJEKSI 80 MG/ML AMPUL 55 0 55 0 55 0 0
83 GENTAMYCIN SULFAT DROPS 0.3 %( tetes mata ) BOTOL 48 0 48 10 38 50 48
84 GLIBENCLAMIDE TABLET 5 MG TABLET 880 1,500 2,380 30 2,350 1,000 1,000
85 GLIMEPIRIDE TABLET 1 MG TABLET 740 0 740 300 440 0 0
86 GLIMEPIRIDE TABLET 3 MG TABLET 2,290 1,000 3,290 330 2,960 1,000 1,000
87 Glucose test system KOTAK 25 0 25 0 25 0 0
88 GUAIFENESIN TABLET 100 MG (Gliseril Guaiakolat 100 mg) TABLET 4,954 1,000 5,954 795 5,159 0 0
89 HALOPERIDOL TABLET 2 MG TABLET 4,205 0 4,205 500 3,705 0 0
90 HAND SANITIZER BOTOL 22 0 22 0 22 0 0
91 HEPATITIS B IMMUNE GLOBULIN (HUMAN) S/D 220 IU/ML (HYPERHEP 0,5 Ml)(HBIG) VIAL 1 0 1 0 1 0 0
92 HERBA VOMITZ (Syrup 60 ml) BOTOL 47 0 47 1 46 0 0
93 HERBACOLD TABLET 804 600 1,404 482 922 0 0
94 HerbaKOF (Reconyl TM, campuran ekstrak yang setara dengan simplisia: Vitex trifolia BOTOL 2 48 50 1 49 0 0
folium 1 GR, Zingiber officinale rhizone 0.25 GR, Abrus precatorius folium 0.25 GR,
Phaleria macrocarpa fructus 0.20 GR) 100 ML
95 HIDROKORTISON CREAM 2,5% TUBE 150 0 150 15 135 72 72
96 HYDROCHLOROTHIAZIDE TABLET 25 MG (HCT) TABLET 980 0 980 0 980 0 0
97 IBUPROFEN SIRUP 200 MG/5 ML BOTOL 69 0 69 6 63 0 0
98 IBUPROFEN TABLET 400 MG TABLET 4,645 1,000 5,645 590 5,055 0 0
99 ICE PACK PCS 10 0 10 0 10 0 0
100 IMUNOMODULATOR KAPSUL (Stimuno) KAPSUL 860 0 860 0 860 0 0
101 INACTIVATED POLIOMYELITIS VACCINE (IPV) VIAL 54 0 54 0 54 0 0
102 INFUSION SET DEWASA SET 5 0 5 0 5 0 0
103 IODIN TEST 10 ML BOTOL 0 1 1 0 1 0 0
104 ISONIAZID TABLET 100 MG (INH 100 MG) TABLET 400 0 400 0 400 0 0
105 ISOSORBIDE DINITRATE TABLET 5 MG (ISDN) TABLET 255 300 555 30 525 0 0
106 IV CATHETER NO.18 PCS 7 0 7 0 7 0 0
107 JARUM VACUTAINER / NEEDLE FLASHBACK PCS 1,000 0 1,000 0 1,000 0 0
108 KACAMATA GOOGLE PCS 14 0 14 0 14 0 0
109 KALSIUM GLUKONAT INJEKSI 100 MG/ML AMPUL 10 0 10 0 10 0 0
110 KANTONG JENAZAH PCS 25 0 25 0 25 0 0
111 KAPAS PUTIH 250 G ROLL 80 0 80 0 80 0 0
112 KARBOL LIQUID PCS 5 0 5 0 5 0 0
113 KASA HYDROFIL 4 M X 15 CM ROLL 30 0 30 0 30 0 0
114 Kertas EKG ROLL 0 0 0 0 0 2 2
115 KETOCONAZOLE SALEP 2% TUBE 30 0 30 4 26 0 0
116 KETOCONAZOLE TABLET 200 MG TABLET 0 0 0 0 0 300 300
117 Ketoprofen injeksi AMPUL 0 0 0 0 0 0 0
118 Ketorolac 30mg/ml injeksi AMPUL 0 0 0 0 0 0 0
119 KIT STOP TB RHZE (150/75/400/275)mg+RH(150/75)mg (TB HIV) PAKET 10 0 10 0 10 0 0
120 KLORAMFENIKOL TETES MATA 0.5% (Reco TM) BOTOL 50 0 50 0 50 0 0
121 KLORAMFENIKOL TETES TELINGA 1 % BOTOL 46 0 46 0 46 0 0
122 LARUTAN DESINFEKTAN (ALKOHOL CAIRAN DESINFECTANT 70%) BOTOL 25 0 25 0 25 0 0
123 LIDOCAINE INJEKSI 2% AMPUL 243 100 343 0 343 0 0
124 LORATADINE TABLET 10 MG TABLET 0 0 0 0 0 1,000 1,000
125 LYTACUR (Syrup 60 ml) BOTOL 30 48 78 9 69 0 0
126 MAGNESIUM SULFAT INJEKSI 20 % (i.v.) FLACON 20 0 20 0 20 0 0
127 MAGNESIUM SULFAT INJEKSI 40 % (i.v.) FLACON 20 0 20 0 20 0 0
128 MASKER (TALI) (TIES ON) PCS 900 0 900 0 900 0 0
129 MASKER HIJAB (HEADLOOP) PCS 4,150 0 4,150 100 4,050 0 0
130 MASKER KARET (EARLOOP) PCS 11,100 0 11,100 150 10,950 0 0
131 MASKER KN95 PCS 0 360 360 20 340 0 0
132 MASKER N95 PCS 384 0 384 0 384 0 0
133 MASKER NON MEDIS PCS 105 0 105 0 105 0 0
134 MDT COMBI MB ADULT : RIFAMPICIN 300 MG, CLOFAZIMINE 100 MG | DAPSON 100 BLISTER 1 0 1 0 1 0 0
MG
135 Medroxy Progesteron Acetat Inj. VIAL 4 0 4 0 4 0 0
136 METFORMIN HCL TABLET 500 MG TABLET 4,495 0 4,495 2,055 2,440 5,000 5,000
137 METHYLERGOMETRINE INJEKSI 0.2 MG/ML AMPUL 191 0 191 0 191 0 0
138 METHYLERGOMETRINE TABLET 0.125 MG TABLET 200 0 200 0 200 0 0
139 METHYLPREDNISOLONE TABLET 4 MG TABLET 493 0 493 30 463 3,000 1,000
140 METOCLOPRAMIDE TABLET 5 MG TABLET 1,800 0 1,800 0 1,800 0 0
141 METRONIDAZOLE TABLET 500 MG TABLET 547 0 547 80 467 2,000 2,000
142 MICONAZOLE SALEP 2% TUBE 90 0 90 19 71 0 0
143 MODERNA VACCINE COVID19 14 Dosis VIAL VIAL 2 0 2 0 2 0 0
144 MULTIVITAMIN DAN ZINC (CAVIPLEX CDEZ) TABLET 839 0 839 204 635 0 0
145 MULTIVITAMIN TABLET MG TABLET 1,192 0 1,192 144 1,048 0 0
146 NASAL CANNULA ANAK PACK 8 0 8 0 8 0 0
147 NASAL CANNULA DEWASA PACK 6 0 6 0 6 0 0
148 NATRIUM DIKLOFENAK TABLET 25 MG TABLET 8,093 0 8,093 1,116 6,977 0 0
149 NATRIUM DIKLOFENAK TABLET 50 MG TABLET 12 0 12 0 12 0 0
150 NYSTATIN OVULA 100000 IU/G(tablet vaginal) TABLET 184 0 184 0 184 0 0
151 NYSTATIN TABLET SALUT 500.000 IU(tablet salut gula) TABLET 200 0 200 0 200 0 0
152 OBAT BATUK HITAM (OBH) SIRUP BOTOL 6 0 6 0 6 0 0
153 OMEPRAZOLE INJEKSI 40 MG/VIAL VIAL 10 0 10 0 10 10 10
154 OSELTAMIVIR PHOSPHATE TABLET 75 MG KAPSUL 120 0 120 0 120 0 0
155 Oximeter UNIT 7 0 7 0 7 0 0
156 OXYTOCIN INJEKSI 10 IU/ML AMPUL 167 0 167 0 167 0 0
157 PAKET APD SET 2 0 2 0 2 0 0
158 PAKET STOP TB KATEGORI 1 KIT 5 0 5 0 5 0 0
159 PARACETAMOL SIRUP 120 MG/5 ML BOTOL 60 100 160 9 151 0 0
160 PARACETAMOL TABLET 500 MG TABLET 6,757 2,000 8,757 1,952 6,805 1,000 1,000
161 PERMETHRIN SALEP 5 % () TUBE 20 0 20 0 20 0 0
162 PFIZER VACCINE COVID19 6 DOSIS VIAL VIAL 27 5 32 0 32 0 0
163 PHENOBARBITAL INJEKSI 50 MG/ML AMPUL 0 0 0 0 0 10 10
164 PHENOL GLYCEROL (TETES TELINGA) 10% BOTOL 59 0 59 13 46 0 0
165 PHENYLPROPANOLAMINE | CHLORPHENAMINE | PARACETAMOL | GUAIFENESIN TABLET 42 0 42 6 36 0 0
TABLET ( Paraflu)(ANTI FLU & BATUK)
166 PIRIDOKSIN HCL ( VIT. B6 ) 10 MG TABLET 5,411 0 5,411 254 5,157 0 0
167 PLESTER ADHESIVE NON WOVEN FABRIC 5CM X 5M ROLL 11 5 16 1 15 0 0
168 Portable oxygen generator/OXYGEN CONCENTRATOR SET 1 0 1 0 1 0 0
169 POT SPUTUM PCS 500 0 500 0 500 0 0
170 POVIDONE IODINE 10% 300ML BOTOL 5 0 5 0 5 0 0
171 POVIDONE IODINE 10% 30ML BOTOL 7 17 24 0 24 0 0
172 POWDERED EXAMINATION GLOVES SIZE L PCS 1,800 0 1,800 0 1,800 0 0
173 POWDERED EXAMINATION SIZE M PCS 500 0 500 0 500 0 0
174 PREDNISONE TABLET 5 MG TABLET 6,163 1,000 7,163 911 6,252 0 0
175 PROPRANOLOL TABLET 10 MG TABLET 350 500 850 60 790 0 0
176 RAPID 1 HIV TEST 377 0 377 0 377 0 0
177 RAPID DIAGNOSTIC SYPHILIS TEST TEST 210 0 210 0 210 0 0
178 RAPID TEST HbsAg PCS 342 0 342 0 342 0 0
179 RETINOL PALMITATE TABLET 100000 IU (Vitamin A Biru) KAPSUL 100 0 100 0 100 0 0
180 RETINOL PALMITATE TABLET 200000 IU (Vitamin A Merah) KAPSUL 2,150 0 2,150 0 2,150 0 0
181 RINGER LAKTAT 500 ML (RL Infus) 500 ML 10 0 10 0 10 0 0
182 RISPERIDONE TABLET 2 MG TABLET 180 0 180 35 145 0 0
183 SAFETY BOX 5 LITER PCS 52 0 52 0 52 0 0
184 SALBUTAMOL TABLET 2 MG TABLET 455 7,000 7,455 80 7,375 0 0
185 SALEP 2-4 KOMBINASI: ASAM SALISILAT 2% + BELERANG ENDAP 4% POT 39 0 39 0 39 0 0
186 SARUNG TANGAN STERIL NO. 7 PASANG 30 0 30 0 30 0 0
187 SARUNG TANGAN STERIL NO. 7.5 PASANG 36 0 36 0 36 0 0
188 SEPATU BOOT PASANG 10 0 10 0 10 0 0
189 SERUM ANTI BISA ULAR POLIVALEN (KUDA) 5 ML (A.B.U.) (i.m./i.v.) VIAL 0 0 0 0 0 1 1
190 SIANOKOBALAMIN (VITAMIN B12) INJEKSI 500 MCG AMPUL 108 0 108 0 108 0 0
191 SIANOKOBALAMIN TABLET 50 MCG TABLET 2,125 2,000 4,125 885 3,240 3,000 3,000
192 SIMVASTATIN TABLET 20 MG TABLET 4,549 0 4,549 350 4,199 0 0
193 SINOPHARM 1 VIAL @ 2 DOSIS VIAL 28 0 28 0 28 0 0
194 SODIUM CHLORIDE INFUS 0.9 % (NaCl Infus 0,9%) BOTOL 20 0 20 0 20 0 0
195 ST GYNAECOLOG STERIL PASANG 23 0 23 0 23 0 0
196 STYROFOAM PCS 36 0 36 0 36 0 0
197 SULFADIAZINE SILVER SALEP 10 MG/G TUBE 38 0 38 0 38 0 0
198 TABLET TAMBAH DARAH KOMBINASI Fe + ASAM FOLAT TABLET 8,080 0 8,080 470 7,610 0 0
199 Td VACCIN VIAL 0 37 37 0 37 0 0
200 TEMEPHOS 1% 1 GR (ABATE) PCS 20 0 20 0 20 0 0
201 TETAGAM CAIRAN INJEKSI 250 IU/ML(DUS, 1 PREFILLED SYRINGE @ 1 ML) VIAL 1 1 2 0 2 1 1
202 TETRACYCLYN 500 MG KAPSUL 500 0 500 0 500 0 0
203 THIAMINE (VITAMIN B1) 50 MG TABLET 102 5,000 5,102 90 5,012 0 0
204 TRIFLUOPERAZINE TABLET 5 MG TABLET 220 0 220 0 220 0 0
205 TRIHEXYPHENIDYL TABLET 2 MG (THP 2 MG) TABLET 4,780 1,500 6,280 540 5,740 0 0
206 UNDERPAD PCS 40 0 40 0 40 0 0
207 URIC ACID TEST SYSTEM KOTAK 10 0 10 0 10 0 0
208 VACCINE COVID 19 MDV VIAL 325 0 325 0 325 0 0
209 VACUUM TUBE STERILE K3 EDTA 3ML soft needle tendre PCS 2,000 0 2,000 0 2,000 0 0
210 VAKSIN HUMAN PAPILOMA VIRUS (HPV) VIAL 103 0 103 0 103 0 0
211 VAKSIN MEASLES AND RUBELLA (MR) VIAL 149 0 149 0 149 0 0
212 VAKSIN MENINGITIS VIAL 14 0 14 0 14 0 0
213 VAKSIN PCV MDV 4 DOSIS (Pneumococcal Conjugate Vaccine) VIAL 10 10 20 0 20 0 0
214 VITAMIN B KOMPLEKS: VITAMIN B1 2 MG, VITAMIN B2 2 MG, VITAMIN B6 2 MG, TABLET 6,021 2,000 8,021 2,334 5,687 1,500 1,500
NICOTINAMIDE 20 MG, Ca PANTOTHENATE 10 MG
215 VITAMIN D3 CHOLECALCIFEROL 1000 IU TABLET TABLET 230 0 230 0 230 0 0
216 ZINC SULFATE SIRUP 20 MG BOTOL 60 ML BOTOL 270 0 270 0 270 0 0
217 ZINC SULPHATE TABLET 20 MG TABLET 1,865 0 1,865 125 1,740 0 0

MENGETAHUI / MENYETUJUI YANG MENYERAHKAN KEPALA YANG MENERIMA

a/n KEPALA DINAS KESEHATAN KEPALA INSTALASI FARMASI PUSKESMAS MADIUN PUSKESMAS MADIUN
KABID SUMBERDAYA KESEHATAN

THOMAS ADIWIBOWO, SKM, M.Kes Indriani, S. Far dr. Agnes Ani Triana Nully Andaretha Sugianto, S.Farm., Apt
NIP : 196605081988121003 NIP : 198505272011012025 NIP : 19810510 201101 2 008 NIP : 19950917 202012 2 007
Unit Penerima : PUSKESMAS MADIUN Bulan : Nov
Kecamatan : Madiun Tahun : 2022
Kabupaten : Madiun
Provinsi : Jawa Timur
No Nama Satuan Awal Masuk Pesediaan Keluar Saldo Permintaan Pemberian Keterangan
1 ACETYLCYSTEINE TABLET 200 MG KAPSUL 5,189 0 5,189 0 5,189 0 0
2 ACYCLOVIR TABLET 400 MG TABLET 650 0 650 35 615 0 0
3 ALAT SUNTIK SEKALI PAKAI 0,5 ML PCS 12,765 0 12,765 0 12,765 0 0
4 ALAT SUNTIK SEKALI PAKAI 0.3 ML PCS 3,550 0 3,550 0 3,550 0 0
5 ALAT SUNTIK SEKALI PAKAI 1 ML PCS 100 0 100 0 100 0 0
6 ALAT SUNTIK SEKALI PAKAI 3 ML PCS 115 0 115 0 115 0 0
7 ALAT SUNTIK SEKALI PAKAI 5 ML PCS 100 0 100 0 100 0 0
8 ALBENDAZOLE TABLET 400 MG TABLET 1,073 0 1,073 0 1,073 0 0
9 ALKOHOL 70% 1 LITER BOTOL 129 0 129 0 129 0 0
10 ALKOHOL SWAB PCS 1,900 0 1,900 0 1,900 1,000 1,000
11 ALLOPURINOL TABLET 100 MG TABLET 1,587 0 1,587 85 1,502 0 0
12 ALLOPURINOL TABLET 300 MG TABLET 1,875 0 1,875 226 1,649 0 0
13 AMINOPHYLLINE INJEKSI 24 MG/ML AMPUL 10 0 10 3 7 0 0
14 AMITRIPTYLINE TABLET 25 MG TABLET 100 0 100 0 100 0 0
15 AMLODIPINE TABLET 10 MG TABLET 3,796 1,000 4,796 1,270 3,526 2,500 2,500
16 AMLODIPINE TABLET 5 MG TABLET 2,883 900 3,783 1,519 2,264 3,000 3,000
17 AMOXYCILLIN SIRUP 125 MG/5 ML BOTOL 17 0 17 0 17 0 0
18 AMOXYCILLIN TABLET 500 MG TABLET 5,449 1,000 6,449 953 5,496 0 0
19 AMPICILLIN INJEKSI 1 G/VIAL VIAL 0 10 10 4 6 0 0
20 ANTACIDA TABLET 400 MG TABLET 4,914 2,000 6,914 694 6,220 1,000 1,000
21 ANTIFUNGI: ASAM SALICYLICUM 30 MG, ASAM BENZOICUM 60 MG POT 24 0 24 0 24 0 0
22 ANTIHEMOROID DOEN SUPPOSITORIA 2 gr SUPPO 32 0 32 2 30 0 0
23 APRON FILM WHITE PCS 40 0 40 0 40 0 0
24 AQUA PRO INJEKSI 25 ML VIAL 241 0 241 15 226 0 0
25 ASAM MEFENAMAT TABLET 500 MG TABLET 3,432 5,000 8,432 1,198 7,234 0 0
26 ASAM TRANEKSAMAT INJEKSI (50MG/ML)/(250MG/5ML) AMPUL 0 10 10 4 6 0 0
27 ASCORBIC ACID (VITAMIN C) TABLET 250 MG TABLET 21,672 0 21,672 1,324 20,348 0 0
28 ASCORBIC ACID (VITAMIN C) TABLET 50 MG TABLET 12,976 0 12,976 1,062 11,914 0 0
29 ASCORBIC ACID (VITAMIN C) TABLET 500 MG TABLET 1,050 0 1,050 10 1,040 0 0
30 ASEPTIC GEL 1 LITER BOTOL 2 0 2 0 2 0 0
31 ASEPTIC GEL 5 Lt GALON 38 0 38 0 38 0 0
32 ASEPTIC GEL 500 CC BOTOL 36 0 36 0 36 0 0
33 ATROPINE SULPHATE INJEKSI 0.25 MG/ML AMPUL 30 0 30 0 30 0 0
34 ATTAPULGITE 630 MG / PULAREX TABLET 809 0 809 118 691 0 0
35 BAJU APD (DISPOSABLE PROTECTIVE COVER ALL)/HAZMAT PCS 317 0 317 0 317 0 0
36 BEDAK SALISIL SERBUK 2 % KOTAK 108 0 108 10 98 0 0
37 BENZATHINE BENZYLPENICILLIN INJEKSI 240000 IU VIAL 0 3 3 0 3 0 0
38 BETAHISTINE TABLET 6 MG TABLET 1,429 0 1,429 221 1,208 0 0
39 BISACODYL SUPPOSITORIA 10 MG SUPPO 41 0 41 0 41 0 0
40 BLOOD LANCET PCS 100 1,500 1,600 0 1,600 0 0
41 BUBUK TABUR GIZI SACHET 1,650 0 1,650 0 1,650 0 0
42 CALCIUM LACTATE TABLET 500 MG TABLET 4,384 0 4,384 1,052 3,332 1,500 1,500
43 CAPTOPRIL TABLET 12.5 MG TABLET 2,300 0 2,300 305 1,995 0 0
44 CEFADROXIL TABLET 500 MG KAPSUL 240 0 240 25 215 0 0
45 CHLORAMPHENICOL KAPSUL 250 MG KAPSUL 875 0 875 0 875 0 0
46 CHLORAMPHENICOL SALEP KULIT 2% (BUFACETIN SK 15 GR) TUBE 125 0 125 14 111 0 0
47 CHLORPHENIRAMINE MALEAT TABLET 4 MG (CTM) TABLET 6,981 2,000 8,981 2,052 6,929 0 0
48 CHLORPROMAZINE TABLET 25 MG (CPZ 25 MG) TABLET 3,725 0 3,725 530 3,195 0 0
49 Cholesterol (total) test system KOTAK 50 0 50 0 50 0 0
50 CHROMIC CATGUT WITH NEEDLE SURGICAL SUTURES 3/0 PCS 35 0 35 0 35 0 0
51 CLOZAPINE TABLET 25 MG TABLET 150 0 150 0 150 0 0
52 CODEINE TABLET 10 MG TABLET 615 0 615 4 611 0 0
53 COTRIMOXAZOLE (DOEN I DEWASA) : Sulfametoxazole 400 mg + Trimetoprim 80 mg TABLET 3,542 0 3,542 58 3,484 0 0
tablet
54 COTRIMOXAZOLE SUSPENSI KOMBINASI: SULFAMETOXAZOLE 200 MG + BOTOL 112 0 112 0 112 0 0
TRIMETROPIN 40 MG/5 ML
55 COVID-19 Ag TEST KIT 60 0 60 0 60 0 0
56 COVID-19 ANTIBODY IgM/IgG RAPID TEST PCS 3 0 3 0 3 0 0
57 CURCUMA 20 MG TABLET TABLET 950 0 950 0 950 0 0
58 DBS kit EID KIT 1 0 1 0 1 0 0
59 DEXAMETHASONE 0.5 MG TABLET TABLET 4,934 0 4,934 725 4,209 0 0
60 DEXAMETHASONE INJEKSI 5 MG/ML AMPUL 50 0 50 0 50 0 0
61 DIAZEPAM RECTAL 5MG / STESOLID (5/BOX) TUBE 5 0 5 0 5 0 0
62 DIAZEPAM TABLET 5 MG TABLET 40 0 40 0 40 0 0
63 DIPHENHYDRAMINE INJEKSI 10 MG/ML AMPUL 101 0 101 5 96 0 0
64 DOMPERIDONE TABLET 10 MG TABLET 735 0 735 0 735 0 0
65 DT VACCINE VIAL 22 4 26 0 26 0 0
66 EPINEPHRINE INJEKSI 1 MG/ML (i.v./s.k./i.m.) AMPUL 11 0 11 2 9 0 0
67 ERGOTAMINE TARTRATE|CAFFEINE TABLET (ANTI MIGRAIN) TABLET 364 0 364 15 349 0 0
68 Etanol 70% 1000 ml BOTOL 3 0 3 0 3 0 0
69 ETHYL CHLORIDE SPRAY BOTOL 3 3 6 0 6 0 0
70 EXAMINATION GLOVES SIZE L (HANDSCOON NON STERIL FREE POWDER L) PCS 1,000 0 1,000 0 1,000 0 0
71 EXAMINATION GLOVES SIZE M (HANDSCOON NON STERIL FREE POWDER M) PCS 0 0 0 0 0 0 0
72 EXAMINATION GLOVES SIZE S ( HANDSCOON NON STERIL FREE POWDER S) PCS 100 0 100 0 100 0 0
73 FACE SHIELD PCS 38 0 38 0 38 0 0
74 FAVIPIRAVIR 200 MG TABLET TABLET 680 0 680 40 640 0 0
75 FITOMENADION (VIT. K) INJEKSI 10 MG/ML AMPUL 60 30 90 0 90 0 0
76 FITOMENADION (VIT. K1) 10 MG TABLET SALUT GULA TABLET 447 0 447 10 437 0 0
77 FITOMENADION (VITAMIN K) INJEKSI 2 MG/ML AMPUL 3 0 3 0 3 0 0
78 FLUPHENAZINE DECANOATE INJEKSI 25 MG/ML (i.m.)/SIKZONOATE AMPUL 20 0 20 2 18 0 0
79 FRAMYCETIN SULFATE TULE LEMBAR 47 0 47 10 37 0 0
80 FUROSEMIDE TABLET 40 MG TABLET 667 0 667 0 667 0 0
81 Garam Oralit Kombinasi Serbuk (200 ml air) SACHET 518 0 518 44 474 0 0
82 GENEXPERT MTB/RIF CARTRIDGE KIT 850 100 950 0 950 0 0
83 GENTAMYCIN CAIRAN INJEKSI 80 MG/ML AMPUL 55 0 55 0 55 0 0
84 GENTAMYCIN SULFAT DROPS 0.3 %( tetes mata ) BOTOL 38 48 86 17 69 24 24
85 GLIBENCLAMIDE TABLET 5 MG TABLET 2,350 1,000 3,350 80 3,270 1,000 1,000
86 GLIMEPIRIDE TABLET 1 MG TABLET 440 0 440 0 440 0 0
87 GLIMEPIRIDE TABLET 3 MG TABLET 2,940 1,000 3,940 550 3,390 1,000 1,000
88 Glucose test system KOTAK 25 0 25 0 25 0 0
89 GUAIFENESIN TABLET 100 MG (Gliseril Guaiakolat 100 mg) TABLET 5,127 0 5,127 2,048 3,079 3,000 0 kosong
90 HALOPERIDOL TABLET 2 MG TABLET 3,695 0 3,695 530 3,165 0 0
91 HAND SANITIZER BOTOL 22 0 22 0 22 0 0
92 HEPATITIS B IMMUNE GLOBULIN (HUMAN) S/D 220 IU/ML (HYPERHEP 0,5 Ml)(HBIG) VIAL 1 0 1 0 1 0 0
93 HERBA VOMITZ (Syrup 60 ml) BOTOL 46 0 46 0 46 0 0
94 HERBACOLD TABLET 922 0 922 549 373 0 0
95 HerbaKOF (Reconyl TM, campuran ekstrak yang setara dengan simplisia: Vitex trifolia BOTOL 49 0 49 0 49 0 0
folium 1 GR, Zingiber officinale rhizone 0.25 GR, Abrus precatorius folium 0.25 GR,
Phaleria macrocarpa fructus 0.20 GR) 100 ML
96 HIDROKORTISON CREAM 2,5% TUBE 135 72 207 37 170 48 48
97 HYDROCHLOROTHIAZIDE TABLET 25 MG (HCT) TABLET 980 0 980 0 980 0 0
98 IBUPROFEN SIRUP 200 MG/5 ML BOTOL 63 0 63 0 63 0 0
99 IBUPROFEN TABLET 400 MG TABLET 5,045 0 5,045 610 4,435 0 0
100 ICE PACK PCS 10 0 10 0 10 0 0
101 IMUNOMODULATOR KAPSUL (Stimuno) KAPSUL 860 0 860 0 860 0 0
102 INACTIVATED POLIOMYELITIS VACCINE (IPV) VIAL 54 0 54 0 54 0 0
103 INFUSION SET DEWASA SET 5 0 5 0 5 0 0
104 IODIN TEST 10 ML BOTOL 1 0 1 0 1 0 0
105 ISONIAZID TABLET 100 MG (INH 100 MG) TABLET 400 0 400 0 400 0 0
106 ISOSORBIDE DINITRATE TABLET 5 MG (ISDN) TABLET 525 0 525 100 425 0 0
107 IV CATHETER NO.18 PCS 7 0 7 0 7 0 0
108 JARUM VACUTAINER / NEEDLE FLASHBACK PCS 1,000 0 1,000 0 1,000 0 0
109 KACAMATA GOOGLE PCS 14 0 14 0 14 0 0
110 KALSIUM GLUKONAT INJEKSI 100 MG/ML AMPUL 10 0 10 3 7 0 0
111 KANTONG JENAZAH PCS 25 0 25 0 25 0 0
112 KAPAS PUTIH 250 G ROLL 80 0 80 0 80 0 0
113 KARBOL LIQUID PCS 5 0 5 0 5 0 0
114 KASA HYDROFIL 4 M X 15 CM ROLL 30 0 30 0 30 0 0
115 Kertas EKG ROLL 0 2 2 0 2 0 0
116 KETOCONAZOLE SALEP 2% TUBE 26 0 26 1 25 0 0
117 KETOCONAZOLE TABLET 200 MG TABLET 0 300 300 0 300 0 0
118 KIT STOP TB RHZE (150/75/400/275)mg+RH(150/75)mg (TB HIV) PAKET 10 0 10 0 10 0 0
119 KLORAMFENIKOL TETES MATA 0.5% (Reco TM) BOTOL 50 0 50 6 44 0 0
120 KLORAMFENIKOL TETES TELINGA 1 % BOTOL 46 0 46 8 38 0 0
121 LARUTAN DESINFEKTAN (ALKOHOL CAIRAN DESINFECTANT 70%) BOTOL 25 0 25 0 25 0 0
122 LIDOCAINE INJEKSI 2% AMPUL 343 0 343 251 92 0 0
123 LORATADINE TABLET 10 MG TABLET 0 1,000 1,000 0 1,000 0 0
124 LYTACUR (Syrup 60 ml) BOTOL 69 0 69 0 69 0 0
125 MAGNESIUM SULFAT INJEKSI 20 % (i.v.) FLACON 20 0 20 0 20 0 0
126 MAGNESIUM SULFAT INJEKSI 40 % (i.v.) FLACON 20 0 20 0 20 0 0
127 MASKER (TALI) (TIES ON) PCS 900 0 900 0 900 0 0
128 MASKER HIJAB (HEADLOOP) PCS 4,050 0 4,050 250 3,800 0 0
129 MASKER KARET (EARLOOP) PCS 10,950 0 10,950 100 10,850 0 0
130 MASKER KN95 PCS 340 0 340 0 340 0 0
131 MASKER N95 PCS 384 0 384 0 384 0 0
132 MASKER NON MEDIS PCS 105 0 105 0 105 0 0
133 MDT COMBI MB ADULT : RIFAMPICIN 300 MG, CLOFAZIMINE 100 MG | DAPSON 100 BLISTER 1 1 2 0 2 0 0
MG
134 Medroxy Progesteron Acetat Inj. VIAL 4 0 4 0 4 0 0
135 METFORMIN HCL TABLET 500 MG TABLET 2,440 5,000 7,440 1,924 5,516 3,000 3,000
136 METHYLERGOMETRINE INJEKSI 0.2 MG/ML AMPUL 191 0 191 0 191 0 0
137 METHYLERGOMETRINE TABLET 0.125 MG TABLET 200 0 200 0 200 0 0
138 METHYLPREDNISOLONE TABLET 4 MG TABLET 453 1,000 1,453 28 1,425 0 0
139 METOCLOPRAMIDE TABLET 5 MG TABLET 1,800 0 1,800 0 1,800 0 0
140 METRONIDAZOLE TABLET 500 MG TABLET 467 2,000 2,467 130 2,337 0 0
141 MICONAZOLE SALEP 2% TUBE 71 0 71 5 66 24 24
142 MODERNA VACCINE COVID19 14 Dosis VIAL VIAL 2 0 2 0 2 0 0
143 MULTIVITAMIN DAN ZINC (CAVIPLEX CDEZ) TABLET 635 0 635 189 446 0 0
144 MULTIVITAMIN TABLET MG TABLET 1,048 0 1,048 366 682 0 0
145 NASAL CANNULA ANAK PACK 8 0 8 0 8 0 0
146 NASAL CANNULA DEWASA PACK 6 0 6 0 6 0 0
147 NATRIUM DIKLOFENAK TABLET 25 MG TABLET 6,977 0 6,977 1,267 5,710 0 0
148 NATRIUM DIKLOFENAK TABLET 50 MG TABLET 12 0 12 0 12 0 0
149 NYSTATIN OVULA 100000 IU/G(tablet vaginal) TABLET 184 0 184 3 181 0 0
150 NYSTATIN TABLET SALUT 500.000 IU(tablet salut gula) TABLET 200 0 200 0 200 0 0
151 OBAT BATUK HITAM (OBH) SIRUP BOTOL 6 0 6 0 6 0 0
152 OMEPRAZOLE INJEKSI 40 MG/VIAL VIAL 10 10 20 0 20 0 0
153 OSELTAMIVIR PHOSPHATE TABLET 75 MG KAPSUL 120 0 120 0 120 0 0
154 Oximeter UNIT 7 0 7 0 7 0 0
155 OXYTOCIN INJEKSI 10 IU/ML AMPUL 167 0 167 0 167 0 0
156 PAKET APD SET 2 0 2 0 2 0 0
157 PAKET STOP TB KATEGORI 1 KIT 5 0 5 0 5 0 0
158 PARACETAMOL SIRUP 120 MG/5 ML BOTOL 151 0 151 0 151 0 0
159 PARACETAMOL TABLET 500 MG TABLET 6,805 1,000 7,805 2,758 5,047 2,000 2,000
160 PERMETHRIN SALEP 5 % () TUBE 20 0 20 0 20 0 0
161 PFIZER VACCINE COVID19 6 DOSIS VIAL VIAL 32 5 37 0 37 0 0
162 PHENOBARBITAL INJEKSI 50 MG/ML AMPUL 0 10 10 0 10 0 0
163 PHENOL GLYCEROL (TETES TELINGA) 10% BOTOL 46 0 46 2 44 0 0
164 PHENYLPROPANOLAMINE | CHLORPHENAMINE | PARACETAMOL | GUAIFENESIN TABLET 36 0 36 0 36 0 0
TABLET ( Paraflu)(ANTI FLU & BATUK)
165 PIRIDOKSIN HCL ( VIT. B6 ) 10 MG TABLET 5,157 0 5,157 529 4,628 0 0
166 PLESTER ADHESIVE NON WOVEN FABRIC 5CM X 5M ROLL 15 0 15 0 15 5 5
167 Portable oxygen generator/OXYGEN CONCENTRATOR SET 1 0 1 0 1 0 0
168 POT SPUTUM PCS 500 0 500 0 500 0 0
169 POVIDONE IODINE 10% 300ML BOTOL 5 0 5 0 5 0 0
170 POVIDONE IODINE 10% 30ML BOTOL 24 0 24 0 24 0 0
171 POWDERED EXAMINATION GLOVES SIZE L PCS 1,800 0 1,800 0 1,800 0 0
172 POWDERED EXAMINATION SIZE M PCS 500 0 500 0 500 0 0
173 PREDNISONE TABLET 5 MG TABLET 6,252 0 6,252 586 5,666 0 0
174 PROPRANOLOL TABLET 10 MG TABLET 790 0 790 60 730 0 0
175 RANITIDINE TABLET 150 MG TABLET 0 0 0 0 0 3,000 3,000
176 RAPID 1 HIV TEST 377 0 377 0 377 0 0
177 RAPID DIAGNOSTIC SYPHILIS TEST TEST 210 0 210 0 210 0 0
178 RAPID TEST HbsAg PCS 342 0 342 0 342 0 0
179 RETINOL PALMITATE TABLET 100000 IU (Vitamin A Biru) KAPSUL 100 0 100 0 100 0 0
180 RETINOL PALMITATE TABLET 200000 IU (Vitamin A Merah) KAPSUL 2,150 0 2,150 0 2,150 0 0
181 RINGER LAKTAT 500 ML (RL Infus) 500 ML 10 0 10 0 10 0 0
182 RISPERIDONE TABLET 2 MG TABLET 145 0 145 0 145 0 0
183 SAFETY BOX 5 LITER PCS 52 0 52 0 52 0 0
184 SALBUTAMOL TABLET 2 MG TABLET 7,375 0 7,375 190 7,185 0 0
185 SALEP 2-4 KOMBINASI: ASAM SALISILAT 2% + BELERANG ENDAP 4% POT 39 0 39 4 35 0 0
186 SARUNG TANGAN STERIL NO. 7 PASANG 29 0 29 0 29 0 0
187 SARUNG TANGAN STERIL NO. 7.5 PASANG 36 0 36 0 36 0 0
188 SEPATU BOOT PASANG 10 0 10 0 10 0 0
189 SERUM ANTI BISA ULAR POLIVALEN (KUDA) 5 ML (A.B.U.) (i.m./i.v.) VIAL 0 1 1 0 1 0 0
190 SIANOKOBALAMIN (VITAMIN B12) INJEKSI 500 MCG AMPUL 108 0 108 0 108 0 0
191 SIANOKOBALAMIN TABLET 50 MCG TABLET 3,240 3,000 6,240 1,477 4,763 0 0
192 SIMVASTATIN TABLET 20 MG TABLET 4,199 0 4,199 196 4,003 0 0
193 SINOPHARM 1 VIAL @ 2 DOSIS VIAL 28 0 28 0 28 0 0
194 SODIUM CHLORIDE INFUS 0.9 % (NaCl Infus 0,9%) BOTOL 20 0 20 0 20 0 0
195 ST GYNAECOLOG STERIL PASANG 23 0 23 0 23 0 0
196 STYROFOAM PCS 36 0 36 0 36 0 0
197 SULFADIAZINE SILVER SALEP 10 MG/G TUBE 38 0 38 3 35 10 0 kosong
198 TABLET TAMBAH DARAH KOMBINASI Fe + ASAM FOLAT TABLET 7,610 0 7,610 721 6,889 0 0
199 Td VACCIN VIAL 37 0 37 0 37 0 0
200 TEMEPHOS 1% 1 GR (ABATE) PCS 20 0 20 0 20 0 0
201 TETAGAM CAIRAN INJEKSI 250 IU/ML(DUS, 1 PREFILLED SYRINGE @ 1 ML) VIAL 2 1 3 1 2 1 1
202 TETRACYCLYN 500 MG KAPSUL 500 0 500 0 500 0 0
203 THIAMINE (VITAMIN B1) 50 MG TABLET 5,012 0 5,012 1,480 3,532 1,000 1,000
204 TRIFLUOPERAZINE TABLET 5 MG TABLET 220 0 220 0 220 0 0
205 TRIHEXYPHENIDYL TABLET 2 MG (THP 2 MG) TABLET 5,740 0 5,740 450 5,290 0 0
206 UNDERPAD PCS 40 0 40 0 40 0 0
207 URIC ACID TEST SYSTEM KOTAK 10 0 10 0 10 0 0
208 VACCINE COVID 19 MDV VIAL 325 0 325 0 325 0 0
209 VACUUM TUBE STERILE K3 EDTA 3ML soft needle tendre PCS 2,000 0 2,000 0 2,000 0 0
210 VAKSIN DPT-HB-Hib (PENTABIO) AMPUL 0 10 10 0 10 0 0
211 VAKSIN HUMAN PAPILOMA VIRUS (HPV) VIAL 103 0 103 0 103 0 0
212 VAKSIN MEASLES AND RUBELLA (MR) VIAL 149 0 149 0 149 0 0
213 VAKSIN MENINGITIS VIAL 14 0 14 0 14 0 0
214 VAKSIN PCV MDV 4 DOSIS (Pneumococcal Conjugate Vaccine) VIAL 20 0 20 0 20 0 0
215 VITAMIN B KOMPLEKS: VITAMIN B1 2 MG, VITAMIN B2 2 MG, VITAMIN B6 2 MG, TABLET 5,687 1,500 7,187 3,001 4,186 3,000 3,000
NICOTINAMIDE 20 MG, Ca PANTOTHENATE 10 MG
216 VITAMIN D3 CHOLECALCIFEROL 1000 IU TABLET TABLET 230 0 230 20 210 0 0
217 ZINC SULFATE SIRUP 20 MG BOTOL 60 ML BOTOL 270 0 270 0 270 0 0
218 ZINC SULPHATE TABLET 20 MG TABLET 1,740 0 1,740 191 1,549 0 0

MENGETAHUI / MENYETUJUI YANG MENYERAHKAN KEPALA YANG MENERIMA

a/n KEPALA DINAS KESEHATAN KEPALA INSTALASI FARMASI PUSKESMAS MADIUN PUSKESMAS MADIUN
KABID SUMBERDAYA KESEHATAN

THOMAS ADIWIBOWO, SKM, M.Kes Indriani, S. Far dr. Agnes Ani Triana Nully Andaretha Sugianto, S.Farm., Apt
NIP : 196605081988121003 NIP : 198505272011012025 NIP : 19810510 201101 2 008 NIP : 19950917 202012 2 007
Unit Penerima : PUSKESMAS MADIUN Bulan : Dec
Kecamatan : Madiun Tahun : 2022
Kabupaten : Madiun
Provinsi : Jawa Timur
No Nama Satuan Awal Masuk Pesediaan Keluar Saldo Permintaan Pemberian Keterangan
1 ACETYLCYSTEINE TABLET 200 MG KAPSUL 5,189 0 5,189 5,189 0 0 0
2 ACYCLOVIR TABLET 400 MG TABLET 615 0 615 310 305 300 300
3 ALAT SUNTIK SEKALI PAKAI 0,5 ML PCS 12,765 0 12,765 0 12,765 0 0
4 ALAT SUNTIK SEKALI PAKAI 0.3 ML PCS 3,550 0 3,550 0 3,550 0 0
5 ALAT SUNTIK SEKALI PAKAI 1 ML PCS 100 0 100 0 100 0 0
6 ALAT SUNTIK SEKALI PAKAI 3 ML PCS 115 0 115 6 109 0 0
7 ALAT SUNTIK SEKALI PAKAI 5 ML PCS 100 0 100 0 100 0 0
8 ALBENDAZOLE TABLET 400 MG TABLET 1,073 0 1,073 0 1,073 0 0
9 ALKOHOL 70% 1 LITER BOTOL 129 0 129 0 129 0 0
10 ALKOHOL SWAB PCS 1,900 1,000 2,900 80 2,820 1,000 1,000
11 ALLOPURINOL TABLET 100 MG TABLET 1,502 0 1,502 424 1,078 1,000 1,000
12 ALLOPURINOL TABLET 300 MG TABLET 1,649 0 1,649 428 1,221 1,000 200
13 AMINOPHYLLINE INJEKSI 24 MG/ML AMPUL 7 0 7 0 7 0 0
14 AMITRIPTYLINE TABLET 25 MG TABLET 100 0 100 0 100 0 0
15 AMLODIPINE TABLET 10 MG TABLET 3,526 2,500 6,026 1,295 4,731 2,500 2,500
16 AMLODIPINE TABLET 5 MG TABLET 2,264 3,000 5,264 1,809 3,455 1,800 1,800
17 AMOXYCILLIN SIRUP 125 MG/5 ML BOTOL 17 0 17 0 17 0 0
18 AMOXYCILLIN TABLET 500 MG TABLET 5,496 0 5,496 2,486 3,010 4,000 6,000
19 AMPICILLIN INJEKSI 1 G/VIAL VIAL 6 0 6 0 6 0 0
20 ANTACIDA TABLET 400 MG TABLET 6,220 1,000 7,220 2,876 4,344 2,500 2,500
21 ANTIFUNGI: ASAM SALICYLICUM 30 MG, ASAM BENZOICUM 60 MG POT 24 0 24 6 18 0 0
22 ANTIHEMOROID DOEN SUPPOSITORIA 2 gr SUPPO 30 0 30 9 21 30 0 kosong
23 APRON FILM WHITE PCS 40 0 40 0 40 0 0
24 AQUA PRO INJEKSI 25 ML VIAL 226 0 226 12 214 50 50
25 ASAM MEFENAMAT TABLET 500 MG TABLET 7,234 0 7,234 2,013 5,221 0 0
26 ASAM TRANEKSAMAT INJEKSI (50MG/ML)/(250MG/5ML) AMPUL 6 0 6 0 6 0 0
27 ASCORBIC ACID (VITAMIN C) TABLET 250 MG TABLET 20,348 0 20,348 1,989 18,359 0 0
28 ASCORBIC ACID (VITAMIN C) TABLET 50 MG TABLET 11,914 0 11,914 1,512 10,402 0 0
29 ASCORBIC ACID (VITAMIN C) TABLET 500 MG TABLET 600 0 600 600 0 0 0
30 ASEPTIC GEL 1 LITER BOTOL 2 0 2 0 2 0 0
31 ASEPTIC GEL 5 Lt GALON 38 0 38 4 34 0 0
32 ASEPTIC GEL 500 CC BOTOL 36 0 36 0 36 0 0
33 ATROPINE SULPHATE INJEKSI 0.25 MG/ML AMPUL 30 0 30 20 10 0 0
34 ATTAPULGITE 630 MG / PULAREX TABLET 691 0 691 110 581 300 300
35 BAJU APD (DISPOSABLE PROTECTIVE COVER ALL)/HAZMAT PCS 317 0 317 0 317 0 0
36 BEDAK SALISIL SERBUK 2 % KOTAK 98 0 98 20 78 36 36
37 BENZATHINE BENZYLPENICILLIN INJEKSI 240000 IU VIAL 3 0 3 3 0 0 0
38 BETAHISTINE TABLET 6 MG TABLET 1,208 0 1,208 216 992 500 0 kosong
39 BISACODYL SUPPOSITORIA 10 MG SUPPO 41 0 41 3 38 0 0
40 BLOOD LANCET PCS 1,600 0 1,600 0 1,600 500 500
41 BUBUK TABUR GIZI SACHET 1,650 0 1,650 1,650 0 0 0
42 CALCIUM LACTATE TABLET 500 MG TABLET 3,332 1,500 4,832 1,422 3,410 2,500 2,500
43 CAPTOPRIL TABLET 12.5 MG TABLET 1,995 0 1,995 348 1,647 1,500 1,500
44 CEFADROXIL TABLET 500 MG KAPSUL 215 0 215 50 165 300 300
45 CHLORAMPHENICOL KAPSUL 250 MG KAPSUL 875 0 875 100 775 0 0
46 CHLORAMPHENICOL SALEP KULIT 2% (BUFACETIN SK 15 GR) TUBE 111 0 111 31 80 48 0 kosong
47 CHLORPHENIRAMINE MALEAT TABLET 4 MG (CTM) TABLET 6,929 0 6,929 1,833 5,096 2,000 2,000
48 CHLORPROMAZINE TABLET 25 MG (CPZ 25 MG) TABLET 3,195 0 3,195 540 2,655 2,000 0 kosong
49 Cholesterol (total) test system KOTAK 50 0 50 0 50 0 0
50 CHROMIC CATGUT WITH NEEDLE SURGICAL SUTURES 3/0 PCS 35 0 35 0 35 0 0
51 CLOZAPINE TABLET 25 MG TABLET 150 0 150 30 120 0 0
52 CODEINE TABLET 10 MG TABLET 611 0 611 5 606 0 0
53 COTRIMOXAZOLE (DOEN I DEWASA) : Sulfametoxazole 400 mg + Trimetoprim 80 mg TABLET 3,484 0 3,484 614 2,870 0 0
tablet
54 COTRIMOXAZOLE SUSPENSI KOMBINASI: SULFAMETOXAZOLE 200 MG + BOTOL 112 0 112 6 106 0 0
TRIMETROPIN 40 MG/5 ML
55 COVID-19 Ag TEST KIT 60 0 60 60 0 0 0
56 COVID-19 ANTIBODY IgM/IgG RAPID TEST PCS 3 0 3 0 3 0 0
57 CURCUMA 20 MG TABLET TABLET 950 0 950 0 950 0 0
58 DBS kit EID KIT 1 0 1 1 0 0 0
59 DEXAMETHASONE 0.5 MG TABLET TABLET 4,209 0 4,209 418 3,791 0 0
60 DEXAMETHASONE INJEKSI 5 MG/ML AMPUL 50 0 50 50 0 20 0 kosong
61 DIAZEPAM RECTAL 5MG / STESOLID (5/BOX) TUBE 5 0 5 0 5 0 0
62 DIAZEPAM TABLET 5 MG TABLET 40 0 40 0 40 0 0
63 DIGOXIN 0,25 MG TABLET 0 0 0 0 0 300 300
64 DIPHENHYDRAMINE INJEKSI 10 MG/ML AMPUL 96 0 96 13 83 0 0
65 DOMPERIDONE TABLET 10 MG TABLET 735 0 735 10 725 0 0
66 DT VACCINE VIAL 26 0 26 26 0 0 0
67 EPINEPHRINE INJEKSI 1 MG/ML (i.v./s.k./i.m.) AMPUL 9 0 9 0 9 0 0
68 ERGOTAMINE TARTRATE|CAFFEINE TABLET (ANTI MIGRAIN) TABLET 349 0 349 20 329 0 0
69 Etanol 70% 1000 ml BOTOL 3 0 3 0 3 0 0
70 ETHYL CHLORIDE SPRAY BOTOL 6 0 6 0 6 0 0
71 EXAMINATION GLOVES SIZE L (HANDSCOON NON STERIL FREE POWDER L) PCS 1,000 0 1,000 0 1,000 0 0
72 EXAMINATION GLOVES SIZE S ( HANDSCOON NON STERIL FREE POWDER S) PCS 100 0 100 0 100 0 0
73 FACE SHIELD PCS 38 0 38 0 38 0 0
74 FAVIPIRAVIR 200 MG TABLET TABLET 640 0 640 0 640 0 0
75 FITOMENADION (VIT. K) INJEKSI 10 MG/ML AMPUL 90 0 90 30 60 0 0
76 FITOMENADION (VIT. K1) 10 MG TABLET SALUT GULA TABLET 437 0 437 10 427 0 0
77 FITOMENADION (VITAMIN K) INJEKSI 2 MG/ML AMPUL 3 0 3 3 0 0 0
78 FLUPHENAZINE DECANOATE INJEKSI 25 MG/ML (i.m.)/SIKZONOATE AMPUL 18 0 18 3 15 10 10
79 FRAMYCETIN SULFATE TULE LEMBAR 37 0 37 0 37 0 0
80 FUROSEMIDE TABLET 40 MG TABLET 667 0 667 20 647 0 0
81 Garam Oralit Kombinasi Serbuk (200 ml air) SACHET 474 0 474 232 242 300 300
82 GENEXPERT MTB/RIF CARTRIDGE KIT 950 0 950 950 0 0 0
83 GENTAMYCIN CAIRAN INJEKSI 80 MG/ML AMPUL 55 0 55 0 55 0 0
84 GENTAMYCIN SULFAT DROPS 0.3 %( tetes mata ) BOTOL 69 24 93 7 86 0 0
85 GLIBENCLAMIDE TABLET 5 MG TABLET 3,270 1,000 4,270 660 3,610 2,500 2,500
86 GLIMEPIRIDE TABLET 1 MG TABLET 440 0 440 335 105 0 0
87 GLIMEPIRIDE TABLET 3 MG TABLET 3,390 1,000 4,390 870 3,520 2,500 2,500
88 Glucose test system KOTAK 25 9 34 28 6 0 0
89 GUAIFENESIN TABLET 100 MG (Gliseril Guaiakolat 100 mg) TABLET 3,079 0 3,079 2,321 758 2,000 0 kosong
90 HALOPERIDOL TABLET 2 MG TABLET 3,165 0 3,165 570 2,595 2,000 2,000
91 HAND SANITIZER BOTOL 22 0 22 0 22 0 0
92 HEPATITIS B IMMUNE GLOBULIN (HUMAN) S/D 220 IU/ML (HYPERHEP 0,5 Ml)(HBIG) VIAL 1 0 1 1 0 0 0
93 HERBA VOMITZ (Syrup 60 ml) BOTOL 46 0 46 0 46 0 0
94 HERBACOLD TABLET 373 0 373 329 44 0 0
95 HerbaKOF (Reconyl TM, campuran ekstrak yang setara dengan simplisia: Vitex trifolia BOTOL 49 0 49 3 46 0 0
folium 1 GR, Zingiber officinale rhizone 0.25 GR, Abrus precatorius folium 0.25 GR,
Phaleria macrocarpa fructus 0.20 GR) 100 ML
96 HIDROKORTISON CREAM 2,5% TUBE 170 48 218 97 121 48 48
97 HYDROCHLOROTHIAZIDE TABLET 25 MG (HCT) TABLET 980 0 980 125 855 0 0
98 IBUPROFEN SIRUP 200 MG/5 ML BOTOL 63 0 63 0 63 0 0
99 IBUPROFEN TABLET 400 MG TABLET 4,435 0 4,435 509 3,926 3,000 3,000
100 ICE PACK PCS 10 0 10 10 0 0 0
101 IMUNOMODULATOR KAPSUL (Stimuno) KAPSUL 860 0 860 0 860 0 0
102 INACTIVATED POLIOMYELITIS VACCINE (IPV) VIAL 54 0 54 54 0 0 0
103 INFUSION SET DEWASA SET 5 0 5 1 4 0 0
104 IODIN TEST 10 ML BOTOL 1 0 1 1 0 0 0
105 ISONIAZID TABLET 100 MG (INH 100 MG) TABLET 400 0 400 400 0 0 0
106 ISOSORBIDE DINITRATE TABLET 5 MG (ISDN) TABLET 425 0 425 0 425 0 0
107 IV CATHETER NO.18 PCS 7 0 7 1 6 0 0
108 JARUM VACUTAINER / NEEDLE FLASHBACK PCS 1,000 0 1,000 1,000 0 0 0
109 KACAMATA GOOGLE PCS 14 0 14 0 14 0 0
110 KALSIUM GLUKONAT INJEKSI 100 MG/ML AMPUL 7 0 7 0 7 0 0
111 KANTONG JENAZAH PCS 25 0 25 0 25 0 0
112 KAPAS PUTIH 250 G ROLL 80 0 80 0 80 0 0
113 KARBOL LIQUID PCS 5 0 5 0 5 0 0
114 KASA HIDROFIL 2y x 80cm PACK 0 0 0 0 0 0 0
115 KASA HYDROFIL 4 M X 15 CM ROLL 30 0 30 0 30 0 0
116 KASA PEMBALUT HIDROFIL 40 YDS X 80 CM ROLL 0 0 0 0 0 3 3
117 Kertas EKG ROLL 2 0 2 0 2 0 0
118 KETOCONAZOLE SALEP 2% TUBE 25 0 25 25 0 48 0 kosong
119 KETOCONAZOLE TABLET 200 MG TABLET 300 0 300 0 300 0 0
120 KIT STOP TB RHZE (150/75/400/275)mg+RH(150/75)mg (TB HIV) PAKET 10 0 10 0 10 0 0
121 KLORAMFENIKOL TETES MATA 0.5% (Reco TM) BOTOL 44 0 44 16 28 0 0
122 KLORAMFENIKOL TETES TELINGA 1 % BOTOL 38 0 38 10 28 0 0
123 LARUTAN DESINFEKTAN (ALKOHOL CAIRAN DESINFECTANT 70%) BOTOL 25 0 25 0 25 0 0
124 LIDOCAINE INJEKSI 2% AMPUL 92 0 92 0 92 0 0
125 LORATADINE TABLET 10 MG TABLET 1,000 0 1,000 162 838 1,000 1,000
126 LYTACUR (Syrup 60 ml) BOTOL 69 0 69 1 68 0 0
127 MAGNESIUM SULFAT INJEKSI 20 % (i.v.) FLACON 20 0 20 10 10 5 5
128 MAGNESIUM SULFAT INJEKSI 40 % (i.v.) FLACON 20 0 20 10 10 5 5
129 MASKER (TALI) (TIES ON) PCS 900 0 900 0 900 0 0
130 MASKER HIJAB (HEADLOOP) PCS 3,800 0 3,800 150 3,650 0 0
131 MASKER KARET (EARLOOP) PCS 10,850 0 10,850 50 10,800 0 0
132 MASKER KN95 PCS 340 0 340 0 340 0 0
133 MASKER N95 PCS 384 0 384 0 384 0 0
134 MASKER NON MEDIS PCS 105 0 105 0 105 0 0
135 MDT COMBI MB ADULT : RIFAMPICIN 300 MG, CLOFAZIMINE 100 MG | DAPSON 100 BLISTER 2 1 3 0 3 1 1
MG
136 Medroxy Progesteron Acetat Inj. VIAL 4 0 4 0 4 0 0
137 METFORMIN HCL TABLET 500 MG TABLET 5,516 3,000 8,516 3,036 5,480 4,000 4,000
138 METHYLERGOMETRINE INJEKSI 0.2 MG/ML AMPUL 191 0 191 6 185 0 0
139 METHYLERGOMETRINE TABLET 0.125 MG TABLET 200 0 200 0 200 0 0
140 METHYLPREDNISOLONE TABLET 4 MG TABLET 1,425 0 1,425 496 929 0 0
141 METOCLOPRAMIDE TABLET 5 MG TABLET 1,800 0 1,800 1,800 0 0 0
142 METRONIDAZOLE TABLET 500 MG TABLET 2,337 0 2,337 52 2,285 0 0
143 MICONAZOLE SALEP 2% TUBE 66 24 90 16 74 0 0
144 MODERNA VACCINE COVID19 14 Dosis VIAL VIAL 2 0 2 2 0 0 0
145 MULTIVITAMIN DAN ZINC (CAVIPLEX CDEZ) TABLET 446 0 446 191 255 0 0
146 MULTIVITAMIN TABLET MG TABLET 682 0 682 80 602 0 0
147 NASAL CANNULA ANAK PACK 8 0 8 5 3 0 0
148 NASAL CANNULA DEWASA PACK 6 0 6 2 4 0 0
149 NATRIUM DIKLOFENAK TABLET 25 MG TABLET 5,710 0 5,710 1,545 4,165 0 0
150 NATRIUM DIKLOFENAK TABLET 50 MG TABLET 12 0 12 10 2 3,000 3,000
151 NYSTATIN OVULA 100000 IU/G(tablet vaginal) TABLET 181 0 181 81 100 0 0
152 NYSTATIN TABLET SALUT 500.000 IU(tablet salut gula) TABLET 200 0 200 200 0 0 0
153 OBAT BATUK HITAM (OBH) SIRUP BOTOL 6 0 6 1 5 0 0
154 OMEPRAZOLE INJEKSI 40 MG/VIAL VIAL 20 0 20 10 10 0 0
155 OSELTAMIVIR PHOSPHATE TABLET 75 MG KAPSUL 120 0 120 20 100 0 0
156 Oximeter UNIT 7 0 7 0 7 0 0
157 OXYTOCIN INJEKSI 10 IU/ML AMPUL 167 0 167 117 50 0 0
158 PAKET APD SET 2 0 2 0 2 0 0
159 PAKET STOP TB KATEGORI 1 KIT 5 0 5 3 2 0 0
160 PARACETAMOL SIRUP 120 MG/5 ML BOTOL 151 0 151 13 138 0 0
161 PARACETAMOL TABLET 500 MG TABLET 5,047 2,000 7,047 2,308 4,739 3,000 3,000
162 PERMETHRIN SALEP 5 % () TUBE 20 0 20 1 19 0 0
163 PFIZER VACCINE COVID19 6 DOSIS VIAL VIAL 37 15 52 52 0 0 0
164 PHENOBARBITAL INJEKSI 50 MG/ML AMPUL 10 0 10 0 10 0 0
165 PHENOL GLYCEROL (TETES TELINGA) 10% BOTOL 44 0 44 5 39 24 0 kosong
166 PHENYLPROPANOLAMINE | CHLORPHENAMINE | PARACETAMOL | GUAIFENESIN TABLET 36 0 36 36 0 0 0
TABLET ( Paraflu)(ANTI FLU & BATUK)
167 PIRIDOKSIN HCL ( VIT. B6 ) 10 MG TABLET 4,628 0 4,628 286 4,342 1,000 7,000
168 PLESTER ADHESIVE NON WOVEN FABRIC 5CM X 5M ROLL 15 5 20 14 6 10 10
169 Portable oxygen generator/OXYGEN CONCENTRATOR SET 1 0 1 0 1 0 0
170 POT SPUTUM PCS 500 0 500 500 0 500 0 TB
171 POVIDONE IODINE 10% 300ML BOTOL 5 0 5 2 3 0 0
172 POVIDONE IODINE 10% 30ML BOTOL 24 0 24 17 7 10 10
173 POWDERED EXAMINATION GLOVES SIZE L PCS 1,800 0 1,800 0 1,800 0 0
174 POWDERED EXAMINATION SIZE M PCS 500 0 500 0 500 0 0
175 PREDNISONE TABLET 5 MG TABLET 5,666 0 5,666 791 4,875 0 0
176 PROPRANOLOL TABLET 10 MG TABLET 730 0 730 30 700 0 0
177 RANITIDINE TABLET 150 MG TABLET 0 3,000 3,000 200 2,800 0 0
178 RAPID 1 HIV TEST 377 0 377 210 167 0 0
179 RAPID DIAGNOSTIC SYPHILIS TEST TEST 210 0 210 210 0 0 0
180 RAPID TEST HbsAg PCS 342 0 342 275 67 50 50
181 RETINOL PALMITATE TABLET 100000 IU (Vitamin A Biru) KAPSUL 100 0 100 0 100 0 0
182 RETINOL PALMITATE TABLET 200000 IU (Vitamin A Merah) KAPSUL 2,150 0 2,150 0 2,150 0 0
183 RINGER LAKTAT 500 ML (RL Infus) 500 ML 10 0 10 1 9 0 0
184 RISPERIDONE TABLET 2 MG TABLET 145 0 145 37 108 0 0
185 SAFETY BOX 5 LITER PCS 52 0 52 0 52 0 0
186 SALBUTAMOL TABLET 2 MG TABLET 7,185 0 7,185 100 7,085 0 0
187 SALEP 2-4 KOMBINASI: ASAM SALISILAT 2% + BELERANG ENDAP 4% POT 35 0 35 2 33 0 0
188 SARUNG TANGAN STERIL NO. 7 PASANG 29 0 29 0 29 0 0
189 SARUNG TANGAN STERIL NO. 7.5 PASANG 36 0 36 0 36 0 0
190 SEPATU BOOT PASANG 10 0 10 0 10 0 0
191 SERUM ANTI BISA ULAR POLIVALEN (KUDA) 5 ML (A.B.U.) (i.m./i.v.) VIAL 1 0 1 0 1 0 0
192 SIANOKOBALAMIN (VITAMIN B12) INJEKSI 500 MCG AMPUL 108 0 108 108 0 100 100
193 SIANOKOBALAMIN TABLET 50 MCG TABLET 4,763 0 4,763 881 3,882 2,000 2,000
194 SIMVASTATIN TABLET 20 MG TABLET 4,003 0 4,003 120 3,883 0 0
195 SINOPHARM 1 VIAL @ 2 DOSIS VIAL 28 0 28 28 0 0 0
196 SODIUM CHLORIDE INFUS 0.9 % (NaCl Infus 0,9%) BOTOL 20 0 20 0 20 0 0
197 ST GYNAECOLOG STERIL PASANG 23 0 23 0 23 0 0
198 STYROFOAM PCS 36 0 36 0 36 0 0
199 SULFADIAZINE SILVER SALEP 10 MG/G TUBE 35 0 35 35 0 10 0 kosong
200 TABLET TAMBAH DARAH KOMBINASI Fe + ASAM FOLAT TABLET 6,889 0 6,889 2,626 4,263 0 0
201 Td VACCIN VIAL 37 0 37 37 0 0 0
202 TEMEPHOS 1% 1 GR (ABATE) PCS 20 0 20 20 0 0 0
203 TETAGAM CAIRAN INJEKSI 250 IU/ML(DUS, 1 PREFILLED SYRINGE @ 1 ML) VIAL 2 1 3 1 2 2 0
204 TETRACYCLYN 500 MG KAPSUL 500 0 500 500 0 0 0
205 THIAMINE (VITAMIN B1) 50 MG TABLET 3,532 1,000 4,532 1,685 2,847 3,000 3,000
206 TRIFLUOPERAZINE TABLET 5 MG TABLET 220 0 220 0 220 0 0
207 TRIHEXYPHENIDYL TABLET 2 MG (THP 2 MG) TABLET 5,290 0 5,290 480 4,810 2,000 2,000
208 UNDERPAD PCS 40 0 40 0 40 0 0
209 URIC ACID TEST SYSTEM KOTAK 10 0 10 0 10 0 0
210 VACCINE COVID 19 MDV VIAL 325 0 325 325 0 0 0
211 VACUUM TUBE STERILE K3 EDTA 3ML soft needle tendre PCS 2,000 0 2,000 2,000 0 0 0
212 VAKSIN DPT-HB-Hib (PENTABIO) AMPUL 10 10 20 20 0 0 0
213 VAKSIN HUMAN PAPILOMA VIRUS (HPV) VIAL 103 0 103 103 0 0 0
214 VAKSIN MEASLES AND RUBELLA (MR) VIAL 149 0 149 149 0 0 0
215 VAKSIN MENINGITIS VIAL 14 0 14 14 0 0 0
216 VAKSIN PCV MDV 4 DOSIS (Pneumococcal Conjugate Vaccine) VIAL 20 0 20 20 0 0 0
217 VITAMIN B KOMPLEKS: VITAMIN B1 2 MG, VITAMIN B2 2 MG, VITAMIN B6 2 MG, TABLET 4,186 3,000 7,186 3,463 3,723 4,000 4,000
NICOTINAMIDE 20 MG, Ca PANTOTHENATE 10 MG
218 VITAMIN D3 CHOLECALCIFEROL 1000 IU TABLET TABLET 210 0 210 30 180 0 0
219 ZINC SULFATE SIRUP 20 MG BOTOL 60 ML BOTOL 270 0 270 270 0 0 0
220 ZINC SULPHATE TABLET 20 MG TABLET 1,549 0 1,549 188 1,361 0 0

MENGETAHUI / MENYETUJUI YANG MENYERAHKAN KEPALA YANG MENERIMA

a/n KEPALA DINAS KESEHATAN KEPALA INSTALASI FARMASI PUSKESMAS MADIUN PUSKESMAS MADIUN
KABID SUMBERDAYA KESEHATAN

THOMAS ADIWIBOWO, SKM, M.Kes Indriani, S. Far dr. Agnes Ani Triana Nully Andaretha Sugianto, S.Farm., Apt
NIP : 196605081988121003 NIP : 198505272011012025 NIP : 19810510 201101 2 008 NIP : 19950917 202012 2 007