berita acara pemusnahan obat

8/19/2019 Berita Acara Pemusnahan Obat

1/50

BERITA ACARA PENGHAPUSAN/PEMUSNAHAN OBAT

PUSKESMAS MODO

TAHUN 2014

NO Nama Obat Kemasan Harga Satuan Jumlah

1 Diazepam 2 mg Tablet Kaleng/1000 tablet 355 Jan-12

2 Diazepam 2 mg Tablet Kaleng/1000 tablet !3 "ar-11

3 Diazepam 2 mg Tablet Kaleng/1000 tablet 202 N#$-11

% Diazepam 2 mg Tablet Kaleng/1000 tablet 1! N#$-11

5 Diazepam in&e'si (mpul K#ta'/30 ampul 1) Sep-11

* Diazepam in&e'si (mpul K#ta'/30 ampul 2* Sep-13

) (mitriptilin 25 mg Tablet K#ta'/100 tablet %3 Jun-12

Kl#rpr#mazin Tablet Kaleng/1000 tablet 21*5 (ug-11

! Hal#peri+#l 0,5 mg Tablet K#ta'/100 tablet 120 Jun-1310 en#barbital in&e'si (mpul K#ta'/30 ampul *0 Sep-12

11 en#barbital Tablet Tablet Kaleng/1000 tablet 1%2!) eb-12

12 en#barbital Tablet Tablet Kaleng/1000 tablet 2!5 eb-12

13 en#barbital Tablet Tablet Kaleng/1000 tablet 3)11 Jun-12

Kepala .us'esmas "#+#

T(H (,"+,Kep

1!*)0)15 1!03 1 011

en u angga 4p re


2/50


3/50


PUSKESMAS MODO


1 .eha7aian (mpul *1 Jul-112 etametas#n 'rim Tube K#ta'/2% tube 12 De7-10

3 Kl#ram8eni7#l tetes telinga #t#l K#ta'/2% b#t#l 2 Jan-10

% 9in7 Tablet K#ta'/100 tablet 2* De7-10

5 Obat Tambah Darah Tablet * Jun-11

* Obat lu Tablet * "ar-11

) (ntalgin n&e'si (mpul K#ta'/30 ampul 1) O7t-11

.it#gin (mpul K#ta'/10 ampul !1 (ug-11

! ":#mergin (mpul K#ta'/10 ampul %2 (ug-11

10 pine8rin in&e'si (mpul K#ta'/30 ampul O7t-11

11 Tiamin in&e'si (mpul K#ta'/30 ampul * (pr-11

12 De'sametas#n in&e'si (mpul K#ta'/100 ampul ! Sep-11

13 pine8rin in&e'si (mpul K#ta'/30 ampul 5! eb-11

1% ;i7illin in&e'si ;ial K#ta'/10 $ial 30 Jul-12

15 ;i7illin in&e'si ;ial K#ta'/10 $ial 15 (ug-12

1* De'sametas#n in&e'si (mpul K#ta'/100 ampul 50 Jun-11

1)


4/50

2) (7et#sal Tablet K#ta'/100 tablet 20) O7t-11

2 "etilerg#metrin Tablet K#ta'/100 tablet *5! N#$-11

2! K#trim#'saz#le .e+iatri' Tablet K#ta'/100 tablet 335 N#$-11

30 K#trim#'saz#le .e+iatri' Tablet K#ta'/100 tablet 135 Jul-12

31 (m#'sisilin 250 mg Kapsul K#ta'/120 'apsul 120 De7-10


5/50


PUSKESMAS MODO


32 (spilet Tablet 0 De7-1133 Kl#ram8eni'#l 250 mg Kapsul Kaleng/250 'apsul 3* Sep-11

3% Kl#ram8eni'#l 250 mg Kapsul Kaleng/250 'apsul 152 N#$-11

35 Kalsium =a'tat Tablet Kaleng/1000 tablet 01

3* =i+#7ain in&e'si (mpul K#ta'/30 ampul 1* Jun-11

3) it#mena+i#n in&e'si (mpul K#ta'/30 ampul %3 (pr-11

3 it#mena+i#n in&e'si (mpul K#ta'/30 ampul 203 (ug-11

3! De'sametas#n in&e'si (mpul K#ta'/100 ampul 1 Sep-11

%0 (min#>lin in&e'si (mpul K#ta'/30 ampul 5 Jul-10

%1 .it#gin (mpul K#ta'/ 10 ampul 1* Jul-11

%2 .it#gin (mpul K#ta'/10 ampul 2% (ug-10

%3 ":#mergin (mpul K#ta'/10 ampul 1 Sep-10

%% Diphenhi+ramin in&e'si (mpul K#ta'/30 ampul 1 (ug-10

%5 (?ua .r# n&e'si steril ;ial K#ta'/10 $ial %0 Sep-11

%* Thiame4 Kapsul K#ta'/100 'apsul 0 (ug-11

%) (ll#purin#l Tablet K#ta'/100 tablet 2%0 Sep-11

% "et#'l#prami+ Tablet K#ta'/100 tablet %%* N#$-11

%! N#$ar#n Tablet Kaleng/1000 tablet 3)0 Jul-1150 Hibi7et H#spital 7#n7entrat #t#l 1 "a:-0!

51 Kl#r#?uin Tablet Kaleng/1000 tablet 11%% O7t-11

52 Hi+r#7l#rtiazi+ Tablet Kaleng/1000 tablet %10 Jan-11

53 .iri+#'sin Tablet Kaleng/1000 tablet 1)1 Sep-11

5% s#s#rbi+ Dinitrat Tablet K#ta'/100 tablet *)0 eb-11

55


6/50

5 De'str#met#r8an Tablet Kaleng/1000 tablet 2000 Jun-11

5! St#ma7h Tube Tube 1 (pr-0!

*0 Kalsium =a'tat Tablet Kaleng/1000 tablet 1%53 N#$-11

*1


7/50


PUSKESMAS MODO


*3


8/50

!


9/50


PUSKESMAS MODO


!% Obat (sma Tablet %2 Jun-10!5 Obat Ba7ing "eben+az#le Tablet 1 Sep-12

!* 9in' Dispersibel Tablet K#ta'/100 tablet 15 (ug-11

!) Otsu "gSO% %0A ;ial * 13-01-201

! Otsu "gSO% %0A ;ial 1 )/!/2012

!! Otsu-D %0 ;ial 1 )/1/2012

100 Thiam8eni7#l Kapsul K#ta'/100 'apsul 1%0 "a:-10

101 O4:tetrasi'lin in&e'si ;ial K#ta'/10 $ial 10 (ug-0!

102 O4:tetrasi'lin Salep mata 1 A Tube K#ta'/25%tube 2% "a:-10

103 .apa$erin HBl in&e'si (mpul K#ta'/30 ampul %0 O7t-0!

10% Kl#ram8eni7#l Salep mata 1 A Tube K#ta'/2% tube ) "a:-10

105 Tiamin in&e'si (mpul K#ta'/30 ampul 1 Jul-10

10* N#$ar#n ;ial 2 "a:-10

10) Terram:7in in&e'si ;ial % (pr-10

10 Hi+r#7hl#rtiazi+a Tablet Kaleng/1000 tablet !35 Sep-11

10! (sam (s7#rbat 50 mg Tablet Kaleng/1000 tablet 1535 "ar-10

110 (sam (s7#rbat 50 mg Tablet Kaleng/1000 tablet 3*5 "a:-10

111 Tiamin tablet Tablet Kaleng/1000 tablet 2000 Sep-11112 N#$a+#4in Tablet Kaleng/1000 tablet 2*%% Jun-11

113 Salbutam#l 2 mg Tablet K#ta'/100 tablet !0 Jun-10

11% Sian#'#balamin in&e'si (mpul K#ta'/100 ampul ) Sep-11

115 Dig#4in Tablet K#ta'/100 tablet 1)00 Jun-12

11* Dig#4in Tablet K#ta'/100 tablet ! Jun-12

11) Hi+r#7hl#rtiazi+ Tablet Kaleng/1000 tablet !%3 "a:-12

11 Osetalmi$ir 'apsul )5 mg Kapsul K#ta'/100 'apsul 0 Jun-12

11! (7:7l#$ir 200 mg Tablet K#ta'/100 tablet 10 "ar-11

entu'Se+iaan

Tanggal 4pireD6/Ka+alua


10/50

120 .r#pilti#urasil Tablet Kaleng/100 tablet 100 Sep-12

121 .r#pilti#urasil Tablet Kaleng/100 tablet 100 Sep-12

122 .r#pilti#urasil Tablet Kaleng/100 tablet 200 Jun-12

123 .r#pilti#urasil Tablet Kaleng/100 tablet 12 De7-11

12% Sul8a+#4ine .:rimethamine Tablet K#ta'/100 tablet 100 Sep-11


11/50


PUSKESMAS MODO


125 Sul8a+#4ine .:rimethamine Tablet K#ta'/100 tablet !51 N#$-1112* Sul8a+#4ine .:rimethamine Tablet K#ta'/100 tablet 15! Jun-12

12) 8e+rin Tablet Kaleng/1000 tablet 35* Jan-12

12 .r#pan#l#l Tablet K#ta'/100 tablet 100 Jun-12

12! .r#pan#l#l Tablet K#ta'/100 tablet 50 Jul-11

130 De4tr#se %0 A 25 ml ;ial 2% )/1/2012

131 Otsu- "gSO% 20 A 25 ml ;ial * 2%-12-201

132 D#4:7:7line Kapsul K#ta'/100 'apsul 1%1 1/1/2012

133 D#4:7:7line Kapsul K#ta'/100 'apsul 200 De7-11

13% S7#pma Tablet K#ta'/100 tablet 50 "a:-12

135 K#trim#'saz#le .e+iatri' Tablet K#ta'/100 tablet 20 "ar-12

13* Dermazin Bream Tube 1 Jul-10

13) etin#l 200000 @/'apsul Kapsul #t#l/ 50 'apsul 50 eb-12

13 (ll#purin#l Tube K#ta'/100 tablet )0 Jul-11

13! .it#gin (mpul K#ta'/10 ampul 10 O7t-0!

1%0 it#mena+i#n Tablet #t#l/100 tablet 20 (ug-11

1%1 =i+#7ain in&e'si (mpul K#ta'/30 ampul 23 Jun-11

1%2 Salbutam#l 2 mg Tablet K#ta'/100 tablet 15 N#$-111%3


12/50

151 ur#semi+e Tablet K#ta'/100 tablet 20 "a:-13

152 Dig#4in Tablet K#ta'/100 tablet 100 Sep-12

153 uinin Tablet K#ta'/*0 tablet 3* (pr-03

15% 9in' Tablet K#ta'/100 tablet 500 N#$-12

155 "etr#ni+az#le 500 mg Tablet K#ta'/100 tablet 2)* N#$-12


13/50


PUSKESMAS MODO


15* (ll#purin#l Tablet K#ta'/100 tablet %0 (pr-1315) Dermazin Bream Tube 1 Jul-10

15 etin#l 200000 @/'apsul Kapsul #t#l/ 50 'apsul 50 eb-12

15! (ll#purin#l Tube K#ta'/100 tablet )0 Jul-11

1*0 .it#gin (mpul K#ta'/10 ampul 10 O7t-0!

1*1 it#mena+i#n Tablet #t#l/100 tablet 20 (ug-11

1*2 =i+#7ain in&e'si (mpul K#ta'/30 ampul 23 Jun-11

1*3 Salbutam#l 2 mg Tablet K#ta'/100 tablet 15 N#$-11

1*%


14/50

12 (sam (s7#rbat 50 mg Tablet Kaleng/1000 tablet 30 (ug-12

13 N#ristal sirup #t#l #4/50 b#t#l 1 De7-12

1% Diphenhi+ramin in&e'si (mpul K#ta'/30 ampul 30 (ug-10

15 Diphenhi+ramin in&e'si (mpul K#ta'/30 ampul 3 eb-13

1* "etr#ni+az#le 250 mg Tablet K#ta'/100 tablet 0 Jun-0!


15/50


PUSKESMAS MODO


1) Bipr#C#4a7in Tablet K#ta'/100 tablet 20) (ug-111 Bapt#pril 25 mg Tablet K#ta'/100 tablet 1%0 (ug-10

1! .it#gin in&e'si (mpul K#ta'/10 ampul 1) Sep-13

1!0 Bami+e4#n (mpul ! Jun-0*

1!1 =i+#7ain in&e'si (mpul K#ta'/30 ampul 21 Jun-11

1!2 it#mena+i#n in&e'si (mpul K#ta'/30 ampul 2! (pr-10

1!3 it#mena+i#n in&e'si (mpul K#ta'/30 ampul ! O7t-10

1!% pine8rin in&e'si (mpul K#ta'/30 ampul 5 eb-11

1!5 De'sametas#n in&e'si (mpul K#ta'/100 ampul 10 De7-10

1!* Diphenhi+ramin in&e'si (mpul K#ta'/30 ampul 2 eb-12

1!) Kl#ram8eni7#l 250 mg Kapsul Kaleng/250 'apsul !00 N#$-10

1! Kalsium =a'tat Tablet Kaleng/1000 tablet 52! Jun-0!

1!! .arasetam#l 500 mg Tablet Kaleng/1000 tablet 23 O7t-10

200 (ntasi+ Tablet Kaleng/1000 tablet 1000 (pr-11

201 ;it, '#mple's Tablet Kaleng/1000 tablet 1000 Jul-11

202 .re+nis#n Tablet Kaleng/1000 tablet 1!00 Sep-0)

203 .re+nis#n Tablet Kaleng/1000 tablet )50 De7-0!

20% 8e+rin Tablet Kaleng/1000 tablet %00 De7-0!205 .iri+#'sin Tablet Kaleng/1000 tablet !00 Sep-10

20* 4tra' ella+#na Tablet Kaleng/1000 tablet 00 De7-10

20) Sian#'#balamin Tablet Kaleng/1000 tablet 1000 Jul-11

20 (min#>lin 200 mg Tablet #t#l/100 tablet 1000 Jun-10

20! it#mena+i#n Tablet #t#l/100 tablet % (ug-12

210 ta'ri+in #t#l #t#l/300 ml 1 Sep-10

211 (nti8ungi Salep .#t K#ta'/2% p#t 5 Jan-11

212 E#+i#l Kapsul #t#l/100 'apsul 100 Jul-0!

entu'Se+iaan



16/50

213 Kapt#pril12,5 mg Tablet K#ta'/100 tablet *0 Jun-0

21% .:rantel pam#at Tablet K#ta'/2% tablet %0 Jul-10

215 Kl#ram8eni'#l tetes telinga #t#l K#ta'/2% b#t#l % "ar-10

21* .hen#l


17/50


PUSKESMAS MODO


21 .rima?uin Tablet Kaleng/1000 tablet 50 Jun-0

21! Be8#ta4ime serbu' in&e'si ;ial K#ta'/2 $ial 10 De7-11

220 Otsutran- )0 #t#l 12 11/10/201

221 lin 200 mg Tablet #t#l/100 tablet 300 Sep-0

entu'Se+iaan



18/50

2%5 Kl#ram8eni'#l Tetes Telinga #t#l K#ta'/2% #t#l 11 De7-0!

2%* O4:tetra7:7line salep 'ulit Tube K#ta'/2% tube 31 "ar-10

2%) it#mena+i#n n&e'si (mpul K#ta'/30 ampul 2* "a:-10

2% Bal7ianta 10 Tablet !0 Jun-11


19/50


PUSKESMAS MODO


2%!


20/50

2)5 (lben+az#le Tablet K#ta'/30 tablet "a:-12

2)* Ni8e+ipin Tablet K#ta'/100 tablet 0 !/)/2012

2)) Hi+r#'l#rtiazi+ Tablet Kaleng/1000 tablet 1%)1 "a:-12

2) (ntalgin Tablet K#ta'/100 tablet 300 "ar-12

2)! Seles B 50 mg Tablet Kaleng/1000 tablet 500 O7t-13


21/50


PUSKESMAS MODO


20 Be8a+r#'sil Kapsul 'a#ta'/100 'apsul 5 De7-13

21 OH Sirup #t#l #t#l/*0 ml 3 O7t-11

22 De4tr#met#r8an sirup #t#l #t#l/*0 ml 23 O7t-11

23 N#$a7hl#r suspensi #t#l #t#l/*0 ml 5 (ug-12

2% it#mena+i#n Tablet #t#l/100 tablet 0 N#$-13

25 rg#tamin BaFein Tablet #t#l/100 tablet 100 "ar-12

2*


22/50


23/50


PUSKESMAS MODO


1 ;, Bhateter N#, 2% .7s K#ta'/50 p7s ) Jul-12

2 ;, Bhateter N#, 2% .7s K#ta'/50 p7s 1 "a:-13

3 ;, Bhateter N#, 22 .7s K#ta'/50 p7s 1 (pr-11

% ;, Bhateter N#, 22 .7s K#ta'/50 p7s 1 Sep-13

5 ;, Bhateter N#, 21 .7s K#ta'/50 p7s 3 Sep-0!

* n8us set ana' .7s K#ta'/25 p7s 1 2-0-201

) n8us set ana' .7s K#ta'/25 p7s 2 )/*/2013

;, Bhateter N#, 20 .7s K#ta'/50 p7s 1!1 21-12-201

! ugen#l #t#l 2 N#$-13

10 =is#l #t#l 3 Jun-1311 Sil' la7' .7s K#ta'/3* p7s 33 De7-10

12 .lain Batgut N#, 3/0 .7s K#ta'/2% p7s ! De7-10

13 .lain Batgut N#, 3/0 .7s K#ta'/2% p7s 32 Sep-10

1% ;, Bhateter N#, 22 .7s K#ta'/50 p7s 1 Jul-12

15 ;, Bhateter N#, 20 .7s K#ta'/50 p7s 1 De7-11

1* isturi .7s K#ta'/100 p7s 1 De7-11

1) (lat Sunti' Se'ali .a'ai 3 ml .7s K#ta'/100 p7s 3 eb-13

1 (lat Sunti' Se'ali .a'ai 5 ml .7s K#ta'/100 p7s ** 10/!/200!

1! (lat Sunti' Se'ali .a'ai 3 ml .7s K#ta'/100 p7s 3%% O7t-13

20 n8us set ana' .7s K#ta'/25 p7s !% O7t-13

21 n8us set +eGasa .7s K#ta'/25 p7s % O7t-13

22 Oni#ne4 N#, 25 < .7s K#ta'/100 p7s 100 2!-0)-201

23 ;, Bhateter N#,2% .7s K#ta'/50 p7s 100 5/11/2013

2% @rin ag .7s 15 O7t-12

25 =:#>l Batgut Br#me .7s 1 De7-0

2* ing Nee+le N#, 23 < 4 3/% .7s K#ta'/50 p7s !% Jun-11

entu'Se+iaan



24/50

2) ing Nee+le N#, 25 < 4 3/% .7s K#ta'/50 p7s )) Sep-11

2 ing Nee+le N#, 2) < 4 3/% .7s K#ta'/50 p7s % De7-11

2! (lat Sunti' Se'ali .a'ai 25 ml .7s K#ta'/100 p7s 25 "ar-10

30 ing Nee+le N#, 21 < 4 3/% .7s K#ta'/50 p7s 2) (ug-12

31 (lat Sunti' Se'ali .a'ai 3 ml .7s K#ta'/100 p7s )0 Jul-11


25/50


PUSKESMAS MODO


32 n8us set ana' .7s K#ta'/25 p7s 1 1-10-2010

33 (bb#7ath N#, 1 .7s K#ta'/50 p7s %5 Jan-10

3% Sil' la7' N#, 3/0 .7s K#ta'/3* p7s 1 Sep-11

35 ; Bhateter N#, 1 .7s K#ta'/50 p7s 5 15-11-2002

3* ; Bhateter N#, 2% .7s K#ta'/50 p7s 1 Jan-10

3) ;, Bhateter N#, 20 .7s K#ta'/50 p7s 1 eb-12

3 til Bhl#ri+a #t#l 3 De7-11

3! (lat Sunti' Se'ali .a'ai 5 ml .7s K#ta'/100 p7s 13 (ug-11

%0 (lat Sunti' Se'ali .a'ai 5 ml .7s K#ta'/100 p7s 11) Sep-11

%1 (lat Sunti' Se'ali .a'ai 25 ml .7s K#ta'/100 p7s 5 %/1/2012

"N


26/50

N#, at7h Nama .erusahan Ket

=H 3**% J .T,Kimia arma

N< 3133 J .T,Kimia arma

H 3031 J .T,Kimia arma

H 3030 J .T,Kimia arma

0*0)01% .T, n+#8arma

0000* .T, n+#8arma

00*00* .T, n+#8arma

H *11** .T, Kimia arma

0!0%003 .T, n+#8arma

153)!00%-2 .T, .hapr#s Tb',

)025* .T, Kimia arma

)0331 .T, Kimia arma

0)0*00! .T, n+#8arma

III,,IIIIIIIIIIIIIIIII201%

.engel#lah Obat .us'esmas "#+#

K(S"((T S,arm

Nip, 1!*0%21 201101 2 01!


27/50


28/50


150520%-1 .T, .hapr#s

15%55123 .T, .hapr#s

D,0%%30) .T, rla

010003 .T, n+#8arma

0)0500 .T, n+#8arma

0)1202! .T, n+#8arma

15313011-1 .T, .hapr#s

0*31 .T, thi7a

0*22 .T, thi7a

153%%003-2 .T, .hapr#s15%02005-2 .T, .hapr#s

1533)025-1 .T, .hapr#s

021%) .T, thi7a

0!*51 .T, "ei&i n+#

0!*53 .T, "ei&i n+#

0)0503) .T, n+#8arma

J*1)!% .T, Kimia arma

)-1232 .T, N#$apharin

*1%0 .T, Kimia arma

)!-123! .T, N#$apharin

053500% .T, .hapr#s

J *1%0 .T, Kimia arma

)%-0)3) .T, N#$apharin

K *2013 .T, Kimia arma

< 1!3) J .T, Kimia arma

K< 215) J .T, Kimia arma


29/50

1530100*-1 .T, .hapr#s

< 1)51 J .T, Kimia arma

!%33*020 .T, .hapr#s

533*00% .T, .hapr#s

*110%* .T, n+#8arma


30/50


!!%5501 .T, "e+i8arma

)!-0%%2 .T, N#$apharin

*0*02 .T, N#$apharin

.T, N#$apharin

00505) .T, n+#8arma

153200*-3 .T, .hapr#s

1532015-1 .T, .hapr#s

1533)022-2 .T, .hapr#s

)10%231 .T, =u7as

0)5)0 .T, thi7a)05*2 .T, thi7a

)05)% .T, thi7a

!%3%202!-2 .T, .hapr#s

)!01*5 .T, N#$apharin

)0!% .T, N#$apharin

*13* .T, Kimia arma

K *1!)* .T, Kimia arma

))020 .T, N#$apharin

. *2*!

J *1)*% .T, Kimia arma

( *001% .T, Kimia arma

10!0) .T, (> arma

( 230) HJ .T, Earin+# armatama

0*0*033 .T, n+#8arma

J *132 .T, Kimia arma

12)210 .T, Kimia arma


31/50

0*0*03 .T, n+#8arma

0%050%

K *1!*1 .T, Kimia arma

1)051% .T, i+atra

B )0533 .T, Kimia arma


32/50


J *1 )2% .T, Kimia arma

K *15 .T, Kimia arma

053200)-2 .T, .hapr#s

)102032 .T, =u7as D&a&a

=( 0!100 .T,


33/50

BB )10%% .T, n+#8arma

0*11131 .T, n+#8arma

0*0300) .T, n+#8arma

D 0!10 .T, n+#8arma

0)0*021 .T, n+#8arma


34/50


0)05010 .T, n+#8arma

0)0*002 .T, n+#8arma

K 2*)) J"D .T, Kimia arma

2 ( 3) .T, Otsu'a

)*13* .T, Otsu'a

)* ( 30 .T, Otsu'a

B 001 zer

J *1%*2 .T, Ja:a "as

12502011 .T, "arin =iza

)125 .T, Kimia arma

)!-*003 .T, N#$apharin

)*-0*31 .T, N#$apharin

050%00! .T, n+#8arma

0*0031 .T, n+#8arma

0050!) .T, n+#8arma

0050!% .T, n+#8arma

)0!!0 .T, Kimia arma

00*002 .T, n+#8arma

05303002 .T, .hapr#s


35/50

0*0035 .T, n+#8arma

0*0*023 .T, n+#8arma

0*0*022 .T, n+#8arma

0*1203! .T, n+#8arma

0)0)00) .T, n+#8arma


36/50


K *1!1% .T, Kimia arma

)1211 .T, Kimia arma

! = 0!1! .T, Kimia arma

0*050 .T, n+#8arma

D 11*0) J .T, Kimia arma

)* ( 30 .T, Otsu'a

!3 = 3* .T, Otsu'a

=< 25% J .T, Kimia arma

B 0303 1 .T, Earin+#

!01105 .T, 8ars .harma7euti7al0)01001 .T, n+#8arma

0550*013 .T, .hapr#s

02!1** .T, Kimia arma

0)10* .T, N#$apharin

0))% .T, thi7a

0531005 .T, .hapr#s

005052 .T, n+#8arma

K *1!12 .T, Kimia arma

0!11022 .T, n+#8arma

N %3)1 .T, (+itama a:a

KK 31*3 J .T, Kimia arma

0)1100) .T, n+#8arma

0!20* .T, Kimia arma

)10202 .T, =u7as .harma7euti7al

010123 .T, Ba$e4 H#llan+

0)100 .T, n+#8arma


37/50

0*% .T, Kimia arma

00*102 .T, n+#8arma

D 21003 .T, Kimia arma

3%)! .T, Kimia arma

TD" 1*53! .T, ern#8arm


38/50



0550*013 .T, .hapr#s

02!1** .T, Kimia arma

0)10* .T, N#$apharin

0))% .T, thi7a

0531005 .T, .hapr#s

005052 .T, n+#8arma

K *1!12 .T, Kimia arma

0!11022 .T, n+#8arma

N %3)1 .T, (+itama a:aKK 31*3 J .T, Kimia arma

0)1100) .T, n+#8arma

0!20* .T, Kimia arma

)10202 .T, =u7as .harma7euti7al

010123 .T, Ba$e4 H#llan+

0)100 .T, n+#8arma

0*% .T, Kimia arma

00*102 .T, n+#8arma


3%)! .T, Kimia arma

TD" 1*53! .T, ern#8arm


< 1!3) J .T, Kimia arma

* K 1003 .T, Duta Kaisar

0)05011 .T, n+#8arma

153*012 .T, .hapr#s


39/50

H !1%* .T, Kimia arma

1)121) .T, "e7#sin n+#

!%3%203% .T, .hapr#s

253%200%-1 .T, .hapr#s

%3*3002 .T, .hapr#s


40/50


)1!10 .T, N#$apharin

30015 .T, De4a "e+i7a

100033 .T, thi7a

210*0)1 .T, =u7as

0050*2 .T, n+#8arma

0532002-3 .T, .hapr#s

2532011-3 .T, .hapr#s

021%) .T, thi7a

0*110*1 .T, n+#8arma

)102032 .T, =u7as"< 0!%) T .T, Kimia arma

%0!%2 .T, Kimia arma

3)30100** .T, "arin =iza armasi

10)11* .T, rrita .harma

))-0305 .T, N#$apharin

)!-123! .T, N#$apharin

= *320* .T, Kimia arma

%0!0*3 .T, n+#8arma

0*0*030 .T, n+#8arma

12)0* T .T, Kimia arma

))-032% .T, N#$apharin

) ( 0%2 .T, B#r#net Br#G

153100) .T, .hapr#s

200!0) .T, (> arma

200!01010 .T, "arin

**00 .T, Kimia arma

212!) .T Ki i


41/50

212!) .T, Kimia arma

( 2%11 KJ .T, Earin+#

12*13 .T, Kimia arma

= 111)% .T, =u7as D&a&a

5123 .T, n8ar (ris .harma


42/50


)%30*00! .T, .hapr#s

.SN 2%)3) .T, ern#8arm

3* J )* B .T, Otsu'a n+#

0!12032 .T, n+# arma

%*2)1010) .T, "arin =iza

253*01% .T, .hapr#s

01100) .T, n+# arma

K 101103 .T, Kimia arma

J 1010%0 .T, Kimia arma

00)002 .T, n+# arma00*31 .T, Kimia arma

32)3 .T, (+i Tama a:a

10 ( 0*2 .T, thi7a

15%010 .T, He4pharm Ja:a

3532011-3 .T, .hapr#s

353201!-1 .T, .hapr#s

10 B 01! .T, =u7as D&a&a

253%2002-2 .T, .hapr#s

253%200%-1 .T, .hapr#s

1553!5 .T, He4pharm Ja:a

15%50 .T, He4pharm Ja:a

1)0)03 .T, i+atra ha'ti

!%3302! .T, .hapr#s

B 0525 .T, Kimia arma

15153! .T, Kimia arma

10 .T, Der


43/50

D 0%%22 .T, rla


)1031%1 .T, =u7as D&a&a

)0)00*2 .T (rm#4in+# arma


44/50


053)3115 .T, .hapr#s

05*0101 .T, .hapr#s!%*01001% .T, .hapr#s

01000 .T, He4pharm Ja:a

3533)02)-1 .T, .hapr#s

B030* T 0*% .T, n+# arma

B 030% T 0*! .T, n+# arma

.N 23%35 .T, ern#8arm

)2!-53020 .T, .>zer

0)0503) .T, n+# arma

)10%231 .T, =u7as D&a&a

3*03* .T, ern#8arm

*12!3) .T, thi7a

123120*10 .T, "arin

1)132 G .T, Kimia arma

%*2511101 .T, "arin

10 J 033 .T, thi7a

1010*% .T, thi7a

K 101103 .T, Kimia arma3533)02)-1 .T, .hapr#s

J 20)%0% .T, (7ta$is

" 15** J .T, Kimia arma


0*% .T, Kimia arma

(1 03*3 J .T, Kimia arma

!33%* .T, Se&ahtera =estari

0530*01%-3 .T, .hapr#s


45/50

0530*01% 3 .T, .hapr#s

< !132 .T, Kimia arma

)0!!0 .T, Kimia arma

3- 3)0* .T, N#$apharin

!%%%% .T, Se&ahtera =estari


46/50


= 23) J .T, Kimia arma

J 10-0!0 .T, (> arma.T, N#$apharin

-151 .T, N#$apharin

%*2)1010) .T, "arin =iza

B !035! .T, Kimia arma

1)051% .T, i+atra ha'ti

153%20 .T, .hapr#s

1!0110 .T, .hapr#s

51** J .T, Kimia arma

*0!*! .T, Kimia arma

30015 .T, De4a "e+i7a

(*0051 .T, Kimia arma

1%1 .T, .hit# arma

0)001* .T, n+# arma

%%501 .T, rla

0!0*2% .T, n+# arma

3-0%%1 .T, N#$apharin


47/50


48/50


)21) .T, Ja:amas "e+i7

005%10 .T, "e+e4 "e+i'a0*0501 .T, D (+s:te .r#

101252%3 .T, raun

.T, raun

0)02 .T, .rima (l'esin+#

2000*0 .T, n+#8arma

20101222 .T, raun

11!01010 .T, Kimia arma

!*0221% .T, N#$apharin

1501200* .T, One "e+

20012005 .T, One "e+

15102005 .T, One "e+

*2!0 .T, Ja:amas "e+i7

*2!0 .T, Ja:amas "e+i7

( 052*5% .T, raun

0300% .T, One Je7t

.T, .rima (l'esin+#

101012 .T, O7ean "e+i7a

101012 .T, O7ean "e+i7a

101012 .T, O7ean "e+i7a

2000)30 .T, .rima (l'esin+#

2010110*

21/)2),01 .T, Truge "e+i7al

003*31 .T, ;#mel

200*0) .T, Ja:amas "e+i7

200*10 .T, Ja:amas "e+i7


49/50

200)01 .T, Ja:amas "e+i7

050322 .T, raun

310!200) .T, Ja:amas "e+i7

200*0 .T, Ja:amas "e+i7


50/50


2005101 .T, Ja:amas "e+i7

1!015 .T, Otsu'a n+#0*0!03 .T, .rima (l'esin+#

!11001 .T, n+#8arma

20015 .T, Otsu'a n+#

) 1001521 .T, =ab#rat#ri#us

! = 0!1! .T, Duta Kaisar arm

*2322)! .T,

200*10 .T, Ja:amas "e+i7

200)0105 .T, .r#> S:ringe

"#+#III,,IIIIIIIIIIIIIIIII201%

.engel#lah Obat .us'esmas "#+#

K(S"((T S,arm

Nip, 1!*0%21 201101 2 01!

berita acara pemusnahan obat

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