form_rko 2016_fornas arjasari ttp

8/19/2019 Form_rko 2016_fornas Arjasari Ttp

1/98

RENCANA KEBUTUHAN OBAT TAHUN 2016

UPTD PELAYANAN KESEHATAN KECAMATAN ARJASARI

PUSKESMAS ARJASARI

NO NAMA OBAT SATUAN

1 2 3 4 5 6 (=5x15!! " (=6

1 A.B.U. I (khusus ular dari luar Papua) inj (i.m./i.v.) vial 0 0 0

2 A.B.U.II (khusus ular dari Papua) inj (i.m./i.v.) vial 0 0 0

3 Air untuk vial amp 25 m ampul 0 0 0

! Al"#nda$%l ta" !00 m& ta"l#t 0 0 0

5 Al"#nda$%l susp 200 m&/5 m "%t%l 0 0 0

' Al%purin%l ta" 100 m& ta"l#t 52! 768 11520 1

* Al%purin%l ta" 300 m& ta"l#t 0 0 0

+ Amil%rid ta" 5 m& ta"l#t 0 0 0

Amin%,lin ta" 150 m& ta"l#t 0 0 0

10 Amin%,lin ta" 200 m& ta"l#t 0 100 1500

11 Amin%,lin inj 2! m&/m vial 0 0 0

12 Ami%dar%n ta" 200 m& a" 0 0 0

13 Amitriptilin ta" sal 25 m& ta"l#t salut 0 0 0

1! ta"l#t 0 0 0

15 ta"l#t 2*00 360 5!00

1' ta"l#t 55+' 900 13500

1* Am%ksisilin ta" 500 m& ta"l#t +++0 9130 13'50 !

1+ Am%ksisilin sir %rt# 250 m&/5 m "%t%l 0 50 *50

1 Ampisilin s#r" inj 250 m&/vial vial 0 0 0

20 Ampisilin s#r" inj 1000 m&/vial vial 0 0 0

21 Vial 0 0 0

SISA STOK31

DESEMBER2015

PEMAKAINPERBULAN

JUMLAHKEBUTUHAN

USUL201

Aml%dipin ta" sal 25 m&

Aml%dipin ta" 5 m&

Aml%dipin ta" 10 m&

Anal%& insulin rapid atin& (inj 100 UI/ml (k#masan

vial artrid disp%si"l# p#n,ll artrid)


2/98

NO NAMA OBAT SATUAN

1 2 3 4 5 6 (=5x15!! " (=6

SISA STOK31

DESEMBER2015

PEMAKAINPERBULAN

JUMLAHKEBUTUHAN

USUL201

22 Vial 0 0 0

23 Vial 0 0 0

2! vial 0 5 *5

25 ta"l#t kunah 0 3166 !*!0

!

2' "%t%l 0 336 50!0

2* tu"# 0 32 !+0

2+ supp 0 !2 '30

2 kapsul 0 0 0

30 kapsul 0 0 0

31 Art#m#th#r inj +0 m&/m vial 0 0 0

32 Art#sunat s#r" inj '0 m&/m (i.v./i.m.) vial 0 0 0

33 Articulating paper 0 0 0

3! Asam as#tilsalisilat (as#t%sal) ta" 100 m& a" 0 0 0

35 Asam as#tilsalisilat (as#t%sal) ta" +0 m& ta"l#t 0 20 300

3' Asam ask%r"at (vitamin ) ta" 50 m& ta"l#t 0 2657 3+55 3

3* Asam ask%r"at (vitamin ) ta" 250 m& ta"l#t 0 0 0

3+ Asam %lat ta" 0! m& ta"l#t 0 0 0

3 Asam %lat ta" 1 m& ta"l#t 0 0 0

!0 Asam %lat ta" 5 m& ta"l#t 0 0 0

!1 Asam m##namat kaps 250 m& kapsul 0 0 0

!2 Asam m##namat kaps 500 m& kapsul 0 2+2 !33+0 !3!3 Asam salisilat 5 sal#p 0 0 0

Anal%& insulin l%n& atin& (inj 100 UI/ml (k#masan vialartrid disp%si"l# p#n,ll artrid)

Anal%& insulin mi4 insulin (inj 100 UI/ml (k#masan vialartrid disp%si"l# p#n,ll artrid)

An#st#tik l%kal &i&i k%m"inasi lid%kain l 2 6#pin#rin 1 +0.000 inj 2 m

Antasida k%m"inasi aluminium hidr%ksida 200 m& 6ma&n#sium hidr%ksida 200 m&

Antasida k%m"inasi aluminium hidr%ksida 200 m& 6ma&n#sium hidr%ksida 200 m&

Antiun&i sal#p k%m"inasi asam "#n$%at ' 6 asamsalisilat 3

Antih#m%r%id k%m"inasi "ismut su"&alat 150 m& 6h#ksakl%r%#n 25 m& 6 lid%kain 10 m& 6 s#n& %ksida120 m& sup ad 2 &

Antimalaria k%m"inasi sulad%ksin 500 m& 6pirim#tamin 25 m&

Antiparkins%n k%m"inasi "#ns#ra$id 25 m& 6l#v%d%pa 100 m&

k#rtas 7arna


3/98

NO NAMA OBAT SATUAN

1 2 3 4 5 6 (=5x15!! " (=6

SISA STOK31

DESEMBER2015

PEMAKAINPERBULAN

JUMLAHKEBUTUHAN

USUL201

!! Asam salisilat 01 larutan 0 0 0

!5 Asikl%vir ta" 200 m& ta"l#t *00 50 *50

!' Asikl%vir ta" !00 m& ta"l#t '0 300 !500

!* Atapul&it ta"l#t 0 300 !500

!+ At#n%l%l ta" 50 m& ta"l#t 0 0 0

! At#n%l%l ta" 100 m& ta"l#t 0 0 0

50 Atr%pin ta" 05 m& ta"l#t 0 0 0

51 Atr%pin inj 025 m&/m (i.v./i.m./s.k.) vial 0 0 0

52 Bahan tumpatan s#m#ntara lar s#r" "%t%l 0 0 0

53 B#dak salisil s#r" 2 s#r"uk 0 50 *50

5! B#n$atin p#nisilin inj 12 juta UI/m (i.m.) vial 0 0 0

55 B#n$atin p#nisilin inj 2! juta UI/m (i.m.) vial 0 0 0

5' B#tam#tas%n krim 05 m&/& krim 0 12! 1+'0

5* B#tam#tas%n tts mata 1 m&/m "%t%l 0 0 0

5+ Bisak%dil ta" salut 5 m& ta" salut 0 20 300

5 Bisak%dil sup 5 m& supp 0 0 0 '0 Bisak%dil sup 10 m& supp 0 10 150

'1 Bis%pr%l%l ta" 25 m& a" 0 0 0

'2 Bis%pr%l%l ta" 5 m& ta"l#t 0 0 0

'3 Bud#s%nid ih 200 m&/d%sis B%t%l 0 0 0

'! Bud#s%nid s#r" ih 100 m&/d%sis B%t%l 0 0 0

'5 B%t%l 0 0 0

'' B%t%l 0 0 0

'* Coal tar lar 5 % "%t%l 0 0 0

'+ Copper T s#t/"uah 0 0 0

' 8aps%n ta" s%r#d 100 m& 0 0 0

*0 8#ksam#tas%n inj 5 m&/m (i.v./i.m.) vial 0 5 *5

Bud#s%nid-%rm%t#r%l (fxed combination)9 ih 1'0/!5

Bud#s%nid-%rm%t#r%l (fxed combination)9 ih +0/!5

ta" scored


4/98

NO NAMA OBAT SATUAN

1 2 3 4 5 6 (=5x15!! " (=6

SISA STOK31

DESEMBER2015

PEMAKAINPERBULAN

JUMLAHKEBUTUHAN

USUL201

*1 8#ksam#tas%n ta" 05 m& ta"l#t 3'150 3948 5220 23

*2 8ia$#pam inj 5 m&/m (i.v./i.m.) vial 0 0 0

*3 8ia$#pam lar r#ktal 5 m&/25 m lar r#ktal 1 3 !5

*! 8ia$#pam lar r#ktal 10 m&/25 m lar r#ktal 0 0 0

*5 8ia$#pam ta" 2 m& ta"l#t 0 130 150

*' 8ia$#pam ta" 5 m& ta"l#t 0 0 0

** 8i#tilkar"ama$in ta" 100 m& ta"l#t 0 0 0

*+ 8i#nhidramin inj 10 m&/m (i.v./i.m.) vial 0 0 0

* 8i&%ksin ta" 025 m& ta"l#t 20 30 !50

+0 8iltia$#m ta" 30 m& a" 0 0 0

+1 8iltia$#m l ta" 30 m& ta"l#t 0 0 0

+2 8iltia$#m kaps :; 100 m&


5/98

NO NAMA OBAT SATUAN

1 2 3 4 5 6 (=5x15!! " (=6

SISA STOK31

DESEMBER2015

PEMAKAINPERBULAN

JUMLAHKEBUTUHAN

USUL201

+ =tam"ut%l ta" 500 m& ta"l#t 0 0 0

=tan%l "%t%l *0 "%t%l 0 10 150

100 =til kl%rida s#mpr%t 100 m "%t%l 0 1 15

101 =t%n%str#l implan '+ m& implan 0 0 0

102 =un%l "%t%l 0 0 0

103 >#nit%in ?a kaps 50 m& kapsul 0 0 0

10! >#nit%in ?a kaps 100 m& kapsul 0 0 0

105 >#nit%in ?a inj 100 m&/2 m ampul 0 0 0

10' >#nit%in ?a inj 50 m&/m ampul 0 0 0

10* >#n%"ar"ital ta" 30 m& ta"l#t 0 360 5!00

10+ >#n%"ar"ital ta" 100 m& ta"l#t 0 0 0

10 >#n%ksim#til p#nisilin (p#nisilin @) ta" 250 m& ta"l#t 0 0 0

110 >#n%ksim#til p#nisilin (p#nisilin @) ta" 500 m& ta"l#t 0 0 0

111 vial 0 0 0

112 >#n%t#r%l h"r a#r%s%l 100 m&/pu B%t%l 0 0 0

113 >#n%t#r%l h"r airan ih 01 B%t%l 0 0 0 11! >#rr% umarat kaps lunak 300 m& kaps. unak 0 0 0

115 >#rr% sulat ta" salut 300 m& ta"l#t salut 0 0 0

11' >#rr% sulat sir. 15 m&/5 m "%t%l 0 0 0

11* >it%m#nadi%n (vitamin < 1) ta" sal 10 m& ta". :alut 23! 90 1350

11+ >it%m#nadi%n (vitamin < 1) inj 2 m&/m (i.m.) vial 0 0 0

11 >lu%r ta" 05 m& ta"l#t 0 0 0

120 >lu%r kapl 1 m& kapsul 0 0 0

121 >lu%r s#diaan t%pikal tu"# 0 0 0

122 >lu%r#s#in tts mata 25 m&/m "%t%l 0 0 0

123 >%rm%kr#s%l "%t%l 0 0 0

12! >ur%s#mid ta" !0 m& ta"l#t 0 120 1+00

>#n%ksim#til p#nisilin (p#nisilin @) s#r" inj 3 juta UI/vial


6/98

NO NAMA OBAT SATUAN

1 2 3 4 5 6 (=5x15!! " (=6

SISA STOK31

DESEMBER2015

PEMAKAINPERBULAN

JUMLAHKEBUTUHAN

USUL201

125 >ur%s#mid inj 10 m&/m (i.v./i.m.) ampul 0 0 0

12' Galactose microparticle200-400 mg micropart/m l 0 0 0

12* sah#t 0 500 *500

12+ sah#t 0 0 0 12 "%t%l 0 0 0

130 cocoa butter 0 0 0

131 li"#nklamid ta" 25 m& ta"l#t 0 0 0

132 li"#nklamid ta" 5 m& ta"l#t 3050 120 1+00 (1

133 likla$id ta"l#t C; 30 m& ta"l#t 0 0 0

13! likla$id ta"l#t :; '0 m& ta"l#t 0 0 0

135 likla$id ta"l#t +0 m& ta"l#t 0 0 0

13' lim#pirid ta" 1 m& ta"l#t 0 0 0

13* lim#pirid ta" 2 m& ta"l#t 0 0 0

13+ lim#pirid ta" 3 m& ta"l#t 0 0 0

13 lim#pirid ta" ! m& ta"l#t 0 0 0 1!0 lipi$id ta" 5 m& ta"l#t 0 0 0

1!1 lipi$id ta" 10 m& ta"l#t 0 0 0

1!2 lis#ril trinitrat kaps :; 25 m&


7/98

NO NAMA OBAT SATUAN

1 2 3 4 5 6 (=5x15!! " (=6

SISA STOK31

DESEMBER2015

PEMAKAINPERBULAN

JUMLAHKEBUTUHAN

USUL201

151 al%p#rid%l ta" 05 m& ta"l#t 310 90 1350

152 al%p#rid%l ta" 15 m& ta"l#t 250 300 !500

153 al%p#rid%l ta" 2 m& ta"l#t 0 0 0

15! al%p#rid%l ta" 5 m& ta"l#t 2!0 60 00

155 al%p#rid%l tts 2 m&/m "%t%l 0 0 0

15' al%p#rid%l inj 5 m&/m (i.m.) vial 0 0 0

15* #patitis B imun%&l%"ulin (human) inj 05 m vial 0 0 0

15+ idr%n p#r%ksida "%t%l 3 "%t%l 0 0 0

15 idr%n p#r%ksida lar. k%ns#ntrat 3 "%t%l 0 0 0

1'0 idr%kl%r%tia$id ta" 25 m& ta"l#t 1300 420 '300

1'1 idr%k%rtis%n s#r" inj 100 m&/vial vial 0 0 0

1'2 idr%k%rtis%n krim 25 krim 3+ 22! 33'0

1'3 idr%ksi kl%r%kuin ta" 200 m& ta"l#t 0 0 0

1'! idr%ksi kl%r%kuin ta" !00 m& ta"l#t 0 0 0

1'5 i%sina "util"r%mida ta" 10 m& ta"l#t 0 0 0

1'' Vial 0 0 0

1'* Vial 0 0 0

1'+ Vial 0 0 0

1' )uman tetanus imunoglobulin in* 250 +, "im$ vial 0 0 0

1*0 )uman tetanus imunoglobulin in* 500 +, "im$ vial 0 0 0

1*1 I"upr%#n ta" 200 m& ta"l#t 0 0 0

1*2 I"upr%#n ta" !00 m& ta"l#t 300 2500 3*500 2

1*3 I"upr%#n sir 100 m&/5 m "%t%l 0 20 300

1*! I"upr%#n sir 200 m&/5 m "%t%l 0 0 0

1*5 Imidapril ta" 10 m& a" 0 0 0

1*' Imidapril ta" 5 m& a" 0 0 0

uman insulin int#rm#diat# atin& inj 100 UI/ml(k#masan vial/ artrid disp%si"l# p#n,ll artrid)

uman insulin mi4 insulin inj 100 UI/ml (k#masan vialartrid disp%si"l# p#n,ll artrid)

uman insulin sh%rt atin& inj 100 UI/ml (k#masanvial artrid disp%si"l# p#n,ll artrid)


8/98

NO NAMA OBAT SATUAN

1 2 3 4 5 6 (=5x15!! " (=6

SISA STOK31

DESEMBER2015

PEMAKAINPERBULAN

JUMLAHKEBUTUHAN

USUL201

1** Ipratr%pium "r%mida ih 20m&/pu B%t%l 0 0 0

1*+ Ipratr%pium "r%mida ih padat 20 m& pu 0 0 0

1* Ipratr%pium "r%mida n#"uli$#r 0025 "%t%l 0 10 150

1+0 Ir"#sartan ta" 150 m& a" 0 0 0

1+1 Ir"#sartan ta" 300 m& a" 0 0 0

1+2 Is%nia$id ta" 100 m& ta"l#t 0 0 0

1+3 Is%nia$id ta" 300 m& ta"l#t 0 0 0

1+! Is%s%r"id dinitrat ta" 10 m& a" 0 0 0

1+5 Is%s%r"id dinitrat ta" 5 m& ta"l#t 1*0 20 300

1+'


9/98

NO NAMA OBAT SATUAN

1 2 3 4 5 6 (=5x15!! " (=6

SISA STOK31

DESEMBER2015

PEMAKAINPERBULAN

JUMLAHKEBUTUHAN

USUL201

20! kapsul 0 0 0

205


10/98

NO NAMA OBAT SATUAN

1 2 3 4 5 6 (=5x15!! " (=6

SISA STOK31

DESEMBER2015

PEMAKAINPERBULAN

JUMLAHKEBUTUHAN

USUL201

230 Pak#t 0 0 0

231 Pak#t 0 0 0

232 Pak#t 3 3 !5

233 Pak#t 0 0 0

23! Pak#t 0 0 0

235 Pak#t 1 + 120

23' Pak#t 0 0 0

23* ta"l#t 0 0 0

23+ "%t%l 0 0 0

23 B%t%l 0 0 0

2!0 B%t%l 0 0 0

2!1 B%t%l 0 0 0

2!2


11/98

NO NAMA OBAT SATUAN

1 2 3 4 5 6 (=5x15!! " (=6

SISA STOK31

DESEMBER2015

PEMAKAINPERBULAN

JUMLAHKEBUTUHAN

USUL201

2!5 ta"l#t 1+! 740 11100

1

2!' ta"l#t 0

0

0

2!*


12/98

NO NAMA OBAT SATUAN

1 2 3 4 5 6 (=5x15!! " (=6

SISA STOK31

DESEMBER2015

PEMAKAINPERBULAN

JUMLAHKEBUTUHAN

USUL201

2*1 C#t%rmin ta" 500 m& ta"l#t 0 0 0 1

2*2 C#t%rmin ta" +50 m& ta"l#t 0 0 0

2*3 C#tild%pa ta" sal 250 m& a" 0 0 0

2*! C#til#r&%m#trin ta" salut 0125 m& ta"l#t 0 60 00

2*5 C#til#r&%m#trin inj 02 m&/Cl ampul 0 0 0

2*' C#tilpr#dnis%l%n ta" 1' m& a" 0 0 0

2** C#tilpr#dnis%l%n ta" ! m& a" 0 1'' 2!0 2

2*+ C#tilpr#dnis%l%n ta" + m& a" 0 0 0

2* C#t%kl%pramid ta" 5 m& ta"l#t 0 0 0

2+0 C#t%kl%pramid ta" 10 m& ta"l#t 0 0 0

2+1 C#tr%nida$%l ta" 250 m& ta"l#t 0 0 0 3

2+2 C#tr%nida$%l ta" 500 m& ta"l#t 0 500 *500 *

2+3 C#tr%nida$%l sir 125 m&/5 m "%t%l 0 0 0

2+! C#tr%nida$%l lar in 5 m&/m "%t%l 0 0 0

2+5 C#tr%nida$%l %vula 500 m& supp 0 0 0

2+' Cik%na$%l s#r" 2 vial 0 66 0 2+* Cik%na$%l krim 2 krim 0 94 1!10 1

2++ ?atrium "ikar"%nat ta" 500 m& ta"l#t 350 760 11!00 11

2+ ?atrium dikl%#nak ta" 25 m& ta"l#t 0 0 0

20 ?atrium dikl%#nak ta" 50 m& ta" 50 m& **0+ 1658 2!+*0 1*

21 ?atrium hip%kl%rit "%t%l k%ns#ntrat 5 "%t%l 0 0 0

22 ?atrium ti%sulat inj 25 (i.v.) vial 0 0 0

23 ?i#dipin kaps 10 m& kapsul *52 400 '000 5

2! ?i#dipin ta" :; 20 m& a" 0 0 0

25 ?i#dipin ta" :; 30 m& a" 0 0 0

2' ?ik%tinamid ta" 5 m& ta"l#t 0 0 0

2* ?ik%tinamid ta" 20 m& ta"#t 0 0 0


13/98

NO NAMA OBAT SATUAN

1 2 3 4 5 6 (=5x15!! " (=6

SISA STOK31

DESEMBER2015

PEMAKAINPERBULAN

JUMLAHKEBUTUHAN

USUL201

2+ ?ik%tinamid ta" 100 m& ta"l#t 0 0 0

2 ?istatin ta" salut 500.000 UI ta"l#t salut 50 30 !50

300 ?istatin susp 100.000 UI/m "%t%l 0 10 150

301 ?istatin ta" va&inal 100.000 UI/ta" supp 35 '0 00

302 ?itr%urant%in ta" 50 m& ta"l#t 0 0 0

303 ?%r#pin#rin inj 1 m&/m ampul 0 0 0

30! Eksin ih &as dlm ta"un& "%tl 0 0 0

305 Eksim#ta$%lin tts hidun& 0025 "%t%l 0 0 0

30' Eksim#ta$%lin tts hidun& 0050 "%t%l 0 0 0

30* Eksit%sin inj 10 UI/m ampul 0 0 0

30+ El%patadin tts mata 01 "%t%l 0 0 0

30 Em#pra$%l kaps 20 m& kapsul 1!10 1!0 2100

310 Em#pra$%l inj !0 m&/10 m ampul 0 0 0

311 Para%rmald#hid ta" 1 & ta"l#t 0 0 0

312 Paras#tam%l ta" 500 m& ta"l#t 0 12406 1+'00 1+

313 Paras#tam%l sir 120 m&/5 m "%t%l 0 508

*'20 *31! Paras#tam%l tts '0 m&/0' m "%t%l 1300 80 1200

315 Pasta d#vitalisasi (n%n ars#n) tu"# 0 0 0

31' Pasta p#n&isi saluran akar tu"# 0 0 0

31* P#rak nitrat lar 20 "%t%l 0 0 0

31+ P#rak suladia$in krim 1 p%t 0 0 0

31 P#rind%prilar&inin ta" 5 m& a" 0 0 0

320 P#rm#trin krim 5 p%t 100 15 225

321 Pirant#l pam%at ta" s%r#d 125 m& ta"l#t s%r# 0 0 0

322 Pirant#l pam%at ta" s%r#d 250 m& ta"l#t s%r# 0 0 0

323 Pirant#l pam%at ta" 500 m& ta"l#t 0 0 0

32! Pirant#l pam%at susp 125 m&/5 m "%t%l 0 0 0


14/98

NO NAMA OBAT SATUAN

1 2 3 4 5 6 (=5x15!! " (=6

SISA STOK31

DESEMBER2015

PEMAKAINPERBULAN

JUMLAHKEBUTUHAN

USUL201

325 Pira$inamid ta" 500 m& ta"l#t 0 0 0

32' Pirid%ksin (vitamin B') ta" 10 m& ta"l#t 0 3018 !52*0 !5

32* Pirid%ksin (vitamin B') ta" 25 m& ta"l#t 0 0 0

32+ Pirid%ksin (vitamin B') inj 100 m&/m ampul 0 0 0

32 P%vid%n i%din lar 100 m&/m "%t%l 0 0 0

330 Pra$ikuant#l ta" s%r#d 300 m& ta"l#t s%r# 0 0 0

331 Pra$ikuant#l ta" s%r#d '00 m& ta"l#t s%r# 0 0 0

332 Pr#dnis%n 5 m& ta"l#t 0 1109 1''35 1'

333 Primakuin 15 m& ta"l#t 0 0 0

33! Pr%"#n#sid 500 m& ta"l#t 0 0 0

335 Pr%kain "#n$ilp#nisilin inj 1 juta UI/vial (i.m.) vial 0 0 0

33' Pr%kain "#n$ilp#nisilin s#r" inj 3 juta UI/vial (i.m.) vial 0 0 0

33* Pr%pilti%urasil 100 m& ta"l#t 0 0 0

33+ pr%pran%l%l 10 m& ta"l#t 0 0 0

33 ;amipril ta" 10 m& a" 0 0 0

3!0 ;amipril ta" 5 m& a" 0 0 0 3!1 ;amipril ta" 25 m& a" 0 0 0

3!2 ;anitidin 150 m& ta"l#t 253!! 2822 !2330 1'

3!3 ;#tin%l (vitamin A) kaps lunak 100.000 UI kapsul lunak 12 '0 00

3!! ;#tin%l (vitamin A) kaps lunak 200.000 UI kaps lunak 2!1 500 *500

3!5 ;iampisin 300 m& kapsul 0 0 0

3!' ;isp#rid%n ta" 3 m& a" 0 0 0

3!* ;isp#rid%n ta" sal 1 m& a" sal 0 0 0

3!+ ;isp#rid%n ta" sal 2 m& a" sal 0 0 0

3! :al"utam%l a#r%s%l 100 m& B%t%l 0 0 0

350 :al"utam%l airan s#r" ih 200 m&/kaps 6 r%tahal#r B%t%l 0 0 0

351 :al"utam%l sir 2 m&/5 ml B%t%l 0 0 0


15/98

NO NAMA OBAT SATUAN

1 2 3 4 5 6 (=5x15!! " (=6

SISA STOK31

DESEMBER2015

PEMAKAINPERBULAN

JUMLAHKEBUTUHAN

USUL201

352 :al"utam%l 2 m& ta"l#t 1' 442 ''30

353 :al"utam%l ! m& ta"l#t 0 200 3000

35! :al"utam%l lar ih 05 "%t%l 0 0 0

355 :al"utam%l "%t%l ih 01 "%t%l 0 0 0

35' tu"# 0 51 *'5

35* :#rum antidit#ri (A.8.:) i.m 10.000 UI/vial vial 0 0 0

35+ :#rum antidit#ri (A.8.:) i.m 20.000 UI/vial vial 0 0 0

35 :#rum antira"i#s inj 200 UI/m vial 0 0 0

3'0 :#rum antira"i#s inj100 UI/m vial 0 0 0

3'1 :#rum antit#tanus (A..:) inj 1500 UI/amp (i.m.) ampul 0 0 0

3'2 :#rum antit#tanus (A..:) inj 10.000 UI/vial (i.m /i.v.) vial 0 0 0

3'3 :#rum antit#tanus (A..:) inj 20.000 UI/vial (i.m /i.v.) vial 0 0 0

3'! :#tiri$in 5 m&/5 m "%t%l 0 0 0

3'5 :ian%k%"alamin (vitamin B12) 50 m& ta"l#t 0 0 0 12

3'' :ian%k%"alamin (vitamin B12) 500 m&/m ampul 0 0 0

3'* :imvastatin 10 m& ta"l#t salut 0 210 3150

3'+ :imvastatin 20 m& ta"#t salut 0 0 0

3' :ipr%D%ksasin 500 m& 0 '50 *50

3*0 :pir%n%lakt%n 25 m& ta"l#t 0 0 0

3*1 :tr#pt%misin 1000 m&/vial vial 0 0 0

3*2 9urgical ginggi#al pac. pasta 0 0 0

3*3 #lmisartan ta" !0 m& a" 0 0 0

3*! #lmisartan ta" +0 m& a" 0 0 0

3*5 #%,lin ta" 100 m& a" 0 0 0

3*' #%,lin ta" 150 m& a" 0 0 0

3** #%,lin ta" :; 300 m& a" 0 0 0

3*+ #r"utalin ta" 25 m& a" 0 0 0

:al#p 2-! k%m"inasi asam salisilat 2 6 "#l#ran&#ndap !

ta"l#t scored


16/98

NO NAMA OBAT SATUAN

1 2 3 4 5 6 (=5x15!! " (=6

SISA STOK31

DESEMBER2015

PEMAKAINPERBULAN

JUMLAHKEBUTUHAN

USUL201

3* #tanus t%4%id vial 0 0 0

3+0 #trakain 05 "%t%l 0 0 0

3+1 #trasiklin 250 m& kapsul *!0 300 !500

3+2 #trasiklin 500 m& kapsul 0 50 *50

3+3 iamin (vitamin B1) 50 m& ta"l#t ++2' 2792 !1++0 33

3+! i%tr%pium s#r" ih 1+ m& 6 handihall#r B%t%l 0 0 0

3+5 i%tr%pium s#r" ih 1+ m& r#,ll B%t%l 0 0 0

3+' riDu%p#ra$in ta" sal 5 m& a" sal 0 0 0

3+* rih#ksi#nidil 2 m& ta"l#t !0 380 5*00

3++ ampul 0 0 0

3+ @aksin B vial 0 30 !50

30 @aksin ampak vial 0 25 3*5

31 @aksin j#rap dit#ri t#tanus p#rtusis (8P) vial 0 0 0

32 @aksin j#rap dit#ri t#tanus (8) vial 0 0 0

33 vial 0 30 !50

3! @aksin k%m"inasi 8P 6 h#patitis B vial 0 0 0 35 @aksin p%li% "%t%l 0 '0 00

3' @aksin ra"i#s untuk manusia vial 0 0 0

3* @alpr%at sir 250 m&/5 m "%t%l 0 0 0

3+ @alpr%at ta" sal 250 m& a" sal 0 0 0

3 @alpr%at ta" sal 500 m& a" sal 0 0 0

!00 @alpr%at ta" :; 500 m& a" 0 0 0

!01 @alpr%at ta" :; 250 m& a" 0 0 0

!02 @alsartan ta" 1'0 m& a" 0 0 0

!03 @alsartan ta" +0 m& a" 0 0 0

!0! @#rapamil ta" +0 m& a" 0 0 0

!05 @#rapamil ta" 2!0 m& a" 0 0 0

u"#rkulin protein purifed deri#ati#e ''0 "i.$

@aksin j#rap t#tanus (tetanus adsorbed toxoid)


17/98

NO NAMA OBAT SATUAN

1 2 3 4 5 6 (=5x15!! " (=6 # 4

SISA STOK31

DESEMBER2015

PEMAKAINPERBULAN

JUMLAHKEBUTUHAN

USULAN2015

!0' @itamin B k%mpl#ks ta"l#t 0 4544 '+1'0 '+1

!0* :inc '0 mg/m "%t%l 0 30 !50 !

!0+ :inc 20 mg ta"l#t disp 300 710 10'50 103

!0 :inc 20 mg/5 m "%t%l 0 0 0

!10 :inc '0 mg sah#t 0 0 0

NO

NAMA OBAT SATUANPEMAKAIAN BULANAN

Nambo Arjasari!11 Alv%&l 0

!12 ambroksol sirup 15 mg/ 5 ml Botol 260 388

!13 ambroksol tablet 30 mg tablet 2497 1876

!1! Am%ksillin inj#ksi Ampul 88 0

!15 Am%ksillin :r 125 m& / 5 ml B%t%l 275 0

!1' Am%4iillin 250 kap a"l#t 2967 0

!1* Ani%sn# 8#sin#ktan B%t%l 0 0

!1+ Antal&in a" ta"l#t 740 0

!1 Antik%a&ulan =8A 1 4 250 & B%t%l 0 0

!20 AFuad#st 500 ml B%t%l 0 0

!21 Asam ran#ksamat 500 m& ta"l#t 0 0

!22 asiklovir krim 5 % tube 38 78

!23 besi ( fe ) tablet tambah darah + asam folat tablet 0 100

!2! Betahistine tablet 0 0

!25 Endomethasone Botol 0 0

!2' ekstrak belladona tablet 10 mg tablet 79 236

!2* fenol gliserol tetes telinga 10 % Botol 0 20

JML TOTALPEMAKAIAN

HARGASATUAN


18/98

NO NAMA OBAT SATUAN

1 2 3 4 5 6 (=5x15!!

SISA STOK31

DESEMBER2015

PEMAKAINPERBULAN

JUMLAHKEBUTUHAN

!2+ gentamisin salep kulit 0,1 % tube 25 96

!2 gliseril guaiakolat tablet 100 mg tablet 3613 3870

!30 multivitamin sirup ( lybex) Botol 190 217

!31 multivitamin tablet ( hemaport ) tablet 1003 1500

!32 natrium klorida cairan infus 0,9 % 500 ml Botol 34 3

!33 obat antidiare nonspesifik tablet ( pularex ) 250

!3! obat batuk hitam (OBH) sirup 100 ml 586

!35 obat flu sirup ( Ponflu ) 278

!3' obat flu tablet ( Ponflu ) 2660

!3* oksitetrasiklin HCL salep kulit 118

!3+ oksitetrasiklin HCL salep mata 90

!3 piroksicam 1274

!!0 salep luka bakar 12

!!1 sulfacetamid Na tetes mata 95

!!2 Amoxicillin kapsul 250 mg 1690

!!3 Cefadroxil sirup kering 125 mg / 5 ml 35 22

!!! Cefixime tab tablet 0

!!5 Co-Amoksiklav Tab. tablet 0

!!' salbutamol nebulezer 1 mg/ml-2,5 ml 5

!!* gentamisin salep mata ( genoint) 0,3 % 10

!!+ azithromycin 500 mg 5

!! gentian violet 2

!50 glucosamine tablet

!51 cefixime 100mg

!52 cefixime sirup botol 0 0

!53 chloramphenicol tetes telinga botol 0 20

!5! ketokonazol salep kulit 20


19/98

NO NAMA OBAT SATUAN

1 2 3 4 5 6 (=5x15!! " (

SISA STOK31

DESEMBER2015

PEMAKAINPERBULAN

JUMLAHKEBUTUHAN

US2

!55 neurobion inj

!5' OAT KAT 2 2

!5* ranitidin inj

!5+ rivanol 5

!5 sulfasetamid Na tetes mata 50!'0 amoxicillin sirup 125mg/5 ml 250

!'1 amoxicillin kapsul 250 mg 1250

!'2 thiamphenicol kapsul

!'3 thiamphenicol sirup

!'! Alat Suntik sekali pakai 0,05 ml ADS 150 0

!'5 Alat Suntik sekali pakai 0,5 ml ADS !00 0

!'' Alat Suntik sekali pakai 1 ml 211 11

!'* Alat Suntik sekali pakai 10 ml 3* 0

!'+ Alat Suntik sekali pakai 20 ml 0 0

!' Alat Suntik sekali pakai 2,5 ml / 3 ml '11 100

!*0 Alat Suntik sekali pakai 5 ml 305 60

!*1 bisturi no 11 11 20

!*2 Catgut/Benang bedah No.2/0 0 10

!*3 Foley catheter 12 0 0

!*! Foley catheter 14 0 0

!*5 Foley catheter 16 10 1

!*' Foley catheter 18 10 10

!** Foley catheter 20 0 5

!*+ Infusion set anak 0 1

!* Infusion set dewasa 0 1

!+0 IV. Catheter No. 18 0 2

!+1 IV. Catheter No. 20 0 2


20/98

NO NAMA OBAT SATUAN

1 2 3 4 5 6 (=5x15!! " (=6

SISA STOK31

DESEMBER2015

PEMAKAINPERBULAN

JUMLAHKEBUTUHAN

USUL201

!+2 Kapas Pembalut/Absorben 250 gram 10 3

!+3 Kasa Pembalut Hidrofil 4 m x 10 cm 0 7

!+! Kasa Pembalut Hidrofil 4 m x 5 cm 0 7

!+518 20

!+' masker pieces 0 50

!+* masker N95 pieces 4 4

!++ Plester 5 yards x 2 inch ;%l 7 5

!+ Sarung tangan steril disposible no.7 0 12

!0 Sarung tangan steril disposible no.7,5 0 12

!1 Sarung tangan non steril disposible M 0 35

!2 Sarung tangan non steril disposible L 0 20

!30

10

!! Sendok Obat pi##s 100 150!5 Objek glass pak 1 2

!' spirtus 1 liter '-. 1 2

!* Pot Dahak /,+ 112 30!+ Plastik Obat 7X10 12 15

! plastik Obat 8,7X13 3 10

500 lisol '-. 5 5

501 micropore '-. 0 2

502 plester hipafix ). 7 2

503 polibag hitam /% 10 2

50! polibag kuning /% 10 3

505 polibag hijau /% 10 3

50' safety box /,+ 50 10

50* supratulle 0 2

Kasa sterill 16 x 16 cm (Kassa steril antibiotik

Framisetin (Lomatulle))

Silk ( Benang Bedah Sutera ) No. 3/0 dengan jarum

bedah


21/98

NO NAMA OBAT SATUAN

1 2 3 4 5 6 (=5x15!! " (=6

SISA STOK31

DESEMBER2015

PEMAKAINPERBULAN

JUMLAHKEBUTUHAN

USUL201

KEPALA PUSKESMAS

( ....................................................... ) ?IP. .............................................)

?IP.


22/98


23/98


24/98


25/98


26/98


27/98


28/98


29/98


30/98


31/98


32/98


33/98


34/98


35/98


36/98


37/98


38/98

JUMLAH

HARGAKASI


39/98


40/98


41/98


42/98


43/98


44/98


45/98


46/98


47/98


48/98


49/98


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51/98


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64/98

1UNTUK DATA PENUNJANG PENGADAAN OBAT MOHON DICEKLIST ITEM OBAT Y

2CEKLIST PADA KOLOM KEBUTUHAN PUSKESMAS

3AGAR TIDAK MENAMBAH INSERT DITENGAH7 ITEMOBAT YANG DIBUTUHKAN

DITAMBAHKAN DIBARIS KOLOM PALING TERAKHIR DAN DIBOLD BER:ARNA

8AS KES

K.%+ -)%/, N%&% O'%- S%-;%< TK 1 TK 2 TK 3

ANALGESIK ANTI PIRETIK ANTI IN8LAMASI NON STEROID ANTI PIRAI

1. Analsik ?%n ?ark%tika - Asam as#tilsalisilat (A:=E:A) ta"l#t 100 m&

ta"l#t 500 m&

- I"upr%#n ta"l#t 200 m& G G G

ta"l#t !00 m& G G G

sirup 100 m&/ 5 ml G G G

- C#tampir%n (Antal&in) ta"l#t 500 m&

inj#ksi 250 m&/ml i.m

- ?atrium dikl%#nak ta"l#t 25 m& G G G

ta"l#t 50 m& G G G

- Paras#tam%l ta"l#t 100 m& G G G

ta"l#t 500 m& G G G

sirup 120 m&/ 5 ml G G Gtts '0 m&/ 0' ml G G G

- Asam m##namat kapl#t 500 m& G G G

kapsul 200 m& G G G

2. Antipirai - All%purin%l ta"l#t 100 m& G G G

ANASTETIK

1. Anast#tik l%kal - =til kl%rida s#mpr%t "tl 100 ml G G G

- id%kain (6 #pin#rin 1200.000) inj#ksi

2. Eksin Anast#tik umum - Eksin as dlm ta"un& G G G

3. Pr%s#dur p#ri %p#rati %"at - Atr%pin (sulat) inj#ksi 1 m&/ml G G G

- 8#ksam#tas%n Inj#ksi 5 m&/ ml G G G

ta"l#t 05 m&

- 8i#nhidramin Inj#ksi 10 m&/ml i.m G G G

- =pin#rin (Adr#nalin) Inj#ksi 01 i.v G G G

- #nit%in ta"l#t 30 m& G G G

Inj#ksi 50 m&/ml G G G

> " "it l t "l t 30 G G G

ANTIALERGI >%< O'%- ;


65/98

8AS KES

K.%+ -)%/, N%&% O'%- S%-;%< TK 1 TK 2 TK 3

ANTI IN8EKSI # ANTI BAKTERI

A?=CI?I


66/98

8AS KES

K.%+ -)%/, N%&% O'%- S%-;%< TK 1 TK 2 TK 3

10. Antiun&i - ris#%ulvin (mir%ni$#d) ta"l#t 125 m& G G G

- ?istatin ta"l#t salut 500.000 IU/ ta" G G G

ta"l#t va&ina 100.000 UI/ ta" G G G

-


67/98

8AS KES

K.%+ -)%/, N%&% O'%- S%-;%< TK 1 TK 2 TK 3

- >%rm%kr#s%l airan G G G

- Gutta perc&a dana paper points 15 - !0 mm G G G

!5 - +0 mm G G G

-


68/98

8AS KES

K.%+ -)%/, N%&% O'%- S%-;%< TK 1 TK 2 TK 3

- Aml%dipin ta"l#t 5 m& G G G

ta"l#t 10 m& G G G

- At#n%l%l ta"l#t 50 m& G G G

ta"l#t 100 m& G G

- 8iltia$#m ta"l#t 30 m& G G

- idr%kl%rtia$ida ta"l#t 25 m& G G G- ur%s#mid ta"l#t !0 m& G G G

inj#ksi 10 m&/m i.v i.m G .pp G G

-


69/98

8AS KES

K.%+ -)%/, N%&% O'%- S%-;%< TK 1 TK 2 TK 3

1. Eral - aram Eralit II :#r"uk G G G

-


70/98

8AS KES

K.%+ -)%/, N%&% O'%- S%-;%< TK 1 TK 2 TK 3

5. E"at untuk 8iar# - Atapul&it ta"l#t G G G

- aram %ralit s#r"uk untuk 200 ml Air G G G

- :inc G G G

-


71/98

8AS KES

K.%+ -)%/, N%&% O'%- S%-;%< TK 1 TK 2 TK 3

tts hidun& 0050 G G G

ITAMIN >%< MINERAL

- Asam ask%r"at (vitamin ) ta"l#t 50 m& G G G

ta"l#t 250 m& G G G

- =r&%kalsi#r%l (vitamin 82) kapsul 50.000 UI G G G

-


72/98

NG ADA DAN DIBUTUHKAN PUSKESMAS

ILUAR 8ORM9

G

GGG

GGGG

GGG

G

GG

G

GGGGGGG

G

GGGG

GG

GGG

G

KEBUTUHANPUSKESMAS


73/98

KEBUTUHANPUSKESMAS

GGGG

G

GG

G

G

G

GGG

GGG

G

GGGG

GGGG

G

G

GGGGG


74/98

KEBUTUHANPUSKESMAS

GGGGG

G

G

GG

GGG

G

G

GGG

GG

GG

G

GGG

G

GG


75/98

KEBUTUHANPUSKESMAS

G

G

G

G

GG

GGG

GG

G

G

G


76/98

KEBUTUHANPUSKESMAS

GGG

GG

GGGGGG

GG

G

GG

G

G

G

G

GGG

GGG

G

GGGG

GG

G

GG

G


77/98

KEBUTUHANPUSKESMAS

GG

GGGG

G

GGGGG

G

GG

G

GGG

G

GG

G

G

G

GGGG

GGG

G


78/98

KEBUTUHANPUSKESMAS

GGG

G

GGG

G

GGG

GG

G

G

G

G

G

G

G

GGGGG

G

GG


79/98

KEBUTUHANPUSKESMAS

G

GGGGG

G

G

GG

G

GGG

GGGG

G


80/98

STOK OPNAME OBAT BERASAL DARI DROPING

1MOHON DI KROSCEK KESESUAIAN DATA NYA DENGAN DATA YANG DIKIRIM KE DINKES (UPTD

2STOK OPNAME PERSEDIAAN YANG ADA DI FORM. INI UNTUK OBAT DAN PERBEKALAN KESEHA

3DATA YANG TIDAK SESUAI HARAP DIGANTI PADA KOLOM/ BARIS PUSKESMASNYA LANGSUNG D

4AGAR TIDAK MERUBAH/ MENAMBAH (INSERT) OBAT DITENGAN, PENAMBAHAN ITEM OBAT DIT5DATA OBAT DARI SUMBER DANA BLUD AGAR DIPISAHKAN DARI FORMAT INI

REKAP STOK OPNAME PERSEDIAAN OBAT DAN PERBEKALAN KESEHATAN

PER 31 DESEMBER 2015

PUSKESMAS/ UPTD PELAYANAN KESEHATAN KABUPATEN BANDUNG

No. ARJASARI Jumlah harga

1 2 4 6 ARJASARI

1Albendazol tablet 400 mg tablet 338.00 - -

2Alopurinol tablet 100 mg tablet 86.00 524 !50'!.00

3Ambroksol sirup 15 mg/ 5 ml botol 2,821.50 -

-4Ambroksol tablet 30 mg tablet 123.20 - -

5Aminofilin tablet 200 mg ampul 90.00 - -

6Amitriptilin tablet 25 mg tablet 102.00 - -

7Amlodipin tablet 10 mg tablet 330.00 - -

8Amoksisilin kaplet 500 mg kaplet 272.00 - -

9Amoksisilin kapsul 250 mg kapsul 211.00 2,140 !515!0.00

10Amoksisilin sirup kering 125 mg/ 5 ml botol 2,445.00 - -

11Antalgin (Metampiron) tablet 500 mg tablet 176.00 - -

12Antasida DOEN suspensi botol 2,100.00 - -

13Antasida DOEN tablet tablet 75.00 - -

14Antidiare nonspesifik, attalpulgit tablet tablet 190.00 - -

15Antidiare nonspesifik, kaolin - pektin sirup botol 4,950.00 -

-16Antifungi DOEN salep tube 1,904.40 - -

17Antihemoroid DOEN Suppositoria supp 3,300.00 - -

18Antimigren DOEN tablet tablet 123.00 - -

19Aqua Pro Injeksi sterill bebas Pirogen vial 5,000.00 - -

20Asam Asetilsalisilat tablet 100 mg tablet 116.00 - -

21Asam Askorbat (Vit. C) tablet 50 mg tablet 95.00 - -

22Asam Mefenamat kaplet 500 mg kaplet 95.00 - -

23Asiklovir krim 5% tube 3,373.70 - -

24Asiklovir tablet 400 mg tablet 345.00 60 20*00.00

25Atropin injeksi 0,25 mg/ml ampul 1,230.00 - -

26Azitromisin tablet 500 mg tablet 4,500.00 - -

27Bedak salisil 2% - 50 gram kotak 1,120.00 - -28Besi kombinasi asam folat tablet sacht 42.00 63 2'!'.00

29Betametason krim 0.1 % tube 1,520.00 - -

30Deksametason tablet 0,5 mg tablet 52.58 - -

31Diazepam injeksi 5 mg/ml-2 ml ampul 2,036.00 - -

32Diazepam rectal 5 mg tube 11,525.00 1 11525.00

33Diazepam tablet 2 mg tablet 31.90 - -

34Difenhidramin HCl injeksi 10 mg/ ml ampul 960.01 - -

35Digoxin tablet 0,25 mg tablet 97.00 20 1!0.00

36Dimenhidrinat tablet 50 mg tablet 104.00 - -

Nama Barang

(Obat/ BMHP)

Satuan

Barang

Harga Satuan

(Rp.)


81/98

37Domperidon tablet 10 mg tablet 167.00 - -

38Ekstrak beladonna tablet 10 mg tablet 31.68 204 '!'2.*2

39Epinefrin HCl injeksi 0,1% - 1 ml ampul 1,500.00 - -

40Eritromisin kapsul 250 mg kapsul 497.00 - -

41Eritromisin sirup 200 mg/ 5 ml botol 920.00 - -

42Etakridin larutan 0,1% - 300 ml botol 2,212.16 - -

43Etambutol tablet 500 mg tablet 410.00 - -

44Etanol larutan 70 % - 100 ml botol 2,500.00 - -45Fenilbutazon tablet 200 mg tablet 97.00 - -

46Fenobarbital injeksi 50 mg/ ml ampul 1,800.00 - -

47Fenobarbital tablet 30 mg tablet 143.55 - -

48Fenoksimetil penisilin tablet 250 mg tablet 272.00 - -

49Fenoksimetil penisilin tablet 500 mg tablet 510.00 - -

50Fenol gliserol Tetes Telinga 10% botol 2,042.00 - -

51Fitomenadion ( Vit K) injeksi 2 mg/ml ampul 3,417.00 - -

52Fitomenadion (Vit. K) tablet 10 mg tablet 634.00 - -

53Flukonazol tablet 150 mg tablet 22,000.00 - -

54Furosemid Injeksi i.v./i.m. 10 mg/ml - 2 ml ampul 2,060.08 - -

55Furosemida tablet 40 mg tablet 85.00 - -

56Garam oralit II (200ml) Serbuk sase 285.00 - -

57Gentamisin injeksi 80 mg/ 2,5 ml ampul 3,251.60 - -

58Gentian violet larutan 1% botol 895.00 - -

59Glibenklamide tablet 5 mg tablet 54.00 50 2*00.00

60Glimepirid tablet 2 mg tablet 436.00 - -

61Gliserin larutan - 100 ml botol 5,333.00 - -

62Gluconas calcicus 10% - 10 ml vial 8,974.94 - -

63Glukosa larutan steril (infus) 5% botol 5,313.00 - -

64Griseofulvin tablet 125 mg tablet 228.00 850 13+00.00

65Griseril guaiakolat tablet 100 mg tablet 38.50 - -

66Haloperidol tablet 0.5 mg tablet 59.00 310 1+20.00

67Haloperidol tablet 1.5 mg tablet 69.00 250 1*250.00

68Haloperidol tablet 5 mg tablet 96.00 240 230!0.00

69Hidroklortiazid tablet 25 mg tablet 33.00 1,300 !200.00

70Hidrokortison krim 2,5% tube 2,798.00 38 10'32!.00

71Ibuprofen suspensi 100 mg/5ml botol 3,499.00 - -

72Ibuprofen tablet 200 mg tablet 92.57 - -

73Ibuprofen tablet 400 mg tablet 149.00 - -

74Isoniazide tablet 100 mg tablet 137.00 - -

75Isosorbid Dinitrat tablet sublingual 5 mg tablet 92.00 170 15'!0.00

76Kalsium Laktat (Kalk) tablet 500 mg tablet 49.50 140 '30.00

77Kaptopril tablet 12.5 mg tablet 62.00 - -

78Kaptopril tablet 25 mg tablet 80.00 1,658 132'!0.00

79Karbamazepine tablet 200 mg tablet 245.00 90 22050.00

80Ketokonazole tablet 200 mg tablet 300.00 - -

81Kloramfenicol kapsul 250 mg kapsul 275.00 1,300 35*500.00

82Kloramfenikol salep mata 1% tube 1,600.00 - -

83Kloramfenikol suspensi 125 mg/5 ml - 60 ml botol 3,700.00 - -

85Kloramfenikol tetes telinga 3% tube 1,599.00 - -

86Klorfeniramin maleat (CTM) tablet 4 mg tablet 51.00 50 2550.00

87Klorpromazin HCl tablet salut 25 mg tablet 38.00 550 2000.00

88Kotrimoksazol susp. 120 mg/5 ml - 60ml botol 2,145.00 -

89Kotrimosazol tablet 240 mg (peadreatrik) tablet 65.27 - -

90Kotrimosazol tablet 480 mg tablet 149.00 184 2*!1'.00


82/98

91Larutan antiseptik Klorheksidin (handwash) botol 79,200.00 - -

92Larutan Polikresulen botol 17,393.00 - -

93Lidocain injeksi 2 % - ml tablet 868.59 - -

94Lidokain Komb. Epinefrin injeksi ampul 1,295.00 97 125'15.00

95Magnesium sulfat injeksi 20% - 25 ml vial 2,078.00 - -

96Magnesium sulfat injeksi 40% - 25 ml vial 2,629.00 - -

97Meloksikam tablet 15 mg tablet 348.00 - -

98Metformin tablet 500 mg tablet 105.00 - -99Metilergometrin maleat injeksi 0,2 mg/ml ampul 4,620.00 - -

100Metilprednisolon tablet 4 mg tablet 205.00 - -

101Metoklorpramid injeksi 5 mg/ ml ampul 859.98 - -

102Metoklorpramid tablet 10 mg tablet 89.00 - -

103Metronidazole tablet 500 mg tablet 160.00 - -

104Mikonazol krim 2% tube 3,000.00 - -

105Multivitamin plus sirup botol 7,150.00 - -

106Multivitamin plus Fe kapsul tablet 1,249.60 - -

107Natrium Bikarbonat tablet 500 mg tablet 14.30 350 5005.00

108Natrium Diklofenak tablet 50 mg tablet 200.00 - -

109Natrium Klorida larutan infus 0,9% - 500 ml botol 4,700.00 9 !2300.00

110Nifedipine tablet 10 mg tablet 100.00 - -

111Nistatin tablet 500.000 IU tablet 640.00 50 32000.00

112Nistatin tablet vaginal 100.000 IU tablet 480.00 35 1'+00.00

113Obat antituberkulosa FDC kat. 1 paket 359,900.00 1 3500.00

114Obat batuk hitam sirup botol 3,850.00 - -

115Obat flu kombinasi sirup botol 6,996.00 - -

116Obat flu kombinasi tablet botol 550.00 -

117Oksitetrasiklin HCl salep kulit 3% tube 2,090.00 - -

118Oksitetrasiklin HCl salep mata 1 % tube 1,600.00 8 12+00.00

119Oksitosin injeksi 10 IU/ml ampul 2,200.00 - -

120Parasetamol drop tetes 60 mg/0,6 ml botol 5,200.00 - -

121Parasetamol sirup 120 mg/ 5 ml botol 1,438.00 - -

122Parasetamol tablet 100 mg tablet 36.03 - -

123Parasetamol tablet 500 mg tablet 89.00 - -

124Permetrin 5% krim tube 11,475.00 - -

125Pirantel Pamoat tablet 125 mg tablet 296.00 - -

126Pirazinamid tablet 500 mg tablet 198.00 - -

127Piridoxin HCl (Vit. B6) tablet 10 mg tablet 14.96 - -

128Piroxicam kapsul 20 mg kapsul 104.50 - -

129Povidon iodida 10% larutan - 30 ml botol 2,163.00 8 1*30!.00

130Povidon iodida 10% larutan - 300 ml botol 14,203.00 - -

131Prednisone tablet 5 mg tablet 97.90 - -

132Propanolol tablet 10 mg tablet 77.00 - -

133Propiltiourasil tablet 100 mg tablet 264.00 - -

134Ranitidin injeksi 25 mg/ml ampul 1,140.00 - -

135Ranitidine tablet 150 mg tablet 120.00 344 !12+0.00

136Reserpin tablet 0,25 mg tablet 88.00 - -

137Rifampisin kapsul 300 mg kapsul 376.00 - -

138Ringer Laktat larutan infus - 500 ml botol 5,200.00 - -

139Salbutamol 1 mg/ NaCl 2,5 ml ampul 8,690.00 5 !3!50.00

140Salbutamol inhalasi 100 mcg can 63,750.00 - -

141Salbutamol plus ipratonium nebulaizer ampul 13,750.00 - -

142Salbutamol tablet 2 mg tablet 59.00 16 !!.00


83/98

143Salep 2-4 kombinasi : Asam Salisilat 2% + Belerang endap 4% tube 1,229.16 -

-

144Salep luka bakar; ekstrak plasenta plus neomisin tube 11,500.50 - -

145Salisil bedak 2% tube 1,120.00 - -

146Sefadroksil sirup kering 125 mg / 5 ml botol 5,200.00 - -

147Sefotaksim injeksi 1 gram vial 2,950.00 - -

148Seftriaxone injeksi 1 gram vial 8,000.00 - -

149Sianokobalamin injeksi 500 mcg/ ml ampul 1,078.00 - -150Sianokobalamin tablet 50 mcg tablet 13.10 - -

151Simvastatin tablet 10 mg tablet 169.00 - -

152Siprofloksasin tablet 500 mg tablet 550.00 - -

153Spironolakton tablet 25 mg tablet 315.00 - -

154Sulfasetamid Na Tetes Mata 15% botol 3,300.00 - -

155Tetrasiklin kapsul 250 mg kapsul 148.00 740 10520.00

156Tetrasiklin kapsul 500 mg kapsul 206.00 - -

157Tiamfenikol kapsul 500 mg kapsul 431.00 - -

158Tiamin HCl tablet 50 mg tablet 36.30 - -

159Tiamin injeksi 100 mg/ml ampul 680.00 - -

160Trihexifenidril Hidroksida tablet 2 mg tablet 275.00 40 11000.00

161Vitamin B Kompleks tablet tablet 107.00 - -

162Zink Sirup 20 mg/5 ml - 60 ml botol 7,400.00 - -

163Zink tablet 200 mg dispersible tablet 292.00 300 +*'00.00

-

164Bahan tambalan sementara (caviton) tube 165,000.00 - -

165Etil Klorida Cairan Semprot 100 ml botol 148,500.00 - -

166Eugenol botol 16,667.00 - -

167Glass ionomer semen ART (Ketac molar) paket 547,800.00 - -

168Kalsium Hidroksida Pasta tube 242,000.00 - -

169Klor fenol kamfer (CHKM) tube 74,800.00 - -

170Larutan TSR (Tooth Stain Remover) botol 88,000.00 - -

171Obat bahan gigi komb: Butamben, Iodoform, Eugenol (Alvolgyl) tube 374,000.00

- -

172Olie Pelumas Dental unit botol 299,200.00 - -

173Paper points absorbent 15-40 set 38,500.00 - -

174Semen Seng Powder dan Liquid botol 93,500.00 - -

-

175Alat Suntik sekali pakai 1 ml pcs 1,100.00 - -

176Alat Suntik sekali pakai 3 ml pcs 957.00 - -

177Alat Suntik sekali pakai 5 ml pcs 750.00 - -

178Catgut/Benang bedah No.2/0 sase 5,583.33 - -

179Catgut/Benang bedah No.3/0 sase 5,583.33 - -

180Foley catheter 16 pcs 8,470.00 - -

181Infus set anak bks 4,015.00 - -182Infus set dewasa bks 8,800.00 - -

183IV. Catheter No. 18 pcs 8,800.00 - -




187Kapas Pembalut/Absorben 250 gram bks 15,070.00 - -

188Kasa Gulung 36 m x 80 cm bks 143,000.00 - -

189Kasa Pembalut Hidrofil 4 m x 10 cm bks 1,100.00 - -

190Kasa Pembalut Hidrofil 4 m x 5 cm bks 550.00 - -

191Kasa sterill 16 x 16 cm kotak 8,250.00 - -


84/98

192Kassa steril antibiotik framisetin (Lomatull) sase 13,200.00 - -

193Masker 3 ply pcs 990.00 - -

194Masker N 95 pcs 7,700.00 - -

195Mucous Ekstraktor/slem seccher disposible pcs 10,450.00 - -

196Plester 5 yards x 2 inch roll 12,100.00 - -

197Sarung tangan steril 7 G psg 6,325.00 - -

198Silk ( Benang Bedah Sutera ) No. 3/0 dengan jarum bedah sase 3,055.56 -

-199Umbilical Klem pcs 1,000.00 - -

200Underpad (non woven) steril 60 x 90 lbr 6,270.00 - -

-

201Kaporit serbuk kg 39,100.00 - -

202Lisol, desinfektan C 1000 ltr 60,500.00 - -

JUMLAH TOTAL R/ 2435325"2


85/98

INKES/ UPTD OBAT

BAT)

AN YANG MASIH DIDROPING/KIRIM DARI DINAS KESEHATAN

N DI BERI WARNA/ DBOLD WARNA MERAH

MBAHKAN DIAKHIR BARIS SETELAH JUMLAH TOTAL


86/98


87/98


88/98


89/98


90/98

1ITEM/ NAMA OBAT DIISI SESUAI DENGAN DATA YANG TERTERA DIFAKTUR

2HARGA DICANTUMKAN SETELAH PPN, DAPAT DILIHAT PADA FAKTUR ATAU DOKUMEN SPK/ SP3KOLOM KETERANGAN DIISI DENGAN NAMA PENYEDIA/ PBF

4

REKAP STOK OPNAME PERSEDIAAN OBAT DAN PERBEKALAN KESEHATAN

PER 31 DESEMBER 2015

PUSKESMAS/ UPTD PELAYANAN KESEHATAN KABUPATEN BANDUNG

No. ARJASARI Total Harga

1 2 6 ARJASARI

1 Ambroxol sirup 15 mg/ 5 ml 2821.5 2385 Rp 6,729,277.50

2 Ambroxol tablet 30 mg 123.2 24400 Rp 3,006,080.00

3 Amlodipin Tablet 5 mg 187 2700 Rp 504,900.00

4 Amlodipin Tablet 10 mg 330 5586 Rp 1,843,380.00

5 Amoxicillin kaplet 500 mg 272 89880 Rp 24,447,360.00

6 Antidiare Nonspesifik tablet (Pularex) 190 3190 Rp 606,100.00

7 Asiklovir krim 5% 3373.7 400 Rp 1,349,480.00

8asiklovir 200 mg 237 700 Rp 165,900.00

9Kaptopril tablet 12.5 mg 62 2996 Rp 185,752.00

10Sefadroxil sirup kering 125 mg/ 5 ml 5200 100 Rp 520,000.00

11Dexametasone tablet 0,5 mg 52.58 36150 Rp 1,900,767.0012Domperidone tablet 10 mg 167 2000 Rp 334,000.00

13Fenol Gliserol Tetes Telinga 10% 2042 74 Rp 151,108.00

14Fitomenadion (Vit. K) tablet 10 mg 634 234 Rp 148,356.00

15gentamisin Salep mata(genoint) 0,3 % 2600 134 Rp 348,400.00

16Gentamisin Salep Kulit 0,1 % 1350 388 Rp 523,800.00

17Glibenclamide tablet 5 mg 54 3000 Rp 162,000.00

18Griseofulvin tablet 125 mg 228 1000 Rp 228,000.00

19Griseril Guaiakolat tablet 100 mg 38.5 15662 Rp 602,987.00

20Ibuprofen tablet 400 mg 149 9300 Rp 1,385,700.00

21Ketokonazole tablet 200 mg 300 3320 Rp 996,000.0022kloramfenikol Salep kulit (bufacetin) 3524 168 Rp 592,032.00

23Kloramfenikol Salep Mata 1 % 1600 204 Rp 326,400.00

24Multivitamin Dewasa Kapsul (Hemaport) 732 15880 Rp 11,624,160.00

25Multivitamin Sirup Anak (Lybex) 13860 2500 Rp 34,650,000.00

26Natrium Diklofenak tablet 50 mg 200 7708 Rp 1,541,600.00

27Nifedipine tablet 10 mg 100 752 Rp 75,200.00

28Obat Batuk Hitam (OBH) Sirup 100 ml 3850 1401 Rp 5,393,850.00

29Obat Flu Sirup (Ponflu Sirup) 12705 2222 Rp 28,230,510.00

STOK OPNAME OBAT BERASAL DARI

PENGADAAN/ PEMBELIAN BLUD

KOLOM NAMA PUSKESMAS YANG TELAH DISEDIAKAN

(SESUAI NAMA PUSKESMASNYA)

Nama Barang

(Obat/ BMHP)

Harga

Satuan

(Rp.)


91/98

30Obat Flu Tablet (Ponflu) 655 19968 Rp 13,079,040.00

31Oksitetrasiklin HCl Salep Kulit 3% 2090 1692 Rp 3,536,280.00

32Paracetamol drops tetes 60 mg / 0,6 ml 5200 1300 Rp 6,760,000.00

33Permetrin 11475 100 Rp 1,147,500.00

34Ranitidine tablet 150 mg 120 25000 Rp 3,000,000.00

35 Tiamin HCl (Vit. B1) tablet 50 mg 36.3 8826 Rp 320,383.80

TOTAL Rp 156,416,303.30

36 Alat Suntik sekali pakai 1 ml 1100 122 Rp 134,200.00

37 Alat Suntik sekali pakai 2,5 ml / 3 ml 1038.4 625 Rp 649,000.00

38 Alat Suntik sekali pakai 5 ml 750 167 Rp 125,250.00

39 bisturi 11520 37 Rp 426,240.00

40Catgut/Benang bedah No.2/0 50966.67 14 Rp 713,533.38

41Foley catheter 16 8470 12 Rp 101,640.00

42Foley catheter 18 18000 9 Rp 162,000.00

43Infusion set anak 4015 11 Rp 44,165.00

44Infusion set dewasa 4620 3 Rp 13,860.00

45IV. Catheter No. 18 8355 12 Rp 100,260.00

46IV. Catheter No. 20 8355 10 Rp 83,550.00

47Kapas Pembalut/Absorben 250 gram 15070 12 Rp 180,840.00

48Kasa Pembalut Hidrofil 4 m x 10 cm 1100 88 Rp 96,800.00

49Kasa Pembalut Hidrofil 4 m x 5 cm 550 96 Rp 52,800.00

50Kasa sterill 16 x 16 cm 8250 50 Rp 412,500.00

51masker 21945 190 Rp 4,169,550.00

52masker N95 30000 62 Rp 1,860,000.00

53Plester 5 yards x 2 inch 23100 6 Rp 138,600.00

54Sarung tangan steril disposible no.7 6600 123 Rp 811,800.00

55Sarung tangan steril disposible no.7,5 6600 88 Rp 580,800.00

56Sarung tangan non steril disposible M 5940 475 Rp 2,821,500.00

57Sarung tangan non steril disposible L 5940 290 Rp 1,722,600.00

5828875

4 Rp 115,500.00

59Sendok Obat 500 1050 Rp 525,000.00

60Objek glass 30000 12 Rp 360,000.00

61spirtus 1 liter 20000 10 Rp 200,000.00

62Pot Dahak 2000 420 Rp 840,000.00

63Plastik Obat 7X10 50000 19 Rp 950,000.00 TOTAL Rp 18,391,988.38

TOTAL SELURUH Rp 174,808,291.68

Silk ( Benang Bedah Sutera ) No. 3/0 dengan jarum

bedah


92/98


93/98


94/98

JUMLAH TOTAL


95/98

No.

1 2 4 6

1Alopurinol tablet 100 mg tablet 86.00

2Amitriptilin tablet 25 mg tablet 102.003Amoksisilin kaplet 500 mg kaplet 272.00

4Amoksisilin kapsul 250 mg kapsul 211.00

5Amoksisilin sirup kering 125 mg/ 5 ml botol 2,445.00

6Antalgin plus vitamin neurotropik tablet 616.00

7Antasida DOEN suspensi botol 2,100.00

8Antasida DOEN tablet tablet 75.00

9Antidiare nonspesifik, attalpulgit tablet tablet 517.00

10Antidiare nonspesifik, attalpulgit tablet tablet 190.00

11Antimigren DOEN tablet tablet 123.00

12Asam Asetilsalisilat tablet 100 mg tablet 116.00

13Asam Askorbat (Vit. C) tablet 50 mg tablet 95.00

14Asiklovir tablet 400 mg tablet 345.00

15Atropin injeksi 0,25 mg/ml ampul 1,230.00

16Azitromisin tablet 500 mg tablet 4,500.00

17Besi kombinasi asam folat tablet sacht 42.00

18Betametason krim 0.1 % tube 1,520.00

19Diazepam injeksi 5 mg/ml-2 ml ampul 2,036.00

20Diazepam rectal 5 mg tube 11,525.00

21Diazepam tablet 2 mg tablet 31.90

22Difenhidramin HCl injeksi 10 mg/ ml ampul 960.01

23Epinefrin HCl injeksi 0,1% - 1 ml ampul 1,500.00

24Eritromisin kapsul 250 mg kapsul 497.00

25Eritromisin sirup 200 mg/ 5 ml botol 920.00

26Etakridin larutan 0,1% - 300 ml botol 2,212.16

27Etambutol tablet 500 mg tablet 410.00

28Etanol larutan 70 % - 100 ml botol 2,500.00

29Fenilbutazon tablet 200 mg tablet 97.00

30Fenobarbital injeksi 50 mg/ ml ampul 1,800.00

31Fenobarbital tablet 30 mg tablet 143.55

32Fenoksimetil penisilin tablet 250 mg tablet 272.00

33Fenoksimetil penisilin tablet 500 mg tablet 510.00

34Fenol gliserol Tetes Telinga 10% botol 2,042.00

35Fitomenadion ( Vit K) injeksi 2 mg/ml ampul 3,417.00

36Fitomenadion (Vit. K) tablet 10 mg tablet 634.00

37Flukonazol tablet 150 mg tablet 22,000.00

38Furosemid Injeksi i.v./i.m. 10 mg/ml - 2 ml ampul 2,060.08

39Garam oralit II (200ml) Serbuk sase 285.00

40Gentamisiin salep kulit tube 2,750.00

41Glibenklamide tablet 5 mg tablet 54.00

42Glimepirid tablet 2 mg tablet 436.00

43Gluconas calcicus 10% - 10 ml vial 8,974.94

44Glukosa larutan steril (infus) 5% botol 5,313.00

45Griseofulvin tablet 125 mg tablet 228.00

46Haloperidol tablet 0.5 mg tablet 59.00

Nama Barang

(Obat/

BMHP)

Satuan

Barang

Harga Satuan

(Rp.)


96/98

47Haloperidol tablet 1.5 mg tablet 69.00

48Haloperidol tablet 5 mg tablet 96.00

49Hidroklortiazid tablet 25 mg tablet 33.00

50Hidrokortison krim 2,5% tube 2,798.00

51Ibuprofen tablet 400 mg tablet 149.00

52Isoniazide tablet 100 mg tablet 137.00

53Isosorbid Dinitrat tablet sublingual 5 mg tablet 92.00

54Kalsium Laktat (Kalk) tablet 500 mg tablet 49.5055Kaptopril tablet 12.5 mg tablet 62.00

56Kaptopril tablet 25 mg tablet 80.00

57Karbamazepine tablet 200 mg tablet 245.00

58Ketokonazole tablet 200 mg tablet 300.00

59Klindamisin kapsul 300 mg kapsul 553.00

60Kloramfenicol kapsul 250 mg kapsul 275.00

61Klorfeniramin maleat (CTM) tablet 4 mg tablet 51.00

62Klorpromazin HCl tablet salut 25 mg tablet 38.00

63Kotrimoksazol susp. 120 mg/5 ml - 60ml botol 2,145.00

64Kotrimosazol tablet 480 mg tablet 149.00

65Lidocain injeksi 2 % - ml tablet 868.59

66Magnesium sulfat injeksi 20% - 25 ml vial 2,078.00

67Magnesium sulfat injeksi 40% - 25 ml vial 2,629.00

68 tablet 154.00

69Metilergometrin maleat injeksi 0,2 mg/ml ampul 4,620.00

70Metronidazole tablet 500 mg tablet 160.00

71Mikonazol krim 2% tube 3,000.00

72Multivitamin plus Fe kapsul tablet 1,249.60

73Multivitamin suplemen 1,300.00

74Natrium Bikarbonat tablet 500 mg tablet 14.30

75Natrium Klorida larutan infus 0,9% - 500 ml botol 4,700.00

76Nistatin tablet 500.000 IU tablet 640.00

77Nistatin tablet vaginal 100.000 IU tablet 480.00

78Obat antituberkulosa FDC Anak paket 214,900.00

79Obat antituberkulosa FDC kat. 1 paket 359,900.00

80Obat antituberkulosa FDC kat. 2 paket 1,199,900.00

81Obat batuk hitam sirup botol 6,996.00

82Obat flu kombinasi tablet botol 550.00

83Oksitetrasiklin HCl salep mata 1 % tube 1,600.00

84Oksitosin injeksi 10 IU/ml ampul 2,200.00

85Parasetamol sirup 120 mg/ 5 ml botol 1,438.00

86Parasetamol tablet 500 mg tablet 89.00

87Permetrin 5% krim tube 11,475.00

88Pirantel Pamoat tablet 125 mg tablet 296.00

89Pirazinamid tablet 500 mg tablet 198.00

90Povidon iodida 10% larutan - 30 ml botol 2,163.00

91Propanolol tablet 10 mg tablet 77.00

92Propiltiourasil tablet 100 mg tablet 264.00

93Ranitidine tablet 150 mg tablet 120.00

94Retinol kapsul lunak 100.000 IU kapsul 260.00

95Retinol kapsul lunak 200.000 IU kapsul 459.00

96Ringer Laktat larutan infus - 500 ml botol 5,200.00

97Salbutamol 1 mg/ NaCl 2,5 ml ampul 8,690.00

Metilergometrin maleat (Metergin) tablet salut

0,125 mg


97/98

98Salbutamol tablet 2 mg tablet 59.00

99 tube 1,229.16

100Sianokobalamin injeksi 500 mcg/ ml ampul 1,078.00

101Simvastatin tablet 10 mg tablet 169.00

102Siprofloksasin tablet 500 mg tablet 550.00

103Spironolakton tablet 25 mg tablet 315.00

104Tetrasiklin kapsul 250 mg kapsul 148.00105Trihexifenidril Hidroksida tablet 2 mg tablet 275.00

106Vitamin B Kompleks tablet tablet 107.00

107Zink Sirup 20 mg/5 ml - 60 ml botol 7,400.00

108Zink tablet 200 mg dispersible tablet 292.00

109Bahan preventive gigi (White varnish) sase 110,000.00

110Etil Klorida Cairan Semprot 100 ml botol 148,500.00

111Gutta percha points 15-40 set 38,500.00

112Paper points absorbent 15-40 set 38,500.00

113Semen Seng Powder dan Liquid botol 93,500.00

114Alat Suntik sekali pakai 3 ml pcs 957.00

115Alat Suntik sekali pakai 5 ml pcs 750.00

116Alat Suntik sekali pakai ADS 0,5 ml pcs 1,980.00

117Catgut/Benang bedah No.2/0 sase 5,583.33

118Catgut/Benang bedah No.3/0 sase 5,583.33

119Collar neck buah 97,790.00

120Elastis verband 3" roll 49,500.00

121Foley catheter 16 pcs 8,470.00

122Infus set anak bks 4,015.00

123Infus set dewasa bks 8,800.00

124IV. Catheter No. 20 pcs 8,800.00



127Kantong mayat buah 215,600.00

128Kasa Pembalut Hidrofil 4 m x 10 cm bks 1,100.00

129Kasa Pembalut Hidrofil 4 m x 5 cm bks 550.00

130Masker 3 ply pcs 990.00

131Masker with visor pcs 5,500.00

132Mucous Ekstraktor/slem seccher disposible pcs 10,450.00

133Plester 5 yards x 2 inch roll 12,100.00

134Pot dahak pcs 1,750.00

135Safety box pcs 18,625.00

136Sarung tangan steril 7 G psg 6,325.00

137 sase 3,055.56

138Slang/ Canula Oksigen Dewasa pcs 7,700.00

139Spalk Anak psg 63,800.00

140Spalk Dewasa psg 94,600.00

141Verban elastis 10 cm roll 29,500.00

142Hygiene kit 1 paket 159,950.00

143Kaporit serbuk kg 23,100.00

Salep 2-4 kombinasi : Asam Salisilat 2% +

Belerang endap 4%

Silk ( Benang Bedah Sutera ) No. 3/0 dengan

jarum bedah


98/98

144Kaporit serbuk 39,100.00

145Kaporit serbuk kg 39,100.00

146Kaporit tablet kg 55,000.00

147Lisol ltr 41,000.00

148PAC pak 1 kg 14,300.00

149Penjernih Air Cepat sase 2,100.00

150Polybag ramah lingkungan lbr 10,225.00

151Polybag sampah/limbah warna hitam pak 29,700.00

152Polybag sampah/limbah warna kuning pak 29,700.00

153Sepatu boot psg 164,877.00

154HIV test kit 1 onco tes/ kit 54,000.00

155HIV test kit 1 vikia tes/ kit 37,400.00

156HIV test kit 2 tes/ kit 40,700.00

157HIV test kit 3 tes/ kit 40,700.00

158Kaca sediaan (Object glass) kotak 19,500.00

159Larutan imersion oil - 100 ml botol 237,930.00

160Larutan Ziehl nelsen paket 195,047.00

161Stik glukosa kotak 200,000.00

162Stik kolestrol kotak 185,000.00

163Sypilis RPR Antigent test @ 500 test tes/ kit 2,035,000.00

164Sypilis TP Rapid test @ 30 test tes/ kit 1,100,000.00

165Anti diferi serum vial 953,199.99

166Anti tetanus serum vial 126,500.00

167Vaksin BCG vial 55,506.00

168Vaksin Campak vial 26,895.00

169Vaksin DPT HIB vial 63,930.00

170Vaksin DT vial 17,105.00

171Vaksin HBV vial 19,096.00

172Vaksin Polio vial 18,997.00

173Vaksin TD vial 16,181.00

174Vaksin TT vial 14,201.00

btl 500

gram

form_rko 2016_fornas arjasari ttp

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