06.Parigi Oktober 2016

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  Lampiran Berita Acara Stock Opname per Tgl/Bln/Thn A. Sumber Dana DAK (Obat Pelayanan Kesehatan Dasar Tahun ! #$ %o%ama ObatSatuanPenerimaan Oktober ! #&'olume(umlah )arga'olume(umlah )arga'olume #Alben*a+ol tablet , mgTablet ,!-.   !Alopurinol tablet # mgTablet # &.   $Ambrool tablet $ mgTablet 01.$#   ,Amlo*ipin tablet - mgTablet !, .   -Amoksisilin kapsul/kaplet - mgKapsul !!0.   &Amoksisilin sirup kering #!- mg/-mlBotol !2-##.   3Tablet 3$.#!   0Botol !2 &-.   1Anti4ungi DO5% Kombinasi 6 Asam ben+oat & 7 8 Asam Salisilat $ 7Pot !2 1&.$$   # Asam askorbat (9itamin : tablet # mgTablet -&.   ##Asam ;e4enamat kapsul/kaplet - mgKaplet ##,.0,   #!Asiklo9ir krim - 7Tube !2$&3.   #$Asiklo9ir tablet , mgTablet $, .   #,Besi (<< sul4at ! mg 8 asam 4olat 2!- mg tabletTablet ,&.   #-:etri+ine tablet # mgTablet #00.  #&Deksametason in=eksi i.9. -mg/mlAmpul #20- .    #3Deksametason tablet 2- mgTablet 0#.    #0Dekstrometor4an sirup # mg/-mlBotol #2,&3.,    #1Di4enhi*ramin in=eksi i.m. # mg/mlAmpul #2 ,-.,,    ! Doksisiklin kapsul/kaplet # mg Kapsul !- .    !#Domperi*on tablet # mgTablet #1!.#$    !!5pine4rin (a*renalin in=eksi 2# 7Ampul #2&- .    !$5takri*in larutan 2# 7Botol !2$-,.!!    !,5tanol 3 7 # mlBotol $!2 .    !->itomena*ion ('it.K# in=eksi # mg/mlAmpul #23!$.    !&>itomena*ion (9it.K# tablet salut gula # mgTablet &, .-1    !3>urosemi* tablet , mgTablet 01.&$    )arga Satuan ObatSisa Stock Per $ September ! #&Pengeluaran Oktobe! #&  Antasi*a DO5% < tablet kunyah2kombinasi 6 Aluminium hi*roksi*a ! mg2 ;agnesium hi*roksi*a ! mg Antasi*a DO5% << suspensi2 kombinasi 6 Aluminium hi*roksi*a ! mg2 ;agnesium hi*roksi*a ! mg  %o%ama ObatSatuan'olume(umlah )arga'olume(umlah )arga'olume)arga Satuan Obat !0Sachet $!!.    !1?entamisin salep kulit 2# 7Tube #2,&1.    $ ?entamisin sul4at tetes mata 2$ 7Tube $2#1,.    $#?liseril ?uaiakolat tablet # mgTablet $ .&1    $!?lukosa larutan in4us - 7 sterilBotol -20,,.    $$?riseo4ul9in tablet #!- mgTablet ! ,.    $,)i*rokortison krim !2- 7Tube !2-#1.    $-)yoscine % Butilbromi*e 8 Parasetamol kapletTablet #2!!-.    $&<bupro4en tablet , mgTablet #-!.-    $3<sosorbi* Dinitrat tablet sublingual - mgTablet # #.    $0Ketokona+ol krim ! 7Tube ,2!-$.    $1Kloram4enikol kapsul/kaplet !- mgKapsul !- .    , Kloram4enikol suspensi #!- mg/- mlBotol ,2 #&. -# ! ,20#&. -# ,#Kloram4enikol tetes telinga $ 7Botol #23-1.    ,!Klor4eniramina maleat (:T; tablet , mgTablet !$.    ,$Klorproma+in tablet salut !- mgTablet - .    ,,Tablet #,&.!,    ,-Tablet !2!#!.1,    ,&Li*okain in=eksi ! 7 ():l 8 5pine4rin # 6 0  !mlAmpul #2,0-.    ,3Lisol2 mengan*ung kresol tersabun - 7Botol -&2- .    ,0Loperami* tablet ! mgTablet # .3#   ,1 ;eloksikam tablet 32- mg Tablet !$,.    - ;etampiron in=eksi !- mgAmpul #2- .3,    -#;etampiron tablet - mgTablet #!!.    -! ;et4ormin ):l tablet - mg Tablet # -.    -$;etilergometrin ;aleat in=eksi 2! mg # ml Ampul #2&$1.    -, ;etilpre*nisolon tablet , mg Tablet #10.    --;etroni*a+ol tablet !- mgTablet #!3.&$    -&%atrium *iklo4enak tablet - mgTablet ! &.    -3%atrium klori*a larutan in4us 21 7Botol -2$1 .   -0%istatin tablet salut - . @</gTablet 3 ,.    -1%istatin 9aginal tablet # . @</gTablet ,,0.    & Obat Antituberkulosis >D: Kategori # Paket $1-2 ! .    ?aram Oralit < serbuk2 kombinasi 6 natrium 2-! g2 kalium klori*a 2$ g2 trinatrium sitrat *ihi*rat 2-0 g2 glukosa anhi*rat !23 g Kotrimoksa+ol DO5% < (*easa kombinasi 6 Sul4ametoksa+ol , mg2 Trimetoprim 0 mgKotrimoksa+ol suspensi kombinasi 6 Sul4ametoksa+ol ! mg2 Trimetoprim , mg  %o%ama ObatSatuan'olume(umlah )arga'olume(umlah )arga'olume)arga Satuan Obat &#Obat batuk hitam (OB) cairanBotol #2$$1.0    &!Oksitetrasiklin in=eksi <.m. - mg/ml# ml'ial $2,# . $ # !2$ . $ &$Oksitetrasiklin salep kulit $ 7Tube #2&,&.    &,Oksitosin in=eksi # @</ml# ml Ampul #21&$.-    &- Omepra+ol kapsul/kaplet ! mg Kapsul !&-.    &&Papa9erin tablet , mgTablet #!0. $2$ ,!!2, .  &3Parasetamol sirup #! mg/- mlBotol #2, $.&    &0Pirantel tablet score #!- mgTablet !00.    &1Piroksikam kapsul/kaplet/tablet ! mgKapsul 1!.    3 Po9i*on <o*i*a larutan # 7 $ mlBotol #,23 .    3#Pre*nison tablet - mgTablet -3.    3!Primakuin tablet #- mgTablet #!-.    3$ aniti*in tablet #- mg Tablet ##1.    3,etinol (9itamin A # . @< kapsul lunakKapsul !-,.    3-etinol (9itamin A ! . @< kapsul lunakKapsul ,#!.    3&inger laktat larutan in4usBotol -23! .    33Salbutamol tablet ! mgTablet 3 .    30Salisil be*ak ! 7Ktk #2#0 .    31Se4a*roksil sirup kering #!- mg/- mlBotol -2!,0.    0 Sianokobalamin (9itamin B#! in=eksi - mcg Ampul #2 &3.    0# Sim9astatin tablet # mg Tablet #0 .    0! Sipro4loksasin tablet - mg Tablet !,#.    0$Tetrasiklin kapsul/kaplet !- mgKapsul #,3.    0,Tiamin (9itamin B# # mg tabletTablet 0-.    0- Cinc tablet ! mg Tablet ,1$.-    (umlah 3!12-#&.   A AT K5S5)ATA% / BA)A% )AB<S PAKA<  0&Alat suntik sekali pakai !2- mlPcs #2#,#.0    03Alat suntik sekali pakai - mlPcs #2#,#.0#    00:atgut /Benang Be*ah plain %o.!/ *g =arum be*ah Pcs !12$$$.$$ #$! $203#2111.-& #0 01:atgut /Benang Be*ah :hromic %o.!/ *g =arum be*ahPcs !12$$$.$$ #$! $203#2111.-& #0 1 :atgut/Benang Be*ah plain %o.$/ *g =arum be*ah Pcs !32 ,#.&3 #$! $2-&12- .,, #0 1#:atgut/Benang Be*ah :hromic %o.$/ *g =arum be*ah Pcs !32 ,#.&3 #$! $2-&12- .,, #0 1!Disposible ;askerPcs #2!$3.-    1$>oley :atheter no #0 *an ! masingmasing - pcsPcs 12$, .     %o%ama ObatSatuan'olume(umlah )arga'olume(umlah )arga'olume)arga Satuan Obat 1,?lo9es surgical %o. 0 Pcs ,2&3-.    1-<n4usion set anakSet ,2, . 11 ,$-2& .  1&<n4usion set *easaSet $20- .    13Kapas Pembalut / Absorben !- gramBungkus 02!,,.    10Kasa Kompres #&  #& steril (isi #& lembarKotak 12$& .    11Kasa Pembalut , m  0 cmoll & 23!#. & $&,2$!&.  # Plester - yar*s  ! incholl !-2100.    # #Silk (Benang Be*ah Sutera %o. $/ *engan =arum be*ahPcs 32&0,.3! #, # 32-0&. 0 #, # !5til Klori*a sprayBotol ##-2- .   # $?lass <onomer :ement ATBotol ,$,2-#-.   # ,Kalsium )i*roksi*a PastaTube #$$2# .   # -Klor4enol kam4er ;enthol ( :)K; Botol & 2- .  # &;ummi4ying PastaBotol #1$2& .  # 3Semen Seng >os4at serbuk *an cairanBotol # !20, .  # 0Temporary Stopping >letcher (>letcher serbuk *an cairanBotol $32, .  # 1De9italisasi Pasta %on ArsenBotol ,!12 !.  ##  A:T (Artesunate - mg 8 Amo*iauin anhy*ri*a ! mgTablet #2-#!.-  ###Pot Sputum Pot -2 .  ##!:alcii ?luconas in=eksiAmpul !&2 01.#3  (umlah #-231 2-#!. 0 TOTA #&2-! 2 !0 ;engetahui Kepala Puskesmas #!320,#213 .#3  !#2$1!2-&-.  >itriyani2 SK;%<P. #130 1!$ ! - # ! 3
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