Laporan Pemakaian Obat 2015

7/24/2019 Laporan Pemakaian Obat 2015

1/200

L A P O R A N H A R I A N P E M A K A I A N O B A T

PUSKESMAS TAHUN : 2015

KECAMATAN BULAN : JANUARIPROVINSI

KOTA

NO NAMA OBAT SATUANT A N G G A L

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

1 Alopurinol tablet 100 mg / Mezaluric Tablet 10 6 20 50 50 50 30

2 Amlodipin tablet 5 mg Tablet 10 10 60 30 80 70 50 100 50 50

3 Aminoi llin tablet 200 mg Tablet 10 20 20 20 20 20 20

4 Amo!"ilin !aplet 500 mg #aplet 226 235 214 200 300 290 300 250 180 300 479 350 230 2

5 Amo!"ilin "irup !ering 125 mg/ 5 ml $ 60 ml %otol 9 4 5 3 4 1 2 2 6 2

6 Anta"ida &'() * tablet !un+a,- !ombina"i . Aluminium idro Tablet 90 50 25 120 70 81 46 90 80 83 126 90

7 Anta"ida &'() ** "u"pen"i- !ombina"i . Aluminium idro!"ida %otol 5 6 5 5 8 5 5

8 Anti %a!teri &'() "alep !ombina"i . %a"itra"in 500 */g ol Tube 2 1 2

9 Antibioti! Topi!al ell+ )eom+cin ulate 0-5 lacenta (! Tube

10 Antidiare tablet #aolin 550 mg ectin 20 mg / )eo &iao Tablet 20 6 5 100 26 60 7 30 6 52

11 Antidiare "u"pen"i #aolin 700 mg ectin 66 mg $ 60 ml / # %otol

12 Antiungi &'() !ombina"i A" %enzoat 6 A" ali"ilat 3 $ ot

13 Anti emmoroid &'() !ombina"i . %i"mut "ubgalat 150 mg upp

14 Anti emmoroid #ap"ul . (!"tra! raptop,+lli :olium 80 ; #ap"ul

15 Antiine!"i Topi!al dengan #orti!o"teroid !rim #lorameni!ol b Tube 3 4 3 3 6 3

16 Antimigren . (rgotamin Tartrat 1 mg #oein 50 mg Tablet

17 Aitamin ; tablet 50 mg Tablet 125 72 150 89 190 99 87 67 120 102 181 160 120 1

20 A"am Meenamat !aplet 500 mg #aplet 60 120 140 58 140 80 106 85 85 100 106 130 120 2

21 A"i!lo?ir !rim 5 $ 5 gr Tube 2 2 5 2

22 A"i!lo?ir tablet 400 mg Tablet 5 41 21

23 A"pimec / Aceto"al 80 mg Tablet

24 Atropin in=e!"i im/i?/"! 0-25 mg/ml "ulat $ 1 ml Ampul

25 %e"i ** ulat 200 mg A"am :olat 0-25 mg tablet tamba, da Tablet 180 30 100 60 90 120 100 230 60 80 120 130 50

26 %eta,i"tin Me"ilat tablet 6 mg / )o?ert+ Tablet 10 6

27 %etameta"on #rim 01 "ebagai ?alerat $ 5 gr / Mola"on Tube 1 10 1 1 2


2/200

28 %i"oprolol tablet 5 mg Tablet

29 %ora@ l+"erin 'M 10 $ 8 ml %otol 5 4 4 2 6

30 %rom,e!"in tablet 8 mg / %romiar Tablet 140 90 88 80 40 80 60 90 60 60 50 40 62

31 %rom,e!"in larutan 2mg/ml untu! )ebulizer $ 50 ml / %i"ol?o %otol

32 ;ei@im 100 mg

33 &e!"ameta"on tablet 0-5 mg / Molacort Tablet 40 60 40 45 80 20 65 60 20 79 60 20 60

34 &e!trometoran "irup 10mg/5 ml %r $ 60 ml %otol

35 &e!"trometoran tablet 15 mg %r Tablet

36 &ien,idramin in=e!"i 10 mg/ml / (tadr+l Ampul

37 &igo!"in tablet 0-25 mg Tablet

38 &o!"i"i!lin !ap"ul 100 mg / &o@i,at #ap"ul39 &onperidon 10 mg 50 50 40 13 20

40 (edrin tablet 25 mg ;l Tablet

41 (pinerin Adrenalin in=e!"i 0-1 "ebagai ;l $ 1 ml Ampul

42 (ritromi"in !ap"ul 500 mg #ap"ul 10 15 10 5 20

43 (ritromi"in "irup 200 mg 5 /ml $ 60 ml %otol

44 (ta!ridin i?anol Barutan 0-1 $ 300 ml %otol 2 1 2 1

45 :enol li"erol tete" telinga 10 $ 5 ml %otol

46 :itomenadion>it #1 tablet "alut gula 10 mg Tablet 24 10 10 10

47 :uro"emid tablet 40 mg Tablet

48 aram 'ralit * "erbu!- !ombina"i . )atrium 0-52 g- #alium !lori ac, 20 15 26 67 2 17 13 32 21 18

49 emibrozil 300 mg !ap"ul #ap"ul

50 entam+cin "alep !ulit 0-1 $ 5 gr / entale@ Tube 5 6 8 9 5 2 6 7

51 liben!lamid tablet 5 mg Tablet 20 29 20 20 7

52 li"eril uaia!olat tablet 100 mg Tablet 153 82 90 120 120 82 123 81 165 91 40 30 140

53 luco"e Barutan *nu" 5 "teril $ 500 ml %otol

54 ri"eoul?in tablet 125 mg / ricin Tablet

55 idro!lortiazid ;T tablet 25 mg Tablet 5 15 20 33 5 15 10 13 10

56 idro!orti"on !rim 2-5 $ 5 gr / Be@acorton Tube 2 1 4 3 4 4 4

57 +o"cine $ ) $ %utilbromide tablet 10 mg / copma Tablet

58 *buproen tablet 400 mg Tablet 5 15 60 50 5 20 4 80

59 *c,t+ol "alep !ulit $ 15 gr ot 1 1

60 *"o"orbid dinitrat *&) tablet "ublingual 5 mg Tablet

61 #alium permanganat # "erbu! $ 5 gr ot

62 #al"ium la!tat #al! tablet 500 mg Tablet 80 120 100 85 60 10 30 53 10 60 30

63 #aptopril tablet 25 mg Tablet 45 70 40 30 30 40 60 40 15 30 20 40 20


3/200

64 #lindami"in !ap"ul 300 mg #ap"ul 32 30

65 #lorameni!ol !ap"ul 250 mg #ap"ul

66 #lorameni!ol "alep mata 1 $ 5 gr Tube

67 #lorameni!ol "u"pen"i 125 mg/5ml $ 60 ml %otol

68 #lorameni!ol tete" mata 0-5 $ 5 ml / (rlam+cetin %otol

69 #lorameni!ol tete" telinga 3 $ 5 ml %otol

70 #loreniramin maleat ;TM tablet 4 mg Tablet 265 520 191 210 240 250 300 320 230 320 120 302 540

71 #otimo!"azol &'() * deCa"a !ombina"i . ulameto!"azol Tablet 10 42 12 11 22

72 #otimo!"azol &'() ** pedriati! !ombina"i . ulameto!"azo Tablet

73 #otimo!"azol u"pen"i !ombina"i . ulameto!"azol 200 mg %otol

74 Be?ertraan "alep $ 15 gr ot75 Bido!ain in=e!"i 2 $ 2 ml Ampul

76 Bido!ain comp in=e!"i Bidocain 2 ;l (pinerin 1 . 8000 Ampul

77 Bin!omi"in !ap"ul 500 mg #ap"ul

78 Boperamid tablet 2 mg Tablet

79 Boratadin tablet 10 mg Tablet

80 Mebendazol tablet 100 mg Tablet

81 Metampiron Antalgin tablet 500 mg Tablet50 50 4

82 Metormin ;l tablet 500 mg Tablet

83 Metilergometrin Maleat Metilergometrin tablet "alut 0-125 mg Tablet

84 Metronidazol tablet 500 mg Tablet

85 Mi!onazol !rim/ "alep 2 )itrat $ 10 gr / Moladerm Tube 2 3 5 4 5 6

86 Multi?it irup $ 60 ml / B+be@ %otol 13 14 9 36 5 5 11 2 11 3 8

87 Multi?it Tablet / e,a?ral Tablet 20 97 33 100 40 80 82 34 6 120 15 11 49

88 )atrium %i!arbonat tablet 500 mg Tablet

89 )atrium &i!loena! tablet 50 mg / #emoren Tablet 80 60 60 50 80 40 80 6 39

90 )atrium #lorida larutan inu" 0-9 $ 500 ml %otol

91 )atrium #lorida larutan 0-9 $ 25 ml untu! )ebulizer %otol

92 )iedipin tablet 10 mg Tablet

93 )i"tatin tablet "alut 500000 */g Tablet 3

94 )i"tatin ?aginal tablet 100000 */g Tablet 5 3 7 10

95 'bat batu! itam '% ;airan $100 ml non Al!o,ol %otol 11 26 10 5 5 27 29 17 2 10 5

96 'bat encernaan tablet &ia"ta"e 200 mg- an!reatin 100 mg Tablet

97 '!"itetra"i!lin ;l "alep !ulit 3 $ 5 gr Tube

98 '!"itetra"i!lin ;l "alep mata 1 $ 5 gr Tube

99 'meprazol !ap"ul 20 mg #ap"ul


4/200

100 apa?erin tablet 40 mg Tablet

101 ara"etamol &rop 100 mg Tablet 50 4 8 6 50 4 20 4 4 8 2

102 ara"etamol "irup 120 mg / 5ml $ 60 ml %otol 16 11 16 4 6 5 4 2 6 5 5 21 2

103 ara"etamol tablet 100 mg Tablet

104 ara"etamol tablet 500 mg Tablet 441 520 318 80 450 100 827 100 200 178 877 726 350

105 irido!"in >itamin %6 tablet 10 mg ;l Tablet 128 102 121 140 265 130 373 170 230 140 133 184 100

106 iro!"i!am tablet 10 mg Tablet 52 22 50 90 60 60 90 6 50 90 60 60 5

107 oli!re"ulen !onden"a"i $ 10 ml / Albot,+l %otol

108 o?idon *odida larutan 10 $ 300 ml %otol

109 redni"on tablet 5 mg Tablet 55 150 65 50 90 60 60 85 80 145 86 60 60

110 ropanolol tablet 10 mg ;l Tablet111 ropiltioura"il tablet 100 mg

112 anitidin tablet 150 mg Tablet 74 6 80 20 6 10 6 10 6 6

113 inger Ba!tat larutan inu" $ 500 ml %otol

114 albutamol tablet 2 mg "ebagai "ulat Tablet 2 12 9 10 12 5 2 8 5

115 albutamol 25 mg/ ml untu! )ebulizer / >entolin %otol

116 alep 2$4 !ombina"i . A"am ali"ilat 2 %elerang endap 4 ot

117 ali"il %eda! 2 $ 50 gr #ota! 3 2 2 6 5 7 8 6 7 2

118 eadro!"il #ap"ul 500 mg #ap"ul 80 80 100 50 50 80 120 29 80 26 10

119 iano!obalamin ?itamin %12 tablet 50 mcg Tablet 30 10 120 80 90 20 50 50 10 100 60 135 80

120 im?a"tatin tablet 10 mg Tablet 25 40 20 100 15 10 30 100 10 15

121 iprolo!"a"in tablet 500 mg "ebagai ;l Tablet 40 20 15 60 54

122 ula"etamida )atrium tete" mata 15 $ 5 ml %otol

123 Tetra"i!lin !ap"ul 500 mg #ap"ul

124 T,iameni!ol !ap"ul 500 mg #ap"ul

125 Tiamin >itamin %1 tablet 50 mg ;l/ )itrat Tablet 210 102 72 90 120 136 164 60 50 60 150 164 94

126 >itamin % #omple!" tablet Tablet 50 60 50 60 150 164 94 60 50 60 23 22 94

127 Dinc tablet 20 mg Tablet 20 35 40 30 50 20 20

128 Meto!lopramid tablet 10 mg Tablet

OBAT GIGI

1 (til c,lorid "pra+ 100 ml 1 1

2 (ugenol cairan 1

ZAT TAMBAHAN

eagen Deinel"en 1


5/200

PERBEKALAN KESEHATAN

1 Alat "unti! "e!al i pa!ai 3 ml 100 100 100

2 (tanol 70

3 !apa" embalut /ab"orben 250 gram

4 #a""a idroil teril u!- 16 @ 16

5 #a""a pembalut ,idroil 4m @ 10 cm

6 Ma"!er

7 1

8 arung Tangan 1 1 1

OBAT PSIKOTROPIKA

1 Alprazolam tablet 1 mg Tablet 2 52 Amitriptilin tablet "alut 25 mg ;l Tablet

3 ;lobazam tablet 10 mg Tablet

4 &iazepam tablet 2 mg Tablet

5 &iazepam tablet 5 mg Tablet 10 3

6 &iazepan in=e!"i 5 mg /ml $ 2 ml Ampul

7 &iazepam tube ectal 5 mg/25 ml / te"olid Tube rectal

8 :enobarbital tablet 30 mg Tablet

9 :luo@etin tablet 10 mg / Antipre"tin Tablet

10 aloperidol tablet 1-5 mg Tablet

11 aloperidol tablet 5 mg Tablet 15 60 60 60

12 *mipramin tablet 25 mg / Toranil Tablet

13 #arbamazepin tablet 200 mg Tablet

14 #lorpromazin tablet "alut 100 mg ;l Tablet

15 #odein tablet 10 mg Tablet

16 i"peridon tablet 2 mg Tablet

17 ertralin tablet / )udep Tablet

18 Tri,e!"ienidil tablet 2 mg Tablet

EMBALAGE

1 #antong #re"e! obat ceta!an- u!uran 15 @ 30 Bembar 100 100 60 100 150 100 50 150 100 50 100 100 150

2 la"ti! 'bat dg !lip ceta!an- u!uran 7 @ 10 cm a! /100lbr4 1 4 3 2 4 4 8

3 la"ti! 'bat dg !lip ceta!an- u!uran 10 @ 15 cm a! /100lbr

4 #erta" er!amen u!uran 8 @ 11 a! /1000lbr 1 1 1

5 endo! obat c" 20 10 10 20 20 10 20 20 20 10 20 10

le"ter non alergi 0-5 inc, / Micropor


6/200

Mengeta,ui- enanggu

#epala u"!e"ma"

drg *radani Eupitaningrum M!e" upri,

)* 196501011994032002 )* 197601


7/200

TOTAL22 23 24 25 26 27 28 29 30 31

6 50 10 10 10 10 60 60 70 531

22 50 80 30 80 80 30 1-020

36 183

250 248 121 205 299 120 334 267 298 6-606

4 4 3 7 3 14 3 4 89

10 65 120 100 120 100 130 90 140 2-006

3 45

2 2 2 3

$

60 50 4 32 4 6 10 502

$

$

$

$

1 2 2 2 32

$

$

$

104 191 160 200 120 200 169 93 60 3-319

71 77 130 140 110 140 60 60 84 2-672

1 12

82

$

$

60 320 90 500 230 188 80 391 140 3-869

16

3 1 3 3 5 2 36


8/200

$

2 5 3 3 40

85 30 60 57 30 57 78 30 21 1-470

$$

50 60 30 80 50 40 30 50 50 1-209

$

$

$

$

$

28 30 10 281

$

$

60

$

2 1 1 15

$

3 2 10 2 81

4 14

50 5 18 3 319

$

8 5 8 6 8 88

10 10 25 35 10 35 20 20 2 342

80 115 90 100 96 100 50 115 60 2-340

$

$

13 5 5 10 8 8 195

2 1 1 1 1 3 3 39

$

2 10 16 327

1 1 1 5

$

$

30 50 120 80 10 60 100 1-260

20 31 101 55 20 55 30 20 20 1-043


9/200

62

$

$

$$

$

419 305 204 375 250 475 129 254 389 7-177

34 10 10 30 198

$

$

$

$

$

$

$

$

30 154

$

$

$

7 32

2 11 2 2 13 13 7 9 11 231

32 32 46 17 20 17 14 14 47 1-067

$

25 23 20 23 636

$

$

$

5 21

3 38

17 5 5 5 21 5 17 14 19 285

$

1 5 2 2 12

$

$


10/200

$

5 23 8 20 5 10 254

2 21 8 12 7 12 2 8 11 208

$

642 589 737 400 799 881 835 575 923 12-715

200 250 80 120 100 120 182 131 242 4-256

90 60 60 10 50 30 6 40 10 1-111

$

$

20 20 90 100 105 100 59 66 50 1-906

$

$

20 14 28 16 17 30 20 439

$

6 3 5 12 5 11 110

$

$

3 4 4 1 6 66

30 46 30 30 10 30 20 40 977

50 50 63 80 125 80 152 20 126 1-764

10 10 10 10 10 35 605

10 10 20 42 20 12 24 12 435

$

$

$

220 170 132 132 198 132 60 88 132 3-164

30 35 60 60 50 60 150 164 94 1-930

20 60 10 70 20 70 30 30 535

$

$

$

2

1

$

1

$


11/200

$

100 400

$

$$

$

$

1

3

$

5 5 17

4 14

$

$

11 2 2 30

$

1 1

$

$

$

50 20 20 6 20 350

$

$

$

$

$

$

$

$

$

150 30 100 50 80 50 50 100 80 2-500

1 1 1 1 2 40

$

1 1 5

20 10 10 50 10 50 10 20 400


12/200

$

$


13/200

LAPORAN HARIAN PEMAKAIAN OBAT

PUSKESMAS : CILE!UG TAHUN : 2015

KECAMATAN : CILE!UG BULAN : "EBRUARI

)' )AMA '%AT ATA)

1 2 # $ 5 % & ' ( 10 11 12 1# 1$ 15

1 Tablet 102 10 10 20 10 110

2 Albot,+l con %otol3 Alletrol tete" mata %otol

4 Amlodipin tablet 5 mg Tablet 70 30 40 10 10

5 Aminoillin tablet 200 mg Tablet 11 6 10 10 29

6 Amo!"ilin !aplet 500 mg #aplet 333 301 340 213 203 181 217 171 243 332 210 205

7 Amo!"ilin "irup !ering 125 mg/ 5 ml $ 60 ml %otol 5 4 10 16 11 3 2 3 3 1 8

8 Tablet 196 90 FFF 40 90 40 70 10 80 50 100 80

9 %otol 2 8 3 1 2 1 1

10 Tube 1 1 1

11 Tube

12 Tablet 10 64 68 56 10 28 15 100 25

13 %otol

14 ot

15 upp 4

16 #ap"ul

17 Tube 1 3 1 1 FFF 3 1

18 Tablet

19 >ial

20 A"am A"!orbat >itamin ; tablet 50 mg Tablet 88 99 622 124 200 30 120 108 257 336 138 67

21 A"am Meenamat !aplet 500 mg #aplet 90 60 70 160 190 120 30 140 210 70 100

22 A"i!lo?ir !rim 5 $ 5 gr Tube 1 2 1 2 1 3

23 A"i!lo?ir tablet 400 mg Tablet 20 FFF 40 20 31


25 Tablet 60 30 300 600 420 330 240 30

Alopurinol tablet 100 mg / Mr)*+,ric

Anta"ida &'() * tablet !un+a,- !ombina"i . Aluminium idro!"ida200 mg Magne"ium idro!"ida 200 mg

Anta"ida &'() ** "u"pen"i- !ombina"i . Aluminium idro!"ida 200

mg /5 ml Magne"ium idro!"ida 200 mg /5 ml $ 60 mlAnti %a!teri &'() "alep !ombina"i . %a"itra"in 500 */g olimi!"in 10000 */g

Antibioti! Topi!al ell+ )eom+cin ulate 0-5 lacenta (!"tra!10 $ 15 gr / Biop+*c-.o-

Antidiare tablet #aolin 550 mg ectin 20 mg / No !i*/or

Antidiare "u"pen"i #aolin 700 mg ectin 66 mg $ 60 ml /K*o+ic

Antiungi &'() !ombina"i A" %enzoat 6 A" ali"ilat 3 $ 30gr / i./i+3

Anti emmoroid &'() !ombina"i . %i"mut "ubgalat 150 mg e!"a!loroen 2-5 mg

Anti emmoroid #ap"ul . (!"tra! raptop,+lli :olium 80 ;itru"%iola?onoid 20 / H*oro4*r3

Antiine!"i Topi!al dengan #orti!o"teroid !rim #lorameni!ol ba"e20 mg redni"olon 2-5 mg $ 10 gr / K+or/o-



%e"i ** ulat 200 mg A"am :olat 0-25 mg tablet tamba, dara,!ombina"i


14/200

26 Tablet 10 FFF 10

27 Tube 3 1 2 2 4

28 %ioplacenton


30 %ora@ l+"erin 'M 10 $ 8 ml %otol 1 FFF 1 1 2 1

31 %rom,e!"in tablet 8 mg / %romiar Tablet 189 158 58 36 49 20 30 115 88 83 54

32-

33 ;ei@im 100 mg

34 Tablet 37 101 59 69 50 22 13 63 61 41 45



37 Ampul


39 &omperidon tablet 10 mg Tablet 10 20 2 70 8 3

40 #ap"ul



43 (ritromi"in !ap"ul 500 mg #ap"ul


45 (ta!ridin i?anol Barutan 0-1 $ 300 ml %otol 3 1



48 :uro"emid tablet 40 mg Tablet 5

49 ac, 10 29 20 8 30 28 15 10 33 8 14


51 Tube 3 FFF 1 1 FFF 1 8 1 FFF

52 liben!lamid tablet 5 mg Tablet 120 30 7 20

53 li"eril uaia!olat tablet 100 mg Tablet 171 356 20 134 115 148 114 100 121 150 139 121



56 idro!lortiazid ;T tablet 25 mg Tablet 20 10 25 20 10 40

57 Tube 3 3 2 6 2 1 3 1 2 11 2

58 Tablet

%eta,i"tin Me"ilat tablet 6 mg / No6r.7

%etameta"on #rim 01 "ebagai ?alerat $ 5 gr / Mo+*o-

%rom,e!"in larutan 2mg/ml untu! )ebulizer $ 50 ml / Bio+6o-

&e!"ameta"on tablet 0-5 mg / Mo+*cor.

&ien,idramin in=e!"i 10 mg/ml / E.*3r7+

&o!"i"i!lin !ap"ul 100 mg / !o8i*.

aram 'ralit * "erbu!- !ombina"i . )atrium 0-52 g- #alium !lorida0-30 g - Trinatrium "itrat di,idrat 0-58 g- lu!o"a an,idrat 2-7 g

entam+cin "alep !ulit 0-1 $ 5 gr / G-.*+8

idro!orti"on !rim 2-5 $ 5 gr / L8*cor.o-

+o"cine $ ) $ %utilbromide tablet 10 mg / Scop*


15/200

59 *buproen tablet 400 mg Tablet 5 10 10 15 10 4

60 *c,t+ol "alep !ulit $ 15 gr ot


62

#alium permanganat # "erbu! $ 5 grot

63 #al"ium la!tat #al! tablet 500 mg Tablet 100 10 170 20 190 120 10

64 #eto!onazole

65 #aptopril tablet 25 mg Tablet 180 35 40 160 70 10 40 70 97 30

66 #lindami"in !ap"ul 300 mg #ap"ul 10 20 10 13 30


68 #lorameni!ol "alep mata 1 $ 5 gr Tube 4 1


70 %otol 2

71 #lorameni!ol tete" telinga 3 $ 5 ml %otol 1

72 #loreniramin maleat ;TM tablet 4 mg Tablet 450 381 695 350 290 355 270 242 370 584 296 281

73 Tablet

74 Tablet

75 %otol 4 5 4 2 2 6 14 7 5 43

76 Be?ertraan "alep $ 15 gr ot

77 Bido!ain in=e!"i 2 $ 2 ml Ampul

78 Ampul





83 Metampiron Antalgin tablet 500 mg Tablet 20 FFF 30 20

84 Metormin ;l tablet 500 mg Tablet 80 10 30


86 Metronidazol tablet 500 mg Tablet 46 30 48 56

87 Tube 2 1 2 2 25 1 2 1

88 %otol 13 7 17 2 6 5 14 20 26 10 FFF

89 Tablet 29 99 46 43 5 10 18 75 92 20 20 30

#lorameni!ol tete" mata 0-5 $ 5 ml / Er+*7c.i-

#otimo!"azol &'() * deCa"a !ombina"i . ulameto!"azol 400mg Trimetoprim 80 mg

#otimo!"azol &'() ** pedriati! !ombina"i . ulameto!"azol 100mg Trimetoprim 20 mg

#otimo!"azol u"pen"i !ombina"i . ulameto!"azol 200 mg Trimetoprim 40 mg/ 5 ml $ 60 ml

Bido!ain comp in=e!"i Bidocain 2 ;l (pinerin 1 . 80000 $ 2ml

Mi!onazol !rim/ "alep 2 )itrat $ 10 gr / Mo+*3r

Multi?it irup $ 60 ml / L798

Multi?it Tablet / P*6r*+


16/200


91 Tablet 30 6 12 10 30 36 10 68 26 10 50




95 )i"tatin tablet "alut 500000 */g Tablet

96 )i"tatin ?aginal tablet 100000 */g Tablet 5 13 3

97 'bat batu! itam '% ;airan $100 ml non Al!o,ol %otol39 12 1 13 20 15 10 21 15 27 17 12

98 Tablet

99 '!"itetra"i!lin ;l "alep !ulit 3 $ 5 gr Tube



102 apa?erin tablet 40 mg Tablet

103 aracetamol drop %otol 6 7 9 8 2 8 4 19 7 19 1

104 ara"etamol "irup 120 mg / 5ml $ 60 ml %otol 14 17 16 11 15 3 13 15 18 22 10


106 ara"etamol tablet 500 mg Tablet 781 631 440 505 325 937 397 554 536 487 427

107 irido!"in >itamin %6 tablet 10 mg ;l Tablet 166 166 176 132 104 192 214 185 129 201

108 iro!"i!am tablet 10 mg Tablet 164 22 16 22 12 10 FFF 122 22 100

109 %otol


111 redni"on tablet 5 mg Tablet 40 30 100 16 30 50 41 266 40 125

112 ropanolol tablet 10 mg ;l Tablet

113 ropiltioura"il tablet 100 mg Tablet

114 anitidin tablet 150 mg Tablet 52 24 8 10 12 27 2 12 FFF


116 albutamol tablet 2 mg "ebagai "ulat Tablet 5 2 16 7 3 13 65 5

117 %otol

118 ot 12 1

119 ali"il %eda! 2 $ 50 gr #ota! 5 5 4 5 6 1 3 1 5 1 4

120 eadro!"il #ap"ul 500 mg #ap"ul 60 60 30 30 50 10 39 70 85 55 20

121 iano!obalamin ?itamin %12 tablet 50 mcg Tablet 190 126 118 94 52 125 56 113 194 112 100

)atrium &i!loena! tablet 50 mg / Kor-

'bat encernaan tablet &ia"ta"e 200 mg- an!reatin 100 mg /Li9ro)7

oli!re"ulen !onden"a"i $ 10 ml / A+9o.7+

albutamol 25 mg/ ml untu! )ebulizer / V-.o+i-

alep 2$4 !ombina"i . A"am ali"ilat 2 %elerang endap 4 $30 gr


17/200

122 im?a"tatin tablet 10 mg Tablet 45 25 40 10 20 40 10 25 10 FFF

123 iprolo!"a"in tablet 500 mg "ebagai ;l Tablet 30 12 6 22 10 FFF 22 FFF




127 Tiamin >itamin %1 tablet 50 mg ;l/ )itrat Tablet 246 112 120 104 96 115 50 93 190 112 182

128 >itamin % #omple!" tablet Tablet 133 42 120 101 29 50 60 23 41 56 24

129 Dinc tablet 20 mg Tablet 10 40 30 10 40 35 20 120 35 20 FFF

OBAT KEJIAAN

1 Alprazolam tablet 1 mg Tablet

2 Amitriptilin tablet "alut 25 mg ;l Tablet 5 3



5 &iazepam tablet 5 mg Tablet 2 2


7 Tube rectal


9 Tablet 5 10


11 aloperidol tablet 5 mg Tablet 30 20

12 Tablet





17 Tablet

18 tezolid tub


OBAT GIGI

1 Arti!ulating aper %u!u

2 %ur ig, peed #ota!

3 %ur BoC peed #ota!

4 ;a?it / &entorit ot

5 ;elluloid "trip et

&iazepam tube ectal 5 mg/25 ml / S.o+i3

:luo@etin tablet 10 mg / A-.ipr.i-

*mipramin tablet 25 mg / To/r*-i+

ertralin tablet / N,3p


18/200

6 ;re"open $ 13 ml %otol

7 &entin ;onditioner %otol

8 &e?itali"a"i a"ta )on Ar"en %tl / !t!

9 &i"clo"ing Agent Tube

10 &i"po"ible "ali?a e=e!tor %ung!u" G 100 pc"

11 (til ;,lorida "pra+ $ 100 ml %otol 2

12 (ugenol cairan %otol

13 et

14 et

15 et

16 Macro gold prop+len (&TA et

17 'il pra+ %otol

18 Ampul

100

19 ulper+l %otol

20 pon elatin ;ubicel" / pongo"tan/ aemo"pon c"

21 Temporar+ topping :letc,er :letc,er "erbu! dan cairan et

22 Tetric ) ;eram a!et

23 Tetric ) ;eram eill A2- A3- A3-5 $ 3-5 gr Tube

24 Tetric %onding $ 6 gr %otol

25 Tetric (tc, eill $ 2 gr Tube

26 Ampul

27 H+le"te"in )on Adrenalin in=e!"i Ampul


1 Alat unti! "e!ali pa!ai 0-05 ml c"


3 Alat unti! "e!ali pa!ai 1 ml c"

4 Alat unti! "e!ali pa!ai 3 ml c" 100


6 %lood "et et

7 %enang %eda, ;atgut )o 2/0 $ 3/0 dengan =arum beda, ac,

8 %enang %eda, il! )o 2/0 $ 3/0 dengan =arum beda, ac,

9 %enang %eda, ;atgut ;,romic 2/0 $100 m ;a""ete

la"" *onomer adiopa! / ",i VII

la"" *onomer ;ement AT / ",i I; < K.*c Mo+*r

#al"ium idro!"ida pa"ta / C*+ci3or < !7c*+

'bat Ane"te"i Bo!al *n=e!"i Bido!ain ;l 20 ml Adrenalin 125mcg / P*c*i-

H+le"te"in Adrenalin in=e!"i / Sc*-3o-.


19/200

10 %enang %eda, ;atgut lain 3/0 $100 m ;a""ete

11 %enang %eda, il! %lac! 3/0 $100 m ;a""ete

12 &ental :ilm an",in c"

13 (tanol 70 $ 1 B %otol

14 el / (# %otol

15 *nu"ion et Ana! c"

16 *nu"ion et &eCa"a c"

17 *> ;at,eter )o18 et


19 arum a,it %eda, )o 9 "/d 14 #ulit $ T ac,

20 arum a,it %eda, )o 9 "/d 14 'tot $ ac,

21 #apa" embalut / ab"orben 250 gram %ung!u"

22 #a""a idroil teril u! 16 @ 16 #ota!

23 #a""a idroil u! 36 m @ 40 cm / 40 +ard @ 80 cm oll

24 #a""a pembalut ,idroil 4m @ 10 cm oll

25 #erta" (# oll

26 #erta" on+ 110 oll

27 Barutan ;lorin 5-25 $ 1 B &e"ine!tan Alat %otol

28 Barutan &e"inectan $ 1 B &e"ine!tan uangan %otol

29 Bembar

30 Ma"!er #ota! 2 1

31 Ma"!er '2 c"

32 Ma"!er nebulizer "et deCa"a c"

33 Ma"!er nebulizer "et ana! c"

34 '!"igen dalam tabung Tabung

35 le"ter 5 +ard H 2 inc, oll

36 oll 1

37 ot rin c"

38 arung Tangan #ota! 2

39 aet+ %o@ c"

40 urgical blade no11 i"au %eda, c"

EMBALAGE

1 #antong #re"e! obat ceta!an- u!uran 15 @ 30 Bembar 100 60 100 150 100 180 100 150 100 100 100

2 la"ti! 'bat dg !lip ceta!an- u!uran 7 @ 10 cm a! /100lbr 3 1 2 1 1 3 2 1 1


#a""a "teril mengandung obat :ram+cetin / Lo*.,++



20/200

4 #erta" er!amen u!uran 8 @ 11 a! /1000lbr 1 1

5 endo! obat c" 20 20 20 10 20 10 20 20 20 10 20 10

Mengeta,ui-

#epala u"!e"ma"

( drg. Iradani Yupitaningrum, M.Kes )

I!. 196501041994032002


21/200

"#"$%18 19 20 21 22 23 24 25 26 27 28 29 30 31

10 5 20 341

&

&

80 80 42 40 20 80 50 62 10 704

12 9 12 10 20 2 10 180164 352 172 482 423 270 273 236 218 6,043

2 2 3 5 7 2 8 2 7 109

40 15 45 110 20 100 100 10 1,392

2 6 2 2 3 8 1 44

2 5

&

30 122 22 58 20 28 122 50 20 976

&

&10

30 40 88

1 1 1 1 3 22

&

&

90 224 94 200 152 103 84 152 32 3,651

100 75 80 210 110 125 110 90 140 2,520

2 1 1 17

15 10 15 171

&

30 330 300 100 300 10 3,140


22/200

FFF 10 60

2 2 1 2 4 1 4 3 34

&

&

1 3 7 2 9 1 3368 168 88 128 133 107 93 178 31 2,126

&

&

25 39 33 83 67 61 53 84 53 1,174

&

&

&

&

2 7 3 3 10 10 164

&

&

&

&

&

1 1 1 2 1 1 2 15

&

10 23 69FFF 5 3 2 25

20 26 15 41 7 13 17 57 12 432

12 12

1 8 5 10 4 1 2 57

20 35 40 20 111 413

103 155 130 150 144 119 226 122 89 3,150

&

&10 10 15 10 195

FFF 6 1 1 1 1 14 3 65

&


23/200

10 15 2 5 5 101

1 2

&

&

120 220 10 70 1,050

10 1085 70 15 10 20 10 65 1,026

83

&

1 1 1 7 2 3 20

&

1 4 2 1 11

1 2 1 1 2 2 2 1 14

315 493 448 565 347 350 399 330 259 8,862

12 42 54

&

6 15 2 15 3 6 8 30 2 193

&

&

&

&

&

&

&

10 20 10 150

10 30 95 50 10 405

&

24 12 22 36 110 440

1 2 1 2 45

18 18 26 21 30 20 17 23 5 348

47 26 20 95 110 63 15 73 29 1,049


24/200

&

10 40 20 56 12 6 66 38 20 628

&

&

&20 3 3 26

3 3 10 14 3 54

24 29 19 3 13 19 21 16 16 405

6 12 1 18 10 17 64

1 6 10

&

&

6 4 10

7 7 4 12 1 6 13 5 2 155

12 28 9 11 14 13 13 19 8 317

&

450 767 355 746 725 623 547 640 306 12,313

223 279 89 247 265 202 207 221 46 3,797

30 20 37 50 10 32 26 6 867

&

&70 75 50 85 85 8 165 145 70 1,771

&

&

14 47 57 42 35 20 36 114 586

&

8 11 14 3 3 11 2 20 9 227

&

2 2 1 6 24

8 6 2 5 3 3 1 29 103

45 75 80 106 45 30 55 1,070

96 201 148 142 122 118 202 385 16 2,966


25/200

20 10 10 60 69 454

12 10 20 10 18 20 248

&

&

&

126 221 138 142 112 158 200 394 96 3,345

72 102 23 91 152 21 105 352 51 1,768

30 70 20 75 41 20 30 49 20 755

&

&

7 3 2 2 16

3 10 26

&

&

2 2 1 1 2 1 3 16

&

&

&

5 20

&

FFF 110

&

&

2 1 3

&&

&

&

&

&

&

&

&

&&

&


26/200

&

&

&

&

&

2

&

&

&

&

&

&

100

&

&

&

&

&

&

&

&

&

&

&

&

&

&

100

&

&

&

&

&


27/200

&

&

&

&

&

&

&&

&

&

&

&

&

&

&

&

&&

&

&

3

&

&

&

&

&

1

&

2

&

&

&

&

100 100 150 100 60 100 150 100 50 2,600

1 2 1 3 6 1 1 1 37

1 1


28/200

1 2 6

20 20 20 20 20 20 10 20 10 400

&

enanggung aCab 'bat

upri,artiCi- AM:

)* 197601172009 02 2004


29/200



KECAMATAN : CILE!UG BULAN : MARET

)' )AMA '%AT ATA)

1 2 # $ 5 % & ' ( 10 11 12 1# 1$ 15

1 Tablet 10 100 10 20 40 10 90 20 100

2 Albot,+l con %otol

3 Alletrol tete" mata %otol

4 Amlodipin tablet 5 mg Tablet 30 120 30 60 70 84 80 10 30 70

5 Aminoillin tablet 200 mg Tablet 10 10 5 30 12 6 20 40

6 Amo!"ilin !aplet 500 mg #aplet 393 321 500 259 209 251 342 230 181 167 158 254

7 Amo!"ilin "irup !ering 125 mg/ 5 ml $ 60 ml %otol 5 3 6 2 3 4 7 5 3 4 4 6

8 Tablet 110 120 20 80 40 200 132 155 50 50 20 30

9 %otol 3 2 FFF 1 1 2 3

10 Tube 2 4 1 1

11 Tube

12 Tablet 33 58 10 10 10 111 26 80

13 %otol

14 ot

15 upp 8 2 6

16 #ap"ul 2

17 Tube 2 FFF 4 2 FFF

18 Tablet

19 >ial

20 A"am A"!orbat >itamin ; tablet 50 mg Tablet 146 178 267 321 230 121 135 FFF 164 94 366 131

21 A"am Meenamat !aplet 500 mg #aplet 140 110 80 70 70 50 150 90 90 106 80 40

22 A"i!lo?ir !rim 5 $ 5 gr Tube 2

23 A"i!lo?ir tablet 400 mg Tablet 14 31


25 Tablet 30 130 30 500 560 30 460 420 30 150


Anta"ida &'() * tablet !un+a,- !ombina"i . Aluminium idro!"ida200 mg Magne"ium idro!"ida 200 mg

Anta"ida &'() ** "u"pen"i- !ombina"i . Aluminium idro!"ida 200

mg /5 ml Magne"ium idro!"ida 200 mg /5 ml $ 60 mlAnti %a!teri &'() "alep !ombina"i . %a"itra"in 500 */g olimi!"in 10000 */g

Antibioti! Topi!al ell+ )eom+cin ulate 0-5 lacenta (!"tra!10 $ 15 gr / Biop+*c-.o-


Antidiare "u"pen"i #aolin 700 mg ectin 66 mg $ 60 ml /K*o+ic

Antiungi &'() !ombina"i A" %enzoat 6 A" ali"ilat 3 $ 30gr / i./i+3



Antiine!"i Topi!al dengan #orti!o"teroid !rim #lorameni!ol ba"e20 mg redni"olon 2-5 mg $ 10 gr / K+or/o-Antiine!"i Topi!al dengan #orti!o"teroid !rim #lorameni!ol ba"e20 mg redni"olon 2-5 mg $ 10 gr / K+or/o-




30/200

26 Tablet

27 Tube 3 1 2 1 1

28 %ioplacenton


30 %ora@ l+"erin 'M 10 $ 8 ml %otol 2 2 FFF 1

31 %rom,e!"in tablet 8 mg / %romiar Tablet 43 39 82 93 112 90 23 10 118 98 190 94

32

33 ;ei@im 100 mg

34 Tablet 64 52 38 32 54 26 99 56 67 55 37 50



37 Ampul


39 &omperidon tablet 10 mg Tablet 13 3 2 20

40 #ap"ul


42

(pinerin Adrenalin in=e!"i 0-1 "ebagai ;l $ 1 mlAmpul

43 (ritromi"in !ap"ul 500 mg #ap"ul 20 12 10


45 (ta!ridin i?anol Barutan 0-1 $ 300 ml %otol 1 1 2


47 :itomenadion>it #1 tablet "alut gula 10 mg Tablet 6 10 10 FFF

48 :uro"emid tablet 40 mg Tablet 3 3

49 ac, 28 16 9 17 19 6 5 6 6 9 21


51 Tube 2 4 1 10 2 10 4 3 3

52 liben!lamid tablet 5 mg Tablet 20 50 50

53 li"eril uaia!olat tablet 100 mg Tablet 169 203 65 60 126 37 248 186 49 51 106



56 idro!lortiazid ;T tablet 25 mg Tablet 13 20 56 3 10 FFF 10

57 Tube 3 1 1 1 FFF

58 Tablet







aram 'ralit * "erbu!- !ombina"i . )atrium 0-52 g- #alium !lorida0-30 g - Trinatrium "itrat di,idrat 0-58 g- lu!o"a an,idrat 2-7 g





31/200

59 *buproen tablet 400 mg Tablet 10 5 20 35 10 10 3 10 40

60 *c,t+ol "alep !ulit $ 15 gr ot 1



63 #al"ium la!tat #al! tablet 500 mg Tablet 30 10 210 10

64 #eto!onazole 5

65 #aptopril tablet 25 mg Tablet 60 110 10 45 15 20 10 20 150

66 #lindami"in !ap"ul 300 mg #ap"ul 13


68 #lorameni!ol "alep mata 1 $ 5 gr Tube 2 2 1


70 %otol 1 3

71 #lorameni!ol tete" telinga 3 $ 5 ml %otol 1 1 FFF 2 2 2 1 1 2

72 #loreniramin maleat ;TM tablet 4 mg Tablet 403 230 224 317 282 226 379 193 212 236 243 300

73 Tablet

34 10 20 10

74 Tablet

75 %otol 9 4 5 4 1 3 1 5 7 3

76 Be?ertraan "alep $ 15 gr ot 2


78 Ampul





83 Metampiron Antalgin tablet 500 mg Tablet

84 Metormin ;l tablet 500 mg Tablet 45 10 10 5 40 15


86 Metronidazol tablet 500 mg Tablet 46 66 12 12 28 42 74 10 24 22 70

87 Tube

5 3 1 2 4

88 Multi?it irup $ 60 ml / l+be@ %otol 13 3 1 9 8

89 Tablet 53 38 94 10 43 5 82 45 58 FFF


#otimo!"azol &'() * deCa"a !ombina"i . ulameto!"azol 400mg Trimetoprim 80 mg

#otimo!"azol &'() ** pedriati! !ombina"i . ulameto!"azol 100mg Trimetoprim 20 mg

#otimo!"azol u"pen"i !ombina"i . ulameto!"azol 200 mg Trimetoprim 40 mg/ 5 ml $ 60 ml

Bido!ain comp in=e!"i Bidocain 2 ;l (pinerin 1 . 80000 $ 2ml




32/200


91 Tablet 40 10 FFF 28 6 46 30 16 20 40




95 )i"tatin tablet "alut 500000 */g Tablet 3 3 20

96 )i"tatin ?aginal tablet 100000 */g Tablet 13

97 'bat batu! itam '% ;airan $100 ml non Al!o,ol %otol21 26 17 18 9 25 18 14 10 6 19 14

98 Tablet 18 6 28 16 16 6 12 6 22

99 '!"itetra"i!lin ;l "alep !ulit 3 $ 5 gr Tube 1



102 apa?erin tablet 40 mg Tablet 6 12

103 aracetamol drop %otol 23 9 3 32 3 85 9 50 18 4 3 9

104 ara"etamol "irup 120 mg / 5ml $ 60 ml %otol 12 11 7 8 16 6 16 11 6 7 7 4


106 ara"etamol tablet 500 mg Tablet 702 705 399 446 406 754 575 318 468 544 550 494

107 irido!"in >itamin %6 tablet 10 mg ;l Tablet 243 220 108 77 92 164 193 41 119 154

108 iro!"i!am tablet 10 mg Tablet 44 110 10 6 100

109 %otol


111 redni"on tablet 5 mg Tablet 140 35 60 58 50 76 120 65 45 62 83 70


113

ropiltioura"il tablet 100 mgTablet

100114 anitidin tablet 150 mg Tablet 28 30 16 10 40 10 20 16 6



117 %otol

118 ot

119 ali"il %eda! 2 $ 50 gr #ota! 6 4 FFF 1 2 5 3 1 3 2

120 eadro!"il #ap"ul 500 mg #ap"ul 80

121 iano!obalamin ?itamin %12 tablet 50 mcg Tablet 138 48 80 80 162 140 106 48 56 140 122 100





alep 2$4 !ombina"i . A"am ali"ilat 2 %elerang endap 4 $30 gr


33/200

122 im?a"tatin tablet 10 mg Tablet 25 30 10 20 30 20 60 30 20 40 100


124 upral+"in "+r %otol 10 1 FFF 9 1 10 1 18 9 17




128 Tiamin >itamin %1 tablet 50 mg ;l/ )itrat Tablet 146 58 70 80 100 230 121 78 76 130 272 100

129 >itamin % #omple!" tablet Tablet 45 110 30 234 234 35 76 42 64 22 151 52

130 Dinc tablet 20 mg Tablet 50 10 15 30 20 20 10 10 10 30 50

OBAT KEJIAAN


2 Amitriptilin tablet "alut 25 mg ;l Tablet 10





7 Tube rectal


9 Tablet 5

10 aloperidol tablet 1-5 mg Tablet 30

11 aloperidol tablet 5 mg Tablet 20

12 Tablet





17 Tablet

18 tezolid tub


OBAT GIGI










34/200









13 et

14 et 1

15 et


17 'il pra+ %otol

18 Ampul

19 ulper+l %otol







26 Ampul






4 Alat unti! "e!ali pa!ai 3 ml c" 100 300


6 %lood "et et






'bat Ane"te"i Bo!al *n=e!"i Bido!ain ;l 20 ml Adrenalin 125mcg / P*c*i-



35/200





13 (tanol 70 $ 1 B %otol 1

14 el / (# %otol







21 #apa" embalut / ab"orben 250 gram %ung!u" 2




25 #erta" (# oll

26

#erta" on+ 110 oll



29 Bembar

30 Ma"!er #ota! 2 4

31 Ma"!er '2 c"





36 oll

37 ot rin c" 100


39 aet+ %o@ c"


EMBALAGE

1 #antong #re"e! obat ceta!an- u!uran 15 @ 30 Bembar 100 100 60 100 100 50 150 100

2 la"ti! 'bat dg !lip ceta!an- u!uran 7 @ 10 cm a! /100lbr 4 1 3 2 4




36/200



5 endo! obat c" 20 34 50 10 10 20 20 10 54 20 20 20

Mengeta,ui-

#epala u"!e"ma"


I!. 196501041994032002


37/200

"#"$%18 19 20 21 22 23 24 25 26 27 28 29 30 31

10 10 10 10 10 10 480

&

&

80 130 40 10 10 10 960

6 11 20 170

231 204 264 336 384 317 200 209 183 300 500 7,0197 3 2 2 3 4 1 1 2 4 4 93

70 100 60 140 70 100 160 80 30 50 80 2,123

13 1 3 3 1 35

3 11

&

10 58 10 22 20 20 25 519

&

&

1 20

32 20 92

1 1 2 1 2 3 24

&

&

193 72 209 90 94 242 100 56 22 100 120 3,761

60 130 35 70 200 70 70 80 100 199 2,325

1 1 1 1 8

20 3 25 93

&

390 450 36 260 3,541

10 20 20 10 61


38/200

0 0 0

2 2 3 6 3 1 1 1 3 5 35

&

&

2 1 2 5 3 1 2 2 1 3 4 38

94 89 9 65 205 66 22 22 20 200 264 2,192

&

&

44 58 80 60 51 119 230 33 31 1,408

&

&

&

&

5 10 11 10 10 6 3 3 25 123&

&

&

20 25 10 10 15 122

15

2 1 1 3 11

1 1 1 5

20 15 71

4 5 5 20

26 16 20 8 5 8 67 22 326

30 30

5 4 5 4 6 2 2 1 15 10 100

20 7 10 157

71 85 122 122 95 112 300 200 132 120 108 2,951

&

&

20 15 10 9 9 30 2151 2 1 1 - 10 1 5 30

&

10 5 10 5 5 5 203


39/200

2 3

&

&

110 120 20 150 395 1,075

5

70 10 15 5 35 85 40 40 65 200 120 1,175

13

&

FFF 1 2 3 5 20

2 1

2 5 14

1 3 1 1 2 1 1 24

359 385 361 362 401 283 540 453 178 100 104 7,254

80 20 36 20 21 251

&

13 7 6 3 2 2 2 2 5 6 102

2 1 2 8

&

&

&&

&

&

20 20 40

30 90 355

&

12 65 24 34 36 24 24 73 758

1 2 5 1 1 1 1 3 32

18 9 17 107

51 20 33 62 10 12 5 5 15 784

&

714


40/200

26 70 30 134 30 50 40 40 32 714

&

&

&

3 10 5 3 3 53

5 5 5 28

25 16 21 21 34 14 34 52 6 24 23 506

6 10 12 36 15 15 236

1 5

&

&

11 294 7 8 6 6 2 5 5 2 304

14 5 16 12 14 6 5 5 5 8 8 234

&

492 286 490 711 614 411 715 614 411 456 453 12,958

105 106 166 179 149 104 128 128 335 234 193 3,405

30 20 50 10 30 108 72 680

&

&

152 130 42 145 342 345 33 345 725 3,291&

100

32 50 18 36 36 12 74 500

&

5 2 6 5 5 34 19 139

&

1 1 2

9 3 6 2 1 4 2 2 3 69

60 20 10 10 10 200

62 84 102 207 56 80 110 110 52 234 105 2,676

40 20 30 20 40 40 61 736

10 10 20 10 10 10 60 352


41/200

10 10 20 10 10 10 60 352

18 9 1 10 19 1 9 1 1 9 184

&

&

&

52 92 112 227 86 31 100 150 52 23 50 2,730100 234 234 107 128 65 100 52 41 60 89 2,403

50 25 30 40 10 10 100 30 590

&

&

3 15 5 10 35

10 3 23

&

&

2 2 2 2 8&

&

&

5 10

30 20 80

10 30 60 120

&

&

&&

&

&

&

&

&

&

&

&

&

&

&

&


42/200

&

&

&

&

1

&

&

1

&

&

&

&

&

&&

&

&

&

&

&

&

&

&

&&

&

400

&

&

&

&

&

&


43/200

&

&

1

&

&

&

&

&

&

&

2

7 7

&

&

&

&

&

&

&

6

&

&

&

&

&&

100

2

&

&

&

&

200 200 30 100 150 50 80 50 100 80 2,100

3 1 1 1 2 30

&

1 2 5


44/200

1 2 5

10 10 10 10 2 50 10 50 10 20 500

&

enanggung aCab 'bat

upri,artiCi- AM:

)* 197601172009 02 2004



45/200

PUSKESMAS : CILE!UG TAHUN : 2015KECAMATAN : CILE!UG BULAN : APRIL

)' )AMA '%AT ATA)

1 2 3 4 5 6 7 8 9 10 11 12 13 14

1 Tablet # 10 FFF # 40 10 90 100



4 Amlodipin tablet 5 mg Tablet 30 FFF 70 84 80 10 30

5 Aminoillin tablet 200 mg Tablet 10 5 5 3

6 Amo!"ilin !aplet 500 mg #aplet 393 FFF 500 209 251 393 342 230 181 158 25

7 Amo!"ilin "irup !ering 125 mg/ 5 ml $ 60 ml %otol 5 6 3 4 7 5 3 4

8 Tablet 122 110 20 40 200 23 132 155 50 20 3

9 %otol 3 FFF 1 2 1 2

10 Tube 2 1 2 1

11 Tube

12 Tablet 33 10 10 111 26 9

13 %otol

14 ot

15 upp 2

16 #ap"ul 2

17 Tube

2 4 2 4 18 Tablet

19 >ial

20 A"am A"!orbat >itamin ; tablet 50 mg Tablet 146 112 131 131 121 146 135 135 164 131 13

21 A"am Meenamat !aplet 500 mg #aplet 130 155 80 70 50 178 150 90 FFF 80 17

22 A"i!lo?ir !rim 5 $ 5 gr Tube 3 2

23 A"i!lo?ir tablet 400 mg Tablet 15 14 2

24

Atropin in=e!"i im/i?/"! 0-25 mg/ml "ulat $ 1 mlAmpul


Anta"ida &'() * tablet !un+a,- !ombina"i . Aluminium idro!"ida 200 mg Magne"ium idro!"ida 200 mg

Anta"ida &'() ** "u"pen"i- !ombina"i . Aluminium idro!"ida 200 mg /5ml Magne"ium idro!"ida 200 mg /5 ml $ 60 ml

Anti %a!teri &'() "alep !ombina"i . %a"itra"in 500 */g olimi!"in10000 */g

Antibioti! Topi!al ell+ )eom+cin ulate 0-5 lacenta (!"tra! 10 $15 gr / Biop+*c-.o-


Antidiare "u"pen"i #aolin 700 mg ectin 66 mg $ 60 ml / K*o+ic

Antiungi &'() !ombina"i A" %enzoat 6 A" ali"ilat 3 $ 30 gr /i./i+3



Antiine!"i Topi!al dengan #orti!o"teroid !rim #lorameni!ol ba"e 20 mg redni"olon 2-5 mg $ 10 gr / K+or/o-



25 Tablet30 130 122 560 12 122 420

%e"i ** ulat 200 mg A"am :olat 0-25 mg tablet tamba, dara,! bi i


46/200

30 130 122 560 12 122 420

26 Tablet

27 Tube 3 1 1 1 6

28 %ioplacenton


30 %ora@ l+"erin 'M 10 $ 8 ml %otol 2 2

31 %rom,e!"in tablet 8 mg / %romiar Tablet 100 43 82 112 90 100 23 10 118 190

32

33 ;ei@im 100 mg

34 Tablet 64 38 54 26 119 FFF 119 67 11935 &e!trometoran "irup 10mg/5 ml %r $ 60 ml %otol


37 Ampul


39 &omperidon tablet 10 mg Tablet 3 2 20 20

40 #ap"ul



43 (ritromi"in !ap"ul 500 mg #ap"ul


45 (ta!ridin i?anol Barutan 0-1 $ 300 ml %otol 1 1 2




49 ac, 28 9 19 6 5 6 FFF 9


51 Tube 2 10 2 10 4

52 liben!lamid tablet 5 mg Tablet 4 FFF 50

53 li"eril uaia!olat tablet 100 mg Tablet 20 169 65 126 37 20 23 23 49 51



56 idro!lortiazid ;T tablet 25 mg Tablet

!ombina"i







aram 'ralit * "erbu!- !ombina"i . )atrium 0-52 g- #alium !lorida 0-30 g -Trinatrium "itrat di,idrat 0-58 g- lu!o"a an,idrat 2-7 g


57 Tube 1 1 1 10idro!orti"on !rim 2-5 $ 5 gr / L8*cor.o-


47/200

58 Tablet

59 *buproen tablet 400 mg Tablet 10 20 10 10 3 10 20

60 *c,t+ol "alep !ulit $ 15 gr ot 61 *"o"orbid dinitrat *&) tablet "ublingual 5 mg Tablet



64 #eto!onazole

65 #aptopril tablet 25 mg Tablet 5 60 10 27 15 5 20 10 122 150

66 #lindami"in !ap"ul 300 mg #ap"ul


68 #lorameni!ol "alep mata 1 $ 5 gr Tube 2 1 1


70 %otol 1 3

71 #lorameni!ol tete" telinga 3 $ 5 ml %otol 1 FFF 2 2 1 FFF

72 #loreniramin maleat ;TM tablet 4 mg Tablet 283 403 224 282 226 283 379 193 212 243

73 Tablet

80 10 80 10

74 Tablet

75 %otol 4 4 1 3 1 7



78 Bido!ain comp in=e!"i Bidocain 2 ;l (pinerin 1 . 80000 $ 2 ml Ampul






84 Metormin ;l tablet 500 mg Tablet 45 10 10 5 40


86 Metronidazol tablet 500 mg Tablet 32 46 12 28 42 48 10 10 24 70



#otimo!"azol &'() * deCa"a !ombina"i . ulameto!"azol 400 mg

Trimetoprim 80 mg#otimo!"azol &'() ** pedriati! !ombina"i . ulameto!"azol 100 mg Trimetoprim 20 mg

#otimo!"azol u"pen"i !ombina"i . ulameto!"azol 200 mg Trimetoprim40 mg/ 5 ml $ 60 ml

87 Tube3



48/200

3

88 Multi?it irup $ 60 ml / l+be@ %otol

89 Tablet 53 94 43 58 58 5 58 82 58


91 Tablet





96 )i"tatin ?aginal tablet 100000 */g Tablet 3 FFF 13 3 11

97 'bat batu! itam '% ;airan $100 ml non Al!o,ol %otol15 FFF 15 10 11 12 13 15 20 10

98 Tablet

99 '!"itetra"i!lin ;l "alep !ulit 3 $ 5 gr Tube 6 4 1



102 apa?erin tablet 40 mg Tablet 6

103 aracetamol drop %otol 12 23 3 3 12 9 18 3

104 ara"etamol "irup 120 mg / 5ml $ 60 ml %otol 9 12 7 16 6 9 16 11 6 7


106 ara"etamol tablet 500 mg Tablet 702 399 406 300 614 575 318 468 392 4

107 irido!"in >itamin %6 tablet 10 mg ;l Tablet 100 243 108 92 164 100 193 300 119 104 1

108 iro!"i!am tablet 10 mg Tablet 44 20 20 20 20 10 20 100

109 %otol


111 redni"on tablet 5 mg Tablet 90 140 60 50 76 60 80 65 45 80 112 ropanolol tablet 10 mg ;l Tablet

113 ropiltioura"il tablet 100 mg Tablet 100

114 anitidin tablet 150 mg Tablet 28 16 10 40 40 10 20 40



117






118 alep 2$4 !ombina"i . A"am ali"ilat 2 %elerang endap 4 $ 30 gr ot1


49/200

1

119 ali"il %eda! 2 $ 50 gr #ota! 5 6 4 5 2 5 5 7 3 3

120 eadro!"il #ap"ul 500 mg #ap"ul 4 FFF

121 iano!obalamin ?itamin %12 tablet 50 mcg Tablet 234 138 80 162 140 234 106 48 56 122 122 im?a"tatin tablet 10 mg Tablet 48 25 10 30 20 48 30 20


124 upral+"in "+r %otol 10 FFF 10 10 10 10 10 10 18 17




128 Tiamin >itamin %1 tablet 50 mg ;l/ )itrat Tablet 146 FFF 70 100 230 146 121 278 76 272

129 >itamin % #omple!" tablet Tablet 58 45 30 23 35 64

130 Dinc tablet 20 mg Tablet 110 50 10 30 20 10 20 10 FFF 30

OBAT KEJIAAN


2 Amitriptilin tablet "alut 25 mg ;l Tablet

3 ;lobazam tablet 10 mg Tablet4 &iazepam tablet 2 mg Tablet

5 &iazepam tablet 5 mg Tablet 5


7 Tube rectal


9 Tablet 5



12 Tablet





17 Tablet

18 tezolid tub







50/200

OBAT GIGI













13 et

14 et

15 et


17 'il pra+ %otol

18 Ampul

19 ulper+l %otol







26 Ampul








'bat Ane"te"i Bo!al *n=e!"i Bido!ain ;l 20 ml Adrenalin 125 mcg /P*c*i-



Al t ti! ! li ! i 3 l


51/200



6 %lood "et et








14 el / (# %otol











25 #erta" (# oll




29 Bembar

30 Ma"!er #ota!

31 Ma"!er '2 c"






36 oll

37 ot rin c"



52/200

37 ot rin c"

38 ot &a,a!


40 aet+ %o@ c"


EMBALAGE

1 #antong #re"e! obat ceta!an- u!uran 15 @ 30 Bembar 100 100 100 700 100 100 100 300 100

2 la"ti! 'bat dg !lip ceta!an- u!uran 7 @ 10 cm a! /100lbr 1 3 4

3 la"ti! 'bat dg !lip ceta!an- u!uran 10 @ 15 cm a! /100lbr 4


5 endo! obat c" 20 50 10 20 20 10 54 20

Mengeta,ui-

#epala u"!e"ma"


I!. 196501041994032002


53/200

"#"$%17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

10 FFF 10 # # 10 10 10 80 31 10 466

&

61 80 40 10 10 10 60 70 20 730

4 4 6 11 20 23 96

242 231 264 233 248 336 384 317 209 183 90 110 6,928

5 7 2 6 6 2 3 4 1 2 4 4 98

76 70 60 93 200 140 70 100 80 30 90 50 2,064

2 2 3 4 1 3 1 30

3 9

&

10 58 80 10 22 20 25 32 553

&

&1 7

32 16 80

1 5 2 1 2 29

&

&

146 131 131 146 146 90 94 242 146 146 146 100 3,401

155 60 130 178 178 178 70 200 178 80 178 100 3,194

FFF 2 12

FFF 3 25 117

&

65 390 450 387 45 260 3,143

10 10 20 10 80


54/200

2 3 6 3 1 1 3 37

&

&4 2 2 5 5 3 1 2 1 3 33

94 123 100 100 65 205 66 22 20 31 200 2,118

&

&

51 44 80 112 114 115 102 119 FFF 119 119 119 2,128

&

&

&

&

2 5 11 50 20 10 10 6 3 25 247

&

&

&

15 14 30 15 15 15 16 165

2 1 3 10

2 3 1 1 1 8

20 15 95

4 4 5 19

6 26 20 46 8 5 8 67 22 15 12 362

20 20

1 5 4 6 2 1 50

140 20 4 4 7 13 100 450

85 71 20 20 20 20 95 112 12 13 72 12 1,360

&

&

12 10 8 30

2 1 1 1 - 10 1 48

&

20 10 5 10 5 5 20 20 20 FFF 283


55/200

20 10 5 10 5 5 5 20 20 20 FFF 283

1 2

&

&20 110 115 20 100 395 110 110 110 1,780

12 13 25

20 70 15 78 56 150 35 85 40 65 200 1,423

16 67 173

&

1 FFF 1 1 1 2 3 1 8 29

1 2 5 1 1 161 FFF 1 1 2 1 1 1 1 1 19

197 359 361 283 283 362 401 283 453 178 283 143 7,183

10 190

&

8 13 6 3 2 2 5 66

1 1 4

&

&

&

&

&

&

20 20 20 20 20 20 135

40 30 120 120 120 120 120 120 20 1,005

&

12 FFF 10 12 12 12 12 10 24 73 27 48 616

2 2 2 4 4 4 29

&


56/200

40 51 33 58 58 62 10 12 5 15 58 52 1,124

&

11 16 50

&

&

&

FFF 5 3 17

3 3 5 5 52

15 20 10 20 12 13 28 20 10 11 28 13 15 387

12 12 14 12 35 15 10011

&

30 30

14 11 31

5 4 8 12 12 6 6 2 5 2 159

15 14 16 21 8 12 14 6 34 5 12 8 287

&

443 492 490 614 614 711 614 411 614 411 614 456 11,732

120 105 166 100 300 179 141 104 450 335 104 234 4,412

50 20 220 100 50 10 30 108 1,142

&

&

90 70 80 86 60 80 40 70 60 80 60 87 1,809

&

166 266

26 40 32 40 40 50 18 40 94 12 40 74 796

&

11 5 6 12 12 5 5 12 12 12 182

&

1 FFF 1 1 FFF 1 10

1 9 6 5 5 2 1 4 2 3 5 5 100


57/200

4 4 20 10 10 35 105

120 62 102 234 234 207 56 80 110 56 120 200 3,369

40 FFF 48 48 20 30 20 40 619

30 10 10 30 30 20 30 32 10 10 504

19 18 48 10 10 10 19 10 FFF 10 10 10 329

&

&

&

170 345 112 146 146 227 86 56 150 50 146 23 3,811

42 58 58 50 24 65 52 41 60 825

15 50 30 20 30 40 10 10 30 585

&&

15 5 8 30

4 3 7

&

&

2 2 6 2 2 20 10 65

&

&

&5 5 5 20

10

10 10 60 100

&

&

20 20 10 50

&

&

&

1 1

&


58/200

&

100 200

&

&


59/200

&

&

&&

&

&

&

&

&

&

&

&

&&

2

7 7

&

10

&

&

&

&

&

7

&

&

&

&

&

3 3

300 300

2 4


60/200

&

&

&&

400 100 400 240 100 100 60 100 100 100 100 100 4,400

1 1 10

4 4 16

1 1 4

10 10 44 10 10 2 10 50 10 400

&

enanggung aCab 'bat

upri,artiCi- AM:

)* 197601172009 02 2004



61/200


KECAMATAN : CILE!UG BULAN : MEI

)' )AMA '%AT ATA)

1 2 3 4 5 6 7 8 9 11 12 13

1 Tablet 10 FFF # 40 90 12



4 Amlodipin tablet 5 mg Tablet 30 FFF 70 84 80 30

5 Aminoillin tablet 200 mg Tablet 10 5 5 3

6 Amo!"ilin !aplet 500 mg #aplet 393 500 100 209 251 393 342 181 315 158

7 Amo!"ilin "irup !ering 125 mg/ 5 ml $ 60 ml %otol 5 6 3 4 7 3 3 4

8 Tablet 110 20 40 200 23 132 50 20

9 %otol 3 1 2 1 2

10 Tube 1 2 111 Tube

12 Tablet 33 10 10 111 26

13 %otol

14 ot

15 upp 2

16 #ap"ul 2

17 Tube

2 4 2 418 Tablet

19 >ial

20 A"am A"!orbat >itamin ; tablet 50 mg Tablet 112 131 131 121 146 135 164 131

21 A"am Meenamat !aplet 500 mg #aplet 155 80 70 50 178 150 90 80

22 A"i!lo?ir !rim 5 $ 5 gr Tube 3


Anta"ida &'() * tablet !un+a,- !ombina"i . Aluminium idro!"ida 200 mg Magne"ium idro!"ida 200 mg

Anta"ida &'() ** "u"pen"i- !ombina"i . Aluminium idro!"ida 200 mg /5ml Magne"ium idro!"ida 200 mg /5 ml $ 60 ml

Anti %a!teri &'() "alep !ombina"i . %a"itra"in 500 */g olimi!"in10000 */gAntibioti! Topi!al ell+ )eom+cin ulate 0-5 lacenta (!"tra! 10 $15 gr / Biop+*c-.o-


Antidiare "u"pen"i #aolin 700 mg ectin 66 mg $ 60 ml / K*o+ic

Antiungi &'() !ombina"i A" %enzoat 6 A" ali"ilat 3 $ 30 gr /i./i+3



Antiine!"i Topi!al dengan #orti!o"teroid !rim #lorameni!ol ba"e 20 mg

redni"olon 2-5 mg $ 10 gr / K+or/o-Antiine!"i Topi!al dengan #orti!o"teroid !rim #lorameni!ol ba"e 20 mg redni"olon 2-5 mg $ 10 gr / K+or/o-


23 A"i!lo?ir tablet 400 mg Tablet 15 14



62/200

25 Tablet 30 130 122 560 12 420

26 Tablet

27 Tube 3 1 1 1 6

28 %ioplacenton


30 %ora@ l+"erin 'M 10 $ 8 ml %otol

31 %rom,e!"in tablet 8 mg / %romiar Tablet 43 82 112 90 100 23 118 1

32

33 ;ei@im 100 mg

34 Tablet 64 38 54 26 50 50 67 5



37 Ampul


39 &omperidon tablet 10 mg Tablet 3

40 #ap"ul



43 (ritromi"in !ap"ul 500 mg #ap"ul 10


45 (ta!ridin i?anol Barutan 0-1 $ 300 ml %otol

1 146 :enol li"erol tete" telinga 10 $ 5 ml %otol

47 :itomenadion>it #1 tablet "alut gula 10 mg Tablet 6 10 10 20 20 2


49 ac, 28 9 19 6 5 6









aram 'ralit * "erbu!- !ombina"i . )atrium 0-52 g- #alium !lorida 0-30 g -Trinatrium "itrat di,idrat 0-58 g- lu!o"a an,idrat 2-7 g

51 Tube 2 10 2 4

52 liben!lamid tablet 5 mg Tablet 4 50

53 li"eril uaia!olat tablet 100 mg Tablet 169 FFF 169 90 169 90 FFF 49 90



63/200

li"eril uaia!olat tablet 100 mg 169 FFF 169 90 169 90 FFF 49 90



56 idro!lortiazid ;T tablet 25 mg Tablet 12 12 12 12 12 FFF

57 Tube 1 1

58 Tablet

59 *buproen tablet 400 mg Tablet 10 20 10 10 FFF 2

60 *c,t+ol "alep !ulit $ 15 gr ot




64 #alium &i!lo?ena! 50 mg

65 #eto!onazole

66 #aptopril tablet 25 mg Tablet 60 10 27 15 5 20 122 1

67 #lindami"in !ap"ul 300 mg #ap"ul


69 #lorameni!ol "alep mata 1 $ 5 gr Tube 2 1 10 10


71 %otol

72 #lorameni!ol tete" telinga 3 $ 5 ml %otol 1 FFF 2

73 #loreniramin maleat ;TM tablet 4 mg Tablet 403 224 282 226 283 379 212 2

74 Tablet

10 80 10

75 Tablet

76 %otol 4 4 1 FFF






#otimo!"azol &'() * deCa"a !ombina"i . ulameto!"azol 400 mg Trimetoprim 80 mg

#otimo!"azol &'() ** pedriati! !ombina"i . ulameto!"azol 100 mg Trimetoprim 20 mg

#otimo!"azol u"pen"i !ombina"i . ulameto!"azol 200 mg Trimetoprim40 mg/ 5 ml $ 60 ml

79 Bido!ain comp in=e!"i Bidocain 2 ;l (pinerin 1 . 80000 $ 2 ml Ampul



64/200


82

Boratadin tablet 10 mgTablet



85 Metormin ;l tablet 500 mg Tablet 45 10 10 40


87 Metronidazol tablet 500 mg Tablet 46 12 130 28 42 48 10 24 100

88 Tube

89 Multi?it irup $ 60 ml / l+be@ %otol

90 Tablet 53 94 43 58 58 5 82


92 Tablet





97 )i"tatin ?aginal tablet 100000 */g Tablet

98 'bat batu! itam '% ;airan $100 ml non Al!o,ol %otol15 FFF 10 11 12 13 20

99 Tablet

100 '!"itetra"i!lin ;l "alep !ulit 3 $ 5 gr Tube 4 1



103 apa?erin tablet 40 mg Tablet 6

104 aracetamol drop %otol 23 3 3 6

105 ara"etamol "irup 120 mg / 5ml $ 60 ml %otol 12 7 16 6


Mi!onazol !rim/ "alep 2 )itrat $ 10 gr /Mo+*3r




107 ara"etamol tablet 500 mg Tablet 702 399 200 406 300 614 575 468 200 392

108 irido!"in >itamin %6 tablet 10 mg ;l Tablet 90 108 92 92 164 100 193 119 104

109 iro!"i!am tablet 10 mg Tablet 44 20 20 20 20 FFF 100


65/200

110 %otol


112 redni"on tablet 5 mg Tablet 140 80 80 80 80 252 80 45 80 80


114 ropiltioura"il tablet 100 mg Tablet

115 anitidin tablet 150 mg Tablet 28 16 10 40 40 20 40


117 albutamol tablet 2 mg "ebagai "ulat Tablet 3 12 4 12 8 1 12

118

119 alep 2$4 !ombina"i . A"am ali"ilat 2 %elerang endap 4 $ 30 gr ot 5 1

120 ali"il %eda! 2 $ 50 gr #ota! 6 6 6 6 6 6 6 3 3

121 eadro!"il #ap"ul 500 mg #ap"ul 4

122 iano!obalamin ?itamin %12 tablet 50 mcg Tablet 138 80 162 140 234 106 56 122123 im?a"tatin tablet 10 mg Tablet 25 10 30 20 48 20

124 iprolo!"a"in tablet 500 mg "ebagai ;l Tablet 20 30 10 125

125 upral+"in "+r %otol 10 FFF 20 5 FFF 5 4




129 Tiamin >itamin %1 tablet 50 mg ;l/ )itrat Tablet 146 70 100 230 146 121 76 272

130 >itamin % #omple!" tablet Tablet 45 30 23 35 50 80 64 58 58

131 Dinc tablet 20 mg Tablet 50 10 30 20 10 FFF

OBAT KEJIAAN


2 Amitriptilin tablet "alut 25 mg ;l Tablet





5 &iazepam tablet 5 mg Tablet 5



66/200

p = g

7 Tube rectal


9 Tablet 5

10 aloperidol tablet 1-5 mg Tablet 10


12 Tablet





17 Tablet

18 tezolid tub


OBAT GIGI











11 (til ;,lorida "pra+ $ 100 ml %otol


13 et






14 et

15 et





67/200


17 'il pra+ %otol

18 Ampul

19 ulper+l %otol







26 Ampul








6 %lood "et et








'bat Ane"te"i Bo!al *n=e!"i Bido!ain ;l 20 ml Adrenalin 125 mcg /P*c*i-


14 el / (# %otol




68/200









25 #erta" (# oll




29 Bembar

30 Ma"!er #ota!

31 Ma"!er '2 c"32 Ma"!er nebulizer "et deCa"a c"




36 oll

37 ot rin c"

38 ot &a,a!39 arung Tangan #ota! 2

40 aet+ %o@ c"


EMBALAGE

1 #antong #re"e! obat ceta!an- u!uran 15 @ 30 Bembar 100 100 100 100 200



2 la"ti! 'bat dg !lip ceta!an- u!uran 7 @ 10 cm a! /100lbr 1 4

3 la"ti! 'bat dg !lip ceta!an- u!uran 10 @ 15 cm a! /100lbr 4


5 d ! b t


69/200

5 endo! obat c" 20 50 10 20 20 54 20

Mengeta,ui-

#epala u"!e"ma"


I!. 196501041994032002


70/200

TANGGAL"#"$%

18 19 20 21 22 23 25 26 27 28 29 30

10 12 10 # # 10 10 29 12 31 13 10 321

&

80 40 46 10 10 10 60 70 60 20 730

4 4 6 20 30 23 46 161

100 100 100 248 336 100 100 100 183 90 40 4,732

7 2 6 6 2 4 1 2 4 4 79

70 60 93 200 140 100 212 80 30 90 50 1,723

9 3 3 2 2 3 1 3 3 1 3 3 47

1 3 8

&

10 58 80 10 22 20 25 15 32 462

&

&3

32 43 5 16 98

1 5 2 31 1 2 54

&

&

131 131 146 146 90 242 79 146 146 146 100 2,720

60 60 80 178 178 178 77 10 178 80 178 80 2,368

2 3 2 4 4 3 22

20 70 3 53 50 25 250

&

390 450 387 45 200 400 300 55 3,501

10 10 16 10 46


71/200

2 3 6 1 1 5 3 42&

&

&

94 31 31 46 65 66 8 22 20 31 31 1,303

&

&

44 46 80 70 80 70 119 80 FFF 80 80 80 1,348

&

&

&

&

3 6

&

&

&

10

2 1 3 8

&

FFF 34 20 15 175

4 2 5 17

26 20 46 8 8 19 22 15 12 270

20 19 39

14 5 5 5 6 2 1 5 5 66

18 20 4 4 13 117

169 70 80 80 80 70 21 80 12 13 72 12 1,915

&

&


72/200

12 12 FFF 12 12 10 15 8 165

1 1 1 - 10 1 15 41

&

10 5 10 5 5 1 136

1 1 2

&

&

90 110 110 110 620

12 8 2070 15 78 56 150 85 40 65 97 1,070

16 3 19

&

8 8 1 12 1 1 3 35 1 8 8 111

&

1 1 1 1 1 1 1 11

359 361 283 283 362 283 453 178 283 133 5,513

10 6 116

&

13 6 3 2 2 2 5 50

1 1 1 4

&

&

&

&

&

&


73/200

20 20 20 60

30 120 120 120 95 120 20 730

&

12 80 10 12 12 12 10 80 24 73 27 48 920

2 2 1 2 13

&

51 87 80 80 80 62 12 80 5 15 58 52 1,171

&

&&

&

&

3 1 3 10

2 3 3 5 5 18

20 10 13 12 13 20 10 11 28 13 268

31 15 46

3 8

&

&

14 10 30

2 5 2 47

5 12 8 78

&

492 200 672 100 520 711 411 200 100 411 614 456 9,222

112 92 166 100 100 179 104 92 450 335 104 234 3,220

100 100 23 20 14 108 829

&

2 2

1 993


74/200

70 80 FFF 86 60 80 80 80 FFF 80 80 80 1,993

&&

FFF 32 40 40 50 40 13 94 12 40 74 709

&

24 88

&

1 5 1 1 5 1 1 22

9 6 5 5 2 4 12 2 3 5 5 106

4 4 10 10 35 29 100

62 111 50 80 90 50 80 110 56 120 60 2,007

44 32 48 20 20 40 48 48 20 515

10 7 10 212

14 10 10 15 112

&

&

&

345 112 120 146 50 59 150 50 50 23 2,611

58 58 42 58 112 50 58 58 FFF 58 58 58 1,227

10 10 FFF 10 10 30 210

&

&

15 4 8 27

&

&

&

2 2 5 7 21

&

&

&

5 10

10 20 40


75/200

10 20 40

10 30&

&

20 6 26

&

&

&

&

&

&

&

&

&

&

1 1

1 1

1 1

&

1 1

&200 200

&

1 1

&

&

&

&

&

&

1 1


76/200

&&

1 1

&

&

&

&

&

&

&

&

&

&

100 100 400

&

&

&

&

&&

&

&

1 1

&

&

&

&

&

&

&


77/200

1

3 3

&

1

&

&

&

&

&

6

&

&

&

&

&

&

&

2 4

&

&

&

&

100 100 100 100 100 100 100 100 1,500

5 5 1 4 20

1 5

1 1 4

10 44 2 10 30 10 300

&


78/200

enanggung aCab 'bat

upri,artiCi- AM:

)* 197601172009 02 2004




79/200

KECAMATAN : CILE!UG BULAN : JUNI

)' )AMA '%AT ATA)

1 2 3 4 5 6 8 9 10 11 12 13 14

1 Tablet % 10



4 Amlodipin tablet 5 mg Tablet 50 60 60 90 85 50

5 Aminoillin tablet 200 mg Tablet 27 12 10 FFF 10

6 Amo!"ilin !aplet 500 mg #aplet 189 168 180 164 175 196 200 212 FFF 87 69

7 Amo!"ilin "irup !ering 125 mg/ 5 ml $ 60 ml %otol 3 7 5 3 5 7 5 3 6 1

8 Tablet 81 45 100 25 75 60 115 75 70 100 61

9 %otol 1 FFF 1 1 2 FFF 3

10 Tube 4 2

11 Tube

12 Tablet 20 50 20 10 FFF 10 10 6

13 %otol

14 ot

15 upp

16 #ap"ul 18 30 10 20

17 Tube 3 1 3 1 FFF 1 FFF 1 118 Tablet

19 >ial

20 A"am A"!orbat >itamin ; tablet 50 mg Tablet 44 288 92 106 23 149 66 187 78 168 59

21 A"am Meenamat !aplet 500 mg #aplet 200 160 60 50 133 80 15 60 80 50

22 A"i!lo?ir !rim 5 $ 5 gr Tube 1 5 3

Alopurinol tablet 100 mg / Mr

Documents

Laporan Pemakaian Obat 2015