PEMERINTAH KABUPATEN BOLAANG MONGONDOW SELATAN

DINAS KESEHATAN
UPTD PUSKESMAS PINOLOSIAN KECAMATAN PINOLOSIAN

NOMOR : 445/PKM-P/ / VII / 2019

LAMPIRAN : -
PERIHAL : Permintaan Obat

NO NAMA OBAT SATUAN JUMLAH KETETANGAN

1 Acyclovir Krim 5% tube 10

2 Acyclovir tablet 400 mg tablet 1000 ED JAUH
3 Alkohol Swabs pcs 2000
4 Ambroxile tablet 30 mg tablet 1500
5 Amlodipin tablet 10 mg tablet 6000
6 Amlodipin tablet 5 mg tablet 6000
7 Antasida Suspensi botol 150
8 Asam Ascorbat 50 mg (vitamin C) tablet 2000
9 Asam Mefenamat 500 mg Tablet 5000 ED JAUH
10 Betametason Krim 0,05 % tube 25
11 Captopril 12,5 mg tablet 2000
12 Captopril 25 mg tablet 2000
13 Captopril 50 mg tablet 3000
14 Fitomenadion (VIT. K1) 10 mg botol 500
15 Folley Cateter no.18 pcs 30
16 Folley Cateter no.20 pcs 10
17 Gliceril Guayacolat 10 mg tablet 2000
18 Glukosa Larutan Infus 5 % botol 40
19 Handscoon Steril no.7 psg 1000
20 Ibuprofen suspensi 100 mg/5 ml botol 50
21 Ibuprofen tablet 400 mg tablet 1000
22 Infusion Set Anak pcs 100
23 Infusion Set Dewasa pcs 300
24 Kalsium Lactat 500 mg tablet 2000
25 Kassa Hidrofil 36 m x 80 m rol 5
26 Kassa Pembalut hidrofil 4 m x 15 cm rol 100
27 Kassa steril 16 cm x 16 cm kotak 300
28 Kassa Kompres steril 40 x 40 cm pcs 200
29 Kloramfenicol tetes telinga 3 % botol 10
30 Kotrimoksazol tablet 480 mg tablet 2000 ED JAUH
31 Lidokain Injeksi 2 % + kombinasi epinefrin ampul 100
32 Lysol 1 Liter botol 3
33 Masker N95 pcs 40
34 Metformin HCl tablet 500 mg tablet 2000
35 Metil prednisolon 4 mg tablet 1000
36 Multivitamin Anak botol 50
37 Natrium Klorida 0,9% botol 100
38 Nifedipin 10 mg tablet 2000
39 Oksitetrasiklin Salep Kulit 3% tube 25
40 Papaverin Tab 40 mg tablet 1000
41 Paracetamol Drops botol 100
42 Paracetamol sirup 120 ml/5 ml botol 200
43 Plester rol 20
44 Povidon Iodin 30 ml botol 10
45 Povidon Iodin 300 ml botol 10
46 Ranitidin Injeksi 25 mg/ml ampul 100
47 Sefadroksil kapsul 500 mg tablet 1000
48 Siprofloxacin tab 500 mg tablet 600
49 Benovit C Dragee tablet 2000
50 Echinatur Kids botol 30
51 Ketorolac Injeksi ampul 25
52 Nevradin E Dragee tablet 1000
53 Noza tablet 1500
54 Vitamin A Kapsul Merah 200.000 UI Tablet 1000 ED JAUH
55 Vitamin A Kapsul Biru 100.000 UI tablet 500
56 Multivitamin Anak botol 50
57 REAGEN TB Paket 5
58 OAT FDC Kat I Paket 5

Mengetahui Petugas
Kepala Puskesmas Pinolosian

I Wayan Sugiri Hairunnisa Nursah

Nip. 19710913 199403 1 007 Nip.19870913 201402 2 001
 Hairunnisa Nursah
ip.19870913 201402 2 001