1 0 3 2 6 7 8 19 11 10 13 1 12 1 16 17
Amal!am Po.de H! P;L Asen Pas#a;"aus#%ne# Den#o%# De/%n#e< Pas#a De/%#al%sas% $as#a (non asen) Eu!enol "a%an =%lm on#!en !%!% =u>% I? Glass Ionome "emen# (!" %<) Glass Ionome =u>% II (P;L) Kals%um %doks%da $as#a Monoklokam@e men#ol "a%an Mumm%@&%n! $as#a *emen sen! @os@a# se-uk dan "a%an *%l/e amal!an se-uk 2+62 *$ons !ela#%n "%-%"le "u-%"les 1<1<1 "m Tem$oa& s#o$$%n! @le#"e se-uk dan "a%an T%kesol @omal%n (#k@) "a%an
Bo#ol Ko#ak Po# Bo#ol Bo#ol Bo#ol Ko#ak Bo#ol Bo#ol Bo#ol Ko#ak Bo#ol Bo#ol *e# Bo#ol Ko#ak *e# Bo#ol
+ + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + +
1 0 3 2 6 7 8 19 11 10 13 1 12 1 16 17 18 09 01 00 03 0 02 0 06 07 08 39 31 30 33 3 32 3 36 37 38
Alkool 69 Asam Ase#a# 299 ml Asam klo%da 91 n Asam sul@asal%s%la# 09 EDTA Bu-uk K&ol Lau#an Benned%"# Lau#an Bu@@e Pos$a# P 60 $o G%emsa Lau#an Eos%n 0 Lau#an Es-a" Lau#an E#anol asam Lau#an G%emsa *#a%n Lau#an Ha&em Lau#an H- Po#ome#%k Lau#an Ka-ol =uks%n Lau#an Me#%len B%u Lau#an Ress E"ke (Tom-os%#) Lau#an Tuk Lau#an F%el Neelsen L%sol Me#anol Rea!en An%sol Rea!en An#% H-s A! (s#%k) Rea!en Asam 'a# (*#%$) Rea!en oles#eol Rea!en om-u #es# 19 M u%ne Rea!en om-u Tes# '%n Rea!en ea#%n%ne K%# Rea!en Glu"ose K%# Rea!en Glukosa Daa (s#%$) Rea!en Gol daa A Rea!en Gol daa An#% A Rea!en Gol daa An#% AB Rea!en Gol daa An#% B Rea!en Gol daa B Rea!en Gol daaAB Rea!en Haemo!lo-%n Rea!en HB* A! (*#%k) Rea!en HDL oles#eol (D%e"#)
ml ml ml ml m! ml ml ml ml ml ml ml ml ml ml ml ml ml ml ml ml ml s#%k s#%$ ml ml ml ml ml *#%$ ml ml ml ml ml ml ml *#%k ml
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
9 1 0 3 2 6 7 8 29 21 20
Rea!en T&!l%"e%des K%# Rea!en 'ea R1 Rea!en 'ea R0 Rea!en '%d A"%d *al%s%l s$%%#us 19 *$%%#us Tes# Keam%lan ; HG Tes %dal *almonela Paa T&$%a A+H %dal *almonela Paa T&$%a A+O %dal *almonela Paa T&$%a B+H %dal *almonela Paa T&$%a B+O %dal *almonella T&$%a H %dal *almonella T&$%a O
ml ml ml ml ml ml P"s ml ml ml ml ml ml
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
1 0 3 2 6 7 8 19 11 10 13 1 12 1 16 17 18 09 01 00 03 0 02 0 06 07 08 39 31 30 33 3 32 3 36 37 38
Al-endaol #a-le# 99 m! Alo$u%nol #a-le# 199 m! Alo$u%nol #a-le# 399 m! Al$aolam #a-le# 902 m! Al$aolam #a-le# 92 m! Al$aolam #a-le# 1 m! Am-o
eks% 0m!;ml Am%no$%l%n #a-le# 129 m! Am%no$%l%n #a-le# 099 m! Am%#%$#%l%n #a-le# salu# 02 m! (Hl) Amoks%s%l%n ka$le# 299 m! Amoks%s%l%n ka$sul 029 m! Amoks%s%l%n se-uk %n>eks% 1999 m! Amoks%s%l%n s%u$ ke%n! 102 m!; 2 ml Am$%s%l%n ka$le# 299 m! Am$%s%l%n ka$sul 029 m! Am$%s%l%n se-uk %n>eks% 1999 m!;ml Am$%s%l%n se-uk %n>eks% 299 m!;/%al Am$%s%l%n s%u$ ke%n! 102m!;2 ml An#as%da DOEN I #a-le# kun&a kom-%nas% Al(OH)3 099 m! 5 M!(OH)0 099 m! An#as%da DOEN II sus$ens% kom-%nas% Al(OH)3 099 m!;2 ml 5 M!(OH)0 099 m!;2 ml An#%-ak#e% DOEN sale$ kom-%nas% : Bas%#as%n 299 I';! 5 Pol%m%ks%n 19999 I';! An#%@un!% DOEN kom-%nas% : As Benoa# 5 As *al%s%la# 3 An#%emoo%d DOEN kom-%nas% : B%smu# *u-!ala# 129 m! 5 Heksakloo@en 02 m! An#%mala%a DOEN kom-%nas% : P%%me#am%n 02 m! 5 *ul@adoks%n 299 m! An#%m%!en DOEN kom-%nas% : E!o#am%n Ta#a# 1 m! 5 Ko@e%n 29 m! An#%$ak%nson DOEN #a-le# kom-%nas% : Ka-%do$a 02 m! 5 Le/odo$a 029 m! AJua $o %n>eks% s#e%l -e-as $%o!en A#eme#e %n>eks% 1 ml : 79 m! A#esuna#e %n>eks% 9 m! A#esuna#e #a-le# Asam Ase#%lsal%s%la# #a-le# 199 m! (Ase#osal) Asam Ase#%lsal%s%la# #a-le# 299 m! (Ase#osal) Asam asko-a# (%#) #a-le# 029 m! Asam asko-a# (%#) #a-le# 199 m! Asam asko-a# (%#) #a-le# 29 m!
Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Bo#ol Ta-le# Ta-le# Am$ul Ta-le# Ta-le# Ta-le# *alu# Ka$le# Ka$sul %al Bo#ol Ka$le# Ka$sul %al %al Bo#ol Ta-le# Kun&a Bo#ol Tu-e Po# *u$$ Ta-le# Ta-le# Ta-le# %al Am$ul %al Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Ta-le#
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
9 1 0 3 2 6 7 8 29 21 20 23 2 22 2 26 27 28 9 1 0 3 2 6 7 8 69 61 60 63 6 62 6 66 67 68 79 71 70 73 7
Asam =ola# #a-le# 1 m! Asam =ola# #a-le# 2 m! Asam Me@enama# ka$sul 029 m! Asam Me@enama# #a-le# salu# sela$u# 299 m! Asam Taneksama# %n>eks% Ase#aolam%d #a-le# 029 m! As%klo/% k%m 2 As%klo/% #a-le# 099 m! As%klo/% #a-le# 99 m! A#enolol #a-le# 29 m! A#enolol #a-le# 199 m! A#o$%n sul@a# %n>eks% 902m!;ml A#o$%n sul@a# #a-le# 92 m! A#o$%n sul@a# #e#es ma#a 92 Bena#%n -en%l $en%s%l%n %n>10 >u#a %u;/%al Bena#%n -en%l $en%s%l%n %n>0 >u#a %u;/%al Bes% (II) sul@a# 6 H0O #a-le# salu# 399 m! Bes% s%u$ Be#a%s#%n Mes%la# #a-le# m! Be#ame#ason k%m 91 Be#ame#ason #a-le# 92 m! B%so$olol #a-le# 2 m! Bomeks%n #a-le# 7 m! e#%%%ne #a-le# 19 m! %sa$%de #a-le# 2 m! lo-aam #a-le# 19 m! lo-e#asol k%m 992 Da$son #a-le# 199 m! Deksame#ason %n>eks% 2 m!;ml Deksame#ason #a-le# 92 m! Deks#an 69+lau#an %n@us s#e%l Deks#ome#o@an s%u$ 19 m!;2ml (HB) Deks#ome#o@an #a-le# 12 m! (HB) D%ae$am %n>eks% 2 m!;ml D%ae$am #a-le# 0 m! D%ae$am #a-le# 2 m! D%e#%lka-ama%n s%#a# #a-le# 199 m! D%@en%dam%n %n>eks% 19 m!;ml (Hl) D%!oks%n #a-le# 902 m! D%!oks%n #a-le# 9902 m! D%kloksas%l%n ka$sul 102 m! D%kloksas%l%n ka$sul 029 m! D%kloksas%l%n ka$sul 299 m! D%l#%aem #a-le# 39 m! (Hl) D%men%d%na#e #a-le# 29 m!
Ta-le# Ta-le# Ka$sul Ta-le# Am$ul Ta-le# Tu-e Ta-le# Ta-le# Ta-le# Ta-le# Am$ul Ta-le# Bo#ol %al %al Ta-le# *alu# Bo#ol Ta-le# Tu-e Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Tu-e Ta-le# Am$ul Ta-le# Bo#ol Bo#ol Ta-le# Am$ul Ta-le# Ta-le# Ta-le# Am$ul Ta-le# Ta-le# Ka$sul Ka$sul Ka$sul Ta-le# Ta-le#
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
72 7 76 77 78 89 81 80 83 8 82 8 86 87 88 199 191 190 193 19 192 19 196 197 198 119 111 110 113 11 112 11 116 117 118 109 101 100 103 10 102 10 106 107 108
D%so$%am%d ka$sul 199 m! Doks%s%kl%n ka$sul 199 m! Dom$e%dom sus$ens% 2 m!;2 ml Dom$e%dom #a-le# 19 m! E@ed%n "l #a-le# 02 m! Eks#ak -aladon #a-le# 19 m! E$%ne@%n Hl (adenal%n) %n> 91 +1 ml E%#om%s%n ka$sul 029 m! E%#om%s%n ka$sul 299 m! E%#om%s%n s%u$ 099 m!;2ml E#ak%d%n (%/anol) lau#an 91 E#am-u#ol #a-le# 029 m! (Hl) E#am-u#ol #a-le# salu# 299 m! (Hl) E#o$os%d ka$sul 199 m! =amo#%d%ne #a-le# 9 m! =amo#%d%ne #a-le# 09 m! =en%l-u#ason #a-le# 099 m! =en%#o%n ka$sul 199 m! =en%#o%n Na#%um %n>eks% 29 m!;ml =en%#o%n Na#%um ka$sul 199 m! =en%#o%n Na#%um ka$sul 39 m! =eno-a-%#al %n>eks% 29 m!;ml =eno-a-%#al #a-le# 199 m! =eno-a-%#al #a-le# 39 m! =enoks%me#%l $en%s%l%na #a-le# 029 m! =enoks%me#%l $en%s%l%na #a-le# 299 m! =enol!l%seol #e#es #el%n!a 19 =%#omenad%on (/%#k1) %n>eks% 19 m!;ml =%#omenad%on (/%#k) #a-le# salu# 19 m! =luokonaol ka$sul 29 m! =lou%de #a-le# 92 m! =lou%de #a-le# 1 m! =uosem%d %n>eks% 19 m!;ml =uosem%d #a-le# 9 m! Gameksan emuls% 1 Gaam oal%# un#uk 1999 ml a% Gaam oal%# un#uk 099 ml a% Gem@%-o%l ka$sul 399 m! Gem@%-o%l ka$sul 99 m! Gen#am%s%n %n>eks% 79 m!;ml (*ul@a#) Gen#am%s%n sale$ kul%# (*ul@a#) Gen#am%s%n #e#es ma#a 93 (*ul@a#) Gen#%an /%ole# lau#an 1 Gl%-enklam%da #a-le# 2 m! Gl%me$%%de #a-le# 1 m!
Ka$sul Ka$sul Bo#ol Ta-le# Ta-le# Ta-le# Am$ul Ka$sul Ka$sul Bo#ol Bo#ol Ta-le# Ta-le# Ka$sul Ta-le# Ta-le# Ta-le# Ka$sul Am$ul Ka$sul Ka$sul Am$ul Ta-le# Ta-le# Ta-le# Ta-le# Bo#ol Am$ul Ta-le# Ka$sul Ta-le# Ta-le# Am$ul Ta-le# Bo#ol *a"e# *a"e# Ka$sul Ka$sul %al Tu-e Bo#ol Bo#ol Ta-le# Ta-le#
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
139 131 130 133 13 132 13 136 137 138 19 11 10 13 1 12 1 16 17 18 129 121 120 123 12 122 12 126 127 128 19 11 10 13 1 12 1 16 17 18 169 161 160 163 16
Gl%me$%%de #a-le# 0 m! Gl%me$%%de #a-le# 3 m! Gl%me$%%de #a-le# m! Gl%$%%de #a-le# 2 m! Gl%Ju%don #a-le# 39 m! Gl%se%l !ua&akola# #a-le# 199 m! Gl%se%n Glukosa lau#an %n@us 19 s#e%l Glukosa lau#an %n@us 9 s#e%l Glukosa lau#an %n@us 2 s#e%l G%seo@ul/%n #a-le# 102 m! m%"on%ed Halo$e%dol #a-le# 92 m! Halo$e%dol #a-le# 12 m! Halo$e%dol #a-le# 0 m! Halo$e%dol #a-le# 2 m! Hdokloo#%a%da ("#) #a-le# 02 m! H%doko#%son k%m 1 H%doko#%son k%m 02 H&os"%ne+N+Bu#%l-om%de #a-le# 19 m! I-u$o@en #a-le# 099 m! I-u$o@en #a-le# 99 m! Indome#as%n ka$sul 02 m! Iod%ol ka$sul lunak I$eka s%u$ 91 Ison%a%d #a-le# 199 m! Ison%a%d #a-le# 399 m! Isoso-%d d%n%#a# #a-le# su-l%n!ual 2 m ! I#akonaole ka$sul 199 m! Kal%um d%klo@enak #a-le# 02 m! Kal%um d%klo@enak #a-le# 29 m! Kal%um Klo%da #a-le# 399 m! Kals%um Ka-ona# #a-le# 299 m! Kal%um $eman!ana# se-uk Kals%um Ka-ona# #a-le# 299 m! Kals%um lak#a# (kalk) #a-le# 299 m! Ka$#o$%l #a-le# 102 m! Ka$#o$%l #a-le# 02 m! Ka$#o$%l #a-le# 29 m! Ka-amae$%n #a-le# 099 m! Ke#am%n %n>eks% 19 m!;ml Ke#okonaol k%m 0 Ke#okonaol #a-le# 099 m! Ke#o$o@en %n>eks% 199 m! Ke#o$o@en #a-le# 199 m! Kl%ndam%s%n ka$sul 129 m!
Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Bo#ol Bo#ol Am$ul Bo#ol Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Tu-e Tu-e Ta-le# Ta-le# Ta-le# Ka$sul Ka$sul Bo#ol Ta-le# Ta-le# Ta-le# Ka$sul Ta-le# Ta-le# Ta-le# Ta-le# Bo#ol Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# %al Tu-e Ta-le# Am$ul Ta-le# Ka$sul
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
162 16 166 167 168 179 171 170 173 17 172 17 176 177 178 189 181 180 183 18 182 18 186 187 188 099 091 090 093 09 092 09 096 097 098 019 011 010 013 01 012 01 016 017 018
Kl%ndam%s%n ka$sul 399 m! Klo@a%m%n ka$sul 199 m! m%"on%ed Klom%@en #a-le# 29 m! Klon%d%n #a-le# 912 m! Kloam@en%kol ka$sul 029 m! Kloam@en%kol sale$ ma#a 1 Kloam@en%kol sus$ens% 102 m! ; 2 ml Kloam@en%kol #e#es ma#a 92 Kloam@en%kol #e#es #el%n!a 3 Klo@en%am%n malea# ("#m) #a-le# m! Klooku%n @os@a# #a-le# 129 m! Klooku%n @os@a# #a-le# 029 m! Klooku%n @os@a# %n>eks% Klo$oma%n Hl #a-le# salu# 199 m! Klo$oma%n Hl #a-le# salu# 02 m! Klo$oma%n Hl %n> 02 m!;ml + 1 ml Klo$oma%n Hl %n> 2 m!;ml+0 ml Klo$o$am%d #a-le# 199 m! Kode%n "l #a-le# 19 m! Kode%n "l #a-le# 12 m! Kode%n "l #a-le# 09 m! Kolk%s%n #a-le# 299 m! Kom-%nas% $%%me#am%n 02m!5sul@adoks%l%n 299m! Ko#%moksaol de.asa #a-le# kom-%nas% *ul@ame#oksaol 99 m! 5 T%me#o$%m 79 m! Ko#%moksaol $ed%a#%k #a-le# kom-%nas% *ul@ame#oksaol 199 m! 5 T%me#o$%m 09 m! Ko#%moksaol sus$ens% kom-%nas% *ul@ame#oksaol 099 m! 5 T%me#o$%m 9 m! ; 2 m l Ku%n%d%n #a-le# 199 m! Ku%n%d%n #a-le# 099 m! Ku%n%n (k%na) #a-le# 099 m! Ku%n%n d%%doklo%da %n>eks% 02 + 0 ml Ku%n%n sul@a# #a-le# 000 m! (6 0o) Lano$aol ka$sul 39 m! Le/am%sol #a-le# 29 m! Le/o@loksas%n #a-le# 299 m! L%doka%n %n>eks% 0 L%doka%n %n>eks% 0 5 E@%ne$%n 1 : 79999 + 0 m! L%nkom%s%n ka$sul 029 m! L%nkom%s%n ka$sul 299 m! L%s%no$%l #a-le# 19 m! L%s%no$%l #a-le# 09 m! L%s%no$%l #a-le# 2 m! Lo$eam%d #a-le# 2 m! Loa#ad%n #a-le# 19 m! Ma!nes%um sul@a# %n>eks% (%/) 09 +02 ml Ma!nes%um sul@a# %n>eks% (%/) 9 +02 ml
Ka$sul Ka$sul Ta-le# Ta-le# Ka$sul Tu-e Bo#ol Bo#ol Bo#ol Ta-le# Ta-le# Ta-le# Am$ul Ta-le# *alu# Ta-le# *alu# Am$ul Am$ul Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Bo#ol Ta-le# Ta-le# Ta-le# Am$ul Ta-le# Ka$sul Ta-le# Ta-le# Am$ul %al Ka$sul Ka$sul Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# %al %al
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
009 001 000 003 00 002 00 006 007 008 039 031 030 033 03 032 03 036 037 038 09 01 00 03 0 02 0 06 07 08 029 021 020 023 02 022 02 026 027 028 09 01 00 03 0
Ma!nes%um sul@a# se-uk 39 ! Me-endaol s%u$ 199 m!;2 ml Me-endaol #a-le# 199 m! Me-endaol #a-le# 299 m! Meloks%kam su$$ Meloks%kam #a-le# 12 m! Meloks%kam #a-le# 62 m! Meka$#o$u%n #a-le# 29 m! Me#am$%on (an#al!%n) %n>eks% 029 m!;ml Me#am$%on (an#al!%n) #a-le# 299 m! Me#@om%n Hl #a-le# 299 m! Me#%ldo$a #a-le# 029 m! Me#%le!ome#%n malea# #a-le# salu# 9102 m! Me#%le!ome#%n malea# %n>eks% 9099 m!+1ml Me#%l$edn%solon #a-le# 1 m! Me#%l$edn%solon #a-le# 7 m! Me#%l$edn%solon #a-le# m! Me#oklo$am%de %n>eks% 2 m!;ml Me#oklo$am%de s%u$ 2 m!;ml Me#oklo$am%de #a-le# 2 m ! Me#oklo$am%de #a-le# 19 m! Me#on%daol %n@us 299 m!;199 ml Me#on%daol #a-le# 029 m! Me#on%daol #a-le# 299 m! M%konaol k%m;sale$ 0 Na#%um -%ka-ona# #a-le# 299 m! Na#%um d%klo@enak #a-le# 02 m! Na#%um d%klo@enak #a-le# 29 m! Na#%um @louese%n #e#es ma#a 0 Na#%um klo%da lau#an %n@us 98 s#e%l Na#%um #%osul@a# %n>eks% 02 + 19 ml Neom%s%n ka$sul 299 m! N%@ed%$%n #a-le# 19 m! N%s#a#%n 199999 %u;! #a-le# /a!%nal N%s#a#%n 299999 %u #a-le# salu# O-a# an#% #u-ekulos%s ka#e!o% 1 O-a# an#% #u-ekulos%s ka#e!o% 0 O-a# an#% #u-ekulos%s ka#e!o% 3 O-a# an#% #u-ekulos%s ka#e!o% O-a# an#% #u-ekulos%s ka#e!o% anak O-a# An#% Tu-ekulos%s s%s%$an anak O-a# an#% #u-ekulos%s s%s%$an de.asa O-a# An#% Tu-ekulos%s ka#e!o% 1 =D O-a# An#% Tu-ekulos%s ka#e!o% 1 =D III =D O-a# An#% Tu-ekulos%s ka#e!o% 0 =D
*ase Bo#ol Ta-le# Ta-le# *u$$ Ta-le# Ta-le# Ta-le# Am$ul Ta-le# Ta-le# Ta-le# Ta-le# Am$ul Ta-le# Ta-le# Ta-le# Am$ul Bo#ol Ta-le# Ta-le# Bo#ol Ta-le# Ta-le# Tu-e Ta-le# Ta-le# Ta-le# Bo#ol Bo#ol Am$ul Ka$sul Ta-le# Ta-le# a!%nal Ta-le# *alu# Pake# Pake# Pake# Pake# Pake# Pake# Pake# Pake# Pake# Pake#
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
02 0 06 07 08 069 061 060 063 06 062 06 066 067 068 079 071 070 073 07 072 07 076 077 078 089 081 080 083 08 082 08 086 087 088 399 391 390 393 39 392 39 396 397 398
O-a# An#% Tu-ekulos%s s%s%$an =D O-a# -a#uk %#am (OBH) s&u$ O-a# -a#uk $u#% (OBP) s&u$ O@loeks% %m 29m!;ml+19 ml Oks%#e#as%kl%n "l sala$ kul%# 3 Oks%#e#as%kl%n "l sala$ ma#a 1 Oks%#os%n %n> 19 %u;ml+1ml Ome$aol ka$sul 09 m! Pa$a/e%n %n>eks% 9 m!;ml Pa$a/e%n #a-le# 9 m! Paa"e#amol s%u$ 109 m!;2 ml Paa"e#amol #a-le# 199 ! Paa"e#amol #a-le# 299 ! Pe@ena%n #a-le# 1 m! Pe@ena%n #a-le# m! Pe#%d%n "l %n>eks% 29 m!;ml+0 ml P%loka$%n "l;n%#a# #e#es ma#a 0 P%a"e#am %n>eks% 1 ! ; 2 ml P%a"e#am #a-le# 1099 m! P%a"e#am #a-le# 799 m! P%a"e#am #a-le# 99 m! P%an#el $amoa# #a-le# 102 m! P%a%nam%d #a-le# 299 m! P%%doks%n "l #a-le# 19 m! P%oks%kam #a-le# 19 m! P%oks%kam #a-le# 09 m! Pa/as#a#%n #a-le# 19 m! Pa/as#a#%n #a-le# 09 m! Pol%$e$#%da kom-%nas% doen lau#an %n@us Pa%kuan#el #a-le# 399 m! Pa%kuan#el #a-le# 99 m! Pedn%son #a-le# 2 m! P%maJu%n #a-le# 12 m! Poka%n -en%l $en%s%l%n G 3 >u#a %u ; /%al %n>eks% Pome#a%n #a-le# 02 m! Po$anolol "l #a-le# 19 m! Po$anolol "l #a-le# 9 m! Po$%l#%ouas%l #a-le# 29 m! Po$%l#%ouas%l #a-le# 199 m! Ran%#%d%n %n>eks% 02 m! ; 0 ml Ran%#%d%n #a-le# 129 m! Rese$%n #a-le# 919 m! Rese$%n #a-le# 902 m!
Pake# Bo#ol Bo#ol Ta-le# Ta-le# %al Tu-e Tu-e Am$ul Ka$sul Am$ul Ta-le# Bo#ol Ta-le# Ta-le# Ta-le# Ta-le# Am$ul Bo#ol Am$ul Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Bo#ol Ta-le# Ta-le# Ta-le# Ta-le# %al Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Am$ul Ta-le# Ta-le# Ta-le#
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
319 Re#%nol (/%#a) ka$sul lunak 199999 %u 311 Re#%nol (/%#a) ka$sul lunak 099999 %u 310 Re#%nol (/%#a) #a-le# 29999 %u 313 R%@am$%s%n ka$le# 99 m! 31 R%@am$%s%n ka$sul 399 m! 312 R%@am$%s%n ka$sul 29 m! 31 R%n!e lak#a# lau#an %n@us s#e%l 316 *al-u#amol #a-le# 0 m! 317 *al-u#amol #a-le# m! 318 *ale$ 0+ kom-%nas% Asam *al%s%la# 0 5 Belean! enda$ 309 *al%s%l -edak 0 301 *e@adoks%l s%u$ ke%n! 102 m!; 2 ml 300 *e@adoks%l ka$sul 029 m! 303 *e@adoks%l ka$sul 299 m! 30 *e@aleks%n ka$sul 029 m! 302 *e@aleks%n ka$sul 299 m! 30 *e@aol%n %n>eks% 1 ! 306 *e@%ks%m ka$sul 199 m! 307 *e@%ks%m s%u$ ke%n! 199 m! ; 2 m! 308 *e@o#aks%m %n>eks% 92 ! 339 *e@#%akson %n>eks% 1! 331 *e@uoks%m se-uk %n>eks% 629 m! ; /%al 330 *%anoko-alam%n (/%#- 10) %n>eks% 299 m"!;ml 333 *%anoko-alam%n (/%#- 10) #a-le# 29 m"! 33 *%me#%d%n #a-le# 099 m! 332 *%m/as#a#%n #a-le# 2 m! 33 *%m/as#a#%n #a-le# 19 m! 336 *%m/as#a#%n #a-le# 09 m! 337 *%$o@loksas%n #a-le# 029 m! 338 *%$o@loksas%n #a-le# 299 m! 39 *$%am%s%n #a-le# 029 m! 31 *$%am%s%n #a-le# 299 m! 30 *$%onolak#on #a-le# 02 m! 33 *$%onolak#on #a-le# 199 m! 3 *#e$#om%s%n sul@a# se-uk %n> 1999 m!;/%al 32 *#e$#om%s%n sul@a# se-uk %n> 1299 m!;/%al 3 *ul@ad%a%n #a-le# 299 m! 36 *ul@ame#oksaol #a-le# 99 m! 37 *ul@asala%n #a-le# 299 m! 38 *ul@ad%m%d%n #a-le# 299 m! 329 *ul@ase#am%da na#%um #e#es ma#a 12 321 Tamoks%@en #a-le# 09 m! 320 Teo@%l%n #a-le# 129 m! 323 Te-ula#al% #a-le# 02 m! 32 Te#aka%n "l #e#es ma#a 92
Ka$sul Lunak Ka$sul Lunak Ta-le# Ka$le# Ka$sul Ka$sul Bo#ol Ta-le# Ta-le# Po# Ko#ak Bo#ol Ka$sul Ka$sul Ka$sul Ka$sul %al Ka$sul Bo#ol %al %al %al Am$ul Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# Ta-le# %al %al Ta-le# Ta-le# Ta-le# Ta-le# Bo#ol Ta-le# Ta-le# Ta-le# Bo#ol
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
322 32 326 327 328 39 31 30 33 3 32 3 36 37 38 369 361 360
1 0 3 2 6 7 8 19 11 10 13 1 12 1 16 17 18 09 01 00 03 0 02
Te#as%kl%n "l ka$sul 029 m! Te#as%kl%n "l ka$sul 299 m! T%am@en%kol ka$sul 029 m! T%am@en%kol ka$sul 299 m! T%am%n "l ( /%# -1) %n> 199 m!;ml+1ml T%am%n "l monon%#a# (/%#-1) #a-le# 29 m! T%o$en#al na#%um se-uk %n> 1999 m! Tamadol %n>eks% 29 m!;ml Tamadol ka$sul 29 m! Ta-le# #am-a daa kom-%nas% : Bes% (II) sul@a# 099m! 5 Asam @ola# 902 m!) T%am%n "l ( /%# -1) %n> 199 m!;ml+1ml T%am%n "l monon%#a# (/%#-1) #a-le# 29 m! T%eks%@en%d%l %doklo%da #a-le# 0 m! T%"odaole 299 m! Ta-le# %#am%n B kom$leks #a-le# od%um $o/%don lau#an 19 39 ml od%um $o/%don lau#an 19 399 ml F%n" 09 m! #a-le#
Da&an#ul Do$lle !el EKG !el Gl%seol H%do!en Peoks%da 3 I"#%ol Fal@ Mul#%/%#am%n anak s&u$ Mul#%/%#am%n de.asa s&u$ O-a# Ku#u Ram-u# Oks%!en !as dalam #a-un! Paa@omalde%d #a-le# 1 ! '*G Gel en#ol%n ; Bao#e" (ne-ulese) od%um Kumu Ra-%es %mmune !lo-ul%n (uman) 129 %u;ml *eum an#% -%sa ula $ol%/alen %n> 2 ml (a-u %) *eum an#% -%sa ula $ol%/alen %n> 29 ml (a-u %%) *eum an#% d%@#e% %n> 09999 %u;/%al (ads) *eum an#% #e#anus %n>1299 %u;am$ul (a#s) *eum an#% #e#anus %n>09999 %u;am$ul (a#s) *us$ens% sen! %nsul%n %n> 9 %u;ml+19 ml (uman) aks%n He$a#%#%s B1 %n> aks%n a-%es /eo aks%n BG aks%n TT
Ka$sul Ka$sul Ka$sul Ka$sul Am$ul Ta-le# Am$ul Am$ul Ka$sul Ta-le# Am$ul Ta-le# Ta-le# Ta-le# Ta-le# Bo#ol Bo#ol Ta-le#
Lem-a Tu-e Tu-e Bo#ol Bo#ol Tu-e Bo#ol Bo#ol Bo#ol Ta-un! Ta-le# Bo#ol Am$ul Bo#ol %al %al %al %al %al %al %al %al %al Am$ul Am$ul
+ + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + +
0 06
aks%n DPT;DPT+HB;DPT+HB+H%O-a# an#% mala%a
Am$ul Ta-le#
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
1 0 3 2 6 7 8 19 11 10 13 1 12 1 16 17 18 09 01 00 03 0 02 0 06 07 08 39 31 30 33 3 32 3 36 37 38 9 1 0 3
Ala# sun#%k sekal% $aka% 1 ml Ala# sun#%k sekal% $aka% 19 ml Ala# sun#%k sekal% $aka% 02 ml Ala# sun#%k sekal% $aka% 3 ml Ala# sun#%k sekal% $aka% 2 ml B%s#u%; P%sau Blood Lan"e# Blood Tan@us%on *e# Blood Tan@us%on *e# a#!u# ; -enan! -eda no 3;9 a#!u# ; -enan! -eda no 3;9 (199 ml) a#!u# ; -enan! -eda no0;9+3;9 =olle& a#e#e No 1 =olle& a#e#e No 1 =olle& a#e#e No 17 Hands"oon no 69 Hands"oon no 62 Hands"oon non s#e%l In@us%on se# anak In@us%on se# de.asa I a#e#e No 17 G I a#e#e No 09 G I a#e#e No 00 G I a#e#e No 0 G ,aum >a%# (-eda) no8 s;d 1 Ka$as -elemak 299 !am Ka$as Pem-alu# Ka$as $em-alu#;a-so-en 1999 !am ; -un!kus Ka$as $em-alu#;a-so-en 029 !am Kasa elas#%s 62 < 0 m Kasa kom$es 9;9 s#e%l Kasa $em-alu# 0 m < 79 "m Kasa $em-alu# < 3 elas#%" Kasa $em-alu# %do@%l m < 12 "m Kasa $em-alu# %do@%l m < 3 "m Kasa s#e%l < 19 "m Ke#as EKG Ke#as med%"%ne $a"k Lan"e#; Lan"%n! de/%"e Lensa T%ssues Needle BD Needle No 03 Pem-alu# !%$s Ples#e 2 &ad < 0 %n"
*e# *e# *e# *e# *e# P"s P"s *e# *e# *a"e# Roll *a"e# P"s
P"s P"s P"s P"s P"s *e# *e# *e# *e# *e# *e# P"s Roll Roll Roll Roll Roll Roll Roll Roll Roll Roll Roll *a"e# *a"e# P"s Bo#ol P"s P"s Roll Roll
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
2 6 7 8 29 21 20 23 2 22
Po# s$u#um Po# '%n *%lk (Benan! Beda *u#ea) No 3;9 *%lk (Benan! Beda *u#ea) No 3;9 (199 m) *l%de M%kosko$ Ta-un! en#%@u!e $&e" Ta-un! Reaks% 10<62 P&e" %n! Nedle No 01 %n! Nedle No 03 %n! Nedle No 02 %n! Nedle No 06
Po# Po# P"s Roll P"s P"s P"s P"s P"s P"s P"s
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
1 0 3 2 6 7 8 19 11 10 13 1 12 1 16 17
Amal!am Po.de H! P;L Asen Pas#a;"aus#%ne# Den#o%# De/%n#e< Pas#a De/%#al%sas% $as#a (non asen) Eu!enol "a%an =%lm on#!en !%!% =u>% I? Glass Ionome "emen# (!" %<) Glass Ionome =u>% II (P;L) Kals%um %doks%da $as#a Monoklokam@e men#ol "a%an Mumm%@&%n! $as#a *emen sen! @os@a# se-uk dan "a%an *%l/e amal!an se-uk 2+62 *$ons !ela#%n "%-%"le "u-%"les 1<1<1 "m Tem$oa& s#o$$%n! @le#"e se-uk dan "a%an T%kesol @omal%n (#k@) "a%an
Bo#ol Ko#ak Po# Bo#ol Bo#ol Bo#ol Ko#ak Bo#ol Bo#ol Bo#ol Ko#ak Bo#ol Bo#ol *e# Bo#ol Ko#ak *e# Bo#ol
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
Bo#ol 1 0 3 2 6 7 8 19 11 10 13 1 12 1 16 17 18 09 01 00 03 0 02 0 06 07 08 39 31 30 33 3 32 3 36 37 38 9 1
Alkool 69 Asam Ase#a# 299 ml Asam klo%da 91 n Asam sul@asal%s%la# 09 EDTA Bu-uk K&ol Lau#an Benned%"# Lau#an Bu@@e Pos$a# P 60 $o G%emsa Lau#an Eos%n 0 Lau#an Es-a" Lau#an E#anol asam Lau#an G%emsa *#a%n Lau#an Ha&em Lau#an H- Po#ome#%k Lau#an Ka-ol =uks%n Lau#an Me#%len B%u Lau#an Ress E"ke (Tom-os%#) Lau#an Tuk Lau#an F%el Neelsen L%sol Me#anol Rea!en An%sol Rea!en An#% H-s A! (s#%k) Rea!en Asam 'a# (*#%$) Rea!en oles#eol Rea!en om-u #es# 19 M u%ne Rea!en om-u Tes# '%n Rea!en ea#%n%ne K%# Rea!en Glu"ose K%# Rea!en Glukosa Daa (s#%$) Rea!en Gol daa A Rea!en Gol daa An#% A Rea!en Gol daa An#% AB Rea!en Gol daa An#% B Rea!en Gol daa B Rea!en Gol daaAB Rea!en Haemo!lo-%n Rea!en HB* A! (*#%k) Rea!en HDL oles#eol (D%e"#) Rea!en T&!l%"e%des K %# Rea!en 'ea R1
ml ml ml ml m! ml ml ml ml ml ml ml ml ml ml ml ml ml ml ml ml ml s#%k s#%$ ml ml ml ml ml *#%$ ml ml ml ml ml ml ml *#%k ml ml ml
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
0 3 2 6 7 8 29 21 20
Rea!en 'ea R0 Rea!en '%d A"%d *al%s%l s$%%#us 19 *$%%#us Tes# Keam%lan ; HG Tes %dal *almonela Paa T&$%a A+H %dal *almonela Paa T&$%a A+O %dal *almonela Paa T&$%a B+H %dal *almonela Paa T&$%a B+O %dal *almonella T&$%a H %dal *almonella T&$%a O
ml ml ml ml P"s ml ml ml ml ml ml
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
Puskesmas Kecamatan Kota Propinsi
No%
: UPT Puskesmas Panarung : Pahandut : Palangka Raya : Kalimantan Tengah
Kode Puskesmas Pelaporan Bulan Permintaan Bulan Tahun
Nama Obat(B)P *edis(Reagen(Bahan Pera+atan ,igi !
#
1
Air untuk Injeksi 25 ml
2
Alopurinol tablet/kapsul/kaplet 100 mg
3
Ambroxol tablet 30 mg
4
Amlodipin tablet 10 mg
&atuan
&tok -+al
Peneri' maan
Perse' diaan
.
4
5
$/405
: 445 : Oktober : Noember : !"#$
Pema' kaian
&tok -khir
1
2/$'1
Permin' taan 3
Vial
+
+
Tablet
+
+
Tablet
4,100
199
10
377
Tablet
+
+
+
5
Antasida *<; I tablet kuna($ kombinasi Aluminium idroksida 200 mg agnesium idroksida 200 mg
Tablet
+
+
+
6
Antasida *<; II suspensi$ kombinasi Aluminium idroksida 200 mg/5 ml agnesium idroksida 200 mg/5 ml
Botol
+
+
+
7
Anti(emoroid$ kombinasi bismut subgalat 150 mg (eksakloro.en 2$5 mg lidokain 10 mg seng oksida 120 mg
Supp
+
+
+
8
Asam Asetilsalisilat asetosal! tablet/kaplet/kapsul 80 mg
Tablet
+
+
+
"
Asam #olat tablet 0$4 mg
10
Asiklo%ir tablet 400 mg
Tablet Tablet
+
+
+
+
+
Tube
+
+
+
Ampul
+
+
+
Tablet
+
+
+
10
19
+
19
10
19
+
19
+
+
+
13
&etametason krim 0$1' sebagai )alerat!
14
*eksametason injeksi i+%+/i+m+ 5 mg/ml
15
*ek sametason tab let 0$5 mg
16
*ia,epam larutan rektal 10 mg/2$5 m-
Tube
17
*ia,epam larutan rektal 5 mg/2$5 m-
Tube
18
*ia,epam tablet 5 mg
+ 1812
+
&eta(istin
+ 72
Sach
&edak salisil serbuk 2'
+ 0999
Tablet
11 12
2,000
Tablet
No%
Nama Obat(B)P *edis(Reagen(Bahan Pera+atan ,igi
&atuan
&tok -+al
Peneri' maan
Perse' diaan
#
!
.
4
5
$/405
Alat ese(atan dan &>
Pema' kaian
&tok -khir
1
Permin' taan
2/$'1
3
+
+
+ 1171
1
Alat suntik sekali pakai 1 ml
Pcs
1,200
1099
18
2
Alat suntik sekali pakai 10 ml
Pcs
200
099
+
099
3
Alat suntik sekali pakai 3 ml
Pcs
2,000
0999
30
187
4
Alat suntik sekali pakai 5 ml
Pcs
600
99
09
279
5
.ixomull stre=t( 5 =m x 5 m
6
In.usion set anak
Pcs
7
In.usion set deBasa
8
I):A C>$ Bit( Bings D port$ no+ 22
"
oll
+
+
20
09
09
Pcs
20
09
09
Pcs
20
09
09
I):A C>$ Bit( Bings D port$ no+ 24
Pcs
20
09
09
10
apas pembalut/absorben 250 gram
oll
150
129
129 399
11
asa pembalut 2 m x 80 =m
oll
300
399
12
Eell 82 gram
Tube
50
29
29
13
Pcs
200
099
099
14
Botol
50
29
29
15
@a.eglo%e xamination lo%es -
Bo!
25
02
02
16
@I- &-A 3/0 ? 26
Pcs
+
+
ang *eminta : Kepala UPT Puskesmas Panarung
ang *enerima Petugas Puskesmas
6amaludin7 -%*d%Kep
-nna Ru8aida
OBAT DANA KAPITASI Puskesmas Kecamatan Kota Propinsi
: UPT Puskesmas Panarung : Pahandut : Palangka Raya : Kalimantan Tengah
Kode Puskesmas Pelaporan Bulan Permintaan Bulan Tahun
No%
Nama Obat(B)P *edis(Reagen(Bahan Pera+atan ,igi
#
!
&atuan
&tok -+al
.
4
Vial
#
Peneri' maan
Perse' diaan
5
$/405
: 445 : Noember : esember : !"#$
Pema' kaian
&tok -khir
1
2/$'1
+
Permin' taan 3
+
1
Air untuk Injeksi 25 ml
2
Alopurinol tablet/kapsul/kaplet 100 mg
Tablet
#
+
3
Ambroxol tablet 30 mg
Tablet
3,4$$
377
4
Amlodipin tablet 10 mg
Tablet
#
+
+
5
Antasida *<; I tablet kuna($ kombinasi Aluminium idroksida 200 mg agnesium idroksida 200 mg
Tablet
#
+
+
6
Antasida *<; II suspensi$ kombinasi Aluminium idroksida 200 mg/5 ml agnesium idroksida 200 mg/5 ml
Botol
#
+
+
7
Anti(emoroid$ kombinasi bismut subgalat 150 mg (eksakloro.en 2$5 mg lidokain 10 mg seng oksida 120 mg
Supp
#
+
+
8
Asam Asetilsalisilat asetosal! tablet/kaplet/kapsul 80 mg
Tablet
#
+
+
"
Asam #olat tablet 0$4 mg
Tablet
#
+
10
Asiklo%ir tablet 400 mg
Tablet
1,%15
1812
+ 1,17$
0319
+ 126
1678
11
&edak salisil serbuk 2'
Sach
#
+
+
12
&eta(istin
Tablet
#
+
+
13
&etametason krim 0$1' sebagai )alerat!
Tube
#
+
+
14
*eksametason injeksi i+%+/i+m+ 5 mg/ml
Ampul
#
+
+
15
*eksametason tablet 0$5 mg
Tablet
#
+
+
16
*ia,epam larutan rektal 10 mg/2$5 m-
Tube
10
19
19
17
*ia,epam larutan rektal 5 mg/2$5 m-
Tube
10
19
19
18
*ia,epam tablet 5 mg
Tablet
#
+
+
No%
Nama Obat(B)P *edis(Reagen(Bahan Pera+atan ,igi
&atuan
&tok -+al
Peneri' maan
Perse' diaan
!
.
4
5
$/405
#
Pema' kaian 1
Permin' taan
2/$'1
+
Alat ese(atan dan &>
&tok -khir
+
3
+
1
Alat suntik sekali pakai 1 ml
Pc s
1,1$1
1171
26
1122
2
Alat suntik sekali pakai 10 ml
Pcs
200
099
20
179
3
Alat suntik sekali pakai 3 ml
Pc s
1,%6$
187
1$0
1677
4
Alat suntik sekali pakai 5 ml
Pcs
5$0
279
26
22
5
.ixomull stre=t( 5 =m x 5 m
oll
#
+
+
6
In.usion set anak
Pcs
20
09
09
7
In.usion set deBasa
Pcs
20
09
09
8
I):A C>$ Bit( Bings D port$ no+ 22
Pcs
20
09
09
"
I):A C>$ Bit( Bings D port$ no+ 24
Pcs
20
09
10
apas pembalut/absorben 250 gram
oll
150
129
6
1
3
086
09
11
asa pembalut 2 m x 80 =m
oll
300
399
12
Eell 82 gram
Tube
50
29
13
Pcs
200
099
14
B otol
50
29
1
8
2
03
4 3
186
15
@a.eglo%e xamination lo%es -
Bo!
25
02
16
@I- &-A 4/0 ? 16
Pcs
#
+
+
17
@I- &-A 5/0 ? 20 *engetahui : Kepala UPT Puskesmas Panarung
Pcs
#
+
+
6amaludin7 -%*d%Kep N9P% #3$1"1"4 #322"! # ""!
ang *enerima Petugas Puskesmas
-nna Ru8aida N9P% #312"2#2 #333". ! ""5
OBAT DANA KAPITASI Puskesmas Kecamatan Kota Propinsi
: UPT Puskesmas Panarung : Pahandut : Palangka Raya : Kalimantan Tengah
Kode Puskesmas Pelaporan Bulan Permintaan Bulan Tahun
No%
Nama Obat(B)P *edis(Reagen(Bahan Pera+atan ,igi
#
!
&atuan
&tok -+al
.
4
Vial
Peneri' maan
Perse' diaan
5
$/405
#
+
: 445 : Oktober : Noember : !"#$
Pema' kaian
&tok -khir
1
2/$'1
Permin' taan 3
+
1
Air untuk Injeksi 25 ml
2
Alopurinol tablet/kapsul/kaplet 100 mg
Tablet
#
+
+
3
Ambroxol tablet 30 mg
Tablet
2,310
0319
0319
4
Amlodipin tablet 10 mg
Tablet
#
+
+
5
Antasida *<; I tablet kuna($ kombinasi Aluminium idroksida 200 mg agnesium idroksida 200 mg
Tablet
#
19999
19999
6
Antasida *<; II suspensi$ kombinasi Aluminium idroksida 200 mg/5 ml agnesium idroksida 200 mg/5 ml
Botol
#
+
+
7
Anti(emoroid$ kombinasi bismut subgalat 150 mg (eksakloro.en 2$5 mg lidokain 10 mg seng oksida 120 mg
Supp
#
500
299
299
8
Asam Asetilsalisilat asetosal! tablet/kaplet/kapsul 80 mg
Tablet
#
+
+
"
Asam #olat tablet 0$4 mg
Tablet
#
1,000
1999
1999
10
Asiklo%ir tablet 400 mg
Tablet
1,7
%$1678
1678
11
&edak salisil serbuk 2'
Sach
#
99
99
12
&eta(istin
Tablet
#
13
&etametason krim 0$1' sebagai )alerat!
Tube
#
14
*eksametason injeksi i+%+/i+m+ 5 mg/ml
Ampul
#
15
*eksametason tablet 0$5 mg
Tablet
#
+
+
16
*ia,epam larutan rektal 10 mg/2$5 m-
Tube
10
19
19
17
*ia,epam larutan rektal 5 mg/2$5 m-
Tube
10
19
19
18
*ia,epam tablet 5 mg
Tablet
#
+
+
10,000
600
+
+
400
99
99
300
399
399
No%
Nama Obat(B)P *edis(Reagen(Bahan Pera+atan ,igi
&atuan
&tok -+al
Peneri' maan
Perse' diaan
!
.
4
5
$/405
#
Pema' kaian 1
+
Alat ese(atan dan &>
1,155
&tok -khir
Permin' taan
2/$'1
+
3
+
1
Alat suntik sekali pakai 1 ml
Pcs
2
Alat suntik sekali pakai 10 ml
Pcs
1$0
179
179
3
Alat suntik sekali pakai 3 ml
Pcs
1,7$$
1677
1677
4
Alat suntik sekali pakai 5 ml
Pcs
554
22
22
5
.ixomull stre=t( 5 =m x 5 m
oll
#
+
+
6
In.usion set anak
Pcs
20
09
09
7
In.usion set deBasa
Pcs
20
09
09
8
I):A C>$ Bit( Bings D port$ no+ 22
Pcs
20
09
09
"
I):A C>$ Bit( Bings D port$ no+ 24
Pcs
20
09
09
10
apas pembalut/absorben 250 gram
oll
144
1
1 086
1122
1122
11
asa pembalut 2 m x 80 =m
oll
2%7
086
12
Eell 82 gram
Tube
46
13
Pcs
1%7
186
186
14
B otol
4%
8
8
15
@a.eglo%e xamination lo%es -
Bo!
23
03
03
16
@I- &-A 4/0 ? 16
Pcs
#
24
0
0
17
@I- &-A 5/0 ? 20 ang *eminta : Kepala UPT Puskesmas Panarung
Pcs
#
24
0
0
6amaludin7 -%*d%Kep N9P #3$1"1"4 #322"! # ""!
ang *enerima Petugas Puskesmas
-nna Ru8aida N9P #312"2#2 #333". ! ""5
Puskesmas Kecamatan Kota Propinsi
: UPT Puskesmas Panarung : Pahandut : Palangka Raya : Kalimantan Tengah
Kode Puskesmas Pelaporan Bulan Permintaan Bulan Tahun
No%
Nama Obat(B)P *edis(Reagen(Bahan Pera+atan ,igi
&atuan
#
!
.
&9&- &TOK P;R .# ;&
PPR
P;N,% 9
<=-*% B-RU
Vial
1
Air untuk Injeksi 25 ml
2
Alopurinol tablet/kapsul/kaplet 100 mg
3
Ambroxol tablet 30 mg
4
Amlodipin tablet 10 mg
5
Antasida *<; I tablet kuna($ kombinasi Aluminium idroksida 200 mg agnesium idroksida 200 mg
Tablet
6
Antasida *<; II suspensi$ kombinasi Aluminium idroksida 200 mg/5 ml agnesium idroksida 200 mg/5 ml
Botol
7 8 " 10 11 12 13 14 15 16 17 18 1" 20 21 22 23 24 25 26 27 28 2" 30 31 32 33 34 35
Anti(emoroid$ kombinasi bismut subgalat 150 mg (eksakloro.en 2$5 mg lidokain 10 mg seng oksida 120 mg Asam Asetilsalisilat asetosal! tablet/kaplet/kapsul 80 mg Asam #olat tablet 0$4 mg Asiklo%ir tablet 400 mg &edak salisil serbuk 2' &eta(istin &etametason krim 0$1' sebagai )alerat! *eksametason injeksi i+%+/i+m+ 5 mg/ml *eks ametason tablet 0$5 mg *ia,epam larutan rektal 10 mg/2$5 m*ia,epam larutan rektal 5 mg/2$5 m *ia,epam tablet 5 mg *i.en(idramin injeksi i+%+/i+m+ 10 mg/ml l! *omperidon suspensi/sirup 5 mg/5 ml *omperidon tablet 10 mg #enobarbital injeksi i+m+/i+%+ 50 mg/ml #itomenadion )it+1! tablet salut gula 10 mg em.ibro,il kapsul/kaplet 300 mg entamis in salep mata 0$3' entamis in tetes mata 0$3' liseril guaakolat tablet 100 mg idroklorotia,id tab 25 mg idrokortison krim 2$5 ' uman tetanus imunoglobulinn injeksi i+m+ 250 I alsium -aktat alk! tablet/kapsul/kaplet 500 mg arbogliserin tetes telinga 10' etokona,ol krim 2' lor.eniramina aleat ! tablet/kapsul/kaplet 4 mg odein tablet 10 mg
Supp Tablet Tablet Tablet Sach Tablet Tube Ampul Tablet Tube Tube Tablet Ampul Botol Tablet Ampul Tablet Kapsul Tube Botol Tablet Tablet Tube Unit Tablet Botol Tube Tablet Tablet
36
ombinasi Injeksi *epot ! edroksi progesteron asetat 25 mg st
Vial
115
5
1
5
37
otrimoksa,ol @uspensi komb @ul.ametoksa,ol 200 mg 9 rimetoprim 40 mg / 5 ml
Botol
300
35
4$
50
38 3" 40 41 42 43 44 45 46 47
-idokain injeksi 2' l! 9 pine.rin 1 80+000 : 2ml -isinopril tablet 5 mg -oratadin tablet 10 mg etildopa tablet salut 250 mg etilprednisolon tablet 4 mg etilprednisolon tablet 8 mg ikona,ol krim/salep 2 ' ;itrat! ;atrium *iklo.enak tablet 50 mg ;i.edipin tablet/kapsul 10 mg ;istatin %aginal tablet 100+000 I/ g
Ampul Tablet Tablet Tablet Tablet Tablet Tube Tablet Tablet Tablet
242 700 $,700
2
3
3
30
50
50
240 400 2,370 $0
7 20 20 10
10 50 20 20
10 50 20 20
Tablet Tablet Tablet 1,000
450 700 650 600
20 50
30 50
30 30
250 300
15
24
24
3 5
5 % 40
10 10 100
10 10 70
10 10 14$ 3$5 2,720 30 1,300 132 140 17,200 3%2 5 $,200 17$ 3%0 5%,%00 1,500
1 20
$ $ 200 5
10
10
50 10 5 150
50 3 10 170
160 5 10 230
K--=U-R&-
51 52 53 54 55 56 57 58 5" 60 61 62 63 64 65 66 67
>aras etamol drop 100 mg/ml >aras etamol tablet 500 mg >irantel tablet s=ore base! 125 mg >rimakuin tablet 15 mg ?anitidin injeks i 25 mg/ml ?anitidin tablet 150 mg ?inger -aktat larutan in.us @e.adroksil kapsul/kaplet 500 mg @e.adroksil sir kering 250 mg/5 [email protected] kapsul/kaplet 100 mg @e.iksim @I?> ?I; 100 mg/5 -
@etiri,in tablet 10 mg @ianokobalamin %itamin &12! injeksi 500 m=g @im%astatin s=ored tablet 10 mg @ipro.loksasin tablet 500 mg sebagai l! iamin )itamin &1! tablet/kapsul/kaplet 50 mg l/ ;itrat! )itamin & kompleks
68
in= tablet dispersible 20 mg
Botol Tablet Tablet Tablet Ampul Tablet Botol Kapsul Botol Kapsul Botol Tablet Ampul Tablet Tablet Tablet Tablet
1$4
6
10
6
7,000 1$
20
30
20
420
10
24,000
Tablet
1,%00
100
5
3
50
40
100
10
No%
Nama Obat(B)P *edis(Reagen(Bahan Pera+atan ,igi
&atuan
#
!
.
&9&- &TOK P;R .# ;&
Alat ese(atan dan &> 1 2 3 4 5 6 7 8 " 10 11 12 13 14 15 16 17
Alat suntik sekali pakai 1 ml Alat suntik sekali pakai 10 ml Alat suntik sekali pakai 3 ml Alat suntik sekali pakai 5 ml .ixomull stre=t( 5 =m x 5 m In.usion set anak In.usion set deBasa I):A C>$ Bit( Bings D port$ no+ 22 I):A C>$ Bit( Bings D port$ no+ 24 apas pembalut/absorben 250 gram asa pembalut 2 m x 80 =m Eell 82 gram
6amaludin7 -%*d%Kep N9P% #3$1"1"4 #322"! # ""!
Pcs Pcs Pcs Pcs oll Pcs Pcs Pcs Pcs oll oll Tube Pcs Botol Bo! Pcs Pcs
1,0$0 100 1,3$0 465 20 20 20 20 134 27% 41 174 3% 16 24 24
5
3
5 5
3
1
2
1
2 1 1
1 3