Laporan Apotek Rawat Jalan Juni 2023 2

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APOTEK RAWAT JALAN

RUMAH SAKIT UMUM DAERAH TEUNGKU PEUKAN
KABUPATEN ACEH BARAT DAYA
BULAN : DESEMBER
TAHUN : 2022
SUMBER DANA : BLUD
Jumlah Pengeluaran Raawat

No. Nama Barang Satuan Stok Awal Penerimaan Sisa Stok Expiry Date Keterangan
Persediaan Jalan
1 2 3 4 5 6 7 9 10 11
NARKOTIK
1 CODEIN TABLET 10 MG TABLET 124 600 724 724 0
2 CODEIN TABLET 15 MG E-KATALOG) TABLET 0 0 0 0 0
3 CODEIN TABLET 20 MG E-KATALOG) AMPUL 607 500 1107 1107 0
4 DUROGESIC 12,5 MU Matrix - Fentanil patch 12,5 mcg/jam PATCH 5 0 5 0 5 Nov-23
5 DUROGESIC 25 mcg/HF -Fentanil patch 25 mcg/jam PATCH 3 0 3 0 3 Dec-23
6 FENTANIL INJEKSI i.m/i.v 0,05 mg/ml, ampul 2 ml AMPUL 0 0 0 0 0
7 MORPHINE HYDROCHLORIDE /MORFIN tablet 10 mg TABLET 0 0 0 0 0
8 MST Continus 10-Morfin tablet lepas lambat 10 mg TABLET 0 0 0 0 0
10 MORFIN INJEKSI 2 mg/mL (1 mL) AMPUL 0 0 0 0 0
11 PETHIDIN HCL Injeksi Ampul 50 mg/ml AMPUL 0 0 0 0 0
PSIKOTROPIK 0
1 ALPRAZOLAM TABLET 0.25 MG TABLET 0 0 0 0 0

3 ALPRAZOLAM TABLET 1 MG TABLET 450 1000 1450 481 969
4 CLOBAZAM TABLET 10 MG/ ASABIUM / CLOFRITIS TABLET 725 1000 1725 1192 533 Apr-25
5 DIAZEPAM TABLET 2 MG TABLET 558 1800 2358 1063 1295
6 DIAZEPAM TABLET 5 MG TABLET 3 0 3 0 3 Dec-24
7 DIAZEPAM INJ 5 mg/ ml (i.v. / i.m.) AMPUL 0 0 0 0 0
8 LORAZEPAM TABLET 0,5 MG/ MERLOPAM TABLET 0 0 0 0 0
9 LORAZEPAM TABLET 1 MG/ RENAQUIL TABLET 0 0 0 0 0
10 LORAZEPAM TABLET 2 MG / MERLOPAM TABLET 2 MG TABLET 353 0 353 129 224
11 MIDAZOLAM injeksi 5 mg/ml (i.v.) / FORTANEST INJ AMPUL 0 0 0 0 0
12 PHENOBARBITAL inj. 50 mg/ml AMPUL 0 0 0 0 0
13 PHENOBARBITAL TABLET 30 MG TABLET 549 0 549 208 341 Apr-23
14 SIBITAL 50 MG- PHENOBARBITAL TABLET 50 MG TABLET 0 0 0 0 0
15 SIBITAL injeksi 200 mg/2 Ml AMPUL 0 0 0 0 0
16 STESOLID - Diazepam larutan rektal 10 mg/2,5 mL TUBE 0 0 0 0 0
0
PREKUSOR FARMASI 0
1 ALERFED TAB -Triploridine HCL 2,5 mg, pseudoephedrine HCL 60 mg TABLET 180 3000 3180 2485 695 Jul-24
2 EFEDRIN HCL INJEKSI- 50 MG/ ML AMPUL 0 0 0 0 0

3 ERGOTAMINE 1 MG + COFFEINE 50 MG TABLET 0 0 0 0 0
4 METIL ERGOMETRIN MALEAT 0,125 MG / METERGIN TABLET 270 100 370 0 370 May-24
5 METIL ERGOMETRINE inj 0,2 mg/ml AMPUL 0 0 0 0 0
LAPIFED SYR -Triploridine HCL 1,35 mg, pseudoephedrine HCL 30 mg
6
setiap 5 Ml
BOTOL 10 60 70 70 0
LAPIFED EXPECTORAN SYRUP -Triprolidine hcl 1,25 mg; pseudoephedrine

7
hcl 15 mg; guaifenesin 100 mg
BOTOL 0 0 0 0 0
LAPIFED DM SYRUP -Triprolidine HCl 1.25 mg, pseudoephedrine HCl 30
mg, dextromethorphan HBr 10 mg
8 BOTOL 54 0 54 54 0
0
OBAT-OBAT TERTENTU 0
1 AMITRIPTILIN HCL TABLET 25 MG TABLET 207 3000 3207 2167 1040 May-26
2 CHLORPROMAZINE TABLET 100 MG TAB/ CPZ TABLET 0 0 0 0 0
3 CHLORPROMAZINE TABLE 25 MG TAB/ CPZ TABLET 649 300 949 112 837 Jul-25
4 CHLORPROMAZINE INJEKSI 5 mg/ml ( i.m.) / CPZ AMPUL 0 0 0 0 0
5 HALLOPERIDOL TABLET 0.5 MG TABLET 0 0 0 0 0 Jul-23
6 HALLOPERIDOL TABLET 1,5 MG TABLET 0 0 0 0 0
7 HALLOPERIDOL TABLET 2 MG TABLET 396 800 1196 960 236 Apr-24
8 HALLOPERIDOL TABLET 5 MG / LODOMER TABLET 0 1100 1100 678 422 Nov-24
9 HALLOPERIDOL 5 MG/INJ (LODOMER INJ) AMPUL 0 0 0 0 0
10 HALLOPERIDOL / HALDOL DECANOAS 50 MG/ML INJ AMPUL 10 0 10 0 10 Mar-23
11 TRIHEKSIFENIDIL TABLET 2MG /THF TABLET 11 1300 1311 897 414 Jun-25
12 TRAMADOL INJ 50 MG AMPUL 0 0 0 0 0
13 TRAMADOL 50 mg capsul CAPSUL 0 0 0 0 0
LAPORAN REKAPAN AMPRAHAN OBAT DAN BAHAN MEDIS HABIS PAKA
APOTEK RAWAT JALAN
BULAN : JANUARI
TAHUN : 2023
SUMBER DANA : BLUD
TANGGAL
NO NAMA OBAT/BMHP SATUAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1 ALBENDAZOLE TAB TABLET
2 ALBENDAZOLE SYR BOTOL
3 ALLOPURINOL 100 MG TABLET
5 ACT (ARTESUNAT/AMODIQUINE/HIDROCLOROTIAZID) TABLET
6 AMBROXOL SYR BOTOL 50 8
7 AMBROXOL TAB TABLET
8 AMINOPHYLLIN TAB 150 MG- DECAFIL TABLET
9 AMINOPHYLLIN TAB 200 MG TABLET
10 AMLODIPINE 10 MG TABLET 500 500 1000 1000 500 500
11 AMLODIPINE 5 MG TABLET 300 300 300
12 AMOXICILIN 500 mg TAB TABLET 600 600
13 AMOXILIN SYR 125mg/ 5ml BOTOL
15 ANADIUM TABLET 300
16 ANDRIOL CAP CAPSUL
17 ANTASIDA SYR BOTOL
18 ANTASIDA TABLET TABLET 2000 1000 1000
19 ANTI HEMOROID SUPP SUPP 30 20 30
20 ANTI FUNGI TUBE
21 AQUA PRO INJEKSI/AQUABIDES VIAL 20
22 ASAM TRANEKSAMAT TAB TABLET 500
23 ASAM FOLAT 1 MG TABLET 500
24 ASAM FOLAT 0,4 MG(AFOLAT ) /PROFOLAT TABLET
25 ASAM SALICILAT KILOGRAM
26 ADALAT OROS - Nifedipin tab 30 mg TABLET
27 ARICEPT EVESS - Donepezil Hcl 10 mg TABLET
28 ASAM MEFENAMAT TAB TABLET
29 ASAM PIPEMIDAT (UROTRACTIN/URINTER)400 MG TABLET 500
30 ASETOSAL 100 TAB TABLET
31 ASETOSAL 80 TAB (CARTYLO/ASPILET)MINIASPI TABLET 100
32 ASIKLOVIR 200 MG TABLET
34 ASIKLOVIR SALAP KULIT TUBE
35 ASIKLOVIR SALAP MATA 3 % cream 5 gr ( LACYVIR) TUBE
36 ATROPIN SULFAS TABLET 0,5 MG TABLET
37 AZITHROMYCIN 500MG TABLET
38 AZITROMYCIN 250 MG TABLET
39 AZITROMYCIN SYR 200 mg/ 5 Ml BOTOL 24
40 ACETYLCYSTEINE 200 MG TABLET 600 600 300
41 APTILL /ALBOTHIL ( POLICRESULEN 36 %) TABLET
42 AVAMYS - Flutikason furoat intranasal Spray FLS
43 AVODART 0,5 MG KAPSOL
44 BEDAQUILINE (MDR) TABLET
45 BERRYVISION TABLET
46 BEROTEC MDI - Fenoterol HBr aerosol 100 mcg/dosis PCS 20 30 18 1000
47 BETAHISTIN MELEAT 6 MG TABLET 500
48 BETAHISTIN MELEAT 24 MG /BETASERC TABLET 300 300 300
49 BETAMETASON KRIM 0,1% TUBE
50 BETA BLOK/ATENOLOL 100 MG TABLET
51 BICNAT/NATRIUM BICARBONAT 500 MG TABLET
52 BISOPROLOL 1,25 MG/ CONCOR TABLET
54 BISOPROLOL 5 MG TABLET
55 BIONEMI TABLET
56 BROMHEXIN TABLET
57 BRONSOLVAN 150 mg (Theophillin) TABLET
58 BURNAZIN CREAM 35 G TUBE
59 BURNAZIN CREAM 500 G POT
60 BACITRACYN 500 IU/g + Polimiksin 10.000 IU/g ZALF /Anti Bak TUBE
61 CANDESARTAN CILEXETIL 16 MG TABLET 600
63 CAPTOPRIL 12,5 MG TABLET
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
64 CAPTOPRIL 25 MG TABLET
65 CARBOGLISERIN TETES TELINGA (PHENOL GLISERIL) BOTOL
66 CARBAMAZEPIN 200 MG TAB/BAMGETOL TABLET
67 CASODEX 150 MG TABLET
68 CEFADROXIL 250 MG TABLET
69 CEFADROXIL 500 MG TABLET 500 500
70 CEFADROXYL SYR 125 MG/5 ML BOTOL
71 CEFADROXYL SYR 250 MG/5 ML BOTOL 60
72 CEFIXIM 100 MG TABLET
73 CEFIXIM 200 MG TABLET 1000 500 1000 1200
74 CEFIXIME SYR sirup kering 100 mg/5 ml BOTOL
75 Cendo Fluorescein 2% MINIDOSE
76 Cendo Bralifex MINIDOSE
77 Cendo Catarlent MINIDOSE 300
78 Cendo Carpine 2% 0,6 ml MINIDOSE
79 Cendo Floxa MINIDOSE 500
80 Cendo lyteers MINIDOSE 300 500 300 200 300 300
81 Cendo Lubricen MINIDOSE
82 Cendo Mydriatil 0,5 % MINIDOSE
83 Cendo Mydriatil 1% BOTOL
84 Cendo Natacen MINIDOSE
85 Cendo Noncort MINIDOSE 300 200
86 Cendo Pantocain 0,5 % MINIDOSE
87 Cendo Pantocain 2% MINIDOSE
88 Cendo Timolol 0,25 % MINIDOSE
89 Cendo timolol 0.5 % MINIDOSE
90 Cendo Tropin 1 % 0,6 ml mini dose MINIDOSE
91 Cendo Vitrolenta MINIDOSE 50 100
92 Cendo xitrol MINIDOSE
93 Cendo xitrol Salep Mata / eye ointment TUBE
94 Cendo Siloksan MINIDOSE
95 Cendo Cenfresh 0,6 ml MINIDOSE
96 Cendo sanbe tear BOTOL
97 Cendo Tobrosan 0,6 ml MINIDOSE
98 Cendo Polydex 0,6 ml MINIDOSE 130
99 Cendo Statrol 0,6 ml MINIDOSE
100 Cendo Polypred MINIDOSE
101 Cendo Protagent A 0,6 ml MINIDOSE 200
102 Cendo P-Pred 10 mg/ 0,6 ml MINIDOSE
103 Cendo Posop 0,6 ml MINIDOSE
104 Cendo Hyalub 0,6 ml MINIDOSE
105 CETERIZIN 10 mg TABLET 1000 1000 1000 1000 1000 1000 1000 1000
106 CETIRIZIN SYR 5 mg/5 ml BOTOL 10
107 CHLORAMPHENICOL 250 MG TABLET
109 CHLORAMPHENICOL 1% SALAP MATA TUBE
110 CHLORAMPHENICOL SYR 125MG/ML BOTOL
111 CHLORAMPHENICOL TETES TELINGA / RECO BOTOL
112 CHLORAMPHENICOL 2% SALAP KULIT(BUFACETIN) TUBE
113 CIPROFLOXACIN TAB 500 MG TABLET
114 CITICOLIN 1000 MG TABLET 1050
115 CITICOLIN 500 MG TABLET 300 1080 540 600 300
116 CILOSTAZOL 100 MG TABLET 300 500
117 CLOFAZIMINE (MDR) TABLET
118 CLOPIDOGREL 75 MG / CPG TABLET 300 600 500 500 500 300
119 CLOZAPINE ( CLORILEX ) 25 MG TABLET 600
120 CLOZAPINE ( CLORILEX ) 100 MG TABLET 300 750
121 COLCHICINE (AR GOUT ) TABLET
122 CECIL PLUS TABLET
123 COMBIVENT NEBULE FLS
124 COTRIMOXAZOL 480 MG TABLET 300
125 COTRIMOXAZOL SYR BOTOL
126 CTM TAB/ ORPHEN TABLET
127 CURCUMA /CAVICUR TABLET 1200 600
128 CYCLOSERINE 250 MG (MDR) TABLET
129 DHAVIT SYR BOTOL
130 DEPAKENE SYR /ASAM VALPROAT 250 mg/5 ml BOTOL 48 48
131 DEPAKOTE 250 MG (Valproat tab 250 mg) TABLET
132 DEPAKOTE ER 250 MG (Valproat tab SR 250 mg) TABLET
133 DIvalproex Sodium 500 TABLET 500 1000 500
134 DEXAMETASON 0,5 MG TABLET 300
135 DEXOCORT 0,25 CREM-Desoksimetason 0,25% 10 G TUBE
136 DESOXYMETASONE CREAM 0,25% 15 G TUBE 50
137 DIGOXIN 0,25 mg TAB TABLET
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
138 DILTIAZEM 30 mg TAB TABLET
139 DIAMICRON MR 60 - Gliklazid tab MR 60mg TABLET
140 DIMENHYDRINAT 50 MG TABLET
141 DOMPERIDONE SYR 5mg/5ml 60 ml BOTOL
142 DOMPERIDONE 10 MG TABLET 900 1000 1000 1000
143 DOPAMET 250 MG- Metildopa tablet salut 250 mg TABLET
144 Divalproex Sodium 250 TABLET
145 DULCOLAKTOL SYR BOTOL
146 DULCOLAX SUPP INFANT - Bisakodil suppositoria 5 mg SUPP
147 DULCOLAX SUPP ADULT - Bisakodil suppositoria 10 mg SUPP
148 DULCOLAX TAB/ MELAXAN/ BISAKODIL 5 MG TABLET
149 D-VIT FT TABLET
150 ELIZAC ( FLUOXETINE ) 20 MG TABLET 180 30 53
151 EPERISON 50 MG TABLET
152 ERITROMISIN 250 MG TABLET
154 ERITROMYCIN SYR Kering 200 mg/ 5 ml BOTOL 50
155 ETAMBUTOL 500 TABLET 500
156 ERDOMEX TABLET
157 ETHAMBUTOL 400 MG (MDR) TABLET
158 ETHIONAMIDE 250 MG (MDR) TABLET
159 EUTHYROX 100 MG - Levotiroksin tablet 100 mcg TABLET
161 FENYTOIN NATRIUM 100 mg TAB TABLET
162 FERRO K SYR BOTOL
163 FLIXOTIDE NEBULE - Flutikason Propionat nebule 0,5 mg PCS
164 FLUCONAZOLE TABLET
165 FLUCONAZOLE INF BOTOL
166 FLUNARIZIN 10 MG TABLET
167 FLUNARIZIN 5 MG TABLET 500
168 FOLAMIL CAPSUL 200
169 FUCILEX OINMENT/ ACDAT-Natrium fusidat krim 20 mg/g 5G TUBE
170 FUROSEMID 40 MG TABLET 400
171 GABAPENTIN 300 MG TABLET
172 GABAPENTIN 100 MG (ALPENTIN) TABLET 1000 1000 1300 1000 1000 1000 1000 1000 1000 1000 2000
173 GEMFIBROZIL 600 MG CAPSUL
175 GENTAMISIN SALAP KULIT 0,1% TUBE 100 100
176 GENTAMISIN SALAP MATA 0,3% TUBE
177 GENTAMISIN TETES MATA 0,3% BOTOL
178 GENTIAN VIOLET BOTOL
179 GLAUSETA-Asetazolamid 250 mg TABLET
180 GLAUCON 250 MG -Asetazolamid 250 mg TABLET
181 GLIBENCLAMIDE 5 MG TABLET
182 GLIKUIDON 30 MG TABLET
183 GLIMEPIRIDE 1 MG TABLET
187 GLISERIL GUAYAKOLAT 100 MG TABLET
188 GLUCOSAMIN TAB / FITBON TABLET 300 600
189 GOFLEX -NABUMETONE 500 MG TABLET
190 GLUCODEX / GLICLAZIDE-Gliklazid tab 80 mg TABLET 500
191 GRISEOFULVIN 500 mg TABLET
193 HARNAL D - TAMSULOSIN HCI 0,2 mg TABLET 280 280 280 280 280 280
194 HARNAL OCAS - TAMSULOSIN HCI 0,4 mg TABLET
195 HERBESSER CD 100 - Diltiazem Kapsul SR 100mg -100 TABLET
197 HIDROKLOROTIAZID/ HCT 25 MG TABLET
198 HIDROKORTISON 2,5% 5 G TUBE
199 HIDROKORTISON 1% - 5G TUBE
200 HYALOPH Eye Drops BOTOL
201 HYTRIN/TERAZOSIN 1MG TABLET
202 HYTROZ/TERAZOSIN 2MG TABLET
HUMALOG MIX 25 KWIKPEN - Analog Insulin Intermediate
203 PEN 30 30 20 30
acting
HUMALOGcombine
MIXwith
50short or long -acting
KWIKPEN AnalogInjInsulin
100 UI/ml
Intermediate
204 PEN
acting
NOVOMIXcombine
30 -with shortinsulinintermediate
Analog or long acting Inj 100 UI/ml
acting combine with
205 PEN
short or long acting inj 100 IU/Ml
206 HUMALOG KWIKPEN- Analog Insulin Fast Acting Inj 100 UI/ml PEN
207 NOVORAPID -Analog Insulin Fast Acting inj 100 IU/ml PEN
208 APIDRA -Analog Insulin Fast Acting inj 100 IU/ml PEN
209 HUMULIN R KWIKPEN -Human Insulin Fast Acting inj 100 IU/ml PEN
210 SANSULIN LOG-G-Analog Insulin Long Acting inj 100 IU/ml PEN
211 LEVEMIR -Analog Insulin Long Acting inj 100 IU/ml PEN
212 LANTUS -Analog Insulin Long Acting inj 100 IU/ml PEN 20
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
213 BASAGLAR -Analog Insulin Long Acting inj 100 IU/ml PEN
214 ENZELIN -Analog Insulin Long Acting inj 100 IU/ml PEN
HUMULIN R KWIKPEN - Human Insulin Short Acting Inj 100
215 PEN
UI/ml
216 HYSTOLAN 20 mg (Isoxsuprine Hcl) TABLET
217 HESROID (EKSTRAK CITRUS AF)/ VERIDIN TABLET
IALUSET PLUS CREAM 100 G- Hyaluronic Acid 2mg, Silver
218 TUBE
Sulfadiazine 10 g
219 IBUPROFEN 200 MG / PROFEN TABLET
220 IBUPROFEN 400 MG TABLET 1000 1000
221 IBUPROFEN 100 mg/5 ml SYR BOTOL
223 ICHTIYOL SALAP TUBE
224 ILIADIN DROPS - Oksimetazolin Tetes Hidung 0.025% BOTOL
225 ILIADIN SPRAY - Oksimetazolin Tetes Hidung 0.050% BOTOL 20
226 INH 100 MG TAB TABLET
227 INH 300 MG TABLET 300 500
228 IRBESARTAN 300 MG TABLET
229 IRBESARTRAN 150 MG TABLET
230 ISDN 5 mg TABLET
232 ISONIAZID 300 MG (MDR) TABLET
233 ISOTIC ADRETOR 0,25% - Timolol tetes mata 0,25 % BOTOL
235 ITRACONAZOLE TABLET 300 300
236 KANAMYCIN INJ 1 GRAM VIAL
237 KA.DICLOFENAK 50 MG TABLET
239 KALSIUM LAKTAT TAB / KALK TABLET
240 KALSIUM ASCORBAT TABLET 500 500
241 KETOPROFEN Supositoria 100 mg/ SUPRAFENID SUPP
242 KANDISTATIN DROP TABLET
243 KENDARON (AMIODARON HCL 200 MG) TABLET
244 KETOCONAZOLE 200 MG TABLET
245 KETOKONAZOL KRIM 2% TUBE
246 KLINDAMICIN 150 MG TABLET
248 KLODERMA KRIM 5 GR- Clobetasol Propionat 0,05% TUBE
249 KLODERMA KRIM 10 GR- Clobetasol Propionat 0,05% TUBE 100 100
250 KLODERMA OINTMEN 5 GR- Clobetasol Propionat 0,05% TUBE
252 KOLKATRIOL/OSTRIOL- Kalsitriol Kapsul Lunak 0,25 mcg TABLET
253 KSR- Kalium Klorida tablet SR 600 mg TABLET
254 LACTO B/ L-BIO SACHET
255 LACTULOSA SYR- 3,335 g/5 mL BOTOL
256 LEVOFLOXACIN 750 MG TABLET
257 LAMICTAL 25 MG - Lamotrigine 25 mg TABLET
258 LANSOPRAZOLE 30 MG CAPSUL 5000 1000 2000 2000 2000 2000 1000 2000 3000 2000
LAXADINE EMULSI/KOMPOLAX -Parafin + gliserin +
259 BOTOL
fenolftalein
260 LEVOFLOXACIN 250 MG (MDR) TABLET
262 LEVOCIN- -Levofloksasin
LEVOPAR AntiparkinsonttsDOEN
mata tablet kombinasi: Benserazid 25 FLS
263 mg + Levodopa 100 mg TABLET
264 LINEZOLID 600 MG (MDR) TABLET
265 LISINOPRIL 10 MG TABLET
267 LOPERAMIDE 2 MG TABLET
268 LORATADINE 10MG TABLET 2500
269 MECOBALAMIN TAB TABLET 2500 2500 2500
270 MELOXICAM 15 MG TABLET 500 1000 1000 1000 1000
271 MELOXICAM 7,5 MG TABLET 1000 300
272 METFORMIN 500 MG TABLET 500 500 500
273 METFORMIN 850 MG TABLET
274 METIL PREDNISOLONE 4 MG TABLET 1000 1000 1000
275 METIL PREDNISOLONE 8 MG TABLET 1000 1000 1000 1000
276 METIL PREDNISOLON 16 MG TABLET
277 METOCLOPRAMIDE10 MG TABLET
278 METRONIDAZOLE 500 MG TABLET
279 METRONIDAZOLE sirup 125 mg/5 ml BOTOL
280 METRONIDAZOLE INFUS 5 mg/ ml BOTOL
281 MICONAZOLE KRIM 2 % (Nitrat) 10 G TUBE 48
282 MICARDIS 40MG - Telmisartan tab 40mg TABLET
284 MOLASMA - Terbutalin tablet 2,5 mg TABLET
285 MOMETASON CREAM 0,1% 10 G TUBE
286 MOXIFLOXACIN (MDR) TABLET
287 NaCL 0,9 % INFUS BOTOL 20
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
288 NATRIUM DIKLOFENAK 25 MG TABLET
289 NATRIUM DIKLOFENAK 50 MG TABLET 2800 2800 2800
290 NASACORT - Triamsinolon asetonid nasal Spray 55 mcg/puff BOTOL
291 NEURODEX / NEUROHAX TAB TABLET 1000 1000 1000
292 NEO-MERCAZOLE- Carbimazole 5 mg TABLET
293 NEW-DIATAB/New Antides - Atapulgite 600 mg tablet TABLET
294 NIPEDIPINE 10 MG TABLET
295 NITROKAF RETARD - Gliseril trinitrat kaps SR 2,5 mg TABLET 1000
296 NITRAL - Gliseril trinitrat tab sublingual 0,5 mg TABLET
297 NORESTIL / PRIMOLUT (NORELUT) TABLET
298 NOTISIL ( WARFARIN 2 MG) TABLET
299 SUKRALFAT SYR - 500 mg / 5 ml, 100 ml BOTOL
300 ULSIDEX - Sukralfat tab 500 mg TABLET
301 NYSTATIN DROPS BOTOL
302 NYSTATIN TAB ORAL 500.000 IU/ g TABLET
303 NYSTATIN VAGINAL TAB 100.000 IU/ g TABLET
304 OAT AWAL 4 FDC Dewasa TABLET 1680
305 OAT LANJUTAN 2 FDC Dewasa/STOP TB KIT TABLET 1680 1344
306 OAT AWAL 3 FDC Anak TABLET
307 OAT LANJUTAN 2 FDC Anak TABLET 1680
308 ETHAMBUTOL PAKET FDC 400MG TABLET
310 STREPTOMYCIN INJ 1 GR PAKET FDC VIAL
311 AQUA PRO INJ PAKET FDC AMPUL
312 OCUFLAM Eye Drops BOTOL
313 OFLOXACIN 200 MG TABLET
315 OFLOXACIN (AKILEN) TETES TELINGA BOTOL
316 OLANZAPINE 10 mg TABLET 150 300
317 OMEPRAZOLE 20 MG CAPSUL
318 ONDANCENTRON 8 MG TABLET 300
319 ONBREZ BREEZHALER CAPSUL
320 ORALIT SACHET
321 OSTEOCAL TABLET
322 OXYTETRACYCLIN SALP KULIT 3 % TUBE
323 PAS ACID 5,52G (MDR) SACHET
324 PARACETAMOL DROP BOTOL
325 PARACETAMOL SYR 120 mg/ 5ml BOTOL
326 PARACETAMOL 500 MG TABLET 1000 2000 1000 1000 3000 2000
327 PIRACETAM 800 mg TABLET 300 500
329 PIRANTEL PAMOAT 125 mg BOTOL
330 PIRANTEL PAMOAT susp 125 mg/5 ml BOTOL
331 PREGABALIN 75 TABLET 420 280
332 PREGABALIN 150 TABLET
333 PK CRYSTAL 50% POT
334 PIOGLITAZONE TABLET
335 PREDNISON 5 MG TABLET
336 POLIDEMISIN EYE DROP BOTOL
337 PROPANOLOL 10 MG TABLET 500
338 PROPANOLOL 40 MG TABLET
339 PROSTER / MISOPROSTOL 200 MG TABLET 300
340 PROPILTIOURASIL / PTU 100 MG TABLET
341 PRAMIFROL ER (PRAMIPEXOLE DIHYDROCHLORIDE) TABLET
342 PIRAZINAMID 400 MG (MDR) TABLET
344 PIRAZINAMID 500 MG TABLET 500
345 PYRIDOXIN - VIT B6 100MG (MDR) TABLET
346 PULMICORT PCS
347 CHLOROQUINE PHOSPHATE TABLET
348 QUINININ 200 MG TABLET
349 RANIVEL 60 ML (RANITIDINE SYR) BOTOL
350 RAMIPRIL 2,5 TABLET
351 RAMIPRIL 5 MG TABLET
353 RANITIDINE 150 MG TABLET 1000 1000 1000
354 RETOP CAPSUL
355 RISPERIDON 1 MG TABLET 500
356 RISPERIDON (PERSIDOL) 2 MG TABLET 1000
357 RISPERIDON 3 MG TABLET
358 REQUIP PD 24 hour -Ropinirole tablet lepas Lambat 4 mg TABLET
361 RETINOL (VITAMIN A) 100.000 IU KAPSUL
362 RIFAMPICIN 300 MG TABLET
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
363 RIFAMPICIN 450 MG TABLET 500
365 SANDEPRIL 50 MG TABLET
366 SAMCOBION CAPSUL
367 SALBUTAMOL 2 MG TABLET 100 45
368 SALBUTAMOL 4 MG TABLET
369 SALBUTAMOL SIRUP BOTOL
370 SALOFALK - Mesalazine 250 mg TABLET
371 SANOSKIN OXY 30 G TUBE
372 SALISYL TALK BUNGKUS
373 SILIDOKSIN 4 MG (URIEF) TABLET 500
374 SCABIMITE CREAM 10 G / SCACID - Permetrin krim 5% TUBE
SERETIDE DISKUS 500 MCG Salmeterol 50 mcg + Flutikason
375 KANISTER
Propionate 500 mcg
SERETIDE DISKUS 250 MCG - Kombinasi: Salmeterol 50 mcg;
376 KANISTER
Flutikason propionat 250 mcg 50
377 KANISTER
Flutikason propionat 100 mcg
378 SEREQUEL XL.200 MG/Quetiapine Fumarate 200 mg TABLET 100
379 SF TAB / Tablet tambah darah TABLET 500
380 SIKZONOATE INJ AMPUL
381 SIMVASTATIN 10 MG TABLET 300
383 SISTENOL- Parasetamol, N-Asetilsistein TABLET
384 SPIRIVA -Tiotropium 18 mcg serbuk inhalasi refill CAPSUL
385 SPIRIVA+ Handihaler -Tiotropium 18 mcg + handihaller PCS
386 SPIRONOLAKTON 100 MG TABLET
387 SPIRONOLAKTON 25 MG TABLET 500
388 SYNARCUS - Flusinolon asetonid krim 0,025% 5 G TUBE
SYMBICORT TURBUHALER 160/4.5 MCG - Budesonide -
389 BOTOL
Formoterol 160/4.5 mcg 120 dosis
STALEVO - Kombinasi: Levodopa 100 mg; Karbidopa 25 mg;
390 TABLET 300
Entekapon 200 mg
391 STELOSI ( TRIFLUOXPERAZIN ) 5 MG TABLET
392 STREPTOMICIN 1 GRAM VIAL 56
393 SUPRAMOX DROP SYR(AMOXCILIN DROP) BOTOL
394 SULFADIAZIN CREAM 1 % 35 G TUBE
395 SULFADOXIN TABLET
396 SOFT U DERM SOFT- Urea krim 10 %, kemasan pot/tube TUBE
397 TAMOFEN 10 Mg (TAMOXIFEN 10 MG) TABLET 60
398 FOROTIC OTIC SOLUTION - Ofloksasin tets telinga 3% BOTOL
399 TB VIT 6 TAB TABLET
400 TELBIVUDIN 600 mg / SEBIVO TABLET
401 THIAMFENIKOL SYR BOTOL
402 THIAMPHENICOL/SOLATHIM CAPSUL
403 TIM-OPHTAL Tetes Mata BOTOL
404 TOPSY- Lidocain, Prilocain 5 g TUBE
405 THYROZOL 5 - Tiamazol tab 5 mg TABLET 300
406 THYROZOL 10 - Tiamazol tab 10 mg TABLET
407 ULTROGESTAN100 mg (Progesteron termikronisasi) TABLET 90
408 URSODEOXYCHOLIC ACID 250 MG TABLET
409 V.BLOC-CARVEDILOL 6.25 MG TABLET
410 VAGIZOL OVULA - Metronidazol ovula 500 mg SUPP
411 VALSARTAN 80 MG TABLET 1200
412 VALSARTAN 160 MG TABLET
413 VASELIN KG 1
414 VENTOLIN INHELER/ SALBULIN APPL
415 VENTOLIN NEBULES AMPUL
416 VELUTINE NEBULES AMPUL
417 VITAMIN K 10 MG TABLET
418 VITAMIN B1 50 MG TABLET 600
419 VITAMIN B 12 50 mcg TABLET
420 VITAMIN B 6 TAB (PIRIDOXIN) 10 mg TABLET 2000
421 VITAMIN B KOMPLEKS TABLET
422 VITAMIN C 50 MG TABLET
424 VIGAMOX- Moksifloksasin tetes mata 0,5% BOTOL
425 XYLOCAINE SPRAY BOTOL
426 ZINK SIRUP 20 mg/5 Ml BOTOL
427 ZINK 20 MG TABLET
428 ZINK OXID TUBE
429 ZINK PRO DROP 10 mg / ml BOTOL
430 ZIDOFUDIN/LAMIVUDDIN/HEPLAV TABLET
431 ZINNAT 250 - Sefuroksim tablet 250 mg TABLET
433 ZALF 24 POT
434 ZONIA / ABILIFY DISCMELT /ARIPIPRAZOLE 10MG TABLET 100 40
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1 ALKOHOL 70 % @ 1 liter PCS

2 ARM SLING (Kain Penyangga Tangan) S PCS
3 ARM SLING (Kain Penyangga Tangan) M PCS
4 ARM SLING (Kain Penyangga Tangan) L PCS
5 COLOSTOMY BAG PCS
6 AQUACELL 10x10 cm PCS
7 GARAM INGGRIS PCS
8 H2O2 3 % LITER 2
9 HANDSCOON NON STERIL S PCS
10 HANDSCOON NON STERIL M PCS
11 HANDSCOON NON STERIL L PCS
12 KAPAS 250 gr PCS
13 KAPSUL KOSONG NO. 0 PCS
14 KAPSUL KOSONG NO. 00 PCS 2000
15 KASA GULUNG 4 x 10 ROL 2000
16 KASA GULUNG 4 x 3 ROL
17 Masker PCS 200
18 Nanopass Needle for pen injeksi Insulin32.5G (0.22x4mm PCS
19 Nanopass Needle for pen injeksi Insulin 34G x 4mm PCS
20 Pot Plastik 100 ml PCS
23 Pot Plastik 40 ml PCS 210
25 Povidon Iodine LITER
26 SANOSKIN/MELLADERM-PLUS TULLE PCS
27 SOFTA MAN / POLI CLEAN (Hand Sanitizer) BOTOL
28 POLI WASH BOTOL
29 SPUIT 1 cc PCS
30 SPUIT 3 cc PCS
31 SPUIT 5 cc PCS
32 SPUIT 5 CC PAKET FDC PCS
33 SPUIT 10 cc PCS
34 SPUIT 20 cc PCS
35 SPUIT 50 cc PCS
36 SPUIT 60 cc PCS
37 WECARE-AH PCS
38 WECARE-DC PCS
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
LAPORAN NARKOTIKA/PSIKOTROPIKA/PREKURSOR FARMASI

APOTEK RAWAT JALAN
N ACEH BARAT DAYA
BULAN : JANUARI
TAHUN : 2023
SUMBER DANA : BLUD
No. Nama Barang Satuan 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

1 2 3
NARKOTIK
1 CODEIN TABLET 10 MG TABLET 500
2 CODEIN TABLET 15 MG E-KATALOG) TABLET
3 CODEIN TABLET 20 MG E-KATALOG) TABLET 500 500 500
4 DUROGESIC 12,5 MU Matrix - Fentanil patch 12,5 mcg/jam PATCH
5 DUROGESIC 25 mcg/HF -Fentanil patch 25 mcg/jam PATCH
6 FENTANIL INJEKSI i.m/i.v 0,05 mg/ml, ampul 2 ml AMPUL
7 MORPHINE HYDROCHLORIDE /MORFIN tablet 10 mg TABLET
8 MST Continus 10-Morfin tablet lepas lambat 10 mg TABLET
10 MORFIN INJEKSI 2 mg/mL (1 mL) AMPUL
11 PETHIDIN HCL Injeksi Ampul 50 mg/ml AMPUL
PSIKOTROPIK
1 ALPRAZOLAM TABLET 0.25 MG TABLET
3 ALPRAZOLAM TABLET 1 MG TABLET
4 CLOBAZAM TABLET 10 MG/ ASABIUM TABLET 500 500
5 DIAZEPAM TABLET 2 MG TABLET 500
6 DIAZEPAM TABLET 5 MG TABLET
7 DIAZEPAM INJ 5 mg/ ml (i.v. / i.m.) AMPUL
8 LORAZEPAM TABLET 0,5 MG/ MERLOPAM TABLET
LORAZEPAM TABLET 1 MG/ RENAQUIL TABLET
10 LORAZEPAM TABLET 2 MG / MERLOPAM TABLET 2 MG TABLET 400
11 MIDAZOLAM injeksi 5 mg/ml (i.v.) / FORTANEST INJ AMPUL
12 PHENOBARBITAL inj. 50 mg/ml AMPUL
13 PHENOBARBITAL TABLET 30 MG TABLET
14 SIBITAL 50 MG- PHENOBARBITAL TABLET 50 MG TABLET
15 SIBITAL injeksi 200 mg/2 Ml AMPUL
16 STESOLID - Diazepam larutan rektal 10 mg/2,5 mL TUBE
PREKUSOR FARMASI
ALERFED TAB -Triploridine HCL 2,5 mg, pseudoephedrine HCL

1 TABLET 300 300 300 300 300
60 mg
2 EFEDRIN HCL INJEKSI- 50 MG/ ML AMPUL
3 ERGOTAMINE 1 MG + COFFEINE 50 MG TABLET
4 METIL ERGOMETRIN MALEAT 0,125 MG / METERGIN TABLET
5 METIL ERGOMETRINE inj 0,2 mg/ml AMPUL
LAPIFED SYR -Triploridine HCL 1,35 mg, pseudoephedrine HCL

6 BOTOL
30 mg setiap 5 Ml
LAPIFED EXPECTORAN SYRUP -Triprolidine hcl 1,25 mg;

7 BOTOL
pseudoephedrine hcl 15 mg; guaifenesin 100 mg
LAPIFED DM SYRUP -Triprolidine HCl 1.25 mg,
pseudoephedrine HCl 30 mg, dextromethorphan HBr 10 mg
8 BOTOL
OBAT-OBAT TERTENTU
1 AMITRIPTILIN HCL TABLET 25 MG TABLET 1000
2 CHLORPROMAZINE TABLET 100 MG TAB/ CPZ TABLET
3 CHLORPROMAZINE TABLE 25 MG TAB/ CPZ TABLET
4 CHLORPROMAZINE INJEKSI 5 mg/ml ( i.m.) / CPZ AMPUL
5 HALLOPERIDOL TABLET 0.5 MG TABLET
6 HALLOPERIDOL TABLET 1,5 MG VIAL
7 HALLOPERIDOL TABLET 2 MG TABLET
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
8 HALLOPERIDOL TABLET 5 MG / LODOMER TABLET 500 300
9 HALLOPERIDOL 5 MG/INJ (LODOMER INJ) AMPUL
10 HALLOPERIDOL (HALDOL DECANOAS) 50 MG/ML INJ AMPUL
11 TRIHEKSIFENIDIL TABLET 2MG /THF TABLET 500 300 500
12 TRAMADOL INJ 50 MG AMPUL
13 TRAMADOL 50 mg capsul CAPSUL
Menyetujui
Kepala Instalasi Farmasi
RSU Teungku Peukan
Kabupaten Aceh Barat Daya
Zulfikar, S.Si., Apt.

Nip. 19780502 2001121 1 005
Mengetahui
Kabid Penunjang Medis
RSU Teungku Peukan
Sukardi, S.Kep
Nip. 19760123 200312 1 001
OBAT DAN BAHAN MEDIS HABIS PAKAI
RAWAT JALAN
DAERAH TEUNGKU PEUKAN
ACEH BARAT DAYA
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
0
0
0
58
0
0
0
4000
300 900 2100
1200
0
0
420 720
0
0
2000 6000
100 180
0
20
500 1000
1000 1500
0
0
0
0
0
500 1000
0
100
0
0
0
0
0
0
0
24
600 1500 3600
0
0
0
0
0
30 1098
500
300 500 1700
0
0
0
0
300 1000 1300
0
0
0
0
0
0
0
540 1140
540
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
1000 1000
0
0
500 1500
0
60
0
1000 4700
0
0
0
300 600
0
500 1000
300 500 2700
0
0
0
0
500
0
0
0
0
0
100 250
0
0
0
0
0
0
130
0
0
200
0
0
0
1000 3000 12000
10
0
0
0
0
0
0
1000 1000
1050
600 1200 4620
800
400 400
500 1000 4200
500 1100
1050
0
0
0
300
0
0
600 1200 3600
0
0
48 144
0
0
500 2500
300
0
50
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
0
0
3900
0
0
0
0
0
0
0
263
500 500
0
0
50
500 1000
0
0
0
0
0
0
0
0
0
0
0
500
200 400
0
400
0
3150 15450
0
0
100 300
0
0
0
0
0
500 500
0
0
0
0
0
0
300 1200
0
300 600 1400
0
0
336 560 2576
0
0
0
0
0
0
0
0
0
50 160
50 50
0
0
0
0
0
0
0
20
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
0
0
0
0
0
1000 3000
0
0
0
0
20
500 500
300 1100
0
0
500 500
0
0
0
0
600
0
0
0
0
1500 2500
0
0
0
0
0
0
1000 1000
0
200
0
0
120 120
0
0
0
0
0
2000 5000 5000 34000
0
0
0
0
0
0
0
0
0
2500
5000 12500
1000 3000 8500
1000 2300
1000 2500
0
3000
1000 3000 8000
0
0
0
0
0
96 144
0
0
0
0
300 300
20
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
2800 11200
0
1500 3000 2400 9900
0
0
0
1000 2000
0
0
0
0
0
0
0
0
1680 3360
3024
0
1680
0
0
0
0
0
0
0
0
300 750
0
1000 1300
0
0
0
0
0
0
0
2000 3000 15000
800
600
0
0
280 560 1540
0
0
0
0
0
500
0
300
0
0
0
600 600
1000 1500
0
0
0
0
0
0
0
0
3600 6600
0
1000 1500
500 1000 2500
0
0
0
0
0
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
500
500 500
0
0
145
0
0
0
0
0
500
0
150
50 50
0
300 400
400 900
0
600 600 1500
500 800
0
0
0
0
500
0
300
300 500 800
56
0
0
0
0
60
0
0
0
0
0
0
0
300
0
90
300 300
0
0
1200
0
1
0
0
0
0
600
0
2000
0
0
0
0
0
0
0
0
0
0
0
0
0
140
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
0
0
0
0
0
2
0
0
0
0
0
2000
2000
0
200
0
0
0
0
0
210
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
OTROPIKA/PREKURSOR FARMASI
RAWAT JALAN
21 22 23 24 25 26 27 28 29 30 31 TOTAL
500
0
500 2000
0
0
0
0
0
0
0
0
0
0
0
0
1000
500
0
0
0
0
400
0
0
200 1000 1200
0
0
0
0
500 500 2500
0
0
0
1000
0
0
0
0
0
500 500
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
500 500 1800
0
0
500 1800
Blangpidie, 01 Februari 2023

Koordinator Apotek Rawat Jalan
RSU Teungku Peukan
Musfizar,Amd.Farm
Nip. 19870920 201103 1 001
Mengetahui
Penunjang Medis
eungku Peukan
n Aceh Barat Daya
kardi, S.Kep
0123 200312 1 001
APOTEK RAWAT JALAN
BULAN : JANUARI
TAHUN : 2023
SUMBER DANA : BLUD

Persediaan Jalan
1 2 3 4 5 6 7 9 10 11
NARKOTIK
1 CODEIN TABLET 10 MG TABLET 0 500 500 378 122 Jul-25
3 CODEIN TABLET 20 MG E-KATALOG) AMPUL 0 2000 2000 1774 226 Nov-26
0 0
PSIKOTROPIK 0 0

3 ALPRAZOLAM TABLET 1 MG TABLET 969 0 969 89 880
5 DIAZEPAM TABLET 2 MG TABLET 1295 500 1795 1669 126 Apr-25
0 0
PREKUSOR FARMASI 0 0

6
setiap 5 Ml
BOTOL 0 0 0 0 0

7
BOTOL 0 0 0 0 0
8 BOTOL 0 0 0 0 0
0 0
OBAT-OBAT TERTENTU 0 0
APOTEK RAWAT JALAN
BULAN : Februari
TAHUN : 2023
SUMBER DANA : BLUD
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
3 ALLOPURINOL 100 MG TABLET 500
6 AMBROXOL SYR BOTOL
12 AMOXICILIN 500 mg TAB TABLET 500
18 ANTASIDA TABLET TABLET 2000 2000 1000
19 ANTI HEMOROID SUPP SUPP 50
20 ANTI FUNGI TUBE
21 AQUA PRO INJEKSI/AQUABIDES VIAL 30
22 ASAM TRANEKSAMAT TAB TABLET
27 ARICEPT EVESS - Donepezil Hcl 10 mg TABLET 336
28 ASAM MEFENAMAT TAB TABLET 1000
31 ASETOSAL 80 TAB (CARTYLO/ASPILET)MINIASPI TABLET
40 ACETYLCYSTEINE 200 MG TABLET 1200
42 AVAMYS - Flutikason furoat intranasal Spray FLS
43 AVODART 0,5 MG KAPSOL
46 BEROTEC MDI - Fenoterol HBr aerosol 100 mcg/dosis PCS 30
47 BETAHISTIN MELEAT 6 MG TABLET 300 300
48 BETAHISTIN MELEAT 24 MG /BETASERC TABLET 300 300
49 BETAMETASON KRIM 0,1% TUBE 100
53 BISOPROLOL 2,5 MG/ CONCOR TABLET 500
55 BIONEMI TABLET
56 BROMHEXIN TABLET
62 CANDESARTAN CILEXETIL 8 MG TABLET 540 600
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
69 CEFADROXIL 500 MG TABLET 500
73 CEFIXIM 200 MG TABLET 2000
74 CEFIXIME SYR sirup kering 100 mg/5 ml BOTOL 25
79 Cendo Floxa MINIDOSE 300
80 Cendo lyteers MINIDOSE 300 400 300 300
85 Cendo Noncort MINIDOSE 300
90 Cendo Tropin 1 % 0,6 ml mini dose MINIDOSE 100
91 Cendo Vitrolenta MINIDOSE 50 50 100
98 Cendo Polydex 0,6 ml MINIDOSE
105 CETERIZIN 10 mg TABLET 2000 1000 1000 1000
106 CETIRIZIN SYR 5 mg/5 ml BOTOL
115 CITICOLIN 500 MG TABLET 600 600 600
116 CILOSTAZOL 100 MG TABLET
118 CLOPIDOGREL 75 MG / CPG TABLET 1000 1000 500
124 COTRIMOXAZOL 480 MG TABLET
127 CURCUMA /CAVICUR TABLET 1200 1200 1200
133 DIvalproex Sodium 500 TABLET 1500 2400
134 DEXAMETASON 0,5 MG TABLET
136 DESOXYMETASONE CREAM 0,25% 15 G TUBE
137 DIGOXIN 0,25 mg TAB TABLET 200
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
142 DOMPERIDONE 10 MG TABLET 500 1000
144 Divalproex Sodium 250 TABLET
147 DULCOLAX SUPP ADULT - Bisakodil suppositoria 10 mg SUPP 50 50
149 D-VIT FT TABLET
150 ELIZAC ( FLUOXETINE ) 20 MG TABLET
151 EPERISON 50 MG TABLET 1000
154 ERITROMYCIN SYR Kering 200 mg/ 5 ml BOTOL
155 ETAMBUTOL 500 TABLET
156 ERDOMEX TABLET
167 FLUNARIZIN 5 MG TABLET 500 1000
171 GABAPENTIN 300 MG TABLET 500 250
172 GABAPENTIN 100 MG (ALPENTIN) TABLET 3150 3150 3150
175 GENTAMISIN SALAP KULIT 0,1% TUBE 50 50 100
179 GLAUSETA-Asetazolamid 250 mg TABLET 500
184 GLIMEPIRIDE 2 MG TABLET 500
188 GLUCOSAMIN TAB / FITBON TABLET 300 300 300 300 300
190 GLUCODEX / GLICLAZIDE-Gliklazid tab 80 mg TABLET
193 HARNAL D - TAMSULOSIN HCI 0,2 mg TABLET 280 280 560 560
198 HIDROKORTISON 2,5% 5 G TUBE 40
203 PEN 50 30
acting
HUMALOGcombine
MIXwith
100 UI/ml
Intermediate
204 PEN 30
acting
NOVOMIXcombine
acting combine with
205 PEN
206 HUMALOG KWIKPEN- Analog Insulin Fast Acting Inj 100 UI/ml PEN 30
207 NOVORAPID -Analog Insulin Fast Acting inj 100 IU/ml PEN 30
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
215 PEN
UI/ml
218 TUBE
Sulfadiazine 10 g
220 IBUPROFEN 400 MG TABLET 700 1000
225 ILIADIN SPRAY - Oksimetazolin Tetes Hidung 0.050% BOTOL
227 INH 300 MG TABLET 500
235 ITRACONAZOLE TABLET 480
239 KALSIUM LAKTAT TAB / KALK TABLET 1000
240 KALSIUM ASCORBAT TABLET
241 KETOPROFEN Supositoria 100 mg/ SUPRAFENID SUPP 60
258 LANSOPRAZOLE 30 MG CAPSUL 2000 1500
259 BOTOL
fenolftalein
263 mg + Levodopa 100 mg TABLET 300
268 LORATADINE 10MG TABLET
269 MECOBALAMIN TAB TABLET 1500 1000 2500
270 MELOXICAM 15 MG TABLET 1000 1500
271 MELOXICAM 7,5 MG TABLET
272 METFORMIN 500 MG TABLET 1000 1000
274 METIL PREDNISOLONE 4 MG TABLET 2000 500
275 METIL PREDNISOLONE 8 MG TABLET 2000 2000
276 METIL PREDNISOLON 16 MG TABLET 500
278 METRONIDAZOLE 500 MG TABLET 1000
279 METRONIDAZOLE Ovula PCS
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
288 NATRIUM DIKLOFENAK 25 MG TABLET 1000 1000
291 NEURODEX / NEUROHAX TAB TABLET 1000 1000 2400
293 NEW-DIATAB/New Antides - Atapulgite 600 mg tablet TABLET 500
299 SUKRALFAT SYR - 500 mg / 5 ml, 100 ml BOTOL
301 NYSTATIN DROPS BOTOL 20
305 OAT LANJUTAN 2 FDC Dewasa/STOP TB KIT TABLET
307 OAT LANJUTAN 2 FDC Anak TABLET
317 OMEPRAZOLE 20 MG CAPSUL 2000 2000 1000 3000 3000 2000 2000
318 ONDANCENTRON 8 MG TABLET
320 ORALIT SACHET
321 OSTEOCAL TABLET
326 PARACETAMOL 500 MG TABLET 2000 1000 2000 2000 2000
327 PIRACETAM 800 mg TABLET
328 PIRACETAM 1200 mg TABLET 1000
331 PREGABALIN 75 TABLET 280 280 560 280
337 PROPANOLOL 10 MG TABLET 400
339 PROSTER / MISOPROSTOL 200 MG TABLET
344 PIRAZINAMID 500 MG TABLET
346 PULMICORT PCS
353 RANITIDINE 150 MG TABLET 500
354 RETOP CAPSUL
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
374 SCABIMITE CREAM 10 G / SCACID - Permetrin krim 5% TUBE 30
375 KANISTER
Propionate 500 mcg
376 KANISTER
Flutikason propionat 250 mcg 50 50
377 KANISTER
378 SEREQUEL XL.200 MG/Quetiapine Fumarate 200 mg TABLET 100
379 SF TAB / Tablet tambah darah TABLET
382 SIMVASTATIN 20 MG TABLET 600 1200
389 BOTOL
Formoterol 160/4.5 mcg 120 dosis 20
390 TABLET 210
Entekapon 200 mg
391 STELOSI ( TRIFLUOXPERAZIN ) 5 MG TABLET 500
392 STREPTOMICIN 1 GRAM VIAL 56
397 TAMOFEN 10 Mg (TAMOXIFEN 10 MG) TABLET
407 ULTROGESTAN100 mg (Progesteron termikronisasi) TABLET
408 URSODEOXYCHOLIC ACID 250 MG TABLET 300
413 VASELIN KG
418 VITAMIN B1 50 MG TABLET
420 VITAMIN B 6 TAB (PIRIDOXIN) 10 mg TABLET
421 VITAMIN B KOMPLEKS TABLET 2000
428 ZINK OXID TUBE
433 ZALF 24 POT
434 ZONIA / ABILIFY DISCMELT /ARIPIPRAZOLE 10MG TABLET 300
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

5 COLOSTOMY BAG PCS
7 GARAM INGGRIS PCS
8 H2O2 3 % LITER
12 KAPAS 250 gr PCS
17 Masker PCS 200
28 POLI WASH BOTOL
29 SPUIT 1 cc PCS
30 SPUIT 3 cc PCS 100
31 SPUIT 5 cc PCS
34 SPUIT 20 cc PCS
35 SPUIT 50 cc PCS
36 SPUIT 60 cc PCS
37 WECARE-AH PCS
38 WECARE-DC PCS
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

APOTEK RAWAT JALAN
N ACEH BARAT DAYA
BULAN : Februari
TAHUN : 2023
SUMBER DANA : BLUD

1 2 3
NARKOTIK
1 CODEIN TABLET 10 MG TABLET 1000
3 CODEIN TABLET 20 MG E-KATALOG) TABLET 500 300
PSIKOTROPIK
4 CLOBAZAM TABLET 10 MG/ ASABIUM TABLET 1000
5 DIAZEPAM TABLET 2 MG TABLET 1000 200
10 LORAZEPAM TABLET 2 MG / MERLOPAM TABLET 2 MG TABLET
PREKUSOR FARMASI

1 TABLET 500 300
60 mg

6 BOTOL 60
30 mg setiap 5 Ml

7 BOTOL 60
8 BOTOL 60
OBAT-OBAT TERTENTU
1 AMITRIPTILIN HCL TABLET 25 MG TABLET 500 500
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
8 HALLOPERIDOL TABLET 5 MG / LODOMER TABLET 100
Menyetujui
RSU Teungku Peukan

Nip. 19780502 2001121 1 005
Mengetahui
RSU Teungku Peukan
Sukardi, S.Kep
Nip. 19760123 200312 1 001
RAWAT JALAN
ACEH BARAT DAYA
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
500
0
0
0
0
0
0
1000 500 3500
500 500 3130
500
0
0
150
0
0
2000 7000
50
0
30
0
1000
0
0
0
336
1000
500 1000
0
0
0
1000 1000
0
0
0
0
0
25
600 1800
0
0
0
0
500 500
30 30 90
600
600 600 1800
100
0
0
0
500
0
0
0
0
0
0
0
600
540 1680
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
0
0
0
500
0
0
0
1000 3000
50 75
0
0
300 500
0
300
500 1800
0
0
0
0
300
0
0
0
0
100
200
0
0
50 50
0
0
0
0
0
0
300
0
0
0
2000 1000 8000
0
0
0
0
0
0
0
0
300 1350
1050 2850
300 300
0
1000 3500
650 1150
600 1200
0
0
0
0
0
0
300 3900
400 400
0
96
0
0
3900
0
0
0
200
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
0
0
1500
0
0
0
0
100
0
0
0
500 1500
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1500
300 500 1100
0
200
750
3150 12600
0
0
200
0
0
0
500
0
0
0
0
500
0
0
0
600 2100
0
0
0
0
392 2072
0
0
0
0
40
0
0
0
0
20 100
30
0
30
30
0
0
0
0
30
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
0
0
0
0
0
1700
0
0
0
0
0
0
500 1000
0
0
0
0
0
0
0
480
0
0
0
500 1500
0
60
0
0
0
12 12
0
0
0
0
0
0
0
0
0
0
0
0
1500 5000
0
500 500
0
0
300
0
0
0
0
0
2500 2500 10000
2500 500 5500
0
600 2600
0
2000 4500
2000 6000
500
0
1000
0
0
96
0
0
0
12 12
0
20
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
2000
2800 6600
0
2400 2400 9200
0
500
0
1000
0
300 300
0
0
0
20
0
0
1680
0
0
0
0
0
0
0
0
0
0
0
300
2000 1000 2000 20000
1050 1050
0
0
0
0
0
0
0
2000 11000
0
1000
0
0
280 140 1820
0
0
0
0
0
400
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2000 2500
0
500 1500
1000 1000 1000 4000
300 300 600
0
0
0
0
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
500
0
0
0
0
0
0
0
0
500
30
150
50
0
200 300
500 500
0
600 1200
1800
0
0
0
0
500
0
50
30
210
1000 1500
56
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
300 600
0
50 50
0
0
0
0
0
0
0
400 400
0
0
2000
0
0
0
0
0
0
0
0
0
0
0
0
300
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
0
0
0
0
0
0
0
0
0
0
2000
2000
0
0
200
0
0
0
0
210
325
0
0
0
0
0
0
100
0
0
100
0
0
0
0
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
RAWAT JALAN
21 22 23 24 25 26 27 28 29 30 31 TOTAL
1000 2000
0
800
0
0
0
0
0
0
0
0
0
0
300 300
0
1000
1000 2200
0
0
0
0
0
0
0
0
0
0
0
0
1000 1800
60
60
60
0
0
500 1500
0
500 500
0
0
0
500 500
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
500 600
0
0
1300
Blangpidie,28 Februari 2023

RSU Teungku Peukan
Musfizar,Amd.Farm
Nip. 19870920 201103 1 001
Mengetahui
Penunjang Medis
eungku Peukan
n Aceh Barat Daya
kardi, S.Kep
0123 200312 1 001
APOTEK RAWAT JALAN
BULAN : FEBRUARI
TAHUN : 2023
SUMBER DANA : BLUD

Persediaan Jalan
1 2 3 4 5 6 7 9 10 11
NARKOTIK
1 CODEIN TABLET 10 MG TABLET 122 2000 2122 597 1525 Nov-26
0 0
PSIKOTROPIK 0 0

3 ALPRAZOLAM TABLET 1 MG TABLET 880 0 880 42 838 May-26
0 0

6
setiap 5 Ml
BOTOL 0 60 60 8 52 Sep-24

7
BOTOL 0 60 60 23 37
8 BOTOL 0 60 60 7 53 Oct-24
0 0
APOTEK RAWAT JALAN
BULAN : Maret
TAHUN : 2023
SUMBER DANA : BLUD
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
10 AMLODIPINE 10 MG TABLET 500 300 1000 1000
11 AMLODIPINE 5 MG TABLET 300 1000
12 AMOXICILIN 500 mg TAB TABLET 1000 1000
15 ANADIUM TABLET 150 300
18 ANTASIDA TABLET TABLET 500 1000 1000 1000 1000
19 ANTI HEMOROID SUPP SUPP
20 ANTI FUNGI TUBE
21 AQUA PRO INJEKSI/AQUABIDES VIAL
23 ASAM FOLAT 1 MG TABLET 500 1000
29 ASAM PIPEMIDAT (UROTRACTIN/URINTER)400 MG TABLET 500 1000
40 ACETYLCYSTEINE 200 MG TABLET 600 900 1200
42 AVAMYS - Flutikason furoat intranasal Spray FLS 20 20
43 AVODART 0,5 MG KAPSOL 300
45 BERRYVISION TABLET 500 500
55 BIONEMI TABLET
56 BROMHEXIN TABLET
61 CANDESARTAN CILEXETIL 16 MG TABLET 300 300 300
62 CANDESARTAN CILEXETIL 8 MG TABLET 300 150 90
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
64 CAPTOPRIL 25 MG TABLET 1000
73 CEFIXIM 200 MG TABLET 1000 1000
77 Cendo Catarlent MINIDOSE
78 Cendo Carpine 2% 0,6 ml MINIDOSE 300
79 Cendo Floxa MINIDOSE 300 300
80 Cendo lyteers MINIDOSE 300 300 500
85 Cendo Noncort MINIDOSE 100 200 200
102 Cendo P-Pred 10 mg/ 0,6 ml MINIDOSE 300 200
105 CETERIZIN 10 mg TABLET 1000 1000 2000 1000 1000 1000
114 CITICOLIN 1000 MG TABLET 500 500
124 COTRIMOXAZOL 480 MG TABLET 500
127 CURCUMA /CAVICUR TABLET 700 1000 1000 1000
133 DIvalproex Sodium 500 TABLET 500 1000
134 DEXAMETASON 0,5 MG TABLET 1000
137 DIGOXIN 0,25 mg TAB TABLET 500
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
144 Divalproex Sodium 250 TABLET 300
148 DULCOLAX TAB/ MELAXAN/ BISAKODIL 5 MG TABLET 150
149 D-VIT FT TABLET
151 EPERISON 50 MG TABLET 500 500 500
154 ERITROMYCIN SYR Kering 200 mg/ 5 ml BOTOL 50
156 ERDOMEX TABLET
170 FUROSEMID 40 MG TABLET
171 GABAPENTIN 300 MG TABLET 2160
175 GENTAMISIN SALAP KULIT 0,1% TUBE 48 288
179 GLAUSETA-Asetazolamid 250 mg TABLET 500 500
183 GLIMEPIRIDE 1 MG TABLET 300 300
188 GLUCOSAMIN TAB / FITBON TABLET 600 600 600
193 HARNAL D - TAMSULOSIN HCI 0,2 mg TABLET 560 280 280
203 PEN 30 30 30 30
acting
HUMALOGcombine
MIXwith
100 UI/ml
Intermediate
204 PEN 30 30
acting
NOVOMIXcombine
acting combine with
205 PEN
206 HUMALOG KWIKPEN- Analog Insulin Fast Acting Inj 100 UI/ml PEN 20 30
211 LEVEMIR -Analog Insulin Long Acting inj 100 IU/ml PEN 20
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
215 PEN
UI/ml
218 TUBE
Sulfadiazine 10 g
220 IBUPROFEN 400 MG TABLET
221 IBUPROFEN 100 mg/5 ml SYR BOTOL 60
225 ILIADIN SPRAY - Oksimetazolin Tetes Hidung 0.050% BOTOL 30
230 ISDN 5 mg TABLET 300
235 ITRACONAZOLE TABLET
238 KA.DICLOFENAK 25 MG TABLET 200
245 KETOKONAZOL KRIM 2% TUBE 48
254 LACTO B/ L-BIO SACHET 100
258 LANSOPRAZOLE 30 MG CAPSUL 3000 1500 1500 1500 2500 3000 1500
259 BOTOL
fenolftalein
269 MECOBALAMIN TAB TABLET 1000 1500 1000 2500 2500
270 MELOXICAM 15 MG TABLET 1000 1000 1000 1000
271 MELOXICAM 7,5 MG TABLET 1000
272 METFORMIN 500 MG TABLET 1000 600 1000
274 METIL PREDNISOLONE 4 MG TABLET 1000
275 METIL PREDNISOLONE 8 MG TABLET 1000 1000 2000 1000 1000 1000
282 MICARDIS 40MG - Telmisartan tab 40mg TABLET 300
285 MOMETASON CREAM 0,1% 10 G TUBE 48 18
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
289 NATRIUM DIKLOFENAK 50 MG TABLET 1000 1000 1000 1000
291 NEURODEX / NEUROHAX TAB TABLET 1000 2000
294 NIPEDIPINE 10 MG TABLET 300 500
299 SUKRALFAT SYR - 500 mg / 5 ml, 100 ml BOTOL 96 96
304 OAT AWAL 4 FDC Dewasa TABLET
305 OAT LANJUTAN 2 FDC Dewasa/STOP TB KIT TABLET 1680
306 OAT AWAL 3 FDC Anak TABLET 1680
316 OLANZAPINE 10 mg TABLET
317 OMEPRAZOLE 20 MG CAPSUL 2000 2000 2000 2000 1000 1000
320 ORALIT SACHET 100
321 OSTEOCAL TABLET
326 PARACETAMOL 500 MG TABLET 2000 2000 2000 10000
331 PREGABALIN 75 TABLET 280 420 700 490 480
334 PIOGLITAZONE TABLET 300
341 PRAMIFROL ER (PRAMIPEXOLE DIHYDROCHLORIDE) TABLET 150
346 PULMICORT PCS
354 RETOP CAPSUL
355 RISPERIDON 1 MG TABLET 1000 1000
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
367 SALBUTAMOL 2 MG TABLET 1000
369 SALBUTAMOL SIRUP BOTOL 60
373 SILIDOKSIN 4 MG (URIEF) TABLET 500 500 500
375 KANISTER
Propionate 500 mcg
376 KANISTER
377 KANISTER
378 Quetiapine Fumarate 200 mg TABLET 100
379 SF TAB / Tablet tambah darah TABLET
387 SPIRONOLAKTON 25 MG TABLET 500 500 600
389 BOTOL
Formoterol 160/4.5 mcg 120 dosis
390 TABLET 600
Entekapon 200 mg
391 STELOSI ( TRIFLUOXPERAZIN ) 5 MG TABLET
392 STREPTOMICIN 1 GRAM VIAL
407 ULTROGESTAN100 mg (Progesteron termikronisasi) TABLET 60 150
411 VALSARTAN 80 MG TABLET 300 600
413 VASELIN KG
421 VITAMIN B KOMPLEKS TABLET 1000
422 VITAMIN C 50 MG TABLET 1000 1000
428 ZINK OXID TUBE
433 ZALF 24 POT
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

5 COLOSTOMY BAG PCS
7 GARAM INGGRIS PCS
8 H2O2 3 % LITER
12 KAPAS 250 gr PCS
17 Masker PCS
28 POLI WASH BOTOL
29 SPUIT 1 cc PCS
30 SPUIT 3 cc PCS
31 SPUIT 5 cc PCS
33 SPUIT 10 cc PCS
34 SPUIT 20 cc PCS
35 SPUIT 50 cc PCS
36 SPUIT 60 cc PCS
37 WECARE-AH PCS
38 WECARE-DC PCS
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

APOTEK RAWAT JALAN
N ACEH BARAT DAYA
BULAN : Maret
TAHUN : 2023
SUMBER DANA : BLUD

1 2 3
NARKOTIK
1 CODEIN TABLET 10 MG TABLET
PSIKOTROPIK
5 DIAZEPAM TABLET 2 MG TABLET 1000
PREKUSOR FARMASI

1 TABLET 1000
60 mg

6 BOTOL
30 mg setiap 5 Ml

7 BOTOL 60
8 BOTOL
OBAT-OBAT TERTENTU
2 CHLORPROMAZINE TABLET 100 MG TAB/ CPZ TABLET 500
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
11 TRIHEKSIFENIDIL TABLET 2MG /THF TABLET 1000
Menyetujui
RSU Teungku Peukan

Nip. 19780502 2001121 1 005
Mengetahui
RSU Teungku Peukan
Sukardi, S.Kep
Nip. 19760123 200312 1 001
RAWAT JALAN
ACEH BARAT DAYA
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
500
0
0
0
0
0
0
500 500 3800
1300
2000
0
0
450
0
0
4500
0
0
15 15
600
1500
0
0
0
0
500 1500
1500
0
0
0
0
0
0
0
0
0
20
2700
0
40
300
0
500 300 1800
50
300 1300
300 300 1500
0
0
0
0
300 300
0
0
0
0
0
0
0
300 1200
540
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
1000
0
0
0
500
1000
0
0
0
500 1000 3500

0
0
24 24
0
300
600
300 300 1000 2700
0
0
0
0
500
0
0
0
0
0
50 151
0
0
0
0
0
0
0
0
0
300
300 200 1000
0
0
1000 8000
0
0
0
0
0
0
0
0
600 1600
300 2700
300 100 1200
0
1000
300 800
500
0
0
0
500
0
0
1000 4700
0
0
96
0
0
1000 2500
1000
0
0
500
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
0
0
1000 3000
0
300
0
0
0
150
0
0
500 2000
0
0
50
1000
0
0
0
0
0
0
0
0
0
0
500
800 1400
200
0
0
2160 4320
9450
0
0
336
0
0
0
1000
0
0
0
600
600
0
0
0
600 2400
0
0
0
0
280 1400
0
0
0
0
0
0
0
0
20 20
120
20 30 110
0
30 80
30
0
0
0
20
30
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
0
0
0
0
0
0
60
0
0
0
30
0
500
0
0
300
0
0
0
0
0
0
0
200
500
0
0
0
0
0
48
0
0
0
0
0
0
0
0
100
0
0
0
3000 3000 3000 23500
0
0
0
0
0
0
0
0
0
0
3400 1000 1000 13900
1000 1000 6000
1000 2000
2600
0
1000 1000 3000
1000 1000 9000
0
0
500
0
0
48
300
0
0
66
0
20
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
2800 4800
2800 6800
0
3000
0
0
800
300 800
0
0
0
192
0
48
0
0
0
840 2520
1680
3360
0
0
56 56
0
0
0
0
0
0
10000
300 300
0
100
0
0
0
0
0
16000
0
1500
0
0
280 420 280 3350
0
0
300
0
0
0
0
0
0
210 360
0
0
0
0
0
0
0
0
0
0
0
1000
0
500 2500
500
500 500
0
0
0
0
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
0
0
1000
500 1100
60
0
0
0
1500
0
150
50
0
100 200
0
10 10
200 800
900
0
0
0
0
1600
0
600
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
210
500
0
0
900
0
0
0
0
0
0
0
0
0
1000
500 2500
0
0
0
0
0
0
0
0
0
0
0
300
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
0
0
0
0
0
0
0
0
0
0
0
2000 2000
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
RAWAT JALAN
21 22 23 24 25 26 27 28 29 30 31 TOTAL
0
0
0
0
0
0
0
0
0
0
0
0
0
300 300
0
1000 1500
500 1500
0
0
0
0
0
0
0
0
0
0
0
0
1000
60 120
60 60
0
0
800
500
0
0
0
0
300 300
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
400
0
0
500 1500
Blangpidie,31 Maret 2023

RSU Teungku Peukan
Musfizar,Amd.Farm
Nip. 19870920 201103 1 001
Mengetahui
Penunjang Medis
eungku Peukan
n Aceh Barat Daya
kardi, S.Kep
0123 200312 1 001
APOTEK RAWAT JALAN
BULAN : FEBRUARI
TAHUN : 2023
SUMBER DANA : BLUD

Persediaan Jalan
1 2 3 4 5 6 7 9 10 11
NARKOTIK
0 0
PSIKOTROPIK 0 0

0 0

6
setiap 5 Ml
BOTOL 52 0 52 37 15 Sep-24

7
BOTOL 37 120 157 108 49
8 BOTOL 53 60 113 66 47 Oct-24
0 0
3 CHLORPROMAZINE TABLE 25 MG TAB/ CPZ TABLET 432 0 432 -82 514 Jul-25
APOTEK RAWAT JALAN
BULAN : APRIL
TAHUN : 2023
SUMBER DANA : BLUD
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
6 AMBROXOL SYR BOTOL 50
7 AMBROXOL TAB TABLET 1000
12 AMOXICILIN 500 mg TAB TABLET
18 ANTASIDA TABLET TABLET 1000 1000
20 ANTI FUNGI TUBE
22 ASAM TRANEKSAMAT TAB TABLET
37 AZITHROMYCIN 500MG TABLET 500
42 AVAMYS - Flutikason furoat intranasal Spray FLS 20
48 BETAHISTIN MELEAT 24 MG /BETASERC TABLET 300 300 600
55 BIONEMI TABLET
56 BROMHEXIN TABLET
60 BACITRACYN 500 IU/g + Polimiksin 10.000 IU/g ZALF /Anti Bak TUBE 100
62 CANDESARTAN CILEXETIL 8 MG TABLET
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
66 CARBAMAZEPIN 200 MG TAB/BAMGETOL TABLET 500
73 CEFIXIM 200 MG TABLET 500 500
76 Cendo Bralifex MINIDOSE 24
79 Cendo Floxa MINIDOSE
80 Cendo lyteers MINIDOSE 300
101 Cendo Protagent A 0,6 ml MINIDOSE
102 Cendo P-Pred 10 mg/ 0,6 ml MINIDOSE 300
105 CETERIZIN 10 mg TABLET 1000 1000 1000 1000 500 1000
115 CITICOLIN 500 MG TABLET 300 300 600 600
118 CLOPIDOGREL 75 MG / CPG TABLET 1000 1500
120 CLOZAPINE ( CLORILEX ) 100 MG TABLET 500 600 500
125 COTRIMOXAZOL SYR BOTOL 50
127 CURCUMA /CAVICUR TABLET 1000 500 1000
130 DEPAKENE SYR /ASAM VALPROAT 250 mg/5 ml BOTOL 48
133 DIvalproex Sodium 500 TABLET 500 1000 1000
136 DESOXYMETASONE CREAM 0,25% 15 G TUBE 100
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
138 DILTIAZEM 30 mg TAB TABLET 300
142 DOMPERIDONE 10 MG TABLET 1000
144 Divalproex Sodium 250 TABLET 500 500
149 D-VIT FT TABLET
150 ELIZAC ( FLUOXETINE ) 20 MG TABLET 1050
151 EPERISON 50 MG TABLET 500 1000
156 ERDOMEX TABLET
159 EUTHYROX 100 MG - Levotiroksin tablet 100 mcg TABLET 400
171 GABAPENTIN 300 MG TABLET 300 600 600 600 600 600
172 GABAPENTIN 100 MG (ALPENTIN) TABLET 3150
175 GENTAMISIN SALAP KULIT 0,1% TUBE
188 GLUCOSAMIN TAB / FITBON TABLET 600
193 HARNAL D - TAMSULOSIN HCI 0,2 mg TABLET
203 PEN 30 50
acting
HUMALOGcombine
MIXwith
100 UI/ml
Intermediate
204 PEN 40
acting
NOVOMIXcombine
acting combine with
205 PEN
206 HUMALOG KWIKPEN- Analog Insulin Fast Acting Inj 100 UI/ml PEN 30
210 Glaritus PEN 10
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
215 PEN
UI/ml
218 TUBE
Sulfadiazine 10 g
220 IBUPROFEN 400 MG TABLET
235 ITRACONAZOLE TABLET 150
239 KALSIUM LAKTAT TAB / KALK TABLET
247 KLINDAMICIN 300 MG TABLET 300
254 LACTO B/ L-BIO SACHET 300
258 LANSOPRAZOLE 30 MG CAPSUL 3000 3000 3000 12000
259 BOTOL
fenolftalein
269 MECOBALAMIN TAB TABLET 1500 2500 1000 1500 2500 2500 1000 1000
272 METFORMIN 500 MG TABLET 500
276 METIL PREDNISOLON 16 MG TABLET 1000
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
288 NATRIUM DIKLOFENAK 25 MG TABLET
291 NEURODEX / NEUROHAX TAB TABLET
295 NITROKAF RETARD - Gliseril trinitrat kaps SR 2,5 mg TABLET 500 500 500 300
299 SUKRALFAT SYR - 500 mg / 5 ml, 100 ml BOTOL 96
305 OAT LANJUTAN 2 FDC Dewasa/STOP TB KIT TABLET 840 840
317 OMEPRAZOLE 20 MG CAPSUL 1000
318 ONDANCENTRON 8 MG TABLET 300 300
320 ORALIT SACHET
321 OSTEOCAL TABLET
326 PARACETAMOL 500 MG TABLET
331 PREGABALIN 75 TABLET 420 420
344 PIRAZINAMID 500 MG TABLET 500
346 PULMICORT PCS
354 RETOP CAPSUL
356 RISPERIDON (PERSIDOL) 2 MG TABLET 1000 500 1000
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
373 SILIDOKSIN 4 MG (URIEF) TABLET 300 500
375 KANISTER
Propionate 500 mcg
376 KANISTER
377 KANISTER
378 Quetiapine Fumarate 200 mg TABLET 120 90
380 SIKZONOATE INJ AMPUL 10
381 SIMVASTATIN 10 MG TABLET
382 SIMVASTATIN 20 MG TABLET
389 BOTOL
390 TABLET
Entekapon 200 mg
391 STELOSI ( TRIFLUOXPERAZIN ) 5 MG TABLET 500 500
411 VALSARTAN 80 MG TABLET 300 300 300 600
413 VASELIN KG 1
420 VITAMIN B 6 TAB (PIRIDOXIN) 10 mg TABLET 2000
421 VITAMIN B KOMPLEKS TABLET 500 500 1000
422 VITAMIN C 50 MG TABLET 1000
428 ZINK OXID TUBE
433 ZALF 24 POT
434 ZONIA / ABILIFY DISCMELT /ARIPIPRAZOLE 10MG TABLET
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

5 COLOSTOMY BAG PCS
7 GARAM INGGRIS PCS
8 H2O2 3 % LITER
12 KAPAS 250 gr PCS
17 Masker PCS
28 POLI WASH BOTOL
29 SPUIT 1 cc PCS
30 SPUIT 3 cc PCS
31 SPUIT 5 cc PCS
33 SPUIT 10 cc PCS
34 SPUIT 20 cc PCS
35 SPUIT 50 cc PCS
36 SPUIT 60 cc PCS
37 WECARE-AH PCS
38 WECARE-DC PCS
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

APOTEK RAWAT JALAN
N ACEH BARAT DAYA
BULAN : Maret
TAHUN : 2023
SUMBER DANA : BLUD

1 2 3
NARKOTIK
PSIKOTROPIK
2 ALPRAZOLAM TABLET 0.5 MG TABLET 500
16 STESOLID - Diazepam larutan rektal 10 mg/2,5 mL TUBE 5
17 STESOLID - Diazepam larutan rektal 5 mg/2,5 mL TUBE 5
PREKUSOR FARMASI

1 TABLET 300 500
60 mg

6 BOTOL 60
30 mg setiap 5 Ml

7 BOTOL 60
8 BOTOL
OBAT-OBAT TERTENTU
1 AMITRIPTILIN HCL TABLET 25 MG TABLET 500
7 HALLOPERIDOL TABLET 2 MG TABLET 300
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
8 HALLOPERIDOL TABLET 5 MG / LODOMER TABLET
11 TRIHEKSIFENIDIL TABLET 2MG /THF TABLET 500 500
Menyetujui
RSU Teungku Peukan

Nip. 19780502 2001121 1 005
Mengetahui
RSU Teungku Peukan
Sukardi, S.Kep
Nip. 19760123 200312 1 001
RAWAT JALAN
ACEH BARAT DAYA
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
500
0
0
50
1000
0
0
500 3000
900
0
0
0
300
0
0
2000
0
0
120 120
0
1500
0
0
0
280 280
500
500
0
0
0
0
0
0
0
500
0
20
1200
0
20
300
0
2000
30
1000
1200
0
0
0
0
500
0
0
0
0
0
0
100
90
0
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
500 500
0
500
0
0
0
0
0
0
1000 2000
50
0
24
300
0
0
300 600
0
0
0
0
300
0
0
0
0
0
100
0
0
0
0
0
0
0
0
0
0
200 500
0
0
2000 7500
0
0
0
0
0
0
0
500 500
300
1800
600
0
2500
900
1600
0
0
0
0
50
0
1000 3500
0
0
48
0
0
2500
0
0
59 159
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
300
0
0
0
1000 2000
0
1000
0
0
0
0
0
1050
1500
0
0
0
1000
0
0
0
400
300
0
0
0
0
0
1000
500 500
300 800
0
100 100
3300
500 3650
0
0
0
0
0
0
500
0
0
0
0
300
0
500
0
600 1200
0
0
0
0
0
0
0
0
0
0
0
0
0
0
30 110
30 70
0
30
40
0
0
10
30
30
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
0
0
0
0
0
0
0
0
0
0
0
0
500
0
0
0
0
0
0
0
300 450
0
0
0
0
0
0
0
0
0
0
0
300
76 76
0
0
0
0
0
300
0
0
0
21000
0
0
0
0
0
0
0
0
0
0
2500 16000
3500
500
500
0
1000 4000
3500
1000
0
500
0
0
96
0
0
0
0
0
20
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
1000 1000 5500
0
0
0
0
0
300 2100
0
0
0
96
0
20
0
0
1680 2520
1680
0
0
0
0
0
0
0
0
0
0
510
1000
600
0
0
0
0
0
0
0
2000 2000
0
0
0
0
420 1260
0
0
0
0
0
0
0
0
0
0
0
0
500
0
0
0
0
0
0
0
0
1000
0
500 2000
2500
1500
0
0
0
0
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
1000
0
0
0
0
0
0
0
0
0
500 1300
30 30
100
0
210
500
10
0
0
0
0
0
900
0
0
20
600 600
1000
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
300
0
0
1500
0
1
0
0
0
0
0
0
2000
300 2300
1000
0
0
0
0
0
0
0
0
0
0
0
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
250 250
0
0
0
0
0
0
0
0
0
0
0
0
100 100
0
0
0
0
0
0
0
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
RAWAT JALAN
21 22 23 24 25 26 27 28 29 30 31 TOTAL
0
0
0
0
0
0
0
0
0
0
0
0
0
500
0
500
1500
0
0
0
0
0
0
0
0
0
0
5
5
300 1100
60
60
60 60
0
0
500
0
0
0
0
0
400 700
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
0
1000
Blangpidie,31 Maret 2023

RSU Teungku Peukan
Musfizar,Amd.Farm
Nip. 19870920 201103 1 001
Mengetahui
Penunjang Medis
eungku Peukan
n Aceh Barat Daya
kardi, S.Kep
0123 200312 1 001
APOTEK RAWAT JALAN
BULAN : APRIL
TAHUN : 2023
SUMBER DANA : BLUD

Persediaan Jalan
1 2 3 4 5 6 7 9 10 11
NARKOTIK
0 0
PSIKOTROPIK 0 0

13 PHENOBARBITAL TABLET 30 MG TABLET 664 0 664 664 0
16 STESOLID - Diazepam larutan rektal 10 mg/2,5 mL TUBE 0 5 5 0 5 Dec-24
0 0

6
setiap 5 Ml
BOTOL 15 60 75 36 39 Sep-24

7
BOTOL 49 60 109 107 2
8 BOTOL 47 60 107 47 60 Oct-24
0 0
2 CHLORPROMAZINE TABLET 100 MG TAB/ CPZ 6 439 0 439 33 406
APOTEK RAWAT JALAN
BULAN : MEI
TAHUN : 2023
SUMBER DANA : BLUD
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
7 AMBROXOL TAB TABLET 500 500
12 AMOXICILIN 500 mg TAB TABLET 500
13 AMOXILIN SYR 125mg/ 5ml BOTOL 50 30
14 AMOXILIN 250 mg Tablet 300
18 ANTASIDA TABLET TABLET
20 ANTI FUNGI TUBE
27 ARICEPT EVESS - Donepezil Hcl 10 mg TABLET 196
28 ASAM MEFENAMAT TAB TABLET 1000 300 500
29 ASAM PIPEMIDAT (UROTRACTIN/URINTER)400 MG TABLET 300 1000
31 ASETOSAL 80 TAB (CARTYLO/ASPILET)MINIASPI TABLET 1000
33 ASIKLOVIR 400 MG TABLET 300
39 AZITROMYCIN SYR 200 mg/ 5 Ml BOTOL
40 ACETYLCYSTEINE 200 MG TABLET 180 300
42 AVAMYS - Flutikason furoat intranasal Spray FLS 20 20
46 BEROTEC MDI - Fenoterol HBr aerosol 100 mcg/dosis PCS 20 30
47 BETAHISTIN MELEAT 6 MG TABLET
53 BISOPROLOL 2,5 MG/ CONCOR TABLET 500 500
55 BIONEMI TABLET
56 BROMHEXIN TABLET
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
66 CARBAMAZEPIN 200 MG TAB/BAMGETOL TABLET 500
72 CEFIXIM 100 MG TABLET 500 500 500
80 Cendo lyteers MINIDOSE 500 300 300 300
105 CETERIZIN 10 mg TABLET 1000 1000 1000
113 CIPROFLOXACIN TAB 500 MG TABLET 500
115 CITICOLIN 500 MG TABLET 600 1050
116 CILOSTAZOL 100 MG TABLET 300
117 CLOFAZIMINE (MDR) TABLET 500
120 CLOZAPINE ( CLORILEX ) 100 MG TABLET
127 CURCUMA /CAVICUR TABLET 1000 500 1000 500 300 1000
133 DIvalproex Sodium 500 TABLET 1200
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
143 DOPAMET 250 MG- Metildopa tablet salut 250 mg TABLET 500
144 Divalproex Sodium 250 TABLET 500
149 D-VIT FT TABLET
156 ERDOMEX TABLET
158 ETHIONAMIDE 250 MG (MDR) TABLET 400
168 FOLAMIL CAPSUL
169 FUCILEX OINMENT/ ACDAT-Natrium fusidat krim 20 mg/g 5G TUBE 50
171 GABAPENTIN 300 MG TABLET 300 600 600 2160
175 GENTAMISIN SALAP KULIT 0,1% TUBE 60
188 GLUCOSAMIN TAB / FITBON TABLET 300 600 600
193 HARNAL D - TAMSULOSIN HCI 0,2 mg TABLET 112
203 PEN 30 30 30 30
acting
HUMALOGcombine
MIXwith
100 UI/ml
Intermediate
204 PEN 20 30
acting
NOVOMIXcombine
acting combine with
205 PEN 30 30
207 NOVORAPID -Analog Insulin Fast Acting inj 100 IU/ml PEN
210 Glaritus PEN
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
215 PEN
UI/ml
218 TUBE
Sulfadiazine 10 g
220 IBUPROFEN 400 MG TABLET 1000
245 KETOKONAZOL KRIM 2% TUBE 48
247 KLINDAMICIN 300 MG TABLET 500
248 KLODERMA KRIM 5 GR- Clobetasol Propionat 0,05% TUBE 50
252 KOLKATRIOL/OSTRIOL- Kalsitriol Kapsul Lunak 0,25 mcg TABLET 1050
258 LANSOPRAZOLE 30 MG CAPSUL 300 3000 2400 2400 2400 2500 4800
259 BOTOL
fenolftalein
260 LEVOFLOXACIN 250 MG (MDR) TABLET 500
264 LINEZOLID 600 MG (MDR) TABLET 300
269 MECOBALAMIN TAB TABLET 2500 1000 2500 2500 2500
274 METIL PREDNISOLONE 4 MG TABLET 1000 1000 1000 1000 1000
283 MICARDIS 80MG - Telmisartan tab 80mg TABLET 300 600
285 MOMETASON CREAM 0,1% 10 G TUBE 50
286 MOXIFLOXACIN (MDR) TABLET 300
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
288 NATRIUM DIKLOFENAK 25 MG TABLET 1000 300 2800
295 NITROKAF RETARD - Gliseril trinitrat kaps SR 2,5 mg TABLET 500 1000 1000
297 NORESTIL / PRIMOLUT (NORELUT) TABLET 150 150
299 SUKRALFAT SYR - 500 mg / 5 ml, 100 ml BOTOL 96 96
301 NYSTATIN DROPS BOTOL
316 OLANZAPINE 10 mg TABLET
317 OMEPRAZOLE 20 MG CAPSUL 1000 600 400
318 ONDANCENTRON 8 MG TABLET 600
321 OSTEOCAL TABLET
326 PARACETAMOL 500 MG TABLET 300 2000 1000 2000
327 PIRACETAM 800 mg TABLET 500
343 PIRAZINAMID 500 MG (MDR) TABLET 500
346 PULMICORT PCS
354 RETOP CAPSUL
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
368 SALBUTAMOL 4 MG TABLET 300
372 SALISYL TALK BUNGKUS 800
375 KANISTER
Propionate 500 mcg
376 KANISTER
377 KANISTER
381 SIMVASTATIN 10 MG TABLET 500 500 500
389 BOTOL
390 TABLET
Entekapon 200 mg
410 VAGIZOL OVULA - Metronidazol ovula 500 mg SUPP 50
411 VALSARTAN 80 MG TABLET 300 300 600 300 300
413 VASELIN KG 1
421 VITAMIN B KOMPLEKS TABLET 1000 1000 1000 1000
423 VITAMIN C 500 MG TABLET 300 500
427 ZINK 20 MG TABLET 500
428 ZINK OXID TUBE
433 ZALF 24 POT
434 ZONIA / ABILIFY DISCMELT /ARIPIPRAZOLE 10MG TABLET
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

5 COLOSTOMY BAG PCS
7 GARAM INGGRIS PCS
8 H2O2 3 % LITER 1
12 KAPAS 250 gr PCS
17 Masker PCS
28 POLI WASH BOTOL
29 SPUIT 1 cc PCS
30 SPUIT 3 cc PCS
31 SPUIT 5 cc PCS
34 SPUIT 20 cc PCS
35 SPUIT 50 cc PCS
36 SPUIT 60 cc PCS
37 WECARE-AH PCS
38 WECARE-DC PCS
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

APOTEK RAWAT JALAN
N ACEH BARAT DAYA
BULAN : Maret
TAHUN : 2023
SUMBER DANA : BLUD

1 2 3
NARKOTIK
PSIKOTROPIK
4 CLOBAZAM TABLET 10 MG/ ASABIUM TABLET 1000 300
PREKUSOR FARMASI

1 TABLET 300 300 300 600
60 mg

6 BOTOL
30 mg setiap 5 Ml

7 BOTOL 60 60
8 BOTOL
OBAT-OBAT TERTENTU
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
11 TRIHEKSIFENIDIL TABLET 2MG /THF TABLET 1000
Menyetujui
RSU Teungku Peukan

Nip. 19780502 2001121 1 005
Mengetahui
RSU Teungku Peukan
Sukardi, S.Kep
Nip. 19760123 200312 1 001
RAWAT JALAN
ACEH BARAT DAYA
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
1000
0
0
0
1000
0
0
1000 1000 4900
1800
500
80
1000 1300
300
0
0
0
0
0
0
500
1000
0
0
0
196
500 2300
500 1800
0
1000
0
300 600
0
0
0
0
0
0
1200 1680
0
40
300
0
400 1400
30 20 100
500 500
300 300 1800
0
0
0
0
500 1500
0
0
0
0
0
0
0
0
0
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
500
0
0
1000
0
0
500 2000
1000 2200
50 50
0
0
200 400
0
0
1400
0
0
0
0
300
0
0
0
0
0
50 200
0
0
0
0
0
0
0
0
0
200
0
0
0
1000 1000 1000 1000 7000
0
0
0
0
0
0
0
500
600
1050 1050 3750
300 600
500
300 5000 7900
500 1000
300 500 800
300 300
0
0
0
0
0
1000 300 5600
0
0
48 96
500 500
0
1200
0
0
0
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
0
0
500 1000 3500
500
1000 1500
0
0
0
0
0
0
500 800
0
0
0
0
0
0
400
300
0
0
0
0
0
0
600 600
1000
300 300
50 100
0
300 300 4260
6400
0
0
50 110
0
0
0
500 1000
0
0
0
0
300 900
0
0
0
600 2100
0
0
0
0
112
0
0
0
0
0
0
0
0
0
30 30 180
30 20 100
60
0
30 30 60
0
0
30 20 50
30
30 50
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
0
0
0
0
0
500 1500
0
0
0
0
0
0
1000
0
0
0
0
0
0
0
300 300
0
0
0
1000
0
0
0
0
0
48
0
500
50 100
0
0
0
1050
0
100 100
0
0
0
2400 2400 2400 2400 4800 32200
0
500
0
0
0
300
0
0
0
0
1000 2500 5000 19500
1000 1000 1000 5800
1000
1000 2000
0
1000 6000
1000 1000 5500
1000 1000
0
500 1500
0
0
96
0
900
0
50 100
300
20
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
4100
1000 6800
0
0
0
0
0
2500
0
300
0
96 48 48 384
0
0
0
0
1680
1680 3360
0
0
0
0
0
0
0
0
0
0
0
1000 3000
600 1200
0
100
0
0
0
0
0
2000 2000 9300
500
500 500
0
0
560 600 2560
0
0
0
0
0
0
0
0
0
0
0
500
0
0
0
0
0
0
0
0
0
1000 3500
0
300 800
500 1000
200 200
0
0
0
0
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
600
0
0
300 800
300
0
400 400
0
800
300
30 30
150
50 50
0
150
400 700
0
1500
300 1300
0
0
0
0
0
0
20
1000
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
600 600
0
50
300 600 2700
0
1
0
0
0
0
0
0
0
300 4300
0
1000 1800
0
0
0
500
0
0
0
0
0
0
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
100
0
0
0
0
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
RAWAT JALAN
21 22 23 24 25 26 27 28 29 30 31 TOTAL
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1300
500 2000
0
0
0
0
0
0
0
0
0
0
0
0
1500
60 60
60 180
60 60
0
0
500 1300
0
0
0
0
0
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
1000
0
0
1000
Blangpidie,31 Mei 2023

RSU Teungku Peukan
Musfizar,Amd.Farm
Nip. 19870920 201103 1 001
Mengetahui
Penunjang Medis
eungku Peukan
n Aceh Barat Daya
kardi, S.Kep
0123 200312 1 001
APOTEK RAWAT JALAN
BULAN : Mei
TAHUN : 2023
SUMBER DANA : BLUD

Persediaan Jalan
1 2 3 4 5 6 7 9 10 11
NARKOTIK
0 0
PSIKOTROPIK 0 0

0 0

6
setiap 5 Ml
BOTOL 39 60 99 51 48 Sep-24

7
BOTOL 2 180 182 150 32
8 BOTOL 60 60 120 85 35 Oct-24
0 0
2 CHLORPROMAZINE TABLET 100 MG TAB/ CPZ 6 406 0 406 86 320
APOTEK RAWAT JALAN
BULAN : JUNI
TAHUN : 2023
SUMBER DANA : BLUD
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
6 AMBROXOL SYR BOTOL 50
12 AMOXICILIN 500 mg TAB TABLET
14 AMOXILIN 250 mg Tablet
15 ANADIUM TABLET
18 ANTASIDA TABLET TABLET
20 ANTI FUNGI TUBE
28 ASAM MEFENAMAT TAB TABLET 500 1000
37 AZITHROMYCIN 500MG TABLET 300
39 AZITROMYCIN SYR 200 mg/ 5 Ml BOTOL
42 AVAMYS - Flutikason furoat intranasal Spray FLS 20
46 BEROTEC MDI - Fenoterol HBr aerosol 100 mcg/dosis PCS 20 20 20
49 BETAMETASON KRIM 0,1% TUBE 50
55 BIONEMI TABLET
56 BROMHEXIN TABLET
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
69 CEFADROXIL 500 MG TABLET 500 500
72 CEFIXIM 100 MG TABLET 500 600 1000
80 Cendo lyteers MINIDOSE
85 Cendo Noncort MINIDOSE
101 Cendo Protagent A 0,6 ml MINIDOSE
105 CETERIZIN 10 mg TABLET 1000 2000 2000
113 CIPROFLOXACIN TAB 500 MG TABLET 500
114 CITICOLIN 1000 MG TABLET
116 CILOSTAZOL 100 MG TABLET 600
127 CURCUMA /CAVICUR TABLET 1000 1000 1000 200
133 DIvalproex Sodium 500 TABLET 1000
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
142 DOMPERIDONE 10 MG TABLET 500 1200 1050
144 Divalproex Sodium 250 TABLET 2000 2000 2000
149 D-VIT FT TABLET
156 ERDOMEX TABLET
171 GABAPENTIN 300 MG TABLET 600 720 600 600
175 GENTAMISIN SALAP KULIT 0,1% TUBE 60 60 48
178 GENTIAN VIOLET BOTOL 10
179 GLAUSETA-Asetazolamid 250 mg TABLET
181 GLIBENCLAMIDE 5 MG TABLET 300
188 GLUCOSAMIN TAB / FITBON TABLET 600 600 600 600 1620
193 HARNAL D - TAMSULOSIN HCI 0,2 mg TABLET
203 PEN 30 30 20 30 30
acting
HUMALOGcombine
MIXwith
100 UI/ml
Intermediate
204 PEN 30 30 30
acting
NOVOMIXcombine
acting combine with
205 PEN 30
207 NOVORAPID -Analog Insulin Fast Acting inj 100 IU/ml PEN 30 30 20 30
210 Glaritus PEN 20
212 LANTUS -Analog Insulin Long Acting inj 100 IU/ml PEN
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
215 PEN
UI/ml
218 TUBE
Sulfadiazine 10 g
220 IBUPROFEN 400 MG TABLET 500 1000 1000
227 INH 300 MG TABLET
247 KLINDAMICIN 300 MG TABLET 300 500
248 KLODERMA KRIM 5 GR- Clobetasol Propionat 0,05% TUBE 144
252 KOLKATRIOL/OSTRIOL- Kalsitriol Kapsul Lunak 0,25 mcg TABLET 300 600 1050 1050
258 LANSOPRAZOLE 30 MG CAPSUL 2400 2400 4800 2400 4800
259 BOTOL
fenolftalein
269 MECOBALAMIN TAB TABLET
270 MELOXICAM 15 MG TABLET 1000 1000 2000
271 MELOXICAM 7,5 MG TABLET 300 1000
275 METIL PREDNISOLONE 8 MG TABLET 1000 1000 1000 1000 1000 2000
277 METOCLOPRAMIDE10 MG TABLET 300
278 METRONIDAZOLE 500 MG TABLET
281 MICONAZOLE KRIM 2 % (Nitrat) 10 G TUBE
283 MICARDIS 80MG - Telmisartan tab 80mg TABLET 600
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
294 NIPEDIPINE 10 MG TABLET 300
295 NITROKAF RETARD - Gliseril trinitrat kaps SR 2,5 mg TABLET 500 1000 1000
299 SUKRALFAT SYR - 500 mg / 5 ml, 100 ml BOTOL 48 96 96 96
316 OLANZAPINE 10 mg TABLET 600
317 OMEPRAZOLE 20 MG CAPSUL 1000
321 OSTEOCAL TABLET
326 PARACETAMOL 500 MG TABLET 1000 2000 2000 2000 2000
346 PULMICORT PCS
354 RETOP CAPSUL
356 RISPERIDON (PERSIDOL) 2 MG TABLET 1000 1000
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
367 SALBUTAMOL 2 MG TABLET 400 500 500
373 SILIDOKSIN 4 MG (URIEF) TABLET 1000 1000
374 SCABIMITE CREAM 10 G / SCACID - Permetrin krim 5% TUBE 30
375 KANISTER
Propionate 500 mcg
376 KANISTER
377 KANISTER
380 SIKZONOATE INJ AMPUL 10 10
389 BOTOL
390 TABLET
Entekapon 200 mg 600
411 VALSARTAN 80 MG TABLET 600 600
412 VALSARTAN 160 MG TABLET 600
413 VASELIN KG 1
418 VITAMIN B1 50 MG TABLET 500
420 VITAMIN B 6 TAB (PIRIDOXIN) 10 mg TABLET 1000 2000
421 VITAMIN B KOMPLEKS TABLET
428 ZINK OXID TUBE
433 ZALF 24 POT
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

5 COLOSTOMY BAG PCS
7 GARAM INGGRIS PCS
8 H2O2 3 % LITER
12 KAPAS 250 gr PCS
17 Masker PCS
28 POLI WASH BOTOL
29 SPUIT 1 cc PCS
30 SPUIT 3 cc PCS
31 SPUIT 5 cc PCS
33 SPUIT 10 cc PCS
34 SPUIT 20 cc PCS
35 SPUIT 50 cc PCS
36 SPUIT 60 cc PCS
37 WECARE-AH PCS
38 WECARE-DC PCS
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

APOTEK RAWAT JALAN
N ACEH BARAT DAYA
BULAN : Maret
TAHUN : 2023
SUMBER DANA : BLUD

1 2 3
NARKOTIK
PSIKOTROPIK
PREKUSOR FARMASI

1 TABLET
60 mg

6 BOTOL 60
30 mg setiap 5 Ml

7 BOTOL 60 60
8 BOTOL 60
OBAT-OBAT TERTENTU
3 CHLORPROMAZINE TABLE 25 MG TAB/ CPZ TABLET 300
TANGGAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
8 HALLOPERIDOL TABLET 5 MG / LODOMER TABLET
Menyetujui
RSU Teungku Peukan

Nip. 19780502 2001121 1 005
Mengetahui
RSU Teungku Peukan
Sukardi, S.Kep
Nip. 19760123 200312 1 001
RAWAT JALAN
ACEH BARAT DAYA
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
0
0
0
50
300 300
0
0
2000 5000
1300
0
0
0
0
0
0
0
0
0
0
500
2000
0
0
0
0
1500
1000 2000
0
500 500
0
900 900
0
0
0
300
0
0
1020
0
20
300 450
0
0
20 80
1000
300 600 1800
50
0
0
0
1000
0
0
0
0
0
0
0
600 900
0
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
0
0
0
1000
0
0
2100
900 1950
50
0
0
300
0
0
0
0
0
0
0
0
0
0
0
0
0
200
0
0
0
0
0
0
0
0
0
0
0
0
0
2000 1000 8000
0
0
0
0
0
0
0
500
600 600
2700
600 1200
0
500 3500
500 1300
300
0
0
0
0
0
0
3200
0
0
48 96
0
0
1000
500 500
0
0
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
0
0
2750
0
4400 10400
0
0
0
0
0
0
150 500 1150
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1000 2000
300
0
300
600 900 4020
6300 15750
0
0
60 12 240
0
0
10
300 300
0
300
0
300 300
500 1500
0
0
0
180 4200
0
0
0
0
0
0
0
0
0
0
0
0
0
0
50 190
90
30
0
20 130
0
0
8 28
0
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
0
0
0
0
0
2500
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
500
0
0
0
0
0
0
0
300 1100
144
0
0
0
600 3600
0
0
0
0
0
4800 9600 31200
0
0
0
0
0
0
0
0
0
0
0
2000 6000
1000 2300
1000 2000
0
4600
2000 1000 10000
0
300
500 500
0
0
48 48 96
0
600 1200
0
0
50 50
20
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
1000 3000
1000 2800 9600
0
0
0
0
300
1000 3500
0
0
0
96 144 576
0
20
0
0
1680
1680
0
1680
0
0
0
0
0
0
0
0
600
1000
0
0
100
0
0
0
0
0
3000 12000
500 500
1400
0
0
960 2248
0
0
0
0
0
0
0
0
0
0
0
0
500 500
0
0
0
0
0
0
0
0
4000
0
2000
2000
1000
0
0
0
0
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
500
0
0
0
1400
0
0
0
0
0
1000 3000
30
200
100
0
300
500
20
1500
1000 3000
0
0
0
400
400
0
20
600
500 1000
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
300 300
0
0
150 1350
600
1
0
0
0
0
500
0
3000
0
0
0
0
0
0
0
0
0
0
0
0
0
200
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
0
0
0
0
0
0
0
0
0
0
0
0
1000
1000
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
RAWAT JALAN
21 22 23 24 25 26 27 28 29 30 31 TOTAL
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
500
300 1700
0
0
0
0
0
0
0
0
0
0
0
0
60 120
60 180
60 120
0
0
300 700
300 300
300 600
0
0
0
0
TANGGAL
TOTAL
21 22 23 24 25 26 27 28 29 30 31
1000 1000
0
0
2000
Blangpidie,31 Mei 2023

RSU Teungku Peukan
Musfizar,Amd.Farm
Nip. 19870920 201103 1 001
Mengetahui
Penunjang Medis
eungku Peukan
n Aceh Barat Daya
kardi, S.Kep
0123 200312 1 001
APOTEK RAWAT JALAN
BULAN : JUNI
TAHUN : 2023
SUMBER DANA : BLUD

Persediaan Jalan
1 2 3 4 5 6 7 9 10 11
NARKOTIK
0 0
PSIKOTROPIK 0 0

0 0
1 ALERFED TAB -Triploridine HCL 2,5 mg, pseudoephedrine HCL 60 mg TABLET 0 0 0 0 0 Dec-99

6
setiap 5 Ml
BOTOL 48 120 168 121 47 Sep-24

7
BOTOL 32 180 212 148 64 Dec-24
8 BOTOL 35 120 155 129 26 Oct-24
0 0

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APOTEK RAWAT JALAN

Jumlah Pengeluaran Raawat

1 CODEIN TABLET 10 MG TABLET 124 600 724 724 0

2 CODEIN TABLET 15 MG E-KATALOG) TABLET 0 0 0 0 0

3 CODEIN TABLET 20 MG E-KATALOG) AMPUL 607 500 1107 1107 0

4 DUROGESIC 12,5 MU Matrix - Fentanil patch 12,5 mcg/jam PATCH 5 0 5 0 5 Nov-23

5 DUROGESIC 25 mcg/HF -Fentanil patch 25 mcg/jam PATCH 3 0 3 0 3 Dec-23

6 FENTANIL INJEKSI i.m/i.v 0,05 mg/ml, ampul 2 ml AMPUL 0 0 0 0 0

7 MORPHINE HYDROCHLORIDE /MORFIN tablet 10 mg TABLET 0 0 0 0 0

8 MST Continus 10-Morfin tablet lepas lambat 10 mg TABLET 0 0 0 0 0

9 MST Continus 15-Morfin tablet lepas lambat 15 mg TABLET 0 0 0 0 0

10 MORFIN INJEKSI 2 mg/mL (1 mL) AMPUL 0 0 0 0 0

11 PETHIDIN HCL Injeksi Ampul 50 mg/ml AMPUL 0 0 0 0 0

1 ALPRAZOLAM TABLET 0.25 MG TABLET 0 0 0 0 0

2 EFEDRIN HCL INJEKSI- 50 MG/ ML AMPUL 0 0 0 0 0

LAPIFED EXPECTORAN SYRUP -Triprolidine hcl 1,25 mg; pseudoephedrine

SUMBER DANA : BLUD

1 ALKOHOL 70 % @ 1 liter PCS

LAPORAN NARKOTIKA/PSIKOTROPIKA/PREKURSOR FARMASI

No. Nama Barang Satuan 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

ALERFED TAB -Triploridine HCL 2,5 mg, pseudoephedrine HCL

2 EFEDRIN HCL INJEKSI- 50 MG/ ML AMPUL

3 ERGOTAMINE 1 MG + COFFEINE 50 MG TABLET

4 METIL ERGOMETRIN MALEAT 0,125 MG / METERGIN TABLET

5 METIL ERGOMETRINE inj 0,2 mg/ml AMPUL

LAPIFED SYR -Triploridine HCL 1,35 mg, pseudoephedrine HCL

LAPIFED EXPECTORAN SYRUP -Triprolidine hcl 1,25 mg;

12 TRAMADOL INJ 50 MG AMPUL

13 TRAMADOL 50 mg capsul CAPSUL

Zulfikar, S.Si., Apt.

500 500 2500

Blangpidie, 01 Februari 2023

Jumlah Pengeluaran Raawat

1 CODEIN TABLET 10 MG TABLET 0 500 500 378 122 Jul-25

2 CODEIN TABLET 15 MG E-KATALOG) TABLET 0 0 0 0 0

3 CODEIN TABLET 20 MG E-KATALOG) AMPUL 0 2000 2000 1774 226 Nov-26

4 DUROGESIC 12,5 MU Matrix - Fentanil patch 12,5 mcg/jam PATCH 5 0 5 0 5 Nov-23

5 DUROGESIC 25 mcg/HF -Fentanil patch 25 mcg/jam PATCH 3 0 3 0 3 Dec-23

6 FENTANIL INJEKSI i.m/i.v 0,05 mg/ml, ampul 2 ml AMPUL 0 0 0 0 0

7 MORPHINE HYDROCHLORIDE /MORFIN tablet 10 mg TABLET 0 0 0 0 0

8 MST Continus 10-Morfin tablet lepas lambat 10 mg TABLET 0 0 0 0 0

9 MST Continus 15-Morfin tablet lepas lambat 15 mg TABLET 0 0 0 0 0

10 MORFIN INJEKSI 2 mg/mL (1 mL) AMPUL 0 0 0 0 0

11 PETHIDIN HCL Injeksi Ampul 50 mg/ml AMPUL 0 0 0 0 0

1 ALPRAZOLAM TABLET 0.25 MG TABLET 0 0 0 0 0

2 EFEDRIN HCL INJEKSI- 50 MG/ ML AMPUL 0 0 0 0 0

LAPIFED EXPECTORAN SYRUP -Triprolidine hcl 1,25 mg; pseudoephedrine

SUMBER DANA : BLUD

1 ALKOHOL 70 % @ 1 liter PCS

LAPORAN NARKOTIKA/PSIKOTROPIKA/PREKURSOR FARMASI

No. Nama Barang Satuan 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

ALERFED TAB -Triploridine HCL 2,5 mg, pseudoephedrine HCL

2 EFEDRIN HCL INJEKSI- 50 MG/ ML AMPUL

3 ERGOTAMINE 1 MG + COFFEINE 50 MG TABLET

4 METIL ERGOMETRIN MALEAT 0,125 MG / METERGIN TABLET

5 METIL ERGOMETRINE inj 0,2 mg/ml AMPUL

LAPIFED SYR -Triploridine HCL 1,35 mg, pseudoephedrine HCL

LAPIFED EXPECTORAN SYRUP -Triprolidine hcl 1,25 mg;

12 TRAMADOL INJ 50 MG AMPUL