RSU CAHAYA MEDIKA

DAFTAR TROLLEY
EMERGENSI

RSU CAHAYA MEDIKA

LACI I
EXP
NO NAMA OBAT
RSU CAHAYA MEDIKA JUMLAH
DATE
Injeksi
LACI II
1 Amiodaron 50 mg/ml inj 4 ampul 01/24
2 Aminophylline Inj 24 mg/ml 3 ampul EXP 03/25
3 NO NAMA ALAT
Asam traneksamak 100 mg/ml JUMLAH
3 ampul DATE01/27
4 Infus
Atropin sulfat 0,25 mg/ml Inj 5 ampul 02/25
5 1 Calsium
Aqua 25Gluconas
ml 10% 23fles
ampul 02/25
05/24
6 2 Dexamethasone
Otsu DextroseInj5% 5 mg/ml
(100 ml) 15fles
ampul 01/25
10/24
7 3 Dextrose 40%
NaCl 0,9 % (100 ml) 2 ampul
1 fles 02/24
04/25
8 4 Dopamin
NaCl 0,9200
%mg/5
(500 ml
ml)inj 22fles
ampul 09/25
08/24
9 5 Dobutamin 25 mg/ml
(500 inj 21fles
ampul 05/26
06/25
Ringer Lactat ml)
10 Diazepam 5 mg/ ml Inj (Valisanbe®) 2 ampul 09/24
07/24
6 Widahes® (500 ml) 1 fles
11 Digoxin 0,25 mg/ml inj (Fargoxin®) 1 ampul 08/24
Alkes
12 Efedrin inj 3 ampul 12/24
1 BD Conecta 2 pcs 12/27
13 Epinephrin 50 mg/ml (kulkas) 5 ampul 06/25
2 Infusion set makro 1 pcs 04/27
14 Meylon 84 1 fles 08/2
3 Infusion set mikro 1 pcs 04/28
15 MgSO4 40%/25 ml 2 fles 09/24
4 I.V.Catheter No.24 1 pcs 09/27
16 Norephinefrin 1 mg/ml inj 2 ampul 05/24
5 I.V.Catheter No.22 1 pcs 03/28
Kepala Unit Farmasi
6 I.V.Cateheter No.20 1 pcs 09/26
7 I.V.Catheter No.18 1 pcs 06/26
8 Perfusor 1 pcs 12/27
9 Spuit 1 cc 2 pcs 11/26
10 Spuit 3 cc 2 pcs 09/27
11 Spuit 5 cc
Apt.Musdalipah.,S.Farm
1 pcs 01/28
12 Spuit 10 cc 1 pcs 02/27
13 Spuit 20 cc 1 pcs 11/27
ugd 14 Spuit 50 cc 1 pcs 04/28
15 Transfusi set 1 pcs 09/27
Kepala Unit Farmasi

Apt.Musdalipah.,S.Farm
Ugd
 RSU CAHAYA MEDIKA

LACI III

EXP
NO NAMA ALAT JUMLAH
DATE
1 Handscoon steril No. 6,5 2 pcs 09/27
2 Handscoon steril No. 7 2 pcs 08/27
3 Ett 6,5 1 pcs 02/28
4 Ett 7,0 1 pcs 07/28
5 Ett 7,5 1 pcs 02/28
6 Nasal canula dewasa 1 pcs 04/28
7 Nasal canula anak 1pcs 01/27
8 Nasal canula bayi 1 pcs 01/25
9 Nebuliser mask dewasa 1 pcs 06/22
10 Nebuliser mask anak 1 pcs 04/27
11 Suction catheter No. 08 1 pcs 03/26
12 Suction catheter No. 16 1 pcs 01/27
13 Stomach tube No. 18 1 pcs 08/26
Kepala Unit Farmasi

Apt.Musdalipah.,S.Farm

ICU
 RSU CAHAYA MEDIKA

DAFTAR TROLLEY
EMERGENSI
RSU CAHAYA MEDIKA
LACI I
RSU CAHAYA MEDIKA EXP
NO NAMA OBAT JUMLAH
DATE
Injeksi
LACI II
1 Amiodaron 50 mg/ml inj 4 ampul 02/24
2 Aminophylline Inj 24 mg/ml 3 ampul EXP 08/25
NO NAMA ALAT JUMLAH
3 Asam traneksamak 100 mg/ml 3 ampul DATE04/27
4InfusAtropin sulfat 0,25 mg/ml Inj 5 ampul 02/25
5 1 Calsium
Aqua 25Gluconas
ml 10% 3 ampul 03/25
2 fles 08/25
6 2 Dexamethasone Inj 5 mg/ml
Otsu Dextrose 5% (100 ml) 5 ampul
1 fles 10/24
01/25
7 3 Dextrose
NaCl 0,940%
% (100 ml) 2 fles
1 fles 02/24
07/25
8 4 Dopamin
NaCl 0,9200
% mg/5 ml inj
(500 ml) 2 ampul 04/26
2 fles 08/24
9 5 Dobutamin 25 mg/ml
Ringer Lactat (500 ml)inj 1 ampul
2 fles 06/25
07/26
10 6 Diazepam
Widahes® 5 mg/
(500ml
ml)Inj (Valisanbe®) 1 fles
2 ampul 12/24
07/24
11Alkes
Digoxin 0,25 mg/ml inj (Fargoxin®) 1 ampul 08/24
12 Efedrin inj 3 ampul 02/28
12/24
1 BD Conecta 2 pcs
13 Epinephrin 50 mg/ml (kulkas) 5 ampul 04/28
06/25
2 Infuset makro 1 pcs
14 Meylon 84 1 ampul 08/24
3 Infuset mikro 1 pcs 03/27
15 MgSO4 40%/25 ml 2 fles 06/25
4 I.V.Catheter No.24 1 pcs 09/27
16 Norephinefrin 1 mg/ml inj 2 ampul 08/24
5 I.V.Catheter No.22 1 pcs 03/28
Kepala Unit Farmasi
6 I.V.Cateheter No.20 1 pcs 10/26
7 I.V.Catheter No.18 1 pcs 04/27
8 perfusor 1 pcs 12/27
9 Spuit 1 cc 2 pcs 04/28
10 Spuit 3 cc 2 pcs 03/28
11 Spuit 5 cc Apt.Musdalipah.,S.Farm
1 pcs 06/28
12 Spuit 10 cc 1 pcs 08/27
13 Spuit 20 cc 1 pcs 02/26
14 Spuit 50 cc 1 pcs 04/28
15 Transfusi set 1 pcs 08/27
TROLLY ICU Kepala Unit Farmasi

Apt.Musdalipah.,S.Farm
TROLLY ICU

RSU CAHAYA MEDIKA

LACI III

EXP
NO NAMA ALAT JUMLAH
DATE
1 Handscoon steril No. 6,5 2 pcs 03/27
2 Handscoon steril No. 7 2 pcs 09/27
3 Ett 6,5 1 pcs 02/28
4 Ett 7,0 1 pcs 08/26
5 Ett 7,5 1 pcs 04/28
6 Nasal canula dewasa 1 pcs 06/27
7 Nasal canula anak 1 pcs 06/27
8 Nasal canula bayi 1 pcs 06/27
9 Nebuliser mask dewasa 1 pcs 06/27
10 Nebuliser mask anak 1 pcs 09/26
11 Suction catheter No. 08 1 pcs 02/28
12 Suction catheter No. 16 1 pcs 07/24
13 Stomach tube No. 18 1 pcs 01/27
Kepala Unit Farmasi

Apt.Musdalipah.,S.Farm
TROLLY HCU

RSU CAHAYA MEDIKA

DAFTAR TROLLEY
EMERGENSI
RSU CAHAYA MEDIKA
LACI I
EXP
NO NAMA OBAT JUMLAH
DATE
Injeksi
1 Amiodaron 50 mg/ml inj 4 ampul 01/24
2 Aminophylline Inj 24 mg/ml 3 ampul 08/25
3 Asam traneksamak 100 mg/ml 3 ampul 04/27
4 Atropin sulfat 0,25 mg/ml Inj 5 ampul 02/25
5 Calsium Gluconas 10% 3 ampul 08/25
6 Dexamethasone Inj 5 mg/ml (1 ml) 5 ampul 10/24
7 Dextrose 40% 2 fles 02/24
8 Dopamin 200 mg/ 5ml inj 2 ampul 08/24
9 Dobutamin 25 mg/ml inj 1 ampul 06/25
Diazepam 5 mg/ml Inj
10 2 ampul 07/24
(Valisanbe®)
11 Digoxin inj (Fargoxin®) 1 ampul 08/24
12 Ephedrin 50 mg/ml inj 3 ampul 12/24
13 Epinephrin 50 mg/ml (kulkas) 5 ampul 06/25
14 Meylon 84 1 fles 08/24
15 MgSO4 40%/25 ml 2 fles 02/25
16 Norephinefrin 1 mg/ml inj 2 ampul 08/24
Kepala Unit Farmasi

Apt. Musdalipah.,S.Farm
TROLLY HCU

RSU CAHAYA MEDIKA

LACI II

EXP
NO NAMA ALAT JUMLAH
DATE
Infus
1 Aqua 25 ml 2 fles 03/25
2 Otsu Dextrose 5% (100 ml) 1 fles 01/25
3 NaCl 0,9 % (100 ml) 1 fles 07/25
4 Nacl 0,9% (500ml) 2 fles 04/26
5 Ringer Lactate 2 fles 07/26
6 Widahes® (500 ml) 1 fles 12/24
Alkes
1 BD Conecta 2 pcs 02/28
2 Infuset makro 1 pcs 02/28
3 Infuset mikro 1 pcs 02/28
4 I.V.Catheter No.24 1 pcs 02/28
5 I.V.Cateheter No.22 1 pcs 10/26
6 I.V.Catheter No.20 1 pcs 04/27
7 I.V Catheter No 18 1 pcs 09/27
8 Perfusor 1 pcs 12/27
9 Spuit 1 cc 2 pcs 04/28
10 Spuit 3 cc 2 pcs 03/28
11 Spuit 5 cc 1 pcs 06/28
12 Spuit 10 cc 1 pcs 08/27
13 Spuit 20 cc 1 pcs 02/26
14 Spuit 50 cc 1 pcs 04/28
15 Transfusion set 1 pcs 08/27
Kepala Unit Farmasi

Apt. Musdalipah.,S.Farm
TROLLY HCU

RSU CAHAYA MEDIKA

LACI III

EXP
NO NAMA ALAT JUMLAH
DATE
1 Handscoon steril No.6,5 2 pcs 09/27
2 Handscoon steril No. 7 2 pcs 09/27
3 Ett 6,5 1 pcs 8/26
4 Ett 7,0 1 pcs 8/26
5 Ett 7,5 1 pcs 8/26
6 Nasal canula dewasa 1 pcs 04/28
7 Nasal canula anak 1 pcs 06/27
8 Nasal canula bayi 1 pcs 06/27
9 Nebuliser mask dewasa 1 pcs 09/26
10 Nebuliser mask anak 1 pcs 09/26
11 Suction catheter No. 08 1 pcs 02/28
12 Suction catheter No. 16 1 pcs 07/24
13 Stomach tube No. 16 1 pcs 01/27
Kepala Unit Farmasi

Apt.Musdalipah.,S.Farm
BOX EMERGENCY OK

RSU CAHAYA MEDIKA

LACI I
EXP
NO NAMA OBAT JUMLAH
DATE
Injeksi
1 Amiodaron 50 mg/ml inj 4 ampul 02/24
2 Aminophylline Inj 24 mg/ml 2 ampul 08/25
3 Asam traneksamak 100 mg/ml 3 ampul 01/27
4 Atropin sulfat 0,25 mg/ml Inj 3 ampul 10/24
5 Calsium Gluconas 10% 3 ampul 08/25
6 Dexamethasone Inj 5 mg/ml (1 ml) 5 ampul 06/24
7 Dextrose 40% 2 ampul 07/24
8 Dopamin 200 mg/ 5ml inj 2 ampul 03/24
9 Dobutamin 25 mg/ml inj 1 ampul 06/25
Diazepam 5mg/ ml Inj
10 2 ampul 12/23
(Valisanbe®)
11 Digoxin inj (Fargoxin®) 1 ampul 08/24
12 Ephedrin 50 mg/ml inj 3 ampul 12/24
13 Epinephrin 50 mg/ml (kulkas) 5 ampul 06/25
14 Meylon 84 1 ampul 08/24
15 MgSO4 40%/25 ml 2 fles 09/24
16 Norephinefrin 1 mg/ml inj 2 ampul 05/24
Kepala Unit Farmasi

Apt. Musdalipah.,S.Farm
Box emergency OK

RSU CAHAYA MEDIKA

LACI II

EXP
NO NAMA ALAT JUMLAH
DATE
Infus
1 Aqua 25 ml 2 fles 02/25
2 Dextrose 5% (100 ml) 1 fles 01/25
3 NaCl 0,9 % (100 ml) 1 fles 04/25
4 Widahes (500 ml) 1 fles 12/24
Alkes
1 BD Conecta 2 pcs 08//27
2 ETT 6,5 1 pcs 02/28
3 ETT 7 1 pcs 07/28
4 ETT 7,5 1 pcs 02/28
5 Infus set dewasa 1 pcs 07/27
6 I.V.Catheter No.24 1 pcs 10/26
7 I.V.Catheter No.22 1 pcs 10/26
8 I.V.Cateheter No.20 1 pcs 07/26
9 I.V.Catheter No.18 1 pcs 09/26
10 Perfusor 1 pcs 12/27
11 Spuit 1 cc 2 pcs 11/27
12 Spuit 3 cc 2 pcs 02/28
13 Spuit 5 cc 1 pcs 12/27
14 Spuit 10 cc 1 pcs 02/28
15 Spuit 20 cc 1 pcs 12/26
16 Spuit 50 cc 1 pcs 04/28
17 Transfusion set 1 pcs 08/27

Kepala Unit Farmasi

Apt. Musdalipah.,S.Farm
 BOX EMERGENCY PERAWATAN LANTAI 2

RSU CAHAYA MEDIKA

DAFTAR TROLLEY
EMERGENSI
RSU CAHAYA MEDIKA
LACI I
EXP
NO NAMA OBAT JUMLAH
DATE
Injeksi
1 Amiodaron 50 mg/ml inj 4 ampul 02/24
2 Aminophylline Inj 24 mg/ml 2 ampul 08/25
3 Asam traneksamak 100 mg/ml 3 ampul 01/27
4 Atropin sulfat 0,25 mg/ml Inj 3 ampul 10/24
5 Calsium Gluconas 10% 2 ampul 08/25
6 Dexamethasone Inj 5 mg/ml (1 ml) 5 ampul 10/24
7 Dextrose 40% 2 fles 07/24
8 Dopamin 200 mg/ 5ml inj 1 ampul 03/24
9 Dobutamin 25 mg/ml inj 1 ampul 09/24
10 Diazepam Inj (Valisanbe®) 1 ampul 07/24
11 Digoxin inj (Fargoxin®) 1 ampul 08/24
12 Ephedrin 50 mg/ml inj 3 ampul 12/24
13 Epinephrin 50 mg/ml (kulkas) 5 ampul 06/25
14 Meylon 84 1 fles 08/24
15 MgSO4 40%/25 ml 2 fles 08/24
16 Norephinefrin 1 mg/ml inj 1 ampul 05/24
Kepala Unit Farmasi

Apt. Musdalipah.,S.Farm
 Box emergency perawatan lantaii 2

Trolly emergency lantai 2

RSU CAHAYA MEDIKA

LACI II

EXP
NO NAMA ALAT JUMLAH
DATE
Infus
1 Aqua 25 ml 2 fles 03/25
2 Dextrose 5% (100 ml) 1 fles 01/25
3 NaCl 0,9 % (100 ml) 1 fles 07/24
4 Nacl 0,9 % (500 ml) 2 fles 05/26
4 Ringer Lactat (500 ml) 2 fles 07/26
5 Widahes® (500 ml) 1 fles 12/24
Alkes
1 BD Conecta 2 pcs 02/28
2 Infussion set makro 1 pcs 02/28
3 Infusion set mikro 1 pcs 04/28
4 I.V.Catheter No.24 1 pcs 09/27
6 I.V.Catheter No.22 1 pcs 02/28
7 I.V.Cateheter No.20 1 pcs 10/26
8 I.V.Catheter No.18 1 pcs 09/26
9 Perfusor 1 pcs 08/27
10 Spuit 1 cc 2 pcs 04/28
11 Spuit 3 cc 2 pcs 03/28
12 Spuit 5 cc 1 pcs 02/28
13 Spuit 10 cc 1 pcs 08/27
14 Spuit 20 cc 1 pcs 12/26
15 Spuit 50 cc 1 pcs 08/26
16 Transfusion set 1 pcs 07/28
Kepala Unit Farmasi

Apt. Musdalipah.,S.Farm

Trolly emergency lantai 2

 RSU CAHAYA MEDIKA

LACI III

EXP
NO NAMA ALAT JUMLAH
DATE
1 Handscoon steril No.6,5 2 pcs 09/26
2 Handscoon steril No. 7 2 pcs 08/27
3 Ett 6,5 1 pcs 02/26
4 Ett 7,0 1 pcs 07/26
5 Ett 7,5 1 pcs 08/24
6 Nasal canula dewasa 1 pcs 04/28
7 Nasal canula anak 1 pcs 06/27
8 Nasal canula bayi 1 pcs 02/27
9 Nebuliser mask dewasa 1 pcs 02/27
10 Nebuliser mask anak 1 pcs 08/27
11 Suction catheter No. 08 1 pcs 03/26
12 Suction catheter No. 16 1 pcs 01/25
13 Stomach tube No. 16 1 pcs 01/27
Kepala Unit Farmasi

Apt.Musdalipah.,S.Farm
BOX EMERGENCY VK

RSU CAHAYA MEDIKA

LACI I
EXP
NO NAMA OBAT JUMLAH
DATE
Injeksi
1 Amiodaron 50 mg/ml inj 4 ampul 01/24
2 Aminophylline Inj 24 mg/ml 2 ampul 08/25
3 Asam traneksamak 100 mg/ml 3 ampul 01/27
4 Atropin sulfat 0,25 mg/ml Inj 3 ampul 10/24
5 Calsium Gluconas 10% 2 ampul 02/25
6 Dexamethasone Inj 5 mg/ml (1 ml) 5 ampul 10/24
7 Dextrose 40% 2 fles 04/24
8 Dopamin 200 mg/ 5ml inj 1 ampul 03/24
9 Dobutamin 25 mg/ml inj 1 ampul 09/24
10 Diazepam Inj (Valisanbe®) 1 ampul 07/24
11 Digoxin inj (Fargoxin®) 1 ampul 08/24
12 Ephedrin 50 mg/ml inj 3 ampul 12/24
13 Epinephrin 50 mg/ml (kulkas) 5 ampul 06/25
14 Meylon 84 1 fles 08/24
15 MgSO4 40%/25 ml 2 fles 07/24
16 Norephinefrin 1 mg/ml inj 2 ampul 05/24
Kepala Unit Farmasi

Apt. Musdalipah.,S.Farm
 Box emergency vk

RSU CAHAYA MEDIKA

LACI II

EXP
NO NAMA ALAT JUMLAH
DATE
Infus
1 Aqua 25 ml 2 fles 07/25
2 dextrose 5% (100 ml) 1 fles 01/25
3 NaCl 0,9 % (100 ml) 1 fles 04/25
4 Widahes® (500 ml) 1 fles 09/24
Alkes
1 BD Conecta 2 pcs 10/27
2 Ett 6,5 1 pcs 02/28
3 Ett 7,0 1 pcs 07/28
4 Ett 7,5 1 pcs 02/28
5 Infus set dewasa 1 pcs 07/27
6 I.V.Catheter No.24 1 pcs 10/26
7 I.V.Catheter No.22 1 pcs 10/26
8 I.V.Cateheter No.20 1 pcs 07/26
9 I.V.Catheter No.18 1 pcs 09/26
10 Perfusor 1 pcs 09/26
11 Spuit 1 cc 2 pcs 11/27
12 Spuit 3 cc 2 pcs 02/28
13 Spuit 5 cc 1 pcs 12/27
14 Spuit 10 cc 1 pcs 02/28
15 Spuit 20 cc 1 pcs 06/27
16 Spuit 50 cc 1 pcs 09/26
17 Transfusion set 1 pcs 02/27

Kepala Unit Farmasi

Apt. Musdalipah.,S.Farm
Troly lantai 3

RSU CAHAYA MEDIKA

DAFTAR TROLLEY
EMERGENSI
RSU CAHAYA MEDIKA
LACI I
EXP
NO NAMA OBAT JUMLAH
DATE
Injeksi
1 Amiodaron 50 mg/ml inj 4 ampul 01/24
2 Aminophylline Inj 24 mg/ml 3 ampul 08/25
3 Asam traneksamak 100 mg/ml 3 ampul 01/27
4 Atropin sulfat 0,25 mg/ml Inj 5 ampul 02/25
5 Calsium Gluconas 10% 3 ampul 08/25
6 Dexamethasone Inj 5 mg/ml (1 ml) 5 ampul 10/24
7 Dextrose 40% 2 fles 02/24
8 Dopamin 200 mg/ 5ml inj 2 ampul 03/24
9 Dobutamin 25 mg/ml inj 1 ampul 06/25
Diazepam 5 mg/ml Inj
10 2 ampul 07/24
(Valisanbe®)
11 Digoxin inj (Fargoxin®) 1 ampul 08/24
12 Ephedrin 50 mg/ml inj 3 ampul 12/24
13 Epinephrin 50 mg/ml (kulkas) 5 ampul 06/25
14 Meylon 84 1 fles 08/24
15 MgSO4 40%/25 ml 2 fles 07/24
16 Norephinefrin 1 mg/ml inj 2 ampul 08/24
Kepala Unit Farmasi

Apt. Musdalipah.,S.Farm
Troly lantai 3

RSU CAHAYA MEDIKA

LACI II

EXP
NO NAMA ALAT JUMLAH
DATE
Infus
1 Aqua 25 ml 2 fles 01/25
2 Dextrose 5% (100 ml) 1 fles 01/25
3 NaCl 0,9 % (100 ml) 1 fles 05/25
4 NaCl 0,9 % (500 ml) 2 fles 02/25
5 Ringer Lactat (500 ml) 2 fles 03/25
6 Widahes® (500 ml) 1 fles 09/24
Alkes
1 BC Conecta 2 pcs 08/27
2 Handscoon steril No. 6,5 2 pcs 09/27
3 Handscoon steril No. 7 2 pcs 09/27
4 Infusion set dewasa 1 pcs 04/28
5 Infusion set anak 1 pcs 12/27
6 I.V.Catheter No.24 1 pcs 09/27
7 I.V.Catheter No.22 1 pcs 02/28
8 I.V.Cateheter No.20 1 pcs 09/26
9 I.V.Catheter No.18 1 pcs 09/26
10 Nasal canula dewasa 1 pcs 09/26
11 Nasal canula anak 1 pcs 09/26
12 Nasal canula bayi 1 pcs 11/26
13 Perfusor 1 pcs 08/27
14 Spuit 1 cc 2 pcs 11/27
15 Spuit 3 cc 2 pcs 03/28
16 Spuit 5 cc 1 pcs 08/26
17 Spuit 10 cc 1 pcs 02/28
18 Spuit 20 cc 1 pcs 06/27
19 Spuit 50 cc 1 pcs 12/27
20 Transfusi set 1 pcs 09/27
Kepala Unit Farmasi

Apt.Musdalipah.,S.Farm
Troly lantai 3

RSU CAHAYA MEDIKA

LACI III

EXP
NO NAMA ALAT JUMLAH
DATE
1 Ambu bag 1 pcs
2 Ett 6,5 1 pcs 02/26
3 Ett 7,0 1 pcs 07/26
4 Ett 7,5 1 pcs 11/26
5 Laringoskop 1 pcs
6 Nebuliser mask dewasa 1 pcs 06/27
7 Nebuliser mask anak 1 pcs 04/27
8 Suction catheter No. 08 1 pcs 03/26
9 Suction catheter No. 16 1 pcs 01/27
10 Stomach tube No. 18 1 pcs 08/26
Kepala Unit Farmasi

Apt.Musdalipah.,S.Farm
Box ambulance

RSU CAHAYA MEDIKA

LACI I
EXP
NO NAMA OBAT JUMLAH
DATE
Injeksi
1 Amiodaron 50 mg/ml inj 4 ampul 01/24
2 Aminophylline Inj 24 mg/ml 2 ampul 08/25
3 Asam traneksamak 100 mg/ml 3 ampul 09/26
4 Atropin sulfat 0,25 mg/ml Inj 3 ampul 10/24
5 Calsium Gluconas 10% 3 ampul 08/25
6 Dexamethasone Inj 5 mg/ml (1 ml) 5 ampul 10/24
7 Dextrose 40% 2 ampul 07/24
8 Dopamin 200 mg/ 5ml inj 2 ampul 03/24
9 Dobutamin 25 mg/ml inj 1 ampul 09/24
Diazepam 5mg/ ml Inj
10 2 ampul 07/23
(Valisanbe®)
11 Digoxin inj (Fargoxin®) 1 ampul 08/24
12 Ephedrin 50 mg/ml inj 3 ampul 12/24
13 Epinephrin 50 mg/ml (kulkas) 5 ampul 06/25
14 Meylon 84 1 ampul 08/24
15 MgSO4 40%/25 ml 2 fles 06/25
16 Norephinefrin 1 mg/ml inj 2 ampul 05/24
Kepala Unit Farmasi

Apt. Musdalipah.,S.Farm
 RSU CAHAYA MEDIKA

LACI II

EXP
NO NAMA ALAT JUMLAH
DATE
Infus
1 Aqua 25 ml 2 fles 02/25
2 dextrose 5% (100 ml) 1 fles 01/25
3 NaCl 0,9 % (100 ml) 1 fles 04/25
4 Widahes® (500 ml) 1 fles 12/24
Alkes
1 BD Conecta 2 pcs 08/27
2 Ett 6,5 1 pcs 02/26
3 Ett 7,0 1 pcs 08/26
4 Ett 7,5 1 pcs 07/25
5 Infus set dewasa 1 pcs 05/25
6 I.V.Catheter No.24 1 pcs 10/26
7 I.V.Catheter No.22 1 pcs 10/26
8 I.V.Cateheter No.20 1 pcs 07/26
9 I.V.Catheter No.18 1 pcs 09/26
10 Perfusor 1 pcs 12/26
11 Spuit 1 cc 2 pcs 11/27
12 Spuit 3 cc 2 pcs 02/28
13 Spuit 5 cc 1 pcs 12/27
14 Spuit 10 cc 1 pcs 02/28
15 Spuit 20 cc 1 pcs 11/27
16 Spuit 50 cc 1 pcs 06/27
17 Transfusion set 1 pcs 08/27

Kepala Unit Farmasi

Apt. Musdalipah.,S.Farm
Kit emergency

RSU CAHAYA MEDIKA

LACI I
EXP
NO NAMA OBAT JUMLAH
DATE
Injeksi
1 Amiodaron 50 mg/ml inj 4 ampul 01/24
2 Aminophylline Inj 24 mg/ml 2 ampul 08/25
3 Asam traneksamak 100 mg/ml 3 ampul 01/27
4 Atropin sulfat 0,25 mg/ml Inj 3 ampul 10/24
5 Calsium Gluconas 10% 3 ampul 02/25
6 Dexamethasone Inj 5 mg/ml (1 ml) 5 ampul 10/24
7 Dextrose 40% 2 ampul 07/24
8 Dopamin 200 mg/ 5ml inj 2 ampul 08/24
9 Dobutamin 25 mg/ml inj 1 ampul 06/25
Diazepam 5mg/ ml Inj
10 1 ampul 06/24
(Valisanbe®)
11 Digoxin inj (Fargoxin®) 1 ampul 08/24
12 Ephedrin 50 mg/ml inj 3 ampul 12/24
13 Epinephrin 50 mg/ml (kulkas) 5 ampul 06/25
14 Meylon 84 2 fles 08/24
15 MgSO4 40%/25 ml 2 fles 06/25
16 Norephinefrin 1 mg/ml inj 2 ampul 08/24
Kepala Unit Farmasi

Apt. Musdalipah.,S.Farm
Kit emergency

RSU CAHAYA MEDIKA

LACI II

EXP
NO NAMA ALAT JUMLAH
DATE
Infus
1 Aqua 25 ml 2 fles 07/25
2 Dextrose 5% (100 ml) 1 fles 01/25
3 NaCl 0,9 % (100 ml) 1 fles 04/25
4 Widahes (500 ml) 1 fles 09/24
Alkes
1 BD Conecta 2 pcs 08//27
2 ETT 6,5 1 pcs 02/28
3 ETT 7 1 pcs 12/28
4 ETT 7,5 1 pcs 08/28
5 Infus set dewasa 1 pcs 08/26
6 I.V.Catheter No.24 1 pcs 07/27
7 I.V.Catheter No.22 1 pcs 10/26
8 I.V.Cateheter No.20 1 pcs 07/26
9 I.V.Catheter No.18 1 pcs 09/26
10 Perfusor 1 pcs 08/27
11 Spuit 1 cc 2 pcs 02/27
12 Spuit 3 cc 2 pcs 02/28
13 Spuit 5 cc 1 pcs 12/27
14 Spuit 10 cc 1 pcs 02/28
15 Spuit 20 cc 1 pcs 11/27
16 Spuit 50 cc 1 pcs 06/27
15 Transfusion set 1 pcs 10/27

Kepala Unit Farmasi

Apt. Musdalipah.,S.Farm
BOX TAMBAHAN

RSU CAHAYA MEDIKA

LACI I
EXP
NO NAMA OBAT JUMLAH
DATE
Injeksi
1 Amiodaron 50 mg/ml inj 1 ampul 02/24
2 Aminophylline Inj 24 mg/ml 2 ampul 08/25
3 Asam traneksamak 100 mg/ml 3 ampul 09/26
4 Atropin sulfat 0,25 mg/ml Inj 3 ampul 10/24
5 Calsium Gluconas 10% 2 ampul 02/25
6 Dexamethasone Inj 5 mg/ml (1 ml) 5 ampul 10/24
7 Dextrose 40% 2 ampul 07/24
8 Dopamin 200 mg/ 5ml inj 1 ampul 10/24
9 Dobutamin 25 mg/ml inj 1 ampul 09/24
10 Diazepam Inj (Valisanbe®) 1 ampul 12/23
11 Digoxin inj (Fargoxin®) 1 ampul 08/24
12 Ephedrin 50 mg/ml inj 3 ampul 12/24
13 Epinephrine Inj 1 mg/ml (kulkas) 3 ampul 08/23
14 Meylon 84 1 ampul 08/24
15 MgSO4 40%/25 ml 1 fles 07/24
16 Norephinefrin 1 mg/ml inj 1 ampul 05/24
Kepala Unit Farmasi

Apt. Musdalipah.,S.Farm
 RSU CAHAYA MEDIKA

LACI II

NO NAMA ALAT JUMLAH EXP DATE

Infus
1 Aqua 25 ml 2 fles 07/25
2 Glukosa 5% (100 ml) 1 fles 01/25
3 NaCl 0,9 % (100 ml) 1 fles 04/24
4 Gelafusal® (500 ml) 1 fles 06/25
Alkes
1 BD Conecta 2 pcs 08/27
2 Ett 6,5 1 pcs 02/26
3 Ett 7,0 1 pcs 12/24
4 Ett 7,5 1 pcs 08/24
5 Infus set dewasa 1 pcs 11/27
6 I.V.Catheter No.24 1 pcs 04/27
7 I.V.Catheter No.22 1 pcs 10/26
8 I.V.Cateheter No.20 1 pcs 10/26
9 I.V.Catheter No.18 1 pcs 09/26
10 Perfusor 1 pcs 12/26
11 Spuit 1 cc 2 pcs 11/27
12 Spuit 3 cc 2 pcs 02/28
13 Spuit 5 cc 1 pcs 12/27
14 Spuit 10 cc 1 pcs 02/28
17 Transfusion set 1 pcs 09/27

Kepala Unit Farmasi

Apt. Musdalipah.,S.Farm
OK

RSU CAHAYA MEDIKA

LACI I
EXP
NO NAMA OBAT JUMLAH
DATE
Injeksi
1 Amiodaron 50 mg/ml inj 4 ampul 02/24
2 Aminophylline Inj 24 mg/ml 2 ampul 08/25
3 Asam traneksamak 100 mg/ml 3 ampul 01/27
4 Atracurium 50 mg/5 ml inj 2 ampul 08/23
4 Atropin sulfat 0,25 mg/ml Inj 3 ampul 10/24
5 Calsium Gluconas 10% 2 ampul 08/25
6 Dexamethasone Inj 5 mg/ml (1 ml) 5 ampul 10/24
7 Dextrose 40% 2 ampul 07/24
8 Dopamin 200 mg/ 5ml inj 1 ampul 03/24
9 Dobutamin 25 mg/ml inj 1 ampul 06/25
10 Diazepam Inj (Valisanbe®) 1 ampul 12/23
11 Digoxin inj (Fargoxin®) 1 ampul 08/24
12 Ephedrin 50 mg/ml inj 5 ampul 12/24
13 Epinephrine Inj 1 mg/ml (kulkas) 3 ampul 08/23
14 Meylon 84 1 ampul 10/24
15 MgSO4 40%/25 ml 1 fles 09/24
16 Norephinefrin 1 mg/ml inj 1 ampul 05/24
Kepala Unit Farmasi

Apt. Musdalipah.,S.Farm
 RSU CAHAYA MEDIKA

LACI II
EXP
NO NAMA ALAT JUMLAH
DATE
Infus
1 Aqua 25 ml 2 fles 12/25
2 Glukosa 5% (100 ml) 1 fles 01/25
3 NaCl 0,9 % (100 ml) 1 fles 04/25
4 Widahes® (500 ml) 1 fles 12/24
Alkes
1 BD Conecta 2 pcs 08/27
2 Ett 6,5 1 pcs 02/26
3 Ett 7,0 1 pcs 07/26
4 Ett 7,5 1 pcs 02/25
5 Infus set dewasa 1 pcs 07/27
6 I.V.Catheter No.24 1 pcs 04/27
7 I.V.Catheter No.22 1 pcs 10/26
8 I.V.Cateheter No.20 1 pcs 10/26
9 I.V.Catheter No.18 1 pcs 09/26
10 Perfusor 1 pcs 12/26
11 Spuit 1 cc 2 pcs 10/27
12 Spuit 3 cc 2 pcs 02/26
13 Spuit 5 cc 2 pcs 12/27
14 Spuit 10 cc 2 pcs 02/28
15 Spuit 20 cc 1 pcs 11/27
16 Spuit 50 cc 1 pcs 12/27
17 Transfusion set 1 pcs 10/27

Kepala Unit Farmasi

Perinatologi

PERINATOLOGI

RSU CAHAYA MEDIKA

LACI I
EXP
NO NAMA OBAT JUMLAH
DATE
Injeksi
1 Aminophylline Inj 24 mg/ml 2 ampul 08/25
2 Calsium Gluconas 10% 2 ampul 08/25
3 Dexamethasone Inj 5 mg/ml (1 ml) 5 ampul 10/24
4 Diazepam Inj (Valisanbe®) 1 ampul 12/23
5 Digoxin inj (Fargoxin®) 1 ampul 08/24
6 Epinephrine Inj 1 mg/ml (kulkas) 3 ampul 08/23
7 Midanest inj 1 ampul 01/25
8 Meylon 84 1 ampul 08/24
9 Phenobarbital inj (Sibital®) 1 ampul 06/24
Kepala Unit Farmasi

Apt. Musdalipah.,S.Farm
 RSU CAHAYA MEDIKA

LACI II

EXP
NO NAMA ALAT JUMLAH
DATE
Infus
1 Asering 1 fles 03/25
2 Glukosa 10% (500 ml) 1 fles 01/25
3 NaCl 0,9 % (100 ml) 1 fles 05/24
4 NaCl 0,9 % (500 ml) 1 fles 01/26
Alkes
1 BD Conecta 2 pcs 10/27
2 Ett 2,5 1 pcs 04/24
3 Ett 3,0 1 pcs 02/26
4 Ett 3,5 1 pcs 02/25
Ett 4,0 1 pcs 04/25
5 Infus set Mikro 1 pcs 12/27
6 Feeding tube 3,5 1 pcs 03/25
7 Feeding tube 5,0 1 pcs 12/24
8 Feeding tube 8,0 1 pcs 08/24
9 Nasal canula bayi 1 pcs 02/27
10 Handscoon steril 7,0 1 pcs 08/27
11 Spuit 1 cc 1 pcs 07/27
12 Spuit 3 cc 1 pcs 07/27
13 Spuit 5 cc 1 pcs 12/27
14 Spuit 10 cc 1 pcs 02/28
15 Suction catheter 8 1 pcs 02/28
Kepala Unit Farmasi

Apt. Musdalipah.,S.Farm
Ambulance (belum dicek)

RSU CAHAYA MEDIKA

LACI I
EXP
NO NAMA OBAT JUMLAH
DATE
Injeksi
1 Amiodaron 50 mg/ml inj 1 ampul 02/24
2 Aminophylline Inj 24 mg/ml 2 ampul 08/25
3 Asam traneksamak 100 mg/ml 2 ampul 09/26
4 Atropin sulfat 0,25 mg/ml Inj 3 ampul 10/24
5 Calsium Gluconas 10% 2 ampul 08/25
6 Dexamethasone Inj 5 mg/ml (1 ml) 5 ampul 10/24
7 Dextrose 40% 1 ampul 07/24
8 Dopamin 200 mg/ 5ml inj 1 ampul 03/24
9 Dobutamin 25 mg/ml inj 1 ampul 09/24
10 Diazepam Inj (Valisanbe®) 1 ampul 12/23
11 Digoxin inj (Fargoxin®) 1 ampul 08/24
12 Ephedrin 50 mg/ml inj 3 ampul 12/24
13 Epinephrine Inj 1 mg/ml 3 ampul 08/23
14 Lidocain 2% inj 3 ampul 06/26
15 Meylon 84 1 ampul 08/24
16 MgSO4 40%/25 ml 1 fles 07/24
17 Norephinefrin 1 mg/ml inj 1 ampul 05/24
Kepala Unit Farmasi

Apt. Musdalipah.,S.Farm
 RSU CAHAYA MEDIKA

LACI II

NO NAMA ALAT JUMLAH EXP DATE

Infus
1 Aqua 25 ml 2 fles 12/25
2 NaCl 0,9 % (100 ml) 1 fles 04/25
3 Gelafusal® (500 ml) 1 fles 06/25
Alkes
1 BD Conecta 2 pcs 08/27
2 Ett 6,5 1 pcs 02/26
3 Ett 7,0 1 pcs 08/26
4 Ett 7,5 1 pcs 07/25
5 Infus set dewasa 1 pcs 05/25
6 I.V.Catheter No.24 1 pcs 04/27
7 I.V.Catheter No.22 1 pcs 10/26
8 I.V.Cateheter No.20 1 pcs 10/26
9 I.V.Catheter No.18 1 pcs 09/26
10 Perfusor 1 pcs 12/26
11 Spuit 1 cc 2 pcs 11/27
12 Spuit 3 cc 2 pcs 02/28
13 Spuit 5 cc 1 pcs 12/27
14 Spuit 10 cc 1 pcs 02/28
15 Spuit 20 cc 1 pcs 11/27
16 Spuit 50 cc 1 pcs 12/27
17 Transfusion set 1 pcs 08/27

Kepala Unit Farmasi

Apt. Musdalipah.,S.Farm