Lplpo PTM 2024
Uploaded by
folderwindautamiLplpo PTM 2024
Uploaded by
folderwindautamiLAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PTM
Pos/Pustu : PELAPORAN BULAN
PUSKESMAS : MAKARTI MULYA PERMINTAAN BULAN
KECAMATAN : MESUJI
KABUPATEN : OGAN KOMERING ILIR
PROPINSI : SUMATERA SELATAN
NO. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN
1 2 3 4 5 6
1 Absorbent tipped applicator (alcohol swab) Pcs 0 0
2 ACARBOSE 100 MG Tablet 0 0
3 ACARBOSE 50 MG Tablet 0 0
4 Acetylcystein Kapsul 200mg Kapsul 0 200 200
5 Acyclovir cream Tube 0 5 5
6 Acyclovir tab 200 mg Tablet 0 0
7 Acyclovir tab 400 mg Tablet 0 100 100
8 Albendazol tab 400 mg Tablet 0 0
9 ALIVE BIOCOM (C&ZINC) Tablet 0 0
10 ALIVE NUTRIBION (B1,B6,B12) Tablet 0 0
11 ALIVE ZIC syr Botol 0 0
12 ALIVE D1000 TAB Tablet 0 0
13 Alkohol Liquid (etanol) 70%-1000 ml Tablet 0 0
14 Allopurinol 100 mg Tablet 250 250
15 Allopurinol 300 mg Tablet 0 0
16 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0
17 Aminophylline tab 200 mg Tablet 0 0
18 Amitriptyline 25 mg tab Tablet 0 0
19 Amlodipine tab 5 mg Tablet 290 500 790
20 Amlodipine 10 mg Tablet 0 0
21 AMOXICILLIN DROP Botol 0 0
22 Amoxycillin 250 mg Kapsul 0 0
23 Amoxycillin 500 mg Kaptab 120 200 320
24 Amoxycillin Syr Btl 0 0
25 Ampicilin 1 gr Inj Vial 0 0
26 Antasida DOEN Kombinasi Tablet 300 1000 1300
27 Antasida Syr DOEN Btl 0 0
28 Anti Bisa Ular 5 ml (ABU I)/ Biosave Ampul 0 0
29 Asam Mefenamat 500 mg tab Tablet 300 600 900
30 Ascorbic acid (Vit.C) 50 mg Tablet 110 110
31 Aspirin (miniaspi) 80 mg tab Tablet 40 40
32 Atropine inj 0,25 mg/ml Ampul 0 0
33 Attapulgite Tablet (Pularex) Tablet 0 0
34 Attapulgite Tablet 600 mg (New Antides) Tablet 0 0
35 Automated blood grouping (Tes Gol. Darah) Paket 0 0
36 AZITROMISIN 500 mg tab Tablet 0 0
37 Bactivec Larvasida 30ml Botol 0 0
38 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0
39 Bedak Salisil 2% Btl 3 3
40 Benzoic acid |salicylic acid salep (anti fungi) Tube 0 0
41 Betahistine Mesylate 6 mg tab Tablet 80 80
42 Betamethasone 0,1% krim Tube10 gr 13 13
43 Betamethasone 0,5% krim tube 5 g 0 0
44 Biosens DBD (DBD TEST) Pcs 0 0
45 Bisacodyl 5mg Tablet 0 0
46 Bismuth subgallas (antihemoroid) Pot 0 0
47 Calcium chloride lactate infus (RL) Botol 0 0
48 Calsium Laktat (Kalk) 500 mg Tablet 0 0
49 CANDESARTAN 16 Tablet 0 0
50 CANDESARTAN 8 Tablet 0 0
51 Captopril 12,5 mg Tablet 190 190
52 Captopril 25 mg Tablet 240 240
53 Carbamazepin tab Tablet 0 0
54 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 0 0
55 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 0 0
56 Cefadroxil 500mg Tablet 0 0
57 CEFIXIME 200 MG Kapsul 0 0
58 CEFIXIME 100MG Tablet 0 0
59 Cefotaaxime Sodium inj 1gr Vial 0 0
60 CEFRIAXONE INJ Vial 0 0
61 Cetirizine 5 mg/5 ml sirup Botol 0 0
62 Cetirizine Tab Tablet 0 0
63 Chloramhenicol Salep Mata 1% Tube 0 0
64 Chloramphenicol 250 mg caps Tablet 0 0
65 Chloramphenicol Suspensi 125 mg/ml Btl 0 0
66 Chloramphenicol TT 3% Botol 0 0
67 Chloramphenicol/ Hidrokortison krim 2,5% Tube 0 0
68 Chlorpheniramine Maleat (CTM) 4 mg Tablet 30 1000 1030
69 Chlorpromazine HCl 100 mg Tablet 0 0
70 Chlorpromazine HCl 25mg Tablet 0 0
71 Cimetidin 200 tab Tablet 0 0
72 Ciprofloxacin 500 mg tab Tablet 70 70
73 Ciprofloxacin Infus Botol 0 0
74 Clindamycin 300mg Kapsul 0 0
75 CLOZAPIN 25 Tablet 0 0
76 Coverall/Hazmat XL/XXL Set 0 0
77 Crefe Flesh 10cm Rol 0 0
78 Cresol liquid 1 Liter (lysol) Botol 0 0
79 Denpro Orafil Plus Temporary Pcs 0 0
80 Devitalisasi pasta/Pulp X pot 0 0
81 Dexamethasone 0,5 mg Tablet 0 0
82 Dexamethasone inj 5mg/ml-1ml Ampul 0 0
83 Diazepam 2 mg Tablet 0 0
84 Diazepam 5mg/ml-2 ml inj Ampul 0 0
85 Diclofenac sodium 25 mg tab Tablet 0 0
86 Diclofenac sodium 50 mg tab Tablet 310 700 1010
87 Digoxin 0,25 mg Tablet 0 0
88 Dimenhydrinate 50mg Tablet 0 0
89 Dipenhidramine HCl inj 10mg/ml Ampul 0 0
90 Domperidone 10 mg Tablet 380 380
91 Domperidone sr Botol 0 0
92 Doxycycline 100 mg Kapsul Kapsul 0 0
93 Dulcolax tab Tablet 0 0
94 DULCOLAX SUPPOS 10 MG supp 0 0
95 DULCOLAX SUPPOS 5 MG INFANT supp 0 0
96 Epinephrine HCl/bitartrat inj 0,1% Btl 0 0
97 Erythromicin 250 mg capsul Kapsul 0 0
98 Erythromicin 500 mg capsul Kapsul 50 50
99 Erythromicin Syr Btl 0 0
100 Ethacridine (Rivanol) 0,1% 300 ml Btl 0 0
101 Ethacridine (Rivanol) 0,1% 100ml Btl 0 0
102 Ethanol ( Aseptan ) 500 cc+ Pump Botol 0 0
103 Ethyl Chloride Btl 0 0
104 Eugenol cairan Btl 0 0
105 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 0
106 Folic acid 1mg ( asam folat) Tablet 0 0
107 Folley Catheter No.16 Pcs 0 0
108 Furosemida 40 mg Tablet 40 40
109 Furosemida Injeksi Ampul 0 0
110 Garam Oralit Sachet 0 0
111 Gentamicyn 0,1% SK Tube 0 0
112 Gentamicyn 0,3% TM Botol 6 24 30
113 Gentamicyn Inj 40 mg/ml Ampul 0 0
114 Glass lonomer Paket 0 0
115 Glibenclamide 5 mg Tablet 10 10
116 GLICLAZIDE TAB Tablet 0 0
117 Glimepiride 1 mg Tablet 0 0
118 Glukosa larutan infus 10% Botol 0 0
119 Glukosa larutan infus 5% Botol 0 0
120 Griseofulvin 125 mg Tablet 0 0
121 Guaifenesin 100 Tab/GG Tab Tablet 0 0
122 Haloperidol 0,5 mg tab Tablet 0 0
123 Haloperidol 1,5 mg tab Tablet 0 0
124 Haloperidol 5 mg tab Tablet 0 0
125 Herbakoof 100ml Botol 0 0
126 Human chorionic (HCG/Tes kehamilan ) Strip 0 0
127 Hydrochlorotiazide (HCT) 25 mg Tablet 70 70
128 H2O2 100 ML Botol 0 0
129 Ibuprofen 200 mg Tablet 0 0
130 Ibuprofen 400 mg Tablet 50 50
131 Ibuprofen sirup Botol 0 0
132 Ichthyol salep 10% Pcs 0 0
133 Immunoglobulin human anti-tetanus (Tetagam) Pcs 0 0
134 INDEC HIV1/2&SPHYLLIS pcs 0 0
135 Infus set dewasa Pcs 0 0
136 Infusi set anak Pcs 0 0
137 Isosorbide tablet Tablet 0 0
138 IV Catheter No.20 Pcs 0 0
139 IV Catheter No.22 Pcs 0 0
140 IV Catheter No.24 Pcs 0 0
141 Jarum Jahit Kulit Pcs 0 0
142 Kalium Permanganat Serbuk Pcs 0 0
143 Kapas pembalut/Absorben 250 g Pcs 0 0
144 Kasa kompres 40/40 steril Pcs 0 0
145 Kasa pembalut 2x80 Pcs 0 0
146 Kasa pembalut hidrofil 4 m x 15 cm Pcs 0 0
147 Kasa pembalut hidrofil 4 m x 3 cm Pcs 0 0
148 Ketac Universal (61108) Pcs 0 0
149 Ketac Universal (61111) Pcs 0 0
150 Ketoconazole 200 mg Cream Tube 0 0
151 Ketoconazole 200 mg tab Tablet 30 30
152 Ketorolac inj 30mg Ampul 0 0
153 Klorokina Fosfat 250 mg Tablet 0 0
154 KOTRIMOXAZOL 800/160 MG TAB Tablet 0 0
155 LAKTULOSE SYR Botol 0 0
156 Lancet Pcs 0 0
157 Levertran Salep/ Salep Luka Bakar Btl 0 0
158 Lidocain 2% Ampul 0 0
159 Lidocaine spray (Xylocaine spray) Pcs 0 0
160 Lidokain Comp. inj Kombinasi Ampul 0 0
161 Liquorice liquid extract (OBH) Botol 0 0
162 Locoriz Cream Tablet 0 0
163 Loperamid 2 mg tab / Diastrix 2 mg Tablet 30 200 230
164 Loratadine 10 mg tab Tablet 240 500 740
165 LYTACUR SYR Botol 0 0
166 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 0
167 Magnesium Sulfat Injeksi 40% (MgSO4) Ampul 0 0
168 Masker Pcs 0 0
169 Masker Earloop Pcs 0 0
170 Masker Headloop Pcs 0 0
171 Masker KN95 Pcs 0 0
172 Masker Plus Pcs 0 0
173 Masker Tie on Pcs 0 0
174 Medical adhesive tape (dermafix/leukomed) Pcs 0 0
175 Meprovent inj Ampul 0 0
176 Metamizole injeksi (antalgin 1000) Ampul 0 0
177 Metformin 500mg tab Tablet 40 2600 2640
178 Methyl Ergometrin Maleat 0,125 mg Tab 0 0
179 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0
180 Methyl Prednisolon tab 16 mg Tablet 0 0
181 Methyl Prednisolon tab 4 mg Tablet 130 130
182 Methyl Rosanilinium (gentian violet) Botol 0 0
183 METOCLOPROMIDE TAB Tablet 0 0
184 Metronidazol 250 mg tab Tablet 0 0
185 Metronidazol 500 mg tab Tablet 0 0
186 Metronidazol Infus Botol 0 0
187 Metronidazol syr Botol 0 0
188 Miconazole 2% Salep Kulit Tube 13 13
189 MOMETASONE Krim Tube 0 0
190 Moutpiece Steribreath 250's Pck 0 0
191 Natrium Bikarbonat 500 mg Tablet 0 0
192 Nifedipin 10 mg tab Kapsul 60 60
193 Nonwoven Fixation Rool Pcs 0 0
194 Nystatin Drop 100.000 IU Btl 0 0
195 Nystatin Tab Vag 10.000 iu/g Tablet 0 0
196 Octadin Botol 1000ml Botol 0 0
197 Octadin Spray 5ml Botol 0 0
198 Omeprazole inj Vial 0 0
199 Omeprazole kaps Tablet 250 600 850
200 Ondansetron iv/im 4mg Ampul 0 0
201 ONDANSETRON TAB Tablet 0 0
202 Otsu D-40 25ml Botol 0 0
203 Oxytetracycline HCl 1% Salep Mata Tube 0 0
204 Oxytetracycline HCl 3% Salep Kulit Tube 0 0
205 Oxytocin inj 10 IU Ampul 0 0
206 Papaverin 40 mg tab Tablet 0 0
207 Papaverin inj Tablet 0 0
208 Paracetamol Drops 15 ml Botol 0 0
209 Parasetamol 1000mg/100ml infus Botol 0 0
210 Parasetamol 120 mg/5 ml Syr Botol 0 0
211 Parasetamol 500 mg Tablet 180 1000 1180
212 Patient Lubricant (My Jelly ) Tube 0 0
213 Pehavral tab Tablet 0 0
214 Permethrin (Scabimite Cream) Tube 0 0
215 Phenobarbital 30 mg Tablet 0 0
216 Phenobarbital inj 50mg/ml-2ml Ampul 0 0
217 Phenol gliserol 10% TT Botol 0 0
218 Phytomenadione (Vit.K1) 10 mg Tablet 0 0
219 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 0
220 Phytomenadione (Vit.K1) inj 2 mg/ml Ampul 0 0
221 Piracetam 400 mg Tablet 0 0
222 Piroxicam 20 mg tab Tablet 0 0
223 Pisau Disposable (Mess No.10/11/20/21) pisau 0 0
224 Plesterku (Leukoplast) Pcs 0 0
225 Poli Aid 1 liter Botol 0 0
226 POLIAID 5L Botol 0 0
227 Policlean Handrub Botol 0 0
228 POLIDESINFEKTAN 5 L Botol 0 0
229 Polifix 10x5cm Pcs 0 0
230 Polifix 5x1cm Pcs 0 0
231 Polifix 5x5cm Pcs 0 0
232 POLIGEL 500 ML Botol 0 0
233 POLIGEL 5 L Botol 0 0
234 POLISOFT ALK HANDRUB 500 ML Botol 0 0
235 POLISOFT ALK HANDRUB 5 L Botol 0 0
236 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 0 0
237 Poliwash 500 ml Botol 0 0
238 POLIWASH 5 L Botol 0 0
239 Povidon iodium 10% 1000 ml Botol 0 0
240 Povidon iodium 10% 300 ml Botol 0 0
241 Povidon iodium 10% 60 ml Botol 0 0
242 Povidon Iodium 10% 30 ml Botol 0 0
243 Prednison 5 mg Tablet 90 90
244 Primaquin 15 mg tab Tablet 0 0
245 Propranolol HCl 10 mg Tablet 0 0
246 Propranolol HCl 40 mg Tablet 0 0
247 Propylthiouracil 100 mg Tablet 0 0
248 Protein Gluco Test Strip 0 0
249 Pyrantel Pamoat 125 mg Tablet 0 0
250 Pyridoxine HCl 10 mg Tablet 0 0
251 Ranitidin 150 mg Tablet 190 500 690
252 Ranitidin Injeksi Ampul 0 0
253 Rapid Test antigen (Panbio) Pcs 0 0
254 Retinol (Vit.A) kaps 100.000 iu Tablet 0 0
255 Retinol (Vit.A) kaps 200.000 iu Tablet 0 0
256 Risperidone 2mg Tablet 0 0
257 ROEKO ENDO FROST Botol 0 0
258 Salbutamol 2 mg Tablet 0 0
259 Salep 2-4 Kombinasi Tube 0 20 20
260 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0 0
261 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0
262 Sarung tangan (HandScuun Steril) No.7,5 Pcs 0 0
263 Sarung tangan (HandScuun) L Pcs 0 0
264 Sarung tangan (HandScuun) S/ M/ L Pcs 0 0
265 Sarung tangan nitril pcs 0 0
266 Semen Seng Fosfat Serbuk & Cairan Set 0 0
267 Sianocobalamin (Vit B12) 50 mg tab Tablet 340 340
268 Sianocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0
269 Silk (Benang Bedah) No. 3/0 Pcs 0 0
270 Silver Sulfadiazine Tube 0 0
271 Simvastatin 10 mg tab Kapsul 120 120
272 Simvastatin 20 mg tab Tablet 320 320
273 Sodium cloride infus 0,9% ( NACL ) Botol 0 0
274 Softanol 5 Liter Botol 0 0
275 Softanol 500ml Botol 0 0
276 Spuit 1 ml Pcs 0 0
277 Spuit 3 ml Pcs 0 0
278 Spuit 5 ml Pcs 0 0
279 Stericide 5 Liter Botol 0 0
280 Stimuno Capsul Forte Kapsul 0 0
281 Stimuno syrup Botol 0 0
282 Strip Asam Urat Pcs 0 0
283 Strip Gula Darah box 0 0
284 Strip kolestrol Pcs 0 0
285 SUKRALFAT TAB Tablet 0 0
286 SUKRALFAT SYR Botol 0 0
287 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 0 0
288 Sulfamethoxazole|trimethoprim (cotri) syr Botol 0 0
289 Sulfasetamida 15% TM Ampul 0 0
290 Surgical gown XL Set 0 0
291 Tetracycline 250 mg Tablet 0 0
292 Tetracycline 500 mg Tablet 0 0
293 Thiamine HCl (Vit B1) 50 mg Tablet 0 0
294 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0
295 Tranexamic Acid inj 5% Ampul 0 0
296 TRANEXAMIC ACID TAB Tablet 0 0
297 Trepocheck syphilis Pcs 0 0
298 Trihexyphenidyl tab 2 mg Tablet 0 0
299 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 0 0
300 Urin Bag Pcs 0 0
301 Usg Gel Botol 0 0
302 Vaksin Rabies Vero/ Verorab Paket 0 0
303 VALSARTAN 80 Tablet 0 0
304 VALSARTAN 160 Tablet 0 0
305 Viorex Liq 2% 5 Liter Botol 0 0
306 Viorex Liq 2% 500ml Botol 0 0
307 Virocheck HIV Pcs 0 0
308 Vitamin B Kompleks Tablet 160 600 760
309 Vitamin K Infant Inj Ampul 0 0
310 Water liquid (aqua P,I) Botol 0 0
311 Wing Needle No.21 Pcs 0 0
312 Wing Needle No.27 Pcs 0 0
313 Xpert MTB/RIF pcs 0 0
314 Zinc Drop Botol 0 0
315 Zinc tab Tablet 0 0
316 HB Test (Hemachroma Plus Microcuvette) Box 0
317 HIV Sifilis Combo Box 0 0
318 Kapas Lidi Box 0 0
319 Asam Asetat Botol 0 0
320 Sasklin Desinfektan 500 mL Botol 0 0
321 Kapas 1000 gr Box 0 0
322 Ameritek Test Box 0 0
323 Pot Feses Pack 0 0
324 Ambroxol Tablet Tablet 70 70
325 Ambroxol Syrup Botol 0 0
326 Reagen E.Coli 0 0
327 Caroto Gel 80 gr/ ECG Gel 0 0
328 Kertas ECG uk. 80 mmx 20 m 0 0
329 Kertas ECG uk. 80 mmx 90 mmx 280 0 0
330 Combur Test 0 0
UMUM BPJS JUMLAH
JUMLAH KUNJUNGAN RESEP
Mengetahui
Pengelola Obat Puskesmas
apt. Winda Utami, S. Farm.
NIP 199509112022032013
MINTAAN OBAT (LPLPO) PTM/PUSLING
: JANUARI DOKUMEN NOMOR TANGGAL
: FEBUARI DINKES KAB/KOTA
IFK KAB/KOTA
PUSKESMAS
STOK STOK nov des jan
PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AKHIR OPTIMUM
7 8 9 10 11 12
0 277 1343
0 980 1000
0 24 25
200 0 0
2 3 1000 920
0 0 0
100 1 6
0 1200 1000
0 3 10
0 0 0
0 45 50
0 150 260
0 440 120
250 3500 3550
0 38 35
0 0 0
0 1500 2598
0 109 220
790 2 0
0 2500 3500
0 454 860
0 0 0
320 0 0
0 0 5
0 0 0
1300 150 100
0 0 0
0 0 24
900 0 0
110 80 70
40 20 30
0 800 1500
0 30 53
0 0 0
0 5 1
0 20 15
0 275 270
0 1550 3570
3 2190 1030
0 3000 1200
80 150 260
13 36 48
0 1 27
0 1000 0
0 0 10
0 6 27
0 5000 200
0 30 25
0 100 150
0 50 35
190 10 35
240 100 99
0 3440 160
0 60 0
0 0 0
0 0 0
0 2500 1500
0 0 0
0 100 350
0 0 5
0 0 1
0 1 5
0 0 0
0 0 0
0 4000 3000
0 30 20
0 47 40
530 500 11 9
0 0 0
0 4000 3400
0 0 90
70 470 80
0 15 31
0 4000 1200
0 0 0
0 0 0
0 18 5
0 0 0
0 440 500
0 0 0
0 5 6
0 20 23
0 0 1
0 0 1
0 0 0
1010 470 420
0 0 0
0 10 17
0 500 120
380 0 0
0 302 41
0 30 19
0 100 23
0 30 35
0 0 0
0 2190 780
0 4200 2200
50 7 9
0 0 0
0 50 140
0 2000 3000
0 0 0
0 0 0
0 30 300
0 100 104
0 89 50
0 50 110
40 0 0
0 1013 2000
0 22 116
0 15 12
30 0 5
0 80 96
0 33 32
10 200 80
0 150 58
0 102 97
0 0 99
0 0 0
0 0 0
0 8 5
0 75 50
0 43 146
0 20 15
0 31 32
0 0 2
70 0 2
0 80 54
0 200 540
50 15 20
0 0 0
0 500 250
0 0 0
0 0 0
0 0 0
0 200 107
0 0 0
0 0 0
0 600 900
0 270 270
0 0 0
0 6 15
0 0 0
0 76 500
0 0 0
0 0 0
0 0 0
0 500 570
0 0 102
0 20 0
30 3257 4010
0 0 0
0 0 0
0 0 0
0 3500 2500
0 0 0
0 0 0
0 1200 2453
0 0 0
0 1 0
0 100 120
0 0 1
230 0 0
740 300 250
0 0 0
0 2 6
0 195 24
0 0 0
0 0 0
0 0 60
0 3200 3500
0 10 15
0 20 0
0 50 125
0 45 10
0 100 34
1740 900 0 0
0 0 0
0 19 6
0 20 25
130 17 0
0 4000 5380
0 2 10
0 1200 830
0 23 24
0 0 0
0 0 0
13 0 0
0 300 320
0 0 0
0 75 35
60 0 0
0 1500 1200
0 0 20
0 25 21
0 0 0
0 9 1
0 0 0
850 25 27
0 0 0
0 0 0
0 10 0
0 0 0
0 1 9
0 0 9
0 2 0
0 1400 1654
0 0 0
0 0 0
0 0 0
380 800 0 0
0 0 0
0 0 124
0 300 110
0 2500 2700
0 14 10
0 0 0
0 0 0
0 0 42
0 1000 1200
0 500 430
0 22 12
0 190 31
0 302 142
0 0 0
0 0 0
0 714 1550
0 0 0
0 890 710
0 0 0
0 0 6
0 1 12
0 1490 1500
0 16 13
0 0 0
0 2 7
0 265 490
0 1200 1000
0 106 532
0 0 0
0 500 250
0 67 9
90 100 99
0 0 67
0 84 80
0 0 0
0 263 35
0 0 0
0 0 0
0 360 50
390 300 0 0
0 920 750
0 0 0
0 13 15
0 49 0
0 210 250
0 0 600
0 0 19
13 7 0 0
0 2 0
0 0 4
0 0 0
0 10 59
0 570 750
0 0 0
0 30 22
340 0 0
0 0 0
0 0 0
0 0 17
120 0 0
320 1000 1500
0 0 0
0 0 0
0 200 300
0 2500 1500
0 12 9
0 0 0
0 200 120
0 0 0
0 200 600
0 180 140
0 0 30
0 0 0
0 0 0
0 0 0
0 0 0
0 12 13
0 100 320
0 0 0
0 0 0
0 0 0
0 2 0
0 0 2
0 2 0
0 2 0
0 0 0
0 0 1000
0 770 220
0 100 150
0 10 10
0 100 200
0 100 500
0 500 10
0
0 500 500
0
460 300
0 800 900
0 10 10
0 1000 950
0 9 8
0 1000 800
0 9 5
0 9 8
0
0 500 2000
0
0
0
0
0
0
70
0
0
0
0
0
0
Yang Membuat
Pengelola Obat Pustu / Poskesdes ….
NIP
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PTM
Pos/Pustu : PELAPORAN BULAN
PUSKESMAS : MAKARTI MULYA PERMINTAAN BULAN
KECAMATAN : MESUJI
KABUPATEN : OGAN KOMERING ILIR
PROPINSI : SUMATERA SELATAN
NO. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN
1 2 3 4 5 6
1 Absorbent tipped applicator (alcohol swab) Pcs 0 0
2 ACARBOSE 100 MG Tablet 0 0
3 ACARBOSE 50 MG Tablet 0 0
4 Acetylcystein Kapsul 200mg Kapsul 200 200 400
5 Acyclovir cream Tube 3 3
6 Acyclovir tab 200 mg Tablet 0 0
7 Acyclovir tab 400 mg Tablet 100 100
8 Albendazol tab 400 mg Tablet 0 0
9 ALIVE BIOCOM (C&ZINC) Tablet 0 0
10 ALIVE NUTRIBION (B1,B6,B12) Tablet 0 0
11 ALIVE ZIC syr Botol 0 0
12 ALIVE D1000 TAB Tablet 0 0
13 Alkohol Liquid (etanol) 70%-1000 ml Tablet 0 0
14 Allopurinol 100 mg Tablet 250 250
15 Allopurinol 300 mg Tablet 0 0
16 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0
17 Aminophylline tab 200 mg Tablet 0 0
18 Amitriptyline 25 mg tab Tablet 0 0
19 Amlodipine tab 5 mg Tablet 790 790
20 Amlodipine 10 mg Tablet 0 0
21 AMOXICILLIN DROP Botol 0 0
22 Amoxycillin 250 mg Kapsul 0 0
23 Amoxycillin 500 mg Kaptab 320 320
24 Amoxycillin Syr Btl 0 0
25 Ampicilin 1 gr Inj Vial 0 0
26 Antasida DOEN Kombinasi Tablet 1300 1300
27 Antasida Syr DOEN Btl 0 0
28 Anti Bisa Ular 5 ml (ABU I)/ Biosave Ampul 0 0
29 Asam Mefenamat 500 mg tab Tablet 900 900
30 Ascorbic acid (Vit.C) 50 mg Tablet 110 110
31 Aspirin (miniaspi) 80 mg tab Tablet 40 40
32 Atropine inj 0,25 mg/ml Ampul 0 0
33 Attapulgite Tablet (Pularex) Tablet 0 0
34 Attapulgite Tablet 600 mg (New Antides) Tablet 0 0
35 Automated blood grouping (Tes Gol. Darah) Paket 0 0
36 AZITROMISIN 500 mg tab Tablet 0 0
37 Bactivec Larvasida 30ml Botol 0 0
38 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0
39 Bedak Salisil 2% Btl 3 3
40 Benzoic acid |salicylic acid salep (anti fungi) Tube 0 0
41 Betahistine Mesylate 6 mg tab Tablet 80 80
42 Betamethasone 0,1% krim Tube10 gr 13 13
43 Betamethasone 0,5% krim tube 5 g 0 0
44 Biosens DBD (DBD TEST) Pcs 0 0
45 Bisacodyl 5mg Tablet 0 0
46 Bismuth subgallas (antihemoroid) Pot 0 0
47 Calcium chloride lactate infus (RL) Botol 0 0
48 Calsium Laktat (Kalk) 500 mg Tablet 0 0
49 CANDESARTAN 16 Tablet 0 0
50 CANDESARTAN 8 Tablet 0 0
51 Captopril 12,5 mg Tablet 190 1000 1190
52 Captopril 25 mg Tablet 240 240
53 Carbamazepin tab Tablet 0 0
54 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 0 0
55 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 0 0
56 Cefadroxil 500mg Tablet 0 0
57 CEFIXIME 200 MG Kapsul 0 0
58 CEFIXIME 100MG Tablet 0 0
59 Cefotaaxime Sodium inj 1gr Vial 0 0
60 CEFRIAXONE INJ Vial 0 0
61 Cetirizine 5 mg/5 ml sirup Botol 0 0
62 Cetirizine Tab Tablet 0 0
63 Chloramhenicol Salep Mata 1% Tube 0 0
64 Chloramphenicol 250 mg caps Tablet 0 0
65 Chloramphenicol Suspensi 125 mg/ml Btl 0 0
66 Chloramphenicol TT 3% Botol 0 0
67 Chloramphenicol/ Hidrokortison krim 2,5% Tube 0 0
68 Chlorpheniramine Maleat (CTM) 4 mg Tablet 500 700 1200
69 Chlorpromazine HCl 100 mg Tablet 0 0
70 Chlorpromazine HCl 25mg Tablet 0 0
71 Cimetidin 200 tab Tablet 0 0
72 Ciprofloxacin 500 mg tab Tablet 70 70
73 Ciprofloxacin Infus Botol 0 0
74 Clindamycin 300mg Kapsul 0 0
75 CLOZAPIN 25 Tablet 0 0
76 Coverall/Hazmat XL/XXL Set 0 0
77 Crefe Flesh 10cm Rol 0 0
78 Cresol liquid 1 Liter (lysol) Botol 0 0
79 Denpro Orafil Plus Temporary Pcs 0 0
80 Devitalisasi pasta/Pulp X pot 0 0
81 Dexamethasone 0,5 mg Tablet 0 0
82 Dexamethasone inj 5mg/ml-1ml Ampul 0 0
83 Diazepam 2 mg Tablet 0 0
84 Diazepam 5mg/ml-2 ml inj Ampul 0 0
85 Diclofenac sodium 25 mg tab Tablet 0 0
86 Diclofenac sodium 50 mg tab Tablet 1010 500 1510
87 Digoxin 0,25 mg Tablet 0 0
88 Dimenhydrinate 50mg Tablet 0 0
89 Dipenhidramine HCl inj 10mg/ml Ampul 0 0
90 Domperidone 10 mg Tablet 380 380
91 Domperidone sr Botol 0 0
92 Doxycycline 100 mg Kapsul Kapsul 0 0
93 Dulcolax tab Tablet 0 0
94 DULCOLAX SUPPOS 10 MG supp 0 0
95 DULCOLAX SUPPOS 5 MG INFANT supp 0 0
96 Epinephrine HCl/bitartrat inj 0,1% Btl 0 0
97 Erythromicin 250 mg capsul Kapsul 0 0
98 Erythromicin 500 mg capsul Kapsul 50 50
99 Erythromicin Syr Btl 0 0
100 Ethacridine (Rivanol) 0,1% 300 ml Btl 0 0
101 Ethacridine (Rivanol) 0,1% 100ml Btl 0 0
102 Ethanol ( Aseptan ) 500 cc+ Pump Botol 0 0
103 Ethyl Chloride Btl 0 0
104 Eugenol cairan Btl 0 0
105 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 0
106 Folic acid 1mg ( asam folat) Tablet 0 0
107 Folley Catheter No.16 Pcs 0 0
108 Furosemida 40 mg Tablet 40 40
109 Furosemida Injeksi Ampul 0 0
110 Garam Oralit Sachet 0 0
111 Gentamicyn 0,1% SK Tube 0 0
112 Gentamicyn 0,3% TM Botol 30 30
113 Gentamicyn Inj 40 mg/ml Ampul 0 0
114 Glass lonomer Paket 0 0
115 Glibenclamide 5 mg Tablet 10 10
116 GLICLAZIDE TAB Tablet 0 0
117 Glimepiride 1 mg Tablet 0 0
118 Glukosa larutan infus 10% Botol 0 0
119 Glukosa larutan infus 5% Botol 0 0
120 Griseofulvin 125 mg Tablet 0 0
121 Guaifenesin 100 Tab/GG Tab Tablet 0 0
122 Haloperidol 0,5 mg tab Tablet 0 0
123 Haloperidol 1,5 mg tab Tablet 0 0
124 Haloperidol 5 mg tab Tablet 0 0
125 Herbakoof 100ml Botol 0 0
126 Human chorionic (HCG/Tes kehamilan ) Strip 0 0
127 Hydrochlorotiazide (HCT) 25 mg Tablet 70 70
128 H2O2 100 ML Botol 0 0
129 Ibuprofen 200 mg Tablet 0 0
130 Ibuprofen 400 mg Tablet 50 50
131 Ibuprofen sirup Botol 0 0
132 Ichthyol salep 10% Pcs 0 0
133 Immunoglobulin human anti-tetanus (Tetagam) Pcs 0 0
134 INDEC HIV1/2&SPHYLLIS pcs 0 0
135 Infus set dewasa Pcs 0 0
136 Infusi set anak Pcs 0 0
137 Isosorbide tablet Tablet 0 0
138 IV Catheter No.20 Pcs 0 0
139 IV Catheter No.22 Pcs 0 0
140 IV Catheter No.24 Pcs 0 0
141 Jarum Jahit Kulit Pcs 0 0
142 Kalium Permanganat Serbuk Pcs 0 0
143 Kapas pembalut/Absorben 250 g Pcs 0 0
144 Kasa kompres 40/40 steril Pcs 0 0
145 Kasa pembalut 2x80 Pcs 0 0
146 Kasa pembalut hidrofil 4 m x 15 cm Pcs 0 0
147 Kasa pembalut hidrofil 4 m x 3 cm Pcs 0 0
148 Ketac Universal (61108) Pcs 0 0
149 Ketac Universal (61111) Pcs 0 0
150 Ketoconazole 200 mg Cream Tube 0 0
151 Ketoconazole 200 mg tab Tablet 30 30
152 Ketorolac inj 30mg Ampul 0 0
153 Klorokina Fosfat 250 mg Tablet 0 0
154 KOTRIMOXAZOL 800/160 MG TAB Tablet 0 0
155 LAKTULOSE SYR Botol 0 0
156 Lancet Pcs 0 0
157 Levertran Salep/ Salep Luka Bakar Btl 0 0
158 Lidocain 2% Ampul 0 0
159 Lidocaine spray (Xylocaine spray) Pcs 0 0
160 Lidokain Comp. inj Kombinasi Ampul 0 0
161 Liquorice liquid extract (OBH) Botol 0 0
162 Locoriz Cream Tablet 0 0
163 Loperamid 2 mg tab / Diastrix 2 mg Tablet 230 230
164 Loratadine 10 mg tab Tablet 740 740
165 LYTACUR SYR Botol 0 0
166 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 0
167 Magnesium Sulfat Injeksi 40% (MgSO4) Ampul 0 0
168 Masker Pcs 0 0
169 Masker Earloop Pcs 0 0
170 Masker Headloop Pcs 0 0
171 Masker KN95 Pcs 0 0
172 Masker Plus Pcs 0 0
173 Masker Tie on Pcs 0 0
174 Medical adhesive tape (dermafix/leukomed) Pcs 0 0
175 Meprovent inj Ampul 0 0
176 Metamizole injeksi (antalgin 1000) Ampul 0 0
177 Metformin 500mg tab Tablet 900 900
178 Methyl Ergometrin Maleat 0,125 mg Tab 0 0
179 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0
180 Methyl Prednisolon tab 16 mg Tablet 0 0
181 Methyl Prednisolon tab 4 mg Tablet 130 130
182 Methyl Rosanilinium (gentian violet) Botol 0 0
183 METOCLOPROMIDE TAB Tablet 0 0
184 Metronidazol 250 mg tab Tablet 0 0
185 Metronidazol 500 mg tab Tablet 0 200 200
186 Metronidazol Infus Botol 0 0
187 Metronidazol syr Botol 0 0
188 Miconazole 2% Salep Kulit Tube 13 28 41
189 MOMETASONE Krim Tube 0 0
190 Moutpiece Steribreath 250's Pck 0 0
191 Natrium Bikarbonat 500 mg Tablet 0 0
192 Nifedipin 10 mg tab Kapsul 60 100 160
193 Nonwoven Fixation Rool Pcs 0 0
194 Nystatin Drop 100.000 IU Btl 0 0
195 Nystatin Tab Vag 10.000 iu/g Tablet 0 0
196 Octadin Botol 1000ml Botol 0 0
197 Octadin Spray 5ml Botol 0 0
198 Omeprazole inj Vial 0 0
199 Omeprazole kaps Tablet 850 850
200 Ondansetron iv/im 4mg Ampul 0 0
201 ONDANSETRON TAB Tablet 0 0
202 Otsu D-40 25ml Botol 0 0
203 Oxytetracycline HCl 1% Salep Mata Tube 0 0
204 Oxytetracycline HCl 3% Salep Kulit Tube 0 0
205 Oxytocin inj 10 IU Ampul 0 0
206 Papaverin 40 mg tab Tablet 0 0
207 Papaverin inj Tablet 0 0
208 Paracetamol Drops 15 ml Botol 0 0
209 Parasetamol 1000mg/100ml infus Botol 0 0
210 Parasetamol 120 mg/5 ml Syr Botol 0 0
211 Parasetamol 500 mg Tablet 800 800
212 Patient Lubricant (My Jelly ) Tube 0 0
213 Pehavral tab Tablet 0 0
214 Permethrin (Scabimite Cream) Tube 0 0
215 Phenobarbital 30 mg Tablet 0 0
216 Phenobarbital inj 50mg/ml-2ml Ampul 0 0
217 Phenol gliserol 10% TT Botol 0 0
218 Phytomenadione (Vit.K1) 10 mg Tablet 0 0
219 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 0
220 Phytomenadione (Vit.K1) inj 2 mg/ml Ampul 0 0
221 Piracetam 400 mg Tablet 0 0
222 Piroxicam 20 mg tab Tablet 0 0
223 Pisau Disposable (Mess No.10/11/20/21) pisau 0 0
224 Plesterku (Leukoplast) Pcs 0 0
225 Poli Aid 1 liter Botol 0 0
226 POLIAID 5L Botol 0 0
227 Policlean Handrub Botol 0 0
228 POLIDESINFEKTAN 5 L Botol 0 0
229 Polifix 10x5cm Pcs 0 0
230 Polifix 5x1cm Pcs 0 0
231 Polifix 5x5cm Pcs 0 0
232 POLIGEL 500 ML Botol 0 0
233 POLIGEL 5 L Botol 0 0
234 POLISOFT ALK HANDRUB 500 ML Botol 0 0
235 POLISOFT ALK HANDRUB 5 L Botol 0 0
236 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 0 0
237 Poliwash 500 ml Botol 0 0
238 POLIWASH 5 L Botol 0 0
239 Povidon iodium 10% 1000 ml Botol 0 0
240 Povidon iodium 10% 300 ml Botol 0 0
241 Povidon iodium 10% 60 ml Botol 0 0
242 Povidon Iodium 10% 30 ml Botol 0 0
243 Prednison 5 mg Tablet 90 90
244 Primaquin 15 mg tab Tablet 0 0
245 Propranolol HCl 10 mg Tablet 0 0
246 Propranolol HCl 40 mg Tablet 0 0
247 Propylthiouracil 100 mg Tablet 0 0
248 Protein Gluco Test Strip 0 0
249 Pyrantel Pamoat 125 mg Tablet 0 0
250 Pyridoxine HCl 10 mg Tablet 0 0
251 Ranitidin 150 mg Tablet 300 200 500
252 Ranitidin Injeksi Ampul 0 0
253 Rapid Test antigen (Panbio) Pcs 0 0
254 Retinol (Vit.A) kaps 100.000 iu Tablet 0 0
255 Retinol (Vit.A) kaps 200.000 iu Tablet 0 0
256 Risperidone 2mg Tablet 0 0
257 ROEKO ENDO FROST Botol 0 0
258 Salbutamol 2 mg Tablet 0 200 200
259 Salep 2-4 Kombinasi Tube 7 7
260 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0 0
261 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0
262 Sarung tangan (HandScuun Steril) No.7,5 Pcs 0 0
263 Sarung tangan (HandScuun) L Pcs 0 0
264 Sarung tangan (HandScuun) S/ M/ L Pcs 0 0
265 Sarung tangan nitril pcs 0 0
266 Semen Seng Fosfat Serbuk & Cairan Set 0 0
267 Sianocobalamin (Vit B12) 50 mg tab Tablet 340 340
268 Sianocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0
269 Silk (Benang Bedah) No. 3/0 Pcs 0 0
270 Silver Sulfadiazine Tube 0 0
271 Simvastatin 10 mg tab Kapsul 120 120
272 Simvastatin 20 mg tab Tablet 320 320
273 Sodium cloride infus 0,9% ( NACL ) Botol 0 0
274 Softanol 5 Liter Botol 0 0
275 Softanol 500ml Botol 0 0
276 Spuit 1 ml Pcs 0 0
277 Spuit 3 ml Pcs 0 0
278 Spuit 5 ml Pcs 0 0
279 Stericide 5 Liter Botol 0 0
280 Stimuno Capsul Forte Kapsul 0 0
281 Stimuno syrup Botol 0 0
282 Strip Asam Urat Pcs 0 0
283 Strip Gula Darah box 0 0
284 Strip kolestrol Pcs 0 0
285 SUKRALFAT TAB Tablet 0 0
286 SUKRALFAT SYR Botol 0 0
287 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 0 0
288 Sulfamethoxazole|trimethoprim (cotri) syr Botol 0 0
289 Sulfasetamida 15% TM Ampul 0 0
290 Surgical gown XL Set 0 0
291 Tetracycline 250 mg Tablet 0 0
292 Tetracycline 500 mg Tablet 0 0
293 Thiamine HCl (Vit B1) 50 mg Tablet 0 0
294 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0
295 Tranexamic Acid inj 5% Ampul 0 0
296 TRANEXAMIC ACID TAB Tablet 0 0
297 Trepocheck syphilis Pcs 0 0
298 Trihexyphenidyl tab 2 mg Tablet 0 0
299 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 0 0
300 Urin Bag Pcs 0 0
301 Usg Gel Botol 0 0
302 Vaksin Rabies Vero/ Verorab Paket 0 0
303 VALSARTAN 80 Tablet 0 0
304 VALSARTAN 160 Tablet 0 0
305 Viorex Liq 2% 5 Liter Botol 0 0
306 Viorex Liq 2% 500ml Botol 0 0
307 Virocheck HIV Pcs 0 0
308 Vitamin B Kompleks Tablet 300 100 400
309 Vitamin K Infant Inj Ampul 0 0
310 Water liquid (aqua P,I) Botol 0 0
311 Wing Needle No.21 Pcs 0 0
312 Wing Needle No.27 Pcs 0 0
313 Xpert MTB/RIF pcs 0 0
314 Zinc Drop Botol 0 0
315 Zinc tab Tablet 0 300 300
316 HB Test (Hemachroma Plus Microcuvette) Box 0 0
317 HIV Sifilis Combo Box 0 0
318 Kapas Lidi Box 0 0
319 Asam Asetat Botol 0 0
320 Sasklin Desinfektan 500 mL Botol 0 0
321 Kapas 1000 gr Box 0 0
322 Ameritek Test Box 0 0
323 Pot Feses Pack 0 0
324 Ambroxol Tablet Tablet 70 100 170
325 Ambroxol Syrup Botol 0 0
326 Reagen E.Coli 0 0
327 Caroto Gel 80 gr/ ECG Gel 0 0
328 Kertas ECG uk. 80 mmx 20 m 0 0
329 Kertas ECG uk. 80 mmx 90 mmx 280 0 0
330 Combur Test 0 0
UMUM JAMSOSKES BPJS JUMLAH
JUMLAH KUNJUNGAN RESEP
Mengetahui
Pengelola Obat Puskesmas
apt. Winda Utami, S. Farm.
NIP 199509112022032013
MINTAAN OBAT (LPLPO) PTM/PUSLING
: FEBUARI DOKUMEN NOMOR TANGGAL
: MARET DINKES KAB/KOTA
IFK KAB/KOTA
PUSKESMAS
STOK STOK nov des jan
PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AKHIR OPTIMUM
7 8 9 10 11 12
0 277 1343
0 980 1000
0 24 25
100 300 0 0
3 1000 920
0 0 0
100 1 6
0 1200 1000
0 3 10
0 0 0
0 45 50
0 150 260
0 440 120
50 200 3500 3550
0 38 35
0 0 0
0 1500 2598
0 109 220
590 200 2 0
0 2500 3500
0 454 860
0 0 0
320 0 0 0
0 0 5
0 0 0
1100 200 150 100
0 0 0
0 0 24
900 0 0
110 0 80 70
40 0 20 30
0 800 1500
0 30 53
0 0 0
0 5 1
0 20 15
0 275 270
0 1550 3570
3 0 2190 1030
0 3000 1200
80 0 150 260
0 13 36 48
0 1 27
0 1000 0
0 0 10
0 6 27
0 5000 200
0 30 25
0 100 150
0 50 35
990 200 10 35
240 100 99
0 3440 160
0 60 0
0 0 0
0 0 0
0 2500 1500
0 0 0
0 100 350
0 0 5
0 0 1
0 1 5
0 0 0
0 0 0
0 4000 3000
0 30 20
0 47 40
1200 0 11 9
0 0 0
0 4000 3400
0 0 90
70 0 470 80
0 15 31
0 4000 1200
0 0 0
0 0 0
0 18 5
0 0 0
0 440 500
0 0 0
0 5 6
0 20 23
0 0 1
0 0 1
0 0 0
910 600 470 420
0 0 0
0 10 17
0 500 120
380 0 0 0
0 302 41
0 30 19
0 100 23
0 30 35
0 0 0
0 2190 780
0 4200 2200
50 0 7 9
0 0 0
0 50 140
0 2000 3000
0 0 0
0 0 0
0 30 300
0 100 104
0 89 50
0 50 110
40 0 0 0
0 1013 2000
0 22 116
0 15 12
30 0 5
0 80 96
0 33 32
10 0 200 80
0 150 58
0 102 97
0 0 99
0 0 0
0 0 0
0 8 5
0 75 50
0 43 146
0 20 15
0 31 32
0 0 2
70 0 0 2
0 80 54
0 200 540
50 0 15 20
0 0 0
0 500 250
0 0 0
0 0 0
0 0 0
0 200 107
0 0 0
0 0 0
0 600 900
0 270 270
0 0 0
0 6 15
0 0 0
0 76 500
0 0 0
0 0 0
0 0 0
0 500 570
0 0 102
0 20 0
30 0 3257 4010
0 0 0
0 0 0
0 0 0
0 3500 2500
0 0 0
0 0 0
0 1200 2453
0 0 0
0 1 0
0 100 120
0 0 1
230 0 0 0
740 0 300 250
0 0 0
0 2 6
0 195 24
0 0 0
0 0 0
0 0 60
0 3200 3500
0 10 15
0 20 0
0 50 125
0 45 10
0 100 34
900 0 0 0
0 0 0
0 19 6
0 20 25
130 0 17 0
0 4000 5380
0 2 10
0 1200 830
200 0 23 24
0 0 0
0 0 0
41 0 0 0
0 300 320
0 0 0
0 75 35
160 0 0 0
0 1500 1200
0 0 20
0 25 21
0 0 0
0 9 1
0 0 0
850 0 25 27
0 0 0
0 0 0
0 10 0
0 0 0
0 1 9
0 0 9
0 2 0
0 1400 1654
0 0 0
0 0 0
0 0 0
700 100 0 0
0 0 0
0 0 124
0 300 110
0 2500 2700
0 14 10
0 0 0
0 0 0
0 0 42
0 1000 1200
0 500 430
0 22 12
0 190 31
0 302 142
0 0 0
0 0 0
0 714 1550
0 0 0
0 890 710
0 0 0
0 0 6
0 1 12
0 1490 1500
0 16 13
0 0 0
0 2 7
0 265 490
0 1200 1000
0 106 532
0 0 0
0 500 250
0 67 9
90 0 100 99
0 0 67
0 84 80
0 0 0
0 263 35
0 0 0
0 0 0
0 360 50
500 0 0 0
0 920 750
0 0 0
0 13 15
0 49 0
0 210 250
0 0 600
200 0 0 19
7 0 0 0
0 2 0
0 0 4
0 0 0
0 10 59
0 570 750
0 0 0
0 30 22
340 0 0 0
0 0 0
0 0 0
0 0 17
120 0 0 0
320 0 1000 1500
0 0 0
0 0 0
0 200 300
0 2500 1500
0 12 9
0 0 0
0 200 120
0 0 0
0 200 600
0 180 140
0 0 30
0 0 0
0 0 0
0 0 0
0 0 0
0 12 13
0 100 320
0 0 0
0 0 0
0 0 0
0 2 0
0 0 2
0 2 0
0 2 0
0 0 0
0 0 1000
0 770 220
0 100 150
0 10 10
0 100 200
0 100 500
0 500 10
0
0 500 500
0
400 0
0 800 900
0 10 10
0 1000 950
0 9 8
0 1000 800
0 9 5
300 0 9 8
0
0 500 2000
0
0
0
0
0
0
170 0
0
0
0
0
0
0
Yang Membuat
Pengelola Obat Pustu / Poskesdes ….
NIP
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PTM
Pos/Pustu : PELAPORAN BULAN
PUSKESMAS : MAKARTI MULYA PERMINTAAN BULAN
KECAMATAN : MESUJI
KABUPATEN : OGAN KOMERING ILIR
PROPINSI : SUMATERA SELATAN
NO. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN
1 2 3 4 5 6
1 Absorbent tipped applicator (alcohol swab) Pcs 0 100 100
2 ACARBOSE 100 MG Tablet 0 0
3 ACARBOSE 50 MG Tablet 0 0
4 Acetylcystein Kapsul 200mg Kapsul 300 0 300
5 Acyclovir cream Tube 3 0 3
6 Acyclovir tab 200 mg Tablet 0 0
7 Acyclovir tab 400 mg Tablet 100 0 100
8 Albendazol tab 400 mg Tablet 0 0
9 ALIVE BIOCOM (C&ZINC) Tablet 0 0
10 ALIVE NUTRIBION (B1,B6,B12) Tablet 0 0
11 ALIVE ZIC syr Botol 0 0
12 ALIVE D1000 TAB Tablet 0 0
13 Alkohol Liquid (etanol) 70%-1000 ml Tablet 0 0
14 Allopurinol 100 mg Tablet 200 0 200
15 Allopurinol 300 mg Tablet 0 0
16 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0
17 Aminophylline tab 200 mg Tablet 0 0
18 Amitriptyline 25 mg tab Tablet 0 0
19 Amlodipine tab 5 mg Tablet 200 500 700
20 Amlodipine 10 mg Tablet 0 0
21 AMOXICILLIN DROP Botol 0 0
22 Amoxycillin 250 mg Kapsul 0 0
23 Amoxycillin 500 mg Kaptab 0 100 100
24 Amoxycillin Syr Btl 0 0
25 Ampicilin 1 gr Inj Vial 0 0
26 Antasida DOEN Kombinasi Tablet 200 500 700
27 Antasida Syr DOEN Btl 0 0
28 Anti Bisa Ular 5 ml (ABU I)/ Biosave Ampul 0 0
29 Asam Mefenamat 500 mg tab Tablet 900 0 900
30 Ascorbic acid (Vit.C) 50 mg Tablet 0 0
31 Aspirin (miniaspi) 80 mg tab Tablet 0 0
32 Atropine inj 0,25 mg/ml Ampul 0 0
33 Attapulgite Tablet (Pularex) Tablet 0 0
34 Attapulgite Tablet 600 mg (New Antides) Tablet 0 0
35 Automated blood grouping (Tes Gol. Darah) Paket 0 0
36 AZITROMISIN 500 mg tab Tablet 0 0
37 Bactivec Larvasida 30ml Botol 0 0
38 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0
39 Bedak Salisil 2% Btl 0 0
40 Benzoic acid |salicylic acid salep (anti fungi) Tube 0 0
41 Betahistine Mesylate 6 mg tab Tablet 0 0
42 Betamethasone 0,1% krim Tube10 gr 13 0 13
43 Betamethasone 0,5% krim tube 5 g 0 0
44 Biosens DBD (DBD TEST) Pcs 0 0
45 Bisacodyl 5mg Tablet 0 0
46 Bismuth subgallas (antihemoroid) Pot 0 0
47 Calcium chloride lactate infus (RL) Botol 0 0
48 Calsium Laktat (Kalk) 500 mg Tablet 0 100 100
49 CANDESARTAN 16 Tablet 0 0
50 CANDESARTAN 8 Tablet 0 0
51 Captopril 12,5 mg Tablet 200 500 700
52 Captopril 25 mg Tablet 240 500 740
53 Carbamazepin tab Tablet 0 0
54 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 0 0
55 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 0 0
56 Cefadroxil 500mg Tablet 0 0
57 CEFIXIME 200 MG Kapsul 0 0
58 CEFIXIME 100MG Tablet 0 0
59 Cefotaaxime Sodium inj 1gr Vial 0 0
60 CEFRIAXONE INJ Vial 0 0
61 Cetirizine 5 mg/5 ml sirup Botol 0 0
62 Cetirizine Tab Tablet 0 0
63 Chloramhenicol Salep Mata 1% Tube 0 0
64 Chloramphenicol 250 mg caps Tablet 0 0
65 Chloramphenicol Suspensi 125 mg/ml Btl 0 0
66 Chloramphenicol TT 3% Botol 0 0
67 Chloramphenicol/ Hidrokortison krim 2,5% Tube 0 0
68 Chlorpheniramine Maleat (CTM) 4 mg Tablet 0 0
69 Chlorpromazine HCl 100 mg Tablet 0 0
70 Chlorpromazine HCl 25mg Tablet 0 0
71 Cimetidin 200 tab Tablet 0 0
72 Ciprofloxacin 500 mg tab Tablet 0 0
73 Ciprofloxacin Infus Botol 0 0
74 Clindamycin 300mg Kapsul 0 0
75 CLOZAPIN 25 Tablet 0 0
76 Coverall/Hazmat XL/XXL Set 0 0
77 Crefe Flesh 10cm Rol 0 0
78 Cresol liquid 1 Liter (lysol) Botol 0 0
79 Denpro Orafil Plus Temporary Pcs 0 0
80 Devitalisasi pasta/Pulp X pot 0 0
81 Dexamethasone 0,5 mg Tablet 0 0
82 Dexamethasone inj 5mg/ml-1ml Ampul 0 0
83 Diazepam 2 mg Tablet 0 0
84 Diazepam 5mg/ml-2 ml inj Ampul 0 0
85 Diclofenac sodium 25 mg tab Tablet 0 0
86 Diclofenac sodium 50 mg tab Tablet 600 200 800
87 Digoxin 0,25 mg Tablet 0 0
88 Dimenhydrinate 50mg Tablet 0 0
89 Dipenhidramine HCl inj 10mg/ml Ampul 0 0
90 Domperidone 10 mg Tablet 0 0
91 Domperidone sr Botol 0 0
92 Doxycycline 100 mg Kapsul Kapsul 0 0
93 Dulcolax tab Tablet 0 0
94 DULCOLAX SUPPOS 10 MG supp 0 0
95 DULCOLAX SUPPOS 5 MG INFANT supp 0 0
96 Epinephrine HCl/bitartrat inj 0,1% Btl 0 0
97 Erythromicin 250 mg capsul Kapsul 0 0
98 Erythromicin 500 mg capsul Kapsul 0 0
99 Erythromicin Syr Btl 0 0
100 Ethacridine (Rivanol) 0,1% 300 ml Btl 0 0
101 Ethacridine (Rivanol) 0,1% 100ml Btl 0 0
102 Ethanol ( Aseptan ) 500 cc+ Pump Botol 0 0
103 Ethyl Chloride Btl 0 0
104 Eugenol cairan Btl 0 0
105 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 0
106 Folic acid 1mg ( asam folat) Tablet 0 0
107 Folley Catheter No.16 Pcs 0 0
108 Furosemida 40 mg Tablet 0 100 100
109 Furosemida Injeksi Ampul 0 0
110 Garam Oralit Sachet 0 0
111 Gentamicyn 0,1% SK Tube 0 0
112 Gentamicyn 0,3% TM Botol 30 3 33
113 Gentamicyn Inj 40 mg/ml Ampul 0 0
114 Glass lonomer Paket 0 0
115 Glibenclamide 5 mg Tablet 0 1000 1000
116 GLICLAZIDE TAB Tablet 0 0
117 Glimepiride 1 mg Tablet 0 0
118 Glukosa larutan infus 10% Botol 0 0
119 Glukosa larutan infus 5% Botol 0 0
120 Griseofulvin 125 mg Tablet 0 100 100
121 Guaifenesin 100 Tab/GG Tab Tablet 0 0
122 Haloperidol 0,5 mg tab Tablet 0 0
123 Haloperidol 1,5 mg tab Tablet 0 0
124 Haloperidol 5 mg tab Tablet 0 0
125 Herbakoof 100ml Botol 0 0
126 Human chorionic (HCG/Tes kehamilan ) Strip 0 0
127 Hydrochlorotiazide (HCT) 25 mg Tablet 0 0
128 H2O2 100 ML Botol 0 0
129 Ibuprofen 200 mg Tablet 0 0
130 Ibuprofen 400 mg Tablet 0 0
131 Ibuprofen sirup Botol 0 0
132 Ichthyol salep 10% Pcs 0 0
133 Immunoglobulin human anti-tetanus (Tetagam) Pcs 0 0
134 INDEC HIV1/2&SPHYLLIS pcs 0 0
135 Infus set dewasa Pcs 0 0
136 Infusi set anak Pcs 0 0
137 Isosorbide tablet Tablet 0 0
138 IV Catheter No.20 Pcs 0 0
139 IV Catheter No.22 Pcs 0 0
140 IV Catheter No.24 Pcs 0 0
141 Jarum Jahit Kulit Pcs 0 0
142 Kalium Permanganat Serbuk Pcs 0 0
143 Kapas pembalut/Absorben 250 g Pcs 0 0
144 Kasa kompres 40/40 steril Pcs 0 0
145 Kasa pembalut 2x80 Pcs 0 0
146 Kasa pembalut hidrofil 4 m x 15 cm Pcs 0 0
147 Kasa pembalut hidrofil 4 m x 3 cm Pcs 0 0
148 Ketac Universal (61108) Pcs 0 0
149 Ketac Universal (61111) Pcs 0 0
150 Ketoconazole 200 mg Cream Tube 0 0
151 Ketoconazole 200 mg tab Tablet 0 0
152 Ketorolac inj 30mg Ampul 0 0
153 Klorokina Fosfat 250 mg Tablet 0 0
154 KOTRIMOXAZOL 800/160 MG TAB Tablet 0 0
155 LAKTULOSE SYR Botol 0 0
156 Lancet Pcs 0 200 200
157 Levertran Salep/ Salep Luka Bakar Btl 0 0
158 Lidocain 2% Ampul 0 0
159 Lidocaine spray (Xylocaine spray) Pcs 0 0
160 Lidokain Comp. inj Kombinasi Ampul 0 0
161 Liquorice liquid extract (OBH) Botol 0 0
162 Locoriz Cream Tablet 0 0
163 Loperamid 2 mg tab / Diastrix 2 mg Tablet 0 0
164 Loratadine 10 mg tab Tablet 0 300 300
165 LYTACUR SYR Botol 0 0
166 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 0
167 Magnesium Sulfat Injeksi 40% (MgSO4) Ampul 0 0
168 Masker Pcs 0 300 300
169 Masker Earloop Pcs 0 0
170 Masker Headloop Pcs 0 0
171 Masker KN95 Pcs 0 0
172 Masker Plus Pcs 0 0
173 Masker Tie on Pcs 0 0
174 Medical adhesive tape (dermafix/leukomed) Pcs 0 0
175 Meprovent inj Ampul 0 0
176 Metamizole injeksi (antalgin 1000) Ampul 0 0
177 Metformin 500mg tab Tablet 0 0
178 Methyl Ergometrin Maleat 0,125 mg Tab 0 0
179 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0
180 Methyl Prednisolon tab 16 mg Tablet 0 0
181 Methyl Prednisolon tab 4 mg Tablet 0 400 400
182 Methyl Rosanilinium (gentian violet) Botol 0 0
183 METOCLOPROMIDE TAB Tablet 0 0
184 Metronidazol 250 mg tab Tablet 0 0
185 Metronidazol 500 mg tab Tablet 0 200 200
186 Metronidazol Infus Botol 0 0
187 Metronidazol syr Botol 0 0
188 Miconazole 2% Salep Kulit Tube 0 0
189 MOMETASONE Krim Tube 0 0
190 Moutpiece Steribreath 250's Pck 0 0
191 Natrium Bikarbonat 500 mg Tablet 0 0
192 Nifedipin 10 mg tab Kapsul 0 0
193 Nonwoven Fixation Rool Pcs 0 0
194 Nystatin Drop 100.000 IU Btl 0 0
195 Nystatin Tab Vag 10.000 iu/g Tablet 0 0
196 Octadin Botol 1000ml Botol 0 0
197 Octadin Spray 5ml Botol 0 0
198 Omeprazole inj Vial 0 0
199 Omeprazole kaps Tablet 0 400 400
200 Ondansetron iv/im 4mg Ampul 0 0
201 ONDANSETRON TAB Tablet 0 0
202 Otsu D-40 25ml Botol 0 0
203 Oxytetracycline HCl 1% Salep Mata Tube 0 0
204 Oxytetracycline HCl 3% Salep Kulit Tube 0 0
205 Oxytocin inj 10 IU Ampul 0 0
206 Papaverin 40 mg tab Tablet 0 0
207 Papaverin inj Tablet 0 0
208 Paracetamol Drops 15 ml Botol 0 0
209 Parasetamol 1000mg/100ml infus Botol 0 0
210 Parasetamol 120 mg/5 ml Syr Botol 0 0
211 Parasetamol 500 mg Tablet 100 1000 1100
212 Patient Lubricant (My Jelly ) Tube 0 0
213 Pehavral tab Tablet 0 0
214 Permethrin (Scabimite Cream) Tube 0 0
215 Phenobarbital 30 mg Tablet 0 0
216 Phenobarbital inj 50mg/ml-2ml Ampul 0 0
217 Phenol gliserol 10% TT Botol 0 0
218 Phytomenadione (Vit.K1) 10 mg Tablet 0 0
219 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 0
220 Phytomenadione (Vit.K1) inj 2 mg/ml Ampul 0 0
221 Piracetam 400 mg Tablet 0 0
222 Piroxicam 20 mg tab Tablet 0 0
223 Pisau Disposable (Mess No.10/11/20/21) pisau 0 0
224 Plesterku (Leukoplast) Pcs 0 0
225 Poli Aid 1 liter Botol 0 0
226 POLIAID 5L Botol 0 0
227 Policlean Handrub Botol 0 0
228 POLIDESINFEKTAN 5 L Botol 0 0
229 Polifix 10x5cm Pcs 0 0
230 Polifix 5x1cm Pcs 0 0
231 Polifix 5x5cm Pcs 0 0
232 POLIGEL 500 ML Botol 0 0
233 POLIGEL 5 L Botol 0 0
234 POLISOFT ALK HANDRUB 500 ML Botol 0 0
235 POLISOFT ALK HANDRUB 5 L Botol 0 0
236 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 0 0
237 Poliwash 500 ml Botol 0 0
238 POLIWASH 5 L Botol 0 0
239 Povidon iodium 10% 1000 ml Botol 0 0
240 Povidon iodium 10% 300 ml Botol 0 0
241 Povidon iodium 10% 60 ml Botol 0 0
242 Povidon Iodium 10% 30 ml Botol 0 0
243 Prednison 5 mg Tablet 0 200 200
244 Primaquin 15 mg tab Tablet 0 0
245 Propranolol HCl 10 mg Tablet 0 0
246 Propranolol HCl 40 mg Tablet 0 0
247 Propylthiouracil 100 mg Tablet 0 0
248 Protein Gluco Test Strip 0 0
249 Pyrantel Pamoat 125 mg Tablet 0 0
250 Pyridoxine HCl 10 mg Tablet 0 0
251 Ranitidin 150 mg Tablet 0 0
252 Ranitidin Injeksi Ampul 0 0
253 Rapid Test antigen (Panbio) Pcs 0 0
254 Retinol (Vit.A) kaps 100.000 iu Tablet 0 0
255 Retinol (Vit.A) kaps 200.000 iu Tablet 0 0
256 Risperidone 2mg Tablet 0 0
257 ROEKO ENDO FROST Botol 0 0
258 Salbutamol 2 mg Tablet 0 0
259 Salep 2-4 Kombinasi Tube 7 2 9
260 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0 0
261 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0
262 Sarung tangan (HandScuun Steril) No.7,5 Pcs 0 0
263 Sarung tangan (HandScuun) L Pcs 0 0
264 Sarung tangan (HandScuun) S/ M/ L Pcs 0 100 100
265 Sarung tangan nitril pcs 0 0
266 Semen Seng Fosfat Serbuk & Cairan Set 0 0
267 Sianocobalamin (Vit B12) 50 mg tab Tablet 0 500 500
268 Sianocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0
269 Silk (Benang Bedah) No. 3/0 Pcs 0 0
270 Silver Sulfadiazine Tube 0 0
271 Simvastatin 10 mg tab Kapsul 0 0
272 Simvastatin 20 mg tab Tablet 0 200 200
273 Sodium cloride infus 0,9% ( NACL ) Botol 0 0
274 Softanol 5 Liter Botol 0 0
275 Softanol 500ml Botol 0 0
276 Spuit 1 ml Pcs 0 0
277 Spuit 3 ml Pcs 0 0
278 Spuit 5 ml Pcs 0 0
279 Stericide 5 Liter Botol 0 0
280 Stimuno Capsul Forte Kapsul 0 0
281 Stimuno syrup Botol 0 0
282 Strip Asam Urat Pcs 0 625 625
283 Strip Gula Darah box 0 10 10
284 Strip kolestrol Pcs 0 200 200
285 SUKRALFAT TAB Tablet 0 0
286 SUKRALFAT SYR Botol 0 0
287 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 0 0
288 Sulfamethoxazole|trimethoprim (cotri) syr Botol 0 0
289 Sulfasetamida 15% TM Ampul 0 0
290 Surgical gown XL Set 0 0
291 Tetracycline 250 mg Tablet 0 0
292 Tetracycline 500 mg Tablet 0 0
293 Thiamine HCl (Vit B1) 50 mg Tablet 0 0
294 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0
295 Tranexamic Acid inj 5% Ampul 0 0
296 TRANEXAMIC ACID TAB Tablet 0 0
297 Trepocheck syphilis Pcs 0 0
298 Trihexyphenidyl tab 2 mg Tablet 0 0
299 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 0 200 200
300 Urin Bag Pcs 0 0
301 Usg Gel Botol 0 0
302 Vaksin Rabies Vero/ Verorab Paket 0 0
303 VALSARTAN 80 Tablet 0 0
304 VALSARTAN 160 Tablet 0 0
305 Viorex Liq 2% 5 Liter Botol 0 0
306 Viorex Liq 2% 500ml Botol 0 0
307 Virocheck HIV Pcs 0 0
308 Vitamin B Kompleks Tablet 0 1100 1100
309 Vitamin K Infant Inj Ampul 0 0
310 Water liquid (aqua P,I) Botol 0 0
311 Wing Needle No.21 Pcs 0 0
312 Wing Needle No.27 Pcs 0 0
313 Xpert MTB/RIF pcs 0 0
314 Zinc Drop Botol 0 0
315 Zinc tab Tablet 0 0
316 HB Test (Hemachroma Plus Microcuvette) Box 0 0
317 HIV Sifilis Combo Box 0 0
318 Kapas Lidi Box 0 0
319 Asam Asetat Botol 0 0
320 Sasklin Desinfektan 500 mL Botol 0 0
321 Kapas 1000 gr Box 0 0
322 Ameritek Test Box 0 0
323 Pot Feses Pack 0 0
324 Ambroxol Tablet Tablet 0 200 200
325 Ambroxol Syrup Botol 0 0
326 Reagen E.Coli 0 0
327 Caroto Gel 80 gr/ ECG Gel 0 0
328 Kertas ECG uk. 80 mmx 20 m 0 0
329 Kertas ECG uk. 80 mmx 90 mmx 280 0 0
330 Combur Test 0 0
UMUM JAMSOSKES BPJS JUMLAH
JUMLAH KUNJUNGAN RESEP
Mengetahui
Pengelola Obat Puskesmas
apt. Winda Utami, S. Farm.
NIP 199509112022032013
MINTAAN OBAT (LPLPO) PTM/PUSLING
: DOKUMEN NOMOR TANGGAL
: DINKES KAB/KOTA
IFK KAB/KOTA
PUSKESMAS
STOK STOK nov des jan
PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AKHIR OPTIMUM
7 8 9 10 11 12
100 0 200 277 1343
0 980 1000
0 24 25
0 300 0 0
0 3 1000 920
0 0 0
0 100 1 6
0 1200 1000
0 3 10
0 0 0
0 45 50
0 150 260
0 440 120
100 100 500 3500 3550
0 38 35
0 0 0
0 1500 2598
0 109 220
110 590 2 0
0 200 2500 3500
0 454 860
0 0 0
40 60 0 0
0 0 5
0 0 0
380 320 500 150 100
0 0 0
0 0 24
900 0 500 0 0
0 80 70
0 20 30
0 800 1500
0 30 53
0 0 0
0 5 1
0 20 15
0 275 270
0 1550 3570
0 2190 1030
0 3000 1200
0 200 150 260
0 13 36 48
0 1 27
0 1000 0
0 0 10
0 6 27
0 5000 200
30 70 200 30 25
0 100 150
0 50 35
590 110 600 10 35
370 370 500 100 99
0 3440 160
0 60 0
0 0 0
0 0 0
0 2500 1500
0 0 0
0 100 350
0 0 5
0 0 1
0 1 5
0 0 0
0 0 0
0 4000 3000
0 30 20
0 47 40
0 11 9
0 0 0
0 4000 3400
0 0 90
0 470 80
0 15 31
0 4000 1200
0 0 0
0 0 0
0 18 5
0 0 0
0 440 500
0 0 0
0 200 5 6
0 20 23
0 0 1
0 0 1
0 0 0
770 30 500 470 420
0 0 0
0 10 17
0 500 120
0 0 0
0 302 41
0 30 19
0 100 23
0 30 35
0 0 0
0 2190 780
0 4200 2200
0 7 9
0 0 0
0 50 140
0 2000 3000
0 0 0
0 0 0
0 30 300
0 100 104
0 89 50
0 50 110
0 100 0 0
0 1013 2000
0 22 116
0 15 12
9 24 10 0 5
0 80 96
0 33 32
60 940 200 80
0 150 58
0 102 97
0 0 99
0 0 0
0 100 0 0
0 300 8 5
0 75 50
0 43 146
0 20 15
0 31 32
0 0 2
0 0 2
0 80 54
0 200 540
0 15 20
0 0 0
0 500 250
0 0 0
0 0 0
0 0 0
0 200 107
0 0 0
0 0 0
0 600 900
0 270 270
0 0 0
0 6 15
0 0 0
0 76 500
0 0 0
0 0 0
0 0 0
0 500 570
0 0 102
0 20 0
0 3257 4010
0 0 0
0 0 0
0 0 0
0 3500 2500
100 100 200 0 0
0 0 0
0 1200 2453
0 0 0
0 1 0
0 100 120
0 0 1
0 0 0
200 100 200 300 250
0 0 0
0 2 6
0 195 24
68 232 0 0
0 0 0
0 0 60
0 3200 3500
0 10 15
0 20 0
0 50 125
0 45 10
0 100 34
0 5000 0 0
0 0 0
0 19 6
0 20 25
30 370 17 0
0 4000 5380
0 2 10
0 1200 830
20 180 100 23 24
0 0 0
0 0 0
0 20 0 0
0 300 320
0 0 0
0 75 35
0 200 0 0
0 1500 1200
0 0 20
0 25 21
0 0 0
0 9 1
0 0 0
130 270 100 25 27
0 0 0
0 0 0
0 10 0
0 0 0
0 1 9
0 0 9
0 2 0
0 1400 1654
0 0 0
0 0 0
0 0 0
960 140 300 0 0
0 0 0
0 0 124
0 300 110
0 2500 2700
0 14 10
0 0 0
0 0 0
0 0 42
0 1000 1200
0 500 430
0 22 12
0 190 31
0 302 142
0 0 0
0 0 0
0 714 1550
0 0 0
0 890 710
0 0 0
0 0 6
0 1 12
0 1490 1500
0 16 13
0 0 0
0 2 7
0 265 490
0 1200 1000
0 106 532
0 0 0
0 500 250
0 67 9
20 180 100 100 99
0 0 67
0 84 80
0 0 0
0 263 35
0 0 0
0 0 0
0 360 50
0 200 0 0
0 920 750
0 0 0
0 13 15
0 49 0
0 210 250
0 0 600
0 0 19
0 9 0 0
0 2 0
0 0 4
0 0 0
0 10 59
68 32 200 570 750
0 0 0
0 30 22
290 210 500 0 0
0 0 0
0 0 0
0 0 17
0 0 0
40 160 500 1000 1500
0 0 0
0 0 0
0 200 300
0 2500 1500
0 12 9
0 0 0
0 200 120
0 0 0
0 200 600
268 357 300 180 140
10 0 6 0 30
200 0 300 0 0
0 0 0
0 0 0
0 0 0
0 12 13
0 100 320
0 0 0
0 0 0
0 0 0
0 2 0
0 0 2
0 2 0
0 2 0
0 0 0
0 0 1000
0 200 770 220
0 100 150
0 10 10
0 100 200
0 100 500
0 500 10
0
0 500 500
0
860 240 500
0 800 900
0 10 10
0 1000 950
0 9 8
0 1000 800
0 9 5
0 9 8
0
0 500 2000
0
0
0
0
0
0
10 190
0
0
0
0
0
0
Yang Membuat
Pengelola Obat Pustu / Poskesdes ….
NIP
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PTM
Pos/Pustu : PELAPORAN BULAN
PUSKESMAS : MAKARTI MULYA PERMINTAAN BULAN
KECAMATAN : MESUJI
KABUPATEN : OGAN KOMERING ILIR
PROPINSI : SUMATERA SELATAN
NO. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN
1 2 3 4 5 6
1 Absorbent tipped applicator (alcohol swab) Pcs 0 200 200
2 ACARBOSE 100 MG Tablet 0 0
3 ACARBOSE 50 MG Tablet 0 0
4 Acetylcystein Kapsul 200mg Kapsul 300 300
5 Acyclovir cream Tube 3 3
6 Acyclovir tab 200 mg Tablet 0 0
7 Acyclovir tab 400 mg Tablet 100 100
8 Albendazol tab 400 mg Tablet 0 0
9 ALIVE BIOCOM (C&ZINC) Tablet 0 0
10 ALIVE NUTRIBION (B1,B6,B12) Tablet 0 0
11 ALIVE ZIC syr Botol 0 0
12 ALIVE D1000 TAB Tablet 0 0
13 Alkohol Liquid (etanol) 70%-1000 ml Tablet 0 0
14 Allopurinol 100 mg Tablet 100 100
15 Allopurinol 300 mg Tablet 0 0
16 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0
17 Aminophylline tab 200 mg Tablet 0 0
18 Amitriptyline 25 mg tab Tablet 0 0
19 Amlodipine tab 5 mg Tablet 590 590
20 Amlodipine 10 mg Tablet 0 0
21 AMOXICILLIN DROP Botol 0 0
22 Amoxycillin 250 mg Kapsul 0 0
23 Amoxycillin 500 mg Kaptab 60 60
24 Amoxycillin Syr Btl 0 0
25 Ampicilin 1 gr Inj Vial 0 0
26 Antasida DOEN Kombinasi Tablet 320 500 820
27 Antasida Syr DOEN Btl 0 0
28 Anti Bisa Ular 5 ml (ABU I)/ Biosave Ampul 0 0
29 Asam Mefenamat 500 mg tab Tablet 0 1000 1000
30 Ascorbic acid (Vit.C) 50 mg Tablet 0 0
31 Aspirin (miniaspi) 80 mg tab Tablet 0 0
32 Atropine inj 0,25 mg/ml Ampul 0 0
33 Attapulgite Tablet (Pularex) Tablet 0 0
34 Attapulgite Tablet 600 mg (New Antides) Tablet 0 0
35 Automated blood grouping (Tes Gol. Darah) Paket 0 0
36 AZITROMISIN 500 mg tab Tablet 0 0
37 Bactivec Larvasida 30ml Botol 0 0
38 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0
39 Bedak Salisil 2% Btl 0 0
40 Benzoic acid |salicylic acid salep (anti fungi) Tube 0 0
41 Betahistine Mesylate 6 mg tab Tablet 0 200 200
42 Betamethasone 0,1% krim Tube10 gr 13 13
43 Betamethasone 0,5% krim tube 5 g 0 0
44 Biosens DBD (DBD TEST) Pcs 0 0
45 Bisacodyl 5mg Tablet 0 0
46 Bismuth subgallas (antihemoroid) Pot 0 0
47 Calcium chloride lactate infus (RL) Botol 0 0
48 Calsium Laktat (Kalk) 500 mg Tablet 70 200 270
49 CANDESARTAN 16 Tablet 0 0
50 CANDESARTAN 8 Tablet 0 0
51 Captopril 12,5 mg Tablet 110 500 610
52 Captopril 25 mg Tablet 370 500 870
53 Carbamazepin tab Tablet 0 0
54 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 0 0
55 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 0 0
56 Cefadroxil 500mg Tablet 0 0
57 CEFIXIME 200 MG Kapsul 0 0
58 CEFIXIME 100MG Tablet 0 0
59 Cefotaaxime Sodium inj 1gr Vial 0 0
60 CEFRIAXONE INJ Vial 0 0
61 Cetirizine 5 mg/5 ml sirup Botol 0 0
62 Cetirizine Tab Tablet 0 0
63 Chloramhenicol Salep Mata 1% Tube 0 0
64 Chloramphenicol 250 mg caps Tablet 0 0
65 Chloramphenicol Suspensi 125 mg/ml Btl 0 0
66 Chloramphenicol TT 3% Botol 0 0
67 Chloramphenicol/ Hidrokortison krim 2,5% Tube 0 0
68 Chlorpheniramine Maleat (CTM) 4 mg Tablet 0 0
69 Chlorpromazine HCl 100 mg Tablet 0 0
70 Chlorpromazine HCl 25mg Tablet 0 0
71 Cimetidin 200 tab Tablet 0 0
72 Ciprofloxacin 500 mg tab Tablet 0 0
73 Ciprofloxacin Infus Botol 0 0
74 Clindamycin 300mg Kapsul 0 0
75 CLOZAPIN 25 Tablet 0 0
76 Coverall/Hazmat XL/XXL Set 0 0
77 Crefe Flesh 10cm Rol 0 0
78 Cresol liquid 1 Liter (lysol) Botol 0 0
79 Denpro Orafil Plus Temporary Pcs 0 0
80 Devitalisasi pasta/Pulp X pot 0 0
81 Dexamethasone 0,5 mg Tablet 0 0
82 Dexamethasone inj 5mg/ml-1ml Ampul 0 0
83 Diazepam 2 mg Tablet 0 0
84 Diazepam 5mg/ml-2 ml inj Ampul 0 0
85 Diclofenac sodium 25 mg tab Tablet 0 0
86 Diclofenac sodium 50 mg tab Tablet 30 30
87 Digoxin 0,25 mg Tablet 0 0
88 Dimenhydrinate 50mg Tablet 0 0
89 Dipenhidramine HCl inj 10mg/ml Ampul 0 0
90 Domperidone 10 mg Tablet 0 0
91 Domperidone sr Botol 0 0
92 Doxycycline 100 mg Kapsul Kapsul 0 0
93 Dulcolax tab Tablet 0 0
94 DULCOLAX SUPPOS 10 MG supp 0 0
95 DULCOLAX SUPPOS 5 MG INFANT supp 0 0
96 Epinephrine HCl/bitartrat inj 0,1% Btl 0 0
97 Erythromicin 250 mg capsul Kapsul 0 0
98 Erythromicin 500 mg capsul Kapsul 0 0
99 Erythromicin Syr Btl 0 0
100 Ethacridine (Rivanol) 0,1% 300 ml Btl 0 0
101 Ethacridine (Rivanol) 0,1% 100ml Btl 0 0
102 Ethanol ( Aseptan ) 500 cc+ Pump Botol 0 0
103 Ethyl Chloride Btl 0 0
104 Eugenol cairan Btl 0 0
105 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 0
106 Folic acid 1mg ( asam folat) Tablet 0 0
107 Folley Catheter No.16 Pcs 0 0
108 Furosemida 40 mg Tablet 100 100
109 Furosemida Injeksi Ampul 0 0
110 Garam Oralit Sachet 0 0
111 Gentamicyn 0,1% SK Tube 0 0
112 Gentamicyn 0,3% TM Botol 24 10 34
113 Gentamicyn Inj 40 mg/ml Ampul 0 0
114 Glass lonomer Paket 0 0
115 Glibenclamide 5 mg Tablet 940 940
116 GLICLAZIDE TAB Tablet 0 0
117 Glimepiride 1 mg Tablet 0 0
118 Glukosa larutan infus 10% Botol 0 0
119 Glukosa larutan infus 5% Botol 0 0
120 Griseofulvin 125 mg Tablet 100 100
121 Guaifenesin 100 Tab/GG Tab Tablet 0 0
122 Haloperidol 0,5 mg tab Tablet 0 0
123 Haloperidol 1,5 mg tab Tablet 0 0
124 Haloperidol 5 mg tab Tablet 0 0
125 Herbakoof 100ml Botol 0 0
126 Human chorionic (HCG/Tes kehamilan ) Strip 0 0
127 Hydrochlorotiazide (HCT) 25 mg Tablet 0 0
128 H2O2 100 ML Botol 0 0
129 Ibuprofen 200 mg Tablet 0 0
130 Ibuprofen 400 mg Tablet 0 0
131 Ibuprofen sirup Botol 0 0
132 Ichthyol salep 10% Pcs 0 0
133 Immunoglobulin human anti-tetanus (Tetagam) Pcs 0 0
134 INDEC HIV1/2&SPHYLLIS pcs 0 0
135 Infus set dewasa Pcs 0 0
136 Infusi set anak Pcs 0 0
137 Isosorbide tablet Tablet 0 0
138 IV Catheter No.20 Pcs 0 0
139 IV Catheter No.22 Pcs 0 0
140 IV Catheter No.24 Pcs 0 0
141 Jarum Jahit Kulit Pcs 0 0
142 Kalium Permanganat Serbuk Pcs 0 0
143 Kapas pembalut/Absorben 250 g Pcs 0 0
144 Kasa kompres 40/40 steril Pcs 0 0
145 Kasa pembalut 2x80 Pcs 0 0
146 Kasa pembalut hidrofil 4 m x 15 cm Pcs 0 0
147 Kasa pembalut hidrofil 4 m x 3 cm Pcs 0 0
148 Ketac Universal (61108) Pcs 0 0
149 Ketac Universal (61111) Pcs 0 0
150 Ketoconazole 200 mg Cream Tube 0 0
151 Ketoconazole 200 mg tab Tablet 0 0
152 Ketorolac inj 30mg Ampul 0 0
153 Klorokina Fosfat 250 mg Tablet 0 0
154 KOTRIMOXAZOL 800/160 MG TAB Tablet 0 0
155 LAKTULOSE SYR Botol 0 0
156 Lancet Pcs 100 200 300
157 Levertran Salep/ Salep Luka Bakar Btl 0 0
158 Lidocain 2% Ampul 0 0
159 Lidocaine spray (Xylocaine spray) Pcs 0 0
160 Lidokain Comp. inj Kombinasi Ampul 0 0
161 Liquorice liquid extract (OBH) Botol 0 0
162 Locoriz Cream Tablet 0 0
163 Loperamid 2 mg tab / Diastrix 2 mg Tablet 0 0
164 Loratadine 10 mg tab Tablet 100 200 300
165 LYTACUR SYR Botol 0 0
166 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 0
167 Magnesium Sulfat Injeksi 40% (MgSO4) Ampul 0 0
168 Masker Pcs 232 232
169 Masker Earloop Pcs 0 0
170 Masker Headloop Pcs 0 0
171 Masker KN95 Pcs 0 0
172 Masker Plus Pcs 0 0
173 Masker Tie on Pcs 0 0
174 Medical adhesive tape (dermafix/leukomed) Pcs 0 0
175 Meprovent inj Ampul 0 0
176 Metamizole injeksi (antalgin 1000) Ampul 0 0
177 Metformin 500mg tab Tablet 0 0
178 Methyl Ergometrin Maleat 0,125 mg Tab 0 0
179 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0
180 Methyl Prednisolon tab 16 mg Tablet 0 0
181 Methyl Prednisolon tab 4 mg Tablet 370 370
182 Methyl Rosanilinium (gentian violet) Botol 0 0
183 METOCLOPROMIDE TAB Tablet 0 0
184 Metronidazol 250 mg tab Tablet 0 0
185 Metronidazol 500 mg tab Tablet 180 200 380
186 Metronidazol Infus Botol 0 0
187 Metronidazol syr Botol 0 0
188 Miconazole 2% Salep Kulit Tube 0 24 24
189 MOMETASONE Krim Tube 0 0
190 Moutpiece Steribreath 250's Pck 0 0
191 Natrium Bikarbonat 500 mg Tablet 0 0
192 Nifedipin 10 mg tab Kapsul 0 200 200
193 Nonwoven Fixation Rool Pcs 0 0
194 Nystatin Drop 100.000 IU Btl 0 0
195 Nystatin Tab Vag 10.000 iu/g Tablet 0 0
196 Octadin Botol 1000ml Botol 0 0
197 Octadin Spray 5ml Botol 0 0
198 Omeprazole inj Vial 0 0
199 Omeprazole kaps Tablet 270 200 470
200 Ondansetron iv/im 4mg Ampul 0 0
201 ONDANSETRON TAB Tablet 0 0
202 Otsu D-40 25ml Botol 0 0
203 Oxytetracycline HCl 1% Salep Mata Tube 0 0
204 Oxytetracycline HCl 3% Salep Kulit Tube 0 0
205 Oxytocin inj 10 IU Ampul 0 0
206 Papaverin 40 mg tab Tablet 0 0
207 Papaverin inj Tablet 0 0
208 Paracetamol Drops 15 ml Botol 0 0
209 Parasetamol 1000mg/100ml infus Botol 0 0
210 Parasetamol 120 mg/5 ml Syr Botol 0 0
211 Parasetamol 500 mg Tablet 140 300 440
212 Patient Lubricant (My Jelly ) Tube 0 0
213 Pehavral tab Tablet 0 0
214 Permethrin (Scabimite Cream) Tube 0 0
215 Phenobarbital 30 mg Tablet 0 0
216 Phenobarbital inj 50mg/ml-2ml Ampul 0 0
217 Phenol gliserol 10% TT Botol 0 0
218 Phytomenadione (Vit.K1) 10 mg Tablet 0 0
219 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 0
220 Phytomenadione (Vit.K1) inj 2 mg/ml Ampul 0 0
221 Piracetam 400 mg Tablet 0 0
222 Piroxicam 20 mg tab Tablet 0 0
223 Pisau Disposable (Mess No.10/11/20/21) pisau 0 0
224 Plesterku (Leukoplast) Pcs 0 0
225 Poli Aid 1 liter Botol 0 0
226 POLIAID 5L Botol 0 0
227 Policlean Handrub Botol 0 0
228 POLIDESINFEKTAN 5 L Botol 0 0
229 Polifix 10x5cm Pcs 0 0
230 Polifix 5x1cm Pcs 0 0
231 Polifix 5x5cm Pcs 0 0
232 POLIGEL 500 ML Botol 0 0
233 POLIGEL 5 L Botol 0 0
234 POLISOFT ALK HANDRUB 500 ML Botol 0 0
235 POLISOFT ALK HANDRUB 5 L Botol 0 0
236 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 0 0
237 Poliwash 500 ml Botol 0 0
238 POLIWASH 5 L Botol 0 0
239 Povidon iodium 10% 1000 ml Botol 0 0
240 Povidon iodium 10% 300 ml Botol 0 0
241 Povidon iodium 10% 60 ml Botol 0 0
242 Povidon Iodium 10% 30 ml Botol 0 0
243 Prednison 5 mg Tablet 180 500 680
244 Primaquin 15 mg tab Tablet 0 0
245 Propranolol HCl 10 mg Tablet 0 0
246 Propranolol HCl 40 mg Tablet 0 0
247 Propylthiouracil 100 mg Tablet 0 0
248 Protein Gluco Test Strip 0 0
249 Pyrantel Pamoat 125 mg Tablet 0 0
250 Pyridoxine HCl 10 mg Tablet 0 0
251 Ranitidin 150 mg Tablet 0 200 200
252 Ranitidin Injeksi Ampul 0 0
253 Rapid Test antigen (Panbio) Pcs 0 0
254 Retinol (Vit.A) kaps 100.000 iu Tablet 0 0
255 Retinol (Vit.A) kaps 200.000 iu Tablet 0 0
256 Risperidone 2mg Tablet 0 0
257 ROEKO ENDO FROST Botol 0 0
258 Salbutamol 2 mg Tablet 0 0
259 Salep 2-4 Kombinasi Tube 9 9
260 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0 0
261 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0
262 Sarung tangan (HandScuun Steril) No.7,5 Pcs 0 0
263 Sarung tangan (HandScuun) L Pcs 0 0
264 Sarung tangan (HandScuun) S/ M/ L Pcs 32 200 232
265 Sarung tangan nitril pcs 0 0
266 Semen Seng Fosfat Serbuk & Cairan Set 0 0
267 Sianocobalamin (Vit B12) 50 mg tab Tablet 210 500 710
268 Sianocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0
269 Silk (Benang Bedah) No. 3/0 Pcs 0 0
270 Silver Sulfadiazine Tube 0 0
271 Simvastatin 10 mg tab Kapsul 0 0
272 Simvastatin 20 mg tab Tablet 160 160
273 Sodium cloride infus 0,9% ( NACL ) Botol 0 0
274 Softanol 5 Liter Botol 0 0
275 Softanol 500ml Botol 0 0
276 Spuit 1 ml Pcs 0 0
277 Spuit 3 ml Pcs 0 0
278 Spuit 5 ml Pcs 0 0
279 Stericide 5 Liter Botol 0 0
280 Stimuno Capsul Forte Kapsul 0 0
281 Stimuno syrup Botol 0 0
282 Strip Asam Urat Pcs 357 357
283 Strip Gula Darah box 0 0
284 Strip kolestrol Pcs 0 0
285 SUKRALFAT TAB Tablet 0 0
286 SUKRALFAT SYR Botol 0 0
287 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 0 0
288 Sulfamethoxazole|trimethoprim (cotri) syr Botol 0 0
289 Sulfasetamida 15% TM Ampul 0 0
290 Surgical gown XL Set 0 0
291 Tetracycline 250 mg Tablet 0 0
292 Tetracycline 500 mg Tablet 0 0
293 Thiamine HCl (Vit B1) 50 mg Tablet 0 0
294 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0
295 Tranexamic Acid inj 5% Ampul 0 0
296 TRANEXAMIC ACID TAB Tablet 0 0
297 Trepocheck syphilis Pcs 0 0
298 Trihexyphenidyl tab 2 mg Tablet 0 0
299 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 200 200
300 Urin Bag Pcs 0 0
301 Usg Gel Botol 0 0
302 Vaksin Rabies Vero/ Verorab Paket 0 0
303 VALSARTAN 80 Tablet 0 0
304 VALSARTAN 160 Tablet 0 0
305 Viorex Liq 2% 5 Liter Botol 0 0
306 Viorex Liq 2% 500ml Botol 0 0
307 Virocheck HIV Pcs 0 0
308 Vitamin B Kompleks Tablet 240 500 740
309 Vitamin K Infant Inj Ampul 0 0
310 Water liquid (aqua P,I) Botol 0 0
311 Wing Needle No.21 Pcs 0 0
312 Wing Needle No.27 Pcs 0 0
313 Xpert MTB/RIF pcs 0 0
314 Zinc Drop Botol 0 0
315 Zinc tab Tablet 0 0
316 HB Test (Hemachroma Plus Microcuvette) Box 0 0
317 HIV Sifilis Combo Box 0 0
318 Kapas Lidi Box 0 0
319 Asam Asetat Botol 0 0
320 Sasklin Desinfektan 500 mL Botol 0 0
321 Kapas 1000 gr Box 0 0
322 Ameritek Test Box 0 0
323 Pot Feses Pack 0 0
324 Ambroxol Tablet Tablet 190 190
325 Ambroxol Syrup Botol 0 0
326 Reagen E.Coli 0 0
327 Caroto Gel 80 gr/ ECG Gel 0 0
328 Kertas ECG uk. 80 mmx 20 m 0 0
329 Kertas ECG uk. 80 mmx 90 mmx 280 0 0
330 Combur Test 0 0
UMUM JAMSOSKES BPJS JUMLAH
JUMLAH KUNJUNGAN RESEP
Mengetahui
Pengelola Obat Puskesmas
apt. Winda Utami, S. Farm.
NIP 199509112022032013
MINTAAN OBAT (LPLPO) PTM/PUSLING
: DOKUMEN NOMOR TANGGAL
: DINKES KAB/KOTA
IFK KAB/KOTA
PUSKESMAS
STOK STOK nov des jan
PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AKHIR OPTIMUM
7 8 9 10 11 12
200 277 1343
0 980 1000
0 24 25
30 270 0 0
3 1000 920
0 0 0
100 1 6
0 1200 1000
0 3 10
0 0 0
0 45 50
0 150 260
0 440 120
90 10 3500 3550
0 38 35
0 0 0
0 1500 2598
0 109 220
30 560 2 0
0 2500 3500
0 454 860
0 0 0
60 0 0 0
0 0 5
0 0 0
220 600 150 100
0 0 0
0 0 24
490 510 0 0
0 80 70
0 20 30
0 800 1500
0 30 53
0 0 0
0 5 1
0 20 15
0 275 270
0 1550 3570
0 2190 1030
0 3000 1200
10 190 150 260
13 36 48
0 1 27
0 1000 0
0 0 10
0 6 27
0 5000 200
270 30 25
0 100 150
0 50 35
290 320 10 35
360 510 100 99
0 3440 160
0 60 0
0 0 0
0 0 0
0 2500 1500
0 0 0
0 100 350
0 0 5
0 0 1
0 1 5
0 0 0
0 0 0
0 4000 3000
0 30 20
0 47 40
0 11 9
0 0 0
0 4000 3400
0 0 90
0 470 80
0 15 31
0 4000 1200
0 0 0
0 0 0
0 18 5
0 0 0
0 440 500
0 0 0
0 5 6
0 20 23
0 0 1
0 0 1
0 0 0
30 0 470 420
0 0 0
0 10 17
0 500 120
0 0 0
0 302 41
0 30 19
0 100 23
0 30 35
0 0 0
0 2190 780
0 4200 2200
0 7 9
0 0 0
0 50 140
0 2000 3000
0 0 0
0 0 0
0 30 300
0 100 104
0 89 50
0 50 110
100 0 0
0 1013 2000
0 22 116
0 15 12
2 32 0 5
0 80 96
0 33 32
10 930 200 80
0 150 58
0 102 97
0 0 99
0 0 0
100 0 0
0 8 5
0 75 50
0 43 146
0 20 15
0 31 32
0 0 2
0 0 2
0 80 54
0 200 540
0 15 20
0 0 0
0 500 250
0 0 0
0 0 0
0 0 0
0 200 107
0 0 0
0 0 0
0 600 900
0 270 270
0 0 0
0 6 15
0 0 0
0 76 500
0 0 0
0 0 0
0 0 0
0 500 570
0 0 102
0 20 0
0 3257 4010
0 0 0
0 0 0
0 0 0
0 3500 2500
300 0 0
0 0 0
0 1200 2453
0 0 0
0 1 0
0 100 120
0 0 1
0 0 0
210 90 300 250
0 0 0
0 2 6
0 195 24
232 0 0
0 0 0
0 0 60
0 3200 3500
0 10 15
0 20 0
0 50 125
0 45 10
0 100 34
0 0 0
0 0 0
0 19 6
0 20 25
120 250 17 0
0 4000 5380
0 2 10
0 1200 830
10 370 23 24
0 0 0
0 0 0
2 22 0 0
0 300 320
0 0 0
0 75 35
200 0 0
0 1500 1200
0 0 20
0 25 21
0 0 0
0 9 1
0 0 0
100 370 25 27
0 0 0
0 0 0
0 10 0
0 0 0
0 1 9
0 0 9
0 2 0
0 1400 1654
0 0 0
0 0 0
0 0 0
440 0 0 0
0 0 0
0 0 124
0 300 110
0 2500 2700
0 14 10
0 0 0
0 0 0
0 0 42
0 1000 1200
0 500 430
0 22 12
0 190 31
0 302 142
0 0 0
0 0 0
0 714 1550
0 0 0
0 890 710
0 0 0
0 0 6
0 1 12
0 1490 1500
0 16 13
0 0 0
0 2 7
0 265 490
0 1200 1000
0 106 532
0 0 0
0 500 250
0 67 9
30 650 100 99
0 0 67
0 84 80
0 0 0
0 263 35
0 0 0
0 0 0
0 360 50
160 40 0 0
0 920 750
0 0 0
0 13 15
0 49 0
0 210 250
0 0 600
0 0 19
9 0 0
0 2 0
0 0 4
0 0 0
0 10 59
232 570 750
0 0 0
0 30 22
210 500 0 0
0 0 0
0 0 0
0 0 17
0 0 0
160 1000 1500
0 0 0
0 0 0
0 200 300
0 2500 1500
0 12 9
0 0 0
0 200 120
0 0 0
0 200 600
357 180 140
0 0 30
0 0 0
0 0 0
0 0 0
0 0 0
0 12 13
0 100 320
0 0 0
0 0 0
0 0 0
0 2 0
0 0 2
0 2 0
0 2 0
0 0 0
0 0 1000
200 770 220
0 100 150
0 10 10
0 100 200
0 100 500
0 500 10
0
0 500 500
0
610 130
0 800 900
0 10 10
0 1000 950
0 9 8
0 1000 800
0 9 5
0 9 8
0
0 500 2000
0
0
0
0
0
0
10 180
0
0
0
0
0
0
Yang Membuat
Pengelola Obat Pustu / Poskesdes ….
NIP
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PTM
Pos/Pustu : PELAPORAN BULAN
PUSKESMAS : MAKARTI MULYA PERMINTAAN BULAN
KECAMATAN : MESUJI
KABUPATEN : OGAN KOMERING ILIR
PROPINSI : SUMATERA SELATAN
NO. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN
1 2 3 4 5 6
1 Absorbent tipped applicator (alcohol swab) Pcs 200 200
2 ACARBOSE 100 MG Tablet 0 0
3 ACARBOSE 50 MG Tablet 0 0
4 Acetylcystein Kapsul 200mg Kapsul 270 270
5 Acyclovir cream Tube 3 3
6 Acyclovir tab 200 mg Tablet 0 0
7 Acyclovir tab 400 mg Tablet 100 100
8 Albendazol tab 400 mg Tablet 0 0
9 ALIVE BIOCOM (C&ZINC) Tablet 0 0
10 ALIVE NUTRIBION (B1,B6,B12) Tablet 0 0
11 ALIVE ZIC syr Botol 0 0
12 ALIVE D1000 TAB Tablet 0 0
13 Alkohol Liquid (etanol) 70%-1000 ml Tablet 0 0
14 Allopurinol 100 mg Tablet 10 10
15 Allopurinol 300 mg Tablet 0 0
16 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0
17 Aminophylline tab 200 mg Tablet 0 0
18 Amitriptyline 25 mg tab Tablet 0 0
19 Amlodipine tab 5 mg Tablet 560 560
20 Amlodipine 10 mg Tablet 0 0
21 AMOXICILLIN DROP Botol 0 0
22 Amoxycillin 250 mg Kapsul 0 0
23 Amoxycillin 500 mg Kaptab 0 0
24 Amoxycillin Syr Btl 0 0
25 Ampicilin 1 gr Inj Vial 0 0
26 Antasida DOEN Kombinasi Tablet 600 600
27 Antasida Syr DOEN Btl 0 0
28 Anti Bisa Ular 5 ml (ABU I)/ Biosave Ampul 0 0
29 Asam Mefenamat 500 mg tab Tablet 510 510
30 Ascorbic acid (Vit.C) 50 mg Tablet 0 0
31 Aspirin (miniaspi) 80 mg tab Tablet 0 0
32 Atropine inj 0,25 mg/ml Ampul 0 0
33 Attapulgite Tablet (Pularex) Tablet 0 0
34 Attapulgite Tablet 600 mg (New Antides) Tablet 0 0
35 Automated blood grouping (Tes Gol. Darah) Paket 0 0
36 AZITROMISIN 500 mg tab Tablet 0 0
37 Bactivec Larvasida 30ml Botol 0 0
38 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0
39 Bedak Salisil 2% Btl 0 0
40 Benzoic acid |salicylic acid salep (anti fungi) Tube 0 0
41 Betahistine Mesylate 6 mg tab Tablet 190 190
42 Betamethasone 0,1% krim Tube10 gr 13 13
43 Betamethasone 0,5% krim tube 5 g 0 0
44 Biosens DBD (DBD TEST) Pcs 0 0
45 Bisacodyl 5mg Tablet 0 0
46 Bismuth subgallas (antihemoroid) Pot 0 0
47 Calcium chloride lactate infus (RL) Botol 0 0
48 Calsium Laktat (Kalk) 500 mg Tablet 270 270
49 CANDESARTAN 16 Tablet 0 0
50 CANDESARTAN 8 Tablet 0 0
51 Captopril 12,5 mg Tablet 320 320
52 Captopril 25 mg Tablet 510 510
53 Carbamazepin tab Tablet 0 0
54 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 0 0
55 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 0 0
56 Cefadroxil 500mg Tablet 0 0
57 CEFIXIME 200 MG Kapsul 0 0
58 CEFIXIME 100MG Tablet 0 0
59 Cefotaaxime Sodium inj 1gr Vial 0 0
60 CEFRIAXONE INJ Vial 0 0
61 Cetirizine 5 mg/5 ml sirup Botol 0 0
62 Cetirizine Tab Tablet 0 0
63 Chloramhenicol Salep Mata 1% Tube 0 0
64 Chloramphenicol 250 mg caps Tablet 0 0
65 Chloramphenicol Suspensi 125 mg/ml Btl 0 0
66 Chloramphenicol TT 3% Botol 0 0
67 Chloramphenicol/ Hidrokortison krim 2,5% Tube 0 0
68 Chlorpheniramine Maleat (CTM) 4 mg Tablet 0 0
69 Chlorpromazine HCl 100 mg Tablet 0 0
70 Chlorpromazine HCl 25mg Tablet 0 0
71 Cimetidin 200 tab Tablet 0 0
72 Ciprofloxacin 500 mg tab Tablet 0 0
73 Ciprofloxacin Infus Botol 0 0
74 Clindamycin 300mg Kapsul 0 0
75 CLOZAPIN 25 Tablet 0 0
76 Coverall/Hazmat XL/XXL Set 0 0
77 Crefe Flesh 10cm Rol 0 0
78 Cresol liquid 1 Liter (lysol) Botol 0 0
79 Denpro Orafil Plus Temporary Pcs 0 0
80 Devitalisasi pasta/Pulp X pot 0 0
81 Dexamethasone 0,5 mg Tablet 0 0
82 Dexamethasone inj 5mg/ml-1ml Ampul 0 0
83 Diazepam 2 mg Tablet 0 0
84 Diazepam 5mg/ml-2 ml inj Ampul 0 0
85 Diclofenac sodium 25 mg tab Tablet 0 0
86 Diclofenac sodium 50 mg tab Tablet 0 0
87 Digoxin 0,25 mg Tablet 0 0
88 Dimenhydrinate 50mg Tablet 0 0
89 Dipenhidramine HCl inj 10mg/ml Ampul 0 0
90 Domperidone 10 mg Tablet 0 0
91 Domperidone sr Botol 0 0
92 Doxycycline 100 mg Kapsul Kapsul 0 0
93 Dulcolax tab Tablet 0 0
94 DULCOLAX SUPPOS 10 MG supp 0 0
95 DULCOLAX SUPPOS 5 MG INFANT supp 0 0
96 Epinephrine HCl/bitartrat inj 0,1% Btl 0 0
97 Erythromicin 250 mg capsul Kapsul 0 0
98 Erythromicin 500 mg capsul Kapsul 0 0
99 Erythromicin Syr Btl 0 0
100 Ethacridine (Rivanol) 0,1% 300 ml Btl 0 0
101 Ethacridine (Rivanol) 0,1% 100ml Btl 0 0
102 Ethanol ( Aseptan ) 500 cc+ Pump Botol 0 0
103 Ethyl Chloride Btl 0 0
104 Eugenol cairan Btl 0 0
105 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 0
106 Folic acid 1mg ( asam folat) Tablet 0 0
107 Folley Catheter No.16 Pcs 0 0
108 Furosemida 40 mg Tablet 100 100
109 Furosemida Injeksi Ampul 0 0
110 Garam Oralit Sachet 0 0
111 Gentamicyn 0,1% SK Tube 0 0
112 Gentamicyn 0,3% TM Botol 32 32
113 Gentamicyn Inj 40 mg/ml Ampul 0 0
114 Glass lonomer Paket 0 0
115 Glibenclamide 5 mg Tablet 930 930
116 GLICLAZIDE TAB Tablet 0 0
117 Glimepiride 1 mg Tablet 0 0
118 Glukosa larutan infus 10% Botol 0 0
119 Glukosa larutan infus 5% Botol 0 0
120 Griseofulvin 125 mg Tablet 100 100
121 Guaifenesin 100 Tab/GG Tab Tablet 0 0
122 Haloperidol 0,5 mg tab Tablet 0 0
123 Haloperidol 1,5 mg tab Tablet 0 0
124 Haloperidol 5 mg tab Tablet 0 0
125 Herbakoof 100ml Botol 0 0
126 Human chorionic (HCG/Tes kehamilan ) Strip 0 0
127 Hydrochlorotiazide (HCT) 25 mg Tablet 0 0
128 H2O2 100 ML Botol 0 0
129 Ibuprofen 200 mg Tablet 0 0
130 Ibuprofen 400 mg Tablet 0 0
131 Ibuprofen sirup Botol 0 0
132 Ichthyol salep 10% Pcs 0 0
133 Immunoglobulin human anti-tetanus (Tetagam) Pcs 0 0
134 INDEC HIV1/2&SPHYLLIS pcs 0 0
135 Infus set dewasa Pcs 0 0
136 Infusi set anak Pcs 0 0
137 Isosorbide tablet Tablet 0 0
138 IV Catheter No.20 Pcs 0 0
139 IV Catheter No.22 Pcs 0 0
140 IV Catheter No.24 Pcs 0 0
141 Jarum Jahit Kulit Pcs 0 0
142 Kalium Permanganat Serbuk Pcs 0 0
143 Kapas pembalut/Absorben 250 g Pcs 0 0
144 Kasa kompres 40/40 steril Pcs 0 0
145 Kasa pembalut 2x80 Pcs 0 0
146 Kasa pembalut hidrofil 4 m x 15 cm Pcs 0 0
147 Kasa pembalut hidrofil 4 m x 3 cm Pcs 0 0
148 Ketac Universal (61108) Pcs 0 0
149 Ketac Universal (61111) Pcs 0 0
150 Ketoconazole 200 mg Cream Tube 0 0
151 Ketoconazole 200 mg tab Tablet 0 0
152 Ketorolac inj 30mg Ampul 0 0
153 Klorokina Fosfat 250 mg Tablet 0 0
154 KOTRIMOXAZOL 800/160 MG TAB Tablet 0 0
155 LAKTULOSE SYR Botol 0 0
156 Lancet Pcs 300 300
157 Levertran Salep/ Salep Luka Bakar Btl 0 0
158 Lidocain 2% Ampul 0 0
159 Lidocaine spray (Xylocaine spray) Pcs 0 0
160 Lidokain Comp. inj Kombinasi Ampul 0 0
161 Liquorice liquid extract (OBH) Botol 0 0
162 Locoriz Cream Tablet 0 0
163 Loperamid 2 mg tab / Diastrix 2 mg Tablet 0 0
164 Loratadine 10 mg tab Tablet 90 90
165 LYTACUR SYR Botol 0 0
166 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 0
167 Magnesium Sulfat Injeksi 40% (MgSO4) Ampul 0 0
168 Masker Pcs 232 232
169 Masker Earloop Pcs 0 0
170 Masker Headloop Pcs 0 0
171 Masker KN95 Pcs 0 0
172 Masker Plus Pcs 0 0
173 Masker Tie on Pcs 0 0
174 Medical adhesive tape (dermafix/leukomed) Pcs 0 0
175 Meprovent inj Ampul 0 0
176 Metamizole injeksi (antalgin 1000) Ampul 0 0
177 Metformin 500mg tab Tablet 0 0
178 Methyl Ergometrin Maleat 0,125 mg Tab 0 0
179 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0
180 Methyl Prednisolon tab 16 mg Tablet 0 0
181 Methyl Prednisolon tab 4 mg Tablet 250 250
182 Methyl Rosanilinium (gentian violet) Botol 0 0
183 METOCLOPROMIDE TAB Tablet 0 0
184 Metronidazol 250 mg tab Tablet 0 0
185 Metronidazol 500 mg tab Tablet 370 370
186 Metronidazol Infus Botol 0 0
187 Metronidazol syr Botol 0 0
188 Miconazole 2% Salep Kulit Tube 22 22
189 MOMETASONE Krim Tube 0 0
190 Moutpiece Steribreath 250's Pck 0 0
191 Natrium Bikarbonat 500 mg Tablet 0 0
192 Nifedipin 10 mg tab Kapsul 200 200
193 Nonwoven Fixation Rool Pcs 0 0
194 Nystatin Drop 100.000 IU Btl 0 0
195 Nystatin Tab Vag 10.000 iu/g Tablet 0 0
196 Octadin Botol 1000ml Botol 0 0
197 Octadin Spray 5ml Botol 0 0
198 Omeprazole inj Vial 0 0
199 Omeprazole kaps Tablet 370 370
200 Ondansetron iv/im 4mg Ampul 0 0
201 ONDANSETRON TAB Tablet 0 0
202 Otsu D-40 25ml Botol 0 0
203 Oxytetracycline HCl 1% Salep Mata Tube 0 0
204 Oxytetracycline HCl 3% Salep Kulit Tube 0 0
205 Oxytocin inj 10 IU Ampul 0 0
206 Papaverin 40 mg tab Tablet 0 0
207 Papaverin inj Tablet 0 0
208 Paracetamol Drops 15 ml Botol 0 0
209 Parasetamol 1000mg/100ml infus Botol 0 0
210 Parasetamol 120 mg/5 ml Syr Botol 0 0
211 Parasetamol 500 mg Tablet 0 0
212 Patient Lubricant (My Jelly ) Tube 0 0
213 Pehavral tab Tablet 0 0
214 Permethrin (Scabimite Cream) Tube 0 0
215 Phenobarbital 30 mg Tablet 0 0
216 Phenobarbital inj 50mg/ml-2ml Ampul 0 0
217 Phenol gliserol 10% TT Botol 0 0
218 Phytomenadione (Vit.K1) 10 mg Tablet 0 0
219 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 0
220 Phytomenadione (Vit.K1) inj 2 mg/ml Ampul 0 0
221 Piracetam 400 mg Tablet 0 0
222 Piroxicam 20 mg tab Tablet 0 0
223 Pisau Disposable (Mess No.10/11/20/21) pisau 0 0
224 Plesterku (Leukoplast) Pcs 0 0
225 Poli Aid 1 liter Botol 0 0
226 POLIAID 5L Botol 0 0
227 Policlean Handrub Botol 0 0
228 POLIDESINFEKTAN 5 L Botol 0 0
229 Polifix 10x5cm Pcs 0 0
230 Polifix 5x1cm Pcs 0 0
231 Polifix 5x5cm Pcs 0 0
232 POLIGEL 500 ML Botol 0 0
233 POLIGEL 5 L Botol 0 0
234 POLISOFT ALK HANDRUB 500 ML Botol 0 0
235 POLISOFT ALK HANDRUB 5 L Botol 0 0
236 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 0 0
237 Poliwash 500 ml Botol 0 0
238 POLIWASH 5 L Botol 0 0
239 Povidon iodium 10% 1000 ml Botol 0 0
240 Povidon iodium 10% 300 ml Botol 0 0
241 Povidon iodium 10% 60 ml Botol 0 0
242 Povidon Iodium 10% 30 ml Botol 0 0
243 Prednison 5 mg Tablet 650 650
244 Primaquin 15 mg tab Tablet 0 0
245 Propranolol HCl 10 mg Tablet 0 0
246 Propranolol HCl 40 mg Tablet 0 0
247 Propylthiouracil 100 mg Tablet 0 0
248 Protein Gluco Test Strip 0 0
249 Pyrantel Pamoat 125 mg Tablet 0 0
250 Pyridoxine HCl 10 mg Tablet 0 0
251 Ranitidin 150 mg Tablet 40 40
252 Ranitidin Injeksi Ampul 0 0
253 Rapid Test antigen (Panbio) Pcs 0 0
254 Retinol (Vit.A) kaps 100.000 iu Tablet 0 0
255 Retinol (Vit.A) kaps 200.000 iu Tablet 0 0
256 Risperidone 2mg Tablet 0 0
257 ROEKO ENDO FROST Botol 0 0
258 Salbutamol 2 mg Tablet 0 0
259 Salep 2-4 Kombinasi Tube 9 9
260 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0 0
261 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0
262 Sarung tangan (HandScuun Steril) No.7,5 Pcs 0 0
263 Sarung tangan (HandScuun) L Pcs 0 0
264 Sarung tangan (HandScuun) S/ M/ L Pcs 232 232
265 Sarung tangan nitril pcs 0 0
266 Semen Seng Fosfat Serbuk & Cairan Set 0 0
267 Sianocobalamin (Vit B12) 50 mg tab Tablet 500 500
268 Sianocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0
269 Silk (Benang Bedah) No. 3/0 Pcs 0 0
270 Silver Sulfadiazine Tube 0 0
271 Simvastatin 10 mg tab Kapsul 0 0
272 Simvastatin 20 mg tab Tablet 160 160
273 Sodium cloride infus 0,9% ( NACL ) Botol 0 0
274 Softanol 5 Liter Botol 0 0
275 Softanol 500ml Botol 0 0
276 Spuit 1 ml Pcs 0 0
277 Spuit 3 ml Pcs 0 0
278 Spuit 5 ml Pcs 0 0
279 Stericide 5 Liter Botol 0 0
280 Stimuno Capsul Forte Kapsul 0 0
281 Stimuno syrup Botol 0 0
282 Strip Asam Urat Pcs 357 357
283 Strip Gula Darah box 0 0
284 Strip kolestrol Pcs 0 0
285 SUKRALFAT TAB Tablet 0 0
286 SUKRALFAT SYR Botol 0 0
287 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 0 0
288 Sulfamethoxazole|trimethoprim (cotri) syr Botol 0 0
289 Sulfasetamida 15% TM Ampul 0 0
290 Surgical gown XL Set 0 0
291 Tetracycline 250 mg Tablet 0 0
292 Tetracycline 500 mg Tablet 0 0
293 Thiamine HCl (Vit B1) 50 mg Tablet 0 0
294 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0
295 Tranexamic Acid inj 5% Ampul 0 0
296 TRANEXAMIC ACID TAB Tablet 0 0
297 Trepocheck syphilis Pcs 0 0
298 Trihexyphenidyl tab 2 mg Tablet 0 0
299 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 200 200
300 Urin Bag Pcs 0 0
301 Usg Gel Botol 0 0
302 Vaksin Rabies Vero/ Verorab Paket 0 0
303 VALSARTAN 80 Tablet 0 0
304 VALSARTAN 160 Tablet 0 0
305 Viorex Liq 2% 5 Liter Botol 0 0
306 Viorex Liq 2% 500ml Botol 0 0
307 Virocheck HIV Pcs 0 0
308 Vitamin B Kompleks Tablet 130 130
309 Vitamin K Infant Inj Ampul 0 0
310 Water liquid (aqua P,I) Botol 0 0
311 Wing Needle No.21 Pcs 0 0
312 Wing Needle No.27 Pcs 0 0
313 Xpert MTB/RIF pcs 0 0
314 Zinc Drop Botol 0 0
315 Zinc tab Tablet 0 0
316 HB Test (Hemachroma Plus Microcuvette) Box 0 0
317 HIV Sifilis Combo Box 0 0
318 Kapas Lidi Box 0 0
319 Asam Asetat Botol 0 0
320 Sasklin Desinfektan 500 mL Botol 0 0
321 Kapas 1000 gr Box 0 0
322 Ameritek Test Box 0 0
323 Pot Feses Pack 0 0
324 Ambroxol Tablet Tablet 180 180
325 Ambroxol Syrup Botol 0 0
326 Reagen E.Coli 0 0
327 Caroto Gel 80 gr/ ECG Gel 0 0
328 Kertas ECG uk. 80 mmx 20 m 0 0
329 Kertas ECG uk. 80 mmx 90 mmx 280 0 0
330 Combur Test 0 0
UMUM JAMSOSKES BPJS JUMLAH
JUMLAH KUNJUNGAN RESEP
Mengetahui
Pengelola Obat Puskesmas
apt. Winda Utami, S. Farm.
NIP 199509112022032013
MINTAAN OBAT (LPLPO) PTM/PUSLING
: DOKUMEN NOMOR TANGGAL
: DINKES KAB/KOTA
IFK KAB/KOTA
PUSKESMAS
STOK STOK nov des jan
PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AKHIR OPTIMUM
7 8 9 10 11 12
200 277 1343
0 980 1000
0 24 25
270 0 0
3 1000 920
0 0 0
100 1 6
0 1200 1000
0 3 10
0 0 0
0 45 50
0 150 260
0 440 120
10 3500 3550
0 38 35
0 0 0
0 1500 2598
0 109 220
560 2 0
0 2500 3500
0 454 860
0 0 0
0 0 0
0 0 5
0 0 0
600 150 100
0 0 0
0 0 24
510 0 0
0 80 70
0 20 30
0 800 1500
0 30 53
0 0 0
0 5 1
0 20 15
0 275 270
0 1550 3570
0 2190 1030
0 3000 1200
190 150 260
13 36 48
0 1 27
0 1000 0
0 0 10
0 6 27
0 5000 200
270 30 25
0 100 150
0 50 35
320 10 35
510 100 99
0 3440 160
0 60 0
0 0 0
0 0 0
0 2500 1500
0 0 0
0 100 350
0 0 5
0 0 1
0 1 5
0 0 0
0 0 0
0 4000 3000
0 30 20
0 47 40
0 11 9
0 0 0
0 4000 3400
0 0 90
0 470 80
0 15 31
0 4000 1200
0 0 0
0 0 0
0 18 5
0 0 0
0 440 500
0 0 0
0 5 6
0 20 23
0 0 1
0 0 1
0 0 0
0 470 420
0 0 0
0 10 17
0 500 120
0 0 0
0 302 41
0 30 19
0 100 23
0 30 35
0 0 0
0 2190 780
0 4200 2200
0 7 9
0 0 0
0 50 140
0 2000 3000
0 0 0
0 0 0
0 30 300
0 100 104
0 89 50
0 50 110
100 0 0
0 1013 2000
0 22 116
0 15 12
32 0 5
0 80 96
0 33 32
930 200 80
0 150 58
0 102 97
0 0 99
0 0 0
100 0 0
0 8 5
0 75 50
0 43 146
0 20 15
0 31 32
0 0 2
0 0 2
0 80 54
0 200 540
0 15 20
0 0 0
0 500 250
0 0 0
0 0 0
0 0 0
0 200 107
0 0 0
0 0 0
0 600 900
0 270 270
0 0 0
0 6 15
0 0 0
0 76 500
0 0 0
0 0 0
0 0 0
0 500 570
0 0 102
0 20 0
0 3257 4010
0 0 0
0 0 0
0 0 0
0 3500 2500
300 0 0
0 0 0
0 1200 2453
0 0 0
0 1 0
0 100 120
0 0 1
0 0 0
90 300 250
0 0 0
0 2 6
0 195 24
232 0 0
0 0 0
0 0 60
0 3200 3500
0 10 15
0 20 0
0 50 125
0 45 10
0 100 34
0 0 0
0 0 0
0 19 6
0 20 25
250 17 0
0 4000 5380
0 2 10
0 1200 830
370 23 24
0 0 0
0 0 0
22 0 0
0 300 320
0 0 0
0 75 35
200 0 0
0 1500 1200
0 0 20
0 25 21
0 0 0
0 9 1
0 0 0
370 25 27
0 0 0
0 0 0
0 10 0
0 0 0
0 1 9
0 0 9
0 2 0
0 1400 1654
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 124
0 300 110
0 2500 2700
0 14 10
0 0 0
0 0 0
0 0 42
0 1000 1200
0 500 430
0 22 12
0 190 31
0 302 142
0 0 0
0 0 0
0 714 1550
0 0 0
0 890 710
0 0 0
0 0 6
0 1 12
0 1490 1500
0 16 13
0 0 0
0 2 7
0 265 490
0 1200 1000
0 106 532
0 0 0
0 500 250
0 67 9
650 100 99
0 0 67
0 84 80
0 0 0
0 263 35
0 0 0
0 0 0
0 360 50
40 0 0
0 920 750
0 0 0
0 13 15
0 49 0
0 210 250
0 0 600
0 0 19
9 0 0
0 2 0
0 0 4
0 0 0
0 10 59
232 570 750
0 0 0
0 30 22
500 0 0
0 0 0
0 0 0
0 0 17
0 0 0
160 1000 1500
0 0 0
0 0 0
0 200 300
0 2500 1500
0 12 9
0 0 0
0 200 120
0 0 0
0 200 600
357 180 140
0 0 30
0 0 0
0 0 0
0 0 0
0 0 0
0 12 13
0 100 320
0 0 0
0 0 0
0 0 0
0 2 0
0 0 2
0 2 0
0 2 0
0 0 0
0 0 1000
200 770 220
0 100 150
0 10 10
0 100 200
0 100 500
0 500 10
0
0 500 500
0
130
0 800 900
0 10 10
0 1000 950
0 9 8
0 1000 800
0 9 5
0 9 8
0
0 500 2000
0
0
0
0
0
0
180
0
0
0
0
0
0
Yang Membuat
Pengelola Obat Pustu / Poskesdes ….
NIP
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSTU M
Pos/Pustu : PELAPORAN BULAN
PUSKESMAS : MAKARTI MULYA PERMINTAAN BULAN
KECAMATAN : MESUJI
KABUPATEN : OGAN KOMERING ILIR
PROPINSI : SUMATERA SELATAN
NO. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN
1 2 3 4 5 6
1 Absorbent tipped applicator (alcohol swab) Pcs 200 200
2 ACARBOSE 100 MG Tablet 0 0
3 ACARBOSE 50 MG Tablet 0 0
4 Acetylcystein Kapsul 200mg Kapsul 270 270
5 Acyclovir cream Tube 3 3
6 Acyclovir tab 200 mg Tablet 0 0
7 Acyclovir tab 400 mg Tablet 100 100
8 Albendazol tab 400 mg Tablet 0 0
9 ALIVE BIOCOM (C&ZINC) Tablet 0 0
10 ALIVE NUTRIBION (B1,B6,B12) Tablet 0 0
11 ALIVE ZIC syr Botol 0 0
12 ALIVE D1000 TAB Tablet 0 0
13 Alkohol Liquid (etanol) 70%-1000 ml Tablet LAPORAN PEMAKAIAN DAN LEMBA
14 Allopurinol 100 mg Tablet 10 10
15 Allopurinol 300 mg Tablet 0 0
16 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0
17 Aminophylline tab 200 mg Tablet 0 0
18 Amitriptyline 25 mg tab Tablet 0 0
19 Amlodipine tab 5 mg Tablet 560 560
20 Amlodipine 10 mg Tablet 0 0
21 AMOXICILLIN DROP Botol 0 0
22 Amoxycillin 250 mg Kapsul 0 0
23 Amoxycillin 500 mg Kaptab 0 0
24 Amoxycillin Syr Btl 0 0
25 Ampicilin 1 gr Inj Vial 0 0
26 Antasida DOEN Kombinasi Tablet 600 600
27 Antasida Syr DOEN Btl 0 0
28 Anti Bisa Ular 5 ml (ABU I)/ Biosave Ampul 0 0
29 Asam Mefenamat 500 mg tab Tablet 510 510
30 Ascorbic acid (Vit.C) 50 mg Tablet 0 0
31 Aspirin (miniaspi) 80 mg tab Tablet 0 0
32 Atropine inj 0,25 mg/ml Ampul 0 0
33 Attapulgite Tablet (Pularex) Tablet 0 0
34 Attapulgite Tablet 600 mg (New Antides) Tablet 0 0
35 Automated blood grouping (Tes Gol. Darah) Paket 0 0
36 AZITROMISIN 500 mg tab Tablet 0 0
37 Bactivec Larvasida 30ml Botol 0 0
38 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0
39 Bedak Salisil 2% Btl 0 0
40 Benzoic acid |salicylic acid salep (anti fungi) Tube 0 0
41 Betahistine Mesylate 6 mg tab Tablet 190 190
42 Betamethasone 0,1% krim Tube10 gr 13 13
43 Betamethasone 0,5% krim tube 5 g 0 0
44 Biosens DBD (DBD TEST) Pcs 0 0
45 Bisacodyl 5mg Tablet 0 0
46 Bismuth subgallas (antihemoroid) Pot 0 0
47 Calcium chloride lactate infus (RL) Botol 0 0
48 Calsium Laktat (Kalk) 500 mg Tablet 270 270
49 CANDESARTAN 16 Tablet 0 0
50 CANDESARTAN 8 Tablet 0 0
51 Captopril 12,5 mg Tablet 320 320
52 Captopril 25 mg Tablet 510 510
53 Carbamazepin tab Tablet 0 0
54 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 0 0
55 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 0 0
56 Cefadroxil 500mg Tablet 0 0
57 CEFIXIME 200 MG Kapsul 0 0
58 CEFIXIME 100MG Tablet 0 0
59 Cefotaaxime Sodium inj 1gr Vial 0 0
60 CEFRIAXONE INJ Vial 0 0
61 Cetirizine 5 mg/5 ml sirup Botol 0 0
62 Cetirizine Tab Tablet 0 0
63 Chloramhenicol Salep Mata 1% Tube 0 0
64 Chloramphenicol 250 mg caps Tablet 0 0
65 Chloramphenicol Suspensi 125 mg/ml Btl 0 0
66 Chloramphenicol TT 3% Botol 0 0
67 Chloramphenicol/ Hidrokortison krim 2,5% Tube 0 0
68 Chlorpheniramine Maleat (CTM) 4 mg Tablet 0 0
69 Chlorpromazine HCl 100 mg Tablet 0 0
70 Chlorpromazine HCl 25mg Tablet 0 0
71 Cimetidin 200 tab Tablet 0 0
72 Ciprofloxacin 500 mg tab Tablet 0 0
73 Ciprofloxacin Infus Botol 0 0
74 Clindamycin 300mg Kapsul 0 0
75 CLOZAPIN 25 Tablet 0 0
76 Coverall/Hazmat XL/XXL Set 0 0
77 Crefe Flesh 10cm Rol 0 0
78 Cresol liquid 1 Liter (lysol) Botol 0 0
79 Denpro Orafil Plus Temporary Pcs 0 0
80 Devitalisasi pasta/Pulp X pot 0 0
81 Dexamethasone 0,5 mg Tablet 0 0
82 Dexamethasone inj 5mg/ml-1ml Ampul 0 0
83 Diazepam 2 mg Tablet 0 0
84 Diazepam 5mg/ml-2 ml inj Ampul 0 0
85 Diclofenac sodium 25 mg tab Tablet 0 0
86 Diclofenac sodium 50 mg tab Tablet 0 0
87 Digoxin 0,25 mg Tablet 0 0
88 Dimenhydrinate 50mg Tablet 0 0
89 Dipenhidramine HCl inj 10mg/ml Ampul 0 0
90 Domperidone 10 mg Tablet 0 0
91 Domperidone sr Botol 0 0
92 Doxycycline 100 mg Kapsul Kapsul 0 0
93 Dulcolax tab Tablet 0 0
94 DULCOLAX SUPPOS 10 MG supp 0 0
95 DULCOLAX SUPPOS 5 MG INFANT supp 0 0
96 Epinephrine HCl/bitartrat inj 0,1% Btl 0 0
97 Erythromicin 250 mg capsul Kapsul 0 0
98 Erythromicin 500 mg capsul Kapsul 0 0
99 Erythromicin Syr Btl 0 0
100 Ethacridine (Rivanol) 0,1% 300 ml Btl 0 0
101 Ethacridine (Rivanol) 0,1% 100ml Btl 0 0
102 Ethanol ( Aseptan ) 500 cc+ Pump Botol 0 0
103 Ethyl Chloride Btl 0 0
104 Eugenol cairan Btl 0 0
105 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 0
106 Folic acid 1mg ( asam folat) Tablet 0 0
107 Folley Catheter No.16 Pcs 0 0
108 Furosemida 40 mg Tablet 100 100
109 Furosemida Injeksi Ampul 0 0
110 Garam Oralit Sachet 0 0
111 Gentamicyn 0,1% SK Tube 0 0
112 Gentamicyn 0,3% TM Botol 32 32
113 Gentamicyn Inj 40 mg/ml Ampul 0 0
114 Glass lonomer Paket 0 0
115 Glibenclamide 5 mg Tablet 930 930
116 GLICLAZIDE TAB Tablet 0 0
117 Glimepiride 1 mg Tablet 0 0
118 Glukosa larutan infus 10% Botol 0 0
119 Glukosa larutan infus 5% Botol 0 0
120 Griseofulvin 125 mg Tablet 100 100
121 Guaifenesin 100 Tab/GG Tab Tablet 0 0
122 Haloperidol 0,5 mg tab Tablet 0 0
123 Haloperidol 1,5 mg tab Tablet 0 0
124 Haloperidol 5 mg tab Tablet 0 0
125 Herbakoof 100ml Botol 0 0
126 Human chorionic (HCG/Tes kehamilan ) Strip 0 0
127 Hydrochlorotiazide (HCT) 25 mg Tablet 0 0
128 H2O2 100 ML Botol 0 0
129 Ibuprofen 200 mg Tablet 0 0
130 Ibuprofen 400 mg Tablet 0 0
131 Ibuprofen sirup Botol 0 0
132 Ichthyol salep 10% Pcs 0 0
133 Immunoglobulin human anti-tetanus (Tetagam) Pcs 0 0
134 INDEC HIV1/2&SPHYLLIS pcs 0 0
135 Infus set dewasa Pcs 0 0
136 Infusi set anak Pcs 0 0
137 Isosorbide tablet Tablet 0 0
138 IV Catheter No.20 Pcs 0 0
139 IV Catheter No.22 Pcs 0 0
140 IV Catheter No.24 Pcs 0 0
141 Jarum Jahit Kulit Pcs 0 0
142 Kalium Permanganat Serbuk Pcs 0 0
143 Kapas pembalut/Absorben 250 g Pcs 0 0
144 Kasa kompres 40/40 steril Pcs 0 0
145 Kasa pembalut 2x80 Pcs 0 0
146 Kasa pembalut hidrofil 4 m x 15 cm Pcs 0 0
147 Kasa pembalut hidrofil 4 m x 3 cm Pcs 0 0
148 Ketac Universal (61108) Pcs 0 0
149 Ketac Universal (61111) Pcs 0 0
150 Ketoconazole 200 mg Cream Tube 0 0
151 Ketoconazole 200 mg tab Tablet 0 0
152 Ketorolac inj 30mg Ampul 0 0
153 Klorokina Fosfat 250 mg Tablet 0 0
154 KOTRIMOXAZOL 800/160 MG TAB Tablet 0 0
155 LAKTULOSE SYR Botol 0 0
156 Lancet Pcs 300 300
157 Levertran Salep/ Salep Luka Bakar Btl 0 0
158 Lidocain 2% Ampul 0 0
159 Lidocaine spray (Xylocaine spray) Pcs 0 0
160 Lidokain Comp. inj Kombinasi Ampul 0 0
161 Liquorice liquid extract (OBH) Botol 0 0
162 Locoriz Cream Tablet 0 0
163 Loperamid 2 mg tab / Diastrix 2 mg Tablet 0 0
164 Loratadine 10 mg tab Tablet 90 90
165 LYTACUR SYR Botol 0 0
166 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 0
167 Magnesium Sulfat Injeksi 40% (MgSO4) Ampul 0 0
168 Masker Pcs 232 232
169 Masker Earloop Pcs 0 0
170 Masker Headloop Pcs 0 0
171 Masker KN95 Pcs 0 0
172 Masker Plus Pcs 0 0
173 Masker Tie on Pcs 0 0
174 Medical adhesive tape (dermafix/leukomed) Pcs 0 0
175 Meprovent inj Ampul 0 0
176 Metamizole injeksi (antalgin 1000) Ampul 0 0
177 Metformin 500mg tab Tablet 0 0
178 Methyl Ergometrin Maleat 0,125 mg Tab 0 0
179 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0
180 Methyl Prednisolon tab 16 mg Tablet 0 0
181 Methyl Prednisolon tab 4 mg Tablet 250 250
182 Methyl Rosanilinium (gentian violet) Botol 0 0
183 METOCLOPROMIDE TAB Tablet 0 0
184 Metronidazol 250 mg tab Tablet 0 0
185 Metronidazol 500 mg tab Tablet 370 370
186 Metronidazol Infus Botol 0 0
187 Metronidazol syr Botol 0 0
188 Miconazole 2% Salep Kulit Tube 22 22
189 MOMETASONE Krim Tube 0 0
190 Moutpiece Steribreath 250's Pck 0 0
191 Natrium Bikarbonat 500 mg Tablet 0 0
192 Nifedipin 10 mg tab Kapsul 200 200
193 Nonwoven Fixation Rool Pcs 0 0
194 Nystatin Drop 100.000 IU Btl 0 0
195 Nystatin Tab Vag 10.000 iu/g Tablet 0 0
196 Octadin Botol 1000ml Botol 0 0
197 Octadin Spray 5ml Botol 0 0
198 Omeprazole inj Vial 0 0
199 Omeprazole kaps Tablet 370 370
200 Ondansetron iv/im 4mg Ampul 0 0
201 ONDANSETRON TAB Tablet 0 0
202 Otsu D-40 25ml Botol 0 0
203 Oxytetracycline HCl 1% Salep Mata Tube 0 0
204 Oxytetracycline HCl 3% Salep Kulit Tube 0 0
205 Oxytocin inj 10 IU Ampul 0 0
206 Papaverin 40 mg tab Tablet 0 0
207 Papaverin inj Tablet 0 0
208 Paracetamol Drops 15 ml Botol 0 0
209 Parasetamol 1000mg/100ml infus Botol 0 0
210 Parasetamol 120 mg/5 ml Syr Botol 0 0
211 Parasetamol 500 mg Tablet 0 0
212 Patient Lubricant (My Jelly ) Tube 0 0
213 Pehavral tab Tablet 0 0
214 Permethrin (Scabimite Cream) Tube 0 0
215 Phenobarbital 30 mg Tablet 0 0
216 Phenobarbital inj 50mg/ml-2ml Ampul 0 0
217 Phenol gliserol 10% TT Botol 0 0
218 Phytomenadione (Vit.K1) 10 mg Tablet 0 0
219 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 0
220 Phytomenadione (Vit.K1) inj 2 mg/ml Ampul 0 0
221 Piracetam 400 mg Tablet 0 0
222 Piroxicam 20 mg tab Tablet 0 0
223 Pisau Disposable (Mess No.10/11/20/21) pisau 0 0
224 Plesterku (Leukoplast) Pcs 0 0
225 Poli Aid 1 liter Botol 0 0
226 POLIAID 5L Botol 0 0
227 Policlean Handrub Botol 0 0
228 POLIDESINFEKTAN 5 L Botol 0 0
229 Polifix 10x5cm Pcs 0 0
230 Polifix 5x1cm Pcs 0 0
231 Polifix 5x5cm Pcs 0 0
232 POLIGEL 500 ML Botol 0 0
233 POLIGEL 5 L Botol 0 0
234 POLISOFT ALK HANDRUB 500 ML Botol 0 0
235 POLISOFT ALK HANDRUB 5 L Botol 0 0
236 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 0 0
237 Poliwash 500 ml Botol 0 0
238 POLIWASH 5 L Botol 0 0
239 Povidon iodium 10% 1000 ml Botol 0 0
240 Povidon iodium 10% 300 ml Botol 0 0
241 Povidon iodium 10% 60 ml Botol 0 0
242 Povidon Iodium 10% 30 ml Botol 0 0
243 Prednison 5 mg Tablet 650 650
244 Primaquin 15 mg tab Tablet 0 0
245 Propranolol HCl 10 mg Tablet 0 0
246 Propranolol HCl 40 mg Tablet 0 0
247 Propylthiouracil 100 mg Tablet 0 0
248 Protein Gluco Test Strip 0 0
249 Pyrantel Pamoat 125 mg Tablet 0 0
250 Pyridoxine HCl 10 mg Tablet 0 0
251 Ranitidin 150 mg Tablet 40 40
252 Ranitidin Injeksi Ampul 0 0
253 Rapid Test antigen (Panbio) Pcs 0 0
254 Retinol (Vit.A) kaps 100.000 iu Tablet 0 0
255 Retinol (Vit.A) kaps 200.000 iu Tablet 0 0
256 Risperidone 2mg Tablet 0 0
257 ROEKO ENDO FROST Botol 0 0
258 Salbutamol 2 mg Tablet 0 0
259 Salep 2-4 Kombinasi Tube 9 9
260 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0 0
261 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0
262 Sarung tangan (HandScuun Steril) No.7,5 Pcs 0 0
263 Sarung tangan (HandScuun) L Pcs 0 0
264 Sarung tangan (HandScuun) S/ M/ L Pcs 232 232
265 Sarung tangan nitril pcs 0 0
266 Semen Seng Fosfat Serbuk & Cairan Set 0 0
267 Sianocobalamin (Vit B12) 50 mg tab Tablet 500 500
268 Sianocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0
269 Silk (Benang Bedah) No. 3/0 Pcs 0 0
270 Silver Sulfadiazine Tube 0 0
271 Simvastatin 10 mg tab Kapsul 0 0
272 Simvastatin 20 mg tab Tablet 160 160
273 Sodium cloride infus 0,9% ( NACL ) Botol 0 0
274 Softanol 5 Liter Botol 0 0
275 Softanol 500ml Botol 0 0
276 Spuit 1 ml Pcs 0 0
277 Spuit 3 ml Pcs 0 0
278 Spuit 5 ml Pcs 0 0
279 Stericide 5 Liter Botol 0 0
280 Stimuno Capsul Forte Kapsul 0 0
281 Stimuno syrup Botol 0 0
282 Strip Asam Urat Pcs 357 357
283 Strip Gula Darah box 0 0
284 Strip kolestrol Pcs 0 0
285 SUKRALFAT TAB Tablet 0 0
286 SUKRALFAT SYR Botol 0 0
287 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 0 0
288 Sulfamethoxazole|trimethoprim (cotri) syr Botol 0 0
289 Sulfasetamida 15% TM Ampul 0 0
290 Surgical gown XL Set 0 0
291 Tetracycline 250 mg Tablet 0 0
292 Tetracycline 500 mg Tablet 0 0
293 Thiamine HCl (Vit B1) 50 mg Tablet 0 0
294 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0
295 Tranexamic Acid inj 5% Ampul 0 0
296 TRANEXAMIC ACID TAB Tablet 0 0
297 Trepocheck syphilis Pcs 0 0
298 Trihexyphenidyl tab 2 mg Tablet 0 0
299 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 200 200
300 Urin Bag Pcs 0 0
301 Usg Gel Botol 0 0
302 Vaksin Rabies Vero/ Verorab Paket 0 0
303 VALSARTAN 80 Tablet 0 0
304 VALSARTAN 160 Tablet 0 0
305 Viorex Liq 2% 5 Liter Botol 0 0
306 Viorex Liq 2% 500ml Botol 0 0
307 Virocheck HIV Pcs 0 0
308 Vitamin B Kompleks Tablet 130 130
309 Vitamin K Infant Inj Ampul 0 0
310 Water liquid (aqua P,I) Botol 0 0
311 Wing Needle No.21 Pcs 0 0
312 Wing Needle No.27 Pcs 0 0
313 Xpert MTB/RIF pcs 0 0
314 Zinc Drop Botol 0 0
315 Zinc tab Tablet 0 0
316 HB Test (Hemachroma Plus Microcuvette) Box 0 0
317 HIV Sifilis Combo Box 0 0
318 Kapas Lidi Box 0 0
319 Asam Asetat Botol 0 0
320 Sasklin Desinfektan 500 mL Botol 0 0
321 Kapas 1000 gr Box 0 0
322 Ameritek Test Box 0 0
323 Pot Feses Pack 0 0
324 Ambroxol Tablet Tablet 180 180
325 Ambroxol Syrup Botol 0 0
326 Reagen E.Coli 0 0
327 Caroto Gel 80 gr/ ECG Gel 0 0
328 Kertas ECG uk. 80 mmx 20 m 0 0
329 Kertas ECG uk. 80 mmx 90 mmx 280 0 0
330 Combur Test 0 0
UMUM JAMSOSKES BPJS JUMLAH
JUMLAH KUNJUNGAN RESEP
Mengetahui
Pengelola Obat Puskesmas
apt. Winda Utami, S. Farm.
NIP 199509112022032013
TAAN OBAT (LPLPO) PUSTU MEKAR WANGI
: DOKUMEN NOMOR TANGGAL
: DINKES KAB/KOTA
IFK KAB/KOTA
PUSKESMAS
STOK STOK nov des jan
PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AKHIR OPTIMUM
7 8 9 10 11 12
200 277 1343
0 980 1000
0 24 25
270 0 0
3 1000 920
0 0 0
100 1 6
0 1200 1000
0 3 10
0 0 0
0 45 50
0 150 260
AN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PTM/PUSLING
10 3500 3550
0 38 35
0 0 0
0 1500 2598
0 109 220
560 2 0
0 2500 3500
0 454 860
0 0 0
0 0 0
0 0 5
0 0 0
600 150 100
0 0 0
0 0 24
510 0 0
0 80 70
0 20 30
0 800 1500
0 30 53
0 0 0
0 5 1
0 20 15
0 275 270
0 1550 3570
0 2190 1030
0 3000 1200
190 150 260
13 36 48
0 1 27
0 1000 0
0 0 10
0 6 27
0 5000 200
270 30 25
0 100 150
0 50 35
320 10 35
510 100 99
0 3440 160
0 60 0
0 0 0
0 0 0
0 2500 1500
0 0 0
0 100 350
0 0 5
0 0 1
0 1 5
0 0 0
0 0 0
0 4000 3000
0 30 20
0 47 40
0 11 9
0 0 0
0 4000 3400
0 0 90
0 470 80
0 15 31
0 4000 1200
0 0 0
0 0 0
0 18 5
0 0 0
0 440 500
0 0 0
0 5 6
0 20 23
0 0 1
0 0 1
0 0 0
0 470 420
0 0 0
0 10 17
0 500 120
0 0 0
0 302 41
0 30 19
0 100 23
0 30 35
0 0 0
0 2190 780
0 4200 2200
0 7 9
0 0 0
0 50 140
0 2000 3000
0 0 0
0 0 0
0 30 300
0 100 104
0 89 50
0 50 110
100 0 0
0 1013 2000
0 22 116
0 15 12
32 0 5
0 80 96
0 33 32
930 200 80
0 150 58
0 102 97
0 0 99
0 0 0
100 0 0
0 8 5
0 75 50
0 43 146
0 20 15
0 31 32
0 0 2
0 0 2
0 80 54
0 200 540
0 15 20
0 0 0
0 500 250
0 0 0
0 0 0
0 0 0
0 200 107
0 0 0
0 0 0
0 600 900
0 270 270
0 0 0
0 6 15
0 0 0
0 76 500
0 0 0
0 0 0
0 0 0
0 500 570
0 0 102
0 20 0
0 3257 4010
0 0 0
0 0 0
0 0 0
0 3500 2500
300 0 0
0 0 0
0 1200 2453
0 0 0
0 1 0
0 100 120
0 0 1
0 0 0
90 300 250
0 0 0
0 2 6
0 195 24
232 0 0
0 0 0
0 0 60
0 3200 3500
0 10 15
0 20 0
0 50 125
0 45 10
0 100 34
0 0 0
0 0 0
0 19 6
0 20 25
250 17 0
0 4000 5380
0 2 10
0 1200 830
370 23 24
0 0 0
0 0 0
22 0 0
0 300 320
0 0 0
0 75 35
200 0 0
0 1500 1200
0 0 20
0 25 21
0 0 0
0 9 1
0 0 0
370 25 27
0 0 0
0 0 0
0 10 0
0 0 0
0 1 9
0 0 9
0 2 0
0 1400 1654
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 124
0 300 110
0 2500 2700
0 14 10
0 0 0
0 0 0
0 0 42
0 1000 1200
0 500 430
0 22 12
0 190 31
0 302 142
0 0 0
0 0 0
0 714 1550
0 0 0
0 890 710
0 0 0
0 0 6
0 1 12
0 1490 1500
0 16 13
0 0 0
0 2 7
0 265 490
0 1200 1000
0 106 532
0 0 0
0 500 250
0 67 9
650 100 99
0 0 67
0 84 80
0 0 0
0 263 35
0 0 0
0 0 0
0 360 50
40 0 0
0 920 750
0 0 0
0 13 15
0 49 0
0 210 250
0 0 600
0 0 19
9 0 0
0 2 0
0 0 4
0 0 0
0 10 59
232 570 750
0 0 0
0 30 22
500 0 0
0 0 0
0 0 0
0 0 17
0 0 0
160 1000 1500
0 0 0
0 0 0
0 200 300
0 2500 1500
0 12 9
0 0 0
0 200 120
0 0 0
0 200 600
357 180 140
0 0 30
0 0 0
0 0 0
0 0 0
0 0 0
0 12 13
0 100 320
0 0 0
0 0 0
0 0 0
0 2 0
0 0 2
0 2 0
0 2 0
0 0 0
0 0 1000
200 770 220
0 100 150
0 10 10
0 100 200
0 100 500
0 500 10
0
0 500 500
0
130
0 800 900
0 10 10
0 1000 950
0 9 8
0 1000 800
0 9 5
0 9 8
0
0 500 2000
0
0
0
0
0
0
180
0
0
0
0
0
0
Yang Membuat
Pengelola Obat Pustu / Poskesdes ….
NIP
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PTM
Pos/Pustu : PELAPORAN BULAN
PUSKESMAS : MAKARTI MULYA PERMINTAAN BULAN
KECAMATAN : MESUJI
KABUPATEN : OGAN KOMERING ILIR
PROPINSI : SUMATERA SELATAN
NO. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN
1 2 3 4 5 6
1 Absorbent tipped applicator (alcohol swab) Pcs 200 200
2 ACARBOSE 100 MG Tablet 0 0
3 ACARBOSE 50 MG Tablet 0 0
4 Acetylcystein Kapsul 200mg Kapsul 270 270
5 Acyclovir cream Tube 3 3
6 Acyclovir tab 200 mg Tablet 0 0
7 Acyclovir tab 400 mg Tablet 100 100
8 Albendazol tab 400 mg Tablet 0 0
9 ALIVE BIOCOM (C&ZINC) Tablet 0 0
10 ALIVE NUTRIBION (B1,B6,B12) Tablet 0 0
11 ALIVE ZIC syr Botol 0 0
12 ALIVE D1000 TAB Tablet 0 0
13 Alkohol Liquid (etanol) 70%-1000 ml Tablet 0 0
14 Allopurinol 100 mg Tablet 10 10
15 Allopurinol 300 mg Tablet 0 0
16 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0
17 Aminophylline tab 200 mg Tablet 0 0
18 Amitriptyline 25 mg tab Tablet 0 0
19 Amlodipine tab 5 mg Tablet 560 560
20 Amlodipine 10 mg Tablet 0 0
21 AMOXICILLIN DROP Botol 0 0
22 Amoxycillin 250 mg Kapsul 0 0
23 Amoxycillin 500 mg Kaptab 0 0
24 Amoxycillin Syr Btl 0 0
25 Ampicilin 1 gr Inj Vial 0 0
26 Antasida DOEN Kombinasi Tablet 600 600
27 Antasida Syr DOEN Btl 0 0
28 Anti Bisa Ular 5 ml (ABU I)/ Biosave Ampul 0 0
29 Asam Mefenamat 500 mg tab Tablet 510 510
30 Ascorbic acid (Vit.C) 50 mg Tablet 0 0
31 Aspirin (miniaspi) 80 mg tab Tablet 0 0
32 Atropine inj 0,25 mg/ml Ampul 0 0
33 Attapulgite Tablet (Pularex) Tablet 0 0
34 Attapulgite Tablet 600 mg (New Antides) Tablet 0 0
35 Automated blood grouping (Tes Gol. Darah) Paket 0 0
36 AZITROMISIN 500 mg tab Tablet 0 0
37 Bactivec Larvasida 30ml Botol 0 0
38 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0
39 Bedak Salisil 2% Btl 0 0
40 Benzoic acid |salicylic acid salep (anti fungi) Tube 0 0
41 Betahistine Mesylate 6 mg tab Tablet 190 190
42 Betamethasone 0,1% krim Tube10 gr 13 13
43 Betamethasone 0,5% krim tube 5 g 0 0
44 Biosens DBD (DBD TEST) Pcs 0 0
45 Bisacodyl 5mg Tablet 0 0
46 Bismuth subgallas (antihemoroid) Pot 0 0
47 Calcium chloride lactate infus (RL) Botol 0 0
48 Calsium Laktat (Kalk) 500 mg Tablet 270 270
49 CANDESARTAN 16 Tablet 0 0
50 CANDESARTAN 8 Tablet 0 0
51 Captopril 12,5 mg Tablet 320 320
52 Captopril 25 mg Tablet 510 510
53 Carbamazepin tab Tablet 0 0
54 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 0 0
55 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 0 0
56 Cefadroxil 500mg Tablet 0 0
57 CEFIXIME 200 MG Kapsul 0 0
58 CEFIXIME 100MG Tablet 0 0
59 Cefotaaxime Sodium inj 1gr Vial 0 0
60 CEFRIAXONE INJ Vial 0 0
61 Cetirizine 5 mg/5 ml sirup Botol 0 0
62 Cetirizine Tab Tablet 0 0
63 Chloramhenicol Salep Mata 1% Tube 0 0
64 Chloramphenicol 250 mg caps Tablet 0 0
65 Chloramphenicol Suspensi 125 mg/ml Btl 0 0
66 Chloramphenicol TT 3% Botol 0 0
67 Chloramphenicol/ Hidrokortison krim 2,5% Tube 0 0
68 Chlorpheniramine Maleat (CTM) 4 mg Tablet 0 0
69 Chlorpromazine HCl 100 mg Tablet 0 0
70 Chlorpromazine HCl 25mg Tablet 0 0
71 Cimetidin 200 tab Tablet 0 0
72 Ciprofloxacin 500 mg tab Tablet 0 0
73 Ciprofloxacin Infus Botol 0 0
74 Clindamycin 300mg Kapsul 0 0
75 CLOZAPIN 25 Tablet 0 0
76 Coverall/Hazmat XL/XXL Set 0 0
77 Crefe Flesh 10cm Rol 0 0
78 Cresol liquid 1 Liter (lysol) Botol 0 0
79 Denpro Orafil Plus Temporary Pcs 0 0
80 Devitalisasi pasta/Pulp X pot 0 0
81 Dexamethasone 0,5 mg Tablet 0 0
82 Dexamethasone inj 5mg/ml-1ml Ampul 0 0
83 Diazepam 2 mg Tablet 0 0
84 Diazepam 5mg/ml-2 ml inj Ampul 0 0
85 Diclofenac sodium 25 mg tab Tablet 0 0
86 Diclofenac sodium 50 mg tab Tablet 0 0
87 Digoxin 0,25 mg Tablet 0 0
88 Dimenhydrinate 50mg Tablet 0 0
89 Dipenhidramine HCl inj 10mg/ml Ampul 0 0
90 Domperidone 10 mg Tablet 0 0
91 Domperidone sr Botol 0 0
92 Doxycycline 100 mg Kapsul Kapsul 0 0
93 Dulcolax tab Tablet 0 0
94 DULCOLAX SUPPOS 10 MG supp 0 0
95 DULCOLAX SUPPOS 5 MG INFANT supp 0 0
96 Epinephrine HCl/bitartrat inj 0,1% Btl 0 0
97 Erythromicin 250 mg capsul Kapsul 0 0
98 Erythromicin 500 mg capsul Kapsul 0 0
99 Erythromicin Syr Btl 0 0
100 Ethacridine (Rivanol) 0,1% 300 ml Btl 0 0
101 Ethacridine (Rivanol) 0,1% 100ml Btl 0 0
102 Ethanol ( Aseptan ) 500 cc+ Pump Botol 0 0
103 Ethyl Chloride Btl 0 0
104 Eugenol cairan Btl 0 0
105 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 0
106 Folic acid 1mg ( asam folat) Tablet 0 0
107 Folley Catheter No.16 Pcs 0 0
108 Furosemida 40 mg Tablet 100 100
109 Furosemida Injeksi Ampul 0 0
110 Garam Oralit Sachet 0 0
111 Gentamicyn 0,1% SK Tube 0 0
112 Gentamicyn 0,3% TM Botol 32 32
113 Gentamicyn Inj 40 mg/ml Ampul 0 0
114 Glass lonomer Paket 0 0
115 Glibenclamide 5 mg Tablet 930 930
116 GLICLAZIDE TAB Tablet 0 0
117 Glimepiride 1 mg Tablet 0 0
118 Glukosa larutan infus 10% Botol 0 0
119 Glukosa larutan infus 5% Botol 0 0
120 Griseofulvin 125 mg Tablet 100 100
121 Guaifenesin 100 Tab/GG Tab Tablet 0 0
122 Haloperidol 0,5 mg tab Tablet 0 0
123 Haloperidol 1,5 mg tab Tablet 0 0
124 Haloperidol 5 mg tab Tablet 0 0
125 Herbakoof 100ml Botol 0 0
126 Human chorionic (HCG/Tes kehamilan ) Strip 0 0
127 Hydrochlorotiazide (HCT) 25 mg Tablet 0 0
128 H2O2 100 ML Botol 0 0
129 Ibuprofen 200 mg Tablet 0 0
130 Ibuprofen 400 mg Tablet 0 0
131 Ibuprofen sirup Botol 0 0
132 Ichthyol salep 10% Pcs 0 0
133 Immunoglobulin human anti-tetanus (Tetagam) Pcs 0 0
134 INDEC HIV1/2&SPHYLLIS pcs 0 0
135 Infus set dewasa Pcs 0 0
136 Infusi set anak Pcs 0 0
137 Isosorbide tablet Tablet 0 0
138 IV Catheter No.20 Pcs 0 0
139 IV Catheter No.22 Pcs 0 0
140 IV Catheter No.24 Pcs 0 0
141 Jarum Jahit Kulit Pcs 0 0
142 Kalium Permanganat Serbuk Pcs 0 0
143 Kapas pembalut/Absorben 250 g Pcs 0 0
144 Kasa kompres 40/40 steril Pcs 0 0
145 Kasa pembalut 2x80 Pcs 0 0
146 Kasa pembalut hidrofil 4 m x 15 cm Pcs 0 0
147 Kasa pembalut hidrofil 4 m x 3 cm Pcs 0 0
148 Ketac Universal (61108) Pcs 0 0
149 Ketac Universal (61111) Pcs 0 0
150 Ketoconazole 200 mg Cream Tube 0 0
151 Ketoconazole 200 mg tab Tablet 0 0
152 Ketorolac inj 30mg Ampul 0 0
153 Klorokina Fosfat 250 mg Tablet 0 0
154 KOTRIMOXAZOL 800/160 MG TAB Tablet 0 0
155 LAKTULOSE SYR Botol 0 0
156 Lancet Pcs 300 300
157 Levertran Salep/ Salep Luka Bakar Btl 0 0
158 Lidocain 2% Ampul 0 0
159 Lidocaine spray (Xylocaine spray) Pcs 0 0
160 Lidokain Comp. inj Kombinasi Ampul 0 0
161 Liquorice liquid extract (OBH) Botol 0 0
162 Locoriz Cream Tablet 0 0
163 Loperamid 2 mg tab / Diastrix 2 mg Tablet 0 0
164 Loratadine 10 mg tab Tablet 90 90
165 LYTACUR SYR Botol 0 0
166 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 0
167 Magnesium Sulfat Injeksi 40% (MgSO4) Ampul 0 0
168 Masker Pcs 232 232
169 Masker Earloop Pcs 0 0
170 Masker Headloop Pcs 0 0
171 Masker KN95 Pcs 0 0
172 Masker Plus Pcs 0 0
173 Masker Tie on Pcs 0 0
174 Medical adhesive tape (dermafix/leukomed) Pcs 0 0
175 Meprovent inj Ampul 0 0
176 Metamizole injeksi (antalgin 1000) Ampul 0 0
177 Metformin 500mg tab Tablet 0 0
178 Methyl Ergometrin Maleat 0,125 mg Tab 0 0
179 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0
180 Methyl Prednisolon tab 16 mg Tablet 0 0
181 Methyl Prednisolon tab 4 mg Tablet 250 250
182 Methyl Rosanilinium (gentian violet) Botol 0 0
183 METOCLOPROMIDE TAB Tablet 0 0
184 Metronidazol 250 mg tab Tablet 0 0
185 Metronidazol 500 mg tab Tablet 370 370
186 Metronidazol Infus Botol 0 0
187 Metronidazol syr Botol 0 0
188 Miconazole 2% Salep Kulit Tube 22 22
189 MOMETASONE Krim Tube 0 0
190 Moutpiece Steribreath 250's Pck 0 0
191 Natrium Bikarbonat 500 mg Tablet 0 0
192 Nifedipin 10 mg tab Kapsul 200 200
193 Nonwoven Fixation Rool Pcs 0 0
194 Nystatin Drop 100.000 IU Btl 0 0
195 Nystatin Tab Vag 10.000 iu/g Tablet 0 0
196 Octadin Botol 1000ml Botol 0 0
197 Octadin Spray 5ml Botol 0 0
198 Omeprazole inj Vial 0 0
199 Omeprazole kaps Tablet 370 370
200 Ondansetron iv/im 4mg Ampul 0 0
201 ONDANSETRON TAB Tablet 0 0
202 Otsu D-40 25ml Botol 0 0
203 Oxytetracycline HCl 1% Salep Mata Tube 0 0
204 Oxytetracycline HCl 3% Salep Kulit Tube 0 0
205 Oxytocin inj 10 IU Ampul 0 0
206 Papaverin 40 mg tab Tablet 0 0
207 Papaverin inj Tablet 0 0
208 Paracetamol Drops 15 ml Botol 0 0
209 Parasetamol 1000mg/100ml infus Botol 0 0
210 Parasetamol 120 mg/5 ml Syr Botol 0 0
211 Parasetamol 500 mg Tablet 0 0
212 Patient Lubricant (My Jelly ) Tube 0 0
213 Pehavral tab Tablet 0 0
214 Permethrin (Scabimite Cream) Tube 0 0
215 Phenobarbital 30 mg Tablet 0 0
216 Phenobarbital inj 50mg/ml-2ml Ampul 0 0
217 Phenol gliserol 10% TT Botol 0 0
218 Phytomenadione (Vit.K1) 10 mg Tablet 0 0
219 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 0
220 Phytomenadione (Vit.K1) inj 2 mg/ml Ampul 0 0
221 Piracetam 400 mg Tablet 0 0
222 Piroxicam 20 mg tab Tablet 0 0
223 Pisau Disposable (Mess No.10/11/20/21) pisau 0 0
224 Plesterku (Leukoplast) Pcs 0 0
225 Poli Aid 1 liter Botol 0 0
226 POLIAID 5L Botol 0 0
227 Policlean Handrub Botol 0 0
228 POLIDESINFEKTAN 5 L Botol 0 0
229 Polifix 10x5cm Pcs 0 0
230 Polifix 5x1cm Pcs 0 0
231 Polifix 5x5cm Pcs 0 0
232 POLIGEL 500 ML Botol 0 0
233 POLIGEL 5 L Botol 0 0
234 POLISOFT ALK HANDRUB 500 ML Botol 0 0
235 POLISOFT ALK HANDRUB 5 L Botol 0 0
236 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 0 0
237 Poliwash 500 ml Botol 0 0
238 POLIWASH 5 L Botol 0 0
239 Povidon iodium 10% 1000 ml Botol 0 0
240 Povidon iodium 10% 300 ml Botol 0 0
241 Povidon iodium 10% 60 ml Botol 0 0
242 Povidon Iodium 10% 30 ml Botol 0 0
243 Prednison 5 mg Tablet 650 650
244 Primaquin 15 mg tab Tablet 0 0
245 Propranolol HCl 10 mg Tablet 0 0
246 Propranolol HCl 40 mg Tablet 0 0
247 Propylthiouracil 100 mg Tablet 0 0
248 Protein Gluco Test Strip 0 0
249 Pyrantel Pamoat 125 mg Tablet 0 0
250 Pyridoxine HCl 10 mg Tablet 0 0
251 Ranitidin 150 mg Tablet 40 40
252 Ranitidin Injeksi Ampul 0 0
253 Rapid Test antigen (Panbio) Pcs 0 0
254 Retinol (Vit.A) kaps 100.000 iu Tablet 0 0
255 Retinol (Vit.A) kaps 200.000 iu Tablet 0 0
256 Risperidone 2mg Tablet 0 0
257 ROEKO ENDO FROST Botol 0 0
258 Salbutamol 2 mg Tablet 0 0
259 Salep 2-4 Kombinasi Tube 9 9
260 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0 0
261 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0
262 Sarung tangan (HandScuun Steril) No.7,5 Pcs 0 0
263 Sarung tangan (HandScuun) L Pcs 0 0
264 Sarung tangan (HandScuun) S/ M/ L Pcs 232 232
265 Sarung tangan nitril pcs 0 0
266 Semen Seng Fosfat Serbuk & Cairan Set 0 0
267 Sianocobalamin (Vit B12) 50 mg tab Tablet 500 500
268 Sianocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0
269 Silk (Benang Bedah) No. 3/0 Pcs 0 0
270 Silver Sulfadiazine Tube 0 0
271 Simvastatin 10 mg tab Kapsul 0 0
272 Simvastatin 20 mg tab Tablet 160 160
273 Sodium cloride infus 0,9% ( NACL ) Botol 0 0
274 Softanol 5 Liter Botol 0 0
275 Softanol 500ml Botol 0 0
276 Spuit 1 ml Pcs 0 0
277 Spuit 3 ml Pcs 0 0
278 Spuit 5 ml Pcs 0 0
279 Stericide 5 Liter Botol 0 0
280 Stimuno Capsul Forte Kapsul 0 0
281 Stimuno syrup Botol 0 0
282 Strip Asam Urat Pcs 357 357
283 Strip Gula Darah box 0 0
284 Strip kolestrol Pcs 0 0
285 SUKRALFAT TAB Tablet 0 0
286 SUKRALFAT SYR Botol 0 0
287 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 0 0
288 Sulfamethoxazole|trimethoprim (cotri) syr Botol 0 0
289 Sulfasetamida 15% TM Ampul 0 0
290 Surgical gown XL Set 0 0
291 Tetracycline 250 mg Tablet 0 0
292 Tetracycline 500 mg Tablet 0 0
293 Thiamine HCl (Vit B1) 50 mg Tablet 0 0
294 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0
295 Tranexamic Acid inj 5% Ampul 0 0
296 TRANEXAMIC ACID TAB Tablet 0 0
297 Trepocheck syphilis Pcs 0 0
298 Trihexyphenidyl tab 2 mg Tablet 0 0
299 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 200 200
300 Urin Bag Pcs 0 0
301 Usg Gel Botol 0 0
302 Vaksin Rabies Vero/ Verorab Paket 0 0
303 VALSARTAN 80 Tablet 0 0
304 VALSARTAN 160 Tablet 0 0
305 Viorex Liq 2% 5 Liter Botol 0 0
306 Viorex Liq 2% 500ml Botol 0 0
307 Virocheck HIV Pcs 0 0
308 Vitamin B Kompleks Tablet 130 130
309 Vitamin K Infant Inj Ampul 0 0
310 Water liquid (aqua P,I) Botol 0 0
311 Wing Needle No.21 Pcs 0 0
312 Wing Needle No.27 Pcs 0 0
313 Xpert MTB/RIF pcs 0 0
314 Zinc Drop Botol 0 0
315 Zinc tab Tablet 0 0
316 HB Test (Hemachroma Plus Microcuvette) Box 0 0
317 HIV Sifilis Combo Box 0 0
318 Kapas Lidi Box 0 0
319 Asam Asetat Botol 0 0
320 Sasklin Desinfektan 500 mL Botol 0 0
321 Kapas 1000 gr Box 0 0
322 Ameritek Test Box 0 0
323 Pot Feses Pack 0 0
324 Ambroxol Tablet Tablet 180 180
325 Ambroxol Syrup Botol 0 0
326 Reagen E.Coli 0 0
327 Caroto Gel 80 gr/ ECG Gel 0 0
328 Kertas ECG uk. 80 mmx 20 m 0 0
329 Kertas ECG uk. 80 mmx 90 mmx 280 0 0
330 Combur Test 0 0
UMUM JAMSOSKES BPJS JUMLAH
JUMLAH KUNJUNGAN RESEP
Mengetahui
Pengelola Obat Puskesmas
apt. Winda Utami, S. Farm.
NIP 199509112022032013
MINTAAN OBAT (LPLPO) PTM/PUSLING
: DOKUMEN NOMOR TANGGAL
: DINKES KAB/KOTA
IFK KAB/KOTA
PUSKESMAS
STOK STOK nov des jan
PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AKHIR OPTIMUM
7 8 9 10 11 12
200 277 1343
0 980 1000
0 24 25
270 0 0
3 1000 920
0 0 0
100 1 6
0 1200 1000
0 3 10
0 0 0
0 45 50
0 150 260
0 440 120
10 3500 3550
0 38 35
0 0 0
0 1500 2598
0 109 220
560 2 0
0 2500 3500
0 454 860
0 0 0
0 0 0
0 0 5
0 0 0
600 150 100
0 0 0
0 0 24
510 0 0
0 80 70
0 20 30
0 800 1500
0 30 53
0 0 0
0 5 1
0 20 15
0 275 270
0 1550 3570
0 2190 1030
0 3000 1200
190 150 260
13 36 48
0 1 27
0 1000 0
0 0 10
0 6 27
0 5000 200
270 30 25
0 100 150
0 50 35
320 10 35
510 100 99
0 3440 160
0 60 0
0 0 0
0 0 0
0 2500 1500
0 0 0
0 100 350
0 0 5
0 0 1
0 1 5
0 0 0
0 0 0
0 4000 3000
0 30 20
0 47 40
0 11 9
0 0 0
0 4000 3400
0 0 90
0 470 80
0 15 31
0 4000 1200
0 0 0
0 0 0
0 18 5
0 0 0
0 440 500
0 0 0
0 5 6
0 20 23
0 0 1
0 0 1
0 0 0
0 470 420
0 0 0
0 10 17
0 500 120
0 0 0
0 302 41
0 30 19
0 100 23
0 30 35
0 0 0
0 2190 780
0 4200 2200
0 7 9
0 0 0
0 50 140
0 2000 3000
0 0 0
0 0 0
0 30 300
0 100 104
0 89 50
0 50 110
100 0 0
0 1013 2000
0 22 116
0 15 12
32 0 5
0 80 96
0 33 32
930 200 80
0 150 58
0 102 97
0 0 99
0 0 0
100 0 0
0 8 5
0 75 50
0 43 146
0 20 15
0 31 32
0 0 2
0 0 2
0 80 54
0 200 540
0 15 20
0 0 0
0 500 250
0 0 0
0 0 0
0 0 0
0 200 107
0 0 0
0 0 0
0 600 900
0 270 270
0 0 0
0 6 15
0 0 0
0 76 500
0 0 0
0 0 0
0 0 0
0 500 570
0 0 102
0 20 0
0 3257 4010
0 0 0
0 0 0
0 0 0
0 3500 2500
300 0 0
0 0 0
0 1200 2453
0 0 0
0 1 0
0 100 120
0 0 1
0 0 0
90 300 250
0 0 0
0 2 6
0 195 24
232 0 0
0 0 0
0 0 60
0 3200 3500
0 10 15
0 20 0
0 50 125
0 45 10
0 100 34
0 0 0
0 0 0
0 19 6
0 20 25
250 17 0
0 4000 5380
0 2 10
0 1200 830
370 23 24
0 0 0
0 0 0
22 0 0
0 300 320
0 0 0
0 75 35
200 0 0
0 1500 1200
0 0 20
0 25 21
0 0 0
0 9 1
0 0 0
370 25 27
0 0 0
0 0 0
0 10 0
0 0 0
0 1 9
0 0 9
0 2 0
0 1400 1654
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 124
0 300 110
0 2500 2700
0 14 10
0 0 0
0 0 0
0 0 42
0 1000 1200
0 500 430
0 22 12
0 190 31
0 302 142
0 0 0
0 0 0
0 714 1550
0 0 0
0 890 710
0 0 0
0 0 6
0 1 12
0 1490 1500
0 16 13
0 0 0
0 2 7
0 265 490
0 1200 1000
0 106 532
0 0 0
0 500 250
0 67 9
650 100 99
0 0 67
0 84 80
0 0 0
0 263 35
0 0 0
0 0 0
0 360 50
40 0 0
0 920 750
0 0 0
0 13 15
0 49 0
0 210 250
0 0 600
0 0 19
9 0 0
0 2 0
0 0 4
0 0 0
0 10 59
232 570 750
0 0 0
0 30 22
500 0 0
0 0 0
0 0 0
0 0 17
0 0 0
160 1000 1500
0 0 0
0 0 0
0 200 300
0 2500 1500
0 12 9
0 0 0
0 200 120
0 0 0
0 200 600
357 180 140
0 0 30
0 0 0
0 0 0
0 0 0
0 0 0
0 12 13
0 100 320
0 0 0
0 0 0
0 0 0
0 2 0
0 0 2
0 2 0
0 2 0
0 0 0
0 0 1000
200 770 220
0 100 150
0 10 10
0 100 200
0 100 500
0 500 10
0
0 500 500
0
130
0 800 900
0 10 10
0 1000 950
0 9 8
0 1000 800
0 9 5
0 9 8
0
0 500 2000
0
0
0
0
0
0
180
0
0
0
0
0
0
Yang Membuat
Pengelola Obat Pustu / Poskesdes ….
NIP
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PTM
Pos/Pustu : PELAPORAN BULAN
PUSKESMAS : MAKARTI MULYA PERMINTAAN BULAN
KECAMATAN : MESUJI
KABUPATEN : OGAN KOMERING ILIR
PROPINSI : SUMATERA SELATAN
NO. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN
1 2 3 4 5 6
1 Absorbent tipped applicator (alcohol swab) Pcs 200 200
2 ACARBOSE 100 MG Tablet 0 0
3 ACARBOSE 50 MG Tablet 0 0
4 Acetylcystein Kapsul 200mg Kapsul 270 270
5 Acyclovir cream Tube 3 3
6 Acyclovir tab 200 mg Tablet 0 0
7 Acyclovir tab 400 mg Tablet 100 100
8 Albendazol tab 400 mg Tablet 0 0
9 ALIVE BIOCOM (C&ZINC) Tablet 0 0
10 ALIVE NUTRIBION (B1,B6,B12) Tablet 0 0
11 ALIVE ZIC syr Botol 0 0
12 ALIVE D1000 TAB Tablet 0 0
13 Alkohol Liquid (etanol) 70%-1000 ml Tablet 0 0
14 Allopurinol 100 mg Tablet 10 10
15 Allopurinol 300 mg Tablet 0 0
16 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0
17 Aminophylline tab 200 mg Tablet 0 0
18 Amitriptyline 25 mg tab Tablet 0 0
19 Amlodipine tab 5 mg Tablet 560 560
20 Amlodipine 10 mg Tablet 0 0
21 AMOXICILLIN DROP Botol 0 0
22 Amoxycillin 250 mg Kapsul 0 0
23 Amoxycillin 500 mg Kaptab 0 0
24 Amoxycillin Syr Btl 0 0
25 Ampicilin 1 gr Inj Vial 0 0
26 Antasida DOEN Kombinasi Tablet 600 600
27 Antasida Syr DOEN Btl 0 0
28 Anti Bisa Ular 5 ml (ABU I)/ Biosave Ampul 0 0
29 Asam Mefenamat 500 mg tab Tablet 510 510
30 Ascorbic acid (Vit.C) 50 mg Tablet 0 0
31 Aspirin (miniaspi) 80 mg tab Tablet 0 0
32 Atropine inj 0,25 mg/ml Ampul 0 0
33 Attapulgite Tablet (Pularex) Tablet 0 0
34 Attapulgite Tablet 600 mg (New Antides) Tablet 0 0
35 Automated blood grouping (Tes Gol. Darah) Paket 0 0
36 AZITROMISIN 500 mg tab Tablet 0 0
37 Bactivec Larvasida 30ml Botol 0 0
38 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0
39 Bedak Salisil 2% Btl 0 0
40 Benzoic acid |salicylic acid salep (anti fungi) Tube 0 0
41 Betahistine Mesylate 6 mg tab Tablet 190 190
42 Betamethasone 0,1% krim Tube10 gr 13 13
43 Betamethasone 0,5% krim tube 5 g 0 0
44 Biosens DBD (DBD TEST) Pcs 0 0
45 Bisacodyl 5mg Tablet 0 0
46 Bismuth subgallas (antihemoroid) Pot 0 0
47 Calcium chloride lactate infus (RL) Botol 0 0
48 Calsium Laktat (Kalk) 500 mg Tablet 270 270
49 CANDESARTAN 16 Tablet 0 0
50 CANDESARTAN 8 Tablet 0 0
51 Captopril 12,5 mg Tablet 320 320
52 Captopril 25 mg Tablet 510 510
53 Carbamazepin tab Tablet 0 0
54 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 0 0
55 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 0 0
56 Cefadroxil 500mg Tablet 0 0
57 CEFIXIME 200 MG Kapsul 0 0
58 CEFIXIME 100MG Tablet 0 0
59 Cefotaaxime Sodium inj 1gr Vial 0 0
60 CEFRIAXONE INJ Vial 0 0
61 Cetirizine 5 mg/5 ml sirup Botol 0 0
62 Cetirizine Tab Tablet 0 0
63 Chloramhenicol Salep Mata 1% Tube 0 0
64 Chloramphenicol 250 mg caps Tablet 0 0
65 Chloramphenicol Suspensi 125 mg/ml Btl 0 0
66 Chloramphenicol TT 3% Botol 0 0
67 Chloramphenicol/ Hidrokortison krim 2,5% Tube 0 0
68 Chlorpheniramine Maleat (CTM) 4 mg Tablet 0 0
69 Chlorpromazine HCl 100 mg Tablet 0 0
70 Chlorpromazine HCl 25mg Tablet 0 0
71 Cimetidin 200 tab Tablet 0 0
72 Ciprofloxacin 500 mg tab Tablet 0 0
73 Ciprofloxacin Infus Botol 0 0
74 Clindamycin 300mg Kapsul 0 0
75 CLOZAPIN 25 Tablet 0 0
76 Coverall/Hazmat XL/XXL Set 0 0
77 Crefe Flesh 10cm Rol 0 0
78 Cresol liquid 1 Liter (lysol) Botol 0 0
79 Denpro Orafil Plus Temporary Pcs 0 0
80 Devitalisasi pasta/Pulp X pot 0 0
81 Dexamethasone 0,5 mg Tablet 0 0
82 Dexamethasone inj 5mg/ml-1ml Ampul 0 0
83 Diazepam 2 mg Tablet 0 0
84 Diazepam 5mg/ml-2 ml inj Ampul 0 0
85 Diclofenac sodium 25 mg tab Tablet 0 0
86 Diclofenac sodium 50 mg tab Tablet 0 0
87 Digoxin 0,25 mg Tablet 0 0
88 Dimenhydrinate 50mg Tablet 0 0
89 Dipenhidramine HCl inj 10mg/ml Ampul 0 0
90 Domperidone 10 mg Tablet 0 0
91 Domperidone sr Botol 0 0
92 Doxycycline 100 mg Kapsul Kapsul 0 0
93 Dulcolax tab Tablet 0 0
94 DULCOLAX SUPPOS 10 MG supp 0 0
95 DULCOLAX SUPPOS 5 MG INFANT supp 0 0
96 Epinephrine HCl/bitartrat inj 0,1% Btl 0 0
97 Erythromicin 250 mg capsul Kapsul 0 0
98 Erythromicin 500 mg capsul Kapsul 0 0
99 Erythromicin Syr Btl 0 0
100 Ethacridine (Rivanol) 0,1% 300 ml Btl 0 0
101 Ethacridine (Rivanol) 0,1% 100ml Btl 0 0
102 Ethanol ( Aseptan ) 500 cc+ Pump Botol 0 0
103 Ethyl Chloride Btl 0 0
104 Eugenol cairan Btl 0 0
105 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 0
106 Folic acid 1mg ( asam folat) Tablet 0 0
107 Folley Catheter No.16 Pcs 0 0
108 Furosemida 40 mg Tablet 100 100
109 Furosemida Injeksi Ampul 0 0
110 Garam Oralit Sachet 0 0
111 Gentamicyn 0,1% SK Tube 0 0
112 Gentamicyn 0,3% TM Botol 32 32
113 Gentamicyn Inj 40 mg/ml Ampul 0 0
114 Glass lonomer Paket 0 0
115 Glibenclamide 5 mg Tablet 930 930
116 GLICLAZIDE TAB Tablet 0 0
117 Glimepiride 1 mg Tablet 0 0
118 Glukosa larutan infus 10% Botol 0 0
119 Glukosa larutan infus 5% Botol 0 0
120 Griseofulvin 125 mg Tablet 100 100
121 Guaifenesin 100 Tab/GG Tab Tablet 0 0
122 Haloperidol 0,5 mg tab Tablet 0 0
123 Haloperidol 1,5 mg tab Tablet 0 0
124 Haloperidol 5 mg tab Tablet 0 0
125 Herbakoof 100ml Botol 0 0
126 Human chorionic (HCG/Tes kehamilan ) Strip 0 0
127 Hydrochlorotiazide (HCT) 25 mg Tablet 0 0
128 H2O2 100 ML Botol 0 0
129 Ibuprofen 200 mg Tablet 0 0
130 Ibuprofen 400 mg Tablet 0 0
131 Ibuprofen sirup Botol 0 0
132 Ichthyol salep 10% Pcs 0 0
133 Immunoglobulin human anti-tetanus (Tetagam) Pcs 0 0
134 INDEC HIV1/2&SPHYLLIS pcs 0 0
135 Infus set dewasa Pcs 0 0
136 Infusi set anak Pcs 0 0
137 Isosorbide tablet Tablet 0 0
138 IV Catheter No.20 Pcs 0 0
139 IV Catheter No.22 Pcs 0 0
140 IV Catheter No.24 Pcs 0 0
141 Jarum Jahit Kulit Pcs 0 0
142 Kalium Permanganat Serbuk Pcs 0 0
143 Kapas pembalut/Absorben 250 g Pcs 0 0
144 Kasa kompres 40/40 steril Pcs 0 0
145 Kasa pembalut 2x80 Pcs 0 0
146 Kasa pembalut hidrofil 4 m x 15 cm Pcs 0 0
147 Kasa pembalut hidrofil 4 m x 3 cm Pcs 0 0
148 Ketac Universal (61108) Pcs 0 0
149 Ketac Universal (61111) Pcs 0 0
150 Ketoconazole 200 mg Cream Tube 0 0
151 Ketoconazole 200 mg tab Tablet 0 0
152 Ketorolac inj 30mg Ampul 0 0
153 Klorokina Fosfat 250 mg Tablet 0 0
154 KOTRIMOXAZOL 800/160 MG TAB Tablet 0 0
155 LAKTULOSE SYR Botol 0 0
156 Lancet Pcs 300 300
157 Levertran Salep/ Salep Luka Bakar Btl 0 0
158 Lidocain 2% Ampul 0 0
159 Lidocaine spray (Xylocaine spray) Pcs 0 0
160 Lidokain Comp. inj Kombinasi Ampul 0 0
161 Liquorice liquid extract (OBH) Botol 0 0
162 Locoriz Cream Tablet 0 0
163 Loperamid 2 mg tab / Diastrix 2 mg Tablet 0 0
164 Loratadine 10 mg tab Tablet 90 90
165 LYTACUR SYR Botol 0 0
166 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 0
167 Magnesium Sulfat Injeksi 40% (MgSO4) Ampul 0 0
168 Masker Pcs 232 232
169 Masker Earloop Pcs 0 0
170 Masker Headloop Pcs 0 0
171 Masker KN95 Pcs 0 0
172 Masker Plus Pcs 0 0
173 Masker Tie on Pcs 0 0
174 Medical adhesive tape (dermafix/leukomed) Pcs 0 0
175 Meprovent inj Ampul 0 0
176 Metamizole injeksi (antalgin 1000) Ampul 0 0
177 Metformin 500mg tab Tablet 0 0
178 Methyl Ergometrin Maleat 0,125 mg Tab 0 0
179 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0
180 Methyl Prednisolon tab 16 mg Tablet 0 0
181 Methyl Prednisolon tab 4 mg Tablet 250 250
182 Methyl Rosanilinium (gentian violet) Botol 0 0
183 METOCLOPROMIDE TAB Tablet 0 0
184 Metronidazol 250 mg tab Tablet 0 0
185 Metronidazol 500 mg tab Tablet 370 370
186 Metronidazol Infus Botol 0 0
187 Metronidazol syr Botol 0 0
188 Miconazole 2% Salep Kulit Tube 22 22
189 MOMETASONE Krim Tube 0 0
190 Moutpiece Steribreath 250's Pck 0 0
191 Natrium Bikarbonat 500 mg Tablet 0 0
192 Nifedipin 10 mg tab Kapsul 200 200
193 Nonwoven Fixation Rool Pcs 0 0
194 Nystatin Drop 100.000 IU Btl 0 0
195 Nystatin Tab Vag 10.000 iu/g Tablet 0 0
196 Octadin Botol 1000ml Botol 0 0
197 Octadin Spray 5ml Botol 0 0
198 Omeprazole inj Vial 0 0
199 Omeprazole kaps Tablet 370 370
200 Ondansetron iv/im 4mg Ampul 0 0
201 ONDANSETRON TAB Tablet 0 0
202 Otsu D-40 25ml Botol 0 0
203 Oxytetracycline HCl 1% Salep Mata Tube 0 0
204 Oxytetracycline HCl 3% Salep Kulit Tube 0 0
205 Oxytocin inj 10 IU Ampul 0 0
206 Papaverin 40 mg tab Tablet 0 0
207 Papaverin inj Tablet 0 0
208 Paracetamol Drops 15 ml Botol 0 0
209 Parasetamol 1000mg/100ml infus Botol 0 0
210 Parasetamol 120 mg/5 ml Syr Botol 0 0
211 Parasetamol 500 mg Tablet 0 0
212 Patient Lubricant (My Jelly ) Tube 0 0
213 Pehavral tab Tablet 0 0
214 Permethrin (Scabimite Cream) Tube 0 0
215 Phenobarbital 30 mg Tablet 0 0
216 Phenobarbital inj 50mg/ml-2ml Ampul 0 0
217 Phenol gliserol 10% TT Botol 0 0
218 Phytomenadione (Vit.K1) 10 mg Tablet 0 0
219 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 0
220 Phytomenadione (Vit.K1) inj 2 mg/ml Ampul 0 0
221 Piracetam 400 mg Tablet 0 0
222 Piroxicam 20 mg tab Tablet 0 0
223 Pisau Disposable (Mess No.10/11/20/21) pisau 0 0
224 Plesterku (Leukoplast) Pcs 0 0
225 Poli Aid 1 liter Botol 0 0
226 POLIAID 5L Botol 0 0
227 Policlean Handrub Botol 0 0
228 POLIDESINFEKTAN 5 L Botol 0 0
229 Polifix 10x5cm Pcs 0 0
230 Polifix 5x1cm Pcs 0 0
231 Polifix 5x5cm Pcs 0 0
232 POLIGEL 500 ML Botol 0 0
233 POLIGEL 5 L Botol 0 0
234 POLISOFT ALK HANDRUB 500 ML Botol 0 0
235 POLISOFT ALK HANDRUB 5 L Botol 0 0
236 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 0 0
237 Poliwash 500 ml Botol 0 0
238 POLIWASH 5 L Botol 0 0
239 Povidon iodium 10% 1000 ml Botol 0 0
240 Povidon iodium 10% 300 ml Botol 0 0
241 Povidon iodium 10% 60 ml Botol 0 0
242 Povidon Iodium 10% 30 ml Botol 0 0
243 Prednison 5 mg Tablet 650 650
244 Primaquin 15 mg tab Tablet 0 0
245 Propranolol HCl 10 mg Tablet 0 0
246 Propranolol HCl 40 mg Tablet 0 0
247 Propylthiouracil 100 mg Tablet 0 0
248 Protein Gluco Test Strip 0 0
249 Pyrantel Pamoat 125 mg Tablet 0 0
250 Pyridoxine HCl 10 mg Tablet 0 0
251 Ranitidin 150 mg Tablet 40 40
252 Ranitidin Injeksi Ampul 0 0
253 Rapid Test antigen (Panbio) Pcs 0 0
254 Retinol (Vit.A) kaps 100.000 iu Tablet 0 0
255 Retinol (Vit.A) kaps 200.000 iu Tablet 0 0
256 Risperidone 2mg Tablet 0 0
257 ROEKO ENDO FROST Botol 0 0
258 Salbutamol 2 mg Tablet 0 0
259 Salep 2-4 Kombinasi Tube 9 9
260 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0 0
261 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0
262 Sarung tangan (HandScuun Steril) No.7,5 Pcs 0 0
263 Sarung tangan (HandScuun) L Pcs 0 0
264 Sarung tangan (HandScuun) S/ M/ L Pcs 232 232
265 Sarung tangan nitril pcs 0 0
266 Semen Seng Fosfat Serbuk & Cairan Set 0 0
267 Sianocobalamin (Vit B12) 50 mg tab Tablet 500 500
268 Sianocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0
269 Silk (Benang Bedah) No. 3/0 Pcs 0 0
270 Silver Sulfadiazine Tube 0 0
271 Simvastatin 10 mg tab Kapsul 0 0
272 Simvastatin 20 mg tab Tablet 160 160
273 Sodium cloride infus 0,9% ( NACL ) Botol 0 0
274 Softanol 5 Liter Botol 0 0
275 Softanol 500ml Botol 0 0
276 Spuit 1 ml Pcs 0 0
277 Spuit 3 ml Pcs 0 0
278 Spuit 5 ml Pcs 0 0
279 Stericide 5 Liter Botol 0 0
280 Stimuno Capsul Forte Kapsul 0 0
281 Stimuno syrup Botol 0 0
282 Strip Asam Urat Pcs 357 357
283 Strip Gula Darah box 0 0
284 Strip kolestrol Pcs 0 0
285 SUKRALFAT TAB Tablet 0 0
286 SUKRALFAT SYR Botol 0 0
287 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 0 0
288 Sulfamethoxazole|trimethoprim (cotri) syr Botol 0 0
289 Sulfasetamida 15% TM Ampul 0 0
290 Surgical gown XL Set 0 0
291 Tetracycline 250 mg Tablet 0 0
292 Tetracycline 500 mg Tablet 0 0
293 Thiamine HCl (Vit B1) 50 mg Tablet 0 0
294 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0
295 Tranexamic Acid inj 5% Ampul 0 0
296 TRANEXAMIC ACID TAB Tablet 0 0
297 Trepocheck syphilis Pcs 0 0
298 Trihexyphenidyl tab 2 mg Tablet 0 0
299 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 200 200
300 Urin Bag Pcs 0 0
301 Usg Gel Botol 0 0
302 Vaksin Rabies Vero/ Verorab Paket 0 0
303 VALSARTAN 80 Tablet 0 0
304 VALSARTAN 160 Tablet 0 0
305 Viorex Liq 2% 5 Liter Botol 0 0
306 Viorex Liq 2% 500ml Botol 0 0
307 Virocheck HIV Pcs 0 0
308 Vitamin B Kompleks Tablet 130 130
309 Vitamin K Infant Inj Ampul 0 0
310 Water liquid (aqua P,I) Botol 0 0
311 Wing Needle No.21 Pcs 0 0
312 Wing Needle No.27 Pcs 0 0
313 Xpert MTB/RIF pcs 0 0
314 Zinc Drop Botol 0 0
315 Zinc tab Tablet 0 0
316 HB Test (Hemachroma Plus Microcuvette) Box 0 0
317 HIV Sifilis Combo Box 0 0
318 Kapas Lidi Box 0 0
319 Asam Asetat Botol 0 0
320 Sasklin Desinfektan 500 mL Botol 0 0
321 Kapas 1000 gr Box 0 0
322 Ameritek Test Box 0 0
323 Pot Feses Pack 0 0
324 Ambroxol Tablet Tablet 180 180
325 Ambroxol Syrup Botol 0 0
326 Reagen E.Coli 0 0
327 Caroto Gel 80 gr/ ECG Gel 0 0
328 Kertas ECG uk. 80 mmx 20 m 0 0
329 Kertas ECG uk. 80 mmx 90 mmx 280 0 0
330 Combur Test 0 0
UMUM JAMSOSKES BPJS JUMLAH
JUMLAH KUNJUNGAN RESEP
Mengetahui
Pengelola Obat Puskesmas
apt. Winda Utami, S. Farm.
NIP 199509112022032013
MINTAAN OBAT (LPLPO) PTM/PUSLING
: DOKUMEN NOMOR TANGGAL
: DINKES KAB/KOTA
IFK KAB/KOTA
PUSKESMAS
STOK STOK nov des jan
PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AKHIR OPTIMUM
7 8 9 10 11 12
200 277 1343
0 980 1000
0 24 25
270 0 0
3 1000 920
0 0 0
100 1 6
0 1200 1000
0 3 10
0 0 0
0 45 50
0 150 260
0 440 120
10 3500 3550
0 38 35
0 0 0
0 1500 2598
0 109 220
560 2 0
0 2500 3500
0 454 860
0 0 0
0 0 0
0 0 5
0 0 0
600 150 100
0 0 0
0 0 24
510 0 0
0 80 70
0 20 30
0 800 1500
0 30 53
0 0 0
0 5 1
0 20 15
0 275 270
0 1550 3570
0 2190 1030
0 3000 1200
190 150 260
13 36 48
0 1 27
0 1000 0
0 0 10
0 6 27
0 5000 200
270 30 25
0 100 150
0 50 35
320 10 35
510 100 99
0 3440 160
0 60 0
0 0 0
0 0 0
0 2500 1500
0 0 0
0 100 350
0 0 5
0 0 1
0 1 5
0 0 0
0 0 0
0 4000 3000
0 30 20
0 47 40
0 11 9
0 0 0
0 4000 3400
0 0 90
0 470 80
0 15 31
0 4000 1200
0 0 0
0 0 0
0 18 5
0 0 0
0 440 500
0 0 0
0 5 6
0 20 23
0 0 1
0 0 1
0 0 0
0 470 420
0 0 0
0 10 17
0 500 120
0 0 0
0 302 41
0 30 19
0 100 23
0 30 35
0 0 0
0 2190 780
0 4200 2200
0 7 9
0 0 0
0 50 140
0 2000 3000
0 0 0
0 0 0
0 30 300
0 100 104
0 89 50
0 50 110
100 0 0
0 1013 2000
0 22 116
0 15 12
32 0 5
0 80 96
0 33 32
930 200 80
0 150 58
0 102 97
0 0 99
0 0 0
100 0 0
0 8 5
0 75 50
0 43 146
0 20 15
0 31 32
0 0 2
0 0 2
0 80 54
0 200 540
0 15 20
0 0 0
0 500 250
0 0 0
0 0 0
0 0 0
0 200 107
0 0 0
0 0 0
0 600 900
0 270 270
0 0 0
0 6 15
0 0 0
0 76 500
0 0 0
0 0 0
0 0 0
0 500 570
0 0 102
0 20 0
0 3257 4010
0 0 0
0 0 0
0 0 0
0 3500 2500
300 0 0
0 0 0
0 1200 2453
0 0 0
0 1 0
0 100 120
0 0 1
0 0 0
90 300 250
0 0 0
0 2 6
0 195 24
232 0 0
0 0 0
0 0 60
0 3200 3500
0 10 15
0 20 0
0 50 125
0 45 10
0 100 34
0 0 0
0 0 0
0 19 6
0 20 25
250 17 0
0 4000 5380
0 2 10
0 1200 830
370 23 24
0 0 0
0 0 0
22 0 0
0 300 320
0 0 0
0 75 35
200 0 0
0 1500 1200
0 0 20
0 25 21
0 0 0
0 9 1
0 0 0
370 25 27
0 0 0
0 0 0
0 10 0
0 0 0
0 1 9
0 0 9
0 2 0
0 1400 1654
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 124
0 300 110
0 2500 2700
0 14 10
0 0 0
0 0 0
0 0 42
0 1000 1200
0 500 430
0 22 12
0 190 31
0 302 142
0 0 0
0 0 0
0 714 1550
0 0 0
0 890 710
0 0 0
0 0 6
0 1 12
0 1490 1500
0 16 13
0 0 0
0 2 7
0 265 490
0 1200 1000
0 106 532
0 0 0
0 500 250
0 67 9
650 100 99
0 0 67
0 84 80
0 0 0
0 263 35
0 0 0
0 0 0
0 360 50
40 0 0
0 920 750
0 0 0
0 13 15
0 49 0
0 210 250
0 0 600
0 0 19
9 0 0
0 2 0
0 0 4
0 0 0
0 10 59
232 570 750
0 0 0
0 30 22
500 0 0
0 0 0
0 0 0
0 0 17
0 0 0
160 1000 1500
0 0 0
0 0 0
0 200 300
0 2500 1500
0 12 9
0 0 0
0 200 120
0 0 0
0 200 600
357 180 140
0 0 30
0 0 0
0 0 0
0 0 0
0 0 0
0 12 13
0 100 320
0 0 0
0 0 0
0 0 0
0 2 0
0 0 2
0 2 0
0 2 0
0 0 0
0 0 1000
200 770 220
0 100 150
0 10 10
0 100 200
0 100 500
0 500 10
0
0 500 500
0
130
0 800 900
0 10 10
0 1000 950
0 9 8
0 1000 800
0 9 5
0 9 8
0
0 500 2000
0
0
0
0
0
0
180
0
0
0
0
0
0
Yang Membuat
Pengelola Obat Pustu / Poskesdes ….
NIP
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PTM
Pos/Pustu : PELAPORAN BULAN
PUSKESMAS : MAKARTI MULYA PERMINTAAN BULAN
KECAMATAN : MESUJI
KABUPATEN : OGAN KOMERING ILIR
PROPINSI : SUMATERA SELATAN
NO. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN
1 2 3 4 5 6
1 Absorbent tipped applicator (alcohol swab) Pcs 200 200
2 ACARBOSE 100 MG Tablet 0 0
3 ACARBOSE 50 MG Tablet 0 0
4 Acetylcystein Kapsul 200mg Kapsul 270 270
5 Acyclovir cream Tube 3 3
6 Acyclovir tab 200 mg Tablet 0 0
7 Acyclovir tab 400 mg Tablet 100 100
8 Albendazol tab 400 mg Tablet 0 0
9 ALIVE BIOCOM (C&ZINC) Tablet 0 0
10 ALIVE NUTRIBION (B1,B6,B12) Tablet 0 0
11 ALIVE ZIC syr Botol 0 0
12 ALIVE D1000 TAB Tablet 0 0
13 Alkohol Liquid (etanol) 70%-1000 ml Tablet 0 0
14 Allopurinol 100 mg Tablet 10 10
15 Allopurinol 300 mg Tablet 0 0
16 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0
17 Aminophylline tab 200 mg Tablet 0 0
18 Amitriptyline 25 mg tab Tablet 0 0
19 Amlodipine tab 5 mg Tablet 560 560
20 Amlodipine 10 mg Tablet 0 0
21 AMOXICILLIN DROP Botol 0 0
22 Amoxycillin 250 mg Kapsul 0 0
23 Amoxycillin 500 mg Kaptab 0 0
24 Amoxycillin Syr Btl 0 0
25 Ampicilin 1 gr Inj Vial 0 0
26 Antasida DOEN Kombinasi Tablet 600 600
27 Antasida Syr DOEN Btl 0 0
28 Anti Bisa Ular 5 ml (ABU I)/ Biosave Ampul 0 0
29 Asam Mefenamat 500 mg tab Tablet 510 510
30 Ascorbic acid (Vit.C) 50 mg Tablet 0 0
31 Aspirin (miniaspi) 80 mg tab Tablet 0 0
32 Atropine inj 0,25 mg/ml Ampul 0 0
33 Attapulgite Tablet (Pularex) Tablet 0 0
34 Attapulgite Tablet 600 mg (New Antides) Tablet 0 0
35 Automated blood grouping (Tes Gol. Darah) Paket 0 0
36 AZITROMISIN 500 mg tab Tablet 0 0
37 Bactivec Larvasida 30ml Botol 0 0
38 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0
39 Bedak Salisil 2% Btl 0 0
40 Benzoic acid |salicylic acid salep (anti fungi) Tube 0 0
41 Betahistine Mesylate 6 mg tab Tablet 190 190
42 Betamethasone 0,1% krim Tube10 gr 13 13
43 Betamethasone 0,5% krim tube 5 g 0 0
44 Biosens DBD (DBD TEST) Pcs 0 0
45 Bisacodyl 5mg Tablet 0 0
46 Bismuth subgallas (antihemoroid) Pot 0 0
47 Calcium chloride lactate infus (RL) Botol 0 0
48 Calsium Laktat (Kalk) 500 mg Tablet 270 270
49 CANDESARTAN 16 Tablet 0 0
50 CANDESARTAN 8 Tablet 0 0
51 Captopril 12,5 mg Tablet 320 320
52 Captopril 25 mg Tablet 510 510
53 Carbamazepin tab Tablet 0 0
54 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 0 0
55 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 0 0
56 Cefadroxil 500mg Tablet 0 0
57 CEFIXIME 200 MG Kapsul 0 0
58 CEFIXIME 100MG Tablet 0 0
59 Cefotaaxime Sodium inj 1gr Vial 0 0
60 CEFRIAXONE INJ Vial 0 0
61 Cetirizine 5 mg/5 ml sirup Botol 0 0
62 Cetirizine Tab Tablet 0 0
63 Chloramhenicol Salep Mata 1% Tube 0 0
64 Chloramphenicol 250 mg caps Tablet 0 0
65 Chloramphenicol Suspensi 125 mg/ml Btl 0 0
66 Chloramphenicol TT 3% Botol 0 0
67 Chloramphenicol/ Hidrokortison krim 2,5% Tube 0 0
68 Chlorpheniramine Maleat (CTM) 4 mg Tablet 0 0
69 Chlorpromazine HCl 100 mg Tablet 0 0
70 Chlorpromazine HCl 25mg Tablet 0 0
71 Cimetidin 200 tab Tablet 0 0
72 Ciprofloxacin 500 mg tab Tablet 0 0
73 Ciprofloxacin Infus Botol 0 0
74 Clindamycin 300mg Kapsul 0 0
75 CLOZAPIN 25 Tablet 0 0
76 Coverall/Hazmat XL/XXL Set 0 0
77 Crefe Flesh 10cm Rol 0 0
78 Cresol liquid 1 Liter (lysol) Botol 0 0
79 Denpro Orafil Plus Temporary Pcs 0 0
80 Devitalisasi pasta/Pulp X pot 0 0
81 Dexamethasone 0,5 mg Tablet 0 0
82 Dexamethasone inj 5mg/ml-1ml Ampul 0 0
83 Diazepam 2 mg Tablet 0 0
84 Diazepam 5mg/ml-2 ml inj Ampul 0 0
85 Diclofenac sodium 25 mg tab Tablet 0 0
86 Diclofenac sodium 50 mg tab Tablet 0 0
87 Digoxin 0,25 mg Tablet 0 0
88 Dimenhydrinate 50mg Tablet 0 0
89 Dipenhidramine HCl inj 10mg/ml Ampul 0 0
90 Domperidone 10 mg Tablet 0 0
91 Domperidone sr Botol 0 0
92 Doxycycline 100 mg Kapsul Kapsul 0 0
93 Dulcolax tab Tablet 0 0
94 DULCOLAX SUPPOS 10 MG supp 0 0
95 DULCOLAX SUPPOS 5 MG INFANT supp 0 0
96 Epinephrine HCl/bitartrat inj 0,1% Btl 0 0
97 Erythromicin 250 mg capsul Kapsul 0 0
98 Erythromicin 500 mg capsul Kapsul 0 0
99 Erythromicin Syr Btl 0 0
100 Ethacridine (Rivanol) 0,1% 300 ml Btl 0 0
101 Ethacridine (Rivanol) 0,1% 100ml Btl 0 0
102 Ethanol ( Aseptan ) 500 cc+ Pump Botol 0 0
103 Ethyl Chloride Btl 0 0
104 Eugenol cairan Btl 0 0
105 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 0
106 Folic acid 1mg ( asam folat) Tablet 0 0
107 Folley Catheter No.16 Pcs 0 0
108 Furosemida 40 mg Tablet 100 100
109 Furosemida Injeksi Ampul 0 0
110 Garam Oralit Sachet 0 0
111 Gentamicyn 0,1% SK Tube 0 0
112 Gentamicyn 0,3% TM Botol 32 32
113 Gentamicyn Inj 40 mg/ml Ampul 0 0
114 Glass lonomer Paket 0 0
115 Glibenclamide 5 mg Tablet 930 930
116 GLICLAZIDE TAB Tablet 0 0
117 Glimepiride 1 mg Tablet 0 0
118 Glukosa larutan infus 10% Botol 0 0
119 Glukosa larutan infus 5% Botol 0 0
120 Griseofulvin 125 mg Tablet 100 100
121 Guaifenesin 100 Tab/GG Tab Tablet 0 0
122 Haloperidol 0,5 mg tab Tablet 0 0
123 Haloperidol 1,5 mg tab Tablet 0 0
124 Haloperidol 5 mg tab Tablet 0 0
125 Herbakoof 100ml Botol 0 0
126 Human chorionic (HCG/Tes kehamilan ) Strip 0 0
127 Hydrochlorotiazide (HCT) 25 mg Tablet 0 0
128 H2O2 100 ML Botol 0 0
129 Ibuprofen 200 mg Tablet 0 0
130 Ibuprofen 400 mg Tablet 0 0
131 Ibuprofen sirup Botol 0 0
132 Ichthyol salep 10% Pcs 0 0
133 Immunoglobulin human anti-tetanus (Tetagam) Pcs 0 0
134 INDEC HIV1/2&SPHYLLIS pcs 0 0
135 Infus set dewasa Pcs 0 0
136 Infusi set anak Pcs 0 0
137 Isosorbide tablet Tablet 0 0
138 IV Catheter No.20 Pcs 0 0
139 IV Catheter No.22 Pcs 0 0
140 IV Catheter No.24 Pcs 0 0
141 Jarum Jahit Kulit Pcs 0 0
142 Kalium Permanganat Serbuk Pcs 0 0
143 Kapas pembalut/Absorben 250 g Pcs 0 0
144 Kasa kompres 40/40 steril Pcs 0 0
145 Kasa pembalut 2x80 Pcs 0 0
146 Kasa pembalut hidrofil 4 m x 15 cm Pcs 0 0
147 Kasa pembalut hidrofil 4 m x 3 cm Pcs 0 0
148 Ketac Universal (61108) Pcs 0 0
149 Ketac Universal (61111) Pcs 0 0
150 Ketoconazole 200 mg Cream Tube 0 0
151 Ketoconazole 200 mg tab Tablet 0 0
152 Ketorolac inj 30mg Ampul 0 0
153 Klorokina Fosfat 250 mg Tablet 0 0
154 KOTRIMOXAZOL 800/160 MG TAB Tablet 0 0
155 LAKTULOSE SYR Botol 0 0
156 Lancet Pcs 300 300
157 Levertran Salep/ Salep Luka Bakar Btl 0 0
158 Lidocain 2% Ampul 0 0
159 Lidocaine spray (Xylocaine spray) Pcs 0 0
160 Lidokain Comp. inj Kombinasi Ampul 0 0
161 Liquorice liquid extract (OBH) Botol 0 0
162 Locoriz Cream Tablet 0 0
163 Loperamid 2 mg tab / Diastrix 2 mg Tablet 0 0
164 Loratadine 10 mg tab Tablet 90 90
165 LYTACUR SYR Botol 0 0
166 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 0
167 Magnesium Sulfat Injeksi 40% (MgSO4) Ampul 0 0
168 Masker Pcs 232 232
169 Masker Earloop Pcs 0 0
170 Masker Headloop Pcs 0 0
171 Masker KN95 Pcs 0 0
172 Masker Plus Pcs 0 0
173 Masker Tie on Pcs 0 0
174 Medical adhesive tape (dermafix/leukomed) Pcs 0 0
175 Meprovent inj Ampul 0 0
176 Metamizole injeksi (antalgin 1000) Ampul 0 0
177 Metformin 500mg tab Tablet 0 0
178 Methyl Ergometrin Maleat 0,125 mg Tab 0 0
179 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0
180 Methyl Prednisolon tab 16 mg Tablet 0 0
181 Methyl Prednisolon tab 4 mg Tablet 250 250
182 Methyl Rosanilinium (gentian violet) Botol 0 0
183 METOCLOPROMIDE TAB Tablet 0 0
184 Metronidazol 250 mg tab Tablet 0 0
185 Metronidazol 500 mg tab Tablet 370 370
186 Metronidazol Infus Botol 0 0
187 Metronidazol syr Botol 0 0
188 Miconazole 2% Salep Kulit Tube 22 22
189 MOMETASONE Krim Tube 0 0
190 Moutpiece Steribreath 250's Pck 0 0
191 Natrium Bikarbonat 500 mg Tablet 0 0
192 Nifedipin 10 mg tab Kapsul 200 200
193 Nonwoven Fixation Rool Pcs 0 0
194 Nystatin Drop 100.000 IU Btl 0 0
195 Nystatin Tab Vag 10.000 iu/g Tablet 0 0
196 Octadin Botol 1000ml Botol 0 0
197 Octadin Spray 5ml Botol 0 0
198 Omeprazole inj Vial 0 0
199 Omeprazole kaps Tablet 370 370
200 Ondansetron iv/im 4mg Ampul 0 0
201 ONDANSETRON TAB Tablet 0 0
202 Otsu D-40 25ml Botol 0 0
203 Oxytetracycline HCl 1% Salep Mata Tube 0 0
204 Oxytetracycline HCl 3% Salep Kulit Tube 0 0
205 Oxytocin inj 10 IU Ampul 0 0
206 Papaverin 40 mg tab Tablet 0 0
207 Papaverin inj Tablet 0 0
208 Paracetamol Drops 15 ml Botol 0 0
209 Parasetamol 1000mg/100ml infus Botol 0 0
210 Parasetamol 120 mg/5 ml Syr Botol 0 0
211 Parasetamol 500 mg Tablet 0 0
212 Patient Lubricant (My Jelly ) Tube 0 0
213 Pehavral tab Tablet 0 0
214 Permethrin (Scabimite Cream) Tube 0 0
215 Phenobarbital 30 mg Tablet 0 0
216 Phenobarbital inj 50mg/ml-2ml Ampul 0 0
217 Phenol gliserol 10% TT Botol 0 0
218 Phytomenadione (Vit.K1) 10 mg Tablet 0 0
219 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 0
220 Phytomenadione (Vit.K1) inj 2 mg/ml Ampul 0 0
221 Piracetam 400 mg Tablet 0 0
222 Piroxicam 20 mg tab Tablet 0 0
223 Pisau Disposable (Mess No.10/11/20/21) pisau 0 0
224 Plesterku (Leukoplast) Pcs 0 0
225 Poli Aid 1 liter Botol 0 0
226 POLIAID 5L Botol 0 0
227 Policlean Handrub Botol 0 0
228 POLIDESINFEKTAN 5 L Botol 0 0
229 Polifix 10x5cm Pcs 0 0
230 Polifix 5x1cm Pcs 0 0
231 Polifix 5x5cm Pcs 0 0
232 POLIGEL 500 ML Botol 0 0
233 POLIGEL 5 L Botol 0 0
234 POLISOFT ALK HANDRUB 500 ML Botol 0 0
235 POLISOFT ALK HANDRUB 5 L Botol 0 0
236 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 0 0
237 Poliwash 500 ml Botol 0 0
238 POLIWASH 5 L Botol 0 0
239 Povidon iodium 10% 1000 ml Botol 0 0
240 Povidon iodium 10% 300 ml Botol 0 0
241 Povidon iodium 10% 60 ml Botol 0 0
242 Povidon Iodium 10% 30 ml Botol 0 0
243 Prednison 5 mg Tablet 650 650
244 Primaquin 15 mg tab Tablet 0 0
245 Propranolol HCl 10 mg Tablet 0 0
246 Propranolol HCl 40 mg Tablet 0 0
247 Propylthiouracil 100 mg Tablet 0 0
248 Protein Gluco Test Strip 0 0
249 Pyrantel Pamoat 125 mg Tablet 0 0
250 Pyridoxine HCl 10 mg Tablet 0 0
251 Ranitidin 150 mg Tablet 40 40
252 Ranitidin Injeksi Ampul 0 0
253 Rapid Test antigen (Panbio) Pcs 0 0
254 Retinol (Vit.A) kaps 100.000 iu Tablet 0 0
255 Retinol (Vit.A) kaps 200.000 iu Tablet 0 0
256 Risperidone 2mg Tablet 0 0
257 ROEKO ENDO FROST Botol 0 0
258 Salbutamol 2 mg Tablet 0 0
259 Salep 2-4 Kombinasi Tube 9 9
260 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0 0
261 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0
262 Sarung tangan (HandScuun Steril) No.7,5 Pcs 0 0
263 Sarung tangan (HandScuun) L Pcs 0 0
264 Sarung tangan (HandScuun) S/ M/ L Pcs 232 232
265 Sarung tangan nitril pcs 0 0
266 Semen Seng Fosfat Serbuk & Cairan Set 0 0
267 Sianocobalamin (Vit B12) 50 mg tab Tablet 500 500
268 Sianocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0
269 Silk (Benang Bedah) No. 3/0 Pcs 0 0
270 Silver Sulfadiazine Tube 0 0
271 Simvastatin 10 mg tab Kapsul 0 0
272 Simvastatin 20 mg tab Tablet 160 160
273 Sodium cloride infus 0,9% ( NACL ) Botol 0 0
274 Softanol 5 Liter Botol 0 0
275 Softanol 500ml Botol 0 0
276 Spuit 1 ml Pcs 0 0
277 Spuit 3 ml Pcs 0 0
278 Spuit 5 ml Pcs 0 0
279 Stericide 5 Liter Botol 0 0
280 Stimuno Capsul Forte Kapsul 0 0
281 Stimuno syrup Botol 0 0
282 Strip Asam Urat Pcs 357 357
283 Strip Gula Darah box 0 0
284 Strip kolestrol Pcs 0 0
285 SUKRALFAT TAB Tablet 0 0
286 SUKRALFAT SYR Botol 0 0
287 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 0 0
288 Sulfamethoxazole|trimethoprim (cotri) syr Botol 0 0
289 Sulfasetamida 15% TM Ampul 0 0
290 Surgical gown XL Set 0 0
291 Tetracycline 250 mg Tablet 0 0
292 Tetracycline 500 mg Tablet 0 0
293 Thiamine HCl (Vit B1) 50 mg Tablet 0 0
294 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0
295 Tranexamic Acid inj 5% Ampul 0 0
296 TRANEXAMIC ACID TAB Tablet 0 0
297 Trepocheck syphilis Pcs 0 0
298 Trihexyphenidyl tab 2 mg Tablet 0 0
299 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 200 200
300 Urin Bag Pcs 0 0
301 Usg Gel Botol 0 0
302 Vaksin Rabies Vero/ Verorab Paket 0 0
303 VALSARTAN 80 Tablet 0 0
304 VALSARTAN 160 Tablet 0 0
305 Viorex Liq 2% 5 Liter Botol 0 0
306 Viorex Liq 2% 500ml Botol 0 0
307 Virocheck HIV Pcs 0 0
308 Vitamin B Kompleks Tablet 130 130
309 Vitamin K Infant Inj Ampul 0 0
310 Water liquid (aqua P,I) Botol 0 0
311 Wing Needle No.21 Pcs 0 0
312 Wing Needle No.27 Pcs 0 0
313 Xpert MTB/RIF pcs 0 0
314 Zinc Drop Botol 0 0
315 Zinc tab Tablet 0 0
316 HB Test (Hemachroma Plus Microcuvette) Box 0 0
317 HIV Sifilis Combo Box 0 0
318 Kapas Lidi Box 0 0
319 Asam Asetat Botol 0 0
320 Sasklin Desinfektan 500 mL Botol 0 0
321 Kapas 1000 gr Box 0 0
322 Ameritek Test Box 0 0
323 Pot Feses Pack 0 0
324 Ambroxol Tablet Tablet 180 180
325 Ambroxol Syrup Botol 0 0
326 Reagen E.Coli 0 0
327 Caroto Gel 80 gr/ ECG Gel 0 0
328 Kertas ECG uk. 80 mmx 20 m 0 0
329 Kertas ECG uk. 80 mmx 90 mmx 280 0 0
330 Combur Test 0 0
UMUM JAMSOSKES BPJS JUMLAH
JUMLAH KUNJUNGAN RESEP
Mengetahui
Pengelola Obat Puskesmas
apt. Winda Utami, S. Farm.
NIP 199509112022032013
MINTAAN OBAT (LPLPO) PTM/PUSLING
: DOKUMEN NOMOR TANGGAL
: DINKES KAB/KOTA
IFK KAB/KOTA
PUSKESMAS
STOK STOK nov des jan
PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AKHIR OPTIMUM
7 8 9 10 11 12
200 277 1343
0 980 1000
0 24 25
270 0 0
3 1000 920
0 0 0
100 1 6
0 1200 1000
0 3 10
0 0 0
0 45 50
0 150 260
0 440 120
10 3500 3550
0 38 35
0 0 0
0 1500 2598
0 109 220
560 2 0
0 2500 3500
0 454 860
0 0 0
0 0 0
0 0 5
0 0 0
600 150 100
0 0 0
0 0 24
510 0 0
0 80 70
0 20 30
0 800 1500
0 30 53
0 0 0
0 5 1
0 20 15
0 275 270
0 1550 3570
0 2190 1030
0 3000 1200
190 150 260
13 36 48
0 1 27
0 1000 0
0 0 10
0 6 27
0 5000 200
270 30 25
0 100 150
0 50 35
320 10 35
510 100 99
0 3440 160
0 60 0
0 0 0
0 0 0
0 2500 1500
0 0 0
0 100 350
0 0 5
0 0 1
0 1 5
0 0 0
0 0 0
0 4000 3000
0 30 20
0 47 40
0 11 9
0 0 0
0 4000 3400
0 0 90
0 470 80
0 15 31
0 4000 1200
0 0 0
0 0 0
0 18 5
0 0 0
0 440 500
0 0 0
0 5 6
0 20 23
0 0 1
0 0 1
0 0 0
0 470 420
0 0 0
0 10 17
0 500 120
0 0 0
0 302 41
0 30 19
0 100 23
0 30 35
0 0 0
0 2190 780
0 4200 2200
0 7 9
0 0 0
0 50 140
0 2000 3000
0 0 0
0 0 0
0 30 300
0 100 104
0 89 50
0 50 110
100 0 0
0 1013 2000
0 22 116
0 15 12
32 0 5
0 80 96
0 33 32
930 200 80
0 150 58
0 102 97
0 0 99
0 0 0
100 0 0
0 8 5
0 75 50
0 43 146
0 20 15
0 31 32
0 0 2
0 0 2
0 80 54
0 200 540
0 15 20
0 0 0
0 500 250
0 0 0
0 0 0
0 0 0
0 200 107
0 0 0
0 0 0
0 600 900
0 270 270
0 0 0
0 6 15
0 0 0
0 76 500
0 0 0
0 0 0
0 0 0
0 500 570
0 0 102
0 20 0
0 3257 4010
0 0 0
0 0 0
0 0 0
0 3500 2500
300 0 0
0 0 0
0 1200 2453
0 0 0
0 1 0
0 100 120
0 0 1
0 0 0
90 300 250
0 0 0
0 2 6
0 195 24
232 0 0
0 0 0
0 0 60
0 3200 3500
0 10 15
0 20 0
0 50 125
0 45 10
0 100 34
0 0 0
0 0 0
0 19 6
0 20 25
250 17 0
0 4000 5380
0 2 10
0 1200 830
370 23 24
0 0 0
0 0 0
22 0 0
0 300 320
0 0 0
0 75 35
200 0 0
0 1500 1200
0 0 20
0 25 21
0 0 0
0 9 1
0 0 0
370 25 27
0 0 0
0 0 0
0 10 0
0 0 0
0 1 9
0 0 9
0 2 0
0 1400 1654
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 124
0 300 110
0 2500 2700
0 14 10
0 0 0
0 0 0
0 0 42
0 1000 1200
0 500 430
0 22 12
0 190 31
0 302 142
0 0 0
0 0 0
0 714 1550
0 0 0
0 890 710
0 0 0
0 0 6
0 1 12
0 1490 1500
0 16 13
0 0 0
0 2 7
0 265 490
0 1200 1000
0 106 532
0 0 0
0 500 250
0 67 9
650 100 99
0 0 67
0 84 80
0 0 0
0 263 35
0 0 0
0 0 0
0 360 50
40 0 0
0 920 750
0 0 0
0 13 15
0 49 0
0 210 250
0 0 600
0 0 19
9 0 0
0 2 0
0 0 4
0 0 0
0 10 59
232 570 750
0 0 0
0 30 22
500 0 0
0 0 0
0 0 0
0 0 17
0 0 0
160 1000 1500
0 0 0
0 0 0
0 200 300
0 2500 1500
0 12 9
0 0 0
0 200 120
0 0 0
0 200 600
357 180 140
0 0 30
0 0 0
0 0 0
0 0 0
0 0 0
0 12 13
0 100 320
0 0 0
0 0 0
0 0 0
0 2 0
0 0 2
0 2 0
0 2 0
0 0 0
0 0 1000
200 770 220
0 100 150
0 10 10
0 100 200
0 100 500
0 500 10
0
0 500 500
0
130
0 800 900
0 10 10
0 1000 950
0 9 8
0 1000 800
0 9 5
0 9 8
0
0 500 2000
0
0
0
0
0
0
180
0
0
0
0
0
0
Yang Membuat
Pengelola Obat Pustu / Poskesdes ….
NIP
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PTM
Pos/Pustu : PELAPORAN BULAN
PUSKESMAS : MAKARTI MULYA PERMINTAAN BULAN
KECAMATAN : MESUJI
KABUPATEN : OGAN KOMERING ILIR
PROPINSI : SUMATERA SELATAN
NO. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN
1 2 3 4 5 6
1 Absorbent tipped applicator (alcohol swab) Pcs 200 200
2 ACARBOSE 100 MG Tablet 0 0
3 ACARBOSE 50 MG Tablet 0 0
4 Acetylcystein Kapsul 200mg Kapsul 270 270
5 Acyclovir cream Tube 3 3
6 Acyclovir tab 200 mg Tablet 0 0
7 Acyclovir tab 400 mg Tablet 100 100
8 Albendazol tab 400 mg Tablet 0 0
9 ALIVE BIOCOM (C&ZINC) Tablet 0 0
10 ALIVE NUTRIBION (B1,B6,B12) Tablet 0 0
11 ALIVE ZIC syr Botol 0 0
12 ALIVE D1000 TAB Tablet 0 0
13 Alkohol Liquid (etanol) 70%-1000 ml Tablet 0 0
14 Allopurinol 100 mg Tablet 10 10
15 Allopurinol 300 mg Tablet 0 0
16 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0
17 Aminophylline tab 200 mg Tablet 0 0
18 Amitriptyline 25 mg tab Tablet 0 0
19 Amlodipine tab 5 mg Tablet 560 560
20 Amlodipine 10 mg Tablet 0 0
21 AMOXICILLIN DROP Botol 0 0
22 Amoxycillin 250 mg Kapsul 0 0
23 Amoxycillin 500 mg Kaptab 0 0
24 Amoxycillin Syr Btl 0 0
25 Ampicilin 1 gr Inj Vial 0 0
26 Antasida DOEN Kombinasi Tablet 600 600
27 Antasida Syr DOEN Btl 0 0
28 Anti Bisa Ular 5 ml (ABU I)/ Biosave Ampul 0 0
29 Asam Mefenamat 500 mg tab Tablet 510 510
30 Ascorbic acid (Vit.C) 50 mg Tablet 0 0
31 Aspirin (miniaspi) 80 mg tab Tablet 0 0
32 Atropine inj 0,25 mg/ml Ampul 0 0
33 Attapulgite Tablet (Pularex) Tablet 0 0
34 Attapulgite Tablet 600 mg (New Antides) Tablet 0 0
35 Automated blood grouping (Tes Gol. Darah) Paket 0 0
36 AZITROMISIN 500 mg tab Tablet 0 0
37 Bactivec Larvasida 30ml Botol 0 0
38 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0
39 Bedak Salisil 2% Btl 0 0
40 Benzoic acid |salicylic acid salep (anti fungi) Tube 0 0
41 Betahistine Mesylate 6 mg tab Tablet 190 190
42 Betamethasone 0,1% krim Tube10 gr 13 13
43 Betamethasone 0,5% krim tube 5 g 0 0
44 Biosens DBD (DBD TEST) Pcs 0 0
45 Bisacodyl 5mg Tablet 0 0
46 Bismuth subgallas (antihemoroid) Pot 0 0
47 Calcium chloride lactate infus (RL) Botol 0 0
48 Calsium Laktat (Kalk) 500 mg Tablet 270 270
49 CANDESARTAN 16 Tablet 0 0
50 CANDESARTAN 8 Tablet 0 0
51 Captopril 12,5 mg Tablet 320 320
52 Captopril 25 mg Tablet 510 510
53 Carbamazepin tab Tablet 0 0
54 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 0 0
55 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 0 0
56 Cefadroxil 500mg Tablet 0 0
57 CEFIXIME 200 MG Kapsul 0 0
58 CEFIXIME 100MG Tablet 0 0
59 Cefotaaxime Sodium inj 1gr Vial 0 0
60 CEFRIAXONE INJ Vial 0 0
61 Cetirizine 5 mg/5 ml sirup Botol 0 0
62 Cetirizine Tab Tablet 0 0
63 Chloramhenicol Salep Mata 1% Tube 0 0
64 Chloramphenicol 250 mg caps Tablet 0 0
65 Chloramphenicol Suspensi 125 mg/ml Btl 0 0
66 Chloramphenicol TT 3% Botol 0 0
67 Chloramphenicol/ Hidrokortison krim 2,5% Tube 0 0
68 Chlorpheniramine Maleat (CTM) 4 mg Tablet 0 0
69 Chlorpromazine HCl 100 mg Tablet 0 0
70 Chlorpromazine HCl 25mg Tablet 0 0
71 Cimetidin 200 tab Tablet 0 0
72 Ciprofloxacin 500 mg tab Tablet 0 0
73 Ciprofloxacin Infus Botol 0 0
74 Clindamycin 300mg Kapsul 0 0
75 CLOZAPIN 25 Tablet 0 0
76 Coverall/Hazmat XL/XXL Set 0 0
77 Crefe Flesh 10cm Rol 0 0
78 Cresol liquid 1 Liter (lysol) Botol 0 0
79 Denpro Orafil Plus Temporary Pcs 0 0
80 Devitalisasi pasta/Pulp X pot 0 0
81 Dexamethasone 0,5 mg Tablet 0 0
82 Dexamethasone inj 5mg/ml-1ml Ampul 0 0
83 Diazepam 2 mg Tablet 0 0
84 Diazepam 5mg/ml-2 ml inj Ampul 0 0
85 Diclofenac sodium 25 mg tab Tablet 0 0
86 Diclofenac sodium 50 mg tab Tablet 0 0
87 Digoxin 0,25 mg Tablet 0 0
88 Dimenhydrinate 50mg Tablet 0 0
89 Dipenhidramine HCl inj 10mg/ml Ampul 0 0
90 Domperidone 10 mg Tablet 0 0
91 Domperidone sr Botol 0 0
92 Doxycycline 100 mg Kapsul Kapsul 0 0
93 Dulcolax tab Tablet 0 0
94 DULCOLAX SUPPOS 10 MG supp 0 0
95 DULCOLAX SUPPOS 5 MG INFANT supp 0 0
96 Epinephrine HCl/bitartrat inj 0,1% Btl 0 0
97 Erythromicin 250 mg capsul Kapsul 0 0
98 Erythromicin 500 mg capsul Kapsul 0 0
99 Erythromicin Syr Btl 0 0
100 Ethacridine (Rivanol) 0,1% 300 ml Btl 0 0
101 Ethacridine (Rivanol) 0,1% 100ml Btl 0 0
102 Ethanol ( Aseptan ) 500 cc+ Pump Botol 0 0
103 Ethyl Chloride Btl 0 0
104 Eugenol cairan Btl 0 0
105 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 0
106 Folic acid 1mg ( asam folat) Tablet 0 0
107 Folley Catheter No.16 Pcs 0 0
108 Furosemida 40 mg Tablet 100 100
109 Furosemida Injeksi Ampul 0 0
110 Garam Oralit Sachet 0 0
111 Gentamicyn 0,1% SK Tube 0 0
112 Gentamicyn 0,3% TM Botol 32 32
113 Gentamicyn Inj 40 mg/ml Ampul 0 0
114 Glass lonomer Paket 0 0
115 Glibenclamide 5 mg Tablet 930 930
116 GLICLAZIDE TAB Tablet 0 0
117 Glimepiride 1 mg Tablet 0 0
118 Glukosa larutan infus 10% Botol 0 0
119 Glukosa larutan infus 5% Botol 0 0
120 Griseofulvin 125 mg Tablet 100 100
121 Guaifenesin 100 Tab/GG Tab Tablet 0 0
122 Haloperidol 0,5 mg tab Tablet 0 0
123 Haloperidol 1,5 mg tab Tablet 0 0
124 Haloperidol 5 mg tab Tablet 0 0
125 Herbakoof 100ml Botol 0 0
126 Human chorionic (HCG/Tes kehamilan ) Strip 0 0
127 Hydrochlorotiazide (HCT) 25 mg Tablet 0 0
128 H2O2 100 ML Botol 0 0
129 Ibuprofen 200 mg Tablet 0 0
130 Ibuprofen 400 mg Tablet 0 0
131 Ibuprofen sirup Botol 0 0
132 Ichthyol salep 10% Pcs 0 0
133 Immunoglobulin human anti-tetanus (Tetagam) Pcs 0 0
134 INDEC HIV1/2&SPHYLLIS pcs 0 0
135 Infus set dewasa Pcs 0 0
136 Infusi set anak Pcs 0 0
137 Isosorbide tablet Tablet 0 0
138 IV Catheter No.20 Pcs 0 0
139 IV Catheter No.22 Pcs 0 0
140 IV Catheter No.24 Pcs 0 0
141 Jarum Jahit Kulit Pcs 0 0
142 Kalium Permanganat Serbuk Pcs 0 0
143 Kapas pembalut/Absorben 250 g Pcs 0 0
144 Kasa kompres 40/40 steril Pcs 0 0
145 Kasa pembalut 2x80 Pcs 0 0
146 Kasa pembalut hidrofil 4 m x 15 cm Pcs 0 0
147 Kasa pembalut hidrofil 4 m x 3 cm Pcs 0 0
148 Ketac Universal (61108) Pcs 0 0
149 Ketac Universal (61111) Pcs 0 0
150 Ketoconazole 200 mg Cream Tube 0 0
151 Ketoconazole 200 mg tab Tablet 0 0
152 Ketorolac inj 30mg Ampul 0 0
153 Klorokina Fosfat 250 mg Tablet 0 0
154 KOTRIMOXAZOL 800/160 MG TAB Tablet 0 0
155 LAKTULOSE SYR Botol 0 0
156 Lancet Pcs 300 300
157 Levertran Salep/ Salep Luka Bakar Btl 0 0
158 Lidocain 2% Ampul 0 0
159 Lidocaine spray (Xylocaine spray) Pcs 0 0
160 Lidokain Comp. inj Kombinasi Ampul 0 0
161 Liquorice liquid extract (OBH) Botol 0 0
162 Locoriz Cream Tablet 0 0
163 Loperamid 2 mg tab / Diastrix 2 mg Tablet 0 0
164 Loratadine 10 mg tab Tablet 90 90
165 LYTACUR SYR Botol 0 0
166 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 0
167 Magnesium Sulfat Injeksi 40% (MgSO4) Ampul 0 0
168 Masker Pcs 232 232
169 Masker Earloop Pcs 0 0
170 Masker Headloop Pcs 0 0
171 Masker KN95 Pcs 0 0
172 Masker Plus Pcs 0 0
173 Masker Tie on Pcs 0 0
174 Medical adhesive tape (dermafix/leukomed) Pcs 0 0
175 Meprovent inj Ampul 0 0
176 Metamizole injeksi (antalgin 1000) Ampul 0 0
177 Metformin 500mg tab Tablet 0 0
178 Methyl Ergometrin Maleat 0,125 mg Tab 0 0
179 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0
180 Methyl Prednisolon tab 16 mg Tablet 0 0
181 Methyl Prednisolon tab 4 mg Tablet 250 250
182 Methyl Rosanilinium (gentian violet) Botol 0 0
183 METOCLOPROMIDE TAB Tablet 0 0
184 Metronidazol 250 mg tab Tablet 0 0
185 Metronidazol 500 mg tab Tablet 370 370
186 Metronidazol Infus Botol 0 0
187 Metronidazol syr Botol 0 0
188 Miconazole 2% Salep Kulit Tube 22 22
189 MOMETASONE Krim Tube 0 0
190 Moutpiece Steribreath 250's Pck 0 0
191 Natrium Bikarbonat 500 mg Tablet 0 0
192 Nifedipin 10 mg tab Kapsul 200 200
193 Nonwoven Fixation Rool Pcs 0 0
194 Nystatin Drop 100.000 IU Btl 0 0
195 Nystatin Tab Vag 10.000 iu/g Tablet 0 0
196 Octadin Botol 1000ml Botol 0 0
197 Octadin Spray 5ml Botol 0 0
198 Omeprazole inj Vial 0 0
199 Omeprazole kaps Tablet 370 370
200 Ondansetron iv/im 4mg Ampul 0 0
201 ONDANSETRON TAB Tablet 0 0
202 Otsu D-40 25ml Botol 0 0
203 Oxytetracycline HCl 1% Salep Mata Tube 0 0
204 Oxytetracycline HCl 3% Salep Kulit Tube 0 0
205 Oxytocin inj 10 IU Ampul 0 0
206 Papaverin 40 mg tab Tablet 0 0
207 Papaverin inj Tablet 0 0
208 Paracetamol Drops 15 ml Botol 0 0
209 Parasetamol 1000mg/100ml infus Botol 0 0
210 Parasetamol 120 mg/5 ml Syr Botol 0 0
211 Parasetamol 500 mg Tablet 0 0
212 Patient Lubricant (My Jelly ) Tube 0 0
213 Pehavral tab Tablet 0 0
214 Permethrin (Scabimite Cream) Tube 0 0
215 Phenobarbital 30 mg Tablet 0 0
216 Phenobarbital inj 50mg/ml-2ml Ampul 0 0
217 Phenol gliserol 10% TT Botol 0 0
218 Phytomenadione (Vit.K1) 10 mg Tablet 0 0
219 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 0
220 Phytomenadione (Vit.K1) inj 2 mg/ml Ampul 0 0
221 Piracetam 400 mg Tablet 0 0
222 Piroxicam 20 mg tab Tablet 0 0
223 Pisau Disposable (Mess No.10/11/20/21) pisau 0 0
224 Plesterku (Leukoplast) Pcs 0 0
225 Poli Aid 1 liter Botol 0 0
226 POLIAID 5L Botol 0 0
227 Policlean Handrub Botol 0 0
228 POLIDESINFEKTAN 5 L Botol 0 0
229 Polifix 10x5cm Pcs 0 0
230 Polifix 5x1cm Pcs 0 0
231 Polifix 5x5cm Pcs 0 0
232 POLIGEL 500 ML Botol 0 0
233 POLIGEL 5 L Botol 0 0
234 POLISOFT ALK HANDRUB 500 ML Botol 0 0
235 POLISOFT ALK HANDRUB 5 L Botol 0 0
236 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 0 0
237 Poliwash 500 ml Botol 0 0
238 POLIWASH 5 L Botol 0 0
239 Povidon iodium 10% 1000 ml Botol 0 0
240 Povidon iodium 10% 300 ml Botol 0 0
241 Povidon iodium 10% 60 ml Botol 0 0
242 Povidon Iodium 10% 30 ml Botol 0 0
243 Prednison 5 mg Tablet 650 650
244 Primaquin 15 mg tab Tablet 0 0
245 Propranolol HCl 10 mg Tablet 0 0
246 Propranolol HCl 40 mg Tablet 0 0
247 Propylthiouracil 100 mg Tablet 0 0
248 Protein Gluco Test Strip 0 0
249 Pyrantel Pamoat 125 mg Tablet 0 0
250 Pyridoxine HCl 10 mg Tablet 0 0
251 Ranitidin 150 mg Tablet 40 40
252 Ranitidin Injeksi Ampul 0 0
253 Rapid Test antigen (Panbio) Pcs 0 0
254 Retinol (Vit.A) kaps 100.000 iu Tablet 0 0
255 Retinol (Vit.A) kaps 200.000 iu Tablet 0 0
256 Risperidone 2mg Tablet 0 0
257 ROEKO ENDO FROST Botol 0 0
258 Salbutamol 2 mg Tablet 0 0
259 Salep 2-4 Kombinasi Tube 9 9
260 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0 0
261 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0
262 Sarung tangan (HandScuun Steril) No.7,5 Pcs 0 0
263 Sarung tangan (HandScuun) L Pcs 0 0
264 Sarung tangan (HandScuun) S/ M/ L Pcs 232 232
265 Sarung tangan nitril pcs 0 0
266 Semen Seng Fosfat Serbuk & Cairan Set 0 0
267 Sianocobalamin (Vit B12) 50 mg tab Tablet 500 500
268 Sianocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0
269 Silk (Benang Bedah) No. 3/0 Pcs 0 0
270 Silver Sulfadiazine Tube 0 0
271 Simvastatin 10 mg tab Kapsul 0 0
272 Simvastatin 20 mg tab Tablet 160 160
273 Sodium cloride infus 0,9% ( NACL ) Botol 0 0
274 Softanol 5 Liter Botol 0 0
275 Softanol 500ml Botol 0 0
276 Spuit 1 ml Pcs 0 0
277 Spuit 3 ml Pcs 0 0
278 Spuit 5 ml Pcs 0 0
279 Stericide 5 Liter Botol 0 0
280 Stimuno Capsul Forte Kapsul 0 0
281 Stimuno syrup Botol 0 0
282 Strip Asam Urat Pcs 357 357
283 Strip Gula Darah box 0 0
284 Strip kolestrol Pcs 0 0
285 SUKRALFAT TAB Tablet 0 0
286 SUKRALFAT SYR Botol 0 0
287 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 0 0
288 Sulfamethoxazole|trimethoprim (cotri) syr Botol 0 0
289 Sulfasetamida 15% TM Ampul 0 0
290 Surgical gown XL Set 0 0
291 Tetracycline 250 mg Tablet 0 0
292 Tetracycline 500 mg Tablet 0 0
293 Thiamine HCl (Vit B1) 50 mg Tablet 0 0
294 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0
295 Tranexamic Acid inj 5% Ampul 0 0
296 TRANEXAMIC ACID TAB Tablet 0 0
297 Trepocheck syphilis Pcs 0 0
298 Trihexyphenidyl tab 2 mg Tablet 0 0
299 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 200 200
300 Urin Bag Pcs 0 0
301 Usg Gel Botol 0 0
302 Vaksin Rabies Vero/ Verorab Paket 0 0
303 VALSARTAN 80 Tablet 0 0
304 VALSARTAN 160 Tablet 0 0
305 Viorex Liq 2% 5 Liter Botol 0 0
306 Viorex Liq 2% 500ml Botol 0 0
307 Virocheck HIV Pcs 0 0
308 Vitamin B Kompleks Tablet 130 130
309 Vitamin K Infant Inj Ampul 0 0
310 Water liquid (aqua P,I) Botol 0 0
311 Wing Needle No.21 Pcs 0 0
312 Wing Needle No.27 Pcs 0 0
313 Xpert MTB/RIF pcs 0 0
314 Zinc Drop Botol 0 0
315 Zinc tab Tablet 0 0
316 HB Test (Hemachroma Plus Microcuvette) Box 0 0
317 HIV Sifilis Combo Box 0 0
318 Kapas Lidi Box 0 0
319 Asam Asetat Botol 0 0
320 Sasklin Desinfektan 500 mL Botol 0 0
321 Kapas 1000 gr Box 0 0
322 Ameritek Test Box 0 0
323 Pot Feses Pack 0 0
324 Ambroxol Tablet Tablet 180 180
325 Ambroxol Syrup Botol 0 0
326 Reagen E.Coli 0 0
327 Caroto Gel 80 gr/ ECG Gel 0 0
328 Kertas ECG uk. 80 mmx 20 m 0 0
329 Kertas ECG uk. 80 mmx 90 mmx 280 0 0
330 Combur Test 0 0
UMUM JAMSOSKES BPJS JUMLAH
JUMLAH KUNJUNGAN RESEP
Mengetahui
Pengelola Obat Puskesmas
apt. Winda Utami, S. Farm.
NIP 199509112022032013
MINTAAN OBAT (LPLPO) PTM/PUSLING
: DOKUMEN NOMOR TANGGAL
: DINKES KAB/KOTA
IFK KAB/KOTA
PUSKESMAS
STOK STOK nov des jan
PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AKHIR OPTIMUM
7 8 9 10 11 12
200 277 1343
0 980 1000
0 24 25
270 0 0
3 1000 920
0 0 0
100 1 6
0 1200 1000
0 3 10
0 0 0
0 45 50
0 150 260
0 440 120
10 3500 3550
0 38 35
0 0 0
0 1500 2598
0 109 220
560 2 0
0 2500 3500
0 454 860
0 0 0
0 0 0
0 0 5
0 0 0
600 150 100
0 0 0
0 0 24
510 0 0
0 80 70
0 20 30
0 800 1500
0 30 53
0 0 0
0 5 1
0 20 15
0 275 270
0 1550 3570
0 2190 1030
0 3000 1200
190 150 260
13 36 48
0 1 27
0 1000 0
0 0 10
0 6 27
0 5000 200
270 30 25
0 100 150
0 50 35
320 10 35
510 100 99
0 3440 160
0 60 0
0 0 0
0 0 0
0 2500 1500
0 0 0
0 100 350
0 0 5
0 0 1
0 1 5
0 0 0
0 0 0
0 4000 3000
0 30 20
0 47 40
0 11 9
0 0 0
0 4000 3400
0 0 90
0 470 80
0 15 31
0 4000 1200
0 0 0
0 0 0
0 18 5
0 0 0
0 440 500
0 0 0
0 5 6
0 20 23
0 0 1
0 0 1
0 0 0
0 470 420
0 0 0
0 10 17
0 500 120
0 0 0
0 302 41
0 30 19
0 100 23
0 30 35
0 0 0
0 2190 780
0 4200 2200
0 7 9
0 0 0
0 50 140
0 2000 3000
0 0 0
0 0 0
0 30 300
0 100 104
0 89 50
0 50 110
100 0 0
0 1013 2000
0 22 116
0 15 12
32 0 5
0 80 96
0 33 32
930 200 80
0 150 58
0 102 97
0 0 99
0 0 0
100 0 0
0 8 5
0 75 50
0 43 146
0 20 15
0 31 32
0 0 2
0 0 2
0 80 54
0 200 540
0 15 20
0 0 0
0 500 250
0 0 0
0 0 0
0 0 0
0 200 107
0 0 0
0 0 0
0 600 900
0 270 270
0 0 0
0 6 15
0 0 0
0 76 500
0 0 0
0 0 0
0 0 0
0 500 570
0 0 102
0 20 0
0 3257 4010
0 0 0
0 0 0
0 0 0
0 3500 2500
300 0 0
0 0 0
0 1200 2453
0 0 0
0 1 0
0 100 120
0 0 1
0 0 0
90 300 250
0 0 0
0 2 6
0 195 24
232 0 0
0 0 0
0 0 60
0 3200 3500
0 10 15
0 20 0
0 50 125
0 45 10
0 100 34
0 0 0
0 0 0
0 19 6
0 20 25
250 17 0
0 4000 5380
0 2 10
0 1200 830
370 23 24
0 0 0
0 0 0
22 0 0
0 300 320
0 0 0
0 75 35
200 0 0
0 1500 1200
0 0 20
0 25 21
0 0 0
0 9 1
0 0 0
370 25 27
0 0 0
0 0 0
0 10 0
0 0 0
0 1 9
0 0 9
0 2 0
0 1400 1654
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 124
0 300 110
0 2500 2700
0 14 10
0 0 0
0 0 0
0 0 42
0 1000 1200
0 500 430
0 22 12
0 190 31
0 302 142
0 0 0
0 0 0
0 714 1550
0 0 0
0 890 710
0 0 0
0 0 6
0 1 12
0 1490 1500
0 16 13
0 0 0
0 2 7
0 265 490
0 1200 1000
0 106 532
0 0 0
0 500 250
0 67 9
650 100 99
0 0 67
0 84 80
0 0 0
0 263 35
0 0 0
0 0 0
0 360 50
40 0 0
0 920 750
0 0 0
0 13 15
0 49 0
0 210 250
0 0 600
0 0 19
9 0 0
0 2 0
0 0 4
0 0 0
0 10 59
232 570 750
0 0 0
0 30 22
500 0 0
0 0 0
0 0 0
0 0 17
0 0 0
160 1000 1500
0 0 0
0 0 0
0 200 300
0 2500 1500
0 12 9
0 0 0
0 200 120
0 0 0
0 200 600
357 180 140
0 0 30
0 0 0
0 0 0
0 0 0
0 0 0
0 12 13
0 100 320
0 0 0
0 0 0
0 0 0
0 2 0
0 0 2
0 2 0
0 2 0
0 0 0
0 0 1000
200 770 220
0 100 150
0 10 10
0 100 200
0 100 500
0 500 10
0
0 500 500
0
130
0 800 900
0 10 10
0 1000 950
0 9 8
0 1000 800
0 9 5
0 9 8
0
0 500 2000
0
0
0
0
0
0
180
0
0
0
0
0
0
Yang Membuat
Pengelola Obat Pustu / Poskesdes ….
NIP
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PTM
Pos/Pustu : PELAPORAN BULAN
PUSKESMAS : MAKARTI MULYA PERMINTAAN BULAN
KECAMATAN : MESUJI
KABUPATEN : OGAN KOMERING ILIR
PROPINSI : SUMATERA SELATAN
NO. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN
1 2 3 4 5 6
1 Absorbent tipped applicator (alcohol swab) Pcs 200 200
2 ACARBOSE 100 MG Tablet 0 0
3 ACARBOSE 50 MG Tablet 0 0
4 Acetylcystein Kapsul 200mg Kapsul 270 270
5 Acyclovir cream Tube 3 3
6 Acyclovir tab 200 mg Tablet 0 0
7 Acyclovir tab 400 mg Tablet 100 100
8 Albendazol tab 400 mg Tablet 0 0
9 ALIVE BIOCOM (C&ZINC) Tablet 0 0
10 ALIVE NUTRIBION (B1,B6,B12) Tablet 0 0
11 ALIVE ZIC syr Botol 0 0
12 ALIVE D1000 TAB Tablet 0 0
13 Alkohol Liquid (etanol) 70%-1000 ml Tablet 0 0
14 Allopurinol 100 mg Tablet 10 10
15 Allopurinol 300 mg Tablet 0 0
16 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0
17 Aminophylline tab 200 mg Tablet 0 0
18 Amitriptyline 25 mg tab Tablet 0 0
19 Amlodipine tab 5 mg Tablet 560 560
20 Amlodipine 10 mg Tablet 0 0
21 AMOXICILLIN DROP Botol 0 0
22 Amoxycillin 250 mg Kapsul 0 0
23 Amoxycillin 500 mg Kaptab 0 0
24 Amoxycillin Syr Btl 0 0
25 Ampicilin 1 gr Inj Vial 0 0
26 Antasida DOEN Kombinasi Tablet 600 600
27 Antasida Syr DOEN Btl 0 0
28 Anti Bisa Ular 5 ml (ABU I)/ Biosave Ampul 0 0
29 Asam Mefenamat 500 mg tab Tablet 510 510
30 Ascorbic acid (Vit.C) 50 mg Tablet 0 0
31 Aspirin (miniaspi) 80 mg tab Tablet 0 0
32 Atropine inj 0,25 mg/ml Ampul 0 0
33 Attapulgite Tablet (Pularex) Tablet 0 0
34 Attapulgite Tablet 600 mg (New Antides) Tablet 0 0
35 Automated blood grouping (Tes Gol. Darah) Paket 0 0
36 AZITROMISIN 500 mg tab Tablet 0 0
37 Bactivec Larvasida 30ml Botol 0 0
38 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0
39 Bedak Salisil 2% Btl 0 0
40 Benzoic acid |salicylic acid salep (anti fungi) Tube 0 0
41 Betahistine Mesylate 6 mg tab Tablet 190 190
42 Betamethasone 0,1% krim Tube10 gr 13 13
43 Betamethasone 0,5% krim tube 5 g 0 0
44 Biosens DBD (DBD TEST) Pcs 0 0
45 Bisacodyl 5mg Tablet 0 0
46 Bismuth subgallas (antihemoroid) Pot 0 0
47 Calcium chloride lactate infus (RL) Botol 0 0
48 Calsium Laktat (Kalk) 500 mg Tablet 270 270
49 CANDESARTAN 16 Tablet 0 0
50 CANDESARTAN 8 Tablet 0 0
51 Captopril 12,5 mg Tablet 320 320
52 Captopril 25 mg Tablet 510 510
53 Carbamazepin tab Tablet 0 0
54 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 0 0
55 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 0 0
56 Cefadroxil 500mg Tablet 0 0
57 CEFIXIME 200 MG Kapsul 0 0
58 CEFIXIME 100MG Tablet 0 0
59 Cefotaaxime Sodium inj 1gr Vial 0 0
60 CEFRIAXONE INJ Vial 0 0
61 Cetirizine 5 mg/5 ml sirup Botol 0 0
62 Cetirizine Tab Tablet 0 0
63 Chloramhenicol Salep Mata 1% Tube 0 0
64 Chloramphenicol 250 mg caps Tablet 0 0
65 Chloramphenicol Suspensi 125 mg/ml Btl 0 0
66 Chloramphenicol TT 3% Botol 0 0
67 Chloramphenicol/ Hidrokortison krim 2,5% Tube 0 0
68 Chlorpheniramine Maleat (CTM) 4 mg Tablet 0 0
69 Chlorpromazine HCl 100 mg Tablet 0 0
70 Chlorpromazine HCl 25mg Tablet 0 0
71 Cimetidin 200 tab Tablet 0 0
72 Ciprofloxacin 500 mg tab Tablet 0 0
73 Ciprofloxacin Infus Botol 0 0
74 Clindamycin 300mg Kapsul 0 0
75 CLOZAPIN 25 Tablet 0 0
76 Coverall/Hazmat XL/XXL Set 0 0
77 Crefe Flesh 10cm Rol 0 0
78 Cresol liquid 1 Liter (lysol) Botol 0 0
79 Denpro Orafil Plus Temporary Pcs 0 0
80 Devitalisasi pasta/Pulp X pot 0 0
81 Dexamethasone 0,5 mg Tablet 0 0
82 Dexamethasone inj 5mg/ml-1ml Ampul 0 0
83 Diazepam 2 mg Tablet 0 0
84 Diazepam 5mg/ml-2 ml inj Ampul 0 0
85 Diclofenac sodium 25 mg tab Tablet 0 0
86 Diclofenac sodium 50 mg tab Tablet 0 0
87 Digoxin 0,25 mg Tablet 0 0
88 Dimenhydrinate 50mg Tablet 0 0
89 Dipenhidramine HCl inj 10mg/ml Ampul 0 0
90 Domperidone 10 mg Tablet 0 0
91 Domperidone sr Botol 0 0
92 Doxycycline 100 mg Kapsul Kapsul 0 0
93 Dulcolax tab Tablet 0 0
94 DULCOLAX SUPPOS 10 MG supp 0 0
95 DULCOLAX SUPPOS 5 MG INFANT supp 0 0
96 Epinephrine HCl/bitartrat inj 0,1% Btl 0 0
97 Erythromicin 250 mg capsul Kapsul 0 0
98 Erythromicin 500 mg capsul Kapsul 0 0
99 Erythromicin Syr Btl 0 0
100 Ethacridine (Rivanol) 0,1% 300 ml Btl 0 0
101 Ethacridine (Rivanol) 0,1% 100ml Btl 0 0
102 Ethanol ( Aseptan ) 500 cc+ Pump Botol 0 0
103 Ethyl Chloride Btl 0 0
104 Eugenol cairan Btl 0 0
105 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 0
106 Folic acid 1mg ( asam folat) Tablet 0 0
107 Folley Catheter No.16 Pcs 0 0
108 Furosemida 40 mg Tablet 100 100
109 Furosemida Injeksi Ampul 0 0
110 Garam Oralit Sachet 0 0
111 Gentamicyn 0,1% SK Tube 0 0
112 Gentamicyn 0,3% TM Botol 32 32
113 Gentamicyn Inj 40 mg/ml Ampul 0 0
114 Glass lonomer Paket 0 0
115 Glibenclamide 5 mg Tablet 930 930
116 GLICLAZIDE TAB Tablet 0 0
117 Glimepiride 1 mg Tablet 0 0
118 Glukosa larutan infus 10% Botol 0 0
119 Glukosa larutan infus 5% Botol 0 0
120 Griseofulvin 125 mg Tablet 100 100
121 Guaifenesin 100 Tab/GG Tab Tablet 0 0
122 Haloperidol 0,5 mg tab Tablet 0 0
123 Haloperidol 1,5 mg tab Tablet 0 0
124 Haloperidol 5 mg tab Tablet 0 0
125 Herbakoof 100ml Botol 0 0
126 Human chorionic (HCG/Tes kehamilan ) Strip 0 0
127 Hydrochlorotiazide (HCT) 25 mg Tablet 0 0
128 H2O2 100 ML Botol 0 0
129 Ibuprofen 200 mg Tablet 0 0
130 Ibuprofen 400 mg Tablet 0 0
131 Ibuprofen sirup Botol 0 0
132 Ichthyol salep 10% Pcs 0 0
133 Immunoglobulin human anti-tetanus (Tetagam) Pcs 0 0
134 INDEC HIV1/2&SPHYLLIS pcs 0 0
135 Infus set dewasa Pcs 0 0
136 Infusi set anak Pcs 0 0
137 Isosorbide tablet Tablet 0 0
138 IV Catheter No.20 Pcs 0 0
139 IV Catheter No.22 Pcs 0 0
140 IV Catheter No.24 Pcs 0 0
141 Jarum Jahit Kulit Pcs 0 0
142 Kalium Permanganat Serbuk Pcs 0 0
143 Kapas pembalut/Absorben 250 g Pcs 0 0
144 Kasa kompres 40/40 steril Pcs 0 0
145 Kasa pembalut 2x80 Pcs 0 0
146 Kasa pembalut hidrofil 4 m x 15 cm Pcs 0 0
147 Kasa pembalut hidrofil 4 m x 3 cm Pcs 0 0
148 Ketac Universal (61108) Pcs 0 0
149 Ketac Universal (61111) Pcs 0 0
150 Ketoconazole 200 mg Cream Tube 0 0
151 Ketoconazole 200 mg tab Tablet 0 0
152 Ketorolac inj 30mg Ampul 0 0
153 Klorokina Fosfat 250 mg Tablet 0 0
154 KOTRIMOXAZOL 800/160 MG TAB Tablet 0 0
155 LAKTULOSE SYR Botol 0 0
156 Lancet Pcs 300 300
157 Levertran Salep/ Salep Luka Bakar Btl 0 0
158 Lidocain 2% Ampul 0 0
159 Lidocaine spray (Xylocaine spray) Pcs 0 0
160 Lidokain Comp. inj Kombinasi Ampul 0 0
161 Liquorice liquid extract (OBH) Botol 0 0
162 Locoriz Cream Tablet 0 0
163 Loperamid 2 mg tab / Diastrix 2 mg Tablet 0 0
164 Loratadine 10 mg tab Tablet 90 90
165 LYTACUR SYR Botol 0 0
166 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 0
167 Magnesium Sulfat Injeksi 40% (MgSO4) Ampul 0 0
168 Masker Pcs 232 232
169 Masker Earloop Pcs 0 0
170 Masker Headloop Pcs 0 0
171 Masker KN95 Pcs 0 0
172 Masker Plus Pcs 0 0
173 Masker Tie on Pcs 0 0
174 Medical adhesive tape (dermafix/leukomed) Pcs 0 0
175 Meprovent inj Ampul 0 0
176 Metamizole injeksi (antalgin 1000) Ampul 0 0
177 Metformin 500mg tab Tablet 0 0
178 Methyl Ergometrin Maleat 0,125 mg Tab 0 0
179 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0
180 Methyl Prednisolon tab 16 mg Tablet 0 0
181 Methyl Prednisolon tab 4 mg Tablet 250 250
182 Methyl Rosanilinium (gentian violet) Botol 0 0
183 METOCLOPROMIDE TAB Tablet 0 0
184 Metronidazol 250 mg tab Tablet 0 0
185 Metronidazol 500 mg tab Tablet 370 370
186 Metronidazol Infus Botol 0 0
187 Metronidazol syr Botol 0 0
188 Miconazole 2% Salep Kulit Tube 22 22
189 MOMETASONE Krim Tube 0 0
190 Moutpiece Steribreath 250's Pck 0 0
191 Natrium Bikarbonat 500 mg Tablet 0 0
192 Nifedipin 10 mg tab Kapsul 200 200
193 Nonwoven Fixation Rool Pcs 0 0
194 Nystatin Drop 100.000 IU Btl 0 0
195 Nystatin Tab Vag 10.000 iu/g Tablet 0 0
196 Octadin Botol 1000ml Botol 0 0
197 Octadin Spray 5ml Botol 0 0
198 Omeprazole inj Vial 0 0
199 Omeprazole kaps Tablet 370 370
200 Ondansetron iv/im 4mg Ampul 0 0
201 ONDANSETRON TAB Tablet 0 0
202 Otsu D-40 25ml Botol 0 0
203 Oxytetracycline HCl 1% Salep Mata Tube 0 0
204 Oxytetracycline HCl 3% Salep Kulit Tube 0 0
205 Oxytocin inj 10 IU Ampul 0 0
206 Papaverin 40 mg tab Tablet 0 0
207 Papaverin inj Tablet 0 0
208 Paracetamol Drops 15 ml Botol 0 0
209 Parasetamol 1000mg/100ml infus Botol 0 0
210 Parasetamol 120 mg/5 ml Syr Botol 0 0
211 Parasetamol 500 mg Tablet 0 0
212 Patient Lubricant (My Jelly ) Tube 0 0
213 Pehavral tab Tablet 0 0
214 Permethrin (Scabimite Cream) Tube 0 0
215 Phenobarbital 30 mg Tablet 0 0
216 Phenobarbital inj 50mg/ml-2ml Ampul 0 0
217 Phenol gliserol 10% TT Botol 0 0
218 Phytomenadione (Vit.K1) 10 mg Tablet 0 0
219 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 0
220 Phytomenadione (Vit.K1) inj 2 mg/ml Ampul 0 0
221 Piracetam 400 mg Tablet 0 0
222 Piroxicam 20 mg tab Tablet 0 0
223 Pisau Disposable (Mess No.10/11/20/21) pisau 0 0
224 Plesterku (Leukoplast) Pcs 0 0
225 Poli Aid 1 liter Botol 0 0
226 POLIAID 5L Botol 0 0
227 Policlean Handrub Botol 0 0
228 POLIDESINFEKTAN 5 L Botol 0 0
229 Polifix 10x5cm Pcs 0 0
230 Polifix 5x1cm Pcs 0 0
231 Polifix 5x5cm Pcs 0 0
232 POLIGEL 500 ML Botol 0 0
233 POLIGEL 5 L Botol 0 0
234 POLISOFT ALK HANDRUB 500 ML Botol 0 0
235 POLISOFT ALK HANDRUB 5 L Botol 0 0
236 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 0 0
237 Poliwash 500 ml Botol 0 0
238 POLIWASH 5 L Botol 0 0
239 Povidon iodium 10% 1000 ml Botol 0 0
240 Povidon iodium 10% 300 ml Botol 0 0
241 Povidon iodium 10% 60 ml Botol 0 0
242 Povidon Iodium 10% 30 ml Botol 0 0
243 Prednison 5 mg Tablet 650 650
244 Primaquin 15 mg tab Tablet 0 0
245 Propranolol HCl 10 mg Tablet 0 0
246 Propranolol HCl 40 mg Tablet 0 0
247 Propylthiouracil 100 mg Tablet 0 0
248 Protein Gluco Test Strip 0 0
249 Pyrantel Pamoat 125 mg Tablet 0 0
250 Pyridoxine HCl 10 mg Tablet 0 0
251 Ranitidin 150 mg Tablet 40 40
252 Ranitidin Injeksi Ampul 0 0
253 Rapid Test antigen (Panbio) Pcs 0 0
254 Retinol (Vit.A) kaps 100.000 iu Tablet 0 0
255 Retinol (Vit.A) kaps 200.000 iu Tablet 0 0
256 Risperidone 2mg Tablet 0 0
257 ROEKO ENDO FROST Botol 0 0
258 Salbutamol 2 mg Tablet 0 0
259 Salep 2-4 Kombinasi Tube 9 9
260 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0 0
261 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0
262 Sarung tangan (HandScuun Steril) No.7,5 Pcs 0 0
263 Sarung tangan (HandScuun) L Pcs 0 0
264 Sarung tangan (HandScuun) S/ M/ L Pcs 232 232
265 Sarung tangan nitril pcs 0 0
266 Semen Seng Fosfat Serbuk & Cairan Set 0 0
267 Sianocobalamin (Vit B12) 50 mg tab Tablet 500 500
268 Sianocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0
269 Silk (Benang Bedah) No. 3/0 Pcs 0 0
270 Silver Sulfadiazine Tube 0 0
271 Simvastatin 10 mg tab Kapsul 0 0
272 Simvastatin 20 mg tab Tablet 160 160
273 Sodium cloride infus 0,9% ( NACL ) Botol 0 0
274 Softanol 5 Liter Botol 0 0
275 Softanol 500ml Botol 0 0
276 Spuit 1 ml Pcs 0 0
277 Spuit 3 ml Pcs 0 0
278 Spuit 5 ml Pcs 0 0
279 Stericide 5 Liter Botol 0 0
280 Stimuno Capsul Forte Kapsul 0 0
281 Stimuno syrup Botol 0 0
282 Strip Asam Urat Pcs 357 357
283 Strip Gula Darah box 0 0
284 Strip kolestrol Pcs 0 0
285 SUKRALFAT TAB Tablet 0 0
286 SUKRALFAT SYR Botol 0 0
287 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 0 0
288 Sulfamethoxazole|trimethoprim (cotri) syr Botol 0 0
289 Sulfasetamida 15% TM Ampul 0 0
290 Surgical gown XL Set 0 0
291 Tetracycline 250 mg Tablet 0 0
292 Tetracycline 500 mg Tablet 0 0
293 Thiamine HCl (Vit B1) 50 mg Tablet 0 0
294 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0
295 Tranexamic Acid inj 5% Ampul 0 0
296 TRANEXAMIC ACID TAB Tablet 0 0
297 Trepocheck syphilis Pcs 0 0
298 Trihexyphenidyl tab 2 mg Tablet 0 0
299 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 200 200
300 Urin Bag Pcs 0 0
301 Usg Gel Botol 0 0
302 Vaksin Rabies Vero/ Verorab Paket 0 0
303 VALSARTAN 80 Tablet 0 0
304 VALSARTAN 160 Tablet 0 0
305 Viorex Liq 2% 5 Liter Botol 0 0
306 Viorex Liq 2% 500ml Botol 0 0
307 Virocheck HIV Pcs 0 0
308 Vitamin B Kompleks Tablet 130 130
309 Vitamin K Infant Inj Ampul 0 0
310 Water liquid (aqua P,I) Botol 0 0
311 Wing Needle No.21 Pcs 0 0
312 Wing Needle No.27 Pcs 0 0
313 Xpert MTB/RIF pcs 0 0
314 Zinc Drop Botol 0 0
315 Zinc tab Tablet 0 0
316 HB Test (Hemachroma Plus Microcuvette) Box 0 0
317 HIV Sifilis Combo Box 0 0
318 Kapas Lidi Box 0 0
319 Asam Asetat Botol 0 0
320 Sasklin Desinfektan 500 mL Botol 0 0
321 Kapas 1000 gr Box 0 0
322 Ameritek Test Box 0 0
323 Pot Feses Pack 0 0
324 Ambroxol Tablet Tablet 180 180
325 Ambroxol Syrup Botol 0 0
326 Reagen E.Coli 0 0
327 Caroto Gel 80 gr/ ECG Gel 0 0
328 Kertas ECG uk. 80 mmx 20 m 0 0
329 Kertas ECG uk. 80 mmx 90 mmx 280 0 0
330 Combur Test 0 0
UMUM JAMSOSKES BPJS JUMLAH
JUMLAH KUNJUNGAN RESEP
Mengetahui
Pengelola Obat Puskesmas
apt. Winda Utami, S. Farm.
NIP 199509112022032013
MINTAAN OBAT (LPLPO) PTM/PUSLING
: DOKUMEN NOMOR TANGGAL
: DINKES KAB/KOTA
IFK KAB/KOTA
PUSKESMAS
STOK STOK nov des jan
PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AKHIR OPTIMUM
7 8 9 10 11 12
200 277 1343
0 980 1000
0 24 25
270 0 0
3 1000 920
0 0 0
100 1 6
0 1200 1000
0 3 10
0 0 0
0 45 50
0 150 260
0 440 120
10 3500 3550
0 38 35
0 0 0
0 1500 2598
0 109 220
560 2 0
0 2500 3500
0 454 860
0 0 0
0 0 0
0 0 5
0 0 0
600 150 100
0 0 0
0 0 24
510 0 0
0 80 70
0 20 30
0 800 1500
0 30 53
0 0 0
0 5 1
0 20 15
0 275 270
0 1550 3570
0 2190 1030
0 3000 1200
190 150 260
13 36 48
0 1 27
0 1000 0
0 0 10
0 6 27
0 5000 200
270 30 25
0 100 150
0 50 35
320 10 35
510 100 99
0 3440 160
0 60 0
0 0 0
0 0 0
0 2500 1500
0 0 0
0 100 350
0 0 5
0 0 1
0 1 5
0 0 0
0 0 0
0 4000 3000
0 30 20
0 47 40
0 11 9
0 0 0
0 4000 3400
0 0 90
0 470 80
0 15 31
0 4000 1200
0 0 0
0 0 0
0 18 5
0 0 0
0 440 500
0 0 0
0 5 6
0 20 23
0 0 1
0 0 1
0 0 0
0 470 420
0 0 0
0 10 17
0 500 120
0 0 0
0 302 41
0 30 19
0 100 23
0 30 35
0 0 0
0 2190 780
0 4200 2200
0 7 9
0 0 0
0 50 140
0 2000 3000
0 0 0
0 0 0
0 30 300
0 100 104
0 89 50
0 50 110
100 0 0
0 1013 2000
0 22 116
0 15 12
32 0 5
0 80 96
0 33 32
930 200 80
0 150 58
0 102 97
0 0 99
0 0 0
100 0 0
0 8 5
0 75 50
0 43 146
0 20 15
0 31 32
0 0 2
0 0 2
0 80 54
0 200 540
0 15 20
0 0 0
0 500 250
0 0 0
0 0 0
0 0 0
0 200 107
0 0 0
0 0 0
0 600 900
0 270 270
0 0 0
0 6 15
0 0 0
0 76 500
0 0 0
0 0 0
0 0 0
0 500 570
0 0 102
0 20 0
0 3257 4010
0 0 0
0 0 0
0 0 0
0 3500 2500
300 0 0
0 0 0
0 1200 2453
0 0 0
0 1 0
0 100 120
0 0 1
0 0 0
90 300 250
0 0 0
0 2 6
0 195 24
232 0 0
0 0 0
0 0 60
0 3200 3500
0 10 15
0 20 0
0 50 125
0 45 10
0 100 34
0 0 0
0 0 0
0 19 6
0 20 25
250 17 0
0 4000 5380
0 2 10
0 1200 830
370 23 24
0 0 0
0 0 0
22 0 0
0 300 320
0 0 0
0 75 35
200 0 0
0 1500 1200
0 0 20
0 25 21
0 0 0
0 9 1
0 0 0
370 25 27
0 0 0
0 0 0
0 10 0
0 0 0
0 1 9
0 0 9
0 2 0
0 1400 1654
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 124
0 300 110
0 2500 2700
0 14 10
0 0 0
0 0 0
0 0 42
0 1000 1200
0 500 430
0 22 12
0 190 31
0 302 142
0 0 0
0 0 0
0 714 1550
0 0 0
0 890 710
0 0 0
0 0 6
0 1 12
0 1490 1500
0 16 13
0 0 0
0 2 7
0 265 490
0 1200 1000
0 106 532
0 0 0
0 500 250
0 67 9
650 100 99
0 0 67
0 84 80
0 0 0
0 263 35
0 0 0
0 0 0
0 360 50
40 0 0
0 920 750
0 0 0
0 13 15
0 49 0
0 210 250
0 0 600
0 0 19
9 0 0
0 2 0
0 0 4
0 0 0
0 10 59
232 570 750
0 0 0
0 30 22
500 0 0
0 0 0
0 0 0
0 0 17
0 0 0
160 1000 1500
0 0 0
0 0 0
0 200 300
0 2500 1500
0 12 9
0 0 0
0 200 120
0 0 0
0 200 600
357 180 140
0 0 30
0 0 0
0 0 0
0 0 0
0 0 0
0 12 13
0 100 320
0 0 0
0 0 0
0 0 0
0 2 0
0 0 2
0 2 0
0 2 0
0 0 0
0 0 1000
200 770 220
0 100 150
0 10 10
0 100 200
0 100 500
0 500 10
0
0 500 500
0
130
0 800 900
0 10 10
0 1000 950
0 9 8
0 1000 800
0 9 5
0 9 8
0
0 500 2000
0
0
0
0
0
0
180
0
0
0
0
0
0
Yang Membuat
Pengelola Obat Pustu / Poskesdes ….
NIP
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PTM
Pos/Pustu : PELAPORAN BULAN
PUSKESMAS : MAKARTI MULYA PERMINTAAN BULAN
KECAMATAN : MESUJI
KABUPATEN : OGAN KOMERING ILIR
PROPINSI : SUMATERA SELATAN
NO. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN
1 2 3 4 5 6
1 Absorbent tipped applicator (alcohol swab) Pcs 200 200
2 ACARBOSE 100 MG Tablet 0 0
3 ACARBOSE 50 MG Tablet 0 0
4 Acetylcystein Kapsul 200mg Kapsul 270 270
5 Acyclovir cream Tube 3 3
6 Acyclovir tab 200 mg Tablet 0 0
7 Acyclovir tab 400 mg Tablet 100 100
8 Albendazol tab 400 mg Tablet 0 0
9 ALIVE BIOCOM (C&ZINC) Tablet 0 0
10 ALIVE NUTRIBION (B1,B6,B12) Tablet 0 0
11 ALIVE ZIC syr Botol 0 0
12 ALIVE D1000 TAB Tablet 0 0
13 Alkohol Liquid (etanol) 70%-1000 ml Tablet 0 0
14 Allopurinol 100 mg Tablet 10 10
15 Allopurinol 300 mg Tablet 0 0
16 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0
17 Aminophylline tab 200 mg Tablet 0 0
18 Amitriptyline 25 mg tab Tablet 0 0
19 Amlodipine tab 5 mg Tablet 560 560
20 Amlodipine 10 mg Tablet 0 0
21 AMOXICILLIN DROP Botol 0 0
22 Amoxycillin 250 mg Kapsul 0 0
23 Amoxycillin 500 mg Kaptab 0 0
24 Amoxycillin Syr Btl 0 0
25 Ampicilin 1 gr Inj Vial 0 0
26 Antasida DOEN Kombinasi Tablet 600 600
27 Antasida Syr DOEN Btl 0 0
28 Anti Bisa Ular 5 ml (ABU I)/ Biosave Ampul 0 0
29 Asam Mefenamat 500 mg tab Tablet 510 510
30 Ascorbic acid (Vit.C) 50 mg Tablet 0 0
31 Aspirin (miniaspi) 80 mg tab Tablet 0 0
32 Atropine inj 0,25 mg/ml Ampul 0 0
33 Attapulgite Tablet (Pularex) Tablet 0 0
34 Attapulgite Tablet 600 mg (New Antides) Tablet 0 0
35 Automated blood grouping (Tes Gol. Darah) Paket 0 0
36 AZITROMISIN 500 mg tab Tablet 0 0
37 Bactivec Larvasida 30ml Botol 0 0
38 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0
39 Bedak Salisil 2% Btl 0 0
40 Benzoic acid |salicylic acid salep (anti fungi) Tube 0 0
41 Betahistine Mesylate 6 mg tab Tablet 190 190
42 Betamethasone 0,1% krim Tube10 gr 13 13
43 Betamethasone 0,5% krim tube 5 g 0 0
44 Biosens DBD (DBD TEST) Pcs 0 0
45 Bisacodyl 5mg Tablet 0 0
46 Bismuth subgallas (antihemoroid) Pot 0 0
47 Calcium chloride lactate infus (RL) Botol 0 0
48 Calsium Laktat (Kalk) 500 mg Tablet 270 270
49 CANDESARTAN 16 Tablet 0 0
50 CANDESARTAN 8 Tablet 0 0
51 Captopril 12,5 mg Tablet 320 320
52 Captopril 25 mg Tablet 510 510
53 Carbamazepin tab Tablet 0 0
54 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 0 0
55 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 0 0
56 Cefadroxil 500mg Tablet 0 0
57 CEFIXIME 200 MG Kapsul 0 0
58 CEFIXIME 100MG Tablet 0 0
59 Cefotaaxime Sodium inj 1gr Vial 0 0
60 CEFRIAXONE INJ Vial 0 0
61 Cetirizine 5 mg/5 ml sirup Botol 0 0
62 Cetirizine Tab Tablet 0 0
63 Chloramhenicol Salep Mata 1% Tube 0 0
64 Chloramphenicol 250 mg caps Tablet 0 0
65 Chloramphenicol Suspensi 125 mg/ml Btl 0 0
66 Chloramphenicol TT 3% Botol 0 0
67 Chloramphenicol/ Hidrokortison krim 2,5% Tube 0 0
68 Chlorpheniramine Maleat (CTM) 4 mg Tablet 0 0
69 Chlorpromazine HCl 100 mg Tablet 0 0
70 Chlorpromazine HCl 25mg Tablet 0 0
71 Cimetidin 200 tab Tablet 0 0
72 Ciprofloxacin 500 mg tab Tablet 0 0
73 Ciprofloxacin Infus Botol 0 0
74 Clindamycin 300mg Kapsul 0 0
75 CLOZAPIN 25 Tablet 0 0
76 Coverall/Hazmat XL/XXL Set 0 0
77 Crefe Flesh 10cm Rol 0 0
78 Cresol liquid 1 Liter (lysol) Botol 0 0
79 Denpro Orafil Plus Temporary Pcs 0 0
80 Devitalisasi pasta/Pulp X pot 0 0
81 Dexamethasone 0,5 mg Tablet 0 0
82 Dexamethasone inj 5mg/ml-1ml Ampul 0 0
83 Diazepam 2 mg Tablet 0 0
84 Diazepam 5mg/ml-2 ml inj Ampul 0 0
85 Diclofenac sodium 25 mg tab Tablet 0 0
86 Diclofenac sodium 50 mg tab Tablet 0 0
87 Digoxin 0,25 mg Tablet 0 0
88 Dimenhydrinate 50mg Tablet 0 0
89 Dipenhidramine HCl inj 10mg/ml Ampul 0 0
90 Domperidone 10 mg Tablet 0 0
91 Domperidone sr Botol 0 0
92 Doxycycline 100 mg Kapsul Kapsul 0 0
93 Dulcolax tab Tablet 0 0
94 DULCOLAX SUPPOS 10 MG supp 0 0
95 DULCOLAX SUPPOS 5 MG INFANT supp 0 0
96 Epinephrine HCl/bitartrat inj 0,1% Btl 0 0
97 Erythromicin 250 mg capsul Kapsul 0 0
98 Erythromicin 500 mg capsul Kapsul 0 0
99 Erythromicin Syr Btl 0 0
100 Ethacridine (Rivanol) 0,1% 300 ml Btl 0 0
101 Ethacridine (Rivanol) 0,1% 100ml Btl 0 0
102 Ethanol ( Aseptan ) 500 cc+ Pump Botol 0 0
103 Ethyl Chloride Btl 0 0
104 Eugenol cairan Btl 0 0
105 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 0
106 Folic acid 1mg ( asam folat) Tablet 0 0
107 Folley Catheter No.16 Pcs 0 0
108 Furosemida 40 mg Tablet 100 100
109 Furosemida Injeksi Ampul 0 0
110 Garam Oralit Sachet 0 0
111 Gentamicyn 0,1% SK Tube 0 0
112 Gentamicyn 0,3% TM Botol 32 32
113 Gentamicyn Inj 40 mg/ml Ampul 0 0
114 Glass lonomer Paket 0 0
115 Glibenclamide 5 mg Tablet 930 930
116 GLICLAZIDE TAB Tablet 0 0
117 Glimepiride 1 mg Tablet 0 0
118 Glukosa larutan infus 10% Botol 0 0
119 Glukosa larutan infus 5% Botol 0 0
120 Griseofulvin 125 mg Tablet 100 100
121 Guaifenesin 100 Tab/GG Tab Tablet 0 0
122 Haloperidol 0,5 mg tab Tablet 0 0
123 Haloperidol 1,5 mg tab Tablet 0 0
124 Haloperidol 5 mg tab Tablet 0 0
125 Herbakoof 100ml Botol 0 0
126 Human chorionic (HCG/Tes kehamilan ) Strip 0 0
127 Hydrochlorotiazide (HCT) 25 mg Tablet 0 0
128 H2O2 100 ML Botol 0 0
129 Ibuprofen 200 mg Tablet 0 0
130 Ibuprofen 400 mg Tablet 0 0
131 Ibuprofen sirup Botol 0 0
132 Ichthyol salep 10% Pcs 0 0
133 Immunoglobulin human anti-tetanus (Tetagam) Pcs 0 0
134 INDEC HIV1/2&SPHYLLIS pcs 0 0
135 Infus set dewasa Pcs 0 0
136 Infusi set anak Pcs 0 0
137 Isosorbide tablet Tablet 0 0
138 IV Catheter No.20 Pcs 0 0
139 IV Catheter No.22 Pcs 0 0
140 IV Catheter No.24 Pcs 0 0
141 Jarum Jahit Kulit Pcs 0 0
142 Kalium Permanganat Serbuk Pcs 0 0
143 Kapas pembalut/Absorben 250 g Pcs 0 0
144 Kasa kompres 40/40 steril Pcs 0 0
145 Kasa pembalut 2x80 Pcs 0 0
146 Kasa pembalut hidrofil 4 m x 15 cm Pcs 0 0
147 Kasa pembalut hidrofil 4 m x 3 cm Pcs 0 0
148 Ketac Universal (61108) Pcs 0 0
149 Ketac Universal (61111) Pcs 0 0
150 Ketoconazole 200 mg Cream Tube 0 0
151 Ketoconazole 200 mg tab Tablet 0 0
152 Ketorolac inj 30mg Ampul 0 0
153 Klorokina Fosfat 250 mg Tablet 0 0
154 KOTRIMOXAZOL 800/160 MG TAB Tablet 0 0
155 LAKTULOSE SYR Botol 0 0
156 Lancet Pcs 300 300
157 Levertran Salep/ Salep Luka Bakar Btl 0 0
158 Lidocain 2% Ampul 0 0
159 Lidocaine spray (Xylocaine spray) Pcs 0 0
160 Lidokain Comp. inj Kombinasi Ampul 0 0
161 Liquorice liquid extract (OBH) Botol 0 0
162 Locoriz Cream Tablet 0 0
163 Loperamid 2 mg tab / Diastrix 2 mg Tablet 0 0
164 Loratadine 10 mg tab Tablet 90 90
165 LYTACUR SYR Botol 0 0
166 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 0
167 Magnesium Sulfat Injeksi 40% (MgSO4) Ampul 0 0
168 Masker Pcs 232 232
169 Masker Earloop Pcs 0 0
170 Masker Headloop Pcs 0 0
171 Masker KN95 Pcs 0 0
172 Masker Plus Pcs 0 0
173 Masker Tie on Pcs 0 0
174 Medical adhesive tape (dermafix/leukomed) Pcs 0 0
175 Meprovent inj Ampul 0 0
176 Metamizole injeksi (antalgin 1000) Ampul 0 0
177 Metformin 500mg tab Tablet 0 0
178 Methyl Ergometrin Maleat 0,125 mg Tab 0 0
179 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0
180 Methyl Prednisolon tab 16 mg Tablet 0 0
181 Methyl Prednisolon tab 4 mg Tablet 250 250
182 Methyl Rosanilinium (gentian violet) Botol 0 0
183 METOCLOPROMIDE TAB Tablet 0 0
184 Metronidazol 250 mg tab Tablet 0 0
185 Metronidazol 500 mg tab Tablet 370 370
186 Metronidazol Infus Botol 0 0
187 Metronidazol syr Botol 0 0
188 Miconazole 2% Salep Kulit Tube 22 22
189 MOMETASONE Krim Tube 0 0
190 Moutpiece Steribreath 250's Pck 0 0
191 Natrium Bikarbonat 500 mg Tablet 0 0
192 Nifedipin 10 mg tab Kapsul 200 200
193 Nonwoven Fixation Rool Pcs 0 0
194 Nystatin Drop 100.000 IU Btl 0 0
195 Nystatin Tab Vag 10.000 iu/g Tablet 0 0
196 Octadin Botol 1000ml Botol 0 0
197 Octadin Spray 5ml Botol 0 0
198 Omeprazole inj Vial 0 0
199 Omeprazole kaps Tablet 370 370
200 Ondansetron iv/im 4mg Ampul 0 0
201 ONDANSETRON TAB Tablet 0 0
202 Otsu D-40 25ml Botol 0 0
203 Oxytetracycline HCl 1% Salep Mata Tube 0 0
204 Oxytetracycline HCl 3% Salep Kulit Tube 0 0
205 Oxytocin inj 10 IU Ampul 0 0
206 Papaverin 40 mg tab Tablet 0 0
207 Papaverin inj Tablet 0 0
208 Paracetamol Drops 15 ml Botol 0 0
209 Parasetamol 1000mg/100ml infus Botol 0 0
210 Parasetamol 120 mg/5 ml Syr Botol 0 0
211 Parasetamol 500 mg Tablet 0 0
212 Patient Lubricant (My Jelly ) Tube 0 0
213 Pehavral tab Tablet 0 0
214 Permethrin (Scabimite Cream) Tube 0 0
215 Phenobarbital 30 mg Tablet 0 0
216 Phenobarbital inj 50mg/ml-2ml Ampul 0 0
217 Phenol gliserol 10% TT Botol 0 0
218 Phytomenadione (Vit.K1) 10 mg Tablet 0 0
219 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 0
220 Phytomenadione (Vit.K1) inj 2 mg/ml Ampul 0 0
221 Piracetam 400 mg Tablet 0 0
222 Piroxicam 20 mg tab Tablet 0 0
223 Pisau Disposable (Mess No.10/11/20/21) pisau 0 0
224 Plesterku (Leukoplast) Pcs 0 0
225 Poli Aid 1 liter Botol 0 0
226 POLIAID 5L Botol 0 0
227 Policlean Handrub Botol 0 0
228 POLIDESINFEKTAN 5 L Botol 0 0
229 Polifix 10x5cm Pcs 0 0
230 Polifix 5x1cm Pcs 0 0
231 Polifix 5x5cm Pcs 0 0
232 POLIGEL 500 ML Botol 0 0
233 POLIGEL 5 L Botol 0 0
234 POLISOFT ALK HANDRUB 500 ML Botol 0 0
235 POLISOFT ALK HANDRUB 5 L Botol 0 0
236 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 0 0
237 Poliwash 500 ml Botol 0 0
238 POLIWASH 5 L Botol 0 0
239 Povidon iodium 10% 1000 ml Botol 0 0
240 Povidon iodium 10% 300 ml Botol 0 0
241 Povidon iodium 10% 60 ml Botol 0 0
242 Povidon Iodium 10% 30 ml Botol 0 0
243 Prednison 5 mg Tablet 650 650
244 Primaquin 15 mg tab Tablet 0 0
245 Propranolol HCl 10 mg Tablet 0 0
246 Propranolol HCl 40 mg Tablet 0 0
247 Propylthiouracil 100 mg Tablet 0 0
248 Protein Gluco Test Strip 0 0
249 Pyrantel Pamoat 125 mg Tablet 0 0
250 Pyridoxine HCl 10 mg Tablet 0 0
251 Ranitidin 150 mg Tablet 40 40
252 Ranitidin Injeksi Ampul 0 0
253 Rapid Test antigen (Panbio) Pcs 0 0
254 Retinol (Vit.A) kaps 100.000 iu Tablet 0 0
255 Retinol (Vit.A) kaps 200.000 iu Tablet 0 0
256 Risperidone 2mg Tablet 0 0
257 ROEKO ENDO FROST Botol 0 0
258 Salbutamol 2 mg Tablet 0 0
259 Salep 2-4 Kombinasi Tube 9 9
260 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0 0
261 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0
262 Sarung tangan (HandScuun Steril) No.7,5 Pcs 0 0
263 Sarung tangan (HandScuun) L Pcs 0 0
264 Sarung tangan (HandScuun) S/ M/ L Pcs 232 232
265 Sarung tangan nitril pcs 0 0
266 Semen Seng Fosfat Serbuk & Cairan Set 0 0
267 Sianocobalamin (Vit B12) 50 mg tab Tablet 500 500
268 Sianocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0
269 Silk (Benang Bedah) No. 3/0 Pcs 0 0
270 Silver Sulfadiazine Tube 0 0
271 Simvastatin 10 mg tab Kapsul 0 0
272 Simvastatin 20 mg tab Tablet 160 160
273 Sodium cloride infus 0,9% ( NACL ) Botol 0 0
274 Softanol 5 Liter Botol 0 0
275 Softanol 500ml Botol 0 0
276 Spuit 1 ml Pcs 0 0
277 Spuit 3 ml Pcs 0 0
278 Spuit 5 ml Pcs 0 0
279 Stericide 5 Liter Botol 0 0
280 Stimuno Capsul Forte Kapsul 0 0
281 Stimuno syrup Botol 0 0
282 Strip Asam Urat Pcs 357 357
283 Strip Gula Darah box 0 0
284 Strip kolestrol Pcs 0 0
285 SUKRALFAT TAB Tablet 0 0
286 SUKRALFAT SYR Botol 0 0
287 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 0 0
288 Sulfamethoxazole|trimethoprim (cotri) syr Botol 0 0
289 Sulfasetamida 15% TM Ampul 0 0
290 Surgical gown XL Set 0 0
291 Tetracycline 250 mg Tablet 0 0
292 Tetracycline 500 mg Tablet 0 0
293 Thiamine HCl (Vit B1) 50 mg Tablet 0 0
294 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0
295 Tranexamic Acid inj 5% Ampul 0 0
296 TRANEXAMIC ACID TAB Tablet 0 0
297 Trepocheck syphilis Pcs 0 0
298 Trihexyphenidyl tab 2 mg Tablet 0 0
299 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 200 200
300 Urin Bag Pcs 0 0
301 Usg Gel Botol 0 0
302 Vaksin Rabies Vero/ Verorab Paket 0 0
303 VALSARTAN 80 Tablet 0 0
304 VALSARTAN 160 Tablet 0 0
305 Viorex Liq 2% 5 Liter Botol 0 0
306 Viorex Liq 2% 500ml Botol 0 0
307 Virocheck HIV Pcs 0 0
308 Vitamin B Kompleks Tablet 130 130
309 Vitamin K Infant Inj Ampul 0 0
310 Water liquid (aqua P,I) Botol 0 0
311 Wing Needle No.21 Pcs 0 0
312 Wing Needle No.27 Pcs 0 0
313 Xpert MTB/RIF pcs 0 0
314 Zinc Drop Botol 0 0
315 Zinc tab Tablet 0 0
316 HB Test (Hemachroma Plus Microcuvette) Box 0 0
317 HIV Sifilis Combo Box 0 0
318 Kapas Lidi Box 0 0
319 Asam Asetat Botol 0 0
320 Sasklin Desinfektan 500 mL Botol 0 0
321 Kapas 1000 gr Box 0 0
322 Ameritek Test Box 0 0
323 Pot Feses Pack 0 0
324 Ambroxol Tablet Tablet 180 180
325 Ambroxol Syrup Botol 0 0
326 Reagen E.Coli 0 0
327 Caroto Gel 80 gr/ ECG Gel 0 0
328 Kertas ECG uk. 80 mmx 20 m 0 0
329 Kertas ECG uk. 80 mmx 90 mmx 280 0 0
330 Combur Test 0 0
UMUM JAMSOSKES BPJS JUMLAH
JUMLAH KUNJUNGAN RESEP
Mengetahui
Pengelola Obat Puskesmas
apt. Winda Utami, S. Farm.
NIP 199509112022032013
MINTAAN OBAT (LPLPO) PTM/PUSLING
: DOKUMEN NOMOR TANGGAL
: DINKES KAB/KOTA
IFK KAB/KOTA
PUSKESMAS
STOK STOK nov des jan
PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AKHIR OPTIMUM
7 8 9 10 11 12
200 277 1343
0 980 1000
0 24 25
270 0 0
3 1000 920
0 0 0
100 1 6
0 1200 1000
0 3 10
0 0 0
0 45 50
0 150 260
0 440 120
10 3500 3550
0 38 35
0 0 0
0 1500 2598
0 109 220
560 2 0
0 2500 3500
0 454 860
0 0 0
0 0 0
0 0 5
0 0 0
600 150 100
0 0 0
0 0 24
510 0 0
0 80 70
0 20 30
0 800 1500
0 30 53
0 0 0
0 5 1
0 20 15
0 275 270
0 1550 3570
0 2190 1030
0 3000 1200
190 150 260
13 36 48
0 1 27
0 1000 0
0 0 10
0 6 27
0 5000 200
270 30 25
0 100 150
0 50 35
320 10 35
510 100 99
0 3440 160
0 60 0
0 0 0
0 0 0
0 2500 1500
0 0 0
0 100 350
0 0 5
0 0 1
0 1 5
0 0 0
0 0 0
0 4000 3000
0 30 20
0 47 40
0 11 9
0 0 0
0 4000 3400
0 0 90
0 470 80
0 15 31
0 4000 1200
0 0 0
0 0 0
0 18 5
0 0 0
0 440 500
0 0 0
0 5 6
0 20 23
0 0 1
0 0 1
0 0 0
0 470 420
0 0 0
0 10 17
0 500 120
0 0 0
0 302 41
0 30 19
0 100 23
0 30 35
0 0 0
0 2190 780
0 4200 2200
0 7 9
0 0 0
0 50 140
0 2000 3000
0 0 0
0 0 0
0 30 300
0 100 104
0 89 50
0 50 110
100 0 0
0 1013 2000
0 22 116
0 15 12
32 0 5
0 80 96
0 33 32
930 200 80
0 150 58
0 102 97
0 0 99
0 0 0
100 0 0
0 8 5
0 75 50
0 43 146
0 20 15
0 31 32
0 0 2
0 0 2
0 80 54
0 200 540
0 15 20
0 0 0
0 500 250
0 0 0
0 0 0
0 0 0
0 200 107
0 0 0
0 0 0
0 600 900
0 270 270
0 0 0
0 6 15
0 0 0
0 76 500
0 0 0
0 0 0
0 0 0
0 500 570
0 0 102
0 20 0
0 3257 4010
0 0 0
0 0 0
0 0 0
0 3500 2500
300 0 0
0 0 0
0 1200 2453
0 0 0
0 1 0
0 100 120
0 0 1
0 0 0
90 300 250
0 0 0
0 2 6
0 195 24
232 0 0
0 0 0
0 0 60
0 3200 3500
0 10 15
0 20 0
0 50 125
0 45 10
0 100 34
0 0 0
0 0 0
0 19 6
0 20 25
250 17 0
0 4000 5380
0 2 10
0 1200 830
370 23 24
0 0 0
0 0 0
22 0 0
0 300 320
0 0 0
0 75 35
200 0 0
0 1500 1200
0 0 20
0 25 21
0 0 0
0 9 1
0 0 0
370 25 27
0 0 0
0 0 0
0 10 0
0 0 0
0 1 9
0 0 9
0 2 0
0 1400 1654
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 124
0 300 110
0 2500 2700
0 14 10
0 0 0
0 0 0
0 0 42
0 1000 1200
0 500 430
0 22 12
0 190 31
0 302 142
0 0 0
0 0 0
0 714 1550
0 0 0
0 890 710
0 0 0
0 0 6
0 1 12
0 1490 1500
0 16 13
0 0 0
0 2 7
0 265 490
0 1200 1000
0 106 532
0 0 0
0 500 250
0 67 9
650 100 99
0 0 67
0 84 80
0 0 0
0 263 35
0 0 0
0 0 0
0 360 50
40 0 0
0 920 750
0 0 0
0 13 15
0 49 0
0 210 250
0 0 600
0 0 19
9 0 0
0 2 0
0 0 4
0 0 0
0 10 59
232 570 750
0 0 0
0 30 22
500 0 0
0 0 0
0 0 0
0 0 17
0 0 0
160 1000 1500
0 0 0
0 0 0
0 200 300
0 2500 1500
0 12 9
0 0 0
0 200 120
0 0 0
0 200 600
357 180 140
0 0 30
0 0 0
0 0 0
0 0 0
0 0 0
0 12 13
0 100 320
0 0 0
0 0 0
0 0 0
0 2 0
0 0 2
0 2 0
0 2 0
0 0 0
0 0 1000
200 770 220
0 100 150
0 10 10
0 100 200
0 100 500
0 500 10
0
0 500 500
0
130
0 800 900
0 10 10
0 1000 950
0 9 8
0 1000 800
0 9 5
0 9 8
0
0 500 2000
0
0
0
0
0
0
180
0
0
0
0
0
0
Yang Membuat
Pengelola Obat Pustu / Poskesdes ….
NIP
LAMPIRAN BERITA ACARA PENCACAHAN OBAT AKHIR TAHUN PUSKESMAS MAKARTI MULYA
PUSKESMAS : MAKARTI MULYA TAHUN : 2024
KABUPATEN : OGAN KOMERING ILIR PROPINSI : SUMATERA SELATAN
MENURUT PENCATATAN
PENERIMAAN 1 PENGELUARAN SALDO 31 DES HASIL
NO. NAMA OBAT SATUAN SALDO 1 PENCACAHAN SELISIH KADALUARSA RUSAK HILANG
JANUARI 2024 JANUARI S/D 31 1 JANUARI S/D 2024
DES 2024 31 DES 2024
1 2 3 4 5 6 7 8 9 10 11 12
1 Absorbent tipped applicator (alcohol swab) Pcs 0 300 100 200 200
2 ACARBOSE 100 MG Tablet 0 0 0 0 0
3 ACARBOSE 50 MG Tablet 0 0 0 0 0
4 Acetylcystein Kapsul 200mg Kapsul 0 400 130 270 270
5 Acyclovir cream Tube 0 5 2 3 3
6 Acyclovir tab 200 mg Tablet 0 0 0 0 0
7 Acyclovir tab 400 mg Tablet 0 100 0 100 100
8 Albendazol tab 400 mg Tablet 0 0 0 0 0
9 ALIVE BIOCOM (C&ZINC) Tablet 0 0 0 0 0
10 ALIVE NUTRIBION (B1,B6,B12) Tablet 0 0 0 0 0
11 ALIVE ZIC syr Botol 0 0 0 0 0
12 ALIVE D1000 TAB Tablet 0 0 0 0 0
13 Alkohol Liquid (etanol) 70%-1000 ml Tablet 0 0 0 0 0
14 Allopurinol 100 mg Tablet 250 0 240 10 10
15 Allopurinol 300 mg Tablet 0 0 0 0 0
16 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0 0 0 0
17 Aminophylline tab 200 mg Tablet 0 0 0 0 0
18 Amitriptyline 25 mg tab Tablet 0 0 0 0 0
19 Amlodipine tab 5 mg Tablet 290 1000 730 560 560
20 Amlodipine 10 mg Tablet 0 0 0 0 0
21 AMOXICILLIN DROP Botol 0 0 0 0 0
22 Amoxycillin 250 mg Kapsul 0 0 0 0 0
23 Amoxycillin 500 mg Kaptab 120 300 420 0 0
24 Amoxycillin Syr Btl 0 0 0 0 0
25 Ampicilin 1 gr Inj Vial 0 0 0 0 0
26 Antasida DOEN Kombinasi Tablet 300 2000 1700 600 600
27 Antasida Syr DOEN Btl 0 0 0 0 0
28 Anti Bisa Ular 5 ml (ABU I)/ Biosave Ampul 0 0 0 0 0
29 Asam Mefenamat 500 mg tab Tablet 300 1600 1390 510 510
30 Ascorbic acid (Vit.C) 50 mg Tablet 110 0 110 0 0
31 Aspirin (miniaspi) 80 mg tab Tablet 40 0 40 0 0
32 Atropine inj 0,25 mg/ml Ampul 0 0 0 0 0
33 Attapulgite Tablet (Pularex) Tablet 0 0 0 0 0
34 Attapulgite Tablet 600 mg (New Antides) Tablet 0 0 0 0 0
35 Automated blood grouping (Tes Gol. Darah) Paket 0 0 0 0 0
36 AZITROMISIN 500 mg tab Tablet 0 0 0 0 0
37 Bactivec Larvasida 30ml Botol 0 0 0 0 0
38 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0 0 0 0
39 Bedak Salisil 2% Btl 3 0 3 0 0
40 Benzoic acid |salicylic acid salep (anti fungi) Tube 0 0 0 0 0
41 Betahistine Mesylate 6 mg tab Tablet 80 200 90 190 190
42 Betamethasone 0,1% krim Tube10 gr 13 0 0 13 13
43 Betamethasone 0,5% krim tube 5 g 0 0 0 0 0
44 Biosens DBD (DBD TEST) Pcs 0 0 0 0 0
45 Bisacodyl 5mg Tablet 0 0 0 0 0
46 Bismuth subgallas (antihemoroid) Pot 0 0 0 0 0
47 Calcium chloride lactate infus (RL) Botol 0 0 0 0 0
48 Calsium Laktat (Kalk) 500 mg Tablet 0 300 30 270 270
49 CANDESARTAN 16 Tablet 0 0 0 0 0
50 CANDESARTAN 8 Tablet 0 0 0 0 0
51 Captopril 12,5 mg Tablet 190 2000 1870 320 320
52 Captopril 25 mg Tablet 240 1000 730 510 510
53 Carbamazepin tab Tablet 0 0 0 0 0
54 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 0 0 0 0 0
55 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 0 0 0 0 0
56 Cefadroxil 500mg Tablet 0 0 0 0 0
57 CEFIXIME 200 MG Kapsul 0 0 0 0 0
58 CEFIXIME 100MG Tablet 0 0 0 0 0
59 Cefotaaxime Sodium inj 1gr Vial 0 0 0 0 0
60 CEFRIAXONE INJ Vial 0 0 0 0 0
61 Cetirizine 5 mg/5 ml sirup Botol 0 0 0 0 0
62 Cetirizine Tab Tablet 0 0 0 0 0
63 Chloramhenicol Salep Mata 1% Tube 0 0 0 0 0
64 Chloramphenicol 250 mg caps Tablet 0 0 0 0 0
65 Chloramphenicol Suspensi 125 mg/ml Btl 0 0 0 0 0
66 Chloramphenicol TT 3% Botol 0 0 0 0 0
67 Chloramphenicol/ Hidrokortison krim 2,5% Tube 0 0 0 0 0
68 Chlorpheniramine Maleat (CTM) 4 mg Tablet 30 1700 1730 0 0
69 Chlorpromazine HCl 100 mg Tablet 0 0 0 0 0
70 Chlorpromazine HCl 25mg Tablet 0 0 0 0 0
71 Cimetidin 200 tab Tablet 0 0 0 0 0
72 Ciprofloxacin 500 mg tab Tablet 70 0 70 0 0
73 Ciprofloxacin Infus Botol 0 0 0 0 0
74 Clindamycin 300mg Kapsul 0 0 0 0 0
75 CLOZAPIN 25 Tablet 0 0 0 0 0
76 Coverall/Hazmat XL/XXL Set 0 0 0 0 0
77 Crefe Flesh 10cm Rol 0 0 0 0 0
78 Cresol liquid 1 Liter (lysol) Botol 0 0 0 0 0
79 Denpro Orafil Plus Temporary Pcs 0 0 0 0 0
80 Devitalisasi pasta/Pulp X pot 0 0 0 0 0
81 Dexamethasone 0,5 mg Tablet 0 0 0 0 0
82 Dexamethasone inj 5mg/ml-1ml Ampul 0 0 0 0 0
83 Diazepam 2 mg Tablet 0 0 0 0 0
84 Diazepam 5mg/ml-2 ml inj Ampul 0 0 0 0 0
85 Diclofenac sodium 25 mg tab Tablet 0 0 0 0 0
86 Diclofenac sodium 50 mg tab Tablet 310 1400 1710 0 0
87 Digoxin 0,25 mg Tablet 0 0 0 0 0
88 Dimenhydrinate 50mg Tablet 0 0 0 0 0
89 Dipenhidramine HCl inj 10mg/ml Ampul 0 0 0 0 0
90 Domperidone 10 mg Tablet 380 0 380 0 0
91 Domperidone sr Botol 0 0 0 0 0
92 Doxycycline 100 mg Kapsul Kapsul 0 0 0 0 0
93 Dulcolax tab Tablet 0 0 0 0 0
94 DULCOLAX SUPPOS 10 MG supp 0 0 0 0 0
95 DULCOLAX SUPPOS 5 MG INFANT supp 0 0 0 0 0
96 Epinephrine HCl/bitartrat inj 0,1% Btl 0 0 0 0 0
97 Erythromicin 250 mg capsul Kapsul 0 0 0 0 0
98 Erythromicin 500 mg capsul Kapsul 50 0 50 0 0
99 Erythromicin Syr Btl 0 0 0 0 0
100 Ethacridine (Rivanol) 0,1% 300 ml Btl 0 0 0 0 0
101 Ethacridine (Rivanol) 0,1% 100ml Btl 0 0 0 0 0
102 Ethanol ( Aseptan ) 500 cc+ Pump Botol 0 0 0 0 0
103 Ethyl Chloride Btl 0 0 0 0 0
104 Eugenol cairan Btl 0 0 0 0 0
105 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 0 0 0 0
106 Folic acid 1mg ( asam folat) Tablet 0 0 0 0 0
107 Folley Catheter No.16 Pcs 0 0 0 0 0
108 Furosemida 40 mg Tablet 40 100 40 100 100
109 Furosemida Injeksi Ampul 0 0 0 0 0
110 Garam Oralit Sachet 0 0 0 0 0
111 Gentamicyn 0,1% SK Tube 0 0 0 0 0
112 Gentamicyn 0,3% TM Botol 6 37 11 32 32
113 Gentamicyn Inj 40 mg/ml Ampul 0 0 0 0 0
114 Glass lonomer Paket 0 0 0 0 0
115 Glibenclamide 5 mg Tablet 10 1000 80 930 930
116 GLICLAZIDE TAB Tablet 0 0 0 0 0
117 Glimepiride 1 mg Tablet 0 0 0 0 0
118 Glukosa larutan infus 10% Botol 0 0 0 0 0
119 Glukosa larutan infus 5% Botol 0 0 0 0 0
120 Griseofulvin 125 mg Tablet 0 100 0 100 100
121 Guaifenesin 100 Tab/GG Tab Tablet 0 0 0 0 0
122 Haloperidol 0,5 mg tab Tablet 0 0 0 0 0
123 Haloperidol 1,5 mg tab Tablet 0 0 0 0 0
124 Haloperidol 5 mg tab Tablet 0 0 0 0 0
125 Herbakoof 100ml Botol 0 0 0 0 0
126 Human chorionic (HCG/Tes kehamilan ) Strip 0 0 0 0 0
127 Hydrochlorotiazide (HCT) 25 mg Tablet 70 0 70 0 0
128 H2O2 100 ML Botol 0 0 0 0 0
129 Ibuprofen 200 mg Tablet 0 0 0 0 0
130 Ibuprofen 400 mg Tablet 50 0 50 0 0
131 Ibuprofen sirup Botol 0 0 0 0 0
132 Ichthyol salep 10% Pcs 0 0 0 0 0
133 Immunoglobulin human anti-tetanus (Tetagam) Pcs 0 0 0 0 0
134 INDEC HIV1/2&SPHYLLIS pcs 0 0 0 0 0
135 Infus set dewasa Pcs 0 0 0 0 0
136 Infusi set anak Pcs 0 0 0 0 0
137 Isosorbide tablet Tablet 0 0 0 0 0
138 IV Catheter No.20 Pcs 0 0 0 0 0
139 IV Catheter No.22 Pcs 0 0 0 0 0
140 IV Catheter No.24 Pcs 0 0 0 0 0
141 Jarum Jahit Kulit Pcs 0 0 0 0 0
142 Kalium Permanganat Serbuk Pcs 0 0 0 0 0
143 Kapas pembalut/Absorben 250 g Pcs 0 0 0 0 0
144 Kasa kompres 40/40 steril Pcs 0 0 0 0 0
145 Kasa pembalut 2x80 Pcs 0 0 0 0 0
146 Kasa pembalut hidrofil 4 m x 15 cm Pcs 0 0 0 0 0
147 Kasa pembalut hidrofil 4 m x 3 cm Pcs 0 0 0 0 0
148 Ketac Universal (61108) Pcs 0 0 0 0 0
149 Ketac Universal (61111) Pcs 0 0 0 0 0
150 Ketoconazole 200 mg Cream Tube 0 0 0 0 0
151 Ketoconazole 200 mg tab Tablet 30 0 30 0 0
152 Ketorolac inj 30mg Ampul 0 0 0 0 0
153 Klorokina Fosfat 250 mg Tablet 0 0 0 0 0
154 KOTRIMOXAZOL 800/160 MG TAB Tablet 0 0 0 0 0
155 LAKTULOSE SYR Botol 0 0 0 0 0
156 Lancet Pcs 0 400 100 300 300
157 Levertran Salep/ Salep Luka Bakar Btl 0 0 0 0 0
158 Lidocain 2% Ampul 0 0 0 0 0
159 Lidocaine spray (Xylocaine spray) Pcs 0 0 0 0 0
160 Lidokain Comp. inj Kombinasi Ampul 0 0 0 0 0
161 Liquorice liquid extract (OBH) Botol 0 0 0 0 0
162 Locoriz Cream Tablet 0 0 0 0 0
163 Loperamid 2 mg tab / Diastrix 2 mg Tablet 30 200 230 0 0
164 Loratadine 10 mg tab Tablet 240 1000 1150 90 90
165 LYTACUR SYR Botol 0 0 0 0 0
166 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 0 0 0 0
167 Magnesium Sulfat Injeksi 40% (MgSO4) Ampul 0 0 0 0 0
168 Masker Pcs 0 300 68 232 232
169 Masker Earloop Pcs 0 0 0 0 0
170 Masker Headloop Pcs 0 0 0 0 0
171 Masker KN95 Pcs 0 0 0 0 0
172 Masker Plus Pcs 0 0 0 0 0
173 Masker Tie on Pcs 0 0 0 0 0
174 Medical adhesive tape (dermafix/leukomed) Pcs 0 0 0 0 0
175 Meprovent inj Ampul 0 0 0 0 0
176 Metamizole injeksi (antalgin 1000) Ampul 0 0 0 0 0
177 Metformin 500mg tab Tablet 40 2600 2640 0 0
178 Methyl Ergometrin Maleat 0,125 mg Tab 0 0 0 0 0
179 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0 0 0 0
180 Methyl Prednisolon tab 16 mg Tablet 0 0 0 0 0
181 Methyl Prednisolon tab 4 mg Tablet 130 400 280 250 250
182 Methyl Rosanilinium (gentian violet) Botol 0 0 0 0 0
183 METOCLOPROMIDE TAB Tablet 0 0 0 0 0
184 Metronidazol 250 mg tab Tablet 0 0 0 0 0
185 Metronidazol 500 mg tab Tablet 0 600 230 370 370
186 Metronidazol Infus Botol 0 0 0 0 0
187 Metronidazol syr Botol 0 0 0 0 0
188 Miconazole 2% Salep Kulit Tube 13 52 43 22 22
189 MOMETASONE Krim Tube 0 0 0 0 0
190 Moutpiece Steribreath 250's Pck 0 0 0 0 0
191 Natrium Bikarbonat 500 mg Tablet 0 0 0 0 0
192 Nifedipin 10 mg tab Kapsul 60 300 160 200 200
193 Nonwoven Fixation Rool Pcs 0 0 0 0 0
194 Nystatin Drop 100.000 IU Btl 0 0 0 0 0
195 Nystatin Tab Vag 10.000 iu/g Tablet 0 0 0 0 0
196 Octadin Botol 1000ml Botol 0 0 0 0 0
197 Octadin Spray 5ml Botol 0 0 0 0 0
198 Omeprazole inj Vial 0 0 0 0 0
199 Omeprazole kaps Tablet 250 1200 1080 370 370
200 Ondansetron iv/im 4mg Ampul 0 0 0 0 0
201 ONDANSETRON TAB Tablet 0 0 0 0 0
202 Otsu D-40 25ml Botol 0 0 0 0 0
203 Oxytetracycline HCl 1% Salep Mata Tube 0 0 0 0 0
204 Oxytetracycline HCl 3% Salep Kulit Tube 0 0 0 0 0
205 Oxytocin inj 10 IU Ampul 0 0 0 0 0
206 Papaverin 40 mg tab Tablet 0 0 0 0 0
207 Papaverin inj Tablet 0 0 0 0 0
208 Paracetamol Drops 15 ml Botol 0 0 0 0 0
209 Parasetamol 1000mg/100ml infus Botol 0 0 0 0 0
210 Parasetamol 120 mg/5 ml Syr Botol 0 0 0 0 0
211 Parasetamol 500 mg Tablet 180 2300 2480 0 0
212 Patient Lubricant (My Jelly ) Tube 0 0 0 0 0
213 Pehavral tab Tablet 0 0 0 0 0
214 Permethrin (Scabimite Cream) Tube 0 0 0 0 0
215 Phenobarbital 30 mg Tablet 0 0 0 0 0
216 Phenobarbital inj 50mg/ml-2ml Ampul 0 0 0 0 0
217 Phenol gliserol 10% TT Botol 0 0 0 0 0
218 Phytomenadione (Vit.K1) 10 mg Tablet 0 0 0 0 0
219 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 0 0 0 0
220 Phytomenadione (Vit.K1) inj 2 mg/ml Ampul 0 0 0 0 0
221 Piracetam 400 mg Tablet 0 0 0 0 0
222 Piroxicam 20 mg tab Tablet 0 0 0 0 0
223 Pisau Disposable (Mess No.10/11/20/21) pisau 0 0 0 0 0
224 Plesterku (Leukoplast) Pcs 0 0 0 0 0
225 Poli Aid 1 liter Botol 0 0 0 0 0
226 POLIAID 5L Botol 0 0 0 0 0
227 Policlean Handrub Botol 0 0 0 0 0
228 POLIDESINFEKTAN 5 L Botol 0 0 0 0 0
229 Polifix 10x5cm Pcs 0 0 0 0 0
230 Polifix 5x1cm Pcs 0 0 0 0 0
231 Polifix 5x5cm Pcs 0 0 0 0 0
232 POLIGEL 500 ML Botol 0 0 0 0 0
233 POLIGEL 5 L Botol 0 0 0 0 0
234 POLISOFT ALK HANDRUB 500 ML Botol 0 0 0 0 0
235 POLISOFT ALK HANDRUB 5 L Botol 0 0 0 0 0
236 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 0 0 0 0 0
237 Poliwash 500 ml Botol 0 0 0 0 0
238 POLIWASH 5 L Botol 0 0 0 0 0
239 Povidon iodium 10% 1000 ml Botol 0 0 0 0 0
240 Povidon iodium 10% 300 ml Botol 0 0 0 0 0
241 Povidon iodium 10% 60 ml Botol 0 0 0 0 0
242 Povidon Iodium 10% 30 ml Botol 0 0 0 0 0
243 Prednison 5 mg Tablet 90 700 140 650 650
244 Primaquin 15 mg tab Tablet 0 0 0 0 0
245 Propranolol HCl 10 mg Tablet 0 0 0 0 0
246 Propranolol HCl 40 mg Tablet 0 0 0 0 0
247 Propylthiouracil 100 mg Tablet 0 0 0 0 0
248 Protein Gluco Test Strip 0 0 0 0 0
249 Pyrantel Pamoat 125 mg Tablet 0 0 0 0 0
250 Pyridoxine HCl 10 mg Tablet 0 0 0 0 0
251 Ranitidin 150 mg Tablet 190 900 1050 40 40
252 Ranitidin Injeksi Ampul 0 0 0 0 0
253 Rapid Test antigen (Panbio) Pcs 0 0 0 0 0
254 Retinol (Vit.A) kaps 100.000 iu Tablet 0 0 0 0 0
255 Retinol (Vit.A) kaps 200.000 iu Tablet 0 0 0 0 0
256 Risperidone 2mg Tablet 0 0 0 0 0
257 ROEKO ENDO FROST Botol 0 0 0 0 0
258 Salbutamol 2 mg Tablet 0 200 200 0 0
259 Salep 2-4 Kombinasi Tube 0 22 20 9 2
260 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0 0 0 0 0
261 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0 0 0 0
262 Sarung tangan (HandScuun Steril) No.7,5 Pcs 0 0 0 0 0
263 Sarung tangan (HandScuun) L Pcs 0 0 0 0 0
264 Sarung tangan (HandScuun) S/ M/ L Pcs 0 300 68 232 232
265 Sarung tangan nitril pcs 0 0 0 0 0
266 Semen Seng Fosfat Serbuk & Cairan Set 0 0 0 0 0
267 Sianocobalamin (Vit B12) 50 mg tab Tablet 340 1000 840 500 500
268 Sianocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0 0 0 0
269 Silk (Benang Bedah) No. 3/0 Pcs 0 0 0 0 0
270 Silver Sulfadiazine Tube 0 0 0 0 0
271 Simvastatin 10 mg tab Kapsul 120 0 120 0 0
272 Simvastatin 20 mg tab Tablet 320 200 360 160 160
273 Sodium cloride infus 0,9% ( NACL ) Botol 0 0 0 0 0
274 Softanol 5 Liter Botol 0 0 0 0 0
275 Softanol 500ml Botol 0 0 0 0 0
276 Spuit 1 ml Pcs 0 0 0 0 0
277 Spuit 3 ml Pcs 0 0 0 0 0
278 Spuit 5 ml Pcs 0 0 0 0 0
279 Stericide 5 Liter Botol 0 0 0 0 0
280 Stimuno Capsul Forte Kapsul 0 0 0 0 0
281 Stimuno syrup Botol 0 0 0 0 0
282 Strip Asam Urat Pcs 0 625 268 357 357
283 Strip Gula Darah box 0 10 10 0 0
284 Strip kolestrol Pcs 0 200 200 0 0
285 SUKRALFAT TAB Tablet 0 0 0 0 0
286 SUKRALFAT SYR Botol 0 0 0 0 0
287 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 0 0 0 0 0
288 Sulfamethoxazole|trimethoprim (cotri) syr Botol 0 0 0 0 0
289 Sulfasetamida 15% TM Ampul 0 0 0 0 0
290 Surgical gown XL Set 0 0 0 0 0
291 Tetracycline 250 mg Tablet 0 0 0 0 0
292 Tetracycline 500 mg Tablet 0 0 0 0 0
293 Thiamine HCl (Vit B1) 50 mg Tablet 0 0 0 0 0
294 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0 0 0 0
295 Tranexamic Acid inj 5% Ampul 0 0 0 0 0
296 TRANEXAMIC ACID TAB Tablet 0 0 0 0 0
297 Trepocheck syphilis Pcs 0 0 0 0 0
298 Trihexyphenidyl tab 2 mg Tablet 0 0 0 0 0
299 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 0 200 0 200 200
300 Urin Bag Pcs 0 0 0 0 0
301 Usg Gel Botol 0 0 0 0 0
302 Vaksin Rabies Vero/ Verorab Paket 0 0 0 0 0
303 VALSARTAN 80 Tablet 0 0 0 0 0
304 VALSARTAN 160 Tablet 0 0 0 0 0
305 Viorex Liq 2% 5 Liter Botol 0 0 0 0 0
306 Viorex Liq 2% 500ml Botol 0 0 0 0 0
307 Virocheck HIV Pcs 0 0 0 0 0
308 Vitamin B Kompleks Tablet 160 2300 2330 130 130
309 Vitamin K Infant Inj Ampul 0 0 0 0 0
310 Water liquid (aqua P,I) Botol 0 0 0 0 0
311 Wing Needle No.21 Pcs 0 0 0 0 0
312 Wing Needle No.27 Pcs 0 0 0 0 0
313 Xpert MTB/RIF pcs 0 0 0 0 0
314 Zinc Drop Botol 0 0 0 0 0
315 Zinc tab Tablet 0 300 300 0 0
316 HB Test (Hemachroma Plus Microcuvette) Box 0 0 0 0 0
317 HIV Sifilis Combo Box 0 0 0 0 0
318 Kapas Lidi Box 0 0 0 0 0
319 Asam Asetat Botol 0 0 0 0 0
320 Sasklin Desinfektan 500 mL Botol 0 0 0 0 0
321 Kapas 1000 gr Box 0 0 0 0 0
322 Ameritek Test Box 0 0 0 0 0
323 Pot Feses Pack 0 0 0 0 0
324 Ambroxol Tablet Tablet 70 300 190 180 180
325 Ambroxol Syrup Botol 0 0 0 0 0
326 Reagen E.Coli 0 0 0 0 0
327 Caroto Gel 80 gr/ ECG Gel 0 0 0 0 0
328 Kertas ECG uk. 80 mmx 20 m 0 0 0 0 0
329 Kertas ECG uk. 80 mmx 90 mmx 280 0 0 0 0 0
330 Combur Test 0 0 0 0 0
Yang Membuat
Pengelola Obat Poskesdes Makarti Mulya
NIP.
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