LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO )

SUB UNIT U S I L A
UPT PUSKESMAS KLANGENAN
PELAPORAN BULAN
PERMINTAAN BULAN

: DESEMBER 2015
: JANUARI 2016

NO

NAMA OBAT

SATU

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47

Aminofilin 200 mg
Amoksisilin 250 mg
Amoksisilin 500 mg
Amoksisilin Sirup
Antalgin 500 mg
Antasida DOEN tab
Anti Bakteri SK
Anti Fungi SK

AN
Tablet
Kapsul
Tablet
Botol
Tablet
Tablet
Tube
Tube

As. Askorbat (Vit. C) 50

Tablet

Betametason SK
Captopril 125 mg
Deksametason 0,5
Dekstrometorfan Syr
Dekstrometorfan Tab

Tube
Tablet
Tablet
Botol
Tablet

Fitomenadion (Vit. K) Tab

Tablet

Furosemid tab
Garam Oralit
Gentamisin SK
Gentian Violet
G.G
Griseofulvin 125 mg
Hidrokortison SK
Ibuprofen 200 mg
Ibuprofen 400 mg
Kalk
Oksitetrasiklin Sk
Captopril 25 mg
CTM
Kotrimoksazol Susp
Kotrimoksazol 120
Kotrimoksazol 480
Metronidazol 250
Na. Bikarbonat
Nifedipin 100
OBH
Oksitetrasiklin SM
Parasetamol Sir
Parasetamol 100
Parasetamol 500
Piridoksin (Vit. B6)
Simvastatin 20 mg
Salep 2-4
Salisil Bedak
Sulfacetamid Na. TM

Tablet
Sachet
Tube
Botol
Tablet
Tablet
Tube
Tablet
Tablet
Tablet
Tube
Botol
Tablet
Botol
Tablet
Tablet
Tablet
Tablet
Tablet
Botol
Tube
Botol
Tablet
Tablet
Tablet
Tablet
Tube
Bks
Botol

Tab. Tambah Darah Fe

Tablet

Tiamin (Vit.B1) tab

Vit. B Complek

Tablet
Tablet

STOK
AWAL
4

0
0
0
0
0
86
0
0
188
0
0
54
0
0
0
0
0
0
0
207
0
0
0
0
162
0
0
98
0
0
0
0
0
0
0
4
0
0
86
94
0
0
4
0
0
180

PENERI- PERSEMAAN
DIAAN
5
6 = 4+5

0
0
0
0
0
50
3
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
100
0
0
100
0

0
0
0
0
10
0
0
450
0
0
0
5
0
0
0

0
0
0
0
0
136
3
0
188
0
0
54
0
0
0
0
0
0
0
207
0
6
0
100
162
0
100
98
0
0
0
0
0
0
10
4
0
0
536
94
0
0
9
0
0
0
180

PEMAKAIAN
7

0
0
0
0
0
136
1
0
9
0
0
54
0
0
0
0
0
0
0
0
5
0
100
162
0
100
98

0
0
0
0
9
0
0
0
536
94
0
0
8
0
0
0
45

STOK
AKHIR
8 = 6-7

0
0
0
0
0
0
2
0
179
0
0
0
0
0
0
0
0
0
0
207
0
1
0
0
0
0
0
0
0
0
0
0
0
0
1
4
0
0
0
0
0
0
1
0
0
0
135

STOK
OPTIMUM

9 =(7X1,2)

0
0
0
0
0
163.2
1.2
0
10.8
0
0
64.8
0
0
0
0
0
0
0
0
0
6
0
120
194.4
0
120
117.6
0
0
0
0
0
0
10.8
0
0
0
643.2
112.8
0
0
9.6
0
0
0
54

48 Glibenklamid
Jumlah Kunjungan Pasien

Tablet

Mengetahui
Kepala UPT Puskesmas
Klangenan

dr. H. ASEP FIRMANSJAH. MHKes

NIP. 19700904 200112 1 002

30
Umum
Askes
Tidak Bayar
Jumlah

30

10

20

12

1
0
111
112
Yang Menyerahkan
Pengelola Obat

ROHMAT RUDIANTO

NIP. 19810603 200211 1 001

Yang Melapor
Bidan Desa /

ENTIN ARN

NIP. 1980028 200

PERMINTAAN OBAT ( LPLPO )

SILA
LANGENAN

PERMINTAAN
10 = 9-8

0
0
0
0
0
163.2
-0.8
0
-168.2
0
0
64.8
0
0
0
0
0
0
0
-207
0
5
0
120
194.4
0
120
117.6
0
0
0
0
0
0
9.8
-4
0
0
643.2
112.8
0
0
8.6
0
0
0
-81

PEMBERIAN
11

KET
12

-8

Yang Melapor / meminta

Bidan Desa / Perawat

ENTIN ARNATIN

NIP. 1980028 200801 2 005