Lplpo 2014

DAFTAR STOK OBAT PUSKESMAS BENU - BENUA
PERIODE APRIL S/D JUNI 2014

SISA
No. NAMA
STOK
1 Acyclovir 400 mg 520
2 acyclovir cream 75
3 Alopurinol tablet 100 mg 1,100
4 Amoxicillin sirup kering 125 mg/5ml 395
5 Amoxicillin kaplet 500 mg 10,900
6 Amlodipine 10 mg 600
7 Antasida doen syrup 90
8 Antasida doen tablet 10,200
9 Antibakteri doen salep kombinasi( Bacitracin ) 100
10 Antihemoroid doen kombinasi 40
11 Antifungi doen kombinasi 13
12 Antimigrain doen kombinasi(Ergotamin Kafein) 300
13 Asam askorbat(vit C) tablet 250 mg 3,250
15 Asam Mefenamat tablet 500 mg (novastan) 8,300
16 Bioplacenton salep 5
17 Betametason krim 0,1 % 294
18 Captopril 25 mg 2,000
19 Cefadroksil 500 mg 500
20 Cetrizin 160
21 Ciprofloksasin 500 mg 1,900
22 Darplex 4 box
23 Cimetidin 1,200
24 Deksametason tablet 0,5 mg 13,900
25 Diazepam tab 2 mg 1,235
26 Doxicyclin 100 mg 6,000
27 Efedrin hcl tablet 25 mg 1,000
28 Eritromycin 500 mg 200
29 Fenobarbital tablet 30 mg 817
30 Furosemid tablet 40 mg 500
31 Garam Oralit 200 ml air 800
32 Glibenklamid tablet 5 mg 1,000
33 Gliseril guayakolat tablet 100 mg 9,000
34 Griseofulvin tab 125 mg, micronized 700
35 Hidroklorotiazid( hct ) tablet 25 mg 1,000
36 Hidrokortison cream 2,5 mg 72
37 Ibuprofen tablet 200 mg 700
38 Ibuprofen tablet 400 mg 1,800
39 Isosorbid dinitrat tablet sublingual 5 mg 60
40 Kalsium laktat ( Kalk ) tablet 500mg 14,000
41 Kloramfenikol kapsul 250 mg 4,000
42 Kloramfenikol salep mata 1 % 24
43 Klorfeniramin maleat (ctm) tablet 4 mg 1,000
44 Kotrimoksasol suspensi 193
45 Kotrimoksasol dewasa 480 mg tablet 2,000
46 Metilergometrin maleat tablet salut 0,125 mg 500
47 Metronidazol tablet 250 mg 900
SISA
No. NAMA
STOK
49 Metoklopramide 1,000
50 Miconazol 96
51 Natrium diclofenac 1,850
52 Natrium klorida larutan infus 0,9 % steril 18
53 Nodiar 400
54 Nistatin 100.000 iu/g tablet vaginal 200
55 Oksitetrasiklin hcl salep kulit 3 % 175
56 Oksitatrasiklin hcl salep mata 50
57 Papaverin 5,000
58 Paracetamol sirup 120 mg/5 ml 337
59 Paracetamol 500 mg 13,600
60 Pirantel Pamoat Tablet 125 mg 400
61 Piridoksin hcl tablet 10 mg 4,000
62 Piroxikam 1,600
63 Prednison tablet 5 mg 5,000
64 Procurma syrup 100
65 Propiltiourasiltablet 100 mg 200
66 Propranolol hcl tablet 40 mg 200
67 Ranitidin 200
68 Salbutamol tablet 4 mg 1,300
69 Salisil bedak 2 % 30
70 Salbutamol tablet 2 mg 300
71 Stesolit 9
72 Simvastatin 300
73 Supralivron 1,800
74 Tablet tambah darah kombinasi 1,800
75 Tetrasiklin hcl kapsul 500 mg 800
76 Thiamin hcl mononitrat (vit b1 tablet 50 mg 3,000
77 Thiamphenicol 500 mg 200
78 Vitamin B komplek tablet 14,000
79 Zink Disposibe 6,000
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT PSIKOTROPIKA
LPLPO
KODE PUSKESMAS
PUSKESMAS : BENU-BENUA
KECAMATAN : KENDARI BARAT
KAB/KOTA : KENDARI
PROPINSI : SULAWESI TENGGARA
SISA
KODE NAMA
STOK
1 2 9
409 Diazepam tab 2 mg 1,235
606 Fenobarbital tablet 30 mg 817
1605 Stesolit Rectal 5 mg 4
Kepala Puskesmas Benu-Benua
( dr. Rahmiyanti)
Nip. 19760916 200604 2008
DAFTAR OBAT EXPIRE 2014
No. NAMA
DAFTAR OBAT EXPIRE 2014
SISA TANGGAL
STOK EXPIRE
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
LPLPO
KODE PUSKESMAS 7 7
4 4
7 3
7 3
0 0
1 1
0 0
2
PUSKESMAS
KAB/KOTA : KENDARI
KELAS SATU STOK PENERI PERSE PEMA- SISA
KODE NAMA
TERAPI AN AWAL MAAN DIAAN KAIAN STOK
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9
1 Abbocath 20 68 68 5 63
2 ACT/Arsuamon 1,017 2 box 2 box 2 box
3 Acyclovir 200 mg 1.2 tab 0 -
4 Acyclovir 400 mg 839 839 45 794
6 acyclovir cream 1.2 tub 194 194 5 189
7 Air raksa dental use 14.2 btl 0 -
8 Alat suntik sekali pakai 1 ml 32 set 370 370 30 340
9 Alat suntik sekali pakai 0,5 ml 32 set 70 70 50 20
12 Alat suntik sekali pakai 5 ml 32 160 160 40 120
13 Albendazol tablet 400 mg tab 0 -
14 ALBOTIL 9 tab 3 3 1 2
15 Alopurinol tablet 100 mg 6,1,1 tab 42 200 242 170 72
16 Aminofillin tablet 200 mg 0 -
17 Aminofillin injeksi 20 mg/ml - 10 ml 26,1 amp 0 -
18 Amitriptillin hcl tablet salut 25 mg 26.1 tab 0 -
19 Amoxicillin sirup kering 125 mg/5ml 23.2 btl 270 270 98 172
20 Amoxicillin kaplet 500 mg ( kimoxil ) tab 11,613 11613 3,642 7,971
21 Ampicillin kaplet 500 mg 6,2,1 kap 0 -
22 Ampicillin sirup kering 125 mg/5ml 6,2,1 btl 0 -
23 Amlodipine10 mg tab 4 90 94 94
24 Antalgin ( metampiron ) Novaron 500 mg 1.2 tab 5,274 5274 630 4,644
25 Antasida doen syrup, kombinasi btl 35 35 15 20
26 Antasida doen tablet, kombinasi 25.1 tab 8,957 8957 1,287 7,670
27 Antibakteri doen salep kombinasi( Bacitracin ) 18.2 tub 144 144 34 110
28 Antihemoroid doen kombinasi 25.3 sup 0 -
29 Antifungi doen kombinasi 18.3 pot 35 35 22 13
30 Antimigrain doen kombinasi(Ergotamin Kafein) 7.2 tab 300 300 - 300
31 Aqua proinjeksi steril,bebas pirogen 20.3 amp 8 8 2 6
32 Aquades steril 30 btl 0 -
33 Asam askorbat(vit C) tablet 250 mg 29 tab 5,919 5919 - 5,919
34 Asam askorbat(vit C) tablet 50 mg 29 tab 2,000 2000 1,027 973
35 Asam Mefenamat tablet 500 mg (novastan) 31 tab 16,145 16145 1,325 14,820
36 Asam klorida 0,1 n btl 0 -
37 Asam sulfasalisilat 20 % 31 btl 0 -
38 Benzatin benzil penisillin inj.1,2 juta iu/vial 6,2,1 vial 0 -
40 Besi sirup 10.1 btl 0 -
41 Betametason krim 0,1 % 18.4 tub 260 260 48 212
42 Bisturi 0 -
43 Catgut/benang bedah no.2/0-3/0(plain % Chromic) 32 sak 48 48 - 48
44 Captopril 12,5 mg 6,2,3 tab 1,668 1668 1,267 401
45 Captopril 25 mg 573 600 1173 1,018 155
46 Cefadroksil 500 mg -
47 Cetrizin 37 37 16 21
48 Ciprofloksasin 500 mg tab
49 Darplex
50 Cimetidin tab 100
51 Deksametason inj 5mg/ml -1 ml 3 amp 92 92
52 Deksametason tablet 0,5 mg 16.4 tab 20,821 20821 2,007 18,814
53 Dektran 70 - larutan infus 6 % steril 11.2 btl 0 -
54 Dektrometorfan hbr sirup 10 mg/5ml 26.2 btl 120 120 30 90
55 Dektrometorfan hbr tablet 15 mg 26.2 tab 2,620 2620 70 2,550
56 Devitalisasi Pasta ( non Arsem ) 14.1 btl 0 -
57 Diazepam inj 5mg/ml - 2ml 5 amp 0 -
58 Diazepam tab 2 mg 5 tab 586 586 21 565
59 Dietilkarbamazin sitrat tablet 100 mg 6,1,2 tab 0 -
60 Difenhidramin hcl inj 10 mg/ml - 1ml 3 amp 0 -
61 Digoksin tablet 0,25 mg 17.5 tab
62 Doxicyclin 100 mg 6,708 6708 200 6,508
63 Efedrin hcl tablet 25 mg 26.1 tab 43 1000 1043 187 856
64 Ekstrak belladon tablet 10 mg 25.4 tab 0 -
65 Epineprin hcl/bitartratn (adrenalin) inj.0.1%-1ml 3 amp 0 -
66 Etakridin ( rivanol ) larutan 0,1 % 13.2 btl 6 6 2 4
67 Etanol 70%( Alkohol ) 13.2 btl 3 3 6 2 4
68 Eritromycin 500 mg 2.2 btl 0 -
69 Etil klorida semprot 14.1 btl - 2 2 2 -
70 Euginol Cairan 14.1 btl 0 -
71 Fenitoin natrium inj 50 mg/ml 5 amp 0 -
72 Fanitoin natrium kapsul 100 mg 5 kap 0 -
73 Fenitoin natrium kapsul 30 mg 5 kap 0 -
74 Fenobarbital injeksi 50mg/ml - 2ml 5 amp 0 -
75 Fenobarbital tablet 100 mg 5 tab 0 -
76 Fenobarbital tablet 30 mg 5 tab 1,223 1223 6 1,217
77 Fenoksimetil penisillina tablet 500 mg 6,2,1 tab 0 -
78 Fenol Gliserol tts telinga 10 % 28.2 btl 0 -
79 Fitominadion ( vit k ) inj 10 mg/ml - 1ml 10.2 amp 4 4 - 4
80 Fitominadion ( vit k ) tablet salut 10 mg 10.2 tab 0 -
81 Fletser cairan dan serbuk 0 -
82 Furosemid tablet 40 mg 14 tab 500 500 500
83 Gameksan Emulsi 1 % 18.5 btl 0 -
84 Garam Oralit 1000 ml air 20.1 sak 0 -
85 Garam Oralit 200 ml air 20.1 sak 443 443 165 278
86 Gentian violet larutan 1 % 14.2 btl 0 -
87 Glass Ionomer cement (qc ix) 14.1 set 0 -
88 Glibenklamid tablet 5 mg 16,1,1 tab 9 9 9
89 Gliseril guayakolat tablet 100 mg 26.3 tab 13,907 13907 2,081 11,826
90 Gliserin 25.6 btl 0 -
91 Glukosa larutan infus 10 % 20.2 btl 0 -
93 Griseofulvin tab 125 mg, micronized 6.3 tab 560 560 99 461
94 Haloperidol tablet 0,5 mg 23.4 tab 0 -
96 Hand scound No.7,5 20 20 20
97 Hidroklorotiazid( hct ) tablet 25 mg 15 tab 2,301 2301 201 2,100
98 Hidrokortison cream 2,5 mg 18.4 tub 214 214 3 211
99 Ibuprofen tablet 200 mg 1.2 tab 200 200 - 200
100 Ibuprofen tablet 400 mg 1.2 tab 2,647 2647 308 2,339
101 Infusien set anak 3.2 set 0 -
102 Infusien set dewasa 3.2 set 50 50 10 40
103 Insulin reguler inj 40 iu/ml - 10 ml (human) 16,1,2 amp 0 -
104 Iodial Kapsul lunak 16.3 kap 0 -
105 Ipeka sirup 0,14 % 4.2 btl 0 -
106 Isoniazid tablet 100 mg 6,2,4 tab 0 -
108 Isosorbid dinitrat tablet sublingual 5 mg 17.1 tab 0 -
109 jarum jahit 32 set 0 -
110 Kalium permanganat serbuk 13.1 btl 0
111 Kalsium hidroksida pasta 14.1 tub
112 Kalsium laktat ( Kalk ) tablet 500mg 29 tab 6,550 6550 651 5,899
113 Kapas berlemak 500 gram 32 bks 0 -
114 Kapas pembalut/absorben 250 gram 32 bks 8 8 2 6
115 Karbamazin tablet 200 mg 5 rol 0 -
116 Kasa pembalut 3,6 x 10 cm 32 rol
117 Kasa Pembalut 2m x 80 cm 32 rol 3 3 2 1
118 Kasa pembalut hidrofil 4m x 15 cm 32 rol 0 -
119 Kasa Steril 32 rol 10 10 - 10
120 Kasa Pembalut hidrofil 40m x 80 cm 32 rol 0 -
121 Kloramfenikol kapsul 250 mg 6,2,2 kap 3,009 3009 526 2,483
122 Kloramfenikol salep mata 1 % 21,2,1 tub 0 -
123 Kloramfenikol tetes telinga 3 % 28.1 btl 0 -
124 Kloramfenikol tetes Mata
125 Klorfeniramin maleat (ctm) tablet 4 mg 3 tab 15,545 15545 492 15,053
126 Kloroquin fosfat tablet 250 mg 6,4,2,1 tab 0 -
127 Klorpromazin hcl tablet salut 25 mg 23.4 tab 0 -
128 Klopropamid tablet 100 mg 16,1,1 tab 0 -
129 Kodein hcl tablet 10 mg 26.2 tab 0 -
130 Kombinasi pirimetamin 25 mg+Sulfadoksin 500mg 6.422 tab 0 -
131 Kotrimoksasol pediatrik tablet 6,2,2 tab 0 -
132 Kotrimoksasol suspensi 6,2,2 btl 276 276 45 231
133 Kotrimoksasol dewasa 480 mg tablet 6,2,2 tab 8,908 8908 294 8,614
134 Kuinin dihidrokklorida inj 25 % -2ml 6,4,2,2 amp 0 -
135 Kuinin sulfat tablet 222 mg ( 7 h2o ) 64,2,2 tab 0 -
136 Larutan Benedict 31 btl 0 -
137 Larutan eosin 2% 31 btl 0 -
138 Larutan etanol asam 31 btl 0 -
139 Larutan giemsa stain 31 btl 0 -
140 Larutan Karbol fuksin 31 btl 0 -
141 Larutan metilen biru 31 btl 0 -
142 Larutan turk 31 btl 0 -
143 Lidokain kompositum injeksi 14.1 amp 60 60 60
144 Lidokain 2% 13.2 btl 0 -
145 Magnesium sulfat injeksi ( iv ) 20 % - 25 ml 5 amp 0 -
147 Masker 50 50 10 40
148 Metilergometrin maleat tablet salut 0,125 mg 22.1 tab 19 19 18 1
149 Metilergometrin maleat injeksi 0,200 mg - 1 ml 22.1 amp 0 -
150 Metronidazol tablet 250 mg 6,2,2 tab 822 822 93 729
151 Metronidazol tablet 500 mg tab 500 500 500
152 Metformin Hcl 500 mg tab 388 388 388
153 Metoklopramide 14.1 btl 907 907 217 690
154 Miconazol 14.1 btl 102 102 14 88
155 Natrium, bikarbonat tablet 500 mg 4.1 tab 0 -
156 Natrium diclofenac 12,2,3 btl 1 400 401 152 249
157 Natrium klorida larutan infus 0,9 % steril 20.2 btl 20 20 1 19
158 Nodiar 4.1 amp 121 121 77 44
159 Nistatin 100.000 iu/g tablet vaginal 6.3 tab 282 282 29 253
160 Obat antituberkolosis kategori 1 6,2,4 pkt 10 10 3 7
161 Obat antituberkolosis kategori 2 6,2,4 pkt 0 -
163 Obat antituberkolosis kategori anak 6,2,4 pkt 0 -
164 Obat antituberkolosis kategori sisipan 26.3 btl 1 1 - 1
165 Obat batuk hitam ( OBH ) cairan 2.2 tbg 78 78 - 78
166 Oksitetrasiklin hcl salep kulit 3 % 18.2 tub 115 115 - 115
167 Oksitatrasiklin hcl salep mata 21,2,2 tub 43 43 - 43
168 Oksitosin inj 10 iu/ml - 1 ml 22.1 amp 20 20 - 20
169 Papaverin 13.2 tab 1,140 1140 - 1,140
170 Paracetamol sirup 120 mg/5 ml 1.2 btl 226 226 - 226
171 Paracetamol 500 mg 1.2 tab 15,264 15264 - 15,264
172 Pirantel Pamoat Tablet 125 mg 6,1,1 tab 275 275 - 275
173 Piridoksin hcl tablet 10 mg 29 tab 0 -
174 Piroxikam 21,2,5 btl 198 500 698 - 698
175 Plester 5 yard x 2 inch 32 rol 4 4 - 4
176 Polikresulen 14.2 btl 0 -
177 Prednison tablet 5 mg 16.4 tab 2,507 2507 150 2,357
178 Primakuin tablet 15 mg 6,4,2,2 tab 947 947 14 933
179 Procurma syrup btl 27 50 77 66 11
180 Propiltiourasiltablet 100 mg 16.3 tab 0 -
181 Propranolol hcl tablet 40 mg 7.1 tab 0 -
182 Ranitidin 9 tab 0 -
183 Reserpin tablet 0,10 mg 17.3 tab 0 -
185 Retinol (vitamin A) kapsul 100.000 iu 29 kap 200 200 100 100
187 Ringer laktat larutan infus steril 20.2 btl 80 80 20 60
188 Salbutamol tablet 4 mg 26.1 tab 642 642 115 527
189 Salep 2-4 kombinasi 18.4 pot 70 70 32 38
190 Salisil bedak 2 % 18.8 ktk 16 16 10 6
191 Salbutamol tablet 2 mg 18.3 btl 0 -
192 Stesolit 14.2 set 9 9 1 8
193 Simvastatin 27.1 vial 0 -
194 Sianokobalamin (vit B 12) inj 500 mcg/ml 10.1 amp 0 -
195 Silk (benang bedah sutera) no.3/0 32 sak 0 -
196 Siver amalgam serbuk 65-75 % 14.1 btl 0 -
197 Suspensi seng insulin inj. 40 iu/ml - 10 ml (human) 16,1,2 vial 0 -
198 Tablet tambah darah kombinasi 10.1 tab 2,927 2927 577 2,350
199 Tetrakain hcl tetes mata 21.2 btl 0 -
200 Tetrasiklin hcl kapsul 250 mg 6,2,2 kap 0 -
201 Tetrasiklin hcl kapsul 500 mg 6,2,2 kap 320 320 30 290
202 Thiamin hcl (vit b1) inj.100 mg/ml - 1ml 29 amp 0 -
203 Thiamin hcl mononitrat (vit b1 tablet 50 mg 29 tab 3,966 3966 178 3,788
204 Thiamphenicol suspensi sirup kering btl 2 2 2
205 Tiopental natrium serbuk inj 1000 mg/amp 2.2 amp 0 -
206 Vaksin rabies vero 27.2 set 0 -
207 Vitamin B komplek tablet 29 tab 2780 3000 5780 2,497 3,283
208 Yodium povidon larutan 10 % 30 ml 13.1 btl 4 4 2 2
211 Zink Disposibe 3880 3880 490 3,390
212 C-K Jet 30 G 0 -
213 Catgut 3-0 42 42 30 12
214 Jarum Sambung & Benang side 23 23 - 23
215 Jarum Jahit Kulit Sedang 12 12 - 12
216 Jarum jahit Kulit Besar 0 -
217 Lisol 1 1 1
218 Pot Sputum 100 100 - 100
219 Urine Strip strip 10 10
220 kontrasepsi implant strip 10 10 10
221 Kontrasepsi injk.progestern 3 bln vial 60 60 60
222 Susuk Kb II 10 10 10
223 Euginol Cairan 1 1 1
224 Denturi 2 2 2
225 Bioplacenton salep 3 3 - 3
226 Formoksazole 1 1 - 1
GRATIS ASKES ASKESKIN JAMSOSTEK

JUMLAH KUNJUNGAN RESEP 322 298 540 11
Mengetahui/menyetujui yang menyerahkan Yang menerima/melapo

Kepala Dinkes Kota Kendari kepala GFK Kepala Puskesmas Benu-B
( ) ( ) ( dr. Rahmiyanti)
NIP. NIP. Nip. 19760916 200604 20
AN DAN LEMBAR PERMINTAAN OBAT
LPLPO
Kendari, Jan-14
Bulan : 0 12
Tahun : 2 0 1 3 LB 2
STOK PERMIN- PEMBERIAN

KET
OPT TAAN INPRES ASKES APBD LAIN JML
10 11 12 13 14 15 16 17
JAMSOSTEK TOTAL
11 1171
Yang menerima/melapor Yang menerima

Kepala Puskesmas Benu-Benua Petugas Puskesmas
( dr. Rahmiyanti) ( Muliyani Harli,AMF)

Nip. 19760916 200604 2008 NIP. 19860613 201001 2017
BULAN
No. NAMA
jan feb Maret april mei Juni juli Agustus
1 Abbocath 20 0 0 20 1 0 0 0
2 Abbocath 18 0 0 0 0 0 0 0
3 Acyclovir 200 mg 0 0 0 0 0 0 0
4 Acyclovir 400 mg 424 50 0 20 50 0 100 0
6 acyclovir cream 139 0 0 0 0 75 0 0
7 Air raksa dental use 0 0 0 0 0 0 0 0
8 Alat suntik sekali pakai 1 ml 201 21 60 50 0 59 20 0
9 Alat suntik sekali pakai 0,5 ml 0 0 0 0 0 20 0 0
10 Alat suntik sekali pakai 2,5 ml 31 0 30 21 1 42 0 0
13 Albendazol tablet 400 mg 0 0 0 0 0 0 0 0
14 ALBOTIL 1 1 1 0 0 0 1 0
15 Alopurinol tablet 100 mg 72 0 300 200 200 200 100 300
16 Aminofillin tablet 200 mg 0 0 0 0 0 0 0 0
17 Aminofillin injeksi 20 mg/ml - 10 ml 0 0 0 0 0 0 0 0
18 Amitriptillin hcl tablet salut 25 mg 0 0 0 0 0 0 0 0
19 Amoxicillin sirup kering 125 mg/5ml 242 66 9 63 108 6 46 35
20 Amoxicillin kaplet 500 mg ( kimoxil ) 971 1400 1700 3200 2400 2400 1900 2000
21 Ampicillin kaplet 500 mg 0 0 0 0 0 0 0 0
22 Ampicillin sirup kering 125 mg/5ml 0 0 0 0 0 0 0 0
23 Amlodipine 5 mg 150 90 0 210 210 270 180 220
24 Antalgin ( metampiron ) Novaron 500 mg 4644 0 0 0 0 0 0 0
25 Antasida doen syrup, kombinasi 70 5 5 5 9 6 5 7
26 Antasida doen tablet, kombinasi 2970 800 700 1000 900 900 500 900
27 Antibakteri doen salep kombinasi( Bacitracin ) 110 0 0 16 19 15 25 25
28 Antihemoroid doen kombinasi 10 0 0 16 10 12 0 32
29 Antifungi doen kombinasi 0 0 0 0 2 0 0 0
30 Antimigrain doen kombinasi(Ergotamin Kafein) 400 100 0 200 100 0 0 0
31 Aqua proinjeksi steril,bebas pirogen 0 0 6 0 0 10 0 0
32 Aquades steril 0 0 0 0 0 0 0 0
33 Asam askorbat(vit C) tablet 250 mg 2169 250 250 500 1250 1500 0 0
34 Asam askorbat(vit C) tablet 50 mg 973 0 0 0 0 1000 1000 0
35 Asam Mefenamat tablet 500 mg (novastan) 7120 700 700 1100 1300 1500 900 700
36 Asam klorida 0,1 n 0 0 0 0 0 0 0 0
37 Asam sulfasalisilat 20 % 0 0 0 0 0 0 0 0
38 Betahistin 0 0 0 0 0 0 0 0
39 Benzatin benzil penisillin inj.2,4 juta iu/vial 0 0 0 0 0 0 0 0
40 Bioplacenton salep 2 0 1 0 0 0 0 2
41 Betametason krim 0,1 % 112 0 75 50 50 73 43 63
42 Bisturi 10 2 0 5 0 19 0 0
43 Catgut/benang bedah no.2/0-3/0(plain % Chromic) 48 12 3 19 27 0 11 0
44 Captopril 12,5 mg 1001 0 0 0 0 0 0 0
45 Captopril 25 mg 155 0 0 700 400 500 400 900
46 Cefadroksil 500 mg 400 100 0 100 0 0 0 0
47 Cetrizin 0 51 0 30 100 30 0 100
48 Ciprofloksasin 500 mg 700 400 500 500 500 700 200 500
49 Darplex 1 box 0 0 0 0 0 0 0
50 Cimetidin 500 200 100 0 0 200 100 0
51 Deksametason inj 5mg/ml -1 ml 92 0 0 0 0 0 0 0
52 Deksametason tablet 0,5 mg 1514 1700 1700 3000 1500 2000 1500 1400
53 Dektran 70 - larutan infus 6 % steril 0 0 0 0 0 0 0 0
54 Dektrometorfan hbr sirup 10 mg/5ml 0 37 0 0 0 0 0 0
55 Dektrometorfan hbr tablet 15 mg 2550 0 0 0 0 0 0 0
56 Devitalisasi Pasta ( non Arsem ) 0 0 0 0 0 0 0 0
57 Diazepam inj 5mg/ml - 2ml 0 0 0 0 0 0 0 0
58 Diazepam tab 2 mg 195 68 67 36 96 63 51 96
59 Dietilkarbamazin sitrat tablet 100 mg 0 0 0 0 0 0 0 0
60 Difenhidramin hcl inj 10 mg/ml - 1ml 0 0 0 0 0 0 0 0
61 Digoksin tablet 0,25 mg 0 0 0 0 0 0 0 0
62 Doxicyclin 100 mg 508 0 0 0 0 0 0 100
63 Efedrin hcl tablet 25 mg 856 250 250 250 250 250 250 250
64 Ekstrak belladon tablet 10 mg 0 0 0 0 0 0 0 0
65 Epineprin hcl/bitartratn (adrenalin) inj.0.1%-1ml 0 0 0 0 0 0 0 0
66 Etakridin ( rivanol ) larutan 0,1 % 0 0 0 0 0 0 0 0
67 Etanol 70%( Alkohol ) 2 2 2 2 2 0 2 0
68 Eritromycin 500 mg 0 0 0 0 0 0 0 0
69 Etil klorida semprot 0 0 0 1 0 1 0 0
70 Euginol Cairan 0 0 0 0 0 0 0 0
71 Fenitoin natrium inj 50 mg/ml 0 0 0 0 0 0 0 0
72 Fanitoin natrium kapsul 100 mg 0 0 0 0 0 0 0 0
73 Fenitoin natrium kapsul 30 mg 0 0 0 0 0 0 0 0
74 Fenobarbital injeksi 50mg/ml - 2ml 0 0 0 0 0 0 0 0
75 Fenobarbital tablet 100 mg 0 0 0 0 0 0 0 0
76 Fenobarbital tablet 30 mg 394 0 6 6 23 2 1 7
77 Fenoksimetil penisillina tablet 500 mg 0 0 0 0 0 0 0 0
78 Fenol Gliserol tts telinga 10 % 0 0 0 0 0 0 0 0
79 Fitominadion ( vit k ) inj 10 mg/ml - 1ml 34 30 30 0 0 30 0 0
80 Fitominadion ( vit k ) tablet salut 10 mg 0 0 0 0 0 0 0 0
81 Fletser cairan dan serbuk 0 0 0 0 0 0 0 0
82 Furosemid tablet 40 mg 0 0 0 0 0 0 0 0
83 Gameksan Emulsi 1 % 0 0 0 0 0 0 0 0
84 Garam Oralit 1000 ml air 0 0 0 0 0 0 0 0
85 Garam Oralit 200 ml air 8 70 200 500 200 100 200 200
86 Gentian violet larutan 1 % 0 0 0 0 0 0 0 0
87 Gentamicin zalf kulit 0 0 0 0 0 0 0 0
88 Glibenklamid tablet 5 mg 0 0 0 400 200 200 200 400
89 Gliseril guayakolat tablet 100 mg 2826 1000 1000 3000 2000 3000 2000 2000
90 Gliserin 0 0 0 0 0 0 0 0
91 Glukosa larutan infus 10 % 0 0 0 0 0 0 0 0
92 Glukosa larutan infus 5 % 0 0 0 0 0 0 0 0
93 Griseofulvin tab 125 mg, micronized 161 200 0 300 200 200 100 200
94 Haloperidol tablet 0,5 mg 0 0 0 0 0 0 0 0
95 Haloperidol tablet 1,5 mg 0 0 0 0 0 0 0 0
96 Hand scound No.7,5 0 0 0 0 0 45 25 2
97 Hidroklorotiazid( hct ) tablet 25 mg 3100 1000 0 400 300 0 300 300
98 Hidrokortison cream 2,5 mg 187 48 0 0 12 12 0 13
99 Ibuprofen tablet 200 mg 100 0 100 200 0 0 200 0
100 Ibuprofen tablet 400 mg 3039 500 500 600 600 600 400 1400
101 Infusien set anak 0 0 0 0 0 0 0 0
102 Infusien set dewasa 0 0 1 0 1 0 0 0
103 Insulin reguler inj 40 iu/ml - 10 ml (human) 0 0 0 0 0 0 0 0
104 Iodial Kapsul lunak 0 0 0 0 0 0 0 0
105 Ipeka sirup 0,14 % 0 0 0 0 0 0 0 0
106 Isoniazid tablet 100 mg 0 0 0 0 0 0 0 0
107 Isoniazid tablet 300 mg 0 0 0 0 0 0 0 0
108 Isosorbid dinitrat tablet sublingual 5 mg 0 0 0 0 0 0 0 0
109 jarum jahit 0 0 0 12 0 0 0 0
110 Kalium permanganat serbuk 0 0 0 0 0 0 0 0
111 Ketoconazole krim 0 0 0 0 0 0 0 0
112 Kalsium laktat ( Kalk ) tablet 500mg 899 0 1000 4100 600 1000 500 800
113 Kapas berlemak 500 gram 0 0 0 0 0 0 0 0
114 Kapas pembalut/absorben 250 gram 10 2 2 3 2 4 1 1
115 Karbamazin tablet 200 mg 0 0 0 0 0 0 0 0
116 Kasa pembalut 3,6 x 10 cm 0 5 5 40 80 120 0 0
117 Kasa Pembalut 2m x 80 cm 0 0 1 0 0 0 0 0
118 Kasa pembalut hidrofil 4m x 15 cm 0 0 0 0 0 0 0 0
119 Kasa Steril 4 7 7 0 1 9 0 2
120 Kasa Pembalut hidrofil 40m x 80 cm 0 0 0 0 0 0 0 0
121 Kloramfenikol kapsul 250 mg 733 0 1000 750 0 1250 0 0
122 Kloramfenikol salep mata 1 % 0 0 0 0 0 8 0 0
123 Kloramfenikol tetes telinga 3 % 0 0 0 0 0 0 0 0
124 Kloramfenikol tetes Mata 3 0 0 0 0 0 0 0
125 Klorfeniramin maleat (ctm) tablet 4 mg 9053 2000 3000 0 6000 0 1700 2000
126 Kloroquin fosfat tablet 250 mg 0 0 0 0 0 0 0 0
127 Klorpromazin hcl tablet salut 25 mg 0 0 0 0 0 0 0 0
128 Klopropamid tablet 100 mg 0 0 0 0 0 0 0 0
129 Kodein hcl tablet 10 mg 0 0 0 0 0 0 0 0
130 Kombinasi pirimetamin 25 mg+Sulfadoksin 500mg 0 0 0 0 0 0 0 0
131 Kotrimoksasol pediatrik tablet 0 0 0 0 0 0 0 0
132 Kotrimoksasol suspensi 151 0 37 63 71 51 26 24
133 Kotrimoksasol dewasa 480 mg tablet 9014 100 500 0 100 400 500 300
134 Kuinin dihidrokklorida inj 25 % -2ml 0 0 0 0 0 0 0 0
135 Kuinin sulfat tablet 222 mg ( 7 h2o ) 0 0 0 0 0 0 0 0
136 Larutan Benedict 0 0 0 0 0 0 0 0
137 Larutan eosin 2% 0 0 0 0 0 0 0 0
138 Larutan etanol asam 0 0 0 0 0 0 0 0
139 Larutan giemsa stain 0 0 0 0 0 0 0 0
140 Larutan Karbol fuksin 0 0 0 0 0 0 0 0
141 Larutan metilen biru 0 0 0 0 0 0 0 0
142 Loratadine 0 0 0 0 0 0 0 0
143 Lidokain kompositum injeksi 0 0 0 30 30 60 0 30
144 Lidokain 2% 0 0 0 10 30 20 0 0
145 Magnesium sulfat injeksi ( iv ) 20 % - 25 ml 0 0 0 0 0 0 0 0
146 Magnesium sulfat injeksi ( iv ) 40 % - 25 ml 0 0 0 0 0 0 0 0
147 Masker 20 20 60 50 70 80 60 20
148 Metilergometrin maleat tablet salut 0,125 mg 101 400 0 100 100 200 400 0
149 Metilergometrin maleat injeksi 0,200 mg - 1 ml 0 60 0 0 0 0 30 0
150 Metronidazol tablet 250 mg 329 0 0 0 0 300 100 0
151 Metronidazol tablet 500 mg 0 0 0 0 0 0 0 0
152 Metformin Hcl 500 mg 0 0 0 0 0 0 0 0
153 Metoklopramide 490 200 200 200 100 200 200 300
154 Miconazol 64 0 24 24 0 10 14 20
155 Natrium, bikarbonat tablet 500 mg 0 0 0 0 0 0 0 0
156 Natrium diclofenac 0 499 400 250 400 450 750 200
157 Natrium klorida larutan infus 0,9 % steril 1 0 0 0 0 0 0 0
158 Nodiar 44 100 0 100 0 200 100 100
159 Nistatin 100.000 iu/g tablet vaginal 0 0 53 5 10 85 0 0
160 Obat antituberkolosis kategori 1 6 2 2 5 1 3 1 3
163 Obat antituberkolosis kategori anak 0 0 0 0 0 0 0 0
Obat antituberkolosis kategori sisipan
164 Omeprazole 0 0 0 0 0 0 0 0
165 Obat batuk hitam ( OBH ) cairan 78 10 0 0 0 0 0 0
166 Oksitetrasiklin hcl salep kulit 3 % 165 25 50 34 41 12 44 24
167 Oksitatrasiklin hcl salep mata 23 5 15 0 50 0 25 0
168 Oksitosin inj 10 iu/ml - 1 ml 30 50 0 50 0 50 0 0
169 Papaverin 0 0 140 0 0 0 0 200
170 Paracetamol sirup 120 mg/5 ml 218 58 43 57 37 46 24 28
171 Paracetamol 500 mg 11464 4100 3100 5000 2900 3300 3900 1000
172 Pirantel Pamoat Tablet 125 mg 75 100 0 20 80 0 0 40
173 Piridoksin hcl tablet 10 mg 0 0 0 0 0 0 0 1000
174 Piroxikam 1198 500 400 700 500 400 300 400
175 Plester 5 yard x 2 inch 2 0 5 3 4 2 1 0
176 Pot Sputum 150 0 50 0 0 100 0 50
177 Prednison tablet 5 mg 2357 0 0 100 300 400 300 200
178 Primakuin tablet 15 mg 933 0 0 0 0 0 0 0
179 Procurma syrup 111 36 14 62 38 0 0 0
180 Propiltiourasiltablet 100 mg 0 0 0 0 0 0 0 0
181 Propranolol hcl tablet 40 mg 0 0 0 100 0 0 0 0
182 Ranitidin 400 600 300 200 600 400 100 0
183 Reserpin tablet 0,10 mg 0 0 0 0 0 0 0 0
184 Reserpin tablet 0,25 mg 0 0 0 0 0 0 0 0
185 Retinol (vitamin A) kapsul 100.000 iu 100 650 0 0 0 0 0 0
186 Retinol (vitamin A) kapsul 200.000 iu 100 1100 0 0 0 0 100 650
187 Ringer laktat larutan infus steril 22 23 7 0 3 20 5 0
188 Salbutamol tablet 4 mg 327 0 200 100 100 200 0 100
189 Salep 2-4 kombinasi 38 0 0 0 0 0 0 0
190 Salisil bedak 2 % 0 0 0 0 0 16 9 29
191 Salbutamol tablet 2 mg 200 100 0 100 0 0 100 0
192 Stesolit 0 3 1 1 3 0 0 0
193 Simvastatin 150 30 60 150 210 210 50 490
194 Supralivron 400 300 500 500 300 600 400 1000
195 Silk (benang bedah sutera) no.3/0 0 0 0 0 6 5 0 0
196 Siver amalgam serbuk 65-75 % 0 0 0 0 0 0 0 0
197 Suspensi seng insulin inj. 40 iu/ml - 10 ml (human) 0 0 0 0 0 0 0 0
198 Tablet tambah darah kombinasi 0 0 550 0 600 0 0 0
199 Tetrakain hcl tetes mata 0 0 0 0 0 0 0 0
200 Tetrasiklin hcl kapsul 250 mg 0 0 0 0 0 0 0 0
201 Tetrasiklin hcl kapsul 500 mg 0 0 0 0 0 0 0 0
202 Thiamin hcl (vit b1) inj.100 mg/ml - 1ml 0 0 0 0 0 0 0 0
203 Thiamin hcl mononitrat (vit b1 tablet 50 mg 188 600 0 0 0 0 0 0
204 Thiamphenicol 500 mg 0 0 0 180 0 0 100 0
205 Tiopental natrium serbuk inj 1000 mg/amp 0 0 0 0 0 0 0 0
206 Vaksin rabies vero 0 0 0 0 0 0 0 0
207 Vitamin B komplek tablet 5283 1000 3000 3000 3000 3000 2000 3000
208 Yodium povidon larutan 10 % 30 ml 0 0 1 3 0 1 0 1
211 Zink Disposibe 90 0 200 600 0 0 300 0
212 Slide 0 0 0 0 0 0 0 0
213 Spritus 0 0 1 liter 0 0 0 0
214 Rokles 1
215 Jarum Sambung & Benang side 23 0 0 0 0 0 0 0
216 Jarum jahit Kulit sedang 12 0 0 0 0 0 0 0
217 Domperidone syrup 0 0 0 0 0 0 7
218 Asam Folat 0 0 0 0 0 0 100 0
219 Biolisin syrup 0 0 0 0 0 0 0 35
220 Lodia 0 0 0 0 0 0 0
221 Vitamin B12 Injeksi 0 0 0 0 0 0 0 0
222 Bromhexin 0 0 0 0 0 0 600 0
223 Metil Prednisolon 0 0 0 400 300
224 Formoksazole 1 0 0
225 Catgut 3_0 12 0 0 0
BULAN Total
Sept Okt November Des Penerimaan
62 0 20 0 103
0 0 0 0 -
0 0 0 0 -
30 0 60 40 774
0 0 25 0 239
0 0 0 0 -
3 0 10 0 424
3 0 1 96 120
6 0 0 6 137
3 0 60 0 342
0 0 100 5 200
0 0 0 0 -
1 2 0 0 7
400 200 300 253 2,525
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
31 35 39 17 697
2600 2400 3200 2136 26,307
0 0 0 0 -
0 0 0 0 -
290 180 330 265 2,395
0 0 0 0 4,644
0 3 5 12 132
1000 1700 1300 750 13,420
0 5 20 25 260
40 26 24 20 190
0 0 0 5 7
0 0 100 100 1,000
0 0 0 0 16
0 0 0 0 -
0 0 0 0 5,919
2000 1000 0 1000 6,973
900 1200 1800 920 18,840
0 0 0 0 -
0 0 0 0 -
0 0 150 60 210
0 0 0 0 -
0 0 2 2 9
0 90 75 25 656
5 10 5 10 66
0 0 16 0 136
0 0 0 0 1,001
700 700 500 250 5,205
0 0 100 0 700
0 0 50 89 450
900 500 400 66 5,866
0 0 0 0 -
100 0 0 0 1,200
0 0 0 0 92
2400 2000 2800 1520 23,034
0 0 0 0 -
0 0 0 0 37
0 0 0 0 2,550
0 0 0 0 -
0 0 0 0 -
53 75 102 44 946
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
0 0 0 0 608
500 750 0 250 4,106
0 0 0 0 -
0 0 0 0 -
1 0 0 0 1
1 1 5 0 19
0 0 0 0 -
1 1 2 1 7
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
2 2 0 1 444
0 0 0 0 -
0 0 0 0 -
0 0 0 0 124
0 30 70 0 100
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
400 100 200 200 2,378
0 0 0 0 -
0 2 3 5 10
400 400 0 220 2,420
4000 3000 3000 1000 27,826
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
200 100 0 160 1,821
0 0 0 0 -
0 0 0 0 -
28 10 0 0 110
300 300 400 200 6,600
35 0 5 5 317
600 0 200 100 1,500
200 600 800 460 9,699
0 0 0 0 -
0 0 0 0 2
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
0 0 0 0 12
0 0 0 14 14
0 5 5 5 15
900 700 400 1000 11,899
0 0 0 0 -
9 0 0 1 35
0 0 0 0 -
50 50 50 10 410
0 0 0 0 1
0 0 0 0 -
4 0 2 5 41
0 0 0 0 -
250 1250 250 0 5,483
24 0 2 0 34
0 0 0 0 -
0 0 0 0 3
7500 3000 3200 2400 39,853
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
39 73 46 17 598
200 300 300 146 11,860
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
0 0 50 0 50
30 60 60 60 360
0 0 0 0 60
0 0 0 0 -
0 0 0 0 -
160 80 120 40 780
0 300 0 200 1,801
0 0 0 0 90
500 0 10 90 1,329
0 400 100 300 800
0 0 0 0 -
200 200 200 100 2,590
28 0 0 14 198
0 0 0 0 -
700 350 900 590 5,489
3 0 7 3 14
200 100 0 100 1,044
100 0 0 0 253
1 6 5 2 37
0 0 0 0 -
0 0 0 0 -
0 0 0 0 -
1 1
0 0 0 0 -
0 0 0 10 98
48 24 24 48 539
25 0 5 4 152
0 0 50 0 230
300 0 0 0 640
77 29 45 43 705
7500 1400 3600 3000 50,264
60 0 0 100 475
0 1300 0 700 3,000
600 400 600 630 6,628
2 0 0 1 20
50 0 0 0 400
400 300 400 240 4,997
0 0 0 0 933
0 0 0 0 261
0 0 0 0 -
0 100 0 0 200
1000 400 500 410 4,910
0 0 0 0 -
0 0 0 0 -
250 0 0 0 1,000
600 50 0 50 2,650
0 0 25 0 105
200 200 300 0 1,727
0 0 0 0 38
22 10 29 24 139
200 0 100 0 800
2 2 3 1 16
120 0 0 261 1,731
1400 800 1100 1380 8,680
0 0 5 0 16
0 0 0 0 -
0 0 0 0 -
600 0 0 0 1,750
0 0 0 0 -
0 0 0 0 -
290 0 0 0 290
0 0 0 0 -
0 0 1000 0 1,788
0 0 0 0 280
0 0 0 0 -
0 0 0 0 -
4000 3000 2000 2000 34,283
1 1 2 0 10
2 1 0 0 13
1 1 0 0 11
0 0 0 200 1,390
0 0 0 0 -
0 0 -
0
0 0 23
0 0
4 3 11 0 25
0 0 100
135 44 86 57 357
0 60 0 60
0 0 -
500 100 300 100 1,600
100 200 100 0 1,100
0 1
0
STOK BULAN
No. NAMA
AWAL jan feb april mei juli Agustus Okt Des
1 Abbocath 20 63 20 50
2 Abbocath 18 20
3 Acyclovir 200 mg
4 Acyclovir 400 mg 794 200
6 acyclovir cream 189 25 50
7 Air raksa dental use
8 Alat suntik sekali pakai 1 ml 340 200 100
9 Alat suntik sekali pakai 0,5 ml 20 100
10 Alat suntik sekali pakai 2,5 ml 255 100
11 Alat suntik sekali pakai 3 ml 85 100 100 100
12 Alat suntik sekali pakai 5 ml 120 100
13 Albendazol tablet 400 mg
14 ALBOTIL 2 3 3 2
15 Alopurinol tablet 100 mg 72 700 700 500 2000
16 Aminofillin tablet 200 mg
17 Aminofillin injeksi 20 mg/ml - 10 ml
18 Amitriptillin hcl tablet salut 25 mg
19 Amoxicillin sirup kering 125 mg/5ml 172 360 180 240
20 Amoxicillin kaplet 500 mg ( kimoxil ) 7,971 7000 7000 7000
21 Ampicillin kaplet 500 mg
22 Ampicillin sirup kering 125 mg/5ml
23 Amlodipine 5 mg 150 90 600 150 120 600 1200
24 Antalgin ( metampiron ) Novaron 500 mg 4,644
25 Antasida doen syrup, kombinasi 20 100 50 50
26 Antasida doen tablet, kombinasi 7,670 7000
27 Antibakteri doen salep kombinasi( Bacitracin ) 110 100 100
28 Antihemoroid doen kombinasi 50 50 30 100
29 Antifungi doen kombinasi 13
30 Antimigrain doen kombinasi(Ergotamin Kafein) 300 500 500
31 Aqua proinjeksi steril,bebas pirogen 6 30
32 Aquades steril
34 Asam askorbat(vit C) tablet 50 mg 973 3000 5000 5000
35 Asam Mefenamat tablet 500 mg (novastan) 14,820 2000 1000 3000
36 Asam klorida 0,1 n
37 Asam sulfasalisilat 20 %
38 Betahistin 150 210
39 Benzatin benzil penisillin inj.2,4 juta iu/vial
40 Bioplacenton salep 3 5 3
41 Betametason krim 0,1 % 212 100 144 200 200
42 Bisturi 100 100
43 Catgut/benang bedah no.2/0-3/0(plain % Chromic) 48 72 24 24
44 Captopril 12,5 mg 401 600
45 Captopril 25 mg 155 2000 400 3000 2000
46 Cefadroksil 500 mg 500 500 500
47 Cetrizin 21 90 100 150 200
48 Ciprofloksasin 500 mg 500 2000 1000 2000 3000
49 Darplex - 5 box
50 Cimetidin 2000
51 Deksametason inj 5mg/ml -1 ml 92
52 Deksametason tablet 0,5 mg 18,814 2000 6000
53 Dektran 70 - larutan infus 6 % steril
54 Dektrometorfan hbr sirup 10 mg/5ml 90
55 Dektrometorfan hbr tablet 15 mg 2,550 3000
56 Devitalisasi Pasta ( non Arsem )
57 Diazepam inj 5mg/ml - 2ml
58 Diazepam tab 2 mg 565 1000
59 Dietilkarbamazin sitrat tablet 100 mg
60 Difenhidramin hcl inj 10 mg/ml - 1ml
61 Digoksin tablet 0,25 mg
62 Doxicyclin 100 mg 6,508
63 Efedrin hcl tablet 25 mg 856 500 1000 1500 1000
64 Ekstrak belladon tablet 10 mg
65 Epineprin hcl/bitartratn (adrenalin) inj.0.1%-1ml
66 Etakridin ( rivanol ) larutan 0,1 % 4
67 Etanol 70%( Alkohol ) 4 3 8 5 3
68 Eritromycin 500 mg 200
69 Etil klorida semprot - 4 3 2
70 Euginol Cairan
71 Fenitoin natrium inj 50 mg/ml
72 Fanitoin natrium kapsul 100 mg
73 Fenitoin natrium kapsul 30 mg
74 Fenobarbital injeksi 50mg/ml - 2ml
75 Fenobarbital tablet 100 mg
76 Fenobarbital tablet 30 mg 1,217
77 Fenoksimetil penisillina tablet 500 mg
78 Fenol Gliserol tts telinga 10 %
79 Fitominadion ( vit k ) inj 10 mg/ml - 1ml 4 150 60
80 Fitominadion ( vit k ) tablet salut 10 mg 300
81 Fletser cairan dan serbuk
82 Furosemid tablet 40 mg 500
83 Gameksan Emulsi 1 %
84 Garam Oralit 1000 ml air
85 Garam Oralit 200 ml air 278 500 300 500 500 1200
86 Gentian violet larutan 1 %
87 Gentamicin zalf kulit 30
88 Glibenklamid tablet 5 mg 1000 1000 200 500
89 Gliseril guayakolat tablet 100 mg 11,826 2,000 10,000 15,000
90 Gliserin
91 Glukosa larutan infus 10 %
92 Glukosa larutan infus 5 %
93 Griseofulvin tab 125 mg, micronized 461 600 1000 600
94 Haloperidol tablet 0,5 mg
95 Haloperidol tablet 1,5 mg
96 Hand scound No.7,5 200 100 100
97 Hidroklorotiazid( hct ) tablet 25 mg 2,100 2000 1000 1000 1000
98 Hidrokortison cream 2,5 mg 211 96 96 96
99 Ibuprofen tablet 200 mg 200 500 200 300 1000
100 Ibuprofen tablet 400 mg 2,339 3000 500 2000 3000
101 Infusien set anak
102 Infusien set dewasa 40
103 Insulin reguler inj 40 iu/ml - 10 ml (human)
104 Iodial Kapsul lunak
105 Ipeka sirup 0,14 %
106 Isoniazid tablet 100 mg
107 Isoniazid tablet 300 mg
108 Isosorbid dinitrat tablet sublingual 5 mg 60
109 jarum jahit 12
110 Kalium permanganat serbuk 24
111 Ketokenazole krim 25
112 Kalsium laktat ( Kalk ) tablet 500mg 5,899 1000 1000 3000 2000
113 Kapas berlemak 500 gram
114 Kapas pembalut/absorben 250 gram 6 10 3 5 10 15
115 Karbamazin tablet 200 mg
116 Kasa pembalut 3,6 x 10 cm 200 100 200 100
117 Kasa Pembalut 2m x 80 cm 1
118 Kasa pembalut hidrofil 4m x 15 cm
119 Kasa Steril 10 10 15 1 20
120 Kasa Pembalut hidrofil 40m x 80 cm
121 Kloramfenikol kapsul 250 mg 2,483 1000 3000
122 Kloramfenikol salep mata 1 % 8 24 48
123 Kloramfenikol tetes telinga 3 %
124 Kloramfenikol tetes Mata 3
125 Klorfeniramin maleat (ctm) tablet 4 mg 15,053 3,000 2,000 15,000 15,000
126 Kloroquin fosfat tablet 250 mg
127 Klorpromazin hcl tablet salut 25 mg
128 Klopropamid tablet 100 mg
129 Kodein hcl tablet 10 mg
130 Kombinasi pirimetamin 25 mg+Sulfadoksin 500mg
131 Kotrimoksasol pediatrik tablet
132 Kotrimoksasol suspensi 231 100 50 250 100
133 Kotrimoksasol dewasa 480 mg tablet 8,614 1000 500 1500 500 1000
134 Kuinin dihidrokklorida inj 25 % -2ml
135 Kuinin sulfat tablet 222 mg ( 7 h2o )
136 Larutan Benedict
137 Larutan eosin 2%
138 Larutan etanol asam
139 Larutan giemsa stain
140 Larutan Karbol fuksin
141 Larutan metilen biru
142 Loratadine 250
143 Lidokain kompositum injeksi 120 240 60
144 Lidokain 2% 100 100
145 Magnesium sulfat injeksi ( iv ) 20 % - 25 ml
146 Magnesium sulfat injeksi ( iv ) 40 % - 25 ml
147 Masker 40 100 300 200 200 80
148 Metilergometrin maleat tablet salut 0,125 mg 1 1000 1000
149 Metilergometrin maleat injeksi 0,200 mg - 1 ml 60 120
150 Metronidazol tablet 250 mg 729 500 500
152 Metformin Hcl 500 mg
153 Metoklopramide 690 700 500 600 1000
154 Miconazol 88 48 48 48 86
155 Natrium, bikarbonat tablet 500 mg
156 Natrium diclofenac 249 1500 1000 1000 3000
157 Natrium klorida larutan infus 0,9 % steril 19 20
158 Nodiar 44 300 200 500 200 600
159 Nistatin 100.000 iu/g tablet vaginal 253 200 300
160 Obat antituberkolosis kategori 1 7 10 10 10 10
161 Obat antituberkolosis kategori 2
162 Obat antituberkolosis kategori 3
163 Obat antituberkolosis kategori anak
Obat antituberkolosis kategori sisipan 1
164 Omeprazole 150
165 Obat batuk hitam ( OBH ) cairan 78 10 24
166 Oksitetrasiklin hcl salep kulit 3 % 115 200 100 100 144
167 Oksitatrasiklin hcl salep mata 43 50 100 100
168 Oksitosin inj 10 iu/ml - 1 ml 20 50 10 150 100
169 Papaverin 1,140
170 Paracetamol sirup 120 mg/5 ml 226 180 50 200 100 400
171 Paracetamol 500 mg 15,264 7,000 1,000 9,000 10,000 20,000
172 Pirantel Pamoat Tablet 125 mg 275 100 200 100
173 Piridoksin hcl tablet 10 mg 3000 1000 2000
174 Piroxikam 698 2000 1000 2000 1500
175 Plester 5 yard x 2 inch 4 6 12 6 6
176 Pot Sputum 100 100 200 200
177 Prednison tablet 5 mg 2,357 5000
178 Primakuin tablet 15 mg 933
179 Procurma syrup 11 100 50 100
180 Propiltiourasiltablet 100 mg 200
181 Propranolol hcl tablet 40 mg 200
182 Ranitidin 1000 500 1000 2000 2000
183 Reserpin tablet 0,10 mg
184 Reserpin tablet 0,25 mg
185 Retinol (vitamin A) kapsul 100.000 iu 100 700 700
186 Retinol (vitamin A) kapsul 200.000 iu 100 2500 500
187 Ringer laktat larutan infus steril 60 40 20
188 Salbutamol tablet 4 mg 527 800 500 1000
189 Salep 2-4 kombinasi 38
190 Salisil bedak 2 % 6 20 50 50 20
191 Salbutamol tablet 2 mg 300 300 500 500
192 Stesolit 8 5 10 10
193 Simvastatin 150 90 300 300 450 180 300
194 Supralivron 1500 1500 1500 1500 3000
195 Silk (benang bedah sutera) no.3/0 36
196 Siver amalgam serbuk 65-75 %
197 Suspensi seng insulin inj. 40 iu/ml - 10 ml (human)
198 Tablet tambah darah kombinasi 2,350
199 Tetrakain hcl tetes mata
200 Tetrasiklin hcl kapsul 250 mg
201 Tetrasiklin hcl kapsul 500 mg 290
202 Thiamin hcl (vit b1) inj.100 mg/ml - 1ml
203 Thiamin hcl mononitrat (vit b1 tablet 50 mg 3,788
204 Thiamphenicol 500 mg 200
205 Tiopental natrium serbuk inj 1000 mg/amp
206 Vaksin rabies vero
207 Vitamin B komplek tablet 3,283 10000 10000 10000 12000
208 Yodium povidon larutan 10 % 30 ml 2 6 6 12
209 Yodium povidon larutan 10 % 300 ml 2 3 6 6 2
210 Yodium povidon larutan 10 % 60 ml 2 6 6
211 Zink Disposibe 3,390
212 Slide 5 box
213 Spritus 1 liter
Rockles 1
214 Jarum Sambung & Benang side 23
215 Jarum jahit kulit sedang 12
216 Domperidone syrup 50 50
217 Asam Folat 200
218 Biolisin syrup 180 200 50
219 Lodia 300 300
220 Vitamin B12 Injeksi 100
221 Bromhexin 600 500 3000
222 Metil Prednisolon 500 500 1000
223 Formoksazole 1
Catgut 3_0 12
Total
Penerimaan
70
20
-
200
75
-
300
100
100
300
100
-
8
3,900
-
-
-
780
21,000
-
-
2,910
-
200
7,000
200
230
-
1,000
30
-
-
13,000
6,000
-
-
360
-
8
644
200
120
600
7,400
1,500
540
8,000
-
2,000
-
8,000
-
-
3,000
-
-
1,000
-
-
-
-
4,000
-
-
-
19
200
9
-
-
-
-
-
-
-
-
-
210
300
-
500
-
-
3,000
-
30
2,700
27,000
-
-
-
2,200
-
-
400
5,000
288
2,000
8,500
-
-
-
-
-
-
-
60
12
24
25
7,000
-
43
-
600
-
-
46
-
4,000
80
-
3
35,000
-
-
-
-
-
-
500
4,500
-
-
-
-
-
-
-
-
250
420
200
-
-
880
2,000
180
1,000
1,000
-
2,800
230
-
6,500
20
1,800
500
40
-
-
-
-
150
34
544
250
310
-
930
47,000
400
6,000
6,500
30
500
5,000
-
250
200
200
6,500
-
-
1,400
3,000
60
2,300
-
140
1,600
25
1,770
9,000
36
-
-
-
-
-
-
-
-
200
-
-
42,000
24
17
12
-
-
-
100
200
430
600
100
4,100
2,000
-
LPLPO
KODE PUSKESMAS 7 7
4 4
7 3
7 3
0 0
1 1
0 0
2
PUSKESMAS
KAB/KOTA : KENDARI
KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9
1 Abbocath 20 63 20 83 - 83
2 ACT/Arsuamon 1,017 0 -
4 Acyclovir 400 mg 794 200 994 424 570
6 acyclovir cream 1.2 tub 189 25 214 139 75
9 Alat suntik sekali pakai 0,5 ml 32 set 20 20 - 20
11 Alat suntik sekali pakai 3 ml 32 set 85 100 185 13 172
12 Alat suntik sekali pakai 5 ml 32 120 100 220 63 157
14 ALBOTIL 9 tab 2 3 5 1 4
19 Amoxicillin sirup kering 125 mg/5ml 23.2 btl 172 360 532 242 290
20 Amoxicillin kaplet 500 mg ( kimoxil ) tab 7,971 7000 14971 971 14,000
23 Amlodipine 5 mg tab 150 150 150
24 Antalgin ( metampiron ) Novaron 500 mg 1.2 tab 4,644 4644 4,644
25 Antasida doen syrup, kombinasi btl 20 100 120 70 50
26 Antasida doen tablet, kombinasi 25.1 tab 7,670 7000 14670 2,970 11,700
27 Antibakteri doen salep kombinasi( Bacitracin ) 18.2 tub 110 110 110
28 Antihemoroid doen kombinasi 25.3 sup 50 50 10 40
29 Antifungi doen kombinasi 18.3 pot 13 13 - 13
30 Antimigrain doen kombinasi(Ergotamin Kafein) 7.2 tab 300 500 800 400 400
31 Aqua proinjeksi steril,bebas pirogen 20.3 amp 6 6 - 6
33 Asam askorbat(vit C) tablet 250 mg 29 tab 5,919 5919 2,169 3,750
34 Asam askorbat(vit C) tablet 50 mg 29 tab 973 3000 3973 973 3,000
35 Asam Mefenamat tablet 500 mg (novastan) 31 tab 14,820 2000 16820 7,120 9,700
41 Betametason krim 0,1 % 18.4 tub 212 100 312 112 200
42 Bisturi 100 100 10 90
43 Catgut/benang bedah no.2/0-3/0(plain % Chromic) 32 sak 48 72 120 48 72
44 Captopril 12,5 mg 6,2,3 tab 401 600 1001 1,001
45 Captopril 25 mg 155 155 155
46 Cefadroksil 500 mg 500 500 400 100
47 Cetrizin 21 90 111 - 111
48 Ciprofloksasin 500 mg tab 500 2000 2500 700 1,800
49 Darplex - 5 box 5 box 1 box 4 box
50 Cimetidin tab 2000 2000 500 1,500
51 Deksametason inj 5mg/ml -1 ml 3 amp 92 92 92
54 Dektrometorfan hbr sirup 10 mg/5ml 26.2 btl 90 90 - 90
55 Dektrometorfan hbr tablet 15 mg 26.2 tab 2,550 3000 5550 2,550 3,000
58 Diazepam tab 2 mg 5 tab 565 1000 1565 195 1,370
62 Doxicyclin 100 mg 6,508 6508 508 6,000
63 Efedrin hcl tablet 25 mg 26.1 tab 856 856 856
66 Etakridin ( rivanol ) larutan 0,1 % 13.2 btl 4 4 - 4
68 Eritromycin 500 mg 2.2 btl 200 200 - 200
69 Etil klorida semprot 14.1 btl - 0 - -
76 Fenobarbital tablet 30 mg 5 tab 1,217 1217 394 823
79 Fitominadion ( vit k ) inj 10 mg/ml - 1ml 10.2 amp 4 150 154 34 120
82 Furosemid tablet 40 mg 14 tab 500 500 - 500
85 Garam Oralit 200 ml air 20.1 sak 278 500 778 8 770
88 Glibenklamid tablet 5 mg 16,1,1 tab 0 -
89 Gliseril guayakolat tablet 100 mg 26.3 tab 11,826 2,000 13826 2,826 11,000
93 Griseofulvin tab 125 mg, micronized 6.3 tab 461 600 1061 161 900
96 Hand scound No.7,5 0 - -
97 Hidroklorotiazid( hct ) tablet 25 mg 15 tab 2,100 2000 4100 3,100 1,000
98 Hidrokortison cream 2,5 mg 18.4 tub 211 96 307 187 120
99 Ibuprofen tablet 200 mg 1.2 tab 200 500 700 100 600
100 Ibuprofen tablet 400 mg 1.2 tab 2,339 3000 5339 3,039 2,300
102 Infusien set dewasa 3.2 set 40 40 - 40
105 Ipeka sirup 0,14 % 4.2 btl 0 -
108 Isosorbid dinitrat tablet sublingual 5 mg 17.1 tab 60 60 - 60
111 Kalsium hidroksida pasta 14.1 tub 0 -
112 Kalsium laktat ( Kalk ) tablet 500mg 29 tab 5,899 5899 899 5,000
114 Kapas pembalut/absorben 250 gram 32 bks 6 10 16 10 6
116 Kasa pembalut 3,6 x 10 cm 32 rol 200 200 - 200
117 Kasa Pembalut 2m x 80 cm 32 rol 1 1 - 1
119 Kasa Steril 32 rol 10 10 20 4 16
121 Kloramfenikol kapsul 250 mg 6,2,2 kap 2,483 1000 3483 733 2,750
122 Kloramfenikol salep mata 1 % 21,2,1 tub 0 -
124 Kloramfenikol tetes Mata 3 3 3
125 Klorfeniramin maleat (ctm) tablet 4 mg 3 tab 15,053 3,000 18053 9,053 9,000
132 Kotrimoksasol suspensi 6,2,2 btl 231 100 331 151 180
133 Kotrimoksasol dewasa 480 mg tablet 6,2,2 tab 8,614 1000 9614 9,014 600
143 Lidokain kompositum injeksi 14.1 amp 120 120 - 120
144 Lidokain 2% 13.2 btl 0 -
147 Masker 40 100 140 20 120
148 Metilergometrin maleat tablet salut 0,125 mg 22.1 tab 1 1000 1001 101 900
149 Metilergometrin maleat injeksi 0,200 mg - 1 ml 22.1 amp 60 60 - 60
150 Metronidazol tablet 250 mg 6,2,2 tab 729 500 1229 329 900
151 Metronidazol tablet 500 mg tab 0 -
152 Metformin Hcl 500 mg tab 0 -
153 Metoklopramide 14.1 btl 690 700 1390 490 900
154 Miconazol 14.1 btl 88 48 136 64 72
156 Natrium diclofenac 12,2,3 btl 249 1500 1749 - 1,749
158 Nodiar 4.1 amp 44 300 344 44 300
159 Nistatin 100.000 iu/g tablet vaginal 6.3 tab 253 253 - 253
160 Obat antituberkolosis kategori 1 6,2,4 pkt 7 10 17 6 11
165 Obat batuk hitam ( OBH ) cairan 2.2 tbg 78 78 78
166 Oksitetrasiklin hcl salep kulit 3 % 18.2 tub 115 200 315 165 150
167 Oksitatrasiklin hcl salep mata 21,2,2 tub 43 50 93 23 70
168 Oksitosin inj 10 iu/ml - 1 ml 22.1 amp 20 50 70 30 40
169 Papaverin 13.2 tab 1,140 1140 - 1,140
170 Paracetamol sirup 120 mg/5 ml 1.2 btl 226 180 406 218 188
171 Paracetamol 500 mg 1.2 tab 15,264 7,000 22264 11,464 10,800
172 Pirantel Pamoat Tablet 125 mg 6,1,1 tab 275 100 375 75 300
173 Piridoksin hcl tablet 10 mg 29 tab 3000 3000 - 3,000
174 Piroxikam 21,2,5 btl 698 2000 2698 1,198 1,500
175 Plester 5 yard x 2 inch 32 rol 4 6 10 2 8
177 Prednison tablet 5 mg 16.4 tab 2,357 5000 7357 2,357 5,000
178 Primakuin tablet 15 mg 6,4,2,2 tab 933 933 933
179 Procurma syrup btl 11 100 111 111 -
180 Propiltiourasiltablet 100 mg 16.3 tab 0 - -
182 Ranitidin 9 tab 1000 1000 400 600
185 Retinol (vitamin A) kapsul 100.000 iu 29 kap 100 700 800 100 700
186 Retinol (vitamin A) kapsul 200.000 iu 29 kap 100 2500 2600 100 2,500
187 Ringer laktat larutan infus steril 20.2 btl 60 40 100 22 78
188 Salbutamol tablet 4 mg 26.1 tab 527 800 1327 327 1,000
189 Salep 2-4 kombinasi 18.4 pot 38 38 38
190 Salisil bedak 2 % 18.8 ktk 6 6 - 6
191 Salbutamol tablet 2 mg 18.3 btl 300 300 200 100
192 Stesolit 14.2 set 8 8 - 8
193 Simvastatin 27.1 vial 150 150 150 -
195 Silk (benang bedah sutera) no.3/0 32 sak 36 36 - 36
198 Tablet tambah darah kombinasi 10.1 tab 2,350 2350 - 2,350
201 Tetrasiklin hcl kapsul 500 mg 6,2,2 kap 290 290 - 290
204 Thiamphenicol suspensi sirup kering btl 0 -
207 Vitamin B komplek tablet 29 tab 3,283 10000 13283 5,283 8,000
208 Yodium povidon larutan 10 % 30 ml 13.1 btl 2 2 - 2
209 Yodium povidon larutan 10 % 300 ml 13.1 btl 2 3 5 1 4
211 Zink Disposibe 3,390 3390 90 3,300
212 C-K Jet 30 G 0 -
213 Catgut 3-0 12 12 12
214 Jarum Sambung & Benang side 23 23 23
215 Jarum Jahit Kulit Sedang 12 12 12
217 Lisol 0 -
218 Pot Sputum 100 100 200 150 50
219 Urine Strip strip 1 box 1 box
220 kontrasepsi implant strip 0 -
221 Kontrasepsi injk.progestern 3 bln vial 0 -
222 Susuk Kb II 0 -
223 Euginol Cairan 0 -
224 Denturi 0 -
225 Bioplacenton salep 3 5 8 2 6
226 Formoksazole 1 1 1
227 Supralivron tab 1500 1500 400 1,100


Kepala Dinkes Kota Kendari kepala GFK Kepala Puskesmas Benu-Be
NIP. NIP. Nip. 19760916 200604 20
N DAN LEMBAR PERMINTAAN OBAT
LPLPO
Kendari, Jan-14
Bulan : 0 1
Tahun : 2 0 1 4 LB 2

KET
10 11 12 13 14 15 16 17
expire
JAMSOSTEK TOTAL
8 1426


Nip. 19760916 200604 2008 NIP. 19860613 201001 2017
LPLPO
KODE PUSKESMAS 7 7
4 4
7 3
7 3
0 0
1 1
0 0
2
PUSKESMAS
KAB/KOTA : KENDARI
KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9
1 Abbocath 20 83 83 - 83
4 Acyclovir 400 mg 570 570 50 520
6 acyclovir cream 1.2 tub 75 75 - 75
15 Alopurinol tablet 100 mg 6,1,1 tab 700 700 - 700
23 Amlodipine 5 mg tab 90 90 90
24 Antalgin ( metampiron ) Novaron 500 mg 1.2 tab 0 -
26 Antasida doen tablet, kombinasi 25.1 tab 11,700 11700 800 10,900
27 Antibakteri doen salep kombinasi( Bacitracin ) 18.2 tub 0 -
28 Antihemoroid doen kombinasi 25.3 sup 40 40 - 40
30 Antimigrain doen kombinasi(Ergotamin Kafein) 7.2 tab 400 400 100 300
33 Asam askorbat(vit C) tablet 250 mg 29 tab 3,750 3750 250 3,500
35 Asam Mefenamat tablet 500 mg (novastan) 31 tab 9,700 9700 700 9,000
41 Betametason krim 0,1 % 18.4 tub 200 200 - 200
42 Bisturi 90 90 2 88
43 Catgut/benang bedah no.2/0-3/0(plain % Chromic) 32 sak 72 72 12 60
44 Captopril 12,5 mg 6,2,3 tab 0 -
45 Captopril 25 mg 0 -
46 Cefadroksil 500 mg 100 100 100
47 Cetrizin 111 111 51 60
48 Ciprofloksasin 500 mg tab 1,800 1800 400 1,400
49 Darplex 4 box 4 box 4 box
50 Cimetidin tab 1,500 1500 200 1,300
51 Deksametason inj 5mg/ml -1 ml 3 amp 0 -
54 Dektrometorfan hbr sirup 10 mg/5ml 26.2 btl 90 90 37 53
55 Dektrometorfan hbr tablet 15 mg 26.2 tab 3,000 3000 - 3,000
58 Diazepam tab 2 mg 5 tab 1,370 1370 68 1,302
62 Doxicyclin 100 mg 6,000 6000 - 6,000
63 Efedrin hcl tablet 25 mg 26.1 tab 500 500 250 250
67 Etanol 70%( Alkohol ) 13.2 btl 5 5 2 3
69 Etil klorida semprot 14.1 btl - 0 - -
76 Fenobarbital tablet 30 mg 5 tab 823 823 - 823
79 Fitominadion ( vit k ) inj 10 mg/ml - 1ml 10.2 amp 120 120 30 90
96 Hand scound No.7,5 - 0 - -
97 Hidroklorotiazid( hct ) tablet 25 mg 15 tab 1,000 1000 2000 1,000 1,000
105 Ipeka sirup 0,14 % 4.2 btl 0 -
112 Kalsium laktat ( Kalk ) tablet 500mg 29 tab 5,000 5000 - 5,000
116 Kasa pembalut 3,6 x 10 cm 32 rol 200 200 5 195
117 Kasa Pembalut 2m x 80 cm 32 rol 1 1 - 1
119 Kasa Steril 32 rol 16 16 7 9
121 Kloramfenikol kapsul 250 mg 6,2,2 kap 2,750 2750 - 2,750
122 Kloramfenikol salep mata 1 % 21,2,1 tub 0 - -
124 Kloramfenikol tetes Mata 0 -
125 Klorfeniramin maleat (ctm) tablet 4 mg 3 tab 9,000 2,000 11000 2,000 9,000
126 Kloroquin fosfat tablet 250 mg 6,4,2,1 tab 0 - -
130 Kombinasi pirimetamin 25 mg+Sulfadoksin 500mg 6.422 tab 0 - -
132 Kotrimoksasol suspensi 6,2,2 btl 180 180 - 180
133 Kotrimoksasol dewasa 480 mg tablet 6,2,2 tab 600 500 1100 100 1,000
144 Lidokain 2% 13.2 btl 0 - -
147 Masker 120 120 20 100
149 Metilergometrin maleat injeksi 0,200 mg - 1 ml 22.1 amp 60 60 60
150 Metronidazol tablet 250 mg 6,2,2 tab 900 900 - 900
151 Metronidazol tablet 500 mg tab 0 - -
154 Miconazol 14.1 btl 72 72 - 72
156 Natrium diclofenac 12,2,3 btl 1,749 1749 499 1,250
157 Natrium klorida larutan infus 0,9 % steril 20.2 btl 18 18 - 18
158 Nodiar 4.1 amp 300 300 100 200
165 Obat batuk hitam ( OBH ) cairan 2.2 tbg 10 10 10
166 Oksitetrasiklin hcl salep kulit 3 % 18.2 tub 150 150 25 125
167 Oksitatrasiklin hcl salep mata 21,2,2 tub 70 70 5 65
168 Oksitosin inj 10 iu/ml - 1 ml 22.1 amp 40 10 50 50
169 Papaverin 13.2 tab 1,140 1140 - 1,140
172 Pirantel Pamoat Tablet 125 mg 6,1,1 tab 300 300 100 200
173 Piridoksin hcl tablet 10 mg 29 tab 3,000 3000 - 3,000
174 Piroxikam 21,2,5 btl 1,500 1500 500 1,000
177 Prednison tablet 5 mg 16.4 tab 5,000 5000 - 5,000
178 Primakuin tablet 15 mg 6,4,2,2 tab 0 -
179 Procurma syrup btl - 50 50 36 14
180 Propiltiourasiltablet 100 mg 16.3 tab - 0 - -
182 Ranitidin 9 tab 600 500 1100 600 500
186 Retinol (vitamin A) kapsul 200.000 iu 29 kap 2,500 2500 1,100 1,400
188 Salbutamol tablet 4 mg 26.1 tab 1,000 1000 - 1,000
189 Salep 2-4 kombinasi 18.4 pot 0 -
191 Salbutamol tablet 2 mg 18.3 btl 100 100 100
192 Stesolit 14.2 set 8 8 3 5
193 Simvastatin 27.1 vial - 90 90 30 60
207 Vitamin B komplek tablet 29 tab 8,000 8000 1,000 7,000
211 Zink Disposibe 3,300 3300 - 3,300
212 C-K Jet 30 G 0 -
213 Catgut 3-0 0 -
214 Jarum Sambung & Benang side 0 -
215 Jarum Jahit Kulit Sedang 0 -
217 Lisol 0 -
218 Pot Sputum 50 50 - 50
219 Urine Strip strip 1 box 1 box 1 box
220 kontrasepsi implant strip 0 -
221 Kontrasepsi injk.progestern 3 bln vial 0 -
222 Susuk Kb II 0 -
223 Euginol Cairan 0 -
224 Denturi 0 -
226 Formoksazole 0 -
227 Supralivron tab 1,100 1100 300 800


Kepala Dinkes Kota Kendari kepala GFK Kepala Puskesmas Benu-Be
NIP. NIP. Nip. 19760916 200604 20
AN DAN LEMBAR PERMINTAAN OBAT
LPLPO
Kendari, Feb-14
Bulan : 0 2
Tahun : 2 0 1 4 LB 2

KET
10 11 12 13 14 15 16 17
JAMSOSTEK TOTAL
7 1227


Nip. 19760916 200604 2008 NIP. 19860613 201001 2017
LPLPO
KODE PUSKESMAS 7 7
4 4
7 3
7 3
0 0
1 1
0 0
2
PUSKESMAS
KAB/KOTA : KENDARI
KELAS SATU STOK PENERI PERSE PEMA- SISA STOK
KODE NAMA
TERAPI AN AWAL MAAN DIAAN KAIAN STOK OPT
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9 10
1 Abbocath 20 83 83 - 83
4 Acyclovir 400 mg 520 520 - 520
12 Alat suntik sekali pakai 5 ml 32 138 138 - 138
15 Alopurinol tablet 100 mg 6,1,1 tab 700 700 300 400
23 Amlodipine 5 mg tab 0 -
26 Antasida doen tablet, kombinasi 25.1 tab 10,900 10900 700 10,200
27 Antibakteri doen salep kombinasi( Bacitracin ) 18.2 tub 0 -
28 Antihemoroid doen kombinasi 25.3 sup 40 40 - 40
31 Aqua proinjeksi steril,bebas pirogen 20.3 amp 6 6 6
35 Asam Mefenamat tablet 500 mg (novastan) 31 tab 9,000 9000 700 8,300
40 Bioplacenton salep 6 6 1 5
42 Bisturi 88 88 - 88
43 Catgut/benang bedah no.3/0(plain % Chromic) 32 sak 60 60 3 57
45 Captopril 25 mg 0 -
46 Cefadroksil 500 mg 0 -
47 Cetrizin 60 60 - 60
48 Ciprofloksasin 500 mg tab 1,400 1400 500 900
50 Cimetidin tab 1,300 1300 100 1,200
54 Dektrometorfan hbr sirup 10 mg/5ml 26.2 btl 53 53 - 53
55 Dektrometorfan hbr tablet 15 mg 26.2 tab 3,000 3000 - 3,000
62 Doxicyclin 100 mg 6,000 6000 - 6,000
63 Efedrin hcl tablet 25 mg 26.1 tab 250 250 250
69 Etil klorida semprot 14.1 btl - 0 -
76 Fenobarbital tablet 30 mg 5 tab 823 823 6 817
93 Griseofulvin tab 125 mg, micronized 6.3 tab 700 700 - 700
96 Hand scound No.7,5 - 0 -
97 Hidroklorotiazid( hct ) tablet 25 mg 15 tab 1,000 1000 - 1,000
98 Hidrokortison cream 2,5 mg 18.4 tub 72 72 - 72
99 Ibuprofen tablet 200 mg 1.2 tab 600 600 100 500
105 Ipeka sirup 0,14 % 4.2 btl 0 -
109 jarum hekting otot uk. Besar 32 set 0 -
112 Kalsium laktat ( Kalk ) tablet 500mg 29 tab 5,000 5000 1,000 4,000
117 Kasa Pembalut 2m x 80 cm 32 rol 1 1 1
121 Kloramfenikol kapsul 250 mg 6,2,2 kap 2,750 2750 1,000 1,750
122 Kloramfenikol salep mata 1 % 21,2,1 tub - 0 -
125 Klorfeniramin maleat (ctm) tablet 4 mg 3 tab 9,000 9000 3,000 6,000
126 Kloroquin fosfat tablet 250 mg 6,4,2,1 tab - 0 -
130 Kombinasi pirimetamin 25 mg+Sulfadoksin 500mg 6.422 tab - 0 -
133 Kotrimoksasol dewasa 480 mg tablet 6,2,2 tab 1,000 1000 500 500
144 Lidokain 2% 13.2 btl - 0 -
147 Masker 100 100 60 40
148 Metilergometrin maleat tablet salut 0,125 mg 22.1 tab 500 500 - 500
149 Metilergometrin maleat injeksi 0,200 mg - 1 ml 22.1 amp 0 -
151 Metronidazol tablet 500 mg tab - 0 -
154 Miconazol 14.1 btl 72 72 24 48
156 Natrium diclofenac 12,2,3 btl 1,250 1250 400 850
158 Nodiar 4.1 amp 200 200 - 200
165 Obat batuk hitam ( OBH ) cairan 2.2 tbg 0 -
168 Oksitosin inj 10 iu/ml - 1 ml 22.1 amp 0 -
169 Papaverin 13.2 tab 1,140 1140 140 1,000
170 Paracetamol sirup 120 mg/5 ml 1.2 btl 180 180 43 137
171 Paracetamol 500 mg 1.2 tab 7,700 7700 3,100 4,600
173 Piridoksin hcl tablet 10 mg 29 tab 3,000 3000 - 3,000
174 Piroxikam 21,2,5 btl 1,000 1000 400 600
175 Plester 5 yard x 2 inch 32 rol 8 8 5 3
176 Pot Sputum 50 50 50
177 Prednison tablet 5 mg 16.4 tab 5,000 5000 - 5,000
179 Procurma syrup btl 14 14 14
180 Propiltiourasiltablet 100 mg 16.3 tab - 0 -
182 Ranitidin 9 tab 500 500 300 200
185 Retinol (vitamin A) kapsul 100.000 iu 29 kap 50 50 - 50
186 Retinol (vitamin A) kapsul 200.000 iu 29 kap 1,400 1400 - 1,400
188 Salbutamol tablet 4 mg 26.1 tab 1,000 1000 200 800
191 Salbutamol tablet 2 mg 18.3 btl 0 -
192 Stesolit 14.2 set 5 5 1 4
193 Simvastatin 27.1 vial 60 60 60
194 Supralivron tab 800 800 500 300
198 Tablet tambah darah kombinasi 10.1 tab 2,350 2350 550 1,800
203 Thiamin hcl mononitrat (vit b1 tablet 50 mg 29 tab 3,000 3000 - 3,000
207 Vitamin B komplek tablet 29 tab 7,000 7000 3,000 4,000
211 Zink Disposibe 3,300 3300 200 3,100
212 C-K Jet 30 G 0 -
214 Catgut/benang bedah no.3/0 (rolll)
215 Slide
216 spritus
217 Blood Lancet
218 Pipet tetes
219 Rockles 13 ml
220 Pulveril
221 Carpule
222 Formakresol
223
224
225
226
227

Mengetahui/menyetujui yang menyerahkan Yang menerima/melapor

Kepala Dinkes Kota Kendari kepala GFK Kepala Puskesmas Benu-Benua
NIP. NIP. Nip. 19760916 200604 2008

LPLPO
KODE PUSKESMAS
KAB/KOTA : KENDARI

KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9 10
409 Diazepam tab 2 mg 5 tab 1,302 1,302 67 1,235
1605 Stesolit Rectal 5 mg 14.2 set 5 5 1 4
( dr. Rahmiyanti)
Nip. 19760916 200604 2008
AN LEMBAR PERMINTAAN OBAT
LPLPO
Kendari, Apr-14
Bulan : 0 3
Tahun : 2 0 1 4 LB 2
PERMIN- PEMBERIAN
KET
TAAN INPRES ASKES APBD LAIN JML
11 12 13 14 15 16 17
200
100
3
1000
600
500
100
30
150
1,000
1,000
500
60
1000
1,000
60
200
300
48
1,000
200
200
500
10
48
1,000
15
3000
10
15
5,000
50
1500
100
300
120
1000
500
48
1,000
200
10
100
100
150
200
9,000
200
1000
1000
12
200
300
200
1000
20
500
72
20
300
5
300
1500
10,000
6
6
6
100
1 roll
10 box
1 liter
2 box
10
1
TOTAL
1030

( dr. Rahmiyanti) ( Wahyuni Marzuki, S.Farm)

Nip. 19760916 200604 2008 NIP. 19830425 200903 2 001
BAR PERMINTAAN OBAT PSIKOTROPIKA

LPLPO
Bulan MARET Hal.1

Tahun 2014 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17
Yang menerima/melapor
Apoteker/ asisten Apoteker Penanggung Jawab
( Wahyuni Marzuki, S.Farm)

NIP. 19830425 200903 2 001
LPLPO
KODE PUSKESMAS 7 7
4 4
7 3
7 3
0 0
1 1
0 0
2
PUSKESMAS
KAB/KOTA : KENDARI
KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9 10
1 Abbocath 20 83 83 20 63
4 Acyclovir 400 mg 520 520 20 500
14 ALBOTIL 9 tab 2 3 5 - 5
23 Amlodipine 5 mg tab 600 600 210 390
26 Antasida doen tablet, kombinasi 25.1 tab 10,200 10200 1,000 9,200
35 Asam Mefenamat tablet 500 mg (novastan) 31 tab 8,300 8300 1,100 7,200
42 Bisturi 88 88 5 83
43 Catgut/benang bedah no.3/0(plain % Chromic) 32 sak 57 24 81 19 62
45 Captopril 25 mg 2000 2000 700 1,300
46 Cefadroksil 500 mg 500 500 100 400
47 Cetrizin 60 100 160 30 130
48 Ciprofloksasin 500 mg tab 900 1000 1900 500 1,400
50 Cimetidin tab 1,200 1200 - 1,200
54 Dektrometorfan hbr sirup 10 mg/5ml 26.2 btl
55 Dektrometorfan hbr tablet 15 mg 26.2 tab
62 Doxicyclin 100 mg 6,000 6000 - 6,000
69 Etil klorida semprot 14.1 btl 4 4 1 3
79 Fitominadion ( vit k ) inj 10 mg/ml - 1ml 10.2 amp 60 60 120 - 120
88 Glibenklamid tablet 5 mg 16,1,1 tab 1000 1000 400 600
96 Hand scound No.7,5 200 200 - 200
97 Hidroklorotiazid( hct ) tablet 25 mg 15 tab 1,000 1000 400 600
98 Hidrokortison cream 2,5 mg 18.4 tub 72 72 - 72
100 Ibuprofen tablet 400 mg 1.2 tab 1,300 500 1800 600 1,200
105 Ipeka sirup 0,14 % 4.2 btl 0 -
109 jarum hekting otot uk. Besar 32 set 12 12 12 -
112 Kalsium laktat ( Kalk ) tablet 500mg 29 tab 4,000 1000 5000 4,100 900
116 Kasa pembalut 3,6 x 10 cm 32 rol 190 100 290 40 250
117 Kasa Pembalut 2m x 80 cm 32 rol 0 -
119 Kasa Steril 32 rol 2 15 17 - 17
121 Kloramfenikol kapsul 250 mg 6,2,2 kap 1,750 3000 4750 750 4,000
122 Kloramfenikol salep mata 1 % 21,2,1 tub 8 8 - 8
125 Klorfeniramin maleat (ctm) tablet 4 mg 3 tab 6,000 6000 - 6,000
133 Kotrimoksasol dewasa 480 mg tablet 6,2,2 tab 500 1500 2000 - 2,000
143 Lidokain kompositum injeksi 14.1 amp 120 120 30 90
144 Lidokain 2% 13.2 btl 100 100 10 90
147 Masker 40 300 340 50 290
151 Metronidazol tablet 500 mg tab 0 -
153 Metoklopramide 14.1 btl 500 500 1000 200 800
154 Miconazol 14.1 btl 48 48 96 24 72
156 Natrium diclofenac 12,2,3 btl 850 1000 1850 250 1,600
158 Nodiar 4.1 amp 200 200 400 100 300
165 Obat batuk hitam ( OBH ) cairan 2.2 tbg 0 -
169 Papaverin 13.2 tab 1,000 1000 - 1,000
172 Pirantel Pamoat Tablet 125 mg 6,1,1 tab 200 200 400 20 380
173 Piridoksin hcl tablet 10 mg 29 tab 3,000 1000 4000 - 4,000
174 Piroxikam 21,2,5 btl 600 1000 1600 700 900
176 Pot Sputum 200 200 - 200
177 Prednison tablet 5 mg 16.4 tab 5,000 5000 100 4,900
179 Procurma syrup btl 100 100 62 38
180 Propiltiourasiltablet 100 mg 16.3 tab 0 -
181 Propranolol hcl tablet 40 mg 7.1 tab 200 200 100 100
182 Ranitidin 9 tab 200 1000 1200 200 1,000
186 Retinol (vitamin A) kapsul 200.000 iu 29 kap 1,400 1400 - 1,400
187 Ringer laktat larutan infus steril 20.2 btl 48 20 68 - 68
188 Salbutamol tablet 4 mg 26.1 tab 800 500 1300 100 1,200
190 Salisil bedak 2 % 18.8 ktk 6 20 26 - 26
192 Stesolit 14.2 set 4 5 9 1 8
193 Simvastatin 27.1 vial 300 300 150 150
194 Supralivron tab 300 1500 1800 500 1,300
203 Thiamin hcl mononitrat (vit b1 tablet 50 mg 29 tab 3,000 3000 - 3,000
204 Thiamphenicol 500 mg btl 200 200 180 20
207 Vitamin B komplek tablet 29 tab 4,000 10000 14000 3,000 11,000
210 Yodium povidon larutan 10 % 60 ml 13.1 btl 4 6 10 - 10
211 Zink Disposibe 3,100 3100 600 2,500
212 Slide 5 box 5 box 5 box
213 spritus 1 liter 1 liter 1 liter
214 Rockles 13 ml 1 1 1

JUMLAH KUNJUNGAN RESEP

NIP. NIP. Nip. 19760916 200604 2008

LPLPO
KODE PUSKESMAS
KAB/KOTA : KENDARI

KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9 10
1605 Stesolit Rectal 5 mg 14.2 set 4 5 9 1 8
( dr. Rahmiyanti)
Nip. 19760916 200604 2008
LPLPO
Kendari, Apr-14
Bulan : 0 3
Tahun : 2 0 1 4 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17
TOTAL
0

Nip. 19760916 200604 2008 NIP. 19830425 200903 2 001

LPLPO
Bulan APRIL Hal.1

Tahun 2014 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17

NIP. 19830425 200903 2 001
LPLPO
KODE PUSKESMAS 7 7
4 4
7 3
7 3
0 0
1 1
0 0
2
PUSKESMAS
KAB/KOTA : KENDARI
KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9 10
1 Abbocath 20 63 63 1 62
2 ACT/Arsuamon 1,017 - -
3 Acyclovir 200 mg 1.2 tab - -
4 Acyclovir 400 mg 500 500 50 450
7 Air raksa dental use 14.2 btl - -
8 Alat suntik sekali pakai 1 ml 32 set 208 208 - 208
13 Albendazol tablet 400 mg tab - -
14 ALBOTIL 9 tab 5 5 - 5
16 Aminofillin tablet 200 mg - -
17 Aminofillin injeksi 20 mg/ml - 10 ml 26,1 amp - -
18 Amitriptillin hcl tablet salut 25 mg 26.1 tab - -
20 Amoxicillin kaplet 500 mg ( kimoxil ) tab 7,700 7,700 2,400 5,300
21 Ampicillin kaplet 500 mg 6,2,1 kap - -
22 Ampicillin sirup kering 125 mg/5ml 6,2,1 btl - -
23 Amlodipine 5 mg tab 390 150 540 210 330
24 Antalgin ( metampiron ) Novaron 500 mg 1.2 tab - -
26 Antasida doen tablet, kombinasi 25.1 tab 9,200 9,200 900 8,300
30 Antimigrain doen kombinasi(Ergotamin Kafein) 7.2 tab 100 100 100
32 Aquades steril 30 btl - -
33 Asam askorbat(vit C) tablet 250 mg 29 tab 2,750 2,750 1,250 1,500
34 Asam askorbat(vit C) tablet 50 mg 29 tab 3,000 3,000 - 3,000
35 Asam Mefenamat tablet 500 mg (novastan) 31 tab 7,200 7,200 1,300 5,900
36 Asam klorida 0,1 n btl - -
37 Asam sulfasalisilat 20 % 31 btl - -
38 Benzatin benzil penisillin inj.1,2 juta iu/vial 6,2,1 vial - -
42 Bisturi 83 83 - 83
44 Captopril 12,5 mg 6,2,3 tab - -
45 Captopril 25 mg 1,300 400 1,700 400 1,300
46 Cefadroksil 500 mg 400 400 - 400
47 Cetrizin 130 130 100 30
48 Ciprofloksasin 500 mg tab 1,400 1,400 500 900
50 Cimetidin tab 1,200 1,200 - 1,200
51 Deksametason inj 5mg/ml -1 ml 3 amp - -
52 Deksametason tablet 0,5 mg 16.4 tab 10,900 10,900 1,500 9,400
53 Dektran 70 - larutan infus 6 % steril 11.2 btl - -
54 Dektrometorfan hbr sirup 10 mg/5ml 26.2 btl - -
55 Dektrometorfan hbr tablet 15 mg 26.2 tab - -
56 Devitalisasi Pasta ( non Arsem ) 14.1 btl - -
57 Diazepam inj 5mg/ml - 2ml 5 amp - -
59 Dietilkarbamazin sitrat tablet 100 mg 6,1,2 tab - -
60 Difenhidramin hcl inj 10 mg/ml - 1ml 3 amp - -
61 Digoksin tablet 0,25 mg 17.5 tab - -
62 Doxicyclin 100 mg 6,000 6,000 - 6,000
64 Ekstrak belladon tablet 10 mg 25.4 tab - -
65 Epineprin hcl/bitartratn (adrenalin) inj.0.1%-1ml 3 amp - -
69 Etil klorida semprot 14.1 btl 3 3 - 3
70 Euginol Cairan 14.1 btl - -
71 Fenitoin natrium inj 50 mg/ml 5 amp - -
72 Fanitoin natrium kapsul 100 mg 5 kap - -
73 Fenitoin natrium kapsul 30 mg 5 kap - -
74 Fenobarbital injeksi 50mg/ml - 2ml 5 amp - -
75 Fenobarbital tablet 100 mg 5 tab - -
77 Fenoksimetil penisillina tablet 500 mg 6,2,1 tab - -
78 Fenol Gliserol tts telinga 10 % 28.2 btl - -
80 Fitominadion ( vit k ) tablet salut 10 mg 10.2 tab - -
81 Fletser cairan dan serbuk - -
83 Gameksan Emulsi 1 % 18.5 btl - -
84 Garam Oralit 1000 ml air 20.1 sak - -
86 Gentian violet larutan 1 % 14.2 btl - -
87 Glass Ionomer cement (qc ix) 14.1 set - -
89 Gliseril guayakolat tablet 100 mg 26.3 tab 6,000 6,000 2,000 4,000
90 Gliserin 25.6 btl - -
91 Glukosa larutan infus 10 % 20.2 btl - -
94 Haloperidol tablet 0,5 mg 23.4 tab - -
96 Hand scound No.7,5 200 200 - 200
97 Hidroklorotiazid( hct ) tablet 25 mg 15 tab 600 600 300 300
100 Ibuprofen tablet 400 mg 1.2 tab 1,200 1,200 600 600
101 Infusien set anak 3.2 set - -
103 Insulin reguler inj 40 iu/ml - 10 ml (human) 16,1,2 amp - -
104 Iodial Kapsul lunak 16.3 kap - -
105 Ipeka sirup 0,14 % 4.2 btl - -
106 Isoniazid tablet 100 mg 6,2,4 tab - -
109 jarum hekting otot uk. Besar 32 set - - -
110 Kalium permanganat serbuk 13.1 btl - -
111 Kalsium hidroksida pasta 14.1 tub - -
112 Kalsium laktat ( Kalk ) tablet 500mg 29 tab 900 1000 1,900 600 1,300
113 Kapas berlemak 500 gram 32 bks - -
115 Karbamazin tablet 200 mg 5 rol - -
117 Kasa Pembalut 2m x 80 cm 32 rol - -
118 Kasa pembalut hidrofil 4m x 15 cm 32 rol - -
119 Kasa Steril 32 rol 17 17 1 16
120 Kasa Pembalut hidrofil 40m x 80 cm 32 rol - -
121 Kloramfenikol kapsul 250 mg 6,2,2 kap 4,000 4,000 - 4,000
123 Kloramfenikol tetes telinga 3 % 28.1 btl - -
124 Kloramfenikol tetes Mata - -
125 Klorfeniramin maleat (ctm) tablet 4 mg 3 tab 6,000 6,000 6,000
126 Kloroquin fosfat tablet 250 mg 6,4,2,1 tab - -
127 Klorpromazin hcl tablet salut 25 mg 23.4 tab - -
128 Klopropamid tablet 100 mg 16,1,1 tab - -
129 Kodein hcl tablet 10 mg 26.2 tab - -
130 Kombinasi pirimetamin 25 mg+Sulfadoksin 500mg 6.422 tab - -
131 Kotrimoksasol pediatrik tablet 6,2,2 tab - -
133 Kotrimoksasol dewasa 480 mg tablet 6,2,2 tab 2,000 2,000 100 1,900
134 Kuinin dihidrokklorida inj 25 % -2ml 6,4,2,2 amp - -
135 Kuinin sulfat tablet 222 mg ( 7 h2o ) 64,2,2 tab - -
136 Larutan Benedict 31 btl - -
137 Larutan eosin 2% 31 btl - -
138 Larutan etanol asam 31 btl - -
139 Larutan giemsa stain 31 btl - -
140 Larutan Karbol fuksin 31 btl - -
141 Larutan metilen biru 31 btl - -
142 Larutan turk 31 btl - -
144 Lidokain 2% 13.2 btl 90 90 30 60
145 Magnesium sulfat injeksi ( iv ) 20 % - 25 ml 5 amp - -
147 Masker 290 290 70 220
151 Metronidazol tablet 500 mg tab - -
152 Metformin Hcl 500 mg tab - -
154 Miconazol 14.1 btl 72 72 - 72
155 Natrium, bikarbonat tablet 500 mg 4.1 tab - -
156 Natrium diclofenac 12,2,3 btl 1,600 1,600 400 1,200
158 Nodiar 4.1 amp 300 300 - 300
161 Obat antituberkolosis kategori 2 6,2,4 pkt - -
163 Obat antituberkolosis kategori anak 6,2,4 pkt - -
165 Obat batuk hitam ( OBH ) cairan 2.2 tbg - -
167 Oksitatrasiklin hcl salep mata 21,2,2 tub 50 50 50
169 Papaverin 13.2 tab 1,000 1,000 - 1,000
171 Paracetamol 500 mg 1.2 tab 8,600 8,600 2,900 5,700
173 Piridoksin hcl tablet 10 mg 29 tab 4,000 4,000 - 4,000
174 Piroxikam 21,2,5 btl 900 900 500 400
176 Pot Sputum 200 200 - 200
177 Prednison tablet 5 mg 16.4 tab 4,900 4,900 300 4,600
178 Primakuin tablet 15 mg 6,4,2,2 tab - -
179 Procurma syrup btl 38 38 38
180 Propiltiourasiltablet 100 mg 16.3 tab - -
181 Propranolol hcl tablet 40 mg 7.1 tab 100 100 - 100
182 Ranitidin 9 tab 1,000 1,000 600 400
183 Reserpin tablet 0,10 mg 17.3 tab - -
186 Retinol (vitamin A) kapsul 200.000 iu 29 kap 1,400 1,400 - 1,400
188 Salbutamol tablet 4 mg 26.1 tab 1,200 1,200 100 1,100
189 Salep 2-4 kombinasi 18.4 pot - -
191 Salbutamol tablet 2 mg 18.3 btl 200 200 - 200
192 Stesolit 14.2 set 8 8 3 5
193 Simvastatin 27.1 vial 150 300 450 210 240
194 Supralivron tab 1,300 1,300 300 1,000
195 Silk (benang bedah sutera) no.3/0 32 sak 36 36 6 30
196 Siver amalgam serbuk 65-75 % 14.1 btl - -
197 Suspensi seng insulin inj. 40 iu/ml - 10 ml (human) 16,1,2 vial - -
198 Tablet tambah darah kombinasi 10.1 tab 1,800 1,800 600 1,200
199 Tetrakain hcl tetes mata 21.2 btl - -
200 Tetrasiklin hcl kapsul 250 mg 6,2,2 kap - -
202 Thiamin hcl (vit b1) inj.100 mg/ml - 1ml 29 amp - -
203 Thiamin hcl mononitrat (vit b1 tablet 50 mg 29 tab 3,000 3,000 - 3,000
204 Thiamphenicol 500 mg btl 200 200 - 200
205 Tiopental natrium serbuk inj 1000 mg/amp 2.2 amp - -
206 Urine Strip strip 1 box 1 BOX 1 box
207 Vitamin B komplek tablet 29 tab 11,000 11,000 3,000 8,000
211 Zink Disposibe 2,500 2,500 - 2,500
212 Slide 5 box 5 BOX 5 box
213 spritus
214 Rockles 13 ml


NIP. NIP. Nip. 19760916 200604 2008

LPLPO
KODE PUSKESMAS
KAB/KOTA : KENDARI

KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9 10
( dr. Rahmiyanti)
Nip. 19760916 200604 2008
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN TAMBAHAN OBAT
KODE PUSKESMAS 7 7
4 4
7 3
7 3
0 0
1 1
0 0
2
PUSKESMAS
KAB/KOTA : KENDARI

KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9 10
1 Amlodipine 5 mg tab 390 150 540 210 330
2 Captopril 25 mg 1,300 400 1,700 400 1,300

NIP. NIP. Nip. 19760916 200604 2008
LPLPO
Kendari, Jun-14
Bulan : 0 5
Tahun : 2 0 1 4 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17
EXPIRE
TOTAL
0

Nip. 19760916 200604 2008 NIP. 19830425 200903 2 001

LPLPO
Bulan MEI Hal.1

Tahun 2014 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17

NIP. 19830425 200903 2 001
MBAR PERMINTAAN TAMBAHAN OBAT
Kendari, May-14
Bulan : 0 5
Tahun : 2 0 1 4 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17


Nip. 19760916 200604 2008 NIP. 19830425 200903 2 001
LPLPO
KODE PUSKESMAS 7 7
4 4
7 3
7 3
0 0
1 1
0 0
2
PUSKESMAS
KAB/KOTA : KENDARI
KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9 10
1 Abbocath 20 62 62 - 62
4 Acyclovir 400 mg 450 450 80 370
28 Antihemoroid doen kombinasi 25.3 sup 14 14 14 -
30 Antimigrain doen kombinasi(Ergotamin Kafein) 7.2 tab - -
33 Asam askorbat(vit C) tablet 250 mg 29 tab 1,500 1,500 1,500 -
42 Bisturi 83 83 14 69
43 Catgut/benang bedah no.3/0(plain % Chromic) 32 sak 35 35 - 35
45 Captopril 25 mg 1,300 1,300 700 600
46 Cefadroksil 500 mg 400 400 200 200
47 Cetrizin 30 30 - 30
48 Ciprofloksasin 500 mg tab 900 900 800 100
49 Darplex 4 box 4 box - 4 box
50 Cimetidin tab 1,200 1,200 200 1,000
58 Diazepam tab 2 mg 5 tab 1,103 1,103 303 800
62 Doxicyclin 100 mg 6,000 6,000 - 6,000
63 Efedrin hcl tablet 25 mg 26.1 tab 500 500 500 -
67 Etanol 70%( Alkohol ) 13.2 btl 5 5 - 5
68 Eritromycin 500 mg 2.2 btl 200 200 100 100
85 Garam Oralit 200 ml air 20.1 sak 100 100 100 -
93 Griseofulvin tab 125 mg, micronized 6.3 tab 200 200 200
96 Hand scound No.7,5 200 200 180 20
97 Hidroklorotiazid( hct ) tablet 25 mg 15 tab 300 300 300
100 Ibuprofen tablet 400 mg 1.2 tab 600 600 600 -
105 Ipeka sirup 0,14 % 4.2 btl - -
108 Isosorbid dinitrat tablet sublingual 5 mg 17.1 tab 60 60 60
109 jarum hekting otot uk. Besar 32 set - -
112 Kalsium laktat ( Kalk ) tablet 500mg 29 tab 1,300 1,300 1,000 300
121 Kloramfenikol kapsul 250 mg 6,2,2 kap 4,000 4,000 1,250 2,750
122 Kloramfenikol salep mata 1 % 21,2,1 tub 8 8 8 -
125 Klorfeniramin maleat (ctm) tablet 4 mg 3 tab - -
132 Kotrimoksasol suspensi 6,2,2 btl 59 59 59 -
143 Lidokain kompositum injeksi 14.1 amp 60 60 60 -
144 Lidokain 2% 13.2 btl 60 60 20 40
147 Masker 220 220 80 140
148 Metilergometrin maleat tablet salut 0,125 mg 22.1 tab 300 300 300 -
154 Miconazol 14.1 btl 72 72 24 48
156 Natrium diclofenac 12,2,3 btl 1,200 1,200 500 700
158 Nodiar 4.1 amp 300 300 200 100
167 Oksitatrasiklin hcl salep mata 21,2,2 tub - -
169 Papaverin 13.2 tab 1,000 1,000 - 1,000
173 Piridoksin hcl tablet 10 mg 29 tab 4,000 4,000 1,000 3,000
174 Piroxikam 21,2,5 btl 400 400 400 -
176 Pot Sputum 200 200 - 200
179 Procurma syrup btl - -
182 Ranitidin 9 tab 400 400 400 -
188 Salbutamol tablet 4 mg 26.1 tab 1,100 1,100 300 800
192 Stesolit 14.2 set 5 5 - 5
193 Simvastatin 27.1 vial 240 240 240 -
194 Supralivron tab 1,000 1,000 500 500
198 Tablet tambah darah kombinasi 10.1 tab 1,200 1,200 - 1,200
201 Tetrasiklin hcl kapsul 500 mg 6,2,2 kap 290 290 90 200
206 Urine Strip strip 1 box 1 BOX - 1 box
211 Zink Disposibe 2,500 2,500 200 2,300
212 Slide 5 box 5 BOX - 5 box


NIP. NIP. Nip. 19760916 200604 2008

LPLPO
KODE PUSKESMAS
KAB/KOTA : KENDARI

KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9 10
( dr. Rahmiyanti)
Nip. 19760916 200604 2008
LPLPO
Kendari, Jul-14
Bulan : 0 6
Tahun : 2 0 1 4 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17
50 EXPIRE
100
100
100
100
1500
200
7,000
1200
500
50
50
50
500
EXPIRE
5,000
1,000
100
100
24
3,000
150
2000
2,000
1,500
10
200
500
48
1,500
10,000
1000
100
1000
48
300
2,000
48
3,000
10
200
2
10
25
15,000
250
500
240
200
1,000
600
48
1,000
500
200
10
100
100
100
100
100
10,000
100
2000
2000
6
300
2000
700
1000
48
50
500
5
1200
1500
10,000
6
4
TOTAL
0

Nip. 19760916 200604 2008 NIP. 19830425 200903 2 001

LPLPO
Bulan MEI Hal.1

Tahun 2014 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17

NIP. 19830425 200903 2 001
LPLPO
KODE PUSKESMAS 7 7
4 4
7 3
7 3
0 0
1 1
0 0
2
PUSKESMAS
KAB/KOTA : KENDARI
KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9 10
1 Abbocath 20 62 62 - 62
4 Acyclovir 400 mg 450 450 - 450
6 acyclovir cream 1.2 tub 75 75 75
9 Alat suntik sekali pakai 0,5 ml 32 set 20 20 20 -
30 Antimigrain doen kombinasi(Ergotamin Kafein) 7.2 tab - -
33 Asam askorbat(vit C) tablet 250 mg 29 tab 1,500 1,500 1,500 -
42 Bisturi 83 83 19 64
45 Captopril 25 mg 1,300 1,300 500 800
46 Cefadroksil 500 mg 400 400 - 400
47 Cetrizin 30 30 30
48 Ciprofloksasin 500 mg tab 900 900 700 200
50 Cimetidin tab 1,200 1,200 200 1,000
62 Doxicyclin 100 mg 6,000 6,000 - 6,000
85 Garam Oralit 200 ml air 20.1 sak 100 100 100
93 Griseofulvin tab 125 mg, micronized 6.3 tab 200 200 200
96 Hand scound No.7,5 200 200 45 155
97 Hidroklorotiazid( hct ) tablet 25 mg 15 tab 300 300 - 300
100 Ibuprofen tablet 400 mg 1.2 tab 600 600 600 -
105 Ipeka sirup 0,14 % 4.2 btl - -
112 Kalsium laktat ( Kalk ) tablet 500mg 29 tab 1,300 1,300 1,000 300
122 Kloramfenikol salep mata 1 % 21,2,1 tub 8 8 8
125 Klorfeniramin maleat (ctm) tablet 4 mg 3 tab - -
143 Lidokain kompositum injeksi 14.1 amp 60 60 60 -
144 Lidokain 2% 13.2 btl 60 60 20 40
147 Masker 220 220 80 140
154 Miconazol 14.1 btl 72 72 10 62
158 Nodiar 4.1 amp 300 300 200 100
167 Oksitatrasiklin hcl salep mata 21,2,2 tub - -
169 Papaverin 13.2 tab 1,000 1,000 - 1,000
174 Piroxikam 21,2,5 btl 400 400 400
176 Pot Sputum 200 200 100 100
182 Ranitidin 9 tab 400 400 400
188 Salbutamol tablet 4 mg 26.1 tab 1,100 1,100 200 900
192 Stesolit 14.2 set 5 5
194 Supralivron tab 1,000 1,000 600 400
211 Zink Disposibe 2,500 2,500 - 2,500
213 Bromhexin tablet
214 Metil Prednisolon Tablet
215 Domperidone Syrup
216 Asam Folat


NIP. NIP. Nip. 19760916 200604 2008

LPLPO
KODE PUSKESMAS
KAB/KOTA : KENDARI

KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9 10
1605 Stesolit Rectal 5 mg 14.2 set 5 5
( dr. Rahmiyanti)
Nip. 19760916 200604 2008
LPLPO
Kendari, Jul-14
Bulan : 0 6
Tahun : 2 0 1 4 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17
50 EXPIRE
100
100
100
100
1500
200
7,000
1200
500
50
50
50
500
EXPIRE
5,000
1,000
100
100
24
3,000
150
2000
2,000
1,500
10
200
500
48
1,500
10,000
1000
100
1000
48
300
2,000
48
3,000
10
200
2
10
25
15,000
250
500
240
200
1,000
600
48
1,000
500
200
10
100
100
100
100
100
10,000
100
2000
2000
6
300
2000
700
1000
48
50
500
5
1200
1500
10,000
6
4
600
500
50
200
TOTAL

Nip. 19760916 200604 2008 NIP. 19830425 200903 2 001

LPLPO
Bulan JUNI Hal.1

Tahun 2014 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17

NIP. 19830425 200903 2 001
LPLPO
KODE PUSKESMAS 7 7
4 4
7 3
7 3
0 0
1 1
0 0
2
PUSKESMAS
KAB/KOTA : KENDARI
KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9 10
1 Abbocath 20 62 62 - 62
4 Acyclovir 400 mg 450 450 100 350
9 Alat suntik sekali pakai 0,5 ml 32 set - 100 100 - 100
10 Alat suntik sekali pakai 2,5 ml 32 set 130 100 230 - 230
20 Amoxicillin kaplet 500 mg ( kimoxil ) tab 2,900 7000 9,900 1,900 8,000
28 Antihemoroid doen kombinasi 25.3 sup 2 50 52 - 52
33 Asam askorbat(vit C) tablet 250 mg 29 tab - - -
34 Asam askorbat(vit C) tablet 50 mg 29 tab 2,000 5000 7,000 1,000 6,000
35 Asam Mefenamat tablet 500 mg (novastan) 31 tab 4,400 1000 5,400 900 4,500
42 Bisturi 64 100 164 - 164
43 Catgut/benang bedah no.3/0(plain % Chromic) 32 sak 35 24 59 11 48
45 Captopril 25 mg 800 3000 3,800 400 3,400
46 Cefadroksil 500 mg 400 400 - 400
47 Cetrizin 150 150 - 150
48 Ciprofloksasin 500 mg tab 200 2000 2,200 200 2,000
50 Cimetidin tab 1,000 1,000 100 900
52 Deksametason tablet 0,5 mg 16.4 tab 7,400 2000 9,400 1,500 7,900
58 Diazepam tab 2 mg 5 tab 1,040 1,040 51 989
62 Doxicyclin 100 mg 6,000 6,000 - 6,000
63 Efedrin hcl tablet 25 mg 26.1 tab 250 1500 1,750 250 1,500
69 Etil klorida semprot 14.1 btl 2 3 5 - 5
88 Glibenklamid tablet 5 mg 16,1,1 tab 200 1000 1,200 200 1,000
89 Gliseril guayakolat tablet 100 mg 26.3 tab 1,000 10,000 11,000 2,000 9,000
93 Griseofulvin tab 125 mg, micronized 6.3 tab 1000 1,000 100 900
96 Hand scound No.7,5 155 100 255 25 230
97 Hidroklorotiazid( hct ) tablet 25 mg 15 tab 300 1000 1,300 300 1,000
98 Hidrokortison cream 2,5 mg 18.4 tub 48 96 144 - 144
100 Ibuprofen tablet 400 mg 1.2 tab - 2000 2,000 400 1,600
105 Ipeka sirup 0,14 % 4.2 btl - -
116 Kasa pembalut 3,6 x 10 cm 32 rol 50 200 250 - 250
119 Kasa Steril 32 rol 7 1 8 - 8
125 Klorfeniramin maleat (ctm) tablet 4 mg 3 tab 15,000 15,000 1,700 13,300
133 Kotrimoksasol dewasa 480 mg tablet 6,2,2 tab 1,500 500 2,000 500 1,500
143 Lidokain kompositum injeksi 14.1 amp - 240 240 - 240
144 Lidokain 2% 13.2 btl 40 40 - 40
147 Masker 140 200 340 60 280
148 Metilergometrin maleat tablet salut 0,125 mg 22.1 tab 100 1000 1,100 400 700
149 Metilergometrin maleat injeksi 0,200 mg - 1 ml 22.1 amp 120 120 30 90
153 Metoklopramide 14.1 btl 500 600 1,100 200 900
154 Miconazol 14.1 btl 62 48 110 14 96
156 Natrium diclofenac 12,2,3 btl 750 1000 1,750 750 1,000
158 Nodiar 4.1 amp 100 500 600 100 500
159 Nistatin 100.000 iu/g tablet vaginal 6.3 tab 100 200 300 - 300
168 Oksitosin inj 10 iu/ml - 1 ml 22.1 amp 50 100 150 - 150
169 Papaverin 13.2 tab 1,000 1,000 - 1,000
171 Paracetamol 500 mg 1.2 tab 2,400 10,000 12,400 3,900 8,500
172 Pirantel Pamoat Tablet 125 mg 6,1,1 tab 300 100 400 - 400
173 Piridoksin hcl tablet 10 mg 29 tab 4,000 2000 6,000 - 6,000
174 Piroxikam 21,2,5 btl 2000 2,000 300 1,700
176 Pot Sputum 100 100 - 100
182 Ranitidin 9 tab 2000 2,000 100 1,900
185 Retinol (vitamin A) kapsul 100.000 iu 29 kap 50 700 750 - 750
186 Retinol (vitamin A) kapsul 200.000 iu 29 kap 1,400 1,400 100 1,300
188 Salbutamol tablet 4 mg 26.1 tab 900 1000 1,900 - 1,900
190 Salisil bedak 2 % 18.8 ktk 10 50 60 9 51
191 Salbutamol tablet 2 mg 18.3 btl 200 500 700 100 600
192 Stesolit 14.2 set 5 10 15 14
194 Supralivron tab 400 1500 1,900 400 1,500
207 Vitamin B komplek tablet 29 tab 5,000 10000 15,000 2,000 13,000
208 Yodium povidon larutan 10 % 30 ml 13.1 btl 3 6 9 - 9
211 Zink Disposibe 2,500 2,500 300 2,200
213 Bromhexin tablet 600 600 600 -
214 Metil Prednisolon Tablet 500 500 400 100
215 Domperidone Syrup 50 50 - 50
216 Asam Folat 200 200 100 100


NIP. NIP. Nip. 19760916 200604 2008

LPLPO
KODE PUSKESMAS
KAB/KOTA : KENDARI

KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9 10
409 Diazepam tab 2 mg 5 tab 1,040 1040 51 989
( dr. Rahmiyanti)
Nip. 19760916 200604 2008
LPLPO
Kendari, Aug-14
Bulan : 0 7
Tahun : 2 0 1 4 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17
TOTAL

Nip. 19760916 200604 2008 NIP. 19860613 201001 2017

LPLPO
Bulan JULI Hal.1

Tahun 2014 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17
( Muliyani Harli,AMF)
NIP. 19860613 201001 2017
LPLPO
KODE PUSKESMAS 7 7
4 4
7 3
7 3
0 0
1 1
0 0
2
PUSKESMAS
KAB/KOTA : KENDARI
KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9 10
1 Abbocath 20 62 62 - 62
4 Acyclovir 400 mg 350 350 - 350
27 Antibakteri doen salep kombinasi( Bacitracin ) 18.2 tub 25 25 25 -
28 Antihemoroid doen kombinasi 25.3 sup 52 30 82 32 50
33 Asam askorbat(vit C) tablet 250 mg 29 tab - -
35 Asam Mefenamat tablet 500 mg (novastan) 31 tab 4,500 4,500 700 3,800
42 Bisturi 164 164 - 164
45 Captopril 25 mg 3,400 3,400 900 2,500
46 Cefadroksil 500 mg 400 400 - 400
47 Cetrizin 150 150 100 50
48 Ciprofloksasin 500 mg tab 2,000 2,000 500 1,500
50 Cimetidin tab 900 900 - 900
62 Doxicyclin 100 mg 6,000 6,000 100 5,900
63 Efedrin hcl tablet 25 mg 26.1 tab 1,500 1,500 250 1,250
69 Etil klorida semprot 14.1 btl 5 5 - 5
88 Glibenklamid tablet 5 mg 16,1,1 tab 1,000 1,000 400 600
96 Hand scound No.7,5 230 230 2 228
97 Hidroklorotiazid( hct ) tablet 25 mg 15 tab 1,000 1,000 300 700
100 Ibuprofen tablet 400 mg 1.2 tab 1,600 1,600 1,400 200
105 Ipeka sirup 0,14 % 4.2 btl - -
112 Kalsium laktat ( Kalk ) tablet 500mg 29 tab 2,800 2,800 800 2,000
116 Kasa pembalut 3,6 x 10 cm 32 rol 250 250 - 250
144 Lidokain 2% 13.2 btl 40 40 - 40
147 Masker 280 280 20 260
154 Miconazol 14.1 btl 96 96 20 76
158 Nodiar 4.1 amp 500 200 700 100 600
169 Papaverin 13.2 tab 1,000 1,000 200 800
174 Piroxikam 21,2,5 btl 1,700 1,700 400 1,300
176 Pot Sputum 100 100 50 50
180 Propiltiourasiltablet 100 mg 16.3 tab 200 200 - 200
182 Ranitidin 9 tab 1,900 1,900 - 1,900
186 Retinol (vitamin A) kapsul 200.000 iu 29 kap 1,300 1,300 650 650
187 Ringer laktat larutan infus steril 20.2 btl 40 40 - 40
192 Stesolit 14.2 set 14 14 - 14
194 Supralivron tab 1,500 1500 3,000 1,000 2,000
211 Zink Disposibe 2,200 2,200 - 2,200
212 Slide 5 box 5 BOX 5 BOX
213 Bromhexin tablet - 500 500 - 500
214 Metil Prednisolon Tablet 100 500 600 300 300
215 Domperidone Syrup 50 50 7 43
216 Asam Folat 100 100 - 100
Biolisin syrup 180 180 35 145
LODIA 300 300 - 300

NIP. NIP. Nip. 19760916 200604 2008

LPLPO
KODE PUSKESMAS
KAB/KOTA : KENDARI

KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9 10
1605 Stesolit Rectal 5 mg 14.2 set 14 14 14
( dr. Rahmiyanti)
Nip. 19760916 200604 2008
LPLPO
Kendari, Sep-14
Bulan : 0 8
Tahun : 2 0 1 4 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17
TOTAL

Nip. 19760916 200604 2008 NIP. 19860613 201001 2017

LPLPO
Bulan AGUSTUS Hal.1

Tahun 2014 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17
( Muliyani Harli,AMF)
NIP. 19860613 201001 2017
LPLPO
KODE PUSKESMAS 7 7
4 4
7 3
7 3
0 0
1 1
0 0
2
PUSKESMAS
KAB/KOTA : KENDARI
KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9 10
1 Abbocath 20 62 62 62 EXPIRE
4 Acyclovir 400 mg 350 350 30 320
25 Antasida doen syrup, kombinasi btl 108 108 - 108
26 Antasida doen tablet, kombinasi 25.1 tab 6,000 6,000 1,000 5,000
27 Antibakteri doen salep kombinasi( Bacitracin ) 18.2 tub - - -
41 Betametason krim 0,1 % 18.4 tub 190 190 - 190
42 Bisturi 164 164 5 159
45 Captopril 25 mg 2,500 2,500 700 1,800
46 Cefadroksil 500 mg 400 400 - 400
47 Cetrizin 50 50 - 50
48 Ciprofloksasin 500 mg tab 1,500 1,500 900 600
49 Darplex box 4 4 - 4
50 Cimetidin tab 900 900 100 800
62 Doxicyclin 100 mg 5,900 5,900 - 5,900
63 Efedrin hcl tablet 25 mg 26.1 tab 1,250 1,250 500 750
66 Etakridin ( rivanol ) larutan 0,1 % 13.2 btl 4 4 1 3
96 Hand scound No.7,5 228 228 28 200
99 Ibuprofen tablet 200 mg 1.2 tab 600 600 600
100 Ibuprofen tablet 400 mg 1.2 tab 200 200 200
105 Ipeka sirup 0,14 % 4.2 btl - -
112 Kalsium laktat ( Kalk ) tablet 500mg 29 tab 2,000 2,000 900 1,100
114 Kapas pembalut/absorben 250 gram 32 bks 9 9 9
121 Kloramfenikol kapsul 250 mg 6,2,2 kap 2,750 2,750 250 2,500
122 Kloramfenikol salep mata 1 % 21,2,1 tub 24 24 24
130 Kombinasi pirimetamin 25 mg+Sulfadoksin 500mg 6.422 tab 100 100 - 100
144 Lidokain 2% 13.2 btl 40 40 - 40
147 Masker 260 260 160 100
150 Metronidazol tablet 250 mg 6,2,2 tab 500 500 500
154 Miconazol 14.1 btl 76 76 28 48
156 Natrium diclofenac 12,2,3 btl 800 800 700 100
158 Nodiar 4.1 amp 600 600 200 400
164 Obat antituberkolosis kategori sisipan 26.3 btl 1 1 1
169 Papaverin 13.2 tab 800 800 300 500
171 Paracetamol 500 mg 1.2 tab 7,500 7,500 7,500 -
174 Piroxikam 21,2,5 btl 1,300 1,300 600 700
176 Pot Sputum 50 50 50
180 Propiltiourasiltablet 100 mg 16.3 tab 200 200 200
182 Ranitidin 9 tab 1,900 1,900 1,000 900
190 Salisil bedak 2 % 18.8 ktk 22 22 22
192 Stesolit 14.2 set 14 14 2 12
193 Simvastatin 27.1 vial 120 120 120
194 Supralivron tab 2,000 2,000 1,400 600
198 Tablet tambah darah kombinasi 10.1 tab 1,200 1,200 600 600
201 Tetrasiklin hcl kapsul 500 mg 6,2,2 kap 290 290 290 EXPIRE
206 Urine Strip strip 1 box 1 BOX
211 Zink Disposibe 2,200 2,200 - 2,200
212 Slide box 5 5 5
213 Bromhexin tablet 500 500 500
214 Metil Prednisolon Tablet 300 300 100 200
216 Asam Folat 100 100 - 100
LODIA 300 300 - 300

NIP. NIP. Nip. 19760916 200604 2008

LPLPO
KODE PUSKESMAS
KAB/KOTA : KENDARI

KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9 10
1605 Stesolit Rectal 5 mg 14.2 set 14 14 12
( dr. Rahmiyanti)
Nip. 19760916 200604 2008
LPLPO
Kendari, Oct-14
Bulan : 0 9
Tahun : 2 0 1 4 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17
50
2
2000
7,000
1200
100
100
5,000
3,000
3
300
1,000
2,000
500
200
3000
6,000
1,000
300
1,200
1,500
15,000
600
100
1000
96
1,000
3,000
48
3,000
15
100
20
48
20
20
15,000
100
1000
60
100
300
500
1000
1000
1,000
96
3,000
600
300
100
150
100
400
20,000
1500
6
200
100
2000
500
48
100
500
900
3000
12,000
2
6
3,000
1,000
50
300
600
TOTAL

( dr. Rahmiyanti) ( Wahyuni Marzuki, S.farm)
Nip. 19760916 200604 2008 NIP. 19830425 200903 2 001

LPLPO
Bulan Oktober Hal.1

Tahun 2014 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17
( Wahyuni Marzuki, S. Farm)

NIP. 19860613 201001 2017
LPLPO
KODE PUSKESMAS 7 7
4 4
7 3
7 3
0 0
1 1
0 0
2
PUSKESMAS
KAB/KOTA : KENDARI
KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9 10
1 Abbocath 20 50 50 - 50
2 Abbocath 18 1,017 20 20 - 20
4 Acyclovir 400 mg 320 320 - 320
14 ALBOTIL 9 tab 3 2 5 2 3
15 Alopurinol tablet 100 mg 6,1,1 tab 200 2000 2,200 200 2,000
20 Amoxicillin kaplet 500 mg ( kimoxil ) tab 3,400 7000 10,400 2,400 8,000
23 Amlodipine 5 mg tab 90 1200 1,290 180 1,110
28 Antihemoroid doen kombinasi 25.3 sup 10 100 110 26 84
34 Asam askorbat(vit C) tablet 50 mg 29 tab 4,000 5000 9,000 1,000 8,000
35 Asam Mefenamat tablet 500 mg (novastan) 31 tab 2,900 3000 5,900 1,200 4,700
38 Betahistin tablet 150 150 - 150
40 Bioplacenton salep 3 3 6 - 6
42 Bisturi 159 159 10 149
45 Captopril 25 mg 1,800 2000 3,800 700 3,100
46 Cefadroksil 500 mg 400 500 900 - 900
47 Cetrizin 50 200 250 - 250
48 Ciprofloksasin 500 mg tab 600 3000 3,600 500 3,100
52 Deksametason tablet 0,5 mg 16.4 tab 4,100 6000 10,100 2,000 8,100
62 Doxicyclin 100 mg 5,900 5,900 - 5,900
63 Efedrin hcl tablet 25 mg 26.1 tab 750 1000 1,750 750 1,000
69 Etil klorida semprot 14.1 btl 4 2 6 1 5
80 Fitominadion ( vit k ) tablet salut 10 mg 10.2 tab 300 300 30 270
85 Garam Oralit 200 ml air 20.1 sak 200 1200 1,400 100 1,300
87 Gentamicin Zalf kulit tube 30 30 2 28
89 Gliseril guayakolat tablet 100 mg 26.3 tab 3,000 15,000 18,000 3,000 15,000
93 Griseofulvin tab 125 mg, micronized 6.3 tab 500 600 1,100 100 1,000
96 Hand scound No.7,5 200 100 300 10 290
97 Hidroklorotiazid( hct ) tablet 25 mg 15 tab 400 1000 1,400 300 1,100
98 Hidrokortison cream 2,5 mg 18.4 tub 96 96 192 - 192
99 Ibuprofen tablet 200 mg 1.2 tab 1000 1,000 - 1,000
100 Ibuprofen tablet 400 mg 1.2 tab 3000 3,000 600 2,400
105 Ipeka sirup 0,14 % 4.2 btl - -
111 Ketoconazole krim tub 25 25 5 20
112 Kalsium laktat ( Kalk ) tablet 500mg 29 tab 1,100 1,100 700 400
114 Kapas pembalut/absorben 250 gram 32 bks 15 15 - 15
116 Kasa pembalut 3,6 x 10 cm 32 rol 200 100 300 50 250
119 Kasa Steril 32 rol 2 20 22 - 22
125 Klorfeniramin maleat (ctm) tablet 4 mg 3 tab 3,800 15,000 18,800 3,000 15,800
133 Kotrimoksasol dewasa 480 mg tablet 6,2,2 tab 1,000 1000 2,000 300 1,700
142 Loratadine 31 tablet 250 250 - 250
143 Lidokain kompositum injeksi 14.1 amp 180 60 240 60 180
144 Lidokain 2% 13.2 btl 40 100 140 - 140
147 Masker 100 200 300 80 220
151 Metronidazol tablet 500 mg tab 1000 1,000 400 600
153 Metoklopramide 14.1 btl 400 1000 1,400 200 1,200
154 Miconazol 14.1 btl 48 86 134 - 134
156 Natrium diclofenac 12,2,3 btl 100 3000 3,100 350 2,750
158 Nodiar 4.1 amp 400 600 1,000 100 900
159 Nistatin 100.000 iu/g tablet vaginal 6.3 tab 200 300 500 - 500
164 Omeprazole 26.3 tablet 150 150 - 150
167 Oksitatrasiklin hcl salep mata 21,2,2 tub 50 100 150 - 150
169 Papaverin 13.2 tab 500 500 - 500
171 Paracetamol 500 mg 1.2 tab - 20,000 20,000 1,400 18,600
174 Piroxikam 21,2,5 btl 700 1500 2,200 400 1,800
175 Plester 5 yard x 2 inch 32 rol 9 6 15 - 15
176 Pot Sputum 200 200 - 200
181 Propranolol hcl tablet 40 mg 7.1 tab 200 200 100 100
182 Ranitidin 9 tab 900 2000 2,900 400 2,500
186 Retinol (vitamin A) kapsul 200.000 iu 29 kap 50 500 550 50 500
191 Salbutamol tablet 2 mg 18.3 btl 400 500 900 - 900
192 Stesolit 14.2 set 12 12 2 10
193 Simvastatin 27.1 vial - -
194 Supralivron tab 600 3000 3,600 800 2,800
198 Tablet tambah darah kombinasi 10.1 tab 600 600 - 600
206 Urine Strip strip 1 BOX
207 Vitamin B komplek tablet 29 tab 6,000 12000 18,000 3,000 15,000
211 Zink Disposibe 2,200 2,200 - 2,200
212 Slide box 5 5 5
213 Bromhexin tablet 3000 3,000 100 2,900
214 Metil Prednisolon Tablet 200 1000 1,200 200 1,000
215 Domperidone Syrup 39 50 89 3 86
216 Asam Folat 100 100 - 100
Biolisin syrup 10 200 210 44 166
LODIA 300 300 600 - 600

NIP. NIP. Nip. 19760916 200604 2008

LPLPO
KODE PUSKESMAS
KAB/KOTA : KENDARI

KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9 10
( dr. Rahmiyanti)
Nip. 19760916 200604 2008
LPLPO
Kendari, Nov-14
Bulan : 1 0
Tahun : 2 0 1 4 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17
TOTAL

Nip. 19760916 200604 2008 NIP. 19830425 200903 2 001

LPLPO
Bulan Oktober Hal.1

Tahun 2014 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17

NIP. 19860613 201001 2017
LPLPO
KODE PUSKESMAS 7 7
4 4
7 3
7 3
0 0
1 1
0 0
2
PUSKESMAS
KAB/KOTA : KENDARI
KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9 10
1 Abbocath 20 50 50 20 30
2 Abbocath 18 1,017 20 20 - 20
4 Acyclovir 400 mg 320 320 60 260
15 Alopurinol tablet 100 mg 6,1,1 tab 2,000 2,000 300 1,700
23 Amlodipine 10 mg tab 1,110 1,110 330 780
38 Betahistin tablet 150 150 150
42 Bisturi 149 149 5 144
45 Captopril 25 mg 3,100 3,100 500 2,600
46 Cefadroksil 500 mg 900 900 100 800
47 Cetrizin 250 250 50 200
62 Doxicyclin 100 mg 5,900 5,900 - 5,900
63 Efedrin hcl tablet 25 mg 26.1 tab 1,000 1,000 - 1,000
80 Fitominadion ( vit k ) tablet salut 10 mg 10.2 tab 270 270 70 200
85 Garam Oralit 200 ml air 20.1 sak 1,300 1,300 200 1,100
88 Glibenklamid tablet 5 mg 16,1,1 tab - -
93 Griseofulvin tab 125 mg, micronized 6.3 tab 1,000 1,000 - 1,000
96 Hand scound No.7,5 290 290 - 290
97 Hidroklorotiazid( hct ) tablet 25 mg 15 tab 1,100 1,100 400 700
99 Ibuprofen tablet 200 mg 1.2 tab 1,000 1,000 200 800
100 Ibuprofen tablet 400 mg 1.2 tab 2,400 2,400 800 1,600
105 Ipeka sirup 0,14 % 4.2 btl - -
112 Kalsium laktat ( Kalk ) tablet 500mg 29 tab 400 400 400
114 Kapas pembalut/absorben 250 gram 32 bks 15 15 - 15
119 Kasa Steril 32 rol 22 22 2 20
121 Kloramfenikol kapsul 250 mg 6,2,2 kap 2,250 2,250 250 2,000
122 Kloramfenikol salep mata 1 % 21,2,1 tub 48 48 2 46
142 Loratadine 31 tablet 250 250 50 200
144 Lidokain 2% 13.2 btl 140 140 - 140
147 Masker 220 220 120 100
151 Metronidazol tablet 500 mg tab 600 600 100 500
153 Metoklopramide 14.1 btl 1,200 1,200 200 1,000
154 Miconazol 14.1 btl 134 134 - 134
158 Nodiar 4.1 amp 900 900 - 900
169 Papaverin 13.2 tab 500 500 - 500
174 Piroxikam 21,2,5 btl 1,800 1,800 600 1,200
176 Pot Sputum 200 200 - 200
182 Ranitidin 9 tab 2,500 2,500 500 2,000
192 Stesolit 14.2 set 10 10 3 7
194 Supralivron tab 2,800 2,800 1,100 1,700
203 Thiamin hcl mononitrat (vit b1 tablet 50 mg 29 tab 3,000 3,000 1,000 2,000
211 Zink Disposibe 2,200 2,200 - 2,200
212 Slide box 5 5 5
213 Bromhexin tablet 2,900 2,900 300 2,600
214 Metil Prednisolon Tablet 1,000 1,000 100 900
216 Asam Folat 100 100 - 100
LODIA 600 600 60 540

NIP. NIP. Nip. 19760916 200604 2008

LPLPO
KODE PUSKESMAS
KAB/KOTA : KENDARI

KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9 10
( dr. Rahmiyanti)
Nip. 19760916 200604 2008
LPLPO
KODE PUSKESMAS 7 4 7 3 0 1 0 2
KAB/KOTA : KENDARI
KODE NAMA
1 2 3 4 9 9 9 10
38 Betahistin tablet 150 150 150
88 Glibenklamid tablet 5 mg 16,1,1 tab - -
112 Kalsium laktat ( Kalk ) tablet 500mg 29 tab 400 400 400
147 Masker 220 220 120 100
192 Stesolit 14.2 set 10 10 3 7

NIP. NIP. Nip. 19760916 200604 2008
LPLPO
Kendari, Dec-14
Bulan : 1 1
Tahun : 2 0 1 4 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17
TOTAL

Nip. 19760916 200604 2008 NIP. 19830425 200903 2 001

LPLPO
Bulan November Hal.1

Tahun 2014 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17

NIP. 19860613 201001 2017
LPLPO
Kendari, /12/ 2014
Bulan : 1 22 Hal.1
Tahun : 2 0 0
1 8
6
4 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17
200
500
20
2,000
100
500
20
10
24
24
20
10
600
50


Nip. 19760916 200604 2008 NIP. 19830425 200903 2 001
LPLPO
KODE PUSKESMAS 7 7
4 4
7 3
7 3
0 0
1 1
0 0
2
PUSKESMAS
KAB/KOTA : KENDARI
KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9 10
1 Abbocath 20 30 30 - 30
2 Abbocath 18 1,017 20 20 - 20
4 Acyclovir 400 mg 260 260 40 220
9 Alat suntik sekali pakai 0,5 ml 32 set 96 96 96
15 Alopurinol tablet 100 mg 6,1,1 tab 1,700 1,700 253 1,447
38 Betahistin tablet 210 210 60 150
42 Bisturi 144 144 10 134
45 Captopril 25 mg 2,600 2,600 250 2,350
46 Cefadroksil 500 mg 800 800 - 800
47 Cetrizin 200 200 89 111
62 Doxicyclin 100 mg 5,900 5,900 - 5,900
63 Efedrin hcl tablet 25 mg 26.1 tab 1,000 1,000 250 750
80 Fitominadion ( vit k ) tablet salut 10 mg 10.2 tab 200 200 - 200
85 Garam Oralit 200 ml air 20.1 sak 1,100 1,100 200 900
93 Griseofulvin tab 125 mg, micronized 6.3 tab 1,000 1,000 160 840
96 Hand scound No.7,5 290 290 - 290
100 Ibuprofen tablet 400 mg 1.2 tab 1,600 1,600 460 1,140
105 Ipeka sirup 0,14 % 4.2 btl - -
110 Kalium permanganat serbuk 13.1 btl 24 24 14 10
112 Kalsium laktat ( Kalk ) tablet 500mg 29 tab 2000 2,000 1,000 1,000
119 Kasa Steril 32 rol 20 20 5 15
126 Kloramfenikol Syrup 6,4,2,1 tab - -
142 Loratadine 31 tablet 200 200 - 200
144 Lidokain 2% 13.2 btl 140 140 - 140
147 Masker 100 80 180 40 140
151 Metronidazol tablet 500 mg tab 500 500 300 200
153 Metoklopramide 14.1 btl 1,000 1,000 100 900
154 Miconazol 14.1 btl 134 134 14 120
157 Natrium klorida larutan infus 0,9 % steril 20.2 btl 8 20 28 3 25
158 Nodiar 4.1 amp 900 900 100 800
165 Obat batuk hitam ( OBH ) cairan 2.2 tbg 24 24 10 14
169 Papaverin 13.2 tab 500 500 - 500
173 Piridoksin hcl tablet 10 mg 29 tab 3,700 3,700 700 3,000
174 Piroxikam 21,2,5 btl 1,200 1,200 630 570
176 Pot Sputum 200 200 - 200
182 Ranitidin 9 tab 2,000 2,000 410 1,590
188 Salbutamol tablet 4 mg 26.1 tab 1,100 1,100 - 1,100
190 Salisil bedak 2 % 18.8 ktk 11 20 31 24 7
192 Stesolit 14.2 set 7 10 17 1 16
194 Supralivron tab 1,700 1,700 1,380 320
205 Thiamfenicol syrup 2.2 amp - -
211 Zink Disposibe 2,200 2,200 200 2,000
212 Slide box 5 5 5
213 Bromhexin tablet 2,600 2,600 100 2,500
214 Metil Prednisolon Tablet 900 900 - 900
215 Domperidone Syrup 75 75 - 75
216 Asam Folat 100 100 - 100
217 Biolisin syrup 80 50 130 57 73
218 LODIA 540 540 - 540
219 Vitamin B12 injeksi 100 100 - 100
BPJS Umum (KTP) TOTAL
JUMLAH KUNJUNGAN RESEP 514 531 1045

NIP. NIP. Nip. 19760916 200604 2008

LPLPO
KODE PUSKESMAS
KAB/KOTA : KENDARI

KODE NAMA
1 2 3 4 5 6 7=(5+6) 8=(7-9) 9 10
1605 Stesolit Rectal 5 mg 14.2 set 7 10 17 1 16
( dr. Rahmiyanti)
Nip. 19760916 200604 2008
LPLPO
KODE PUSKESMAS 7 4 7 3 0 1 0 2
KAB/KOTA : KENDARI
KODE NAMA
1 2 3 4 9 9 9 10
NIP. NIP. Nip. 19760916 200604 2008
LPLPO
Kendari, Dec-14
Bulan : 1 2
Tahun : 2 0 1 4 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17
200
25
200
200
100
2
500
150
7,000
900
4,000
50
50
2,000
2,500
300
10
1,000
200
5,000
750
10
200
2,000
5,000
400
1,000
2,500
48
25
2,000
20
24
24
5,000
48
100
100
300
300
1,000
1,000
300
2,000
300
48
5,000
100
1,500
100
1,000
500
1,500
20
48
80
900
3,000
100
20
500
100
200

Nip. 19760916 200604 2008 NIP. 19830425 200903 2 001

LPLPO
Bulan Desember Hal.1

Tahun 2014 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17

NIP. 19860613 201001 2017
LPLPO
Kendari, /12/ 2014
Bulan : 1 22 Hal.1
Tahun : 2 0 0
1 8
6
4 LB 2
PERMIN- PEMBERIAN
KET
11 12 13 14 15 16 17

Nip. 19760916 200604 2008 NIP. 19830425 200903 2 001

Lplpo 2014

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DAFTAR STOK OBAT PUSKESMAS BENU - BENUA

PERIODE APRIL S/D JUNI 2014

Kepala Puskesmas Benu-Benua

GRATIS ASKES ASKESKIN JAMSOSTEK

Mengetahui/menyetujui yang menyerahkan Yang menerima/melapo

STOK PERMIN- PEMBERIAN

Yang menerima/melapor Yang menerima

( dr. Rahmiyanti) ( Muliyani Harli,AMF)

GRATIS ASKES ASKESKIN JAMSOSTEK

Mengetahui/menyetujui yang menyerahkan Yang menerima/melapo

STOK PERMIN- PEMBERIAN

Yang menerima/melapor Yang menerima

( dr. Rahmiyanti) ( Muliyani Harli,AMF)

GRATIS ASKES ASKESKIN JAMSOSTEK

Mengetahui/menyetujui yang menyerahkan Yang menerima/melapo

STOK PERMIN- PEMBERIAN

Yang menerima/melapor Yang menerima

( dr. Rahmiyanti) ( Muliyani Harli,AMF)

GRATIS ASKES ASKESKIN JAMSOSTEK

Mengetahui/menyetujui yang menyerahkan Yang menerima/melapor

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT PSIKOTROPIKA

KELAS SATU STOK PENERI PERSE PEMA- SISA STOK

Kepala Puskesmas Benu-Benua

Yang menerima/melapor Yang menerima

( dr. Rahmiyanti) ( Wahyuni Marzuki, S.Farm)

BAR PERMINTAAN OBAT PSIKOTROPIKA

Bulan MARET Hal.1

( Wahyuni Marzuki, S.Farm)

GRATIS ASKES ASKESKIN JAMSOSTEK

Mengetahui/menyetujui yang menyerahkan Yang menerima/melapor

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT PSIKOTROPIKA

KELAS SATU STOK PENERI PERSE PEMA- SISA STOK

Kepala Puskesmas Benu-Benua

Yang menerima/melapor Yang menerima

BAR PERMINTAAN OBAT PSIKOTROPIKA

Bulan APRIL Hal.1

( Wahyuni Marzuki, S.Farm)

GRATIS ASKES ASKESKIN JAMSOSTEK

Mengetahui/menyetujui yang menyerahkan Yang menerima/melapor

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT PSIKOTROPIKA

KELAS SATU STOK PENERI PERSE PEMA- SISA STOK

Kepala Puskesmas Benu-Benua

KELAS SATU STOK PENERI PERSE PEMA- SISA STOK

Mengetahui/menyetujui yang menyerahkan Yang menerima/melapor

Yang menerima/melapor Yang menerima

BAR PERMINTAAN OBAT PSIKOTROPIKA

Bulan MEI Hal.1

( Wahyuni Marzuki, S.Farm)

Yang menerima/melapor Yang menerima

( dr. Rahmiyanti) ( Wahyuni Marzuki, S.Farm)

GRATIS ASKES ASKESKIN JAMSOSTEK

Mengetahui/menyetujui yang menyerahkan Yang menerima/melapor

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT PSIKOTROPIKA

KELAS SATU STOK PENERI PERSE PEMA- SISA STOK

Kepala Puskesmas Benu-Benua

Yang menerima/melapor Yang menerima

BAR PERMINTAAN OBAT PSIKOTROPIKA

Bulan MEI Hal.1

( Wahyuni Marzuki, S.Farm)

GRATIS ASKES ASKESKIN JAMSOSTEK

Mengetahui/menyetujui yang menyerahkan Yang menerima/melapor

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT PSIKOTROPIKA

KELAS SATU STOK PENERI PERSE PEMA- SISA STOK