LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN (LPLPO) SUB UNIT _______________________________________

BULAN

NAMA OBAT
NO SATUAN STOK AWAL PERMINTAAN PENERIMAAN
1 Albendasol Tablet 400 mg Tablet
2 Albendazol suspensi 200 mg/5 ml Botol
3 Alopurinol Tablet 100 mg Tablet
5 Ambroxol sirup 15 mg/ml Botol
6 Ambroxol Tablet 30 mg Tablet
7 Aminofilin Tablet 200 mg Tablet
8 Aminofilin Injeksi 24 mg/ml - 10 ML Amp
10 Amlodipin tablet 5 mg Tablet
12 Amoksisilin Sirup Kering 125 mg/5 ml Botol
13 Amoksisilin Kapsul 250 mg Tablet
14 Amoksisilin Kapsul 500 mg Tablet
15 Ampisillin sirup kering 125 mg/5ml Botol
16 Antalgin ( metampiron ) Tablet 500 mg Tablet
17 Antalgin Injeksi 250 mg/ml - 2 ml Tablet
18 Antasida DOEN Tablet Kombinasi : Tablet
19 Antasida DOEN syr Botol
20 Anti Bakteri DOEN, Salep Kombinasi Tablet
21 Antihemoroid supp Tablet
22 Antimigrain Doen Kombinasi Tablet
23 Asam Askorbat ( Vit C ) Tablet 50 mg Tablet
24 Asam Mefenamat Tablet 500 mg Tablet
25 Asam Traneksamat 500 mg Tablet
26 Asam Traneksamat injeksi 250 mg Tablet
27 Asetosal Tablet 100 mg Tablet
28 Asetosal Tablet 500 mg Tablet
29 Asiklovir Tablet 400 mg Tablet
30 Asiklovir Tablet 200 mg Tablet
31 Asiklovir Krim 5 % Tube
32 Atropin Sulfat Injeksi 0,25 mg/ml - 1 ml Tablet
33 Atropin Sulfat Tablet 0,5 mg Tablet
34 Attapulgite Pektin Tablet
35 Besi II tablet Tablet
36 Betahistin Mesilat Tablet 6 mg Tablet
37 Betametason Krim 0,1 % Tube
38 Bisacodyl 5 mg Tablet
39 Bisoprolol tablet 5mg Tablet
40 Bromheksin Tablet 8 mg Tablet
 NAMA OBAT
NO SATUAN STOK AWAL PERMINTAAN PENERIMAAN
41 Cetirizin sirup 5 mg/5 ml Botol
42 Cetirizine tablet 10 mg Tablet
43 Deksametason Inj.5 mg/ml - 1 ml Tablet
44 Deksametason Tablet 0,5 mg Tablet
47 Diazepam Inj. 5 mg/ml - 2 ml Amp
48 Diazepam Rectal 10 mg Tablet
49 Diazepam Tablet 2 mg Tablet
50 Diazepam Tablet 5 mg Tablet
51 Difenhidramin HCL Inj. 10 mg/ml - 1 ml Amp
52 Digoksin Tablet 0,25 mg Tablet
53 Diltiazem HCl Tablet 30 mg Tablet
54 Dimenhidrinat Tablet Tablet
55 Doksisiklin Kapsul 100 mg Tablet
56 Domperidon Suspensi 5 mg/ 5 ml Botol
57 Domperidon Tablet 10 mg Tablet
58 Echinacea purpurea 250mg, Zinc picolinate 10 mg tabTablet
59 Efedrin HCL Tablet 25 mg Tablet
60 Ekstrak Belladon Tablet 10 mg Tablet
61 Eritromisin Kapsul 250 mg Tablet
62 Eritromisin Tablet 500 mg Tablet
63 Eritromisin Sirup 200 mg/5 mg Tablet
64 Etambutol HCL Tablet 250 mg Tablet
65 Famotidin Tablet 20 mg Tablet
66 Fenobarbital Injeksi 50 mg/ml - 2 ml Tablet
67 Fenobarbital Tablet 100 mg Tablet
68 Fenobarbital Tablet 30 mg Tablet
69 Fenol Gliserol Tetes Telinga 10 % Tablet
70 Fitomenadion ( Vit. K 1 ) Inj. 10 mg/ml - 1 ml Amp
71 Fitomenadion ( Vit. K ) Tablet Salut 10 mg Tablet
72 Furosemid Tablet 40 mg Tablet
73 Furosemid Injeksi i.v / i.m 10 mg/ml Amp
74 Gameksan Emulsi 1 % Tablet
75 Garam Oralit 200 ml Air Sct
76 Gentamisin injeksi 40 mg/ml Amp
77 Gentamisin Salep Kulit 0,1 % Tube
78 Gentian Violet Larutan 1 % Tablet
79 Glibenklamid Tablet 5 mg Tablet
80 Glimepirid 1 mg Tablet
81 Gliseril Guayakolat Tablet 100 mg Tablet
 NAMA OBAT
NO SATUAN STOK AWAL PERMINTAAN PENERIMAAN
82 Glukosa Larutan Infus 5 % Steril (Produk lokal) Tablet
83 Griseofulvin Tablet 125 mg, Micronized Tablet
84 Haloperidol Tablet 0,5 mg Tablet
85 Haloperidol Tablet 1,5 mg Tablet
86 Haloperidol Tablet 2 mg Tablet
87 Haloperidol Tablet 5 mg Tablet
88 Haloperidol Dekanoat Injeksi Tablet
89 Haloperidol Injeksi 5 mg/ml Amp
90 Hidroklorotiazid ( HCT ) Tablet 25 mg Tablet
91 Hidrokortison Krim 2,5 % Tablet
93 Ibuprofen suspensi 100 mg/5 ml Botol
94 Ibuprofen Tablet 200 mg Tablet
95 Ibuprofen Tablet 400 mg Tablet
96 Isosorbid Dinitrat Tablet Sublingual 5 mg Tablet
97 Imipramin 25 mg tablet Tablet
98 Kalium Diklofenak Tablet 50 mg Tablet
99 Kalium Permanganat Serbuk Tablet
100 Kalsium Laktat ( Kalk ) Tablet 500 mg Tablet
101 Kaolin Pektin Sirup Botol
102 Kaptopril Tablet 12,5 mg Tablet
103 Kaptopril Tablet 25 mg Tablet
104 Kaptopril Tablet 50 mg Tablet
105 Karbamazepin Tablet 200 mg Tablet
106 Ketokonazol Tablet 200 mg Tablet
107 Ketokonazol Krim 2% Tablet
108 Klindamisin Kapsul 300 mg Tablet
109 Kloramfenikol Kapsul 250 mg Tablet
110 Kloramfenikol Suspensi 125 mg/5 ml Botol
111 Kloramfenikol Tetes Mata 0,5 % Botol
112 Kloramfenikol Salep Mata 1 % Tube
113 Kloramfenikol Tetes Telinga 3 % Botol
114 Klorfeniramin Maleat ( CTM ) Tablet 4 mg Tablet
115 Klorpromazin HCL Tablet Salut 100 mg Tablet
116 Klozapine 25 mg Tablet
117 Kodein HCl Tablet 10 mg Tablet
118 Kodein HCl Tablet 15 mg Tablet
119 Kotrimoksasol Pediatrik Tablet Tablet
120 Kotrimoksasol Suspensi Botol
121 Kotrimoksasol Dewasa Tablet Tablet
 NAMA OBAT
NO SATUAN STOK AWAL PERMINTAAN PENERIMAAN
122 Lanzoprazol kapsul/kaplet 30 mg Tablet
123 Levofloksasin Tablet 500 mg Tablet
124 Lidokain Kompositum Injeksi Amp
125 Lidokain Hcl Injeksi 2 % Amp
126 Lisinopril Tablet 5 mg Tablet
127 Loratadin Tablet 10 mg Tablet
128 Lorazepam 2 mg Tablet
129 Loperamid Tablet Tablet
130 Meloksikam Tablet 7,5 mg Tablet
131 Metil Ergometrin Maleat Tablet Salut 0,125 mg Tablet
132 Metil Ergometrin Maleat Inj. 0,200 mg - 1 ml Amp
133 Metformin HCl Tablet 500 mg Tablet
134 Metoklopramide Tablet 5 mg Tablet
135 Metoklopramide Sirup 5 mg/5ml Botol
136 Metronidasol Tablet 250 mg Tablet
137 Metronidasol Tablet 500 mg Tablet
138 Mikonazol Krim/Salep 2 % Tube
139 Multivitamin Sirup Tablet
140 Multivitamin tablet Tablet
141 Natrium Diklofenak Tablet 50 mg Tablet
142 Natrium Klorida Larutan Infus 0,9 % Steril Botol
143 Nifedipin Tablet 10 mg Tablet
144 Nistatin 100.000 IU/G Tablet Vaginal Tablet
145 Nistatin 500.000 IU Tablet Salut Tablet
146 Obat Batuk Hitam ( O.B.H ) Cairan Botol
147 Obat Flu Kombinasi (Alpara) Tablet
148 Oksitetrasiklin HCL Salep 3 % Tube
149 Oksitetrasiklin HCL Salep Mata Tube
150 Oksitosin Injeksi 10 IU/ml - 1 ml Amp
151 Omeprazol Kapsul 20 mg Tablet
152 Papaverin Tablet 40 mg Tablet
153 Papaverin Injeksi 40 mg/ml Amp
154 Parasetamol Drops Tablet
155 Parasetamol Sirup 120 mg/5 ml Tablet
156 Parasetamol Tablet 500 mg Tablet
157 Piracetam Tablet 400 mg Tablet
158 Piracetam Tablet 800 mg Tablet
159 Pirantel Pamoat Tablet 125 mg Tablet
160 Piridoksin HCL Tablet 10 mg Tablet
 NAMA OBAT
NO SATUAN STOK AWAL PERMINTAAN PENERIMAAN
161 Piroksikam Kapsul 10 mg Tablet
162 Piroksikam Tablet 20 mg Tablet
163 Polikresulen Tablet
164 Prednison Tablet 5 mg Tablet
165 Propiltiourasil Tablet 100 mg Tablet
166 Propanolol HCL Tablet 40 mg Tablet
167 Ranitidin Tablet 150 mg Tablet
168 Ringer Asetat Cairan Infus Botol
169 Ringer Laktat Larutan Infus Steril Botol
170 Risperidone Tablet 2 mg Tablet
171 Salbutamol Tablet 4 mg Tablet
172 Salep 24 Tube
173 Salisil Bedak 2 % Kotak
174 Sefadroxil Sirup Kering 125 mg/ml Tablet
175 Sefadroxil Kapsul 250 mg Tablet
176 Sefadroxil Kapsul 500 mg Tablet
177 Sianokobalamin ( Vit. B 12 ) Inj. 500 mcg/ml Amp
178 Sianokobalamin (Vit.B12) Tablet 50 mcg Tablet
179 Simetidin Tablet 200 mg Tablet
180 Simvastatin Tablet 10 mg Tablet
181 Siprofloksasin Tablet 500 mg Tablet
182 Sulfasetamid Natrium Tetes Mata 15 % Botol
183 Terbutalin tablet 2,5 mg Tablet
184 Tetrasiklin HCL Kapsul 250 mg Tablet
185 Tetrasiklin HCL Kapsul 500 mg Tablet
186 Tiamfenikol Kapsul 500 mg Tablet
187 Tiamfenikol sirup kering 125 mg / 5 ml Tablet
188 Tiamin HCL ( Vit. B1 ) Inj. 100 mg/ml - 1 ml Tablet
189 Tiamin HCL Mononitrat ( Vit B 1 ) Tablet 50 mg Tablet
190 Tramadol Injeksi 50 mg/ml Amp
191 Tramadol Kapsul 50 mg Tablet
192 Triamcinolon salep Tube
193 Triheksiphenidyl Tablet
194 Vitamin B complek Tablet
195 Yodium povidon 30 ml Botol
196 Yodium povidon 60 ml Botol
197 Yodium povidon 90 ml Botol
198 Zink tab 200 mg Tablet
199 Alat Suntik Sekali Pakai 1 ml pcs
200 Alat Suntik Sekali Pakai 2,5 ml pcs
 NAMA OBAT
NO SATUAN STOK AWAL PERMINTAAN PENERIMAAN
201 Alat Suntik Sekali Pakai 3 ml pcs
202 Alat Suntik Sekali Pakai 5 ml pcs
203 Alat Suntik Sekali Pakai 10 ml pcs
204 Catgut / Benang Bedah No. 3/0 dengan jarum bedah pcs
205 Dresing penutup luka berperekat 5cm x 5m pcs
206 Etanol (Alkohol 70%) Botol
207 Kapas Pembalut / Absorben 250 gram pcs
208 Kasa Hidrofil Steril uk. 16x16 (isi 16 lembar) pcs
209 Kasa Pembalut 2 m x 80 cm pcs
210 Kasa Pembalut Elastic 3 inchi pcs
211 Kasa Pembalut Hidrofil 4 m x 3 cm pcs
212 Kasa Pembalut Hidrofil 4 m x 5 cm pcs
213 Kasa Pembalut Hidrofil 4 m x 10 cm pcs
214 Kasa Pembalut Hidrofil 4 m x 15 cm pcs
215 Kasa Hidrofil uk. 36 m x 80 cm pcs
216 Kateter (Folley / Urine) No. 10 pcs
217 Kateter (Folley / Urine) No. 16 pcs
218 Kateter (Folley / Urine) No. 18 pcs
219 Masker pcs
220 Mess / Pisau scalpel no 11 pcs
221 Polifix 5cm X 1 m (dressing) pcs
222 Sarung Tangan Karet Obgyn Sekali Pakai Steril pcs
223 Sarung Tangan Karet Sekali Pakai S pcs
224 Sarung Tangan Karet Sekali Pakai M pcs
225 Sarung Tangan Karet Sekali Pakai L pcs
226 Silk / Benang Sutra no. 3/0 dengan Jarum Bedah pcs
227 Urine Bag pcs
228 Under Pad 60x90 Steril pcs
229 Wing Needle No. 25 G pcs

Mengetahui ,
 NAMA OBAT
NO SATUAN STOK AWAL PERMINTAAN PENERIMAAN
Kepala UPTD Puskesmas Purwoasri Penanggung Jawab Sub unit
UNIT _______________________________________

PERSEDIAAN PEMAKAIAN SISA STOK KET

PERSEDIAAN PEMAKAIAN SISA STOK KET
PERSEDIAAN PEMAKAIAN SISA STOK KET
PERSEDIAAN PEMAKAIAN SISA STOK KET
PERSEDIAAN PEMAKAIAN SISA STOK KET
PERSEDIAAN PEMAKAIAN SISA STOK KET

Kediri ,
PERSEDIAAN PEMAKAIAN SISA STOK KET
Pengelola Obat
PEMAKAIAN OBAT POSY. LANSIA BULAN _________________________________

NO NAMA OBAT JUMLAH W.TENGAH KTW MEKIKIS

1 ALLOPURINOL

2 AMOKSISILLIN 500

3 ANTALGIN

4 ANTASIDA

5 ASAM ASKORBAT

6 ASAM MEFENAMAT

7 DEKSAMETHASON

8 GLIBEN

9 IBUPROFEN 400 MG

10 KALIUM DIKLOFENAK

11 KAPTOPRIL 25MG

12 KOTRIM D

13 METRONIDAZOL 500MG

14 NADIK

15 PAPAVERIN

16 PARASETAMOL 500MG

17 PIRIDOKSIN B6

18 PIROKSIKAM 20MG

19 SALBUTAMOL

20 SIANOKOBALAMIN B12
21 THIAMIN B1

22

23

24

25

26

27
MERJOYO MRANGGEN P.DADI PESING JANTOK BULU
MUNENG