DINAS KESEHATAN KABUPATEN PURBALINGGA

RB UMMI AMANAH
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPPO-PKD)

PELAPORAN BULAN/PERIODE :
PERMINTAAN BULAN/PERIODE :

STOK PENERI PERSE PEMA SISA PERMIN PEMBE

NO NAMA OBAT SATUAN KET
AWAL MAAN DIAAN KAIAN STOK TAAN RIAN
1 Acyclovir Salf Tube
2 Acyclovir Tab Tab
3 Albendazol Tab
4 Alcohol Btl
5 Ambroxol Syrup Btl
6 Aminofilin 200 mg Tab
7 Amoxan Drop Btl
8 Amoxicillin 500 mg Tab
9 Amoxicillin syrup 12 mg/5 ml Btl
10 Antasida Tab
11 Antidiare/Omekur/Cimetidine Tab
12 Aquades Btl
13 Asam Folat 400 mcg Tab
14 Asam Mefenamat Tab
15 B6 Tab
16 Baby Cough Btl
17 Biothicol Syrup Btl
18 Bufantasid Syrup Btl
19 Burnazin Tube
20 Burraginol Tube
21 Candistatin Drop Btl
22 Caviplex Syrup Btl
23 Cefadroxil Tab
24 Ciprofloxacin Tab
25 Clindamicin Tab Tab
26 Clonidin Tab
27 Colfin Syrup Btl
28 Comtusi Syrup Btl
29 Cotrimoxazole Tab
30 Cotrimoxazole Syrup Btl
31 D5 % Flabot
32 Demacolin Tab
33 Dexametasone Inj Amp
34 Dexamethasone 0,5 mg Tab
35 Diazepam Tab
36 Dulcolac Tab Tab
37 Erlamicetin Tube
38 Fe/besi Tab
39 Fimahes Flabot
40 Fitomenadion (vit K tab) Tab
41 Fitomenadion (vit K-1) inj 2ml Amp
42 Furosemid Tab
43 Gentamicin salep kulit Tube
44 Gliceril Guayacolat 100 mg Tab
45 H-Booster Btl
46 HCL 0,1 N Btl
47 Hidrokortison krim 2,5 % Tube
48 Hystolan Tab
49 Immodium Tab
50 Kalsium laktat 500 mg Tab
51 Kaltrofen Sub
52 Ketoconazole Tab Tab
53 Ketoconazole Salp Tube
54 Klrofeniramin meleate (CTM) Tab
55 Kotrimoxazol 480 mg Tab
56 Kotrimoxazol syrup Btl
57 Lacto B Sac
58 Lidocain Amp
59 Livron B-Plex Tab
60 Metilergometrin Meleat 0,125 m Tab
61 Metronidazol Tab
62 Microlax Tube
63 Momilen Tube
64 NaCl Flabot
65 Neurosanbe Tab
66 Nifedipin Tab
67 Omeprazol Tab
68 Ondansetron Tab
69 Ondansetron Inj Amp
70 Oxytocin Amp
71 Paracetamol 500mg Tab
72 Paracetamol sirup 120 mg/5 ml Btl
73 Povidon Iodine 10 % 30 ml Btl
74 Premaston Tab
75 Regumen Tab
76 RL Tab
77 Salisil Bedak 2 % Sac
78 Sanmol Drop Btl
79 Syntocinon Amp
80 Thiamphenicol Tab
81 Thrombop Gel Tube
82 Tiamin HCl (B1) Tab
83 Tobroson Tetes Mata Tube
84 Transpulmin Tube
85 Tremenza Tab
86 Vitamin C Tab
87 Vitamin B12 inj Amp
88 Vitonal ASI Tab
89 Vitonal F Tab
90 Vitonal Lacta Tab
91 Vitonal M Tab
92 Vitonal M Syrup Btl
93 Wybert Syrup Btl
94 Zink tablet Tab

ALAT KESEHATAN

1 Cut Gut Chromic 3.0 Pcs

2 Foley Catheter 16 Pcs
3 Gluco-Protein Stick Pcs
4 Handscoon Single Use Psg
5 Handscoon Single Use Psg
6 Handscoon Streril 7 dan 8 Psg
7 Infus Set Pcs
8 IV Catheter 20 Pcs
9 Kanul Oksigen Pcs
10 Kapas pembalut 250 gram Pcs
11 Kassa Gulung 20x80 Rol
12 Kassa steril Box
13 Lancet Pcs
14 Leukomed IV Film Pcs
15 Masker Pcs
16 Mucus Ekstractor Btl
17 Needles Pcs
18 Oksigen Murni Tabung
19 Pelarut Vaksin BCG Vial
20 Pelarut Vaksin MR Vial
21 Spuit 0,05 cc Pcs
22 Spuit 0,5 cc Pcs
23 Spuit 10 cc Pcs
24 Spuit 3 cc Pcs
25 Spuit 5 cc Pcs
26 Tes Pack Pcs
27 Ultrasound Gel Can
28 Umbilical Klem Pcs
29 Vaksin BCG Vial
30 Vaksin DPT Hb Vial
31 Vaksin Hb0 Vial
32 Vaksin IPV Vial
33 Vaksin MR Vial
34 Vaksin Polio Vial
35 Vaksin Td Vial
 Cyclo
Bulan Stok Penerimaan Persediaan Pemakaian Sisa stok

Depo Neo
Bulan Stok Penerimaan Persediaan Pemakaian Sisa stok
 DINAS KESEHATAN KABUPATEN PURBALINGGA
RB UMMI AMANAH
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPPO-PKD)

PELAPORAN BULAN/PERIODE :
PERMINTAAN BULAN/PERIODE :

TANGGAL
NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
1 Acyclovir Salf
2 Acyclovir Tab
3 Albendazol
4 Alcohol
5 Ambroxol Syrup
6 Aminofilin 200 mg
7 Amoxan Drop
8 Amoxicillin 500 mg
9 Amoxicillin syrup 12 mg/5 ml
10 Antasida
11 Antidiare/Omekur/Cimetidine
12 Aquades
13 Asam Folat 400 mcg
14 Asam Mefenamat
15 B6
16 Baby Cough
17 Biothicol Syrup
18 Bufantasid Syrup
19 Burnazin
20 Burraginol
21 Candistatin Drop
22 Caviplex Syrup
23 Cefadroxil
24 Ciprofloxacin
25 Clindamicin Tab
26 Clonidin
27 Colfin Syrup
28 Comtusi Syrup
29 Cotrimoxazole
30 Cotrimoxazole Syrup
31 D5 %

TANGGAL
NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
32 Demacolin
33 Dexametasone Inj
34 Dexamethasone 0,5 mg
35 Diazepam
36 Dulcolac Tab
37 Erlamicetin
38 Fe/besi
39 Fimahes
40 Fitomenadion (vit K tab)
41 Fitomenadion (vit K-1) inj 2ml
42 Furosemid
43 Gentamicin salep kulit
44 Gliceril Guayacolat 100 mg
45 H-Booster
46 HCL 0,1 N
47 Hidrokortison krim 2,5 %
48 Hystolan
49 Immodium
50 Kalsium laktat 500 mg
51 Kaltrofen
52 Ketoconazole Tab
53 Ketoconazole Salp
54 Klrofeniramin meleate (CTM)
55 Kotrimoxazol 480 mg
56 Kotrimoxazol syrup
57 Lacto B
58 Lidocain
59 Livron B-Plex
60 Metilergometrin Meleat 0,125 m
61 Metronidazol
62 Microlax
63 Momilen
64 NaCl
65 Neurosanbe
66 Nifedipin
67 Omeprazol
68 Ondansetron
69 Ondansetron Inj

TANGGAL
NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
70 Oxytocin
71 Paracetamol 500mg
72 Paracetamol sirup 120 mg/5 ml
73 Povidon Iodine 10 % 30 ml
74 Premaston
75 Regumen
76 RL
77 Salisil Bedak 2 %
78 Sanmol Drop
79 Syntocinon
80 Thiamphenicol
81 Thrombop Gel
82 Tiamin HCl (B1)
83 Tobroson Tetes Mata
84 Transpulmin
85 Tremenza
86 Vitamin C
87 Vitamin B12 inj
88 Vitonal ASI
89 Vitonal F
90 Vitonal Lacta
91 Vitonal M
92 Vitonal M Syrup
93 Wybert Syrup
94 Zink tablet

ALAT KESEHATAN
TANGGAL
NO NAMA ALKES
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
1 Catgut Chromic 3.0
2 Foley Catheter 16
3 Gluco-Protein Stick
4 Handscoon Single Use
5 Handscoon Single Use
6 Handscoon Streril 7 dan 8
7 Infus Set
8 IV Catheter 20

TANGGAL
NO NAMA ALKES
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
9 Kanul Oksigen
10 Kapas pembalut 250 gram
11 Kassa Gulung 20x80
12 Kassa steril
13 Lancet
14 Leukomed IV Film
15 Masker
16 Mucus Ekstractor
17 Needles
18 Oksigen Murni
19 Spuit 0,05 cc
20 Spuit 0,5 cc
21 Spuit 10 cc
22 Spuit 3 cc
23 Spuit 5 cc
24 Tes Pack
25 Ultrasound Gel
26 Umbilical Klem
 VAKSIN
TANGGAL
NO NAMA VAKSIN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
1 Pelarut Vaksin BCG
2 Pelarut Vaksin MR
3 Vaksin BCG
4 Vaksin DPT Hb
5 Vaksin Hb0
6 Vaksin IPV
7 Vaksin MR
8 Vaksin Polio
9 Vaksin Td

KB
TANGGAL
NO NAMA VAKSIN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
1 Cyclofem
2 Depo Neo
TOTAL
TOTAL
TOTAL
TOTAL

TOTAL
TOTAL

TOTAL