LAPORAN PEMAKAIAN DAN LEM

(LPLPO

Kode Puskesmas :
Puskesmas : SEMUNTUL
Kecamatan : RANTAU BAYUR
Kab/ Kodya : BANYUASIN
Propinsi : SUM-SEL

KELAS SATU STOK PENERI

KODE NAMA OBAT
TERAPI AN AWAL MAAN
APBD
OBAT GENERIK
1 Ambroxol sirup 15 mg/ ml 25 25
2 Ambroxol tablet 30 mg 1300 700
3 Asiklovir krim 5% 35
4 Klorfeniramina Maleat (CTM) 4 mg tablet 17000 10000
5 Klorpromazin tablet salut 100 mg 0
6 Meloksikam tablet 15 mg 550 600
7 Oksitetrasiklin Salep Kulit 3 % 0
OBAT NON GENERIK 0
1 Akita Tablet 1400 600
2 Ternix Plus Syrup 0
3 Momilen Baby Gold 0 25
4 Starbion kapsul 1750 1000
5 Caranal kapsul 3000 2600
6 OBH FM 28 36
7 Solvinex 1100 1000
0
DAK 0
1 Air untuk injeksi 25 ml 0
2 Alkohol 70 % 1 L 10 2
3 Alopurinol tablet 100 mg 1500 1000
4 Alprazolam tablet 0,25 mg 0
5 Alprazolam tablet 0,5 mg 0 1000
6 Alprazolam tablet 1mg 150
7 Amoksisilin sirup kering 125 mg/5ml 650 240
8 Amoksisilin tablet 500 mg 7300 5000
9 Amitriptilin tablet salut 25 mg (HCL) 300
10 Amlodipin tablet 5 mg 1260 2100
11 Asam Asetilsalisilat(Asetosal)tablet 80mg 1800
12 Asam Mefenamat kapsul/kaplet 500 mg 23100 9600
13 Asam Traneksamat injeksi 20 60
14 Asiklovir tablet 200 mg 2330 1000
15 Asiklovir tablet 400 mg 1540 1000
16 Antasida DOEN Tablet Kombinasi Mg Hidroksida 200 mg+ 13100 10000
Al Hidroksida 200 mg 0
17 Antasida DOEN II suspensi 143 100
18 Antifungi DOEN salep, Kombinasi:Asam Benzoat 6% 61 48
Asam Salisilat 3%
19 Antihemoroid,komb bismut subgalat 150mg 140 60
heksaklorofen 2,5mg lidokain 10mg seng oksida 120mg 0
20 Anti Bakteri DOEN salep 83 50
21 Anti Malaria Doen komb pirimetamin 25mg 1100 500
sulfadoksin 500mg 0
22 Atropin Injeksi 5 mg/ml 279
23 Asam Askorbat (Vit C) tablet 50 mg 3800 3000
24 Asam Fusidat Krim 20 mg/g 0
25 Azitromisin tablet 500 mg 470 200
26 Betahistin tablet 6 mg 660 900
27 Betametason krim 0,1 % 67 50
28 Clobazam tablet 10 mg 1050
29 Deksametason tablet 0,5 mg 1850 1500
30 Deksametason injeksi 5 mg/ml 420 400
31 Desoksimetason krim 0,25% 0
32 Diazepam tablet 5 mg 2300
33 Digoksin Tablet 0,25 mg 1600 400
34 Difenhidramin injeksi 10 mg/ml 107 150
35 Domperidon Suspensi 5 mg/ 5 ml 47 50
36 Domperidon Tablet 10 mg 1433 800
37 Epinefrin (Adrenalin) injeksi 0,1% 46
38 Erythromycin 250 mg tablet 200 200
39 Etanol 70% cairan 0
40 Eugenol cairan 4 3
41 Fenobarbital injeksi 50 mg/ ml 180 30
42 Fenofibrat kaps 100 mg 1750 900
43 Fitomenadion (Vit. K 1) Tablet 10 mg 1423 500
44 Fitomenadion (Vit. K 1) Injeksi 10 mg/ml-1 ml 139 60
45 Fitomenadion (Vit. K 1) Injeksi 2 mg/ml-1 ml 305 60
46 Furosemid tablet 40 mg 600 300
47 Garam Oralit serbuk kombinasi 7250 1200
48 Glukosa Larutan Infus 5% Steril 13 60
49 Glibenklamid Tablet 5 mg 0
50 Glimepiride Tablet 5 mg 2800 1500
51 Gliserin Lar 50% 10 25
52 Haloperidol tablet 0,5 mg 4235
53 Haloperidol tablet 5 mg 300
54 Haloperidol injeksi 50 mg/ml 0
55 Hidrokortison krim 2,5% 81 24
56 Hidroklorotiazid 25 mg 1100 300
57 Ibuprofen Suspensi 100mg/5ml 129 50
58 Ibuprofen tablet 200 mg 2365 2000
59 Isosorbid Dinitrat 5 mg 725 300
60 Jellco 24G 105 50
61 Jellco 22G 109 50
62 Jellco 20 105 50
63 Kalsium Laktat (Kalk) 500 mg 6500 3000
64 Kaptopril 25 mg 1650 1500
65 Karbol Gliseril Tetes Telinga 10% 43
66 Ketokonazol krim 2% 19
67 Ketokonazol Tablet 200 mg 1250 1000
68 Ketorolac injeksi 30 mg 0
69 Klindamisin Kapsul 150 mg 0
70 Kloramfenikol salep mata 1% 52 24
71 Kloramfenikol suspensi 125 mg/5ml 50 50
72 Klopromazin tablet salut 100mg (HCl) 200
73 Klozapin 25 mg 470 300
74 Klorfeniramina Maleat (CTM) 4 mg tablet 0
75 Kotrimoksazol Suspensi Kombinasi Sulfametoksazol 195 100
200 mg+Trimetroprin 40 mg/5 ml 0
76 Kotrimoksazol Tablet Kombinasi Sulfametoksazol 5800 3000
400 mg+Trimetropin 80 mg 0
77 Lanzoprazol kapsul 30 mg 1350 600
78 Lidokain HCL 2% + Epinefrin 1:80.000-2ml 200 180
000-2ml 0
79 Lisol 1 Liter 22
80 Loperamid tablet 2 mg 1900 1000
81 Lorazepam tablet 2 mg 400 500
82 Magnesium Sulfat Injeksi 20% 0
83 Magnesium Sulfat Injeksi 40% 0
84 Metformin HCL tablet 500 mg 4750 4000
85 Methylergometrine injeksi 0,2mg/ml 97 100
86 Metiprednisolon tablet 4 mg 1576 2000
87 Metoklopramide 10mg 950 1000
88 Metoklopramide sirup 5 mg/5ml 35
89 Metronidazol Ovula 500 mg 70 50
90 Metronidazol Sirup 125 mg/5ml 27 50
91 Metronidazol tablet 500 mg 1120 2000
92 Momethasone Furoate 0,1%krim 0
93 N-Asetil Sistein tablet 200 mg 0
94 Natrium Klorida Larutan Infus 0,9% Steril 48 60
95 Natrium Diklofenak tablet 25 mg 1235 3000
96 Nifedipin 10mg tablet 2050 1000
97 Nistatin tablet salut 500.000 iu/g 1020 500
 98 Nistatin Vaginal tablet 100.000 iu/g 900 500
99 Oksitosin injeksi 10 IU/ml 0
100 Omeprazol Kapsul 20 mg 2430 1800
101 Ondansetron kaplet 4 mg 325 900
102 Parasetamol drops 11 112
103 Parasetamol Sirup 120 mg/5ml 400 200
104 Parasetamol tablet 500 mg 23250 20000
105 Pirantel Pamoat Susp 125mg/5ml 28 50
106 Pirantel tablet score (base) 125 mg 2900 500
107 Piridoksin (Vitamin B6) 10 mg 1050 2000
108 Prednison tablet 5 mg 6350 5000
109 Propiltiourasil tablet 100 mg 2500 1000
110 Povidon Iodida larutan 10% 36 24
111 Ranitidin Injeksi 25 mg/ 2 ml 181 200
112 Ranitidin tablet 150 mg 3720 5000
113 Ringer Laktat Larutan Infus Steril 156 100
114 Risperidon tablet 1 mg 0
115 Rivanol 300 cc 24 24
116 Salbutamol tablet 4 mg 2100 2000
117 Salbutamol Sirup 0
118 Salep 24, Kombinasi : Asam Salisilat 2%+Belerang endap 4% 5 48
119 Salisil Bedak 2% 0
120 Sefadroksil Sirup Kering 27 60
121 Sefadroksil kapsul 500 mg 500 3000
122 Sefiksim kapsul 100 mg 2500
123 Sefiksim sirup kering 100 mg/5ml 0 96
124 Sefotaksim serbuk injeksi 1000mg 110 20
125 Serum Antitetanus(ATS)cairan injeksi 1500IU/amp 0
126 Setirizin sirup 5mg/5ml 0
127 Setirizine Tablet 10 mg 1500 2000
128 Sianokobalamin (Vit B12) Injeksi 500 mcg-ml 450 200
129 Simvastatin Tablet 10 mg 2630 1500
130 Siprofloksasin tablet 500 mg 3200 2000
131 Sukralfat susp 500 mg/5ml, 100 ml 13
132 Sukralfat tablet 500 mg/ 5 ml 2380 1000
133 Tetrasiklin HCI Kapsul 250 mg 1500 500
134 Tetrasiklin HCI Kapsul 500 mg 3560 1000
135 Thiamin (vitamin B1) tablet 50 mg 510 500
136 Triheksifenidil 2 mg 2390
137 Valsartan tab 80 mg 280
138 Vitamin B Kompleks tablet 900 1000
139 Zincpro drops 22
140 Zinc syrup 10 mg/ml 28 48
141 Zinc tablet 20 mg 2900 1500
Alat Kesehatan 0
 1 Alat Suntik Sekali Pakai 3 ml 700 1200
2 Alat Suntik Sekali Pakai 5 ml 3200 800
3 Alkohol Swab 400 300
4 Aseptic Gel 500cc + dispenser 44
5 Catgut chromic 2/0 +jarum 1/2 GT 35 mm 53 24
6 Catgut chromic 3/0 +jarum 1/2 GT 35 mm 53
7 Catgut Plain 3/0 +jarum 1/2 GT 35 mm 120 48
8 Catgut Plain 2/0 +jarum 1/2 GT 35 mm 115 48
9 Catheter 2 Way no.16 34
10 Catheter 2 Way no.18 28
11 Dermafix T 10x8 cm 30
12 Infus Set Anak 30
13 Infus Set Dewasa 77
14 Kapas Pembalut/ Absorben 50 gr 28
15 Kapas Pembalut/ Absorben 250 gr 28 10
16 Kapas Pembalut/absorben 500 gr 25 10
17 Kassa Kompres Steril 40 x 40 cm 136 50
18 Kassa Pembalut 2 x 80 cm 55 30
19 Kassa Hidrofil 4 x 15 cm 65 50
20 Maxter Exam Non Powder L 200 300
21 Maxter Exam Non Powder M 200 300
22 Maxter Exam Non Powder s 200 300
23 MPM MEDIKIT SAVETY IV CATETHER SUPERCARTH 5 G20 0
24 MPM MEDIKIT SAVETY IV CATETHER SUPERCARTH 5 G22 0
25 MPM MEDIKIT SAVETY IV CATETHER SUPERCARTH 5 G24 0
26 GEA NASAL OXYGEN CANULA ADULT@100 pcs/box 20 20
27 GEA NASAL OXYGEN CANULA CHILD @100 pcs/box 20 20
28 GEA NASAL OXYGEN CANULA INFANT@100 pcs/box 20 20
29 GEA NEBULIZER WITH MASK ADULT/DEWASA 100's/box 20 20
30 GEA NEBULIZER WITH MASK CHILD /ANAK 100's/box 20 20
31 New DRC T 40 Y x 80 cm Plain 10
32 GEA OXYGEN MASK ADULT/DEWASA 100 pcs/ box 20 20
33 GEA OXYGEN MASK CHILD /ANAK 100 pcs/ box 20 20
34 Pembalut Elastis 10 cm x 4,55 m 0
35 Pembalut Elastis 7,5 cm x 4,55 m 10 10
36 Poliban 5 cm x 2,7 MT 6 3
37 Polifix 10 cm x 5 m 15 10
38 Polifix 5 cm x 5 m 23 20
39 Poligyp 5 cm x 2,7 m 5 3
40 Poliwash 500 ml 36 12
41 Safeglove PF no.7 0
42 Silk 2/0 + jarum 1/2 GT 35mm 69
43 SMI Silk Black 3/0 HR 26 MM 36 24
44 Surgical Mask - 3ply Earloop 50 100
45 Surgical Mask - 3ply tie on 50 100
46 Sterile Latex Surgical Gloves Size 7 67
46 Urine Bag 0

UMUM
ASKES
JUMLAH KUNJUNGAN RESEP BAYAR TIDAK BAYAR

Mengetahui/ Menyetujui Yang Menyerahkan

Ka. UPT Instalasi Farmasi
Kabupaten Banyuasin

Hj. Nurhasanah, SKM, M.Kes

Nip.19740712 199301 2 001
AN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

Laporan Bulan : Mey 2018

Permintaan Bulan :
Nomor :
Tanggal :

PERSEDI PEMA SISA STOK PERMIN PEMBERIAN

AAN KAIAN STOK OPT TAAN INPRES ASKES APBD LAIN

50 20 30
2000 1100 900
35 20 15
27000 13000 14000
0 0
1150 250 900
0 0
0 0
2000 700 1300
0 0
25 13 12
2750 800 1950
5600 1200 4400
64 31 33
2100 200 1900
0 0
0 0
0 0
12 12
2500 1100 1400
0 0
1000 1000 0
150 150 0
890 260 630
12300 4900 7400
300 100 200
3360 1680 1680
1800 1800
32700 18400 14300
80 10 70
3330 2100 1230
 2540 600 1940
23100 9400 13700
0 0
243 42 201
109 49 60
0 0
200 200
0 0
133 49 84
1600 1600
0 0
279 279
6800 3600 3200
0 0
670 470 200
1560 690 870
117 35 82
1050 190 860
3350 2100 1250
820 276 544
0 0 0
2300 2300
2000 1000 1000
257 10 247
97 10 87
2233 1000 1233
46 46
400 200 200
0 0
7 7
210 210
2650 900 1750
1923 1000 923
199 85 114
365 196 169
900 200 700
8450 100 8350
73 2 71
0 0
4300 2000 2300
35 35
4235 4235
300 70 230
0 0
105 62 43
1400 1100 300
179 179
4365 2000 2365
1025 500 525
155 113 42
159 106 53
155 101 54
9500 3700 5800
3150 1600 1550
43 43 0
19 15 4
2250 750 1500
0 0
0 0
76 22 54
100 100
200 200
770 180 590
0 0
295 10 285
0 0
8800 3500 5300
0 0
1950 1280 670
380 137 243
0 0
22 22 0
2900 1000 1900
900 900
0 0
0 0
8750 4300 4450
197 90 107
3576 2650 926
1950 1000 950
35 35
120 120
77 77
3120 2200 920
0 0
0 0
108 5 103
4235 2400 1835
3050 1100 1950
1520 800 720
 1400 500 900
0 0
4230 2350 1880
1225 782 443
123 90 33
600 85 515
43250 10600 32650
78 23 55
3400 1200 2200
3050 100 2950
11350 6400 4950
3500 3500
60 30 30
381 150 231
8720 6100 2620
256 208 48
0 0
48 19 29
4100 1900 2200
0 0
53 50 3
0 0
87 20 67
3500 3000 500
2500 1000 1500
96 7 89
130 50 80
0 0
0 0
3500 1500 2000
650 320 330
4130 2700 1430
5200 1700 3500
13 8 5
3380 380 3000
2000 1100 900
4560 1400 3160
1010 1010
2390 620 1770
280 120 160
1900 1500 400
22 22 0
76 58 18
4400 1400 3000
0 0
1900 1900
4000 4000
700 450 250
44 28 16
77 50 27
53 50 3
168 106 62
163 103 60
34 34
28 20 8
30 30
30 20 10
77 50 27
28 28
38 38
35 10 25
186 186
85 25 60
115 115
500 500
500 500
500 500
0 0
0 0
0 0
40 40
40 40
40 40
40 40
40 40
10 10
40 40
40 40
0 0
20 10 10
9 9
25 25
43 20 23
8 8
48 48
0 0
69 69
60 3 57
150 150
150 150
 67 20 47
0 0

JUMLAH

kan Pimpinan Puskesmas Yang Menerima

rmasi Petugas Puskesmas
asin

, M.Kes dr. Nilawat Sary oktarini, AMF

1 2 001 Nip. 198203142011012006 Nip. 198910282011012007
 KET
JMLH
ng Menerima
gas Puskesmas

y oktarini, AMF
282011012007
 LAPORAN PEMAKAIAN DAN LEM
(LPLPO)

Kode Puskesmas :
Puskesmas : SEMUNTUL
Kecamatan : RANTAU BAYUR
Kab/ Kodya : BANYUASIN
Propinsi : SUM-SEL

KELAS SATU STOK PENERI

KODE NAMA OBAT
TERAPI AN AWAL MAAN
APBD
OBAT GENERIK
1 Ambroxol sirup 15 mg/ ml 30
2 Ambroxol tablet 30 mg 900
3 Asiklovir krim 5% 15
4 Klorfeniramina Maleat (CTM) 4 mg tablet 14000
5 Klorpromazin tablet salut 100 mg 0
6 Meloksikam tablet 15 mg 900
7 Oksitetrasiklin Salep Kulit 3 % 0
OBAT NON GENERIK 0
1 Akita Tablet 1300
2 Ternix Plus Syrup 0
3 Momilen Baby Gold 12
4 Starbion kapsul 1950
5 Caranal kapsul 4400
6 OBH FM 33
7 Solvinex 1900
0
DAK 0
1 Air untuk injeksi 25 ml 0
2 Alkohol 70 % 1 L 12
3 Alopurinol tablet 100 mg 1400
4 Alprazolam tablet 0,25 mg 0
5 Alprazolam tablet 0,5 mg 0
6 Alprazolam tablet 1mg 0
7 Amoksisilin sirup kering 125 mg/5ml 630
8 Amoksisilin tablet 500 mg 7400
9 Amitriptilin tablet salut 25 mg (HCL) 200
10 Amlodipin tablet 5 mg 1680
11 Asam Asetilsalisilat(Asetosal)tablet 80mg 1800
12 Asam Mefenamat kapsul/kaplet 500 mg 14300
13 Asam Traneksamat injeksi 70
14 Asiklovir tablet 200 mg 1230
15 Asiklovir tablet 400 mg 1940
16 Antasida DOEN Tablet Kombinasi Mg Hidroksida 200 mg+ 13700
Al Hidroksida 200 mg 0
17 Antasida DOEN II suspensi 201
18 Antifungi DOEN salep, Kombinasi:Asam Benzoat 6% 60
Asam Salisilat 3% 0
19 Antihemoroid,komb bismut subgalat 150mg 200
heksaklorofen 2,5mg lidokain 10mg seng oksida 120mg 0
20 Anti Bakteri DOEN salep 84
21 Anti Malaria Doen komb pirimetamin 25mg 1600
sulfadoksin 500mg 0
22 Atropin Injeksi 5 mg/ml 279
23 Asam Askorbat (Vit C) tablet 50 mg 3200
24 Asam Fusidat Krim 20 mg/g 0
25 Azitromisin tablet 500 mg 200
26 Betahistin tablet 6 mg 870
27 Betametason krim 0,1 % 82
28 Clobazam tablet 10 mg 860
29 Deksametason tablet 0,5 mg 1250
30 Deksametason injeksi 5 mg/ml 544
31 Desoksimetason krim 0,25% 0
32 Diazepam tablet 5 mg 2300
33 Digoksin Tablet 0,25 mg 1000
34 Difenhidramin injeksi 10 mg/ml 247
35 Domperidon Suspensi 5 mg/ 5 ml 87
36 Domperidon Tablet 10 mg 1233
37 Epinefrin (Adrenalin) injeksi 0,1% 46
38 Erythromycin 250 mg tablet 200
39 Etanol 70% cairan 0
40 Eugenol cairan 7
41 Fenobarbital injeksi 50 mg/ ml 210
42 Fenofibrat kaps 100 mg 1750
43 Fitomenadion (Vit. K 1) Tablet 10 mg 923
44 Fitomenadion (Vit. K 1) Injeksi 10 mg/ml-1 ml 114
45 Fitomenadion (Vit. K 1) Injeksi 2 mg/ml-1 ml 169
46 Furosemid tablet 40 mg 700
47 Garam Oralit serbuk kombinasi 8350
48 Glukosa Larutan Infus 5% Steril 71
49 Glibenklamid Tablet 5 mg 0
50 Glimepiride Tablet 5 mg 2300
51 Gliserin Lar 50% 35
52 Haloperidol tablet 0,5 mg 4235
53 Haloperidol tablet 5 mg 230
54 Haloperidol injeksi 50 mg/ml 0
55 Hidrokortison krim 2,5% 43
56 Hidroklorotiazid 25 mg 300
57 Ibuprofen Suspensi 100mg/5ml 211
58 Ibuprofen tablet 200 mg 2365
59 Isosorbid Dinitrat 5 mg 525
60 Jellco 24G 42
61 Jellco 22G 53
62 Jellco 20 54
63 Kalsium Laktat (Kalk) 500 mg 5800
64 Kaptopril 25 mg 1550
65 Karbol Gliseril Tetes Telinga 10% 0
66 Ketokonazol krim 2% 4
67 Ketokonazol Tablet 200 mg 1500
68 Ketorolac injeksi 30 mg 0
69 Klindamisin Kapsul 150 mg 0
70 Kloramfenikol salep mata 1% 54
71 Kloramfenikol suspensi 125 mg/5ml 200
72 Klopromazin tablet salut 100mg (HCl) 200
73 Klozapin 25 mg 590
74 Klorfeniramina Maleat (CTM) 4 mg tablet 0
75 Kotrimoksazol Suspensi Kombinasi Sulfametoksazol 285
200 mg+Trimetroprin 40 mg/5 ml 0
76 Kotrimoksazol Tablet Kombinasi Sulfametoksazol 5300
400 mg+Trimetropin 80 mg 0
77 Lanzoprazol kapsul 30 mg 670
78 Lidokain HCL 2% + Epinefrin 1:80.000-2ml 243
000-2ml 0
79 Lisol 1 Liter 0
80 Loperamid tablet 2 mg 1900
81 Lorazepam tablet 2 mg 900
82 Magnesium Sulfat Injeksi 20% 0
83 Magnesium Sulfat Injeksi 40% 0
84 Metformin HCL tablet 500 mg 4450
85 Methylergometrine injeksi 0,2mg/ml 107
86 Metiprednisolon tablet 4 mg 926
87 Metoklopramide 10mg 950
88 Metoklopramide sirup 5 mg/5ml 35
89 Metronidazol Ovula 500 mg 120
90 Metronidazol Sirup 125 mg/5ml 115
91 Metronidazol tablet 500 mg 920
92 Momethasone Furoate 0,1%krim 0
93 N-Asetil Sistein tablet 200 mg 0
94 Natrium Klorida Larutan Infus 0,9% Steril 103
95 Natrium Diklofenak tablet 25 mg 1835
96 Nifedipin 10mg tablet 1950
97 Nistatin tablet salut 500.000 iu/g 720
 98 Nistatin Vaginal tablet 100.000 iu/g 900
99 Oksitosin injeksi 10 IU/ml 0
100 Omeprazol Kapsul 20 mg 1880
101 Ondansetron kaplet 4 mg 443
102 Parasetamol drops 33
103 Parasetamol Sirup 120 mg/5ml 515
104 Parasetamol tablet 500 mg 32650
105 Pirantel Pamoat Susp 125mg/5ml 55
106 Pirantel tablet score (base) 125 mg 2200
107 Piridoksin (Vitamin B6) 10 mg 2950
108 Prednison tablet 5 mg 4950
109 Propiltiourasil tablet 100 mg 3500
110 Povidon Iodida larutan 10% 30
111 Ranitidin Injeksi 25 mg/ 2 ml 231
112 Ranitidin tablet 150 mg 2620
113 Ringer Laktat Larutan Infus Steril 48
114 Risperidon tablet 1 mg 0
115 Rivanol 300 cc 29
116 Salbutamol tablet 4 mg 2200
117 Salbutamol Sirup 0
118 Salep 24, Kombinasi : Asam Salisilat 2%+Belerang endap 4% 36
119 Salisil Bedak 2% 0
120 Sefadroksil Sirup Kering 67
121 Sefadroksil kapsul 500 mg 500
122 Sefiksim kapsul 100 mg 1500
123 Sefiksim sirup kering 100 mg/5ml 89
124 Sefotaksim serbuk injeksi 1000mg 80
125 Serum Antitetanus(ATS)cairan injeksi 1500IU/amp 0
126 Setirizin sirup 5mg/5ml 0
127 Setirizine Tablet 10 mg 2000
128 Sianokobalamin (Vit B12) Injeksi 500 mcg-ml 330
129 Simvastatin Tablet 10 mg 1430
130 Siprofloksasin tablet 500 mg 3500
131 Sukralfat susp 500 mg/5ml, 100 ml 5
132 Sukralfat tablet 500 mg/ 5 ml 3000
133 Tetrasiklin HCI Kapsul 250 mg 900
134 Tetrasiklin HCI Kapsul 500 mg 3160
135 Thiamin (vitamin B1) tablet 50 mg 1010
136 Triheksifenidil 2 mg 1770
137 Valsartan tab 80 mg 420
138 Vitamin B Kompleks tablet 400
139 Zincpro drops 0
140 Zinc syrup 10 mg/ml 18
141 Zinc tablet 20 mg 3000
Alat Kesehatan 0
 1 Alat Suntik Sekali Pakai 3 ml 1900
2 Alat Suntik Sekali Pakai 5 ml 4000
3 Alkohol Swab 250
4 Aseptic Gel 500cc + dispenser 16
5 Catgut chromic 2/0 +jarum 1/2 GT 35 mm 27
6 Catgut chromic 3/0 +jarum 1/2 GT 35 mm 3
7 Catgut Plain 3/0 +jarum 1/2 GT 35 mm 62
8 Catgut Plain 2/0 +jarum 1/2 GT 35 mm 60
9 Catheter 2 Way no.16 34
10 Catheter 2 Way no.18 8
11 Dermafix T 10x8 cm 30
12 Infus Set Anak 10
13 Infus Set Dewasa 27
14 Kapas Pembalut/ Absorben 50 gr 28
15 Kapas Pembalut/ Absorben 250 gr 38
16 Kapas Pembalut/absorben 500 gr 25
17 Kassa Kompres Steril 40 x 40 cm 186
18 Kassa Pembalut 2 x 80 cm 60
19 Kassa Hidrofil 4 x 15 cm 115
20 Maxter Exam Non Powder L 500
21 Maxter Exam Non Powder M 500
22 Maxter Exam Non Powder s 500
23 MPM MEDIKIT SAVETY IV CATETHER SUPERCARTH 5 G20 0
24 MPM MEDIKIT SAVETY IV CATETHER SUPERCARTH 5 G22 0
25 MPM MEDIKIT SAVETY IV CATETHER SUPERCARTH 5 G24 0
26 GEA NASAL OXYGEN CANULA ADULT@100 pcs/box 40
27 GEA NASAL OXYGEN CANULA CHILD @100 pcs/box 40
28 GEA NASAL OXYGEN CANULA INFANT@100 pcs/box 40
29 GEA NEBULIZER WITH MASK ADULT/DEWASA 100's/box 40
30 GEA NEBULIZER WITH MASK CHILD /ANAK 100's/box 40
31 New DRC T 40 Y x 80 cm Plain 10
32 GEA OXYGEN MASK ADULT/DEWASA 100 pcs/ box 40
33 GEA OXYGEN MASK CHILD /ANAK 100 pcs/ box 40
34 Pembalut Elastis 10 cm x 4,55 m 0
35 Pembalut Elastis 7,5 cm x 4,55 m 10
36 Poliban 5 cm x 2,7 MT 9
37 Polifix 10 cm x 5 m 25
38 Polifix 5 cm x 5 m 23
39 Poligyp 5 cm x 2,7 m 8
40 Poliwash 500 ml 48
41 Safeglove PF no.7 0
42 Silk 2/0 + jarum 1/2 GT 35mm 69
43 SMI Silk Black 3/0 HR 26 MM 57
44 Surgical Mask - 3ply Earloop 150
45 Surgical Mask - 3ply tie on 150
46 Sterile Latex Surgical Gloves Size 7 47
46 Urine Bag 0

UMUM
ASKES
JUMLAH KUNJUNGAN RESEP BAYAR TIDAK BAYAR

Mengetahui/ Menyetujui Yang Menyerahkan

Ka. UPT Instalasi Farmasi
Kabupaten Banyuasin

Hj. Nurhasanah, SKM, M.Kes

Nip.19740712 199301 2 001
N PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

Laporan Bulan : Juni

Permintaan Bulan : Juli
Nomor :
Tanggal :

PERSEDI PEMA SISA STOK PERMIN PEMBERIAN

AAN KAIAN STOK OPT TAAN INPRES ASKES APBD LAIN

30 25 5 200
900 500 400 2000
15 10 5 100
14000 2435 11565 100
0 0
900 388 512 1500
0 0
0 0
1300 172 1128 2000
0 0 100
12 9 3 100
1950 350 1600 2000
4400 800 3600 2000
33 11 22 100
1900 1900 500
0 0
0 0
0 0 50
12 12 20
1400 240 1160 3000
0 0 1000
0 0 1000
0 0 1000
630 141 489 100
7400 893 6507 2000
200 200 100
1680 241 1439 5000
1800 1800
14300 4210 10090 500
70 2 68 20
1230 200 1030 500
 1940 576 1364 2000
13700 3073 10627 5000
0 0
201 33 168 200
60 8 52 48
0 0
200 200
0 0
84 1 83 50
1600 1600
0 0
279 279
3200 1053 2147 5000
0 0
200 20 180
870 44 826 900
82 6 76
860 860
1250 200 1050 3000
544 50 494 400
0 0 100
2300 2300
1000 1000 500
247 17 230 150
87 15 72 100
1233 238 995 2000
46 46
200 200
0 0
7 7
210 210
1750 134 1616
923 96 827 200
114 19 95
169 60 109 60
700 85 615 1000
8350 1192 7158
71 3 68 100
0 0
2300 638 1662 500
35 35
4235 60 4175
230 230 2000
0 0
43 8 35 50
300 300
211 11 200
2365 549 1816 2000
525 125 400 200
42 42 50
53 53 50
54 54 50
5800 1630 4170 5000
1550 144 1406 5000
0 0
4 4 50
1500 165 1335 1000
0 0
0 0 2000
54 3 51 100
200 27 173
200 200
590 590
0 0
285 6 279 50
0 0
5300 128 5172 1000
0 0
670 235 435 600
243 3 240 60
0 0
0 0 30
1900 173 1727 2000
900 900
0 0 10
0 0 10
4450 230 4220 500
107 107 100
926 168 758 2000
950 150 800 500
35 35 50
120 120
115 10 105 50
920 97 823 2000
0 0 50
0 0
103 103 40
1835 135 1700 3000
1950 35 1915 500
720 110 610 2000
 900 900
0 0 500
1880 246 1634 5000
443 95 348 1000
33 4 29 200
515 22 493
32650 692 31958
55 2 53 10
2200 288 1912
2950 1938 1012 2000
4950 170 4780 2000
3500 3500
30 30 36
231 6 225 200
2620 194 2426 5000
48 48 100
0 0 1000
29 8 21 24
2200 302 1898 2000
0 0 50
36 36 50
0 0 200
67 4 63 60
500 214 286 2000
1500 150 1350 500
89 7 82 50
80 10 70
0 0 20
0 0 50
2000 340 1660 2000
330 205 125 200
1430 90 1340 1500
3500 179 3321 2000
5 5 0 60
3000 932 2068
900 500 400
3160 365 2795 1000
1010 200 810 2000
1770 1770
420 30 390
400 400 5000
0 0 50
18 8 10 60
3000 232 2768 300
0 0
1900 1500 400 1200
4000 4000
250 250 500
16 16 12
27 27 48
3 3 48
62 62 48
60 60 48
34 34
8 8
30 30
10 10
27 27 100
28 28
38 38 10
25 25 10
186 186
60 60
115 115
500 500 500
500 500 500
500 500 500
0 0
0 0
0 0
40 40
40 40
40 40
40 40
40 40
10 10
40 40
40 40
0 0
10 10
9 9
25 25
23 23
8 8
48 48
0 0
69 69
57 57 200
150 150 0 200
150 150 0 200
 47 47 0 100
0 0 0 0

JUMLAH

kan Pimpinan Puskesmas Yang Menerima

rmasi Petugas Puskesmas
asin

, M.Kes dr. Nilawat Sary oktarini, AMF

1 2 001 Nip. 198203142011012006 Nip. 198910282011012007
 KET
JMLH
ng Menerima
gas Puskesmas

y oktarini, AMF
282011012007