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BUKU CATATAN HARIAN PEMAKAIAN OBAT ( RUTIN ) 2018

PUSKESMAS : PAGADEN BULAN MEI


KECAMATAN : PAGADEN JML KASUS :
KAB/KOTA : SUBANG JML RESEP :

PERSEDIAAN JUMLAH PEMAKAIAN OBAT PADA TANGGAL :


JUMLAH SISA
NO NAMA OBAT SATUAN PERSEDI PENA JUML PEMAKAI AKHIR
AAN MBAH AH 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 AN BULAN
AWAL AN
1 Asiklovir SK Tube 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 0 0
2 Ambroxol Syr Botol @ 60 ml 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 0 0
3 Ambroxol Tab Box @ 10 Strip 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 0 0
4 Antalgin 500 mg Tablet Box @ 10 Strip 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 0 0
5 Antalgin Plus / Ramalgin Plus Box @ 10 Strip 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 0 0
6 Bisakodil Tablet / Laxana Box @ 10 Strip 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 0 0
7 Bromhexin Tablet / Bromifar Box @ 10 Strip 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 0 0
8 Dexchlorpheniramin + Dexamethason / Box @ 10 Strip 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 0 0
Dexlosan
9 Dexchlorpheniramin maleat 2 mg Box @10 Strip 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 0 0
10 Etakridin / Rivanol Botol @ 100 ml 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 0 0
11 Eugenol Botol @ 10 ml 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 0 0
12 Famotidin 20 mg / Rafico Box @ 10 Strip 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 0 0
13 Gentian Violet Botol 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 0 0
14 GG 100 mg Box @ 10 Strip 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 0 0
15 Glibenklamid Box @ 10 Strip 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 0 0
16 Griseofulvin / Gricin 125 Box @ 10 Strip 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 0 0
17 Kaolin Pectin Syr / Antamen Syr Botol @ 60 ml 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 0 0
18 Kloramfenikol TM Plus Botol @ 5 ml 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 0 0
19 Kloramfenikol TT / Erlamisetin Botol @ 10 ml 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 0 0
20 Meloxicam 15 mg Box @ 5 Strip 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 0 0
21 Meloxicam 7,5 mg Box @ 5 Strip 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 0 0
22 Multivitamin Tab / Ramaton Tab Box @ 10 Strip 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 0 0
23 Natrium Bikarbonat Tablet Botol @ 100 Tab 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 0 0
24 Obat Batuk Herbal Dewasa / Herbakof Botol @ 60 ml 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 0 0
25 Obat Batuk Syr + PCT anak / Remco Syr Botol @ 60 ml 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 0 0

26 Obat Batuk Tab / Calortusin Box @ 10 Strip 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 0 0


27 Papaverin 40 mg Box @ 10 Strip 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 0 0
28 Piroxicam 10 mg Tab Box @ 10 Strip 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 0 0
29 Piroxicam 20 mg Tab Box @ 10 Strip 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 0 0
30 Spongostan Box @ 50 pcs 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 0 0
31 Simetidin 200 mg Box @ 10 Strip 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 0 0
32 Thiamfenikol Kaps / Riamycin 500 mg Box @ 10 Strip 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 0 0
33 Thiamfenikol Syr / Riamycin DS Botol @ 60 ml 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 0 0
34 Vitamin + FE / Ramabion Box @ 10 Strip 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 0 0
35 Valetamat Inj Botol @ 10 ampul 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 0 0
36 Vitamin Syr / Biovitan Syr Botol @ 60 ml 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 0 0
37 0 TAB 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 0 0
38 0 TAB 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 0 0
39 0 TAB 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 0 0
40 0 TAB 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 0 0
BUKU CATATAN HARIAN PEMAKAIAN OBAT ( RUTIN ) 2018
PUSKESMAS : PAGADEN BULAN JUNI
KECAMATAN : PAGADEN JML KASUS :
KAB/KOTA : SUBANG JML RESEP :

PERSEDIAAN JUMLAH PEMAKAIAN OBAT PADA TANGGAL :


JUMLAH SISA
NO NAMA OBAT SATUAN PERSEDI PENA JUML PEMAKAI AKHIR
AAN MBAH AH 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 AN BULAN
AWAL AN
1 Asiklovir SK Tube 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 0 0
2 Ambroxol Syr Botol @ 60 ml 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 0 0
3 Ambroxol Tab Box @ 10 Strip 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 0 0
4 Antalgin 500 mg Tablet Box @ 10 Strip 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 0 0
5 Antalgin Plus / Ramalgin Plus Box @ 10 Strip 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 0 0
6 Bisakodil Tablet / Laxana Box @ 10 Strip 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 0 0
7 Bromhexin Tablet / Bromifar Box @ 10 Strip 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 0 0
8 Dexchlorpheniramin + Dexamethason / Box @ 10 Strip 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 0 0
Dexlosan
9 Dexchlorpheniramin maleat 2 mg Box @10 Strip 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 0 0
10 Etakridin / Rivanol Botol @ 100 ml 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 0 0
11 Eugenol Botol @ 10 ml 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 0 0
12 Famotidin 20 mg / Rafico Box @ 10 Strip 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 0 0
13 Gentian Violet Botol 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 0 0
14 GG 100 mg Box @ 10 Strip 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 0 0
15 Glibenklamid Box @ 10 Strip 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 0 0
16 Griseofulvin / Gricin 125 Box @ 10 Strip 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 0 0
17 Kaolin Pectin Syr / Antamen Syr Botol @ 60 ml 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 0 0
18 Kloramfenikol TM Plus Botol @ 5 ml 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 0 0
19 Kloramfenikol TT / Erlamisetin Botol @ 10 ml 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 0 0
20 Meloxicam 15 mg Box @ 5 Strip 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 0 0
21 Meloxicam 7,5 mg Box @ 5 Strip 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 0 0
22 Multivitamin Tab / Ramaton Tab Box @ 10 Strip 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 0 0
23 Natrium Bikarbonat Tablet Botol @ 100 Tab 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 0 0
24 Obat Batuk Herbal Dewasa / Herbakof Botol @ 60 ml 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 0 0
25 Obat Batuk Syr + PCT anak / Remco Syr Botol @ 60 ml 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 0 0
26 Obat Batuk Tab / Calortusin Box @ 10 Strip 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 0 0
27 Papaverin 40 mg Box @ 10 Strip 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 0 0
28 Piroxicam 10 mg Tab Box @ 10 Strip 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 0 0
29 Piroxicam 20 mg Tab Box @ 10 Strip 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 0 0
30 Spongostan Box @ 50 pcs 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 0 0
31 Simetidin 200 mg Box @ 10 Strip 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 0 0
32 Thiamfenikol Kaps / Riamycin 500 mg Box @ 10 Strip 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 0 0
33 Thiamfenikol Syr / Riamycin DS Botol @ 60 ml 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 0 0
34 Vitamin + FE / Ramabion Box @ 10 Strip 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 0 0
35 Valetamat Inj Botol @ 10 ampul 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 0 0
36 Vitamin Syr / Biovitan Syr Botol @ 60 ml 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 0 0
37 0 TAB 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 0 0
38 0 TAB 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 0 0
39 0 TAB 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 0 0
40 0 TAB 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 0 0
BUKU CATATAN HARIAN PEMAKAIAN OBAT ( RUTIN ) 2018
PUSKESMAS : PAGADEN BULAN JULI
KECAMATAN : PAGADEN JML KASUS :
KAB/KOTA : SUBANG JML RESEP :

PERSEDIAAN JUMLAH PEMAKAIAN OBAT PADA TANGGAL :


JUMLAH SISA
NO NAMA OBAT SATUAN PERSEDI PENA JUML PEMAKAI AKHIR
AAN MBAH 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 AN BULAN
AH
AWAL AN
1 Asiklovir SK Tube 0 1 1 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 1
2 Ambroxol Syr Botol @ 60 ml 0 2 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 0 0 0 0 2
3 Ambroxol Tab Box @ 10 Strip 0 3 3 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 3
4 Antalgin 500 mg Tablet Box @ 10 Strip 0 4 4 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 4
5 Antalgin Plus / Ramalgin Plus Box @ 10 Strip 0 5 5 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 5
6 Bisakodil Tablet / Laxana Box @ 10 Strip 0 6 6 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 6
7 Bromhexin Tablet / Bromifar Box @ 10 Strip 0 7 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 0 0 0 0 0 0 0 0 7
8 Dexchlorpheniramin + Dexamethason / Box @ 10 Strip 0 8 8 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
Dexlosan
0 8
9 Dexchlorpheniramin maleat 2 mg Box @10 Strip 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 0 0
10 Etakridin / Rivanol Botol @ 100 ml 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 0 0
11 Eugenol Botol @ 10 ml 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 0 0
12 Famotidin 20 mg / Rafico Box @ 10 Strip 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 0 0
13 Gentian Violet Botol 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 0 0
14 GG 100 mg Box @ 10 Strip 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 0 0
15 Glibenklamid Box @ 10 Strip 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 0 0
16 Griseofulvin / Gricin 125 Box @ 10 Strip 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 0 0
17 Kaolin Pectin Syr / Antamen Syr Botol @ 60 ml 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 0 0
18 Kloramfenikol TM Plus Botol @ 5 ml 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 0 0
19 Kloramfenikol TT / Erlamisetin Botol @ 10 ml 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 0 0
20 Meloxicam 15 mg Box @ 5 Strip 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 0 0
21 Meloxicam 7,5 mg Box @ 5 Strip 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 0 0
22 Multivitamin Tab / Ramaton Tab Box @ 10 Strip 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 0 0
23 Natrium Bikarbonat Tablet Botol @ 100 Tab 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 0 0
24 Obat Batuk Herbal Dewasa / Herbakof Botol @ 60 ml 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 0 0
25 Obat Batuk Syr + PCT anak / Remco Syr Botol @ 60 ml 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
0 0
26 Obat Batuk Tab / Calortusin Box @ 10 Strip 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 0 0
27 Papaverin 40 mg Box @ 10 Strip 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 0 0
28 Piroxicam 10 mg Tab Box @ 10 Strip 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 0 0
29 Piroxicam 20 mg Tab Box @ 10 Strip 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 0 0
30 Spongostan Box @ 50 pcs 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 0 0
31 Simetidin 200 mg Box @ 10 Strip 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 0 0
32 Thiamfenikol Kaps / Riamycin 500 mg Box @ 10 Strip 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 0 0
33 Thiamfenikol Syr / Riamycin DS Botol @ 60 ml 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 0 0
34 Vitamin + FE / Ramabion Box @ 10 Strip 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 0 0
35 Valetamat Inj Botol @ 10 ampul 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 0 0
36 Vitamin Syr / Biovitan Syr Botol @ 60 ml 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 0 0
37 0 TAB 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 0 0
38 0 TAB 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 0 0
39 0 TAB 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 0 0
40 0 TAB 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 0 0
BUKU CATATAN HARIAN PEMAKAIAN OBAT ( RUTIN ) 2018
PUSKESMAS : PAGADEN BULAN AGUST
KECAMATAN : PAGADEN JML KASUS :
KAB/KOTA : SUBANG JML RESEP :

PERSEDIAAN JUMLAH PEMAKAIAN OBAT PADA TANGGAL :


JUMLAH SISA
NO NAMA OBAT SATUAN PERSEDI PENA JUML PEMAKAI AKHIR
AAN MBAH AH 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 AN BULAN
AWAL AN
1 Asiklovir SK Tube 0 1 1 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 1
2 Ambroxol Syr Botol @ 60 ml 0 2 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 0 0 0 0 2
3 Ambroxol Tab Box @ 10 Strip 0 3 3 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 3
4 Antalgin 500 mg Tablet Box @ 10 Strip 0 4 4 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 4
5 Antalgin Plus / Ramalgin Plus Box @ 10 Strip 0 5 5 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 5
6 Bisakodil Tablet / Laxana Box @ 10 Strip 0 6 6 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 6
7 Bromhexin Tablet / Bromifar Box @ 10 Strip 0 7 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 0 0 0 0 0 0 0 0 7
8 Dexchlorpheniramin + Dexamethason / Box @ 10 Strip 0 8 8 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 8
Dexlosan
9 Dexchlorpheniramin maleat 2 mg Box @10 Strip 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 0 0
10 Etakridin / Rivanol Botol @ 100 ml 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 0 0
11 Eugenol Botol @ 10 ml 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 0 0
12 Famotidin 20 mg / Rafico Box @ 10 Strip 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 0 0
13 Gentian Violet Botol 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 0 0
14 GG 100 mg Box @ 10 Strip 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 0 0
15 Glibenklamid Box @ 10 Strip 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 0 0
16 Griseofulvin / Gricin 125 Box @ 10 Strip 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 0 0
17 Kaolin Pectin Syr / Antamen Syr Botol @ 60 ml 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 0 0
18 Kloramfenikol TM Plus Botol @ 5 ml 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 0 0
19 Kloramfenikol TT / Erlamisetin Botol @ 10 ml 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 0 0
20 Meloxicam 15 mg Box @ 5 Strip 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 0 0
21 Meloxicam 7,5 mg Box @ 5 Strip 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 0 0
22 Multivitamin Tab / Ramaton Tab Box @ 10 Strip 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 0 0
23 Natrium Bikarbonat Tablet Botol @ 100 Tab 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 0 0
24 Obat Batuk Herbal Dewasa / Herbakof Botol @ 60 ml 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 0 0
25 Obat Batuk Syr + PCT anak / Remco Syr Botol @ 60 ml 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 0 0

26 Obat Batuk Tab / Calortusin Box @ 10 Strip 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 0 0


27 Papaverin 40 mg Box @ 10 Strip 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 0 0
28 Piroxicam 10 mg Tab Box @ 10 Strip 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 0 0
29 Piroxicam 20 mg Tab Box @ 10 Strip 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 0 0
30 Spongostan Box @ 50 pcs 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 0 0
31 Simetidin 200 mg Box @ 10 Strip 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 0 0
32 Thiamfenikol Kaps / Riamycin 500 mg Box @ 10 Strip 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 0 0
33 Thiamfenikol Syr / Riamycin DS Botol @ 60 ml 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 0 0
34 Vitamin + FE / Ramabion Box @ 10 Strip 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 0 0
35 Valetamat Inj Botol @ 10 ampul 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 0 0
36 Vitamin Syr / Biovitan Syr Botol @ 60 ml 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 0 0
37 0 TAB 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 0 0
38 0 TAB 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 0 0
39 0 TAB 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 0 0
40 0 TAB 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 0 0
BUKU CATATAN HARIAN PEMAKAIAN OBAT ( RUTIN ) 2018
PUSKESMAS : PAGADEN BULAN SEPTEM
KECAMATAN : PAGADEN JML KASUS :
KAB/KOTA : SUBANG JML RESEP :

PERSEDIAAN JUMLAH PEMAKAIAN OBAT PADA TANGGAL :


JUMLAH SISA
NO NAMA OBAT SATUAN PERSEDI PENA JUML PEMAKAI AKHIR
AAN MBAH AH 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 AN BULAN
AWAL AN
1 Asiklovir SK Tube 0 1 1 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 1
2 Ambroxol Syr Botol @ 60 ml 0 2 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 0 0 0 0 2
3 Ambroxol Tab Box @ 10 Strip 0 3 3 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 3
4 Antalgin 500 mg Tablet Box @ 10 Strip 0 4 4 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 4
5 Antalgin Plus / Ramalgin Plus Box @ 10 Strip 0 5 5 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 5
6 Bisakodil Tablet / Laxana Box @ 10 Strip 0 6 6 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 6
7 Bromhexin Tablet / Bromifar Box @ 10 Strip 0 7 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 0 0 0 0 0 0 0 0 7
8 Dexchlorpheniramin + Dexamethason / Box @ 10 Strip 0 8 8 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 8
Dexlosan
9 Dexchlorpheniramin maleat 2 mg Box @10 Strip 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 0 0
10 Etakridin / Rivanol Botol @ 100 ml 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 0 0
11 Eugenol Botol @ 10 ml 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 0 0
12 Famotidin 20 mg / Rafico Box @ 10 Strip 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 0 0
13 Gentian Violet Botol 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 0 0
14 GG 100 mg Box @ 10 Strip 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 0 0
15 Glibenklamid Box @ 10 Strip 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 0 0
16 Griseofulvin / Gricin 125 Box @ 10 Strip 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 0 0
17 Kaolin Pectin Syr / Antamen Syr Botol @ 60 ml 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 0 0
18 Kloramfenikol TM Plus Botol @ 5 ml 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 0 0
19 Kloramfenikol TT / Erlamisetin Botol @ 10 ml 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 0 0
20 Meloxicam 15 mg Box @ 5 Strip 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 0 0
21 Meloxicam 7,5 mg Box @ 5 Strip 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 0 0
22 Multivitamin Tab / Ramaton Tab Box @ 10 Strip 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 0 0
23 Natrium Bikarbonat Tablet Botol @ 100 Tab 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 0 0
24 Obat Batuk Herbal Dewasa / Herbakof Botol @ 60 ml 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 0 0
25 Obat Batuk Syr + PCT anak / Remco Syr Botol @ 60 ml 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 0 0

26 Obat Batuk Tab / Calortusin Box @ 10 Strip 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 0 0


27 Papaverin 40 mg Box @ 10 Strip 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 0 0
28 Piroxicam 10 mg Tab Box @ 10 Strip 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 0 0
29 Piroxicam 20 mg Tab Box @ 10 Strip 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 0 0
30 Spongostan Box @ 50 pcs 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 0 0
31 Simetidin 200 mg Box @ 10 Strip 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 0 0
32 Thiamfenikol Kaps / Riamycin 500 mg Box @ 10 Strip 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 0 0
33 Thiamfenikol Syr / Riamycin DS Botol @ 60 ml 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 0 0
34 Vitamin + FE / Ramabion Box @ 10 Strip 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 0 0
35 Valetamat Inj Botol @ 10 ampul 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 0 0
36 Vitamin Syr / Biovitan Syr Botol @ 60 ml 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 0 0
37 0 TAB 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 0 0
38 0 TAB 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 0 0
39 0 TAB 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 0 0
40 0 TAB 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 0 0
BUKU CATATAN HARIAN PEMAKAIAN OBAT ( RUTIN ) 2018
PUSKESMAS : PAGADEN BULAN OKTOB
KECAMATAN : PAGADEN JML KASUS :
KAB/KOTA : SUBANG JML RESEP :

PERSEDIAAN JUMLAH PEMAKAIAN OBAT PADA TANGGAL :


JUMLAH SISA
NO NAMA OBAT SATUAN PERSEDI PENA JUML PEMAKAI AKHIR
AAN MBAH AH 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 AN BULAN
AWAL AN
1 Asiklovir SK Tube 0 1 1 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 1
2 Ambroxol Syr Botol @ 60 ml 0 2 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 0 0 0 0 2
3 Ambroxol Tab Box @ 10 Strip 0 3 3 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 3
4 Antalgin 500 mg Tablet Box @ 10 Strip 0 4 4 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 4
5 Antalgin Plus / Ramalgin Plus Box @ 10 Strip 0 5 5 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 5
6 Bisakodil Tablet / Laxana Box @ 10 Strip 0 6 6 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 6
7 Bromhexin Tablet / Bromifar Box @ 10 Strip 0 7 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 0 0 0 0 0 0 0 0 7
8 Dexchlorpheniramin + Dexamethason / Box @ 10 Strip 0 8 8 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 8
Dexlosan

9 Dexchlorpheniramin maleat 2 mg Box @10 Strip 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 0 0


10 Etakridin / Rivanol Botol @ 100 ml 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 0 0
11 Eugenol Botol @ 10 ml 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 0 0
12 Famotidin 20 mg / Rafico Box @ 10 Strip 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 0 0
13 Gentian Violet Botol 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 0 0
14 GG 100 mg Box @ 10 Strip 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 0 0
15 Glibenklamid Box @ 10 Strip 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 0 0
16 Griseofulvin / Gricin 125 Box @ 10 Strip 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 0 0
17 Kaolin Pectin Syr / Antamen Syr Botol @ 60 ml 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 0 0
18 Kloramfenikol TM Plus Botol @ 5 ml 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 0 0
19 Kloramfenikol TT / Erlamisetin Botol @ 10 ml 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 0 0
20 Meloxicam 15 mg Box @ 5 Strip 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 0 0
21 Meloxicam 7,5 mg Box @ 5 Strip 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 0 0
22 Multivitamin Tab / Ramaton Tab Box @ 10 Strip 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 0 0
23 Natrium Bikarbonat Tablet Botol @ 100 Tab 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 0 0
24 Obat Batuk Herbal Dewasa / Herbakof Botol @ 60 ml 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 0 0
25 Obat Batuk Syr + PCT anak / Remco Syr Botol @ 60 ml 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 0 0

26 Obat Batuk Tab / Calortusin Box @ 10 Strip 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 0 0


27 Papaverin 40 mg Box @ 10 Strip 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 0 0
28 Piroxicam 10 mg Tab Box @ 10 Strip 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 0 0
29 Piroxicam 20 mg Tab Box @ 10 Strip 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 0 0
30 Spongostan Box @ 50 pcs 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 0 0
31 Simetidin 200 mg Box @ 10 Strip 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 0 0
32 Thiamfenikol Kaps / Riamycin 500 mg Box @ 10 Strip 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 0 0
33 Thiamfenikol Syr / Riamycin DS Botol @ 60 ml 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 0 0
34 Vitamin + FE / Ramabion Box @ 10 Strip 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 0 0
35 Valetamat Inj Botol @ 10 ampul 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 0 0
36 Vitamin Syr / Biovitan Syr Botol @ 60 ml 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 0 0
37 0 TAB 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 0 0
38 0 TAB 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 0 0
39 0 TAB 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 0 0
40 0 TAB 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 0 0
BUKU CATATAN HARIAN PEMAKAIAN OBAT ( RUTIN ) 2018
PUSKESMAS : PAGADEN BULAN NOVEM
KECAMATAN : PAGADEN JML KASUS :
KAB/KOTA : SUBANG JML RESEP :

PERSEDIAAN JUMLAH PEMAKAIAN OBAT PADA TANGGAL :


JUMLAH SISA
NO NAMA OBAT SATUAN PERSEDI PENA JUML PEMAKAI AKHIR
AAN MBAH AH 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 AN BULAN
AWAL AN
1 Asiklovir SK Tube 0 1 1 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 1
2 Ambroxol Syr Botol @ 60 ml 0 2 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 0 0 0 0 2
3 Ambroxol Tab Box @ 10 Strip 0 3 3 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 3
4 Antalgin 500 mg Tablet Box @ 10 Strip 0 4 4 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 4
5 Antalgin Plus / Ramalgin Plus Box @ 10 Strip 0 5 5 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 5
6 Bisakodil Tablet / Laxana Box @ 10 Strip 0 6 6 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 6
7 Bromhexin Tablet / Bromifar Box @ 10 Strip 0 7 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 0 0 0 0 0 0 0 0 7
8 Dexchlorpheniramin + Dexamethason / Box @ 10 Strip 0 8 8 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 8
Dexlosan

9 Dexchlorpheniramin maleat 2 mg Box @10 Strip 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 0 0


10 Etakridin / Rivanol Botol @ 100 ml 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 0 0
11 Eugenol Botol @ 10 ml 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 0 0
12 Famotidin 20 mg / Rafico Box @ 10 Strip 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 0 0
13 Gentian Violet Botol 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 0 0
14 GG 100 mg Box @ 10 Strip 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 0 0
15 Glibenklamid Box @ 10 Strip 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 0 0
16 Griseofulvin / Gricin 125 Box @ 10 Strip 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 0 0
17 Kaolin Pectin Syr / Antamen Syr Botol @ 60 ml 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 0 0
18 Kloramfenikol TM Plus Botol @ 5 ml 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 0 0
19 Kloramfenikol TT / Erlamisetin Botol @ 10 ml 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 0 0
20 Meloxicam 15 mg Box @ 5 Strip 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 0 0
21 Meloxicam 7,5 mg Box @ 5 Strip 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 0 0
22 Multivitamin Tab / Ramaton Tab Box @ 10 Strip 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 0 0
23 Natrium Bikarbonat Tablet Botol @ 100 Tab 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 0 0
24 Obat Batuk Herbal Dewasa / Herbakof Botol @ 60 ml 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 0 0
25 Obat Batuk Syr + PCT anak / Remco Syr Botol @ 60 ml 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 0 0

26 Obat Batuk Tab / Calortusin Box @ 10 Strip 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 0 0


27 Papaverin 40 mg Box @ 10 Strip 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 0 0
28 Piroxicam 10 mg Tab Box @ 10 Strip 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 0 0
29 Piroxicam 20 mg Tab Box @ 10 Strip 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 0 0
30 Spongostan Box @ 50 pcs 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 0 0
31 Simetidin 200 mg Box @ 10 Strip 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 0 0
32 Thiamfenikol Kaps / Riamycin 500 mg Box @ 10 Strip 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 0 0
33 Thiamfenikol Syr / Riamycin DS Botol @ 60 ml 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 0 0
34 Vitamin + FE / Ramabion Box @ 10 Strip 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 0 0
35 Valetamat Inj Botol @ 10 ampul 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 0 0
36 Vitamin Syr / Biovitan Syr Botol @ 60 ml 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 0 0
37 0 TAB 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 0 0
38 0 TAB 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 0 0
39 0 TAB 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 0 0
40 0 TAB 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 0 0
BUKU CATATAN HARIAN PEMAKAIAN OBAT ( RUTIN ) 2018
PUSKESMAS : PAGADEN BULAN DESEM
KECAMATAN : PAGADEN JML KASUS :
KAB/KOTA : SUBANG JML RESEP :

PERSEDIAAN JUMLAH PEMAKAIAN OBAT PADA TANGGAL :


JUMLAH SISA
NO NAMA OBAT SATUAN PERSEDI PENA JUML PEMAKAI AKHIR
AAN MBAH AH 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 AN BULAN
AWAL AN
1 Asiklovir SK Tube 0 1 1 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 1
2 Ambroxol Syr Botol @ 60 ml 0 2 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 0 0 0 0 2
3 Ambroxol Tab Box @ 10 Strip 0 3 3 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 3
4 Antalgin 500 mg Tablet Box @ 10 Strip 0 4 4 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 4
5 Antalgin Plus / Ramalgin Plus Box @ 10 Strip 0 5 5 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 5
6 Bisakodil Tablet / Laxana Box @ 10 Strip 0 6 6 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 6
7 Bromhexin Tablet / Bromifar Box @ 10 Strip 0 7 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 0 0 0 0 0 0 0 0 7
8 Dexchlorpheniramin + Dexamethason / Box @ 10 Strip 0 8 8 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 8
Dexlosan

9 Dexchlorpheniramin maleat 2 mg Box @10 Strip 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 0 0


10 Etakridin / Rivanol Botol @ 100 ml 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 0 0
11 Eugenol Botol @ 10 ml 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 0 0
12 Famotidin 20 mg / Rafico Box @ 10 Strip 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 0 0
13 Gentian Violet Botol 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 0 0
14 GG 100 mg Box @ 10 Strip 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 0 0
15 Glibenklamid Box @ 10 Strip 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 0 0
16 Griseofulvin / Gricin 125 Box @ 10 Strip 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 0 0
17 Kaolin Pectin Syr / Antamen Syr Botol @ 60 ml 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 0 0
18 Kloramfenikol TM Plus Botol @ 5 ml 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 0 0
19 Kloramfenikol TT / Erlamisetin Botol @ 10 ml 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 0 0
20 Meloxicam 15 mg Box @ 5 Strip 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 0 0
21 Meloxicam 7,5 mg Box @ 5 Strip 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 0 0
22 Multivitamin Tab / Ramaton Tab Box @ 10 Strip 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 0 0
23 Natrium Bikarbonat Tablet Botol @ 100 Tab 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 0 0
24 Obat Batuk Herbal Dewasa / Herbakof Botol @ 60 ml 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 0 0
25 Obat Batuk Syr + PCT anak / Remco Syr Botol @ 60 ml 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 0 0

26 Obat Batuk Tab / Calortusin Box @ 10 Strip 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 0 0


27 Papaverin 40 mg Box @ 10 Strip 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 0 0
28 Piroxicam 10 mg Tab Box @ 10 Strip 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 0 0
29 Piroxicam 20 mg Tab Box @ 10 Strip 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 0 0
30 Spongostan Box @ 50 pcs 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 0 0
31 Simetidin 200 mg Box @ 10 Strip 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 0 0
32 Thiamfenikol Kaps / Riamycin 500 mg Box @ 10 Strip 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 0 0
33 Thiamfenikol Syr / Riamycin DS Botol @ 60 ml 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 0 0
34 Vitamin + FE / Ramabion Box @ 10 Strip 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 0 0
35 Valetamat Inj Botol @ 10 ampul 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 0 0
36 Vitamin Syr / Biovitan Syr Botol @ 60 ml 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 0 0
37 0 TAB 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 0 0
38 0 TAB 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 0 0
39 0 TAB
40 0 TAB
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) PUSKESMAS 2018
PUSKESMAS : PAGADEN SUB UNIT : UGD DOKUMEN NOMOR TANGGAL
KECAMATAN : PAGADEN PELAPORAN BULAN / PERIODE : MEI PUSKESMAS
KAB/KOTA : SUBANG PERMINTAAN BULAN / PERIODE : JUNI LEMBAR MERAH : PUSKESMAS
PROVINSI : JAWA BARAT LEMBAR KUNING : ARSIP
PEMBERIAN
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR PERMINTAAN JUMLAH
BS/APBN APBD I APBD II DAK BPJS
1 Asiklovir SK Tube 0 0 0 0 0
2 Ambroxol Syr Botol @ 60 ml 0 0 0 0 0
3 Ambroxol Tab Box @ 10 Strip 0 0 0 0 0
4 Antalgin 500 mg Tablet Box @ 10 Strip 0 0 0 0 0
5 Antalgin Plus / Ramalgin Plus Box @ 10 Strip 0 0 0 0 0
6 Bisakodil Tablet / Laxana Box @ 10 Strip 0 0 0 0 0
7 Bromhexin Tablet / Bromifar Box @ 10 Strip 0 0 0 0 0
8 Dexchlorpheniramin + Dexamethason / Box @ 10 Strip 0 0 0 0 0
Dexlosan

9 Dexchlorpheniramin maleat 2 mg Box @10 Strip 0 0 0 0 0


10 Etakridin / Rivanol Botol @ 100 ml 0 0 0 0 0
11 Eugenol Botol @ 10 ml 0 0 0 0 0
12 Famotidin 20 mg / Rafico Box @ 10 Strip 0 0 0 0 0
13 Gentian Violet Botol 0 0 0 0 0
14 GG 100 mg Box @ 10 Strip 0 0 0 0 0
15 Glibenklamid Box @ 10 Strip 0 0 0 0 0
16 Griseofulvin / Gricin 125 Box @ 10 Strip 0 0 0 0 0
17 Kaolin Pectin Syr / Antamen Syr Botol @ 60 ml 0 0 0 0 0
18 Kloramfenikol TM Plus Botol @ 5 ml 0 0 0 0 0
19 Kloramfenikol TT / Erlamisetin Botol @ 10 ml 0 0 0 0 0
20 Meloxicam 15 mg Box @ 5 Strip 0 0 0 0 0
21 Meloxicam 7,5 mg Box @ 5 Strip 0 0 0 0 0
22 Multivitamin Tab / Ramaton Tab Box @ 10 Strip 0 0 0 0 0
23 Natrium Bikarbonat Tablet Botol @ 100 0 0 0 0 0
Tab
24 Obat Batuk Herbal Dewasa / Herbakof Botol @ 60 ml 0 0 0 0 0
25 Obat Batuk Syr + PCT anak / Remco Syr Botol @ 60 ml 0 0 0 0 0
26 Obat Batuk Tab / Calortusin Box @ 10 Strip 0 0 0 0 0
27 Papaverin 40 mg Box @ 10 Strip 0 0 0 0 0
28 Piroxicam 10 mg Tab Box @ 10 Strip 0 0 0 0 0
29 Piroxicam 20 mg Tab Box @ 10 Strip 0 0 0 0 0
30 Spongostan Box @ 50 pcs 0 0 0 0 0
31 Simetidin 200 mg Box @ 10 Strip 0 0 0 0 0
32 Thiamfenikol Kaps / Riamycin 500 mg Box @ 10 Strip 0 0 0 0 0
33 Thiamfenikol Syr / Riamycin DS Botol @ 60 ml 0 0 0 0 0

34 Vitamin + FE / Ramabion Box @ 10 Strip 0 0 0 0 0

35 Valetamat Inj Botol @ 10 0 0 0 0 0


ampul
36 Vitamin Syr / Biovitan Syr Botol @ 60 ml 0 0 0 0 0

37 - TAB 0 0 0 0 0

38 - TAB 0 0 0 0 0

39 - TAB 0 0 0 0 0

40 - TAB 0 0 0 0 0

BAYAR/UMUM BPJS JAMKESDA JUMLAH NTOTAL


RAWAT
RAWAT JALAN RAWAT INAP RAWAT JALAN RAWAT INAP RAWAT JALAN RAWAT INAP RAWAT JALAN
JUMLAH KUNJUNGAN RESEP INAP
0 0 0 0 0 0 0 0
0 0 0 0
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) PUSKESMAS 2018
PUSKESMAS : PAGADEN SUB UNIT : UGD DOKUMEN NOMOR TANGGAL
KECAMATAN : PAGADEN PELAPORAN BULAN / PERIODE : JUNI PUSKESMAS
KAB/KOTA : SUBANG PERMINTAAN BULAN / PERIODE : JULI LEMBAR MERAH : PUSKESMAS
PROVINSI : JAWA BARAT LEMBAR KUNING : ARSIP
PEMBERIAN
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR PERMINTAAN JUMLAH
BS/APBN APBD I APBD II DAK BPJS
1 Asiklovir SK Tube 0 0 0 0 0

2 Ambroxol Syr Botol @ 60 ml 0 0 0 0 0

3 Ambroxol Tab Box @ 10 Strip 0 0 0 0 0

4 Antalgin 500 mg Tablet Box @ 10 Strip 0 0 0 0 0

5 Antalgin Plus / Ramalgin Plus Box @ 10 Strip 0 0 0 0 0

6 Bisakodil Tablet / Laxana Box @ 10 Strip 0 0 0 0 0

7 Bromhexin Tablet / Bromifar Box @ 10 Strip 0 0 0 0 0


8 Dexchlorpheniramin + Dexamethason / Box @ 10 Strip 0 0 0 0 0
Dexlosan

9 Dexchlorpheniramin maleat 2 mg Box @10 Strip 0 0 0 0 0

10 Etakridin / Rivanol Botol @ 100 ml 0 0 0 0 0

11 Eugenol Botol @ 10 ml 0 0 0 0 0

12 Famotidin 20 mg / Rafico Box @ 10 Strip 0 0 0 0 0

13 Gentian Violet Botol 0 0 0 0 0

14 GG 100 mg Box @ 10 Strip 0 0 0 0 0

15 Glibenklamid Box @ 10 Strip 0 0 0 0 0

16 Griseofulvin / Gricin 125 Box @ 10 Strip 0 0 0 0 0

17 Kaolin Pectin Syr / Antamen Syr Botol @ 60 ml 0 0 0 0 0

18 Kloramfenikol TM Plus Botol @ 5 ml 0 0 0 0 0

19 Kloramfenikol TT / Erlamisetin Botol @ 10 ml 0 0 0 0 0

20 Meloxicam 15 mg Box @ 5 Strip 0 0 0 0 0

21 Meloxicam 7,5 mg Box @ 5 Strip 0 0 0 0 0

22 Multivitamin Tab / Ramaton Tab Box @ 10 Strip 0 0 0 0 0

23 Natrium Bikarbonat Tablet Botol @ 100 0 0 0 0 0


Tab
24 Obat Batuk Herbal Dewasa / Herbakof Botol @ 60 ml 0 0 0 0 0

25 Obat Batuk Syr + PCT anak / Remco Syr Botol @ 60 ml 0 0 0 0 0

26 Obat Batuk Tab / Calortusin Box @ 10 Strip 0 0 0 0 0

27 Papaverin 40 mg Box @ 10 Strip 0 0 0 0 0


28 Piroxicam 10 mg Tab Box @ 10 Strip 0 0 0 0 0

29 Piroxicam 20 mg Tab Box @ 10 Strip 0 0 0 0 0

30 Spongostan Box @ 50 pcs 0 0 0 0 0

31 Simetidin 200 mg Box @ 10 Strip 0 0 0 0 0

32 Thiamfenikol Kaps / Riamycin 500 mg Box @ 10 Strip 0 0 0 0 0

33 Thiamfenikol Syr / Riamycin DS Botol @ 60 ml 0 0 0 0 0

34 Vitamin + FE / Ramabion Box @ 10 Strip 0 0 0 0 0

35 Valetamat Inj Botol @ 10 0 0 0 0 0


ampul
36 Vitamin Syr / Biovitan Syr Botol @ 60 ml 0 0 0 0 0

136 - TAB 0 0 0 0 0

137 - TAB 0 0 0 0 0

138 - TAB 0 0 0 0 0

139 - TAB 0 0 0 0 0

BAYAR/UMUM BPJS JAMKESDA JUMLAH NTOTAL


RAWAT JALAN RAWAT INAP RAWAT JALAN RAWAT INAP RAWAT JALAN RAWAT INAP RAWAT JALAN RAWAT
JUMLAH KUNJUNGAN RESEP INAP
0 0 0 0 0 0 0 0
0 0 0 0
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) PUSKESMAS 2018
PUSKESMAS : PAGADEN SUB UNIT : UGD DOKUMEN NOMOR TANGGAL
KECAMATAN : PAGADEN PELAPORAN BULAN / PERIODE : JULI PUSKESMAS
KAB/KOTA : SUBANG PERMINTAAN BULAN / PERIODE : AGUSTUS LEMBAR MERAH : PUSKESMAS
PROVINSI : JAWA BARAT LEMBAR KUNING : ARSIP
PEMBERIAN
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR PERMINTAAN JUMLAH
BS/APBN APBD I APBD II DAK BPJS
1 Asiklovir SK Tube 0 0 0 0 0

2 Ambroxol Syr Botol @ 60 ml 0 0 0 0 0

3 Ambroxol Tab Box @ 10 Strip 0 0 0 0 0

4 Antalgin 500 mg Tablet Box @ 10 Strip 0 0 0 0 0

5 Antalgin Plus / Ramalgin Plus Box @ 10 Strip 0 0 0 0 0

6 Bisakodil Tablet / Laxana Box @ 10 Strip 0 0 0 0 0

7 Bromhexin Tablet / Bromifar Box @ 10 Strip 0 0 0 0 0


8 Dexchlorpheniramin + Dexamethason / Box @ 10 Strip 0 0 0 0 0
Dexlosan

9 Dexchlorpheniramin maleat 2 mg Box @10 Strip 0 0 0 0 0

10 Etakridin / Rivanol Botol @ 100 ml 0 0 0 0 0

11 Eugenol Botol @ 10 ml 0 0 0 0 0

12 Famotidin 20 mg / Rafico Box @ 10 Strip 0 0 0 0 0

13 Gentian Violet Botol 0 0 0 0 0

14 GG 100 mg Box @ 10 Strip 0 0 0 0 0

15 Glibenklamid Box @ 10 Strip 0 0 0 0 0

16 Griseofulvin / Gricin 125 Box @ 10 Strip 0 0 0 0 0

17 Kaolin Pectin Syr / Antamen Syr Botol @ 60 ml 0 0 0 0 0

18 Kloramfenikol TM Plus Botol @ 5 ml 0 0 0 0 0

19 Kloramfenikol TT / Erlamisetin Botol @ 10 ml 0 0 0 0 0

20 Meloxicam 15 mg Box @ 5 Strip 0 0 0 0 0

21 Meloxicam 7,5 mg Box @ 5 Strip 0 0 0 0 0

22 Multivitamin Tab / Ramaton Tab Box @ 10 Strip 0 0 0 0 0

23 Natrium Bikarbonat Tablet Botol @ 100 Tab 0 0 0 0 0

24 Obat Batuk Herbal Dewasa / Herbakof Botol @ 60 ml 0 0 0 0 0


25 Obat Batuk Syr + PCT anak / Remco Syr Botol @ 60 ml 0 0 0 0 0

26 Obat Batuk Tab / Calortusin Box @ 10 Strip 0 0 0 0 0

27 Papaverin 40 mg Box @ 10 Strip 0 0 0 0 0

28 Piroxicam 10 mg Tab Box @ 10 Strip 0 0 0 0 0

29 Piroxicam 20 mg Tab Box @ 10 Strip 0 0 0 0 0

30 Spongostan Box @ 50 pcs 0 0 0 0 0

31 Simetidin 200 mg Box @ 10 Strip 0 0 0 0 0

32 Thiamfenikol Kaps / Riamycin 500 mg Box @ 10 Strip 0 0 0 0 0

33 Thiamfenikol Syr / Riamycin DS Botol @ 60 ml 0 0 0 0 0

34 Vitamin + FE / Ramabion Box @ 10 Strip 0 0 0 0 0

35 Valetamat Inj Botol @ 10 ampu 0 0 0 0 0

36 Vitamin Syr / Biovitan Syr Botol @ 60 ml 0 0 0 0 0

37 - TAB 0 0 0 0 0

38 - TAB 0 0 0 0 0

39 - TAB 0 0 0 0 0

40 - TAB 0 0 0 0 0

BAYAR/UMUM BPJS JAMKESDA JUMLAH NTOTAL


RAWAT
RAWAT JALAN RAWAT INAP RAWAT JALAN RAWAT INAP RAWAT JALAN RAWAT INAP RAWAT JALAN
JUMLAH KUNJUNGAN RESEP INAP
0 0 0 0 0 0 0 0
0 0 0 0
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) PUSKESMAS 2018
PUSKESMAS : PAGADEN SUB UNIT : UGD DOKUMEN NOMOR TANGGAL
KECAMATAN : PAGADEN PELAPORAN BULAN / PERIODE : AGUSTUS PUSKESMAS
KAB/KOTA : SUBANG PERMINTAAN BULAN / PERIODE : SEPTEMBER LEMBAR MERAH : PUSKESMAS
PROVINSI : JAWA BARAT LEMBAR KUNING : ARSIP
PEMBERIAN
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR PERMINTAAN JUMLAH
BS/APBN APBD I APBD II DAK BPJS
1 Asiklovir SK Tube 0 1 1 0 1
2 Ambroxol Syr Botol @ 60 ml 0 2 2 0 2
3 Ambroxol Tab Box @ 10 Strip 0 3 3 0 3
4 Antalgin 500 mg Tablet Box @ 10 Strip 0 4 4 0 4
5 Antalgin Plus / Ramalgin Plus Box @ 10 Strip 0 5 5 0 5
6 Bisakodil Tablet / Laxana Box @ 10 Strip 0 6 6 0 6
7 Bromhexin Tablet / Bromifar Box @ 10 Strip 0 7 7 0 7
8 Dexchlorpheniramin + Dexamethason / Box @ 10 Strip 0 8 8 0 8
Dexlosan
9 Dexchlorpheniramin maleat 2 mg Box @10 Strip 0 0 0 0 0
10 Etakridin / Rivanol Botol @ 100 ml 0 0 0 0 0
11 Eugenol Botol @ 10 ml 0 0 0 0 0
12 Famotidin 20 mg / Rafico Box @ 10 Strip 0 0 0 0 0
13 Gentian Violet Botol 0 0 0 0 0
14 GG 100 mg Box @ 10 Strip 0 0 0 0 0
15 Glibenklamid Box @ 10 Strip 0 0 0 0 0
16 Griseofulvin / Gricin 125 Box @ 10 Strip 0 0 0 0 0
17 Kaolin Pectin Syr / Antamen Syr Botol @ 60 ml 0 0 0 0 0
18 Kloramfenikol TM Plus Botol @ 5 ml 0 0 0 0 0
19 Kloramfenikol TT / Erlamisetin Botol @ 10 ml 0 0 0 0 0
20 Meloxicam 15 mg Box @ 5 Strip 0 0 0 0 0
21 Meloxicam 7,5 mg Box @ 5 Strip 0 0 0 0 0
22 Multivitamin Tab / Ramaton Tab Box @ 10 Strip 0 0 0 0 0
23 Natrium Bikarbonat Tablet Botol @ 100 Tab 0 0 0 0 0
24 Obat Batuk Herbal Dewasa / Herbakof Botol @ 60 ml 0 0 0 0 0
25 Obat Batuk Syr + PCT anak / Remco Syr Botol @ 60 ml 0 0 0 0 0
26 Obat Batuk Tab / Calortusin Box @ 10 Strip 0 0 0 0 0
27 Papaverin 40 mg Box @ 10 Strip 0 0 0 0 0
28 Piroxicam 10 mg Tab Box @ 10 Strip 0 0 0 0 0
29 Piroxicam 20 mg Tab Box @ 10 Strip 0 0 0 0 0
30 Spongostan Box @ 50 pcs 0 0 0 0 0
31 Simetidin 200 mg Box @ 10 Strip 0 0 0 0 0
32 Thiamfenikol Kaps / Riamycin 500 mg Box @ 10 Strip 0 0 0 0 0
33 Thiamfenikol Syr / Riamycin DS Botol @ 60 ml 0 0 0 0 0
34 Vitamin + FE / Ramabion Box @ 10 Strip 0 0 0 0 0
35 Valetamat Inj Botol @ 10 ampu 0 0 0 0 0
36 Vitamin Syr / Biovitan Syr Botol @ 60 ml 0 0 0 0 0
37 - TAB 0 0 0 0 0
38 - TAB 0 0 0 0 0
39 - TAB 0 0 0 0 0
40 - TAB 0 0 0 0 0

BAYAR/UMUM BPJS JAMKESDA JUMLAH NTOTAL


RAWAT
RAWAT JALAN RAWAT INAP RAWAT JALAN RAWAT INAP RAWAT JALAN RAWAT INAP RAWAT JALAN
JUMLAH KUNJUNGAN RESEP INAP
0 0 0 0 0 0 0 0
0 0 0 0
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) PUSKESMAS 2018
PUSKESMAS : PAGADEN SUB UNIT : UGD DOKUMEN NOMOR TANGGAL
KECAMATAN : PAGADEN PELAPORAN BULAN / PERIODE : SEPTEMBER PUSKESMAS
KAB/KOTA : SUBANG PERMINTAAN BULAN / PERIODE : OKTOBER LEMBAR MERAH : PUSKESMAS
PROVINSI : JAWA BARAT LEMBAR KUNING : ARSIP
PEMBERIAN
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR PERMINTAAN JUMLAH
BS/APBN APBD I APBD II DAK BPJS
1 Asiklovir SK Tube 0 1 1 0 1
2 Ambroxol Syr Botol @ 60 ml 0 2 2 0 2
3 Ambroxol Tab Box @ 10 Strip 0 3 3 0 3
4 Antalgin 500 mg Tablet Box @ 10 Strip 0 4 4 0 4
5 Antalgin Plus / Ramalgin Plus Box @ 10 Strip 0 5 5 0 5
6 Bisakodil Tablet / Laxana Box @ 10 Strip 0 6 6 0 6
7 Bromhexin Tablet / Bromifar Box @ 10 Strip 0 7 7 0 7
8 Dexchlorpheniramin + Dexamethason / Box @ 10 Strip 0 8 8 0 8
Dexlosan

9 Dexchlorpheniramin maleat 2 mg Box @10 Strip 0 0 0 0 0


10 Etakridin / Rivanol Botol @ 100 ml 0 0 0 0 0
11 Eugenol Botol @ 10 ml 0 0 0 0 0
12 Famotidin 20 mg / Rafico Box @ 10 Strip 0 0 0 0 0
13 Gentian Violet Botol 0 0 0 0 0
14 GG 100 mg Box @ 10 Strip 0 0 0 0 0
15 Glibenklamid Box @ 10 Strip 0 0 0 0 0
16 Griseofulvin / Gricin 125 Box @ 10 Strip 0 0 0 0 0
17 Kaolin Pectin Syr / Antamen Syr Botol @ 60 ml 0 0 0 0 0
18 Kloramfenikol TM Plus Botol @ 5 ml 0 0 0 0 0
19 Kloramfenikol TT / Erlamisetin Botol @ 10 ml 0 0 0 0 0
20 Meloxicam 15 mg Box @ 5 Strip 0 0 0 0 0
21 Meloxicam 7,5 mg Box @ 5 Strip 0 0 0 0 0
22 Multivitamin Tab / Ramaton Tab Box @ 10 Strip 0 0 0 0 0
23 Natrium Bikarbonat Tablet Botol @ 100 Tab 0 0 0 0 0
24 Obat Batuk Herbal Dewasa / Herbakof Botol @ 60 ml 0 0 0 0 0
25 Obat Batuk Syr + PCT anak / Remco Syr Botol @ 60 ml 0 0 0 0 0
26 Obat Batuk Tab / Calortusin Box @ 10 Strip 0 0 0 0 0
27 Papaverin 40 mg Box @ 10 Strip 0 0 0 0 0
28 Piroxicam 10 mg Tab Box @ 10 Strip 0 0 0 0 0
29 Piroxicam 20 mg Tab Box @ 10 Strip 0 0 0 0 0
30 Spongostan Box @ 50 pcs 0 0 0 0 0
31 Simetidin 200 mg Box @ 10 Strip 0 0 0 0 0
32 Thiamfenikol Kaps / Riamycin 500 mg Box @ 10 Strip 0 0 0 0 0
33 Thiamfenikol Syr / Riamycin DS Botol @ 60 ml 0 0 0 0 0
34 Vitamin + FE / Ramabion Box @ 10 Strip 0 0 0 0 0
35 Valetamat Inj Botol @ 10 ampu 0 0 0 0 0
36 Vitamin Syr / Biovitan Syr Botol @ 60 ml 0 0 0 0 0
37 - TAB 0 0 0 0 0
38 - TAB 0 0 0 0 0
39 - TAB 0 0 0 0 0
40 - TAB 0 0 0 0 0

BAYAR/UMUM BPJS JAMKESDA JUMLAH NTOTAL


RAWAT
RAWAT JALAN RAWAT INAP RAWAT JALAN RAWAT INAP RAWAT JALAN RAWAT INAP RAWAT JALAN
JUMLAH KUNJUNGAN RESEP INAP
0 0 0 0 0 0 0 0
0 0 0 0
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) PUSKESMAS 2018
PUSKESMAS : PAGADEN SUB UNIT : UGD DOKUMEN NOMOR TANGGAL
KECAMATAN : PAGADEN PELAPORAN BULAN / PERIODE : OKTOBER PUSKESMAS
KAB/KOTA : SUBANG PERMINTAAN BULAN / PERIODE : NOVEMBER LEMBAR MERAH : PUSKESMAS
PROVINSI : JAWA BARAT LEMBAR KUNING : ARSIP
PEMBERIAN
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR PERMINTAAN JUMLAH
BS/APBN APBD I APBD II DAK BPJS
1 Asiklovir SK Tube 0 1 1 0 1
2 Ambroxol Syr Botol @ 60 ml 0 2 2 0 2
3 Ambroxol Tab Box @ 10 Strip 0 3 3 0 3
4 Antalgin 500 mg Tablet Box @ 10 Strip 0 4 4 0 4
5 Antalgin Plus / Ramalgin Plus Box @ 10 Strip 0 5 5 0 5
6 Bisakodil Tablet / Laxana Box @ 10 Strip 0 6 6 0 6
7 Bromhexin Tablet / Bromifar Box @ 10 Strip 0 7 7 0 7
8 Dexchlorpheniramin + Dexamethason / Box @ 10 Strip 0 8 8 0 8
Dexlosan

9 Dexchlorpheniramin maleat 2 mg Box @10 Strip 0 0 0 0 0


10 Etakridin / Rivanol Botol @ 100 ml 0 0 0 0 0
11 Eugenol Botol @ 10 ml 0 0 0 0 0
12 Famotidin 20 mg / Rafico Box @ 10 Strip 0 0 0 0 0
13 Gentian Violet Botol 0 0 0 0 0
14 GG 100 mg Box @ 10 Strip 0 0 0 0 0
15 Glibenklamid Box @ 10 Strip 0 0 0 0 0
16 Griseofulvin / Gricin 125 Box @ 10 Strip 0 0 0 0 0
17 Kaolin Pectin Syr / Antamen Syr Botol @ 60 ml 0 0 0 0 0
18 Kloramfenikol TM Plus Botol @ 5 ml 0 0 0 0 0
19 Kloramfenikol TT / Erlamisetin Botol @ 10 ml 0 0 0 0 0
20 Meloxicam 15 mg Box @ 5 Strip 0 0 0 0 0
21 Meloxicam 7,5 mg Box @ 5 Strip 0 0 0 0 0
22 Multivitamin Tab / Ramaton Tab Box @ 10 Strip 0 0 0 0 0
23 Natrium Bikarbonat Tablet Botol @ 100 0 0 0 0 0
Tab
24 Obat Batuk Herbal Dewasa / Herbakof Botol @ 60 ml 0 0 0 0 0
25 Obat Batuk Syr + PCT anak / Remco Syr Botol @ 60 ml 0 0 0 0 0
26 Obat Batuk Tab / Calortusin Box @ 10 Strip 0 0 0 0 0
27 Papaverin 40 mg Box @ 10 Strip 0 0 0 0 0
28 Piroxicam 10 mg Tab Box @ 10 Strip 0 0 0 0 0
29 Piroxicam 20 mg Tab Box @ 10 Strip 0 0 0 0 0
30 Spongostan Box @ 50 pcs 0 0 0 0 0
31 Simetidin 200 mg Box @ 10 Strip 0 0 0 0 0
32 Thiamfenikol Kaps / Riamycin 500 mg Box @ 10 Strip 0 0 0 0 0
33 Thiamfenikol Syr / Riamycin DS Botol @ 60 ml 0 0 0 0 0
34 Vitamin + FE / Ramabion Box @ 10 Strip 0 0 0 0 0
35 Valetamat Inj Botol @ 10 0 0 0 0 0
ampul
36 Vitamin Syr / Biovitan Syr Botol @ 60 ml 0 0 0 0 0
37 - TAB 0 0 0 0 0
38 - TAB 0 0 0 0 0
39 - TAB 0 0 0 0 0
40 - TAB 0 0 0 0 0

BAYAR/UMUM BPJS JAMKESDA JUMLAH NTOTAL


RAWAT
RAWAT JALAN RAWAT INAP RAWAT JALAN RAWAT INAP RAWAT JALAN RAWAT INAP RAWAT JALAN
JUMLAH KUNJUNGAN RESEP INAP
0 0 0 0 0 0 0 0
0 0 0 0
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) PUSKESMAS 2018
PUSKESMAS : PAGADEN SUB UNIT : UGD DOKUMEN NOMOR TANGGAL
KECAMATAN : PAGADEN PELAPORAN BULAN / PERIODE : NOVEMBER PUSKESMAS
KAB/KOTA : SUBANG PERMINTAAN BULAN / PERIODE : DESEMBER LEMBAR MERAH : PUSKESMAS
PROVINSI : JAWA BARAT LEMBAR KUNING : ARSIP
PEMBERIAN
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR PERMINTAAN JUMLAH
BS/APBN APBD I APBD II DAK BPJS
1 Asiklovir SK Tube 0 1 1 0 1
2 Ambroxol Syr Botol @ 60 ml 0 2 2 0 2
3 Ambroxol Tab Box @ 10 Strip 0 3 3 0 3
4 Antalgin 500 mg Tablet Box @ 10 Strip 0 4 4 0 4
5 Antalgin Plus / Ramalgin Plus Box @ 10 Strip 0 5 5 0 5
6 Bisakodil Tablet / Laxana Box @ 10 Strip 0 6 6 0 6
7 Bromhexin Tablet / Bromifar Box @ 10 Strip 0 7 7 0 7
8 Dexchlorpheniramin + Dexamethason / Box @ 10 Strip 0 8 8 0 8
Dexlosan

9 Dexchlorpheniramin maleat 2 mg Box @10 Strip 0 0 0 0 0


10 Etakridin / Rivanol Botol @ 100 ml 0 0 0 0 0
11 Eugenol Botol @ 10 ml 0 0 0 0 0
12 Famotidin 20 mg / Rafico Box @ 10 Strip 0 0 0 0 0
13 Gentian Violet Botol 0 0 0 0 0
14 GG 100 mg Box @ 10 Strip 0 0 0 0 0
15 Glibenklamid Box @ 10 Strip 0 0 0 0 0
16 Griseofulvin / Gricin 125 Box @ 10 Strip 0 0 0 0 0
17 Kaolin Pectin Syr / Antamen Syr Botol @ 60 ml 0 0 0 0 0
18 Kloramfenikol TM Plus Botol @ 5 ml 0 0 0 0 0
19 Kloramfenikol TT / Erlamisetin Botol @ 10 ml 0 0 0 0 0
20 Meloxicam 15 mg Box @ 5 Strip 0 0 0 0 0
21 Meloxicam 7,5 mg Box @ 5 Strip 0 0 0 0 0
22 Multivitamin Tab / Ramaton Tab Box @ 10 Strip 0 0 0 0 0
23 Natrium Bikarbonat Tablet Botol @ 100 0 0 0 0 0
Tab
24 Obat Batuk Herbal Dewasa / Herbakof Botol @ 60 ml 0 0 0 0 0
25 Obat Batuk Syr + PCT anak / Remco Syr Botol @ 60 ml 0 0 0 0 0
26 Obat Batuk Tab / Calortusin Box @ 10 Strip 0 0 0 0 0
27 Papaverin 40 mg Box @ 10 Strip 0 0 0 0 0
28 Piroxicam 10 mg Tab Box @ 10 Strip 0 0 0 0 0
29 Piroxicam 20 mg Tab Box @ 10 Strip 0 0 0 0 0
30 Spongostan Box @ 50 pcs 0 0 0 0 0
31 Simetidin 200 mg Box @ 10 Strip 0 0 0 0 0
32 Thiamfenikol Kaps / Riamycin 500 mg Box @ 10 Strip 0 0 0 0 0
33 Thiamfenikol Syr / Riamycin DS Botol @ 60 ml 0 0 0 0 0
34 Vitamin + FE / Ramabion Box @ 10 Strip 0 0 0 0 0
35 Valetamat Inj Botol @ 10 0 0 0 0 0
ampul
36 Vitamin Syr / Biovitan Syr Botol @ 60 ml 0 0 0 0 0
37 - TAB 0 0 0 0 0
38 - TAB 0 0 0 0 0
39 - TAB 0 0 0 0 0
40 - TAB 0 0 0 0 0

BAYAR/UMUM BPJS JAMKESDA JUMLAH NTOTAL


RAWAT
RAWAT JALAN RAWAT INAP RAWAT JALAN RAWAT INAP RAWAT JALAN RAWAT INAP RAWAT JALAN
JUMLAH KUNJUNGAN RESEP INAP
0 0 0 0 0 0 0 0
0 0 0 0
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) PUSKESMAS 2018
PUSKESMAS : PAGADEN SUB UNIT : UGD DOKUMEN NOMOR TANGGAL
KECAMATAN : PAGADEN PELAPORAN BULAN / PERIODE : DESEMBER PUSKESMAS
KAB/KOTA : SUBANG PERMINTAAN BULAN / PERIODE : JANUARI 19 LEMBAR MERAH : PUSKESMAS
PROVINSI : JAWA BARAT LEMBAR KUNING : ARSIP
PEMBERIAN
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR PERMINTAAN JUMLAH
BS/APBN APBD I APBD II DAK BPJS
1 Asiklovir SK Tube 0 1 1 0 1
2 Ambroxol Syr Botol @ 60 ml 0 2 2 0 2
3 Ambroxol Tab Box @ 10 Strip 0 3 3 0 3
4 Antalgin 500 mg Tablet Box @ 10 Strip 0 4 4 0 4
5 Antalgin Plus / Ramalgin Plus Box @ 10 Strip 0 5 5 0 5
6 Bisakodil Tablet / Laxana Box @ 10 Strip 0 6 6 0 6
7 Bromhexin Tablet / Bromifar Box @ 10 Strip 0 7 7 0 7
8 Dexchlorpheniramin + Dexamethason / Box @ 10 Strip 0 8 8 0 8
Dexlosan
9 Dexchlorpheniramin maleat 2 mg Box @10 Strip 0 0 0 0 0
10 Etakridin / Rivanol Botol @ 100 ml 0 0 0 0 0
11 Eugenol Botol @ 10 ml 0 0 0 0 0
12 Famotidin 20 mg / Rafico Box @ 10 Strip 0 0 0 0 0
13 Gentian Violet Botol 0 0 0 0 0
14 GG 100 mg Box @ 10 Strip 0 0 0 0 0
15 Glibenklamid Box @ 10 Strip 0 0 0 0 0
16 Griseofulvin / Gricin 125 Box @ 10 Strip 0 0 0 0 0
17 Kaolin Pectin Syr / Antamen Syr Botol @ 60 ml 0 0 0 0 0
18 Kloramfenikol TM Plus Botol @ 5 ml 0 0 0 0 0
19 Kloramfenikol TT / Erlamisetin Botol @ 10 ml 0 0 0 0 0
20 Meloxicam 15 mg Box @ 5 Strip 0 0 0 0 0
21 Meloxicam 7,5 mg Box @ 5 Strip 0 0 0 0 0
22 Multivitamin Tab / Ramaton Tab Box @ 10 Strip 0 0 0 0 0
23 Natrium Bikarbonat Tablet Botol @ 100 0 0 0 0 0
Tab
24 Obat Batuk Herbal Dewasa / Herbakof Botol @ 60 ml 0 0 0 0 0
25 Obat Batuk Syr + PCT anak / Remco Syr Botol @ 60 ml 0 0 0 0 0

26 Obat Batuk Tab / Calortusin Box @ 10 Strip 0 0 0 0 0


27 Papaverin 40 mg Box @ 10 Strip 0 0 0 0 0
28 Piroxicam 10 mg Tab Box @ 10 Strip 0 0 0 0 0
29 Piroxicam 20 mg Tab Box @ 10 Strip 0 0 0 0 0
30 Spongostan Box @ 50 pcs 0 0 0 0 0
31 Simetidin 200 mg Box @ 10 Strip 0 0 0 0 0
32 Thiamfenikol Kaps / Riamycin 500 mg Box @ 10 Strip 0 0 0 0 0
33 Thiamfenikol Syr / Riamycin DS Botol @ 60 ml 0 0 0 0 0
34 Vitamin + FE / Ramabion Box @ 10 Strip 0 0 0 0 0
35 Valetamat Inj Botol @ 10 0 0 0 0 0
ampul
36 Vitamin Syr / Biovitan Syr Botol @ 60 ml 0 0 0 0 0
37 - TAB 0 0 0 0 0
38 - TAB 0 0 0 0 0
39 - TAB 0 0 0 0 0
40 - TAB 0 0 0 0 0

BAYAR/UMUM BPJS JAMKESDA JUMLAH NTOTAL


RAWAT
RAWAT JALAN RAWAT INAP RAWAT JALAN RAWAT INAP RAWAT JALAN RAWAT INAP RAWAT JALAN
JUMLAH KUNJUNGAN RESEP INAP
0 0 0 0 0 0 0 0
0 0 0 0

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