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PUSKESMAS: KARANGAN PELAPORAN BULAN : NOVEMBER

KECAMATAN: KARANGAN PERMINTAAN BULAN/PERIODE : 2018
KABUPATEN : KUTAI TIMUR

PERMINTAAN
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN MASA ED KET
INPRES ASKES APBD I APBD II LAIN2 JUMLAH
1 2 3 4 5 6 7 8 9 10 11 12
JENIS TABLET/KAPSUL/KAPLET
1 Acyclovir 200mg Tablet 1300 1300 100 1200 May-19
2 Acyclovir 400mg Tablet 0 0
3 Albendazole 400mg Tablet 0 100 100 0 100 Jul-21
4 Allopurinol 300 mg Tablet 0 0
5 Ambroxol Tablet 4200 4200 400 3800 Nov-20
6 Amlodiphine 10mg Tablet 900 900 1800 150 1650 Aug-20
7 Aminophilin 200mg Tablet 0 0
8 Amitrhiptylline 25mg Tablet 0 0
9 Amoxiycillin 250 mg Tablet 100 100 100 0 Jun-20
10 Amoxycillin 500mg Tablet 1300 3000 4300 700 3600 Jun-19
11 Ampicillin 500mg Tablet 0 0
12 Antalgin 500mg Tablet 0 0
13 Antasida doen Tablet 0 0
14 Asamefenamat 500mg Tablet 1800 1800 1100 700 Jan-20
15 Asamefenamat 250mg Tablet 0 0
16 Asetosal 500mg Tablet 0 0
17 Atrhopin sulfate 0,25mg Tablet 0 0
18 Besi sulfate 300mg (FE) Tablet 1100 2000 3100 400 2700 Aug-19
19 Calcium lactat 500mg Tablet 3000 3000 0 3000
20 CTM 4mg Tablet 5800 2000 7800 5800 2000 Oct-20 ED:5800
21 Carbamazephine 200mg Tablet 0 0 0
22 Cetirizine HCI Tablet 0 0
23 Captopril 25mg Tablet 0 0 0
24 Captopril 12,5mg Tablet 0 0 0
25 Cefadroxyl 500mg Tablet 1400 1000 2400 400 2000 Jan-20
26 Chloro kina 250mg Tablet 0 0
27 Chlorpromazine 100mg Tablet 200 200 0 200
28 Chlorpromazine 25mg Tablet 0 0
29 Cholrampenicole 500mg Tablet 0 0
30 Cotrimoxazole 480mg Tablet 2300 500 2800 2300 500 Jul-19 ED:2300
31 Cotrimoxazole pediatric Tablet 0 0
32 Cefixime Tablet 300 300 0 300 Mar-20
33 Ciprofloxacin 500mg Tablet 1400 1400 100 1300 Jun-20
34 Clindamisin Tablet 300 300 600 0 600 May-19
35 Codein Tablet 150 150 0 150
36 Cimetidine 200mg Tablet 0 0
37 Dexamethasone 0,5mg Tablet 800 2000 2800 600 2200 May-19
38 Diazepam 2mg Tablet 0 0
39 Diazepam 5mg Tablet 0 0
40 Diethylcarbamazetpine sulfate 100mg Tablet 0 0
41 Digoxin 0,25mg Tablet 1400 1400 0 1400 Apr-20
42 Dimenhidrinate 30mg Tablet 100 300 400 0 400 Apr-22
43 Domperidone 10mg Tablet 700 700 0 700 Dec-20
44 Doxycycline 100mg Tablet 400 400 100 300 Aug-20
45 Eritrhomicyn 250mg Tablet 0 0
46 Eritrhomicyn 500mg Tablet 200 200 0 200 May-22
47 Epedrina HCL 25mg Tablet 0 0
48 Ergothamine+cafeine Tablet 0 0 0 Sep-18 ED
49 Etambuthol HCL 250 Tablet 0 0
50 Extract belladona 10mg Tablet 0 0
51 Furosemide 40mg Tablet 400 200 600 0 600 Jan-21
52 GG 100mg Tablet 0 0
53 Glibenclamide 5 mg Tablet 1000 1000 0 1000 Jul-23
54 Gliseofulfine 125mg Tablet 1000 1000 0 1000 Aug-20
55 Guafenesin Tablet 0 0
56 HCT 25mg Tablet 100 100 0 100 Aug-20
57 Halloperidole 0,5mg Tablet 970 970 0 970
58 Inh 300mg Tablet 0 0
59 Inh 100mg Tablet 0 0 0
60 Ibuprofen 200mg Tablet 0 1500 1500 0 1500 Aug-20
61 Ibuprofen 400mg Tablet 0 0 0
62 Isosorbide dinitrate Tablet 1200 1200 0 1200 Jul-20
63 Kinina sulfate 222mg Tablet 0 0
65 Komb.Piretamin+sulfadoxin Tablet 0 0
66 Lefofloxacin Tablet 0 0
67 Loratadine 10mg Tablet 0 1000 1000 0 1000 May-21 ED
68 Loperamide 2mg Tablet 500 500 300 200 Jul-20
69 Meloxicam 7,5 mg Tablet 0 0
70 Mebendazole 100mg Tablet 0 0
71 Metilprednisolon Tablet 100 1000 1100 0 1100 Aug-20
72 Methyl ergometrine 0,125mg Tablet 300 300 0 300 Jan-20
73 Metoclopramide 5mg Tablet 1600 1000 2600 100 2500 Sep-20
74 Metoclopramide 10 mg Tablet 400 400 0 400 Sep-19
75 Metronidazole 250mg Tablet 800 800 100 700 Jun-20
76 Metronidazole 500mg Tablet 0 0 0
77 Natrium diklofenak 25mg Tablet 3000 3000 0 3000 Jul-23
78 Natrium diklofenak 50mg Tablet 0 0
 79 Natrium fenition 30mg Tablet 190 190 0 190
80 Nistatyn 100.000 IU Tablet 115 115 0 115 Aug-19
81 Noza Tablet 100 100 0 100 Apr-22
82 Omeprazole Tablet 270 270 0 270 Aug-21
83 Papaverin 40mg Tablet 0 0
84 Paraphomaldehida 1g Tablet 0 0
85 Paracetamol 100mg Tablet 0 0
86 Paracetamol 500mg Tablet 5000 5000 0 5000 Aug-20
87 Penobarbithal 100mg Tablet 0 0
88 Penobharbital 30mg Tablet 0 0
89 Piroxicam 10 mg Tablet 0 0
90 Piroxicam 20mg Tablet 0 0
91 Phyrantelpamoat 365mg Tablet 0 0
92 Phenylbutazon Tablet 0 0
93 Phytomenadione 10mg Tablet 0 0
94 Prednisone 5mg Tablet 0 0
95 Prima kina 15mg Tablet 0 0
96 Prophanolol 40mg Tablet 0 0 0
97 Prophyturacyl 100mg Tablet 0 0 0
98 Pyrazinamide 500mg Tablet 0 0
99 Preserpine 0,10mg Tablet 0 0
100 Preserpine 0,25mg Tablet 0 0
101 Salbutamol 2mg Tablet 0 0
102 Salbutamol 4 mg Tablet 1700 1700 0 1700 Apr-22
103 Simvastatin 10 mg Tablet 60 1800 1860 0 1860 Jul-21
104 Simvastatin 20mg Tablet 100 1800 1900 0 1900 Apr-20
105 Tetrasikline 500mg Tablet 100 100 0 100 Jun-20
106 Thyampenicol 500mg Tablet 200 200 400 50 350 Dec-21
107 Thryhexphenidil 2mg Tablet 0 0
108 Trifalgin Tablet 0 0
109 Vit A 20000 IU Tablet 0 0
110 Vit B 50.000 IU Tablet 0 0
111 Vit B1 50mg Tablet 1000 1000 2000 300 1700 Jun-21
112 Vit B6 10mg Tablet 2000 2000 0 2000 Feb-21
113 Vit B complex Tablet 300 3000 3300 200 3100 Jan-21
114 Vit C 50mg Tablet 1400 2000 3400 100 3300 Jan-21
115 Vit K 10 mg Tablet 0 0
116 Vit B12 Tablet 1300 2000 3300 100 3200 Sep-19
117 Zinc Tablet 1500 1500 300 1200 Jul-20
OBAT JENIS SYRUP
118 Albendazol Botol 30 30 0 30 Mar-19
119 Amoxycillin syr 250 mg Botol 16 16 3 13 Jan-19
120 Amoxicilin 125 mg Botol 115 115 20 95 Aug-19
121 Ampicillin syr Botol 0 0
122 Ambroxol syr 60mg Botol 200 200 0 200 Sep-20
123 Antasida doen suspensi Botol 200 200 0 200 Aug-20
124 Aqua pro injeksi Botol 23 23 0 23 Apr-20
125 Aquades steril Botol 0 0
126 Asam klorida 0,1 n Botol 0 0
127 Asam sulfosalisilate 20% Botol 0 0
128 Atrhopine sulfate tts mata 0,2% Botol 0 0
129 Betadine 30mL Botol 0 0
130 Cetirizine Botol 6 50 56 6 50 May-19
131 Cefadroxyl syr ker Botol 79 48 127 0 127 Feb-19
132 Chlorampenycole syr Botol 39 39 0 39 Jun-19
133 Chlorampenycole tts tlg 3% Botol 0 0
134 Cotrimoxazole suspensi Botol 16 200 216 10 206 Jul-19
135 Eritromicyne dry syr Botol 0 0
136 Ethanol 70% 1L Botol 0 1 1 0 1
137 Ethypherane syr Botol 0 0
138 Feno glycerol tts tlinga 10% Botol 0 0
139 Gamexan emulsi Botol 0 0
140 Gentian violet larutan 1% Botol 0 0
141 Glycerol Botol 9 9 0 9 Jul-20
142 Glucose 10% inf Botol 0 0
143 Glucose 40% inf Botol 0 0
144 Glucose 5% inf Botol 80 80 0 80 Jul-19
145 Ibuprofen Botol 10 100 110 5 105 Oct-19
146 Lacto B Sacet 0 0 0
147 larutan H2o2 50% 800mg Botol 0 0
148 Laxadin Botol 9 25 34 0 34 Aug-20
149 Lycol 50% Botol 0 0
150 Magnesium sulfate injeksi 40% 25ml Botol 0 0 0 Oct-18 ED
151 Magnesium sulfate injeksi 20% 25ml Botol 12 12 0 12
152 Magnesium sulfate serbuk 30g Botol 0 0
153 Metanol Botol 0 0
154 Metronidazole infus Botol 10 10 0 10 May-21
155 Natrium Fluoresein tts mt 2% Botol 0 0
156 Natrium Klorida infus 0,9% Botol 200 200 0 200 May-22
157 OBH syrup Botol 0 0
158 Paracetamol 120mg/5ml Botol 0 0 0
159 Pilocarpin tts 2% Botol 0 0
160 Piperazine 20% syr Botol 0 0
161 Paracetamol drops Botol 0 0
162 RL infus Botol 80 200 280 80 200 Aug-22
163 Rivanol 0,1%Larutan Botol 0 0
164 sulfate setamit tts 15% Botol 0 0
165 Sucralfat Botol 5 5 5 0 Aug-19
166 Tetraciclin tts mata 0,5% Botol 0 0
167 Betadine 10% 300ml Botol 0 0
168 Betadine 10% 60ml Botol 0 0
169 Betadine 10% 30ml Botol 0 0
170 Betadine 10% 1000ml Botol 0 2 2 0 2
OBAT SUNTIK /INJEK (AMPUL/VIAL)
171 ADS injeksi 20.000 IU Vial 0 0
172 Ampisilin Ampul 0 0
173 Amynophiline injeksi Ampul 0 0
174 Antalgin Ampul 21 21 0 21 Aug-21
175 Atrophine Ampul 0 0
176 Arthesunate Vial 0 0
177 Chlorpromazine 25mg/ml Ampul 89 89 0 89
178 Combiven Ampul 60 60 0 60 Feb-19
179 Dexamethasone Ampul 100 100 200 0 200 Dec-19
180 Diazepam Ampul 0 0
181 Dipenhydramine Ampul 45 45 0 45 Aug-19
182 Epinheprina 0,1% 1ml Ampul 4 4 0 4
183 Kinina 25% 2ml Ampul 0 0
184 Lydocain HCL Injeksi Ampul 95 100 195 5 190 Mar-21
185 Metamizole Ampul 100 100 0 100 Jan-20
186 Methyl ergometrine 0,2 mg/Ml Ampul 91 91 0 91
187 Oxytetracicline 50mg/Ml Vial 0 0
188 Oxytosine 10 IU/ml Ampul 147 147 0 147
189 Papaverin Ampul 0 0
190 Petidine 50mg/2ml Ampul 10 10 0 10
191 Phenobarbithal Ampul 30 30 0 30
192 Phytomenadion Ampul 30 60 90 0 90 Sep-19
193 Phytogin Vial 0 0
194 Anti Bisa Ular (ABU) Vial 1 1 0 1
195 Vaksin Rabies Vero Ampul 0 0
196 Ventolin Ampul 20 20 0 20 Jul-20
197 Vit B12 100mg/ml Ampul 0 0
198 Vit K 10mg/ml Ampul 0 0
OBAT LUAR (TUBE,POT DAN SUPPO)
199 Acyclovir zalf Kulit tube 100 100 0 100 8/212
200 Alleterol (tts mata) Botol 8 24 32 0 32 Sep-19
201 Anti hemoroid supposetoria suppo 0 0 0 Sep-21
202 Anti bakteri zalf Bacitrasin+polymicin tube 0 0
203 Betamethasone zalf tube 0 25 25 0 25 Mar-21
204 Bioplacenton tube 20 20 0 20 Mar-20
205 Cendo Lyters Botol 5 15 20 0 20 Aug-20
206 Clorampenicol zalf mata 1% tube 0 0 0
207 Desoksimetason tube 20 20 0 20 Feb-19
208 Gen0int zalf mata tube 52 52 0 52 Jun-21
209 Hydrocortyson 2,5% cream tube 13 48 61 13 48 Feb-21
210 Kalium permanganat serbuk pot 0 0
211 Ketoconazole2% cream tube 0 50 50 0 50 Apr-21
212 Miconazole cream tube 24 24 48 0 48 Nov-21
213 Mometason tube 12 12 0 12 May-19
214 Molakscrem tube 2 2 0 2 Jun-21
215 0ttopaint tetes telinga Botol 10 10 0 10 Aug-19
216 Oxytetrasiklin zalf 3% tube 0 0
217 Oxytetrasiklin zalf mata 1% tube 0 0
218 Salf 2/4 pot 2 2 0 2 Jul-21
219 Salf anti fungi doen pot 0 0
220 Salycil bedak 2% pot 9 100 109 9 100 Sep-19
221 Skizone tube 0 0
222 Sulfadiazin silfer tube 1 1 0 1 Oct-20
223 stesolid rectal tube 14 14 0 14
OBAT PROGRAM (PAKET,SET,BUNGKUS)
224 OAT Kat 1 Paket 12 12 0 12
225 OAT Kat 2 Paket 0 0
226 OAT Kat 3 Paket 0 0
227 OAT Kat sisipan Paket 0 0
228 Oksigen gas dalam tabung M3 0 0
229 Oralit 1000ml Bks 0 0
230 Oralit 200ml Bks 0 500 500 0 500 Oct-20
231 Lysmin Botol 0 0
233 Betahistin Tablet 60 900 960 30 930 Aug-20
234 Ponconeuron Tablet 0 0
235 Ketoconazole Tablet 1000 1000 0 1000 Jul-20
236 Cefixime Botol 0 0
237 Ponflu Tablet 0 0
238 domperidone drops Botol 0 0
239 furosemid inj ampul 35 35 0 35 May-19
240 Sulfa tetes mata Botol 0 0
241 Metformin Tablet 900 900 0 900 Jun-19
242 Leukoplast pcs 0 0 0
243 Ranitidine inj Ampul 100 100 0 100 Apr-21
244 Lexapram Botol 60 60 0 60 Aug-19
245 Diastop/neo diagon Tablet 500 500 0 500 Apr-21
246 Ceftriaxone Vial 0 0
247 Calcii gluconas Ampul 10 10 0 10 Sep-19
248 domperidone syr Botol 5 100 105 0 105 Oct-20
249 Ranitidin Tablet 1300 1300 300 1000 Jul-20
250 Vit C 250 g Tablet 0 0
251 Gentamicin tts mata Botol 0 0
252 Fludane Tablet Tablet 0 0
253 Cefotaxim inj Ampul 16 16 0 16 Mar-19
254 Ponflu syr Btl 0 0
255 Fludane syr Btl 0 0
256 Fludane syr plus Btl 0 0
257 Genoint slp kulit Tube 0 0
258 Amlodipin 5 mg Tablet 600 600 0 600 Sep-20
259 Condiabet Tablet 0 0
260 Trifacort / Prednison Tablet 0 0
261 nifedipine tablet 150 200 350 50 300 Jan-20
262 Sintrol Tablet 0 0
263 vagizol Ovula 55 55 55 0 Oct-18 ED
264 Sulfadoxin Tablet 0 0
265 Trisela Botol 0 0
266 Fevrin Tablet 0 0
267 Dumin Rectal suppo 0 20 20 0 20 Apr-21
268 haldol inj Ampul 19 19 0 19
269 Bronsolvon Tablet 600 600 0 600 Jun-22
270 Ondancentron Ampul 200 200 0 200 Apr-21
271 Omeprazole Ampul 20 20 0 20 May-21
272 Clopidogrel Tablet 30 30 0 30 Mar-19
273 Concor 10 mg Tablet 30 30 60 0 60 Mar-20
274 Concor 1,25 mg Tablet 50 100 150 0 150 Mar-20
275 Betablok 50 mg Tablet 30 30 0 30 Nov-20
276 Asam folat Tablet 200 1000 1200 200 1000 Aug-19
277 Azitromicyn Tablet 20 100 120 0 120 Mar-22
278 Interizinc Botol 16 16 11 5 Jun-19
279 Berotex Botol 0 0 0
280 Dulcolax suppo suppo 34 34 0 34
281 Ketoprofen suppo 10 10 0 10
282 Ketorolac inj Ampul 0 0
283 Lansoprazole Tablet 0 0 0
284 Ofloxacin 200 MG Tablet 50 50 0 50 Apr-21
285 Spironolakton 25 mg Tablet 100 100 100 0 Nov-18 ED
286 Ulsidex Tablet 500 500 0 500 Feb-21
287 Decacetin tts mata Botol 0 0
288 Metoklopramide inj Ampul 0 0
289 Gentamicin inj Ampul 45 45 0 45 Nov-19
290 Gavistal Drop Botol 20 20 0 20 Jul-19
291 Becefort Botol 0 0
292 Febrinex Botol 0 50 50 0 50 Sep-21
293 Dextrofen Botol 0 0 0
294 Bioron Ampul 70 100 170 0 170 Sep-19
295 Pehavral Tablet 0 0
296 Bioron Tablet 0 0
297 Dariantul Bks 0 0 0
298 Ondansentron Tablet 60 60 0 60 Jul-19
299 Metilprednisolon Vial 3 10 13 0 13 May-20
300 Prednisone Tablet 500 500 0 500 Apr-20
301 Calporosis Tablet 210 1200 1410 0 1410 Mar-21
302 Hemorogard Tablet 90 90 0 90 Oct-19
303 Gemfibrozil Tablet 480 480 0 480 Jan-20
304 Paracetamol Infus Botol 0 0
305 Salbutamol Syr Botol 34 34 0 34 Dec-18
306 Fartolin Botol 3 3 0 3 Jun-19
307 Tramadol Tablet 300 300 0 300
308 gentamicin salf kulit salf 0 0
309 S0ft U-derm tube 29 29 0 29 Jun-20
310 Avamys Botol 3 3 0 3 Feb-20
311 Atroven Botol 3 3 0 3 Jul-19
312 Flixatide Botol 0 0 0 Sep-19
313 Iliadin Botol 12 12 0 12 Mar-19
314 Seretide Botol 0 0 0 Oct-18
315 Crofed Botol 0 0 0
316 Mucos Drop Botol 7 7 0 7 Jul-20
317 Nifudiar Botol 10 10 0 10 Mar-21
318 Pirantel Botol 40 40 0 40 Aug-19
319 Y-Rins Botol 0 0 0
ALKES
320 Abocath 18 0 0 0
321 Abocath 20 0 50 50 0 50
322 Abocath 22 20 20 0 20
323 Abocath 24 0 50 50 0 50
324 Folay Cateter 12 10 10 0 10
325 Folay Cateter 18 10 10 0 10
326 Infuset anak 50 50 100 5 95 Oct-22
327 Infuset dwasa 50 150 200 5 195 Nov-22
328 I.V Cateter 26 0 50 50 0 50
329 Kapas 100 g 0 3 3 0 3
330 Kasa 16x16 4 4 0 4 Jan-23
331 Kasa 40x80 0 0 0
332 Masker Nebu Anak 4 4 0 4 Jan-21
333 Masker Nebu Dewasa 4 4 0 4 Aug-22
334 Oksigen Canula Anak 4 4 0 4 Mar-22
335 Oksigen Canula Dewasa 4 4 0 4 Apr-22
336 Oksigen Canula Neonatus 3 3 0 3 Mar-22
337 Sarung Tangan S Box 1 2 3 0 3
338 Sarung Tangan M Box 0 1 1 0 1
339 Sarung Tangan L Box 1 1 0 1
340 Spuit 1ml Box 0 2 2 0 2 Sep-22
341 Spuit 3ml Box 0 2 2 0 2 Sep-21
342 Spuit 5ml Box 0 2 2 0 2 Sep-21
343 Spuit 10ml Box 0 2 2 0 2 Sep-22
344 Aximet Non Woman 0 1 1 0 1 Sep-22
345 Urine Bag 10 10 0 10 Nov-22

UMUM
TOTAL ITEM JUMLAH
BPJS JUMLAH OBAT DALAM ITEM OBAT
BAYAR TIDAK BAYAR R/ GENERIK
JUMLAH KUNJUNGAN RESEP
2 3 4 5 6 7
164 0 40 204 615 377

Yang Meminta Mengetahui / Menyetujui Yang Menyerahkan Yang Menerima

Kepala UPT Puskesmas Karangan Kepala Dinkes II / GFK Petugas GFK Petugas Puskesmas

dr. Carlos Alfons Sibarani Nandang Prasetyo W. S.Farm..,Apt

NIP. 19780520 201412 1 001 NIP. NIP. NRPK : 17.7.0500211