LAPORAN OBAT PONED

BULAN JANUARI 2020

STOK PEMAKAIAN TERI JML PAKAI SISA PEMAKAIAN JML PEMAKAIAN JML PEMAKAIAN
NAMA OBAT AWAL 1 2 3 4 5 6 7 MA 8 9 10 11 12 13 14 PAKAI SISA 15 16 17 18 19 20 21 PAKAI SISA 22 23 24 25 26
Amoxicilin 500mg 50 20 10 10 100 40 0 10 10 20
Amoxicilin Inj 0 0 0 0
Asam Mefenamat 0 0 0 0
Besi II Sulfas 0 0 0 0
Ephineprin Inj 5 0 0 0
Pitomenadion / Vit K inj 21 2 1 1 4 0 1 1 2
Lidocain Comp Inj 35 2 1 3 0 1 1 2
Lisol 0 0 0 0
Metilergometrin Maleat 0,125mg 0 0 0 0
Metilergometrin Maleat Inj 0 0 0 0
MgSO4 20% 2 0 0 0
MgSO4 40% 5 1 1 0 0
Oxytocin Inj 0 0 0 0
Oksitetrasiklin salep mata 0 0 0 0
Gentamisin SM 0 0 0 0
Paracetamol 500mg 130 20 10 10 40 0 10 10 20
Pehacain Inj 0 0 0 0
Ringer Laktat 500ml infus 6 2 5 2 0 1 1
Povidon iodin 30ml 0 0 0 0
Povidon iodin 60 ml 2 0 0 0
Ampicillin Inj 4 0 0 0
Atropin Inj 0 0 0 0
Betadine 30ml 4 0 0 0
Betadine 60ml 0 0 0 0
Dexa Inj 5 0 0 0
Dipenhidramin Inj 0 0 0 0
Diazepam Inj 0 0 0 0
Nefedipin 10mg 45 2 2 0 0
Stesolid tab 0 0 0 0
Vit A 22 4 2 2 8 0 2 2 4
ALAT KESEHATAN
Abbocath No. 18 6 0 0 0
Abbocath No. 20 6 1 1 0 1 1
Abbocath No. 24 0 0 0 0
Alkohol swab 0 0 0 0
Catgut cromic 3/0 0 0 0 0
Catgut cromic 3/0 19mm 0 0 0 0
Catgut Plain 3/0 0 0 0 0
Handscoon Steril No.7,5 0 0 0 0
Handscoon Non Steril No.M 20 2 2 2 6 6 6 2 2
Handscoon Non Steril No.S 90 14 8 8 4 100 34 6 6 10 12 22
Handscoon Obsgyn (Panjang) 4 1 1 0 0
Hepafik 1 0 0 0
Dressing IV 0 1 1 0 1 1
Infus Set anak 4 0 0 0
Infus Set Dewasa 33 1 1 0 1 1
Kapas Pembalut 0 0 0 0
Kassa Gulung Panjang 40 X 80 1 1 1 1 0 0
Kassa Steril 25 0 0 0
Kateter 0 1 1 0 0
Masker 0 0 0 0
Plester 170 0 0 0
Popok Dewasa No. M 0 0 0 0
Popok Dewasa No. L 0 0 0 0
Popok Dewasa No. XL 0 0 0 0
Selang O2 Anak 0 0 0 0
Selang O2 Dewasa 2 0 0 0
Spuit 1cc 20 1 1 1 3 1 1 1 1 2
Spuit 3cc 0 2 2 2 20 6 2 2 2 2 4
Spuit 5cc 0 0 0 0
Spuit 10cc 86 1 1 0 0
Transfusi Set 0 0 0 0
Underpad 5 2 1 1 1 10 5 0 1 1 2
Urine Bag 12 1 1 0 0
Protein urine stik 0 0 0

TOTAL PASIEN : 12
BPJS : 10
UMUM : 2
PEMAKAIAN JML TOTAL STOK
27 28 29 30 31 PAKAI PAKAI AKHIR
10 10 70 80
0 0 0
0 0 0
0 0 0
0 0 5
1 1 7 14
1 1 6 29
0 0 0
0 0 0
0 0 0
0 0 2
2 2 3 2
0 0 0
0 0 0
0 0 0
10 10 70 60
0 0 0
2 2 5 6
0 0 0
0 0 2
0 0 4
0 0 0
0 0 4
0 0 0
0 0 5
0 0 0
0 0 0
2 2 4 41
0 0 0
2 2 14 8

0 0 6
1 1 3 3
0 0 0
0 0 0
0 0 0
0 0 0
 0 0 0
0 0 0
2 4 6 20 0
14 14 76 114
2 2 3 1
0 0 1
1 1 3 -3
0 0 4
0 2 31
0 0 0
0 1 1
0 0 25
1 1 2 -2
0 0 0
0 0 170
0 0 0
0 0 0
0 0 0
0 0 0
0 0 2
1 1 7 13
2 2 14 6
0 0 0
1 1 2 84
0 0 0
1 1 2 9 6
1 1 2 10
0 0 0

Gunem, 31 Januari 2020

Petugas

Ana Khotijah
NIP. 19881123 201704 2001
 LAPORAN OBAT PONED
BULAN FEBRUARI 2019

STOK PEMAKAIAN TERI JML PEMAKAIAN JML PEMAKAIAN JML PEMAKAIAN

NO NAMA OBAT PAKAI SISA SISA
AWAL 1 2 3 4 5 6 7 MA 8 9 10 11 12 13 14 PAKAI 15 16 17 18 19 20 21 PAKAI SISA 22 23 24 25 26 27 28
1 Amoxicilin 500mg 0 0 0 0 0 0
2 Amoxicilin Inj 0 0 0 0 0 0
3 Asam Mefenamat 0 0 0 0 0 0
4 Besi II Sulfas 0 0 0 0 0 0
5 Ephineprin Inj 0 0 0 0 0 0
6 Pitomenadion / Vit K inj 0 0 0 0 0 0
7 Lidocain Comp Inj 0 0 0 0 0 0
8 Lisol 0 0 0 0 0 0
9 Metilergometrin Maleat 0,125mg 0 0 0 14 0 14
10 Metilergometrin Maleat Inj 0 0 0 0 0 0
11 MgSO4 20% 0 0 0 0 0 0
12 MgSO4 40% 0 0 0 0 0 0
13 Oxytocin Inj 0 0 0 0 0 0
14 Oksitetrasiklin salep mata 0 0 0 0 0 0
15 Gentamisin SM 0 0 0 0 0 0
16 Paracetamol 500mg 0 0 0 0 0 0
17 Pehacain Inj 0 0 0 0 0 0
18 Ringer Laktat 500ml infus 0 0 0 0 0 0
19 Povidon iodin 30ml 0 0 0 0 0 0
20 Povidon iodin 300ml 0 0 0 0 0 0
21 Aquadest 0 0 0 0 0 0
22 Aminophilin Inj 0 0 0 0 0 0
23 Atropin Inj 0 0 0 0 0 0
24 Betadine 30ml 0 0 0 0 0 0
25 Betadine 60ml 0 0 0 0 0 0
26 Dexa Inj 0 0 0 0 0 0
27 Dipenhidramin Inj 0 0 0 0 0 0
28 Diazepam Inj 0 0 0 0 0 0
29 Nefedipin 10mg 0 0 0 0 0 0
30 Stesolid tab 0 0 0 0 0 0
31 Vit A
ALAT KESEHATAN 0 0 0 0 0 0
1 Abbocath No. 18 0 0 0 0 0 0
2 Abbocath No. 20 0 0 0 0 0 0
3 Abbocath No. 24 0 0 0 0 0 0
4 Alkohol swab 0 0 0 0 0 0
5 Catgut cromic 3/0 0 0 0 0 0 0
 6 Catgut cromic 3/0 19mm 0 0 0 0 0 0
7 Catgut Plain 3/0 0 0 0 0 0 0
8 Handscoon Steril No.7,5 0 0 0 0 0 0
9 Handscoon Non Steril No.M 0 0 0 0 0 0
10 Handscoon Non Steril No.S 0 0 0 0 0 0
11 Handscoon Obsgyn (Panjang) 0 0 0 0 0 0
12 Hepafik 0 0 0 0 0 0
13 Hepafik Infus stiril 0 0 0 0 0 0
14 Infus Set anak 0 0 0 0 0 0
15 Infus Set Dewasa 0 0 0 0 0 0
16 Kapas Pembalut 0 0 0 0 0 0
17 Kassa Gulung Panjang 40 X 80 0 0 0 0 0 0
18 Kassa Steril 0 0 0 0 0 0
19 Kateter 0 0 0 0 0 0
20 Masker 0 0 0 0 0 0
21 Plester 0 0 0 0 0 0
22 Popok Dewasa No. M 0 0 0 0 0 0
23 Popok Dewasa No. L 0 0 0 0 0 0
24 Popok Dewasa No. XL 0 0 0 0 0 0
25 Selang O2 Anak 0 0 0 0 0 0
26 Selang O2 Dewasa 0 0 0 0 0 0
27 Spuit 1cc 0 0 0 0 0 0
28 Spuit 3cc 0 0 0 0 0 0
29 Spuit 5cc 0 0 0 0 0 0
30 Spuit 10cc 0 0 0 0 0 0
31 Transfusi Set 0 0 0 0 0 0
32 Underpad 0 0 0 0 0 0
33 Urine Bag 0 0 0 0 0 0
34 Protein urine stik

Gunem, 28 F

NIP. 19881123
KAIAN JML TOTAL STOK
29 30 31 PAKAI PAKAI AKHIR
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
 0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

Gunem, 28 Februari 2018

Petugas

Ana Khotijah
NIP. 19881123 201704 2001
 LAPORAN OBAT PONED
BULAN MEI 2019

PEMAKAIAN
NO NAMA OBAT STOK AWAL TERIMA
1 2 3 4 5 6 7
1 Amoxicilin 500mg 120 10 10 10 10 10 100
2 Amoxicilin Inj 13
3 Asam Mefenamat 209 10 10 10 10 10
4 Besi II Sulfas 2280 40 40 40 40 40
5 Ephineprin Inj 0
6 Pitomenadion / Vit K inj 30 1 1 1 1 1
7 Lidocain Comp Inj 34 1 1 1 1 1
8 Lisol 0
9 Metilergometrin Maleat 0,125mg 0
10 Metilergometrin Maleat Inj 5 1
11 MgSO4 20% 3
12 MgSO4 40% 9
13 Oxytocin Inj 4 1 1 1 1 1 13
14 Oksitetrasiklin salep mata 0 1
15 Gentamisin SM 0
16 Paracetamol 500mg 0
17 Pehacain Inj 0
18 Ringer Laktat 500ml infus 10 20
19 Povidon iodin 30ml 0
20 Povidon iodin 60ml 0
21 Aquadest 10
22 Aminophilin Inj 0
23 Atropin Inj 0
24 Betadine 30ml 10 1 1
25 Betadine 60ml 7 1 1 1
26 Dexa Inj 5
27 Dipenhidramin Inj 0
28 Diazepam Inj 0
29 Nefedipin 10mg 68
30 Stesolid tab 0
31 Vit A
ALAT KESEHATAN 0
1 Abbocath No. 18 9 10
2 Abbocath No. 20 31 20
3 Abbocath No. 24 0
4 Alkohol swab 0
5 Catgut cromic 3/0 5
6 Catgut cromic 3/0 19mm 0
7 Catgut Plain 3/0 0
8 Handscoon Steril No.7,5 0
9 Handscoon Non Steril No.M 150 14 10 12 18 14 100
10 Handscoon Non Steril No.S
11 Handscoon Obsgyn (Panjang) 44 2 2 2 2 2 50
12 Hepafik 0
13 IV Dressing 34
14 Infus Set anak 4
15 Infus Set Dewasa 40
16 Kapas Pembalut 0
17 Kassa Gulung Panjang 40 X 80 0
18 Kassa 4 x 15 0
19 Kateter 8
20 Masker 2 2 2 2 2 2 100
21 Plester bulat 0 2 2 200
22 Popok Dewasa No. M 0 0 0 0 0 0
23 Popok Dewasa No. L 1 1 1 1 1 1 8
24 Popok Dewasa No. XL 12 6
25 Selang O2 Anak 0
26 Selang O2 Dewasa 2
27 Spuit 1cc 107 1 1 1 1 1
28 Spuit 3cc 105 2 2 1 1 2
29 Spuit 5cc 18
30 Spuit 10cc 98 1
31 Transfusi Set 38
32 Underpad 31 1 1 1 1 1 20
33 Urine Bag 16
34 Protein urine stik
 PEMAKAIAN PEMAKAIAN
JML PAKAI SISA JML PAKAI SISA
8 9 10 11 12 13 14 15 16 17 18
50 0 0
0 0 0
50 0 0
200 0 0
0 0 0
5 0 0
5 0 0
0 0 0
0 0 0
1 0 0
0 0 0
0 0 0
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
2 0 0
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
0 0 0
0 0 0
0 0 0
0 0 0
68 0 0
0 0 0
10 0 0
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 0 0
4 0 0
0 0 0
8 0 0
0 0 0
0 0 0
0 0 0
10 0 0
8 0 0
0 0 0
1 0 0
0 0 0
5 0 0
0 0 0
PEMAKAIAN PEMAKAIAN
JML PAKAI SISA JML PAKAI
19 20 21 22 23 24 25 26 27 28 29 30 31
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

Gunem, 28 Mei 2019

Petugas

Ana Khotijah
NIP. 19881123 201704 2001
TOTAL MARET
PAKAI

50 170
0 13
50 159
200 2080
0 0
5 25
5 29
0 0
0 0
1 4
0 3
0 9
5 12
0 1
0 0
0 0
0 0
0 30
0 0
0 0
0 10
0 0
0 0
2 8
3 4
0 5
0 0
0 0
0 68
0 0

0 0
0 19
0 51
0 0
0 0
0 5
0 0
0 0
0 0
68 182
0 0
10 84
0 0
0 34
0 4
0 40
0 0
0 0
0 0
0 8
10 92
4 196
0 0
8 1
0 18
0 0
0 2
10 97
8 97
0 18
1 97
0 38
5 46
0 16
 LAPORAN OBAT PONED
BULAN AGUSTUS 2019

STOK PEMAKAIAN TERI JML PAKAI SISA PEMAKAIAN

NO NAMA OBAT AWAL 1 2 3 4 5 6 7 MA 8 9 10
1 Amoxicilin 500mg 0 0
2 Amoxicilin Inj 0 0
3 Asam Mefenamat 0 0
4 Besi II Sulfas 0 0
5 Ephineprin Inj 0 0
6 Pitomenadion / Vit K inj 0 0
7 Lidocain Comp Inj 0 0
8 Lisol 0 0
9 Metilergometrin Maleat 0,125mg 0 0
10 Metilergometrin Maleat Inj 0 0
MgSO4 20% 0
11 MgSO4 40% 0 0
12 Oxytocin Inj 0 0
13 Oksitetrasiklin salep mata 0 0
Gentamisin SM 0
14 Paracetamol 500mg 0 0
15 Pehacain Inj 0 0
16 Ringer Laktat 500ml infus 0 0
17 Povidon iodin 30ml 0 0
18 Povidon iodin 300ml 0 0
19 Aminophilin Inj 0 0
20 Atropin Inj 0 0
21 Betadine 30ml 0 0
22 Betadine 60ml 0 0
23 Dexa Inj 0 0
24 Dipenhidramin Inj 0 0
25 Diazepam Inj 0 0
26 Nefedipin 10mg 0 0
27 Stesolid tab 0 0
28 Vit A 0 0
ALAT KESEHATAN 0
1 Abbocath No. 18 0 0
2 Abbocath No. 20 0 0
3 Abbocath No. 24 0 0
4 Alkohol swab 0 0
5 Catgut cromic 3/0 0 0
6 Catgut cromic 3/0 19mm 0 0
7 Catgut Plain 3/0 0 0
8 Handscoon Steril No.7,5 0 0
9 Handscoon Non Steril No.M 0 0
10 Handscoon Non Steril No.S 0 0
11 Handscoon Obsgyn (Panjang) 0 0
12 Hepafik 0 0
13 Hepafik Infus stiril 0 0
14 Infus Set anak 0 0
15 Infus Set Dewasa 0 0
Jeli 1
16 Kapas Pembalut 0 0
17 Kassa Gulung Panjang 40 X 80 0 0
18 Kassa Steril 0 0
19 Kateter 0 0
20 Masker 0 0
21 Plester 0 0
22 Popok Dewasa No. M 0 0
23 Popok Dewasa No. L 0 0
24 Popok Dewasa No. XL 0 0
25 Selang O2 Anak 0 0
26 Selang O2 Dewasa 0 0
27 Spuit 1cc 0 0
28 Spuit 3cc 0 0
29 Spuit 5cc 0 0
30 Spuit 10cc 0 0
31 Transfusi Set 0 0
32 Underpad 0 0
33 Urine Bag 0 0
PEMAKAIAN JML PEMAKAIAN JML PEMAKAIAN
11 12 13 14 PAKAI SISA 15 16 17 18 19 20 21 PAKAI SISA 22 23 24 25 26 27 28 29
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

0 0
0 0
0 0

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

Gunem, 30 Desember 2017

Petugas

Ana Khotijah
NIP. 19881123 201704 2001
IAN JML TOTAL STOK
30 31 PAKAI PAKAI AKHIR
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0
0 0 0
0 0 0
0 0 0
0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
 0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

Gunem, 30 Desember 2017

Petugas

Ana Khotijah
NIP. 19881123 201704 2001
 LAPORAN OBAT PONED
BULAN MARET 2019

PEMAKAIAN JML PEMAKAIAN

NO NAMA OBAT STOK AWAL TERIMA SISA
1 2 3 4 5 6 7 PAKAI 8 9
1 Amoxicilin 500mg 200 0 200
2 Amoxicilin Inj 0 0
3 Asam Mefenamat 200 0 200
4 Besi II Sulfas 0 0
5 Ephineprin Inj 0 0
6 Pitomenadion / Vit K inj 0 0
7 Lidocain Comp Inj 0 0
8 Lisol 0 0
9 Metilergometrin Maleat 0,125mg 0 0
10 Metilergometrin Maleat Inj 0 0
11 MgSO4 20% 0 0
12 MgSO4 40% 0 0
13 Oxytocin Inj 0 0
14 Oksitetrasiklin salep mata 0 0
15 Gentamisin SM 0 0
16 Paracetamol 500mg 0 0
17 Pehacain Inj 0 0
18 Ringer Laktat 500ml infus 0 0
19 Povidon iodin 30ml 0 0
20 Povidon iodin 300ml 0 0
21 Aquadest 6 0 6
22 Aminophilin Inj 0 0
23 Atropin Inj 0 0
24 Betadine 30ml 0 0
25 Betadine 60ml 15 0 15
26 Dexa Inj 0 0
27 Dipenhidramin Inj 0 0
28 Diazepam Inj 0 0
29 Nefedipin 10mg 0 0
30 Stesolid tab 0 0
31 Vit A
ALAT KESEHATAN 0 0
1 Abbocath No. 18 0 0
2 Abbocath No. 20 20 0 20
3 Abbocath No. 24 0 0
4 Alkohol swab 0 0
5 Catgut cromic 3/0 0 0
6 Catgut cromic 3/0 19mm 0 0
7 Catgut Plain 3/0 0 0
8 Handscoon Steril No.7,5 0 0
9 Handscoon Non Steril No.M 100 0 100
10 Handscoon Non Steril No.S 0 0
11 Handscoon Obsgyn (Panjang) 0 0
12 Hepafik 0 0
13 Hepafik Infus stiril 100 0 100
14 Infus Set anak 0 0
15 Infus Set Dewasa 13 0 13
16 Kapas Pembalut 0 0
17 Kassa Gulung Panjang 40 X 80 0 0
18 Kassa Steril 0 0
19 Kateter 10 0 10
20 Masker 100 0 100
21 Plester 0 0
22 Popok Dewasa No. M 0 0
23 Popok Dewasa No. L 16 0 16
24 Popok Dewasa No. XL 6 0 6
25 Selang O2 Anak 0 0
26 Selang O2 Dewasa 2 0 2
27 Spuit 1cc 0 0
28 Spuit 3cc 0 0
29 Spuit 5cc 0 0
30 Spuit 10cc 0 0
31 Transfusi Set 50 0 50
32 Underpad 0 0
33 Urine Bag 20 0 20
34 Protein urine stik
PEMAKAIAN JML PEMAKAIAN JML PEMAKAIAN
PAKAI SISA SISA
10 11 12 13 14 15 16 17 18 19 20 21 PAKAI 22 23 24 25 26 27 28
0 200 0 200
0 0 0 0
0 200 0 200
0 0 0 2610
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 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 0 6
0 0 0 0
0 0 0 0
0 0 0 0
0 15 0 15
0 0 0 0
0 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 0 20
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 100 0 100
0 0 0 0
0 0 0 0
0 0 0 0
0 100 0 100
0 0 0 0
0 13 0 13
0 0 0 0
0 0 0 0
0 0 0 0
0 10 0 10
0 100 0 100
0 0 0 0
0 0 0 0
0 16 0 16
0 6 0 6
0 0 0 0
0 2 0 2
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 50 0 50
0 0 0 0
0 20 0 20

Gunem, 28 Maret 2

NIP. 19881123 201704

AKAIAN JML TOTAL STOK
29 30 31 PAKAI PAKAI AKHIR

0 0 200
0 0 0
0 0 200
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 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
0 0 0
0 0 0
0 0 0
0 0 15
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

0 0 0
0 0 0
0 0 20
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
 0 0 100
0 0 0
0 0 0
0 0 0
0 0 100
0 0 0
0 0 13
0 0 0
0 0 0
0 0 0
0 0 10
0 0 100
0 0 0
0 0 0
0 0 16
0 0 6
0 0 0
0 0 2
0 0 0
0 0 0
0 0 0
0 0 0
0 0 50
0 0 0
0 0 20

Gunem, 28 Maret 2019

Petugas

Ana Khotijah
NIP. 19881123 201704 2001
 LAPORAN OBAT PONED
BULAN APRIL 2019

STOK PEMAKAIAN JML PEMAKAIAN

NO NAMA OBAT TERIMA PAKAI SISA
AWAL 1 2 3 4 5 6 7 8 9 10
1 Amoxicilin 500mg 0 0
2 Amoxicilin Inj 0 0
3 Asam Mefenamat 0 0
4 Besi II Sulfas 0 0
5 Ephineprin Inj 0 0
6 Pitomenadion / Vit K inj 0 0
7 Lidocain Comp Inj 0 0
8 Lisol 0 0
9 Metilergometrin Maleat 0,125mg 0 0
10 Metilergometrin Maleat Inj 0 0
11 MgSO4 20% 0 0
12 MgSO4 40% 0 0
13 Oxytocin Inj 0 0
14 Oksitetrasiklin salep mata 0 0
15 Gentamisin SM 0 0
16 Paracetamol 500mg 0 0
17 Pehacain Inj 0 0
18 Ringer Laktat 500ml infus 0 0
19 Povidon iodin 30ml 0 0
20 Povidon iodin 300ml 0 0
21 Aquadest 0 0
22 Aminophilin Inj 0 0
23 Atropin Inj 0 0
24 Betadine 30ml 0 0
25 Betadine 60ml 0 0
26 Dexa Inj 0 0
27 Dipenhidramin Inj 0 0
28 Diazepam Inj 0 0
29 Nefedipin 10mg 0 0
30 Stesolid tab 0 0
31 Vit A
ALAT KESEHATAN 0 0
1 Abbocath No. 18 0 0
2 Abbocath No. 20 0 0
3 Abbocath No. 24 0 0
4 Alkohol swab 0 0
5 Catgut cromic 3/0 0 0
6 Catgut cromic 3/0 19mm 0 0
7 Catgut Plain 3/0 0 0
8 Handscoon Steril No.7,5 0 0
9 Handscoon Non Steril No.M 0 0
10 Handscoon Non Steril No.S 0 0
11 Handscoon Obsgyn (Panjang) 0 0
12 Hepafik 0 0
13 Hepafik Infus stiril 0 0
14 Infus Set anak 0 0
15 Infus Set Dewasa 0 0
16 Kapas Pembalut 0 0
17 Kassa Gulung Panjang 40 X 80 0 0
18 Kassa Steril 0 0
19 Kateter 0 0
20 Masker 0 0
21 Plester 0 0
22 Popok Dewasa No. M 0 0
23 Popok Dewasa No. L 0 0
24 Popok Dewasa No. XL 0 0
25 Selang O2 Anak 0 0
26 Selang O2 Dewasa 0 0
27 Spuit 1cc 0 0
28 Spuit 3cc 0 0
29 Spuit 5cc 0 0
30 Spuit 10cc 0 0
31 Transfusi Set 0 0
32 Underpad 0 0
33 Urine Bag 0 0
34 Protein urine stik
PEMAKAIAN JML PEMAKAIAN JML PEMAKAIAN
SISA SISA
11 12 13 14 PAKAI 15 16 17 18 19 20 21 PAKAI 22 23 24 25 26 27 28 29
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 2610
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0

0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0

Gunem, 28 April 2019

Petugas

Ana Khotijah
NIP. 19881123 201704 2001
AIAN JML TOTAL STOK
30 31 PAKAI PAKAI AKHIR

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
 0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

Gunem, 28 April 2019

Petugas

Ana Khotijah
NIP. 19881123 201704 2001
 LAPORAN OBAT PONED
BULAN JUNI 2019

PEMAKAIAN JML PEMAKAIA

NO NAMA OBAT STOK AWAL TERIMA SISA
1 2 3 4 5 6 7 PAKAI 8
1 Amoxicilin 500mg 200 0 200
2 Amoxicilin Inj 0 0
3 Asam Mefenamat 200 0 200
4 Besi II Sulfas 0 0
5 Ephineprin Inj 0 0
6 Pitomenadion / Vit K inj 0 0
7 Lidocain Comp Inj 30 0 30
8 Lisol 0 0
9 Metilergometrin Maleat 0,125mg 0 0
10 Metilergometrin Maleat Inj 0 0
11 MgSO4 20% 0 0
12 MgSO4 40% 0 0
13 Oxytocin Inj 16 0 16
14 Oksitetrasiklin salep mata 0 0
15 Gentamisin SM 0 0
16 Paracetamol 500mg 0 0
17 Pehacain Inj 0 0
18 Ringer Laktat 500ml infus 40 0 40
19 Povidon iodin 30ml 0 0
20 Povidon iodin 60ml 0 0
21 Aquadest 0 0
22 Aminophilin Inj 0 0
23 Atropin Inj 0 0
24 Betadine 30ml 0 0
25 Betadine 60ml 0 0
26 Dexa Inj 0 0
27 Dipenhidramin Inj 0 0
28 Diazepam Inj 0 0
29 Nefedipin 10mg 0 0
30 Stesolid tab 0 0
31 Vit A
ALAT KESEHATAN 0 0
1 Abbocath No. 18 0 0
2 Abbocath No. 20 0 0
3 Abbocath No. 24 0 0
4 Alkohol swab 0 0
5 Catgut cromic 3/0 0 0
6 Catgut cromic 3/0 19mm 0 0
7 Catgut Plain 3/0 0 0
8 Handscoon Steril No.7,5 0 0
9 Handscoon Non Steril No.M 100 0 100
10 Handscoon Non Steril No.S 0 0
11 Handscoon Obsgyn (Panjang) 0 0
12 Hepafik 0 0
13 IV Dressing 0 0
14 Infus Set anak 0 0
15 Infus Set Dewasa 0 0
16 Kapas Pembalut 0 0
17 Kassa Gulung Panjang 40 X 80 0 0
18 Kassa 4 x 15 0 0
19 Kateter 0 0
20 Masker 0 0
21 Plester bulat 0 0
22 Popok Dewasa No. M 0 0
23 Popok Dewasa No. L 8
24 Popok Dewasa No. XL 8 0 8
25 Selang O2 Anak 0 0
26 Selang O2 Dewasa 0 0
27 Spuit 1cc 10 -10
28 Spuit 3cc 0 0
29 Spuit 5cc 0 0
30 Spuit 10cc 0 0
31 Transfusi Set 0 0
32 Underpad 20 0 20
33 Urine Bag 0 0
34 Protein urine stik
 PEMAKAIAN JML PEMAKAIAN JML PEMAKAIAN
SISA SISA
9 10 11 12 13 14 PAKAI 15 16 17 18 19 20 21 PAKAI 22 23 24 25 26
0 200 0 200
0 0 0 0
0 200 0 200
0 0 0 0
0 0 0 0
0 0 0 0
0 30 0 30
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 16 0 16
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 40 0 40
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0

0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 100 0 100
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 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 0 8
0 0 0 0
0 0 0 0
0 -10 0 -10
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 20 0 20
0 0 0 0
PEMAKAIAN JML TOTAL STOK
27 28 29 30 31 PAKAI PAKAI AKHIR

0 0 200
0 0 0
0 0 200
0 0 0
0 0 0
0 0 0
0 0 30
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 16
0 0 0
0 0 0
0 0 0
0 0 0
0 0 40
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
 0 0 100
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 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 -1
0 0 8
0 0 0
0 0 0
0 10 -10
0 0 0
0 0 0
0 0 0
0 0 0
0 0 20
0 0 0

Gunem, 30 Juni 2019

Petugas

Ana Khotijah
NIP. 19881123 201704 2001
 LAPORAN OBAT PONED
BULAN JULI 2019

STOK PEMAKAIAN JML

NO NAMA OBAT TERIMA
AWAL 1 2 3 4 5 6 7 PAKAI
1 Amoxicilin 500mg 0
2 Amoxicilin Inj 0
3 Asam Mefenamat 0
4 Besi II Sulfas 0
5 Ephineprin Inj 0
6 Pitomenadion / Vit K inj 30 0
7 Lidocain Comp Inj 0
8 HCL 0,1 ml 1 0
9 Metilergometrin Maleat 0,125mg 0
10 Metilergometrin Maleat Inj 0
11 MgSO4 20% 0
12 MgSO4 40% 0
13 Oxytocin Inj 0
14 Oksitetrasiklin salep mata 0
15 Gentamisin SM 0
16 Paracetamol 500mg 0
17 Pehacain Inj 0
18 Ringer Laktat 500ml infus 0
19 Povidon iodin 30ml 0
20 Povidon iodin 60ml 0
21 Aquadest 0
22 Aminophilin Inj 0
23 Ampicilin Inj 10 0
24 Betadine 30ml 0
25 Betadine 60ml 0
26 Dexa Inj 0
27 Dipenhidramin Inj 0
28 Diazepam Inj 0
29 Nefedipin 10mg 30 0
30 Stesolid tab 0
31 Vit A
ALAT KESEHATAN 0
1 Abbocath No. 18 0
2 Abbocath No. 20 0
3 Abbocath No. 24 0
4 Alkohol swab 0
5 Catgut cromic 3/0 0
6 Catgut cromic 3/0 19mm 0
7 Catgut Plain 3/0 0
8 Handscoon Steril No.7,5 0
9 Handscoon Non Steril No.M 0
10 Handscoon Non Steril No.S 200 0
11 Handscoon Obsgyn (Panjang) 0
12 Hepafik 1 0
13 IV Dressing 30 0
14 Infus Set anak 0
15 Infus Set Dewasa 0
16 Kapas Pembalut 0
17 Kassa Gulung Panjang 40 X 80 1 0
18 Kassa 4 x 15 0
19 Kateter no 18 10 0
20 Masker 0
21 Plester bulat 0
22 Popok Dewasa No. M
23 Popok Dewasa No. L 8
24 Popok Dewasa No. XL 0
25 Selang O2 Anak 0
26 Selang O2 Dewasa 0
27 Spuit 1cc 10
28 Spuit 3cc 0
29 Spuit 5cc 0
30 Spuit 10cc 0
31 Transfusi Set 0
32 Underpad 0
33 Urine Bag 0
34 Protein urine stik

TOTAL PASIEN : 11
JKN : 10
UMUM : 1
 PEMAKAIAN JML PEMAKAIAN JML PE
SISA SISA SISA
8 9 10 11 12 13 14 PAKAI 15 16 17 18 19 20 21 PAKAI 22
0 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 0 30 0 30
0 0 0 0 0
1 0 1 0 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 0 0 0
0 0 0 0 0
0 0 0 0 0
0 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 0 10 0 10
0 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 0 30 0 30
0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
200 0 200 0 200
0 0 0 0 0
1 0 1 0 1
30 0 30 0 30
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 0 1 0 1
0 0 0 0 0
10 0 10 0 10
0 0 0 0 0
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 0 -10 0 -10
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 PEMAKAIAN JML TOTAL STOK
23 24 25 26 27 28 29 30 31 PAKAI PAKAI AKHIR
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 30
0 0 0
0 0 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 0
0 0 0
0 0 0
0 0 0
0 0 10
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 30
0 0 0

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 200
0 0 0
0 0 1
0 0 30
0 0 0
0 0 0
0 0 0
0 0 1
0 0 0
0 0 10
0 0 0
0 0 0
0 0 0
0 1 -1
0 0 0
0 0 0
0 0 0
0 10 -10
0 0 0
0 0 0
 0 0 0
0 0 0
0 0 0
0 0 0

Gunem, 31 Juli 2019

Petugas

Ana Khotijah
NIP. 19881123 201704 2001
 LAPORAN OBAT PONED
BULAN JULI 2019

PEMAKAIAN
NO NAMA OBAT STOK AWAL TERIMA JML PAKAI SISA
1 2 3 4 5 6 7
1 Amoxicilin 500mg 200 0 200
2 Amoxicilin Inj 0 0
3 Asam Mefenamat 200 0 200
4 Besi II Sulfas 0 0
5 Ephineprin Inj 0 0
6 Pitomenadion / Vit K inj 0 0
7 Lidocain Comp Inj 0 0
8 HCL 0,1 ml 0 0
9 Metilergometrin Maleat 0,125mg 0 0
10 Metilergometrin Maleat Inj 0 0
11 MgSO4 20% 0 0
12 MgSO4 40% 0 0
13 Oxytocin Inj 0 0
14 Oksitetrasiklin salep mata 0 0
15 Gentamisin SM 0 0
16 Paracetamol 500mg 0 0
17 Pehacain Inj 0 0
18 Ringer Laktat 500ml infus 0 0
19 Povidon iodin 30ml 0 0
20 Povidon iodin 60ml 0 0
21 Aquadest 0 0
22 Aminophilin Inj 0 0
23 Ampicilin Inj 0 0
24 Betadine 30ml 0 0
25 Betadine 60ml 0 0
26 Dexa Inj 0 0
27 Dipenhidramin Inj 0 0
28 Diazepam Inj 0 0
29 Nefedipin 10mg 0 0
30 Stesolid tab 0 0
31 Vit A
ALAT KESEHATAN 0 0
1 Abbocath No. 18 0 0
2 Abbocath No. 20 0 0
3 Abbocath No. 24 0 0
4 Alkohol swab 0 0
5 Catgut cromic 3/0 0 0
6 Catgut cromic 3/0 19mm 0 0
7 Catgut Plain 3/0 0 0
8 Handscoon Steril No.7,5 0 0
9 Handscoon Non Steril No.M 0 0
10 Handscoon Non Steril No.S 0 0
11 Handscoon Obsgyn (Panjang) 0 0
12 Hepafik 1 0 1
13 IV Dressing 0 0
14 Infus Set anak 0 0
15 Infus Set Dewasa 0 0
16 Kapas Pembalut 0 0
17 Kassa Gulung Panjang 40 X 80 1 0 1
18 Kassa 4 x 15 0 0
19 Kateter no 18 0 0
20 Masker 50 0 50
21 Plester bulat 0 0
22 Popok Dewasa No. M
23 Popok Dewasa No. L 8
24 Popok Dewasa No. XL 0 0
25 Selang O2 Anak 0 0
26 Selang O2 Dewasa 0 0
27 Spuit 1cc 10 -10
28 Spuit 3cc 0 0
29 Spuit 5cc 0 0
30 Spuit 10cc 0 0
31 Transfusi Set 0 0
32 Underpad 10 0 10
33 Urine Bag 0 0
34 Protein urine stik

TOTAL PASIEN : 6
JKN : 5
jampersal: 1
 PEMAKAIAN JML PEMAKAIAN JML PEMAKAIAN
PAKAI SISA SISA
8 9 10 11 12 13 14 15 16 17 18 19 20 21 PAKAI 22 23 24
0 200 0 200
0 0 0 0
0 200 0 200
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0

0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 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 0 1
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 1 0 1
0 0 0 0
0 0 0 0
0 50 0 50
0 0 0 0

0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 -10 0 -10
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 10 0 10
0 0 0 0
 PEMAKAIAN JML TOTAL STOK
25 26 27 28 29 30 31 PAKAI PAKAI AKHIR

0 0 200
0 0 0
0 0 200
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

0 0 0
0 0 0
0 0 0
0 0 0
0 0 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
0 0 0
0 0 0
0 0 0
0 0 0
0 0 1
0 0 0
0 0 0
0 0 50
0 0 0
0 0 0
0 1 -1
0 0 0
0 0 0
0 0 0
0 10 -10
0 0 0
0 0 0
0 0 0
0 0 0
0 0 10
0 0 0

Gunem, 31 Agustus 2019

Petugas

Ana Khotijah
NIP. 19881123 201704 2001
 LAPORAN OBAT PONED
BULAN SEPTEMBER 2019

STOK PEMAKAIAN JML PEMAKAIAN

NO NAMA OBAT TERIMA SISA
AWAL 1 2 3 4 5 6 7 PAKAI 8 9 10
1 Amoxicilin 500mg 0 0
2 Amoxicilin Inj 0 0
3 Asam Mefenamat 0 0
4 Besi II Sulfas 0 0
5 Ephineprin Inj 5 0 5
6 Pitomenadion / Vit K inj 0 0
7 Lidocain Comp Inj 0 0
8 HCL 0,1 ml 0 0
9 Metilergometrin Maleat 0,125mg 0 0
10 Metilergometrin Maleat Inj 0 0
11 MgSO4 20% 0 0
12 MgSO4 40% 0 0
13 Oxytocin Inj 0 0
14 Oksitetrasiklin salep mata 0 0
15 Gentamisin SM 0 0
16 Paracetamol 500mg 0 0
17 Pehacain Inj 0 0
18 Ringer Laktat 500ml infus 0 0
19 Povidon iodin 30ml 0 0
20 Povidon iodin 60ml 0 0
21 Aquadest 0 0
22 Aminophilin Inj 0 0
23 Ampicilin Inj 0 0
24 Betadine 30ml 0 0
25 Betadine 60ml 0 0
26 Dexa Inj 0 0
27 Dipenhidramin Inj 0 0
28 Diazepam Inj 0 0
29 Nefedipin 10mg 0 0
30 Stesolid tab 0 0
31 Vit A
ALAT KESEHATAN 0 0
1 Abbocath No. 18 0 0
2 Abbocath No. 20 0 0
3 Abbocath No. 24 0 0
4 Alkohol swab 0 0
5 Catgut cromic 3/0 0 0
6 Catgut cromic 3/0 19mm 0 0
7 Catgut Plain 3/0 0 0
8 Handscoon Steril No.7,5 0 0
9 Handscoon Non Steril No.M 200 0 200
10 Handscoon Non Steril No.S 100 0 100
11 Handscoon Obsgyn (Panjang) 0 0
12 Hepafik 0 0
13 IV Dressing 0 0
14 Infus Set anak 0 0
15 Infus Set Dewasa 0 0
16 Kapas Pembalut 0 0
17 Kassa Gulung Panjang 40 X 80 0 0
18 Kassa 4 x 15 0 0
19 Kateter no 18 0 0
20 Masker 50 0 50
21 Plester bulat 0 0
22 Popok Dewasa No. M 0 0
23 Popok Dewasa No. L 0 0
24 Popok Dewasa No. XL 6 0 6
25 Selang O2 Anak 0 0
26 Selang O2 Dewasa 0 0
27 Spuit 1cc 0 0
28 Spuit 3cc 0 0
29 Spuit 5cc 0 0
30 Spuit 10cc 0 0
31 Transfusi Set 0 0
32 Underpad 10 0 10
33 Urine Bag 0 0
34 Protein urine stik

TOTAL PASIEN : 19
JKN : 17
Jampersal: 1
Umum: 1
PEMAKAIAN JML PEMAKAIAN JML SISA PEMAKAIAN
SISA
11 12 13 14 PAKAI 15 16 17 18 19 20 21 PAKAI 22 23 24 25 26 27 28 29 30 31
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 5 0 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
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0

0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 200 0 200
0 100 0 100
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 50 0 50
0 0 0 0
0 0 0 0
0 0 0 0
0 6 0 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 10 0 10
0 0 0 0

Gunem, 31 September 2019

Petugas

Ana Khotijah
NIP. 19881123 201704 2001
 JML TOTAL STOK
PAKAI PAKAI AKHIR

0 0 0
0 0 0
0 0 0
0 0 0
0 0 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 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
 0 0 200
0 0 100
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 50
0 0 0
0 0 0
0 1 -1
0 0 6
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 10
0 0 0

m, 31 September 2019

881123 201704 2001

 LAPORAN OBAT PONED
BULAN OKTOBER 2019

STOK PEMAKAIAN JML SISA PEMAKAIAN

NO NAMA OBAT TERIMA PAKAI
AWAL 1 2 3 4 5 6 7 8 9 10 11 12 13 14
1 Amoxicilin 500mg 100 0 100
2 Amoxicilin Inj 0 0
3 Asam Mefenamat 100 0 100
4 Besi II Sulfas 0 0
5 Ephineprin Inj 0 0
6 Pitomenadion / Vit K inj 0 0
7 Lidocain Comp Inj 0 0
8 HCL 0,1 ml 0 0
9 Metilergometrin Maleat 0,125mg 0 0
10 Metilergometrin Maleat Inj 0 0
11 MgSO4 20% 0 0
12 MgSO4 40% 0 0
13 Oxytocin Inj 0 0
14 Oksitetrasiklin salep mata 0 0
15 Gentamisin SM 0 0
16 Paracetamol 500mg 0 0
17 Pehacain Inj 0 0
18 Ringer Laktat 500ml infus 20 0 20
19 Povidon iodin 30ml 0 0
20 Povidon iodin 60ml 0 0
21 Aquadest 0 0
22 Aminophilin Inj 0 0
23 Ampicilin Inj 0 0
24 Betadine 30ml 0 0
25 Betadine 60ml 0 0
26 Dexa Inj 0 0
27 Dipenhidramin Inj 0 0
28 Diazepam Inj 0 0
29 Nefedipin 10mg 20 0 20
30 Stesolid tab 0 0
31 Vit A
ALAT KESEHATAN 0 0
1 Abbocath No. 18 0 0
2 Abbocath No. 20 10 0 10
3 Abbocath No. 24 0 0
4 Alkohol swab 0 0
5 Catgut cromic 3/0 0 0
6 Catgut cromic 3/0 19mm 0 0
7 Catgut Plain 3/0 0 0
8 Handscoon Steril No.7,5 0 0
9 Handscoon Non Steril No.M 0 0
10 Handscoon Non Steril No.S 0 0
11 Handscoon Obsgyn (Panjang) 0 0
12 Hepafik 0 0
13 IV Dressing 0 0
14 Infus Set anak 0 0
15 Infus Set Dewasa 25 0 25
16 Kapas Pembalut 0 0
17 Kassa Gulung Panjang 40 X 80 0 0
18 Kassa 4 x 15 0 0
19 Kateter no 18 0 0
20 Masker 50 0 50
21 Plester bulat 0 0
22 Popok Dewasa No. M 0 0
23 Popok Dewasa No. L 0 0
24 Popok Dewasa No. XL 0 0
25 Selang O2 Anak 0 0
26 Selang O2 Dewasa 0 0
27 Spuit 1cc 0 0
28 Spuit 3cc 0 0
29 Spuit 5cc 0 0
30 Spuit 10cc 0 0
31 Transfusi Set 0 0
32 Underpad 0 0
33 Urine Bag 0 0
34 Protein urine stik

TOTAL PASIEN : 7
JKN : 5
Jampersal: 1
Umum: 1
 JML PEMAKAIAN JML SISA PEMAKAIAN JML TOTAL STOK
PAKAI SISA 15 16 17 18 19 20 21 PAKAI 22 23 24 25 26 27 28 29 30 31 PAKAI PAKAI AKHIR

0 100 0 100 0 0 100

0 0 0 0 0 0 0
0 100 0 100 0 0 100
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 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 0 20 0 0 20
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 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 0 20 0 0 20
0 0 0 0 0 0 0

0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 10 0 10 0 0 10
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 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 0 25 0 0 25
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 50 0 50 0 0 50
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

Gunem, 31 Oktober 2019

Petugas

Ana Khotijah
NIP. 19881123 201704 2001
 LAPORAN OBAT PONED
BULAN NOVEMBER 2019

STOK PEMAKAIAN JML PEMAKAIAN

NO NAMA OBAT TERIMA SISA
AWAL 1 2 3 4 5 6 7 PAKAI 8 9 10 11 12
1 Amoxicilin 500mg 200 0 200
2 Amoxicilin Inj 0 0
3 Asam Mefenamat 0 0
4 Besi II Sulfas 0 0
5 Ephineprin Inj 0 0
6 Pitomenadion / Vit K inj 40 0 40
7 Lidocain Comp Inj 0 0
8 HCL 0,1 ml 0 0
9 Metilergometrin Maleat 0,125mg 0 0
10 Metilergometrin Maleat Inj 0 0
11 MgSO4 20% 0 0
12 MgSO4 40% 0 0
13 Oxytocin Inj 0 0
14 Oksitetrasiklin salep mata 0 0
15 Gentamisin SM 0 0
16 Paracetamol 500mg 200 0 200
17 Pehacain Inj 0 0
18 Ringer Laktat 500ml infus 0 0
19 Povidon iodin 30ml 0 0
20 Povidon iodin 60ml 0 0
21 Aquadest 0 0
22 Aminophilin Inj 0 0
23 Ampicilin Inj 0 0
24 Betadine 30ml 0 0
25 Betadine 60ml 0 0
26 Dexa Inj 5 0 5
27 Dipenhidramin Inj 0 0
28 Diazepam Inj 0 0
29 Nefedipin 10mg 0 0
30 Stesolid tab 0 0
31 Vit A 20 0 20
ALAT KESEHATAN 0 0
1 Abbocath No. 18 0 0
2 Abbocath No. 20 0 0
3 Abbocath No. 24 0 0
4 Alkohol swab 0 0
5 Catgut cromic 3/0 0 0
6 Catgut cromic 3/0 19mm 0 0
7 Catgut Plain 3/0 0 0
8 Handscoon Steril No.7,5 0 0
9 Handscoon Non Steril No.M 100 0 100
10 Handscoon Non Steril No.S 0 0
11 Handscoon Obsgyn (Panjang) 50 0 50
12 Hepafik 0 0
13 IV Dressing 0 0
14 Infus Set anak 0 0
15 Infus Set Dewasa 0 0
16 Kapas Pembalut 0 0
17 Kassa Gulung Panjang 40 X 80 0 0
18 Kassa 4 x 15 0 0
19 Kateter no 18 0 0
20 Masker 0 0
21 Plester bulat 0 0
22 Popok Dewasa No. M 0 0
23 Popok Dewasa No. L 0 0
24 Popok Dewasa No. XL 0 0
25 Selang O2 Anak 0 0
26 Selang O2 Dewasa 0 0
27 Spuit 1cc 0 0
28 Spuit 3cc 0 0
29 Spuit 5cc 0 0
30 Spuit 10cc 0 0
31 Transfusi Set 0 0
32 Underpad 20 0 20
33 Urine Bag 0 0
34 Protein urine stik

TOTAL PASIEN : 18
JKN : 13
Jampersal: 1
Umum: 4
PEMAKAIAN JML PEMAKAIAN JML SISA PEMAKAIAN JML TOTAL
SISA
13 14 PAKAI 15 16 17 18 19 20 21 PAKAI 22 23 24 25 26 27 28 29 30 31 PAKAI PAKAI

0 200 0 200 0 0
0 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 40 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 200 0 200 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 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 0 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 20 0 20 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 100 0 100 0 0
0 0 0 0 0 0
0 50 0 50 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 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 0 20 0 0
0 0 0 0 0 0

Gunem, 30 November 2019

Petugas

Ana Khotijah
NIP. 19881123 201704 2001
STOK
AKHIR

200
0
0
0
0
40
0
0
0
0
0
0
0
0
0
200
0
0
0
0
0
0
0
0
0
5
0
0
0
0
20
0
0
0
0
0
0
0
0
0
100
0
50
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
20
0
 LAPORAN OBAT PONED
BULAN DESEMBER 2019

STOK PEMAKAIAN JML PEMAKAIAN JML PEMAKAIAN

NO NAMA OBAT TERIMA SISA SISA
AWAL 1 2 3 4 5 6 7 PAKAI 8 9 10 11 12 13 14 PAKAI 15 16 17 18 19
1 Amoxicilin 500mg 0 0 0 0
2 Amoxicilin Inj 0 0 0 0
3 Asam Mefenamat 0 0 0 0
4 Besi II Sulfas 90 0 90 0 90
5 Ephineprin Inj 0 0 0 0
6 Pitomenadion / Vit K inj 0 0 0 0
7 Lidocain Comp Inj 30 0 30 0 30
8 HCL 0,1 ml 0 0 0 0
9 Metilergometrin Maleat 0,125mg 0 0 0 0
10 Metilergometrin Maleat Inj 10 0 10 0 10
11 MgSO4 20% 0 0 0 0
12 MgSO4 40% 0 0 0 0
13 Oxytocin Inj 0 0 0 0
14 Oksitetrasiklin salep mata 0 0 0 0
15 Gentamisin SM 0 0 0 0
16 Paracetamol 500mg 100 0 100 0 100
17 Pehacain Inj 0 0 0 0
18 Ringer Laktat 500ml infus 0 0 0 0
19 Povidon iodin 30ml 0 0 0 0
20 Povidon iodin 60ml 0 0 0 0
21 Aquadest 0 0 0 0
22 Aminophilin Inj 0 0 0 0
23 Ampicilin Inj 0 0 0 0
24 Betadine 30ml 0 0 0 0
25 Betadine 60ml 0 0 0 0
26 Dexa Inj 0 0 0 0
27 Dipenhidramin Inj 0 0 0 0
28 Diazepam Inj 0 0 0 0
29 Nefedipin 10mg 0 0 0 0
30 Stesolid tab 0 0 0 0
31 Vit A 20 0 20 0 20
ALAT KESEHATAN 0 0 0 0
1 Abbocath No. 18 0 0 0 0
2 Abbocath No. 20 0 0 0 0
3 Abbocath No. 24 0 0 0 0
4 Alkohol swab 0 0 0 0
5 Catgut cromic 3/0 0 0 0 0
6 Catgut cromic 3/0 19mm 0 0 0 0
7 Catgut Plain 3/0 0 0 0 0
8 Handscoon Steril No.7,5 0 0 0 0
9 Handscoon Non Steril No.M 100 0 100 0 100
10 Handscoon Non Steril No.S 100 0 100 0 100
11 Handscoon Obsgyn (Panjang) 0 0 0 0
12 Hepafik 0 0 0 0
13 IV Dressing 0 0 0 0
14 Infus Set anak 0 0 0 0
15 Infus Set Dewasa 0 0 0 0
16 Kapas Pembalut 0 0 0 0
17 Kassa Gulung Panjang 40 X 80 0 0 0 0
18 Kassa 4 x 15 0 0 0 0
19 Kateter no 18 0 0 0 0
20 Masker 0 0 0 0
21 Plester bulat 0 0 0 0
22 Popok Dewasa No. M 0 0 0 0
23 Popok Dewasa No. L 0 0 0 0
24 Popok Dewasa No. XL 0 0 0 0
25 Selang O2 Anak 0 0 0 0
26 Selang O2 Dewasa 0 0 0 0
27 Spuit 1cc 20 0 20 0 20
28 Spuit 3cc 0 0 0 0
29 Spuit 5cc 0 0 0 0
30 Spuit 10cc 0 0 0 0
31 Transfusi Set 0 0 0 0
32 Underpad 0 0 0 0
33 Urine Bag 0 0 0 0
34 Protein urine stik

TOTAL PASIEN : 10
JKN : 8
Jampersal: 1
Umum: 1
PEMAKAIAN JML PEMAKAIAN JML TOTAL STOK
SISA
20 21 PAKAI 22 23 24 25 26 27 28 29 30 31 PAKAI PAKAI AKHIR

0 0 0 0
0 0 0 0
0 0 0 0
90 0 0 90
0 0 0 0
0 0 0 0
30 0 0 30
0 0 0 0
0 0 0 0
10 0 0 10
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
100 0 0 100
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
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 0 0 20
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
100 0 0 100
100 0 0 100
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
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 0 0 20
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0

Gunem, 31 Desember 2019

Petugas

Ana Khotijah
NIP. 19881123 201704 2001