LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSKESMAS

PUSKESMAS : CAHYA MAJU PELAPORAN BULAN : OKTOBER 2020 DOKUMEN NOMOR TANGGAL
KECAMATAN : LEMPUING PERMINTAAS BULAN : DINKES KAB/KOTA
KABUPATEN : OGAN KOMERING ILIR IFK KAB/KOTA
PROPINSI : SUMATERA SELATAN PUSKESMAS

STOK STOK STOK

NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AWAL AKHIR OPTIMUM

1 2 3 4 5 6 7 8 9 10 11 12

1 Absorbent tipped applicator (alcohol swab) Pcs 80 100 180 36 144

2 Acetylcystein Kapsul 200mg Kapsul 0 0 0 0 0 50 50
3 Acyclovir tab 200 mg Tablet 0 0 0 0 0 1000 100
4 Acyclovir cream Tube 0 0 0 0 0
5 Albendazol tab 400 mg Tablet 0 0 0 0 0
6 Alkohol Liquid (etanol) 70%-1000 ml Btl 2 10 12 3 9
7 Allopurinol 100 mg Tablet 2500 4100 6600 1250 5350
8 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0 0 0 0
9 Aminophylline tab 200 mg Tablet 0 0 0 0 0
10 Amitriptyline 25 mg tab Tablet 0 0 0 0 0
11 Amlodipine tab 5 mg Tablet 3330 0 3330 430 2900
12 Amoxycillin Syr Btl 133 200 333 67 266
13 Amoxycillin 250 mg Kapsul 0 0 0 0 0
14 Amoxycillin 500 mg Kaptab 14690 0 14690 2790 11900
15 Ampicilin 1 gr Inj Vial 0 0 0 0 0
16 Antasida Syr DOEN Btl 61 200 261 57 204
17 Antasida DOEN Kombinasi Tablet 11600 0 11600 1750 9850
18 Anti Bisa Ular 5 ml (ABU I)/ Biosave Vial 0 0 0 0 0
19 Asam Mefenamat 500 mg tab Tablet 0 2000 2000 2000 0
20 Ascorbic acid (Vit.C) 50 mg Tablet 0 6000 6000 2300 3700
21 Ascorbic acid |calsium carbonate 500 mg (Pehavral) Tablet 0 0 0 0 0
22 Aspirin (miniaspi) 100 mg tab Tablet 0 0 0 0 0
23 Atropine inj 0,25 mg/ml Ampul 0 0 0 0 0
24 Attapulgite Tablet (Pularex) Tablet 0 0 0 0 0
25 Attapulgite Tablet 600 mg (New Antides) Tablet 0 0 0 0 0
26 Automated blood grouping (Tes Gol. Darah) Paket 0 0 0 0 0
27 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0 0 0 0
28 Bedak Salisil 2% Btl 0 0 0 0 0
29 Benzoic acid |salicylic acid salep (anti fungi) pot 3 96 99 31 68
30 Betahistine Mesylate 6 mg tab Tablet 2800 1100 3900 1600 2300
31 Betamethasone 0,1% krim Tube 125 125 250 82 168
 HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : OKTOBER 2020
STOK STOK STOK
NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12

32 Bisacodyl 5mg Tablet 0 0 0 0 0

33 Bismuth subgallas (antihemoroid) Supp 0 100 100 44 56
34 Calcium chloride lactate infus (RL) Botol 8 220 228 62 166
35 Calsium Laktat (Kalk) 500 mg Tablet 930 3000 3930 1200 2730
36 Captopril 12,5 mg Tablet 0 0 0 0 0
37 Captopril 25 mg Tablet 0 0 0 0 0
38 Carbamazepin tab Tablet 2700 0 2700 500 2200
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 19 96 115 43 72
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 132 0 132 38 94
41 Cefadroxil 500mg Tablet 0 0 0 0 0
42 Cetirizine 5 mg/5 ml sirup Botol 0 0 0 0 0
43 Chloramhenicol Salep Mata 1% Tube 48 0 48 24 24
44 Chloramphenicol Suspensi 125 mg/ml Btl 0 0 0 0 0
45 Chloramphenicol 250 mg caps Tablet 0 0 0 0 0
46 Chloramphenicol TT 3% Botol 0 0 0 0 0
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 80 96 176 83 93
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 0 0 0 0 0 5000 5000
49 Chlorpromazine HCl 100 mg Tablet 3500 0 3500 500 3000
50 Cimetidin 200 tab Tablet 0 0 0 0 0
51 Ciprofloxacin 500 mg tab Tablet 0 0 0 0 0
52 Ciprofloxacin Infus Botol 0 0 0 0 0
53 Clindamycin 300mg Kapsul 0 0 0 0 0
54 Cresol liquid 1 Liter (lysol) Botol 3 10 13 5 8
55 Cyanocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0 0 0 0
56 Devitalisasi pasta pot 0 0 0 0 0
57 Dexamethasone 0,5 mg Tablet 0 0 0 0 0
58 Dexamethasone inj 5mg/ml-1ml Ampul 227 100 327 97 230
59 Diazepam 5mg/ml-2 ml inj Ampul 0 0 0 0 0
60 Diazepam 2 mg Tablet 0 0 0 0 0
61 Diclofenac sodium 25 mg tab Tablet 0 0 0 0 0 3000 3000
62 Digoxin 0,25 mg Tablet 200 0 200 0 200
63 Dimenhydrinate 50mg Tablet 0 0 0 0 0
64 Dipenhidramine HCl inj 10mg/ml Ampul 0 60 60 21 39
65 Domperidone 10 mg Tablet 0 3000 3000 1450 1550
66 Doxycycline 100 mg Kapsul Kapsul 0 0 0 0 0
67 Epinephrine HCl/bitartrat inj 0,1% Ampul 0 0 0 0 0
68 Erythromicin Syr Btl 72 48 120 46 74
 HALAMAN : 3 LPLPO No: 0 LAPORAN BULAN : OKTOBER 2020
STOK STOK STOK
NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12

69 Erythromicin 500 mg capsul Kapsul 0 0 0 0 0

70 Ethacridine (Rivanol) 0,1% Btl 0 0 0 0 0
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 0 10 10 5 5
72 Eugenol cairan Btl 0 0 0 0 0
73 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 0 0 0 0
74 Folic acid 1mg ( asam folat) Tablet 0 0 0 0 0
75 Folley Catheter No.16 Pcs 31 0 31 0 31
76 Furosemida Injeksi Ampul 0 0 0 0 0
77 Furosemida 40 mg Tablet 660 0 660 170 490
78 Garam Oralit Sachet 0 0 0 0 0 500 500
79 Gentamicyn 0,3% TM Botol 120 0 120 41 79
80 Gentamicyn Inj 40 mg/ml Ampul 0 0 0 0 0
81 Gentamicyn 0,1% SK Tube 0 0 0 0 0
82 Glass lonomer Paket 0 0 0 0 0
83 Glibenclamide 5 mg Tablet 0 0 0 0 0
84 Glimepiride 1 mg Tablet 0 0 0 0 0
85 Glukosa larutan infus 10% Botol 20 0 20 20 0
86 Glukosa larutan infus 5% Botol 0 80 80 46 34
87 Griseofulvin 125 mg Tablet 0 0 0 0 0 5000 5000
88 Guaifenesin 100 Tab (GG tab) Tablet 0 0 0 0 0
89 Haloperidol 0,5 mg tab Tablet 0 0 0 0 0
90 Haloperidol 5 mg tab Tablet 2500 0 2500 500 2000
91 Human chorionic (HCG/Tes kehamilan ) Strip 10 100 110 57 53
92 Hydrochlorotiazide (HCT) 25 mg Tablet 0 0 0 0 0
93 Ibuprofen sirup Botol 0 200 200 84 116
94 Ibuprofen 200 mg Tablet 0 0 0 0 0
95 Ibuprofen 400 mg Tablet 0 0 0 0 0
96 Ichthyol salep 10% pot 0 0 0 0 0
97 Immunoglobulin human anti-tetanus (Tetagam) Ampul 0 0 0 0 0
98 Infus set dewasa Pcs 0 150 150 40 110
99 Infusi set anak Pcs 0 0 0 0 0
100 Iodium Povidon 10% 30 ml Botol 30 100 130 59 71
101 Isosorbide tablet Tablet 300 0 300 0 300
102 IV Catheter No.20 Pcs 173 0 173 41 132
103 IV Catheter No.22 Pcs 62 0 62 39 23
104 IV Catheter No.24 Pcs 156 0 156 52 104
105 Jarum Jahit Kulit Pcs 0 0 0 0 0
 HALAMAN : 4 LPLPO No: 0 LAPORAN BULAN : OKTOBER 2020
STOK STOK STOK
NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12

106 Kalium Permanganat Serbuk pot 0 0 0 0 0

107 Kapas pembalut/Absorben 250 g Pcs 7 10 17 4 13
108 Kasa pembalut 2x80 Pcs 35 0 35 19 16
109 Kasa pembalut hidrofil 4 m x 15 cm Pcs 50 0 50 18 32
110 Kasa pembalut hidrofil 4 m x 3 cm Pcs 0 50 50 0 50
111 Kasa kompres 40/40 steril Pcs 47 0 47 0 47
112 Ketoconazole 200 mg Cream Tube 91 0 91 52 39
113 Ketoconazole 200 mg tab Tablet 0 0 0 0 0
114 Klorokina Fosfat 250 mg Tablet 0 0 0 0 0
115 Levertran Salep/ Salep Luka Bakar pot 0 0 0 0 0
116 Lidocain 2% Ampul 0 0 0 0 0
117 Lidokain Comp. inj Kombinasi Ampul 0 0 0 0 0 200 200
118 Lidocaine spray (Xylocaine spray) Botol 0 0 0 0 0
119 Liquorice liquid extract (OBH) Botol 0 0 0 0 0
120 Locoriz Cream Tube 0 0 0 0 0
121 Loperamid 2 m tab Tablet 0 0 0 0 0
122 Loratadine 10 mg tab Tablet 0 2000 2000 1300 700
123 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 0 0 0 0
124 Magnesium Sulfat Injeksi 40% (MgSO4) Ampul 0 0 0 0 0
125 Masker Pcs 0 0 0 0 0
126 Medical adhesive tape (dermafix/leukomed) Pcs 0 0 0 0 0
127 Metamizole injeksi (antalgin 1000) Ampul 0 0 0 0 0
128 Metformin 500mg tab Tablet 5930 0 5930 1900 4030
129 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0 0 0 0
130 Methyl Ergometrin Maleat 0,125 mg Tab 200 0 200 0 200
131 Methyl Prednisolon tab 4 mg Tablet 2700 0 2700 1700 1000
132 Methyl Rosanilinium (gentian violet) Botol 0 0 0 0 0
133 Metronidazol 250 mg tab Tablet 0 0 0 0 0
134 Metronidazol 500 mg tab Tablet 0 0 0 0 0
135 Metronidazol Infus Botol 0 0 0 0 0
136 Metronidazol syr Botol 0 0 0 0 0
137 Miconazole 2% Salep Kulit Tube 118 0 118 31 87
138 Momilen Baby Gold Sirup Botol 0 0 0 0 0
139 Natrium Bikarbonat 500 mg Tablet 0 0 0 0 0
140 Nifedipin 10 mg tab Kapsul 0 0 0 0 0
141 Nystatin Tab Vag 10.000 iu/g Tablet 110 0 110 0 110
142 Omeprazole inj Vial 0 0 0 0 0
 HALAMAN : 5 LPLPO No: 0 LAPORAN BULAN : OKTOBER 2020
STOK STOK STOK
NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12

143 Omeprazole kaps Kapsul 0 0 0 0 0 3000 3000

144 Oxytetracycline HCl 1% Salep Mata Tube 158 0 158 41 117
145 Oxytetracycline HCl 3% Salep Kulit Tube 0 0 0 0 0
146 Oxytocin inj 10 IU Ampul 0 0 0 0 0
147 Papaverin 40 mg tab Tablet 0 0 0 0 0
148 Papaverin inj Tablet 0 0 0 0 0
149 Paracetamol Drops 15 ml Botol 0 0 0 0 0
150 Parasetamol 120 mg/5 ml Syr Botol 341 0 341 81 260
151 Parasetamol 500 mg Tablet 11200 0 11200 3500 7700
152 Patient Lubricant (My Jelly ) Tube 0 0 0 0 0
153 Permethrin (Scabimite Cream) Tube 0 120 120 65 55
154 Phenobarbital inj 50mg/ml-2ml Ampul 0 0 0 0 0
155 Phenobarbital 100 mg Tablet 0 0 0 0 0
156 Phenol gliserol 10% TT Botol 0 0 0 0 0
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 155 30 185 42 143
158 Phytomenadione (Vit.K1) 10 mg Tablet 2700 0 2700 250 2450
159 Piracetam 400 mg Tablet 0 0 0 0 0
160 Piroxicam 20 mg tab Tablet 0 0 0 0 0
161 Pisau Disposable (Mess No.14/21) Pcs 0 0 0 0 0
162 Plesterku (Leukoplast) Pcs 0 0 0 0 0
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 0 0 0 0 0
164 Povidon iodium 10% 300 ml Botol 20 0 20 0 20
165 Prednison 5 mg Tablet 2540 3200 5740 1200 4540
166 Primaquin 15 mg tab Tablet 0 0 0 0 0
167 Profolat tab Tablet 0 0 0 0 0
168 Prokaina Penisilin G inj 3.000.000 iu Ampul 0 0 0 0 0
169 Propranolol HCl 10 mg Tablet 100 0 100 0 100
170 Propranolol HCl 40 mg Tablet 0 0 0 0 0
171 Propylthiouracil 100 mg Tablet 0 0 0 0 0
172 Protein Gluco Test Strip 0 0 0 0 0
173 Pyrantel Pamoat 125 mg Tablet 0 0 0 0 0
174 Pyridoxine HCl 10 mg Tablet 0 0 0 0 0
175 Ranitidin 150 mg Tablet 0 0 0 0 0
176 Ranitidin Injeksi Ampul 0 0 0 0 0
177 Retinol (Vit.A) kaps 100.000 iu Kapsul 2400 0 2400 0 2400
178 Retinol (Vit.A) kaps 200.000 iu Kapsul 4000 0 4000 0 4000
179 Risperidone 2mg Tablet 1900 0 1900 400 1500
 HALAMAN : 6 LPLPO No: 0 LAPORAN BULAN : OKTOBER 2020
STOK STOK STOK
NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12

180 Salbutamol 2 mg Tablet 4000 0 4000 1100 2900

181 Salep 2-4 Kombinasi pot 0 96 96 31 65
182 Sarung tangan (HandScuun) No.7,5 Pcs 0 0 0 0 0
183 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0 0 0 0 0
184 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0 0 0 0
185 Sarung tangan (HandScuun Steril) No.7,5 Pcs 0 0 0 0 0
186 Semen Seng Fosfat Serbuk & Cairan Set 0 0 0 0 0
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 4100 0 4100 2100 2000
188 Silk (Benang Bedah) No. 3/0 Pcs 0 0 0 0 0
189 Silver Sulfadiazine Tube 0 0 0 0 0
190 Simvastatin 10 mg tab Tablet 0 0 0 0 0
191 Sodium cloride infus 0,9% ( NACL ) Botol 40 0 40 30 10
192 Spuit 1 ml Pcs 0 0 0 0 0
193 Spuit 3 ml Pcs 360 1200 1560 410 1150
194 Spuit 5 ml Pcs 545 300 845 160 685
195 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 0 0 0 0 0
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 341 0 341 59 282
197 Sulfasetamida 15% TM Botol 0 0 0 0 0
198 Tetracycline 250 mg Tablet 0 0 0 0 0
199 Tetracycline 500 mg Tablet 0 4000 4000 1650 2350
200 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0 0 0 0
201 Thiamine HCl (Vit B1) 50 mg Tablet 0 8000 8000 2600 5400
202 Trihexyphenidyl tab 2 mg Tablet 0 0 0 0 0
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 9100 0 9100 1050 8050
204 Urin Bag Pcs 0 0 0 0 0
205 Usg Gel Botol 0 0 0 0 0
206 Vaksin Rabies Vero/ Verorab Paket 0 0 0 0 0
207 Vitamin B Kompleks Tablet 4800 0 4800 1900 2900
208 Vitamin K Infant Inj Ampul 0 0 0 0 0
209 Water liquid (aqua P,I) Botol 0 0 0 0 0
210 Wing Needle No.21 Pcs 0 0 0 0 0
211 Wing Needle No.27 Pcs 0 0 0 0 0
212 Zinc Sulphate Suppositoria (Superhoid) Kapsul 0 0 0 0 0
213 Zinc tab Tablet 0 0 0 0 0 2000 2000
214 Ondansetron iv/im 4 mg Ampul 8 0 8 8 0
215 Tranexamic Acid inj 5% Ampul 0 0
216 Poliwash 500 ml Botol 0 0
 HALAMAN : 7 LPLPO No: 0 LAPORAN BULAN : OKTOBER 2020
STOK STOK STOK
NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12

217 Policlean Handrub Botol 0 0 0 0 0

218 Sarung Tangan (Handscuun) L Pcs 0 0 0 0 0
219 Cefotaxime Sodium inj 1 gr Vial 13 0 13 8 5
220 Methyl Prednisolon tab 16 mg Tablet 0 0 0 0 0
221 Lancet Pcs 0 0 0 0 0
222 Strip Kolesterol Pcs 0 0 0 0 0
223 Strip Gula Darah Pcs 0 0 0 0 0
224 Strip Asam Urat Pcs 0 0 0 0 0
225 Nonwoven Fixation Rol Pcs 0 0 0 0 0
226 Paracetamol 1000 mg /100 ml Botol 0 0 0 0 0
227 Otsu D-40 25 ml Botol 0 0 0 0 0
228 Ketorolac inj 30 mg Ampul 0 0 0 0 0
229 Dulcolax tab Tablet 0 0 0 0 0
230 Ibuprofen 400 mg.1 Tablet 110 0 110 110 0
231 Permethrin (Scabimite Cream).1 Tube 0 0 0 0 0
232 Masker Plus Pcs 0 0 0 0 0
233 Eritromicin 250mg Tab 0 2200 2200 888 1312
234
235
236
237
238
239
240
241

UMUM JAMSOSKES BPJS JUMLAH

JUMLAH KUNJUNGAN RESEP
0

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

Kepala Dinas Kesehatan Kab. OKI Kepala Instalasi Farmasi Dinkes OKI Pimpinan Puskesmas Pengelola Obat Puskesmas

Iwan Setiawan.SKM.M.Kes
NIP. 197303051998031005 Himayanti.S.Si.,Apt TITIK SUSWATININGSIH, Am.Keb FRIDA ROSPITA PURBA
NIP. 197702212005012005 NIP. 19680713 198812 2 001 NIP. 19660317 198712 2 001