PuskESMAS Rencana Kebutuhan Obat 2021

DOKUMEN RENCANA KEBUTUHAN OBAT PUSKESMAS TAHUN 2021
PUSKESMAS :
KECAMATAN :
KABUPATEN : OGAN KOMERING ILIR
PROPINSI : SUMATERA SELATAN
STOK JUMLAH
NO. NAMA OBAT JAN FEB MAR APR MEI JUN JULI AGST SEPT OKT NOP DES TOTAL
PENGAMAN RENCANA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
1 Absorbent tipped applicator (alcohol swab) 450 200 60 440 150 100 500 100 100 0 0 0 2100 210 2310
2 Acetylcystein Kapsul 200mg 100 0 0 0 0 0 0 0 0 0 0 0 100 100
3 Acyclovir tab 200 mg 50 0 0 0 0 0 0 0 0 0 0 0 50 50
4 Acyclovir cream 4 0 0 0 0 0 0 0 0 0 0 0 4 4
5 Albendazol tab 400 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Alkohol Liquid (etanol) 70%-1000 ml 12 4 4 3 0 0 0 0 0 0 0 0 23 23
7 Allopurinol 100 mg 100 0 0 0 0 0 1500 1000 500 0 0 0 3100 3100
8 Aminophylline Inj 24 mg/ml-10 ml 0 0 0 0 0 0 12 8 6 0 0 0 26 26
9 Aminophylline tab 200 mg 750 500 400 1100 600 400 0 0 0 0 0 0 3750 3750
10 Amitriptyline 25 mg tab 1700 700 350 1750 700 500 2000 700 500 0 0 0 8900 8900
11 Amlodipine tab 5 mg 0 0 0 0 0 0 1600 800 600 0 0 0 3000 3000
12 Amoxycillin Syr 75 45 35 95 30 30 100 50 60 0 0 0 520 520
13 Amoxycillin 250 mg 9000 4000 3000 4000 2000 1000 0 0 0 0 0 0 23000 23000
14 Amoxycillin 500 mg 21500 4000 4200 2000 300 0 12500 4500 3500 0 0 0 52500 52500
15 Ampicilin 1 gr Inj 2 2 2 5 4 3 5 8 4 0 0 0 35 35
16 Antasida Syr DOEN 100 28 20 102 40 40 100 70 30 0 0 0 530 530
17 Antasida DOEN Kombinasi 21100 5000 4500 5500 3500 1500 8600 4000 2000 0 0 0 55700 55700
18 Anti Bisa Ular 5 ml (ABU I)/ Biosave 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Asam Mefenamat 500 mg tab 2000 1300 700 0 0 0 2000 800 700 0 0 0 7500 7500
20 Ascorbic acid (Vit.C) 50 mg 2100 1000 900 0 0 0 0 0 0 0 0 0 4000 4000
21 Ascorbic acid |calsium carbonate 500 mg (Peh 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Aspirin (miniaspi) 100 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0
23 Atropine inj 0,25 mg/ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Attapulgite Tablet (Pularex) 1700 1000 500 200 0 0 0 0 0 0 0 0 3400 3400
25 Attapulgite Tablet 600 mg (New Antides) 1400 500 300 100 100 0 0 0 0 0 0 0 2400 2400
26 Automated blood grouping (Tes Gol. Darah) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
27 Bahan Tambal Gigi Sementara (Fletcher/Cavit 0 0 0 0 0 0 0 0 0 0 0 0 0 0
28 Bedak Salisil 2% 20 20 8 22 11 9 0 0 0 0 0 0 90 90
29 Benzoic acid |salicylic acid salep (anti fungi) 48 25 18 42 40 30 50 50 30 0 0 0 333 333
30 Betahistine Mesylate 6 mg tab 0 0 0 0 0 0 1700 600 700 0 0 0 3000 3000
31 Betamethasone 0,1% krim 75 25 15 25 15 20 60 50 30 0 0 0 315 315
STOK JUMLAH
PENGAMAN RENCANA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
32 Bisacodyl 5mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
33 Bismuth subgallas (antihemoroid) 24 20 10 10 16 5 9 0 0 0 0 0 94 94
34 Calcium chloride lactate infus (RL) 60 40 0 80 60 40 120 60 40 0 0 0 500 500
35 Calsium Laktat (Kalk) 500 mg 16000 5000 5000 3000 1700 300 7600 5000 1000 0 0 0 44600 44600
36 Captopril 12,5 mg 1700 700 400 1800 900 700 500 600 200 0 0 0 7500 7500
37 Captopril 25 mg 2000 900 500 2000 1200 800 0 0 0 0 0 0 7400 7400
38 Carbamazepin tab 100 0 0 100 100 0 100 200 100 0 0 0 700 700
39 Catgut/Benang Chromic Bedah No.2/0-3/0 72 48 72 72 48 24 72 20 4 0 0 0 432 432
40 Catgut/Benang Plain Bedah No.2/0-3/0 72 48 48 72 72 48 96 72 24 0 0 0 552 552
41 Cefadroxil 500mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
42 Cetirizine 5 mg/5 ml sirup 31 20 10 0 0 0 0 0 0 0 0 0 61 61
43 Chloramhenicol Salep Mata 1% 26 28 12 56 25 25 60 20 25 0 0 0 277 277
44 Chloramphenicol Suspensi 125 mg/ml 50 25 17 8 0 0 0 0 0 0 0 0 100 100
45 Chloramphenicol 250 mg caps 1800 900 800 2000 700 200 0 0 0 0 0 0 6400 6400
46 Chloramphenicol TT 3% 0 0 0 0 0 0 0 0 0 0 0 0 0 0
47 Chloramphenicol/ Hidrokortison krim 2,5% 50 35 25 60 30 25 94 25 30 0 0 0 374 374
48 Chlorpheniramine Maleat (CTM) 4 mg 22200 5500 5500 3500 2500 0 0 0 0 0 0 0 39200 39200
49 Chlorpromazine HCl 100 mg 100 100 0 100 0 100 500 300 100 0 0 0 1300 1300
50 Cimetidin 200 tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0
51 Ciprofloxacin 500 mg tab 2200 900 500 200 0 0 0 0 0 0 0 0 3800 3800
52 Ciprofloxacin Infus 0 0 0 0 0 0 3 1 1 0 0 0 5 5
53 Clindamycin 300mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
54 Cresol liquid 1 Liter (lysol) 8 4 3 13 5 5 0 0 0 0 0 0 38 38
55 Cyanocobalamin (Vit B12) inj 500 mcg/ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0
56 Devitalisasi pasta 0 0 0 0 0 0 0 0 0 0 0 0 0 0
57 Dexamethasone 0,5 mg 9000 5000 3000 11000 4000 4000 1100 800 100 0 0 0 38000 38000
58 Dexamethasone inj 5mg/ml-1ml 400 100 150 350 200 200 300 100 100 0 0 0 1900 1900
59 Diazepam 5mg/ml-2 ml inj 0 0 0 10 5 5 6 2 2 0 0 0 30 30
60 Diazepam 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
61 Diclofenac sodium 25 mg tab 2300 900 800 2800 1200 700 100 0 0 0 0 0 8800 8800
62 Digoxin 0,25 mg 2800 1300 700 800 200 0 2200 700 600 0 0 0 9300 9300
63 Dimenhydrinate 50mg 1100 400 300 1300 600 300 1600 600 200 0 0 0 6400 6400
64 Dipenhidramine HCl inj 10mg/ml 120 90 30 120 90 60 180 60 60 0 0 0 810 810
65 Domperidone 10 mg 3000 2000 1500 0 0 0 0 0 0 0 0 0 6500 6500
66 Doxycycline 100 mg Kapsul 300 100 200 200 200 200 200 0 0 0 0 0 1400 1400
67 Epinephrine HCl/bitartrat inj 0,1% 0 0 0 0 0 0 0 0 0 0 0 0 0 0
68 Erythromicin Syr 32 23 17 46 20 20 56 20 20 0 0 0 254 254
STOK JUMLAH
PENGAMAN RENCANA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
69 Erythromicin 500 mg capsul 2600 1100 900 3000 1100 900 3500 1500 800 0 0 0 15400 15400
70 Ethacridine (Rivanol) 0,1% 20 9 5 16 6 4 7 0 0 0 0 0 67 67
71 Ethanol ( Aseptan ) 500 cc+ Pump 12 4 4 0 0 0 0 0 0 0 0 0 20 20
72 Eugenol cairan 0 0 0 0 0 0 0 0 0 0 0 0 0 0
73 Ferrous fumarate ( Tab. Tambah Darah ) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
74 Folic acid 1mg ( asam folat) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
75 Folley Catheter No.16 0 0 0 0 0 0 4 2 3 0 0 0 9 9
76 Furosemida Injeksi 0 0 0 0 0 0 25 20 30 0 0 0 75 75
77 Furosemida 40 mg 2000 800 500 0 0 0 2100 1100 800 0 0 0 7300 7300
78 Garam Oralit 0 0 0 0 0 0 0 0 0 0 0 0 0 0
79 Gentamicyn 0,3% TM 24 13 8 21 16 9 27 25 25 0 0 0 168 168
80 Gentamicyn Inj 40 mg/ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0
81 Gentamicyn 0,1% SK 75 25 16 4 0 0 0 0 0 0 0 0 120 120
82 Glass lonomer 0 0 0 0 0 0 0 0 0 0 0 0 0 0
83 Glibenclamide 5 mg 1800 900 600 300 0 0 1400 600 400 0 0 0 6000 6000
84 Glimepiride 1 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
85 Glukosa larutan infus 10% 60 20 30 40 20 0 0 0 0 0 0 0 170 170
86 Glukosa larutan infus 5% 40 40 40 80 20 20 70 40 20 0 0 0 370 370
87 Griseofulvin 125 mg 1800 800 500 0 0 0 0 0 0 0 0 0 3100 3100
88 Guaifenesin 100 Tab (GG tab) 21500 5500 5000 1500 0 0 0 0 0 0 0 0 33500 33500
89 Haloperidol 0,5 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0
90 Haloperidol 5 mg tab 100 0 100 0 0 0 300 100 200 0 0 0 800 800
91 Human chorionic (HCG/Tes kehamilan ) 300 100 100 0 0 0 0 0 0 0 0 0 500 500
92 Hydrochlorotiazide (HCT) 25 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
93 Ibuprofen sirup 50 30 25 35 20 10 0 0 0 0 0 0 170 170
94 Ibuprofen 200 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
95 Ibuprofen 400 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
96 Ichthyol salep 10% 0 0 0 0 0 0 0 0 0 0 0 0 0 0
97 Immunoglobulin human anti-tetanus (Tetagam 0 0 0 0 0 0 0 0 0 0 0 0 0 0
98 Infus set dewasa 120 80 60 40 20 17 13 0 0 0 0 0 350 350
99 Infusi set anak 80 50 30 70 35 25 50 40 30 0 0 0 410 410
100 Iodium Povidon 10% 30 ml 17 7 5 19 7 8 0 0 0 0 0 0 63 63
101 Isosorbide tablet 1800 900 700 2000 1000 1000 1300 600 100 0 0 0 9400 9400
102 IV Catheter No.20 50 50 50 100 50 50 100 50 50 0 0 0 550 550
103 IV Catheter No.22 100 50 50 150 50 50 100 50 50 0 0 0 650 650
104 IV Catheter No.24 100 80 30 140 50 50 150 50 50 0 0 0 700 700
105 Jarum Jahit Kulit 0 0 0 0 0 0 0 0 0 0 0 0 0 0
STOK JUMLAH
PENGAMAN RENCANA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
106 Kalium Permanganat Serbuk 0 0 0 0 0 0 0 0 0 0 0 0 0 0
107 Kapas pembalut/Absorben 250 g 13 4 4 15 5 5 2 0 0 0 0 0 48 48
108 Kasa pembalut 2x80 95 50 35 55 40 18 2 0 0 0 0 0 295 295
109 Kasa pembalut hidrofil 4 m x 15 cm 50 40 20 40 35 20 5 0 0 0 0 0 210 210
110 Kasa pembalut hidrofil 4 m x 3 cm 80 80 30 85 45 35 60 20 30 0 0 0 465 465
111 Kasa kompres 40/40 steril 120 100 60 70 55 65 110 50 50 0 0 0 680 680
112 Ketoconazole 200 mg Cream 52 23 17 55 30 30 80 30 20 0 0 0 337 337
113 Ketoconazole 200 mg tab 1200 800 300 1500 800 400 200 0 0 0 0 0 5200 5200
114 Klorokina Fosfat 250 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
115 Levertran Salep/ Salep Luka Bakar 0 0 0 0 0 0 0 0 0 0 0 0 0 0
116 Lidocain 2% 0 0 0 0 0 0 5 3 2 0 0 0 10 10
117 Lidokain Comp. inj Kombinasi 120 90 60 30 0 0 0 0 0 0 0 0 300 300
118 Lidocaine spray (Xylocaine spray) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
119 Liquorice liquid extract (OBH) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
120 Locoriz Cream 0 0 0 0 0 0 0 0 0 0 0 0 0 0
121 Loperamid 2 m tab 100 0 0 0 0 0 0 0 0 0 0 0 100 100
122 Loratadine 10 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0
123 Magnesium Sulfat Injeksi 20% (MgSO4) 0 0 0 0 0 0 5 2 2 0 0 0 9 9
124 Magnesium Sulfat Injeksi 40% (MgSO4) 0 0 0 0 0 0 5 2 1 0 0 0 8 8
125 Masker 100 0 0 0 0 0 0 0 0 0 0 0 100 100
126 Medical adhesive tape (dermafix/leukomed) 9 5 4 0 0 0 0 0 0 0 0 0 18 18
127 Metamizole injeksi (antalgin 1000) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Metformin 500mg tab 2100 600 1500 2700 1300 800 2700 1700 1200 0 0 0 14600 14600
129 Methyl Ergometrin Maleat inj 0,2 mg/ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0
130 Methyl Ergometrin Maleat 0,125 mg 3500 1300 2200 500 500 100 2000 1000 800 0 0 0 11900 11900
131 Methyl Prednisolon tab 4 mg 1600 1200 800 2000 1300 700 2200 900 900 0 0 0 11600 11600
132 Methyl Rosanilinium (gentian violet) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
133 Metronidazol 250 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0
134 Metronidazol 500 mg tab 1700 900 600 400 0 0 0 0 0 0 0 0 3600 3600
135 Metronidazol Infus 1 0 0 0 0 0 2 1 1 0 0 0 5 5
136 Metronidazol syr 0 0 0 0 0 0 0 0 0 0 0 0 0 0
137 Miconazole 2% Salep Kulit 68 40 25 79 50 30 102 60 25 0 0 0 479 479
138 Momilen Baby Gold Sirup 0 0 0 0 0 0 0 0 0 0 0 0 0 0
139 Natrium Bikarbonat 500 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
140 Nifedipin 10 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0
141 Nystatin Tab Vag 10.000 iu/g 100 20 23 87 20 45 75 20 15 0 0 0 405 405
142 Omeprazole inj 15 15 15 15 13 7 7 2 1 0 0 0 90 90
STOK JUMLAH
PENGAMAN RENCANA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
143 Omeprazole kaps 0 0 0 0 0 0 0 0 0 0 0 0 0 0
144 Oxytetracycline HCl 1% Salep Mata 0 0 0 0 0 0 50 12 13 0 0 0 75 75
145 Oxytetracycline HCl 3% Salep Kulit 0 0 0 0 0 0 0 0 0 0 0 0 0 0
146 Oxytocin inj 10 IU 0 0 0 0 0 0 0 0 0 0 0 0 0 0
147 Papaverin 40 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0
148 Papaverin inj 0 0 0 0 0 0 0 0 0 0 0 0 0 0
149 Paracetamol Drops 15 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0
150 Parasetamol 120 mg/5 ml Syr 180 60 60 80 35 15 100 50 50 0 0 0 630 630
151 Parasetamol 500 mg 9000 5500 3500 7800 3500 1500 10000 4000 2500 0 0 0 47300 47300
152 Patient Lubricant (My Jelly ) 1 2 2 2 1 1 0 0 0 0 0 0 9 9
153 Permethrin (Scabimite Cream) 4 2 0 0 0 0 0 0 0 0 0 0 6 6
154 Phenobarbital inj 50mg/ml-2ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0
155 Phenobarbital 100 mg 300 200 100 200 200 200 100 100 100 0 0 0 1500 1500
156 Phenol gliserol 10% TT 48 24 10 24 0 0 0 0 0 0 0 0 106 106
157 Phytomenadione (Vit.K1) inj 10 mg/ml 0 0 0 0 0 0 60 30 30 0 0 0 120 120
158 Phytomenadione (Vit.K1) 10 mg 4000 2000 900 100 0 0 2300 1100 800 0 0 0 11200 11200
159 Piracetam 400 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
160 Piroxicam 20 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0
161 Pisau Disposable (Mess No.14/21) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
162 Plesterku (Leukoplast) 2 0 0 0 0 0 0 0 0 0 0 0 2 2
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Bio 0 0 0 0 0 0 0 0 0 0 0 0 0 0
164 Povidon iodium 10% 300 ml 12 5 4 4 0 0 0 0 0 0 0 0 25 25
165 Prednison 5 mg 8500 4000 3500 8000 4000 3000 10000 5000 3000 0 0 0 49000 49000
166 Primaquin 15 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0
167 Profolat tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0
168 Prokaina Penisilin G inj 3.000.000 iu 0 0 0 0 0 0 0 0 0 0 0 0 0 0
169 Propranolol HCl 10 mg 1300 1000 700 2000 700 700 2100 1000 800 0 0 0 10300 10300
170 Propranolol HCl 40 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
171 Propylthiouracil 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
172 Protein Gluco Test 18 8 8 5 3 2 0 0 0 0 0 0 44 44
173 Pyrantel Pamoat 125 mg 300 150 150 0 0 0 700 500 300 0 0 0 2100 2100
174 Pyridoxine HCl 10 mg 8000 4500 2500 0 0 0 6000 4500 1500 0 0 0 27000 27000
175 Ranitidin 150 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
176 Ranitidin Injeksi 0 0 0 0 0 0 0 0 0 0 0 0 0 0
177 Retinol (Vit.A) kaps 100.000 iu 0 0 0 0 0 0 400 200 200 0 0 0 800 800
178 Retinol (Vit.A) kaps 200.000 iu 0 0 0 0 0 0 600 200 200 0 0 0 1000 1000
179 Risperidone 2mg 0 0 0 0 0 0 500 600 300 0 0 0 1400 1400
STOK JUMLAH
PENGAMAN RENCANA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
180 Salbutamol 2 mg 2000 1100 500 2400 1300 700 2700 1500 1000 0 0 0 13200 13200
181 Salep 2-4 Kombinasi 92 48 27 73 24 24 0 0 0 0 0 0 288 288
182 Sarung tangan (HandScuun) No.7,5 300 100 100 400 100 100 100 0 0 0 0 0 1200 1200
183 Sarung tangan (HandScuun Steril) No. 6,5 0 0 0 0 0 0 0 0 0 0 0 0 0 0
184 Sarung tangan (HandScuun Steril) No.7 0 0 0 0 0 0 0 0 0 0 0 0 0 0
185 Sarung tangan (HandScuun Steril) No.7,5 50 0 0 0 0 0 0 0 0 0 0 0 50 50
186 Semen Seng Fosfat Serbuk & Cairan 0 0 0 0 0 0 0 0 0 0 0 0 0 0
187 Sianocobalamin (Vit B12) 50 mg tab 9000 4500 2500 1600 500 0 7000 4000 1000 0 0 0 30100 30100
188 Silk (Benang Bedah) No. 3/0 72 38 36 36 20 14 0 0 0 0 0 0 216 216
189 Silver Sulfadiazine 53 23 12 31 13 9 8 0 0 0 0 0 149 149
190 Simvastatin 10 mg tab 1700 800 500 2000 800 800 0 0 0 0 0 0 6600 6600
191 Sodium cloride infus 0,9% ( NACL ) 40 10 0 40 16 4 60 40 40 0 0 0 250 250
192 Spuit 1 ml 400 200 100 100 0 0 0 0 0 0 0 0 800 800
193 Spuit 3 ml 600 300 300 600 300 300 200 0 0 0 0 0 2600 2600
194 Spuit 5 ml 200 100 100 100 100 0 0 0 0 0 0 0 600 600
195 Sulfadoxine | Pyrimethamine Tablet 500mg| 1300 900 300 0 0 0 0 0 0 0 0 0 2500 2500
196 Sulfamethoxazole | trimethoprim (cotri) syr 15 0 0 0 0 0 60 25 15 0 0 0 115 115
197 Sulfasetamida 15% TM 0 0 0 0 0 0 0 0 0 0 0 0 0 0
198 Tetracycline 250 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
199 Tetracycline 500 mg 0 0 0 0 0 0 2500 1200 800 0 0 0 4500 4500
200 Thiamine HCl (Vit B1) inj 100 mg/ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0
201 Thiamine HCl (Vit B1) 50 mg 13000 4500 2500 0 0 0 0 0 0 0 0 0 20000 20000
202 Trihexyphenidyl tab 2 mg 100 100 0 100 0 0 0 0 0 0 0 0 300 300
203 Trimethoprim (cotrimoxazol 480 mg) tablet 5000 3000 1000 5800 4000 900 7800 3500 1300 0 0 0 32300 32300
204 Urin Bag 3 2 2 3 1 1 1 0 0 0 0 0 13 13
205 Usg Gel 2 1 1 2 2 1 3 1 1 0 0 0 14 14
206 Vaksin Rabies Vero/ Verorab 0 0 0 0 0 0 0 0 0 0 0 0 0 0
207 Vitamin B Kompleks 7000 4000 1000 11000 4000 4500 12400 5000 4500 0 0 0 53400 53400
208 Vitamin K Infant Inj 0 0 0 0 0 0 0 0 0 0 0 0 0 0
209 Water liquid (aqua P,I) 8 5 4 13 5 3 16 4 3 0 0 0 61 61
210 Wing Needle No.21 0 0 0 0 0 0 0 0 0 0 0 0 0 0
211 Wing Needle No.27 0 0 0 0 0 0 0 0 0 0 0 0 0 0
212 Zinc Sulphate Suppositoria (Superhoid) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
213 Zinc tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0
214 Ondansetron iv/im 4 mg 3 1 5 4 5 2 6 5 6 0 0 0 37 37
215 Tranexamic Acid inj 5% 8 4 3 5 3 2 0 0 0 0 0 0 25 25
216 Poliwash 500 ml 0 0 0 3 1 1 0 0 0 0 0 0 5 5
STOK JUMLAH
PENGAMAN RENCANA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
217 Policlean Handrub 0 0 0 0 0 0 0 0 0 0 0 0 0 0
218 Sarung Tangan (Handscuun) L 300 100 100 50 50 0 0 0 0 0 0 0 600 600
219 Cefotaxime Sodium inj 1 gr 0 0 0 40 22 18 10 15 10 0 0 0 115 115
220 Methyl Prednisolon tab 16 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
221 Lancet 0 0 0 0 0 0 0 0 0 0 0 0 0 0
222 Strip Kolesterol 0 0 0 0 0 0 0 0 0 0 0 0 0 0
223 Strip Gula Darah 0 0 0 0 0 0 0 0 0 0 0 0 0 0
224 Strip Asam Urat 0 0 0 0 0 0 0 0 0 0 0 0 0 0
225 Nonwoven Fixation Rol 2 2 1 5 3 2 1 0 1 0 0 0 17 17
226 Paracetamol 1000 mg /100 ml 0 0 0 5 4 1 5 4 1 0 0 0 20 20
227 Otsu D-40 25 ml 0 0 0 40 10 20 15 12 5 0 0 0 102 102
228 Ketorolac inj 30 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
229 Dulcolax tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0
230 Ibuprofen 400 mg.1 0 0 0 1700 600 700 2000 1000 600 0 0 0 6600 6600
231 Permethrin (Scabimite Cream).1 10 6 7 0 0 0 0 0 0 0 0 0 23 23
232 Masker Plus 200 200 100 0 0 0 0 0 0 0 0 0 500 500
233 0 0 0 0 0 0 0 0 0 0 0 0 0 0
234 0 0 0 0 0 0 0 0 0 0 0 0 0 0
235 0 0 0 0 0 0 0 0 0 0 0 0 0 0
236 0 0 0 0 0 0 0 0 0 0 0 0 0 0
237 0 0 0 0 0 0 0 0 0 0 0 0 0 0
238 0 0 0 0 0 0 0 0 0 0 0 0 0 0
239 0 0 0 0 0 0 0 0 0 0 0 0 0 0
240 0 0 0 0 0 0 0 0 0 0 0 0 0 0
241 0 0 0 0 0 0 0 0 0 0 0 0 0 0
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
..................................... ..................................... ..................................... .....................................
NIP. NIP. NIP. NIP.
LAMPIRAN BERITA ACARA PENCACAHAN OBAT AKHIR TAHUN PUSKESMAS
PUSKESMAS : TAHUN : 2020
KECAMATAN :
KABUPATEN : OGAN KOMERING ILIR
PROPINSI : SUMATERA SELATAN
MENURUT PENCATATAN HASIL SELISIH KADALUARSA RUSAK HILANG

NO. NAMA OBAT SATUAN SALDO 1 PENERIMAAN 1 PENGELUARAN 1 SALDO 31 DES
JANUARI 2020 JANUARI S/D 31 JANUARI S/D 31 2020 PENCACAHAN
DES 2020 DES 2020
1 2 3 4 5 6 7 8 9 10 11 12
1 Absorbent tipped applicator (alcohol swab) Pcs 50 2100 2100 50 50
2 Acetylcystein Kapsul 200mg Kapsul 100 0 100 0 0
3 Acyclovir tab 200 mg Tablet 50 0 50 0 0
4 Acyclovir cream Tube 4 0 4 0 0
5 Albendazol tab 400 mg Tablet 0 0 0 0 0
6 Alkohol Liquid (etanol) 70%-1000 ml Btl 3 20 23 0 0
7 Allopurinol 100 mg Tablet 100 3000 3100 0 0
8 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 30 26 4 4
9 Aminophylline tab 200 mg Tablet 150 3600 3750 0 0
10 Amitriptyline 25 mg tab Tablet 0 9000 8900 100 100
11 Amlodipine tab 5 mg Tablet 0 3000 3000 0 0
12 Amoxycillin Syr Btl 50 500 520 30 30
13 Amoxycillin 250 mg Kapsul 0 23000 23000 0 0
14 Amoxycillin 500 mg Kaptab 500 54000 52500 2000 2000
15 Ampicilin 1 gr Inj Vial 1 40 35 6 6
16 Antasida Syr DOEN Btl 0 550 530 20 20
17 Antasida DOEN Kombinasi Tablet 500 55200 55700 0 0
18 Anti Bisa Ular 5 ml (ABU I)/ Biosave Vial 0 0 0 0 0
19 Asam Mefenamat 500 mg tab Tablet 0 7500 7500 0 0
20 Ascorbic acid (Vit.C) 50 mg Tablet 0 4000 4000 0 0
21 Ascorbic acid |calsium carbonate 500 mg (Pehavr 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 200 3200 3400 0 0
25 Attapulgite Tablet 600 mg (New Antides) Tablet 0 2400 2400 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 90 90 0 0
29 Benzoic acid |salicylic acid salep (anti fungi) pot 7 336 333 10 10
30 Betahistine Mesylate 6 mg tab Tablet 0 3000 3000 0 0
31 Betamethasone 0,1% krim Tube 0 325 315 10 10
HALAMAN : 2
DES 2019 DES 2019
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 4 90 94 0 0
34 Calcium chloride lactate infus (RL) Botol 100 400 500 0 0
35 Calsium Laktat (Kalk) 500 mg Tablet 0 44600 44600 0 0
36 Captopril 12,5 mg Tablet 300 7200 7500 0 0
37 Captopril 25 mg Tablet 0 7400 7400 0 0
38 Carbamazepin tab Tablet 300 500 700 100 100
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 48 384 432 0 0
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 48 528 552 24 24
41 Cefadroxil 500mg Tablet 0 0 0 0 0
42 Cetirizine 5 mg/5 ml sirup Botol 11 50 61 0 0
43 Chloramhenicol Salep Mata 1% Tube 4 288 277 15 15
44 Chloramphenicol Suspensi 125 mg/ml Btl 0 100 100 0 0
45 Chloramphenicol 250 mg caps Tablet 0 6400 6400 0 0
46 Chloramphenicol TT 3% Botol 0 0 0 0 0
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 10 384 374 20 20
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 1000 38200 39200 0 0
49 Chlorpromazine HCl 100 mg Tablet 300 1100 1300 100 100
50 Cimetidin 200 tab Tablet 0 0 0 0 0
51 Ciprofloxacin 500 mg tab Tablet 0 3800 3800 0 0
52 Ciprofloxacin Infus Botol 0 5 5 0 0
53 Clindamycin 300mg Kapsul 0 0 0 0 0
54 Cresol liquid 1 Liter (lysol) Botol 0 38 38 0 0
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 38000 38000 0 0
58 Dexamethasone inj 5mg/ml-1ml Ampul 0 1900 1900 0 0
59 Diazepam 5mg/ml-2 ml inj Ampul 0 30 30 0 0
60 Diazepam 2 mg Tablet 0 0 0 0 0
61 Diclofenac sodium 25 mg tab Tablet 0 8800 8800 0 0
62 Digoxin 0,25 mg Tablet 0 9400 9300 100 100
63 Dimenhydrinate 50mg Tablet 0 6600 6400 200 200
64 Dipenhidramine HCl inj 10mg/ml Ampul 30 810 810 30 30
65 Domperidone 10 mg Tablet 500 6000 6500 0 0
66 Doxycycline 100 mg Kapsul Kapsul 100 1300 1400 0 0
67 Epinephrine HCl/bitartrat inj 0,1% Ampul 0 0 0 0 0
68 Erythromicin Syr Btl 0 264 254 10 10
HALAMAN : 3
DES 2019 DES 2019
1 2 3 4 5 6 7 8 9 10 11 12
69 Erythromicin 500 mg capsul Kapsul 100 15500 15400 200 200
70 Ethacridine (Rivanol) 0,1% Btl 0 67 67 0 0
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 2 18 20 0 0
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 0 10 9 1 1
76 Furosemida Injeksi Ampul 0 75 75 0 0
77 Furosemida 40 mg Tablet 500 6800 7300 0 0
78 Garam Oralit Sachet 0 0 0 0 0
79 Gentamicyn 0,3% TM Botol 0 168 168 0 0
80 Gentamicyn Inj 40 mg/ml Ampul 0 0 0 0 0
81 Gentamicyn 0,1% SK Tube 0 120 120 0 0
82 Glass lonomer Paket 0 0 0 0 0
83 Glibenclamide 5 mg Tablet 0 6000 6000 0 0
84 Glimepiride 1 mg Tablet 0 0 0 0 0
85 Glukosa larutan infus 10% Botol 10 160 170 0 0
87 Griseofulvin 125 mg Tablet 100 3000 3100 0 0
88 Guaifenesin 100 Tab (GG tab) Tablet 1500 32000 33500 0 0
89 Haloperidol 0,5 mg tab Tablet 0 0 0 0 0
90 Haloperidol 5 mg tab Tablet 200 1000 800 400 400
91 Human chorionic (HCG/Tes kehamilan ) Strip 0 500 500 0 0
92 Hydrochlorotiazide (HCT) 25 mg Tablet 0 0 0 0 0
93 Ibuprofen sirup Botol 20 150 170 0 0
94 Ibuprofen 200 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 100 250 350 0 0
99 Infusi set anak Pcs 30 400 410 20 20
100 Iodium Povidon 10% 30 ml Botol 0 63 63 0 0
101 Isosorbide tablet Tablet 100 9300 9400 0 0
102 IV Catheter No.20 Pcs 0 600 550 50 50
105 Jarum Jahit Kulit Pcs 0 0 0 0 0
HALAMAN : 4
DES 2019 DES 2019
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 1 47 48 0 0
108 Kasa pembalut 2x80 Pcs 0 295 295 0 0
109 Kasa pembalut hidrofil 4 m x 15 cm Pcs 0 210 210 0 0
111 Kasa kompres 40/40 steril Pcs 50 700 680 70 70
112 Ketoconazole 200 mg Cream Tube 12 325 337 0 0
113 Ketoconazole 200 mg tab Tablet 100 5100 5200 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 10 10 0 0
117 Lidokain Comp. inj Kombinasi Ampul 120 180 300 0 0
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 100 0 100 0 0
122 Loratadine 10 mg tab Tablet 0 0 0 0 0
123 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 10 9 1 1
125 Masker Pcs 100 0 100 0 0
126 Medical adhesive tape (dermafix/leukomed) Pcs 20 0 18 2 2
127 Metamizole injeksi (antalgin 1000) Ampul 0 0 0 0 0
128 Metformin 500mg tab Tablet 0 14600 14600 0 0
129 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0 0 0 0
130 Methyl Ergometrin Maleat 0,125 mg Tab 200 11200 11900 -500 -500
131 Methyl Prednisolon tab 4 mg Tablet 0 11600 11600 0 0
132 Methyl Rosanilinium (gentian violet) Botol 0 0 0 0 0
133 Metronidazol 250 mg tab Tablet 0 0 0 0 0
135 Metronidazol Infus Botol 1 5 5 1 1
136 Metronidazol syr Botol 0 0 0 0 0
137 Miconazole 2% Salep Kulit Tube 0 504 479 25 25
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 50 400 405 45 45
142 Omeprazole inj Vial 0 90 90 0 0
HALAMAN : 5
DES 2019 DES 2019
1 2 3 4 5 6 7 8 9 10 11 12
143 Omeprazole kaps Kapsul 0 0 0 0 0
144 Oxytetracycline HCl 1% Salep Mata Tube 0 75 75 0 0
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 30 600 630 0 0
151 Parasetamol 500 mg Tablet 0 47300 47300 0 0
152 Patient Lubricant (My Jelly ) Tube 2 7 9 0 0
153 Permethrin (Scabimite Cream) Tube 6 0 6 0 0
154 Phenobarbital inj 50mg/ml-2ml Ampul 0 0 0 0 0
155 Phenobarbital 100 mg Tablet 0 1500 1500 0 0
156 Phenol gliserol 10% TT Botol 10 96 106 0 0
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 120 120 0 0
158 Phytomenadione (Vit.K1) 10 mg Tablet 0 11300 11200 100 100
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 2 0 2 0 0
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat Ampul 0 0 0 0 0
164 Povidon iodium 10% 300 ml Botol 0 25 25 0 0
165 Prednison 5 mg Tablet 0 49000 49000 0 0
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 300 10200 10300 200 200
171 Propylthiouracil 100 mg Tablet 0 0 0 0 0
172 Protein Gluco Test Strip 4 40 44 0 0
173 Pyrantel Pamoat 125 mg Tablet 0 2100 2100 0 0
174 Pyridoxine HCl 10 mg Tablet 0 27000 27000 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 0 800 800 0 0
179 Risperidone 2mg Tablet 0 1500 1400 100 100
HALAMAN : 6
DES 2019 DES 2019
1 2 3 4 5 6 7 8 9 10 11 12
180 Salbutamol 2 mg Tablet 0 13200 13200 0 0
181 Salep 2-4 Kombinasi pot 24 264 288 0 0
182 Sarung tangan (HandScuun) No.7,5 Pcs 0 1200 1200 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 50 0 50 0 0
186 Semen Seng Fosfat Serbuk & Cairan Set 0 0 0 0 0
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 0 30100 30100 0 0
188 Silk (Benang Bedah) No. 3/0 Pcs 0 216 216 0 0
189 Silver Sulfadiazine Tube 10 139 149 0 0
190 Simvastatin 10 mg tab Tablet 0 6600 6600 0 0
191 Sodium cloride infus 0,9% ( NACL ) Botol 50 200 250 0 0
192 Spuit 1 ml Pcs 200 600 800 0 0
193 Spuit 3 ml Pcs 100 2500 2600 0 0
194 Spuit 5 ml Pcs 300 300 600 0 0
195 Sulfadoxine | Pyrimethamine Tablet 500mg|25 Tablet 0 2500 2500 0 0
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 15 100 115 0 0
197 Sulfasetamida 15% TM Botol 0 0 0 0 0
198 Tetracycline 250 mg Tablet 0 0 0 0 0
200 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0 0 0 0
201 Thiamine HCl (Vit B1) 50 mg Tablet 0 20000 20000 0 0
202 Trihexyphenidyl tab 2 mg Tablet 300 0 300 0 0
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 0 32500 32300 200 200
204 Urin Bag Pcs 3 10 13 0 0
205 Usg Gel Botol 0 15 14 1 1
206 Vaksin Rabies Vero/ Verorab Paket 0 0 0 0 0
207 Vitamin B Kompleks Tablet 0 54900 53400 1500 1500
208 Vitamin K Infant Inj Ampul 0 0 0 0 0
209 Water liquid (aqua P,I) Botol 1 63 61 3 3
210 Wing Needle No.21 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
214 Ondansetron iv/im 4 mg Ampul 1 40 37 4 4
215 Tranexamic Acid inj 5% Ampul 0 25 25 0 0
216 Poliwash 500 ml Botol 0 5 5 0 0
HALAMAN : 7
DES 2019 DES 2019
1 2 3 4 5 6 7 8 9 10 11 12
217 Policlean Handrub Botol
218 Sarung Tangan (Handscuun) L Pcs
219 Cefotaxime Sodium inj 1 gr Vial
220 Methyl Prednisolon tab 16 mg Tablet
221 Lancet Pcs
222 Strip Kolesterol Pcs
223 Strip Gula Darah Pcs
224 Strip Asam Urat Pcs
225 Nonwoven Fixation Rol Pcs
226 Paracetamol 1000 mg /100 ml Botol
227 Otsu D-40 25 ml Botol
228 Ketorolac inj 30 mg Ampul
229 Dulcolax tab Tablet
230 Ibuprofen 400 mg.1 Tablet
231 Permethrin (Scabimite Cream).1 Tube
232 Masker Plus Pcs
Mengetahui/ Menyetujui Yang Membuat

Pimpinan Puskesmas SAKSI - SAKSI Pengelola Obat Puskesmas
1 2
..................................... .....................................
..................................... .....................................
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSKESMAS
PUSKESMAS : PELAPORAN BULAN : DESEMBER 2020 DOKUMEN NOMOR TANGGAL
KECAMATAN : 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 50 50 50 -50
2 Acetylcystein Kapsul 200mg Kapsul 0 0 0 0
3 Acyclovir tab 200 mg Tablet 0 0 0 0
4 Acyclovir cream Tube 0 0 0 0
5 Albendazol tab 400 mg Tablet 0 0 0 0
6 Alkohol Liquid (etanol) 70%-1000 ml Btl 0 0 0 0
7 Allopurinol 100 mg Tablet 0 0 0 0
8 Aminophylline Inj 24 mg/ml-10 ml Ampul 4 4 4 -4
9 Aminophylline tab 200 mg Tablet 0 0 0 0
10 Amitriptyline 25 mg tab Tablet 100 100 100 -100
11 Amlodipine tab 5 mg Tablet 0 0 0 0
12 Amoxycillin Syr Btl 30 30 30 -30
13 Amoxycillin 250 mg Kapsul 0 0 0 0
14 Amoxycillin 500 mg Kaptab 2000 2000 2000 -2000
15 Ampicilin 1 gr Inj Vial 6 6 6 -6
16 Antasida Syr DOEN Btl 20 20 20 -20
17 Antasida DOEN Kombinasi Tablet 0 0 0 0
18 Anti Bisa Ular 5 ml (ABU I)/ Biosave Vial 0 0 0 0
19 Asam Mefenamat 500 mg tab Tablet 0 0 0 0
20 Ascorbic acid (Vit.C) 50 mg Tablet 0 0 0 0
21 Ascorbic acid |calsium carbonate 500 mg (Peh Tablet 0 0 0 0
22 Aspirin (miniaspi) 100 mg tab Tablet 0 0 0 0
23 Atropine inj 0,25 mg/ml Ampul 0 0 0 0
24 Attapulgite Tablet (Pularex) Tablet 0 0 0 0
25 Attapulgite Tablet 600 mg (New Antides) Tablet 0 0 0 0
26 Automated blood grouping (Tes Gol. Darah) Paket 0 0 0 0
27 Bahan Tambal Gigi Sementara (Fletcher/Cavit Pcs 0 0 0 0
28 Bedak Salisil 2% Btl 0 0 0 0
29 Benzoic acid |salicylic acid salep (anti fungi) pot 10 10 10 -10
30 Betahistine Mesylate 6 mg tab Tablet 0 0 0 0
31 Betamethasone 0,1% krim Tube 10 10 10 -10
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : DESEMBER 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
32 Bisacodyl 5mg Tablet 0 0 0 0
33 Bismuth subgallas (antihemoroid) Supp 0 0 0 0
34 Calcium chloride lactate infus (RL) Botol 0 0 0 0
35 Calsium Laktat (Kalk) 500 mg Tablet 0 0 0 0
36 Captopril 12,5 mg Tablet 0 0 0 0
37 Captopril 25 mg Tablet 0 0 0 0
38 Carbamazepin tab Tablet 100 100 100 -100
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 0 0 0 0
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 24 24 24 -24
41 Cefadroxil 500mg Tablet 0 0 0 0
42 Cetirizine 5 mg/5 ml sirup Botol 0 0 0 0
43 Chloramhenicol Salep Mata 1% Tube 15 15 15 -15
44 Chloramphenicol Suspensi 125 mg/ml Btl 0 0 0 0
45 Chloramphenicol 250 mg caps Tablet 0 0 0 0
46 Chloramphenicol TT 3% Botol 0 0 0 0
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 20 20 20 -20
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 0 0 0 0
49 Chlorpromazine HCl 100 mg Tablet 100 100 100 -100
50 Cimetidin 200 tab Tablet 0 0 0 0
51 Ciprofloxacin 500 mg tab Tablet 0 0 0 0
52 Ciprofloxacin Infus Botol 0 0 0 0
53 Clindamycin 300mg Kapsul 0 0 0 0
54 Cresol liquid 1 Liter (lysol) Botol 0 0 0 0
55 Cyanocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0 0 0
56 Devitalisasi pasta pot 0 0 0 0
57 Dexamethasone 0,5 mg Tablet 0 0 0 0
58 Dexamethasone inj 5mg/ml-1ml Ampul 0 0 0 0
59 Diazepam 5mg/ml-2 ml inj Ampul 0 0 0 0
60 Diazepam 2 mg Tablet 0 0 0 0
61 Diclofenac sodium 25 mg tab Tablet 0 0 0 0
62 Digoxin 0,25 mg Tablet 100 100 100 -100
63 Dimenhydrinate 50mg Tablet 200 200 200 -200
64 Dipenhidramine HCl inj 10mg/ml Ampul 30 30 30 -30
65 Domperidone 10 mg Tablet 0 0 0 0
66 Doxycycline 100 mg Kapsul Kapsul 0 0 0 0
67 Epinephrine HCl/bitartrat inj 0,1% Ampul 0 0 0 0
68 Erythromicin Syr Btl 10 10 10 -10
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
69 Erythromicin 500 mg capsul Kapsul 200 200 200 -200
70 Ethacridine (Rivanol) 0,1% Btl 0 0 0 0
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 0 0 0 0
72 Eugenol cairan Btl 0 0 0 0
73 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 0 0 0
74 Folic acid 1mg ( asam folat) Tablet 0 0 0 0
75 Folley Catheter No.16 Pcs 1 1 1 -1
76 Furosemida Injeksi Ampul 0 0 0 0
77 Furosemida 40 mg Tablet 0 0 0 0
78 Garam Oralit Sachet 0 0 0 0
79 Gentamicyn 0,3% TM Botol 0 0 0 0
80 Gentamicyn Inj 40 mg/ml Ampul 0 0 0 0
81 Gentamicyn 0,1% SK Tube 0 0 0 0
82 Glass lonomer Paket 0 0 0 0
83 Glibenclamide 5 mg Tablet 0 0 0 0
84 Glimepiride 1 mg Tablet 0 0 0 0
85 Glukosa larutan infus 10% Botol 0 0 0 0
87 Griseofulvin 125 mg Tablet 0 0 0 0
88 Guaifenesin 100 Tab (GG tab) Tablet 0 0 0 0
89 Haloperidol 0,5 mg tab Tablet 0 0 0 0
90 Haloperidol 5 mg tab Tablet 400 400 400 -400
91 Human chorionic (HCG/Tes kehamilan ) Strip 0 0 0 0
92 Hydrochlorotiazide (HCT) 25 mg Tablet 0 0 0 0
93 Ibuprofen sirup Botol 0 0 0 0
94 Ibuprofen 200 mg Tablet 0 0 0 0
96 Ichthyol salep 10% pot 0 0 0 0
97 Immunoglobulin human anti-tetanus (Tetagam Ampul 0 0 0 0
98 Infus set dewasa Pcs 0 0 0 0
99 Infusi set anak Pcs 20 20 20 -20
100 Iodium Povidon 10% 30 ml Botol 0 0 0 0
101 Isosorbide tablet Tablet 0 0 0 0
102 IV Catheter No.20 Pcs 50 50 50 -50
103 IV Catheter No.22 Pcs 0 0 0 0
105 Jarum Jahit Kulit Pcs 0 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
106 Kalium Permanganat Serbuk pot 0 0 0 0
107 Kapas pembalut/Absorben 250 g Pcs 0 0 0 0
108 Kasa pembalut 2x80 Pcs 0 0 0 0
109 Kasa pembalut hidrofil 4 m x 15 cm Pcs 0 0 0 0
110 Kasa pembalut hidrofil 4 m x 3 cm Pcs 10 10 10 -10
111 Kasa kompres 40/40 steril Pcs 70 70 70 -70
112 Ketoconazole 200 mg Cream Tube 0 0 0 0
113 Ketoconazole 200 mg tab Tablet 0 0 0 0
114 Klorokina Fosfat 250 mg Tablet 0 0 0 0
115 Levertran Salep/ Salep Luka Bakar pot 0 0 0 0
116 Lidocain 2% Ampul 0 0 0 0
117 Lidokain Comp. inj Kombinasi Ampul 0 0 0 0
118 Lidocaine spray (Xylocaine spray) Botol 0 0 0 0
119 Liquorice liquid extract (OBH) Botol 0 0 0 0
120 Locoriz Cream Tube 0 0 0 0
121 Loperamid 2 m tab Tablet 0 0 0 0
122 Loratadine 10 mg tab Tablet 0 0 0 0
123 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 1 1 1 -1
125 Masker Pcs 0 0 0 0
126 Medical adhesive tape (dermafix/leukomed) Pcs 0 0 0 0
127 Metamizole injeksi (antalgin 1000) Ampul 0 0 0 0
128 Metformin 500mg tab Tablet 100 100 100 -100
129 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0 0 0
130 Methyl Ergometrin Maleat 0,125 mg Tab 0 0 0 0
131 Methyl Prednisolon tab 4 mg Tablet 0 0 0 0
132 Methyl Rosanilinium (gentian violet) Botol 0 0 0 0
133 Metronidazol 250 mg tab Tablet 0 0 0 0
135 Metronidazol Infus Botol 1 1 1 -1
136 Metronidazol syr Botol 0 0 0 0
137 Miconazole 2% Salep Kulit Tube 25 25 25 -25
138 Momilen Baby Gold Sirup Botol 0 0 0 0
139 Natrium Bikarbonat 500 mg Tablet 0 0 0 0
140 Nifedipin 10 mg tab Kapsul 0 0 0 0
141 Nystatin Tab Vag 10.000 iu/g Tablet 45 45 45 -45
142 Omeprazole inj Vial 0 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
143 Omeprazole kaps Kapsul 0 0 0 0
144 Oxytetracycline HCl 1% Salep Mata Tube 0 0 0 0
145 Oxytetracycline HCl 3% Salep Kulit Tube 0 0 0 0
146 Oxytocin inj 10 IU Ampul 0 0 0 0
147 Papaverin 40 mg tab Tablet 0 0 0 0
148 Papaverin inj Tablet 0 0 0 0
149 Paracetamol Drops 15 ml Botol 0 0 0 0
150 Parasetamol 120 mg/5 ml Syr Botol 0 0 0 0
151 Parasetamol 500 mg Tablet 0 0 0 0
152 Patient Lubricant (My Jelly ) Tube 0 0 0 0
153 Permethrin (Scabimite Cream) Tube 0 0 0 0
154 Phenobarbital inj 50mg/ml-2ml Ampul 0 0 0 0
155 Phenobarbital 100 mg Tablet 0 0 0 0
156 Phenol gliserol 10% TT Botol 0 0 0 0
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 0 0 0
158 Phytomenadione (Vit.K1) 10 mg Tablet 100 100 100 -100
159 Piracetam 400 mg Tablet 0 0 0 0
160 Piroxicam 20 mg tab Tablet 0 0 0 0
161 Pisau Disposable (Mess No.14/21) Pcs 0 0 0 0
162 Plesterku (Leukoplast) Pcs 0 0 0 0
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Bio Ampul 0 0 0 0
164 Povidon iodium 10% 300 ml Botol 0 0 0 0
165 Prednison 5 mg Tablet 0 0 0 0
166 Primaquin 15 mg tab Tablet 0 0 0 0
167 Profolat tab Tablet 0 0 0 0
168 Prokaina Penisilin G inj 3.000.000 iu Ampul 0 0 0 0
169 Propranolol HCl 10 mg Tablet 200 200 200 -200
170 Propranolol HCl 40 mg Tablet 0 0 0 0
171 Propylthiouracil 100 mg Tablet 0 0 0 0
172 Protein Gluco Test Strip 0 0 0 0
173 Pyrantel Pamoat 125 mg Tablet 0 0 0 0
174 Pyridoxine HCl 10 mg Tablet 0 0 0 0
175 Ranitidin 150 mg Tablet 0 0 0 0
176 Ranitidin Injeksi Ampul 0 0 0 0
177 Retinol (Vit.A) kaps 100.000 iu Kapsul 0 0 0 0
179 Risperidone 2mg Tablet 100 100 100 -100
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
180 Salbutamol 2 mg Tablet 0 0 0 0
181 Salep 2-4 Kombinasi pot 0 0 0 0
182 Sarung tangan (HandScuun) No.7,5 Pcs 0 0 0 0
183 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0 0 0 0
184 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0 0 0
185 Sarung tangan (HandScuun Steril) No.7,5 Pcs 0 0 0 0
186 Semen Seng Fosfat Serbuk & Cairan Set 0 0 0 0
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 0 0 0 0
188 Silk (Benang Bedah) No. 3/0 Pcs 0 0 0 0
189 Silver Sulfadiazine Tube 0 0 0 0
190 Simvastatin 10 mg tab Tablet 0 0 0 0
191 Sodium cloride infus 0,9% ( NACL ) Botol 0 0 0 0
192 Spuit 1 ml Pcs 0 0 0 0
193 Spuit 3 ml Pcs 0 0 0 0
194 Spuit 5 ml Pcs 0 0 0 0
195 Sulfadoxine | Pyrimethamine Tablet 500mg| Tablet 0 0 0 0
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 0 0 0 0
197 Sulfasetamida 15% TM Botol 0 0 0 0
198 Tetracycline 250 mg Tablet 0 0 0 0
200 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0 0 0
201 Thiamine HCl (Vit B1) 50 mg Tablet 0 0 0 0
202 Trihexyphenidyl tab 2 mg Tablet 0 0 0 0
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 200 200 200 -200
204 Urin Bag Pcs 0 0 0 0
205 Usg Gel Botol 1 1 1 -1
206 Vaksin Rabies Vero/ Verorab Paket 0 0 0 0
207 Vitamin B Kompleks Tablet 1500 1500 1500 -1500
208 Vitamin K Infant Inj Ampul 0 0 0 0
209 Water liquid (aqua P,I) Botol 3 3 3 -3
210 Wing Needle No.21 Pcs 0 0 0 0
212 Zinc Sulphate Suppositoria (Superhoid) Kapsul 0 0 0 0
213 Zinc tab Tablet 0 0 0 0
214 Ondansetron iv/im 4 mg Ampul 4 4 4 -4
215 Tranexamic Acid inj 5% Ampul 0 0 0 0
216 Poliwash 500 ml Botol 0 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
217 Policlean Handrub Botol 0 0 0 0
218 Sarung Tangan (Handscuun) L Pcs 0 0 0 0
219 Cefotaxime Sodium inj 1 gr Vial 15 15 15 -15
221 Lancet Pcs 0 0 0 0
222 Strip Kolesterol Pcs 0 0 0 0
223 Strip Gula Darah Pcs 0 0 0 0
224 Strip Asam Urat Pcs 0 0 0 0
225 Nonwoven Fixation Rol Pcs 0 0 0 0
226 Paracetamol 1000 mg /100 ml Botol 0 0 0 0
227 Otsu D-40 25 ml Botol 3 3 3 -3
228 Ketorolac inj 30 mg Ampul 0 0 0 0
229 Dulcolax tab Tablet 0 0 0 0
230 Ibuprofen 400 mg.1 Tablet 0 0 0 0
231 Permethrin (Scabimite Cream).1 Tube 0 0 0 0
232 Masker Plus Pcs 0 0 0 0
233 0 0 0 0
234 0 0 0 0
235 0 0 0 0
236 0 0 0 0
237 0 0 0 0
238 0 0 0 0
239 0 0 0 0
240 0 0 0 0
241 0 0 0 0

0

Iwan Setiawan, SKM, Mkes Himayanti, S.Si, Mkes, Apt Andi Gunawan, SKM Norman Fahlevi
Nip. 1973 09051998031005 Nip. 197702212005120005 Nip. 197806022008011021 Nip. 198108152007011007
PUSKESMAS : PELAPORAN BULAN : NOPEMBER 2020 DOKUMEN NOMOR TANGGAL
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : NOPEMBER 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
192 Spuit 1 ml Pcs 0 0 0 0
193 Spuit 3 ml Pcs 0 0 0 0
194 Spuit 5 ml Pcs 0 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
227 Otsu D-40 25 ml Botol 3 3 3 -3
233 0 0 0 0
234 0 0 0 0
235 0 0 0 0
236 0 0 0 0
237 0 0 0 0
238 0 0 0 0
239 0 0 0 0
240 0 0 0 0
241 0 0 0 0

0

Nip. 1973 09051998031005 Nip. 197702212005120005 Nip. 197806022008011021 Nip. 198108152007011007
PUSKESMAS : PELAPORAN BULAN : OKTOBER 2020 DOKUMEN NOMOR TANGGAL
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : OKTOBER 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
192 Spuit 1 ml Pcs 0 0 0 0
193 Spuit 3 ml Pcs 0 0 0 0
194 Spuit 5 ml Pcs 0 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
227 Otsu D-40 25 ml Botol 3 3 3 -3
233 0 0 0 0
234 0 0 0 0
235 0 0 0 0
236 0 0 0 0
237 0 0 0 0
238 0 0 0 0
239 0 0 0 0
240 0 0 0 0
241 0 0 0 0

0

Nip. 1973 09051998031005 Nip. 197702212005120005 Nip. 197806022008011021 Nip. 198108152007011007
PUSKESMAS : AIR SUGIHAN JALUR 25 PELAPORAN BULAN : SEPTEMBER 2020 DOKUMEN NOMOR TANGGAL
KECAMATAN : AIR SUGIHAN PERMINTAAN BULAN : OKTOBER 2020 DINKES KAB/KOTA
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
1 Absorbent tipped applicator (alcohol swab) Pcs 150 150 100 50 840 600
2 Acetylcystein Kapsul 200mg Kapsul 0 0 0 0 0 3500
3 Acyclovir tab 200 mg Tablet 0 0 0 0 0 4000
4 Acyclovir cream Tube 0 0 0 0 0 150
5 Albendazol tab 400 mg Tablet 0 0 0 0 0 2000
6 Alkohol Liquid (etanol) 70%-1000 ml Btl 0 0 0 0 0 30
7 Allopurinol 100 mg Tablet 500 500 500 0 3600 4000
8 Aminophylline Inj 24 mg/ml-10 ml Ampul 10 10 6 4 31.2 30
9 Aminophylline tab 200 mg Tablet 0 0 0 0 0 2000
10 Amitriptyline 25 mg tab Tablet 600 600 500 100 2640 2540
11 Amlodipine tab 5 mg Tablet 600 600 600 0 3600 3600
12 Amoxycillin Syr Btl 90 90 60 30 252 250
13 Amoxycillin 250 mg Kapsul 0 0 0 0 0 9000
14 Amoxycillin 500 mg Kaptab 5500 5500 3500 2000 25600 23600
15 Ampicilin 1 gr Inj Vial 10 10 4 6 20.4 15
16 Antasida Syr DOEN Btl 50 50 30 20 240 250
17 Antasida DOEN Kombinasi Tablet 2000 2000 2000 0 18520 21000
18 Anti Bisa Ular 5 ml (ABU I)/ Biosave Vial 0 0 0 0 0 6
19 Asam Mefenamat 500 mg tab Tablet 700 700 700 0 4200 4500
20 Ascorbic acid (Vit.C) 50 mg Tablet 0 0 0 0 0 15000
21 Ascorbic acid |calsium carbonate 500 mg (Peh Tablet 0 0 0 0 0 4000
22 Aspirin (miniaspi) 100 mg tab Tablet 0 0 0 0 0 4000
23 Atropine inj 0,25 mg/ml Ampul 0 0 0 0 0 0
24 Attapulgite Tablet (Pularex) Tablet 0 0 0 0 0 3000
25 Attapulgite Tablet 600 mg (New Antides) Tablet 0 0 0 0 0 3000
26 Automated blood grouping (Tes Gol. Darah) Paket 0 0 0 0 0 4
27 Bahan Tambal Gigi Sementara (Fletcher/Cavit Pcs 0 0 0 0 0 0
28 Bedak Salisil 2% Btl 0 0 0 0 0 30
29 Benzoic acid |salicylic acid salep (anti fungi) pot 40 40 30 10 156 150
30 Betahistine Mesylate 6 mg tab Tablet 700 700 700 0 3600 3600
31 Betamethasone 0,1% krim Tube 40 40 30 10 168 200
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
32 Bisacodyl 5mg Tablet 0 0 0 0 0 2000
33 Bismuth subgallas (antihemoroid) Supp 0 0 0 0 45 45
34 Calcium chloride lactate infus (RL) Botol 40 40 40 0 264 260
35 Calsium Laktat (Kalk) 500 mg Tablet 1000 1000 1000 0 17320 19000
36 Captopril 12,5 mg Tablet 200 200 200 0 1760 3000
37 Captopril 25 mg Tablet 0 0 0 0 0 3000
38 Carbamazepin tab Tablet 200 200 100 100 480 400
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 4 4 4 0 125.6 192
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 48 48 24 24 230.4 192
41 Cefadroxil 500mg Tablet 0 0 0 0 0 3000
42 Cetirizine 5 mg/5 ml sirup Botol 0 0 0 0 0 100
43 Chloramhenicol Salep Mata 1% Tube 40 40 25 15 126 100
44 Chloramphenicol Suspensi 125 mg/ml Btl 0 0 0 0 0 150
45 Chloramphenicol 250 mg caps Tablet 0 0 0 0 0 3000
46 Chloramphenicol TT 3% Botol 0 0 0 0 0 75
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 50 50 30 20 178.8 175
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 0 0 0 0 0 21000
49 Chlorpromazine HCl 100 mg Tablet 200 200 100 100 1080 1000
50 Cimetidin 200 tab Tablet 0 0 0 0 0 3000
51 Ciprofloxacin 500 mg tab Tablet 0 0 0 0 0 5000
52 Ciprofloxacin Infus Botol 1 1 1 0 6 6
53 Clindamycin 300mg Kapsul 0 0 0 0 0 3000
54 Cresol liquid 1 Liter (lysol) Botol 0 0 0 0 0 16
55 Cyanocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0 0 0 0 500
56 Devitalisasi pasta pot 0 0 0 0 0 0
57 Dexamethasone 0,5 mg Tablet 100 100 100 0 2400 18000
58 Dexamethasone inj 5mg/ml-1ml Ampul 100 100 100 0 600 600
59 Diazepam 5mg/ml-2 ml inj Ampul 2 2 2 0 12 30
60 Diazepam 2 mg Tablet 0 0 0 0 0 3000
61 Diclofenac sodium 25 mg tab Tablet 0 0 0 0 0 3500
62 Digoxin 0,25 mg Tablet 700 700 600 100 4200 4100
63 Dimenhydrinate 50mg Tablet 400 400 200 200 2880 2600
64 Dipenhidramine HCl inj 10mg/ml Ampul 90 90 60 30 360 300
65 Domperidone 10 mg Tablet 0 0 0 0 0 4500
66 Doxycycline 100 mg Kapsul Kapsul 0 0 0 0 1000 1000
67 Epinephrine HCl/bitartrat inj 0,1% Ampul 0 0 0 0 0 30
68 Erythromicin Syr Btl 30 30 20 10 115.2 100
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
69 Erythromicin 500 mg capsul Kapsul 1000 1000 800 200 6960 6700
70 Ethacridine (Rivanol) 0,1% Btl 0 0 0 0 35 50
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 0 0 0 0 0 20
72 Eugenol cairan Btl 0 0 0 0 0 0
73 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 0 0 0 0 0
74 Folic acid 1mg ( asam folat) Tablet 0 0 0 0 0 3000
75 Folley Catheter No.16 Pcs 4 4 3 1 10.8 9.8
76 Furosemida Injeksi Ampul 30 30 30 0 90 90
77 Furosemida 40 mg Tablet 800 800 800 0 4800 4800
78 Garam Oralit Sachet 0 0 0 0 0 600
79 Gentamicyn 0,3% TM Botol 25 25 25 0 92.4 100
80 Gentamicyn Inj 40 mg/ml Ampul 0 0 0 0 0 60
81 Gentamicyn 0,1% SK Tube 0 0 0 0 0 150
82 Glass lonomer Paket 0 0 0 0 0 0
83 Glibenclamide 5 mg Tablet 400 400 400 0 2880 3000
84 Glimepiride 1 mg Tablet 0 0 0 0 0 1500
85 Glukosa larutan infus 10% Botol 0 0 0 0 0 0
87 Griseofulvin 125 mg Tablet 0 0 0 0 0 3500
88 Guaifenesin 100 Tab (GG tab) Tablet 0 0 0 0 0 18000
89 Haloperidol 0,5 mg tab Tablet 0 0 0 0 0 500
90 Haloperidol 5 mg tab Tablet 600 600 200 400 720 400
91 Human chorionic (HCG/Tes kehamilan ) Strip 0 0 0 0 0 500
92 Hydrochlorotiazide (HCT) 25 mg Tablet 0 0 0 0 0 4500
93 Ibuprofen sirup Botol 0 0 0 0 0 150
94 Ibuprofen 200 mg Tablet 0 0 0 0 0 3000
96 Ichthyol salep 10% pot 0 0 0 0 0 30
97 Immunoglobulin human anti-tetanus (Tetagam Ampul 0 0 0 0 0 15
98 Infus set dewasa Pcs 0 0 0 0 0 250
99 Infusi set anak Pcs 50 50 30 20 144 150
100 Iodium Povidon 10% 30 ml Botol 0 0 0 0 0 40
101 Isosorbide tablet Tablet 100 100 100 0 2400 3500
102 IV Catheter No.20 Pcs 100 100 50 50 240 250
105 Jarum Jahit Kulit Pcs 0 0 0 0 0 0
STOK STOK STOK
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 0
107 Kapas pembalut/Absorben 250 g Pcs 0 0 0 0 15 20
108 Kasa pembalut 2x80 Pcs 0 0 0 0 15 80
109 Kasa pembalut hidrofil 4 m x 15 cm Pcs 0 0 0 0 35 100
111 Kasa kompres 40/40 steril Pcs 120 120 50 70 252 180
112 Ketoconazole 200 mg Cream Tube 20 20 20 0 156 175
113 Ketoconazole 200 mg tab Tablet 0 0 0 0 2000 3000
114 Klorokina Fosfat 250 mg Tablet 0 0 0 0 0 0
115 Levertran Salep/ Salep Luka Bakar pot 0 0 0 0 0 30
116 Lidocain 2% Ampul 2 2 2 0 15 210
117 Lidokain Comp. inj Kombinasi Ampul 0 0 0 0 0 210
118 Lidocaine spray (Xylocaine spray) Botol 0 0 0 0 0 15
119 Liquorice liquid extract (OBH) Botol 0 0 0 0 0 100
120 Locoriz Cream Tube 0 0 0 0 0 50
121 Loperamid 2 m tab Tablet 0 0 0 0 0 3000
122 Loratadine 10 mg tab Tablet 0 0 0 0 0 3000
123 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 3 3 2 1 10.8 9.8
124 Magnesium Sulfat Injeksi 40% (MgSO4) Ampul 3 3 1 2 9.6 7.6
125 Masker Pcs 0 0 0 0 0 1000
126 Medical adhesive tape (dermafix/leukomed) Pcs 0 0 0 0 0 150
127 Metamizole injeksi (antalgin 1000) Ampul 0 0 0 0 0 60
128 Metformin 500mg tab Tablet 1300 1300 1200 100 6720 6600
129 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0 0 0 0 300
130 Methyl Ergometrin Maleat 0,125 mg Tab 800 800 800 0 4560 4500
131 Methyl Prednisolon tab 4 mg Tablet 900 900 900 0 4800 4800
132 Methyl Rosanilinium (gentian violet) Botol 0 0 0 0 0 150
133 Metronidazol 250 mg tab Tablet 0 0 0 0 0 2000
135 Metronidazol Infus Botol 2 2 1 1 4.8 4
136 Metronidazol syr Botol 0 0 0 0 0 100
137 Miconazole 2% Salep Kulit Tube 50 50 25 25 224.4 200
138 Momilen Baby Gold Sirup Botol 0 0 0 0 0 50
139 Natrium Bikarbonat 500 mg Tablet 0 0 0 0 0 4000
140 Nifedipin 10 mg tab Kapsul 0 0 0 0 0 4500
141 Nystatin Tab Vag 10.000 iu/g Tablet 60 60 15 45 132 100
142 Omeprazole inj Vial 1 1 1 0 12 30
STOK STOK STOK
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
144 Oxytetracycline HCl 1% Salep Mata Tube 13 13 13 0 90 100
145 Oxytetracycline HCl 3% Salep Kulit Tube 0 0 0 0 0 150
146 Oxytocin inj 10 IU Ampul 0 0 0 0 0 600
147 Papaverin 40 mg tab Tablet 0 0 0 0 0 0
148 Papaverin inj Tablet 0 0 0 0 0 0
149 Paracetamol Drops 15 ml Botol 0 0 0 0 0 50
150 Parasetamol 120 mg/5 ml Syr Botol 50 50 50 0 240 250
151 Parasetamol 500 mg Tablet 2500 2500 2500 0 20800 21000
152 Patient Lubricant (My Jelly ) Tube 0 0 0 0 0 10
153 Permethrin (Scabimite Cream) Tube 0 0 0 0 0 20
154 Phenobarbital inj 50mg/ml-2ml Ampul 0 0 0 0 0 30
155 Phenobarbital 100 mg Tablet 100 100 100 0 360 400
156 Phenol gliserol 10% TT Botol 0 0 0 0 0 120
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 30 30 30 0 122.4 122.4
158 Phytomenadione (Vit.K1) 10 mg Tablet 900 900 800 100 5040 4900
159 Piracetam 400 mg Tablet 0 0 0 0 0 3000
160 Piroxicam 20 mg tab Tablet 0 0 0 0 0 3000
161 Pisau Disposable (Mess No.14/21) Pcs 0 0 0 0 0 200
162 Plesterku (Leukoplast) Pcs 0 0 0 0 0 30
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Bio Ampul 0 0 0 0 0 15
164 Povidon iodium 10% 300 ml Botol 0 0 0 0 0 25
165 Prednison 5 mg Tablet 3000 3000 3000 0 21600 21600
166 Primaquin 15 mg tab Tablet 0 0 0 0 0 3000
167 Profolat tab Tablet 0 0 0 0 0 0
168 Prokaina Penisilin G inj 3.000.000 iu Ampul 0 0 0 0 0 10
169 Propranolol HCl 10 mg Tablet 1000 1000 800 200 4680 4400
171 Propylthiouracil 100 mg Tablet 0 0 0 0 0 2000
172 Protein Gluco Test Strip 0 0 0 0 0 200
173 Pyrantel Pamoat 125 mg Tablet 300 300 300 0 1800 1800
174 Pyridoxine HCl 10 mg Tablet 1500 1500 1500 0 18600 20000
175 Ranitidin 150 mg Tablet 0 0 0 0 0 3000
176 Ranitidin Injeksi Ampul 0 0 0 0 0 120
177 Retinol (Vit.A) kaps 100.000 iu Kapsul 200 200 200 0 960 1000
179 Risperidone 2mg Tablet 400 400 300 100 1680 1600
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
180 Salbutamol 2 mg Tablet 1000 1000 1000 0 6240 6200
181 Salep 2-4 Kombinasi pot 0 0 0 0 0 120
182 Sarung tangan (HandScuun) No.7,5 Pcs 0 0 0 0 600 600
183 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0 0 0 0 0 800
184 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0 0 0 0 800
185 Sarung tangan (HandScuun Steril) No.7,5 Pcs 0 0 0 0 0 800
186 Semen Seng Fosfat Serbuk & Cairan Set 0 0 0 0 0 0
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 1000 1000 1000 0 18800 20000
188 Silk (Benang Bedah) No. 3/0 Pcs 0 0 0 0 0 216
189 Silver Sulfadiazine Tube 0 0 0 0 0 30
190 Simvastatin 10 mg tab Tablet 0 0 0 0 0 4000
191 Sodium cloride infus 0,9% ( NACL ) Botol 40 40 40 0 168 160
192 Spuit 1 ml Pcs 0 0 0 0 0 800
193 Spuit 3 ml Pcs 0 0 0 0 1000 1200
194 Spuit 5 ml Pcs 0 0 0 0 0 600
195 Sulfadoxine | Pyrimethamine Tablet 500mg| Tablet 0 0 0 0 0 3500
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 15 15 15 0 160 200
197 Sulfasetamida 15% TM Botol 0 0 0 0 0 125
198 Tetracycline 250 mg Tablet 0 0 0 0 0 4000
200 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0 0 0 0 120
201 Thiamine HCl (Vit B1) 50 mg Tablet 0 0 0 0 0 18000
202 Trihexyphenidyl tab 2 mg Tablet 0 0 0 0 0 2000
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 1500 1500 1300 200 15120 15000
204 Urin Bag Pcs 0 0 0 0 0.2 10
205 Usg Gel Botol 2 2 1 1 10.6 10
206 Vaksin Rabies Vero/ Verorab Paket 0 0 0 0 0 5
207 Vitamin B Kompleks Tablet 6000 6000 4500 1500 26280 25000
208 Vitamin K Infant Inj Ampul 0 0 0 0 0 30
209 Water liquid (aqua P,I) Botol 6 6 3 3 27.6 25
210 Wing Needle No.21 Pcs 0 0 0 0 0 0
212 Zinc Sulphate Suppositoria (Superhoid) Kapsul 0 0 0 0 0 20
213 Zinc tab Tablet 0 0 0 0 0 3000
214 Ondansetron iv/im 4 mg Ampul 10 10 6 4 34.8 30.8
215 Tranexamic Acid inj 5% Ampul 0 0 0 0 0 60
216 Poliwash 500 ml Botol 0 0 0 0 0 20
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
217 Policlean Handrub Botol 0 0 0 0 0 15
218 Sarung Tangan (Handscuun) L Pcs 0 0 0 0 0 600
219 Cefotaxime Sodium inj 1 gr Vial 25 25 10 15 52 37
221 Lancet Pcs 0 0 0 0 0 15
222 Strip Kolesterol Pcs 0 0 0 0 0 300
223 Strip Gula Darah Pcs 0 0 0 0 0 500
224 Strip Asam Urat Pcs 0 0 0 0 0 500
225 Nonwoven Fixation Rol Pcs 1 1 1 0 5 5
226 Paracetamol 1000 mg /100 ml Botol 1 1 1 0 16 16
227 Otsu D-40 25 ml Botol 8 8 5 3 38.4 35
228 Ketorolac inj 30 mg Ampul 0 0 0 0 0 20
229 Dulcolax tab Tablet 0 0 0 0 0 2000
230 Ibuprofen 400 mg.1 Tablet 600 600 600 0 4320 4300
231 Permethrin (Scabimite Cream).1 Tube 0 0 0 0 0 0
232 Masker Plus Pcs 0 0 0 0 0 800
233 0 0 0 0
234 0 0 0 0
235 0 0 0 0
236 0 0 0 0
237 0 0 0 0
238 0 0 0 0
239 0 0 0 0
240 0 0 0 0
241 0 0 0 0

0

Iwan Setiawan, SKM, Mkes Himayanti, S.Si, Mkes, Apt Andi Gunawan Norman Fahlevi
Nip. 1973 09051998031005 Nip. 197702212005120005 Nip. 197806022008011021 Nip. 198108152007011007
PUSKESMAS : AIR SUGIHAN JALUR 25 PELAPORAN BULAN : AGUSTUS 2020 DOKUMEN NOMOR TANGGAL
KECAMATAN : AIR SUGIHAN PERMINTAAN BULAN : DINKES KAB/KOTA
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
1 Absorbent tipped applicator (alcohol swab) Pcs 250 250 100 150 -150
7 Allopurinol 100 mg Tablet 1500 1500 1000 500 -500
8 Aminophylline Inj 24 mg/ml-10 ml Ampul 18 18 8 10 -10
9 Aminophylline tab 200 mg Tablet 0 0 0 0 0
10 Amitriptyline 25 mg tab Tablet 1300 1300 700 600 -600
11 Amlodipine tab 5 mg Tablet 1400 1400 800 600 -600
12 Amoxycillin Syr Btl 140 140 50 90 -90
13 Amoxycillin 250 mg Kapsul 0 0 0 0 0
14 Amoxycillin 500 mg Kaptab 10000 10000 4500 5500 -5500
15 Ampicilin 1 gr Inj Vial 18 18 8 10 -10
16 Antasida Syr DOEN Btl 120 120 70 50 -50
17 Antasida DOEN Kombinasi Tablet 6000 6000 4000 2000 -2000
19 Asam Mefenamat 500 mg tab Tablet 1500 1500 800 700 -700
21 Ascorbic acid |calsium carbonate 500 mg (Pehavr Tablet 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 90 90 50 40 -40
30 Betahistine Mesylate 6 mg tab Tablet 1300 1300 600 700 -700
31 Betamethasone 0,1% krim Tube 90 90 50 40 -40
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : AGUSTUS 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
33 Bismuth subgallas (antihemoroid) Supp 0 0 0 0 0
34 Calcium chloride lactate infus (RL) Botol 100 100 60 40 -40
35 Calsium Laktat (Kalk) 500 mg Tablet 6000 6000 5000 1000 -1000
36 Captopril 12,5 mg Tablet 800 800 600 200 -200
37 Captopril 25 mg Tablet 0 0 0 0 0
38 Carbamazepin tab Tablet 400 400 200 200 -200
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 24 24 20 4 -4
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 120 120 72 48 -48
43 Chloramhenicol Salep Mata 1% Tube 60 60 20 40 -40
45 Chloramphenicol 250 mg caps Tablet 0 0 0 0 0
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 75 75 25 50 -50
49 Chlorpromazine HCl 100 mg Tablet 500 500 300 200 -200
52 Ciprofloxacin Infus Botol 2 2 1 1 -1
54 Cresol liquid 1 Liter (lysol) Botol 0 0 0 0 0
57 Dexamethasone 0,5 mg Tablet 900 900 800 100 -100
58 Dexamethasone inj 5mg/ml-1ml Ampul 200 200 100 100 -100
59 Diazepam 5mg/ml-2 ml inj Ampul 4 4 2 2 -2
61 Diclofenac sodium 25 mg tab Tablet 0 0 0 0 0
62 Digoxin 0,25 mg Tablet 1400 1400 700 700 -700
63 Dimenhydrinate 50mg Tablet 1000 1000 600 400 -400
64 Dipenhidramine HCl inj 10mg/ml Ampul 150 150 60 90 -90
66 Doxycycline 100 mg Kapsul Kapsul 0 0 0 0 0
68 Erythromicin Syr Btl 50 50 20 30 -30
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
69 Erythromicin 500 mg capsul Kapsul 2500 2500 1500 1000 -1000
70 Ethacridine (Rivanol) 0,1% Btl 0 0 0 0 0
75 Folley Catheter No.16 Pcs 6 6 2 4 -4
76 Furosemida Injeksi Ampul 50 50 20 30 -30
77 Furosemida 40 mg Tablet 1900 1900 1100 800 -800
79 Gentamicyn 0,3% TM Botol 50 50 25 25 -25
83 Glibenclamide 5 mg Tablet 1000 1000 600 400 -400
86 Glukosa larutan infus 5% Botol 60 60 40 20 -20
90 Haloperidol 5 mg tab Tablet 700 700 100 600 -600
93 Ibuprofen sirup Botol 0 0 0 0 0
97 Immunoglobulin human anti-tetanus (Tetagam) Ampul 0 0 0 0 0
98 Infus set dewasa Pcs 0 0 0 0 0
99 Infusi set anak Pcs 90 90 40 50 -50
100 Iodium Povidon 10% 30 ml Botol 0 0 0 0 0
101 Isosorbide tablet Tablet 700 700 600 100 -100
102 IV Catheter No.20 Pcs 150 150 50 100 -100
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
107 Kapas pembalut/Absorben 250 g Pcs 0 0 0 0 0
108 Kasa pembalut 2x80 Pcs 0 0 0 0 0
110 Kasa pembalut hidrofil 4 m x 3 cm Pcs 60 60 20 40 -40
111 Kasa kompres 40/40 steril Pcs 170 170 50 120 -120
112 Ketoconazole 200 mg Cream Tube 50 50 30 20 -20
113 Ketoconazole 200 mg tab Tablet 0 0 0 0 0
116 Lidocain 2% Ampul 5 5 3 2 -2
123 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 5 5 2 3 -3
124 Magnesium Sulfat Injeksi 40% (MgSO4) Ampul 5 5 2 3 -3
125 Masker Pcs 0 0 0 0 0
128 Metformin 500mg tab Tablet 3000 3000 1700 1300 -1300
130 Methyl Ergometrin Maleat 0,125 mg Tab 1800 1800 1000 800 -800
131 Methyl Prednisolon tab 4 mg Tablet 1800 1800 900 900 -900
135 Metronidazol Infus Botol 3 3 1 2 -2
137 Miconazole 2% Salep Kulit Tube 110 110 60 50 -50
141 Nystatin Tab Vag 10.000 iu/g Tablet 80 80 20 60 -60
142 Omeprazole inj Vial 3 3 2 1 -1
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
144 Oxytetracycline HCl 1% Salep Mata Tube 25 25 12 13 -13
150 Parasetamol 120 mg/5 ml Syr Botol 100 100 50 50 -50
151 Parasetamol 500 mg Tablet 6500 6500 4000 2500 -2500
152 Patient Lubricant (My Jelly ) Tube 0 0 0 0 0
155 Phenobarbital 100 mg Tablet 200 200 100 100 -100
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 60 60 30 30 -30
158 Phytomenadione (Vit.K1) 10 mg Tablet 2000 2000 1100 900 -900
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 0 0 0 0 0
165 Prednison 5 mg Tablet 8000 8000 5000 3000 -3000
169 Propranolol HCl 10 mg Tablet 2000 2000 1000 1000 -1000
172 Protein Gluco Test Strip 0 0 0 0 0
173 Pyrantel Pamoat 125 mg Tablet 800 800 500 300 -300
174 Pyridoxine HCl 10 mg Tablet 6000 6000 4500 1500 -1500
177 Retinol (Vit.A) kaps 100.000 iu Kapsul 400 400 200 200 -200
178 Retinol (Vit.A) kaps 200.000 iu Kapsul 400 400 200 200 -200
179 Risperidone 2mg Tablet 1000 1000 600 400 -400
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
180 Salbutamol 2 mg Tablet 2500 2500 1500 1000 -1000
181 Salep 2-4 Kombinasi pot 0 0 0 0 0
182 Sarung tangan (HandScuun) No.7,5 Pcs 0 0 0 0 0
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 5000 5000 4000 1000 -1000
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 80 80 40 40 -40
192 Spuit 1 ml Pcs 0 0 0 0 0
193 Spuit 3 ml Pcs 0 0 0 0 0
194 Spuit 5 ml Pcs 0 0 0 0 0
195 Sulfadoxine | Pyrimethamine Tablet 500mg|25m Tablet 0 0 0 0 0
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 40 40 25 15 -15
199 Tetracycline 500 mg Tablet 2000 2000 1200 800 -800
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 5000 5000 3500 1500 -1500
204 Urin Bag Pcs 0 0 0 0 0
205 Usg Gel Botol 3 3 1 2 -2
207 Vitamin B Kompleks Tablet 11000 11000 5000 6000 -6000
209 Water liquid (aqua P,I) Botol 10 10 4 6 -6
214 Ondansetron iv/im 4 mg Ampul 15 15 5 10 -10
215 Tranexamic Acid inj 5% Ampul 0 0 0 0 0
STOK STOK STOK
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 40 40 15 25 -25
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 1 1 0 1 -1
226 Paracetamol 1000 mg /100 ml Botol 5 5 4 1 -1
227 Otsu D-40 25 ml Botol 20 20 12 8 -8
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 1600 1600 1000 600 -600
231 Permethrin (Scabimite Cream).1 Tube 0 0 0 0 0
232 Masker Plus Pcs 0 0 0 0 0
233 0 0 0 0
234 0 0 0 0
235 0 0 0 0
236 0 0 0 0
237 0 0 0 0
238 0 0 0 0
239 0 0 0 0
240 0 0 0 0
241 0 0 0 0

0

Iwan Setiawan, SKM, Mkes Himayanti, S.Si, Mkes, Apt Erniwati, SE, Mkes Norman Fahlevi
Nip. 1973 09051998031005 Nip. 197702212005120005 Nip. 196209161988032005 Nip. 198108152007011007
USTUS 2020
USTUS 2020
USTUS 2020
USTUS 2020
USTUS 2020
USTUS 2020
PUSKESMAS : AIR SUGIHAN JALUR 25 PELAPORAN BULAN : JULI 2020 DOKUMEN NOMOR TANGGAL
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
1 Absorbent tipped applicator (alcohol swab) Pcs 50 700 750 500 250 -250
7 Allopurinol 100 mg Tablet 0 3000 3000 1500 1500 -1500
8 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 30 30 12 18 -18
10 Amitriptyline 25 mg tab Tablet 300 3000 3300 2000 1300 -1300
11 Amlodipine tab 5 mg Tablet 0 3000 3000 1600 1400 -1400
12 Amoxycillin Syr Btl 40 200 240 100 140 -140
14 Amoxycillin 500 mg Kaptab 0 22500 22500 12500 10000 -10000
15 Ampicilin 1 gr Inj Vial 3 20 23 5 18 -18
16 Antasida Syr DOEN Btl 20 200 220 100 120 -120
17 Antasida DOEN Kombinasi Tablet 0 14600 14600 8600 6000 -6000
19 Asam Mefenamat 500 mg tab Tablet 0 3500 3500 2000 1500 -1500
28 Bedak Salisil 2% Btl 0 0 0 0 0 0
29 Benzoic acid |salicylic acid salep (anti fungi) pot 20 120 140 50 90 -90
30 Betahistine Mesylate 6 mg tab Tablet 0 3000 3000 1700 1300 -1300
31 Betamethasone 0,1% krim Tube 0 150 150 60 90 -90
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : JULI 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
33 Bismuth subgallas (antihemoroid) Supp 9 0 9 9 0 0
34 Calcium chloride lactate infus (RL) Botol 20 200 220 120 100 -100
35 Calsium Laktat (Kalk) 500 mg Tablet 0 13600 13600 7600 6000 -6000
36 Captopril 12,5 mg Tablet 400 900 1300 500 800 -800
38 Carbamazepin tab Tablet 0 500 500 100 400 -400
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 96 0 96 72 24 -24
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 72 144 216 96 120 -120
43 Chloramhenicol Salep Mata 1% Tube 0 120 120 60 60 -60
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 25 144 169 94 75 -75
49 Chlorpromazine HCl 100 mg Tablet 100 900 1000 500 500 -500
52 Ciprofloxacin Infus Botol 0 5 5 3 2 -2
57 Dexamethasone 0,5 mg Tablet 1000 1000 2000 1100 900 -900
58 Dexamethasone inj 5mg/ml-1ml Ampul 100 400 500 300 200 -200
59 Diazepam 5mg/ml-2 ml inj Ampul 10 0 10 6 4 -4
62 Digoxin 0,25 mg Tablet 0 3600 3600 2200 1400 -1400
63 Dimenhydrinate 50mg Tablet 100 2500 2600 1600 1000 -1000
64 Dipenhidramine HCl inj 10mg/ml Ampul 30 300 330 180 150 -150
68 Erythromicin Syr Btl 10 96 106 56 50 -50
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
69 Erythromicin 500 mg capsul Kapsul 0 6000 6000 3500 2500 -2500
70 Ethacridine (Rivanol) 0,1% Btl 0 7 7 7 0 0
75 Folley Catheter No.16 Pcs 0 10 10 4 6 -6
76 Furosemida Injeksi Ampul 0 75 75 25 50 -50
77 Furosemida 40 mg Tablet 0 4000 4000 2100 1900 -1900
79 Gentamicyn 0,3% TM Botol 5 72 77 27 50 -50
83 Glibenclamide 5 mg Tablet 0 2400 2400 1400 1000 -1000
86 Glukosa larutan infus 5% Botol 10 120 130 70 60 -60
90 Haloperidol 5 mg tab Tablet 0 1000 1000 300 700 -700
99 Infusi set anak Pcs 40 100 140 50 90 -90
100 Iodium Povidon 10% 30 ml Botol 0 0 0 0 0 0
101 Isosorbide tablet Tablet 0 2000 2000 1300 700 -700
102 IV Catheter No.20 Pcs 0 250 250 100 150 -150
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
110 Kasa pembalut hidrofil 4 m x 3 cm Pcs 20 100 120 60 60 -60
111 Kasa kompres 40/40 steril Pcs 80 200 280 110 170 -170
112 Ketoconazole 200 mg Cream Tube 30 100 130 80 50 -50
116 Lidocain 2% Ampul 0 10 10 5 5 -5
123 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 10 10 5 5 -5
124 Magnesium Sulfat Injeksi 40% (MgSO4) Ampul 0 10 10 5 5 -5
125 Masker Pcs 0 0 0 0 0 0
128 Metformin 500mg tab Tablet 200 5500 5700 2700 3000 -3000
130 Methyl Ergometrin Maleat 0,125 mg Tab 0 3800 3800 2000 1800 -1800
131 Methyl Prednisolon tab 4 mg Tablet 0 4000 4000 2200 1800 -1800
135 Metronidazol Infus Botol 0 5 5 2 3 -3
137 Miconazole 2% Salep Kulit Tube 20 192 212 102 110 -110
141 Nystatin Tab Vag 10.000 iu/g Tablet 55 100 155 75 80 -80
142 Omeprazole inj Vial 10 0 10 7 3 -3
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
144 Oxytetracycline HCl 1% Salep Mata Tube 0 75 75 50 25 -25
150 Parasetamol 120 mg/5 ml Syr Botol 0 200 200 100 100 -100
151 Parasetamol 500 mg Tablet 0 16500 16500 10000 6500 -6500
155 Phenobarbital 30 mg Tablet 200 100 300 100 200 -200
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 120 120 60 60 -60
158 Phytomenadione (Vit.K1) 10 mg Tablet 0 4300 4300 2300 2000 -2000
165 Prednison 5 mg Tablet 0 18000 18000 10000 8000 -8000
169 Propranolol HCl 10 mg Tablet 100 4000 4100 2100 2000 -2000
173 Pyrantel Pamoat 125 mg Tablet 0 1500 1500 700 800 -800
174 Pyridoxine HCl 10 mg Tablet 0 12000 12000 6000 6000 -6000
177 Retinol (Vit.A) kaps 100.000 iu Kapsul 0 800 800 400 400 -400
178 Retinol (Vit.A) kaps 200.000 iu Kapsul 0 1000 1000 600 400 -400
179 Risperidone 2mg Tablet 0 1500 1500 500 1000 -1000
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
180 Salbutamol 2 mg Tablet 0 5200 5200 2700 2500 -2500
181 Salep 2-4 Kombinasi pot 0 0 0 0 0 0
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 0 12000 12000 7000 5000 -5000
189 Silver Sulfadiazine Tube 8 0 8 8 0 0
191 Sodium cloride infus 0,9% ( NACL ) Botol 0 140 140 60 80 -80
192 Spuit 1 ml Pcs 0 0 0 0 0 0
193 Spuit 3 ml Pcs 200 0 200 200 0 0
194 Spuit 5 ml Pcs 0 0 0 0 0 0
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 0 100 100 60 40 -40
199 Tetracycline 500 mg Tablet 0 4500 4500 2500 2000 -2000
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 100 12700 12800 7800 5000 -5000
204 Urin Bag Pcs 1 0 1 1 0 0
205 Usg Gel Botol 0 6 6 3 3 -3
207 Vitamin B Kompleks Tablet 500 22900 23400 12400 11000 -11000
209 Water liquid (aqua P,I) Botol 2 24 26 16 10 -10
213 Zinc tab Tablet 0 0 0 0 0 0
214 Ondansetron iv/im 4 mg Ampul 1 20 21 6 15 -15
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
219 Cefotaxime Sodium inj 1 gr Vial 20 30 50 10 40 -40
221 Lancet Pcs 0 0 0 0 0 0
225 Nonwoven Fixation Rol Pcs 0 2 2 1 1 -1
226 Paracetamol 1000 mg /100 ml Botol 0 10 10 5 5 -5
227 Otsu D-40 25 ml Botol 10 25 35 15 20 -20
230 Ibuprofen 400 mg.1 Tablet 0 3600 3600 2000 1600 -1600
232 Masker Plus Pcs 0 0 0 0 0 0
233 0 0 0 0
234 0 0 0 0
235 0 0 0 0
236 0 0 0 0
237 0 0 0 0
238 0 0 0 0
239 0 0 0 0
240 0 0 0 0
241 0 0 0 0

0

Nip. 1973 09051998031005 Nip. 197702212005120005 Nip. 196209161988032005 Nip. 198108152007011007
PUSKESMAS : AIR SUGIHAN JALUR 25 PELAPORAN BULAN : JUNI 2020 DOKUMEN NOMOR TANGGAL
KECAMATAN : AIR SUGIHAN PERMINTAAN BULAN : JULI 2020 DINKES KAB/KOTA
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
6 Alkohol Liquid (etanol) 70%-1000 ml Btl 0 0 0 0 19.2 20
8 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0 0 0 0 30
15 Ampicilin 1 gr Inj Vial 6 6 3 3 14.4 11.4
16 Antasida Syr DOEN Btl 60 60 40 20 218.4 200
28 Bedak Salisil 2% Btl 9 9 9 0 50.4 50.4
29 Benzoic acid |salicylic acid salep (anti fungi) pot 50 50 30 20 134.4 120
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : JUNI 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
33 Bismuth subgallas (antihemoroid) Supp 14 14 5 9 37.2 30
43 Chloramhenicol Salep Mata 1% Tube 25 25 25 0 127.2 125
44 Chloramphenicol Suspensi 125 mg/ml Btl 0 0 0 0 138.3 150
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 50 50 25 25 138 150
54 Cresol liquid 1 Liter (lysol) Botol 5 5 5 0 22.6 23
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
70 Ethacridine (Rivanol) 0,1% Btl 4 4 4 0 31.2 31
75 Folley Catheter No.16 Pcs 0 0 0 0 0 5
79 Gentamicyn 0,3% TM Botol 14 14 9 5 79.8 74.8
85 Glukosa larutan infus 10% Botol 0 0 0 0 122.4 80
86 Glukosa larutan infus 5% Botol 30 30 20 10 122.4 120
99 Infusi set anak Pcs 65 65 25 40 138.54 100
100 Iodium Povidon 10% 30 ml Botol 8 8 8 0 40.8 40
HALAMAN : 4 LPLPO No: LAPORAN BULAN : JUNI 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
108 Kasa pembalut 2x80 Pcs 20 20 18 2 135.6 133.6
112 Ketoconazole 200 mg Cream Tube 60 60 30 30 138 108
116 Lidocain 2% Ampul 0 0 0 0 0 300
123 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 0 0 0 0 10
125 Masker Pcs 0 0 0 0 0 1000
135 Metronidazol Infus Botol 0 0 0 0 0 5
137 Miconazole 2% Salep Kulit Tube 50 50 30 20 222.9 200
141 Nystatin Tab Vag 10.000 iu/g Tablet 100 100 45 55 185.4 100
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
152 Patient Lubricant (My Jelly ) Tube 1 1 1 0 4.8 4
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 0 0 0 0 120
164 Povidon iodium 10% 300 ml Botol 0 0 0 0 21.8 21
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
181 Salep 2-4 Kombinasi pot 24 24 24 0 145.8 144
189 Silver Sulfadiazine Tube 17 17 9 8 63.6 50
192 Spuit 1 ml Pcs 0 0 0 0 470 500
193 Spuit 3 ml Pcs 500 500 300 200 1440 1200
194 Spuit 5 ml Pcs 0 0 0 0 480 500
204 Urin Bag Pcs 2 2 1 1 4.8 3
205 Usg Gel Botol 1 1 1 0 6 6
209 Water liquid (aqua P,I) Botol 5 5 3 2 25.5 23.5
214 Ondansetron iv/im 4 mg Ampul 3 3 2 1 14.2 13.2
215 Tranexamic Acid inj 5% Ampul 2 2 2 0 10.2 10.2
216 Poliwash 500 ml Botol 1 1 1 0 4.8 6
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
221 Lancet Pcs 0 0 0 0 0 10
225 Nonwoven Fixation Rol Pcs 2 2 2 0 10.2 10.2
226 Paracetamol 1000 mg /100 ml Botol 1 1 1 0 10.2 10.2
227 Otsu D-40 25 ml Botol 30 30 20 10 84 25
232 Masker Plus Pcs 0 0 0 0 0 800
233 0 0 0 0
234 0 0 0 0
235 0 0 0 0
236 0 0 0 0
237 0 0 0 0
238 0 0 0 0
239 0 0 0 0
240 0 0 0 0
241 0 0 0 0

0

Nip. 1973 09051998031005 Nip. 197702212005120005 Nip. 196209161988032005 Nip. 198108152007011007
PUSKESMAS : AIR SUGIHAN JALUR 25 PELAPORAN BULAN : MEI 2020 DOKUMEN NOMOR TANGGAL
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
9 Aminophylline tab 200 mg Tablet 1000 1000 600 400 -400
13 Amoxycillin 250 mg Kapsul 3000 3000 2000 1000 -1000
14 Amoxycillin 500 mg Kaptab 300 300 300 0 0
19 Asam Mefenamat 500 mg tab Tablet 0 0 0 0 0
21 Ascorbic acid |calsium carbonate 500 mg (Peh Tablet 0 0 0 0 0
27 Bahan Tambal Gigi Sementara (Fletcher/Cavit Pcs 0 0 0 0 0
28 Bedak Salisil 2% Btl 20 20 11 9 -9
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : MEI 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
33 Bismuth subgallas (antihemoroid) Supp 30 30 16 14 -14
34 Calcium chloride lactate infus (RL) Botol 120 120 60 60 -60
37 Captopril 25 mg Tablet 2000 2000 1200 800 -800
38 Carbamazepin tab Tablet 100 100 100 0 0
45 Chloramphenicol 250 mg caps Tablet 900 900 700 200 -200
54 Cresol liquid 1 Liter (lysol) Botol 10 10 5 5 -5
59 Diazepam 5mg/ml-2 ml inj Ampul 20 20 5 15 -15
61 Diclofenac sodium 25 mg tab Tablet 2000 2000 1200 800 -800
62 Digoxin 0,25 mg Tablet 200 200 200 0 0
66 Doxycycline 100 mg Kapsul Kapsul 600 600 200 400 -400
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
70 Ethacridine (Rivanol) 0,1% Btl 10 10 6 4 -4
77 Furosemida 40 mg Tablet 0 0 0 0 0
83 Glibenclamide 5 mg Tablet 0 0 0 0 0
90 Haloperidol 5 mg tab Tablet 0 0 0 0 0
93 Ibuprofen sirup Botol 30 30 20 10 -10
97 Immunoglobulin human anti-tetanus (Tetagam Ampul 0 0 0 0 0
98 Infus set dewasa Pcs 50 50 20 30 -30
100 Iodium Povidon 10% 30 ml Botol 15 15 7 8 -8
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
107 Kapas pembalut/Absorben 250 g Pcs 12 12 5 7 -7
108 Kasa pembalut 2x80 Pcs 60 60 40 20 -20
113 Ketoconazole 200 mg tab Tablet 1400 1400 800 600 -600
116 Lidocain 2% Ampul 0 0 0 0 0
125 Masker Pcs 0 0 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
152 Patient Lubricant (My Jelly ) Tube 2 2 1 1 -1
158 Phytomenadione (Vit.K1) 10 mg Tablet 0 0 0 0 0
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Bio Ampul 0 0 0 0 0
172 Protein Gluco Test Strip 5 5 3 2 -2
173 Pyrantel Pamoat 125 mg Tablet 0 0 0 0 0
174 Pyridoxine HCl 10 mg Tablet 0 0 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
181 Salep 2-4 Kombinasi pot 48 48 24 24 -24
182 Sarung tangan (HandScuun) No.7,5 Pcs 300 300 100 200 -200
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 500 500 500 0 0
188 Silk (Benang Bedah) No. 3/0 Pcs 34 34 20 14 -14
189 Silver Sulfadiazine Tube 30 30 13 17 -17
190 Simvastatin 10 mg tab Tablet 1600 1600 800 800 -800
191 Sodium cloride infus 0,9% ( NACL ) Botol 20 20 16 4 -4
192 Spuit 1 ml Pcs 0 0 0 0 0
193 Spuit 3 ml Pcs 800 800 300 500 -500
194 Spuit 5 ml Pcs 100 100 100 0 0
195 Sulfadoxine | Pyrimethamine Tablet 500mg| Tablet 0 0 0 0 0
204 Urin Bag Pcs 3 3 1 2 -2
205 Usg Gel Botol 3 3 2 1 -1
215 Tranexamic Acid inj 5% Ampul 5 5 3 2 -2
216 Poliwash 500 ml Botol 2 2 1 1 -1
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
218 Sarung Tangan (Handscuun) L Pcs 50 50 50 0 0
219 Cefotaxime Sodium inj 1 gr Vial 60 60 22 38 -38
221 Lancet Pcs 0 0 0 0 0
226 Paracetamol 1000 mg /100 ml Botol 5 5 4 1 -1
227 Otsu D-40 25 ml Botol 40 40 10 30 -30
230 Ibuprofen 400 mg.1 Tablet 1300 1300 600 700 -700
233 0 0 0 0
234 0 0 0 0
235 0 0 0 0
236 0 0 0 0
237 0 0 0 0
238 0 0 0 0
239 0 0 0 0
240 0 0 0 0
241 0 0 0 0

0

Nip. 1973 09051998031005 Nip. 197702212005120005 Nip. 196209161988032005 Nip. 198108152007011007
PUSKESMAS : AIR SUGIHAN JALUR 25 PELAPORAN BULAN : APRIL 2020 DOKUMEN NOMOR TANGGAL
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
9 Aminophylline tab 200 mg Tablet 100 2000 2100 1100 1000 -1000
13 Amoxycillin 250 mg Kapsul 1000 6000 7000 4000 3000 -3000
25 Attapulgite Tablet 600 mg (New Antides) Tablet 200 0 200 100 100 -100
28 Bedak Salisil 2% Btl 2 40 42 22 20 -20
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : APRIL 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
33 Bismuth subgallas (antihemoroid) Supp 20 20 40 10 30 -30
37 Captopril 25 mg Tablet 200 3800 4000 2000 2000 -2000
45 Chloramphenicol 250 mg caps Tablet 100 2800 2900 2000 900 -900
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 1000 5000 6000 3500 2500 -2500
54 Cresol liquid 1 Liter (lysol) Botol 3 20 23 13 10 -10
59 Diazepam 5mg/ml-2 ml inj Ampul 0 30 30 10 20 -20
61 Diclofenac sodium 25 mg tab Tablet 0 4800 4800 2800 2000 -2000
66 Doxycycline 100 mg Kapsul Kapsul 500 300 800 200 600 -600
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
70 Ethacridine (Rivanol) 0,1% Btl 2 24 26 16 10 -10
93 Ibuprofen sirup Botol 15 50 65 35 30 -30
98 Infus set dewasa Pcs 90 0 90 40 50 -50
100 Iodium Povidon 10% 30 ml Botol 1 33 34 19 15 -15
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
107 Kapas pembalut/Absorben 250 g Pcs 2 25 27 15 12 -12
108 Kasa pembalut 2x80 Pcs 15 100 115 55 60 -60
113 Ketoconazole 200 mg tab Tablet 300 2600 2900 1500 1400 -1400
116 Lidocain 2% Ampul 0 0 0 0 0 0
125 Masker Pcs 0 0 0 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
152 Patient Lubricant (My Jelly ) Tube 4 0 4 2 2 -2
172 Protein Gluco Test Strip 10 0 10 5 5 -5
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
181 Salep 2-4 Kombinasi pot 25 96 121 73 48 -48
182 Sarung tangan (HandScuun) No.7,5 Pcs 0 700 700 400 300 -300
188 Silk (Benang Bedah) No. 3/0 Pcs 34 36 70 36 34 -34
189 Silver Sulfadiazine Tube 5 56 61 31 30 -30
190 Simvastatin 10 mg tab Tablet 0 3600 3600 2000 1600 -1600
192 Spuit 1 ml Pcs 100 0 100 100 0 0
193 Spuit 3 ml Pcs 100 1300 1400 600 800 -800
194 Spuit 5 ml Pcs 200 0 200 100 100 -100
204 Urin Bag Pcs 6 0 6 3 3 -3
205 Usg Gel Botol 1 4 5 2 3 -3
215 Tranexamic Acid inj 5% Ampul 5 5 10 5 5 -5
216 Poliwash 500 ml Botol 0 5 5 3 2 -2
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
218 Sarung Tangan (Handscuun) L Pcs 0 100 100 50 50 -50
219 Cefotaxime Sodium inj 1 gr Vial 0 100 100 40 60 -60
221 Lancet Pcs 0 0 0 0 0
226 Paracetamol 1000 mg /100 ml Botol 0 10 10 5 5 -5
227 Otsu D-40 25 ml Botol 0 80 80 40 40 -40
230 Ibuprofen 400 mg.1 Tablet 0 3000 3000 1700 1300 -1300
233 0 0 0 0
234 0 0 0 0
235 0 0 0 0
236 0 0 0 0
237 0 0 0 0
238 0 0 0 0
239 0 0 0 0
240 0 0 0 0
241 0 0 0 0

0

Nip. 1973 09051998031005 Nip. 197702212005120005 Nip. 196209161988032005 Nip. 198108152007011007
PUSKESMAS : AIR SUGIHAN JALUR 25 PELAPORAN BULAN : MARET 2020 DOKUMEN NOMOR TANGGAL
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
15 Ampicilin 1 gr Inj Vial 7 7 2 5 7.2 8
16 Antasida Syr DOEN Btl 22 22 20 2 177.6 200
21 Ascorbic acid |calsium carbonate 500 mg (Pehavral) Tablet 0 0 0 0 0 5000
27 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0 0 0 0 0
28 Bedak Salisil 2% Btl 10 10 8 2 57.6 50
29 Benzoic acid |salicylic acid salep (anti fungi) pot 30 30 18 12 109.2 100
HALAMAN : 2 LPLPO No: LAPORAN BULAN : MARET 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
33 Bismuth subgallas (antihemoroid) Supp 30 30 10 20 64.8 50
42 Cetirizine 5 mg/5 ml sirup Botol 10 10 10 0 73.2 150
43 Chloramhenicol Salep Mata 1% Tube 22 22 12 10 79.2 100
44 Chloramphenicol Suspensi 125 mg/ml Btl 25 25 17 8 110.4 150
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 45 45 25 20 132 125
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
70 Ethacridine (Rivanol) 0,1% Btl 7 7 5 2 40.8 38
79 Gentamicyn 0,3% TM Botol 11 11 8 3 54 50
81 Gentamicyn 0,1% SK Tube 20 20 16 4 139.2 125
97 Immunoglobulin human anti-tetanus (Tetagam) Ampul 0 0 0 0 0 15
99 Infusi set anak Pcs 50 50 30 20 192 150
100 Iodium Povidon 10% 30 ml Botol 6 6 5 1 34.8 33
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
107 Kapas pembalut/Absorben 250 g Pcs 6 6 4 2 25.2 25
112 Ketoconazole 200 mg Cream Tube 37 37 17 20 110.4 125
116 Lidocain 2% Ampul 0 0 0 0 0 150
125 Masker Pcs 0 0 0 0 950 900
135 Metronidazol Infus Botol 0 0 0 0 2.5 3
137 Miconazole 2% Salep Kulit Tube 60 60 25 35 133 150
141 Nystatin Tab Vag 10.000 iu/g Tablet 130 130 23 107 171.6 50
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
156 Phenol gliserol 10% TT Botol 10 10 10 0 98.4 100
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 0 0 0 0 0 10
164 Povidon iodium 10% 300 ml Botol 8 8 4 4 25.2 21
172 Protein Gluco Test Strip 18 18 8 10 40.8 30
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
181 Salep 2-4 Kombinasi pot 52 52 27 25 200.4 175
188 Silk (Benang Bedah) No. 3/0 Pcs 70 70 36 34 175.2 180
189 Silver Sulfadiazine Tube 17 17 12 5 105.6 100.6
192 Spuit 1 ml Pcs 200 200 100 100 840 600
193 Spuit 3 ml Pcs 400 400 300 100 1440 1300
194 Spuit 5 ml Pcs 300 300 100 200 480 300
195 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 300 300 300 0 3000 3000
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 0 0 0 0 112.5 100
204 Urin Bag Pcs 8 8 2 6 8.4 0
205 Usg Gel Botol 2 2 1 1 4.8 4
209 Water liquid (aqua P,I) Botol 7 7 4 3 20.4 17.4
213 Zinc tab Tablet 0 0 0 0 0 3000
214 Ondansetron iv/im 4 mg Ampul 7 7 5 2 10.8 10
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
221 Lancet Pcs 0 0 0 0 0 0
225 Nonwoven Fixation Rol Pcs 1 1 1 0 7.2 10
227 Otsu D-40 25 ml Botol 0 0 0 0 0 80
231 Permethrin (Scabimite Cream).1 Tube 7 7 7 0 27.6 30
232 Masker Plus Pcs 100 100 100 0 600 800
233 0 0 0 0
234 0 0 0 0
235 0 0 0 0
236 0 0 0 0
237 0 0 0 0
238 0 0 0 0
239 0 0 0 0
240 0 0 0 0
241 0 0 0 0

0

Nip. 1973 09051998031005 Nip. 197702212005120005 Nip. 196209161988032005 Nip. 198108152007011007
PUSKESMAS : AIR SUGIHAN 25 PELAPORAN BULAN : FEBRUARI 2020 DOKUMEN NOMOR TANGGAL
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
6 Alkohol Liquid (etanol) 70%-1000 ml Btl 11 11 4 7 -7
9 Aminophylline tab 200 mg Tablet 1000 1000 500 500 -500
13 Amoxycillin 250 mg Kapsul 8000 8000 4000 4000 -4000
14 Amoxycillin 500 mg Kaptab 10000 10000 4000 6000 -6000
19 Asam Mefenamat 500 mg tab Tablet 2000 2000 1300 700 -700
20 Ascorbic acid (Vit.C) 50 mg Tablet 1900 1900 1000 900 -900
21 Ascorbic acid |calsium carbonate 500 mg (Peh Tablet 0 0 0 0 0
24 Attapulgite Tablet (Pularex) Tablet 1700 1700 1000 700 -700
25 Attapulgite Tablet 600 mg (New Antides) Tablet 1000 1000 500 500 -500
27 Bahan Tambal Gigi Sementara (Fletcher/Cavit Pcs 0 0 0 0 0
28 Bedak Salisil 2% Btl 30 30 20 10 -10
LPLPO No: HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : FEBRUARI 2020
STOK STOK STOK
AKHIR AKHIR OPTIMUM
1 2 3 8 5 6 7 8 9 10 11 12
33 Bismuth subgallas (antihemoroid) Supp 50 50 20 30 -30
34 Calcium chloride lactate infus (RL) Botol 40 40 40 0 0
37 Captopril 25 mg Tablet 1600 1600 900 700 -700
38 Carbamazepin tab Tablet 200 200 0 200 -200
42 Cetirizine 5 mg/5 ml sirup Botol 30 30 20 10 -10
44 Chloramphenicol Suspensi 125 mg/ml Btl 50 50 25 25 -25
45 Chloramphenicol 250 mg caps Tablet 1800 1800 900 900 -900
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 12000 12000 5500 6500 -6500
51 Ciprofloxacin 500 mg tab Tablet 1400 1400 900 500 -500
54 Cresol liquid 1 Liter (lysol) Botol 10 10 4 6 -6
59 Diazepam 5mg/ml-2 ml inj Ampul 0 0 0 0 0
61 Diclofenac sodium 25 mg tab Tablet 1700 1700 900 800 -800
62 Digoxin 0,25 mg Tablet 2000 2000 1300 700 -700
65 Domperidone 10 mg Tablet 3500 3500 2000 1500 -1500
66 Doxycycline 100 mg Kapsul Kapsul 800 800 100 700 -700
STOK STOK STOK
AKHIR AKHIR OPTIMUM
1 2 3 8 5 6 7 8 9 10 11 12
70 Ethacridine (Rivanol) 0,1% Btl 16 16 9 7 -7
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 8 8 4 4 -4
77 Furosemida 40 mg Tablet 1300 1300 800 500 -500
81 Gentamicyn 0,1% SK Tube 45 45 25 20 -20
83 Glibenclamide 5 mg Tablet 1800 1800 900 900 -900
87 Griseofulvin 125 mg Tablet 1300 1300 800 500 -500
88 Guaifenesin 100 Tab (GG tab) Tablet 12000 12000 5500 6500 -6500
90 Haloperidol 5 mg tab Tablet 100 100 0 100 -100
91 Human chorionic (HCG/Tes kehamilan ) Strip 200 200 100 100 -100
93 Ibuprofen sirup Botol 70 70 30 40 -40
97 Immunoglobulin human anti-tetanus (Tetagam Ampul 0 0 0 0 0
98 Infus set dewasa Pcs 230 230 80 150 -150
100 Iodium Povidon 10% 30 ml Botol 13 13 7 6 -6
STOK STOK STOK
AKHIR AKHIR OPTIMUM
1 2 3 8 5 6 7 8 9 10 11 12
107 Kapas pembalut/Absorben 250 g Pcs 10 10 4 6 -6
108 Kasa pembalut 2x80 Pcs 100 100 50 50 -50
113 Ketoconazole 200 mg tab Tablet 1400 1400 800 600 -600
116 Lidocain 2% Ampul 0 0 0 0 0
117 Lidokain Comp. inj Kombinasi Ampul 180 180 90 90 -90
125 Masker Pcs 0 0 0 0 0
126 Medical adhesive tape (dermafix/leukomed) Pcs 9 9 5 4 -4
134 Metronidazol 500 mg tab Tablet 1900 1900 900 1000 -1000
STOK STOK STOK
AKHIR AKHIR OPTIMUM
1 2 3 8 5 6 7 8 9 10 11 12
152 Patient Lubricant (My Jelly ) Tube 8 8 2 6 -6
156 Phenol gliserol 10% TT Botol 34 34 24 10 -10
158 Phytomenadione (Vit.K1) 10 mg Tablet 3000 3000 2000 1000 -1000
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Bio Ampul 0 0 0 0 0
164 Povidon iodium 10% 300 ml Botol 13 13 5 8 -8
172 Protein Gluco Test Strip 26 26 8 18 -18
173 Pyrantel Pamoat 125 mg Tablet 300 300 150 150 -150
174 Pyridoxine HCl 10 mg Tablet 7000 7000 4500 2500 -2500
STOK STOK STOK
AKHIR AKHIR OPTIMUM
1 2 3 8 5 6 7 8 9 10 11 12
181 Salep 2-4 Kombinasi pot 100 100 48 52 -52
182 Sarung tangan (HandScuun) No.7,5 Pcs 200 200 100 100 -100
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 7000 7000 4500 2500 -2500
188 Silk (Benang Bedah) No. 3/0 Pcs 108 108 38 70 -70
189 Silver Sulfadiazine Tube 40 40 23 17 -17
190 Simvastatin 10 mg tab Tablet 1300 1300 800 500 -500
191 Sodium cloride infus 0,9% ( NACL ) Botol 10 10 10 0 0
192 Spuit 1 ml Pcs 400 400 200 200 -200
193 Spuit 3 ml Pcs 700 700 300 400 -400
194 Spuit 5 ml Pcs 400 400 100 300 -300
195 Sulfadoxine | Pyrimethamine Tablet 500mg| Tablet 1200 1200 900 300 -300
201 Thiamine HCl (Vit B1) 50 mg Tablet 7000 7000 4500 2500 -2500
202 Trihexyphenidyl tab 2 mg Tablet 200 200 100 100 -100
204 Urin Bag Pcs 10 10 2 8 -8
205 Usg Gel Botol 3 3 1 2 -2
215 Tranexamic Acid inj 5% Ampul 12 12 4 8 -8
STOK STOK STOK
AKHIR AKHIR OPTIMUM
1 2 3 8 5 6 7 8 9 10 11 12
218 Sarung Tangan (Handscuun) L Pcs 200 200 100 100 -100
219 Cefotaxime Sodium inj 1 gr Vial 0 0 0 0 0
221 Lancet 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
230 Ibuprofen 400 mg.1 Tablet 0 0 0 0 0
231 Permethrin (Scabimite Cream).1 Tube 13 13 6 7 -7
232 Masker Plus Pcs 300 300 200 100 -100
233 0 0 0 0
234 0 0 0 0
235 0 0 0 0
236 0 0 0 0
237 0 0 0 0
238 0 0 0 0
239 0 0 0 0
240 0 0 0 0
241 0 0 0 0

0

Nip. 197309051998031005 Nip. 19770221200512005 Nip. 196209161988032005 Nip. 198108152007011007
PUSKESMAS : AIR SUGIHAN JALUR 25 PELAPORAN BULAN : JANUARI 2020 DOKUMEN NOMOR TANGGAL
STOK STOK
STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
6 Alkohol Liquid (etanol) 70%-1000 ml Btl 3 20 23 12 11 -11
9 Aminophylline tab 200 mg Tablet 150 1600 1750 750 1000 -1000
13 Amoxycillin 250 mg Kapsul 0 17000 17000 9000 8000 -8000
19 Asam Mefenamat 500 mg tab Tablet 0 4000 4000 2000 2000 -2000
20 Ascorbic acid (Vit.C) 50 mg Tablet 0 4000 4000 2100 1900 -1900
24 Attapulgite Tablet (Pularex) Tablet 200 3200 3400 1700 1700 -1700
25 Attapulgite Tablet 600 mg (New Antides) Tablet 0 2400 2400 1400 1000 -1000
28 Bedak Salisil 2% Btl 0 50 50 20 30 -30
LPLPO No: HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : JANUARI 2020
STOK STOK STOK
AKHIR AKHIR OPTIMUM
1 2 3 8 5 6 7 8 9 10 11 12
33 Bismuth subgallas (antihemoroid) Supp 4 70 74 24 50 -50
37 Captopril 25 mg Tablet 0 3600 3600 2000 1600 -1600
42 Cetirizine 5 mg/5 ml sirup Botol 11 50 61 31 30 -30
44 Chloramphenicol Suspensi 125 mg/ml Btl 0 100 100 50 50 -50
45 Chloramphenicol 250 mg caps Tablet 0 3600 3600 1800 1800 -1800
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 1000 33200 34200 22200 12000 -12000
51 Ciprofloxacin 500 mg tab Tablet 0 3600 3600 2200 1400 -1400
54 Cresol liquid 1 Liter (lysol) Botol 0 18 18 8 10 -10
61 Diclofenac sodium 25 mg tab Tablet 0 4000 4000 2300 1700 -1700
65 Domperidone 10 mg Tablet 500 6000 6500 3000 3500 -3500
66 Doxycycline 100 mg Kapsul Kapsul 100 1000 1100 300 800 -800
STOK STOK STOK
AKHIR AKHIR OPTIMUM
1 2 3 8 5 6 7 8 9 10 11 12
70 Ethacridine (Rivanol) 0,1% Btl 0 36 36 20 16 -16
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 2 18 20 12 8 -8
77 Furosemida 40 mg Tablet 500 2800 3300 2000 1300 -1300
81 Gentamicyn 0,1% SK Tube 0 120 120 75 45 -45
83 Glibenclamide 5 mg Tablet 0 3600 3600 1800 1800 -1800
87 Griseofulvin 125 mg Tablet 100 3000 3100 1800 1300 -1300
88 Guaifenesin 100 Tab (GG tab) Tablet 1500 32000 33500 21500 12000 -12000
90 Haloperidol 5 mg tab Tablet 200 0 200 100 100 -100
91 Human chorionic (HCG/Tes kehamilan ) Strip 0 500 500 300 200 -200
93 Ibuprofen sirup Botol 20 100 120 50 70 -70
98 Infus set dewasa Pcs 100 250 350 120 230 -230
100 Iodium Povidon 10% 30 ml Botol 0 30 30 17 13 -13
STOK STOK STOK
AKHIR AKHIR OPTIMUM
1 2 3 8 5 6 7 8 9 10 11 12
107 Kapas pembalut/Absorben 250 g Pcs 1 22 23 13 10 -10
108 Kasa pembalut 2x80 Pcs 0 195 195 95 100 -100
113 Ketoconazole 200 mg tab Tablet 100 2500 2600 1200 1400 -1400
116 Lidocain 2% Ampul 0 0 0 0 0 0
117 Lidokain Comp. inj Kombinasi Ampul 120 180 300 120 180 -180
125 Masker Pcs 100 0 100 100 0 0
126 Medical adhesive tape (dermafix/leukomed) Pcs 20 0 20 9 11 -11
134 Metronidazol 500 mg tab Tablet 0 3600 3600 1700 1900 -1900
STOK STOK STOK
AKHIR AKHIR OPTIMUM
1 2 3 8 5 6 7 8 9 10 11 12
152 Patient Lubricant (My Jelly ) Tube 2 7 9 1 8 -8
153 Permethrin (Scabimite Cream) Tube 6 0 6 4 2 -2
156 Phenol gliserol 10% TT Botol 10 72 82 48 34 -34
158 Phytomenadione (Vit.K1) 10 mg Tablet 0 7000 7000 4000 3000 -3000
164 Povidon iodium 10% 300 ml Botol 0 25 25 12 13 -13
172 Protein Gluco Test Strip 4 40 44 18 26 -26
173 Pyrantel Pamoat 125 mg Tablet 0 600 600 300 300 -300
174 Pyridoxine HCl 10 mg Tablet 0 15000 15000 8000 7000 -7000
STOK STOK STOK
AKHIR AKHIR OPTIMUM
1 2 3 8 5 6 7 8 9 10 11 12
181 Salep 2-4 Kombinasi pot 24 168 192 92 100 -100
182 Sarung tangan (HandScuun) No.7,5 Pcs 0 500 500 300 200 -200
188 Silk (Benang Bedah) No. 3/0 Pcs 0 180 180 72 108 -108
189 Silver Sulfadiazine Tube 10 83 93 53 40 -40
190 Simvastatin 10 mg tab Tablet 0 3000 3000 1700 1300 -1300
192 Spuit 1 ml Pcs 200 600 800 400 400 -400
193 Spuit 3 ml Pcs 100 1200 1300 600 700 -700
194 Spuit 5 ml Pcs 300 300 600 200 400 -400
195 Sulfadoxine | Pyrimethamine Tablet 500mg| Tablet 0 2500 2500 1300 1200 -1200
201 Thiamine HCl (Vit B1) 50 mg Tablet 0 20000 20000 13000 7000 -7000
202 Trihexyphenidyl tab 2 mg Tablet 300 0 300 100 200 -200
204 Urin Bag Pcs 3 10 13 3 10 -10
205 Usg Gel Botol 0 5 5 2 3 -3
215 Tranexamic Acid inj 5% Ampul 0 20 20 8 12 -12
HALAMAN : 7 HALAMAN : 7 LPLPO No: 0 LAPORAN BULAN : JANUARI 2020
PERSEDIAAN STOK STOK
AKHIR OPTIMUM
1 2 3 6 5 6 7 8 9 10 11 12
218 Sarung Tangan (Handscuun) L Pcs 0 500 500 300 200 -200
221 Lancet Pcs 0 0 0 0 0 0
227 Otsu D-40 25 ml Botol 0 0 0 0 0 0
231 Permethrin (Scabimite Cream).1 Tube 0 23 23 10 13 -13
232 Masker Plus Pcs 0 500 500 200 300 -300
233 0 0 0
234 0 0 0
235 0 0 0
236 0 0 0
237 0 0 0
238 0 0 0
239 0 0 0
240 0 0 0
241 0 0 0

0

Plt. Kepala Dinas Kesehatan Kab. OKI Kepala Instalasi Farmasi Dinkes OKI Pimpinan Puskesmas Pengelola Obat Puskesmas
Nip. 19730905 199803 1 005 Nip. 19770221 200501 2 005 Nip. 196209161988032005 Nip. 198108152007011007

PuskESMAS Rencana Kebutuhan Obat 2021

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

PuskESMAS Rencana Kebutuhan Obat 2021

Uploaded by

Copyright:

Available Formats

DOKUMEN RENCANA KEBUTUHAN OBAT PUSKESMAS TAHUN 2021

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

MENURUT PENCATATAN HASIL SELISIH KADALUARSA RUSAK HILANG

Mengetahui/ Menyetujui Yang Membuat

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

You might also like