LPLPO 2020 Puskemas

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) 3 0 76 77 26 5 0 0 0 0 0 0 187 18.7 205.7
2 Acetylcystein Kapsul 200mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Acyclovir tab 200 mg 102 103 80 70 80 10 0 0 0 0 0 0 445 445
4 Acyclovir cream 3 3 20 1 0 1 0 0 0 0 0 0 28 28
5 Albendazol tab 400 mg 0 4 152 163 178 58 0 0 0 0 0 0 555 555
6 Alkohol Liquid (etanol) 70%-1000 ml 3 5 12 3 4 0 0 0 0 0 0 0 27 27
7 Allopurinol 100 mg 430 270 670 320 180 135 0 0 0 0 0 0 2005 2005
8 Aminophylline Inj 24 mg/ml-10 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Aminophylline tab 200 mg 0 0 515 210 140 50 0 0 0 0 0 0 915 915
10 Amitriptyline 25 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Amlodipine tab 5 mg 300 148 310 250 220 140 0 0 0 0 0 0 1368 1368
12 Amoxycillin Syr 32 16 55 25 14 10 0 0 0 0 0 0 152 152
13 Amoxycillin 250 mg 720 215 795 900 260 140 0 0 0 0 0 0 3030 3030
14 Amoxycillin 500 mg 995 1005 1230 635 350 375 0 0 0 0 0 0 4590 4590
15 Ampicilin 1 gr Inj 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Antasida Syr DOEN 13 11 64 47 19 18 0 0 0 0 0 0 172 172
17 Antasida DOEN Kombinasi 1132 683 1320 758 432 409 0 0 0 0 0 0 4734 4734
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 0 0 70 80 80 40 0 0 0 0 0 0 270 270
20 Ascorbic acid (Vit.C) 50 mg 470 428 930 495 290 321 0 0 0 0 0 0 2934 2934
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) 180 122 315 330 270 310 0 0 0 0 0 0 1527 1527
25 Attapulgite Tablet 600 mg (New Antides) 350 100 320 230 230 220 0 0 0 0 0 0 1450 1450
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% 16 11 22 29 8 2 0 0 0 0 0 0 88 88
29 Benzoic acid |salicylic acid salep (anti fungi) 14 5 41 32 24 19 0 0 0 0 0 0 135 135
30 Betahistine Mesylate 6 mg tab 205 130 350 155 159 113 0 0 0 0 0 0 1112 1112
31 Betamethasone 0,1% krim 0 1 39 24 16 9 0 0 0 0 0 0 89 89
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) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
34 Calcium chloride lactate infus (RL) 0 5 14 11 3 15 0 0 0 0 0 0 48 48
35 Calsium Laktat (Kalk) 500 mg 240 155 740 360 365 230 0 0 0 0 0 0 2090 2090
36 Captopril 12,5 mg 670 390 680 510 390 310 0 0 0 0 0 0 2950 2950
37 Captopril 25 mg 190 170 850 520 350 330 0 0 0 0 0 0 2410 2410
38 Carbamazepin tab 20 0 680 0 0 0 0 0 0 0 0 0 700 700
39 Catgut/Benang Chromic Bedah No.2/0-3/0 11 13 11 8 11 4 0 0 0 0 0 0 58 58
40 Catgut/Benang Plain Bedah No.2/0-3/0 3 1 6 7 8 0 0 0 0 0 0 0 25 25
41 Cefadroxil 500mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
42 Cetirizine 5 mg/5 ml sirup 20 13 59 25 27 10 0 0 0 0 0 0 154 154
43 Chloramhenicol Salep Mata 1% 16 18 31 24 10 4 0 0 0 0 0 0 103 103
44 Chloramphenicol Suspensi 125 mg/ml 0 0 18 12 21 3 0 0 0 0 0 0 54 54
45 Chloramphenicol 250 mg caps 420 320 521 410 320 259 0 0 0 0 0 0 2250 2250
46 Chloramphenicol TT 3% 0 0 0 0 0 0 0 0 0 0 0 0 0 0
47 Chloramphenicol/ Hidrokortison krim 2,5% 19 12 32 11 27 6 0 0 0 0 0 0 107 107
48 Chlorpheniramine Maleat (CTM) 4 mg 764 726 1730 712 520 385 0 0 0 0 0 0 4837 4837
49 Chlorpromazine HCl 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
50 Cimetidin 200 tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0
51 Ciprofloxacin 500 mg tab 530 380 840 560 410 210 0 0 0 0 0 0 2930 2930
52 Ciprofloxacin Infus 0 0 0 0 0 0 0 0 0 0 0 0 0 0
53 Clindamycin 300mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
54 Cresol liquid 1 Liter (lysol) 0 1 2 1 0 0 0 0 0 0 0 0 4 4
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 0 0 570 820 590 175 0 0 0 0 0 0 2155 2155
58 Dexamethasone inj 5mg/ml-1ml 0 0 2 0 0 0 0 0 0 0 0 0 2 2
59 Diazepam 5mg/ml-2 ml inj 0 0 2 2 0 0 0 0 0 0 0 0 4 4
60 Diazepam 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
61 Diclofenac sodium 25 mg tab 880 770 1230 640 380 330 0 0 0 0 0 0 4230 4230
62 Digoxin 0,25 mg 0 0 135 125 110 60 0 0 0 0 0 0 430 430
63 Dimenhydrinate 50mg 0 0 160 190 160 130 0 0 0 0 0 0 640 640
64 Dipenhidramine HCl inj 10mg/ml 112 48 84 76 46 28 0 0 0 0 0 0 394 394
65 Domperidone 10 mg 260 154 320 286 154 115 0 0 0 0 0 0 1289 1289
66 Doxycycline 100 mg Kapsul 0 0 0 0 0 0 0 0 0 0 0 0 0 0
67 Epinephrine HCl/bitartrat inj 0,1% 0 0 0 0 0 0 0 0 0 0 0 0 0 0
68 Erythromicin Syr 0 0 7 8 8 6 0 0 0 0 0 0 29 29
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 280 140 300 230 190 200 0 0 0 0 0 0 1340 1340
70 Ethacridine (Rivanol) 0,1% 0 0 4 2 5 3 0 0 0 0 0 0 14 14
71 Ethanol ( Aseptan ) 500 cc+ Pump 0 0 19 0 0 0 0 0 0 0 0 0 19 19
72 Eugenol cairan 0 0 0 0 0 1 0 0 0 0 0 0 1 1
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) 300 250 430 190 150 180 0 0 0 0 0 0 1500 1500
75 Folley Catheter No.16 0 0 0 0 0 0 0 0 0 0 0 0 0 0
76 Furosemida Injeksi 0 0 0 0 0 0 0 0 0 0 0 0 0 0
77 Furosemida 40 mg 140 120 90 160 110 60 0 0 0 0 0 0 680 680
78 Garam Oralit 2 2 49 0 0 5 0 0 0 0 0 0 58 58
79 Gentamicyn 0,3% TM 0 0 10 6 7 7 0 0 0 0 0 0 30 30
80 Gentamicyn Inj 40 mg/ml 0 0 13 0 0 0 0 0 0 0 0 0 13 13
81 Gentamicyn 0,1% SK 0 0 28 15 11 1 0 0 0 0 0 0 55 55
82 Glass lonomer 0 0 0 2 0 0 0 0 0 0 0 0 2 2
83 Glibenclamide 5 mg 365 225 280 180 190 250 0 0 0 0 0 0 1490 1490
84 Glimepiride 1 mg 270 190 250 350 250 240 0 0 0 0 0 0 1550 1550
85 Glukosa larutan infus 10% 0 0 0 0 0 0 0 0 0 0 0 0 0 0
86 Glukosa larutan infus 5% 0 3 84 0 0 0 0 0 0 0 0 0 87 87
87 Griseofulvin 125 mg 425 188 540 640 600 280 0 0 0 0 0 0 2673 2673
88 Guaifenesin 100 Tab (GG tab) 930 424 1644 732 498 387 0 0 0 0 0 0 4615 4615
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 0 0 0 0 0 0 0 0 0 0 0 0 0 0
91 Human chorionic (HCG/Tes kehamilan ) 29 12 1 1 4 1 0 0 0 0 0 0 48 48
92 Hydrochlorotiazide (HCT) 25 mg 0 0 20 90 125 42 0 0 0 0 0 0 277 277
93 Ibuprofen sirup 7 6 36 19 14 4 0 0 0 0 0 0 86 86
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 1 13 12 1 0 5 0 0 0 0 0 0 32 32
99 Infusi set anak 4 8 131 81 32 19 0 0 0 0 0 0 275 275
100 Iodium Povidon 10% 30 ml 0 0 7 9 8 6 0 0 0 0 0 0 30 30
101 Isosorbide tablet 0 120 70 90 90 100 0 0 0 0 0 0 470 470
102 IV Catheter No.20 1 0 8 4 7 5 0 0 0 0 0 0 25 25
103 IV Catheter No.22 4 7 14 10 17 8 0 0 0 0 0 0 60 60
104 IV Catheter No.24 0 1 12 10 18 9 0 0 0 0 0 0 50 50
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 1 1 6 0 1 1 0 0 0 0 0 0 10 10
108 Kasa pembalut 2x80 0 0 4 6 6 2 0 0 0 0 0 0 18 18
109 Kasa pembalut hidrofil 4 m x 15 cm 0 0 16 27 21 14 0 0 0 0 0 0 78 78
110 Kasa pembalut hidrofil 4 m x 3 cm 0 0 7 5 11 10 0 0 0 0 0 0 33 33
111 Kasa kompres 40/40 steril 0 0 15 71 112 0 0 0 0 0 0 0 198 198
112 Ketoconazole 200 mg Cream 1 2 20 4 5 1 0 0 0 0 0 0 33 33
113 Ketoconazole 200 mg tab 575 300 280 175 124 82 0 0 0 0 0 0 1536 1536
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 1 1 3 0 0 0 0 0 0 0 5 5
116 Lidocain 2% 0 0 0 0 0 0 0 0 0 0 0 0 0 0
117 Lidokain Comp. inj Kombinasi 17 5 17 5 40 19 0 0 0 0 0 0 103 103
118 Lidocaine spray (Xylocaine spray) 0 0 1 0 0 0 0 0 0 0 0 0 1 1
119 Liquorice liquid extract (OBH) 0 0 15 1 0 0 0 0 0 0 0 0 16 16
120 Locoriz Cream 0 0 0 0 0 0 0 0 0 0 0 0 0 0
121 Loperamid 2 m tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0
122 Loratadine 10 mg tab 514 200 650 325 492 180 0 0 0 0 0 0 2361 2361
123 Magnesium Sulfat Injeksi 20% (MgSO4) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
124 Magnesium Sulfat Injeksi 40% (MgSO4) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
125 Masker 35 5 825 25 5 2 0 0 0 0 0 0 897 897
126 Medical adhesive tape (dermafix/leukomed) 0 0 2 2 5 0 0 0 0 0 0 0 9 9
127 Metamizole injeksi (antalgin 1000) 0 0 7 2 3 1 0 0 0 0 0 0 13 13
128 Metformin 500mg tab 30 30 160 210 180 100 0 0 0 0 0 0 710 710
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 450 130 80 120 270 60 0 0 0 0 0 0 1110 1110
131 Methyl Prednisolon tab 4 mg 700 390 310 250 200 105 0 0 0 0 0 0 1955 1955
132 Methyl Rosanilinium (gentian violet) 3 4 6 10 2 3 0 0 0 0 0 0 28 28
133 Metronidazol 250 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0
134 Metronidazol 500 mg tab 150 82 770 350 570 167 0 0 0 0 0 0 2089 2089
135 Metronidazol Infus 0 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Metronidazol syr 0 0 0 0 0 0 0 0 0 0 0 0 0 0
137 Miconazole 2% Salep Kulit 0 2 13 5 3 1 0 0 0 0 0 0 24 24
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 6 20 124 50 0 0 0 0 0 0 200 200
140 Nifedipin 10 mg tab 350 245 110 90 105 0 0 0 0 0 0 0 900 900
141 Nystatin Tab Vag 10.000 iu/g 34 106 50 40 70 50 0 0 0 0 0 0 350 350
142 Omeprazole inj 0 0 10 6 7 1 0 0 0 0 0 0 24 24
STOK JUMLAH
PENGAMAN RENCANA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
143 Omeprazole kaps 10 20 220 70 60 20 0 0 0 0 0 0 400 400
144 Oxytetracycline HCl 1% Salep Mata 5 1 7 1 4 2 0 0 0 0 0 0 20 20
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 10 21 6 6 10 0 0 0 0 0 0 53 53
150 Parasetamol 120 mg/5 ml Syr 35 33 28 12 30 6 0 0 0 0 0 0 144 144
151 Parasetamol 500 mg 1012 598 1801 1470 540 430 0 0 0 0 0 0 5851 5851
152 Patient Lubricant (My Jelly ) 0 0 1 0 2 0 0 0 0 0 0 0 3 3
153 Permethrin (Scabimite Cream) 0 0 5 1 3 0 0 0 0 0 0 0 9 9
154 Phenobarbital inj 50mg/ml-2ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0
155 Phenobarbital 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
156 Phenol gliserol 10% TT 19 9 21 12 14 4 0 0 0 0 0 0 79 79
157 Phytomenadione (Vit.K1) inj 10 mg/ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0
158 Phytomenadione (Vit.K1) 10 mg 105 70 301 70 95 40 0 0 0 0 0 0 681 681
159 Piracetam 400 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
160 Piroxicam 20 mg tab 298 180 660 70 20 60 0 0 0 0 0 0 1288 1288
161 Pisau Disposable (Mess No.14/21) 0 0 2 2 3 2 0 0 0 0 0 0 9 9
162 Plesterku (Leukoplast) 1 4 0 0 0 0 0 0 0 0 0 0 5 5
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 0 0 6 4 4 3 0 0 0 0 0 0 17 17
165 Prednison 5 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Primaquin 15 mg tab 350 210 390 165 100 90 0 0 0 0 0 0 1305 1305
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 0 0 90 60 200 130 0 0 0 0 0 0 480 480
170 Propranolol HCl 40 mg 0 0 60 60 70 100 0 0 0 0 0 0 290 290
171 Propylthiouracil 100 mg 0 0 20 20 90 0 0 0 0 0 0 0 130 130
172 Protein Gluco Test 0 0 13 10 10 17 0 0 0 0 0 0 50 50
173 Pyrantel Pamoat 125 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
174 Pyridoxine HCl 10 mg 0 200 900 0 0 0 0 0 0 0 0 0 1100 1100
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 0 0 0 0 0 0 0 0
178 Retinol (Vit.A) kaps 200.000 iu 0 0 0 0 0 0 0 0 0 0 0 0 0 0
179 Risperidone 2mg 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
180 Salbutamol 2 mg 0 20 520 320 270 140 0 0 0 0 0 0 1270 1270
181 Salep 2-4 Kombinasi 0 0 0 0 0 0 0 0 0 0 0 0 0 0
182 Sarung tangan (HandScuun) No.7,5 24 0 259 90 121 141 0 0 0 0 0 0 635 635
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 0 0 0 0 0 0 0 0 0 0 0 0 0 0
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 840 692 840 340 420 200 0 0 0 0 0 0 3332 3332
188 Silk (Benang Bedah) No. 3/0 0 0 0 0 0 5 0 0 0 0 0 0 5 5
189 Silver Sulfadiazine 0 0 7 0 3 10 0 0 0 0 0 0 20 20
190 Simvastatin 10 mg tab 796 140 330 287 260 100 0 0 0 0 0 0 1913 1913
191 Sodium cloride infus 0,9% ( NACL ) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
192 Spuit 1 ml 0 0 143 147 124 126 0 0 0 0 0 0 540 540
193 Spuit 3 ml 476 220 465 333 285 280 0 0 0 0 0 0 2059 2059
194 Spuit 5 ml 20 0 145 140 254 103 0 0 0 0 0 0 662 662
195 Sulfadoxine | Pyrimethamine Tablet 500mg| 0 0 0 0 0 0 0 0 0 0 0 0 0 0
196 Sulfamethoxazole | trimethoprim (cotri) syr 11 3 39 17 34 31 0 0 0 0 0 0 135 135
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 257 30 550 20 140 30 0 0 0 0 0 0 1027 1027
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 812 435 530 223 0 0 0 0 0 0 0 0 2000 2000
202 Trihexyphenidyl tab 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
203 Trimethoprim (cotrimoxazol 480 mg) tablet 540 290 300 305 542 113 0 0 0 0 0 0 2090 2090
204 Urin Bag 0 0 1 0 0 0 0 0 0 0 0 0 1 1
205 Usg Gel 0 0 0 0 0 0 0 0 0 0 0 0 0 0
206 Vaksin Rabies Vero/ Verorab 0 0 0 0 0 0 0 0 0 0 0 0 0 0
207 Vitamin B Kompleks 753 765 970 470 320 185 0 0 0 0 0 0 3463 3463
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) 0 0 42 0 0 0 0 0 0 0 0 0 42 42
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 0 140 140 360 85 0 0 0 0 0 0 725 725
214 Ondansetron iv/im 4 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
215 Tranexamic Acid inj 5% 0 0 0 0 0 0 0 0 0 0 0 0 0 0
216 Poliwash 500 ml 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
217 Policlean Handrub 0 0 0 0 0 0 0 0 0 0 0 0 0 0
218 Sarung Tangan (Handscuun) L 0 0 260 0 0 0 0 0 0 0 0 0 260 260
219 Cefotaxime Sodium inj 1 gr 0 0 0 0 0 0 0 0 0 0 0 0 0 0
220 Methyl Prednisolon tab 16 mg 0 0 170 55 110 55 0 0 0 0 0 0 390 390
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 0 0 0 0 0 0 0 0 0 0 0 0 0 0
226 Paracetamol 1000 mg /100 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0
227 Otsu D-40 25 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0
228 Ketorolac inj 30 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
229 Dulcolax tab 0 0 105 5 10 10 0 0 0 0 0 0 130 130
230 Ibuprofen 400 mg.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0
231 Permethrin (Scabimite Cream).1 0 0 0 0 0 0 0 0 0 0 0 0 0 0
232 Masker Plus 0 0 0 0 0 0 0 0 0 0 0 0 0 0
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
3416
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 PENERIMAAN 1 PENGELUARAN 1
SALDO 1 JANUARI S/D 31 JANUARI S/D 31 SALDO 31 DES PENCACAHAN
JANUARI 2020 DES 2020 DES 2020 2020
1 2 3 4 5 6 7 8 9 10 11 12
1 Absorbent tipped applicator (alcohol swab) Pcs 233 0 187 0 0
2 Acetylcystein Kapsul 200mg Kapsul 0 0 0 0 0
3 Acyclovir tab 200 mg Tablet 1700 0 445 1255 1255
4 Acyclovir cream Tube 53 0 28 25 25
5 Albendazol tab 400 mg Tablet 990 0 555 435 435
6 Alkohol Liquid (etanol) 70%-1000 ml Btl 31 4 27 8 8
7 Allopurinol 100 mg Tablet 2700 0 2005 695 695
8 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0 0 0 0
9 Aminophylline tab 200 mg Tablet 1400 0 915 485 485
10 Amitriptyline 25 mg tab Tablet 1000 0 0 1000 1000
11 Amlodipine tab 5 mg Tablet 2400 0 1368 1032 1032
12 Amoxycillin Syr Btl 181 154 152 183 183
13 Amoxycillin 250 mg Kapsul 2200 1900 3030 1070 1070
14 Amoxycillin 500 mg Kaptab 4600 2600 4590 2610 2610
15 Ampicilin 1 gr Inj Vial 0 0 0 0 0
16 Antasida Syr DOEN Btl 180 100 172 108 108
17 Antasida DOEN Kombinasi Tablet 5000 2100 4734 2366 2366
18 Anti Bisa Ular 5 ml (ABU I)/ Biosave Vial 0 0 0 0 0
19 Asam Mefenamat 500 mg tab Tablet 0 1000 270 730 730
20 Ascorbic acid (Vit.C) 50 mg Tablet 3000 2000 2934 2066 2066
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 1200 2900 1527 2573 2573
25 Attapulgite Tablet 600 mg (New Antides) Tablet 2100 500 1450 1150 1150
26 Automated blood grouping (Tes Gol. Darah) Paket 2 0 0 2 2
27 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0 0 0 0
28 Bedak Salisil 2% Btl 61 78 88 51 51
29 Benzoic acid |salicylic acid salep (anti fungi) pot 290 0 135 155 155
30 Betahistine Mesylate 6 mg tab Tablet 1500 0 1112 388 388
31 Betamethasone 0,1% krim Tube 162 0 89 73 73
HALAMAN : 2
NO. NAMA OBAT SATUAN SALDO 1 PENERIMAAN 1 PENGELUARAN 1 SALDO 31 DES
JANUARI 2019 JANUARI S/D 31 JANUARI S/D 31 2019 PENCACAHAN
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 0 0 0 0 0
34 Calcium chloride lactate infus (RL) Botol 123 20 48 95 95
35 Calsium Laktat (Kalk) 500 mg Tablet 2800 1700 2090 2410 2410
36 Captopril 12,5 mg Tablet 4800 2800 2950 4650 4650
37 Captopril 25 mg Tablet 3000 3700 2410 4290 4290
38 Carbamazepin tab Tablet 700 0 700 0 0
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 187 0 58 129 129
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 87 0 25 62 62
41 Cefadroxil 500mg Tablet 0 0 0 0 0
42 Cetirizine 5 mg/5 ml sirup Botol 160 0 154 6 6
43 Chloramhenicol Salep Mata 1% Tube 167 0 103 64 64
44 Chloramphenicol Suspensi 125 mg/ml Btl 49 100 54 95 95
45 Chloramphenicol 250 mg caps Tablet 2800 1500 2250 2050 2050
46 Chloramphenicol TT 3% Botol 0 0 0 0 0
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 194 48 107 135 135
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 3800 3300 4837 2263 2263
49 Chlorpromazine HCl 100 mg Tablet 100 0 0 100 100
50 Cimetidin 200 tab Tablet 0 0 0 0 0
51 Ciprofloxacin 500 mg tab Tablet 4950 1200 2930 3220 3220
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 19 0 4 15 15
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 7000 2155 4845 4845
58 Dexamethasone inj 5mg/ml-1ml Ampul 2 0 2 0 0
59 Diazepam 5mg/ml-2 ml inj Ampul 4 0 4 0 0
60 Diazepam 2 mg Tablet 0 0 0 0 0
61 Diclofenac sodium 25 mg tab Tablet 4800 1400 4230 1970 1970
62 Digoxin 0,25 mg Tablet 900 0 430 470 470
63 Dimenhydrinate 50mg Tablet 1100 0 640 460 460
64 Dipenhidramine HCl inj 10mg/ml Ampul 690 0 394 296 296
65 Domperidone 10 mg Tablet 3000 0 1289 1711 1711
66 Doxycycline 100 mg Kapsul Kapsul 0 0 0 0 0
67 Epinephrine HCl/bitartrat inj 0,1% Ampul 78 0 0 78 78
68 Erythromicin Syr Btl 66 0 29 37 37
HALAMAN : 3
DES 2019 DES 2019
1 2 3 4 5 6 7 8 9 10 11 12
69 Erythromicin 500 mg capsul Kapsul 1900 1100 1340 1660 1660
70 Ethacridine (Rivanol) 0,1% Btl 81 0 14 67 67
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 24 0 19 5 5
72 Eugenol cairan Btl 2 0 1 1 1
73 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 0 0 0 0
74 Folic acid 1mg ( asam folat) Tablet 1500 0 1500 0 0
75 Folley Catheter No.16 Pcs 10 0 0 10 10
76 Furosemida Injeksi Ampul 20 0 0 20 20
77 Furosemida 40 mg Tablet 1550 0 680 870 870
78 Garam Oralit Sachet 101 0 58 43 43
79 Gentamicyn 0,3% TM Botol 0 96 30 66 66
80 Gentamicyn Inj 40 mg/ml Ampul 20 0 13 7 7
81 Gentamicyn 0,1% SK Tube 136 0 55 81 81
82 Glass lonomer Paket 2 0 2 0 0
83 Glibenclamide 5 mg Tablet 2500 0 1490 1010 1010
84 Glimepiride 1 mg Tablet 2600 0 1550 1050 1050
85 Glukosa larutan infus 10% Botol 0 0 0 0 0
87 Griseofulvin 125 mg Tablet 3880 0 2673 1207 1207
88 Guaifenesin 100 Tab (GG tab) Tablet 5100 2100 4615 2585 2585
89 Haloperidol 0,5 mg tab Tablet 0 0 0 0 0
90 Haloperidol 5 mg tab Tablet 0 0 0 0 0
91 Human chorionic (HCG/Tes kehamilan ) Strip 52 0 48 4 4
92 Hydrochlorotiazide (HCT) 25 mg Tablet 700 0 277 423 423
93 Ibuprofen sirup Botol 120 0 86 34 34
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 3 0 0 3 3
98 Infus set dewasa Pcs 186 0 32 154 154
99 Infusi set anak Pcs 388 100 275 213 213
100 Iodium Povidon 10% 30 ml Botol 72 0 30 42 42
101 Isosorbide tablet Tablet 800 0 470 330 330
102 IV Catheter No.20 Pcs 80 0 25 55 55
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 18 0 10 8 8
108 Kasa pembalut 2x80 Pcs 90 0 18 72 72
109 Kasa pembalut hidrofil 4 m x 15 cm Pcs 160 0 78 82 82
111 Kasa kompres 40/40 steril Pcs 198 0 198 0 0
112 Ketoconazole 200 mg Cream Tube 86 0 33 53 53
113 Ketoconazole 200 mg tab Tablet 2000 1000 1536 1464 1464
114 Klorokina Fosfat 250 mg Tablet 0 0 0 0 0
115 Levertran Salep/ Salep Luka Bakar pot 23 0 5 18 18
116 Lidocain 2% Ampul 0 0 0 0 0
117 Lidokain Comp. inj Kombinasi Ampul 116 120 103 133 133
118 Lidocaine spray (Xylocaine spray) Botol 1 0 1 0 0
119 Liquorice liquid extract (OBH) Botol 52 0 16 36 36
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 4000 0 2361 1639 1639
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 900 0 897 3 3
126 Medical adhesive tape (dermafix/leukomed) Pcs 85 0 9 76 76
127 Metamizole injeksi (antalgin 1000) Ampul 38 0 13 25 25
128 Metformin 500mg tab Tablet 1200 0 710 490 490
129 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0 0 0 0
130 Methyl Ergometrin Maleat 0,125 mg Tab 1500 0 1110 390 390
131 Methyl Prednisolon tab 4 mg Tablet 1400 2700 1955 2145 2145
132 Methyl Rosanilinium (gentian violet) Botol 46 0 28 18 18
133 Metronidazol 250 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 83 0 24 59 59
138 Momilen Baby Gold Sirup Botol 0 0 0 0 0
139 Natrium Bikarbonat 500 mg Tablet 300 0 200 100 100
140 Nifedipin 10 mg tab Kapsul 900 0 900 0 0
141 Nystatin Tab Vag 10.000 iu/g Tablet 540 0 350 190 190
142 Omeprazole inj Vial 27 33 24 36 36
HALAMAN : 5
DES 2019 DES 2019
1 2 3 4 5 6 7 8 9 10 11 12
143 Omeprazole kaps Kapsul 630 0 400 230 230
144 Oxytetracycline HCl 1% Salep Mata Tube 35 0 20 15 15
145 Oxytetracycline HCl 3% Salep Kulit Tube 0 0 0 0 0
146 Oxytocin inj 10 IU Ampul 70 0 0 70 70
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 75 0 53 22 22
150 Parasetamol 120 mg/5 ml Syr Botol 144 0 144 0 0
151 Parasetamol 500 mg Tablet 1700 8700 5851 4549 4549
152 Patient Lubricant (My Jelly ) Tube 9 0 3 6 6
153 Permethrin (Scabimite Cream) Tube 30 0 9 21 21
154 Phenobarbital inj 50mg/ml-2ml Ampul 90 0 0 90 90
155 Phenobarbital 100 mg Tablet 0 0 0 0 0
156 Phenol gliserol 10% TT Botol 143 0 79 64 64
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 0 0 0 0
158 Phytomenadione (Vit.K1) 10 mg Tablet 1151 0 681 470 470
159 Piracetam 400 mg Tablet 0 0 0 0 0
160 Piroxicam 20 mg tab Tablet 2300 0 1288 1012 1012
161 Pisau Disposable (Mess No.14/21) Pcs 81 0 9 72 72
162 Plesterku (Leukoplast) Pcs 12 0 5 7 7
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat Ampul 3 0 0 3 3
164 Povidon iodium 10% 300 ml Botol 44 0 17 27 27
165 Prednison 5 mg Tablet 0 2000 0 2000 2000
166 Primaquin 15 mg tab Tablet 1900 0 1305 595 595
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 1000 0 480 520 520
171 Propylthiouracil 100 mg Tablet 500 0 130 370 370
172 Protein Gluco Test Strip 83 0 50 33 33
173 Pyrantel Pamoat 125 mg Tablet 0 0 0 0 0
174 Pyridoxine HCl 10 mg Tablet 1200 1300 1100 1400 1400
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 0 0 0 0
178 Retinol (Vit.A) kaps 200.000 iu Kapsul 0 0 0 0 0
179 Risperidone 2mg Tablet 100 0 0 100 100
HALAMAN : 6
DES 2019 DES 2019
1 2 3 4 5 6 7 8 9 10 11 12
180 Salbutamol 2 mg Tablet 1500 2000 1270 2230 2230
181 Salep 2-4 Kombinasi pot 0 0 0 0 0
182 Sarung tangan (HandScuun) No.7,5 Pcs 840 400 635 605 605
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 3300 2000 3332 1968 1968
188 Silk (Benang Bedah) No. 3/0 Pcs 65 0 5 60 60
189 Silver Sulfadiazine Tube 20 10 20 10 10
190 Simvastatin 10 mg tab Tablet 2740 0 1913 827 827
191 Sodium cloride infus 0,9% ( NACL ) Botol 34 0 0 34 34
192 Spuit 1 ml Pcs 1382 300 540 1142 1142
193 Spuit 3 ml Pcs 3350 1000 2059 2291 2291
194 Spuit 5 ml Pcs 1555 0 662 893 893
195 Sulfadoxine | Pyrimethamine Tablet 500mg|25 Tablet 0 0 0 0 0
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 208 0 135 73 73
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 1100 900 2000 0 0
202 Trihexyphenidyl tab 2 mg Tablet 500 0 0 500 500
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 3300 0 2090 1210 1210
204 Urin Bag Pcs 18 0 1 17 17
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 2900 2500 3463 1937 1937
208 Vitamin K Infant Inj Ampul 0 0 0 0 0
209 Water liquid (aqua P,I) Botol 42 0 42 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 1000 0 725 275 275
214 Ondansetron iv/im 4 mg Ampul 0 10 0 10 10
215 Tranexamic Acid inj 5% Ampul 0 20 0 20 20
216 Poliwash 500 ml Botol 0 2 0 2 2
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
H.Amir Syarifuddin,SKM,M.Kes Tumiran,AM.Kep

NIP.19670512 198803 1 005
Wiwin hardianingsih,AM.Keb Harleni,Amd.Keb
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSKESMAS
PUSKESMAS : PELAPORAN BULAN : NOPEMBER 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 46 46 46 -46
2 Acetylcystein Kapsul 200mg Kapsul 0 0 0 0
3 Acyclovir tab 200 mg Tablet 1255 1255 1255 -1255
4 Acyclovir cream Tube 25 25 25 -25
5 Albendazol tab 400 mg Tablet 435 435 435 -435
6 Alkohol Liquid (etanol) 70%-1000 ml Btl 8 8 8 -8
7 Allopurinol 100 mg Tablet 695 695 695 -695
8 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0 0 0
9 Aminophylline tab 200 mg Tablet 485 485 485 -485
10 Amitriptyline 25 mg tab Tablet 1000 1000 1000 -1000
11 Amlodipine tab 5 mg Tablet 1032 1032 1032 -1032
12 Amoxycillin Syr Btl 183 183 183 -183
13 Amoxycillin 250 mg Kapsul 1070 1070 1070 -1070
14 Amoxycillin 500 mg Kaptab 2610 2610 2610 -2610
15 Ampicilin 1 gr Inj Vial 0 0 0 0
16 Antasida Syr DOEN Btl 108 108 108 -108
17 Antasida DOEN Kombinasi Tablet 2366 2366 2366 -2366
18 Anti Bisa Ular 5 ml (ABU I)/ Biosave Vial 0 0 0 0
19 Asam Mefenamat 500 mg tab Tablet 730 730 730 -730
20 Ascorbic acid (Vit.C) 50 mg Tablet 2066 2066 2066 -2066
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 2573 2573 2573 -2573
25 Attapulgite Tablet 600 mg (New Antides) Tablet 1150 1150 1150 -1150
26 Automated blood grouping (Tes Gol. Darah) Paket 2 2 2 -2
27 Bahan Tambal Gigi Sementara (Fletcher/Cavit Pcs 0 0 0 0
28 Bedak Salisil 2% Btl 51 51 51 -51
29 Benzoic acid |salicylic acid salep (anti fungi) pot 155 155 155 -155
30 Betahistine Mesylate 6 mg tab Tablet 388 388 388 -388
31 Betamethasone 0,1% krim Tube 73 73 73 -73
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
32 Bisacodyl 5mg Tablet 0 0 0 0
33 Bismuth subgallas (antihemoroid) Supp 0 0 0 0
34 Calcium chloride lactate infus (RL) Botol 95 95 95 -95
35 Calsium Laktat (Kalk) 500 mg Tablet 2410 2410 2410 -2410
36 Captopril 12,5 mg Tablet 4650 4650 4650 -4650
37 Captopril 25 mg Tablet 4290 4290 4290 -4290
38 Carbamazepin tab Tablet 0 0 0 0
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 129 129 129 -129
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 62 62 62 -62
41 Cefadroxil 500mg Tablet 0 0 0 0
42 Cetirizine 5 mg/5 ml sirup Botol 6 6 6 -6
43 Chloramhenicol Salep Mata 1% Tube 64 64 64 -64
44 Chloramphenicol Suspensi 125 mg/ml Btl 95 95 95 -95
45 Chloramphenicol 250 mg caps Tablet 2050 2050 2050 -2050
46 Chloramphenicol TT 3% Botol 0 0 0 0
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 135 135 135 -135
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 2263 2263 2263 -2263
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 3220 3220 3220 -3220
52 Ciprofloxacin Infus Botol 0 0 0 0
53 Clindamycin 300mg Kapsul 0 0 0 0
54 Cresol liquid 1 Liter (lysol) Botol 15 15 15 -15
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 4845 4845 4845 -4845
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 1970 1970 1970 -1970
62 Digoxin 0,25 mg Tablet 470 470 470 -470
63 Dimenhydrinate 50mg Tablet 460 460 460 -460
64 Dipenhidramine HCl inj 10mg/ml Ampul 296 296 296 -296
65 Domperidone 10 mg Tablet 1711 1711 1711 -1711
66 Doxycycline 100 mg Kapsul Kapsul 0 0 0 0
67 Epinephrine HCl/bitartrat inj 0,1% Ampul 78 78 78 -78
68 Erythromicin Syr Btl 37 37 37 -37
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
69 Erythromicin 500 mg capsul Kapsul 1660 1660 1660 -1660
70 Ethacridine (Rivanol) 0,1% Btl 67 67 67 -67
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 5 5 5 -5
72 Eugenol cairan Btl 1 1 1 -1
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 10 10 10 -10
76 Furosemida Injeksi Ampul 20 20 20 -20
77 Furosemida 40 mg Tablet 870 870 870 -870
78 Garam Oralit Sachet 43 43 43 -43
79 Gentamicyn 0,3% TM Botol 66 66 66 -66
80 Gentamicyn Inj 40 mg/ml Ampul 7 7 7 -7
81 Gentamicyn 0,1% SK Tube 81 81 81 -81
82 Glass lonomer Paket 0 0 0 0
83 Glibenclamide 5 mg Tablet 1010 1010 1010 -1010
84 Glimepiride 1 mg Tablet 1050 1050 1050 -1050
85 Glukosa larutan infus 10% Botol 0 0 0 0
86 Glukosa larutan infus 5% Botol 40 40 40 -40
87 Griseofulvin 125 mg Tablet 1207 1207 1207 -1207
88 Guaifenesin 100 Tab (GG tab) Tablet 2585 2585 2585 -2585
89 Haloperidol 0,5 mg tab Tablet 0 0 0 0
90 Haloperidol 5 mg tab Tablet 0 0 0 0
91 Human chorionic (HCG/Tes kehamilan ) Strip 4 4 4 -4
92 Hydrochlorotiazide (HCT) 25 mg Tablet 423 423 423 -423
93 Ibuprofen sirup Botol 34 34 34 -34
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 3 3 3 -3
98 Infus set dewasa Pcs 154 154 154 -154
99 Infusi set anak Pcs 213 213 213 -213
100 Iodium Povidon 10% 30 ml Botol 42 42 42 -42
101 Isosorbide tablet Tablet 330 330 330 -330
102 IV Catheter No.20 Pcs 55 55 55 -55
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 8 8 8 -8
108 Kasa pembalut 2x80 Pcs 72 72 72 -72
109 Kasa pembalut hidrofil 4 m x 15 cm Pcs 82 82 82 -82
111 Kasa kompres 40/40 steril Pcs 0 0 0 0
112 Ketoconazole 200 mg Cream Tube 53 53 53 -53
113 Ketoconazole 200 mg tab Tablet 1464 1464 1464 -1464
114 Klorokina Fosfat 250 mg Tablet 0 0 0 0
115 Levertran Salep/ Salep Luka Bakar pot 18 18 18 -18
116 Lidocain 2% Ampul 0 0 0 0
117 Lidokain Comp. inj Kombinasi Ampul 133 133 133 -133
118 Lidocaine spray (Xylocaine spray) Botol 0 0 0 0
119 Liquorice liquid extract (OBH) Botol 36 36 36 -36
120 Locoriz Cream Tube 0 0 0 0
121 Loperamid 2 m tab Tablet 0 0 0 0
122 Loratadine 10 mg tab Tablet 1639 1639 1639 -1639
123 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 0 0 0
125 Masker Pcs 3 3 3 -3
126 Medical adhesive tape (dermafix/leukomed) Pcs 76 76 76 -76
127 Metamizole injeksi (antalgin 1000) Ampul 25 25 25 -25
128 Metformin 500mg tab Tablet 490 490 490 -490
129 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0 0 0
130 Methyl Ergometrin Maleat 0,125 mg Tab 390 390 390 -390
131 Methyl Prednisolon tab 4 mg Tablet 2145 2145 2145 -2145
132 Methyl Rosanilinium (gentian violet) Botol 18 18 18 -18
133 Metronidazol 250 mg tab Tablet 0 0 0 0
134 Metronidazol 500 mg tab Tablet 1711 1711 1711 -1711
135 Metronidazol Infus Botol 0 0 0 0
136 Metronidazol syr Botol 0 0 0 0
137 Miconazole 2% Salep Kulit Tube 59 59 59 -59
138 Momilen Baby Gold Sirup Botol 0 0 0 0
139 Natrium Bikarbonat 500 mg Tablet 100 100 100 -100
140 Nifedipin 10 mg tab Kapsul 0 0 0 0
141 Nystatin Tab Vag 10.000 iu/g Tablet 190 190 190 -190
142 Omeprazole inj Vial 36 36 36 -36
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
143 Omeprazole kaps Kapsul 230 230 230 -230
144 Oxytetracycline HCl 1% Salep Mata Tube 15 15 15 -15
145 Oxytetracycline HCl 3% Salep Kulit Tube 0 0 0 0
146 Oxytocin inj 10 IU Ampul 70 70 70 -70
147 Papaverin 40 mg tab Tablet 0 0 0 0
148 Papaverin inj Tablet 0 0 0 0
149 Paracetamol Drops 15 ml Botol 22 22 22 -22
150 Parasetamol 120 mg/5 ml Syr Botol 0 0 0 0
151 Parasetamol 500 mg Tablet 4549 4549 4549 -4549
152 Patient Lubricant (My Jelly ) Tube 6 6 6 -6
153 Permethrin (Scabimite Cream) Tube 21 21 21 -21
154 Phenobarbital inj 50mg/ml-2ml Ampul 90 90 90 -90
155 Phenobarbital 100 mg Tablet 0 0 0 0
156 Phenol gliserol 10% TT Botol 64 64 64 -64
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 0 0 0
158 Phytomenadione (Vit.K1) 10 mg Tablet 470 470 470 -470
159 Piracetam 400 mg Tablet 0 0 0 0
160 Piroxicam 20 mg tab Tablet 1012 1012 1012 -1012
161 Pisau Disposable (Mess No.14/21) Pcs 72 72 72 -72
162 Plesterku (Leukoplast) Pcs 7 7 7 -7
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Bio Ampul 3 3 3 -3
164 Povidon iodium 10% 300 ml Botol 27 27 27 -27
165 Prednison 5 mg Tablet 2000 2000 2000 -2000
166 Primaquin 15 mg tab Tablet 595 595 595 -595
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 520 520 520 -520
171 Propylthiouracil 100 mg Tablet 370 370 370 -370
172 Protein Gluco Test Strip 33 33 33 -33
173 Pyrantel Pamoat 125 mg Tablet 0 0 0 0
174 Pyridoxine HCl 10 mg Tablet 1400 1400 1400 -1400
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 2230 2230 2230 -2230
181 Salep 2-4 Kombinasi pot 0 0 0 0
182 Sarung tangan (HandScuun) No.7,5 Pcs 605 605 605 -605
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 1968 1968 1968 -1968
188 Silk (Benang Bedah) No. 3/0 Pcs 60 60 60 -60
189 Silver Sulfadiazine Tube 10 10 10 -10
190 Simvastatin 10 mg tab Tablet 827 827 827 -827
191 Sodium cloride infus 0,9% ( NACL ) Botol 34 34 34 -34
192 Spuit 1 ml Pcs 1142 1142 1142 -1142
193 Spuit 3 ml Pcs 2291 2291 2291 -2291
194 Spuit 5 ml Pcs 893 893 893 -893
195 Sulfadoxine | Pyrimethamine Tablet 500mg| Tablet 0 0 0 0
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 73 73 73 -73
197 Sulfasetamida 15% TM Botol 0 0 0 0
198 Tetracycline 250 mg Tablet 0 0 0 0
199 Tetracycline 500 mg Tablet 273 273 273 -273
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 500 500 500 -500
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 1210 1210 1210 -1210
204 Urin Bag Pcs 17 17 17 -17
205 Usg Gel Botol 0 0 0 0
206 Vaksin Rabies Vero/ Verorab Paket 0 0 0 0
207 Vitamin B Kompleks Tablet 1937 1937 1937 -1937
208 Vitamin K Infant Inj Ampul 0 0 0 0
209 Water liquid (aqua P,I) Botol 0 0 0 0
210 Wing Needle No.21 Pcs 0 0 0 0
212 Zinc Sulphate Suppositoria (Superhoid) Kapsul 0 0 0 0
213 Zinc tab Tablet 275 275 275 -275
214 Ondansetron iv/im 4 mg Ampul 10 10 10 -10
215 Tranexamic Acid inj 5% Ampul 20 20 20 -20
216 Poliwash 500 ml Botol 2 2 2 -2
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
217 Policlean Handrub Botol 2 2 2 -2
218 Sarung Tangan (Handscuun) L Pcs 740 740 740 -740
219 Cefotaxime Sodium inj 1 gr Vial 0 0 0 0
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 3 3 3 -3
226 Paracetamol 1000 mg /100 ml Botol 0 0 0 0
227 Otsu D-40 25 ml Botol 0 0 0 0
228 Ketorolac inj 30 mg Ampul 0 0 0 0
229 Dulcolax tab Tablet 20 20 20 -20
230 Ibuprofen 400 mg.1 Tablet 1000 1000 1000 -1000
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

Plt. Kepala Dinas Kesehatan Kab. OKI Kepala Instalasi Farmasi Dinkes OKI Pimpinan Puskesmas Pengelola Obat Puskesmas
Iwan Setiawan, SKM, Mkes Himayanti, S.Si, Mkes, Apt H.Amir Syarifuddin,SKM,M.Kes Tumiran,Am.Kep
Nip. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP.19670512 198803 1 005 Nip.-

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
125 Masker Pcs 3 3 3 -3
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 1142 1142 1142 -1142
193 Spuit 3 ml Pcs 2291 2291 2291 -2291
194 Spuit 5 ml Pcs 893 893 893 -893
204 Urin Bag Pcs 17 17 17 -17
213 Zinc tab Tablet 275 275 275 -275
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 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. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP.19670512 198803 1 005 Nip.-

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 DOKUMEN
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
125 Masker Pcs 3 3 3 -3
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 1142 1142 1142 -1142
193 Spuit 3 ml Pcs 2291 2291 2291 -2291
194 Spuit 5 ml Pcs 893 893 893 -893
204 Urin Bag Pcs 17 17 17 -17
213 Zinc tab Tablet 275 275 275 -275
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 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. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP.19670512 198803 1 005 Nip.-

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
125 Masker Pcs 3 3 3 -3
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 1142 1142 1142 -1142
193 Spuit 3 ml Pcs 2291 2291 2291 -2291
194 Spuit 5 ml Pcs 893 893 893 -893
204 Urin Bag Pcs 17 17 17 -17
213 Zinc tab Tablet 275 275 275 -275
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 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. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP.19670512 198803 1 005 Nip.-

STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
21 Ascorbic acid |calsium carbonate 500 mg (Pehavr Tablet 0 0 0 0
27 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0 0 0
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
97 Immunoglobulin human anti-tetanus (Tetagam) Ampul 3 3 3 -3
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
125 Masker Pcs 3 3 3 -3
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 3 3 3 -3
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
192 Spuit 1 ml Pcs 1142 1142 1142 -1142
193 Spuit 3 ml Pcs 2291 2291 2291 -2291
194 Spuit 5 ml Pcs 893 893 893 -893
195 Sulfadoxine | Pyrimethamine Tablet 500mg|25m Tablet 0 0 0 0
204 Urin Bag Pcs 17 17 17 -17
213 Zinc tab Tablet 275 275 275 -275
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 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. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP.19670512 198803 1 005 Nip.-

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
125 Masker Pcs 3 3 3 -3
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 1142 1142 1142 -1142
193 Spuit 3 ml Pcs 2291 2291 2291 -2291
194 Spuit 5 ml Pcs 893 893 893 -893
204 Urin Bag Pcs 17 17 17 -17
213 Zinc tab Tablet 275 275 275 -275
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 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. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP.19670512 198803 1 005 Nip.-
PUSKESMAS : RANTAU DURIAN PELAPORAN BULAN : JUNI 2020 DOKUMEN NOMOR TANGGAL
KECAMATAN : LEMPUING JAYA PERMINTAAS BULAN : JULI 2020 DINKES KAB/KOTA
STOK STOK STOK

NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11
1 Absorbent tipped applicator (alcohol swab) Pcs 51 51 5 46 46 0
3 Acyclovir tab 200 mg Tablet 1265 1265 10 1255 2255 1000
4 Acyclovir cream Tube 26 26 1 25 100 75
5 Albendazol tab 400 mg Tablet 493 493 58 435 435 0
7 Allopurinol 100 mg Tablet 830 830 135 695 2695 2000
9 Aminophylline tab 200 mg Tablet 535 535 50 485 485 0
11 Amlodipine tab 5 mg Tablet 1172 1172 140 1032 1032 0
12 Amoxycillin Syr Btl 193 193 10 183 250 67
13 Amoxycillin 250 mg Kapsul 1210 1210 140 1070 2070 1000
14 Amoxycillin 500 mg Kaptab 2985 2985 375 2610 3610 1000
16 Antasida Syr DOEN Btl 126 126 18 108 250 142
17 Antasida DOEN Kombinasi Tablet 2775 2775 409 2366 3366 1000
19 Asam Mefenamat 500 mg tab Tablet 770 770 40 730 2730 2000
20 Ascorbic acid (Vit.C) 50 mg Tablet 2387 2387 321 2066 4066 2000
21 Ascorbic acid |calsium carbonate 500 mg (Pehavral) Tablet 0 0 0 0
24 Attapulgite Tablet (Pularex) Tablet 2883 2883 310 2573 2573 0
25 Attapulgite Tablet 600 mg (New Antides) Tablet 1370 1370 220 1150 1150 0
28 Bedak Salisil 2% Btl 53 53 2 51 101 50
29 Benzoic acid |salicylic acid salep (anti fungi) pot 174 174 19 155 155 0
30 Betahistine Mesylate 6 mg tab Tablet 501 501 113 388 2388 2000
31 Betamethasone 0,1% krim Tube 82 82 9 73 200 127
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11
34 Calcium chloride lactate infus (RL) Botol 110 110 15 95 95 0
35 Calsium Laktat (Kalk) 500 mg Tablet 2640 2640 230 2410 3000 590
36 Captopril 12,5 mg Tablet 4960 4960 310 4650 4650 0
37 Captopril 25 mg Tablet 4620 4620 330 4290 4290 0
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 133 133 4 129 129 0
42 Cetirizine 5 mg/5 ml sirup Botol 16 16 10 6 106 100
43 Chloramhenicol Salep Mata 1% Tube 68 68 4 64 150 86
44 Chloramphenicol Suspensi 125 mg/ml Btl 98 98 3 95 195 100
45 Chloramphenicol 250 mg caps Tablet 2309 2309 259 2050 3050 1000
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 141 141 6 135 235 100
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 2648 2648 385 2263 5263 3000
51 Ciprofloxacin 500 mg tab Tablet 3430 3430 210 3220 3220 0
57 Dexamethasone 0,5 mg Tablet 5020 5020 175 4845 5845 1000
61 Diclofenac sodium 25 mg tab Tablet 2300 2300 330 1970 4970 3000
62 Digoxin 0,25 mg Tablet 530 530 60 470 470 0
63 Dimenhydrinate 50mg Tablet 590 590 130 460 1000 540
64 Dipenhidramine HCl inj 10mg/ml Ampul 324 324 28 296 396 100
65 Domperidone 10 mg Tablet 1826 1826 115 1711 1711 0
68 Erythromicin Syr Btl 43 43 6 37 137 100
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11
69 Erythromicin 500 mg capsul Kapsul 1860 1860 200 1660 2660 1000
70 Ethacridine (Rivanol) 0,1% Btl 70 70 3 67 67 0
72 Eugenol cairan Btl 2 2 1 1 1 0
74 Folic acid 1mg ( asam folat) Tablet 180 180 180 0 200 200
77 Furosemida 40 mg Tablet 930 930 60 870 870 0
78 Garam Oralit Sachet 48 48 5 43 43 0
79 Gentamicyn 0,3% TM Botol 73 73 7 66 150 84
81 Gentamicyn 0,1% SK Tube 82 82 1 81 181 100
83 Glibenclamide 5 mg Tablet 1260 1260 250 1010 1010 0
84 Glimepiride 1 mg Tablet 1290 1290 240 1050 1050 0
87 Griseofulvin 125 mg Tablet 1487 1487 280 1207 3207 2000
88 Guaifenesin 100 Tab (GG tab) Tablet 2972 2972 387 2585 5585 3000
91 Human chorionic (HCG/Tes kehamilan ) Strip 5 5 1 4 100 96
92 Hydrochlorotiazide (HCT) 25 mg Tablet 465 465 42 423 423 0
93 Ibuprofen sirup Botol 38 38 4 34 184 150
98 Infus set dewasa Pcs 159 159 5 154 154 0
99 Infusi set anak Pcs 232 232 19 213 213 0
100 Iodium Povidon 10% 30 ml Botol 48 48 6 42 42 0
101 Isosorbide tablet Tablet 430 430 100 330 330 0
102 IV Catheter No.20 Pcs 60 60 5 55 55 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11
107 Kapas pembalut/Absorben 250 g Pcs 9 9 1 8 20 12
108 Kasa pembalut 2x80 Pcs 74 74 2 72 72 0
109 Kasa pembalut hidrofil 4 m x 15 cm Pcs 96 96 14 82 182 100
112 Ketoconazole 200 mg Cream Tube 54 54 1 53 100 47
113 Ketoconazole 200 mg tab Tablet 1546 1546 82 1464 2464 1000
117 Lidokain Comp. inj Kombinasi Ampul 152 152 19 133 133 0
122 Loratadine 10 mg tab Tablet 1819 1819 180 1639 2639 1000
125 Masker Pcs 5 5 2 3 3000 2997
127 Metamizole injeksi (antalgin 1000) Ampul 26 26 1 25 75 50
128 Metformin 500mg tab Tablet 590 590 100 490 1490 1000
130 Methyl Ergometrin Maleat 0,125 mg Tab 450 450 60 390 390 0
131 Methyl Prednisolon tab 4 mg Tablet 2250 2250 105 2145 3145 1000
132 Methyl Rosanilinium (gentian violet) Botol 21 21 3 18 68 50
134 Metronidazol 500 mg tab Tablet 1878 1878 167 1711 2711 1000
137 Miconazole 2% Salep Kulit Tube 60 60 1 59 109 50
139 Natrium Bikarbonat 500 mg Tablet 150 150 50 100 600 500
141 Nystatin Tab Vag 10.000 iu/g Tablet 240 240 50 190 190 0
142 Omeprazole inj Vial 37 37 1 36 36 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11
143 Omeprazole kaps Kapsul 250 250 20 230 2230 2000
144 Oxytetracycline HCl 1% Salep Mata Tube 17 17 2 15 115 100
149 Paracetamol Drops 15 ml Botol 32 32 10 22 122 100
150 Parasetamol 120 mg/5 ml Syr Botol 6 6 6 0 150 150
151 Parasetamol 500 mg Tablet 4979 4979 430 4549 5549 1000
156 Phenol gliserol 10% TT Botol 68 68 4 64 114 50
158 Phytomenadione (Vit.K1) 10 mg Tablet 510 510 40 470 2000 1530
160 Piroxicam 20 mg tab Tablet 1072 1072 60 1012 3012 2000
161 Pisau Disposable (Mess No.14/21) Pcs 74 74 2 72 72 0
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 3 3 3 3 0
164 Povidon iodium 10% 300 ml Botol 30 30 3 27 27 0
166 Primaquin 15 mg tab Tablet 685 685 90 595 595 0
169 Propranolol HCl 10 mg Tablet 650 650 130 520 520 0
172 Protein Gluco Test Strip 50 50 17 33 58 25
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11
180 Salbutamol 2 mg Tablet 2370 2370 140 2230 3230 1000
182 Sarung tangan (HandScuun) No.7,5 Pcs 746 746 141 605 805 200
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 2168 2168 200 1968 3968 2000
188 Silk (Benang Bedah) No. 3/0 Pcs 65 65 5 60 60 0
189 Silver Sulfadiazine Tube 20 20 10 10 10 0
190 Simvastatin 10 mg tab Tablet 927 927 100 827 2827 2000
192 Spuit 1 ml Pcs 1268 1268 126 1142 1142 0
193 Spuit 3 ml Pcs 2571 2571 280 2291 3291 1000
194 Spuit 5 ml Pcs 996 996 103 893 893 0
195 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 0 0 0 0
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 104 104 31 73 173 100
199 Tetracycline 500 mg Tablet 303 303 30 273 2273 2000
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 1323 1323 113 1210 3210 2000
204 Urin Bag Pcs 17 17 17 17 0
207 Vitamin B Kompleks Tablet 2122 2122 185 1937 4937 3000
213 Zinc tab Tablet 360 360 85 275 275 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11
217 Policlean Handrub Botol 2 2 2 8 6
218 Sarung Tangan (Handscuun) L Pcs 740 740 740 740 0
225 Nonwoven Fixation Rol Pcs 3 3 3 3 0
227 Otsu D-40 25 ml Botol 0 0 0 0
229 Dulcolax tab Tablet 30 30 10 20 220 200
230 Ibuprofen 400 mg.1 Tablet 1000 1000 1000 1000 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

269 363 632

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.19670512 198803 1 005 Nip.-
TANGGAL
KET
12
: JUNI 2020
KET
12
: JUNI 2020
KET
12
: JUNI 2020
KET
12
: JUNI 2020
KET
12
: JUNI 2020
KET
12
: JUNI 2020
KET
12
Yang Membuat
Pengelola Obat Puskesmas
Tumiran,Am.Kep
Nip.-
PUSKESMAS : RANTAU DURIAN PELAPORAN BULAN : MEI 2020 DOKUMEN NOMOR TANGGAL
KECAMATAN : LEMPUING JAYA PERMINTAAS 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 77 77 26 51 51 0
6 Alkohol Liquid (etanol) 70%-1000 ml Btl 12 12 4 8 8 0
9 Aminophylline tab 200 mg Tablet 675 675 140 535 535 0
11 Amlodipine tab 5 mg Tablet 1392 1392 220 1172 1172 0
14 Amoxycillin 500 mg Kaptab 3335 3335 350 2985 2985 0
24 Attapulgite Tablet (Pularex) Tablet 3153 3153 270 2883 2883 0
25 Attapulgite Tablet 600 mg (New Antides) Tablet 1600 1600 230 1370 1370 0
28 Bedak Salisil 2% Btl 61 61 8 53 53 0
29 Benzoic acid |salicylic acid salep (anti fungi) pot 198 198 24 174 174 0
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
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 144 144 11 133 133 0
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 70 70 8 62 62 0
44 Chloramphenicol Suspensi 125 mg/ml Btl 119 119 21 98 98 0
45 Chloramphenicol 250 mg caps Tablet 2629 2629 320 2309 2309 0
51 Ciprofloxacin 500 mg tab Tablet 3840 3840 410 3430 3430 0
62 Digoxin 0,25 mg Tablet 640 640 110 530 530 0
63 Dimenhydrinate 50mg Tablet 750 750 160 590 590 0
64 Dipenhidramine HCl inj 10mg/ml Ampul 370 370 46 324 324 0
65 Domperidone 10 mg Tablet 1980 1980 154 1826 1826 0
68 Erythromicin Syr Btl 51 51 8 43 43 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
69 Erythromicin 500 mg capsul Kapsul 2050 2050 190 1860 1860 0
70 Ethacridine (Rivanol) 0,1% Btl 75 75 5 70 70 0
72 Eugenol cairan Btl 2 2 2 2 0
77 Furosemida 40 mg Tablet 1040 1040 110 930 930 0
79 Gentamicyn 0,3% TM Botol 80 80 7 73 73 0
81 Gentamicyn 0,1% SK Tube 93 93 11 82 82 0
83 Glibenclamide 5 mg Tablet 1450 1450 190 1260 1260 0
84 Glimepiride 1 mg Tablet 1540 1540 250 1290 1290 0
92 Hydrochlorotiazide (HCT) 25 mg Tablet 590 590 125 465 465 0
93 Ibuprofen sirup Botol 52 52 14 38 38 0
100 Iodium Povidon 10% 30 ml Botol 56 56 8 48 48 0
101 Isosorbide tablet Tablet 520 520 90 430 430 0
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 10 10 1 9 9 0
108 Kasa pembalut 2x80 Pcs 80 80 6 74 74 0
112 Ketoconazole 200 mg Cream Tube 59 59 5 54 54 0
115 Levertran Salep/ Salep Luka Bakar pot 21 21 3 18 18 0
117 Lidokain Comp. inj Kombinasi Ampul 192 192 40 152 152 0
122 Loratadine 10 mg tab Tablet 2311 2311 492 1819 1819 0
125 Masker Pcs 10 10 5 5 5 0
126 Medical adhesive tape (dermafix/leukomed) Pcs 81 81 5 76 76 0
127 Metamizole injeksi (antalgin 1000) Ampul 29 29 3 26 26 0
128 Metformin 500mg tab Tablet 770 770 180 590 590 0
130 Methyl Ergometrin Maleat 0,125 mg Tab 720 720 270 450 450 0
132 Methyl Rosanilinium (gentian violet) Botol 23 23 2 21 21 0
134 Metronidazol 500 mg tab Tablet 2448 2448 570 1878 1878 0
137 Miconazole 2% Salep Kulit Tube 63 63 3 60 60 0
139 Natrium Bikarbonat 500 mg Tablet 274 274 124 150 150 0
141 Nystatin Tab Vag 10.000 iu/g Tablet 310 310 70 240 240 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 8 8 2 6 6 0
153 Permethrin (Scabimite Cream) Tube 24 24 3 21 21 0
156 Phenol gliserol 10% TT Botol 82 82 14 68 68 0
158 Phytomenadione (Vit.K1) 10 mg Tablet 605 605 95 510 510 0
161 Pisau Disposable (Mess No.14/21) Pcs 77 77 3 74 74 0
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 3 3 3 3 0
164 Povidon iodium 10% 300 ml Botol 34 34 4 30 30 0
166 Primaquin 15 mg tab Tablet 785 785 100 685 685 0
171 Propylthiouracil 100 mg Tablet 460 460 90 370 370 0
172 Protein Gluco Test Strip 60 60 10 50 50 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
188 Silk (Benang Bedah) No. 3/0 Pcs 65 65 65 65 0
190 Simvastatin 10 mg tab Tablet 1187 1187 260 927 927 0
192 Spuit 1 ml Pcs 1392 1392 124 1268 1268 0
193 Spuit 3 ml Pcs 2856 2856 285 2571 2571 0
194 Spuit 5 ml Pcs 1250 1250 254 996 996 0
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 1865 1865 542 1323 1323 0
204 Urin Bag Pcs 17 17 17 17 0
213 Zinc tab Tablet 720 720 360 360 360 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
218 Sarung Tangan (Handscuun) L Pcs 740 740 740 740 0
225 Nonwoven Fixation Rol Pcs 3 3 3 3 0
227 Otsu D-40 25 ml Botol 0 0 0 0
229 Dulcolax tab Tablet 40 40 10 30 30 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

267 298 565

Iwan Setiawan, SKM, Mkes Himayanti, S.Si, Mkes, A H.Amir Syarifuddin,SKM,M.Kes Tumiran,Am.Kep
Nip. 19730905 199803 1 005 Nip. 19770221 200501 2 NIP.19670512 198803 1 005 Nip.-
PUSKESMAS : RANTAU DURIAN PELAPORAN BULAN : APR 2020 DOKUMEN NOMOR TANGGAL
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
3 Acyclovir tab 200 mg Tablet 1415 1415 70 1345 0
5 Albendazol tab 400 mg Tablet 834 834 163 671 0
7 Allopurinol 100 mg Tablet 1330 1330 320 1010 0
10 Amitriptyline 25 mg tab Tablet 1000 1000 1000 0
19 Asam Mefenamat 500 mg tab Tablet 930 930 80 850 0
26 Automated blood grouping (Tes Gol. Darah) Paket 2 2 2 0
30 Betahistine Mesylate 6 mg tab Tablet 815 815 155 660 0
31 Betamethasone 0,1% krim Tube 122 122 24 98 0
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : APR 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
42 Cetirizine 5 mg/5 ml sirup Botol 68 68 25 43 0
43 Chloramhenicol Salep Mata 1% Tube 102 102 24 78 0
49 Chlorpromazine HCl 100 mg Tablet 100 100 100 0
67 Epinephrine HCl/bitartrat inj 0,1% Ampul 78 78 78 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 5 5 5 0
72 Eugenol cairan Btl 2 2 2 0
74 Folic acid 1mg ( asam folat) Tablet 520 520 190 330 0
75 Folley Catheter No.16 Pcs 10 10 10 0
76 Furosemida Injeksi Ampul 20 20 20 0
78 Garam Oralit Sachet 48 48 48 0
80 Gentamicyn Inj 40 mg/ml Ampul 7 7 7 0
82 Glass lonomer Paket 2 2 2 0 0
87 Griseofulvin 125 mg Tablet 2727 2727 640 2087 0
91 Human chorionic (HCG/Tes kehamilan ) Strip 10 10 1 9 0
97 Immunoglobulin human anti-tetanus (Tetagam) Ampul 3 3 3 0
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 10 10 10 0
125 Masker Pcs 35 35 25 10 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
143 Omeprazole kaps Kapsul 380 380 70 310 0
144 Oxytetracycline HCl 1% Salep Mata Tube 22 22 1 21 0
146 Oxytocin inj 10 IU Ampul 70 70 70 0
149 Paracetamol Drops 15 ml Botol 44 44 6 38 0
150 Parasetamol 120 mg/5 ml Syr Botol 48 48 12 36 0
152 Patient Lubricant (My Jelly ) Tube 8 8 8 0
154 Phenobarbital inj 50mg/ml-2ml Ampul 90 90 90 0
160 Piroxicam 20 mg tab Tablet 1162 1162 70 1092 0
162 Plesterku (Leukoplast) Pcs 7 7 7 0
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 3 3 3 0
179 Risperidone 2mg Tablet 100 100 100 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
188 Silk (Benang Bedah) No. 3/0 Pcs 65 65 65 0
189 Silver Sulfadiazine Tube 13 10 23 23 0
191 Sodium cloride infus 0,9% ( NACL ) Botol 34 34 34 0
192 Spuit 1 ml Pcs 1539 1539 147 1392 0
193 Spuit 3 ml Pcs 3189 3189 333 2856 0
194 Spuit 5 ml Pcs 1390 1390 140 1250 0
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 155 155 17 138 0
202 Trihexyphenidyl tab 2 mg Tablet 500 500 500 0
204 Urin Bag Pcs 17 17 17 0
213 Zinc tab Tablet 860 860 140 720 0
214 Ondansetron iv/im 4 mg Ampul 10 10 10 0
215 Tranexamic Acid inj 5% Ampul 20 20 20 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
218 Sarung Tangan (Handscuun) L Pcs 740 740 740 0
225 Nonwoven Fixation Rol Pcs 3 3 3 0
227 Otsu D-40 25 ml Botol 0 0 0 0
229 Dulcolax tab Tablet 45 45 5 40 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

174 363 537

Nip. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP.19670512 198803 1 005 Nip.-
PUSKESMAS : RANTAU DURIAN PELAPORAN BULAN : MAR 2020 DOKUMEN NOMOR TANGGAL
KECAMATAN : LEMPUING JAYA PERMINTAAS BULAN : APRIL 2020 DINKES KAB/KOTA
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
4 Acyclovir cream Tube 47 47 20 27 99 72
6 Alkohol Liquid (etanol) 70%-1000 ml Btl 27 27 12 15 50 35
10 Amitriptyline 25 mg tab Tablet 1000 1000 1000 0
21 Ascorbic acid |calsium carbonate 500 mg (Pehavral) Tablet 0 0 0 1000 1000
26 Automated blood grouping (Tes Gol. Darah) Paket 2 2 2 0
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : MAR 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
38 Carbamazepin tab Tablet 680 680 680 0 0
46 Chloramphenicol TT 3% Botol 0 0 0 100 100
49 Chlorpromazine HCl 100 mg Tablet 100 100 100 0
50 Cimetidin 200 tab Tablet 0 0 0 1000 1000
53 Clindamycin 300mg Kapsul 0 0 0 1000 1000
54 Cresol liquid 1 Liter (lysol) Botol 18 18 2 16 38 22
58 Dexamethasone inj 5mg/ml-1ml Ampul 2 2 2 0 0
67 Epinephrine HCl/bitartrat inj 0,1% Ampul 78 78 78 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 24 24 19 5 55 50
72 Eugenol cairan Btl 2 2 2 0
73 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 0 0 1000 1000
75 Folley Catheter No.16 Pcs 10 10 10 0
76 Furosemida Injeksi Ampul 20 20 20 0
86 Glukosa larutan infus 5% Botol 84 84 84 0 40 40
96 Ichthyol salep 10% pot 0 0 0 200 200
97 Immunoglobulin human anti-tetanus (Tetagam) Ampul 3 3 3 0
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 16 16 6 10 0
114 Klorokina Fosfat 250 mg Tablet 0 0 0 1000 1000
115 Levertran Salep/ Salep Luka Bakar pot 23 23 1 22 72 50
118 Lidocaine spray (Xylocaine spray) Botol 1 1 1 0 0
121 Loperamid 2 m tab Tablet 0 0 0 1000 1000
125 Masker Pcs 860 860 825 35 2035 2000
140 Nifedipin 10 mg tab Kapsul 305 305 110 195 1195 1000
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
146 Oxytocin inj 10 IU Ampul 70 70 70 0
154 Phenobarbital inj 50mg/ml-2ml Ampul 90 90 90 0
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 3 3 3 0
173 Pyrantel Pamoat 125 mg Tablet 0 0 0 0 0
174 Pyridoxine HCl 10 mg Tablet 1000 1000 900 100 3100 3000
175 Ranitidin 150 mg Tablet 0 0 0 3000 3000
176 Ranitidin Injeksi Ampul 0 0 0 100 100
179 Risperidone 2mg Tablet 100 100 100 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
183 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0 0 0 1000 1000
188 Silk (Benang Bedah) No. 3/0 Pcs 65 65 65 0
191 Sodium cloride infus 0,9% ( NACL ) Botol 34 34 34 0
192 Spuit 1 ml Pcs 1682 1682 143 1539 0
193 Spuit 3 ml Pcs 3654 3654 465 3189 0
194 Spuit 5 ml Pcs 1535 1535 145 1390 0
201 Thiamine HCl (Vit B1) 50 mg Tablet 753 753 530 223 1423 1200
202 Trihexyphenidyl tab 2 mg Tablet 500 500 500 0
204 Urin Bag Pcs 18 18 1 17 0
209 Water liquid (aqua P,I) Botol 42 42 42 0 0
213 Zinc tab Tablet 1000 1000 140 860 2860 2000
214 Ondansetron iv/im 4 mg Ampul 10 10 10 0
215 Tranexamic Acid inj 5% Ampul 20 20 20 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
218 Sarung Tangan (Handscuun) L Pcs 1000 1000 260 740 1740 1000
225 Nonwoven Fixation Rol Pcs 3 3 3 0
227 Otsu D-40 25 ml Botol 0 0 0 0
229 Dulcolax tab Tablet 150 150 105 45 0
230 Ibuprofen 400 mg.1 Tablet 0 0 0 0
232 Masker Plus Pcs 0 0 0 1000 1000
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

158 444 602

Nip. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP.19670512 198803 1 005 Nip.-
PUSKESMAS : RANTAU DURIAN PELAPORAN BULAN Feb-20 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 230 230 230
2 Acetylcystein Kapsul 200mg Kapsul 0 0 0
3 Acyclovir tab 200 mg Tablet 1598 1598 103 1495
4 Acyclovir cream Tube 50 50 3 47
5 Albendazol tab 400 mg Tablet 990 990 4 986
6 Alkohol Liquid (etanol) 70%-1000 ml Btl 32 32 5 27
7 Allopurinol 100 mg Tablet 2270 2270 270 2000
8 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0 0
9 Aminophylline tab 200 mg Tablet 1400 1400 1400
10 Amitriptyline 25 mg tab Tablet 1000 1000 1000
11 Amlodipine tab 5 mg Tablet 2100 2100 148 1952
12 Amoxycillin Syr Btl 269 269 16 253
13 Amoxycillin 250 mg Kapsul 3380 3380 215 3165
14 Amoxycillin 500 mg Kaptab 6205 6205 1005 5200
15 Ampicilin 1 gr Inj Vial 0 0 0
16 Antasida Syr DOEN Btl 267 267 11 256
17 Antasida DOEN Kombinasi Tablet 5968 5968 683 5285
18 Anti Bisa Ular 5 ml (ABU I)/ Biosave Vial 0 0 0
19 Asam Mefenamat 500 mg tab Tablet 1000 1000 1000
20 Ascorbic acid (Vit.C) 50 mg Tablet 4530 4530 428 4102
21 Ascorbic acid |calsium carbonate 500 mg (Pehavral) Tablet 0 0 0
22 Aspirin (miniaspi) 100 mg tab Tablet 0 0 0
23 Atropine inj 0,25 mg/ml Ampul 0 0 0
24 Attapulgite Tablet (Pularex) Tablet 3920 3920 122 3798
25 Attapulgite Tablet 600 mg (New Antides) Tablet 2250 2250 100 2150
26 Automated blood grouping (Tes Gol. Darah) Paket 2 2 2
27 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0 0
28 Bedak Salisil 2% Btl 123 123 11 112
29 Benzoic acid |salicylic acid salep (anti fungi) pot 276 276 5 271
30 Betahistine Mesylate 6 mg tab Tablet 1295 1295 130 1165
31 Betamethasone 0,1% krim Tube 162 162 1 161
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN Feb-20
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
33 Bismuth subgallas (antihemoroid) Supp 0 0 0
34 Calcium chloride lactate infus (RL) Botol 123 123 5 118
35 Calsium Laktat (Kalk) 500 mg Tablet 3760 3760 155 3605
36 Captopril 12,5 mg Tablet 4930 4930 390 4540
37 Captopril 25 mg Tablet 4410 4410 170 4240
38 Carbamazepin tab Tablet 680 680 680
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 176 176 13 163
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 84 84 1 83
41 Cefadroxil 500mg Tablet 0 0 0
42 Cetirizine 5 mg/5 ml sirup Botol 140 140 13 127
43 Chloramhenicol Salep Mata 1% Tube 151 151 18 133
44 Chloramphenicol Suspensi 125 mg/ml Btl 149 149 149
45 Chloramphenicol 250 mg caps Tablet 3880 3880 320 3560
46 Chloramphenicol TT 3% Botol 0 0 0
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 175 175 12 163
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 6336 6336 726 5610
49 Chlorpromazine HCl 100 mg Tablet 100 100 100
50 Cimetidin 200 tab Tablet 0 0 0
51 Ciprofloxacin 500 mg tab Tablet 5620 5620 380 5240
52 Ciprofloxacin Infus Botol 0 0 0
53 Clindamycin 300mg Kapsul 0 0 0
54 Cresol liquid 1 Liter (lysol) Botol 19 19 1 18
55 Cyanocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0 0
56 Devitalisasi pasta pot 0 0 0
57 Dexamethasone 0,5 mg Tablet 3000 3000 3000
58 Dexamethasone inj 5mg/ml-1ml Ampul 2 2 2
59 Diazepam 5mg/ml-2 ml inj Ampul 4 4 4
60 Diazepam 2 mg Tablet 0 0 0
61 Diclofenac sodium 25 mg tab Tablet 5320 5320 770 4550
62 Digoxin 0,25 mg Tablet 900 900 900
63 Dimenhydrinate 50mg Tablet 1100 1100 1100
64 Dipenhidramine HCl inj 10mg/ml Ampul 578 578 48 530
65 Domperidone 10 mg Tablet 2740 2740 154 2586
66 Doxycycline 100 mg Kapsul Kapsul 0 0 0
67 Epinephrine HCl/bitartrat inj 0,1% Ampul 78 78 78
68 Erythromicin Syr Btl 66 66 66
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
69 Erythromicin 500 mg capsul Kapsul 2720 2720 140 2580
70 Ethacridine (Rivanol) 0,1% Btl 81 81 81
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 24 24 24
72 Eugenol cairan Btl 2 2 2
73 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 0 0
75 Folley Catheter No.16 Pcs 10 10 10
76 Furosemida Injeksi Ampul 20 20 20
77 Furosemida 40 mg Tablet 1410 1410 120 1290
79 Gentamicyn 0,3% TM Botol 96 96 96
80 Gentamicyn Inj 40 mg/ml Ampul 20 20 20
81 Gentamicyn 0,1% SK Tube 136 136 136
82 Glass lonomer Paket 2 2 2
83 Glibenclamide 5 mg Tablet 2135 2135 225 1910
84 Glimepiride 1 mg Tablet 2330 2330 190 2140
85 Glukosa larutan infus 10% Botol 0 0 0
87 Griseofulvin 125 mg Tablet 3455 3455 188 3267
88 Guaifenesin 100 Tab (GG tab) Tablet 6270 6270 424 5846
89 Haloperidol 0,5 mg tab Tablet 0 0 0
90 Haloperidol 5 mg tab Tablet 0 0 0
91 Human chorionic (HCG/Tes kehamilan ) Strip 23 23 12 11
92 Hydrochlorotiazide (HCT) 25 mg Tablet 700 700 700
93 Ibuprofen sirup Botol 113 113 6 107
94 Ibuprofen 200 mg Tablet 0 0 0
95 Ibuprofen 400 mg Tablet 0 0 0
96 Ichthyol salep 10% pot 0 0 0
97 Immunoglobulin human anti-tetanus (Tetagam) Ampul 3 3 3
98 Infus set dewasa Pcs 185 185 13 172
99 Infusi set anak Pcs 384 384 8 376
100 Iodium Povidon 10% 30 ml Botol 72 72 72
101 Isosorbide tablet Tablet 800 800 120 680
102 IV Catheter No.20 Pcs 79 79 79
103 IV Catheter No.22 Pcs 129 129 7 122
105 Jarum Jahit Kulit Pcs 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
108 Kasa pembalut 2x80 Pcs 90 90 90
109 Kasa pembalut hidrofil 4 m x 15 cm Pcs 160 160 160
111 Kasa kompres 40/40 steril Pcs 198 198 198
112 Ketoconazole 200 mg Cream Tube 85 85 2 83
113 Ketoconazole 200 mg tab Tablet 1425 1425 300 1125
114 Klorokina Fosfat 250 mg Tablet 0 0 0
115 Levertran Salep/ Salep Luka Bakar pot 23 23 23
116 Lidocain 2% Ampul 0 0 0
117 Lidokain Comp. inj Kombinasi Ampul 219 219 5 214
118 Lidocaine spray (Xylocaine spray) Botol 1 1 1
119 Liquorice liquid extract (OBH) Botol 52 52 52
120 Locoriz Cream Tube 0 0 0
121 Loperamid 2 m tab Tablet 0 0 0
122 Loratadine 10 mg tab Tablet 3486 3486 200 3286
123 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 0 0
124 Magnesium Sulfat Injeksi 40% (MgSO4) Ampul 0 0 0
125 Masker Pcs 865 865 5 860
126 Medical adhesive tape (dermafix/leukomed) Pcs 85 85 85
127 Metamizole injeksi (antalgin 1000) Ampul 38 38 38
128 Metformin 500mg tab Tablet 1170 1170 30 1140
129 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0 0
130 Methyl Ergometrin Maleat 0,125 mg Tab 1050 1050 130 920
131 Methyl Prednisolon tab 4 mg Tablet 2400 2400 390 2010
132 Methyl Rosanilinium (gentian violet) Botol 43 43 4 39
133 Metronidazol 250 mg tab Tablet 0 0 0
135 Metronidazol Infus Botol 0 0 0
136 Metronidazol syr Botol 0 0 0
137 Miconazole 2% Salep Kulit Tube 83 83 2 81
138 Momilen Baby Gold Sirup Botol 0 0 0
139 Natrium Bikarbonat 500 mg Tablet 300 300 300
141 Nystatin Tab Vag 10.000 iu/g Tablet 506 506 106 400
142 Omeprazole inj Vial 27 27 27
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
143 Omeprazole kaps Kapsul 620 620 20 600
144 Oxytetracycline HCl 1% Salep Mata Tube 30 30 1 29
145 Oxytetracycline HCl 3% Salep Kulit Tube 0 0 0
146 Oxytocin inj 10 IU Ampul 70 70 70
147 Papaverin 40 mg tab Tablet 0 0 0
148 Papaverin inj Tablet 0 0 0
149 Paracetamol Drops 15 ml Botol 75 75 10 65
151 Parasetamol 500 mg Tablet 6388 6388 598 5790
152 Patient Lubricant (My Jelly ) Tube 9 9 9
153 Permethrin (Scabimite Cream) Tube 30 30 30
154 Phenobarbital inj 50mg/ml-2ml Ampul 90 90 90
155 Phenobarbital 100 mg Tablet 0 0 0
156 Phenol gliserol 10% TT Botol 124 124 9 115
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 0 0
158 Phytomenadione (Vit.K1) 10 mg Tablet 1046 1046 70 976
159 Piracetam 400 mg Tablet 0 0 0
160 Piroxicam 20 mg tab Tablet 2002 2002 180 1822
161 Pisau Disposable (Mess No.14/21) Pcs 81 81 81
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 3 3 3
164 Povidon iodium 10% 300 ml Botol 44 44 44
165 Prednison 5 mg Tablet 0 0 0
166 Primaquin 15 mg tab Tablet 1550 1550 210 1340
167 Profolat tab Tablet 0 0 0
168 Prokaina Penisilin G inj 3.000.000 iu Ampul 0 0 0
169 Propranolol HCl 10 mg Tablet 1000 1000 1000
171 Propylthiouracil 100 mg Tablet 500 500 500
172 Protein Gluco Test Strip 83 83 83
173 Pyrantel Pamoat 125 mg Tablet 0 0 0
174 Pyridoxine HCl 10 mg Tablet 1200 1200 200 1000
175 Ranitidin 150 mg Tablet 0 0 0
176 Ranitidin Injeksi Ampul 0 0 0
177 Retinol (Vit.A) kaps 100.000 iu Kapsul 0 0 0
178 Retinol (Vit.A) kaps 200.000 iu Kapsul 0 0 0
179 Risperidone 2mg Tablet 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 2500 2500 20 2480
181 Salep 2-4 Kombinasi pot 0 0 0
182 Sarung tangan (HandScuun) No.7,5 Pcs 816 816 816
183 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0 0 0
184 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0 0
185 Sarung tangan (HandScuun Steril) No.7,5 Pcs 0 0 0
186 Semen Seng Fosfat Serbuk & Cairan Set 0 0 0
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 4460 4460 692 3768
188 Silk (Benang Bedah) No. 3/0 Pcs 65 65 65
189 Silver Sulfadiazine Tube 20 20 20
190 Simvastatin 10 mg tab Tablet 1944 1944 140 1804
191 Sodium cloride infus 0,9% ( NACL ) Botol 34 34 34
192 Spuit 1 ml Pcs 1682 1682 1682
193 Spuit 3 ml Pcs 3874 3874 220 3654
194 Spuit 5 ml Pcs 1535 1535 1535
195 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 0 0 0
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 197 197 3 194
197 Sulfasetamida 15% TM Botol 0 0 0
198 Tetracycline 250 mg Tablet 0 0 0
200 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0 0
202 Trihexyphenidyl tab 2 mg Tablet 500 500 500
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 2760 2760 290 2470
204 Urin Bag Pcs 18 18 18
205 Usg Gel Botol 0 0 0
206 Vaksin Rabies Vero/ Verorab Paket 0 0 0
207 Vitamin B Kompleks Tablet 3647 3647 765 2882
208 Vitamin K Infant Inj Ampul 0 0 0
209 Water liquid (aqua P,I) Botol 42 42 42
210 Wing Needle No.21 Pcs 0 0 0
211 Wing Needle No.27 Pcs 0 0 0
212 Zinc Sulphate Suppositoria (Superhoid) Kapsul 0 0 0
213 Zinc tab Tablet 1000 1000 1000
214 Ondansetron iv/im 4 mg Ampul 10 10 10
215 Tranexamic Acid inj 5% Ampul 20 20 20
216 Poliwash 500 ml Botol 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
218 Sarung Tangan (Handscuun) L Pcs 1000 1000 1000
219 Cefotaxime Sodium inj 1 gr Vial 0 0 0
220 Methyl Prednisolon tab 16 mg Tablet 1000 1000 1000
221 Lancet Pcs 0 0 0
222 Strip Kolesterol Pcs 0 0 0
223 Strip Gula Darah Pcs 0 0 0
224 Strip Asam Urat Pcs 0 0 0
225 Nonwoven Fixation Rol Pcs 3 3 3
226 Paracetamol 1000 mg /100 ml Botol 0 0 0
227 Otsu D-40 25 ml Botol 0 0 0
228 Ketorolac inj 30 mg Ampul 0 0 0
229 Dulcolax tab Tablet 150 150 150
230 Ibuprofen 400 mg.1 Tablet 0 0 0
231 Permethrin (Scabimite Cream).1 Tube 0 0 0
232 Masker Plus Pcs 0 0 0
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

311 382 693

Nip. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP.19670512 198803 1 005 Nip.-
PUSKESMAS : PUSKESMAS RANTAU DURIAN PELAPORAN BULAN : JAN 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 233 233 3 230
2 Acetylcystein Kapsul 200mg Kapsul 0 0
3 Acyclovir tab 200 mg Tablet 1700 1700 102 1598
4 Acyclovir cream Tube 53 53 3 50
5 Albendazol tab 400 mg Tablet 990 990 990
7 Allopurinol 100 mg Tablet 2700 2700 430 2270
8 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0
9 Aminophylline tab 200 mg Tablet 1400 1400 1400
10 Amitriptyline 25 mg tab Tablet 1000 1000 1000
11 Amlodipine tab 5 mg Tablet 2400 2400 300 2100
12 Amoxycillin Syr Btl 181 120 301 32 269
15 Ampicilin 1 gr Inj Vial 0 0
18 Anti Bisa Ular 5 ml (ABU I)/ Biosave Vial 0 0
19 Asam Mefenamat 500 mg tab Tablet 1000 1000 1000
21 Ascorbic acid |calsium carbonate 500 mg (Pehavral) Tablet 0 0
22 Aspirin (miniaspi) 100 mg tab Tablet 0 0
23 Atropine inj 0,25 mg/ml Ampul 0 0
26 Automated blood grouping (Tes Gol. Darah) Paket 2 2 2
27 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0
29 Benzoic acid |salicylic acid salep (anti fungi) pot 290 290 14 276
30 Betahistine Mesylate 6 mg tab Tablet 1500 1500 205 1295
31 Betamethasone 0,1% krim Tube 162 162 162
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : JAN 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
33 Bismuth subgallas (antihemoroid) Supp 0 0
34 Calcium chloride lactate infus (RL) Botol 123 123 123
35 Calsium Laktat (Kalk) 500 mg Tablet 2800 1200 4000 240 3760
36 Captopril 12,5 mg Tablet 4800 800 5600 670 4930
37 Captopril 25 mg Tablet 3000 1600 4600 190 4410
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 187 187 11 176
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 87 87 3 84
41 Cefadroxil 500mg Tablet 0 0
42 Cetirizine 5 mg/5 ml sirup Botol 160 160 20 140
43 Chloramhenicol Salep Mata 1% Tube 167 167 16 151
44 Chloramphenicol Suspensi 125 mg/ml Btl 49 100 149 149
46 Chloramphenicol TT 3% Botol 0 0
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 194 194 19 175
49 Chlorpromazine HCl 100 mg Tablet 100 100 100
50 Cimetidin 200 tab Tablet 0 0
52 Ciprofloxacin Infus Botol 0 0
53 Clindamycin 300mg Kapsul 0 0
54 Cresol liquid 1 Liter (lysol) Botol 19 19 19
55 Cyanocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0
56 Devitalisasi pasta pot 0 0
57 Dexamethasone 0,5 mg Tablet 3000 3000 3000
58 Dexamethasone inj 5mg/ml-1ml Ampul 2 2 2
59 Diazepam 5mg/ml-2 ml inj Ampul 4 4 4
60 Diazepam 2 mg Tablet 0 0
62 Digoxin 0,25 mg Tablet 900 900 900
63 Dimenhydrinate 50mg Tablet 1100 1100 1100
64 Dipenhidramine HCl inj 10mg/ml Ampul 690 690 112 578
65 Domperidone 10 mg Tablet 3000 3000 260 2740
66 Doxycycline 100 mg Kapsul Kapsul 0 0
67 Epinephrine HCl/bitartrat inj 0,1% Ampul 78 78 78
68 Erythromicin Syr Btl 66 66 66
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
70 Ethacridine (Rivanol) 0,1% Btl 81 81 81
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 24 24 24
72 Eugenol cairan Btl 2 2 2
73 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 0
75 Folley Catheter No.16 Pcs 10 10 10
76 Furosemida Injeksi Ampul 20 20 20
77 Furosemida 40 mg Tablet 1550 1550 140 1410
79 Gentamicyn 0,3% TM Botol 96 96 96
80 Gentamicyn Inj 40 mg/ml Ampul 20 20 20
81 Gentamicyn 0,1% SK Tube 136 136 136
82 Glass lonomer Paket 2 2 2
83 Glibenclamide 5 mg Tablet 2500 2500 365 2135
84 Glimepiride 1 mg Tablet 2600 2600 270 2330
85 Glukosa larutan infus 10% Botol 0 0
86 Glukosa larutan infus 5% Botol 87 87 87
87 Griseofulvin 125 mg Tablet 3880 3880 425 3455
89 Haloperidol 0,5 mg tab Tablet 0 0
90 Haloperidol 5 mg tab Tablet 0 0
91 Human chorionic (HCG/Tes kehamilan ) Strip 52 52 29 23
92 Hydrochlorotiazide (HCT) 25 mg Tablet 700 700 700
93 Ibuprofen sirup Botol 120 120 7 113
94 Ibuprofen 200 mg Tablet 0 0
95 Ibuprofen 400 mg Tablet 0 0
96 Ichthyol salep 10% pot 0 0
97 Immunoglobulin human anti-tetanus (Tetagam) Ampul 3 3 3
98 Infus set dewasa Pcs 186 186 1 185
99 Infusi set anak Pcs 388 388 4 384
100 Iodium Povidon 10% 30 ml Botol 72 72 72
101 Isosorbide tablet Tablet 800 800 800
104 IV Catheter No.24 Pcs 132 132 132
105 Jarum Jahit Kulit Pcs 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
108 Kasa pembalut 2x80 Pcs 90 90 90
111 Kasa kompres 40/40 steril Pcs 198 198 198
112 Ketoconazole 200 mg Cream Tube 86 86 1 85
113 Ketoconazole 200 mg tab Tablet 2000 2000 575 1425
114 Klorokina Fosfat 250 mg Tablet 0 0
115 Levertran Salep/ Salep Luka Bakar pot 23 23 23
116 Lidocain 2% Ampul 0 0
118 Lidocaine spray (Xylocaine spray) Botol 1 1 1
119 Liquorice liquid extract (OBH) Botol 52 52 52
120 Locoriz Cream Tube 0 0
121 Loperamid 2 m tab Tablet 0 0
122 Loratadine 10 mg tab Tablet 4000 4000 514 3486
123 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 0
124 Magnesium Sulfat Injeksi 40% (MgSO4) Ampul 0 0
125 Masker Pcs 900 900 35 865
126 Medical adhesive tape (dermafix/leukomed) Pcs 85 85 85
127 Metamizole injeksi (antalgin 1000) Ampul 38 38 38
128 Metformin 500mg tab Tablet 1200 1200 30 1170
129 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0
130 Methyl Ergometrin Maleat 0,125 mg Tab 1500 1500 450 1050
132 Methyl Rosanilinium (gentian violet) Botol 46 46 3 43
133 Metronidazol 250 mg tab Tablet 0 0
135 Metronidazol Infus Botol 0 0
136 Metronidazol syr Botol 0 0
137 Miconazole 2% Salep Kulit Tube 83 83 83
138 Momilen Baby Gold Sirup Botol 0 0
139 Natrium Bikarbonat 500 mg Tablet 300 300 300
141 Nystatin Tab Vag 10.000 iu/g Tablet 540 540 34 506
142 Omeprazole inj Vial 27 27 27
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
143 Omeprazole kaps Kapsul 630 630 10 620
144 Oxytetracycline HCl 1% Salep Mata Tube 35 35 5 30
145 Oxytetracycline HCl 3% Salep Kulit Tube 0 0
146 Oxytocin inj 10 IU Ampul 70 70 70
147 Papaverin 40 mg tab Tablet 0 0
148 Papaverin inj Tablet 0 0
149 Paracetamol Drops 15 ml Botol 75 75 75
151 Parasetamol 500 mg Tablet 1700 5700 7400 1012 6388
152 Patient Lubricant (My Jelly ) Tube 9 9 9
153 Permethrin (Scabimite Cream) Tube 30 30 30
154 Phenobarbital inj 50mg/ml-2ml Ampul 90 90 90
155 Phenobarbital 100 mg Tablet 0 0
156 Phenol gliserol 10% TT Botol 143 143 19 124
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 0
158 Phytomenadione (Vit.K1) 10 mg Tablet 1151 1151 105 1046
159 Piracetam 400 mg Tablet 0 0
160 Piroxicam 20 mg tab Tablet 2300 2300 298 2002
161 Pisau Disposable (Mess No.14/21) Pcs 81 81 81
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 3 3 3
164 Povidon iodium 10% 300 ml Botol 44 44 44
165 Prednison 5 mg Tablet 0 0
166 Primaquin 15 mg tab Tablet 1900 1900 350 1550
167 Profolat tab Tablet 0 0
168 Prokaina Penisilin G inj 3.000.000 iu Ampul 0 0
171 Propylthiouracil 100 mg Tablet 500 500 500
172 Protein Gluco Test Strip 83 83 83
173 Pyrantel Pamoat 125 mg Tablet 0 0
174 Pyridoxine HCl 10 mg Tablet 1200 1200 1200
175 Ranitidin 150 mg Tablet 0 0
176 Ranitidin Injeksi Ampul 0 0
177 Retinol (Vit.A) kaps 100.000 iu Kapsul 0 0
178 Retinol (Vit.A) kaps 200.000 iu Kapsul 0 0
179 Risperidone 2mg Tablet 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 1500 1000 2500 2500
181 Salep 2-4 Kombinasi pot 0 0
182 Sarung tangan (HandScuun) No.7,5 Pcs 840 840 24 816
183 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0 0
184 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0
185 Sarung tangan (HandScuun Steril) No.7,5 Pcs 0 0
186 Semen Seng Fosfat Serbuk & Cairan Set 0 0
188 Silk (Benang Bedah) No. 3/0 Pcs 65 65 65
189 Silver Sulfadiazine Tube 20 20 20
190 Simvastatin 10 mg tab Tablet 2740 2740 796 1944
191 Sodium cloride infus 0,9% ( NACL ) Botol 34 34 34
192 Spuit 1 ml Pcs 1382 300 1682 1682
193 Spuit 3 ml Pcs 3350 1000 4350 476 3874
194 Spuit 5 ml Pcs 1555 1555 20 1535
195 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 0 0
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 208 208 11 197
197 Sulfasetamida 15% TM Botol 0 0
198 Tetracycline 250 mg Tablet 0 0
200 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0
202 Trihexyphenidyl tab 2 mg Tablet 500 500 500
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 3300 3300 540 2760
204 Urin Bag Pcs 18 18 18
205 Usg Gel Botol 0 0
206 Vaksin Rabies Vero/ Verorab Paket 0 0
207 Vitamin B Kompleks Tablet 2900 1500 4400 753 3647
208 Vitamin K Infant Inj Ampul 0 0
209 Water liquid (aqua P,I) Botol 42 42 42
210 Wing Needle No.21 Pcs 0 0
211 Wing Needle No.27 Pcs 0 0
212 Zinc Sulphate Suppositoria (Superhoid) Kapsul 0 0
213 Zinc tab Tablet 1000 1000 1000
214 Ondansetron iv/im 4 mg Ampul 10 10 10
215 Tranexamic Acid inj 5% Ampul 20 20 20
216 Poliwash 500 ml Botol 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
218 Sarung Tangan (Handscuun) L Pcs 500 500 1000 1000
219 Cefotaxime Sodium inj 1 gr Vial 0 0
220 Methyl Prednisolon tab 16 mg Tablet 1000 1000 1000
221 Lancet Pcs 0 0
222 Strip Kolesterol Pcs 0 0
223 Strip Gula Darah Pcs 0 0
224 Strip Asam Urat Pcs 0 0
225 Nonwoven Fixation Rol Pcs 3 3 3
226 Paracetamol 1000 mg /100 ml Botol 0 0
227 Otsu D-40 25 ml Botol 0 0
228 Ketorolac inj 30 mg Ampul 0 0
229 Dulcolax tab Tablet 150 150 150
230 Ibuprofen 400 mg.1 Tablet 0 0
231 Permethrin (Scabimite Cream).1 Tube 0 0
232 Masker Plus Pcs 0 0
233 0 0
234 0 0
235 0 0
236 0 0
237 0 0
238 0 0
239 0 0
240 0 0
241 0 0

163 224 387

Nip. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP.19670512 198803 1 005 Nip.-

LPLPO 2020 Puskemas

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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

H.Amir Syarifuddin,SKM,M.Kes Tumiran,AM.Kep

PUSKESMAS : PELAPORAN BULAN : NOPEMBER 2020 DOKUMEN NOMOR TANGGAL

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

PUSKESMAS : PELAPORAN BULAN : NOPEMBER 2020 DOKUMEN NOMOR TANGGAL

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

PUSKESMAS : PELAPORAN BULAN : NOPEMBER 2020 DOKUMEN NOMOR TANGGAL

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

PUSKESMAS : PELAPORAN BULAN : NOPEMBER 2020 DOKUMEN NOMOR TANGGAL

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

PUSKESMAS : PELAPORAN BULAN : NOPEMBER 2020 DOKUMEN NOMOR TANGGAL

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

PUSKESMAS : PELAPORAN BULAN : NOPEMBER 2020 DOKUMEN NOMOR TANGGAL

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

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

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

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