LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSKESMAS

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

STOK STOK STOK

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

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

1 Absorbent tipped applicator (alcohol swab) Pcs 0 100 100 20 80

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 10 10 6 4
7 Allopurinol 100 mg Tablet 2400 4000 6400 1990 4410
8 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0 0 0
9 Aminophylline tab 200 mg Tablet 0 0 0 0
10 Amitriptyline 25 mg tab Tablet 0 0 0 0
11 Amlodipine tab 5 mg Tablet 1860 2100 3960 380 3580
12 Amoxycillin Syr Btl 0 300 300 86 214
13 Amoxycillin 250 mg Kapsul 0 0 0 0
14 Amoxycillin 500 mg Kaptab 8950 12000 20950 3280 17670
15 Ampicilin 1 gr Inj Vial 0 0 0 0
16 Antasida Syr DOEN Btl 0 150 150 26 124
17 Antasida DOEN Kombinasi Tablet 7950 7400 15350 1900 13450
18 Anti Bisa Ular 5 ml (ABU I)/ Biosave Vial 0 0 0 0
19 Asam Mefenamat 500 mg tab Tablet 0 2000 2000 1150 850
20 Ascorbic acid (Vit.C) 50 mg Tablet 0 0 0 0
21 Ascorbic acid |calsium carbonate 500 mg (Pehavral) 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/Caviton) Pcs 0 0 0 0
28 Bedak Salisil 2% Btl 0 0 0 0
29 Benzoic acid |salicylic acid salep (anti fungi) pot 58 58 10 48
30 Betahistine Mesylate 6 mg tab Tablet 1860 3000 4860 1060 3800
31 Betamethasone 0,1% krim Tube 77 175 252 60 192
 HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : AGUSTUS 2020
STOK STOK STOK
NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12

32 Bisacodyl 5mg Tablet 0 0 0 0

33 Bismuth subgallas (antihemoroid) Supp 0 0 0 0
34 Calcium chloride lactate infus (RL) Botol 160 160 73 87
35 Calsium Laktat (Kalk) 500 mg Tablet 2170 1000 3170 1150 2020
36 Captopril 12,5 mg Tablet 0 0 0 0
37 Captopril 25 mg Tablet 0 0 0 0
38 Carbamazepin tab Tablet 1600 2000 3600 500 3100
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 75 75 37 38
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 123 48 171 18 153
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 47 48 95 18 77
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 40 96 136 13 123
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 0 0 0 0
49 Chlorpromazine HCl 100 mg Tablet 2100 2500 4600 600 4000
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 10 10 4 6
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 216 200 416 78 338
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 200 200 0 200
63 Dimenhydrinate 50mg Tablet 0 0 0 0
64 Dipenhidramine HCl inj 10mg/ml Ampul 0 0 0 0
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 92 72 164 65 99
 HALAMAN : 3 LPLPO No: 0 LAPORAN BULAN : AGUSTUS 2020
STOK STOK STOK
NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12

69 Erythromicin 500 mg capsul Kapsul 2680 2680 1235 1445

70 Ethacridine (Rivanol) 0,1% Btl 5 5 2 3
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 0 15 15 7 8
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 18 20 38 4 34
76 Furosemida Injeksi Ampul 0 0 0 0
77 Furosemida 40 mg Tablet 300 600 900 140 760
78 Garam Oralit Sachet 0 0 0 0
79 Gentamicyn 0,3% TM Botol 73 120 193 51 142
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 20 20 0 20
86 Glukosa larutan infus 5% Botol 56 56 29 27
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 1600 2000 3600 600 3000
91 Human chorionic (HCG/Tes kehamilan ) Strip 0 100 100 43 57
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
95 Ibuprofen 400 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 50 50 23 27
99 Infusi set anak Pcs 0 0 0 0
100 Iodium Povidon 10% 30 ml Botol 0 100 100 17 83
101 Isosorbide tablet Tablet 300 300 0 300
102 IV Catheter No.20 Pcs 117 100 217 25 192
103 IV Catheter No.22 Pcs 122 122 36 86
104 IV Catheter No.24 Pcs 113 100 213 29 184
105 Jarum Jahit Kulit Pcs 0 0 0 0
 HALAMAN : 4 LPLPO No: 0 LAPORAN BULAN : AGUSTUS 2020
STOK STOK STOK
NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12

106 Kalium Permanganat Serbuk pot 0 0 0 0

107 Kapas pembalut/Absorben 250 g Pcs 2 15 17 2 15
108 Kasa pembalut 2x80 Pcs 0 50 50 15 35
109 Kasa pembalut hidrofil 4 m x 15 cm Pcs 55 50 105 41 64
110 Kasa pembalut hidrofil 4 m x 3 cm Pcs 22 22 9 13
111 Kasa kompres 40/40 steril Pcs 86 86 12 74
112 Ketoconazole 200 mg Cream Tube 58 100 158 26 132
113 Ketoconazole 200 mg tab Tablet 30 30 30 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 0 0 0 0
124 Magnesium Sulfat Injeksi 40% (MgSO4) Ampul 0 0 0 0
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 3600 5000 8600 1320 7280
129 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0 0 0
130 Methyl Ergometrin Maleat 0,125 mg Tab 200 200 0 200
131 Methyl Prednisolon tab 4 mg Tablet 1310 3000 4310 1130 3180
132 Methyl Rosanilinium (gentian violet) Botol 0 0 0 0
133 Metronidazol 250 mg tab Tablet 0 0 0 0
134 Metronidazol 500 mg tab Tablet 0 0 0 0
135 Metronidazol Infus Botol 0 0 0 0
136 Metronidazol syr Botol 0 0 0 0
137 Miconazole 2% Salep Kulit Tube 79 96 175 35 140
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 110 110 0 110
142 Omeprazole inj Vial 0 0 0 0
 HALAMAN : 5 LPLPO No: 0 LAPORAN BULAN : AGUSTUS 2020
STOK STOK STOK
NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12

143 Omeprazole kaps Kapsul 0 0 0 0

144 Oxytetracycline HCl 1% Salep Mata Tube 58 100 158 0 158
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 207 300 507 88 419
151 Parasetamol 500 mg Tablet 8700 1000 9700 3700 6000
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 106 150 256 64 192
158 Phytomenadione (Vit.K1) 10 mg Tablet 1450 2000 3450 560 2890
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/Biosat) Ampul 0 0 0 0
164 Povidon iodium 10% 300 ml Botol 0 20 20 0 20
165 Prednison 5 mg Tablet 2410 4000 6410 2410 4000
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 100 100 0 100
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 190 2000 2190 1300 890
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 2000 2000 4000 0 4000
178 Retinol (Vit.A) kaps 200.000 iu Kapsul 3000 3000 6000 0 6000
179 Risperidone 2mg Tablet 1100 1500 2600 400 2200
 HALAMAN : 6 LPLPO No: 0 LAPORAN BULAN : AGUSTUS 2020
STOK STOK STOK
NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12

180 Salbutamol 2 mg Tablet 3270 4300 7570 1970 5600

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 2900 5000 7900 1950 5950
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 10 10 10 0
191 Sodium cloride infus 0,9% ( NACL ) Botol 58 58 10 48
192 Spuit 1 ml Pcs 0 0 0 0
193 Spuit 3 ml Pcs 0 1000 1000 370 630
194 Spuit 5 ml Pcs 0 1000 1000 230 770
195 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 0 0 0 0
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 214 300 514 93 421
197 Sulfasetamida 15% TM Botol 0 0 0 0
198 Tetracycline 250 mg Tablet 0 0 0 0
199 Tetracycline 500 mg Tablet 0 500 500 400 100
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 5600 6000 11600 1410 10190
204 Urin Bag Pcs 0 0 0 0
205 Usg Gel Botol 0 0 0 0
206 Vaksin Rabies Vero/ Verorab Paket 0 0 0 0
207 Vitamin B Kompleks Tablet 3500 5000 8500 2100 6400
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
211 Wing Needle No.27 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 15 15 4 11
215 Tranexamic Acid inj 5% Ampul 0 0 0 0
216 Poliwash 500 ml Botol 0 0 0 0
 HALAMAN : 7 LPLPO No: 0 LAPORAN BULAN : AGUSTUS 2020
STOK STOK STOK
NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12

217 Policlean Handrub Botol 0 0 0 0

218 Sarung Tangan (Handscuun) L Pcs 0 0 0 0
219 Cefotaxime Sodium inj 1 gr Vial 20 20 0 20
220 Methyl Prednisolon tab 16 mg Tablet 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 0 0 0 0
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 0 0 0 0
230 Ibuprofen 400 mg.1 Tablet 3380 3380 1670 1710
231 Permethrin (Scabimite Cream).1 Tube 0 0 0 0
232 Masker Plus Pcs 0 0 0 0
233
234
235
236
237
238
239
240
241

UMUM JAMSOSKES BPJS JUMLAH

JUMLAH KUNJUNGAN RESEP

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

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

Iwan Setiawan.SKM.M.Kes Himayanti.S.Si.,Apt TITIK SUSWATININGSIH, Am.Keb FRIDA ROSPITA PURBA

NIP. 197303051998031005 NIP. 197702212005012005 NIP. 19680713 198812 2 001 NIP. 19660317 198712 2 001