Lplpo 2020 Puskemas Ppii Waty Okeey

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) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Acetylcystein Kapsul 200mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Acyclovir tab 200 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Acyclovir cream 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Albendazol tab 400 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Alkohol Liquid (etanol) 70%-1000 ml 0 0 10 0 0 0 0 0 0 0 0 0 10 10
7 Allopurinol 100 mg 200 800 1000 0 0 0 0 500 0 0 0 0 2500 2500
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 200 0 0 0 200 100 0 0 0 0 0 0 500 500
10 Amitriptyline 25 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Amlodipine tab 5 mg 0 0 0 0 0 0 0 300 0 0 0 0 300 300
12 Amoxycillin Syr 50 100 100 140 20 30 60 50 0 0 0 0 550 550
13 Amoxycillin 250 mg 100 700 1000 500 100 100 500 0 0 0 0 0 3000 3000
14 Amoxycillin 500 mg 1000 2000 3000 2000 500 500 2000 2000 0 0 0 0 13000 13000
15 Ampicilin 1 gr Inj 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Antasida Syr DOEN 50 50 100 50 5 20 30 50 0 0 0 0 355 355
17 Antasida DOEN Kombinasi 500 3000 3000 2000 500 500 2000 1500 0 0 0 0 13000 13000
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 100 900 0 0 0 0 0 700 0 0 0 0 1700 1700
20 Ascorbic acid (Vit.C) 50 mg 0 500 1500 0 0 0 0 500 0 0 0 0 2500 2500
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) 200 200 0 500 100 100 0 0 0 0 0 0 1100 1100
25 Attapulgite Tablet 600 mg (New Antides) 200 0 0 0 0 0 0 0 0 0 0 0 200 200
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% 10 30 50 20 10 10 15 0 0 0 0 0 145 145
29 Benzoic acid |salicylic acid salep (anti fungi) 16 0 0 0 30 0 5 10 0 0 0 0 61 61
30 Betahistine Mesylate 6 mg tab 0 0 0 0 0 0 0 300 0 0 0 0 300 300
31 Betamethasone 0,1% krim 25 50 30 30 10 24 20 20 0 0 0 0 209 209
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) 10 0 0 0 0 0 0 10 0 0 0 0 20 20
34 Calcium chloride lactate infus (RL) 40 20 100 200 100 0 30 20 0 0 0 0 510 510
35 Calsium Laktat (Kalk) 500 mg 1500 3000 2000 2000 500 500 1000 1000 0 0 0 0 11500 11500
36 Captopril 12,5 mg 700 1000 1000 1000 100 200 1000 500 0 0 0 0 5500 5500
37 Captopril 25 mg 500 1000 1000 1500 200 300 1000 700 0 0 0 0 6200 6200
38 Carbamazepin tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0
39 Catgut/Benang Chromic Bedah No.2/0-3/0 0 0 10 40 0 10 0 12 0 0 0 0 72 72
40 Catgut/Benang Plain Bedah No.2/0-3/0 0 0 0 40 0 0 0 0 0 0 0 0 40 40
41 Cefadroxil 500mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
42 Cetirizine 5 mg/5 ml sirup 0 0 0 0 0 0 0 0 0 0 0 0 0 0
43 Chloramhenicol Salep Mata 1% 20 20 25 0 0 0 0 0 0 0 0 0 65 65
44 Chloramphenicol Suspensi 125 mg/ml 10 30 30 30 0 0 0 0 0 0 0 0 100 100
45 Chloramphenicol 250 mg caps 100 300 800 500 100 300 500 200 0 0 0 0 2800 2800
46 Chloramphenicol TT 3% 0 0 0 0 0 0 0 0 0 0 0 0 0 0
47 Chloramphenicol/ Hidrokortison krim 2,5% 20 30 30 48 20 24 100 10 0 0 0 0 282 282
48 Chlorpheniramine Maleat (CTM) 4 mg 1000 3000 2000 3000 0 500 2000 1000 0 0 0 0 12500 12500
49 Chlorpromazine HCl 100 mg 0 0 100 100 100 100 200 400 0 0 0 0 1000 1000
50 Cimetidin 200 tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0
51 Ciprofloxacin 500 mg tab 0 700 1500 2000 3500 0 0 0 0 0 0 0 7700 7700
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) 6 0 0 0 0 0 0 2 0 0 0 0 8 8
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 0 1000 500 500 2000 3000 0 0 0 0 7000 7000
58 Dexamethasone inj 5mg/ml-1ml 30 50 30 30 20 20 50 50 0 0 0 0 280 280
59 Diazepam 5mg/ml-2 ml inj 0 0 0 0 0 2 0 5 0 0 0 0 7 7
60 Diazepam 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
61 Diclofenac sodium 25 mg tab 1500 1000 2000 2000 500 200 1000 800 0 0 0 0 9000 9000
62 Digoxin 0,25 mg 300 0 0 0 100 200 0 0 0 0 0 0 600 600
63 Dimenhydrinate 50mg 100 0 0 0 0 0 0 100 0 0 0 0 200 200
64 Dipenhidramine HCl inj 10mg/ml 15 90 90 30 30 20 60 30 0 0 0 0 365 365
65 Domperidone 10 mg 500 1000 1000 0 200 100 500 500 0 0 0 0 3800 3800
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 10 10 10 20 0 10 6 0 0 0 0 0 66 66
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 100 100 600 100 100 100 300 200 0 0 0 0 1600 1600
70 Ethacridine (Rivanol) 0,1% 10 20 30 10 20 5 20 10 0 0 0 0 125 125
71 Ethanol ( Aseptan ) 500 cc+ Pump 5 6 4 0 0 0 0 3 0 0 0 0 18 18
72 Eugenol cairan 0 0 0 0 0 0 0 0 0 0 0 0 0 0
73 Ferrous fumarate ( Tab. Tambah Darah ) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
74 Folic acid 1mg ( asam folat) 400 0 0 0 0 0 0 100 0 0 0 0 500 500
75 Folley Catheter No.16 0 0 0 3 3 0 0 0 0 0 0 0 6 6
76 Furosemida Injeksi 0 0 5 5 30 0 0 0 0 0 0 0 40 40
77 Furosemida 40 mg 0 0 0 0 0 0 0 100 0 0 0 0 100 100
78 Garam Oralit 0 100 0 0 0 0 0 0 0 0 0 0 100 100
79 Gentamicyn 0,3% TM 10 50 20 25 10 5 30 20 0 0 0 0 170 170
80 Gentamicyn Inj 40 mg/ml 0 0 0 10 0 10 0 0 0 0 0 0 20 20
81 Gentamicyn 0,1% SK 30 60 48 10 20 5 21 0 0 0 0 0 194 194
82 Glass lonomer 0 0 0 0 0 0 0 0 0 0 0 0 0 0
83 Glibenclamide 5 mg 1000 1000 500 500 300 0 300 400 0 0 0 0 4000 4000
84 Glimepiride 1 mg 200 200 200 0 0 0 0 0 0 0 0 0 600 600
85 Glukosa larutan infus 10% 10 20 20 5 5 0 0 10 0 0 0 0 70 70
86 Glukosa larutan infus 5% 20 50 50 20 20 0 10 20 0 0 0 0 190 190
87 Griseofulvin 125 mg 500 500 2000 0 0 0 0 0 0 0 0 0 3000 3000
88 Guaifenesin 100 Tab (GG tab) 700 1000 2000 500 500 100 500 200 0 0 0 0 5500 5500
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 ) 0 100 0 0 0 0 0 0 0 0 0 0 100 100
92 Hydrochlorotiazide (HCT) 25 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
93 Ibuprofen sirup 10 50 20 50 20 10 10 5 0 0 0 0 175 175
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 10 70 100 20 10 0 20 30 0 0 0 0 260 260
99 Infusi set anak 0 50 30 30 20 10 10 10 0 0 0 0 160 160
100 Iodium Povidon 10% 30 ml 20 30 30 30 5 10 5 5 0 0 0 0 135 135
101 Isosorbide tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0
102 IV Catheter No.20 0 0 0 10 0 0 0 20 0 0 0 0 30 30
103 IV Catheter No.22 0 20 10 20 20 0 30 10 0 0 0 0 110 110
104 IV Catheter No.24 10 50 30 24 20 10 50 20 0 0 0 0 214 214
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 5 14 2 2 2 5 5 0 0 0 0 36 36
108 Kasa pembalut 2x80 5 10 15 0 5 5 10 10 0 0 0 0 60 60
109 Kasa pembalut hidrofil 4 m x 15 cm 20 100 100 20 20 0 15 50 0 0 0 0 325 325
110 Kasa pembalut hidrofil 4 m x 3 cm 100 100 75 100 0 10 50 0 0 0 0 0 435 435
111 Kasa kompres 40/40 steril 30 50 100 20 20 20 20 50 0 0 0 0 310 310
112 Ketoconazole 200 mg Cream 10 50 20 5 10 10 0 5 0 0 0 0 110 110
113 Ketoconazole 200 mg tab 700 1000 1000 300 500 100 400 100 0 0 0 0 4100 4100
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 10 22 0 0 0 0 0 0 0 0 0 0 32 32
116 Lidocain 2% 0 0 0 0 0 0 0 0 0 0 0 0 0 0
117 Lidokain Comp. inj Kombinasi 20 90 60 30 0 20 30 36 0 0 0 0 286 286
118 Lidocaine spray (Xylocaine spray) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
119 Liquorice liquid extract (OBH) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
120 Locoriz Cream 0 0 0 0 0 0 0 0 0 0 0 0 0 0
121 Loperamid 2 m tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0
122 Loratadine 10 mg tab 400 500 500 500 300 100 200 300 0 0 0 0 2800 2800
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 0 0 0 0 0 0 0 0 0 0 0 0 0 0
126 Medical adhesive tape (dermafix/leukomed) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
127 Metamizole injeksi (antalgin 1000) 10 20 10 20 10 0 10 10 0 0 0 0 90 90
128 Metformin 500mg tab 0 1000 1000 1000 200 0 300 500 0 0 0 0 4000 4000
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 0 500 200 500 200 100 500 500 0 0 0 0 2500 2500
131 Methyl Prednisolon tab 4 mg 500 2500 0 0 0 0 2000 800 0 0 0 0 5800 5800
132 Methyl Rosanilinium (gentian violet) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
133 Metronidazol 250 mg tab 0 100 700 0 0 0 0 0 0 0 0 0 800 800
134 Metronidazol 500 mg tab 500 1000 1000 1000 300 100 500 300 0 0 0 0 4700 4700
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 25 20 20 24 20 10 16 10 0 0 0 0 145 145
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 0 300 200 100 0 0 0 0 0 0 0 600 600
140 Nifedipin 10 mg tab 0 500 500 300 0 0 300 0 0 0 0 0 1600 1600
141 Nystatin Tab Vag 10.000 iu/g 0 30 70 0 0 0 40 40 0 0 0 0 180 180
142 Omeprazole inj 0 0 0 2 5 0 8 0 0 0 0 0 15 15
STOK JUMLAH
PENGAMAN RENCANA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
143 Omeprazole kaps 0 0 0 0 0 0 0 0 0 0 0 0 0 0
144 Oxytetracycline HCl 1% Salep Mata 0 20 20 0 0 11 0 0 0 0 0 0 51 51
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 20 0 0 0 0 12 0 0 0 0 0 32 32
150 Parasetamol 120 mg/5 ml Syr 50 150 150 100 20 20 50 30 0 0 0 0 570 570
151 Parasetamol 500 mg 2000 5000 5000 3000 1000 500 3000 3000 0 0 0 0 22500 22500
152 Patient Lubricant (My Jelly ) 0 2 0 0 0 0 0 0 0 0 0 0 2 2
153 Permethrin (Scabimite Cream) 30 30 0 0 0 0 0 0 0 0 0 0 60 60
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 10 30 10 20 10 2 5 0 0 0 0 0 87 87
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 200 200 0 500 200 100 200 500 0 0 0 0 1900 1900
159 Piracetam 400 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
160 Piroxicam 20 mg tab 2000 1000 1000 0 0 0 0 0 0 0 0 0 4000 4000
161 Pisau Disposable (Mess No.14/21) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
162 Plesterku (Leukoplast) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
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 5 5 0 0 0 0 0 0 0 0 0 0 10 10
165 Prednison 5 mg 2000 2000 2000 1000 400 500 3000 2000 0 0 0 0 12900 12900
166 Primaquin 15 mg tab 0 0 200 0 0 0 100 0 0 0 0 0 300 300
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 0 0 0 0 0 0 0 0 0 0 0 0
170 Propranolol HCl 40 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
171 Propylthiouracil 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0
172 Protein Gluco Test 0 0 20 10 20 20 20 10 0 0 0 0 100 100
173 Pyrantel Pamoat 125 mg 200 500 200 0 200 0 100 0 0 0 0 0 1200 1200
174 Pyridoxine HCl 10 mg 1200 1000 500 1000 1000 200 1000 500 0 0 0 0 6400 6400
175 Ranitidin 150 mg 500 0 0 0 0 0 0 0 0 0 0 0 500 500
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 1000 2000 1500 2000 500 300 500 1000 0 0 0 0 8800 8800
181 Salep 2-4 Kombinasi 10 24 27 0 0 0 10 10 0 0 0 0 81 81
182 Sarung tangan (HandScuun) No.7,5 0 500 200 400 300 0 0 0 0 0 0 0 1400 1400
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 80 0 0 0 0 0 0 0 0 0 0 0 80 80
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 500 1000 1000 1000 200 200 0 800 0 0 0 0 4700 4700
188 Silk (Benang Bedah) No. 3/0 0 0 0 15 0 0 28 0 0 0 0 0 43 43
189 Silver Sulfadiazine 0 0 0 3 0 0 0 0 0 0 0 0 3 3
190 Simvastatin 10 mg tab 700 2000 1000 600 500 300 0 600 0 0 0 0 5700 5700
191 Sodium cloride infus 0,9% ( NACL ) 40 0 0 10 20 20 0 20 0 0 0 0 110 110
192 Spuit 1 ml 100 1000 0 100 0 0 100 100 0 0 0 0 1400 1400
193 Spuit 3 ml 500 1200 500 500 200 100 200 300 0 0 0 0 3500 3500
194 Spuit 5 ml 500 500 500 200 200 100 100 300 0 0 0 0 2400 2400
195 Sulfadoxine | Pyrimethamine Tablet 500mg| 100 0 500 0 0 0 0 0 0 0 0 0 600 600
196 Sulfamethoxazole | trimethoprim (cotri) syr 20 0 50 20 0 0 0 20 0 0 0 0 110 110
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 200 800 2000 0 0 0 0 500 0 0 0 0 3500 3500
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 1000 1000 3000 0 0 0 0 800 0 0 0 0 5800 5800
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 0 2000 2000 2000 500 500 2000 1000 0 0 0 0 10000 10000
204 Urin Bag 0 0 0 3 2 0 0 0 0 0 0 0 5 5
205 Usg Gel 0 0 0 0 2 3 2 1 0 0 0 0 8 8
206 Vaksin Rabies Vero/ Verorab 0 0 0 0 0 0 0 0 0 0 0 0 0 0
207 Vitamin B Kompleks 2000 3000 2000 2000 500 500 2000 2000 0 0 0 0 14000 14000
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) 10 20 20 0 5 0 10 10 0 0 0 0 75 75
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 200 1000 500 1000 500 200 200 500 0 0 0 0 4100 4100
214 Ondansetron iv/im 4 mg 0 0 0 0 0 0 0 5 0 0 0 0 5 5
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 4 0 0 0 0 0 0 0 0 4 4
218 Sarung Tangan (Handscuun) L 0 0 0 0 0 0 0 0 0 0 0 0 0 0
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 1900 0 0 0 0 0 0 0 0 0 0 0 1900 1900
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 1 1 0 0 0 0 0 2 2
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 0 0 0 0 0 0 0 0 0 0 0 0
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
2616
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 : PEMATANG PANGGANG II TAHUN : 2020
KECAMATAN : MESUJI MAKMUR
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 0 0 0 0 0
2 Acetylcystein Kapsul 200mg Kapsul 0 0 0 0 0
3 Acyclovir tab 200 mg Tablet 0 0 0 0 0
4 Acyclovir cream Tube 0 0 0 0 0
5 Albendazol tab 400 mg Tablet 0 0 0 0 0
6 Alkohol Liquid (etanol) 70%-1000 ml Btl 10 0 10 0 0
7 Allopurinol 100 mg Tablet 2000 10000 2500 9500 9500
8 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 120 0 120 120
9 Aminophylline tab 200 mg Tablet 100 400 500 0 0
10 Amitriptyline 25 mg tab Tablet 0 0 0 0 0
11 Amlodipine tab 5 mg Tablet 0 5100 300 4800 4800
12 Amoxycillin Syr Btl 10 960 550 420 420
13 Amoxycillin 250 mg Kapsul 500 6500 3000 4000 4000
14 Amoxycillin 500 mg Kaptab 5000 21000 13000 13000 13000
15 Ampicilin 1 gr Inj Vial 0 0 0 0 0
16 Antasida Syr DOEN Btl 50 550 355 245 245
17 Antasida DOEN Kombinasi Tablet 500 26000 13000 13500 13500
18 Anti Bisa Ular 5 ml (ABU I)/ Biosave Vial 0 0 0 0 0
19 Asam Mefenamat 500 mg tab Tablet 0 3000 1700 1300 1300
20 Ascorbic acid (Vit.C) 50 mg Tablet 2000 5000 2500 4500 4500
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 3800 0 1100 2700 2700
25 Attapulgite Tablet 600 mg (New Antides) Tablet 200 0 200 0 0
26 Automated blood grouping (Tes Gol. Darah) Paket 0 0 0 0 0
27 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0 0 0 0
28 Bedak Salisil 2% Btl 30 120 145 5 5
29 Benzoic acid |salicylic acid salep (anti fungi) pot 16 120 61 75 75
30 Betahistine Mesylate 6 mg tab Tablet 0 5000 300 4700 4700
31 Betamethasone 0,1% krim Tube 17 350 209 158 158
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 10 50 20 40 40
34 Calcium chloride lactate infus (RL) Botol 60 700 510 250 250
35 Calsium Laktat (Kalk) 500 mg Tablet 3500 17000 11500 9000 9000
36 Captopril 12,5 mg Tablet 5500 4500 5500 4500 4500
37 Captopril 25 mg Tablet 3800 6200 6200 3800 3800
38 Carbamazepin tab Tablet 0 0 0 0 0
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 72 0 72 0 0
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 63 120 40 143 143
41 Cefadroxil 500mg Tablet 0 0 0 0 0
42 Cetirizine 5 mg/5 ml sirup Botol 0 0 0 0 0
43 Chloramhenicol Salep Mata 1% Tube 65 216 65 216 216
44 Chloramphenicol Suspensi 125 mg/ml Btl 0 100 100 0 0
45 Chloramphenicol 250 mg caps Tablet 0 4500 2800 1700 1700
46 Chloramphenicol TT 3% Botol 0 0 0 0 0
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 48 528 282 294 294
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 0 16500 12500 4000 4000
49 Chlorpromazine HCl 100 mg Tablet 0 5600 1000 4600 4600
50 Cimetidin 200 tab Tablet 0 0 0 0 0
51 Ciprofloxacin 500 mg tab Tablet 7700 0 7700 0 0
52 Ciprofloxacin Infus Botol 0 0 0 0 0
53 Clindamycin 300mg Kapsul 0 0 0 0 0
54 Cresol liquid 1 Liter (lysol) Botol 6 10 8 8 8
55 Cyanocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0 0 0 0
56 Devitalisasi pasta pot 0 0 0 0 0
57 Dexamethasone 0,5 mg Tablet 0 20000 7000 13000 13000
58 Dexamethasone inj 5mg/ml-1ml Ampul 30 530 280 280 280
59 Diazepam 5mg/ml-2 ml inj Ampul 0 10 7 3 3
60 Diazepam 2 mg Tablet 0 0 0 0 0
61 Diclofenac sodium 25 mg tab Tablet 2300 9700 9000 3000 3000
62 Digoxin 0,25 mg Tablet 500 800 600 700 700
63 Dimenhydrinate 50mg Tablet 200 0 200 0 0
64 Dipenhidramine HCl inj 10mg/ml Ampul 60 750 365 445 445
65 Domperidone 10 mg Tablet 1900 7500 3800 5600 5600
66 Doxycycline 100 mg Kapsul Kapsul 0 0 0 0 0
67 Epinephrine HCl/bitartrat inj 0,1% Ampul 0 0 0 0 0
68 Erythromicin Syr Btl 0 96 66 30 30
HALAMAN : 3
DES 2019 DES 2019
1 2 3 4 5 6 7 8 9 10 11 12
69 Erythromicin 500 mg capsul Kapsul 0 2800 1600 1200 1200
70 Ethacridine (Rivanol) 0,1% Btl 75 72 125 22 22
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 5 20 18 7 7
72 Eugenol cairan Btl 0 0 0 0 0
73 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 9990 0 9990 9990
74 Folic acid 1mg ( asam folat) Tablet 400 0 500 -100 -100
75 Folley Catheter No.16 Pcs 0 30 6 24 24
76 Furosemida Injeksi Ampul 40 0 40 0 0
77 Furosemida 40 mg Tablet 0 5000 100 4900 4900
78 Garam Oralit Sachet 200 0 100 100 100
79 Gentamicyn 0,3% TM Botol 0 456 170 286 286
80 Gentamicyn Inj 40 mg/ml Ampul 20 0 20 0 0
81 Gentamicyn 0,1% SK Tube 26 168 194 0 0
82 Glass lonomer Paket 0 0 0 0 0
83 Glibenclamide 5 mg Tablet 4000 4600 4000 4600 4600
84 Glimepiride 1 mg Tablet 600 2000 600 2000 2000
85 Glukosa larutan infus 10% Botol 0 200 70 130 130
87 Griseofulvin 125 mg Tablet 3000 0 3000 0 0
88 Guaifenesin 100 Tab (GG tab) Tablet 5500 0 5500 0 0
89 Haloperidol 0,5 mg tab Tablet 0 0 0 0 0
90 Haloperidol 5 mg tab Tablet 0 1000 0 1000 1000
91 Human chorionic (HCG/Tes kehamilan ) Strip 0 100 100 0 0
92 Hydrochlorotiazide (HCT) 25 mg Tablet 0 0 0 0 0
93 Ibuprofen sirup Botol 0 200 175 25 25
94 Ibuprofen 200 mg Tablet 0 0 0 0 0
96 Ichthyol salep 10% pot 0 0 0 0 0
97 Immunoglobulin human anti-tetanus (Tetagam) Ampul 0 0 0 0 0
98 Infus set dewasa Pcs 260 0 260 0 0
99 Infusi set anak Pcs 0 350 160 190 190
100 Iodium Povidon 10% 30 ml Botol 60 175 135 100 100
101 Isosorbide tablet Tablet 0 1000 0 1000 1000
102 IV Catheter No.20 Pcs 20 200 30 190 190
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 10 55 36 29 29
108 Kasa pembalut 2x80 Pcs 13 137 60 90 90
109 Kasa pembalut hidrofil 4 m x 15 cm Pcs 145 400 325 220 220
111 Kasa kompres 40/40 steril Pcs 100 300 310 90 90
112 Ketoconazole 200 mg Cream Tube 5 150 110 45 45
113 Ketoconazole 200 mg tab Tablet 2500 4500 4100 2900 2900
114 Klorokina Fosfat 250 mg Tablet 0 0 0 0 0
115 Levertran Salep/ Salep Luka Bakar pot 32 0 32 0 0
116 Lidocain 2% Ampul 0 0 0 0 0
117 Lidokain Comp. inj Kombinasi Ampul 46 240 286 0 0
118 Lidocaine spray (Xylocaine spray) Botol 0 0 0 0 0
119 Liquorice liquid extract (OBH) Botol 0 0 0 0 0
120 Locoriz Cream Tube 0 0 0 0 0
121 Loperamid 2 m tab Tablet 0 0 0 0 0
122 Loratadine 10 mg tab Tablet 3400 0 2800 600 600
123 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 0 0 0 0
125 Masker Pcs 0 0 0 0 0
126 Medical adhesive tape (dermafix/leukomed) Pcs 0 0 0 0 0
127 Metamizole injeksi (antalgin 1000) Ampul 90 0 90 0 0
128 Metformin 500mg tab Tablet 0 12000 4000 8000 8000
129 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0 0 0 0
130 Methyl Ergometrin Maleat 0,125 mg Tab 0 5000 2500 2500 2500
131 Methyl Prednisolon tab 4 mg Tablet 0 12000 5800 6200 6200
132 Methyl Rosanilinium (gentian violet) Botol 0 0 0 0 0
133 Metronidazol 250 mg tab Tablet 800 0 800 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 21 216 145 92 92
138 Momilen Baby Gold Sirup Botol 0 0 0 0 0
139 Natrium Bikarbonat 500 mg Tablet 700 0 600 100 100
140 Nifedipin 10 mg tab Kapsul 2000 0 1600 400 400
141 Nystatin Tab Vag 10.000 iu/g Tablet 0 300 180 120 120
142 Omeprazole inj Vial 15 0 15 0 0
HALAMAN : 5
DES 2019 DES 2019
1 2 3 4 5 6 7 8 9 10 11 12
143 Omeprazole kaps Kapsul 0 0 0 0 0
144 Oxytetracycline HCl 1% Salep Mata Tube 51 150 51 150 150
145 Oxytetracycline HCl 3% Salep Kulit Tube 0 0 0 0 0
146 Oxytocin inj 10 IU Ampul 0 0 0 0 0
147 Papaverin 40 mg tab Tablet 0 0 0 0 0
148 Papaverin inj Tablet 0 0 0 0 0
149 Paracetamol Drops 15 ml Botol 32 0 32 0 0
150 Parasetamol 120 mg/5 ml Syr Botol 50 800 570 280 280
151 Parasetamol 500 mg Tablet 0 39500 22500 17000 17000
152 Patient Lubricant (My Jelly ) Tube 4 0 2 2 2
153 Permethrin (Scabimite Cream) Tube 60 0 60 0 0
154 Phenobarbital inj 50mg/ml-2ml Ampul 0 0 0 0 0
155 Phenobarbital 100 mg Tablet 0 0 0 0 0
156 Phenol gliserol 10% TT Botol 7 96 87 16 16
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 120 0 120 120
158 Phytomenadione (Vit.K1) 10 mg Tablet 2600 3800 1900 4500 4500
159 Piracetam 400 mg Tablet 0 0 0 0 0
160 Piroxicam 20 mg tab Tablet 4000 0 4000 0 0
161 Pisau Disposable (Mess No.14/21) Pcs 0 0 0 0 0
162 Plesterku (Leukoplast) Pcs 0 0 0 0 0
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat Ampul 0 0 0 0 0
164 Povidon iodium 10% 300 ml Botol 10 10 10 10 10
165 Prednison 5 mg Tablet 0 21000 12900 8100 8100
166 Primaquin 15 mg tab Tablet 700 0 300 400 400
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 0 0 0 0 0
171 Propylthiouracil 100 mg Tablet 0 0 0 0 0
172 Protein Gluco Test Strip 0 100 100 0 0
173 Pyrantel Pamoat 125 mg Tablet 1800 0 1200 600 600
174 Pyridoxine HCl 10 mg Tablet 1200 11500 6400 6300 6300
175 Ranitidin 150 mg Tablet 500 0 500 0 0
176 Ranitidin Injeksi Ampul 0 0 0 0 0
177 Retinol (Vit.A) kaps 100.000 iu Kapsul 0 3000 0 3000 3000
179 Risperidone 2mg Tablet 0 1000 0 1000 1000
HALAMAN : 6
DES 2019 DES 2019
1 2 3 4 5 6 7 8 9 10 11 12
180 Salbutamol 2 mg Tablet 5900 13600 8800 10700 10700
181 Salep 2-4 Kombinasi pot 61 96 81 76 76
182 Sarung tangan (HandScuun) No.7,5 Pcs 500 900 1400 0 0
183 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0 0 0 0 0
184 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0 0 0 0
185 Sarung tangan (HandScuun Steril) No.7,5 Pcs 80 0 80 0 0
186 Semen Seng Fosfat Serbuk & Cairan Set 0 0 0 0 0
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 3200 5000 4700 3500 3500
188 Silk (Benang Bedah) No. 3/0 Pcs 43 144 43 144 144
189 Silver Sulfadiazine Tube 3 0 3 0 0
190 Simvastatin 10 mg tab Tablet 3400 4800 5700 2500 2500
191 Sodium cloride infus 0,9% ( NACL ) Botol 40 200 110 130 130
192 Spuit 1 ml Pcs 600 1500 1400 700 700
193 Spuit 3 ml Pcs 500 4000 3500 1000 1000
194 Spuit 5 ml Pcs 800 3200 2400 1600 1600
195 Sulfadoxine | Pyrimethamine Tablet 500mg|25 Tablet 0 600 600 0 0
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 90 300 110 280 280
197 Sulfasetamida 15% TM Botol 0 0 0 0 0
198 Tetracycline 250 mg Tablet 0 0 0 0 0
200 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0 0 0 0
201 Thiamine HCl (Vit B1) 50 mg Tablet 0 15000 5800 9200 9200
202 Trihexyphenidyl tab 2 mg Tablet 0 0 0 0 0
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 0 19000 10000 9000 9000
204 Urin Bag Pcs 0 30 5 25 25
205 Usg Gel Botol 0 10 8 2 2
206 Vaksin Rabies Vero/ Verorab Paket 0 0 0 0 0
207 Vitamin B Kompleks Tablet 4500 17500 14000 8000 8000
208 Vitamin K Infant Inj Ampul 0 0 0 0 0
209 Water liquid (aqua P,I) Botol 10 90 75 25 25
210 Wing Needle No.21 Pcs 0 0 0 0 0
212 Zinc Sulphate Suppositoria (Superhoid) Kapsul 0 0 0 0 0
213 Zinc tab Tablet 7700 0 4100 3600 3600
214 Ondansetron iv/im 4 mg Ampul 0 100 5 95 95
215 Tranexamic Acid inj 5% Ampul 0 0 0 0 0
216 Poliwash 500 ml Botol 1900 0 0 1900 1900
HALAMAN : 7
DES 2019 DES 2019
1 2 3 4 5 6 7 8 9 10 11 12
217 Policlean Handrub Botol
218 Sarung Tangan (Handscuun) L Pcs
219 Cefotaxime Sodium inj 1 gr Vial
220 Methyl Prednisolon tab 16 mg Tablet
221 Lancet Pcs
222 Strip Kolesterol Pcs
223 Strip Gula Darah Pcs
224 Strip Asam Urat Pcs
225 Nonwoven Fixation Rol Pcs
226 Paracetamol 1000 mg /100 ml Botol
227 Otsu D-40 25 ml Botol
228 Ketorolac inj 30 mg Ampul
229 Dulcolax tab Tablet
230 Ibuprofen 400 mg.1 Tablet
231 Permethrin (Scabimite Cream).1 Tube
232 Masker Plus Pcs
Mengetahui/ Menyetujui Yang Membuat

Pimpinan Puskesmas SAKSI - SAKSI Pengelola Obat Puskesmas
1 2
..................................... .....................................
..................................... .....................................
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTA
PUSKESMAS : PEMATANG PANGGANG II PELAPORAN BULAN
KECAMATAN : MESUJI MAKMUR PERMINTAAN BULAN
STOK
NO. NAMA OBAT SATUAN PENERIMAAN
AWAL
1 2 3 4 5
1 Absorbent tipped applicator (alcohol swab) Pcs 0
2 Acetylcystein Kapsul 200mg Kapsul 0
3 Acyclovir tab 200 mg Tablet 600
4 Acyclovir cream Tube 0
5 Albendazol tab 400 mg Tablet 0
6 Alkohol Liquid (etanol) 70%-1000 ml Btl 10
7 Allopurinol 100 mg Tablet 7000
8 Aminophylline Inj 24 mg/ml-10 ml Ampul 0
9 Aminophylline tab 200 mg Tablet 300
10 Amitriptyline 25 mg tab Tablet 0
11 Amlodipine tab 5 mg Tablet 400
12 Amoxycillin Syr Btl 160
13 Amoxycillin 250 mg Kapsul 500
14 Amoxycillin 500 mg Kaptab 10000
15 Ampicilin 1 gr Inj Vial 0
16 Antasida Syr DOEN Btl 100
17 Antasida DOEN Kombinasi Tablet 6000
18 Anti Bisa Ular 5 ml (ABU I)/ Biosave Vial 0
19 Asam Mefenamat 500 mg tab Tablet 0
20 Ascorbic acid (Vit.C) 50 mg Tablet 2400
21 Ascorbic acid |calsium carbonate 500 mg (Peh Tablet 0
22 Aspirin (miniaspi) 100 mg tab Tablet 0
23 Atropine inj 0,25 mg/ml Ampul 28
24 Attapulgite Tablet (Pularex) Tablet 4400
25 Attapulgite Tablet 600 mg (New Antides) Tablet 400
26 Automated blood grouping (Tes Gol. Darah) Paket 1
27 Bahan Tambal Gigi Sementara (Fletcher/Cavit Pcs 0
28 Bedak Salisil 2% Btl 60
29 Benzoic acid |salicylic acid salep (anti fungi) pot 16
30 Betahistine Mesylate 6 mg tab Tablet 0
31 Betamethasone 0,1% krim Tube 67
STOK
AWAL
1 2 3 4 5
32 Bisacodyl 5mg Tablet 0
33 Bismuth subgallas (antihemoroid) Supp 10
34 Calcium chloride lactate infus (RL) Botol 180
35 Calsium Laktat (Kalk) 500 mg Tablet 6500
36 Captopril 12,5 mg Tablet 8500
37 Captopril 25 mg Tablet 5800
38 Carbamazepin tab Tablet 0
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 96
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 87
41 Cefadroxil 500mg Tablet 0
42 Cetirizine 5 mg/5 ml sirup Botol 0
43 Chloramhenicol Salep Mata 1% Tube 90
44 Chloramphenicol Suspensi 125 mg/ml Btl 0
45 Chloramphenicol 250 mg caps Tablet 700
46 Chloramphenicol TT 3% Botol 0
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 96
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 5000
49 Chlorpromazine HCl 100 mg Tablet 0
50 Cimetidin 200 tab Tablet 0
51 Ciprofloxacin 500 mg tab Tablet 8700
52 Ciprofloxacin Infus Botol 0
53 Clindamycin 300mg Kapsul 0
54 Cresol liquid 1 Liter (lysol) Botol 9
55 Cyanocobalamin (Vit B12) inj 500 mcg/ml Ampul 0
56 Devitalisasi pasta pot 0
57 Dexamethasone 0,5 mg Tablet 0
58 Dexamethasone inj 5mg/ml-1ml Ampul 180
59 Diazepam 5mg/ml-2 ml inj Ampul 0
60 Diazepam 2 mg Tablet 0
61 Diclofenac sodium 25 mg tab Tablet 4300
62 Digoxin 0,25 mg Tablet 1000
63 Dimenhydrinate 50mg Tablet 200
64 Dipenhidramine HCl inj 10mg/ml Ampul 160
65 Domperidone 10 mg Tablet 5900
66 Doxycycline 100 mg Kapsul Kapsul 0
67 Epinephrine HCl/bitartrat inj 0,1% Ampul 60
68 Erythromicin Syr Btl 0
STOK
AWAL
1 2 3 4 5
69 Erythromicin 500 mg capsul Kapsul 200
70 Ethacridine (Rivanol) 0,1% Btl 95
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 13
72 Eugenol cairan Btl 0
73 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0
74 Folic acid 1mg ( asam folat) Tablet 400
75 Folley Catheter No.16 Pcs 0
76 Furosemida Injeksi Ampul 40
77 Furosemida 40 mg Tablet 0
78 Garam Oralit Sachet 200
79 Gentamicyn 0,3% TM Botol 0
80 Gentamicyn Inj 40 mg/ml Ampul 20
81 Gentamicyn 0,1% SK Tube 76
82 Glass lonomer Paket 0
83 Glibenclamide 5 mg Tablet 4100
84 Glimepiride 1 mg Tablet 700
85 Glukosa larutan infus 10% Botol 0
86 Glukosa larutan infus 5% Botol 60
87 Griseofulvin 125 mg Tablet 4000
88 Guaifenesin 100 Tab (GG tab) Tablet 6500
89 Haloperidol 0,5 mg tab Tablet 0
90 Haloperidol 5 mg tab Tablet 0
91 Human chorionic (HCG/Tes kehamilan ) Strip 30
92 Hydrochlorotiazide (HCT) 25 mg Tablet 0
93 Ibuprofen sirup Botol 0
94 Ibuprofen 200 mg Tablet 0
95 Ibuprofen 400 mg Tablet 0
96 Ichthyol salep 10% pot 0
97 Immunoglobulin human anti-tetanus (Tetaga Ampul 0
98 Infus set dewasa Pcs 280
99 Infusi set anak Pcs 0
100 Iodium Povidon 10% 30 ml Botol 80
101 Isosorbide tablet Tablet 0
102 IV Catheter No.20 Pcs 25
105 Jarum Jahit Kulit Pcs 0
STOK
AWAL
1 2 3 4 5
106 Kalium Permanganat Serbuk pot 0
107 Kapas pembalut/Absorben 250 g Pcs 15
108 Kasa pembalut 2x80 Pcs 20
109 Kasa pembalut hidrofil 4 m x 15 cm Pcs 170
110 Kasa pembalut hidrofil 4 m x 3 cm Pcs 175
111 Kasa kompres 40/40 steril Pcs 100
112 Ketoconazole 200 mg Cream Tube 35
113 Ketoconazole 200 mg tab Tablet 3000
114 Klorokina Fosfat 250 mg Tablet 0
115 Levertran Salep/ Salep Luka Bakar pot 52
116 Lidocain 2% Ampul 0
117 Lidokain Comp. inj Kombinasi Ampul 246
118 Lidocaine spray (Xylocaine spray) Botol 0
119 Liquorice liquid extract (OBH) Botol 0
120 Locoriz Cream Tube 0
121 Loperamid 2 m tab Tablet 4200
122 Loratadine 10 mg tab Tablet 4000
123 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0
124 Magnesium Sulfat Injeksi 40% (MgSO4) Ampul 0
125 Masker Pcs 0
126 Medical adhesive tape (dermafix/leukomed) Pcs 0
127 Metamizole injeksi (antalgin 1000) Ampul 90
128 Metformin 500mg tab Tablet 200
129 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0
130 Methyl Ergometrin Maleat 0,125 mg Tab 100
131 Methyl Prednisolon tab 4 mg Tablet 0
132 Methyl Rosanilinium (gentian violet) Botol 0
133 Metronidazol 250 mg tab Tablet 1000
134 Metronidazol 500 mg tab Tablet 3500
135 Metronidazol Infus Botol 0
136 Metronidazol syr Botol 0
137 Miconazole 2% Salep Kulit Tube 51
138 Momilen Baby Gold Sirup Botol 0
139 Natrium Bikarbonat 500 mg Tablet 1000
140 Nifedipin 10 mg tab Kapsul 4000
141 Nystatin Tab Vag 10.000 iu/g Tablet 40
142 Omeprazole inj Vial 15
STOK
AWAL
1 2 3 4 5
143 Omeprazole kaps Kapsul 1110
144 Oxytetracycline HCl 1% Salep Mata Tube 76
145 Oxytetracycline HCl 3% Salep Kulit Tube 0
146 Oxytocin inj 10 IU Ampul 0
147 Papaverin 40 mg tab Tablet 0
148 Papaverin inj Tablet 0
149 Paracetamol Drops 15 ml Botol 62
150 Parasetamol 120 mg/5 ml Syr Botol 200
151 Parasetamol 500 mg Tablet 7000
152 Patient Lubricant (My Jelly ) Tube 6
153 Permethrin (Scabimite Cream) Tube 60
154 Phenobarbital inj 50mg/ml-2ml Ampul 0
155 Phenobarbital 100 mg Tablet 0
156 Phenol gliserol 10% TT Botol 27
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 10
158 Phytomenadione (Vit.K1) 10 mg Tablet 4600
159 Piracetam 400 mg Tablet 0
160 Piroxicam 20 mg tab Tablet 6000
161 Pisau Disposable (Mess No.14/21) Pcs 0
162 Plesterku (Leukoplast) Pcs 5
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Bio Ampul 0
164 Povidon iodium 10% 300 ml Botol 15
165 Prednison 5 mg Tablet 0
166 Primaquin 15 mg tab Tablet 700
167 Profolat tab Tablet 0
168 Prokaina Penisilin G inj 3.000.000 iu Ampul 0
169 Propranolol HCl 10 mg Tablet 0
170 Propranolol HCl 40 mg Tablet 0
171 Propylthiouracil 100 mg Tablet 0
172 Protein Gluco Test Strip 0
173 Pyrantel Pamoat 125 mg Tablet 2800
174 Pyridoxine HCl 10 mg Tablet 2700
175 Ranitidin 150 mg Tablet 500
176 Ranitidin Injeksi Ampul 0
177 Retinol (Vit.A) kaps 100.000 iu Kapsul 0
178 Retinol (Vit.A) kaps 200.000 iu Kapsul 0
179 Risperidone 2mg Tablet 0
STOK
AWAL
1 2 3 4 5
180 Salbutamol 2 mg Tablet 8900
181 Salep 2-4 Kombinasi pot 71
182 Sarung tangan (HandScuun) No.7,5/M Pcs 500
183 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0
184 Sarung tangan (HandScuun Steril) No.7 Pcs 0
185 Sarung tangan (HandScuun Steril) No.7,5 Pcs 130
186 Semen Seng Fosfat Serbuk & Cairan Set 0
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 6200
188 Silk (Benang Bedah) No. 3/0 Pcs 53
189 Silver Sulfadiazine Tube 3
190 Simvastatin 10 mg tab Tablet 4400
191 Sodium cloride infus 0,9% ( NACL ) Botol 80
192 Spuit 1 ml Pcs 800
195 Sulfadoxine | Pyrimethamine Tablet 500mg Tablet 400
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 290
197 Sulfasetamida 15% TM Botol 0
198 Tetracycline 250 mg Tablet 2000
199 Tetracycline 500 mg Tablet 5000
200 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0
201 Thiamine HCl (Vit B1) 50 mg Tablet 3500
202 Trihexyphenidyl tab 2 mg Tablet 0
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 0
204 Urin Bag Pcs 0
205 Usg Gel Botol 0
206 Vaksin Rabies Vero/ Verorab Paket 0
207 Vitamin B Kompleks Tablet 7500
208 Vitamin K Infant Inj Ampul 0
209 Water liquid (aqua P,I) Botol 10
210 Wing Needle No.21 Pcs 0
211 Wing Needle No.27 Pcs 0
212 Zinc Sulphate Suppositoria (Superhoid) Kapsul 0
213 Zinc tab Tablet 9700
214 0
215 Sarung Tangan (HandScuun) L 500
216 Methyl Prednisolon tab 16 mg 2000
STOK
AWAL
1 2 3 4 5
217 0
218 0
219 0
220 Methyl Prednisolon tab 16 mg 0 2000 0
221 0
222 0
223 0
224 0
225 0
226 0
227 0
228 0
229 0
230 0
231 0
232 0
233 0
234 0
235 0
236 0
237 0
238 0
239 0
240 0
241 0
UMUM JAMSOSKES BPJS

360 270
Mengetahui Mengetahui
Kepala Dinas Kesehatan Kab. OKI Kepala Instalasi Farmasi Dinkes OKI
H.M. Lubis., SKM., M. Kes. Himayanti ,S.Si., M. Kes., Apt

NIP. 19660603 198703 1 003 NIP. 19770221 200501 2 005
EMBAR PERMINTAAN OBAT (LPLPO) PUSKESMAS
PORAN BULAN : DESEMBER 2019 DOKUMEN NOMOR
MINTAAN BULAN : JANUARI 2020 DINKES KAB/KOTA
IFK KAB/KOTA
PUSKESMAS
STOK STOK
PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN
AKHIR OPTIMUM
6 7 8 9 10 11
0 0 0 0 0
0 0 0 0 0
600 600 0 5000 5000
0 0 0 200 200
0 0 0 1000 1000
10 0 10 0 0
7000 5000 2000 10000 8000
0 0 0 10 10
300 200 100 500 400
0 0 0 0
400 400 0 5000 5000
160 150 10 500 490
500 0 500 5000 4500
10000 5000 5000 15000 10000
0 0 0 0 0
100 50 50 300 250
6000 5500 500 10000 9500
0 0 0 0 0
0 0 0 10000 10000
2400 400 2000 0 0
0 0 0 0 0
0 0 0 0
28 28 0 0 0
4400 600 3800 0 0
400 200 200 0 0
1 1 0 2 2
0 0 0 0 0
60 30 30 150 120
16 0 16 0 0
0 0 0 5000 5000
67 50 17 200 183
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN
STOK STOK
AKHIR OPTIMUM
6 7 8 9 10 11
0 0 0 0 0
10 0 10 0 0
180 120 60 500 440
6500 3000 3500 15000 11500
8500 3000 5500 10000 4500
5800 2000 3800 10000 6200
0 0 0 0
96 24 72 0 0
87 24 63 0 0
0 0 0 10000 10000
0 0 0 100 100
90 25 65 0 0
0 0 0 200 200
700 700 0 5000 5000
0 0 0 100 100
96 48 48 200 152
5000 5000 0 15000 15000
0 0 0 1000 1000
0 0 0 5000 5000
8700 1000 7700 0 0
0 0 0 0 0
0 0 0 0 0
9 3 6 15 9
0 0 0 200 200
0 0 0 0 0
0 0 0 0 0
180 150 30 200 170
0 0 0 30 30
0 0 0 1000 1000
4300 2000 2300 10000 7700
1000 500 500 0 0
200 0 200 0 0
160 100 60 300 240
5900 4000 1900 10000 8100
0 0 0 0 0
60 60 0 0 0
0 0 0 100 100
STOK STOK
OPTIMUM
STOK
AKHIR OPTIMUM
6 7 8 9 10 11
200 200 0 1000 1000
95 20 75 0 0
13 8 5 20 15
0 0 0 0
0 0 0 5000 5000
400 0 400 0 0
0 0 0 30 30
40 0 40 0 0
0 0 0 5000 5000
200 0 200 0 0
0 0 0 200 200
20 0 20 0 0
76 50 26 200 174
0 0 0 0 0
4100 100 4000 0 0
700 100 600 0 0
0 0 0 200 200
60 20 40 300 260
4000 1000 3000 0 0
6500 1000 5500 0 0
0 0 0 0 0
0 0 0 0 0
30 30 0 200 200
0 0 0 0 0
0 0 0 200 200
0 0 0 0 0
0 0 0 10000 10000
0 0 0 100 100
0 0 0 5 5
280 20 260 500 240
0 0 0 200 200
80 20 60 200 140
0 0 0 0 0
25 5 20 0 0
0 0 0 200 200
0 0 0 500 500
0 0 0 100 100
STOK STOK
AKHIR OPTIMUM
6 7 8 9 10 11
0 0 0 100 100
15 5 10 20 10
20 7 13 30 17
170 25 145 300 155
175 100 75 500 425
100 0 100 220 120
35 30 5 100 95
3000 500 2500 7000 4500
0 0 0 0 0
52 20 32 100 68
0 0 0 0 0
246 200 46 300 254
0 0 0 0 0
0 0 0 300 300
0 0 0 0 0
4200 4200 0 5000 5000
4000 600 3400 0 0
0 0 0 0 0
0 0 0 50 50
0 0 0 2000 2000
0 0 0 0 0
90 0 90 0 0
200 200 0 5000 5000
0 0 0 100 100
100 100 0 5000 5000
0 0 0 5000 5000
0 0 0 200 200
1000 200 800 0 0
3500 1000 2500 7000 4500
0 0 0 0 0
0 0 0 100 100
51 30 21 100 79
0 0 0 200 200
1000 300 700 0 0
4000 2000 2000 8000 6000
40 40 0 100 100
15 0 15 0
STOK STOK
AKHIR OPTIMUM
6 7 8 9 10 11
1110 1110 0 5000 5000
76 25 51 0 0
0 0 0 100 100
0 0 0 200 200
0 0 0 5000 5000
0 0 0 100 100
62 30 32 0 0
200 150 50 500 450
7000 7000 0 15000 15000
6 2 4 0 0
60 0 60 0 0
0 0 0 0 0
0 0 0 0 0
27 20 7 100 93
10 10 0 100 100
4600 2000 2600 0 0
0 0 0 1000 1000
6000 2000 4000 15000 11000
0 0 0 100 100
5 5 0 50 50
0 0 0 0 0
15 5 10 0 0
0 0 0 10000 10000
700 0 700 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2000 2000
0 0 0 5000 5000
0 0 0 100 100
2800 1000 1800 0 0
2700 1500 1200 7000 5800
500 0 500 0 0
0 0 0 0 0
0 0 0 2000 2000
0 0 0 2000 2000
0 0 0 0 0
STOK STOK
AKHIR OPTIMUM
6 7 8 9 10 11
8900 3000 5900 15000 9100
71 10 61 0 0
500 0 500 1000 500
0 0 0 0 0
0 0 0 0 0
130 50 80 1000 920
0 0 0 0 0
6200 3000 3200 10000 6800
53 10 43 0 0
3 0 3 0 0
4400 1000 3400 10000 6600
80 40 40 300 260
800 200 600 2000 1400
1500 1000 500 3000 2500
1300 500 800 3000 2200
400 400 0 1000 1000
290 200 90 400 310
0 0 0 100 100
2000 2000 0 0 0
5000 2000 3000 0 0
0 0 0 100 100
3500 3500 0 10000 10000
0 0 0 0 0
0 0 0 10000 10000
0 0 0 30 30
0 0 0 10 10
0 0 0 0 0
7500 3000 4500 15000 10500
0 0 0 0 0
10 0 10 50 40
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
9700 2000 7700 0 0
500 500 0 0 0
2000 100 1900 0 0
STOK STOK
AKHIR OPTIMUM
6 7 8 9 10 11
0 0 0
0 0 0
0 0 0
2000 100 1900 0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
JUMLAH
630
engetahui Mengetahui/ Menyetujui Yang Membuat

si Farmasi Dinkes OKI Pimpinan Puskesmas Pengelola Obat Puskesmas
S.Si., M. Kes., Apt H. Purnomo MUSLIMAH ASMAWATI

221 200501 2 005 NIP. 1965 0217 198712 1001 NIP.19860101 201001 2022
TANGGAL
KET
12
: DESEMBER 2019
KET
12
: DESEMBER 2019
KET
KET
12
: DESEMBER 2019
KET
12
: DESEMBER 2019
KET
12
: DESEMBER 2019
KET
12
: DESEMBER 2019
KET
12
0
Yang Membuat
Pengelola Obat Puskesmas
MUSLIMAH ASMAWATI
P.19860101 201001 2022
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSKESMAS
PUSKESMAS : PEMATANG PANGGANG II PELAPORAN BULAN : JANUARI 2020 DOKUMEN NOMOR TANGGAL
KECAMATAN : MESUJI MAKMUR PERMINTAAS BULAN Feb-20 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
9 Aminophylline tab 200 mg Tablet 100 400 500 200 300 0
12 Amoxycillin Syr Btl 10 480 490 50 440 0
13 Amoxycillin 250 mg Kapsul 500 4500 5000 100 4900 0
14 Amoxycillin 500 mg Kaptab 5000 10000 15000 1000 14000 0
16 Antasida Syr DOEN Btl 50 250 300 50 250 0
17 Antasida DOEN Kombinasi Tablet 500 9500 10000 500 9500 0
19 Asam Mefenamat 500 mg tab Tablet 0 1000 1000 100 900 0
21 Ascorbic acid |calsium carbonate 500 mg (Peh Tablet 0 0 0 0 0
27 Bahan Tambal Gigi Sementara (Fletcher/Cavit Pcs 0 0 0 0 0
28 Bedak Salisil 2% Btl 30 120 150 10 140 0
31 Betamethasone 0,1% krim Tube 17 200 217 25 192 0
HALAMAN : 2 LPLPO No: 0 : JANUARI 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
34 Calcium chloride lactate infus (RL) Botol 60 60 40 20
35 Calsium Laktat (Kalk) 500 mg Tablet 3500 11500 15000 1500 13500 0
36 Captopril 12,5 mg Tablet 5500 4500 10000 700 9300 0
37 Captopril 25 mg Tablet 3800 6200 10000 500 9500 0
44 Chloramphenicol Suspensi 125 mg/ml Btl 0 100 100 10 90 0
45 Chloramphenicol 250 mg caps Tablet 0 2500 2500 100 2400 0
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 48 144 192 20 172 0
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 0 15000 15000 1000 14000 0
49 Chlorpromazine HCl 100 mg Tablet 0 1000 1000 0 1000 0
58 Dexamethasone inj 5mg/ml-1ml Ampul 30 170 200 30 170 0
61 Diclofenac sodium 25 mg tab Tablet 2300 7700 10000 1500 8500 0
64 Dipenhidramine HCl inj 10mg/ml Ampul 60 240 300 15 285 0
65 Domperidone 10 mg Tablet 1900 2500 4400 500 3900 0
68 Erythromicin Syr Btl 0 96 96 10 86 0
HALAMAN : 3 LPLPO No: 0 LAPORAN BULAN : JANUARI 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
69 Erythromicin 500 mg capsul Kapsul 0 1000 1000 100 900 0
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 5 10 15 5 10 0
74 Folic acid 1mg ( asam folat) Tablet 400 400 400 0 0
75 Folley Catheter No.16 Pcs 0 30 30 0 30 0
79 Gentamicyn 0,3% TM Botol 0 192 192 10 182 0
81 Gentamicyn 0,1% SK Tube 26 168 194 30 164 0
85 Glukosa larutan infus 10% Botol 0 200 200 10 190 0
86 Glukosa larutan infus 5% Botol 40 260 300 20 280 0
91 Human chorionic (HCG/Tes kehamilan ) Strip 0 100 100 0 100 0
93 Ibuprofen sirup Botol 0 200 200 10 190 0
97 Immunoglobulin human anti-tetanus (Tetagam Ampul 0 0 0 0 0
99 Infusi set anak Pcs 0 200 200 0 200 0
100 Iodium Povidon 10% 30 ml Botol 60 50 110 20 90 0
103 IV Catheter No.22 Pcs 0 200 200 0 200 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 20 1 19 0
108 Kasa pembalut 2x80 Pcs 13 17 30 5 25 0
109 Kasa pembalut hidrofil 4 m x 15 cm Pcs 145 150 295 20 275 0
111 Kasa kompres 40/40 steril Pcs 100 200 300 30 270 0
112 Ketoconazole 200 mg Cream Tube 5 100 105 10 95 0
113 Ketoconazole 200 mg tab Tablet 2500 4500 7000 700 6300 0
117 Lidokain Comp. inj Kombinasi Ampul 46 240 286 20 266 0
125 Masker Pcs 0 0 0 0 0
128 Metformin 500mg tab Tablet 0 5000 5000 0 5000 0
130 Methyl Ergometrin Maleat 0,125 mg Tab 0 5000 5000 0 5000 0
131 Methyl Prednisolon tab 4 mg Tablet 0 3000 3000 500 2500 0
134 Metronidazol 500 mg tab Tablet 2500 3000 5500 500 5000 0
137 Miconazole 2% Salep Kulit Tube 21 96 117 25 92 0
141 Nystatin Tab Vag 10.000 iu/g Tablet 0 100 100 0 100 0
HALAMAN : 5 LPLPO No: 0 : JANUARI 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
150 Parasetamol 120 mg/5 ml Syr Botol 50 500 550 50 500 0
151 Parasetamol 500 mg Tablet 0 15000 15000 2000 13000 0
156 Phenol gliserol 10% TT Botol 7 96 103 10 93 0
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Bio Ampul 0 0 0 0 0
165 Prednison 5 mg Tablet 0 10000 10000 2000 8000 0
172 Protein Gluco Test Strip 0 100 100 0 100 0
174 Pyridoxine HCl 10 mg Tablet 1200 5800 7000 1200 5800 0
LPLPO No: HALAMAN : 6 LPLPO No: 0 LAPORAN BULAN : JANUARI 2020
STOK STOK STOK
AKHIR AKHIR OPTIMUM
1 2 3 8 5 6 7 8 9 10 11 12
180 Salbutamol 2 mg Tablet 5900 5000 10900 1000 9900 0
182 Sarung tangan (HandScuun) No.7,5/M Pcs 500 200 700 0 700 0
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 3200 5000 8200 500 7700 0
190 Simvastatin 10 mg tab Tablet 3400 3300 6700 700 6000 0
192 Spuit 1 ml Pcs 600 1000 1600 100 1500 0
193 Spuit 3 ml Pcs 500 2500 3000 500 2500 0
194 Spuit 5 ml Pcs 800 2200 3000 500 2500 0
195 Sulfadoxine | Pyrimethamine Tablet 500mg| Tablet 0 600 600 100 500 0
201 Thiamine HCl (Vit B1) 50 mg Tablet 0 5000 5000 1000 4000 0
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 0 10000 10000 0 10000 0
204 Urin Bag Pcs 0 30 30 0 30 0
205 Usg Gel Botol 0 10 10 0 10 0
207 Vitamin B Kompleks Tablet 4500 10500 15000 2000 13000 0
209 Water liquid (aqua P,I) Botol 10 40 50 10 40 0
213 Zinc tab Tablet 7700 7700 200 7500 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
217 Policlean Handrub Botol 0 0 0 0 0
218 Sarung Tangan (Handscuun) L Pcs 0 0 0 0 0
219 Cefotaxime Sodium inj 1 gr Vial 0 0 0 0 0
221 Lancet Pcs 0 0 0 0 0
222 Strip Kolesterol Pcs 0 0 0 0 0
223 Strip Gula Darah Pcs 0 0 0 0 0
224 Strip Asam Urat Pcs 0 0 0 0 0
225 Nonwoven Fixation Rol Pcs 0 2 2 0 2 0
226 Paracetamol 1000 mg /100 ml Botol 0 0 0 0 0
227 Otsu D-40 25 ml Botol 0 0 0 0 0
228 Ketorolac inj 30 mg Ampul 0 0 0 0 0
229 Dulcolax tab Tablet 0 0 0 0 0
230 Ibuprofen 400 mg.1 Tablet 0 0 0 0 0
231 Permethrin (Scabimite Cream).1 Tube 0 0 0 0 0
232 Masker Plus Pcs 0 0 0 0 0
233 0 0 0 0 0
234 0 0 0 0 0
235 0 0 0 0 0
236 0 0 0 0 0
237 0 0 0 0 0
238 0 0 0 0 0
239 0 0 0 0 0
240 0 0 0 0 0
241 0 0 0 0 0

253 219 472

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. Purnomo MUSLIMAH ASMAWATI
Nip. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP. 1965 0217 198712 1 002 NIP.19860101 201001 2022
PUSKESMAS : PEMATANG PANGGANG II PELAPORAN BULAN : FEBRUARI 2020 DOKUMEN NOMOR TANGGAL
KECAMATAN : MESUJI MAKMUR PERMINTAAS BULAN :MARET 2020 DINKES KAB/KOTA
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 : FEBRUARI 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
34 Calcium chloride lactate infus (RL) Botol 20 20 20 0 200 200
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 10 10 6 4 0
74 Folic acid 1mg ( asam folat) Tablet 0 0 0 0 0
96 Ichthyol salep 10% pot 0 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
125 Masker Pcs 0 0 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
192 Spuit 1 ml Pcs 1500 1500 1000 500 0
193 Spuit 3 ml Pcs 2500 2500 1200 1300 0
194 Spuit 5 ml Pcs 2500 2500 500 2000 0
195 Sulfadoxine | Pyrimethamine Tablet 500mg| Tablet 500 500 0 500 0
201 Thiamine HCl (Vit B1) 50 mg Tablet 4000 4000 1000 3000 0
204 Urin Bag Pcs 30 30 0 30 0
205 Usg Gel Botol 10 10 0 10 0
213 Zinc tab Tablet 7500 7500 1000 6500 0
216 Poliwash 500 ml Botol 1900 1900 1900 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
217 Policlean Handrub Botol 0 0 0 0
218 Sarung Tangan (Handscuun) L Pcs 0 0 0 0
219 Cefotaxime Sodium inj 1 gr Vial 0 0 0 0
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 2 2 0 2 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 0 0 0 0
231 Permethrin (Scabimite Cream).1 Tube 0 0 0 0
232 Masker Plus Pcs 0 0 0 0
233 0 0 0 0
234 0 0 0 0
235 0 0 0 0
236 0 0 0 0
237 0 0 0 0
238 0 0 0 0
239 0 0 0 0
240 0 0 0 0
241 0 0 0 0

347 206 553

IWAN SETIAWAN,SKM, Mkes Himayanti, S.Si, Mkes, Apt H. Purnomo MUSLIMAH ASMAWATI
NIP. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP. 1965 0217 198712 1 002 NIP.19860101 201001 2022
PUSKESMAS : PEMATANG PANGGANG II PELAPORAN BULAN : MARET 2020 DOKUMEN NOMOR TANGGAL
KECAMATAN : MESUJI MAKMUR 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 0 0 0 0
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 10 10 10 0 50 50
7 Allopurinol 100 mg Tablet 1000 1000 1000 0 10000 10000
20 Ascorbic acid (Vit.C) 50 mg Tablet 1500 1500 1500 0 10000 10000
26 Automated blood grouping (Tes Gol. Darah) Paket 0 0 0 0 2 2
29 Benzoic acid |salicylic acid salep (anti fungi) pot 0 0 0 0 100 100
30 Betahistine Mesylate 6 mg tab Tablet 0 0 0 0 5000 5000
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : MARET 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
33 Bismuth subgallas (antihemoroid) Supp 0 0 0 0 50 50
34 Calcium chloride lactate infus (RL) Botol 0 200 200 100 100 500 400
36 Captopril 12,5 mg Tablet 8300 8300 1000 7300 0 0
41 Cefadroxil 500mg Tablet 0 0 0 0 10000 10000
42 Cetirizine 5 mg/5 ml sirup Botol 0 0 0 0 100 100
43 Chloramhenicol Salep Mata 1% Tube 25 25 25 0 100 100
44 Chloramphenicol Suspensi 125 mg/ml Btl 60 60 30 30 200 170
46 Chloramphenicol TT 3% Botol 0 0 0 0 100 100
50 Cimetidin 200 tab Tablet 0 0 0 0 5000 5000
51 Ciprofloxacin 500 mg tab Tablet 7000 7000 1500 5500 10000 4500
53 Clindamycin 300mg Kapsul 0 0 0 0 5000 5000
54 Cresol liquid 1 Liter (lysol) Botol 0 0 0 0 50 50
55 Cyanocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0 0 0 200 200
57 Dexamethasone 0,5 mg Tablet 0 0 0 0 20000 20000
59 Diazepam 5mg/ml-2 ml inj Ampul 0 0 0 0 60 60
60 Diazepam 2 mg Tablet 0 0 0 0 5000 5000
62 Digoxin 0,25 mg Tablet 200 200 0 200 1000 800
63 Dimenhydrinate 50mg Tablet 100 100 0 100 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
70 Ethacridine (Rivanol) 0,1% Btl 45 45 30 15 100 85
73 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 0 0 0 5000 5000
74 Folic acid 1mg ( asam folat) Tablet 0 0 0 0 5000 5000
77 Furosemida 40 mg Tablet 0 0 0 0 5000 5000
83 Glibenclamide 5 mg Tablet 2000 2000 500 1500 10000 8500
84 Glimepiride 1 mg Tablet 200 200 200 0 5000 5000
87 Griseofulvin 125 mg Tablet 2000 2000 2000 0 5000 5000
88 Guaifenesin 100 Tab (GG tab) Tablet 3800 3800 2000 1800 15000 13200
95 Ibuprofen 400 mg Tablet 0 0 0 0 10000 10000
96 Ichthyol salep 10% pot 0 0 0 0 100 100
98 Infus set dewasa Pcs 180 180 100 80 300 220
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 0 100 100
115 Levertran Salep/ Salep Luka Bakar pot 0 0 0 0 100 100
119 Liquorice liquid extract (OBH) Botol 0 0 0 0 300 300
120 Locoriz Cream Tube 0 0 0 0 100 100
121 Loperamid 2 m tab Tablet 0 0 0 0 5000 5000
122 Loratadine 10 mg tab Tablet 2500 2500 500 2000 -2000
125 Masker Pcs 0 0 0 0 2000 2000
127 Metamizole injeksi (antalgin 1000) Ampul 60 60 10 50 200 150
129 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0 0 0 100 100
132 Methyl Rosanilinium (gentian violet) Botol 0 0 0 0 100 100
136 Metronidazol syr Botol 0 0 0 0 100 100
138 Momilen Baby Gold Sirup Botol 0 0 0 0 200 200
140 Nifedipin 10 mg tab Kapsul 1500 1500 500 1000 10000 9000
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
143 Omeprazole kaps Kapsul 0 0 0 0 10000 10000
144 Oxytetracycline HCl 1% Salep Mata Tube 31 31 20 11 100 89
146 Oxytocin inj 10 IU Ampul 0 0 0 0 200 200
147 Papaverin 40 mg tab Tablet 0 0 0 0 10000 10000
148 Papaverin inj Tablet 0 0 0 0 100 100
149 Paracetamol Drops 15 ml Botol 12 12 0 12 100 88
159 Piracetam 400 mg Tablet 0 0 0 0 1000 1000
160 Piroxicam 20 mg tab Tablet 1000 1000 1000 0 10000 10000
162 Plesterku (Leukoplast) Pcs 0 0 0 0 100 100
164 Povidon iodium 10% 300 ml Botol 0 0 0 0 30 30
171 Propylthiouracil 100 mg Tablet 0 0 0 0 5000 5000
175 Ranitidin 150 mg Tablet 0 0 0 0 10000 10000
176 Ranitidin Injeksi Ampul 0 0 0 0 30 30
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
181 Salep 2-4 Kombinasi pot 27 27 27 0 100 100
182 Sarung tangan (HandScuun) No.7,5 Pcs 200 200 200 0 2000 2000
184 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0 0 0 1000 1000
185 Sarung tangan (HandScuun Steril) No.7,5 Pcs 0 0 0 0 2000 2000
191 Sodium cloride infus 0,9% ( NACL ) Botol 0 0 0 0 200 200
192 Spuit 1 ml Pcs 500 500 0 500 0
193 Spuit 3 ml Pcs 1300 1300 500 800 2000 1200
194 Spuit 5 ml Pcs 2000 2000 500 1500 0
195 Sulfadoxine | Pyrimethamine Tablet 500mg| Tablet 500 500 500 0 1000 1000
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 70 70 50 20 300 280
199 Tetracycline 500 mg Tablet 2000 2000 2000 0 5000 5000
200 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0 0 0 300 300
204 Urin Bag Pcs 30 30 0 30 0
205 Usg Gel Botol 10 10 0 10 0
208 Vitamin K Infant Inj Ampul 0 0 0 0 100 100
210 Wing Needle No.21 Pcs 0 0 0 0 0 0
211 Wing Needle No.27 Pcs 0 0 0 0 0 0
213 Zinc tab Tablet 6500 6500 500 6000 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
225 Nonwoven Fixation Rol Pcs 2 2 2 0
227 Otsu D-40 25 ml Botol 0 0 0 0
232 Masker Plus Pcs 0 0 0 2000 2000
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

183 242 425

IWANIWAN
SETIAWAN,SKM,
SETIAWAN,SKM,
MkesMkes Himayanti, S.Si, Mkes, Apt H. Purnomo MUSLIMAH ASMAWATI
NIP.NIP.
19730905
19730905
199803
199803
1 005
1 005 Nip. 19770221 200501 2 005 NIP. 1965 0217 198712 1002 NIP.19860101 201001 2022
PUSKESMAS : PEMATANG PANGGANG II PELAPORAN BULAN : APRIL 2020 DOKUMEN NOMOR TANGGAL
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
6 Alkohol Liquid (etanol) 70%-1000 ml Btl 0 0 0 0
7 Allopurinol 100 mg Tablet 0 0 0 0
8 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0 0 0
9 Aminophylline tab 200 mg Tablet 300 300 300 0
10 Amitriptyline 25 mg tab Tablet 0 0 0 0
11 Amlodipine tab 5 mg Tablet 0 0 0 0
15 Ampicilin 1 gr Inj Vial 0 0 0 0
18 Anti Bisa Ular 5 ml (ABU I)/ Biosave Vial 0 0 0 0
19 Asam Mefenamat 500 mg tab Tablet 0 0 0 0
20 Ascorbic acid (Vit.C) 50 mg Tablet 0 0 0 0
21 Ascorbic acid |calsium carbonate 500 mg (Peh Tablet 0 0 0 0
22 Aspirin (miniaspi) 100 mg tab Tablet 0 0 0 0
23 Atropine inj 0,25 mg/ml Ampul 0 0 0 0
25 Attapulgite Tablet 600 mg (New Antides) Tablet 0 0 0 0
26 Automated blood grouping (Tes Gol. Darah) Paket 0 0 0 0
27 Bahan Tambal Gigi Sementara (Fletcher/Cavit Pcs 0 0 0 0
29 Benzoic acid |salicylic acid salep (anti fungi) pot 0 120 120 0 120 0
30 Betahistine Mesylate 6 mg tab Tablet 0 0 0 0
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : APRIL 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
32 Bisacodyl 5mg Tablet 0 0 0 0
33 Bismuth subgallas (antihemoroid) Supp 0 0 0 0
34 Calcium chloride lactate infus (RL) Botol 100 500 600 200 400 0
38 Carbamazepin tab Tablet 0 0 0 0
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 0 0 0 0
46 Chloramphenicol TT 3% Botol 0 0 0 0
50 Cimetidin 200 tab Tablet 0 0 0 0
52 Ciprofloxacin Infus Botol 0 0 0 0
53 Clindamycin 300mg Kapsul 0 0 0 0
54 Cresol liquid 1 Liter (lysol) Botol 0 0 0 0
55 Cyanocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0 0 0
56 Devitalisasi pasta pot 0 0 0 0
57 Dexamethasone 0,5 mg Tablet 0 20000 20000 1000 19000 0
59 Diazepam 5mg/ml-2 ml inj Ampul 0 10 10 0 10 0
62 Digoxin 0,25 mg Tablet 200 800 1000 0 1000 0
66 Doxycycline 100 mg Kapsul Kapsul 0 0 0 0
67 Epinephrine HCl/bitartrat inj 0,1% Ampul 0 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
70 Ethacridine (Rivanol) 0,1% Btl 15 72 87 10 77 0
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 0 0 0 0
72 Eugenol cairan Btl 0 0 0 0
73 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 0 0 0
74 Folic acid 1mg ( asam folat) Tablet 0 0 0 0
77 Furosemida 40 mg Tablet 0 0 0 0
82 Glass lonomer Paket 0 0 0 0
84 Glimepiride 1 mg Tablet 0 0 0 0
87 Griseofulvin 125 mg Tablet 0 0 0 0
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 0 0 0 0
92 Hydrochlorotiazide (HCT) 25 mg Tablet 0 0 0 0
94 Ibuprofen 200 mg Tablet 0 0 0 0
97 Immunoglobulin human anti-tetanus (Tetagam Ampul 0 0 0 0
101 Isosorbide tablet Tablet 0 0 0 0
105 Jarum Jahit Kulit Pcs 0 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
106 Kalium Permanganat Serbuk pot 0 0 0 0
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
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
123 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 0 0 0
125 Masker Pcs 0 0 0 0
126 Medical adhesive tape (dermafix/leukomed) Pcs 0 0 0 0
129 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0 0 0
132 Methyl Rosanilinium (gentian violet) Botol 0 0 0 0
133 Metronidazol 250 mg tab Tablet 0 0 0 0
135 Metronidazol Infus Botol 0 0 0 0
136 Metronidazol syr Botol 0 0 0 0
138 Momilen Baby Gold Sirup Botol 0 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
143 Omeprazole kaps Kapsul 0 0 0 0
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
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
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 0 0 0
159 Piracetam 400 mg Tablet 0 0 0 0
160 Piroxicam 20 mg tab Tablet 0 0 0 0
161 Pisau Disposable (Mess No.14/21) Pcs 0 0 0 0
162 Plesterku (Leukoplast) Pcs 0 0 0 0
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Bio Ampul 0 0 0 0
164 Povidon iodium 10% 300 ml Botol 0 0 0 0
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 0 0 0 0
171 Propylthiouracil 100 mg Tablet 0 0 0 0
175 Ranitidin 150 mg Tablet 0 0 0 0
176 Ranitidin Injeksi Ampul 0 0 0 0
177 Retinol (Vit.A) kaps 100.000 iu Kapsul 0 0 0 0
179 Risperidone 2mg Tablet 0 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
181 Salep 2-4 Kombinasi pot 0 96 96 0 96 0
182 Sarung tangan (HandScuun) No.7,5 Pcs 0 700 700 400 300 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
191 Sodium cloride infus 0,9% ( NACL ) Botol 0 200 200 10 190 0
192 Spuit 1 ml Pcs 500 500 100 400 0
193 Spuit 3 ml Pcs 800 500 1300 500 800 0
194 Spuit 5 ml Pcs 1500 1500 200 1300 0
195 Sulfadoxine | Pyrimethamine Tablet 500mg| Tablet 0 0 0 0
197 Sulfasetamida 15% TM Botol 0 0 0 0
198 Tetracycline 250 mg Tablet 0 0 0 0
200 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0 0 0
201 Thiamine HCl (Vit B1) 50 mg Tablet 0 0 0 0
202 Trihexyphenidyl tab 2 mg Tablet 0 0 0 0
204 Urin Bag Pcs 30 30 3 27 0
205 Usg Gel Botol 10 10 0 10 0
206 Vaksin Rabies Vero/ Verorab Paket 0 0 0 0
208 Vitamin K Infant Inj Ampul 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 6000 6000 1000 5000 0
214 Ondansetron iv/im 4 mg Ampul 0 0 0 0
215 Tranexamic Acid inj 5% Ampul 0 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
217 Policlean Handrub Botol 0 4 4 4 0 0
226 Paracetamol 1000 mg /100 ml Botol 0 10 10 0 10 0
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

107 0 169 276

NIP. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP. 1965 0217 198712 1002 NIP.19860101 201001 2022
PUSKESMAS : PEMATANG PANGGANG II PELAPORAN BULAN : MEI 2020 DOKUMEN NOMOR TANGGAL
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
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
44 Chloramphenicol Suspensi 125 mg/ml Btl 0 0 0 0
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 7500 7500 7500 0
60 Diazepam 2 mg Tablet 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
HALAMAN : 5 LPLPO No: 0 0 : MEI 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
189 Silver Sulfadiazine Tube 0 0 0 0
192 Spuit 1 ml Pcs 400 400 0 400 0
193 Spuit 3 ml Pcs 800 800 200 600 0
194 Spuit 5 ml Pcs 1300 1300 200 1100 0
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 0 0 0 0
204 Urin Bag Pcs 27 27 2 25 0
205 Usg Gel Botol 10 10 2 8 0
213 Zinc tab Tablet 5000 5000 500 4500 0
HALAMAN : 7 LPLPO No: 0 0 : MEI 2020
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

45 67 112

NIP. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP. 1965 0217 198712 1002 NIP.19860101 201001 2022
PUSKESMAS : PEMATANG PANGGANG II PELAPORAN BULAN : JUNI 2020 DOKUMEN NOMOR TANGGAL
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
12 Amoxycillin Syr Btl 260 260 30 230 -230
13 Amoxycillin 250 mg Kapsul 4600 4600 100 4500 -4500
14 Amoxycillin 500 mg Kaptab 6500 6500 500 6000 -6000
16 Antasida Syr DOEN Btl 145 145 20 125 -125
17 Antasida DOEN Kombinasi Tablet 6000 6000 500 5500 -5500
24 Attapulgite Tablet (Pularex) Tablet 2800 2800 100 2700 -2700
28 Bedak Salisil 2% Btl 30 30 10 20 -20
29 Benzoic acid |salicylic acid salep (anti fungi) pot 90 90 0 90 -90
31 Betamethasone 0,1% krim Tube 72 72 24 48 -48
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : JUNI 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
34 Calcium chloride lactate infus (RL) Botol 300 300 0 300 -300
35 Calsium Laktat (Kalk) 500 mg Tablet 6000 6000 500 5500 -5500
36 Captopril 12,5 mg Tablet 6200 6200 200 6000 -6000
37 Captopril 25 mg Tablet 5800 5800 300 5500 -5500
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 22 22 10 12 -12
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 23 23 0 23 -23
45 Chloramphenicol 250 mg caps Tablet 2700 2700 300 2400 -2400
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 188 188 24 164 -164
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 7500 7500 500 7000 -7000
49 Chlorpromazine HCl 100 mg Tablet 700 700 100 600 -600
51 Ciprofloxacin 500 mg tab Tablet 0 0 0 0
57 Dexamethasone 0,5 mg Tablet 18500 18500 500 18000 -18000
58 Dexamethasone inj 5mg/ml-1ml Ampul 200 200 20 180 -180
59 Diazepam 5mg/ml-2 ml inj Ampul 10 10 2 8 -8
61 Diclofenac sodium 25 mg tab Tablet 5000 5000 200 4800 -4800
62 Digoxin 0,25 mg Tablet 900 900 200 700 -700
63 Dimenhydrinate 50mg Tablet 100 100 0 100 -100
64 Dipenhidramine HCl inj 10mg/ml Ampul 195 195 20 175 -175
65 Domperidone 10 mg Tablet 1700 1700 100 1600 -1600
68 Erythromicin Syr Btl 46 46 10 36 -36
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
69 Erythromicin 500 mg capsul Kapsul 1800 1800 100 1700 -1700
70 Ethacridine (Rivanol) 0,1% Btl 57 57 5 52 -52
75 Folley Catheter No.16 Pcs 24 24 0 24 -24
76 Furosemida Injeksi Ampul 0 0 0 0
78 Garam Oralit Sachet 100 100 0 100 -100
79 Gentamicyn 0,3% TM Botol 173 173 5 168 -168
81 Gentamicyn 0,1% SK Tube 26 26 5 21 -21
83 Glibenclamide 5 mg Tablet 700 700 0 700 -700
85 Glukosa larutan infus 10% Botol 140 140 0 140 -140
86 Glukosa larutan infus 5% Botol 140 140 0 140 -140
88 Guaifenesin 100 Tab (GG tab) Tablet 800 800 100 700 -700
93 Ibuprofen sirup Botol 50 50 10 40 -40
98 Infus set dewasa Pcs 50 50 0 50 -50
99 Infusi set anak Pcs 220 220 10 210 -210
100 Iodium Povidon 10% 30 ml Botol 20 20 10 10 -10
102 IV Catheter No.20 Pcs 10 10 0 10 -10
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 2 14 -14
108 Kasa pembalut 2x80 Pcs 45 45 5 40 -40
109 Kasa pembalut hidrofil 4 m x 15 cm Pcs 85 85 0 85 -85
110 Kasa pembalut hidrofil 4 m x 3 cm Pcs 200 200 10 190 -190
111 Kasa kompres 40/40 steril Pcs 80 80 20 60 -60
113 Ketoconazole 200 mg tab Tablet 3500 3500 100 3400 -3400
117 Lidokain Comp. inj Kombinasi Ampul 86 86 20 66 -66
122 Loratadine 10 mg tab Tablet 1200 1200 100 1100 -1100
127 Metamizole injeksi (antalgin 1000) Ampul 20 20 0 20 -20
128 Metformin 500mg tab Tablet 3800 3800 0 3800 -3800
130 Methyl Ergometrin Maleat 0,125 mg Tab 3600 3600 100 3500 -3500
131 Methyl Prednisolon tab 4 mg Tablet 6000 6000 0 6000 -6000
134 Metronidazol 500 mg tab Tablet 1700 1700 100 1600 -1600
137 Miconazole 2% Salep Kulit Tube 56 56 10 46 -46
139 Natrium Bikarbonat 500 mg Tablet 100 100 0 100 -100
140 Nifedipin 10 mg tab Kapsul 700 700 0 700 -700
141 Nystatin Tab Vag 10.000 iu/g Tablet 200 200 0 200 -200
142 Omeprazole inj Vial 8 8 8 -8
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
149 Paracetamol Drops 15 ml Botol 12 12 0 12 -12
150 Parasetamol 120 mg/5 ml Syr Botol 80 80 20 60 -60
151 Parasetamol 500 mg Tablet 11800 11800 500 11300 -11300
152 Patient Lubricant (My Jelly ) Tube 2 2 0 2 -2
156 Phenol gliserol 10% TT Botol 23 23 2 21 -21
158 Phytomenadione (Vit.K1) 10 mg Tablet 1500 1500 100 1400 -1400
165 Prednison 5 mg Tablet 13600 13600 500 13100 -13100
166 Primaquin 15 mg tab Tablet 500 500 0 500 -500
172 Protein Gluco Test Strip 50 50 20 30 -30
173 Pyrantel Pamoat 125 mg Tablet 700 700 0 700 -700
174 Pyridoxine HCl 10 mg Tablet 8000 8000 200 7800 -7800
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
180 Salbutamol 2 mg Tablet 12500 12500 300 12200 -12200
181 Salep 2-4 Kombinasi pot 96 96 0 96 -96
182 Sarung tangan (HandScuun) No.7,5 Pcs 0 0 0 0
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 4500 4500 200 4300 -4300
188 Silk (Benang Bedah) No. 3/0 Pcs 28 28 0 28 -28
190 Simvastatin 10 mg tab Tablet 3400 3400 300 3100 -3100
191 Sodium cloride infus 0,9% ( NACL ) Botol 170 170 20 150 -150
192 Spuit 1 ml Pcs 400 400 0 400 -400
193 Spuit 3 ml Pcs 600 600 100 500 -500
194 Spuit 5 ml Pcs 1100 1100 100 1000 -1000
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 0 0 0 0
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 12500 12500 500 12000 -12000
204 Urin Bag Pcs 25 25 0 25 -25
205 Usg Gel Botol 8 8 3 5 -5
207 Vitamin B Kompleks Tablet 12500 12500 500 12000 -12000
209 Water liquid (aqua P,I) Botol 45 45 0 45 -45
213 Zinc tab Tablet 4500 4500 200 4300 -4300
216 Poliwash 500 ml Botol 1900 1900 1900 -1900
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
225 Nonwoven Fixation Rol Pcs 2 2 1 1 -1
226 Paracetamol 1000 mg /100 ml Botol 10 10 0 10 -10
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

35 0 181 216

NIP. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP. 1965 0217 198712 1002 NIP.19860101 201001 2022
PUSKESMAS : PEMATANG PANGGANG II PELAPORAN BULAN : JULI 2020 DOKUMEN NOMOR TANGGAL
KECAMATAN : MESUJI MAKMUR PERMINTAAN BULAN : AGUSTUS 2020 DINKES KAB/KOTA
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 : JULI 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 12 12 0 12 300 288
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 23 23 0 23 300 277
42 Cetirizine 5 mg/5 ml sirup Botol 0 0 0 0 100 100
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
78 Garam Oralit Sachet 100 100 0 100 1000 900
80 Gentamicyn Inj 40 mg/ml Ampul 0 0 0 0 50 50
87 Griseofulvin 125 mg Tablet 0 0 0 0 5000 5000
88 Guaifenesin 100 Tab (GG tab) Tablet 700 700 500 200 15000 14800
90 Haloperidol 5 mg tab Tablet 0 0 0 0 1000 1000
91 Human chorionic (HCG/Tes kehamilan ) Strip 0 0 0 0 500 500
93 Ibuprofen sirup Botol 40 40 10 30 200 170
98 Infus set dewasa Pcs 50 50 20 30 500 470
101 Isosorbide tablet Tablet 0 0 0 0 1000 1000
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
115 Levertran Salep/ Salep Luka Bakar pot 0 0 0 0 30 30
119 Liquorice liquid extract (OBH) Botol 0 0 0 0 100 100
121 Loperamid 2 m tab Tablet 0 0 0 0 5000 5000
122 Loratadine 10 mg tab Tablet 1100 1100 200 900 5000 4100
125 Masker Pcs 0 0 0 0 5000 5000
127 Metamizole injeksi (antalgin 1000) Ampul 20 20 10 10 200 190
129 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0 0 0 200 200
136 Metronidazol syr Botol 0 0 0 0 100 100
140 Nifedipin 10 mg tab Kapsul 700 700 300 400 5000 4600
142 Omeprazole inj Vial 8 8 8 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
143 Omeprazole kaps Kapsul 0 0 0 0 10000 10000
145 Oxytetracycline HCl 3% Salep Kulit Tube 0 0 0 0 200 200
146 Oxytocin inj 10 IU Ampul 0 0 0 0 200 200
149 Paracetamol Drops 15 ml Botol 12 12 12 0 200 200
153 Permethrin (Scabimite Cream) Tube 0 0 0 0 100 100
156 Phenol gliserol 10% TT Botol 21 21 5 16 100 84
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 0 0 0 100 100
158 Phytomenadione (Vit.K1) 10 mg Tablet 1400 1400 200 1200 5000 3800
160 Piroxicam 20 mg tab Tablet 0 0 0 0 10000 10000
162 Plesterku (Leukoplast) Pcs 0 0 0 0 50 50
170 Propranolol HCl 40 mg Tablet 0 0 0 0 1000 1000
171 Propylthiouracil 100 mg Tablet 0 0 0 0 5000 5000
175 Ranitidin 150 mg Tablet 0 0 0 0 5000 5000
177 Retinol (Vit.A) kaps 100.000 iu Kapsul 0 0 0 0 3000 3000
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 4300 4300 4300 0
188 Silk (Benang Bedah) No. 3/0 Pcs 28 28 28 0 200 200
190 Simvastatin 10 mg tab Tablet 3100 3100 3100 0
191 Sodium cloride infus 0,9% ( NACL ) Botol 150 150 150 0
192 Spuit 1 ml Pcs 400 400 100 300 1000 700
193 Spuit 3 ml Pcs 500 500 200 300 2000 1700
194 Spuit 5 ml Pcs 1000 1000 100 900 2000 1100
202 Trihexyphenidyl tab 2 mg Tablet 0 0 0 0 1000 1000
204 Urin Bag Pcs 25 25 0 25 0
205 Usg Gel Botol 5 5 2 3 0
213 Zinc tab Tablet 4300 4300 200 4100 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
227 Otsu D-40 25 ml Botol 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

22 0 238 260

NIP. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP. 1965 0217 198712 1002 NIP.19860101 201001 2022
PUSKESMAS : PEMATANG PANGGANG II PELAPORAN BULAN : AGUSTUS 2020 DOKUMEN NOMOR TANGGAL
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
7 Allopurinol 100 mg Tablet 0 10000 10000 500 9500 0
8 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 120 120 0 120 0
11 Amlodipine tab 5 mg Tablet 0 5100 5100 300 4800 0
13 Amoxycillin 250 mg Kapsul 4000 4000 4000 0
20 Ascorbic acid (Vit.C) 50 mg Tablet 0 5000 5000 500 4500 0
21 Ascorbic acid |calsium carbonate 500 mg (Pehavr Tablet 0 0 0 0 0
27 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0 0 0 0
30 Betahistine Mesylate 6 mg tab Tablet 0 5000 5000 300 4700 0
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : AGUSTUS 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
33 Bismuth subgallas (antihemoroid) Supp 0 50 50 10 40 0
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 23 120 143 0 143 0
54 Cresol liquid 1 Liter (lysol) Botol 0 10 10 2 8 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
74 Folic acid 1mg ( asam folat) Tablet 0 0 100 -100 0
90 Haloperidol 5 mg tab Tablet 0 1000 1000 0 1000 0
97 Immunoglobulin human anti-tetanus (Tetagam) Ampul 0 0 0 0 0
101 Isosorbide tablet Tablet 0 1000 1000 0 1000 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
125 Masker Pcs 0 0 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
149 Paracetamol Drops 15 ml Botol 0 0 0 0
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 120 120 0 120 0
158 Phytomenadione (Vit.K1) 10 mg Tablet 1200 3800 5000 500 4500 0
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 0 0 0 0 0
170 Propranolol HCl 40 mg Tablet 0 1000 1000 0 1000 0
179 Risperidone 2mg Tablet 0 1000 1000 0 1000 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 0 144 144 0 144 0
192 Spuit 1 ml Pcs 300 500 800 100 700 0
193 Spuit 3 ml Pcs 300 1000 1300 300 1000 0
194 Spuit 5 ml Pcs 900 1000 1900 300 1600 0
195 Sulfadoxine | Pyrimethamine Tablet 500mg|25m Tablet 0 0 0 0 0
199 Tetracycline 500 mg Tablet 0 5000 5000 500 4500 0
204 Urin Bag Pcs 25 25 0 25 0
205 Usg Gel Botol 3 3 1 2 0
213 Zinc tab Tablet 4100 4100 500 3600 0
214 Ondansetron iv/im 4 mg Ampul 0 100 100 5 95 0
HALAMAN : 7 LPLPO No: 0 0 : AGUSTUS 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
218 Sarung Tangan (Handscuun) L Pcs 0 0 0 0 0
219 Cefotaxime Sodium inj 1 gr Vial 0 0 0 0 0
221 Lancet Pcs 0 0 0 0 0
227 Otsu D-40 25 ml Botol 0 0 0 0 0
229 Dulcolax tab Tablet 0 0 0 0 0
230 Ibuprofen 400 mg.1 Tablet 0 0 0 0 0
231 Permethrin (Scabimite Cream).1 Tube 0 0 0 0 0
232 Masker Plus Pcs 0 0 0 0 0
233 0 0 0 0
234 0 0 0 0
235 0 0 0 0
236 0 0 0 0
237 0 0 0 0
238 0 0 0 0
239 0 0 0 0
240 0 0 0 0
241 0 0 0 0

118 0 184 302

IWAN SETIAWAN,SKM, Mkes Himayanti, S.Si, Mkes, Apt SITI MUNTOWIYAH, S.Kep MUSLIMAH ASMAWATI
NIP. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP. 19741029 200604 2 008 NIP.19860101 201001 2022
USTUS 2020
USTUS 2020
USTUS 2020
USTUS 2020
USTUS 2020
USTUS 2020
PUSKESMAS : PEMATANG PANGGANG II PELAPORAN BULAN : SEPTEMBER 2020 DOKUMEN NOMOR TANGGAL
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
7 Allopurinol 100 mg Tablet 9500 9500 9500 -9500
8 Aminophylline Inj 24 mg/ml-10 ml Ampul 120 120 120 -120
11 Amlodipine tab 5 mg Tablet 4800 4800 4800 -4800
12 Amoxycillin Syr Btl 420 420 420 -420
13 Amoxycillin 250 mg Kapsul 4000 4000 4000 -4000
14 Amoxycillin 500 mg Kaptab 13000 13000 13000 -13000
16 Antasida Syr DOEN Btl 245 245 245 -245
17 Antasida DOEN Kombinasi Tablet 13500 13500 13500 -13500
19 Asam Mefenamat 500 mg tab Tablet 1300 1300 1300 -1300
20 Ascorbic acid (Vit.C) 50 mg Tablet 4500 4500 4500 -4500
24 Attapulgite Tablet (Pularex) Tablet 2700 2700 2700 -2700
28 Bedak Salisil 2% Btl 5 5 5 -5
29 Benzoic acid |salicylic acid salep (anti fungi) pot 75 75 75 -75
30 Betahistine Mesylate 6 mg tab Tablet 4700 4700 4700 -4700
31 Betamethasone 0,1% krim Tube 158 158 158 -158
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : SEPTEMBER 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
33 Bismuth subgallas (antihemoroid) Supp 40 40 40 -40
34 Calcium chloride lactate infus (RL) Botol 250 250 250 -250
35 Calsium Laktat (Kalk) 500 mg Tablet 9000 9000 9000 -9000
36 Captopril 12,5 mg Tablet 4500 4500 4500 -4500
37 Captopril 25 mg Tablet 3800 3800 3800 -3800
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 0 0 0 0
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 143 143 143 -143
43 Chloramhenicol Salep Mata 1% Tube 216 216 216 -216
45 Chloramphenicol 250 mg caps Tablet 1700 1700 1700 -1700
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 294 294 294 -294
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 4000 4000 4000 -4000
49 Chlorpromazine HCl 100 mg Tablet 4600 4600 4600 -4600
54 Cresol liquid 1 Liter (lysol) Botol 8 8 8 -8
57 Dexamethasone 0,5 mg Tablet 13000 13000 13000 -13000
58 Dexamethasone inj 5mg/ml-1ml Ampul 280 280 280 -280
59 Diazepam 5mg/ml-2 ml inj Ampul 3 3 3 -3
61 Diclofenac sodium 25 mg tab Tablet 3000 3000 3000 -3000
62 Digoxin 0,25 mg Tablet 700 700 700 -700
63 Dimenhydrinate 50mg Tablet 0 0 0 0
64 Dipenhidramine HCl inj 10mg/ml Ampul 445 445 445 -445
65 Domperidone 10 mg Tablet 5600 5600 5600 -5600
68 Erythromicin Syr Btl 30 30 30 -30
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
69 Erythromicin 500 mg capsul Kapsul 1200 1200 1200 -1200
70 Ethacridine (Rivanol) 0,1% Btl 22 22 22 -22
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 7 7 7 -7
73 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 9990 9990 9990 -9990
74 Folic acid 1mg ( asam folat) Tablet -100 -100 -100 100
75 Folley Catheter No.16 Pcs 24 24 24 -24
77 Furosemida 40 mg Tablet 4900 4900 4900 -4900
78 Garam Oralit Sachet 100 100 100 -100
79 Gentamicyn 0,3% TM Botol 286 286 286 -286
80 Gentamicyn Inj 40 mg/ml Ampul 0 0 0 0
81 Gentamicyn 0,1% SK Tube 0 0 0 0
83 Glibenclamide 5 mg Tablet 4600 4600 4600 -4600
84 Glimepiride 1 mg Tablet 2000 2000 2000 -2000
85 Glukosa larutan infus 10% Botol 130 130 130 -130
88 Guaifenesin 100 Tab (GG tab) Tablet 0 0 0 0
90 Haloperidol 5 mg tab Tablet 1000 1000 1000 -1000
93 Ibuprofen sirup Botol 25 25 25 -25
98 Infus set dewasa Pcs 0 0 0 0
99 Infusi set anak Pcs 190 190 190 -190
100 Iodium Povidon 10% 30 ml Botol 100 100 100 -100
101 Isosorbide tablet Tablet 1000 1000 1000 -1000
102 IV Catheter No.20 Pcs 190 190 190 -190
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 29 29 29 -29
108 Kasa pembalut 2x80 Pcs 90 90 90 -90
109 Kasa pembalut hidrofil 4 m x 15 cm Pcs 220 220 220 -220
111 Kasa kompres 40/40 steril Pcs 90 90 90 -90
112 Ketoconazole 200 mg Cream Tube 45 45 45 -45
113 Ketoconazole 200 mg tab Tablet 2900 2900 2900 -2900
117 Lidokain Comp. inj Kombinasi Ampul 0 0 0 0
122 Loratadine 10 mg tab Tablet 600 600 600 -600
127 Metamizole injeksi (antalgin 1000) Ampul 0 0 0 0
128 Metformin 500mg tab Tablet 8000 8000 8000 -8000
130 Methyl Ergometrin Maleat 0,125 mg Tab 2500 2500 2500 -2500
131 Methyl Prednisolon tab 4 mg Tablet 6200 6200 6200 -6200
134 Metronidazol 500 mg tab Tablet 800 800 800 -800
137 Miconazole 2% Salep Kulit Tube 92 92 92 -92
139 Natrium Bikarbonat 500 mg Tablet 100 100 100 -100
140 Nifedipin 10 mg tab Kapsul 400 400 400 -400
141 Nystatin Tab Vag 10.000 iu/g Tablet 120 120 120 -120
142 Omeprazole inj Vial 0 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
144 Oxytetracycline HCl 1% Salep Mata Tube 150 150 150 -150
150 Parasetamol 120 mg/5 ml Syr Botol 280 280 280 -280
151 Parasetamol 500 mg Tablet 17000 17000 17000 -17000
152 Patient Lubricant (My Jelly ) Tube 2 2 2 -2
156 Phenol gliserol 10% TT Botol 16 16 16 -16
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 120 120 120 -120
158 Phytomenadione (Vit.K1) 10 mg Tablet 4500 4500 4500 -4500
164 Povidon iodium 10% 300 ml Botol 10 10 10 -10
165 Prednison 5 mg Tablet 8100 8100 8100 -8100
166 Primaquin 15 mg tab Tablet 400 400 400 -400
170 Propranolol HCl 40 mg Tablet 1000 1000 1000 -1000
172 Protein Gluco Test Strip 0 0 0 0
173 Pyrantel Pamoat 125 mg Tablet 600 600 600 -600
174 Pyridoxine HCl 10 mg Tablet 6300 6300 6300 -6300
177 Retinol (Vit.A) kaps 100.000 iu Kapsul 3000 3000 3000 -3000
179 Risperidone 2mg Tablet 1000 1000 1000 -1000
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
180 Salbutamol 2 mg Tablet 10700 10700 10700 -10700
181 Salep 2-4 Kombinasi pot 76 76 76 -76
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 3500 3500 3500 -3500
188 Silk (Benang Bedah) No. 3/0 Pcs 144 144 144 -144
190 Simvastatin 10 mg tab Tablet 2500 2500 2500 -2500
191 Sodium cloride infus 0,9% ( NACL ) Botol 130 130 130 -130
192 Spuit 1 ml Pcs 700 700 700 -700
193 Spuit 3 ml Pcs 1000 1000 1000 -1000
194 Spuit 5 ml Pcs 1600 1600 1600 -1600
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 280 280 280 -280
199 Tetracycline 500 mg Tablet 4500 4500 4500 -4500
201 Thiamine HCl (Vit B1) 50 mg Tablet 9200 9200 9200 -9200
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 9000 9000 9000 -9000
204 Urin Bag Pcs 25 25 25 -25
205 Usg Gel Botol 2 2 2 -2
207 Vitamin B Kompleks Tablet 8000 8000 8000 -8000
209 Water liquid (aqua P,I) Botol 25 25 25 -25
213 Zinc tab Tablet 3600 3600 3600 -3600
214 Ondansetron iv/im 4 mg Ampul 95 95 95 -95
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
226 Paracetamol 1000 mg /100 ml Botol 10 10 10 -10
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. 1965 0217 198712 1002 NIP.19860101 201001 2022
PUSKESMAS : PEMATANG PANGGANG II PELAPORAN BULAN : OKTOBER 2020 DOKUMEN NOMOR TANGGAL
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : OKTOBER 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
192 Spuit 1 ml Pcs 700 700 700 -700
193 Spuit 3 ml Pcs 1000 1000 1000 -1000
194 Spuit 5 ml Pcs 1600 1600 1600 -1600
204 Urin Bag Pcs 25 25 25 -25
213 Zinc tab Tablet 3600 3600 3600 -3600
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. 1965 0217 198712 1002 NIP.19860101 201001 2022
PUSKESMAS : PEMATANG PANGGANG II PELAPORAN BULAN : NOPEMBER 2020 DOKUMEN NOMOR TANGGAL
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : NOPEMBER 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
192 Spuit 1 ml Pcs 700 700 700 -700
193 Spuit 3 ml Pcs 1000 1000 1000 -1000
194 Spuit 5 ml Pcs 1600 1600 1600 -1600
204 Urin Bag Pcs 25 25 25 -25
213 Zinc tab Tablet 3600 3600 3600 -3600
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. 1965 0217 198712 1002 NIP.19860101 201001 2022
PUSKESMAS : PEMATANG PANGGANG II PELAPORAN BULAN : DESEMBER 2020 DOKUMEN NOMOR TANGGAL
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : DESEMBER 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
192 Spuit 1 ml Pcs 700 700 700 -700
193 Spuit 3 ml Pcs 1000 1000 1000 -1000
194 Spuit 5 ml Pcs 1600 1600 1600 -1600
204 Urin Bag Pcs 25 25 25 -25
213 Zinc tab Tablet 3600 3600 3600 -3600
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. 1965 0217 198712 1002 NIP.19860101 201001 2022

Lplpo 2020 Puskemas Ppii Waty Okeey

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