You are on page 1of 16

LEMBAR PERMINTAAN DAN LEMBAR PELAPORAN OBAT (L

PUSKESMAS
PUSKESMAS : PENUSUPAN
KECAMATAN : PANGKAH PELAPORAN BULAN : JULI 2018
KABUPATEN : TEGAL

PENERIMAAN
NO NAMA OBAT SATUANSTOK AWAL
BON PROGRAMUMUM
1 2 3 4 5 6 7

1 A.B.U SERUM VIAL 1


2 A.T.S INJ. 1.500 IU AMP 2
3 ACETOSAL 100 MG TAB TAB 0
4 ACYCLOVIR KRIM TUBE 33 50
5 ACYCLOVIR TABLET 200 MG TAB 791
6 ALBENDAZOL TABLET TAB 0
7 ALLOPURINOL TAB. 100 MG TAB 0 300 300
8 ALLOPURINOL TAB. 300 MG TAB 0
9 ALPRAZOLAM TABLET 1 MG TAB 0
10 AMINOFILINA TAB. 200 MG TAB 223
11 AMITRIPTILIN TAB TAB 0 200
12 AMLODIPINE TAB. 5 MG TAB 0
13 AMLODIPINE TAB. 10 MG TAB 0 120
14 AMOKSISILIN INJEKSI 1 G VIAL 40
15 AMOKSISILIN KAPLET 500 MG TAB 14,310 5,000
16 AMOKSISILIN SIRUP KERING 125 MG BTL 237
17 AMOKSISILIN SIRUP KERING 250 MG BTL 65
18 ANTASIDA DOEN TAB. TAB 10,988 2,000
19 ANTI HEMOROID SUPP. SUPP 35 30
20 ANTI MIGREN DOEN KOMB. TAB 200
21 ANTI PARKINSON TABLET TAB 0
22 ANTIFUNGI ZALF POT 0
23 AQUA PRO INJ. STERIL AMP 139
24 ASAM ASETILSALISILAT (MINIASPI) TAB 0
25 ASAM ASKORBAT TAB. 50 MG TAB 6,577 3,000
26 ASAM FOLAT 0,4 MG TAB 140
27 ASAM FOLAT 1 MG TAB 0
28 ASAM MEFENAMAT KAPSUL 250 MG KAP 0
29 ASAM MEFENAMAT KAPLET 500 MG KAPL 692 500
30 ATAPULGIT TABLET 600 MG TAB 0
31 ATROPIN SULFAT INJ. 0,25 MG/ML AMP 4
32 ATROPIN SULFAT TAB. 0,5 MG TAB 0
33 AZITROMISIN 500 MG TAB 0
34 BETAHISTIN TAB. 6 MG TAB 130 180 60
35 BETAMETASON KRIM 0,1 % TUBE 0
36 BETAMETASON KRIM 0,5 MG/GRAM TUBE 180 48
37 BISAKODIL TABLET TAB 110
38 CAPTOPRIL TABLET 12,5 MG TAB 0
39 CAPTOPRIL TABLET 25 MG TAB 1,885 600
40 CARBAMAZEPINE TABLET TAB 0 200
41 CAVICUR DRAGEE DRAGEE 404 400
42 CEFADROXYL KAPSUL 500 MG KAPS 0
43 CEFADROXYL SIRUP BTL 0
44 CEFIXIM KAPS. 100 MG KAP 0 100 100
45 CEFTRIAXON INJ. 1 GRAM VIAL 40
46 CIMETIDIN TAB. 200 MG TAB 0
47 CIPROFLOKSASIN 500 MG KAPS 290 500
48 CLINDAMYCIN 300 MG KAP 90 100 100
49 CODEIN TABLET 10 MG TAB 124
50 DEKSAMETASON INJ. 5 MG/ML AMP 17
51 DEKSAMETASON TAB. 0,5 MG TAB 9,089 3,000
52 DIAZEPAM INJ. 5 MG/ML AMP 5
53 DIAZEPAM TABLET 2 MG TAB 100
54 DIAZEPAM TABLET 5 MG TAB 0
55 DIFENHIDRAMIN INJ. 10 MG/ML AMP 0
56 DIGOKSIN TAB 0,25 MG TAB 0
57 DIMENHIDRINAT TAB. 10 MG TAB 200
58 DOMPERIDON TAB. 10 MG TAB 151 100
59 EPINEFRIN HCL INJ. 0,1 % AMP 36
60 ERITROMICIN KAPS. 250 MG KAP 318
61 ERITROMICIN KAPS. 500 MG KAP 0
62 ERPHAFLU KAPLET KAPL 205
63 ETAKRIDINA ( RIVANOL ) 0,1 % BTL 0
64 ETANOL 70 % BTL 10
65 FENIL BUTAZON TAB. 200 MG TAB 0
66 FENOBARBITAL INJ. 50 MG/ML AMP 11
67 FENOBARBITAL TAB. 30 MG TAB 124
68 FITOMENADION INJ. 10 MG/ML AMP 10
69 FITOMENADION TAB. 10 MG TAB 0
70 FLUOKONAZOL TAB 0
71 FLUOKSETIN TABLET TAB 0
72 FUROSEMIDE TAB. 40 MG TAB 296 200
73 GARAM ORALIT UNTUK 200 ML BKS 3,900
74 GENTAMISIN INJEKSI AMP 0
75 GENTAMISIN SALEP MATA TUBE 0
76 GENTAMISIN TETES MATA BTL 0
77 GENTIAN VIOLET LAR. 1 % BTL 49
78 GLIBENKLAMID TAB. 5 MG TAB 0 200 100
79 GLISERIL GUAIAKOLAT TAB. 100 MG TAB 7,989 5,000
80 GLUKOSA LAR INFUS 5 % BTL 43
81 GLUKOSA LAR INFUS 10 % BTL 3
82 GRISEOFULVIN TAB. 125 MG TAB 100 200
83 HALOPERIDOL TABLET 1,5 MG TAB 0
84 HALOPERIDOL TABLET 5 MG TAB 0
85 HEMOROGARD TAB 18 60
86 HEPAGARD TAB 0
87 HIDROKLORTIAZIDA TABLET 25 MG TAB 0
88 HIDROKORTISON KRIM 1% TUBE 228
89 HIOSINA BUTILBROMIDA INJ. / SPASHAMP 5
90 HIOSINA BUTILBROMIDA TAB. / SPAS TAB 0 200
91 IBUPROFEN TAB. 200 MG TAB 430 1,000
92 IBUPROFEN TAB. 400 MG TAB 0
93 ICHTYOL SALEP POT 0
94 ISONIAZID TABLET 100 MG TAB 0
95 ISONIAZID TABLET 300 MG TAB 0
96 ISOSORBID DINITRAT 5 MG TAB. S.L TAB 103
97 ITRAKONAZOL TAB. 100 MG TAB 0
98 KALIUM DIKLOFENAK TAB. 50 MG TAB 0
99 KALSIUM LAKTAT TAB. 500 MG TAB 8,951 6,000
100 KETOKONAZOL TAB TAB 147
101 KLONIDIN TAB. 0,15 MG TAB 425 400
102 KLORAMFENIKOL KAPSUL (CHLORA KAPS 210 100
103 KLORAMFENIKOL SALEP KULIT 2% ( TUBE 164 72
104 KLORAMFENIKOL SALEP MATA 1% TUBE 77
105 KLORAMFENIKOL SUSPENSI BTL 150
106 KLORAMFENIKOL TETES MATA (DEC TUBE 176 30
107 KLORAMFENIKOL TETES TELINGA 3 BTL 0 30 15
108 KLORFENIRAMIN MALEAT TAB. 4 M TAB 7,869 5,000
109 KLORPROMAZIN TAB.100 MG TAB 0
110 KLORPROMAZINA HCL INJ. 5 MG/ML AMP 0
111 KLORPROMAZINA HCL INJ. 25 MG/M AMP 0
112 KOTRIMOKSAZOL SUSPENSI BTL 308
113 KOTRIMOKSAZOL TAB. DEWASA TAB 838 400
114 KOTRIMOKSAZOL TAB. FORTE 800/ TAB 454
115 KOTRIMOKSAZOL TAB. PEDIATRIK TAB 0
116 LESDIAR KAPLET KAPL 0
117 LINCOMYCIN KAPS. 500 MG KAPS 0
118 LIVRON B PLEX TAB 0
119 LOPERAMIDE TABLET TAB 0
120 MASFLU FORTE TABLET TAB 0
121 MEBENDAZOL TAB. 500 MG TAB 127
122 MELOXICAM TAB. 15 MG TAB 100
123 METFORMIN TAB. 500 MG TAB 0 100
124 METIL ERGOMETRIN MALEAT INJ AMP 90
125 METIL ERGOMETRIN MALEAT TAB. TAB 184
126 METIL PREDNISOLON TAB. 4 MG TAB 0
127 METOKLOPRAMID INJEKSI AMP 0
128 METOKLOPRAMID TAB. 5 MG TAB 0
129 METOKLOPRAMID TAB. 10 MG TAB 400
130 METRONIDAZOL SIRUP 125 MG/5ML BTL 0
131 METRONIDAZOL TAB. 250 MG TAB 1,122
132 METRONIDAZOL TAB. 500 MG TAB 345 200
133 MIKONAZOL KRIM 2 % TUBE 131
134 MOLEXFLU SIRUP BTL 20
135 NATRIUM DIKLOFENAK TABLET 25 TAB 0
136 NATRIUM DIKLOFENAK TABLET 50 TAB 0
137 NATRIUM FENITOIN KAPS. 30 MG KAPS 0
138 NATRIUM FENITOIN KAPS. 100 MG KAPS 0 100
139 NATRIUM KLORIDA LAR. INFUS 0,9 BTL 22
140 NEO KAOMINAL SUSPENSI BTL 185 60
141 NEOCENTA GEL TUBE 0
142 NIFEDIPIN TAB. TAB 152
143 NISTATIN 100.000 IU TAB. VAGINA TAB 148
144 NISTATIN 500.000 IU TAB 196
145 NODIAR TABLET TAB 0
146 OBAT BATUK HITAM BTL 175 150
147 OKSITETRASIKLIN HCL SALEP KULI TUBE 0
148 OKSITETRASIKLIN HCL SALEP MATA TUBE 0
149 OKSITOSIN INJEKSI AMP 69 100
150 OMEPRAZOLE INJEKSI 40 MG/10 ML AMP 0
151 OMEPRAZOLE KAPSUL KAP 16 90
152 PARASETAMOL DROPS 15 ML BTL 105
153 PARASETAMOL SIRUP 120 MG/ML BTL 467 300
154 PARASETAMOL TAB. 500 MG TAB 24,068 10,000
155 PERAK SULFADIAZIN KRIM 1% TUBE 32
156 PERMETRIM (SCABIMITE) KRIM 10 TUBE 5 15
157 PIRANTEL PAMOAT TAB. TAB 159
158 PIRIDOKSIN HCL TAB. 10 MG TAB 6,259 2,000
159 PIRIDOKSIN TABLET 25 MG TAB 350
160 PIROXICAM 10 MG TAB 930 400
161 PIROXICAM 20 MG TAB 0 300
162 POVIDON IODIDA 10% 30 ML BTL 0
163 POVIDON IODIDA 10% 60 ML BTL 22 23
164 POVIDON IODIDA 10% 300 ML BTL 0
165 POVIDON IODIDA 10% 1.000 ML BTL 0
166 PREDNISON TAB. 5 MG TAB 2,695
167 PROPRANOLOL TABLET 10 MG TAB 200
168 PROPRANOLOL TABLET 40 MG TAB 54
169 PROTECTOR SOLUTION BOTOL 0
170 R. L INFUS BTL 120 60
171 RANITIDIN INJEKSI AMP 7
172 RANITIDIN TAB. 150 MG TAB 256 300 100
173 RISPERIDON TAB TAB 100
174 SALBUTAMOL NEBULES 0,1% (VENT AMP 5
175 SALBUTAMOL TABLET 2 MG TAB 406
176 SALBUTANOL TABLET 4 MG TAB 0
177 SALEP 2-4 POT 86
178 SALISIL BEDAK 2 % KTK 193 100
179 SAMCODRYL SIRUP BTL 0
180 SIANOKOBALAMIN INJ. 500 MG/ML AMP 0
181 SIANOKOBALAMIN TAB. 50 MCG TAB 9,599 2,000
182 SIMVASTATIN TABLET 10 MG TAB 250
183 SIMVASTATIN TABLET 20 MG TAB 0
184 TENSIGARD TAB. TAB 108
185 TETRASIKLIN KAPSUL 250 MG KAPS 553
186 TETRASIKLIN KAPSUL 500 MG KAPS 725
187 THIAMINE HCL TAB. 50 MG TAB 10,615
188 THIAMPHENICOL KAPS 500 MG KAPS 0
189 TRAMADOL INJEKSI AMP 0
190 TRAMADOL KAPS. 50 MG KAPS 0
191 TRIFLUOPERAZIN TABLET TAB 0
192 TRIHEKSIFENIDIL HCL TAB. 2 MG TAB 0
193 ULSAFAT SUSPENSI BTL 0
194 VITAMIN B KOMPLEK TAB. TAB 4,006 1,000
195 ZINK TABLET TAB 4,855

REAGENSIA
196 LARUTAN ASAM KLORIDA BTL 2
197 LARUTAN BENEDICT BTL 3

OBAT GIGI
198 ALBOTHYL CONCENTRAT BOTOL 0
199 APTIL SOLUTION BTL 0
200 DEVITALISASI PASTA BTL 1
201 ETIL KLORIDA SEMPROT BTL 4
202 EUGENOL CAIRAN BTL 4
203 GLASS IONOMER CEMENT SET 0
204 KALSIUM HIDROKSIDA PASTA BTL 0
205 LIDOKAIN INJEKSI 2% AMP 107
206 LIDOKAIN KOMP. INJ. AMP 85
207 MONOKLORKAMFER MENTOL CAIR BTL 0
208 MUMMYFYING PASTA BTL 0
209 SEMEN SENG FOSFAT BTL 0
210 TEMPORARY STOPPING FLETCHER BTL 0

ALAT KESEHATAN
211 ABBOCATH NO. 18 SET 7 100
212 ABBOCATH NO. 20 SET 82
213 ABBOCATH NO. 22 SET 0
214 ABBOCATH NO. 24 SET 0
215 ABBOCATH NO. 26 SET 13
216 ALAT SUNTIK DISPOSIBLE 1 ML SET 136
217 ALAT SUNTIK DISPOSIBLE 2,5 ML SET 336
218 ALAT SUNTIK DISPOSIBLE 5 ML SET 320
219 ALAT SUNTIK DISPOSIBLE 10 ML SET 221
220 ALAT SUNTIK DISPOSIBLE 20 ML SET 308
221 CATGUT SACHET 0 1
222 FOLLEY CATHETER NO. 14 SET 7
223 FOLLEY CATHETER NO. 16 SET 20
224 FOLLEY CATHETER NO. 18 SET 11
225 HANDSCHOEN NON STERIL SET 0 300
226 HANDSCHOEN STERIL SET 600
227 INFUSION SET ANAK SET 15
228 INFUSION SET DEWASA SET 123
229 KAPAS PEMBALUT 250 GRAM BKS 10
230 KASA HIDROFIL STERIL 16 X 16 ROL 57
231 KASA HIDROFIL 36 M X 80 CM ROL 0 1
232 KASA PEMBALUT 2 M X 80 CM ROL 7 10
233 KASA PEMBALUT 4 M X 10 CM ROL 60
234 KASA PEMBALUT 4 M X 5 CM ROL 65
235 MASKER SET 600 300
236 NEEDLE 23 G SET 0
237 PLESTER ROL 6
238 SAFETY BOX SET 0
239 SARUNG TANGAN OBGYN STERIL PASANG 50
240 SILK KTK 0
241 TRANFUSI SET SET 105
242 URINE BAG SET 35

OBAT TUBERCULOSIS
243 FDC KATEGORI I PAKET 13
244 FDC KATEGORI II PAKET 1
245 FDC KATEGORI ANAK PAKET 0
246 OAT KOMBIPAK KATEGORI 1 PAKET 0

OBAT KUSTA
247 MDT MB ANAK BLISTER 0
248 MDT MB DEWASA BLISTER 18
249 MDT PB ANAK BLISTER 0
250 MDT PB DEWASA BLISTER 12

OBAT HIV AIDS


251 EFAVIRENZ 600 MG BTL 0
252 LAMIVUDINE 150 MG BTL 0
253 NEVIRAPINE 200 MG BTL 0
254 TENOFOVIR (TDF) 300 MG BTL 0
TENOFOVIR 300 + LAMIVUDIN 300
255 + EFAVIRNA 600 (ATRIPLA BTL 0
DEWASA)
ZIDOVUDINE 300 MG +
256 LAMIVUDINE 150 MG (DUVIRAL) BTL 0
ZIDOVUDINE + LAMIVUDINE +
257 NEVIRAPINE (ATRIPLA ANAK) BTL 0
258 ZIDOVUDINE 100 MG BTL 0

OBAT GIZI
259 HEMAFORT TABLET TAB 0
260 IODIUM TEST SET 90
261 MINERAL MIX SACHET 0
262 RETINOL KAPSUL 100.000 IU KAPS 900
263 RETINOL KAPSUL 200.000 IU KAPS 3,500
264 SAMCOBION KAPSUL KAPS 0
265 SANGOVITIN KAPS 13,500
266 TABLET TAMBAH DARAH ( Fe ) TAB 20,000
267 TABURIA SACHET 0
268 VITABION KAPSUL KAPS 0

PONED & KIA


269 AMPICILLIN INJ. 1 G VIAL 0
270 CA GLUKONAS INJ. 100 MG/ML AMP 6
271 MgSO4 20 % INJ. 25 ML VIAL 15
272 MgSO4 40 % INJ. 25 ML VIAL 62
273 NATRIUM TIROKSINA TABLET TAB 0
274 PROCAIN BENZIL PENISILIN INJ. VIAL 0
275 VITAMIN K INFANT INJEKSI AMP 197
0
TAMBAHAN 0
1 0
2 0
3 0
4 0
5 0
6 0
7 0
8 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
16 0
17 0
18 0
19 0
20 0

UMUM JPKM ASKES TOTAL


JUMLAH KUNJUNGAN RESEP
1054 1224 101 2379

Mengetahui/Menyetujui
a.n Kepala Dinas Kesehatan Kab. Tegal Yang Menyerahkan
Kepala Gudang Farmasi Petugas GFK

...................................................... ................................................
NIP. NIP.
R PELAPORAN OBAT (LPLPO)

JULI 2018 FORM LPLPO PUSKESMAS

RIMAAN JUMLAH
PENGELUAR
PERSEDIAA SISA KETERANGAN
TOTAL AN
N
8 9 ( 4+8 ) 10 11 ( 9-10 ) 12

0 1 1
0 2 2
0 0 0
50 83 3 80
0 791 27 764
0 0 0 0
600 600 80 520
0 0 0 0
0 0 0 0
0 223 0 223
200 200 18 182
0 0 0 0
120 120 0 120
0 40 0 40
5,000 19,310 1,025 18,285
0 237 0 237
0 65 25 40
2,000 12,988 693 12,295
30 65 5 60
0 200 10 190
0 0 0 0
0 0 0 0
0 139 0 139
0 0 0 0
3,000 9,577 0 9,577
0 140 0 140
0 0 0 0
0 0 0 0
500 1,192 0 1,192
0 0 0 0
0 4 0 4
0 0 0 0
0 0 0 0
240 370 80 290
0 0 0 0
48 228 16 212
0 110 0 110
0 0 0 0
600 2,485 280 2,205
200 200 0 200
400 804 36 768
0 0 0 0
0 0 0 0
200 200 10 190
0 40 0 40
0 0 0 0
500 790 30 760
200 290 50 240
0 124 0 124
0 17 0 17
3,000 12,089 356 11,733
0 5 0 5
0 100 14 86
0 0 0 0
0 0 0 0
0 0 0 0
0 200 10 190
100 251 9 242
0 36 0 36
0 318 0 318
0 0 25 -25
0 205 0 205
0 0 0 0
0 10 0 10
0 0 0 0
0 11 0 11
0 124 0 124
0 10 0 10
0 0 0 0
0 0 0 0
0 0 0 0
200 496 33 463
0 3,900 0 3,900
0 0 0 0
0 0 0 0
0 0 1 -1
0 49 2 47
300 300 70 230
5,000 12,989 892 12,097
0 43 0 43
0 3 0 3
200 300 0 300
0 0 0 0
0 0 0 0
60 78 0 78
0 0 0 0
0 0 0 0
0 228 3 225
0 5 0 5
200 200 0 200
1,000 1,430 580 850
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 103 3 100
0 0 0 0
0 0 0 0
6,000 14,951 637 14,314
0 147 0 147
400 825 0 825
100 310 0 310
72 236 0 236
0 77 4 73
0 150 0 150
30 206 0 206
45 45 0 45
5,000 12,869 0 12,869
0 0 0 0
0 0 0 0
0 0 0 0
0 308 13 295
400 1,238 22 1,216
0 454 0 454
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 127 1 126
0 100 25 75
100 100 40 60
0 90 0 90
0 184 0 184
0 0 0 0
0 0 0 0
0 0 0 0
0 400 41 359
0 0 0 0
0 1,122 30 1,092
200 545 75 470
0 131 1 130
0 20 0 20
0 0 30 -30
0 0 0 0
0 0 0 0
100 100 0 100
0 22 0 22
60 245 10 235
0 0 0 0
0 152 5 147
0 148 2 146
0 196 0 196
0 0 0 0
150 325 19 306
0 0 0 0
0 0 0 0
100 169 0 169
0 0 0 0
90 106 76 30
0 105 2 103
300 767 41 726
10,000 34,068 2,851 31,217
0 32 0 32
15 20 1 19
0 159 0 159
2,000 8,259 0 8,259
0 350 0 350
400 1,330 146 1,184
300 300 224 76
0 0 0 0
23 45 0 45
0 0 0 0
0 0 0 0
0 2,695 65 2,630
0 200 0 200
0 54 0 54
0 0 0 0
60 180 0 180
0 7 0 7
400 656 50 606
0 100 0 100
0 5 0 5
0 406 113 293
0 0 0 0
0 86 2 84
100 293 0 293
0 0 0 0
0 0 0 0
2,000 11,599 0 11,599
0 250 56 194
0 0 0 0
0 108 16 92
0 553 0 553
0 725 10 715
0 10,615 0 10,615
0 0 25 -25
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
1,000 5,006 207 4,799
0 4,855 80 4,775

0 2 0 2
0 3 0 3

0 0 0 0
0 0 0 0
0 1 0 1
0 4 0 4
0 4 0 4
0 0 0 0
0 0 0 0
0 107 0 107
0 85 0 85
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0

100 107 0 107


0 82 0 82
0 0 0 0
0 0 0 0
0 13 0 13
0 136 0 136
0 336 0 336
0 320 0 320
0 221 0 221
0 308 0 308
1 1 0 1
0 7 0 7
0 20 0 20
0 11 0 11
300 300 0 300
0 600 0 600
0 15 0 15
0 123 0 123
0 10 0 10
0 57 0 57
1 1 0 1
10 17 0 17
0 60 0 60
0 65 0 65
300 900 0 900
0 0 0 0
0 6 0 6
0 0 0 0
0 50 0 50
0 0 0 0
0 105 0 105
0 35 0 35

0 13 0 13
0 1 0 1
0 0 0 0
0 0 0 0

0 0 0 0
0 18 0 18
0 0 0 0
0 12 0 12

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 90 0 90
0 0 0 0
0 900 0 900
0 3,500 0 3,500
0 0 0 0
0 13,500 0 13,500
0 20,000 0 20,000
0 0 0 0
0 0 0 0

0 0 0 0
0 6 0 6
0 15 0 15
0 62 0 62
0 0 0 0
0 0 0 0
0 197 0 197
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

Yang Meminta Yang Menerima


Kepala Puskesmas Petugas Puskesmas

Taryana, SKM.M.Kes Lestari Ambar P, AMF


NIP. 19680505 199003 1 NIP. 19830915 201001 2 023

You might also like