AN LEMBAR PERMINTAAN OBAT (LPLPO)

PUSKESMAS : MERAMBANG
KECAMATAN : BULIK TIMUR
KABUPATEN : LAMANDAU
PROVINSI : KABUPATEN

stok
NO NAMA OBAT KEMASAN

OBAT
1 Acetylcysteine 200 mg tab 720
2 Acyclovir tab tab 50
3 Albendazol 400 mg tab 400
4 Allupurinol 100mg tab tab 400
5 Ambroxol 30 mg tab 600
6 Ambroxol sirup btl 103
7 Aminofilin injeksi amp 3
8 Amlodipine 5 mg tab 60
9 Amlodipine 10 mg tab 4,800
10 Amoxicillin 250 mg Kap 2,200
11 Amoxicillin 500 mg kap 1,200
12 Amoxicillin sirup /etamox btl 98
13 Anabion sirup btl 144
14 Antasida tab tab 300
15 Antibakteri DOEN salep ( Bacitracin ) tube 33
16 Antifungi DOEN kombinasi pot 33
17 Asam Mefenamat tab 300
18 Atropin sulfat injeksi amp 20
19 Betametason cream tube 126
20 Biolysin sirup btl 12
21 Calcium lactate (Kalk) tab 200
22 Calortusin tab 2,000
23 Calortusin sirup btl 100
24 Cefadroxil sirup btl 60 ml 2
25 Cetrizine tab 4,900
26 Cetrizine sirup btl 60 ml 31
27 Chloramphenicol salep (Bufacetin) tube 11
28 Chloramphenicol salep mata 1% tube 25
29 Chloramphenicol suspensi botol 30
30 Chlorpheniramine maleat (CTM) tab 200
31 Cimetidine tab 200
32 Cotrimoksazol 960 mg tab 300
33 Cotrimoksazol sirup btl 82
34 Dexamethasone tab 300
35 Diazepam 5 mg tab 100
36 Diazepam inj. 5 mg / Stesolid amp 10
37 Dimenhidrinat 50 mg tab 800
38 Diphenhidramin inj.10 mg amp 60
39 Domperidon 10 mg tab 1,100
40 Ergotamin Caffein tab 100
41 Erytromisin 500 mg tab 800
42 Fenobarbital 30mg tab tab 100
43 Flutamol tab 300
44 Furosemid 40mg tab tab 350
45 Gentamisin tetes mata btl 33
46 Glibenklamid 5mg tab tab 1,300
47 Glimepiride tab 2 mg tab 100
48 Glukosa larutan 10% btl 20
49 Glukosa larutan 5% btl 169
50 Herbacold tab 420
51 Herbapain tab 480
52 Hidroklorotiazid (HCT) tab 1,000
53 Hidrokortison cream 2,5% tube 22
54 Ibuprofen tab 200
55 Ketokonazole krim tube 6
56 Lidokain inj amp 100
57 Lidokain kompositur inj amp 59
58 Lisol btl 6
59 Loratadin tab tab 200
60 Metil ergometrine tab tab 400
61 Metil Prednisolon 8mg tab 1,900
62 Metoklopramid 5 mg tab 500
63 Metronidazole tab 1,000
64 Mineral Mix sachet 30
65 Natrium Diklofenak tab tab 1,200
66 Natrium klorida infus 0,9 % (NaCl) btl 500ml 158
67 Neodiagon 650 mg tab 100
68 Nistatin 100.000 IU tab 500
69 Nistatin 500.000 IU salut gula tab 700
70 Omeprazole tab 300
71 Oralit sachet 400
72 Oxytetracycline salep mata 1 % tube 55
73 Pacdin sirup btl 12
74 Paracetamol drop btl 44
75 Paracetamol sirup / hufagesic btl 60 ml 86
76 Paracetamol tab 500 mg tab 1,400
77 Piroxicam 20 mg tab 200
78 Pyrantel Pantrin 130 mg tab 360
79 Pyrantel sirup btl 50
80 Ranitidin injeksi amp 10
81 Ringer Laktat infus ( R L ) btl 500ml 117
82 Salbutamol tab 4 mg tab 0
83 Salep 2 - 4 kombinasi pot 7
84 Samcorbex tab 3,000
85 Simvastatin 10mg tab tab 690
86 Sivit multivitamin tab 840
87 Tablet tambah darah Neo tab 3,720
88 Tetrasiklin kapsul 500 mg kapsul 300
89 Trihexyphenidyl 2 mg tab 100
90 Vitamin B Compleks tab tab 5,100
 91 Vitamin B1 (Tiamin) 50 mg tab 5,200
92 Vitamin B12 (Sianokobalamin) injeksi amp 162
93 Vitamin B6 (Piridoxin) 10 mg tab 400
94 Vitamin C (Asam askorbat) 50 mg tab 1,600
95 Vitamin K (Fitomenadion inj 2 mg/ml amp 24
96 Vitamin K (Fitomenadion) tab 10mg tab 900
97 Vitamin K (vitka infant) inj amp 5
98 Wida DS-1/4 NS infus 500 ml btl 26
99 Zink tablet tab 900
100 Zink sirup btl 144
BMHP 0
1 Abbocat No. 20 biji 9
2 Abbocat No. 22 biji 2
3 Abbocat No. 26 biji 28
4 Alat suntik 0,05 ml set 40
5 Alat suntik 0,5 ml insulin set 500
6 Alat suntik 1 ml set 100
7 Alat suntik 10 ml set 43
8 Alat suntik 3 ml set 625
9 Alat suntik 5 ml set 690
10 Alkohol Swab ktk 23
11 APD pcs 39
12 Apron biru pcs 2
13 Bisturi 21 kotak 1
14 Bisturi 36 kotak 2
15 Catgut chromic 2/0 buah 65
16 Catgut chromic 3/0 buah 28
17 Desinfektan (septalkan) btl 3
18 Etanol (alkohol) 70% 1000 ml btl 5
19 Etanol (alkohol) 70% 300 ml btl 56
20 Etakridin (rivanol) 0,1% 300 ml btl 16
21 Face shield pcs 16
22 Foley Catheter No. 20 buah 4
23 Handrub 500 ml pcs 10
24 Infus set anak buah 135
25 Infus set dewasa buah 26
26 Jepit tali pusat pcs 94
27 Kacamata google pcs 6
28 Kapas pembalut absorven 500 roll 5
29 Kasa hidrofil 40 x 80 cm roll 6
30 Kasa steril ktk 136
31 Masker pcs 4,200
32 Masker N95 pcs 50
33 Nasal Oksigen buah 4
34 Nebulizer adult pcs 5
35 Nebulizer paediatrick pcs 5
36 Nurse cap box 1
37 Pelindung muka pcs 22
38 Plesterin 10 cm x 5 m roll 51
39 Pore hipoallergenic paper tape pcs 36
40 pp tes buah 150
41 Sarung Tangan gynecolog psg 50
42 Sarung Tangan non steril psg 2,200
43 Sarung Tangan steril no.7 psg 16
44 Sarung Tangan steril no.7,5 psg 28
45 Sarung Tangan steril no.8 psg 23
46 Sepatu Boot psg 1
47 Silk 2/0 pcs 72
48 Silk 3/0 pcs 72
49 Test golongan darah A box 2
50 Test golongan darah B box 2
51 Underpad pcs 180
52 Urine Bag buah 4
53 USG gel pcs 2
54 Yodium P larut 10 % 30 ml btl 5
 DAFTAR PERSEDIAAN VAKSIN PER 30 JUNI 2021
PUSKESMAS MERAMBANG KABUPATEN LAMANDAU
Saldo Akhir Tahun Per 31 Des 2020 Periode 1 Januari s/d 30 Juni 2021 Saldo Per 30 Juni 2021
No Nama Obat Kemasan Persediaan Masuk Persediaan Keluar
Satuan Harga (Rp) Jumlah (RP) Satuan Harga Jumlah
Satuan Harga (Rp) Jumlah (Rp) Satuan Harga Jumlah (Rp)
1 BCG Vial 23.00 60,140.00 1,383,220.00 20.00 60,140.00 1,202,800.00 17.00 60,140.00 1,022,380.00 26.00 60,140.00 1,563,640.00
2 DPT HB HIB Vial 26.00 76,285.00 1,983,410.00 70.00 76,285.00 5,339,950.00 32.00 76,285.00 2,441,120.00 64.00 76,285.00 4,882,240.00
3 POLIO Vial 15.00 19,954.00 299,310.00 90.00 19,954.00 1,795,860.00 90.00 19,954.00 1,795,860.00 15.00 19,954.00 299,310.00
4 MR Vial 29.00 166,265.00 4,821,685.00 10.00 166,265.00 1,662,650.00 23.00 166,265.00 3,824,095.00 16.00 166,265.00 2,660,240.00
5 HBO Vial 10.00 23,270.00 232,700.00 20.00 23,270.00 465,400.00 15.00 23,270.00 349,050.00 15.00 23,270.00 349,050.00
6 TD Vial 13.00 16,500.00 214,500.00 10.00 16,500.00 165,000.00 6.00 16,500.00 99,000.00 17.00 16,500.00 280,500.00
7 DT Vial 0.00 17,790.00 0.00 0.00 17,790.00 0.00 0.00 17,790.00 0.00 0.00 17,790.00 0.00
8 ABU Vial 1.00 465,640.00 465,640.00 0.00 465,640.00 0.00 0.00 465,640.00 0.00 1.00 465,640.00 465,640.00
9 IPV Vial 12.00 139,000.00 1,668,000.00 40.00 139,000.00 5,560,000.00 16.00 139,000.00 2,224,000.00 36.00 139,000.00 5,004,000.00
10 VERORAB Vial 3.00 165,000.00 495,000.00 26.00 165,000.00 4,290,000.00 29.00 165,000.00 4,785,000.00 0.00 165,000.00 0.00
JUMLAH 11,563,465.00 20,481,660.00 16,540,505.00 15,504,620.00

Mengetahui Yang Melapor

Kepala Puskesmas Merambang Pengelola Obat Puskesmas Merambang

WIWIK FATMAWATI, A.Md.Keb DEWI, S.Farm., Apt

NIP. 19900820 201403 2 004 NIP. 19920602 201903 2 021
 DAFTAR PERSEDIAAN BMHP VAKSIN PER 30 JUNI 2021
PUSKESMAS MERAMBANG KABUPATEN LAMANDAU
Saldo Akhir Tahun Per 31 Des 2020 Periode 1 Januari s/d 30 Juni 2021 Saldo Per 30 Juni 2021
No Nama Obat Kemasan Persediaan Masuk Persediaan Keluar
Satuan Harga (Rp) Jumlah (RP) Satuan Harga Jumlah
Satuan Harga (Rp) Jumlah (Rp) Satuan Harga Jumlah (Rp)
1 ADS 0,05 ml pcs 0 1,518.00 0.00 100.00 1,518.00 151,800.00 0.00 1,518.00 0.00 100.00 1,518.00 151,800.00
2 ADS 0,5 ml pcs 500.00 1,240.00 620,000.00 0.00 1,240.00 0.00 297.00 1,240.00 368,280.00 203.00 1,240.00 251,720.00
3 ADS 0,5 ml pcs 0 1,185.00 0.00 100.00 1,185.00 118,500.00 0.00 1,185.00 0.00 100.00 1,185.00 118,500.00
4 ADS 5 ml pcs 0 1,470.00 0.00 100.00 1,470.00 147,000.00 0.00 1,470.00 0.00 100.00 1,470.00 147,000.00
5 Alkohol swab pcs 0 95.00 0.00 200.00 95.00 19,000.00 200.00 95.00 19,000.00 0.00 95.00 0.00
6 safety box pcs 12.00 24,122.00 289,464.00 0.00 24,122.00 0.00 12.00 24,122.00 289,464.00 0.00 24,122.00 0.00
7 safety box pcs 0 16,360.00 0.00 15.00 16,360.00 245,400.00 7.00 16,360.00 114,520.00 8.00 16,360.00 130,880.00
JUMLAH 909,464.00 681,700.00 791,264.00 799,900.00

Mengetahui Yang Melapor

Kepala Puskesmas Merambang Pengelola Obat Puskesmas Merambang

WIWIK FATMAWATI, A.Md.Keb DEWI, S.Farm., Apt

NIP. 19900820 201403 2 004 NIP. 19920602 201903 2 021
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)
PUSKESMAS : MERAMBANG
KECAMATAN : BULIK TIMUR
KABUPATEN : LAMANDAU : AGUSTUS
PROVINSI : KABUPATEN LAMANDAU : 2021

NO NAMA KEMASAN STOK AWAL PENERIMAAN PEMAKAIAN STOK AKHIR

VAKSIN
1 BCG Vial 25 4 21
2 DPT HB HIB Vial 57 9 48
3 POLIO Vial 58 9 49
4 MR Vial 14 5 9
5 HBO Vial 12 4 8
6 TD Vial 0 0 0
7 DT Vial 0 0 0
8 ABU Vial 1 0 1
9 IPV Vial 34 1 33
10 VERORAB Vial 4 1 3
10 Vaksin Covid Vial 0 101 41 60
BMHP
1 ADS 0,05 ml pcs 386 5 381
2 ADS 0,5 ml pcs 272 470 382 360
3 ADS 3 ml pcs 85 5 80
4 ADS 5 ml pcs 579 7 572
5 Alkohol swab pcs 0 460 350 110
6 Safety box pcs 7 4 2 9

Mengetahui Yang Melapor

Kepala Puskesmas Merambang Pengelola Obat Puskesmas Merambang

WIWIK FATMAWATI, A.Md.Keb DEWI, S.Farm., Apt

NIP. 19900820 201403 2 004 NIP. 19920602 201903 2 021