Register Obat Apotik

REGISTER PENGGUNAAN OBAT HARIAN DI LOKET OBAT PUSKESMAS BUHU
BULAN : 2018
Stok Peneri Sisa

NO NAMA OBAT 26 27 28 29 30 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 JLH
Awal maan Stok
1 Acyclovir 200 mg
2 Acyclovir 400 mg
3 Acyclovir Salep
4 Albothyl 10ml
5 Allopurinol 100mg
6 Ambroxol Syrup
7 Ambroxol Tab
8 Aminofilin 200mg
9 Amitriptilin hcl 25mg
10 Amlodipin 10 mg
11 Amlodipppin 5 mg
12 Amoksisilin 250mg
13 Amoksisilin 500mg
14 Amoksisilin sir. 125/5ml
15 Ampisilin 500mg
16 Ampisilin Sir. 125/5ml
17 Antalgin 500mg
18 Antasida Doen 500mg
19 Antasida Doen Syrup
20 Anti Hemmoroid supp
21 Anti Parkinson Doen Komb.
22 Asam askorbat 250mg
23 Asam askorbat 50mg
24 Asam Mefenamat
25 Asetosal 100mg
26 Asetosal 500mg
27 Attapulgid
28 Betahistin
29 Betametason Krim
30 Bisoprololol 5 mg
31 Bromheksin HCl
32 Captopril 25 mg
33 Cetrizine Syrup
34 Cetrizine Tab
35 Curcuma
36 Dasabion
37 Deksametason 0,5mg
38 Dekstrometorfan hbr 15 mg
39 Dekstrometorfan sir. 10mg
40 Diazepam 2mg
41 Diazepam 5mg
42 Dietilkarbamzin sitrat 100mg
43 Digoksin 0,25mg
44 Diltiazem
45 Domperidon Syr
Stok Peneri Sisa
NO NAMA OBAT 26 27 28 29 30 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 JLH
Awal maan Stok
46 Domperidone Tab
47 Dopamet
48 Efedrin tab 25mg
49 Ekstrak beladona 10mg
50 Erytromisin
51 Erytromisin Syr
52 Fenobarbital 30mg
53 Fenol gliserol tts. Ttl. 10,5
54 Fitomenadion 10mg
55 Furosemid 40mg
56 Garam Oralit 200ml air
57 Gemfibrozil
58 Gentamicyn Salep
59 Gention violet 1%
60 Glibenklamid Tablet 5 mg
61 Gliquidon
62 Gliseril guayakolat 100mg
63 Griseofulvin 125mg
64 Haloperidol 5mg
65 Hidroklorotiazida 25mg
66 Hidrokortison Krim 2,5%
67 Ibuprofen 200mg
68 Ibuprofen 400mg
69 Isosorbid Dinitrat
70 Kalsium Laktat 500mg
71 Karbamzepin 200mg
72 Ketokenazole Krim
73 Ketokonazole
74 Kloramphenikol 250mg
75 Kloramphenikol tts. Tel. 3%
76 Kloramphenikol ZM 1%
77 Klorokuin fosfat 150 mg
78 Klorpheniramin maleat (CTM)
79 Klorpromazin hcl 25mg

80 Klorpromazina hcl 100mg
81 Kodein hcl 10 mg
82 Komb. Pirimetamin+Suldoks
83 Kotrimoksazol 120mg
84 Kotrimoksazol 480mg
85 Kotrimoksazol suspensi
86 Lanzoprasol
87 Loperamid
88 Loratadin
89 Mebendazol 100 mg
90 Metformin
91 Metilergeometrin 0.125mg
92 Metilprednisolon
Stok Peneri Sisa
NO NAMA OBAT 26 27 28 29 30 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 JLH
Awal maan Stok
93 Metoclopramide Tab
94 Metronidazol 250mg
95 Metronidazol 500mg
96 Miconazole Saleep
97 Natrium Diclofenac 50 mg
98 Natrium Fenitoina 100mg
99 Natrium Fenitoina 30mg
100 Nistati 100.000 iu/g vagina
101 Nistati 500.000 iu/g vagina
102 OBH sirup
103 Oksitetrasiklin hcl ZK 3%
104 Oksitetrasiklin hcl ZM 1%
105 P. T. U 100mg
106 Parasetamol 100 mg
107 Parasetamol 500mg
108 Parasetamol sir. 120mg/5ml
109 Perpenazin 4mg
110 Pirantel Pamoat 125mg
111 Piridoksin 10 mg
112 Piroxicam
113 Prednison 5mg
114 Primakuin 15mg
115 Propranolol hcl 40mg
116 Pyronolakton
117 Ranitidin
118 Reserpina 0,1mg
119 Reserpina 0,25mg
120 Salbutamol 2mg
121 Salep 2-4
122 Salisil Bedak 2%
123 Sefadroxil
124 Sefixime
125 Simvastatin
126 Siprofloxacin 500 mg
127 Sulfadimidin 500mg
128 Sulfasetamid TM 15%
129 Tablet Tambah Darah
130 Tetrakain hcl TM 0,5%
131 Tetraksilin 500 mg
132 Tetrasiklin hcl 250mg
133 Tiamin hcl (Vit. B1) 50mg
134 Trihexifenidil hcl 2mg
135 Vitamin B. Complex
136 Whitefield salep
137 Zink Syrup
138 Zink Tab
139
140
Stok Peneri Sisa
NO NAMA OBAT 26 27 28 29 30 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 JLH
Awal maan Stok
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
Stok Peneri Sisa
NO NAMA OBAT 26 27 28 29 30 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 JLH
Awal maan Stok
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
RENCANA KEBUTUHAN OBAT PUSKESMAS BUHU
TAHUN 2010
PEMAKAIAN KEBUTUHAN TAHUN 2010

KODE NAMA OBAT SAT. RATA-RATA KET
TAHUN 2009 BULANAN TAHUNAN
1 2 3 4 5 6 7
001 Air Raksa Dental Use Botol #REF! #REF! #REF!
002 Abocath no. 18 Buah #REF! #REF! #REF!
005 Allopurinol 100mg Tablet #REF! #REF! #REF!
006 Aminofilin Inj 24mg/ml-10ml Ampul #REF! #REF! #REF!
007 Aminofilin 200mg Tablet #REF! #REF! #REF!
008 Amitriptilin hcl 25mg Tablet #REF! #REF! #REF!
009 Amoksisilin 250mg Kapsul #REF! #REF! #REF!
010 Amoksisilin sir. 125/5ml Botol #REF! #REF! #REF!
011 Amoksisilin 500mg Tablet #REF! #REF! #REF!
012 Ampisilin 500mg Tablet #REF! #REF! #REF!
013 Ampisilin Sir. 125/5ml Botol #REF! #REF! #REF!
014 Antalgin injeksi Ampul #REF! #REF! #REF!
015 Antalgin 500mg Tablet #REF! #REF! #REF!
016 Antasida Doen 500mg Tablet #REF! #REF! #REF!
017 Anti Hemmoroid supp Tablet 3 4 42
018 Aqua pro inj 20ml Vial #REF! #REF! #REF!
019 Asam askorbat 250mg Tablet #REF! #REF! #REF!
020 Asam askorbat 50mg Tablet #REF! #REF! #REF!
021 Whitefield salep Pot #REF! #REF! #REF!
022 Asetosal 500mg Tablet #REF! #REF! #REF!
023 Anti Parkinson Doen Komb. Tablet #REF! #REF! #REF!
024 Asam Sulfosalisilat 20% Botol #REF! #REF! #REF!
025 Asetosal 100mg Tablet #REF! #REF! #REF!
026 Atropin Sulfat inj 0,25mg/1ml Ampul #REF! #REF! #REF!
027 Atropin Sulfat 0.5mg Tablet #REF! #REF! #REF!
028 Atropin sulfat tts mata 0,5mg Botol #REF! #REF! #REF!
029 Albothyl 10ml Botol #REF! #REF! 100
halaman 6 dari 100 halaman

1 2 3 4 5 6 7
030 Betametason Krim Tube #REF! #REF! #REF!
031 Besi (II) sulfat Tablet #REF! #REF! 15000
032 Catgut/benang bedah 2/0-3/0 Buah #REF! #REF! #REF!
033 Dapson 100 mg Tablet #REF! #REF! #REF!
034 Deksametason inj 5mg/-1ml Ampul #REF! #REF! #REF!
035 Deksametason 0,5mg Tablet #REF! #REF! #REF!
036 Dietilkarbamzin sitrat 100mg Tablet #REF! #REF! #REF!
037 Dekstrometorfan sir. 10mg Botol #REF! #REF! #REF!
038 Dekstrometorfan hbr 15 mg Tablet #REF! #REF! #REF!
039 Devitalisasi pasta Pot #REF! #REF! #REF!
040 Diazepam inj 5mg/ml-2ml Ampul #REF! #REF! #REF!
041 Diazepam 2mg Tablet #REF! #REF! #REF!
042 Diazepam 5mg Tablet #REF! #REF! #REF!
043 Difenhiramin inj 10mg Ampul #REF! #REF! #REF!
044 Disposible 1ml Buah #REF! #REF! #REF!
045 Disposible 3 ml Buah #REF! #REF! #REF!
046 Disposible 5 ml Buah #REF! #REF! #REF!
047 Digoksin 0,25mg Tablet #REF! #REF! #REF!
048 Efedrin tab 25mg Tablet #REF! #REF! #REF!
049 Ekstrak beladona 10mg Tablet #REF! #REF! #REF!
050 Epinefrin (adrenalin) inj Ampul #REF! #REF! #REF!
051 Etakrinidin (Rifanol) 0,1% Botol #REF! #REF! #REF!
052 Etanol 70% 1000ml Botol #REF! #REF! #REF!
053 Etil Klorida semprot Botol 0.7 0.8 10
054 Eugenol cairan Botol #REF! #REF! #REF!
055 Fenobarbital inj 50mg/ml-2ml Ampul #REF! #REF! #REF!
056 Fenobarbital 30mg Tablet #REF! #REF! #REF!
057 Fenobarbital 100mg Tablet #REF! #REF! #REF!
058 Fenol gliserol tts. Ttl. 10,5 Botol #REF! #REF! 100
059 Fitomenadion inj 10mg/ml-1ml Ampul #REF! #REF! #REF!
060 Fitomenadion 10mg Tablet #REF! #REF! #REF!

1 2 3 4 5 6 7
061 Furosemid 40mg Tablet #REF! #REF! #REF!
062 Gameksan emulsi 1% Botol #REF! #REF! #REF!
063 Garam Oralit 200ml air Bungkus #REF! #REF! #REF!
064 Gention violet 1% Botol #REF! #REF! #REF!
065 Gliseril guayakolat 100mg Tablet #REF! #REF! #REF!
066 Gliserol Botol #REF! #REF! #REF!
067 Glukosa lar. Inf. 10% steril Botol #REF! #REF! #REF!
068 Glukosa lar. Inf. 40% steril Botol #REF! #REF! #REF!
069 Glukosa lar.Inf. 5% steril Botol #REF! #REF! #REF!
070 Griseofulvin 125mg Tablet #REF! #REF! #REF!
071 Fenoksimetil Penisilin Tablet #REF! #REF! #REF!
072 Glibenklamid Tablet 5 mg Tablet #REF! #REF! #REF!
073 Hidroklorotiazida 25mg Tablet #REF! #REF! #REF!
074 Hidrokortison Krim 2,5% Tube #REF! #REF! #REF!
075 Haloperidol 5mg Tablet #REF! #REF! #REF!
076 Hand Scoen Buah #REF! #REF! 500
077 Isosorbid Dinitrat Tablet #REF! #REF! 500
078 Ibuprofen 200mg Tablet #REF! #REF! #REF!
079 Ibu profen 400mg Tablet #REF! #REF! #REF!
080 Infusion set anak Buah #REF! #REF! #REF!
081 Infusion set dewasa Buah #REF! #REF! #REF!
082 Isoniasid (INH) 100 mg Tablet #REF! #REF! #REF!
083 Isoniasid (INH) 300 mg Tablet #REF! #REF! #REF!
084 Jarum Jahit No 9 s/d 14 Buah #REF! #REF! 100
085 Jarum suntik / NALD Buah #REF! #REF! #REF!
086 Kalium permanganat serbuk Tablet #REF! #REF! #REF!
087 Kalsium Laktat 500mg Tablet #REF! #REF! #REF!
088 Kategori 1 paket #REF! #REF! #REF! program
089 Kapas Berlemak 500mg Rol #REF! #REF! #REF!
090 Kapas Pembalut 250mg Rol #REF! #REF! #REF!
091 Kasa kompres 40X40 steril Bungkus #REF! #REF! #REF!

1 2 3 4 5 6 7
092 Kasa kompres 2X80 cm Rol #REF! #REF! #REF!
093 Kasa pembalut 4mX15cm Rol #REF! #REF! #REF!
094 Kasa pembalut 4mX3cm Rol #REF! #REF! #REF!
095 Kinina dihidroklorida inj 25% Ampul #REF! #REF! #REF!
096 Karbamzepin 200mg Tablet #REF! #REF! #REF!
097 Kloramphenikol 250mg Kapsul #REF! #REF! #REF!
098 Kloramphenikol ZM 1% Tube 3 4 42
099 Kloramphenikol tts. Tel. 3% Botol #REF! #REF! #REF!
100 Klorpheniramin maleat (CTM) Tablet #REF! #REF! #REF!
101 Klorokuin fosfat 150 mg Tablet #REF! #REF! #REF!
102 Klorpromazin hcl 25mg Tablet #REF! #REF! #REF!
103 Klorpromazina hcl 100mg Tablet #REF! #REF! 1000
104 Klorpromazina hcl inj 5mg Ampul #REF! #REF! #REF!
105 Klorpromazina hcl inj 25mg Ampul #REF! #REF! #REF!
106 Kodein hcl 10 mg Tablet #REF! #REF! 500
107 Komb. Pirimetamin+Suldoks Tablet #REF! #REF! #REF!
108 Kotrimoksazol suspensi Botol #REF! #REF! #REF!
109 Kotrimoksazol 480mg Tablet #REF! #REF! #REF!
110 Kotrimoksazol 120mg Tablet #REF! #REF! #REF!
111 Larutan Benedic Botol #REF! #REF! #REF!
112 Larutan eosin 2% Botol #REF! #REF! #REF!
113 Larutan Gabet Botol #REF! #REF! #REF!
114 Larutan Glesastain Botol #REF! #REF! #REF!
115 Larutan kinyoun Botol #REF! #REF! #REF!
116 Larutan turk Botol #REF! #REF! #REF!
117 Lidokain comp. inj. Ampul #REF! #REF! #REF!
118 Lisol Botol #REF! #REF! 48
119 Mebendazol 100 mg Tablet #REF! #REF! #REF!
120 Metamol Botol #REF! #REF! #REF!
121 Metilergeometrin Maleat inj Ampul #REF! #REF! #REF!
122 Metilergeometrin 0.125mg Tablet #REF! #REF! #REF!

1 2 3 4 5 6 7
123 Metronidazol 250mg Tablet #REF! #REF! #REF!
124 Metronidazol 500mg Tablet #REF! #REF! #REF!
125 Monoklorkamfer mentol cairan Botol #REF! #REF! #REF!
126 Mummiying pasta Botol #REF! #REF! #REF!
127 Natrium Bicarbonat 500 mg Tablet #REF! #REF! #REF!
128 Natrium Fenitoina 100mg Kapsul #REF! #REF! #REF!
129 Natrium Fenitoina 30mg Kapsul #REF! #REF! #REF!
130 Nacl inf.0,9% steril Botol #REF! #REF! #REF!
131 Nistati 500.000 iu/g vagina Tablet #REF! #REF! #REF!
132 Nistati 100.000 iu/g vagina Tablet #REF! #REF! #REF!
133 OBH sirup Botol #REF! #REF! #REF!
134 Oksitetrasiklin hcl ZM 1% Tube #REF! #REF! #REF!
135 Oksitetrasiklin hcl ZK 3% Tube #REF! #REF! #REF!
136 Oksitetrasiklin hcl inj Ampul #REF! #REF! #REF!
137 Oksitosin inj 10 iu/ml-1ml Ampul #REF! #REF! #REF!
138 Parafermaldehide 1 gram Tablet #REF! #REF! #REF!
139 Parasetamol sir. 120mg/5ml Botol #REF! #REF! #REF!
140 Parasetamol 100 mg Tablet #REF! #REF! #REF!
141 Parasetamol 500mg Tablet #REF! #REF! #REF!
142 Pirantel Pamoat 125mg Tablet #REF! #REF! #REF!
143 Piridoksin 10 mg Tablet #REF! #REF! #REF!
144 Plester 5 yart X 2 inch Rol #REF! #REF! #REF!
145 Polipeptida Botol #REF! #REF! #REF!
146 Prednison 5mg Tablet #REF! #REF! #REF!
147 Primakuin 15mg Tablet #REF! #REF! 1000
148 P. T. U 100mg Tablet #REF! #REF! #REF!
149 Propranolol hcl 40mg Tablet #REF! #REF! #REF!
150 Perpenazin 4mg Tablet #REF! #REF! #REF!
151 Phetidin inj Ampul #REF! #REF! #REF!
152 Reserpina 0,1mg Tablet #REF! #REF! #REF!
153 Reserpina 0,25mg Tablet #REF! #REF! #REF!

1 2 3 4 5 6 7
154 Retinol Kaps. 200.000 iu Kapsul #REF! #REF! #REF!
155 Retinol Kaps. 50.000 iu Tablet #REF! #REF! #REF!
156 Ringer Laktat lar. Infus Botol #REF! #REF! #REF!
157 Salep 2-4 Pot #REF! #REF! #REF!
158 Salbutamol 2mg Tablet #REF! #REF! #REF!
159 Salisil Bedak 2% Botol #REF! #REF! #REF!
160 Salisil Spiritus 10% Botol #REF! #REF! 50
161 Semen seng fosfat serbuk Set #REF! #REF! #REF!
162 Sianokobalamin inj 500mg Ampul #REF! #REF! #REF!
163 Silk Benang Sutra no. 3/0 Sak #REF! #REF! #REF!
164 Silfer amalgam 65/75% Botol #REF! #REF! #REF!
165 Spons gelatin 1X1X1cm tbg #REF! #REF! #REF!
166 Sulfadimidin 500mg Tablet #REF! #REF! #REF!
167 Sulfasetamid TM 15% Botol #REF! #REF! #REF!
168 Temporary Stopping Fletcher Set #REF! #REF! #REF!
169 Tetrakain hcl TM 0,5% Botol #REF! #REF! #REF!
170 Tetrasiklin hcl 250mg Kapsul #REF! #REF! #REF!
171 Tetraksilin 500 mg Kaplet #REF! #REF! #REF!
172 Tiamin hcl (Vit. B1) 50mg Tablet #REF! #REF! #REF!
173 Tiamin hcl inj. 100mg/ml-1ml Ampul #REF! #REF! #REF!
174 Trikresol Formalin (TKF) Botol #REF! #REF! #REF!
175 Trihexifenidil hcl 2mg Tablet #REF! #REF! #REF!
176 Vitamin B. Complex Tablet #REF! #REF! #REF!
177 Yodium Povidon 10% 30ml Botol #REF! #REF! #REF!
178 Yodium Povidon 10% 300ml Botol #REF! #REF! #REF!
179 Captopril 25 mg Tablet #REF! #REF! #REF!
180 Captopril 12,5 mg Tablet #REF! #REF! #REF!
181 KOH pasta Tube 0 0 0
182 Siprofloxacin 500 mg Tablet #REF! #REF! #REF!
183 MgSO4 40 % Btl #REF! #REF! #REF!
184 MgSO4 20 % Btl #REF! #REF! #REF!

1 2 3 4 5 6 7
Mengetahui Petugas Pengelola Obat

Kepala Puskesmas Buhu Puskesmas Buhu
dr. Sri Darsianti Tuna H. Muhtar Rahim, S.Kep, Ns

NIP. 19741210 200604 2 017 NIP. 19730525 199903 1 008

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)
PUSKESMAS : BUHU PELAPORAN BULAN/PERIODE : JANUARI 2011 DINKES KAB. GORONTALO

KECAMATAN : TIBAWA PERMINTAAN BULAN/PERIODE : FEBRUARI 2011 INSTALASI FARMASI
KABUPATEN : GORONTALO PUSKESMAS
PROPINSI : GORONTALO
STOCK PENE- PERSE- PEMA- SISA STOCK PERMIN PEMBERIAN
KODE NAMA OBAT SAT. TAAN
AWAL RIMAAN DIAAN KAIAN STOCK OPT. PKPSBBM DAU Program
1 2 3 4 5 6 7 8 9 10 11 12 13
001 Abocath no. 18 Buah 0 0 0 0 0 0 0
002 Abocath no. 20 Buah 10 0 10 0 10 0 0
003 Abocath no. 24 Buah 8 0 8 0 8 0 0
004 Air Raksa Dental Use Botol 0 0 0 0 0 0 0
005 Albothyl 10ml Botol 0 0 0 0 0 0 50
006 Allopurinol 100mg Tablet 81 0 81 0 81 0 0
007 Aminofilin 200mg Tablet 413 0 413 0 413 0 0
008 Aminofilin Inj 24mg/ml-10ml Ampul 26 0 26 0 26 0 0
009 Amitriptilin hcl 25mg Tablet 100 0 100 0 100 0 0
010 Amoksisilin 250mg Kapsul 0 0 0 0 0 0 0
011 Amoksisilin 500mg Tablet 1450 1000 2450 1919 531 2264 1733
012 Amoksisilin sir. 125/5ml Botol 6 20 26 12 14 14 0
013 Ampisilin 500mg Tablet 0 0 0 0 0 0 1000
014 Ampisilin Sir. 125/5ml Botol 0 0 0 0 0 0 20
015 Antalgin 500mg Tablet 28 0 28 0 28 0 1000
016 Antalgin injeksi Ampul 0 0 0 0 0 0 0
017 Antasida Doen 500mg Tablet 1683 2000 3683 1955 1728 2307 579
018 Anti Hemmoroid supp Tablet 10 0 10 0 10 0 0
019 Anti Parkinson Doen Komb. Tablet 100 0 100 0 100 0 0
020 Aqua pro inj 20ml Vial 0 0 0 0 0 0 0
021 Asam askorbat 250mg Tablet 0 0 0 0 0 0 0
023 Asam Mefenamat 500 mg Kaplet 37 1500 1537 1019 518 1202 684
024 Asam Sulfosalisilat 20% Botol 0 0 0 0 0 0 0
025 Asetosal 100mg Tablet 40 0 40 0 40 0 0
027 Atropin Sulfat 0.5mg Tablet 0 0 0 0 0 0 0
028 Atropin Sulfat inj 0,25mg/1ml Ampul 0 0 0 0 0 0 0
file:///conversion/tmp/activity_task_scratch/554832632.xls halaman 13 dari 100 halaman

1 2 3 4 5 6 7 8 9 10 11 12 13
029 Atropin sulfat tts mata 0,5mg Botol 0 0 0 0 0 0 0
030 Besi (II) sulfat Tablet 0 0 0 0 0 0 0
031 Betametason Krim Tube 0 50 50 30 20 35 15
032 Bisoprololol 5 mg 90 0 90 0 90 0 0
033 Captopril 12,5 mg Tablet 0 0 0 0 0 0 0
034 Captopril 25 mg Tablet 196 1200 1396 683 713 806 93
035 Catgut/benang bedah 2/0-3/0 Buah 35 0 35 15 20 18 0
036 Curcuma Tablet 0 500 500 500 0 590 1000
037 Dapson 100 mg Tablet 0 0 0 0 0 0 0
038 Deksametason 0,5mg Tablet 69 2000 2069 1669 400 1969 1569
039 Deksametason inj 5mg/-1ml Ampul 0 0 0 0 0 0 30
040 Dekstrometorfan hbr 15 mg Tablet 277 0 277 9 268 11 0
041 Dekstrometorfan sir. 10mg Botol 0 12 12 0 12 0 0
042 Devitalisasi pasta Pot 0 0 0 0 0 0 0
043 Diazepam 2mg Tablet 1083 1000 2083 1423 660 1679 1019
045 Diazepam inj 5mg/ml-2ml Ampul 0 0 0 0 0 0 0
046 Dietilkarbamzin sitrat 100mg Tablet 0 0 0 0 0 0 0
047 Difenhiramin inj 10mg Ampul 60 150 210 150 60 177 117
048 Digoksin 0,25mg Tablet 40 0 40 0 40 0 0
049 Diltiazem 300 0 300 0 300 0 0
050 Disposible 1ml Buah 0 0 0 0 0 0 0
051 Disposible 3 ml Buah 100 200 300 200 100 236 136
053 Domperidon Syr Btl 0 5 5 5 0 6 50
054 Efedrin tab 25mg Tablet 950 0 950 528 422 623 0
055 Ekstrak beladona 10mg Tablet 0 0 0 0 0 0 100
056 Epinefrin (adrenalin) inj Ampul 13 0 13 0 13 0 0
057 Erytromisin Kapsul 300 120 420 300 120 354 234
058 Erytromisin Syr Btl 5 5 10 5 5 6 0
059 Etakrinidin (Rifanol) 0,1% Botol 0 7 7 0 7 0 0
060 Etanol 70% 1000ml Botol 1 4 5 4 1 5 4
061 Etil Klorida semprot Botol 0 1 1 0 1 0 0
062 Eugenol cairan Botol 8 0 8 0 8 0 0

1 2 3 4 5 6 7 8 9 10 11 12 13
063 Fenobarbital 100mg Tablet 0 0 0 0 0 0 0
065 Fenobarbital inj 50mg/ml-2ml Ampul 0 0 0 0 0 0 0
066 Fenoksimetil Penisilin Tablet 0 0 0 0 0 0 0
067 Fenol gliserol tts. Ttl. 10,5 Botol 0 0 0 0 0 0 50
068 Fitomenadion 10mg Tablet 154 0 154 0 154 0 0
069 Fitomenadion inj 10mg/ml-1ml Ampul 0 0 0 0 0 0 0
070 Furosemid 40mg Tablet 56 0 56 0 56 0 0
071 Gameksan emulsi 1% Botol 0 0 0 0 0 0 0
072 Garam Oralit 200ml air Bungkus 409 0 409 30 379 35 0
073 Gention violet 1% Botol 2 0 2 0 2 0 0
074 Glibenklamid Tablet 5 mg Tablet 147 0 147 0 147 0 0
075 Gliquidon 200 0 200 0 200 0 0
076 Gliseril guayakolat 100mg Tablet 1739 2000 3739 1853 1886 2187 301
077 Gliserol Botol 0 0 0 0 0 0 0
078 Glukosa lar. Inf. 10% steril Botol 0 0 0 0 0 0 0
080 Glukosa lar.Inf. 5% steril Botol 36 0 36 0 36 0 0
081 Griseofulvin 125mg Tablet 211 600 811 654 157 772 615
082 Haloperidol 5mg Tablet 0 0 0 0 0 0 0
083 Hand Scoen No. 7 Buah 35 0 35 15 20 18 0
084 Hand Scoen No. 7 1/2 Psg 24 7 31 15 16 18 2
085 Hand Scoen No. 8 Psg 10 50 60 35 25 41 16
086 Hidroklorotiazida 25mg Tablet 321 0 321 6 315 7 0
087 Hidrokortison Krim 2,5% Tube 7 24 31 16 15 19 4
088 Ibu profen 400mg Tablet 2 600 602 0 602 0 0
089 Ibuprofen 200mg Tablet 568 0 568 34 534 40 0
090 Infusion set anak Buah 18 0 18 0 18 0 0
091 Infusion set dewasa Buah 1 0 1 0 1 0 0
092 Isoniasid (INH) 100 mg Tablet 0 0 0 0 0 0 0
094 Isosorbid Dinitrat Tablet 91 0 91 0 91 0 0
095 Jarum Jahit No 9 s/d 14 Buah 0 0 0 0 0 0 20
096 Jarum suntik / NALD Buah 0 0 0 0 0 0 200

1 2 3 4 5 6 7 8 9 10 11 12 13
097 Kalium permanganat serbuk Tablet 0 0 0 0 0 0 0
098 Kalsium Laktat 500mg Tablet 1267 0 1267 656 611 774 2000
099 Kapas Berlemak 500mg Rol 0 0 0 0 0 0 0
100 Kapas Pembalut 250mg Rol 2 5 7 1 6 1 0
101 Karbamzepin 200mg Tablet 100 0 100 0 100 0 0
102 Kasa kompres 2X80 cm Rol 3 15 18 16 2 19 17
103 Kasa kompres 40X40 steril Bungkus 5 20 25 20 5 24 19
104 Kasa pembalut 4mX15cm Rol 10 0 10 0 10 0 0
106 Kategori 1 paket 0 0 0 0 0 0 0
107 Ketokonazole 50 200 250 200 50 236 186
108 Kinina dihidroklorida inj 25% Ampul 0 0 0 0 0 0 0
109 Kloramphenikol 250mg Kapsul 257 0 257 6 251 7 0
110 Kloramphenikol tts. Tel. 3% Botol 17 0 17 0 17 0 0
111 Kloramphenikol ZM 1% Tube 21 0 21 0 21 0 0
112 Klorokuin fosfat 150 mg Tablet 2827 0 2827 1030 1797 1215 0
113 Klorpheniramin maleat (CTM) Tablet 1433 5000 6433 2192 4241 2587 0
114 Klorpromazin hcl 25mg Tablet 749 0 749 0 749 0 0
115 Klorpromazina hcl 100mg Tablet 0 0 0 0 0 0 0
116 Klorpromazina hcl inj 25mg Ampul 0 0 0 0 0 0 0
118 Kodein hcl 10 mg Tablet 0 0 0 0 0 0 100
119 KOH pasta Tube 0 0 0 0 0 0 0
120 Komb. Pirimetamin+Suldoks Tablet 100 0 100 100 0 118 0
121 Kotrimoksazol 120mg Tablet 177 1000 1177 42 1135 50 0
123 Kotrimoksazol suspensi Botol 50 0 50 12 38 14 0
124 Lanzoprasol 300 0 300 0 300 0 0
125 Larutan Benedic Botol 0 0 0 0 0 0 0
126 Larutan eosin 2% Botol 0 0 0 0 0 0 0
127 Larutan Gabet Botol 0 0 0 0 0 0 0
128 Larutan Glesastain Botol 0 0 0 0 0 0 0
129 Larutan kinyoun Botol 0 0 0 0 0 0 0
130 Larutan turk Botol 0 0 0 0 0 0 0

1 2 3 4 5 6 7 8 9 10 11 12 13
131 Lidokain comp. inj. Ampul 20 150 170 20 150 24 0
132 Lisol Botol 0 1 1 0 1 0 0
133 Loperamid 0 0 0 0 0 0 0
134 Loratadin 100 0 100 0 100 0 0
135 Masker Buah 0 200 200 100 100 118 18
136 Mebendazol 100 mg Tablet 0 0 0 0 0 0 0
137 Metamol Botol 0 0 0 0 0 0 0
138 Metformin Tablet 200 0 200 0 200 0 0
139 Metilergeometrin 0.125mg Tablet 294 500 794 400 394 472 0
140 Metilergeometrin Maleat inj Ampul 30 60 90 0 90 0 0
141 Metilprednisolon Tablet 500 0 500 0 500 0 0
142 Metronidazol 250mg Tablet 891 0 891 0 891 0 0
144 MgSO4 20 % Btl 0 0 0 0 0 0 0
145 MgSO4 40 % Btl 0 0 0 0 0 0 0
146 Monoklorkamfer mentol cairan Botol 0 0 0 0 0 0 0
147 Mummiying pasta Botol 0 0 0 0 0 0 0
148 Nacl inf.0,9% steril Botol 0 0 0 0 0 0 0
149 Natrium Bicarbonat 500 mg Tablet 0 0 0 0 0 0 1000
150 Natrium Fenitoina 100mg Kapsul 0 0 0 0 0 0 0
152 Nistati 100.000 iu/g vagina Tablet 0 0 0 0 0 0 0
154 OBH sirup Botol 5 0 5 0 5 0 20
155 Oksitetrasiklin hcl inj Ampul 0 0 0 0 0 0 0
156 Oksitetrasiklin hcl ZK 3% Tube 17 25 42 16 26 19 0
157 Oksitetrasiklin hcl ZM 1% Tube 48 0 48 1 47 1 0
158 Oksitosin inj 10 iu/ml-1ml Ampul 20 20 40 0 40 0 0
159 P. T. U 100mg Tablet 77 200 277 173 104 204 100
160 Parafermaldehide 1 gram Tablet 0 0 0 0 0 0 0
161 Parasetamol 100 mg Tablet 214 0 214 18 196 21 200
162 Parasetamol 500mg Tablet 1360 2000 3360 2954 406 3486 3080
163 Parasetamol sir. 120mg/5ml Botol 13 12 25 16 9 19 10
164 Perpenazin 4mg Tablet 0 0 0 0 0 0 0

1 2 3 4 5 6 7 8 9 10 11 12 13
165 Phetidin inj Ampul 0 0 0 0 0 0 0
166 Pirantel Pamoat 125mg Tablet 118 0 118 0 118 0 0
167 Piridoksin 10 mg Tablet 922 5000 5922 2041 3881 2408 0
168 Piroxicam 500 0 500 18 482 21 0
169 Plester 5 yart X 2 inch Rol 2 6 8 6 2 7 5
170 Polipeptida Botol 0 0 0 0 0 0 0
171 Prednison 5mg Tablet 356 2000 2356 1045 1311 1233 0
172 Primakuin 15mg Tablet 0 0 0 0 0 0 0
173 Propranolol hcl 40mg Tablet 97 0 97 0 97 0 0
174 Pyronolakton 100 0 100 0 100 0 0
175 Ranitidin Tablet 400 500 900 639 261 754 493
176 Reserpina 0,1mg Tablet 0 0 0 0 0 0 0
178 Retinol Kaps. 200.000 iu Kapsul 0 0 0 0 0 0 0
179 Retinol Kaps. 50.000 iu Tablet 0 0 0 0 0 0 0
180 Ringer Laktat lar. Infus Botol 20 0 20 0 20 0 0
181 Salbutamol 2mg Tablet 49 0 49 42 7 50 0
182 Salep 2-4 Pot 10 0 10 10 0 12 0
183 Salisil Bedak 2% Botol 1 20 21 12 9 14 5
184 Salisil Spiritus 10% Botol 0 0 0 0 0 0 10
185 Sefadroxil 500 mg Kapsul 50 250 300 270 30 319 289
186 Semen seng fosfat serbuk Set 2 0 2 0 2 0 0
187 Sianokobalamin inj 500mg Ampul 50 0 50 0 50 0 0
188 Silfer amalgam 65/75% Botol 3 0 3 0 3 0 0
189 Silk Benang Sutra no. 3/0 Sak 0 0 0 0 0 0 0
190 Simvastatin 210 0 210 0 210 0 0
191 Siprofloxacin 500 mg Tablet 197 200 397 72 325 85 0
192 Spons gelatin 1X1X1cm tbg 0 0 0 0 0 0 0
193 Sulfadimidin 500mg Tablet 0 0 0 0 0 0 1000
194 Sulfasetamid TM 15% Botol 0 0 0 0 0 0 0
195 Temporary Stopping Fletcher Set 0 0 0 0 0 0 0
196 Tetrakain hcl TM 0,5% Botol 8 0 8 3 5 4 0
197 Tetraksilin 500 mg Kaplet 312 0 312 100 212 118 0
198 Tetrasiklin hcl 250mg Kapsul 758 1000 1758 1200 558 1416 858

1 2 3 4 5 6 7 8 9 10 11 12 13
199 Tiamin hcl (Vit. B1) 50mg Tablet 2561 2000 4561 2362 2199 2787 588
200 Tiamin hcl inj. 100mg/ml-1ml Ampul 11 10 21 14 7 17 0
201 Trihexifenidil hcl 2mg Tablet 0 0 0 0 0 0 100
202 Trikresol Formalin (TKF) Botol 0 0 0 0 0 0 0
203 Vitamin B. Complex Tablet 1695 2000 3695 2303 1392 2718 1326
204 Whitefield salep Pot 0 0 0 0 0 0 0
205 Yodium Povidon 10% 300ml Botol 1 0 1 1 0 1 3
207
208
209
210
211
212
UMUM ASKES JAMKESMAS JAMKESDA TOTAL

JUMLAH KUNJUNGAN RESEP
497 20 331 0 848
Mengetahui, Petugas Pengelola Oba

dr. Sri Darsianti Tuna H. Muhtar Rahim, S.Kep,

NIP. 19741210 200604 2 017 NIP. 19730525 199903 1

DAN LEMBAR PERMINTAAN OBAT (LPLPO)
PEMBERIAN
DIKES PROV DAK
KET
14 15 16

PEMBERIAN
DIKES PROV DAK
KET
14 15 16

PEMBERIAN
DIKES PROV DAK
KET
14 15 16

PEMBERIAN
DIKES PROV DAK
KET
14 15 16

PEMBERIAN
DIKES PROV DAK
KET
14 15 16

PEMBERIAN
DIKES PROV DAK
KET
14 15 16

PEMBERIAN
DIKES PROV DAK
KET
14 15 16
Petugas Pengelola Obat

Puskesmas Buhu
H. Muhtar Rahim, S.Kep, Ns.

NIP. 19730525 199903 1 008

PUSKESMAS : BUHU PELAPORAN BULAN/PERIODE : FEBRUARI 2011 DINKES KAB. GORONTALO

KECAMATAN : TIBAWA PERMINTAAN BULAN/PERIODE : MARET 2011 INSTALASI FARMASI
KABUPATEN : GORONTALO PUSKESMAS
PROPINSI : GORONTALO
1 2 3 4 5 6 7 8 9 10 11 12 13
001 Abocath no. 18 Buah 0 0 0 0 0 0 0
002 Abocath no. 20 Buah 10 0 10 2 8 2 0
003 Abocath no. 24 Buah 8 0 8 3 5 4 0
006 Allopurinol 100mg Tablet 81 0 81 9 72 11 0
007 Aminofilin 200mg Tablet 413 0 413 0 413 0 0
009 Amitriptilin hcl 25mg Tablet 100 0 100 0 100 0 0
015 Antalgin 500mg Tablet 28 0 28 0 28 0 0
018 Anti Hemmoroid supp Tablet 10 0 10 0 10 0 0
019 Anti Parkinson Doen Komb. Tablet 100 0 100 0 100 0 0
023 Asam Mefenamat 500 mg Kaplet 518 600 1118 660 458 779 321

1 2 3 4 5 6 7 8 9 10 11 12 13
031 Betametason Krim Tube 20 25 45 12 33 14 0
032 Bisoprololol 5 mg 90 0 90 0 90 0 0
036 Curcuma Tablet 0 100 100 100 0 118 1000
037 Dapson 100 mg Tablet 0 0 0 0 0 0 0
040 Dekstrometorfan hbr 15 mg Tablet 268 0 268 36 232 42 0
041 Dekstrometorfan sir. 10mg Botol 12 0 12 0 12 0 0
048 Digoksin 0,25mg Tablet 40 0 40 0 40 0 0
049 Diltiazem 300 0 300 0 300 0 0
053 Domperidon Syr Btl 0 5 5 3 2 4 50
054 Efedrin tab 25mg Tablet 422 0 422 70 352 83 0
057 Erytromisin Kapsul 120 120 240 0 240 0 0
058 Erytromisin Syr Btl 5 0 5 0 5 0 0
060 Etanol 70% 1000ml Botol 1 4 5 4 1 5 4
061 Etil Klorida semprot Botol 1 1 2 1 1 1 0

1 2 3 4 5 6 7 8 9 10 11 12 13
070 Furosemid 40mg Tablet 56 0 56 0 56 0 0
072 Garam Oralit 200ml air Bungkus 379 0 379 30 349 35 0
073 Gention violet 1% Botol 2 0 2 0 2 0 0
074 Glibenklamid Tablet 5 mg Tablet 147 0 147 100 47 118 0
075 Gliquidon 200 0 200 0 200 0 0
081 Griseofulvin 125mg Tablet 157 500 657 36 621 42 0
084 Hand Scoen No. 7 1/2 Psg 16 2 18 0 18 0 0
085 Hand Scoen No. 8 Psg 25 16 41 35 6 41 35
086 Hidroklorotiazida 25mg Tablet 315 0 315 3 312 4 0
088 Ibu profen 400mg Tablet 602 0 602 0 602 0 0
094 Isosorbid Dinitrat Tablet 91 0 91 0 91 0 0

1 2 3 4 5 6 7 8 9 10 11 12 13
101 Karbamzepin 200mg Tablet 100 0 100 0 100 0 0
106 Kategori 1 paket 0 0 0 0 0 0 0
107 Ketokonazole 50 200 250 0 250 0 0
109 Kloramphenikol 250mg Kapsul 251 0 251 0 251 0 0
110 Kloramphenikol tts. Tel. 3% Botol 17 0 17 0 17 0 0
111 Kloramphenikol ZM 1% Tube 21 0 21 0 21 0 0
112 Klorokuin fosfat 150 mg Tablet 1797 0 1797 0 1797 0 0
114 Klorpromazin hcl 25mg Tablet 749 0 749 0 749 0 0
119 KOH pasta Tube 0 0 0 0 0 0 0
120 Komb. Pirimetamin+Suldoks Tablet 0 1000 1000 600 400 708 0
123 Kotrimoksazol suspensi Botol 38 0 38 18 20 21 0
124 Lanzoprasol 300 0 300 126 174 149 0

1 2 3 4 5 6 7 8 9 10 11 12 13
132 Lisol Botol 1 0 1 0 1 0 0
133 Loperamid 0 0 0 0 0 0 0
134 Loratadin 100 0 100 0 100 0 0
135 Masker Buah 100 50 150 150 0 177 177
137 Metamol Botol 0 0 0 0 0 0 0
138 Metformin Tablet 200 0 200 0 200 0 0
139 Metilergeometrin 0.125mg Tablet 394 0 394 0 394 0 0
141 Metilprednisolon Tablet 500 0 500 300 200 354 154
144 MgSO4 20 % Btl 0 0 0 0 0 0 5
145 MgSO4 40 % Btl 0 0 0 0 0 0 5
149 Natrium Diclofenac 50 mg Tablet 0 1000 1000 700 300 826 1000
154 OBH sirup Botol 5 20 25 12 13 14 20
157 Oksitetrasiklin hcl ZM 1% Tube 47 0 47 0 47 0 0
159 P. T. U 100mg Tablet 104 100 204 166 38 196 158
161 Parasetamol 100 mg Tablet 196 0 196 0 196 0 200

1 2 3 4 5 6 7 8 9 10 11 12 13
166 Pirantel Pamoat 125mg Tablet 118 0 118 0 118 0 0
168 Piroxicam 482 0 482 100 382 118 0
171 Prednison 5mg Tablet 1311 0 1311 71 1240 84 0
173 Propranolol hcl 40mg Tablet 97 0 97 0 97 0 0
174 Pyronolakton 100 0 100 0 100 0 0
175 Ranitidin Tablet 261 500 761 650 111 767 656
182 Salep 2-4 Pot 0 0 0 0 0 0 0
183 Salisil Bedak 2% Botol 9 5 14 12 2 14 12
185 Sefadroxil 500 mg Kapsul 30 200 230 26 204 31 0
190 Simvastatin 210 0 210 30 180 35 0
196 Tetrakain hcl TM 0,5% Botol 5 0 5 0 5 0 0
197 Tetraksilin 500 mg Kaplet 212 0 212 0 212 0 0
198 Tetrasiklin hcl 250mg Kapsul 558 1000 1558 0 1558 0 0

1 2 3 4 5 6 7 8 9 10 11 12 13
203 Vitamin B. Complex Tablet 1392 2000 3392 1554 1838 1834 0
207 Cefixim Tablet 0 0 0 0 0 0 500
208
209
210
211
212

714 29 482 2 1227
Mengetahui, Petugas Pengelola Oba

dr. Sri Darsianti Tuna H. Muhtar Rahim, S.Kep,

NIP. 19741210 200604 2 017 NIP. 19730525 199903 1

PEMBERIAN
DIKES PROV DAK
KET
14 15 16

PEMBERIAN
DIKES PROV DAK
KET
14 15 16

PEMBERIAN
DIKES PROV DAK
KET
14 15 16

PEMBERIAN
DIKES PROV DAK
KET
14 15 16

PEMBERIAN
DIKES PROV DAK
KET
14 15 16

PEMBERIAN
DIKES PROV DAK
KET
14 15 16

PEMBERIAN
DIKES PROV DAK
KET
14 15 16
Petugas Pengelola Obat

Puskesmas Buhu
H. Muhtar Rahim, S.Kep, Ns.

NIP. 19730525 199903 1 008

DOKUMEN BUKTI MUTASI OBAT
: BUHU BULAN
KECAMATAN : TIBAWA TAHUN
PENGELUARAN
PERSE
STOCK PENE-
KODE NAMA OBAT SAT. -
AWAL RIMAAN LOKET POLINDES POSKESDE PUSTU PUSTU
PUSLING
RUANG
DIAAN OBAT BUHU S ILOPONU LABANU MOTILANGO TINDAKAN
1 2 3 4 5 6 11 12 13 14 15 16 17
002 Abocath no. 18 Buah 0 0 0 0 0 0 0 0 0 0
004 Abocath no. 20 Buah 10 0 10 0 0 0 0 0 0 0
003 Abocath no. 24 Buah 8 0 8 0 0 0 0 0 0 0
001 Air Raksa Dental Use Botol 0 0 0 0 0 0 0 0 0 0
029 Albothyl 10ml Botol 0 0 0 0 0 0 0 0 0 0
005 Allopurinol 100mg Tablet 0 0 0 0 0 0 0 0 0 0
007 Aminofilin 200mg Tablet 0 0 0 0 0 0 0 0 0 0
006 Aminofilin Inj 24mg/ml-10ml Ampul 26 0 26 0 0 0 0 0 0 0
008 Amitriptilin hcl 25mg Tablet 0 0 0 0 0 0 0 0 0 0
009 Amoksisilin 250mg Kapsul 0 0 0 0 0 0 0 0 0 0
011 Amoksisilin 500mg Tablet 1200 1000 2200 300 200 200 200 300 400 0
010 Amoksisilin sir. 125/5ml Botol 0 20 20 0 2 2 2 2 2 0
012 Ampisilin 500mg Tablet 0 0 0 0 0 0 0 0 0 0
013 Ampisilin Sir. 125/5ml Botol 0 0 0 0 0 0 0 0 0 0
015 Antalgin 500mg Tablet 0 0 0 0 0 0 0 0 0 0
014 Antalgin injeksi Ampul 0 0 0 0 0 0 0 0 0 0
016 Antasida Doen 500mg Tablet 1000 2000 3000 500 200 200 200 300 300 0
017 Anti Hemmoroid supp Tablet 0 0 0 0 0 0 0 0 0 0
023 Anti Parkinson Doen Komb. Tablet 0 0 0 0 0 0 0 0 0 0
018 Aqua pro inj 20ml Vial 0 0 0 0 0 0 0 0 0 0
019 Asam askorbat 250mg Tablet 0 0 0 0 0 0 0 0 0 0
187 Asam Mefenamat 0 1500 1500 0 200 200 100 200 200 0
024 Asam Sulfosalisilat 20% Botol 0 0 0 0 0 0 0 0 0 0
025 Asetosal 100mg Tablet 0 0 0 0 0 0 0 0 0 0
027 Atropin Sulfat 0.5mg Tablet 0 0 0 0 0 0 0 0 0 0

PENGELUARAN
PERSE
STOCK PENE-
PUSLING
RUANG
1 2 3 4 5 6 11 12 13 14 15 16 17
026 Atropin Sulfat inj 0,25mg/1ml Ampul 0 0 0 0 0 0 0 0 0 0
028 Atropin sulfat tts mata 0,5mg Botol 0 0 0 0 0 0 0 0 0 0
031 Besi (II) sulfat Tablet 0 0 0 0 0 0 0 0 0 0
030 Betametason Krim Tube 0 50 50 5 5 5 5 5 5 0
188 Bisoprololol 5 mg 60 0 60 0 0 0 0 0 0 0
180 Captopril 12,5 mg Tablet 0 0 0 0 0 0 0 0 0 0
179 Captopril 25 mg Tablet 0 1200 1200 0 100 100 100 100 200 0
032 Catgut/benang bedah 2/0-3/0 Buah 35 0 35 0 2 2 2 2 0 5
189 Curcuma 0 500 500 0 100 100 50 100 100 0
033 Dapson 100 mg Tablet 0 0 0 0 0 0 0 0 0 0
035 Deksametason 0,5mg Tablet 0 2000 2000 700 200 200 200 200 300 0
034 Deksametason inj 5mg/-1ml Ampul 0 0 0 0 0 0 0 0 0 0
038 Dekstrometorfan hbr 15 mg Tablet 0 0 0 0 0 0 0 0 0 0
037 Dekstrometorfan sir. 10mg Botol 0 12 12 0 0 0 0 0 0 0
039 Devitalisasi pasta Pot 0 0 0 0 0 0 0 0 0 0
041 Diazepam 2mg Tablet 1000 1000 2000 200 200 200 200 200 300 0
040 Diazepam inj 5mg/ml-2ml Ampul 0 0 0 0 0 0 0 0 0 0
036 Dietilkarbamzin sitrat 100mg Tablet 0 0 0 0 0 0 0 0 0 0
043 Difenhiramin inj 10mg Ampul 60 150 210 0 20 20 20 20 20 30
047 Digoksin 0,25mg Tablet 0 0 0 0 0 0 0 0 0 0
190 Diltiazem 200 0 200 0 0 0 0 0 0 0
044 Disposible 1ml Buah 0 0 0 0 0 0 0 0 0 0
045 Disposible 3 ml Buah 100 200 300 0 30 30 30 30 30 30
191 Domperidon Syr 0 5 5 0 1 1 0 1 1 0
048 Efedrin tab 25mg Tablet 500 0 500 0 100 100 100 100 0 0
049 Ekstrak beladona 10mg Tablet 0 0 0 0 0 0 0 0 0 0
050 Epinefrin (adrenalin) inj Ampul 13 0 13 0 0 0 0 0 0 0
192 Erytromisin 180 120 300 0 60 60 60 60 0 0
193 Erytromisin Syr 2 5 7 0 1 1 1 1 0 0

PENGELUARAN
PERSE
STOCK PENE-
PUSLING
RUANG
1 2 3 4 5 6 11 12 13 14 15 16 17
051 Etakrinidin (Rifanol) 0,1% Botol 0 7 7 0 0 0 0 0 0 0
052 Etanol 70% 1000ml Botol 1 4 5.0 0 0.5 0.5 0.5 0.5 1 1
053 Etil Klorida semprot Botol 0 1 1.0 0 0 0 0 0 0 0
054 Eugenol cairan Botol 8 0 8 0 0 0 0 0 0 0
057 Fenobarbital 100mg Tablet 0 0 0 0 0 0 0 0 0 0
055 Fenobarbital inj 50mg/ml-2ml Ampul 0 0 0 0 0 0 0 0 0 0
071 Fenoksimetil Penisilin Tablet 0 0 0 0 0 0 0 0 0 0
058 Fenol gliserol tts. Ttl. 10,5 Botol 0 0 0 0 0 0 0 0 0 0
060 Fitomenadion 10mg Tablet 0 0 0 0 0 0 0 0 0 0
059 Fitomenadion inj 10mg/ml-1ml Ampul 0 0 0 0 0 0 0 0 0 0
061 Furosemid 40mg Tablet 0 0 0 0 0 0 0 0 0 0
062 Gameksan emulsi 1% Botol 0 0 0 0 0 0 0 0 0 0
063 Garam Oralit 200ml air Bungkus 400 0 400 100 0 0 0 0 0 0
064 Gention violet 1% Botol 0 0 0 0 0 0 0 0 0 0
072 Glibenklamid Tablet 5 mg Tablet 100 0 100 0 0 0 0 0 0 0
194 Gliquidon 100 0 100 0 0 0 0 0 0 0
065 Gliseril guayakolat 100mg Tablet 1000 2000 3000 0 200 200 200 200 300 0
066 Gliserol Botol 0 0 0 0 0 0 0 0 0 0
067 Glukosa lar. Inf. 10% steril Botol 0 0 0 0 0 0 0 0 0 0
069 Glukosa lar.Inf. 5% steril Botol 36 0 36 0 0 0 0 0 0 0
070 Griseofulvin 125mg Tablet 0 600 600 0 100 100 100 100 100 0
075 Haloperidol 5mg Tablet 0 0 0 0 0 0 0 0 0 0
076 Hand Scoen No. 7 Buah 35 0 35 0 5 5 0 0 0 5
185 Hand Scoen No. 7 1/2 Psg 24 7 31 0 5 0 0 0 5 5
186 Hand Scoen No. 8 Psg 10 50 60 0 0 0 10 5 5 10
073 Hidroklorotiazida 25mg Tablet 0 0 0 0 0 0 0 0 0 0
074 Hidrokortison Krim 2,5% Tube 4 24 28 2 2 2 2 2 2 0
079 Ibu profen 400mg Tablet 0 600 600 0 0 0 0 0 0 0
078 Ibuprofen 200mg Tablet 500 0 500 0 0 0 0 0 0 0

PENGELUARAN
PERSE
STOCK PENE-
PUSLING
RUANG
1 2 3 4 5 6 11 12 13 14 15 16 17
080 Infusion set anak Buah 18 0 18 0 0 0 0 0 0 0
081 Infusion set dewasa Buah 1 0 1 0 0 0 0 0 0 0
082 Isoniasid (INH) 100 mg Tablet 0 0 0 0 0 0 0 0 0 0
077 Isosorbid Dinitrat Tablet 0 0 0 0 0 0 0 0 0 0
084 Jarum Jahit No 9 s/d 14 Buah 0 0 0 0 0 0 0 0 0 0
085 Jarum suntik / NALD Buah 0 0 0 0 0 0 0 0 0 0
086 Kalium permanganat serbuk Tablet 0 0 0 0 0 0 0 0 0 0
087 Kalsium Laktat 500mg Tablet 1000 0 1000 600 100 100 100 0 0 0
089 Kapas Berlemak 500mg Rol 0 0 0 0 0 0 0 0 0 0
090 Kapas Pembalut 250mg Rol 2 5 7 0 0 0 0 0 0 1
096 Karbamzepin 200mg Tablet 0 0 0 0 0 0 0 0 0 0
092 Kasa kompres 2X80 cm Rol 3 15 18 0 2 2 2 2 0 6
091 Kasa kompres 40X40 steril Bungkus 5 20 25 0 3 3 3 3 0 6
093 Kasa pembalut 4mX15cm Rol 10 0 10 0 0 0 0 0 0 0
088 Kategori 1 paket 0 0 0 0 0 0 0 0 0 0
195 Ketokonazole 0 200 200 0 50 0 50 50 50 0
095 Kinina dihidroklorida inj 25% Ampul 0 0 0 0 0 0 0 0 0 0
097 Kloramphenikol 250mg Kapsul 0 0 0 0 0 0 0 0 0 0
099 Kloramphenikol tts. Tel. 3% Botol 16 0 16 0 0 0 0 0 0 0
098 Kloramphenikol ZM 1% Tube 18 0 18 0 0 0 0 0 0 0
101 Klorokuin fosfat 150 mg Tablet 2000 0 2000 0 200 200 200 200 0 0
100 Klorpheniramin maleat (CTM) Tablet 1000 5000 6000 500 200 200 200 300 400 0
102 Klorpromazin hcl 25mg Tablet 0 0 0 0 0 0 0 0 0 0
103 Klorpromazina hcl 100mg Tablet 0 0 0 0 0 0 0 0 0 0
105 Klorpromazina hcl inj 25mg Ampul 0 0 0 0 0 0 0 0 0 0
106 Kodein hcl 10 mg Tablet 0 0 0 0 0 0 0 0 0 0
181 KOH pasta Tube 0 0 0 0 0 0 0 0 0 0
107 Komb. Pirimetamin+Suldoks Tablet 100 0 100 0 20 20 20 20 20 0

PENGELUARAN
PERSE
STOCK PENE-
PUSLING
RUANG
1 2 3 4 5 6 11 12 13 14 15 16 17
110 Kotrimoksazol 120mg Tablet 0 1000 1000 0 0 0 0 0 0 0
108 Kotrimoksazol suspensi Botol 46 0 46 0 2 2 2 2 2 0
196 Lanzoprasol 200 0 200 0 0 0 0 0 0 0
111 Larutan Benedic Botol 0 0 0 0 0 0 0 0 0 0
112 Larutan eosin 2% Botol 0 0 0 0 0 0 0 0 0 0
113 Larutan Gabet Botol 0 0 0 0 0 0 0 0 0 0
114 Larutan Glesastain Botol 0 0 0 0 0 0 0 0 0 0
115 Larutan kinyoun Botol 0 0 0 0 0 0 0 0 0 0
116 Larutan turk Botol 0 0 0 0 0 0 0 0 0 0
117 Lidokain comp. inj. Ampul 20 150 170 0 0 0 0 0 0 20
118 Lisol Botol 0 1 1 0 0 0 0 0 0 0
197 Loperamid 0 0 0 0 0 0 0 0 0 0
198 Loratadin 100 0 100 0 0 0 0 0 0 0
199 Masker 0 200 200 0 20 20 15 20 10 0
119 Mebendazol 100 mg Tablet 0 0 0 0 0 0 0 0 0 0
120 Metamol Botol 0 0 0 0 0 0 0 0 0 0
200 Metformin 100 0 100 0 0 0 0 0 0 0
122 Metilergeometrin 0.125mg Tablet 200 500 700 0 100 100 100 0 0 0
121 Metilergeometrin Maleat inj Ampul 30 60 90 0 0 0 0 0 0 0
201 Metilprednisolon 400 0 400 0 0 0 0 0 0 0
123 Metronidazol 250mg Tablet 800 0 800 0 0 0 0 0 0 0
184 MgSO4 20 % Btl 0 0 0 0 0 0 0 0 0 0
183 MgSO4 40 % Btl 0 0 0 0 0 0 0 0 0 0
125 Monoklorkamfer mentol cairan Botol 0 0 0 0 0 0 0 0 0 0
126 Mummiying pasta Botol 0 0 0 0 0 0 0 0 0 0
130 Nacl inf.0,9% steril Botol 0 0 0 0 0 0 0 0 0 0
127 Natrium Bicarbonat 500 mg Tablet 0 0 0 0 0 0 0 0 0 0
128 Natrium Fenitoina 100mg Kapsul 0 0 0 0 0 0 0 0 0 0

PENGELUARAN
PERSE
STOCK PENE-
PUSLING
RUANG
1 2 3 4 5 6 11 12 13 14 15 16 17
132 Nistati 100.000 iu/g vagina Tablet 0 0 0 0 0 0 0 0 0 0
133 OBH sirup Botol 0 0 0 0 0 0 0 0 0 0
136 Oksitetrasiklin hcl inj Ampul 0 0 0 0 0 0 0 0 0 0
135 Oksitetrasiklin hcl ZK 3% Tube 19 25 44 7 2 2 2 2 0 2
134 Oksitetrasiklin hcl ZM 1% Tube 40 0 40 0 0 0 0 0 0 0
137 Oksitosin inj 10 iu/ml-1ml Ampul 20 20 40 0 0 0 0 0 0 0
148 P. T. U 100mg Tablet 0 200 200 0 20 20 20 20 0 0
138 Parafermaldehide 1 gram Tablet 0 0 0 0 0 0 0 0 0 0
140 Parasetamol 100 mg Tablet 0 0 0 0 0 0 0 0 0 0
141 Parasetamol 500mg Tablet 1000 2000 3000 1250 250 250 250 250 500 0
139 Parasetamol sir. 120mg/5ml Botol 7 12 19 0 2 2 2 2 2 0
150 Perpenazin 4mg Tablet 0 0 0 0 0 0 0 0 0 0
151 Phetidin inj Ampul 0 0 0 0 0 0 0 0 0 0
142 Pirantel Pamoat 125mg Tablet 100 0 100 0 0 0 0 0 0 0
143 Piridoksin 10 mg Tablet 0 5000 5000 0 300 200 200 300 400 0
202 Piroxicam 400 0 400 0 0 0 0 0 0 0
144 Plester 5 yart X 2 inch Rol 2 6 8 0 1 1 1 1 0 1
145 Polipeptida Botol 0 0 0 0 0 0 0 0 0 0
146 Prednison 5mg Tablet 0 2000 2000 0 200 100 200 200 200 0
147 Primakuin 15mg Tablet 0 0 0 0 0 0 0 0 0 0
149 Propranolol hcl 40mg Tablet 0 0 0 0 0 0 0 0 0 0
203 Pyronolakton 0 0 0 0 0 0 0 0 0 0
204 Ranitidin 300 500 800 0 100 100 100 100 100 0
152 Reserpina 0,1mg Tablet 0 0 0 0 0 0 0 0 0 0
154 Retinol Kaps. 200.000 iu Kapsul 0 0 0 0 0 0 0 0 0 0
155 Retinol Kaps. 50.000 iu Tablet 0 0 0 0 0 0 0 0 0 0
156 Ringer Laktat lar. Infus Botol 20 0 20 0 0 0 0 0 0 0
158 Salbutamol 2mg Tablet 0 0 0 0 0 0 0 0 0 0
157 Salep 2-4 Pot 10 0 10 0 2 2 2 2 2 0

PENGELUARAN
PERSE
STOCK PENE-
PUSLING
RUANG
1 2 3 4 5 6 11 12 13 14 15 16 17
159 Salisil Bedak 2% Botol 0 20 20 0 2 2 2 2 2 0
160 Salisil Spiritus 10% Botol 0 0 0 0 0 0 0 0 0 0
205 Sefadroxil 0 250 250 0 50 50 50 50 50 0
161 Semen seng fosfat serbuk Set 2 0 2 0 0 0 0 0 0 0
162 Sianokobalamin inj 500mg Ampul 50 0 50 0 0 0 0 0 0 0
164 Silfer amalgam 65/75% Botol 3 0 3 0 0 0 0 0 0 0
163 Silk Benang Sutra no. 3/0 Sak 0 0 0 0 0 0 0 0 0 0
206 Simvastatin 180 0 180 0 0 0 0 0 0 0
182 Siprofloxacin 500 mg Tablet 100 200 300 0 0 0 0 0 0 0
165 Spons gelatin 1X1X1cm tbg 0 0 0 0 0 0 0 0 0 0
166 Sulfadimidin 500mg Tablet 0 0 0 0 0 0 0 0 0 0
167 Sulfasetamid TM 15% Botol 0 0 0 0 0 0 0 0 0 0
168 Temporary Stopping Fletcher Set 0 0 0 0 0 0 0 0 0 0
169 Tetrakain hcl TM 0,5% Botol 3 0 3 0 0 0 0 0 3 0
171 Tetraksilin 500 mg Kaplet 100 0 100 0 0 0 0 0 100 0
170 Tetrasiklin hcl 250mg Kapsul 600 1000 1600 400 200 200 200 200 200 0
172 Tiamin hcl (Vit. B1) 50mg Tablet 2000 2000 4000 200 300 300 300 300 300 0
173 Tiamin hcl inj. 100mg/ml-1ml Ampul 11 10 21 0 2 2 2 2 2 2
175 Trihexifenidil hcl 2mg Tablet 0 0 0 0 0 0 0 0 0 0
174 Trikresol Formalin (TKF) Botol 0 0 0 0 0 0 0 0 0 0
176 Vitamin B. Complex Tablet 1000 2000 3000 0 300 300 300 300 500 0
021 Whitefield salep Pot 0 0 0 0 0 0 0 0 0 0
178 Yodium Povidon 10% 300ml Botol 1 0 1 0 0 0 0 0 0 1
207 0 0 0 0 0 0 0 0 0 0
208 0 0 0 0 0 0 0 0 0 0
209 0 0 0 0 0 0 0 0 0 0
210 0 0 0 0 0 0 0 0 0 0
211 0 0 0 0 0 0 0 0 0 0
212 0 0 0 0 0 0 0 0 0 0
Mengetahui Petugas Pengelola Obat Petugas

PENGELUARAN
PERSE
STOCK PENE-
PUSLING
RUANG
1 2 3 4 5 6 11 12 13 14 15 16 17
Kepala Puskesmas Buhu Puskesmas Buhu Puskes
dr. Sri Darsianti Tuna H. Muhtar Rahim, S.Kep, Ns. Santi

NIP. 19741210 200604 2 017 NIP. 19730525 199903 1 008 NIP. 197803

EN BUKTI MUTASI OBAT
BULAN : Januari
TAHUN : 2011
PENGELUARAN
SISA
POSKESDES STOCK KET
MOTILANGO
TOTAL
18 19 20 21
0 0 0
0 0 10
0 0 8
0 0 0
0 0 0
0 0 0
0 0 0
0 0 26
0 0 0
0 0 0
200 1800 400
2 12 8
0 0 0
0 0 0
0 0 0
0 0 0
200 1900 1100
0 0 0
0 0 0
0 0 0
0 0 0
250 2000 1000
100 1000 500
0 0 0
0 0 0
0 0 0
0 0 0

PENGELUARAN
SISA
POSKESDES STOCK
KET
MOTILANGO
TOTAL
18 19 20 21
0 0 0
0 0 0
0 0 0
5 35 15
0 0 60
0 0 0
0 600 600
2 15 20
50 500 0
0 0 0
200 2000 0
0 0 0
0 0 0
0 0 12
0 0 0
200 1500 500
0 0 0
0 0 0
0 0 0
20 150 60
0 0 0
0 0 200
0 0 0
20 200 100
0 0 200
1 5 0
100 500 0
0 0 0
0 0 13
60 300 0
1 5 2

PENGELUARAN
SISA
POSKESDES STOCK
KET
MOTILANGO
TOTAL
18 19 20 21
0 0 7
0 4 1
0 0 1
0 0 8
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
0 100 300
0 0 0
0 0 100
0 0 100
200 1300 1700
0 0 0
0 0 0
0 0 0
0 0 36
100 600 0
0 0 0
0 15 20
0 15 16
5 35 25
0 0 0
2 14 14
0 0 600
0 0 500

PENGELUARAN
SISA
POSKESDES STOCK
KET
MOTILANGO
TOTAL
18 19 20 21
0 0 18
0 0 1
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
100 1000 0
0 0 0
0 1 6
0 0 0
2 16 2
2 20 5
0 0 10
0 0 0
0 0 0
0 200 0
0 0 0
0 0 0
0 0 16
0 0 18
200 1000 1000
200 2000 4000
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 100 0

PENGELUARAN
SISA
POSKESDES STOCK
KET
MOTILANGO
TOTAL
18 19 20 21
0 0 1000
0 100 800
2 12 34
0 0 200
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 20 150
0 0 1
0 0 0
0 0 100
15 100 100
0 0 0
0 0 0
0 0 100
100 400 300
0 0 90
0 0 400
0 0 800
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

PENGELUARAN
SISA
POSKESDES STOCK
KET
MOTILANGO
TOTAL
18 19 20 21
0 0 0
0 0 0
0 0 0
0 0 0
2 19 25
0 0 40
0 0 40
20 100 100
0 0 0
0 0 0
250 3000 0
2 12 7
0 0 0
0 0 0
0 0 100
200 1600 3400
0 0 400
1 6 2
0 0 0
100 1000 1000
0 0 0
0 0 0
0 0 0
100 600 200
0 0 0
0 0 0
0 0 0
0 0 0
0 0 20
0 0 0
0 10 0

PENGELUARAN
SISA
POSKESDES STOCK
KET
MOTILANGO
TOTAL
18 19 20 21
2 12 8
0 0 0
0 250 0
0 0 2
0 0 50
0 0 3
0 0 0
0 0 180
0 0 300
0 0 0
0 0 0
0 0 0
0 0 0
0 3 0
0 100 0
200 1600 0
300 2000 2000
2 14 7
0 0 0
0 0 0
300 2000 1000
0 0 0
0 1 0
0 0 13
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
Petugas Loket Obat

PENGELUARAN
SISA
POSKESDES STOCK
KET
MOTILANGO
TOTAL
18 19 20 21
Puskesmas Buhu
Santi Rahim
NIP. 19780315 200604 2 007

DOKUMEN BUKTI MUTASI OBAT
: BUHU BULAN
KECAMATAN : TIBAWA TAHUN
PENGELUARAN
PERSE
STOCK PENE-
PUSLING
RUANG
1 2 3 4 5 6 11 12 13 14 15 16 17
001 Abocath no. 18 Buah 0 0 0 0 0 0 0 0 0 0
002 Abocath no. 20 Buah 10 0 10 0 0 0 0 0 0 2
003 Abocath no. 24 Buah 8 0 8 0 0 0 0 0 0 3
004 Air Raksa Dental Use Botol 0 0 0 0 0 0 0 0 0 0
005 Albothyl 10ml Botol 0 0 0 0 0 0 0 0 0 0
006 Allopurinol 100mg Tablet 0 0 0 0 0 0 0 0 0 0
007 Aminofilin 200mg Tablet 0 0 0 0 0 0 0 0 0 0
008 Aminofilin Inj 24mg/ml-10ml Ampul 26 0 26 0 0 0 0 0 0 0
009 Amitriptilin hcl 25mg Tablet 0 0 0 0 0 0 0 0 0 0
010 Amoksisilin 250mg Kapsul 0 0 0 0 0 0 0 0 0 0
011 Amoksisilin 500mg Tablet 400 2000 2400 500 200 200 200 300 400 0
012 Amoksisilin sir. 125/5ml Botol 8 0 8 0 0 0 0 0 0 0
013 Ampisilin 500mg Tablet 0 0 0 0 0 0 0 0 0 0
014 Ampisilin Sir. 125/5ml Botol 0 0 0 0 0 0 0 0 0 0
015 Antalgin 500mg Tablet 0 0 0 0 0 0 0 0 0 0
016 Antalgin injeksi Ampul 0 0 0 0 0 0 0 0 0 0
017 Antasida Doen 500mg Tablet 1100 1000 2100 200 200 200 200 300 300 0
018 Anti Hemmoroid supp Tablet 0 0 0 0 0 0 0 0 0 0
019 Anti Parkinson Doen Komb. Tablet 0 0 0 0 0 0 0 0 0 0
020 Aqua pro inj 20ml Vial 0 0 0 0 0 0 0 0 0 0
023 Asam Mefenamat 500 600 1100 100 100 100 100 100 100 0
024 Asam Sulfosalisilat 20% Botol 0 0 0 0 0 0 0 0 0 0
027 Atropin Sulfat 0.5mg Tablet 0 0 0 0 0 0 0 0 0 0

PENGELUARAN
PERSE
STOCK PENE-
PUSLING
RUANG
1 2 3 4 5 6 11 12 13 14 15 16 17
028 Atropin Sulfat inj 0,25mg/1ml Ampul 0 0 0 0 0 0 0 0 0 0
029 Atropin sulfat tts mata 0,5mg Botol 0 0 0 0 0 0 0 0 0 0
030 Besi (II) sulfat Tablet 0 0 0 0 0 0 0 0 0 0
031 Betametason Krim Tube 15 25 40 0 2 2 2 2 2 0
032 Bisoprololol 5 mg 60 0 60 0 0 0 0 0 0 0
033 Captopril 12,5 mg Tablet 0 0 0 0 0 0 0 0 0 0
034 Captopril 25 mg Tablet 600 300 900 0 100 100 100 100 100 0
035 Catgut/benang bedah 2/0-3/0 Buah 20 0 20 0 0 0 0 0 0 0
036 Curcuma 0 100 100 0 0 0 0 0 100 0
037 Dapson 100 mg Tablet 0 0 0 0 0 0 0 0 0 0
038 Deksametason 0,5mg Tablet 0 2000 2000 100 100 100 100 100 100 0
039 Deksametason inj 5mg/-1ml Ampul 0 0 0 0 0 0 0 0 0 0
040 Dekstrometorfan hbr 15 mg Tablet 0 0 0 0 0 0 0 0 0 0
041 Dekstrometorfan sir. 10mg Botol 12 0 12 0 0 0 0 0 0 0
042 Devitalisasi pasta Pot 0 0 0 0 0 0 0 0 0 0
045 Diazepam inj 5mg/ml-2ml Ampul 0 0 0 0 0 0 0 0 0 0
046 Dietilkarbamzin sitrat 100mg Tablet 0 0 0 0 0 0 0 0 0 0
047 Difenhiramin inj 10mg Ampul 60 25 85 0 0 0 0 0 0 0
048 Digoksin 0,25mg Tablet 0 0 0 0 0 0 0 0 0 0
049 Diltiazem 200 0 200 0 0 0 0 0 0 0
050 Disposible 1ml Buah 0 0 0 0 0 0 0 0 0 0
053 Domperidon Syr 0 5 5 2 1 0 0 1 1 0
054 Efedrin tab 25mg Tablet 0 0 0 0 0 0 0 0 0 0
055 Ekstrak beladona 10mg Tablet 0 0 0 0 0 0 0 0 0 0
056 Epinefrin (adrenalin) inj Ampul 13 0 13 0 0 0 0 0 0 0
057 Erytromisin 0 120 120 0 0 0 0 0 0 0
058 Erytromisin Syr 2 0 2 0 0 0 0 0 0 0

PENGELUARAN
PERSE
STOCK PENE-
PUSLING
RUANG
1 2 3 4 5 6 11 12 13 14 15 16 17
059 Etakrinidin (Rifanol) 0,1% Botol 7 0 7 0 0 0 0 0 0 0
060 Etanol 70% 1000ml Botol 1 4 5.0 0 0.5 0.5 0.5 0.5 0.5 1.0
061 Etil Klorida semprot Botol 1 1 2.0 0 0 0 0 0 0 1
062 Eugenol cairan Botol 8 0 8 0 0 0 0 0 0 0
065 Fenobarbital inj 50mg/ml-2ml Ampul 0 0 0 0 0 0 0 0 0 0
066 Fenoksimetil Penisilin Tablet 0 0 0 0 0 0 0 0 0 0
067 Fenol gliserol tts. Ttl. 10,5 Botol 0 0 0 0 0 0 0 0 0 0
068 Fitomenadion 10mg Tablet 0 154 154 0 40 34 40 0 0 0
069 Fitomenadion inj 10mg/ml-1ml Ampul 0 0 0 0 0 0 0 0 0 0
070 Furosemid 40mg Tablet 0 0 0 0 0 0 0 0 0 0
071 Gameksan emulsi 1% Botol 0 0 0 0 0 0 0 0 0 0
072 Garam Oralit 200ml air Bungkus 300 0 300 0 0 0 0 0 0 0
073 Gention violet 1% Botol 0 0 0 0 0 0 0 0 0 0
074 Glibenklamid Tablet 5 mg Tablet 100 0 100 0 20 10 10 20 30 0
075 Gliquidon 100 0 100 0 0 0 0 0 0 0
076 Gliseril guayakolat 100mg Tablet 1700 2000 3700 400 200 200 200 200 300 0
077 Gliserol Botol 0 0 0 0 0 0 0 0 0 0
080 Glukosa lar.Inf. 5% steril Botol 36 0 36 0 0 0 0 0 0 3
081 Griseofulvin 125mg Tablet 0 500 500 0 0 0 0 0 0 0
082 Haloperidol 5mg Tablet 0 0 0 0 0 0 0 0 0 0
083 Hand Scoen No. 7 Buah 20 0 20 0 0 0 0 0 0 0
084 Hand Scoen No. 7 1/2 Psg 16 2 18 0 0 0 0 0 0 0
085 Hand Scoen No. 8 Psg 25 16 41 0 5 5 5 5 0 10
086 Hidroklorotiazida 25mg Tablet 0 0 0 0 0 0 0 0 0 0
087 Hidrokortison Krim 2,5% Tube 14 24 38 8 0 0 0 0 0 0

PENGELUARAN
PERSE
STOCK PENE-
PUSLING
RUANG
1 2 3 4 5 6 11 12 13 14 15 16 17
090 Infusion set anak Buah 18 0 18 0 1 1 1 1 0 2
091 Infusion set dewasa Buah 1 0 1 0 0 0 0 0 0 0
094 Isosorbid Dinitrat Tablet 0 0 0 0 0 0 0 0 0 0
095 Jarum Jahit No 9 s/d 14 Buah 0 0 0 0 0 0 0 0 0 0
096 Jarum suntik / NALD Buah 0 0 0 0 0 0 0 0 0 0
097 Kalium permanganat serbuk Tablet 0 0 0 0 0 0 0 0 0 0
098 Kalsium Laktat 500mg Tablet 0 2000 2000 200 200 200 200 0 0 0
099 Kapas Berlemak 500mg Rol 0 0 0 0 0 0 0 0 0 0
100 Kapas Pembalut 250mg Rol 6 0 6 0 1 1 1 1 1 0
101 Karbamzepin 200mg Tablet 0 0 0 0 0 0 0 0 0 0
102 Kasa kompres 2X80 cm Rol 2 15 17 0 2 2 2 2 0 6
103 Kasa kompres 40X40 steril Bungkus 5 19 24 0 0 0 0 0 0 0
106 Kategori 1 paket 0 0 0 0 0 0 0 0 0 0
107 Ketokonazole 0 200 200 0 0 0 0 0 0 0
108 Kinina dihidroklorida inj 25% Ampul 0 0 0 0 0 0 0 0 0 0
109 Kloramphenikol 250mg Kapsul 0 0 0 0 0 0 0 0 0 0
110 Kloramphenikol tts. Tel. 3% Botol 16 0 16 0 0 0 0 0 0 0
111 Kloramphenikol ZM 1% Tube 18 0 18 0 0 0 0 0 0 0
112 Klorokuin fosfat 150 mg Tablet 1000 0 1000 0 0 0 0 0 0 0
113 Klorpheniramin maleat (CTM) Tablet 4000 0 4000 500 200 200 200 300 400 0
114 Klorpromazin hcl 25mg Tablet 0 0 0 0 0 0 0 0 0 0
115 Klorpromazina hcl 100mg Tablet 0 0 0 0 0 0 0 0 0 0
118 Kodein hcl 10 mg Tablet 0 0 0 0 0 0 0 0 0 0
119 KOH pasta Tube 0 0 0 0 0 0 0 0 0 0
120 Komb. Pirimetamin+Suldoks Tablet 0 1000 1000 0 100 100 100 100 100 0

PENGELUARAN
PERSE
STOCK PENE-
PUSLING
RUANG
1 2 3 4 5 6 11 12 13 14 15 16 17
123 Kotrimoksazol suspensi Botol 34 0 34 0 3 3 3 3 3 0
124 Lanzoprasol 200 0 200 0 20 20 20 20 20 0
125 Larutan Benedic Botol 0 0 0 0 0 0 0 0 0 0
126 Larutan eosin 2% Botol 0 0 0 0 0 0 0 0 0 0
127 Larutan Gabet Botol 0 0 0 0 0 0 0 0 0 0
128 Larutan Glesastain Botol 0 0 0 0 0 0 0 0 0 0
129 Larutan kinyoun Botol 0 0 0 0 0 0 0 0 0 0
130 Larutan turk Botol 0 0 0 0 0 0 0 0 0 0
131 Lidokain comp. inj. Ampul 150 0 150 0 0 0 0 0 0 0
132 Lisol Botol 1 0 1 0 0 0 0 0 0 0
133 Loperamid 0 0 0 0 0 0 0 0 0 0
134 Loratadin 100 0 100 100 0 0 0 0 0 0
135 Masker 100 50 150 0 20 20 15 20 10 50
136 Mebendazol 100 mg Tablet 0 0 0 0 0 0 0 0 0 0
137 Metamol Botol 0 0 0 0 0 0 0 0 0 0
138 Metformin 100 0 100 0 0 0 0 0 0 0
139 Metilergeometrin 0.125mg Tablet 300 0 300 0 0 0 0 0 0 0
140 Metilergeometrin Maleat inj Ampul 90 0 90 0 0 0 0 0 0 0
141 Metilprednisolon 400 0 400 0 50 50 50 50 0 50
144 MgSO4 20 % Btl 0 0 0 0 0 0 0 0 0 0
145 MgSO4 40 % Btl 0 0 0 0 0 0 0 0 0 0
146 Monoklorkamfer mentol cairan Botol 0 0 0 0 0 0 0 0 0 0
147 Mummiying pasta Botol 0 0 0 0 0 0 0 0 0 0
148 Nacl inf.0,9% steril Botol 0 0 0 0 0 0 0 0 0 0
149 Natrium Diclofenac 50 mg pil 0 1000 1000 100 100 100 100 100 200 0

PENGELUARAN
PERSE
STOCK PENE-
PUSLING
RUANG
1 2 3 4 5 6 11 12 13 14 15 16 17
154 OBH sirup Botol 0 20 20 0 2 2 2 2 2 0
155 Oksitetrasiklin hcl inj Ampul 0 0 0 0 0 0 0 0 0 0
156 Oksitetrasiklin hcl ZK 3% Tube 25 0 25 0 0 0 0 0 0 0
157 Oksitetrasiklin hcl ZM 1% Tube 40 0 40 0 0 0 0 0 0 0
158 Oksitosin inj 10 iu/ml-1ml Ampul 40 0 40 0 0 0 0 0 0 0
159 P. T. U 100mg Tablet 100 100 200 100 20 20 20 20 0 0
160 Parafermaldehide 1 gram Tablet 0 0 0 0 0 0 0 0 0 0
161 Parasetamol 100 mg Tablet 0 0 0 0 0 0 0 0 0 0
162 Parasetamol 500mg Tablet 0 3000 3000 500 250 250 250 250 500 0
163 Parasetamol sir. 120mg/5ml Botol 7 12 19 6 2 2 2 2 3 0
164 Perpenazin 4mg Tablet 0 0 0 0 0 0 0 0 0 0
165 Phetidin inj Ampul 0 0 0 0 0 0 0 0 0 0
166 Pirantel Pamoat 125mg Tablet 100 0 100 0 0 0 0 0 0 0
167 Piridoksin 10 mg Tablet 3400 0 3400 800 300 200 200 300 400 0
168 Piroxicam 400 0 400 0 20 20 20 20 0 0
169 Plester 5 yart X 2 inch Rol 2 5 7 0 0 0 0 0 0 1
170 Polipeptida Botol 0 0 0 0 0 0 0 0 0 0
171 Prednison 5mg Tablet 1000 0 1000 0 0 0 0 0 0 0
172 Primakuin 15mg Tablet 0 0 0 0 0 0 0 0 0 0
173 Propranolol hcl 40mg Tablet 0 0 0 0 0 0 0 0 0 0
174 Pyronolakton 0 0 0 0 0 0 0 0 0 0
175 Ranitidin 200 500 700 0 100 100 100 100 100 0
178 Retinol Kaps. 200.000 iu Kapsul 0 0 0 0 0 0 0 0 0 0
179 Retinol Kaps. 50.000 iu Tablet 0 0 0 0 0 0 0 0 0 0
180 Ringer Laktat lar. Infus Botol 20 0 20 0 2 2 2 0 0 12
181 Salbutamol 2mg Tablet 0 0 0 0 0 0 0 0 0 0
182 Salep 2-4 Pot 0 0 0 0 0 0 0 0 0 0

PENGELUARAN
PERSE
STOCK PENE-
PUSLING
RUANG
1 2 3 4 5 6 11 12 13 14 15 16 17
183 Salisil Bedak 2% Botol 8 5 13 1 2 2 2 2 2 0
184 Salisil Spiritus 10% Botol 0 0 0 0 0 0 0 0 0 0
185 Sefadroxil Kapsul 0 200 200 0 0 0 0 0 0 0
186 Semen seng fosfat serbuk Set 2 0 2 0 0 0 0 0 0 0
187 Sianokobalamin inj 500mg Ampul 50 0 50 0 0 0 0 0 0 0
188 Silfer amalgam 65/75% Botol 3 0 3 0 0 0 0 0 0 0
189 Silk Benang Sutra no. 3/0 Sak 0 0 0 0 0 0 0 0 0 0
190 Simvastatin 180 0 180 0 30 0 0 0 0 0
191 Siprofloxacin 500 mg Tablet 300 0 300 0 0 0 0 0 0 0
192 Spons gelatin 1X1X1cm tbg 0 0 0 0 0 0 0 0 0 0
193 Sulfadimidin 500mg Tablet 0 0 0 0 0 0 0 0 0 0
194 Sulfasetamid TM 15% Botol 0 0 0 0 0 0 0 0 0 0
195 Temporary Stopping Fletcher Set 0 0 0 0 0 0 0 0 0 0
196 Tetrakain hcl TM 0,5% Botol 0 0 0 0 0 0 0 0 0 0
197 Tetraksilin 500 mg Kaplet 0 0 0 0 0 0 0 0 0 0
198 Tetrasiklin hcl 250mg Kapsul 0 1000 1000 0 0 0 0 0 0 0
199 Tiamin hcl (Vit. B1) 50mg Tablet 2000 1000 3000 1200 300 300 300 300 300 0
200 Tiamin hcl inj. 100mg/ml-1ml Ampul 7 0 7 0 0 0 0 0 0 0
201 Trihexifenidil hcl 2mg Tablet 0 0 0 0 0 0 0 0 0 0
202 Trikresol Formalin (TKF) Botol 0 0 0 0 0 0 0 0 0 0
203 Vitamin B. Complex Tablet 1000 2000 3000 700 200 200 200 200 300 0
204 Whitefield salep Pot 0 0 0 0 0 0 0 0 0 0
207
208
209
210
211
212
Mengetahui Petugas Pengelola Obat Petugas

PENGELUARAN
PERSE
STOCK PENE-
PUSLING
RUANG
1 2 3 4 5 6 11 12 13 14 15 16 17
Kepala Puskesmas Buhu Puskesmas Buhu Puskes
dr. Sri Darsianti Tuna H. Muhtar Rahim, S.Kep, Ns. Santi

NIP. 19741210 200604 2 017 NIP. 19730525 199903 1 008 NIP. 197803

EN BUKTI MUTASI OBAT
BULAN : Februari
TAHUN : 2011
PENGELUARAN
SISA
POSKESDES STOCK KET
MOTILANGO
TOTAL
18 19 20 21
0 0 0
0 2 8
0 3 5
0 0 0
0 0 0
0 0 0
0 0 0
0 0 26
0 0 0
0 0 0
200 2000 400
0 0 8
0 0 0
0 0 0
0 0 0
0 0 0
200 1600 500
0 0 0
0 0 0
0 0 0
0 0 0
0 0 1000
100 700 400
0 0 0
0 0 0
0 0 0
0 0 0

PENGELUARAN
SISA
POSKESDES STOCK
KET
MOTILANGO
TOTAL
18 19 20 21
0 0 0
0 0 0
0 0 0
2 12 28
0 0 60
0 0 0
100 600 300
0 0 20
0 100 0
0 0 0
100 700 1300
0 0 0
0 0 0
0 0 12
0 0 0
100 1000 500
0 0 0
0 0 0
0 0 0
0 0 85
0 0 0
0 0 200
0 0 0
0 0 300
0 0 200
0 5 0
0 0 0
0 0 0
0 0 13
0 0 120
0 0 2

PENGELUARAN
SISA
POSKESDES STOCK
KET
MOTILANGO
TOTAL
18 19 20 21
0 0 7
0.5 4 1.0
0 1 1
0 0 8
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
40 154 0
0 0 0
0 0 0
0 0 0
0 0 300
0 0 0
10 100 0
0 0 100
200 1700 2000
0 0 0
0 0 0
0 0 0
0 3 33 20
0 0 500
0 0 0
0 0 20
0 0 18
5 35 6
0 0 0
0 8 30
0 0 600
0 0 500

PENGELUARAN
SISA
POSKESDES STOCK
KET
MOTILANGO
TOTAL
18 19 20 21
1 7 11 7
0 0 1
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
200 1000 1000
0 0 0
0 5 1
0 0 0
2 16 1
0 0 24
1 10 0
0 0 0
0 0 0
0 0 200
0 0 0
0 0 0
0 0 16
0 0 18
0 0 1000
200 2000 2000
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
100 600 400

PENGELUARAN
SISA
POSKESDES STOCK
KET
MOTILANGO
TOTAL
18 19 20 21
0 0 1000
0 200 600
3 18 16 16
20 120 80
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 150
0 0 1
0 0 0
0 100 0
15 150 0
0 0 0
0 0 0
0 0 100
0 0 300
0 0 90
50 300 100
0 0 800
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
100 800 200
0 0 0
0 0 0

PENGELUARAN
SISA
POSKESDES STOCK
KET
MOTILANGO
TOTAL
18 19 20 21
0 0 0
0 0 0
2 12 8
0 0 0
0 0 25
0 0 40
0 0 40
20 200 0
0 0 0
0 0 0
250 2250 750
2 19 0
0 0 0
0 0 0
0 0 100
200 2400 1000
20 100 300 100
0 1 6 1
0 0 0
0 0 1000
0 0 0
0 0 0
0 0 0
100 600 100
0 0 0
0 0 0
0 0 0
0 0 0
2 20 0
0 0 0
0 0 0

PENGELUARAN
SISA
POSKESDES STOCK
KET
MOTILANGO
TOTAL
18 19 20 21
2 13 0
0 0 0
0 0 200
0 0 2
0 0 50
0 0 3
0 0 0
0 30 150 30
0 0 300
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 1000
300 3000 0
0 0 7
0 0 0
0 0 0
200 2000 1000
0 0 0
0 0 3
1 5 18
Petugas Loket Obat

PENGELUARAN
SISA
POSKESDES STOCK
KET
MOTILANGO
TOTAL
18 19 20 21
Puskesmas Buhu
Santi Rahim
NIP. 19780315 200604 2 007

UNIT PELAYANAN : LOKET OBAT PELAPORAN BULAN/PERIODE

PUSKESMAS : BUHU PERMINTAAN BULAN/PERIODE
KECAMATAN : TIBAWA
1 2 3 4 5 6 7 8 9 10 11 12 13
002 Abocath no. 18 Buah 0 0 0 0 0 0 0
004 Abocath no. 20 Buah 0 0 0 0 0 0 0
003 Abocath no. 24 Buah 0 0 0 0 0 0 0
005 Allopurinol 100mg Tablet 81 0 81 0 81 0 -81
007 Aminofilin 200mg Tablet 413 0 413 0 413 0 -413
008 Amitriptilin hcl 25mg Tablet 100 0 100 0 100 0 -100
010 Amoksisilin sir. 125/5ml Botol 6 0 6 0 6 0 -6
015 Antalgin 500mg Tablet 28 0 28 0 28 0 -28
017 Anti Hemmoroid supp Tablet 10 0 10 0 10 0 -10
023 Anti Parkinson Doen Komb. Tablet 100 0 100 0 100 0 -100
187 Asam Mefenamat 37 0 37 19 18 22 4
025 Asetosal 100mg Tablet 40 0 40 0 40 0 -40

1 2 3 4 5 6 7 8 9 10 11 12 13
030 Betametason Krim Tube 0 5 5 0 5 0 -5
188 Bisoprololol 5 mg 30 0 30 0 30 0 -30
179 Captopril 25 mg Tablet 196 0 196 83 113 98 -15
189 Curcuma 0 0 0 0 0 0 0
033 Dapson 100 mg Tablet 0 0 0 0 0 0 0
038 Dekstrometorfan hbr 15 mg Tablet 277 0 277 9 268 11 -257
037 Dekstrometorfan sir. 10mg Botol 3 0 3 0 3 0 -3
041 Diazepam 2mg Tablet 83 200 283 123 160 145 -15
047 Digoksin 0,25mg Tablet 40 0 40 0 40 0 -40
190 Diltiazem 100 0 100 0 100 0 -100
191 Domperidon Syr 0 0 0 0 0 0 0
048 Efedrin tab 25mg Tablet 450 0 450 28 422 33 -389
192 Erytromisin 120 0 120 0 120 0 -120
193 Erytromisin Syr 3 0 3 0 3 0 -3
052 Etanol 70% 1000ml Botol 0 0 0.0 0 0.0 0.0 0
053 Etil Klorida semprot Botol 0 0 0.0 0 0.0 0.0 0

1 2 3 4 5 6 7 8 9 10 11 12 13
056 Fenobarbital 30mg Tablet 475 0 475 46 429 54 -375
060 Fitomenadion 10mg Tablet 155 0 155 0 155 0 -155
061 Furosemid 40mg Tablet 56 0 56 0 56 0 -56
063 Garam Oralit 200ml air Bungkus 9 100 109 30 79 35 -44
064 Gention violet 1% Botol 2 0 2 0 2 0 -2
072 Glibenklamid Tablet 5 mg Tablet 61 0 61 0 61 0 -61
194 Gliquidon 100 0 100 0 100 0 -100
070 Griseofulvin 125mg Tablet 211 0 211 54 157 64 -93
185 Hand Scoen No. 7 1/2 psg 0 0 0 0 0 0 0
186 Hand Scoen No. 8 psg 0 0 0 0 0 0 0
073 Hidroklorotiazida 25mg Tablet 421 0 421 6 415 7 -408
079 Ibu profen 400mg Tablet 102 0 102 0 102 0 -102
077 Isosorbid Dinitrat Tablet 91 0 91 0 91 0 -91

1 2 3 4 5 6 7 8 9 10 11 12 13
087 Kalsium Laktat 500mg Tablet 267 600 867 256 611 302 -309
096 Karbamzepin 200mg Tablet 100 0 100 0 100 0 -100
088 Kategori 1 paket 0 0 0 0 0 0 0
195 Ketokonazole 50 0 50 0 50 0 -50
097 Kloramphenikol 250mg Kapsul 257 0 257 6 251 7 -244
099 Kloramphenikol tts. Tel. 3% Botol 1 0 1 0 1 0 -1
098 Kloramphenikol ZM 1% Tube 3 0 3 0 3 0 -3
101 Klorokuin fosfat 150 mg Tablet 827 0 827 30 797 35 -762
102 Klorpromazin hcl 25mg Tablet 749 0 749 0 749 0 -749
181 KOH pasta Tube 0 0 0 0 0 0 0
107 Komb. Pirimetamin+Suldoks Tablet 100 0 100 0 100 0 -100
110 Kotrimoksazol 120mg Tablet 177 0 177 42 135 50 -85
108 Kotrimoksazol suspensi Botol 4 0 4 0 4 0 -4
196 Lanzoprasol 100 0 100 0 100 0 -100

1 2 3 4 5 6 7 8 9 10 11 12 13
118 Lisol Botol 0 0 0 0 0 0 0
197 Loperamid 0 0 0 0 0 0 0
198 Loratadin 0 0 0 0 0 0 0
199 Masker 0 0 0 0 0 0 0
120 Metamol Botol 0 0 0 0 0 0 0
200 Metformin 100 0 100 0 100 0 -100
122 Metilergeometrin 0.125mg Tablet 94 0 94 0 94 0 -94
201 Metilprednisolon 100 0 100 0 100 0 -100
123 Metronidazol 250mg Tablet 91 0 91 0 91 0 -91
184 MgSO4 20 % Btl 0 0 0 0 0 0 0
183 MgSO4 40 % Btl 0 0 0 0 0 0 0
127 Natrium Bicarbonat 500 mg Tablet 0 0 0 0 0 0 0
133 OBH sirup Botol 5 0 5 0 5 0 -5
134 Oksitetrasiklin hcl ZM 1% Tube 8 0 8 1 7 1 -6
148 P. T. U 100mg Tablet 77 0 77 73 4 86 82
140 Parasetamol 100 mg Tablet 214 0 214 18 196 21 -175

1 2 3 4 5 6 7 8 9 10 11 12 13
142 Pirantel Pamoat 125mg Tablet 38 0 38 0 38 0 -38
202 Piroxicam 100 0 100 18 82 21 -61
146 Prednison 5mg Tablet 356 0 356 45 311 53 -258
149 Propranolol hcl 40mg Tablet 97 0 97 0 97 0 -97
203 Pyronolakton 100 0 100 0 100 0 -100
204 Ranitidin 100 0 100 39 61 46 -15
153 Reserpina 0,25mg Tablet 494 0 494 0 494 0 -494
157 Salep 2-4 Pot 0 0 0 0 0 0 0
159 Salisil Bedak 2% Botol 1 0 1 0 1 0 -1
205 Sefadroxil 50 0 50 20 30 24 -6
206 Simvastatin 30 0 30 0 30 0 -30
169 Tetrakain hcl TM 0,5% Botol 5 0 5 0 5 0 -5
171 Tetraksilin 500 mg Kaplet 212 0 212 0 212 0 -212
170 Tetrasiklin hcl 250mg Kapsul 158 400 558 0 558 0 -558

1 2 3 4 5 6 7 8 9 10 11 12 13
176 Vitamin B. Complex Tablet 695 0 695 303 392 358 -34
207
208
209
210
211
212

0 0 0 0 0
Mengetahui Petugas Pengelola Obat Petugas Lo

Kepala Puskesmas Buhu Puskesmas Buhu Puskesma
dr. Sri Darsianti Tuna H. Muhtar Rahim, S.Kep, Ns. Santi R

NIP. 19741210 200604 2 017 NIP. 19730525 199903 1 008 NIP. 19780315 2

: JANUARI 2011
: FEBRUARI 2011
PEMBERIAN
DIKES PROV LAIN-LAIN
KET
14 15 16

PEMBERIAN
KET
14 15 16

PEMBERIAN
KET
14 15 16

PEMBERIAN
KET
14 15 16

PEMBERIAN
KET
14 15 16

PEMBERIAN
KET
14 15 16

PEMBERIAN
KET
14 15 16
Petugas Loket Obat

Puskesmas Buhu
Santi Rahim
NIP. 19780315 200604 2 007

UNIT PELAYANAN : LOKET OBAT PELAPORAN BULAN/PERIODE

PUSKESMAS : BUHU PERMINTAAN BULAN/PERIODE
KECAMATAN : TIBAWA
1 2 3 4 5 6 7 8 9 10 11 12 13
001 Abocath no. 18 Buah 0 0 0 0 0 0 0
002 Abocath no. 20 Buah 0 0 0 0 0 0 0
003 Abocath no. 24 Buah 0 0 0 0 0 0 0
006 Allopurinol 100mg Tablet 81 0 81 9 72 11 -61
007 Aminofilin 200mg Tablet 413 0 413 0 413 0 -413
009 Amitriptilin hcl 25mg Tablet 100 0 100 0 100 0 -100
015 Antalgin 500mg Tablet 28 0 28 0 28 0 -28
018 Anti Hemmoroid supp Tablet 10 0 10 0 10 0 -10
019 Anti Parkinson Doen Komb. Tablet 100 0 100 0 100 0 -100
023 Asam Mefenamat 18 100 118 60 58 71 13
025 Asetosal 100mg Tablet 40 0 40 0 40 0 -40

1 2 3 4 5 6 7 8 9 10 11 12 13
031 Betametason Krim Tube 5 0 5 0 5 0 -5
032 Bisoprololol 5 mg 30 0 30 0 30 0 -30
036 Curcuma 0 0 0 0 0 0 0
037 Dapson 100 mg Tablet 0 0 0 0 0 0 0
040 Dekstrometorfan hbr 15 mg Tablet 268 0 268 36 232 42 -190
041 Dekstrometorfan sir. 10mg Botol 3 0 3 0 3 0 -3
043 Diazepam 2mg Tablet 160 300 460 144 316 170 -146
048 Digoksin 0,25mg Tablet 40 0 40 0 40 0 -40
049 Diltiazem 100 0 100 0 100 0 -100
053 Domperidon Syr 0 2 2 0 2 0 -2
054 Efedrin tab 25mg Tablet 422 0 422 70 352 83 -269
057 Erytromisin 120 0 120 0 120 0 -120
058 Erytromisin Syr 3 0 3 0 3 0 -3
060 Etanol 70% 1000ml Botol 0 0 0.0 0 0.0 0.0 0
061 Etil Klorida semprot Botol 0 0 0.0 0 0.0 0.0 0

1 2 3 4 5 6 7 8 9 10 11 12 13
064 Fenobarbital 30mg Tablet 429 0 429 27 402 32 -370
070 Furosemid 40mg Tablet 56 0 56 0 56 0 -56
072 Garam Oralit 200ml air Bungkus 79 0 79 30 49 35 -14
073 Gention violet 1% Botol 2 0 2 0 2 0 -2
074 Glibenklamid Tablet 5 mg Tablet 61 0 61 0 61 0 -61
075 Gliquidon 100 0 100 0 100 0 -100
081 Griseofulvin 125mg Tablet 157 0 157 36 121 42 -79
084 Hand Scoen No. 7 1/2 psg 0 0 0 0 0 0 0
085 Hand Scoen No. 8 psg 0 0 0 0 0 0 0
086 Hidroklorotiazida 25mg Tablet 415 0 415 3 412 4 -408
087 Hidrokortison Krim 2,5% Tube 1 8 9 3 6 4 -2
088 Ibu profen 400mg Tablet 102 0 102 0 102 0 -102
094 Isosorbid Dinitrat Tablet 91 0 91 0 91 0 -91

1 2 3 4 5 6 7 8 9 10 11 12 13
101 Karbamzepin 200mg Tablet 100 0 100 0 100 0 -100
106 Kategori 1 paket 0 0 0 0 0 0 0
107 Ketokonazole 50 0 50 0 50 0 -50
109 Kloramphenikol 250mg Kapsul 251 0 251 0 251 0 -251
110 Kloramphenikol tts. Tel. 3% Botol 1 0 1 0 1 0 -1
111 Kloramphenikol ZM 1% Tube 3 0 3 0 3 0 -3
112 Klorokuin fosfat 150 mg Tablet 797 0 797 0 797 0 -797
114 Klorpromazin hcl 25mg Tablet 749 0 749 0 749 0 -749
119 KOH pasta Tube 0 0 0 0 0 0 0
120 Komb. Pirimetamin+Suldoks Tablet 100 0 100 0 100 0 -100
122 Kotrimoksazol 480mg Tablet 96 0 96 0 96 0 -96
123 Kotrimoksazol suspensi Botol 4 0 4 0 4 0 -4
124 Lanzoprasol 100 0 100 6 94 7 -87

1 2 3 4 5 6 7 8 9 10 11 12 13
132 Lisol Botol 0 0 0 0 0 0 0
133 Loperamid 0 0 0 0 0 0 0
134 Loratadin 0 100 100 0 100 0 -100
135 Masker 0 0 0 0 0 0 0
137 Metamol Botol 0 0 0 0 0 0 0
138 Metformin 100 0 100 0 100 0 -100
139 Metilergeometrin 0.125mg Tablet 94 0 94 0 94 0 -94
141 Metilprednisolon 100 0 100 0 100 0 -100
144 MgSO4 20 % Btl 0 0 0 0 0 0 0
145 MgSO4 40 % Btl 0 0 0 0 0 0 0
149 Natrium Diclofenac 50 mg Tablet 0 100 100 0 100 0 -100
154 OBH sirup Botol 5 0 5 0 5 0 -5
157 Oksitetrasiklin hcl ZM 1% Tube 7 0 7 0 7 0 -7
159 P. T. U 100mg Tablet 4 100 104 66 38 78 40
161 Parasetamol 100 mg Tablet 196 0 196 0 196 0 -196

1 2 3 4 5 6 7 8 9 10 11 12 13
166 Pirantel Pamoat 125mg Tablet 38 0 38 0 38 0 -38
167 Piridoksin 10 mg Tablet 481 800 1281 436 845 514 -331
168 Piroxicam 82 0 82 0 82 0 -82
171 Prednison 5mg Tablet 311 0 311 71 240 84 -156
173 Propranolol hcl 40mg Tablet 97 0 97 0 97 0 -97
174 Pyronolakton 100 0 100 0 100 0 -100
175 Ranitidin 61 0 61 50 11 59 48
177 Reserpina 0,25mg Tablet 494 0 494 0 494 0 -494
181 Salbutamol 2mg Tablet 7 0 7 0 7 0 -7
182 Salep 2-4 Pot 0 0 0 0 0 0 0
183 Salisil Bedak 2% Botol 1 1 2 0 2 0 -2
185 Sefadroxil 30 0 30 26 4 31 27
190 Simvastatin 30 0 30 0 30 0 -30
191 Siprofloxacin 500 mg Tablet 25 0 25 0 25 0 -25
196 Tetrakain hcl TM 0,5% Botol 5 0 5 0 5 0 -5
197 Tetraksilin 500 mg Kaplet 212 0 212 0 212 0 -212
198 Tetrasiklin hcl 250mg Kapsul 558 0 558 0 558 0 -558
199 Tiamin hcl (Vit. B1) 50mg Tablet 199 1200 1399 540 859 637 -222

1 2 3 4 5 6 7 8 9 10 11 12 13
203 Vitamin B. Complex Tablet 392 700 1092 254 838 300 -538
207
208
209
210
211
212

187 19 94 2 302
Mengetahui Petugas Pengelola Obat Petugas Lo

Kepala Puskesmas Buhu Puskesmas Buhu Puskesma
dr. Sri Darsianti Tuna H. Muhtar Rahim, S.Kep, Ns. Santi R

NIP. 19741210 200604 2 017 NIP. 19730525 199903 1 008 NIP. 19780315 2

: FEBRUARI 2011
: MARET 2011
PEMBERIAN
KET
14 15 16

PEMBERIAN
KET
14 15 16

PEMBERIAN
KET
14 15 16

PEMBERIAN
KET
14 15 16

PEMBERIAN
KET
14 15 16

PEMBERIAN
KET
14 15 16

PEMBERIAN
KET
14 15 16
Petugas Loket Obat

Puskesmas Buhu
Santi Rahim
NIP. 19780315 200604 2 007

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REGISTER PENGGUNAAN OBAT HARIAN DI LOKET OBAT PUSKESMAS BUHU

Stok Peneri Sisa

79 Klorpromazin hcl 25mg

PEMAKAIAN KEBUTUHAN TAHUN 2010

002 Abocath no. 18 Buah #REF! #REF! #REF!

003 Abocath no. 24 Buah #REF! #REF! #REF!

004 Abocath no. 20 Buah #REF! #REF! #REF!

005 Allopurinol 100mg Tablet #REF! #REF! #REF!

006 Aminofilin Inj 24mg/ml-10ml Ampul #REF! #REF! #REF!

007 Aminofilin 200mg Tablet #REF! #REF! #REF!

008 Amitriptilin hcl 25mg Tablet #REF! #REF! #REF!

009 Amoksisilin 250mg Kapsul #REF! #REF! #REF!

010 Amoksisilin sir. 125/5ml Botol #REF! #REF! #REF!

011 Amoksisilin 500mg Tablet #REF! #REF! #REF!

012 Ampisilin 500mg Tablet #REF! #REF! #REF!

013 Ampisilin Sir. 125/5ml Botol #REF! #REF! #REF!

014 Antalgin injeksi Ampul #REF! #REF! #REF!

015 Antalgin 500mg Tablet #REF! #REF! #REF!

016 Antasida Doen 500mg Tablet #REF! #REF! #REF!

017 Anti Hemmoroid supp Tablet 3 4 42

018 Aqua pro inj 20ml Vial #REF! #REF! #REF!

019 Asam askorbat 250mg Tablet #REF! #REF! #REF!

020 Asam askorbat 50mg Tablet #REF! #REF! #REF!

021 Whitefield salep Pot #REF! #REF! #REF!

022 Asetosal 500mg Tablet #REF! #REF! #REF!

023 Anti Parkinson Doen Komb. Tablet #REF! #REF! #REF!

024 Asam Sulfosalisilat 20% Botol #REF! #REF! #REF!

025 Asetosal 100mg Tablet #REF! #REF! #REF!

026 Atropin Sulfat inj 0,25mg/1ml Ampul #REF! #REF! #REF!

027 Atropin Sulfat 0.5mg Tablet #REF! #REF! #REF!

029 Albothyl 10ml Botol #REF! #REF! 100

halaman 6 dari 100 halaman

031 Besi (II) sulfat Tablet #REF! #REF! 15000

032 Catgut/benang bedah 2/0-3/0 Buah #REF! #REF! #REF!

033 Dapson 100 mg Tablet #REF! #REF! #REF!

034 Deksametason inj 5mg/-1ml Ampul #REF! #REF! #REF!

035 Deksametason 0,5mg Tablet #REF! #REF! #REF!

036 Dietilkarbamzin sitrat 100mg Tablet #REF! #REF! #REF!

037 Dekstrometorfan sir. 10mg Botol #REF! #REF! #REF!

038 Dekstrometorfan hbr 15 mg Tablet #REF! #REF! #REF!

039 Devitalisasi pasta Pot #REF! #REF! #REF!

040 Diazepam inj 5mg/ml-2ml Ampul #REF! #REF! #REF!

041 Diazepam 2mg Tablet #REF! #REF! #REF!

042 Diazepam 5mg Tablet #REF! #REF! #REF!

043 Difenhiramin inj 10mg Ampul #REF! #REF! #REF!

044 Disposible 1ml Buah #REF! #REF! #REF!

045 Disposible 3 ml Buah #REF! #REF! #REF!

046 Disposible 5 ml Buah #REF! #REF! #REF!

047 Digoksin 0,25mg Tablet #REF! #REF! #REF!

048 Efedrin tab 25mg Tablet #REF! #REF! #REF!

049 Ekstrak beladona 10mg Tablet #REF! #REF! #REF!

050 Epinefrin (adrenalin) inj Ampul #REF! #REF! #REF!

051 Etakrinidin (Rifanol) 0,1% Botol #REF! #REF! #REF!

052 Etanol 70% 1000ml Botol #REF! #REF! #REF!

053 Etil Klorida semprot Botol 0.7 0.8 10

054 Eugenol cairan Botol #REF! #REF! #REF!

055 Fenobarbital inj 50mg/ml-2ml Ampul #REF! #REF! #REF!

056 Fenobarbital 30mg Tablet #REF! #REF! #REF!

057 Fenobarbital 100mg Tablet #REF! #REF! #REF!

059 Fitomenadion inj 10mg/ml-1ml Ampul #REF! #REF! #REF!

060 Fitomenadion 10mg Tablet #REF! #REF! #REF!

halaman 7 dari 100 halaman

062 Gameksan emulsi 1% Botol #REF! #REF! #REF!