Lplpo 2021 Sungsang

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)
Kode Puskesmas : P1607100101 Laporan Bulan : FEBRUARI 2021

Puskesmas : SUNGSANG Permintaan Bulan : MARET - APRIL 2021
Kecamatan : BANYUASIN II Nomor : 094/ 074 /ADMIN/PKM-SSG/II/2021
Kab/ Kodya : BANYUASIN Tanggal : 4 MARET 2021
Propinsi : SUMATERA SELATAN
KOD KELAS SATU STOK PENERI PERSEDI PEMA SISA STOK PERMIN PEMBERIAN
NAMA OBAT KET
E TERAPI AN AWAL MAAN AAN KAIAN STOK OPT TAAN INPRES ASKES APBD LAIN JMLH
APBD
1 ACIFAR KRIM tube 50 0 50 50 0 200

2 AKITA TABLET tablet 500 0 500 500 0 5000
3 AMOXIXILIN 125MG SIRUP DS botol 0 0 0 0 0 500
4 BEDAK SALICYL zak 154 0 154 24 130 300
5 BIOMEGA tablet 0 0 0 0 0 5000
6 CEFADROXIL KAPSUL kapsul 0 0 0 0 0 5000
7 CIPROFLOXACIN TABLET tablet 0 0 0 0 0 5000
8 EMTURNAS KAPLET tablet 0 0 0 0 0 10000
9 ERLAMYCETIN EAR DROP botol 0 0 0 0 0 300
10 FIMESTAN FORTE tablet 0 0 0 0 0 10000
11 HICO GEL tube 0 0 0 0 0 100
12 LOPERAMID TABLET tablet 900 0 900 0 900 0
13 MULSANOL SIRUP botol 0 0 0 0 0 300
14 NISAGON KRIM tube 0 0 0 0 0 100
15 OKSITETRASIKLIN SK 3% tube 0 0 0 0 0 500
16 PEHAVRAL tablet 0 0 0 0 0 20000
17 PHAROLIT SACHET 120 0 120 0 120 0
18 PRATIFAR 20 tablet 0 0 0 0 0 0
19 ZECAXOL SIRUP botol 0 0 0 0 0 300
20 ZECAXOL TABLET tablet 0 0 0 0 0 10000
OBAT PAJAK ROKOK

1 Acifar Cream tube 0 0 0 0 0 200
2 Amoxicilin 125mg Syr Kering botol 0 0 0 0 0 200
3 Amlodipin 10 mg tablet tablet 0 0 0 0 0 3600
4 Akita Tablet tablet 0 0 0 0 0 2000
5 Azitromycin Kaplet kaplet 0 0 0 0 0 0
6 Biomega tablet 0 0 0 0 0 2000
7 Bronchitin Expectorant botol 0 0 0 0 0 200
8 Calestar Syrup botol 0 0 0 0 0 200
9 Citicolin Injeksi ampul 0 0 0 0 0 50
10 Citicolin Kaplet kaplet 0 0 0 0 0 2000
NAMA OBAT KET
11 Chloramphenicol Suspensi botol 0 0 0 0 0 0
12 Clindamicin Kapsul Kapsul 0 0 0 0 0 1000
13 CTM tablet 0 0 0 0 0 10000
14 Dexametason Tablet tablet 0 0 0 0 0 10000
15 Elomox Cream tube 0 0 0 0 0 200
16 Emturnas Kaplet kaplet 0 0 0 0 0 10000
17 Erlamycetin Tetes Telinga botol 0 0 0 0 0 50
18 Estalex tablet 0 0 0 0 0 1000
19 Fimestan Forte tablet 0 0 0 0 0 10000
20 Flucadex Kaplet kaplet 0 0 0 0 0 5000
21 Hico Gel tube 0 0 0 0 0 50
22 Ibuprofen 200mg Tablet tablet 0 0 0 0 0 10000
24 Imuco Syrup botol 0 0 0 0 0 200
25 Lico-C tablet 0 0 0 0 0 2000
26 Licocure Kapsul kapsul 0 0 0 0 0 5000
27 Loperamide HCL tablet 0 0 0 0 0 2000
28 Melosikam Tablet 15mg tablet 0 0 0 0 0 10000
29 Metronidazole Tablet tablet 0 0 0 0 0 10000
30 Mulsanol Syrup botol 0 0 0 0 0 200
31 Nifedipin Tablet tablet 0 0 0 0 0 2000
32 Nisagon Krim tube 0 0 0 0 0 100
33 OBH Rama botol 0 0 0 0 0 200
34 Oralit Sachet 0 0 0 0 0 0
35 Oxytetracyclin Salap Kulit tube 0 0 0 0 0 100
36 Pehavral kapsul 0 0 0 0 0 10000
37 Prednison Tablet tablet 0 0 0 0 0 10000
38 Propiltiouasil Tablet tablet 0 0 0 0 0 0
39 Ranitidin Injeksi ampul 0 0 0 0 0 0
40 Ranitidin Tablet tablet 0 0 0 0 0 2000
41 Salicyl Bedak zak 0 0 0 0 0 24
42 Sefadroxil 500mg kapsul 0 0 0 0 0 5000
43 Sefiksim Kapsul kapsul 0 0 0 0 0 5000
44 Siprofloksasin 500mg tablet 0 0 0 0 0 10000
45 Sukralfat 500mg Syrup botol 0 0 0 0 0 200
46 Zecaxol Syrup botol 0 0 0 0 0 200
47 Zecaxol Tablet tablet 0 0 0 0 0 5000
48 Tablet Tambah Darah tablet 0 0 0 0 0 5000
Alat Kesehatan
1 Acticare Antiseptik Handscrub 5 L Shipment GL 0 0 0 0 0 10
2 Acticare Antiseptik Handscrub 500 ML Shipment botol 0 0 0 0 0 20
3 Acticare Antiseptik Handrub 5 L Shipment GL 0 0 0 0 0 10
4 Acticare Antiseptik Handrub 500 ML Shipment botol 0 0 0 0 0 20
5 Acticare Alcohol Swab CHG 2 % Shipment pcs 0 0 0 0 0 500
NAMA OBAT KET
6 Cavidagel,15g tube 0 0 0 0 0 0
7 Tro-Sensosurge, Surgical Plus Glove Steril,6.0 pcs 0 0 0 0 0 200
8 Tro-Sensosurge, Surgical plus Glove Steril,6.5 pcs 0 0 0 0 0 200
11 Pharmacoll Comport Plus,10 cm x 10 cm pcs 0 0 0 0 0 10
12 Postofix-PU Post Operative Dressing 10 cm x 10 cm pcs 0 0 0 0 0 10
DAK
1 Air Untuk Injeksi 25 ml botol 0 0 0 0 0 200
2 Air Untuk Irigasi Inf 1000 ml botol 20 0 20 0 20 0
3 Alopurinol tablet 100 mg Box/100 tablet 0 0 0 0 0 0
4 Alprazolam tablet 0,25 mg Box/100 kapsul 0 0 0 0 0 5000
5 Alprazolam tablet 0,5 mg Box/100 tablet 0 0 0 0 0 5000
6 Alprazolam tablet 1mg Box/100 kapsul 0 0 0 0 0 5000
7 Amoksisilin Drop 100 mg/ml botol 60 ml 0 0 0 0 0 500
8 Amoksisilin sirup kering 250 mg/5ml botol 60 ml 0 0 0 0 0 500
9 Amoksisilin tablet 250 mg Box/100 tablet 0 0 0 0 0 20000
11 Aminofilin Injeksi 24 mg/ml ampul 30 0 30 30 0 0
12 Amitriptilin tablet salut 25 mg (HCL) Box/100 tablet 300 0 300 0 300 0
13 Amlodipin tablet 5 mg Box/30 tablet 2100 0 2100 600 1500 3600
14 Asam Asetilsalisilat(Asetosal)tablet 80mg Box/100 tablet 0 0 0 0 0 0
15 Asam Mefenamat kapsul/kaplet 500 mg Box/100 tablet 0 0 0 0 0 20000
16 Asam Traneksamat injeksi box/10 ampul 0 0 0 0 0 0
17 Asam Traneksmat 500 mg tablet tablet 0 0 0 0 0 5000
18 Asiklovir tablet 200 mg Box/100 tablet 0 0 0 0 0 500
20 Antasida DOEN Tablet Kombinasi Mg Hidroksida 200 mg+ Box/100 tablet 800 0 800 0 800 0
Al Hidroksida 200 mg Box/100 tablet
21 Antasida DOEN II suspensi Botol 60 ml 0 0 0 0 0 500
22 Antifungi DOEN salep, Kombinasi:Asam Benzoat 6% pot 0 0 0 0 0 0
Asam Salisilat 3%
23 Antihemoroid,komb bismut subgalat 150mg Box/100 tablet 0 0 0 0 0 0
heksaklorofen 2,5mg lidokain 10mg seng oksida 120mg
24 Anti Bakteri DOEN salep Box/25 tube 0 0 0 0 0 0
25 Anti Malaria Doen komb pirimetamin 25mg Box/100 tablet 1100 0 1100 0 1100 0
sulfadoksin 500mg
26 Atropin Injeksi 0,25 mg/ml ampul 0 0 0 0 0 0
27 Atropin Injeksi 5 mg/ml Box/30 ampul 0 0 0 0 0 0
28 Asam Askorbat (Vit C) tablet 50 mg box/ 100 tablet 0 0 0 0 0 20000
29 Asam Fusidat Krim 20 mg/g tube 0 0 0 0 0 200
30 Azitromisin tablet 500 mg tablet 0 0 0 0 0 0
31 Betahistin tablet 6 mg ktk @ 3x10 tablet 0 0 0 0 0 5000
32 Betametason krim 0,1 % box/25 tube 0 0 0 0 0 200
NAMA OBAT KET
33 Candesartan 8 mg tablet 900 0 900 0 900 2000
34 Clobazam tablet 10 mg Box/100 tablet 0 0 0 0 0 2000
35 Clopidogrel tablet salut selaput 75 mg tablet 150 0 150 0 150 2000
36 Deksametason tablet 0,5 mg Box/100 tablet 0 0 0 0 0 10000
37 Deksametason injeksi 5 mg/ml Box/100 ampul 40 0 40 0 40 0
38 Depakote Divalproex Sorodium (Valproat) 250mg tablet 0 0 0 0 0 1000
39 Depakote Divalproex Sorodium (Valproat) 250mg Suspensi Botol 0 0 0 0 0 200
40 Desoksimetason krim 0,25% tube 0 0 0 0 0 200
41 Dextral Syrup botol 0 0 0 0 0 500
42 Diazepam injeksi 5 mg/ml ampul 15 0 15 0 15 0
43 Diazepam Tablet 2 mg tablet 300 0 300 0 300 1000
44 Diazepam tablet 5 mg tablet 0 0 0 0 0 5000
45 Digoksin Tablet 0,25 mg Box/100 tablet 0 0 0 0 0 0
46 Difenhidramin injeksi 10 mg/ml Box/30 ampul 300 0 300 0 300 0
47 Domperidon Suspensi 5 mg/ 5 ml Botol/60 ml 0 0 0 0 0 200
48 Domperidon Tablet 10 mg Box/100 tablet 1200 0 1200 0 1200 5000
49 Dulcolax Bisacodil Suppos 10 mg suppos 0 0 0 0 0 0
50 Efedrin HCL Inj 50 mg/ml ampul 0 0 0 0 0 0
51 Epinefrin (Adrenalin) injeksi 0,1% Box/30 ampul 0 0 0 0 0 0
52 Erythromycin 250 mg tablet Box/100 tablet 0 0 0 0 0 0
53 Eritromicin Sterate Tablet 500 mg tablet 0 0 0 0 0 0
54 Etil Klorida Spray 100 ml botol 0 0 0 0 0 20
55 Fenitoin/Phenytoin Sodium Kapsul 30 mg tablet 600 0 600 200 400 2000
56 Fenobarbital injeksi 50 mg/5ml ampul 0 0 0 0 0 0
57 Fenobarbital Tablet 30 mg tablet 0 0 0 0 0 0
58 Fentanil Injeksi 0,05 mg/ml ampul 2mg 0 0 0 0 0 0
59 Fenofibrat kaps 100 mg Box/30 tablet 0 0 0 0 0 0
60 Ferro Fumarat 60 mg+as. Folat 0,4 mg (TTD) tablet 0 0 0 0 0 0
61 Fitomenadion (Vit. K 1) Tablet 10 mg Box/100 kapsul 1400 0 1400 0 1400 5000
62 Fitomenadion (Vit. K 1) Injeksi 10 mg/ml-1 ml Box/30 ampul 0 0 0 0 0 180
64 Furosemid tablet 40 mg box/20x10 tab 0 0 0 0 0 0
65 Fusilex Krim (Fusidic Acid) krim 20% 20 mg/g tube 0 0 0 0 0 200
66 Garam Oralit serbuk kombinasi sachet 0 0 0 0 0 0
67 Glukosa Larutan Infus 5% Steril Botol/500 ml 0 0 0 0 0 0
68 Glibenklamid Tablet 5 mg Box/100 tablet 500 0 500 0 500 1000
69 Glimepiride Tablet 1 mg Box/30 tablet 1800 0 1800 0 1800 1000
70 Griseofulvin (micronized) tablet 500 mg Tablet 0 0 0 0 0 0
71 Haloperidol Drop 2 mg/ml botol 27 0 27 0 27 200
72 Haloperidol tablet 0,5 mg Box/100 tablet 0 0 0 0 0 1000
73 Haloperidol tablet 2 mg Box/100 tablet 0 0 0 0 0 0
75 Haloperidol injeksi 50 mg/ml box/5 ampul@1ml 0 0 0 0 0 0
76 Hidrokortison krim 2,5% tube 5 gr 0 0 0 0 0 200
77 Hidroklorotiazid 25 mg tablet 6300 0 6300 0 6300 5000
NAMA OBAT KET
78 Ibuprofen Suspensi 100mg/5ml botol 0 0 0 0 0 200
79 Ibuprofen tablet 200 mg box/ 100 tablet 0 0 0 0 0 20000
80 Isosorbid Dinitrat 5 mg Box/100 tablet 300 0 300 0 300 0
81 Kalsium Glukonat inj 10% ampul 48 0 48 0 48 0
82 Kalsium Laktat (Kalk) 500 mg tablet 600 0 600 0 600 20000
83 Kaptopril 12,5 mg tablet 1500 0 1500 300 1200 20000
84 Kaptopril 25 mg Box/100 tablet 0 0 0 0 0 20000
85 Karbol gliserin Tetes Telinga 10% botol 5 ml 0 0 0 0 0 100
86 Ketokonazol krim 2% tube 10 gram 0 0 0 0 0 100
87 Ketokonazol Tablet 200 mg Box/50 tablet 400 0 400 0 400 5000
88 Ketoprofen Supositoria 100 mg suppos 60 0 60 0 60 0
89 Ketorolac injeksi 30 mg box/12 ampul 80 0 80 0 80 0
90 Klindamisin Kapsul 150 mg Box/50 kapsul 0 0 0 0 0 5000
91 Kloramfenikol salep mata 1% tube 5gram 0 0 0 0 0 200
92 Kloramfenikol suspensi 125 mg/5ml botol 350 0 350 50 300 0
93 Klopromazin tablet salut 100mg (HCl) ktk @ 10x10 tablet 0 0 0 0 0 1000
94 Klozapin 25 mg Box/50 tablet 0 0 0 0 0 1000
95 Klorfeniramina Maleat (CTM) 4 mg tablet Box/100 tablet 0 0 0 0 0 10000
96 Kompolax : Parafin+gliserin+Fenolflaten Susp botol 0 0 0 0 0 100
97 Kotrimoksazol Suspensi Kombinasi Sulfametoksazol Botol/60 ml 200 0 200 200 0 300
200 mg+Trimetroprin 40 mg/5 ml
98 Kotrimoksazol Tablet Kombinasi Sulfametoksazol Box/100 tablet 1500 0 1500 1000 500 0
400 mg+Trimetropin 80 mg
99 Lanzoprazol kapsul 30 mg box/ 20 tablet 0 0 0 0 0 5000
100 Levofloksasin tablet 500 mg tablet 150 0 150 0 150 0
101 Lidokain injeksi 2% (HCL)+epinefrin 1:800 Box/30 ampul 270 0 270 0 270 90
000-2ml
102 Loperamid tablet 2 mg tablet 0 0 0 0 0 5000
103 Loratadin tablet 10 mg Box/100 tablet 0 0 0 0 0 5000
104 Lorazepam tablet 0,5 mg tablet 0 0 0 0 0 0
105 Lorazepam tablet 2 mg tablet 0 0 0 0 0 0
106 Magnesium Sulfat Injeksi 20% Dus 120 ml PE@25ml 20 0 20 10 10 0
108 Metformin HCL tablet 500 mg Box/100 tablet 0 0 0 0 0 0
109 Methylergometrin injeksi 0,2 mg/ml Box/30 ampul 0 0 0 0 0 0
110 Methylergometrin Maleat tablet 0,125 mg Tablet 100 0 100 0 100 0
111 Metilprednisolon tablet 4 mg Box/100 tablet 0 0 0 0 0 5000
112 Metoklopramide 5 mg Tablet 0 0 0 0 0 0
113 Metoklopramide 10 mg Box/100 tablet 0 0 0 0 0 0
114 Metoklopramide sirup 5 mg/5ml botol 0 0 0 0 0 0
115 Metronidazol Ovula 500 mg suppos 50 0 50 0 50 100
116 Metronidazol Sirup 125 mg/5ml botol 0 0 0 0 0 5000
117 Metronidazol tablet tablet 0 0 0 0 0 100
118 Momethasone Furoate 0,1%krim tube 0 0 0 0 0 500
119 N-Asetil Sistein tablet 200 mg tablet 0 0 0 0 0 0
NAMA OBAT KET
120 Natrium Klorida Larutan Infus 0,9% Steril Botol/500 ml 40 0 40 40 0 5000
121 Natrium Diklofenak tablet 25 mg Box/50 tablet 0 0 0 0 0 5000
123 Nifedipin 10 mg tablet box/100 tablet 0 0 0 0 0 0
124 Nistatin tablet salut 500.000 iu/g Box/100 tablet 0 0 0 0 0 0
125 Nistatin Vaginal tablet 100.000 iu/g Box/100 tablet 0 0 0 0 0 0
126 Obat Batuk Hitam (OBH) botol 60 0 60 60 0 500
127 Oksitetrasiklin 1% salap mata tube 0 0 0 0 0 0
128 Oksitosin injeksi 10 IU/ml box/10 ampul 0 0 0 0 0 500
129 Omeprazol Kapsul 20 mg Box/30 kapsul 0 0 0 0 0 9000
130 Ondansetron Hydrochloride Injeksi 2 mg/ml ampul 35 0 35 0 35 200
131 Ondansetron kaplet 4 mg tablet 0 0 0 0 0 5000
133 Parasetamol drops botol 15 ml 60 0 60 60 0 200
134 Parasetamol Sirup 120 mg/5ml botol 60 ml 0 0 0 0 0 500
135 Parasetamol tablet 500 mg box/ 100 tablet 0 0 0 0 0 50000
136 Pirantel Pamoat Susp 125 mg/5ml botol 0 0 0 0 0 0
137 Pirantel tablet score (base) 125 mg box/25x4 tablet 600 0 600 0 600 200
138 Piridoksin (Vitamin B6) 10 mg Box/100 tablet 0 0 0 0 0 5000
139 Prednison tablet 5 mg Box/100 tablet 0 0 0 0 0 5000
140 Propiltiourasil tablet 100 mg botol/100 tablet 700 0 700 0 700 0
141 Ranitidin Injeksi 25 mg/ 2 ml Box/10 ampul 300 0 300 0 300 100
142 Ranitidin tablet 150 mg Box/100 tablet 0 0 0 0 0 1000
143 Ringer Laktat Larutan Infus Steril Botol/500 ml 0 300 300 40 260 200
144 Risperidon tablet 1 mg box/100 tablet 0 0 0 0 0 2000
145 Risperidon tablet 2 mg tablet 0 0 0 0 0 2000
146 Salbutamol tablet 2 mg tablet 600 0 600 100 500 2000
148 Salbutamol Sirup 2mg/5ml botol 49 0 49 0 49 200
149 Salep 24, Kombinasi : Asam Salisilat 2%+Belerang endap 4% pot 0 0 0 0 0 200
150 Salisil Bedak 2% box 50 gram 0 0 0 0 0 200
151 Scabmide Permetrin krim 5% tube 0 0 0 0 0 200
152 Sefadroksil Sirup Kering botol 0 0 0 0 0 2000
153 Sefadroksil kapsul 500 mg Box/100 tablet 0 0 0 0 0 2000
154 Sefiksim kapsul 100 mg Box/30 tablet 0 0 0 0 0 2000
155 Sefiksim Kapsul 200 mg tablet 0 0 0 0 0 2000
156 Sefiksim sirup kering 100 mg/5ml botol 30 ml 0 0 0 0 0 200
157 Sefotaksim serbuk injeksi 1000mg vial 0 0 0 0 0 0
158 Seftriakson Serbuk Injeksi 1000mg vial 0 0 0 0 0 0
159 Serum Anti bisa Ular (A.B.U) vial 0 0 0 0 0 0
160 Serum Antitetanus(ATS)cairan injeksi 1500IU/amp ampul 0 0 0 0 0 0
161 Setirizin sirup 5mg/5ml botol 0 0 0 0 0 2000
162 Setirizine Tablet 10 mg Box/50 tablet 0 0 0 0 0 200
163 Sianokobalamin (Vit B12) Injeksi 500 mcg-ml Box/100 ampul 20 0 20 0 20 0
164 Sikzonoate Injeksi ampul 5 0 5 0 5 0
NAMA OBAT KET
165 Simvastatin Tablet 10 mg Box/30 tablet 1560 0 1560 0 1560 3000
166 Siprofloksasin tablet 500 mg Box/100 tablet 0 0 0 0 0 3000
167 Sukralfat susp 500 mg/5ml, 100 ml botol 0 0 0 0 0 200
168 Sukralfat tablet 500 mg/ 5 ml tablet 0 0 0 0 0 5000
169 Tetrasiklin HCI Kapsul 250 mg Box/100 kapsul 0 0 0 0 0 5000
170 Tetrasiklin HCI Kapsul 500 mg Box/100 tablet 0 0 0 0 0 2000
171 Thiamin (vitamin B1) tablet 50 mg Box/100 tablet 0 0 0 0 0 1000
172 Triheksifenidil 2 mg Box/100 tablet 1754 0 1754 374 1380 2000
173 Valsartan tab 80 mg Box/100 tablet 0 0 0 0 0 2000
174 Vitamin B Kompleks tablet Box/100 tablet 0 0 0 0 0 2000
175 Zincpro drops botol 0 0 0 0 0 200
176 Zinc syrup 10 mg/ml botol 0 0 0 0 0 200
178 Zinc tablet 20 mg box/10x10 tab 400 0 400 0 400 2000
Obat Gigi
1 Bur Carbide Highspeed Round Box 0 0 0 0 0 0
2 Cavit G RF 28G Bottle Dus 0 0 0 0 0 0
3 Composit Finishing Kit Box 0 0 0 0 0 0
4 Fluoride Varnish Box 0 0 0 0 0 0
5 Ketac Universal HM Intro Kit A3 Dus 0 0 0 0 0 0
6 Micro Brush Box 0 0 0 0 0 0
7 Paramono Clorofenol Dus 0 0 0 0 0 0
8 Saliva Ejector Kantong 0 0 0 0 0 0
9 Tricresolformalina Dus 0 0 0 0 0 0
10 3M 1470IK Z250 XT Syr Intro Kit LA/APAC/MEA Kit 0 0 0 0 0 0
11 3M 1370L Z250 Syringe Intro Kit LA/APAC Kit 0 0 0 0 0 0
Alat Kesehatan
1 Alat Suntik Sekali Pakai 3 ml Box/100 set 500 0 500 0 500 2000
3 Alkohol 70 % 1 L botol 25 0 25 0 25 50
4 Acticare Alkohol Swab box 0 0 0 0 0 0
5 Alkazyme Sachet 25 mg Sachet 3 0 3 0 3 2
6 Alkacide 1 L High Level Diksinfektant botol 0 0 0 0 0 2
7 Aseptic Liquid 100 ml botol 20 0 20 0 20 50
8 Antiseptic Hand Rub 500 ml botol 0 0 0 0 0 50
9 Antiseptic Hand Rub 5 Liter GL 0 0 0 0 0 5
10 Aseptic Gel 500cc + dispenser botol 0 0 0 0 0 50
11 Autocheck 3in1 Multi Monitoring System unit 0 0 0 0 0 5
12 Autocheck Glucose Test Strip 50 Strips 50 Strip/Box Box 0 0 0 0 0 100
13 Autocheck Uric Acid Test Strip 50 Strips /Box Box 0 0 0 0 0 100
14 Autocheck Total Cholestrol Test Strip 25 Strips/Box Box 0 0 0 0 0 100
15 Botol Kimiawi Plastik 1 L botol 0 0 0 0 0 10
16 Catgut chromic 2/0 +jarum 1/2 GT 35 mm set 76 0 76 0 76 0
NAMA OBAT KET
18 Catgut Plain 3/0 +jarum 1/2 GT 35 mm set 138 0 138 0 138 0
20 Gynaecological Glove, Small pcs 0 0 0 0 0 500
21 Gynaecological Glove, Medium pcs 0 0 0 0 0 500
22 Gynaecological Glove , Large pcs 0 0 0 0 0 500
23 Lingettes/Wipes Alcohol Free Cleaner Disinfectant Pack 0 0 0 0 0 20
24 Catheter 2 Way no.16 set 40 0 40 0 40 40
26 Cuticel Classic 10CM X10CM sachet 48 0 48 0 48 0
27 Cutisorb Abseorbent Compress 10 x10 cm pcs 0 0 0 0 0 0
28 Dermafix T 10x8 cm pcs 40 0 40 0 40 0
30 Dermanios Scrub Chlorhexidin botol 0 0 0 0 0 20
31 Disposible Blood Transfusion Sets pcs 10 0 10 0 10 0
32 Duk Lubang Steril 25 x 30 cm pcs 5 0 5 0 5 0
33 Eugenol cairan botol 0 0 0 0 0 0
34 Hidrogen Peroksida 3% botol 0 0 0 0 0 0
35 Infus Set Anak Box/100 set 300 0 300 0 300 100
36 Infus Set Dewasa Box/100 set 0 0 0 0 0 100
37 Aximed IV Chateter WP No.20 pcs 0 0 0 0 0 100
39 Aximed IV Chateter WP No.24 psc 0 0 0 0 0 100
40 Aximed Swab 2-PLY pcs 0 0 0 0 0 300
41 Kassa Kompres Steril 40 x 40 cm buah 60 0 60 0 60 40
42 Kassa Pembalut 2 x 80 cm roll 0 0 0 0 0 40
43 Kassa Steril 16 cm x 16 cm roll 0 0 0 0 0 40
44 Kassa Hidrofil 4 x 15 cm roll 0 0 0 0 0 40
45 Kassa Steril 10 x 10 cm, 8 ply 1x5's Pack 20 0 20 0 20 0
46 Leukomed IV Film 6 x 8 cm Sachet 200 0 200 0 200 0
47 Leukoplast 2,5 cm x 4,5 m roll 20 0 20 0 20 0
49 Lisol 1 Liter botol 0 0 0 0 0 50
50 Peter Silk type 3/0 USP 2 MET 1/2 Taper Point pcs 2 0 2 0 2 50
51 PHARMAFIX Wound Dressing 10 cm x 500 cm roll 0 0 0 0 0 50
53 POWDER LATEX MEDICAL EXAM GLOVES L box 0 0 0 0 0 20
54 POWDER LATEX MEDICAL EXAM GLOVES M box 0 0 0 0 0 20
55 POWDER LATEX MEDICAL EXAM GLOVES S box 0 0 0 0 0 20
56 Nonwoven Fixiation 5 cm x 10 m roll 30 0 30 0 30 0
58 Oral Sponge Steril bag 30 0 30 0 30 50
59 Paper Tape 5.0cm x 9.14 m roll 45 0 45 0 45 0
60 Povidon Iodida larutan 30 ml Botol 30 ml 0 0 0 0 0 0
61 Povidon Iodida larutan 300 ml botol 300 ml 24 0 24 0 24 20
NAMA OBAT KET
62 Rivanol 300 cc botol 20 0 20 0 20 0
63 Sabun Anti Bakteri 5 liter GL 0 0 0 0 0 20
64 Sabun Anti Bakteri 500 ml + Disp botol 0 0 0 0 0 20
65 Surgical Mask - 3ply Earloop set 0 0 0 0 0 200
66 Surgical Mask - 3ply tie on set 0 0 0 0 0 200
67 Surgical Mask - 3ply Hijab pcs 0 0 0 0 0 200
68 Sterile Latex Surgical Gloves Size 6,5 pcs 0 0 0 0 0 200
69 Sterile Latex Surgical Gloves Size 7 pcs 0 0 0 0 0 200
70 Troge Tro-Soluset G ( Infusion Set ) set 10 0 10 0 10 200
71 U Pad Steril 60 x 90 cm blister 40 0 40 0 40 0
72 Uniflex 23154"(4.5X10.0CM) roll 6 0 6 0 6 0
73 Uniflex 23143"(4.5X7.50CM) roll 6 0 6 0 6 0
74 Urine Bag buah 100 0 100 0 100 0
Total
JUMLAH KUNJUNGAN RESEP
1454
Mengetahui/ Menyetujui Yang Menyerahkan Pimpinan Puskesmas Yang Menerima

Kasi Kefarmasian Petugas Puskesmas
Iwan Afriansyah, S. Farm Nolo Widodo, SKM Dewi, SST Mahani, S. Farm
NIP. 19870405 201001 1 002 NIP. 197206 199503 1 001 NIP. 19760909 200801 2 004 NIP. 19860731 201001 2 016
(LPLPO)
Kode Puskesmas : P1607100101 Laporan Bulan : MARET 2021

Puskesmas : SUNGSANG
Kecamatan : BANYUASIN II
Kab/ Kodya : BANYUASIN
NAMA OBAT KET
APBD
1 ACIFAR KRIM tube 0 50 50 50 0

2 AKITA TABLET tablet 0 0 0 0 0
3 AMOXIXILIN 125MG SIRUP DS botol 0 300 300 300 0
4 BEDAK SALICYL zak 130 0 130 82 48
5 BIOMEGA tablet 0 0 0 0 0
6 CEFADROXIL KAPSUL kapsul 0 0 0 0 0
7 CIPROFLOXACIN TABLET tablet 0 0 0 0 0
8 EMTURNAS KAPLET tablet 0 0 0 0 0
9 ERLAMYCETIN EAR DROP botol 0 0 0 0 0
10 FIMESTAN FORTE tablet 0 0 0 0 0
11 HICO GEL tube 0 0 0 0 0
12 LOPERAMID TABLET tablet 900 500 1400 500 900
13 MULSANOL SIRUP botol 0 0 0 0 0
14 NISAGON KRIM tube 0 0 0 0 0
15 OKSITETRASIKLIN SK 3% tube 0 0 0 0 0
16 PEHAVRAL tablet 0 0 0 0 0
17 PHAROLIT SACHET 120 0 120 0 120
18 PRATIFAR 20 tablet 0 0 0 0 0
19 ZECAXOL SIRUP botol 0 0 0 0 0
20 ZECAXOL TABLET tablet 0 0 0 0 0
OBAT PAJAK ROKOK

1 Acifar Cream tube 0 0 0 0 0
2 Amoxicilin 125mg Syr Kering botol 0 0 0 0 0
3 Amlodipin 10 mg tablet tablet 0 0 0 0 0
4 Akita Tablet tablet 0 800 800 600 200
5 Azitromycin Kaplet kaplet 0 60 60 12 48
6 Biomega tablet 0 1000 1000 1000 0
7 Bronchitin Expectorant botol 0 30 30 30 0
8 Calestar Syrup botol 0 30 30 30 0
9 Citicolin Injeksi ampul 0 10 10 5 5
10 Citicolin Kaplet kaplet 0 100 100 100 0
NAMA OBAT KET
11 Chloramphenicol Suspensi botol 0 0 0 0 0
12 Clindamicin Kapsul Kapsul 0 100 100 100 0
13 CTM tablet 0 500 500 500 0
14 Dexametason Tablet tablet 0 300 300 300 0
15 Elomox Cream tube 0 10 10 10 0
16 Emturnas Kaplet kaplet 0 4000 4000 1800 2200
17 Erlamycetin Tetes Telinga botol 0 10 10 10 0
18 Estalex tablet 0 100 100 0 100
19 Fimestan Forte tablet 0 2500 2500 1200 1300
20 Flucadex Kaplet kaplet 0 500 500 0 500
21 Hico Gel tube 0 10 10 10 0
22 Ibuprofen 200mg Tablet tablet 0 200 200 0 200
24 Imuco Syrup botol 0 10 10 0 10
25 Lico-C tablet 0 500 500 0 500
26 Licocure Kapsul kapsul 0 200 200 0 200
27 Loperamide HCL tablet 0 0 0 0 0
28 Melosikam Tablet 15mg tablet 0 500 500 0 500
29 Metronidazole Tablet tablet 0 200 200 0 200
30 Mulsanol Syrup botol 0 96 96 96 0
31 Nifedipin Tablet tablet 0 100 100 100 0
32 Nisagon Krim tube 0 10 10 10 0
33 OBH Rama botol 0 50 50 50 0
34 Oralit Sachet 0 0 0 0 0
35 Oxytetracyclin Salap Kulit tube 0 30 30 30 0
36 Pehavral kapsul 0 800 800 800 0
37 Prednison Tablet tablet 0 500 500 500 0
38 Propiltiouasil Tablet tablet 0 0 0 0 0
39 Ranitidin Injeksi ampul 0 0 0 0 0
40 Ranitidin Tablet tablet 0 200 200 100 100
41 Salicyl Bedak zak 0 40 40 18 22
42 Sefadroxil 500mg kapsul 0 100 100 0 100
43 Sefiksim Kapsul kapsul 0 100 100 0 100
44 Siprofloksasin 500mg tablet 0 100 100 0 100
45 Sukralfat 500mg Syrup botol 0 0 0 0 0
46 Zecaxol Syrup botol 0 50 50 50 0
47 Zecaxol Tablet tablet 0 1500 1500 600 900
48 Tablet Tambah Darah tablet 0 6900 6900 6900 0
Alat Kesehatan
1 Acticare Antiseptik Handscrub 5 L Shipment GL 0 0 0 0 0
2 Acticare Antiseptik Handscrub 500 ML Shipment botol 0 0 0 0 0
3 Acticare Antiseptik Handrub 5 L Shipment GL 0 0 0 0 0
4 Acticare Antiseptik Handrub 500 ML Shipment botol 0 5 5 5 0
5 Acticare Alcohol Swab CHG 2 % Shipment pcs 0 500 500 500 0
NAMA OBAT KET
6 Cavidagel,15g tube 0 10 10 0 10
7 Tro-Sensosurge, Surgical Plus Glove Steril,6.0 pcs 0 50 50 50 0
8 Tro-Sensosurge, Surgical plus Glove Steril,6.5 pcs 0 50 50 50 0
11 Pharmacoll Comport Plus,10 cm x 10 cm pcs 0 0 0 0 0
12 Postofix-PU Post Operative Dressing 10 cm x 10 cm pcs 0 0 0 0 0
DAK
1 Air Untuk Injeksi 25 ml botol 0 0 0 0 0
2 Air Untuk Irigasi Inf 1000 ml botol 20 0 20 0 20
3 Alopurinol tablet 100 mg Box/100 tablet 0 0 0 0 0
4 Alprazolam tablet 0,25 mg Box/100 kapsul 0 0 0 0 0
5 Alprazolam tablet 0,5 mg Box/100 tablet 0 1000 1000 1000 0
6 Alprazolam tablet 1mg Box/100 kapsul 0 1000 1000 976 24
7 Amoksisilin Drop 100 mg/ml botol 60 ml 0 0 0 0 0
8 Amoksisilin sirup kering 250 mg/5ml botol 60 ml 0 0 0 0 0
9 Amoksisilin tablet 250 mg Box/100 tablet 0 0 0 0 0
11 Aminofilin Injeksi 24 mg/ml ampul 0 0 0 0 0
12 Amitriptilin tablet salut 25 mg (HCL) Box/100 tablet 300 0 300 0 300
13 Amlodipin tablet 5 mg Box/30 tablet 1500 3000 4500 1800 2700
14 Asam Asetilsalisilat(Asetosal)tablet 80mg Box/100 tablet 0 0 0 0 0
15 Asam Mefenamat kapsul/kaplet 500 mg Box/100 tablet 0 0 0 0 0
16 Asam Traneksamat injeksi box/10 ampul 0 30 30 30 0
17 Asam Traneksmat 500 mg tablet tablet 0 0 0 0 0
18 Asiklovir tablet 200 mg Box/100 tablet 0 0 0 0 0
20 Antasida DOEN Tablet Kombinasi Mg Hidroksida 200 mg+ Box/100 tablet 800 0 800 0 800
21 Antasida DOEN II suspensi Botol 60 ml 0 0 0 0 0
22 Antifungi DOEN salep, Kombinasi:Asam Benzoat 6% pot 0 0 0 0 0
Asam Salisilat 3%
23 Antihemoroid,komb bismut subgalat 150mg Box/100 tablet 0 0 0 0 0
24 Anti Bakteri DOEN salep Box/25 tube 0 0 0 0 0
25 Anti Malaria Doen komb pirimetamin 25mg Box/100 tablet 1100 0 1100 0 1100
sulfadoksin 500mg
26 Atropin Injeksi 0,25 mg/ml ampul 0 0 0 0 0
27 Atropin Injeksi 5 mg/ml Box/30 ampul 0 0 0 0 0
28 Asam Askorbat (Vit C) tablet 50 mg box/ 100 tablet 0 0 0 0 0
29 Asam Fusidat Krim 20 mg/g tube 0 0 0 0 0
30 Azitromisin tablet 500 mg tablet 0 0 0 0 0
31 Betahistin tablet 6 mg ktk @ 3x10 tablet 0 300 300 300 0
32 Betametason krim 0,1 % box/25 tube 0 10 10 10 0
NAMA OBAT KET
33 Candesartan 8 mg tablet 900 300 1200 0 1200
34 Clobazam tablet 10 mg Box/100 tablet 0 0 0 0 0
35 Clopidogrel tablet salut selaput 75 mg tablet 150 0 150 50 100
36 Deksametason tablet 0,5 mg Box/100 tablet 0 0 0 0 0
37 Deksametason injeksi 5 mg/ml Box/100 ampul 40 100 140 60 80
38 Depakote Divalproex Sorodium (Valproat) 250mg tablet 0 0 0 0 0
39 Depakote Divalproex Sorodium (Valproat) 250mg Suspensi Botol 0 0 0 0 0
40 Desoksimetason krim 0,25% tube 0 12 12 12 0
41 Dextral Syrup botol 0 0 0 0 0
42 Diazepam injeksi 5 mg/ml ampul 15 0 15 0 15
43 Diazepam Tablet 2 mg tablet 300 0 300 200 100
44 Diazepam tablet 5 mg tablet 0 0 0 0 0
45 Digoksin Tablet 0,25 mg Box/100 tablet 0 300 300 100 200
46 Difenhidramin injeksi 10 mg/ml Box/30 ampul 300 150 450 0 450
47 Domperidon Suspensi 5 mg/ 5 ml Botol/60 ml 0 50 50 50 0
48 Domperidon Tablet 10 mg Box/100 tablet 1200 1000 2200 0 2200
49 Dulcolax Bisacodil Suppos 10 mg suppos 0 0 0 0 0
50 Efedrin HCL Inj 50 mg/ml ampul 0 0 0 0 0
51 Epinefrin (Adrenalin) injeksi 0,1% Box/30 ampul 0 0 0 0 0
52 Erythromycin 250 mg tablet Box/100 tablet 0 0 0 0 0
53 Eritromicin Sterate Tablet 500 mg tablet 0 0 0 0 0
54 Etil Klorida Spray 100 ml botol 0 5 5 5 5
55 Fenitoin/Phenytoin Sodium Kapsul 30 mg tablet 400 1000 1400 200 1200
56 Fenobarbital injeksi 50 mg/5ml ampul 0 0 0 0 0
57 Fenobarbital Tablet 30 mg tablet 0 0 0 0 0
58 Fentanil Injeksi 0,05 mg/ml ampul 2mg 0 0 0 0 0
59 Fenofibrat kaps 100 mg Box/30 tablet 0 0 0 0 0
60 Ferro Fumarat 60 mg+as. Folat 0,4 mg (TTD) tablet 0 0 0 0 0
61 Fitomenadion (Vit. K 1) Tablet 10 mg Box/100 kapsul 1400 500 1900 500 1400
62 Fitomenadion (Vit. K 1) Injeksi 10 mg/ml-1 ml Box/30 ampul 0 0 0 0 0
64 Furosemid tablet 40 mg box/20x10 tab 0 1000 1000 400 600
65 Fusilex Krim (Fusidic Acid) krim 20% 20 mg/g tube 0 10 10 10 0
66 Garam Oralit serbuk kombinasi sachet 0 0 0 0 0
67 Glukosa Larutan Infus 5% Steril Botol/500 ml 0 0 0 0 0
68 Glibenklamid Tablet 5 mg Box/100 tablet 500 1000 1500 600 900
69 Glimepiride Tablet 1 mg Box/30 tablet 1800 1000 2800 0 2800
70 Griseofulvin (micronized) tablet 500 mg Tablet 0 0 0 0 0
71 Haloperidol Drop 2 mg/ml botol 27 10 37 0 37
72 Haloperidol tablet 0,5 mg Box/100 tablet 0 0 0 0 0
73 Haloperidol tablet 2 mg Box/100 tablet 0 0 0 0 0
75 Haloperidol injeksi 50 mg/ml box/5 ampul@1ml 0 0 0 0 0
76 Hidrokortison krim 2,5% tube 5 gr 0 0 0 0 0
77 Hidroklorotiazid 25 mg tablet 6300 500 6800 600 6200
NAMA OBAT KET
78 Ibuprofen Suspensi 100mg/5ml botol 0 100 100 100 0
79 Ibuprofen tablet 200 mg box/ 100 tablet 0 0 0 0 0
80 Isosorbid Dinitrat 5 mg Box/100 tablet 300 0 300 0 300
81 Kalsium Glukonat inj 10% ampul 48 0 48 0 48
82 Kalsium Laktat (Kalk) 500 mg tablet 600 500 1100 700 400
83 Kaptopril 12,5 mg tablet 1200 1000 2200 700 1500
84 Kaptopril 25 mg Box/100 tablet 0 0 0 0 0
85 Karbol gliserin Tetes Telinga 10% botol 5 ml 0 0 0 0 0
86 Ketokonazol krim 2% tube 10 gram 0 0 0 0 0
87 Ketokonazol Tablet 200 mg Box/50 tablet 400 300 700 50 650
88 Ketoprofen Supositoria 100 mg suppos 60 0 60 0 60
89 Ketorolac injeksi 30 mg box/12 ampul 80 0 80 0 80
90 Klindamisin Kapsul 150 mg Box/50 kapsul 0 0 0 0 0
91 Kloramfenikol salep mata 1% tube 5gram 0 0 0 0 0
92 Kloramfenikol suspensi 125 mg/5ml botol 300 0 350 50 300
93 Klopromazin tablet salut 100mg (HCl) ktk @ 10x10 tablet 0 0 0 0 0
94 Klozapin 25 mg Box/50 tablet 0 0 0 0 0
95 Klorfeniramina Maleat (CTM) 4 mg tablet Box/100 tablet 0 0 0 0 0
96 Kompolax : Parafin+gliserin+Fenolflaten Susp botol 0 0 0 0 0
97 Kotrimoksazol Suspensi Kombinasi Sulfametoksazol Botol/60 ml 0 100 100 100 0
98 Kotrimoksazol Tablet Kombinasi Sulfametoksazol Box/100 tablet 500 0 500 0 500
99 Lanzoprazol kapsul 30 mg box/ 20 tablet 0 600 600 600 0
100 Levofloksasin tablet 500 mg tablet 150 0 150 0 150
101 Lidokain injeksi 2% (HCL)+epinefrin 1:800 Box/30 ampul 270 150 420 180 240
000-2ml
102 Loperamid tablet 2 mg tablet 0 0 0 0 0
103 Loratadin tablet 10 mg Box/100 tablet 0 300 300 300 0
104 Lorazepam tablet 0,5 mg tablet 0 0 0 0 0
105 Lorazepam tablet 2 mg tablet 0 0 0 0 0
106 Magnesium Sulfat Injeksi 20% Dus 120 ml PE@25ml 10 0 10 0 10
108 Metformin HCL tablet 500 mg Box/100 tablet 0 3000 3000 2200 800
109 Methylergometrin injeksi 0,2 mg/ml Box/30 ampul 0 0 0 0 0
110 Methylergometrin Maleat tablet 0,125 mg Tablet 100 0 100 0 100
111 Metilprednisolon tablet 4 mg Box/100 tablet 0 500 500 500 0
112 Metoklopramide 5 mg Tablet 0 0 0 0 0
113 Metoklopramide 10 mg Box/100 tablet 0 0 0 0 0
114 Metoklopramide sirup 5 mg/5ml botol 0 0 0 0 0
115 Metronidazol Ovula 500 mg suppos 50 30 80 0 80
116 Metronidazol Sirup 125 mg/5ml botol 0 0 0 0 0
117 Metronidazol tablet tablet 0 0 0 0 0
118 Momethasone Furoate 0,1%krim tube 0 0 0 0 0
119 N-Asetil Sistein tablet 200 mg tablet 0 0 0 0 0
NAMA OBAT KET
120 Natrium Klorida Larutan Infus 0,9% Steril Botol/500 ml 0 60 60 18 42
121 Natrium Diklofenak tablet 25 mg Box/50 tablet 0 0 0 0 0
123 Nifedipin 10 mg tablet box/100 tablet 0 0 0 0 0
124 Nistatin tablet salut 500.000 iu/g Box/100 tablet 0 0 0 0 0
125 Nistatin Vaginal tablet 100.000 iu/g Box/100 tablet 0 0 0 0 0
126 Obat Batuk Hitam (OBH) botol 0 0 0 0 0
127 Oksitetrasiklin 1% salap mata tube 0 0 0 0 0
128 Oksitosin injeksi 10 IU/ml box/10 ampul 0 0 0 0 0
129 Omeprazol Kapsul 20 mg Box/30 kapsul 0 0 0 0 0
130 Ondansetron Hydrochloride Injeksi 2 mg/ml ampul 35 0 35 5 30
131 Ondansetron kaplet 4 mg tablet 0 150 150 0 150
133 Parasetamol drops botol 15 ml 0 0 0 0 0
134 Parasetamol Sirup 120 mg/5ml botol 60 ml 0 500 500 500 0
135 Parasetamol tablet 500 mg box/ 100 tablet 0 0 0 0 0
136 Pirantel Pamoat Susp 125 mg/5ml botol 0 0 0 0 0
137 Pirantel tablet score (base) 125 mg box/25x4 tablet 600 200 800 0 800
138 Piridoksin (Vitamin B6) 10 mg Box/100 tablet 0 0 0 0 0
139 Prednison tablet 5 mg Box/100 tablet 0 0 0 0 0
140 Propiltiourasil tablet 100 mg botol/100 tablet 700 500 1200 0 1200
141 Ranitidin Injeksi 25 mg/ 2 ml Box/10 ampul 300 0 300 10 290
142 Ranitidin tablet 150 mg Box/100 tablet 0 0 0
143 Ringer Laktat Larutan Infus Steril Botol/500 ml 260 0 260 100 160
144 Risperidon tablet 1 mg box/100 tablet 0 0 0 0 0
145 Risperidon tablet 2 mg tablet 0 500 500 152 348
146 Salbutamol tablet 2 mg tablet 500 500 1000 1000 0
148 Salbutamol Sirup 2mg/5ml botol 49 49 98 0 98
149 Salep 24, Kombinasi : Asam Salisilat 2%+Belerang endap 4% pot 0 0 0 0 0
150 Salisil Bedak 2% box 50 gram 0 0 0 0 0
151 Scabmide Permetrin krim 5% tube 0 0 0 0 0
152 Sefadroksil Sirup Kering botol 0 60 60 60 0
153 Sefadroksil kapsul 500 mg Box/100 tablet 0 0 0 0 0
154 Sefiksim kapsul 100 mg Box/30 tablet 0 0 0 0 0
155 Sefiksim Kapsul 200 mg tablet 0 0 0 0 0
156 Sefiksim sirup kering 100 mg/5ml botol 30 ml 0 0 0 0 0
157 Sefotaksim serbuk injeksi 1000mg vial 0 0 0 0 0
158 Seftriakson Serbuk Injeksi 1000mg vial 0 0 0 0 0
159 Serum Anti bisa Ular (A.B.U) vial 0 0 0 0 0
160 Serum Antitetanus(ATS)cairan injeksi 1500IU/amp ampul 0 0 0 0 0
161 Setirizin sirup 5mg/5ml botol 0 0 0 0 0
162 Setirizine Tablet 10 mg Box/50 tablet 0 0 0 0 0
163 Sianokobalamin (Vit B12) Injeksi 500 mcg-ml Box/100 ampul 20 0 20 0 20
164 Sikzonoate Injeksi ampul 5 0 5 0 5
NAMA OBAT KET
165 Simvastatin Tablet 10 mg Box/30 tablet 1560 1500 3060 1260 1800
166 Siprofloksasin tablet 500 mg Box/100 tablet 0 0 0 0 0
167 Sukralfat susp 500 mg/5ml, 100 ml botol 0 25 25 25 0
168 Sukralfat tablet 500 mg/ 5 ml tablet 0 0 0 0 0
169 Tetrasiklin HCI Kapsul 250 mg Box/100 kapsul 0 0 0 0 0
170 Tetrasiklin HCI Kapsul 500 mg Box/100 tablet 0 0 0 0 0
171 Thiamin (vitamin B1) tablet 50 mg Box/100 tablet 0 0 0 0 0
172 Triheksifenidil 2 mg Box/100 tablet 1380 0 1380 382 998
173 Valsartan tab 80 mg Box/100 tablet 0 0 0 0 0
174 Vitamin B Kompleks tablet Box/100 tablet 0 0 0 0 0
175 Zincpro drops botol 0 0 0 0 0
176 Zinc syrup 10 mg/ml botol 0 0 0 0 0
178 Zinc tablet 20 mg box/10x10 tab 400 0 400 0 400
Obat Gigi
1 Bur Carbide Highspeed Round Box 0 0 0 0 0
2 Cavit G RF 28G Bottle Dus 0 0 0 0 0
3 Composit Finishing Kit Box 0 0 0 0 0
4 Fluoride Varnish Box 0 0 0 0 0
5 Ketac Universal HM Intro Kit A3 Dus 0 0 0 0 0
6 Micro Brush Box 0 0 0 0 0
7 Paramono Clorofenol Dus 0 0 0 0 0
8 Saliva Ejector Kantong 0 0 0 0 0
9 Tricresolformalina Dus 0 0 0 0 0
10 3M 1470IK Z250 XT Syr Intro Kit LA/APAC/MEA Kit 0 0 0 0 0
11 3M 1370L Z250 Syringe Intro Kit LA/APAC Kit 0 0 0 0 0
Alat Kesehatan
1 Alat Suntik Sekali Pakai 3 ml Box/100 set 500 0 500 500 0
3 Alkohol 70 % 1 L botol 25 10 35 6 29
4 Acticare Alkohol Swab box 0 0 0 0 0
5 Alkazyme Sachet 25 mg Sachet 3 1 4 0 4
6 Alkacide 1 L High Level Diksinfektant botol 0 1 1 0 1
7 Aseptic Liquid 100 ml botol 20 0 20 0 20
8 Antiseptic Hand Rub 500 ml botol 0 0 0 0 0
9 Antiseptic Hand Rub 5 Liter GL 0 0 0 0 0
10 Aseptic Gel 500cc + dispenser botol 0 0 0 0 0
11 Autocheck 3in1 Multi Monitoring System unit 0 0 0 0 0
12 Autocheck Glucose Test Strip 50 Strips 50 Strip/Box Box 0 0 0 0 0
13 Autocheck Uric Acid Test Strip 50 Strips /Box Box 0 0 0 0 0
14 Autocheck Total Cholestrol Test Strip 25 Strips/Box Box 0 0 0 0 0
15 Botol Kimiawi Plastik 1 L botol 0 0 0 0 0
16 Catgut chromic 2/0 +jarum 1/2 GT 35 mm set 76 48 124 48 76
NAMA OBAT KET
18 Catgut Plain 3/0 +jarum 1/2 GT 35 mm set 138 48 186 48 138
20 Gynaecological Glove, Small pcs 0 0 0 0 0
21 Gynaecological Glove, Medium pcs 0 0 0 0 0
22 Gynaecological Glove , Large pcs 0 0 0 0 0
23 Lingettes/Wipes Alcohol Free Cleaner Disinfectant Pack 0 0 0 0 0
24 Catheter 2 Way no.16 set 40 10 50 30 20
26 Cuticel Classic 10CM X10CM sachet 48 0 48 0 48
27 Cutisorb Abseorbent Compress 10 x10 cm pcs 0 0 0 0 0
28 Dermafix T 10x8 cm pcs 40 50 90 0 90
30 Dermanios Scrub Chlorhexidin botol 0 0 0 0 0
31 Disposible Blood Transfusion Sets pcs 10 0 10 0 10
32 Duk Lubang Steril 25 x 30 cm pcs 5 0 5 0 5
33 Eugenol cairan botol 0 0 0 0 0
34 Hidrogen Peroksida 3% botol 0 0 0 0 0
35 Infus Set Anak Box/100 set 300 50 350 50 300
36 Infus Set Dewasa Box/100 set 0 0 0 0 0
37 Aximed IV Chateter WP No.20 pcs 0 0 0 0 0
39 Aximed IV Chateter WP No.24 psc 0 0 0 0 0
40 Aximed Swab 2-PLY pcs 0 0 0 0 0
41 Kassa Kompres Steril 40 x 40 cm buah 60 40 100 70 30
42 Kassa Pembalut 2 x 80 cm roll 0 10 10 0 10
43 Kassa Steril 16 cm x 16 cm roll 0 10 10 10 0
44 Kassa Hidrofil 4 x 15 cm roll 0 0 0 0 0
45 Kassa Steril 10 x 10 cm, 8 ply 1x5's Pack 20 20 40 40 0
46 Leukomed IV Film 6 x 8 cm Sachet 200 0 200 0 200
47 Leukoplast 2,5 cm x 4,5 m roll 20 20 40 12 28
49 Lisol 1 Liter botol 0 0 0 0 0
50 Peter Silk type 3/0 USP 2 MET 1/2 Taper Point pcs 2 1 3 0 3
51 PHARMAFIX Wound Dressing 10 cm x 500 cm roll 0 0 0 0 0
53 POWDER LATEX MEDICAL EXAM GLOVES L box 0 0 0 0 0
54 POWDER LATEX MEDICAL EXAM GLOVES M box 0 0 0 0 0
55 POWDER LATEX MEDICAL EXAM GLOVES S box 0 0 0 0 0
56 Nonwoven Fixiation 5 cm x 10 m roll 30 0 30 6 24
58 Oral Sponge Steril bag 30 0 30 0 30
59 Paper Tape 5.0cm x 9.14 m roll 45 0 45 0 45
60 Povidon Iodida larutan 30 ml Botol 30 ml 0 0 0 0 0
61 Povidon Iodida larutan 300 ml botol 300 ml 24 10 34 0 34
NAMA OBAT KET
62 Rivanol 300 cc botol 20 10 30 0 30
63 Sabun Anti Bakteri 5 liter GL 0 0 0 0 0
64 Sabun Anti Bakteri 500 ml + Disp botol 0 5 5 5 0
65 Surgical Mask - 3ply Earloop set 0 0 0 0 0
66 Surgical Mask - 3ply tie on set 0 0 0 0 0
67 Surgical Mask - 3ply Hijab pcs 0 0 0 0 0
68 Sterile Latex Surgical Gloves Size 6,5 pcs 0 0 0 0 0
69 Sterile Latex Surgical Gloves Size 7 pcs 0 0 0 0 0
70 Troge Tro-Soluset G ( Infusion Set ) set 10 0 10 0 10
71 U Pad Steril 60 x 90 cm blister 40 10 50 0 50
72 Uniflex 23154"(4.5X10.0CM) roll 6 0 6 0 6
73 Uniflex 23143"(4.5X7.50CM) roll 6 0 6 0 6
74 Urine Bag buah 100 0 100 0 100
Total
1656

NIP. 19870405 201001 1 002 NIP. 197206 199503 1 001 NIP. 19760909 200801 2 004 NIP. 19860731 201001 2 016
(LPLPO)
Kode Puskesmas : P1607100101 Laporan Bulan : APRIL 2021

Puskesmas : SUNGSANG Permintaan Bulan : MEI - JUNI 2021
Kecamatan : BANYUASIN II Nomor : 094/ /ADMIN/PKM-SSG/II/2021
Kab/ Kodya : BANYUASIN Tanggal : APRIL 2021
NAMA OBAT KET
APBD

11 HICO GEL tube 0 0 0 0 0 100
17 PHAROLIT SACHET 120 0 120 0 120 0
18 PRATIFAR 20 tablet 0 0 0 0 0 0
OBAT PAJAK ROKOK

NAMA OBAT KET
13 CTM tablet 0 0 0 0 0 10000
18 Estalex tablet 100 0 100 0 100 1000
21 Hico Gel tube 0 0 0 0 0 50
25 Lico-C tablet 500 0 500 0 500 2000
33 OBH Rama botol 0 0 0 0 0 200
Alat Kesehatan
NAMA OBAT KET
DAK
Asam Salisilat 3%
sulfadoksin 500mg
NAMA OBAT KET
NAMA OBAT KET
000-2ml
NAMA OBAT KET
NAMA OBAT KET
Obat Gigi
Alat Kesehatan
3 Alkohol 70 % 1 L botol 29 0 29 0 29 50
NAMA OBAT KET
NAMA OBAT KET
62 Rivanol 300 cc botol 30 0 30 0 30 0
72 Uniflex 23154"(4.5X10.0CM) roll 6 0 6 0 6 0
73 Uniflex 23143"(4.5X7.50CM) roll 6 0 6 0 6 0
74 Urine Bag buah 100 0 100 0 100 0
Total
1446

NIP. 19870405 201001 1 002 NIP. 197206 199503 1 001 NIP. 19760909 200801 2 004 NIP. 19860731 201001 2 016
(LPLPO)
Kode Puskesmas : P1607100101 Laporan Bulan : MEI 2021

NAMA OBAT KET
APBD

OBAT PAJAK ROKOK

6 Biomega tablet 0 1000 1000 1000 0
NAMA OBAT KET
13 CTM tablet 0 800 800 800 0
18 Estalex tablet 100 100 200 0 200
21 Hico Gel tube 0 10 10 10 0
25 Lico-C tablet 500 300 800 200 600
36 Pehavral kapsul 0 1000 1000 1000 0
Alat Kesehatan
NAMA OBAT KET
DAK
Asam Salisilat 3%
sulfadoksin 500mg
NAMA OBAT KET
NAMA OBAT KET
000-2ml
NAMA OBAT KET
142 Ranitidin tablet 150 mg Box/100 tablet 0 0 0 0 0
NAMA OBAT KET
Obat Gigi
Alat Kesehatan
3 Alkohol 70 % 1 L botol 29 10 39 19 20
NAMA OBAT KET
NAMA OBAT KET
62 Rivanol 300 cc botol 30 0 30 0 30
72 Uniflex 23154"(4.5X10.0CM) roll 6 0 6 0 6
73 Uniflex 23143"(4.5X7.50CM) roll 6 0 6 0 6
74 Urine Bag buah 100 0 100 0 100
Total
1890

NIP. 19870405 201001 1 002 NIP. 197206 199503 1 001 NIP. 19760909 200801 2 004 NIP. 19860731 201001 2 016
(LPLPO)
Kode Puskesmas : P1607100101 Laporan Bulan : JUNI 2021

Puskesmas : SUNGSANG Permintaan Bulan : JULI - AGUSTUS 2021
Kecamatan : BANYUASIN II Nomor : 094/ /ADMIN/PKM-SSG/VII/2021
Kab/ Kodya : BANYUASIN Tanggal : JULI 2021
NAMA OBAT KET
APBD

11 HICO GEL tube 0 0 0 0 0 100
17 PHAROLIT SACHET 120 0 120 0 120 120
18 PRATIFAR 20 tablet 0 0 0 0 0 2000
OBAT PAJAK ROKOK

NAMA OBAT KET
13 CTM tablet 0 0 0 0 0 10000
18 Estalex tablet 200 0 200 0 200 1000
21 Hico Gel tube 0 0 0 0 0 50
25 Lico-C tablet 600 0 600 600 0 2000
33 OBH Rama botol 0 0 0 0 0 200
Alat Kesehatan
NAMA OBAT KET
DAK
Asam Salisilat 3%
sulfadoksin 500mg
NAMA OBAT KET
NAMA OBAT KET
000-2ml
NAMA OBAT KET
NAMA OBAT KET
Obat Gigi
Alat Kesehatan
3 Alkohol 70 % 1 L botol 20 0 20 0 20 50
NAMA OBAT KET
NAMA OBAT KET
62 Rivanol 300 cc botol 30 0 30 0 30 0
72 Uniflex 23154"(4.5X10.0CM) roll 6 0 6 0 6 0
73 Uniflex 23143"(4.5X7.50CM) roll 6 0 6 0 6 0
74 Urine Bag buah 100 0 100 0 100 0
Total
2009

NIP. 19870405 201001 1 002 NIP. 197206 199503 1 001 NIP. 19760909 200801 2 004 NIP. 19860731 201001 2 016
(LPLPO)
Kode Puskesmas : P1607100101 Laporan Bulan : JULI 2021

NAMA OBAT KET
APBD

OBAT PAJAK ROKOK

6 Biomega tablet 0 1000 1000 1000 0
NAMA OBAT KET
13 CTM tablet 0 1000 1000 1000 0
18 Estalex tablet 200 0 200 200 0
21 Hico Gel tube 0 10 10 10 0
25 Lico-C tablet 0 500 500 500 0
33 OBH Rama botol 0 100 100 100 0
36 Pehavral kapsul 0 1000 1000 1000 0
Alat Kesehatan
NAMA OBAT KET
DAK
Asam Salisilat 3%
sulfadoksin 500mg
NAMA OBAT KET
NAMA OBAT KET
000-2ml
NAMA OBAT KET
NAMA OBAT KET
Obat Gigi
Alat Kesehatan
3 Alkohol 70 % 1 L botol 20 10 30 10 20
NAMA OBAT KET
NAMA OBAT KET
62 Rivanol 300 cc botol 30 0 30 10 20
72 Uniflex 23154"(4.5X10.0CM) roll 6 0 6 0 6
73 Uniflex 23143"(4.5X7.50CM) roll 6 0 6 0 6
74 Urine Bag buah 100 0 100 0 100
Total
3205

NIP. 19870405 201001 1 002 NIP. 197206 199503 1 001 NIP. 19760909 200801 2 004 NIP. 19860731 201001 2 016
(LPLPO)
Kode Puskesmas : P1607100101 Laporan Bulan : AGUSTUS 2021

Puskesmas : SUNGSANG Permintaan Bulan : SEPTEMBER - OKTOBER 2021
Kecamatan : BANYUASIN II Nomor : 094/ /ADMIN/PKM-SSG/IX/2021
Kab/ Kodya : BANYUASIN Tanggal : SEPTEMBER 2021
NAMA OBAT KET
APBD
ACIFAR KRIM tube 0 0 0 0 0 200

11 HICO GEL tube 0 0 0 0 0 100
17 PHAROLIT SACHET 0 0 0 0 0 120
18 PRATIFAR 20 tablet 0 0 0 0 0 2000
OBAT PAJAK ROKOK

NAMA OBAT KET
13 CTM tablet 0 0 0 0 0 10000
21 Hico Gel tube 0 0 0 0 0 50
25 Lico-C tablet 0 0 0 0 0 2000
33 OBH Rama botol 0 0 0 0 0 200
Alat Kesehatan
NAMA OBAT KET
DAK
Asam Salisilat 3%
sulfadoksin 500mg
NAMA OBAT KET
NAMA OBAT KET
000-2ml
NAMA OBAT KET
NAMA OBAT KET
Obat Gigi
Alat Kesehatan
3 Alkohol 70 % 1 L botol 20 0 20 0 20 50
NAMA OBAT KET
NAMA OBAT KET
62 Rivanol 300 cc botol 20 0 20 0 20 0
72 Uniflex 23154"(4.5X10.0CM) roll 6 0 6 0 6 0
73 Uniflex 23143"(4.5X7.50CM) roll 6 0 6 0 6 0
74 Urine Bag buah 100 0 100 0 100 0
Total
2965

NIP. 19870405 201001 1 002 NIP. 197206 199503 1 001 NIP. 19760909 200801 2 004 NIP. 19860731 201001 2 016
(LPLPO)
Kode Puskesmas : P1607100101 Laporan Bulan : SEPTEMBER 2021

NAMA OBAT KET
APBD

OBAT PAJAK ROKOK

6 Biomega tablet 0 2000 2000 2000 0
NAMA OBAT KET
13 CTM tablet 0 1000 1000 1000 0
18 Estalex tablet 0 500 500 500 0
21 Hico Gel tube 0 10 10 10 0
25 Lico-C tablet 0 1000 1000 1000 0
34 Oralit Sachet 0 300 300 0 300
36 Pehavral kapsul 0 1000 1000 1000 0
Alat Kesehatan
NAMA OBAT KET
DAK
Asam Salisilat 3%
sulfadoksin 500mg
NAMA OBAT KET
NAMA OBAT KET
000-2ml
NAMA OBAT KET
NAMA OBAT KET
Obat Gigi
Alat Kesehatan
3 Alkohol 70 % 1 L botol 20 5 25 0 25
NAMA OBAT KET
NAMA OBAT KET
62 Rivanol 300 cc botol 20 0 20 0 20
72 Uniflex 23154"(4.5X10.0CM) roll 6 0 6 0 6
73 Uniflex 23143"(4.5X7.50CM) roll 6 0 6 0 6
74 Urine Bag buah 100 0 100 0 100
Total

NIP. 19870405 201001 1 002 NIP. 197206 199503 1 001 NIP. 19760909 200801 2 004 NIP. 19860731 201001 2 016
(LPLPO)
Kode Puskesmas : P1607100101 Laporan Bulan : OKTOBER 2021

Puskesmas : SUNGSANG Permintaan Bulan : NOVEMBER - DESEMBER 2021
Kecamatan : BANYUASIN II Nomor : 094/ /ADMIN/PKM-SSG/XI/2021
Kab/ Kodya : BANYUASIN Tanggal : NOVEMBER 2021
NAMA OBAT KET
APBD
ACIFAR KRIM tube 0 0 0 0 0 200

11 HICO GEL tube 0 0 0 0 0 100
17 PHAROLIT SACHET 0 0 0 0 0 120
18 PRATIFAR 20 tablet 0 0 0 0 0 2000
OBAT PAJAK ROKOK

NAMA OBAT KET
13 CTM tablet 0 0 0 0 0 10000
21 Hico Gel tube 0 0 0 0 0 50
25 Lico-C tablet 0 0 0 0 0 2000
33 OBH Rama botol 0 0 0 0 0 200
34 Oralit Sachet 300 0 300 300 0 0
Alat Kesehatan
NAMA OBAT KET
DAK
Asam Salisilat 3%
sulfadoksin 500mg
NAMA OBAT KET
NAMA OBAT KET
000-2ml
NAMA OBAT KET
NAMA OBAT KET
Obat Gigi
Alat Kesehatan
3 Alkohol 70 % 1 L botol 25 0 25 5 20 50
NAMA OBAT KET
NAMA OBAT KET
62 Rivanol 300 cc botol 20 0 20 0 20 0
72 Uniflex 23154"(4.5X10.0CM) roll 6 0 6 0 6 0
73 Uniflex 23143"(4.5X7.50CM) roll 6 0 6 0 6 0
74 Urine Bag buah 100 0 100 0 100 0
Total

Iwan Afriansyah, S. Farm Nolo Widodo, SKM Herlina, SKM., M.Kes Mahani, S. Farm
NIP. 19870405 201001 1 002 NIP. 197206 199503 1 001 NIP. 19730711 199301 2 002 NIP. 19860731 201001 2 016

Lplpo 2021 Sungsang

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Lplpo 2021 Sungsang

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LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

Kode Puskesmas : P1607100101 Laporan Bulan : FEBRUARI 2021

1 ACIFAR KRIM tube 50 0 50 50 0 200

OBAT PAJAK ROKOK

Mengetahui/ Menyetujui Yang Menyerahkan Pimpinan Puskesmas Yang Menerima

Kode Puskesmas : P1607100101 Laporan Bulan : MARET 2021

1 ACIFAR KRIM tube 0 50 50 50 0

OBAT PAJAK ROKOK

Mengetahui/ Menyetujui Yang Menyerahkan Pimpinan Puskesmas Yang Menerima

Kode Puskesmas : P1607100101 Laporan Bulan : APRIL 2021

1 ACIFAR KRIM tube 0 0 0 0 0 200

OBAT PAJAK ROKOK

Mengetahui/ Menyetujui Yang Menyerahkan Pimpinan Puskesmas Yang Menerima

Kode Puskesmas : P1607100101 Laporan Bulan : MEI 2021

1 ACIFAR KRIM tube 0 0 0 0 0

OBAT PAJAK ROKOK

Mengetahui/ Menyetujui Yang Menyerahkan Pimpinan Puskesmas Yang Menerima

Kode Puskesmas : P1607100101 Laporan Bulan : JUNI 2021

1 ACIFAR KRIM tube 0 0 0 0 0 200

OBAT PAJAK ROKOK

Mengetahui/ Menyetujui Yang Menyerahkan Pimpinan Puskesmas Yang Menerima

Kode Puskesmas : P1607100101 Laporan Bulan : JULI 2021

1 ACIFAR KRIM tube 0 0 0 0 0

OBAT PAJAK ROKOK

Mengetahui/ Menyetujui Yang Menyerahkan Pimpinan Puskesmas Yang Menerima

Kode Puskesmas : P1607100101 Laporan Bulan : AGUSTUS 2021

ACIFAR KRIM tube 0 0 0 0 0 200

OBAT PAJAK ROKOK

Mengetahui/ Menyetujui Yang Menyerahkan Pimpinan Puskesmas Yang Menerima

Kode Puskesmas : P1607100101 Laporan Bulan : SEPTEMBER 2021

1 ACIFAR KRIM tube 0 0 0 0 0

OBAT PAJAK ROKOK

Mengetahui/ Menyetujui Yang Menyerahkan Pimpinan Puskesmas Yang Menerima

Kode Puskesmas : P1607100101 Laporan Bulan : OKTOBER 2021

ACIFAR KRIM tube 0 0 0 0 0 200

OBAT PAJAK ROKOK

Mengetahui/ Menyetujui Yang Menyerahkan Pimpinan Puskesmas Yang Menerima

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