PEMERINTAHAN KABUPATEN MUR

PUSAT KESEHATAN MASYARAKAT TUM

KECAMATAN SUMBER BARI
Jalan Kapios RT.III - Tumbang Kunyi

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTA

PUSTU :
KECAMATAN : SUMBER BARITO
KABUPATEN : MURUNG RAYA
PROPINSI : KALIMANTAN TENGAH

STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN
AWAL

OBAT
1 Acylovir Krim 5% Tube
2 Acyclovir Tablet 200mg Tablet

3 Acylovir Tablet 400mg Tablet

4 Albendazole Suspensi Botol

5 Albendazole Tablet 400mg Tablet

6 Allopurinol Tablet 100mg Tablet

7 Ambroxol HCL Syr Botol

8 Ambroxol HCL 30mg Tablet

9 Aminopillin Inj 24mg/ml Ampul

10 Aminopillin Tablet 200mg Tablet

11 Amitriptilin Tablet

12 Amlodipine 10mg Tablet Tablet

13 Amlodipine 5 mg Tablet

14 Amoxcicillin Kapsul 250mg Kapsul

15 Amoxcicillin Tablet 500mg Tablet

16 Amoxcicillin Syrup kering 125mg/5ml Botol

17 Amoxicillin Syrup Forte Botol

18 Anaton Tablet

19 Anaton Syr Botol

20 Antasida Doen Tablet Kunyah Tablet

21 Antasida Syr Botol

22 Antifungi Doen salep Kombinasi Pot

23 Antihemaroid Supp

24 Asam Folat Tablet

25 Asam Mefenamat 250mg Kapsul

26 Asam Mefenamat 500mg Tablet

27 Asam Tranexamat 500mg Tablet

28 Asam Transeknamat Injeksi Ampul

29 Asetosal 100mg Tablet

30 Atrovin Injeksi Ampul

31 Bacitracin Polymixcin B Tube

32 Bedak Salisil Kotak

33 Betahistin Tablet

34 Bethametasone Krim 0.1% Tube

35 Bethametasone Cr (Skizone) Tube

36 Bisoprolol Fumarate 5mg Tablet

37 Burnasin Cream Tube

38 Carbamazepine 200mg Tablet

39 Catopril 12,5 mg Tablet

40 Catopril 25 mg Tablet

41 Captopril 50mg Tablet

42 Caviplek ( Multivitamin ) Tablet

43 Cefadroxil 500mg Kapsul

44 Cefadroxil Syr Botol

45 Cefadroxil syr Forte Botol

46 Cefixime 100mg Kapsul

47 Cefixime Syr Botol

48 Cefotaxime Injeksi 1,0 g Ampul

49 Cetirizin syr Botol

50 Chlorampenicol 250 mg Kapsul

51 Chlorampenicol Salep mata Pcs

52 Chlorampenicol syr Botol

53 Cimetidin 15mg Tablet

54 Ciprofloxacin 500mg Tablet

55 Citikolin injeksi Ampul

56 Clindamicin 150mg Kapsul

57 Clipodogrel Tablet

58 Clonidine Tablet

59 Clorpheniramine Maleat (CTM) Tablet

60 Clozapine 25mg Tablet

61 Codein 10mg Tablet

62 Combivent Fls

63 Cotrimokzasole 480 mg Tablet

64 Cotrimokzasole Pediatrik Tablet

65 Cotrimokzasole syr Botol

66 CPZ 100 mg Tablet

67 CPZ 25 mg Tablet

68 Decacetine Tetes Mata Botol

69 Dexametasone Injeksi Ampul

70 Dexametasone Tablet 0,5mg Tablet

71 Diazepam Injeksi Ampul

72 Diazepam Tablet Tablet

73 Digoxin Tablet Tablet

74 Dimenhydrinate Tablet 50mg Tablet

75 Dipenhydramine Injeksi Ampul

76 Diklofenak sodium 50mg Tablet

77 Diklofenak sodium 25mg Tablet

78 Domperidone Syrup Botol

79 Domperidone Tablet 10mg Tablet

80 Doxyciclin Tablet Tablet

81 Ducolax (bisakodil) Supp Supp

82 Epinefrine Injeksi 0,1% Ampul

83 Ergotamine-Cafein Tablet Tablet

84 Erythromycin Syrup Kering Botol

85 Erytromicin 250mg Kapsul

86 Erytromisin 500mg Kapsul

87 Fenobarbital Injeksi Ampul

88 Fenobarbital 30 mg Kapsul

89 Ferrous Sulfate Tablet

90 Furosemide Injeksi Ampul

91 Furosemide Tablet 40mg Tablet

92 Garam Oralit Serbuk sachet

93 Gentamicin 40mg Injeksi Ampul

94 Gentamicin Salep Kulit 0,1% Tube

95 Gentamisin Tetes Mata Botol

96 Gentamisin Salep mata Tube

BMHP GUDANG OBAT PKM

1 Abocath 18 Pcs
2 Abocath 20 Pcs
3 Abocath 22 Pcs
4 Abocath 24 Pcs
5 Abocath 26 Pcs
6 Alkohol Swab Pcs
7 Alkohol 1000ml Botol
8 Alkohol 100ml Botol
9 AquaPro Injeksi Steril Flabot
10 Aseptan Liquid Botol
11 Bisturi no.12 Pcs
12 Bisturi no.15 Pcs
13 Bracket Handwash Pcs
14 Catgut Chromic 3/0 100m Pcs
15 Catgut Chromic 2/0 (3.5 Metric) Pcs
16 Catgut Chromic 3/0 HR-37 Pcs
17 Catgut Chromic 3/0 (3 Metric) Pcs
18 Catgut Plain 2/0 (3.5M) Pcs
19 Chateter No.18 Pcs
20 Chateter no. 14 Pcs
21 Chateter no. 16 Pcs
22 Dermafix 10 x 25 Pcs
23 Fixomull 10 x 5 Pcs
24 Fixomull 5 x 5 Pcs
25 Glukosa Larutan Infus 10% Fls
26 Glukosa Larutan Infus 5% Fls
27 Handscoon Steril No 7 Pasang
28 Handscon Sterill No. 7 1/2 Pasang
29 Handscoon L Pcs
30 Handscoon M Pcs
31 Handscoon S Pcs
32 Hidrogen Peroksida Botol
33 Infuset Anak Pcs
34 Infuset Dewasa Pcs
35 Isopalster roll
36 Jarum Kulit No 12 Pcs
37 Jarum Kulit No 13 Pcs
38 Kapas 1000g Gulung
39 Kapas 250 gram Gulung
40 Kapas 500 gram roll
41 Kasa Kotak steril 16 x 16 pcs/kotak
42 Kasa Kotak steril 18 x 22 pcs/kotak
43 Kasa 4m x 5cm roll
44 Kasa 4m x 10cm roll
45 Kasa 4m x 15cm roll
46 Kasa Hidrofil 2m x 80 cm roll
47 Kasa Hidrofil 40yard x 80 cm roll
48 Kasa Kompres 40cmx 40cm lembar
49 Kertas Puyer lembar
50 Klip Obat 13 x 8.7 Pcs
51 Klip Obat 10cmx7cm Pcs
52 Klip Obat 8cm x 5cm Pcs
53 Leukoplast 2.5 x 4.5 roll
54 Leukoplast 7.5 x 4.5 roll
55 Lisol 1 L Botol
56 Magnesium Sulfate Inj 20% Fls
57 Magnesium Sulfate Inj 40% Fls
58 Masker Karet Pcs
59 Masker Tali Pcs
60 Masker Oksigen Dws Pcs
61 Masker Oksigen anak Pcs
62 Masker Oksigen Neonatus (Bayi) Pcs
63 Medical regulator Pcs
64 Mucus Extractor Pcs
65 Natrium Klorida Larutan Infus 0,9% Fls
66 Needle 23 Pcs
67 Needle 25 Pcs
68 NGT 14 Pcs
69 NGT 16 Pcs
70 NGT 18 Pcs
71 NGT 20 Pcs
72 Oxyflow Dewasa Pcs
73 Oxyflow Anak Pcs
74 Plesterin bulat Pcs
75 Policlean Botol
76 Polifix 5cm x 1m Pcs
 77 Povidone Lodida 300ml Larutan Botol
78 Povidone Lodida 30ml Larutan Botol
79 PP tes Pcs
80 Ringer Lactat Larutan Infus Flabot
81 Rivanol 300ml Botol
82 Signa gel Pcs
83 Silk Braided 2/0 H-R 37mm/2/0( 3M ) Pcs
84 Silk Braided 3/0 H-R 30mm/3/0( 2 M pcs
85 Spuit 1 cc pcs
86 Spuit 2,5cc pcs
87 Spuit 3cc pcs
88 Spuit 5cc Pcs
89 Spuit 10cc pcs
90 Spuit 50cc Pcs
91 Threeway Infus Pcs
92 Tabung Oksigen Besar tabung
93 Tabung Oksigen Sedang tabung
94 Tabung Oksigen Kecil tabung
95 Ultra Fix Pcs
96 UnderPad pcs
97 Urine Bag pcs
98 Wida DS 5% Fls
99 Wing Needle 21 roll
100 Wing Needle 23 roll
101 Wing Needle 25 roll
102 Wing Needle 27 roll
103 Zink Oxide Tipe Tube

Yang Menyerahkan, Mengetahui :

Petugas Gudang/Apoteker Penanggung Jawab Kepala Puskesmas Tumbang Kunyi

Apt. FEBBY MARTEDI A.md., Kep

NIP. NIP. 19720908 199303 1 005
KABUPATEN MURUNG RAYA
MASYARAKAT TUMBANG KUNYI
TAN SUMBER BARITO
s RT.III - Tumbang Kunyi Kode Pos 73911

MBAR PERMINTAAN OBAT ( LPLPO ) PUSTU

PELAPORAN BULAN/PERIODE :
PERMINTAAN BULAN/PERIODE :

STOK STOK
PEMAKAIAN ED PERMINTAAN PEMBERIAN KET
AKHIR OPTIMAL
/RUSAK

BAT
OBAT PKM
 Yang Menerima,
smas Tumbang Kunyi Petugas Pustu

RTEDI A.md., Kep ………………………………….

19720908 199303 1 005
 Mengetahui : Yang Menerima
Kepala Puskesmas Long Hubung

dr. Yohanes Adam Elsoin

NIP. 19850522 201505 1 001
 Yang Menerima,
Petugas Pustu

………………………………….