LAPORAN PEMAKAIAN HARIAN

(LPH)

KODE PUSKESMAS :
PUSKESMAS : KWOOR
KECAMATAN : KWOOR LB 2 :
KABUPATEN : TAMBRAUW BULAN : April
PROVINSI : PAPUA BARAT TAHUN : 2022

TANGGAL
No. NAMA OBAT SATUAN JUMLAH
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 26 27 28 29 30 31
1 Allopurinol tablet 100mg tablet 0
2 Aminofilin tablet 200mg tablet 0
3 Aminofilin injeksi 24mg/ml ampul 0
4 Amlodipin tablet 10mg tablet 0
5 Amlodipin tablet 5mg tablet 0
6 Amoksisilin kapsul/kaplet 500mg tablet 0
7 Amoksisilin Syr botol 0
8 Antasida Doen Tablet tablet 0
9 Anti fungi doen salap (Withfield) pot 0
10 Antalgin 500 mg tablet 0
11 Asam folat 1mg tablet 0
12 Asiklovir tablet 200mg tablet 0
13 Azitromicyn tablet 500mg tablet 0
14 Cetirizin tablet 10mg tablet 0
15 Cefotaxim Inj Vial 0
16 Dexamethasone injeksi 5mg/1ml ampul 0
17 Dextrose infus 5% (glukosa) botol 0
18 Diazepam tablet 5mg tablet 0
19 Diazepam injeksi 5mg/ml ampul 0
21 Diphenhydramin injeksi 10mg/ml ampul 0
22 Domperidon suspensi/sirup 5 mg/5 ml botol 0
23 Eritromisin 250mg tablet 0
24 Etambutol tablet 500mg tablet 0
25 Epineprin 1mg/ml injeksi ampul 0
26 Farmadol 500 mg tablet 0
27 Farsorbid tablet 10mg tablet 0
28 Farsorbid inj ampul 0
29 Furosemid tablet 40mg tablet 0
30 Furosemid inj 20mg/2 ml ampul 0
31 Gentamisin salep tube 0
32 Glibenclamida tablet 5mg tablet 0
33 Glimepiride tablet 4mg tablet 0
34 Guaifenesin tablet 100mg tablet 0
 TANGGAL
No. NAMA OBAT SATUAN JUMLAH
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 26 27 28 29 30 31
35 Griseofulvin tablet 125mg tablet 0
36 Haloperidol 5mg tablet 0
37 Hidroklorotiazid tablet 25mg tablet 0
38 Hidrokortison krim 1% tube 0
39 Hidrokortison krim 2,5 % tube 0
40 Ibuprofen suspensi 200mg/5ml botol 0
41 KN 3B Larutan Infus botol 0
42 Kalsium Laktat (Kalk) tablet 500mg tablet 0
43 kaptopril tablet 12,5mg tablet 0
44 Kaptopril tablet 25mg tablet 0
45 Ketorolac injeksi 30mg/ml ampul 0
46 Kloramfenikol caps 250mg caps 0
47 Kloramfenikol suspensi 60ml botol 0
48 Kotrimoksasol tablet 480mg tablet 0
49 Kotrimoksasol suspensi 240mg/5ml botol 0
50 Lidokain 2 % inj ampul 0
51 Methylprednisolon tablet 0
52 Methylergometrin 0,125mg tablet 0
53 Metoklopramid Syrup (Primpen) botol 0
54 Metoklopramid drop 10 ml (Gavistal) botol 0
55 Metoklopramid tablet 10mg tablet 0
56 Natrium Diklofenat tablet 0
57 Nystatin drops 100.000 IU/ml botol 0
58 Papaverin tablet 40mg tablet 0
59 Paracetamol Drops 100mg/ml botol 0
60 Paracetamol syrup 60ml botol 0
61 Paracetamol Infus botol 0
62 Phytomenadion 10mg tablet tablet 0
63 Pirantel Pamoat 125 mg tablet 0
64 Piridoksin (Vitamin B-6) tablet 10mg tablet 0
65 Povidon Iodida larutan 300ml botol 0
66 Povidon Iodida larutan 10% 1000 ml botol 0
67 Prednison tablet 5mg tablet 0
68 Propanolol tablet 40mg tablet 0
69 Quinine sulfat tablet salut 222mg tablet 0
70 Ranitidin tablet 150mg tablet 0
71 Ranitidin Injeksi ampul 0
72 Retinol (Vitamin A) 100.000 IU kapsul kapsul lunak 0
73 Rifampisin tablet 450mg tablet 0
74 Rifampisin tablet 600mg tablet 0
75 Ringer Laktat larutan infus 5% botol 0
76 Rivanol 100ml botol 0
77 Salep 2-4 30 gr Pot 0
 TANGGAL
No. NAMA OBAT SATUAN JUMLAH
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 26 27 28 29 30 31
78 Salbutamol 2 mg tablet 0
79 Sefadroksil Syr 250mg/5 ml botol 0
80 Sefiksim sirup kering 100 mg/5 ml botol 0
81 Sefotaksim injeksi 1g vial 0
82 Simvastatin tablet 20mg tablet 0
83 Sodium klorida 0,9% 500 ml (NaCl) botol 0
84 Streptomycin 1,0g vial 0
85 Tablet tambah darah tablet 0
86 Tetrasiklin kapsul/kaplet 500mg tablet 0
87 Tiamin (Vitamin B1) tablet 50mg tablet 0
88 Tramadol Injeksi 50 mg/ ml flacon 0
89 Ventolin Inhaler botol 0
90 Vitamin B-Compleks tablet tablet 0
91 Vitamin C tablet 50mg tablet 0
92 Vitamin B12 Inj ampul 0
93 Zinc sulfate 20mg tablet 0
OBAT TAMBAHAN SATUAN JUMLAH
1 Afitamol (Paracetamol 500mg) tablet 0
2 Alpara caps 150mg tablet 0
3 Alpara syrup 60ml botol 0
4 Alphamol (Paracetamol) drop 15ml botol 0
5 Alphamol (Paracetamol) syrup 60ml botol 0
6 Alphamol (Paracetamol) tab 600mg tablet 0
7 Arkavit C kaplet (Vitamin&suplemen) tablet 0
8 Artoferum (Vitamin&suplemen) tablet 0
9 Becefort multivitamin tab tablet 0
10 Becom zet tab tablet 0
11 Betafort syrup multivitamin botol 0
12 Betominplex (Vitamin&suplemen) tablet 0
13 Bisacodil 5mg tablet 0
14 Bionicom C kaplet (Vitamin&suplemen) tablet 0
15 Bioron Tab Vitamin tablet 0
16 Broadapen 500mg (Ampicillin tab) tablet 0
17 Broadapen syrup 125mg/5ml (Ampicillin botol 0
18 Buscopan inj 20mg ampul 0
19 Buscopan plus tab tablet 0
20 Caldece tab tablet 0
21 Cartylo 80 mg tablet 0
22 Curcumin syrup (Vitamin&suplemen) botol 0
23 Decatona (Phenytoin sodium) 30mg tablet 0
24 Dobrizol (Lansoprazol) kapsul 0
25 Ersylan expectorant 60 ml botol 0
26 Falergi 10 MG tablet 0
 TANGGAL
No. NAMA OBAT SATUAN JUMLAH
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 26 27 28 29 30 31
27 Farbion 5000 inj 3 ml ampul 0
28 Favipiravir 200 MG tablet 0
29 Fixacep Syrup 30 ML botol 0
30 Fluocort N krim tube 0
31 Fucilex N krim tube 0
32 Fungoral 200 mg tablet 0
33 Gentalex krim 5gr (Gentamicin) tube 0
34 Ginstamin (Stamina pria) tablet 0
35 Grow Calc 60ml (Vit. Dewasa) Syrup botol 0
36 Hot up cream 50gr tube 0
37 Ivermectin 12 mg tablet 0
38 Klorferson (Chloramphenicol) krim 10g tube 0
39 Kompolax syrup botol 0
40 Lecozinc (Zinc sulfat monohidrat) tablet 0
41 Lexacrol forte syrup 100ml botol 0
42 Lexagin 500mg (Metamizole) tablet 0
43 Lexicam 10mg (Piroxicam) tablet 0
44 Mirabion (Vitamin dan Mineral) tablet 0
45 Molacort (Dexamethasone) 0,75mg tablet 0
46 Molapect syp 15 MG/60 ML botol 0
47 Molasma tab tablet 0
48 Molavir (Acyclovir) krim 5% tube 0
49 Multiviral (Vitamin&suplemen) tablet 0
50 Nexitra caps (Tranexamic acid 500mg) tablet 0
51 Novamag tab tablet 0
52 Novaxifen 400 MG tablet 0
53 Novaxifen forte syrup botol 0
54 Osteosan tab tablet 0
55 Pantrin 250mg (Pyrantel pamoat) tablet 0
56 Paracaf (Paracetamol caffeine) tablet 0
57 Paracaf extra (Paracetamol caffeine ibu tablet 0
58 Pehacain 2ml inj ampul 0
59 Phadilon 4 MG tablet 0
60 Pritacort tab tablet 0
61 Pritagesic tab tablet 0
62 Proast Syr (Salbutamol) botol 0
63 Ramvit C kaplet (Vitamin&suplemen) tablet 0
64 Ragyl 500 mg (Metronidazole) tablet 0
65 Santa e caps tablet 0
66 Tranexamic acid inj 100mg ampul 0
67 Wida HSD botol 0
68 Wida KN-2 500ml botol 0
69 Yekamulvita tablet 0
 TANGGAL
No. BAHAN HABIS PAKAI SATUAN JUMLAH
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 26 27 28 29 30 31
1 Alat suntik Syringe Disposable 1 cc pcs 0
2 Alat suntik Syringe Disposable 3 cc pcs 0
3 Alat suntik Syringe Disposable 5 cc pcs 0
4 Alkohol Swab dus 0
5 Alkohol 70% 1 L botol 0
6 Antiseptic Handrub 500ml botol 0
7 Autocheck 3 in 1 (GEA) dus 0
8 Aximed Chrom catg 3-0,75 cm dus 0
9 Aximed Face Mask Ear Loop dus 0
10 Aximed Feeding 100 cm tube No. 6 pcs 0
11 Aximed Female Chatheter No. 14 pcs 0
12 Aximed IV-Cath WP, No 26 pcs 0
13 Aximed Lancet no 28 G dus 0
14 Aximed Nonwoven Fixation 10cm x 10m roll 0
15 Aximed Nonwoven Fixation 5cm x 10m roll 0
16 Aximed Plain catg 3-0,75 cm dus 0
17 Baymed Masker Earloop dus 0
18 Baymed Plus Desinfektan 750 ml botol 0
19 Biosilk-silk 3/0 75 cm dus 0
20 Cosmomed Iv Cannula With Inj No. 26G dus 0
21 Iv Cath Wp Inj No. 18G pcs 0
22 Iv Cath Wp Inj No. 20G pcs 0
23 Iv Cath Wp Inj No. 22G pcs 0
24 Iv Cath Wp Inj No. 26G pcs 0
25 Kapas 500g roll 0
26 Kasa Hidrofil 2y x 80 cm roll 0
27 Kasa Hidrofil 3 x 15 cm roll 0
28 Kasa Hidrofil 4y x 10 cm roll 0
29 Kasa Hidrofil 4y x 15 cm roll 0
30 Kasa Hidrofil 4y x 5 cm roll 0
31 Kasa Hidrofil DRC Ukuran 40y x 80 cm (rol besar) roll 0
32 Kasa Hidrofil 3 X 10 cm roll 0
33 Kasa Hidrofil 3 yard x 5 cm roll 0
34 Kasa Husada Kasa Lipat 10 X10 cm roll 0
35 Kasa Husada Kasa Lipat 7,5 X7,5 cm roll 0
36 Leukoplast 1622H 2,5 cm x 4,5 m lbr 0
37 Masker earloop dus 0
38 Medika Alkohol 95% 1 ml botol 0
39 Medika Alkohol 95% 300 ml botol 0
40 Plastik Obat Besar 8,7 x 13 lbr 0
41 Plastik Obat Kecil (etiket) 5 cmx 8 cm lbr 0
42 Septalkan 750 ml botol 0
43 Septalkan Lingettes dus 0
 TANGGAL
No. BAHAN HABIS PAKAI SATUAN JUMLAH
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 26 27 28 29 30 31
44 Serenity Alkohol swab pcs 0
45 Serenity Blood lancet 28G pcs 0
46 Serenity Catgut chromic needle 2/0 dus 0
47 Serenity Catgut chromic needle 3/0 dus 0
48 Serenity Infusion set 20ml (anak) pcs 0
49 Serenity Infusion set 60ml (dewasa) pcs 0
50 Serenity IV Cath non inj No. 18G pcs 0
51 Serenity IV Cath non inj No. 20G pcs 0
52 Serenity IV Cath non inj No. 22G pcs 0
53 Serenity IV Cath non inj No. 24G pcs 0
54 Serenity Masker N-95 dus 0
55 Serenity Mucus extractor 25ml pcs 0
56 Serenity Nasal Oxygen Canula Anak dus 0
57 Serenity Nasal Oxygen Canula Dewasa dus 0
58 Serenity Nasal Oxygen Canula Neonate dus 0
59 Serenity Oxygen Mask for Infant pcs 0
60 Serenity Oxygen Mask for Pediatric pcs 0
61 Serenity Oxygen Masker Dewasa pcs 0
62 Serenity Sarung tangan No 6,5 dus 0
63 Serenity Sarung tangan No 7,5 dus 0
64 Serenity Silk Braided needle 3/0 dus 0
65 Serenity Spuit 1ml (Insulin) dus 0
66 Strip Alat Cek Asam Urat (Merk Autocheck) dus 0
67 Strip Alat Cek Cholestrol (Merk Autocheck) dus 0
68 Strip Alat Cek Gula darah (Merk Autocheck) dus 0
69 Trosensosurge plus surgical gloves 6,0 pcs 0
70 Water for Injeksi 25 ml ampul 0
71 Lysol botol 0
72 Rapid Test pcs 0
73 Ziel Neelsen pcs 0
74 Alkohol 70% 100 ml botol 0
75 0
76 0
77 0

Mengetahui,
KEPALA PUSKESMAS MUBRANI PEMBUAT LAPORAN

LINCE MAMBRASAR, Amd.Keb PAHAD ABDULLAH, S.Farm