LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN REAGEN (LPLPR)

PUSKESMAS : SELEMADEG TIMUR II PELAPORAN PERIODE Maret 2022

KECAMATAN : SELEMADEG TIMUR PERMINTAAN PERIODE April 2022
KABUPATEN : TABANAN

Stok Penerimaa Pemakaia Permintaa Pemberia

Kode No Nama Reagen Satuan Persediaan Sisa Stok Ket
awal n n n n
1 2 3 4 5 6 7=(5+6) 8 9=(7-8) 10 11
R1 1 Blood glucose test strips Strip 0 0 0
R2 2 Uric acid test strips Strip 0 0 0
R3 3 Cholestrol test strip Strip 0 0 0
R4 4 PP.Test Strip( One Step Rapid HCG Strip ) Strip 0 0 0 50
R5 5 HB test strip Strip 0 0 0 50
R6 6 Urine Test Strip 3P Strip 0 0 0
R7 7 Urine Test Strip 10P Strip 0 0 0
R8 8 Dengue NS 1 Ag test card Test 0 0 0
R9 9 Salmonella Paratyphi Anti Bodies Test AH Test 0 0 0
R10 10 Salmonella Paratyphi Anti Bodies Test AO Test 0 0 0
R11 11 Salmonella Paratyphi Anti Bodies Test BH Test 0 0 0
R12 12 Salmonella Paratyphi Anti Bodies Test BO Test 0 0 0
R13 13 Salmonella Paratyphi Anti Bodies Test CO Test 0 0 0
R14 14 Salmonella Paratyphi Anti Bodies Test H Test 0 0 0
R15 15 Salmonella Paratyphi Anti Bodies Test O Test 0 0 0
R16 16 Salmonella Paratyphi Anti Bodies Test CH Test 0 0 0
R17 17 Dilluent Galon @ 20 L 0 0 0
R18 18 Rinse Galon @ 5,5 L 0 0 0
R19 19 Lyse Botol @500 mL 0 0 0
R20 20 E-Z Cleanser Botol @100 mL 0 0 0
R21 21 Probe Cleanser Botol @ 50 ml 0 0 0
R22 22 Control Normal Hematology Analyzer Vial @ 3 mL 0 0 0
R23 23 Antisera Golongan Darah A&B Paket @ 10mL 0 0 0 1
R24 24 HIV 1/2 Anti Body Rapid Test Oncoprobe Test 0 0 0
R25 25 HIV 1/2 Anti Body Rapid Test Intec Test 0 0 0
R26 26 HIV 1/2 Anti Body Rapid Test Vikia Test 0 0 0
R27 27 SD Bioline HIV Test 59 59 5 54
R28 28 SD HBsAg Test 23 23 5 18
R29 29 SD Biosensor Syphilis Ab Test Test 59 59 5 54
R30 30 RPR Fokus Syphilis Test 0 0 0
R31 31 Vacutube Gel Clot Activator (Kuning) Tube 0 0 0
R32 32 Vacutube Gel Clot Activator (Merah) Tube 0 0 0 100
 Stok Penerimaa Pemakaia Permintaa Pemberia
Kode No Nama Reagen Satuan Persediaan Sisa Stok Ket
awal n n n n

R33 33 Tabung EDTA (Ungu) Tube 0 0 0

R34 34 AST/SGOT Reagent Kit @ 4x30 mL 0 0 0
R35 35 ALT/SGPT Reagent Kit @ 4x30 mL 0 0 0
R36 36 Creatinin Reagent Kit @ 2x250 mL 0 0 0
R37 37 Urea Nitrogent (Bun) Kit @ 4x30 mL 0 0 0
R38 38 Control Serum Normal Kimia Klinik Vial @ 5 mL 0 0 0
R39 39 Yellow Tip Pcs 0 0 0
R40 40 Blue Tip Pcs 0 0 0
R41 41 Alkohol Swab Sachet 658 1500 2158 2158 0
R42 42 Reagen TB (Ziehl Neellsen Paket @ 10 mL 0 0 0
R43 43 Safe T Pro Une Blood lancet Pcs 0 0 0
R44 44 Slide frosted Box @ 72 pcs 439 439 7 432
R45 45 Oil Imersi Botol 4 4 4
R46 46 Tissue Lensa Lembar 0 0 0
R47 47 BD Vacutaner Pcs 0 0 0
R48 48 Sarung Tangan M Pasag 0 0 0
R49 49 Sarung Tangan L Pasag 0 0 0
R50 50 Cary-Blair-Medium Tube @ 500 g 0 0 0
R51 51 Lactose Broth H Tube @ 500 g 0 0 0
R52 52 Alkohol 70 % Botol 1 Liter 0 0 0
R53 53 Cotton Swab Pcs 0 0 0
R54 54 Rapid Tes HIV 2 Fokus Test 0 0 0
R55 55 Blood Lancet Avico/semilias pcs 0 0 0
56 TP Shypilis test 0 0 0
57 VTM + swab pcs 191 191 4 187
58 Pewarna MDT (3x100 ml) botol 4 4 4
59 Pewarna Giemsa (1x100 ml) botol 4 4 4
60 Rapid Test Antigen test 862 862 131 731
61 Dengue NS1Ag +Ab Combo Test 50 50 50
62 Klip Besar 20*30 cm pak 1 1 1
63 Klip Kecil pak 1 1 1
64 HIV 1/2 (Rapid 1 RDT HIV) Virochek Test 75 75 75

Mengetahui : Yang Menyerahkan

Kepala Puskesmas Selemadeg Timur 2 Petugas Gudang Obat Puskesmas Petugas Puskesmas

( dr. Ni Putu Partini ) ( Ni Kadek Eni Mulyani ) (I Nengah Rustana )

NIP. 196607262002122003 NIP.- NIP.196406251987031008
 REKAP PEMAKAIAN REAGEN
Maret 2022

pemakai
Kode No Nama Reagen Satuan exp
an

B1 1 Blood glucose test strips Strip 0

B2 2 Uric acid test strips Strip 0
B3 3 Cholestrol test strip Strip 0
B4 4 PP.Test Strip( One Step Rapid HCG Strip ) Strip 0
B5 5 HB test strip Strip 0
B6 6 Urine Test Strip 3P Strip 0
B7 7 Urine Test Strip 10P Strip 0
B8 8 Dengue NS 1 Ag test card Test 0
B9 9 Salmonella Paratyphi Anti Bodies Test AH Test 0
B10 10 Salmonella Paratyphi Anti Bodies Test AO Test 0
B11 11 Salmonella Paratyphi Anti Bodies Test BH Test 0
B12 12 Salmonella Paratyphi Anti Bodies Test BO Test 0
B13 13 Salmonella Paratyphi Anti Bodies Test CO Test 0
B14 14 Salmonella Paratyphi Anti Bodies Test H Test 0
B15 15 Salmonella Paratyphi Anti Bodies Test O Test 0
B16 16 Salmonella Paratyphi Anti Bodies Test CH Test 0
B17 17 Dilluent Galon @ 20 L 0
B18 18 Rinse Galon @ 5,5 L 0
B19 19 Lyse Botol @500 mL 0
B20 20 E-Z Cleanser Botol @100 mL 0
B21 21 Probe Cleanser Botol @ 50 ml 0
B22 22 Control Normal Hematology Analyzer Vial @ 3 mL 0
B23 23 Antisera Golongan Darah A&B Paket @ 10mL 0
B24 24 HIV 1/2 Anti Body Rapid Test Oncoprobe Test 0
B25 25 HIV 1/2 Anti Body Rapid Test Intec Test 0
B26 26 HIV 1/2 Anti Body Rapid Test Vikia Test 0
B27 27 SD Bioline HIV Test 5
B28 28 SD HBsAg Test 5
B29 29 SD Biosensor Syphilis Ab Test Test 5
B30 30 RPR Fokus Syphilis Test 0
B31 31 Vacutube Gel Clot Activator (Kuning) Tube 0
B32 32 Vacutube Gel Clot Activator (Merah) Tube 0
B33 33 Tabung EDTA (Ungu) Tube 0
B34 34 AST/SGOT Reagent Kit @ 4x30 mL 0
B35 35 ALT/SGPT Reagent Kit @ 4x30 mL 0
B36 36 Creatinin Reagent Kit @ 2x250 mL 0
B37 37 Urea Nitrogent (Bun) Kit @ 4x30 mL 0
B38 38 Control Serum Normal Kimia Klinik Vial @ 5 mL 0
B39 39 Yellow Tip Pcs 0
B40 40 Blue Tip Pcs 0
B41 41 Alkohol Swab Sachet 2158
B42 42 Reagen TB (Ziehl Neellsen Paket @ 10 mL 0
B43 43 Safe T Pro Une Blood lancet Pcs 0
B44 44 Slide frosted Box @ 72 pcs 7
B45 45 Oil Imersi Botol 0
B46 46 Tissue Lensa Lembar 0
B47 47 BD Vacutaner Pcs 0
B48 48 Sarung Tangan M Pasag 0
B49 49 Sarung Tangan L Pasag 0
B50 50 Cary-Blair-Medium Tube @ 500 g 0
B51 51 Lactose Broth H Tube @ 500 g 0
B52 52 Alkohol 70 % Botol 1 Liter 0
B53 53 Cotton Swab Pcs 0
54 Rapid Tes HIV 2 Fokus Test 0
55 Blood Lancet Avico pcs 0
 Total
Pemakai
an

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
5
5
5
0
0
0
0
0
0
0
0
0
0
0
2158
0
0
7
0
0
0
0
0
0
0
0
0
0
0
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN REAGEN (LPLPR)
PUSKESMAS

PUSKESMAS : SELEMADEG TIMUR II PELAPORAN PERIODE Maret 2022

KECAMATAN : SELEMADEG TIMUR PERMINTAAN PERIODE April 2022
KABUPATEN : TABANAN

Stok Penerimaa Pemakaia Permintaa Pemberia

Kode No Nama Reagen Satuan Persediaan Sisa Stok Ket
awal n n n n
1 2 3 4 5 6 7=(5+6) 8 9=(7-8) 10 11
R1 1 Blood glucose test strips Strip 0 0 0
R2 2 Uric acid test strips Strip 0 0 0
R3 3 Cholestrol test strip Strip 0 0 0
R4 4 PP.Test Strip( One Step Rapid HCG Strip ) Strip 0 0 0 50
R5 5 HB test strip Strip 48 48 48 50 EXP
R6 6 Urine Test Strip 3P Strip 0 0 0
R7 7 Urine Test Strip 10P Strip 0 0 0
R8 8 Dengue NS 1 Ag test card Test 0 0 0
R9 9 Salmonella Paratyphi Anti Bodies Test AH Test 0 0 0
R10 10 Salmonella Paratyphi Anti Bodies Test AO Test 0 0 0
R11 11 Salmonella Paratyphi Anti Bodies Test BH Test 0 0 0
R12 12 Salmonella Paratyphi Anti Bodies Test BO Test 0 0 0
R13 13 Salmonella Paratyphi Anti Bodies Test CO Test 0 0 0
R14 14 Salmonella Paratyphi Anti Bodies Test H Test 0 0 0
R15 15 Salmonella Paratyphi Anti Bodies Test O Test 0 0 0
R16 16 Salmonella Paratyphi Anti Bodies Test CH Test 0 0 0
R17 17 Dilluent Galon @ 20 L 0 0 0
R18 18 Rinse Galon @ 5,5 L 0 0 0
R19 19 Lyse Botol @500 mL 0 0 0
R20 20 E-Z Cleanser Botol @100 mL 0 0 0
R21 21 Probe Cleanser Botol @ 50 ml 0 0 0
R22 22 Control Normal Hematology Analyzer Vial @ 3 mL 0 0 0
R23 23 Antisera Golongan Darah A&B Paket @ 10mL 0 0 0 1
R24 24 HIV 1/2 Anti Body Rapid Test Oncoprobe Test 0 0 0
R25 25 HIV 1/2 Anti Body Rapid Test Intec Test 0 0 0
R26 26 HIV 1/2 Anti Body Rapid Test Vikia Test 0 0 0
R27 27 SD Bioline HIV Test 509 509 5 504
R28 28 SD HBsAg Test 43 43 5 38
R29 29 SD Biosensor Syphilis Ab Test Test 59 59 5 54
R30 30 RPR Fokus Syphilis Test 0 0 0
R31 31 Vacutube Gel Clot Activator (Kuning) Tube 0 0 0
R32 32 Vacutube Gel Clot Activator (Merah) Tube 0 0 0 100
 Stok Penerimaa Pemakaia Permintaa Pemberia
Kode No Nama Reagen Satuan Persediaan Sisa Stok Ket
awal n n n n

R33 33 Tabung EDTA (Ungu) Tube 0 0 0

R34 34 AST/SGOT Reagent Kit @ 4x30 mL 0 0 0
R35 35 ALT/SGPT Reagent Kit @ 4x30 mL 0 0 0
R36 36 Creatinin Reagent Kit @ 2x250 mL 0 0 0
R37 37 Urea Nitrogent (Bun) Kit @ 4x30 mL 0 0 0
R38 38 Control Serum Normal Kimia Klinik Vial @ 5 mL 0 0 0
R39 39 Yellow Tip Pcs 0 0 0
R40 40 Blue Tip Pcs 0 0 0
R41 41 Alkohol Swab Sachet 658 1500 2158 2158 0
R42 42 Reagen TB (Ziehl Neellsen Paket @ 10 mL 0 0 0
R43 43 Safe T Pro Une Blood lancet Pcs 0 0 0
R44 44 Slide frosted Box @ 72 pcs 439 439 7 432
R45 45 Oil Imersi Botol 4 4 4
R46 46 Tissue Lensa Lembar 0 0 0
R47 47 BD Vacutaner Pcs 0 0 0
R48 48 Sarung Tangan M Pasag 0 0 0
R49 49 Sarung Tangan L Pasag 0 0 0
R50 50 Cary-Blair-Medium Tube @ 500 g 0 0 0
R51 51 Lactose Broth H Tube @ 500 g 0 0 0
R52 52 Alkohol 70 % Botol 1 Liter 0 0 0
R53 53 Cotton Swab Pcs 0 0 0
R54 54 Rapid Tes HIV 2 Fokus Test 0 0 0
R55 55 Blood Lancet Avico/semilias pcs 0 0 0
56 TP Shypilis test 307 307 307 exp
57 VTM + swab pcs 191 191 4 187
58 Pewarna MDT (3x100 ml) botol 4 4 4
59 Pewarna Giemsa (1x100 ml) botol 4 4 4
60 Rapid Test Antigen test 862 862 131 731
61 Dengue NS1Ag +Ab Combo Test 50 50 50
62 Klip Besar 20*30 cm pak 1 1 1
63 Klip Kecil pak 1 1 1
64 HIV 1/2 (Rapid 1 RDT HIV) Virochek Test 75 75 75

Mengetahui :
Kepala Dinas Kabupaten Tabanan Yang Menyerahkan Yang Meminta Petugas Puskesmas
Kepala Puskesmas

(………………………………………………..) (…………………………………) ( dr.NI Putu Partini ) (I Nengah Rustana )

NIP. NIP. NIP.196607262002122003 NIP.196406251987031008