LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (

PUSTU/POSKESDES
PUSTU/POSKESDES : SUKAMANTRI
KECAMATAN : KARANG TENGAH
KABUPATEN : CIANJUR
PELAPORAN BULAN :
PERMINTAAN BULAN : JUNI 2022

Jumlah
NO NAMA OBAT SATUAN Stok Awal Penerimaan
Persediaan

1 2 3 4 5 6
1 Alat Suntik Sekali Pakai 1 ml SET 0 0 0
2 Alat Suntik Sekali Pakai 10 ml SET 0 0 0
3 Alat Suntik Sekali Pakai 3 ml SET 0 0 0
4 Alat Suntik Sekali Pakai 5 ml SET 0 0 0
5 Albendazol tab TABLET 0 0 0
6 Alkohol Swab KOTAK 0 0 0
7 Alopurinol Tablet 100 mg TABLET 0 0 0
8 Amlodipin Tablet 10 mg TABLET 0 0 0
9 Amlodipin Tablet 5 mg TABLET 0 0 0
10 Amoksisilin 250 mg KAPSUL 0 0 0
11 Amoksisilin 500 mg TABLET 0 0 0
12 Amoksisilin Syrup 125 mg/ 5 ml BOTOL 0 0 0
13 Antasida DOEN I tablet kunyah TABLET 0 0 0
14 Antasida DOEN II suspensi, Botol 0 0 0
15 Asam Askorbat 50 mg TABLET 0 0 0
16 Asam Mefenamat 500 mg TABLET 0 0 0
17 Asetilsistein kapsul 0 0 0
18 Betametason Krim 0,1 %- 5 mg TUBE 0 0 0
19 Ca-Glukonas injeksi IV 10% Ampul 0 0 0
20 Captopril Tablet 25 mg TABLET 0 0 0
21 Catgut Chromic No.2/0 Sachet 0 0 0
22 Catgut Chromic No.3/0 Sachet 0 0 0
23 Catgut plain No.2/0 Sachet 0 0 0
24 Catgut Plain No.3/0 Sachet 0 0 0
25 Cetirizin Tablet 10mg TABLET 0 0 0
26 Cetirizin Syrup BOTOL 0 0 0
27 Cyprofloxacin Tablet 500 mg TABLET 0 0 0
28 Deksametason Injeksi 5 mg/ ml AMPUL 0 0 0
29 Deksametason Tablet 0,5 mg TABLET 0 0 0
30 Digoxin 0,25 mg TABLET 0 0 0
31 Domperidon Syrup Botol 0 0 0
32 Domperidon Tablet 10mg TABLET 0 0 0
33 Eritromisin sirup 200 mg/ 5 ml BOTOL 0 0 0
34 Etanol 70 % 100 ml BOTOL 0 0 0
35 Etanol 70 % 1000 ml BOTOL 0 0 0
36 Fenolgliserol TT 10 % 5 ml BOTOL 0 0 0
37 Fitomenadion Injeksi 10 mg/ ml AMPUL 0 0 0
38 Fitomenadion Injeksi 2 mg/ ml AMPUL 0 0 0
39 Fitomenadion Salut Gula 10 mg TABLET 0 0 0
40 Folley Catheter No. 18 Buah 0 0 0
41 Folley Catheter No. 20 Buah 0 0 0
42 Furosemid Tablet 40 mg TABLET 0 0 0
43 Garam Oralit 200 ml Air SASE 0 0 0
44 Gentamisin Salep Kulit 0.1% TUBE 0 0 0
45 Gentamisin TM TUBE 0 0 0
46 Glibenklamid 5 mg TABLET 0 0 0
47 Gliseril Guayakolat 100 mg TABLET 0 0 0
48 Hand Sanitizer Botol 0 0 0
49 Hidroklorotiazid ( HCT ) 25 mg TABLET 0 0 0
50 Hidrokortison Krim 2,5 % TUBE 0 0 0
51 Ibuprofen 200 mg TABLET 0 0 0
52 Ibuprofen 400 mg TABLET 0 0 0
53 Ibuprofen suspensi 200mg/5ml BOTOL 0 0 0
54 Infusion Set Anak SET 0 0 0
55 Infusion Set Dewasa SET 0 0 0
56 IV Catheter/abocath No. 18 Buah 0 0 0
57 IV Catheter/abocath No. 20 Buah 0 0 0
58 IV Catheter/abocath No.22 Buah 0 0 0
59 IV Catheter/abocath No.24 Buah 0 0 0
60 Kalium Diklofenak 50 mg TABLET 0 0 0
61 Kalsium Laktat 500 mg TABLET 0 0 0
62 Kapas Pembalut 250 mg ROL 0 0 0
63 Karbamazepin 200 mg TABLET 0 0 0
64 Kasa Kompres 16x16 steril KOTAK 0 0 0
65 Kasa Pembalut Hidrofil 4 m x 10 cm ROL 0 0 0
66 Kasa Pembalut Hidrofil 4 m x 5 cm ROL 0 0 0
67 Ketokonazol 200 mg TABLET 0 0 0
68 Ketokonazol Krim 2 % Tube 15 g 0 0 0
69 Kloramfenikol 250 mg KAPSUL 0 0 0
70 Kloramfenikol SM TUBE 0 0 0
71 Kloramfenikol TM 0.5 % 5 ml BOTOL 0 0 0
72 Kloramfenikol TT 3 % 5 ml BOTOL 0 0 0
73 Klorfeniramin Maleat (CTM) 4 mg TABLET 0 0 0
74 Kotrimoksazole Suspensi BOTOL 0 0 0
75 Kotrimoksazole Tablet Dewasa TABLET 0 0 0
76 Lidokain Injeksi 2% AMPUL 0 0 0
77 Loratadin tab 10mg TABLET 0 0 0
78 Magnesium Sulfat Injeksi 20 % VIAL 0 0 0
79 Magnesium Sulfat Injeksi 40 % VIAL 0 0 0
80 Masker 3 Fly earloop Buah 0 0 0
81 Metformin HCl Tablet 500mg TABLET 0 0 0
82 Metil Prednisolon 4 mg TABLET 0 0 0
83 Metildopa tab sal 250 mg TABLET 0 0 0
84 Metilergometrin Maleat Inj. 0,200 AMPUL 0 0 0
85 Metilergometrin Maleat tab 0,125 mg TABLET 0 0 0
86 Metronidazole 250 mg TABLET 0 0 0
87 Metronidazole 500 mg TABLET 0 0 0
88 Mikonazol krim 2% TUBE 0 0 0
89 Multivitamin tablet Caplet 0 0 0
90 Natrium Bikarbonat 500 mg/bicnat TABLET 0 0 0
91 Natrium Diklofenak 50 mg TABLET 0 0 0
92 Natrium Klorida Infus 0,9 % Steril BOTOL 0 0 0
93 Nipedifin 10 mg TABLET 0 0 0
94 Nistatin 100.000 IU/ Gram Vaginal TABLET 0 0 0
95 Obat Diare Tablet TABLET 0 0 0
96 Oksitetrasiklin HCL SK 1 % 3,5 Gr TUBE 0 0 0
97 Oksitetrasiklin HCL SM 1 % 3,5 Gr TUBE 0 0 0
98 Oksitosin Injeksi 10 IU/ ml AMPUL 0 0 0
99 Omeprazol Kapsul 20 mg KAPSUL 0 0 0
100 Parasetamol Drops BOTOL 0 0 0
101 Parasetamol Syrup 120 mg/ ml BOTOL 0 0 0
102 Parasetamol tablet 500 mg TABLET 0 0 0
103 Permetrin Krim 5% (Scabimite) TUBE 0 0 0
104 Piridoksin HCL 10 mg/B6 TABLET 0 0 0
105 Plester 6 Yards x 2 Inch ROL 0 0 0
106 Povidon Iodida 10 % 30 ml BOTOL 0 0 0
107 Povidon Iodida 10 % 300 ml BOTOL 0 0 0
108 PP test Buah 0 0 0
109 Prednison 5 mg TABLET 0 0 0
110 Ranitidin Injek Ampul 0 0 0
111 Ranitidin tablet 150mg TABLET 0 0 0
112 RL Larutan infus Steril 500ml BOTOL 0 0 0
113 Salbutamol 2 mg TABLET 0 0 0
114 Salbutamol 4 mg TABLET 0 0 0
115 Salbutamol Cairan inhalasi 0,1 % Botol plastik 0 0 0
116 Salep 2-4 Komb. POT 0 0 0
117 Salisil Bedak 2 % 50 Gram KOTAK 0 0 0
118 Sarung tangan No. 6.5 Pasang 0 0 0
119 Sarung tangan No. 7 Pasang 0 0 0
120 Sarung tangan No. 7.5 Pasang 0 0 0
121 Sarung Tangan Periksa s Buah 0 0 0
122 Sarung Tangan Periksa M Buah 0 0 0
123 Silk No 3/0( Benang Bedah Sutera) SACHET 0 0 0
124 Simvastatin 10mg TABLET 0 0 0
125 Thiamin HCL (Vit. B1) 50 mg TABLET 0 0 0
126 Urine Bag BUAH 0 0 0
127 Vitamin B. Komplek TABLET 0 0 0
128 Zink dispersibel tablet TABLET 0 0 0
129 Vaksin BCG Vial 0 0 0
130 Vaksin HB Uniject Vial 0 0 0
131 Vaksin DPT-HB/HIB Vial 0 0 0
132 Vaksin Polio (bOPV) Vial 0 0 0
133 Vaksin Polio IPV 5 Dosis Vial 0 0 0
134 Vaksin Campak Vial 0 0 0
135 Vaksin Td Vial 0 0 0
136 Pelarut BCG Vial 0 0 0
137 Pelarut Campak Vial 0 0 0
138 Dropper Polio Buah 0 0 0
139 Vaksin Polio IPV 10 Dosis Vial 0 0 0
140 Vaksin Campak MR Vial 0 0 0
141 Pelarut Campak MR Vial 0 0 0
142 Bioplacenton tube 0 0 0

Yang menyerahkan,
Pelaksana Program Farmasi

Yanti Nurhati S.Si.,Apt

NIP 197707082011012002
MINTAAN OBAT (LPLPO)

Pemakaian Stok akhir Permintaan Pemberian

7 8 10 11
0 0 30 30
0 0 20 10
0 0 50 50
0 0 20 10
0 0 200 200
0 0 2 2
0 0
0 0 200 200
0 0 200 300
0 0
0 0 200 100
0 0 10 6
0 0 400 400
0 0 10 10
0 0
0 0 200 200
0 0 200 60
0 0
0 0
0 0
0 0 10
0 0
0 0
0 0
0 0 200 100
0 0 10 6
0 0 200 100
0 0 10 6
0 0 200 200
0 0
0 0 10 10
0 0 200 100
0 0
0 0 2
0 0 2 2
0 0
0 0
0 0 10
0 0
0 0
0 0 2 2
0 0
0 0 100 100
0 0
0 0
0 0
0 0 100 100
0 0 2 2
0 0
0 0
0 0
0 0 200 200
0 0
0 0 4 4
0 0 4 4
0 0 4 4
0 0 4 4
0 0 4 4
0 0 4 4
0 0
0 0 200 200
0 0
0 0
0 0 2 2
0 0 2 5
0 0
0 0 200 100
0 0
0 0
0 0
0 0
0 0
0 0 200 200
0 0 40 40
0 0 200 100
0 0 10 10
0 0
0 0 4 2
0 0 4 2
0 0
0 0
0 0 200 100
0 0
0 0 4 4
0 0 200
0 0
0 0
0 0
0 0 200
0 0 200 200
0 0 200 100
0 0 2 2
0 0
0 0
0 0
0 0
0 0
0 0 10 10
0 0 200 60
0 0
0 0
0 0 200 100
0 0 4 4
0 0
0 0 2 2
0 0 2
0 0 2
0 0 50
0 0 200 100
0 0
0 0 200 200
0 0 10 10
0 0
0 0
0 0
0 0
0 0 4 4
0 0 6 6
0 0
0 0
0 0 100 100
0 0
0 0 4 4
0 0
0 0 200 200
0 0 2 2
0 0 200 200
0 0 200 200
0 0
0 0 10 10
0 0
0 0
0 0 10 6
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 2

Yang menerima
PJ Pustu/Poskesdes

Yani/Anisa
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)
PUSTU/POSKESDES
PUSKESMAS : SUKAMANTRI
KECAMATAN : KARANG TENGAH
KABUPATEN : CIANJUR
PELAPORAN BULAN : JUNI 2022
PERMINTAAN BULAN : JULI 2022

Jumlah
NO NAMA OBAT SATUAN Stok Awal Penerimaan Pemakaian Stok akhir Permintaan Pemberian
Persediaan

1 2 3 4 5 6 7 8 10 11
1 Alat Suntik Sekali Pakai 1 ml SET 0 30 30 30 0 30 20
2 Alat Suntik Sekali Pakai 10 ml SET 0 10 10 10 0 10 4
3 Alat Suntik Sekali Pakai 3 ml SET 0 50 50 30 20 50 50
4 Alat Suntik Sekali Pakai 5 ml SET 0 10 10 0 10 10 10
5 Albendazol tab TABLET 0 200 200 0 200 100 100
6 Alkohol Swab KOTAK 0 2 2 2 0 2 2
7 Alopurinol Tablet 100 mg TABLET 0 0 0 0 200 200
8 Amlodipin Tablet 10 mg TABLET 0 200 200 30 170 200 200
9 Amlodipin Tablet 5 mg TABLET 0 300 300 50 250 200 200
10 Amoksisilin 250 mg KAPSUL 0 0 0 0 400
11 Amoksisilin 500 mg TABLET 0 100 100 100 0 200 200
12 Amoksisilin Syrup 125 mg/ 5 ml BOTOL 0 6 6 6 0 10 6
13 Antasida DOEN I tablet kunyah TABLET 0 400 400 200 200 400 400
14 Antasida DOEN II suspensi, Botol 0 10 10 6 4 10 10
15 Asam Askorbat 50 mg TABLET 0 0 0 0 200
16 Asam Mefenamat 500 mg TABLET 0 200 200 100 100 200 200
17 Asetilsistein kapsul 0 60 60 30 30 90 120
18 Betametason Krim 0,1 %- 5 mg TUBE 0 0 0 0 8
19 Ca-Glukonas injeksi IV 10% Ampul 0 0 0 0 4
20 Captopril Tablet 25 mg TABLET 0 0 0 0 200
21 Catgut Chromic No.2/0 Sachet 0 0 0 0 20
22 Catgut Chromic No.3/0 Sachet 0 0 0 0 20
23 Catgut plain No.2/0 Sachet 0 0 0 0 20
24 Catgut Plain No.3/0 Sachet 0 0 0 0 20
25 Cetirizin Tablet 10mg TABLET 0 100 100 50 50 200 200
26 Cetirizin Syrup BOTOL 0 6 6 3 3 10 10
27 Cyprofloxacin Tablet 500 mg TABLET 0 100 100 30 70 200
28 Deksametason Injeksi 5 mg/ ml AMPUL 0 6 6 2 4 10
29 Deksametason Tablet 0,5 mg TABLET 0 200 200 60 140 200 200
30 Digoxin 0,25 mg TABLET 0 0 0 0 100 100
31 Domperidon Syrup Botol 0 10 10 6 4 10 10
32 Domperidon Tablet 10mg TABLET 0 100 100 30 70 200
33 Eritromisin sirup 200 mg/ 5 ml BOTOL 0 0 0 0 10 10
34 Etanol 70 % 100 ml BOTOL 0 0 0 0 2
35 Etanol 70 % 1000 ml BOTOL 0 2 2 1 1 2
36 Fenolgliserol TT 10 % 5 ml BOTOL 0 0 0 0 6
37 Fitomenadion Injeksi 10 mg/ ml AMPUL 0 0 0 0 20
38 Fitomenadion Injeksi 2 mg/ ml AMPUL 0 0 0 0 20
39 Fitomenadion Salut Gula 10 mg TABLET 0 0 0 0 200 100
40 Folley Catheter No. 18 Buah 0 0 0 0 2 2
41 Folley Catheter No. 20 Buah 0 2 2 1 1 2 2
42 Furosemid Tablet 40 mg TABLET 0 0 0 0 200 100
43 Garam Oralit 200 ml Air SASE 0 100 100 30 70 100 50
44 Gentamisin Salep Kulit 0.1% TUBE 0 0 0 0 10
45 Gentamisin TM TUBE 0 0 0 0 10
46 Glibenklamid 5 mg TABLET 0 0 0 0 200
47 Gliseril Guayakolat 100 mg TABLET 0 100 100 100 0 200 100
48 Hand Sanitizer Botol 0 2 2 0 2 2 2
49 Hidroklorotiazid ( HCT ) 25 mg TABLET 0 0 0 0 200
50 Hidrokortison Krim 2,5 % TUBE 0 0 0 0 10
51 Ibuprofen 200 mg TABLET 0 0 0 0 200
52 Ibuprofen 400 mg TABLET 0 200 200 100 100 200 200
53 Ibuprofen suspensi 200mg/5ml BOTOL 0 0 0 0 10 10
54 Infusion Set Anak SET 0 4 4 1 3 4 4
55 Infusion Set Dewasa SET 0 4 4 4 0 4 4
56 IV Catheter/abocath No. 18 Buah 0 4 4 2 2 4 4
57 IV Catheter/abocath No. 20 Buah 0 4 4 3 1 10 10
58 IV Catheter/abocath No.22 Buah 0 4 4 1 3 6 6
59 IV Catheter/abocath No.24 Buah 0 4 4 1 3 4 4
60 Kalium Diklofenak 50 mg TABLET 0 0 0 0 200 50
61 Kalsium Laktat 500 mg TABLET 0 200 200 50 150 200 100
62 Kapas Pembalut 250 mg ROL 0 0 0 0 2
63 Karbamazepin 200 mg TABLET 0 0 0 0 200 100
64 Kasa Kompres 16x16 steril KOTAK 0 2 2 2 0 4 4
65 Kasa Pembalut Hidrofil 4 m x 10 cm ROL 0 5 5 0 5 6
66 Kasa Pembalut Hidrofil 4 m x 5 cm ROL 0 0 0 0 4 10
67 Ketokonazol 200 mg TABLET 0 100 100 30 70 100 50
68 Ketokonazol Krim 2 % Tube 15 g 0 0 0 0 10
69 Kloramfenikol 250 mg KAPSUL 0 0 0 0 200
70 Kloramfenikol SM TUBE 0 0 0 0 10
71 Kloramfenikol TM 0.5 % 5 ml BOTOL 0 0 0 0 6
72 Kloramfenikol TT 3 % 5 ml BOTOL 0 0 0 0 6
73 Klorfeniramin Maleat (CTM) 4 mg TABLET 0 200 200 150 50 200 100
74 Kotrimoksazole Suspensi BOTOL 0 40 40 10 30 20 20
75 Kotrimoksazole Tablet Dewasa TABLET 0 100 100 20 80 200 200
76 Lidokain Injeksi 2% AMPUL 0 10 10 10 0 10
77 Loratadin tab 10mg TABLET 0 0 0 0 200 100
78 Magnesium Sulfat Injeksi 20 % VIAL 0 2 2 0 2 2 2
79 Magnesium Sulfat Injeksi 40 % VIAL 0 2 2 0 2 2 2
80 Masker 3 Fly earloop Buah 0 0 0 0 100
81 Metformin HCl Tablet 500mg TABLET 0 0 0 0 200 100
82 Metil Prednisolon 4 mg TABLET 0 100 100 0 100 100 100
83 Metildopa tab sal 250 mg TABLET 0 0 0 0 200
84 Metilergometrin Maleat Inj. 0,200 AMPUL 0 4 4 3 1 4 4
85 Metilergometrin Maleat tab 0,125 mg TABLET 0 0 0 0 100
86 Metronidazole 250 mg TABLET 0 0 0 0 200
87 Metronidazole 500 mg TABLET 0 0 0 0 200
88 Mikonazol krim 2% TUBE 0 0 0 0 10
89 Multivitamin tablet Caplet 0 0 0 0 200
90 Natrium Bikarbonat 500 mg/bicnat TABLET 0 200 200 20 180 200 200
91 Natrium Diklofenak 50 mg TABLET 0 100 100 20 80 200 50
92 Natrium Klorida Infus 0,9 % Steril BOTOL 0 2 2 0 2 4
93 Nipedifin 10 mg TABLET 0 0 0 0 200
94 Nistatin 100.000 IU/ Gram Vaginal TABLET 0 0 0 0 10
95 Obat Diare Tablet TABLET 0 0 0 0 200
96 Oksitetrasiklin HCL SK 1 % 3,5 Gr TUBE 0 0 0 0 10
97 Oksitetrasiklin HCL SM 1 % 3,5 Gr TUBE 0 0 0 0 10
98 Oksitosin Injeksi 10 IU/ ml AMPUL 0 10 10 10 0 20 20
99 Omeprazol Kapsul 20 mg KAPSUL 0 60 60 20 40 60 60
100 Parasetamol Drops BOTOL 0 0 0 0 20 10
101 Parasetamol Syrup 120 mg/ ml BOTOL 0 0 0 0 60 20
102 Parasetamol tablet 500 mg TABLET 0 100 100 100 0 400 200
103 Permetrin Krim 5% (Scabimite) TUBE 0 4 4 0 4 4 4
104 Piridoksin HCL 10 mg/B6 TABLET 0 0 0 0 100
105 Plester 6 Yards x 2 Inch ROL 0 2 2 1 1 2
106 Povidon Iodida 10 % 30 ml BOTOL 0 0 0 0 2
107 Povidon Iodida 10 % 300 ml BOTOL 0 0 0 0 2
108 PP test Buah 0 0 0 0 100
109 Prednison 5 mg TABLET 0 100 100 0 100 100 100
110 Ranitidin Injek Ampul 0 0 0 0 6
111 Ranitidin tablet 150mg TABLET 0 200 200 0 200 100 100
112 RL Larutan infus Steril 500ml BOTOL 0 10 10 10 0 20 20
113 Salbutamol 2 mg TABLET 0 0 0 0 200
114 Salbutamol 4 mg TABLET 0 0 0 0 200
115 Salbutamol Cairan inhalasi 0,1 % Botol plastik 0 0 0 0 2 2
116 Salep 2-4 Komb. POT 0 0 0 0 10
117 Salisil Bedak 2 % 50 Gram KOTAK 0 4 4 2 2 6 4
118 Sarung tangan No. 6.5 Pasang 0 6 6 6 0 10 10
119 Sarung tangan No. 7 Pasang 0 0 0 0
120 Sarung tangan No. 7.5 Pasang 0 0 0 0
121 Sarung Tangan Periksa S Buah 0 100 100 100 0 100 100
122 Sarung Tangan Periksa M Buah 0 0 0 0
123 Silk No 3/0( Benang Bedah Sutera) SACHET 0 4 4 4 0 10
124 Simvastatin 10mg TABLET 0 0 0 0 200 100
125 Thiamin HCL (Vit. B1) 50 mg TABLET 0 200 200 40 160 200 200
126 Urine Bag BUAH 0 2 2 0 2 2 2
127 Vitamin B. Komplek TABLET 0 200 200 100 100 200 200
128 Zink dispersibel tablet TABLET 0 200 200 100 100 200 200
129 Vaksin BCG Vial 0 0 0 0
130 Vaksin HB Uniject Vial 0 10 10 10 0 20 10
131 Vaksin DPT-HB/HIB Vial 0 0 0 0
132 Vaksin Polio (bOPV) Vial 0 0 0 0
133 Vaksin Polio IPV 5 Dosis Vial 0 6 6 0 6
134 Vaksin Campak Vial 0 0 0 0
135 Vaksin Td Vial 0 0 0 0
136 Pelarut BCG Vial 0 0 0 0
137 Pelarut Campak Vial 0 0 0 0
138 Dropper Polio Buah 0 0 0 0
139 Vaksin Polio IPV 10 Dosis Vial 0 0 0 0
140 Vaksin Campak MR Vial 0 0 0 0
141 Pelarut Campak MR Vial 0 0 0 0
142 Bioplacenton TABLET 0 0 0 0 200

Yang menyerahkan, Yang menerima

Pelaksana Program Farmasi PJ Pustu/Poskesdes

Yanti Nurhati S.Si.,Apt Yani/Anisa

NIP 197707082011012002
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)
PUSTU/POSKESDES
PUSKESMAS : SUKAMANTRI
KECAMATAN : KARANG TENGAH
KABUPATEN : CIANJUR
PELAPORAN BULAN : JULI 2022
PERMINTAAN BULAN : AGUSTUS 2022

Jumlah
NO NAMA OBAT SATUAN Stok Awal Penerimaan Pemakaian Stok akhir
Persediaan

1 2 3 4 5 6 7 8
1 Alat Suntik Sekali Pakai 1 ml SET 0 20 20 20 0
2 Alat Suntik Sekali Pakai 10 ml SET 0 4 4 4 0
3 Alat Suntik Sekali Pakai 3 ml SET 20 50 70 30 40
4 Alat Suntik Sekali Pakai 5 ml SET 10 10 20 15 5
5 Albendazol tab TABLET 200 100 300 300 0
6 Alkohol Swab KOTAK 0 2 2 2 0
7 Alopurinol Tablet 100 mg TABLET 0 200 200 0 200
8 Amlodipin Tablet 10 mg TABLET 170 200 370 100 270
9 Amlodipin Tablet 5 mg TABLET 250 200 450 50 400
10 Amoksisilin 250 mg KAPSUL 0 0 0
11 Amoksisilin 500 mg TABLET 0 200 200 200 0
12 Amoksisilin Syrup 125 mg/ 5 ml BOTOL 0 6 6 6 0
13 Antasida DOEN I tablet kunyah TABLET 200 400 600 250 350
14 Antasida DOEN II suspensi, Botol 4 10 14 10 4
15 Asam Askorbat 50 mg TABLET 0 0 0
16 Asam Mefenamat 500 mg TABLET 100 200 300 100 200
17 Asetilsistein kapsul 30 120 150 150 0
18 Betametason Krim 0,1 %- 5 mg TUBE 0 0 0
19 Ca-Glukonas injeksi IV 10% Ampul 0 0 0
20 Captopril Tablet 25 mg TABLET 0 0 0
21 Catgut Chromic No.2/0 Sachet 0 0 0
22 Catgut Chromic No.3/0 Sachet 0 0 0
23 Catgut plain No.2/0 Sachet 0 0 0
24 Catgut Plain No.3/0 Sachet 0 0 0
25 Cetirizin Tablet 10mg TABLET 50 200 250 100 150
26 Cetirizin Syrup BOTOL 3 10 13 8 5
27 Cyprofloxacin Tablet 500 mg TABLET 70 70 20 50
28 Deksametason Injeksi 5 mg/ ml AMPUL 4 4 1 3
29 Deksametason Tablet 0,5 mg TABLET 140 200 340 150 190
30 Digoxin 0,25 mg TABLET 0 100 100 0 100
31 Domperidon Syrup Botol 4 10 14 4 10
32 Domperidon Tablet 10mg TABLET 70 70 20 50
33 Eritromisin sirup 200 mg/ 5 ml BOTOL 0 10 10 5 5
34 Etanol 70 % 100 ml BOTOL 0 0 0
35 Etanol 70 % 1000 ml BOTOL 1 1 0 1
36 Fenolgliserol TT 10 % 5 ml BOTOL 0 0 0
37 Fitomenadion Injeksi 10 mg/ ml AMPUL 0 0 0
38 Fitomenadion Injeksi 2 mg/ ml AMPUL 0 0 0
39 Fitomenadion Salut Gula 10 mg TABLET 0 100 100 40 60
40 Folley Catheter No. 18 Buah 0 2 2 0 2
41 Folley Catheter No. 20 Buah 1 2 3 0 3
42 Furosemid Tablet 40 mg TABLET 0 100 100 0 100
43 Garam Oralit 200 ml Air SASE 70 50 120 20 100
44 Gentamisin Salep Kulit 0.1% TUBE 0 0 0
45 Gentamisin TM TUBE 0 0 0
46 Glibenklamid 5 mg TABLET 0 0 0
47 Gliseril Guayakolat 100 mg TABLET 0 100 100 100 0
48 Hand Sanitizer Botol 2 2 4 2 2
49 Hidroklorotiazid ( HCT ) 25 mg TABLET 0 0 0
50 Hidrokortison Krim 2,5 % TUBE 0 0 0
51 Ibuprofen 200 mg TABLET 0 0 0
52 Ibuprofen 400 mg TABLET 100 200 300 50 250
53 Ibuprofen suspensi 200mg/5ml BOTOL 0 10 10 10 0
54 Infusion Set Anak SET 3 4 7 1 6
55 Infusion Set Dewasa SET 0 4 4 4 0
56 IV Catheter/abocath No. 18 Buah 2 4 6 1 5
57 IV Catheter/abocath No. 20 Buah 1 10 11 6 5
58 IV Catheter/abocath No.22 Buah 3 6 9 1 8
59 IV Catheter/abocath No.24 Buah 3 4 7 1 6
60 Kalium Diklofenak 50 mg TABLET 0 50 50 50 0
61 Kalsium Laktat 500 mg TABLET 150 100 250 100 150
62 Kapas Pembalut 250 mg ROL 0 0 0
63 Karbamazepin 200 mg TABLET 0 100 100 0 100
64 Kasa Kompres 16x16 steril KOTAK 0 4 4 4 0
65 Kasa Pembalut Hidrofil 4 m x 10 cm ROL 5 5 2 3
66 Kasa Pembalut Hidrofil 4 m x 5 cm ROL 0 10 10 4 6
67 Ketokonazol 200 mg TABLET 70 50 120 20 100
68 Ketokonazol Krim 2 % Tube 15 g 0 0 0
69 Kloramfenikol 250 mg KAPSUL 0 0 0
70 Kloramfenikol SM TUBE 0 0 0
71 Kloramfenikol TM 0.5 % 5 ml BOTOL 0 0 0
72 Kloramfenikol TT 3 % 5 ml BOTOL 0 0 0
73 Klorfeniramin Maleat (CTM) 4 mg TABLET 50 100 150 100 50
74 Kotrimoksazole Suspensi BOTOL 30 20 50 20 30
75 Kotrimoksazole Tablet Dewasa TABLET 80 200 280 50 230
76 Lidokain Injeksi 2% AMPUL 0 0 0
77 Loratadin tab 10mg TABLET 0 100 100 0 100
78 Magnesium Sulfat Injeksi 20 % VIAL 2 2 4 0 4
79 Magnesium Sulfat Injeksi 40 % VIAL 2 2 4 0 4
80 Masker 3 Fly earloop Buah 0 0 0
81 Metformin HCl Tablet 500mg TABLET 0 100 100 0 100
82 Metil Prednisolon 4 mg TABLET 100 100 200 0 200
83 Metildopa tab sal 250 mg TABLET 0 0 0
84 Metilergometrin Maleat Inj. 0,200 AMPUL 1 4 5 3 2
85 Metilergometrin Maleat tab 0,125 mg TABLET 0 0 0
86 Metronidazole 250 mg TABLET 0 0 0
87 Metronidazole 500 mg TABLET 0 0 0
88 Mikonazol krim 2% TUBE 0 0 0
89 Multivitamin tablet Caplet 0 0 0
90 Natrium Bikarbonat 500 mg/bicnat TABLET 180 200 380 0 380
91 Natrium Diklofenak 50 mg TABLET 80 50 130 80 50
92 Natrium Klorida Infus 0,9 % Steril BOTOL 2 2 1 1
93 Nipedifin 10 mg TABLET 0 0 0
94 Nistatin 100.000 IU/ Gram Vaginal TABLET 0 0 0
95 Obat Diare Tablet TABLET 0 0 0
96 Oksitetrasiklin HCL SK 1 % 3,5 Gr TUBE 0 0 0
97 Oksitetrasiklin HCL SM 1 % 3,5 Gr TUBE 0 0 0
98 Oksitosin Injeksi 10 IU/ ml AMPUL 0 20 20 10 10
99 Omeprazol Kapsul 20 mg KAPSUL 40 60 100 20 80
100 Parasetamol Drops BOTOL 0 10 10 10 0
101 Parasetamol Syrup 120 mg/ ml BOTOL 0 20 20 20 0
102 Parasetamol tablet 500 mg TABLET 0 200 200 200 0
103 Permetrin Krim 5% (Scabimite) TUBE 4 4 8 4 4
104 Piridoksin HCL 10 mg/B6 TABLET 0 0 0
105 Plester 6 Yards x 2 Inch ROL 1 1 1 0
106 Povidon Iodida 10 % 30 ml BOTOL 0 0 0
107 Povidon Iodida 10 % 300 ml BOTOL 0 0 0
108 PP test Buah 0 0 0
109 Prednison 5 mg TABLET 100 100 200 0 200
110 Ranitidin Injek Ampul 0 0 0
111 Ranitidin tablet 150mg TABLET 200 100 300 0 300
112 RL Larutan infus Steril 500ml BOTOL 0 20 20 6 14
113 Salbutamol 2 mg TABLET 0 0 0
114 Salbutamol 4 mg TABLET 0 0 0
115 Salbutamol Cairan inhalasi 0,1 % Botol plastik 0 2 2 2 0
116 Salep 2-4 Komb. POT 0 0 0
117 Salisil Bedak 2 % 50 Gram KOTAK 2 4 6 3 3
118 Sarung tangan No. 6.5 Pasang 0 10 10 10 0
119 Sarung tangan No. 7 Pasang 0 0 0
120 Sarung tangan No. 7.5 Pasang 0 0 0
121 Sarung Tangan Periksa S Buah 0 100 100 100 0
122 Sarung Tangan Periksa M Buah 0 0 0
123 Silk No 3/0( Benang Bedah Sutera) SACHET 0 0 0
124 Simvastatin 10mg TABLET 0 100 100 20 80
125 Thiamin HCL (Vit. B1) 50 mg TABLET 160 200 360 130 230
126 Urine Bag BUAH 2 2 4 0 4
127 Vitamin B. Komplek TABLET 100 200 300 100 200
128 Zink dispersibel tablet TABLET 100 200 300 50 250
129 Vaksin BCG Vial 0 0 0
130 Vaksin HB Uniject Vial 0 10 10 10 0
131 Vaksin DPT-HB/HIB Vial 0 0 0
132 Vaksin Polio (bOPV) Vial 0 0 0
133 Vaksin Polio IPV 5 Dosis Vial 6 6 6
134 Vaksin Campak Vial 0 0 0
135 Vaksin Td Vial 0 0 0
136 Pelarut BCG Vial 0 0 0
137 Pelarut Campak Vial 0 0 0
138 Dropper Polio Buah 0 0 0
139 Vaksin Polio IPV 10 Dosis Vial 0 0 0
140 Vaksin Campak MR Vial 0 0 0
141 Pelarut Campak MR Vial 0 0 0
142 Bioplacenton tube 0 0 0

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Pelaksana Program Farmasi PJ Pustu/Poskesd

Yanti Nurhati S.Si.,Apt Yani/Anisa

NIP 197707082011012002
BAT (LPLPO)

Permintaan Pemberian

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 20

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PJ Pustu/Poskesdes

Yani/Anisa