. .

PERMINTAAN OBAT RANAP PONED PUSKESMAS GUNTUR I

BULAN :
TANGGAL PERMINTAAN OBAT
NO. NAMA OBAT

1 Aciclovir Tablet 200 mg

2 Aciclovir Salep Kulit
3 Aciclovir Tablet 400 mg
4 Albendazole Tablet 400 mg
6 Alupurinol Tablet 100 mg
7 Alupurinol Tablet 300 mg
8 ALPRAZOLAM 0,5 MG
9 Ambroxol Syrup 15mg/5ml
10 Ambroxol Tablet
11 Amoksisilin Syr Forte 250 mg/ 5 ml
12 Amoksisilina Kapsul 500 mg
13 Amoksisilina Sirup kering 125 mg/5 ml
14 AMLODIPIN 10 MG
15 AMLODIPIN 5 MG
16 Antalgin ( Metampiron ) Tablet 500 mg
17 Antasida Doen suspensi btl. 60 ml
18 Antasida DOEN Tablet 500 mg
19 Anti Bakteri DOEN Salep kombinasi
20 Anti Hemoroid DOEN Kombinasi
21 Antifungi DOEN Kombinasi
22 Aqua Pro Injeksi
23 ASETOSAL 80 MG/Miniaspi
25 Asam Askorbat (VitC ) Tablet 50 mg
26 Asam Folat Tablet
27 Asam Mefenamat 500 mg
29 ASERING INFUS
30 Atrofin Sulfat Injeksi 0,25 mg
31 Attapulgite 600 mg/New Antides
32 Betametason 0,1% krim
33 BETAHISTIN 6 MG
34 Bisacodil TAB 5 mg
35 Bisacodil supp 10 mg
36 Captopril Tablet 12,5 mg
37 Captopril Tablet 25 mg
38 CAPTOPRIL 50 MG
40 Cefotaxim Injeksi 1 g
41 Ceftriaxone Injeksi
42 Ciprofloksacin tablet 500 mg
43 Deksametason Injeksi 5 mg / ml - 1 ml
44 Deksametason Tablet 0,5 mg
45 Diazepam Injeksi 5 mg / Ml - 2 ml
46 Diazepam Rectal Tube/Stesolit
47 Diazepam Tablet 2 mg
48 Diazepam Tablet 5 mg
49 Difenhidramin HCL Injeksi 10 mg/ml - 1 ml
 . .
50 Digoksin Tablet 0,25 mg
51 Dimenhidrinate 50 mg
52 Domperidon Syr 5mg/5 ml
53 Domperidon 10 MG TAB
54 Epinefrina Hcl/Bitatrat ( ADRENALIN)
55 Furosemida Tablet 40 mg
56 Fitomenadion (Vit K1) Tablet.s
57 Fenobarbital Inj 50 mg/ ml - 2 ml
58 Fitomenadion (Vit K1) Inj, 10
59 Fitomenadion Inj 2 mg/ ml
60 Fenol Gliserol Tetes Telinga
61 Garam Oralit untuk 200 ml air
62 Gentamisin Tetes mata
63 Gentian Violet larutan 1 %
64 GEMFIBROZIL 300 MG
65 Glibenklamid Tablet 5 mg
66 Gliseril Guaiakolat Tablet 100 mg
67 GLIMEPIRIDE 2 MG
68 GLUKONAS CALCII
69 Glukose larutan Infus 5 % steril
72 Hes 6 %
73 Hidroklorotiazid ( HCT ) Tablet 25 mg
74 Hidrokortison krim 2,5 %
75 Hyoscin-N-Butilbromid tab 10 mg
76 Ibuprofen Tablet 200 mg
77 Ibuprofen Tablet 400 mg
78 Isosorbit Dinitrat Tablet Sublingual 5 mg
79 IBUPROFEN SUSP
80 Ketokonazol 200 mg
81 Kalsium Laktat (kalk) Tablet 500 mg
82 Kalsium Gluconat inj in 10 % (100 mg/100ml)
83 Kotrimoksazol Susp 240 mg / 5 ml
84 Kotrimoksazol 480 mg Tablet
85 Ketokonazol salep
86 Ketokonazole tab
87 Ketorolac inj 10 mg
88 Kloramfenikol Kapsul 250 mg
89 Kloramfenikol Salep mata 1 %
90 Kloramfenikol tetes telinga 3 %
91 Kloramfenikol tetes Mata
92 Kloramfenikol Susp 125 mg/ 5 ml
93 Kloramfenikol Salep kulit 2 %
94 Klorfeniramin Maleat (CTM ) Tablet 4 mg
95 Kodein HCl tab 10 mg
96 KLINDAMISIN 300 MG
97 Lidokain HCL Injeksi
98 Lidokain Komp.Inj, Kombinasi
99 Lizol Mengandung Kresol tersabun 50 %
100 Loperamid Tablet 2 mg
101 Loratadin
 . .
102 Magnesium Sulfat Injeksi/MgSo4
103 Metformin
104 Metilergometrin Maleat (Metilergometrin) Tablet Salut
105 Metilergometrin Maleat Inj 0,200 mg 1 ml
106 Metronidazole 500 mg
107 Mikonazole Cream
108 Metilprednisolon 4 mg
109 Metilprednisolon 8 mg
110 Natrium Diklofenak Tablet 25 mg
111 Natrium Diklofenak Tablet 50 mg
112 Natrium Klorida larutan Infus 0, 9 %
113 Nifedipine 10 mg
114 Nistatin Tablet salut 500.000 IU
115 Nistatin drop
116 Nistatin Tablet Vaginal 100.000 IU / g
117 N-Asetil Sistein 200 mg
118 Obat Batuk Hitam ( O B H )
119 Oksitertrasiklin HCL Salep 3 % Salep Kulit
120 Oksitetrasiklin HCL mata 1 %
121 Oksitosin Injeksi 10 IU / ml - 1 ml
122 Omepazol inj
123 Omeprazol kapsul 20 mg
124 Ondansetron injeksi 4 mg/2 ml
125 Papaverin 40 mg
126 Parasetamol Sirup 120 mg / 5 ml
127 Parasetamol Tablet 500 mg
128 parasetamol drop 100 mg/ ml
129 Phenobarbital 30 mg
130 Phenytoin 100 mg
131 Piridoksin HCL ( Vit.B6 ) Tablet 10 mg
132 Piroxicam Tablet 10 mg
133 Piroxicam Tablet 20 mg
134 Plastik klip
135 Prednison Tablet 5 mg
136 Ranitidin 150 mg
137 Ranitidine Injeksi
138 Ringer Laktat larutan Infus Steril
139 Salbutamol Tablet 2 mg
140 Salbutamol Tablet 4 mg
141 Salep 2-4
142 Salicyl Talk
143 Salbutamol nebules
144 Sarung Tangan no 7
145 Sarung Tangan No. 7,5
146 SARUNG TANGAN NO 8
147 Sarung Tangan M
148 Sendok Obat
149 Sefadroksil
150 Serum Anti tetanus Injeksi 1.500 IU / Amp.
151 Serum Anti Bisa Ular Polivalen Injeksi 5 ml vial
 . .
152 Simetidin 200 mg
153 Simvastatin 10 mg
154 Sulfasetamida Natrium tetes mata 15 %
155 Tambah Darah
156 Tablet zinc
157 Zink Sy
158 Thiamphenicol 500 mg
159 Tiamin HCL/ Monontrat (Vit .B1) Tablet 50 mg
160 Vitamin B Klompek
161 Vitamin C
162 Vitamin B12 Tablet
163 Yodium Povidon larutan 10 % 30 ml
164 Yodium Povidon larutan 10 % 300 ml
165 Anaria Syrup/curviplek
166 Alkohol swab
167 Sulfadiazine Silver
168 Bufacetin
169 Burnazin Krim
170 Bioplacenton Jelly
171 Dulcolax Supp
172 Dextrofen Syr.
173 Dextral Kaplet
174 Guanistrep Syrup
175 Hemorograd Tablet
176 Pulmicort
177 Jovial
178 Samcodin
179 Scopma
180 Samcobion
 . .

JUMLAH
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PERMINTAAN OBAT RANAP PONED PUSKESMAS GUNTUR I

BULAN :

NO. NAMA OBAT JUMLAH

1 Aciclovir Tablet 200 mg

2 Aciclovir Salep Kulit
3 Aciclovir Tablet 400 mg
4 Albendazole Tablet 400 mg
6 Alupurinol Tablet 100 mg
7 Alupurinol Tablet 300 mg
8 ALPRAZOLAM 0,5 MG
9 Ambroxol Syrup 15mg/5ml
10 Ambroxol Tablet
11 Amoksisilin Syr Forte 250 mg/ 5 ml
12 Amoksisilina Kapsul 500 mg
13 Amoksisilina Sirup kering 125 mg/5 ml
14 AMLODIPIN 10 MG
15 AMLODIPIN 5 MG
16 Antalgin ( Metampiron ) Tablet 500 mg
17 Antasida Doen suspensi btl. 60 ml
18 Antasida DOEN Tablet 500 mg
19 Anti Bakteri DOEN Salep kombinasi
20 Anti Hemoroid DOEN Kombinasi
21 Antifungi DOEN Kombinasi
22 Aqua Pro Injeksi
23 ASETOSAL 80 MG/Miniaspi
25 Asam Askorbat (VitC ) Tablet 50 mg
26 Asam Folat Tablet
27 Asam Mefenamat 500 mg
29 ASERING INFUS
30 Atrofin Sulfat Injeksi 0,25 mg
31 Attapulgite 600 mg/New Antides
32 Betametason 0,1% krim
33 BETAHISTIN 6 MG
34 Bisacodil TAB 5 mg
35 Bisacodil supp 10 mg
36 Captopril Tablet 12,5 mg
37 Captopril Tablet 25 mg
38 CAPTOPRIL 50 MG
40 Cefotaxim Injeksi 1 g
41 Ceftriaxone Injeksi
42 Ciprofloksacin tablet 500 mg
43 Deksametason Injeksi 5 mg / ml - 1 ml
44 Deksametason Tablet 0,5 mg
45 Diazepam Injeksi 5 mg / Ml - 2 ml
46 Diazepam Rectal Tube/Stesolit
47 Diazepam Tablet 2 mg
48 Diazepam Tablet 5 mg
49 Difenhidramin HCL Injeksi 10 mg/ml - 1 ml
50 Digoksin Tablet 0,25 mg
51 Dimenhidrinate 50 mg
52 Domperidon Syr 5mg/5 ml
53 Domperidon 10 MG TAB
54 Epinefrina Hcl/Bitatrat ( ADRENALIN)
55 Furosemida Tablet 40 mg
56 Fitomenadion (Vit K1) Tablet.s
57 Fenobarbital Inj 50 mg/ ml - 2 ml
58 Fitomenadion (Vit K1) Inj, 10
59 Fitomenadion Inj 2 mg/ ml
60 Fenol Gliserol Tetes Telinga
61 Garam Oralit untuk 200 ml air
62 Gentamisin Tetes mata
 . .
63 Gentian Violet larutan 1 %
64 GEMFIBROZIL 300 MG
65 Glibenklamid Tablet 5 mg
66 Gliseril Guaiakolat Tablet 100 mg
67 GLIMEPIRIDE 2 MG
68 GLUKONAS CALCII
69 Glukose larutan Infus 5 % steril
72 Hes 6 %
73 Hidroklorotiazid ( HCT ) Tablet 25 mg
74 Hidrokortison krim 2,5 %
75 Hyoscin-N-Butilbromid tab 10 mg
76 Ibuprofen Tablet 200 mg
77 Ibuprofen Tablet 400 mg
78 Isosorbit Dinitrat Tablet Sublingual 5 mg
79 IBUPROFEN SUSP
80 Ketokonazol 200 mg
81 Kalsium Laktat (kalk) Tablet 500 mg
82 Kalsium Gluconat inj in 10 % (100 mg/100ml)
83 Kotrimoksazol Susp 240 mg / 5 ml
84 Kotrimoksazol 480 mg Tablet
85 Ketokonazol salep
86 Ketokonazole tab
87 Ketorolac inj 10 mg
88 Kloramfenikol Kapsul 250 mg
89 Kloramfenikol Salep mata 1 %
90 Kloramfenikol tetes telinga 3 %
91 Kloramfenikol tetes Mata
92 Kloramfenikol Susp 125 mg/ 5 ml
93 Kloramfenikol Salep kulit 2 %
94 Klorfeniramin Maleat (CTM ) Tablet 4 mg
95 Kodein HCl tab 10 mg
96 KLINDAMISIN 300 MG
97 Lidokain HCL Injeksi
98 Lidokain Komp.Inj, Kombinasi
99 Lizol Mengandung Kresol tersabun 50 %
100 Loperamid Tablet 2 mg
101 Loratadin
102 Magnesium Sulfat Injeksi/MgSo4
103 Metformin
104 Metilergometrin Maleat (Metilergometrin) Tablet Salut
105 Metilergometrin Maleat Inj 0,200 mg 1 ml
106 Metronidazole 500 mg
107 Mikonazole Cream
108 Metilprednisolon 4 mg
109 Metilprednisolon 8 mg
110 Natrium Diklofenak Tablet 25 mg
111 Natrium Diklofenak Tablet 50 mg
112 Natrium Klorida larutan Infus 0, 9 %
113 Nifedipine 10 mg
114 Nistatin Tablet salut 500.000 IU
115 Nistatin drop
116 Nistatin Tablet Vaginal 100.000 IU / g
117 N-Asetil Sistein 200 mg
118 Obat Batuk Hitam ( O B H )
119 Oksitertrasiklin HCL Salep 3 % Salep Kulit
120 Oksitetrasiklin HCL mata 1 %
121 Oksitosin Injeksi 10 IU / ml - 1 ml
122 Omepazol inj
123 Omeprazol kapsul 20 mg
124 Ondansetron injeksi 4 mg/2 ml
125 Papaverin 40 mg
126 Parasetamol Sirup 120 mg / 5 ml
127 Parasetamol Tablet 500 mg
 . .
128 parasetamol drop 100 mg/ ml
129 Phenobarbital 30 mg
130 Phenytoin 100 mg
131 Piridoksin HCL ( Vit.B6 ) Tablet 10 mg
132 Piroxicam Tablet 10 mg
133 Piroxicam Tablet 20 mg
134 Plastik klip
135 Prednison Tablet 5 mg
136 Ranitidin 150 mg
137 Ranitidine Injeksi
138 Ringer Laktat larutan Infus Steril
139 Salbutamol Tablet 2 mg
140 Salbutamol Tablet 4 mg
141 Salep 2-4
142 Salicyl Talk
143 Salbutamol nebules
144 Sarung Tangan no 7
145 Sarung Tangan No. 7,5
146 SARUNG TANGAN NO 8
147 Sarung Tangan M
148 Sendok Obat
149 Sefadroksil
150 Serum Anti tetanus Injeksi 1.500 IU / Amp.
151 Serum Anti Bisa Ular Polivalen Injeksi 5 ml vial
152 Simetidin 200 mg
153 Simvastatin 10 mg
154 Sulfasetamida Natrium tetes mata 15 %
155 Tambah Darah
156 Tablet zinc
157 Zink Sy
158 Thiamphenicol 500 mg
159 Tiamin HCL/ Monontrat (Vit .B1) Tablet 50 mg
160 Vitamin B Klompek
161 Vitamin C
162 Vitamin B12 Tablet
163 Yodium Povidon larutan 10 % 30 ml
164 Yodium Povidon larutan 10 % 300 ml
165 Anaria Syrup/curviplek
166 Alkohol swab
167 Sulfadiazine Silver
168 Bufacetin
169 Burnazin Krim
170 Bioplacenton Jelly
171 Dulcolax Supp
172 Dextrofen Syr.
173 Dextral Kaplet
174 Guanistrep Syrup
175 Hemorograd Tablet
176 Pulmicort
177 Jovial
178 Samcodin
179 Scopma
180 Samcobion
. .
 . .

( LPLPO RAWAT INAP PONED )

KD PUSKESMAS :P33210301
PUSKESMAS : GUNTUR I LAPORAN BULAN JANUARI
KECAMATAN : GUNTUR TAHUN 2021
KAB / KODYA : DEMAK
PROPINSI : JAWA TENGAH
KODE NAMA OBAT SATU STOK PENERI PERSE PEMA SISA PERMINT
NO
AN AWAL MAAN DIAAN KAIAN STOK AAN
1 2 3 4 5 6 7 8 9
1 A025 Aciclovir Tablet 200 mg TAB 0 0 0 0 0
2 A013 Aciclovir Salep Kulit TUBE 5 0 5 4 1
3 A026 Aciclovir Tablet 400 mg TAB 0 0 0 0 0
4 A005 Albendazole Tablet 400 mg TAB 0 0 0 0 0
5 A038 Alkohol larutan BTL 1 0 1 0 1
6 A006 Alupurinol Tablet 100 mg TAB 110 0 110 87 23
7 A051 Alupurinol Tablet 300 mg TAB 0 0 0 0 0
8 A030 Ambroxol Syrup 15mg/5ml BTL 7 0 7 0 7
9 A029 Ambroxol Tablet TAB 0 0 0 0 0
10 A047 Amoksisilin Syr Forte 250 mg/ 5 ml BTL 17 0 17 5 12
11 A010 Amoksisilina Kapsul 500 mg Kap 404 600 1004 622 382
12 A012 Amoksisilina Sirup kering 125 mg/5 ml TAB 0 0 0 0 0
13 Amoxicillin Drop BTL 6 0 6 1 5
14 A054 AMLODIPIN 10 MG TAB 113 0 113 65 48
15 A055 AMLODIPIN 5 MG TAB 33 100 133 85 48
16 A017 Antalgin ( Metampiron ) Tablet 500 mg TAB 0 0 0 0 0
17 A018 Antasida Doen suspensi btl. 60 ml BTL 15 15 30 18 12
18 A019 Antasida DOEN Tablet 500 mg TAB 547 300 847 353 494
19 A020 Anti Bakteri DOEN Salep kombinasi TUBE 0 0 0 0 0
20 A021 Anti Hemoroid DOEN Kombinasi SUPP 0 0 0 0 0
21 A022 Antifungi DOEN Kombinasi TUBE 4 0 4 1 3
22 A041 Aqua Pro Injeksi BTL 10 0 10 2 8
 . .

23 A028 Asam Askorbat (VitC ) Tablet 50 mg TAB 509 0 509 102 407
24 A037 Asam Folat Tablet TAB 70 0 70 21 49
25 A036 Asam Mefenamat 500 mg Kap 437 300 737 284 453
26 A023 Asam Tranexamat Injeksi AMP 0 0 0 0 0
27 A049 ASERING INFUS BTL 0 0 0 0 0
28 A035 Atrofin Sulfat Injeksi 0,25 mg AMP 5 0 5 0 5
29 A058 Attapulgite 600 mg/New Antides TAB 187 0 187 48 139
30 MINIASPI 0 0 0 0 0
31 B004 Betametason 0,1% krim TUBE 12 0 12 4 8
32 B018 BETAHISTIN 6 MG TAB 67 0 67 0 67
33 B017 Bisacodil TAB 5 mg TAB 0 0 0 0 0
34 B015 Bisacodil supp 10 mg SUPP 0 0 0 0 0
35 C002 Captopril Tablet 12,5 mg Tab 73 0 73 9 64
36 C003 Captopril Tablet 25 mg Tab 90 0 90 1 89
37 C021 CAPTOPRIL 50 MG TAB 0 0 0 0 0
38 C011 Cefotaxim Injeksi 1 g VIAL 0 0 0 0 0
39 C014 Ceftriaxone Injeksi VIAL 12 0 12 3 9
40 C007 Ciprofloksacin tablet 500 mg TAB 0 0 0 0 0
41 D002 Deksametason Injeksi 5 mg / ml - 1 ml AMP 14 0 14 7 7
42 D003 Deksametason Tablet 0,5 mg TAB 0 0 0 0 0
43 D008 Diazepam Injeksi 5 mg / Ml - 2 ml AMP 0 0 0 0 0
44 D022 Diazepam Rectal Tube/Stesolit TUBE 5 0 5 0 5
45 D009 Diazepam Tablet 2 mg TAB 0 0 0 0 0
46 D010 Diazepam Tablet 5 mg TAB 22 20 42 8 34
47 D013 Digoksin Tablet 0,25 mg TAB 75 0 75 0 75
48 D018 Dimenhidrinate 50 mg TAB 100 0 100 40 60
49 D023 Domperidon Syr 5mg/5 ml BTL 2 0 2 0 2
50 D025 Domperidon 10 MG TAB TAB 0 0 0 0 0
51 D5 FLAC 0 0 0 0 0
52 F001 Furosemida Tablet 40 mg TAB 18 0 18 0 18
53 EPINEPRINE/ ADRENALIN 0 5 5 0 5
54 Ekstra Daun Temouyung 0 0 0 0 0
 . .

55 F003 Fitomenadion (Vit K1) Tablet.s TAB 200 0 200 0 200

56 F004 Fenobarbital Inj 50 mg/ ml - 2 ml AMP 0 0 0 0 0
57 F007 Fitomenadion (Vit K1) Inj, 10 AMP 60 0 60 25 35
58 F012 Fitomenadion Inj 2 mg/ ml AMP 0 0 0 0 0
59 G003 Garam Oralit untuk 200 ml air BKS 4 0 4 1 3
60 GENTAMICIN TETES MATA 0 0 0 0 0
61 G004 Gentian Violet larutan 1 % BTL 0 0 0 0 0
62 G016 GEMFIBROZIL 300 MG TAB 50 0 50 0 50
63 G006 Glibenklamid Tablet 5 mg TAB 14 0 14 0 14
64 G007 Gliseril Guaiakolat Tablet 100 mg TAB 349 0 349 20 329
65 G014 GLIMEPIRIDE 2 MG TAB 50 0 50 7 43
66 GLUKONAS CALCII FLAC 0 0 0 0 0
67 H008 Hes 6 % BTL 50 30 80 0 80
68 H006 Hidroklorotiazid ( HCT ) Tablet 25 mg TAB 0 0 0 0 0
69 H004 Hidrokortison krim 2,5 % TUBE 10 0 10 5 5
70 H013 Hyoscin-N-Butilbromid tab 10 mg TAB 300 0 300 300 0
71 I001 Ibuprofen Tablet 200 mg TAB 0 0 0 0 0
72 I002 Ibuprofen Tablet 400 mg TAB 0 0 0 0 0
73 Infus set BUAH 0 0 0 0 0
74 I010 Isosorbit Dinitrat Tablet Sublingual 5 mg TAB 10 0 10 10 0
75 Kaen 3B BTL 0 0 0 0 0
76 K001 Ketokonazol 200 mg TAB 50 0 50 50 0
77 K004 Kalsium Laktat (kalk) Tablet 500 mg TAB 333 0 333 24 309
78 K040 Kalsium Gluconat inj in 10 % (100 mg/100ml) AMP 0 0 0 0 0
79 K028 Kotrimoksazol Susp 240 mg / 5 ml BTL 4 0 4 0 4
80 K029 Kotrimoksazol 480 mg Tablet TAB 425 0 425 0 425
81 K012 Ketokonazol salep TUBE 0 0 0 0 0
82 K039 Ketorolac inj 10 mg AMP 23 0 23 7 16
83 K014 Kloramfenikol Kapsul 250 mg KAP 0 0 0 0 0
84 Kloramfenikol Kapsul 500 mg KAP 222 200 422 300 122
85 K016 Kloramfenikol tetes telinga 3 % BTL 0 0 0 0 0
86 K024 Kloramfenikol tetes Mata BTL 0 0 0 0 0
 . .

87 K044 Kloramfenikol Susp 125 mg/ 5 ml BTL 11 0 11 5 6

88 K048 Kloramfenikol Salep kulit 2 % TUBE 0 0 0 0 0
89 Kloramfenicol drop BTL 5 0 5 5 0
90 Kloramfenikol Salep mata TUBE 15 0 15 12 3
91 K017 Klorfeniramin Maleat (CTM ) Tablet 4 mg TAB 580 0 580 90 490
92 K025 Kodein HCl tab 10 mg TAB 0 0 0 0 0
93 K047 KLINDAMISIN 300 MG KAP 0 0 0 0 0
94 L010 Lidokain HCL Injeksi AMP 57 0 57 0 57
95 L008 Lidokain Komp.Inj, Kombinasi : Lidokain HCl 2% + Epineprina 1 : 8AMP 12 0 12 12 0
96 L009 Lizol Mengandung Kresol tersabun 50 % BTL 0 0 0 0 0
97 L014 Loperamid Tablet 2 mg TAB 0 0 0 0 0
98 L015 Loratadin TAB 30 0 30 0 30
99 M002 Magnesium Sulfat Injeksi/MgSo4 AMP 2 0 2 0 2
100 Metamizole sodium TAB 164 0 164 51 113
101 M015 Metformin 850 mg TAB 0 0 0 0 0
102 Metformin 500 mg TAB 186 0 186 118 68
103 M007 Metilergometrin Maleat (Metilergometrin) Tablet Salut 0,125 mg TAB
85 0 85 85 0
104 M006 Metilergometrin Maleat Inj 0,200 mg 1 ml AMP 100 0 100 3 97
105 M022 Metoklopramid inj 5 mg/ml AMP 22 10 32 27 5
106 M023 Metoklopramid tab 10 mg TAB 0 0 0 0 0
107 M008 Metronidazol Tablet 250 mg TAB 0 0 0 0 0
108 M014 Metronidazole 500 mg TAB 60 200 260 6 254
109 M018 Mikonazole Cream TUBE 0 0 0 0 0
110 M025 Metilprednisolon 4 mg TAB 170 200 370 249 121
111 M026 Metilprednisolon 8 mg TAB 0 0 0 0 0
112 N011 Natrium Diklofenak Tablet 25 mg TAB 290 0 290 75 215
113 N012 Natrium Diklofenak Tablet 50 mg TAB 0 0 0 0 0
114 N002 Natrium Klorida larutan Infus 0, 9 % BTL 7 18 25 10 15
115 N013 Nifedipine 10 mg TAB 0 0 0 0 0
116 N004 Nistatin Tablet salut 500.000 IU TAB 0 0 0 0 0
117 Nistatin drop 0 0 0 0 0
 . .

118 N005 Nistatin Tablet Vaginal 100.000 IU / g TAB 0 0 0 0 0

119 N020 N-Asetil Sistein 200 mg KAP 141 200 341 187 154
120 OBH 2 0 2 2 0
121 O007 Oksitertrasiklin HCL Salep 3 % Salep Kulit TUBE 0 0 0 0 0
122 O008 Oksitetrasiklin HCL mata 1 % TUBE 0 0 0 0 0
123 O009 Oksitosin Injeksi 10 IU / ml - 1 ml AMP 14 0 14 0 14
124 Omepazol inj Vial 0 0 0 0 0
125 O023 Omeprazol kapsul 20 mg KAP 0 0 0 0 0
126 O017 Ondansetron injeksi 4 mg/2 ml AMP 6 0 6 6 0
127 P020 Papaverin 40 mg Tab 0 0 0 0 0
128 P002 Parasetamol Sirup 120 mg / 5 ml BTL 16 10 26 12 14
129 P004 Parasetamol Tablet 500 mg TAB 646 800 1446 823 623
130 P033 parasetamol drop 100 mg/ ml BTL 8 0 8 1 7
131 P028 Phenobarbital 30 mg TAB 0 0 0 0 0
132 P010 Piridoksin HCL ( Vit.B6 ) Tablet 10 mg TAB 452 0 452 48 404
133 P006 Piroxicam Tablet 10 mg TAB 0 0 0 0 0
134 P007 Piroxicam Tablet 20 mg TAB 0 0 0 0 0
135 P015 Prednison Tablet 5 mg TAB 384 0 384 102 282
136 R009 Ranitidin 150 mg Tab 0 0 0 0 0
137 R013 Ranitidine Injeksi AMP 0 0 0 0 0
138 R008 Ringer Laktat larutan Infus Steril BTL 37 120 157 97 60
139 RISPERIDON 2 MG TAB 10 0 10 10 0
140 SPUIT 1 ML BUAH 0 5 5 5 0
141 S001 Salbutamol Tablet 2 mg TAB 126 0 126 0 126
142 S002 Salbutamol Tablet 4 mg TAB 83 0 83 8 75
143 S004 Salep 2-4 TUBE 0 0 0 0 0
144 S023 Salicyl Talk BUAH 0 0 0 0 0
145 S054 Salbutamol nebules AMP 0 0 0 0 0
146 S026 Sarung Tangan no 7 BUAH 0 0 0 0 0
147 S050 Sarung Tangan No. 7,5 BUAH 0 0 0 0 0
148 S028 SARUNG TANGAN NO 8 BUAH 0 0 0 0 0
149 S051 Sarung Tangan M BUAH 150 0 150 150 0
 . .

150 S021 Sendok Obat pCS 0 0 0 0 0

151 S005 Sefadroksil KAP 0 0 0 0 0
152 Sefadroksil sy 7 0 7 4 3
153 S006 Serum Anti Bisa Ular Polivalen Injeksi 5 ml vial vial 3 0 3 0 3
154 S014 Simetidin 200 mg TAB 0 0 0 0 0
155 S030 Simvastatin 10 mg TAB 0 0 0 0 0
156 Simvastatin 20 mg 68 50 118 88 30
157 Sendok obat BUAH 0 0 0 0 0
158 T026 Tambah Darah TAB 847 0 847 429 418
159 T016 Tablet zinc TAB 104 0 104 13 91
160 Tetra 500 TAB 80 0 80 80 0
161 Zink Sy Sy 1 0 1 1 0
162 Triheksilfenidil Hidroklorida 2 mg TAB 10 0 10 10 0
163 T012 Thiamphenicol 500 mg KAP 0 0 0 0 0
164 T006 Tiamin HCL ( Vit. B 1 ) Injeksi 100 mg / ml -1 ml AMP 0 0 0 0 0
165 T007 Tiamin HCL/ Monontrat (Vit .B1) Tablet 50 mg TAB 472 200 672 280 392
166 V003 Vitamin B Klompek TAB 440 0 440 92 348
167 V005 Vitamin B12 Tablet TAB 370 0 370 0 370
168 Y002 Yodium Povidon larutan 10 % 30 ml BTL 0 0 0 0 0
169 Y004 Yodium Povidon larutan 10 % 300 ml BTL 0 0 0 0 0
MENGETAHUI YANG MEMINTA LAPORAN YANG MENYERAHKAN
Plt.KEPALA PUSKESMAS GUNTUR I PETUGAS SUB UNIT PETUGAS PONED

ROKHIS SAIDAH NORA MARITA SANDRA DYAH SUSANTI

NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
 . .

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

( LPLPO ) NON GENERIK

KD PUSKESMAS :P33210301
PUSKESMAS : GUNTUR I
KECAMATAN : GUNTUR
KAB / KODYA DEMAK
PROPINSI JAWA
: TENGAH

NO. KODE NAMA OBAT SATU STOK PENERI PERSE PEMA SISA PERMINT
AN AWAL MAAN DIAAN KAIAN STOK AAN
1 A058 Anaria Syrup/curviplek BTL 0 0 0 0 0
2 Alkohol swab 0 0 0 0 0
3 CURCUMA SY BTL 10 0 10 0 10
4 Sulfadiazine Silver 5 0 5 5 0
5 B016 Burnazin Krim TUBE 0 0 0 0 0
6 B020 Bioplacenton Jelly TUBE 0 0 0 0 0
7 Hypavik/ Fixomul Roll 1 0 1 0 1
8 D004 Dulcolax Supp Supp 0 0 0 0 0
9 G015 Guanistrep Syrup BTL 0 0 0 0 0
10 H005 Hemorograd Tablet TAB 0 0 0 0 0
11 Multivitamin,multimineral TAB 200 0 200 80 120
12 Pulmicort 0 0 0 0 0
13 Jovial SACHET 0 0 0 0 0
14 Samcodin TAB 0 0 0 0 0
15 S053 Samcobion Kap 0 0 0 0 0
16 T025 Tetagam 250 IU AMP 3 0 3 0 3
JUMLAH KUNJUNGAN RESEP Umum BPJS
36 13 23
MENGETAHUI YANG MEMINTA LAPORAN YANG MENYERAHKAN
Plt.KEPALA PUSKESMAS GUNTUR I PETUGAS SUB UNIT PETUGAS PONED

dr. ROKHIS SAIDAH NORA MARITA SANDRA DYAH SUSANTI

NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
. .
. .
 . .

( LPLPO RAWAT INAP PONED )

KD PUSKESMAS : P33210301
PUSKESMAS :GUNTUR I LAPORAN BULAN FEBRUARI
KECAMATAN : GUNTUR TAHUN 2021
KAB / KODYA : DEMAK
PROPINSI : JAWA TENGAH
KODE NAMA OBAT SATU STOK PENERI PERSE PEMA SISA PERMINT
NO
AN AWAL MAAN DIAAN KAIAN STOK AAN
1 A025 Aciclovir Tablet 200 mg TAB 0 0 0 0 0
2 A013 Aciclovir Salep Kulit TUBE 1 0 1 1 0
3 A026 Aciclovir Tablet 400 mg TAB 0 0 0 0 0
4 A005 Albendazole Tablet 400 mg TAB 0 0 0 0 0
5 A038 Alkohol larutan BTL 1 0 1 1 0
6 A006 Alupurinol Tablet 100 mg TAB 23 100 123 40 83
7 A051 Alupurinol Tablet 300 mg TAB 0 0 0 0 0
8 A030 Ambroxol Syrup 15mg/5ml BTL 7 0 7 2 5
9 A029 Ambroxol Tablet TAB 0 0 0 0 0
10 A047 Amoksisilin Syr Forte 250 mg/ 5 ml BTL 12 5 17 5 12
11 A010 Amoksisilina Kapsul 500 mg Kap 382 500 882 856 26
12 A012 Amoksisilina Sirup kering 125 mg/5 ml TAB 0 0 0 0 0
13 Amoxicillin Drop BTL 5 0 5 0 5
14 A054 AMLODIPIN 10 MG TAB 48 50 98 86 12
15 A055 AMLODIPIN 5 MG TAB 48 50 98 60 38
16 A017 Antalgin ( Metampiron ) Tablet 500 mg TAB 0 0 0 0 0
17 A018 Antasida Doen suspensi btl. 60 ml BTL 12 10 22 14 8
18 A019 Antasida DOEN Tablet 500 mg TAB 494 500 994 337 657
19 A020 Anti Bakteri DOEN Salep kombinasi TUBE 0 0 0 0 0
20 A021 Anti Hemoroid DOEN Kombinasi SUPP 0 0 0 0 0
21 A022 Antifungi DOEN Kombinasi TUBE 3 0 3 3 0
22 A041 Aqua Pro Injeksi BTL 8 0 8 1 7
23 A028 Asam Askorbat (VitC ) Tablet 50 mg TAB 407 0 407 33 374
24 A037 Asam Folat Tablet TAB 49 100 149 29 120
25 A036 Asam Mefenamat 500 mg Kap 453 300 753 498 255
26 A023 Asam Tranexamat Injeksi AMP 0 0 0 0 0
 . .

27 A049 ASERING INFUS BTL 0 0 0 0 0

28 A035 Atrofin Sulfat Injeksi 0,25 mg AMP 5 0 5 0 5
29 A058 Attapulgite 600 mg/New Antides TAB 139 0 139 45 94
30 MINIASPI 0 0 0 0 0
31 B004 Betametason 0,1% krim TUBE 8 0 8 8 0
32 B018 BETAHISTIN 6 MG TAB 67 0 67 67 0
33 B017 Bisacodil TAB 5 mg TAB 0 0 0 0 0
34 B015 Bisacodil supp 10 mg SUPP 0 0 0 0 0
35 C002 Captopril Tablet 12,5 mg Tab 64 0 64 0 64
36 C003 Captopril Tablet 25 mg Tab 89 0 89 7 82
37 C021 CAPTOPRIL 50 MG TAB 0 0 0 0 0
38 C011 Cefotaxim Injeksi 1 g VIAL 0 0 0 0 0
39 C014 Ceftriaxone Injeksi VIAL 9 10 19 0 19
40 C007 Ciprofloksacin tablet 500 mg TAB 0 0 0 0 0
41 D002 Deksametason Injeksi 5 mg / ml - 1 ml AMP 7 10 17 8 9
42 D003 Deksametason Tablet 0,5 mg TAB 0 200 200 74 126
43 D008 Diazepam Injeksi 5 mg / Ml - 2 ml AMP 0 0 0 0 0
44 D022 Diazepam Rectal Tube/Stesolit TUBE 5 0 5 0 5
45 D009 Diazepam Tablet 2 mg TAB 0 0 0 0 0
46 D010 Diazepam Tablet 5 mg TAB 34 0 34 0 34
47 D013 Digoksin Tablet 0,25 mg TAB 75 0 75 0 75
48 D018 Dimenhidrinate 50 mg TAB 60 0 60 60 0
49 D023 Domperidon Syr 5mg/5 ml BTL 2 0 2 2 0
50 D025 Domperidon 10 MG TAB TAB 0 0 0 0 0
51 D5 FLAC 0 0 0 0 0
52 F001 Furosemida Tablet 40 mg TAB 18 0 18 0 18
53 EPINEPRINE/ ADRENALIN 5 0 5 0 5
54 Ekstra Daun Temouyung 0 0 0 0 0
55 F003 Fitomenadion (Vit K1) Tablet.s TAB 200 0 200 0 200
56 F004 Fenobarbital Inj 50 mg/ ml - 2 ml AMP 0 0 0 0 0
57 F007 Fitomenadion (Vit K1) Inj, 10 AMP 35 0 35 5 30
58 F012 Fitomenadion Inj 2 mg/ ml AMP 0 0 0 0 0
59 G003 Garam Oralit untuk 200 ml air BKS 3 0 3 0 3
60 GENTAMICIN TETES MATA 0 0 0 0 0
 . .

61 G004 Gentian Violet larutan 1 % BTL 0 0 0 0 0

62 G016 GEMFIBROZIL 300 MG TAB 50 0 50 37 13
63 G006 Glibenklamid Tablet 5 mg TAB 14 0 14 0 14
64 G007 Gliseril Guaiakolat Tablet 100 mg TAB 329 0 329 12 317
65 G014 GLIMEPIRIDE 2 MG TAB 43 0 43 24 19
66 GLUKONAS CALCII FLAC 0 0 0 0 0
67 H008 Hes 6 % BTL 80 0 80 70 10
68 H006 Hidroklorotiazid ( HCT ) Tablet 25 mg TAB 0 0 0 0 0
69 H004 Hidrokortison krim 2,5 % TUBE 5 0 5 3 2
70 H013 Hyoscin-N-Butilbromid tab 10 mg TAB 0 0 0 0 0
71 I001 Ibuprofen Tablet 200 mg TAB 0 0 0 0 0
72 I002 Ibuprofen Tablet 400 mg TAB 0 100 100 10 90
73 Infus set BUAH 0 0 0 0 0
74 I010 Isosorbit Dinitrat Tablet Sublingual 5 mg TAB 0 50 50 21 29
75 Kaen 3B BTL 0 0 0 0 0
76 K001 Ketokonazol 200 mg TAB 0 0 0 0 0
77 K004 Kalsium Laktat (kalk) Tablet 500 mg TAB 309 0 309 13 296
78 K040 Kalsium Gluconat inj in 10 % (100 mg/100ml) AMP 0 0 0 0 0
79 K028 Kotrimoksazol Susp 240 mg / 5 ml BTL 4 0 4 4 0
80 K029 Kotrimoksazol 480 mg Tablet TAB 425 0 425 325 100
81 K012 Ketokonazol salep TUBE 0 0 0 0 0
82 K039 Ketorolac inj 10 mg AMP 16 0 16 6 10
83 K014 Kloramfenikol Kapsul 250 mg KAP 0 0 0 0 0
84 Kloramfenikol Kapsul 500 mg KAP 122 400 522 447 75
85 K016 Kloramfenikol tetes telinga 3 % BTL 0 0 0 0 0
86 K024 Kloramfenikol tetes Mata BTL 0 0 0 0 0
87 K044 Kloramfenikol Susp 125 mg/ 5 ml BTL 6 0 6 0 6
88 K048 Kloramfenikol Salep kulit 2 % TUBE 0 0 0 0 0
89 Kloramfenicol drop BTL 0 0 0 0 0
90 Kloramfenikol Salep mata TUBE 3 0 3 0 3
91 K017 Klorfeniramin Maleat (CTM ) Tablet 4 mg TAB 490 0 490 50 440
92 K025 Kodein HCl tab 10 mg TAB 0 0 0 0 0
93 K047 KLINDAMISIN 300 MG KAP 0 0 0 0 0
94 L010 Lidokain HCL Injeksi AMP 57 0 57 33 24
 . .

95 L008 Lidokain Komp.Inj, Kombinasi : Lidokain HCl 2% + Epineprina 1 : 8AMP 0 0 0 0 0

96 L009 Lizol Mengandung Kresol tersabun 50 % BTL 0 0 0 0 0
97 L014 Loperamid Tablet 2 mg TAB 0 0 0 0 0
98 L015 Loratadin TAB 30 0 30 10 20
99 M002 Magnesium Sulfat Injeksi/MgSo4 AMP 2 0 2 0 2
100 Metamizole sodium TAB 113 0 113 49 64
101 M015 Metformin 850 mg TAB 0 0 0 0 0
102 Metformin 500 mg TAB 68 0 68 28 40
103 M007 Metilergometrin Maleat (Metilergometrin) Tablet Salut 0,125 mg TAB 0 0 0 0 0
104 M006 Metilergometrin Maleat Inj 0,200 mg 1 ml AMP 97 100 197 55 142
105 M022 Metoklopramid inj 5 mg/ml AMP 5 0 5 2 3
106 M023 Metoklopramid tab 10 mg TAB 0 0 0 0 0
107 M008 Metronidazol Tablet 250 mg TAB 0 0 0 0 0
108 M014 Metronidazole 500 mg TAB 254 0 254 119 135
109 M018 Mikonazole Cream TUBE 0 0 0 0 0
110 M025 Metilprednisolon 4 mg TAB 121 200 321 251 70
111 M026 Metilprednisolon 8 mg TAB 0 0 0 0 0
112 N011 Natrium Diklofenak Tablet 25 mg TAB 215 200 415 153 262
113 N012 Natrium Diklofenak Tablet 50 mg TAB 0 0 0 0 0
114 N002 Natrium Klorida larutan Infus 0, 9 % BTL 15 0 15 5 10
115 N013 Nifedipine 10 mg TAB 0 0 0 0 0
116 N004 Nistatin Tablet salut 500.000 IU TAB 0 0 0 0 0
117 Nistatin drop 0 0 0 0 0
118 N005 Nistatin Tablet Vaginal 100.000 IU / g TAB 0 0 0 0 0
119 N020 N-Asetil Sistein 200 mg KAP 154 200 354 77 277
120 OBH 0 0 0 0 0
121 O007 Oksitertrasiklin HCL Salep 3 % Salep Kulit TUBE 0 0 0 0 0
122 O008 Oksitetrasiklin HCL mata 1 % TUBE 0 0 0 0 0
123 O009 Oksitosin Injeksi 10 IU / ml - 1 ml AMP 14 100 114 0 114
124 Omepazol inj Vial 0 10 10 2 8
125 O023 Omeprazol kapsul 20 mg KAP 0 0 0 0 0
126 O017 Ondansetron injeksi 4 mg/2 ml AMP 0 20 20 11 9
127 P020 Papaverin 40 mg Tab 0 0 0 0 0
 . .

128 P002 Parasetamol Sirup 120 mg / 5 ml BTL 14 5 19 9 10

129 P004 Parasetamol Tablet 500 mg TAB 623 500 1123 510 613
130 P033 parasetamol drop 100 mg/ ml BTL 7 0 7 0 7
131 P028 Phenobarbital 30 mg TAB 0 0 0 0 0
132 P010 Piridoksin HCL ( Vit.B6 ) Tablet 10 mg TAB 404 0 404 144 260
133 P006 Piroxicam Tablet 10 mg TAB 0 0 0 0 0
134 P007 Piroxicam Tablet 20 mg TAB 0 0 0 0 0
135 P015 Prednison Tablet 5 mg TAB 282 0 282 146 136
136 R009 Ranitidin 150 mg Tab 0 0 0 0 0
137 R013 Ranitidine Injeksi AMP 0 0 0 0 0
138 R008 Ringer Laktat larutan Infus Steril BTL 60 0 60 0 60
139 RISPERIDON 2 MG TAB 0 0 0 0 0
140 SPUIT 1 ML BUAH 0 0 0 0 0
141 S001 Salbutamol Tablet 2 mg TAB 126 0 126 0 126
142 S002 Salbutamol Tablet 4 mg TAB 75 0 75 25 50
143 S004 Salep 2-4 TUBE 0 0 0 0 0
144 S023 Salicyl Talk BUAH 0 0 0 0 0
145 S054 Salbutamol nebules AMP 0 0 0 0 0
146 S026 Sarung Tangan no 7 BUAH 0 0 0 0 0
147 S050 Sarung Tangan No. 7,5 BUAH 0 0 0 0 0
148 S028 SARUNG TANGAN NO 8 BUAH 0 0 0 0 0
149 S051 Sarung Tangan M BUAH 0 0 0 0 0
150 S021 Sendok Obat pCS 0 0 0 0 0
151 S005 Sefadroksil KAP 0 0 0 0 0
152 Sefadroksil sy 3 8 11 1 10
153 S006 Serum Anti Bisa Ular Polivalen Injeksi 5 ml vial vial 3 0 3 0 3
154 S014 Simetidin 200 mg TAB 0 0 0 0 0
155 S030 Simvastatin 10 mg TAB 0 0 0 0 0
156 Simvastatin 20 mg 30 100 130 56 74
157 Sendok obat BUAH 0 0 0 0 0
158 T026 Tambah Darah TAB 418 0 418 138 280
159 T016 Tablet zinc TAB 91 0 91 31 60
160 Tetra 500 TAB 0 0 0 0 0
161 Zink Sy Sy 0 0 0 0 0
 . .

162 Triheksilfenidil Hidroklorida 2 mg TAB 0 0 0 0 0

163 T012 Thiamphenicol 500 mg KAP 0 0 0 0 0
164 T006 Tiamin HCL ( Vit. B 1 ) Injeksi 100 mg / ml -1 ml AMP 0 0 0 0 0
165 T007 Tiamin HCL/ Monontrat (Vit .B1) Tablet 50 mg TAB 392 200 592 249 343
166 V003 Vitamin B Klompek TAB 348 0 348 181 167
167 V005 Vitamin B12 Tablet TAB 370 0 370 11 359
168 Y002 Yodium Povidon larutan 10 % 30 ml BTL 0 0 0 0 0
169 Y004 Yodium Povidon larutan 10 % 300 ml BTL 0 0 0 0 0
MENGETAHUI YANG MEMINTA LAPORAN YANG MENYERAHKAN
Plt.KEPALA PUSKESMAS GUNTUR I PETUGAS SUB UNIT PETUGAS PONED

ROKHIS SAIDAH NORA MARITA SANDRA DYAH SUSANTI

NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
 . .

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

( LPLPO ) NON GENERIK

KD PUSKESMAS :P33210301
PUSKESMAS :GUNTUR I
KECAMATAN : GUNTUR
KAB / KODYA DEMAK
PROPINSI JAWA
: TENGAH
NO. KODE NAMA OBAT SATU STOK PENERI PERSE PEMA SISA PERMINT
AN AWAL MAAN DIAAN KAIAN STOK AAN
1 A058 Anaria Syrup/curviplek BTL 0 0 0 0 0
2 Alkohol swab 0 0 0 0 0
3 CURCUMA SY BTL 10 0 10 0 10
4 Sulfadiazine Silver 0 0 0 0 0
5 B016 Burnazin Krim TUBE 0 0 0 0 0
6 B020 Bioplacenton Jelly TUBE 0 0 0 0 0
7 Hypavik/ Fixomul Roll 1 0 1 1 0
8 D004 Dulcolax Supp Supp 0 0 0 0 0
9 G015 Guanistrep Syrup BTL 0 0 0 0 0
10 H005 Hemorograd Tablet TAB 0 0 0 0 0
11 Multivitamin,multimineral TAB 120 0 120 102 18
12 Pulmicort 0 0 0 0 0
13 Jovial SACHET 0 0 0 0 0
14 Samcodin TAB 0 0 0 0 0
15 S053 Samcobion Kap 0 0 0 0 0
16 T025 Tetagam 250 IU AMP 3 5 8 5 3
17 SODIUM CHLORIDE BKS 0 10 10 10 0
18 RAPID ANTIGEN PCS 0 25 25 11 14
19 LANSOPRAZOLE 30 ML CAPS 0 60 60 56 4
20 BECEFORT TAB 0 100 100 88 12
JUMLAH KUNJUNGAN RESEP Umum BPJS
31 11 20
MENGETAHUI YANG MEMINTA LAPORAN YANG MENYERAHKAN
Plt.KEPALA PUSKESMAS GUNTUR I PETUGAS SUB UNIT PETUGAS PONED

dr. ROKHIS SAIDAH NORA MARITA SANDRA DYAH SUSANTI

NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
. .
 LAPORAN PEMAKAIAN DAN LEMBAR PERM
( LPLPO )
KD PUSKESMAS P3321120101
PUSKESMAS MIJEN I
KECAMATAN MIJEN
:
KAB / KODYA : DEMAK
PROPINSI : JAWA TENGAH

NO. KODE NAMA OBAT SATU STOK PENERI PERSE

AN AWAL MAAN DIAAN
1 2 3 4 5 6 7
1 A025 Aciclovir Tablet 200 mg TAB 0
2 A013 Aciclovir Salep Kulit TUBE 0
3 A026 Aciclovir Tablet 400 mg TAB 0
4 A001 Alat Suntik Sekali Pakai 0,05 ml BUAH 0
5 A002 Alat Suntik Sekali Pakai 0,5 ml SET 0
6 A003 Alat Suntik Sekali Pakai 3 ml SET 0
7 A004 Alat Suntik Sekali Pakai 5 ml SET 0
8 A053 Alat Suntik Sekali Pakai 1 ml SET 0
9 A052 Alat Suntik Sekali Pakai 20 ml SET 0
10 A005 Albendazole Tablet 400 mg TAB 0
11 A038 Alkohol larutan BTL 0
12 A006 Alupurinol Tablet 100 mg TAB 0
13 A051 Alupurinol Tablet 300 mg TAB 0
14 A050 ALPRAZOLAM 0,5 MG TAB 0
15 A030 Ambroxol Syrup 15mg/5ml BTL 0
16 A029 Ambroxol Tablet TAB 0
17 A007 Aminofilina Injeksi 24 mg/ml - 10 ml AMP 0
18 A008 Aminofilina Tablet 200 mg TAB 0
19 A045 Amitriptilin 25 mg TAB 0
20 A047 Amoksisilin Syr Forte 250 mg/ 5 ml BTL 0
21 A010 Amoksisilina Kapsul 500 mg Kap 0
22 A012 Amoksisilina Sirup kering 125 mg/5 ml TAB 0
23 A054 AMLODIPIN 10 MG TAB 0
24 A055 AMLODIPIN 5 MG TAB 0
25 A046 Ampisilin inj 1000 mg VIAL 0
26 A014 Ampisilin kapsul 500 mg Kap 0
27 A017 Antalgin ( Metampiron ) Tablet 500 mg TAB 0
28 A018 Antasida Doen suspensi btl. 60 ml BTL 0
29 A019 Antasida DOEN Tablet 500 mg TAB 0
30 A020 Anti Bakteri DOEN Salep kombinasi TUBE 0
31 A021 Anti Hemoroid DOEN Kombinasi SUPP 0
32 A022 Antifungi DOEN Kombinasi TUBE 0
33 A041 Aqua Pro Injeksi BTL 0
34 A056 ASETOSAL 80 MG TAB 0
35 A027 Asam Askorbat (VitC ) Tablet 250 mg TAB 0
36 A028 Asam Askorbat (VitC ) Tablet 50 mg TAB 0
37 A037 Asam Folat Tablet TAB 0
38 A036 Asam Mefenamat 500 mg Kap 0
39 A023 Asam Tranexamat Injeksi AMP 0
40 A049 ASERING INFUS BTL 0
41 A035 Atrofin Sulfat Injeksi 0,25 mg AMP 0
42 A058 Attapulgite 600 mg TAB 0
43 B004 Betametason 0,1% krim TUBE 0
44 B018 BETAHISTIN 6 MG TAB 0
45 B019 BENZATIN BENZIL PENISILIN INJ VIAL 0
46 B001 Bisturi PCS 0
47 B017 Bisacodil TAB 5 mg TAB 0
48 B015 Bisacodil supp 10 mg SUPP 0
49 B021 BLOOD LANCET 26 G BOX 0
50 B013 Bromhexin tab TAB 0
51 C002 Captopril Tablet 12,5 mg Tab 0
52 C003 Captopril Tablet 25 mg Tab 0
53 C021 CAPTOPRIL 50 MG TAB 0
54 C001 Catgut / Benang Bedah No.2/0 - 3/0 dengan Jarum Bedah SET 0
55 C011 Cefotaxim Injeksi 1 g VIAL 0
56 C014 Ceftriaxone Injeksi VIAL 0
57 C007 Ciprofloksacin tablet 500 mg TAB 0
58 C018 Clozapine 100 mg tab TAB 0
59 C007 Clozapine 25 mg tab TAB 0
60 C020 CLOBAZAM 10 MG TAB 0
61 C022 COTTON SWAB SET 0
62 C023 COVER GLASS 20 X 20 BOX 0
63 C019 CUTICELL CLASSIC 10 CM X 10 CM BUAH 0
64 D002 Deksametason Injeksi 5 mg / ml - 1 ml AMP 0
65 D003 Deksametason Tablet 0,5 mg TAB 0
66 D008 Diazepam Injeksi 5 mg / Ml - 2 ml AMP 0
67 D022 Diazepam Rectal Tube TUBE 0
68 D009 Diazepam Tablet 2 mg TAB 0
69 D010 Diazepam Tablet 5 mg TAB 0
70 D019 DIETHIL CARBAMAZINE 100 MG TAB 0
71 D012 Difenhidramin HCL Injeksi 10 mg/ml - 1 ml AMP 0
72 D013 Digoksin Tablet 0,25 mg TAB 0
73 D018 Dimenhidrinate 50 mg TAB 0
74 D023 Domperidon Syr 5mg/5 ml BTL 0
75 D025 Domperidon 10 MG TAB TAB 0
76 D020 Doxycicline 100 mg TAB 0
77 E001 Efedrin HCL Tablet 25 mg TAB 0
78 E002 Ekstrak belladon tablet 10 mg TAB 0
79 E003 Epinefrina Hcl/Bitatrat ( ADRENALIN) AMP 0
80 E010 Erythromicin 250 mg Cap 0
81 E011 Erythromicin 500 mg Cap 0
 82 E005 Etakridin ( Rivanol ) Larutan 0,1 % BTL 0
83 E008 Etylchloride Spray 100 ml BTL 0
84 E009 Eugenol cairan BTL 0
85 F001 Furosemida Tablet 40 mg TAB 0
86 F003 Fitomenadion (Vit K1) Tablet.s TAB 0
87 F004 Fenobarbital Inj 50 mg/ ml - 2 ml AMP 0
88 F007 Fitomenadion (Vit K1) Inj, 10 AMP 0
89 F012 Fitomenadion Inj 2 mg/ ml AMP 0
90 F008 Fenol Gliserol Tetes Telinga BTL 0
91 F013 Fluphenazine Decanoat 25 mg/ml AMP 0
92 F014 Fluconazol 150 mg TAB 0
93 F015 FIXOMULL STRETCH 5 CM X 5 CM ROLL 0
94 G003 Garam Oralit untuk 200 ml air BKS 0
95 G004 Gentian Violet larutan 1 % BTL 0
96 G016 GEMFIBROZIL 300 MG TAB 0
97 G006 Glibenklamid Tablet 5 mg TAB 0
98 G007 Gliseril Guaiakolat Tablet 100 mg TAB 0
99 G014 GLIMEPIRIDE 2 MG TAB 0
100 G011 Glukose larutan Infus 5 % steril BTL 0
101 G012 Griseofulvin Tablet 125 mg Micronized TAB 0
102 H0014 Haloperidol inj 50 mg/ml AMP 0
103 H001 Haloperidol Tablet 0,5 mg TAB 0
104 H002 Haloperidol Tablet 1,5 mg TAB 0
105 H003 Haloperidol Tablet 5 mg TAB 0
106 H016 HAND RUB BTL 0
107 H008 Hes 6 % BTL 0
108 H006 Hidroklorotiazid ( HCT ) Tablet 25 mg TAB 0
109 H004 Hidrokortison krim 2,5 % TUBE 0
110 H013 Hyoscin-N-Butilbromid tab 10 mg TAB 0
111 I001 Ibuprofen Tablet 200 mg TAB 0
112 I002 Ibuprofen Tablet 400 mg TAB 0
113 I003 Infusion set anak SET 0
114 I004 Infusion set dewasa SET 0
115 I012 Iodium Test BTL 0
116 I010 Isosorbit Dinitrat Tablet Sublingual 5 mg TAB 0
117 I016 IV Cateter No. 18 BUAH 0
118 I013 IV Cateter No. 20 BUAH 0
119 I006 IV Cateter No. 22 BUAH 0
120 I014 IV Cateter No. 24 BUAH 0
121 I017 ILIADIN DROP BTL 0
122 I018 ILIADIN SPRAY BTL 0
123 I019 IBUPROFEN SUSP BTL 0
124 J001 Jarum Jahit (bedah) BIJI 0
125 K001 Ketokonazol 200 mg 0
126 K002 Kalsium Glukonat inj 10 % (100mg/ml) AMP 0
127 K004 Kalsium Laktat (kalk) Tablet 500 mg TAB 0
128 K005 Kapas Berlemak 500 gr ROL 0
129 K006 Kapas Pembalut / Absorben 250 gr ROL 0
130 K007 Karbamazepin Tablet 200 mg TAB 0
131 K008 Kasa Kompres 40/40 Steril LBR 0
132 K010 Kasa Pembalut Hidrofil 4 x 15 cm BUAH 0
133 K011 Kasa Pembalut Hidrofil 4 x 3 cm BUAH 0
134 K037 Kasa Pembalut Hidrofil 4 M x 10 cm BUAH 0
135 K041 Kasa Steril 16 cm x 16 cm BOX 0
136 K042 Kaca Sediaan (Obyek Glass/SLIDE) BOX 0
137 K043 Kotak Sediaan/ BOX SLIDE BOX 0
138 K040 Kalisium Gluconat inj in 10 % (100 mg/100ml) AMP 0
139 K012 Ketokonazol salep TUBE 0
140 K039 Ketorolac inj 10 mg AMP 0
141 K014 Kloramfenikol Kapsul 250 mg KAP 0
142 K015 Kloramfenikol Salep mata 1 % TUBE 0
143 K016 Kloramfenikol tetes telinga 3 % BTL 0
144 K024 Kloramfenikol tetes Mata BTL 0
145 K044 Kloramfenikol Susp 125 mg/ 5 ml BTL 0
146 K048 Kloramfenikol Salep kulit 2 % TUBE 0
147 K017 Klorfeniramin Maleat (CTM ) Tablet 4 mg TAB 0
148 K025 Kodein HCl tab 10 mg TAB 0
149 K019 Klorpromazin HCL inj 25 mg/ml-1ml AMP 0
150 K022 Klorpromazin HCL Tablet salut 100 mg TAB 0
151 K021 Klorpromazin HCL Tablet salut 25 mg TAB 0
152 K045 KA-EN 3A SOL/K BTL 0
153 K046 KA-EN 3B SOL/K BTL 0
154 K047 KLINDAMISIN 300 MG KAP 0
155 L010 Lidokain HCL Injeksi AMP 0
156 L008 Lidokain Komp.Inj, Kombinasi : Lidokain HCl 2% + EpineprinAMP 0
157 L009 Lizol Mengandung Kresol tersabun 50 % BTL 0
158 L014 Loperamid Tablet 2 mg TAB 0
159 L015 Loratadin TAB 0
160 M002 Magnesium Sulfat Injeksi AMP 0
161 M016 Masker BUAH 0
162 M024 Masker N95 BUAH 0
163 M017 Mercury Liquid BTL 0
164 M015 Metformin TAB 0
165 M007 Metilergometrin Maleat (Metilergometrin) Tablet Salut 0,125
TAB 0
166 M006 Metilergometrin Maleat Inj 0,200 mg 1 ml AMP 0
167 M022 Metoklopramid inj 5 mg/ml AMP 0
168 M023 Metoklopramid tab 10 mg TAB 0
169 M008 Metronidazol Tablet 250 mg TAB 0
170 M014 Metronidazole 500 mg TAB 0
171 M018 Mikonazole Cream TUBE 0
172 M019 Minyak Kayu Putih BTL 0
173 M020 Minyak Telon BTL 0
174 M025 Metilprednisolon 4 mg TAB 0
175 M026 Metilprednisolon 8 mg TAB 0
176 M021 Mineral Mix Bungkus 0
177 N011 Natrium Diklofenak Tablet 25 mg TAB 0
178 N012 Natrium Diklofenak Tablet 50 mg TAB 0
179 N002 Natrium Klorida larutan Infus 0, 9 % BTL 0
180 N013 Nifedipine 10 mg TAB 0
181 N004 Nistatin Tablet salut 500.000 IU TAB 0
182 N005 Nistatin Tablet Vaginal 100.000 IU / g TAB 0
183 N020 N-Asetil Sistein 200 mg KAP 0
184 O001 Obat anti tuberkulosis kategori I BOX 0
185 O002 Obat anti tuberkulosis kategori II BOX 0
186 O003 obat anti tuberkulosis sisipan BOX 0
187 O004 Obat anti tuberkulosis anak BOX 0
188 O011 Obat Batuk Hitam ( O B H ) BTL 0
189 O012 Obat Kusta PB Dewasa Blister 0
190 O013 Obat Kusta PB Anak Blister 0
191 O014 Obat Kusta MB Dewasa Blister 0
192 O015 Obat Kusta MB Anak Blister 0
193 O022 OAT Kategori I Dewasa-KOMBIPAK BOX 0
194 O007 Oksitertrasiklin HCL Salep 3 % Salep Kulit TUBE 0
195 O008 Oksitetrasiklin HCL mata 1 % TUBE 0
196 O009 Oksitosin Injeksi 10 IU / ml - 1 ml AMP 0
197 O023 Omeprazol kapsul 20 mg KAP 0
198 O017 Ondansetron injeksi 4 mg/2 ml AMP 0
199 P020 Papaverin 40 mg Tab 0
200 P002 Parasetamol Sirup 120 mg / 5 ml BTL 0
201 P004 Parasetamol Tablet 500 mg TAB 0
202 p033 parasetamol drop 100 mg/ ml BTL 0
203 P021 Phenilbutazon 200 mg Tab 0
204 P028 Phenobarbital 30 mg TAB 0
205 P036 Phenytoin 100 mg KAP 0
206 P010 Piridoksin HCL ( Vit.B6 ) Tablet 10 mg TAB 0
207 P006 Piroxicam Tablet 10 mg TAB 0
208 P007 Piroxicam Tablet 20 mg TAB 0
209 P011 Plester 5 Yard x 2 Inch ROL 0
210 P012 Plastik klip PCS 0
211 P034 Pot Sputum (Pot Dahak) BUAH 0
212 P015 Prednison Tablet 5 mg TAB 0
213 P018 Propanolol HCL Tablet 100 mg TAB 0
214 P030 Propanolol HCL Tablet 40 mg TAB 0
215 P035 Propanolol tab 10 mg TAB 0
216 P019 Propiltiourasil Tablet 100 mg TAB 0
217 R009 Ranitidin 150 mg Tab 0
218 R013 Ranitidine Injeksi AMP 0
219 R011 Retinol ( Vitamin A ) Kapsul 200. 000 IU KAP 0
220 R012 Retinol (Vitamin A) Kapsul 100.000 UI Kap 0
221 R008 Ringer Laktat larutan Infus Steril BTL 0
222 R014 Risperidon 2 mg TAB 0
223 R016 Reagen ZN-BTA SET 0
224 R017 Reagen HIV SD 1 (ke-1) SET 0
225 R018 Reagen HBs-AG (VIKIA) BOX 0
226 R019 Reagen HIV 1 & 2 Antibody (ke-3) SET 0
227 R020 Reagen Rapid 1/2 HIV (ke-2) SET 0
228 R021 Reagen Syphilis 3.0 SET 0
229 R022 Reagen HAV (HEPATITIS A) BOX 0
230 S031 Safety Box BUAH 0
231 S001 Salbutamol Tablet 2 mg TAB 0
232 S002 Salbutamol Tablet 4 mg TAB 0
233 S004 Salep 2-4 TUBE 0
234 S023 Salicyl Talk BUAH 0
235 S054 Salbutamol nebules AMP 0
236 S026 Sarung Tangan no 7 BUAH 0
237 S050 Sarung Tangan No. 7,5 BUAH 0
238 S028 SARUNG TANGAN NO 8 BUAH 0
239 S051 Sarung Tangan M BUAH 0
240 S021 Sendok Obat pCS 0
241 S005 Sefadroksil KAP 0
242 S0009 Serum Anti tetanus Injeksi 1.500 IU / Amp. AMP 0
243 S006 Serum Anti Bisa Ular Polivalen Injeksi 5 ml vial vial 0
244 S011 Sianokobalamin ( Vit B 12 ) Injeksi 500 mcq/ml-1ml AMP 0
245 S012 Silk ( Benang Bedah Sutera ) No.3/0 12x3x75 cm de SET 0
246 S014 Simetidin 200 mg TAB 0
247 S030 Simvastatin 10 mg TAB 0
248 S020 Sulfasetamida Natrium tetes mata 15 % BTL 0
249 T026 Tambah Darah NEO TAB 0
250 T016 Tablet zinc TAB 0
251 T004 Tetrasiklin HCL Kapsul 250 mg KAP 0
252 T005 Tetrasiklin HCL Kapsul 500 mg KAP 0
253 T012 Thiamphenicol 500 mg KAP 0
254 T006 Tiamin HCL ( Vit. B 1 ) Injeksi 100 mg / ml -1 ml AMP 0
255 T007 Tiamin HCL/ Monontrat (Vit .B1) Tablet 50 mg TAB 0
256 T008 Tramadol 50 mg Tablet TAB 0
257 T021 Tramadol inj AMP 0
258 T024 Trifluoperazin tab 5 mg Tab 0
259 T027 Tabung Reaksi Vacutainer (Tutup Merah) Box 0
260 T010 Triheksilfenidil Hidroklorida Tablet 2 mg TAB 0
261 V003 Vitamin B Klompek TAB 0
262 V005 Vitamin B12 Tablet TAB 0
263 Y002 Yodium Povidon larutan 10 % 30 ml BTL 0
264 Y004 Yodium Povidon larutan 10 % 300 ml BTL 0
 Mengetahui / Menyetujui Yang Menyerahkan
Kepala Dinas Kesehatan Kab.Demak Kabid.Bind.Farmasi dan Perbekes

LAPORAN PEMAKAIAN DAN LEMBAR PERM

( LPLPO ) NON GEN

KD PUSKESMAS P3321120101
PUSKESMAS MIJEN I
KECAMATAN MIJEN
:
KAB / KODYA DEMAK
PROPINSI :JAWA TENGAH

NO. KODE NAMA OBAT SATU STOK PENERI PERSE

AN AWAL MAAN DIAAN
1 2 3 4 5 6 7
1 A058 Anaria Syrup BTL 0
2 B016 Burnazin Krim TUBE 0
3 D004 Dulcolax Supp Supp 0
4 D016 Dextrofen Syr. SYR 0
5 G015 Guanistrep Syrup BTL 0
6 H005 Hemorograd Tablet TAB 0
7 I017 Iliadin Drops-Oksimetazolin tetes hidung BTL 0
8 I018 Iliadin Spray-Oksimetazolin tetes hidung BTL 0
9 M019 Minyak Kayu Putih BTL 0
10 S053 Samcobion Kap 0
11 S048 Scabimite cr TUBE 0
12 S019 Spashi Injeksi AMP 0
13 T025 Tetagam 250 IU AMP 0
14 V012 Vidabion Cal CAP 0

JUMLAH KUNJUNGAN RESEP Bayar Gratis Jamkesmas

Mengetahui / Menyetujui Yang Menyerahkan

Kepala Dinas Kesehatan Kab.Demak Kabid.Bind.Farmasi dan Perbekes
AIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )

LAPORAN BULAN : 01
TAHUN : 2012
PERMINTAAN BLN : -
TAHUN : 2012

PEMA SISA STOK PERMIN PEMBERIAN

KAIAN STOK OPT TAAN PKD PHB APBD LAIN JML
8 9 10 11 12 13 14 15 16
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
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
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
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
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
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
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
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
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
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
0
0
0
0
 Melaporkan / Meminta Yang menerima
an Perbekes Kepala Puskesmas Mijen I Pengelola Obat

AIAN DAN LEMBAR PERMINTAAN OBAT

( LPLPO ) NON GENERIK

LAPORAN BULAN :
TAHUN : 2012
PERMINTAAN BLN : -
TAHUN : 2011

PEMA SISA STOK PERMIN PEMBERIAN

KAIAN STOK OPT TAAN PKD PHB APBD LAIN JML
8 9 10 11 12 13 14 15 16
0
0
0
0
0
0
0
0
0
0
0
0
 0
0

Jamkesmas UKS ASKES JUMLAH

0

Melaporkan / Meminta Yang menerima

an Perbekes Kepala Puskesmas Mijen I Pengelola Obat
KET

17
KET

17