LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

(LPLPO)

Kode Puskesm :
Puskesmas : Ansus
Distrik : Yapen Barat Bulan : Juli
Kabupaten : Kepulauan Yapen Tahun : 2022
Provinsi : Papua

STOK SISA STOK

NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN RUSAK/ED PERMINTAAN
AWAL STOK OPT
1 Acetylcysteine 200 mg Tablet 0 1,000 1,000 200 0 800
Allopurinol 100 mg Tablet Tablet 500 1,700 2,200 300 0 1,900
2 Ambroksol 30 mg tab Tablet 600 1,500 2,100 400 0 1,700
3 Aminofillin 200 mg Tablet Tablet 0 0 0 0 0 0
4 Aminofillin Injeksi 24 mg/ml-10 ml Ampul 10 0 10 2 ED 8
5 Amlodipin 5 mg tab Tablet 100 0 100 0 0 100
6 Amlodipin 10 mg tab Tablet 0 0 0 0 0 0
7 Amoksisillin 125 mg Sirup/ 5 ml Botol 60 ml 0 89 89 65 0 24
8 Amoksisillin 250 mg kapsul Kapsul 0 0 0 0 0 0
9 Amoksisillin 250 mg Sirup/ 5 ml Botol 60 ml 0 0 0 0 0 0
10 Amoksisillin 500 mg Tablet Tablet 0 12,000 12,000 3,000 0 9,000
11 Ampisillin 1000 mg Injeksi (Vicillin) Vial 10 20 30 0 0 30
12 Antalgin injeksi Ampul 0 0 0 0 0 0
13 Antasid DOEN Tablet kombinasi Tablet 0 3,000 3,000 900 0 2,100
14 Antasid Suspensi Botol 60 ml 20 100 120 39 0 81
15 Anti Bakteri DOEN Salep kombinasi tube 0 0 0 0 0 0
16 Anti Fungi DOEN Kombinasi Pot 6 24 30 6 0 24
17 Anti Haemoroid Suppositoria supp 0 0 0 0 0 0
18 Aqua Demin Onelab 1 Ltr Botol 1L 0 0 0 0 0 0
19 Aqua Pro Injeksi Bebas Pirogen Botol 25 ml 0 20 20 0 0 20
20 Asam Askorbat 50 mg Tablet Tablet 700 5,000 5,700 200 0 5,500
21 Asam Mefenamat 500 mg Tablet 1,300 5,000 6,300 700 0 5,600
22 Asam Traneksamat injeksi 100 mg/ml Ampul 0 20 20 0 0 20
23 Asam Traneksamat 500 mg Tablet 0 0 0 0 0 0
24 Asiklovir 2% cream Tube 0 10 10 10 0 0
25 Asiklovir Tablet 200 mg Tablet 100 0 100 0 0 100
 26 Asiklovir Tablet 400 mg Tablet 50 0 50 0 0 50
27 Azithromycin 500 mg tablet Tablet 80 0 80 0 0 80
28 Betametasone Krim 0,1% tube 0 100 100 0 0 100
29 Captopril Tablet 12,5 mg Tablet 100 500 600 100 0 500

Puskesmas :

STOK SISA STOK

NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN RUSAK/ED PERMINTAAN
AWAL STOK OPT
30 Captopril Tablet 25 mg Tablet 0 0 0 0 0 0
31 Cefadroxyl 250 mg sirker btl 60 ml 53 0 53 20 0 33
32 Cefadroxyl 500 mg kapsul Kapsul 1,000 0 1000 300 0 700
33 Cefixime 100 mg Kapsul 90 0 90 0 0 90
33 Ceftriaxone injeksi 1 g Vial 10 0 10 0 0 10
34 Cetirizine 10 mg Tablet 0 0 0 0 0 0
35 Cetirizine 5 mg/5 ml Ampul 0 0 0 0 0 0
36 Ciprofloxacin 500 mg Tablet 100 0 100 0 0 100
37 Citicolin injeksi Ampul 0 0 0 0 0 0
35 Deksametasone 0,5 mg tab Tablet 3,000 10,000 13,000 2,100 0 10,900
36 Deksametasone 5 mg/ml-1 ml inj Ampul 160 200 360 29 0 331
37 Difenhidramin HCl Injeksi 10 mg/ml-10 ml Vial 0 0 0 0 0 0
38 Difenhidramin HCl Injeksi 10 mg/ml-1 ml Ampul 15 30 45 1 0 44
39 Digoxin Tablet 0,5 mg Tablet 100 0 100 0 0 100
40 Dimenhidrinat tablet 50 mg Tablet 300 0 300 0 0 300
41 Domperidon 10 mg Tablet Tablet 0 500 500 0 0 500
42 Domperidon 5 mg/5 ml sirup Botol 60 ml 0 0 0 0 0 0
43 Epinefrin HCL inj Ampul 0 0 0 0 0 0
44 Ergotamine Caffeine Botol 0 0 0 0 0 0
45. Erythromycin 200 mg/ml Botol 0 30 30 10 0 20
44 Eritromisin kapsul 250 mg Kapsul 200 500 700 0 0 700
45 Erythromycin 500 mg Kaplet Tablet 100 500 600 200 0 400
46 Etakridina ( Rivanol ) Larutan 0,1% 100 ml botol 100 ml 10 0 10 0 0 10
47 Etakridina ( Rivanol ) Larutan 0,1% 300 ml Botol 300 ml 6 0 6 3 0 3
48 Etanol 70% Larutan Btl 100 ml 0 0 0 0 0 0
49 Etanol 70% Larutan Btl 300 ml 8 0 8 0 0 8
50 Etanol 70% Larutan Btl 1000 ml 5 0 5 0 0 5
51 Etil Klorida Semprot Btl 100 ml 0 0 0 0 0 0
52 Fenilbutazon tablet 200 mg Tablet 0 0 0 0 0 0
53 Fenol Gliserol Tetes Telinga 10% botol 6 0 6 0 ED 6
 54 Fitomenadion (vit. K) Injeksi 10 mg/ml-1 ml Ampul 15 30 45 5 0 40
55 Fitomenadion (vit. K) Tablet 10 mg Tablet 0 200 200 100 0 100
56 Furosemid injeksi 10 mg/ml Ampul 0 0 0 0 0 0
57 Furosemid Tablet 40 mg Tablet 200 400 600 0 0 600
58 Garam Oralit untuk 200 ml air sacc 374 500 874 10 0 864
59 Gentamisin injeksi 40 mg/ ml Ampul 0 0 0 0 0 0
60 Gentamicin salep mata Tube 5 13 18 10 0 8
61 Gentamicin Sulfat 0,3% tetes mata Botol 22 0 22 0 0 22
62 Gentamicin salep kulit 0,1% Tube 0 80 80 0 0 80
63 Gentian Violet Larutan 1% Botol 8 0 8 0 0 8
64 Glibenklamida Tablet 5 mg Tablet 500 0 500 0 0 500
65 Glimepiride Tablet 0 0 0 0 0 0
66 Gliseril Guaiakolat Tablet 100 mg Tablet 300 20,000 20300 2,000 0 18300
67 Glukosa 10 % btl 500 ml 0 0 0 0 0 0

Puskesmas :

STOK SISA STOK

NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN RUSAK/ED PERMINTAAN
AWAL STOK OPT
68 Glukosa Larutan Infus 5% Steril Botol 500 ml 41 0 41 0 0 41
69 Griseofulvin Tablet 125 mg Tablet 800 0 800 400 0 400
70 Hidrokortison Krim 2,5% Tube 0 18 18 12 0 6
71 Ibuprofen Tablet 200 mg Tablet 2,400 6,000 8400 2,200 0 6200
72 Ibuprofen Tablet 400 mg Tablet 1,400 4,000 5400 1,100 0 4300
73 Icthyol Salap Pot 30 G 0 0 0 0 0 0
74 Isosorbid Dinitrat Tab.Sublingual 5 mg Tablet 0 0 0 0 0 0
75 Kalium Permangat KMN04 Pot 10 0 10 0 0 10
75 Kalsium Laktat Tablet 500 mg Tablet 1,300 2,000 3300 500 0 2800
76 Ketokenazol cream Tube 65 20 85 56 ED (25 Tube) 4
77 Ketokenazol Tablet 200 mg Tablet 200 100 300 250 0 50
78. Ketorolac 30 mg/ml Ampul 0 24 24 0 0 24
78 Klindamisin 300 mg kapsul Kapsul 0 0 0 0 0 0
79 Kloramfenikol 250 mg kapsul Kapsul 0 0 0 0 0 0
80 Kloramfenikol Salep Kulit Tube 0 0 0 0 0 0
81 Kloramfenikol Salep Mata 1% Tube 0 0 0 0 0 0
82 Kloramfenikol Tetes Telinga 3% Botol 5 ml 0 0 0 0 0 0
83 Klorfeniramin Maleat Tablet 4 mg tablet 288 4,896 5184 2,016 0 3168
84 Kloroquin Tablet 250 mg Tablet 0 0 0 0 0 0
85 Kotrimoksazol 480 mg tablet Tablet 800 3,000 3800 500 0 3300
86 Kotrimoksazol Suspensi Botol 60 ml 10 100 110 3 0 107
87 Levertran salep(Minyak Ikan Salep) Pot 30 gr 0 0 0 0 0 0
88 Lidocain comp inj Ampul 0 0 0 0 0 0
89 Lidocain injeksi (PEHACAIN) Ampul 0 0 0 0 0 0
90 Lidokaina 2 %. Injeksi Ampul 82 100 182 26 0 156
91 Lisol Mengandung Kresol Tersabun 50% Botol 1L 0 0 0 0 0 0
92 Loperamid tablet 2 mg Tablet 0 0 0 0 0 0
93 Loratadin tablet 10 mg Tablet 0 0 0 0 0 0
94 Magnesium sulfat inj (IV) 20% - 25 ml Vial 5 0 5 0 ED 5
95 Magnesium sulfat inj (IV) 40% - 25 ml Vial 0 0 0 0 0 0
96 Metformin 500 mg tab Tablet 0 200 200 0 0 200
97 Metil prednisolone 4 mg tab Tablet 0 0 0 0 0 0
98 Metilergometrin Maleat Injeksi Ampul 20 0 20 0 0 20
99 Metilergometrin Maleat Tablet 0,125 mg Tablet 100 400 500 0 0 500
100 Metoklopramide 10 mg tab Tablet 200 0 200 0 0 200
101 Metoklopramide injeksi Ampul 0 0 0 0 0 0
102 Metronidazol Tablet 250 mg Tablet 0 0 0 0 0 0
103 Metronidazol Tablet 500 mg Tablet 0 1,500 1500 0 0 1500
104 Metronidazol infus Botol 100 ml 0 0 0 0 0 0
104 Myconazol Krim 10 gram tube 0 48 48 5 0 43
:

STOK SISA STOK

NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN RUSAK/ED PERMINTAAN
AWAL STOK OPT
105 Natrium Diklofenak Tablet 25 mg Tablet 0 1,500 1,500 100 0 1,400
106 Natrium Diklofenak Tablet 50 mg Tablet 0 750 750 0 0 750
107 Natrium Klorida Infus 0,9% Steril Botol 500 ml 51 0 51 0 0 51
108 Nifedipin Tablet Tablet 200 0 200 0 0 200
109 Nistatin Tablet 500.000 IU Tablet 100 0 100 0 0 100
110 Nistatin Tablet Vagina 100.000 IU Tablet 40 0 40 0 0 40
111 Obat Batuk Hitam (OBH) Sirup Botol 60 ml 0 0 0 0 0 0
112 Oksiterasiklin HCl Salep Kulit 3% tube 0 75 75 55 0 20
113 Oksiterasiklin HCl Salep Mata 1% tube 0 0 0 0 0 0
114 Oksitosin Injeksi 10 IU/ ml (Pitogin) Ampul 22 20 42 19 0 23
115 Omeprazole injeksi Vial 0 0 0 0 0 0
116 Omeprazole 20 mg caps Kapsul 0 0 0 0 0 0
117 Ondansentron 4 mg/ 2 ml inj Ampul 5 0 5 0 0 5
118 Papaverin HCl 40 mg Tablet Tablet 0 0 0 0 0 0
119 Parasetamol Drops 100 mg/ml Botol 0 0 0 0 0 0
 120 Parasetamol Sirup 120 mg/ 5 ml Botol 60 ml 0 150 150 80 0 70
121. Parasetamol Infus Botol 0 3 3 0 0 3
121 Paracetamol 500 mg Tablet 0 10,000 10,000 2,600 0 7,400
121 Piracetam Tablet 0 0 0 0 0 0
122 Pirantel tablet 125 mg Tablet 52 0 52 0 0 52
123 Pirantel sirup Botol 44 0 44 0 0 44
123 Piridoxin HCl (Vit. B6) Tablet 10 mg Tablet 0 1,200 1,200 700 0 500
124 Piroksikam 20 mg tablet Tablet 500 1,500 2,000 0 0 2,000
125 Povidone Iodine 10% Botol 30 ml 7 0 7 4 0 3
126 Povidone Iodine 10% Botol 300 ml 0 10 10 0 0 10
127 Povidone Iodine 10% btl/60ml 0 10 10 0 0 10
128 Prednisone Tablet 5 mg Tablet 1,600 3,000 4,600 900 0 3,700
129 Prokain Benzil Penisillin 2,4 Juta IU Injeksi Vial 0 0 0 0 0 0
130 Prokain Benzil Penisillin 3 Juta IU Injeksi Vial 10 0 10 2 0 8
131 Ranitidine Injeksi 50 mg/2 ml Ampul 10 60 70 10 0 60
132 Ranitidine Tablet 150 mg Tablet 500 2,000 2,500 600 0 1,900
133 Ringer Laktat Infus Botol 500 ml 155 0 155 50 0 105
134 Salbutamol Tablet 2 mg Tablet 200 0 200 0 0 200
135 Salbutamol Tablet 4 mg Tablet 300 0 300 0 0 300
136 Salep 2-4 Pot 30 g 0 72 72 48 0 24
137 Salisil Bedak 2% Pot 50 g 2 30 32 7 0 25
138 Serum Anti Bisa Ular Inj. 5 ml Vial 0 0 0 0 0 0
139 Serum Anti Bisa Ular II Vial 0 0 0 0 0 0
140 Serum Anti Tetanus Injeksi 1.500 UI Ampul 0 0 0 0 0 0
141 Sianokobalamin (Vit. B12) Inj Ampul 249 200 449 43 0 406
142 Sianokobalamin (Vit. B12) tablet Tablet 100 2,000 2,100 200 0 1,900
143 Simvastatin 10 mg Tablet Tablet 100 0 100 0 0 100
Puskesmas :

STOK SISA STOK

NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN RUSAK/ED PERMINTAAN
AWAL STOK OPT
144 Suldoksin pirimetamin tablet Tablet 0 0 0 0 0 0
145 Tetrasiklin HCL Kapsul 250 mg Kapsul 0 0 0 0 0 0
146 Tetrasiklin HCL Kapsul 500 mg Kapsul 0 0 0 0 0 0
147 Tiamin HCl (Vit B1) Injeksi Ampul 0 0 0 0 0 0
148 Tiamin HCl (Vit B1) Tablet 50 mg Tablet 1,400 2,000 3400 600 0 2800
149 Vitamin B Compleks Tablet Tablet 400 6,000 6400 1,400 0 5000
150 Vitamin C 500 Tablet 0 0 0 0 0 0
150 Zink Dispersible Tablet 500 100 600 100 0 500
151 Zink Sirup Botol 2 0 2 0 ED 2
 OBAT PATEN
1 Ambeven caps kapsul 0 0 0 0 0 0
2 Antoxid Kapsul kkapsul 0 600 600 200 0 400
2 Aspilet chew tab Tablet 0 200 200 0 0 200
3 Becomzet Tablet 200 0 200 200 0 0
3 Bicolax tab Tablet 0 0 0 0 0 0
4 Biosanbe Capsul kapsul 0 0 0 0 0 0
5 Burnazin Cream Tube 0 2 2 0 0 2
6 Caviplex (Vit D) Tablet 90 60 150 0 0 150
6 Caviplex drops Botol 10 ml 0 0 0 0 0 0
7 Cendo Lyteers tetes mata Botol 0 0 0 0 0 0
8 Cendo Tobro eye drop botol 0 0 0 0 0 0
9 Cendo Xitrol eye minidose strip 0 0 0 0 0 0
10 Combantrin Syrup Botol 34 50 84 0 0 84
11 Diapet ktk/100 0 0 0 0 0 0
12 Dulcolax Tablet Tablet 5 0 5 0 0 5
13 Dulcolax supp 5 mg anak supp 0 6 6 0 0 6
14 Dulcolax supp 10 mg dws supp 0 5 5 0 0 5
15 Eutirox Tablet 200 0 200 0 0 200
15. Elkana Tablet 0 500 500 300 0 200
15 Fermia Kapsul kapsul 0 0 0 0 0 0
16 Flutamol tablet Tablet 0 0 0 0 0 0
17 Gentamicin SM (Cendo Genta) btl 0 0 0 0 0 0
Puskesmas :

STOK SISA STOK

NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN RUSAK/ED PERMINTAAN
AWAL STOK OPT
18 Hufabion kaps kapsul 0 0 0 0 0 0
 19 Hufadryl sirup botol 0 0 0 0 0 0
20 Hystolan tablet Tablet 0 0 0 0 0 0
21 Imboost F Tablet Tablet 0 0 0 0 0 0
22 Kina drage Tablet 0 0 0 0 0 0
23 Neo Entrostop Tablet 6x24's Tablet 0 240 240 48 0 192
24 Neo Protifed Tablet Tablet 0 0 0 0 0 0
24 Neurobion injeksi Ampul 21 0 21 9 0 12
25 Neurosanbe Tablet 0 0 0 0 0 0
26 New diatabs Tablet 0 0 0 0 0 0
27 Novabion kapsul 0 0 0 0 0 0
28 Nymico Oral Drops (Nistatin) Botol 1 10 11 0 0 11
29 Osteoflam Tablet 0 0 0 0 0 0
30 Paramex Tsblet 0 0 0 0 0 0
31 Poncofen Kaplet Tablet 0 0 0 0 0 0
32 Premaston Tablet 0 0 0 0 0 0
33 Prenatin DF Kaplet Tablet 0 0 0 0 0 0
34 Procurma syrup Botol 0 0 0 0 0 0
35 Protexinal sirup Botol 0 0 0 0 0 0
36 Quantidex Tablet 0 0 0 0 0 0
34 San B Plex Oral Drops Botol 0 0 0 0 0 0
35 Selcom C Tablet 0 0 0 0 0 0
36 Univit syrup Botol 0 0 0 0 0 0
37 Lycalvit syrup Botol 0 0 0 0 0 0
38 Asedas Botol 0 0 0 0 0 0
39 Trifedrin Tablet 0 0 0 0 0 0
40 Scabicid Tube 0 0 0 0 0 0
41. Scabimite Tube 0 0 0 0 0 0
42. Vicalcyn syrup botol 7 0 7 7 0 0

NARKOTIK
1 Kodein 10 mg tab Tablet 0 0 0 0 0 0

PSIKOTROPIKA
1 Clobazam 10 mg Tablet 0 0 0 0 0 0
2 Diazepam 2 mg Tablet Tablet 100 0 100 0 0 100
3 Diazepam 5 mg Tablet Tablet 100 0 100 0 0 100
4 Diazepam Injeksi 10 mg/ml-2ml Ampul 5 0 5 5 0 0
5 Fenobarbital Injeksi 50 mg/ml- 2 ml Ampul 5 0 5 0 0 5
6 Fenobarbital Tablet 30 mg Tablet 100 0 100 0 0 100
7 Stesolid Injeksi 5 mg/ml-2ml Ampul 0 0 0 0 0 0
 8 Stesolid rectal tube tube 0 0 0 0 0 0

Puskesmas :

STOK SISA STOK

NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN RUSAK/ED PERMINTAAN
AWAL STOK OPT
PROGRAM FILARIASIS 0
1 Albendazol 400 mg Tablet Tablet 700 0 700 0 0 700
2 Dietilkarbamasin sitrat Tablet Tablet 0 0 0 0 0 0

PROGRAM MALARIA
1 Artemeter injeksi i.m Ampul 0 0 0 0 0 0
2 Artesunat injeksi i.v Vial 0 20 20 5 0 15
3 Doksisiklin Kapsul Kapsul 0 0 0 0 0 0
4 Kuinina (Kinin) Tablet 222 mg 7 H2O Tablet 108 0 108 0 0 108
5 Obat Anti Malaria Tablet 2,142 540 2682 585 0 2097
6 Primaquin Tablet 15 mg Tablet 50 1.000 1.050 850 200

PROGRAM TBC
1 OAT Combipak Kat 1 Paket 0 0 0 0 0 0
2 OAT Kategori Anak FDC Paket 0 0 0 0 0 0
3 OAT Kategori I FDC Paket 0 0 0 0 0 0
4 OAT Kategori II FDC Paket 0 0 0 0 0 0

PRGRAM KUSTA
1 Obat Kusta MDT MB Anak blister 0 0 0 0 0 0
2 Obat Kusta MDT MB Dewasa blister 0 0 0 0 0 0
3 Obat Kusta MDT PB Anak blister 0 0 0 0 0 0
4 Obat Kusta MDT PB Dewasa blister 0 0 0 0 0 0

PROGRAM GIZI
1 Retinol (Vit A) Kapsul 100.000 IU Kapsul 0 250 250 0 0 250
2 Retinol (Vit A) Kapsul 200.000 IU Kapsul 200 600 800 0 0 800
3 Tablet Tambah Darah Komb. Tablet 900 3,000 3,900 1,600 0 2,300
4 Mineral Mix sacc 80 0 80 0 0 80

OBAT- OBAT KHUSUS

1 Amitriptyline 25 mg Tablet 0 0 0 0 0 0
 2 Bamgetol Tablet 0 0 0 0 0 0
3 Carbamazepin Tablet 0 0 0 0 0 0
4 Chlorpromazine 100 mg tablet Tablet 0 0 0 0 0 0
5 Chlorpromazine injeksi Ampul 0 0 0 0 0 0
Puskesmas :

STOK SISA STOK

NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN RUSAK/ED PERMINTAAN
AWAL STOK OPT
6 Haloperidol 0,5 mg tablet Tablet 0 0 0 0 0 0
7 Haloperidol 5 mg tablet Tablet 0 0 0 0 0 0
8 Haloperidol Injeksi Ampul 0 0 0 0 0 0
9 Klozapin 25 mg tablet Tablet 0 0 0 0 0 0
10 Lodomer Injeksi Ampul 0 0 0 0 0 0
11 Risperidon 2 mg Tablet Tablet 0 0 0 0 0 0
12 Triheksifenidil 2 mg tablet Tablet 0 0 0 0 0 0

VAKSIN DAN IMMUNOGLOBULIN

1 Vaksin BCG 10 ds vial 0 0 0 0 0 0
2 Vaksin DT 10 ds vial 0 0 0 0 0 0
3 Vaksin campak 10 Ds vial 0 0 0 0 0 0
4 Vaksin polio 10 Ds vial 0 0 0 0 0 0
5 Vaksin Hepatitis B / HBIG syiringe 0 0 0 0 0 0
6 Vaksin DTP-HB 5 Ds vial 0 0 0 0 0 0
7 Vaksin TD vial 0 0 0 0 0 0
8 HBIg syiringe 0 0 0 0 0 0

BMHP
1 Abbocath / IV catheter 18 G Set 38 0 38 0 0 38
2 Abbocath / IV catheter 20 G Set 45 100 145 5 0 140
3 Abbocath / IV catheter 22 G Set 48 37 85 8 0 77
4 Abbocath / IV catheter 24 G Set 32 50 82 0 0 82
5 Abbocath / IV catheter 26 G Set 10 20 30 0 0 30
6 Alat suntik 0,5 ml pcs 200 100 300 0 0 300
7 Alat Suntik Sekali Pakai 0.05 ml pcs 200 0 200 2 0 198
8 Alat Suntik Sekali Pakai 1 ml pcs 220 0 220 0 0 220
 9 Alat Suntik Sekali Pakai 2,5 ml pcs 255 200 455 80 0 375
10 Alat Suntik Sekali Pakai 3 ml pcs 302 1,000 1302 2 0 1300
11 Alat Suntik Sekali Pakai 5 ml pcs 120 1,000 1120 5 0 1115
12 Alkohol Swab pcs 0 1,000 1000 0 0 1000

Puskesmas :

STOK SISA STOK

NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN RUSAK/ED PERMINTAAN
AWAL STOK OPT
13 Anisol btl 0 0 0 0 0 0
14 Aseptan Lig Botol 500 ml 0 5 5 0 0 5
15 Aseptic gel Botol 500 ml 5 0 5 0 0 5
16 Autoclick device Set 0 0 0 0 0 0
17. Baju Hazmat Set 10 0 10 7 0 3
17 Bisturi / Scalpel No 23 pcs 18 100 118 0 0 118
18 Blood Lancet pcs 0 0 0 0 0 0
19 Blood Lancet 26 G pcs 200 1,000 1200 0 0 1200
20 Bola isap/bulb filler / karet pompa pipet pcs 0 0 0 0 0 0
21 Box Slide / Kotak Sediaan Box 0 0 0 0 0 0
22 Buku TB 05 Buku 0 0 0 0 0 0
23 Buku TB 06 Buku 0 0 0 0 0 0
24 Buku TB 09 Buku 0 0 0 0 0 0
25 Buku TB 10 Buku 0 0 0 0 0 0
26 Buku TB 12 buku 0 0 0 0 0 0
27 Catgut/Benang bedah no.2/0-3/0 pcs 91 48 139 15 0 124
28 Folley Catheter 2 way 16 Fr set 2 0 2 0 0 2
29 Folley Catheter 2 way 18 Fr Set 1 0 1 0 0 1
30 Formalin btl 1 L 0 0 0 0 0 0
31 Handscrub / one scrub 500 ml btl 500 ml 3 0 3 0 0 3
32 Hb Sahli paket 0 0 0 0 0 0
33 Hidrogen Peroksida (H2O2) Btl 100 ml 0 0 0 0 0 0
34 Imersi Oil Btl 25 ml 0 1 1 0 0 1
35 Imersi Oil btl 20 ml btl 0 0 0 0 0 0
36 Infusion Set Anak Set 32 0 32 0 0 32
37 Infusion Set Dewasa Set 7 50 57 15 0 42
38 Jarum Hecting Kulit OneMed BT11 pcs 0 0 0 0 0 0
39 Jarum Hecting Kulit OneMed BT13 pcs 0 0 0 0 0 0
40 Jarum Hecting Kulit OneMed BT9 pcs 0 0 0 0 0 0
41 Jarum Hecting Kulit OneMed GR13 pcs 0 0 0 0 0 0
42 Jarum Hecting Kulit OneMed GR9 pcs 0 0 0 0 0 0
 43 Jarum Hecting Kulit OneMed GT11 pcs 0 0 0 0 0 0
44 Jarum Hecting Kulit OneMed GT13 pcs 0 0 0 0 0 0
45 Jarum Hecting Kulit OneMed GT14 pcs 0 0 0 0 0 0
46 Jarum Hecting Kulit OneMed GT15 pcs 0 0 0 0 0 0
47 Jarum Hecting Kulit OneMed GT15 pcs 0 0 0 0 0 0
48 Jarum Hecting Otot OneMed GR11 pcs 0 0 0 0 0 0
49 Kantong Urine (Urine Bag) 2 L Set 13 0 13 2 0 11
Puskesmas :

STOK SISA STOK

NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN RUSAK/ED PERMINTAAN
AWAL STOK OPT
50 Kapas Berlemak 500 gram Rol 3 0 3 0 0 3
51 Kapas Pembalut 250 gram Rol 0 10 10 0 0 10
52 Kapas Pembalut 50 gram Rol 0 0 0 0 0 0
53 Kapass Pembalut 100 gram Rol 7 0 7 0 0 7
53 Kapas 25 gram Rol 10 0 10 1 0 9
53 Kasa Hidrofil 36 x 80 cm Rol 5 0 5 1 0 4
54 Kasa Kompres 40/40 Steril Rol 0 0 0 0 0 0
55 Kasa Pembalut 2 m x 80 cm Rol 15 0 15 1 0 14
56 Kasa Pembalut 4 y x 10 cm Rol 31 0 31 7 0 24
57 Kasa Pembalut 4 y x 15 cm Rol 15 100 115 15 0 100
58 Kasa Pembalut 4 y x 3 cm Rol 0 0 0 0 0 0
59 Kasa Steril 16 X 16 Cm Ktk/16 9 30 39 14 0 25
60 Kertas Lakmus bks/5 0 0 0 0 0 0
61 Kertas pH 0-14 (indikator universal) strip tes 0 0 0 0 0 0
62 Kertas Puyer lembar 30 0 30 30 0 0
63 Larutan EDTA Btl 100 ml 0 0 0 0 0 0
64 Larutan Giemsa Stain btl 500 ml 0 0 0 0 0 0
65 Larutan HCl 0,1 N Btl/100 ml 0 0 0 0 0 0
66 Larutan Turk btl/20 0 0 0 0 0 0
67. Masker Anak pcs 50 0 50 0 0 50
67 Masker Bedah/ Surgical Mask pcs 400 1,000 1400 350 0 1050
68 Masker N95 pcs 0 20 20 0 0 20
69 Metanol Btl 100 ml 0 2 2 0 0 2
70 Micropipet fix vol 500 set 0 1 1 0 0 1
71 Mortir and Stamper Besar set 2 0 2 0 0 2
72 Mortir and Stamper kecil Set 1 0 1 0 0 1
73 Mortir and Stamper sedang Set 2 0 2 0 0 2
74 Nesco strip cholesterol (lama) strip tes 0 0 0 0 0 0
75 Nesco strip glucose (lama) strip tes 0 0 0 0 0 0
 76 Nesco strip haemoglobin (lama) strip tes 0 0 0 0 0 0
77 Nesco strip uric acid (lama) strip tes 0 0 0 0 0 0
78 Nurse cup pcs 54 100 154 0 0 154
79 Pipet tetes kca ex lokal panjang pcs 0 0 0 0 0 0
80 Pipet tetes kca ex lokal pendek pcs 0 0 0 0 0 0
81 Plastik klip 5x8 pcs 1,000 1,000 2,000 700 0 1,300
82 Plastik Klip Obat 7 x 10 cm pcs 0 1,000 1,000 700 0 300
83 Plastik Klip Obat 8,7 x 13 cm pcs 0 1,000 1000 500 0 500
84 Plester 1.25 cm x 4.5 m (0.5 x 5) (7,5 cm x 4,5 m) Rol 0 15 15 3 0 12
85 Hipafix Rol 0 0 0 0 0 0
85 Plester 5 cm x 4.5 m (2 x 5) (10 cm x 5 m) Rol 0 0 0 0 0 0
86 Pot Sputum pot 0 0 0 0 0 0
87 Rak Tabung Reaksi pcs 0 0 0 0 0 0
Puskesmas :

STOK SISA STOK

NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN RUSAK/ED PERMINTAAN
AWAL STOK OPT
88 Rapid Diagnostic Test (RDT) Malaria strip tes 75 250 325 200 0 125
89 Rapid Diagnostic Test (RDT) SD Bioline HBsAg strip tes 0 0 0 0 0 0
90 Rapid Diagnostic Test (RDT) Syphilis Hexagon/frambus strip tes 0 0 0 0 0 0
91 Rapid Test HIV (SD) strip tes 0 0 0 0 0 0
91 Rapid Test HIV 1(Triline) strip tes 0 0 0 0 0 0
92 Rapid Test HIV 1 Right sign strip tes 0 0 0 0 0 0
93 Rapid Test HIV 2 (Focus) strip tes 0 0 0 0 0 0
94 Rapid Test HIV 2 (Oncoprobe) strip tes 0 0 0 0 0 0
95 Rapid Test HIV 3 (Vikia) strip tes 0 0 0 0 0 0
96 Reagen Zehl nielsen paket 0 0 0 0 0 0
97 Sarung Tangan Bedah No 6,5 steril Pasang 50 0 50 0 0 50
98 Sarung Tangan Bedah No 7 steril Pasang 9 0 9 0 0 9
99 Sarung Tangan Bedah No 7.5 steril Pasang 15 200 215 30 0 185
100 Sarung Tangan Bedah No 8 steril Pasang 41 100 141 4 0 137
101 Sarung Tangan Bedah No 8,5 steril Pasang 0 0 0 0 0 0
102 Sarung Tangan Exam uk. L (8-9) Pasang 100 300 400 150 0 250
103 Sarung Tangan Exam uk. M (7-8) Pasang 0 400 400 50 0 350
104 Sarung Tangan Exam uk. S (6-7) Pasang 0 200 200 0 0 200
105 Selotif 0 0 0 0 0 0
105 Sarung Tangan Obgyn No 7.5 Pasang 43 50 93 2 0 91
106 Silk (Benang bedah sutera) No. 2/0 + jarum pcs 0 0 0 0 0 0
107 Silk (Benang bedah sutera) No. 3/0 pcs 36 72 108 10 0 98
108 Silk (Benang bedah sutera) No. 3/0 Rol 0 0 0 0 0 0
 109 Slide MLR (Reg) Slide 0 0 0 0 0 0
110 Slide TB Slide 0 0 0 0 0 0
111 Spirtus btl 1 Liter 0 0 0 0 0 0
112 Suction 46 cm pcs 5 0 5 0 0 5
112 Tes Kehamilan strip strip tes 0 0 0 0 0 0
113 Urine Strip 10 parameter strip tes 0 0 0 0 0 0
114 Vaculab Plain (Tutup Merah) pcs 0 0 0 0 0 0
115 Vacutainer tutup ungu pcs 0 0 0 0 0 0
116. Vigel 30 gram tube 0 6 6 0 0 6
116 Wing Nedle 25G set 8 0 8 0 0 8
117 Underpad set 5 50 55 2 0 53
118 umbilical cord klem (nylon) pcs 0 100 100 0 0 100
BAHAN GIGI
1 Articulating paper box 0 0 0 0 0 0
2 Bahan Bonding (Stae)/masterbond botol 5ml 0 0 0 0 0 0
3 Bahan Etching / scotchbond (3M) botol 15ml 0 0 0 0 0 0
4 Bahan Tambalan Komposit A2 ( 3M) tube 0 0 0 0 0 0
5 Bahan Tambalan Komposit A3/ A3.5 ( 3M) tube 0 0 0 0 0 0
Puskesmas :

STOK SISA STOK

NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN RUSAK/ED PERMINTAAN
AWAL STOK OPT
6 Bahan Tumpatan Sementara (cavit (3M)) tube 0 0 0 0 0 0
7 Calxyl/ calxyl blue tube 0 0 0 0 0 0
8 Caustinerf/ pulp X botol 0 0 0 0 0 0
9 Cresotin liquid 1 botol 0 0 0 0 0 0
10 Cresotin liquid 2 botol 0 0 0 0 0 0
11 Disposible Dental Needle 30 G pcs 0 0 0 0 0 0
12 Eugenol botol 15 ml 0 0 0 0 0 0
13 GIC (pink dan putih) Fuji 7 box 0 0 0 0 0 0
14 Gutta Percha 15 mm- 40 mm set 0 0 0 0 0 0
15 Gutta Percha 45 mm- 80 mm set 0 0 0 0 0 0
16 Hemaspoon pcs 0 0 0 0 0 0
17 Kalsium Hidroksida Pasta (Hydcal) botol 100ml 0 0 0 0 0 0
18 Klorfenol Kamfer Mentol (CHKM) botol 0 0 0 0 0 0
19 Mumifikasi pasta tube 0 0 0 0 0 0
20 N2 (pink)/ eugentin/ iodoform paste botol 0 0 0 0 0 0
21 Trikresolformalin botol 0 0 0 0 0 0
22 paper point 15-40mm set 0 0 0 0 0 0
23 paper point 45-80mm set 0 0 0 0 0 0
 UMUM ASKES/BPJS JUMLAH
JUMLAH KUNJUNGAN RESEP BAYAR TIDAK BAYAR

Mengetahui/Menyetujui Yang menyerahkan Yang Menerima

Kepala DinKes Kab. Kep Yapen Petugas GFK Kepala Puskesmas

(.....................................................) (........................................................ ) (SEPTER RAUBABA, S.KM)

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