LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT/BMHP REGULER

KODE PUSKESMAS : 1071242

PUSKESMAS : TAMPA PADANG

KECAMATAN : KALUKKU
KABUPATEN : MAMUJU
PROPINSI : SULAWESI BARAT

STOK
NO NAMA OBAT/BMHP SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR
PENGAMAN

1 2 3 4 5 6 = (4+5) 7 8 = (6-7) 9 = (7X20%)

1 Accugence Blood Glukosa Box/50 - - - - -
2 Accugence Blood Uric Acid Box/25 - - - - -
3 Acyclovir tab 200 mg Tablet 940 940 5 935 1
4 Acyclovir tab 400 mg Tablet 1,100 1,100 685 415 137
5 Adhesive Wound Strip 5 cm X 5 m (Plester) Roll 25 10 35 18 17 4
6 Alat Suntik Sekali Pakai 1 ml (Stera) Pieces 181 200 381 139 242 28
7 Alat Suntik Sekali Pakai 3 ml Pieces 336 500 836 390 446 78
8 Alat Suntik Sekali Pakai 5 ml Pieces 573 573 197 376 39
9 Allopurinol 100 mg Tablet 1,815 500 2,315 770 1,545 154
10 Allopurinol 300 mg Tablet - 1,000 1,000 200 800 40
11 Aminophyllin 200 mg tab Tablet - - - - -
12 Aminophyllin 24 mg/ml Injeksi Ampul 10 10 - 10 -
13 Aminophyllin Injeksi Ampul - - - - -
14 Amlodipin tablet 10 mg Tablet 4,650 1,000 5,650 2,125 3,525 425
15 Amlodipin tablet 5 mg Tablet 4,820 4,820 1,315 3,505 263
16 Amoxicillin 500 mg Tablet 4,020 3,000 7,020 6,520 500 1,304
17 Amoxicillin Sirup 125 mg/5 ml Botol 236 236 107 129 21
18 Antacida suspensi btl /60 ml 179 200 379 189 190 38
19 Antasida Tab Tablet 3,000 4,000 7,000 5,700 1,300 1,140
20 Antihaemorrid Supp Supp/2 g 67 50 117 44 73 20
21 Antimigrain : ergotamine + coffeine tablet 200 200 400 100 300 20
22 Antiseptik hand rub 500 ml Botol 5 10 15 14 1 3
23 Antiseptik hand rub 500 ml (Henclin 2%) Botol - - - - -
24 Aqua Pro Injeksi 25 ml Btl/25 ml 118 118 24 94 5
25 Asam Asetilsasilisilat tab 80 mg Tablet 40 100 140 - 140 -
26 Asam Askorbat tab 250 mg Tablet 1,530 1,530 730 800 146
27 Asam Askorbat tab 50 mg Tablet 2,370 2,000 4,370 2,510 1,860 502
28 Asam Folat Tab. 1 mg Tablet 950 500 1,450 540 910 108
29 Asam Mefenamat tab 500 mg Tablet 2,900 3,000 5,900 4,000 1,900 800
30 Asering Infus Btl/500 ml 40 40 - 40 -
31 Atapulgit tab 600 mg Tablet 200 200 10 190 2
32 Atropin sulfat Injeksi 0,25 mg/ml Ampul - - - - -
33 Bedak Salisil Pot 17 20 37 22 15 4
34 Betahistin 6 mg Tablet - 1,000 1,000 300 700 60
35 Betametason 0,1% krim Tube - - - - -
36 Bisturi No. 10 Pcs 90 90 30 60 6
37 Blood Lancet Box - - - - -
38 Captopril 12,5 mg Tablet 1,514 1,514 414 1,100 83
39 Captopril 25 mg tablet 2,752 2,000 4,752 1,792 2,960 358
40 Carbamazepin tab 200 mg Tablet 160 160 - 160 -
41 Catgut Chromic 2/0 HR 30 MM Pcs 31 31 28 3 6
42 Catgut Chromic 3/0 HR 30 MM Pcs - - - - -
43 Cefadroxil 500 mg Tablet - - - - -
44 Ciprofloxacin tab 500 mg Tablet - - - - -
45 Dexamethasone 0,5 mg tablet Tablet 1,960 5,000 6,960 4,650 2,310 930
46 Dexamethasone Injeksi Ampul 20 20 20 - 4
47 Diazepam 2 mg Tablet 386 386 81 305 16
48 Diazepam 5 mg Tablet 540 540 - 540 -
49 Diazepam Injeksi Ampul 25 20 45 10 35 2
50 Difenhidramin Injeksi 10 mg/ml Ampul 30 30 - 30 -
51 Digoxin tablet 0,25 mg Tablet 180 180 - 180 -
52 Diltiazem tab 30 mg Tablet 100 100 - 100 -
53 Dimenhidrinat tab 50 mg Tablet 211 500 711 123 588 25
54 Domperidon tablet 10 mg Tablet 180 180 180 - 36
55 Efinefrin Injeksi 0,1% Ampul 50 50 - 50 -
56 Eritromisin kapsul 250 mg Tablet 100 100 - 100 -
57 Eritromisin kapsul 500 mg Capsul 100 100 - 100 -
58 Eritromisin Syrup Botol 7 7 - 7 -
59 Ethanol 70 % 1.000 ml Botol 7 5 12 12 - 2
60 Etylchlorida semprot Btl/100 3 1 4 2 2 0
61 Fenobarbital tab 30 mg Tablet 574 574 20 554 4
62 Fitomenadion (Vit. K1) Injeksi 10 mg/ml Ampul - - - - -
63 Fitomenadion (Vit. K1) Injeksi 2 mg/ml Ampul 65 30 95 35 60 7
64 Fitomenadion 10 mg Tablet 1,137 1,000 2,137 431 1,706 86
65 Furosemide Tablet 40 mg Tablet 247 247 14 233 3
66 Gentamicin Salep Mata (Genoint) 0.3 % Tube - - - - -
67 Gentamicin sulfat TM 0,3% Btl/ 5 ml 20 10 30 25 5 5
68 Glibenklamid tab 5 mg Tablet 2,569 1,000 3,569 956 2,613 191
69 Glimepiride 2 mg Tablet 2,050 1,000 3,050 660 2,390 132
70 Glukosa 10 % Botol 20 20 - 20 -
71 Glukosa 5 % Botol 120 120 40 80 8
72 Griseofulvin 125 mg Tablet 2,555 1,000 3,555 1,005 2,550 201
73 Haloperidol tab 0,5 mg Tablet 528 500 1,028 370 658 74
74 Haloperidol tab 1,5 mg Tablet 10 10 10 - 2
75 Hidroklorothiazid (HCT) tab Tablet 350 350 30 320 6
76 Hidrokortison Cream 2,5% Tube 15 48 63 53 10 11
77 Hiosina butilbromida tab 10 mg Tablet 840 2,000 2,840 910 1,930 182
78 Hypafix 5 cm x 5 m Roll - - - - -
79 Ibuprofen 200 mg Tablet 1,544 3,000 4,544 2,740 1,804 548
80 Ibuprofen 400 mg Tablet 2,365 3,000 5,365 3,265 2,100 653
81 Infus Set Dewasa Pieces - - - - -
82 Infus Set Dewasa Pieces - - - - -
83 Infusion set anak Pcs 100 100 10 90 2
84 Infusion set makro Pcs 286 286 157 129 31
85 Isosorbide Dinitrate tab 5 mg Tablet 360 360 - 360 -
86 IV Canula 18 G Pcs 189 189 47 142 9
87 IV Canula 20 G Pieces 195 50 245 122 123 24
88 IV Canula 22 G Pieces 167 100 267 136 131 27
89 IV Canula 24 G Pieces 78 50 128 50 78 10
90 Jarum Jahit bedah No. 11 Bungkus 12 12 - 12 -
91 Jarum Jahit bedah No. 12 Bungkus 71 71 23 48 5
92 Jarum Jahit bedah No. 9 Bungkus 12 12 - 12 -
93 Ka-en 3B Larutan infus botol 68 68 5 63 1
94 Kalsium Laktat 500 mg Tablet 2,170 1,000 3,170 2,470 700 494
95 Kapas 250 gram Roll 5 10 15 8 7 2
96 Karbogliserin Tetes Telinga (Fenol Gliserol 10%) btl/ 5 ml 27 27 - 27 -
97 Kasa Kompres 40 x 40 cm Pieces 61 50 111 29 82 6
98 Kasa Roll 3,6 x 15 cm Roll 97 97 44 53 9
99 Kasa Roll 3,6 x 5 cm Roll - - - - -
100 Kasa Roll Panjang 40 Y x 80 cm Roll 7 5 12 8 4 2
101 Kasa Steril 16 x 16 cm Box 37 50 87 59 28 12
102 Ketoconazole 200 mg Tablet 165 165 65 100 13
103 Khlorpheniramin Maleat 4 mg (CTM) Tablet 3,938 1,728 5,666 3,244 2,422 649
104 Kloramfenikol caps 250 mg Kapsul - - - - -
105 Kloramfenikol Salep kulit 2% Tube - - - - -
106 Kloramfenikol Salep Mata 1 % (Erlamycetine) Tube 10 10 5 5 1
107 Kloramfenikol Tetes Telinga Botol/5 ml 13 10 23 18 5 4
108 Klorpromazin Tab. 100 mg Tablet 500 500 135 365 27
109 Kotrimoxazole 480 mg Tablet 2,230 2,230 1,214 1,016 243
110 Kotrimoxazole Suspensi Botol 79 79 41 38 8
111 Leukoplast (Plester ) Roll 11 5 16 9 7 2
112 Lidocain HCl Compositum Injeksi Ampul 60 60 120 90 30 18
113 Lidocain HCl injeksi 2% Ampul - - - - -
114 Lisol Botol 12 12 3 9 1
115 Loperamid tablet Tablet 1,880 2,000 3,880 674 3,206 135
116 Loratadine Tablet 10 mg Tab 861 3,000 3,861 1,861 2,000 372
117 Masker Bedah Pieces - - - - -
118 Masker Bedah Earloop Pieces 900 900 900 - 180
119 Masker Bedah Hijab Pieces - 1,000 1,000 550 450 110
120 Masker N95 Box - - - - -
121 Metformin 500 mg Tablet 3,209 1,000 4,209 1,855 2,354 371
122 Metformin 850 mg Tablet - - - - -
123 Methylprednisolon 4 mg Tablet 2,230 1,000 3,230 1,638 1,592 328
124 Metoklorpropamide Injeksi Ampul 35 35 25 10 5
125 Metoklorpropamide tab 10 mg Tablet - - - - -
126 Metoklorpropamide tab 5 mg Tablet 940 500 1,440 540 900 108
127 Metronidazole 500 mg Tablet - - - - -
128 Metylergometrin Maleat Inj Ampul 25 25 - 25 -
129 Metylergometrin Maleat tab. Tablet 100 100 - 100 -
130 Miconazole krim Tube 22 48 70 53 17 11
131 Mission HB Strip Box/50 - - - - -
132 Mission Ultra Total Cholesterol Box/25 - - - - -
133 M-Y Jelly 82 Gram Tube 5 5 3 2 1
134 N-Asetil Sistein 200 mg Tablet 2,270 2,270 2,270 - 454
135 Natrium Diklofenak 25 mg Tablet 1,400 1,400 695 705 139
136 Natrium Diklofenak 50 mg Tablet 2,200 2,000 4,200 1,555 2,645 311
137 Natrium Klorida Inf 0,9% Btl/ 500 ml 149 149 76 73 15
138 Nifedipine 10 mg tablet Tablet 120 120 20 100 4
139 Nistatin Tab. Vag 100.000 UI Tablet vag 178 178 18 160 4
140 Nistatin Tab. Vag 500.000 UI Tablet 100 100 - 100 -
141 Omeprazole capsul 20 mg Kapsul - - - - -
142 Omeprazole Injeksi Vial - - - - -
143 Oxytetracycline Salep Mata Tube - - - - -
144 Oxytocin Inj 10 mg/ml Ampul 6 6 6 - 1
145 Paracetamol syrup Btl/ 60 ml 152 100 252 112 140 22
146 Parasetamol tablet 500 mg Tablet 4,050 3,000 7,050 6,750 300 1,350
147 Plester 5 cm x 5 m Roll - - - - -
148 Prednison tablet 5 mg Tablet 3,070 3,070 1,560 1,510 312
149 Propanolol 10 mg Tablet 500 500 100 400 20
150 Propiltiuourasil (PTU) Tablet 1,470 1,470 165 1,305 33
151 Pyridoksin Hcl (Vitamin B6) Tab. 10 mg Tablet 540 2,000 2,540 1,005 1,535 201
152 Rapid Antigen (Egens) Test - - - - -
153 Reagen Golda Botol 4 4 - 4 -
154 Ringer Laktat Infus Btl/ 500 ml 157 200 357 347 10 69
155 Salbutamol tab 4 mg Tablet - - - - -
156 Salep 2-4 Pot 15 30 45 15 30 3
157 Salep Antifungi 30 gram Pot - - - - -
158 Sarung Tangan L Box 7 2 9 9 - 2
159 Sarung Tangan M Box - - - - -
160 Sarung Tangan S Box - - - - -
161 Sarung tangan steril 7 Pcs - - - - -
162 Sarung Tangan Steril No. 6,5 Pasang - - - - -
163 Sarung Tangan Steril no. 7 Pieces - - - - -
164 Sarung Tangan Steril no. 7,5 Pasang - 50 50 50 - 10
165 Sianocobalamin (Vit. B12) Injeksi 500 mcg Ampul - - - - -
166 Sianocobalamin (Vit. B12) tablet 500 mcg Tablet 3,000 3,000 1,300 1,700 260
167 Silk Black 2/0 HR 30 MM Pcs 82 82 24 58 5
168 Silk Black 3/0 HR 30 MM Pcs 108 108 74 34 15
169 Simvastatin 10 mg Tablet - - - - -
170 Simvastatin 20 mg Tablet 1,710 2,000 3,710 1,310 2,400 262
171 Strip Asam Urat Botol - - - - -
172 Strip Glukosa Botol - - - - -
173 Strip Kolestrol Botol - - - - -
174 Thiamin 50 mg Tablet 2,760 1,000 3,760 1,810 1,950 362
175 Vitamin B Complex tab Tablet 5,320 2000 7,320 7,010 310 1,402
176 Yodium 300 ml Botol 8 5 13 9 4 2
177 Atenolol 100 mg Tablet - - - - -
178 Atenolol 50 mg Tablet - - - -

JUMLAH KUNJUNGAN RESEP KET

NO FASILITAS KESEHATAN
JML
BPJS NON BPJS
1 PUSKESMAS

2 PUSKESMAS PEMBANTU

3 POSKESDES

4 PUSKESMAS KELILING

5 PELAYANAN LUAR GEDUNG

TOTAL 0 0 0

Mengetahui, Menyetujui : Mengetahui

Plt. Kepala Dinas kesehatan Kab. Mamuju Plt. Kepala Instalasi Farmasi Kab. Mamuju Kepala Puskesmas Tampapadang
dr. Acong Fatmawati, S.Si., Apt NURHAEDAH, Amd.Keb
NIP.19651105 200012 1 003 NIP. 19810807 201503 2 003 NIP.19760101 200502 2 010
BULAN PELAPORAN : MARET
BULAN PEMAKAIAN : FEBRUARI
TAHUN : 2022

PEMBERIAN
JUMLAH TOTAL
PERMINTAAN
PEMBERIAN
PKD PROG/DKP LAIN2

10 11 12 13 14
-
-

20
200
500
200
500
1,000
100

2,000

7,000
100
200
6,000
50
200
30
-
 -
-
1,000
6,000
500
5,000

300

30
4,000
200
100
-

3,000

120
120
1,000
5,000
5,000
50

10

-
4,000
 25
5

50
50
1,000

10
1,000
2,000

1,000

500
-
120
3,000

3,000
3,000

50
 100
200
200
300

3,000
10

-
50

10
100

5,000

-
20
50

1,000

20
180
-
5
-
3,000
1,000
1,000
1,000
100
2,000

3,000
50

2,000
1,000

120
10
10
15
6,000
3,000
3,000
300

5,000
50
100
200
200
8,000
 2,000

3,000

400
3,000
-
100
30
30
30

1,000
1,000
1,000
100

3,000
2,000
20
20
20
3,000
8,000
15
100
100

Tampa Padang, 31 Januari 2022

kesmas Tampapadang Yang Membuat Laporan

AH, Amd.Keb Apt. Hasmira Hasanuddin, S.Farm
101 200502 2 010 NIP.19880902 202012 2 003
KET

15
ED . Januari 2022