LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

(LPLPO)

PUSKESMAS : LEMO
KECAMATAN : Teweh Tengah
KABUPATEN : Barito Utara
PROVINSI : Kal-Teng

NO NAMA OBAT UKURAN/ DOSIS STOK AWAL TERIMA

1 Acetosal tab 100 mg 100 tab/kotak -

2 Acyclovir tablet 200 mg 100 tablet/kotak 550
3 Acyclovir Salep Kulit tube -
4 Acyclovir tablet 400 mg 100 tablet/kotak 600
5 Albendazole tablet 400 mg tablet 82
6 Alupurinol tablet 100 mg 100 tablet/kotak -
7 Alupurinol tablet 300 mg 100 tablet/kotak -
8 Ambroxol sirup 15 mg /ml botol 154
9 Ambroxol tab 100 tab/kotak -
10 Aminofilin injeksi -
11 Aminofilin tablet 200 mg tablet 150
12 Amitriptilin tablet salut 25 mg -
13 Amlodipine tab 10 mg 100tablet/kotak 1,130
14 Amlodipine tab 5 mg tab 100 tablet/kotak 1,560
15 Amoksisilin kaplet 250 mg kaplet 10,500
16 Amoksisilin kaplet 500 mg kaplet 10,150
17 Amoksisilin Sirup kering 125 mg/5ml botol -
18 Amoxicilin drop 14
19 Ampicilin tablet 100
20 Antasida Doen II suspensi botol 222
21 Antasida Doen tablet kombinasi tablet -
22 Antifungi Doen Salep 80
23 Antihemoroid Supp suppo 20
24 Aqua pro injeksi botol 42
25 Arfen 400 mg tablet 100tablet/kotak -
26 Armacort cream tube -
27 Asam Askorbat tablet 50 mg/vit c tablet 1,050
28 Asam Folat tablet 1 mg tablet 400
29 Asam Folat tablet 400mcg (Profolat) tablet 210
30 Asam Mefenamat (Solasic) tablet 500 mg tablet 2,650
31 Atenolol tab 50 mg 100 tablet/kotak -
32 Atropine injeksi 100
33 Attapulgite tab 600 mg (new antides) 1,150
34 Betametason krim 1% tube 76
35 Biovitan sirup 159
36 Bisacodyl suppositoria 10 mg suppo -
37 Bisacodyl suppositoria 5 mg suppo -
38 Calsium laktat tablet 500 mg tablet -
39 Captopril tablet 12,5 mg tablet -
40 Captopril tablet 25 mg tablet -
41 Captopril tablet 50 mg tablet 1,530
42 Caviplex sirup 68 96
43 Cefadroksil kapsul 500 mg kapsul 990
44 Cefadroksil 125mg/5ml sirup botol -
45 Cefadroksil 250mg/5ml sirup botol 31
46 Cefixim sirup kering 100 mg/5ml botol -
47 Cendo mydriatril -
48 Cetirizine sirup 87
49 Cetirizine tab -
50 Cianokobalamin injeksi 500 mcg ampul - 100
51 Cianokobalamin tablet 50 mg -
52 Cimetidine Tab tablet 450
53 Ciprofloksasin infus botol -
54 Ciprofloksasin tablet 500 mg tablet 1,650
55 Clindamisin kapsul 300 mg kapsul -
56 Clopidogrel tab 75 mg tablet -
57 Cloramfenikol kapsul 500 mg (chloramex) kapsul -
58 Cloramfenikol kapsul 250 mg kapsul 120
59 Cloramfenikol salep kulit (bufacetin) tube 44
60 Cloramfenikol salep mata tube 24
61 Cloramfenikol syr 125mg/ml botol 94
62 Cloramfenikol Tetes Telinga (Reco TT) botol -
63 Cloramfenikol tetes mata (Reco TM) botol -
64 Clorfeniramini Maleat tablet 4 mg (Orphen) 2,390
65 Cotrimoksazol Doen II tablet anak -
66 Cotrimoksazol Doen Suspensi kombinasi botol -
67 Cotrimoksazol Doen tablet dewasa 480 mg tablet -
68 Deksametason injeksi ampul -
69 Deksametason tablet 0,5 mg tablet -
70 Difenhidramin injeksi 10 mg/ml 112
71 Digoxin tablet 0,25 mg 480
72 Domperidon suspensi 5 mg/5 ml botol -
73 Domperidon tablet 10 mg -
74 Efhedrin inj 50mg/ml ampul 60
75 Epinefrin (adrenalin) injeksi 0.1%/1 ml ampul -
76 Ergotamin Cafein tablet (antimigren) tablet -
77 Eritromisin kaplet 500 mg kaplet -
78 Eritromisin kapsul 250 mg kapsul -
79 Eritromisin sirup 200 mg/5ml botol -
80 Erlamicetyn Tetes Telinga Botol -
81 Etanol 70% (100 ml) botol - 24
Etanol 70% (300 mL) botol - 24
82 Etanol 70% (1000 ml) botol -
83 Ethambutol tablet 250 mg 200 tablet/kotak -
84 Famotidin tablet 40 mg -
85 Fitomenadion injeksi 10 mg/ml ampul -
86 Fitomenadion tablet 10 mg tablet 670
87 Flunadin tablet 100 tablet/kotak -
88 Fondazen tab -
89 Fundifar tablet tablet -
90 Furosemid injeksi10 mg/ml ampul -
91 Furosemid tablet 40 mg 200 tablet/kotak 470
92 Garam Oralit I serbuk ,kombinasi sachet 560
93 Gemfibrozil tab 300 mg tablet -
94 Gentamisin injeksi 40 mg/ ml ampul 50
95 Gentamisin salep kulit 0,1% tube 13
96 Gentamisin salep mata (genoin) tube 126
97 Gentamisin tetes mata 0,3% botol 18
98 Gentian Violet botol 24
99 Geriavita tab -
100 Glibenklamid tablet 5 mg tablet 310
101 Glimepiride tab 1 mg tab tablet -
102 Glimepiride tab 2 mg tab tablet -
103 Glimepiride tab 3 mg tab tablet -
104 Gliseril guaiakolat tablet 100 mg 1000 tablet/botol -
105 Glucodex tab tablet -
106 Glukosa larutan infus 5 % steril botol -
107 Glukose larutan Infus 10 % steril botol 60
108 Griseovulfin 125 g tab tablet 490
109 Guaifenesin tab 100 tablet/box -
110 Hemafort tablet tablet -
111 Hidroklortiazida tablet 25 mg 1000 tablet/botol 515
112 Hidrokortison krim 2,5 % tube 29
113 Ibuprofen suspensi 100 mg /5 ml botol -
114 Ibuprofen tablet 200 mg tablet -
115 Ibuprofen tablet 400 mg tablet -
116 Ifarsyl sirup botol -
117 Isonat tablet tablet -
118 Isoniazida tablet 100 mg 1000 tablet/botol -
119 Isoniazida tablet 300 mg 1000 tablet/botol -
120 Isosorbit Dinitrat tablat sublingual 5 mg 530
121 Katergi tab 600
122 Ketokonazol krim tube 46
123 Ketokonazol tablet 200 mg -
124 Ketorolac injeksi 10 mg ampul -
125 Ketorolac tab tablet 190
126 Ketrorolac injeksi 30 mg/ml ampul 2
127 Lansoprazole casp -
128 Levofloksasin tablet 500 mg 100 tablet/kotak 100
129 Lidokain Comp 2% ampul 90
130 Lidokain injeksi 2% ampul 52
131 Lisol ( Kresol tersaponifikai 50% ) 2
132 Loperamid tablet 2 mg -
133 Loratadin tablet 10 mg tablet -
134 Meloksicam tablet 7,5 mg tablet -
135 Metamizol tab 1,250
136 Metformin Hcl tablet 500 mg tablet -
137 Metformin tab 850 mg 1,070
138 Methylergomethrin injeksi 74
139 Metilergometrin Maleat tablet 0,125 mg tablet 500
140 Metilprednisolon tablet 4 mg -
141 Metilprednisolon tablet 8 mg -
142 Metoklopramide drop 2mg/ml (gavistal) botol -
143 Metoklorpramide sirup 5 mg/5 ml (Lexapram) botol -
144 Metoklorpramide tablet 10 mg tablet -
145 Metoklorpramide tablet 5 mg 565
146 Metronidazole sirup 125 mg/5 ml botol -
147 Metronidazole tablet 250 mg tablet 30
148 Metronidazole tablet 500 mg tablet -
149 Metylprednisolon injeksi -
150 MgSo4 20% 10
151 Mikonazole krim 2% tube -
152 Miniaspi tablet 1,060
153 Mionalgin tasb -
154 Moxalas sirup botol 111
155 Natrium diklofenac tablet 50 mg tablet -
156 Natrium Klorida larutan infus 0,9 % botol 43
157 Nipedipin tablet 10 mg 700
158 Nistatin tablet 500.000 IU tablet -
159 Nistatin tablet salut 100.000 IU/g 500
160 Norages injeksi injeks -
161 Novatrim syr -
162 OBH Sirup 77
163 Ofloxacin tablet 200 mg tablet -
164 Ofloxacin tablet 400 mg 50 tablet/botol 550
165 Oksitetrasiklin injeksi 10 vial/kotak -
166 Oksitetrasiklin Salap kulit 3% tube -
167 Oksitetrasiklin Salap mata 1% tube 40
168 Omeprazol inj 40 mg/vial -
169 Omeprazol kapsul 20 mg kapsul -
170 Oxytocin injeksi -
171 Paracetamol drop -
172 Parasetamol 500 mg tablet 100 tablet/kotak 2,440
173 Parasetamol sirup 125 mg/5ml botol 215
174 Papaverin Hcl Tablet tablet 450
175 Pehavral tablet tablet -
176 Pehacain Injeksi Vial 40
177 Phenitoin kapsul 100 mg kapsul -
178 Phenobarbital injeksi 16
179 Phenolglycerol Tetes Telinga 10% Botol 14
180 Phenytoin inj 100mg/2ml -
181 Phenzacol tablet tablet -
182 Piracetam inj 200mg/ml -
183 Piracetam injeksi 1 g/5 ml -
184 Piracetam tablet 400 mg -
185 Piracetam tablet 800 mg tablet -
186 Pirantel tablet score (base) 125 mg tablet -
187 Pirazinamid tablet 500 mg 100 tablet/kotak -
188 Piridoksin inj 100 mg/ml ampul -
189 Piridoksin tablet 10 mg tablet 470
190 Piroksikam tablet 10 mg -
191 Piroksikam tablet 20 mg tablet -
192 Povidon iodida larutan 10 % 30 ml botol -
193 Povidon iodida larutan 10 % 300 ml botol -
194 Povidon iodida larutan 10 % 60 ml botol 5 12
195 Prednison tablet 5 mg tablet -
196 Propanolol tab 10 mg tablet -
197 Propanolol tablet 40 mg -
198 Ramaflu tablet 100 tablet/kotak -
199 Ramipril tab 2,5 mg tablet -
200 Ramipril tab 5 mg tablet -
201 Ranitidin injeksi 50 mg /2 ml ampul -
202 Ranitidin tablet 150 mg tablet -
203 Remco sirup -
204 Ringer Laktat larutan infus steril botol 11 20
205 Rivanol/Etakridin laktat 0,1 % botol -
206 Salbutamol sirup 121
207 Salbutamol tablet 2 mg tablet 760
208 Salbutamol tablet 4 mg tablet 510
209 Salep 2-4 kombinasi pot 48
210 Salisil Bedak 2% sachet 10
211 Samcodin tab -
212 Simvastatin tablet 10 mg tablet 385
 213 Simvastatin tablet 20 mg tablet 150
214 Solvita sirup botol 120
215 Solfenox Sirup Kering Botol -
216 Sucralate sirup botol -
217 Tablet tambah darah tablet -
218 Ternik Sirup botol -
219 Tetrasiklin kapsul 250 mg kapsul -
220 Tetrasiklin kapsul 500 mg -
221 Thiamin injeksi 100 mg/ml ampul 60
222 Thiamin tablet 50 mg tablet -
223 Tramadol inj 50mg/ml 10
224 Tramadol tablet 40 mg 50 tablet/kotak -
225 Tropidryl sirup 275
226 Vitamin B kompleks tablet -
227 Yekamulvita tab -
228 Zinc syr -
229 Zink tablet tablet -
LABORATORIUM -
230 Alcohol Swab Box -
231 Benecheck alat periksa -
232 Benedict -
233 Blood Lancet box -
234 Box objek glass -
235 Easy touch alat periksa -
236 EDTA 10% -
237 Hayem -
238 Immersion oil -
239 Larutan HCN 0,1N botol -
240 Mikropipet 1000l -
241 Mikropipet 100ul -
242 Mikropipet 10l -
243 Mikropipet 10ul -
244 Mikropipet 1ul -
245 Mikropipet 2ul -
246 Mikropipet 50ul -
247 Mikropipet 5ul -
248 Nesco Multi check -
249 Objek Glass -
250 Pewarna Giemsa -
251 Pewarna Ziehl Neelsen -
252 Poliflex IV Canula -
253 Poligyp 10 cm 8
254 Pot Sputum Pcs -
255 Pot Urin Pcs -
256 Rak tabung reaksi -
 257 Rees Ecker -
258 SM Sedimen -
259 Stik Asam urat Autocheck -
260 Stik Asam urat Benecheck -
261 Stik Asam urat humasens -
262 Stik Gula Autocheck -
263 Stik Gula Beneck -
264 Stik Gula Humasens -
265 Stik kolesterol Autocheck -
266 Stik kolesterol Benecheck -
267 Stik kolesterol Humasens -
268 Stik Urin Parameter Box -
269 Turk -
ALAT KESEHATAN DAN BAHAN HABIS PAKAI -
270 Alat Suntik sekali pakai 1 ml 100 set/kotak 51 200
271 Alat Suntik sekali pakai 2,5ml 100 set/kotak 178
272 Alat Suntik sekali pakai 3 ml 139
273 Alat Suntik sekali pakai 5 ml 100 set/kotak 77
274 Canula nasal oksigen adult -
275 Canula nasal oksigen infant -
276 Canula nasal oksigen pediatric -
277 Catgut crome 1 -
278 Catgut crome 2/0 8
279 Catgut No.2/0 paket 24
280 Catgut plain 3-0 11
281 Fescoplast 1,25cm x 4,5m 5
282 Fescoplast 2,5cm x 4,5 m -
283 Fescoplast 5cm x 4,5 m 11
284 FM Crepe 10cm x 4,55 m 1
285 FM Crepe 7,5cm x 4,55 m 1
286 Folley Cateter 2 way No. 16 set -
287 Folley Cateter 2 way No. 18 set -
288 Folley cateter 3 way No. 18 set -
289 Gips 3 inch roll -
290 Gips 4 inch roll -
291 Gips 6 inch roll -
292 Infuset anak set 17
293 Infuset dewasa set 37
294 IV Catheter No 18 G 50 set/kotak -
295 IV Catheter no.20 G 50 set/kotak -
296 IV Catheter no.22 G 50 set/kotak 129
297 IV Catheter no.24 G 50 set/kotak 20
298 Kapas Berlemak 500 gram bungkus -
299 Kapas pembalut 250 gram bungkus 2 5
300 Kasa hidrofil 36 x 80 cm -
301 Kasa hidrofil 40 x 80 bungkus -
302 Kasa kompres 40 x 40 steril bungkus -
303 Kasa pembalut 2 x 80 roll 15
304 Kasa pembalut 4 x 10 roll 40
305 Kasa Pembalut 4 x 15 roll 2
306 Kasa pembalut 4 x 3 roll -
307 Kasa pembalut 4 x 5 roll 69
308 Kasa steril 10cm x 10cm 73
309 Kasa steril 16 x 16 kotak kotak -
310 Kasa steril 5cm x 5 cm -
311 Kasa steril 7,5cm x 7,5 cm 100
312 Masker karet box -
313 Masker oksigen adult 20
314 Masker oksigen infant -
315 Masker oksigen pediatric 20
316 Masker Tali box - 7
317 Needle 23 100
318 Needle 25 100
319 Needle 27 100
320 Needle hypodermic -
321 Onescrub 2 % -
322 Plain catgut with needle 2/0 box 5
323 Plain catgut with needle 3/0 box 3
324 Plester 5 yards x 2 inchi roll -
325 Sabun antibakteri 500 ml 15
326 Sarung tangan steril no 7 pasang 37 400
327 Sarung tangan steril no. 7.5 pasang 300
328 Sarung tangan UK L box 4
329 Sarung tangan UK M -
330 Sarung tangan UK S -
331 Serum Bisa Ular -
332 Silk black 1 pcs 24
333 Silk black 2/0 pcs 24
334 Silk black 3/0 pcs 24
335 silk black 4/0 pcs 24
336 Silk braided without needle 2/0 5
337 Silk braided without needle 3/0 5
338 Silk no 1 18
339 Silk no 2/0 20
340 Silk no 4/0 20
341 Silk no.3/0 paket 18
342 Surgical tape 1,25 cm x 9,10 cm -
343 Surgical tape 2,5 cm x 9,10 cm -
344 Test Kehamilan -
345 Three way stop cock -
 346 Umbilical Cord Box 3
347 Urine bag -
348 Wing needle no 21 100
349 Wing needle no 23 100
350 Wing needle no 25 100
351 Wing needle no 27 100
OBAT GIGI -
352 3M ESPE Scotchbon -
353 3M ESPE Cavif -
354 3M ESPE Filtek -
355 Fuji-IX -
356 Pulp-X -
357 Tricresol Formalina -
358 Iodoform Paste -
359 Eugenol -
360 Master bond -
361 Mutific -
362 Directa -
363 CHKM 10 ml/botol -
364 Devitalisasi pasta (non arsen) tube -
365 Ethyl Klorida semprot 100 ml/botol -
366 Fletcher serbuk dan cair botol -
367 Glass Ionomer (Fuji) botol -
368 Kalsium Hidroksida Pasta (Hydcal) tube -
369 Mummifying Pasta (Iodoform) tube -
370 Semen Seng Fosfat serbuk dan cairan (Zink) botol -
371 Stopping Flatcher ( Flatcher ) serbuk dan cairan botol -
UMUM
BPJS
JUMLAH KUNJUNGAN RESEP BAYAR GRATIS

Mengetahui, Yang Meminta/Melaporkan

Kepala UPTD, Pertengahan dan Perbekalan Kesehatan Kepala Puskesmas LEMO

H. Setiono, SKM
NIP. 19700916 199303 1 008
AN LEMBAR PERMINTAAN OBAT
(LPLPO)

Dokumen Nomor
UPPK
Puskesmas Lemo
Bulan Desember
Tahun 2019

PEMBERIAN
SEDIA PAKAI SISA STOK STOK OP MINTA
APBD LAIN JML

- - - -
550 - 550 550
- - -
600 - 600 600
82 2 80 82
- - - -
- - - -
154 1 153 154
- - - -
- - - -
150 50 100 160
- - -
1,130 210 920 1,172
1,560 100 1,460 1,580
10,500 100 10,400 10,520
10,150 150 10,000 10,180
- - - -
14 5 9 15
100 - 100 100
222 61 161 234
- - - -
80 - 80 80
20 - 20 20
42 - 42 42
- - -
- - -
1,050 150 900 1,080
400 200 200 440
210 80 130 226
2,650 480 2,170 2,746
- - -
100 - 100 100
1,150 20 1,130 1,154
 76 10 66 78
159 - 159 159
- - - -
- - - -
- - - -
- - - -
- - - -
1,530 330 1,200 1,596
164 24 140 169
990 60 930 1,002
- - - -
31 5 26 32
- - - -
- - - -
87 14 73 90
- - - -
100 - 100 100
- - - -
450 60 390 462
- - - -
1,650 10 1,640 1,652
- - -
- - -
- - - -
120 10 110 122
44 28 16 50
24 - 24 24
94 - 94 94
- - - -
- - - -
2,390 650 1,740 3,800
- - - -
- - - -
- - - -
- - - -
- - - -
112 - 112 112
480 - 480 480
- - - -
- - - -
60 60 - 72
- - - -
- - - -
- - - -
- - - -
 - - - -
- - - -
24 - 24 24
24 - 24 24
- - - -
- - - -
- - - -
- - - -
670 - 670 670
- - - -
- - - -
- - - -
- - - -
470 10 460 472
560 26 534 565
- - - -
50 - 50 50
13 - 13 13
126 - 126 126
18 1 17 18
24 7 17 25
- - - -
310 10 300 312
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
60 1 59 60
490 - 490 490
- - -
- - -
515 20 495 519
29 14 15 32
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
530 10 520 532
600 110 490 622
46 3 43 47
 - - - -
- - - -
190 20 170 194
2 - 2 2
- - - -
100 - 100 100
90 - 90 90
52 - 52 52
2 - 2 2
- - - -
- - - -
- - - -
1,250 620 630 1,374
- - - -
1,070 100 970 1,090
74 - 74 74
500 - 500 500
- - - -
- - - -
- - - -
- - - -
- - - -
565 120 445 589
- - -
30 20 10 34
- - - -
- - - -
10 - 10 10
- - - -
1,060 25 1,035 1,065
- - -
111 111 - 133
- - - -
43 15 28 46
700 - 700 700
- - - -
500 - 500 500
- - - -
- - -
77 25 52 82
- - -
550 - 550 550
- - -
- - -
40 - 40 40
 - - -
- - - -
- - - -
- - -
2,440 710 1,730 2,582
215 54 161 226
450 10 440 452
- - -
40 40 - 48
- - -
16 16 - 19
14 - 14 14
- - - -
- - -
- - - -
- - - -
- - -
- - -
- - - -
- - - -
- - - -
470 120 350 494
- - - -
- - - -
- - - -
- - - -
17 3 14 18
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
31 3 28 57
- - - -
121 - 121 121
760 - 760 760
510 170 340 544
48 - 48 48
10 5 5 11
- - - -
385 135 250 412
150 140 10 178
120 5 115 121
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
60 - 60 60
- - - -
10 - 10 10
- - - -
275 19 256 279
- - - -
- - - -
- - - -
- - - -
-
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
8 - 8 8
- - - -
- - - -
- - - -
 - - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - -
- - - -
-
251 94 157 270
178 - 178 178
139 - 139 139
77 - 77 77
- - - -
- - - -
- - - -
- - - -
8 - 8 8
24 - 24 24
11 - 11 11
5 - 5 5
- - - -
11 - 11 11
1 - 1 1
1 - 1 1
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
17 - 17 17
37 - 37 37
- - - -
- - - -
129 - 129 129
20 - 20 20
- - - -
7 - 7 7
- - - -
 - - - -
- - - -
15 10 5 17
40 - 40 40
2 - 2 2
- - - -
69 - 69 69
73 53 20 84
- - -
- - - -
100 40 60 108
- - - -
20 - 20 20
- - - -
20 - 20 20
7 7 - 8
100 - 100 100
100 - 100 100
100 100 - 120
- - - -
- - - -
5 - 5 5
3 - 3 3
- - - -
15 6 9 16
437 137 300 464
300 100 200 320
4 4 - 5
- - - -
- - - -
- - - -
24 - 24 24
24 - 24 24
24 - 24 24
24 - 24 24
5 - 5 5
5 - 5 5
18 - 18 18
20 - 20 20
20 - 20 20
18 - 18 18
- - - -
- - - -
- - - -
- - - -
 3 - 3 3
- - - -
100 - 100 100
100 - 100 100
100 - 100 100
100 - 100 100
-
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -

JUMLAH

Lemo, 02 Januari 2020

Yang Menerima
Petugas Puskesmas

Achdissam Noor Habibi, S. Farm., Apt

NIP. 19930620 201903 1 004
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

PUSKESMAS : LEMO Dokumen Nomor

KECAMATAN : Teweh Tengah UPPK
KABUPATEN : Barito Utara Puskesmas Lemo
PROVINSI : Kal-Teng Bulan Januari
Tahun 2019

PEMBERIAN
NO NAMA OBAT UKURAN/ DOSIS STOK AWAL TERIMA SEDIA PAKAI SISA STOK STOK OP MINTA
APBD LAIN JML

1 Acetosal tab 100 mg 100 tab/kotak - - - - -

2 Acyclovir tablet 200 mg 100 tablet/kotak 550 550 - 550 550
3 Acyclovir Salep Kulit tube - - - -
4 Acyclovir tablet 400 mg 100 tablet/kotak 600 600 - 600 600
5 Albendazole tablet 400 mg tablet 80 80 - 80 80
6 Alupurinol tablet 100 mg 100 tablet/kotak - 200 200 90 110 218
7 Alupurinol tablet 300 mg 100 tablet/kotak - - - - -
8 Ambroxol sirup 15 mg /ml botol 153 153 28 125 159
9 Ambroxol tab 100 tab/kotak - 100 100 100 - 120 500
10 Aminofilin injeksi - - - - -
11 Aminofilin tablet 200 mg tablet 100 100 - 100 100
12 Amitriptilin tablet salut 25 mg - - - - -
13 Amlodipine tab 10 mg 100tablet/kotak 920 920 240 680 968 500
14 Amlodipine tab 5 mg tab 100 tablet/kotak 1,460 1,460 260 1,200 1,512
15 Amoksisilin kaplet 250 mg kaplet 10,400 10,400 100 10,300 10,420
16 Amoksisilin kaplet 500 mg kaplet 10,000 10,000 - 10,000 10,000
17 Amoksisilin Sirup kering 125 mg/5ml botol - - - - - 100
18 Amoksisilin Sirup kering 250 mg/5ml - 20 20 - 20 20
19 Amoxicilin drop 9 9 2 7 9
20 Ampicilin tablet 100 100 - 100 100
21 Antasida Doen II suspensi botol 161 161 70 91 175 100
22 Antasida Doen tablet kombinasi tablet - 300 300 230 70 346 500
23 Antifungi Doen Salep 80 80 5 75 81
24 Antihemoroid Supp suppo 20 20 9 11 22 20
25 Aqua pro injeksi botol 42 42 12 30 44
26 Arfen 400 mg tablet 100tablet/kotak - - - -
27 Armacort cream tube - - - -
28 Asam Askorbat tablet 50 mg/vit c tablet 900 900 193 707 939
29 Asam Folat tablet 1 mg tablet 200 200 50 150 210
30 Asam Folat tablet 400mcg (Profolat) tablet 130 500 630 395 235 709
31 Asam Mefenamat (Solasic) tablet 500 mg tablet 2,170 2,170 870 1,300 2,344
32 Atenolol tab 50 mg 100 tablet/kotak - - - - -
33 Atropine injeksi 100 100 - 100 100
34 Attapulgite tab 600 mg (new antides) 1,130 1,130 570 560 1,244
35 Betametason krim 1% tube 66 66 16 50 69 50
36 Biovitan sirup 159 159 - 159 159
37 Bisacodyl suppositoria 10 mg suppo - - - - -
38 Bisacodyl suppositoria 5 mg suppo - - - - -
39 Calsium laktat tablet 500 mg tablet - 500 500 20 480 504
40 Captopril tablet 12,5 mg tablet - 200 200 50 150 210 500
41 Captopril tablet 25 mg tablet - - - - -
42 Captopril tablet 50 mg tablet 1,200 1,200 50 1,150 1,210
43 Caviplex sirup 140 140 27 113 145
44 Cefadroksil kapsul 500 mg kapsul 930 930 200 730 970
45 Cefadroksil 125mg/5ml sirup botol - - - - -
46 Cefadroksil 250mg/5ml sirup botol 26 26 10 16 28
47 Cefixim sirup kering 100 mg/5ml botol - - - - -
48 Cendo mydriatril - - - - -
49 Cetirizine sirup 73 73 17 56 76 50
50 Cetirizine tab - 100 100 100 - 120 500
51 Cianokobalamin injeksi 500 mcg ampul 100 100 - 100 100
52 Cianokobalamin tablet 50 mg - - - - -
53 Cimetidine Tab tablet 390 390 140 250 418
54 Ciprofloksasin infus botol - - - - -
55 Ciprofloksasin tablet 500 mg tablet 1,640 1,640 40 1,600 1,648
56 Clindamisin kapsul 300 mg kapsul - - - - -
57 Clopidogrel tab 75 mg tablet - - - - -
58 Cloramfenikol kapsul 500 mg (chloramex) kapsul - - - - - 500
59 Cloramfenikol kapsul 250 mg kapsul 110 110 - 110 110
60 Cloramfenikol salep kulit (bufacetin) tube 16 16 5 11 17 96
61 Cloramfenikol salep mata tube 24 24 5 19 25
62 Cloramfenikol syr 125mg/ml botol 94 94 10 84 96
63 Cloramfenikol Tetes Telinga (Reco TT) botol - - - - - 24
64 Cloramfenikol tetes mata (Reco TM) botol - - - - - 24
65 Clorfeniramini Maleat tablet 4 mg (Orphen) 1,740 1,740 610 1,130 3,800 500
66 Cotrimoksazol Doen II tablet anak - - - - -
 67 Cotrimoksazol Doen Suspensi kombinasi botol - 100 100 - 100 100
68 Cotrimoksazol Doen tablet dewasa 480 mg tablet - 500 500 500 - 600
69 Deksametason injeksi ampul - 50 50 50 - 60
70 Deksametason tablet 0,5 mg tablet - 1,000 1,000 570 430 1,114 500
71 Diphenhydramine Tab Tablet - 300 300 300 360
72 Difenhidramin injeksi 10 mg/ml 112 112 - 112 112
73 Digoxin tablet 0,25 mg 480 480 - 480 480
74 Domperidon suspensi 5 mg/5 ml botol - 20 20 7 13 21 50
75 Domperidon tablet 10 mg - 200 200 20 180 204 500
76 Efhedrin inj 50mg/ml ampul - - - - -
77 Epinefrin (adrenalin) injeksi 0.1%/1 ml ampul - - - - -
78 Ergotamin Cafein tablet (antimigren) tablet - - - - -
79 Eritromisin kaplet 500 mg kaplet - - - - - 500
80 Eritromisin kapsul 250 mg kapsul - - - - -
81 Eritromisin sirup 200 mg/5ml botol - - - - -
82 Erlamicetyn Tetes Telinga Botol - - - - -
83 Etanol 70% (100 ml) botol 24 24 2 22 24
84 Etanol 70% (300 mL) botol 24 24 4 20 25
85 Etanol 70% (1000 ml) botol - - - - -
86 Ethambutol tablet 250 mg 200 tablet/kotak - - - - -
87 Famotidin tablet 40 mg - - - - -
88 Fitomenadion injeksi 10 mg/ml ampul - - - - -
89 Fitomenadion tablet 10 mg tablet 670 670 - 670 670
90 Flunadin tablet 100 tablet/kotak - - - - -
91 Fondazen tab - - - - -
92 Fundifar tablet tablet - - - - -
93 Furosemid injeksi10 mg/ml ampul - - - - -
94 Furosemid tablet 40 mg 200 tablet/kotak 460 460 10 450 462
95 Garam Oralit I serbuk ,kombinasi sachet 534 534 26 508 539
96 Gemfibrozil tab 300 mg tablet - - - - -
97 Gentamisin injeksi 40 mg/ ml ampul 50 50 - 50 50
98 Gentamisin salep kulit 0,1% tube 13 13 2 11 13
99 Gentamisin salep mata (genoin) tube 126 126 - 126 126
100 Gentamisin tetes mata 0,3% botol 17 24 41 - 41 41
101 Gentian Violet botol 17 24 41 7 34 42
102 Geriavita tab - 60 60 60 - 72
103 Glibenklamid tablet 5 mg tablet 300 300 20 280 304
104 Glimepiride tab 1 mg tab tablet - - - - -
105 Glimepiride tab 2 mg tab tablet - 100 100 - 100 100 100
106 Glimepiride tab 3 mg tab tablet - - - - -
107 Gliseril guaiakolat tablet 100 mg 1000 tablet/botol - - - - -
108 Glucodex tab tablet - - - - -
109 Glukosa larutan infus 5 % steril botol - - - - -
110 Glukose larutan Infus 10 % steril botol 59 59 - 59 59
111 Griseovulfin 125 g tab tablet 490 490 120 370 514
112 Guaifenesin tab 100 tablet/box - 1,500 1,500 1,040 460 1,708 500
113 Hemafort tablet tablet - - - -
114 Hidroklortiazida tablet 25 mg 1000 tablet/botol 495 495 10 485 497
115 Hidrokortison krim 2,5 % tube 15 15 13 2 18 96
116 Ibuprofen suspensi 100 mg /5 ml botol - - - - -
117 Ibuprofen tablet 200 mg tablet - - - - -
118 Ibuprofen tablet 400 mg tablet - - - - -
119 Ifarsyl sirup botol - - - - -
120 Isonat tablet tablet - - - - -
121 Isoniazida tablet 100 mg 1000 tablet/botol - - - - -
122 Isoniazida tablet 300 mg 1000 tablet/botol - - - - -
123 Isosorbit Dinitrat tablat sublingual 5 mg 520 520 30 490 526
124 Katergi tab 490 490 120 370 514
125 Ketokonazol krim tube 43 43 7 36 44
126 Ketokonazol tablet 200 mg - - - - -
127 Ketorolac injeksi 10 mg ampul - - - - -
128 Ketorolac tab tablet 170 170 - 170 170
129 Ketrorolac injeksi 30 mg/ml ampul 2 2 2 - 2
130 Lansoprazole casp - - - - -
131 Levofloksasin tablet 500 mg 100 tablet/kotak 100 100 - 100 100
132 Lidokain Comp 2% ampul 90 90 - 90 90
133 Lidokain injeksi 2% ampul 52 52 - 52 52
134 Lisol ( Kresol tersaponifikai 50% ) 2 2 - 2 2
135 Loperamid tablet 2 mg - - - - -
136 Loratadin tablet 10 mg tablet - 200 200 20 180 204 500
137 Meloksicam tablet 7,5 mg tablet - - - - - 500
138 Metamizol tab 630 630 550 80 740
139 Metformin Hcl tablet 500 mg tablet - 100 100 - 100 100 1,000
140 Metformin tab 850 mg 970 970 120 850 994
141 Methylergomethrin injeksi 74 74 - 74 74
142 Metilergometrin Maleat tablet 0,125 mg tablet 500 500 30 470 506
143 Metilprednisolon tablet 4 mg - 100 100 - 100 100 500
144 Metilprednisolon tablet 8 mg - - - - -
145 Metoklopramide drop 2mg/ml (gavistal) botol - - - - -
146 Metoklorpramide sirup 5 mg/5 ml (Lexapram) botol - - - - -
147 Metoklorpramide tablet 10 mg tablet - - - - -
148 Metoklorpramide tablet 5 mg 445 445 160 285 477
149 Metronidazole sirup 125 mg/5 ml botol - - - -
150 Metronidazole tablet 250 mg tablet 10 10 10 - 12
151 Metronidazole tablet 500 mg tablet - - - - - 500
152 Metylprednisolon injeksi - - - - -
153 MgSo4 20% 10 10 - 10 10
154 Mikonazole krim 2% tube - - - - - 48
155 Miniaspi tablet 1,035 1,035 40 995 1,043
156 Mionalgin tab - - - - -
157 Moxalas sirup botol - - - - -
158 Natrium diklofenac tablet 50 mg tablet - 200 200 50 150 210 500
159 Natrium Klorida larutan infus 0,9 % botol 28 28 9 19 30 20
160 Nipedipin tablet 10 mg 700 700 - 700 700
161 Nistatin tablet 500.000 IU tablet - - - - -
162 Nistatin tablet salut 100.000 IU/g 500 500 - 500 500
163 Norages injeksi injeks - - - - -
164 Novatrim syr - - - - -
165 OBH Sirup 52 52 34 18 59 84
166 Ofloxacin tablet 200 mg tablet - - - -
167 Ofloxacin tablet 400 mg 50 tablet/botol 550 550 - 550 550
168 Oksitetrasiklin injeksi 10 vial/kotak - - - - -
169 Oksitetrasiklin Salap kulit 3% tube - - - - -
170 Oksitetrasiklin Salap mata 1% tube 40 40 - 40 40
171 Omeprazol inj 40 mg/vial - - - - -
172 Omeprazol kapsul 20 mg kapsul - 150 150 20 130 154 600
173 Oxytocin injeksi - - - - - 100
174 Paracetamol drop - - - - -
175 Parasetamol 500 mg tablet 100 tablet/kotak 1,730 10,000 11,730 1,560 10,170 12,042
176 Parasetamol sirup 125 mg/5ml botol 161 161 66 95 174 300
177 Papaverin Hcl Tablet tablet 440 440 40 400 448
178 Pehavral tablet tablet - - - -
179 Pehacain Injeksi Vial - 40 40 - 40 40
180 Phenitoin kapsul 100 mg kapsul - - - -
181 Phenobarbital injeksi - - - - -
182 Phenolglycerol Tetes Telinga 10% Botol 14 14 3 11 15 24
183 Phenytoin inj 100mg/2ml - - - - -
184 Phenzacol tablet tablet - - - - -
185 Piracetam inj 200mg/ml - - - - -
186 Piracetam injeksi 1 g/5 ml - - - - -
187 Piracetam tablet 400 mg - - - - -
188 Piracetam tablet 800 mg tablet - - - - -
189 Pirantel tablet score (base) 125 mg tablet - - - - -
190 Pirazinamid tablet 500 mg 100 tablet/kotak - - - - -
191 Piridoksin inj 100 mg/ml ampul - - - - -
192 Piridoksin tablet 10 mg tablet 350 1,000 1,350 190 1,160 1,388
193 Piroksikam tablet 10 mg - - - - -
194 Piroksikam tablet 20 mg tablet - - - - -
195 Povidon iodida larutan 10 % 30 ml botol - - - - -
196 Povidon iodida larutan 10 % 300 ml botol - - - - -
197 Povidon iodida larutan 10 % 60 ml botol 14 14 - 14 14
198 Prednison tablet 5 mg tablet - 500 500 110 390 522 500
199 Propanolol tab 10 mg tablet - - - - -
200 Propanolol tablet 40 mg - - - - -
201 Ramaflu tablet 100 tablet/kotak - - - - -
202 Ramipril tab 2,5 mg tablet - - - - -
203 Ramipril tab 5 mg tablet - - - - -
204 Ranitidin injeksi 50 mg /2 ml ampul - - - - -
205 Ranitidin tablet 150 mg tablet - - - - -
206 Remco sirup - 50 50 9 41 52 50
207 Ringer Laktat larutan infus steril botol 28 20 48 28 20 57
208 Rivanol/Etakridin laktat 0,1 % botol - - - - -
209 Salbutamol sirup 121 121 4 117 122
210 Salbutamol tablet 2 mg tablet 760 760 40 720 768
211 Salbutamol tablet 4 mg tablet 340 340 40 300 348
212 Salep 2-4 kombinasi pot 48 48 4 44 49
213 Salisil Bedak 2% sachet 5 5 4 1 6 100
214 Samcodin tab - 200 200 120 80 224 500
215 Simvastatin tablet 10 mg tablet 250 250 170 80 284 300
216 Simvastatin tablet 20 mg tablet 10 500 510 - 510 510
217 Solvita sirup botol 115 115 10 105 117
218 Solfenox Sirup Kering Botol - - - - -
219 Sucralate sirup botol - - - - -
220 Tablet tambah darah tablet - - - - -
221 Ternik Sirup botol - - - - -
222 Tetrasiklin kapsul 250 mg kapsul - - - - -
 223 Tetrasiklin kapsul 500 mg - - - - -
224 Thiamin injeksi 100 mg/ml ampul 60 60 - 60 60
225 Thiamin tablet 50 mg tablet - - - - -
226 Tramadol inj 50mg/ml 10 10 - 10 10
227 Tramadol tablet 40 mg 50 tablet/kotak - - - - -
228 Tropidryl sirup 256 256 51 205 266 96
229 Vitamin B kompleks tablet - 300 300 140 160 328 1,000
230 Yekamulvita tab - - - - -
231 Zinc syr - 20 20 4 16 21 50
232 Zink tablet tablet - 200 200 - 200 200 500
LABORATORIUM - -
233 Alcohol Swab Box - - - - -
234 Benecheck alat periksa - - - - -
235 Benedict - - - - -
236 Blood Lancet box - - - - -
237 Box objek glass - - - - -
238 Easy touch alat periksa - - - - -
239 EDTA 10% - - - - -
240 Hayem - - - - -
241 Immersion oil - - - - -
242 Larutan HCN 0,1N botol - - - - -
243 Mikropipet 1000l - - - - -
244 Mikropipet 100ul - - - - -
245 Mikropipet 10l - - - - -
246 Mikropipet 10ul - - - - -
247 Mikropipet 1ul - - - - -
248 Mikropipet 2ul - - - - -
249 Mikropipet 50ul - - - - -
250 Mikropipet 5ul - - - - -
251 Mission Alat Periksa 1 1 1 - 1
252 Nesco Multi check - - - - -
253 Objek Glass - - - - -
254 Onecall Alat Periksa 1 1 1 - 1
255 Pewarna Giemsa - - - - -
256 Pewarna Ziehl Neelsen - - - - -
257 Poliflex IV Canula - - - - -
258 Poligyp 10 cm 8 8 - 8 8
259 Pot Sputum Pcs - - - - -
260 Pot Urin Pcs - - - - -
 261 Rak tabung reaksi - - - - -
262 Rees Ecker - - - - -
263 Sino Care Alat Periksa 1 1 1 - 1
264 SM Sedimen - - - - -
265 Stik Asam urat Autocheck - - - - - 5
266 Stik Asam urat Benecheck - - - - - 5
267 Stik Asam urat humasens - - - - - 5
268 Stik Asam Urat Sino Care 6 6 6 - 7 5
269 Stik Gula Autocheck - - - - - 5
270 Stik Gula Beneck - - - - - 5
271 Stik Gula Humasens - - - - - 5
272 Stik Gula Onecall 5 5 5 - 6 5
273 Stik kolesterol Autocheck - - - - - 5
274 Stik kolesterol Benecheck - - - - - 5
275 Stik kolesterol Humasens - - - - - 5
276 Stik Kolesterol Mission 5 5 5 - 6 5
277 Stik Urin Parameter Box - - - - - 2
278 Turk - - - - -
ALAT KESEHATAN DAN BAHAN HABIS PAKAI - -
279 Alat Suntik sekali pakai 1 ml 100 set/kotak 157 157 - 157 157
280 Alat Suntik sekali pakai 2,5ml 100 set/kotak 178 178 - 178 178
281 Alat Suntik sekali pakai 3 ml 139 139 - 139 139
282 Alat Suntik sekali pakai 5 ml 100 set/kotak 77 77 - 77 77
283 Canula nasal oksigen adult - - - - - 10
284 Canula nasal oksigen infant - - - - -
285 Canula nasal oksigen pediatric - - - - - 10
286 Catgut crome 1 - - - - -
287 Catgut crome 2/0 8 8 - 8 8
288 Catgut No.2/0 paket 24 24 - 24 24
289 Catgut plain 3-0 11 11 - 11 11
290 Fescoplast 1,25cm x 4,5m 5 5 - 5 5
291 Fescoplast 2,5cm x 4,5 m - - - - -
292 Fescoplast 5cm x 4,5 m 11 11 - 11 11
293 FM Crepe 10cm x 4,55 m 1 1 - 1 1
294 FM Crepe 7,5cm x 4,55 m 1 1 - 1 1
295 Folley Cateter 2 way No. 16 set - - - - -
296 Folley Cateter 2 way No. 18 set - - - - -
297 Folley cateter 3 way No. 18 set - - - - -
298 Gips 3 inch roll - - - - -
299 Gips 4 inch roll - - - - -
300 Gips 6 inch roll - - - - -
301 Infuset anak set 17 17 - 17 17
302 Infuset dewasa set 37 37 - 37 37
303 IV Catheter No 18 G 50 set/kotak - - - - -
304 IV Catheter no.20 G 50 set/kotak - - - - -
305 IV Catheter no.22 G 50 set/kotak 129 129 - 129 129
306 IV Catheter no.24 G 50 set/kotak 20 20 - 20 20
307 Kapas Berlemak 500 gram bungkus - - - - -
308 Kapas pembalut 250 gram bungkus 7 7 - 7 7
309 Kasa hidrofil 36 x 80 cm - - - - -
310 Kasa hidrofil 40 x 80 bungkus - - - - -
311 Kasa kompres 40 x 40 steril bungkus - - - - -
312 Kasa pembalut 2 x 80 roll 5 5 - 5 5
313 Kasa pembalut 4 x 10 roll 40 40 - 40 40
314 Kasa Pembalut 4 x 15 roll 2 2 - 2 2
315 Kasa pembalut 4 x 3 roll - - - - -
316 Kasa pembalut 4 x 5 roll 69 69 - 69 69
317 Kasa steril 10cm x 10cm 20 20 - 20 20
318 Kasa steril 16 x 16 kotak kotak - - - -
319 Kasa steril 5cm x 5 cm - - - - -
320 Kasa steril 7,5cm x 7,5 cm 60 60 - 60 60
321 Masker karet box - - - - - 10
322 Masker oksigen adult 20 20 - 20 20
323 Masker oksigen infant - - - - -
324 Masker oksigen pediatric 20 20 - 20 20
325 Masker Tali box - - - - - 10
326 Needle 23 100 100 - 100 100
327 Needle 25 100 100 - 100 100
328 Needle 27 - - - - -
329 Needle hypodermic - - - - -
330 Onescrub 2 % - - - - - 24
331 Plain catgut with needle 2/0 box 5 5 - 5 5
332 Plain catgut with needle 3/0 box 3 3 - 3 3
333 Plester 5 yards x 2 inchi roll - - - - -
334 Sabun antibakteri 500 ml 9 9 - 9 9
335 Sarung tangan steril no 7 pasang 300 300 - 300 300 200
336 Sarung tangan steril no. 7.5 pasang 200 200 - 200 200
337 Sarung tangan UK L box - - - - - 3
 338 Sarung tangan UK M - - - - - 3
339 Sarung tangan UK S - - - - - 3
340 Serum Bisa Ular - - - - -
341 Silk black 1 pcs 24 24 - 24 24
342 Silk black 2/0 pcs 24 24 - 24 24
343 Silk black 3/0 pcs 24 24 - 24 24
344 silk black 4/0 pcs 24 24 - 24 24
345 Silk braided without needle 2/0 5 5 - 5 5
346 Silk braided without needle 3/0 5 5 - 5 5
347 Silk no 1 18 18 - 18 18
348 Silk no 2/0 20 20 - 20 20
349 Silk no 4/0 20 20 - 20 20
350 Silk no.3/0 paket 18 18 - 18 18
351 Surgical tape 1,25 cm x 9,10 cm - - - - -
352 Surgical tape 2,5 cm x 9,10 cm - - - - -
353 Test Kehamilan - - - - -
354 Three way stop cock - - - - -
355 Umbilical Cord Box 3 3 - 3 3
356 Urine bag - - - - -
357 Wing needle no 21 100 100 - 100 100
358 Wing needle no 23 100 100 - 100 100
359 Wing needle no 25 100 100 - 100 100
360 Wing needle no 27 100 100 - 100 100
OBAT GIGI - -
361 3M ESPE Scotchbon - - - -
362 3M ESPE Cavif - - - -
363 3M ESPE Filtek - - - -
364 Fuji-IX - - - -
365 Pulp-X - - - -
366 Tricresol Formalina - - - -
367 Iodoform Paste - - - -
368 Eugenol - - - -
369 Master bond - - - -
370 Mutific - - - -
371 Directa - - - -
372 CHKM 10 ml/botol - - - -
373 Devitalisasi pasta (non arsen) tube - - - -
374 Ethyl Klorida semprot 100 ml/botol - - - -
375 Fletcher serbuk dan cair botol - - - -
 376 Glass Ionomer (Fuji) botol - - - -
377 Kalsium Hidroksida Pasta (Hydcal) tube - - - -
378 Mummifying Pasta (Iodoform) tube - - - -
379 Semen Seng Fosfat serbuk dan cairan (Zink) botol - - - -
380 Stopping Flatcher ( Flatcher ) serbuk dan cairan botol - - - -
UMUM
BPJS JUMLAH
JUMLAH KUNJUNGAN RESEP BAYAR GRATIS

Lemo, 02 Februari 2020

Mengetahui, Yang Meminta/Melaporkan Yang Menerima
Kepala UPTD, Pertengahan dan Perbekalan Kesehatan Kepala Puskesmas LEMO Petugas Puskesmas

H. Setiono, SKM Achdissam Noor Habibi, S. Farm., Apt

NIP. 19700916 199303 1 008 NIP. 19930620 201903 1 004