Format Laporan Kunj PKM 2022

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)
PUSKESMAS JAMPANG FORM : LPLPO

Rasio Obat: 49036/1987= 24,6
PUSKESMAS : Jampang
KECAMATAN : Kemang PELAPORAN BULAN / PERIODE : JANUARI DOKUMEN NOMOR
KABUPATEN : BOGOR PERMINTAAN BULAN / PERIODE : FEBRUARI DINAS KAB
PROPINSI : JAWA BARAT PUSKESMAS
STOCK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOCK AKHIR PEMBERIAN

NO. NAMA OBAT SATUAN PERMINTAAN
PKD PROGRAM JKN BOK PKD PROGRAM JKN BOK PKD PROGRAM JKN BOK PKD PROGRAM JKN BOK PKD PROGRAM JKN BOK PKD PROGRAM
1 Albendazol tab tablet

0 24000 0 0 0 24000 0 0 0 24000 0 0 46371
2 Alopurinol tab tablet
200 0 0 0 200 0 0 0 111 89 0 0 0 4086
3 Ambroksol Syrup botol
0 0 0 0 0 0 0 0 0 0 0 0
4 Ambroksol tablet tablet

0 0 0 0 0 0 0 0 0 0 0 0 50457
5 Aminofilin tab tablet
0 0 0 0 0 0 0 0 0 0 0 0
6 Amitriptilin tab tablet

0 0 0 0 0 0 0 0 0 0 0 0 20,67063
7 Amlodipin tab 10 mg tablet
490 0 12200 0 490 0 12200 0 490 3590 0 0 8610 0
8 Amlodipin tab 5mg tablet

300 0 10000 0 300 0 10000 0 300 0 0 10000 0
9 Amoksisilin sirup kering botol

152 0 100 0 152 0 100 0 152 100 0 0 0 0
10 Amoksisilin 250 mg tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
11 Amoksisilin 500 mg tab tablet

0 0 55150 0 0 0 55150 0 4300 0 0 50850 0
12 Antalgin Injeksi ampul

0 0 0 0 0 0 0 0 0 0 0 0
13 Antalgin tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
14 Antasid DOEN sirup botol

73 0 0 0 73 0 0 0 10 63 0 0 0
15 Antasida kombinasi tab kunyah tablet

0 0 38400 0 0 0 38400 0 2765 0 0 35635 0
16 Anti Bakteri DOEN salep kombinasi tube

0 0 0 0 0 0 0 0 0 0 0 0
17 Anti Fungsi kombinasi salep tube

130 0 0 0 130 0 0 0 10 120 0 0 0
18 Anti Hemoroid kombinasi sup Supos

0 0 0 0 20 20 0 0 0 20 0 0 0 50
19 Antimigren DOEN kombinasi tablet

0 0 0 0 0 0 0 0 0 0 0 0
Aqua Pro Injeksi Steril, bebas
20 tablet
pirogen 0 0 90 0 0 0 90 0 0 0 90 0
21 Asam askorbat (vitamin C) tab tablet
0 0 7000 0 0 7000 0 1230 0 0 5770 0
22 Asam Mefenamat kaps tablet

4850 0 4000 0 4850 0 4000 0 2050 2800 0 4000 0
23 Asetosal tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
24 Asiklovir tab 200mg tablet

0 0 0 0 0 0 0 0 0 0 0 0
25 Asiklovir tab 400mg tablet

2550 0 0 0 2550 0 0 100 2450 0 0 0
26 Asilovir Cream tube

0 0 0 0 0 0 0 0 0 0 0 0
27 Atropin Sulfat Injeksi ampul

0 0 0 0 0 0 0 0 0 0 0 0
28 Atropin Sulfat tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
29 Bedak Salisil serb tablet

0 0 349 0 0 0 349 0 60 0 0 289 0
30 Betahistin Melistat tab tablet

0 0 0 0 0 0 0 0 0 0 0 0 300
31 Betametason krim tube

299 0 0 0 299 0 0 0 55 244 0 0 0
32 Deksametason Injeksi ampul

0 0 0 0 0 0 0 0 0 0 0 0
33 Deksametason tab tablet 2300

0 0 8860 0 2300 0 8860 0 2300 860 0 0 8000 0 5000
34 Diazepam enema (Suppos) Supos

80 0 0 0 80 0 0 0 80 0 0 0
35 Diazepam tab tablet

60 0 0 0 60 0 0 0 30 30 0 0 0
36 Difenhidramin HCl Injeksi ampul

0 2 0 0 0 2 0 0 0 2 0 0
37 Digoksin tab tablet

100 0 0 0 100 0 0 0 100 0 0 0
38 Dimenhidrinat tab tablet

0 0 0 0 0 0 0 0 0 0 0 0 300
39 Efedrin HCl tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
Epinefrin HCl / Bitatrtat (Efinefrin /
40 ampul
Adrenalin Injeksi) 0 0 0 0 2 0 2 0 0 0 2 0 0
41 Etanol 70% botol

0 0 0 16 0 0 0 16 3 0 0 0 13
42 Ethambutol tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
FDC anak 3KDT mengandung:
43 rifampisin kapl 75mg + isoniazid tab paket
50mg + pirazinamid tab 150mg (FDC 0 0 0 0 3 0 3 0 0 0 3 0 0
FDC dewasa 2KDT mengandung:
150mg (FDC 2) 0 2 0 0 0 2 0 0 2 0 0 0 0
FDC dewasa 4KDT mengandung:
75mg + pirazinamid tab 400mg + 0 6 0 0 16 0 22 0 0 0 22 0 0
46 FDC Sisipan paket

0 0 0 0 0 0 0 0 0 0 0 0
47 Fenitoin Natrium tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
48 Fenobarbital injeksi ampul
0 0 0 0 0 0 0 0 0 0 0 0
49 Fenobarbital tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
50 Fitomenadion (vitamin K 1) injeksi ampul

230 0 0 0 230 0 0 0 230 0 0 0
51 Fitomenadion (vitamin K 1) tab tablet

100 0 0 0 100 0 0 0 100 0 0 0
52 Furosemid tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
53 Garam oralit kombinasi serb sachet

0 19800 0 0 0 19800 0 0 150 0 19650 0 0
54 Gentamisin Injeksi ampul

0 0 0 0 0 0 0 0 0 0 0 0
55 Gentian Violet Larutan botol

0 0 0 0 0 0 0 0 0 0 0 0
Gigi, Lidokain 2% + epinefrin
56 ampul
1:80.001 0 0 270 0 0 0 270 0 30 0 0 240 0
Gigi, Bahan tumpatan sementara
57 set
lar+ serb (Temporary) 0 0 0 0 0 0 0 0 0 0 0 0
58 Gigi, Bonding buah

0 0 0 0 0 0 0 0 0 0 0 0
59 Gigi, Eritromisin kaps tablet

0 0 0 0 0 0 0 0 0 0 0 0
60 Gigi, Etil Klorida spray botol

15 0 0 0 15 0 0 0 3 12 0 0 0
61 Gigi, Etsa buah

0 0 0 0 0 0 0 0 0 0 0 0
62 Gigi, Eugenol Cairan botol

0 0 0 0 0 0 0 0 0 0 0 0
Gigi, Glass ionomer ART (Atraumatic
63 set
Restorative Treatment) 0 0 0 0 0 0 0 0 0 0 0 0
64 Gigi, Kalsium hidroksida bubuk, pasta tube

0 0 0 0 0 0 0 0 0 0 0 0
Gigi, Klorfenol kamfer mentol
65 botol
(CHKM) cairan 0 0 0 0 0 0 0 0 0 0 0 0
Gigi, Komposit resin Set +Bonding +
66 set
ETSA 0 0 0 0 0 0 0 0 0 0 0 0
67 Gigi, Mummifying Pasta tablet

0 0 0 0 0 0 0 0 0 0 0 0
68 Gigi, Pasta devitalisasi (non arsen) tube

0 0 0 0 0 0 0 0 0 0 0 0
Gigi, Semen Seng Fosfat Serbuk &
69 set
Cairan 0 0 0 0 0 0 0 0 0 0 0 0
70 Glibenklamid tab tablet

700 0 0 0 700 0 0 0 200 500 0 0 0
71 Gliseryl Guayakolat Syrup botol

0 0 0 0 0 0 0 0 0 0 0 0
72 Gliseryl Guayakolat tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
73 Glukosa Larutan Infus botol

0 0 0 0 0 0 0 0 0 0 0 0
74 Griseofulviin (micronized) tab tablet

0 0 0 0 0 0 0 0 0 0 0 0 1000
75 Haloperidol 1.5 mg tab tablet
0 0 0 0 0 0 0 0 0 0 0 0
76 Haloperidol tab 5 mg tab tablet

0 3030 0 0 0 3030 0 0 350 0 2680 0 0
77 Hibiscrub sol botol

0 0 0 0 0 0 0 0 0 0 0 0
78 Hidroklorotiazid tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
79 Hidrokortison krim tube

285 0 154 0 285 0 154 0 55 230 0 154 0
Hydroksil Ethyl Starch
80 botol
200.000(WIDAHES) 0 0 0 0 0 0 0 0 0 0 0 0
81 Ibuprofen tab 200mg tablet

0 0 0 0 0 0 0 0 0 0 0 0
82 Ibuprofen tab 400mg tablet

0 0 1400 0 0 0 1400 0 456 0 0 944 0
83 Isoniazid tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
84 Isosorbid dinitrat tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
85 Kalium Diklofenak tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
86 Kalsium Glukonat injeksi ampul

476 0 0 0 476 0 0 0 476 0 0 0
87 Kalsium laktat tab tablet

1950 0 16600 0 1950 0 16600 0 1950 0 0 16600 0
88 Kaptopril tab tablet

0 0 10200 0 0 0 10200 0 320 0 0 9880 0
89 Karbamazepin tab tablet

0 560 0 0 0 560 0 0 0 560 0 0
90 Karbon Aktif tab tablet 200

0 0 0 0 200 0 0 0 200 0 0 0
91 Ketorolac Injeksi ampul

0 0 0 0 0 0 0 0 0 0 0 0
92 Kloramfenikol kaps tablet

0 0 1600 0 0 0 1600 0 140 0 0 1460 0
93 Kloramfenikol salep tube

24 0 457 0 24 0 457 0 96 24 0 361 0
94 Kloramfenikol salep mata tube

0 0 31 0 0 0 31 0 2 0 0 29 0
95 Kloramfenikol susp Supos

0 0 0 0 0 0 0 0 0 0 0 0 50
96 Klorfeniramin tab (CTM) tablet 5000

0 0 17500 0 5000 0 17500 0 700 500 4300 0 17000 0 5000
97 Klorpromazin tab tablet

0 200 0 0 0 200 0 0 85 0 115 0 0
98 Kodein tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
Kotrimoksazol (dewasa) tab 480mg
99 tablet
kombinasi 1150 0 0 0 1150 0 0 0 1150 0 0 0
Kotrimoksazol anak kombinasi
100 botol
suspensi 225 0 0 0 225 0 0 0 35 190 0 0 0
Kotrrimoksazol Pedriatik kombinasi
101 tablet
tablet 0 0 0 0 0 0 0 0 0 0 0 0
Larutan mengandung elektrolit
102 botol
(Ringer Laktat) 225 0 1000 0 225 0 1000 0 200 25 0 1000 0
103 Levertran salep tube

0 0 0 0 0 0 0 0 0 0 0 0
104 Lidokain Injeksi ampul 65

0 0 0 0 65 0 0 0 65 0 0 0
105 Lisol larutan botol

0 0 0 0 0 0 0 0 0 0 0 0
106 Magnesium Sulfat inj 20% (i.v.) ampul

0 0 0 0 0 0 0 0 0 0 0 0
107 Magnesium Sulfat inj 40% (i.v.) ampul

0 0 0 0 0 0 0 0 0 0 0 0
108 Meloksikam tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
109 Metformin tab tablet 800

0 0 800 0 800 0 800 0 800 800 0 0 0 0 2000
110 Methyl prednisolon tab tablet

800 0 0 0 800 0 0 0 800 0 0 0
111 Methyldopa tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
112 Metilergometrin inj ampul

50 0 0 0 50 0 0 0 50 0 0 0
113 Metilergometrin tab tablet

0 0 0 0 0 0 0 0 0 0 0 0 500
114 Metoklopramid tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
115 Metronidazol tab tablet

0 0 4500 0 0 0 4500 0 100 0 0 4400 0
116 Meylon 84-B.P. ampul

0 0 0 0 0 0 0 0 0 0 0 0
117 Mikonazol krim tube

112 0 0 0 112 0 0 0 112 0 0 0
Multivitamin + mineral + ginseng
118 tablet
(Farmaton) 0 0 0 0 0 0 0 0 0 0 0 0
119 Multivitamin +Vitamin C (Enervon C) tablet

0 0 0 0 0 0 0 0 0 0 0 0
Na. Naurylsulfoacetat +Na.Citrat
120 tube
+sorbitol PEG 400 (Mikrolax) 0 0 0 0 0 0 0 0 0 0 0 0
121 N-Asetil Sistein tab tablet 3840

0 0 9900 0 3840 0 9900 0 2640 300 1200 0 9600 0 5000
122 Natrium Bikarbonat tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
123 Natrium Diklofenak tab tablet 1350

0 0 950 0 1350 0 950 0 100 1350 0 850 0 1000
124 Natrium Klorida Larutan Infus botol

0 0 101 0 0 0 101 0 6 0 0 95 0
125 Neo Diaform tab tablet

0 0 3265 0 0 0 3265 0 425 0 0 2840 0
126 Nifedipin tab tablet 100

100 0 0 0 200 0 0 0 200 0 0 0 200
127 Nistatin tab sal gula 500.000 IU tablet 300

100 0 0 0 400 0 0 0 50 350 0 0 0
128 Nistatin tab vaginal 100.000 IU tablet 100

200 0 0 0 300 0 0 0 300 0 0 0
129 Obat Batukl Hitam ( OBH) Cairan botol
0 0 0 0 0 0 0 0 0 0 0 0
130 Oksigen ih, gas dalam tabung botol

7 0 0 0 7 0 0 0 7 0 0 0
131 Oksitetrasiklin HCl Salep Kulit tube

0 0 0 0 0 0 0 0 0 0 0 0
132 Oksitetrasiklin HCl Salep Mata tube

0 0 84 0 0 0 84 0 7 0 0 77 0
133 Oksitosin injeksi ampul

50 0 0 0 50 0 0 0 50 0 0 0
134 Ondansentron injeksi ampul

0 0 0 0 0 0 0 0 0 0 0 0
135 Papaverin tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
136 Parasetamol sirup botol

625 0 1100 0 625 0 1100 0 210 415 0 1100 0
137 Parasetamol tab 100 mg tablet

0 0 0 0 0 0 0 0 0 0 0 0
138 Parasetamol tab 500 mg tablet

0 0 116264 0 0 0 116264 0 6530 0 0 109734 0
139 Piracetam Injeksi ampul

0 0 0 0 0 0 0 0 0 0 0 0
140 Piridoksin (vitamin B6) tab tablet

16400 0 15550 0 16400 0 15550 0 760 15640 0 15550 0
141 Piroksikam tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
142 Povidon Iodida larutan botol

30 0 0 0 30 0 0 0 30 0 0 0 0 100
143 Prednison tab tablet

0 0 5700 0 0 0 5700 0 4700 0 0 1000 0
144 Proparonol tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
145 Propiltiourasil tab tablet

500 0 0 0 500 0 0 0 50 450 0 0 0
146 Pyrantel l syrup botol

0 0 0 0 0 0 0 0 0 0 0 0
147 Pyrazinamid tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
148 Ranitidin tab tablet

0 0 2900 0 0 0 2900 0 1800 0 0 1100 0
149 Reserpin tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
Retinol (vitamin A) kaps lunak
150 tablet
100.000 IU 0 0 0 0 550 0 550 0 0 0 550 0 0
Retinol (vitamin A) kaps lunak
151 tablet
200.000 IU 0 1650 0 0 3200 0 4850 0 0 0 4850 0 0
152 Rifampisin tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
153 Salbutamol + Nacl injeksi ampul 10

60 0 100 0 70 0 100 0 20 50 0 100 0
154 Salbutamol tab tablet 200

110 0 0 0 310 0 0 0 120 190 0 0 0 300
155 Salep 2-4 kombinasi tube

0 0 0 0 0 0 0 0 0 0 0 0
156 Sefadroksil kaps Kapsul
0 0 0 0 0 0 0 0 0 0 0 0
157 Sefadroksil syrup botol

0 0 0 0 0 0 0 0 0 0 0 0
158 Seftriaxon injeksi ampul

0 0 0 0 0 0 0 0 0 0 0 0
159 Serum anti bisa ular I inj (i.m./i.v.) ampul

1 0 0 0 1 0 0 0 1 0 0 0
160 Serum antitetanus (A.T.S) ampul

0 0 0 0 0 0 0 0 0 0 0 0
161 Sianokobalamin Injeksi (Vit B 12) ampul

0 0 0 0 0 0 0 0 0 0 0 0
162 Simetidin tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
163 Simvastatin tab tablet 800

50 0 0 0 850 0 0 0 130 720 0 0 0 1000
164 Siproploxacin tab tablet

0 0 1950 0 0 0 1950 0 0 0 1950 0
165 Streptomicin Injeksi ampul

0 0 0 0 0 0 0 0 0 0 0 0
166 Tablet Tambah Darah Kombinasi tab sachet

0 64290 0 0 94600 0 158890 0 0 2350 0 156540 0 0
167 Tetes mata deksametason phosphat botol

0 0 0 0 0 0 0 0 0 0 0 0
168 Tetes mata Kloramfenikol botol

0 0 0 0 0 0 0 0 0 0 0 0 100
169 Tetes Mata Levofloksaxin botol

0 0 0 0 0 0 0 0 0 0 0 0
170 Tetes Mata Sulfasetamid Natrium botol

0 0 0 0 0 0 0 0 0 0 0 0
171 Tetes mata Tetrakain Hydroklorida botol

0 0 0 0 0 0 0 0 0 0 0 0
172 Tetes mata Tropikamid botol

0 0 0 0 0 0 0 0 0 0 0 0
173 Tetrasiklin HCl tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
174 Tetrasiklin kaps tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
175 Tiamin (vitamin B1) tab tablet

6800 0 5000 0 6800 0 5000 0 700 6100 0 5000 0
176 Tramadol injeksi ampul

0 0 0 0 0 0 0 0 0 0 0 0
177 Tramadol tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
178 Triheksifenidil tab tablet

0 1640 0 0 1000 0 2640 0 0 1130 0 1510 0 0
179 Vitamin B kompleks tab tablet 7000

0 0 12900 0 7000 0 12900 0 2500 4500 0 12900 0
180 Zinc tab tablet

0 200 0 0 3000 0 3200 0 0 600 0 2600 0 0 1000
OBAT - OBATAN TAMBAHAN

181 Amoksilin injeksi ampul
0 0 0 0 0 0 0 0 0 0 0 0
182 CLOZAPINE 100 mg tablet

0 0 0 0 0 0 0 0 0 0 0 0
183 DOMPERIDONE tablet

100 0 8150 0 100 0 8150 0 100 230 0 0 7920 0
184 Diazepam injeksi injeksi

0 0 0 0 0 0 0 0 0 0 0 0
185 Gentamicin SK 0,15 tube

0 0 0 0 0 0 0 0 0 0 0 0
186 Gentamicin Tetes Mata tube

0 0 24 0 0 0 24 0 0 0 24 0
187 Glimepride 2 mg tablet

1860 0 3300 0 1860 0 3300 0 1000 860 0 3300 0
188 haloperidol injeksi injeksi

0 0 0 0 0 0 0 0 0 0 0 0
189 Ketokonazol tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
190 Ketokonazol cr tube

0 0 426 0 0 0 426 0 25 0 0 401 0
191 Loratadine Tab tablet

0 0 0 0 0 0 0 0 0 0 0 0
192 Omeprazol Kaps Kapsul

0 0 3030 0 0 0 3030 0 30 0 0 3000 0
193 phenol gliserol tetes telinga tube 24

72 0 16 0 96 0 16 0 16 96 0 0 0
194 Risperidone 1mng tablet

0 0 0 0 0 0 0 0 0 0 0 0
195 Risperidone 2mg tablet

0 1710 0 0 2000 0 3710 0 0 1130 0 2580 0 0
196 Ondansetron Tablet tablet

0 0 0 0 0 0 0 0 0 0 0 0
197 Atropin Injeksi ampul

10 0 0 0 10 0 0 0 10 0 0 0
198 Glimepiride 4 mg tablet

0 0 1750 0 0 0 1750 0 0 0 1750 0
199 Oseltamivir 75 mg tablet

0 0 0 0 0 0 0 0 0 0 0 0
200 Cetirizine Tablet

0 0 0 0 0 0 0 0 0 0 0 0
201 Theophylline Tablet

96 0 0 0 96 0 0 0 96 0 0 0
202 Thiamfenikol Tablet

90 0 0 0 90 0 0 0 90 0 0 0
203 Azitromicin Tablet

0 0 0 0 0 0 0 0 0 0 0 0
204 Clozapine 25 mg Tablet

0 3680 0 0 0 3680 0 0 350 0 3330 0 0
205 Asam Ascorbat 500 mg Tablet

800 200 0 0 800 200 0 0 200 800 0 0 0
206 Clindamicin 150 mg Kapsul

0 0 900 0 0 0 900 0 0 0 900 0
207 Vitamin E 200 IU Kapsul

0 920 0 0 0 920 0 0 0 920 0 0
208 Albendazol Susp 200 mg Botol
0 0 0 0 0 0 0 0 0 0 0 0
209 Taburia Sachet

0 0 0 0 0 0 0 0 0 0 0 0
DIazepam ENEMA 10MG/2,5 Suppos

50 0 0 0 50 0 0 0 50 0 0 0
KLORAMFENIKOL TETES TELINGA BOTOL 20

0 0 0 0 20 0 0 0 11 9 0 0 0
ERGOTAMIN + KAFEIN 50 MG TABLET 300

0 0 0 0 300 0 0 0 300 0 0 0
TUBERKULIN PROTEIN PURIFIED

VIAL
DERIVATE SERB INJ 2
0 0 0 0 2 0 2 0 0 0 2 0 0
BAHAN MEDIS HABIS PAKAI
1 ADS 0.05 ml buah

0 100 0 0 0 100 0 0 0 100 0 0
2 ADS 0.5 ml buah

0 14000 0 0 0 14000 0 0 300 0 13700 0 0
3 Alat suntik sekali pakai 1 ml + jarum buah

0 0 600 0 0 0 600 0 0 0 600 0

0 700 300 0 0 700 300 0 200 0 500 300 0

0 500 0 0 0 500 0 0 0 500 0 0
6 Alkohol 70% buah

0 0 0 0 0 0 0 0 0 0 0 0
7 Alkohol swab buah

0 2 500 0 0 2 500 0 25 0 2 475 0
8 Benang, PGA 8/0 US IOL Assorbable buah

0 0 0 0 0 0 0 0 0 0 0 0
9 Benang, Poliglactin 9108-0 suture buah

0 0 0 0 0 0 0 0 0 0 0 0
10 Bisturi (Surgical Blade) buah

0 0 0 0 0 0 0 0 0 0 0 0
11 Blood Lancete buah

0 45 20 0 0 45 20 0 0 45 20 0
12 Box Slide buah

0 0 0 0 0 0 0 0 0 0 0 0
Catgut Chromic/benang bedah no.
13 buah
2/0 + jarum 0 0 0 0 0 0 0 0 0 0 0 0
Catgut Chromic/benang bedah no.
14 buah
3/0 + jarum 12 0 10 0 12 0 10 0 12 0 10 0
Catgut Plain / benang bedah no. 2/0
15 buah
+ jarum 0 0 0 0 0 0 0 0 0 0 0 0
Catgut Plain / benang bedah no. 3/0
16 buah
+ jarum 0 0 0 0 0 0 0 0 0 0 0 0
17 Cup Disposible buah

0 0 0 0 0 0 0 0 0 0 0 0
18 Developer buah
0 0 0 0 0 0 0 0 0 0 0 0
19 Film Rontgen 18 x 23 buah

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
23 Fixer buah
0 0 0 0 0 0 0 0 0 0 0 0
24 Foley Catheter 2 way No. 12 buah

0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0

6 0 0 0 6 0 0 0 6 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0
28 Hanger 24 x 29 buah
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
Hecting needle (tanpa benang) untuk
32 buah
kulit 0 0 0 0 0 0 0 0 0 0 0 0
Hecting needle (tanpa benang) untuk
33 buah
otot 0 0 0 0 0 0 0 0 0 0 0 0
34 Infusion set anak buah

224 0 0 0 224 0 0 0 224 0 0 0
35 Infusion set dewasa buah

141 0 0 0 141 0 0 0 141 0 0 0
36 IV catheter no 18 G buah
25 0 0 0 25 0 0 0 25 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
75 0 0 0 75 0 0 0 75 0 0 0
40 Kaca Slide buah

0 14 0 0 0 14 0 0 0 14 0 0
41 Kapas pembalut / absorben buah

15 0 0 0 15 0 0 0 15 0 0 0
42 kasa hidrophil buah

0 0 0 0 0 0 0 0 0 0 0 0
43 Kasa Steril 16 x 16 buah

4 0 0 0 4 0 0 0 4 0 0 0
44 Kertas EKG buah

0 0 0 0 0 0 0 0 0 0 0 0
45 Kertas Saring buah

0 0 0 0 0 0 0 0 0 0 0 0
46 Lubricating Jelly buah

0 0 0 0 0 0 0 0 0 0 0 0
47 Masker Disposible buah

3 0 110 150 8 3 8 110 150 2 26 3 6 84 150
48 Masker N95 buah
0 0 0 400 0 0 0 400 0 0 0 400
49 Ose buah
0 0 0 0 0 0 0 0 0 0 0 0
50 Plester Besar buah

1 0 3 0 1 0 3 0 1 0 3 0
51 Plester Kecil buah

0 0 99 0 0 0 99 0 0 0 99 0
52 Pot Dahak buah

0 450 0 0 0 450 0 0 150 0 300 0 0
53 Pot Urine buah

0 0 0 0 0 0 0 0 0 0 0 0
54 Safety Box buah

50 67 0 0 50 67 0 0 50 67 0 0
55 Sarung tangan bedah steril buah

2 3 0 0 2 3 0 0 2 3 0 0
56 Sarung tangan Obgyn buah

61 0 0 35 61 0 0 35 61 0 0 35
Sarung Tangan Pendek non steril
57 buah
ukuran L 0 0 0 0 0 0 0 0 0 0 0 0
58 buah
ukuran M 0 0 0 203 1 0 1 0 203 10 0 1 0 193
59 buah
ukuran S 0 0 0 0 0 0 0 0 0 0 0 0
60 Selang Oksigen buah

0 0 6 0 0 0 6 0 0 0 6 0
61 Silk (Benang bedah sutera) No. 3/0 buah

36 0 100 10 36 0 100 10 36 0 100 10
62 Silk( Benang Bedah Sutera) No 2/0 buah

0 0 0 0 0 0 0 0 0 0 0 0
63 Sopratulle buah
0 0 0 0 0 0 0 0 0 0 0 0
64 Tabung EDTA buah

0 800 0 0 0 800 0 0 100 0 700 0 0
65 Tip Blue 500-1000 ul buah

0 0 0 0 0 0 0 0 0 0 0 0
66 Tip White 10-20 ul buah

2 0 0 0 2 0 0 0 2 0 0 0
67 Tip Yellow 50 ul buah

0 2 0 0 0 2 0 0 0 2 0 0
68 Torniquet buah
0 0 0 0 0 0 0 0 0 0 0 0
69 Urine bag steril buah

30 0 0 0 30 0 0 0 30 0 0 0 0
70 APD PCS
0 0 0 0 2 0 2 0 0 0 2 0 0
71 FACE SHIELD PCS

0 0 0 0 0 0 0 0 0 0 0 0
Sarung tangan glove powder free
72 PCS
steril size 6,5 0 0 0 15 0 0 0 15 0 0 0 15
Sarung tangan glove powder free
73 PCS
steril size 7 0 0 0 19 0 0 0 19 0 0 0 19
74 APD Bohorjwi PCS

0 60 0 3 0 60 0 3 10 0 50 0 3
75 Masker Earloop Pcs
0 10 0 0 8 0 18 0 0 2 0 16 0 0
76 APD hygiene pcs

50 0 0 0 16 50 16 0 0 50 16 0 0
77 Masker Kain logo DINKES pcs

0 0 0 0 0 0 0 0 0 0 0 0
78 Masker Kain PCS

0 0 0 0 0 0 0 0 0 0 0 0
79 Rapid Test Corona PCS

0 61 0 0 0 61 0 0 0 61 0 0
80 Spon Boat PCS

0 0 0 0 0 0 0 0 0 0 0 0
81 Google PCS
4 0 0 0 4 0 0 0 4 0 0 0
82 Maksker KN 95 pcs
51 0 0 0 51 0 0 0 51 0 0 0
83 Aseptic Gel Galon

0 0 0 4 0 0 0 4 0 0 0 4
84 Rapid Sipilis Cassete pcs

0 1250 0 0 0 1250 0 0 50 0 1200 0 0
85 Sarung Tangan Karet pcs

0 0 0 10 0 0 0 10 0 0 0 10
86 Sarung Tangan Nitril Box

0 0 0 4 21 0 21 0 4 0 21 0 4
87 Apron Lengan Pendek pcs

0 0 0 35 0 0 0 35 0 0 0 35
88 Nurse Cup Kotak

0 0 0 1800 0 0 0 1800 0 0 0 1800
89 Rapid HIV 1/2 Test

0 1255 0 0 0 1255 0 0 0 1255 0 0
90 Rapid Test Syphilis Test

0 325 0 0 0 325 0 0 0 325 0 0
91 Test
RPR Syphilis 0 0 0 0 0 0 0 0 0 0 0 0
92 Set
APD ( Vaksin Covid) 0 0 0 0 0 0 0 0 0 0 0 0
93 Test
VTM 0 110 0 0 0 110 0 0 0 110 0 0
94 Test
Rapid Antigen 0 618 0 0 0 618 0 0 50 0 568 0 0
95 Pack 0
Plastik Medis 0 7 0 0 7 0 0 0 7 0 0
96 Box 0
Plesterin Bulat 0 8 0 0 8 0 0 0 8 0 0
Pcs 0
97 Kantong Jenazah 0 4 0 0 4 0 0 0 4 0 0
BOX 0
RAPID 2 HIV FOKUS 1 + 2 KHB 0 5 0 0 5 0 0 0 5 0 0
BOTOL 0
USG GEL 0 0 39 0 0 39 0 0 0 39 0
PCS 0
UNDERPAD 0 0 90 0 0 90 0 0 0 90 0
BOTOL 0
CEELCLEAN 0 0 0 1 0 1 0 0 1 0 0 0 0
BOX 0
CELLPACK 0 0 0 1 0 1 0 0 1 0 0 0 0
BOTOL 0
CHOLESTEROL TOTAL 0 0 0 1 0 1 0 0 1 0 0 0 0
BOX 0
HB TEST STRIPS 0 0 0 8 0 8 0 0 0 8 0 0
TEST 0
HBSAG 0 0 0 300 0 300 0 0 0 0 0
Jumlah Kunjungan Bulan : 2441

Tunai : 1224 Jampang, 31-Jan-22
BPJS : 601
PBI : 616 BENDAHARA OBAT PUSKESMAS : Jampang
Gratis : 15
Poned :-
Anak :
Dewasa :
Rawat Inap :
Pasien Gigi : dr. Dini Srie Agustin Debby Eliza Fitri Amd,farm
Pasien Jiwa : NIP. 197408162007012007 NIP. 199303282019022002
Pasien TB :

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LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

PUSKESMAS JAMPANG FORM : LPLPO

STOCK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOCK AKHIR PEMBERIAN

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4 Ambroksol tablet tablet

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10 Amoksisilin 250 mg tab tablet

11 Amoksisilin 500 mg tab tablet

12 Antalgin Injeksi ampul

13 Antalgin tab tablet

14 Antasid DOEN sirup botol

15 Antasida kombinasi tab kunyah tablet

16 Anti Bakteri DOEN salep kombinasi tube

17 Anti Fungsi kombinasi salep tube

18 Anti Hemoroid kombinasi sup Supos

19 Antimigren DOEN kombinasi tablet

22 Asam Mefenamat kaps tablet

23 Asetosal tab tablet

24 Asiklovir tab 200mg tablet

25 Asiklovir tab 400mg tablet

26 Asilovir Cream tube

27 Atropin Sulfat Injeksi ampul

28 Atropin Sulfat tab tablet

29 Bedak Salisil serb tablet

30 Betahistin Melistat tab tablet

31 Betametason krim tube

32 Deksametason Injeksi ampul

33 Deksametason tab tablet 2300

34 Diazepam enema (Suppos) Supos

35 Diazepam tab tablet

36 Difenhidramin HCl Injeksi ampul

37 Digoksin tab tablet

38 Dimenhidrinat tab tablet

39 Efedrin HCl tab tablet

41 Etanol 70% botol

42 Ethambutol tab tablet

46 FDC Sisipan paket

47 Fenitoin Natrium tab tablet

49 Fenobarbital tab tablet

50 Fitomenadion (vitamin K 1) injeksi ampul

51 Fitomenadion (vitamin K 1) tab tablet

52 Furosemid tab tablet

53 Garam oralit kombinasi serb sachet

54 Gentamisin Injeksi ampul

55 Gentian Violet Larutan botol

58 Gigi, Bonding buah

59 Gigi, Eritromisin kaps tablet

60 Gigi, Etil Klorida spray botol

61 Gigi, Etsa buah

62 Gigi, Eugenol Cairan botol

64 Gigi, Kalsium hidroksida bubuk, pasta tube

67 Gigi, Mummifying Pasta tablet

68 Gigi, Pasta devitalisasi (non arsen) tube

70 Glibenklamid tab tablet

71 Gliseryl Guayakolat Syrup botol

72 Gliseryl Guayakolat tab tablet

73 Glukosa Larutan Infus botol

74 Griseofulviin (micronized) tab tablet

76 Haloperidol tab 5 mg tab tablet

77 Hibiscrub sol botol