LAPORAN PEMAKAIAN DAN LEMBARAN PERMIN

( LPLPO )
Kode Puskesmas : 14
Puskesmas : SUNGAI NANAM
Kecamatan : Lembah Gumanti
Kabupaten : Solok
Propinsi : Sumatera Barat

STOK PENERIM PERSEDI

NAMA OBAT SATUAN
AWAL AAN AAN

1 2 3 4 5 6
1 Acyclovir 200 mg Tablet
2 Acyclovir 400 mg Tablet
3 Acyclovir Cream Tube
4 Air Raksa Dental Use Set
5 Alat Suntik Sekali Pakai 0,5 ML Set
6 Alat Suntik Sekali Pakai 0,05 ML Set
7 Alat Suntik Sekali Pakai 1 ML Set 10
8 Alat Suntik Sekali Pakai 2,5 ML/ 3 ML Set 17
9 Alat Suntik Sekali Pakai 5 ML Set 16
10 Albendazole Tab 400 mg Tablet
11 Alopurinol tablet 100 mg Tablet 60
12 Alprazolam tablet 0,5 mg Tablet
13 Ambroxol 30 mg Tablet
14 Ambroxol Syirup 15 mg/ml Botol
15 Aminofilin injeksi 24 mg/ml- 10 ml Ampul
16 Aminofilin tablet 200 MG Tablet
17 Amitriptilin HCL tablet Salut 25 mg Tablet 80
18 Amoksisilin Kaplet 500 mg Kaplet 380
19 Amoksisilin Kaplet 250 mg Kapsul 554
20 Amoksisilin Sirup Kering 125 ml/5 ml Botol -
21 Ampisilin 500 Mg Tablet
22 Antalgin (Metampiron) tablet 500 mg Tablet
23 Antalgin injeksi 250 mg/mL -2 ml Ampul
24 Antasid Sirup Botol 6
25 Antasid DOEN tablet Kombinasi Tablet 265
26 Anti Tuberkulosis Kategori III/FDC Paket
27 Anti Tuberkulosis Kategori II/FDC Paket
28 Anti Tuberkulosis Sisipan Paket
29 Anti Tuberkulosis Kategori I/FDC Paket
30 Anti Bakteri DOEN Salep Kombinasi Tube
31 Anti Fungi DOEN Kombinasi Pot
32 Anti Hemoroid DOEN Kombinasi Suppos
33 Anti Parkinson DOEN Tablet Kombinasi Tablet
34 Anti Tuberkulosis Anak Paket
35 Aquadest Steril 500 ml Botol
36 Aquadest Steril 250 ml Botol
37 Aqua Pro Injeksi Vial
38 Artemeter Tablet Tablet
39 Artesunate Injeksi Vial
40 Asam Askorbat Tablet 50 mg Tablet 515
41 Tablet
42 Asam Folat 1 mg Tablet
43 Asam Klorida 0,1 N Botol
44 Asam Mefenamat Kapsul 500 mg Tablet
45 Asam Sulfasalisilat 20 % Botol
46 Asetosal tablet 500 mg Tablet
47 Atropin SulfatInjeksi 0,25 mg/ml -1 ml Ampul
48 Atropin Sulfat Tablet 0,5 mg Tablet
49 Betahistin Mesilat Tablet 6 mg Tablet
50 Betametason Krem 0,1 % Tube 20
51 Bisoprolol Tablet 5 mg Tablet
52 Ca Glukonas Inj Ampul
53 Carbamazepin 200 mg Tablet 130
54 Captopril 12,5 mg Tablet -
55 Captopril 25 mg Tablet 314
56 Catgut/ Benang Bedah Set 5
57 Cimetidin Tablet Tablet
58 Ciproflaksasin Tablet 500 mg Tablet 200
59 Clobazam Tablet 10 mg Tablet
60 Dektrometorfan HBR Sirup 10 mg/5 ml 60 ml
61 Dektrometorfan HBR Tablet 15 mg Tablet
62 Devitalisasi Pasta ( Non Arsen) Botol
63 Dexametason Injeksi 5 mg/ml -1 ml Ampul -
64 Dexametason Tablet 0,5 mg Tablet 928
65 Diazepam Injeksi 5 mg/ml - 2ml Ampul
66 Diazepam Tablet 2 mg Tablet 100
67 Dietil Karbamazin Sitrat Tablet 100 mg Tablet
 68 Difenhidramin HCL Inj 10 mg/ml - 1 ml Ampul
69 Digoksin Tablet 0,25 mg Tablet
70 Diltiazem Tablet Tablet
71 Dimenhidrinat Tablet 50 mg Tablet
72 Doksisiklin Kapsul Tablet
73 Domperidon Tab 10 mg Tablet
74 Efedrin Tablet 5 mg Tablet
75 Ekstrak Belladona Tablet 10 mg Tablet
76 Epinefrin HCL/Bitartrat Inj 0,1 % - 1 ml Ampul 6
77 Ergotamin Coffein Tablet
78 Eritromisin Kapsul 250 mg Kapsul
79 Etakridin (Rivanol) Larutan 0,1 % Botol
80 Etanol 70 % Botol
81 Etil Klorida Semprot Botol
82 Eugenol Cairan Botol
83 Famotidin Tablet 40 mg Tablet
84 Fenil Butason 200 mg Tablet
85 Fenobarbital Injeksi 50mg/ml - 2ml Tablet
86 Fenobarbital Tablet 30 mg Ampul
87 Fenoksimetil Penisilin Tablet 250 mg Tablet
88 Fenol Gliserol Tetes Teliga 10 % Botol
89 Fitomenadion Inj 10 mg/ml - 1 ml Ampul -
90 Fitomenadion Tablet 10 mg Tablet
91 Fluor Tablet 0,5 mg Tablet
92 Folley Cateter Buah
93 Furosemid Tablet 40 mg Tablet
94 Gameksan Krem Tube
95 Gameksan Emulsi 1 % Botol
96 Garam Oralit untuk 200 ml Air Buah 244
97 Gentian Violet Larutan 1% Botol
98 Gentamycin Inj Ampul
99 Gentamycin Tetes Mata Botol 1
100 Gentamycin Salap Kulit Tube
101 Glass Lonomer Cement (GC IX) Set
102 Glibenklamid Tablet 5 mg Tablet
103 Gliseril Guayakolat Tablet 100 mg Tablet
104 Glukosa Larutan Infus 5 % Botol 20
105 Glukosa Larutan Infus 10 % Botol 20
106 Griseovulfin Tablet 125 mg Tablet
107 Haloperidol Tablet 1,5 mg Tablet 150
108 Haloperidol Tablet 5 mg Tablet
109 Handschoon 7 Psg -
110 Handschoon 7,5 Psg -
111 Handschoon 8 Psg
112 Hidroklortiazid(HCT) Tablet 25 mg Tablet
113 Hidrokortison krim 2,5 % Tube -
114 Ibuprofen 200 mg Tablet Tablet -
115 Ibuprofen 400 mg Tablet Tablet 195
116 Imersil Oil Botol
117 Implan KB Set
118 Eter Alkohol Botol
119 Infusion Set Anak Set -
120 Infusion Set Dewasa Set 11
121 Iodina Test Botol
122 Iodina Kapsul Lunak Kapsul
123 Iodoform pasta Botol
124 Isosorbid Dinitrat Tablet Subt. 5 mg Tablet
125 IV Catheter no 18 Buah 1
126 IV Catheter no 20 Buah -
127 IV Catheter no 22 Buah -
128 IV Catheter no 24 Buah -
129 Jarum Jahit (Bedah) 9 s/d 14 Buah
130 Kalium Hidroksida Pasta Tube
131 Kalsium Laktat (Calac) Tablet 500 mg Tablet -
132 Kapas Pembalut /Adsorben 250 Gram Rol -
133 Kasa pembalut 2M x 80 CM Rol -
134 Kasa Pemblut Hidrtofil 4 M x 15 CM Rol -
135 Kasa Pembalut 35 x 80 CM Rol -
136 Kasa Pembalut Steril 16 CM Kotak -
137 Ketokonazol 200 mg Tablet
138 Kloramfenikol Kapsul 250 mg Kapsul
139 Kloramfenikol Tetes Teliga 3 % Botol
140 Kloramfenikol Tetes Mata 0,5 % Botol
141 Kloramfenikol Salap Mata 1 % Tube
142 Klorfeniramin Meleat (CTM) Tablet 4 mg Botol 281
143 Klorfenol Kanfer mentol (CHKM) Botol
144 Klorokuin Fosfat Tablet 250 mg Tablet
145 Klorpromazin HCL Inj 5mg/ml- 2 ml Ampul
146 Klorpromazin HCL tablet salut 100 mg Tablet 170
147 Klorpromazin HCL tablet salut 25 mg Tablet
148 Klorpropamid Tablet 100 mg Tablet
149 Kodein HCL Tablet 10 mg Tablet
150 Komb.Pirimetamin 25 mg + Sulfadoksin Tablet
151 Kotrimoksazol Suspensi Botol 6
152 Kotrimoksazol Dewasa Tablet Tablet 124
153 Kotrimoksazol Pediatrik Tablet Tablet -
154 Kuinin Dihidroklorida Inj 25 %- 2 ml Ampul
155 Kuinin Sulfat Tablet 222 mg (7 H2o) Tablet
156 Larutan Benedict Botol
157 Larutan Eosin 2 5 Botol
158 Larutan Etanol Asam Botol
159 Larutan Giemsa Stain Botol
160 Larutan Karbol Fuksin Botol
161 Larutan Metilen Biru Botol
162 Larutan Turk Botol
163 Larutan Ress Ecker 200 ml Botol
164 Larutan Na.Citray 3,8 % 100 ml Botol
165 Larutan Asam Asetat 6 % 100 ml Botol
166 Larutan BaCl2 100 ml Botol
167 Larutan Fauchet 100 ml Botol
168 Larutan Buffer Fosfat PH 6,4 500 ml Botol
169 Larutan Schilisinger 500 ml Botol
170 Larutan Lugol 100 ml Botol
171 Larutan Hayem 100 ml Botol
172 Larutan EDTA 100 ml Botol
173 Larutan Xilol 100 ml Botol
174 Levothiroxin Tab Tablet
175 Lidokain Kompositum Injeksi Ampul 12
176 Lincomycin 500 mg Botol
177 Lisol Botol
178 Loperamid Tablet Tablet
179 Magnesium Sulfat Inj.(IV) 20% -25 Ml Vial
180 Magnesium Sulfat Inj.(IV) 40% -25 Ml Vial 5
181 Masker Lembar -
182 Mebendazol Tablet 100 mg Tablet
183 Metanol 500 ml Botol
184 Metformin HCL Tablet 500 mg Tablet 160
185 Metformin HCL Tablet 850 mg Tablet
186 Metil Ergometrin Meleat Injeksi Ampul 6
187 Metil Ergometrin Meleat Tablet 0,125 mg Tablet
188 Metilprednisolon Tablet -
189 Metronidazol Tablet 250 mg Tablet 200
190 Metronidazol Infus Botol
191 Mikonazol Krim Tube
192 Monoklorkamfer Mentol Cairan Botol
193 Mummifying Pasta Botol
194 Natrium Bicarbonat Tablet 500 mg Tablet
195 Natrium Diclofenac 25 mg Tablet
196 Natrium diclofenac 50 mg Tablet
197 Natrium Fenitoin Kapsul 30 mg Tablet
198 Natrium Klorida (NaCl 0,9 %) Infus Botol 15
199 Nifedifin Tab 10 mg Tablet
200 Nistatin 500.000 iU/g Tablet Salut Tablet
201 Obat Batuk Hitam (OBH) cairan Botol
202 Oksitetrasiklin HCL Salep 3 % Tube
203 Oksitetrasiklin HCL Salep Mata 1 % Tube
204 Oksitoksin Injeksi 10 IU/ml-1 ml Vial 6
205 Omeprazol 20 mg Tablet
206 Papaverin Tab 40 mg Tablet
207 Paraformaldehid Tablet 1 Gram Tablet
208 Parasetamol Drops Botol
209 Parasetamol Syirup 120 mg/5 ml Botol -
210 Parasetamol Tablet 100 mg Tablet
211 Parasetamol Tablet 500 mg Tablet -
212 Pehacain Injeksi Ampul
213 Pil KB Tablet
214 Pirantel Pamoat Tablet 365 mg Tablet
215 Piridoksin Tablet 10 mg Tablet 415
216 Piroksikam 10 mg Tablet 80
217 Piroksikam 20 mg Tablet
218 Plester 5 Yard x 2Inch Rol 1
219 Prednison Tablet 5 mg Tablet
220 Primakuin Tablet 15 mg Tablet
221 Propanolol HCL tablet 40 mg Tablet
222 Propilitiourasil Tablet 100 mg Tablet
223 Prokain Benzil Penisilin Vial
224 Rabies Imune Globulin (Human) 150 IU/ml Set
225 Ranitidin Tab 150 mg Tablet 80
226 Ranitidin Injeksi Ampul 10
227 Rapid Test Sypilis Set
228 Reserpin Tablet 0,25 mg Tablet
229 Retinol (Vit.A) Kapsul 200.000 IU Kapsul
230 Retinol (Vit.A) Kapsul 100.000 IU Kapsul
231 Ringer Laktas Larutan Infus Steril Ampul 17
232 Salbutamol Tablet 2 mg Tablet
233 Salbutamol Tablet 4 mg Tablet
234 Salep 2-4 Kombinasi Pot
235 Salisil Bedak 2 % Buah 4
236 Semen Seng Fosfat Serbuk dan cairan Set
237 Serum Anti Bisa Ular Polivalen Inj 5 ml Vial
238 Serum Anti Tetanus Inj 1.500 IU/Ampull Ampul
239 Sianokobalamin (Vit B12) Inj 500 mcg/ml Ampul
240 Sianokobalamin (Vit B12) Tablet Tablet
241 Silk (Benag Bedah Sutera( No.3/0 Set 14
242 Silver Amalgam Serbuk 65-75 % 1 Oz
243 Simvastatin Tablet 10 mg Tablet 60
244 Spons Gelatin Cubicles 1x1x1 Cm Set
245 Spritus 10000 ml Botol
246 Stip Test PH Kotak
247 Sulfadinamin Tablet 500 mg Tablet
248 Sulfasetamid Natrium Tetes Mata 15 % Botol
249 Suntik KB Vial
250 Tabung Oksingen besar Unit
251 Tablet Tambah darah Kombinasi Tablet 150
252 Temporary Stopping Fletcher Buah
253 Test Golongan Dara A,B,AB Set
254 Tetrasiklin Kapsul 250 mg Kapsul
255 Tetrasiklin Kapsul 500 mg Kapsul
256 Thiamin HCL (Vit. B1) Inj 100 mg/ml - 1 ml Ampul 858
257 Thiamin HCL Mononitrat Tablet 50 mg Tablet
258 Tramadol 50 mg Kapsul Kapsul
259 Triheksifenidil HCL Tablet 2 mg Tablet
260 Trikresol Formalin (TKF) Cairan Botol
261 Urin Bag Buah -
262 Vitamin B.Komplek Tablet Tablet 136
263 Wing Nidle No.21 Buah
264 Wing Nidle No.23 Buah
265 Wing Nidle No.25 Buah
266 Yodium Povidon Larutan 10 % 1000 ml Botol
267 Yodium Povidon Larutan 10 % 300 ml Botol
268 Yodium Povidon Larutan 10 % 30 ml Botol
269 Zinc Tab 20 mg Tablet 240
270 Kaca Objek box
271 Pot Sputum botol
272 Dumin Rectal Suppos Tablet
273 ZieNelden Botol
274 Vit K Infant inj 2mg/ml-1ml Ampul
275 Risperidon 2mg tab Tablet
276 Heximer 2mg tab Tablet
277 Stesolid suppos Tablet 5
278 Scopma Plus Tablet
279 Ventolin Nebu Ampul
280 Spasminal Tablet
281 Eritromisin sirup Botol
282 INH tablet Tablet
 Umum BPJS Posyandu Jumlah
JUMLAH KUNJUNGAN RESEP
1459 199 4869 6527

Mengetahui / Menyetujui Yang Menyerahkan

Kepala Dinas Kesehatan Kepala Instalasi Farmasi

Dr.Hj. Sri Efianti. M.Kes Adriani,S.Si.Apt Ali muratwan,Skm

NIP.19690210 2003 12 2 002NIP.19720801 199903 2 004 NIP.19641218 199203 1007
BARAN PERMINTAAN OBAT
)
Bulan FEBRUARI
Tahun : 2018
No. SBBK: (diisi IFK)
Periode : (diisi IFK)

PEMBERI
PEMAKAI SISA PERMINT
AN (Diisi EXP.DATE KET
AN STOK AAN
FK)

7 8 9 10 11 12

10 200
17 100
16 100

60 1000

80 1000
380 1000
554 1000
0 48

6 48
265 1000

515 1500

20 48

130 1000
0 1500
314 1500
5 60

200 1000

0 20
928 1000

100 1000
 6 20

0 30

244 1000

1 15

20 100
20 40

150 1000

0 10
0 10
 0 48
0 1000
195 1000

0 25
11 25

1 24
0 24
0 24
0 24

0 2000
0 10
0 4
0 4
0 50
0 50

281 1000

170 1000

6 24
124 1000
0 1000
 12 30

5 20
0 50

160 1000

6 20

0 1000
200 1000
 15 40

6 20

0 180

0 2000

415 1000
80 1000

1 5

80 1000
10 30

17 60

4 20
 14 20

60 150

150 300

858 5000

0 10
136 1000

240 100

5 15
 Yang Melaporkan / Meminta Yang Menerima
Kepala Puskesmas Pengelola Obat Puskesmas

Ali muratwan,Skm muhammad isya

NIP.19641218 199203 1007 NIP.19810107 2011 01 1008
 LAPORAN PEMAKAIAN DAN LEMBARAN PERMINTAAN OBAT
( LPLPO )
Kode Puskesmas : Bulan : MEI
Puskesmas : SUNGAI NANAM Tahun : 2018
Kecamatan : Lembah Gumanti No. SBBK : (diisi IFK)
Kabupaten : Solok Periode : (diisi IFK)
Propinsi : Sumatera Barat

PEMA PEMBERI
SATU STOK PENERI PERSE SISA PERMIN
NO NAMA OBAT KAIA AN (Diisi EXP.DATE KET
AN AWAL MAAN DIAAN STOK TAAN
N FK)
1 2 3 4 5 6 7 8 9 10 11 12
1 Acyclovir 200 mg Tablet 0 -
2 Acyclovir 400 mg Tablet 0 -
3 Acyclovir Cream Tube 0 -
4 Air Raksa Dental Use Set
5 Alat Suntik Sekali Pakai 0,5 ML Set 490 500 10
6 Alat Suntik Sekali Pakai 0,05 ML Set 497 500 3
7 Alat Suntik Sekali Pakai 1 ML Set 205 205 20 185
8 Alat Suntik Sekali Pakai 2,5 ML/ 3 ML Set 201 201 20 181
9 Alat Suntik Sekali Pakai 5 ML Set 206 206 20 186
10 Albendazole Tab 400 mg Tablet 0 -
11 Alopurinol tablet 100 mg Tablet 1010 1,010 0 1010
12 Alprazolam tablet 0,5 mg Tablet -
13 Ambroxol 30 mg Tablet 0 -
14 Ambroxol Syirup 15 mg/ml Botol
15 Aminofilin injeksi 24 mg/ml- 10 ml Ampul
16 Aminofilin tablet 200 MG Tablet 1000 1,000 0 1000
17 Amitriptilin HCL tablet Salut 25 mg Tablet 495 495 20 475
18 Amoksisilin Kaplet 500 mg Kaplet 4950 4,950 348 4602
19 Amoksisilin Kaplet 250 mg Kapsul 1514 1,514 0 1514
20 Amoksisilin Sirup Kering 125 ml/5 ml Botol 76 76 3 73
21 Ampisilin 500 Mg Tablet
22 Antalgin (Metampiron) tablet 500 mg Tablet
23 Antalgin injeksi 250 mg/mL -2 ml Ampul
24 Antasid Sirup Botol 6 6 0 6
25 Antasid DOEN tablet Kombinasi Tablet 2902 2,902 250 2652
26 Anti Tuberkulosis Kategori III/FDC Paket
27 Anti Tuberkulosis Kategori II/FDC Paket -
28 Anti Tuberkulosis Sisipan Paket
29 Anti Tuberkulosis Kategori I/FDC Paket 15 15 0 15
30 Anti Bakteri DOEN Salep Kombinasi Tube 100 100 0 100
31 Anti Fungi DOEN Kombinasi Pot 120 120 0 120
32 Anti Hemoroid DOEN Kombinasi Suppos 40 40 0 40
33 Anti Parkinson DOEN Tablet Kombinasi Tablet
34 Anti Tuberkulosis Anak Paket 2 2 0 2
35 Aquadest Steril 500 ml Botol
36 Aquadest Steril 250 ml Botol
37 Aqua Pro Injeksi Vial
38 Artemeter Tablet Tablet
39 Artesunate Injeksi Vial
40 Asam Askorbat Tablet 50 mg Tablet 7165 7,165 300 6865
42 Asam Folat 1 mg Tablet 500 500 0 500
43 Asam Klorida 0,1 N Botol
44 Asam Mefenamat Kapsul 500 mg Tablet 900 900 0 900
45 Asam Sulfasalisilat 20 % Botol
46 Asetosal tablet 500 mg Tablet
47 Atropin SulfatInjeksi 0,25 mg/ml -1 ml Ampul
48 Atropin Sulfat Tablet 0,5 mg Tablet
49 Betahistin Mesilat Tablet 6 mg Tablet 300 300 0 300
50 Betametason Krem 0,1 % Tube 61 61 4 57
51 Bisoprolol Tablet 5 mg Tablet 500 500 0 500
52 Ca Glukonas Inj Ampul
53 Carbamazepin 200 mg Tablet 1030 1,030 60 970
54 Captopril 12,5 mg Tablet 1300 1,300 0 1300
55 Captopril 25 mg Tablet 1619 1,619 370 1349
56 Catgut/ Benang Bedah Set 60 60 6 54
57 Cimetidin Tablet Tablet
58 Ciproflaksasin Tablet 500 mg Tablet 1170 1,170 0 1170
59 Clobazam Tablet 10 mg Tablet
60 Dektrometorfan HBR Sirup 10 mg/5 ml Botol
61 Dektrometorfan HBR Tablet 15 mg Tablet
62 Devitalisasi Pasta ( Non Arsen) Botol
63 Dexametason Injeksi 5 mg/ml -1 ml Ampul 95 95 5 90
64 Dexametason Tablet 0,5 mg Tablet 1908 1,908 28 1880
65 Diazepam Injeksi 5 mg/ml - 2ml Ampul 0 -
66 Diazepam Tablet 2 mg Tablet 1065 1,065 0 1065
67 Dietil Karbamazin Sitrat Tablet 100 mg Tablet
68 Difenhidramin HCL Inj 10 mg/ml - 1 ml Ampul
69 Digoksin Tablet 0,25 mg Tablet 200 200 0 200
70 Diltiazem Tablet Tablet 0 -
71 Dimenhidrinat Tablet 50 mg Tablet
72 Doksisiklin Kapsul Tablet
73 Domperidon Tab 10 mg Tablet 900 900 0 900
74 Efedrin Tablet 5 mg Tablet
75 Ekstrak Belladona Tablet 10 mg Tablet 0 -
76 Epinefrin HCL/Bitartrat Inj 0,1 % - 1 ml Ampul 21 21 21 0
77 Ergotamin Coffein Tablet
78 Eritromisin Kapsul 250 mg Kapsul 500 500 0 500
79 Etakridin (Rivanol) Larutan 0,1 % Botol 24 24 0 24
80 Etanol 70 % Botol 8 8 3 5
81 Etil Klorida Semprot Botol 0 -
82 Eugenol Cairan Botol 0 -
83 Famotidin Tablet 40 mg Tablet
84 Fenil Butason 200 mg Tablet
85 Fenobarbital Injeksi 50mg/ml - 2ml Tablet
86 Fenobarbital Tablet 30 mg Ampul 1000 1,000 0 1000
87 Fenoksimetil Penisilin Tablet 250 mg Tablet
88 Fenol Gliserol Tetes Teliga 10 % Botol 48 48 1 47
 89 Fitomenadion Inj 10 mg/ml - 1 ml Ampul 30 30 2 28
90 Fitomenadion Tablet 10 mg Tablet 0 -
91 Fluor Tablet 0,5 mg Tablet
92 Folley Cateter Buah 17 17 5 12
93 Furosemid Tablet 40 mg Tablet 1000 1,000 0 1000
94 Gameksan Krem Tube
95 Gameksan Emulsi 1 % Botol
96 Garam Oralit untuk 200 ml Air Buah 1144 1,144 171 973
97 Gentian Violet Larutan 1% Botol
98 Gentamycin Inj Ampul
99 Gentamycin Tetes Mata Botol 0 -
100 Gentamycin Salap Kulit Tube
101 Glass Lonomer Cement (GC IX) Set
102 Glibenklamid Tablet 5 mg Tablet 1050 1,050 0 1050
103 Gliseril Guayakolat Tablet 100 mg Tablet
104 Glukosa Larutan Infus 5 % Botol 120 120 1 119
105 Glukosa Larutan Infus 10 % Botol 60 60 0 60
106 Griseovulfin Tablet 125 mg Tablet 1000 1,000 0 1000
107 Haloperidol Tablet 1,5 mg Tablet 875 875 30 845
108 Haloperidol Tablet 5 mg Tablet 1000 1,000 0 1000
109 Handschoon 7 pcs
110 Handschoon 7,5 pcs 1200 1,200 1200
111 Handschoon 8 pcs
112 Handscoon Non Steril pcs 400 400 0 400
113 Hidroklortiazid(HCT) Tablet 25 mg Tablet 500 500 0 500
114 Hidrokortison krim 2,5 % Tube 96 96 1 95
115 Ibuprofen 200 mg Tablet Tablet 1000 1,000 0 1000
116 Ibuprofen 400 mg Tablet Tablet 1000 1,000 143 857
117 Imersil Oil Botol
118 Implan KB Set
119 Eter Alkohol Botol
120 Infusion Set Anak Set 10 10 0 10
121 Infusion Set Dewasa Set 55 55 21 34
122 Iodina Test Botol
123 Iodina Kapsul Lunak Kapsul
124 Iodoform pasta Botol
125 Isosorbid Dinitrat Tablet Subt. 5 mg Tablet
126 IV Catheter no 18 Buah 50 50 9 41
127 IV Catheter no 20 Buah 45 45 15 30
128 IV Catheter no 22 Buah 45 45 5 40
129 IV Catheter no 24 Buah 45 45 15 30
130 Jarum Jahit (Bedah) 9 s/d 14 Buah
131 Kalium Hidroksida Pasta Tube
132 Kalsium Laktat (Calac) Tablet 500 mg Tablet 16930 16,930 215 16715
133 Kapas Pembalut /Adsorben 250 Gram Rol 10 10 10 0
134 Kasa pembalut 2M x 80 CM Rol 110 110 0 110
135 Kasa Pemblut Hidrtofil 4 M x 15 CM Rol 100 100 5 95
136 Kasa Pembalut 36 x 80 CM Rol 12 12 0 12
137 Kasa Pembalut Steril 16 CM Kotak 0 -
138 Ketokonazol 200 mg Tablet 500 500 0 500
139 Kloramfenikol Kapsul 250 mg Kapsul
140 Kloramfenikol Tetes Teliga 3 % Botol 0 -
141 Kloramfenikol Tetes Mata 0,5 % Botol 54 54 4 50
142 Kloramfenikol Salap Mata 1 % Tube 24 24 2 22
143 Klorfeniramin Meleat (CTM) Tablet 4 m Botol 19807 19,807 402 19405
144 Klorfenol Kanfer mentol (CHKM) Botol
145 Klorokuin Fosfat Tablet 250 mg Tablet
146 Klorpromazin HCL Inj 5mg/ml- 2 ml Ampul
147 Klorpromazin HCL tablet salut 100 mg Tablet 1150 1,150 exp/ mei
148 Klorpromazin HCL tablet salut 25 mg Tablet
149 Klorpropamid Tablet 100 mg Tablet
150 Kodein HCL Tablet 10 mg Tablet
151 Komb.Pirimetamin 25 mg + Sulfadoksin Tablet
152 Kotrimoksazol Suspensi Botol 100 100 11 89
153 Kotrimoksazol Dewasa Tablet Tablet 1000 1,000 316 684
154 Kotrimoksazol Pediatrik Tablet Tablet 0 -
155 Kuinin Dihidroklorida Inj 25 %- 2 ml Ampul
156 Kuinin Sulfat Tablet 222 mg (7 H2o) Tablet
157 Larutan Benedict Botol
158 Larutan Eosin 2 5 Botol
159 Larutan Etanol Asam Botol
160 Larutan Giemsa Stain Botol
161 Larutan Karbol Fuksin Botol
162 Larutan Metilen Biru Botol
163 Larutan Turk Botol
164 Larutan Ress Ecker 200 ml Botol
165 Larutan Na.Citray 3,8 % 100 ml Botol
166 Larutan Asam Asetat 6 % 100 ml Botol
167 Larutan BaCl2 100 ml Botol
168 Larutan Fauchet 100 ml Botol
169 Larutan Buffer Fosfat PH 6,4 500 ml Botol
170 Larutan Schilisinger 500 ml Botol
171 Larutan Lugol 100 ml Botol
172 Larutan Hayem 100 ml Botol
173 Larutan EDTA 100 ml Botol
174 Larutan Xilol 100 ml Botol
175 Levothiroxin Tab Tablet
176 Lidokain Kompositum Injeksi Ampul 30 30 8 22
177 Lincomycin 500 mg Botol 0 -
178 Lisol Botol 10 10 1 9
179 Loperamid Tablet Tablet 0 -
180 Magnesium Sulfat Inj.(IV) 20% -25 Ml Vial 0 -
181 Magnesium Sulfat Inj.(IV) 40% -25 Ml Vial 24 24 4 20
182 Masker Lembar 39 39 2 37
183 Mebendazol Tablet 100 mg Tablet
184 Metanol 500 ml Botol
185 Metformin HCL Tablet 500 mg Tablet 1130 1,130 130 1000
186 Metformin HCL Tablet 850 mg Tablet
187 Metil Ergometrin Meleat Injeksi Ampul 101 101 3 98
188 Metil Ergometrin Meleat Tablet 0,125 mg Tablet
189 Metilprednisolon Tablet 1050 1,050 21 1029
190 Metronidazol Tablet 250 mg Tablet 1000 1,000 42 958
191 Metronidazol Infus Botol -
192 Mikonazol Krim Tube 48 48 1 47
193 Monoklorkamfer Mentol Cairan Botol
194 Mummifying Pasta Botol
195 Natrium Bicarbonat Tablet 500 mg Tablet 0 -
196 Natrium Diclofenac 25 mg Tablet 2800 2,800 10 2790
197 Natrium diclofenac 50 mg Tablet -
198 Natrium Fenitoin Kapsul 30 mg Tablet
199 Natrium Klorida (NaCl 0,9 %) Infus Botol 51 51 0 51
200 Nifedifin Tab 10 mg Tablet 1000 1,000 100 900
201 Nistatin 500.000 iU/g Tablet Salut Tablet
202 Obat Batuk Hitam (OBH) cairan Botol
203 Oksitetrasiklin HCL Salep 3 % Tube 0 -
204 Oksitetrasiklin HCL Salep Mata 1 % Tube 0 -
205 Oksitoksin Injeksi 10 IU/ml-1 ml Vial 101 101 5 96
206 Omeprazol 20 mg Tablet 300 300 0 300
207 Papaverin Tab 40 mg Tablet
208 Paraformaldehid Tablet 1 Gram Tablet
209 Parasetamol Drops Botol 107 107 47 60
210 Parasetamol Syirup 120 mg/5 ml Botol 200 200 26 174
211 Parasetamol Tablet 100 mg Tablet
212 Parasetamol Tablet 500 mg Tablet 17700 17,700 700 17000
213 Pehacain Injeksi Ampul 0 -
214 Pil KB Tablet
215 Pirantel Pamoat Tablet 365 mg Tablet
216 Piridoksin Tablet 10 mg Tablet 1260 1,260 480 780
217 Piroksikam 10 mg Tablet 80 80 10 70
218 Piroksikam 20 mg Tablet
219 Plester 5 Yard x 2Inch Rol 11 11 2 9
220 Prednison Tablet 5 mg Tablet 1000 1,000 0 1000
221 Primakuin Tablet 15 mg Tablet
222 Propanolol HCL tablet 40 mg Tablet
223 Propilitiourasil Tablet 100 mg Tablet
224 Prokain Benzil Penisilin Vial
225 Rabies Imune Globulin (Human) 150 IU/ Set
226 Ranitidin Tab 150 mg Tablet 1850 2,000 2,000 30 1970 EXP 1850
227 Ranitidin Injeksi Ampul 35 35 0 35
228 Rapid Test Sypilis Set
229 Reserpin Tablet 0,25 mg Tablet
230 Retinol (Vit.A) Kapsul 200.000 IU Kapsul
231 Retinol (Vit.A) Kapsul 100.000 IU Kapsul
232 Ringer Laktas Larutan Infus Steril Ampul 68 68 3
233 Salbutamol Tablet 2 mg Tablet
234 Salbutamol Tablet 4 mg Tablet
235 Salep 2-4 Kombinasi Pot
236 Salisil Bedak 2 % Buah 104 104 1 103
237 Semen Seng Fosfat Serbuk dan cairan Set
238 Serum Anti Bisa Ular Polivalen Inj 5 ml Vial
239 Serum Anti Tetanus Inj 1.500 IU/Ampull Ampul
240 Sianokobalamin (Vit B12) Inj 500 mcg/m Ampul
241 Sianokobalamin (Vit B12) Tablet Tablet 1000 1,000 0 1000
242 Silk (Benag Bedah Sutera( No.3/0 Set 31 31 6 25
243 Silver Amalgam Serbuk 65-75 % 1 Oz
244 Simvastatin Tablet 10 mg Tablet 350 350 0 350
245 Spons Gelatin Cubicles 1x1x1 Cm Set
246 Spritus 10000 ml Botol
247 Stip Test PH Kotak
248 Sulfadinamin Tablet 500 mg Tablet
249 Sulfasetamid Natrium Tetes Mata 15 % Botol
250 Suntik KB Vial
251 Tabung Oksingen besar Unit
252 Tablet Tambah darah Kombinasi Tablet 5670 28,800 5,670 1470 4200 28800 u/ remaja

253 Temporary Stopping Fletcher Buah

254 Test Golongan Dara A,B,AB Set
255 Tetrasiklin Kapsul 250 mg Kapsul
256 Tetrasiklin Kapsul 500 mg Kapsul
257 Thiamin HCL (Vit. B1) Inj 100 mg/ml - 1 Ampul
258 Thiamin HCL Mononitrat Tablet 50 mg Tablet 13984 13948 100 13848
259 Tramadol 50 mg Kapsul Kapsul
260 Triheksifenidil HCL Tablet 2 mg Tablet 1000 1,000 0 1000
261 Trikresol Formalin (TKF) Cairan Botol
262 Urin Bag Buah 0 -
263 Vitamin B.Komplek Tablet Tablet 8939 8939 266 8673
264 Wing Nidle No.21 Buah
265 Wing Nidle No.23 Buah
266 Wing Nidle No.25 Buah
267 Yodium Povidon Larutan 10 % 1000 ml Botol
268 Yodium Povidon Larutan 10 % 300 ml Botol
269 Yodium Povidon Larutan 10 % 60 ml Botol 0 18 18 1 17
270 Zinc Tab 20 mg Tablet 512 512 200 EXP
271 Kaca Objek box 0
272 Pot Sputum botol 0 400 400 u/ lab
273 Dumin Rectal Suppos Tablet 0 -
274 ZieNelden Botol
275 Vit K Infant inj 2mg/ml-1ml Ampul
276 Risperidon 2mg tab Tablet 0 -
277 Heximer 2mg tab Tablet
278 Stesolid suppos Tablet 0 -
279 Scopma Plus Tablet
280 Ventolin Nebu Ampul
281 Spasminal Tablet 0 -
282 Eritromisin sirup Botol 0 -
283 INH tablet Tablet 0 -
284 Sarung Tangan Panjang Psg
285 Under Pack Pcs 10
286 Spuit 10 ML Set 0 0
287 Scopma Plus Tablet 10 10
289 Vaksin antio rabies Vial -
290 HBO / Uniject Vial 61 20 81 41 40
291 BCG Vial 18 20 38 12 26
292 Polio Vial 15 30 45 24 21
293 Pentabio Vial 26 30 56 32 24
294 TT Vial 0
295 TD Vial 14 20 34 13 21
296 DT Vial 0
297 Campak Vial 7 20 27 14 13
298 IPV Vial 1 30 31 15 16
299 Hb Ig Vial

Umum BPJS Posyandu Jumlah

JUMLAH KUNJUNGAN RESEP
47 26 1559 1632

Mengetahui / Menyetujui Yang Menyerahkan Yang Melaporkan / Meminta Yang Menerima

Kepala Dinas Kesehatan Kepala Instalasi Farmasi Kepala Puskesmas Pengelola Obat Puskesmas

Dr.Hj. Sri Efianti. M.Kes Adriani,S.Si.Apt Ali muratwan,Skm Muhammad isya

NIP.19690210 2003 12 2 002 NIP.19720801 199903 2 004 NIP.19641218 199203 1007 NIP.19810107 2011 01 1008