Lplpo PKM Cirinten 2021

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN O
PUSKESMAS
Unit Penerima/PUSKESMAS : CIRINTEN

Kecamatan : CIRINTEN
Kabupaten : LEBAK
Provinsi : BANTEN
STOK
NO NAMA OBAT KEMASAN Penerimaan
AWAL
1 ACEYLCYSTEIN Capsul 200 Mg BOX @60 TAB 0 0

2 ACYCLOVIR CREAM BOX @10 TUBE 0 0
3 ACYCLOVIR TABLET 400 MG BOX @100 TAB 0 0
4 ALBENDAZOLE TABLET 400 MG BOX @30 TAB 5310 0
5 ALKOHOL 70% 1L BTL @ 1000ML 0 0
6 ALLOPURINOL TABLET 100 MG BOX @100 TAB 100 0
7 ALPRAZOLAM TABLET 1 MG BOX @100 TAB 0 0
AMBROKSOL SIRUP 15MG/ML (HOLICOS
8 BTL @60ML 0 0
SIRUP 15 MG/ 5 ML)
9 AMBROXOL 30Mg (HOLICOS Tab) BOX @100 TAB 0 0
10 AMINOPHYLLINE CAIRAN INJEKSI 24 MG/ML BOX @30 AMPUL 0 0
11 AMINOPHYLLINE TABLET 200 MG BTL @ 100 TAB 0 0

12 AMLODIPINE TABLET 10 MG BOX @100 TAB 0 0
13 AMOXYCILLIN SIRUP 125 MG/5 ML BOX@24BTL 0 0
15 AMOXYCILLIN TABLET 250 MG BOX @100 TAB 0 0
17 ANTACIDA SIRUP 400 MG/5 ML BOX@50BTL 0 0
18 ANTACIDA TABLET BOX @100 TAB 0 5000
19 ANTALGIN TABLET 500MG BTL@1000TAB 0 0
20 ANTIHEMOROID SUPPOSITORIA BOX@10 SUP 0 0
21 AQUA PRO INJEKSI INJEKSI VIAL 0 0
ASAM ACETIL SALISILAT (MINIASPI TABLET
22 BOX @100 TAB 0 0
SALUT ENTERIK 80 MG)
23 ASAM ASCORBAT (VITAMIN C) TABLET 50 MG TABLET 500 0
24 ASAM MEFENAMAT TABLET 500 MG BOX @100 TAB 0 0

ATAPULGIT TABLET (NEW ANTIDES TABLET
25 BOX @100 TAB 100 0
600 MG)
26 AZITROMYCIN TABLET 500 Mg TABLET 0 0
27 B12 (CYANOCOBALAMIN) CAIRAN INJEKSI BOX@100AMP 0 0
28 BEDAK SALYCIL BOX@100DUS 0 0

BETAMETASON + NEOMICIN SALEP (BEVALEX
29 BOX@12TUBE 24 0
CREAM TUBE @ 5 GRAM)
30 BETAMETASON CREAM 1 MG BOX@24TUBE 25 0
CAIRAN ELECTROLIT INFUS (WIDA RS Ringer`s
31 BOTOL 500ML 0 0
)
32 CAIRAN INFUS (ASERING 500ml ) BOTOL 500ML 0 0
33 CAIRAN INFUS (RINGER LAKTAT 500ml) BOTOL 500ML 0 0
34 CAPTOPRIL TABLET 12,5 MG BOX@100TAB 0 0
35 CARBAMAZEPINE TABLET 200 MG BOX@100TAB 0 0
36 CEFADROXIL CAPSUL 500 MG BOX@100TAB 0 0
37 CEFADROXIL SIRUP KERING 125MG BOTOL 0 0
38 CETIRIZINE CAPSUL 10 MG BOX @100 TAB 0 0
39 CETIRIZINE SIRUP 5 MG/5 ML BOTOL 0 0
40 CHLORAMPHENICOL CAPSULE 500 MG BOX@100TAB 0 0
41 CHLORAMPHENICOL SUSPENSI 125 MG/5 ML BOX@50BTL 0 0
42 CHLORAMPHENICOL TETES MATA 0.5% BOTOL 0 0

43 CHLORPENIRAMINE MALEAT 4 MG (CTM) BOX@100TAB 1100 0
CHLORPROMAZINE TABLET SALUT SELAPUT
44 BOX@100TAB 0 0
25 MG
CIPROFLOXACIN TABLET SALUT SELAPUT 500
45 BOX@100TAB 0 0
MG
46 CLONIDINE TABLET 0.15 MG BOX@100TAB 0 0
47 CLORAMPHENICOL SALEP KULIT TUBE 9 0
48 CLORAMPHENICOL SALEP MATA TUBE 31 0
49 COTRIMOXAZOLE SIRUP 240 MG/5 ML BOX@50BTL 29 0
50 COTRIMOXAZOLE TABLET 480 MG BOX@100TAB 2800 0
51 DEXAMETHASONE CAIRAN INJEKSI 5 MG AMPUL 60 0
52 DEXAMETHASONE TABLET 0.5 MG BOX @100 TAB 0 0
53 DIAZEPAM ENEMA 10MG/2.5ML TUBE 8 0
55 DIAZEPAM INJ 2.5MG AMPUL 0 0
56 DIAZEPAM TABLET 2 MG BTL@100TAB 0 0
57 DIGOXIN TABLET 0.25 MG BOX @100 TAB 0 200
58 DIPHENHYDRAMINE INJEKSI 10MG/ML BOX@30AMPUL 0 0
59 DOMPERIDONE SIRUP 5 MG/5 ML BOTOL 0 0
60 DOMPERIDONE TABLET 10 MG BOX @100 TAB 0 0
61 ERGOTAMINE TABLET BTL@100TAB 0 0
62 ERYTHROMYCIN CAPSUL 500 MG BOX@100TAB 0 0
63 ERYTHROMYCIN SIRUP KERING 200 MG/5 ML BOTOL 0 0
64 FUROSEMID TABLET BOX@100TAB 400 0

65 GARAM ORALIT BOX@100SACHET 3240 0
66 GEMFIBROZIL TABLET 300MG BOX@100TAB 0 0
67 GENTAMICIN INJEKSI BOX@5 AMPUL 0 0
68 GENTAMICINE SALEP 0.1% (SK) TUBE 0 0
69 GENTAMICINE SALEP 0.3% (SM) TUBE 0 0
70 GENTAMICINE TETES 0.3% (TM) BOTOL 10 0
71 GENTIAN VIOLET BOX@ 50BTL 0 0
72 GLIBENKLAMID TABLET 5 MG TABLET 500 0
73 GLIMEPIRIDE TABLET 2MG BOX@50 TAB 0 0
74 GLISERIL GUAIAKOLAT TABLET 100 MG BOX@100TAB 0 0
75 GLUKOSA 5% CAIRAN INFUS DUS@20BTL 0 0
GUAIFENESIN TABLET (OBAT BATUK
76 BOX@100TAB 1000 0
EKSPEKTORAN)
77 GRISEOFULVIN TABLET 250MG TABLET 100 0
78 HALOPERIDOL TABLET 5 MG BOX@100TAB 0 0
79 HIDROKORTISONE KRIM 2.5% BOX@24TUBE 22 0
80 IBUPROFEN SIRUP 100 MG/5 ML BOTOL 0 0
82 IBUPROFEN TABLET 400 MG TABLET 0 0
83 ISONIAZID TABLET 100 MG BOX @100 TAB 0 0
KALIUM DIKLOFENAK(MEZAC TABLET SALUT
84 BOX@50TAB 0 0
ENTERIK 50 MG)
85 KALSIUM LAKTAT TABLET 500 MG BOX @100 TAB 700 0
86 KETOKONAZOL TABLET 200 mg TABLET 0 0
87 KETOKONAZOLE SALEP BOX@25TUBE 0 0
88 KETOROLAC INJEKSI 30 MG/ML BOX@12AMPUL 0 20
KLORAMPHENICOL+PREDNISOLONE SALEP
89 BOX@12TUBE 0 0
(KLORFESON CREAM TUBE @ 10 GRAM)
LANSOPRAZOLE INJEKSI (PROSOGAN SERBUK

90 AMPUL 0 0
INJEKSI 30 MG)
91 LANSOPRAZOLE TABLET 30MG TABLET 0 0
92 LIDOCAIN HCL INJEKSI 2% BOX@30AMPUL 0 0
LIDOCAIN PLUS EPHINEPRIN (PEHACAIN
93 BOX@20AMPUL 61 0
CAIRAN INJEKSI)
94 LORATADINE CAPTABS 10 MG TABLET 0 0
95 METFORMIN TABLET 500 MG BOX@100TAB 300 1800
METHYLERGOMETRINE TABLET SALUT
96 BOX@100TAB 0 0
SELAPUT 0,125 MG
97 METHYLPREDNISOLONE TABLET 4 MG BOX@100TAB 0 0
METOCLOPRAMIDE SIRUP(LEXAPRAM SIRUP
98 DUS@60BTL 0 0
5 MG/5 ML)
99 METOCLOPRAMIDE TABLET 10 MG TABLET 0 0
100 METRONIDAZOLE OVULA SUP 0 0
101 METRONIDAZOLE TABLET 500 MG BOX@100TAB 200 0
102 MGSO4 INJEKSI 20% AMPUL 0 0
104 MICONAZOLE SALEP 2% BOX@24TUBE 0 0
105 NATRIUM CLORIDA 0.9% INFUS BOTOL 0 0
106 NATRIUM DIKLOFENAK TABLET 25MG BOX@50TAB 0 0
107 NIFEDIPINE TABLET 10 MG TABLET 0 0
NIFEDIPINE TABLET 20 MG (ADALAT OROS
108 TABLET 0 0
20)
OBH JERUK NIPIS sirup 100 Ml(OBH JERUK
109 DUS@50BTL 0 0
NIPIS 100 ML)
110 OMEPRAZOLE CAPSUL 20MG CAPSULE 0 0
111 OXYTOSIN INJEKSI 10 IU/ml AMPUL 0 0
112 OXYTETRACYCLINE SALEP MATA 1% TUBE 22 0
PARACETAMOL DROP 100 mg/ml btl @15ml
113 DUS@56BTL 0 0
(60mg/0,6ml)
114 PARACETAMOL SIRUP 120 MG/5 ML DUS@50BTL 25 0
115 PARACETAMOL TABLET 500 MG BOX@100TAB 0 5000
116 PHENOL GLYCEROL 10% (TT) BOTOL 0 0
PHYTOMENADIONE (VITAMIN K) INJEKSI
117 BOX@30AMPUL 0 0
10Mg/ML
118 BOX@10 AMPUL 320 0
2MG/ML (VIT K INFANT)
PHYTOMENADIONE (VITAMIN K) INJEKSI 2
119 BOX@30AMPUL 0 0
MG/ML
PHYTOMENADIONE (VITAMIN K) TABLET 10
120 BOX@100TAB 0 0
MG
121 PIROXICAM TABLET 10 MG BOX@100TAB 0 2000
122 POVIDON 1000ML BOTOL 0 1
123 POVIDONE IODINE 30 ML BOTOL 0 10
124 PREDNISONE TABLET 5 MG BOX@100TAB 0 0
125 PROKAIN BENZIL PENISILIN G INJEKSI VIAL 0 0
126 PROPANOLOL 40 MG BOX@100TAB 0 0
127 PYRANTEL TABLET 125 MG BOX@100TAB 0 0
128 PYRIDOXINE TABLET TABLET 0 400
129 RANITIDINE INJEKSI 25 MG/ML BOX@10AMPUL 15 0
130 RANITIDINE TABLET 150 MG BOX@100TAB 0 0
131 RIFAMPICIN TABLET 450 MG BOX@100TAB 0 0
132 RIVANOL BOTOL 0 0
SALBUTAMOL LIQUID 0.1 % (INHALER
133 BLISTER@5 AMPUL 130 0
NEBULIZER)
134 SALBUTAMOL TABLET 4 MG BOX@100TAB 0 0
135 SALEP 2-4 KOMBINASI BOX@24POT 0 0
SALEP ANTIBAKTERI DOEN KOMBINASI:

136 BOX@24POT 0 0
Basitrasin 500 IU/g + Polimiksin 10.000 IU/g
137 SALEP ANTIFUNGI DOEN BOX@24POT 0 0
138 SIMVASTATIN TABLET 10 MG BOX@100TAB 0 0
139 SPIRONOLACTONE TABLET 25 MG BOX@100TAB 0 0
140 TABLET TAMBAH DARAH TABLET 37500 0
TERBUTALINE SULFATE/TERBUTALINE
141 VIAL 0 0
CAIRAN IH 2,5MG/ML
142 TETRACYCLINE TABLET 250 MG BOX@100TAB 0 0
143 THIAMINE INJEKSI 100 MG/ML BOX@30AMPUL 0 0
144 THIAMINE TABLET 50 MG BTL@1000TAB 0 0
145 VAGIZOL OVULA 500 MG SUPP 0 0
146 VITAMIN A 100000 IU BTL@50CAPSUL 0 0
148 VITAMIN B COMPLEX BTL@100TAB 0 0
149 ZINC SIRUP (ZIRKUM KID Sirop 60 Ml) BOTOL 0 0
150 ZINC TABLET 20 MG BOX@100TAB 0 0
OBAT GENERIK BERLOGO

STOK
NO NAMA OBAT Kemasan Penerimaan
AWAL
ANALGETIK & ANTIPIRETIK (ARTHRIFEN PLUS
1 BOX@100TAB 0 0
TABLET)
2 ANALGETIK ANTIPIRETI (HOLIMOL CAPTABS) BOX@100TAB 0 0
ANALGETIK GEL (VOLTADEX GEL (NATRIUM

3 TUBE 0 0
DIKLOFENAK SALEP))
4 ANTI ALERGI (PRITACORT TABLET) TABLET 0 0
5 ANTI ALERGI (SONAMIN TABLET) BOX@100TAB 0 0
6 ANTI DIARE (NEO KAOMINAL SUSPENSI) DUS@60BTL 0 0
7 ANTI INFLUENZA (MOLEXFLU CAPTABS) BOX@150TAB 0 0
ANTI INFLUENZA DAN BATUK (ALPARA
8 DUS@60BTL 0 0
SIRUP)
9 BOX@150TAB 300 0
TABLET)
ANTIHEMOROID & UDEMA (DIOS Fillm
10 BOX @ 30 TAB 180 0
Coated Tablet)
MULTIVITAMIN & ANALGETIC (PRITAGESIC
11 BOX@100TAB 0 0
CAPTABS SALUT SELAPUT )
MULTIVITAMIN & ANALGETIC
12 BOX@100TAB 0 0
(TRIFANEURON CAPTABS )
MULTIVITAMIN (BECEFORT TABLET SALUT
13 BOX@100TAB 200 0
GULA)
MULTIVITAMIN ANTIOKSIDAN (ANTOKSID

14 BOX@100TAB 0 0
CAPSUL 10 STRIP @ 10 KAPSUL)
MULTIVITAMIN MINERAL TABLET (LIVRON B
15 BOX @100 TAB 0 0
PLEX TABLET SALUT GULA)
MULTIVITAMIN MINERAL TABLET (PEHAVRAL
16 TABLET 0 0
TABLET)
MULTIVITAMIN NEUROTROPIK (BIO-ATP
17 BOX @100 TAB 100 0
TABLET SALUT SELAPUT)
MULTIVITAMIN NEUROTROPIK
18 BOX @100 TAB 0 0
(MOLANEURON TABLET)
MULTIVITAMIN NEUROTROPIK INJEKSI
19 BOX @ 5 AMPUL 0 0
(BIORON 1000 CAIRAN INJEKSI)
20 MULTIVITAMIN SIRUP (BECEFORT SIRUP) DUS@ 50 BTL 30 0
21 MULTIVITAMIN SIRUP (LYTACUR SIRUP) DUS@ 48 BTL 0 0
MULTIVITAMIN SIRUP (PROCURMA SIRUP 60
22 DUS @50 BTL 50 0
ML)
23 MULTIVITAMIN SIRUP (STIMUNO SIRUP) DUS @48 BTL 0 0
MULTIVITAMIN TABLET TAMBAH DARAH
24 BOX @100 TAB 1100 0
(HEMAFORT TABLET SALUT GULA )
OBAT ANALGESIK
25 (TRAMADOL+PARACETAMOL/TRAMPARA) BOX @100 TAB 180 0
TABLET
OBAT ANALGESIK +DIAZEPAM
26 BOX @ 300 TAB 0 0
(METANEURON)
27 OBAT BATUK HERBAL (HERBAKOF SIRUP) BTL 100ML 0 0
28 OBAT BATUK & FLU (NOVADRYL SIRUP) DUS @50 BTL 0 0
OBAT BATUK DAN FLU (HUSTAB TABLET
29 BOX@ 300 TAB 300 0
30STRIP @10TABLET)
OBAT BATUK EXPECTORAN (HOLIDRYLSIRUP
30 DUS @50 BTL 70 0
BOTOL 100 ML)
31 OBAT FLU DAN BATUK (DEXTRAL KAPLET) BOX @150 TAB 450 0
OBAT FLU DAN BATUK (DEXTRAL SIRUP

32 DUS @60 BTL 0 0
BOTOL 60 ML)
OBAT FLU DAN BATUK (PROTEXINAL SIRUP
33 DUS @50 BTL 0 0
BOTOL @ 60 ML)
OBAT GANGGUAN SALURAN PENCERNAAN
34 VIAL 0 0
INJEKSI (ESOMEPRAZOLE)
OBAT GANGGUAN SISTEM PENCERNAAN

35 BOX @ 160 TAB 0 0
(ALUDONNA-D TABLET 20 STRIP @ 8 TABLET)

36 BOTOL 0 0
(LEXACROL SUSPENSI)
37 OBAT HIPERTENSI HERBAL (TENSI GARD) TABLET 1320 0
38 OBAT HERBAL MATA (OCUGARD CAPSULE) CAPSULE 0 0

39 OBAT OSTEOPOROSIS (RISTONAT TABLET) TABLET 56 0
40 PROBIOTIK (PROBIOKID) SASCET 1 0

41 SKINCOL CREAM TUBE 0 0
SUPLEMENT MULTIVITAMIN & MINERAL
42 TABLET 0 0
(PRENAMIA)
BAHAN MEDIS HABIS PAKAI

STOK
NO NAMA BMHP Kemasan Penerimaan
AWAL
1 ALKOHOL SWAB (AXIMED) BOX 181 0
2 AUTOCLICK LANCING DEVICE (ONEMED) PCS 0 0
BLOOD TRANSFUSION SET (TRANSUFUSI
3 PCS 62 0
DARAH)
4 CAT GUT CHROMIC (ONEMED) BOX@25STRIP 123 0
5 CAT GUT PLAIN (ONEMED) BOX @24 PIECE 135 0
6 DISPOSIBLE 10 ML BOX @24 PIECE 58 0
7 DISPOSIBLE 1ML BOX @100 PIECE 58 0
10 EXAMINATION GLOVES SIZE 6.5 PAIRS 77 0
13 EXAMINATION GLOVES SIZE M PAIRS 87 0
14 EXAMINATION GLOVES SIZE S PAIRS 58 0
15 EXAMINATION GLOVES SIZE XS BOX@100PCS 0 0
16 FOLEY CATHETER NO 16 BOX@100PCS 32 0
17 FOLEY CATHETER NO 18 PIECES 225 0
18 HB HEMOGLOBIN TEST STRIP STRIP 0 0
19 Infusion Set ANAK (COSMOMED) PIECES 132 0
20 Infusion Set DEWASA (COSMOMED) STRIP 362 0
21 IV CATHETER NO 16 (PEN) PCS 10 0
23 IV CATHETER NO 18 (WINGS) PCS 122 0
30 KAPAS PEMBALUT 250 G PIECES 1 0
31 KASA 4 X 10 (ONEMED) PIECES 0 0
33 KASA 4X 5 (ONEMED) PIECES 10 0
34 KASA 16X16 (ONEMED) ROLL 0 100
35 KASA 2 X 80 (COSMOMED ) PACK@10ROLL 3 0
37 KASA 4 X 15 PACK@10ROLL 10 0
38 KASA 40 M X 80 CM KOTAK 0 0
39 LUBRICATING (MY JELLY) ROLL 0 0
40 MASKER (KARET) PACK@25ROLL 600 2000
41 MASKER (TALI) PACK@5ROLL 0 0
Multi-Monitoring System (Total Cholesterol,

42 ROLL 0 0
Blood Glucose, Uric Acid (BENECHECK Plus )
43 Nasal Oxygen Cannula (COSMO MED) TUBE 44 0

44 Nebulizer Mask (ANAK) PCS 6 0
45 Nebulizer Mask (DEWASA ) PCS 58 0
46 OXYGEN MASKER (ANAK)&(DEWASA) PCS 176 0
47 PLASTER PCS 0 10
48 SILK 3 - 0 (ONEMED) PIECES 0 0
STERILIZAZION DRY(STERINTECH Sterilization
49 PIECES 0 0
Roll)
50 TEST CHOLESTEROL STRIP (BENECHECK) PIECES 43 0
51 Test Glucose + Protein (ONEMED) ROLL 0 0
52 TEST GLUCOSE STRIP (BENECHECK) BOX@36 PIECE 93 0
53 TEST HEMOGLOBIN STRIP ROLL 610 0
54 Test Uric Acid Strip(Strip 25's) BeneCheck BOX @ 10 STRIP 15 0
55 Umbilical Cord Clamp (ONEMED) BOX @50 PIECE 0 0

56 UNDERPAD (COSMOMED ) PIECES 589 0
57 URINE BAG WITH HANGER (COSMOMED) PIECES 638 0
OBAT GIGI
NO NAMA OBAT Kemasan Sisa Stok Penerimaan
1 Bahan Cetak Alginate Hygident PACK 0 0

2 Day Stone /Prestia Stone PACK 1 0
3 Devitalisasi/Devital pasta BTL 0 0
4 Etil Klorida spray BTL 1 0
5 Eugnol BTL 1 0
6 Formokresol/Trikresol BTL 1 0
Glas Ionomer Cement Fuji 9 GC extra liquid
7 KOTAK 0 0
Powder/ketoc molar 3m
8 Kalsium Hidroksida Pasta/calsidor doriden BTL 0 0
9 Klorfenol Kanfer Menthol/CHKM BTL 1 0

10 Mummiying Pasta/Iodoform BTL 1 0
11 Semen Seng Fosfat serbuk & cair SET 1 0
12 Spon Gelatin /craspon KOTAK 30 0
Tambalan Combposit ligth cure set
13 SET 0 0
(komposit, Etching, bonding)/T-Ekonome
tempotec(tambalan sementara)/sitodur
14 BTL 1 0
doriden
15 Topical anestesi gel 28/Alpha -Cain Stroberry BTL 0 0
16 Silver Amalgam Serbuk BTL 1 0

17 Xylestesin/Xylonibsa BTL 0 0
SERUM
STOK
AWAL
1 SERUM ANTI TETANUS INJEKSI AMPUL 1 0
2 SERUM ANTI BISA ULAR POLIVALEN INJEKSI AMPUL 0 0
PUSKESMAS
JUMLAH KUNJUNGAN UMUM BPJS
162 3427
Mengetahui/Menyetujui Yang Menyerahkan

Kabid SDK Farmasi dan POM Kepala Seksi Farmasi dan POM
Kabupaten Lebak
Agus Darsono, S.Sos, M.Si Edi Purnomo, SKM, M.Kes

Nip. 19670820 198903 1 011 Nip. 19700603 199203 1 006
EMBAR PERMINTAAN OBAT (LPLPO)
SKESMAS
Laporan Bulan DESEMBER 2020

Permintaan Bulan JANUARI 2021
Stok Perminta Pemberia Keterang

Persediaan Pemakaian Rusak/Ed Sisa Stok
Optimum an n an
0 0 0 0 0 0
0 0 0 0 25
0 0 0 0 200
5310 150 0 5160 0 0 APBN
0 0 0 0 1
100 100 0 0 0 500
0 0 0 0 0 0
0 0 0 0 0 50
0 0 0 0 0 500
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 300
0 0 0 0 0 100
100 60 0 40 0 100
0 0 0 0 0 0
26400 1900 0 24500 0 0
0 0 0 0 0 100
5000 800 0 4200 0 0
0 0 0 0 0 100
0 0 0 0 0 10
0 0 0 0 0 10
0 0 0 0 0 200
500 100 0 400 0 0
0 0 0 0 0 1000
100 100 0 0 0 200
0 0 0 0 0 200
0 0 0 0 0 100
0 0 0 0 0 10
24 24 0 0 0 24
25 25 0 0 0 25
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 100
0 0 0 0 0 500
0 0 0 0 0 0
0 0 0 0 0 200
0 0 0 0 0 50
0 0 0 0 0 100
0 0 0 0 0 50
0 0 0 0 0 500
0 0 0 0 0 50
0 0 0 0 0 25
1100 1100 0 0 0 1000
0 0 0 0 0 0
0 0 0 0 0 500
0 0 0 0 0 100
9 5 0 4 0 0
31 0 0 31 0 0
29 5 0 24 0 0
2800 300 0 2500 0 0
60 40 0 20 0 60
0 0 0 0 0 1000
8 2 0 6 0 0
6 2 0 4 0 0
0 0 0 0 0 10
0 0 0 0 0 100
200 100 0 100 0 100
0 0 0 0 0 90
0 0 0 0 0 50
0 0 0 0 0 100
0 0 0 0 0 0
0 0 0 0 0 100
0 0 0 0 0 50
400 400 0 0 0 500

3240 10 0 3230 0 0 APBN
0 0 0 0 0 200
0 0 0 0 0 0
0 0 0 0 0 25
0 0 0 0 0 25
10 3 0 7 0 25
0 0 0 0 0 0
500 200 0 300 0 0
0 0 0 0 0 200
0 0 0 0 0 1000
0 0 0 0 0 20
1000 200 0 800 0 0
100 100 0 0 0 200

0 0 0 0 0 0
22 10 0 12 0 25
0 0 0 0 0 50
0 0 0 0 0 50
0 0 0 0 0 200
0 0 0 0 0 0
0 0 0 0 0 1000
700 700 0 0 0 1000

0 0 0 0 0 0
0 0 0 0 0 25
20 20 0 0 0 30
0 0 0 0 0 24
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 20
61 20 0 41 0 0
0 0 0 0 0 0
2100 900 0 1200 0 0
0 0 0 0 0 100
0 0 0 0 0 1000
0 0 0 0 0 60
0 0 0 0 0 200
0 0 0 0 0 10
200 200 0 0 0 300
0 0 0 0 0 20
94 50 0 44 0 20
0 0 0 0 0 0
0 0 0 0 0 20
0 0 0 0 0 1000
0 0 0 0 0 100
0 0 0 0 0 100
0 0 0 0 0 50
0 0 0 0 0 0
0 0 0 0 0 100
22 10 0 12 0 24
0 0 0 0 0 0
25 25 0 0 0 100
5000 3300 0 1700 0 2000
0 0 0 0 0 24
0 0 0 0 0 30
320 30 0 290 0 0
0 0 0 0 0 30
0 0 0 0 0 100
2000 800 0 1200 0 0

1 0 0 1 0 0
10 8 0 2 0 10
0 0 0 0 0 2000
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
400 400 0 0 0 1000
15 15 0 0 0 50
0 0 0 0 0 500
0 0 0 0 0 0
0 0 0 0 0 0
130 20 0 110 0 0
0 0 0 0 0 1000
0 0 0 0 0 24
0 0 0 0 0 25
0 0 0 0 0 24
0 0 0 0 0 1000
0 0 0 0 0 300
37500 0 0 37500 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 30
0 0 0 0 0 100
0 0 0 0 0 10
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
stok Perminta Pemberia Keterang

optimum an n an
0 0 0 0 0 500
0 0 0 0 0 0
0 0 0 0 0 25
0 0 0 0 0 1000
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 900
0 0 0 0 0 60
300 300 0 0 0 900
180 30 0 150 0 0
0 0 0 0 0 400
0 0 0 0 0 0
200 200 0 0 0 300
0 0 0 0 0 100
0 0 0 0 0 1000
0 0 0 0 0 0
100 100 0 0 0 300
0 0 0 0 0 0
0 0 0 0 0 0
30 20 0 10 0 50
0 0 0 0 0 0
50 50 0 0 0 50
0 0 0 0 0 48
1100 1100 0 0 0 0
180 180 180 0 0 0 ed
0 780 780 -780 0 0 ED
0 0 0 0 0 0
0 0 0 0 0 0
300 300 0 0 0 600
70 30 0 40 0 0
450 450 0 0 0 600
0 0 0 0 0 60
0 0 0 0 0 50
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
1320 30 0 1290 0 0
0 0 0 0 0 0
56 0 0 56 0 0
1 1 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0

optimum an n an
181 3 0 178 0 0 IFK :174
0 0 0 0 0 0
62 62 0 0 0 0 DAI + IFK
123 10 0 113 0 0 DAI

135 10 0 125 0 0 DAI
58 0 0 58 0 0
58 0 0 58 0 0
6000 200 0 5800 0 0
435 200 0 235 0 0
77 10 0 67 0 0 DAI
220 10 0 210 0 0
0 0 0 0 0 0 DAI
87 87 0 0 0 0
58 58 0 0 0 0
0 0 0 0 0 0
32 5 0 27 0 0
225 10 0 215 0 0 DAI
0 0 0 0 0 0
132 30 0 102 0 0 DAI
362 50 0 312 0 0 DAI
10 5 0 5 0 0
105 0 0 105 0 0
122 0 0 122 0 0
80 0 0 80 0 0
184 10 0 174 0 0
40 30 0 10 0 0
617 20 0 597 0 0
20 20 0 0 0 0
145 0 0 145 0 0
1 1 0 0 0 0 DAI
0 0 0 0 0 30
0 0 0 0 0 0
10 10 0 0 0 30
100 20 0 80 0 0
3 1 0 2 0 0 IFK
0 0 0 0 0 0
10 10 0 0 0 20
0 0 0 0 0 0
0 0 0 0 0 0
2600 1100 0 1500 0 0
0 0 0 0 0 0
0 0 0 0 0 0
44 0 0 44 0 0
6 3 0 3 0 0
58 5 0 53 0 0 IFK
176 10 0 166 0 0 IFK
10 10 0 0 0 10
0 0 0 0 0 36
0 0 0 0 0 0
43 0 0 43 0 0
0 0 0 0 0 0
93 0 0 93 0 0
610 0 0 610 0 0
15 0 0 15 0 0
0 0 0 0 0 0
589 20 0 569 0 0 0
638 10 0 628 0 0

optimum an n an
0 0 0 0 0 1
1 0 0 1 0 0
0 0 0 0 0 1
1 0 0 1 0 0
1 0 0 1 0 0
1 0 0 1 0 0
0 0 0 0 0 1
0 0 0 0 0 1
1 0 0 1 0 0
1 0 0 1 0 0
1 0 0 1 0 0
30 0 0 30 0 0
0 0 0 0 0 1
1 0 0 1 0 0
0 0 0 0 0 1
1 0 0 1 0 0
0 0 0 0 0 1

optimum an n an
1 0 0 1 0 0
0 0 0 0 0 5
PUSLING/ MANLING/
RASIO PEMAKAIAN
JUMLAH PUSTU JUMLAH TOTAL
UMUM BPJS TABLET INJEKSI SIRUP
3589
Yang Meminta Yang Menerima

Kepala Puskesmas Pengelola Obat Puskesmas
H.Madnur Taufik,S.Sos,SKM.MM Ahmad fathurohman,Amd.farm

Nip. 19650404 198808 1 018 0
PUSKESMAS

Kabupaten : LEBAK
Provinsi : BANTEN
STOK
AWAL

5 ALKOHOL 70% 1L BTL @ 1000ML 0 0
8 BTL @60ML 0 0
SIRUP 15 MG/ 5 ML)

22 BOX @100 TAB 0 0

25 BOX @100 TAB 0 200
600 MG)

29 BOX@12TUBE 0 24
31 BOTOL 500ML 0 0
)

44 BOX@100TAB 0 0
25 MG
45 BOX@100TAB 0 0
MG

76 BOX@100TAB 800 0
EKSPEKTORAN)
84 BOX@50TAB 0 0
ENTERIK 50 MG)
89 BOX@12TUBE 0 0

90 AMPUL 0 0
INJEKSI 30 MG)
93 BOX@20AMPUL 41 0
CAIRAN INJEKSI)
96 BOX@100TAB 0 0
SELAPUT 0,125 MG
98 DUS@60BTL 0 0
5 MG/5 ML)
108 TABLET 0 0
20)
109 DUS@50BTL 0 0
NIPIS 100 ML)
113 DUS@56BTL 0 0
(60mg/0,6ml)
117 BOX@30AMPUL 0 0
10Mg/ML
118 BOX@10 AMPUL 290 0
119 BOX@30AMPUL 0 0
MG/ML
120 BOX@100TAB 0 0
MG
131 RIFAMPICIN TABLET 450 MG BOX@100TAB 0
NEBULIZER)

136 BOX@24POT 0 0
141 VIAL 0 0
CAIRAN IH 2,5MG/ML

STOK
AWAL
1 ANALGETIK & ANTIPIRETIK (LYMACIL TABLET) BOX@100TAB 0 4000
2 ANALGETIK ANTIPIRETI (HOLIMOL CAPTABS) BOX@100TAB 0

3 TUBE 0 0
DIKLOFENAK SALEP))
8 DUS@60BTL 0 0
SIRUP)
9 BOX@150TAB 0 900
TABLET)
10 BOX @ 30 TAB 150 0
Coated Tablet)
11 BOX@100TAB 0 400
12 BOX@100TAB 0 0
13 BOX@100TAB 0 300
GULA)

14 BOX@100TAB 0 0
15 BOX @100 TAB 0 0
16 TABLET 0 0
TABLET)
17 BOX @100 TAB 0 300
18 BOX @100 TAB 0 0
(MOLANEURON TABLET)
22 DUS @50 BTL 0 50
ML)
24 BOX @100 TAB 0 1300
OBAT ANALGESIK
TABLET
26 BOX @ 300 TAB 0 0
(METANEURON)
29 BOX@ 300 TAB 0 7000
30STRIP @10TABLET)
30 DUS @50 BTL 40 0
BOTOL 100 ML)

32 DUS @60 BTL 0 0
BOTOL 60 ML)
33 DUS @50 BTL 0 0
BOTOL @ 60 ML)
34 VIAL 0 0

35 BOX @ 160 TAB 0 0

36 BOTOL 0 192
(LEXACROL SUSPENSI)


42 TABLET 0 6000
(PRENAMIA)

STOK
AWAL
3 PCS 0 0
DARAH)
15 EXAMINATION GLOVES SIZE XS BOX@100PCS 0

42 ROLL 0

47 PLASTER PCS 0 0
49 PIECES 0 0
Roll)

OBAT GIGI

5 Eugnol BTL 1 0
7 KOTAK 0 0

13 SET 0 0
14 BTL 1 0
doriden

SERUM
STOK
AWAL
PUSKESMAS

Kabupaten Lebak
Agus Darsono, S.Sos, M.Si Edi Purnomo, SKM, M.Kes

Nip. 19670820 198903 1 011 Nip. 19700603 199203 1 006
SKESMAS
Laporan Bulan JANUARI 2021

Permintaan Bulan FEBRUARI 2021
Stok Perminta Pemberia Keteranga

Optimum an n n
0 0 0 0 0 300
0 0 0 0 24
0 0 0 0 200
5160 30 0 5130 0 0 APBN
0 0 0 0 1
500 200 0 300 0 200
0 0 0 0 0 100
0 0 0 0 0 50
0 0 0 0 0 1000
0 0 0 0 0 30
0 0 0 0 0 100
300 300 0 0 0 500
0 0 0 0 0 24
100 40 0 60 0 0
0 0 0 0 0 500
24500 1500 0 23000 0 0 BLUD
0 0 0 0 0 100
4200 2400 0 1800 0 1000 BLUD
0 0 0 0 0 100
0 0 0 0 0 10
0 0 0 0 0 10
0 0 0 0 0 500
400 0 0 400 0 0
700 700 0 0 0 1000
200 100 0 100 0 300
0 0 0 0 0 100
0 0 0 0 0 100
0 0 0 0 0 100
24 24 0 0 0 48
25 25 0 0 0 25
0 0 0 0 0 100
0 0 0 0 0 0
40 40 0 0 0 80
0 0 0 0 0 500
0 0 0 0 0 100
0 0 0 0 0 1000
0 0 0 0 0 50
0 0 0 0 0 500
0 0 0 0 0 50
0 0 0 0 0 1000
0 0 0 0 0 50
0 0 0 0 0 24
1000 700 0 300 0 1000
0 0 0 0 0 100
0 0 0 0 0 1000
0 0 0 0 0 100
4 4 0 0 0 24
31 10 0 21 0 0
24 10 0 14 0 0
2500 0 0 2500 0 0
120 30 0 90 0 0
0 0 0 0 0 2000
6 0 0 6 0 0
4 0 0 4 0 0
0 0 0 0 0 10
0 0 0 0 0 100
100 0 0 100 0 0
0 0 0 0 0 90
0 0 0 0 0 50
0 0 0 0 0 500
0 0 0 0 0 100
0 0 0 0 0 100
0 0 0 0 0 100
4700 0 0 4700 0 0
3230 5 0 3225 0 0 APBN
0 0 0 0 0 100
0 0 0 0 0 5
0 0 0 0 0 24
0 0 0 0 0 24
31 16 0 15 0 24
0 0 0 0 0 50
300 0 0 300 0 0
0 0 0 0 0 100
0 0 0 0 0 500
0 0 0 0 0 40
800 0 0 800 0 0
100 100 0 0 0 200

0 0 0 0 0 100
36 12 0 24 0 0
0 0 0 0 0 50
0 0 0 0 0 50
0 0 0 0 0 100
0 0 0 0 0 0
0 0 0 0 0 1000
1000 300 0 700 0 0

0 0 0 0 0 500
0 0 0 0 0 25
0 0 0 0 0 48
0 0 0 0 0 24
0 0 0 0 0 10
0 0 0 0 0 1000
0 0 0 0 0 90
41 41 41 0 0 100 ED JAN 21
0 0 0 0 0 100
1200 0 0 1200 0 0 BLUD
0 0 0 0 0 200
0 0 0 0 0 500
0 0 0 0 0 50
0 0 0 0 0 300
0 0 0 0 0 10
300 0 0 300 0 0
0 0 0 0 0 20
44 12 0 32 0 0
0 0 0 0 0 24
20 20 0 0 0 40
0 0 0 0 0 1000
0 0 0 0 0 100
0 0 0 0 0 100
0 0 0 0 0 50
0 0 0 0 0 1000
0 0 0 0 0 100
12 12 0 0 0 24
0 0 0 0 0 56
100 50 0 50 0 50
1700 1700 0 0 0 5000
0 0 0 0 0 25
0 0 0 0 0 60
290 290 290 0 0 100 ED FEB21
0 0 0 0 0 90
0 0 0 0 0 200
1200 300 0 900 0 0 BLUD

1 1 0 0 0 1 BLUD
2 2 0 0 0 5 BLUD
1000 100 0 900 0 0
0 0 0 0 0 10
0 0 0 0 0 100
0 0 0 0 0 500
300 300 0 0 0 1000
0 0 0 0 0 100
0 0 0 0 0 1000
0 0 0 0
0 0 0 0 0 5
410 0 0 410 0 0
200 200 0 0 0 1000

24 24 0 0 0 24
0 0 0 0 0 24
24 8 0 16 0 0
0 0 0 0 0 500
0 0 0 0 0 100
37500 4260 0 33240 0 0
0 0 0 0 0 0
0 0 0 0 0 100
0 0 0 0 0 30
100 100 0 0 0 500
0 0 0 0 0 10
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 500
0 0 0 0 0 50
0 0 0 0 0 500
stok Perminta Pemberia Keteranga

optimum an n n
4000 1400 0 2600 0 0
0 0 0 0
0 0 0 0 0 10
0 0 0 0 0 1050
0 0 0 0 0 1000
0 0 0 0 0 50
0 0 0 0 0 600
0 0 0 0 0 60
900 450 0 450 0 450
150 0 0 150 0 0
400 200 0 200 0 200
0 0 0 0 0 100
300 0 0 300 0 0
0 0 0 0 0 100
0 0 0 0 0 1000
0 0 0 0 0 200
300 0 0 300 0 0
0 0 0 0 0 200
0 0 0 0 0 10
60 30 0 30 0 0
0 0 0 0 0 48
50 0 0 50 0 0
0 0 0 0 0 48
1300 1300 0 0 0 0
0 0 0 0 0 100
0 0 0 0 0 100
96 48 0 48 0 0
0 0 0 0 0 50
7000 4900 0 2100 0 0
40 40 0 0 0 50
600 150 0 450 0 0
0 0 0 0 0 60
0 0 0 0 0 50
0 0 0 0 0 10
0 0 0 0 0 160
192 56 0 136 0 0
1290 30 0 1260 0 0
0 0 0 0 0 30
56 56 56 0 0 0 ED FEB21
0 0 0 0 0 10
0 0 0 0 0 10
6000 6000 0 0 0 0

optimum an n n
178 3 0 175 0 0 IFK :174
0 0 0 0 0 0
0 0 0 0 0 50
113 12 0 101 0 0 DAI

125 12 0 113 0 0 DAI
58 10 0 48 0 0
58 10 0 48 0 0
5800 200 0 5600 0 0
235 100 0 135 0 0
67 67 0 0 0 100 DAI
210 50 0 160 0 0
0 0 0 0 0 100
0 0 0 0 0 500
0 0 0 0 0 500
0 0 0 0
27 5 0 22 0 0
215 5 0 210 0 0 DAI
0 0 0 0 0 0
102 50 0 52 0 50 DAI
312 50 0 262 0 0 DAI
5 5 0 0 0 50
105 20 0 85 0 0
122 20 0 102 0 0
80 10 0 70 0 0
174 20 0 154 0 0
10 10 0 0 0 100
597 0 0 597 0 0
0 0 0 0 0 50
145 20 0 125 0 0
0 0 0 0 0 2
30 5 0 25 0 0
0 0 0 0 0 20
30 10 0 20 0 10
80 80 0 0 0 100
2 0 0 2 0 0 IFK
0 0 0 0 0 20
20 5 0 15 0 0
0 0 0 0 0 0
0 0 0 0 0 10
1500 1500 0 0 0 2000
0 0 0 0 0 2000
0 0 0 0
44 5 0 39 0 0
3 3 0 0 0 50
53 5 0 48 0 0 IFK
166 10 0 156 0 0 IFK
0 0 0 0 0 20
36 0 0 36 0 0
0 0 0 0 0 2
43 43 0 0 0 50
0 0 0 0 0 1
93 50 0 43 0 0
610 0 0 610 0 0
15 15 0 0 0 50
0 0 0 0 0 0
569 69 0 500 0 0
628 10 0 618 0 0

optimum an n n
0 0 0 0 0 1
1 0 0 1 0 0
0 0 0 0 0 1
1 0 0 1 0 0
1 0 0 1 0 0
1 0 0 1 0 0
0 0 0 0 0 1
0 0 0 0 0 1
1 0 0 1 0 0
1 0 0 1 0 0
1 0 0 1 0 0
30 0 0 30 0 0
0 0 0 0 0 1
1 0 0 1 0 0
0 0 0 0 0 1
1 0 0 1 0 0
0 0 0 0 0 1

optimum an n n
1 0 0 1 0
5 5 0 0 0 6
PUSLING/ MANLING/
RASIO PEMAKAIAN
0


Nip. 19650404 198808 1 018 0
PUSKESMAS

Kabupaten : LEBAK
Provinsi : BANTEN
STOK
AWAL

5 ALKOHOL 70% 1L BTL @ 1000ML 0 0
8 BTL @60ML 0 0
SIRUP 15 MG/ 5 ML)

22 BOX @100 TAB 0 0

25 BOX @100 TAB 100 300
600 MG)

29 BOX@12TUBE 0 48
31 BOTOL 500ML 0 0
)

44 BOX@100TAB 0 0
25 MG
45 BOX@100TAB 0 0
MG

76 BOX@100TAB 800 0
EKSPEKTORAN)
84 BOX@50TAB 0 0
ENTERIK 50 MG)
89 BOX@12TUBE 0 0

90 AMPUL 0 0
INJEKSI 30 MG)
93 BOX@20AMPUL 0 60
CAIRAN INJEKSI)
96 BOX@100TAB 0 0
SELAPUT 0,125 MG
98 DUS@60BTL 0 0
5 MG/5 ML)
108 TABLET 0 0
20)
109 DUS@50BTL 0 0
NIPIS 100 ML)
113 DUS@56BTL 0 0
(60mg/0,6ml)
117 BOX@30AMPUL 0 0
10Mg/ML
118 BOX@10 AMPUL 0 0
119 BOX@30AMPUL 0 0
MG/ML
120 BOX@100TAB 0 0
MG
NEBULIZER)

136 BOX@24POT 0 0
141 VIAL 0 0
CAIRAN IH 2,5MG/ML

STOK
AWAL

3 TUBE 0 0
DIKLOFENAK SALEP))
8 DUS@60BTL 0 0
SIRUP)
9 BOX@150TAB 450 450
TABLET)
10 BOX @ 30 TAB 150 360
Coated Tablet)
11 BOX@100TAB 200 500
12 BOX@100TAB 0 0
13 BOX@100TAB 300 0
GULA)

14 BOX@100TAB 0 0
15 BOX @100 TAB 0 0
16 TABLET 0 0
TABLET)
17 BOX @100 TAB 300 300
18 BOX @100 TAB 0 0
(MOLANEURON TABLET)
22 DUS @50 BTL 50 0
ML)
24 BOX @100 TAB 0 0
OBAT ANALGESIK
TABLET
26 BOX @ 300 TAB 0 0
(METANEURON)
29 BOX@ 300 TAB 2100 0
30STRIP @10TABLET)
30 DUS @50 BTL 0 50
BOTOL 100 ML)

32 DUS @60 BTL 0 0
BOTOL 60 ML)
33 DUS @50 BTL 0 0
BOTOL @ 60 ML)
34 VIAL 0 0

35 BOX @ 160 TAB 0 0

36 BOTOL 136 0
(LEXACROL SUSPENSI)


42 TABLET 0 0
(PRENAMIA)

STOK
AWAL
3 PCS 0 0
DARAH)

42 ROLL 0

47 PLASTER PCS 0 0
49 PIECES 0 0
Roll)

OBAT GIGI

5 Eugnol BTL 1 0
7 KOTAK 0 1

13 SET 0 0
14 BTL 1 0
doriden

SERUM
STOK
AWAL
PUSKESMAS

Kabupaten Lebak
dr. Budhi Mulyanto Edi Purnomo, SKM, M.Kes

NIP. 19720222 200502 1 003 Nip. 19700603 199203 1 006
SKESMAS
Laporan Bulan FEBRUARI 2021

Permintaan Bulan MARET 2021

Optimum an n n
0 0 0 0 0 300
0 0 0 0 24
0 0 0 0 200
5130 30 0 5100 0 0 APBN
0 0 0 0 1
500 200 0 300 0 100
0 0 0 0 0 100
0 0 0 0 0 50
0 0 0 0 0 1000
0 0 0 0 0 30
0 0 0 0 0 100
600 0 0 600 0 0
0 0 0 0 0 24
60 30 0 30 0 50
0 0 0 0 0 500
23000 1200 0 21800 0 0 BLUD
0 0 0 0 0 100
2800 1900 0 900 0 1000 BLUD
0 0 0 0 0 100
0 0 0 0 0 10
0 0 0 0 0 10
0 0 0 0 0 500
400 0 0 400 0 0
700 700 0 0 0 1000
400 100 0 300 0 300
0 0 0 0 0 100
0 0 0 0 0 100
0 0 0 0 0 100
48 24 0 24 0 24
25 10 0 15 0 25
0 0 0 0 0 100
0 0 0 0 0 0
40 40 0 0 0 80
0 0 0 0 0 500
0 0 0 0 0 100
0 0 0 0 0 1000
0 0 0 0 0 50
0 0 0 0 0 500
0 0 0 0 0 50
0 0 0 0 0 1000
0 0 0 0 0 50
0 0 0 0 0 24
1300 1000 0 300 0 1000
0 0 0 0 0 100
0 0 0 0 0 1000
0 0 0 0 0 100
0 0 0 0 0 24
21 21 0 0 0 24
14 10 0 4 0 50
2500 100 0 2400 0 0
190 110 0 80 0 30
0 0 0 0 0 2000
6 1 0 5 0 0
4 1 0 3 0 5
0 0 0 0 0 10
0 0 0 0 0 100
100 0 0 100 0 0
0 0 0 0 0 90
0 0 0 0 0 50
0 0 0 0 0 500
0 0 0 0 0 100
0 0 0 0 0 100
0 0 0 0 0 100
9400 0 0 9400 0 0
3225 5 0 3220 0 0 APBN
0 0 0 0 0 100
0 0 0 0 0 5
0 0 0 0 0 24
0 0 0 0 0 24
15 15 0 0 0 24
0 0 0 0 0 50
300 0 0 300 0 0
0 0 0 0 0 100
0 0 0 0 0 500
0 0 0 0 0 40
800 0 0 800 0 0
100 100 0 0 0 200

0 0 0 0 0 100
24 12 0 12 0 12
0 0 0 0 0 50
0 0 0 0 0 50
0 0 0 0 0 100
0 0 0 0 0 0
0 0 0 0 0 1000
700 300 0 400 0 200

0 0 0 0 0 500
0 0 0 0 0 25
0 0 0 0 0 48
0 0 0 0 0 24
0 0 0 0 0 10
0 0 0 0 0 1000
0 0 0 0 0 90
60 60 0 0 0 100
0 0 0 0 0 100
1200 100 0 1100 0 0 BLUD
0 0 0 0 0 200
0 0 0 0 0 500
0 0 0 0 0 50
0 0 0 0 0 300
0 0 0 0 0 10
300 100 0 200 0 100
0 0 0 0 0 20
32 0 0 32 0 0
0 0 0 0 0 24
20 20 0 0 0 40
0 0 0 0 0 1000
0 0 0 0 0 100
0 0 0 0 0 100
0 0 0 0 0 50
0 0 0 0 0 1000
0 0 0 0 0 100
0 0 0 0 0 24
0 0 0 0 0 56
100 50 0 50 0 50
800 800 0 0 0 5000
0 0 0 0 0 25
0 0 0 0 0 60
0 0 0 0 0 100
0 0 0 0 0 90
0 0 0 0 0 200
900 200 0 700 0 0 BLUD

0 0 0 0 0 1
0 0 0 0 0 5
2200 300 0 1900 0 0
0 0 0 0 0 10
0 0 0 0 0 100
0 0 0 0 0 500
300 300 0 0 0 1000
0 0 0 0 0 100
0 0 0 0 0 1000
0 0 0 0
0 0 0 0 0 5
410 10 0 400 0 0
200 200 0 0 0 1000

24 24 0 0 0 24
0 0 0 0 0 24
16 10 0 6 0 24
0 0 0 0 0 500
0 0 0 0 0 100
33240 4080 0 29160 0 0
0 0 0 0 0 0
0 0 0 0 0 100
0 0 0 0 0 30
900 100 0 800 0 0
0 0 0 0 0 10
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 500
0 0 0 0 0 50
0 0 0 0 0 500

optimum an n n
2600 500 0 2100 0 0
0 0 0 0
0 0 0 0 0 10
0 0 0 0 0 1050
0 0 0 0 0 1000
0 0 0 0 0 50
0 0 0 0 0 600
0 0 0 0 0 60
900 450 0 450 0 450
510 30 0 480 0 0
700 100 0 600 0 0
0 0 0 0 0 100
300 300 0 0 0 500
0 0 0 0 0 100
0 0 0 0 0 1000
0 0 0 0 0 200
600 0 0 600 0 0
0 0 0 0 0 200
0 0 0 0 0 10
30 0 0 30 0 0
0 0 0 0 0 48
50 0 0 50 0 0
0 0 0 0 0 48
0 0 0 0 0 0
0 0 0 0 0 100
0 0 0 0 0 100
48 48 0 0 0 48
0 0 0 0 0 50
2100 150 0 1950 0 0
50 10 0 40 0 0
450 150 0 300 0 0
0 0 0 0 0 60
0 0 0 0 0 50
0 0 0 0 0 10
0 0 0 0 0 160
136 50 0 86 0 0
1260 30 0 1230 0 0
0 0 0 0 0 30
0 0 0 0 0 0
0 0 0 0 0 10
0 0 0 0 0 10
0 0 0 0 0 0

optimum an n n
175 10 0 165 0 0 IFK :174
0 0 0 0 0 0
0 0 0 0 0 50
101 0 0 101 0 0 DAI

113 0 0 113 0 0 DAI
48 20 0 28 0 0
48 20 0 28 0 0
5600 200 0 5400 0 0
135 100 0 35 0 0
0 0 0 0 0 100 DAI
160 0 0 160 0 0
0 0 0 0 0 100
200 200 0 0 0 500
200 200 0 0 0 500
0 0 0 0
22 5 0 17 0 0
210 5 0 205 0 0 DAI
0 0 0 0 0 0
52 50 0 2 0 50 DAI
262 50 0 212 0 0 DAI
0 0 0 0 0 50
85 20 0 65 0 0
102 20 0 82 0 0
70 10 0 60 0 0
154 20 0 134 0 0
50 10 0 40 0 0
597 0 0 597 0 0
50 0 0 50 0 0
125 20 0 105 0 0
2 1 0 1 0 2
25 5 0 20 0 0
0 0 0 0 0 20
30 10 0 20 0 10
10 10 0 0 0 100
2 0 0 2 0 0 IFK
0 0 0 0 0 20
15 5 0 10 0 0
0 0 0 0 0 0
0 0 0 0 0 10
3000 350 0 2650 0 0
0 0 0 0 0 2000
0 0 0 0
39 5 0 34 0 0
0 0 0 0 0 50
48 5 0 43 0 0 IFK
156 10 0 146 0 0 IFK
0 0 0 0 0 20
36 0 0 36 0 0
0 0 0 0 0 2
0 0 0 0 0 50
0 0 0 0 0 1
43 0 0 43 0 0
610 0 0 610 0 0
0 0 0 0 0 50
0 0 0 0 0 0
500 50 0 450 0 0
618 10 0 608 0 0

optimum an n n
0 0 0 0 0 1
1 0 0 1 0 0
0 0 0 0 0 1
1 0 0 1 0 0
1 0 0 1 0 0
1 0 0 1 0 0
1 0 0 1 0 0
0 0 0 0 0 1
1 0 0 1 0 0
1 0 0 1 0 0
1 0 0 1 0 0
30 0 0 30 0 0
0 0 0 0 0 1
1 0 0 1 0 0
0 0 0 0 0 1
1 0 0 1 0 0
0 0 0 0 0 1

optimum an n n
1 0 0 1 0 0
6 3 0 3 0 3
PUSLING/ MANLING/
RASIO PEMAKAIAN
0


Nip. 19650404 198808 1 018
PUSKESMAS

Kabupaten : LEBAK
Provinsi : BANTEN
STOK
AWAL

5 ALKOHOL 70% 1L BTL @ 1000ML 0 0
8 BTL @60ML 0 0
SIRUP 15 MG/ 5 ML)

22 BOX @100 TAB 0 200

25 BOX @100 TAB 300 300
600 MG)

29 BOX@12TUBE 24 24
31 BOTOL 500ML 0 0
)

44 BOX@100TAB 0 0
25 MG
45 BOX@100TAB 0 0
MG

76 BOX@100TAB 800 0
EKSPEKTORAN)
84 BOX@50TAB 0 0
ENTERIK 50 MG)
89 BOX@12TUBE 0 0

90 AMPUL 0 0
INJEKSI 30 MG)
93 BOX@20AMPUL 0 100
CAIRAN INJEKSI)
96 BOX@100TAB 0 0
SELAPUT 0,125 MG
98 DUS@60BTL 0 0
5 MG/5 ML)
108 TABLET 0 0
20)
109 DUS@50BTL 0 0
NIPIS 100 ML)
113 DUS@56BTL 0 10
(60mg/0,6ml)

117 BOX@30AMPUL 0 0
10Mg/ML
119 BOX@30AMPUL 0 0
MG/ML
120 BOX@100TAB 0 0
MG
NEBULIZER)
136 BOX@24POT 0 0

141 VIAL 0 0
CAIRAN IH 2,5MG/ML

STOK
AWAL

3 TUBE 0 0
DIKLOFENAK SALEP))
8 DUS@60BTL 0 0
SIRUP)
9 BOX@150TAB 450 450
TABLET)
10 BOX @ 30 TAB 480 0
Coated Tablet)
11 BOX@100TAB 600 500
12 BOX@100TAB 0 0
13 BOX@100TAB 0 300
GULA)
14 BOX@100TAB 0 0

15 BOX @100 TAB 0 0
16 TABLET 0 0
TABLET)
17 BOX @100 TAB 600 0
18 BOX @100 TAB 0 0
(MOLANEURON TABLET)
22 DUS @50 BTL 50 0
ML)
24 BOX @100 TAB 0 0
OBAT ANALGESIK
TABLET
26 BOX @ 300 TAB 0 0
(METANEURON)
29 BOX@ 300 TAB 1950 0
30STRIP @10TABLET)
30 DUS @50 BTL 40 0
BOTOL 100 ML)

32 DUS @60 BTL 0 0
BOTOL 60 ML)
33 DUS @50 BTL 0 0
BOTOL @ 60 ML)
34 VIAL 0 0

35 BOX @ 160 TAB 0 0

36 BOTOL 86 48
(LEXACROL SUSPENSI)

42 TABLET 0 0
(PRENAMIA)

STOK
AWAL
3 PCS 0 0
DARAH)

42 ROLL 0 0

47 PLASTER PCS 0 10
49 PIECES 0 0
Roll)

OBAT GIGI

5 Eugnol BTL 1 0
7 KOTAK 1 0


13 SET 0 0
14 BTL 1 0
doriden

SERUM
STOK
AWAL
PUSKESMAS

Kabupaten Lebak

NIP. 19720222 200502 1 003 Nip. 19700603 199203 1 006
SKESMAS
Laporan Bulan MARET 2021

Permintaan Bulan Apr-21

Optimum an n n
0 0 0 0 0 300
0 0 0 0 0 24
0 0 0 0 0 200
5100 3000 0 2100 0 0 APBN
0 0 0 0 0 1
400 200 0 200 0 100
0 0 0 0 0 100
0 0 0 0 0 50
0 0 0 0 0 1000
0 0 0 0 0 30
0 0 0 0 0 100
600 300 0 300 0 300
0 0 0 0 0 24
90 25 0 65 0 0
0 0 0 0 0 500
21800 5400 0 16400 0 0 BLUD
0 0 0 0 0 100
1900 500 0 1400 0 1000
0 0 0 0 0 100
0 0 0 0 0 10
0 0 0 0 0 10
200 100 0 100 0 0 BLUD
400 100 0 300 0 200
700 600 0 100 0 1000
600 400 0 200 0 300
0 0 0 0 0 100
0 0 0 0 0 100
0 0 0 0 0 100
48 36 0 12 0 24
40 30 0 10 0 25
0 0 0 0 0 100
0 0 0 0 0 0
60 60 0 0 0 80
800 300 0 500 0 0 BLUD
0 0 0 0 0 100
200 100 0 100 0 1000 BLUD
0 0 0 0 0 50
150 100 0 50 0 0 BLUD
0 0 0 0 0 50
0 0 0 0 0 1000
0 0 0 0 0 50
0 0 0 0 0 24
1300 1100 0 200 0 1000
0 0 0 0 0 100
0 0 0 0 0 1000
0 0 0 0 0 100
24 0 0 24 0 0
24 16 0 8 0 24
4 4 0 0 0 50
2400 2400 2400 0 0 0 ED
180 130 0 50 0 100
0 0 0 0 0 2000
5 0 0 5 0 0
3 0 0 3 0 5
0 0 0 0 0 10
0 0 0 0 0 100
100 0 0 100 0 0
0 0 0 0 0 90
0 0 0 0 0 50
0 0 0 0 0 500
0 0 0 0 0 100
0 0 0 0 0 100
0 0 0 0 0 100
9400 5000 0 4400 0 0

3220 10 0 3210 0 0 APBN
0 0 0 0 0 100
0 0 0 0 0 5
48 26 0 22 0 24 BLUD
0 0 0 0 0 24
0 0 0 0 0 24
0 0 0 0 0 50
300 0 0 300 0 0
0 0 0 0 0 100
0 0 0 0 0 500
0 0 0 0 0 40
800 0 0 800 0 0
0 0 0 0 0 200
0 0 0 0 0 100
36 24 0 12 0 24
0 0 0 0 0 50
0 0 0 0 0 50
0 0 0 0 0 100
0 0 0 0 0 0
0 0 0 0 0 1000
600 600 0 0 0 200

300 200 0 100 0 0 BLUD
0 0 0 0 0 25
5 5 0 0 0 48 BLUD
0 0 0 0 0 24
0 0 0 0 0 10
0 0 0 0 0 1000
100 6 0 94 0 0 BLUD
100 20 0 80 0 100
0 0 0 0 0 100
1100 100 0 1000 0 0 BLUD
0 0 0 0 0 200
500 300 0 200 0 500 BLUD
0 0 0 0 0 50
0 0 0 0 0 300
0 0 0 0 0 10
300 300 0 0 0 200
0 0 0 0 0 20
32 0 0 32 0 0
0 0 0 0 0 24
20 20 0 0 0 40
0 0 0 0 0 1000
0 0 0 0 0 100
0 0 0 0 0 100
0 0 0 0 0 50
300 240 0 60 0 1000 BLUD

0 0 0 0 0 100
24 16 0 8 0 24 BLUD
10 2 0 8 0 0 BLUD
100 20 0 80 0 50
BLUD
3800 3100 0 700 0 5000
3000
15 2 0 13 0 0 BLUD
0 0 0 0 0 60
0 0 0 0 0 100
0 0 0 0 0 90
0 0 0 0 0 200
700 400 0 300 0 0 BLUD

0 0 0 0 0 1
20 12 0 8 0 0 BLUD
3200 800 0 2400 0 0
0 0 0 0 0 10
0 0 0 0 0 100
0 0 0 0 0 500
300 300 0 0 0 1000
20 9 0 11 0 0 BLUD
500 400 0 100 0 1000 BLUD
0 0 0 0 0
0 0 0 0 0 5
400 0 0 400 0 0
700 400 0 300 0 1000 BLUD500

24 10 0 14 0 24
0 0 0 0 0 24
30 6 0 24 0 24
300 90 0 210 0 500 BLUD
0 0 0 0 0 100
29160 4620 0 24540 0 0
0 0 0 0 0 0
0 0 0 0 0 100
0 0 0 0 0 30
1700 200 0 1500 0 0
0 0 0 0 0 10
0 0 0 0 0 0
0 0 0 0 0 0
800 300 0 500 0 500
0 0 0 0 0 50
100 80 0 20 0 500 BLUD

optimum an n n
2100 2100 2100 0 0 500 ED
0 0 0 0 0
0 0 0 0 0 10
0 0 0 0 0 1050
0 0 0 0 0 1000
0 0 0 0 0 50
0 0 0 0 0 600
0 0 0 0 0 60
900 750 0 150 0 450
480 30 0 450 0 0
1100 800 0 300 0 500
0 0 0 0 0 100
300 200 0 100 0 500

0 0 0 0 0 100
0 0 0 0 0 1000
0 0 0 0 0 200
600 400 0 200 0 0
0 0 0 0 0 200
0 0 0 0 0 10
30 30 0 0 0 0
0 0 0 0 0 48
50 50 0 0 0 0
0 0 0 0 0 48
0 0 0 0 0 0
0 0 0 0 0 100
0 0 0 0 0 100
48 0 0 48 0 48
0 0 0 0 0 50
1950 450 0 1500 0 0
40 0 0 40 0 0
1350 0 0 1350 0 0
0 0 0 0 0 60
0 0 0 0 0 50
0 0 0 0 0 10
0 0 0 0 0 160
134 48 0 86 0 0
1380 30 0 1350 0 0
0 0 0 0 0 30
0 0 0 0 0 0
0 0 0 0 0 10
0 0 0 0 0 10
0 0 0 0 0 0

optimum an n n
165 5 0 160 0 0 IFK :174
0 0 0 0 0 0
0 0 0 0 0 50
101 25 0 76 0 0 DAI
113 24 0 89 0 0 DAI
28 10 0 18 0 0
28 28 0 0 0 0
5400 500 0 4900 0 0
35 35 0 0 0 100
0 0 0 0 0 100 DAI
160 100 0 60 0 100
0 0 0 0 0 100
200 200 0 0 0 500
200 200 0 0 0 500
0 0 0 0 0
17 5 0 12 0 0
205 5 0 200 0 0 DAI
0 0 0 0 0 0
52 10 0 42 0 50 DAI
212 100 0 112 0 0 DAI
0 0 0 0 0 50
65 10 0 55 0 0
82 10 0 72 0 0
60 20 0 40 0 0
134 20 0 114 0 0
40 10 0 30 0 0
597 50 0 547 0 0
50 10 0 40 0 0
105 10 0 95 0 0
2 0 0 2 0 2
30 5 0 25 0 0
0 0 0 0 0 20
30 20 0 10 0 10
5 2 0 3 0 0 BLUD
2 0 0 2 0 0 IFK
0 0 0 0 0 20
10 5 0 5 0 0
0 0 0 0 0 0
0 0 0 0 0 10
2650 50 0 2600 0 0
0 0 0 0 0 2000
0 0 0 0 0
34 4 0 30 0 0
0 0 0 0 0 50
43 5 0 38 0 0 IFK
146 10 0 136 0 0 IFK
10 6 0 4 0 20 BLUD
36 36 0 0 0 36
0 0 0 0 0 2
0 0 0 0 0 50
0 0 0 0 0 1
43 43 43 0 0 0
610 10 0 600 0 0
0 0 0 0 0 50
0 0 0 0 0
450 50 0 400 0 0
608 20 0 588 0 0

optimum an n n
0 0 0 0 0 1
1 0 0 1 0 0
0 0 0 0 0 1
1 0 0 1 0 0
1 0 0 1 0 0
1 0 0 1 0 0
1 0 0 1 0 0
0 0 0 0 0 1
1 0 0 1 0 0
1 0 0 1 0 0
1 0 0 1 0 0
30 0 0 30 0 0
0 0 0 0 0 1
1 0 0 1 0 0
0 0 0 0 0 1
1 0 0 1 0 0
0 0 0 0 0 1

optimum an n n
1 0 0 1 0 0
6 1 0 5 0 3
PUSLING/ MANLING/
RASIO PEMAKAIAN
0


Nip. 19650404 198808 1 018
PUSKESMAS

Kabupaten : LEBAK
Provinsi : BANTEN
STOK
AWAL

5 ALKOHOL 70% 1L BTL @ 1000ML 0 0
8 BTL @60ML 0 0
SIRUP 15 MG/ 5 ML)

22 BOX @100 TAB 100 0

25 BOX @100 TAB 200 300
600 MG)

29 BOX@12TUBE 12 24
31 BOTOL 500ML 0 0
)

44 BOX@100TAB 0 200
25 MG
45 BOX@100TAB 0 0
MG

76 BOX@100TAB 800 0
EKSPEKTORAN)
84 BOX@50TAB 0 0
ENTERIK 50 MG)
89 BOX@12TUBE 0 0

90 AMPUL 0 0
INJEKSI 30 MG)
93 BOX@20AMPUL 80 100
CAIRAN INJEKSI)
96 BOX@100TAB 0 0
SELAPUT 0,125 MG
98 DUS@60BTL 0 0
5 MG/5 ML)
108 TABLET 0 0
20)
109 DUS@50BTL 0 0
NIPIS 100 ML)
113 DUS@56BTL 8 0
(60mg/0,6ml)
117 BOX@30AMPUL 0 0
10Mg/ML
119 BOX@30AMPUL 0 0
MG/ML
120 BOX@100TAB 0 0
MG
NEBULIZER)

136 BOX@24POT 0 0
141 VIAL 0 0
CAIRAN IH 2,5MG/ML

STOK
AWAL

3 TUBE 0 0
DIKLOFENAK SALEP))
8 DUS@60BTL 0 0
SIRUP)
9 BOX@150TAB 150 450
TABLET)
10 BOX @ 30 TAB 450 0
Coated Tablet)
11 BOX@100TAB 300 1000
12 BOX@100TAB 0 0
13 BOX@100TAB 100 300
GULA)

14 BOX@100TAB 0 0
15 BOX @100 TAB 0 0
16 TABLET 0 0
TABLET)
17 BOX @100 TAB 200 0
18 BOX @100 TAB 0 0
(MOLANEURON TABLET)
22 DUS @50 BTL 0 0
ML)
24 BOX @100 TAB 0 0
OBAT ANALGESIK
TABLET
26 BOX @ 300 TAB 0 0
(METANEURON)
29 BOX@ 300 TAB 1500 0
30STRIP @10TABLET)
30 DUS @50 BTL 40 0
BOTOL 100 ML)

32 DUS @60 BTL 0 0
BOTOL 60 ML)
33 DUS @50 BTL 0 0
BOTOL @ 60 ML)
34 VIAL 0 0

35 BOX @ 160 TAB 0 0

36 BOTOL 86 0
(LEXACROL SUSPENSI)


42 TABLET 0 0
(PRENAMIA)

STOK
AWAL
3 PCS 0 0
DARAH)

42 ROLL 0 0

47 PLASTER PCS 4 10
49 PIECES 0 0
Roll)

OBAT GIGI

5 Eugnol BTL 1 0
7 KOTAK 1 0

13 SET 0 0
14 BTL 1 0
doriden

SERUM
STOK
AWAL
PUSKESMAS

Kabupaten Lebak

NIP. 19720222 200502 1 003 Nip. 19700603 199203 1 006
SKESMAS
Laporan Bulan APRIL 2021

Permintaan Bulan MEI 2021

Optimum an n n
0 0 0 0 0 300
0 0 0 0 0 24
0 0 0 0 0 200
2100 90 0 2010 0 0 APBN
0 0 0 0 0 1
300 200 0 100 0 200
0 0 0 0 0 100
0 0 0 0 0 50
0 0 0 0 0 1000
0 0 0 0 0 30
0 0 0 0 0 100
600 300 0 300 0 300
0 0 0 0 0 24
65 20 0 45 0 0
0 0 0 0 0 500
16400 1400 0 15000 0 0 BLUD
0 0 0 0 0 100
2400 2400 0 0 0 3000
0 0 0 0 0 100
0 0 0 0 0 10
0 0 0 0 0 10
100 0 0 100 0 0 BLUD
500 100 0 400 0 0
800 800 0 0 0 2000
500 0 0 500 0 0
0 0 0 0 0 100
0 0 0 0 0 100
0 0 0 0 0 100
36 36 0 0 0 48
35 33 0 2 0 25
0 0 0 0 0 100
0 0 0 0 0 0
60 60 0 0 0 120
500 300 0 200 0 0 BLUD
0 0 0 0 0 100
100 100 0 0 0 1000 BLUD
0 0 0 0 0 50
200 200 0 0 0 500 BLUD
0 0 0 0 0 50
0 0 0 0 0 1000
0 0 0 0 0 50
0 0 0 0 0 24
1200 1200 0 0 0 2000
200 0 0 200 0 0
0 0 0 0 0 1000
0 0 0 0 0 100
48 0 0 48 0 0
32 16 0 16 0 24
0 0 0 0 0 50
0 0 0 0 0 1000
290 50 0 240 0 0
0 0 0 0 0 2000
5 0 0 5 0 0
8 0 0 8 0 0
10 0 0 10 0 0
0 0 0 0 0 100
100 0 0 100 0 0
0 0 0 0 0 90
0 0 0 0 0 50
0 0 0 0 0 500
0 0 0 0 0 100
0 0 0 0 0 100
0 0 0 0 0 100
4400 200 0 4200 0 0

3210 0 0 3210 0 0 APBN
0 0 0 0 0 100
0 0 0 0 0 5
22 10 0 12 0 24 BLUD
0 0 0 0 0 24
0 0 0 0 0 24
0 0 0 0 0 50
300 0 0 300 0 0
0 0 0 0 0 100
0 0 0 0 0 500
0 0 0 0 0 40
800 200 0 600 0 0
300 0 0 300 0 0
0 0 0 0 0 100
12 12 0 0 0 24
0 0 0 0 0 50
0 0 0 0 0 50
0 0 0 0 0 100
0 0 0 0 0 0
0 0 0 0 0 1000
200 200 0 0 0 1000

100 100 0 0 0 500 BLUD
0 0 0 0 0 25
0 0 0 0 0 48 BLUD
0 0 0 0 0 24
0 0 0 0 0 10
0 0 0 0 0 1000
94 2 0 92 0 0 BLUD
180 20 0 160 0 0
0 0 0 0 0 100
1000 400 0 600 0 0 BLUD
0 0 0 0 0 200
200 200 0 0 0 500 BLUD
0 0 0 0 0 50
0 0 0 0 0 300
0 0 0 0 0 10
0 0 0 0 0 200
0 0 0 0 0 20
32 0 0 32 0 0
0 0 0 0 0 24
20 20 0 0 0 40
0 0 0 0 0 1000
0 0 0 0 0 100
0 0 0 0 0 100
0 0 0 0 0 50
60 60 0 0 0 1000 BLUD
0 0 0 0 0 100
8 8 0 0 0 24 BLUD
8 2 0 6 0 0 BLUD
130 30 0 100 0 50
1700 1700 0 0 0 5000
13 5 0 8 0 0 BLUD
0 0 0 0 0 60
0 0 0 0 0 100
0 0 0 0 0 90
0 0 0 0 0 200
300 300 0 0 0 1000

0 0 0 0 0 1
8 5 0 3 0 10 BLUD
3700 1200 0 2500 0 0
0 0 0 0 0 10
0 0 0 0 0 100
0 0 0 0 0 500
500 500 0 0 0 1000
11 11 0 0 0 50
100 100 0 0 0 1000
0 0 0 0 0
0 0 0 0 0 5
400 0 0 400 0 0
600 400 0 200 0 1000 BLUD 200

38 27 0 11 0 24
0 0 0 0 0 24
24 5 0 19 0 24
210 60 0 150 0 500 BLUD
0 0 0 0 0 100
24540 5760 0 18780 0 0
0 0 0 0 0 0
0 0 0 0 0 100
0 0 0 0 0 30
2400 1600 0 800 0 0
0 0 0 0 0 10
0 0 0 0 0 0
0 0 0 0 0 0
1300 500 0 800 0 0
0 0 0 0 0 50
20 20 0 0 0 500

optimum an n n
0 0 0 0 0 500
0 0 0 0 0
0 0 0 0 0 10
0 0 0 0 0 1050
0 0 0 0 0 1000
0 0 0 0 0 50
900 450 0 450 0 450
0 0 0 0 0 60
600 600 0 0 0 900
450 30 0 420 0 0
1300 800 0 500 0 0
0 0 0 0 0 100
400 200 0 200 0 300
0 0 0 0 0 100
0 0 0 0 0 1000
0 0 0 0 0 200
200 200 0 0 0 500
0 0 0 0 0 200
0 0 0 0 0 10
0 0 0 0 0 48
0 0 0 0 0 48
0 0 0 0 0 50
0 0 0 0 0 48
0 0 0 0 0 0
0 0 0 0 0 100
0 0 0 0 0 100
96 30 0 66 0 0
0 0 0 0 0 50
1500 300 0 1200 0 0
40 0 0 40 0 0
4350 0 0 4350 0 0
0 0 0 0 0 60
0 0 0 0 0 50
0 0 0 0 0 10
0 0 0 0 0 160
86 48 0 38 0 48
1350 0 0 1350 0 0
0 0 0 0 0 30
0 0 0 0 0 0
0 0 0 0 0 10
0 0 0 0 0 10
0 0 0 0 0 0

optimum an n n
160 5 0 155 0 0 IFK :174
0 0 0 0 0 0
0 0 0 0 0 50
76 25 0 51 0 0 DAI
89 24 0 65 0 0 DAI
18 10 0 8 0 0
0 0 0 0 0 200
4900 500 0 4400 0 0
100 0 0 100 0 0
0 0 0 0 0 100 DAI
60 60 0 0 0 100
0 0 0 0 0 100
0 0 0 0 0 500
0 0 0 0 0 500
0 0 0 0 0
12 0 0 12 0 0
200 0 0 200 0 0 DAI
0 0 0 0 0 0
42 10 0 32 0 50 DAI
112 50 0 62 0 100 DAI
0 0 0 0 0 50
55 55 0 0 0 100
72 72 0 0 0 100
40 20 0 20 0 50
114 14 0 100 0 0
30 10 0 20 0 50
547 50 0 497 0 0
40 10 0 30 0 0
95 10 0 85 0 0
4 2 0 2 0 2
25 10 0 15 0 30
0 0 0 0 0 20
20 10 0 10 0 10
3 1 0 2 0 0 BLUD
2 0 0 2 0 0 IFK
0 0 0 0 0 20
5 5 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 10
3600 1500 0 2100 0 0
0 0 0 0 0 2000
0 0 0 0 0
30 4 0 26 0 0
0 0 0 0 0 50
38 5 0 33 0 0 IFK
136 10 0 126 0 0 IFK
14 6 0 8 0 20 BLUD
36 0 0 36 0 0
0 0 0 0 0 2
0 0 0 0 0 50
0 0 0 0 0 1
0 0 0 0 0 0
600 0 0 600 0 0
0 0 0 0 0 50
0 0 0 0 0
400 100 0 300 0 0
588 30 0 558 0 0

optimum an n n
0 0 0 0 0 1
1 0 0 1 0 0
0 0 0 0 0 1
1 0 0 1 0 0
1 0 0 1 0 0
1 0 0 1 0 0
1 0 0 1 0 0
0 0 0 0 0 1
1 0 0 1 0 0
1 0 0 1 0 0
1 0 0 1 0 0
30 0 0 30 0 0
0 0 0 0 0 1
1 0 0 1 0 0
0 0 0 0 0 1
1 0 0 1 0 0
0 0 0 0 0 1

optimum an n n
1 0 0 1 0 0
5 0 0 5 0 0
PUSLING/ MANLING/
RASIO PEMAKAIAN
0


Nip. 19650404 198808 1 018
PUSKESMAS

Kabupaten : LEBAK
Provinsi : BANTEN
STOK
AWAL

5 ALKOHOL 70% 1L BTL @ 1000ML 0 0
8 BTL @60ML 0 0
SIRUP 15 MG/ 5 ML)

22 BOX @100 TAB 100 100

25 BOX @100 TAB 500 0
600 MG)

29 BOX@12TUBE 0 48
31 BOTOL 500ML 0 0
)

44 BOX@100TAB 200 0
25 MG
45 BOX@100TAB 0 0
MG

76 BOX@100TAB 600 0
EKSPEKTORAN)
84 BOX@50TAB 0 0
ENTERIK 50 MG)
89 BOX@12TUBE 0 0

90 AMPUL 0 0
INJEKSI 30 MG)
CAIRAN INJEKSI)
96 BOX@100TAB 0 0
SELAPUT 0,125 MG
98 DUS@60BTL 0 0
5 MG/5 ML)
108 TABLET 0 0
20)
109 DUS@50BTL 0 0
NIPIS 100 ML)
113 DUS@56BTL 6 0
(60mg/0,6ml)
117 BOX@30AMPUL 0 0
10Mg/ML
119 BOX@30AMPUL 0 0
MG/ML
120 BOX@100TAB 0 0
MG
NEBULIZER)

136 BOX@24POT 0 0
141 VIAL 0 0
CAIRAN IH 2,5MG/ML

STOK
AWAL

3 TUBE 0 0
DIKLOFENAK SALEP))
8 DUS@60BTL 0 0
SIRUP)
9 BOX@150TAB 0 900
TABLET)
10 BOX @ 30 TAB 420 0
Coated Tablet)
11 BOX@100TAB 500 0
12 BOX@100TAB 0 0
13 BOX@100TAB 200 300
GULA)

14 BOX@100TAB 0 0
15 BOX @100 TAB 0 0
16 TABLET 0 0
TABLET)
17 BOX @100 TAB 0 400
18 BOX @100 TAB 0 0
(MOLANEURON TABLET)
22 DUS @50 BTL 0 0
ML)
24 BOX @100 TAB 0 0
OBAT ANALGESIK
TABLET
26 BOX @ 300 TAB 0 0
(METANEURON)
29 BOX@ 300 TAB 1200 0
30STRIP @10TABLET)
30 DUS @50 BTL 40 0
BOTOL 100 ML)

32 DUS @60 BTL 0 0
BOTOL 60 ML)
33 DUS @50 BTL 0 0
BOTOL @ 60 ML)
34 VIAL 0 0

35 BOX @ 160 TAB 0 0

36 BOTOL 38 0
(LEXACROL SUSPENSI)


42 TABLET 0 0
(PRENAMIA)

STOK
AWAL
3 PCS 0 0
DARAH)

42 ROLL 0 0

47 PLASTER PCS 8 32
49 PIECES 0 0
Roll)

OBAT GIGI

5 Eugnol BTL 1 0
7 KOTAK 1 0

13 SET 0 0
14 BTL 1 0
doriden

SERUM
STOK
AWAL
PUSKESMAS

Kabupaten Lebak

NIP. 19720222 200502 1 003 Nip. 19700603 199203 1 006
SKESMAS
Laporan Bulan MEI 2021

Permintaan Bulan JUNI 2021

Optimum an n n
200 0 0 200 0 0 BLUD

0 0 0 0 0 24
0 0 0 0 0 200
2010 0 0 2010 0 0 APBN
0 0 0 0 0 1
300 200 0 100 0 200
0 0 0 0 0 100
0 0 0 0 0 50
0 0 0 0 0 1000
0 0 0 0 0 30
0 0 0 0 0 100
600 300 0 300 0 300
0 0 0 0 0 24
45 20 0 25 0 0
0 0 0 0 0 500
15000 3800 0 11200 0 0 BLUD
0 0 0 0 0 100
2500 1300 0 1200 0 2000
0 0 0 0 0 100
0 0 0 0 0 10
0 0 0 0 0 10
200 0 0 200 0 0 BLUD
400 100 0 300 0 0
700 400 0 300 0 2000
500 100 0 400 0 0
100 0 0 100 0 100 BLUD

10 0 0 10 0 100 BLUD
0 0 0 0 0 100
48 24 0 24 0 48
27 20 0 7 0 25
0 0 0 0 0 100
0 0 0 0 0 0
60 60 0 0 0 120
200 0 0 200 0 0 BLUD
0 0 0 0 0 100
1000 100 0 900 0 1000 BLUD
0 0 0 0 0 50
0 200 0 -200 0 500 BLUD
0 0 0 0 0 50
0 0 0 0 0 1000
0 0 0 0 0 50
0 0 0 0 0 24
2000 600 0 1400 0 1500
200 0 0 200 0 0
0 0 0 0 0 1000
0 0 0 0 0 100
48 5 0 43 0 0
16 16 0 0 0 24
0 0 0 0 0 50
1000 200 0 800 0 1000
240 240 0 0 0 200
0 0 0 0 0 2000
5 0 0 5 0 0
8 0 0 8 0 0
10 0 0 10 0 0
0 0 0 0 0 100
100 0 0 100 0 0
0 0 0 0 0 90
0 0 0 0 0 50
0 0 0 0 0 500
0 0 0 0 0 100
0 0 0 0 0 100
0 0 0 0 0 100
4200 200 0 4000 0 0

3210 10 0 3200 0 0 APBN
0 0 0 0 0 100
0 0 0 0 0 5
12 12 0 0 0 24
0 0 0 0 0 24
0 0 0 0 0 24
0 0 0 0 0 50
300 0 0 300 0 0
0 0 0 0 0 100
0 0 0 0 0 500
0 0 0 0 0 40
600 100 0 500 0 0
300 0 0 300 0 0
0 0 0 0 0 100
24 12 0 12 0 24
0 0 0 0 0 50
0 0 0 0 0 50
0 0 0 0 0 100
0 0 0 0 0 0
0 0 0 0 0 1000
500 200 0 300 0 1000

0 0 0 0 0 500 BLUD
0 0 0 0 0 25
0 0 0 0 0 48 BLUD
0 0 0 0 0 24
0 0 0 0 0 10
0 0 0 0 0 1000
92 0 0 92 0 0 BLUD
160 60 0 100 0 0
0 0 0 0 0 100
600 400 0 200 0 0 BLUD
0 0 0 0 0 200
0 0 0 0 0 500 BLUD
0 0 0 0 0 50
0 0 0 0 0 300
0 0 0 0 0 10
0 0 0 0 0 200
0 0 0 0 0 20
32 0 0 32 0 0
0 0 0 0 0 24
20 0 0 20 0 40
0 0 0 0 0 1000
0 0 0 0 0 100
0 0 0 0 0 100
0 0 0 0 0 50
0 0 0 0 0 1000 BLUD
0 0 0 0 0 100
30 8 0 22 0 24 BLUD
6 4 0 2 0 0 BLUD
150 50 0 100 0 50
1000 800 0 200 0 5000
8 5 0 3 0 0 BLUD
0 0 0 0 0 60
0 0 0 0 0 100
0 0 0 0 0 90
0 0 0 0 0 200
0 0 0 0 0 1000
0 0 0 0 0 1
13 3 0 10 0 10 BLUD
2500 800 0 1700 0 0
0 0 0 0 0 10
0 0 0 0 0 100
0 0 0 0 0 500
500 500 0 0 0 1000
0 0 0 0 0 50
0 0 0 0 0 1000
0 0 0 0 0 0
0 0 0 0 0 5
400 20 0 380 0 0
500 100 0 400 0 1000 BLUD 200

35 10 0 25 0 0
0 0 0 0 0 24
19 5 0 14 0 24
150 90 0 60 0 500 BLUD
0 0 0 0 0 100
18780 3390 0 15390 0 0
0 0 0 0 0 0
0 0 0 0 0 100
0 0 0 0 0 30
800 400 0 400 0 0
0 0 0 0 0 10
0 0 0 0 0 0
0 0 0 0 0 0
800 300 0 500 0 0
0 0 0 0 0 50
300 0 0 300 0 0 BLUD

optimum an n n
0 0 0 0 0 500
0 0 0 0 0
0 0 0 0 0 10
0 0 0 0 0 1050
0 0 0 0 0 1000
0 0 0 0 0 50
900 450 0 450 0 300
0 0 0 0 0 60
900 300 0 600 0 300
420 60 0 360 0 0
500 0 0 500 0 0
0 0 0 0 0 100
500 300 0 200 0 200
0 0 0 0 0 100
0 0 0 0 0 1000
0 0 0 0 0 200
400 100 0 300 0 200
0 0 0 0 0 200
0 0 0 0 0 10
0 0 0 0 0 48
0 0 0 0 0 48
0 0 0 0 0 50
0 0 0 0 0 48
0 0 0 0 0 0
0 0 0 0 0 100
0 0 0 0 0 100
66 30 0 36 0 0
0 0 0 0 0 50
1200 300 0 900 0 0
40 10 0 30 0 0
4350 0 0 4350 0 0
0 0 0 0 0 60
0 0 0 0 0 50
0 0 0 0 0 10
0 0 0 0 0 160
38 8 0 30 0 48
1350 0 0 1350 0 0
0 0 0 0 0 30
0 0 0 0 0 0
0 0 0 0 0 10
0 0 0 0 0 10
0 0 0 0 0 0

optimum an n n
155 5 0 150 0 0 IFK :174
0 0 0 0 0 0
0 0 0 0 0 50
51 0 0 51 0 0 DAI
65 0 0 65 0 0 DAI
8 5 0 3 0 100
0 0 0 0 0 200
4400 300 0 4100 0 0
100 20 0 80 0 100
0 0 0 0 0 200
0 0 0 0 0 300
0 0 0 0 0 100
0 0 0 0 0 500
0 0 0 0 0 500
0 0 0 0 0
12 0 0 12 0 0
250 50 0 200 0 0 BLUD 50
0 0 0 0 0 0
32 10 0 22 0 50 DAI
162 100 0 62 0 200
0 0 0 0 0 50
100 0 0 100 0 0
0 0 0 0 0 100
20 20 0 0 0 50
100 5 0 95 0 0
70 20 0 50 0 50
497 100 0 397 0 0
30 0 0 30 0 0
85 5 0 80 0 0
4 1 0 3 0 2
35 15 0 20 0 30
0 0 0 0 0 20
20 10 0 10 0 10
30 10 0 20 0 0 BLUD
2 0 0 2 0 0 IFK
0 0 0 0 0 20
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 10
3100 1500 0 1600 0 0
0 0 0 0 0 2000
0 0 0 0 0 1
26 5 0 21 0 0
0 0 0 0 0 50
33 5 0 28 0 0 IFK
126 10 0 116 0 0 IFK
40 4 0 36 0 0 BLUD
36 0 0 36 0 0
0 0 0 0 0 2
0 0 0 0 0 50
0 0 0 0 0 1
0 0 0 0 0 0
600 0 0 600 0 0
0 0 0 0 0 50
0 0 0 0 0 0
300 100 0 200 0 0
558 20 0 538 0 0

optimum an n n
0 0 0 0 0 1
1 0 0 1 0 0
0 0 0 0 0 1
1 1 0 0 0 2
1 0 0 1 0 0
1 0 0 1 0 0
1 0 0 1 0 0
0 0 0 0 0 1
1 0 0 1 0 0
1 0 0 1 0 0
1 0 0 1 0 0
30 0 0 30 0 0
0 0 0 0 0 1
1 0 0 1 0 0
0 0 0 0 0 1
1 0 0 1 0 0
0 0 0 0 0 1

optimum an n n
1 0 0 1 0 0
5 3 0 2 0 0
PUSLING/ MANLING/
RASIO PEMAKAIAN
0


Nip. 19650404 198808 1 018
PUSKESMAS

Kabupaten : LEBAK
Provinsi : BANTEN
STOK
AWAL

5 ALKOHOL 70% 1L BTL @ 1000ML 0 0
8 BTL @60ML 0 0
SIRUP 15 MG/ 5 ML)

22 BOX @100 TAB 200 0

25 BOX @100 TAB 400 0
600 MG)
26 AZITROMYCIN TABLET 500 Mg TABLET 100
28 BEDAK SALYCIL BOX@100DUS 0

29 BOX@12TUBE 24 24
31 BOTOL 500ML 0 0
)
32 CAIRAN INFUS (ASERING 500ml ) BOTOL 500ML 0
37 CEFADROXIL SIRUP KERING 125MG BOTOL 0

44 BOX@100TAB 200 0
25 MG
45 BOX@100TAB 0 0
MG
54 DIAZEPAM ENEMA 5MG/2.5ML TUBE 8

76 BOX@100TAB 500 0
EKSPEKTORAN)
84 BOX@50TAB 0
ENTERIK 50 MG)
89 BOX@12TUBE 0 0

90 AMPUL 0 0
INJEKSI 30 MG)
CAIRAN INJEKSI)
96 BOX@100TAB 0 0
SELAPUT 0,125 MG
98 DUS@60BTL 0 0
5 MG/5 ML)
108 TABLET 0 0
20)
109 DUS@50BTL 0
NIPIS 100 ML)
113 DUS@56BTL 2 0
(60mg/0,6ml)
117 BOX@30AMPUL 0 0
10Mg/ML
119 BOX@30AMPUL 0 0
MG/ML
120 BOX@100TAB 0 0
MG
126 PROPANOLOL 40 MG BOX@100TAB 0
127 PYRANTEL TABLET 125 MG BOX@100TAB 0
NEBULIZER)

136 BOX@24POT 0 0
141 VIAL 0 0
CAIRAN IH 2,5MG/ML
146 VITAMIN A 100000 IU BTL@50CAPSUL 0
147 VITAMIN A 200000 IU BTL@50CAPSUL 0

STOK
AWAL

3 TUBE 0 0
DIKLOFENAK SALEP))
5 ANTI ALERGI (SONAMIN TABLET) BOX@100TAB 0
6 ANTI DIARE (NEO KAOMINAL SUSPENSI) DUS@60BTL 0
8 DUS@60BTL 0 0
SIRUP)
9 BOX@150TAB 600 300
TABLET)
10 BOX @ 30 TAB 360 0
Coated Tablet)
11 BOX@100TAB 500 0
12 BOX@100TAB 0
13 BOX@100TAB 200 200
GULA)

14 BOX@100TAB 0 0
15 BOX @100 TAB 0 0
16 TABLET 0 0
TABLET)
17 BOX @100 TAB 300 200
18 BOX @100 TAB 0
(MOLANEURON TABLET)
22 DUS @50 BTL 0 0
ML)
24 BOX @100 TAB 0 0
OBAT ANALGESIK
TABLET
26 BOX @ 300 TAB 0 0
(METANEURON)
29 BOX@ 300 TAB 900 0
30STRIP @10TABLET)
30 DUS @50 BTL 30 0
BOTOL 100 ML)

32 DUS @60 BTL 0 0
BOTOL 60 ML)
33 DUS @50 BTL 0 0
BOTOL @ 60 ML)
34 VIAL 0 0

35 BOX @ 160 TAB 0 0

36 BOTOL 30 0
(LEXACROL SUSPENSI)


42 TABLET 0 0
(PRENAMIA)

STOK
AWAL
3 PCS 0 0
DARAH)
18 HB HEMOGLOBIN TEST STRIP STRIP 0
23 IV CATHETER NO 18 (WINGS) PCS 0
24 IV CATHETER NO 20 (PEN) PCS 0
38 KASA 40 M X 80 CM KOTAK 0

42 ROLL 0 0

47 PLASTER PCS 36 0
49 PIECES 0 0
Roll)

OBAT GIGI

5 Eugnol BTL 1 0
7 KOTAK 1 0

13 SET 0 0
14 BTL 1 0
doriden

SERUM
STOK
AWAL
PUSKESMAS

Kabupaten Lebak

NIP. 19720222 200502 1 003 Nip. 19700603 199203 1 006
SKESMAS
Laporan Bulan JUNI 2021

Permintaan Bulan JULI 2021

Optimum an n n
200 30 0 170 0 0 BLUD

0 0 0 0 0 20
0 0 0 0 0 300
2010 120 0 1890 0 0 APBN
0 0 0 0 0 2
300 200 0 100 0 200
0 0 0 0 0 100
0 0 0 0 0 50
0 0 0 0 0 500
0 0 0 0 0 30
0 0 0 0 0 100
600 450 0 150 0 300
0 0 0 0 0 50
0 0 0 0 0 60
0 0 0 0 0 0
11200 2900 0 8300 0 0 BLUD
0 0 0 0 0 50
3200 0 3200 0 1000
0 0 0 0 0 100
0 0 0 0 0 10
0 0 0 0 0 12
200 100 0 100 0 0 BLUD
300 300 0 0 0 1000
1000 800 0 200 0 2000
400 200 0 200 0 200
100 40 0 60 0 0 BLUD
10 4 0 6 0 BLUD
0 0 0 0
48 24 0 24 0 24
32 12 0 20 0 25
0 0 0 0 0 20
0 0 0 0
60 40 0 20 0 120
200 200 0 0 0 0 BLUD
0 0 0 0 0 100
900 500 0 400 0 BLUD
0 0 0 0
0 0 0 0 0 500
0 0 0 0 0 50
0 0 0 0 0 500
0 0 0 0 0 50
0 0 0 0 0 24
2400 2000 0 400 0 2000
200 0 0 200 0 0
0 0 0 0 0 1000
0 0 0 0 0 100
43 43 0 0 0 24
0 0 0 0 0 24
0 0 0 0 0 50
1300 500 0 800 0 500
0 0 0 0 0 100
0 0 0 0 0 3000
5 3 0 2 0 5
8 5 0 3 0 5
10 0 0 10 0 0
0 0 0 0 0 100
100 70 0 30 0 100
0 0 0 0 0 90
0 0 0 0 0 50
0 0 0 0 0 100
0 0 0 0 0 300
0 0 0 0 0 500
0 0 0 0 0 50
4000 2000 0 2000 0 0

3200 3095 0 105 0 0 APBN
0 0 0 0 0 100
0 0 0 0 0 10
0 0 0 0 0 25
0 0 0 0 0 25
0 0 0 0 0 25
0 0 0 0 0 50
300 100 0 200 0 100
0 0 0 0 0 100
0 0 0 0 0 500
0 0 0 0 0 60
500 0 0 500 0 0
300 300 0 0 0 300

0 0 0 0 0 300
36 16 0 20 0 24
0 0 0 0 0 100
0 0 0 0 0 50
0 0 0 0 0 100
0 0 0 0 0 0
0 0 0 0
800 700 0 100 0 1000

0 0 0 0 0 0 BLUD
0 0 0 0 0 25
50 50 0 0 0 0 BLUD
0 0 0 0 0 24
0 0 0 0 0 10
0 0 0 0 0 300
92 12 0 80 0 0 BLUD
100 81 0 19 0 60
0 0 0 0 0 100
200 110 0 90 0 0 BLUD
0 0 0 0 0 300
0 0 0 0 0 0 BLUD
0 0 0 0 0 60
0 0 0 0 0 500
0 0 0 0 0 10
0 0 0 0 0 500
0 0 0 0 0 24
32 32 0 0 0 24
0 0 0 0 0 24
20 20 0 0 0 60
0 0 0 0 0 500
0 0 0 0 0 100
0 0 0 0 0 100
0 0 0 0
300 240 0 60 0 0 BLUD

0 0 0 0 0 0
22 2 0 20 0 0 BLUD
2 2 0 0 0 0 BLUD
300 59 0 241 0 0
1200 1200 0 0 0 5000
3 3 0 0 0 0 BLUD
0 0 0 0 0 60
0 0 0 0 0 100
0 0 0 0 0 60
0 0 0 0 0 300
0 0 0 0 0 1000
0 0 0 0 0 1
10 3 0 7 0 0 BLUD
1700 700 0 1000 0 0
0 0 0 0 0 10
0 0 0 0
0 0 0 0
500 300 0 200 0 300
50 50 0 0 0 BLUD
0 0 0 0 0 1000
0 0 0 0
0 0 0 0 0 5
380 380 380 0 0 20 ED
700 300 0 400 0 500

25 0 0 25 0 0
0 0 0 0 0 24
38 14 0 24 0 0
60 60 0 0 0 0 BLUD
0 0 0 0 0 200
15390 7830 0 7560 0 0
0 0 0 0 0 1
0 0 0 0 0 100
0 0 0 0 0 30
400 0 0 400 0 0
0 0 0 0 0 10
0 0 0 0
0 0 0 0
500 0 0 500 0 0
0 0 0 0 0 50
300 160 0 140 0 0 BLUD

optimum an n n
0 0 0 0 0 500
0 0 0 0
0 0 0 0 0 24
0 0 0 0 0 1050
0 0 0 0
0 0 0 0
750 450 0 300 0 900
0 0 0 0 0 60
900 600 0 300 0 600
360 0 0 360 0 0
500 100 0 400 0 100
0 0 0 0
400 300 0 100 0 300
0 0 0 0 0 300
0 0 0 0 0 500
0 0 0 0 0 200
500 200 0 300 0 200
0 0 0 0
0 0 0 0 0 10
0 0 0 0 0 50
0 0 0 0 0 48
0 0 0 0 0 50
0 0 0 0 0 48
0 0 0 0 0 3000
0 0 0 0 0 100
0 0 0 0 0 300
36 0 0 36 0 0
0 0 0 0 0 50
ED JULI
900 900 900 0 0 900
2021
30 0 0 30 0 0
4350 650 0 3700 0 0
0 0 0 0 0 60
0 0 0 0 0 50
0 0 0 0 0 10
0 0 0 0 0 160
30 30 0 0 0 48
1350 630 0 720 0 0
0 0 0 0 0 90
0 0 0 0 0 0
0 0 0 0 0 10
0 0 0 0 0 5
0 0 0 0 0 200

optimum an n n
150 48 0 102 0 0 IFK :174
0 0 0 0 0 0
0 0 0 0 0 100
51 0 0 51 0 0 DAI
65 0 0 65 0 0 DAI
3 3 0 0 0 100
0 0 0 0 0 300
4100 900 0 3200 0 0
80 80 0 0 0 500
0 0 0 0 0 100
0 0 0 0 0 100
0 0 0 0 100
2300 1200 0 1100 0 0 BLUD
0 0 0 0 0 1000
0 0 0 0 0 100
12 12 0 0 0 20
200 137 0 63 0 0
0 0 0 0
22 0 0 22 0 50 DAI
112 112 0 0 0 200
0 0 0 0 0 50
150 0 0 150 0 0
0 0 0 0
0 0 0 0 100
95 84 0 11 0 50
100 0 0 100 0 0
397 249 0 148 0 0
30 10 0 20 0 0
80 80 0 0 0 50
4 1 0 3 0 2
40 7 0 33 0 0
0 0 0 0 0 0
20 0 0 20 0 0
20 15 0 5 0 0 BLUD
2 2 0 0 0 1
0 0 0 0 0 10
0 0 0 0 0 20
0 0 0 0
0 0 0 0 0 10
3600 1500 0 2100 0 0
0 0 0 0 0 5
0 0 0 0 0 1
21 21 0 0 0 50
0 0 0 0 0 100
28 28 0 0 0 100
116 66 0 50 0 100 IFK
36 31 0 5 0 0 BLUD
36 0 0 36 0 0
0 0 0 0 0 2
0 0 0 0 0 50
0 0 0 0 0 1
0 0 0 0 0 50
600 600 0 0 0 100
0 0 0 0 0 10
0 0 0 0 0 100
200 150 0 50 0 100
538 538 0 0 0 100

optimum an n n
0 0 0 0 0 1
1 1 0 0 0 2
0 0 0 0 0 1
1 1 0 0 0 2
1 1 0 0 0 1
1 1 0 0 0 2
1 1 0 0 0 1
0 0 0 0 0 1
1 1 0 0 0 2
1 1 0 0 0 1
1 1 0 0 0 1
30 0 0 30 0 0
0 0 0 0 0 1
1 1 0 0 0 1
0 0 0 0 0 1
1 1 0 0 0 1
0 0 0 0 0 1

optimum an n n
1 1 0 0 0 2
2 1 0 1 0 4
PUSLING/ MANLING/
RASIO PEMAKAIAN
0


Nip. 19650404 198808 1 018
PUSKESMAS

Kabupaten : LEBAK
Provinsi : BANTEN
STOK
AWAL

5 ALKOHOL 70% 1L BTL @ 1000ML 0 0
8 BTL @60ML 0 0
SIRUP 15 MG/ 5 ML)

22 BOX @100 TAB 100 0

25 BOX @100 TAB 200 200
600 MG)

29 BOX@12TUBE 24 24
31 BOTOL 500ML 0 0
)


44 BOX@100TAB 200 0
25 MG
45 BOX@100TAB 0 0
MG

76 BOX@100TAB 500 0
EKSPEKTORAN)
84 BOX@50TAB 0 0
ENTERIK 50 MG)
89 BOX@12TUBE 0 0

90 AMPUL 0 0
INJEKSI 30 MG)
CAIRAN INJEKSI)
96 BOX@100TAB 0 0
SELAPUT 0,125 MG
98 DUS@60BTL 0 0
5 MG/5 ML)
108 TABLET 0 0
20)
109 DUS@50BTL 0 0
NIPIS 100 ML)
113 DUS@56BTL 0 0
(60mg/0,6ml)
117 BOX@30AMPUL 0 0
10Mg/ML
119 BOX@30AMPUL 0 0
MG/ML
120 BOX@100TAB 0 0
MG
NEBULIZER)
136 BOX@24POT 0 0

141 VIAL 0 0
CAIRAN IH 2,5MG/ML

STOK
AWAL

3 TUBE 0 0
DIKLOFENAK SALEP))
8 DUS@60BTL 0 0
SIRUP)
9 BOX@150TAB 300 600
TABLET)
10 BOX @ 30 TAB 360 0
Coated Tablet)
11 BOX@100TAB 400 0
12 BOX@100TAB 0 0
13 BOX@100TAB 100 0
GULA)
14 BOX@100TAB 0 0

15 BOX @100 TAB 0 0
16 TABLET 0 0
TABLET)
17 BOX @100 TAB 300 200
18 BOX @100 TAB 0 0
(MOLANEURON TABLET)
22 DUS @50 BTL 0 0
ML)
24 BOX @100 TAB 0 0
OBAT ANALGESIK
TABLET
26 BOX @ 300 TAB 0 0
(METANEURON)
29 BOX@ 300 TAB 0 0
30STRIP @10TABLET)
30 DUS @50 BTL 30 0
BOTOL 100 ML)

32 DUS @60 BTL 0 0
BOTOL 60 ML)
33 DUS @50 BTL 0 0
BOTOL @ 60 ML)
34 VIAL 0 0

35 BOX @ 160 TAB 0 0

36 BOTOL 0 0
(LEXACROL SUSPENSI)

42 TABLET 0 0
(PRENAMIA)

STOK
AWAL
3 PCS 0 0
DARAH)
41 MASKER (HIJAB) PACK@50ROLL 0 250

42 ROLL 0 0

47 PLASTER PCS 5 0
49 PIECES 0 0
Roll)

OBAT GIGI

5 Eugnol BTL 0 0
7 KOTAK 0 0


13 SET 0 0
14 BTL 0 0
doriden

SERUM
STOK
AWAL
PUSKESMAS

Kabupaten Lebak

NIP. 19720222 200502 1 003 Nip. 19700603 199203 1 006
SKESMAS
Laporan Bulan JULI 2021

Permintaan Bulan AGUSTUS 2021

Optimum an n n
170 20 0 150 0 0 BLUD

0 0 0 0 0 20
0 0 0 0 0 300
1890 0 0 1890 0 0 APBN
0 0 0 0 0 2
300 100 0 200 0 200
0 0 0 0 0 100
0 0 0 0 0 50
0 0 0 0 0 500
0 0 0 0 0 30
0 0 0 0 0 100
450 300 0 150 0 300
0 0 0 0 0 50
60 0 0 60 0 60
0 0 0 0 0 0
8300 1400 0 6900 0 0 BLUD
0 0 0 0 0 50
3700 2100 0 1600 0 1000
0 0 0 0 0 100
0 0 0 0 0 10
0 0 0 0 0 12
100 20 0 80 0 0 BLUD
600 400 0 200 0 1000
900 600 0 300 0 2000
400 200 0 200 0 200
60 30 0 30 0 0 BLUD
6 2 0 4 0 0 BLUD
0 0 0 0 0 20
48 24 0 24 0 24
45 17 0 28 0 25
0 0 0 0 0 20
0 0 0 0 0
BLUD
1060 100 0 960 0 0
1000
0 0 0 0 0 500
0 0 0 0 0 100
400 130 0 270 0 0 BLUD
0 0 0 0 0 50
0 0 0 0 0 500
0 0 0 0 0 50
0 0 0 0 0 500
0 0 0 0 0 50
0 0 0 0 0 24
2400 600 0 1800 0 2000
200 0 0 200 0 0
0 0 0 0 0 1000
0 0 0 0 0 100
0 0 0 0 0 24
0 0 0 0 0 24
0 0 0 0 0 50
1300 100 0 1200 0 0
0 0 0 0 0 50
0 0 0 0 0 3000
7 1 0 6 0 5
8 1 0 7 0 5
10 0 0 10 0 0
0 0 0 0 0 100
30 30 0 0 0 100
0 0 0 0 0 90
0 0 0 0 0 50
0 0 0 0 0 100
0 0 0 0 0 300
0 0 0 0 0 500
0 0 0 0 0 50
2000 0 0 2000 0 0
105 0 0 105 0 0 APBN
0 0 0 0 0 100
0 0 0 0 0 10
0 0 0 0 0 25
0 0 0 0 0 25
0 0 0 0 0 25
0 0 0 0 0 50
300 150 0 150 0 100
0 0 0 0 0 100
0 0 0 0 0 500
0 0 0 0 0 60
500 200 0 300 0 0
0 0 0 0 0 300
0 0 0 0 0 300
44 15 0 29 0 24
0 0 0 0 0 100
0 0 0 0 0 50
0 0 0 0 0 100
0 0 0 0 0 0
0 0 0 0 0 0
800 300 0 500 0 500

0 0 0 0 0 500
0 0 0 0 0 25
30 30 0 0 0 0 BLUD
0 0 0 0 0 24
0 0 0 0 0 10
0 0 0 0 0 300
80 5 0 75 0 0 BLUD
79 0 0 79 0 60
0 0 0 0 0 100
490 270 0 220 0 0 BLUD
0 0 0 0 0 300
0 0 0 0 0 0 BLUD
0 0 0 0 0 60
0 0 0 0 0 500
0 0 0 0 0 10
0 0 0 0 0 500
0 0 0 0 0 24
0 0 0 0 0 24
0 0 0 0 0 24
20 20 0 0 0 60
0 0 0 0 0 500
0 0 0 0 0 100
0 0 0 0 0 100
0 0 0 0 0
60 60 0 0 0 0 BLUD
0 0 0 0 0 100
20 0 0 20 0 0 BLUD
0 0 0 0 0 0 BLUD
241 15 0 226 0 0
1000 1000 0 0 0 5000
0 0 0 0 0 25
0 0 0 0 0 30
0 0 0 0 0 100
0 0 0 0 0 60
0 0 0 0 0 300
0 0 0 0 0 1000
0 0 0 0 0 1
27 13 0 14 0 0 BLUD
1000 400 0 600 0 0
0 0 0 0 0 10
0 0 0 0 0 0
0 0 0 0 0 100
500 300 0 200 0 300
10 10 0 0 0 100
500 220 0 280 0 0 BLUD
0 0 0 0 0 0
0 0 0 0 0 5
0 0 0 0 0 20
700 400 0 300 0 500

25 0 0 25 0 0
0 0 0 0 0 24
24 0 0 24 0 0
0 0 0 0 0 500
0 0 0 0 0 200
7560 0 0 7560 0 0
0 0 0 0 0 1
0 0 0 0 0 100
0 0 0 0 0 30
400 200 0 200 0 1000
0 0 0 0 0 10
0 0 0 0 0 100
0 0 0 0 0 100
500 500 0 0 0 0
0 0 0 0 0 50
7340 0 0 7340 0 0

optimum an n n
0 0 0 0 0 500
0 0 0 0 0 0
0 0 0 0 0 24
0 0 0 0 0 1050
0 0 0 0 0
0 0 0 0 0 60
900 450 0 450 0 900
0 0 0 0 0 60
900 750 0 150 0 600
360 0 0 360 0 0
400 100 0 300 0 100
0 0 0 0 0
100 100 0 0 0 500

0 0 0 0 0 300
0 0 0 0 0 500
0 0 0 0 0 200
500 200 0 300 0 200
0 0 0 0 0
0 0 0 0 0 10
0 0 0 0 0 50
0 0 0 0 0 48
0 0 0 0 0 50
48 0 0 48 0 48
0 0 0 0 0 3000
0 0 0 0 0 100
0 0 0 0 0 300
36 14 0 22 0 0
0 0 0 0 0 50
0 0 0 0 0 900
30 0 0 30 0 0
3700 450 0 3250 0 0
0 0 0 0 0 60
0 0 0 0 0 50
0 0 0 0 0 10
0 0 0 0 0 160
0 0 0 0 0 48
720 0 0 720 0 0
0 0 0 0 0 90
0 0 0 0 0 0
0 0 0 0 0 10
0 0 0 0 0 5
0 0 0 0 0 200

optimum an n n
102 7 0 95 0 0
0 0 0 0 0 0
0 0 0 0 0 100
51 12 0 39 0 0 DAI
65 12 0 53 0 0 DAI
0 0 0 0 0 100
0 0 0 0 0 300
3200 430 0 2770 0 0
0 0 0 0 0 500
0 0 0 0 0 100
0 0 0 0 0 100
0 0 0 0 0 100
2100 2100 0 0 0 0 BLUD
0 0 0 0 0 1000
0 0 0 0 0 100
0 0 0 0 0 20
63 5 0 58 0 0
0 0 0 0 0
22 10 0 12 0 50 DAI
100 100 0 0 0 400
0 0 0 0 0 50
150 50 0 100 0 0
0 0 0 0 0
100 0 0 100 0
11 0 0 11 0 50
100 0 0 100 0 0
148 65 0 83 0 0
20 20 0 0 0 50
0 0 0 0 0 50
5 0 0 5 0
53 10 0 43 0 0
0 0 0 0 0 0
20 0 0 20 0 0
5 5 0 0 0 0
0 0 0 0 0 1
0 0 0 0 0 10
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 10
2100 1400 0 700 0 0
250 50 0 200 0 5
0 0 0 0 0 1
0 0 0 0 0 50
0 0 0 0 0 100
0 0 0 0 0 100
50 0 0 50 0 100 IFK
5 5 0 0 0 0 BLUD
36 0 0 36 0 0
0 0 0 0 0 2
0 0 0 0 0 50
0 0 0 0 0 1
0 0 0 0 0 50
0 0 0 0 0 100
0 0 0 0 0 10
0 0 0 0 0 100
50 50 0 0 0 100
100 5 0 95 0 0

optimum an n n
0 0 0 0 0 1
0 0 0 0 0 2
0 0 0 0 0 1
1 0 0 1 0 0
0 0 0 0 0 1
1 0 0 1 0 0
0 0 0 0 0 1
0 0 0 0 0 1
0 0 0 0 0 2
1 0 0 1 0 0
0 0 0 0 0 1
30 0 0 30 0 0
0 0 0 0 0 1
0 0 0 0 0 1
0 0 0 0 0 1
0 0 0 0 0 1
0 0 0 0 0 1

optimum an n n
0 0 0 0 2
5 1 0 4 0 0
PUSLING/ MANLING/
RASIO PEMAKAIAN
0


Nip. 19650404 198808 1 018
PUSKESMAS

Kabupaten : LEBAK
Provinsi : BANTEN
STOK
AWAL

5 ALKOHOL 70% 1L BTL @ 1000ML 0 0
8 BTL @60ML 0 0
SIRUP 15 MG/ 5 ML)

22 BOX @100 TAB 80 0

25 BOX @100 TAB 200 200
600 MG)

29 BOX@12TUBE 24 24
31 BOTOL 500ML 0 0
)
32 CAIRAN INFUS (ASERING 500ml ) BOTOL 500ML 0


44 BOX@100TAB 200 0
25 MG
45 BOX@100TAB 0 0
MG

76 BOX@100TAB 300 0
EKSPEKTORAN)
84 BOX@50TAB 0 0
ENTERIK 50 MG)
89 BOX@12TUBE 0 0

90 AMPUL 0 0
INJEKSI 30 MG)
CAIRAN INJEKSI)
96 BOX@100TAB 0 0
SELAPUT 0,125 MG
98 DUS@60BTL 0 0
5 MG/5 ML)
108 TABLET 0 0
20)
109 DUS@50BTL 0 0
NIPIS 100 ML)
113 DUS@56BTL 0 0
(60mg/0,6ml)
117 BOX@30AMPUL 0 0
10Mg/ML
119 BOX@30AMPUL 0 0
MG/ML
120 BOX@100TAB 0 0
MG
NEBULIZER)
136 BOX@24POT 0 0

141 VIAL 0 0
CAIRAN IH 2,5MG/ML

STOK
AWAL

3 TUBE 0 0
DIKLOFENAK SALEP))
8 DUS@60BTL 0 0
SIRUP)
9 BOX@150TAB 150 300
TABLET)
10 BOX @ 30 TAB 360 0
Coated Tablet)
11 BOX@100TAB 300 0
12 BOX@100TAB 0 0
13 BOX@100TAB 0 0
GULA)
14 BOX@100TAB 0 0

15 BOX @100 TAB 0 500
16 TABLET 0 0
TABLET)
17 BOX @100 TAB 300 0
18 BOX @100 TAB 0 0
(MOLANEURON TABLET)
22 DUS @50 BTL 0 50
ML)
24 BOX @100 TAB 0 0
OBAT ANALGESIK
TABLET
26 BOX @ 300 TAB 0 0
(METANEURON)
29 BOX@ 300 TAB 0 0
30STRIP @10TABLET)
30 DUS @50 BTL 30 0
BOTOL 100 ML)

32 DUS @60 BTL 0 0
BOTOL 60 ML)
33 DUS @50 BTL 0 0
BOTOL @ 60 ML)
34 VIAL 0 0

35 BOX @ 160 TAB 0 0

36 BOTOL 0 48
(LEXACROL SUSPENSI)

42 TABLET 0 0
(PRENAMIA)

STOK
AWAL
3 PCS 0 0
DARAH)
41 MASKER (HIJAB) PACK@50ROLL 2000 0

42 ROLL 0 0

47 PLASTER PCS 0 0
49 PIECES 0 0
Roll)

OBAT GIGI

5 Eugnol BTL 0 0
7 KOTAK 0 0


13 SET 0 0
14 BTL 0 0
doriden

SERUM
STOK
AWAL
PUSKESMAS

Kabupaten Lebak

NIP. 19720222 200502 1 003 Nip. 19700603 199203 1 006
SKESMAS
Laporan Bulan AGUSTUS 2021

Permintaan Bulan Sep-21

Optimum an n n
150 30 0 120 0 0 BLUD

0 0 0 0 0 20
0 0 0 0 0 300
1890 0 0 1890 0 0 APBN
0 0 0 0 0 2
400 200 0 200 0 200
0 0 0 0 0 100
0 0 0 0 0 50
0 0 0 0 0 500
0 0 0 0 0 30
0 0 0 0 0 100
450 450 0 0 0 600
0 0 0 0 0 50
120 25 0 95 0 0
0 0 0 0 0 0
6900 1400 0 5500 0 0 BLUD
0 0 0 0 0 50
2600 1500 0 1100 0 1000
0 0 0 0 0 100
0 0 0 0 0 10
0 0 0 0 0 12
80 30 0 50 0 0 BLUD
700 400 0 300 0 500
800 800 0 0 0 2000
400 0 0 400 0 0
30 30 0 0 0 0
4 3 0 1 0 0 BLUD
0 0 0 0 0 20
48 13 0 35 0 0
53 11 0 42 0 0
0 0 0 0 0 20
0 0 0 0
BLUD
960 160 0 800 0 0
1000
0 0 0 0 0 500
0 0 0 0 0 100
270 270 0 0 0 1000
0 0 0 0 0 50
0 0 0 0 0 500
0 0 0 0 0 50
0 0 0 0 0 500
0 0 0 0 0 50
0 0 0 0 0 24
2000 1000 0 1000 0 2000
200 0 0 200 0 0
0 0 0 0 0 1000
0 0 0 0 0 100
24 0 0 24 0 0
0 0 0 0 0 24
0 0 0 0 0 50
1200 0 0 1200 0 0
0 0 0 0 0 50
0 0 0 0 0 3000
11 3 0 8 0 0
12 0 0 12 0 0
10 0 0 10 0 0
0 0 0 0 0 100
0 0 0 0 0 100
0 0 0 0 0 90
0 0 0 0 0 50
0 0 0 0 0 100
0 0 0 0 0 300
0 0 0 0 0 500
0 0 0 0 0 50
2000 0 0 2000 0 0
105 0 0 105 0 0 APBN
0 0 0 0 0 100
0 0 0 0 0 10
24 12 0 12 0 24
0 0 0 0 0 25
0 0 0 0 0 25
0 0 0 0 0 50
250 0 0 250 0 0
0 0 0 0 0 100
0 0 0 0 0 500
0 0 0 0 0 60
300 300 0 0 0 1000
0 0 0 0 0 300
0 0 0 0 0 300
53 0 0 53 0 0
0 0 0 0 0 100
0 0 0 0 0 50
0 0 0 0 0 100
0 0 0 0 0 0
0 0 0 0 0 0
800 400 0 400 0 500

0 0 0 0 0 500
0 0 0 0 0 25
0 0 0 0 0 24
0 0 0 0 0 24
0 0 0 0 0 10
0 0 0 0 0 300
75 23 18 52 0 0 BLUD
139 0 0 139 0 0
0 0 0 0 0 100
220 60 0 160 0 0 BLUD
0 0 0 0 0 300
0 0 0 0 0 0 BLUD
0 0 0 0 0 60
0 0 0 0 0 500
0 0 0 0 0 10
0 0 0 0 0 500
0 0 0 0 0 24
0 0 0 0 0 24
0 0 0 0 0 24
20 0 0 20 0 60
0 0 0 0 0 500
0 0 0 0 0 100
0 0 0 0 0 100
0 0 0 0 0 50
0 0 0 0 0 300
0 0 0 0 0 100
20 0 0 20 0 0 BLUD
0 0 0 0 0 50
226 57 0 169 0 0
0 0 0 0 0 5000
0 0 0 0 0 25
0 0 0 0 0 30
0 0 0 0 0 100
0 0 0 0 0 60
0 0 0 0 0 300
0 0 0 0 0 1000
0 0 0 0 0 1
14 2 0 12 0 0 BLUD
600 300 0 300 0 0
0 0 0 0 0 10
0 0 0 0 0 0
0 0 0 0 0 100
500 300 0 200 0 300
0 0 0 0 0 100
280 180 0 100 0 0 BLUD
0 0 0 0 0 0
0 0 0 0 0 5
0 0 0 0 0 20
600 200 0 400 0 200

25 21 0 4 0 24
0 0 0 0 0 24
24 6 0 18 0 0
0 0 0 0 0 500
0 0 0 0 0 200
34020 5340 0 28680 0 0
0 0 0 0 0 1
0 0 0 0 0 100
0 0 0 0 0 30
700 0 0 700 0 0
0 0 0 0 0 10
400 400 0 0 0 100
1500 500 0 1000 0 0
0 0 0 0 0 0
0 0 0 0 0 50
7340 0 0 7340 0 0

optimum an n n
500 500 0 0 0 1000
0 0 0 0 0 0
0 0 0 0 0 24
0 0 0 0 0 1050
0 0 0 0 0
60 10 0 50 0
750 450 0 300 0 600
0 0 0 0 0 60
450 450 0 0 0 600
360 0 0 360 0 0
300 200 0 100 0 300
0 0 0 0 0 300
0 0 0 0 0 500
0 0 0 0 0 300
500 500 0 0 0 1000
0 0 0 0 0 200
300 300 200 0 0 500
0 0 0 0 0 100
0 0 0 0 0 10
0 0 0 0 0 50
0 0 0 0 0 48
50 20 0 30 0 50
96 48 0 48 0 0
0 0 0 0 0 3000
0 0 0 0 0 100
0 0 0 0 0 300
22 22 0 0 0 60
0 0 0 0 0 50
0 0 0 0 0 900
30 0 0 30 0 0
3250 3250 3250 0 0 600
0 0 0 0 0 60
0 0 0 0 0 50
0 0 0 0 0 10
0 0 0 0 0 160
48 26 0 22 0 48
720 60 0 660 0 0
0 0 0 0 0 90
0 0 0 0 0 0
100 0 0 100 0 0
0 0 0 0 0 5
0 0 0 0 0 200

optimum an n n
95 0 0 95 0 0
0 0 0 0 0 0
0 0 0 0 0 100
39 0 0 39 0 0 DAI
53 0 0 53 0 0 DAI
0 0 0 0 0 100
0 0 0 0 0 300
2770 225 0 2545 0 0
0 0 0 0 0 500
0 0 0 0 0 100
0 0 0 0 0 100
0 0 0 0 0 100
0 0 0 0 0 0 BLUD
0 0 0 0 0 1000
0 0 0 0 0 100
0 0 0 0 0 20
58 10 0 48 0 0
0 0 0 0 0
12 0 0 12 0 50 DAI
100 50 0 50 0 400
0 0 0 0 0 50
100 0 0 100 0 0
0 0 0 0 0
150 20 0 130 0
11 11 0 0 0 50
100 0 0 100 0 0
83 0 0 83 0 0
50 0 0 50 0 0
0 0 0 0 0 50
5 3 0 2 0 2
43 0 0 43 0 0
0 0 0 0 0 0
20 10 0 10 0 20
0 0 0 0 0 20
0 0 0 0 0 1
0 0 0 0 0 10
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 10
950 650 0 300 0 2000
2000 300 0 1700 0
0 0 0 0 0 1
0 0 0 0 0 50
0 0 0 0 0 50
20 0 0 20 0
50 0 0 50 0 100 IFK
0 0 0 0 0 50
36 0 0 36 0 0
0 0 0 0 0 2
0 0 0 0 0 50
0 0 0 0 0 1
0 0 0 0 0 50
0 0 0 0 0 100
0 0 0 0 0 10
0 0 0 0 0 100
120 40 0 80 0 BLUD
95 5 0 90 0 0

optimum an n n
0 0 0 0 0 1
0 0 0 0 0 2
0 0 0 0 0 1
1 0 0 1 0 0
0 0 0 0 0 1
1 1 0 0 0 1
0 0 0 0 0 1
0 0 0 0 0 1
0 0 0 0 0 2
1 0 0 1 0 0
0 0 0 0 0 1
30 0 0 30 0 0
0 0 0 0 0 1
0 0 0 0 0 1
0 0 0 0 0 1
0 0 0 0 0 1
0 0 0 0 0 1

optimum an n n
0 0 0 0 2
4 2 0 2 0 4
PUSLING/ MANLING/
RASIO PEMAKAIAN
0


Nip. 19650404 198808 1 018
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)
PUSKESMAS
Unit Penerima/PUSKESMAS : CIRINTEN Laporan Bulan SEPTEMBER 2021

Kecamatan : CIRINTEN Permintaan Bulan OKTOBER 2021
Kabupaten : LEBAK
Provinsi : BANTEN
STOK Stok Perminta Pemberia Keteranga

NO NAMA OBAT KEMASAN Penerimaan Persediaan Pemakaian Rusak/Ed Sisa Stok
AWAL Optimum an n n
1 ACEYLCYSTEIN Capsul 200 Mg BOX @60 TAB 120 0 120 0 0 120 0 0 BLUD
2 ACYCLOVIR CREAM BOX @10 TUBE 0 0 0 0 0 0 0 20
3 ACYCLOVIR TABLET 400 MG BOX @100 TAB 0 0 0 0 0 0 0 300
4 ALBENDAZOLE TABLET 400 MG BOX @30 TAB 1890 0 1890 30 0 1860 0 0 APBN
5 ALKOHOL 70% 1L BTL @ 1000ML 0 0 0 0 0 0 0 2
6 ALLOPURINOL TABLET 100 MG BOX @100 TAB 200 200 400 200 0 200 0 200
7 ALPRAZOLAM TABLET 1 MG BOX @100 TAB 0 0 0 0 0 0 0 100
8 BTL @60ML 0 0 0 0 0 0 0 50
SIRUP 15 MG/ 5 ML)
9 AMBROXOL 30Mg (HOLICOS Tab) BOX @100 TAB 0 2000 2000 800 0 1200 0 0 BLUD
10 AMINOPHYLLINE CAIRAN INJEKSI 24 MG/ML BOX @30 AMPUL 0 0 0 0 0 0 0 30
11 AMINOPHYLLINE TABLET 200 MG BTL @ 100 TAB 0 0 0 0 0 0 0 100

12 AMLODIPINE TABLET 10 MG BOX @100 TAB 0 1200 1200 0 0 1200 0 0
13 AMOXYCILLIN SIRUP 125 MG/5 ML BOX@24BTL 0 0 0 0 0 0 0 50
15 AMOXYCILLIN TABLET 250 MG BOX @100 TAB 0 0 0 0 0 0 0 0
16 AMOXYCILLIN TABLET 500 MG BOX @100 TAB 5500 0 5500 1800 0 3700 0 0 BLUD
17 ANTACIDA SIRUP 400 MG/5 ML BOX@50BTL 0 0 0 0 0 0 0 50
18 ANTACIDA TABLET BOX @100 TAB 1100 1000 2100 1700 0 400 0 2000
19 ANTALGIN TABLET 500MG BTL@1000TAB 0 0 0 0 0 0 0 100
20 ANTIHEMOROID SUPPOSITORIA BOX@10 SUP 0 0 0 0 0 0 0 10
21 AQUA PRO INJEKSI INJEKSI VIAL 0 0 0 0 0 0 0 12
22 BOX @100 TAB 50 100 150 0 0 150 0 0 BLUD
23 ASAM ASCORBAT (VITAMIN C) TABLET 50 MG TABLET 300 500 800 200 0 600 0 0
24 ASAM MEFENAMAT TABLET 500 MG BOX @100 TAB 0 500 500 500 0 0 0 3000
25 BOX @100 TAB 400 0 400 200 0 200 0 200
600 MG)
26 AZITROMYCIN TABLET 500 Mg TABLET 0 200 200 60 0 140 0 0 BLUD
27 B12 (CYANOCOBALAMIN) CAIRAN INJEKSI BOX@100AMP 1 0 1 1 0 0 0 0 BLUD
28 BEDAK SALYCIL BOX@100DUS 0 0 0 0 0 0 0 20

29 BOX@12TUBE 35 0 35 35 0 0 0 48
30 BETAMETASON CREAM 1 MG BOX@24TUBE 42 50 92 0 0 92 0 0
31 BOTOL 500ML 0 0 0 0 0 0 0 20
)
32 CAIRAN INFUS (ASERING 500ml ) BOTOL 500ML 0 0 0 0 0 0 0
33 CAIRAN INFUS (RINGER LAKTAT 500ml) BOTOL 500ML 800 0 800 180 0 620 0 0 BLUD
34 CAPTOPRIL TABLET 25 MG BOX@100TAB 0 1000 1000 300 0 700 0 0 BLUD
35 CARBAMAZEPINE TABLET 200 MG BOX@100TAB 0 0 0 0 0 0 0 100
36 CEFADROXIL CAPSUL 500 MG BOX@100TAB 0 1000 1000 300 0 700 0 0 BLUD
37 CEFADROXIL SIRUP KERING 125MG BOTOL 0 0 0 0 0 0 0 50
38 CETIRIZINE CAPSUL 10 MG BOX @100 TAB 0 700 700 700 0 0 0 1000 BLUD 500
39 CETIRIZINE SIRUP 5 MG/5 ML BOTOL 0 0 0 0 0 0 0 50
40 CHLORAMPHENICOL CAPSULE 500 MG BOX@100TAB 0 0 0 0 0 0 0 500
41 CHLORAMPHENICOL SUSPENSI 125 MG/5 ML BOX@50BTL 0 0 0 0 0 0 0 50
42 CHLORAMPHENICOL TETES MATA 0.5% BOTOL 0 0 0 0 0 0 0 24

43 CHLORPENIRAMINE MALEAT 4 MG (CTM) BOX@100TAB 1000 500 1500 900 0 600 0 2000
44 BOX@100TAB 200 0 200 0 0 200 0 0
25 MG
45 BOX@100TAB 0 0 0 0 0 0 0 1000
MG
46 CLONIDINE TABLET 0.15 MG BOX@100TAB 0 0 0 0 0 0 0 100
47 CLORAMPHENICOL SALEP KULIT TUBE 24 0 24 0 0 24 0 0
48 CLORAMPHENICOL SALEP MATA TUBE 0 0 0 0 0 0 0 24
49 COTRIMOXAZOLE SIRUP 240 MG/5 ML BOX@50BTL 0 100 100 38 0 62 0 0
50 COTRIMOXAZOLE TABLET 480 MG BOX@100TAB 1200 0 1200 0 0 1200 0 0
51 DEXAMETHASONE CAIRAN INJEKSI 5 MG AMPUL 0 240 240 100 0 140 0 0
52 DEXAMETHASONE TABLET 0.5 MG BOX @100 TAB 0 500 500 500 0 0 0 3000
53 DIAZEPAM ENEMA 10MG/2.5ML TUBE 8 0 8 0 0 8 0 0
55 DIAZEPAM INJ 2.5MG AMPUL 10 0 10 0 0 10 0 0
56 DIAZEPAM TABLET 2 MG BTL@100TAB 0 0 0 0 0 0 0 100
57 DIGOXIN TABLET 0.25 MG BOX @100 TAB 0 0 0 0 0 0 0 100
58 DIPHENHYDRAMINE INJEKSI 10MG/ML BOX@30AMPUL 0 20 20 2 0 18 0 0 BLUD
59 DOMPERIDONE SIRUP 5 MG/5 ML BOTOL 0 0 0 0 0 0 0 50
60 DOMPERIDONE TABLET 10 MG BOX @100 TAB 0 0 0 0 0 0 0 100
61 ERGOTAMINE TABLET BTL@100TAB 0 0 0 0 0 0 0 300
62 ERYTHROMYCIN CAPSUL 500 MG BOX@100TAB 0 500 500 300 0 200 0 0 BLUD
63 ERYTHROMYCIN SIRUP KERING 200 MG/5 ML BOTOL 0 0 0 0 0 0 0 50

64 FUROSEMID TABLET BOX@100TAB 2000 0 2000 200 0 1800 0 0
65 GARAM ORALIT BOX@100SACHET 105 0 105 5 0 100 0 0 APBN
66 GEMFIBROZIL TABLET 300MG BOX@100TAB 0 0 0 0 0 0 0 100
67 GENTAMICIN INJEKSI BOX@5 AMPUL 0 0 0 0 0 0 0 10
68 GENTAMICINE SALEP 0.1% (SK) TUBE 12 74 86 8 0 78 0 0 BLUD 50
69 GENTAMICINE SALEP 0.3% (SM) TUBE 0 0 0 0 0 0 0 25
70 GENTAMICINE TETES 0.3% (TM) BOTOL 0 25 25 7 0 18 0 0 BLUD
71 GENTIAN VIOLET BOX@ 50BTL 0 0 0 0 0 0 0 50
72 GLIBENKLAMID TABLET 5 MG TABLET 250 0 250 50 0 200 0 0
73 GLIMEPIRIDE TABLET 2MG BOX@50 TAB 0 0 0 0 0 0 0 100
74 GLISERIL GUAIAKOLAT TABLET 100 MG BOX@100TAB 0 0 0 0 0 0 0 1000
75 GLUKOSA 5% CAIRAN INFUS DUS@20BTL 0 0 0 0 0 0 0 60
76 BOX@100TAB 0 900 900 700 0 200 0 1000
EKSPEKTORAN)
77 GRISEOFULVIN TABLET 250MG TABLET 0 0 0 0 0 0 0 300
78 HALOPERIDOL TABLET 5 MG BOX@100TAB 0 0 0 0 0 0 0 300
79 HIDROKORTISONE KRIM 2.5% BOX@24TUBE 53 0 53 5 0 48 0 0
80 IBUPROFEN SIRUP 100 MG/5 ML BOTOL 0 0 0 0 0 0 0 100
82 IBUPROFEN TABLET 400 MG TABLET 0 0 0 0 0 0 0 100
83 ISONIAZID TABLET 100 MG BOX @100 TAB 0 0 0 0 0 0 0 0
84 BOX@50TAB 0 0 0 0 0 0 0 0
ENTERIK 50 MG)
85 KALSIUM LAKTAT TABLET 500 MG BOX @100 TAB 400 500 900 800 0 100 0 1000
86 KETOKONAZOL TABLET 200 mg TABLET 0 500 500 50 0 450 0 0 BLUD
87 KETOKONAZOLE SALEP BOX@25TUBE 0 0 0 0 0 0 0 25
88 KETOROLAC INJEKSI 30 MG/ML BOX@12AMPUL 0 36 36 36 0 0 0 24 BLUD
89 BOX@12TUBE 0 0 0 0 0 0 0 24

90 AMPUL 0 0 0 0 0 0 0 10
INJEKSI 30 MG)
91 LANSOPRAZOLE TABLET 30MG TABLET 0 600 600 100 0 500 0 0 BLUD
92 LIDOCAIN HCL INJEKSI 2% BOX@30AMPUL 52 0 52 0 0 52 0 0 BLUD
93 BOX@20AMPUL 139 0 139 20 0 119 0 0
CAIRAN INJEKSI)
94 LORATADINE CAPTABS 10 MG TABLET 0 0 0 0 0 0 0 100
95 METFORMIN TABLET 500 MG BOX@100TAB 160 0 160 160 0 0 0 0 BLUD
96 BOX@100TAB 0 1000 1000 0 0 1000 0 0 BLUD
SELAPUT 0,125 MG
97 METHYLPREDNISOLONE TABLET 4 MG BOX@100TAB 0 2000 2000 700 0 1300 0 0 BLUD
98 DUS@60BTL 0 0 0 0 0 0 0 60
5 MG/5 ML)
99 METOCLOPRAMIDE TABLET 10 MG TABLET 0 0 0 0 0 0 0 500
100 METRONIDAZOLE OVULA SUP 0 0 0 0 0 0 0 10
101 METRONIDAZOLE TABLET 500 MG BOX@100TAB 0 0 0 0 0 0 0 500
102 MGSO4 INJEKSI 20% AMPUL 0 0 0 0 0 0 0 24
104 MICONAZOLE SALEP 2% BOX@24TUBE 0 0 0 0 0 0 0 24
105 NATRIUM CLORIDA 0.9% INFUS BOTOL 20 20 40 20 0 20 0 60
106 NATRIUM DIKLOFENAK TABLET 25MG BOX@50TAB 0 0 0 0 0 0 0 500
107 NIFEDIPINE TABLET 10 MG TABLET 0 0 0 0 0 0 0 100
108 TABLET 0 0 0 0 0 0 0 100
20)
109 DUS@50BTL 0 0 0 0 0 0 0 50
NIPIS 100 ML)
110 OMEPRAZOLE CAPSUL 20MG CAPSULE 0 0 0 0 0 0 0 300
111 OXYTOSIN INJEKSI 10 IU/ml AMPUL 0 100 100 0 0 100 0 0 BLUD
112 OXYTETRACYCLINE SALEP MATA 1% TUBE 20 0 20 20 0 0 0 0 BLUD
113 DUS@56BTL 0 0 0 0 0 0 0 50
(60mg/0,6ml)
114 PARACETAMOL SIRUP 120 MG/5 ML DUS@50BTL 169 0 169 136 0 33 0 100
BLUD
115 PARACETAMOL TABLET 500 MG BOX@100TAB 0 6000 6000 2000 0 4000 0 0
5000
116 PHENOL GLYCEROL 10% (TT) BOTOL 0 0 0 0 0 0 0 25
117 BOX@30AMPUL 0 0 0 0 0 0 0 30
10Mg/ML
118 BOX@10 AMPUL 0 0 0 0 0 0 0 100
119 BOX@30AMPUL 0 0 0 0 0 0 0 60
MG/ML
120 BOX@100TAB 0 1000 1000 100 0 900 0 0 BLUD
MG
121 PIROXICAM TABLET 10 MG BOX@100TAB 0 0 0 0 0 0 0 1000
122 POVIDON 1000ML BOTOL 0 0 0 0 0 0 0 1
123 POVIDONE IODINE 30 ML BOTOL 12 0 12 6 0 6 0 0 BLUD
124 PREDNISONE TABLET 5 MG BOX@100TAB 300 0 300 200 0 100 0 0
125 PROKAIN BENZIL PENISILIN G INJEKSI VIAL 0 0 0 0 0 0 0 10
126 PROPANOLOL 40 MG BOX@100TAB 0 0 0 0 0 0 0 0
127 PYRANTEL TABLET 125 MG BOX@100TAB 0 0 0 0 0 0 0 100
128 PYRIDOXINE TABLET TABLET 200 300 500 400 0 100 0 500
129 RANITIDINE INJEKSI 25 MG/ML BOX@10AMPUL 0 30 30 30 0 0 0 0 BLUD
130 RANITIDINE TABLET 150 MG BOX@100TAB 100 2000 2100 200 0 1900 0 0 BLUD
131 RIFAMPICIN TABLET 450 MG BOX@100TAB 0 0 0 0 0 0 0 0
132 RIVANOL BOTOL 0 0 0 0 0 0 0 5
133 BLISTER@5 AMPUL 0 0 0 0 0 0 0 20
NEBULIZER)
134 SALBUTAMOL TABLET 2 MG BOX@100TAB 400 200 600 400 0 200 0 400
135 SALEP 2-4 KOMBINASI BOX@24POT 4 0 4 4 0 0 0 24

136 BOX@24POT 0 0 0 0 0 0 0 24
137 SALEP ANTIFUNGI DOEN BOX@24POT 18 0 18 8 0 10 0 0

138 SIMVASTATIN TABLET 10 MG BOX@100TAB 0 300 300 90 0 210 0 0 BLUD
139 SPIRONOLACTONE TABLET 25 MG BOX@100TAB 0 0 0 0 0 0 0 200
140 TABLET TAMBAH DARAH TABLET 28680 0 28680 1800 0 26880 0 0
141 VIAL 0 0 0 0 0 0 0 1
CAIRAN IH 2,5MG/ML
142 TETRACYCLINE TABLET 250 MG BOX@100TAB 0 0 0 0 0 0 0 100
143 THIAMINE INJEKSI 100 MG/ML BOX@30AMPUL 0 0 0 0 0 0 0 30
144 THIAMINE TABLET 50 MG BTL@1000TAB 700 0 700 200 0 500 0 0
145 VAGIZOL OVULA 500 MG SUPP 0 0 0 0 0 0 0 10
146 VITAMIN A 100000 IU BTL@50CAPSUL 0 0 0 0 0 0 0 100
148 VITAMIN B COMPLEX BTL@100TAB 0 0 0 0 0 0 0 0
149 ZINC SIRUP (ZIRKUM KID Sirop 60 Ml) BOTOL 0 0 0 0 0 0 0 50
150 ZINC TABLET 20 MG BOX@100TAB 7340 0 7340 100 0 7240 0 0

STOK stok Perminta Pemberia Keteranga
NO NAMA OBAT Kemasan Penerimaan Persediaan Pemakaian Rusak/Ed Sisa Stok
AWAL optimum an n n
1 ANALGETIK & ANTIPIRETIK (LYMACIL TABLET) BOX@100TAB 0 500 500 100 0 400 0 0
2 ANALGETIK ANTIPIRETI (HOLIMOL CAPTABS) BOX@100TAB 0 0 0 0 0 0 0 0

3 TUBE 0 0 0 0 0 0 0 24
DIKLOFENAK SALEP))
4 ANTI ALERGI (PRITACORT TABLET) TABLET 0 0 0 0 0 0 0 1050
5 ANTI ALERGI (SONAMIN TABLET) BOX@100TAB 0 0 0 0 0 0 0
6 ANTI DIARE (NEO KAOMINAL SUSPENSI) DUS@60BTL 50 0 50 6 0 44 0 0
7 ANTI INFLUENZA (MOLEXFLU CAPTABS) BOX@150TAB 300 1200 1500 450 0 1050 0 0
8 ANTI INFLUENZA DAN BATUK (ALPARA SIRUP) DUS@60BTL 0 0 0 0 0 0 0 60

9 BOX@150TAB 0 600 600 450 0 150 0 600
TABLET)
10 BOX @ 30 TAB 360 0 360 0 0 360 0 0
Coated Tablet)
11 BOX@100TAB 100 0 100 100 0 0 0 300
12 BOX@100TAB 0 0 0 0 0 300
13 BOX@100TAB 0 0 0 0 0 0 0 500
GULA)

14 BOX@100TAB 0 300 300 200 0 100 0 300

15 BOX @100 TAB 0 500 500 200 0 300 0 1000
16 TABLET 0 0 0 0 0 0 0 200
TABLET)
17 BOX @100 TAB 0 0 0 0 0 0 0 500
18 BOX @100 TAB 0 0 0 0 0 0 0 100
(MOLANEURON TABLET)
19 BOX @ 5 AMPUL 0 0 0 0 0 0 0 10
20 MULTIVITAMIN SIRUP (BECEFORT SIRUP) DUS@ 50 BTL 0 0 0 0 0 0 0 50
21 MULTIVITAMIN SIRUP (LYTACUR SIRUP) DUS@ 48 BTL 0 0 0 0 0 0 0 48
22 DUS @50 BTL 30 50 80 20 0 60 0 0
ML)
23 MULTIVITAMIN SIRUP (STIMUNO SIRUP) DUS @48 BTL 48 0 48 0 0 48 0 0
24 BOX @100 TAB 0 0 0 0 0 0 0 3000
OBAT ANALGESIK
25 (TRAMADOL+PARACETAMOL/TRAMPARA) BOX @100 TAB 0 0 0 0 0 0 0 100
TABLET
26 BOX @ 300 TAB 0 0 0 0 0 0 0 300
(METANEURON)
27 OBAT BATUK HERBAL (HERBAKOF SIRUP) BTL 100ML 0 48 48 0 0 48 0 0
28 OBAT BATUK & FLU (NOVADRYL SIRUP) DUS @50 BTL 0 0 0 0 0 0 0 50
29 BOX@ 300 TAB 0 0 0 0 0 0 0 900
30STRIP @10TABLET)
30 DUS @50 BTL 30 0 30 1 0 29 0 0
BOTOL 100 ML)
31 OBAT FLU DAN BATUK (DEXTRAL KAPLET) BOX @150 TAB 0 0 0 0 0 0 0 600

32 DUS @60 BTL 0 0 0 0 0 0 0 60
BOTOL 60 ML)
33 DUS @50 BTL 0 0 0 0 0 0 0 50
BOTOL @ 60 ML)
34 VIAL 0 0 0 0 0 0 0 10

35 BOX @ 160 TAB 0 0 0 0 0 0 0 160
36 BOTOL 22 48 70 18 0 52 0 0
(LEXACROL SUSPENSI)
37 OBAT HIPERTENSI HERBAL (TENSI GARD) TABLET 660 0 660 0 0 660 0 0
38 OBAT HERBAL MATA (OCUGARD CAPSULE) CAPSULE 0 0 0 0 0 0 0 90
39 OBAT OSTEOPOROSIS (RISTONAT TABLET) TABLET 0 0 0 0 0 0 0 0
40 PROBIOTIK (PROBIOKID) SASCET 100 0 100 10 0 90 0 0

41 SKINCOL CREAM TUBE 0 0 0 0 0 0 0 5
42 TABLET 0 0 0 0 0 0 0 200
(PRENAMIA)

NO NAMA BMHP Kemasan Penerimaan Persediaan Pemakaian Rusak/Ed Sisa Stok
AWAL optimum an n n
1 ALKOHOL SWAB (AXIMED) BOX 95 0 95 6 0 89 0 0
2 AUTOCLICK LANCING DEVICE (ONEMED) PCS 0 0 0 0 0 0 0 0
3 PCS 0 0 0 0 0 0 0 100
DARAH)
4 CAT GUT CHROMIC (ONEMED) BOX@25STRIP 39 0 39 12 0 27 0 0 DAI
5 CAT GUT PLAIN (ONEMED) BOX @24 PIECE 53 0 53 12 0 41 0 0 DAI
6 DISPOSIBLE 10 ML BOX @24 PIECE 0 0 0 0 0 0 0 100
7 DISPOSIBLE 1ML BOX @100 PIECE 0 200 200 100 0 100 0 0 BLUD
10 EXAMINATION GLOVES SIZE 6.5 PAIRS 0 0 0 0 0 0 0 100
13 EXAMINATION GLOVES SIZE M PAIRS 0 1000 1000 1000 0 0 0 0 BLUD
14 EXAMINATION GLOVES SIZE S PAIRS 0 0 0 0 0 0 0 1000
15 EXAMINATION GLOVES SIZE XS BOX@100PCS 0 0 0 0 0 0 0 100
16 FOLEY CATHETER NO 16 BOX@100PCS 0 0 0 0 0 0 0 20
17 FOLEY CATHETER NO 18 PIECES 48 0 48 10 0 38 0 0
18 HB HEMOGLOBIN TEST STRIP STRIP 0 0 0 0 0 0 0
19 Infusion Set ANAK (COSMOMED) PIECES 12 0 12 0 0 12 0 50 DAI
20 Infusion Set DEWASA (COSMOMED) STRIP 50 50 100 50 0 50 0 400
21 IV CATHETER NO 16 (PEN) PCS 0 0 0 0 0 0 0 50
23 IV CATHETER NO 18 (WINGS) PCS 0 0 0 0 0 0 0
24 IV CATHETER NO 20 (PEN) PCS 130 0 130 10 0 120 0
25 IV CATHETER NO 20 (WINGS) PCS 0 0 0 0 0 0 0 50
30 KAPAS PEMBALUT 250 G PIECES 2 2 4 0 0 4 0 2
31 KASA 4 X 10 (ONEMED) PIECES 43 0 43 5 0 38 0 0
33 KASA 4X 5 (ONEMED) PIECES 10 20 30 10 0 20 0 20
34 KASA 16X16 (ONEMED) ROLL 0 10 10 10 0 0 0 20
35 KASA 2 X 80 (COSMOMED ) PACK@10ROLL 0 0 0 0 0 0 0 1
37 KASA 4 X 15 PACK@10ROLL 0 0 0 0 0 0 0 0
38 KASA 40 M X 80 CM KOTAK 0 0 0 0 0 0 0 0
39 LUBRICATING (MY JELLY) ROLL 0 0 0 0 0 0 0 10
40 MASKER (KARET) PACK@50ROLL 300 1000 1300 500 0 800 0 2000
41 MASKER (HIJAB) PACK@50ROLL 1700 0 1700 700 0 1000 0

42 ROLL 0 0 0 0 0 0 0 1
43 Nasal Oxygen Cannula (COSMO MED) TUBE 0 0 0 0 0 0 0 50

44 Nebulizer Mask (ANAK) PCS 0 0 0 0 0 0 0 50
45 Nebulizer Mask (DEWASA ) PCS 20 0 20 0 0 20 0
46 OXYGEN MASKER (ANAK)&(DEWASA) PCS 50 0 50 0 0 50 0 100 IFK
47 PLASTER PCS 0 0 0 0 0 0 0 50
48 SILK 3 - 0 (ONEMED) PIECES 36 0 36 0 0 36 0 0
49 PIECES 0 0 0 0 0 0 0 2
Roll)
50 TEST CHOLESTEROL STRIP (BENECHECK) PIECES 0 0 0 0 0 0 0 50
51 Test Glucose + Protein (ONEMED) ROLL 0 0 0 0 0 0 0 1
52 TEST GLUCOSE STRIP (BENECHECK) BOX@36 PIECE 0 0 0 0 0 0 0 50
53 TEST HEMOGLOBIN STRIP ROLL 0 0 0 0 0 0 0 100
54 Test Uric Acid Strip(Strip 25's) BeneCheck BOX @ 10 STRIP 0 0 0 0 0 0 0 10
55 Umbilical Cord Clamp (ONEMED) BOX @50 PIECE 0 0 0 0 0 0 0 100

56 UNDERPAD (COSMOMED ) PIECES 80 0 80 50 0 30 0 0 BLUD
57 URINE BAG WITH HANGER (COSMOMED) PIECES 90 0 90 10 0 80 0 0
OBAT GIGI
NO NAMA OBAT Kemasan Sisa Stok Penerimaan Persediaan Pemakaian Rusak/Ed Sisa Stok
optimum an n n
1 Bahan Cetak Alginate Hygident PACK 0 0 0 0 0 0 0 1
2 Day Stone /Prestia Stone PACK 0 0 0 0 0 0 0 2
3 Devitalisasi/Devital pasta BTL 0 0 0 0 0 0 0 1
4 Etil Klorida spray BTL 1 1 2 1 0 1 0 0
5 Eugnol BTL 0 0 0 0 0 0 1
6 Formokresol/Trikresol BTL 0 1 1 0 0 1 0 1
7 KOTAK 0 0 0 0 0 0 0 1
8 Kalsium Hidroksida Pasta/calsidor doriden BTL 0 0 0 0 0 0 0 1
9 Klorfenol Kanfer Menthol/CHKM BTL 0 0 0 0 0 0 0 2

10 Mummiying Pasta/Iodoform BTL 1 0 1 0 0 1 0 0
11 Semen Seng Fosfat serbuk & cair SET 0 0 0 0 0 0 0 1
12 Spon Gelatin /craspon KOTAK 30 0 30 0 0 30 0 0

13 SET 0 0 0 0 0 0 0 1
14 BTL 0 0 0 0 0 0 0 1
doriden
15 Topical anestesi gel 28/Alpha -Cain Stroberry BTL 0 0 0 0 0 0 0 1
16 Silver Amalgam Serbuk BTL 0 0 0 0 0 0 0 1

17 Xylestesin/Xylonibsa BTL 0 0 0 0 0 0 0 1
SERUM
AWAL optimum an n n
1 SERUM ANTI TETANUS INJEKSI AMPUL 0 0 0 0 0 0 0 2
2 SERUM ANTI BISA ULAR POLIVALEN INJEKSI AMPUL 2 4 6 2 0 4 0 0
PUSLING/ MANLING/
PUSKESMAS RASIO PEMAKAIAN
JUMLAH KUNJUNGAN UMUM BPJS UMUM BPJS TABLET INJEKSI SIRUP
0
Mengetahui/Menyetujui Yang Menyerahkan Yang Meminta Yang Menerima

Kabid SDK Farmasi dan POM Kepala Seksi Farmasi dan POM Kepala Puskesmas Pengelola Obat Puskesmas
Kabupaten Lebak
Endang Komarudin, SKM., MA Edi Purnomo, SKM, M.Kes H.Madnur Taufik,S.Sos,SKM.MM Ahmad fathurohman,Amd.farm
NIP. 19820101 200801 1 017 Nip. 19700603 199203 1 006 Nip. 19650404 198808 1 018
PUSKESMAS
Unit Penerima/PUSKESMAS : CIRINTEN Laporan Bulan OKTOBER 2021

Kecamatan : CIRINTEN Permintaan Bulan Nov-21
Kabupaten : LEBAK
Provinsi : BANTEN

AWAL Optimum an n n
4 ALBENDAZOLE TABLET 400 MG BOX @30 TAB 1860 0 1860 1860 1860 0 0 120
5 ALKOHOL 70% 1L BTL @ 1000ML 0 0 0 0 0 0 0 2
8 BTL @60ML 0 0 0 0 0 0 0 50
SIRUP 15 MG/ 5 ML)

22 BOX @100 TAB 150 0 150 50 0 100 0 0 BLUD

25 BOX @100 TAB 200 200 400 100 0 300 0 0
600 MG)
27 B12 (CYANOCOBALAMIN) CAIRAN INJEKSI BOX@100AMP 0 0 0 0 0 0 0 10

29 BOX@12TUBE 0 48 48 30 0 18 0 48
31 BOTOL 500ML 0 0 0 0 0 0 0 20
)
38 CETIRIZINE CAPSUL 10 MG BOX @100 TAB 0 200 200 200 0 0 0 1000

44 BOX@100TAB 200 0 200 0 0 200 0 0
25 MG
45 BOX@100TAB 0 0 0 0 0 0 0 1000
MG

76 BOX@100TAB 200 900 1100 200 0 900 0 500
EKSPEKTORAN)
84 BOX@50TAB 0 0 0 0 0 0 0 0
ENTERIK 50 MG)
88 KETOROLAC INJEKSI 30 MG/ML BOX@12AMPUL 0 0 0 0 0 0 0 24
89 BOX@12TUBE 0 0 0 0 0 0 0 24

90 AMPUL 0 0 0 0 0 0 0 10
INJEKSI 30 MG)
93 BOX@20AMPUL 119 0 119 44 0 75 0 0
CAIRAN INJEKSI)
95 METFORMIN TABLET 500 MG BOX@100TAB 0 0 0 0 0 0 0 500
96 BOX@100TAB 1000 0 1000 0 0 1000 0 0 BLUD
SELAPUT 0,125 MG
98 DUS@60BTL 0 0 0 0 0 0 0 60
5 MG/5 ML)
108 TABLET 0 0 0 0 0 0 0 100
20)
109 DUS@50BTL 0 0 0 0 0 0 0 50
NIPIS 100 ML)
112 OXYTETRACYCLINE SALEP MATA 1% TUBE 0 0 0 0 0 0 0 25
113 DUS@56BTL 0 0 0 0 0 0 0 50
(60mg/0,6ml)
115 PARACETAMOL TABLET 500 MG BOX@100TAB 4000 0 4000 3200 0 800 0 5000 BLUD
117 BOX@30AMPUL 0 0 0 0 0 0 0 30
10Mg/ML
118 BOX@10 AMPUL 0 0 0 0 0 0 0 100
119 BOX@30AMPUL 0 0 0 0 0 0 0 60
MG/ML
120 BOX@100TAB 900 0 900 100 0 800 0 0 BLUD
MG
122 POVIDON 1000ML BOTOL 0 0 0 0 0 0 0 1
129 RANITIDINE INJEKSI 25 MG/ML BOX@10AMPUL 0 0 0 0 0 0 0 50
132 RIVANOL BOTOL 0 0 0 0 0 0 0 5
133 BLISTER@5 AMPUL 0 0 0 0 0 0 0 20
NEBULIZER)
136 BOX@24POT 0 0 0 0 0 0 0 24

141 VIAL 0 0 0 0 0 0 0 1
CAIRAN IH 2,5MG/ML
149 ZINC SIRUP (ZIRKUM KID Sirop 60 Ml) BOTOL 0 0 0 0 0 0 0 50

AWAL optimum an n n

3 TUBE 0 0 0 0 0 0 0 24
DIKLOFENAK SALEP))

9 BOX@150TAB 150 600 750 600 0 150 0 600
TABLET)
10 BOX @ 30 TAB 360 0 360 360 360 0 0 120
Coated Tablet)
11 BOX@100TAB 0 0 0 0 0 0 0 500
12 BOX@100TAB 0 0 0 0 0 0 0 300
13 BOX@100TAB 0 0 0 0 0 0 0 500
GULA)
14 BOX@100TAB 100 300 400 0 0 400 0 0

15 BOX @100 TAB 300 500 800 800 0 0 0 1000
16 TABLET 0 0 0 0 0 0 0 200
TABLET)
17 BOX @100 TAB 0 0 0 0 0 0 0 500
18 BOX @100 TAB 0 0 0 0 0 0 0 100
(MOLANEURON TABLET)
19 BOX @ 5 AMPUL 0 0 0 0 0 0 0 10
22 DUS @50 BTL 60 0 60 10 0 50 0 0
ML)
24 BOX @100 TAB 0 0 0 0 0 0 0 3000
OBAT ANALGESIK
TABLET
26 BOX @ 300 TAB 0 0 0 0 0 0 0 300
(METANEURON)
29 BOX@ 300 TAB 0 0 0 0 0 0 0 900
30STRIP @10TABLET)
30 DUS @50 BTL 29 0 29 21 0 8 0 50
BOTOL 100 ML)

32 DUS @60 BTL 0 0 0 0 0 0 0 60
BOTOL 60 ML)
33 DUS @50 BTL 0 0 0 0 0 0 0 50
BOTOL @ 60 ML)
34 VIAL 0 0 0 0 0 0 0 10

35 BOX @ 160 TAB 0 0 0 0 0 0 0 160

36 BOTOL 52 0 52 18 0 34 0 0
(LEXACROL SUSPENSI)

42 TABLET 0 0 0 0 0 0 0 200
(PRENAMIA)

AWAL optimum an n n
3 PCS 0 0 0 0 0 0 0 100
DARAH)
7 DISPOSIBLE 1ML BOX @100 PIECE 100 0 100 100 0 0 0 100
13 EXAMINATION GLOVES SIZE M PAIRS 0 0 0 0 0 0 0 0 BLUD
15 EXAMINATION GLOVES SIZE XS BOX@100PCS 0 0 0 0 0 0 0 100
18 HB HEMOGLOBIN TEST STRIP STRIP 0 0 0 0 0 0 0
19 Infusion Set ANAK (COSMOMED) PIECES 12 0 12 12 0 0 0 100
24 IV CATHETER NO 20 (PEN) PCS 120 0 120 120 0 0 0
37 KASA 4 X 15 PACK@10ROLL 0 0 0 0 0 0 0 0
38 KASA 40 M X 80 CM KOTAK 0 0 0 0 0 0 0 0
41 MASKER (HIJAB) PACK@50ROLL 1000 0 1000 300 0 700 0 0

42 ROLL 0 0 0 0 0 0 0 1

47 PLASTER PCS 0 0 0 0 0 0 0 50
49 PIECES 0 0 0 0 0 0 0 2
Roll)

56 UNDERPAD (COSMOMED ) PIECES 30 0 30 30 0 0 0 100
OBAT GIGI
optimum an n n
5 Eugnol BTL 0 0 0 0 0 0 0 1
7 KOTAK 0 0 0 0 0 0 0 1


13 SET 0 0 0 0 0 0 0 1
14 BTL 0 0 0 0 0 0 0 1
doriden

SERUM
AWAL optimum an n n
PUSLING/ MANLING/
0

Kabupaten Lebak
NIP. 19820101 200801 1 017 Nip. 19700603 199203 1 006 Nip. 19650404 198808 1 018
PUSKESMAS
Unit Penerima/PUSKESMAS : CIRINTEN Laporan Bulan NOVEMBER 2021

Kecamatan : CIRINTEN Permintaan Bulan DESEMBER 2021
Kabupaten : LEBAK
Provinsi : BANTEN

AWAL Optimum an n n
4 ALBENDAZOLE TABLET 400 MG BOX @30 TAB 0 0 0 0 1860 0 0 120
5 ALKOHOL 70% 1L BTL @ 1000ML 0 0 0 0 0 0 0 2
8 BTL @60ML 0 0 0 0 0 0 0 50
SIRUP 15 MG/ 5 ML)

22 BOX @100 TAB 100 0 100 0 0 100 0 0 BLUD

25 BOX @100 TAB 300 0 300 0 0 300 0 0
600 MG)
27 B12 (CYANOCOBALAMIN) CAIRAN INJEKSI BOX@100AMP 0 200 200 10 0 190 0 0 BLUD

29 BOX@12TUBE 18 24 42 12 0 30 0 48
31 BOTOL 500ML 0 0 0 0 0 0 0 20
)
38 CETIRIZINE CAPSUL 10 MG BOX @100 TAB 0 2000 2000 300 0 1700 0 0 BLUD

44 BOX@100TAB 200 0 200 0 0 200 0 0
25 MG
45 BOX@100TAB 0 0 0 0 0 0 0 1000
MG

76 BOX@100TAB 900 500 1400 0 0 1400 0 0
EKSPEKTORAN)
84 BOX@50TAB 0 0 0 0 0 0 0 0
ENTERIK 50 MG)
88 KETOROLAC INJEKSI 30 MG/ML BOX@12AMPUL 0 100 100 60 0 40 0 0 BLUD
89 BOX@12TUBE 0 0 0 0 0 0 0 24

90 AMPUL 0 0 0 0 0 0 0 10
INJEKSI 30 MG)
93 BOX@20AMPUL 75 100 175 20 0 155 0 0
CAIRAN INJEKSI)
95 METFORMIN TABLET 500 MG BOX@100TAB 0 4000 4000 200 0 3800 0 0 BLUD
96 BOX@100TAB 1000 0 1000 0 0 1000 0 0 BLUD
SELAPUT 0,125 MG
98 DUS@60BTL 0 0 0 0 0 0 0 60
5 MG/5 ML)
108 TABLET 0 0 0 0 0 0 0 100
20)
109 DUS@50BTL 0 0 0 0 0 0 0 50
NIPIS 100 ML)
112 OXYTETRACYCLINE SALEP MATA 1% TUBE 0 0 0 0 0 0 0 25
113 DUS@56BTL 0 0 0 0 0 0 0 50
(60mg/0,6ml)
115 PARACETAMOL TABLET 500 MG BOX@100TAB 800 7000 7800 3200 0 4600 0 5000 BLUD
117 BOX@30AMPUL 0 20 20 0 0 20 0 0 BLUD
10Mg/ML
118 BOX@10 AMPUL 0 0 0 0 0 0 0 100
119 BOX@30AMPUL 0 0 0 0 0 0 0 60
MG/ML
120 BOX@100TAB 800 0 800 0 0 800 0 0 BLUD
MG
122 POVIDON 1000ML BOTOL 0 0 0 0 0 0 0 1
129 RANITIDINE INJEKSI 25 MG/ML BOX@10AMPUL 0 100 100 60 0 40 0 0 BLUD
132 RIVANOL BOTOL 0 0 0 0 0 0 0 5
133 BLISTER@5 AMPUL 0 50 50 5 0 45 0 0 BLUD
NEBULIZER)
136 BOX@24POT 0 0 0 0 0 0 0 24

141 VIAL 0 0 0 0 0 0 0 1
CAIRAN IH 2,5MG/ML
149 ZINC SIRUP (ZIRKUM KID Sirop 60 Ml) BOTOL 0 100 100 10 0 90 0 0 BLUD

AWAL optimum an n n

3 TUBE 0 0 0 0 0 0 0 24
DIKLOFENAK SALEP))

9 BOX@150TAB 150 600 750 300 0 450 0 300
TABLET)
10 BOX @ 30 TAB 0 0 0 0 360 0 0 120
Coated Tablet)
11 BOX@100TAB 0 0 0 0 0 0 0 500
12 BOX@100TAB 0 0 0 0 0 0 0 300
13 BOX@100TAB 0 0 0 0 0 0 0 500
GULA)
14 BOX@100TAB 400 0 400 100 0 300 0 0

15 BOX @100 TAB 0 500 500 500 0 0 0 1000
16 TABLET 0 0 0 0 0 0 0 200
TABLET)
17 BOX @100 TAB 0 0 0 0 0 0 0 500
18 BOX @100 TAB 0 0 0 0 0 0 0 100
(MOLANEURON TABLET)
19 BOX @ 5 AMPUL 0 0 0 0 0 0 0 10
22 DUS @50 BTL 50 0 50 30 0 20 0 50
ML)
24 BOX @100 TAB 0 0 0 0 0 0 0 3000
OBAT ANALGESIK
TABLET
26 BOX @ 300 TAB 0 0 0 0 0 0 0 300
(METANEURON)
29 BOX@ 300 TAB 0 0 0 0 0 0 0 900
30STRIP @10TABLET)
30 DUS @50 BTL 8 0 8 0 0 8 0 50
BOTOL 100 ML)

32 DUS @60 BTL 0 0 0 0 0 0 0 60
BOTOL 60 ML)
33 DUS @50 BTL 0 0 0 0 0 0 0 50
BOTOL @ 60 ML)
34 VIAL 0 0 0 0 0 0 0 10

35 BOX @ 160 TAB 0 0 0 0 0 0 0 160

36 BOTOL 34 0 34 10 0 24 0 0
(LEXACROL SUSPENSI)

42 TABLET 0 0 0 0 0 0 0 200
(PRENAMIA)

AWAL optimum an n n
3 PCS 0 0 0 0 0 0 0 100
DARAH)
7 DISPOSIBLE 1ML BOX @100 PIECE 0 0 0 0 0 0 0 100
9 DISPOSIBLE 5 ML BOX @100 PIECE 0 1000 1000 100 0 900 0 0 BLUD
BLUD
13 EXAMINATION GLOVES SIZE M PAIRS 0 7800 7800 1300 0 6500 0 0
5000
15 EXAMINATION GLOVES SIZE L BOX@100PCS 0 2000 2000 0 0 2000 0 0
18 HB HEMOGLOBIN TEST STRIP STRIP 0 0 0 0 0 0 0 0
19 Infusion Set ANAK (COSMOMED) PIECES 0 0 0 0 0 0 0 100
37 KASA 4 X 15 PACK@10ROLL 0 0 0 0 0 0 0 0
38 KASA 40 M X 80 CM KOTAK 0 0 0 0 0 0 0 0
41 MASKER (HIJAB) PACK@50ROLL 700 0 700 200 0 500 0 0

42 ROLL 0 0 0 0 0 0 0 1

47 PLASTER PCS 0 0 0 0 0 0 0 50
49 PIECES 0 0 0 0 0 0 0 2
Roll)

56 UNDERPAD (COSMOMED ) PIECES 0 40 40 30 0 10 0 100 BLUD
OBAT GIGI
optimum an n n
5 Eugnol BTL 0 0 0 0 0 0 0 1
7 KOTAK 0 0 0 0 0 0 0 1


13 SET 0 0 0 0 0 0 0 1
14 BTL 0 0 0 0 0 0 0 1
doriden

SERUM
AWAL optimum an n n
PUSLING/ MANLING/
0

Kabupaten Lebak
NIP. 19820101 200801 1 017 Nip. 19700603 199203 1 006 Nip. 19650404 198808 1 018

Lplpo PKM Cirinten 2021

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LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN O

Unit Penerima/PUSKESMAS : CIRINTEN

1 ACEYLCYSTEIN Capsul 200 Mg BOX @60 TAB 0 0

10 AMINOPHYLLINE CAIRAN INJEKSI 24 MG/ML BOX @30 AMPUL 0 0

11 AMINOPHYLLINE TABLET 200 MG BTL @ 100 TAB 0 0

23 ASAM ASCORBAT (VITAMIN C) TABLET 50 MG TABLET 500 0

24 ASAM MEFENAMAT TABLET 500 MG BOX @100 TAB 0 0

28 BEDAK SALYCIL BOX@100DUS 0 0

41 CHLORAMPHENICOL SUSPENSI 125 MG/5 ML BOX@50BTL 0 0

42 CHLORAMPHENICOL TETES MATA 0.5% BOTOL 0 0

63 ERYTHROMYCIN SIRUP KERING 200 MG/5 ML BOTOL 0 0

64 FUROSEMID TABLET BOX@100TAB 400 0

LANSOPRAZOLE INJEKSI (PROSOGAN SERBUK

SALEP ANTIBAKTERI DOEN KOMBINASI:

OBAT GENERIK BERLOGO

2 ANALGETIK ANTIPIRETI (HOLIMOL CAPTABS) BOX@100TAB 0 0

ANALGETIK GEL (VOLTADEX GEL (NATRIUM

MULTIVITAMIN ANTIOKSIDAN (ANTOKSID

OBAT FLU DAN BATUK (DEXTRAL SIRUP

OBAT GANGGUAN SISTEM PENCERNAAN

OBAT GANGGUAN SISTEM PENCERNAAN

38 OBAT HERBAL MATA (OCUGARD CAPSULE) CAPSULE 0 0

40 PROBIOTIK (PROBIOKID) SASCET 1 0

BAHAN MEDIS HABIS PAKAI

Multi-Monitoring System (Total Cholesterol,

43 Nasal Oxygen Cannula (COSMO MED) TUBE 44 0

54 Test Uric Acid Strip(Strip 25's) BeneCheck BOX @ 10 STRIP 15 0

55 Umbilical Cord Clamp (ONEMED) BOX @50 PIECE 0 0

NO NAMA OBAT Kemasan Sisa Stok Penerimaan

1 Bahan Cetak Alginate Hygident PACK 0 0

8 Kalsium Hidroksida Pasta/calsidor doriden BTL 0 0

9 Klorfenol Kanfer Menthol/CHKM BTL 1 0

15 Topical anestesi gel 28/Alpha -Cain Stroberry BTL 0 0

16 Silver Amalgam Serbuk BTL 1 0

2 SERUM ANTI BISA ULAR POLIVALEN INJEKSI AMPUL 0 0

Mengetahui/Menyetujui Yang Menyerahkan

Agus Darsono, S.Sos, M.Si Edi Purnomo, SKM, M.Kes

Laporan Bulan DESEMBER 2020

Stok Perminta Pemberia Keterang

500 100 0 400 0 0

100 100 0 0 0 200

400 400 0 0 0 500

1000 200 0 800 0 0

100 100 0 0 0 200

700 700 0 0 0 1000

2000 800 0 1200 0 0

stok Perminta Pemberia Keterang

300 300 0 0 0 900

200 200 0 0 0 300

100 100 0 0 0 300

180 180 180 0 0 0 ed

0 780 780 -780 0 0 ED

300 300 0 0 0 600

450 450 0 0 0 600

stok Perminta Pemberia Keterang

123 10 0 113 0 0 DAI

stok Perminta Pemberia Keterang

stok Perminta Pemberia Keterang

Yang Meminta Yang Menerima

H.Madnur Taufik,S.Sos,SKM.MM Ahmad fathurohman,Amd.farm

Unit Penerima/PUSKESMAS : CIRINTEN

1 ACEYLCYSTEIN Capsul 200 Mg BOX @60 TAB 0 0

10 AMINOPHYLLINE CAIRAN INJEKSI 24 MG/ML BOX @30 AMPUL 0 0