PUSKESMAS : LIMBUR LUBUK MENGKUANG BULAN : DESEMBER

KODE : LIMBUR LUBUK MENGKUANG TAHUN : 2022

KABUPATEN : BUNGO
PROPINSI : JAMBI
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( L B 2 )
STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
1 2 3 4 5 6=(4+5 ) 7 8=(6-7 ) 9 10 11
1 ACT( Artesunat 50 mg + Amodiaquin 200 mg ) tablet 0 0 0 0 0
2 Alat Suntik Sekali Pakai 1 ml pcs 100 0 100 0 100
3 Alat Suntik sekali Pakai 2.5 ml pcs 100 0 100 0 100
4 Alat Suntik sekali Pakai 5 ml pcs 200 0 200 100 100
5 Albendazol 400 mg tablet 0 0 0 0 0
6 Alkohol Swab kotak 14 0 14 4 10
7 Alopurinol 100 mg tablet 5300 0 5300 800 4500
8 Ambroxol tablet tablet 0 0 0 0 0
9 Ambroxol syrup 15 mg / ml botol 0 0 0 0 0
10 Aminophylin 200 mg tablet 0 0 0 0 0
11 Aminophylin injeksi ampul 60 0 60 0 60
12 Amitriptilin Hcl 25 mg tablet 0 0 0 0 0
13 Amlodipin 5 mg tablet 3200 0 3200 1000 2200
14 Amoksisilin 250 mg kapsul 0 0 0 0 0
15 Amoksisilin 500 mg kaplet 8500 0 8500 6000 2500
16 Amoksisilin syrup botol 0 0 0 0 0
17 Antasida Doen Komb syrup botol 0 0 0 0 0
18 Antasida Doen kombinasi tablet 6000 0 6000 400 5600
19 Anti Bakteri Doen salep tube 0 0 0 0 0
20 Anti Fungi Doen Komb.( Whitfield ) pot 96 0 96 32 64
21 Antihemoroid suppos suppos 60 0 60 20 40
22 Antimigrain Doen ( Ergotamin ) tablet 0 0 0 0 0
23 Aqua proinjeksi vial 0 0 0 0 0
24 Artemeter Injeksi 1 ml : 80 mg ampul 0 0 0 0 0
25 Artesunate injeksi 60 ml vial 0 0 0 0 0
26 Asam Ascorbat ( Vit C ) 50 mg tablet 0 0 0 0 0
27 Asam Ascorbat ( Vit C ) 250 mg tablet 0 0 0 0 0
28 Asam Mefenamat 500 mg kaplet 6300 0 6300 300 6000
29 Asam Traneksamat injeksi ampul 0 0 0 0 0
30 Asiklovir 200 mg tablet 0 0 0 0 0
31 Asiklovir 400 mg tablet 1700 0 1700 0 1700
32 Asiklovir crem 5 % tube 0 0 0 0 0
33 Atapulgit 600 mg tablet 100 0 100 0 100
34 Atropin sulfat 0.5 mg tablet 0 0 0 0 0
35 Atropin Sulfat injeksi ampul 0 0 0 0 0
36 Betametason crem tube 75 0 75 25 50
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
37 Cat Gut sack 180 0 180 80 100
38 Captopril 25 mg tablet 4600 0 4600 0 4600
39 Captopril 12.5 mg tablet 3400 0 3400 0 3400
40 Cefadroxil 500 mg tablet 0 0 0 0 0
41 Cefadroxil syrup botol 0 0 0 0 0
42 Cefotaxim injeksi vial 0 0 0 0 0
43 Ceterizin syrup botol 150 0 150 50 100
44 Cetirizin 10 mg tablet 2500 0 2500 1200 1300
45 Ciproploxacin 500 mg tablet 0 0 0 0 0
46 Deksametason 0.5 mg tablet tablet 0 0 0 0 0
47 Deksametason injeksi ampul 50 0 50 50 0
48 Devitalisasi pasta btl 0 0 0 0 0
49 Diazepam 2 mg tablet 0 0 0 0 0
50 Diazepam injeksi 5 mg / 1 ml ampul 0 0 0 0 0
51 Diazepam Rectal 5 mg / 2.5 ml tube 0 0 0 0 0
52 Difenhidramin Hcl injeksi ampul 180 0 180 0 180
53 Digoxin 0.25 mg tablet 0 0 0 0 0
54 Dimenhidrinat 50 mg tablet 900 0 900 100 800
55 Domperidon 10 mg tablet 1000 0 1000 500 500
56 Doxycyklin 100 mg kapsul 0 0 0 0 0
57 E t a n o l 70 % 1 Liter botol 10 0 10 0 10
58 E t a n o l 70 % 100 ml botol 40 0 40 5 35
59 Efedrin Hcl 25 mg tablet 0 0 0 0 0
60 Epinefrin Hcl injeksi ampul 0 0 0 0 0
61 Erytromycin 500 mg kaplet 800 0 800 200 600
62 Erytromycin syrup botol 100 0 100 30 70
63 Etakridin ( Rivanol ) cairan ampul 48 0 48 24 24
64 Etil klorida semprot tabung 7 0 7 2 5
65 Eugenol cairan btl 0 0 0 0 0
66 Fenobarbital 30 mg tablet 0 0 0 0 0
67 Fenobarbital injeksi 50 mg / ml ampul 0 0 0 0 0
68 Fenol gliserol tetes telinga botol 180 0 180 28 152
69 Fitomenadion ( vit K ) 10 mg tab tablet 1000 0 1000 500 500
70 Fitomenadion ( vit K ) 10 mg / 1 ml ampul 180 0 180 80 100
71 Foly Cateter no 16 pices 20 0 20 10 10
72 Foly cateter No 18 pices 20 0 20 10 10
73 Furosemid 40 mg tablet 500 0 500 0 500
74 Garam Oralit 200 ml bungkus 1000 0 1000 500 500
75 Gentamycin injeksi ampul 0 0 0 0 0
76 Gentamycin salep mata 0.3 % tube 24 0 24 0 24
77 Gentamycin tetes mata 0.3 % tube 24 0 24 24 0
78 Gentian violet 1 % botol 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
79 Glass Ionomer Cemen ( GC IX ) set 0 0 0 0 0
80 Glibenklamid 5 mg tablet 900 0 900 100 800
81 Glikasida 80 mg tablet 0 0 0 0 0
82 Gliseril Guayakolat 100 mg tablet 0 0 0 0 0
83 Glukosa Lar infus 10 % kolf 0 0 0 0 0
84 Glukosa lar infus 5 % kolf 100 0 100 0 100
85 Griseofulvin 125 mg tablet 900 0 900 300 600
86 Haloperidol 0.5 mg tablet 0 0 0 0 0
87 Haloperidol 1.5 mg tablet 0 0 0 0 0
88 Haloperidol 5 mg tablet 0 0 0 0 0
89 Haloperidol injeksi ampil 0 0 0 0 0
90 Hand Scoond pasang 800 0 800 300 500
91 Hand scoond steril pices 100 0 100 0 100
92 HCl 0,1 N botol 0 0 0 0 0
93 Hidrogen Peroksida 3 % (H2O2) botol 0 0 0 0 0
94 Hidroklortiazid ( HCT ) 25 mg tablet 800 0 800 200 600
95 Hidrokortison crem 2.5 % tube 120 0 120 0 120
96 Ibuprofen 200 mg tablet 0 0 0 0 0
97 Ibuprofen 400 mg tablet 2000 0 2000 0 2000
98 Ibuprofen syrup 100 mg / ml botol 0 0 0 0 0
99 Infusion set Anak bungkus 250 0 250 100 150
100 Infusion set Dewasa bungkus 100 0 100 0 100
101 Isosorbit Dinitrat 5 mg tablet 300 0 300 50 250
102 IV cateter no. 18 G buah 50 0 50 0 50
103 IV cateter no. 20 G buah 0 0 0 0 0
104 IV cateter no. 22 G buah 100 0 100 50 50
105 IV cateter no. 24 G buah 100 0 100 50 50
106 Kalsium hidroksida pasta pot 0 0 0 0 0
107 Kalsium Laktat 500 mg tablet 2500 0 2500 500 2000
108 Kapas Pembalut 250 gr bungkus 20 0 20 0 20
109 Karbamazepin 200 mg tablet 0 0 0 0 0
110 Kasa pembalut 4 x 5 cm rol 0 0 0 0 0
111 Kasa Pembalut 3 x 10 cm rol 50 0 50 0 50
112 Kasa Pembalut 3 x 15 cm rol 150 0 150 0 150
113 Kasa Pembalut 3 x 5cm rol 100 0 100 0 100
114 Kasa 16 x 16 cm kotak 100 0 100 0 100
115 Keterolak injeksi vial 0 0 0 0 0
116 Ketokonazol 200 mg tablet 1200 0 1200 700 500
117 Ketokonazol krim 2.5 % tube 75 0 75 25 50
118 Kinina 200 mg tablet tablet 0 0 0 0 0
119 Kinina injeksi ampul 0 0 0 0 0
120 Kloramfenikol 250 mg kapsul 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
121 Kloramfenikol salep kulit 2 % tube 48 0 48 24 24
122 Kloramfenikol salep mata 1 % tube 0 0 0 0 0
123 Kloramfenikol tetes Mata botol 0 0 0 0 0
124 Klorfeniramin maleat ( CTM ) 4 mg tablet 0 0 0 0 0
125 Klorokina posfat 250 mg tablet 0 0 0 0 0
126 Klorpromazin Hcl 100 mg tablet 0 0 0 0 0
127 Klorpromazin Hcl 25 mg tablet 0 0 0 0 0
128 Klorpromazin Hcl inj 25 mg / 1 ml ampul 0 0 0 0 0
129 Komb.Primetamin + Sulfadoxin 500 mg tablet 0 0 0 0 0
130 Kotrimoxazol syrup botol 150 0 150 50 100
131 Kotrimoxazol 480 mg tablet 1500 0 1500 0 1500
132 L I s o l 1 Liter botol 0 0 0 0 0
133 Larutan Benedict botol 0 0 0 0 0
134 Larutan Eosin 2 % botol 0 0 0 0 0
135 Larutan Etanol asam botol 0 0 0 0 0
136 Larutan giemsa stain botol 0 0 0 0 0
137 Larutan Karbol Fuksin botol 0 0 0 0 0
138 Larutan Metilan Biru botol 0 0 0 0 0
139 Larutan Turk botol 0 0 0 0 0
140 Lidocain Comp injeksi ampul 110 0 110 0 110
141 Loperamid 2 mg tablet 1200 0 1200 200 1000
142 Loratadin 10 mg tablet 1000 0 1000 500 500
143 Masker Ear Lop pices 450 0 450 150 300
144 Masker Ties On pices 0 0 0 0 0
145 Masker N 95 pices 0 0 0 0 0
146 Metergin 0.125 mg tablet 0 0 0 0 0
147 Metergin injeksi 0.200 mg / 1 ml Metergin inje 0 0 0 0 0
148 Metformin 500 mg tablet 2000 0 2000 700 1300
149 Metil Prednisolon 4 mg tablet 1000 0 1000 0 1000
150 Metoklopramid 10 mg tablet 400 0 400 100 300
151 Metolon Injeksi 5 mg / 2 ml ampul 0 0 0 0 0
152 Metronidazol suspensi botol 0 0 0 0 0
153 Metronidazol tab 500 mg tablet 0 0 0 0 0
154 Miconazol crem tube 36 0 36 0 36
155 Monoklorkamfer mentol cair botol 0 0 0 0 0
156 Multi Vitamin syrup botol 0 0 0 0 0
157 Mumiying Pasta pot 0 0 0 0 0
158 Natrium Bikarbonat 500 mg tablet 0 0 0 0 0
159 Natrium Diklifenak 50 mg tablet 1500 0 1500 500 1000
160 Natrium Klorida 0.9 % kolf 100 0 100 0 100
161 Nipedipin 10 mg tablet 0 0 0 0 0
162 Nistatin 100.000 IU tablet 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
163 Nistatin 500.000 IU tablet 0 0 0 0 0
164 Obat Anti Tuberkulosis Kategori I paket 0 0 0 0 0
165 Obat Anti Tuberkulosis Kategori II paket 0 0 0 0 0
166 Obat Anti Tuberkulosis Kategori anak paket 0 0 0 0 0
167 Obat Anti Tuberkulosis Kategori Sisipan paket 0 0 0 0 0
168 Obat Batuk hitam ( OBH ) botol 0 0 0 0 0
169 Oksitetrasiklin 3 % salep kulit tube 0 0 0 0 0
170 Oksitetrasiklin Hcl 1 % salep mata tube 0 0 0 0 0
171 Oksitetrasiklin Hcl inj 50 mg - 10 ml vial 0 0 0 0 0
172 Oksitocin Injeksi ampul 100 0 100 0 100
173 Omeprazol 20 mg tablet 1500 0 1500 100 1400
174 Ondansetron injeksi ampul 0 0 0 0 0
175 Papaverin 40 mg tablet 0 0 0 0 0
176 Parasetamol 100 mg tablet 0 0 0 0 0
177 Parasetamol 500 mg tablet 4500 0 4500 500 4000
178 Parasetamol Drop botol 0 0 0 0 0
179 Parasetamol Syrup botol 300 0 300 50 250
180 Perak Sulfadiazin krim tube 0 0 0 0 0
181 Pirantel Pamoat 365 mg tablet 700 0 700 0 700
182 Piridoxin Hcl 10 mg tablet 1500 0 1500 700 800
183 Piroxicam 10 mg kapsul 0 0 0 0 0
184 Plester 5 x 500 inchi rol 20 0 20 0 20
185 Policlen botol 0 0 0 0 0
186 Prednison 5 mg tablet 3000 0 3000 600 2400
187 Primaquin 15 mg tablet 0 0 0 0 0
188 Propanolol Hcl 10 mg tablet 0 0 0 0 0
189 Propiltiourasil ( PTU ) 100 mg tablet 0 0 0 0 0
190 Ranitidin 150 mg tablet 5000 0 5000 0 5000
191 Ranitidin injeksi ampul 0 0 0 0 0
192 Resperidon 2 mg tablet 0 0 0 0 0
193 Ringer Laktat lar infus kolf 50 0 50 20 30
194 Salbutamol 2 mg tablet 300 0 300 300 0
195 Salbutamol 4 mg tablet 0 0 0 0 0
196 Salep 2 - 4 pot 65 0 65 20 45
197 Salisil bedak 2 % bungkus 0 0 0 0 0
198 Sefiksin 100 mg tablet 0 0 0 0 0
199 Semen Seng Posfat serbuk dan cairan set 0 0 0 0 0
200 Serum Anti Bisa Ular Polivalen 50 ml vIal 1 0 1 0 1
201 Serum Anti Tetanus 1.500 IU (ATS ) ampul 1 0 1 0 1
202 Sianokobolamin ( B12) tablet tablet 0 0 0 0 0
203 Sianokobolamin injeksi ( Vit B 12 ) ampul 0 0 0 0 0
204 Silk 18 mm x 75 cm sachet 36 0 36 12 24
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
205 Silk 25 mm x 75 cm sachet 36 0 36 12 24
206 Simvastatin 10 mg tablet 2500 0 2500 500 2000
207 Sulfasetamid natrium Tetes mata 15 % botol 0 0 0 0 0
208 Tablet Tambah Darah tablet 58500 0 58500 1500 57000
209 Temporary Stoping Fletcher dan cairan botol 0 0 0 0 0
210 Tetrasiklin Hcl 250 mg kapsul 0 0 0 0 0
211 Tetrasiklin Hcl 500 mg kapsul 0 0 0 0 0
212 Thiamin Hcl ( Vit B1 ) injeksi ampul 0 0 0 0 0
213 Thiamin Hcl tablet 50 mg tablet 3000 0 3000 500 2500
214 Tramadol injeksi 50 mg / ml ampul 0 0 0 0 0
215 Trihexilpenidil 2 mg tablet 0 0 0 0 0
216 Urin Bag pices 20 0 20 20 0
217 Vitamin A 100.000 IU kapsul 0 0 0 0 0
218 Vitamin A 200.000 IU kapsul 0 0 0 0 0
219 Vitamin B Complek tablet 2000 0 2000 300 1700
220 Xilocain spray tabung 0 0 0 0 0
221 Yodium Povidon larutan 30 ml botol 20 0 20 10 10
222 Yodium Povidon larutan 300 ml botol 25 0 25 10 15
223 Zinc tablet 570 0 570 70 500
224 Zinc syrup 20 mg / 5 ml botol 24 0 24 0 24
225 Betahistine mesylate 6 mg tablet 1500 0 1500 500 1000
226 Kompolax sirup botol 44 0 44 28 16
227 Miconazole serbuk botol 0 0 0 0 0
228 Pyrantel pamoat tablet 0 0 0 0 0
229 Scabimite tube 30 0 30 10 20
230 Griseofulvin 250 mg tablet 0 0 0 0 0
231 Aminophylin 150 mg tablet 0 0 0 0 0
232 Amoksisilin syrup 125 mg/ml botol 700 0 700 200 500
233 Betametason diproplonoat crem tube 0 0 0 0 0
234 Tetagam injeksi vial 4 0 4 0 4
235 Desinfectan 500 ml botol 0 0 0 0 0
236 Desinfectan 1 Liter botol 1 0 1 1 0
237 Stimuno Forte tablet 2450 0 2450 100 2350
238 Asam ascorbat 500 mg tablet 15000 0 15000 2500 12500
239 Hyocine Butyl Bromida 10 mg tablet 200 0 200 0 200
240 Hand Sanitizer 500 ml botol 10 0 10 6 4
241 Kapas 100 gram rol 10 0 10 0 10
242 Salbutamol Syr botol 10 0 10 10 0
243 Domperidone Syr botol 0 0 0 0 0
244 Herbacof syr botol 0 0 0 0 0
JUMLAH KUNJUNGAN
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
Mengetahui
Pimpinan Puskesmas Pelapor
Limbur Lubuk Mengkuang

SUTARI, SKM Ranny Fitriany, Amd.Farm

NIP. 197807132008011004 NIP. 19920405 201503 2 004
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT

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PUSKESMAS : LIMBUR LUBUK MENGKUANG BULAN : Januari
KODE : LIMBUR LUBUK MENGKUANG TAHUN : 2023
KABUPATEN : BUNGO
PROPINSI : JAMBI
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( L B 2 )
STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
1 2 3 4 5 6=(4+5 ) 7 8=(6-7 ) 9 10 11
1 ACT( Artesunat 50 mg + Amodiaquin 200 mg ) tablet 0 0 0 0 0
2 Alat Suntik Sekali Pakai 1 ml pcs 100 0 100 50 50 500
3 Alat Suntik sekali Pakai 2.5 ml pcs 100 0 100 100 0 500
4 Alat Suntik sekali Pakai 5 ml pcs 100 0 100 100 0
5 Albendazol 400 mg tablet 0 0 0 0 0
6 Alkohol Swab kotak 10 0 10 10 0 50
7 Alopurinol 100 mg tablet 4500 0 4500 1000 3500 1000
8 Ambroxol tablet tablet 0 0 0 0 0 2000
9 Ambroxol syrup 15 mg / ml botol 0 0 0 0 0 500
10 Aminophylin 200 mg tablet 0 0 0 0 0
11 Aminophylin injeksi ampul 60 0 60 10 50 30
12 Amitriptilin Hcl 25 mg tablet 0 0 0 0 0
13 Amlodipin 5 mg tablet 2200 0 2200 1000 1200 1000
14 Amoksisilin 250 mg kapsul 0 0 0 0 0 1000
15 Amoksisilin 500 mg kaplet 2500 0 2500 900 1600 5000
16 Amoksisilin syrup botol 0 0 0 0 0 300
17 Antasida Doen Komb syrup botol 0 0 0 0 0 500
18 Antasida Doen kombinasi tablet 5600 0 5600 1300 4300 5000
19 Anti Bakteri Doen salep tube 0 0 0 0 0
20 Anti Fungi Doen Komb.( Whitfield ) pot 64 0 64 0 64 100
21 Antihemoroid suppos suppos 40 0 40 40 0 100
22 Antimigrain Doen ( Ergotamin ) tablet 0 0 0 0 0
23 Aqua proinjeksi vial 0 0 0 0 0 200
24 Artemeter Injeksi 1 ml : 80 mg ampul 0 0 0 0 0
25 Artesunate injeksi 60 ml vial 0 0 0 0 0
26 Asam Ascorbat ( Vit C ) 50 mg tablet 0 0 0 0 0 3000
27 Asam Ascorbat ( Vit C ) 250 mg tablet 0 0 0 0 0
28 Asam Mefenamat 500 mg kaplet 6000 0 6000 2000 4000 3000
29 Asam Traneksamat injeksi ampul 0 0 0 0 0 500
30 Asiklovir 200 mg tablet 0 0 0 0 0
31 Asiklovir 400 mg tablet 1700 0 1700 700 1000 500
32 Asiklovir crem 5 % tube 0 0 0 0 0 100
33 Atapulgit 600 mg tablet 100 0 100 100 0
34 Atropin sulfat 0.5 mg tablet 0 0 0 0 0
35 Atropin Sulfat injeksi ampul 0 0 0 0 0
36 Betametason crem tube 50 0 50 0 50
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
37 Cat Gut sack 100 0 100 100 0 100
38 Captopril 25 mg tablet 4600 0 4600 600 4000 3000
39 Captopril 12.5 mg tablet 3400 0 3400 400 3000
40 Cefadroxil 500 mg tablet 0 0 0 0 0
41 Cefadroxil syrup botol 0 0 0 0 0
42 Cefotaxim injeksi vial 0 0 0 0 0 300
43 Ceterizin syrup botol 100 0 100 35 65 100
44 Cetirizin 10 mg tablet 1300 0 1300 1200 100 3000
45 Ciproploxacin 500 mg tablet 0 0 0 0 0
46 Deksametason 0.5 mg tablet tablet 0 0 0 0 0 5000
47 Deksametason injeksi ampul 0 0 0 0 0 100
48 Devitalisasi pasta btl 0 0 0 0 0
49 Diazepam 2 mg tablet 0 0 0 0 0
50 Diazepam injeksi 5 mg / 1 ml ampul 0 0 0 0 0
51 Diazepam Rectal 5 mg / 2.5 ml tube 0 0 0 0 0
52 Difenhidramin Hcl injeksi ampul 180 0 180 180 0
53 Digoxin 0.25 mg tablet 0 0 0 0 0
54 Dimenhidrinat 50 mg tablet 800 0 800 800 0
55 Domperidon 10 mg tablet 500 0 500 0 500
56 Doxycyklin 100 mg kapsul 0 0 0 0 0
57 E t a n o l 70 % 1 Liter botol 10 0 10 5 5 50
58 E t a n o l 70 % 100 ml botol 35 0 35 15 20 50
59 Efedrin Hcl 25 mg tablet 0 0 0 0 0
60 Epinefrin Hcl injeksi ampul 0 0 0 0 0
61 Erytromycin 500 mg kaplet 600 0 600 100 500 1000
62 Erytromycin syrup botol 70 0 70 20 50 120
63 Etakridin ( Rivanol ) cairan ampul 24 0 24 24 0 50
64 Etil klorida semprot tabung 5 0 5 2 3 5
65 Eugenol cairan btl 0 0 0 0 0 5
66 Fenobarbital 30 mg tablet 0 0 0 0 0
67 Fenobarbital injeksi 50 mg / ml ampul 0 0 0 0 0
68 Fenol gliserol tetes telinga botol 152 0 152 8 144 100
69 Fitomenadion ( vit K ) 10 mg tab tablet 500 0 500 300 200
70 Fitomenadion ( vit K ) 10 mg / 1 ml ampul 100 0 100 100 0 100
71 Foly Cateter no 16 pices 10 0 10 10 0 20
72 Foly cateter No 18 pices 10 0 10 10 0 20
73 Furosemid 40 mg tablet 500 0 500 500 0
74 Garam Oralit 200 ml bungkus 500 0 500 0 500 300
75 Gentamycin injeksi ampul 0 0 0 0 0
76 Gentamycin salep mata 0.3 % tube 24 0 24 24 0 24
77 Gentamycin tetes mata 0.3 % tube 0 0 0 0 0 24
78 Gentian violet 1 % botol 0 0 0 0 0 10
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
79 Glass Ionomer Cemen ( GC IX ) set 0 0 0 0 0
80 Glibenklamid 5 mg tablet 800 0 800 300 500 500
81 Glikasida 80 mg tablet 0 0 0 0 0
82 Gliseril Guayakolat 100 mg tablet 0 0 0 0 0 500
83 Glukosa Lar infus 10 % kolf 0 0 0 0 0
84 Glukosa lar infus 5 % kolf 100 0 100 100 0 50
85 Griseofulvin 125 mg tablet 600 0 600 200 400
86 Haloperidol 0.5 mg tablet 0 0 0 0 0
87 Haloperidol 1.5 mg tablet 0 0 0 0 0
88 Haloperidol 5 mg tablet 0 0 0 0 0
89 Haloperidol injeksi ampil 0 0 0 0 0
90 Hand Scoond pasang 500 0 500 0 500 600
91 Hand scoond steril pices 100 0 100 0 100 100
92 HCl 0,1 N botol 0 0 0 0 0
93 Hidrogen Peroksida 3 % (H2O2) botol 0 0 0 0 0
94 Hidroklortiazid ( HCT ) 25 mg tablet 600 0 600 200 400
95 Hidrokortison crem 2.5 % tube 120 0 120 72 48 24
96 Ibuprofen 200 mg tablet 0 0 0 0 0 3000
97 Ibuprofen 400 mg tablet 2000 0 2000 500 1500 3000
98 Ibuprofen syrup 100 mg / ml botol 0 0 0 0 0
99 Infusion set Anak bungkus 150 0 150 100 50 200
100 Infusion set Dewasa bungkus 100 0 100 100 0 200
101 Isosorbit Dinitrat 5 mg tablet 250 0 250 250 0
102 IV cateter no. 18 G buah 50 0 50 0 50
103 IV cateter no. 20 G buah 0 0 0 0 0 100
104 IV cateter no. 22 G buah 50 0 50 0 50 200
105 IV cateter no. 24 G buah 50 0 50 0 50 200
106 Kalsium hidroksida pasta pot 0 0 0 0 0
107 Kalsium Laktat 500 mg tablet 2000 0 2000 400 1600
108 Kapas Pembalut 250 gr bungkus 20 0 20 20 0 20
109 Karbamazepin 200 mg tablet 0 0 0 0 0
110 Kasa pembalut 4 x 5 cm rol 0 0 0 0 0 20
111 Kasa Pembalut 3 x 10 cm rol 50 0 50 50 0 20
112 Kasa Pembalut 3 x 15 cm rol 150 0 150 150 0 20
113 Kasa Pembalut 3 x 5cm rol 100 0 100 100 0 20
114 Kasa 16 x 16 cm kotak 100 0 100 100 0 100
115 Keterolak injeksi vial 0 0 0 0 0 100
116 Ketokonazol 200 mg tablet 500 0 500 500 0 2000
117 Ketokonazol krim 2.5 % tube 50 0 50 50 0 50
118 Kinina 200 mg tablet tablet 0 0 0 0 0
119 Kinina injeksi ampul 0 0 0 0 0
120 Kloramfenikol 250 mg kapsul 0 0 0 0 0 1000
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
121 Kloramfenikol salep kulit 2 % tube 24 0 24 24 0 50
122 Kloramfenikol salep mata 1 % tube 0 0 0 0 0 50
123 Kloramfenikol tetes Mata botol 0 0 0 0 0 50
124 Klorfeniramin maleat ( CTM ) 4 mg tablet 0 0 0 0 0 5000
125 Klorokina posfat 250 mg tablet 0 0 0 0 0
126 Klorpromazin Hcl 100 mg tablet 0 0 0 0 0
127 Klorpromazin Hcl 25 mg tablet 0 0 0 0 0
128 Klorpromazin Hcl inj 25 mg / 1 ml ampul 0 0 0 0 0
129 Komb.Primetamin + Sulfadoxin 500 mg tablet 0 0 0 0 0
130 Kotrimoxazol syrup botol 100 0 100 35 65
131 Kotrimoxazol 480 mg tablet 1500 0 1500 1500 0 1000
132 L I s o l 1 Liter botol 0 0 0 0 0 20
133 Larutan Benedict botol 0 0 0 0 0
134 Larutan Eosin 2 % botol 0 0 0 0 0
135 Larutan Etanol asam botol 0 0 0 0 0
136 Larutan giemsa stain botol 0 0 0 0 0
137 Larutan Karbol Fuksin botol 0 0 0 0 0
138 Larutan Metilan Biru botol 0 0 0 0 0
139 Larutan Turk botol 0 0 0 0 0
140 Lidocain Comp injeksi ampul 110 0 110 110 0 200
141 Loperamid 2 mg tablet 1000 0 1000 100 900 1000
142 Loratadin 10 mg tablet 500 0 500 100 400
143 Masker Ear Lop pices 300 0 300 300 0 300
144 Masker Ties On pices 0 0 0 0 0 300
145 Masker N 95 pices 0 0 0 0 0 100
146 Metergin 0.125 mg tablet 0 0 0 0 0
147 Metergin injeksi 0.200 mg / 1 ml ampul 0 0 0 0 0
148 Metformin 500 mg tablet 1300 0 1300 300 1000 3000
149 Metil Prednisolon 4 mg tablet 1000 0 1000 1000 0 3000
150 Metoklopramid 10 mg tablet 300 0 300 300 0
151 Metolon Injeksi 5 mg / 2 ml ampul 0 0 0 0 0
152 Metronidazol suspensi botol 0 0 0 0 0
153 Metronidazol tab 500 mg tablet 0 0 0 0 0
154 Miconazol crem tube 36 0 36 36 0
155 Monoklorkamfer mentol cair botol 0 0 0 0 0
156 Multi Vitamin syrup botol 0 0 0 0 0 200
157 Mumiying Pasta pot 0 0 0 0 0
158 Natrium Bikarbonat 500 mg tablet 0 0 0 0 0
159 Natrium Diklifenak 50 mg tablet 1000 0 1000 500 500 1000
160 Natrium Klorida 0.9 % kolf 100 0 100 100 0 100
161 Nipedipin 10 mg tablet 0 0 0 0 0
162 Nistatin 100.000 IU tablet 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
163 Nistatin 500.000 IU tablet 0 0 0 0 0
164 Obat Anti Tuberkulosis Kategori I paket 0 0 0 0 0
165 Obat Anti Tuberkulosis Kategori II paket 0 0 0 0 0
166 Obat Anti Tuberkulosis Kategori anak paket 0 0 0 0 0
167 Obat Anti Tuberkulosis Kategori Sisipan paket 0 0 0 0 0
168 Obat Batuk hitam ( OBH ) botol 0 0 0 0 0 200
169 Oksitetrasiklin 3 % salep kulit tube 0 0 0 0 0 50
170 Oksitetrasiklin Hcl 1 % salep mata tube 0 0 0 0 0 50
171 Oksitetrasiklin Hcl inj 50 mg - 10 ml vial 0 0 0 0 0
172 Oksitocin Injeksi ampul 100 0 100 100 0 50
173 Omeprazol 20 mg tablet 1400 0 1400 700 700 3000
174 Ondansetron injeksi ampul 0 0 0 0 0 100
175 Papaverin 40 mg tablet 0 0 0 0 0
176 Parasetamol 100 mg tablet 0 0 0 0 0
177 Parasetamol 500 mg tablet 4000 0 4000 3100 900 5000
178 Parasetamol Drop botol 0 0 0 0 0 20
179 Parasetamol Syrup botol 250 0 250 30 220 200
180 Perak Sulfadiazin krim tube 0 0 0 0 0
181 Pirantel Pamoat 365 mg tablet 700 0 700 0 700
182 Piridoxin Hcl 10 mg tablet 800 0 800 400 400
183 Piroxicam 10 mg kapsul 0 0 0 0 0 3000
184 Plester 5 x 500 inchi rol 20 0 20 20 0 20
185 Policlen botol 0 0 0 0 0 20
186 Prednison 5 mg tablet 2400 0 2400 1400 1000 3000
187 Primaquin 15 mg tablet 0 0 0 0 0
188 Propanolol Hcl 10 mg tablet 0 0 0 0 0
189 Propiltiourasil ( PTU ) 100 mg tablet 0 0 0 0 0
190 Ranitidin 150 mg tablet 5000 0 5000 800 4200 5000
191 Ranitidin injeksi ampul 0 0 0 0 0 100
192 Resperidon 2 mg tablet 0 0 0 0 0
193 Ringer Laktat lar infus kolf 30 0 30 30 0 50
194 Salbutamol 2 mg tablet 0 0 0 0 0
195 Salbutamol 4 mg tablet 0 0 0 0 0
196 Salep 2 - 4 pot 45 0 45 20 25 50
197 Salisil bedak 2 % bungkus 0 0 0 0 0 50
198 Sefiksin 100 mg tablet 0 0 0 0 0 1000
199 Semen Seng Posfat serbuk dan cairan set 0 0 0 0 0
200 Serum Anti Bisa Ular Polivalen 50 ml vIal 1 0 1 0 1 1
201 Serum Anti Tetanus 1.500 IU (ATS ) ampul 1 0 1 0 1 1
202 Sianokobolamin ( B12) tablet tablet 0 0 0 0 0
203 Sianokobolamin injeksi ( Vit B 12 ) ampul 0 0 0 0 0
204 Silk 18 mm x 75 cm sachet 24 0 24 12 12 50
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
205 Silk 25 mm x 75 cm sachet 24 0 24 0 24 50
206 Simvastatin 10 mg tablet 2000 0 2000 600 1400 3000
207 Sulfasetamid natrium Tetes mata 15 % botol 0 0 0 0 0 50
208 Tablet Tambah Darah tablet 57000 0 57000 1500 55500
209 Temporary Stoping Fletcher dan cairan botol 0 0 0 0 0
210 Tetrasiklin Hcl 250 mg kapsul 0 0 0 0 0
211 Tetrasiklin Hcl 500 mg kapsul 0 0 0 0 0
212 Thiamin Hcl ( Vit B1 ) injeksi ampul 0 0 0 0 0
213 Thiamin Hcl tablet 50 mg tablet 2500 0 2500 1600 900 2000
214 Tramadol injeksi 50 mg / ml ampul 0 0 0 0 0
215 Trihexilpenidil 2 mg tablet 0 0 0 0 0
216 Urin Bag pices 0 0 0 0 0 20
217 Vitamin A 100.000 IU kapsul 0 0 0 0 0
218 Vitamin A 200.000 IU kapsul 0 0 0 0 0
219 Vitamin B Complek tablet 1700 0 1700 300 1400 3000
220 Xilocain spray tabung 0 0 0 0 0 5
221 Yodium Povidon larutan 30 ml botol 10 0 10 10 0 20
222 Yodium Povidon larutan 300 ml botol 15 0 15 5 10 20
223 Zinc tablet 500 0 500 500 0 1000
224 Zinc syrup 20 mg / 5 ml botol 24 0 24 24 0
225 Betahistine mesylate 6 mg tablet 1000 0 1000 500 500 2000
226 Kompolax sirup botol 16 0 16 16 0
227 Miconazole serbuk botol 0 0 0 0 0
228 Pyrantel pamoat tablet 0 0 0 0 0
229 Scabimite tube 20 0 20 0 20 100
230 Griseofulvin 250 mg tablet 0 0 0 0 0
231 Aminophylin 150 mg tablet 0 0 0 0 0
232 Amoksisilin syrup 125 mg/ml botol 500 0 500 35 465
233 Betametason diproplonoat crem tube 0 0 0 0 0
234 Tetagam injeksi vial 4 0 4 1 3
235 Desinfectan 500 ml botol 0 0 0 0 0 20
236 Desinfectan 1 Liter botol 0 0 0 0 0 2
237 Stimuno Forte tablet 2350 0 2350 550 1800
238 Asam ascorbat 500 mg tablet 12500 0 12500 1000 11500
239 Hyocine Butyl Bromida 10 mg tablet 200 0 200 0 200
240 Hand Sanitizer 500 ml botol 4 0 4 4 0
241 Kapas 100 gram rol 10 0 10 10 0
242 Salbutamol Syr botol 0 0 0 0 0 100
243 Domperidone Syr botol 0 0 0 0 0 100
244 Herbacof syr botol 0 0 0 0 0 200
JUMLAH KUNJUNGAN
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
Mengetahui
Pimpinan Puskesmas Pelapor
Limbur Lubuk Mengkuang

SUTARI, SKM Ranny Fitriany, Amd.Farm

NIP. 197807132008011004 NIP. 19920405 201503 2 004
PUSKESMAS : LIMBUR LUBUK MENGKUANG BULAN : Februari
KODE : LIMBUR LUBUK MENGKUANG TAHUN : 2023
KABUPATEN : BUNGO
PROPINSI : JAMBI
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( L B 2 )
STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
1 2 3 4 5 6=(4+5 ) 7 8=(6-7 ) 9 10 11
1 ACT( Artesunat 50 mg + Amodiaquin 200 mg ) tablet 0 0 0 0 0
2 Alat Suntik Sekali Pakai 1 ml pcs 50 0 50 20 30
3 Alat Suntik sekali Pakai 2.5 ml pcs 0 0 0 0 0
4 Alat Suntik sekali Pakai 5 ml pcs 0 0 0 0 0
5 Albendazol 400 mg tablet 0 0 0 0 0
6 Alkohol Swab kotak 0 0 0 0 0
7 Alopurinol 100 mg tablet 3500 0 3500 400 3100
8 Ambroxol tablet tablet 0 0 0 0 0
9 Ambroxol syrup 15 mg / ml botol 0 0 0 0 0
10 Aminophylin 200 mg tablet 0 0 0 0 0
11 Aminophylin injeksi ampul 50 0 50 50
12 Amitriptilin Hcl 25 mg tablet 0 0 0 0 0
13 Amlodipin 5 mg tablet 1200 0 1200 600 600
14 Amoksisilin 250 mg kapsul 0 0 0 0 0
15 Amoksisilin 500 mg kaplet 1600 0 1600 1600 0
16 Amoksisilin syrup botol 0 0 0 0 0
17 Antasida Doen Komb syrup botol 0 0 0 0 0
18 Antasida Doen kombinasi tablet 4300 0 4300 1600 2700
19 Anti Bakteri Doen salep tube 0 0 0 0 0
20 Anti Fungi Doen Komb.( Whitfield ) pot 64 0 64 50 14
21 Antihemoroid suppos suppos 0 0 0 0 0
22 Antimigrain Doen ( Ergotamin ) tablet 0 0 0 0 0
23 Aqua proinjeksi vial 0 0 0 0 0
24 Artemeter Injeksi 1 ml : 80 mg ampul 0 0 0 0 0
25 Artesunate injeksi 60 ml vial 0 0 0 0 0
26 Asam Ascorbat ( Vit C ) 50 mg tablet 0 0 0 0 0
27 Asam Ascorbat ( Vit C ) 250 mg tablet 0 0 0 0 0
28 Asam Mefenamat 500 mg kaplet 4000 0 4000 1600 2400
29 Asam Traneksamat injeksi ampul 0 0 0 0 0
30 Asiklovir 200 mg tablet 0 0 0 0 0
31 Asiklovir 400 mg tablet 1000 0 1000 0 1000
32 Asiklovir crem 5 % tube 0 0 0 0 0
33 Atapulgit 600 mg tablet 0 0 0 0 0
34 Atropin sulfat 0.5 mg tablet 0 0 0 0 0
35 Atropin Sulfat injeksi ampul 0 0 0 0 0
36 Betametason crem tube 50 0 50 25 25
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
37 Cat Gut sack 0 0 0 0 0
38 Captopril 25 mg tablet 4000 0 4000 600 3400
39 Captopril 12.5 mg tablet 3000 0 3000 400 2600
40 Cefadroxil 500 mg tablet 0 0 0 0 0
41 Cefadroxil syrup botol 0 0 0 0 0
42 Cefotaxim injeksi vial 0 0 0 0 0
43 Ceterizin syrup botol 65 0 65 35 30
44 Cetirizin 10 mg tablet 100 0 100 100 0
45 Ciproploxacin 500 mg tablet 0 0 0 0 0
46 Deksametason 0.5 mg tablet tablet 0 0 0 0 0
47 Deksametason injeksi ampul 0 0 0 0 0
48 Devitalisasi pasta btl 0 0 0 0 0
49 Diazepam 2 mg tablet 0 0 0 0 0
50 Diazepam injeksi 5 mg / 1 ml ampul 0 0 0 0 0
51 Diazepam Rectal 5 mg / 2.5 ml tube 0 0 0 0 0
52 Difenhidramin Hcl injeksi ampul 0 0 0 0 0
53 Digoxin 0.25 mg tablet 0 0 0 0 0
54 Dimenhidrinat 50 mg tablet 0 0 0 0 0
55 Domperidon 10 mg tablet 500 0 500 0 500
56 Doxycyklin 100 mg kapsul 0 0 0 0 0
57 E t a n o l 70 % 1 Liter botol 5 0 5 5 0
58 E t a n o l 70 % 100 ml botol 20 0 20 15 5
59 Efedrin Hcl 25 mg tablet 0 0 0 0 0
60 Epinefrin Hcl injeksi ampul 0 0 0 0 0
61 Erytromycin 500 mg kaplet 500 0 500 300 200
62 Erytromycin syrup botol 50 0 50 0 50
63 Etakridin ( Rivanol ) cairan ampul 0 0 0 0 0
64 Etil klorida semprot tabung 3 0 3 0 3
65 Eugenol cairan btl 0 0 0 0 0
66 Fenobarbital 30 mg tablet 0 0 0 0 0
67 Fenobarbital injeksi 50 mg / ml ampul 0 0 0 0 0
68 Fenol gliserol tetes telinga botol 144 0 144 0 144
69 Fitomenadion ( vit K ) 10 mg tab tablet 200 0 200 0 200
70 Fitomenadion ( vit K ) 10 mg / 1 ml ampul 0 0 0 0 0
71 Foly Cateter no 16 pices 0 0 0 0 0
72 Foly cateter No 18 pices 0 0 0 0 0
73 Furosemid 40 mg tablet 0 0 0 0 0
74 Garam Oralit 200 ml bungkus 500 0 500 300 200
75 Gentamycin injeksi ampul 0 0 0 0 0
76 Gentamycin salep mata 0.3 % tube 0 0 0 0 0
77 Gentamycin tetes mata 0.3 % tube 0 0 0 0 0
78 Gentian violet 1 % botol 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
79 Glass Ionomer Cemen ( GC IX ) set 0 0 0 0 0
80 Glibenklamid 5 mg tablet 500 0 500 300 200
81 Glikasida 80 mg tablet 0 0 0 0 0
82 Gliseril Guayakolat 100 mg tablet 0 0 0 0 0
83 Glukosa Lar infus 10 % kolf 0 0 0 0 0
84 Glukosa lar infus 5 % kolf 0 0 0 0 0
85 Griseofulvin 125 mg tablet 400 0 400 200 200
86 Haloperidol 0.5 mg tablet 0 0 0 0 0
87 Haloperidol 1.5 mg tablet 0 0 0 0 0
88 Haloperidol 5 mg tablet 0 0 0 0 0
89 Haloperidol injeksi ampil 0 0 0 0 0
90 Hand Scoond pasang 500 0 500 0 500
91 Hand scoond steril pices 100 0 100 0 100
92 HCl 0,1 N botol 0 0 0 0 0
93 Hidrogen Peroksida 3 % (H2O2) botol 0 0 0 0 0
94 Hidroklortiazid ( HCT ) 25 mg tablet 400 0 400 0 400
95 Hidrokortison crem 2.5 % tube 48 0 48 48 0
96 Ibuprofen 200 mg tablet 0 0 0 0 0
97 Ibuprofen 400 mg tablet 1500 0 1500 800 700
98 Ibuprofen syrup 100 mg / ml botol 0 0 0 0 0
99 Infusion set Anak bungkus 50 0 50 50 0
100 Infusion set Dewasa bungkus 0 0 0 0 0
101 Isosorbit Dinitrat 5 mg tablet 0 0 0 0 0
102 IV cateter no. 18 G buah 50 0 50 30 20
103 IV cateter no. 20 G buah 0 0 0 0 0
104 IV cateter no. 22 G buah 50 0 50 30 20
105 IV cateter no. 24 G buah 50 0 50 30 20
106 Kalsium hidroksida pasta pot 0 0 0 0 0
107 Kalsium Laktat 500 mg tablet 1600 0 1600 1400 200
108 Kapas Pembalut 250 gr bungkus 0 0 0 0 0
109 Karbamazepin 200 mg tablet 0 0 0 0 0
110 Kasa pembalut 4 x 5 cm rol 0 0 0 0 0
111 Kasa Pembalut 3 x 10 cm rol 0 0 0 0 0
112 Kasa Pembalut 3 x 15 cm rol 0 0 0 0 0
113 Kasa Pembalut 3 x 5cm rol 0 0 0 0 0
114 Kasa 16 x 16 cm kotak 0 0 0 0 0
115 Keterolak injeksi vial 0 0 0 0 0
116 Ketokonazol 200 mg tablet 0 0 0 0 0
117 Ketokonazol krim 2.5 % tube 0 0 0 0 0
118 Kinina 200 mg tablet tablet 0 0 0 0 0
119 Kinina injeksi ampul 0 0 0 0 0
120 Kloramfenikol 250 mg kapsul 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
121 Kloramfenikol salep kulit 2 % tube 0 0 0 0 0
122 Kloramfenikol salep mata 1 % tube 0 0 0 0 0
123 Kloramfenikol tetes Mata botol 0 0 0 0 0
124 Klorfeniramin maleat ( CTM ) 4 mg tablet 0 0 0 0 0
125 Klorokina posfat 250 mg tablet 0 0 0 0 0
126 Klorpromazin Hcl 100 mg tablet 0 0 0 0 0
127 Klorpromazin Hcl 25 mg tablet 0 0 0 0 0
128 Klorpromazin Hcl inj 25 mg / 1 ml ampul 0 0 0 0 0
129 Komb.Primetamin + Sulfadoxin 500 mg tablet 0 0 0 0 0
130 Kotrimoxazol syrup botol 65 0 65 35 30
131 Kotrimoxazol 480 mg tablet 0 0 0 0 0
132 L I s o l 1 Liter botol 0 0 0 0 0
133 Larutan Benedict botol 0 0 0 0 0
134 Larutan Eosin 2 % botol 0 0 0 0 0
135 Larutan Etanol asam botol 0 0 0 0 0
136 Larutan giemsa stain botol 0 0 0 0 0
137 Larutan Karbol Fuksin botol 0 0 0 0 0
138 Larutan Metilan Biru botol 0 0 0 0 0
139 Larutan Turk botol 0 0 0 0 0
140 Lidocain Comp injeksi ampul 0 0 0 0 0
141 Loperamid 2 mg tablet 900 0 900 100 800
142 Loratadin 10 mg tablet 400 0 400 300 100
143 Masker Ear Lop pices 0 0 0 0 0
144 Masker Ties On pices 0 0 0 0 0
145 Masker N 95 pices 0 0 0 0 0
146 Metergin 0.125 mg tablet 0 0 0 0 0
147 Metergin injeksi 0.200 mg / 1 ml ampul 0 0 0 0 0
148 Metformin 500 mg tablet 1000 0 1000 300 700
149 Metil Prednisolon 4 mg tablet 0 0 0 0 0
150 Metoklopramid 10 mg tablet 0 0 0 0 0
151 Metolon Injeksi 5 mg / 2 ml ampul 0 0 0 0 0
152 Metronidazol suspensi botol 0 0 0 0 0
153 Metronidazol tab 500 mg tablet 0 0 0 0 0
154 Miconazol crem tube 0 0 0 0 0
155 Monoklorkamfer mentol cair botol 0 0 0 0 0
156 Multi Vitamin syrup botol 0 0 0 0 0
157 Mumiying Pasta pot 0 0 0 0 0
158 Natrium Bikarbonat 500 mg tablet 0 0 0 0 0
159 Natrium Diklifenak 50 mg tablet 500 0 500 500 0
160 Natrium Klorida 0.9 % kolf 0 0 0 0 0
161 Nipedipin 10 mg tablet 0 0 0 0 0
162 Nistatin 100.000 IU tablet 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
163 Nistatin 500.000 IU tablet 0 0 0 0 0
164 Obat Anti Tuberkulosis Kategori I paket 0 0 0 0 0
165 Obat Anti Tuberkulosis Kategori II paket 0 0 0 0 0
166 Obat Anti Tuberkulosis Kategori anak paket 0 0 0 0 0
167 Obat Anti Tuberkulosis Kategori Sisipan paket 0 0 0 0 0
168 Obat Batuk hitam ( OBH ) botol 0 0 0 0 0
169 Oksitetrasiklin 3 % salep kulit tube 0 0 0 0 0
170 Oksitetrasiklin Hcl 1 % salep mata tube 0 0 0 0 0
171 Oksitetrasiklin Hcl inj 50 mg - 10 ml vial 0 0 0 0 0
172 Oksitocin Injeksi ampul 0 0 0 0 0
173 Omeprazol 20 mg tablet 700 0 700 500 200
174 Ondansetron injeksi ampul 0 0 0 0 0
175 Papaverin 40 mg tablet 0 0 0 0 0
176 Parasetamol 100 mg tablet 0 0 0 0 0
177 Parasetamol 500 mg tablet 900 0 900 900 0
178 Parasetamol Drop botol 0 0 0 0 0
179 Parasetamol Syrup botol 220 0 220 70 150
180 Perak Sulfadiazin krim tube 0 0 0 0 0
181 Pirantel Pamoat 365 mg tablet 700 0 700 200 500
182 Piridoxin Hcl 10 mg tablet 400 0 400 300 100
183 Piroxicam 10 mg kapsul 0 0 0 0 0
184 Plester 5 x 500 inchi rol 0 0 0 0 0
185 Policlen botol 0 0 0 0 0
186 Prednison 5 mg tablet 1000 0 1000 100 900
187 Primaquin 15 mg tablet 0 0 0 0 0
188 Propanolol Hcl 10 mg tablet 0 0 0 0 0
189 Propiltiourasil ( PTU ) 100 mg tablet 0 0 0 0 0
190 Ranitidin 150 mg tablet 4200 0 4200 1200 3000
191 Ranitidin injeksi ampul 0 0 0 0 0
192 Resperidon 2 mg tablet 0 0 0 0 0
193 Ringer Laktat lar infus kolf 0 0 0 0 0
194 Salbutamol 2 mg tablet 0 0 0 0 0
195 Salbutamol 4 mg tablet 0 0 0 0 0
196 Salep 2 - 4 pot 25 0 25 0 25
197 Salisil bedak 2 % bungkus 0 0 0 0 0
198 Sefiksin 100 mg tablet 0 0 0 0 0
199 Semen Seng Posfat serbuk dan cairan set 0 0 0 0 0
200 Serum Anti Bisa Ular Polivalen 50 ml vIal 1 0 1 0 1
201 Serum Anti Tetanus 1.500 IU (ATS ) ampul 1 0 1 0 1
202 Sianokobolamin ( B12) tablet tablet 0 0 0 0 0
203 Sianokobolamin injeksi ( Vit B 12 ) ampul 0 0 0 0 0
204 Silk 18 mm x 75 cm sachet 12 0 12 12 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
205 Silk 25 mm x 75 cm sachet 24 0 24 0 24
206 Simvastatin 10 mg tablet 1400 0 1400 600 800
207 Sulfasetamid natrium Tetes mata 15 % botol 0 0 0 0 0
208 Tablet Tambah Darah tablet 55500 0 55500 5500 50000
209 Temporary Stoping Fletcher dan cairan botol 0 0 0 0 0
210 Tetrasiklin Hcl 250 mg kapsul 0 0 0 0 0
211 Tetrasiklin Hcl 500 mg kapsul 0 0 0 0 0
212 Thiamin Hcl ( Vit B1 ) injeksi ampul 0 0 0 0 0
213 Thiamin Hcl tablet 50 mg tablet 900 0 900 400 500
214 Tramadol injeksi 50 mg / ml ampul 0 0 0 0 0
215 Trihexilpenidil 2 mg tablet 0 0 0 0 0
216 Urin Bag pices 0 0 0 0 0
217 Vitamin A 100.000 IU kapsul 0 0 0 0 0
218 Vitamin A 200.000 IU kapsul 0 0 0 0 0
219 Vitamin B Complek tablet 1400 0 1400 800 600
220 Xilocain spray tabung 0 0 0 0 0
221 Yodium Povidon larutan 30 ml botol 0 0 0 0 0
222 Yodium Povidon larutan 300 ml botol 10 0 10 5 5
223 Zinc tablet 0 0 0 0 0
224 Zinc syrup 20 mg / 5 ml botol 0 0 0 0 0
225 Betahistine mesylate 6 mg tablet 500 0 500 100 400
226 Kompolax sirup botol 0 0 0 0 0
227 Miconazole serbuk botol 0 0 0 0 0
228 Pyrantel pamoat tablet 0 0 0 0 0
229 Scabimite tube 20 0 20 10 10
230 Griseofulvin 250 mg tablet 0 0 0 0 0
231 Aminophylin 150 mg tablet 0 0 0 0 0
232 Amoksisilin syrup 125 mg/ml botol 465 0 465 65 400
233 Betametason diproplonoat crem tube 0 0 0 0 0
234 Tetagam injeksi vial 3 0 3 1 2
235 Desinfectan 500 ml botol 0 0 0 0 0
236 Desinfectan 1 Liter botol 0 0 0 0 0
237 Stimuno Forte tablet 1800 0 1800 800 1000
238 Asam ascorbat 500 mg tablet 11500 0 11500 1000 10500
239 Hyocine Butyl Bromida 10 mg tablet 200 0 200 0 200
240 Hand Sanitizer 500 ml botol 0 0 0 0 0
241 Kapas 100 gram rol 0 0 0 0 0
242 Salbutamol Syr botol 0 0 0 0 0
243 Domperidone Syr botol 0 0 0 0 0
244 Herbacof syr botol 0 0 0 0 0 200
JUMLAH KUNJUNGAN
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
Mengetahui
Pimpinan Puskesmas Pelapor
Limbur Lubuk Mengkuang

SUTARI, SKM Ranny Fitriany, Amd.Farm

NIP. 197807132008011004 NIP. 19920405 201503 2 004
PUSKESMAS : LIMBUR LUBUK MENGKUANG BULAN : Maret
KODE : LIMBUR LUBUK MENGKUANG TAHUN : 2023
KABUPATEN : BUNGO
PROPINSI : JAMBI
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( L B 2 )
STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
1 2 3 4 5 6=(4+5 ) 7 8=(6-7 ) 9 10 11
1 ACT( Artesunat 50 mg + Amodiaquin 200 mg ) tablet 0 0 0 0 0
2 Alat Suntik Sekali Pakai 1 ml pcs 30 500 530 100 430
3 Alat Suntik sekali Pakai 2.5 ml pcs 0 500 500 100 400
4 Alat Suntik sekali Pakai 5 ml pcs 0 300 300 100 200
5 Albendazol 400 mg tablet 0 0 0 0 0
6 Alkohol Swab kotak 0 50 50 0 50
7 Alopurinol 100 mg tablet 3100 2000 5100 400 4700
8 Ambroxol tablet tablet 0 0 0 0 0
9 Ambroxol syrup 15 mg / ml botol 0 0 0 0 0
10 Aminophylin 150 mg tablet 0 0 0 0 0
11 Aminophylin 200 mg tablet 0 0 0 0 0
12 Aminophylin injeksi ampul 50 30 80 30 50
13 Amitriptilin Hcl 25 mg tablet 0 0 0 0 0
14 Amlodipin 5 mg tablet 600 3900 4500 600 3900
15 Amoksisilin 250 mg kapsul 0 0 0 0 0
16 Amoksisilin 500 mg kaplet 0 5000 5000 2000 3000
17 Amoksisilin syrup 125 mg/ml botol 400 300 700 135 565
18 Amoksisilin syrup botol 0 0 0 0 0
19 Antasida Doen Komb syrup botol 0 0 0 0 0
20 Antasida Doen kombinasi tablet 2700 5000 7700 2700 5000
21 Anti Bakteri Doen (bacitracin) tube 0 75 75 25 50
22 Anti Fungi Doen Komb.( Whitfield ) pot 14 96 110 50 60
23 Antihemoroid suppos suppos 0 100 100 30 70
24 Antimigrain Doen ( Ergotamin ) tablet 0 0 0 0 0
25 Aqua proinjeksi vial 0 0 0 0 0
26 Artemeter Injeksi 1 ml : 80 mg ampul 0 0 0 0 0
27 Artesunate injeksi 60 ml vial 0 0 0 0 0
28 Asam Ascorbat ( Vit C ) 50 mg tablet 0 4000 4000 200 3800
29 Asam Ascorbat ( Vit C ) 250 mg tablet 0 0 0 0 0
30 Asam ascorbat ( Vit C ) 500 mg tablet 10500 0 10500 1500 9000
31 Asam Mefenamat 500 mg kaplet 2400 7500 9900 3500 6400
32 Asam Traneksamat injeksi ampul 0 0 0 0 0
33 Asiklovir 200 mg tablet 0 0 0 0 0
34 Asiklovir 400 mg tablet 1000 0 1000 500 500
35 Asiklovir crem 5 % tube 0 0 0 0 0
36 Atapulgit 650 mg tablet 0 500 500 100 400
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
37 Atropin sulfat 0.5 mg tablet 0 0 0 0 0
38 Atropin Sulfat injeksi ampul 0 20 20 0 20
39 Betahistine mesylate 6 mg tablet 400 2000 2400 400 2000
40 Betametason crem tube 25 125 150 50 100
41 Betametason diproplonoat crem tube 0 0 0 0 0
42 Captopril 12.5 mg tablet 2600 2000 4600 1600 3000
43 Captopril 25 mg tablet 3400 3000 6400 1400 5000
44 Cat Gut sack 0 120 120 70 50
45 Cefadroxil 500 mg tablet 0 0 0 0 0
46 Cefadroxil syrup botol 0 100 100 50 50
47 Cefotaxim injeksi vial 0 0 0 0 0
48 Ceterizin syrup botol 30 0 30 30 0
49 Cetirizin 10 mg tablet 0 3000 3000 500 2500
50 Ciproploxacin 500 mg tablet 0 1000 1000 500 500
51 Deksametason 0.5 mg tablet tablet 0 0 0 0 0
52 Deksametason injeksi ampul 0 100 100 100 0
53 Devitalisasi pasta btl 0 0 0 0 0
54 Diazepam 2 mg tablet 0 0 0 0 0
55 Diazepam injeksi 5 mg / 1 ml ampul 0 0 0 0 0
56 Diazepam Rectal 5 mg / 2.5 ml tube 0 0 0 0 0
57 Difenhidramin Hcl injeksi ampul 0 0 0 0 0
58 Digoxin 0.25 mg tablet 0 0 0 0 0
59 Dimenhidrinat 50 mg tablet 0 1000 1000 500 500
60 Desinfectan 500 ml botol 0 4 4 2 2
61 Desinfectan 5 Liter botol 0 2 2 0 2
62 Domperidon 10 mg tablet 500 1000 1500 500 1000
63 Domperidone Syr botol 0 0 0 0 0
64 Doxycyklin 100 mg kapsul 0 0 0 0 0
65 Erytromycin 500 mg kaplet 200 1000 1200 300 900
66 Erytromycin syrup botol 50 0 50 30 20
67 Etakridin ( Rivanol ) cairan ampul 0 48 48 28 20
68 E t a n o l 70 % 1 Liter botol 0 10 10 5 5
69 E t a n o l 70 % 100 ml botol 5 20 25 15 10
70 Efedrin Hcl 25 mg tablet 0 0 0 0 0
71 Epinefrin Hcl injeksi ampul 0 0 0 0 0
72 Etil klorida semprot tabung 3 0 3 1 2
73 Eugenol cairan btl 0 0 0 0 0
74 Fenobarbital 30 mg tablet 0 0 0 0 0
75 Fenobarbital injeksi 50 mg / ml ampul 0 0 0 0 0
76 Fenol gliserol tetes telinga botol 144 96 240 72 168
77 Fitomenadion ( vit K ) 10 mg tab tablet 200 1000 1200 0 1200
78 Fitomenadion ( vit K ) 10 mg / 1 ml ampul 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
79 Foly Cateter no 16 pices 0 0 0 0 0
80 Foly cateter No 18 pices 0 0 0 0 0
81 Furosemid 40 mg tablet 0 500 500 200 300
82 Garam Oralit 200 ml bungkus 200 300 500 300 200
83 Gentamycin injeksi ampul 0 0 0 0 0
84 Gentamycin salep mata 0.3 % tube 0 24 24 12 12
85 Gentamycin tetes mata 0.3 % tube 0 48 48 12 36
86 Gentian violet 1 % botol 0 0 0 0 0
87 Glass Ionomer Cemen ( GC IX ) set 0 0 0 0 0
88 Glibenklamid 5 mg tablet 200 1000 1200 300 900
89 Glikasida 80 mg tablet 0 0 0 0 0
90 Gliseril Guayakolat 100 mg tablet 0 0 0 0 0
91 Glukosa Lar infus 10 % kolf 0 0 0 0 0
92 Glukosa lar infus 5 % kolf 0 80 80 30 50
93 Griseofulvin 125 mg tablet 200 1000 1200 200 1000
94 Griseofulvin 250 mg tablet 0 0 0 0 0
95 Haloperidol 0.5 mg tablet 0 0 0 0 0
96 Haloperidol 1.5 mg tablet 0 0 0 0 0
97 Haloperidol 5 mg tablet 0 0 0 0 0
98 Haloperidol injeksi ampil 0 0 0 0 0
99 Hand Sanitizer 500 ml botol 0 28 28 12 16
100 Hand Scoond pasang 500 600 1100 300 800
101 Hand scoond steril pices 100 100 200 50 150
102 Herbacof syr botol 0 336 336 96 240
103 HCl 0,1 N botol 0 0 0 0 0
104 Hidrogen Peroksida 3 % (H2O2) botol 0 0 0 0 0
105 Hidroklortiazid ( HCT ) 25 mg tablet 400 0 400 0 400
106 Hidrokortison crem 2.5 % tube 0 48 48 24 24
107 Hyocine Butyl Bromida 10 mg tablet 200 0 200 0 200
108 Ibuprofen 200 mg tablet 0 3000 3000 1000 2000
109 Ibuprofen 400 mg tablet 700 4000 4700 700 4000
110 Ibuprofen syrup 100 mg / ml botol 0 0 0 0 0
111 Infusion set Anak bungkus 0 200 200 150 50
112 Infusion set Dewasa bungkus 0 200 200 150 50
113 Isosorbit Dinitrat 5 mg tablet 0 0 0 0 0
114 IV cateter no. 18 G buah 20 0 20 20 0
115 IV cateter no. 20 G buah 0 100 100 50 50
116 IV cateter no. 22 G buah 20 200 220 120 100
117 IV cateter no. 24 G buah 20 200 220 120 100
118 Kalsium hidroksida pasta pot 0 0 0 0 0
119 Kalsium Laktat 500 mg tablet 200 2500 2700 1700 1000
120 Kapas 100 gram rol 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
121 Kapas Pembalut 250 gr bungkus 0 20 20 10 10
122 Karbamazepin 200 mg tablet 0 0 0 0 0
123 Kasa pembalut 4 x 5 cm rol 0 400 400 50 350
124 Kasa Pembalut 3 x 10 cm rol 0 100 100 50 50
125 Kasa Pembalut 3 x 15 cm rol 0 200 200 100 100
126 Kasa Pembalut 4 x 15cm rol 0 50 50 0 50
127 Kasa Pembalut 3 x 5cm rol 0 100 100 50 50
128 Kasa 16 x 16 cm kotak 0 100 100 40 60
129 Keterolak injeksi vial 0 0 0 0 0
130 Ketokonazol 200 mg tablet 0 2000 2000 1000 1000
131 Ketokonazol krim 2.5 % tube 0 100 100 50 50
132 Kinina 200 mg tablet tablet 0 0 0 0 0
133 Kinina injeksi ampul 0 0 0 0 0
134 Kloramfenikol 250 mg kapsul 0 0 0 0 0
135 Kloramfenikol salep kulit 2 % tube 0 48 48 24 24
136 Kloramfenikol salep mata 1 % tube 0 0 0 0 0
137 Kloramfenikol tetes Mata botol 0 0 0 0 0
138 Klorfeniramin maleat ( CTM ) 4 mg tablet 0 0 0 0 0
139 Klorokina posfat 250 mg tablet 0 0 0 0 0
140 Klorpromazin Hcl 100 mg tablet 0 0 0 0 0
141 Klorpromazin Hcl 25 mg tablet 0 0 0 0 0
142 Klorpromazin Hcl inj 25 mg / 1 ml ampul 0 0 0 0 0
143 Kompolax sirup botol 0 0 0 0 0
144 Komb.Primetamin + Sulfadoxin 500 mg tablet 0 0 0 0 0
145 Kotrimoxazol syrup botol 30 0 30 30 0
146 Kotrimoxazol 480 mg tablet 0 1000 1000 500 500
147 L I s o l 1 Liter botol 0 0 0 0 0
148 Larutan Benedict botol 0 0 0 0 0
149 Larutan Eosin 2 % botol 0 0 0 0 0
150 Larutan Etanol asam botol 0 0 0 0 0
151 Larutan giemsa stain botol 0 0 0 0 0
152 Larutan Karbol Fuksin botol 0 0 0 0 0
153 Larutan Metilan Biru botol 0 0 0 0 0
154 Larutan Turk botol 0 0 0 0 0
155 Lidocain Comp injeksi ampul 0 210 210 120 90
156 Loperamid 2 mg tablet 800 1000 1800 800 1000
157 Loratadin 10 mg tablet 100 0 100 100 0
158 Masker Ear Lop pices 0 1000 1000 300 700
159 Masker Ties On pices 0 0 0 0 0
160 Masker N 95 pices 0 0 0 0 0
161 Metergin injeksi 0.200 mg / 1 ml ampul 0 0 0 0 0
162 Metformin 500 mg tablet 700 3000 3700 700 3000
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
163 Metil Prednisolon 4 mg tablet 0 4000 4000 2000 2000
164 Metil ergometrin maleat 0.125 mg tablet 0 200 200 0 200
165 Metoklopramid 10 mg tablet 0 0 0 0 0
166 Metolon Injeksi 5 mg / 2 ml ampul 0 0 0 0 0
167 Metronidazol suspensi botol 0 0 0 0 0
168 Metronidazol tab 500 mg tablet 0 0 0 0 0
169 Miconazol crem tube 0 0 0 0 0
170 Miconazole serbuk botol 0 0 0 0 0
171 Monoklorkamfer mentol cair botol 0 0 0 0 0
172 Multi Vitamin syrup botol 0 0 0 0 0
173 Mumiying Pasta pot 0 0 0 0 0
174 Natrium Bikarbonat 500 mg tablet 0 0 0 0 0
175 Natrium Diklifenak 50 mg tablet 0 2000 2000 500 1500
176 Natrium Klorida 0.9 % kolf 0 140 140 40 100
177 Nipedipin 10 mg tablet 0 0 0 0 0
178 Nistatin 100.000 IU tablet 0 100 100 10 90
179 Nistatin 500.000 IU tablet 0 0 0 0 0
180 Obat Anti Tuberkulosis Kategori I paket 0 0 0 0 0
181 Obat Anti Tuberkulosis Kategori II paket 0 0 0 0 0
182 Obat Anti Tuberkulosis Kategori anak paket 0 0 0 0 0
183 Obat Anti Tuberkulosis Kategori Sisipan paket 0 0 0 0 0
184 Obat Batuk hitam ( OBH ) botol 0 0 0 0 0
185 Oksitetrasiklin 3 % salep kulit tube 0 0 0 0 0
186 Oksitetrasiklin Hcl 1 % salep mata tube 0 0 0 0 0
187 Oksitetrasiklin Hcl inj 50 mg - 10 ml vial 0 0 0 0 0
188 Oksitocin Injeksi ampul 0 100 100 50 50
189 Omeprazol 20 mg tablet 200 0 200 200 0
190 Ondansetron injeksi ampul 0 0 0 0 0
191 Papaverin 40 mg tablet 0 0 0 0 0
192 Parasetamol 100 mg tablet 0 0 0 0 0
193 Parasetamol 500 mg tablet 0 5000 5000 1500 3500
194 Parasetamol Drop botol 0 0 0 0 0
195 Parasetamol Syrup botol 150 0 150 70 80
196 Permetrin krim 5% (Scabimite) tube 10 30 40 20 20
197 Perak Sulfadiazin krim tube 0 0 0 0 0
198 Pirantel Pamoat 365 mg tablet 500 0 500 200 300
199 Piroxicam 10 mg kapsul 0 0 0 0 0
200 Plester 5 x 500 inchi rol 0 20 20 10 10
201 Policlen botol 0 0 0 0 0
202 Prednison 5 mg tablet 900 4000 4900 900 4000
203 Primaquin 15 mg tablet 0 0 0 0 0
204 Propanolol Hcl 10 mg tablet 0 200 200 100 100
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
205 Piridoxin Hcl 10 mg tablet 100 3500 3600 600 3000
206 Propiltiourasil ( PTU ) 100 mg tablet 0 0 0 0 0
207 Ranitidin 150 mg tablet 3000 8000 11000 3000 8000
208 Ranitidin injeksi ampul 0 0 0 0 0
209 Resperidon 2 mg tablet 0 0 0 0 0
210 Ringer Laktat lar infus kolf 0 120 120 40 80
211 Salbutamol 2 mg tablet 0 2000 2000 1000 1000
212 Salbutamol 4 mg tablet 0 0 0 0 0
213 Salbutamol Syr botol 0 0 0 0 0
214 Salep 2 - 4 pot 25 0 25 0 25
215 Salisil bedak 2 % bungkus 0 0 0 0 0
216 Sefiksin 100 mg tablet 0 0 0 0 0
217 Semen Seng Posfat serbuk dan cairan set 0 0 0 0 0
218 Serum Anti Bisa Ular Polivalen 50 ml vIal 1 3 4 2 2
219 Serum Anti Tetanus 1.500 IU (ATS ) ampul 1 5 6 3 3
220 Sianokobolamin ( B12) tablet tablet 0 3000 3000 1000 2000
221 Sianokobolamin injeksi ( Vit B 12 ) ampul 0 200 200 100 100
222 Silk 17 mm x 76 cm sachet 0 72 72 24 48
223 Silk 25 mm x 75 cm sachet 24 72 96 48 48
224 Simvastatin 10 mg tablet 800 3000 3800 800 3000
225 Stimuno Forte tablet 1000 0 1000 300 700
226 Sulfasetamid natrium Tetes mata 15 % botol 0 0 0 0 0
227 Tablet Tambah Darah tablet 50000 0 50000 15000 35000
228 Tetagam injeksi vial 2 0 2 2 0
229 Temporary Stoping Fletcher dan cairan botol 0 0 0 0 0
230 Tetrasiklin Hcl 250 mg kapsul 0 0 0 0 0
231 Tetrasiklin Hcl 500 mg kapsul 0 0 0 0 0
232 Thiamin Hcl ( Vit B1 ) injeksi ampul 0 0 0 0 0
233 Thiamin Hcl tablet 50 mg tablet 500 0 500 400 100
234 Tramadol injeksi 50 mg / ml ampul 0 0 0 0 0
235 Trihexilpenidil 2 mg tablet 0 0 0 0 0
236 Urin Bag pices 0 0 0 0 0
237 Vitamin A 100.000 IU kapsul 0 0 0 0 0
238 Vitamin A 200.000 IU kapsul 0 0 0 0 0
239 Vitamin B Complek tablet 600 5000 5600 1600 4000
240 Xilocain spray tabung 0 0 0 0 0
241 Yodium Povidon larutan 30 ml botol 0 0 0 0 0
242 Yodium Povidon larutan 100 ml botol 0 40 40 20 20
243 Yodium Povidon larutan 300 ml botol 5 0 5 0 5
244 Zinc tablet 0 0 0 0 0
245 Zinc syrup 20 mg / 5 ml botol 0 0 0 0 0
JUMLAH KUNJUNGAN
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT

Mengetahui
Pimpinan Puskesmas Pelapor
Limbur Lubuk Mengkuang

SUTARI, SKM Ranny Fitriany, Amd.Farm

NIP. 197807132008011004 NIP. 19920405 201503 2 004
PUSKESMAS : LIMBUR LUBUK MENGKUANG BULAN : April
KODE : LIMBUR LUBUK MENGKUANG TAHUN : 2023
KABUPATEN : BUNGO
PROPINSI : JAMBI
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( L B 2 )
STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
1 2 3 4 5 6=(4+5 ) 7 8=(6-7 ) 9 10 11
1 ACT( Artesunat 50 mg + Amodiaquin 200 mg ) tablet 0 0 0 0 0
2 Alat Suntik Sekali Pakai 1 ml pcs 430 0 430 230 200
3 Alat Suntik sekali Pakai 2.5 ml pcs 400 0 400 200 200
4 Alat Suntik sekali Pakai 5 ml pcs 200 0 200 200 0
5 Albendazol 400 mg tablet 0 0 0 0 0
6 Alkohol Swab kotak 50 0 50 0 50
7 Alopurinol 100 mg tablet 4700 0 4700 2700 2000
8 Ambroxol tablet tablet 0 0 0 0 0
9 Ambroxol syrup 15 mg / ml botol 0 0 0 0 0
10 Aminophylin 150 mg tablet 0 0 0 0 0
11 Aminophylin 200 mg tablet 0 0 0 0 0
12 Aminophylin injeksi ampul 50 0 50 30 20
13 Amitriptilin Hcl 25 mg tablet 0 0 0 0 0
14 Amlodipin 5 mg tablet 3900 0 3900 1900 2000
15 Amoksisilin 250 mg kapsul 0 0 0 0 0
16 Amoksisilin 500 mg kaplet 3000 0 3000 2000 1000
17 Amoksisilin syrup 125 mg/ml botol 565 0 565 135 430
18 Amoksisilin syrup botol 0 0 0 0 0
19 Antasida Doen Komb syrup botol 0 0 0 0 0
20 Antasida Doen kombinasi tablet 5000 0 5000 2700 2300
21 Anti Bakteri Doen (bacitracin) tube 50 0 50 25 25
22 Anti Fungi Doen Komb.( Whitfield ) pot 60 0 60 50 10
23 Antihemoroid suppos suppos 70 0 70 30 40
24 Antimigrain Doen ( Ergotamin ) tablet 0 0 0 0 0
25 Aqua proinjeksi vial 0 0 0 0 0
26 Artemeter Injeksi 1 ml : 80 mg ampul 0 0 0 0 0
27 Artesunate injeksi 60 ml vial 0 0 0 0 0
28 Asam Ascorbat ( Vit C ) 50 mg tablet 3800 0 3800 200 3600
29 Asam Ascorbat ( Vit C ) 250 mg tablet 0 0 0 0 0
30 Asam ascorbat ( Vit C ) 500 mg tablet 9000 0 9000 1500 7500
31 Asam Mefenamat 500 mg kaplet 6400 0 6400 3400 3000
32 Asam Traneksamat injeksi ampul 0 0 0 0 0
33 Asiklovir 200 mg tablet 0 0 0 0 0
34 Asiklovir 400 mg tablet 500 0 500 500 0
35 Asiklovir crem 5 % tube 0 0 0 0 0
36 Atapulgit 650 mg tablet 400 0 400 100 300
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
37 Atropin sulfat 0.5 mg tablet 0 0 0 0 0
38 Atropin Sulfat injeksi ampul 20 0 20 0 20
39 Betahistine mesylate 6 mg tablet 2000 0 2000 400 1600
40 Betametason crem tube 100 0 100 50 50
41 Betametason diproplonoat crem tube 0 0 0 0 0
42 Captopril 12.5 mg tablet 3000 0 3000 1600 1400
43 Captopril 25 mg tablet 5000 0 5000 1400 3600
44 Cat Gut sack 50 0 50 30 20
45 Cefadroxil 500 mg tablet 0 0 0 0 0
46 Cefadroxil syrup botol 50 0 50 50 0
47 Cefotaxim injeksi vial 0 0 0 0 0
48 Ceterizin syrup botol 0 0 0 0 0
49 Cetirizin 10 mg tablet 2500 0 2500 500 2000
50 Ciproploxacin 500 mg tablet 500 0 500 500 0
51 Deksametason 0.5 mg tablet tablet 0 0 0 0 0
52 Deksametason injeksi ampul 0 0 0 0 0
53 Devitalisasi pasta btl 0 0 0 0 0
54 Diazepam 2 mg tablet 0 0 0 0 0
55 Diazepam injeksi 5 mg / 1 ml ampul 0 0 0 0 0
56 Diazepam Rectal 5 mg / 2.5 ml tube 0 0 0 0 0
57 Difenhidramin Hcl injeksi ampul 0 0 0 0 0
58 Digoxin 0.25 mg tablet 0 0 0 0 0
59 Dimenhidrinat 50 mg tablet 500 0 500 500 0
60 Desinfectan 500 ml botol 2 0 2 2 0
61 Desinfectan 5 Liter botol 2 0 2 0 2
62 Domperidon 10 mg tablet 1000 0 1000 500 500
63 Domperidone Syr botol 0 0 0 0 0
64 Doxycyklin 100 mg kapsul 0 0 0 0 0
65 Erytromycin 500 mg kaplet 900 0 900 300 600
66 Erytromycin syrup botol 20 0 20 20 0
67 Etakridin ( Rivanol ) cairan ampul 20 0 20 20 0
68 E t a n o l 70 % 1 Liter botol 5 0 5 5 0
69 E t a n o l 70 % 100 ml botol 10 0 10 5 5
70 Efedrin Hcl 25 mg tablet 0 0 0 0 0
71 Epinefrin Hcl injeksi ampul 0 0 0 0 0
72 Etil klorida semprot tabung 2 0 2 1 1
73 Eugenol cairan btl 0 0 0 0 0
74 Fenobarbital 30 mg tablet 0 0 0 0 0
75 Fenobarbital injeksi 50 mg / ml ampul 0 0 0 0 0
76 Fenol gliserol tetes telinga botol 168 0 168 72 96
77 Fitomenadion ( vit K ) 10 mg tab tablet 1200 0 1200 0 1200
78 Fitomenadion ( vit K ) 10 mg / 1 ml ampul 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
79 Foly Cateter no 16 pices 0 0 0 0 0
80 Foly cateter No 18 pices 0 0 0 0 0
81 Furosemid 40 mg tablet 300 0 300 200 100
82 Garam Oralit 200 ml bungkus 200 0 200 0 200
83 Gentamycin injeksi ampul 0 0 0 0 0
84 Gentamycin salep mata 0.3 % tube 12 0 12 12 0
85 Gentamycin tetes mata 0.3 % tube 36 0 36 12 24
86 Gentian violet 1 % botol 0 0 0 0 0
87 Glass Ionomer Cemen ( GC IX ) set 0 0 0 0 0
88 Glibenklamid 5 mg tablet 900 0 900 300 600
89 Glikasida 80 mg tablet 0 0 0 0 0
90 Gliseril Guayakolat 100 mg tablet 0 0 0 0 0
91 Glukosa Lar infus 10 % kolf 0 0 0 0 0
92 Glukosa lar infus 5 % kolf 50 0 50 30 20
93 Griseofulvin 125 mg tablet 1000 0 1000 200 800
94 Griseofulvin 250 mg tablet 0 0 0 0 0
95 Haloperidol 0.5 mg tablet 0 0 0 0 0
96 Haloperidol 1.5 mg tablet 0 0 0 0 0
97 Haloperidol 5 mg tablet 0 0 0 0 0
98 Haloperidol injeksi ampil 0 0 0 0 0
99 Hand Sanitizer 500 ml botol 16 0 16 12 4
100 Hand Scoond pasang 800 0 800 300 500
101 Hand scoond steril pices 150 0 150 50 100
102 Herbacof syr botol 240 0 240 96 144
103 HCl 0,1 N botol 0 0 0 0 0
104 Hidrogen Peroksida 3 % (H2O2) botol 0 0 0 0 0
105 Hidroklortiazid ( HCT ) 25 mg tablet 400 0 400 0 400
106 Hidrokortison crem 2.5 % tube 24 0 24 24 0
107 Hyocine Butyl Bromida 10 mg tablet 200 0 200 0 200
108 Ibuprofen 200 mg tablet 2000 0 2000 1000 1000
109 Ibuprofen 400 mg tablet 4000 0 4000 700 3300
110 Ibuprofen syrup 100 mg / ml botol 0 0 0 0 0
111 Infusion set Anak bungkus 50 0 50 50 0
112 Infusion set Dewasa bungkus 50 0 50 50 0
113 Isosorbit Dinitrat 5 mg tablet 0 0 0 0 0
114 IV cateter no. 18 G buah 0 0 0 0 0
115 IV cateter no. 20 G buah 50 0 50 50 0
116 IV cateter no. 22 G buah 100 0 100 100 0
117 IV cateter no. 24 G buah 100 0 100 100 0
118 Kalsium hidroksida pasta pot 0 0 0 0 0
119 Kalsium Laktat 500 mg tablet 1000 0 1000 700 300
120 Kapas 100 gram rol 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
121 Kapas Pembalut 250 gr bungkus 10 0 10 10 0
122 Karbamazepin 200 mg tablet 0 0 0 0 0
123 Kasa pembalut 4 x 5 cm rol 350 0 350 50 300
124 Kasa Pembalut 3 x 10 cm rol 50 0 50 50 0
125 Kasa Pembalut 3 x 15 cm rol 100 0 100 100 0
126 Kasa Pembalut 4 x 15cm rol 50 0 50 0 50
127 Kasa Pembalut 3 x 5cm rol 50 0 50 50 0
128 Kasa 16 x 16 cm kotak 60 0 60 40 20
129 Keterolak injeksi vial 0 0 0 0 0
130 Ketokonazol 200 mg tablet 1000 0 1000 1000 0
131 Ketokonazol krim 2.5 % tube 50 0 50 50 0
132 Kinina 200 mg tablet tablet 0 0 0 0 0
133 Kinina injeksi ampul 0 0 0 0 0
134 Kloramfenikol 250 mg kapsul 0 0 0 0 0
135 Kloramfenikol salep kulit 2 % tube 24 0 24 24 0
136 Kloramfenikol salep mata 1 % tube 0 0 0 0 0
137 Kloramfenikol tetes Mata botol 0 0 0 0 0
138 Klorfeniramin maleat ( CTM ) 4 mg tablet 0 0 0 0 0
139 Klorokina posfat 250 mg tablet 0 0 0 0 0
140 Klorpromazin Hcl 100 mg tablet 0 0 0 0 0
141 Klorpromazin Hcl 25 mg tablet 0 0 0 0 0
142 Klorpromazin Hcl inj 25 mg / 1 ml ampul 0 0 0 0 0
143 Kompolax sirup botol 0 0 0 0 0
144 Komb.Primetamin + Sulfadoxin 500 mg tablet 0 0 0 0 0
145 Kotrimoxazol syrup botol 0 0 0 0 0
146 Kotrimoxazol 480 mg tablet 500 0 500 500 0
147 L I s o l 1 Liter botol 0 0 0 0 0
148 Larutan Benedict botol 0 0 0 0 0
149 Larutan Eosin 2 % botol 0 0 0 0 0
150 Larutan Etanol asam botol 0 0 0 0 0
151 Larutan giemsa stain botol 0 0 0 0 0
152 Larutan Karbol Fuksin botol 0 0 0 0 0
153 Larutan Metilan Biru botol 0 0 0 0 0
154 Larutan Turk botol 0 0 0 0 0
155 Lidocain Comp injeksi ampul 90 0 90 90 0
156 Loperamid 2 mg tablet 1000 0 1000 800 200
157 Loratadin 10 mg tablet 0 0 0 0 0
158 Masker Ear Lop pices 700 0 700 300 400
159 Masker Ties On pices 0 0 0 0 0
160 Masker N 95 pices 0 0 0 0 0
161 Metergin injeksi 0.200 mg / 1 ml ampul 0 0 0 0 0
162 Metformin 500 mg tablet 3000 0 3000 700 2300
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
163 Metil Prednisolon 4 mg tablet 2000 0 2000 2000 0
164 Metil ergometrin maleat 0.125 mg tablet 200 0 200 0 200
165 Metoklopramid 10 mg tablet 0 0 0 0 0
166 Metolon Injeksi 5 mg / 2 ml ampul 0 0 0 0 0
167 Metronidazol suspensi botol 0 0 0 0 0
168 Metronidazol tab 500 mg tablet 0 0 0 0 0
169 Miconazol crem tube 0 0 0 0 0
170 Miconazole serbuk botol 0 0 0 0 0
171 Monoklorkamfer mentol cair botol 0 0 0 0 0
172 Multi Vitamin syrup botol 0 0 0 0 0
173 Mumiying Pasta pot 0 0 0 0 0
174 Natrium Bikarbonat 500 mg tablet 0 0 0 0 0
175 Natrium Diklifenak 50 mg tablet 1500 0 1500 500 1000
176 Natrium Klorida 0.9 % kolf 100 0 100 40 60
177 Nipedipin 10 mg tablet 0 0 0 0 0
178 Nistatin 100.000 IU tablet 90 0 90 10 80
179 Nistatin 500.000 IU tablet 0 0 0 0 0
180 Obat Anti Tuberkulosis Kategori I paket 0 0 0 0 0
181 Obat Anti Tuberkulosis Kategori II paket 0 0 0 0 0
182 Obat Anti Tuberkulosis Kategori anak paket 0 0 0 0 0
183 Obat Anti Tuberkulosis Kategori Sisipan paket 0 0 0 0 0
184 Obat Batuk hitam ( OBH ) botol 0 0 0 0 0
185 Oksitetrasiklin 3 % salep kulit tube 0 0 0 0 0
186 Oksitetrasiklin Hcl 1 % salep mata tube 0 0 0 0 0
187 Oksitetrasiklin Hcl inj 50 mg - 10 ml vial 0 0 0 0 0
188 Oksitocin Injeksi ampul 50 0 50 50 0
189 Omeprazol 20 mg tablet 0 0 0 0 0
190 Ondansetron injeksi ampul 0 0 0 0 0
191 Papaverin 40 mg tablet 0 0 0 0 0
192 Parasetamol 100 mg tablet 0 0 0 0 0
193 Parasetamol 500 mg tablet 3500 0 3500 1500 2000
194 Parasetamol Drop botol 0 0 0 0 0
195 Parasetamol Syrup botol 80 0 80 70 10
196 Permetrin krim 5% (Scabimite) tube 20 0 20 20 0
197 Perak Sulfadiazin krim tube 0 0 0 0 0
198 Pirantel Pamoat 365 mg tablet 300 0 300 200 100
199 Piroxicam 10 mg kapsul 0 0 0 0 0
200 Plester 5 x 500 inchi rol 10 0 10 10 0
201 Policlen botol 0 0 0 0 0
202 Prednison 5 mg tablet 4000 0 4000 900 3100
203 Primaquin 15 mg tablet 0 0 0 0 0
204 Propanolol Hcl 10 mg tablet 100 0 100 100 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
205 Piridoxin Hcl 10 mg tablet 3000 0 3000 600 2400
206 Propiltiourasil ( PTU ) 100 mg tablet 0 0 0 0 0
207 Ranitidin 150 mg tablet 8000 0 8000 3000 5000
208 Ranitidin injeksi ampul 0 0 0 0 0
209 Resperidon 2 mg tablet 0 0 0 0 0
210 Ringer Laktat lar infus kolf 80 0 80 40 40
211 Salbutamol 2 mg tablet 1000 0 1000 1000 0
212 Salbutamol 4 mg tablet 0 0 0 0 0
213 Salbutamol Syr botol 0 0 0 0 0
214 Salep 2 - 4 pot 25 0 25 0 25
215 Salisil bedak 2 % bungkus 0 0 0 0 0
216 Sefiksin 100 mg tablet 0 0 0 0 0
217 Semen Seng Posfat serbuk dan cairan set 0 0 0 0 0
218 Serum Anti Bisa Ular Polivalen 50 ml vIal 2 0 2 2 0
219 Serum Anti Tetanus 1.500 IU (ATS ) ampul 3 0 3 3 0
220 Sianokobolamin ( B12) tablet tablet 2000 0 2000 1000 1000
221 Sianokobolamin injeksi ( Vit B 12 ) ampul 100 0 100 100 0
222 Silk 17 mm x 76 cm sachet 48 0 48 24 24
223 Silk 25 mm x 75 cm sachet 48 0 48 48 0
224 Simvastatin 10 mg tablet 3000 0 3000 800 2200
225 Stimuno Forte tablet 700 0 700 300 400
226 Sulfasetamid natrium Tetes mata 15 % botol 0 0 0 0 0
227 Tablet Tambah Darah tablet 35000 0 35000 15000 20000
228 Tetagam injeksi vial 0 0 0 0 0
229 Temporary Stoping Fletcher dan cairan botol 0 0 0 0 0
230 Tetrasiklin Hcl 250 mg kapsul 0 0 0 0 0
231 Tetrasiklin Hcl 500 mg kapsul 0 0 0 0 0
232 Thiamin Hcl ( Vit B1 ) injeksi ampul 0 0 0 0 0
233 Thiamin Hcl tablet 50 mg tablet 100 0 100 100 0
234 Tramadol injeksi 50 mg / ml ampul 0 0 0 0 0
235 Trihexilpenidil 2 mg tablet 0 0 0 0 0
236 Urin Bag pices 0 0 0 0 0
237 Vitamin A 100.000 IU kapsul 0 0 0 0 0
238 Vitamin A 200.000 IU kapsul 0 0 0 0 0
239 Vitamin B Complek tablet 4000 0 4000 1600 2400
240 Xilocain spray tabung 0 0 0 0 0
241 Yodium Povidon larutan 30 ml botol 0 0 0 0 0
242 Yodium Povidon larutan 100 ml botol 20 0 20 20 0
243 Yodium Povidon larutan 300 ml botol 5 0 5 0 5
244 Zinc tablet 0 0 0 0 0
245 Zinc syrup 20 mg / 5 ml botol 0 0 0 0 0
JUMLAH KUNJUNGAN
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT

Mengetahui
Pimpinan Puskesmas Pelapor
Limbur Lubuk Mengkuang

SUTARI, SKM Ranny Fitriany, Amd.Farm

NIP. 197807132008011004 NIP. 19920405 201503 2 004
PUSKESMAS : LIMBUR LUBUK MENGKUANG BULAN : Mei
KODE : LIMBUR LUBUK MENGKUANG TAHUN : 2023
KABUPATEN : BUNGO
PROPINSI : JAMBI
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( L B 2 )
STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
1 2 3 4 5 6=(4+5 ) 7 8=(6-7 ) 9 10 11
1 ACT( Artesunat 50 mg + Amodiaquin 200 mg ) tablet 0 0 0 0 0
2 Alat Suntik Sekali Pakai 1 ml pcs 200 0 200 200 0
3 Alat Suntik sekali Pakai 2.5 ml pcs 200 0 200 200 0
4 Alat Suntik sekali Pakai 5 ml pcs 0 0 0 0 0
5 Albendazol 400 mg tablet 0 0 0 0 0
6 Alkohol Swab kotak 50 0 50 0 50
7 Alopurinol 100 mg tablet 2000 0 2000 1700 300
8 Ambroxol tablet tablet 0 0 0 0 0
9 Ambroxol syrup 15 mg / ml botol 0 0 0 0 0
10 Aminophylin 150 mg tablet 0 0 0 0 0
11 Aminophylin 200 mg tablet 0 0 0 0 0
12 Aminophylin injeksi ampul 20 0 20 20 0
13 Amitriptilin Hcl 25 mg tablet 0 0 0 0 0
14 Amlodipin 5 mg tablet 2000 0 2000 1500 500
15 Amoksisilin 250 mg kapsul 0 0 0 0 0
16 Amoksisilin 500 mg kaplet 1000 0 1000 1000 0
17 Amoksisilin syrup 125 mg/ml botol 430 0 430 135 295
18 Amoksisilin syrup botol 0 0 0 0 0
19 Antasida Doen Komb syrup botol 0 0 0 0 0
20 Antasida Doen kombinasi tablet 2300 0 2300 1500 800
21 Anti Bakteri Doen (bacitracin) tube 25 0 25 25 0
22 Anti Fungi Doen Komb.( Whitfield ) pot 10 0 10 10 0
23 Antihemoroid suppos suppos 40 0 40 30 10
24 Antimigrain Doen ( Ergotamin ) tablet 0 0 0 0 0
25 Aqua proinjeksi vial 0 0 0 0 0
26 Artemeter Injeksi 1 ml : 80 mg ampul 0 0 0 0 0
27 Artesunate injeksi 60 ml vial 0 0 0 0 0
28 Asam Ascorbat ( Vit C ) 50 mg tablet 3600 0 3600 200 3400
29 Asam Ascorbat ( Vit C ) 250 mg tablet 0 0 0 0 0
30 Asam ascorbat ( Vit C ) 500 mg tablet 7500 0 7500 1500 6000
31 Asam Mefenamat 500 mg kaplet 3000 0 3000 1000 2000
32 Asam Traneksamat injeksi ampul 0 0 0 0 0
33 Asiklovir 200 mg tablet 0 0 0 0 0
34 Asiklovir 400 mg tablet 0 0 0 0 0
35 Asiklovir crem 5 % tube 0 0 0 0 0
36 Atapulgit 650 mg tablet 300 0 300 100 200
37 Atropin sulfat 0.5 mg tablet 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
38 Atropin Sulfat injeksi ampul 20 0 20 0 20
39 Betahistine mesylate 6 mg tablet 1600 0 1600 400 1200
40 Betametason crem tube 50 0 50 50 0
41 Betametason diproplonoat crem tube 0 0 0 0 0
42 Captopril 12.5 mg tablet 1400 0 1400 400 1000
43 Captopril 25 mg tablet 3600 0 3600 1400 2200
44 Cat Gut sack 20 0 20 10 10
45 Cefadroxil 500 mg tablet 0 0 0 0 0
46 Cefadroxil syrup botol 0 0 0 0 0
47 Cefotaxim injeksi vial 0 0 0 0 0
48 Ceterizin syrup botol 0 0 0 0 0
49 Cetirizin 10 mg tablet 2000 0 2000 500 1500
50 Ciproploxacin 500 mg tablet 0 0 0 0 0
51 Deksametason 0.5 mg tablet tablet 0 0 0 0 0
52 Deksametason injeksi ampul 0 0 0 0 0
53 Devitalisasi pasta btl 0 0 0 0 0
54 Diazepam 2 mg tablet 0 0 0 0 0
55 Diazepam injeksi 5 mg / 1 ml ampul 0 0 0 0 0
56 Diazepam Rectal 5 mg / 2.5 ml tube 0 0 0 0 0
57 Difenhidramin Hcl injeksi ampul 0 0 0 0 0
58 Digoxin 0.25 mg tablet 0 0 0 0 0
59 Dimenhidrinat 50 mg tablet 0 0 0 0 0
60 Desinfectan 500 ml botol 0 0 0 0 0
61 Desinfectan 5 Liter botol 2 0 2 0 2
62 Domperidon 10 mg tablet 500 0 500 500 0
63 Domperidone Syr botol 0 0 0 0 0
64 Doxycyklin 100 mg kapsul 0 0 0 0 0
65 Erytromycin 500 mg kaplet 600 0 600 300 300
66 Erytromycin syrup botol 0 0 0 0 0
67 Etakridin ( Rivanol ) cairan ampul 0 0 0 0 0
68 E t a n o l 70 % 1 Liter botol 0 0 0 0 0
69 E t a n o l 70 % 100 ml botol 5 0 5 5 0
70 Efedrin Hcl 25 mg tablet 0 0 0 0 0
71 Epinefrin Hcl injeksi ampul 0 0 0 0 0
72 Etil klorida semprot tabung 1 0 1 1 0
73 Eugenol cairan btl 0 0 0 0 0
74 Fenobarbital 30 mg tablet 0 0 0 0 0
75 Fenobarbital injeksi 50 mg / ml ampul 0 0 0 0 0
76 Fenol gliserol tetes telinga botol 96 0 96 72 24
77 Fitomenadion ( vit K ) 10 mg tab tablet 1200 0 1200 0 1200
78 Fitomenadion ( vit K ) 10 mg / 1 ml ampul 0 0 0 0 0
79 Foly Cateter no 16 pices 0 0 0 0 0
80 Foly cateter No 18 pices 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
81 Furosemid 40 mg tablet 100 0 100 100 0
82 Garam Oralit 200 ml bungkus 200 0 200 0 200
83 Gentamycin injeksi ampul 0 0 0 0 0
84 Gentamycin salep mata 0.3 % tube 0 0 0 0 0
85 Gentamycin tetes mata 0.3 % tube 24 0 24 12 12
86 Gentian violet 1 % botol 0 0 0 0 0
87 Glass Ionomer Cemen ( GC IX ) set 0 0 0 0 0
88 Glibenklamid 5 mg tablet 600 0 600 300 300
89 Glikasida 80 mg tablet 0 0 0 0 0
90 Gliseril Guayakolat 100 mg tablet 0 0 0 0 0
91 Glukosa Lar infus 10 % kolf 0 0 0 0 0
92 Glukosa lar infus 5 % kolf 20 0 20 20 0
93 Griseofulvin 125 mg tablet 800 0 800 200 600
94 Griseofulvin 250 mg tablet 0 0 0 0 0
95 Haloperidol 0.5 mg tablet 0 0 0 0 0
96 Haloperidol 1.5 mg tablet 0 0 0 0 0
97 Haloperidol 5 mg tablet 0 0 0 0 0
98 Haloperidol injeksi ampil 0 0 0 0 0
99 Hand Sanitizer 500 ml botol 4 0 4 4 0
100 Hand Scoond pasang 500 0 500 300 200
101 Hand scoond steril pices 100 0 100 50 50
102 Herbacof syr botol 144 0 144 96 48
103 HCl 0,1 N botol 0 0 0 0 0
104 Hidrogen Peroksida 3 % (H2O2) botol 0 0 0 0 0
105 Hidroklortiazid ( HCT ) 25 mg tablet 400 0 400 0 400
106 Hidrokortison crem 2.5 % tube 0 0 0 0 0
107 Hyocine Butyl Bromida 10 mg tablet 200 0 200 0 200
108 Ibuprofen 200 mg tablet 1000 0 1000 1000 0
109 Ibuprofen 400 mg tablet 3300 0 3300 700 2600
110 Ibuprofen syrup 100 mg / ml botol 0 0 0 0 0
111 Infusion set Anak bungkus 0 0 0 0 0
112 Infusion set Dewasa bungkus 0 0 0 0 0
113 Isosorbit Dinitrat 5 mg tablet 0 0 0 0 0
114 IV cateter no. 18 G buah 0 0 0 0 0
115 IV cateter no. 20 G buah 0 0 0 0 0
116 IV cateter no. 22 G buah 0 0 0 0 0
117 IV cateter no. 24 G buah 0 0 0 0 0
118 Kalsium hidroksida pasta pot 0 0 0 0 0
119 Kalsium Laktat 500 mg tablet 300 0 300 100 200
120 Kapas 100 gram rol 0 0 0 0 0
121 Kapas Pembalut 250 gr bungkus 0 0 0 0 0
122 Karbamazepin 200 mg tablet 0 0 0 0 0
123 Kasa pembalut 4 x 5 cm rol 300 0 300 50 250
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
124 Kasa Pembalut 3 x 10 cm rol 0 0 0 0 0
125 Kasa Pembalut 3 x 15 cm rol 0 0 0 0 0
126 Kasa Pembalut 4 x 15cm rol 50 0 50 0 50
127 Kasa Pembalut 3 x 5cm rol 0 0 0 0 0
128 Kasa 16 x 16 cm kotak 20 0 20 10 10
129 Keterolak injeksi vial 0 0 0 0 0
130 Ketokonazol 200 mg tablet 0 0 0 0 0
131 Ketokonazol krim 2.5 % tube 0 0 0 0 0
132 Kinina 200 mg tablet tablet 0 0 0 0 0
133 Kinina injeksi ampul 0 0 0 0 0
134 Kloramfenikol 250 mg kapsul 0 0 0 0 0
135 Kloramfenikol salep kulit 2 % tube 0 0 0 0 0
136 Kloramfenikol salep mata 1 % tube 0 0 0 0 0
137 Kloramfenikol tetes Mata botol 0 0 0 0 0
138 Klorfeniramin maleat ( CTM ) 4 mg tablet 0 0 0 0 0
139 Klorokina posfat 250 mg tablet 0 0 0 0 0
140 Klorpromazin Hcl 100 mg tablet 0 0 0 0 0
141 Klorpromazin Hcl 25 mg tablet 0 0 0 0 0
142 Klorpromazin Hcl inj 25 mg / 1 ml ampul 0 0 0 0 0
143 Kompolax sirup botol 0 0 0 0 0
144 Komb.Primetamin + Sulfadoxin 500 mg tablet 0 0 0 0 0
145 Kotrimoxazol syrup botol 0 0 0 0 0
146 Kotrimoxazol 480 mg tablet 0 0 0 0 0
147 L I s o l 1 Liter botol 0 0 0 0 0
148 Larutan Benedict botol 0 0 0 0 0
149 Larutan Eosin 2 % botol 0 0 0 0 0
150 Larutan Etanol asam botol 0 0 0 0 0
151 Larutan giemsa stain botol 0 0 0 0 0
152 Larutan Karbol Fuksin botol 0 0 0 0 0
153 Larutan Metilan Biru botol 0 0 0 0 0
154 Larutan Turk botol 0 0 0 0 0
155 Lidocain Comp injeksi ampul 0 0 0 0 0
156 Loperamid 2 mg tablet 200 0 200 100 100
157 Loratadin 10 mg tablet 0 0 0 0 0
158 Masker Ear Lop pices 400 0 400 300 100
159 Masker Ties On pices 0 0 0 0 0
160 Masker N 95 pices 0 0 0 0 0
161 Metergin injeksi 0.200 mg / 1 ml ampul 0 0 0 0 0
162 Metformin 500 mg tablet 2300 0 2300 700 1600
163 Metil Prednisolon 4 mg tablet 0 0 0 0 0
164 Metil ergometrin maleat 0.125 mg tablet 200 0 200 0 200
165 Metoklopramid 10 mg tablet 0 0 0 0 0
166 Metolon Injeksi 5 mg / 2 ml ampul 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
167 Metronidazol suspensi botol 0 0 0 0 0
168 Metronidazol tab 500 mg tablet 0 0 0 0 0
169 Miconazol crem tube 0 0 0 0 0
170 Miconazole serbuk botol 0 0 0 0 0
171 Monoklorkamfer mentol cair botol 0 0 0 0 0
172 Multi Vitamin syrup botol 0 0 0 0 0
173 Mumiying Pasta pot 0 0 0 0 0
174 Natrium Bikarbonat 500 mg tablet 0 0 0 0 0
175 Natrium Diklifenak 50 mg tablet 1000 0 1000 500 500
176 Natrium Klorida 0.9 % kolf 60 0 60 40 20
177 Nipedipin 10 mg tablet 0 0 0 0 0
178 Nistatin 100.000 IU tablet 80 0 80 10 70
179 Nistatin 500.000 IU tablet 0 0 0 0 0
180 Obat Anti Tuberkulosis Kategori I paket 0 0 0 0 0
181 Obat Anti Tuberkulosis Kategori II paket 0 0 0 0 0
182 Obat Anti Tuberkulosis Kategori anak paket 0 0 0 0 0
183 Obat Anti Tuberkulosis Kategori Sisipan paket 0 0 0 0 0
184 Obat Batuk hitam ( OBH ) botol 0 0 0 0 0
185 Oksitetrasiklin 3 % salep kulit tube 0 0 0 0 0
186 Oksitetrasiklin Hcl 1 % salep mata tube 0 0 0 0 0
187 Oksitetrasiklin Hcl inj 50 mg - 10 ml vial 0 0 0 0 0
188 Oksitocin Injeksi ampul 0 0 0 0 0
189 Omeprazol 20 mg tablet 0 0 0 0 0
190 Ondansetron injeksi ampul 0 0 0 0 0
191 Papaverin 40 mg tablet 0 0 0 0 0
192 Parasetamol 100 mg tablet 0 0 0 0 0
193 Parasetamol 500 mg tablet 2000 0 2000 1500 500
194 Parasetamol Drop botol 0 0 0 0 0
195 Parasetamol Syrup botol 10 0 10 0 10
196 Permetrin krim 5% (Scabimite) tube 0 0 0 0 0
197 Perak Sulfadiazin krim tube 0 0 0 0 0
198 Pirantel Pamoat 365 mg tablet 100 0 100 0 100
199 Piroxicam 10 mg kapsul 0 0 0 0 0
200 Plester 5 x 500 inchi rol 0 0 0 0 0
201 Policlen botol 0 0 0 0 0
202 Prednison 5 mg tablet 3100 0 3100 1900 1200
203 Primaquin 15 mg tablet 0 0 0 0 0
204 Propanolol Hcl 10 mg tablet 0 0 0 0 0
205 Piridoxin Hcl 10 mg tablet 2400 0 2400 400 2000
206 Propiltiourasil ( PTU ) 100 mg tablet 0 0 0 0 0
207 Ranitidin 150 mg tablet 5000 0 5000 1500 3500
208 Ranitidin injeksi ampul 0 0 0 0 0
209 Resperidon 2 mg tablet 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
210 Ringer Laktat lar infus kolf 40 0 40 0 40
211 Salbutamol 2 mg tablet 0 0 0 0 0
212 Salbutamol 4 mg tablet 0 0 0 0 0
213 Salbutamol Syr botol 0 0 0 0 0
214 Salep 2 - 4 pot 25 0 25 0 25
215 Salisil bedak 2 % bungkus 0 0 0 0 0
216 Sefiksin 100 mg tablet 0 0 0 0 0
217 Semen Seng Posfat serbuk dan cairan set 0 0 0 0 0
218 Serum Anti Bisa Ular Polivalen 50 ml vIal 0 0 0 0 0
219 Serum Anti Tetanus 1.500 IU (ATS ) ampul 0 0 0 0 0
220 Sianokobolamin ( B12) tablet tablet 1000 0 1000 1000 0
221 Sianokobolamin injeksi ( Vit B 12 ) ampul 0 0 0 0 0
222 Silk 17 mm x 76 cm sachet 24 0 24 24 0
223 Silk 25 mm x 75 cm sachet 0 0 0 0 0
224 Simvastatin 10 mg tablet 2200 0 2200 800 1400
225 Stimuno Forte tablet 400 0 400 300 100
226 Sulfasetamid natrium Tetes mata 15 % botol 0 0 0 0 0
227 Tablet Tambah Darah tablet 20000 0 20000 15000 5000
228 Tetagam injeksi vial 0 0 0 0 0
229 Temporary Stoping Fletcher dan cairan botol 0 0 0 0 0
230 Tetrasiklin Hcl 250 mg kapsul 0 0 0 0 0
231 Tetrasiklin Hcl 500 mg kapsul 0 0 0 0 0
232 Thiamin Hcl ( Vit B1 ) injeksi ampul 0 0 0 0 0
233 Thiamin Hcl tablet 50 mg tablet 0 0 0 0 0
234 Tramadol injeksi 50 mg / ml ampul 0 0 0 0 0
235 Trihexilpenidil 2 mg tablet 0 0 0 0 0
236 Urin Bag pices 0 0 0 0 0
237 Vitamin A 100.000 IU kapsul 0 0 0 0 0
238 Vitamin A 200.000 IU kapsul 0 0 0 0 0
239 Vitamin B Complek tablet 2400 0 2400 1600 800
240 Xilocain spray tabung 0 0 0 0 0
241 Yodium Povidon larutan 30 ml botol 0 0 0 0 0
242 Yodium Povidon larutan 100 ml botol 0 0 0 0 0
243 Yodium Povidon larutan 300 ml botol 5 0 5 0 5
244 Zinc tablet 0 0 0 0 0
245 Zinc syrup 20 mg / 5 ml botol 0 0 0 0 0
JUMLAH KUNJUNGAN

Mengetahui
Pimpinan Puskesmas Pelapor
Limbur Lubuk Mengkuang
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
SUTARI, SKM Ranny Fitriany, Amd.Farm
NIP. 197807132008011004 NIP. 19920405 201503 2 004
PUSKESMAS : LIMBUR LUBUK MENGKUANG BULAN : JUNI
KODE : LIMBUR LUBUK MENGKUANG TAHUN : 2023
KABUPATEN : BUNGO
PROPINSI : JAMBI
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( L B 2 )
STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
1 2 3 4 5 6=(4+5 ) 7 8=(6-7 ) 9 10 11
1 ACT( Artesunat 50 mg + Amodiaquin 200 mg ) tablet 0 0 0 0 0
2 Alat Suntik Sekali Pakai 1 ml pcs 0 100 100 0 100
3 Alat Suntik sekali Pakai 2.5 ml pcs 0 300 300 200 100
4 Alat Suntik sekali Pakai 5 ml pcs 0 0 0 0 0
5 Albendazol 400 mg tablet 0 0 0 0 0
6 Alkohol Swab kotak 50 50 100 20 80
7 Alopurinol 100 mg tablet 300 1000 1300 700 600
8 Ambroxol tablet tablet 0 0 0 0 0
9 Ambroxol syrup 15 mg / ml botol 0 0 0 0 0
10 Aminophylin 150 mg tablet 0 0 0 0 0
11 Aminophylin 200 mg tablet 0 0 0 0 0
12 Aminophylin injeksi ampul 0 0 0 0 0
13 Amitriptilin Hcl 25 mg tablet 0 0 0 0 0
14 Amlodipin 5 mg tablet 500 1200 1700 1500 200
15 Amoksisilin 250 mg kapsul 0 0 0 0 0
16 Amoksisilin 500 mg kaplet 0 5000 5000 1000 4000
17 Amoksisilin syrup 125 mg/ml botol 295 295 135 160
18 Amoksisilin syrup botol 0 0 0 0 0
19 Antasida Doen Komb syrup botol 0 0 0 0 0
20 Antasida Doen kombinasi tablet 800 5000 5800 1500 4300
21 Anti Bakteri Doen (bacitracin) tube 0 100 100 25 75
22 Anti Fungi Doen Komb.( Whitfield ) pot 0 100 100 10 90
23 Antihemoroid suppos suppos 10 30 40 30 10
24 Antimigrain Doen ( Ergotamin ) tablet 0 0 0 0 0
25 Aqua proinjeksi vial 0 0 0 0 0
26 Artemeter Injeksi 1 ml : 80 mg ampul 0 0 0 0 0
27 Artesunate injeksi 60 ml vial 0 0 0 0 0
28 Asam Ascorbat ( Vit C ) 50 mg tablet 3400 3000 6400 1400 5000
29 Asam Ascorbat ( Vit C ) 250 mg tablet 0 0 0 0 0
30 Asam ascorbat ( Vit C ) 500 mg tablet 6000 0 6000 1500 4500
31 Asam Mefenamat 500 mg kaplet 2000 3000 5000 1000 4000
32 Asam Traneksamat injeksi ampul 0 0 0 0 0
33 Asiklovir 200 mg tablet 0 0 0 0 0
34 Asiklovir 400 mg tablet 0 0 0 0 0
35 Asiklovir crem 5 % tube 0 0 0 0 0
36 Atapulgit 650 mg tablet 200 0 200 100 100
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
37 Atropin sulfat 0.5 mg tablet 0 0 0 0 0
38 Atropin Sulfat injeksi ampul 20 20 40 0 40
39 Betahistine mesylate 6 mg tablet 1200 3000 4200 400 3800
40 Betametason crem tube 0 100 100 50 50
41 Betametason diproplonoat crem tube 0 0 0 0 0
42 Captopril 12.5 mg tablet 1000 3000 4000 400 3600
43 Captopril 25 mg tablet 2200 2200 1400 800
44 Cat Gut sack 10 120 130 10 120
45 Cefadroxil 500 mg tablet 0 0 0 0 0
46 Cefadroxil syrup botol 0 100 100 50 50
47 Cefotaxim injeksi vial 0 0 0 0 0
48 Ceterizin syrup botol 0 0 0 0 0
49 Cetirizin 10 mg tablet 1500 3000 4500 500 4000
50 Ciproploxacin 500 mg tablet 0 3000 3000 500 2500
51 Deksametason 0.5 mg tablet tablet 0 0 0 0 0
52 Deksametason injeksi ampul 0 100 100 50 50
53 Devitalisasi pasta btl 0 0 0 0 0
54 Diazepam 2 mg tablet 0 0 0 0 0
55 Diazepam injeksi 5 mg / 1 ml ampul 0 0 0 0 0
56 Diazepam Rectal 5 mg / 2.5 ml tube 0 0 0 0 0
57 Difenhidramin Hcl injeksi ampul 0 60 60 0 60
58 Digoxin 0.25 mg tablet 0 0 0 0 0
59 Dimenhidrinat 50 mg tablet 0 0 0 0 0
60 Desinfectan 500 ml botol 0 0 0 0 0
61 Desinfectan 5 Liter botol 2 0 2 0 2
62 Domperidon 10 mg tablet 0 1000 1000 500 500
63 Domperidone Syr botol 0 0 0 0 0
64 Doxycyklin 100 mg kapsul 0 0 0 0 0
65 Erytromycin 500 mg kaplet 300 3000 3300 300 3000
66 Erytromycin syrup botol 0 0 0 0 0
67 Etakridin ( Rivanol ) cairan ampul 0 24 24 14 10
68 E t a n o l 70 % 1 Liter botol 0 10 10 5 5
69 E t a n o l 70 % 100 ml botol 0 20 20 5 15
70 Efedrin Hcl 25 mg tablet 0 0 0 0 0
71 Epinefrin Hcl injeksi ampul 0 0 0 0 0
72 Etil klorida semprot tabung 0 0 0 0 0
73 Eugenol cairan btl 0 0 0 0 0
74 Fenobarbital 30 mg tablet 0 0 0 0 0
75 Fenobarbital injeksi 50 mg / ml ampul 0 0 0 0 0
76 Fenol gliserol tetes telinga botol 24 24 48 24 24
77 Fitomenadion ( vit K ) 10 mg tab tablet 1200 3000 4200 0 4200
78 Fitomenadion ( vit K ) 10 mg / 1 ml ampul 0 0 0 0 0
79 Foly Cateter no 16 pices 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
80 Foly cateter No 18 pices 0 0 0 0 0
81 Furosemid 40 mg tablet 0 500 500 100 400
82 Garam Oralit 200 ml bungkus 200 200 400 0 400
83 Gentamycin injeksi ampul 0 0 0 0 0
84 Gentamycin salep mata 0.3 % tube 0 48 48 0 48
85 Gentamycin tetes mata 0.3 % tube 12 48 60 12 48
86 Gentian violet 1 % botol 0 0 0 0 0
87 Glass Ionomer Cemen ( GC IX ) set 0 0 0 0 0
88 Glibenklamid 5 mg tablet 300 1000 1300 300 1000
89 Glikasida 80 mg tablet 0 0 0 0 0
90 Gliseril Guayakolat 100 mg tablet 0 0 0 0 0
91 Glukosa Lar infus 10 % kolf 0 0 0 0 0
92 Glukosa lar infus 5 % kolf 0 100 100 20 80
93 Griseofulvin 125 mg tablet 600 0 600 200 400
94 Griseofulvin 250 mg tablet 0 0 0 0 0
95 Haloperidol 0.5 mg tablet 0 0 0 0 0
96 Haloperidol 1.5 mg tablet 0 0 0 0 0
97 Haloperidol 5 mg tablet 0 0 0 0 0
98 Haloperidol injeksi ampil 0 0 0 0 0
99 Hand Sanitizer 500 ml botol 0 12 12 4 8
100 Hand Scoond pasang 200 200 400 300 100
101 Hand scoond steril pices 50 100 150 50 100
102 Herbacof syr botol 48 96 144 96 48
103 HCl 0,1 N botol 0 0 0 0 0
104 Hidrogen Peroksida 3 % (H2O2) botol 0 0 0 0 0
105 Hidroklortiazid ( HCT ) 25 mg tablet 400 0 400 100 300
106 Hidrokortison crem 2.5 % tube 0 120 120 62 58
107 Hyocine Butyl Bromida 10 mg tablet 200 300 500 200 300
108 Ibuprofen 200 mg tablet 0 3000 3000 1000 2000
109 Ibuprofen 400 mg tablet 2600 0 2600 700 1900
110 Ibuprofen syrup 100 mg / ml botol 0 0 0 0 0
111 Infusion set Anak bungkus 0 200 200 0 200
112 Infusion set Dewasa bungkus 0 200 200 0 200
113 Isosorbit Dinitrat 5 mg tablet 0 0 0 0 0
114 IV cateter no. 18 G buah 0 0 0 0 0
115 IV cateter no. 20 G buah 0 100 100 0 100
116 IV cateter no. 22 G buah 0 200 200 0 200
117 IV cateter no. 24 G buah 0 200 200 0 200
118 Kalsium hidroksida pasta pot 0 0 0 0 0
119 Kalsium Laktat 500 mg tablet 200 3000 3200 100 3100
120 Kapas 100 gram rol 0 0 0 0 0
121 Kapas Pembalut 250 gr bungkus 0 20 20 0 20
122 Karbamazepin 200 mg tablet 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
123 Kasa pembalut 4 x 5 cm rol 250 0 250 150 100
124 Kasa Pembalut 3 x 10 cm rol 0 100 100 50 50
125 Kasa Pembalut 3 x 15 cm rol 0 100 100 50 50
126 Kasa Pembalut 4 x 15cm rol 50 0 50 0 50
127 Kasa Pembalut 3 x 5cm rol 0 100 100 0 100
128 Kasa 16 x 16 cm kotak 10 100 110 10 100
129 Keterolak injeksi vial 0 0 0 0 0
130 Ketokonazol 200 mg tablet 0 1000 1000 0 1000
131 Ketokonazol krim 2.5 % tube 0 0 0 0 0
132 Kinina 200 mg tablet tablet 0 0 0 0 0
133 Kinina injeksi ampul 0 0 0 0 0
134 Kloramfenikol 250 mg kapsul 0 0 0 0 0
135 Kloramfenikol salep kulit 2 % tube 0 0 0 0 0
136 Kloramfenikol salep mata 1 % tube 0 0 0 0 0
137 Kloramfenikol tetes Mata botol 0 0 0 0 0
138 Klorfeniramin maleat ( CTM ) 4 mg tablet 0 0 0 0 0
139 Klorokina posfat 250 mg tablet 0 0 0 0 0
140 Klorpromazin Hcl 100 mg tablet 0 0 0 0 0
141 Klorpromazin Hcl 25 mg tablet 0 0 0 0 0
142 Klorpromazin Hcl inj 25 mg / 1 ml ampul 0 0 0 0 0
143 Kompolax sirup botol 0 0 0 0 0
144 Komb.Primetamin + Sulfadoxin 500 mg tablet 0 0 0 0 0
145 Kotrimoxazol syrup botol 0 0 0 0 0
146 Kotrimoxazol 480 mg tablet 0 5000 5000 2000 3000
147 L I s o l 1 Liter botol 0 0 0 0 0
148 Larutan Benedict botol 0 0 0 0 0
149 Larutan Eosin 2 % botol 0 0 0 0 0
150 Larutan Etanol asam botol 0 0 0 0 0
151 Larutan giemsa stain botol 0 0 0 0 0
152 Larutan Karbol Fuksin botol 0 0 0 0 0
153 Larutan Metilan Biru botol 0 0 0 0 0
154 Larutan Turk botol 0 0 0 0 0
155 Lidocain Comp injeksi ampul 0 120 120 20 100
156 Loperamid 2 mg tablet 100 0 100 100 0
157 Loratadin 10 mg tablet 0 2000 2000 500 1500
158 Masker Ear Lop pices 100 500 600 300 300
159 Masker Ties On pices 0 0 0 0 0
160 Masker N 95 pices 0 0 0 0 0
161 Metergin injeksi 0.200 mg / 1 ml ampul 0 0 0 0 0
162 Metformin 500 mg tablet 1600 0 1600 700 900
163 Metil Prednisolon 4 mg tablet 0 3000 3000 0 3000
164 Metil ergometrin maleat 0.125 mg tablet 200 500 700 200 500
165 Metoklopramid 10 mg tablet 0 1000 1000 0 1000
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
166 Metolon Injeksi 5 mg / 2 ml ampul 0 0 0 0 0
167 Metronidazol suspensi botol 0 0 0 0 0
168 Metronidazol tab 500 mg tablet 0 0 0 0 0
169 Miconazol crem tube 0 48 48 0 48
170 Miconazole serbuk botol 0 48 48 0 48
171 Monoklorkamfer mentol cair botol 0 0 0 0 0
172 Multi Vitamin syrup botol 0 0 0 0 0
173 Mumiying Pasta pot 0 0 0 0 0
174 Natrium Bikarbonat 500 mg tablet 0 0 0 0 0
175 Natrium Diklifenak 50 mg tablet 500 3000 3500 500 3000
176 Natrium Klorida 0.9 % kolf 20 120 140 40 100
177 Nipedipin 10 mg tablet 0 0 0 0 0
178 Nistatin 100.000 IU tablet 70 0 70 10 60
179 Nistatin 500.000 IU tablet 0 0 0 0 0
180 Obat Anti Tuberkulosis Kategori I paket 0 0 0 0 0
181 Obat Anti Tuberkulosis Kategori II paket 0 0 0 0 0
182 Obat Anti Tuberkulosis Kategori anak paket 0 0 0 0 0
183 Obat Anti Tuberkulosis Kategori Sisipan paket 0 0 0 0 0
184 Obat Batuk hitam ( OBH ) botol 0 0 0 0 0
185 Oksitetrasiklin 3 % salep kulit tube 0 0 0 0 0
186 Oksitetrasiklin Hcl 1 % salep mata tube 0 0 0 0 0
187 Oksitetrasiklin Hcl inj 50 mg - 10 ml vial 0 0 0 0 0
188 Oksitocin Injeksi ampul 0 100 100 50 50
189 Omeprazol 20 mg tablet 0 0 0 0 0
190 Ondansetron injeksi ampul 0 0 0 0 0
191 Papaverin 40 mg tablet 0 0 0 0 0
192 Parasetamol 100 mg tablet 0 0 0 0 0
193 Parasetamol 500 mg tablet 500 5000 5500 2500 3000
194 Parasetamol Drop botol 0 0 0 0 0
195 Parasetamol Syrup botol 10 0 10 0 10
196 Permetrin krim 5% (Scabimite) tube 0 30 30 10 20
197 Perak Sulfadiazin krim tube 0 0 0 0 0
198 Pirantel Pamoat 365 mg tablet 100 0 100 50 50
199 Piroxicam 10 mg kapsul 0 0 0 0 0
200 Plester 5 x 500 inchi rol 0 20 20 5 15
201 Policlen botol 0 0 0 0 0
202 Prednison 5 mg tablet 1200 2000 3200 2200 1000
203 Primaquin 15 mg tablet 0 0 0 0 0
204 Propanolol Hcl 10 mg tablet 0 0 0 0 0
205 Piridoxin Hcl 10 mg tablet 2000 1000 3000 500 2500
206 Propiltiourasil ( PTU ) 100 mg tablet 0 0 0 0 0
207 Ranitidin 150 mg tablet 3500 0 3500 1500 2000
208 Ranitidin injeksi ampul 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
209 Resperidon 2 mg tablet 0 0 0 0 0
210 Ringer Laktat lar infus kolf 40 120 160 60 100
211 Salbutamol 2 mg tablet 0 2000 2000 0 2000
212 Salbutamol 4 mg tablet 0 0 0 0 0
213 Salbutamol Syr botol 0 0 0 0 0
214 Salep 2 - 4 pot 25 0 25 0 25
215 Salisil bedak 2 % bungkus 0 0 0 0 0
216 Sefiksin 100 mg tablet 0 0 0 0 0
217 Semen Seng Posfat serbuk dan cairan set 0 0 0 0 0
218 Serum Anti Bisa Ular Polivalen 50 ml vIal 0 2 2 0 2
219 Serum Anti Tetanus 1.500 IU (ATS ) ampul 0 5 5 0 5
220 Sianokobolamin ( B12) tablet tablet 0 1000 1000 500 500
221 Sianokobolamin injeksi ( Vit B 12 ) ampul 0 100 100 0 100
222 Silk 17 mm x 76 cm sachet 0 12 12 0 12
223 Silk 25 mm x 75 cm sachet 0 36 36 0 36
224 Simvastatin 10 mg tablet 1400 0 1400 800 600
225 Stimuno Forte tablet 100 0 100 100 0
226 Sulfasetamid natrium Tetes mata 15 % botol 0 0 0 0 0
227 Tablet Tambah Darah tablet 5000 0 5000 2000 3000
228 Tetagam injeksi vial 0 0 0 0 0
229 Temporary Stoping Fletcher dan cairan botol 0 0 0 0 0
230 Tetrasiklin Hcl 250 mg kapsul 0 0 0 0 0
231 Tetrasiklin Hcl 500 mg kapsul 0 0 0 0 0
232 Thiamin Hcl ( Vit B1 ) injeksi ampul 0 0 0 0 0
233 Thiamin Hcl tablet 50 mg tablet 0 0 0 0 0
234 Tramadol injeksi 50 mg / ml ampul 0 0 0 0 0
235 Trihexilpenidil 2 mg tablet 0 0 0 0 0
236 Urin Bag pices 0 0 0 0 0
237 Vitamin A 100.000 IU kapsul 0 0 0 0 0
238 Vitamin A 200.000 IU kapsul 0 0 0 0 0
239 Vitamin B Complek tablet 800 3000 3800 1800 2000
240 Xilocain spray tabung 0 0 0 0 0
241 Yodium Povidon larutan 30 ml botol 0 0 0 0 0
242 Yodium Povidon larutan 100 ml botol 0 20 20 10 10
243 Yodium Povidon larutan 300 ml botol 5 0 5 0 5
244 Zinc tablet 0 0 0 0 0
245 Zinc syrup 20 mg / 5 ml botol 0 0 0 0 0
JUMLAH KUNJUNGAN

Mengetahui
Pimpinan Puskesmas Pelapor
Limbur Lubuk Mengkuang
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT

SUTARI, SKM Ranny Fitriany, Amd.Farm

NIP. 197807132008011004 NIP. 19920405 201503 2 004
PUSKESMAS : LIMBUR LUBUK MENGKUANG BULAN : JULI
KODE : LIMBUR LUBUK MENGKUANG TAHUN : 2023
KABUPATEN : BUNGO
PROPINSI : JAMBI
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( L B 2 )
STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
1 2 3 4 5 6=(4+5 ) 7 8=(6-7 ) 9 10 11
1 ACT( Artesunat 50 mg + Amodiaquin 200 mg ) tablet 0 0 0 0 0
2 Alat Suntik Sekali Pakai 1 ml pcs 100 0 100 0 100 500
3 Alat Suntik sekali Pakai 2.5 ml pcs 100 0 100 100 0 500
4 Alat Suntik sekali Pakai 5 ml pcs 0 0 0 0 0
5 Albendazol 400 mg tablet 0 0 0 0 0
6 Alkohol Swab kotak 80 0 80 20 60 100
7 Alopurinol 100 mg tablet 600 0 600 500 100 3000
8 Ambroxol tablet tablet 0 0 0 0 0
9 Ambroxol syrup 15 mg / ml botol 0 0 0 0 0
10 Aminophylin 150 mg tablet 0 0 0 0 0
11 Aminophylin 200 mg tablet 0 0 0 0 0
12 Aminophylin injeksi ampul 0 0 0 0 0
13 Amitriptilin Hcl 25 mg tablet 0 0 0 0 0
14 Amlodipin 5 mg tablet 200 0 200 0 200 3000
15 Amoksisilin 250 mg kapsul 0 0 0 0 0
16 Amoksisilin 500 mg kaplet 4000 0 4000 1000 3000 5000
17 Amoksisilin syrup 125 mg/ml botol 160 0 160 135 25 100
18 Amoksisilin syrup botol 0 0 0 0 0
19 Antasida Doen Komb syrup botol 0 0 0 0 0
20 Antasida Doen kombinasi tablet 4300 0 4300 1500 2800 3000
21 Anti Bakteri Doen (bacitracin) tube 75 0 75 25 50 100
22 Anti Fungi Doen Komb.( Whitfield ) pot 90 0 90 10 80
23 Antihemoroid suppos suppos 10 0 10 0 10 20
24 Antimigrain Doen ( Ergotamin ) tablet 0 0 0 0 0
25 Aqua proinjeksi vial 0 0 0 0 0
26 Artemeter Injeksi 1 ml : 80 mg ampul 0 0 0 0 0
27 Artesunate injeksi 60 ml vial 0 0 0 0 0
28 Asam Ascorbat ( Vit C ) 50 mg tablet 5000 0 5000 1400 3600 1000
29 Asam Ascorbat ( Vit C ) 250 mg tablet 0 0 0 0 0
30 Asam ascorbat ( Vit C ) 500 mg tablet 4500 0 4500 1500 3000
31 Asam Mefenamat 500 mg kaplet 4000 0 4000 1000 3000 5000
32 Asam Traneksamat injeksi ampul 0 0 0 0 0
33 Asiklovir 200 mg tablet 0 0 0 0 0 2000
34 Asiklovir 400 mg tablet 0 0 0 0 0
35 Asiklovir crem 5 % tube 0 0 0 0 0 100
36 Atapulgit 650 mg tablet 100 0 100 100 0 1000
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
37 Atropin sulfat 0.5 mg tablet 0 0 0 0 0
38 Atropin Sulfat injeksi ampul 40 0 40 0 40
39 Betahistine mesylate 6 mg tablet 3800 0 3800 400 3400 2000
40 Betametason crem tube 50 0 50 50 0 100
41 Betametason diproplonoat crem tube 0 0 0 0 0
42 Captopril 12.5 mg tablet 3600 0 3600 600 3000
43 Captopril 25 mg tablet 800 0 800 300 500
44 Cat Gut sack 120 0 120 10 110 120
45 Cefadroxil 500 mg tablet 0 0 0 0 0
46 Cefadroxil syrup botol 50 0 50 50 0 100
47 Cefotaxim injeksi vial 0 0 0 0 0
48 Ceterizin syrup botol 0 0 0 0 0 100
49 Cetirizin 10 mg tablet 4000 0 4000 500 3500 3000
50 Ciproploxacin 500 mg tablet 2500 0 2500 500 2000 2000
51 Deksametason 0.5 mg tablet tablet 0 0 0 0 0
52 Deksametason injeksi ampul 50 0 50 50 0 100
53 Devitalisasi pasta btl 0 0 0 0 0
54 Diazepam 2 mg tablet 0 0 0 0 0
55 Diazepam injeksi 5 mg / 1 ml ampul 0 0 0 0 0
56 Diazepam Rectal 5 mg / 2.5 ml tube 0 0 0 0 0
57 Difenhidramin Hcl injeksi ampul 60 0 60 0 60
58 Digoxin 0.25 mg tablet 0 0 0 0 0
59 Dimenhidrinat 50 mg tablet 0 0 0 0 0
60 Desinfectan 500 ml botol 0 0 0 0 0
61 Desinfectan 5 Liter botol 2 0 2 0 2
62 Domperidon 10 mg tablet 500 0 500 500 0 1000
63 Domperidone Syr botol 0 0 0 0 0
64 Doxycyklin 100 mg kapsul 0 0 0 0 0
65 Erytromycin 500 mg kaplet 3000 0 3000 300 2700 1000
66 Erytromycin syrup botol 0 0 0 0 0
67 Etakridin ( Rivanol ) cairan ampul 10 0 10 5 5 50
68 E t a n o l 70 % 1 Liter botol 5 0 5 5 0 20
69 E t a n o l 70 % 100 ml botol 15 0 15 5 10 50
70 Efedrin Hcl 25 mg tablet 0 0 0 0 0
71 Epinefrin Hcl injeksi ampul 0 0 0 0 0
72 Etil klorida semprot tabung 0 0 0 0 0
73 Eugenol cairan btl 0 0 0 0 0
74 Fenobarbital 30 mg tablet 0 0 0 0 0
75 Fenobarbital injeksi 50 mg / ml ampul 0 0 0 0 0
76 Fenol gliserol tetes telinga botol 24 0 24 24 0 48
77 Fitomenadion ( vit K ) 10 mg tab tablet 4200 0 4200 0 4200
78 Fitomenadion ( vit K ) 10 mg / 1 ml ampul 0 0 0 0 0 100
79 Foly Cateter no 16 pices 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
80 Foly cateter No 18 pices 0 0 0 0 0
81 Furosemid 40 mg tablet 400 0 400 100 300 2000
82 Garam Oralit 200 ml bungkus 400 0 400 0 400
83 Gentamycin injeksi ampul 0 0 0 0 0
84 Gentamycin salep mata 0.3 % tube 48 0 48 0 48 100
85 Gentamycin tetes mata 0.3 % tube 48 0 48 12 36 100
86 Gentian violet 1 % botol 0 0 0 0 0
87 Glass Ionomer Cemen ( GC IX ) set 0 0 0 0 0
88 Glibenklamid 5 mg tablet 1000 0 1000 300 700
89 Glikasida 80 mg tablet 0 0 0 0 0
90 Gliseril Guayakolat 100 mg tablet 0 0 0 0 0
91 Glukosa Lar infus 10 % kolf 0 0 0 0 0 100
92 Glukosa lar infus 5 % kolf 80 0 80 20 60 100
93 Griseofulvin 125 mg tablet 400 0 400 200 200
94 Griseofulvin 250 mg tablet 0 0 0 0 0
95 Haloperidol 0.5 mg tablet 0 0 0 0 0
96 Haloperidol 1.5 mg tablet 0 0 0 0 0
97 Haloperidol 5 mg tablet 0 0 0 0 0
98 Haloperidol injeksi ampil 0 0 0 0 0
99 Hand Sanitizer 500 ml botol 8 0 8 4 4
100 Hand Scoond pasang 100 0 100 0 100 100
101 Hand scoond steril pices 100 0 100 50 50 100
102 Herbacof syr botol 48 0 48 48 0 200
103 HCl 0,1 N botol 0 0 0 0 0
104 Hidrogen Peroksida 3 % (H2O2) botol 0 0 0 0 0
105 Hidroklortiazid ( HCT ) 25 mg tablet 300 0 300 100 200
106 Hidrokortison crem 2.5 % tube 58 0 58 48 10
107 Hyocine Butyl Bromida 10 mg tablet 300 0 300 200 100 1000
108 Ibuprofen 200 mg tablet 2000 0 2000 1000 1000
109 Ibuprofen 400 mg tablet 1900 0 1900 700 1200
110 Ibuprofen syrup 100 mg / ml botol 0 0 0 0 0
111 Infusion set Anak bungkus 200 0 200 0 200
112 Infusion set Dewasa bungkus 200 0 200 0 200 100
113 Isosorbit Dinitrat 5 mg tablet 0 0 0 0 0
114 IV cateter no. 18 G buah 0 0 0 0 0 100
115 IV cateter no. 20 G buah 100 0 100 0 100 100
116 IV cateter no. 22 G buah 200 0 200 0 200 100
117 IV cateter no. 24 G buah 200 0 200 0 200 100
118 Kalsium hidroksida pasta pot 0 0 0 0 0
119 Kalsium Laktat 500 mg tablet 3100 0 3100 100 3000
120 Kapas 100 gram rol 0 0 0 0 0
121 Kapas Pembalut 250 gr bungkus 20 0 20 0 20
122 Karbamazepin 200 mg tablet 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
123 Kasa pembalut 4 x 5 cm rol 100 0 100 100 0 100
124 Kasa Pembalut 3 x 10 cm rol 50 0 50 50 0 100
125 Kasa Pembalut 3 x 15 cm rol 50 0 50 50 0 100
126 Kasa Pembalut 4 x 15cm rol 50 0 50 50 0 100
127 Kasa Pembalut 3 x 5cm rol 100 0 100 100 0 100
128 Kasa 16 x 16 cm kotak 100 0 100 50 50 100
129 Keterolak injeksi vial 0 0 0 0 0
130 Ketokonazol 200 mg tablet 1000 0 1000 400 600 1000
131 Ketokonazol krim 2.5 % tube 0 0 0 0 0 100
132 Kinina 200 mg tablet tablet 0 0 0 0 0
133 Kinina injeksi ampul 0 0 0 0 0
134 Kloramfenikol 250 mg kapsul 0 0 0 0 0
135 Kloramfenikol salep kulit 2 % tube 0 0 0 0 0 100
136 Kloramfenikol salep mata 1 % tube 0 0 0 0 0 100
137 Kloramfenikol tetes Mata botol 0 0 0 0 0
138 Klorfeniramin maleat ( CTM ) 4 mg tablet 0 0 0 0 0
139 Klorokina posfat 250 mg tablet 0 0 0 0 0
140 Klorpromazin Hcl 100 mg tablet 0 0 0 0 0
141 Klorpromazin Hcl 25 mg tablet 0 0 0 0 0
142 Klorpromazin Hcl inj 25 mg / 1 ml ampul 0 0 0 0 0
143 Kompolax sirup botol 0 0 0 0 0 100
144 Komb.Primetamin + Sulfadoxin 500 mg tablet 0 0 0 0 0
145 Kotrimoxazol syrup botol 0 0 0 0 0
146 Kotrimoxazol 480 mg tablet 3000 0 3000 2000 1000
147 L I s o l 1 Liter botol 0 0 0 0 0 100
148 Larutan Benedict botol 0 0 0 0 0
149 Larutan Eosin 2 % botol 0 0 0 0 0
150 Larutan Etanol asam botol 0 0 0 0 0
151 Larutan giemsa stain botol 0 0 0 0 0
152 Larutan Karbol Fuksin botol 0 0 0 0 0
153 Larutan Metilan Biru botol 0 0 0 0 0
154 Larutan Turk botol 0 0 0 0 0
155 Lidocain Comp injeksi ampul 100 0 100 20 80 200
156 Loperamid 2 mg tablet 0 0 0 0 0
157 Loratadin 10 mg tablet 1500 0 1500 500 1000
158 Masker Ear Lop pices 300 0 300 300 0 200
159 Masker Ties On pices 0 0 0 0 0
160 Masker N 95 pices 0 0 0 0 0
161 Metergin injeksi 0.200 mg / 1 ml ampul 0 0 0 0 0
162 Metformin 500 mg tablet 900 0 900 700 200 3000
163 Metil Prednisolon 4 mg tablet 3000 0 3000 1500 1500 5000
164 Metil ergometrin maleat 0.125 mg tablet 500 0 500 200 300
165 Metoklopramid 10 mg tablet 1000 0 1000 0 1000
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
166 Metolon Injeksi 5 mg / 2 ml ampul 0 0 0 0 0
167 Metronidazol suspensi botol 0 0 0 0 0
168 Metronidazol tab 500 mg tablet 0 0 0 0 0
169 Miconazol crem tube 48 0 48 0 48
170 Miconazole serbuk botol 48 0 48 0 48
171 Monoklorkamfer mentol cair botol 0 0 0 0 0
172 Multi Vitamin syrup botol 0 0 0 0 0
173 Mumiying Pasta pot 0 0 0 0 0
174 Natrium Bikarbonat 500 mg tablet 0 0 0 0 0
175 Natrium Diklifenak 50 mg tablet 3000 0 3000 500 2500 5000
176 Natrium Klorida 0.9 % kolf 100 0 100 40 60 200
177 Nipedipin 10 mg tablet 0 0 0 0 0
178 Nistatin 100.000 IU tablet 60 0 60 10 50
179 Nistatin 500.000 IU tablet 0 0 0 0 0
180 Obat Anti Tuberkulosis Kategori I paket 0 0 0 0 0
181 Obat Anti Tuberkulosis Kategori II paket 0 0 0 0 0
182 Obat Anti Tuberkulosis Kategori anak paket 0 0 0 0 0
183 Obat Anti Tuberkulosis Kategori Sisipan paket 0 0 0 0 0
184 Obat Batuk hitam ( OBH ) botol 0 0 0 0 0
185 Oksitetrasiklin 3 % salep kulit tube 0 0 0 0 0
186 Oksitetrasiklin Hcl 1 % salep mata tube 0 0 0 0 0
187 Oksitetrasiklin Hcl inj 50 mg - 10 ml vial 0 0 0 0 0
188 Oksitocin Injeksi ampul 50 0 50 50 0
189 Omeprazol 20 mg tablet 0 0 0 0 0
190 Ondansetron injeksi ampul 0 0 0 0 0
191 Papaverin 40 mg tablet 0 0 0 0 0
192 Parasetamol 100 mg tablet 0 0 0 0 0
193 Parasetamol 500 mg tablet 3000 0 3000 2500 500 5000
194 Parasetamol Drop botol 0 0 0 0 0
195 Parasetamol Syrup botol 10 0 10 0 10 100
196 Permetrin krim 5% (Scabimite) tube 20 0 20 10 10 100
197 Perak Sulfadiazin krim tube 0 0 0 0 0
198 Pirantel Pamoat 365 mg tablet 50 0 50 50 0
199 Piroxicam 10 mg kapsul 0 0 0 0 0
200 Plester 5 x 500 inchi rol 15 0 15 5 10 20
201 Policlen botol 0 0 0 0 0
202 Prednison 5 mg tablet 1000 0 1000 1000 0
203 Primaquin 15 mg tablet 0 0 0 0 0
204 Propanolol Hcl 10 mg tablet 0 0 0 0 0
205 Piridoxin Hcl 10 mg tablet 2500 0 2500 500 2000
206 Propiltiourasil ( PTU ) 100 mg tablet 0 0 0 0 0
207 Ranitidin 150 mg tablet 2000 0 2000 1500 500 3000
208 Ranitidin injeksi ampul 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
209 Resperidon 2 mg tablet 0 0 0 0 0
210 Ringer Laktat lar infus kolf 100 0 100 60 40
211 Salbutamol 2 mg tablet 2000 0 2000 0 2000
212 Salbutamol 4 mg tablet 0 0 0 0 0 2000
213 Salbutamol Syr botol 0 0 0 0 0
214 Salep 2 - 4 pot 25 0 25 0 25
215 Salisil bedak 2 % bungkus 0 0 0 0 0
216 Sefiksin 100 mg tablet 0 0 0 0 0
217 Semen Seng Posfat serbuk dan cairan set 0 0 0 0 0
218 Serum Anti Bisa Ular Polivalen 50 ml vIal 2 0 2 0 2
219 Serum Anti Tetanus 1.500 IU (ATS ) ampul 5 0 5 0 5
220 Sianokobolamin ( B12) tablet tablet 500 0 500 0 500
221 Sianokobolamin injeksi ( Vit B 12 ) ampul 100 0 100 50 50
222 Silk 17 mm x 76 cm sachet 12 0 12 0 12 36
223 Silk 25 mm x 75 cm sachet 36 0 36 0 36 36
224 Simvastatin 10 mg tablet 600 0 600 100 500
225 Stimuno Forte tablet 0 0 0 0 0
226 Sulfasetamid natrium Tetes mata 15 % botol 0 0 0 0 0
227 Tablet Tambah Darah tablet 3000 0 3000 2000 1000
228 Tetagam injeksi vial 0 0 0 0 0
229 Temporary Stoping Fletcher dan cairan botol 0 0 0 0 0
230 Tetrasiklin Hcl 250 mg kapsul 0 0 0 0 0
231 Tetrasiklin Hcl 500 mg kapsul 0 0 0 0 0
232 Thiamin Hcl ( Vit B1 ) injeksi ampul 0 0 0 0 0
233 Thiamin Hcl tablet 50 mg tablet 0 0 0 0 0
234 Tramadol injeksi 50 mg / ml ampul 0 0 0 0 0
235 Trihexilpenidil 2 mg tablet 0 0 0 0 0
236 Urin Bag pices 0 0 0 0 0
237 Vitamin A 100.000 IU kapsul 0 0 0 0 0
238 Vitamin A 200.000 IU kapsul 0 0 0 0 0
239 Vitamin B Complek tablet 2000 0 2000 1800 200
240 Xilocain spray tabung 0 0 0 0 0
241 Yodium Povidon larutan 30 ml botol 0 0 0 0 0
242 Yodium Povidon larutan 100 ml botol 10 0 10 10 0
243 Yodium Povidon larutan 300 ml botol 5 0 5 0 5
244 Zinc tablet 0 0 0 0 0 2000
245 Zinc syrup 20 mg / 5 ml botol 0 0 0 0 0 100
JUMLAH KUNJUNGAN

Mengetahui
Pimpinan Puskesmas Pelapor
Limbur Lubuk Mengkuang
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT

SUTARI, SKM Ranny Fitriany, Amd.Farm

NIP. 197807132008011004 NIP. 19920405 201503 2 004
PUSKESMAS : LIMBUR LUBUK MENGKUANG BULAN : AGUSTUS
KODE : LIMBUR LUBUK MENGKUANG TAHUN : 2023
KABUPATEN : BUNGO
PROPINSI : JAMBI
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( L B 2 )
STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
1 2 3 4 5 6=(4+5 ) 7 8=(6-7 ) 9 10 11
1 ACT( Artesunat 50 mg + Amodiaquin 200 mg ) tablet 0 0 0 0 0
2 Alat Suntik Sekali Pakai 1 ml pcs 100 0 100 0 100
3 Alat Suntik sekali Pakai 2.5 ml pcs 0 0 0 0 0
4 Alat Suntik sekali Pakai 5 ml pcs 0 0 0 0 0
5 Albendazol 400 mg tablet 0 0 0 0 0
6 Alkohol Swab kotak 60 0 60 20 40
7 Alopurinol 100 mg tablet 100 0 100 0 100
8 Ambroxol tablet tablet 0 0 0 0 0
9 Ambroxol syrup 15 mg / ml botol 0 0 0 0 0
10 Aminophylin 150 mg tablet 0 0 0 0 0
11 Aminophylin 200 mg tablet 0 0 0 0 0
12 Aminophylin injeksi ampul 0 0 0 0 0
13 Amitriptilin Hcl 25 mg tablet 0 0 0 0 0
14 Amlodipin 5 mg tablet 200 0 200 200
15 Amoksisilin 250 mg kapsul 0 0 0 0 0
16 Amoksisilin 500 mg kaplet 3000 0 3000 3000 0
17 Amoksisilin syrup 125 mg/ml botol 25 0 25 0 25
18 Amoksisilin syrup botol 0 0 0 0 0
19 Antasida Doen Komb syrup botol 0 0 0 0 0
20 Antasida Doen kombinasi tablet 2800 0 2800 1800 1000
21 Anti Bakteri Doen (bacitracin) tube 50 0 50 25 25
22 Anti Fungi Doen Komb.( Whitfield ) pot 80 0 80 10 70
23 Antihemoroid suppos suppos 10 0 10 0 10
24 Antimigrain Doen ( Ergotamin ) tablet 0 0 0 0 0
25 Aqua proinjeksi vial 0 0 0 0 0
26 Artemeter Injeksi 1 ml : 80 mg ampul 0 0 0 0 0
27 Artesunate injeksi 60 ml vial 0 0 0 0 0
28 Asam Ascorbat ( Vit C ) 50 mg tablet 3600 0 3600 1600 2000
29 Asam Ascorbat ( Vit C ) 250 mg tablet 0 0 0 0 0
30 Asam ascorbat ( Vit C ) 500 mg tablet 3000 0 3000 2800 200
31 Asam Mefenamat 500 mg kaplet 3000 0 3000 1000 2000
32 Asam Traneksamat injeksi ampul 0 0 0 0 0
33 Asiklovir 200 mg tablet 0 0 0 0 0
34 Asiklovir 400 mg tablet 0 0 0 0 0
35 Asiklovir crem 5 % tube 0 0 0 0 0
36 Atapulgit 650 mg tablet 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
37 Atropin sulfat 0.5 mg tablet 0 0 0 0 0
38 Atropin Sulfat injeksi ampul 40 0 40 40 0
39 Betahistine mesylate 6 mg tablet 3400 0 3400 1400 2000
40 Betametason crem tube 0 0 0 50 0
41 Betametason diproplonoat crem tube 0 0 0 0 0
42 Captopril 12.5 mg tablet 3000 0 3000 1700 1300
43 Captopril 25 mg tablet 500 0 500 300 200
44 Cat Gut sack 110 0 110 110 0
45 Cefadroxil 500 mg tablet 0 0 0 0 0
46 Cefadroxil syrup botol 0 0 0 0 0
47 Cefotaxim injeksi vial 0 0 0 0 0
48 Ceterizin syrup botol 0 0 0 0 0
49 Cetirizin 10 mg tablet 3500 0 3500 3500 0
50 Ciproploxacin 500 mg tablet 2000 0 2000 2000 0
51 Deksametason 0.5 mg tablet tablet 0 0 0 0 0
52 Deksametason injeksi ampul 0 0 0 0 0
53 Devitalisasi pasta btl 0 0 0 0 0
54 Diazepam 2 mg tablet 0 0 0 0 0
55 Diazepam injeksi 5 mg / 1 ml ampul 0 0 0 0 0
56 Diazepam Rectal 5 mg / 2.5 ml tube 0 0 0 0 0
57 Difenhidramin Hcl injeksi ampul 60 0 60 60 0
58 Digoxin 0.25 mg tablet 0 0 0 0 0
59 Dimenhidrinat 50 mg tablet 0 0 0 0 0
60 Desinfectan 500 ml botol 0 0 0 0 0
61 Desinfectan 5 Liter botol 2 0 2 0 2
62 Domperidon 10 mg tablet 0 0 0 0 0
63 Domperidone Syr botol 0 0 0 0 0
64 Doxycyklin 100 mg kapsul 0 0 0 0 0
65 Erytromycin 500 mg kaplet 2700 0 2700 1400 1300
66 Erytromycin syrup botol 0 0 0 0 0
67 Etakridin ( Rivanol ) cairan ampul 5 0 5 5 0
68 E t a n o l 70 % 1 Liter botol 0 0 0 0 0
69 E t a n o l 70 % 100 ml botol 10 0 10 5 5
70 Efedrin Hcl 25 mg tablet 0 0 0 0 0
71 Epinefrin Hcl injeksi ampul 0 0 0 0 0
72 Etil klorida semprot tabung 0 0 0 0 0
73 Eugenol cairan btl 0 0 0 0 0
74 Fenobarbital 30 mg tablet 0 0 0 0 0
75 Fenobarbital injeksi 50 mg / ml ampul 0 0 0 0 0
76 Fenol gliserol tetes telinga botol 0 0 0 0 0
77 Fitomenadion ( vit K ) 10 mg tab tablet 4200 0 4200 1900 2300
78 Fitomenadion ( vit K ) 10 mg / 1 ml ampul 0 0 0 0 0
79 Foly Cateter no 16 pices 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
80 Foly cateter No 18 pices 0 0 0 0 0
81 Furosemid 40 mg tablet 300 0 300 300 0
82 Garam Oralit 200 ml bungkus 400 0 400 400 0
83 Gentamycin injeksi ampul 0 0 0 0 0
84 Gentamycin salep mata 0.3 % tube 48 0 48 48 0
85 Gentamycin tetes mata 0.3 % tube 36 0 36 36 0
86 Gentian violet 1 % botol 0 0 0 0 0
87 Glass Ionomer Cemen ( GC IX ) set 0 0 0 0 0
88 Glibenklamid 5 mg tablet 700 0 700 300 400
89 Glikasida 80 mg tablet 0 0 0 0 0
90 Gliseril Guayakolat 100 mg tablet 0 0 0 0 0
91 Glukosa Lar infus 10 % kolf 0 0 0 0 0
92 Glukosa lar infus 5 % kolf 60 0 60 60 0
93 Griseofulvin 125 mg tablet 200 0 200 200 0
94 Griseofulvin 250 mg tablet 0 0 0 0 0
95 Haloperidol 0.5 mg tablet 0 0 0 0 0
96 Haloperidol 1.5 mg tablet 0 0 0 0 0
97 Haloperidol 5 mg tablet 0 0 0 0 0
98 Haloperidol injeksi ampil 0 0 0 0 0
99 Hand Sanitizer 500 ml botol 4 0 4 4 0
100 Hand Scoond pasang 100 0 100 0 100
101 Hand scoond steril pices 50 0 50 50 0
102 Herbacof syr botol 0 0 0 0 0
103 HCl 0,1 N botol 0 0 0 0 0
104 Hidrogen Peroksida 3 % (H2O2) botol 0 0 0 0 0
105 Hidroklortiazid ( HCT ) 25 mg tablet 200 0 200 100 100
106 Hidrokortison crem 2.5 % tube 10 0 10 10 0
107 Hyocine Butyl Bromida 10 mg tablet 100 0 100 100 0
108 Ibuprofen 200 mg tablet 1000 0 1000 1000 0
109 Ibuprofen 400 mg tablet 1200 0 1200 0 1200
110 Ibuprofen syrup 100 mg / ml botol 0 0 0 0 0
111 Infusion set Anak bungkus 200 0 200 200 0
112 Infusion set Dewasa bungkus 200 0 200 200 0
113 Isosorbit Dinitrat 5 mg tablet 0 0 0 0 0
114 IV cateter no. 18 G buah 0 0 0 0 0
115 IV cateter no. 20 G buah 100 0 100 100 0
116 IV cateter no. 22 G buah 200 0 200 200 0
117 IV cateter no. 24 G buah 200 0 200 200 0
118 Kalsium hidroksida pasta pot 0 0 0 0 0
119 Kalsium Laktat 500 mg tablet 3000 0 3000 1200 1800
120 Kapas 100 gram rol 0 0 0 0 0
121 Kapas Pembalut 250 gr bungkus 20 0 20 20 0
122 Karbamazepin 200 mg tablet 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
123 Kasa pembalut 4 x 5 cm rol 0 0 0 0 0
124 Kasa Pembalut 3 x 10 cm rol 0 0 0 0 0
125 Kasa Pembalut 3 x 15 cm rol 0 0 0 0 0
126 Kasa Pembalut 4 x 15cm rol 0 0 0 0 0
127 Kasa Pembalut 3 x 5cm rol 0 0 0 0 0
128 Kasa 16 x 16 cm kotak 50 0 50 50 0
129 Keterolak injeksi vial 0 0 0 0 0
130 Ketokonazol 200 mg tablet 600 0 600 400 200
131 Ketokonazol krim 2.5 % tube 0 0 0 0 0
132 Kinina 200 mg tablet tablet 0 0 0 0 0
133 Kinina injeksi ampul 0 0 0 0 0
134 Kloramfenikol 250 mg kapsul 0 0 0 0 0
135 Kloramfenikol salep kulit 2 % tube 0 0 0 0 0
136 Kloramfenikol salep mata 1 % tube 0 0 0 0 0
137 Kloramfenikol tetes Mata botol 0 0 0 0 0
138 Klorfeniramin maleat ( CTM ) 4 mg tablet 0 0 0 0 0
139 Klorokina posfat 250 mg tablet 0 0 0 0 0
140 Klorpromazin Hcl 100 mg tablet 0 0 0 0 0
141 Klorpromazin Hcl 25 mg tablet 0 0 0 0 0
142 Klorpromazin Hcl inj 25 mg / 1 ml ampul 0 0 0 0 0
143 Kompolax sirup botol 0 0 0 0 0
144 Komb.Primetamin + Sulfadoxin 500 mg tablet 0 0 0 0 0
145 Kotrimoxazol syrup botol 0 0 0 0 0
146 Kotrimoxazol 480 mg tablet 1000 0 1000 0 1000
147 L I s o l 1 Liter botol 0 0 0 0 0
148 Larutan Benedict botol 0 0 0 0 0
149 Larutan Eosin 2 % botol 0 0 0 0 0
150 Larutan Etanol asam botol 0 0 0 0 0
151 Larutan giemsa stain botol 0 0 0 0 0
152 Larutan Karbol Fuksin botol 0 0 0 0 0
153 Larutan Metilan Biru botol 0 0 0 0 0
154 Larutan Turk botol 0 0 0 0 0
155 Lidocain Comp injeksi ampul 80 0 80 20 60
156 Loperamid 2 mg tablet 0 0 0 0 0
157 Loratadin 10 mg tablet 1000 0 1000 500 500
158 Masker Ear Lop pices 0 0 0 0 0
159 Masker Ties On pices 0 0 0 0 0
160 Masker N 95 pices 0 0 0 0 0
161 Metergin injeksi 0.200 mg / 1 ml ampul 0 0 0 0 0
162 Metformin 500 mg tablet 200 0 200 200 0
163 Metil Prednisolon 4 mg tablet 1500 0 1500 1500 0
164 Metil ergometrin maleat 0.125 mg tablet 300 0 300 200 100
165 Metoklopramid 10 mg tablet 1000 0 1000 0 1000
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
166 Metolon Injeksi 5 mg / 2 ml ampul 0 0 0 0 0
167 Metronidazol suspensi botol 0 0 0 0 0
168 Metronidazol tab 500 mg tablet 0 0 0 0 0
169 Miconazol crem tube 48 0 48 0 48
170 Miconazole serbuk botol 48 0 48 0 48
171 Monoklorkamfer mentol cair botol 0 0 0 0 0
172 Multi Vitamin syrup botol 0 0 0 0 0
173 Mumiying Pasta pot 0 0 0 0 0
174 Natrium Bikarbonat 500 mg tablet 0 0 0 0 0
175 Natrium Diklifenak 50 mg tablet 2500 0 2500 500 2000
176 Natrium Klorida 0.9 % kolf 60 0 60 40 20
177 Nipedipin 10 mg tablet 0 0 0 0 0
178 Nistatin 100.000 IU tablet 50 0 50 10 40
179 Nistatin 500.000 IU tablet 0 0 0 0 0
180 Obat Anti Tuberkulosis Kategori I paket 0 0 0 0 0
181 Obat Anti Tuberkulosis Kategori II paket 0 0 0 0 0
182 Obat Anti Tuberkulosis Kategori anak paket 0 0 0 0 0
183 Obat Anti Tuberkulosis Kategori Sisipan paket 0 0 0 0 0
184 Obat Batuk hitam ( OBH ) botol 0 0 0 0 0
185 Oksitetrasiklin 3 % salep kulit tube 0 0 0 0 0
186 Oksitetrasiklin Hcl 1 % salep mata tube 0 0 0 0 0
187 Oksitetrasiklin Hcl inj 50 mg - 10 ml vial 0 0 0 0 0
188 Oksitocin Injeksi ampul 0 0 0 0 0
189 Omeprazol 20 mg tablet 0 0 0 0 0
190 Ondansetron injeksi ampul 0 0 0 0 0
191 Papaverin 40 mg tablet 0 0 0 0 0
192 Parasetamol 100 mg tablet 0 0 0 0 0
193 Parasetamol 500 mg tablet 500 0 500 200 300
194 Parasetamol Drop botol 0 0 0 0 0
195 Parasetamol Syrup botol 10 0 10 0 10
196 Permetrin krim 5% (Scabimite) tube 10 0 10 10 0
197 Perak Sulfadiazin krim tube 0 0 0 0 0
198 Pirantel Pamoat 365 mg tablet 0 0 0 0 0
199 Piroxicam 10 mg kapsul 0 0 0 0 0
200 Plester 5 x 500 inchi rol 10 0 10 5 5
201 Policlen botol 0 0 0 0 0
202 Prednison 5 mg tablet 0 0 0 0 0
203 Primaquin 15 mg tablet 0 0 0 0 0
204 Propanolol Hcl 10 mg tablet 0 0 0 0 0
205 Piridoxin Hcl 10 mg tablet 2000 0 2000 500 1500
206 Propiltiourasil ( PTU ) 100 mg tablet 0 0 0 0 0
207 Ranitidin 150 mg tablet 500 0 500 0 500
208 Ranitidin injeksi ampul 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
209 Resperidon 2 mg tablet 0 0 0 0 0
210 Ringer Laktat lar infus kolf 40 0 40 40 0
211 Salbutamol 2 mg tablet 2000 0 2000 0 2000
212 Salbutamol 4 mg tablet 0 0 0 0 0
213 Salbutamol Syr botol 0 0 0 0 0
214 Salep 2 - 4 pot 25 0 25 0 25
215 Salisil bedak 2 % bungkus 0 0 0 0 0
216 Sefiksin 100 mg tablet 0 0 0 0 0
217 Semen Seng Posfat serbuk dan cairan set 0 0 0 0 0
218 Serum Anti Bisa Ular Polivalen 50 ml vIal 2 0 2 0 2
219 Serum Anti Tetanus 1.500 IU (ATS ) ampul 5 0 5 0 5
220 Sianokobolamin ( B12) tablet tablet 500 0 500 0 500
221 Sianokobolamin injeksi ( Vit B 12 ) ampul 50 0 50 50 0
222 Silk 17 mm x 76 cm sachet 12 0 12 0 12
223 Silk 25 mm x 75 cm sachet 36 0 36 0 36
224 Simvastatin 10 mg tablet 500 0 500 100 400
225 Stimuno Forte tablet 0 0 0 0 0
226 Sulfasetamid natrium Tetes mata 15 % botol 0 0 0 0 0
227 Tablet Tambah Darah tablet 1000 0 1000 1000 0
228 Tetagam injeksi vial 0 0 0 0 0
229 Temporary Stoping Fletcher dan cairan botol 0 0 0 0 0
230 Tetrasiklin Hcl 250 mg kapsul 0 0 0 0 0
231 Tetrasiklin Hcl 500 mg kapsul 0 0 0 0 0
232 Thiamin Hcl ( Vit B1 ) injeksi ampul 0 0 0 0 0
233 Thiamin Hcl tablet 50 mg tablet 0 0 0 0 0
234 Tramadol injeksi 50 mg / ml ampul 0 0 0 0 0
235 Trihexilpenidil 2 mg tablet 0 0 0 0 0
236 Urin Bag pices 0 0 0 0 0
237 Vitamin A 100.000 IU kapsul 0 0 0 0 0
238 Vitamin A 200.000 IU kapsul 0 0 0 0 0
239 Vitamin B Complek tablet 200 0 200 0 200
240 Xilocain spray tabung 0 0 0 0 0
241 Yodium Povidon larutan 30 ml botol 0 0 0 0 0
242 Yodium Povidon larutan 100 ml botol 0 0 0 0 0
243 Yodium Povidon larutan 300 ml botol 5 0 5 0 5
244 Zinc tablet 0 0 0 0 0
245 Zinc syrup 20 mg / 5 ml botol 0 0 0 0 0
JUMLAH KUNJUNGAN

Mengetahui
Pimpinan Puskesmas Pelapor
Limbur Lubuk Mengkuang
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT

SUTARI, SKM,MKM Ranny Fitriany, Amd.Farm

NIP. 197807132008011004 NIP. 19920405 201503 2 004
PUSKESMAS : LIMBUR LUBUK MENGKUANG BULAN : September
KODE : LIMBUR LUBUK MENGKUANG TAHUN : 2023
KABUPATEN : BUNGO
PROPINSI : JAMBI
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( L B 2 )
STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
1 2 3 4 5 6=(4+5 ) 7 8=(6-7 ) 9 10 11
1 ACT( Artesunat 50 mg + Amodiaquin 200 mg ) tablet 0 0 0 0 0
2 Alat Suntik Sekali Pakai 1 ml pcs 100 300 400 100 300
3 Alat Suntik sekali Pakai 2.5 ml pcs 0 500 500 100 400
4 Alat Suntik sekali Pakai 5 ml pcs 0 200 200 100 100
5 Albendazol 400 mg tablet 0 0 0 0 0
6 Alkohol Swab kotak 40 100 140 20 120
7 Alopurinol 100 mg tablet 100 3000 3100 1100 2000
8 Ambroxol tablet tablet 0 0 0 0 0
9 Ambroxol syrup 15 mg / ml botol 0 0 0 0 0
10 Aminophylin 150 mg tablet 0 0 0 0 0
11 Aminophylin 200 mg tablet 0 0 0 0 0
12 Aminophylin injeksi ampul 0 0 0 0 0
13 Amitriptilin Hcl 25 mg tablet 0 0 0 0 0
14 Amlodipin 5 mg tablet 200 3000 3200 1200 2000
15 Amoksisilin 250 mg kapsul 0 0 0 0 0
16 Amoksisilin 500 mg kaplet 0 8000 8000 3000 5000
17 Amoksisilin syrup 125 mg/ml botol 25 100 125 25 100
18 Amoksisilin syrup botol 0 0 0 0 0
19 Antasida Doen Komb syrup botol 0 60 60 30 30
20 Antasida Doen kombinasi tablet 1000 3000 4000 1800 2200
21 Anti Bakteri Doen (bacitracin) tube 25 100 125 25 100
22 Anti Fungi Doen Komb.( Whitfield ) pot 70 0 70 30 40
23 Antihemoroid suppos suppos 10 20 30 20 10
24 Antimigrain Doen ( Ergotamin ) tablet 0 0 0 0 0
25 Aqua proinjeksi vial 0 0 0 0 0
26 Artemeter Injeksi 1 ml : 80 mg ampul 0 0 0 0 0
27 Artesunate injeksi 60 ml vial 0 0 0 0 0
28 Asam Ascorbat ( Vit C ) 50 mg tablet 2000 5000 7000 1500 5500
29 Asam Ascorbat ( Vit C ) 250 mg tablet 0 0 0 0 0
30 Asam ascorbat ( Vit C ) 500 mg tablet 200 0 200 200 0
31 Asam Mefenamat 500 mg kaplet 2000 10000 12000 2000 10000
32 Asam Traneksamat injeksi ampul 0 0 0 0 0
33 Asiklovir 200 mg tablet 0 0 0 0 0
34 Asiklovir 400 mg tablet 0 0 0 0 0
35 Asiklovir crem 5 % tube 0 0 0 0 0
36 Atapulgit 650 mg tablet 0 500 500 0 500
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
37 Atropin sulfat 0.5 mg tablet 0 0 0 0 0
38 Atropin Sulfat injeksi ampul 0 20 20 40 (20)
39 Betahistine mesylate 6 mg tablet 2000 2000 4000 1400 2600
40 Betametason crem tube 0 125 125 50 0
41 Betametason diproplonoat crem tube 0 0 0 0 0
42 Captopril 12.5 mg tablet 1300 2000 3300 1700 1600
43 Captopril 25 mg tablet 200 3000 3200 300 2900
44 Cat Gut sack 0 120 120 110 10
45 Cefadroxil 500 mg tablet 0 0 0 0 0
46 Cefadroxil syrup botol 0 100 100 0 100
47 Cefotaxim injeksi vial 0 0 0 0 0
48 Ceterizin syrup botol 0 0 0 0 0
49 Cetirizin 10 mg tablet 0 3000 3000 3500 (500)
50 Ciproploxacin 500 mg tablet 0 1000 1000 2000 (1000)
51 Deksametason 0.5 mg tablet tablet 0 0 0 0 0
52 Deksametason injeksi ampul 0 100 100 0 100
53 Devitalisasi pasta btl 0 0 0 0 0
54 Diazepam 2 mg tablet 0 0 0 0 0
55 Diazepam injeksi 5 mg / 1 ml ampul 0 0 0 0 0
56 Diazepam Rectal 5 mg / 2.5 ml tube 0 0 0 0 0
57 Difenhidramin Hcl injeksi ampul 0 0 0 60 (60)
58 Digoxin 0.25 mg tablet 0 0 0 0 0
59 Dimenhidrinat 50 mg tablet 0 1000 1000 0 1000
60 Desinfectan 500 ml botol 0 4 4 0 4
61 Desinfectan 5 Liter botol 2 2 4 0 4
62 Domperidon 10 mg tablet 0 1000 1000 0 1000
63 Domperidone Syr botol 0 0 0 0 0
64 Doxycyklin 100 mg kapsul 0 0 0 0 0
65 Erytromycin 500 mg kaplet 1300 1000 2300 1400 900
66 Erytromycin syrup botol 0 0 0 0 0
67 Etakridin ( Rivanol ) cairan ampul 0 48 48 5 43
68 E t a n o l 70 % 1 Liter botol 0 10 10 0 10
69 E t a n o l 70 % 100 ml botol 5 20 25 5 20
70 Efedrin Hcl 25 mg tablet 0 0 0 0 0
71 Epinefrin Hcl injeksi ampul 0 0 0 0 0
72 Etil klorida semprot tabung 0 0 0 0 0
73 Eugenol cairan btl 0 0 0 0 0
74 Fenobarbital 30 mg tablet 0 0 0 0 0
75 Fenobarbital injeksi 50 mg / ml ampul 0 0 0 0 0
76 Fenol gliserol tetes telinga botol 0 96 96 0 96
77 Fitomenadion ( vit K ) 10 mg tab tablet 2300 1000 3300 1900 1400
78 Fitomenadion ( vit K ) 10 mg / 1 ml ampul 0 0 0 0 0
79 Foly Cateter no 16 pices 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
80 Foly cateter No 18 pices 0 0 0 0 0
81 Furosemid 40 mg tablet 0 500 500 300 200
82 Garam Oralit 200 ml bungkus 0 300 300 400 (100)
83 Gentamycin injeksi ampul 0 0 0 0 0
84 Gentamycin salep mata 0.3 % tube 0 24 24 48 (24)
85 Gentamycin tetes mata 0.3 % tube 0 48 48 36 12
86 Gentian violet 1 % botol 0 0 0 0 0
87 Glass Ionomer Cemen ( GC IX ) set 0 0 0 0 0
88 Glibenklamid 5 mg tablet 400 1000 1400 300 1100
89 Glikasida 80 mg tablet 0 0 0 0 0
90 Gliseril Guayakolat 100 mg tablet 0 0 0 0 0
91 Glukosa Lar infus 10 % kolf 0 0 0 0 0
92 Glukosa lar infus 5 % kolf 0 80 80 60 20
93 Griseofulvin 125 mg tablet 0 1000 1000 200 800
94 Griseofulvin 250 mg tablet 0 0 0 0 0
95 Haloperidol 0.5 mg tablet 0 0 0 0 0
96 Haloperidol 1.5 mg tablet 0 0 0 0 0
97 Haloperidol 5 mg tablet 0 0 0 0 0
98 Haloperidol injeksi ampil 0 0 0 0 0
99 Hand Sanitizer 500 ml botol 0 28 28 4 24
100 Hand Scoond pasang 100 600 700 0 700
101 Hand scoond steril pices 0 100 100 50 50
102 Herbacof syr botol 0 336 336 0 336
103 HCl 0,1 N botol 0 0 0 0 0
104 Hidrogen Peroksida 3 % (H2O2) botol 0 0 0 0 0
105 Hidroklortiazid ( HCT ) 25 mg tablet 100 0 100 100 0
106 Hidrokortison crem 2.5 % tube 0 48 48 10 38
107 Hyocine Butyl Bromida 10 mg tablet 0 0 0 100 (100)
108 Ibuprofen 200 mg tablet 0 3000 3000 1000 2000
109 Ibuprofen 400 mg tablet 1200 4000 5200 0 5200
110 Ibuprofen syrup 100 mg / ml botol 0 0 0 0 0
111 Infusion set Anak bungkus 0 200 200 200 0
112 Infusion set Dewasa bungkus 0 200 200 200 0
113 Isosorbit Dinitrat 5 mg tablet 0 0 0 0 0
114 IV cateter no. 18 G buah 0 0 0 0 0
115 IV cateter no. 20 G buah 0 100 100 100 0
116 IV cateter no. 22 G buah 0 200 200 200 0
117 IV cateter no. 24 G buah 0 200 200 200 0
118 Kalsium hidroksida pasta pot 0 0 0 0 0
119 Kalsium Laktat 500 mg tablet 1800 2500 4300 1200 3100
120 Kapas 100 gram rol 0 0 0 0 0
121 Kapas Pembalut 250 gr bungkus 0 20 20 20 0
122 Karbamazepin 200 mg tablet 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
123 Kasa pembalut 4 x 5 cm rol 0 400 400 0 400
124 Kasa Pembalut 3 x 10 cm rol 0 100 100 0 100
125 Kasa Pembalut 3 x 15 cm rol 0 200 200 0 200
126 Kasa Pembalut 4 x 15cm rol 0 50 50 0 50
127 Kasa Pembalut 3 x 5cm rol 0 100 100 0 100
128 Kasa 16 x 16 cm kotak 0 100 100 50 50
129 Keterolak injeksi vial 0 0 0 0 0
130 Ketokonazol 200 mg tablet 200 2000 2200 400 1800
131 Ketokonazol krim 2.5 % tube 0 100 100 0 100
132 Kinina 200 mg tablet tablet 0 0 0 0 0
133 Kinina injeksi ampul 0 0 0 0 0
134 Kloramfenikol 250 mg kapsul 0 0 0 0 0
135 Kloramfenikol salep kulit 2 % tube 0 48 48 0 48
136 Kloramfenikol salep mata 1 % tube 0 0 0 0 0
137 Kloramfenikol tetes Mata botol 0 0 0 0 0
138 Klorfeniramin maleat ( CTM ) 4 mg tablet 0 0 0 0 0
139 Klorokina posfat 250 mg tablet 0 0 0 0 0
140 Klorpromazin Hcl 100 mg tablet 0 0 0 0 0
141 Klorpromazin Hcl 25 mg tablet 0 0 0 0 0
142 Klorpromazin Hcl inj 25 mg / 1 ml ampul 0 0 0 0 0
143 Kompolax sirup botol 0 0 0 0 0
144 Komb.Primetamin + Sulfadoxin 500 mg tablet 0 0 0 0 0
145 Kotrimoxazol syrup botol 0 0 0 0 0
146 Kotrimoxazol 480 mg tablet 1000 1000 2000 0 2000
147 L I s o l 1 Liter botol 0 0 0 0 0
148 Larutan Benedict botol 0 0 0 0 0
149 Larutan Eosin 2 % botol 0 0 0 0 0
150 Larutan Etanol asam botol 0 0 0 0 0
151 Larutan giemsa stain botol 0 0 0 0 0
152 Larutan Karbol Fuksin botol 0 0 0 0 0
153 Larutan Metilan Biru botol 0 0 0 0 0
154 Larutan Turk botol 0 0 0 0 0
155 Lidocain Comp injeksi ampul 60 210 270 20 250
156 Loperamid 2 mg tablet 0 1000 1000 0 1000
157 Loratadin 10 mg tablet 500 0 500 500 0
158 Masker Ear Lop pices 0 1000 1000 0 1000
159 Masker Ties On pices 0 0 0 0 0
160 Masker N 95 pices 0 0 0 0 0
161 Metergin injeksi 0.200 mg / 1 ml ampul 0 0 0 0 0
162 Metformin 500 mg tablet 0 3000 3000 200 2800
163 Metil Prednisolon 4 mg tablet 0 4000 4000 1500 2500
164 Metil ergometrin maleat 0.125 mg tablet 100 200 300 200 100
165 Metoklopramid 10 mg tablet 1000 0 1000 0 1000
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
166 Metolon Injeksi 5 mg / 2 ml ampul 0 0 0 0 0
167 Metronidazol suspensi botol 0 0 0 0 0
168 Metronidazol tab 500 mg tablet 0 0 0 0 0
169 Miconazol crem tube 48 0 48 0 48
170 Miconazole serbuk botol 48 0 48 0 48
171 Monoklorkamfer mentol cair botol 0 0 0 0 0
172 Multi Vitamin syrup botol 0 0 0 0 0
173 Mumiying Pasta pot 0 0 0 0 0
174 Natrium Bikarbonat 500 mg tablet 0 0 0 0 0
175 Natrium Diklifenak 50 mg tablet 2000 2000 4000 500 3500
176 Natrium Klorida 0.9 % kolf 20 140 160 40 120
177 Nipedipin 10 mg tablet 0 0 0 0 0
178 Nistatin 100.000 IU tablet 40 100 140 10 130
179 Nistatin 500.000 IU tablet 0 0 0 0 0
180 Obat Anti Tuberkulosis Kategori I paket 0 0 0 0 0
181 Obat Anti Tuberkulosis Kategori II paket 0 0 0 0 0
182 Obat Anti Tuberkulosis Kategori anak paket 0 0 0 0 0
183 Obat Anti Tuberkulosis Kategori Sisipan paket 0 0 0 0 0
184 Obat Batuk hitam ( OBH ) botol 0 0 0 0 0
185 Oksitetrasiklin 3 % salep kulit tube 0 0 0 0 0
186 Oksitetrasiklin Hcl 1 % salep mata tube 0 0 0 0 0
187 Oksitetrasiklin Hcl inj 50 mg - 10 ml vial 0 0 0 0 0
188 Oksitocin Injeksi ampul 0 100 100 0 100
189 Omeprazol 20 mg tablet 0 0 0 0 0
190 Ondansetron injeksi ampul 0 0 0 0 0
191 Papaverin 40 mg tablet 0 0 0 0 0
192 Parasetamol 100 mg tablet 0 0 0 0 0
193 Parasetamol 500 mg tablet 300 5000 5300 200 5100
194 Parasetamol Drop botol 0 0 0 0 0
195 Parasetamol Syrup botol 10 0 10 0 10
196 Permetrin krim 5% (Scabimite) tube 0 30 30 10 20
197 Perak Sulfadiazin krim tube 0 0 0 0 0
198 Pirantel Pamoat 365 mg tablet 0 0 0 0 0
199 Piroxicam 10 mg kapsul 0 0 0 0 0
200 Plester 5 x 500 inchi rol 5 20 25 5 20
201 Policlen botol 0 0 0 0 0
202 Prednison 5 mg tablet 0 4000 4000 0 4000
203 Primaquin 15 mg tablet 0 0 0 0 0
204 Propanolol Hcl 10 mg tablet 0 200 200 0 200
205 Piridoxin Hcl 10 mg tablet 1500 3500 5000 500 4500
206 Propiltiourasil ( PTU ) 100 mg tablet 0 0 0 0 0
207 Ranitidin 150 mg tablet 500 8000 8500 0 8500
208 Ranitidin injeksi ampul 0 0 0 0 0
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT
209 Resperidon 2 mg tablet 0 0 0 0 0
210 Ringer Laktat lar infus kolf 0 120 120 40 80
211 Salbutamol 2 mg tablet 2000 2000 4000 0 4000
212 Salbutamol 4 mg tablet 0 0 0 0 0
213 Salbutamol Syr botol 0 0 0 0 0
214 Salep 2 - 4 pot 25 0 25 0 25
215 Salisil bedak 2 % bungkus 0 0 0 0 0
216 Sefiksin 100 mg tablet 0 0 0 0 0
217 Semen Seng Posfat serbuk dan cairan set 0 0 0 0 0
218 Serum Anti Bisa Ular Polivalen 50 ml vIal 2 3 5 0 5
219 Serum Anti Tetanus 1.500 IU (ATS ) ampul 5 5 10 0 10
220 Sianokobolamin ( B12) tablet tablet 500 3000 3500 0 3500
221 Sianokobolamin injeksi ( Vit B 12 ) ampul 0 200 200 50 150
222 Silk 17 mm x 76 cm sachet 12 72 84 0 84
223 Silk 25 mm x 75 cm sachet 36 72 108 0 108
224 Simvastatin 10 mg tablet 400 3000 3400 100 3300
225 Stimuno Forte tablet 0 0 0 0 0
226 Sulfasetamid natrium Tetes mata 15 % botol 0 0 0 0 0
227 Tablet Tambah Darah tablet 0 0 0 1000 (1000)
228 Tetagam injeksi vial 0 0 0 0 0
229 Temporary Stoping Fletcher dan cairan botol 0 0 0 0 0
230 Tetrasiklin Hcl 250 mg kapsul 0 0 0 0 0
231 Tetrasiklin Hcl 500 mg kapsul 0 0 0 0 0
232 Thiamin Hcl ( Vit B1 ) injeksi ampul 0 0 0 0 0
233 Thiamin Hcl tablet 50 mg tablet 0 0 0 0 0
234 Tramadol injeksi 50 mg / ml ampul 0 0 0 0 0
235 Trihexilpenidil 2 mg tablet 0 0 0 0 0
236 Urin Bag pices 0 0 0 0 0
237 Vitamin A 100.000 IU kapsul 0 0 0 0 0
238 Vitamin A 200.000 IU kapsul 0 0 0 0 0
239 Vitamin B Complek tablet 200 5000 5200 0 5200
240 Xilocain spray tabung 0 0 0 0 0
241 Yodium Povidon larutan 30 ml botol 0 0 0 0 0
242 Yodium Povidon larutan 100 ml botol 0 40 40 0 40
243 Yodium Povidon larutan 300 ml botol 5 0 5 0 5
244 Zinc tablet 0 0 0 0 0
245 Zinc syrup 20 mg / 5 ml botol 0 0 0 0 0
JUMLAH KUNJUNGAN

Mengetahui
Pimpinan Puskesmas Pelapor
Limbur Lubuk Mengkuang
 STOK SISA STOK
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KETERANGAN
AWAL STOK OPT

SUTARI, SKM,MKM Ranny Fitriany, Amd.Farm

NIP. 197807132008011004 NIP. 19920405 201503 2 004