LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO )

PUSKESMAS TONGAUNA UTARA NOMOR TANGGAL

KECAMATAN TONGAUNA UTARA
PROVINSI SULTRA PELAPORAN BULAN : FEBRUARI 2024
KABUPATEN KONAWE PERMINTAAN BULAN : MARET

No NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR PERMINTAAN PEMBERIAN KETERANGAN
1 2 3 4 5 6 7 8 10 11 12

1 Acetylsistein Tablet 3100 0 3,100 - 3,100 (3,100)

2 Alopurinol tablet 100 mg Tablet 1500 0 1,500 500 1,000 (450)
3 Alopurinol tablet 300 mg Tablet 600 0 600 140 460 (306)
4 Ambroksol sirup Botol 0 0 - - - -
5 Ambroksol tablet 30 mg Tablet 1200 0 1,200 - 1,200 (1,200)
6 Aminofillin tablet 200 mg Tablet 0 0 - - - -
7 Amlodipin tablet 10 mg Tablet 770 0 770 70 700 (623)
8 Amlodipin tablet 5 mg Tablet 190 0 190 190 - 209
9 Amoksilin kaplet 500 mg Kaplet 1400 1500 2,900 730 2,170 (1,367)
10 Amoksilin sirup kering 100 mg/ml - 10 ml Botol 0 0 - - - -
11 Amoksilin sirup kering 125 mg/5 ml - 60 ml Botol 10 60 70 10 60 (49)
12 Amoksilin sirup kering 250 mg Botol 0 0 - - - -
13 Amoksilin Drops Botol 6 24 30 - 30 (30)
Antasida DOEN I tablet kunyah, kombinasi : Aluminium
Botol 2,700 300 2,400 (2,070)
14 Hidroksida 200 mg + Magnesium Hidroksida 200 mg 1200 1500
15 Antasida DOEN II suspensi, kombinasi Botol 0 0 - - - -
16 Anti Hemmoroid DOEN kombinasi Supp 0 0 - - - -
17 Antifungi Salep 3 - 6 Pot 0 0 - - - -
18 Antifungi DOEN kombinasi/SALEP WHITE FIELD Pot 0 0 - - - -
19 Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg Tablet 0 0 - - - -
20 Aqua pro injeksi steril, bebas pirogen 25 ml Vial 120 0 120 - 120 (120)
21 Asam Asetilsalisilat tablet 80 mg Tablet 0 0 - - - -
22 Asam Askorbat (Vitamin C) tablet 50 mg Tablet 0 0 - - - -
23 Asam Folat Tablet 900 0 900 - 900 (900)
24 Asam Mefenamat kaplet 500 mg Tablet 1100 1000 2,100 500 1,600 (1,050)
25 Asam Traneksamat Tablet 0 0 - - - -
26 Asiklovir salep kulit Tube 40 20 60 4 56 (52)
27 Asiklovir tablet 200 mg Tablet 400 0 400 - 400 (400)
28 Asiklovir tablet 400 mg Tablet 570 0 570 - 570 (570)
29 Atorvastatin 20 mg Tablet 0 0 - - - -
Besi II Sulfat 200 mg + Asam Folat 0,25 mg (tablet
30 Tablet 4,000 600 3,400 (2,740)
tambah darah kombinasi) 4000 0
31 Betahistin Mesilat tablet 6 mg Tablet 700 0 700 400 300 140
32 Betametason Krim 0.1 % (sebagai valerat) - 5 gr Tube 28 25 53 - 53 (53)
33 Betametason TM ( Vasoma ) Tube 0 10 10 - 10 (10)
34 Bisakodil Tablet 0 0 - - - -
35 Cairan KAEN3B Botol 0 0 - - - -
36 Cefotaxim injeksi Ampul 0 4 4 - 4 (4)
37 Ceftriaxon injeksi Ampul 6 4 10 - 10 (10)
38 Cetirizin Syrup Botol 8 60 68 - 68 (68)
39 Cetirizin Tablet Tablet 300 1500 1,800 600 1,200 (540)
40 Deksametason injeksi 5 mg/ml-1ml Ampul 167 0 167 - 167 (167)
41 Deksametason tablet 0,5 mg Tablet 500 0 500 - 500 (500)
42 Desoximetasone Krem 0,25 %/ DEXOCORT Tube 0 0 - - - -
43 Difenhidramin injeksi 10 mg/ml Ampul 27 0 27 - 27 (27)
44 Digoksin tablet 0,25 mg Tablet 0 0 - - - -
45 Domperidon sirup Botol 5 0 5 2 3 (1)
46 Domperidon Tablet Tablet 800 0 800 100 700 (590)
47 Domperidon Tablet/VOMIPER Tablet 210 0 210 - 210 (210)
48 Dulcolax Suppositoria Supp 0 0 - - - -
49 Epinefrin ( Adrenalin ) injeksi 0,1 % Ampul 3 0 3 - 3 (3)
50 Eritromisin kapsul 500 mg Kapsul 0 0 - - - -
51 Etakridin (Rivanol) Larutan 0,1 % - 300 ml Botol 40 0 40 - 40 (40)
52 Fitomenadion(Vit. K1) injeksi Ampul 4 10 14 6 8 (1)
53 Fitomenadion(Vit. K1) tablet salut gula 10 mg Tablet 700 0 700 - 700 (700)
54 Fluocuinolon salep/Synarcus Pot 0 0 - - - -
55 Furosemid tablet 40 mg Tablet 650 0 650 10 640 (629)
56 Garam Oralit I serbuk, kombinasi / MINERAL MIX Sach 600 0 600 - 600 (600)
57 Gemfibrozil 300 mg kapsul Kapsul 260 0 260 - 260 (260)
58 Gemfibrozil 600 mg kapsul Kapsul 320 0 320 - 320 (320)
59 Gentamycin salep Kulit 0,1% Tube 23 0 23 6 17 (10)
60 Gentamycin salep mata 0,3% Tube 13 24 37 7 30 (22)
61 Gentamycin Tetes Mata Botol 0 0 - - - -
62 Glibenklamid tablet 5 mg Tablet 500 1000 1,500 - 1,500 (1,500)
63 Glimepirid 1 mg Tablet 100 300 400 - 400 (400)
64 Guaifenesin 100 mg Tablet 1600 0 1,600 - 1,600 (1,600)
65 Glucose Larutan Infus 5% steril - 500 ml Kolf 0 0 - - - -
66 Griseofulvin tablet 125 mg Tablet 1400 0 1,400 - 1,400 (1,400)
67 Hidroklortiazid (HCT) tablet 25 mg Tablet 0 0 - - - -
68 Hidrokortison krim 2,5 % - 5 gr Tube 59 0 59 6 53 (46)
69 Hyiosin Bromida Tablet 900 0 900 30 870 (837)
70 Ibuprofen Syrup 60 ml Botol 52 0 52 10 42 (31)
71 Ibuprofen tablet 200 mg Tablet 0 0 - - - -
72 Ibuprofen tablet 400 mg Tablet 1500 1500 3,000 850 2,150 (1,215)
73 Isosorbid dinitrat (ISDN) tablet sublingual 5 mg Tablet 0 0 - - - -
74 Kalsium laktat (Kalk) tablet 500 mg Tablet 1500 0 1,500 600 900 (240)
75 Kaptopril tablet 12,5 mg Tablet 600 0 600 200 400 (180)
76 Kaptopril tablet 25 mg Tablet 900 0 900 200 700 (480)
77 Ketokonazol tablet 200 mg Tablet 250 0 250 - 250 (250)
78 Ketokonazole Krem Tube 20 0 20 11 9 3
79 Ketorolak Injeksi Ampul 30 0 30 - 30 (30)
80 Kloramfenikol kapsul 250 mg Kapsul 0 0 - - - -
81 Kloramfenikol Salep Kulit Tube 32 0 32 - 32 (32)
82 Kloramfenikol suspensi 125 mg/5ml - 60 ml Botol 0 0 - - - -
83 Kloramfenikol tetes telinga 3 % - 5 ml Botol 0 0 - - - -
84 Klorfeniramin maleat (CTM) tablet 4 mg Tablet 900 0 900 300 600 (270)
Kotrimoksazol DOEN I (dewasa) kombinasi :
85 Tablet 1,000 600 400 260
Sulfametoksazol 400 mg + Trimetoprim 80 mg 1000 0
Kotrimoksazol DOEN II (pedriatik) kombinasi :
Tablet - - - -
86 Sulfametoksazol 100 mg + Trimetoprim 20 mg 0 0
Kotrimoksazol Suspensi kombinasi : Sulfametoksazol
87 Tablet 12 10 2 9
200 mg + Trimetoprim 40 mg/ 5 ml - 60 ml 12 0
88 Lansoprazole Kapsul 1400 0 1,400 550 850 (245)
Lidokain comp injeksi (Lidocain 2% (HCl) + Epinefrin 1 :
Ampul 43 8 35 (26)
89 80.000) - 2 ml 13 30
90 Loperamid tablet 2 mg /NOVADIUM Tablet 600 0 600 100 500 (390)
91 Loratadin tablet 10 mg Tablet 900 0 900 - 900 (900)
92 Meloxicam 15 mg Tablet 700 0 700 300 400 (70)
93 Meloxicam 7,5 mg Tablet 0 0 - - - -
94 Mersibion 5000 mg Ampul 18 30 48 12 36 (23)
95 Metampiron (Antalgin) tablet 500 mg Tablet 0 - - -
96 Metformin HCl tablet 500 mg Tablet 1000 0 1,000 400 600 (160)
97 Metil Prednisolon Tablet 100 2000 2,100 300 1,800 (1,470)
98 Metilergometrin Maleat (Metilergometrin) injeksi Ampul 8 25 33 10 23 (12)
Metilergometrin Maleat (Metilergometrin) tablet salut
Tablet - (800)
99 0,125 mg 800 0 800 800
100 Metoklorpramid Tablet 300 0 300 - 300 (300)
101 Metronidazol tablet 500 mg Tablet 500 0 500 - 500 (500)
102 Metronidazole SIRUP Botol 0 0 - - - -
103 Mikonazol krim/ salep 2 % (Nitrat) - 10 gr Tube 17 24 41 6 35 (28)
104 Natrium Diklofenak tablet 25 mg Tablet 0 0 - - - -
105 Natrium Diklofenak tablet 50 mg Tablet 400 1500 1,900 700 1,200 (430)
106 Natrium Klorida larutan infus 0,9% - 500 ml Kolf 31 0 31 3 28 (25)
107 Nifedipin tablet 10 mg Tablet 0 0 - - - -
108 Nistatin tablet salut 500.000 IU/g Tablet 0 0 - - - -
109 Nistatin vaginal tablet 100.000 IU/g Tablet 130 0 130 10 120 (109)
110 Nistatin Drops 12ml/100.000 IU Botol 4 4 2 2 0
111 Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol Botol 0 0 - - - -
112 Ofloxacin tetes telinga Botol 12 0 12 - 12 (12)
113 Oksitetrasiklin HCl salep kulit 3 % - 5 gr Tube 32 0 32 - 32 (32)
114 Oksitetrasiklin HCl salep mata 1 % - 5 gr Tube 0 0 - - - -
115 Oksitocin Injeksi Ampul 0 0 - - - -
116 Omeprazole kapsul 20 mg Kapsul 0 0 - - - -
117 Omeprazole Injeksi Ampul 30 0 30 20 10 12
118 Ondansetron Ampul 0 0 - - - -
119 Ondansetron / DANSEFION Ampul 0 0 - - -
120 Papaverin tablet 40 mg Tablet 0 0 - - - -
121 Parasetamol drops 15 ml Botol 5 20 25 3 22 (19)
122 Parasetamol Infus Botol 2 5 7 4 3 1
123 Parasetamol sirup 120 mg / 5ml - 60 ml Botol 56 100 156 19 137 (116)
124 Parasetamol tablet 500 mg Tablet 1300 1500 2,800 700 2,100 (1,330)
125 Phenol Gliserol tetes telinga Botol 14 0 14 - 14 (14)
126 Piridoksin (Vitamin B6) tablet 10 mg (HCl) Tablet 700 0 700 - 700 (700)
127 Polikresulen (kondensasi) 10 ml / nistatin drop Botol 0 0 - - - -
128 Povidon Iodida larutan 10 % - 1 L Botol 35 0 35 1 34 (33)
129 Povidon Iodida larutan 10 % - 300 ml Botol 0 0 - - - -
130 Povidon Iodida larutan 60 Ml Botol 289 0 289 1 288 (287)
131 Prednison tablet 5 mg Tablet 250 0 250 50 200 (145)
132 Propanolol Tablet 0 0 - - - -
133 Propiltiourasil tablet 100 mg Tablet 0 0 - - - -
134 Ranitidin injeksi Ampul 25 0 25 - 25 (25)
135 Ranitidin tablet 150 mg Tablet 0 0 - - - -
136 Ringer Laktat larutan infus - 500 ml Kolf 25 60 85 46 39 12
137 Salbutamol tablet 4 mg (sebagai sulfat) Tablet 550 1000 1,550 300 1,250 (920)
Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang
Pot - - - -
138 endap 4 % - 30 gr 0 0
139 Salisil Bedak 2 % - 50 gr Pot 15 0 15 - 15 (15)
140 Scabimite Krim - Permetrin Krim 5 % Tube Tube 0 0 - - - -
141 Sefadroksil Kapsul 500 mg Kapsul 500 0 500 250 250 25
142 Sefadroxil sirup 125 MG / WADOXIL Botol 0 0 - - - -
143 Sefadroxil sirup 250 MG Botol 0 0 - - - -

144 Sefadroxil Drop 150mg Botol 30 0 30 10 20 (9)

145 Sianokobalamin (vitamin B12) tablet 50 mcg Tablet 0 0 - - - -
146 Simvastatin tablet 10 mg Tablet 150 0 150 50 100 (45)
147 Simvastatin tablet 20 mg Tablet 800 600 1,400 80 1,320 (1,232)
148 Siprofloksasin tablet 500 mg (sebagai HCl) Tablet 1000 0 1,000 - 1,000 (1,000)
149 Sukralfat Botol 12 0 12 7 5 3
150 Sulfasetamida Natrium tetes mata 15 % - 5 ml Botol 0 0 - - - -
151 Tetrasiklin Kapsul 250 mg Kapsul 0 0 - - - -
152 Tetrasiklin kapsul 500 mg Kapsul 100 0 100 - 100 (100)
153 Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat) Tablet 500 1500 2,000 330 1,670 (1,307)
154 Vitamin B Kompleks tablet Tablet 550 2000 2,550 850 1,700 (765)
155 Zinc tablet 20 mg Tablet 700 0 700 - 700 (700)
156 Zinc sirup Botol 33 0 33 - 33 (33)

OBAT PROGRAM P2M

157 DHP-Prmal Tablet 0 0 - - - -
158 Health Mate Dengue AB Plus ( IGG & IGM ) Tablet 6 0 6 - 6 (6)
159 Health Mate Dengue Combo Plus paket 27 0 27 5 22 (17)
160 Hepatitis rapid test/HBsAg Pcs 30 0 30 5 25 (20)
161 HIV Rapid test Pcs 37 0 37 5 32 (27)
162 Primaquin Pcs 0 0 - - - -
163 RDT Malaria Pcs 85 0 85 5 80 (75)
164 Spyilis Rapid test Pcs 25 0 25 - 25 (25)

OBAT PROGRAM TB PARU

165 Obat FDC Kategori 1 Paket 3 6 9 5 4 2
166 Obat FDC Kategori 2 Paket 0 - - - -
167 Obat FDC Anak Paket 3 0 3 1 2 (1)
168 Obat FDC Sisipan (MDR) Paket 0 0 - - - -

OBAT PROGRAM KECACINGAN

169 Albendazole tablet 400 mg Tablet 4400 0 4,400 - 4,400 (4,400)
170 Pirantel tablet score (base) 125 mg Tablet 0 0 - - - -
171 Pirantel Syrup Botol 0 0 - - - -

OBAT PROGRAM GIZI

172 Retinol (Vitamin A) 100.000 IU kapsul lunak Kapsul 100 0 100 - 100 (100)
173 Retinol (Vitamin A) 200.000 IU kapsul lunak Kapsul 1000 0 1,000 - 1,000 (1,000)
174 Protein Coklat sach 20 0 20 - 20 (20)
175 Protein Gold Vanila sach 0 0 - - - -
176 Protein Vanila sach 0 0 - - - -

OBAT KEJIWAAN
177 Alprazolam tablet 1 mg Tablet 0 0 - - - -
178 Amitriptilin 25 mg Tablet 0 0 - - - -
179 Diazepam tablet 2 mg Tablet 0 0 - - - -
180 Diazepam tablet 5 mg Tablet 0 0 - - - -
181 Diazepam tube Rectal 5 mg/ml / STESOLID Tube rectal 8 0 8 3 5 (2)
182 haloperidol 0.5 mg Tablet 0 0 - - - -
183 haloperidol 1.5 mg Tablet 30 0 30 - 30 (30)
184 haloperidol 5 mg Tablet 0 0 - - - -
185 Phenobarbital 30 mg Tablet 0 0 - - - -

OBAT GIGI
186 CHKM Botol 0 0 - - - -
187 Devitalisasi Pasta (Non Arsen) Btl / ktk 0 0 - - - -
188 Denpro Calplus Btl / ktk 0 0 - - - -
189 Etil Chlorida spray - 100 ml / Lidokain spray/Xylocain Botol 3 0 3 - 3 (3)
190 Eugenol cairan - 15 ml Botol 0 0 - - - -
191 Frutti Fluor Gel Botol 0 0 - - - -
192 Glass Ionomer Cement ART (GCIX) / FUJI IX Set 0 0 - - - -
193 Kalsium Hidroksida pasta / CALCIDOR / DYCAL Set 0 0 - - - -
194 Mummifying Pasta / Iodoform Btl / ktk 0 0 - - - -
195 Semen Seng Fosfat (Powder 30 gr, Liquid 10 ml) Set 0 0 - - - -
196 Silver Amalgam Botol 0 0 - - - -
Temporary Stopping Fletcher Serbuk (Powder) /
Pot - - - -
197 ORAFIL PLUS 0 0

PERBEKALAN KESEHATAN
198 Alat Suntik sekali pakai 0,05 ml Pcs 0 0 - - -
199 Alat Suntik sekali pakai 0,5 ml Pcs 0 0 - - - -
200 Alat Suntik sekali pakai 1 ml Pcs 40 0 40 17 23 (4)
201 Alat Suntik sekali pakai 3 ml Pcs 89 0 89 23 66 (41)
202 Alat Suntik sekali pakai 5 ml Pcs 133 0 133 - 133 (133)
203 Alkohol Swab Kotak 6 0 6 - 6 (6)
204 Benang Bedah Catgut cromic 3/0 HR 27 MM Sach 10 12 22 12 10 3
205 Benang Bedah Catgut No. 3/0 HR 30 MM Sach 0 0 - - - -
206 Benang Bedah Silk Black 3/0 HR 30 MM Sach 10 0 10 - 10 (10)
207 Benang Bedah Silk Black 3/0 HR 20 MM Sach 0 0 - - - -
208 Etanol 70 % - 1 L Botol 24 0 24 2 22 (20)
209 Etanol 70 % - 300 ml Botol 0 0 - - - -
210 Fora Blood Glucosa Pcs 22 0 22 - 22 (22)
211 Feley Catheter FR 14 Pcs 9 0 9 - 9 (9)
212 Feley Catheter Pcs 0 0 - - - -
213 Folley Cateter N0.18 Pcs 0 0 - - - -
214 Hand Sanitizer/ SASKLIN PLUS 500ml Botol 72 0 72 - 72 (72)
215 Humasens 2.0 Plus Glucosa Pcs 0 0 - - - -
216 Infus set Bayi Pcs 0 0 - - - -
217 Infusion Set Anak Pcs 17 0 17 - 17 (17)
218 Infusion Set Dewasa Pcs 33 50 83 28 55 (24)
219 IV. Catheter No.18 G Set 15 0 15 3 12 (9)
220 IV. Catheter No.20 G Set 20 0 20 14 6 9
221 IV. Catheter No.22 G Set 27 50 77 38 39 3
222 IV. Catheter No.24 G Set 25 0 25 2 23 (21)
223 Kapas 100 gram Bungkus 0 0 - - - -
224 Kapas Pembalut / absorben 50 gram Bungkus 0 0 - - - -
225 Kapas Pembalut / absorben 250 gram Bungkus 0 0 - - - -
226 Kassa Hidrofil Steril uk. 16 x 16 Kotak 20 30 50 9 41 (31)
227 Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm Roll 0 0 - - - -
228 Kassa pembalut hidrofil 3 yrd X15 cm Roll 0 0 - 2 (2) 4
229 Kertas EKG Pcs 2 0 2 - 2 (2)
230 Masker Bedah Kotak 20 20 40 2 38 (36)
231 Masker Hijab Kotak 0 0 - - - -
232 Masker N95 Kotak 0 0 - - - -
233 Micropipettes MT II up to 1000 microliter blue Pcs 0 0 - - - -
234 Micropipettes MTSP up to 10 microliter Pcs 0 0 - - - -
235 Micropipettes MT II up to 200 microliter yellow Pcs 0 0 - - - -
236 Nasal Cannula Adult Pcs 34 0 34 - 34 (34)
237 Nasal Cannula Child Pcs 20 0 20 - 20 (20)
238 Nasal Cannula infant Pcs 20 0 20 - 20 (20)
239 Nebulizer Adult (sungkup) Pcs 3 0 3 - 3 (3)
240 Nebulizer Anak (sungkup) Pcs 3 0 3 - 3 (3)
241 Nebulizer Bayi (sungkup) Pcs 3 0 3 - 3 (3)
242 Neo H Blood Gllucosa Pcs 0 0 - - - -
243 Plester 5 yard X 2 inch Roll 0 0 - - - -
244 Plester Zinc Oxide Tape 5 x 450 cm Roll 1 0 1 1 - 1
245 Pot Sputum Pcs 380 0 380 - 380 (380)
246 Sarung Tangan L Kotak 7 0 7 3 4 (1)
247 Sarung Tangan M Kotak 0 10 10 5 5 1
248 Sarung Tangan No. 6,5 Pcs 0 0 - - - -
249 Sarung Tangan No. 7 Pcs 0 0 - - - -
250 Sarung Tangan No. 7,5 Pcs 70 0 70 - 70 (70)
251 Urine Bag Pcs 20 0 20 - 20 (20)
252 USG Gel 500 ml Botol 1 0 1 - 1 (1)
253 USG Gel 5 Liter Botol 1 0 1 - 1 (1)
254 Vacum Tube ClotActivator Glass 3 Ml Pcs 0 0 - - - -
255 Ziltape paper 0,5 inch Roll 17 0 17 - 17 (17)
256 Ziltape paper 1 inch Roll 10 0 10 6 4 3
257 Ziltape paper 2 inch Roll 11 0 11 1 10 (9)

OBAT PONED
258 MgSO4 20 % injeksi Botol 6 0 6 - 6 (6)
259 MgSO4 40 % injeksi Botol 6 0 6 6 - 7
260 Oksitosin injeksi 10 IU/ml - 1 ml Ampul 125 0 125 49 76 (22)

OBAT TAMBAHAN
261 Albuforce Kapsul 210 0 210 210 - 231
262 Aloclair Gel Botol 2 0 2 2 - 2
263 Aloclair Spray Botol 5 0 5 2 3 (1)
264 Alpara Tablet 1150 1500 2,650 750 1,900 (1,075)
265 Fasfit C Tablet 500 0 500 160 340 (164)
266 Fasfit CDEZ Tablet 500 0 500 - 500 (500)
267 Febrinex Syrup Botol 0 0 - - - -
268 Ifarsyl Syrup Botol 2 0 2 1 1 0
269 Kidyvit Botol 12 0 12 - 12 (12)
270 Lasalcom Nebuliseer Tube 40 0 40 20 20 2
271 Lodecon Kaplet 500 0 500 230 270 (17)
272 Novakid Syrup Botol 129 300 429 - 429 (429)
273 Noza Kaplet 0 0 - - - -
274 Nufed Tablet 450 1500 1,950 1,500 450 1,200
275 OBH Molex Syrup Botol 63 0 63 - 63 (63)
276 Striatatmin Kapsul 720 0 720 - 720 (720)
277 Symbicort Tube 0 0 - - - -
278 Vitsap Kapsul 710 0 710 - 710 (710)

VAKSIN
279 ATS Ampul 0 0 - - - -
280 Anti Bisa Ular Ampul 0 0 - - - -
281 Rabies Vero Vial 0 0 - - - -
282 BCG Ampul 1 3 4 1 3 (2)
283 DPT-HB Combo Ampul 0 5 5 5 - 6
284 Polio Ampul 8 0 8 7 1 7
285 Campak + Pelarut Campak Ampul 10 0 10 3 7 (4)
286 TT/TD Ampul 9 0 9 1 8 (7)
287 IPV Ampul 13 0 13 4 9 (5)
288 HB Uniject Ampul 15 0 15 8 7 2
 UMUM ASKES BPJS GRATIS JAMKESMAS JUMLAH
JUMLAH KUNJUNGAN RESEP
- 60 158 2 - 219
Mengetahui / Menyetujui Yang Menyerahkan , Yang Meminta , Yang Membuat ,
Kepala Dinas Kesehatan Kab.Konawe Kepala Instalasi Farmasi Kab.Konawe Kepala Puskesmas Petugas Puskesmas

drg. Mawar Taligana, M.Kes Mulyanti, S.Farm., Apt. JURI,SKM Ice Aquarista,AM,Keb
Nip. 19660726 200212 1 001 NIP. 1986 0910 201101 2 026 NIP. 19700113 199303 1 005 NIP. 19890222 201705 2 004
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO )
PUSKESMAS TONGAUNA UTARA NOMOR TANGGAL
KECAMATAN TONGAUNA UTARA
PROVINSI SULTRA PELAPORAN BULAN : JANUARI 2024
KABUPATEN KONAWE PERMINTAAN BULAN : FEBRUARI

No NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR PERMINTAAN PEMBERIAN KETERANGAN
1 2 3 4 5 6 7 8 10 11 12

1 Acetylsistein Tablet 1100 2400 3,500 400 3,100 (2,660)

2 Alopurinol tablet 100 mg Tablet 1000 1000 2,000 500 1,500 (950)
3 Alopurinol tablet 300 mg Tablet 700 0 700 100 600 (490)
4 Ambroksol sirup Botol 0 0 - - - -
5 Ambroksol tablet 30 mg Tablet 1300 0 1,300 100 1,200 (1,090)
6 Aminofillin tablet 200 mg Tablet 0 0 - - - -
7 Amlodipin tablet 10 mg Tablet 710 150 860 90 770 (671)
8 Amlodipin tablet 5 mg Tablet 700 0 700 510 190 371
9 Amoksilin kaplet 500 mg Kaplet 1000 2000 3,000 1,600 1,400 360
10 Amoksilin sirup kering 100 mg/ml - 10 ml Botol 0 0 - - - -
11 Amoksilin sirup kering 125 mg/5 ml - 60 ml Botol 40 0 40 30 10 23
12 Amoksilin sirup kering 250 mg Botol 0 0 - - - -
13 Amoksilin Drops Botol 22 0 22 16 6 12
Antasida DOEN I tablet kunyah, kombinasi : Aluminium
Botol 2,400 1,200 1,200 120
14 Hidroksida 200 mg + Magnesium Hidroksida 200 mg 2400 0
15 Antasida DOEN II suspensi, kombinasi Botol 0 0 - - - -
16 Anti Hemmoroid DOEN kombinasi Supp 0 0 - - - -
17 Antifungi Salep 3 - 6 Pot 0 0 - - - -
18 Antifungi DOEN kombinasi/SALEP WHITE FIELD Pot 0 0 - - - -
19 Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg Tablet 0 0 - - - -
20 Aqua pro injeksi steril, bebas pirogen 25 ml Vial 120 0 120 - 120 (120)
21 Asam Asetilsalisilat tablet 80 mg Tablet 0 0 - - - -
22 Asam Askorbat (Vitamin C) tablet 50 mg Tablet 3300 0 3,300 - 3,300 (3,300) ED

23 Asam Folat Tablet 900 0 900 - 900 (900)

24 Asam Mefenamat kaplet 500 mg Tablet 1900 0 1,900 800 1,100 (220)
25 Asam Traneksamat Tablet 0 0 - - - -
26 Asiklovir salep kulit Tube 66 0 66 26 40 (11)
27 Asiklovir tablet 200 mg Tablet 400 0 400 - 400 (400)
28 Asiklovir tablet 400 mg Tablet 570 0 570 - 570 (570)
29 Atorvastatin 20 mg Tablet 0 0 - - - -
Besi II Sulfat 200 mg + Asam Folat 0,25 mg (tablet
30 Tablet 4,600 600 4,000 (3,340)
tambah darah kombinasi) 4600 0
31 Betahistin Mesilat tablet 6 mg Tablet 900 0 900 200 700 (480)
32 Betametason Krim 0.1 % (sebagai valerat) - 5 gr Tube 39 0 39 11 28 (16)
33 Betametason TM ( Vasoma ) Tube 0 - - -
34 Bisakodil Tablet 0 0 - - - -
35 Cairan KAEN3B Botol 0 0 - - -
36 Cefotaxim injeksi Ampul 0 0 - - -
37 Ceftriaxon injeksi Ampul 6 0 6 - 6 (6)
38 Cetirizin Syrup Botol 13 0 13 5 8 (3)
39 Cetirizin Tablet Tablet 1300 0 1,300 1,000 300 800
40 Deksametason injeksi 5 mg/ml-1ml Ampul 180 0 180 13 167 (153)
41 Deksametason tablet 0,5 mg Tablet 1400 0 1,400 900 500 490
42 Desoximetasone Krem 0,25 %/ DEXOCORT Tube 0 0 - - - -
43 Difenhidramin injeksi 10 mg/ml Ampul 27 0 27 - 27 (27)
44 Digoksin tablet 0,25 mg Tablet 0 0 - - - -
45 Domperidon sirup Botol 7 0 7 2 5 (3)
46 Domperidon Tablet Tablet 900 0 900 100 800 (690)
47 Domperidon Tablet/VOMIPER Tablet 210 0 210 - 210 (210)
48 Dulcolax Suppositoria Supp 0 0 - - - -
49 Epinefrin ( Adrenalin ) injeksi 0,1 % Ampul 3 0 3 - 3 (3)
50 Eritromisin kapsul 500 mg Kapsul 0 0 - - - -
51 Etakridin (Rivanol) Larutan 0,1 % - 300 ml Botol 41 0 41 1 40 (39)
52 Fitomenadion(Vit. K1) injeksi Ampul 10 0 10 6 4 3
53 Fitomenadion(Vit. K1) tablet salut gula 10 mg Tablet 700 0 700 - 700 (700)
54 Fluocuinolon salep/Synarcus Pot 0 0 - - - -
55 Furosemid tablet 40 mg Tablet 650 0 650 - 650 (650)
56 Garam Oralit I serbuk, kombinasi / MINERAL MIX Sach 650 0 650 50 600 (545)
57 Gemfibrozil 300 mg kapsul Kapsul 260 0 260 - 260 (260)
58 Gemfibrozil 600 mg kapsul Kapsul 320 0 320 - 320 (320)
59 Gentamycin salep Kulit 0,1% Tube 26 0 26 3 23 (20)
60 Gentamycin salep mata 0,3% Tube 21 0 21 8 13 (4)
61 Gentamycin Tetes Mata Botol 0 0 - - - -
62 Glibenklamid tablet 5 mg Tablet 900 0 900 400 500 (60)
63 Glimepirid 1 mg Tablet 340 0 340 240 100 164
64 Guaifenesin 100 mg Tablet 1000 1000 2,000 400 1,600 (1,160)
65 Glucose Larutan Infus 5% steril - 500 ml Kolf 0 0 - - - -
66 Griseofulvin tablet 125 mg Tablet 1400 0 1,400 - 1,400 (1,400)
67 Hidroklortiazid (HCT) tablet 25 mg Tablet 0 0 - - - -
68 Hidrokortison krim 2,5 % - 5 gr Tube 26 36 62 3 59 (56)
69 Hyiosin Bromida Tablet 990 0 990 90 900 (801)
70 Ibuprofen Syrup 60 ml Botol 75 0 75 23 52 (27)
71 Ibuprofen tablet 200 mg Tablet 0 0 - - - -
72 Ibuprofen tablet 400 mg Tablet 3100 0 3,100 1,600 1,500 260
73 Isosorbid dinitrat (ISDN) tablet sublingual 5 mg Tablet 0 0 - - - -
74 Kalsium laktat (Kalk) tablet 500 mg Tablet 800 1000 1,800 300 1,500 (1,170)
75 Kaptopril tablet 12,5 mg Tablet 900 0 900 300 600 (270)
76 Kaptopril tablet 25 mg Tablet 1000 0 1,000 100 900 (790)
77 Ketokonazol tablet 200 mg Tablet 400 0 400 150 250 (85)
78 Ketokonazole Krem Tube 30 0 30 10 20 (9)
79 Ketorolak Injeksi Ampul 30 0 30 - 30 (30)
80 Kloramfenikol kapsul 250 mg Kapsul 0 0 - - - -
81 Kloramfenikol Salep Kulit Tube 35 0 35 3 32 (29)
82 Kloramfenikol suspensi 125 mg/5ml - 60 ml Botol 0 0 - - - -
83 Kloramfenikol tetes telinga 3 % - 5 ml Botol 0 0 - - - -
84 Klorfeniramin maleat (CTM) tablet 4 mg Tablet 1050 0 1,050 150 900 (735)
Kotrimoksazol DOEN I (dewasa) kombinasi :
85 Tablet 1,400 400 1,000 (560)
Sulfametoksazol 400 mg + Trimetoprim 80 mg 1400 0
Kotrimoksazol DOEN II (pedriatik) kombinasi :
Tablet - - - -
86 Sulfametoksazol 100 mg + Trimetoprim 20 mg 0 0
Kotrimoksazol Suspensi kombinasi : Sulfametoksazol
87 Tablet 52 40 12 32
200 mg + Trimetoprim 40 mg/ 5 ml - 60 ml 52 0
88 Lansoprazole Kapsul 2250 0 2,250 850 1,400 (465)
Lidokain comp injeksi (Lidocain 2% (HCl) + Epinefrin 1 :
Ampul 33 20 13 9
89 80.000) - 2 ml 33 0
90 Loperamid tablet 2 mg /NOVADIUM Tablet 900 0 900 300 600 (270)
91 Loratadin tablet 10 mg Tablet 1100 0 1,100 200 900 (680)
92 Meloxicam 15 mg Tablet 1400 0 1,400 700 700 70
93 Meloxicam 7,5 mg Tablet 0 0 - - - -
94 Mersibion 5000 mg Ampul 0 30 30 12 18 (5)
95 Metampiron (Antalgin) tablet 500 mg Tablet 0 0 - - -
96 Metformin HCl tablet 500 mg Tablet 500 600 1,100 100 1,000 (890)
97 Metil Prednisolon Tablet 1750 0 1,750 1,650 100 1,715
98 Metilergometrin Maleat (Metilergometrin) injeksi Ampul 13 0 13 5 8 (3)
Metilergometrin Maleat (Metilergometrin) tablet salut
Tablet - (800)
99 0,125 mg 300 500 800 800
100 Metoklorpramid Tablet 300 0 300 - 300 (300)
101 Metronidazol tablet 500 mg Tablet 800 0 800 300 500 (170)
102 Metronidazole SIRUP Botol 0 0 - - - -
103 Mikonazol krim/ salep 2 % (Nitrat) - 10 gr Tube 24 0 24 7 17 (9)
104 Natrium Diklofenak tablet 25 mg Tablet 0 0 - - - -
105 Natrium Diklofenak tablet 50 mg Tablet 1100 500 1,600 1,200 400 920
106 Natrium Klorida larutan infus 0,9% - 500 ml Kolf 33 0 33 2 31 (29)
107 Nifedipin tablet 10 mg Tablet 0 0 - - - -
108 Nistatin tablet salut 500.000 IU/g Tablet 0 0 - - - -
109 Nistatin vaginal tablet 100.000 IU/g Tablet 130 0 130 - 130 (130)
110 Nistatin Drops 100.000 IU/12 ml Botol 5 5 1 4 (3)
111 Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol Botol 0 0 - - - -
112 Ofloxacin tetes telinga Botol 12 0 12 - 12 (12)
113 Oksitetrasiklin HCl salep kulit 3 % - 5 gr Tube 40 0 40 8 32 (23)
114 Oksitetrasiklin HCl salep mata 1 % - 5 gr Tube 0 0 - - - -
115 Oksitocin Injeksi Ampul 0 0 - - - -
116 Omeprazole kapsul 20 mg Kapsul 0 0 - - - -
117 Omeprazole Injeksi Ampul 30 0 30 - 30 (30)
118 Ondansetron Ampul 0 0 - - - -
119 Ondansetron / DANSEFION Ampul 5 5 5 6
120 Papaverin tablet 40 mg Tablet 0 0 - - - -
121 Parasetamol drops 15 ml Botol 10 0 10 5 5 1
122 Parasetamol Infus Botol 3 0 3 1 2 (1)
123 Parasetamol sirup 120 mg / 5ml - 60 ml Botol 96 0 96 40 56 (12)
124 Parasetamol tablet 500 mg Tablet 1500 1000 2,500 1,200 1,300 20
125 Phenol Gliserol tetes telinga Botol 14 0 14 - 14 (14)
126 Piridoksin (Vitamin B6) tablet 10 mg (HCl) Tablet 800 0 800 100 700 (590)
127 Polikresulen (kondensasi) 10 ml / nistatin drop Botol 0 0 - - - -
128 Povidon Iodida larutan 10 % - 1 L Botol 12 24 36 1 35 (34)
129 Povidon Iodida larutan 10 % - 300 ml Botol 0 0 - - - -
130 Povidon Iodida larutan 60 Ml Botol 300 0 300 11 289 (277)
131 Prednison tablet 5 mg Tablet 300 0 300 50 250 (195)
132 Propanolol Tablet 0 0 - - - -
133 Propiltiourasil tablet 100 mg Tablet 0 0 - - - -
134 Ranitidin injeksi Ampul 25 0 25 - 25 (25)
135 Ranitidin tablet 150 mg Tablet 0 0 - - - -
136 Ringer Laktat larutan infus - 500 ml Kolf 69 0 69 44 25 23
137 Salbutamol tablet 4 mg (sebagai sulfat) Tablet 600 0 600 50 550 (495)
Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang
Pot - - - -
138 endap 4 % - 30 gr 0 0
139 Salisil Bedak 2 % - 50 gr Pot 24 0 24 9 15 (5)
140 Scabimite Krim - Permetrin Krim 5 % Tube Tube 0 0 - - - -
141 Sefadroksil Kapsul 500 mg Kapsul 1000 0 1,000 500 500 50
142 Sefadroxil sirup 125 MG / WADOXIL Botol 0 0 - - - -
143 Sefadroxil sirup 250 MG Botol 0 0 - - - -

144 Sefadroxil Drop 150mg Botol 0 30 30 - 30 (30)

145 Sianokobalamin (vitamin B12) tablet 50 mcg Tablet 0 0 - - - -
146 Simvastatin tablet 10 mg Tablet 250 0 250 100 150 (40)
147 Simvastatin tablet 20 mg Tablet 1400 0 1,400 600 800 (140)
148 Siprofloksasin tablet 500 mg (sebagai HCl) Tablet 1900 0 1,900 900 1,000 (10)
149 Sukralfat Botol 45 0 45 33 12 24
150 Sulfasetamida Natrium tetes mata 15 % - 5 ml Botol 0 0 - - - -
151 Tetrasiklin Kapsul 250 mg Kapsul 0 0 - - - -
152 Tetrasiklin kapsul 500 mg Kapsul 100 0 100 - 100 (100)
153 Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat) Tablet 1100 0 1,100 600 500 160
154 Vitamin B Kompleks tablet Tablet 1600 0 1,600 1,050 550 605
155 Zinc tablet 20 mg Tablet 780 0 780 80 700 (612)
156 Zinc sirup Botol 40 0 40 7 33 (25)

OBAT PROGRAM P2M

157 DHP-Prmal Tablet 0 0 - - - -
158 Health Mate Dengue AB Plus ( IGG & IGM ) Tablet 6 0 6 - 6 (6)
159 Health Mate Dengue Combo Plus paket 30 0 30 3 27 (24)
160 Hepatitis rapid test/HBsAg Pcs 30 0 30 - 30 (30)
161 HIV Rapid test Pcs 37 0 37 - 37 (37)
162 Primaquin Pcs 0 0 - - - -
163 RDT Malaria Pcs 87 0 87 2 85 (83)
164 Spyilis Rapid test Pcs

OBAT PROGRAM TB PARU

165 Obat FDC Kategori 1 Paket 3 0 3 - 3 (3)
166 Obat FDC Kategori 2 Paket 0 - - - -
167 Obat FDC Anak Paket 3 0 3 - 3 (3)
168 Obat FDC Sisipan (MDR) Paket 0 0 - - - -

OBAT PROGRAM KECACINGAN

169 Albendazole tablet 400 mg Tablet 4400 0 4,400 - 4,400 (4,400)
170 Pirantel tablet score (base) 125 mg Tablet 0 0 - - - -
171 Pirantel Syrup Botol 0 0 - - - -

OBAT PROGRAM GIZI

172 Retinol (Vitamin A) 100.000 IU kapsul lunak Kapsul 100 0 100 - 100 (100)
173 Retinol (Vitamin A) 200.000 IU kapsul lunak Kapsul 1000 0 1,000 - 1,000 (1,000)
174 Protein Coklat sach 20 0 20 - 20 (20)
175 Protein Gold Vanila sach 0 0 - - - -
176 Protein Vanila sach 0 0 - - - -

OBAT KEJIWAAN
177 Alprazolam tablet 1 mg Tablet 0 0 - - - -
178 Amitriptilin 25 mg Tablet 0 0 - - - -
179 Diazepam tablet 2 mg Tablet 0 0 - - - -
180 Diazepam tablet 5 mg Tablet 0 0 - - - -
181 Diazepam tube Rectal 5 mg/ml / STESOLID Tube rectal 8 0 8 - 8 (8)
182 haloperidol 0.5 mg Tablet 0 0 - - - -
183 haloperidol 1.5 mg Tablet 30 0 30 - 30 (30)
184 haloperidol 5 mg Tablet 0 0 - - - -
185 Phenobarbital 30 mg Tablet 0 0 - - - -

OBAT GIGI
186 CHKM Botol 0 0 - - - -
187 Devitalisasi Pasta (Non Arsen) Btl / ktk 0 0 - - - -
188 Denpro Calplus Btl / ktk 0 0 - - - -
189 Etil Chlorida spray - 100 ml / Lidokain spray/Xylocain Botol 3 0 3 - 3 (3)
190 Eugenol cairan - 15 ml Botol 0 0 - - - -
191 Frutti Fluor Gel Botol 0 0 - - - -
192 Glass Ionomer Cement ART (GCIX) / FUJI IX Set 0 0 - - - -
193 Kalsium Hidroksida pasta / CALCIDOR / DYCAL Set 0 0 - - - -
194 Mummifying Pasta / Iodoform Btl / ktk 0 0 - - - -
195 Semen Seng Fosfat (Powder 30 gr, Liquid 10 ml) Set 0 0 - - - -
196 Silver Amalgam Botol 0 0 - - - -
Temporary Stopping Fletcher Serbuk (Powder) /
Pot - - - -
197 ORAFIL PLUS 0 0

PERBEKALAN KESEHATAN
198 Alat Suntik sekali pakai 0,05 ml Pcs 0 0 - - -
199 Alat Suntik sekali pakai 0,5 ml Pcs 0 0 - - - -
200 Alat Suntik sekali pakai 1 ml Pcs 64 0 64 24 40 (14)
201 Alat Suntik sekali pakai 3 ml Pcs 106 0 106 17 89 (70)
202 Alat Suntik sekali pakai 5 ml Pcs 133 0 133 - 133 (133)
203 Alkohol Swab Kotak 6 0 6 - 6 (6)
204 Benang Bedah Catgut cromic 3/0 HR 27 MM Sach 15 0 15 5 10 (5)
205 Benang Bedah Catgut No. 3/0 HR 30 MM Sach 0 0 - - - -
206 Benang Bedah Silk Black 3/0 HR 30 MM Sach 10 0 10 - 10 (10)
207 Benang Bedah Silk Black 3/0 HR 20 MM Sach 0 0 - - - -
208 Etanol 70 % - 1 L Botol 0 24 24 - 24 (24)
209 Etanol 70 % - 300 ml Botol 0 0 - - - -
210 Fora Blood Glucosa Pcs 25 0 25 3 22 (19)
211 Feley Catheter FR 14 Pcs 9 0 9 - 9 (9)
212 Feley Catheter Pcs 0 0 - - - -
213 Folley Cateter N0.18 Pcs 0 0 - - - -
214 Hand Sanitizer/ SASKLIN PLUS 500ml Botol 0 72 72 - 72 (72)
215 Humasens 2.0 Plus Glucosa Pcs 0 0 - - - -
216 Infus set Bayi Pcs 0 0 - - - -
217 Infusion Set Anak Pcs 17 0 17 - 17 (17)
218 Infusion Set Dewasa Pcs 56 0 56 23 33 (8)
219 IV. Catheter No.18 G Set 23 0 23 8 15 (6)
220 IV. Catheter No.20 G Set 26 0 26 6 20 (13)
221 IV. Catheter No.22 G Set 55 0 55 28 27 4
222 IV. Catheter No.24 G Set 33 0 33 8 25 (16)
223 Kapas 100 gram Bungkus 0 0 - - - -
224 Kapas Pembalut / absorben 50 gram Bungkus 0 0 - - - -
225 Kapas Pembalut / absorben 250 gram Bungkus 1 0 1 1 - 1
226 Kassa Hidrofil Steril uk. 16 x 16 Kotak 10 20 30 10 20 (9)
227 Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm Roll 0 0 - - - -
228 Kassa pembalut hidrofil 3 yrd X15 cm Roll 2 0 2 2 - 2
229 Kertas EKG Pcs 2 0 2 - 2 (2)
230 Masker Bedah Kotak 8 20 28 8 20 (11)
231 Masker Hijab Kotak 0 0 - - - -
232 Masker N95 Kotak 0 0 - - - -
233 Micropipettes MT II up to 1000 microliter blue Pcs 0 0 - - - -
234 Micropipettes MTSP up to 10 microliter Pcs 0 0 - - - -
235 Micropipettes MT II up to 200 microliter yellow Pcs 0 0 - - - -
236 Nasal Cannula Adult Pcs 34 0 34 - 34 (34)
237 Nasal Cannula Child Pcs 20 0 20 - 20 (20)
238 Nasal Cannula infant Pcs 20 0 20 - 20 (20)
239 Nebulizer Adult (sungkup) Pcs 3 0 3 - 3 (3)
240 Nebulizer Anak (sungkup) Pcs 3 0 3 - 3 (3)
241 Nebulizer Bayi (sungkup) Pcs 3 0 3 - 3 (3)
242 Neo H Blood Gllucosa Pcs 0 0 - - - -
243 Plester 5 yard X 2 inch Roll 0 0 - - - -
244 Plester Zinc Oxide Tape 5 x 450 cm Roll 2 0 2 1 1 0
245 Pot Sputum Pcs 380 0 380 - 380 (380)
246 Sarung Tangan L Kotak 11 0 11 4 7 (3)
247 Sarung Tangan M Kotak 5 0 5 5 - 6
248 Sarung Tangan No. 6,5 Pcs 0 0 - - - -
249 Sarung Tangan No. 7 Pcs 4 0 4 4 - 4
250 Sarung Tangan No. 7,5 Pcs 70 0 70 - 70 (70)
251 Urine Bag Pcs 20 0 20 - 20 (20)
252 USG Gel 500 ml Botol 1 0 1 - 1 (1)
253 USG Gel 5 Liter Botol 1 0 1 - 1 (1)
254 Vacum Tube ClotActivator Glass 3 Ml Pcs 0 0 - - - -
255 Ziltape paper 0,5 inch Roll 17 0 17 - 17 (17)
256 Ziltape paper 1 inch Roll 13 0 13 3 10 (7)
257 Ziltape paper 2 inch Roll 17 0 17 6 11 (4)

OBAT PONED
258 MgSO4 20 % injeksi Botol 6 0 6 - 6 (6)
259 MgSO4 40 % injeksi Botol 6 0 6 - 6 (6)
260 Oksitosin injeksi 10 IU/ml - 1 ml Ampul 165 0 165 40 125 (81)

OBAT TAMBAHAN
261 Albuforce Kapsul 40 200 240 30 210 (177)
262 Aloclair Gel Botol 4 0 4 2 2 0
263 Aloclair Spray Botol 8 0 8 3 5 (2)
264 Alpara Tablet 1950 0 1,950 800 1,150 (270)
265 Fasfit C Tablet 500 0 500 - 500 (500)
266 Fasfit CDEZ Tablet 500 0 500 - 500 (500)
267 Febrinex Syrup Botol 0 0 - - - -
268 Ifarsyl Syrup Botol 12 0 12 10 2 9
269 Kidyvit Botol 14 0 14 2 12 (10)
270 Lasalcom Nebuliseer Tube 40 0 40 - 40 (40)
271 Lodecon Kaplet 900 0 900 400 500 (60)
272 Novakid Syrup Botol 154 0 154 25 129 (102)
273 Noza Kaplet 0 0 - - - -
274 Nufed Tablet 750 0 750 300 450 (120)
275 OBH Molex Syrup Botol 78 0 78 15 63 (47)
276 Striatatmin Kapsul 810 0 810 90 720 (621)
277 Symbicort Tube 0 0 - - - -
278 Vitsap Kapsul 770 0 770 60 710 (644)

VAKSIN
279 ATS Ampul 0 0 - - - -
280 Anti Bisa Ular Ampul 0 0 - - - -
281 Rabies Vero Vial 0 0 - - - -
282 BCG Ampul 3 0 3 2 1 1
283 DPT-HB Combo Ampul 0 0 - - - -
284 Polio Ampul 13 0 13 5 8 (3)
285 Campak + Pelarut Campak Ampul 4 10 14 4 10 (6)
286 TT/TD Ampul 9 0 9 - 9 (9)
287 IPV Ampul 9 10 19 6 13 (6)
288 HB Uniject Ampul 3 15 18 3 15 (12)
 UMUM ASKES BPJS GRATIS JAMKESMAS JUMLAH
JUMLAH KUNJUNGAN RESEP
- 63 192 1 - 256
Mengetahui / Menyetujui Yang Menyerahkan , Yang Meminta , Yang Membuat ,
Kepala Dinas Kesehatan Kab.Konawe Kepala Instalasi Farmasi Kab.Konawe Kepala Puskesmas Petugas Puskesmas

drg. Mawar Taligana, M.Kes Mulyanti, S.Farm., Apt. JURI,SKM Ice Aquarista,AM,Keb
Nip. 19660726 200212 1 001 NIP. 1986 0910 201101 2 026 NIP. 19700113 199303 1 005 NIP. 19890222 201705 2 004
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OB
PUSKESMAS TONGAUNA UTARA
KECAMATAN TONGAUNA UTARA
PROVINSI SULTRA PELAPORAN BULAN : MARET 2024
KABUPATEN KONAWE PERMINTAAN BULAN : APRIL

No NAMA OBAT SATUAN STOK AWAL

1 2 3 4
1 Acetylsistein Tablet 3100
2 Alopurinol tablet 100 mg Tablet 1000
3 Alopurinol tablet 300 mg Tablet 320
4 Ambroksol sirup Botol 0
5 Ambroksol tablet 30 mg Tablet 1200
6 Aminofillin tablet 200 mg Tablet 0
7 Amlodipin tablet 10 mg Tablet 630
8 Amlodipin tablet 5 mg Tablet -190
9 Amoksilin kaplet 500 mg Kaplet 2940
10 Amoksilin sirup kering 100 mg/ml - 10 ml Botol 0
11 Amoksilin sirup kering 125 mg/5 ml - 60 ml Botol 110
12 Amoksilin sirup kering 250 mg Botol 0
13 Amoksilin Drops Botol 54
Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200
14 mg + Magnesium Hidroksida 200 mg
Botol 3600
15 Antasida DOEN II suspensi, kombinasi Botol 0
16 Anti Hemmoroid DOEN kombinasi Supp 0
17 Antifungi Salep 3 - 6 Pot 0
18 Antifungi DOEN kombinasi/SALEP WHITE FIELD Pot 0
19 Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg Tablet 0
20 Aqua pro injeksi steril, bebas pirogen 25 ml Vial 120
21 Asam Asetilsalisilat tablet 80 mg Tablet 0
22 Asam Askorbat (Vitamin C) tablet 50 mg Tablet 0
23 Asam Folat Tablet 900
24 Asam Mefenamat kaplet 500 mg Tablet 2100
25 Asam Traneksamat Tablet 0
26 Asiklovir salep kulit Tube 72
27 Asiklovir tablet 200 mg Tablet 400
28 Asiklovir tablet 400 mg Tablet 570
29 Atorvastatin 20 mg Tablet 0
Besi II Sulfat 200 mg + Asam Folat 0,25 mg (tablet tambah darah
30 Tablet 2800
kombinasi)
31 Betahistin Mesilat tablet 6 mg Tablet -100
32 Betametason Krim 0.1 % (sebagai valerat) - 5 gr Tube 78
33 Betametason TM ( Vasoma ) Tube 20
34 Bisakodil Tablet 0
35 Cairan KAEN3B Botol 0
36 Cefotaxim injeksi Ampul 8
37 Ceftriaxon injeksi Ampul 14
38 Cetirizin Syrup Botol 128
39 Cetirizin Tablet Tablet 2100
40 Deksametason injeksi 5 mg/ml-1ml Ampul 167
41 Deksametason tablet 0,5 mg Tablet 500
42 Desoximetasone Krem 0,25 %/ DEXOCORT Tube 0
43 Difenhidramin injeksi 10 mg/ml Ampul 27
44 Digoksin tablet 0,25 mg Tablet 0
45 Domperidon sirup Botol 1
46 Domperidon Tablet Tablet 600
47 Domperidon Tablet/VOMIPER Tablet 210
48 Dulcolax Suppositoria Supp 0
49 Epinefrin ( Adrenalin ) injeksi 0,1 % Ampul 3
50 Eritromisin kapsul 500 mg Kapsul 0
51 Etakridin (Rivanol) Larutan 0,1 % - 300 ml Botol 40
52 Fitomenadion(Vit. K1) injeksi Ampul 12
53 Fitomenadion(Vit. K1) tablet salut gula 10 mg Tablet 700
54 Fluocuinolon salep/Synarcus Pot 0
55 Furosemid tablet 40 mg Tablet 630
56 Garam Oralit I serbuk, kombinasi / MINERAL MIX Sach 600
57 Gemfibrozil 300 mg kapsul Kapsul 260
58 Gemfibrozil 600 mg kapsul Kapsul 320
59 Gentamycin salep Kulit 0,1% Tube 11
60 Gentamycin salep mata 0,3% Tube 47
61 Gentamycin Tetes Mata Botol 0
62 Glibenklamid tablet 5 mg Tablet 2500
63 Glimepirid 1 mg Tablet 700
64 Guaifenesin 100 mg Tablet 1600
65 Glucose Larutan Infus 5% steril - 500 ml Kolf 0
66 Griseofulvin tablet 125 mg Tablet 1400
67 Hidroklortiazid (HCT) tablet 25 mg Tablet 0
68 Hidrokortison krim 2,5 % - 5 gr Tube 47
69 Hyiosin Bromida Tablet 840
70 Ibuprofen Syrup 60 ml Botol 32
71 Ibuprofen tablet 200 mg Tablet 0
72 Ibuprofen tablet 400 mg Tablet 2800
73 Isosorbid dinitrat (ISDN) tablet sublingual 5 mg Tablet 0
74 Kalsium laktat (Kalk) tablet 500 mg Tablet 300
75 Kaptopril tablet 12,5 mg Tablet 200
76 Kaptopril tablet 25 mg Tablet 500
77 Ketokonazol tablet 200 mg Tablet 250
78 Ketokonazole Krem Tube -2
79 Ketorolak Injeksi Ampul 30
80 Kloramfenikol kapsul 250 mg Kapsul 0
81 Kloramfenikol Salep Kulit Tube 32
82 Kloramfenikol suspensi 125 mg/5ml - 60 ml Botol 0
83 Kloramfenikol tetes telinga 3 % - 5 ml Botol 0
84 Klorfeniramin maleat (CTM) tablet 4 mg Tablet 300
Kotrimoksazol DOEN I (dewasa) kombinasi : Sulfametoksazol
85 Tablet -200
400 mg + Trimetoprim
Kotrimoksazol DOEN II80 mg
(pedriatik) kombinasi : Sulfametoksazol
86 Tablet 0
100 mg + Trimetoprim
Kotrimoksazol Suspensi 20kombinasi
mg : Sulfametoksazol 200 mg +
87 Tablet -8
Trimetoprim 40 mg/ 5 ml - 60 ml
88 Lansoprazole Kapsul 300
Lidokain comp injeksi (Lidocain 2% (HCl) + Epinefrin 1 : 80.000)
89 Ampul 57
- 2 ml
90 Loperamid tablet 2 mg /NOVADIUM Tablet 400
91 Loratadin tablet 10 mg Tablet 900
92 Meloxicam 15 mg Tablet 100
93 Meloxicam 7,5 mg Tablet 0
94 Mersibion 5000 mg Ampul 54
95 Metampiron (Antalgin) tablet 500 mg Tablet
96 Metformin HCl tablet 500 mg Tablet 200
 97 Metil Prednisolon Tablet 3500
98 Metilergometrin Maleat (Metilergometrin) injeksi Ampul 38
99 Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg Tablet 800
100 Metoklorpramid Tablet 300
101 Metronidazol tablet 500 mg Tablet 500
102 Metronidazole SIRUP Botol 0
103 Mikonazol krim/ salep 2 % (Nitrat) - 10 gr Tube 53
104 Natrium Diklofenak tablet 25 mg Tablet 0
105 Natrium Diklofenak tablet 50 mg Tablet 2000
106 Natrium Klorida larutan infus 0,9% - 500 ml Kolf 25
107 Nifedipin tablet 10 mg Tablet 0
108 Nistatin tablet salut 500.000 IU/g Tablet 0
109 Nistatin vaginal tablet 100.000 IU/g Tablet 110
110 Nistatin Drops 12ml/100.000 IU Botol 0
111 Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol Botol 0
112 Ofloxacin tetes telinga Botol 12
113 Oksitetrasiklin HCl salep kulit 3 % - 5 gr Tube 32
114 Oksitetrasiklin HCl salep mata 1 % - 5 gr Tube 0
115 Oksitocin Injeksi Ampul 0
116 Omeprazole kapsul 20 mg Kapsul 0
117 Omeprazole Injeksi Ampul -10
118 Ondansetron Ampul 0
119 Ondansetron / DANSEFION Ampul
120 Papaverin tablet 40 mg Tablet 0
121 Parasetamol drops 15 ml Botol 39
122 Parasetamol Infus Botol 4
123 Parasetamol sirup 120 mg / 5ml - 60 ml Botol 218
124 Parasetamol tablet 500 mg Tablet 2900
125 Phenol Gliserol tetes telinga Botol 14
126 Piridoksin (Vitamin B6) tablet 10 mg (HCl) Tablet 700
127 Polikresulen (kondensasi) 10 ml / nistatin drop Botol 0
128 Povidon Iodida larutan 10 % - 1 L Botol 33
129 Povidon Iodida larutan 10 % - 300 ml Botol 0
130 Povidon Iodida larutan 60 Ml Botol 287
131 Prednison tablet 5 mg Tablet 150
132 Propanolol Tablet 0
133 Propiltiourasil tablet 100 mg Tablet 0
134 Ranitidin injeksi Ampul 25
135 Ranitidin tablet 150 mg Tablet 0
136 Ringer Laktat larutan infus - 500 ml Kolf 53
137 Salbutamol tablet 4 mg (sebagai sulfat) Tablet 1950
Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang endap 4 %
138 Pot 0
- 30 gr
139 Salisil Bedak 2 % - 50 gr Pot 15
140 Scabimite Krim - Permetrin Krim 5 % Tube Tube 0
141 Sefadroksil Kapsul 500 mg Kapsul 0
142 Sefadroxil sirup 125 MG / WADOXIL Botol 0
143 Sefadroxil sirup 250 MG Botol 0
144 Sefadroxil Drop 150mg Botol 10
145 Sianokobalamin (vitamin B12) tablet 50 mcg Tablet 0
146 Simvastatin tablet 10 mg Tablet 50
147 Simvastatin tablet 20 mg Tablet 1840
148 Siprofloksasin tablet 500 mg (sebagai HCl) Tablet 1000
149 Sukralfat Botol -2
150 Sulfasetamida Natrium tetes mata 15 % - 5 ml Botol 0
151 Tetrasiklin Kapsul 250 mg Kapsul 0
152 Tetrasiklin kapsul 500 mg Kapsul 100
153 Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat) Tablet 2840
154 Vitamin B Kompleks tablet Tablet 2850
155 Zinc tablet 20 mg Tablet 700
156 Zinc sirup Botol 33

OBAT PROGRAM P2M

157 DHP-Prmal Tablet 0
158 Health Mate Dengue AB Plus ( IGG & IGM ) Tablet 6
159 Health Mate Dengue Combo Plus paket 17
160 Hepatitis rapid test/HBsAg Pcs 20
161 HIV Rapid test Pcs 27
162 Primaquin Pcs 0
163 RDT Malaria Pcs 75
164 Spyilis Rapid test Pcs 25

OBAT PROGRAM TB PARU

165 Obat FDC Kategori 1 Paket 4
166 Obat FDC Kategori 2 Paket 0
167 Obat FDC Anak Paket 2
168 Obat FDC Sisipan (MDR) Paket 0

OBAT PROGRAM KECACINGAN

169 Albendazole tablet 400 mg Tablet 4400
170 Pirantel tablet score (base) 125 mg Tablet 0
171 Pirantel Syrup Botol 0

OBAT PROGRAM GIZI

172 Retinol (Vitamin A) 100.000 IU kapsul lunak Kapsul 100
173 Retinol (Vitamin A) 200.000 IU kapsul lunak Kapsul 1000
174 Protein Coklat sach 20
175 Protein Gold Vanila sach 0
176 Protein Vanila sach 0

OBAT KEJIWAAN
177 Alprazolam tablet 1 mg Tablet 0
178 Amitriptilin 25 mg Tablet 0
179 Diazepam tablet 2 mg Tablet 0
180 Diazepam tablet 5 mg Tablet 0
181 Diazepam tube Rectal 5 mg/ml / STESOLID Tube rectal 5
182 haloperidol 0.5 mg Tablet 0
183 haloperidol 1.5 mg Tablet 30
184 haloperidol 5 mg Tablet 0
185 Phenobarbital 30 mg Tablet 0
Chloropromazine hcl Tablet 500
Trihexyhenidyl hcl Tablet 200

OBAT GIGI
186 CHKM Botol 0
187 Devitalisasi Pasta (Non Arsen) Btl / ktk 0
188 Denpro Calplus Btl / ktk 0
189 Etil Chlorida spray - 100 ml / Lidokain spray/Xylocain Botol 3
190 Eugenol cairan - 15 ml Botol 0
191 Frutti Fluor Gel Botol 0
192 Glass Ionomer Cement ART (GCIX) / FUJI IX Set 0
193 Kalsium Hidroksida pasta / CALCIDOR / DYCAL Set 0
194 Mummifying Pasta / Iodoform Btl / ktk 0
195 Semen Seng Fosfat (Powder 30 gr, Liquid 10 ml) Set 0
196 Silver Amalgam Botol 0
197 Temporary Stopping Fletcher Serbuk (Powder) / ORAFIL PLUS Pot 0

PERBEKALAN KESEHATAN
198 Alat Suntik sekali pakai 0,05 ml Pcs 0
199 Alat Suntik sekali pakai 0,5 ml Pcs 0
200 Alat Suntik sekali pakai 1 ml Pcs 23
201 Alat Suntik sekali pakai 3 ml Pcs 66
202 Alat Suntik sekali pakai 5 ml Pcs 133
Alat Suntik Sekali Pakai 10 ml Pcs 0
203 Alkohol Swab Kotak 6
204 Benang Bedah Catgut cromic 3/0 HR 27 MM Sach 10
205 Benang Bedah Catgut No. 3/0 HR 30 MM Sach 0
206 Benang Bedah Silk Black 3/0 HR 30 MM Sach 10
207 Benang Bedah Silk Black 3/0 HR 20 MM Sach 0
208 Etanol 70 % - 1 L Botol 22
209 Etanol 70 % - 300 ml Botol 0
210 Fora Blood Glucosa Pcs 22
211 Feley Catheter FR 14 Pcs 9
212 Feley Catheter Pcs 0
213 Folley Cateter N0.18 Pcs 0
214 Hand Sanitizer/ SASKLIN PLUS 500ml Botol 72
215 Humasens 2.0 Plus Glucosa Pcs 0
216 Infus set Bayi Pcs 0
217 Infusion Set Anak Pcs 17
218 Infusion Set Dewasa Pcs 55
219 IV. Catheter No.18 G Set 12
220 IV. Catheter No.20 G Set 6
221 IV. Catheter No.22 G Set 39
222 IV. Catheter No.24 G Set 23
223 Kapas 100 gram Bungkus 0
224 Kapas Pembalut / absorben 50 gram Bungkus 0
225 Kapas Pembalut / absorben 250 gram Bungkus 0
226 Kassa Hidrofil Steril uk. 16 x 16 Kotak 41
227 Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm Roll 0
228 Kassa pembalut hidrofil 3 yrd X15 cm Roll 2
229 Kertas EKG Pcs 2
230 Masker Bedah Kotak 38
231 Masker Hijab Kotak 0
232 Masker N95 Kotak 0
233 Micropipettes MT II up to 1000 microliter blue Pcs 0
234 Micropipettes MTSP up to 10 microliter Pcs 0
235 Micropipettes MT II up to 200 microliter yellow Pcs 0
236 Nasal Cannula Adult Pcs 34
237 Nasal Cannula Child Pcs 20
238 Nasal Cannula infant Pcs 20
239 Nebulizer Adult (sungkup) Pcs 3
240 Nebulizer Anak (sungkup) Pcs 3
241 Nebulizer Bayi (sungkup) Pcs 3
242 Neo H Blood Gllucosa Pcs 0
243 Plester 5 yard X 2 inch Roll 0
244 Plester Zinc Oxide Tape 5 x 450 cm Roll 1
245 Pot Sputum Pcs 380
246 Sarung Tangan L Kotak 4
247 Sarung Tangan M Kotak 5
248 Sarung Tangan No. 6,5 Pcs 0
249 Sarung Tangan No. 7 Pcs 0
250 Sarung Tangan No. 7,5 Pcs 70
251 Urine Bag Pcs 20
252 USG Gel 500 ml Botol 1
253 USG Gel 5 Liter Botol 1
254 Vacum Tube ClotActivator Glass 3 Ml Pcs 0
255 Ziltape paper 0,5 inch Roll 17
256 Ziltape paper 2,5 inch Roll 4
257 Ziltape paper 5 inch Roll 10

OBAT PONED
258 MgSO4 20 % injeksi Botol 6
259 MgSO4 40 % injeksi Botol 6
260 Oksitosin injeksi 10 IU/ml - 1 ml Ampul 125

OBAT TAMBAHAN
261 Albuforce Kapsul 210
262 Aloclair Gel Botol 2
263 Aloclair Spray Botol 2
264 Alpara Tablet 750
265 Fasfit C Tablet 160
266 Fasfit CDEZ Tablet -
267 Febrinex Syrup Botol -
268 Ifarsyl Syrup Botol 1
269 Kidyvit Botol -
270 Lasalcom Nebuliseer Tube 20
271 Lodecon Kaplet 230
272 Novakid Syrup Botol -
273 Noza Kaplet -
274 Nufed Tablet 1,500
275 OBH Molex Syrup Botol -
276 Striatatmin Kapsul -
277 Symbicort Tube -
278 Vitsap Kapsul -

VAKSIN
279 ATS Ampul 0
280 Anti Bisa Ular Ampul 0
281 Rabies Vero Vial 0
282 BCG Ampul 3
283 DPT-HB Combo Ampul 0
284 Polio Ampul 1
285 Campak + Pelarut Campak Ampul 7
286 TT/TD Ampul 8
287 IPV Ampul 9
288 HB Uniject Ampul 7

UMUM
JUMLAH KUNJUNGAN RESEP
-
Mengetahui / Menyetujui Yang Menyerahkan ,
Kepala Dinas Kesehatan Kab.Konawe Kepala Instalasi Farmasi Kab.Konawe

drg. Mawar Taligana, M.Kes Mulyanti, S.Farm., Apt.

Nip. 19660726 200212 1 001 NIP. 1986 0910 201101 2 026
AN DAN LEMBAR PERMINTAAN OBAT ( LPLPO )
NOMOR TANGGAL

RAN BULAN : MARET 2024

RMINTAAN BULAN : APRIL

PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR PERMINTAAN PEMBERIAN KETERANGAN

5 6 7 8 10 11 12
0 3,100 1,600 1,500 260
0 1,000 (300) 1,300 (1,630)
0 320 20 300 (278)
0 - - -
0 1,200 400 800 (360)
0 - - -
0 630 (330) 960 (1,323)
0 (190) (190) (209)
1500 4,440 2,840 100 3,024
0 - -
60 170 104 6 108
0 - - -
24 78 40 14 30
1500 5,100 2,800 800 2,280
0 - - -
0 - - -
0 - -
0 - - -
0 - - -
0 120 70 50 27
0 - - -
0 - - -
0 900 100 800 (690)
1000 3,100 1,200 900 420
0 - - -
20 92 62 10 58
0 400 200 200 20
0 570 170 400 (213)
0 - - -
0 2,800 (1,400) 4,200 (5,740)
0 (100) (700) 600 (1,370)
25 103 72 6 73
10 30 20 22
0 - - -
0 - - -
4 12 3 5 (2)
4 18 7 7 1
60 188 120 8 124
1500 3,600 1,500 600 1,050
0 167 17 150 (131)
0 500 500 550
0 - - -
0 27 5 22 (17)
 0 - - -
0 1 1
0 600 - 600 (600)
0 210 60 150 (84)
0 - - -
0 3 - 3 (3)
0 - - -
0 40 6 34 (27)
10 22 12 13
0 700 - 700 (700)
0 - - -
0 630 180 450 (252)
0 600 200 400 (180)
0 260 - 260 (260)
0 320 - 320 (320)
0 11 11 12
24 71 28 19 12
0 - - -
1000 3,500 1,400 1,100 440
300 1,000 370 330 77
0 1,600 700 900 (130)
0 - - -
0 1,400 100 1,300 (1,190)
0 - - -
0 47 32 15 20
0 840 140 700 (546)
0 32 20 12 10
0 - - -
1500 4,300 2,300 500 2,030
0 - - -
0 300 (1,400) 1,700 (3,240)
0 200 (200) 400 (620)
0 500 (100) 600 (710)
0 250 - 250 (250)
0 (2) (4) 2 (6)
0 30 2 28 (26)
0 - - -
0 32 18 14 6
0 - - -
0 - - -
0 300 (1,900) 2,200 (4,290)
0 (200) (1,400) 1,200 (2,740)
0 - - -
0 (8) -
0 300 200 100 120
30 87 44 13 35
0 400 300 100 230
0 900 200 700 (480)
0 100 - 100 (100)
0 - - -
30 84 50 4 51
0 - - -
0 200 (300) 500 (830)
2000 5,500 3,200 300 3,220
25 63 24 14 12
0 800 800 880
0 300 100 200 (90)
0 500 400 100 340
0 - - -
24 77 37 16 25
0 - - -
1500 3,500 1,600 400 1,360
0 25 12 13 0
0 - - -
0 - - -
0 110 (10) 120 (131)
- (9) 9 (19)
0 - - -
0 12 2 10 (8)
0 32 7 25 (17)
0 - - -
0 - (110) 110 (231)
0 - - -
0 (10) (20) 10 (32)
0 - - -
0 - - -
0 - - -
20 59 36 3 37
5 9 3 1 2
100 318 209 9 221
1500 4,400 2,700 200 2,770
0 14 - 14 (14)
0 700 - 700 (700)
0 - - -
0 33 29 4 28
0 - - -
0 287 37 250 (209)
0 150 (50) 200 (255)
0 - - -
0 - - -
0 25 14 11 4
0 - - -
60 113 45 8 42
1000 2,950 1,250 700 675
0 - -
0 15 10 5 6
0 - - -
0 - - -
0 - - -
0 - - -
0 10 (3) 13 (16)
0 - - -
0 50 50 55
600 2,440 1,220 620 722
0 1,000 800 200 680
0 (2) (13) 11 (25)
 0 - - -
0 - - -
0 100 (100) 200 (310)
1500 4,340 1,840 1,000 1,024
2000 4,850 2,450 400 2,295
0 700 100 600 (490)
0 33 26 7 22

0 - - - -
0 6 - 5 (5)
0 17 5 15 (10)
0 20 5 18 (13)
0 27 5 27 (22)
0 - - -
0 75 5 70 (65)
0 25 - 20 (20)

6 10 5 2 4
0 - - -
0 3 1 1
0 - - -

0 4,400 - 4,400 (4,400)

0 - - - -
0 - - - -

0 100 - 40 (40)
0 1,000 - 40 (40)
0 20 - -
0 - - - -
0 - - - -

0 - - - -
0 - - - -
0 - - - -
0 - - - -
0 5 3 5 (2)
0 - - - -
0 30 - 30 (30)
0 - - - -
0 - - - -
0 500 500
0 200 200

0 - - - -
0 - - - -
0 - - - -
 0 3 - 1 (1)
0 - - - -
0 - - - -
0 - - - -
0 - - - -
0 - - - -
0 - - - -
0 - - - -
0 - - - -

0 - - -
0 - - - -
0 23 17 104 (85)
0 66 23 21 4
0 133 - 123 (123)
0 -
0 6 - -
12 22 12 13
0 - - -
0 10 - -
0 - - -
0 22 2 2
0 - - -
0 22 - -
0 9 - 9 (9)
0 - - -
0 - - -
0 72 - 60 (60)
0 - - -
0 - - -
0 17 - 5 (5)
50 105 28 5 26
0 12 3 3
0 6 14 5 10
50 89 38 15 27
0 23 2 10 (8)
0 - - -
0 - - 70 (70)
0 - - -
30 71 9 10 (0)
0 - - -
0 2 2 2
0 2 - -
20 58 2 15 (13)
0 - - -
0 - - -
0 - - -
0 - - -
0 - - -
0 34 - 10 (10)
0 20 - 10 (10)
0 20 - 5 (5)
 0 3 - 1 (1)
0 3 - 1 (1)
0 3 - 1 (1)
0 - - -
0 - - -
0 1 1 1
0 380 - 250 (250)
0 4 3 3
10 15 5 2 4
0 - - -
0 - - -
0 70 - 10 (10)
0 20 - 9 (9)
0 1 - 1 (1)
0 1 - 1 (1)
0 - - -
0 17 - -
0 4 6 3 4
0 10 1 14 (13)

0 6 - 5 (5)
0 6 6 - 7
0 125 49 76 (22)

0 210 210 - 231

0 2 2 - 2
0 2 2 2
1500 2,250 750 600 225
0 160 160 176
0 - - -
0 - - - -
0 1 1 1
0 - - 2 (2)
0 20 20 - 22
0 230 230 253
300 300 - 300 (300)
0 - - - -
1500 3,000 1,500 2,800 (1,150)
0 - - 27 (27)
0 - - 210 (210)
0 - - - -
0 - - 750 (750)

0 - - - -
0 - - - -
0 - - - -
3 6 1 1 0
5 5 5 - 6
0 1 7 6 2
 0 7 3 5 (2)
0 8 1 7 (6)
0 9 4 12 (8)
0 7 8 9

ASKES BPJS GRATIS JAMKESMAS JUMLAH

50 210 5 - 219
Yang Meminta , Yang Membuat ,
i Farmasi Kab.Konawe Kepala Puskesmas Petugas Puskesmas

Yosef Hermawan,Skm.M.Kes apt. Ari Widianingsih, S. Farm

201101 2 026 NIP. 197909212006011008
TERANGAN
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (
PUSKESMAS TONGAUNA UTARA
KECAMATAN TONGAUNA UTARA
PROVINSI SULTRA PELAPORAN BULAN : MARET 2024
KABUPATEN KONAWE PERMINTAAN BULAN : APRIL

No NAMA OBAT SATUAN STOK AWAL PENERIMAAN

1 2 3 4 5
1 Acetylsistein Tablet 3100 0
2 Alopurinol tablet 100 mg Tablet 1000 1000
3 Alopurinol tablet 300 mg Tablet 600 0
4 Ambroksol sirup Botol 0 0
5 Ambroksol tablet 30 mg Tablet 1200 0
6 Aminofillin tablet 200 mg Tablet 0 0
7 Amlodipin tablet 10 mg Tablet 700 1500
8 Amlodipin tablet 5 mg Tablet 190 0
9 Amoksilin kaplet 500 mg Kaplet 2170 0
10 Amoksilin sirup kering 100 mg/ml - 10 ml Botol 0 0
11 Amoksilin sirup kering 125 mg/5 ml - 60 ml Botol 60 0
12 Amoksilin sirup kering 250 mg Botol 0 0
13 Amoksilin Drops Botol 30 0
Antasida DOEN I tablet kunyah, kombinasi : Aluminium
Botol
14 Hidroksida 200 mg + Magnesium Hidroksida 200 mg 2400 0
15 Antasida DOEN II suspensi, kombinasi Botol 0 0
16 Anti Hemmoroid DOEN kombinasi Supp 0 0
17 Antifungi Salep 3 - 6 Pot 0 20
18 Antifungi DOEN kombinasi/SALEP WHITE FIELD Pot 0 0
19 Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg Tablet 0 0
20 Aqua pro injeksi steril, bebas pirogen 25 ml Vial 120 0
21 Asam Asetilsalisilat tablet 80 mg Tablet 0 0
22 Asam Askorbat (Vitamin C) tablet 50 mg Tablet 0 0
23 Asam Folat Tablet 900 0
24 Asam Mefenamat kaplet 500 mg Tablet 1600 1000
25 Asam Traneksamat Tablet 0 0
26 Asiklovir salep kulit Tube 56 0
27 Asiklovir tablet 200 mg Tablet 400 0
28 Asiklovir tablet 400 mg Tablet 570 0
29 Atorvastatin 20 mg Tablet 0 0
Besi II Sulfat 200 mg + Asam Folat 0,25 mg (tablet
30 Tablet
tambah darah kombinasi) 3400 0
31 Betahistin Mesilat tablet 6 mg Tablet 300 1000
32 Betametason Krim 0.1 % (sebagai valerat) - 5 gr Tube 53 0
33 Betametason TM ( Vasoma ) Tube 0 0
34 Bisakodil Tablet 0 0
35 Cairan KAEN3B Botol 0 0
36 Cefotaxim injeksi Ampul 4 0
37 Ceftriaxon injeksi Ampul 10 0
38 Cetirizin Syrup Botol 68 0
39 Cetirizin Tablet Tablet 300 1000
40 Deksametason injeksi 5 mg/ml-1ml Ampul 167 0
41 Deksametason tablet 0,5 mg Tablet 500 0
42 Desoximetasone Krem 0,25 %/ DEXOCORT Tube 0 0
43 Difenhidramin injeksi 10 mg/ml Ampul 27 0
44 Digoksin tablet 0,25 mg Tablet 0 0
45 Domperidon sirup Botol 3 0
46 Domperidon Tablet Tablet 700 0
47 Domperidon Tablet/VOMIPER Tablet 210 0
48 Dulcolax Suppositoria Supp 0 0
49 Epinefrin ( Adrenalin ) injeksi 0,1 % Ampul 3 0
50 Eritromisin kapsul 500 mg Kapsul 0 0
51 Etakridin (Rivanol) Larutan 0,1 % - 300 ml Botol 40 0
52 Fitomenadion(Vit. K1) injeksi Ampul 8 0
53 Fitomenadion(Vit. K1) tablet salut gula 10 mg Tablet 700 0
54 Fluocuinolon salep/Synarcus Pot 0 0
55 Furosemid tablet 40 mg Tablet 650 0
56 Garam Oralit I serbuk, kombinasi / MINERAL MIX Sach 600 0
57 Gemfibrozil 300 mg kapsul Kapsul 260 0
58 Gemfibrozil 600 mg kapsul Kapsul 320 0
59 Gentamycin salep Kulit 0,1% Tube 23 0
60 Gentamycin salep mata 0,3% Tube 30 0
61 Gentamycin Tetes Mata Botol 0 0
62 Glibenklamid tablet 5 mg Tablet 1500 0
63 Glimepirid 1 mg Tablet 400 0
64 Guaifenesin 100 mg Tablet 1600 0
65 Glucose Larutan Infus 5% steril - 500 ml Kolf 0 0
66 Griseofulvin tablet 125 mg Tablet 1400 0
67 Hidroklortiazid (HCT) tablet 25 mg Tablet 0 0
68 Hidrokortison krim 2,5 % - 5 gr Tube 53 0
69 Hyiosin Bromida Tablet 870 0
70 Ibuprofen Syrup 60 ml Botol 42 0
71 Ibuprofen tablet 200 mg Tablet 0 0
72 Ibuprofen tablet 400 mg Tablet 2150 0
73 Isosorbid dinitrat (ISDN) tablet sublingual 5 mg Tablet 0 0
74 Kalsium laktat (Kalk) tablet 500 mg Tablet 900 1000
75 Kaptopril tablet 12,5 mg Tablet 400 0
76 Kaptopril tablet 25 mg Tablet 900 0
77 Ketokonazol tablet 200 mg Tablet 250 0
78 Ketokonazole Krem Tube 9 0
79 Ketorolak Injeksi Ampul 30 0
80 Kloramfenikol kapsul 250 mg Kapsul 0 0
81 Kloramfenikol Salep Kulit Tube 32 0
82 Kloramfenikol suspensi 125 mg/5ml - 60 ml Botol 0 0
83 Kloramfenikol tetes telinga 3 % - 5 ml Botol 0 0
84 Klorfeniramin maleat (CTM) tablet 4 mg Tablet 600 1500
Kotrimoksazol DOEN I (dewasa) kombinasi :
85 Tablet
Sulfametoksazol 400 mg + Trimetoprim 80 mg 400 2000
Kotrimoksazol DOEN II (pedriatik) kombinasi :
Tablet
86 Sulfametoksazol 100 mg + Trimetoprim 20 mg 0 0
Kotrimoksazol Suspensi kombinasi : Sulfametoksazol
87 Tablet
200 mg + Trimetoprim 40 mg/ 5 ml - 60 ml 2 0
88 Lansoprazole Kapsul 850 0
Lidokain comp injeksi (Lidocain 2% (HCl) + Epinefrin 1 :
Ampul
89 80.000) - 2 ml 35 0
90 Loperamid tablet 2 mg /NOVADIUM Tablet 500 0
91 Loratadin tablet 10 mg Tablet 900 0
92 Meloxicam 15 mg Tablet 400 0
93 Meloxicam 7,5 mg Tablet 0 0
94 Mersibion 5000 mg Ampul 36 0
95 Metampiron (Antalgin) tablet 500 mg Tablet 0
96 Metformin HCl tablet 500 mg Tablet 1000 400
97 Metil Prednisolon Tablet 200 0
98 Metilergometrin Maleat (Metilergometrin) injeksi Ampul 8 0
Metilergometrin Maleat (Metilergometrin) tablet salut
Tablet
99 0,125 mg 800 0
100 Metoklorpramid Tablet 300 0
101 Metronidazol tablet 500 mg Tablet 500 0
102 Metronidazole SIRUP Botol 0 0
103 Mikonazol krim/ salep 2 % (Nitrat) - 10 gr Tube 11 0
104 Natrium Diklofenak tablet 25 mg Tablet 0 0
105 Natrium Diklofenak tablet 50 mg Tablet 400 1000
106 Natrium Klorida larutan infus 0,9% - 500 ml Kolf 31 0
107 Nifedipin tablet 10 mg Tablet 0 0
108 Nistatin tablet salut 500.000 IU/g Tablet 0 0
109 Nistatin vaginal tablet 100.000 IU/g Tablet 130 0
110 Nistatin Drops 12ml/100.000 IU Botol 22 20
111 Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol Botol 0 0
112 Ofloxacin tetes telinga Botol 12 0
113 Oksitetrasiklin HCl salep kulit 3 % - 5 gr Tube 32 20
114 Oksitetrasiklin HCl salep mata 1 % - 5 gr Tube 0 0
115 Oksitocin Injeksi Ampul 0 0
116 Omeprazole kapsul 20 mg Kapsul 0 0
117 Omeprazole Injeksi Ampul 10 20
118 Ondansetron Ampul 0 0
119 Ondansetron / DANSEFION Ampul 0 0
120 Papaverin tablet 40 mg Tablet 0 0
121 Parasetamol drops 15 ml Botol 2 0
122 Parasetamol Infus Botol 2 1
123 Parasetamol sirup 120 mg / 5ml - 60 ml Botol 56 0
124 Parasetamol tablet 500 mg Tablet 1300 0
125 Phenol Gliserol tetes telinga Botol 14 0
126 Piridoksin (Vitamin B6) tablet 10 mg (HCl) Tablet 700 0
127 Polikresulen (kondensasi) 10 ml / nistatin drop Botol 0 0
128 Povidon Iodida larutan 10 % - 1 L Botol 35 0
129 Povidon Iodida larutan 10 % - 300 ml Botol 0 0
130 Povidon Iodida larutan 60 Ml Botol 289 0
131 Prednison tablet 5 mg Tablet 200 0
132 Propanolol Tablet 0 0
133 Propiltiourasil tablet 100 mg Tablet 0 0
134 Ranitidin injeksi Ampul 25 0
135 Ranitidin tablet 150 mg Tablet 0 0
136 Ringer Laktat larutan infus - 500 ml Kolf 39 40
137 Salbutamol tablet 4 mg (sebagai sulfat) Tablet 1250 0
Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang
Pot
138 endap 4 % - 30 gr 0 0
139 Salisil Bedak 2 % - 50 gr Pot 15 0
140 Scabimite Krim - Permetrin Krim 5 % Tube Tube 0 0
141 Sefadroksil Kapsul 500 mg Kapsul 250 0
142 Sefadroxil sirup 125 MG / WADOXIL Botol 0 0
143 Sefadroxil sirup 250 MG Botol 0 0
144 Sefadroxil Drop 150mg Botol 20 0
145 Sianokobalamin (vitamin B12) tablet 50 mcg Tablet 0 0
146 Simvastatin tablet 10 mg Tablet 150 0
147 Simvastatin tablet 20 mg Tablet 1320 0
148 Siprofloksasin tablet 500 mg (sebagai HCl) Tablet 1000 0
149 Sukralfat Botol 5 48
150 Sulfasetamida Natrium tetes mata 15 % - 5 ml Botol 0 0
151 Tetrasiklin Kapsul 250 mg Kapsul 0 0
152 Tetrasiklin kapsul 500 mg Kapsul 100 0
153 Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat) Tablet 1650 0
154 Vitamin B Kompleks tablet Tablet 1700 0
155 Zinc tablet 20 mg Tablet 700 0
156 Zinc sirup Botol 33 0

OBAT PROGRAM P2M

157 DHP-Prmal Tablet 0 0
158 Health Mate Dengue AB Plus ( IGG & IGM ) Tablet 6 0
159 Health Mate Dengue Combo Plus paket 22 0
160 Hepatitis rapid test/HBsAg Pcs 25 0
161 HIV Rapid test Pcs 32 0
162 Primaquin Pcs 0 0
163 RDT Malaria Pcs 80 0
164 Spyilis Rapid test Pcs 25 0

OBAT PROGRAM TB PARU

165 Obat FDC Kategori 1 Paket 4 0
166 Obat FDC Kategori 2 Paket 0
167 Obat FDC Anak Paket 2 0
168 Obat FDC Sisipan (MDR) Paket 0 0

OBAT PROGRAM KECACINGAN

169 Albendazole tablet 400 mg Tablet 4400 0
170 Pirantel tablet score (base) 125 mg Tablet 0 0
171 Pirantel Syrup Botol 0 0

OBAT PROGRAM GIZI

172 Retinol (Vitamin A) 100.000 IU kapsul lunak Kapsul 100 0
173 Retinol (Vitamin A) 200.000 IU kapsul lunak Kapsul 1000 0
174 Protein Coklat sach 20 0
175 Protein Gold Vanila sach 0 0
176 Protein Vanila sach 0 0

OBAT KEJIWAAN
177 Alprazolam tablet 1 mg Tablet 0 0
178 Amitriptilin 25 mg Tablet 0 0
179 Diazepam tablet 2 mg Tablet 0 0
180 Diazepam tablet 5 mg Tablet 0 0
181 Diazepam tube Rectal 5 mg/ml / STESOLID Tube rectal 5 5
182 haloperidol 0.5 mg Tablet 0 0
183 haloperidol 1.5 mg Tablet 30 0
184 haloperidol 5 mg Tablet 0 0
185 Phenobarbital 30 mg Tablet 0 0
 OBAT GIGI
186 CHKM Botol 0 0
187 Devitalisasi Pasta (Non Arsen) Btl / ktk 0 0
188 Denpro Calplus Btl / ktk 0 0
189 Etil Chlorida spray - 100 ml / Lidokain spray/Xylocain Botol 3 0
190 Eugenol cairan - 15 ml Botol 0 0
191 Frutti Fluor Gel Botol 0 0
192 Glass Ionomer Cement ART (GCIX) / FUJI IX Set 0 0
193 Kalsium Hidroksida pasta / CALCIDOR / DYCAL Set 0 0
194 Mummifying Pasta / Iodoform Btl / ktk 0 0
195 Semen Seng Fosfat (Powder 30 gr, Liquid 10 ml) Set 0 0
196 Silver Amalgam Botol 0 0
Temporary Stopping Fletcher Serbuk (Powder) /
Pot
197 ORAFIL PLUS 0 0

PERBEKALAN KESEHATAN
198 Alat Suntik sekali pakai 0,05 ml Pcs 0 0
199 Alat Suntik sekali pakai 0,5 ml Pcs 0 0
200 Alat Suntik sekali pakai 1 ml Pcs 23 100
201 Alat Suntik sekali pakai 3 ml Pcs 89 0
202 Alat Suntik sekali pakai 5 ml Pcs 133 0
203 Alkohol Swab Kotak 6 0
204 Benang Bedah Catgut cromic 3/0 HR 27 MM Sach 10 12
205 Benang Bedah Catgut No. 3/0 HR 30 MM Sach 0 0
206 Benang Bedah Silk Black 3/0 HR 30 MM Sach 10 0
207 Benang Bedah Silk Black 3/0 HR 20 MM Sach 0 0
208 Etanol 70 % - 1 L Botol 24 0
209 Etanol 70 % - 300 ml Botol 0 0
210 Fora Blood Glucosa Pcs 22 0
211 Feley Catheter FR 14 Pcs 9 0
212 Feley Catheter Pcs 0 0
213 Folley Cateter N0.18 Pcs 0 0
214 Hand Sanitizer/ SASKLIN PLUS 500ml Botol 72 0
215 Humasens 2.0 Plus Glucosa Pcs 0 0
216 Infus set Bayi Pcs 0 0
217 Infusion Set Anak Pcs 17 0
218 Infusion Set Dewasa Pcs 33 0
219 IV. Catheter No.18 G Set 12 0
220 IV. Catheter No.20 G Set 6 50
221 IV. Catheter No.22 G Set 39 50
222 IV. Catheter No.24 G Set 23 0
223 Kapas 100 gram Bungkus 0 0
224 Kapas Pembalut / absorben 50 gram Bungkus 0 100
225 Kapas Pembalut / absorben 250 gram Bungkus 0 0
226 Kassa Hidrofil Steril uk. 16 x 16 Kotak 41 30
227 Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm Roll 0 0
228 Kassa pembalut hidrofil 3 yrd X15 cm Roll 0 0
229 Kertas EKG Pcs 2 0
230 Masker Bedah Kotak 38 20
231 Masker Hijab Kotak 0 0
232 Masker N95 Kotak 0 0
233 Micropipettes MT II up to 1000 microliter blue Pcs 0 0
234 Micropipettes MTSP up to 10 microliter Pcs 0 0
235 Micropipettes MT II up to 200 microliter yellow Pcs 0 0
236 Nasal Cannula Adult Pcs 34 0
237 Nasal Cannula Child Pcs 20 0
238 Nasal Cannula infant Pcs 20 0
239 Nebulizer Adult (sungkup) Pcs 3 0
240 Nebulizer Anak (sungkup) Pcs 3 0
241 Nebulizer Bayi (sungkup) Pcs 3 0
242 Neo H Blood Gllucosa Pcs 0 0
243 Plester 5 yard X 2 inch Roll 0 0
244 Plester Zinc Oxide Tape 5 x 450 cm Roll 1 0
245 Pot Sputum Pcs 380 0
246 Sarung Tangan L Kotak 4 10
247 Sarung Tangan M Kotak 5 0
248 Sarung Tangan No. 6,5 Pcs 0 0
249 Sarung Tangan No. 7 Pcs 0 0
250 Sarung Tangan No. 7,5 Pcs 70 0
251 Urine Bag Pcs 20 0
252 USG Gel 500 ml Botol 1 0
253 USG Gel 5 Liter Botol 1 0
254 Vacum Tube ClotActivator Glass 3 Ml Pcs 0 0
255 Ziltape paper 0,5 inch Roll 17 0
256 Ziltape paper 1 inch Roll 10 0
257 Ziltape paper 2 inch Roll 11 0

OBAT PONED
258 MgSO4 20 % injeksi Botol 6 0
259 MgSO4 40 % injeksi Botol 6 0
260 Oksitosin injeksi 10 IU/ml - 1 ml Ampul 76 100

OBAT TAMBAHAN
261 Albuforce Kapsul 0 0
262 Aloclair Gel Botol 0 0
263 Aloclair Spray Botol 3 0
264 Alpara Tablet 1900 1500
265 Fasfit C Tablet 340 0
266 Fasfit CDEZ Tablet 500 0
267 Febrinex Syrup Botol 0 0
268 Ifarsyl Syrup Botol 2 0
269 Kidyvit Botol 12 0
270 Lasalcom Nebuliseer Tube 20 40
271 Lodecon Kaplet 500 0
272 Novakid Syrup Botol 429 60
273 Noza Kaplet 0 0
274 Nufed Tablet 450 1500
275 OBH Molex Syrup Botol 63 0
276 Striatatmin Kapsul 720 0
277 Symbicort Tube 0 0
278 Vitsap Kapsul 710 1200

VAKSIN
279 ATS Ampul 0 0
280 Anti Bisa Ular Ampul 0 0
281 Rabies Vero Vial 0 0
282 BCG Ampul 3 0
283 DPT-HB Combo Ampul 0 0
284 Polio Ampul 1 10
285 Campak + Pelarut Campak Ampul 7 0
286 TT/TD Ampul 8 0
287 IPV Ampul 9 10
288 HB Uniject Ampul 7 0

UMUM ASKES
JUMLAH KUNJUNGAN RESEP
- 70
Mengetahui / Menyetujui Yang Menyerahkan ,
Kepala Dinas Kesehatan Kab.Konawe Kepala Instalasi Farmasi Kab.Konawe

drg. Mawar Taligana, M.Kes Mulyanti, S.Farm., Apt.

Nip. 19660726 200212 1 001 NIP. 1986 0910 201101 2 026
MBAR PERMINTAAN OBAT ( LPLPO )
NOMOR TANGGAL

PERSEDIAAN PEMAKAIAN STOK AKHIR PERMINTAAN PEMBERIAN KETERANGAN

6 7 8 10 11 12
3,100 1,600 1,500 260
2,000 700 1,300 (530)
600 300 300 30
- - - -
1,200 400 800 (360)
- - - -
2,200 600 600 60
190 190 209
2,170 2,070 100 2,177
- - - -
60 54 6 53
- - - -
30 16 14 4

2,400 1,600 800 960

- - - -
- - - -
20 4 16 (12)
- - - -
- - - -
120 20 100 (78)
- - - -
- - - -
900 100 800 (690)
2,600 1,700 900 970
- - - -
56 46 10 41
400 200 200 20
570 170 400 (213)
- - - -

3,400 1,400 2,000 (460)

1,300 700 600 170

53 47 6 46
 - - - -
- - - -
- - - -
4 - 4 (4)
10 3 7 (4)
68 60 8 58
1,300 700 600 170
167 17 150 (131)
500 500 (500)
- - - -
27 5 22 (17)
- - - -
3 3 - 3
700 100 600 (490)
210 60 150 (84)
- - - -
3 - 3 (3)
- - - -
40 6 34 (27)
8 8 - 9
700 - 700 (700)
- - - -
650 10 640 (629)
600 200 400 (180)
260 - 260 (260)
320 - 320 (320)
23 23 - 25
30 5 25 (20)
- - - -
1,500 400 1,100 (660)
400 70 330 (253)
1,600 700 900 (130)
- - - -
1,400 100 1,300 (1,190)
- - - -
53 38 15 27
870 170 700 (513)
42 30 12 21
- - - -
2,150 1,650 500 1,315
- - - -
1,900 600 1,300 (640)
400 - 400 (400)
900 100 800 (690)
250 - 250 (250)
9 11 (2) 14
30 2 28 (26)
- - - -
32 18 14 6
- - - -
- - - -
2,100 - 2,100 (2,100)

2,400 - 2,400 (2,400)

- - - -

2 2 - 2

850 750 100 725

35 22 13 11

500 300 200 130

900 200 700 (480)
400 400 - 440
- - - -
36 26 10 19
- - -
1,400 900 500 490
200 200 - 220
8 10 (2) 13

- (800)
800 800
300 - 300 (300)
500 400 100 340
- - - -
11 11 - 12
- - - -
1,400 1,000 400 700
31 18 13 7
- - - -
- - - -
130 10 120 (109)
42 2 40 (38)
- - - -
 12 - 12 (12)
52 43 9 38
- - - -
- - - -
- - - -
30 10 20 (9)
- - - -
- - -
- - - -
2 2 - 2
3 3 - 3
56 19 37 (16)
1,300 700 600 170
14 - 14 (14)
700 - 700 (700)
- - - -
35 20 15 7
- - - -
289 10 279 (268)
200 - 200 (200)
- - - -
- - - -
25 14 11 4
- - - -
79 68 11 64
1,250 550 700 (95)

- - - -

15 10 5 6
- - - -
250 250 - 275
- - - -
- - - -
20 7 13 (5)
- - - -
150 150 - 165
1,320 700 620 150
1,000 800 200 680
53 53 - 58
- - - -
- - - -
 100 100 - 110
1,650 650 1,000 (285)
1,700 1,300 400 1,030
700 100 600 (490)
33 26 7 22

- - - -
6 - 6 (6)
22 5 17 (12)
25 5 20 (15)
32 5 27 (22)
- - - -
80 5 75 (70)
25 - 25 (25)

4 3 1 2
- - - -
3 3 - 3
- - - -

4,400 50 4,350 (4,295)

- - - -
- - - -

100 - 100 (100)

1,000 - 1,000 (1,000)
20 - 20 (20)
- - - -
- - - -

- - - -
- - - -
- - - -
- - - -
10 8 2 7
- - - -
30 - 30 (30)
- - - -
- - - -
 - - - -
- - - -
- - - -
3 3 - 3
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -

- - -
- - - -
123 19 104 (83)
89 23 66 (41)
133 112 21 102
6 6 - 7
22 5 17 (12)
- - - -
10 3 7 (4)
- - - -
24 20 4 18
- - - -
22 5 17 (12)
9 - 9 (9)
- - - -
- - - -
72 15 57 (41)
- - - -
- - - -
17 7 10 (2)
33 10 23 (12)
12 3 9 (6)
56 40 16 28
89 45 44 6
23 10 13 (2)
- - - -
100 15 85 (69)
- - - -
71 61 10 57
- - - -
- - - -
 2 - 2 (2)
58 35 23 16
- - - -
- - - -
- - - -
- - - -
- - - -
34 20 14 8
20 10 10 1
20 10 10 1
3 2 1 1
3 1 2 (1)
3 1 2 (1)
- - - -
- - - -
1 1 - 1
380 100 280 (170)
14 10 4 7
5 4 1 3
- - - -
- - - -
70 65 5 67
20 11 9 3
1 - 1 (1)
1 - 1 (1)
- - - -
17 5 12 (7)
10 6 4 3
11 2 9 (7)

6 2 4 (2)
6 6 - 7
176 40 136 (92)

- - - -
- - - -
3 2 1 1
3,400 2,800 600 2,480
 340 340 - 374
500 - 500 (500)
- - - -
2 2 - 2
12 5 7 (2)
60 20 40 (18)
500 230 270 (17)
489 189 300 (92)
- - - -
1,950 50 1,900 (1,845)
63 - 63 (63)
720 - 720 (720)
- - - -
1,910 1,160 750 526

- - - -
- - - -
- - - -
3 2 1 1
- - - -
11 10 1 10
7 2 5 (3)
8 1 7 (6)
19 7 12 (4)
7 2 5 (3)

BPJS GRATIS JAMKESMAS JUMLAH

210 5 - 285
Yang Meminta , Yang Membuat ,
Kepala Puskesmas Petugas Puskesmas

Yosef Hermawan,Skm.M.Kes apt. Ari Widianingsih, S, Farm

NIP. 197909212006011008