LAPORAN PEMAKAIAN DAN PENERIMAAN OBAT ASKES

UPT PUSKESMAS : BULAN :

KECAMATAN : TAHUN :

No. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PENGELUARAN

1 2 3 4 5 6 7
1 Bionick Mild Syr Btl -
2 Bionick Syr Btl -
3 Farsifen syr Btl -
4 Milsen Syr Btl -
5 Brodamox 500 mg Kaplet -
6 Mirasic 500 mg Tab -
7 Cargesik 500 mg Tab -
8 Tokasid Tab -
9 Kalium Diklofenac/Flamigra Tab -
10 Cimetidin Tab -
11 Farmoten 12,5 mg Tab -
12 Domperidon 10 mg Tab -
13 Domperidon Syr Btl -
14 Carsida Syr Btl -
15 Laxana Tab Tab -
16 Histigo Tab -
17 Erlamycetin Plus TM Fls -
18 Ramaton Tab -
19 Hufadin Tab -
20 Coparcetin Syr Btl -
21 Renabetic Tab -
22 Axoven Syr Btl -
23 Ichtyol Salep Pot -
24 Levertan Salep Pot -
25 Nisagon Cream Tube -
26 Miraneuro Tab -
27 Mulsanol Syr -
-
-
-
-
-
-
-

Mengetahui
Ka. UPT Puskesmas..................

________________________
NIP.
OBAT ASKES
SISA STOK

8
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
 LAPORAN PEMAKAIAN DAN PENERIMAAN OBA

UPT PUSKESMAS :
KECAMATAN :

No. NAMA OBAT SATUAN STOK AWAL

1 2 3 4
1 Bionick Mild Syr Btl -
2 Bionick Syr Btl -
3 Farsifen syr Btl -
4 Milsen Syr Btl -
5 Brodamox 500 mg Kaplet -
6 Mirasic 500 mg Tab -
7 Cargesik 500 mg Tab -
8 Tokasid Tab -
9 Kalium Diklofenac/Flamigra Tab -
10 Cimetidin Tab -
11 Farmoten 12,5 mg Tab -
12 Domperidon 10 mg Tab -
13 Domperidon Syr Btl -
14 Carsida Syr Btl -
15 Laxana Tab Tab -
16 Histigo Tab -
17 Erlamycetin Plus TM Fls -
18 Ramaton Tab -
19 Hufadin Tab -
20 Coparcetin Syr Btl -
21 Renabetic Tab -
22 Axoven Syr Btl -
23 Ichtyol Salep Pot -
24 Levertan Salep Pot -
25 Nisagon Cream Tube -
26 Miraneuro Tab -
27 Mulsanol Syr -
-
-
-
-
-
-
-
OBAT ASKES
DAN PENERIMAAN OBAT ASKES

BULAN :
TAHUN :

PENERIMAAN PERSEDIAAN PENGELUARAN SISA STOK

5 6 7 8
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -

Mengetahui
Ka. UPT Puskesmas..................
________________________
NIP.
 LAPORAN PEMAKAIAN DAN PENERIMAAN OBA

UPT PUSKESMAS :
KECAMATAN :

No. NAMA OBAT SATUAN STOK AWAL

1 2 3 4
1 Bionick Mild Syr Btl -
2 Bionick Syr Btl -
3 Farsifen syr Btl -
4 Milsen Syr Btl -
5 Brodamox 500 mg Kaplet -
6 Mirasic 500 mg Tab -
7 Cargesik 500 mg Tab -
8 Tokasid Tab -
9 Kalium Diklofenac/Flamigra Tab -
10 Cimetidin Tab -
11 Farmoten 12,5 mg Tab -
12 Domperidon 10 mg Tab -
13 Domperidon Syr Btl -
14 Carsida Syr Btl -
15 Laxana Tab Tab -
16 Histigo Tab -
17 Erlamycetin Plus TM Fls -
18 Ramaton Tab -
19 Hufadin Tab -
20 Coparcetin Syr Btl -
21 Renabetic Tab -
22 Axoven Syr Btl -
23 Ichtyol Salep Pot -
24 Levertan Salep Pot -
25 Nisagon Cream Tube -
26 Miraneuro Tab -
27 Mulsanol Syr -
-
-
-
-
-
-
-
OBAT ASKES
DAN PENERIMAAN OBAT ASKES

BULAN :
TAHUN :

PENERIMAAN PERSEDIAAN PENGELUARAN SISA STOK

5 6 7 8
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -

Mengetahui
Ka. UPT Puskesmas..................
________________________
NIP.
 LAPORAN PEMAKAIAN DAN PENERIMAAN OBAT ASKES

UPT PUSKESMAS :RANTAU TIJANG BULAN

KECAMATAN :PUGUNG TAHUN

No. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN

1 2 3 4 5 6
1 Bionick Mild Syr Btl 36.00 - 36.00
2 Bionick Syr Btl 18.00 - 18.00
3 Farsifen syr Btl - - -
4 Milsen Syr Btl - - -
5 Brodamox 500 mg Kaplet 2,400.00 - 2,400.00
6 Mirasic 500 mg Tab 4,000.00 - 4,000.00
7 Cargesik 500 mg Tab 3,000.00 - 3,000.00
8 Tokasid Tab 80.00 - 80.00
9 Kalium Diklofenac/Flamigra Tab 60.00 - 60.00
10 Cimetidin Tab 20.00 - 20.00
11 Farmoten 12,5 mg Tab 450.00 - 450.00
12 Domperidon 10 mg Tab 400.00 - 400.00
13 Domperidon Syr Btl 2.00 - 2.00
14 Carsida Syr Btl 27.00 - 27.00
15 Laxana Tab Tab 40.00 - 40.00
16 Histigo Tab 180.00 - 180.00
17 Erlamycetin Plus TM Fls 5.00 - 5.00
18 Ramaton Tab 760.00 - 760.00
19 Hufadin Tab 300.00 - 300.00
20 Coparcetin Syr Btl 8.00 - 8.00
21 Renabetic Tab 130.00 - 130.00
22 Axoven Syr Btl 10.00 - 10.00
23 Ichtyol Salep Pot 10.00 - 10.00
24 Levertan Salep Pot 10.00 10.00
25 Nisagon Cream Tube 9.00 - 9.00
26 Miraneuro Tab 2,000.00 - 2,000.00
27 Mulsanol Syr - - -
- -
- -
- -
- -
- -
- -
- -

Mengetahui
Ka. UPT Puskesmas Rantau Tijang

ERMAN SUSILO H, SKM

NIP.196102261982021001
OBAT ASKES
 ASKES

:APRIL
:2014

PENGELUARAN SISA STOK

7 8
15.00 21
6.00 12
-
-
430.00 1,970
750.00 3,250
670.00 2,330
20.00 60
10.00 50
20
50.00 400
80.00 320
1.00 1
11.00 16
10.00 30
80.00 100
1.00 4
160.00 600
40.00 260
5.00 3
30.00 100
2.00 8
4.00 6
3.00 7
1.00 8
380.00 1,620
- -
-
-
-
-
-
-
-

kesmas Rantau Tijang

SUSILO H, SKM
02261982021001
 LAPORAN PEMAKAIAN DAN PENERIMAAN OBAT ASKES

UPT PUSKESMAS : RANTAU TIJANG BULAN

KECAMATAN : PUGUNG TAHUN

No. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN

1 2 3 4 5 6
1 Bionick Mild Syr Btl 21.00 - 21.00
2 Bionick Syr Btl 12.00 - 12.00
3 Farsifen syr Btl - -
4 Milsen Syr Btl - -
5 Brodamox 500 mg Kaplet 1,970.00 - 1,970.00
6 Mirasic 500 mg Tab 3,250.00 - 3,250.00
7 Cargesik 500 mg Tab 2,330.00 - 2,330.00
8 Tokasid Tab 60.00 - 60.00
9 Kalium Diklofenac/Flamigra Tab 50.00 - 50.00
10 Cimetidin Tab 20.00 - 20.00
11 Farmoten 12,5 mg Tab 400.00 - 400.00
12 Domperidon 10 mg Tab 320.00 - 320.00
13 Domperidon Syr Btl 1.00 - 1.00
14 Carsida Syr Btl 16.00 - 16.00
15 Laxana Tab Tab 30.00 - 30.00
16 Histigo Tab 100.00 - 100.00
17 Erlamycetin Plus TM Fls 4.00 - 4.00
18 Ramaton Tab 600.00 - 600.00
19 Hufadin Tab 260.00 - 260.00
20 Coparcetin Syr Btl 3.00 - 3.00
21 Renabetic Tab 100.00 - 100.00
22 Axoven Syr Btl 8.00 - 8.00
23 Ichtyol Salep Pot 6.00 - 6.00
24 Levertan Salep Pot 7.00 - 7.00
25 Nisagon Cream Tube 8.00 - 8.00
26 Miraneuro Tab 1,620.00 - 1,620.00
27 Mulsanol Syr - -
- -
- -
- -
- -
- -
- -
- -

Mengetahui
Ka. UPT Puskesmas Rantau Tijang

ERMAN SUSILO H, SKM

NIP.196102261982021001
OBAT ASKES
 ASKES

: MEI
: 2014

PENGELUARAN SISA STOK

7 8
21.00 -
- 12
-
-
670.00 1,300
450.00 2,800
330.00 2,000
20.00 40
- 50
- 20
50.00 350
20.00 300
1.00 -
4.00 12
10.00 20
30.00 70
1.00 3
250.00 350
60.00 200
3.00 -
50.00 50
2.00 6
2.00 4
2.00 5
1.00 7
520.00 1,100
-
-
-
-
-
-
-
-

kesmas Rantau Tijang

SUSILO H, SKM
02261982021001
 LAPORAN PEMAKAIAN DAN PENERIMAAN OBAT ASKES

UPT PUSKESMAS :RANTAU TIJANG BULAN

KECAMATAN : PUGUNG TAHUN

No. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN

1 2 3 4 5 6
1 Bionick Mild Syr Btl - -
2 Bionick Syr Btl 12.00 - 12.00
3 Farsifen syr Btl - -
4 Milsen Syr Btl - -
5 Brodamox 500 mg Kaplet 1,300.00 - 1,300.00
6 Mirasic 500 mg Tab 2,800.00 - 2,800.00
7 Cargesik 500 mg Tab 2,000.00 - 2,000.00
8 Tokasid Tab 40.00 - 40.00
9 Kalium Diklofenac/Flamigra Tab 50.00 - 50.00
10 Cimetidin Tab 20.00 - 20.00
11 Farmoten 12,5 mg Tab 350.00 - 350.00
12 Domperidon 10 mg Tab 300.00 - 300.00
13 Domperidon Syr Btl - -
14 Carsida Syr Btl 12.00 - 12.00
15 Laxana Tab Tab 20.00 - 20.00
16 Histigo Tab 70.00 - 70.00
17 Erlamycetin Plus TM Fls 3.00 - 3.00
18 Ramaton Tab 350.00 - 350.00
19 Hufadin Tab 200.00 - 200.00
20 Coparcetin Syr Btl - -
21 Renabetic Tab 50.00 - 50.00
22 Axoven Syr Btl 6.00 - 6.00
23 Ichtyol Salep Pot 4.00 - 4.00
24 Levertan Salep Pot 5.00 - 5.00
25 Nisagon Cream Tube 7.00 - 7.00
26 Miraneuro Tab 1,100.00 - 1,100.00
27 Mulsanol Syr - -
- -
- -
- -
- -
- -
- -
- -

Mengetahui
Ka. UPT Puskesmas Rantau Tijang

ERMAN SUSILO H, SKM.

NIP.196102261982021001
OBAT ASKES
SKES

: JUNI
: 2014

PENGELUARAN SISA STOK

7 8
-
12.00 -
-
-
310.00 990
120.00 2,680
260.00 1,740
10.00 30
10.00 40
- 20
80.00 270
20.00 280
-
2.00 10
- 20
20.00 50
- 3
140.00 210
60.00 140
-
10.00 40
1.00 5
1.00 3
1.00 4
1.00 6
260.00 840
-
-
-
-
-
-
-
-

skesmas Rantau Tijang

SUSILO H, SKM.
102261982021001
 LAPORAN PEMAKAIAN DAN PENERIMAAN OBAT ASKES

UPT PUSKESMAS : RANTAU TIJANG BULAN

KECAMATAN : PUGUNG TAHUN

No. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN

1 2 3 4 5 6
1 Bionick Mild Syr Btl - - -
2 Bionick Syr Btl - -
3 Farsifen syr Btl - -
4 Milsen Syr Btl - -
5 Brodamox 500 mg Kaplet 990.00 - 990.00
6 Mirasic 500 mg Tab 2,680.00 - 2,680.00
7 Cargesik 500 mg Tab 1,740.00 - 1,740.00
8 Tokasid Tab 30.00 - 30.00
9 Kalium Diklofenac/Flamigra Tab 40.00 - 40.00
10 Cimetidin Tab 20.00 - 20.00
11 Farmoten 12,5 mg Tab 270.00 - 270.00
12 Domperidon 10 mg Tab 280.00 - 280.00
13 Domperidon Syr Btl - -
14 Carsida Syr Btl 10.00 - 10.00
15 Laxana Tab Tab 20.00 20.00
16 Histigo Tab 50.00 50.00
17 Erlamycetin Plus TM Fls 3.00 3.00
18 Ramaton Tab 210.00 210.00
19 Hufadin Tab 140.00 140.00
20 Coparcetin Syr Btl - -
21 Renabetic Tab 40.00 40.00
22 Axoven Syr Btl 5.00 5.00
23 Ichtyol Salep Pot 3.00 3.00
24 Levertan Salep Pot 4.00 4.00
25 Nisagon Cream Tube 6.00 6.00
26 Miraneuro Tab 840.00 840.00
27 Mulsanol Syr - -
- -
- -
- -
- -
- -
- -
- -

Mengetahui
Ka. UPT Puskesmas Rantau Tijang

ERMAN SUSILO H, SKM.

NIP. 196102261982021001
OBAT ASKES
ASKES

: JULI
: 2014

PENGELUARAN SISA STOK

7 8

- -
- -
- -
- -
270.00 720
320.00 2,360
380.00 1,360
10.00 20
10.00 30
- 20
40.00 230
20.00 260
-
2.00 8
10.00 10
10.00 40
1.00 2
110.00 100
40.00 100
-
10.00 30
1.00 4
1.00 2
2.00 2
1.00 5
260.00 580
-
-
-
-
-
-
-
-

kesmas Rantau Tijang

SUSILO H, SKM.
02261982021001
 LAPORAN PEMAKAIAN DAN PENERIMAAN OBAT ASKES

UPT PUSKESMAS : RANTAU TIJANG BULAN

KECAMATAN : PUGUNG TAHUN

No. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN

1 2 3 4 5 6
1 Bionick Mild Syr Btl - -
2 Bionick Syr Btl - -
3 Farsifen syr Btl - -
4 Milsen Syr Btl - -
5 Brodamox 500 mg Kaplet 720.00 720.00
6 Mirasic 500 mg Tab 2,360.00 2,360.00
7 Cargesik 500 mg Tab 1,360.00 1,360.00
8 Tokasid Tab 20.00 20.00
9 Kalium Diklofenac/Flamigra Tab 30.00 30.00
10 Cimetidin Tab 20.00 20.00
11 Farmoten 12,5 mg Tab 230.00 230.00
12 Domperidon 10 mg Tab 260.00 260.00
13 Domperidon Syr Btl - -
14 Carsida Syr Btl 8.00 8.00
15 Laxana Tab Tab 10.00 10.00
16 Histigo Tab 40.00 40.00
17 Erlamycetin Plus TM Fls 2.00 2.00
18 Ramaton Tab 100.00 100.00
19 Hufadin Tab 100.00 100.00
20 Coparcetin Syr Btl - -
21 Renabetic Tab 30.00 30.00
22 Axoven Syr Btl 4.00 4.00
23 Ichtyol Salep Pot 2.00 2.00
24 Levertan Salep Pot 2.00 2.00
25 Nisagon Cream Tube 5.00 5.00
26 Miraneuro Tab 580.00 580.00
27 Mulsanol Syr - -
- -
- -
- -
- -
- -
- -
- -

Mengetahui
Ka. UPT Puskesmas Rantau Tijang

ERMAN SUSILO H, SKM

NIP. 196102261982021001
OBAT ASKES
T ASKES

: AGUSTUS
: 2014

PENGELUARAN SISA STOK

7 8
-
-
-
-
230.00 490
360.00 2,000
240.00 1,120
10.00 10
10.00 20
20.00 -
60.00 170
20.00 240
-
2.00 6
10.00 -
20.00 20
2
20.00 80
10.00 90
-
10.00 20
1.00 3
2.00 -
2.00 -
1.00 4
280.00 300
-
-
-
-
-
-
-
-

kesmas Rantau Tijang

SUSILO H, SKM
02261982021001
 LAPORAN PEMAKAIAN DAN PENERIMAAN OBAT ASKES

UPT PUSKESMAS : RANTAU TIJANG BULAN

KECAMATAN : PUGUNG TAHUN

No. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN

1 2 3 4 5 6
1 Bionick Mild Syr Btl - -
2 Bionick Syr Btl - -
3 Farsifen syr Btl - -
4 Milsen Syr Btl - -
5 Brodamox 500 mg Kaplet 490.00 490.00
6 Mirasic 500 mg Tab 2,000.00 2,000.00
7 Cargesik 500 mg Tab 1,120.00 1,120.00
8 Tokasid Tab 10.00 10.00
9 Kalium Diklofenac/Flamigra Tab 20.00 20.00
10 Cimetidin Tab - -
11 Farmoten 12,5 mg Tab 170.00 170.00
12 Domperidon 10 mg Tab 240.00 240.00
13 Domperidon Syr Btl - -
14 Carsida Syr Btl 6.00 6.00
15 Laxana Tab Tab - -
16 Histigo Tab 20.00 20.00
17 Erlamycetin Plus TM Fls 2.00 2.00
18 Ramaton Tab 80.00 80.00
19 Hufadin Tab 90.00 90.00
20 Coparcetin Syr Btl - -
21 Renabetic Tab 20.00 20.00
22 Axoven Syr Btl 3.00 3.00
23 Ichtyol Salep Pot - -
24 Levertan Salep Pot - -
25 Nisagon Cream Tube 4.00 4.00
26 Miraneuro Tab 300.00 300.00
27 Mulsanol Syr - -
- -

Mengetahui
Ka. UPT Puskesmas Rantau Tijang

ERMAN SUSILO H, SKM

NIP. 196102261982021001
OBAT ASKES
ASKES

: SEPTEMBER
: 2014

PENGELUARAN SISA STOK

7 8
-
-
-
-
270.00 220
550.00 1,450
120.00 1,000
10.00 -
- 20
-
50.00 120
10.00 230
-
2.00 4
-
10.00 10
2.00 -
60.00 20
20.00 70
-
20.00 -
1.00 2
-
-
2.00 2
110.00 190
-
-

kesmas Rantau Tijang

SUSILO H, SKM
02261982021001
 LAPORAN PEMAKAIAN DAN PENERIMAAN OBAT ASKES

UPT PUSKESMAS : RANTAU TIJANG BULAN

KECAMATAN : PUGUNG TAHUN

No. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN

1 2 3 4 5 6
1 Bionick Mild Syr Btl - -
2 Bionick Syr Btl - -
3 Farsifen syr Btl - -
4 Milsen Syr Btl - -
5 Brodamox 500 mg Kaplet 220.00 220.00
6 Mirasic 500 mg Tab 1,450.00 1,450.00
7 Cargesik 500 mg Tab 1,000.00 1,000.00
8 Tokasid Tab - -
9 Kalium Diklofenac/Flamigra Tab 20.00 20.00
10 Cimetidin Tab - -
11 Farmoten 12,5 mg Tab 120.00 120.00
12 Domperidon 10 mg Tab 230.00 230.00
13 Domperidon Syr Btl - -
14 Carsida Syr Btl 4.00 4.00
15 Laxana Tab Tab - -
16 Histigo Tab 10.00 10.00
17 Erlamycetin Plus TM Fls - -
18 Ramaton Tab 20.00 20.00
19 Hufadin Tab 70.00 70.00
20 Coparcetin Syr Btl - -
21 Renabetic Tab - -
22 Axoven Syr Btl 2.00 2.00
23 Ichtyol Salep Pot - -
24 Levertan Salep Pot - -
25 Nisagon Cream Tube 2.00 2.00
26 Miraneuro Tab 190.00 190.00
27 Mulsanol Syr - -
- -
- -
- -
- -
- -
- -
- -

Mengetahui
Ka. UPT Puskesmas Rantau tijang

ERMAN SUSILO H, SKM

NIP. 196102261982021001
OBAT ASKES
ASKES

: OKTOBER
: 2014

PENGELUARAN SISA STOK

7 8
-
-
-
-
60.00 160
650.00 800
230.00 770
-
10.00 10
-
60.00 60
20.00 210
-
2.00 2
-
10.00 -
-
20.00 -
30.00 40
-
-
1.00 1
-
-
2.00 -
90.00 100
-
-
-
-
-
-
-
-

kesmas Rantau tijang

SUSILO H, SKM
02261982021001
 LAPORAN PEMAKAIAN DAN PENERIMAAN OBA

UPT PUSKESMAS :
KECAMATAN :

No. NAMA OBAT SATUAN STOK AWAL

1 2 3 4
1 Bionick Mild Syr Btl -
2 Bionick Syr Btl -
3 Farsifen syr Btl -
4 Milsen Syr Btl -
5 Brodamox 500 mg Kaplet 160.00
6 Mirasic 500 mg Tab 800.00
7 Cargesik 500 mg Tab 770.00
8 Tokasid Tab -
9 Kalium Diklofenac/Flamigra Tab 10.00
10 Cimetidin Tab -
11 Farmoten 12,5 mg Tab 60.00
12 Domperidon 10 mg Tab 210.00
13 Domperidon Syr Btl -
14 Carsida Syr Btl 2.00
15 Laxana Tab Tab -
16 Histigo Tab -
17 Erlamycetin Plus TM Fls -
18 Ramaton Tab -
19 Hufadin Tab 40.00
20 Coparcetin Syr Btl -
21 Renabetic Tab -
22 Axoven Syr Btl 1.00
23 Ichtyol Salep Pot -
24 Levertan Salep Pot -
25 Nisagon Cream Tube -
26 Miraneuro Tab 100.00
27 Mulsanol Syr -
-
-
-
-
-
-
-
OBAT ASKES
DAN PENERIMAAN OBAT ASKES

BULAN :
TAHUN :

PENERIMAAN PERSEDIAAN PENGELUARAN SISA STOK

5 6 7 8
- -
- -
- -
- -
160.00 60.00 100
800.00 390.00 410
770.00 70.00 700
- -
10.00 10
- -
60.00 10.00 50
210.00 10.00 200
- -
2.00 1.00 1
- -
- -
- -
- -
40.00 10.00 30
- -
- -
1.00 1
- -
- -
- -
100.00 100
- -
- -
- -
- -
- -
- -
- -
- -

Mengetahui
Ka. UPT Puskesmas..................
________________________
NIP.
 LAPORAN PEMAKAIAN DAN PENERIMAAN OBAT ASKES

UPT PUSKESMAS : RANTAU TIJANG BULAN

KECAMATAN : PUGUNG TAHUN

No. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN

1 2 3 4 5 6

1 Bionick Mild Syr Btl - -

2 Bionick Syr Btl - -
3 Farsifen syr Btl - -
4 Milsen Syr Btl - -
5 Brodamox 500 mg Kaplet 100.00 100.00
6 Mirasic 500 mg Tab 410.00 410.00
7 Cargesik 500 mg Tab 700.00 700.00
8 Tokasid Tab - -
9 Kalium Diklofenac/Flamigra Tab 10.00 10.00
10 Cimetidin Tab - -
11 Farmoten 12,5 mg Tab 50.00 50.00
12 Domperidon 10 mg Tab 200.00 200.00
13 Domperidon Syr Btl - -
14 Carsida Syr Btl 1.00 1.00
15 Laxana Tab Tab - -
16 Histigo Tab - -
17 Erlamycetin Plus TM Fls - -
18 Ramaton Tab - -
19 Hufadin Tab 30.00 30.00
20 Coparcetin Syr Btl - -
21 Renabetic Tab - -
22 Axoven Syr Btl 1.00 1.00
23 Ichtyol Salep Pot - -
24 Levertan Salep Pot - -
25 Nisagon Cream Tube - -
26 Miraneuro Tab 100.00 100.00
27 Mulsanol Syr - -
- -

Mengetahui
Ka. UPT Puskesmas Rantau Tijang

ERMAN SUSILO H, SKM

NIP. 196102261982021001
OBAT ASKES
SKES

: DESEMBER
: 2014

PENGELUARAN SISA STOK

7 8

-
-
-
-
50.00 50
270.00 140
180.00 520
-
10
-
20.00 30
200
-
1.00 -
-
-
-
-
20.00 10
-
-
1
-
-
-
40.00 60
-
-

kesmas Rantau Tijang

SUSILO H, SKM
02261982021001
 LAPORAN PEMAKAIAN DAN PENERIMAAN OBAT ASKES

UPT PUSKESMAS : RANTAU TIJANG BULAN

KECAMATAN : PUGUNG TAHUN

No. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN

1 2 3 4 5 6

1 Bionick Mild Syr Btl - -

2 Bionick Syr Btl - -
3 Farsifen syr Btl - -
4 Milsen Syr Btl - -
5 Brodamox 500 mg Kaplet 50.00 50.00
6 Mirasic 500 mg Tab 140.00 140.00
7 Cargesik 500 mg Tab 520.00 520.00
8 Tokasid Tab - -
9 Kalium Diklofenac/Flamigra Tab 10.00 10.00
10 Cimetidin Tab - -
11 Farmoten 12,5 mg Tab 30.00 30.00
12 Domperidon 10 mg Tab 200.00 200.00
13 Domperidon Syr Btl - -
14 Carsida Syr Btl - -
15 Laxana Tab Tab - -
16 Histigo Tab - -
17 Erlamycetin Plus TM Fls - -
18 Ramaton Tab - -
19 Hufadin Tab 10.00 10.00
20 Coparcetin Syr Btl - -
21 Renabetic Tab - -
22 Axoven Syr Btl 1.00 1.00
23 Ichtyol Salep Pot - -
24 Levertan Salep Pot - -
25 Nisagon Cream Tube - -
26 Miraneuro Tab 60.00 60.00
27 Mulsanol Syr - -
- -

Mengetahui
Ka. UPT Puskesmas Rantau Tijang

DAROLI, SKM
NIP. 196408241984031002
OBAT ASKES
SKES

: JANUARI
: 2015

PENGELUARAN SISA STOK

7 8

-
-
-
-
50.00 -
- 140
20.00 500
-
10
-
30.00 -
200
-
- -
-
-
-
-
- 10
-
-
1
-
-
-
60.00 -
-
-

kesmas Rantau Tijang

08241984031002
 LAPORAN PEMAKAIAN DAN PENERIMAAN OBAT ASKES

UPT PUSKESMAS : RANTAU TIJANG BULAN

KECAMATAN : PUGUNG TAHUN

No. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN

1 2 3 4 5 6

1 Bionick Mild Syr Btl - -

2 Bionick Syr Btl - -
3 Farsifen syr Btl - -
4 Milsen Syr Btl - -
5 Brodamox 500 mg Kaplet - -
6 Mirasic 500 mg Tab 140.00 140.00
7 Cargesik 500 mg Tab 520.00 520.00
8 Tokasid Tab - -
9 Kalium Diklofenac/Flamigra Tab 10.00 10.00
10 Cimetidin Tab - -
11 Farmoten 12,5 mg Tab - -
12 Domperidon 10 mg Tab 200.00 200.00
13 Domperidon Syr Btl - -
14 Carsida Syr Btl - -
15 Laxana Tab Tab - -
16 Histigo Tab - -
17 Erlamycetin Plus TM Fls - -
18 Ramaton Tab - -
19 Hufadin Tab 10.00 10.00
20 Coparcetin Syr Btl - -
21 Renabetic Tab - -
22 Axoven Syr Btl 1.00 1.00
23 Ichtyol Salep Pot - -
24 Levertan Salep Pot - -
25 Nisagon Cream Tube - -
26 Miraneuro Tab - -
27 Mulsanol Syr - -
- -

Mengetahui
Ka. UPT Puskesmas Rantau Tijang

DAROLI, SKM
NIP. 196408241984031002
OBAT ASKES
SKES

: FEBRUARI
: 2015

PENGELUARAN SISA STOK

7 8

-
-
-
-
- -
40.00 100
- 520
-
10
-
- -
200
-
- -
-
-
-
-
- 10
-
-
1.00 -
-
-
-
- -
-
-

kesmas Rantau Tijang

08241984031002
 LAPORAN PEMAKAIAN DAN PENERIMAAN OBA

UPT PUSKESMAS :RANTAU TIJANG

KECAMATAN :PUGUNG

No. NAMA OBAT SATUAN STOK AWAL

1 2 3 4
1 Bionick Mild Syr Btl -
2 Bionick Syr Btl -
3 Farsifen syr Btl -
4 Milsen Syr Btl -
5 Brodamox 500 mg Kaplet -
6 Mirasic 500 mg Tab -
7 Cargesik 500 mg Tab -
8 Tokasid Tab -
9 Kalium Diklofenac/Flamigra Tab -
10 Cimetidin Tab -
11 Farmoten 12,5 mg Tab -
12 Domperidon 10 mg Tab -
13 Domperidon Syr Btl -
14 Carsida Syr Btl -
15 Laxana Tab Tab -
16 Histigo Tab -
17 Erlamycetin Plus TM Fls -
18 Ramaton Tab -
19 Hufadin Tab -
20 Coparcetin Syr Btl -
21 Renabetic Tab -
22 Axoven Syr Btl -
23 Ichtyol Salep Pot -
24 Levertan Salep Pot -
25 Nisagon Cream Tube -
26 Miraneuro Tab -
27 Mulsanol Syr -
-
-
-
-
-
-
-
OBAT ASKES
DAN PENERIMAAN OBAT ASKES

BULAN :
TAHUN :

PENERIMAAN PERSEDIAAN PENGELUARAN SISA STOK

5 6 7 8
- - 36.00 (36)
- - 18.00 (18)
- - - -
- - - -
- - 2,350.00 (2,350)
- - 3,860.00 (3,860)
- - 2,480.00 (2,480)
- - 80.00 (80)
- - 50.00 (50)
- - 20.00 (20)
- - 420.00 (420)
- - 200.00 (200)
- - 2.00 (2)
- - 27.00 (27)
- - 40.00 (40)
- - 180.00 (180)
- - 5.00 (5)
- - 760.00 (760)
- - 290.00 (290)
- - 8.00 (8)
- - 130.00 (130)
- - 9.00 (9)
- - 10.00 (10)
- - 10.00 (10)
- - 9.00 (9)
- - 1,940.00 (1,940)
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -

Mengetahui
Ka. UPT Puskesmas..................
________________________
NIP.