LAPORAN PENERIMAAN DAN LEMBAR PEMAKAIAN OBAT

(LPLPO )
LAPOR

UPT PUSKESMAS : UPT PKM KUTA UTARA MINTA

PUSKESMAS PEMBANTU YANG ADA :5 DOK

PROVINSI : Bali IFK

UNIT : PUSTU CANGGU PKM

STOK PENERI PEMAKAI

NO NAMA OBAT SATUAN AWAL MAAN AN

JML JML JML

A. OBAT
1 Acyclovir tablet 400 mg Tablet
2 Acyclovir cream 5 % Tube
3 Alopurinol tablet 100 mg Tablet
4 Ambroxol syrup Botol 6 2
5 Ambroxol tablet 30 mg Tablet 300 90
6 Aminofilin tablet 200 mg Tablet
7 Amlodipine 10 mg T ablet
8 Amlodipine 5 mg T ablet
9 Amoksisilin kapletl 500 mg Kaplet 252 200 168
10 Amoksisilin kapletl 250 mg Kaplet
11 Amoksisilin Syr Forte 250 mg Botol
12 Amoksisilin sirup kering 125 mg/5ml Botol 15 1
13 Amoksisilin drop 100 mg/ml Botol
14 Antasida DOEN kombinasi Tablet 292 200 60
15 Astaxanthin 4 mg tab Tablet
16 Antasida DOEN suspensi Botol
17 Anti Hemoroid DOEN Kombinasi Sup
18 Asam Askorbat (Vit C) tablet 50 mg Tablet 177 200 70
19 Asam Folat Tablet
20 Asam mefenamat tab 500 mg Tablet 33 33
21 Albotyl (polikresol) Botol
22 Albendazole tab 400 mg Tablet
23 Azitromysin 500 Tablet
24 Anti TBC Anak Paket
25 Anti TBC Katagori I Paket
26 Anti TBC Katagori II Paket
27 Basitrasin 500 IU/g + Polimiksin 10.000 Tube
28 IU/g
Besi II Sulfat tablet kombinasi Tablet 390 90
29 Bioplacenton jelly tube
30 Betahistin mesilat 6 mg Tablet
31 Borax gliserine Botol
32 Balsam cap kaki 3 Tube
33 Betametason krim 0.1% Tube
34 Captopril 12,5 mg Tablet 100
35 Captopril 25 mg Tablet
36 Coparcetine ( Obat Flu dan batuk ) Tablet
37 Cetirizine 10 mg Tablet
38 Deksametason injeksi 5 mg/ml - 1 ml Ampul
39 Deksametason tablet 0,5 mg Tablet 194 165
40 Dasepam rectal 5 mg tube 1
41 Diasepam Inj 5 mg/ml Ampul
42 Diazepam tablet 2 mg Tablet
43 Difenhidramin HCl inj 10 mg/ml-1 ml Ampul 6
44 Digoksin tablet 0,25 mg Tablet
45 Doksisiklin Tablet
46 Domperidon Sirup Botol 3 2
47 Dextrofen ( Obat batuk dan pilek syr ) Botol
48 Domperidon drop Botol
49 Deksosimetason Tube
50 Dulcolak ( stolax Supp) Supp
51 Epinefrina (adrenalin) Injeksi 0,1% - 1 ml Ampul
52 Erytromicin 500 mg Tablet
53 Erfaflu ( Obat Flu syp ) Botol
54 Erytromicin syrup Botol
55 Erfakaf sirup Botol
56 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 Ampul
57 Fitomenadion (Vit.K1) tablet salut gula 10 Tablet
58 Fenobarbital tablet 30 mg Tablet
59 Furosemid tablet 40 mg Tablet
60 Fenol Gliserol tetes telinga 10% Botol
61 Garam Oralit untuk 200 ml air Sak 20 100
62 Gentamicin Sulfat TM 0,3% Botol
63 Gentamicin Salep kulit Tube
64 Glibenklamid tablet 5 mg Tablet
65 Griseofulvin tab 125 Tablet
66 Glimeperid 1 mg Tablet
67 Glimeperid 2 mg Tablet
68 Hidroklorotiazid (HCT) tablet 25 mg Tablet
69 Haloperidol 0,5 Tablet
70 Haloperidol 1,5 Tablet
71 Haloperidol 5 mg Tablet
72 Hidrokortison krim 2,5 % Tube 12
73 Hyoscine-N-Butilbromide 10 mg (Scopma) Tablet
74 Hyoscine-N-Butilbromide inj / Buscopan Ampul
75 Ibuprofen tablet 400 mg Tablet
76 Isosorbid Di Nitrat Tablet
77 Imunogard / Vitamin Imunitas Tablet
78 Ibuprofen tablet 200 mg Tablet 60
79 Ibuprofen Sirup Botol
80 Ketokonazole cream 2 % 15 gram Tube
81 Ketokonazole tablet 200 mg Tablet
82 Klindamycin 300 mg Tablet
83 Kloramfenikol tetes telinga 3 % Botol 1 5
84 Kloramphenikol salep mata 1 % Tube 2
85 Kloramphenikol Tetes Mata Botol
86 Klorfeniramin Maleat (CTM) tablet 4 mg Tablet 120 200 80
87 Klorpromazine HCL 100 MG ( CPZ) Tablet
88 Kotrimoksazol Suspensi Botol 10 10
89 Kotrimoksazol tablet 480 mg kombinasi Tablet 26 100 12
90 Kalium Gluconat Ampul
91 Lidokain comp Ampul
92 Lidokain injeksi Ampul
93 Levertran salep (salep minyak ikan) pot
94 Loperamid tablet 2 mg Tablet
95 Loratadin tablet 10 mg Tablet
96 Metformin 500 mg Tablet
97 Meloxicam 15 mg Tablet
98 Methyl Prednisolon 4 mg Tablet
99 Metilergometrin Maleat 0,125 mg Tablet
100 Metoklopramid syrup Botol
101 Metoklopramid tablet 5 mg Tablet
102 Metoklopramid hcl injeksi 5 mg Ampul
103 Metronidazol tablet 500 mg Tablet 30
104 Magnesium Sulfat Inj 40% 25 ml Ampul
105 Magnesium Sulfat Inj 20% 25 ml Ampul
106 Miconazol Tube
107 Metoklorpamid Hcl 5 mg/ml 2 ml Ampul
108 Metoklorpamid Hcl 5 mg tablet Tablet
109 Metronidazol vagina ( flagyl ) Supp
110 Natrium Diklofenac tablet 25 mg Botol
111 Natrium Diklofenac tablet 50 mg Tablet
112 Natrium Klorida larutan infus 0.9% steril Fles
113 New Diatabs ( Pularek ) Tablet 100
114 Nistatin tablet vaginal 100.000 IU/g Tablet 20
115 NB Salep Tube 25
116 OBH ( obat batuk hitam) Botol
117 Omeprazol 20 mg Tablet
118 Oksitosin inj Ampul
119 Ondancetron 8 mg Tablet
120 Ondansetron 8 mg inj Ampul
121 Papaverin Tab 40 mg Tablet
122 Parasetamol Rektal 125 mg/2.5 ml Tube 2
123 Parasetamol Rektal 250 mg/2.5 ml Tube
124 Parasetamol sirup 120 mg/5 ml Botol 13
125 Parasetamol tablet 500 mg Tablet 500 155
126 Perak Sulfadiazin 1% (Burnazin) Tube
127 Piridoksin HCl (Vit.B6) tablet 10 mg Tablet 26 100 32
128 Prednison tablet 5 mg Tablet
129 Parasetamol Drop Botol
130 Pirantel suspensi Botol
131 Pehacain injeksi Ampul 2 1
132 Procurma sirup Botol
133 quinina Tablet
134 Ranitidin Tablet
135 Retinol (vit.A) 100,000 IU tablet salut Tablet
136 Retinol (vit.A) 200.000 IU kapsul lunak Tablet
137 Ringer Laktat larutan infus steril (Produk lo botol 1
138 Salbutamol Nebuliser Ampul
139 TXP ( Triheksifenidil hcl ) Tablet
140 Salbutamol tablet 2 mg Tablet
141 Salbutamol tablet 4 mg Tablet
142 Salisil Bedak 2 % Botol 5
143 Tetracycline Tablet
144 Tetagam Ampul
145 Sefadroxil tablet 500 mg Capsul
146 Sefadroxil 125 syr Botol
147 Sinvastatin tablet 10 mg Tablet
148 Siprofloxacin Tab 500 mg Tablet 100
149 Thiamin hcl tab ( B1) Tablet 300 40
150 Siobion Tablet
151 Vitamin B Kompleks tablet Tablet 500
152 Vitamin B 12 inj Ampul 2 10
153 Zinc tablet 20 mg Tablet
154 Vitacaps ( Multivitamin kapsul ) Tablet
155 Zinc tablet 20 mg Tablet
156 Zinc sirup Botol
157 Zinc drop Botol 3

TOTAL
 D.BHP
188 Aqua pro Injeksi steril, bebas pirogen Fles
189 Alkohol sweb Kotak
190 Duk 60 x 60 pcs
191 Alat suntik 10 ml biji
192 Alat suntik 2,5 ml biji
193 Alat suntik 5 ml biji 2 10
194 Alat suntik 3 cc Pcs 20 5 15
195 Blood Lanset bok
196 Chirurgic gloves size 8.0 Pcs
197 Etanol ( alkohol ) 70 % 100 ml Botol 1 1
198 Etakridina ( rivanol ) larutan 0.1% Botol
199 Elastic Bandage uk 7,5 x 4,5 cm roll
200 Foley Cateter biji
201 Hand scund M Biji
Hand scund M Kotak
202 Hand scund S Biji
Hand scund S Kotak 1 1
203 Infuset anak set 1
204 Infuset dewasa set
205 IV cateter No 18 G Biji
206 IV cateter No 20 G Biji 3
207 IV cateter No 22 G Biji
208 Jarum Heacting no 14 Biji
209 Kapas Pembalut 250 gram Biji
210 Kapas Pembalut 250 gram Biji
211 Kasa Pembalut 2m x 80 cm Rol
212 Kasa Pembalut 2m x 80 cm Rol
213 Kasa Pembalut Hidrofil 4 x 15 cm Rol 2
214 Kasa Pembalut Hidrofil 4 x 3 cm Rol 2 2
215 Kasa hidropyl 40 x 80 cm Rol
216 Kasa Hydropil 16 cm x 16 cm Kotak
217 Kasa Kompres DRC 40 cm x 40 cm Pcs 4 1
218 Klip besar 15 x 10cm Biji
219 Klip sedang 13 x 10cm biji
220 Klip Kecil 10 x 7 cm biji
221 Lisol Botol
222 Masker biji 50
223 Masker bok
224 Medicin packet bok
225 Nurse cup Kotak
226 Nurse cup Kotak
227 Plester 5 yard x 2 inchi rol
228 Plester ultrafik 10 cm x 1 m Rol 1
229 Perhidrol HCL / H2O2 3% Botol
230 Pisau bedah no 11 biji
231 Pisau bedah no 10 biji
232 Pisau bedah no 12 biji
233 Supratul BIJI
234 Supratul bok
235 Silk benang Kotak 3
236 Tranfusi set set
237 Under ped biji
238 Urin Bag biji
239 Wing needle biji
240 Yodium povidon larutan 10% 300ml Botol
241 Needle 22G Flashback pcs

TOTAL

GRATIS BAYAR PHB/ASKES

JUMLAH KUNJUNGAN RESEP

Mengetahui/Menyetujui YangMenyerahkan Yangmeminta

PimpinanPuskesmasKutaUtara Petugasgudangpuskesmas Pelaporpetugaspustu

dr. Ni Putu Purlimaningsih Ni Komang Ayu Triyani Ni Made Artini
NIP.197911202006042006 NIP.198801082011012016

N OBAT

BULAN :

BULAN :

NOMOR TANGGAL

PERMINT TERIM
SISA STOK
AAN A

JML JML JML

0
0
0
4
210 300
0
0
0
284 200
0
0
14
0
432
0
0
0
307
0
0
0
0
0
0
0
0
0
300
0
0
 0
0
0
100
0
0
0
0
29 300
1
0
0
6
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
120
0
0
0
0
0
0
0
0
0
0
12
0
0
 0
0
0
60
0
0
0
0
6
2
0
240
0
0
114 200
0
0
0
0
0
0
0
0
0
0
0
0
0
30
0
0
0
0
0
0
0
0
0
100
20
25
0
0
0
 0
0
0
2
0
13
345 300
0
94
0
0
0
1 5
0
0
0
0
0
1
0
0
0
0
5
0
0
0
0
0
100
260 200
0
500
12
0
0
0
0
3
0
0
0
0
0
12
10
0
0
0 2
0
0
0
0
0
0 100
0
1
0
0
3
0
0
0
0
0
0
2
4
0
0
3
0
0
0
0
50
0
0
0
0
0
 1
0
0

0
0
3
0
0
0
0
0
0

PHB/ASKES

Yangmeminta
Pelaporpetugaspustu

Ni Made Artini

 LAPORAN PENERIMAAN DAN LEMBAR PEMAKAIAN OBAT

(LPLPO )
LAPOR BULAN :

UPT PUSKESMAS : UPT PKM KUTA UTARA MINTA BULAN :

PUSKESMAS PEMBANTU YANG ADA :5 DOK NOMOR TANGGAL

PROVINSI : Bali IFK

UNIT : PUSTU CANGGU PKM

STOK PENERI PEMAKAI PERMINT TERIM

SISA STOK
NO NAMA OBAT SATUAN AWAL MAAN AN AAN A

JML JML JML JML JML JML

A. OBAT
1 Acyclovir tablet 400 mg Tablet - 0
2 Acyclovir cream 5 % Tube - 0
3 Alopurinol tablet 100 mg Tablet - 0
4 Ambroxol syrup Botol 4 4
5 Ambroxol tablet 30 mg Tablet 210 210
6 Aminofilin tablet 200 mg Tablet - 0
7 Amlodipine 10 mg T ablet - 0
8 Amlodipine 5 mg T ablet - 0
9 Amoksisilin kapletl 500 mg Kaplet 284 284
10 Amoksisilin kapletl 250 mg Kaplet - 0
11 Amoksisilin Syr Forte 250 mg Botol - 0
12 Amoksisilin sirup kering 125 mg/5ml Botol 14 14
13 Amoksisilin drop 100 mg/ml Botol - 0
14 Antasida DOEN kombinasi Tablet 432 432
15 Astaxanthin 4 mg tab Tablet - 0
16 Antasida DOEN suspensi Botol - 0
17 Anti Hemoroid DOEN Kombinasi Sup - 0
18 Asam Askorbat (Vit C) tablet 50 mg Tablet 307 307
19 Asam Folat Tablet - 0
20 Asam mefenamat tab 500 mg Tablet - 0
21 Albotyl (polikresol) Botol - 0
22 Albendazole tab 400 mg Tablet - 0
23 Azitromysin 500 Tablet - 0
24 Anti TBC Anak Paket - 0
25 Anti TBC Katagori I Paket - 0
26 Anti TBC Katagori II Paket - 0
27 Basitrasin 500 IU/g + Polimiksin 10.000 Tube - 0
28 IU/g
Besi II Sulfat tablet kombinasi Tablet 300 300
29 Bioplacenton jelly tube - 0
30 Betahistin mesilat 6 mg Tablet - 0
31 Borax gliserine Botol - 0
32 Balsam cap kaki 3 Tube - 0
33 Betametason krim 0.1% Tube - 0
34 Captopril 12,5 mg Tablet 100 100
35 Captopril 25 mg Tablet - 0
36 Coparcetine ( Obat Flu dan batuk ) Tablet - 0
37 Cetirizine 10 mg Tablet - 0
38 Deksametason injeksi 5 mg/ml - 1 ml Ampul - 0
39 Deksametason tablet 0,5 mg Tablet 29 29
40 Dasepam rectal 5 mg tube 1 1
41 Diasepam Inj 5 mg/ml Ampul - 0
42 Diazepam tablet 2 mg Tablet - 0
43 Difenhidramin HCl inj 10 mg/ml-1 ml Ampul 6 6
44 Digoksin tablet 0,25 mg Tablet - 0
45 Doksisiklin Tablet - 0
46 Domperidon Sirup Botol 1 1
47 Dextrofen ( Obat batuk dan pilek syr ) Botol - 0
48 Domperidon drop Botol - 0
49 Deksosimetason Tube - 0
50 Dulcolak ( stolax Supp) Supp - 0
51 Epinefrina (adrenalin) Injeksi 0,1% - 1 ml Ampul - 0
52 Erytromicin 500 mg Tablet - 0
53 Erfaflu ( Obat Flu syp ) Botol - 0
54 Erytromicin syrup Botol - 0
55 Erfakaf sirup Botol - 0
56 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 Ampul - 0
57 Fitomenadion (Vit.K1) tablet salut gula 10 Tablet - 0
58 Fenobarbital tablet 30 mg Tablet - 0
59 Furosemid tablet 40 mg Tablet - 0
60 Fenol Gliserol tetes telinga 10% Botol - 0
61 Garam Oralit untuk 200 ml air Sak 120 120
62 Gentamicin Sulfat TM 0,3% Botol - 0
63 Gentamicin Salep kulit Tube - 0
64 Glibenklamid tablet 5 mg Tablet - 0
65 Griseofulvin tab 125 Tablet - 0
66 Glimeperid 1 mg Tablet - 0
67 Glimeperid 2 mg Tablet - 0
68 Hidroklorotiazid (HCT) tablet 25 mg Tablet - 0
69 Haloperidol 0,5 Tablet - 0
70 Haloperidol 1,5 Tablet - 0
71 Haloperidol 5 mg Tablet - 0
72 Hidrokortison krim 2,5 % Tube 12 12
73 Hyoscine-N-Butilbromide 10 mg (Scopma) Tablet - 0
74 Hyoscine-N-Butilbromide inj / Buscopan Ampul - 0
75 Ibuprofen tablet 400 mg Tablet - 0
76 Isosorbid Di Nitrat Tablet - 0
77 Imunogard / Vitamin Imunitas Tablet - 0
78 Ibuprofen tablet 200 mg Tablet 60 60
79 Ibuprofen Sirup Botol - 0
80 Ketokonazole cream 2 % 15 gram Tube - 0
81 Ketokonazole tablet 200 mg Tablet - 0
82 Klindamycin 300 mg Tablet - 0
83 Kloramfenikol tetes telinga 3 % Botol 6 6
84 Kloramphenikol salep mata 1 % Tube 2 2
85 Kloramphenikol Tetes Mata Botol - 0
86 Klorfeniramin Maleat (CTM) tablet 4 mg Tablet 240 240
87 Klorpromazine HCL 100 MG ( CPZ) Tablet - 0
88 Kotrimoksazol Suspensi Botol - 0
89 Kotrimoksazol tablet 480 mg kombinasi Tablet 114 114
90 Kalium Gluconat Ampul - 0
91 Lidokain comp Ampul - 0
92 Lidokain injeksi Ampul - 0
93 Levertran salep (salep minyak ikan) pot - 0
94 Loperamid tablet 2 mg Tablet - 0
95 Loratadin tablet 10 mg Tablet - 0
96 Metformin 500 mg Tablet - 0
97 Meloxicam 15 mg Tablet - 0
98 Methyl Prednisolon 4 mg Tablet - 0
99 Metilergometrin Maleat 0,125 mg Tablet - 0
100 Metoklopramid syrup Botol - 0
101 Metoklopramid tablet 5 mg Tablet - 0
102 Metoklopramid hcl injeksi 5 mg Ampul - 0
103 Metronidazol tablet 500 mg Tablet 30 30
104 Magnesium Sulfat Inj 40% 25 ml Ampul - 0
105 Magnesium Sulfat Inj 20% 25 ml Ampul - 0
106 Miconazol Tube - 0
107 Metoklorpamid Hcl 5 mg/ml 2 ml Ampul - 0
108 Metoklorpamid Hcl 5 mg tablet Tablet - 0
109 Metronidazol vagina ( flagyl ) Supp - 0
110 Natrium Diklofenac tablet 25 mg Botol - 0
111 Natrium Diklofenac tablet 50 mg Tablet - 0
112 Natrium Klorida larutan infus 0.9% steril Fles - 0
113 New Diatabs ( Pularek ) Tablet 100 100
114 Nistatin tablet vaginal 100.000 IU/g Tablet 20 20
115 NB Salep Tube 25 25
116 OBH ( obat batuk hitam) Botol - 0
117 Omeprazol 20 mg Tablet - 0
118 Oksitosin inj Ampul - 0
119 Ondancetron 8 mg Tablet - 0
120 Ondansetron 8 mg inj Ampul - 0
121 Papaverin Tab 40 mg Tablet - 0
122 Parasetamol Rektal 125 mg/2.5 ml Tube 2 2
123 Parasetamol Rektal 250 mg/2.5 ml Tube - 0
124 Parasetamol sirup 120 mg/5 ml Botol 13 13
125 Parasetamol tablet 500 mg Tablet 345 345
126 Perak Sulfadiazin 1% (Burnazin) Tube - 0
127 Piridoksin HCl (Vit.B6) tablet 10 mg Tablet 94 94
128 Prednison tablet 5 mg Tablet - 0
129 Parasetamol Drop Botol - 0
130 Pirantel suspensi Botol - 0
131 Pehacain injeksi Ampul 1 1
132 Procurma sirup Botol - 0
133 quinina Tablet - 0
134 Ranitidin Tablet - 0
135 Retinol (vit.A) 100,000 IU tablet salut Tablet - 0
136 Retinol (vit.A) 200.000 IU kapsul lunak Tablet - 0
137 Ringer Laktat larutan infus steril (Produk lo botol 1 1
138 Salbutamol Nebuliser Ampul - 0
139 TXP ( Triheksifenidil hcl ) Tablet - 0
140 Salbutamol tablet 2 mg Tablet - 0
141 Salbutamol tablet 4 mg Tablet - 0
142 Salisil Bedak 2 % Botol 5 5
143 Tetracycline Tablet - 0
144 Tetagam Ampul - 0
145 Sefadroxil tablet 500 mg Capsul - 0
146 Sefadroxil 125 syr Botol - 0
147 Sinvastatin tablet 10 mg Tablet - 0
148 Siprofloxacin Tab 500 mg Tablet 100 100
149 Thiamin hcl tab ( B1) Tablet 260 260
150 Siobion Tablet - 0
151 Vitamin B Kompleks tablet Tablet 500 500
152 Vitamin B 12 inj Ampul 12 12
153 Zinc tablet 20 mg Tablet - 0
154 Vitacaps ( Multivitamin kapsul ) Tablet - 0
155 Zinc tablet 20 mg Tablet - 0
156 Zinc sirup Botol - 0
157 Zinc drop Botol 3 3

TOTAL

D.BHP
188 Aqua pro Injeksi steril, bebas pirogen Fles - 0
189 Alkohol sweb Kotak - 0
190 Duk 60 x 60 pcs - 0
191 Alat suntik 10 ml biji - 0
192 Alat suntik 2,5 ml biji - 0
193 Alat suntik 5 ml biji 12 12
194 Alat suntik 3 cc Pcs 10 10
195 Blood Lanset bok - 0
196 Chirurgic gloves size 8.0 Pcs - 0
197 Etanol ( alkohol ) 70 % 100 ml Botol - 0
198 Etakridina ( rivanol ) larutan 0.1% Botol - 0
199 Elastic Bandage uk 7,5 x 4,5 cm roll - 0
200 Foley Cateter biji - 0
201 Hand scund M Biji - 0
Hand scund M Kotak - 0
202 Hand scund S Biji - 0
Hand scund S Kotak - 0
203 Infuset anak set 1 1
204 Infuset dewasa set - 0
205 IV cateter No 18 G Biji - 0
206 IV cateter No 20 G Biji 3 3
207 IV cateter No 22 G Biji - 0
208 Jarum Heacting no 14 Biji - 0
209 Kapas Pembalut 250 gram Biji - 0
210 Kapas Pembalut 250 gram Biji - 0
211 Kasa Pembalut 2m x 80 cm Rol - 0
212 Kasa Pembalut 2m x 80 cm Rol - 0
213 Kasa Pembalut Hidrofil 4 x 15 cm Rol 2 2
214 Kasa Pembalut Hidrofil 4 x 3 cm Rol 4 4
215 Kasa hidropyl 40 x 80 cm Rol - 0
216 Kasa Hydropil 16 cm x 16 cm Kotak - 0
217 Kasa Kompres DRC 40 cm x 40 cm Pcs 3 3
218 Klip besar 15 x 10cm Biji - 0
219 Klip sedang 13 x 10cm biji - 0
220 Klip Kecil 10 x 7 cm biji - 0
221 Lisol Botol - 0
222 Masker biji 50 50
223 Masker bok - 0
224 Medicin packet bok - 0
225 Nurse cup Kotak - 0
226 Nurse cup Kotak - 0
227 Plester 5 yard x 2 inchi rol - 0
228 Plester ultrafik 10 cm x 1 m Rol 1 1
229 Perhidrol HCL / H2O2 3% Botol - 0
230 Pisau bedah no 11 biji - 0
231 Pisau bedah no 10 biji
232 Pisau bedah no 12 biji
233 Supratul BIJI - 0
234 Supratul bok - 0
235 Silk benang Kotak 3 3
236 Tranfusi set set - 0
237 Under ped biji - 0
238 Urin Bag biji - 0
239 Wing needle biji - 0
240 Yodium povidon larutan 10% 300ml Botol - 0
241 Needle 22G Flashback pcs - 0
 TOTAL

GRATIS BAYAR PHB/ASKES

JUMLAH KUNJUNGAN RESEP

Mengetahui/Menyetujui YangMenyerahkan Yangmeminta

PimpinanPuskesmasKutaUtara Petugasgudangpuskesmas Pelaporpetugaspustu

dr. Ni Putu Purlimaningsih Ni Komang Ayu Triyani Ni Made Artini
NIP.197911202006042006 NIP.198801082011012016

 LAPORAN PENERIMAAN DAN LEMBAR PEMAKAIAN OBAT
(LPLPO )
LAPOR BULAN :

UPT PUSKESMAS : UPT PKM KUTA UTARA MINTA BULAN :

PUSKESMAS PEMBANTU YANG ADA :5 DOK NOMOR TANGGAL

PROVINSI : Bali IFK

UNIT : PUSTU CANGGU PKM

STOK PENERI PEMAKAI PERMINT TERIM

SISA STOK
NO NAMA OBAT SATUAN AWAL MAAN AN AAN A

JML JML JML JML JML JML

A. OBAT
1 Acyclovir tablet 400 mg Tablet 0
2 Acyclovir cream 5 % Tube 0
3 Alopurinol tablet 100 mg Tablet 0
4 Ambroxol syrup Botol 0
5 Ambroxol tablet 30 mg Tablet 0
6 Aminofilin tablet 200 mg Tablet 0
7 Amlodipine 10 mg T ablet 0
8 Amlodipine 5 mg T ablet 0
9 Amoksisilin kapletl 500 mg Kaplet 0
10 Amoksisilin kapletl 250 mg Kaplet 0
11 Amoksisilin Syr Forte 250 mg Botol 0
12 Amoksisilin sirup kering 125 mg/5ml Botol 0
13 Amoksisilin drop 100 mg/ml Botol 0
14 Antasida DOEN kombinasi Tablet 0
15 Astaxanthin 4 mg tab Tablet 0
16 Antasida DOEN suspensi Botol 0
17 Anti Hemoroid DOEN Kombinasi Sup 0
18 Asam Askorbat (Vit C) tablet 50 mg Tablet 0
19 Asam Folat Tablet 0
20 Asam mefenamat tab 500 mg Tablet 0
21 Albotyl (polikresol) Botol 0
22 Albendazole tab 400 mg Tablet 0
23 Azitromysin 500 Tablet 0
24 Anti TBC Anak Paket 0
25 Anti TBC Katagori I Paket 0
26 Anti TBC Katagori II Paket 0
27 Basitrasin 500 IU/g + Polimiksin 10.000 Tube 0
28 IU/g
Besi II Sulfat tablet kombinasi Tablet 0
29 Bioplacenton jelly tube 0
30 Betahistin mesilat 6 mg Tablet 0
31 Borax gliserine Botol 0
32 Balsam cap kaki 3 Tube 0
33 Betametason krim 0.1% Tube 0
34 Captopril 12,5 mg Tablet 0
35 Captopril 25 mg Tablet 0
36 Coparcetine ( Obat Flu dan batuk ) Tablet 0
37 Cetirizine 10 mg Tablet 0
38 Deksametason injeksi 5 mg/ml - 1 ml Ampul 0
39 Deksametason tablet 0,5 mg Tablet 0
40 Dasepam rectal 5 mg tube 0
41 Diasepam Inj 5 mg/ml Ampul 0
42 Diazepam tablet 2 mg Tablet 0
43 Difenhidramin HCl inj 10 mg/ml-1 ml Ampul 0
44 Digoksin tablet 0,25 mg Tablet 0
45 Doksisiklin Tablet 0
46 Domperidon Sirup Botol 0
47 Dextrofen ( Obat batuk dan pilek syr ) Botol 0
48 Domperidon drop Botol 0
49 Deksosimetason Tube 0
50 Dulcolak ( stolax Supp) Supp 0
51 Epinefrina (adrenalin) Injeksi 0,1% - 1 ml Ampul 0
52 Erytromicin 500 mg Tablet 0
53 Erfaflu ( Obat Flu syp ) Botol 0
54 Erytromicin syrup Botol 0
55 Erfakaf sirup Botol 0
56 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 Ampul 0
57 Fitomenadion (Vit.K1) tablet salut gula 10 Tablet 0
58 Fenobarbital tablet 30 mg Tablet 0
59 Furosemid tablet 40 mg Tablet 0
60 Fenol Gliserol tetes telinga 10% Botol 0
61 Garam Oralit untuk 200 ml air Sak 0
62 Gentamicin Sulfat TM 0,3% Botol 0
63 Gentamicin Salep kulit Tube 0
64 Glibenklamid tablet 5 mg Tablet 0
65 Griseofulvin tab 125 Tablet 0
66 Glimeperid 1 mg Tablet 0
67 Glimeperid 2 mg Tablet 0
68 Hidroklorotiazid (HCT) tablet 25 mg Tablet 0
69 Haloperidol 0,5 Tablet 0
70 Haloperidol 1,5 Tablet 0
71 Haloperidol 5 mg Tablet 0
72 Hidrokortison krim 2,5 % Tube 0
73 Hyoscine-N-Butilbromide 10 mg (Scopma) Tablet 0
74 Hyoscine-N-Butilbromide inj / Buscopan Ampul 0
75 Ibuprofen tablet 400 mg Tablet 0
76 Isosorbid Di Nitrat Tablet 0
77 Imunogard / Vitamin Imunitas Tablet 0
78 Ibuprofen tablet 200 mg Tablet 0
79 Ibuprofen Sirup Botol 0
80 Ketokonazole cream 2 % 15 gram Tube 0
81 Ketokonazole tablet 200 mg Tablet 0
82 Klindamycin 300 mg Tablet 0
83 Kloramfenikol tetes telinga 3 % Botol 0
84 Kloramphenikol salep mata 1 % Tube 0
85 Kloramphenikol Tetes Mata Botol 0
86 Klorfeniramin Maleat (CTM) tablet 4 mg Tablet 0
87 Klorpromazine HCL 100 MG ( CPZ) Tablet 0
88 Kotrimoksazol Suspensi Botol 0
89 Kotrimoksazol tablet 480 mg kombinasi Tablet 0
90 Kalium Gluconat Ampul 0
91 Lidokain comp Ampul 0
92 Lidokain injeksi Ampul 0
93 Levertran salep (salep minyak ikan) pot 0
94 Loperamid tablet 2 mg Tablet 0
95 Loratadin tablet 10 mg Tablet 0
96 Metformin 500 mg Tablet 0
97 Meloxicam 15 mg Tablet 0
98 Methyl Prednisolon 4 mg Tablet 0
99 Metilergometrin Maleat 0,125 mg Tablet 0
100 Metoklopramid syrup Botol 0
101 Metoklopramid tablet 5 mg Tablet 0
102 Metoklopramid hcl injeksi 5 mg Ampul 0
103 Metronidazol tablet 500 mg Tablet 0
104 Magnesium Sulfat Inj 40% 25 ml Ampul 0
105 Magnesium Sulfat Inj 20% 25 ml Ampul 0
106 Miconazol Tube 0
107 Metoklorpamid Hcl 5 mg/ml 2 ml Ampul 0
108 Metoklorpamid Hcl 5 mg tablet Tablet 0
109 Metronidazol vagina ( flagyl ) Supp 0
110 Natrium Diklofenac tablet 25 mg Botol 0
111 Natrium Diklofenac tablet 50 mg Tablet 0
112 Natrium Klorida larutan infus 0.9% steril Fles 0
113 New Diatabs ( Pularek ) Tablet 0
114 Nistatin tablet vaginal 100.000 IU/g Tablet 0
115 NB Salep Tube 0
116 OBH ( obat batuk hitam) Botol 0
117 Omeprazol 20 mg Tablet 0
118 Oksitosin inj Ampul 0
119 Ondancetron 8 mg Tablet 0
120 Ondansetron 8 mg inj Ampul 0
121 Papaverin Tab 40 mg Tablet 0
122 Parasetamol Rektal 125 mg/2.5 ml Tube 0
123 Parasetamol Rektal 250 mg/2.5 ml Tube 0
124 Parasetamol sirup 120 mg/5 ml Botol 0
125 Parasetamol tablet 500 mg Tablet 0
126 Perak Sulfadiazin 1% (Burnazin) Tube 0
127 Piridoksin HCl (Vit.B6) tablet 10 mg Tablet 0
128 Prednison tablet 5 mg Tablet 0
129 Parasetamol Drop Botol 0
130 Pirantel suspensi Botol 0
131 Pehacain injeksi Ampul 0
132 Procurma sirup Botol 0
133 quinina Tablet 0
134 Ranitidin Tablet 0
135 Retinol (vit.A) 100,000 IU tablet salut Tablet 0
136 Retinol (vit.A) 200.000 IU kapsul lunak Tablet 0
137 Ringer Laktat larutan infus steril (Produk lo botol 0
138 Salbutamol Nebuliser Ampul 0
139 TXP ( Triheksifenidil hcl ) Tablet 0
140 Salbutamol tablet 2 mg Tablet 0
141 Salbutamol tablet 4 mg Tablet 0
142 Salisil Bedak 2 % Botol 0
143 Tetracycline Tablet 0
144 Tetagam Ampul 0
145 Sefadroxil tablet 500 mg Capsul 0
146 Sefadroxil 125 syr Botol 0
147 Sinvastatin tablet 10 mg Tablet 0
148 Siprofloxacin Tab 500 mg Tablet 0
149 Thiamin hcl tab ( B1) Tablet 0
150 Siobion Tablet 0
151 Vitamin B Kompleks tablet Tablet 0
152 Vitamin B 12 inj Ampul 0
153 Zinc tablet 20 mg Tablet 0
154 Vitacaps ( Multivitamin kapsul ) Tablet 0
155 Zinc tablet 20 mg Tablet 0
156 Zinc sirup Botol 0
157 Zinc drop Botol 0

TOTAL

D.BHP
188 Aqua pro Injeksi steril, bebas pirogen Fles 0
189 Alkohol sweb Kotak 0
190 Duk 60 x 60 pcs 0
191 Alat suntik 10 ml biji 0
192 Alat suntik 2,5 ml biji 0
193 Alat suntik 5 ml biji 0
194 Alat suntik 3 cc Pcs 0
195 Blood Lanset bok 0
196 Chirurgic gloves size 8.0 Pcs 0
197 Etanol ( alkohol ) 70 % 100 ml Botol 0
198 Etakridina ( rivanol ) larutan 0.1% Botol 0
199 Elastic Bandage uk 7,5 x 4,5 cm roll 0
200 Foley Cateter biji 0
201 Hand scund M Biji 0
Hand scund M Kotak 0
202 Hand scund S Biji 0
Hand scund S Kotak 0
203 Infuset anak set 0
204 Infuset dewasa set 0
205 IV cateter No 18 G Biji 0
206 IV cateter No 20 G Biji 0
207 IV cateter No 22 G Biji 0
208 Jarum Heacting no 14 Biji 0
209 Kapas Pembalut 250 gram Biji 0
210 Kapas Pembalut 250 gram Biji 0
211 Kasa Pembalut 2m x 80 cm Rol 0
212 Kasa Pembalut 2m x 80 cm Rol 0
213 Kasa Pembalut Hidrofil 4 x 15 cm Rol 0
214 Kasa Pembalut Hidrofil 4 x 3 cm Rol 0
215 Kasa hidropyl 40 x 80 cm Rol 0
216 Kasa Hydropil 16 cm x 16 cm Kotak 0
217 Kasa Kompres DRC 40 cm x 40 cm Pcs 0
218 Klip besar 15 x 10cm Biji 0
219 Klip sedang 13 x 10cm biji 0
220 Klip Kecil 10 x 7 cm biji 0
221 Lisol Botol 0
222 Masker biji 0
223 Masker bok 0
224 Medicin packet bok 0
225 Nurse cup Kotak 0
226 Nurse cup Kotak 0
227 Plester 5 yard x 2 inchi rol 0
228 Plester ultrafik 10 cm x 1 m Rol 0
229 Perhidrol HCL / H2O2 3% Botol 0
230 Pisau bedah no 11 biji 0
231 Pisau bedah no 10 biji
232 Pisau bedah no 12 biji
233 Supratul BIJI 0
234 Supratul bok 0
235 Silk benang Kotak 0
236 Tranfusi set set 0
237 Under ped biji 0
238 Urin Bag biji 0
239 Wing needle biji 0
240 Yodium povidon larutan 10% 300ml Botol 0
241 Needle 22G Flashback pcs 0

TOTAL

GRATIS BAYAR PHB/ASKES

JUMLAH KUNJUNGAN RESEP
 JUMLAH KUNJUNGAN RESEP

Mengetahui/Menyetujui YangMenyerahkan Yangmeminta

PimpinanPuskesmasKutaUtara Petugasgudangpuskesmas Pelaporpetugaspustu

dr. Ni Putu Purlimaningsih Ni Komang Ayu Triyani Ni Made Artini
NIP.197911202006042006 NIP.198801082011012016

 LAPORAN TRIWULAN I PUKESMAS KUTA UTARA
( JANUARI FEBRUARI MARET )

UPT PUSKESMAS : UPT PKM KUTA UTARA

PUSKESMAS PEMBANTU YANG ADA :5
PROVINSI : Bali
UNIT : PUSTU CANGGU

HARGA STOK AWAL

NO NAMA OBAT SATUAN
SATUAN
JML
A. OBAT
1 Acyclovir tablet 400 mg Tablet 750
2 Acyclovir cream 5 % Tube 3000
3 Alopurinol tablet 100 mg Tablet 120
4 Ambroxol syrup Botol 3300
5 Ambroxol tablet 30 mg Tablet 125
6 Aminofilin tablet 200 mg Tablet 104
7 Amlodipine 10 mg T ablet
8 Amlodipine 5 mg T ablet 105
9 Amoksisilin kapletl 500 mg Kaplet 370
10 Amoksisilin kapletl 250 mg Kaplet 216
11 Amoksisilin Syr Forte 250 mg Botol
12 Amoksisilin sirup kering 125 mg/5ml Botol 3699
13 Amoksisilin drop 100 mg/ml Botol 29580
14 Antasida DOEN kombinasi Tablet 135
15 Astaxanthin 4 mg tab Tablet 2379
16 Antasida DOEN suspensi Botol 2643
17 Anti Hemoroid DOEN Kombinasi Sup 1470
18 Asam Askorbat (Vit C) tablet 50 mg Tablet 19
19 Asam Folat Tablet 62
20 Asam mefenamat tab 500 mg Tablet 176
21 Albotyl (polikresol) Botol 21801
22 Albendazole tab 400 mg Tablet
23 Azitromysin 500 Tablet 4500
24 Anti TBC Anak Paket 214990
25 Anti TBC Katagori I Paket 359990
26 Anti TBC Katagori II Paket 1199900
27 Basitrasin 500 IU/g + Polimiksin 10.000 IU/g Tube 2517
28 Besi II Sulfat tablet kombinasi Tablet 27
29 Bioplacenton jelly tube 17530
30 Betahistin mesilat 6 mg Tablet 924
31 Borax gliserine Botol 6270
32 Balsam cap kaki 3 Tube
33 Betametason krim 0.1% Tube 1866
34 Captopril 12,5 mg Tablet 71
35 Captopril 25 mg Tablet 138
36 Coparcetine ( Obat Flu dan batuk ) Tablet 915
37 Cetirizine 10 mg Tablet 330
38 Deksametason injeksi 5 mg/ml - 1 ml Ampul 1580
39 Deksametason tablet 0,5 mg Tablet 24
40 Dasepam rectal 5 mg tube 11517
41 Diasepam Inj 5 mg/ml Ampul 2344
42 Diazepam tablet 2 mg Tablet 13
43 Difenhidramin HCl inj 10 mg/ml-1 ml Ampul 1050
44 Digoksin tablet 0,25 mg Tablet 83
45 Doksisiklin Tablet 230
46 Domperidon Sirup Botol 3624
47 Dextrofen ( Obat batuk dan pilek syr ) Botol 10390
48 Domperidon drop Botol 15600
49 Deksosimetason Tube 9983
50 Dulcolak ( stolax Supp) Supp 6045
51 Epinefrina (adrenalin) Injeksi 0,1% - 1 ml Ampul 2204
52 Erytromicin 500 mg Tablet 535
53 Erfaflu ( Obat Flu syp ) Botol
54 Erytromicin syrup Botol 6700
55 Erfakaf sirup Botol 12980
56 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 ml Ampul 978
57 Fitomenadion (Vit.K1) tablet salut gula 10 mg Tablet 681
58 Fenobarbital tablet 30 mg Tablet 32
59 Furosemid tablet 40 mg Tablet 72
60 Fenol Gliserol tetes telinga 10% Botol 1008
61 Garam Oralit untuk 200 ml air Sak 440
62 Gentamicin Sulfat TM 0,3% Botol 3194
63 Gentamicin Salep kulit Tube 1650
64 Glibenklamid tablet 5 mg Tablet 72
65 Griseofulvin tab 125 Tablet 225
66 Glimeperid 1 mg Tablet 265
67 Glimeperid 2 mg Tablet 436
68 Hidroklorotiazid (HCT) tablet 25 mg Tablet 36
69 Haloperidol 0,5 Tablet 60
70 Haloperidol 1,5 Tablet 123
71 Haloperidol 5 mg Tablet 60
72 Hidrokortison krim 2,5 % Tube 3000
73 Hyoscine-N-Butilbromide 10 mg (Scopma) Tablet 1040
74 Hyoscine-N-Butilbromide inj / Buscopan Ampul 2467
75 Ibuprofen tablet 400 mg Tablet 150
76 Isosorbid Di Nitrat Tablet 65
77 Imunogard / Vitamin Imunitas Tablet 9990
78 Ibuprofen tablet 200 mg Tablet 105
79 Ibuprofen Sirup Botol 3499
80 Ketokonazole cream 2 % 15 gram Tube 4666
81 Ketokonazole tablet 200 mg Tablet 372
82 Klindamycin 300 mg Tablet 685
83 Kloramfenikol tetes telinga 3 % Botol 1000
84 Kloramphenikol salep mata 1 % Tube 1563
85 Kloramphenikol Tetes Mata Botol 2499
86 Klorfeniramin Maleat (CTM) tablet 4 mg Tablet 24
87 Klorpromazine HCL 100 MG ( CPZ) Tablet 104
88 Kotrimoksazol Suspensi Botol 3500
89 Kotrimoksazol tablet 480 mg kombinasi Tablet 165
90 Kalium Gluconat Ampul 7800
91 Lidokain comp Ampul 1033
92 Lidokain injeksi Ampul 1010
93 Levertran salep (salep minyak ikan) pot 1350
94 Loperamid tablet 2 mg Tablet 89
95 Loratadin tablet 10 mg Tablet 154
96 Metformin 500 mg Tablet 182
97 Meloxicam 15 mg Tablet 113
98 Methyl Prednisolon 4 mg Tablet 509
99 Metilergometrin Maleat 0,125 mg Tablet 154
100 Metoklopramid syrup Botol 1914
101 Metoklopramid tablet 5 mg Tablet 73
102 Metoklopramid hcl injeksi 5 mg Ampul 1947
103 Metronidazol tablet 500 mg Tablet 154
104 Magnesium Sulfat Inj 40% 25 ml Ampul 1948
105 Magnesium Sulfat Inj 20% 25 ml Ampul 5500
106 Miconazol Tube 1719
107 Metoklorpamid Hcl 5 mg/ml 2 ml Ampul 7425
108 Metoklorpamid Hcl 5 mg tablet Tablet 73
109 Metronidazol vagina ( flagyl ) Supp 3220
110 Natrium Diklofenac tablet 25 mg Botol 168
111 Natrium Diklofenac tablet 50 mg Tablet 218
112 Natrium Klorida larutan infus 0.9% steril Fles 4899
113 New Diatabs ( Pularek ) Tablet 190
114 Nistatin tablet vaginal 100.000 IU/g Tablet 289
115 NB Salep Tube 20302
116 OBH ( obat batuk hitam) Botol 2500
117 Omeprazol 20 mg Tablet 408
118 Oksitosin inj Ampul 1785
119 Ondancetron 8 mg Tablet 2596
120 Ondansetron 8 mg inj Ampul 10384
121 Papaverin Tab 40 mg Tablet 57
122 Parasetamol Rektal 125 mg/2.5 ml Tube 12672
123 Parasetamol Rektal 250 mg/2.5 ml Tube 32259
124 Parasetamol sirup 120 mg/5 ml Botol 1725
125 Parasetamol tablet 500 mg Tablet 45
126 Perak Sulfadiazin 1% (Burnazin) Tube 33000
127 Piridoksin HCl (Vit.B6) tablet 10 mg Tablet 14
128 Prednison tablet 5 mg Tablet 38
129 Parasetamol Drop Botol 4799
130 Pirantel suspensi Botol 8360
131 Pehacain injeksi Ampul 1363
132 Procurma sirup Botol 14850
133 quinina Tablet 670
134 Ranitidin Tablet 200
135 Retinol (vit.A) 100,000 IU tablet salut Tablet 260
136 Retinol (vit.A) 200.000 IU kapsul lunak Tablet 459
137 Ringer Laktat larutan infus steril (Produk lokal) botol 5200
138 Salbutamol Nebuliser Ampul 10533
139 TXP ( Triheksifenidil hcl ) Tablet 11946
140 Salbutamol tablet 2 mg Tablet 88
141 Salbutamol tablet 4 mg Tablet 97
142 Salisil Bedak 2 % Botol 1025
143 Tetracycline Tablet 257
144 Tetagam Ampul 61817
145 Sefadroxil tablet 500 mg Capsul 700
146 Sefadroxil 125 syr Botol 7227
147 Sinvastatin tablet 10 mg Tablet 513
148 Siprofloxacin Tab 500 mg Tablet 240
149 Thiamin hcl tab ( B1) Tablet 37
150 Siobion Tablet 1194
151 Vitamin B Kompleks tablet Tablet 22
152 Vitamin B 12 inj Ampul 473
153 Zinc tablet 20 mg Tablet 472
154 Vitacaps ( Multivitamin kapsul ) Tablet 948
155 Zinc tablet 20 mg Tablet 470
156 Zinc sirup Botol 12840
157 Zinc drop Botol 12840

TOTAL

D.BHP
188 Aqua pro Injeksi steril, bebas pirogen Fles 1500
189 Alkohol sweb Kotak 5500
190 Duk 60 x 60 pcs
191 Alat suntik 10 ml biji 2750
192 Alat suntik 2,5 ml biji 591
193 Alat suntik 5 ml biji 2640
194 Alat suntik 3 cc Pcs 788
195 Blood Lanset bok 19800
196 Chirurgic gloves size 8.0 Pcs 7980
197 Etanol ( alkohol ) 70 % 100 ml Botol 2500
198 Etakridina ( rivanol ) larutan 0.1% Botol 1800
199 Elastic Bandage uk 7,5 x 4,5 cm roll 81400
200 Foley Cateter biji 8494
201 Hand scund M Biji 360
Hand scund M Kotak 44100
202 Hand scund S Biji 360
Hand scund S Kotak 44100
203 Infuset anak set 3185
204 Infuset dewasa set 2910
205 IV cateter No 18 G Biji 5148
206 IV cateter No 20 G Biji 5148
207 IV cateter No 22 G Biji 5148
208 Jarum Heacting no 14 Biji 15840
209 Kapas Pembalut 250 gram Biji 11396
210 Kapas Pembalut 250 gram Biji 11300
211 Kasa Pembalut 2m x 80 cm Rol 21120
212 Kasa Pembalut 2m x 80 cm Rol 7000
213 Kasa Pembalut Hidrofil 4 x 15 cm Rol 11688
214 Kasa Pembalut Hidrofil 4 x 3 cm Rol 1584
215 Kasa hidropyl 40 x 80 cm Rol 95000
216 Kasa Hydropil 16 cm x 16 cm Kotak 5230
217 Kasa Kompres DRC 40 cm x 40 cm Pcs 1640
218 Klip besar 15 x 10cm Biji 138
219 Klip sedang 13 x 10cm biji 99
220 Klip Kecil 10 x 7 cm biji 79
221 Lisol Botol 37300
222 Masker biji 436
223 Masker bok 21780
224 Medicin packet bok 2310000
225 Nurse cup Kotak 649
226 Nurse cup Kotak 49500
227 Plester 5 yard x 2 inchi rol 31999
228 Plester ultrafik 10 cm x 1 m Rol 8470
229 Perhidrol HCL / H2O2 3% Botol 10800
230 Pisau bedah no 11 biji 660
231 Pisau bedah no 10 biji
232 Pisau bedah no 12 biji
233 Supratul BIJI 11300
234 Supratul bok 206030
235 Silk benang Kotak 6600
236 Tranfusi set set 15015
237 Under ped biji 52800
238 Urin Bag biji 8800
239 Wing needle biji 7400
240 Yodium povidon larutan 10% 300ml Botol 14500
241 Needle 22G Flashback pcs 1650

TOTAL
TOTAL KESELURUHAN

GRATIS BAYAR
JUMLAH KUNJUNGAN RESEP

Mengetahui/Menyetujui
PimpinanPuskesmasKutaUtara


Mengetahui/Menyetujui YangMenyerahkan
PimpinanPuskesmasKutaUtara Petugasgudangpuskesmas

dr. Ni Putu Purlimaningsih Ni Komang Ayu Triyani
NIP.197911202006042006 NIP.198801082011012016

 S KUTA UTARA
ARET )

PENERIM PEMAKAIA
SISA STOK
AAN N

JML JML JML RUPIAH

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

BAYAR PHB/ASKES JUMLAH

Yangmeminta
Pelaporpetugaspustu

 LAPORAN PENERIMAAN DAN LEMBAR PEMAKAIAN OBAT

(LPLPO )
LAPOR BULAN :

UPT PUSKESMAS : UPT PKM KUTA UTARA MINTA BULAN :

PUSKESMAS PEMBANTU YANG ADA :5 DOK NOMOR TANGGAL

PROVINSI : Bali IFK

UNIT : PUSTU CANGGU PKM

STOK PENERI PEMAKAI PERMINT TERIM

SISA STOK
NO NAMA OBAT SATUAN AWAL MAAN AN AAN A

JML JML JML JML JML JML

A. OBAT
1 Acyclovir tablet 400 mg Tablet 0
2 Acyclovir cream 5 % Tube 0
3 Alopurinol tablet 100 mg Tablet 0
4 Ambroxol syrup Botol 0
5 Ambroxol tablet 30 mg Tablet 0
6 Aminofilin tablet 200 mg Tablet 0
7 Amlodipine 10 mg T ablet 0
8 Amlodipine 5 mg T ablet 0
9 Amoksisilin kapletl 500 mg Kaplet 0
10 Amoksisilin kapletl 250 mg Kaplet 0
11 Amoksisilin Syr Forte 250 mg Botol 0
12 Amoksisilin sirup kering 125 mg/5ml Botol 0
13 Amoksisilin drop 100 mg/ml Botol 0
14 Antasida DOEN kombinasi Tablet 0
15 Astaxanthin 4 mg tab Tablet 0
16 Antasida DOEN suspensi Botol 0
17 Anti Hemoroid DOEN Kombinasi Sup 0
18 Asam Askorbat (Vit C) tablet 50 mg Tablet 0
19 Asam Folat Tablet 0
20 Asam mefenamat tab 500 mg Tablet 0
21 Albotyl (polikresol) Botol 0
22 Albendazole tab 400 mg Tablet 0
23 Azitromysin 500 Tablet 0
24 Anti TBC Anak Paket 0
25 Anti TBC Katagori I Paket 0
26 Anti TBC Katagori II Paket 0
27 Basitrasin 500 IU/g + Polimiksin 10.000 Tube 0
28 IU/g
Besi II Sulfat tablet kombinasi Tablet 0
29 Bioplacenton jelly tube 0
30 Betahistin mesilat 6 mg Tablet 0
31 Borax gliserine Botol 0
32 Balsam cap kaki 3 Tube 0
33 Betametason krim 0.1% Tube 0
34 Captopril 12,5 mg Tablet 0
35 Captopril 25 mg Tablet 0
36 Coparcetine ( Obat Flu dan batuk ) Tablet 0
37 Cetirizine 10 mg Tablet 0
38 Deksametason injeksi 5 mg/ml - 1 ml Ampul 0
39 Deksametason tablet 0,5 mg Tablet 0
40 Dasepam rectal 5 mg tube 0
41 Diasepam Inj 5 mg/ml Ampul 0
42 Diazepam tablet 2 mg Tablet 0
43 Difenhidramin HCl inj 10 mg/ml-1 ml Ampul 0
44 Digoksin tablet 0,25 mg Tablet 0
45 Doksisiklin Tablet 0
46 Domperidon Sirup Botol 0
47 Dextrofen ( Obat batuk dan pilek syr ) Botol 0
48 Domperidon drop Botol 0
49 Deksosimetason Tube 0
50 Dulcolak ( stolax Supp) Supp 0
51 Epinefrina (adrenalin) Injeksi 0,1% - 1 ml Ampul 0
52 Erytromicin 500 mg Tablet 0
53 Erfaflu ( Obat Flu syp ) Botol 0
54 Erytromicin syrup Botol 0
55 Erfakaf sirup Botol 0
56 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 Ampul 0
57 Fitomenadion (Vit.K1) tablet salut gula 10 Tablet 0
58 Fenobarbital tablet 30 mg Tablet 0
59 Furosemid tablet 40 mg Tablet 0
60 Fenol Gliserol tetes telinga 10% Botol 0
61 Garam Oralit untuk 200 ml air Sak 0
62 Gentamicin Sulfat TM 0,3% Botol 0
63 Gentamicin Salep kulit Tube 0
64 Glibenklamid tablet 5 mg Tablet 0
65 Griseofulvin tab 125 Tablet 0
66 Glimeperid 1 mg Tablet 0
67 Glimeperid 2 mg Tablet 0
68 Hidroklorotiazid (HCT) tablet 25 mg Tablet 0
69 Haloperidol 0,5 Tablet 0
70 Haloperidol 1,5 Tablet 0
71 Haloperidol 5 mg Tablet 0
72 Hidrokortison krim 2,5 % Tube 0
73 Hyoscine-N-Butilbromide 10 mg (Scopma) Tablet 0
74 Hyoscine-N-Butilbromide inj / Buscopan Ampul 0
75 Ibuprofen tablet 400 mg Tablet 0
76 Isosorbid Di Nitrat Tablet 0
77 Imunogard / Vitamin Imunitas Tablet 0
78 Ibuprofen tablet 200 mg Tablet 0
79 Ibuprofen Sirup Botol 0
80 Ketokonazole cream 2 % 15 gram Tube 0
81 Ketokonazole tablet 200 mg Tablet 0
82 Klindamycin 300 mg Tablet 0
83 Kloramfenikol tetes telinga 3 % Botol 0
84 Kloramphenikol salep mata 1 % Tube 0
85 Kloramphenikol Tetes Mata Botol 0
86 Klorfeniramin Maleat (CTM) tablet 4 mg Tablet 0
87 Klorpromazine HCL 100 MG ( CPZ) Tablet 0
88 Kotrimoksazol Suspensi Botol 0
89 Kotrimoksazol tablet 480 mg kombinasi Tablet 0
90 Kalium Gluconat Ampul 0
91 Lidokain comp Ampul 0
92 Lidokain injeksi Ampul 0
93 Levertran salep (salep minyak ikan) pot 0
94 Loperamid tablet 2 mg Tablet 0
95 Loratadin tablet 10 mg Tablet 0
96 Metformin 500 mg Tablet 0
97 Meloxicam 15 mg Tablet 0
98 Methyl Prednisolon 4 mg Tablet 0
99 Metilergometrin Maleat 0,125 mg Tablet 0
100 Metoklopramid syrup Botol 0
101 Metoklopramid tablet 5 mg Tablet 0
102 Metoklopramid hcl injeksi 5 mg Ampul 0
103 Metronidazol tablet 500 mg Tablet 0
104 Magnesium Sulfat Inj 40% 25 ml Ampul 0
105 Magnesium Sulfat Inj 20% 25 ml Ampul 0
106 Miconazol Tube 0
107 Metoklorpamid Hcl 5 mg/ml 2 ml Ampul 0
108 Metoklorpamid Hcl 5 mg tablet Tablet 0
109 Metronidazol vagina ( flagyl ) Supp 0
110 Natrium Diklofenac tablet 25 mg Botol 0
111 Natrium Diklofenac tablet 50 mg Tablet 0
112 Natrium Klorida larutan infus 0.9% steril Fles 0
113 New Diatabs ( Pularek ) Tablet 0
114 Nistatin tablet vaginal 100.000 IU/g Tablet 0
115 NB Salep Tube 0
116 OBH ( obat batuk hitam) Botol 0
117 Omeprazol 20 mg Tablet 0
118 Oksitosin inj Ampul 0
119 Ondancetron 8 mg Tablet 0
120 Ondansetron 8 mg inj Ampul 0
121 Papaverin Tab 40 mg Tablet 0
122 Parasetamol Rektal 125 mg/2.5 ml Tube 0
123 Parasetamol Rektal 250 mg/2.5 ml Tube 0
124 Parasetamol sirup 120 mg/5 ml Botol 0
125 Parasetamol tablet 500 mg Tablet 0
126 Perak Sulfadiazin 1% (Burnazin) Tube 0
127 Piridoksin HCl (Vit.B6) tablet 10 mg Tablet 0
128 Prednison tablet 5 mg Tablet 0
129 Parasetamol Drop Botol 0
130 Pirantel suspensi Botol 0
131 Pehacain injeksi Ampul 0
132 Procurma sirup Botol 0
133 quinina Tablet 0
134 Ranitidin Tablet 0
135 Retinol (vit.A) 100,000 IU tablet salut Tablet 0
136 Retinol (vit.A) 200.000 IU kapsul lunak Tablet 0
137 Ringer Laktat larutan infus steril (Produk lo botol 0
138 Salbutamol Nebuliser Ampul 0
139 TXP ( Triheksifenidil hcl ) Tablet 0
140 Salbutamol tablet 2 mg Tablet 0
141 Salbutamol tablet 4 mg Tablet 0
142 Salisil Bedak 2 % Botol 0
143 Tetracycline Tablet 0
144 Tetagam Ampul 0
145 Sefadroxil tablet 500 mg Capsul 0
146 Sefadroxil 125 syr Botol 0
147 Sinvastatin tablet 10 mg Tablet 0
148 Siprofloxacin Tab 500 mg Tablet 0
149 Thiamin hcl tab ( B1) Tablet 0
150 Siobion Tablet 0
151 Vitamin B Kompleks tablet Tablet 0
152 Vitamin B 12 inj Ampul 0
153 Zinc tablet 20 mg Tablet 0
154 Vitacaps ( Multivitamin kapsul ) Tablet 0
155 Zinc tablet 20 mg Tablet 0
156 Zinc sirup Botol 0
157 Zinc drop Botol 0

TOTAL

D.BHP
188 Aqua pro Injeksi steril, bebas pirogen Fles 0
189 Alkohol sweb Kotak 0
190 Duk 60 x 60 pcs 0
191 Alat suntik 10 ml biji 0
192 Alat suntik 2,5 ml biji 0
193 Alat suntik 5 ml biji 0
194 Alat suntik 3 cc Pcs 0
195 Blood Lanset bok 0
196 Chirurgic gloves size 8.0 Pcs 0
197 Etanol ( alkohol ) 70 % 100 ml Botol 0
198 Etakridina ( rivanol ) larutan 0.1% Botol 0
199 Elastic Bandage uk 7,5 x 4,5 cm roll 0
200 Foley Cateter biji 0
201 Hand scund M Biji 0
Hand scund M Kotak 0
202 Hand scund S Biji 0
Hand scund S Kotak 0
203 Infuset anak set 0
204 Infuset dewasa set 0
205 IV cateter No 18 G Biji 0
206 IV cateter No 20 G Biji 0
207 IV cateter No 22 G Biji 0
208 Jarum Heacting no 14 Biji 0
209 Kapas Pembalut 250 gram Biji 0
210 Kapas Pembalut 250 gram Biji 0
211 Kasa Pembalut 2m x 80 cm Rol 0
212 Kasa Pembalut 2m x 80 cm Rol 0
213 Kasa Pembalut Hidrofil 4 x 15 cm Rol 0
214 Kasa Pembalut Hidrofil 4 x 3 cm Rol 0
215 Kasa hidropyl 40 x 80 cm Rol 0
216 Kasa Hydropil 16 cm x 16 cm Kotak 0
217 Kasa Kompres DRC 40 cm x 40 cm Pcs 0
218 Klip besar 15 x 10cm Biji 0
219 Klip sedang 13 x 10cm biji 0
220 Klip Kecil 10 x 7 cm biji 0
221 Lisol Botol 0
222 Masker biji 0
223 Masker bok 0
224 Medicin packet bok 0
225 Nurse cup Kotak 0
226 Nurse cup Kotak 0
227 Plester 5 yard x 2 inchi rol 0
228 Plester ultrafik 10 cm x 1 m Rol 0
229 Perhidrol HCL / H2O2 3% Botol 0
230 Pisau bedah no 11 biji 0
231 Pisau bedah no 10 biji
232 Pisau bedah no 12 biji
233 Supratul BIJI 0
234 Supratul bok 0
235 Silk benang Kotak 0
236 Tranfusi set set 0
237 Under ped biji 0
238 Urin Bag biji 0
239 Wing needle biji 0
240 Yodium povidon larutan 10% 300ml Botol 0
241 Needle 22G Flashback pcs 0

TOTAL

GRATIS BAYAR PHB/ASKES

JUMLAH KUNJUNGAN RESEP
 JUMLAH KUNJUNGAN RESEP

Mengetahui/Menyetujui YangMenyerahkan Yangmeminta

PimpinanPuskesmasKutaUtara Petugasgudangpuskesmas Pelaporpetugaspustu

dr. Ni Putu Purlimaningsih Ni Komang Ayu Triyani Ni Made Artini
NIP.197911202006042006 NIP.198801082011012016

 LAPORAN PENERIMAAN DAN LEMBAR PEMAKAIAN OBAT
(LPLPO )
LAPOR BULAN :

UPT PUSKESMAS : UPT PKM KUTA UTARA MINTA BULAN :

PUSKESMAS PEMBANTU YANG ADA :5 DOK NOMOR TANGGAL

PROVINSI : Bali IFK

UNIT : PUSTU CANGGU PKM

STOK PENERI PEMAKAI PERMINT TERIM

SISA STOK
NO NAMA OBAT SATUAN AWAL MAAN AN AAN A

JML JML JML JML JML JML

A. OBAT
1 Acyclovir tablet 400 mg Tablet 0
2 Acyclovir cream 5 % Tube 0
3 Alopurinol tablet 100 mg Tablet 0
4 Ambroxol syrup Botol 0
5 Ambroxol tablet 30 mg Tablet 0
6 Aminofilin tablet 200 mg Tablet 0
7 Amlodipine 10 mg T ablet 0
8 Amlodipine 5 mg T ablet 0
9 Amoksisilin kapletl 500 mg Kaplet 0
10 Amoksisilin kapletl 250 mg Kaplet 0
11 Amoksisilin Syr Forte 250 mg Botol 0
12 Amoksisilin sirup kering 125 mg/5ml Botol 0
13 Amoksisilin drop 100 mg/ml Botol 0
14 Antasida DOEN kombinasi Tablet 0
15 Astaxanthin 4 mg tab Tablet 0
16 Antasida DOEN suspensi Botol 0
17 Anti Hemoroid DOEN Kombinasi Sup 0
18 Asam Askorbat (Vit C) tablet 50 mg Tablet 0
19 Asam Folat Tablet 0
20 Asam mefenamat tab 500 mg Tablet 0
21 Albotyl (polikresol) Botol 0
22 Albendazole tab 400 mg Tablet 0
23 Azitromysin 500 Tablet 0
24 Anti TBC Anak Paket 0
25 Anti TBC Katagori I Paket 0
26 Anti TBC Katagori II Paket 0
27 Basitrasin 500 IU/g + Polimiksin 10.000 Tube 0
28 IU/g
Besi II Sulfat tablet kombinasi Tablet 0
29 Bioplacenton jelly tube 0
30 Betahistin mesilat 6 mg Tablet 0
31 Borax gliserine Botol 0
32 Balsam cap kaki 3 Tube 0
33 Betametason krim 0.1% Tube 0
34 Captopril 12,5 mg Tablet 0
35 Captopril 25 mg Tablet 0
36 Coparcetine ( Obat Flu dan batuk ) Tablet 0
37 Cetirizine 10 mg Tablet 0
38 Deksametason injeksi 5 mg/ml - 1 ml Ampul 0
39 Deksametason tablet 0,5 mg Tablet 0
40 Dasepam rectal 5 mg tube 0
41 Diasepam Inj 5 mg/ml Ampul 0
42 Diazepam tablet 2 mg Tablet 0
43 Difenhidramin HCl inj 10 mg/ml-1 ml Ampul 0
44 Digoksin tablet 0,25 mg Tablet 0
45 Doksisiklin Tablet 0
46 Domperidon Sirup Botol 0
47 Dextrofen ( Obat batuk dan pilek syr ) Botol 0
48 Domperidon drop Botol 0
49 Deksosimetason Tube 0
50 Dulcolak ( stolax Supp) Supp 0
51 Epinefrina (adrenalin) Injeksi 0,1% - 1 ml Ampul 0
52 Erytromicin 500 mg Tablet 0
53 Erfaflu ( Obat Flu syp ) Botol 0
54 Erytromicin syrup Botol 0
55 Erfakaf sirup Botol 0
56 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 Ampul 0
57 Fitomenadion (Vit.K1) tablet salut gula 10 Tablet 0
58 Fenobarbital tablet 30 mg Tablet 0
59 Furosemid tablet 40 mg Tablet 0
60 Fenol Gliserol tetes telinga 10% Botol 0
61 Garam Oralit untuk 200 ml air Sak 0
62 Gentamicin Sulfat TM 0,3% Botol 0
63 Gentamicin Salep kulit Tube 0
64 Glibenklamid tablet 5 mg Tablet 0
65 Griseofulvin tab 125 Tablet 0
66 Glimeperid 1 mg Tablet 0
67 Glimeperid 2 mg Tablet 0
68 Hidroklorotiazid (HCT) tablet 25 mg Tablet 0
69 Haloperidol 0,5 Tablet 0
70 Haloperidol 1,5 Tablet 0
71 Haloperidol 5 mg Tablet 0
72 Hidrokortison krim 2,5 % Tube 0
73 Hyoscine-N-Butilbromide 10 mg (Scopma) Tablet 0
74 Hyoscine-N-Butilbromide inj / Buscopan Ampul 0
75 Ibuprofen tablet 400 mg Tablet 0
76 Isosorbid Di Nitrat Tablet 0
77 Imunogard / Vitamin Imunitas Tablet 0
78 Ibuprofen tablet 200 mg Tablet 0
79 Ibuprofen Sirup Botol 0
80 Ketokonazole cream 2 % 15 gram Tube 0
81 Ketokonazole tablet 200 mg Tablet 0
82 Klindamycin 300 mg Tablet 0
83 Kloramfenikol tetes telinga 3 % Botol 0
84 Kloramphenikol salep mata 1 % Tube 0
85 Kloramphenikol Tetes Mata Botol 0
86 Klorfeniramin Maleat (CTM) tablet 4 mg Tablet 0
87 Klorpromazine HCL 100 MG ( CPZ) Tablet 0
88 Kotrimoksazol Suspensi Botol 0
89 Kotrimoksazol tablet 480 mg kombinasi Tablet 0
90 Kalium Gluconat Ampul 0
91 Lidokain comp Ampul 0
92 Lidokain injeksi Ampul 0
93 Levertran salep (salep minyak ikan) pot 0
94 Loperamid tablet 2 mg Tablet 0
95 Loratadin tablet 10 mg Tablet 0
96 Metformin 500 mg Tablet 0
97 Meloxicam 15 mg Tablet 0
98 Methyl Prednisolon 4 mg Tablet 0
99 Metilergometrin Maleat 0,125 mg Tablet 0
100 Metoklopramid syrup Botol 0
101 Metoklopramid tablet 5 mg Tablet 0
102 Metoklopramid hcl injeksi 5 mg Ampul 0
103 Metronidazol tablet 500 mg Tablet 0
104 Magnesium Sulfat Inj 40% 25 ml Ampul 0
105 Magnesium Sulfat Inj 20% 25 ml Ampul 0
106 Miconazol Tube 0
107 Metoklorpamid Hcl 5 mg/ml 2 ml Ampul 0
108 Metoklorpamid Hcl 5 mg tablet Tablet 0
109 Metronidazol vagina ( flagyl ) Supp 0
110 Natrium Diklofenac tablet 25 mg Botol 0
111 Natrium Diklofenac tablet 50 mg Tablet 0
112 Natrium Klorida larutan infus 0.9% steril Fles 0
113 New Diatabs ( Pularek ) Tablet 0
114 Nistatin tablet vaginal 100.000 IU/g Tablet 0
115 NB Salep Tube 0
116 OBH ( obat batuk hitam) Botol 0
117 Omeprazol 20 mg Tablet 0
118 Oksitosin inj Ampul 0
119 Ondancetron 8 mg Tablet 0
120 Ondansetron 8 mg inj Ampul 0
121 Papaverin Tab 40 mg Tablet 0
122 Parasetamol Rektal 125 mg/2.5 ml Tube 0
123 Parasetamol Rektal 250 mg/2.5 ml Tube 0
124 Parasetamol sirup 120 mg/5 ml Botol 0
125 Parasetamol tablet 500 mg Tablet 0
126 Perak Sulfadiazin 1% (Burnazin) Tube 0
127 Piridoksin HCl (Vit.B6) tablet 10 mg Tablet 0
128 Prednison tablet 5 mg Tablet 0
129 Parasetamol Drop Botol 0
130 Pirantel suspensi Botol 0
131 Pehacain injeksi Ampul 0
132 Procurma sirup Botol 0
133 quinina Tablet 0
134 Ranitidin Tablet 0
135 Retinol (vit.A) 100,000 IU tablet salut Tablet 0
136 Retinol (vit.A) 200.000 IU kapsul lunak Tablet 0
137 Ringer Laktat larutan infus steril (Produk lo botol 0
138 Salbutamol Nebuliser Ampul 0
139 TXP ( Triheksifenidil hcl ) Tablet 0
140 Salbutamol tablet 2 mg Tablet 0
141 Salbutamol tablet 4 mg Tablet 0
142 Salisil Bedak 2 % Botol 0
143 Tetracycline Tablet 0
144 Tetagam Ampul 0
145 Sefadroxil tablet 500 mg Capsul 0
146 Sefadroxil 125 syr Botol 0
147 Sinvastatin tablet 10 mg Tablet 0
148 Siprofloxacin Tab 500 mg Tablet 0
149 Thiamin hcl tab ( B1) Tablet 0
150 Siobion Tablet 0
151 Vitamin B Kompleks tablet Tablet 0
152 Vitamin B 12 inj Ampul 0
153 Zinc tablet 20 mg Tablet 0
154 Vitacaps ( Multivitamin kapsul ) Tablet 0
155 Zinc tablet 20 mg Tablet 0
156 Zinc sirup Botol 0
157 Zinc drop Botol 0

TOTAL

D.BHP
188 Aqua pro Injeksi steril, bebas pirogen Fles 0
189 Alkohol sweb Kotak 0
190 Duk 60 x 60 pcs 0
191 Alat suntik 10 ml biji 0
192 Alat suntik 2,5 ml biji 0
193 Alat suntik 5 ml biji 0
194 Alat suntik 3 cc Pcs 0
195 Blood Lanset bok 0
196 Chirurgic gloves size 8.0 Pcs 0
197 Etanol ( alkohol ) 70 % 100 ml Botol 0
198 Etakridina ( rivanol ) larutan 0.1% Botol 0
199 Elastic Bandage uk 7,5 x 4,5 cm roll 0
200 Foley Cateter biji 0
201 Hand scund M Biji 0
Hand scund M Kotak 0
202 Hand scund S Biji 0
Hand scund S Kotak 0
203 Infuset anak set 0
204 Infuset dewasa set 0
205 IV cateter No 18 G Biji 0
206 IV cateter No 20 G Biji 0
207 IV cateter No 22 G Biji 0
208 Jarum Heacting no 14 Biji 0
209 Kapas Pembalut 250 gram Biji 0
210 Kapas Pembalut 250 gram Biji 0
211 Kasa Pembalut 2m x 80 cm Rol 0
212 Kasa Pembalut 2m x 80 cm Rol 0
213 Kasa Pembalut Hidrofil 4 x 15 cm Rol 0
214 Kasa Pembalut Hidrofil 4 x 3 cm Rol 0
215 Kasa hidropyl 40 x 80 cm Rol 0
216 Kasa Hydropil 16 cm x 16 cm Kotak 0
217 Kasa Kompres DRC 40 cm x 40 cm Pcs 0
218 Klip besar 15 x 10cm Biji 0
219 Klip sedang 13 x 10cm biji 0
220 Klip Kecil 10 x 7 cm biji 0
221 Lisol Botol 0
222 Masker biji 0
223 Masker bok 0
224 Medicin packet bok 0
225 Nurse cup Kotak 0
226 Nurse cup Kotak 0
227 Plester 5 yard x 2 inchi rol 0
228 Plester ultrafik 10 cm x 1 m Rol 0
229 Perhidrol HCL / H2O2 3% Botol 0
230 Pisau bedah no 11 biji 0
231 Pisau bedah no 10 biji
232 Pisau bedah no 12 biji
233 Supratul BIJI 0
234 Supratul bok 0
235 Silk benang Kotak 0
236 Tranfusi set set 0
237 Under ped biji 0
238 Urin Bag biji 0
239 Wing needle biji 0
240 Yodium povidon larutan 10% 300ml Botol 0
241 Needle 22G Flashback pcs 0

TOTAL

GRATIS BAYAR PHB/ASKES

JUMLAH KUNJUNGAN RESEP
 JUMLAH KUNJUNGAN RESEP

Mengetahui/Menyetujui YangMenyerahkan Yangmeminta

PimpinanPuskesmasKutaUtara Petugasgudangpuskesmas Pelaporpetugaspustu

dr. Ni Putu Purlimaningsih Ni Komang Ayu Triyani Ni Made Artini
NIP.197911202006042006 NIP.198801082011012016

 LAPORAN PENERIMAAN DAN LEMBAR PEMAKAIAN OBAT
(LPLPO )
LAPOR BULAN :

UPT PUSKESMAS : UPT PKM KUTA UTARA MINTA BULAN :

PUSKESMAS PEMBANTU YANG ADA :5 DOK NOMOR TANGGAL

PROVINSI : Bali IFK

UNIT : PUSTU CANGGU PKM

STOK PENERI PEMAKAI PERMINT TERIM

SISA STOK
NO NAMA OBAT SATUAN AWAL MAAN AN AAN A

JML JML JML JML JML JML

A. OBAT
1 Acyclovir tablet 400 mg Tablet 0
2 Acyclovir cream 5 % Tube 0
3 Alopurinol tablet 100 mg Tablet 0
4 Ambroxol syrup Botol 0
5 Ambroxol tablet 30 mg Tablet 0
6 Aminofilin tablet 200 mg Tablet 0
7 Amlodipine 10 mg T ablet 0
8 Amlodipine 5 mg T ablet 0
9 Amoksisilin kapletl 500 mg Kaplet 0
10 Amoksisilin kapletl 250 mg Kaplet 0
11 Amoksisilin Syr Forte 250 mg Botol 0
12 Amoksisilin sirup kering 125 mg/5ml Botol 0
13 Amoksisilin drop 100 mg/ml Botol 0
14 Antasida DOEN kombinasi Tablet 0
15 Astaxanthin 4 mg tab Tablet 0
16 Antasida DOEN suspensi Botol 0
17 Anti Hemoroid DOEN Kombinasi Sup 0
18 Asam Askorbat (Vit C) tablet 50 mg Tablet 0
19 Asam Folat Tablet 0
20 Asam mefenamat tab 500 mg Tablet 0
21 Albotyl (polikresol) Botol 0
22 Albendazole tab 400 mg Tablet 0
23 Azitromysin 500 Tablet 0
24 Anti TBC Anak Paket 0
25 Anti TBC Katagori I Paket 0
26 Anti TBC Katagori II Paket 0
27 Basitrasin 500 IU/g + Polimiksin 10.000 Tube 0
28 IU/g
Besi II Sulfat tablet kombinasi Tablet 0
29 Bioplacenton jelly tube 0
30 Betahistin mesilat 6 mg Tablet 0
31 Borax gliserine Botol 0
32 Balsam cap kaki 3 Tube 0
33 Betametason krim 0.1% Tube 0
34 Captopril 12,5 mg Tablet 0
35 Captopril 25 mg Tablet 0
36 Coparcetine ( Obat Flu dan batuk ) Tablet 0
37 Cetirizine 10 mg Tablet 0
38 Deksametason injeksi 5 mg/ml - 1 ml Ampul 0
39 Deksametason tablet 0,5 mg Tablet 0
40 Dasepam rectal 5 mg tube 0
41 Diasepam Inj 5 mg/ml Ampul 0
42 Diazepam tablet 2 mg Tablet 0
43 Difenhidramin HCl inj 10 mg/ml-1 ml Ampul 0
44 Digoksin tablet 0,25 mg Tablet 0
45 Doksisiklin Tablet 0
46 Domperidon Sirup Botol 0
47 Dextrofen ( Obat batuk dan pilek syr ) Botol 0
48 Domperidon drop Botol 0
49 Deksosimetason Tube 0
50 Dulcolak ( stolax Supp) Supp 0
51 Epinefrina (adrenalin) Injeksi 0,1% - 1 ml Ampul 0
52 Erytromicin 500 mg Tablet 0
53 Erfaflu ( Obat Flu syp ) Botol 0
54 Erytromicin syrup Botol 0
55 Erfakaf sirup Botol 0
56 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 Ampul 0
57 Fitomenadion (Vit.K1) tablet salut gula 10 Tablet 0
58 Fenobarbital tablet 30 mg Tablet 0
59 Furosemid tablet 40 mg Tablet 0
60 Fenol Gliserol tetes telinga 10% Botol 0
61 Garam Oralit untuk 200 ml air Sak 0
62 Gentamicin Sulfat TM 0,3% Botol 0
63 Gentamicin Salep kulit Tube 0
64 Glibenklamid tablet 5 mg Tablet 0
65 Griseofulvin tab 125 Tablet 0
66 Glimeperid 1 mg Tablet 0
67 Glimeperid 2 mg Tablet 0
68 Hidroklorotiazid (HCT) tablet 25 mg Tablet 0
69 Haloperidol 0,5 Tablet 0
70 Haloperidol 1,5 Tablet 0
71 Haloperidol 5 mg Tablet 0
72 Hidrokortison krim 2,5 % Tube 0
73 Hyoscine-N-Butilbromide 10 mg (Scopma) Tablet 0
74 Hyoscine-N-Butilbromide inj / Buscopan Ampul 0
75 Ibuprofen tablet 400 mg Tablet 0
76 Isosorbid Di Nitrat Tablet 0
77 Imunogard / Vitamin Imunitas Tablet 0
78 Ibuprofen tablet 200 mg Tablet 0
79 Ibuprofen Sirup Botol 0
80 Ketokonazole cream 2 % 15 gram Tube 0
81 Ketokonazole tablet 200 mg Tablet 0
82 Klindamycin 300 mg Tablet 0
83 Kloramfenikol tetes telinga 3 % Botol 0
84 Kloramphenikol salep mata 1 % Tube 0
85 Kloramphenikol Tetes Mata Botol 0
86 Klorfeniramin Maleat (CTM) tablet 4 mg Tablet 0
87 Klorpromazine HCL 100 MG ( CPZ) Tablet 0
88 Kotrimoksazol Suspensi Botol 0
89 Kotrimoksazol tablet 480 mg kombinasi Tablet 0
90 Kalium Gluconat Ampul 0
91 Lidokain comp Ampul 0
92 Lidokain injeksi Ampul 0
93 Levertran salep (salep minyak ikan) pot 0
94 Loperamid tablet 2 mg Tablet 0
95 Loratadin tablet 10 mg Tablet 0
96 Metformin 500 mg Tablet 0
97 Meloxicam 15 mg Tablet 0
98 Methyl Prednisolon 4 mg Tablet 0
99 Metilergometrin Maleat 0,125 mg Tablet 0
100 Metoklopramid syrup Botol 0
101 Metoklopramid tablet 5 mg Tablet 0
102 Metoklopramid hcl injeksi 5 mg Ampul 0
103 Metronidazol tablet 500 mg Tablet 0
104 Magnesium Sulfat Inj 40% 25 ml Ampul 0
105 Magnesium Sulfat Inj 20% 25 ml Ampul 0
106 Miconazol Tube 0
107 Metoklorpamid Hcl 5 mg/ml 2 ml Ampul 0
108 Metoklorpamid Hcl 5 mg tablet Tablet 0
109 Metronidazol vagina ( flagyl ) Supp 0
110 Natrium Diklofenac tablet 25 mg Botol 0
111 Natrium Diklofenac tablet 50 mg Tablet 0
112 Natrium Klorida larutan infus 0.9% steril Fles 0
113 New Diatabs ( Pularek ) Tablet 0
114 Nistatin tablet vaginal 100.000 IU/g Tablet 0
115 NB Salep Tube 0
116 OBH ( obat batuk hitam) Botol 0
117 Omeprazol 20 mg Tablet 0
118 Oksitosin inj Ampul 0
119 Ondancetron 8 mg Tablet 0
120 Ondansetron 8 mg inj Ampul 0
121 Papaverin Tab 40 mg Tablet 0
122 Parasetamol Rektal 125 mg/2.5 ml Tube 0
123 Parasetamol Rektal 250 mg/2.5 ml Tube 0
124 Parasetamol sirup 120 mg/5 ml Botol 0
125 Parasetamol tablet 500 mg Tablet 0
126 Perak Sulfadiazin 1% (Burnazin) Tube 0
127 Piridoksin HCl (Vit.B6) tablet 10 mg Tablet 0
128 Prednison tablet 5 mg Tablet 0
129 Parasetamol Drop Botol 0
130 Pirantel suspensi Botol 0
131 Pehacain injeksi Ampul 0
132 Procurma sirup Botol 0
133 quinina Tablet 0
134 Ranitidin Tablet 0
135 Retinol (vit.A) 100,000 IU tablet salut Tablet 0
136 Retinol (vit.A) 200.000 IU kapsul lunak Tablet 0
137 Ringer Laktat larutan infus steril (Produk lo botol 0
138 Salbutamol Nebuliser Ampul 0
139 TXP ( Triheksifenidil hcl ) Tablet 0
140 Salbutamol tablet 2 mg Tablet 0
141 Salbutamol tablet 4 mg Tablet 0
142 Salisil Bedak 2 % Botol 0
143 Tetracycline Tablet 0
144 Tetagam Ampul 0
145 Sefadroxil tablet 500 mg Capsul 0
146 Sefadroxil 125 syr Botol 0
147 Sinvastatin tablet 10 mg Tablet 0
148 Siprofloxacin Tab 500 mg Tablet 0
149 Thiamin hcl tab ( B1) Tablet 0
150 Siobion Tablet 0
151 Vitamin B Kompleks tablet Tablet 0
152 Vitamin B 12 inj Ampul 0
153 Zinc tablet 20 mg Tablet 0
154 Vitacaps ( Multivitamin kapsul ) Tablet 0
155 Zinc tablet 20 mg Tablet 0
156 Zinc sirup Botol 0
157 Zinc drop Botol 0

TOTAL

D.BHP
188 Aqua pro Injeksi steril, bebas pirogen Fles 0
189 Alkohol sweb Kotak 0
190 Duk 60 x 60 pcs 0
191 Alat suntik 10 ml biji 0
192 Alat suntik 2,5 ml biji 0
193 Alat suntik 5 ml biji 0
194 Alat suntik 3 cc Pcs 0
195 Blood Lanset bok 0
196 Chirurgic gloves size 8.0 Pcs 0
197 Etanol ( alkohol ) 70 % 100 ml Botol 0
198 Etakridina ( rivanol ) larutan 0.1% Botol 0
199 Elastic Bandage uk 7,5 x 4,5 cm roll 0
200 Foley Cateter biji 0
201 Hand scund M Biji 0
Hand scund M Kotak 0
202 Hand scund S Biji 0
Hand scund S Kotak 0
203 Infuset anak set 0
204 Infuset dewasa set 0
205 IV cateter No 18 G Biji 0
206 IV cateter No 20 G Biji 0
207 IV cateter No 22 G Biji 0
208 Jarum Heacting no 14 Biji 0
209 Kapas Pembalut 250 gram Biji 0
210 Kapas Pembalut 250 gram Biji 0
211 Kasa Pembalut 2m x 80 cm Rol 0
212 Kasa Pembalut 2m x 80 cm Rol 0
213 Kasa Pembalut Hidrofil 4 x 15 cm Rol 0
214 Kasa Pembalut Hidrofil 4 x 3 cm Rol 0
215 Kasa hidropyl 40 x 80 cm Rol 0
216 Kasa Hydropil 16 cm x 16 cm Kotak 0
217 Kasa Kompres DRC 40 cm x 40 cm Pcs 0
218 Klip besar 15 x 10cm Biji 0
219 Klip sedang 13 x 10cm biji 0
220 Klip Kecil 10 x 7 cm biji 0
221 Lisol Botol 0
222 Masker biji 0
223 Masker bok 0
224 Medicin packet bok 0
225 Nurse cup Kotak 0
226 Nurse cup Kotak 0
227 Plester 5 yard x 2 inchi rol 0
228 Plester ultrafik 10 cm x 1 m Rol 0
229 Perhidrol HCL / H2O2 3% Botol 0
230 Pisau bedah no 11 biji 0
231 Pisau bedah no 10 biji
232 Pisau bedah no 12 biji
233 Supratul BIJI 0
234 Supratul bok 0
235 Silk benang Kotak 0
236 Tranfusi set set 0
237 Under ped biji 0
238 Urin Bag biji 0
239 Wing needle biji 0
240 Yodium povidon larutan 10% 300ml Botol 0
241 Needle 22G Flashback pcs 0

TOTAL

GRATIS BAYAR PHB/ASKES

JUMLAH KUNJUNGAN RESEP
 JUMLAH KUNJUNGAN RESEP

Mengetahui/Menyetujui YangMenyerahkan Yangmeminta

PimpinanPuskesmasKutaUtara Petugasgudangpuskesmas Pelaporpetugaspustu

dr. Ni Putu Purlimaningsih Ni Komang Ayu Triyani Ni Made Artini
NIP.197911202006042006 NIP.198801082011012016

 LAPORAN TRIWULAN II PUKESMAS KUTA UTARA
( APRIL MEI JUNI ) 2017

UPT PUSKESMAS : UPT PKM KUTA UTARA

PUSKESMAS PEMBANTU YANG ADA :5
PROVINSI : Bali
UNIT : PUSTU CANGGU

HARGA STOK AWAL

NO NAMA OBAT SATUAN
SATUAN
JML
A. OBAT
1 Acyclovir tablet 400 mg Tablet 750
2 Acyclovir cream 5 % Tube 3000
3 Alopurinol tablet 100 mg Tablet 120
4 Ambroxol syrup Botol 3300
5 Ambroxol tablet 30 mg Tablet 125
6 Aminofilin tablet 200 mg Tablet 104
7 Amlodipine 10 mg T ablet
8 Amlodipine 5 mg T ablet 105
9 Amoksisilin kapletl 500 mg Kaplet 370
10 Amoksisilin kapletl 250 mg Kaplet 216
11 Amoksisilin Syr Forte 250 mg Botol
12 Amoksisilin sirup kering 125 mg/5ml Botol 3699
13 Amoksisilin drop 100 mg/ml Botol 29580
14 Antasida DOEN kombinasi Tablet 135
15 Astaxanthin 4 mg tab Tablet 2379
16 Antasida DOEN suspensi Botol 2643
17 Anti Hemoroid DOEN Kombinasi Sup 1470
18 Asam Askorbat (Vit C) tablet 50 mg Tablet 19
19 Asam Folat Tablet 62
20 Asam mefenamat tab 500 mg Tablet 176
21 Albotyl (polikresol) Botol 21801
22 Albendazole tab 400 mg Tablet
23 Azitromysin 500 Tablet 4500
24 Anti TBC Anak Paket 214990
25 Anti TBC Katagori I Paket 359990
26 Anti TBC Katagori II Paket 1199900
27 Basitrasin 500 IU/g + Polimiksin 10.000 IU/g Tube 2517
28 Besi II Sulfat tablet kombinasi Tablet 27
29 Bioplacenton jelly tube 17530
30 Betahistin mesilat 6 mg Tablet 924
31 Borax gliserine Botol 6270
32 Balsam cap kaki 3 Tube
33 Betametason krim 0.1% Tube 1866
34 Captopril 12,5 mg Tablet 71
35 Captopril 25 mg Tablet 138
36 Coparcetine ( Obat Flu dan batuk ) Tablet 915
37 Cetirizine 10 mg Tablet 330
38 Deksametason injeksi 5 mg/ml - 1 ml Ampul 1580
39 Deksametason tablet 0,5 mg Tablet 24
40 Dasepam rectal 5 mg tube 11517
41 Diasepam Inj 5 mg/ml Ampul 2344
42 Diazepam tablet 2 mg Tablet 13
43 Difenhidramin HCl inj 10 mg/ml-1 ml Ampul 1050
44 Digoksin tablet 0,25 mg Tablet 83
45 Doksisiklin Tablet 230
46 Domperidon Sirup Botol 3624
47 Dextrofen ( Obat batuk dan pilek syr ) Botol 10390
48 Domperidon drop Botol 15600
49 Deksosimetason Tube 9983
50 Dulcolak ( stolax Supp) Supp 6045
51 Epinefrina (adrenalin) Injeksi 0,1% - 1 ml Ampul 2204
52 Erytromicin 500 mg Tablet 535
53 Erfaflu ( Obat Flu syp ) Botol
54 Erytromicin syrup Botol 6700
55 Erfakaf sirup Botol 12980
56 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 ml Ampul 978
57 Fitomenadion (Vit.K1) tablet salut gula 10 mg Tablet 681
58 Fenobarbital tablet 30 mg Tablet 32
59 Furosemid tablet 40 mg Tablet 72
60 Fenol Gliserol tetes telinga 10% Botol 1008
61 Garam Oralit untuk 200 ml air Sak 440
62 Gentamicin Sulfat TM 0,3% Botol 3194
63 Gentamicin Salep kulit Tube 1650
64 Glibenklamid tablet 5 mg Tablet 72
65 Griseofulvin tab 125 Tablet 225
66 Glimeperid 1 mg Tablet 265
67 Glimeperid 2 mg Tablet 436
68 Hidroklorotiazid (HCT) tablet 25 mg Tablet 36
69 Haloperidol 0,5 Tablet 60
70 Haloperidol 1,5 Tablet 123
71 Haloperidol 5 mg Tablet 60
72 Hidrokortison krim 2,5 % Tube 3000
73 Hyoscine-N-Butilbromide 10 mg (Scopma) Tablet 1040
74 Hyoscine-N-Butilbromide inj / Buscopan Ampul 2467
75 Ibuprofen tablet 400 mg Tablet 150
76 Isosorbid Di Nitrat Tablet 65
77 Imunogard / Vitamin Imunitas Tablet 9990
78 Ibuprofen tablet 200 mg Tablet 105
79 Ibuprofen Sirup Botol 3499
80 Ketokonazole cream 2 % 15 gram Tube 4666
81 Ketokonazole tablet 200 mg Tablet 372
82 Klindamycin 300 mg Tablet 685
83 Kloramfenikol tetes telinga 3 % Botol 1000
84 Kloramphenikol salep mata 1 % Tube 1563
85 Kloramphenikol Tetes Mata Botol 2499
86 Klorfeniramin Maleat (CTM) tablet 4 mg Tablet 24
87 Klorpromazine HCL 100 MG ( CPZ) Tablet 104
88 Kotrimoksazol Suspensi Botol 3500
89 Kotrimoksazol tablet 480 mg kombinasi Tablet 165
90 Kalium Gluconat Ampul 7800
91 Lidokain comp Ampul 1033
92 Lidokain injeksi Ampul 1010
93 Levertran salep (salep minyak ikan) pot 1350
94 Loperamid tablet 2 mg Tablet 89
95 Loratadin tablet 10 mg Tablet 154
96 Metformin 500 mg Tablet 182
97 Meloxicam 15 mg Tablet 113
98 Methyl Prednisolon 4 mg Tablet 509
99 Metilergometrin Maleat 0,125 mg Tablet 154
100 Metoklopramid syrup Botol 1914
101 Metoklopramid tablet 5 mg Tablet 73
102 Metoklopramid hcl injeksi 5 mg Ampul 1947
103 Metronidazol tablet 500 mg Tablet 154
104 Magnesium Sulfat Inj 40% 25 ml Ampul 1948
105 Magnesium Sulfat Inj 20% 25 ml Ampul 5500
106 Miconazol Tube 1719
107 Metoklorpamid Hcl 5 mg/ml 2 ml Ampul 7425
108 Metoklorpamid Hcl 5 mg tablet Tablet 73
109 Metronidazol vagina ( flagyl ) Supp 3220
110 Natrium Diklofenac tablet 25 mg Botol 168
111 Natrium Diklofenac tablet 50 mg Tablet 218
112 Natrium Klorida larutan infus 0.9% steril Fles 4899
113 New Diatabs ( Pularek ) Tablet 190
114 Nistatin tablet vaginal 100.000 IU/g Tablet 289
115 NB Salep Tube 20302
116 OBH ( obat batuk hitam) Botol 2500
117 Omeprazol 20 mg Tablet 408
118 Oksitosin inj Ampul 1785
119 Ondancetron 8 mg Tablet 2596
120 Ondansetron 8 mg inj Ampul 10384
121 Papaverin Tab 40 mg Tablet 57
122 Parasetamol Rektal 125 mg/2.5 ml Tube 12672
123 Parasetamol Rektal 250 mg/2.5 ml Tube 32259
124 Parasetamol sirup 120 mg/5 ml Botol 1725
125 Parasetamol tablet 500 mg Tablet 45
126 Perak Sulfadiazin 1% (Burnazin) Tube 33000
127 Piridoksin HCl (Vit.B6) tablet 10 mg Tablet 14
128 Prednison tablet 5 mg Tablet 38
129 Parasetamol Drop Botol 4799
130 Pirantel suspensi Botol 8360
131 Pehacain injeksi Ampul 1363
132 Procurma sirup Botol 14850
133 quinina Tablet 670
134 Ranitidin Tablet 200
135 Retinol (vit.A) 100,000 IU tablet salut Tablet 260
136 Retinol (vit.A) 200.000 IU kapsul lunak Tablet 459
137 Ringer Laktat larutan infus steril (Produk lokal) botol 5200
138 Salbutamol Nebuliser Ampul 10533
139 TXP ( Triheksifenidil hcl ) Tablet 11946
140 Salbutamol tablet 2 mg Tablet 88
141 Salbutamol tablet 4 mg Tablet 97
142 Salisil Bedak 2 % Botol 1025
143 Tetracycline Tablet 257
144 Tetagam Ampul 61817
145 Sefadroxil tablet 500 mg Capsul 700
146 Sefadroxil 125 syr Botol 7227
147 Sinvastatin tablet 10 mg Tablet 513
148 Siprofloxacin Tab 500 mg Tablet 240
149 Thiamin hcl tab ( B1) Tablet 37
150 Siobion Tablet 1194
151 Vitamin B Kompleks tablet Tablet 22
152 Vitamin B 12 inj Ampul 473
153 Zinc tablet 20 mg Tablet 472
154 Vitacaps ( Multivitamin kapsul ) Tablet 948
155 Zinc tablet 20 mg Tablet 470
156 Zinc sirup Botol 12840
157 Zinc drop Botol 12840

TOTAL

D.BHP
188 Aqua pro Injeksi steril, bebas pirogen Fles 1500
189 Alkohol sweb Kotak 5500
190 Duk 60 x 60 pcs
191 Alat suntik 10 ml biji 2750
192 Alat suntik 2,5 ml biji 591
193 Alat suntik 5 ml biji 2640
194 Alat suntik 3 cc Pcs 788
195 Blood Lanset bok 19800
196 Chirurgic gloves size 8.0 Pcs 7980
197 Etanol ( alkohol ) 70 % 100 ml Botol 2500
198 Etakridina ( rivanol ) larutan 0.1% Botol 1800
199 Elastic Bandage uk 7,5 x 4,5 cm roll 81400
200 Foley Cateter biji 8494
201 Hand scund M Biji 360
Hand scund M Kotak 44100
202 Hand scund S Biji 360
Hand scund S Kotak 44100
203 Infuset anak set 3185
204 Infuset dewasa set 2910
205 IV cateter No 18 G Biji 5148
206 IV cateter No 20 G Biji 5148
207 IV cateter No 22 G Biji 5148
208 Jarum Heacting no 14 Biji 15840
209 Kapas Pembalut 250 gram Biji 11396
210 Kapas Pembalut 250 gram Biji 11300
211 Kasa Pembalut 2m x 80 cm Rol 21120
212 Kasa Pembalut 2m x 80 cm Rol 7000
213 Kasa Pembalut Hidrofil 4 x 15 cm Rol 11688
214 Kasa Pembalut Hidrofil 4 x 3 cm Rol 1584
215 Kasa hidropyl 40 x 80 cm Rol 95000
216 Kasa Hydropil 16 cm x 16 cm Kotak 5230
217 Kasa Kompres DRC 40 cm x 40 cm Pcs 1640
218 Klip besar 15 x 10cm Biji 138
219 Klip sedang 13 x 10cm biji 99
220 Klip Kecil 10 x 7 cm biji 79
221 Lisol Botol 37300
222 Masker biji 436
223 Masker bok 21780
224 Medicin packet bok 2310000
225 Nurse cup Kotak 649
226 Nurse cup Kotak 49500
227 Plester 5 yard x 2 inchi rol 31999
228 Plester ultrafik 10 cm x 1 m Rol 8470
229 Perhidrol HCL / H2O2 3% Botol 10800
230 Pisau bedah no 11 biji 660
231 Pisau bedah no 10 biji
232 Pisau bedah no 12 biji
233 Supratul BIJI 11300
234 Supratul bok 206030
235 Silk benang Kotak 6600
236 Tranfusi set set 15015
237 Under ped biji 52800
238 Urin Bag biji 8800
239 Wing needle biji 7400
240 Yodium povidon larutan 10% 300ml Botol 14500
241 Needle 22G Flashback pcs 1650

TOTAL
TOTAL KESELURUHAN

GRATIS BAYAR
JUMLAH KUNJUNGAN RESEP

Mengetahui/Menyetujui
PimpinanPuskesmasKutaUtara


Mengetahui/Menyetujui YangMenyerahkan
PimpinanPuskesmasKutaUtara Petugasgudangpuskesmas

dr. Ni Putu Purlimaningsih Ni Komang Ayu Triyani
NIP.197911202006042006 NIP.198801082011012016

AS KUTA UTARA
17

PENERIM PEMAKAIA
SISA STOK
AAN N

JML JML JML RUPIAH

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

BAYAR PHB/ASKES JUMLAH

Yangmeminta
Pelaporpetugaspustu

 LAPORAN PENERIMAAN DAN LEMBAR PEMAKAIAN OBAT

(LPLPO )
LAPOR BULAN :

UPT PUSKESMAS : UPT PKM KUTA UTARA MINTA BULAN :

PUSKESMAS PEMBANTU YANG ADA :5 DOK NOMOR TANGGAL

PROVINSI : Bali IFK

UNIT : PUSTU CANGGU PKM

STOK PENERI PEMAKAI PERMINT TERIM

SISA STOK
NO NAMA OBAT SATUAN AWAL MAAN AN AAN A

JML JML JML JML JML JML

A. OBAT
1 Acyclovir tablet 400 mg Tablet 0
2 Acyclovir cream 5 % Tube 0
3 Alopurinol tablet 100 mg Tablet 0
4 Ambroxol syrup Botol 0
5 Ambroxol tablet 30 mg Tablet 0
6 Aminofilin tablet 200 mg Tablet 0
7 Amlodipine 10 mg T ablet 0
8 Amlodipine 5 mg T ablet 0
9 Amoksisilin kapletl 500 mg Kaplet 0
10 Amoksisilin kapletl 250 mg Kaplet 0
11 Amoksisilin Syr Forte 250 mg Botol 0
12 Amoksisilin sirup kering 125 mg/5ml Botol 0
13 Amoksisilin drop 100 mg/ml Botol 0
14 Antasida DOEN kombinasi Tablet 0
15 Astaxanthin 4 mg tab Tablet 0
16 Antasida DOEN suspensi Botol 0
17 Anti Hemoroid DOEN Kombinasi Sup 0
18 Asam Askorbat (Vit C) tablet 50 mg Tablet 0
19 Asam Folat Tablet 0
20 Asam mefenamat tab 500 mg Tablet 0
21 Albotyl (polikresol) Botol 0
22 Albendazole tab 400 mg Tablet 0
23 Azitromysin 500 Tablet 0
24 Anti TBC Anak Paket 0
25 Anti TBC Katagori I Paket 0
26 Anti TBC Katagori II Paket 0
27 Basitrasin 500 IU/g + Polimiksin 10.000 Tube 0
28 IU/g
Besi II Sulfat tablet kombinasi Tablet 0
29 Bioplacenton jelly tube 0
30 Betahistin mesilat 6 mg Tablet 0
31 Borax gliserine Botol 0
32 Balsam cap kaki 3 Tube 0
33 Betametason krim 0.1% Tube 0
34 Captopril 12,5 mg Tablet 0
35 Captopril 25 mg Tablet 0
36 Coparcetine ( Obat Flu dan batuk ) Tablet 0
37 Cetirizine 10 mg Tablet 0
38 Deksametason injeksi 5 mg/ml - 1 ml Ampul 0
39 Deksametason tablet 0,5 mg Tablet 0
40 Dasepam rectal 5 mg tube 0
41 Diasepam Inj 5 mg/ml Ampul 0
42 Diazepam tablet 2 mg Tablet 0
43 Difenhidramin HCl inj 10 mg/ml-1 ml Ampul 0
44 Digoksin tablet 0,25 mg Tablet 0
45 Doksisiklin Tablet 0
46 Domperidon Sirup Botol 0
47 Dextrofen ( Obat batuk dan pilek syr ) Botol 0
48 Domperidon drop Botol 0
49 Deksosimetason Tube 0
50 Dulcolak ( stolax Supp) Supp 0
51 Epinefrina (adrenalin) Injeksi 0,1% - 1 ml Ampul 0
52 Erytromicin 500 mg Tablet 0
53 Erfaflu ( Obat Flu syp ) Botol 0
54 Erytromicin syrup Botol 0
55 Erfakaf sirup Botol 0
56 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 Ampul 0
57 Fitomenadion (Vit.K1) tablet salut gula 10 Tablet 0
58 Fenobarbital tablet 30 mg Tablet 0
59 Furosemid tablet 40 mg Tablet 0
60 Fenol Gliserol tetes telinga 10% Botol 0
61 Garam Oralit untuk 200 ml air Sak 0
62 Gentamicin Sulfat TM 0,3% Botol 0
63 Gentamicin Salep kulit Tube 0
64 Glibenklamid tablet 5 mg Tablet 0
65 Griseofulvin tab 125 Tablet 0
66 Glimeperid 1 mg Tablet 0
67 Glimeperid 2 mg Tablet 0
68 Hidroklorotiazid (HCT) tablet 25 mg Tablet 0
69 Haloperidol 0,5 Tablet 0
70 Haloperidol 1,5 Tablet 0
71 Haloperidol 5 mg Tablet 0
72 Hidrokortison krim 2,5 % Tube 0
73 Hyoscine-N-Butilbromide 10 mg (Scopma) Tablet 0
74 Hyoscine-N-Butilbromide inj / Buscopan Ampul 0
75 Ibuprofen tablet 400 mg Tablet 0
76 Isosorbid Di Nitrat Tablet 0
77 Imunogard / Vitamin Imunitas Tablet 0
78 Ibuprofen tablet 200 mg Tablet 0
79 Ibuprofen Sirup Botol 0
80 Ketokonazole cream 2 % 15 gram Tube 0
81 Ketokonazole tablet 200 mg Tablet 0
82 Klindamycin 300 mg Tablet 0
83 Kloramfenikol tetes telinga 3 % Botol 0
84 Kloramphenikol salep mata 1 % Tube 0
85 Kloramphenikol Tetes Mata Botol 0
86 Klorfeniramin Maleat (CTM) tablet 4 mg Tablet 0
87 Klorpromazine HCL 100 MG ( CPZ) Tablet 0
88 Kotrimoksazol Suspensi Botol 0
89 Kotrimoksazol tablet 480 mg kombinasi Tablet 0
90 Kalium Gluconat Ampul 0
91 Lidokain comp Ampul 0
92 Lidokain injeksi Ampul 0
93 Levertran salep (salep minyak ikan) pot 0
94 Loperamid tablet 2 mg Tablet 0
95 Loratadin tablet 10 mg Tablet 0
96 Metformin 500 mg Tablet 0
97 Meloxicam 15 mg Tablet 0
98 Methyl Prednisolon 4 mg Tablet 0
99 Metilergometrin Maleat 0,125 mg Tablet 0
100 Metoklopramid syrup Botol 0
101 Metoklopramid tablet 5 mg Tablet 0
102 Metoklopramid hcl injeksi 5 mg Ampul 0
103 Metronidazol tablet 500 mg Tablet 0
104 Magnesium Sulfat Inj 40% 25 ml Ampul 0
105 Magnesium Sulfat Inj 20% 25 ml Ampul 0
106 Miconazol Tube 0
107 Metoklorpamid Hcl 5 mg/ml 2 ml Ampul 0
108 Metoklorpamid Hcl 5 mg tablet Tablet 0
109 Metronidazol vagina ( flagyl ) Supp 0
110 Natrium Diklofenac tablet 25 mg Botol 0
111 Natrium Diklofenac tablet 50 mg Tablet 0
112 Natrium Klorida larutan infus 0.9% steril Fles 0
113 New Diatabs ( Pularek ) Tablet 0
114 Nistatin tablet vaginal 100.000 IU/g Tablet 0
115 NB Salep Tube 0
116 OBH ( obat batuk hitam) Botol 0
117 Omeprazol 20 mg Tablet 0
118 Oksitosin inj Ampul 0
119 Ondancetron 8 mg Tablet 0
120 Ondansetron 8 mg inj Ampul 0
121 Papaverin Tab 40 mg Tablet 0
122 Parasetamol Rektal 125 mg/2.5 ml Tube 0
123 Parasetamol Rektal 250 mg/2.5 ml Tube 0
124 Parasetamol sirup 120 mg/5 ml Botol 0
125 Parasetamol tablet 500 mg Tablet 0
126 Perak Sulfadiazin 1% (Burnazin) Tube 0
127 Piridoksin HCl (Vit.B6) tablet 10 mg Tablet 0
128 Prednison tablet 5 mg Tablet 0
129 Parasetamol Drop Botol 0
130 Pirantel suspensi Botol 0
131 Pehacain injeksi Ampul 0
132 Procurma sirup Botol 0
133 quinina Tablet 0
134 Ranitidin Tablet 0
135 Retinol (vit.A) 100,000 IU tablet salut Tablet 0
136 Retinol (vit.A) 200.000 IU kapsul lunak Tablet 0
137 Ringer Laktat larutan infus steril (Produk lo botol 0
138 Salbutamol Nebuliser Ampul 0
139 TXP ( Triheksifenidil hcl ) Tablet 0
140 Salbutamol tablet 2 mg Tablet 0
141 Salbutamol tablet 4 mg Tablet 0
142 Salisil Bedak 2 % Botol 0
143 Tetracycline Tablet 0
144 Tetagam Ampul 0
145 Sefadroxil tablet 500 mg Capsul 0
146 Sefadroxil 125 syr Botol 0
147 Sinvastatin tablet 10 mg Tablet 0
148 Siprofloxacin Tab 500 mg Tablet 0
149 Thiamin hcl tab ( B1) Tablet 0
150 Siobion Tablet 0
151 Vitamin B Kompleks tablet Tablet 0
152 Vitamin B 12 inj Ampul 0
153 Zinc tablet 20 mg Tablet 0
154 Vitacaps ( Multivitamin kapsul ) Tablet 0
155 Zinc tablet 20 mg Tablet 0
156 Zinc sirup Botol 0
157 Zinc drop Botol 0

TOTAL

D.BHP
188 Aqua pro Injeksi steril, bebas pirogen Fles 0
189 Alkohol sweb Kotak 0
190 Duk 60 x 60 pcs 0
191 Alat suntik 10 ml biji 0
192 Alat suntik 2,5 ml biji 0
193 Alat suntik 5 ml biji 0
194 Alat suntik 3 cc Pcs 0
195 Blood Lanset bok 0
196 Chirurgic gloves size 8.0 Pcs 0
197 Etanol ( alkohol ) 70 % 100 ml Botol 0
198 Etakridina ( rivanol ) larutan 0.1% Botol 0
199 Elastic Bandage uk 7,5 x 4,5 cm roll 0
200 Foley Cateter biji 0
201 Hand scund M Biji 0
Hand scund M Kotak 0
202 Hand scund S Biji 0
Hand scund S Kotak 0
203 Infuset anak set 0
204 Infuset dewasa set 0
205 IV cateter No 18 G Biji 0
206 IV cateter No 20 G Biji 0
207 IV cateter No 22 G Biji 0
208 Jarum Heacting no 14 Biji 0
209 Kapas Pembalut 250 gram Biji 0
210 Kapas Pembalut 250 gram Biji 0
211 Kasa Pembalut 2m x 80 cm Rol 0
212 Kasa Pembalut 2m x 80 cm Rol 0
213 Kasa Pembalut Hidrofil 4 x 15 cm Rol 0
214 Kasa Pembalut Hidrofil 4 x 3 cm Rol 0
215 Kasa hidropyl 40 x 80 cm Rol 0
216 Kasa Hydropil 16 cm x 16 cm Kotak 0
217 Kasa Kompres DRC 40 cm x 40 cm Pcs 0
218 Klip besar 15 x 10cm Biji 0
219 Klip sedang 13 x 10cm biji 0
220 Klip Kecil 10 x 7 cm biji 0
221 Lisol Botol 0
222 Masker biji 0
223 Masker bok 0
224 Medicin packet bok 0
225 Nurse cup Kotak 0
226 Nurse cup Kotak 0
227 Plester 5 yard x 2 inchi rol 0
228 Plester ultrafik 10 cm x 1 m Rol 0
229 Perhidrol HCL / H2O2 3% Botol 0
230 Pisau bedah no 11 biji 0
231 Pisau bedah no 10 biji
232 Pisau bedah no 12 biji
233 Supratul BIJI 0
234 Supratul bok 0
235 Silk benang Kotak 0
236 Tranfusi set set 0
237 Under ped biji 0
238 Urin Bag biji 0
239 Wing needle biji 0
240 Yodium povidon larutan 10% 300ml Botol 0
241 Needle 22G Flashback pcs 0

TOTAL

GRATIS BAYAR PHB/ASKES

JUMLAH KUNJUNGAN RESEP

Mengetahui/Menyetujui YangMenyerahkan Yangmeminta

PimpinanPuskesmasKutaUtara Petugasgudangpuskesmas Pelaporpetugaspustu

dr. Ni Putu Purlimaningsih Ni Komang Ayu Triyani Ni Made Artini
NIP.197911202006042006 NIP.198801082011012016



dr. Ni Putu Purlimaningsih Ni Komang Ayu Triyani
NIP.197911202006042006 NIP.198801082011012016

 LAPORAN PENERIMAAN DAN LEMBAR PEMAKAIAN OBAT
(LPLPO )
LAPOR BULAN :

UPT PUSKESMAS : UPT PKM KUTA UTARA MINTA BULAN :

PUSKESMAS PEMBANTU YANG ADA :5 DOK NOMOR TANGGAL

PROVINSI : Bali IFK

UNIT : PUSTU CANGGU PKM

STOK PENERI PEMAKAI PERMINT TERIM

SISA STOK
NO NAMA OBAT SATUAN AWAL MAAN AN AAN A

JML JML JML JML JML JML

A. OBAT
1 Acyclovir tablet 400 mg Tablet 0
2 Acyclovir cream 5 % Tube 0
3 Alopurinol tablet 100 mg Tablet 0
4 Ambroxol syrup Botol 0
5 Ambroxol tablet 30 mg Tablet 0
6 Aminofilin tablet 200 mg Tablet 0
7 Amlodipine 10 mg T ablet 0
8 Amlodipine 5 mg T ablet 0
9 Amoksisilin kapletl 500 mg Kaplet 0
10 Amoksisilin kapletl 250 mg Kaplet 0
11 Amoksisilin Syr Forte 250 mg Botol 0
12 Amoksisilin sirup kering 125 mg/5ml Botol 0
13 Amoksisilin drop 100 mg/ml Botol 0
14 Antasida DOEN kombinasi Tablet 0
15 Astaxanthin 4 mg tab Tablet 0
16 Antasida DOEN suspensi Botol 0
17 Anti Hemoroid DOEN Kombinasi Sup 0
18 Asam Askorbat (Vit C) tablet 50 mg Tablet 0
19 Asam Folat Tablet 0
20 Asam mefenamat tab 500 mg Tablet 0
21 Albotyl (polikresol) Botol 0
22 Albendazole tab 400 mg Tablet 0
23 Azitromysin 500 Tablet 0
24 Anti TBC Anak Paket 0
25 Anti TBC Katagori I Paket 0
26 Anti TBC Katagori II Paket 0
27 Basitrasin 500 IU/g + Polimiksin 10.000 Tube 0
28 IU/g
Besi II Sulfat tablet kombinasi Tablet 0
29 Bioplacenton jelly tube 0
30 Betahistin mesilat 6 mg Tablet 0
31 Borax gliserine Botol 0
32 Balsam cap kaki 3 Tube 0
33 Betametason krim 0.1% Tube 0
34 Captopril 12,5 mg Tablet 0
35 Captopril 25 mg Tablet 0
36 Coparcetine ( Obat Flu dan batuk ) Tablet 0
37 Cetirizine 10 mg Tablet 0
38 Deksametason injeksi 5 mg/ml - 1 ml Ampul 0
39 Deksametason tablet 0,5 mg Tablet 0
40 Dasepam rectal 5 mg tube 0
41 Diasepam Inj 5 mg/ml Ampul 0
42 Diazepam tablet 2 mg Tablet 0
43 Difenhidramin HCl inj 10 mg/ml-1 ml Ampul 0
44 Digoksin tablet 0,25 mg Tablet 0
45 Doksisiklin Tablet 0
46 Domperidon Sirup Botol 0
47 Dextrofen ( Obat batuk dan pilek syr ) Botol 0
48 Domperidon drop Botol 0
49 Deksosimetason Tube 0
50 Dulcolak ( stolax Supp) Supp 0
51 Epinefrina (adrenalin) Injeksi 0,1% - 1 ml Ampul 0
52 Erytromicin 500 mg Tablet 0
53 Erfaflu ( Obat Flu syp ) Botol 0
54 Erytromicin syrup Botol 0
55 Erfakaf sirup Botol 0
56 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 Ampul 0
57 Fitomenadion (Vit.K1) tablet salut gula 10 Tablet 0
58 Fenobarbital tablet 30 mg Tablet 0
59 Furosemid tablet 40 mg Tablet 0
60 Fenol Gliserol tetes telinga 10% Botol 0
61 Garam Oralit untuk 200 ml air Sak 0
62 Gentamicin Sulfat TM 0,3% Botol 0
63 Gentamicin Salep kulit Tube 0
64 Glibenklamid tablet 5 mg Tablet 0
65 Griseofulvin tab 125 Tablet 0
66 Glimeperid 1 mg Tablet 0
67 Glimeperid 2 mg Tablet 0
68 Hidroklorotiazid (HCT) tablet 25 mg Tablet 0
69 Haloperidol 0,5 Tablet 0
70 Haloperidol 1,5 Tablet 0
71 Haloperidol 5 mg Tablet 0
72 Hidrokortison krim 2,5 % Tube 0
73 Hyoscine-N-Butilbromide 10 mg (Scopma) Tablet 0
74 Hyoscine-N-Butilbromide inj / Buscopan Ampul 0
75 Ibuprofen tablet 400 mg Tablet 0
76 Isosorbid Di Nitrat Tablet 0
77 Imunogard / Vitamin Imunitas Tablet 0
78 Ibuprofen tablet 200 mg Tablet 0
79 Ibuprofen Sirup Botol 0
80 Ketokonazole cream 2 % 15 gram Tube 0
81 Ketokonazole tablet 200 mg Tablet 0
82 Klindamycin 300 mg Tablet 0
83 Kloramfenikol tetes telinga 3 % Botol 0
84 Kloramphenikol salep mata 1 % Tube 0
85 Kloramphenikol Tetes Mata Botol 0
86 Klorfeniramin Maleat (CTM) tablet 4 mg Tablet 0
87 Klorpromazine HCL 100 MG ( CPZ) Tablet 0
88 Kotrimoksazol Suspensi Botol 0
89 Kotrimoksazol tablet 480 mg kombinasi Tablet 0
90 Kalium Gluconat Ampul 0
91 Lidokain comp Ampul 0
92 Lidokain injeksi Ampul 0
93 Levertran salep (salep minyak ikan) pot 0
94 Loperamid tablet 2 mg Tablet 0
95 Loratadin tablet 10 mg Tablet 0
96 Metformin 500 mg Tablet 0
97 Meloxicam 15 mg Tablet 0
98 Methyl Prednisolon 4 mg Tablet 0
99 Metilergometrin Maleat 0,125 mg Tablet 0
100 Metoklopramid syrup Botol 0
101 Metoklopramid tablet 5 mg Tablet 0
102 Metoklopramid hcl injeksi 5 mg Ampul 0
103 Metronidazol tablet 500 mg Tablet 0
104 Magnesium Sulfat Inj 40% 25 ml Ampul 0
105 Magnesium Sulfat Inj 20% 25 ml Ampul 0
106 Miconazol Tube 0
107 Metoklorpamid Hcl 5 mg/ml 2 ml Ampul 0
108 Metoklorpamid Hcl 5 mg tablet Tablet 0
109 Metronidazol vagina ( flagyl ) Supp 0
110 Natrium Diklofenac tablet 25 mg Botol 0
111 Natrium Diklofenac tablet 50 mg Tablet 0
112 Natrium Klorida larutan infus 0.9% steril Fles 0
113 New Diatabs ( Pularek ) Tablet 0
114 Nistatin tablet vaginal 100.000 IU/g Tablet 0
115 NB Salep Tube 0
116 OBH ( obat batuk hitam) Botol 0
117 Omeprazol 20 mg Tablet 0
118 Oksitosin inj Ampul 0
119 Ondancetron 8 mg Tablet 0
120 Ondansetron 8 mg inj Ampul 0
121 Papaverin Tab 40 mg Tablet 0
122 Parasetamol Rektal 125 mg/2.5 ml Tube 0
123 Parasetamol Rektal 250 mg/2.5 ml Tube 0
124 Parasetamol sirup 120 mg/5 ml Botol 0
125 Parasetamol tablet 500 mg Tablet 0
126 Perak Sulfadiazin 1% (Burnazin) Tube 0
127 Piridoksin HCl (Vit.B6) tablet 10 mg Tablet 0
128 Prednison tablet 5 mg Tablet 0
129 Parasetamol Drop Botol 0
130 Pirantel suspensi Botol 0
131 Pehacain injeksi Ampul 0
132 Procurma sirup Botol 0
133 quinina Tablet 0
134 Ranitidin Tablet 0
135 Retinol (vit.A) 100,000 IU tablet salut Tablet 0
136 Retinol (vit.A) 200.000 IU kapsul lunak Tablet 0
137 Ringer Laktat larutan infus steril (Produk lo botol 0
138 Salbutamol Nebuliser Ampul 0
139 TXP ( Triheksifenidil hcl ) Tablet 0
140 Salbutamol tablet 2 mg Tablet 0
141 Salbutamol tablet 4 mg Tablet 0
142 Salisil Bedak 2 % Botol 0
143 Tetracycline Tablet 0
144 Tetagam Ampul 0
145 Sefadroxil tablet 500 mg Capsul 0
146 Sefadroxil 125 syr Botol 0
147 Sinvastatin tablet 10 mg Tablet 0
148 Siprofloxacin Tab 500 mg Tablet 0
149 Thiamin hcl tab ( B1) Tablet 0
150 Siobion Tablet 0
151 Vitamin B Kompleks tablet Tablet 0
152 Vitamin B 12 inj Ampul 0
153 Zinc tablet 20 mg Tablet 0
154 Vitacaps ( Multivitamin kapsul ) Tablet 0
155 Zinc tablet 20 mg Tablet 0
156 Zinc sirup Botol 0
157 Zinc drop Botol 0

TOTAL

D.BHP
188 Aqua pro Injeksi steril, bebas pirogen Fles 0
189 Alkohol sweb Kotak 0
190 Duk 60 x 60 pcs 0
191 Alat suntik 10 ml biji 0
192 Alat suntik 2,5 ml biji 0
193 Alat suntik 5 ml biji 0
194 Alat suntik 3 cc Pcs 0
195 Blood Lanset bok 0
196 Chirurgic gloves size 8.0 Pcs 0
197 Etanol ( alkohol ) 70 % 100 ml Botol 0
198 Etakridina ( rivanol ) larutan 0.1% Botol 0
199 Elastic Bandage uk 7,5 x 4,5 cm roll 0
200 Foley Cateter biji 0
201 Hand scund M Biji 0
Hand scund M Kotak 0
202 Hand scund S Biji 0
Hand scund S Kotak 0
203 Infuset anak set 0
204 Infuset dewasa set 0
205 IV cateter No 18 G Biji 0
206 IV cateter No 20 G Biji 0
207 IV cateter No 22 G Biji 0
208 Jarum Heacting no 14 Biji 0
209 Kapas Pembalut 250 gram Biji 0
210 Kapas Pembalut 250 gram Biji 0
211 Kasa Pembalut 2m x 80 cm Rol 0
212 Kasa Pembalut 2m x 80 cm Rol 0
213 Kasa Pembalut Hidrofil 4 x 15 cm Rol 0
214 Kasa Pembalut Hidrofil 4 x 3 cm Rol 0
215 Kasa hidropyl 40 x 80 cm Rol 0
216 Kasa Hydropil 16 cm x 16 cm Kotak 0
217 Kasa Kompres DRC 40 cm x 40 cm Pcs 0
218 Klip besar 15 x 10cm Biji 0
219 Klip sedang 13 x 10cm biji 0
220 Klip Kecil 10 x 7 cm biji 0
221 Lisol Botol 0
222 Masker biji 0
223 Masker bok 0
224 Medicin packet bok 0
225 Nurse cup Kotak 0
226 Nurse cup Kotak 0
227 Plester 5 yard x 2 inchi rol 0
228 Plester ultrafik 10 cm x 1 m Rol 0
229 Perhidrol HCL / H2O2 3% Botol 0
230 Pisau bedah no 11 biji 0
231 Pisau bedah no 10 biji
232 Pisau bedah no 12 biji
233 Supratul BIJI 0
234 Supratul bok 0
235 Silk benang Kotak 0
236 Tranfusi set set 0
237 Under ped biji 0
238 Urin Bag biji 0
239 Wing needle biji 0
240 Yodium povidon larutan 10% 300ml Botol 0
241 Needle 22G Flashback pcs 0

TOTAL

GRATIS BAYAR PHB/ASKES

JUMLAH KUNJUNGAN RESEP
 JUMLAH KUNJUNGAN RESEP

Mengetahui/Menyetujui YangMenyerahkan Yangmeminta

PimpinanPuskesmasKutaUtara Petugasgudangpuskesmas Pelaporpetugaspustu

dr. Ni Putu Purlimaningsih Ni Komang Ayu Triyani Ni Made Artini
NIP.197911202006042006 NIP.198801082011012016

 LAPORAN PENERIMAAN DAN LEMBAR PEMAKAIAN OBAT
(LPLPO )
LAPOR

UPT PUSKESMAS : UPT PKM KUTA UTARA MINTA

PUSKESMAS PEMBANTU YANG ADA :5 DOK

PROVINSI : Bali IFK

UNIT : PUSTU CANGGU PKM

STOK PENERI PEMAKAI

NO NAMA OBAT SATUAN AWAL MAAN AN

JML JML JML

A. OBAT
1 Acyclovir tablet 400 mg Tablet
2 Acyclovir cream 5 % Tube
3 Alopurinol tablet 100 mg Tablet
4 Ambroxol syrup Botol
5 Ambroxol tablet 30 mg Tablet
6 Aminofilin tablet 200 mg Tablet
7 Amlodipine 10 mg T ablet
8 Amlodipine 5 mg T ablet
9 Amoksisilin kapletl 500 mg Kaplet
10 Amoksisilin kapletl 250 mg Kaplet
11 Amoksisilin Syr Forte 250 mg Botol
12 Amoksisilin sirup kering 125 mg/5ml Botol
13 Amoksisilin drop 100 mg/ml Botol
14 Antasida DOEN kombinasi Tablet
15 Astaxanthin 4 mg tab Tablet
16 Antasida DOEN suspensi Botol
17 Anti Hemoroid DOEN Kombinasi Sup
18 Asam Askorbat (Vit C) tablet 50 mg Tablet
19 Asam Folat Tablet
20 Asam mefenamat tab 500 mg Tablet
21 Albotyl (polikresol) Botol
22 Albendazole tab 400 mg Tablet
23 Azitromysin 500 Tablet
24 Anti TBC Anak Paket
25 Anti TBC Katagori I Paket
26 Anti TBC Katagori II Paket
27 Basitrasin 500 IU/g + Polimiksin 10.000 Tube
IU/g
28 Besi II Sulfat tablet kombinasi Tablet
29 Bioplacenton jelly tube
30 Betahistin mesilat 6 mg Tablet
31 Borax gliserine Botol
32 Balsam cap kaki 3 Tube
33 Betametason krim 0.1% Tube
34 Captopril 12,5 mg Tablet
35 Captopril 25 mg Tablet
36 Coparcetine ( Obat Flu dan batuk ) Tablet
37 Cetirizine 10 mg Tablet
38 Deksametason injeksi 5 mg/ml - 1 ml Ampul
39 Deksametason tablet 0,5 mg Tablet
40 Dasepam rectal 5 mg tube
41 Diasepam Inj 5 mg/ml Ampul
42 Diazepam tablet 2 mg Tablet
43 Difenhidramin HCl inj 10 mg/ml-1 ml Ampul
44 Digoksin tablet 0,25 mg Tablet
45 Doksisiklin Tablet
46 Domperidon Sirup Botol
47 Dextrofen ( Obat batuk dan pilek syr ) Botol
48 Domperidon drop Botol
49 Deksosimetason Tube
50 Dulcolak ( stolax Supp) Supp
51 Epinefrina (adrenalin) Injeksi 0,1% - 1 ml Ampul
52 Erytromicin 500 mg Tablet
53 Erfaflu ( Obat Flu syp ) Botol
54 Erytromicin syrup Botol
55 Erfakaf sirup Botol
56 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 Ampul
57 Fitomenadion (Vit.K1) tablet salut gula 10 Tablet
58 Fenobarbital tablet 30 mg Tablet
59 Furosemid tablet 40 mg Tablet
60 Fenol Gliserol tetes telinga 10% Botol
61 Garam Oralit untuk 200 ml air Sak
62 Gentamicin Sulfat TM 0,3% Botol
63 Gentamicin Salep kulit Tube
64 Glibenklamid tablet 5 mg Tablet
65 Griseofulvin tab 125 Tablet
66 Glimeperid 1 mg Tablet
67 Glimeperid 2 mg Tablet
68 Hidroklorotiazid (HCT) tablet 25 mg Tablet
69 Haloperidol 0,5 Tablet
70 Haloperidol 1,5 Tablet
71 Haloperidol 5 mg Tablet
72 Hidrokortison krim 2,5 % Tube
73 Hyoscine-N-Butilbromide 10 mg (Scopma) Tablet
74 Hyoscine-N-Butilbromide inj / Buscopan Ampul
75 Ibuprofen tablet 400 mg Tablet
76 Isosorbid Di Nitrat Tablet
77 Imunogard / Vitamin Imunitas Tablet
78 Ibuprofen tablet 200 mg Tablet
79 Ibuprofen Sirup Botol
80 Ketokonazole cream 2 % 15 gram Tube
81 Ketokonazole tablet 200 mg Tablet
82 Klindamycin 300 mg Tablet
83 Kloramfenikol tetes telinga 3 % Botol
84 Kloramphenikol salep mata 1 % Tube
85 Kloramphenikol Tetes Mata Botol
86 Klorfeniramin Maleat (CTM) tablet 4 mg Tablet
87 Klorpromazine HCL 100 MG ( CPZ) Tablet
88 Kotrimoksazol Suspensi Botol
89 Kotrimoksazol tablet 480 mg kombinasi Tablet
90 Kalium Gluconat Ampul
91 Lidokain comp Ampul
92 Lidokain injeksi Ampul
93 Levertran salep (salep minyak ikan) pot
94 Loperamid tablet 2 mg Tablet
95 Loratadin tablet 10 mg Tablet
96 Metformin 500 mg Tablet
97 Meloxicam 15 mg Tablet
98 Methyl Prednisolon 4 mg Tablet
99 Metilergometrin Maleat 0,125 mg Tablet
100 Metoklopramid syrup Botol
101 Metoklopramid tablet 5 mg Tablet
102 Metoklopramid hcl injeksi 5 mg Ampul
103 Metronidazol tablet 500 mg Tablet
104 Magnesium Sulfat Inj 40% 25 ml Ampul
105 Magnesium Sulfat Inj 20% 25 ml Ampul
106 Miconazol Tube
107 Metoklorpamid Hcl 5 mg/ml 2 ml Ampul
108 Metoklorpamid Hcl 5 mg tablet Tablet
109 Metronidazol vagina ( flagyl ) Supp
110 Natrium Diklofenac tablet 25 mg Botol
111 Natrium Diklofenac tablet 50 mg Tablet
112 Natrium Klorida larutan infus 0.9% steril Fles
113 New Diatabs ( Pularek ) Tablet
114 Nistatin tablet vaginal 100.000 IU/g Tablet
115 NB Salep Tube
116 OBH ( obat batuk hitam) Botol
117 Omeprazol 20 mg Tablet
118 Oksitosin inj Ampul
119 Ondancetron 8 mg Tablet
120 Ondansetron 8 mg inj Ampul
121 Papaverin Tab 40 mg Tablet
122 Parasetamol Rektal 125 mg/2.5 ml Tube
123 Parasetamol Rektal 250 mg/2.5 ml Tube
124 Parasetamol sirup 120 mg/5 ml Botol
125 Parasetamol tablet 500 mg Tablet
126 Perak Sulfadiazin 1% (Burnazin) Tube
127 Piridoksin HCl (Vit.B6) tablet 10 mg Tablet
128 Prednison tablet 5 mg Tablet
129 Parasetamol Drop Botol
130 Pirantel suspensi Botol
131 Pehacain injeksi Ampul
132 Procurma sirup Botol
133 quinina Tablet
134 Ranitidin Tablet
135 Retinol (vit.A) 100,000 IU tablet salut Tablet
136 Retinol (vit.A) 200.000 IU kapsul lunak Tablet
137 Ringer Laktat larutan infus steril (Produk lo botol
138 Salbutamol Nebuliser Ampul
139 TXP ( Triheksifenidil hcl ) Tablet
140 Salbutamol tablet 2 mg Tablet
141 Salbutamol tablet 4 mg Tablet
142 Salisil Bedak 2 % Botol
143 Tetracycline Tablet
144 Tetagam Ampul
145 Sefadroxil tablet 500 mg Capsul
146 Sefadroxil 125 syr Botol
147 Sinvastatin tablet 10 mg Tablet
148 Siprofloxacin Tab 500 mg Tablet
149 Thiamin hcl tab ( B1) Tablet
150 Siobion Tablet
151 Vitamin B Kompleks tablet Tablet
152 Vitamin B 12 inj Ampul
153 Zinc tablet 20 mg Tablet
154 Vitacaps ( Multivitamin kapsul ) Tablet
155 Zinc tablet 20 mg Tablet
156 Zinc sirup Botol
157 Zinc drop Botol

TOTAL

D.BHP
188 Aqua pro Injeksi steril, bebas pirogen Fles
189 Alkohol sweb Kotak
190 Duk 60 x 60 pcs
191 Alat suntik 10 ml biji
192 Alat suntik 2,5 ml biji
193 Alat suntik 5 ml biji
194 Alat suntik 3 cc Pcs
195 Blood Lanset bok
196 Chirurgic gloves size 8.0 Pcs
197 Etanol ( alkohol ) 70 % 100 ml Botol
198 Etakridina ( rivanol ) larutan 0.1% Botol
199 Elastic Bandage uk 7,5 x 4,5 cm roll
200 Foley Cateter biji
201 Hand scund M Biji
Hand scund M Kotak
202 Hand scund S Biji
Hand scund S Kotak
203 Infuset anak set
204 Infuset dewasa set
205 IV cateter No 18 G Biji
206 IV cateter No 20 G Biji
207 IV cateter No 22 G Biji
208 Jarum Heacting no 14 Biji
209 Kapas Pembalut 250 gram Biji
210 Kapas Pembalut 250 gram Biji
211 Kasa Pembalut 2m x 80 cm Rol
212 Kasa Pembalut 2m x 80 cm Rol
213 Kasa Pembalut Hidrofil 4 x 15 cm Rol
214 Kasa Pembalut Hidrofil 4 x 3 cm Rol
215 Kasa hidropyl 40 x 80 cm Rol
216 Kasa Hydropil 16 cm x 16 cm Kotak
217 Kasa Kompres DRC 40 cm x 40 cm Pcs
218 Klip besar 15 x 10cm Biji
219 Klip sedang 13 x 10cm biji
220 Klip Kecil 10 x 7 cm biji
221 Lisol Botol
222 Masker biji
223 Masker bok
224 Medicin packet bok
225 Nurse cup Kotak
226 Nurse cup Kotak
227 Plester 5 yard x 2 inchi rol
228 Plester ultrafik 10 cm x 1 m Rol
229 Perhidrol HCL / H2O2 3% Botol
230 Pisau bedah no 11 biji
231 Pisau bedah no 10 biji
232 Pisau bedah no 12 biji
233 Supratul BIJI
234 Supratul bok
235 Silk benang Kotak
236 Tranfusi set set
237 Under ped biji
238 Urin Bag biji
239 Wing needle biji
240 Yodium povidon larutan 10% 300ml Botol
241 Needle 22G Flashback pcs

TOTAL

GRATIS BAYAR PHB/ASKES

JUMLAH KUNJUNGAN RESEP

Mengetahui/Menyetujui YangMenyerahkan Yangmeminta

PimpinanPuskesmasKutaUtara Petugasgudangpuskesmas Pelaporpetugaspustu

dr. Ni Putu Purlimaningsih Ni Komang Ayu Triyani Ni Made Artini
NIP.197911202006042006 NIP.198801082011012016
Mengetahui/Menyetujui YangMenyerahkan Yangmeminta
PimpinanPuskesmasKutaUtara Petugasgudangpuskesmas Pelaporpetugaspustu

dr. Ni Putu Purlimaningsih Ni Komang Ayu Triyani Ni Made Artini
NIP.197911202006042006 NIP.198801082011012016

N OBAT

BULAN :

BULAN :

NOMOR TANGGAL

PERMINT TERIM
SISA STOK
AAN A

JML JML JML

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0

PHB/ASKES

Yangmeminta
Pelaporpetugaspustu

Ni Made Artini
Yangmeminta
Pelaporpetugaspustu

Ni Made Artini

 LAPORAN TRIWULAN III PUKESMAS KUTA UTARA

( JULI AGUSTUS SEPTEMBER )

UPT PUSKESMAS : UPT PKM KUTA UTARA

PUSKESMAS PEMBANTU YANG ADA :5
PROVINSI : Bali
UNIT : PUSTU CANGGU

HARGA STOK AWAL

NO NAMA OBAT SATUAN
SATUAN
JML
A. OBAT
1 Acyclovir tablet 400 mg Tablet 750
2 Acyclovir cream 5 % Tube 3000
3 Alopurinol tablet 100 mg Tablet 120
4 Ambroxol syrup Botol 3300
5 Ambroxol tablet 30 mg Tablet 125
6 Aminofilin tablet 200 mg Tablet 104
7 Amlodipine 10 mg T ablet
8 Amlodipine 5 mg T ablet 105
9 Amoksisilin kapletl 500 mg Kaplet 370
10 Amoksisilin kapletl 250 mg Kaplet 216
11 Amoksisilin Syr Forte 250 mg Botol
12 Amoksisilin sirup kering 125 mg/5ml Botol 3699
13 Amoksisilin drop 100 mg/ml Botol 29580
14 Antasida DOEN kombinasi Tablet 135
15 Astaxanthin 4 mg tab Tablet 2379
16 Antasida DOEN suspensi Botol 2643
17 Anti Hemoroid DOEN Kombinasi Sup 1470
18 Asam Askorbat (Vit C) tablet 50 mg Tablet 19
19 Asam Folat Tablet 62
20 Asam mefenamat tab 500 mg Tablet 176
21 Albotyl (polikresol) Botol 21801
22 Albendazole tab 400 mg Tablet
23 Azitromysin 500 Tablet 4500
24 Anti TBC Anak Paket 214990
25 Anti TBC Katagori I Paket 359990
26 Anti TBC Katagori II Paket 1199900
27 Basitrasin 500 IU/g + Polimiksin 10.000 IU/g Tube 2517
28 Besi II Sulfat tablet kombinasi Tablet 27
29 Bioplacenton jelly tube 17530
30 Betahistin mesilat 6 mg Tablet 924
31 Borax gliserine Botol 6270
32 Balsam cap kaki 3 Tube
33 Betametason krim 0.1% Tube 1866
34 Captopril 12,5 mg Tablet 71
35 Captopril 25 mg Tablet 138
36 Coparcetine ( Obat Flu dan batuk ) Tablet 915
37 Cetirizine 10 mg Tablet 330
38 Deksametason injeksi 5 mg/ml - 1 ml Ampul 1580
39 Deksametason tablet 0,5 mg Tablet 24
40 Dasepam rectal 5 mg tube 11517
41 Diasepam Inj 5 mg/ml Ampul 2344
42 Diazepam tablet 2 mg Tablet 13
43 Difenhidramin HCl inj 10 mg/ml-1 ml Ampul 1050
44 Digoksin tablet 0,25 mg Tablet 83
45 Doksisiklin Tablet 230
46 Domperidon Sirup Botol 3624
47 Dextrofen ( Obat batuk dan pilek syr ) Botol 10390
48 Domperidon drop Botol 15600
49 Deksosimetason Tube 9983
50 Dulcolak ( stolax Supp) Supp 6045
51 Epinefrina (adrenalin) Injeksi 0,1% - 1 ml Ampul 2204
52 Erytromicin 500 mg Tablet 535
53 Erfaflu ( Obat Flu syp ) Botol
54 Erytromicin syrup Botol 6700
55 Erfakaf sirup Botol 12980
56 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 ml Ampul 978
57 Fitomenadion (Vit.K1) tablet salut gula 10 mg Tablet 681
58 Fenobarbital tablet 30 mg Tablet 32
59 Furosemid tablet 40 mg Tablet 72
60 Fenol Gliserol tetes telinga 10% Botol 1008
61 Garam Oralit untuk 200 ml air Sak 440
62 Gentamicin Sulfat TM 0,3% Botol 3194
63 Gentamicin Salep kulit Tube 1650
64 Glibenklamid tablet 5 mg Tablet 72
65 Griseofulvin tab 125 Tablet 225
66 Glimeperid 1 mg Tablet 265
67 Glimeperid 2 mg Tablet 436
68 Hidroklorotiazid (HCT) tablet 25 mg Tablet 36
69 Haloperidol 0,5 Tablet 60
70 Haloperidol 1,5 Tablet 123
71 Haloperidol 5 mg Tablet 60
72 Hidrokortison krim 2,5 % Tube 3000
73 Hyoscine-N-Butilbromide 10 mg (Scopma) Tablet 1040
74 Hyoscine-N-Butilbromide inj / Buscopan Ampul 2467
75 Ibuprofen tablet 400 mg Tablet 150
76 Isosorbid Di Nitrat Tablet 65
77 Imunogard / Vitamin Imunitas Tablet 9990
78 Ibuprofen tablet 200 mg Tablet 105
79 Ibuprofen Sirup Botol 3499
80 Ketokonazole cream 2 % 15 gram Tube 4666
81 Ketokonazole tablet 200 mg Tablet 372
82 Klindamycin 300 mg Tablet 685
83 Kloramfenikol tetes telinga 3 % Botol 1000
84 Kloramphenikol salep mata 1 % Tube 1563
85 Kloramphenikol Tetes Mata Botol 2499
86 Klorfeniramin Maleat (CTM) tablet 4 mg Tablet 24
87 Klorpromazine HCL 100 MG ( CPZ) Tablet 104
88 Kotrimoksazol Suspensi Botol 3500
89 Kotrimoksazol tablet 480 mg kombinasi Tablet 165
90 Kalium Gluconat Ampul 7800
91 Lidokain comp Ampul 1033
92 Lidokain injeksi Ampul 1010
93 Levertran salep (salep minyak ikan) pot 1350
94 Loperamid tablet 2 mg Tablet 89
95 Loratadin tablet 10 mg Tablet 154
96 Metformin 500 mg Tablet 182
97 Meloxicam 15 mg Tablet 113
98 Methyl Prednisolon 4 mg Tablet 509
99 Metilergometrin Maleat 0,125 mg Tablet 154
100 Metoklopramid syrup Botol 1914
101 Metoklopramid tablet 5 mg Tablet 73
102 Metoklopramid hcl injeksi 5 mg Ampul 1947
103 Metronidazol tablet 500 mg Tablet 154
104 Magnesium Sulfat Inj 40% 25 ml Ampul 1948
105 Magnesium Sulfat Inj 20% 25 ml Ampul 5500
106 Miconazol Tube 1719
107 Metoklorpamid Hcl 5 mg/ml 2 ml Ampul 7425
108 Metoklorpamid Hcl 5 mg tablet Tablet 73
109 Metronidazol vagina ( flagyl ) Supp 3220
110 Natrium Diklofenac tablet 25 mg Botol 168
111 Natrium Diklofenac tablet 50 mg Tablet 218
112 Natrium Klorida larutan infus 0.9% steril Fles 4899
113 New Diatabs ( Pularek ) Tablet 190
114 Nistatin tablet vaginal 100.000 IU/g Tablet 289
115 NB Salep Tube 20302
116 OBH ( obat batuk hitam) Botol 2500
117 Omeprazol 20 mg Tablet 408
118 Oksitosin inj Ampul 1785
119 Ondancetron 8 mg Tablet 2596
120 Ondansetron 8 mg inj Ampul 10384
121 Papaverin Tab 40 mg Tablet 57
122 Parasetamol Rektal 125 mg/2.5 ml Tube 12672
123 Parasetamol Rektal 250 mg/2.5 ml Tube 32259
124 Parasetamol sirup 120 mg/5 ml Botol 1725
125 Parasetamol tablet 500 mg Tablet 45
126 Perak Sulfadiazin 1% (Burnazin) Tube 33000
127 Piridoksin HCl (Vit.B6) tablet 10 mg Tablet 14
128 Prednison tablet 5 mg Tablet 38
129 Parasetamol Drop Botol 4799
130 Pirantel suspensi Botol 8360
131 Pehacain injeksi Ampul 1363
132 Procurma sirup Botol 14850
133 quinina Tablet 670
134 Ranitidin Tablet 200
135 Retinol (vit.A) 100,000 IU tablet salut Tablet 260
136 Retinol (vit.A) 200.000 IU kapsul lunak Tablet 459
137 Ringer Laktat larutan infus steril (Produk lokal) botol 5200
138 Salbutamol Nebuliser Ampul 10533
139 TXP ( Triheksifenidil hcl ) Tablet 11946
140 Salbutamol tablet 2 mg Tablet 88
141 Salbutamol tablet 4 mg Tablet 97
142 Salisil Bedak 2 % Botol 1025
143 Tetracycline Tablet 257
144 Tetagam Ampul 61817
145 Sefadroxil tablet 500 mg Capsul 700
146 Sefadroxil 125 syr Botol 7227
147 Sinvastatin tablet 10 mg Tablet 513
148 Siprofloxacin Tab 500 mg Tablet 240
149 Thiamin hcl tab ( B1) Tablet 37
150 Siobion Tablet 1194
151 Vitamin B Kompleks tablet Tablet 22
152 Vitamin B 12 inj Ampul 473
153 Zinc tablet 20 mg Tablet 472
154 Vitacaps ( Multivitamin kapsul ) Tablet 948
155 Zinc tablet 20 mg Tablet 470
156 Zinc sirup Botol 12840
157 Zinc drop Botol 12840

TOTAL

D.BHP
188 Aqua pro Injeksi steril, bebas pirogen Fles 1500
189 Alkohol sweb Kotak 5500
190 Duk 60 x 60 pcs
191 Alat suntik 10 ml biji 2750
192 Alat suntik 2,5 ml biji 591
193 Alat suntik 5 ml biji 2640
194 Alat suntik 3 cc Pcs 788
195 Blood Lanset bok 19800
196 Chirurgic gloves size 8.0 Pcs 7980
197 Etanol ( alkohol ) 70 % 100 ml Botol 2500
198 Etakridina ( rivanol ) larutan 0.1% Botol 1800
199 Elastic Bandage uk 7,5 x 4,5 cm roll 81400
200 Foley Cateter biji 8494
201 Hand scund M Biji 360
Hand scund M Kotak 44100
202 Hand scund S Biji 360
Hand scund S Kotak 44100
203 Infuset anak set 3185
204 Infuset dewasa set 2910
205 IV cateter No 18 G Biji 5148
206 IV cateter No 20 G Biji 5148
207 IV cateter No 22 G Biji 5148
208 Jarum Heacting no 14 Biji 15840
209 Kapas Pembalut 250 gram Biji 11396
210 Kapas Pembalut 250 gram Biji 11300
211 Kasa Pembalut 2m x 80 cm Rol 21120
212 Kasa Pembalut 2m x 80 cm Rol 7000
213 Kasa Pembalut Hidrofil 4 x 15 cm Rol 11688
214 Kasa Pembalut Hidrofil 4 x 3 cm Rol 1584
215 Kasa hidropyl 40 x 80 cm Rol 95000
216 Kasa Hydropil 16 cm x 16 cm Kotak 5230
217 Kasa Kompres DRC 40 cm x 40 cm Pcs 1640
218 Klip besar 15 x 10cm Biji 138
219 Klip sedang 13 x 10cm biji 99
220 Klip Kecil 10 x 7 cm biji 79
221 Lisol Botol 37300
222 Masker biji 436
223 Masker bok 21780
224 Medicin packet bok 2310000
225 Nurse cup Kotak 649
226 Nurse cup Kotak 49500
227 Plester 5 yard x 2 inchi rol 31999
228 Plester ultrafik 10 cm x 1 m Rol 8470
229 Perhidrol HCL / H2O2 3% Botol 10800
230 Pisau bedah no 11 biji 660
231 Pisau bedah no 10 biji
232 Pisau bedah no 12 biji
233 Supratul BIJI 11300
234 Supratul bok 206030
235 Silk benang Kotak 6600
236 Tranfusi set set 15015
237 Under ped biji 52800
238 Urin Bag biji 8800
239 Wing needle biji 7400
240 Yodium povidon larutan 10% 300ml Botol 14500
241 Needle 22G Flashback pcs 1650

TOTAL
TOTAL KESELURUHAN

GRATIS BAYAR
JUMLAH KUNJUNGAN RESEP

Mengetahui/Menyetujui
PimpinanPuskesmasKutaUtara


Mengetahui/Menyetujui YangMenyerahkan
PimpinanPuskesmasKutaUtara Petugasgudangpuskesmas

dr. Ni Putu Purlimaningsih Ni Komang Ayu Triyani
NIP.197911202006042006 NIP.198801082011012016

AS KUTA UTARA
MBER )

PENERIM PEMAKAIA
SISA STOK
AAN N

JML JML JML RUPIAH

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

BAYAR PHB/ASKES JUMLAH

Yangmeminta
Pelaporpetugaspustu

 LAPORAN PENERIMAAN DAN LEMBAR PEMAKAIAN OBAT

(LPLPO )
LAPOR

UPT PUSKESMAS : UPT PKM KUTA UTARA MINTA

PUSKESMAS PEMBANTU YANG ADA :5 DOK

PROVINSI : Bali IFK

UNIT : PUSTU CANGGU PKM

STOK PENERI PEMAKAI

NO NAMA OBAT SATUAN AWAL MAAN AN

JML JML JML

A. OBAT
1 Acyclovir tablet 400 mg Tablet
2 Acyclovir cream 5 % Tube
3 Alopurinol tablet 100 mg Tablet
4 Ambroxol syrup Botol
5 Ambroxol tablet 30 mg Tablet
6 Aminofilin tablet 200 mg Tablet
7 Amlodipine 10 mg T ablet
8 Amlodipine 5 mg T ablet
9 Amoksisilin kapletl 500 mg Kaplet
10 Amoksisilin kapletl 250 mg Kaplet
11 Amoksisilin Syr Forte 250 mg Botol
12 Amoksisilin sirup kering 125 mg/5ml Botol
13 Amoksisilin drop 100 mg/ml Botol
14 Antasida DOEN kombinasi Tablet
15 Astaxanthin 4 mg tab Tablet
16 Antasida DOEN suspensi Botol
17 Anti Hemoroid DOEN Kombinasi Sup
18 Asam Askorbat (Vit C) tablet 50 mg Tablet
19 Asam Folat Tablet
20 Asam mefenamat tab 500 mg Tablet
21 Albotyl (polikresol) Botol
22 Albendazole tab 400 mg Tablet
23 Azitromysin 500 Tablet
24 Anti TBC Anak Paket
25 Anti TBC Katagori I Paket
26 Anti TBC Katagori II Paket
27 Basitrasin 500 IU/g + Polimiksin 10.000 Tube
28 IU/g
Besi II Sulfat tablet kombinasi Tablet
29 Bioplacenton jelly tube
30 Betahistin mesilat 6 mg Tablet
31 Borax gliserine Botol
32 Balsam cap kaki 3 Tube
33 Betametason krim 0.1% Tube
34 Captopril 12,5 mg Tablet
35 Captopril 25 mg Tablet
36 Coparcetine ( Obat Flu dan batuk ) Tablet
37 Cetirizine 10 mg Tablet
38 Deksametason injeksi 5 mg/ml - 1 ml Ampul
39 Deksametason tablet 0,5 mg Tablet
40 Dasepam rectal 5 mg tube
41 Diasepam Inj 5 mg/ml Ampul
42 Diazepam tablet 2 mg Tablet
43 Difenhidramin HCl inj 10 mg/ml-1 ml Ampul
44 Digoksin tablet 0,25 mg Tablet
45 Doksisiklin Tablet
46 Domperidon Sirup Botol
47 Dextrofen ( Obat batuk dan pilek syr ) Botol
48 Domperidon drop Botol
49 Deksosimetason Tube
50 Dulcolak ( stolax Supp) Supp
51 Epinefrina (adrenalin) Injeksi 0,1% - 1 ml Ampul
52 Erytromicin 500 mg Tablet
53 Erfaflu ( Obat Flu syp ) Botol
54 Erytromicin syrup Botol
55 Erfakaf sirup Botol
56 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 Ampul
57 Fitomenadion (Vit.K1) tablet salut gula 10 Tablet
58 Fenobarbital tablet 30 mg Tablet
59 Furosemid tablet 40 mg Tablet
60 Fenol Gliserol tetes telinga 10% Botol
61 Garam Oralit untuk 200 ml air Sak
62 Gentamicin Sulfat TM 0,3% Botol
63 Gentamicin Salep kulit Tube
64 Glibenklamid tablet 5 mg Tablet
65 Griseofulvin tab 125 Tablet
66 Glimeperid 1 mg Tablet
67 Glimeperid 2 mg Tablet
68 Hidroklorotiazid (HCT) tablet 25 mg Tablet
69 Haloperidol 0,5 Tablet
70 Haloperidol 1,5 Tablet
71 Haloperidol 5 mg Tablet
72 Hidrokortison krim 2,5 % Tube
73 Hyoscine-N-Butilbromide 10 mg (Scopma) Tablet
74 Hyoscine-N-Butilbromide inj / Buscopan Ampul
75 Ibuprofen tablet 400 mg Tablet
76 Isosorbid Di Nitrat Tablet
77 Imunogard / Vitamin Imunitas Tablet
78 Ibuprofen tablet 200 mg Tablet
79 Ibuprofen Sirup Botol
80 Ketokonazole cream 2 % 15 gram Tube
81 Ketokonazole tablet 200 mg Tablet
82 Klindamycin 300 mg Tablet
83 Kloramfenikol tetes telinga 3 % Botol
84 Kloramphenikol salep mata 1 % Tube
85 Kloramphenikol Tetes Mata Botol
86 Klorfeniramin Maleat (CTM) tablet 4 mg Tablet
87 Klorpromazine HCL 100 MG ( CPZ) Tablet
88 Kotrimoksazol Suspensi Botol
89 Kotrimoksazol tablet 480 mg kombinasi Tablet
90 Kalium Gluconat Ampul
91 Lidokain comp Ampul
92 Lidokain injeksi Ampul
93 Levertran salep (salep minyak ikan) pot
94 Loperamid tablet 2 mg Tablet
95 Loratadin tablet 10 mg Tablet
96 Metformin 500 mg Tablet
97 Meloxicam 15 mg Tablet
98 Methyl Prednisolon 4 mg Tablet
99 Metilergometrin Maleat 0,125 mg Tablet
100 Metoklopramid syrup Botol
101 Metoklopramid tablet 5 mg Tablet
102 Metoklopramid hcl injeksi 5 mg Ampul
103 Metronidazol tablet 500 mg Tablet
104 Magnesium Sulfat Inj 40% 25 ml Ampul
105 Magnesium Sulfat Inj 20% 25 ml Ampul
106 Miconazol Tube
107 Metoklorpamid Hcl 5 mg/ml 2 ml Ampul
108 Metoklorpamid Hcl 5 mg tablet Tablet
109 Metronidazol vagina ( flagyl ) Supp
110 Natrium Diklofenac tablet 25 mg Botol
111 Natrium Diklofenac tablet 50 mg Tablet
112 Natrium Klorida larutan infus 0.9% steril Fles
113 New Diatabs ( Pularek ) Tablet
114 Nistatin tablet vaginal 100.000 IU/g Tablet
115 NB Salep Tube
116 OBH ( obat batuk hitam) Botol
117 Omeprazol 20 mg Tablet
118 Oksitosin inj Ampul
119 Ondancetron 8 mg Tablet
120 Ondansetron 8 mg inj Ampul
121 Papaverin Tab 40 mg Tablet
122 Parasetamol Rektal 125 mg/2.5 ml Tube
123 Parasetamol Rektal 250 mg/2.5 ml Tube
124 Parasetamol sirup 120 mg/5 ml Botol
125 Parasetamol tablet 500 mg Tablet
126 Perak Sulfadiazin 1% (Burnazin) Tube
127 Piridoksin HCl (Vit.B6) tablet 10 mg Tablet
128 Prednison tablet 5 mg Tablet
129 Parasetamol Drop Botol
130 Pirantel suspensi Botol
131 Pehacain injeksi Ampul
132 Procurma sirup Botol
133 quinina Tablet
134 Ranitidin Tablet
135 Retinol (vit.A) 100,000 IU tablet salut Tablet
136 Retinol (vit.A) 200.000 IU kapsul lunak Tablet
137 Ringer Laktat larutan infus steril (Produk lo botol
138 Salbutamol Nebuliser Ampul
139 TXP ( Triheksifenidil hcl ) Tablet
140 Salbutamol tablet 2 mg Tablet
141 Salbutamol tablet 4 mg Tablet
142 Salisil Bedak 2 % Botol
143 Tetracycline Tablet
144 Tetagam Ampul
145 Sefadroxil tablet 500 mg Capsul
146 Sefadroxil 125 syr Botol
147 Sinvastatin tablet 10 mg Tablet
148 Siprofloxacin Tab 500 mg Tablet
149 Thiamin hcl tab ( B1) Tablet
150 Siobion Tablet
151 Vitamin B Kompleks tablet Tablet
152 Vitamin B 12 inj Ampul
153 Zinc tablet 20 mg Tablet
154 Vitacaps ( Multivitamin kapsul ) Tablet
155 Zinc tablet 20 mg Tablet
156 Zinc sirup Botol
157 Zinc drop Botol

TOTAL
 D.BHP
188 Aqua pro Injeksi steril, bebas pirogen Fles
189 Alkohol sweb Kotak
190 Duk 60 x 60 pcs
191 Alat suntik 10 ml biji
192 Alat suntik 2,5 ml biji
193 Alat suntik 5 ml biji
194 Alat suntik 3 cc Pcs
195 Blood Lanset bok
196 Chirurgic gloves size 8.0 Pcs
197 Etanol ( alkohol ) 70 % 100 ml Botol
198 Etakridina ( rivanol ) larutan 0.1% Botol
199 Elastic Bandage uk 7,5 x 4,5 cm roll
200 Foley Cateter biji
201 Hand scund M Biji
Hand scund M Kotak
202 Hand scund S Biji
Hand scund S Kotak
203 Infuset anak set
204 Infuset dewasa set
205 IV cateter No 18 G Biji
206 IV cateter No 20 G Biji
207 IV cateter No 22 G Biji
208 Jarum Heacting no 14 Biji
209 Kapas Pembalut 250 gram Biji
210 Kapas Pembalut 250 gram Biji
211 Kasa Pembalut 2m x 80 cm Rol
212 Kasa Pembalut 2m x 80 cm Rol
213 Kasa Pembalut Hidrofil 4 x 15 cm Rol
214 Kasa Pembalut Hidrofil 4 x 3 cm Rol
215 Kasa hidropyl 40 x 80 cm Rol
216 Kasa Hydropil 16 cm x 16 cm Kotak
217 Kasa Kompres DRC 40 cm x 40 cm Pcs
218 Klip besar 15 x 10cm Biji
219 Klip sedang 13 x 10cm biji
220 Klip Kecil 10 x 7 cm biji
221 Lisol Botol
222 Masker biji
223 Masker bok
224 Medicin packet bok
225 Nurse cup Kotak
226 Nurse cup Kotak
227 Plester 5 yard x 2 inchi rol
228 Plester ultrafik 10 cm x 1 m Rol
229 Perhidrol HCL / H2O2 3% Botol
230 Pisau bedah no 11 biji
231 Pisau bedah no 10 biji
232 Pisau bedah no 12 biji
233 Supratul BIJI
234 Supratul bok
235 Silk benang Kotak
236 Tranfusi set set
237 Under ped biji
238 Urin Bag biji
239 Wing needle biji
240 Yodium povidon larutan 10% 300ml Botol
241 Needle 22G Flashback pcs

TOTAL

GRATIS BAYAR PHB/ASKES

JUMLAH KUNJUNGAN RESEP

Mengetahui/Menyetujui YangMenyerahkan Yangmeminta

PimpinanPuskesmasKutaUtara Petugasgudangpuskesmas Pelaporpetugaspustu

dr. Ni Putu Purlimaningsih Ni Komang Ayu Triyani Ni Made Artini
NIP.197911202006042006 NIP.198801082011012016

N OBAT

BULAN :

BULAN :

NOMOR TANGGAL

PERMINT TERIM
SISA STOK
AAN A

JML JML JML

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
 0
0
0

0
0
0
0
0
0
0
0
0

PHB/ASKES

Yangmeminta
Pelaporpetugaspustu

Ni Made Artini

 LAPORAN PENERIMAAN DAN LEMBAR PEMAKAIAN OBAT

(LPLPO )
LAPOR

UPT PUSKESMAS : UPT PKM KUTA UTARA MINTA

PUSKESMAS PEMBANTU YANG ADA :5 DOK

PROVINSI : Bali IFK

UNIT : PUSTU CANGGU PKM

STOK PENERI PEMAKAI

NO NAMA OBAT SATUAN AWAL MAAN AN

JML JML JML

A. OBAT
1 Acyclovir tablet 400 mg Tablet
2 Acyclovir cream 5 % Tube
3 Alopurinol tablet 100 mg Tablet
4 Ambroxol syrup Botol
5 Ambroxol tablet 30 mg Tablet
6 Aminofilin tablet 200 mg Tablet
7 Amlodipine 10 mg T ablet
8 Amlodipine 5 mg T ablet
9 Amoksisilin kapletl 500 mg Kaplet
10 Amoksisilin kapletl 250 mg Kaplet
11 Amoksisilin Syr Forte 250 mg Botol
12 Amoksisilin sirup kering 125 mg/5ml Botol
13 Amoksisilin drop 100 mg/ml Botol
14 Antasida DOEN kombinasi Tablet
15 Astaxanthin 4 mg tab Tablet
16 Antasida DOEN suspensi Botol
17 Anti Hemoroid DOEN Kombinasi Sup
18 Asam Askorbat (Vit C) tablet 50 mg Tablet
19 Asam Folat Tablet
20 Asam mefenamat tab 500 mg Tablet
21 Albotyl (polikresol) Botol
22 Albendazole tab 400 mg Tablet
23 Azitromysin 500 Tablet
24 Anti TBC Anak Paket
25 Anti TBC Katagori I Paket
26 Anti TBC Katagori II Paket
27 Basitrasin 500 IU/g + Polimiksin 10.000 Tube
IU/g
28 Besi II Sulfat tablet kombinasi Tablet
29 Bioplacenton jelly tube
30 Betahistin mesilat 6 mg Tablet
31 Borax gliserine Botol
32 Balsam cap kaki 3 Tube
33 Betametason krim 0.1% Tube
34 Captopril 12,5 mg Tablet
35 Captopril 25 mg Tablet
36 Coparcetine ( Obat Flu dan batuk ) Tablet
37 Cetirizine 10 mg Tablet
38 Deksametason injeksi 5 mg/ml - 1 ml Ampul
39 Deksametason tablet 0,5 mg Tablet
40 Dasepam rectal 5 mg tube
41 Diasepam Inj 5 mg/ml Ampul
42 Diazepam tablet 2 mg Tablet
43 Difenhidramin HCl inj 10 mg/ml-1 ml Ampul
44 Digoksin tablet 0,25 mg Tablet
45 Doksisiklin Tablet
46 Domperidon Sirup Botol
47 Dextrofen ( Obat batuk dan pilek syr ) Botol
48 Domperidon drop Botol
49 Deksosimetason Tube
50 Dulcolak ( stolax Supp) Supp
51 Epinefrina (adrenalin) Injeksi 0,1% - 1 ml Ampul
52 Erytromicin 500 mg Tablet
53 Erfaflu ( Obat Flu syp ) Botol
54 Erytromicin syrup Botol
55 Erfakaf sirup Botol
56 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 Ampul
57 Fitomenadion (Vit.K1) tablet salut gula 10 Tablet
58 Fenobarbital tablet 30 mg Tablet
59 Furosemid tablet 40 mg Tablet
60 Fenol Gliserol tetes telinga 10% Botol
61 Garam Oralit untuk 200 ml air Sak
62 Gentamicin Sulfat TM 0,3% Botol
63 Gentamicin Salep kulit Tube
64 Glibenklamid tablet 5 mg Tablet
65 Griseofulvin tab 125 Tablet
66 Glimeperid 1 mg Tablet
67 Glimeperid 2 mg Tablet
68 Hidroklorotiazid (HCT) tablet 25 mg Tablet
69 Haloperidol 0,5 Tablet
70 Haloperidol 1,5 Tablet
71 Haloperidol 5 mg Tablet
72 Hidrokortison krim 2,5 % Tube
73 Hyoscine-N-Butilbromide 10 mg (Scopma) Tablet
74 Hyoscine-N-Butilbromide inj / Buscopan Ampul
75 Ibuprofen tablet 400 mg Tablet
76 Isosorbid Di Nitrat Tablet
77 Imunogard / Vitamin Imunitas Tablet
78 Ibuprofen tablet 200 mg Tablet
79 Ibuprofen Sirup Botol
80 Ketokonazole cream 2 % 15 gram Tube
81 Ketokonazole tablet 200 mg Tablet
82 Klindamycin 300 mg Tablet
83 Kloramfenikol tetes telinga 3 % Botol
84 Kloramphenikol salep mata 1 % Tube
85 Kloramphenikol Tetes Mata Botol
86 Klorfeniramin Maleat (CTM) tablet 4 mg Tablet
87 Klorpromazine HCL 100 MG ( CPZ) Tablet
88 Kotrimoksazol Suspensi Botol
89 Kotrimoksazol tablet 480 mg kombinasi Tablet
90 Kalium Gluconat Ampul
91 Lidokain comp Ampul
92 Lidokain injeksi Ampul
93 Levertran salep (salep minyak ikan) pot
94 Loperamid tablet 2 mg Tablet
95 Loratadin tablet 10 mg Tablet
96 Metformin 500 mg Tablet
97 Meloxicam 15 mg Tablet
98 Methyl Prednisolon 4 mg Tablet
99 Metilergometrin Maleat 0,125 mg Tablet
100 Metoklopramid syrup Botol
101 Metoklopramid tablet 5 mg Tablet
102 Metoklopramid hcl injeksi 5 mg Ampul
103 Metronidazol tablet 500 mg Tablet
104 Magnesium Sulfat Inj 40% 25 ml Ampul
105 Magnesium Sulfat Inj 20% 25 ml Ampul
106 Miconazol Tube
107 Metoklorpamid Hcl 5 mg/ml 2 ml Ampul
108 Metoklorpamid Hcl 5 mg tablet Tablet
109 Metronidazol vagina ( flagyl ) Supp
110 Natrium Diklofenac tablet 25 mg Botol
111 Natrium Diklofenac tablet 50 mg Tablet
112 Natrium Klorida larutan infus 0.9% steril Fles
113 New Diatabs ( Pularek ) Tablet
114 Nistatin tablet vaginal 100.000 IU/g Tablet
115 NB Salep Tube
116 OBH ( obat batuk hitam) Botol
117 Omeprazol 20 mg Tablet
118 Oksitosin inj Ampul
119 Ondancetron 8 mg Tablet
120 Ondansetron 8 mg inj Ampul
121 Papaverin Tab 40 mg Tablet
122 Parasetamol Rektal 125 mg/2.5 ml Tube
123 Parasetamol Rektal 250 mg/2.5 ml Tube
124 Parasetamol sirup 120 mg/5 ml Botol
125 Parasetamol tablet 500 mg Tablet
126 Perak Sulfadiazin 1% (Burnazin) Tube
127 Piridoksin HCl (Vit.B6) tablet 10 mg Tablet
128 Prednison tablet 5 mg Tablet
129 Parasetamol Drop Botol
130 Pirantel suspensi Botol
131 Pehacain injeksi Ampul
132 Procurma sirup Botol
133 quinina Tablet
134 Ranitidin Tablet
135 Retinol (vit.A) 100,000 IU tablet salut Tablet
136 Retinol (vit.A) 200.000 IU kapsul lunak Tablet
137 Ringer Laktat larutan infus steril (Produk lo botol
138 Salbutamol Nebuliser Ampul
139 TXP ( Triheksifenidil hcl ) Tablet
140 Salbutamol tablet 2 mg Tablet
141 Salbutamol tablet 4 mg Tablet
142 Salisil Bedak 2 % Botol
143 Tetracycline Tablet
144 Tetagam Ampul
145 Sefadroxil tablet 500 mg Capsul
146 Sefadroxil 125 syr Botol
147 Sinvastatin tablet 10 mg Tablet
148 Siprofloxacin Tab 500 mg Tablet
149 Thiamin hcl tab ( B1) Tablet
150 Siobion Tablet
151 Vitamin B Kompleks tablet Tablet
152 Vitamin B 12 inj Ampul
153 Zinc tablet 20 mg Tablet
154 Vitacaps ( Multivitamin kapsul ) Tablet
155 Zinc tablet 20 mg Tablet
156 Zinc sirup Botol
157 Zinc drop Botol

TOTAL

D.BHP
188 Aqua pro Injeksi steril, bebas pirogen Fles
189 Alkohol sweb Kotak
190 Duk 60 x 60 pcs
191 Alat suntik 10 ml biji
192 Alat suntik 2,5 ml biji
193 Alat suntik 5 ml biji
194 Alat suntik 3 cc Pcs
195 Blood Lanset bok
196 Chirurgic gloves size 8.0 Pcs
197 Etanol ( alkohol ) 70 % 100 ml Botol
198 Etakridina ( rivanol ) larutan 0.1% Botol
199 Elastic Bandage uk 7,5 x 4,5 cm roll
200 Foley Cateter biji
201 Hand scund M Biji
Hand scund M Kotak
202 Hand scund S Biji
Hand scund S Kotak
203 Infuset anak set
204 Infuset dewasa set
205 IV cateter No 18 G Biji
206 IV cateter No 20 G Biji
207 IV cateter No 22 G Biji
208 Jarum Heacting no 14 Biji
209 Kapas Pembalut 250 gram Biji
210 Kapas Pembalut 250 gram Biji
211 Kasa Pembalut 2m x 80 cm Rol
212 Kasa Pembalut 2m x 80 cm Rol
213 Kasa Pembalut Hidrofil 4 x 15 cm Rol
214 Kasa Pembalut Hidrofil 4 x 3 cm Rol
215 Kasa hidropyl 40 x 80 cm Rol
216 Kasa Hydropil 16 cm x 16 cm Kotak
217 Kasa Kompres DRC 40 cm x 40 cm Pcs
218 Klip besar 15 x 10cm Biji
219 Klip sedang 13 x 10cm biji
220 Klip Kecil 10 x 7 cm biji
221 Lisol Botol
222 Masker biji
223 Masker bok
224 Medicin packet bok
225 Nurse cup Kotak
226 Nurse cup Kotak
227 Plester 5 yard x 2 inchi rol
228 Plester ultrafik 10 cm x 1 m Rol
229 Perhidrol HCL / H2O2 3% Botol
230 Pisau bedah no 11 biji
231 Pisau bedah no 10 biji
232 Pisau bedah no 12 biji
233 Supratul BIJI
234 Supratul bok
235 Silk benang Kotak
236 Tranfusi set set
237 Under ped biji
238 Urin Bag biji
239 Wing needle biji
240 Yodium povidon larutan 10% 300ml Botol
241 Needle 22G Flashback pcs

TOTAL

GRATIS BAYAR PHB/ASKES

JUMLAH KUNJUNGAN RESEP

Mengetahui/Menyetujui YangMenyerahkan Yangmeminta

PimpinanPuskesmasKutaUtara Petugasgudangpuskesmas Pelaporpetugaspustu

dr. Ni Putu Purlimaningsih Ni Komang Ayu Triyani Ni Made Artini
NIP.197911202006042006 NIP.198801082011012016
Mengetahui/Menyetujui YangMenyerahkan Yangmeminta
PimpinanPuskesmasKutaUtara Petugasgudangpuskesmas Pelaporpetugaspustu

dr. Ni Putu Purlimaningsih Ni Komang Ayu Triyani Ni Made Artini
NIP.197911202006042006 NIP.198801082011012016

N OBAT

BULAN :

BULAN :

NOMOR TANGGAL

PERMINT TERIM
SISA STOK
AAN A

JML JML JML

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0

PHB/ASKES

Yangmeminta
Pelaporpetugaspustu

Ni Made Artini
Yangmeminta
Pelaporpetugaspustu

Ni Made Artini

 LAPORAN PENERIMAAN DAN LEMBAR PEMAKAIAN OBAT

(LPLPO )
LAPOR

UPT PUSKESMAS : UPT PKM KUTA UTARA MINTA

PUSKESMAS PEMBANTU YANG ADA :5 DOK

PROVINSI : Bali IFK

UNIT : PUSTU CANGGU PKM

STOK PENERI PEMAKAI

NO NAMA OBAT SATUAN AWAL MAAN AN

JML JML JML

A. OBAT
1 Acyclovir tablet 400 mg Tablet
2 Acyclovir cream 5 % Tube
3 Alopurinol tablet 100 mg Tablet
4 Ambroxol syrup Botol
5 Ambroxol tablet 30 mg Tablet
6 Aminofilin tablet 200 mg Tablet
7 Amlodipine 10 mg T ablet
8 Amlodipine 5 mg T ablet
9 Amoksisilin kapletl 500 mg Kaplet
10 Amoksisilin kapletl 250 mg Kaplet
11 Amoksisilin Syr Forte 250 mg Botol
12 Amoksisilin sirup kering 125 mg/5ml Botol
13 Amoksisilin drop 100 mg/ml Botol
14 Antasida DOEN kombinasi Tablet
15 Astaxanthin 4 mg tab Tablet
16 Antasida DOEN suspensi Botol
17 Anti Hemoroid DOEN Kombinasi Sup
18 Asam Askorbat (Vit C) tablet 50 mg Tablet
19 Asam Folat Tablet
20 Asam mefenamat tab 500 mg Tablet
21 Albotyl (polikresol) Botol
22 Albendazole tab 400 mg Tablet
23 Azitromysin 500 Tablet
24 Anti TBC Anak Paket
25 Anti TBC Katagori I Paket
26 Anti TBC Katagori II Paket
27 Basitrasin 500 IU/g + Polimiksin 10.000 Tube
IU/g
28 Besi II Sulfat tablet kombinasi Tablet
29 Bioplacenton jelly tube
30 Betahistin mesilat 6 mg Tablet
31 Borax gliserine Botol
32 Balsam cap kaki 3 Tube
33 Betametason krim 0.1% Tube
34 Captopril 12,5 mg Tablet
35 Captopril 25 mg Tablet
36 Coparcetine ( Obat Flu dan batuk ) Tablet
37 Cetirizine 10 mg Tablet
38 Deksametason injeksi 5 mg/ml - 1 ml Ampul
39 Deksametason tablet 0,5 mg Tablet
40 Dasepam rectal 5 mg tube
41 Diasepam Inj 5 mg/ml Ampul
42 Diazepam tablet 2 mg Tablet
43 Difenhidramin HCl inj 10 mg/ml-1 ml Ampul
44 Digoksin tablet 0,25 mg Tablet
45 Doksisiklin Tablet
46 Domperidon Sirup Botol
47 Dextrofen ( Obat batuk dan pilek syr ) Botol
48 Domperidon drop Botol
49 Deksosimetason Tube
50 Dulcolak ( stolax Supp) Supp
51 Epinefrina (adrenalin) Injeksi 0,1% - 1 ml Ampul
52 Erytromicin 500 mg Tablet
53 Erfaflu ( Obat Flu syp ) Botol
54 Erytromicin syrup Botol
55 Erfakaf sirup Botol
56 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 Ampul
57 Fitomenadion (Vit.K1) tablet salut gula 10 Tablet
58 Fenobarbital tablet 30 mg Tablet
59 Furosemid tablet 40 mg Tablet
60 Fenol Gliserol tetes telinga 10% Botol
61 Garam Oralit untuk 200 ml air Sak
62 Gentamicin Sulfat TM 0,3% Botol
63 Gentamicin Salep kulit Tube
64 Glibenklamid tablet 5 mg Tablet
65 Griseofulvin tab 125 Tablet
66 Glimeperid 1 mg Tablet
67 Glimeperid 2 mg Tablet
68 Hidroklorotiazid (HCT) tablet 25 mg Tablet
69 Haloperidol 0,5 Tablet
70 Haloperidol 1,5 Tablet
71 Haloperidol 5 mg Tablet
72 Hidrokortison krim 2,5 % Tube
73 Hyoscine-N-Butilbromide 10 mg (Scopma) Tablet
74 Hyoscine-N-Butilbromide inj / Buscopan Ampul
75 Ibuprofen tablet 400 mg Tablet
76 Isosorbid Di Nitrat Tablet
77 Imunogard / Vitamin Imunitas Tablet
78 Ibuprofen tablet 200 mg Tablet
79 Ibuprofen Sirup Botol
80 Ketokonazole cream 2 % 15 gram Tube
81 Ketokonazole tablet 200 mg Tablet
82 Klindamycin 300 mg Tablet
83 Kloramfenikol tetes telinga 3 % Botol
84 Kloramphenikol salep mata 1 % Tube
85 Kloramphenikol Tetes Mata Botol
86 Klorfeniramin Maleat (CTM) tablet 4 mg Tablet
87 Klorpromazine HCL 100 MG ( CPZ) Tablet
88 Kotrimoksazol Suspensi Botol
89 Kotrimoksazol tablet 480 mg kombinasi Tablet
90 Kalium Gluconat Ampul
91 Lidokain comp Ampul
92 Lidokain injeksi Ampul
93 Levertran salep (salep minyak ikan) pot
94 Loperamid tablet 2 mg Tablet
95 Loratadin tablet 10 mg Tablet
96 Metformin 500 mg Tablet
97 Meloxicam 15 mg Tablet
98 Methyl Prednisolon 4 mg Tablet
99 Metilergometrin Maleat 0,125 mg Tablet
100 Metoklopramid syrup Botol
101 Metoklopramid tablet 5 mg Tablet
102 Metoklopramid hcl injeksi 5 mg Ampul
103 Metronidazol tablet 500 mg Tablet
104 Magnesium Sulfat Inj 40% 25 ml Ampul
105 Magnesium Sulfat Inj 20% 25 ml Ampul
106 Miconazol Tube
107 Metoklorpamid Hcl 5 mg/ml 2 ml Ampul
108 Metoklorpamid Hcl 5 mg tablet Tablet
109 Metronidazol vagina ( flagyl ) Supp
110 Natrium Diklofenac tablet 25 mg Botol
111 Natrium Diklofenac tablet 50 mg Tablet
112 Natrium Klorida larutan infus 0.9% steril Fles
113 New Diatabs ( Pularek ) Tablet
114 Nistatin tablet vaginal 100.000 IU/g Tablet
115 NB Salep Tube
116 OBH ( obat batuk hitam) Botol
117 Omeprazol 20 mg Tablet
118 Oksitosin inj Ampul
119 Ondancetron 8 mg Tablet
120 Ondansetron 8 mg inj Ampul
121 Papaverin Tab 40 mg Tablet
122 Parasetamol Rektal 125 mg/2.5 ml Tube
123 Parasetamol Rektal 250 mg/2.5 ml Tube
124 Parasetamol sirup 120 mg/5 ml Botol
125 Parasetamol tablet 500 mg Tablet
126 Perak Sulfadiazin 1% (Burnazin) Tube
127 Piridoksin HCl (Vit.B6) tablet 10 mg Tablet
128 Prednison tablet 5 mg Tablet
129 Parasetamol Drop Botol
130 Pirantel suspensi Botol
131 Pehacain injeksi Ampul
132 Procurma sirup Botol
133 quinina Tablet
134 Ranitidin Tablet
135 Retinol (vit.A) 100,000 IU tablet salut Tablet
136 Retinol (vit.A) 200.000 IU kapsul lunak Tablet
137 Ringer Laktat larutan infus steril (Produk lo botol
138 Salbutamol Nebuliser Ampul
139 TXP ( Triheksifenidil hcl ) Tablet
140 Salbutamol tablet 2 mg Tablet
141 Salbutamol tablet 4 mg Tablet
142 Salisil Bedak 2 % Botol
143 Tetracycline Tablet
144 Tetagam Ampul
145 Sefadroxil tablet 500 mg Capsul
146 Sefadroxil 125 syr Botol
147 Sinvastatin tablet 10 mg Tablet
148 Siprofloxacin Tab 500 mg Tablet
149 Thiamin hcl tab ( B1) Tablet
150 Siobion Tablet
151 Vitamin B Kompleks tablet Tablet
152 Vitamin B 12 inj Ampul
153 Zinc tablet 20 mg Tablet
154 Vitacaps ( Multivitamin kapsul ) Tablet
155 Zinc tablet 20 mg Tablet
156 Zinc sirup Botol
157 Zinc drop Botol

TOTAL

D.BHP
188 Aqua pro Injeksi steril, bebas pirogen Fles
189 Alkohol sweb Kotak
190 Duk 60 x 60 pcs
191 Alat suntik 10 ml biji
192 Alat suntik 2,5 ml biji
193 Alat suntik 5 ml biji
194 Alat suntik 3 cc Pcs
195 Blood Lanset bok
196 Chirurgic gloves size 8.0 Pcs
197 Etanol ( alkohol ) 70 % 100 ml Botol
198 Etakridina ( rivanol ) larutan 0.1% Botol
199 Elastic Bandage uk 7,5 x 4,5 cm roll
200 Foley Cateter biji
201 Hand scund M Biji
Hand scund M Kotak
202 Hand scund S Biji
Hand scund S Kotak
203 Infuset anak set
204 Infuset dewasa set
205 IV cateter No 18 G Biji
206 IV cateter No 20 G Biji
207 IV cateter No 22 G Biji
208 Jarum Heacting no 14 Biji
209 Kapas Pembalut 250 gram Biji
210 Kapas Pembalut 250 gram Biji
211 Kasa Pembalut 2m x 80 cm Rol
212 Kasa Pembalut 2m x 80 cm Rol
213 Kasa Pembalut Hidrofil 4 x 15 cm Rol
214 Kasa Pembalut Hidrofil 4 x 3 cm Rol
215 Kasa hidropyl 40 x 80 cm Rol
216 Kasa Hydropil 16 cm x 16 cm Kotak
217 Kasa Kompres DRC 40 cm x 40 cm Pcs
218 Klip besar 15 x 10cm Biji
219 Klip sedang 13 x 10cm biji
220 Klip Kecil 10 x 7 cm biji
221 Lisol Botol
222 Masker biji
223 Masker bok
224 Medicin packet bok
225 Nurse cup Kotak
226 Nurse cup Kotak
227 Plester 5 yard x 2 inchi rol
228 Plester ultrafik 10 cm x 1 m Rol
229 Perhidrol HCL / H2O2 3% Botol
230 Pisau bedah no 11 biji
231 Pisau bedah no 10 biji
232 Pisau bedah no 12 biji
233 Supratul BIJI
234 Supratul bok
235 Silk benang Kotak
236 Tranfusi set set
237 Under ped biji
238 Urin Bag biji
239 Wing needle biji
240 Yodium povidon larutan 10% 300ml Botol
241 Needle 22G Flashback pcs

TOTAL

GRATIS BAYAR PHB/ASKES

JUMLAH KUNJUNGAN RESEP

Mengetahui/Menyetujui YangMenyerahkan Yangmeminta

PimpinanPuskesmasKutaUtara Petugasgudangpuskesmas Pelaporpetugaspustu

dr. Ni Putu Purlimaningsih Ni Komang Ayu Triyani Ni Made Artini
NIP.197911202006042006 NIP.198801082011012016
Mengetahui/Menyetujui YangMenyerahkan Yangmeminta
PimpinanPuskesmasKutaUtara Petugasgudangpuskesmas Pelaporpetugaspustu

dr. Ni Putu Purlimaningsih Ni Komang Ayu Triyani Ni Made Artini
NIP.197911202006042006 NIP.198801082011012016

N OBAT

BULAN :

BULAN :

NOMOR TANGGAL

PERMINT TERIM
SISA STOK
AAN A

JML JML JML

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0

PHB/ASKES

Yangmeminta
Pelaporpetugaspustu

Ni Made Artini
Yangmeminta
Pelaporpetugaspustu

Ni Made Artini

 LAPORAN TRIWULAN IV PUKESMAS KUTA UTARA

( OKTOBER NOVEMBER DESEMBER ) 2017

UPT PUSKESMAS : UPT PKM KUTA UTARA

PUSKESMAS PEMBANTU YANG ADA :5
PROVINSI : Bali
UNIT : PUSTU CANGGU

HARGA STOK AWAL

NO NAMA OBAT SATUAN
SATUAN
JML
A. OBAT
1 Acyclovir tablet 400 mg Tablet 750
2 Acyclovir cream 5 % Tube 3000
3 Alopurinol tablet 100 mg Tablet 120
4 Ambroxol syrup Botol 3300
5 Ambroxol tablet 30 mg Tablet 125
6 Aminofilin tablet 200 mg Tablet 104
7 Amlodipine 10 mg T ablet
8 Amlodipine 5 mg T ablet 105
9 Amoksisilin kapletl 500 mg Kaplet 370
10 Amoksisilin kapletl 250 mg Kaplet 216
11 Amoksisilin Syr Forte 250 mg Botol
12 Amoksisilin sirup kering 125 mg/5ml Botol 3699
13 Amoksisilin drop 100 mg/ml Botol 29580
14 Antasida DOEN kombinasi Tablet 135
15 Astaxanthin 4 mg tab Tablet 2379
16 Antasida DOEN suspensi Botol 2643
17 Anti Hemoroid DOEN Kombinasi Sup 1470
18 Asam Askorbat (Vit C) tablet 50 mg Tablet 19
19 Asam Folat Tablet 62
20 Asam mefenamat tab 500 mg Tablet 176
21 Albotyl (polikresol) Botol 21801
22 Albendazole tab 400 mg Tablet
23 Azitromysin 500 Tablet 4500
24 Anti TBC Anak Paket 214990
25 Anti TBC Katagori I Paket 359990
26 Anti TBC Katagori II Paket 1199900
27 Basitrasin 500 IU/g + Polimiksin 10.000 IU/g Tube 2517
28 Besi II Sulfat tablet kombinasi Tablet 27
29 Bioplacenton jelly tube 17530
30 Betahistin mesilat 6 mg Tablet 924
31 Borax gliserine Botol 6270
32 Balsam cap kaki 3 Tube
33 Betametason krim 0.1% Tube 1866
34 Captopril 12,5 mg Tablet 71
35 Captopril 25 mg Tablet 138
36 Coparcetine ( Obat Flu dan batuk ) Tablet 915
37 Cetirizine 10 mg Tablet 330
38 Deksametason injeksi 5 mg/ml - 1 ml Ampul 1580
39 Deksametason tablet 0,5 mg Tablet 24
40 Dasepam rectal 5 mg tube 11517
41 Diasepam Inj 5 mg/ml Ampul 2344
42 Diazepam tablet 2 mg Tablet 13
43 Difenhidramin HCl inj 10 mg/ml-1 ml Ampul 1050
44 Digoksin tablet 0,25 mg Tablet 83
45 Doksisiklin Tablet 230
46 Domperidon Sirup Botol 3624
47 Dextrofen ( Obat batuk dan pilek syr ) Botol 10390
48 Domperidon drop Botol 15600
49 Deksosimetason Tube 9983
50 Dulcolak ( stolax Supp) Supp 6045
51 Epinefrina (adrenalin) Injeksi 0,1% - 1 ml Ampul 2204
52 Erytromicin 500 mg Tablet 535
53 Erfaflu ( Obat Flu syp ) Botol
54 Erytromicin syrup Botol 6700
55 Erfakaf sirup Botol 12980
56 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 ml Ampul 978
57 Fitomenadion (Vit.K1) tablet salut gula 10 mg Tablet 681
58 Fenobarbital tablet 30 mg Tablet 32
59 Furosemid tablet 40 mg Tablet 72
60 Fenol Gliserol tetes telinga 10% Botol 1008
61 Garam Oralit untuk 200 ml air Sak 440
62 Gentamicin Sulfat TM 0,3% Botol 3194
63 Gentamicin Salep kulit Tube 1650
64 Glibenklamid tablet 5 mg Tablet 72
65 Griseofulvin tab 125 Tablet 225
66 Glimeperid 1 mg Tablet 265
67 Glimeperid 2 mg Tablet 436
68 Hidroklorotiazid (HCT) tablet 25 mg Tablet 36
69 Haloperidol 0,5 Tablet 60
70 Haloperidol 1,5 Tablet 123
71 Haloperidol 5 mg Tablet 60
72 Hidrokortison krim 2,5 % Tube 3000
73 Hyoscine-N-Butilbromide 10 mg (Scopma) Tablet 1040
74 Hyoscine-N-Butilbromide inj / Buscopan Ampul 2467
75 Ibuprofen tablet 400 mg Tablet 150
76 Isosorbid Di Nitrat Tablet 65
77 Imunogard / Vitamin Imunitas Tablet 9990
78 Ibuprofen tablet 200 mg Tablet 105
79 Ibuprofen Sirup Botol 3499
80 Ketokonazole cream 2 % 15 gram Tube 4666
81 Ketokonazole tablet 200 mg Tablet 372
82 Klindamycin 300 mg Tablet 685
83 Kloramfenikol tetes telinga 3 % Botol 1000
84 Kloramphenikol salep mata 1 % Tube 1563
85 Kloramphenikol Tetes Mata Botol 2499
86 Klorfeniramin Maleat (CTM) tablet 4 mg Tablet 24
87 Klorpromazine HCL 100 MG ( CPZ) Tablet 104
88 Kotrimoksazol Suspensi Botol 3500
89 Kotrimoksazol tablet 480 mg kombinasi Tablet 165
90 Kalium Gluconat Ampul 7800
91 Lidokain comp Ampul 1033
92 Lidokain injeksi Ampul 1010
93 Levertran salep (salep minyak ikan) pot 1350
94 Loperamid tablet 2 mg Tablet 89
95 Loratadin tablet 10 mg Tablet 154
96 Metformin 500 mg Tablet 182
97 Meloxicam 15 mg Tablet 113
98 Methyl Prednisolon 4 mg Tablet 509
99 Metilergometrin Maleat 0,125 mg Tablet 154
100 Metoklopramid syrup Botol 1914
101 Metoklopramid tablet 5 mg Tablet 73
102 Metoklopramid hcl injeksi 5 mg Ampul 1947
103 Metronidazol tablet 500 mg Tablet 154
104 Magnesium Sulfat Inj 40% 25 ml Ampul 1948
105 Magnesium Sulfat Inj 20% 25 ml Ampul 5500
106 Miconazol Tube 1719
107 Metoklorpamid Hcl 5 mg/ml 2 ml Ampul 7425
108 Metoklorpamid Hcl 5 mg tablet Tablet 73
109 Metronidazol vagina ( flagyl ) Supp 3220
110 Natrium Diklofenac tablet 25 mg Botol 168
111 Natrium Diklofenac tablet 50 mg Tablet 218
112 Natrium Klorida larutan infus 0.9% steril Fles 4899
113 New Diatabs ( Pularek ) Tablet 190
114 Nistatin tablet vaginal 100.000 IU/g Tablet 289
115 NB Salep Tube 20302
116 OBH ( obat batuk hitam) Botol 2500
117 Omeprazol 20 mg Tablet 408
118 Oksitosin inj Ampul 1785
119 Ondancetron 8 mg Tablet 2596
120 Ondansetron 8 mg inj Ampul 10384
121 Papaverin Tab 40 mg Tablet 57
122 Parasetamol Rektal 125 mg/2.5 ml Tube 12672
123 Parasetamol Rektal 250 mg/2.5 ml Tube 32259
124 Parasetamol sirup 120 mg/5 ml Botol 1725
125 Parasetamol tablet 500 mg Tablet 45
126 Perak Sulfadiazin 1% (Burnazin) Tube 33000
127 Piridoksin HCl (Vit.B6) tablet 10 mg Tablet 14
128 Prednison tablet 5 mg Tablet 38
129 Parasetamol Drop Botol 4799
130 Pirantel suspensi Botol 8360
131 Pehacain injeksi Ampul 1363
132 Procurma sirup Botol 14850
133 quinina Tablet 670
134 Ranitidin Tablet 200
135 Retinol (vit.A) 100,000 IU tablet salut Tablet 260
136 Retinol (vit.A) 200.000 IU kapsul lunak Tablet 459
137 Ringer Laktat larutan infus steril (Produk lokal) botol 5200
138 Salbutamol Nebuliser Ampul 10533
139 TXP ( Triheksifenidil hcl ) Tablet 11946
140 Salbutamol tablet 2 mg Tablet 88
141 Salbutamol tablet 4 mg Tablet 97
142 Salisil Bedak 2 % Botol 1025
143 Tetracycline Tablet 257
144 Tetagam Ampul 61817
145 Sefadroxil tablet 500 mg Capsul 700
146 Sefadroxil 125 syr Botol 7227
147 Sinvastatin tablet 10 mg Tablet 513
148 Siprofloxacin Tab 500 mg Tablet 240
149 Thiamin hcl tab ( B1) Tablet 37
150 Siobion Tablet 1194
151 Vitamin B Kompleks tablet Tablet 22
152 Vitamin B 12 inj Ampul 473
153 Zinc tablet 20 mg Tablet 472
154 Vitacaps ( Multivitamin kapsul ) Tablet 948
155 Zinc tablet 20 mg Tablet 470
156 Zinc sirup Botol 12840
157 Zinc drop Botol 12840

TOTAL

D.BHP
188 Aqua pro Injeksi steril, bebas pirogen Fles 1500
189 Alkohol sweb Kotak 5500
190 Duk 60 x 60 pcs
191 Alat suntik 10 ml biji 2750
192 Alat suntik 2,5 ml biji 591
193 Alat suntik 5 ml biji 2640
194 Alat suntik 3 cc Pcs 788
195 Blood Lanset bok 19800
196 Chirurgic gloves size 8.0 Pcs 7980
197 Etanol ( alkohol ) 70 % 100 ml Botol 2500
198 Etakridina ( rivanol ) larutan 0.1% Botol 1800
199 Elastic Bandage uk 7,5 x 4,5 cm roll 81400
200 Foley Cateter biji 8494
201 Hand scund M Biji 360
Hand scund M Kotak 44100
202 Hand scund S Biji 360
Hand scund S Kotak 44100
203 Infuset anak set 3185
204 Infuset dewasa set 2910
205 IV cateter No 18 G Biji 5148
206 IV cateter No 20 G Biji 5148
207 IV cateter No 22 G Biji 5148
208 Jarum Heacting no 14 Biji 15840
209 Kapas Pembalut 250 gram Biji 11396
210 Kapas Pembalut 250 gram Biji 11300
211 Kasa Pembalut 2m x 80 cm Rol 21120
212 Kasa Pembalut 2m x 80 cm Rol 7000
213 Kasa Pembalut Hidrofil 4 x 15 cm Rol 11688
214 Kasa Pembalut Hidrofil 4 x 3 cm Rol 1584
215 Kasa hidropyl 40 x 80 cm Rol 95000
216 Kasa Hydropil 16 cm x 16 cm Kotak 5230
217 Kasa Kompres DRC 40 cm x 40 cm Pcs 1640
218 Klip besar 15 x 10cm Biji 138
219 Klip sedang 13 x 10cm biji 99
220 Klip Kecil 10 x 7 cm biji 79
221 Lisol Botol 37300
222 Masker biji 436
223 Masker bok 21780
224 Medicin packet bok 2310000
225 Nurse cup Kotak 649
226 Nurse cup Kotak 49500
227 Plester 5 yard x 2 inchi rol 31999
228 Plester ultrafik 10 cm x 1 m Rol 8470
229 Perhidrol HCL / H2O2 3% Botol 10800
230 Pisau bedah no 11 biji 660
231 Pisau bedah no 10 biji
232 Pisau bedah no 12 biji
233 Supratul BIJI 11300
234 Supratul bok 206030
235 Silk benang Kotak 6600
236 Tranfusi set set 15015
237 Under ped biji 52800
238 Urin Bag biji 8800
239 Wing needle biji 7400
240 Yodium povidon larutan 10% 300ml Botol 14500
241 Needle 22G Flashback pcs 1650

TOTAL
TOTAL KESELURUHAN

GRATIS BAYAR
JUMLAH KUNJUNGAN RESEP

Mengetahui/Menyetujui
PimpinanPuskesmasKutaUtara


Mengetahui/Menyetujui YangMenyerahkan
PimpinanPuskesmasKutaUtara Petugasgudangpuskesmas

dr. Ni Putu Purlimaningsih Ni Komang Ayu Triyani
NIP.197911202006042006 NIP.198801082011012016

AS KUTA UTARA
MBER ) 2017

PENERIM PEMAKAIA
SISA STOK
AAN N

JML JML JML RUPIAH

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

BAYAR PHB/ASKES JUMLAH

Yangmeminta
Pelaporpetugaspustu

 LAPORAN PENERIMAAN DAN LEMBAR PEMAKAIN OBAT

(LPLPO)

UPT PUSKESMAS : UPT PKM KUTA UTARA

PUSKESMAS PEMBANTU YANG ADA :5
PROVINSI : Bali
UNIT : PUSTU CANGGU

HARGA STOK AWAL

NO NAMA OBAT SATUAN
SATUAN

JML
A. OBAT
1 Acyclovir tablet 400 mg Tablet 750
2 Acyclovir cream 5 % Tube 3000
3 Alopurinol tablet 100 mg Tablet 120
4 Ambroxol syrup Botol 3300 4
5 Ambroxol tablet 30 mg Tablet 125 210
6 Aminofilin tablet 200 mg Tablet 104
7 Amlodipine 10 mg T ablet
8 Amlodipine 5 mg T ablet 105
9 Amoksisilin kapletl 500 mg Kaplet 370 284
10 Amoksisilin kapletl 250 mg Kaplet 216
11 Amoksisilin Syr Forte 250 mg Botol
12 Amoksisilin sirup kering 125 mg/5ml Botol 3699 14
13 Amoksisilin drop 100 mg/ml Botol 29580
14 Antasida DOEN kombinasi Tablet 135 432
15 Astaxanthin 4 mg tab Tablet 2379
16 Antasida DOEN suspensi Botol 2643
17 Anti Hemoroid DOEN Kombinasi Sup 1470
18 Asam Askorbat (Vit C) tablet 50 mg Tablet 19 307
19 Asam Folat Tablet 62
20 Asam mefenamat tab 500 mg Tablet 176
21 Albotyl (polikresol) Botol 21801
22 Albendazole tab 400 mg Tablet
23 Azitromysin 500 Tablet 4500
24 Anti TBC Anak Paket 214990
25 Anti TBC Katagori I Paket 359990
26 Anti TBC Katagori II Paket 1199900
27 Basitrasin 500 IU/g + Polimiksin 10.000 IU/g Tube 2517
28 Besi II Sulfat tablet kombinasi Tablet 27 300
29 Bioplacenton jelly tube 17530
30 Betahistin mesilat 6 mg Tablet 924
31 Borax gliserine Botol 6270
32 Balsam cap kaki 3 Tube
33 Betametason krim 0.1% Tube 1866
34 Captopril 12,5 mg Tablet 71 100
35 Captopril 25 mg Tablet 138
36 Coparcetine ( Obat Flu dan batuk ) Tablet 915
37 Cetirizine 10 mg Tablet 330
38 Deksametason injeksi 5 mg/ml - 1 ml Ampul 1580
39 Deksametason tablet 0,5 mg Tablet 24 29
40 Dasepam rectal 5 mg tube 11517 1
41 Diasepam Inj 5 mg/ml Ampul 2344
42 Diazepam tablet 2 mg Tablet 13
43 Difenhidramin HCl inj 10 mg/ml-1 ml Ampul 1050 6
44 Digoksin tablet 0,25 mg Tablet 83
45 Doksisiklin Tablet 230
46 Domperidon Sirup Botol 3624 1
47 Dextrofen ( Obat batuk dan pilek syr ) Botol 10390
48 Domperidon drop Botol 15600
49 Deksosimetason Tube 9983
50 Dulcolak ( stolax Supp) Supp 6045
51 Epinefrina (adrenalin) Injeksi 0,1% - 1 ml Ampul 2204
52 Erytromicin 500 mg Tablet 535
53 Erfaflu ( Obat Flu syp ) Botol
54 Erytromicin syrup Botol 6700
55 Erfakaf sirup Botol 12980
56 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 ml Ampul 978
57 Fitomenadion (Vit.K1) tablet salut gula 10 mg Tablet 681
58 Fenobarbital tablet 30 mg Tablet 32
59 Furosemid tablet 40 mg Tablet 72
60 Fenol Gliserol tetes telinga 10% Botol 1008
61 Garam Oralit untuk 200 ml air Sak 440 120
62 Gentamicin Sulfat TM 0,3% Botol 3194
63 Gentamicin Salep kulit Tube 1650
64 Glibenklamid tablet 5 mg Tablet 72
65 Griseofulvin tab 125 Tablet 225
66 Glimeperid 1 mg Tablet 265
67 Glimeperid 2 mg Tablet 436
68 Hidroklorotiazid (HCT) tablet 25 mg Tablet 36
69 Haloperidol 0,5 Tablet 60
70 Haloperidol 1,5 Tablet 123
71 Haloperidol 5 mg Tablet 60
72 Hidrokortison krim 2,5 % Tube 3000 12
73 Hyoscine-N-Butilbromide 10 mg (Scopma) Tablet 1040
74 Hyoscine-N-Butilbromide inj / Buscopan Ampul 2467
75 Ibuprofen tablet 400 mg Tablet 150
76 Isosorbid Di Nitrat Tablet 65
77 Imunogard / Vitamin Imunitas Tablet 9990
78 Ibuprofen tablet 200 mg Tablet 105 60
79 Ibuprofen Sirup Botol 3499
80 Ketokonazole cream 2 % 15 gram Tube 4666
81 Ketokonazole tablet 200 mg Tablet 372
82 Klindamycin 300 mg Tablet 685
83 Kloramfenikol tetes telinga 3 % Botol 1000 6
84 Kloramphenikol salep mata 1 % Tube 1563 2
85 Kloramphenikol Tetes Mata Botol 2499
86 Klorfeniramin Maleat (CTM) tablet 4 mg Tablet 24 240
87 Klorpromazine HCL 100 MG ( CPZ) Tablet 104
88 Kotrimoksazol Suspensi Botol 3500 -
89 Kotrimoksazol tablet 480 mg kombinasi Tablet 165 114
90 Kalium Gluconat Ampul 7800
91 Lidokain comp Ampul 1033
92 Lidokain injeksi Ampul 1010
93 Levertran salep (salep minyak ikan) pot 1350
94 Loperamid tablet 2 mg Tablet 89
95 Loratadin tablet 10 mg Tablet 154
96 Metformin 500 mg Tablet 182
97 Meloxicam 15 mg Tablet 113
98 Methyl Prednisolon 4 mg Tablet 509
99 Metilergometrin Maleat 0,125 mg Tablet 154
100 Metoklopramid syrup Botol 1914
101 Metoklopramid tablet 5 mg Tablet 73
102 Metoklopramid hcl injeksi 5 mg Ampul 1947
103 Metronidazol tablet 500 mg Tablet 154 30
104 Magnesium Sulfat Inj 40% 25 ml Ampul 1948
105 Magnesium Sulfat Inj 20% 25 ml Ampul 5500
106 Miconazol Tube 1719
107 Metoklorpamid Hcl 5 mg/ml 2 ml Ampul 7425
108 Metoklorpamid Hcl 5 mg tablet Tablet 73
109 Metronidazol vagina ( flagyl ) Supp 3220
110 Natrium Diklofenac tablet 25 mg Botol 168
111 Natrium Diklofenac tablet 50 mg Tablet 218
112 Natrium Klorida larutan infus 0.9% steril Fles 4899 1
113 New Diatabs ( Pularek ) Tablet 190 100
114 Nistatin tablet vaginal 100.000 IU/g Tablet 289 20
115 NB Salep Tube 20302 25
116 OBH ( obat batuk hitam) Botol 2500
117 Omeprazol 20 mg Tablet 408
118 Oksitosin inj Ampul 1785
119 Ondancetron 8 mg Tablet 2596
120 Ondansetron 8 mg inj Ampul 10384
121 Papaverin Tab 40 mg Tablet 57
122 Parasetamol Rektal 125 mg/2.5 ml Tube 12672 2
123 Parasetamol Rektal 250 mg/2.5 ml Tube 32259
124 Parasetamol sirup 120 mg/5 ml Botol 1725 13
125 Parasetamol tablet 500 mg Tablet 45 345
126 Perak Sulfadiazin 1% (Burnazin) Tube 33000
127 Piridoksin HCl (Vit.B6) tablet 10 mg Tablet 14 94
128 Prednison tablet 5 mg Tablet 38
129 Parasetamol Drop Botol 4799
130 Pirantel suspensi Botol 8360
131 Pehacain injeksi Ampul 1363 1
132 Procurma sirup Botol 14850
133 quinina Tablet 670
134 Ranitidin Tablet 200
135 Retinol (vit.A) 100,000 IU tablet salut Tablet 260
136 Retinol (vit.A) 200.000 IU kapsul lunak Tablet 459
137 Ringer Laktat larutan infus steril (Produk lokal) botol 5200 1
138 Salbutamol Nebuliser Ampul 10533
139 TXP ( Triheksifenidil hcl ) Tablet 11946
140 Salbutamol tablet 2 mg Tablet 88
141 Salbutamol tablet 4 mg Tablet 97
142 Salisil Bedak 2 % Botol 1025 5
143 Tetracycline Tablet 257
144 Tetagam Ampul 61817
145 Sefadroxil tablet 500 mg Capsul 700
146 Sefadroxil 125 syr Botol 7227
147 Sinvastatin tablet 10 mg Tablet 513
148 Siprofloxacin Tab 500 mg Tablet 240 100
149 Thiamin hcl tab ( B1) Tablet 37 260
150 Siobion Tablet 1194
151 Vitamin B Kompleks tablet Tablet 22 500
152 Vitamin B 12 inj Ampul 473 12
153 Zinc tablet 20 mg Tablet 472
154 Vitacaps ( Multivitamin kapsul ) Tablet 948
155 Zinc tablet 20 mg Tablet 470
156 Zinc sirup Botol 12840
157 Zinc drop Botol 12840 3
 TOTAL

D.BHP
188 Aqua pro Injeksi steril, bebas pirogen Fles 1500
189 Alkohol sweb Kotak 5500
190 Duk 60 x 60 pcs
191 Alat suntik 10 ml biji 2750
192 Alat suntik 2,5 ml biji 591
193 Alat suntik 5 ml biji 2640 12
194 Alat suntik 3 cc Pcs 788 10
195 Blood Lanset bok 19800
196 Chirurgic gloves size 8.0 Pcs 7980
197 Etanol ( alkohol ) 70 % 100 ml Botol 2500
198 Etakridina ( rivanol ) larutan 0.1% Botol 1800
199 Elastic Bandage uk 7,5 x 4,5 cm roll 81400
200 Foley Cateter biji 8494
201 Hand scund M Biji 360
Hand scund M Kotak 44100
202 Hand scund S Biji 360
Hand scund S Kotak 44100
203 Infuset anak set 3185 1
204 Infuset dewasa set 2910
205 IV cateter No 18 G Biji 5148
206 IV cateter No 20 G Biji 5148 3
207 IV cateter No 22 G Biji 5148
208 Jarum Heacting no 14 Biji 15840
209 Kapas Pembalut 250 gram Biji 11396
210 Kapas Pembalut 250 gram Biji 11300
211 Kasa Pembalut 2m x 80 cm Rol 21120
212 Kasa Pembalut 2m x 80 cm Rol 7000
213 Kasa Pembalut Hidrofil 4 x 15 cm Rol 11688 2
214 Kasa Pembalut Hidrofil 4 x 3 cm Rol 1584 4
215 Kasa hidropyl 40 x 80 cm Rol 95000
216 Kasa Hydropil 16 cm x 16 cm Kotak 5230
217 Kasa Kompres DRC 40 cm x 40 cm Pcs 1640 3
218 Klip besar 15 x 10cm Biji 138
219 Klip sedang 13 x 10cm biji 99
220 Klip Kecil 10 x 7 cm biji 79
221 Lisol Botol 37300
222 Masker biji 436 50
223 Masker bok 21780
224 Medicin packet bok 2310000
225 Nurse cup Kotak 649
226 Nurse cup Kotak 49500
227 Plester 5 yard x 2 inchi rol 31999
228 Plester ultrafik 10 cm x 1 m Rol 8470 1
229 Perhidrol HCL / H2O2 3% Botol 10800
230 Pisau bedah no 11 biji 660
231 Pisau bedah no 10 biji
232 Pisau bedah no 12 biji
233 Supratul BIJI 11300
234 Supratul bok 206030
235 Silk benang Kotak 6600 3
236 Tranfusi set set 15015
237 Under ped biji 52800
238 Urin Bag biji 8800
239 Wing needle biji 7400
240 Yodium povidon larutan 10% 300ml Botol 14500
241 Needle 22G Flashback pcs 1650

TOTAL
TOTAL KESELURUHAN

GRATIS BAYAR
JUMLAH KUNJUNGAN RESEP
32 15

Mengetahui/Menyetujui YangMenyerahkan
PimpinanPuskesmasKutaUtara Petugasgudangpuskesmas




dr. Ni Putu Purlimaningsih Ni Komang Ayu Triyani
NIP.197911202006042006 NIP.198801082011012016

R PEMAKAIN OBAT

PENERIM PEMAKAIA
SISA STOK PERMINTA PEMBERIA
AAN N
AN N

JML JML JML RUPIAH

0 0
0 0
0 0
4 0 0 10
70 140 17510 200
0 0
0 0
0 0
200 90 394 145780
0 0
0 0
5 9 33294 10
0 0
52 380 51297
0 0
0 0
0 0
40 267 5073
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
240 60 1620 500
 0 0
0 0
0 0
0 0
0 0
100 7100 300
0 0 200
0 0
0 0
0 0
300 80 249 5976 200
1 11517
0 0
0 0
6 6300
0 0
0 0
1 3624
0 0
0 0
0 0
0 0
0 0
0 0 300
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
120 52800
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
12 36000
 0 0
0 0
0 0
0 0
0 0
60 6300 200
0 0
0 0
0 0
0 0
6 6000
2 3126
0 0
20 220 5280
0 0
0 0
200 314 51810
0 0
0 0
0 0
0 0
0 0
0 0 200
0 0
0 0
0 0 200
0 0
0 0
0 0
0 0
30 4620 100
0 0 2
0 0
5 5 8594
0 0
0 0
0 0
0 0
0 0
1 0 0 4
100 19000
20 5780
1 24 487238
10 1 9 22500
 0 0
0 0
0 0
0 0
0 0
2 25344
0 0
1 12 20700
300 70 575 25875
0 0
30 64 915 100
0 0
0 0
0 0
5 2 4 5452
0 0
0 0
0 0
0 0
0 0
1 0 0 4
0 0
0 0
0 0
0 0
1 4 4100
0 0
0 0
0 0
0 0
0 0
100 24000 200
200 10 450 16650
0 0
500 11000
12 5676
0 0
0 0
0 0
0 0
3 38520
 0 0
0 0 1
0 0
0 0
0 0
10 10 12 31680 10
10 12 8 6300 30
0 0
0 0
2 1 1 2500 3
0 0
0 0
0 0
0 0
0 0
100 15 85 30600
0 0 2
1 3185
0 0 4
0 0 4
3 15444
0 0
0 0
0 0
0 0 2
0 0
0 0
1 1 11688 4
2 2 3168 4
0 0
0 0
2 1 1640 4
300 160 140 19250
0 0
0 0
0 0
15 35 15246
0 0 2
0 0
0 0
 0 0
0 0
1 0 0 4
0 0
0 0

0 0 4
0 0
2 1 6600 4
0 0
0 0
0 0
0 0
0 0 2
0 0

1323671

BAYAR PHB/ASKES JUMLAH

15 32 47

Yangmeminta
Pelaporpetugaspustu

NiMadeArtini
22.4.048.9823