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LAPORAN PEMEKAIAN DAN LEMBAR PERMINTAAN OBAT

[ LPLPO ]
PUSKESMAS PEMBANTU :
KECAMATAN :
KABUPATEN : Bulan :
PROPINSI : Tahun :

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN


1 Allupurinol 100 mg Tablet
2 Aminopillin Tablet
3 Aminopillin injeksi Ampul
4 Amoxicillin 500 mg Kaplet
5 Amoxicillin 125 mg syr Botol
6 Antalgin 500 mg Tablet
7 Antalgin injeksi Ampul
8 Antasida Tablet
9 Atr S04 Tablet
10 Atr S04 Injeksi Ampul
11 Asam Ascorbat /Vit c 50 mg Tablet
12 Bedak salisil talk Botol
13 Cotrimoxazole 480 mg Tablet
14 Cotrimoxazole Syr Botol
15 Clorampenicol 250 mg Kapsul
16 CTM Tablet
17 Cloroquin Tablet
18 Cat gut Pcs
19 Dexametason 0,5 mg Tablet
20 Dexametason Injeksi Ampul
21 Dekstrometorphan hbr Tablet
22 Dekstrometorphan hbr Syr Botol
23 Dipenhidramin hcl Injeksi Ampul
24 D 5% Infus Botol
25 Etanol / Alkohol 1 ltr Botol
26 Efineprin Injeksi Ampul
27 Gentian Violet Botol
28 Gliseril g Tablet
29 Glibenklamid Tablet
30 Hct Tablet
31 Ibufropen 200 mg Tablet
32 Infus set Dws Pcs
33 Infus set Anak Pcs
34 Isosorbid Dinitrat Tablet
35 Mebendazole Syr Botol
36 Metronidazole 250 mg Tablet
37 Nistatin Tablet
38 Na cl Infus Botol
39 OBP Syr Botol
40 Oralit Bungkus
41 Oxytettrasiklin Injeksi Vial
42 Oxytettrasiklin salep kulit Tube
43 Paracetamol 500 mg Tablet
44 Paracetamol Syr Botol
45 Prednison Tablet
46 Propanolol 40 mg Tablet
47 Reserpin Tablet
48 RL Infus Botol
49 Spuid 3 cc Pcs
50 Vit B1 Tablet
51 Vit B1 Injeksi Ampul
52 Vit B6 Tablet
53 Vit B6 Injeksi Ampul
54 Vit B comp Tablet
55 Vit K / Pitominadion Tablet
56 Vit K / Pitominadion Injeksi Ampul
57 Wing Nedle 21 g Pcs
58 Wing Nedle 23 g Pcs
59 Rivanol Botol
SISA STOK KETERANGAN
LAPORAN PEMEKAIAN DAN LEMBAR PERMINTAAN OBAT
[ LPLPO ]

PUSKESMAS PEMBANTU :
KECAMATAN :
KABUPATEN : Bulan :
PROPINSI : Tahun :

STOK SISA
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN
AWAL STOK
1 Allupurinol 100 mg Tablet 1,000 1,000
2 Aminopillin Tablet
3 Aminopillin injeksi Ampul
4 Amoxicillin 500 mg Kaplet
5 Amoxicillin 125 mg syr Botol
6 Antalgin 500 mg Tablet
7 Antalgin injeksi Ampul
8 Antasida Tablet
9 Atr S04 Tablet
10 Atr S04 Injeksi Ampul
11 Asam Ascorbat /Vit c 50 mg Tablet
12 Bedak salisil talk Botol
13 Cotrimoxazole 480 mg Tablet
14 Cotrimoxazole Syr Botol
15 Clorampenicol 250 mg Kapsul
16 CTM Tablet
17 Cloroquin Tablet
18 Cat gut Pcs
19 Dexametason 0,5 mg Tablet
20 Dexametason Injeksi Ampul
21 Dekstrometorphan hbr Tablet
22 Dekstrometorphan hbr Syr Botol
23 Dipenhidramin hcl Injeksi Ampul
24 D 5% Infus Botol
25 Etanol / Alkohol 1 ltr Botol
26 Efineprin Injeksi Ampul
27 Gentian Violet Botol
28 Gliseril g Tablet
29 Glibenklamid Tablet
30 Hct Tablet
31 Ibufropen 200 mg Tablet
32 Infus set Dws Pcs
33 Infus set Anak Pcs
34 Isosorbid Dinitrat Tablet
35 Mebendazole Syr Botol
36 Metronidazole 250 mg Tablet
37 Nistatin Tablet
38 Na cl Infus Botol
39 OBP Syr Botol
40 Oralit Bungkus
41 Oxytettrasiklin Injeksi Vial
42 Oxytettrasiklin salep kulit Tube
43 Paracetamol 500 mg Tablet
44 Paracetamol Syr Botol
45 Prednison Tablet
46 Propanolol 40 mg Tablet
47 Reserpin Tablet
48 RL Infus Botol
49 Spuid 3 cc Pcs
50 Vit B1 Tablet
51 Vit B1 Injeksi Ampul
52 Vit B6 Tablet
53 Vit B6 Injeksi Ampul
54 Vit B comp Tablet
55 Vit K / Pitominadion Tablet

56 Vit K / Pitominadion Injeksi Ampul


57 Wing Nedle 21 g Pcs
58 Wing Nedle 23 g Pcs
59 Rivanol Botol
AN DAN LEMBAR PERMINTAAN OBAT
[ LPLPO ]

KETERANGAN