LAPORAN PENGGUNAAN OBAT HARIAN (

JKN
Bulan :

No Nama Obat Kemasan Gol Persediaan Droping Jumlah Jumlah jenis obat P
Awal Persediaan 1 2 3 4 5 6 7 8 9 10 11 12 13 14
1 Abbocat No ; 18 Pcs JKA A
ASKES
KS
JLH
2 Abbocat No ; 20 Pcs JKA
ASKES
KS
JLH
3 Abbocat No ; 22 Pcs JKA
ASKES
KS
JLH
4 Abbocat No ; 24 Pcs JKA
ASKES
KS
JLH
5 Alat suntik 2,5 cc Pcs JKA
ASKES
KS
JLH
6 Alat suntik 5 cc Pcs JKA
ASKES
KS
JLH
7 Amoxillin 250 mg Capsul JKA
ASKES
KS
JLH
8 Amoxilin Capl 500 mg Kaplet JKA
ASKES
KS
JLH
9 Amoxilin Ds Botol JKA
 ASKES
KS
JLH
10 Antasida doen Tab Tablet JKA
ASKES
KS
JLH
11 Antasida doen Syrup Botol JKA
ASKES
KS

12 Aciclovir 200 mg Tablet JKA

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KS
13 Aciclovir 400 mg Tablet JKA
ASKES
KS
14 Aciclovir cream Tube JKA
ASKES
KS
15 Amlodipin 5 mg Tablet JKA
ASKES
KS
16 Amlodipin 10 mg Tablet JKA
ASKES
KS
JLH
17 Ambroxol 30 mg Tablet JKA
ASKES
KS
18 Ambroxol syr Botol JKA
ASKES
KS
JLH
19 Asam mefenamat 500 mg Tablet JKA
ASKES
KS
JLH
20 Allopurinol 100 mg Tablet JKA
ASKES
KS
JLH
21 Atropin sulfat Tablet JKA
 ASKES
KS
JLH
22 Anti hemaroit Supp JKA
ASKES
KS
JLH
23 Anti fungi / 2 - 4 zalp Pot JKA
ASKES
KS
JLH
24 Aminopilin Tab 200 mg Tablet JKA
ASKES
KS
JLH
25 Amitriptyline Tablet JKA
ASKES
KS
JLH
26 Asam folat Tablet JKA
ASKES
KS
JLH
27 Bisturi Pcs JKA
Askes
ks
JLH
28 Betametason Cream Tablet JKA
ASKES
KS
JLH
29 Bicarbonat natrikus /bicnat Tab JKA
Askes
ks
JLH
29 CTM Tab 4 mg Tablet JKA
Askes
KS
JLH
30 Cotrimoxazol tab 480 mg Tablet JKA
 Askes
KS
JLH
31 Cotrimoxazol syrup Btl JKA
Askes
KS
JLH
32 Cloramfenikol Caps 250 mg Capsul JKA
Askes
KS
JLH
33 Chloramphenicol syrup Btl JKA
Askes
KS
JLH
34 Chloramphenicol Zm Tube JKA
Askes
KS
JLH
35 Cloramfenikol Tm Botol JKA
Askes
KS
JLH
36 Chloramphenicol Tt Tablet JKA
Askes
KS
JLH
37 Cefadroxyl 500 mg Tablet JKA
Askes
KS
JLH
38 Cefadroxyl syr Tablet JKA
Askes
KS
JLH
39 Clorpromazin Tab 100 mg Tablet JKA
Askes
KS
JLH
40 Clorpromazin Inj Botol JKa
Askes
KS
JLH
41 Codeina HCl Tab 10 mg Tablet JKA
Askes
KS
JLH
42 Captopril 12,5 Tablet JKA
Askes
KS
JLH
43 Captopril 25 mg Tablet JKA
Askes
KS
JLH
44 Captopril 50 mg Tablet JKA
Askes
KS
JLH
45 Cyprofloxacin 500 mg Tablet JKA
Askes
KS
JLH
46 Clobazam 10 mg Tablet JKA
Askes
KS
JLH
47 Cat gut plain No : 2 / 0 Saset JKA
Askes
KS
JLH
48 Cat gut cromic No : 2 / 0 Saset JKA
Askes
KS
JLH
49 Cat gut cromic No : 3 / 0 Saset JKA
Askes
KS
JLH
50 Dexametason Tab 0,5 mg Tablet JKA
Askes
KS
JLH
51 Dexametason Inj Amp JLKA
Askes
KS
 JLH
52 Diazepam Tab 2 mg Tablet JLKA
Askes
KS
JLH
53 Doxyciklin Caps JLKA
Askes
KS
JLH
54 Diethylcabamazin Tab JLKA
Askes
KS
JLH
55 Diltiazem Tablet JKA
Askes
KS
JLH
56 Difenhidramine Inj Amp JLKA
Askes
KS
JLH
57 Domperidon Tab JKA
Askes
KS
JLH
58 Efedrin HCl Tab 25 mg Tab JKA
Askes
KS
JLH
59 Erytromisin Syrup Btl JKA
Askes
KS
JLH
60 Ergotamin Tartrat Tab JKA
Askes
KS
JLH
61 Furrosemida 40 mg Tab JKA
Askes
KS
JLH
63 Gliserilguayakolat 100 mg Tab JKA
Askes
KS
JLH
64 Grisiofulvin Tab 125 mg Tab JKA
Askes
KS
JLH
65 Gentanycin tm Btl JKA
Askes
KS
JLH
66 Gentamycin zk Tube JKA
Askes
KS
JLH
67 Glimepiride Tab JKA
Askes
KS
JLH
68 Glibenklamida Tab 5 mg Tab JKA
Askes
KS
JLH
69 Glucosa ifus Flc JKA
Askes
KS
JLH
70 Garam Oralit 200 mg Saset JKA
Askes
KS
JLH
71 Hidroklorotiazida Tab 25 mg Tab JKA
Askes
KS
JLH
72 Hikortison Cream Tube JKA
Askes
KS
JLH
73 Halloperidol Tab 0,5 mg Tab JKA
Askes
KS
 JLH
74 Halloperidol 1,5 mg Tab JKA
Askes
KS
JLH
75 Halloperidol 1,5 mg Tab JKA
Askes
KS
JLH
76 Halloperidol 5 mg Tab JKA
Askes
KS
JLH
77 Hand scun Ps JKA
Askes
KS
JLH
78 Infusionset anak Pcs JKA
Askes
KS
JLH
79 Infusionset dewasa Pcs JKA
Askes
KS
JLH
79 Isosorbiddinitrit Tab JKA
Askes
KS
JLH
80 Ibuprofen 200 mg Tab JKA
Askes
KS
JLH
81 Kalk Tab JKA
Askes
KS
JLH
82 Ketokenazol Tab JKA
Askes
KS
JLH
83 Ketokenazol cream Tube JKA
Askes
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 JLH
84 Kasa pembalut 4 X 10 rol JKA
Askes
KS
JLH
85 Kasa pebalut 4 X 15 rol JKA
Askes
KS
JLH
86 Levofloxasin Tab JKA
Askes
KS
JLH
87 Levetran zalp Tube JKA
Askes
KS
JLH
88 Loperamide 2 mg Tab JKA
Askes
KS
JLH
68 Lidocain Inj Amp JKA
Askes
KS
JLH
64 Metilergometrin Tab Tab JKA
Askes
KS
JLH
65 Metilergometrin Inj Amp JKA
Askes
KS
JLH
66 Metronidazol 500 mg Tab JKA
Askes
KS
JLH
67 Meloxikam 15 mg Caps JKA
Askes
KS
JLH
68 Metformin Hcl Tab JKA
Askes
 KS
JLH
69 Metoclopamide Tab JKA
Askes
KS
JLH
Miconazol cream Tube JKA
Askes
KS
JLH
Masker mulut Lbr JKA
Askes
KS
JLH
Natrium diklofenat Tab JKA
Askes
KS
JLH
Nistatin Oral Tab JKA
Askes
KS
JLH
Neo antides JKA
Askes
KS
JLH
Nifedipin Tab JKA
Askes
KS
JLH
Nacl inf Flc JKA
Askes
KS
JLH
Oksitrasiklin Zm JKA
Askes
KS
JLH
Oksitrasiklin Zk JKA
Askes
KS
JLH
Obat batuk hitam JKA
 Askes
KS
JLH
69 Paracetamol Tab 500 mg JKA
Askes
KS
JLH
70 Paracetamol Syrup 120 mg JKA
Askes
KS
JLH
71 Prednison Tab 5 mg JKA
Askes
KS
JLH
72 Piroksikam Caps JKA
Askes
KS
JLH
73 Pirantel Tab 125 mg JKA
Askes
KS
JLH
74 Piridoksin HCl 10 mg JKA
Askes
KS
JLH
75 Propiltiourasil Tab 100 mg JKA
Askes
KS
JLH
76 Propanolol Tab 10 mg JKA
Askes
KS
JLH
77 Propanolol Tab 40 mg JKA
Askes
KS
JLH
78 Ranitidin Tab JKA
Askes
 KS
JLH
79 Ranitidin Inj JKA
Askes
KS
JLH
80 Retinol 200.000 IU JKA
Askes
KS
JLH
81 Reserpin Tab JKA
Askes
KS
JLH
82 Salbutamol Tab 4 mg JKA
Askes
KS
JLH
83 Salisil Bedak 2% JKA
Askes
KS
JLH
84 Side JKA
Askes
KS
JLH
85 Slet Box JKA
Askes
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JLH
86 Tetrasiklin HCL 500 mg JKA
Askes
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JLH
87 JKA
Askes
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JLH
88 JKA
Askes
KS
JLH
89 JKA
 Askes
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JLH
90 Tiamin HCl ( Vit B1 ) 50 mg JKA
Askes
KS
JLH
91 Triheksifenidril HCl 2 mg JKA
Askes
KS
JLH
92 Thiampenikol Kapl 500 mg JKA
Askes
KS
JLH
93 Vitamin B Complek JKA
Askes
KS
JLH
94 Asam Askorbat (vit. C ) JKA
50 mg Askes
KS
JLH

Mengetahui ,
Kepala Puskesmas

dr. H. Syarbaini, M. Kes

Nip. 140 360 289

Bulan :

No Nama Obat Satuan Persediaan Droping Jumlah Jumlah jenis obat P

Awal Persediaan 1 2 3 4 5 6 7 8 9 10 11 12 13 14
1 buah
2 botol
3 Ampul
4 Antalgin Inj Ampul
 5 Aqua Pro Inj Steril Vial
6 Aqubidest Steril botol
7 ATS Inj 20000 IU Ampul
8 Benzatina BP 2,4 Jt IU Vial
9 Bisturi / Pisau Bedah buah
10 Catgut / Benang Bedah set
11 Deksametason Inj Ampul
12 Deazepam Inj 2 mg Ampul
13 Dipenhidramin Inj Ampul
14 Etakridin Komp botol
15 Etanol 70 % botol
16 Etil Klorida Semprot botol
17 Eudenol Cair botol
18 Fitomenadion Inj Ampul
19 Glukosa Lar Inf 5 % botol
20 Hand Scun Set
21 Infusion Set Anak buah
22 Infusion Set Anak buah
23 Kapas Pembalut 250 mg Bks
24 Kaporit Kg
25 Kasa Pembalut 4 m x 15 cm rol
26 Lar. Benedict botol
27 Lar. Eosin 2% botol
28 Lar. Etanol Asam botol
29 Lar. Giemsastain botol
30 Lar. Karbol Fuksin botol
31 Lar. Metilan Biru botol
32 Lisol botol
33 Metil Ergometrin Maleat Inj Ampul
34 Natrium Klorida Inf 0,9 % botol
35 Obat Tuberkulosis Kat 1 paket
36 Obat Tuberkulosis Kat 2 paket
37 Obat Tuberkulosis Kat 3 paket
38 Obat Tuberkulosis Sisipan paket
39 Obat Tuberkulosis Kat Anak paket
40 Oksitetrasiklin Inj Vial
41 Oksitosin Inj Ampul
42 Plester rol
43 Renger Laktat Inf botol
44 Sianokobalamin Inj Ampul
45 Silk set
46 Tiamina Inj Ampul
47 Wing Nedle Unit
48 Xilomidon Inj Vial
49 Yodium Povidon 30 ml botol

Jumlah Kunjungan JPKM

ASKES
KS

Mengetahui ,
Kepala Puskesmas

dr. H. Syarbaini, M. Kes

Nip. 140 360 289

No Nama Obat Satuan Persediaan Droping Jumlah Jumlah jenis obat P

Awal Persediaan 1 2 3 4 5 6 7 8 9 10 11 12 13 14
JPKM
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JPKM
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JPKM
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JPKM
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JPKM
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JPKM
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JPKM
Askes
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JPKM
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JPKM
Askes
KS
JPKM
Askes
KS
JPKM
Askes
KS
JPKM
Askes
KS
JPKM
Askes
KS
JPKM
Askes
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JPKM
Askes
KS
JPKM
Askes
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JPKM
Askes
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JPKM
Askes
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JPKM
Askes
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JPKM
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JPKM
Askes
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RIAN ( LPOH )

enis obat Pada Tanggal Pemakaian Jumlah Sisa Akhir Keterangan

15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Pemakaian Bulan
 Idi Rayeuk ,
Petugas Apotik

FatImah Cut
Nip. 140 266 670

enis obat Pada Tanggal Pemakaian Jumlah Sisa Akhir Keterangan

15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Pemakaian Bulan
 Idi Rayeuk ,
Petugas Apotik

FatImah Cut
Nip. 140 266 670

enis obat Pada Tanggal Pemakaian Jumlah Sisa Akhir Keterangan

15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Pemakaian Bulan
No NAMA OBAT KEMASAN No NAMA OBAT

1 Amoxillin 250 mg Capsul 62 Halloperidol 2,5 mg

2 Amoxilin Capl 500 mg Kaplet 63 Halloperidol 1,5 mg
3 Amoxilin Dry syrup Botol 64 Halloperidol 5 mg
4 Antasida doen Tab Tablet 65 Isosorbiddinitrit
5 Antasida doen Syrup Botol 66 Ibuprofen 200 mg
6 Aciclovir 200 mg Tablet 67 Kalk
7 Aciclovir 400 mg Tablet 68 Ketokenazol
8 Aciclovir cream Tube 69 Ketokenazol cream
9 Amlodipin 5 mg Tablet 70 Kasa pembalut 4 X 10
10 Amlodipin 10 mg Tablet 71 Kasa pebalut 4 X 15
11 Ambroxol 30 mg Tablet 72 Levofloxasin
12 Ambroxol syr Botol 73 Levetran zalp
13 Asam mefenamat 500 mg Tablet 74 Loperamide 2 mg
14 Allopurinol 100 mg Tablet 75 Metilergometrin Tab
15 Atropin sulfat Tablet 76 Metronidazol 250 mg
16 Anti hemaroit Supp 77 Metronidazol 500 mg
17 Anti fungi / 2 - 4 zalp Pot 78 Metilergometrin Tab
18 Aminopilin Tab 200 mg Tablet 79 Meloxikam 15 mg
19 Amitriptyline 25 mg Tablet 80 Metformin Hcl
20 Asam folat 400 mcg Tablet 81 Metoclopamide
21 Betametason Cream Tablet 82 Miconazol cream
22 Bicarbonat natrikus /bicnat Tab 83 Natrium bicarbonat
23 CTM Tab 4 mg Tablet 84 Natrium diklofenat
24 Cotrimoxazol tab 480 mg Tablet 85 Nistatin Oral
25 Cotrimoxazol syrup Btl 86 Neo antides
26 Cloramfenikol Caps 250 mg Capsul 87 Nifedipin
27 Chloramphenicol syrup Btl 88 Nacl inf 500 ml
28 Chloramphenicol Zm Tube 89 Oksitrasiklin Zm
29 Cloramfenikol Tm Botol 90 Oksitrasiklin Zk
30 Chloramphenicol Tt Tablet 91 Obat batuk hitam
31 Cefadroxyl 500 mg Tablet 92 Paracetamol Tab 500 mg
32 Cefadroxyl syr Tablet 93 Paracetamol Syrup 120 mg
33 Clorpromazin Tab 100 mg Tablet 94 Prednison Tab 5 mg
34 Clorpromazin Inj Botol 95 Piroksikam Caps
35 Codeina HCl Tab 10 mg Tablet 96 Pirantel 125 mg
36 Captopril 12,5 mg Tablet 97 Piridoksin HCl 10 mg
37 Captopril 25 mg Tablet 98 Propiltiourasil Tab 100 mg
38 Captopril 50 mg Tablet 99 Propanolol Tab 10 mg
39 Cyprofloxacin 500 mg Tablet 100 Propanolol Tab 40 mg
40 Clobazam 10 mg Tablet 101 Ranitidin 150 mg
41 Dexametason Tab 0,5 mg Tablet 102 Retinol 200.000 IU
42 Diazepam Tab 2 mg Tablet 103 Salbutamol Tab 4 mg
43 Doxyciklin Caps 104 Salisil Bedak 2%
44 Diethylcabamazin Tab 105 Tetrasiklin HCL 500 mg
45 Diltiazem Tablet 106 Tiamin HCl ( Vit B1 ) 50 mg
46 Domperidon Tab 107 Triheksifenidril HCl 2 mg
47 Efedrin HCl Tab 25 mg Tab 108 Thiampenikol Kapl 500 mg
48 Erytromisin Syrup Btl 109 Tramadol 50 mg
49 Ergotamin Tartrat Tab 110 Truvit syrup
50 Furrosemida 40 mg Tab 111 Tetracyclin 500 mg
51 Gliserilguayakolat 100 mg Tab 112 Tes kehamilan
52 Grisiofulvin Tab 125 mg Tab 113 Tes Asam urat
53 Gentanycin tm Btl 114 Tes Colestrol
54 Gentamycin zk Tube 115 Tes KGD
55 Glimepiride Tab 116 Vit B 6 10 mg
56 Glibenklamida Tab 5 mg Tab 117 Vit B 12 50 mg
KEMASAN

Tab
Tab
Tab
Tab
Tab
Tab
Tab
Tube
rol
rol
Tab
Tube
Tab
Tab
Tab
Tab
Tab
Caps
Tab
Tab
Tube
Tab
Tab
Tab
TAB
Tab
Flc
Tube
Tube
btl
Tab
btl
Tab
Tab
Tab
TAB
Tab
Tab
Tab
Tab
Tab
Tab
Tab
Tab
Tab
Tab
Tab
Caps
Btl
Caps
Pcs
Pcs
Pcs
Pcs
Tab
Tab
57 Glucosa ifus Flc 118 Vit B complek
58 Garam Oralit 200 mg Saset 119 Vit C 50 mg
59 Hidroklorotiazida Tab 25 mg Tab 120 Zink 20 mg
60 Hikortison Cream Tube 121 Zink syrup
61 Halloperidol Tab 0,5 mg Tab 122
Tab
Tab
Tab
Btl