Lplpo S.opt - Mei 2019

LAPORAN PEMAKAIAN DAN PENGELUARAN OBAT
( LPLPO )
KODE PUSKESMAS :
PUSKESMAS :
KECAMATAN :
KAB. / KODYA : Kotabaru
PROPINSI : Kalimantan Selatan
No STOK
KODE NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN
URUT AWAL
1 2 3 4 5 6 7
GOLONGAN OBAT GENERIK / ESENSIAL
1 02182020 Alopurinol tablet 100 mg Tab 0 0
2 03180520 Alopurinol tablet 300 mg Tab 0 0
3 01170720 Aminofilin tablet 200 mg Tab 0 0
4 01170419 Aminofilin injeksi 24 mg/ml - 10 ml Amp 0 0
5 01171119 Amitriptilin HCl tab. Salut 25 mg Tab 0 0
6 03190221 Amoksisilin kaplet 500 mg Kapl 0 0
7 01180519 Amoksisilin sirup kering 125 mg / 5 ml Btl 0 0

No STOK
URUT
AWAL
8 02181019 Antasida Doen tablet kombinasi Tab 0 0
9 03180822 Antibakteri doen salep kombinasi (Bacitracin) Tub 0 0
10 01180222 Antihemoroid doen kombinasi Suppo 0 0
11 02180620 Antifungi doen kombinasi Pot 0 0
12 03181019 Antimigran doen kombinasi (Ergotamin) Tab 0 0
13 01180721 Antasida suspensi Btl 0 0
14 01180121 Aqua proinjeksi steril, bebas pirogen Btl 0 0
15 02180421 Asam askorbat (vit c) tablet 50 mg Tab 0 0
Asam askorbat (vit c) tablet 250 mg Tab 0 0
16 03180520 Asetosal 80 mg (Miniaspi 80 mg) Tab 0 0
17 01181019 Atropin sulfat injeksi 0,25 mg/ml - 1 ml Amp 0 0
18 03181019 Acetyl Cystein 200mg Kaps 0 0
19 03180322 Acyclovir tablet 200 mg Tab 0 0

No STOK
URUT
AWAL
20 03180722 Acyclovir tablet 400 mg Tab 0 0
21 Acyclovir tablet Cream Tube 0 0
22 02181020 Ambroksol sirup Btl 0 0
23 01170920 Ambroksol tablet 30mg Tab 0 0
24 03181520 Asam Mefenamat tablet 500 mg Tab 0 0
25 03190222 Asam Traneksamat Tablet 500 mg Tab 0 0
26 03171119 Asam Traneksamat 100 mg/5 ml Injeksi Amp 0 0
29 01180820 Asam folat tab 1 mg Tab 0 0
30 03180920 Amlodipin 5mg Tab 0 0
31 01180821 Amlodipin 10 mg Tab 0 0
32 01170820 Betametason krim 0,1 % Tub 0 0
33 02181120 Betahistin mesilate tablet 6 mg Tab 0 0
34 01180820 Cefadroxil 500 mg kaps Kaps 0 0
35 03180820 Cefadroxil sirup kering 250 mg/5ml Btl 0 0
36 Captopril tablet 12,5 mg Tab 0 0
37 02180820 Captopril tablet 25 mg Tab 0 0

No STOK
URUT
AWAL
38 03180821 Captopril tablet 50 mg Tab 0 0
39 03180420 Ciprofloxacin tablet 500 mg Tab 0 0
40 01180320 Cetirizine Tab 10 mg Tab 0 0
41 Cetirizine Syrup Botol 0 0
42 Cefotaxim injeksi Vial 0 0
43 03180920 Ceptriaxon injeksi Vial 0 0
44 Cimetidin Tab 0 0
45 Clyndamicin 150 mg Tab 0 0
46 03180520 Deksametason inj 5 mg/ml - 1 ml Amp 0 0
47 03180520 Deksametason tablet 0,5 mg Tab 0 0
48 01180220 Diazepam inj 5 mg/ml - 2 ml Amp 0 0
49 Diazepam rectal (Stesolid rectal 10 mg) Tube 0 0
50 Diazepam tablet 2 mg Tab 0 0
51 03180822 Diazepam tablet 5 mg Tab 0 0
52 01180121 Difenhidramin HCl inj 10 mg/ml - 1 ml Amp 0 0

No STOK
URUT
AWAL
53 01180620 Digoksin tablet 0,25 mg Tab 0 0
54 01180821 Domperidone tablet 10 mg Tab 0 0
55 03181020 Domperidon suspensi 5 mg / 5 ml Btl 0 0
56 03180720 Doxycycline 100 mg Kaps 0 0
57 01170219 Efedrin HCl tablet 25 mg Tab 0 0
58 03191120 Epinefrin 1 mg/ml inj s.c/i.m Amp 0 0
59 01181020 Etakridin (rivanol) larutan 0,1 % Btl 0 0
60 02180822 Erytromicin kaplet 500 mg Kapl 0 0
61 Erytromicin Syrup Botol 0 0
62 02180522 Etambutol tab 500mg ( HCL ) Tab 0 0
63 03171020 Etanol 70 % ( 1000 ML ) Btl 0 0
64 03180320 Fenotoin natrium kapsul 100 mg Kap 0 0
65 02190720 Fenol Gliserol Tetes Telinga 10% Btl 0 0
66 03180520 Fenobarbital injeksi 50 mg/ml - 2 ml Amp 0 0
67 03180423 Fenobarbital tablet 30 mg Tab 0 0
68 03181119 Fitomenadion (vit K 1) injeksi 10 mg/ml - 1 ml Amp 0 0
69 01181220 Fitomenadion (vit K 1) tablet salut 10 mg Tab 0 0
70 01180121 Furosemid tablet 40 mg Tab 0 0

No STOK
URUT
AWAL
71 01180819 Furosemid inj 10mg/ml amp 0 0
72 01180323 Glibenklamid Tab 0 0
73 03180323 Glibenklamid Tab 0 0
74 03190921 Glimepiride 1 mg Tab 0 0
75 03170121 Glimepiride 2 mg Tab 0 0
76 01170921 Gliseril guayakolat 100 mg Tab 0 0
77 03171121 Gliserin Btl 0 0
78 03171219 Glukosa larutan infus 5 % steril Btl 0 0
79 03180620 Griseofulvin tablet 125 mg, micronized Tab 0 0
80 03171119 Gentamycin Sulfat Inj 2 ml Amp 0 0
81 01180521 Gentamycin tetes mata 0,3 % Btl 0 0
82 Gentian Violet Btl 0 0
83 03170320 Haloperidol tablet 0,5 mg Tab 0 0
84 02180719 Haloperidol tablet 1,5 mg Tab 0 0
85 02190719 Haloperidol tablet 5 mg Tab 0 0

No STOK
URUT
AWAL
86 03170522 Hidroklorotiazid (HCT) tablet 25 mg Tab 0 0
87 01180222 Hidrokortison krim 2,5 mg Tub 0 0
88 01170219 Isoniazid tab 300 mg Tab 0 0
89 01180420 Ibuprofen syr 100mg/ 5 ml Botol 0 0
90 Ibuprofen200 mg Tab 0 0
91 02190822 Ibuprofen400 mg Tab 0 0
92 01180722 Isosorbid dinitrat tablet sublingual 5 mg Tab 0 0
93 03180220 Kalsium laktat (kalk) tablet 500 gram Tab 0 0
94 03170619 Karbamazepin tablet 200 gram Tab 0 0
95 03180322 Kloramfenikol kapsul 250 mg Kap 0 0
96 01180221 Kloramfenikol salep mata 1 % Tub 0 0
97 02190320 Kloramfenikol Tetes Mata Btl 0 0
98 02190921 Kloramfenikol Tetes Telinga 1% Btl 0 0
99 02170620 Kloramfenikol Suspensi 125 mg/5ml Btl 0 0
100 03181022 Klorfeniramin maleat (CTM) tablet 4 mg Tab 0 0
101 Klorpromazin HCl tablet salut 25 mg Tab 0 0
102 02180320 Klorpromazin HCl tablet salut 100 mg Tab 0 0
103 01170819 Klorpromazine HCL inj 25mg/ml-1 ml injeksi Amp 0 0

No STOK
URUT
AWAL
104 01170720 Kodein HCl tablet 10 mg Tab 0 0
105 03181221 Kodein HCl tablet 10 mg Tab 0 0
106 Kotrimoksazol 480 mg Tab 0 0
107 01170420 Kotrimoksazol suspensi Btl 0 0
108 03180620 Ketokonazole 200mg Tab Tab 0 0
109 01180222 Ketokonazole cream Tub 0 0
110 03180521 Lidokain kompositum injeksi Amp 0 0
111 01170000 Lisol Btl 0 0
112 01170220 Lar anhydrous dextrose,Nacl,Kcl,Na laktat,(KAEN 3B) Btl 0 0
113 03180821 Loratadine 5 mg Tab 0 0
114 03191120 Metilergometrin maleat inj. 0,2 mg - 1 ml Amp 0 0
115 Metilergometrin maleat tablet 0,25 mg Tab 0 0
116 03170321 Miconazol 2 % cream Tub 0 0
117 03180922 Metoklopramide tablet 10 mg Tab 0 0
118 Metoklopramide Injeksi Amp 0 0

No STOK
URUT
AWAL
119 01180522 Metoklopramide sirup 5 mg/5ml (Primpen) Btl 0 0
120 Metronidazol Tab 500 mg Tab 0 0
121 Metronidazol Tab 250 mg Tab 0 0
122 Metronidazol Syrup Botol 0 0
123 01170720 Metronidazol larutan Infus Btl 0 0
124 03191120 Metronidazol larutan Infus 5 mg/ml Btl 0 0
125 03180821 Metilprednisolon 4 mg Tab 0 0
126 03190123 Metilprednisolon 16 mg Tab 0 0
127 03180920 Metformin 500 mg Tab 0 0
128 01180920 Metformin 850 mg Tab 0 0
129 03190321 Metamizole Inj 500mg/ml Amp 0 0
130 01170320 Metoklopramide sir ( Norvom Syr) btl 0 0
131 Magnesium Sulfat 40% (MgSo4) Vial 0 0
132 02190820 Magnesium Sulfat 20% (MgSo4) Vial 0 0
133 03191220 Natrium klorida larutan infus 0,9% steril Btl 0 0
134 01180220 Nistatin 100.000 iu/g tablet vaginal Tab 0 0
135 03180421 Nistatin 500.000 iu tablet salut Tab 0 0
136 03180623 Natrium diclofenak 25 mg Tab 0 0

No STOK
URUT
AWAL
137 03180621 Natrium diclofenak 50 mg Tab 0 0
138 02190521 Nifedipine Tab 0 0
139 02171020 Obat batuk hitam (o.b.h) cairan Btl 0 0
140 03191120 Oksitosin injeksi 10 iu/ml - ml Amp 0 0
141 Oksitetrasiklin Salep kulit Tube 0 0
142 02190721 Oksitetrasiklin Salep Mata Tub 0 0
143 03191020 Omeprazole kapsul/kaplet 20 mg Kap 0 0
144 03180000 Parasetamol syr 120 mg / 5 ml Btl 0 0
145 03191220 Parasetamol tablet 500 mg Tab 0 0
146 01180319 Parasetamol tetes 60mg/ 0,6 ml Botol 15 ml 0 0
147 Papaverin Tablet 40 mg Tab 0 0
148 01170319 Petidin HCl injeksi 50 mg/ml - 2 ml Amp 0 0
149 03180121 Piridoksin HCl tablet 10 mg Tab 0 0
150 03180720 Prednison tablet 5 mg Tab 0 0
151 03170919 Primakuin tablet 15 mg Tab 0 0

No STOK
URUT
AWAL
152 01170621 Propiltiourasil tablet 100 mg Tab 0 0
153 03180721 Propranolol HCl tablet 10 mg Tab 0 0
154 01170319 Pehamoxil injeksi (Amoxilin Injeksi) Vial 0 0
155 Piracetam Injeksi 1g / ml vial 0 0
156 02180820 Piracetam 800mg Tab 0 0
157 02180220 Pirazinamide 500mg tab Tab 0 0
158 Pyroxicam tablet 20 mg Tab 0 0
159 Pyrantel Pamoat 125 mg Tab 0 0
160 03180523 Quinine 222 mg Tab 0 0
161 03170222 Ringer laktat larutan infus steril Btl 0 0
162 03181120 Ranitidin tablet 150 mg Tab 0 0
163 03190920 Ranitidin Injeksi 50mg/2ml Amp 0 0
164 03170420 Retinol (vitamin A) kapsul 100.000 iu Kap 0 0
165 Retinol (vitamin A) kapsul 200.000 iu Kap 0 0
166 Rifampisin kaplet 300 mg Tab 0 0
167 02180422 Rifampisin kaplet 600 mg Tab 0 0
168 03180921 Salbutamol tablet 2 mg Tab 0 0
169 01170721 Salbutamol tablet 4 mg Tab 0 0

No STOK
URUT
AWAL
170 01180921 Salep 2-4 kombinasi Pot 0 0
171 01180420 Salisil bedak 2 % Ktk 0 0
172 02180720 Serum anti bisa ular polivalen inj. 5 ml (abu I) Vial 0 0
173 01181219 Serum anti tatanus inj. 1.500 iu/ampul (a.t.s I ) Amp 0 0
174 01180521 Sianokobalamin (Vit. B12) inj. 500 mcg/ml Amp 0 0
175 03180123 Sianokobalamin (Vit. B12) tablet 50 mcg Tab 0 0
176 03180720 Simvastatin tablet 10 mg Tab 0 0
179 03190820 Spironolactone 25 mg Tab 0 0

Tetrasiklin 250 mg Kaps 0 0
180 Tetrasiklin 500 mg Kaps 0 0
181 01170420 Tiamin HCl (Vit. B1) inj. 100 mg/ml - 1 ml Amp 0 0
182 03180320 Tiamin HCl monohidrat (Vit. B1) tablet 50 mg Tab 0 0
183 03180920 Triheksifenidil hidroklorida tablet 2 mg Tab 0 0
184 01170920 Thiamfenikol tab 500 mg Tab 0 0

No STOK
URUT
AWAL
185 03180221 Tramadol Injeksi 100mg/2ml Amp 0 0
186 03180221 Vitamin B kompleks tablet Tab 0 0
187 03190821 Viccillin Ampisilin serbuk injeksi 250 mg Amp 0 0
188 01181219 Wida Bes Btl 0 0
189 Yodium povidon larutan 10 % 30 ml Btl 0 0
190 Yodium povidon larutan 10 % 60 ml Btl 0 0
191 03180321 Yodium povidon larutan 10 % 300 ml Btl 0 0
192 01180320 Zink Tablet 20 mg Tab 0 0
GOLONGAN OBAT GIGI 0 0

1 01170720 Cholorophenol camphor menthol (chkm) ktk 0 0
2 Arsen / Caustinerf rapide Btl 0 0
3 Devitalisasi pasta (non arsen) caustinerf forte 0 0
4 02180523 Etil klorida semprot Kaleng 0 0
5 01170000 Eugenol cairan Btl 0 0
6 Glass Ionomer (gcix) / Fuji IX set 0 0
7 Iodoform paste Ktk 0 0
8 kalsium hidroksida pasta tube 0 0
9 Mummifying pasta / tempophore btl 0 0
No STOK
URUT
AWAL
10 Semen seng fosfat serbuk dan cairan 0 0

11 Spons gelatin Cubicles 1 x 1 x 1 Cm Ktk 0 0
12 Temporary stopingfletcher serbuk dan cairan set 0 0
13 01170720 Trikresol formalin (TKF) cairan Btl 0 0
14 01170319 Ceivtron( tambalan sementara ) ktk 0 0
GOLONGAN OBAT BAHAN HABIS PAKAI 0 0
1 03181120 Alkohol Swab Pcs 0 0
2 Bisturi No 11 Pcs 0 0
5 01171119 Catgut/benang bedah no.2/0 plain Sak 0 0
6 01171119 Catgut/benang bedah no.2/0 chromic sak 0 0
7 01171119 Catgut/benang bedah no. 3/0 chromic Sak 0 0
8 01170322 Elastic band roll 0 0
9 03170321 Folley catheter no.16 pcs 0 0
No STOK
URUT
AWAL
10 03170421 Folley catheter no.18 Pcs 0 0

11 03171121 Folley catheter no.20 Pcs 0 0
12 02170119 Infusion set anak Set 0 0
13 01170922 Kapas berlemak 500 gram Bks 0 0
14 03180721 Kapas pembalut/absorben 250 gram Bks 0 0
15 03180122 Kasa kompres 40/40 steril Rol 0 0
16 03180721 Kasa Steril 16x16 cm kotak 0 0
17 03180322 Kasa pembalut 36 m x 80 cm Rol 0 0
18 03171021 Kasa pembalut 40 m x 80 cm Rol 0 0
19 03180422 Kasa pembalut 2ml x 80 cm Rol 0 0
20 02190224 Kasa pembalut 2ml x 80 cm Rol 0 0
21 02191020 Kasa Pembalut 40 m x 40 cm Rol 0 0
22 03180422 Kasa pembalut hidrofil 4 m x 10 cm Rol 0 0
23 03180322 Kasa Pembalut hidrofil 4 x 3 pack 0 0
24 02180423 Kasa steril Kasa Steril 10 x 10, 8ply, 1x10's Pcs 0 0
25 01180323 Masker Karet (ear loop) Kotak 0 0
26 02170322 Masker Karet Pcs 0 0
27 03170322 Masker Hijab Pcs 0 0
No STOK
URUT
AWAL
28 02170921 Optiva No.20 ( Cathy IV. Cannula 20 G ) Set 0 0

31 01170320 Pembalut gips 3 inchi Rol 0 0
32 03170821 Silk (benang bedah sutera) no. 3/0 Box 0 0
33 03170219 Ultrasonic gel galon 5 liter OM Galon 0 0
34 03180722 Umbrical Cord Nylon OM Pcs 0 0
35 03170122 Urine bag Steril Pcs 0 0
36 03170422 Sarung Tangan Non Steril Pcs 0 0
37 01170422 Polid Aid Botol 0 0
38 03180221 Aseptic Gel Botol 0 0
39 02170119 Alat Suntik 10 ml Set 0 0
40 01190523 Polyflex IV. Cannula 24G (Optiva 24G) Pcs 0 0
42 01190323 Polywin IV. Cannula 26G (Optiva 26G) Pcs 0 0
No STOK
URUT
AWAL

44 01180000 Sarung Tangan Steril ( Mas Surgical Gloves) S pcs 0 0
45 01190623 Sarung Tangan Steril ( Mas Surgical Gloves) M pcs 0 0
46 01181122 Mas Nasal Oxygen Cannula Infant (anak) Pcs 0 0
47 01181122 Mas Nasal Oxygen Cannula Adult (dewasa) Pcs 0 0
48 01190823 Sarung Tangan Steril (Surgical gloves) 7,5 Pair 0 0
49 01180822 Sarung Tangan Steril (Surgical gloves) 6.5 Pair 0 0
50 01190723 Sarung Tangan Steril (Surgical gloves) 7 Pair 0 0
51 01180722 Spuit 1 cc pcs 0 0
52 01180122 Spuit 2,5 cc pcs 0 0
53 03170521 Spuit 3 cc ( STERA ) Pcs 0 0
54 Spuit 5 cc Pcs 0 0
55 01180022 Spuit 20 cc pcs 0 0
56 01180022 Infus set anak pcs 0 0
57 01190823 Infus set dewasa pcs 0 0
58 02181222 Pap Smear kit Steril (L) set 0 0
59 02180323 Pap Smear kit Steril (M) set 0 0
60 02180623 Pap Smear kit Steril (S) set 0 0
No STOK
URUT
AWAL
61 01180322 Imaske Surgical Face mask tie on Pcs 0 0

62 02180523 Umbilical Cord Nylon OM Pcs 0 0
63 03180622 Pharmafix 15x 500 cm Rol 0 0
66 01180622 Optime 2/0 Pcs 0 0
67 01191222 Optime 3/0 Pcs 0 0
68 01180123 IV Catheter No. 24 G Pcs 0 0
69 01180123 IV Catheter No. 22 G Pcs 0 0
GOLONGAN OBAT TAMBAHAN

1 02170720 Calsidol syr/Biovitan Syr/Solvita syr btl 0 0
2 02190919 Hemafort Tab 0 0
3 03180720 Bisacodyl 5 mg Tab 0 0
4 01170422 Levetran salep Pot 0 0
No STOK
URUT
AWAL
5 01170921 Tyalisin plus syr Btl 0 0

6 01170920 Novadiar syrup btl 0 0
7 02180922 Noza tablet/ Supra Flu Tab 0 0
8 01170920 Pimtrakol sirup/Clortusin Syr/Novatusin syr Btl 0 0
9 03171019 Ventolin Nebules 2,5 mg Amp 0 0
10 02180821 Baby cough Btl 0 0
11 02171020 Zolagel Pot 0 0
12 02170921 Solafluz Sirup Botol 0 0
13 03180821 New Antides Tablet (atapulgit) Tab 0 0
14 02180622 Dextamine syr Btl 0 0
15 Bioron Tab 0 0
16 Becefort Tab 0 0
17 Vital Tetes Telinga Btl 0 0
18 Hustab Tab 0 0
19 Scopma Tab 0 0
GOLONGAN OBAT PROGRAM MALARIA 0 0

1 04190521 Primakuin tab 15 mg tablet 0 0
2 04191022 Kuinin (kina) tab 222 mg tablet 0 0
No STOK
URUT
AWAL
3 04190621 Artesunate Inj, vial 60 mg vial 0 0

4 04170000 LABORATORY KID PAKET 0 0
5 04170000 SLIDE BOX BUAH 0 0
6 04190519 Obat Anti Malaria DHP (Dihydroartemisinin) Tablet 0 0
7 04170000 Cynoff 25 UL Botol 0 0
8 04180419 Bactivec Botol 0 0
9 04180419 RDT DBD Combo TEST 0 0
10 04180000 Sipermetrin zeta 15 UL Galon 0 0
11 04190000 Kaca Slide (objek glass frosted 7105 one) Pcs 0 0
12 04181120 SD HBsAG WB (Multi) TEST 0 0
13 04180000 Mikroskop optical olympus Pcs 0 0
14 04190000 Mikroskop + Box Nikon Eclipse E-100 Unit 0 0
15 ACT (Artesunate + Amodiaquin) blister 0 0
16 Artemeter injeksi 1 ml : 80 mg ampul 0 0
17 Kloroquin tab 250 mg tablet 0 0
18 Kuinin (kina) inj 25% - 2ml ampul 0 0
19 Besi II sulfat 200 mg sac 0 0
24 ACT ANAK BLISTER 0 0
No STOK
URUT
AWAL
25 ACT REMAJA BLISTER 0 0

26 ACT DEWASA BLISTER 0 0
27 RDT/HRP2 Malaria TEST 0 0
28 INSEKTISIDA KOTAK 0 0
29 KELAMBU BUAH 0 0
30 BLOOD SLIDE BOX 0 0
31 GIEMSA BOX 0 0
32 IMERSION OIL BOTOL 0 0
33 VACCINOSTYL BOX 0 0
34 Darplex / OAM KOTAK 0 0
35 Obat Anti Malaria DHP (Dihydroartemisinin) Tablet 0 0
36 Abate 1 kg Galon 0 0
37 RDT Dengue Igg/ Igm TEST 0 0
38 RDT Degue NS I antigen Box 0 0
39 Blood Lancet TEST 0 0
40 Mikropipet single channel pipettor Pcs 0 0
41 Mikroskop Malaria Leica/DM 500 Pcs 0 0
GOLONGAN OBAT PROGRAM FILARIASIS
No STOK
URUT
AWAL
1 04180820 Dietil karbamazepin Sitrat tab 100 mg tablet 0 0

2 04170622 Albendazole 400 mg tablet 0 0
3 Oseltamivir tab tablet 0 0
4 FTS (Filariasis Test Strip) test 0 0
5 Lancet Fastclick/BD Microtainer pcs 0 0
6 RDT Brugia Filariasis pcs 0 0
7 Betason N cream tube 0 0
No STOK
URUT
AWAL
GOLONGAN OBAT PROGRAM TB PARU

1 04190320 Obat Anti tuberkulosis FDC I Paket 0 0
2 04180521 Obat Anti tuberkulosis FDC II Paket 0 0
3 04180220 Obat Anti tuberkulosis Anak Paket 0 0
4 04190722 Obat Anti TBC FDC Kombipak kategori I Paket 0 0
5 Obat Anti tuberkulosis katagori 1 Paket 0 0
6 Obat Anti tuberkulosis sisipan Paket 0 0
7 Streptomisin serbuk injeksi i.v 1000mg/ml vial 0 0
8 04190820 Reagen Zn kit 0 0
9 04180123 Pot Sputum pot 0 0
10 04180220 Isoniazid tab 100 mg Tab 0 0
GOLONGAN OBAT PROGRAM DIARE

1 04190423 Garam Oralit 200 ml sac 0 0
2 04180720 ZINK Tablet 20 mg tablet 0 0
GOLONGAN OBAT PROGRAM ISPA

1 04170721 Masker N95 Pcs 0 0
2 04170000 Sound Timer Unit 0 0
3 04170000 Pulse Oxtmetri Portable Unit 0 0
No STOK
URUT
AWAL
4 04170000 Buku Lembar Balik ISPA Pcs 0 0
GOLONGAN OBAT PROGRAM KUSTA

1 04181221 MB.Dewasa blister 0 0
2 04180121 MB. Anak blister 0 0
PB.Anak Blister
3 04180820 PB.Dewasa blister 0 0
GOLONGAN OBAT PROGRAM IMUNISASI

1 04180223 ADS .0,05 ml pcs 0 0
2 04180222 ADS.0,5 ml pcs 0 0
3 ADS.2,5 ml pcs 0 0
4 04180323 ADS 5 ml pcs 0 0
5 DPT-HB-HIB vial 0 0
6 HB-PID vial 0 0
7 Buku infomasi dan Edukasi Imunisasi pcs 0 0
8 Spanduk Imunisasi pcs 0 0
9 X-Banner Imunisasi pcs 0 0
10 VAR (verorab) vial 0 0
11 Rabies Immune Globulin (Human) vial 0 0
No STOK
URUT
AWAL
12 Campak 10 doses vial 0 0

13 Campak 20 doses vial 0 0
14 Campak Bias vial 0 0
15 Vaksin Flubio vial 0 0
16 04180000 Safety box Pcs 0 0
17 04181219 BCG (10 doses) vial 0 0
18 00000000 Polio BOVP 10 doses vial 0 0
19 04190420 IPV Polio vial 0 0
20 04180421 DT vial 0 0
No STOK
URUT
AWAL
21 04180321 TD Bumil vial 0 0

22 04190721 TD vial 0 0
23 04180719 VAR (verorab) Vial 0 0
24 04181120 Rabies Immune Globulin (Human) Vial 0 0
25 041804223 Spidol Pen Marker Pcs 0 0
26 04180120 Vaksin Measles and Rubella 10 DS vial 0 0
27 04190619 Vaksin Menivax Paket 0 0
28 04180820 HBIG Amp 0 0
GOLONGAN OBAT PROGRAM GIZI

1 04180420 Besi (II) Sulphate (Tablet tambah darah Ibu Nifas) Tab 0 0
2 04180220 Vitamin A 200.000 IU Kap 0 0
3 04180221 Vitamin A 100.000 IU Kap 0 0
4 04180820 Mineral Mix Sach 0 0
5 04180520 Fenobarbital 50 mg injeksi Amp 0 0
6 04181020 Gentamisin Sulfat Injeksi 40 mg/ml Amp 0 0
7 04180920 Glukonas Kalsikus 1 gr Amp 0 0
8 04181120 Magnesium Sulfat 40% (MgSo4) Btl 0 0
9 04180819 Prokain Penisillin 3 juta IU vial 0 0
No STOK
URUT
AWAL
10 04180420 Phytomenadion 2 mg/ml Amp 0 0

11 04181120 Ampisilin Serbuk injeksi i.m/i.v 1000mg vial 0 0
12 Iodine Test Btl
13 MP ASI Biskuit Bks
14 04181021 Diazepam injeksi 5 mg/ml Amp 0 0
GOLONGAN OBAT PROGRAM KIA
1 04180000 Deteksi tes kehamilan Paket 0 0
2 Calsium Gluconas 100 mg/ml Injeksi Amp 0 0
3 Oksitosin Inj 10 IU 1 ml amp 0 0
4 Fitomenadion 10 mg/ vit K inj amp 0 0
5 Progesteron Depot Inj 1 ml Vial 0 0
6 Ampicillin Inj Vial 0 0
7 Pil KB Kombinasi cycles 0 0
8 Urine Strip strip 0 0
9 Diazepam inj 5 mg/ ml amp 0 0
10 Natrium Tiroksin / Tyhrax tab tab 0 0
11 Gentamicin 80 mg inj amp 0 0
12 Implant KB buah 0 0
No STOK
URUT
AWAL
13 Prokain Penisiline 3 ml unit inj Vial 0 0

14 Metil ergometrine Maleat 0,2 mg/1 ml inj amp 0 0
15 Metil ergometrine Maleat 125 mg tab 0 0
16 Mg Sulfat 20% 25 ml Vial 0 0
17 Mg Sulfat 40% 25 ml Vial 0 0
18 Albendazol 400 mg tab 0 0
19 IV catheter 18 pcs 0 0
20 Ampicillin Inj Vial 0 0
GOLONGAN OBAT PROGRAM JIWA

1 04180620 Haloperidol 0,5 mg Tab 0 0
2 Haloperidol 1.5 mg Tab 0 0
3 Haloperidol 5 mg Tab 0 0
4 Haloperidol inj 5 mg/ml ampul 0 0
5 Haloperidol dekanoat inj 50 mg/ml ampul 0 0
6 04181019 Karbamazepin 200 mg Tab 0 0
7 Triheksifenidil hidroklorida tablet 2 mg Tab 0 0
8 Klobazam 10 mg tablet tablet 0 0
9 Amitripilin HCL 25 mg tablet tablet 0 0
No STOK
URUT
AWAL
10 Klorpromazin 100 mg tablet tablet 0 0

11 Risperidon 2 mg Tablet tablet 0 0
12 Klozapin 25 mg tablet tablet 0 0
13 Trifluoperazine HCL 5 mg tablet tablet 0 0
14 Imipramin HCL 25 mg tablet tablet 0 0
15 Fluoksetin 10 mg tablet tablet 0 0
16 Metadon HCL 50 mg/5 ml btl 1 L 0 0
GOLONGAN OBAT PROGRAM HIV 0 0

1 04191020 Rapid I (SD Bioline HIV 1/2.3.0 Multi Pcs 0 0
No STOK
URUT
AWAL
2 04190720 Rapid 2 HIV Anti HIV 1/2 Cassette PDI Pcs 0 0

3 04190620 Rapid Test HIV 3 (Biomerux/Vikia/HIV 1/2) Pcs 0 0
4 04180000 RPR Sypilis Test 0 0
5 04180000 Swab Desinfektan (Descoderm) Pcs 0 0
6 04181021 Latex Sarung Tangan Pcs 0 0
7 04181222 Yellow Tipe (mikropipet) Pcs 0 0
8 04180922 Blue Tipe (Mikropipet) Pcs 0 0
9 04180519 Human Hexagon Sypilis Test 0 0
10 Tabung Vacuntainer Plast 5 ml Buah 0 0
11 Vacum Blood Collection Needle 22 G buah 0 0
12 Tipe Ukuran 61 Pcs 0 0
13 04180000 Tipe Ukuran 60 Pcs 0 0
JUMLAH KUNJUNGAN RESEP UMUM BPJS

No STOK
URUT
AWAL
Mengetahui / Menyetujui
Kepala Dinas Kesehatan Kepala IFK Plt. Kepala Puskesmas
…………………………………
………………………………………………. ………………………………………………. ……………………………………………….

NIP……………………………………. NIP……………………………………. NIP…………………………………….
Keterangan Kode : 01/� , 18/� , 02/� , 20/�

A. Dua digit pertama ─˃ (01;APBD II, 02;Buffer Stok, 03;DAK, 04;Program)
B. Dua digit Kedua ─˃ (Tahun Pengadaan)
C. Dua digit Ketiga ─˃ (Bulan Expired)
D. Dua digit Keempat ─˃ (Tahun Expired)
UARAN OBAT
BULAN :
TAHUN : 2019
SISA PEMBERIAN
STOK OPT PERMINTAAN KET
STOK
INFRES ASKES APBD LAIN JML
8 9 10 11 12 13 14 15 16
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
SISA PEMBERIAN
STOK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
JUMLAH
SISA PEMBERIAN
STOK
ala Puskesmas …………………. , 2019
……………………… Pengelola Obat Instalasi

Farmasi Puskesmas ……………
…………………………………. ……………………………………………….
………………………………. NIP…………………………………….

Lplpo S.opt - Mei 2019

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Lplpo S.opt - Mei 2019

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LAPORAN PEMAKAIAN DAN PENGELUARAN OBAT

1 02182020 Alopurinol tablet 100 mg Tab 0 0

2 03180520 Alopurinol tablet 300 mg Tab 0 0

3 01170720 Aminofilin tablet 200 mg Tab 0 0

4 01170419 Aminofilin injeksi 24 mg/ml - 10 ml Amp 0 0

5 01171119 Amitriptilin HCl tab. Salut 25 mg Tab 0 0

6 03190221 Amoksisilin kaplet 500 mg Kapl 0 0

7 01180519 Amoksisilin sirup kering 125 mg / 5 ml Btl 0 0

8 02181019 Antasida Doen tablet kombinasi Tab 0 0

9 03180822 Antibakteri doen salep kombinasi (Bacitracin) Tub 0 0

10 01180222 Antihemoroid doen kombinasi Suppo 0 0

11 02180620 Antifungi doen kombinasi Pot 0 0

12 03181019 Antimigran doen kombinasi (Ergotamin) Tab 0 0

13 01180721 Antasida suspensi Btl 0 0

14 01180121 Aqua proinjeksi steril, bebas pirogen Btl 0 0

15 02180421 Asam askorbat (vit c) tablet 50 mg Tab 0 0

Asam askorbat (vit c) tablet 250 mg Tab 0 0

16 03180520 Asetosal 80 mg (Miniaspi 80 mg) Tab 0 0

17 01181019 Atropin sulfat injeksi 0,25 mg/ml - 1 ml Amp 0 0

18 03181019 Acetyl Cystein 200mg Kaps 0 0

19 03180322 Acyclovir tablet 200 mg Tab 0 0

20 03180722 Acyclovir tablet 400 mg Tab 0 0

21 Acyclovir tablet Cream Tube 0 0

22 02181020 Ambroksol sirup Btl 0 0

23 01170920 Ambroksol tablet 30mg Tab 0 0

24 03181520 Asam Mefenamat tablet 500 mg Tab 0 0

25 03190222 Asam Traneksamat Tablet 500 mg Tab 0 0

26 03171119 Asam Traneksamat 100 mg/5 ml Injeksi Amp 0 0

27 03190621 Asam Traneksamat 250 mg/5 ml Injeksi Amp 0 0

28 03191021 Asam Traneksamat 500 mg/5 ml Injeksi Amp 0 0

29 01180820 Asam folat tab 1 mg Tab 0 0

30 03180920 Amlodipin 5mg Tab 0 0

31 01180821 Amlodipin 10 mg Tab 0 0

32 01170820 Betametason krim 0,1 % Tub 0 0

33 02181120 Betahistin mesilate tablet 6 mg Tab 0 0

34 01180820 Cefadroxil 500 mg kaps Kaps 0 0

35 03180820 Cefadroxil sirup kering 250 mg/5ml Btl 0 0

36 Captopril tablet 12,5 mg Tab 0 0

37 02180820 Captopril tablet 25 mg Tab 0 0

38 03180821 Captopril tablet 50 mg Tab 0 0

39 03180420 Ciprofloxacin tablet 500 mg Tab 0 0

40 01180320 Cetirizine Tab 10 mg Tab 0 0

41 Cetirizine Syrup Botol 0 0

42 Cefotaxim injeksi Vial 0 0

43 03180920 Ceptriaxon injeksi Vial 0 0

45 Clyndamicin 150 mg Tab 0 0

46 03180520 Deksametason inj 5 mg/ml - 1 ml Amp 0 0

47 03180520 Deksametason tablet 0,5 mg Tab 0 0

48 01180220 Diazepam inj 5 mg/ml - 2 ml Amp 0 0

49 Diazepam rectal (Stesolid rectal 10 mg) Tube 0 0

50 Diazepam tablet 2 mg Tab 0 0

51 03180822 Diazepam tablet 5 mg Tab 0 0

52 01180121 Difenhidramin HCl inj 10 mg/ml - 1 ml Amp 0 0

53 01180620 Digoksin tablet 0,25 mg Tab 0 0

54 01180821 Domperidone tablet 10 mg Tab 0 0

55 03181020 Domperidon suspensi 5 mg / 5 ml Btl 0 0

56 03180720 Doxycycline 100 mg Kaps 0 0

57 01170219 Efedrin HCl tablet 25 mg Tab 0 0

58 03191120 Epinefrin 1 mg/ml inj s.c/i.m Amp 0 0

59 01181020 Etakridin (rivanol) larutan 0,1 % Btl 0 0

60 02180822 Erytromicin kaplet 500 mg Kapl 0 0

61 Erytromicin Syrup Botol 0 0