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FORM 1

LAPORAN BULANAN PELAYANAN KEFARMASIAN DI PUSKESMAS


Puskesmas : Mekarsari
Bulan : Januari
Tahun : 2019

JENIS PELAYANAN RESEP


NO TANGGAL KONSELING INFORMASI
RAWAT JALAN RAWAT INAP

(1) (2) (3) (4) (5) (6)


5 1/1/2019 28 2 30
6 1/2/2019 41 41
7 1/3/2019 13 13
8 1/4/2019 13 1 14
9 1/5/2019 24 24
10 1/6/2019 0
11 1/7/2019 28 2 30
12 1/8/2019 40 1 41
13 1/9/2019 16 16
14 1/10/2019 32 32
15 1/11/2019 26 26
16 1/12/2019 20 1 21
17 1/13/2019 1 1
18 1/14/2019 30 2 32
19 1/15/2019 37 37
20 1/16/2019 29 29
21 1/17/2019 24 24
22 1/18/2019 24 24
23 1/19/2019 22 22
24 1/20/2019 0
25 1/21/2019 16 16
26 1/22/2019 24 2 26
27 1/23/2019 24 2 26
28 1/24/2019 40 40
29 1/25/2019 16 16
30 1/26/2019 21 2 23
31 1/27/2019 0
32 1/28/2019 32 2
33 1/29/2019 28 1
34 1/30/2019 22
35 1/31/2019 26 2
696 21 717
TOTAL

Mekarsari, 31 Januari 2019


Pengelola Obat Puskesmas Mekarsari

Imas Muliyat
NIP.19880617 201001 2 008
FORM 1

LAPORAN BULANAN PELAYANAN KEFARMASIAN DI PUSKESMAS


Puskesmas : Mekarsari
Bulan : Februari
Tahun : 2019

JENIS PELAYANAN RESEP


NO TANGGAL KONSELING INFORMASI
RAWAT JALAN RAWAT INAP

(1) (2) (3) (4) (5) (6)


1 2/1/2028 18 1 18
2 2/2/2028 24 2 24
3 2/3/2028 0 0
4 2/4/2028 27 1 27
5 2/5/2028 0 1 0
6 2/6/2028 33 1 33
7 2/7/2028 34 5 34
8 2/8/2028 16 16
9 2/9/2028 23 2 23
10 2/10/2028 0 1 0
11 2/11/2028 14 14
12 2/12/2028 20 20
13 2/13/2028 25 1 25
14 2/14/2028 34 1 34
15 2/15/2028 16 1 16
16 2/16/2028 22 1 22
17 2/17/2028 0 0
18 2/18/2028 19 2 19
19 2/19/2028 19 19
20 2/20/2028 13 3 13
21 2/21/2028 24 3 24
22 2/22/2028 42 1 42
23 2/23/2028 24 1 24
24 2/24/2028 0 0
25 2/25/2028 42 42
26 2/26/2028 37 2 37
27 2/27/2028 29 2 29
28 2/28/2028 37 2 37
TOTAL 592 0 34 626

Mekarsari, 28 Februari 2019


Pengelola Obat Puskesmas Mekarsari

Imas Muliyat
NIP.19880617 202002 2 008
FORM 1

LAPORAN BULANAN PELAYANAN KEFARMASIAN DI PUSKESMAS


Puskesmas : Mekarsari
Bulan : Maret
Tahun : 2019

JENIS PELAYANAN RESEP


NO TANGGAL KONSELING INFORMASI
RAWAT JALAN RAWAT INAP

(1) (2) (3) (4) (5) (6)


4 3/1/2019 18 1 19
5 3/2/2019 28 1 29
6 3/3/2019 0 3 3
7 3/4/2019 32 32
8 3/5/2019 29 29
9 3/6/2019 27 27
10 3/7/2019 12 1 13
11 3/8/2019 16 16
12 3/9/2019 23 1 24
13 3/10/2019 0 0
14 3/11/2019 17 1 18
15 3/12/2019 30 1 31
16 3/13/2019 30 30
17 3/14/2019 24 24
18 3/15/2019 12 12
19 3/16/2019 16 1 17
20 3/17/2019 0 0
21 3/18/2019 33 1 34
22 3/19/2019 26 1 27
23 3/20/2019 21 1 22
24 3/21/2019 39 39
25 3/22/2019 20 20
26 3/23/2019 12 1 13
27 3/24/2019 0 0
28 3/25/2019 32 1 33
29 3/26/2019 39 1 40
30 3/27/2019 20 20
31 3/28/2019 33 1 34
32 3/29/2019 15
33 3/30/2019 21 2
34 3/31/2019 1
625 20 645
TOTAL

Mekarsari, 31 Maret 2019


Pengelola Obat Puskesmas Mekarsari

Imas Muliyat
NIP.19880617 203003 2 008
FORM 1

LAPORAN BULANAN PELAYANAN KEFARMASIAN DI PUSKESMAS


Puskesmas : Mekarsari
Bulan : April
Tahun : 2019

JENIS PELAYANAN RESEP


NO TANGGAL KONSELING INFORMASI
RAWAT JALAN RAWAT INAP

(1) (2) (3) (4) (5) (6)


1 4/1/2018 21 4 25
2 4/2/2018 21 2 23
3 4/3/2018 - 1 1
4 4/4/2018 34 34
5 4/5/2018 19 1 20
6 4/6/2018 17 1 18
7 4/7/2018 - 2 2
8 4/8/2018 34 3 37
9 4/9/2018 16 16
10 4/10/2018 17 3 20
11 4/11/2018 29 2 31
12 4/12/2018 18 1 19
13 4/13/2018 24 24
14 4/14/2018 - -
15 4/15/2018 27 1 28
16 4/16/2018 22 22
17 4/17/2018 - -
18 4/18/2018 45 2 47
19 4/19/2018 - 2 2
20 4/20/2018 16 16
21 4/21/2018 - 2 2
22 4/22/2018 26 26
23 4/23/2018 30 30
24 4/24/2018 20 20
25 4/25/2018 38 38
26 4/26/2018 14 14
27 4/27/2018 17 17
28 4/28/2018 - -
29 4/29/2018 18 1 19
30 4/30/2018 27 1 28
550 29 579
TOTAL

Mekarsari, 30 April 2018


Pengelola Obat Puskesmas Mekarsari

Imas Muliyat
NIP.19880617 204004 2 008
FORM 1

LAPORAN BULANAN PELAYANAN KEFARMASIAN DI PUSKESMAS


Puskesmas : Mekarsari
Jeni Puskesmas : Perawatan
Kab : Barito Kuala
Prov : Kalimantan Selatan
Bulan : Mei
Tahun : 2019

JENIS PELAYANAN RESEP


NO TANGGAL KONSELING INFORMASI
RAWAT JALAN RAWAT INAP

(1) (2) (3) (4) (5) (6)


1 5/1/2019 0 2 2
2 5/2/2019 55 2 57
3 5/3/2019 21 1 22
4 5/4/2019 28 28
5 5/5/2019 0 1 1
6 5/6/2019 36 1 37
7 5/7/2019 19 2 21
8 5/8/2019 24 1 25
9 5/9/2019 34 34
10 5/10/2019 23 1 24
11 5/11/2019 19 1 20
12 5/12/2019 0 1 1
13 5/13/2019 30 30
14 5/14/2019 21 21
15 5/15/2019 29 1 30
16 5/16/2019 29 29
17 5/17/2019 26 26
18 5/18/2019 14 1 15
19 5/19/2019 0 1 1
20 5/20/2019 35 35
21 5/21/2019 11 1 12
22 5/22/2019 18 18
23 5/23/2019 23 23
24 5/24/2019 17 17
25 5/25/2019 9 9
26 5/26/2019 0 0
27 5/27/2019 42 42
28 5/28/2019 19 1 20
29 5/29/2019 1
30 5/30/2019 0 3
31 5/31/2019 3
582 25 607
TOTAL

Mekarsari, 31 Mei 2018


Pengelola Obat Puskesmas Mekarsari

Imas Muliyat
NIP.19880617 205005 2 008
FORM 1

LAPORAN BULANAN PELAYANAN KEFARMASIAN DI PUSKESMAS


Puskesmas : Mekarsari
JeniS Puskesmas : Perawatan
Kab : Barito Kuala
Prov : Kalimantan Selatan
Bulan : Juni
Tahun : 2018

JENIS PELAYANAN RESEP


NO TANGGAL KONSELING INFORMASI
RAWAT JALAN RAWAT INAP

(1) (2) (3) (4) (5) (6)


1 6/1/2018 0
2 6/2/2018 19 19
3 6/3/2018 0
4 6/4/2018 16 16
5 6/5/2018 12 3 15
6 6/6/2018 21 21
7 6/7/2018 24 24
8 6/8/2018 5 5
9 6/9/2018 13 13
10 6/10/2018 0
11 6/11/2018 2 2
12 6/12/2018 0
13 6/13/2018 0
14 6/14/2018 1 1
15 6/15/2018 2 2
16 6/16/2018 4 4
17 6/17/2018 0
18 6/18/2018 1 1
19 6/19/2018 2 2
20 6/20/2018 1 1
21 6/21/2018 63 2 65
22 6/22/2018 18 18
23 6/23/2018 18 18
24 6/24/2018 1 1
25 6/25/2018 38 1 39
26 6/26/2018 21 21
27 6/27/2018 0
28 6/28/2018 19 19
29 6/29/2018 24 24
30 6/30/2018 17 1 18
31 31/06/2018

328 21 349
TOTAL

Mekarsari, 30 Juni 2018


Pengelola Obat Puskesmas Mekarsari

Imas Muliyat
NIP.19880617 206006 2 008
FORM 1

LAPORAN BULANAN PELAYANAN KEFARMASIAN DI PUSKESMAS


Puskesmas : Mekarsari
JeniS Puskesmas : Perawatan
Kab : Barito Kuala
Prov : Kalimantan Selatan
Bulan : Juli
Tahun : 2018

JENIS PELAYANAN RESEP


NO TANGGAL KONSELING INFORMASI
RAWAT JALAN RAWAT INAP

(1) (2) (3) (4) (5) (6)


1 7/1/2018 0
2 7/2/2018 22 2 24
3 7/3/2018 18 2 20
4 7/4/2018 10 2 12
5 7/5/2018 47 47
6 7/7/2018 12 2 14
7 7/7/2018 15 15
8 7/8/2018 5 1 6
9 7/9/2018 13 1 14
10 7/10/2018 11 11
11 7/11/2018 9 9
12 7/12/2018 27 2 29
13 7/13/2018 8 2 10
14 7/14/2018 9 2 11
15 7/15/2018 0
16 7/16/2018 31 31
17 7/17/2018 27 27
18 7/18/2018 22 22
19 7/19/2018 29 1 30
20 7/20/2018 19 2 21
21 7/21/2018 12 12
22 7/22/2018 28 2 30
23 7/23/2018 0
24 7/24/2018 21 21
25 7/25/2018 16 2 18
26 7/26/2018 22 22
27 7/27/2018 11 11
28 7/28/2018 14 14
29 7/29/2018 2 2
30 7/30/2018 21 21
31 7/31/2018 21
500 25 525
TOTAL

Mekarsari, 31 Juli 2018


Pengelola Obat Puskesmas Mekarsari

Imas Muliyat
NIP.19880717 207007 2 008
FORM 1

LAPORAN BULANAN PELAYANAN KEFARMASIAN DI PUSKESMAS


Puskesmas : Mekarsari
JeniS Puskesmas : Perawatan
Kab : Barito Kuala
Prov : Kalimantan Selatan
Bulan : Agustus
Tahun : 2018

JENIS PELAYANAN RESEP


NO TANGGAL KONSELING INFORMASI
RAWAT JALAN RAWAT INAP

(1) (2) (3) (4) (5) (6)


1 8/1/2018 19 2 21
2 8/2/2018 28 28
3 8/3/2018 17 17
4 8/4/2018 19 1 20
5 8/5/2018 0
6 8/6/2018 29 29
7 8/7/2018 19 19
8 8/8/2018 19 19
9 8/9/2018 36 36
10 8/10/2018 17 3 20
11 8/11/2018 18 1 19
12 8/12/2018 3 3
13 8/13/2018 30 30
14 8/14/2018 14 14
15 8/15/2018 10 2 12
16 8/16/2018 30 30
17 8/17/2018 1 1
18 8/18/2018 21 21
19 8/19/2018 0
20 8/20/2018 21 21
21 8/21/2018 24 24
22 8/22/2018 1 1
23 8/23/2018 23 2 25
24 8/24/2018 16 1 17
25 8/25/2018 20 2 22
26 8/26/2018 2 2
27 8/27/2018 37 37
28 8/28/2018 33 2 35
29 8/29/2018 24 24
30 8/30/2018 29 29
31 8/31/2018 14 14
567 23 590
TOTAL

Mekarsari, 31 Agustus 2018


Pengelola Obat Puskesmas Mekarsari

Imas Muliyat
NIP.19880817 208008 2 008
FORM 1

LAPORAN BULANAN PELAYANAN KEFARMASIAN DI PUSKESMAS


Puskesmas : Mekarsari
JeniS Puskesmas : Perawatan
Kab : Barito Kuala
Prov : Kalimantan Selatan
Bulan : September
Tahun : 2018

JENIS PELAYANAN RESEP


NO TANGGAL KONSELING INFORMASI
RAWAT JALAN RAWAT INAP

(1) (2) (3) (4) (5) (6)


1 9/1/2018 21 2 23
2 9/2/2018 1 1
3 9/3/2018 32 32
4 9/4/2018 19 19
5 9/5/2018 22 22
6 9/6/2018 36 36
7 9/7/2018 23 1 24
8 9/8/2018 17 17
9 9/9/2018 1 1
10 9/10/2018 38 38
11 9/11/2018 0
12 9/12/2018 34 34
13 9/13/2018 47 47
14 9/14/2018 11 1 12
15 9/15/2018 25 25
16 9/16/2018 0
17 9/17/2018 29 2 31
18 9/18/2018 24 2 26
19 9/19/2018 26 26
20 9/20/2018 34 2 36
21 9/21/2018 12 2 14
22 9/22/2018 20 20
23 9/23/2018 1 1
24 9/24/2018 38 3 41
25 9/25/2018 22 22
26 9/26/2018 36 36
27 9/27/2018 25 1 26
28 9/28/2018 11 11
29 9/29/2018 27 1 28
30 9/30/2018 1 1
31 31/09/2018 0
629 21 650
TOTAL

Mekarsari, 30 September 2018


Pengelola Obat Puskesmas Mekarsari

Imas Muliyat
NIP.19880917 209009 2 009
FORM 1

LAPORAN BULANAN PELAYANAN KEFARMASIAN DI PUSKESMAS


Puskesmas : Mekarsari
JeniS Puskesmas : Perawatan
Kab : Barito Kuala
Prov : Kalimantan Selatan
Bulan : Oktober
Tahun : 2018

JENIS PELAYANAN RESEP


NO TANGGAL KONSELING INFORMASI
RAWAT JALAN RAWAT INAP

(1) (2) (3) (4) (5) (6)


1 10/1/2018 36 2 38
2 10/2/2018 32 32
3 10/3/2018 20 2 22
4 10/4/2018 41 41
5 10/5/2018 12 3 15
6 10/6/2018 14 14
7 10/7/2018 2 2
8 10/8/2018 33 33
9 10/9/2018 22 2 24
10 10/10/2018 25 2 27
11 10/11/2018 27 1 28
12 10/12/2018 20 1 21
13 10/13/2018 16 1 17
14 10/14/2018 1 1
15 10/15/2018 32 1 33
16 10/16/2018 30 30
17 10/17/2018 22 2 24
18 10/18/2018 25 2 27
19 10/19/2018 12 1 13
20 10/20/2018 21 21
21 10/21/2018 1 1
22 10/22/2018 44 1 45
23 10/23/2018 26 26
24 10/24/2018 25 25
25 10/25/2018 25 25
26 10/26/2018 13 13
27 10/27/2018 14 14
28 10/28/2018 0
29 10/29/2018 36 36
30 10/30/2018 30 30
31 10/31/2018 29 29
682 25 707
TOTAL

Mekarsari, 31 Oktober 2018


Mengetahui
Kepala Puskesmas Rawat Inap Mekarsari

Abdul Rahim, S.Kep


NIP.19711109 199202 1 001
FORM 1

LAPORAN BULANAN PELAYANAN KEFARMASIAN DI PUSKESMAS


Puskesmas : Mekarsari
JeniS Puskesmas : Perawatan
Kab : Barito Kuala
Prov : Kalimantan Selatan
Bulan : Nopember
Tahun : 2018

JENIS PELAYANAN RESEP


NO TANGGAL KONSELING INFORMASI
RAWAT JALAN RAWAT INAP

(1) (2) (3) (4) (5) (6)


1 11/1/2018 23 23
2 11/2/2018 21 1 22
3 11/3/2018 16 1 17
4 11/4/2018 0 0
5 11/5/2018 39 39
6 11/6/2018 22 22
7 11/7/2018 19 19
8 11/8/2018 37 37
9 11/9/2018 27 27
10 11/10/2018 13 3 16
11 11/11/2018 20 20
12 11/12/2018 2 2
13 11/13/2018 1 1
14 11/14/2018 22 22
15 11/15/2018 32 1 33
16 11/16/2018 16 16
17 11/17/2018 1 1
18 11/18/2018 0
19 11/19/2018 0
20 11/20/2018 2 2
21 11/21/2018 28 28
22 11/22/2018 43 43
23 11/23/2018 18 2 20
24 11/24/2018 17 17
25 11/25/2018 1 1
26 11/26/2018 24 24
27 11/27/2018 25 25
28 11/28/2018 14 14
29 11/29/2018 34 34
30 11/30/2018 25 25
535 15 550
TOTAL

Mekarsari, 30 Nopember 2018


Mengetahui
Kepala Puskesmas Rawat Inap Mekarsari

Abdul Rahim, S.Kep


NIP.19711109 199202 1 001
FORM 1

LAPORAN BULANAN PELAYANAN KEFARMASIAN DI PUSKESMAS


Puskesmas : Mekarsari
JeniS Puskesmas : Perawatan
Kab : Barito Kuala
Prov : Kalimantan Selatan
Bulan : Desember
Tahun : 2018

JENIS PELAYANAN RESEP


NO TANGGAL KONSELING INFORMASI
RAWAT JALAN RAWAT INAP

(1) (2) (3) (4) (5) (6)


1 12/1/2018 20 20
2 12/2/2018 0
3 12/3/2018 43 43
4 12/4/2018 28 28
5 12/5/2018 31 31
6 12/6/2018 40 40
7 12/7/2018 0
8 12/8/2018 17 17
9 12/9/2018 37 2 39
10 12/10/2018 42 42
11 12/11/2018 28 28
12 12/12/2018 35 2 37
13 12/13/2018 37 2 39
14 12/14/2018 14 2 16
15 12/15/2018 25 2 27
16 12/16/2018 38 2 40
17 12/17/2018 38 2 40
18 12/18/2018 21 21
19 12/19/2018 10 10
20 12/20/2018 36 2 38
21 12/21/2018 13 2 15
22 12/22/2018 23 23
23 12/23/2018 2 2
24 12/24/2018 2 2
25 12/25/2018 2 2
26 12/26/2018 32 32
27 12/27/2018 29 29
28 12/28/2018 23 23
29 12/29/2018 17 17
30 12/30/2018 2 2
31 12/31/2018 18 2 20
695 28 723
TOTAL

Mekarsari, 31 Desember 2018


Mengetahui
Kepala Puskesmas Rawat Inap Mekarsari

Abdul Rahim, S.Kep


NIP.19711109 199202 1 001

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