LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

(LPLPO)
Puskesmas Hal. 1
UPT Puskesmas Dinas Kesehatan Kecamatan : UPT PUSKESMAS TENGGAYUN LB2
Kecamatan : BANDAR LAKSAMANA
Kab/Kota : BENGKALIS Bulan : Mei
Propinsi : RIAU Tahun : 2019

PEMAK PEMBERIAN
STOK PENERI PERSE PEMAKAIAN SISA STOK PERMIN
NO NAMA OBAT SATUAN AIAN APBD APBD KET
AWAL MAAN DIAAN STOCK OPT TAAN APBN JML
R/ Rusak EXP JML RATA2 II I
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
1 ACYCLOVIR 400 MG Tab 110 0 110 58 0 0 58 52 2500
2 ACYCLOVIR 200 MG TAB 3749 0 3749 40 0 0 40 3709 1000
3 ACYCLOVIR Krim 5 % TUBE 945 0 945 7 0 0 7 938 100
4 AIR RAKSA DENTAL USE BTL 0 0 0 0 0 0 0 0
5 ALAT SUNTIK 3 ML SET 900 0 900 10 0 0 10 890
6 ALAT SUNTIK 1 ML SET 500 0 500 50 0 0 50 450 1000
7 ALAT SUNTIK 5 ML SET 1200 0 1200 10 0 0 10 1100
8 ALBENDAZOL 400 MG TAB 400 0 400 4 0 0 5 395 300
9 ALKOHOL 70 % BTL 170 0 170 0 0 0 0 170
10 ALLOPURINOL 100 MG TAB 630 0 630 30 0 600 630 0 4500
11 ALPRAZOLAM 0,5 MG TAB 0 0 0 0 0 0 0 0
12 ALPRAZOLAM 1 MG TAB 0 0 0 0 0 0 0 0
13 AMBROXOL 30 MG TAB 2615 0 2615 178 0 0 178 2437 5000
14 AMBROXOL SYR BTL 514 0 514 45 0 0 45 469 50
15 AMINOPHILIN INJ AMP 0 0 0 0 0 0 0 0
16 AMINOPHILLIN TAB 200 MG TAB 0 0 0 0 0 0 0 0
17 AMITRIPTILIN 25 MG TAB 400 0 400 0 0 0 0 400 300
18 AMOKSISILLIN 250 MG KAPS 412 0 412 172 0 0 172 240
19 AMOKSISILLIN 500 MG TAB 18861 0 18861 1086 0 0 1086 17775 3500
20 AMOKSISILLIN SK 125 MG BTL 268 0 268 34 0 0 34 234 480
21 AMPICILLIN INJ 1 G AMP 0 0 0 0 0 0 0 0
22 AMPICILLIN 500 MG TAB 0 0 0 0 0 0 0 0
23 ANTALGIN 500 MG TAB 0 0 0 0 0 0 0 0
24 ANTALGIN INJEKSI / METHAMPYRON INJEKSI AMP 0 0 0 0 0 0 0 0
25 ANTACIDA DOEN TABLET I TAB 12855 0 12855 440 0 0 440 12415 1000
 Bulan : : Hal. 2
Tahun : : LB2
PEMAK PEMBERIAN
STOK PENERI PERSE PEMAKAIAN SISA STOK PERMIN
NO NAMA OBAT SATUAN AIAN APBD APBD KET
AWAL MAAN DIAAN STOCK OPT TAAN APBN JML
R/ Rusak EXP JML RATA2 II I
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
26 ANTASIDA SYR BTL 500 0 500 123 0 0 123 377 100
27 ANTI BAKTERI / BACITRACIN TUBE 52 0 52 0 0 52 52 0 48
28 ANTI FUNGI DOEN SALAP TUBE 0 0 0 0 0 0 0 0
29 ANTI HEMAROID SUSP 140 0 140 6 0 0 6 134
30 ANTI MIGRAIN DOEN TAB 0 0 0 0 0 0 0 0
31 ANTI PARKINSON DOEN TABLET TAB 0 0 0 0 0 0 0 0
32 ANVOMER B-6/PROVOMER TAB 606 0 606 10 0 0 0 596 300
33 AQUAPRO INJ TAB 17 0 17 0 0 0 0 17 50
34 ASAM ASKORBAT ( VIT. C ) 50 MG VIAL 9000 0 9000 737 0 0 737 8263 500
35 ASAM ASKORBAT ( VIT. C ) 250 MG TAB 0 0 0 0 0 0 0 0
36 ASAM MEFENAMAT 250 MG VIAL 0 0 0 0 0 0 0 0
37 ASAM MEFENAMAT 500 MG / FARGETIX TABLET TAB 13145 0 13145 300 0 0 300 12845 1000
38 ASETOSAL 100 MG TAB 0 0 0 0 0 0 0 0
39 ASETOSAL 500 MG BTL 0 0 0 0 0 0 0 0
40 ATROPIN TM TAB 0 0 0 0 0 0 0 0
41 ASPAR-K TAB 0 0 0 0 0 0 0 0
42 ATRANAC 25 MG/NATRIUM DIKLOFENAK 25 MG TAB 2800 0 2800 120 0 0 120 2680
43 ATRANAC 50 MG/NATRIUM DIKLOFENAK 50 MG BTL 5244 0 5244 380 0 0 380 4864
44 ATTAPULGIT 600 MG+PECTIN 50 MG/MOLAGIT TAB 855 0 855 14 0 0 14 841 300
45 ANTISERA A 10 ML BTL 0 0 0 0 0 0 0 0
46 ANTISERA B 10 ML BTL 0 0 0 0 0 0 0 0
47 ANTISERA D 10 ML BTL 0 0 0 0 0 0 0 0
48 BETAHISTIN 6 MG TAB 1150 0 1150 150 0 0 150 1000 1000
49 BETAMETASON CREAM 0,1 % TUBE 315 0 315 14 0 0 14 301
50 BETASON N-CREAM TUBE 0 0 0 0 0 0 0 0
51 BIOPLASENTON JELLY TUBE 0 0 0 0 0 0 0 0
52 BIONEURON TABLET TAB 0 0 0 0 0 0 0 0
53 BISAKODIL SUPPOSITORIA / STOLAX SUPPOSITORIA SUPP 0 0 0 0 0 0 0 0 20
54 BISAKODIL TABLET/BICOLAX TABLET SUPP 210 0 210 5 0 0 5 205 300
 Bulan : : Hal. 3
Tahun : : LB2
PEMAK PEMBERIAN
STOK PENERI PERSE PEMAKAIAN SISA STOK PERMIN
NO NAMA OBAT SATUAN AIAN APBD APBD KET
AWAL MAAN DIAAN STOCK OPT TAAN APBN JML
R/ Rusak EXP JML RATA2 II I
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
55 BISOPROLOL TABLET TAB 0 0 0 0 0 0 0 0 2000
56 BROMHEKSIN HCL TABLET 8 MG / NOVAHEKSIN TAB 0 0 0 0 0 0 0 0
57 CALSIDOR SYR BTL 0 0 0 0 0 0 0 0
58 CAPTOPRIL 12,5 MG TAB 0 0 0 0 0 0 0 0
59 CAPTOPRIL 25 MG TAB 4085 0 4085 150 0 0 150 3935 1200
60 CAT GUT 2/0-3/0 SACH 39 0 39 0 0 0 0 39 60
61 CEFADROXIL SYR 125 MG BTL 0 0 0 0 0 0 0 0 180
62 CEFADROXIL 500 MG TAB 1805 0 1805 136 0 0 136 1669 1200
63 CEFIXIME 100 MG TAB 0 0 0 0 0 0 0 0 300
64 CEFIXIME DRY SYR BTL 0 0 0 0 0 0 0 0
65 CEFOTAXIM 1 G INJ AMP 0 0 0 0 0 0 0 0
66 CEFTRIAXON 1 GRAM INJ VIAL 0 0 0 0 0 0 5 -5
67 CETADOP INJ AMP 0 0 0 0 0 0 0 0
68 CETIRIZIN 10 MG TAB 11415 0 11415 138 0 0 138 11277
69 CEFALEXIN 500 MG TAB 0 0 0 0 0 0 0 0
70 CHLOR HEXIDINE/POLI AID BTL 0 0 0 0 0 0 0 0
71 CHLORAMFECORT CREAM TUBE 0 0 0 0 0 0 0 0
72 CHLORPROMAZIN 100 MG TAB 280 0 280 0 0 280 280 0 500
73 CHLORPROMAZIN INJEKSI 5 MG / ML AMP 0 0 0 0 0 0 0 0
74 CHLORPROMAZIN INJEKSI 25 MG / ML AMP 0 0 0 0 0 0 0 0
75 CIFROLOXACIN 500 MG TAB 1200 0 1200 95 0 0 95 1105
76 CITICOLIN INJEKSI 125 MG/ML TAB 0 0 0 0 0 0 0 0
77 CLOBAZAM TAB 0 0 0 0 0 0 0 0
78 CO AMOKSIKLAV TAB / PALENTIN TAB TAB 0 0 0 0 0 0 0 0
79 DEKSAMETHASON INJ 5 MG AMP 0 0 0 0 0 0 0 0
80 DEKSAMETHASON 0.5 MG TAB TAB 1720 0 1720 917 0 0 917 803 7500
81 DEKSTROMETHORPAN 15 MG TAB 0 0 0 0 0 0 0 0
82 DEKSTROMETHORPAN SYR BTL 0 0 0 0 0 0 0 0
83 DEVITALISASI PASTA BTL 0 0 0 0 0 0 0 0
 Bulan : : Hal. 4
Tahun : : LB2
PEMAK PEMBERIAN
STOK PENERI PERSE PEMAKAIAN SISA STOK PERMIN
NO NAMA OBAT SATUAN AIAN APBD APBD KET
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R/ Rusak EXP JML RATA2 II I
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
84 DEXANTA TAB 0 0 0 0 0 0 0 0
85 DIAZEPAM INJEKSI 5 MG AMP 30 0 30 0 0 0 0 30 20
86 DIAZEPAM TAB 2 MG TAB 0 0 0 0 0 0 0 0 500
87 DIFENHIDRAMIN INJ / ETADRYL INJEKSI AMP 30 0 30 0 0 0 0 30
88 DIGOXIN 0,25 MG TAB 200 0 200 0 0 0 0 0 200
89 DIMENHIDRINAT 50 MG BTL 0 0 0 0 0 0 20 -20 300
90 DOMPERIDON TABLET BTL 2162 0 2162 40 0 0 40 2122
91 DOMPERIDON SYR TAB 280 0 280 10 0 0 10 270
92 DULCOLAX SUPP INFANT 5 MG TUBE 0 0 0 0 0 0 0 0 25
93 EFEDRIN HCL 25 MG TAB 0 0 0 0 0 0 0 0
94 ENZYMFORT TAB 0 0 0 0 0 0 0 0
95 EPINEFRIN INJ / ADRENALIN INJEKSI AMP 18 0 18 0 0 0 0 18 100
96 ERYTROMICIN 250 MG TAB 0 0 0 0 0 0 0 0
97 ERYTROMICIN 500 MG TAB 0 0 0 0 0 0 0 0
98 ERYTROMICIN SYR BTL 0 0 0 0 0 0 0 0
99 ETAKRIDIN 0,1 % RIVANOL BTL 0 0 0 0 0 0 0 0 50
100 ETIL KLORIDA SEMPROT BTL 0 0 0 0 0 0 0 0
101 EUGENOL CAIRAN BTL 0 0 0 0 0 0 0 0
102 EXTRAK BELLADONA TAB 0 0 0 0 0 0 0 0
103 FAMOTIDINE 40 MG AMP 0 0 0 0 0 0 0 0
104 FENETOIN NATRIUM 30 MG TAB 0 0 0 0 0 0 0 0
105 FENOBARBITAL TABLET 30 MG CAPS 0 0 0 0 0 0 0 0 500
106 FENOL GLISEROL TT 10% AMP 0 0 0 0 0 0 0 0
107 FUROSEMID 40 MG TAB 110 0 110 10 0 0 10 100 1200
108 FITOMENADION ( VIT. K ) 10 MG TAB 0 0 0 0 0 0 0 0 3500
109 FITOMENADION ( VIT. K ) INJ AMP 22 0 22 0 0 0 15 7 30
110 FOLLEY CATHETER TWO WAY 30 CC NO. 16 PCS 8 0 8 0 0 0 0 8 50
111 FOLLEY CATHETER TWO WAY 30 CC NO. 18 PCS 5 0 5 0 0 0 0 5 30
112 FLUOR 0.5 MG TAB 0 0 0 0 0 0 0 0
 Bulan :: Hal. 5
Tahun :: LB2
PEMAK PEMBERIAN
STOK PENERI PERSE PEMAKAIAN SISA STOK PERMIN
NO NAMA OBAT SATUAN AIAN APBD APBD KET
AWAL MAAN DIAAN STOCK OPT TAAN APBN JML
R/ Rusak EXP JML RATA2 II I
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
113 FORMALIN LARUTAN BTL 0 0 0 0 0 0 0 0
114 FORMOKRESOL ( PENGGANTI TKF ) BTL 0 0 0 0 0 0 0 0
115 FUROSEMID INJ AMP 0 0 0 0 0 0 0 0
116 GARAM ORALIT BKS 1700 0 1700 55 0 0 55 1645 1000
117 GENTAMISIN TM TUBE 130 0 130 5 0 0 5 125
118 GENTAMICIN 0,1 % SK TUBE 560 0 560 41 0 0 41 519 720
119 GENTAMICIN INJ 80 MG AMP 0 0 0 0 0 0 0 0
120 GENTIAN VIOLET BTL 80 0 80 0 0 0 0 80
121 GLASS IONOMERT CEMENT ( GC IX ) BTL 0 0 0 0 0 0 0 0
122 GLIBENKLAMID 5 MG TAB 850 0 850 70 0 0 70 780 1500
123 GLISERIL GUAIAKOLAT TAB 0 0 0 0 0 0 0 0 1000
124 GLUKOSA 10 % BTL 0 0 0 0 0 0 0 0
125 GLUKOSA 40 % BTL 0 0 0 0 0 0 0 0
126 GLUKOSA 5 % BTL 40 0 40 0 0 40 40 0
127 GRAVINON TAB 0 0 0 0 0 0 0 0
128 GRISEOFULVIN 125 MG TAB 200 0 200 0 0 200 0 0 500
129 HALOPERIDOL 0.5 MG TAB 1120 0 1120 0 0 200 0 990 500
130 HALOPERIDOL 1.5 MG ROL 0 0 0 0 0 0 0 0
131 HEMOGARD KAPS TAB 0 0 0 0 0 0 0 0
132 HIDROKLORTIAZID 25 MG TAB 2045 0 2045 30 0 0 30 2015
133 HYDROKORTISON 2.5% TUBE 537 0 537 20 0 0 20 517
134 HYOSYN N-BUTIL BROMIDA TABLET 10 MG TAB 0 0 0 0 0 0 0 0
135 IBU PROFEN 200 MG TAB 824 0 824 504 0 0 504 320
136 IBUPROFEN 400 MG TAB 0 0 0 0 0 0 0 0 5000
137 INFUS SET ANAK SET 72 0 72 0 0 0 0 72
138 INFUS SET DEWASA SET 110 0 110 0 0 0 0 110 120
139 ISOSORBID DINITRAT 5 MG TAB 0 0 0 0 0 0 0 0 500
140 IV CATHETER 20 SET 200 0 200 0 0 0 0 200 100
141 IV CATHETER 22 SET 100 0 100 0 0 0 0 100 200
 Bulan : : Hal. 6
Tahun : : LB2
PEMAK PEMBERIAN
STOK PENERI PERSE PEMAKAIAN SISA STOK PERMIN
NO NAMA OBAT SATUAN AIAN APBD APBD KET
AWAL MAAN DIAAN STOCK OPT TAAN APBN JML
R/ Rusak EXP JML RATA2 II I
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
142 IV CATHETER 24 SET 350 0 350 0 0 0 0 350
143 KALSIUM HIDROKSIDA PASTA SET 0 0 0 0 0 0 0 0
144 KALSIUM LAKTAT 500 MG TAB 4720 0 4720 190 0 0 190 4530
145 KAPAS ABSORBEN 250 G ROL 0 0 0 0 0 0 0 0
146 KAPAS BERLEMAK TUBE 0 0 0 0 0 0 0 0
147 KASA 16 X 16 CM ROL 0 0 0 0 0 0 0 0
148 KASA 2 X 80 CM ROL 0 0 0 0 0 0 0 0
149 KASA 40 X 80 CM ROL 4 0 4 0 0 0 0 4
150 KASA 4 X 15 CM ROL 0 0 0 0 0 0 0 0
151 KASA 4 X 3 CM ROL 0 0 0 0 0 0 0 0
152 KASA 40 X 40 CM ROL 0 0 0 0 0 0 0 0
153 KETOKONAZOL 200 MG TAB 1742 0 1742 30 0 0 30 1712 500
154 KLORAMFENIKOL 250 MG / COLCETIN KAPSUL KAPS 0 0 0 0 0 0 0 0 1000
155 KLORAMFENIKOL SM TUBE 0 0 0 0 0 0 0 0
156 KLORAMFENIKOL SYR / COLCETIN SYRUP BTL 0 0 0 0 0 0 0 0
157 KLORAMFENIKOL TETES TELINGA 3 % BTL 0 0 0 0 0 0 0 0
158 KLORAMFENIKOL TM 0,5 % BTL 0 0 0 0 0 0 0 0
159 KLORFENIRAMINA MALEAT / PEHACLOR TAB TAB 29484 0 29484 606 0 0 606 28878
160 KLORFENOLKAMFER MENTOL (CHKM) AMP 0 0 0 0 0 0 0 0
161 KLOROQUIN FOSFAT 25R0/150 MG TAB 0 0 0 0 0 0 0 0
162 KOTRIMOKSAZOL 480 MG TAB 230 0 230 20 0 210 230 0 1000
163 KOTRIMOKSAZOL SYR BTL 397 0 397 0 0 397 397 0 150
164 KOTRIMOXAZOL 120 MG TAB 0 0 0 0 0 0 0 0
165 LACBON TAB 575 0 575 46 0 0 46 529 1000
166 LANSOPRAZOL 30 MG KAPS 495 0 495 70 0 0 70 425
167 LARUTAN ASAM ALKOHOL 3 % 100 ML BTL 0 0 0 0 0 0 0 0
168 LARUTAN ASAM SULFOSALISILAT 20 % 100 ML BTL 0 0 0 0 0 0 0 0
169 LARUTAN BENEDICT 100 ML BTL 0 0 0 0 0 0 0 0
170 LARUTAN EOSIN 2 % 100 ML BTL 0 0 0 0 0 0 0 0
 Bulan : : Hal. 7
Tahun : : LB2
PEMAK PEMBERIAN
STOK PENERI PERSE PEMAKAIAN SISA STOK PERMIN
NO NAMA OBAT SATUAN AIAN APBD APBD KET
AWAL MAAN DIAAN STOCK OPT TAAN APBN JML
R/ Rusak EXP JML RATA2 II I
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
171 LARUTAN GIEMSA STAIN 100 ML BTL 0 0 0 0 0 0 0 0
172 LARUTAN HAYEM 100 ML BTL 0 0 0 0 0 0 0 0
173 LARUTAN HCL 0.1 N 100 ML BTL 0 0 0 0 0 0 0 0
174 LARUTAN KARBOL FUKHSIN 0.3 % 100 ML BTL 0 0 0 0 0 0 0 0
175 LARUTAN METILEN BIRU 0.3 % 100 ML BTL 0 0 0 0 0 0 0 0
176 LARUTAN TURK BTL 0 0 0 0 0 0 0 0
177 LEVOFLOXACIN 500 MG BTL 400 0 400 0 0 0 0 400 300
178 LIDOKAIN KOMPOSITUM INJEKSI BTL 100 0 100 5 0 0 5 95 90
179 LISOL BTL 0 0 0 0 0 0 0 0
180 LIVRON B PLEX TAB 0 0 0 0 0 0 0 0
181 LYSAGOR TABLET TAB 0 0 0 0 0 0 0 0
182 LOPERAMID TABLET 2 MG TAB 786 0 786 32 0 0 32 754 800
183 MASKER BKS 250 0 250 0 0 0 0 250 200
184 MELOXICAM 7,5 MG TAB 0 0 0 0 0 0 0 0
185 MELOXICAM 15 MG TAB 0 0 0 0 0 0 0 0
186 METFORMIN 500 MG TAB 2700 0 2700 35 0 0 135 2565 1000
187 METANOL BTL 0 0 0 0 0 0 0 0 10
188 METHIL PREDNISOLON 4 MG TAB 4400 0 4400 48 0 0 48 4352
189 METHOCLORPROPAMID 15 MG TAB 861 0 861 40 0 0 40 821
190 METHOCLORPROPAMID 15 MG/VOSEA SIRUP BTL 0 0 0 0 0 0 0 0
191 METILERGOMETRIN 0,125 MG TAB 180 0 180 20 0 0 20 160 500
192 METILERGOMETRIN MALEAT INJ/MYOMERGIN INJ AMP 250 0 250 5 0 0 5 245 200
193 METRONIDAZOL 250 MG TAB 0 0 0 0 0 0 0 0
194 METRONIDAZOL 500 MG TAB 0 0 0 0 0 0 0 0 800
195 MICONAZOL KRIM 2 % TUBE 216 0 216 8 0 0 8 208
196 MUMIFYING PASTA/IODOFORM PASTA BTL 0 0 0 0 0 0 0 0
197 NALD INJEKSI 23 G PCS 0 0 0 0 0 0 0 0
198 NATRIUM BICARBONAT BTL 900 0 900 35 0 0 35 865
199 NATRIUM KLORIDA INFUS 0,9 % BTL 160 0 160 0 0 0 0 0
 Bulan : : Hal. 8
Tahun : : LB2
PEMAK PEMBERIAN
STOK PENERI PERSE PEMAKAIAN SISA STOK PERMIN
NO NAMA OBAT SATUAN AIAN APBD APBD KET
AWAL MAAN DIAAN STOCK OPT TAAN APBN JML
R/ Rusak EXP JML RATA2 II I
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
200 NEURODIAL TAB 0 0 0 0 0 0 0 0
201 NEUROVIT E TAB 0 0 0 0 0 0 0 0
202 NEUROSANBE INJEKSI AMP 0 0 0 0 0 0 0 0
203 NIFEDIPIN 10 MG TAB 200 0 200 0 0 0 0 200 700
204 NISTATIN TAB VAG 100.000 IU TAB 200 0 200 10 0 0 10 190 1000
205 NISTATIN 500.000 IU TAB 200 0 200 5 0 0 5 145 1200
206 OBH/OBH TROPIKA PLUS BTL 386 0 386 43 0 0 43 343 420
207 OFLOXACIN TAB 0 0 0 0 0 0 0 0
208 OMEPRAZOL 20 MG KAPS 0 0 0 0 0 0 0 0 400
209 OXITETRASIKLIN INJ VIAL 0 0 0 0 0 0 0 0
210 OXITETRASIKLIN SM TUBE 0 0 0 0 0 0 0 0
211 OXITETRASIKLIN SK 3 % TUBE 0 0 0 0 0 0 0 0
212 PANKREON FOR CHILDREN SACH 0 0 0 0 0 0 0 0
213 PAPAVERIN HCL 40 MG TAB 0 0 0 0 0 0 0 0
214 PARAFORMALDEHID BTL 0 0 0 0 0 0 0 0
215 PARASETAMOL 500 MG TAB 13873 0 13873 1238 0 0 1238 12635 1000
216 PARASETAMOL SYR BTL 1000 0 1000 57 0 0 57 943 100
217 PEHAMOXIL 125 MG SIRUP KERING SACH 0 0 0 0 0 0 0 0
218 PHETIDIN INJEKSI TAB 0 0 0 0 0 0 0 0
219 PIRACETAM 400 MG AMP 0 0 0 0 0 0 0 0
220 PIRACETAM 800 MG TAB 0 0 0 0 0 0 0 0
221 PIRACETAM INJ AMP 0 0 0 0 0 0 0 0
222 PIRANTEL 125 MG TAB 0 0 0 0 0 0 0 0
223 PIROXICAM 10 TAB 0 0 0 0 0 0 0 0
224 PIROXICAM 20 TAB 635 0 635 180 0 0 180 455 2000
225 PITOGIN/OKSITOSIN INJ AMP 140 0 140 0 0 0 0 140 200
226 PLANOTEST SACH 0 0 0 0 0 0 0 0
227 PLASTER 5X2 '' /HYPAFIX ROL 14 0 14 0 0 0 0 14 15
228 POVIDON IODIDA 30 ML BTL 67 0 67 0 0 0 0 67
 Bulan : : Hal. 9
Tahun : : LB2
PEMAK PEMBERIAN
STOK PENERI PERSE PEMAKAIAN SISA STOK PERMIN
NO NAMA OBAT SATUAN AIAN APBD APBD KET
AWAL MAAN DIAAN STOCK OPT TAAN APBN JML
R/ Rusak EXP JML RATA2 II I
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
229 POVIDON IODIDA 300 ML BTL 32 0 32 0 0 0 0 32
230 PREDNISON TABLET TAB 2982 0 2982 208 0 0 208 2774 8000
231 PRIMAQUIN 15 MG TAB 0 0 0 0 0 0 0 0
232 PROPANOLOL 10 MG TAB 0 0 0 0 0 0 0 0
233 PROPANOLOL 40 MG TAB 0 0 0 0 0 0 0 0
234 PROPILTIURACIL TAB 400 0 400 0 0 0 0 400
235 PYRIDOXIN HCL ( VIT.B6 ) 10 MG TAB 6400 0 6400 46 0 0 46 6354
236 RANITIDIN 10 MG TAB 3512 0 3512 360 0 0 360 3152 1500
237 RANITIDIN INJ AMP 0 0 0 0 0 0 0 0
238 RESERPIN 0,25 MG TAB 0 0 0 0 0 0 0 0
239 RETAPHIL SR TAB 0 0 0 0 0 0 0 0
240 RIFAMPISIN 300 MG TAB 0 0 0 0 0 0 0 0
241 RIFAMPISIN 600 MG TAB 0 0 0 0 0 0 0 0
242 RIHEST SYR TAB 0 0 0 0 0 0 0 0
243 RINGER LAKTAT BTL 47 0 47 0 0 0 0 47 80
244 SALAP 2-4 POT 0 0 0 0 0 0 0 0
245 SALBUTAMOL 2 MG TAB 0 0 0 0 0 0 0 0
246 SALBUTAMOL 4 MG TAB 2819 0 2819 204 0 0 204 2615 3000
247 KODEIN 10 MG TAB 0 0 0 0 0 0 0 0
248 SALISIL BEDAK BKS 0 0 0 0 0 0 0 0
249 SARUNG TANGAN NON STERIL NO.7 I/2 PCS 400 0 400 0 0 0 0 400 500
250 SARUNG TANGAN STERIL NO.7 1/2 PCS 200 0 200 0 0 0 0 200 200
251 SCABICID CR 10 G TAB 98 0 98 3 0 0 3 95 60
252 SEMEN SENG FOSFAT SERBUK DAN CAIR BTL 0 0 0 0 0 0 0 0
253 SERUM ANTI BISA ULAR VIAL 3 0 3 0 0 0 0 3
254 SERUM ANTI TETANUS INJ 1.500 IU VIAL 5 0 5 0 0 0 0 5
255 SERUM ANTI TETANUS INJ 20,000 IU VIAL 0 0 0 0 0 0 0 0
256 SIANOKOBALAMIN 50 MG TAB 3900 0 3900 30 0 0 30 3870
257 SIANOKOBALAMIN INJ AMP 58 0 58 1 0 0 1 57
 Bulan :: Hal. 10
Tahun :: LB2
PEMAK PEMBERIAN
STOK PENERI PERSE PEMAKAIAN SISA STOK PERMIN
NO NAMA OBAT SATUAN AIAN APBD APBD KET
AWAL MAAN DIAAN STOCK OPT TAAN APBN JML
R/ Rusak EXP JML RATA2 II I
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
258 SILK SACH 20 0 20 2 0 0 2 18 48
259 SILVER AMALGAM SERBUK BTL 0 0 0 0 0 0 0 0
260 SIMVASTATIN 10 MG TAB 0 0 0 0 0 0 0 0
261 SIMVASTATIN 20 MG TAB 5130 0 5130 65 0 0 65 5065
262 SPIRAMYCIN 500 MG TAB 0 0 0 0 0 0 0 0
263 SPON GLATIN CUBLICLES 1X1X1 CM / CURASPON DENTAL 0 0 0 0 0 0 0 0
264 SULFADOXIN/PRIMETAMIN TAB 0 0 0 0 0 0 0 0
265 TABLET TAMBAH DARAH TAB 11305 0 11305 760 0 0 760 10545
266 TEMPORARY STOPING FLETCHER L&P BTL 0 0 0 0 0 0 0 0
267 TENSIGARD TAB 0 0 0 0 0 0 0 0
268 TETRASIKLIN 250 MG CAPS 0 0 0 0 0 0 0 0
269 TETRASIKLIN 500 MG KAPL 0 0 0 0 0 0 0 0
270 THIAMFENICOL 500 MG CAPS 0 0 0 0 0 0 0 0
271 THIAMIN HCL 50 MG TAB 2310 0 2310 70 0 0 70 2240
272 THIAMIN INJ AMP 0 0 0 0 0 0 0 0
273 TRAMADOL 50 MG TAB 550 0 550 0 0 0 0 550 750
274 TRAMADOL INJ/KAMADOL INJEKSI AMP 0 0 0 0 0 0 0 0
275 TRIHEKSIFENIDIL 2 MG TAB 500 0 500 0 0 0 0 500
276 URINE BAG SET 20 0 20 0 0 0 0 20 30
277 VIT A 100 000 IU / MERAH TAB 0 0 0 0 0 0 0 0
278 VIT A 200 000 IU / BIRU TAB 0 0 0 0 0 0 0 0
279 VIT D3 AKTIF/KOLKALTIOR BTL 0 0 0 0 0 0 0 0
280 VITAMIN B KOMPLEKS TAB 17470 0 17470 359 0 0 359 17111
281 EXCOSIN SYR BTL 0 0 0 0 0 0 0 0
282 OPINEURON SET 0 0 0 0 0 0 0 0
283 BLOOD LANCET SET 0 0 0 0 0 0 0 0
284 FENOBARBITAL INJ AMP 0 0 0 0 0 0 0 0
285 ZINK TAB 0 0 0 0 0 0 0 0 1000
286 METOKLOPROPAMID SYR/LEXAPRAM SYR BTL 263 0 263 3 0 260 263 0 120
 Bulan :: Hal. 11
Tahun :: LB2
PEMAK PEMBERIAN
STOK PENERI PERSE PEMAKAIAN SISA STOK PERMIN
NO NAMA OBAT SATUAN AIAN APBD APBD KET
AWAL MAAN DIAAN STOCK OPT TAAN APBN JML
R/ Rusak EXP JML RATA2 II I
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
287 ALKOHOL SWABS SET 0 0 0 0 0 0 0 0 500
288 PAMOL SUPP TAB 0 0 0 0 0 0 0 0
289 BECOM ZET TAB 0 0 0 0 0 0 0 0
290 PARASETAMOL SYR DROP BTL 187 0 187 17 0 0 17 170 56
291 ASAM TRANEKSAMAT AMP 85 0 85 0 0 0 0 85
292 SANBE KIDS SYR BTL 0 0 0 0 0 0 0 0
293 NEUROPIL INJ AMP 0 0 0 0 0 0 0 0
296 ALAT SUNTIK 0.5 ML SET 0 0 0 0 0 0 0 0
297 ALAT SUNTIK 0.05 ML SET 0 0 0 0 0 0 0 0
298 IV CATHETER NO 18 SET 400 0 400 0 0 0 0 400
299 IV CATHETER NO 16 SET 100 0 100 0 0 0 0 100 200
300 FOLLY CATHETER NO 14 SET 0 0 0 0 0 0 0 0
301 METOKLOPROPAMID INJ AMP 0 0 0 0 0 0 0 0
302 BUSCOPAN INJ AMP 0 0 0 0 0 0 0 0
303 KALNEX INJ AMP 0 0 0 0 0 0 0 0
304 NEO K INJ AMP 0 0 0 0 0 0 0 0
305 NACL 0.1 N PLAKON 0 0 0 0 0 0 0 0
306 ETHIFERAN INJ AMP 0 0 0 0 0 0 0 0
307 SCOPAMIN INJ AMP 0 0 0 0 0 0 0 0
308 ADRENALIN INJ AMP 0 0 0 0 0 0 0 0
309 AMLODIPIN 5 MG TAB 8120 0 8120 713 0 0 713 7407
310 AMLODIPIN 10 MG TAB 0 0 0 0 0 0 0 0 3000
311 AMBEVEN TAB 0 0 0 0 0 0 0 0
312 INH TAB 0 0 0 0 0 0 0 0
313 D 40% INJ PLAKON 0 0 0 0 0 0 0 0
314 DOXICICLIN TAB 300 0 300 0 0 0 0 300 200
315 LORATADIN TAB 700 0 700 10 0 0 10 690
316 ALINAMIN F INJ AMP 0 0 0 0 0 0 0 0
317 SOHOBION INJ AMP 0 0 0 0 0 0 0 0
 Bulan :
: Hal. 11
Tahun :
: LB2
PEMAK PEMBERIAN
STOK PENERI PERSE PEMAKAIAN SISA STOK PERMIN
NO NAMA OBAT SATUAN AIAN APBD APBD KET
AWAL MAAN DIAAN STOCK OPT TAAN APBN JML
R/ Rusak EXP JML RATA2 II I
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
318 TRANSAMIN INJ/ETINEX INJ AMP 0 0 0 0 0 0 0 0
319 STESOLID RECT TUBE 0 0 0 0 0 0 0 0 25
320 REAGEN GOL DARAH BTL 0 0 0 0 0 0 0 0
321 NALD SEGI TIGA TANPA BENANG SET 0 0 0 0 0 0 0 0
322 NASAL KANUL ANAK SET 10 0 10 0 0 0 0 10
323 NASAL KANUL DEWASA SET 10 0 10 0 0 0 0 10
324 NGT ANAK SET 0 0 0 0 0 0 0 0
325 NGT DEWASA SET 0 0 0 0 0 0 0 0
326 ELKANA SYRUP BTL 96 0 96 21 0 0 21 75
327 E-CARE HAND RUB UNIT 23 0 23 0 0 0 0 0
328 E-CARE HAND SCRUB UNIT 23 0 23 0 0 0 0 23
329 OXITETRASIKLIN SM 0.5% TUBE 0 0 0 0 0 0 0 0
330 TRANSFUSI SET SET 0 0 0 0 0 0 0 0
331 IV CATHETER NO 14 SET 0 0 0 0 0 0 0 0 200
332 UMBILIKAL CORD CLEAM SET 10 0 10 0 0 0 0 10
333 NOZA SET 100 0 100 0 0 0 0 100 500
334 ASAM FOLAT/FOLIC ACID TAB 750 0 750 250 0 0 250 500 3000
335 ALKOHOL 96% BTL 1 0 0 0 0 0 0 1 10
336 OBAT KATEGORI ANAK I PAKET 3 0 3 0 0 0 0 3 3
337 OBAT KATEGORI I PAKET 0 0 0 0 0 0 0 0 6
338 OBAT KATEGORI II PAKET 0 0 0 0 0 0 0 0 6
339 MAGNESIUM SULFAT 20% PLAKON 0 0 0 0 0 0 0 0
340 MAGNESIUM SULFAT 40% PLAKON 0 0 0 0 0 0 0 0 30
341 SCOPMA TAB 1900 0 1900 110 0 0 110 1790
342 ZINK SYR BTL 0 0 0 0 0 0 0 0 300
343 KETOCONAZOL CREAM TUBE 97 0 97 10 0 0 10 87
344 DUMIN RECTAL TUBE 18 0 18 0 0 0 0 0
345 BIOLISIN SYRUP BTL 88 0 88 12 0 0 12 76

Mengetahui / Menyetujui Yang menyerahkan Yang Menerima/Melapor Yang Menerima

An. Kepala Dinas Kesehatan Staf Seksi Farmasi Kepala UPT Puskesmas Sadar jaya Penanggung Jawab Gudang Obat
Kabupaten Bengkalis Kecamatan Siak Kecil
Kepala Seksi Kefarmasian

( dr.ROLAS JAMES SIMANULLANG ) SITI KHOTIJAH,AMK

NIP 19770418 200501 1 006 NIP.19850203 201503 2 003