LPLPO 2020 Puskemas

LAMPIRAN BERITA ACARA PENCACAHAN OBAT AKHIR TAHUN PUSKESMAS
PUSKESMAS : TAHUN : 2020

KECAMATAN :
KABUPATEN : OGAN KOMERING ILIR
PROPINSI : SUMATERA SELATAN
MENURUT PENCATATAN HASIL SELISIH KADALUARSA RUSAK HILANG

NO. NAMA OBAT SATUAN SALDO 1 PENERIMAAN 1 PENGELUARAN 1 SALDO 31 DES
JANUARI 2020 JANUARI S/D 31 JANUARI S/D 31 2020 PENCACAHAN
DES 2020 DES 2020
1 2 3 4 5 6 7 8 9 10 11 12
1 Absorbent tipped applicator (alcohol swab) Pcs
2 Acetylcystein Kapsul 200mg Kapsul
3 Acyclovir tab 200 mg Tablet
4 Acyclovir cream Tube
5 Albendazol tab 400 mg Tablet
6 Alkohol Liquid (etanol) 70%-1000 ml Btl
7 Allopurinol 100 mg Tablet
8 Aminophylline Inj 24 mg/ml-10 ml Ampul
9 Aminophylline tab 200 mg Tablet
10 Amitriptyline 25 mg tab Tablet
11 Amlodipine tab 5 mg Tablet
12 Amoxycillin Syr Btl
13 Amoxycillin 250 mg Kapsul
14 Amoxycillin 500 mg Kaptab
15 Ampicilin 1 gr Inj Vial
16 Antasida Syr DOEN Btl
17 Antasida DOEN Kombinasi Tablet
18 Anti Bisa Ular 5 ml (ABU I)/ Biosave Vial
19 Asam Mefenamat 500 mg tab Tablet
20 Ascorbic acid (Vit.C) 50 mg Tablet
21 Ascorbic acid |calsium carbonate 500 mg (Pehav Tablet
22 Aspirin (miniaspi) 100 mg tab Tablet
23 Atropine inj 0,25 mg/ml Ampul
24 Attapulgite Tablet (Pularex) Tablet
25 Attapulgite Tablet 600 mg (New Antides) Tablet
26 Automated blood grouping (Tes Gol. Darah) Paket
27 Bahan Tambal Gigi Sementara (Fletcher/Caviton Pcs
28 Bedak Salisil 2% Btl
29 Benzoic acid |salicylic acid salep (anti fungi) pot
30 Betahistine Mesylate 6 mg tab Tablet
31 Betamethasone 0,1% krim Tube
HALAMAN : 2
NO. NAMA OBAT SATUAN PENERIMAAN 1 PENGELUARAN 1
SALDO 1 JANUARI S/D 31 JANUARI S/D 31 SALDO 31 DES PENCACAHAN
JANUARI 2019 2019
DES 2019 DES 2019
1 2 3 4 5 6 7 8 9 10 11 12
32 Bisacodyl 5mg Tablet
33 Bismuth subgallas (antihemoroid) Supp
34 Calcium chloride lactate infus (RL) Botol
35 Calsium Laktat (Kalk) 500 mg Tablet
36 Captopril 12,5 mg Tablet
37 Captopril 25 mg Tablet
38 Carbamazepin tab Tablet
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs
41 Cefadroxil 500mg Tablet
42 Cetirizine 5 mg/5 ml sirup Botol
43 Chloramhenicol Salep Mata 1% Tube
44 Chloramphenicol Suspensi 125 mg/ml Btl
45 Chloramphenicol 250 mg caps Tablet
46 Chloramphenicol TT 3% Botol
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet
49 Chlorpromazine HCl 100 mg Tablet
50 Cimetidin 200 tab Tablet
51 Ciprofloxacin 500 mg tab Tablet
52 Ciprofloxacin Infus Botol
53 Clindamycin 300mg Kapsul
54 Cresol liquid 1 Liter (lysol) Botol
55 Cyanocobalamin (Vit B12) inj 500 mcg/ml Ampul
56 Devitalisasi pasta pot
57 Dexamethasone 0,5 mg Tablet
58 Dexamethasone inj 5mg/ml-1ml Ampul
59 Diazepam 5mg/ml-2 ml inj Ampul
60 Diazepam 2 mg Tablet
61 Diclofenac sodium 25 mg tab Tablet
62 Digoxin 0,25 mg Tablet
63 Dimenhydrinate 50mg Tablet
64 Dipenhidramine HCl inj 10mg/ml Ampul
65 Domperidone 10 mg Tablet
66 Doxycycline 100 mg Kapsul Kapsul
67 Epinephrine HCl/bitartrat inj 0,1% Ampul
68 Erythromicin Syr Btl
HALAMAN : 3
JANUARI 2019 2019
DES 2019 DES 2019
1 2 3 4 5 6 7 8 9 10 11 12
69 Erythromicin 500 mg capsul Kapsul
70 Ethacridine (Rivanol) 0,1% Btl
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol
72 Eugenol cairan Btl
73 Ferrous fumarate ( Tab. Tambah Darah ) Tablet
74 Folic acid 1mg ( asam folat) Tablet
75 Folley Catheter No.16 Pcs
76 Furosemida Injeksi Ampul
77 Furosemida 40 mg Tablet
78 Garam Oralit Sachet
79 Gentamicyn 0,3% TM Botol
80 Gentamicyn Inj 40 mg/ml Ampul
81 Gentamicyn 0,1% SK Tube
82 Glass lonomer Paket
83 Glibenclamide 5 mg Tablet
84 Glimepiride 1 mg Tablet
85 Glukosa larutan infus 10% Botol
87 Griseofulvin 125 mg Tablet
88 Guaifenesin 100 Tab (GG tab) Tablet
89 Haloperidol 0,5 mg tab Tablet
90 Haloperidol 5 mg tab Tablet
91 Human chorionic (HCG/Tes kehamilan ) Strip
92 Hydrochlorotiazide (HCT) 25 mg Tablet
93 Ibuprofen sirup Botol
94 Ibuprofen 200 mg Tablet
96 Ichthyol salep 10% pot
97 Immunoglobulin human anti-tetanus (Tetagam) Ampul
98 Infus set dewasa Pcs
99 Infusi set anak Pcs
100 Iodium Povidon 10% 30 ml Botol
101 Isosorbide tablet Tablet
102 IV Catheter No.20 Pcs
105 Jarum Jahit Kulit Pcs
KADALUARSA RUSAK HILANG
NO. NAMA OBAT SATUAN
1 2 3 10 11 12
106 Kalium Permanganat Serbuk pot
107 Kapas pembalut/Absorben 250 g Pcs
108 Kasa pembalut 2x80 Pcs
109 Kasa pembalut hidrofil 4 m x 15 cm Pcs
111 Kasa kompres 40/40 steril Pcs
112 Ketoconazole 200 mg Cream Tube
113 Ketoconazole 200 mg tab Tablet
114 Klorokina Fosfat 250 mg Tablet
115 Levertran Salep/ Salep Luka Bakar pot
116 Lidocain 2% Ampul
117 Lidokain Comp. inj Kombinasi Ampul
118 Lidocaine spray (Xylocaine spray) Botol
119 Liquorice liquid extract (OBH) Botol
120 Locoriz Cream Tube
121 Loperamid 2 m tab Tablet
122 Loratadine 10 mg tab Tablet
123 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul
125 Masker Pcs
126 Medical adhesive tape (dermafix/leukomed) Pcs
127 Metamizole injeksi (antalgin 1000) Ampul
128 Metformin 500mg tab Tablet
129 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul
130 Methyl Ergometrin Maleat 0,125 mg Tab
131 Methyl Prednisolon tab 4 mg Tablet
132 Methyl Rosanilinium (gentian violet) Botol
133 Metronidazol 250 mg tab Tablet
135 Metronidazol Infus Botol
136 Metronidazol syr Botol
137 Miconazole 2% Salep Kulit Tube
138 Momilen Baby Gold Sirup Botol
139 Natrium Bikarbonat 500 mg Tablet
140 Nifedipin 10 mg tab Kapsul
141 Nystatin Tab Vag 10.000 iu/g Tablet
142 Omeprazole inj Vial
HALAMAN : 5
JANUARI 2019 2019
DES 2019 DES 2019
1 2 3 4 5 6 7 8 9 10 11 12
143 Omeprazole kaps Kapsul
144 Oxytetracycline HCl 1% Salep Mata Tube
145 Oxytetracycline HCl 3% Salep Kulit Tube
146 Oxytocin inj 10 IU Ampul
147 Papaverin 40 mg tab Tablet
148 Papaverin inj Tablet
149 Paracetamol Drops 15 ml Botol
150 Parasetamol 120 mg/5 ml Syr Botol
151 Parasetamol 500 mg Tablet
152 Patient Lubricant (My Jelly ) Tube
153 Permethrin (Scabimite Cream) Tube
154 Phenobarbital inj 50mg/ml-2ml Ampul
155 Phenobarbital 100 mg Tablet
156 Phenol gliserol 10% TT Botol
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul
158 Phytomenadione (Vit.K1) 10 mg Tablet
159 Piracetam 400 mg Tablet
160 Piroxicam 20 mg tab Tablet
161 Pisau Disposable (Mess No.14/21) Pcs
162 Plesterku (Leukoplast) Pcs
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat Ampul
164 Povidon iodium 10% 300 ml Botol
165 Prednison 5 mg Tablet
166 Primaquin 15 mg tab Tablet
167 Profolat tab Tablet
168 Prokaina Penisilin G inj 3.000.000 iu Ampul
169 Propranolol HCl 10 mg Tablet
171 Propylthiouracil 100 mg Tablet
172 Protein Gluco Test Strip
173 Pyrantel Pamoat 125 mg Tablet
174 Pyridoxine HCl 10 mg Tablet
175 Ranitidin 150 mg Tablet
176 Ranitidin Injeksi Ampul
177 Retinol (Vit.A) kaps 100.000 iu Kapsul
179 Risperidone 2mg Tablet
KADALUARSA RUSAK HILANG
NO. NAMA OBAT SATUAN
1 2 3 10 11 12
180 Salbutamol 2 mg Tablet
181 Salep 2-4 Kombinasi pot
182 Sarung tangan (HandScuun) No.7,5 Pcs
183 Sarung tangan (HandScuun Steril) No. 6,5 Pcs
184 Sarung tangan (HandScuun Steril) No.7 Pcs
185 Sarung tangan (HandScuun Steril) No.7,5 Pcs
186 Semen Seng Fosfat Serbuk & Cairan Set
187 Sianocobalamin (Vit B12) 50 mg tab Tablet
188 Silk (Benang Bedah) No. 3/0 Pcs
189 Silver Sulfadiazine Tube
190 Simvastatin 10 mg tab Tablet
191 Sodium cloride infus 0,9% ( NACL ) Botol
192 Spuit 1 ml Pcs
193 Spuit 3 ml Pcs
194 Spuit 5 ml Pcs
195 Sulfadoxine | Pyrimethamine Tablet 500mg|25 Tablet
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol
197 Sulfasetamida 15% TM Botol
198 Tetracycline 250 mg Tablet
200 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul
201 Thiamine HCl (Vit B1) 50 mg Tablet
202 Trihexyphenidyl tab 2 mg Tablet
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet
204 Urin Bag Pcs
205 Usg Gel Botol
206 Vaksin Rabies Vero/ Verorab Paket
207 Vitamin B Kompleks Tablet
208 Vitamin K Infant Inj Ampul
209 Water liquid (aqua P,I) Botol
210 Wing Needle No.21 Pcs
212 Zinc Sulphate Suppositoria (Superhoid) Kapsul
213 Zinc tab Tablet
214 Ondansetron iv/im 4 mg Ampul
215 Tranexamic Acid inj 5% Ampul
216 Poliwash 500 ml Botol
HALAMAN : 7
JANUARI 2019 2019
DES 2019 DES 2019
1 2 3 4 5 6 7 8 9 10 11 12
217 Policlean Handrub Botol
218 Sarung Tangan (Handscuun) L Pcs
219 Cefotaxime Sodium inj 1 gr Vial
221 Lancet Pcs
222 Strip Kolesterol Pcs
223 Strip Gula Darah Pcs
224 Strip Asam Urat Pcs
225 Nonwoven Fixation Rol Pcs
226 Paracetamol 1000 mg /100 ml Botol
227 Otsu D-40 25 ml Botol
228 Ketorolac inj 30 mg Ampul
229 Dulcolax tab Tablet
230 Ibuprofen 400 mg.1 Tablet
231 Permethrin (Scabimite Cream).1 Tube
232 Masker Plus Pcs
Mengetahui/ Menyetujui Yang Membuat

Pimpinan Puskesmas SAKSI - SAKSI Pengelola Obat Puskesmas
1 2
..................................... .....................................
..................................... .....................................
DOKUMEN RENCANA KEBUTUHAN OBAT PUSKESMAS TAHUN 2021
PUSKESMAS : SUGIH WARAS
KECAMATAN : TELUK GELAM
PROPINSI : SUMATERA SELATAN
STOK JUMLAH
NO. NAMA OBAT JAN FEB MAR APR MEI JUN JULI AGST SEPT OKT NOP DES TOTAL
PENGAMAN RENCANA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
1 Absorbent tipped applicator (alcohol swab) 15 74 0 164 0 0 0 6 22 14 10 20 325 65 390
2 Acetylcystein Kapsul 200mg 210 71 142 45 0 0 0 0 0 0 0 0 468 93.6 561.6
3 Acyclovir tab 200 mg 180 160 110 65 210 90 220 90 203 95 0 0 1423 284.6 1707.6
4 Acyclovir cream 10 24 3 5 8 0 0 0 0 0 0 0 50 10 60
5 Albendazol tab 400 mg 81 24 0 54 0 0 30 0 13 25 0 0 227 45.4 272.4
6 Alkohol Liquid (etanol) 70%-1000 ml 5 5 7 3 12 6 0 6 1 5 3 2 55 11 66
7 Allopurinol 100 mg 475 375 265 0 0 110 130 170 90 180 130 130 2055 411 2466
8 Aminophylline Inj 24 mg/ml-10 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Aminophylline tab 200 mg 110 153 110 57 75 60 115 0 0 0 0 0 680 136 816
10 Amitriptyline 25 mg tab 100 0 140 110 130 30 80 120 138 60 0 0 908 181.6 1089.6
11 Amlodipine tab 5 mg 0 0 0 0 0 90 90 115 200 120 130 0 745 149 894
12 Amoxycillin Syr 58 38 65 142 0 0 0 0 0 0 38 35 376 75.2 451.2
13 Amoxycillin 250 mg 0 190 458 667 493 264 445 460 223 0 0 0 3200 640 3840
14 Amoxycillin 500 mg 1645 1415 1241 1381 915 940 755 680 641 1110 632 610 11965 2393 14358
15 Ampicilin 1 gr Inj 0 0 0 0 0 4 4 0 0 0 0 0 8 1.6 9.6
16 Antasida Syr DOEN 0 73 76 87 45 40 29 0 0 15 77 34 476 95.2 571.2
17 Antasida DOEN Kombinasi 770 780 545 855 715 740 550 850 879 985 820 415 8904 1780.8 10684.8
18 Anti Bisa Ular 5 ml (ABU I)/ Biosave 0 0 0 1 0 0 0 0 0 0 0 0 1 0.2 1.2
19 Asam Mefenamat 500 mg tab 0 100 360 410 130 0 0 0 0 100 220 310 1630 326 1956
20 Ascorbic acid (Vit.C) 50 mg 530 587 311 530 220 273 0 366 513 1320 430 230 5310 1062 6372
21 Ascorbic acid |calsium carbonate 500 mg (Pehavral) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Aspirin (miniaspi) 100 mg tab 150 50 0 110 90 160 60 0 0 0 0 0 620 124 744
23 Atropine inj 0,25 mg/ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Attapulgite Tablet (Pularex) 160 120 0 200 160 150 145 220 170 110 150 150 1735 347 2082
25 Attapulgite Tablet 600 mg (New Antides) 130 100 150 112 130 140 40 184 0 0 0 0 986 197.2 1183.2
26 Automated blood grouping (Tes Gol. Darah) 0 0 0 0 1 0 0 0 0 1 0 0 2 0.4 2.4
27 Bahan Tambal Gigi Sementara (Fletcher/Caviton) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
28 Bedak Salisil 2% 28 25 19 31 19 25 10 0 0 0 0 0 157 31.4 188.4
29 Benzoic acid |salicylic acid salep (anti fungi) 9 2 16 12 11 8 20 5 11 11 10 0 115 23 138
30 Betahistine Mesylate 6 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
31 Betamethasone 0,1% krim 59 20 18 36 21 19 17 31 27 23 26 17 314 314 628
STOK JUMLAH
PENGAMAN RENCANA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
32 Bisacodyl 5mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
33 Bismuth subgallas (antihemoroid) 25 13 16 29 16 28 35 22 26 20 27 3 260 52 312
34 Calcium chloride lactate infus (RL) 9 11 8 5 6 34 18 31 6 5 6 3 142 28.4 170.4
35 Calsium Laktat (Kalk) 500 mg 200 220 370 310 480 590 240 736 531 760 418 270 5125 1025 6150
36 Captopril 12,5 mg 470 372 350 330 441 260 240 713 320 144 0 0 3640 728 4368
37 Captopril 25 mg 447 467 316 300 259 420 185 605 420 280 340 250 4289 857.8 5146.8
38 Carbamazepin tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
39 Catgut/Benang Chromic Bedah No.2/0-3/0 15 17 19 5 11 14 9 14 11 9 4 10 138 27.6 165.6
40 Catgut/Benang Plain Bedah No.2/0-3/0 0 0 0 0 0 7 6 13 6 10 8 10 60 12 72
41 Cefadroxil 500mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
42 Cetirizine 5 mg/5 ml sirup 24 0 0 0 0 0 0 0 0 0 0 0 24 4.8 28.8
43 Chloramhenicol Salep Mata 1% 16 12 17 20 13 7 13 13 12 16 10 12 161 32.2 193.2
44 Chloramphenicol Suspensi 125 mg/ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
45 Chloramphenicol 250 mg caps 75 100 140 190 180 195 110 90 0 0 0 0 1080 216 1296
46 Chloramphenicol TT 3% 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
47 Chloramphenicol/ Hidrokortison krim 2,5% 12 12 12 24 12 23 14 45 21 16 18 12 221 44.2 265.2
48 Chlorpheniramine Maleat (CTM) 4 mg 3500 852 913 1245 910 1850 845 918 585 1050 609 750 14027 2805.4 16832.4
49 Chlorpromazine HCl 100 mg 160 130 0 0 0 0 0 135 145 120 205 0 895 179 1074
50 Cimetidin 200 tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
51 Ciprofloxacin 500 mg tab 360 282 375 283 365 265 155 285 42 0 0 0 2412 482.4 2894.4
52 Ciprofloxacin Infus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
53 Clindamycin 300mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
54 Cresol liquid 1 Liter (lysol) 5 2 5 3 4 0 0 5 1 4 3 2 34 6.8 40.8
55 Cyanocobalamin (Vit B12) inj 500 mcg/ml 0 0 0 0 0 0 0 0 0 100 0 0 100 20 120
56 Devitalisasi pasta 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
57 Dexamethasone 0,5 mg 0 310 537 1222 909 820 460 751 1113 980 898 0 8000 1600 9600
58 Dexamethasone inj 5mg/ml-1ml 57 12 12 21 37 42 33 33 24 26 30 5 332 66.4 398.4
59 Diazepam 5mg/ml-2 ml inj 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
60 Diazepam 2 mg 230 30 0 0 0 0 0 0 0 0 0 0 260 52 312
61 Diclofenac sodium 25 mg tab 740 530 461 460 100 530 370 495 354 120 330 690 5180 1036 6216
62 Digoxin 0,25 mg 0 0 0 0 0 0 0 20 0 50 0 100 170 34 204
63 Dimenhydrinate 50mg 100 190 50 120 0 90 60 70 0 0 0 0 680 136 816
64 Dipenhidramine HCl inj 10mg/ml 63 24 45 25 25 35 30 52 0 0 0 0 299 59.8 358.8
65 Domperidone 10 mg 281 257 286 260 352 0 0 0 0 110 140 400 2086 417.2 2503.2
66 Doxycycline 100 mg Kapsul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
67 Epinephrine HCl/bitartrat inj 0,1% 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
68 Erythromicin Syr 46 15 25 22 18 12 16 30 35 11 8 0 238 47.6 285.6
STOK JUMLAH
PENGAMAN RENCANA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
69 Erythromicin 500 mg capsul 195 130 138 207 210 240 285 190 220 195 120 200 2330 466 2796
70 Ethacridine (Rivanol) 0,1% 6 4 8 5 4 7 6 7 5 5 8 2 67 13.4 80.4
71 Ethanol ( Aseptan ) 500 cc+ Pump 3 1 20 0 0 0 0 3 4 3 2 2 38 7.6 45.6
72 Eugenol cairan 1 0 1 1 0 0 0 0 0 0 0 0 3 0.6 3.6
73 Ferrous fumarate ( Tab. Tambah Darah ) 719 410 380 260 170 240 230 260 155 1100 450 600 4974 994.8 5968.8
74 Folic acid 1mg ( asam folat) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
75 Folley Catheter No.16 2 8 2 4 3 3 0 9 2 0 1 0 34 6.8 40.8
76 Furosemida Injeksi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
77 Furosemida 40 mg 245 120 88 105 0 60 0 0 130 110 100 200 1158 231.6 1389.6
78 Garam Oralit 0 0 0 0 0 0 0 0 0 30 55 70 155 31 186
79 Gentamicyn 0,3% TM 0 19 10 26 19 12 26 15 28 17 55 10 237 47.4 284.4
80 Gentamicyn Inj 40 mg/ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
81 Gentamicyn 0,1% SK 14 12 5 15 12 17 11 12 22 13 0 0 133 26.6 159.6
82 Glass lonomer 1 0 0 0 0 0 0 0 0 0 0 0 1 0.2 1.2
83 Glibenclamide 5 mg 250 80 49 132 0 0 0 0 0 60 140 100 811 162.2 973.2
84 Glimepiride 1 mg 120 50 90 130 20 55 0 0 0 60 95 0 620 124 744
85 Glukosa larutan infus 10% 3 4 3 5 4 5 2 8 3 5 5 0 47 9.4 56.4
86 Glukosa larutan infus 5% 3 6 4 5 4 7 3 12 6 6 2 1 59 11.8 70.8
87 Griseofulvin 125 mg 290 207 230 170 193 140 165 120 0 0 0 0 1515 303 1818
88 Guaifenesin 100 Tab (GG tab) 1166 1070 897 1280 0 934 775 1188 696 1730 816 520 11072 2214.4 13286.4
89 Haloperidol 0,5 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
90 Haloperidol 5 mg tab 0 0 0 0 0 0 0 120 140 340 140 0 740 148 888
91 Human chorionic (HCG/Tes kehamilan ) 20 12 18 24 8 23 21 15 23 34 16 20 234 46.8 280.8
92 Hydrochlorotiazide (HCT) 25 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
93 Ibuprofen sirup 18 32 20 16 23 38 30 19 17 27 14 10 264 52.8 316.8
94 Ibuprofen 200 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
95 Ibuprofen 400 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
96 Ichthyol salep 10% 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
97 Immunoglobulin human anti-tetanus (Tetagam) 0 0 0 0 0 0 0 0 1 0 0 0 1 0.2 1.2
98 Infus set dewasa 10 11 7 20 23 8 8 22 5 5 10 0 129 25.8 154.8
99 Infusi set anak 8 2 8 25 5 5 3 5 3 10 10 2 86 17.2 103.2
100 Iodium Povidon 10% 30 ml 5 11 10 6 10 10 5 8 4 7 2 6 84 16.8 100.8
101 Isosorbide tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
102 IV Catheter No.20 8 4 3 5 6 8 3 13 6 11 5 10 82 16.4 98.4
103 IV Catheter No.22 6 11 4 6 8 7 5 6 4 9 4 10 80 16 96
104 IV Catheter No.24 5 2 1 8 5 6 8 2 3 4 5 10 59 11.8 70.8
105 Jarum Jahit Kulit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
STOK JUMLAH
PENGAMAN RENCANA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
106 Kalium Permanganat Serbuk 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
107 Kapas pembalut/Absorben 250 g 0 2 4 6 2 1 0 0 0 0 4 3 22 4.4 26.4
108 Kasa pembalut 2x80 19 12 16 15 10 21 6 12 12 4 18 15 160 32 192
109 Kasa pembalut hidrofil 4 m x 15 cm 7 6 6 16 7 11 4 8 11 6 4 11 97 19.4 116.4
110 Kasa pembalut hidrofil 4 m x 3 cm 7 4 12 11 9 14 3 19 17 9 8 13 126 25.2 151.2
111 Kasa kompres 40/40 steril 20 10 9 20 12 25 23 35 23 24 13 13 227 45.4 272.4
112 Ketoconazole 200 mg Cream 17 6 11 25 11 6 10 23 17 28 17 13 184 36.8 220.8
113 Ketoconazole 200 mg tab 120 130 120 270 220 250 130 279 290 365 382 150 2706 541.2 3247.2
114 Klorokina Fosfat 250 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
115 Levertran Salep/ Salep Luka Bakar 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
116 Lidocain 2% 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
117 Lidokain Comp. inj Kombinasi 20 19 25 29 10 28 36 25 26 23 13 40 294 58.8 352.8
118 Lidocaine spray (Xylocaine spray) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
119 Liquorice liquid extract (OBH) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
120 Locoriz Cream 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
121 Loperamid 2 m tab 150 320 50 220 180 130 170 150 204 0 0 0 1574 314.8 1888.8
122 Loratadine 10 mg tab 715 535 205 373 180 76 0 0 0 135 185 280 2684 536.8 3220.8
123 Magnesium Sulfat Injeksi 20% (MgSO4) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
124 Magnesium Sulfat Injeksi 40% (MgSO4) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
125 Masker 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
126 Medical adhesive tape (dermafix/leukomed) 30 6 0 13 31 0 0 0 0 0 0 0 80 16 96
127 Metamizole injeksi (antalgin 1000) 6 0 0 0 0 0 0 0 0 0 0 0 6 1.2 7.2
128 Metformin 500mg tab 250 130 110 230 220 80 70 140 40 60 110 0 1440 288 1728
129 Methyl Ergometrin Maleat inj 0,2 mg/ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
130 Methyl Ergometrin Maleat 0,125 mg 160 120 100 165 120 130 20 140 20 110 60 0 1145 229 1374
131 Methyl Prednisolon tab 4 mg 0 120 280 215 170 220 180 280 280 155 155 200 2255 451 2706
132 Methyl Rosanilinium (gentian violet) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
133 Metronidazol 250 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
134 Metronidazol 500 mg tab 400 391 339 450 420 380 365 290 318 257 0 0 3610 722 4332
135 Metronidazol Infus 0 0 1 0 0 0 0 0 0 0 0 0 1 0.2 1.2
136 Metronidazol syr 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
137 Miconazole 2% Salep Kulit 6 2 18 14 27 8 15 35 23 31 12 10 201 40.2 241.2
138 Momilen Baby Gold Sirup 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
139 Natrium Bikarbonat 500 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
140 Nifedipin 10 mg tab 110 120 110 128 152 0 0 0 0 0 0 0 620 124 744
141 Nystatin Tab Vag 10.000 iu/g 19 16 7 21 20 20 10 10 10 18 19 0 170 34 204
142 Omeprazole inj 0 0 0 4 0 0 0 0 0 0 0 0 4 0.8 4.8
STOK JUMLAH
PENGAMAN RENCANA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
143 Omeprazole kaps 0 0 0 0 0 0 0 0 0 100 140 50 290 58 348
144 Oxytetracycline HCl 1% Salep Mata 19 0 0 0 0 0 0 0 28 14 33 6 100 20 120
145 Oxytetracycline HCl 3% Salep Kulit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
146 Oxytocin inj 10 IU 25 10 10 21 12 7 8 12 11 15 4 5 140 28 168
147 Papaverin 40 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
148 Papaverin inj 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
149 Paracetamol Drops 15 ml 41 12 8 0 0 0 0 0 0 0 0 0 61 12.2 73.2
150 Parasetamol 120 mg/5 ml Syr 69 145 70 98 0 0 0 0 0 15 137 20 554 110.8 664.8
151 Parasetamol 500 mg 3580 979 1530 1593 1215 1150 773 1625 1390 1255 1255 705 17050 3410 20460
152 Patient Lubricant (My Jelly ) 3 4 1 2 4 2 4 3 1 0 0 0 24 4.8 28.8
153 Permethrin (Scabimite Cream) 5 4 12 5 8 2 0 0 0 0 0 0 36 7.2 43.2
154 Phenobarbital inj 50mg/ml-2ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
155 Phenobarbital 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
156 Phenol gliserol 10% TT 6 30 12 16 10 13 5 5 3 11 7 10 128 25.6 153.6
157 Phytomenadione (Vit.K1) inj 10 mg/ml 0 0 0 0 0 38 0 0 5 18 0 10 71 14.2 85.2
158 Phytomenadione (Vit.K1) 10 mg 160 40 130 270 16 138 20 90 50 210 30 0 1154 230.8 1384.8
159 Piracetam 400 mg 100 80 0 120 0 0 0 0 0 0 0 0 300 60 360
160 Piroxicam 20 mg tab 625 385 0 0 0 0 0 0 0 0 0 0 1010 202 1212
161 Pisau Disposable (Mess No.14/21) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
162 Plesterku (Leukoplast) 4 6 8 2 6 5 2 2 3 3 2 1 44 8.8 52.8
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
164 Povidon iodium 10% 300 ml 6 2 5 6 5 5 5 2 0 3 2 0 41 8.2 49.2
165 Prednison 5 mg 0 90 180 210 260 270 180 450 250 210 260 0 2360 472 2832
166 Primaquin 15 mg tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
167 Profolat tab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
168 Prokaina Penisilin G inj 3.000.000 iu 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
169 Propranolol HCl 10 mg 0 0 0 80 50 0 20 90 0 30 0 0 270 54 324
170 Propranolol HCl 40 mg 0 0 0 0 0 0 0 0 0 50 0 0 50 10 60
171 Propylthiouracil 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
172 Protein Gluco Test 8 0 0 0 0 0 100 0 0 0 0 0 108 21.6 129.6
173 Pyrantel Pamoat 125 mg 24 13 24 44 15 12 30 10 55 12 0 0 239 47.8 286.8
174 Pyridoxine HCl 10 mg 330 240 246 410 250 320 290 460 330 220 285 10 3391 678.2 4069.2
175 Ranitidin 150 mg 250 470 290 480 393 475 210 195 180 290 50 100 3383 676.6 4059.6
176 Ranitidin Injeksi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
177 Retinol (Vit.A) kaps 100.000 iu 70 70 0 0 0 20 0 0 20 60 0 0 240 48 288
178 Retinol (Vit.A) kaps 200.000 iu 50 38 0 0 0 20 0 0 20 60 0 0 188 37.6 225.6
179 Risperidone 2mg 0 0 0 0 0 0 50 74 100 76 70 0 370 74 444
STOK JUMLAH
PENGAMAN RENCANA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
180 Salbutamol 2 mg 280 210 191 161 230 220 135 137 211 150 367 53 2345 469 2814
181 Salep 2-4 Kombinasi 14 12 10 16 10 12 20 11 12 5 11 0 133 26.6 159.6
182 Sarung tangan (HandScuun) No.7,5 0 12 100 26 11 20 10 21 0 0 0 0 200 40 240
183 Sarung tangan (HandScuun Steril) No. 6,5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
184 Sarung tangan (HandScuun Steril) No.7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
185 Sarung tangan (HandScuun Steril) No.7,5 4 10 20 22 0 0 0 0 0 0 0 0 56 11.2 67.2
186 Semen Seng Fosfat Serbuk & Cairan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
187 Sianocobalamin (Vit B12) 50 mg tab 180 630 290 293 175 212 0 0 0 220 140 0 2140 428 2568
188 Silk (Benang Bedah) No. 3/0 6 15 8 10 6 4 2 8 5 4 0 0 68 13.6 81.6
189 Silver Sulfadiazine 1 0 2 0 1 0 0 0 1 0 0 0 5 1 6
190 Simvastatin 10 mg tab 210 280 140 200 270 190 150 215 110 220 80 30 2095 419 2514
191 Sodium cloride infus 0,9% ( NACL ) 10 5 9 5 4 5 3 8 5 6 12 0 72 14.4 86.4
192 Spuit 1 ml 83 24 52 47 56 60 73 134 54 85 54 75 797 159.4 956.4
193 Spuit 3 ml 62 56 110 96 110 74 67 98 102 20 51 73 919 183.8 1102.8
194 Spuit 5 ml 24 41 66 34 59 45 27 19 0 0 0 27 342 68.4 410.4
195 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
196 Sulfamethoxazole | trimethoprim (cotri) syr 34 22 35 40 35 40 34 32 18 13 16 10 329 65.8 394.8
197 Sulfasetamida 15% TM 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
198 Tetracycline 250 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
199 Tetracycline 500 mg 150 130 0 0 0 145 0 0 100 255 165 100 1045 209 1254
200 Thiamine HCl (Vit B1) inj 100 mg/ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
201 Thiamine HCl (Vit B1) 50 mg 870 630 290 448 384 330 359 286 390 552 630 145 5314 1062.8 6376.8
202 Trihexyphenidyl tab 2 mg 60 50 0 0 0 0 0 0 0 80 200 0 390 78 468
203 Trimethoprim (cotrimoxazol 480 mg) tablet 260 440 250 470 385 283 275 245 375 390 230 0 3603 720.6 4323.6
204 Urin Bag 2 1 2 0 0 0 0 0 0 0 0 0 5 1 6
205 Usg Gel 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
206 Vaksin Rabies Vero/ Verorab 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
207 Vitamin B Kompleks 0 0 0 0 0 580 609 1365 855 591 1206 395 5601 1120.2 6721.2
208 Vitamin K Infant Inj 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
209 Water liquid (aqua P,I) 5 4 3 5 2 2 2 2 2 0 0 0 27 5.4 32.4
210 Wing Needle No.21 6 0 2 0 0 8 0 0 0 0 0 0 16 3.2 19.2
211 Wing Needle No.27 4 0 0 0 0 3 0 0 0 0 0 0 7 1.4 8.4
212 Zinc Sulphate Suppositoria (Superhoid) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
213 Zinc tab 260 138 266 190 110 160 120 80 190 380 180 10 2084 416.8 2500.8
214 Ondansetron iv/im 4 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
215 Tranexamic Acid inj 5% 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
216 Poliwash 500 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
STOK JUMLAH
PENGAMAN RENCANA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
217 Policlean Handrub 0 0 0 0 0 0 0 0 0 5 0 0 5 1 6
218 Sarung Tangan (Handscuun) L 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
219 Cefotaxime Sodium inj 1 gr 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
220 Methyl Prednisolon tab 16 mg 500 320 280 0 110 0 150 120 100 220 25 0 1825 365 2190
221 Lancet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
222 Strip Kolesterol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
223 Strip Gula Darah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
224 Strip Asam Urat 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
225 Nonwoven Fixation Rol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
226 Paracetamol 1000 mg /100 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
227 Otsu D-40 25 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
228 Ketorolac inj 30 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
229 Dulcolax tab 50 20 0 0 0 0 0 0 0 20 10 0 100 20 120
230 Ibuprofen 400 mg.1 0 0 0 0 0 240 0 0 310 450 120 0 1120 224 1344
231 Permethrin (Scabimite Cream).1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
232 Masker Plus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
UMUM JAMSOSKES BPJS JUMLAH

JUMLAH KUNJUNGAN RESEP
5805
Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

Kepala Dinas Kesehatan Kab. OKI Kepala Instalasi Farmasi Dinkes OKI Pimpinan Puskesmas Pengelola Obat Puskesmas
Iwan Setiawan, SKM, M.Kes Himayanti, S.Si, M.Kes, Apt DORIS, SKM, M.Kes NURBAITI, Amd.Farm
Nip. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP. 198004 1 2 200003 1 002 NIP. 19660625 119003 2 004
LAMPIRAN BERITA ACARA PENCACAHAN OBAT AKHIR TAHUN PUSKESMAS
PUSKESMAS : SUGIH WARAS TAHUN : 2020
KECAMATAN : TELUK GELAM
PROVINSI : SUMATERA SELATAN

JANUARI 2020 DES 2020 DES 2020 2020
1 2 3 4 5 6 7 8 9 10 11 12
1 Absorbent tipped applicator (alcohol swab) Pcs 153 300 325 128
2 Acetylcystein Kapsul 200mg Kapsul 468 0 468 0
3 Acyclovir tab 200 mg Tablet 1423 100 1423 100
4 Acyclovir cream Tube 50 0 50 0
5 Albendazol tab 400 mg Tablet 880 0 227 653
6 Alkohol Liquid (etanol) 70%-1000 ml Btl 38 20 55 3
7 Allopurinol 100 mg Tablet 1115 2500 2055 1560
8 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0 0 0
9 Aminophylline tab 200 mg Tablet 280 400 680 0
10 Amitriptyline 25 mg tab Tablet 348 1500 908 940
11 Amlodipine tab 5 mg Tablet 0 1200 745 455
12 Amoxycillin Syr Btl 123 480 376 227
13 Amoxycillin 250 mg Kapsul 0 3200 3200 0
14 Amoxycillin 500 mg Kaptab 9835 10000 11965 7870
15 Ampicilin 1 gr Inj Vial 15 0 8 7
16 Antasida Syr DOEN Btl 0 650 476 174
17 Antasida DOEN Kombinasi Tablet 3349 11000 8904 5445
18 Anti Bisa Ular 5 ml (ABU I)/ Biosave Vial 1 0 1 0
19 Asam Mefenamat 500 mg tab Tablet 0 3000 1630 1370
20 Ascorbic acid (Vit.C) 50 mg Tablet 1451 9000 5310 5141
21 Ascorbic acid |calsium carbonate 500 mg (Pehav Tablet 0 0 0 0
22 Aspirin (miniaspi) 100 mg tab Tablet 620 0 620 0
23 Atropine inj 0,25 mg/ml Ampul 0 0 0 0
24 Attapulgite Tablet (Pularex) Tablet 835 900 1735 0
25 Attapulgite Tablet 600 mg (New Antides) Tablet 986 0 986 0
26 Automated blood grouping (Tes Gol. Darah) Paket 2 0 2 0
27 Bahan Tambal Gigi Sementara (Fletcher/Caviton Pcs 0 0 0 0
28 Bedak Salisil 2% Btl 57 100 157 0
29 Benzoic acid |salicylic acid salep (anti fungi) pot 94 120 115 99
30 Betahistine Mesylate 6 mg tab Tablet 0 0 0 0
31 Betamethasone 0,1% krim Tube 59 350 314 95
HALAMAN : 2
DES 2019 DES 2019
1 2 3 4 5 6 7 8 9 10 11 12
32 Bisacodyl 5mg Tablet 0 0 0 0
33 Bismuth subgallas (antihemoroid) Supp 100 250 260 90
34 Calcium chloride lactate infus (RL) Botol 131 100 142 89
35 Calsium Laktat (Kalk) 500 mg Tablet 2259 4500 5125 1634
36 Captopril 12,5 mg Tablet 1340 2300 3640 0
37 Captopril 25 mg Tablet 1605 3000 4289 316
38 Carbamazepin tab Tablet 0 0 0 0
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 230 0 138 92
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 0 192 60 132
41 Cefadroxil 500mg Tablet 0 0 0 0
42 Cetirizine 5 mg/5 ml sirup Botol 24 0 24 0
43 Chloramhenicol Salep Mata 1% Tube 115 96 161 50
44 Chloramphenicol Suspensi 125 mg/ml Btl 0 0 0 0
45 Chloramphenicol 250 mg caps Tablet 380 700 1080 0
46 Chloramphenicol TT 3% Botol 0 0 0 0
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 90 288 221 157
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 6209 12000 14027 4182
49 Chlorpromazine HCl 100 mg Tablet 290 700 895 95
50 Cimetidin 200 tab Tablet 0 0 0 0
51 Ciprofloxacin 500 mg tab Tablet 812 1600 2412 0
52 Ciprofloxacin Infus Botol 0 0 0 0
53 Clindamycin 300mg Kapsul 0 0 0 0
54 Cresol liquid 1 Liter (lysol) Botol 9 30 34 5
55 Cyanocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 100 100 0
56 Devitalisasi pasta pot 0 0 0 0
57 Dexamethasone 0,5 mg Tablet 0 8000 8000 0
58 Dexamethasone inj 5mg/ml-1ml Ampul 164 250 332 82
59 Diazepam 5mg/ml-2 ml inj Ampul 0 0 0 0
60 Diazepam 2 mg Tablet 2320 0 260 2060
61 Diclofenac sodium 25 mg tab Tablet 840 5200 5180 860
62 Digoxin 0,25 mg Tablet 0 500 170 330
63 Dimenhydrinate 50mg Tablet 580 100 680 0
64 Dipenhidramine HCl inj 10mg/ml Ampul 149 150 299 0
65 Domperidone 10 mg Tablet 836 2600 2086 1350
66 Doxycycline 100 mg Kapsul Kapsul 0 0 0 0
67 Epinephrine HCl/bitartrat inj 0,1% Ampul 57 0 0 57
68 Erythromicin Syr Btl 46 192 238 0
HALAMAN : 3
DES 2019 DES 2019
1 2 3 4 5 6 7 8 9 10 11 12
69 Erythromicin 500 mg capsul Kapsul 1510 1700 2330 880
70 Ethacridine (Rivanol) 0,1% Btl 53 40 67 26
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 14 30 38 6
72 Eugenol cairan Btl 2 1 3 0
73 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 16719 12390 4974 24135
74 Folic acid 1mg ( asam folat) Tablet 0 0 0 0
75 Folley Catheter No.16 Pcs 5 30 34 1
76 Furosemida Injeksi Ampul 0 0 0 0
77 Furosemida 40 mg Tablet 558 1000 1158 400
78 Garam Oralit Sachet 0 200 155 45
79 Gentamicyn 0,3% TM Botol 0 288 237 51
80 Gentamicyn Inj 40 mg/ml Ampul 0 0 0 0
81 Gentamicyn 0,1% SK Tube 37 96 133 0
82 Glass lonomer Paket 1 0 1 0
83 Glibenclamide 5 mg Tablet 511 1000 811 700
84 Glimepiride 1 mg Tablet 465 500 620 345
85 Glukosa larutan infus 10% Botol 57 40 47 50
87 Griseofulvin 125 mg Tablet 1515 0 1515 0
88 Guaifenesin 100 Tab (GG tab) Tablet 10846 8000 11072 7774
89 Haloperidol 0,5 mg tab Tablet 0 0 0 0
90 Haloperidol 5 mg tab Tablet 0 2500 740 1760
91 Human chorionic (HCG/Tes kehamilan ) Strip 43 300 234 109
92 Hydrochlorotiazide (HCT) 25 mg Tablet 0 0 0 0
93 Ibuprofen sirup Botol 150 200 264 86
94 Ibuprofen 200 mg Tablet 0 0 0 0
96 Ichthyol salep 10% pot 0 0 0 0
97 Immunoglobulin human anti-tetanus (Tetagam) Ampul 1 2 1 2
98 Infus set dewasa Pcs 129 0 129 0
99 Infusi set anak Pcs 157 200 86 271
100 Iodium Povidon 10% 30 ml Botol 26 140 84 82
101 Isosorbide tablet Tablet 0 0 0 0
102 IV Catheter No.20 Pcs 114 100 82 132
105 Jarum Jahit Kulit Pcs 0 0 0 0
HALAMAN : 4
DES 2019 DES 2019
1 2 3 4 5 6 7 8 9 10 11 12
106 Kalium Permanganat Serbuk pot 0 0 0 0
107 Kapas pembalut/Absorben 250 g Pcs 0 25 22 3
108 Kasa pembalut 2x80 Pcs 19 130 160 -11
109 Kasa pembalut hidrofil 4 m x 15 cm Pcs 70 140 97 113
111 Kasa kompres 40/40 steril Pcs 101 300 227 174
112 Ketoconazole 200 mg Cream Tube 75 175 184 66
113 Ketoconazole 200 mg tab Tablet 1480 2000 2706 774
114 Klorokina Fosfat 250 mg Tablet 0 0 0 0
115 Levertran Salep/ Salep Luka Bakar pot 0 0 0 0
116 Lidocain 2% Ampul 0 0 0 0
117 Lidokain Comp. inj Kombinasi Ampul 201 210 294 117
118 Lidocaine spray (Xylocaine spray) Botol 0 0 0 0
119 Liquorice liquid extract (OBH) Botol 0 0 0 0
120 Locoriz Cream Tube 0 0 0 0
121 Loperamid 2 m tab Tablet 1574 0 1574 0
122 Loratadine 10 mg tab Tablet 2048 2000 2684 1364
123 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 0 0 0
125 Masker Pcs 0 0 0 0
126 Medical adhesive tape (dermafix/leukomed) Pcs 80 0 80 0
127 Metamizole injeksi (antalgin 1000) Ampul 45 0 6 39
128 Metformin 500mg tab Tablet 495 1800 1440 855
129 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0 0 0
130 Methyl Ergometrin Maleat 0,125 mg Tab 1345 0 1145 200
131 Methyl Prednisolon tab 4 mg Tablet 0 3000 2255 745
132 Methyl Rosanilinium (gentian violet) Botol 0 0 0 0
133 Metronidazol 250 mg tab Tablet 0 0 0 0
135 Metronidazol Infus Botol 19 0 1 18
136 Metronidazol syr Botol 0 0 0 0
137 Miconazole 2% Salep Kulit Tube 135 192 201 126
138 Momilen Baby Gold Sirup Botol 0 0 0 0
139 Natrium Bikarbonat 500 mg Tablet 0 0 0 0
140 Nifedipin 10 mg tab Kapsul 620 0 620 0
141 Nystatin Tab Vag 10.000 iu/g Tablet 65 200 170 95
142 Omeprazole inj Vial 4 0 4 0
HALAMAN : 5
DES 2019 DES 2019
1 2 3 4 5 6 7 8 9 10 11 12
143 Omeprazole kaps Kapsul 0 2010 290 1720
144 Oxytetracycline HCl 1% Salep Mata Tube 19 100 100 19
145 Oxytetracycline HCl 3% Salep Kulit Tube 0 0 0 0
146 Oxytocin inj 10 IU Ampul 200 0 140 60
147 Papaverin 40 mg tab Tablet 0 0 0 0
148 Papaverin inj Tablet 0 0 0 0
149 Paracetamol Drops 15 ml Botol 61 0 61 0
150 Parasetamol 120 mg/5 ml Syr Botol 82 600 554 128
151 Parasetamol 500 mg Tablet 6768 17000 17050 6718
152 Patient Lubricant (My Jelly ) Tube 24 0 24 0
153 Permethrin (Scabimite Cream) Tube 36 0 36 0
154 Phenobarbital inj 50mg/ml-2ml Ampul 0 0 0 0
155 Phenobarbital 100 mg Tablet 0 0 0 0
156 Phenol gliserol 10% TT Botol 62 96 128 30
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 0 150 71 79
158 Phytomenadione (Vit.K1) 10 mg Tablet 1320 900 1154 1066
159 Piracetam 400 mg Tablet 300 0 300 0
160 Piroxicam 20 mg tab Tablet 1010 0 1010 0
161 Pisau Disposable (Mess No.14/21) Pcs 0 0 0 0
162 Plesterku (Leukoplast) Pcs 81 0 44 37
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat Ampul 0 0 0 0
164 Povidon iodium 10% 300 ml Botol 26 20 41 5
165 Prednison 5 mg Tablet 0 4000 2360 1640
166 Primaquin 15 mg tab Tablet 0 0 0 0
167 Profolat tab Tablet 0 0 0 0
168 Prokaina Penisilin G inj 3.000.000 iu Ampul 0 0 0 0
169 Propranolol HCl 10 mg Tablet 0 500 270 230
171 Propylthiouracil 100 mg Tablet 0 0 0 0
172 Protein Gluco Test Strip 8 100 108 0
173 Pyrantel Pamoat 125 mg Tablet 375 100 239 236
174 Pyridoxine HCl 10 mg Tablet 2620 1300 3391 529
175 Ranitidin 150 mg Tablet 3530 0 3383 147
176 Ranitidin Injeksi Ampul 0 0 0 0
177 Retinol (Vit.A) kaps 100.000 iu Kapsul 140 1000 240 900
179 Risperidone 2mg Tablet 0 500 370 130
HALAMAN : 6
DES 2019 DES 2019
1 2 3 4 5 6 7 8 9 10 11 12
180 Salbutamol 2 mg Tablet 1475 1300 2345 430
181 Salep 2-4 Kombinasi pot 56 96 133 19
182 Sarung tangan (HandScuun) No.7,5 Pcs 0 200 200 0
183 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0 0 0 0
184 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0 0 0
185 Sarung tangan (HandScuun Steril) No.7,5 Pcs 56 0 56 0
186 Semen Seng Fosfat Serbuk & Cairan Set 0 0 0 0
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 280 3500 2140 1640
188 Silk (Benang Bedah) No. 3/0 Pcs 125 144 68 201
189 Silver Sulfadiazine Tube 5 0 5 0
190 Simvastatin 10 mg tab Tablet 867 1710 2095 482
191 Sodium cloride infus 0,9% ( NACL ) Botol 70 100 72 98
192 Spuit 1 ml Pcs 468 600 797 271
193 Spuit 3 ml Pcs 175 900 919 156
194 Spuit 5 ml Pcs 115 200 342 -27
195 Sulfadoxine | Pyrimethamine Tablet 500mg|25 Tablet 1560 0 0 1560
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 303 200 329 174
197 Sulfasetamida 15% TM Botol 0 0 0 0
198 Tetracycline 250 mg Tablet 0 0 0 0
200 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0 0 0
201 Thiamine HCl (Vit B1) 50 mg Tablet 2539 7000 5314 4225
202 Trihexyphenidyl tab 2 mg Tablet 110 500 390 220
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 2640 4300 3603 3337
204 Urin Bag Pcs 5 0 5 0
205 Usg Gel Botol 0 0 0 0
206 Vaksin Rabies Vero/ Verorab Paket 0 0 0 0
207 Vitamin B Kompleks Tablet 0 11000 5601 5399
208 Vitamin K Infant Inj Ampul 0 0 0 0
209 Water liquid (aqua P,I) Botol 9 28 27 10
210 Wing Needle No.21 Pcs 26 0 16 10
212 Zinc Sulphate Suppositoria (Superhoid) Kapsul 0 0 0 0
213 Zinc tab Tablet 2198 1000 2084 1114
214 Ondansetron iv/im 4 mg Ampul 0 0 0 0
215 Tranexamic Acid inj 5% Ampul 0 0 0 0
216 Poliwash 500 ml Botol 0 0 0 0
HALAMAN : 7
DES 2019 DES 2019
1 2 3 4 5 6 7 8 9 10 11 12
221 Lancet Pcs
232 Masker Plus Pcs

Pimpinan Puskesmas SAKSI - SAKSI Pengelola Obat Puskesmas
1 2
NURBAITI, Amd.Farm
Iwan Setiawan, SKM, M.Kes NIP. 19660625 119003 2 004
Nip. 19730905 199803 1 005
..................................... .....................................
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSKESMAS
PUSKESMAS : SUGIH WARAS PELAPORAN BULAN : DESEMBER 2020 DOKUMEN NOMOR TANGGAL
KECAMATAN : TELUK GELAM PERMINTAAN BULAN : DINKES KAB/KOTA
KABUPATEN : OGAN KOMERING ILIR IFK KAB/KOTA
PROVINSI : SUMATERA SELATAN PUSKESMAS
STOK STOK STOK

NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
2 Acetylcystein Kapsul 200mg Kapsul 0 0 0
3 Acyclovir tab 200 mg Tablet 100 100 100
4 Acyclovir cream Tube 0 0 0
5 Albendazol tab 400 mg Tablet 653 653 653
8 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0 0
9 Aminophylline tab 200 mg Tablet 0 0 0
10 Amitriptyline 25 mg tab Tablet 940 940 940
11 Amlodipine tab 5 mg Tablet 455 455 455
13 Amoxycillin 250 mg Kapsul 0 0 0
15 Ampicilin 1 gr Inj Vial 7 7 7
18 Anti Bisa Ular 5 ml (ABU I)/ Biosave Vial 0 0 0
21 Ascorbic acid |calsium carbonate 500 mg (Pehavral) Tablet 0 0 0
22 Aspirin (miniaspi) 100 mg tab Tablet 0 0 0
23 Atropine inj 0,25 mg/ml Ampul 0 0 0
25 Attapulgite Tablet 600 mg (New Antides) Tablet 0 0 0
26 Automated blood grouping (Tes Gol. Darah) Paket 0 0 0
27 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0 0
28 Bedak Salisil 2% Btl 0 0 0
29 Benzoic acid |salicylic acid salep (anti fungi) pot 99 99 99
30 Betahistine Mesylate 6 mg tab Tablet 0 0 0
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : DESEMBER 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
32 Bisacodyl 5mg Tablet 0 0 0
36 Captopril 12,5 mg Tablet 0 0 0
38 Carbamazepin tab Tablet 0 0 0
41 Cefadroxil 500mg Tablet 0 0 0
42 Cetirizine 5 mg/5 ml sirup Botol 0 0 0
44 Chloramphenicol Suspensi 125 mg/ml Btl 0 0 0
45 Chloramphenicol 250 mg caps Tablet 0 0 0
46 Chloramphenicol TT 3% Botol 0 0 0
49 Chlorpromazine HCl 100 mg Tablet 95 95 95
50 Cimetidin 200 tab Tablet 0 0 0
51 Ciprofloxacin 500 mg tab Tablet 0 0 0
52 Ciprofloxacin Infus Botol 0 0 0
53 Clindamycin 300mg Kapsul 0 0 0
55 Cyanocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0 0
56 Devitalisasi pasta pot 0 0 0
57 Dexamethasone 0,5 mg Tablet 0 0 0
59 Diazepam 5mg/ml-2 ml inj Ampul 0 0 0
60 Diazepam 2 mg Tablet 2060 2060 2060
63 Dimenhydrinate 50mg Tablet 0 0 0
64 Dipenhidramine HCl inj 10mg/ml Ampul 0 0 0
66 Doxycycline 100 mg Kapsul Kapsul 0 0 0
67 Epinephrine HCl/bitartrat inj 0,1% Ampul 57 57 57
68 Erythromicin Syr Btl 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
72 Eugenol cairan Btl 0 0 0
74 Folic acid 1mg ( asam folat) Tablet 0 0 0
75 Folley Catheter No.16 Pcs 1 1 1
76 Furosemida Injeksi Ampul 0 0 0
80 Gentamicyn Inj 40 mg/ml Ampul 0 0 0
81 Gentamicyn 0,1% SK Tube 0 0 0
82 Glass lonomer Paket 0 0 0
84 Glimepiride 1 mg Tablet 345 345 345
85 Glukosa larutan infus 10% Botol 50 50 50
87 Griseofulvin 125 mg Tablet 0 0 0
89 Haloperidol 0,5 mg tab Tablet 0 0 0
90 Haloperidol 5 mg tab Tablet 1760 1760 1760
92 Hydrochlorotiazide (HCT) 25 mg Tablet 0 0 0
94 Ibuprofen 200 mg Tablet 0 0 0
96 Ichthyol salep 10% pot 0 0 0
97 Immunoglobulin human anti-tetanus (Tetagam) Ampul 2 2 2
98 Infus set dewasa Pcs 0 0 0
101 Isosorbide tablet Tablet 0 0 0
105 Jarum Jahit Kulit Pcs 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
106 Kalium Permanganat Serbuk pot 0 0 0
108 Kasa pembalut 2x80 Pcs 4 4 15 -11
114 Klorokina Fosfat 250 mg Tablet 0 0 0
115 Levertran Salep/ Salep Luka Bakar pot 0 0 0
116 Lidocain 2% Ampul 0 0 0
118 Lidocaine spray (Xylocaine spray) Botol 0 0 0
119 Liquorice liquid extract (OBH) Botol 0 0 0
120 Locoriz Cream Tube 0 0 0
121 Loperamid 2 m tab Tablet 0 0 0
123 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 0 0
125 Masker Pcs 0 0 0
126 Medical adhesive tape (dermafix/leukomed) Pcs 0 0 0
127 Metamizole injeksi (antalgin 1000) Ampul 39 39 39
128 Metformin 500mg tab Tablet 855 855 855
129 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0 0
130 Methyl Ergometrin Maleat 0,125 mg Tab 200 200 200
132 Methyl Rosanilinium (gentian violet) Botol 0 0 0
133 Metronidazol 250 mg tab Tablet 0 0 0
135 Metronidazol Infus Botol 18 18 18
136 Metronidazol syr Botol 0 0 0
138 Momilen Baby Gold Sirup Botol 0 0 0
139 Natrium Bikarbonat 500 mg Tablet 0 0 0
140 Nifedipin 10 mg tab Kapsul 0 0 0
141 Nystatin Tab Vag 10.000 iu/g Tablet 95 95 95
142 Omeprazole inj Vial 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
145 Oxytetracycline HCl 3% Salep Kulit Tube 0 0 0
147 Papaverin 40 mg tab Tablet 0 0 0
148 Papaverin inj Tablet 0 0 0
149 Paracetamol Drops 15 ml Botol 0 0 0
152 Patient Lubricant (My Jelly ) Tube 0 0 0
153 Permethrin (Scabimite Cream) Tube 0 0 0
154 Phenobarbital inj 50mg/ml-2ml Ampul 0 0 0
155 Phenobarbital 100 mg Tablet 0 0 0
158 Phytomenadione (Vit.K1) 10 mg Tablet 1066 1066 1066
159 Piracetam 400 mg Tablet 0 0 0
160 Piroxicam 20 mg tab Tablet 0 0 0
161 Pisau Disposable (Mess No.14/21) Pcs 0 0 0
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 0 0 0
164 Povidon iodium 10% 300 ml Botol 5 5 5
165 Prednison 5 mg Tablet 1640 1640 1640
166 Primaquin 15 mg tab Tablet 0 0 0
167 Profolat tab Tablet 0 0 0
168 Prokaina Penisilin G inj 3.000.000 iu Ampul 0 0 0
169 Propranolol HCl 10 mg Tablet 230 230 230
171 Propylthiouracil 100 mg Tablet 0 0 0
172 Protein Gluco Test Strip 0 0 0
173 Pyrantel Pamoat 125 mg Tablet 236 236 236
176 Ranitidin Injeksi Ampul 0 0 0
177 Retinol (Vit.A) kaps 100.000 iu Kapsul 900 900 900
179 Risperidone 2mg Tablet 130 130 130
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
181 Salep 2-4 Kombinasi pot 19 19 19
182 Sarung tangan (HandScuun) No.7,5 Pcs 0 0 0
183 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0 0 0
185 Sarung tangan (HandScuun Steril) No.7,5 Pcs 0 0 0
186 Semen Seng Fosfat Serbuk & Cairan Set 0 0 0
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 1640 1640 1640
188 Silk (Benang Bedah) No. 3/0 Pcs 201 201 201
189 Silver Sulfadiazine Tube 0 0 0
191 Sodium cloride infus 0,9% ( NACL ) Botol 98 98 98
192 Spuit 1 ml Pcs 346 346 75 271
193 Spuit 3 ml Pcs 229 229 73 156
194 Spuit 5 ml Pcs 0 0 27 -27
195 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 1560 1560 1560
197 Sulfasetamida 15% TM Botol 0 0 0
198 Tetracycline 250 mg Tablet 0 0 0
200 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0 0
202 Trihexyphenidyl tab 2 mg Tablet 220 220 220
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 3337 3337 3337
204 Urin Bag Pcs 0 0 0
205 Usg Gel Botol 0 0 0
206 Vaksin Rabies Vero/ Verorab Paket 0 0 0
208 Vitamin K Infant Inj Ampul 0 0 0
209 Water liquid (aqua P,I) Botol 10 10 10
210 Wing Needle No.21 Pcs 10 10 10
212 Zinc Sulphate Suppositoria (Superhoid) Kapsul 0 0 0
213 Zinc tab Tablet 1124 1124 10 1114
214 Ondansetron iv/im 4 mg Ampul 0 0 0
215 Tranexamic Acid inj 5% Ampul 0 0 0
216 Poliwash 500 ml Botol 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
217 Policlean Handrub Botol 5 5 5 -5
218 Sarung Tangan (Handscuun) L Pcs 0 0 0 0
219 Cefotaxime Sodium inj 1 gr Vial 0 0 0 0
220 Methyl Prednisolon tab 16 mg Tablet 575 575 575 -575
221 Lancet Pcs 0 0 0 0
222 Strip Kolesterol Pcs 0 0 0 0
223 Strip Gula Darah Pcs 0 0 0 0
224 Strip Asam Urat Pcs 0 0 0 0
225 Nonwoven Fixation Rol Pcs 0 0 0 0
226 Paracetamol 1000 mg /100 ml Botol 0 0 0 0
227 Otsu D-40 25 ml Botol 0 0 0 0
228 Ketorolac inj 30 mg Ampul 0 0 0 0
229 Dulcolax tab Tablet 20 20 20 -20
230 Ibuprofen 400 mg.1 Tablet 880 880 880 -880
231 Permethrin (Scabimite Cream).1 Tube 0 0 0 0
232 Masker Plus Pcs 0 0 0 0
233 0 0 0 0
234 0 0 0 0
235 0 0 0 0
236 0 0 0 0
237 0 0 0 0
238 0 0 0 0
239 0 0 0 0
240 0 0 0 0
241 0 0 0 0

0

Nip. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP. 198004 1 2 200003 1 002 NIP. 19660625 119003 2 004
PUSKESMAS : SUGIH WARAS PELAPORAN BULAN : NOVEMBER 2020 DOKUMEN NOMOR TANGGAL
KECAMATAN : TELUK GELAM PERMINTAAS BULAN : DINKES KAB/KOTA
PROPINSI : SUMATERA SELATAN PUSKESMAS
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
3 Acyclovir tab 200 mg Tablet 100 100 100
10 Amitriptyline 25 mg tab Tablet 940 940 940
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : NOVEMBER 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
36 Captopril 12,5 mg Tablet 0 0 0
62 Digoxin 0,25 mg Tablet 430 430 430
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
81 Gentamicyn 0,1% SK Tube 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
108 Kasa pembalut 2x80 Pcs 22 22 18 4
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 89 89 89
173 Pyrantel Pamoat 125 mg Tablet 236 236 236
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
184 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0 0
188 Silk (Benang Bedah) No. 3/0 Pcs 201 201 201
192 Spuit 1 ml Pcs 400 400 54 346
193 Spuit 3 ml Pcs 280 280 51 229
194 Spuit 5 ml Pcs 0 0 0
213 Zinc tab Tablet 1304 1304 180 1124
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
217 Policlean Handrub Botol 5 5 5
218 Sarung Tangan (Handscuun) L Pcs 0 0 0
219 Cefotaxime Sodium inj 1 gr Vial 0 0 0
221 Lancet Pcs 0 0 0
222 Strip Kolesterol Pcs 0 0 0
223 Strip Gula Darah Pcs 0 0 0
224 Strip Asam Urat Pcs 0 0 0
225 Nonwoven Fixation Rol Pcs 0 0 0
226 Paracetamol 1000 mg /100 ml Botol 0 0 0
227 Otsu D-40 25 ml Botol 0 0 0
228 Ketorolac inj 30 mg Ampul 0 0 0
229 Dulcolax tab Tablet 30 30 10 20
230 Ibuprofen 400 mg.1 Tablet 1000 1000 120 880
231 Permethrin (Scabimite Cream).1 Tube 0 0 0
232 Masker Plus Pcs 0 0 0
233 0 0 0
234 0 0 0
235 0 0 0
236 0 0 0
237 0 0 0
238 0 0 0
239 0 0 0
240 0 0 0
241 0 0 0

406 183 589

Nip. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP. 198004 1 2 200003 1 002 NIP. 19660625 119003 2 004
PUSKESMAS : SUGIH WARAS PELAPORAN BULAN : OKTOBER 2020 DOKUMEN NOMOR TANGGAL
PROPINSI : SUMATERA SELATAN PUSKESMAS 3/10/2020
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
3 Acyclovir tab 200 mg Tablet 95 100 195 95 100
6 Alkohol Liquid (etanol) 70%-1000 ml Btl 3 10 13 5 8
7 Allopurinol 100 mg Tablet 0 2000 2000 180 1820
11 Amlodipine tab 5 mg Tablet 405 300 705 120 585
14 Amoxycillin 500 mg Kaptab 5222 5000 10222 1110 9112
16 Antasida Syr DOEN Btl 0 300 300 15 285
17 Antasida DOEN Kombinasi Tablet 2665 5000 7665 985 6680
19 Asam Mefenamat 500 mg tab Tablet 0 2000 2000 100 1900
20 Ascorbic acid (Vit.C) 50 mg Tablet 4121 3000 7121 1320 5801
31 Betamethasone 0,1% krim Tube 61 100 161 23 138
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : OKTOBER 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
33 Bismuth subgallas (antihemoroid) Supp 40 100 140 20 120
34 Calcium chloride lactate infus (RL) Botol 43 60 103 5 98
35 Calsium Laktat (Kalk) 500 mg Tablet 1082 2000 3082 760 2322
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 107 96 203 16 187
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 1591 5000 6591 1050 5541
49 Chlorpromazine HCl 100 mg Tablet 220 200 420 120 300
54 Cresol liquid 1 Liter (lysol) Botol 4 10 14 4 10
55 Cyanocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 100 100 100 0
61 Diclofenac sodium 25 mg tab Tablet 0 2000 2000 120 1880
65 Domperidone 10 mg Tablet 0 2000 2000 110 1890
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
69 Erythromicin 500 mg capsul Kapsul 395 1000 1395 195 1200
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 3 10 13 3 10
78 Garam Oralit Sachet 0 200 200 30 170
79 Gentamicyn 0,3% TM Botol 37 96 133 17 116
83 Glibenclamide 5 mg Tablet 0 1000 1000 60 940
84 Glimepiride 1 mg Tablet 0 500 500 60 440
88 Guaifenesin 100 Tab (GG tab) Tablet 7840 3000 10840 1730 9110
90 Haloperidol 5 mg tab Tablet 1740 500 2240 340 1900
91 Human chorionic (HCG/Tes kehamilan ) Strip 79 100 179 34 145
93 Ibuprofen sirup Botol 37 100 137 27 110
100 Iodium Povidon 10% 30 ml Botol 47 50 97 7 90
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
109 Kasa pembalut hidrofil 4 m x 15 cm Pcs 84 50 134 6 128
111 Kasa kompres 40/40 steril Pcs 124 100 224 24 200
112 Ketoconazole 200 mg Cream Tube 74 50 124 28 96
117 Lidokain Comp. inj Kombinasi Ampul 73 120 193 23 170
122 Loratadine 10 mg tab Tablet 0 2000 2000 135 1865
128 Metformin 500mg tab Tablet 525 500 1025 60 965
137 Miconazole 2% Salep Kulit Tube 131 48 179 31 148
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
143 Omeprazole kaps Kapsul 0 2010 2010 100 1910
150 Parasetamol 120 mg/5 ml Syr Botol 0 300 300 15 285
151 Parasetamol 500 mg Tablet 4933 5000 9933 1255 8678
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 47 60 107 18 89
164 Povidon iodium 10% 300 ml Botol 0 10 10 3 7
165 Prednison 5 mg Tablet 1110 1000 2110 210 1900
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 0 2000 2000 220 1780
191 Sodium cloride infus 0,9% ( NACL ) Botol 56 60 116 6 110
192 Spuit 1 ml Pcs 485 485 85 400
193 Spuit 3 ml Pcs 0 300 300 20 280
194 Spuit 5 ml Pcs 0 0 0
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 13 200 213 13 200
199 Tetracycline 500 mg Tablet 255 1000 1255 255 1000
201 Thiamine HCl (Vit B1) 50 mg Tablet 4552 1000 5552 552 5000
202 Trihexyphenidyl tab 2 mg Tablet 0 500 500 80 420
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 2957 1000 3957 390 3567
207 Vitamin B Kompleks Tablet 4591 3000 7591 591 7000
213 Zinc tab Tablet 684 1000 1684 380 1304
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
217 Policlean Handrub Botol 10 10 5 5
227 Otsu D-40 25 ml Botol 0 0 0
233
234 0
235 0 0 0
236 0 0 0
237 0 0 0
238 0 0 0
239 0 0 0
240 0 0 0
241 0 0 0

0

Nip. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP. 198004 1 2 200003 1 002 NIP. 19660625 119003 2 004
PUSKESMAS : SUGIH WARAS PELAPORAN BULAN : SEPTEMBER 2020 DOKUMEN NOMOR TANGGAL
KECAMATAN : TELUK GELAM PERMINTAAN BULAN : OKTOBER 2020 DINKES KAB/KOTA
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
3 Acyclovir tab 200 mg Tablet 298 298 203 95 50
13 Amoxycillin 250 mg Kapsul 223 223 223 0 3000
21 Ascorbic acid |calsium carbonate 500 mg (Pehavral) Tablet 0 0 0 3000
27 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0 0 3
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : SEPTEMBER 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
36 Captopril 12,5 mg Tablet 464 464 320 144 1000
37 Captopril 25 mg Tablet 1606 1606 420 1186 1000
49 Chlorpromazine HCl 100 mg Tablet 365 365 145 220 200
51 Ciprofloxacin 500 mg tab Tablet 42 42 42 0 2000
57 Dexamethasone 0,5 mg Tablet 2991 2991 1113 1878 4000
68 Erythromicin Syr Btl 54 54 35 19 100
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
81 Gentamicyn 0,1% SK Tube 35 35 22 13 100
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
113 Ketoconazole 200 mg tab Tablet 1961 1961 290 1671 1000
125 Masker Pcs 0 0 0 1000
134 Metronidazol 500 mg tab Tablet 575 575 318 257 2000
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
152 Patient Lubricant (My Jelly ) Tube 1 1 1 0 5
156 Phenol gliserol 10% TT Botol 61 61 3 58 50
174 Pyridoxine HCl 10 mg Tablet 1374 1374 330 1044 1000
175 Ranitidin 150 mg Tablet 767 767 180 587 1000
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
192 Spuit 1 ml Pcs 539 539 54 485
193 Spuit 3 ml Pcs 102 102 102 0 300
194 Spuit 5 ml Pcs 0 0 0 100
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 31 31 18 13 200
213 Zinc tab Tablet 874 874 190 684 1000
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
227 Otsu D-40 25 ml Botol 0 0 0
229 Dulcolax tab Tablet 50 50 50
233 0 0 0
234 0 0 0
235 0 0 0
236 0 0 0
237 0 0 0
238 0 0 0
239 0 0 0
240 0 0 0
241 0 0 0

94 510 604

Nip. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP. 19660625 119003 2 004
PUSKESMAS : SUGIH WARAS PELAPORAN BULAN : AGUSTUS 2020 DOKUMEN NOMOR TANGGAL
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
12 Amoxycillin Syr Btl 0 0 0
19 Asam Mefenamat 500 mg tab Tablet 0 0 0
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : AGUSTUS 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
73 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 21690 5010 26700 260 26440
77 Furosemida 40 mg Tablet 940 940 940
78 Garam Oralit Sachet 0 0 0
83 Glibenclamide 5 mg Tablet 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
107 Kapas pembalut/Absorben 250 g Pcs 0 0 0
108 Kasa pembalut 2x80 Pcs 0 50 50 12 38
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
143 Omeprazole kaps Kapsul 0 0 0
144 Oxytetracycline HCl 1% Salep Mata Tube 100 100 100
150 Parasetamol 120 mg/5 ml Syr Botol 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
188 Silk (Benang Bedah) No. 3/0 Pcs 74 144 218 8 210
192 Spuit 1 ml Pcs 473 200 673 134 539
193 Spuit 3 ml Pcs 0 200 200 98 102
194 Spuit 5 ml Pcs 19 19 19 0
213 Zinc tab Tablet 954 954 80 874
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
227 Otsu D-40 25 ml Botol 0 0 0
230 Ibuprofen 400 mg.1 Tablet 1760 1760 1760
233 0 0 0
234 0 0 0
235 0 0 0
236 0 0 0
237 0 0 0
238 0 0 0
239 0 0 0
240 0 0 0
241 0 0 0

431 81 512

Iwan Setiawan, SKM, M.Kes Himayanti, S.Si, M.Kes, Apt NURBAITI
Nip. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP. 19660625 119003 2 004
USTUS 2020
USTUS 2020
USTUS 2020
USTUS 2020
USTUS 2020
USTUS 2020
PUSKESMAS : SUGIH WARAS PELAPORAN BULAN : JULI 2020 DOKUMEN NOMOR TANGGAL
KECAMATAN : TELUK GELAM PERMINTAAN BULAN : AGUSTUS 2020 DINKES KAB/KOTA
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
1 Absorbent tipped applicator (alcohol swab) Pcs 200 200 200
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN AGUSTUS 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
HALAMAN : 3 LPLPO No: 0 LAPORAN BULAN AGUSTUS 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 0 0 0
73 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 14540 7380 21920 230 21690
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
179 Risperidone 2mg Tablet 0 500 500 50 450
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
192 Spuit 1 ml Pcs 546 546 73 473
193 Spuit 3 ml Pcs 67 67 67 0
194 Spuit 5 ml Pcs 46 46 27 19
213 Zinc tab Tablet 1074 1074 120 954
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
227 Otsu D-40 25 ml Botol 0 0 0
233 0 0 0
234 0 0 0
235 0 0 0
236 0 0 0
237 0 0 0
238 0 0 0
239 0 0 0
240 0 0 0
241 0 0 0

351 172 523

Iwan Setiawan, SKM, M.Kes Himayanti, S.Si, M.Kes, Apt DORIS, SKM, M,Kes NURBAITI
Nip. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP. 19800412 200003 1 002 NIP. 19660625 119003 2 004
USTUS 2020
USTUS 2020
USTUS 2020
USTUS 2020
PUSKESMAS : SUGIH WARAS PELAPORAN BULAN : JUNI 2020 DOKUMEN NOMOR

STOK STOK STOK

NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11
1 Absorbent tipped applicator (alcohol swab) Pcs 0 200 200 0 200
10 Amitriptyline 25 mg tab Tablet 368 1000 1368 30 1338
19 Asam Mefenamat 500 mg tab Tablet 0 0 0
29 Benzoic acid |salicylic acid salep (anti fungi) pot 116 48 164 8 156
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 96 96 192 7 185
54 Cresol liquid 1 Liter (lysol) Botol 0 0 0
58 Dexamethasone inj 5mg/ml-1ml Ampul 175 100 275 42 233
63 Dimenhydrinate 50mg Tablet 120 100 220 90 130
65 Domperidone 10 mg Tablet 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11
70 Ethacridine (Rivanol) 0,1% Btl 51 15 66 7 59
75 Folley Catheter No.16 Pcs 6 10 16 3 13
77 Furosemida 40 mg Tablet 0 1000 1000 60 940
102 IV Catheter No.20 Pcs 138 50 188 8 180
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11
131 Methyl Prednisolon tab 4 mg Tablet 1215 1000 2215 220 1995
141 Nystatin Tab Vag 10.000 iu/g Tablet 82 100 182 20 162
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11
158 Phytomenadione (Vit.K1) 10 mg Tablet 1504 100 1604 138 1466
177 Retinol (Vit.A) kaps 100.000 iu Kapsul 0 1000 1000 20 980
178 Retinol (Vit.A) kaps 200.000 iu Kapsul 0 1000 1000 20 980
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11
180 Salbutamol 2 mg Tablet 1203 500 1703 220 1483
190 Simvastatin 10 mg tab Tablet 487 990 1477 190 1287
192 Spuit 1 ml Pcs 606 606 60 546
193 Spuit 3 ml Pcs 141 141 74 67
194 Spuit 5 ml Pcs 91 91 45 46
209 Water liquid (aqua P,I) Botol 8 10 18 2 16
213 Zinc tab Tablet 1234 1234 160 1074
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11
220 Methyl Prednisolon tab 16 mg Tablet 1190 1190 1190
227 Otsu D-40 25 ml Botol 0 0 0
230 Ibuprofen 400 mg.1 Tablet 0 2000 2000 240 1760
233 0 0 0
234 0 0 0
235 0 0 0
236 0 0 0
237 0 0 0
238 0 0 0
239 0 0 0
240 0 0 0
241 0 0 0

104 327 431

Iwan Setiawan, SKM, M.Kes Himayanti, S.Si, M.Kes, Apt LINDA ARYANI, SKM NURBAITI
Nip. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP. 19820209 200501 2 005 NIP. 19660625 119003 2 004
TANGGAL
KET
12
: JUNI 2020
KET
12
: JUNI 2020
KET
12
: JUNI 2020
KET
12
: JUNI 2020
KET
12
: JUNI 2020
KET
12
: JUNI 2020
KET
12
Yang Membuat
engelola Obat Puskesmas
NURBAITI
19660625 119003 2 004
PUSKESMAS : SUGIH WARAS PELAPORAN BULAN : MEI 2020 DOKUMEN NOMOR
KECAMATAN : TELUK GELAM PERMINTAAN BULAN : JUNI 2020 DINKES KAB/KOTA

STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11
1 Absorbent tipped applicator (alcohol swab) Pcs 0 0 0
7 Allopurinol 100 mg Tablet 0 0 0
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 96 96 96
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11
88 Guaifenesin 100 Tab (GG tab) Tablet 11433 11433 11433
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11
192 Spuit 1 ml Pcs 662 662 56 606
193 Spuit 3 ml Pcs 251 251 110 141
194 Spuit 5 ml Pcs 150 150 59 91
207 Vitamin B Kompleks Tablet 3000 3000 3000
213 Zinc tab Tablet 1344 1344 110 1234
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11
227 Otsu D-40 25 ml Botol 0 0 0
233 0 0 0
234 0 0 0
235 0 0 0
236 0 0 0
237 0 0 0
238 0 0 0
239 0 0 0
240 0 0 0
241 0 0 0

164 309 473

Nip. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP. 19820209 200501 2 005 NIP. 19660625 119003 2 004
TANGGAL
KET
12
: MEI 2020
KET
12
: MEI 2020
KET
12
: MEI 2020
KET
12
: MEI 2020
KET
12
: MEI 2020
KET
12
: MEI 2020
KET
12
Yang Membuat
engelola Obat Puskesmas
NURBAITI
19660625 119003 2 004
PUSKESMAS : PELAPORAN BULAN : APRIL 2020 DOKUMEN NOMOR TANGGAL

KECAMATAN : PERMINTAAN BULAN : DINKES KAB/KOTA
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
7 Allopurinol 100 mg Tablet 0 0 0
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : APRIL 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 96 96 96
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
192 Spuit 1 ml Pcs 709 709 47 662
193 Spuit 3 ml Pcs 347 347 96 251
194 Spuit 5 ml Pcs 184 184 34 150
207 Vitamin B Kompleks Tablet 3000 3000 3000
213 Zinc tab Tablet 1534 1534 190 1344
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
220 Methyl Prednisolon tab 16 mg Tablet 1300 1300 1300
227 Otsu D-40 25 ml Botol 0 0 0
233 0 0 0
234 0 0 0
235 0 0 0
236 0 0 0
237 0 0 0
238 0 0 0
239 0 0 0
240 0 0 0
241 0 0 0

397 190 587

Nip. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP. 19820209 200501 2 005 NIP. 19660625 119003 2 004
PUSKESMAS : SUGIH WARAS PELAPORAN BULAN : MARET 2020 DOKUMEN NOMOR TANGGAL
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
1 Absorbent tipped applicator (alcohol swab) Pcs 164 164 164 -164
2 Acetylcystein Kapsul 200mg Kapsul 187 187 142 45 -45
3 Acyclovir tab 200 mg Tablet 1083 1083 110 973 -973
4 Acyclovir cream Tube 16 16 3 13 -13
5 Albendazol tab 400 mg Tablet 775 775 775 -775
6 Alkohol Liquid (etanol) 70%-1000 ml Btl 28 28 7 21 -21
9 Aminophylline tab 200 mg Tablet 417 417 110 307 -307
10 Amitriptyline 25 mg tab Tablet 748 748 140 608 -608
12 Amoxycillin Syr Btl 207 207 65 142 -142
13 Amoxycillin 250 mg Kapsul 2810 2810 458 2352 -2352
14 Amoxycillin 500 mg Kaptab 11775 11775 1241 10534 -10534
15 Ampicilin 1 gr Inj Vial 15 15 15 -15
16 Antasida Syr DOEN Btl 277 277 76 201 -201
17 Antasida DOEN Kombinasi Tablet 5799 5799 545 5254 -5254
18 Anti Bisa Ular 5 ml (ABU I)/ Biosave Vial 1 1 1 -1
19 Asam Mefenamat 500 mg tab Tablet 900 900 360 540 -540
20 Ascorbic acid (Vit.C) 50 mg Tablet 1334 1334 311 1023 -1023
22 Aspirin (miniaspi) 100 mg tab Tablet 420 420 420 -420
24 Attapulgite Tablet (Pularex) Tablet 1455 1455 1455 -1455
25 Attapulgite Tablet 600 mg (New Antides) Tablet 756 756 150 606 -606
26 Automated blood grouping (Tes Gol. Darah) Paket 2 2 2 -2
27 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0 0 0
28 Bedak Salisil 2% Btl 104 104 19 85 -85
29 Benzoic acid |salicylic acid salep (anti fungi) pot 155 155 16 139 -139
30 Betahistine Mesylate 6 mg tab Tablet 0 0 0 0
31 Betamethasone 0,1% krim Tube 130 130 18 112 -112
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : MARET 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
32 Bisacodyl 5mg Tablet 0 0 0 0
33 Bismuth subgallas (antihemoroid) Supp 162 162 16 146 -146
34 Calcium chloride lactate infus (RL) Botol 111 111 8 103 -103
35 Calsium Laktat (Kalk) 500 mg Tablet 2839 2839 370 2469 -2469
36 Captopril 12,5 mg Tablet 1798 1798 350 1448 -1448
37 Captopril 25 mg Tablet 2691 2691 316 2375 -2375
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 198 198 19 179 -179
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 96 96 96 -96
43 Chloramhenicol Salep Mata 1% Tube 183 183 17 166 -166
45 Chloramphenicol 250 mg caps Tablet 905 905 140 765 -765
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 162 162 12 150 -150
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 8857 8857 913 7944 -7944
50 Cimetidin 200 tab Tablet 0 0 0 0
51 Ciprofloxacin 500 mg tab Tablet 1770 1770 375 1395 -1395
54 Cresol liquid 1 Liter (lysol) Botol 12 12 5 7 -7
57 Dexamethasone 0,5 mg Tablet 4690 4690 537 4153 -4153
58 Dexamethasone inj 5mg/ml-1ml Ampul 245 245 12 233 -233
60 Diazepam 2 mg Tablet 2060 2060 2060 -2060
61 Diclofenac sodium 25 mg tab Tablet 2770 2770 461 2309 -2309
63 Dimenhydrinate 50mg Tablet 290 290 50 240 -240
64 Dipenhidramine HCl inj 10mg/ml Ampul 212 212 45 167 -167
65 Domperidone 10 mg Tablet 898 898 286 612 -612
67 Epinephrine HCl/bitartrat inj 0,1% Ampul 57 57 57 -57
68 Erythromicin Syr Btl 81 81 25 56 -56
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
69 Erythromicin 500 mg capsul Kapsul 1885 1885 138 1747 -1747
70 Ethacridine (Rivanol) 0,1% Btl 68 68 8 60 -60
72 Eugenol cairan Btl 2 2 1 1 -1
73 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 15590 15590 380 15210 -15210
75 Folley Catheter No.16 Pcs 15 15 2 13 -13
77 Furosemida 40 mg Tablet 193 193 88 105 -105
79 Gentamicyn 0,3% TM Botol 77 77 10 67 -67
81 Gentamicyn 0,1% SK Tube 107 107 5 102 -102
83 Glibenclamide 5 mg Tablet 181 181 49 132 -132
84 Glimepiride 1 mg Tablet 295 295 90 205 -205
85 Glukosa larutan infus 10% Botol 90 90 3 87 -87
86 Glukosa larutan infus 5% Botol 87 87 4 83 -83
87 Griseofulvin 125 mg Tablet 1018 1018 230 788 -788
88 Guaifenesin 100 Tab (GG tab) Tablet 13610 13610 897 12713 -12713
91 Human chorionic (HCG/Tes kehamilan ) Strip 111 111 18 93 -93
92 Hydrochlorotiazide (HCT) 25 mg Tablet 0 0 0 0
93 Ibuprofen sirup Botol 200 200 20 180 -180
97 Immunoglobulin human anti-tetanus (Tetagam) Ampul 1 1 1 -1
98 Infus set dewasa Pcs 108 108 7 101 -101
99 Infusi set anak Pcs 347 347 8 339 -339
100 Iodium Povidon 10% 30 ml Botol 50 50 10 40 -40
102 IV Catheter No.20 Pcs 152 152 3 149 -149
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
107 Kapas pembalut/Absorben 250 g Pcs 13 13 4 9 -9
108 Kasa pembalut 2x80 Pcs 58 58 16 42 -42
109 Kasa pembalut hidrofil 4 m x 15 cm Pcs 97 97 6 91 -91
110 Kasa pembalut hidrofil 4 m x 3 cm Pcs 85 85 12 73 -73
111 Kasa kompres 40/40 steril Pcs 171 171 9 162 -162
112 Ketoconazole 200 mg Cream Tube 152 152 11 141 -141
113 Ketoconazole 200 mg tab Tablet 2230 2230 120 2110 -2110
117 Lidokain Comp. inj Kombinasi Ampul 252 252 25 227 -227
121 Loperamid 2 m tab Tablet 1104 1104 50 1054 -1054
122 Loratadine 10 mg tab Tablet 834 834 205 629 -629
125 Masker Pcs 0 0 0 0
126 Medical adhesive tape (dermafix/leukomed) Pcs 44 44 44 -44
127 Metamizole injeksi (antalgin 1000) Ampul 39 39 39 -39
128 Metformin 500mg tab Tablet 1115 1115 110 1005 -1005
130 Methyl Ergometrin Maleat 0,125 mg Tab 1065 1065 100 965 -965
131 Methyl Prednisolon tab 4 mg Tablet 1880 1880 280 1600 -1600
132 Methyl Rosanilinium (gentian violet) Botol 0 0 0 0
134 Metronidazol 500 mg tab Tablet 2819 2819 339 2480 -2480
135 Metronidazol Infus Botol 19 19 1 18 -18
137 Miconazole 2% Salep Kulit Tube 223 223 18 205 -205
140 Nifedipin 10 mg tab Kapsul 390 390 110 280 -280
141 Nystatin Tab Vag 10.000 iu/g Tablet 130 130 7 123 -123
142 Omeprazole inj Vial 4 4 4 -4
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
146 Oxytocin inj 10 IU Ampul 165 165 10 155 -155
147 Papaverin 40 mg tab Tablet 0 0 0 0
148 Papaverin inj Tablet 0 0 0 0
149 Paracetamol Drops 15 ml Botol 8 8 8 0 0
150 Parasetamol 120 mg/5 ml Syr Botol 168 168 70 98 -98
151 Parasetamol 500 mg Tablet 9209 9209 1530 7679 -7679
152 Patient Lubricant (My Jelly ) Tube 17 17 1 16 -16
153 Permethrin (Scabimite Cream) Tube 27 27 12 15 -15
156 Phenol gliserol 10% TT Botol 122 122 12 110 -110
158 Phytomenadione (Vit.K1) 10 mg Tablet 1920 1920 130 1790 -1790
159 Piracetam 400 mg Tablet 120 120 120 -120
161 Pisau Disposable (Mess No.14/21) Pcs 0 0 0 0
162 Plesterku (Leukoplast) Pcs 71 71 8 63 -63
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 0 0 0 0
164 Povidon iodium 10% 300 ml Botol 28 28 5 23 -23
165 Prednison 5 mg Tablet 1910 1910 180 1730 -1730
169 Propranolol HCl 10 mg Tablet 500 500 500 -500
170 Propranolol HCl 40 mg Tablet 510 510 510 -510
171 Propylthiouracil 100 mg Tablet 0 0 0 0
172 Protein Gluco Test Strip 100 100 100 -100
173 Pyrantel Pamoat 125 mg Tablet 438 438 24 414 -414
174 Pyridoxine HCl 10 mg Tablet 3350 3350 246 3104 -3104
175 Ranitidin 150 mg Tablet 2810 2810 290 2520 -2520
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
180 Salbutamol 2 mg Tablet 1785 1785 191 1594 -1594
181 Salep 2-4 Kombinasi pot 126 126 10 116 -116
182 Sarung tangan (HandScuun) No.7,5 Pcs 188 188 100 88 -88
185 Sarung tangan (HandScuun Steril) No.7,5 Pcs 42 42 20 22 -22
186 Semen Seng Fosfat Serbuk & Cairan Set 0 0 0 0
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 970 970 290 680 -680
188 Silk (Benang Bedah) No. 3/0 Pcs 104 104 8 96 -96
189 Silver Sulfadiazine Tube 4 4 2 2 -2
190 Simvastatin 10 mg tab Tablet 1097 1097 140 957 -957
191 Sodium cloride infus 0,9% ( NACL ) Botol 55 55 9 46 -46
192 Spuit 1 ml Pcs 761 761 52 709 -709
193 Spuit 3 ml Pcs 457 457 110 347 -347
194 Spuit 5 ml Pcs 250 250 66 184 -184
195 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 1560 1560 1560 -1560
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 247 247 35 212 -212
201 Thiamine HCl (Vit B1) 50 mg Tablet 2039 2039 290 1749 -1749
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 3240 3240 250 2990 -2990
204 Urin Bag Pcs 2 2 2 0 0
207 Vitamin B Kompleks Tablet 3000 3000 3000 -3000
209 Water liquid (aqua P,I) Botol 18 18 3 15 -15
210 Wing Needle No.21 Pcs 20 20 2 18 -18
211 Wing Needle No.27 Pcs 3 3 3 -3
213 Zinc tab Tablet 1800 1800 266 1534 -1534
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
217 Policlean Handrub Botol 10 10 10 -10
219 Cefotaxime Sodium inj 1 gr Vial 0 0 0 0
220 Methyl Prednisolon tab 16 mg Tablet 1580 1580 280 1300 -1300
221 Lancet Pcs 0 0 0 0
225 Nonwoven Fixation Rol Pcs 0 0 0 0
226 Paracetamol 1000 mg /100 ml Botol 0 0 0 0
227 Otsu D-40 25 ml Botol 0 0 0 0
228 Ketorolac inj 30 mg Ampul 0 0 0 0
229 Dulcolax tab Tablet 50 50 50 -50
231 Permethrin (Scabimite Cream).1 Tube 0 0 0 0
233 0 0 0 0
234 0 0 0 0
235 0 0 0 0
236 0 0 0 0
237 0 0 0 0
238 0 0 0 0
239 0 0 0 0
240 0 0 0 0
241 0 0 0 0

312 323 635

Nip. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP. 19820209 200501 2 005 NIP. 19660625 119003 2 004
PUSKESMAS : SUGIH WARAS PELAPORAN BULAN : FEBRUARI 2020 DOKUMEN NOMOR TANGGAL
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
1 Absorbent tipped applicator (alcohol swab) Pcs 138 100 238 74 164
9 Aminophylline tab 200 mg Tablet 170 400 570 153 417
12 Amoxycillin Syr Btl 65 180 245 38 207
24 Attapulgite Tablet (Pularex) Tablet 675 900 1575 120 1455
28 Bedak Salisil 2% Btl 29 100 129 25 104
29 Benzoic acid |salicylic acid salep (anti fungi) pot 85 72 157 2 155
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : FEBRUARI 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
43 Chloramhenicol Salep Mata 1% Tube 99 96 195 12 183
45 Chloramphenicol 250 mg caps Tablet 305 700 1005 100 905
51 Ciprofloxacin 500 mg tab Tablet 452 1600 2052 282 1770
58 Dexamethasone inj 5mg/ml-1ml Ampul 107 150 257 12 245
60 Diazepam 2 mg Tablet 2090 2090 30 2060
64 Dipenhidramine HCl inj 10mg/ml Ampul 86 150 236 24 212
65 Domperidone 10 mg Tablet 555 600 1155 257 898
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
70 Ethacridine (Rivanol) 0,1% Btl 47 25 72 4 68
75 Folley Catheter No.16 Pcs 3 20 23 8 15
81 Gentamicyn 0,1% SK Tube 23 96 119 12 107
85 Glukosa larutan infus 10% Botol 54 40 94 4 90
86 Glukosa larutan infus 5% Botol 53 40 93 6 87
99 Infusi set anak Pcs 149 200 349 2 347
: FEBRUARI 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 12
107 Kapas pembalut/Absorben 250 g Pcs 0 15 15 2 13
141 Nystatin Tab Vag 10.000 iu/g Tablet 46 100 146 16 130
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
150 Parasetamol 120 mg/5 ml Syr Botol 13 300 313 145 168
156 Phenol gliserol 10% TT Botol 56 96 152 30 122
158 Phytomenadione (Vit.K1) 10 mg Tablet 1160 800 1960 40 1920
164 Povidon iodium 10% 300 ml Botol 20 10 30 2 28
173 Pyrantel Pamoat 125 mg Tablet 351 100 451 13 438
174 Pyridoxine HCl 10 mg Tablet 2290 1300 3590 240 3350
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
180 Salbutamol 2 mg Tablet 1195 800 1995 210 1785
181 Salep 2-4 Kombinasi pot 42 96 138 12 126
182 Sarung tangan (HandScuun) No.7,5 Pcs 0 200 200 12 188
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 100 1500 1600 630 970
192 Spuit 1 ml Pcs 385 400 785 24 761
193 Spuit 3 ml Pcs 113 400 513 56 457
194 Spuit 5 ml Pcs 91 200 291 41 250
204 Urin Bag Pcs 3 3 1 2
209 Water liquid (aqua P,I) Botol 4 18 22 4 18
213 Zinc tab Tablet 1938 1938 138 1800
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
227 Otsu D-40 25 ml Botol 0 0 0
233
234
235
236
237
238
239
240
241

235 468 703

Plt. Kepala Dinas Kesehatan Kab. OKI Kepala Instalasi Farmasi Dinkes OKI Pimpinan Puskesmas Pengelola Obat Puskesmas
Nip. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP. 19820209 200501 2 005 NIP. 19660625 119003 2 004
PUSKESMAS : SUGIH WARAS PELAPORAN BULAN : JANUARI 2020 DOKUMEN NOMOR TANGGAL
KECAMATAN : TELUK GELAM PERMINTAAN BULAN : FEBRUARI DINKES KAB/KOTA
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
1 Absorbent tipped applicator (alcohol swab) Pcs 153 153 15 138 188 100
2 Acetylcystein Kapsul 200mg Kapsul 468 468 210 258 934 1000
3 Acyclovir tab 200 mg Tablet 1423 1423 180 1243 700 100
4 Acyclovir cream Tube 50 50 10 40 67.6 70
5 Albendazol tab 400 mg Tablet 880 880 81 799 215.2 500
6 Alkohol Liquid (etanol) 70%-1000 ml Btl 38 38 5 33 31.6 20
7 Allopurinol 100 mg Tablet 1115 1115 475 640 1918 2000
9 Aminophylline tab 200 mg Tablet 280 280 110 170 478 308
10 Amitriptyline 25 mg tab Tablet 348 348 100 248 358 500
12 Amoxycillin Syr Btl 123 123 58 65 202 200
14 Amoxycillin 500 mg Kaptab 9835 9835 1645 8190 4624 5000
17 Antasida DOEN Kombinasi Tablet 3349 3349 770 2579 4666 4000
20 Ascorbic acid (Vit.C) 50 mg Tablet 1451 1451 530 921 2722 3000
22 Aspirin (miniaspi) 100 mg tab Tablet 620 620 150 470 550 600
24 Attapulgite Tablet (Pularex) Tablet 835 835 160 675 856 900
25 Attapulgite Tablet 600 mg (New Antides) Tablet 986 986 130 856 634 700
27 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0 0 5 5
28 Bedak Salisil 2% Btl 57 57 28 29 120.4 100
29 Benzoic acid |salicylic acid salep (anti fungi) pot 94 94 9 85 48.4 50
30 Betahistine Mesylate 6 mg tab Tablet 0 0 0 1000 1000
31 Betamethasone 0,1% krim Tube 59 59 59 0 143.2 150
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : JANUARI 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
32 Bisacodyl 5mg Tablet 0 0 0 1000 1000
33 Bismuth subgallas (antihemoroid) Supp 100 100 25 75 112 100
34 Calcium chloride lactate infus (RL) Botol 131 131 9 122 30.4 50
35 Calsium Laktat (Kalk) 500 mg Tablet 2259 2259 200 2059 893.2 1000
36 Captopril 12,5 mg Tablet 1340 1340 470 870 1374.4 1300
37 Captopril 25 mg Tablet 1605 1605 447 1158 1644.4 2000
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 230 230 15 215 0
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 0 0 0 0 100 100
41 Cefadroxil 500mg Tablet 0 0 0 2000 2000
42 Cetirizine 5 mg/5 ml sirup Botol 24 24 24 0 89.2 100
43 Chloramhenicol Salep Mata 1% Tube 115 115 16 99 166 100
45 Chloramphenicol 250 mg caps Tablet 380 380 75 305 652 700
46 Chloramphenicol TT 3% Botol 0 0 0 100 100
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 90 90 12 78 77.2 100
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 6209 6209 3500 2709 7372 7000
49 Chlorpromazine HCl 100 mg Tablet 290 290 160 130 406 500
50 Cimetidin 200 tab Tablet 0 0 0 1000 1000
51 Ciprofloxacin 500 mg tab Tablet 812 812 360 452 1594 1600
54 Cresol liquid 1 Liter (lysol) Botol 9 9 5 4 23.2 20
55 Cyanocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0 0 200 200
58 Dexamethasone inj 5mg/ml-1ml Ampul 164 164 57 107 215.2 150
60 Diazepam 2 mg Tablet 2320 2320 230 2090 500
61 Diclofenac sodium 25 mg tab Tablet 840 840 740 100 3202 3200
63 Dimenhydrinate 50mg Tablet 580 580 100 480 382 0
64 Dipenhidramine HCl inj 10mg/ml Ampul 149 149 63 86 144.4 150
65 Domperidone 10 mg Tablet 836 836 281 555 1063.6 1000
67 Epinephrine HCl/bitartrat inj 0,1% Ampul 57 57 57 0
68 Erythromicin Syr Btl 46 46 46 0 107.2 100
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
69 Erythromicin 500 mg capsul Kapsul 1510 1510 195 1315 664 700
70 Ethacridine (Rivanol) 0,1% Btl 53 53 6 47 26.8 25
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 14 14 3 11 18.4 20
72 Eugenol cairan Btl 2 2 1 1 5 4
73 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 16719 16719 719 16000 1714 2000
75 Folley Catheter No.16 Pcs 5 5 2 3 17.2 15
77 Furosemida 40 mg Tablet 558 558 245 313 688 700
78 Garam Oralit Sachet 0 0 0 200 200
81 Gentamicyn 0,1% SK Tube 37 37 14 23 86.8 100
82 Glass lonomer Paket 1 1 1 0 2 2
83 Glibenclamide 5 mg Tablet 511 511 250 261 1096 1000
84 Glimepiride 1 mg Tablet 465 465 120 345 490 500
85 Glukosa larutan infus 10% Botol 57 57 3 54 31.6 30
86 Glukosa larutan infus 5% Botol 56 56 3 53 23.2 25
87 Griseofulvin 125 mg Tablet 1515 1515 290 1225 1294 1300
88 Guaifenesin 100 Tab (GG tab) Tablet 10846 10846 1166 9680 4802.8 5000
89 Haloperidol 0,5 mg tab Tablet 0 0 0 500 500
91 Human chorionic (HCG/Tes kehamilan ) Strip 43 43 20 23 97.6 100
92 Hydrochlorotiazide (HCT) 25 mg Tablet 0 0 0 500 500
94 Ibuprofen 200 mg Tablet 0 0 0 3000 3000
95 Ibuprofen 400 mg Tablet 0 0 0 3000 3000
96 Ichthyol salep 10% pot 0 0 0 100 100
98 Infus set dewasa Pcs 129 129 10 119 29.2 30
99 Infusi set anak Pcs 157 157 8 149 304 155
100 Iodium Povidon 10% 30 ml Botol 26 26 5 21 46 40
103 IV Catheter No.22 Pcs 94 94 6 88 25.6 50
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
106 Kalium Permanganat Serbuk pot 0 0 0 100 100
107 Kapas pembalut/Absorben 250 g Pcs 0 0 0 15 15
108 Kasa pembalut 2x80 Pcs 19 19 19 0 71.2 70
109 Kasa pembalut hidrofil 4 m x 15 cm Pcs 70 70 7 63 40 40
110 Kasa pembalut hidrofil 4 m x 3 cm Pcs 46 46 7 39 41.2 40
111 Kasa kompres 40/40 steril Pcs 101 101 20 81 85.6 100
112 Ketoconazole 200 mg Cream Tube 75 75 17 58 59.2 60
113 Ketoconazole 200 mg tab Tablet 1480 1480 120 1360 658 1000
115 Levertran Salep/ Salep Luka Bakar pot 0 0 0 100 100
117 Lidokain Comp. inj Kombinasi Ampul 201 201 20 181 904 200
118 Lidocaine spray (Xylocaine spray) Botol 0 0 0 10 10
119 Liquorice liquid extract (OBH) Botol 0 0 0 300 300
121 Loperamid 2 m tab Tablet 1574 1574 150 1424 587.2 800
122 Loratadine 10 mg tab Tablet 2048 2048 715 1333 1376.8 1300
125 Masker Pcs 0 0 0 263.2 300
126 Medical adhesive tape (dermafix/leukomed) Pcs 80 80 30 50 96.4 50
127 Metamizole injeksi (antalgin 1000) Ampul 45 45 6 39 0
128 Metformin 500mg tab Tablet 495 495 250 245 877.6 1000
130 Methyl Ergometrin Maleat 0,125 mg Tab 1345 1345 160 1185 0
132 Methyl Rosanilinium (gentian violet) Botol 0 0 0 50 50
134 Metronidazol 500 mg tab Tablet 1610 1610 400 1210 1738 2000
136 Metronidazol syr Botol 0 0 0 100 100
137 Miconazole 2% Salep Kulit Tube 135 135 6 129 53.2 100
138 Momilen Baby Gold Sirup Botol 0 0 0 200 200
140 Nifedipin 10 mg tab Kapsul 620 620 110 510 500
141 Nystatin Tab Vag 10.000 iu/g Tablet 65 65 19 46 67.6 70
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
143 Omeprazole kaps Kapsul 0 0 0 311.2 1000
144 Oxytetracycline HCl 1% Salep Mata Tube 19 19 19 0 77.2 70
145 Oxytetracycline HCl 3% Salep Kulit Tube 0 0 0 50 50
146 Oxytocin inj 10 IU Ampul 200 200 25 175 90.4 100
147 Papaverin 40 mg tab Tablet 0 0 0 1000 1000
148 Papaverin inj Tablet 0 0 0 50 50
149 Paracetamol Drops 15 ml Botol 61 61 41 20 206.8 200
150 Parasetamol 120 mg/5 ml Syr Botol 82 82 69 13 362.8 300
151 Parasetamol 500 mg Tablet 6768 6768 3580 3188 9702.4 7000
152 Patient Lubricant (My Jelly ) Tube 24 24 3 21 0
153 Permethrin (Scabimite Cream) Tube 36 36 5 31 26.8 50
156 Phenol gliserol 10% TT Botol 62 62 6 56 41.2 100
158 Phytomenadione (Vit.K1) 10 mg Tablet 1320 1320 160 1160 538 800
159 Piracetam 400 mg Tablet 300 300 100 200 0
160 Piroxicam 20 mg tab Tablet 1010 1010 625 385 1828 1443
161 Pisau Disposable (Mess No.14/21) Pcs 0 0 0 10 10
162 Plesterku (Leukoplast) Pcs 81 81 4 77 26.8 50
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 0 0 0 0
164 Povidon iodium 10% 300 ml Botol 26 26 6 20 23.2 25
169 Propranolol HCl 10 mg Tablet 0 0 0 500 500
171 Propylthiouracil 100 mg Tablet 0 0 0 200 200
172 Protein Gluco Test Strip 8 8 8 0 100 100
173 Pyrantel Pamoat 125 mg Tablet 375 375 24 351 100
174 Pyridoxine HCl 10 mg Tablet 2620 2620 330 2290 982 1300
175 Ranitidin 150 mg Tablet 3530 3530 250 3280 0
177 Retinol (Vit.A) kaps 100.000 iu Kapsul 140 140 70 70 250 1000
178 Retinol (Vit.A) kaps 200.000 iu Kapsul 88 88 50 38 220 1500
179 Risperidone 2mg Tablet 0 0 0 1000 1000
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
180 Salbutamol 2 mg Tablet 1475 1475 280 1195 856 800
181 Salep 2-4 Kombinasi pot 56 56 14 42 52 100
182 Sarung tangan (HandScuun) No.7,5 Pcs 0 0 0 200 200
184 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0 0 100 100
185 Sarung tangan (HandScuun Steril) No.7,5 Pcs 56 56 4 52 26.8 50
186 Semen Seng Fosfat Serbuk & Cairan Set 0 0 0 5 5
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 280 280 180 100 1229.2 1500
188 Silk (Benang Bedah) No. 3/0 Pcs 125 125 6 119 0
189 Silver Sulfadiazine Tube 5 5 1 4 0
191 Sodium cloride infus 0,9% ( NACL ) Botol 70 70 10 60 35.2 30
192 Spuit 1 ml Pcs 468 468 83 385 389.2 350
193 Spuit 3 ml Pcs 175 175 62 113 364 400
194 Spuit 5 ml Pcs 115 115 24 91 110.8 200
195 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 1560 1560 1560 0
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 303 303 34 269 150.4 200
197 Sulfasetamida 15% TM Botol 0 0 0 100 100
199 Tetracycline 500 mg Tablet 280 280 150 130 500 500
200 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0 0 100 100
201 Thiamine HCl (Vit B1) 50 mg Tablet 2539 2539 870 1669 2008 2000
202 Trihexyphenidyl tab 2 mg Tablet 110 110 60 50 1000 1000
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 2640 2640 260 2380 1150 1300
204 Urin Bag Pcs 5 5 2 3 0
209 Water liquid (aqua P,I) Botol 9 9 5 4 22 18
210 Wing Needle No.21 Pcs 26 26 6 20 0
211 Wing Needle No.27 Pcs 7 7 4 3 0
212 Zinc Sulphate Suppositoria (Superhoid) Kapsul 0 0 0 100 100
213 Zinc tab Tablet 2198 2198 260 1938 994 1000
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
220 Methyl Prednisolon tab 16 mg Tablet 2400 2400 500 1900 1210 1000
227 Otsu D-40 25 ml Botol 0 0 0
229 Dulcolax tab Tablet 120 120 50 70 100
233 0 0 0
234 0 0 0
235 0 0 0
236 0 0 0
237 0 0 0
238 0 0 0
239 0 0 0
240 0 0 0
241 0 0 0

234 514 748

Plt. Kepala Dinas Kesehatan Kab. OKI Kepala Instalasi Farmasi Dinkes OKI Pimpinan Puskesmas Pengelola Obat Puskesmas
Iwan Setiawan, SKM, Mkes Himayanti, S.Si, Mkes, Apt LINDA ARYANI, SKM NURBAITI
Nip. 19730905 199803 1 005 Nip. 19770221 200501 2 005 NIP. 19820209 200501 2 005 NIP. 19660625 119003 2 004
PUSKESMAS : SUGIH WARAS PELAPORAN BULAN : 2020 DOKUMEN NOMOR TANGGAL
STOK STOK STOK

AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
1 Absorbent tipped applicator (alcohol swab) Pcs
2 Acetylcystein Kapsul 200mg Kapsul
3 Acyclovir tab 200 mg Tablet
4 Acyclovir cream Tube
5 Albendazol tab 400 mg Tablet
6 Alkohol Liquid (etanol) 70%-1000 ml Btl
7 Allopurinol 100 mg Tablet
8 Aminophylline Inj 24 mg/ml-10 ml Ampul
9 Aminophylline tab 200 mg Tablet
10 Amitriptyline 25 mg tab Tablet
11 Amlodipine tab 5 mg Tablet
12 Amoxycillin Syr Btl
13 Amoxycillin 250 mg Kapsul
14 Amoxycillin 500 mg Kaptab
15 Ampicilin 1 gr Inj Vial
16 Antasida Syr DOEN Btl
17 Antasida DOEN Kombinasi Tablet
18 Anti Bisa Ular 5 ml (ABU I)/ Biosave Vial
19 Asam Mefenamat 500 mg tab Tablet
20 Ascorbic acid (Vit.C) 50 mg Tablet
21 Ascorbic acid |calsium carbonate 500 mg (Pehavral) Tablet
22 Aspirin (miniaspi) 100 mg tab Tablet
23 Atropine inj 0,25 mg/ml Ampul
24 Attapulgite Tablet (Pularex) Tablet
25 Attapulgite Tablet 600 mg (New Antides) Tablet
26 Automated blood grouping (Tes Gol. Darah) Paket
27 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs
28 Bedak Salisil 2% Btl
29 Benzoic acid |salicylic acid salep (anti fungi) pot
30 Betahistine Mesylate 6 mg tab Tablet
31 Betamethasone 0,1% krim Tube
HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : 2020
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
32 Bisacodyl 5mg Tablet
33 Bismuth subgallas (antihemoroid) Supp
34 Calcium chloride lactate infus (RL) Botol
35 Calsium Laktat (Kalk) 500 mg Tablet
36 Captopril 12,5 mg Tablet
37 Captopril 25 mg Tablet
38 Carbamazepin tab Tablet
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs
41 Cefadroxil 500mg Tablet
42 Cetirizine 5 mg/5 ml sirup Botol
43 Chloramhenicol Salep Mata 1% Tube
44 Chloramphenicol Suspensi 125 mg/ml Btl
45 Chloramphenicol 250 mg caps Tablet
46 Chloramphenicol TT 3% Botol
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet
49 Chlorpromazine HCl 100 mg Tablet
50 Cimetidin 200 tab Tablet
51 Ciprofloxacin 500 mg tab Tablet
52 Ciprofloxacin Infus Botol
53 Clindamycin 300mg Kapsul
54 Cresol liquid 1 Liter (lysol) Botol
55 Cyanocobalamin (Vit B12) inj 500 mcg/ml Ampul
56 Devitalisasi pasta pot
57 Dexamethasone 0,5 mg Tablet
58 Dexamethasone inj 5mg/ml-1ml Ampul
59 Diazepam 5mg/ml-2 ml inj Ampul
60 Diazepam 2 mg Tablet
61 Diclofenac sodium 25 mg tab Tablet
62 Digoxin 0,25 mg Tablet
63 Dimenhydrinate 50mg Tablet
64 Dipenhidramine HCl inj 10mg/ml Ampul
65 Domperidone 10 mg Tablet
66 Doxycycline 100 mg Kapsul Kapsul
67 Epinephrine HCl/bitartrat inj 0,1% Ampul
68 Erythromicin Syr Btl
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
69 Erythromicin 500 mg capsul Kapsul
70 Ethacridine (Rivanol) 0,1% Btl
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol
72 Eugenol cairan Btl
73 Ferrous fumarate ( Tab. Tambah Darah ) Tablet
74 Folic acid 1mg ( asam folat) Tablet
75 Folley Catheter No.16 Pcs
76 Furosemida Injeksi Ampul
77 Furosemida 40 mg Tablet
78 Garam Oralit Sachet
79 Gentamicyn 0,3% TM Botol
80 Gentamicyn Inj 40 mg/ml Ampul
81 Gentamicyn 0,1% SK Tube
82 Glass lonomer Paket
83 Glibenclamide 5 mg Tablet
84 Glimepiride 1 mg Tablet
87 Griseofulvin 125 mg Tablet
88 Guaifenesin 100 Tab (GG tab) Tablet
89 Haloperidol 0,5 mg tab Tablet
90 Haloperidol 5 mg tab Tablet
91 Human chorionic (HCG/Tes kehamilan ) Strip
92 Hydrochlorotiazide (HCT) 25 mg Tablet
93 Ibuprofen sirup Botol
96 Ichthyol salep 10% pot
97 Immunoglobulin human anti-tetanus (Tetagam) Ampul
98 Infus set dewasa Pcs
99 Infusi set anak Pcs
100 Iodium Povidon 10% 30 ml Botol
101 Isosorbide tablet Tablet
105 Jarum Jahit Kulit Pcs
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
106 Kalium Permanganat Serbuk pot
107 Kapas pembalut/Absorben 250 g Pcs
108 Kasa pembalut 2x80 Pcs
111 Kasa kompres 40/40 steril Pcs
112 Ketoconazole 200 mg Cream Tube
113 Ketoconazole 200 mg tab Tablet
114 Klorokina Fosfat 250 mg Tablet
115 Levertran Salep/ Salep Luka Bakar pot
116 Lidocain 2% Ampul
117 Lidokain Comp. inj Kombinasi Ampul
118 Lidocaine spray (Xylocaine spray) Botol
119 Liquorice liquid extract (OBH) Botol
120 Locoriz Cream Tube
121 Loperamid 2 m tab Tablet
122 Loratadine 10 mg tab Tablet
125 Masker Pcs
126 Medical adhesive tape (dermafix/leukomed) Pcs
127 Metamizole injeksi (antalgin 1000) Ampul
128 Metformin 500mg tab Tablet
129 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul
130 Methyl Ergometrin Maleat 0,125 mg Tab
132 Methyl Rosanilinium (gentian violet) Botol
135 Metronidazol Infus Botol
136 Metronidazol syr Botol
137 Miconazole 2% Salep Kulit Tube
138 Momilen Baby Gold Sirup Botol
139 Natrium Bikarbonat 500 mg Tablet
140 Nifedipin 10 mg tab Kapsul
141 Nystatin Tab Vag 10.000 iu/g Tablet
142 Omeprazole inj Vial
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
143 Omeprazole kaps Kapsul
144 Oxytetracycline HCl 1% Salep Mata Tube
145 Oxytetracycline HCl 3% Salep Kulit Tube
146 Oxytocin inj 10 IU Ampul
147 Papaverin 40 mg tab Tablet
148 Papaverin inj Tablet
149 Paracetamol Drops 15 ml Botol
150 Parasetamol 120 mg/5 ml Syr Botol
151 Parasetamol 500 mg Tablet
152 Patient Lubricant (My Jelly ) Tube
153 Permethrin (Scabimite Cream) Tube
154 Phenobarbital inj 50mg/ml-2ml Ampul
155 Phenobarbital 100 mg Tablet
156 Phenol gliserol 10% TT Botol
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul
158 Phytomenadione (Vit.K1) 10 mg Tablet
159 Piracetam 400 mg Tablet
160 Piroxicam 20 mg tab Tablet
161 Pisau Disposable (Mess No.14/21) Pcs
162 Plesterku (Leukoplast) Pcs
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul
164 Povidon iodium 10% 300 ml Botol
165 Prednison 5 mg Tablet
166 Primaquin 15 mg tab Tablet
167 Profolat tab Tablet
168 Prokaina Penisilin G inj 3.000.000 iu Ampul
171 Propylthiouracil 100 mg Tablet
172 Protein Gluco Test Strip
173 Pyrantel Pamoat 125 mg Tablet
174 Pyridoxine HCl 10 mg Tablet
175 Ranitidin 150 mg Tablet
176 Ranitidin Injeksi Ampul
179 Risperidone 2mg Tablet
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
180 Salbutamol 2 mg Tablet
181 Salep 2-4 Kombinasi pot
182 Sarung tangan (HandScuun) No.7,5 Pcs
183 Sarung tangan (HandScuun Steril) No. 6,5 Pcs
184 Sarung tangan (HandScuun Steril) No.7 Pcs
185 Sarung tangan (HandScuun Steril) No.7,5 Pcs
186 Semen Seng Fosfat Serbuk & Cairan Set
187 Sianocobalamin (Vit B12) 50 mg tab Tablet
188 Silk (Benang Bedah) No. 3/0 Pcs
189 Silver Sulfadiazine Tube
190 Simvastatin 10 mg tab Tablet
191 Sodium cloride infus 0,9% ( NACL ) Botol
192 Spuit 1 ml Pcs
193 Spuit 3 ml Pcs
194 Spuit 5 ml Pcs
195 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol
197 Sulfasetamida 15% TM Botol
200 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul
201 Thiamine HCl (Vit B1) 50 mg Tablet
202 Trihexyphenidyl tab 2 mg Tablet
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet
204 Urin Bag Pcs
205 Usg Gel Botol
206 Vaksin Rabies Vero/ Verorab Paket
207 Vitamin B Kompleks Tablet
208 Vitamin K Infant Inj Ampul
209 Water liquid (aqua P,I) Botol
212 Zinc Sulphate Suppositoria (Superhoid) Kapsul
213 Zinc tab Tablet
214 Ondansetron iv/im 4 mg Ampul
215 Tranexamic Acid inj 5% Ampul
216 Poliwash 500 ml Botol
STOK STOK STOK
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
221 Lancet Pcs
232 Masker Plus Pcs
233
234
235
236
237
238
239
240
241


Pimpinan Puskesmas Pengelola Obat Puskesmas
LINDA ARYANI, SKM NURBAITI

NIP. 19820209 200501 2 005 NIP. 19660625 119003 2 004
: 2020
: 2020
: 2020
: 2020
: 2020
: 2020

LPLPO 2020 Puskemas

Diunggah oleh

Informasi Dokumen

Judul Asli

Hak Cipta

Format Tersedia

Bagikan dokumen Ini

Bagikan atau Tanam Dokumen

Opsi Berbagi

Apakah menurut Anda dokumen ini bermanfaat?

Apakah konten ini tidak pantas?

Hak Cipta:

Format Tersedia

LPLPO 2020 Puskemas

Diunggah oleh

Hak Cipta:

Format Tersedia

LAMPIRAN BERITA ACARA PENCACAHAN OBAT AKHIR TAHUN PUSKESMAS

PUSKESMAS : TAHUN : 2020

MENURUT PENCATATAN HASIL SELISIH KADALUARSA RUSAK HILANG

Mengetahui/ Menyetujui Yang Membuat

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

MENURUT PENCATATAN HASIL SELISIH KADALUARSA RUSAK HILANG

Mengetahui/ Menyetujui Yang Membuat

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

PUSKESMAS : SUGIH WARAS PELAPORAN BULAN : JUNI 2020 DOKUMEN NOMOR

KECAMATAN : TELUK GELAM PERMINTAAN BULAN : DINKES KAB/KOTA

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

PUSKESMAS : SUGIH WARAS PELAPORAN BULAN : MEI 2020 DOKUMEN NOMOR

KECAMATAN : TELUK GELAM PERMINTAAN BULAN : JUNI 2020 DINKES KAB/KOTA

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

PUSKESMAS : PELAPORAN BULAN : APRIL 2020 DOKUMEN NOMOR TANGGAL

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

STOK STOK STOK

UMUM JAMSOSKES BPJS JUMLAH

Mengetahui/ Menyetujui Yang Membuat

LINDA ARYANI, SKM NURBAITI

Anda mungkin juga menyukai