LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

PUSKESMAS : SESUA
KECAMATAN : MALINAU BARAT PELAPORAN BULAN : JANUARI 2022
KABUPATEN : MALINAU PERMINTAAN BLN/PERIODE : TW 1

STOK SISA STOK PERMINTAA KETERANGAN

NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAN PEMAKAIAN
AWAL STOK OPS N EXD
1 Acyclovir Salep Kulit Tube 377 5 372
2 Acyclovir Tab 400 mg Tablet 575 100 275
3 Adrenalin Bitartat Ampul 0 0 0
4 Albendazole 400 mg Tablet 0 0 0
5 Alletrol tetes mata Botol 0 0 0
6 Allopurinol Tab 100 mg Tablet 1350 300 1050
7 Alpara Tablet 0 0 0
8 Ambroxol Syr 15 mg/5 ml Botol 0 0 0
9 Ambroxol Tab 30 mg Tablet 0 0 0
10 Aminofilin Inj 24 mg/ml Ampul 0 0 0
11 Aminofilin Tab 200 mg Tablet 0 0 0
12 Amitriptilin Tab 25 mg Tablet 0 0 0
13 Amlodipin 5 mg Tablet 0 0 0
14 Amoksisillin Kap 250 mg Tablet 0 0 0
15 Amoksisillin Kap 500 mg Tablet 4500 300 4200
16 Amoksisillin Syr 125 mg/5 ml Botol 37 5 32
17 Ampicillin Injeksi Ampul 0 0 0
18 Ampisilin Kap 500 mg Tablet 800 100 700
19 Ampisilin Syr 125 mg/5 ml Botol 95 5 90
20 Antalgin Inj 250 mg/ml Ampul 0 0 0
21 Antalgin Tab 500 mg/ Metamozole Tablet 0 0 0
22 Antasid DOEN Tab Komb Tablet 3700 400 3300
23 Antasid Sirup Botol 0 0 0
24 Antifungi DOEN Pot 0 0 0
25 Antihaemoroid DOEN Komb Supp 0 0 0
26 Arsuamon Tab Tablet 0 0 0
27 Arterakine Tab Tablet 0 0 0
28 Asam Askorbat Tab 50 mg Tablet 11400 600 10800
29 Asam Folat 1 mg Tablet 0 0 0
30 Asam Mefenamat Kap 500 mg Tablet 1300 300 1000
31 Atropin Sulfat Inj 0,25 mg/ml Ampul 0 0 0
32 Bacitrasin Salep Tube 0 0 0
33 Betametason Cream 0,1 % Tube 200 5 195
34 Bioplacenton Tube 0 0 0
35 Bromheksin Tablet 0 0 0
36 Bromheksin Sirup Botol 0 0 0
37 Burnazin Tube 0 0 0
38 Buscopan Tab 10 mg Tablet 0 0 0
39 Captopril 12,5 mg Tablet 2500 200 2300
Captopril 25 mg Tablet 1700 200 1500
41 Cefixime Kaps 100 mg Kapsul 0 0 0
42 Cefixime Syrup Botol 0 0 0
43 Cendocetamide 15 % Botol 0 0 0
44 Cendotropin Tetes Mata Botol 0 0 0
45 Centabio Tube 0 0 0
46 Cephadroxil Kap 250 mg Kapsul 0 0 0
47 Cephadroxil Kap 500 mg Kapsul 0 0 0
48 Cephadroxil Syr Botol 0 0 0
49 Cetirizine Tablet 1500 200 1300
50 Chefalexin Kap 500 mg Tablet 0 0 0
51 Cimetidine 200 mg Tablet 0 0 0
52 Cinolon N 10 gr Tube 0 0 0
53 Ciprofloxacin Tab 500 mg Tablet 0 0 0
54 Cohistin Syrup Botol 0 0 0
56 CTM Tab 4 mg Tablet 2800 500 2300
57 Curcuma Tablet 0 0 0
58 Curliv Syrup/Multivitamin syr Botol 0 0 0
59 Deksametason Inj 5 mg/ml Ampul 0 0 0
60 Deksametason Tab 0,5 mg Tablet 900 100 800
61 Dekstrometorfan HBr 15 mg Tablet 0 0 0
62 Dekstrometorfan Syr Botol 0 0 0
63 Diazepam Inj 5 mg/ml Ampul 0 0 0
64 Diazepam Tab 2 mg Tablet 0 0 0
65 Diclofam 50 mg Tablet 0 0 0
66 Digoksin Tab 0,25 mg Tablet 0 0 0
67 Diltiazem Tab 30 Mg Tablet 0 0 0
68 Domperidon Tab Tablet 0 0 0
69 Doxycicline Kaps 100 mg Kapsul 0 0 0
70 Dulcolax Supp Anak Supp 0 0 0
71 Dulcolax/bisakodil Tab 5 mg Tablet 0 0 0
72 Dumin Tablet 0 0 0
73 Efedrin Tab 25 mg Tablet 0 0 0
74 Efinefrin Inj 0,1 % Ampul 0 0 0
75 Ekstrak Belladon Tab 10 mg Tablet 0 0 0
76 Elkana Tablet 0 0 0
77 Ergotamin Koffein Tab Tablet 0 0 0
78 Erlamicetine Botol 0 0 0
79 Erytromisin Kap 500 mg Kapsul 0 0 0
80 Erytromisin Syr 125 mg/ 5 ml Botol 0 0 0
81 Etambutol Tab 500 mg Tablet 0 0 0
82 Famotidin 20 mg/40 mg Tablet 0 0 0
83 Fenobarbital Inj 50 mg/ml Ampul 0 0 0
84 Fenobarbital Tab 30 mg Tablet 0 0 0
85 Fenol Gliserol Tts Telinga 10 % Botol 0 0 0
86 Ferrous Sulfat Tab Tablet 0 0 0
87 Fitomenadion (Vit.K) Inj Ampul 0 0 0
88 Fitomenadion (Vit.K) Tab Tablet 0 0 0
89 Fitomenadion (Vit.K3) Inj Ampul 0 0 0
90 Fluoroscein Tetes Mata 2 % Botol 0 0 0
91 Furosemid Inj 10 ml Ampul 0 0 0
92 Furosemid Tab 40 mg Tablet 0 0 0
93 Gamexan Emulsi 1 % Botol 0 0 0
94 Garam Oralit 200 ml Sachet 450 100 350
95 Genoit Salep Mata Tube 0 0 0
96 Gentamisin Salep Kulit Tube 0 0 0
98 Gentamisin Tetes Mata Botol 0 0 0
99 Gentian Violet Lar 1 % Botol 0 0 0
100 GG Tab 100 mg Tablet 1300 300 1000
101 Glibenklamid Tab 5 mg Tablet 0 0 0
102 Glimepiride 2 mg Tablet 0 0 0
103 Glimepiride 4 mg Tablet 0 0 0
104 Griseofulvin Tab 125 mg Tablet 0 0 0
105 Griseofulvin Tab 500 mg Tablet 0 0 0
106 Haloperidol Tab 0,5 mg Tablet 0 0 0
107 Hidrokortison Cream 2,5 % Tube 52 24 28
108 Ibuprofen syr botol 0 0 0
109 Ibuprofen Tab 400 mg Tablet 0 0 0
110 Ichtiyol Salep Pot 0 0 0
111 INH Tab 100 mg Tablet 0 0 0
112 INH Tab 300 mg Tablet 0 0 0
113 Inmatrol Tetes Mata Botol 0 0 0
114 Inpepsa Sirup Botol 0 0 0
115 Isosorbid Dinitrat Tab 10mg Tablet 0 0 0
116 Kalium Diklofenak Tab 50 mg Tablet 0 0 0
117 Kalium Permanganat Tablet 0 0 0
118 Kalsium Laktat Tab 500 mg Tablet 1000 200 800
119 Kanamicyn Inj Vial 0 0 0
120 Ketokonazole Cream 2 % Tube 0 0 0
121 Ketokonazole Tab 200 mg Tablet 0 0 0
122 Kinina Tab 222 mg Tablet 0 0 0
123 Klindamisin 150 mg Kapsul 0 0 0
124 Klindamisin 300 mg Kapsul 0 0 0
125 Kloramfenikol Kaps 250 mg Kapsul 0 0 0
126 Kloramfenikol Salep Mata 1 % Tube 0 0 0
127 Kloramfenikol Syr 125 mg/5 ml Botol 0 0 0
128 Kloramfenikol Tetes Mata Botol 0 0 0
129 Kloramfenikol Tetes Telinga 3 % Botol 0 0 0
130 Klorpromazin 100 mg Tablet 0 0 0
131 Kodein Tab 10 mg Tablet 0 0 0
132 Kotrimoksazol syr 240 mg/5 ml Botol 0 0 0
133 Kotrimoksazol Tab 120 mg Tablet 0 0 0
134 Kotrimoksazol Tab 400 mg Tablet 0 0 0
135 Lacbon Tablet 0 0 0
136 Lanzoprazole Kapsul 0 0 0
137 Levertran Salep Tube 0 0 0
138 Levofloxacin Tab 500 mg Tablet 0 0 0
139 Lidokain komb Inj Ampul 40 5 35
140 Livron B Plex Tablet 0 0 0
141 Lodia Tablet 0 0 0
142 Loperamid Tablet 0 0 0
143 Loratadin 10 mg Tablet 170 100 70
144 Lubricating Jelly Tube 0 0 0
145 Mebendazol Tab 100 mg Tablet 0 0 0
146 Mediamere Tablet 0 0 0
147 Meloxicam 15 mg Tablet 0 0 0
148 Meloxicam 7,5 mg Tablet 0 0 0
149 Metformin 500 mg Tablet 1250 100 1150
150 Methil Prednisolon Tab 4 mg Tablet 950 200 750
151 Methil Prednisolon Tab 8 mg Tablet 0 0 0
152 Metil Ergometrin Inj Ampul 0 0 0
153 Metil ergometrin Tab 0,125 mg Tablet 0 0 0
154 Metoch / Ethiferan Inj 5 mg Ampul 0 0 0
155 Metoklopramid Tab 10 mg Tablet 0 0 0
156 Metronidazol Tab 250 mg Tablet 0 0 0
157 Metronidazol Tab 500 mg Tablet 0 0 0
158 Miconazol Salep Tube 0 0 0
159 Minyak Kayu Putih Botol 7 3 4
160 Molagit Tablet 0 0 0
161 Molexdryl Sirup Botol 0 0 0
162 Na.Diklofenak Tab 25 mg Tablet 1200 200 1000
163 Na.Diklofenak Tab 50 mg Tablet 0 0 0
164 Nifedipin Tab Tablet 0 0 0
165 Nistatin Supp Supp 0 0 0
166 Nistatin Tab Tablet 0 0 0
167 Nitral Vial 0 0 0
168 Obat Tambah Darah Tablet 0 0 0
169 OBH Sirup Botol 0 0 0
170 Ofloxacin Tab 200 mg Tablet 0 0 0
171 Ofloxacin Tab 400 mg Tablet 0 0 0
172 Oksitetrasiklin Inj 50 mg/vial Vial 0 0 0
173 Oksitetrasiklin Salep Kulit 3 % Tube 0 0 0
174 Oksitetrasiklin Salep Mata 1 % Tube 0 0 0
175 Oksitosin Inj 10 iu/ml Ampul 88 5 83
176 Omeprazole Kaps 20 mg Tablet 800 200 600
177 ondasteron inj ampul 0 0 0
178 Papaverin Tab 40 mg Tablet 0 0 0
179 Paracetamol drops Botol 0 0 0
180 Paracetamol Syr 120 mg/5 ml Botol 150 50 100
181 Paracetamol Tab 100 mg Tablet 0 0 0
182 Paracetamol Tab 500 mg Tablet 8700 500 8200
183 Peditox Botol 0 0 0
184 Piracetam Inj Ampul 0 0 0
185 Pirantel Pamoat Tab 125 mg Tablet 0 0 0
186 Pirazinamid Tab 500 mg Tablet 0 0 0
187 Pirimetamin Sulfadoksin Tab Tablet 0 0 0
188 Piroxicam Kap 20 mg Tablet 0 0 0
189 Prednison Tab 5 mg Tablet 0 0 0
190 Primakina Tab 15 mg Tablet 0 0 0
191 Propanolol Tab 40 mg Tablet 0 0 0
192 Propiltiourasil Tab 100 mg Tablet 0 0 0
193 Pyridoksin (Vit.B6) Tab 10 mg Tablet 0 0 0
194 Ranitidin Inj Ampul 319 5 314
195 Ranitidin Tab 150 mg Tablet 1200 200 1000
196 Reserpin Tab 0,25 mg Tablet 0 0 0
197 Rifampisin 300 mg Kapsul 0 0 0
198 Rifampisin 450 mg Kapsul 0 0 0
199 Rifampisin 600 mg Kapsul 0 0 0
200 Risperidon Tablet 0 0 0
201 Salbutamol Tab 2 mg Tablet 800 200 600
202 Salbutamol Tab 4mg Tablet 0 0 0
203 Salep 2-4 Komb Pot 93 3 90
204 Salisil Bedak 2% kotak 0 0 0
205 Sangobion Tablet 0 0 0
206 Serum Anti Tetanus (ATS) 1500 IU/AMP Vial 0 0 0
207 Sianokobalamin (Vit.B12) Inj Ampul 1500 300 1200
208 Sianokobalamin Tab 50 mg Tablet 0 0 0
209 Simvastatin Tablet 800 300 500
210 Stesolid Rectal Tube 0 0 0
211 Streptomicin Inj Vial 0 0 0
212 Sulfacetamid Tts Mata 15 % Botol 0 0 0
213 Tetrasiklin Kaps 500 mg Kapsul 0 0 0
214 Thiamin (Vit.B1) Inj Ampul 0 0 0
215 Thiamin (Vit.B1) Tab 50 mg Tablet 900 200 700
216 Tiamphenikol Kap 500 mg Kapsul 0 0 0
217 Tiamphenikol Syrup Botol 0 0 0
218 Tramadol Tab 50 mg Tablet 0 0 0
219 Triheksifenidil Tab 2 mg Tablet 0 0 0
220 Ventolin 2,5 mg Tube 0 0 0
221 Vit. A Biru Kapsul 200 50 150
222 Vit. A merah Kapsul 600 100 500
223 Vit. B com Injeksi Tablet 0 0 0
224 Vit. B kompleks Tab Tablet 2300 300 2000
225 Xylomidon Inj Vial 0 0 0
226 Zinc Dispersible 20 mg Tablet 3300 300 3000
Cairan dan Larutan
226 Alkohol 70 % Liter 0 0 0
227 Alkohol Swabs kotak 100 100 0
228 Aquabidest 500 ml Botol 0 0 0
229 Aquadest 100 ml Botol 0 0 0
230 Aquadest 25 ml Botol 0 0 0
231 ASK Botol 0 0 0
232 Glukosa Infus 10 % Botol 0 0 0
233 Glukosa Infus 5 % Botol 0 0 0
234 HCL 0,1 N 100 ML Botol 0 0 0
235 H2O2 3 % Botol 0 0 0
236 Lisol 50 % Botol 0 0 0
237 NaCl Infus 0,9 % Botol 0 0 0
238 Povidon Iodida 10% Botol 0 0 0
239 Ringer Laktat Infus Botol 0 0 0
240 Rivanol Lar 0,1 % 300ml Botol 0 0 0
241 Yodium Povidon 1000 ml Botol 0 0 0
242 Yodium Povidon 30 ml Botol 0 0 0
243 Yodium Povidon 300 ml kotak 0 0 0
Alat Kesehatan
243 Abbocath 16 G vasofix pcs 0 0 0
244 Abbocath 18 G vasofix pcs 0 0 0
245 Abbocath 20 G vasofix pcs 0 0 0
246 Abbocath 21 G vasofix pcs 0 0 0
247 Abbocath 24 G vasofix pcs 0 0 0
248 Abbocath 25 G vasofix pcs 0 0 0
249 Abbocath 27 G vasofix pcs 0 0 0
250 Alat Suntik Dispo 0,05 ml pcs 240 40 200
251 Alat Suntik Dispo 0,5 ml pcs 0 0 0
252 Alat Suntik Dispo 1 ml pcs 0 0 0
253 Alat Suntik Dispo 3 ml pcs 100 100 0
254 Alat Suntik Dispo 10 ml pcs 0 0 0
255 Alat Suntik Dispo 5 ml pcs 0 0 0
256 Aesculap blades Bisturi pcs 0 0 0
257 Catgut 2/0 (2 metric) pcs 0 0 0
258 Catgut 2/0 (3 metric) pcs 0 0 0
259 Catgut 2/0 (3,5 metric)DS-19 pcs 0 0 0
260 Catgut 2/0 (3,5 metric)DS-30 pcs 0 0 0
261 Catgut 2/0 with needle pcs 0 0 0
262 Catgut 3/0 (2 metric) pcs 0 0 0
263 Catgut Chromic no 3 pcs 0 0 0
264 Catgut chromic no 6 pcs 0 0 0
265 Coverplast pcs 0 0 0
266 Daryant Tulle kotak 0 0 0
268 Handschon M kotak 65 65 0
269 Handschon No.7 Steril pcs 0 0 0
270 Handschon No.7,5 pcs 140 40 100
271 Handschon S kotak 0 0 0
272 Handschoon 6,5 kotak 0 0 0
273 Handschoon L kotak 0 0 0
274 Hypapix Plester pcs 0 0 0
275 Infusion Set Anak pcs 0 0 0
276 Infusion Set Dewasa pcs 0 0 0
277 Kapas Pembalut 1000 mg Rol 0 0 0
278 Kapas Pembalut 250 mg Rol 0 0 0
279 Kapas Pembalut 500 mg Rol 0 0 0
280 Kasa Hidrofil 4 m x 10 cm Elastis kotak 0 0 0
281 Kasa Hidrofil 4 y x 80 cm Rol 0 0 0
282 Kasa Kompres Steril 40/40 kotak 0 0 0
283 Kasa Pembalut 2 m X 80 cm Rol 0 0 0
284 Kertas puyer perkamen Rim 1100 300 800
285 Kasa Panjang 40 x 80 cm rol 17 3 14
286 Lancet kotak 0 0 0
287 Lomatuel kotak 0 0 0
287 Masker Earloop pcs 207 5 202
288 Medicet 20 G pcs 0 0 0
 289 Medicet 24 G pcs 0 0 0
290 Needle 23 G X 1 1/4 pcs 0 0 0
291 Needle BR 10 pcs 0 0 0
292 Needle BR 13 pcs 0 0 0
293 Needle BR 16 pcs 0 0 0
294 Needle BT 27 pcs 0 0 0
295 Needle GT 10 pcs 0 0 0
296 Needle GT 12 pcs 0 0 0
297 Needle GT 14 pcs 0 0 0
298 Otopain Tube 0 0 0
299 Pembalut Gibs pcs 0 0 0
300 Plastik Obat 5 x 8 kotak 592 100 492
301 Plastik Obat 7 x 10 kotak 945 200 745
302 Plastik Obat 8,7 x 13 kotak 0 0 0
303 Plester 5 y X 2 Inch / leukoplas 7,5 x 4,5 cm Rol 0 0 0
304 Stick Rapid IMS / Syipilis pcs 0 0 0
305 Stick Rapid HIV Pcs 0 0 0
306 Stick HBsAg pcs 7 3 4
307 Silk No 2/0 pcs 50 0 50
308 Strip Hb famili pcs 450 50 400
305 Strip Test Cholestrol pcs 350 100 250
306 Strip test Glucose pcs 0 0 0
307 Strip test Uric Acid pcs 0 0 0
308 Surgical Blade No. 11 pcs 0 0 0
309 Surgical Blade No. 15 pcs 0 0 0
310 Surgical Blade No. 21 pcs 0 0 0
311 Surgical Masker (Betali) pcs 0 0 0
312 Wing Needle No.21 G x 3/4 kotak 0 0 0
313 Wing Needle No.23 G kotak 0 0 0
314 Wing Needle No.25 G kotak 0 0 0
315 Wing Needle No.27 G kotak 0 0 0
Obat Gigi
316 Alpha Acid kotak 0 0 0
 317 Aspar K Tablet 0 0 0
318 Charm Bord kotak 0 0 0
319 Charmfl plus kotak 0 0 0
320 Cimento de zinco Botol 0 0 0
321 Devitec Botol 0 0 0
322 Duron Group pcs 0 0 0
323 Etil Klorid Spray Botol 0 0 0
324 Eugenol cair Botol 0 0 0
325 Farmacol Forte Botol 0 0 0
326 Fletcher Liquid Botol 0 0 0
327 Fletcher Powder Botol 0 0 0
328 Glass Ionemer Liquid 7,5 kotak 0 0 0
329 Glass Ionemer Powder 100 gr Kotak 0 0 0
330 Iodoform Pasta Botol 0 0 0
331 Klorfenol Kamfer Mentol(CHKM) Botol 0 0 0
332 Multifix Liquid Kotak 0 0 0
333 Multifix Powder Kotak 0 0 0
334 Natural Lock pcs 0 0 0
335 Pehacain inj Ampul 0 0 0
336 Phosphoric Acid Etchan 6 Kotak 0 0 0
337 Semen Seng Fosfat Botol 0 0 0
378 technew hydcal -paste base and catalyst box 0 0 0
339 denpro orafil plus temporary filling Botol 0 0 0
Laboratorium
340 Coverglass 18 X 18 pcs 0 0 0
341 Kartu Golda Lembar 0 0 0
342 Lancet pcs 0 0 0
343 Larutan HCl 1 % Botol 0 0 0
344 Pot sampel pcs 0 0 0
345 Rak Tabung reaksi pcs 0 0 0
346 Reagen Widal pcs 0 0 0
347 Slide pcs 0 0 0
348 Tabung Centrifuge pcs 0 0 0
 349 One Med Test Kehamilan Instan pcs 0 0 0
350 0bjek glass 7105 box 0 0 0
351 Tabung EDTA 3 cc pcs 0 0 0
352 Anti A 10 ml (Gol-Darah) Botol 0 0 0
353 Anti AB 10 ml (Gol-Darah) Botol 0 0 0
354 Anti B 10 ml (Gol-Darah) Botol 0 0 0
356 Anti D 10 ml (Gol-Darah) Botol 0 0 0

Obat Tambahan
351 Batugin Tablet 0 0 0
352 Caviplex Tablet 0 0 0
353 Fondazen Tablet 0 0 0
354 Jeli USG Botol 0 0 0
357 Trombopop Tube 0 0 0
358 Vit. B com Injeksi Ampul 0 0 0
359 Tramadol Injeksi Ampul 0 0 0
360 Loratadine Tablet 0 0 0
361 Dextral tablet 0 0 0
362 Antiseptic Botol 0 0 0
363 Doxycycline Tablet 0 0 0
364 Difenhidramin Injeksi Ampul 0 0 0
365 Zink Syrup Botol 0 0 0
366 Acetyl Sistem tab tablet 0 0 0
367 Alco Plus Syr btl 0 0 0
368 Curcuma Plus/Vitamin btl 0 0 0
369 ETABION Kapsul 0 0 0
370 reagen golongan darah kotak 0 0 0
371 silk surgiroll roll 0 0 0
372 Ambubag pcs 0 0 0
373 neek chler dewasa pcs 0 0 0
 374 neek chler anak pcs 0 0 0
375 masker oksigen non rebreating Anak psc 0 0 0
376 nassal canule 02 'L' pcs 0 0 0
377 spalak psc 0 0 0
378 perlak underpad pcs 0 0 0
378 curcuma sharpy blackcurent 200 ml botol 0 0
379 Cuticell Clasic 10 cm x 10cm pcs 0 0 0
380 Aesculap Blades (Bisturi) box 0 0 0
381 Plesterin bulat non woven pcs 0 0 0
382 Hansaplas pcs 0 0 0
383 I.V Catheter 20G (STERACTH) Pcs 0 0 0
384 Vasofik I.V Chateter No 18 pcs 0 0 0
389 Lumpang pcs 0 0 0
390 mortir pcs 0 0 0
391 suture needle hecting pcs 0 0 0
392 hipavix pcs 0 0 0
393 dermafix pcs 0 0 0
394 Curcuma sharpy strawbery 60 ml botol 0 0 0
395 Curcuma Grow orange 200 ml botol 0 0 0
396 Metformin 850 mg tablet 0 0 0
397 Trepocheck sypilis pcs 0 0 0
Mengetahui Mengetahui Mengetahui
Kepala Puskesmas Sesua Kepala UPTD GFK Malinau Petugas UPTD GFK Malinau Petugas Gudang Obat Puskesmas

dr. Tumpak H.R. Sirait Selfie Palalangan S.Si Faris Dwi S. A.Md.,Far Trifena, A.Md.Farm
Nip. 19810313 200803 1 004 Nip. 19731127 200604 2 004 Nip. 19900805 201403 1 001 PTT
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
PUSKESMAS : SESUA
KECAMATAN : MALINAU BARAT PELAPORAN BULAN : FEBRUARI 2022
KABUPATEN : MALINAU PERMINTAAN BLN/PERIODE : TW 1

STOK SISA STOK KETERANGAN

NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAN PEMAKAIAN PERMINTAAN
AWAL STOK OPS EXD
1 Acyclovir Salep Kulit Tube 372 10 362
2 Acyclovir Tab 400 mg Tablet 275 150 125
3 Adrenalin Bitartat Ampul 0 0 0
4 Albendazole 400 mg Tablet 0 0 0
5 Alletrol tetes mata Botol 0 0 0
6 Allopurinol Tab 100 mg Tablet 1050 500 550
7 Alpara Tablet 0 0 0
8 Ambroxol Syr 15 mg/5 ml Botol 0 0 0
9 Ambroxol Tab 30 mg Tablet 0 0 0
10 Aminofilin Inj 24 mg/ml Ampul 0 0 0
11 Aminofilin Tab 200 mg Tablet 0 0 0
12 Amitriptilin Tab 25 mg Tablet 0 0 0
13 Amlodipin 5 mg Tablet 0 0 0
14 Amoksisillin Kap 250 mg Tablet 0 0 0
15 Amoksisillin Kap 500 mg Tablet 4200 300 3700
16 Amoksisillin Syr 125 mg/5 ml Botol 32 10 22
17 Ampicillin Injeksi Ampul 0 0 0
18 Ampisilin Kap 500 mg Tablet 700 300 400
19 Ampisilin Syr 125 mg/5 ml Botol 90 10 80
20 Antalgin Inj 250 mg/ml Ampul 0 0 0
21 Antalgin Tab 500 mg/ Metamozole Tablet 0 0 0
22 Antasid DOEN Tab Komb Tablet 3300 600 2700
23 Antasid Sirup Botol 0 0 0
24 Antifungi DOEN Pot 0 0 0
25 Antihaemoroid DOEN Komb Supp 0 0 0
26 Arsuamon Tab Tablet 0 0 0
27 Arterakine Tab Tablet 0 0 0
28 Asam Askorbat Tab 50 mg Tablet 10800 600 10200
29 Asam Folat 1 mg Tablet 0 0 0
30 Asam Mefenamat Kap 500 mg Tablet 1000 400 600
31 Atropin Sulfat Inj 0,25 mg/ml Ampul 0 0 0
32 Bacitrasin Salep Tube 0 0 0
33 Betametason Cream 0,1 % Tube 195 10 185
34 Bioplacenton Tube 0 0 0
35 Bromheksin Tablet 0 0 0
36 Bromheksin Sirup Botol 0 0 0
37 Burnazin Tube 0 0 0
38 Buscopan Tab 10 mg Tablet 0 0 0
39 Captopril 12,5 mg Tablet 2300 300 2000
Captopril 25 mg Tablet 1500 200 1300
41 Cefixime Kaps 100 mg Kapsul 0 0 0
42 Cefixime Syrup Botol 0 0 0
43 Cendocetamide 15 % Botol 0 0 0
44 Cendotropin Tetes Mata Botol 0 0 0
45 Centabio Tube 0 0 0
46 Cephadroxil Kap 250 mg Kapsul 0 0 0
47 Cephadroxil Kap 500 mg Kapsul 0 0 0
48 Cephadroxil Syr Botol 0 0 0
49 Cetirizine Tablet 1300 300 1000
50 Chefalexin Kap 500 mg Tablet 0 0 0
51 Cimetidine 200 mg Tablet 0 0 0
52 Cinolon N 10 gr Tube 0 0 0
53 Ciprofloxacin Tab 500 mg Tablet 0 0 0
54 Cohistin Syrup Botol 0 0 0
56 CTM Tab 4 mg Tablet 2300 300 2000
57 Curcuma Tablet 0 0 0
58 Curliv Syrup/Multivitamin syr Botol 0 0 0
59 Deksametason Inj 5 mg/ml Ampul 0 0 0
60 Deksametason Tab 0,5 mg Tablet 800 300 500
61 Dekstrometorfan HBr 15 mg Tablet 0 0 0
62 Dekstrometorfan Syr Botol 0 0 0
63 Diazepam Inj 5 mg/ml Ampul 0 0 0
64 Diazepam Tab 2 mg Tablet 0 0 0
65 Diclofam 50 mg Tablet 0 0 0
66 Digoksin Tab 0,25 mg Tablet 0 0 0
67 Diltiazem Tab 30 Mg Tablet 0 0 0
68 Domperidon Tab Tablet 0 0 0
69 Doxycicline Kaps 100 mg Kapsul 0 0 0
70 Dulcolax Supp Anak Supp 0 0 0
71 Dulcolax/bisakodil Tab 5 mg Tablet 0 0 0
72 Dumin Tablet 0 0 0
73 Efedrin Tab 25 mg Tablet 0 0 0
74 Efinefrin Inj 0,1 % Ampul 0 0 0
75 Ekstrak Belladon Tab 10 mg Tablet 0 0 0
76 Elkana Tablet 0 0 0
77 Ergotamin Koffein Tab Tablet 0 0 0
78 Erlamicetine Botol 0 0 0
79 Erytromisin Kap 500 mg Kapsul 0 0 0
80 Erytromisin Syr 125 mg/ 5 ml Botol 0 0 0
81 Etambutol Tab 500 mg Tablet 0 0 0
82 Famotidin 20 mg/40 mg Tablet 0 0 0
83 Fenobarbital Inj 50 mg/ml Ampul 0 0 0
84 Fenobarbital Tab 30 mg Tablet 0 0 0
85 Fenol Gliserol Tts Telinga 10 % Botol 0 0 0
86 Ferrous Sulfat Tab Tablet 0 0 0
87 Fitomenadion (Vit.K) Inj Ampul 0 0 0
88 Fitomenadion (Vit.K) Tab Tablet 0 0 0
89 Fitomenadion (Vit.K3) Inj Ampul 0 0 0
90 Fluoroscein Tetes Mata 2 % Botol 0 0 0
91 Furosemid Inj 10 ml Ampul 0 0 0
92 Furosemid Tab 40 mg Tablet 0 0 0
93 Gamexan Emulsi 1 % Botol 0 0 0
94 Garam Oralit 200 ml Sachet 350 100 250
95 Genoit Salep Mata Tube 0 0 0
96 Gentamisin Salep Kulit Tube 0 0 0
98 Gentamisin Tetes Mata Botol 0 0 0
99 Gentian Violet Lar 1 % Botol 0 0 0
100 GG Tab 100 mg Tablet 1000 600 400
101 Glibenklamid Tab 5 mg Tablet 0 0 0
102 Glimepiride 2 mg Tablet 0 0 0
103 Glimepiride 4 mg Tablet 0 0 0
104 Griseofulvin Tab 125 mg Tablet 0 0 0
105 Griseofulvin Tab 500 mg Tablet 0 0 0
106 Haloperidol Tab 0,5 mg Tablet 0 0 0
107 Hidrokortison Cream 2,5 % Tube 28 8 20
108 Ibuprofen syr botol 0 0 0
109 Ibuprofen Tab 400 mg Tablet 0 0 0
110 Ichtiyol Salep Pot 0 0 0
111 INH Tab 100 mg Tablet 0 0 0
112 INH Tab 300 mg Tablet 0 0 0
113 Inmatrol Tetes Mata Botol 0 0 0
114 Inpepsa Sirup Botol 0 0 0
115 Isosorbid Dinitrat Tab 10mg Tablet 0 0 0
116 Kalium Diklofenak Tab 50 mg Tablet 0 0 0
117 Kalium Permanganat Tablet 0 0 0
118 Kalsium Laktat Tab 500 mg Tablet 800 200 200
119 Kanamicyn Inj Vial 0 0 0
120 Ketokonazole Cream 2 % Tube 0 0 0
121 Ketokonazole Tab 200 mg Tablet 0 0 0
122 Kinina Tab 222 mg Tablet 0 0 0
123 Klindamisin 150 mg Kapsul 0 0 0
124 Klindamisin 300 mg Kapsul 0 0 0
125 Kloramfenikol Kaps 250 mg Kapsul 0 0 0
126 Kloramfenikol Salep Mata 1 % Tube 0 0 0
127 Kloramfenikol Syr 125 mg/5 ml Botol 0 0 0
128 Kloramfenikol Tetes Mata Botol 0 0 0
129 Kloramfenikol Tetes Telinga 3 % Botol 0 0 0
130 Klorpromazin 100 mg Tablet 0 0 0
131 Kodein Tab 10 mg Tablet 0 0 0
132 Kotrimoksazol syr 240 mg/5 ml Botol 0 0 0
133 Kotrimoksazol Tab 120 mg Tablet 0 0 0
134 Kotrimoksazol Tab 400 mg Tablet 0 0 0
135 Lacbon Tablet 0 0 0
136 Lanzoprazole Kapsul 0 0 0
137 Levertran Salep Tube 0 0 0
138 Levofloxacin Tab 500 mg Tablet 0 0 0
139 Lidokain komb Inj Ampul 35 5 5
140 Livron B Plex Tablet 0 0 0
141 Lodia Tablet 0 0 0
142 Loperamid Tablet 0 0 0
143 Loratadin 10 mg Tablet 70 0 70
144 Lubricating Jelly Tube 0 0 0
145 Mebendazol Tab 100 mg Tablet 0 0 0
146 Mediamere Tablet 0 0 0
147 Meloxicam 15 mg Tablet 0 0 0
148 Meloxicam 7,5 mg Tablet 0 0 0
149 Metformin 500 mg Tablet 1150 300 850
150 Methil Prednisolon Tab 4 mg Tablet 750 200 550
151 Methil Prednisolon Tab 8 mg Tablet 0 0 0
152 Metil Ergometrin Inj Ampul 0 0 0
153 Metil ergometrin Tab 0,125 mg Tablet 0 0 0
154 Metoch / Ethiferan Inj 5 mg Ampul 0 0 0
155 Metoklopramid Tab 10 mg Tablet 0 0 0
156 Metronidazol Tab 250 mg Tablet 0 0 0
157 Metronidazol Tab 500 mg Tablet 0 0 0
158 Miconazol Salep Tube 0 0 0
159 Minyak Kayu Putih Botol 4 4 0
160 Molagit Tablet 0 0 0
161 Molexdryl Sirup Botol 0 0 0
162 Na.Diklofenak Tab 25 mg Tablet 1000 400 600
163 Na.Diklofenak Tab 50 mg Tablet 0 0 0
164 Nifedipin Tab Tablet 0 0 0
165 Nistatin Supp Supp 0 0 0
166 Nistatin Tab Tablet 0 0 0
167 Nitral Vial 0 0 0
168 Obat Tambah Darah Tablet 0 0 0
169 OBH Sirup Botol 0 0 0
170 Ofloxacin Tab 200 mg Tablet 0 0 0
171 Ofloxacin Tab 400 mg Tablet 0 0 0
172 Oksitetrasiklin Inj 50 mg/vial Vial 0 0 0
173 Oksitetrasiklin Salep Kulit 3 % Tube 0 0 0
174 Oksitetrasiklin Salep Mata 1 % Tube 0 0 0
175 Oksitosin Inj 10 iu/ml Ampul 83 10 73
176 Omeprazole Kaps 20 mg Tablet 600 300 300
177 ondasteron inj ampul 0 0 0
178 Papaverin Tab 40 mg Tablet 0 0 0
179 Paracetamol drops Botol 0 0 0
180 Paracetamol Syr 120 mg/5 ml Botol 100 50 50
181 Paracetamol Tab 100 mg Tablet 0 0 0
182 Paracetamol Tab 500 mg Tablet 8200 500 7700
183 Peditox Botol 0 0 0
184 Piracetam Inj Ampul 0 0 0
185 Pirantel Pamoat Tab 125 mg Tablet EXP 0 0
186 Pirazinamid Tab 500 mg Tablet 0 0 0
187 Pirimetamin Sulfadoksin Tab Tablet 0 0 0
188 Piroxicam Kap 20 mg Tablet 0 0 0
189 Prednison Tab 5 mg Tablet 0 0 0
190 Primakina Tab 15 mg Tablet 0 0 0
191 Propanolol Tab 40 mg Tablet 0 0 0
192 Propiltiourasil Tab 100 mg Tablet 0 0 0
193 Pyridoksin (Vit.B6) Tab 10 mg Tablet 0 0 0
194 Ranitidin Inj Ampul 314 5 309
195 Ranitidin Tab 150 mg Tablet 1000 500 500
196 Reserpin Tab 0,25 mg Tablet 0 0 0
197 Rifampisin 300 mg Kapsul 0 0 0
198 Rifampisin 450 mg Kapsul 0 0 0
199 Rifampisin 600 mg Kapsul 0 0 0
200 Risperidon Tablet 0 0 0
201 Salbutamol Tab 2 mg Tablet 600 200 400
202 Salbutamol Tab 4mg Tablet 0 0 0
203 Salep 2-4 Komb Pot 90 5 85
204 Salisil Bedak 2% kotak 0 0 0
205 Sangobion Tablet 0 0 0
206 Serum Anti Tetanus (ATS) 1500 IU/AMP Vial 0 0 0
207 Sianokobalamin (Vit.B12) Inj Ampul 1200 500 700
208 Sianokobalamin Tab 50 mg Tablet 0 0 0
209 Simvastatin Tablet 500 300 200
210 Stesolid Rectal Tube 0 0 0
211 Streptomicin Inj Vial 0 0 0
212 Sulfacetamid Tts Mata 15 % Botol 0 0 0
213 Tetrasiklin Kaps 500 mg Kapsul 0 0 0
214 Thiamin (Vit.B1) Inj Ampul 0 0 0
215 Thiamin (Vit.B1) Tab 50 mg Tablet 700 300 400
216 Tiamphenikol Kap 500 mg Kapsul 0 0 0
217 Tiamphenikol Syrup Botol 0 0 0
218 Tramadol Tab 50 mg Tablet 0 0 0
219 Triheksifenidil Tab 2 mg Tablet 0 0 0
220 Ventolin 2,5 mg Tube 0 0 0
221 Vit. A Biru Kapsul 150 50 100
222 Vit. A merah Kapsul 500 200 300
223 Vit. B com Injeksi Tablet 0 0 0
224 Vit. B kompleks Tab Tablet 2000 500 1500
225 Xylomidon Inj Vial 0 0 0
226 Zinc Dispersible 20 mg Tablet 3000 500 1500
Cairan dan Larutan
226 Alkohol 70 % Liter 0 0 0
227 Alkohol Swabs kotak 0 100 0
228 Aquabidest 500 ml Botol 0 0 0
229 Aquadest 100 ml Botol 0 0 0
230 Aquadest 25 ml Botol 0 0 0
231 ASK Botol 0 0 0
232 Glukosa Infus 10 % Botol 0 0 0
233 Glukosa Infus 5 % Botol 0 0 0
234 HCL 0,1 N 100 ML Botol 0 0 0
235 H2O2 3 % Botol 0 0 0
236 Lisol 50 % Botol 0 0 0
237 NaCl Infus 0,9 % Botol 0 0 0
238 Povidon Iodida 10% Botol 0 0 0
239 Ringer Laktat Infus Botol 0 0 0
240 Rivanol Lar 0,1 % 300ml Botol 0 0 0
241 Yodium Povidon 1000 ml Botol 0 0 0
242 Yodium Povidon 30 ml Botol 0 0 0
243 Yodium Povidon 300 ml kotak 0 0 0
Alat Kesehatan
243 Abbocath 16 G vasofix pcs 0 0 0
244 Abbocath 18 G vasofix pcs 0 0 0
245 Abbocath 20 G vasofix pcs 0 0 0
246 Abbocath 21 G vasofix pcs 0 0 0
247 Abbocath 24 G vasofix pcs 0 0 0
248 Abbocath 25 G vasofix pcs 0 0 0
249 Abbocath 27 G vasofix pcs 0 0 0
250 Alat Suntik Dispo 0,05 ml pcs 200 50 150
251 Alat Suntik Dispo 0,5 ml pcs 0 0 0
252 Alat Suntik Dispo 1 ml pcs 0 0 0
253 Alat Suntik Dispo 3 ml pcs 0 0 0
254 Alat Suntik Dispo 10 ml pcs 0 0 0
255 Alat Suntik Dispo 5 ml pcs 0 0 0
256 Aesculap blades Bisturi pcs 0 0 0
257 Catgut 2/0 (2 metric) pcs 0 0 0
258 Catgut 2/0 (3 metric) pcs 0 0 0
259 Catgut 2/0 (3,5 metric)DS-19 pcs 0 0 0
260 Catgut 2/0 (3,5 metric)DS-30 pcs 0 0 0
261 Catgut 2/0 with needle pcs 0 0 0
262 Catgut 3/0 (2 metric) pcs 0 0 0
263 Catgut Chromic no 3 pcs 0 0 0
264 Catgut chromic no 6 pcs 0 0 0
265 Coverplast pcs 0 0 0
266 Daryant Tulle kotak 0 0 0
268 Handschon M kotak 0 0 0
269 Handschon No.7 Steril pcs 0 0 0
270 Handschon No.7,5 pcs 100 100 0
271 Handschon S kotak 0 0 0
272 Handschoon 6,5 kotak 0 0 0
273 Handschoon L kotak 0 0 0
274 Hypapix Plester pcs 0 0 0
275 Infusion Set Anak pcs 0 0 0
276 Infusion Set Dewasa pcs 0 0 0
277 Kapas Pembalut 1000 mg Rol 0 0 0
278 Kapas Pembalut 250 mg Rol 0 0 0
279 Kapas Pembalut 500 mg Rol 0 0 0
280 Kasa Hidrofil 4 m x 10 cm Elastis kotak 0 0 0
281 Kasa Hidrofil 4 y x 80 cm Rol 0 0 0
282 Kasa Kompres Steril 40/40 kotak 0 0 0
283 Kasa Pembalut 2 m X 80 cm Rol 0 0 0
284 Kertas puyer perkamen Rim 800 300 500
285 Kasa Panjang 40 x 80 cm rol 14 2 12
286 Lancet kotak 0 0 0
287 Lomatuel kotak 0 0 0
287 Masker Earloop pcs 202 5 197
288 Medicet 20 G pcs 0 0 0
 289 Medicet 24 G pcs 0 0 0
290 Needle 23 G X 1 1/4 pcs 0 0 0
291 Needle BR 10 pcs 0 0 0
292 Needle BR 13 pcs 0 0 0
293 Needle BR 16 pcs 0 0 0
294 Needle BT 27 pcs 0 0 0
295 Needle GT 10 pcs 0 0 0
296 Needle GT 12 pcs 0 0 0
297 Needle GT 14 pcs 0 0 0
298 Otopain Tube 0 0 0
299 Pembalut Gibs pcs 0 0 0
300 Plastik Obat 5 x 8 kotak 492 192 300
301 Plastik Obat 7 x 10 kotak 745 245 700
302 Plastik Obat 8,7 x 13 kotak 0 0 0
Plester 5 y X 2 Inch / leukoplas 7,5 x 4,5
303 Rol 0 0 0
cm
304 Stick Rapid IMS / Syipilis pcs 0 0 0
305 Stick Rapid HIV Pcs 0 0 0
306 Stick HBsAg pcs 4 1 3
307 Silk No 2/0 pcs 50 0 50
308 Strip Hb famili pcs 400 50 350
305 Strip Test Cholestrol pcs 250 150 100
306 Strip test Glucose pcs 0 0 0
307 Strip test Uric Acid pcs 0 0 0
308 Surgical Blade No. 11 pcs 0 0 0
309 Surgical Blade No. 15 pcs 0 0 0
310 Surgical Blade No. 21 pcs 0 0 0
311 Surgical Masker (Betali) pcs 0 0 0
312 Wing Needle No.21 G x 3/4 kotak 0 0 0
313 Wing Needle No.23 G kotak 0 0 0
314 Wing Needle No.25 G kotak 0 0 0
315 Wing Needle No.27 G kotak 0 0 0
Obat Gigi
 316 champhenol kotak 0 0 0
317 Cresotin kotak 0 0 0
318 master bond kotak 0 0 0
319 Paramon chlorofenol kotak 0 0 0
320 Cimento de zinco Botol 0 0 0
321 Pulp x Botol 0 0 0
322 Duron Group pcs 0 0 0
323 Etil Klorid Spray Botol 0 0 0
324 Eugenol cair Botol 0 0 0
325 Farmacol Forte Botol 0 0 0
326 Fletcher Liquid Botol 0 0 0
327 Fletcher Powder Botol 0 0 0
328 Glass Ionemer Liquid 7,5 kotak 0 0 0
329 Glass Ionemer Powder 100 gr Kotak 0 0 0
330 iodotin Botol 0 0 0
331 Klorfenol Kamfer Mentol(CHKM) Botol 0 0 0
332 Multifix Liquid Kotak 0 0 0
333 Multifix Powder Kotak 0 0 0
334 Natural Lock pcs 0 0 0
335 Pehacain inj Ampul 0 0 0
336 Phosphoric Acid Etchan 6 Kotak 0 0 0
337 Zitemp Botol 0 0 0
378 technew hydcal -paste base and catalyst box 0 0 0
339 orafil plus temporary filling Botol 0 0 0
Laboratorium
340 Coverglass 18 X 18 pcs 0 0 0
341 Kartu Golda Lembar 0 0 0
342 Lancet pcs 0 0 0
343 Larutan HCl 1 % Botol 0 0 0
344 Pot sampel pcs 0 0 0
345 Rak Tabung reaksi pcs 0 0 0
346 Reagen Widal pcs 0 0 0
347 Slide pcs 0 0 0
 348 Tabung Centrifuge pcs 0 0 0
349 One Med Test Kehamilan Instan pcs 0 0 0
350 0bjek glass 7105 box 0 0 0
351 Tabung EDTA 3 cc pcs 0 0 0
352 Anti A 10 ml (Gol-Darah) Botol 0 0 0
353 Anti AB 10 ml (Gol-Darah) Botol 0 0 0
354 Anti B 10 ml (Gol-Darah) Botol 0 0 0
356 Anti D 10 ml (Gol-Darah) Botol 0 0 0

Obat Tambahan
351 Batugin Tablet 0 0 0
352 Caviplex Tablet 0 0 0
353 Fondazen Tablet 0 0 0
354 Jeli USG Botol 0 0 0
357 Trombopop Tube 0 0 0
358 Vit. B com Injeksi Ampul 0 0 0
359 Tramadol Injeksi Ampul 0 0 0
360 Loratadine Tablet 0 0 0
361 Dextral tablet 0 0 0
362 Antiseptic Botol 0 0 0
363 Doxycycline Tablet 0 0 0
364 Difenhidramin Injeksi Ampul 0 0 0
365 Zink Syrup Botol 0 0 0
366 Acetyl Sistem tab tablet 0 0 0
367 Alco Plus Syr btl 0 0 0
368 Curcuma Plus/Vitamin btl 0 0 0
369 ETABION Kapsul 0 0 0
370 reagen golongan darah kotak 0 0 0
371 silk surgiroll roll 0 0 0
372 Ambubag pcs 0 0 0
 373 neek chler dewasa pcs 0 0 0
374 neek chler anak pcs 0 0 0
375 masker oksigen non rebreating Anak psc 0 0 0
376 nassal canule 02 'L' pcs 0 0 0
377 spalak psc 0 0 0
378 perlak underpad pcs 0 0 0
378 curcuma sharpy blackcurent 200 ml botol 0 0 0
379 Cuticell Clasic 10 cm x 10cm pcs 0 0 0
380 Aesculap Blades (Bisturi) box 0 0 0
381 Plesterin bulat non woven pcs 0 0 0
382 Hansaplas pcs 0 0 0
383 I.V Catheter 20G (STERACTH) Pcs 0 0 0
384 Vasofik I.V Chateter No 18 pcs 0 0 0
389 Lumpang pcs 0 0 0
390 mortir pcs 0 0 0
391 suture needle hecting pcs 0 0 0
392 hipavix pcs 0 0 0
393 dermafix pcs 0 0 0
394 Curcuma sharpy strawbery 60 ml botol 0 0 0
395 Curcuma Grow orange 200 ml botol 0 0 0
396 Metformin 850 mg tablet 0 0 0
397 Trepocheck sypilis pcs 0 0 0
Mengetahui Mengetahui Mengetahui
Kepala Puskesmas Sesua Kepala UPTD GFK Malinau Petugas UPTD GFK Malinau Petugas Gudang Obat Puskesmas

dr. Tumpak H.R. Sirait Selfie Palalangan S.Si Faris Dwi S. A.Md.,Far Trifena, A.Md.Farm
Nip. 19810313 200803 1 004 Nip. 19731127 200604 2 004 Nip. 19900805 201403 1 001 PTT
 LAPORAN PEMAKAIAN DAN LEMBAR
PUSKESMAS : SESUA
KECAMATAN : MALINAU BARAT
KABUPATEN : MALINAU

STOK
NO NAMA OBAT SATUAN PENERIMAAN
AWAL
1 Acyclovir Salep Kulit Tube 362
2 Acyclovir Tab 400 mg Tablet 125
3 Adrenalin Bitartat Ampul 0
4 Albendazole 400 mg Tablet 0
5 Alletrol tetes mata Botol 0
6 Allopurinol Tab 100 mg Tablet 550
7 Alpara Tablet 0
8 Ambroxol Syr 15 mg/5 ml Botol 0
9 Ambroxol Tab 30 mg Tablet 0
10 Aminofilin Inj 24 mg/ml Ampul 0
11 Aminofilin Tab 200 mg Tablet 0
12 Amitriptilin Tab 25 mg Tablet 0
13 Amlodipin 5 mg Tablet 0
14 Amoksisillin Kap 250 mg Tablet 0
15 Amoksisillin Kap 500 mg Tablet 3700
16 Amoksisillin Syr 125 mg/5 ml Botol 22
17 Ampicillin Injeksi Ampul 0
18 Ampisilin Kap 500 mg Tablet 400
19 Ampisilin Syr 125 mg/5 ml Botol 80

20 Antalgin Inj 250 mg/ml Ampul 0

Antalgin Tab 500 mg/
21 Tablet
Metamozole 0
22 Antasid DOEN Tab Komb Tablet 2700
23 Antasid Sirup Botol 0
24 Antifungi DOEN Pot 0
25 Antihaemoroid DOEN Komb Supp 0
26 Arsuamon Tab Tablet 0
27 Arterakine Tab Tablet 0
28 Asam Askorbat Tab 50 mg Tablet 10200
29 Asam Folat 1 mg Tablet 0
30 Asam Mefenamat Kap 500 mg Tablet 600
31 Atropin Sulfat Inj 0,25 mg/ml Ampul 0
32 Bacitrasin Salep Tube 0
33 Betametason Cream 0,1 % Tube 185
34 Bioplacenton Tube 0
35 Bromheksin Tablet 0
36 Bromheksin Sirup Botol 0
37 Burnazin Tube 0
38 Buscopan Tab 10 mg Tablet 0
39 Captopril 12,5 mg Tablet 2000
Captopril 25 mg Tablet 1300
41 Cefixime Kaps 100 mg Kapsul 0
42 Cefixime Syrup Botol 0
43 Cendocetamide 15 % Botol 0
44 Cendotropin Tetes Mata Botol 0
45 Centabio Tube 0
46 Cephadroxil Kap 250 mg Kapsul 0
47 Cephadroxil Kap 500 mg Kapsul 0
48 Cephadroxil Syr Botol 0
49 Cetirizine Tablet 1000
50 Chefalexin Kap 500 mg Tablet 0
51 Cimetidine 200 mg Tablet 0
52 Cinolon N 10 gr Tube 0
53 Ciprofloxacin Tab 500 mg Tablet 0
54 Cohistin Syrup Botol 0
56 CTM Tab 4 mg Tablet 2000
57 Curcuma Tablet 0
58 Curliv Syrup/Multivitamin syr Botol 0
59 Deksametason Inj 5 mg/ml Ampul 0
60 Deksametason Tab 0,5 mg Tablet 500
61 Dekstrometorfan HBr 15 mg Tablet 0
62 Dekstrometorfan Syr Botol 0
63 Diazepam Inj 5 mg/ml Ampul 0
64 Diazepam Tab 2 mg Tablet 0
65 Diclofam 50 mg Tablet 0
66 Digoksin Tab 0,25 mg Tablet 0
67 Diltiazem Tab 30 Mg Tablet 0
68 Domperidon Tab Tablet 0
69 Doxycicline Kaps 100 mg Kapsul 0
70 Dulcolax Supp Anak Supp 0
71 Dulcolax/bisakodil Tab 5 mg Tablet 0
72 Dumin Tablet 0
73 Efedrin Tab 25 mg Tablet 0
74 Efinefrin Inj 0,1 % Ampul 0
75 Ekstrak Belladon Tab 10 mg Tablet 0
76 Elkana Tablet 0
77 Ergotamin Koffein Tab Tablet 0
 78 Erlamicetine Botol 0
79 Erytromisin Kap 500 mg Kapsul 0
80 Erytromisin Syr 125 mg/ 5 ml Botol 0
81 Etambutol Tab 500 mg Tablet 0
82 Famotidin 20 mg/40 mg Tablet 0
83 Fenobarbital Inj 50 mg/ml Ampul 0
84 Fenobarbital Tab 30 mg Tablet 0
85 Fenol Gliserol Tts Telinga 10 % Botol 0
86 Ferrous Sulfat Tab Tablet 0
87 Fitomenadion (Vit.K) Inj Ampul 0
88 Fitomenadion (Vit.K) Tab Tablet 0
89 Fitomenadion (Vit.K3) Inj Ampul 0
90 Fluoroscein Tetes Mata 2 % Botol 0
91 Furosemid Inj 10 ml Ampul 0
92 Furosemid Tab 40 mg Tablet 0
93 Gamexan Emulsi 1 % Botol 0
94 Garam Oralit 200 ml Sachet 250
95 Genoit Salep Mata Tube 0
96 Gentamisin Salep Kulit Tube 0
98 Gentamisin Tetes Mata Botol 0
99 Gentian Violet Lar 1 % Botol 0
100 GG Tab 100 mg Tablet 400
101 Glibenklamid Tab 5 mg Tablet 0
102 Glimepiride 2 mg Tablet 0
103 Glimepiride 4 mg Tablet 0
104 Griseofulvin Tab 125 mg Tablet 0
105 Griseofulvin Tab 500 mg Tablet 0
106 Haloperidol Tab 0,5 mg Tablet 0
107 Hidrokortison Cream 2,5 % Tube 20
108 Ibuprofen syr botol 0
109 Ibuprofen Tab 400 mg Tablet 0
110 Ichtiyol Salep Pot 0
111 INH Tab 100 mg Tablet 0
112 INH Tab 300 mg Tablet 0
113 Inmatrol Tetes Mata Botol 0
114 Inpepsa Sirup Botol 0
115 Isosorbid Dinitrat Tab 10mg Tablet 0
116 Kalium Diklofenak Tab 50 mg Tablet 0
117 Kalium Permanganat Tablet 0
118 Kalsium Laktat Tab 500 mg Tablet 200
119 Kanamicyn Inj Vial 0
120 Ketokonazole Cream 2 % Tube 0
121 Ketokonazole Tab 200 mg Tablet 0
122 Kinina Tab 222 mg Tablet 0
123 Klindamisin 150 mg Kapsul 0
124 Klindamisin 300 mg Kapsul 0
125 Kloramfenikol Kaps 250 mg Kapsul 0
126 Kloramfenikol Salep Mata 1 % Tube 0
127 Kloramfenikol Syr 125 mg/5 ml Botol 0
128 Kloramfenikol Tetes Mata Botol 0
129 Kloramfenikol Tetes Telinga 3 % Botol 0
130 Klorpromazin 100 mg Tablet 0
131 Kodein Tab 10 mg Tablet 0
132 Kotrimoksazol syr 240 mg/5 ml Botol 0
133 Kotrimoksazol Tab 120 mg Tablet 0
134 Kotrimoksazol Tab 400 mg Tablet 0
135 Lacbon Tablet 0
136 Lanzoprazole Kapsul 0
137 Levertran Salep Tube 0
138 Levofloxacin Tab 500 mg Tablet 0
139 Lidokain komb Inj Ampul 5
140 Livron B Plex Tablet 0
141 Lodia Tablet 0
142 Loperamid Tablet 0
143 Loratadin 10 mg Tablet 70
144 Lubricating Jelly Tube 0
145 Mebendazol Tab 100 mg Tablet 0
146 Mediamere Tablet 0
147 Meloxicam 15 mg Tablet 0
148 Meloxicam 7,5 mg Tablet 0
149 Metformin 500 mg Tablet 850
150 Methil Prednisolon Tab 4 mg Tablet 550
151 Methil Prednisolon Tab 8 mg Tablet 0
152 Metil Ergometrin Inj Ampul 0
153 Metil ergometrin Tab 0,125 mg Tablet 0
154 Metoch / Ethiferan Inj 5 mg Ampul 0
155 Metoklopramid Tab 10 mg Tablet 0
156 Metronidazol Tab 250 mg Tablet 0
157 Metronidazol Tab 500 mg Tablet 0
158 Miconazol Salep Tube 0
159 Minyak Kayu Putih Botol 4
160 Molagit Tablet 0
161 Molexdryl Sirup Botol 0
162 Na.Diklofenak Tab 25 mg Tablet 600
163 Na.Diklofenak Tab 50 mg Tablet 0
164 Nifedipin Tab Tablet 0
165 Nistatin Supp Supp 0
166 Nistatin Tab Tablet 0
167 Nitral Vial 0
168 Obat Tambah Darah Tablet 0
169 OBH Sirup Botol 0
170 Ofloxacin Tab 200 mg Tablet 0
171 Ofloxacin Tab 400 mg Tablet 0
172 Oksitetrasiklin Inj 50 mg/vial Vial 0
173 Oksitetrasiklin Salep Kulit 3 % Tube 0
174 Oksitetrasiklin Salep Mata 1 % Tube 0
175 Oksitosin Inj 10 iu/ml Ampul 73
176 Omeprazole Kaps 20 mg Tablet 300
177 ondasteron inj ampul 0
178 Papaverin Tab 40 mg Tablet 0
179 Paracetamol drops Botol 0
180 Paracetamol Syr 120 mg/5 ml Botol 50
181 Paracetamol Tab 100 mg Tablet 0
182 Paracetamol Tab 500 mg Tablet 7700
183 Peditox Botol 0
184 Piracetam Inj Ampul 0
185 Pirantel Pamoat Tab 125 mg Tablet 0
186 Pirazinamid Tab 500 mg Tablet 0
187 Pirimetamin Sulfadoksin Tab Tablet 0
188 Piroxicam Kap 20 mg Tablet 0
189 Prednison Tab 5 mg Tablet 0
190 Primakina Tab 15 mg Tablet 0
191 Propanolol Tab 40 mg Tablet 0
192 Propiltiourasil Tab 100 mg Tablet 0
193 Pyridoksin (Vit.B6) Tab 10 mg Tablet 0
194 Ranitidin Inj Ampul 309
195 Ranitidin Tab 150 mg Tablet 500
196 Reserpin Tab 0,25 mg Tablet 0
197 Rifampisin 300 mg Kapsul 0
198 Rifampisin 450 mg Kapsul 0
199 Rifampisin 600 mg Kapsul 0
200 Risperidon Tablet 0
201 Salbutamol Tab 2 mg Tablet 400
202 Salbutamol Tab 4mg Tablet 0
203 Salep 2-4 Komb Pot 85
204 Salisil Bedak 2% kotak 0
205 Sangobion Tablet 0
206 Serum Anti Tetanus (ATS) 1500 Vial 0
207 Sianokobalamin (Vit.B12) Inj Ampul 700
 208 Sianokobalamin Tab 50 mg Tablet 0
209 Simvastatin Tablet 200
210 Stesolid Rectal Tube 0
211 Streptomicin Inj Vial 0
212 Sulfacetamid Tts Mata 15 % Botol 0
213 Tetrasiklin Kaps 500 mg Kapsul 0
214 Thiamin (Vit.B1) Inj Ampul 0
215 Thiamin (Vit.B1) Tab 50 mg Tablet 400
216 Tiamphenikol Kap 500 mg Kapsul 0
217 Tiamphenikol Syrup Botol 0
218 Tramadol Tab 50 mg Tablet 0
219 Triheksifenidil Tab 2 mg Tablet 0
220 Ventolin 2,5 mg Tube 0
221 Vit. A Biru Kapsul 100
222 Vit. A merah Kapsul 300
223 Vit. B com Injeksi Tablet 0
224 Vit. B kompleks Tab Tablet 1500
225 Xylomidon Inj Vial 0
226 Zinc Dispersible 20 mg Tablet 1500
Cairan dan Larutan
226 Alkohol 70 % Liter 0
227 Alkohol Swabs kotak 0
228 Aquabidest 500 ml Botol 0
229 Aquadest 100 ml Botol 0
230 Aquadest 25 ml Botol 0
231 ASK Botol 0
232 Glukosa Infus 10 % Botol 0
233 Glukosa Infus 5 % Botol 0
234 HCL 0,1 N 100 ML Botol 0
235 H2O2 3 % Botol 0
236 Lisol 50 % Botol 0
237 NaCl Infus 0,9 % Botol 0
238 Povidon Iodida 10% Botol 0
239 Ringer Laktat Infus Botol 0
240 Rivanol Lar 0,1 % 300ml Botol 0
241 Yodium Povidon 1000 ml Botol 0
242 Yodium Povidon 30 ml Botol 0
243 Yodium Povidon 300 ml kotak 0
Alat Kesehatan
243 Abbocath 16 G vasofix pcs 0
244 Abbocath 18 G vasofix pcs 0
245 Abbocath 20 G vasofix pcs 0
246 Abbocath 21 G vasofix pcs 0
247 Abbocath 24 G vasofix pcs 0
248 Abbocath 25 G vasofix pcs 0
249 Abbocath 27 G vasofix pcs 0
250 Alat Suntik Dispo 0,05 ml pcs 150
251 Alat Suntik Dispo 0,5 ml pcs 0
252 Alat Suntik Dispo 1 ml pcs 0
253 Alat Suntik Dispo 3 ml pcs 0
254 Alat Suntik Dispo 10 ml pcs 0
255 Alat Suntik Dispo 5 ml pcs 0
256 Aesculap blades Bisturi pcs 0
257 Catgut 2/0 (2 metric) pcs 0
258 Catgut 2/0 (3 metric) pcs 0
259 Catgut 2/0 (3,5 metric)DS-19 pcs 0
260 Catgut 2/0 (3,5 metric)DS-30 pcs 0
261 Catgut 2/0 with needle pcs 0
262 Catgut 3/0 (2 metric) pcs 0
263 Catgut Chromic no 3 pcs 0
264 Catgut chromic no 6 pcs 0
265 Coverplast pcs 0
266 Daryant Tulle kotak 0
268 Handschon M kotak 0
269 Handschon No.7 Steril pcs 0
270 Handschon No.7,5 pcs 0
271 Handschon S kotak 0
272 Handschoon 6,5 kotak 0
273 Handschoon L kotak 0
274 Hypapix Plester pcs 0
275 Infusion Set Anak pcs 0
276 Infusion Set Dewasa pcs 0
277 Kapas Pembalut 1000 mg Rol 0
278 Kapas Pembalut 250 mg Rol 0
279 Kapas Pembalut 500 mg Rol 0
280 Kasa Hidrofil 4 m x 10 cm Elastiskotak 0
281 Kasa Hidrofil 4 y x 80 cm Rol 0
282 Kasa Kompres Steril 40/40 kotak 0
283 Kasa Pembalut 2 m X 80 cm Rol 0
284 Kertas puyer perkamen Rim 500
285 Kasa Panjang 40 x 80 cm rol 12
286 Lancet kotak 0
287 Lomatuel kotak 0
287 Masker Earloop pcs 197
288 Medicet 20 G pcs 0
289 Medicet 24 G pcs 0
 290 Needle 23 G X 1 1/4 pcs 0
291 Needle BR 10 pcs 0
292 Needle BR 13 pcs 0
293 Needle BR 16 pcs 0
294 Needle BT 27 pcs 0
295 Needle GT 10 pcs 0
296 Needle GT 12 pcs 0
297 Needle GT 14 pcs 0
298 Otopain Tube 0
299 Pembalut Gibs pcs 0
300 Plastik Obat 5 x 8 kotak 300
301 Plastik Obat 7 x 10 kotak 700
302 Plastik Obat 8,7 x 13 kotak 0
Plester 5 y X 2 Inch / leukoplas
303 Rol 0
7,5 x 4,5 cm
304 Stick Rapid IMS / Syipilis pcs 0
305 Stick Rapid HIV Pcs 0
306 Stick HBsAg pcs 3
307 Silk No 2/0 pcs 50
308 Strip Hb famili pcs 350
305 Strip Test Cholestrol pcs 100
306 Strip test Glucose pcs 0
307 Strip test Uric Acid pcs 0
308 Surgical Blade No. 11 pcs 0
309 Surgical Blade No. 15 pcs 0
310 Surgical Blade No. 21 pcs 0
311 Surgical Masker (Betali) pcs 0
312 Wing Needle No.21 G x 3/4 kotak 0
313 Wing Needle No.23 G kotak 0
314 Wing Needle No.25 G kotak 0
315 Wing Needle No.27 G kotak 0
Obat Gigi
316 champhenol kotak 0
317 Cresotin kotak 0
318 master bond kotak 0
319 Paramon chlorofenol kotak 0
320 Cimento de zinco Botol 0
321 Devitec Botol 0
322 Duron Group pcs 0
323 Etil Klorid Spray Botol 0
324 Eugenol cair Botol 0
325 Farmacol Forte Botol 0
326 Fletcher Liquid Botol 0
 327 Fletcher Powder Botol 0
328 Glass Ionemer Liquid 7,5 kotak 0
329 Glass Ionemer Powder 100 gr Kotak 0
330 iodotin Botol 0
331 Klorfenol Kamfer Mentol(CHKMBotol 0
332 Multifix Liquid Kotak 0
333 Multifix Powder Kotak 0
334 Natural Lock pcs 0
335 Pehacain inj Ampul 0
336 Phosphoric Acid Etchan 6 Kotak 0
337 Zitemp Botol 0
technew hydcal -paste base and
378 box
catalyst 0
denpro orafil plus temporary
339 Botol
filling 0
Laboratorium
340 Coverglass 18 X 18 pcs 0
341 Kartu Golda Lembar 0
342 Lancet pcs 0
343 Larutan HCl 1 % Botol 0
344 Pot sampel pcs 0
345 Rak Tabung reaksi pcs 0
346 Reagen Widal pcs 0
347 Slide pcs 0
348 Tabung Centrifuge pcs 0
349 One Med Test Kehamilan Instan pcs 0
350 0bjek glass 7105 box 0
351 Tabung EDTA 3 cc pcs 0
352 Anti A 10 ml (Gol-Darah) Botol 0
353 Anti AB 10 ml (Gol-Darah) Botol 0
354 Anti B 10 ml (Gol-Darah) Botol 0
356 Anti D 10 ml (Gol-Darah) Botol 0

Obat Tambahan
351 Batugin Tablet 0
352 Caviplex Tablet 0
353 Fondazen Tablet 0
354 Jeli USG Botol 0
357 Trombopop Tube 0
358 Vit. B com Injeksi Ampul 0
 359 Tramadol Injeksi Ampul 0
360 Loratadine Tablet 0
361 Dextral tablet 0
362 Antiseptic Botol 0
363 Doxycycline Tablet 0
364 Difenhidramin Injeksi Ampul 0
365 Zink Syrup Botol 0
366 Acetyl Sistem tab tablet 0
367 Alco Plus Syr btl 0
368 Curcuma Plus/Vitamin btl 0
369 ETABION Kapsul 0
370 reagen golongan darah kotak 0
371 silk surgiroll roll 0
372 Ambubag pcs 0
373 neek chler dewasa pcs 0
374 neek chler anak pcs 0
masker oksigen non rebreating
375 psc 0
Anak
376 nassal canule 02 'L' pcs 0
377 spalak psc 0
378 perlak underpad pcs 0
378 curcuma sharpy blackcurent 200 botol 0
ml
379 Cuticell Clasic 10 cm x 10cm pcs 0
380 Aesculap Blades (Bisturi) box 0
381 Plesterin bulat non woven pcs 0
382 Hansaplas pcs 0
383 I.V Catheter 20G (STERACTH) Pcs 0
384 Vasofik I.V Chateter No 18 pcs 0
389 Lumpang pcs 0
390 mortir pcs 0
391 suture needle hecting pcs 0
392 hipavix pcs 0
393 dermafix pcs 0
394 botol
Curcuma sharpy strawbery 60 ml 0
395 Curcuma Grow orange 200 ml botol 0
396 Metformin 850 mg tablet 0
397 Trepocheck sypilis pcs 0
Mengetahui Mengetahui
Kepala Puskesmas Sesua Kepala UPTD GFK Malinau
dr. Tumpak H.R. Sirait Selfie Palalangan S.Si
Nip. 19810313 200803 1 004 Nip. 19731127 200604 2 004
KAIAN DAN LEMBAR PERMINTAAN OBAT

PELAPORAN BULAN
PERMINTAAN BLN/PERIODE

STOK
PERSEDIAN PEMAKAIAN SISA STOK PERMINTAAN
OPS
5 357 50 Tube
25 100 250 Tablet
0 0
0 0
0 0
250 300 20 BOX
0 0
0 0 50 BOTOL
0 0 20 BOX
0 0
0 0
0 0
0 0 20 BOX
0 0
500 3200 20 BOX
10 12 2 KOTAK
0 0
200 200
10 70

0 0

0 0
500 2200 20 BOX
0 0 2 KOTAK
0 0
0 0
0 0
0 0
500 9700 20 BOX
0 0 20 BOX
300 300 20 BOX
0 0
0 0 50 TUBE
10 175 50 TUBE
 0 0
0 0
0 0
0 0 5 KOTAK
0 0
300 1700 10 KOTAK
200 1100
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
200 800 20 BOX
0 0
0 0
0 0
0 0
0 0
500 1500 20 BOX
0 0
0 0
0 0 10 AMPUL
200 300 20 BOX
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 20 BOX
0 0
0 0
0 0 10 BOX
0 0
0 0
0 0
0 0
0 0
0 0
 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 20 BOTOL
0 0 50 BOX
0 0 10 AMPUL
0 0
0 0
0 0
0 0
0 0
0 0
100 150 10 KOTAK
0 0
0 0 250 TUBE
0 0
0 0
300 100 30 BOX
0 0
0 0
0 0
0 0 10 BOX
0 0
0 0
8 8 250 TUBE
0 0 5 KOTAK
0 0
0 0 10 POT
0 0
0 0
0 0
0 0
0 0
0 0 20 BOX
0 0
100 100 10 BOX
0 0
0 0 200 TUBE
0 0 20 BOX
 0 0
0 0 10 BOX
0 0
0 0 10 BOX
0 0 100 TUBE
0 0
0 0 20 BOTOL
0 0 20 BOTOL
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 5 5 KOTAK
0 0
0 0
0 0 20 BOX
0 0 10 BOX
0 0 10 TUBE
0 0
0 0 10 BOX
0 0 10 BOX
0 0 20 BOX
200 650 10 BOX
200 350 20 BOX
0 0
0 0
0 0
0 0
0 0
0 0 20 BOX
0 0
0 0
0 4 24 BOTOL
0 0 10 BOX
0 0
300 300 20 BOX
0 0
0 0
 0 0
0 0
0 0
0 0
0 0 10 BOTOL
0 0
0 0
0 0
0 0
0 0
10 0 3 KOTAK
200 100 20 BOX
0 0
0 0
0 0 3 KOTAK
20 30 2 KOTAK
0 0
500 7200 20 BOX
0 0
0 0
0 0 10 BOX
0 0
0 0
0 0
0 0 10 BOX
0 0
0 0
0 0
0 0
5 304 3 KOTAK
200 300 10 BOX
0 0
0 0
0 0
0 0
0 0
100 300 10 BOX
0 0
5 80
0 0 20 KOTAK
0 0 10 KOTAK
0 0
500 200 10 KOTAK
 0 0
100 100 30 BOX
0 0
0 0
0 0
0 0
0 0
200 0 10 BOX
0 0 10 BOX
0 0
0 0
0 0
0 0
50 50 20 BOTOL
200 100 20 BOTOL
0 0 10 BOTOL
500 1000 20 BOX
0 0
500 1000 20 BOX

0 0 20 BOTOL
0 0 20 KOTAK
0 0 10 BOTOL
0 0 10 BOTOL
0 0
0 0
0 0 1 KOTAK
0 0
0 0
0 0 5 BOTOL
0 0 5 BOTOL
0 0 20 BOTOL
0 0 10 BOTOL
0 0 5 KOTAK
0 0 20 BOTOL
0 0
0 0
0 0

0 0
0 0
0 0
0 0
0 0
0 0
0 0
50 100
0 0
0 0 5 KOTAK
0 0 10 KOTAK
0 0
0 0 5 KOTAK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 10 KOTAK
0 0
0 0
0 0
0 0
0 0 10 KOTAK
0 0 10 KOTAK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 50 KOTAK
0 0
0 500
0 12
0 0 10 KOTAK
0 0
6 191 50 KOTAK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 300 50 PCS
0 700 50 PCS
0 0 20 PCS
0 0
0 0 3 KOTAK
0 0 5 KOTAK
0 3 5 KOTAK
0 0
0 350 5 KOTAK
100 0 250 KOTAK
0 0 250 KOTAK
0 0 250 KOTAK
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

0 0 5 KOTAK
0 0 5 KOTAK
0 0 5 KOTAK
0 0 5 KOTAK
0 0
0 0
0 0
0 0 5 KOTAK
0 0 5 KOTAK
0 0
0 0
0 0
0 0 5 KOTAK
0 0 5 KOTAK
0 0 5 KOTAK
0 0
0 0
0 0
0 0
0 0
0 0 5 KOTAK
0 0 5 KOTAK

0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 10 PCS
0 0
0 0
0 0
0 0

0 0 10 BOX
0 0
0 0
0 0 10 BOTOL
0 0 5 KOTAK
0 0
 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 20 BOX
0 0
0 0
0 0 10 BOX
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

0 0 10 KOTAK
0 0
0 0
0 0
Mengetahui
Petugas UPTD GFK Malinau Petugas Gudang Obat Puskesmas
Faris Dwi S. A.Md.,Far Trifena, A.Md.Farm
Nip. 19900805 201403 1 001 PTT
: MARET 2022
: TW 1

KETERANGAN EXD
gas Gudang Obat Puskesmas
Trifena, A.Md.Farm
PTT
 LAPORAN PEMAKAIAN DAN LEMBAR P
PUSKESMAS : SESUA
KECAMATAN : MALINAU BARAT
KABUPATEN : MALINAU

STOK
NO NAMA OBAT SATUAN PENERIMAAN
AWAL
1 Acyclovir Salep Kulit Tube 357 0
2 Acyclovir Tab 400 mg Tablet 100 250
3 Adrenalin Bitartat Ampul 0 0
4 Albendazole 400 mg Tablet 0 0
5 Alletrol tetes mata Botol 0 0
6 Allopurinol Tab 100 mg Tablet 300 2000
7 Alpara Tablet 0 0
8 Ambroxol Syr 15 mg/5 ml Botol 0 0
9 Ambroxol Tab 30 mg Tablet 0 2000
10 Aminofilin Inj 24 mg/ml Ampul 0 0
11 Aminofilin Tab 200 mg Tablet 0 0
12 Amitriptilin Tab 25 mg Tablet 0 0
13 Amlodipin 5 mg Tablet 0 2000
14 Amoksisillin Kap 250 mg Tablet 0 0
15 Amoksisillin Kap 500 mg Tablet 3200 2000
16 Amoksisillin Syr 125 mg/5 ml Botol 12 200
17 Ampicillin Injeksi Ampul 0 0
18 Ampisilin Kap 500 mg Tablet 200 0
19 Ampisilin Syr 125 mg/5 ml Botol 70 0
20 Antalgin Inj 250 mg/ml Ampul 0 0
21 Antalgin Tab 500 mg/ Metamozole Tablet 0 0
22 Antasid DOEN Tab Komb Tablet 2200 2000
23 Antasid Sirup Botol 0 120
24 Antifungi DOEN Pot 0 0
25 Antihaemoroid DOEN Komb Supp 0 0
26 Arsuamon Tab Tablet 0 0
27 Arterakine Tab Tablet 0 0
28 Asam Askorbat Tab 50 mg Tablet 9700 7000
29 Asam Folat 1 mg Tablet 0 2000
30 Asam Mefenamat Kap 500 mg Tablet 300 0
31 Atropin Sulfat Inj 0,25 mg/ml Ampul 0 0
32 Bacitrasin Salep Tube 0 0
33 Betametason Cream 0,1 % Tube 175 50
34 Bioplacenton Tube 0 0
35 Bromheksin Tablet 0 0
36 Bromheksin Sirup Botol 0 0
37 Burnazin Tube 0 0
38 Buscopan Tab 10 mg Tablet 0 0
39 Captopril 12,5 mg Tablet 1700 1000
Captopril 25 mg Tablet 1100 0
41 Cefixime Kaps 100 mg Kapsul 0 0
42 Cefixime Syrup Botol 0 0
43 Cendocetamide 15 % Botol 0 0
44 Cendotropin Tetes Mata Botol 0 0
45 Centabio Tube 0 0
46 Cephadroxil Kap 250 mg Kapsul 0 0
47 Cephadroxil Kap 500 mg Kapsul 0 0
48 Cephadroxil Syr Botol 0 0
49 Cetirizine Tablet 800 2000
50 Chefalexin Kap 500 mg Tablet 0 0
51 Cimetidine 200 mg Tablet 0 0
52 Cinolon N 10 gr Tube 0 0
53 Ciprofloxacin Tab 500 mg Tablet 0 0
54 Cohistin Syrup Botol 0 0
56 CTM Tab 4 mg Tablet 1500 2000
57 Curcuma Tablet 0 0
58 Curliv Syrup/Multivitamin syr Botol 0 0
59 Deksametason Inj 5 mg/ml Ampul 0 10
60 Deksametason Tab 0,5 mg Tablet 300 0
61 Dekstrometorfan HBr 15 mg Tablet 0 0
62 Dekstrometorfan Syr Botol 0 0
63 Diazepam Inj 5 mg/ml Ampul 0 0
64 Diazepam Tab 2 mg Tablet 0 0
65 Diclofam 50 mg Tablet 0 0
66 Digoksin Tab 0,25 mg Tablet 0 0
67 Diltiazem Tab 30 Mg Tablet 0 0
68 Domperidon Tab Tablet 0 0
69 Doxycicline Kaps 100 mg Kapsul 0 0
70 Dulcolax Supp Anak Supp 0 0
71 Dulcolax/bisakodil Tab 5 mg Tablet 0 0
72 Dumin Tablet 0 0
73 Efedrin Tab 25 mg Tablet 0 0
74 Efinefrin Inj 0,1 % Ampul 0 0
75 Ekstrak Belladon Tab 10 mg Tablet 0 0
76 Elkana Tablet 0 0
77 Ergotamin Koffein Tab Tablet 0 0
78 Erlamicetine Botol 0 0
79 Erytromisin Kap 500 mg Kapsul 0 0
80 Erytromisin Syr 125 mg/ 5 ml Botol 0 0
 81 Etambutol Tab 500 mg Tablet 0 0
82 Famotidin 20 mg/40 mg Tablet 0 0
83 Fenobarbital Inj 50 mg/ml Ampul 0 0
84 Fenobarbital Tab 30 mg Tablet 0 0
85 Fenol Gliserol Tts Telinga 10 % Botol 0 20
86 Ferrous Sulfat Tab Tablet 0 0
87 Fitomenadion (Vit.K) Inj Ampul 0 10
88 Fitomenadion (Vit.K) Tab Tablet 0 0
89 Fitomenadion (Vit.K3) Inj Ampul 0 0
90 Fluoroscein Tetes Mata 2 % Botol 0 0
91 Furosemid Inj 10 ml Ampul 0 0
92 Furosemid Tab 40 mg Tablet 0 0
93 Gamexan Emulsi 1 % Botol 0 0
94 Garam Oralit 200 ml Sachet 150 1000
95 Genoit Salep Mata Tube 0 0
96 Gentamisin Salep Kulit Tube 0 0
98 Gentamisin Tetes Mata Botol 0 0
99 Gentian Violet Lar 1 % Botol 0 0
100 GG Tab 100 mg Tablet 100 3000
101 Glibenklamid Tab 5 mg Tablet 0 0
102 Glimepiride 2 mg Tablet 0 0
103 Glimepiride 4 mg Tablet 0 0
104 Griseofulvin Tab 125 mg Tablet 0 0
105 Griseofulvin Tab 500 mg Tablet 0 0
106 Haloperidol Tab 0,5 mg Tablet 0 0
107 Hidrokortison Cream 2,5 % Tube 8 240
108 Ibuprofen syr botol 0 60
109 Ibuprofen Tab 400 mg Tablet 0 0
110 Ichtiyol Salep Pot 0 0
111 INH Tab 100 mg Tablet 0 0
112 INH Tab 300 mg Tablet 0 0
113 Inmatrol Tetes Mata Botol 0 0
114 Inpepsa Sirup Botol 0 0
115 Isosorbid Dinitrat Tab 10mg Tablet 0 0
116 Kalium Diklofenak Tab 50 mg Tablet 0 0
117 Kalium Permanganat Tablet 0 0
118 Kalsium Laktat Tab 500 mg Tablet 100 1000
119 Kanamicyn Inj Vial 0 0
120 Ketokonazole Cream 2 % Tube 0 200
121 Ketokonazole Tab 200 mg Tablet 0 0
122 Kinina Tab 222 mg Tablet 0 0
123 Klindamisin 150 mg Kapsul 0 0
124 Klindamisin 300 mg Kapsul 0 1000
125 Kloramfenikol Kaps 250 mg Kapsul 0 0
126 Kloramfenikol Salep Mata 1 % Tube 0 120
127 Kloramfenikol Syr 125 mg/5 ml Botol 0 0
128 Kloramfenikol Tetes Mata Botol 0 0
129 Kloramfenikol Tetes Telinga 3 % Botol 0 0
130 Klorpromazin 100 mg Tablet 0 0
131 Kodein Tab 10 mg Tablet 0 0
132 Kotrimoksazol syr 240 mg/5 ml Botol 0 0
133 Kotrimoksazol Tab 120 mg Tablet 0 0
134 Kotrimoksazol Tab 400 mg Tablet 0 0
135 Lacbon Tablet 0 0
136 Lanzoprazole Kapsul 0 0
137 Levertran Salep Tube 0 0
138 Levofloxacin Tab 500 mg Tablet 0 0
139 Lidokain komb Inj Ampul 5 150
140 Livron B Plex Tablet 0 0
141 Lodia Tablet 0 0
142 Loperamid Tablet 0 0
143 Loratadin 10 mg Tablet 0 0
144 Lubricating Jelly Tube 0 12
145 Mebendazol Tab 100 mg Tablet 0 0
146 Mediamere Tablet 0 0
147 Meloxicam 15 mg Tablet 0 0
148 Meloxicam 7,5 mg Tablet 0 0
149 Metformin 500 mg Tablet 650 0
150 Methil Prednisolon Tab 4 mg Tablet 350 0
151 Methil Prednisolon Tab 8 mg Tablet 0 0
152 Metil Ergometrin Inj Ampul 0 0
153 Metil ergometrin Tab 0,125 mg Tablet 0 0
154 Metoch / Ethiferan Inj 5 mg Ampul 0 0
155 Metoklopramid Tab 10 mg Tablet 0 0
156 Metronidazol Tab 250 mg Tablet 0 0
157 Metronidazol Tab 500 mg Tablet 0 0
158 Miconazol Salep Tube 0 0
159 Minyak Kayu Putih Botol 4 0
160 Molagit Tablet 0 0
161 Molexdryl Sirup Botol 0 0
162 Na.Diklofenak Tab 25 mg Tablet 300 1000
163 Na.Diklofenak Tab 50 mg Tablet 0 1000
164 Nifedipin Tab Tablet 0 0
165 Nistatin Supp Supp 0 0
166 Nistatin Tab Tablet 0 0
167 Nitral Vial 0 0
168 Obat Tambah Darah Tablet 0 0
169 OBH Sirup Botol 0 0
170 Ofloxacin Tab 200 mg Tablet 0 0
171 Ofloxacin Tab 400 mg Tablet 0 0
172 Oksitetrasiklin Inj 50 mg/vial Vial 0 0
173 Oksitetrasiklin Salep Kulit 3 % Tube 0 0
174 Oksitetrasiklin Salep Mata 1 % Tube 0 0
175 Oksitosin Inj 10 iu/ml Ampul 0 0
176 Omeprazole Kaps 20 mg Tablet 100 4000
177 ondasteron inj ampul 0 0
178 Papaverin Tab 40 mg Tablet 0 0
179 Paracetamol drops Botol 0 288
180 Paracetamol Syr 120 mg/5 ml Botol 30 200
181 Paracetamol Tab 100 mg Tablet 0 0
182 Paracetamol Tab 500 mg Tablet 7200 2000
183 Peditox Botol 0 0
184 Piracetam Inj Ampul 0 0
185 Pirantel Pamoat Tab 125 mg Tablet 0 2000
186 Pirazinamid Tab 500 mg Tablet 0 0
187 Pirimetamin Sulfadoksin Tab Tablet 0 0
188 Piroxicam Kap 20 mg Tablet 0 0
189 Prednison Tab 5 mg Tablet 0 1000
190 Primakina Tab 15 mg Tablet 0 0
191 Propanolol Tab 40 mg Tablet 0 0
192 Propiltiourasil Tab 100 mg Tablet 0 0
193 Pyridoksin (Vit.B6) Tab 10 mg Tablet 0 0
194 Ranitidin Inj Ampul 304 50
195 Ranitidin Tab 150 mg Tablet 300 1000
196 Reserpin Tab 0,25 mg Tablet 0 0
197 Rifampisin 300 mg Kapsul 0 0
198 Rifampisin 450 mg Kapsul 0 0
199 Rifampisin 600 mg Kapsul 0 0
200 Risperidon Tablet 0 0
201 Salbutamol Tab 2 mg Tablet 300 0
202 Salbutamol Tab 4mg Tablet 0 0
203 Salep 2-4 Komb Pot 80 0
204 Salisil Bedak 2% kotak 0 0
205 Sangobion Tablet 0 0
206 Serum Anti Tetanus (ATS) 1500 IU/ Vial 0 0
207 Sianokobalamin (Vit.B12) Inj Ampul 200 0
208 Sianokobalamin Tab 50 mg Tablet 0 0
209 Simvastatin Tablet 100 3000
210 Stesolid Rectal Tube 0 0
 211 Streptomicin Inj Vial 0 0
212 Sulfacetamid Tts Mata 15 % Botol 0 0
213 Tetrasiklin Kaps 500 mg Kapsul 0 0
214 Thiamin (Vit.B1) Inj Ampul 0 0
215 Thiamin (Vit.B1) Tab 50 mg Tablet 0 600
216 Tiamphenikol Kap 500 mg Kapsul 0 0
217 Tiamphenikol Syrup Botol 0 0
218 Tramadol Tab 50 mg Tablet 0 0
219 Triheksifenidil Tab 2 mg Tablet 0 0
220 Ventolin 2,5 mg Tube 0 0
221 Vit. A Biru Kapsul 50 0
222 Vit. A merah Kapsul 100 0
223 Vit. B com Injeksi Tablet 0 0
224 Vit. B kompleks Tab Tablet 1000 2000
225 Xylomidon Inj Vial 0 0
226 Zinc Dispersible 20 mg Tablet 1000 2000
Cairan dan Larutan
226 Alkohol 70 % Liter 0 20
227 Alkohol Swabs kotak 0 1000
228 Aquabidest 500 ml Botol 0 0
229 Aquadest 100 ml Botol 0 0
230 Aquadest 25 ml Botol 0 0
231 ASK Botol 0 0
232 Glukosa Infus 10 % Botol 0 20
233 Glukosa Infus 5 % Botol 0 0
234 HCL 0,1 N 100 ML Botol 0 0
235 H2O2 3 % Botol 0 0
236 Lisol 50 % Botol 0 0
237 NaCl Infus 0,9 % Botol 0 20
238 Povidon Iodida 10% Botol 0 24
239 Ringer Laktat Infus Botol 0 100
240 Rivanol Lar 0,1 % 300ml Botol 0 0
241 Yodium Povidon 1000 ml Botol 0 0
242 Yodium Povidon 30 ml Botol 0 0
243 Yodium Povidon 300 ml kotak 0 0
Alat Kesehatan
243 Abbocath 16 G vasofix pcs 0 0
244 Abbocath 18 G vasofix pcs 0 0
245 Abbocath 20 G vasofix pcs 0 0
246 Abbocath 21 G vasofix pcs 0 0
247 Abbocath 24 G vasofix pcs 0 0
248 Abbocath 25 G vasofix pcs 0 0
249 Abbocath 27 G vasofix pcs 0 0
250 Alat Suntik Dispo 0,05 ml pcs 100 0
251 Alat Suntik Dispo 0,5 ml pcs 0 0
252 Alat Suntik Dispo 1 ml pcs 0 500
253 Alat Suntik Dispo 3 ml pcs 0 0
254 Alat Suntik Dispo 10 ml pcs 0 0
255 Alat Suntik Dispo 5 ml pcs 0 300
256 Aesculap blades Bisturi pcs 0 0
257 Catgut 2/0 (2 metric) pcs 0 0
258 Catgut 2/0 (3 metric) pcs 0 0
259 Catgut 2/0 (3,5 metric)DS-19 pcs 0 0
260 Catgut 2/0 (3,5 metric)DS-30 pcs 0 0
261 Catgut 2/0 with needle pcs 0 0
262 Catgut 3/0 (2 metric) pcs 0 0
263 Catgut Chromic no 3 pcs 0 0
264 Catgut chromic no 6 pcs 0 0
265 Coverplast pcs 0 0
266 Daryant Tulle kotak 0 0
268 Handschon M kotak 0 0
269 Handschon No.7 Steril pcs 0 0
270 Handschon No.7,5 pcs 0 0
271 Handschon S kotak 0 0
272 Handschoon 6,5 kotak 0 0
273 Handschoon L kotak 0 10
274 Hypapix Plester pcs 0 0
275 Infusion Set Anak pcs 0 0
276 Infusion Set Dewasa pcs 0 0
277 Kapas Pembalut 1000 mg Rol 0 0
278 Kapas Pembalut 250 mg Rol 0 0
279 Kapas Pembalut 500 mg Rol 0 0
280 Kasa Hidrofil 4 m x 10 cm Elastis kotak 0 0
281 Kasa Hidrofil 4 y x 80 cm Rol 0 0
282 Kasa Kompres Steril 40/40 kotak 0 100
283 Kasa Pembalut 2 m X 80 cm Rol 0 0
284 Kertas puyer perkamen Rim 500 0
285 Kasa Panjang 40 x 80 cm rol 12 0
286 Lancet kotak 0 1000
287 Lomatuel kotak 0 0
287 Masker Earloop pcs 191 0
288 Medicet 20 G pcs 0 0
289 Medicet 24 G pcs 0 0
290 Needle 23 G X 1 1/4 pcs 0 0
291 Needle BR 10 pcs 0 0
292 Needle BR 13 pcs 0 0
 293 Needle BR 16 pcs 0 0
294 Needle BT 27 pcs 0 0
295 Needle GT 10 pcs 0 0
296 Needle GT 12 pcs 0 0
297 Needle GT 14 pcs 0 0
298 Otopain Tube 0 0
299 Pembalut Gibs pcs 0 0
300 Plastik Obat 5 x 8 kotak 300 10
301 Plastik Obat 7 x 10 kotak 700 10
302 Plastik Obat 8,7 x 13 kotak 0 10
Plester 5 y X 2 Inch / leukoplas 7,5 x
303 Rol 0 0
4,5 cm
304 Stick Rapid IMS / Syipilis pcs 0 0
305 Stick Rapid HIV Pcs 0 0
306 Stick HBsAg pcs 3 3
307 Silk No 2/0 pcs 0 0
308 Strip Hb famili pcs 350 125
305 Strip Test Cholestrol pcs 0 0
306 Strip test Glucose pcs 0 250
307 Strip test Uric Acid pcs 0 0
308 Surgical Blade No. 11 pcs 0 0
309 Surgical Blade No. 15 pcs 0 0
310 Surgical Blade No. 21 pcs 0 0
311 Surgical Masker (Betali) pcs 0 0
312 Wing Needle No.21 G x 3/4 kotak 0 0
313 Wing Needle No.23 G kotak 0 0
314 Wing Needle No.25 G kotak 0 0
315 Wing Needle No.27 G kotak 0 0
Obat Gigi
316 champhenol kotak 0 0
317 Cresotin kotak 0 0
318 master bond kotak 0 5
319 Paramon chlorofenol kotak 0 5
320 Cimento de zinco Botol 0 0
321 Devitec Botol 0 0
322 Duron Group pcs 0 0
323 Etil Klorid Spray Botol 0 10
324 Eugenol cair Botol 0 5
325 Farmacol Forte Botol 0 0
326 Fletcher Liquid Botol 0 0
327 Fletcher Powder Botol 0 0
328 Glass Ionemer Liquid 7,5 kotak 0 0
329 Glass Ionemer Powder 100 gr Kotak 0 0
 330 iodotin Botol 0 5
331 Klorfenol Kamfer Mentol(CHKM) Botol 0 0
332 Multifix Liquid Kotak 0 0
333 Multifix Powder Kotak 0 0
334 Natural Lock pcs 0 0
335 Pehacain inj Ampul 0 0
336 Phosphoric Acid Etchan 6 Kotak 0 0
337 Zitemp Botol 0 5
technew hydcal -paste base and
378 box
catalyst 0 0
339 denpro orafil plus temporary filling Botol 0 0
Laboratorium 0 0
340 Coverglass 18 X 18 pcs 0 0
341 Kartu Golda Lembar 0 0
342 Lancet pcs 0 0
343 Larutan HCl 1 % Botol 0 0
344 Pot sampel pcs 0 0
345 Rak Tabung reaksi pcs 0 0
346 Reagen Widal pcs 0 0
347 Slide pcs 0 0
348 Tabung Centrifuge pcs 0 0
349 One Med Test Kehamilan Instan pcs 0 0
350 0bjek glass 7105 box 0 0
351 Tabung EDTA 3 cc pcs 0 0
352 Anti A 10 ml (Gol-Darah) Botol 0 0
353 Anti AB 10 ml (Gol-Darah) Botol 0 0
354 Anti B 10 ml (Gol-Darah) Botol 0 0
356 Anti D 10 ml (Gol-Darah) Botol 0 0

Obat Tambahan
351 Batugin Tablet 0 0
352 Caviplex Tablet 0 0
353 Fondazen Tablet 0 0
354 Jeli USG Botol 0 0
357 Trombopop Tube 0 0
358 Vit. B com Injeksi Ampul 0 0
359 Tramadol Injeksi Ampul 0 0
360 Loratadine Tablet 0 0
361 Dextral tablet 0 0
362 Antiseptic Botol 0 0
 363 Doxycycline Tablet 0 0
364 Difenhidramin Injeksi Ampul 0 0
365 Zink Syrup Botol 0 0
366 Acetyl Sistem tab tablet 0 0
367 Alco Plus Syr btl 0 0
368 Curcuma Plus/Vitamin btl 0 0
369 ETABION Kapsul 0 0
370 reagen golongan darah kotak 0 0
371 silk surgiroll roll 0 0
372 Ambubag pcs 0 0
373 neek chler dewasa pcs 0 0
374 neek chler anak pcs 0 0
375 masker oksigen non rebreating Anak psc 0 0
376 nassal canule 02 'L' pcs 0 0
377 spalak psc 0 0
378 perlak underpad pcs 0 0
378 curcuma sharpy blackcurent 200 ml botol 0 0
379 Cuticell Clasic 10 cm x 10cm pcs 0 0
380 Aesculap Blades (Bisturi) box 0 0
381 Plesterin bulat non woven pcs 0 0
382 Hansaplas pcs 0 0
383 I.V Catheter 20G (STERACTH) Pcs 0 0
384 Vasofik I.V Chateter No 18 pcs 0 0
389 Lumpang pcs 0 0
390 mortir pcs 0 0
391 suture needle hecting pcs 0 0
392 hipavix pcs 0 0
393 dermafix pcs 0 0
394 Curcuma sharpy strawbery 60 ml botol 0 0
395 Curcuma Grow orange 200 ml botol 0 0
396 Metformin 850 mg tablet 0 0
397 Trepocheck sypilis pcs 0 0
Mengetahui Mengetahui
Kepala Puskesmas Sesua Kepala UPTD GFK Malinau

Eddy Aryadie. A.Md.,Kl Selfie Palalangan S.Si

Nip. 19750218 200502 1001 Nip. 19731127 200604 2 004
AN DAN LEMBAR PERMINTAAN OBAT

PELAPORAN BULAN : APRIL 2022

PERMINTAAN BLN/PERIODE : TW 2

STOK KETERANGAN
PERSEDIAN PEMAKAIAN SISA STOK PERMINTAAN
OPS EXD
0 24 583
0 24 350
0 0 0
0 0 0
0 0 0
0 200 2300
0 0 0
0 0 0
0 300 1700
0 0 0
0 0 0
0 0 0
0 200 1800
0 0 0
0 500 5200
0 10 212
0 0 0
0 100 100
0 30 40
0 0 0
0 0 0
0 500 3700
0 10 110
0 0 0
0 0 0
0 0 0
0 0 0
0 500 16200
0 300 1700
0 100 200
0 0 0
0 0 0
0 24 225
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 300 2400
0 300 800
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 300 2500
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 500 3000
0 0 0
0 0 0
0 2 8
0 200 100
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 5 15
0 0 0
0 2 8
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 100 1050
0 0 0
0 0 0
0 0 0
0 0 0
0 300 2800
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 24 224
0 5 55
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 300 900
0 0 0
0 100 100
0 0 0
0 0 0
0 0 0
0 0 1000
0 0 0
0 0 120
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 5 150
0 0 0
0 0 0
0 0 0
0 0 0
0 2 10
0 0 0
0 0 0
0 0 0
0 0 0
0 200 550
0 100 250
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 4 0
0 0 0
0 0 0
0 200 1100
0 200 800
0 0 0
0 0 0
0 0 0
0 0 0
 0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
10 0 0
0 200 3700
0 0 0
0 0 0
0 10 278
0 30 200
0 0 0
0 300 6900
0 0 0
0 0 0
0 100 1900
0 0 0
0 0 0
0 0 0
0 300 700
0 0 0
0 0 0
0 0 0
0 0 0
0 5 349
0 200 1100
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 200 100
0 0 0
0 5 75
0 0 0
0 0 0
0 0 0
500 0 0
0 0 0
0 300 2800
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 100 500
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 50 0
0 50 50
0 0 0
0 500 2500
0 0 0
0 5000 2500

0 3 17
0 400 600
0 0 0
0 0 0
0 0 0
0 0 0
0 0 20
0 0 0
0 0 0
0 0 0
0 0 0
0 5 15
0 2 22
0 5 95
0 0 0
0 0 0
0 0 0
0 0 0

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 50
0 0 0
0 100 400
0 0 0
0 0 0
0 100 200
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 2 8
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 5 95
0 0 0
0 50 450
0 2 10
0 0 0
0 0 0
0 6 185
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
 0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 5 305
0 0 710
0 0 10
0 0 0
0 0 0
0 0 0
0 3 3
0 0 0
0 75 400
100 0 0
0 100 150
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

0 0 0
0 0 0
0 2 3
0 2 3
0 0 0
0 0 0
0 0 0
0 3 7
0 0 5
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0
0
0 0 0
0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
 0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
Mengetahui
Petugas UPTD GFK Malinau Petugas Gudang Obat Puskesmas

Faris Dwi S. A.Md.,Far Trifena, A.Md.Farm

Nip. 19900805 201403 1 001 PTT
 LAPORAN PEMAKAIAN DAN LEMBA
PUSKESMAS : SESUA
KECAMATAN : MALINAU BARAT
KABUPATEN : MALINAU

STOK
NO NAMA OBAT SATUAN PENERIMAAN
AWAL
1 Acyclovir Salep Kulit Tube 583
2 Acyclovir Tab 400 mg Tablet 350
3 Adrenalin Bitartat Ampul 0
4 Albendazole 400 mg Tablet 0
5 Alletrol tetes mata Botol 0
6 Allopurinol Tab 100 mg Tablet 2300
7 Alpara Tablet 0
8 Ambroxol Syr 15 mg/5 ml Botol 0
9 Ambroxol Tab 30 mg Tablet 1700
10 Aminofilin Inj 24 mg/ml Ampul 0
11 Aminofilin Tab 200 mg Tablet 0
12 Amitriptilin Tab 25 mg Tablet 0
13 Amlodipin 5 mg Tablet 1800
14 Amoksisillin Kap 250 mg Tablet 0
15 Amoksisillin Kap 500 mg Tablet 5200
16 Amoksisillin Syr 125 mg/5 ml Botol 212
17 Ampicillin Injeksi Ampul 0
18 Ampisilin Kap 500 mg Tablet 100
19 Ampisilin Syr 125 mg/5 ml Botol 40
20 Antalgin Inj 250 mg/ml Ampul 0
Antalgin Tab 500 mg/
21 Tablet
Metamozole 0
22 Antasid DOEN Tab Komb Tablet 3700
23 Antasid Sirup Botol 110
24 Antifungi DOEN Pot 0
25 Antihaemoroid DOEN Komb Supp 0
26 Arsuamon Tab Tablet 0
27 Arterakine Tab Tablet 0
28 Asam Askorbat Tab 50 mg Tablet 16200
29 Asam Folat 1 mg Tablet 1700
30 Asam Mefenamat Kap 500 mg Tablet 200
31 Atropin Sulfat Inj 0,25 mg/ml Ampul 0
32 Bacitrasin Salep Tube 0
33 Betametason Cream 0,1 % Tube 225
34 Bioplacenton Tube 0
35 Bromheksin Tablet 0
36 Bromheksin Sirup Botol 0
37 Burnazin Tube 0
38 Buscopan Tab 10 mg Tablet 0
39 Captopril 12,5 mg Tablet 2400
Captopril 25 mg Tablet 800
41 Cefixime Kaps 100 mg Kapsul 0
42 Cefixime Syrup Botol 0
43 Cendocetamide 15 % Botol 0
44 Cendotropin Tetes Mata Botol 0
45 Centabio Tube 0
46 Cephadroxil Kap 250 mg Kapsul 0
47 Cephadroxil Kap 500 mg Kapsul 0
48 Cephadroxil Syr Botol 0
49 Cetirizine Tablet 2500
50 Chefalexin Kap 500 mg Tablet 0
51 Cimetidine 200 mg Tablet 0
52 Cinolon N 10 gr Tube 0
53 Ciprofloxacin Tab 500 mg Tablet 0
54 Cohistin Syrup Botol 0
56 CTM Tab 4 mg Tablet 3000
57 Curcuma Tablet 0
58 Curliv Syrup/Multivitamin syr Botol 0
59 Deksametason Inj 5 mg/ml Ampul 8
60 Deksametason Tab 0,5 mg Tablet 100
61 Dekstrometorfan HBr 15 mg Tablet 0
62 Dekstrometorfan Syr Botol 0
63 Diazepam Inj 5 mg/ml Ampul 0
64 Diazepam Tab 2 mg Tablet 0
65 Diclofam 50 mg Tablet 0
66 Digoksin Tab 0,25 mg Tablet 0
67 Diltiazem Tab 30 Mg Tablet 0
68 Domperidon Tab Tablet 0
69 Doxycicline Kaps 100 mg Kapsul 0
70 Dulcolax Supp Anak Supp 0
71 Dulcolax/bisakodil Tab 5 mg Tablet 0
72 Dumin Tablet 0
73 Efedrin Tab 25 mg Tablet 0
74 Efinefrin Inj 0,1 % Ampul 0
75 Ekstrak Belladon Tab 10 mg Tablet 0
76 Elkana Tablet 0
77 Ergotamin Koffein Tab Tablet 0
78 Erlamicetine Botol 0
79 Erytromisin Kap 500 mg Kapsul 0
 80 Erytromisin Syr 125 mg/ 5 ml Botol 0
81 Etambutol Tab 500 mg Tablet 0
82 Famotidin 20 mg/40 mg Tablet 0
83 Fenobarbital Inj 50 mg/ml Ampul 0
84 Fenobarbital Tab 30 mg Tablet 0
85 Fenol Gliserol Tts Telinga 10 % Botol 15
86 Ferrous Sulfat Tab Tablet 0
87 Fitomenadion (Vit.K) Inj Ampul 8
88 Fitomenadion (Vit.K) Tab Tablet 0
89 Fitomenadion (Vit.K3) Inj Ampul 0
90 Fluoroscein Tetes Mata 2 % Botol 0
91 Furosemid Inj 10 ml Ampul 0
92 Furosemid Tab 40 mg Tablet 0
93 Gamexan Emulsi 1 % Botol 0
94 Garam Oralit 200 ml Sachet 1050
95 Genoit Salep Mata Tube 0
96 Gentamisin Salep Kulit Tube 0
98 Gentamisin Tetes Mata Botol 0
99 Gentian Violet Lar 1 % Botol 0
100 GG Tab 100 mg Tablet 2800
101 Glibenklamid Tab 5 mg Tablet 0
102 Glimepiride 2 mg Tablet 0
103 Glimepiride 4 mg Tablet 0
104 Griseofulvin Tab 125 mg Tablet 0
105 Griseofulvin Tab 500 mg Tablet 0
106 Haloperidol Tab 0,5 mg Tablet 0
107 Hidrokortison Cream 2,5 % Tube 224
108 Ibuprofen syr botol 55
109 Ibuprofen Tab 400 mg Tablet 0
110 Ichtiyol Salep Pot 0
111 INH Tab 100 mg Tablet 0
112 INH Tab 300 mg Tablet 0
113 Inmatrol Tetes Mata Botol 0
114 Inpepsa Sirup Botol 0
115 Isosorbid Dinitrat Tab 10mg Tablet 0
116 Kalium Diklofenak Tab 50 mg Tablet 0
117 Kalium Permanganat Tablet 0
118 Kalsium Laktat Tab 500 mg Tablet 900
119 Kanamicyn Inj Vial 0
120 Ketokonazole Cream 2 % Tube 100
121 Ketokonazole Tab 200 mg Tablet 0
122 Kinina Tab 222 mg Tablet 0
123 Klindamisin 150 mg Kapsul 0
124 Klindamisin 300 mg Kapsul 1000
125 Kloramfenikol Kaps 250 mg Kapsul 0
126 Kloramfenikol Salep Mata 1 % Tube 120
127 Kloramfenikol Syr 125 mg/5 ml Botol 0
128 Kloramfenikol Tetes Mata Botol 0
129 Kloramfenikol Tetes Telinga 3 % Botol 0
130 Klorpromazin 100 mg Tablet 0
131 Kodein Tab 10 mg Tablet 0
132 Kotrimoksazol syr 240 mg/5 ml Botol 0
133 Kotrimoksazol Tab 120 mg Tablet 0
134 Kotrimoksazol Tab 400 mg Tablet 0
135 Lacbon Tablet 0
136 Lanzoprazole Kapsul 0
137 Levertran Salep Tube 0
138 Levofloxacin Tab 500 mg Tablet 0
139 Lidokain komb Inj Ampul 150
140 Livron B Plex Tablet 0
141 Lodia Tablet 0
142 Loperamid Tablet 0
143 Loratadin 10 mg Tablet 0
144 Lubricating Jelly Tube 10
145 Mebendazol Tab 100 mg Tablet 0
146 Mediamere Tablet 0
147 Meloxicam 15 mg Tablet 0
148 Meloxicam 7,5 mg Tablet 0
149 Metformin 500 mg Tablet 550
150 Methil Prednisolon Tab 4 mg Tablet 250
151 Methil Prednisolon Tab 8 mg Tablet 0
152 Metil Ergometrin Inj Ampul 0
153 Metil ergometrin Tab 0,125 mg Tablet 0
154 Metoch / Ethiferan Inj 5 mg Ampul 0
155 Metoklopramid Tab 10 mg Tablet 0
156 Metronidazol Tab 250 mg Tablet 0
157 Metronidazol Tab 500 mg Tablet 0
158 Miconazol Salep Tube 0
159 Minyak Kayu Putih Botol 0
160 Molagit Tablet 0
161 Molexdryl Sirup Botol 0
162 Na.Diklofenak Tab 25 mg Tablet 1100
163 Na.Diklofenak Tab 50 mg Tablet 800
164 Nifedipin Tab Tablet 0
165 Nistatin Supp Supp 0
166 Nistatin Tab Tablet 0
167 Nitral Vial 0
168 Obat Tambah Darah Tablet 0
169 OBH Sirup Botol 0
170 Ofloxacin Tab 200 mg Tablet 0
171 Ofloxacin Tab 400 mg Tablet 0
172 Oksitetrasiklin Inj 50 mg/vial Vial 0
173 Oksitetrasiklin Salep Kulit 3 % Tube 0
174 Oksitetrasiklin Salep Mata 1 % Tube 0
175 Oksitosin Inj 10 iu/ml Ampul 0
176 Omeprazole Kaps 20 mg Tablet 3700
177 ondasteron inj ampul 0
178 Papaverin Tab 40 mg Tablet 0
179 Paracetamol drops Botol 278
180 Paracetamol Syr 120 mg/5 ml Botol 200
181 Paracetamol Tab 100 mg Tablet 0
182 Paracetamol Tab 500 mg Tablet 6900
183 Peditox Botol 0
184 Piracetam Inj Ampul 0
185 Pirantel Pamoat Tab 125 mg Tablet 1900
186 Pirazinamid Tab 500 mg Tablet 0
187 Pirimetamin Sulfadoksin Tab Tablet 0
188 Piroxicam Kap 20 mg Tablet 0
189 Prednison Tab 5 mg Tablet 700
190 Primakina Tab 15 mg Tablet 0
191 Propanolol Tab 40 mg Tablet 0
192 Propiltiourasil Tab 100 mg Tablet 0
193 Pyridoksin (Vit.B6) Tab 10 mg Tablet 0
194 Ranitidin Inj Ampul 349
195 Ranitidin Tab 150 mg Tablet 1100
196 Reserpin Tab 0,25 mg Tablet 0
197 Rifampisin 300 mg Kapsul 0
198 Rifampisin 450 mg Kapsul 0
199 Rifampisin 600 mg Kapsul 0
200 Risperidon Tablet 0
201 Salbutamol Tab 2 mg Tablet 100
202 Salbutamol Tab 4mg Tablet 0
203 Salep 2-4 Komb Pot 75
204 Salisil Bedak 2% kotak 0
205 Sangobion Tablet 0
206 Serum Anti Tetanus (ATS) 1500 Vial 0
207 Sianokobalamin (Vit.B12) Inj Ampul 0
208 Sianokobalamin Tab 50 mg Tablet 0
209 Simvastatin Tablet 2800
 210 Stesolid Rectal Tube 0
211 Streptomicin Inj Vial 0
212 Sulfacetamid Tts Mata 15 % Botol 0
213 Tetrasiklin Kaps 500 mg Kapsul 0
214 Thiamin (Vit.B1) Inj Ampul 0
215 Thiamin (Vit.B1) Tab 50 mg Tablet 500
216 Tiamphenikol Kap 500 mg Kapsul 0
217 Tiamphenikol Syrup Botol 0
218 Tramadol Tab 50 mg Tablet 0
219 Triheksifenidil Tab 2 mg Tablet 0
220 Ventolin 2,5 mg Tube 0
221 Vit. A Biru Kapsul 0
222 Vit. A merah Kapsul 50
223 Vit. B com Injeksi Tablet 0
224 Vit. B kompleks Tab Tablet 2500
225 Xylomidon Inj Vial 0
226 Zinc Dispersible 20 mg Tablet 2500
Cairan dan Larutan
226 Alkohol 70 % Liter 17
227 Alkohol Swabs kotak 600
228 Aquabidest 500 ml Botol 0
229 Aquadest 100 ml Botol 0
230 Aquadest 25 ml Botol 0
231 ASK Botol 0
232 Glukosa Infus 10 % Botol 20
233 Glukosa Infus 5 % Botol 0
234 HCL 0,1 N 100 ML Botol 0
235 H2O2 3 % Botol 0
236 Lisol 50 % Botol 0
237 NaCl Infus 0,9 % Botol 15
238 Povidon Iodida 10% Botol 22
239 Ringer Laktat Infus Botol 95
240 Rivanol Lar 0,1 % 300ml Botol 0
241 Yodium Povidon 1000 ml Botol 0
242 Yodium Povidon 30 ml Botol 0
243 Yodium Povidon 300 ml kotak 0
Alat Kesehatan
243 Abbocath 16 G vasofix pcs 0
244 Abbocath 18 G vasofix pcs 0
245 Abbocath 20 G vasofix pcs 0
246 Abbocath 21 G vasofix pcs 0
247 Abbocath 24 G vasofix pcs 0
248 Abbocath 25 G vasofix pcs 0
249 Abbocath 27 G vasofix pcs 0
250 Alat Suntik Dispo 0,05 ml pcs 50
251 Alat Suntik Dispo 0,5 ml pcs 0
252 Alat Suntik Dispo 1 ml pcs 400
253 Alat Suntik Dispo 3 ml pcs 0
254 Alat Suntik Dispo 10 ml pcs 0
255 Alat Suntik Dispo 5 ml pcs 200
256 Aesculap blades Bisturi pcs 0
257 Catgut 2/0 (2 metric) pcs 0
258 Catgut 2/0 (3 metric) pcs 0
259 Catgut 2/0 (3,5 metric)DS-19 pcs 0
260 Catgut 2/0 (3,5 metric)DS-30 pcs 0
261 Catgut 2/0 with needle pcs 0
262 Catgut 3/0 (2 metric) pcs 0
263 Catgut Chromic no 3 pcs 0
264 Catgut chromic no 6 pcs 0
265 Coverplast pcs 0
266 Daryant Tulle kotak 0
268 Handschon M kotak 0
269 Handschon No.7 Steril pcs 0
270 Handschon No.7,5 pcs 0
271 Handschon S kotak 0
272 Handschoon 6,5 kotak 0
273 Handschoon L kotak 8
274 Hypapix Plester pcs 0
275 Infusion Set Anak pcs 0
276 Infusion Set Dewasa pcs 0
277 Kapas Pembalut 1000 mg Rol 0
278 Kapas Pembalut 250 mg Rol 0
279 Kapas Pembalut 500 mg Rol 0
280 Kasa Hidrofil 4 m x 10 cm Elastis kotak 0
281 Kasa Hidrofil 4 y x 80 cm Rol 0
282 Kasa Kompres Steril 40/40 kotak 95
283 Kasa Pembalut 2 m X 80 cm Rol 0
284 Kertas puyer perkamen Rim 450
285 Kasa Panjang 40 x 80 cm rol 10
286 Lancet kotak 0
287 Lomatuel kotak 0
287 Masker Earloop pcs 185
288 Medicet 20 G pcs 0
289 Medicet 24 G pcs 0
290 Needle 23 G X 1 1/4 pcs 0
291 Needle BR 10 pcs 0
 292 Needle BR 13 pcs 0
293 Needle BR 16 pcs 0
294 Needle BT 27 pcs 0
295 Needle GT 10 pcs 0
296 Needle GT 12 pcs 0
297 Needle GT 14 pcs 0
298 Otopain Tube 0
299 Pembalut Gibs pcs 0
300 Plastik Obat 5 x 8 kotak 305
301 Plastik Obat 7 x 10 kotak 710
302 Plastik Obat 8,7 x 13 kotak 10
Plester 5 y X 2 Inch / leukoplas
303 Rol 0
7,5 x 4,5 cm
304 Stick Rapid IMS / Syipilis pcs 0
305 Stick Rapid HIV Pcs 0
306 Stick HBsAg pcs 3
307 Silk No 2/0 pcs 0
308 Strip Hb famili pcs 400
305 Strip Test Cholestrol pcs 0
306 Strip test Glucose pcs 150
307 Strip test Uric Acid pcs 0
308 Surgical Blade No. 11 pcs 0
309 Surgical Blade No. 15 pcs 0
310 Surgical Blade No. 21 pcs 0
311 Surgical Masker (Betali) pcs 0
312 Wing Needle No.21 G x 3/4 kotak 0
313 Wing Needle No.23 G kotak 0
314 Wing Needle No.25 G kotak 0
315 Wing Needle No.27 G kotak 0
Obat Gigi
316 champhenol kotak 0
317 Cresotin kotak 0
318 master bond kotak 3
319 Paramon chlorofenol kotak 3
320 Cimento de zinco Botol 0
321 Devitec Botol 0
322 Duron Group pcs 0
323 Etil Klorid Spray Botol 7
324 Eugenol cair Botol 5
325 Farmacol Forte Botol 0
326 Fletcher Liquid Botol 0
327 Fletcher Powder Botol 0
328 Glass Ionemer Liquid 7,5 kotak 0
 329 Glass Ionemer Powder 100 gr Kotak 0
330 iodotin Botol 0
331 Klorfenol Kamfer Mentol(CHKM)Botol 0
332 Multifix Liquid Kotak 0
333 Multifix Powder Kotak 0
334 Natural Lock pcs 0
335 Pehacain inj Ampul 0
336 Phosphoric Acid Etchan 6 Kotak 0
337 Zitemp Botol 0
technew hydcal -paste base and
378 box 0
catalyst
denpro orafil plus temporary
339 Botol
filling 0
Laboratorium 0
340 Coverglass 18 X 18 pcs 0
341 Kartu Golda Lembar 0
342 Lancet pcs 0
343 Larutan HCl 1 % Botol 0
344 Pot sampel pcs 0
345 Rak Tabung reaksi pcs 0
346 Reagen Widal pcs 0
347 Slide pcs 0
348 Tabung Centrifuge pcs 0
349 One Med Test Kehamilan Instan pcs 0
350 0bjek glass 7105 box 0
351 Tabung EDTA 3 cc pcs 0
352 Anti A 10 ml (Gol-Darah) Botol 0
353 Anti AB 10 ml (Gol-Darah) Botol 0
354 Anti B 10 ml (Gol-Darah) Botol 0
356 Anti D 10 ml (Gol-Darah) Botol 0

Obat Tambahan
351 Batugin Tablet 0
352 Caviplex Tablet 0
353 Fondazen Tablet 0
354 Jeli USG Botol 0
357 Trombopop Tube 0
358 Vit. B com Injeksi Ampul 0
359 Tramadol Injeksi Ampul 0
360 Loratadine Tablet 0
 361 Dextral tablet 0
362 Antiseptic Botol 0
363 Doxycycline Tablet 0
364 Difenhidramin Injeksi Ampul 0
365 Zink Syrup Botol 0
366 Acetyl Sistem tab tablet 0
367 Alco Plus Syr btl 0
368 Curcuma Plus/Vitamin btl 0
369 ETABION Kapsul 0
370 reagen golongan darah kotak 0
371 silk surgiroll roll 0
372 Ambubag pcs 0
373 neek chler dewasa pcs 0
374 neek chler anak pcs 0
masker oksigen non rebreating
375 psc 0
Anak
376 nassal canule 02 'L' pcs 0
377 spalak psc 0
378 perlak underpad pcs 0
378 curcuma sharpy blackcurent 200 botol 0
ml
379 Cuticell Clasic 10 cm x 10cm pcs 0
380 Aesculap Blades (Bisturi) box 0
381 Plesterin bulat non woven pcs 0
382 Hansaplas pcs 0
383 I.V Catheter 20G (STERACTH) Pcs 0
384 Vasofik I.V Chateter No 18 pcs 0
389 Lumpang pcs 0
390 mortir pcs 0
391 suture needle hecting pcs 0
392 hipavix pcs 0
393 dermafix pcs 0
394 botol
Curcuma sharpy strawbery 60 ml 0
395 Curcuma Grow orange 200 ml botol 0
396 Metformin 850 mg tablet 0
397 Trepocheck sypilis pcs 0
Mengetahui Mengetahui
Kepala Puskesmas Sesua Kepala UPTD GFK Malinau
Eddy Aryadie. A.Md.,Kl Selfie Palalangan S.Si
Nip. 19750218 200502 1001 Nip. 19731127 200604 2 004
AIAN DAN LEMBAR PERMINTAAN OBAT

PELAPORAN BULAN
PERMINTAAN BLN/PERIODE

STOK
PERSEDIAN PEMAKAIAN SISA STOK PERMINTAAN
OPS
0 24 559
0 100 250
0 0 0
0 0 0
0 0 0
0 500 1800
0 0 0
0 0 0
0 500 1200
0 0 0
0 0 0
0 0 0
0 200 1600
0 0 0
0 500 4700
0 15 197
0 0 0
0 100 100
0 15 25
0 0 0

0 0 0
0 500 3200
0 10 100
0 0 0
0 0 0
0 0 0
0 0 0
0 500 15700
0 500 1200
0 200 0
0 0 0
0 0 0
0 24 201
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 300 2100
0 300 500
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 300 2200
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 500 4700
0 0 0
0 0 0
0 1 7
0 100 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 15
0 0 0
0 0 8
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 300 750
0 0 0
0 0 0
0 0 0
0 0 0
0 300 2500
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 24 200
0 6 49
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 300 600
0 0 0
0 0 100
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 5 145
0 0 0
0 0 0
0 0 0
0 0 0
0 0 10
0 0 0
0 0 0
0 0 0
0 0 0
0 100 450
0 150 100
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 300 800
0 200 600
0 0 0
0 0 0
0 0 0
 0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
10 0 10
0 200 3500
0 0 0
0 0 0
0 10 268
0 30 170
0 0 0
0 500 6400
0 0 0
0 0 0
0 100 1800
0 0 0
0 0 0
0 0 0
0 300 400
0 0 0
0 0 0
0 0 0
0 0 0
0 5 344
0 200 900
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 100 0
0 0 0
0 5 70
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 300 2500
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 100 400
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 500 2000
0 0 0
0 500 2000

0 3 0
0 100 500
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 5 10
0 0 22
0 5 90
0 0 0
0 0 0
0 0 0
0 0 0

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 100 300
0 0 0
0 0 0
0 100 100
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 2 6
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 5 95
0 0 0
0 50 50
0 0 10
0 0 0
0 0 0
0 5 180
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 5 300
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 1 2
0 0 0
0 50 350
0 0 0
0 50 100
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

0 0 0
0 0 0
0 0 3
0 0 3
0 0 0
0 0 0
0 0 0
0 0 7
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0
0
0
0 0
0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
 0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0
0 0
0 0 0
0 0 0
0 0 0
Mengetahui Mengetahui
Petugas UPTD GFK Malinau Petugas Gudang Obat Puskesmas
Faris Dwi S. A.Md.,Far Trifena, A.Md.Farm
Nip. 19900805 201403 1 001 PTT
: MEI 2022
: TW 2

KETERANGAN
EXD
 Mengetahui
udang Obat Puskesmas
Trifena, A.Md.Farm
PTT
 LAPORAN PEMAKAIAN DAN LEMBAR PER
PUSKESMAS : SESUA
KECAMATAN : MALINAU BARAT
KABUPATEN : MALINAU

STOK
NO NAMA OBAT SATUAN PENERIMAAN
AWAL
1 Acyclovir Salep Kulit Tube 559
2 Acyclovir Tab 400 mg Tablet 250
3 Adrenalin Bitartat Ampul 0
4 Albendazole 400 mg Tablet 0
5 Alletrol tetes mata Botol 0
6 Allopurinol Tab 100 mg Tablet 1800
7 Alpara Tablet 0
8 Ambroxol Syr 15 mg/5 ml Botol 0
9 Ambroxol Tab 30 mg Tablet 1200
10 Aminofilin Inj 24 mg/ml Ampul 0
11 Aminofilin Tab 200 mg Tablet 0
12 Amitriptilin Tab 25 mg Tablet 0
13 Amlodipin 5 mg Tablet 1600
14 Amoksisillin Kap 250 mg Tablet 0
15 Amoksisillin Kap 500 mg Tablet 4700
16 Amoksisillin Syr 125 mg/5 ml Botol 197
17 Ampicillin Injeksi Ampul 0
18 Ampisilin Kap 500 mg Tablet 100
19 Ampisilin Syr 125 mg/5 ml Botol 25
20 Antalgin Inj 250 mg/ml Ampul 0
21 Antalgin Tab 500 mg/ Metamozole Tablet
0
22 Antasid DOEN Tab Komb Tablet 3200
23 Antasid Sirup Botol 100
24 Antifungi DOEN Pot 0
25 Antihaemoroid DOEN Komb Supp 0
26 Arsuamon Tab Tablet 0
27 Arterakine Tab Tablet 0
28 Asam Askorbat Tab 50 mg Tablet 15700
29 Asam Folat 1 mg Tablet 1200
30 Asam Mefenamat Kap 500 mg Tablet 0
31 Atropin Sulfat Inj 0,25 mg/ml Ampul 0
32 Bacitrasin Salep Tube 0
33 Betametason Cream 0,1 % Tube 201
34 Bioplacenton Tube 0
35 Bromheksin Tablet 0
36 Bromheksin Sirup Botol 0
37 Burnazin Tube 0
38 Buscopan Tab 10 mg Tablet 0
39 Captopril 12,5 mg Tablet 2100
Captopril 25 mg Tablet 500
41 Cefixime Kaps 100 mg Kapsul 0
42 Cefixime Syrup Botol 0
43 Cendocetamide 15 % Botol 0
44 Cendotropin Tetes Mata Botol 0
45 Centabio Tube 0
46 Cephadroxil Kap 250 mg Kapsul 0
47 Cephadroxil Kap 500 mg Kapsul 0
48 Cephadroxil Syr Botol 0
49 Cetirizine Tablet 2200
50 Chefalexin Kap 500 mg Tablet 0
51 Cimetidine 200 mg Tablet 0
52 Cinolon N 10 gr Tube 0
53 Ciprofloxacin Tab 500 mg Tablet 0
54 Cohistin Syrup Botol 0
56 CTM Tab 4 mg Tablet 4700
57 Curcuma Tablet 0
58 Curliv Syrup/Multivitamin syr Botol 0
59 Deksametason Inj 5 mg/ml Ampul 7
60 Deksametason Tab 0,5 mg Tablet 0
61 Dekstrometorfan HBr 15 mg Tablet 0
62 Dekstrometorfan Syr Botol 0
63 Diazepam Inj 5 mg/ml Ampul 0
64 Diazepam Tab 2 mg Tablet 0
65 Diclofam 50 mg Tablet 0
66 Digoksin Tab 0,25 mg Tablet 0
67 Diltiazem Tab 30 Mg Tablet 0
68 Domperidon Tab Tablet 0
69 Doxycicline Kaps 100 mg Kapsul 0
70 Dulcolax Supp Anak Supp 0
71 Dulcolax/bisakodil Tab 5 mg Tablet 0
72 Dumin Tablet 0
73 Efedrin Tab 25 mg Tablet 0
74 Efinefrin Inj 0,1 % Ampul 0
75 Ekstrak Belladon Tab 10 mg Tablet 0
76 Elkana Tablet 0
77 Ergotamin Koffein Tab Tablet 0
78 Erlamicetine Botol 0
79 Erytromisin Kap 500 mg Kapsul 0
80 Erytromisin Syr 125 mg/ 5 ml Botol 0
81 Etambutol Tab 500 mg Tablet 0
82 Famotidin 20 mg/40 mg Tablet 0
83 Fenobarbital Inj 50 mg/ml Ampul 0
84 Fenobarbital Tab 30 mg Tablet 0
85 Fenol Gliserol Tts Telinga 10 % Botol 15
86 Ferrous Sulfat Tab Tablet 0
87 Fitomenadion (Vit.K) Inj Ampul 8
88 Fitomenadion (Vit.K) Tab Tablet 0
89 Fitomenadion (Vit.K3) Inj Ampul 0
90 Fluoroscein Tetes Mata 2 % Botol 0
91 Furosemid Inj 10 ml Ampul 0
92 Furosemid Tab 40 mg Tablet 0
93 Gamexan Emulsi 1 % Botol 0
94 Garam Oralit 200 ml Sachet 750
95 Genoit Salep Mata Tube 0
96 Gentamisin Salep Kulit Tube 0
98 Gentamisin Tetes Mata Botol 0
99 Gentian Violet Lar 1 % Botol 0
100 GG Tab 100 mg Tablet 2500
101 Glibenklamid Tab 5 mg Tablet 0
102 Glimepiride 2 mg Tablet 0
103 Glimepiride 4 mg Tablet 0
104 Griseofulvin Tab 125 mg Tablet 0
105 Griseofulvin Tab 500 mg Tablet 0
106 Haloperidol Tab 0,5 mg Tablet 0
107 Hidrokortison Cream 2,5 % Tube 200
108 Ibuprofen syr botol 49
109 Ibuprofen Tab 400 mg Tablet 0
110 Ichtiyol Salep Pot 0
111 INH Tab 100 mg Tablet 0
112 INH Tab 300 mg Tablet 0
113 Inmatrol Tetes Mata Botol 0
114 Inpepsa Sirup Botol 0
115 Isosorbid Dinitrat Tab 10mg Tablet 0
116 Kalium Diklofenak Tab 50 mg Tablet 0
117 Kalium Permanganat Tablet 0
118 Kalsium Laktat Tab 500 mg Tablet 600
119 Kanamicyn Inj Vial 0
120 Ketokonazole Cream 2 % Tube 100
121 Ketokonazole Tab 200 mg Tablet 0
122 Kinina Tab 222 mg Tablet 0
123 Klindamisin 150 mg Kapsul 0
124 Klindamisin 300 mg Kapsul 0
125 Kloramfenikol Kaps 250 mg Kapsul 0
126 Kloramfenikol Salep Mata 1 % Tube 0
127 Kloramfenikol Syr 125 mg/5 ml Botol 0
128 Kloramfenikol Tetes Mata Botol 0
129 Kloramfenikol Tetes Telinga 3 % Botol 0
130 Klorpromazin 100 mg Tablet 0
131 Kodein Tab 10 mg Tablet 0
132 Kotrimoksazol syr 240 mg/5 ml Botol 0
133 Kotrimoksazol Tab 120 mg Tablet 0
134 Kotrimoksazol Tab 400 mg Tablet 0
135 Lidokain komb Inj Inj 0
136 Lanzoprazole Kapsul 0
137 Levertran Salep Tube 0
138 Levofloxacin Tab 500 mg Tablet 0
139 Lidokain komb Inj Ampul 145
140 Livron B Plex Tablet 0
141 Lodia Tablet 0
142 Loperamid Tablet 0
143 Loratadin 10 mg Tablet 0
144 Lubricating Jelly Tube 10
145 Mebendazol Tab 100 mg Tablet 0
146 Mediamere Tablet 0
147 Meloxicam 15 mg Tablet 0
148 Meloxicam 7,5 mg Tablet 0
149 Metformin 500 mg Tablet 450
150 Methil Prednisolon Tab 4 mg Tablet 100
151 Methil Prednisolon Tab 8 mg Tablet 0
152 Metil Ergometrin Inj Ampul 0
153 Metil ergometrin Tab 0,125 mg Tablet 0
154 Metoch / Ethiferan Inj 5 mg Ampul 0
155 Metoklopramid Tab 10 mg Tablet 0
156 Metronidazol Tab 250 mg Tablet 0
157 Metronidazol Tab 500 mg Tablet 0
158 Miconazol Salep Tube 0
159 Minyak Kayu Putih Botol 0
160 Molagit Tablet 0
161 Molexdryl Sirup Botol 0
162 Na.Diklofenak Tab 25 mg Tablet 800
163 Na.Diklofenak Tab 50 mg Tablet 600
164 Nifedipin Tab Tablet 0
165 Nistatin Supp Supp 0
166 Nistatin Tab Tablet 0
167 Nitral Vial 0
168 Obat Tambah Darah Tablet 0
169 OBH Sirup Botol 0
170 Ofloxacin Tab 200 mg Tablet 0
171 Ofloxacin Tab 400 mg Tablet 0
172 Oksitetrasiklin Inj 50 mg/vial Vial 0
173 Oksitetrasiklin Salep Kulit 3 % Tube 0
174 Oksitetrasiklin Salep Mata 1 % Tube 0
175 Oksitosin Inj 10 iu/ml Ampul 10
176 Omeprazole Kaps 20 mg Tablet 3500
177 ondasteron inj ampul 0
178 Papaverin Tab 40 mg Tablet 0
179 Paracetamol drops Botol 268
180 Paracetamol Syr 120 mg/5 ml Botol 170
181 Paracetamol Tab 100 mg Tablet 0
182 Paracetamol Tab 500 mg Tablet 6400
183 Peditox Botol 0
184 Piracetam Inj Ampul 0
185 Pirantel Pamoat Tab 125 mg Tablet 1800
186 Pirazinamid Tab 500 mg Tablet 0
187 Pirimetamin Sulfadoksin Tab Tablet 0
188 Piroxicam Kap 20 mg Tablet 0
189 Prednison Tab 5 mg Tablet 400
190 Primakina Tab 15 mg Tablet 0
191 Propanolol Tab 40 mg Tablet 0
192 Propiltiourasil Tab 100 mg Tablet 0
193 Pyridoksin (Vit.B6) Tab 10 mg Tablet 0
194 Ranitidin Inj Ampul 344
195 Ranitidin Tab 150 mg Tablet 900
196 Reserpin Tab 0,25 mg Tablet 0
197 Rifampisin 300 mg Kapsul 0
198 Rifampisin 450 mg Kapsul 0
199 Rifampisin 600 mg Kapsul 0
200 Risperidon Tablet 0
201 Salbutamol Tab 2 mg Tablet 0
202 Salbutamol Tab 4mg Tablet 0
203 Salep 2-4 Komb Pot 70
204 Salisil Bedak 2% kotak 0
205 Sangobion Tablet 0
206 Serum Anti Tetanus (ATS) 1500 I Vial 0
207 Sianokobalamin (Vit.B12) Inj Ampul 0
208 Sianokobalamin Tab 50 mg Tablet 0
209 Simvastatin Tablet 2500
 210 Stesolid Rectal Tube 0
211 Streptomicin Inj Vial 0
212 Sulfacetamid Tts Mata 15 % Botol 0
213 Tetrasiklin Kaps 500 mg Kapsul 0
214 Thiamin (Vit.B1) Inj Ampul 0
215 Thiamin (Vit.B1) Tab 50 mg Tablet 400
216 Tiamphenikol Kap 500 mg Kapsul 0
217 Tiamphenikol Syrup Botol 0
218 Tramadol Tab 50 mg Tablet 0
219 Triheksifenidil Tab 2 mg Tablet 0
220 Ventolin 2,5 mg Tube 0
221 Vit. A Biru Kapsul 0
222 Vit. A merah Kapsul 0
223 Vit. B com Injeksi Tablet 0
224 Vit. B kompleks Tab Tablet 2000
225 Xylomidon Inj Vial 0
226 Zinc Dispersible 20 mg Tablet 2000
Cairan dan Larutan
226 Alkohol 70 % Liter 0
227 Alkohol Swabs kotak 500
228 Aquabidest 500 ml Botol 0
229 Aquadest 100 ml Botol 0
230 Aquadest 25 ml Botol 0
231 ASK Botol 0
232 Glukosa Infus 10 % Botol 0
233 Glukosa Infus 5 % Botol 0
234 HCL 0,1 N 100 ML Botol 0
235 H2O2 3 % Botol 0
236 Lisol 50 % Botol 0
237 NaCl Infus 0,9 % Botol 10
238 Povidon Iodida 10% Botol 22
239 Ringer Laktat Infus Botol 90
240 Rivanol Lar 0,1 % 300ml Botol 0
241 Yodium Povidon 1000 ml Botol 0
242 Yodium Povidon 30 ml Botol 0
243 Yodium Povidon 300 ml kotak 0
Alat Kesehatan
243 Abbocath 16 G vasofix pcs 0
244 Abbocath 18 G vasofix pcs 0
245 Abbocath 20 G vasofix pcs 0
246 Abbocath 21 G vasofix pcs 0
247 Abbocath 24 G vasofix pcs 0
248 Abbocath 25 G vasofix pcs 0
249 Abbocath 27 G vasofix pcs 0
250 Alat Suntik Dispo 0,05 ml pcs 0
251 Alat Suntik Dispo 0,5 ml pcs 0
252 Alat Suntik Dispo 1 ml pcs 300
253 Alat Suntik Dispo 3 ml pcs 0
254 Alat Suntik Dispo 10 ml pcs 0
255 Alat Suntik Dispo 5 ml pcs 100
256 Aesculap blades Bisturi pcs 0
257 Catgut 2/0 (2 metric) pcs 0
258 Catgut 2/0 (3 metric) pcs 0
259 Catgut 2/0 (3,5 metric)DS-19 pcs 0
260 Catgut 2/0 (3,5 metric)DS-30 pcs 0
261 Catgut 2/0 with needle pcs 0
262 Catgut 3/0 (2 metric) pcs 0
263 Catgut Chromic no 3 pcs 0
264 Catgut chromic no 6 pcs 0
265 Coverplast pcs 0
266 Daryant Tulle kotak 0
268 Handschon M kotak 0
269 Handschon No.7 Steril pcs 0
270 Handschon No.7,5 pcs 0
271 Handschon S kotak 0
272 Handschoon 6,5 kotak 0
273 Handschoon L kotak 6
274 Hypapix Plester pcs 0
275 Infusion Set Anak pcs 0
276 Infusion Set Dewasa pcs 0
277 Kapas Pembalut 1000 mg Rol 0
278 Kapas Pembalut 250 mg Rol 0
279 Kapas Pembalut 500 mg Rol 0
280 Kasa Hidrofil 4 m x 10 cm Elastis kotak 0
281 Kasa Hidrofil 4 y x 80 cm Rol 0
282 Kasa Kompres Steril 40/40 kotak 95
283 Kasa Pembalut 2 m X 80 cm Rol 0
284 Kertas puyer perkamen Rim 50
285 Kasa Panjang 40 x 80 cm rol 10
286 Lancet kotak 0
287 Supratule kotak 0
287 Masker Earloop pcs 180
288 Medicet 20 G pcs 0
289 Medicet 24 G pcs 0
290 Needle 23 G X 1 1/4 pcs 0
291 Needle BR 10 pcs 0
 292 Needle BR 13 pcs 0
293 Needle BR 16 pcs 0
294 Needle BT 27 pcs 0
295 Needle GT 10 pcs 0
296 Needle GT 12 pcs 0
297 Needle GT 14 pcs 0
298 Otopain Tube 0
299 Pembalut Gibs pcs 0
300 Plastik Obat 5 x 8 kotak 300
301 Plastik Obat 7 x 10 kotak 0
302 Plastik Obat 8,7 x 13 kotak 0
Plester 5 y X 2 Inch / leukoplas 7,5
303 Rol 0
x 4,5 cm
304 Stick Rapid IMS / Syipilis pcs 0
305 Stick Rapid HIV Pcs 0
306 Stick HBsAg pcs 2
307 Silk No 2/0 pcs 0
308 Strip Hb famili pcs 350
305 Strip Test Cholestrol pcs 0
306 Strip test Glucose pcs 100
307 Strip test Uric Acid pcs 0
308 Surgical Blade No. 11 pcs 0
309 Surgical Blade No. 15 pcs 0
310 Surgical Blade No. 21 pcs 0
311 Surgical Masker (Betali) pcs 0
312 Wing Needle No.21 G x 3/4 kotak 0
313 Wing Needle No.23 G kotak 0
314 Wing Needle No.25 G kotak 0
315 Wing Needle No.27 G kotak 0
Obat Gigi
316 champhenol kotak 0
317 Cresotin kotak 0
318 master bond kotak 3
319 Paramon chlorofenol kotak 3
320 Cimento de zinco Botol 0
321 Devitec Botol 0
322 Duron Group pcs 0
323 Etil Klorid Spray Botol 7
324 Eugenol cair Botol 0
325 Farmacol Forte Botol 0
326 Fletcher Liquid Botol 0
327 Fletcher Powder Botol 0
328 Glass Ionemer Liquid 7,5 kotak 0
 329 Glass Ionemer Powder 100 gr Kotak 0
330 iodotin Botol 0
331 Klorfenol Kamfer Mentol(CHKM) Botol 0
332 Multifix Liquid Kotak 0
333 Multifix Powder Kotak 0
334 Natural Lock pcs 0
335 Pehacain inj Ampul 0
336 Phosphoric Acid Etchan 6 Kotak 0
337 Zitemp Botol 0
technew hydcal -paste base and
378 box 0
catalyst
339 denpro orafil plus temporary filling Botol 0
Laboratorium 0
340 Coverglass 18 X 18 pcs 0
341 Kartu Golda Lembar 0
342 Lancet pcs 0
343 Larutan HCl 1 % Botol 0
344 Pot sampel pcs 0
345 Rak Tabung reaksi pcs 0
346 Reagen Widal pcs 0
347 Slide pcs 0
348 Tabung Centrifuge pcs 0
349 One Med Test Kehamilan Instan pcs 0
350 0bjek glass 7105 box 0
351 Tabung EDTA 3 cc pcs 0
352 Anti A 10 ml (Gol-Darah) Botol 0
353 Anti AB 10 ml (Gol-Darah) Botol 0
354 Anti B 10 ml (Gol-Darah) Botol 0
356 Anti D 10 ml (Gol-Darah) Botol 0

Obat Tambahan
351 Batugin Tablet 0
352 Caviplex Tablet 0
353 Fondazen Tablet 0
354 Jeli USG Botol 0
357 Trombopop Tube 0
358 Vit. B com Injeksi Ampul 0
359 Tramadol Injeksi Ampul 0
360 Loratadine Tablet 0
361 Dextral tablet 0
 362 Antiseptic Botol 0
363 Doxycycline Tablet 0
364 Difenhidramin Injeksi Ampul 0
365 Zink Syrup Botol 0
366 Acetyl Sistem tab tablet 0
367 Alco Plus Syr btl 0
368 Curcuma Plus/Vitamin btl 0
369 ETABION Kapsul 0
370 reagen golongan darah kotak 0
371 silk surgiroll roll 0
372 Ambubag pcs 0
373 neek chler dewasa pcs 0
374 neek chler anak pcs 0
masker oksigen non rebreating
375 psc 0
Anak
376 nassal canule 02 'L' pcs 0
377 spalak psc 0
378 perlak underpad pcs 0
378 curcuma sharpy blackcurent 200 botol 0
ml
379 Cuticell Clasic 10 cm x 10cm pcs 0
380 Aesculap Blades (Bisturi) box 0
381 Plesterin bulat non woven pcs 0
382 Hansaplas pcs 0
383 I.V Catheter 20G (STERACTH) Pcs 0
384 Vasofik I.V Chateter No 18 pcs 0
389 Lumpang pcs 0
390 mortir pcs 0
391 suture needle hecting pcs 0
392 hipavix pcs 0
393 dermafix pcs 0
394 Curcuma sharpy strawbery 60 ml botol 0
395 Curcuma Grow orange 200 ml botol 0
396 Metformin 850 mg tablet 0
397 Trepocheck sypilis pcs 0
Mengetahui Mengetahui
Kepala Puskesmas Sesua Kepala UPTD GFK Malinau

Eddy Aryadie. A.Md.,Kl Selfie Palalangan S.Si

Nip. 19750218 200502 1001 Nip. 19731127 200604 2 004
IAN DAN LEMBAR PERMINTAAN OBAT

PELAPORAN BULAN : JUNI 2022

PERMINTAAN BLN/PERIODE : TW 2

SISA STOK KETERANGAN

PERSEDIAN PEMAKAIAN PERMINTAAN
STOK OPS EXD
0 24 535 50 Tube
0 0 250 20 BOX
0 0 0
0 0 0
0 0 0
0 300 1500 20 BOX
0 0 0
0 0 0 50 BOTOL
0 400 800 20 BOX
0 0 0
0 0 0
0 0 0
0 300 1300 10 BOX
0 0 0
0 500 4200 20 BOX
0 10 187 2 KOTAK
0 0 0
0 100 0
0 10 15
0 0 0

0 0
0 500 2700 20 BOX
0 10 90 1 KOTAK
0 0 0
0 0 0
0 0 0
0 0 0
0 500 15200 20 BOX
0 500 700 20 BOX
0 0 0 20 BOX
0 0 0
0 0 0
0 24 177 50 TUBE
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 300 1800 10 KOTAK
0 100 400 10 KOTAK
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 300 1900 20 BOX
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 500 4200 20 BOX
0 0 0
0 0 0
0 2 5 10 AMPUL
0 0 0 20 BOX
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0 10 BOX
0 0 0
0 0 0
0 0 0 10 BOX
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 2 13 10 BOTOL
0 0 0 50 BOX
0 0 0 10 AMPUL
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 300 650 10 KOTAK
0 0 0
0 0 0 250 TUBE
0 0 0
0 0 0
0 500 2000 30 BOX
0 0 0
0 0 0
0 0 0
0 0 0 10 BOX
0 0 0
0 0 0
0 24 176 250 TUBE
0 5 44 5 KOTAK
0 0 0
0 0 0 10 POT
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0 20 BOX
0 0 0
0 200 400 10 BOX
0 0 0
0 0 0
0 0 0 20 BOX
0 0 0
0 0 0 10 BOX
0 0 0
0 0 0 10 BOX
0 0 0 100 TUBE
0 0 0
0 0 0 20 BOTOL
0 0 0 20 BOTOL
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0 5 KOTAK
0 0 0
0 0 0
0 0 0
0 5 140 5 KOTAK
0 0 0
0 0 0
0 0 0 20 BOX
0 0 0 10 BOX
0 0 0 10 TUBE
0 0 0
0 0 0 10 BOX
0 0 0 10 BOX
0 0 0 20 BOX
0 0 450 10 BOX
0 100 0 20 BOX
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0 5 KOTAK
0 0 0 24 BOTOL
0 0 0 10 BOX
0 0 0
0 100 700 20 BOX
0 100 500
0 0 0
0 0 0
0 0 0
 0 0 0
0 0 0 20 BOX
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
10 0 0 3 KOTAK
0 200 3200 20 BOX
0 0 0
0 0 0
0 10 258 3 KOTAK
0 10 160 2 KOTAK
0 0 0
0 500 5900 20 BOX
0 0 0
0 0 0
0 100 1700
0 0 0
0 0 0
0 0 0
0 100 300 10 BOX
0 0 0
0 0 0
0 0 0
0 0 0
0 5 339 3 KOTAK
0 200 700 10 BOX
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0 10 BOX
0 0 0
0 5 65
0 0 0 20 KOTAK
0 0 0 10 KOTAK
0 0 0
0 0 0 10 KOTAK
0 0 0
0 300 2200 30 BOX
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 100 300 10 BOX
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0 20 BOTOL
0 0 0 20 BOTOL
0 0 0 10 BOTOL
0 500 1500 20 BOX
0 0 0
0 500 1500 20 BOX

0 0 0 20 BOTOL
0 200 300 20 KOTAK
0 0 0 10 BOTOL
0 0 0 10 BOTOL
0 0 0
0 0 0
0 0 0 1 KOTAK
0 0 0
0 0 0
0 0 0 5 BOTOL
0 0 0 5 BOTOL
0 5 5 20 BOTOL
0 0 0 10 BOTOL
0 5 85 5 KOTAK
0 0 0 20 BOTOL
0 0 0
0 0 0
0 0 0

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 100 200 5 KOTAK
0 0 0 10 KOTAK
0 0 0
0 0 100 5 KOTAK
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0 10 KOTAK
0 0 0 10 KOTAK
0 0 0
0 0 0
0 0 0 10 KOTAK
0 0 0
0 0 6 10 KOTAK
0 0 0 10 KOTAK
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0 50 KOTAK
0 0 0
0 0 0
0 0 0
0 0 0 10 KOTAK
0 0 0 20 KOTAK
0 10 170 50 KOTAK
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0 5 PCS
0 0 0 50 PCS
0 0 0 50 PCS
0 0 0 20 PCS
0 0
0 0 0 3 KOTAK
0 0 0 5 KOTAK
0 1 1 5 KOTAK
0 0 0
0 50 300 10 KOTAK
0 0 0 250 KOTAK
0 50 50 250 KOTAK
0 0 0 250 KOTAK
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

0 0 0 5 KOTAK
0 0 0 5 KOTAK
0 0 3 5 KOTAK
0 0 3 5 KOTAK
0 0 0
0 0 0
0 0 0
0 0 7 5 KOTAK
0 0 0 5 KOTAK
0 0 0
0 0 0
0 0 0
0 0 0 5 KOTAK
0 0 0 5 KOTAK
0 0 0 5 KOTAK
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0 5 KOTAK
0 0 0 5 KOTAK
0 0
0
0 0 0
0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

0 0 0 10 BOX
0 0 0
0 0 0
0 0 0 10 BOTOL
0 0 0 5 KOTAK
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0 20 BOX
0 0 0
0 0 0
0 0 0 10 BOX
0 0 0
0 0
0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0 3 KOTAK
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0 10 PCS
0 0 0
0 0 0 10 KOTAK
0 0 0
0 0 0
0 0 0
Mengetahui Mengetahui
Petugas UPTD GFK Malinau Petugas Gudang Obat Puskesmas

Faris Dwi S. A.Md.,Far Trifena, A.Md.Farm

Nip. 19900805 201403 1 001 PTT
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTA
PUSKESMAS : SESUA
KECAMATAN : MALINAU BARAT
KABUPATEN : MALINAU

STOK
NO NAMA OBAT SATUAN PERSEDIAN
AWAL
1 Acyclovir Salep Kulit Tube 535 0
2 Acyclovir Tab 400 mg Tablet 250 0
3 Adrenalin Bitartat Ampul 0 0
4 Albendazole 400 mg Tablet 0 0
5 Alletrol tetes mata Botol 0 0
6 Allopurinol Tab 100 mg Tablet 1500 0
7 Alpara Tablet 0 0
8 Ambroxol Syr 15 mg/5 ml Botol 0 0
9 Ambroxol Tab 30 mg Tablet 800 0
10 Aminofilin Inj 24 mg/ml Ampul 0 0
11 Aminofilin Tab 200 mg Tablet 0 0
12 Amitriptilin Tab 25 mg Tablet 0 0
13 Amlodipin 5 mg Tablet 1300 0
14 Amoksisillin Kap 250 mg Tablet 0 0
15 Amoksisillin Kap 500 mg Tablet 4200 0
16 Amoksisillin Syr 125 mg/5 ml Botol 187 0
17 Ampicillin Injeksi Ampul 0 0
18 Ampisilin Kap 500 mg Tablet 0 0
19 Ampisilin Syr 125 mg/5 ml Botol 15 0
20 Antalgin Inj 250 mg/ml Ampul 0 0
21 Antalgin Tab 500 mg/ Metamozole Tablet
0 0
22 Antasid DOEN Tab Komb Tablet 2700 0
23 Antasid Sirup Botol 90 0
24 Antifungi DOEN Pot 0 0
25 Antihaemoroid DOEN Komb Supp 0 0
26 Arsuamon Tab Tablet 0 0
27 Arterakine Tab Tablet 0 0
28 Asam Askorbat Tab 50 mg Tablet 15200 0
29 Asam Folat 1 mg Tablet 700 0
30 Asam Mefenamat Kap 500 mg Tablet 0 0
31 Atropin Sulfat Inj 0,25 mg/ml Ampul 0 0
32 Bacitrasin Salep Tube 0 0
33 Betametason Cream 0,1 % Tube 177 0
34 Bioplacenton Tube 0 0
35 Bromheksin Tablet 0 0
36 Bromheksin Sirup Botol 0 0
37 Burnazin Tube 0 0
38 Buscopan Tab 10 mg Tablet 0 0
39 Captopril 12,5 mg Tablet 1800 0
Captopril 25 mg Tablet 400 0
41 Cefixime Kaps 100 mg Kapsul 0 0
42 Cefixime Syrup Botol 0 0
43 Cendocetamide 15 % Botol 0 0
44 Cendotropin Tetes Mata Botol 0 0
45 Centabio Tube 0 0
46 Cephadroxil Kap 250 mg Kapsul 0 0
47 Cephadroxil Kap 500 mg Kapsul 0 0
48 Cephadroxil Syr Botol 0 0
49 Cetirizine Tablet 1900 0
50 Chefalexin Kap 500 mg Tablet 0 0
51 Cimetidine 200 mg Tablet 0 0
52 Cinolon N 10 gr Tube 0 0
53 Ciprofloxacin Tab 500 mg Tablet 0 0
54 Cohistin Syrup Botol 0 0
56 CTM Tab 4 mg Tablet 4200 0
57 Curcuma Tablet 0 0
58 Curliv Syrup/Multivitamin syr Botol 0 0
59 Deksametason Inj 5 mg/ml Ampul 5 0
60 Deksametason Tab 0,5 mg Tablet 0 0
61 Dekstrometorfan HBr 15 mg Tablet 0 0
62 Dekstrometorfan Syr Botol 0 0
63 Diazepam Inj 5 mg/ml Ampul 0 0
64 Diazepam Tab 2 mg Tablet 0 0
65 Diclofam 50 mg Tablet 0 0
66 Digoksin Tab 0,25 mg Tablet 0 0
67 Diltiazem Tab 30 Mg Tablet 0 0
68 Domperidon Tab Tablet 0 0
69 Doxycicline Kaps 100 mg Kapsul 0 0
70 Dulcolax Supp Anak Supp 0 0
71 Dulcolax/bisakodil Tab 5 mg Tablet 0 0
72 Dumin Tablet 0 0
73 Efedrin Tab 25 mg Tablet 0 0
74 Efinefrin Inj 0,1 % Ampul 0 0
75 Ekstrak Belladon Tab 10 mg Tablet 0 0
76 Elkana Tablet 0 0
77 Ergotamin Koffein Tab Tablet 0 0
78 Erlamicetine Botol 0 0
79 Erytromisin Kap 500 mg Kapsul 0 0
 80 Erytromisin Syr 125 mg/ 5 ml Botol 0 0
81 Etambutol Tab 500 mg Tablet 0 0
82 Famotidin 20 mg/40 mg Tablet 0 0
83 Fenobarbital Inj 50 mg/ml Ampul 0 0
84 Fenobarbital Tab 30 mg Tablet 0 0
85 Fenol Gliserol Tts Telinga 10 % Botol 13 0
86 Ferrous Sulfat Tab Tablet 0 0
87 Fitomenadion (Vit.K) Inj Ampul 0 0
88 Fitomenadion (Vit.K) Tab Tablet 0 0
89 Fitomenadion (Vit.K3) Inj Ampul 0 0
90 Fluoroscein Tetes Mata 2 % Botol 0 0
91 Furosemid Inj 10 ml Ampul 0 0
92 Furosemid Tab 40 mg Tablet 0 0
93 Gamexan Emulsi 1 % Botol 0 0
94 Garam Oralit 200 ml Sachet 650 0
95 Genoit Salep Mata Tube 0 0
96 Gentamisin Salep Kulit Tube 0 0
98 Gentamisin Tetes Mata Botol 0 0
99 Gentian Violet Lar 1 % Botol 0 0
100 GG Tab 100 mg Tablet 2000 0
101 Glibenklamid Tab 5 mg Tablet 0 0
102 Glimepiride 2 mg Tablet 0 0
103 Glimepiride 4 mg Tablet 0 0
104 Griseofulvin Tab 125 mg Tablet 0 0
105 Griseofulvin Tab 500 mg Tablet 0 0
106 Haloperidol Tab 0,5 mg Tablet 0 0
107 Hidrokortison Cream 2,5 % Tube 176 0
108 Ibuprofen syr botol 44 0
109 Ibuprofen Tab 400 mg Tablet 0 0
110 Ichtiyol Salep Pot 0 0
111 INH Tab 100 mg Tablet 0 0
112 INH Tab 300 mg Tablet 0 0
113 Inmatrol Tetes Mata Botol 0 0
114 Inpepsa Sirup Botol 0 0
115 Isosorbid Dinitrat Tab 10mg Tablet 0 0
116 Kalium Diklofenak Tab 50 mg Tablet 0 0
117 Kalium Permanganat Tablet 0 0
118 Kalsium Laktat Tab 500 mg Tablet 400 0
119 Kanamicyn Inj Vial 0 0
120 Ketokonazole Cream 2 % Tube 0 0
121 Ketokonazole Tab 200 mg Tablet 0 0
122 Kinina Tab 222 mg Tablet 0 0
123 Klindamisin 150 mg Kapsul 0 0
124 Klindamisin 300 mg Kapsul 0 0
125 Kloramfenikol Kaps 250 mg Kapsul 0 0
126 Kloramfenikol Salep Mata 1 % Tube 0 0
127 Kloramfenikol Syr 125 mg/5 ml Botol 0 0
128 Kloramfenikol Tetes Mata Botol 0 0
129 Kloramfenikol Tetes Telinga 3 % Botol 0 0
130 Klorpromazin 100 mg Tablet 0 0
131 Kodein Tab 10 mg Tablet 0 0
132 Kotrimoksazol syr 240 mg/5 ml Botol 0 0
133 Kotrimoksazol Tab 120 mg Tablet 0 0
134 Kotrimoksazol Tab 400 mg Tablet 0 0
135 Lidokain komb Inj Inj 0 0
136 Lanzoprazole Kapsul 0 0
137 Levertran Salep Tube 0 0
138 Levofloxacin Tab 500 mg Tablet 0 0
139 Lidokain komb Inj Ampul 140 0
140 Livron B Plex Tablet 0 0
141 Lodia Tablet 0 0
142 Loperamid Tablet 0 0
143 Loratadin 10 mg Tablet 0 0
144 Lubricating Jelly Tube 0 0
145 Mebendazol Tab 100 mg Tablet 0 0
146 Mediamere Tablet 0 0
147 Meloxicam 15 mg Tablet 0 0
148 Meloxicam 7,5 mg Tablet 0 0
149 Metformin 500 mg Tablet 450 0
150 Methil Prednisolon Tab 4 mg Tablet 0 0
151 Methil Prednisolon Tab 8 mg Tablet 0 0
152 Metil Ergometrin Inj Ampul 0 0
153 Metil ergometrin Tab 0,125 mg Tablet 0 0
154 Metoch / Ethiferan Inj 5 mg Ampul 0 0
155 Metoklopramid Tab 10 mg Tablet 0 0
156 Metronidazol Tab 250 mg Tablet 0 0
157 Metronidazol Tab 500 mg Tablet 0 0
158 Miconazol Salep Tube 0 0
159 Minyak Kayu Putih Botol 0 0
160 Molagit Tablet 0 0
161 Molexdryl Sirup Botol 0 0
162 Na.Diklofenak Tab 25 mg Tablet 700 0
163 Na.Diklofenak Tab 50 mg Tablet 500 0
164 Nifedipin Tab Tablet 0 0
165 Nistatin Supp Supp 0 0
166 Nistatin Tab Tablet 0 0
167 Nitral Vial 0 0
168 Obat Tambah Darah Tablet 0 0
169 OBH Sirup Botol 0 0
170 Ofloxacin Tab 200 mg Tablet 0 0
171 Ofloxacin Tab 400 mg Tablet 0 0
172 Oksitetrasiklin Inj 50 mg/vial Vial 0 0
173 Oksitetrasiklin Salep Kulit 3 % Tube 0 0
174 Oksitetrasiklin Salep Mata 1 % Tube 0 0
175 Oksitosin Inj 10 iu/ml Ampul 0 10
176 Omeprazole Kaps 20 mg Tablet 3200 0
177 ondasteron inj ampul 0 0
178 Papaverin Tab 40 mg Tablet 0 0
179 Paracetamol drops Botol 258 0
180 Paracetamol Syr 120 mg/5 ml Botol 160 0
181 Paracetamol Tab 100 mg Tablet 0 0
182 Paracetamol Tab 500 mg Tablet 5900 0
183 Peditox Botol 0 0
184 Piracetam Inj Ampul 0 0
185 Pirantel Pamoat Tab 125 mg Tablet 1700 0
186 Pirazinamid Tab 500 mg Tablet 0 0
187 Pirimetamin Sulfadoksin Tab Tablet 0 0
188 Piroxicam Kap 20 mg Tablet 0 0
189 Prednison Tab 5 mg Tablet 300 0
190 Primakina Tab 15 mg Tablet 0 0
191 Propanolol Tab 40 mg Tablet 0 0
192 Propiltiourasil Tab 100 mg Tablet 0 0
193 Pyridoksin (Vit.B6) Tab 10 mg Tablet 0 0
194 Ranitidin Inj Ampul 339 0
195 Ranitidin Tab 150 mg Tablet 700 0
196 Reserpin Tab 0,25 mg Tablet 0 0
197 Rifampisin 300 mg Kapsul 0 0
198 Rifampisin 450 mg Kapsul 0 0
199 Rifampisin 600 mg Kapsul 0 0
200 Risperidon Tablet 0 0
201 Salbutamol Tab 2 mg Tablet 0 0
202 Salbutamol Tab 4mg Tablet 0 0
203 Salep 2-4 Komb Pot 65 0
204 Salisil Bedak 2% kotak 0 0
205 Sangobion Tablet 0 0
206 Serum Anti Tetanus (ATS) 1500 I Vial 0 0
207 Sianokobalamin (Vit.B12) Inj Ampul 0 0
208 Sianokobalamin Tab 50 mg Tablet 0 0
209 Simvastatin Tablet 2200 0
 210 Stesolid Rectal Tube 0 0
211 Streptomicin Inj Vial 0 0
212 Sulfacetamid Tts Mata 15 % Botol 0 0
213 Tetrasiklin Kaps 500 mg Kapsul 0 0
214 Thiamin (Vit.B1) Inj Ampul 0 0
215 Thiamin (Vit.B1) Tab 50 mg Tablet 300 0
216 Tiamphenikol Kap 500 mg Kapsul 0 0
217 Tiamphenikol Syrup Botol 0 0
218 Tramadol Tab 50 mg Tablet 0 0
219 Triheksifenidil Tab 2 mg Tablet 0 0
220 Ventolin 2,5 mg Tube 0 0
221 Vit. A Biru Kapsul 0 0
222 Vit. A merah Kapsul 0 0
223 Vit. B com Injeksi Tablet 0 0
224 Vit. B kompleks Tab Tablet 1500 0
225 Xylomidon Inj Vial 0 0
226 Zinc Dispersible 20 mg Tablet 1500 0
Cairan dan Larutan
226 Alkohol 70 % Liter 0 0
227 Alkohol Swabs kotak 300 0
228 Aquabidest 500 ml Botol 0 0
229 Aquadest 100 ml Botol 0 0
230 Aquadest 25 ml Botol 0 0
231 ASK Botol 0 0
232 Glukosa Infus 10 % Botol 0 0
233 Glukosa Infus 5 % Botol 0 0
234 HCL 0,1 N 100 ML Botol 0 0
235 H2O2 3 % Botol 0 0
236 Lisol 50 % Botol 0 0
237 NaCl Infus 0,9 % Botol 5 0
238 Povidon Iodida 10% Botol 0 0
239 Ringer Laktat Infus Botol 85 0
240 Rivanol Lar 0,1 % 300ml Botol 0 0
241 Yodium Povidon 1000 ml Botol 0 0
242 Yodium Povidon 30 ml Botol 0 0
243 Yodium Povidon 300 ml kotak 0 0
Alat Kesehatan
243 Abbocath 16 G vasofix pcs 0 0
244 Abbocath 18 G vasofix pcs 0 0
245 Abbocath 20 G vasofix pcs 0 0
246 Abbocath 21 G vasofix pcs 0 0
247 Abbocath 24 G vasofix pcs 0 0
248 Abbocath 25 G vasofix pcs 0 0
249 Abbocath 27 G vasofix pcs 0 0
250 Alat Suntik Dispo 0,05 ml pcs 0 0
251 Alat Suntik Dispo 0,5 ml pcs 0 0
252 Alat Suntik Dispo 1 ml pcs 200 0
253 Alat Suntik Dispo 3 ml pcs 0 0
254 Alat Suntik Dispo 10 ml pcs 0 0
255 Alat Suntik Dispo 5 ml pcs 100 0
256 Aesculap blades Bisturi pcs 0 0
257 Catgut 2/0 (2 metric) pcs 0 0
258 Catgut 2/0 (3 metric) pcs 0 0
259 Catgut 2/0 (3,5 metric)DS-19 pcs 0 0
260 Catgut 2/0 (3,5 metric)DS-30 pcs 0 0
261 Catgut 2/0 with needle pcs 0 0
262 Catgut 3/0 (2 metric) pcs 0 0
263 Catgut Chromic no 3 pcs 0 0
264 Catgut chromic no 6 pcs 0 0
265 Coverplast pcs 0 0
266 Daryant Tulle kotak 0 0
268 Handschon M kotak 0 0
269 Handschon No.7 Steril pcs 0 0
270 Handschon No.7,5 pcs 0 0
271 Handschon S kotak 0 0
272 Handschoon 6,5 kotak 0 0
273 Handschoon L kotak 6 0
274 Hypapix Plester pcs 0 0
275 Infusion Set Anak pcs 0 0
276 Infusion Set Dewasa pcs 0 0
277 Kapas Pembalut 1000 mg Rol 0 0
278 Kapas Pembalut 250 mg Rol 0 0
279 Kapas Pembalut 500 mg Rol 0 0
280 Kasa Hidrofil 4 m x 10 cm Elastis kotak 0 0
281 Kasa Hidrofil 4 y x 80 cm Rol 0 0
282 Kasa Kompres Steril 40/40 kotak 0 0
283 Kasa Pembalut 2 m X 80 cm Rol 0 0
284 Kertas puyer perkamen Rim 0 0
285 Kasa Panjang 40 x 80 cm rol 0 0
286 Lancet kotak 0 0
287 Supratule kotak 0 0
287 Masker Earloop pcs 0 40
288 Medicet 20 G pcs 0 0
289 Medicet 24 G pcs 0 0
290 Needle 23 G X 1 1/4 pcs 0 0
291 Needle BR 10 pcs 0 0
 292 Needle BR 13 pcs 0 0
293 Needle BR 16 pcs 0 0
294 Needle BT 27 pcs 0 0
295 Needle GT 10 pcs 0 0
296 Needle GT 12 pcs 0 0
297 Needle GT 14 pcs 0 0
298 Otopain Tube 0 0
299 Pembalut Gibs pcs 0 0
300 Plastik Obat 5 x 8 kotak 0 0
301 Plastik Obat 7 x 10 kotak 0 0
302 Plastik Obat 8,7 x 13 kotak 0 0
Plester 5 y X 2 Inch / leukoplas 7,5
303 Rol 0
x 4,5 cm
304 Stick Rapid IMS / Syipilis pcs 0 0
305 Stick Rapid HIV Pcs 0 0
306 Stick HBsAg pcs 1 5
307 Silk No 2/0 pcs 0 0
308 Strip Hb famili pcs 300 250
305 Strip Test Cholestrol pcs 0 0
306 Strip test Glucose pcs 50 0
307 Strip test Uric Acid pcs 0 0
308 Surgical Blade No. 11 pcs 0 0
309 Surgical Blade No. 15 pcs 0 0
310 Surgical Blade No. 21 pcs 0 0
311 Surgical Masker (Betali) pcs 0 0
312 Wing Needle No.21 G x 3/4 kotak 0 0
313 Wing Needle No.23 G kotak 0 0
314 Wing Needle No.25 G kotak 0 0
315 Wing Needle No.27 G kotak 0 0
Obat Gigi
316 champhenol kotak 0 0
317 Cresotin kotak 0 0
318 master bond kotak 3 0
319 Paramon chlorofenol kotak 3 0
320 Cimento de zinco Botol 0 0
321 Devitec Botol 0 0
322 Duron Group pcs 0 0
323 Etil Klorid Spray Botol 7 0
324 Eugenol cair Botol 0 0
325 Farmacol Forte Botol 0 0
326 Fletcher Liquid Botol 0 0
327 Fletcher Powder Botol 0 0
328 Glass Ionemer Liquid 7,5 kotak 0 0
 329 Glass Ionemer Powder 100 gr Kotak 0 0
330 iodotin Botol 0 0
331 Klorfenol Kamfer Mentol(CHKM) Botol 0 0
332 Multifix Liquid Kotak 0 0
333 Multifix Powder Kotak 0 0
334 Natural Lock pcs 0 0
335 Pehacain inj Ampul 0 0
336 Phosphoric Acid Etchan 6 Kotak 0 0
337 Zitemp Botol 0 0
technew hydcal -paste base and
378 box 0
catalyst 0
339 denpro orafil plus temporary filling Botol 0 0
Laboratorium
340 Coverglass 18 X 18 pcs 0 0
341 Kartu Golda Lembar 0 0
342 Lancet pcs 0 0
343 Larutan HCl 1 % Botol 0 0
344 Pot sampel pcs 0 0
345 Rak Tabung reaksi pcs 0 0
346 Reagen Widal pcs 0 0
347 Slide pcs 0 0
348 Tabung Centrifuge pcs 0 0
349 One Med Test Kehamilan Instan pcs 0 0
350 0bjek glass 7105 box 0 0
351 Tabung EDTA 3 cc pcs 0 0
352 Anti A 10 ml (Gol-Darah) Botol 0 0
353 Anti AB 10 ml (Gol-Darah) Botol 0 0
354 Anti B 10 ml (Gol-Darah) Botol 0 0
356 Anti D 10 ml (Gol-Darah) Botol 0 0

Obat Tambahan
351 Batugin Tablet 0 0
352 Caviplex Tablet 0 0
353 Fondazen Tablet 0 0
354 Jeli USG Botol 0 0
357 Trombopop Tube 0 0
358 Vit. B com Injeksi Ampul 0 0
359 Tramadol Injeksi Ampul 0 0
360 Loratadine Tablet 0 0
361 Dextral tablet 0 0
 362 Antiseptic Botol 0 0
363 Doxycycline Tablet 0 0
364 Difenhidramin Injeksi Ampul 0 0
365 Zink Syrup Botol 0 0
366 Acetyl Sistem tab tablet 0 0
367 Alco Plus Syr btl 0 0
368 Curcuma Plus/Vitamin btl 0 0
369 ETABION Kapsul 0 0
370 reagen golongan darah kotak 0 0
371 silk surgiroll roll 0 0
372 Ambubag pcs 0 0
373 neek chler dewasa pcs 0
374 neek chler anak pcs 0
masker oksigen non rebreating
375 psc 0 0
Anak
376 nassal canule 02 'L' pcs 0 0
377 spalak psc 0 0
378 perlak underpad pcs 0 0
378 botol 0 0
curcuma sharpy blackcurent 200 ml
379 Cuticell Clasic 10 cm x 10cm pcs 0 0
380 Aesculap Blades (Bisturi) box 0 0
381 Plesterin bulat non woven pcs 0 0
382 Hansaplas pcs 0 0
383 I.V Catheter 20G (STERACTH) Pcs 0 0
384 Vasofik I.V Chateter No 18 pcs 0 0
389 Lumpang pcs 0 0
390 mortir pcs 0 0
391 suture needle hecting pcs 0 0
392 hipavix pcs 0 0
393 dermafix pcs 0 0
394 Curcuma sharpy strawbery 60 ml botol 0 0
395 Curcuma Grow orange 200 ml botol 0 0
396 Metformin 850 mg tablet 0 0
397 Trepocheck sypilis pcs 0 0
Mengetahui Mengetahui Mengetahui
Kepala Puskesmas Sesua Kepala UPTD GFK Mal Petugas UPTD GFK Malinau

Eddy Aryadie. A.Md.,Kl Selfie Palalangan S.Si Faris Dwi S. A.Md.,Far

Nip. 19750218 200502 1001 Nip. 19731127 200604 Nip. 19900805 201403 1 001
AN LEMBAR PERMINTAAN OBAT

PELAPORAN BULAN : JULI 2022

PERMINTAAN BLN/PERIODE : TW 3

SISA STOK KETERANGAN

PEMAKAIAN PERMINTAAN
STOK OPS EXD
24 511
100 1250
0 0
0 0
0 0
300 3500
0 0
0 0
500 300
0 0
0 0
0 0
300 1000
0 0
500 4700
10 387
0 0
0 0
10 5
0 0

0 0
500 4200
10 152
0 0
0 0
0 0
0 0
600 21600
300 2400
0 0
0 0
0 0
24 203
0 0
0 0
 0 0
0 0
0 0
300 2500
100 1300
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
300 2600
0 0
0 0
0 0
0 0
0 0
500 5700
0 0
0 0
2 18
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
300 700
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
 0 0
0 0
0 0
0 0
0 0
5 37
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
300 1350
0 0
0 0
0 0
0 0
500 2500
0 0
0 0
0 0
0 0
0 0
0 0
24 140
10 34
0 0
0 0
0 0
0 0
0 0
0 0
0 0
300 1700
0 0
300 100
0 0
0 0
0 0
0 0
0 0
 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
5 255
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
200 850
100 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
200 500
100 500
0 0
0 0
0 0
 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
300 3900
0 0
0 0
20 430
20 340
0 0
500 7300
0 0
0 0
100 1600
0 0
0 0
0 0
300 1000
0 0
0 0
0 0
0 0
5 409
200 1500
0 0
0 0
0 0
0 0
0 0
0 0
0 0
5 60
0 0
0 0
0 0
0 0
0 0
300 3900
 0 0
0 0
0 0
0 0
0 0
300 1000
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
500 3000
0 0
400 3100

3 7
100 200
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
5 20
0 0
5 120
0 0
0 0
0 0
0 0

0 0
0 0
0 0
0 0
0 0
0 0
 0 0
0 0
0 0
100 100
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
5 35
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
1 4
0 0
50 500
0 0
25 25
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
Mengetahui Mengetahui
Petugas UPTD GFK Malinau Petugas Gudang Obat Puskesmas

Faris Dwi S. A.Md.,Far Trifena, A.Md.Farm

Nip. 19900805 201403 1 001 PTT
 LAPORAN PEMAKAIAN DAN LEMBAR PERM
PUSKESMAS : SESUA
KECAMATAN : MALINAU BARAT
KABUPATEN : MALINAU

STOK
NO NAMA OBAT SATUAN PENERIMAAN
AWAL
1 Acyclovir Salep Kulit Tube 511
2 Acyclovir Tab 400 mg Tablet 1250
3 Adrenalin Bitartat Ampul 0
4 Albendazole 400 mg Tablet 0
5 Alletrol tetes mata Botol 0
6 Allopurinol Tab 100 mg Tablet 3500
7 Alpara Tablet 0
8 Ambroxol Syr 15 mg/5 ml Botol 0
9 Ambroxol Tab 30 mg Tablet 300
10 Aminofilin Inj 24 mg/ml Ampul 0
11 Aminofilin Tab 200 mg Tablet 0
12 Amitriptilin Tab 25 mg Tablet 0
13 Amlodipin 5 mg Tablet 1000
14 Amoksisillin Kap 250 mg Tablet 0
15 Amoksisillin Kap 500 mg Tablet 4700
16 Amoksisillin Syr 125 mg/5 ml Botol 387
17 Ampicillin Injeksi Ampul 0
18 Ampisilin Kap 500 mg Tablet 0
19 Ampisilin Syr 125 mg/5 ml Botol 5
20 Antalgin Inj 250 mg/ml Ampul 0
21 Antalgin Tab 500 mg/ Metamozole Tablet 0
22 Antasid DOEN Tab Komb Tablet 4200
23 Antasid Sirup Botol 152
24 Antifungi DOEN Pot 0
25 Antihaemoroid DOEN Komb Supp 0
26 Arsuamon Tab Tablet 0
27 Arterakine Tab Tablet 0
28 Asam Askorbat Tab 50 mg Tablet 21600
29 Asam Folat 1 mg Tablet 2400
30 Asam Mefenamat Kap 500 mg Tablet 0
31 Atropin Sulfat Inj 0,25 mg/ml Ampul 0
32 Bacitrasin Salep Tube 0
33 Betametason Cream 0,1 % Tube 203
34 Bioplacenton Tube 0
35 Bromheksin Tablet 0
36 Bromheksin Sirup Botol 0
37 Burnazin Tube 0
38 Buscopan Tab 10 mg Tablet 0
39 Captopril 12,5 mg Tablet 2500
Captopril 25 mg Tablet 1300
41 Cefixime Kaps 100 mg Kapsul 0
42 Cefixime Syrup Botol 0
43 Cendocetamide 15 % Botol 0
44 Cendotropin Tetes Mata Botol 0
45 Centabio Tube 0
46 Cephadroxil Kap 250 mg Kapsul 0
47 Cephadroxil Kap 500 mg Kapsul 0
48 Cephadroxil Syr Botol 0
49 Cetirizine Tablet 2600
50 Chefalexin Kap 500 mg Tablet 0
51 Cimetidine 200 mg Tablet 0
52 Cinolon N 10 gr Tube 0
53 Ciprofloxacin Tab 500 mg Tablet 0
54 Cohistin Syrup Botol 0
56 CTM Tab 4 mg Tablet 5700
57 Curcuma Tablet 0
58 Curliv Syrup/Multivitamin syr Botol 0
59 Deksametason Inj 5 mg/ml Ampul 18
60 Deksametason Tab 0,5 mg Tablet 0
61 Dekstrometorfan HBr 15 mg Tablet 0
62 Dekstrometorfan Syr Botol 0
63 Diazepam Inj 5 mg/ml Ampul 0
64 Diazepam Tab 2 mg Tablet 0
65 Diclofam 50 mg Tablet 0
66 Digoksin Tab 0,25 mg Tablet 0
67 Diltiazem Tab 30 Mg Tablet 0
68 Domperidon Tab Tablet 700
69 Doxycicline Kaps 100 mg Kapsul 0
70 Dulcolax Supp Anak Supp 0
71 Dulcolax/bisakodil Tab 5 mg Tablet 0
72 Dumin Tablet 0
73 Efedrin Tab 25 mg Tablet 0
74 Efinefrin Inj 0,1 % Ampul 0
75 Ekstrak Belladon Tab 10 mg Tablet 0
76 Elkana Tablet 0
77 Ergotamin Koffein Tab Tablet 0
78 Erlamicetine Botol 0
79 Erytromisin Kap 500 mg Kapsul 0
80 Erytromisin Syr 125 mg/ 5 ml Botol 0
 81 Etambutol Tab 500 mg Tablet 0
82 Famotidin 20 mg/40 mg Tablet 0
83 Fenobarbital Inj 50 mg/ml Ampul 0
84 Fenobarbital Tab 30 mg Tablet 0
85 Fenol Gliserol Tts Telinga 10 % Botol 37
86 Ferrous Sulfat Tab Tablet 0
87 Fitomenadion (Vit.K) Inj Ampul 0
88 Fitomenadion (Vit.K) Tab Tablet 0
89 Fitomenadion (Vit.K3) Inj Ampul 0
90 Fluoroscein Tetes Mata 2 % Botol 0
91 Furosemid Inj 10 ml Ampul 0
92 Furosemid Tab 40 mg Tablet 0
93 Gamexan Emulsi 1 % Botol 0
94 Garam Oralit 200 ml Sachet 1350
95 Genoit Salep Mata Tube 0
96 Gentamisin Salep Kulit Tube 0
98 Gentamisin Tetes Mata Botol 0
99 Gentian Violet Lar 1 % Botol 0
100 GG Tab 100 mg Tablet 2500
101 Glibenklamid Tab 5 mg Tablet 0
102 Glimepiride 2 mg Tablet 0
103 Glimepiride 4 mg Tablet 0
104 Griseofulvin Tab 125 mg Tablet 0
105 Griseofulvin Tab 500 mg Tablet 0
106 Haloperidol Tab 0,5 mg Tablet 0
107 Hidrokortison Cream 2,5 % Tube 140
108 Ibuprofen syr botol 34
109 Ibuprofen Tab 400 mg Tablet 0
110 Ichtiyol Salep Pot 0
111 INH Tab 100 mg Tablet 0
112 INH Tab 300 mg Tablet 0
113 Inmatrol Tetes Mata Botol 0
114 Inpepsa Sirup Botol 0
115 Isosorbid Dinitrat Tab 10mg Tablet 0
116 Kalium Diklofenak Tab 50 mg Tablet 1700
117 Kalium Permanganat Tablet 0
118 Kalsium Laktat Tab 500 mg Tablet 100
119 Kanamicyn Inj Vial 0
120 Ketokonazole Cream 2 % Tube 0
121 Ketokonazole Tab 200 mg Tablet 0
122 Kinina Tab 222 mg Tablet 0
123 Klindamisin 150 mg Kapsul 0
124 Klindamisin 300 mg Kapsul 0
125 Kloramfenikol Kaps 250 mg Kapsul 0
126 Kloramfenikol Salep Mata 1 % Tube 0
127 Kloramfenikol Syr 125 mg/5 ml Botol 0
128 Kloramfenikol Tetes Mata Botol 0
129 Kloramfenikol Tetes Telinga 3 % Botol 0
130 Klorpromazin 100 mg Tablet 0
131 Kodein Tab 10 mg Tablet 0
132 Kotrimoksazol syr 240 mg/5 ml Botol 0
133 Kotrimoksazol Tab 120 mg Tablet 0
134 Kotrimoksazol Tab 400 mg Tablet 0
135 Lidokain komb Inj Inj 0
136 Lanzoprazole Kapsul 0
137 Levertran Salep Tube 0
138 Levofloxacin Tab 500 mg Tablet 0
139 Lidokain komb Inj Ampul 255
140 Livron B Plex Tablet 0
141 Lodia Tablet 0
142 Loperamid Tablet 0
143 Loratadin 10 mg Tablet 0
144 Lubricating Jelly Tube 0
145 Mebendazol Tab 100 mg Tablet 0
146 Mediamere Tablet 0
147 Meloxicam 15 mg Tablet 0
148 Meloxicam 7,5 mg Tablet 0
149 Metformin 500 mg Tablet 850
150 Methil Prednisolon Tab 4 mg Tablet 0
151 Methil Prednisolon Tab 8 mg Tablet 0
152 Metil Ergometrin Inj Ampul 0
153 Metil ergometrin Tab 0,125 mg Tablet 0
154 Metoch / Ethiferan Inj 5 mg Ampul 0
155 Metoklopramid Tab 10 mg Tablet 0
156 Metronidazol Tab 250 mg Tablet 0
157 Metronidazol Tab 500 mg Tablet 0
158 Miconazol Salep Tube 0
159 Minyak Kayu Putih Botol 0
160 Molagit Tablet 0
161 Molexdryl Sirup Botol 0
162 Na.Diklofenak Tab 25 mg Tablet 500
163 Na.Diklofenak Tab 50 mg Tablet 500
164 Nifedipin Tab Tablet 0
165 Nistatin Supp Supp 0
166 Nistatin Tab Tablet 0
167 Nitral Vial 0
168 Obat Tambah Darah Tablet 0
169 OBH Sirup Botol 0
170 Ofloxacin Tab 200 mg Tablet 0
171 Ofloxacin Tab 400 mg Tablet 0
172 Oksitetrasiklin Inj 50 mg/vial Vial 0
173 Oksitetrasiklin Salep Kulit 3 % Tube 0
174 Oksitetrasiklin Salep Mata 1 % Tube 0
175 Oksitosin Inj 10 iu/ml Ampul 0
176 Omeprazole Kaps 20 mg Tablet 3900
177 ondasteron inj ampul 0
178 Papaverin Tab 40 mg Tablet 0
179 Paracetamol drops Botol 430
180 Paracetamol Syr 120 mg/5 ml Botol 340
181 Paracetamol Tab 100 mg Tablet 0
182 Paracetamol Tab 500 mg Tablet 7300
183 Peditox Botol 0
184 Piracetam Inj Ampul 0
185 Pirantel Pamoat Tab 125 mg Tablet 1600
186 Pirazinamid Tab 500 mg Tablet 0
187 Pirimetamin Sulfadoksin Tab Tablet 0
188 Piroxicam Kap 20 mg Tablet 0
189 Prednison Tab 5 mg Tablet 1000
190 Primakina Tab 15 mg Tablet 0
191 Propanolol Tab 40 mg Tablet 0
192 Propiltiourasil Tab 100 mg Tablet 0
193 Pyridoksin (Vit.B6) Tab 10 mg Tablet 0
194 Ranitidin Inj Ampul 409
195 Ranitidin Tab 150 mg Tablet 1500
196 Reserpin Tab 0,25 mg Tablet 0
197 Rifampisin 300 mg Kapsul 0
198 Rifampisin 450 mg Kapsul 0
199 Rifampisin 600 mg Kapsul 0
200 Risperidon Tablet 0
201 Salbutamol Tab 2 mg Tablet 0
202 Salbutamol Tab 4mg Tablet 0
203 Salep 2-4 Komb Pot 60
204 Salisil Bedak 2% kotak 0
205 Sangobion Tablet 0
206 Serum Anti Tetanus (ATS) 1500 IU Vial 0
207 Sianokobalamin (Vit.B12) Inj Ampul 0
208 Sianokobalamin Tab 50 mg Tablet 0
209 Simvastatin Tablet 3900
210 Stesolid Rectal Tube 0
 211 Streptomicin Inj Vial 0
212 Sulfacetamid Tts Mata 15 % Botol 0
213 Tetrasiklin Kaps 500 mg Kapsul 0
214 Thiamin (Vit.B1) Inj Ampul 0
215 Thiamin (Vit.B1) Tab 50 mg Tablet 1000
216 Tiamphenikol Kap 500 mg Kapsul 0
217 Tiamphenikol Syrup Botol 0
218 Tramadol Tab 50 mg Tablet 0
219 Triheksifenidil Tab 2 mg Tablet 0
220 Ventolin 2,5 mg Tube 0
221 Vit. A Biru Kapsul 0
222 Vit. A merah Kapsul 0
223 Vit. B com Injeksi Tablet 0
224 Vit. B kompleks Tab Tablet 3000
225 Xylomidon Inj Vial 0
226 Zinc Dispersible 20 mg Tablet 3100
Cairan dan Larutan
226 Alkohol 70 % Liter 7
227 Alkohol Swabs kotak 200
228 Aquabidest 500 ml Botol 0
229 Aquadest 100 ml Botol 0
230 Aquadest 25 ml Botol 0
231 ASK Botol 0
232 Glukosa Infus 10 % Botol 0
233 Glukosa Infus 5 % Botol 0
234 HCL 0,1 N 100 ML Botol 0
235 H2O2 3 % Botol 0
236 Lisol 50 % Botol 0
237 NaCl Infus 0,9 % Botol 20
238 Povidon Iodida 10% Botol 0
239 Ringer Laktat Infus Botol 120
240 Rivanol Lar 0,1 % 300ml Botol 0
241 Yodium Povidon 1000 ml Botol 0
242 Yodium Povidon 30 ml Botol 0
243 Yodium Povidon 300 ml kotak 0
Alat Kesehatan
243 Abbocath 16 G vasofix pcs 0
244 Abbocath 18 G vasofix pcs 0
245 Abbocath 20 G vasofix pcs 0
246 Abbocath 21 G vasofix pcs 0
247 Abbocath 24 G vasofix pcs 0
248 Abbocath 25 G vasofix pcs 0
249 Abbocath 27 G vasofix pcs 0
250 Alat Suntik Dispo 0,05 ml pcs 0
251 Alat Suntik Dispo 0,5 ml pcs 0
252 Alat Suntik Dispo 1 ml pcs 100
253 Alat Suntik Dispo 3 ml pcs 0
254 Alat Suntik Dispo 10 ml pcs 0
255 Alat Suntik Dispo 5 ml pcs 0
256 Aesculap blades Bisturi pcs 0
257 Catgut 2/0 (2 metric) pcs 0
258 Catgut 2/0 (3 metric) pcs 0
259 Catgut 2/0 (3,5 metric)DS-19 pcs 0
260 Catgut 2/0 (3,5 metric)DS-30 pcs 0
261 Catgut 2/0 with needle pcs 0
262 Catgut 3/0 (2 metric) pcs 0
263 Catgut Chromic no 3 pcs 0
264 Catgut chromic no 6 pcs 0
265 Coverplast pcs 0
266 Daryant Tulle kotak 0
268 Handschon M kotak 0
269 Handschon No.7 Steril pcs 0
270 Handschon No.7,5 pcs 0
271 Handschon S kotak 0
272 Handschoon 6,5 kotak 0
273 Handschoon L kotak 0
274 Hypapix Plester pcs 0
275 Infusion Set Anak pcs 0
276 Infusion Set Dewasa pcs 0
277 Kapas Pembalut 1000 mg Rol 0
278 Kapas Pembalut 250 mg Rol 0
279 Kapas Pembalut 500 mg Rol 0
280 Kasa Hidrofil 4 m x 10 cm Elastis kotak 0
281 Kasa Hidrofil 4 y x 80 cm Rol 0
282 Kasa Kompres Steril 40/40 kotak 0
283 Kasa Pembalut 2 m X 80 cm Rol 0
284 Kertas puyer perkamen Rim 0
285 Kasa Panjang 40 x 80 cm rol 0
286 Lancet kotak 0
287 Supratule kotak 0
287 Masker Earloop pcs 35
288 Medicet 20 G pcs 0
289 Medicet 24 G pcs 0
290 Needle 23 G X 1 1/4 pcs 0
291 Needle BR 10 pcs 0
292 Needle BR 13 pcs 0
 293 Needle BR 16 pcs 0
294 Needle BT 27 pcs 0
295 Needle GT 10 pcs 0
296 Needle GT 12 pcs 0
297 Needle GT 14 pcs 0
298 Otopain Tube 0
299 Pembalut Gibs pcs 0
300 Plastik Obat 5 x 8 kotak 0
301 Plastik Obat 7 x 10 kotak 0
302 Plastik Obat 8,7 x 13 kotak 0
Plester 5 y X 2 Inch / leukoplas 7,5 x
303 Rol 0
4,5 cm
304 Stick Rapid IMS / Syipilis pcs 0
305 Stick Rapid HIV Pcs 0
306 Stick HBsAg pcs 4
307 Silk No 2/0 pcs 0
308 Strip Hb famili pcs 500
305 Strip Test Cholestrol pcs 0
306 Strip test Glucose pcs 25
307 Strip test Uric Acid pcs 0
308 Surgical Blade No. 11 pcs 0
309 Surgical Blade No. 15 pcs 0
310 Surgical Blade No. 21 pcs 0
311 Surgical Masker (Betali) pcs 0
312 Wing Needle No.21 G x 3/4 kotak 0
313 Wing Needle No.23 G kotak 0
314 Wing Needle No.25 G kotak 0
315 Wing Needle No.27 G kotak 0
Obat Gigi
316 champhenol kotak 0
317 Cresotin kotak 0
318 master bond kotak 0
319 Paramon chlorofenol kotak 0
320 Cimento de zinco Botol 0
321 Devitec Botol 0
322 Duron Group pcs 0
323 Etil Klorid Spray Botol 0
324 Eugenol cair Botol 0
325 Farmacol Forte Botol 0
326 Fletcher Liquid Botol 0
327 Fletcher Powder Botol 0
328 Glass Ionemer Liquid 7,5 kotak 0
329 Glass Ionemer Powder 100 gr Kotak 0
 330 iodotin Botol 0
331 Klorfenol Kamfer Mentol(CHKM) Botol 0
332 Multifix Liquid Kotak 0
333 Multifix Powder Kotak 0
334 Natural Lock pcs 0
335 Pehacain inj Ampul 0
336 Phosphoric Acid Etchan 6 Kotak 0
337 Zitemp Botol 0
technew hydcal -paste base and
378 box 0
catalyst
339 denpro orafil plus temporary filling Botol 0
Laboratorium
340 Coverglass 18 X 18 pcs 0
341 Kartu Golda Lembar 0
342 Lancet pcs 0
343 Larutan HCl 1 % Botol 0
344 Pot sampel pcs 0
345 Rak Tabung reaksi pcs 0
346 Reagen Widal pcs 0
347 Slide pcs 0
348 Tabung Centrifuge pcs 0
349 One Med Test Kehamilan Instan pcs 0
350 0bjek glass 7105 box 0
351 Tabung EDTA 3 cc pcs 0
352 Anti A 10 ml (Gol-Darah) Botol 0
353 Anti AB 10 ml (Gol-Darah) Botol 0
354 Anti B 10 ml (Gol-Darah) Botol 0
356 Anti D 10 ml (Gol-Darah) Botol 0
Obat Tambahan
351 Batugin Tablet 0
352 Caviplex Tablet 0
353 Fondazen Tablet 0
354 Jeli USG Botol 0
357 Trombopop Tube 0
358 Vit. B com Injeksi Ampul 0
359 Tramadol Injeksi Ampul 0
360 Loratadine Tablet 0
361 Dextral tablet 0
362 Antiseptic Botol 0
363 Doxycycline Tablet 0
364 Difenhidramin Injeksi Ampul 0
365 Zink Syrup Botol 0
366 Acetyl Sistem tab tablet 0
 367 Alco Plus Syr btl 0
368 Curcuma Plus/Vitamin btl 0
369 ETABION Kapsul 0
370 reagen golongan darah kotak 0
371 silk surgiroll roll 0
372 Ambubag pcs 0
373 neek chler dewasa pcs 0
374 neek chler anak pcs 0
375 masker oksigen non rebreating Anak psc 0
376 nassal canule 02 'L' pcs 0
377 spalak psc 0
378 perlak underpad pcs 0
378 curcuma sharpy blackcurent 200 ml botol 0
379 Cuticell Clasic 10 cm x 10cm pcs 0
380 Aesculap Blades (Bisturi) box 0
381 Plesterin bulat non woven pcs 0
382 Hansaplas pcs 0
383 I.V Catheter 20G (STERACTH) Pcs 0
384 Vasofik I.V Chateter No 18 pcs 0
389 Lumpang pcs 0
390 mortir pcs 0
391 suture needle hecting pcs 0
392 hipavix pcs 0
393 dermafix pcs 0
394 Curcuma sharpy strawbery 60 ml botol 0
395 Curcuma Grow orange 200 ml botol 0
396 Metformin 850 mg tablet 0
397 Trepocheck sypilis pcs 0
Mengetahui Mengetahui
Kepala Puskesmas Sesua Kepala UPTD GFK Malinau

Eddy Aryadie. A.Md.,Kl Selfie Palalangan S.Si

Nip. 19750218 200502 1001 Nip. 19731127 200604 2 004
IAN DAN LEMBAR PERMINTAAN OBAT

PELAPORAN BULAN : AGUSTUS 2022

PERMINTAAN BLN/PERIODE : TW 3

SISA STOK KETERANGAN

PERSEDIAN PEMAKAIAN PERMINTAAN
STOK OPS EXD
0 24 487
0 300 950
0 0 0
0 0 0
0 0 0
0 300 3200
0 0 0
0 0 0
0 300 0
0 0 0
0 0 0
0 0 0
0 300 700
0 0 0
0 500 4200
0 20 367
0 0 0
0 0 0
0 5 0
0 0 0
0 0 0
0 500 3700
0 10 142
0 0 0
0 0 0
0 0 0
0 0 0
0 500 21.1
0 500 1900
0 0 0
0 0 0
0 0 0
0 24 179
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 300 2200
0 300 1000
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 300 2300
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 500 5200
0 0 0
0 0 0
0 5 13
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 200 500
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 5 32
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 350 1000
0 0 0
0 0 0
0 0 0
0 0 0
0 500 2000
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 24 166
0 5 29
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 100 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 10 245
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 200 300
0 200 300
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
10 0 0
0 200 3700
0 0 0
0 0 0
0 10 420
0 10 330
0 0 0
0 500 6800
0 0 0
0 0 0
0 100 1500
0 0 0
0 0 0
0 0 0
0 300 700
0 0 0
0 0 0
0 0 0
0 0 0
0 5 404
0 200 1300
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 5 5
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 300 3600
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 300 700
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 500 2500
0 0 0
0 500 2600

0 2 5
0 200 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 5 15
0 0 0
0 5 115
0 0 0
0 0 0
0 0 0
0 0 0

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 100
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 10 25
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 50 450
0 0 0
0 25 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0
0
0 0 0
0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
Mengetahui Mengetahui
Petugas UPTD GFK Malinau Petugas Gudang Obat Puskesmas

Faris Dwi S. A.Md.,Far Trifena, A.Md.Farm

Nip. 19900805 201403 1 001 PTT
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
PUSKESMAS : SESUA
KECAMATAN : MALINAU BARAT PELAPORAN BULAN : SEPTEMBER 2022
KABUPATEN : MALINAU PERMINTAAN BLN/PERIODE : TW 3

STOK SISA STOK KETERANGAN

NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAN PEMAKAIAN PERMINTAAN
AWAL STOK OPS EXD
1 Acyclovir Salep Kulit Tube 487 0 24 463 50 Tube
2 Acyclovir Tab 400 mg Tablet 950 0 0 0 20 BOX
3 Adrenalin Bitartat Ampul 0 0 0 0
4 Albendazole 400 mg Tablet 0 0 0 0
5 Alletrol tetes mata Botol 0 0 0 0
6 Allopurinol Tab 100 mg Tablet 3200 0 300 2900 50 BOX
7 Alpara Tablet 0 0 0 0
8 Ambroxol Syr 15 mg/5 ml Botol 0 0 0 0 50 BOTOL
9 Ambroxol Tab 30 mg Tablet 0 0 0 0 50 BOX
10 Aminofilin Inj 24 mg/ml Ampul 0 0 0 0
11 Aminofilin Tab 200 mg Tablet 0 0 0 0
12 Amitriptilin Tab 25 mg Tablet 0 0 0 0
13 Amlodipin 5 mg Tablet 700 0 100 600 20 BOX
14 Amoksisillin Kap 250 mg Tablet 0 0 0 0
15 Amoksisillin Kap 500 mg Tablet 4200 0 500 3700 50 BOX
16 Amoksisillin Syr 125 mg/5 ml Botol 367 0 10 357 2 KOTAK
17 Ampicillin Injeksi Ampul 0 0 0 0
18 Ampisilin Kap 500 mg Tablet 0 0 0 0
19 Ampisilin Syr 125 mg/5 ml Botol 0 0 0 0
20 Antalgin Inj 250 mg/ml Ampul 0 0 0 0
Antalgin Tab 500 mg/
21 Tablet 0 0 0 0
Metamozole
22 Antasid DOEN Tab Komb Tablet 3700 0 500 3200 50 BOX
23 Antasid Sirup Botol 142 0 10 132 3 KOTAK
24 Antifungi DOEN Pot 0 0 0 0
25 Antihaemoroid DOEN Komb Supp 0 0 0 0
26 Arsuamon Tab Tablet 0 0 0 0
27 Arterakine Tab Tablet 0 0 0 0
28 Asam Askorbat Tab 50 mg Tablet 21600 0 500 21100 30 BOX
29 Asam Folat 1 mg Tablet 1900 0 500 1400 30 BOX
30 Asam Mefenamat Kap 500 mg Tablet 0 0 0 0 30 BOX
 STOK SISA STOK KETERANGAN
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAN PEMAKAIAN PERMINTAAN
AWAL STOK OPS EXD
31 Atropin Sulfat Inj 0,25 mg/ml Ampul 0 0 0 0
32 Bacitrasin Salep Tube 0 0 0 0
33 Betametason Cream 0,1 % Tube 179 0 24 155 5 KOTAK
34 Bioplacenton Tube 0 0 0 0
35 Bromheksin Tablet 0 0 0 0
36 Bromheksin Sirup Botol 0 0 0 0
37 Burnazin Tube 0 0 0 0
38 Buscopan Tab 10 mg Tablet 0 0 0 0
39 Captopril 12,5 mg Tablet 2200 0 200 2000
Captopril 25 mg Tablet 1000 0 100 900
41 Cefixime Kaps 100 mg Kapsul 0 0 0 0 10 BOX
42 Cefixime Syrup Botol 0 0 0 0
43 Cendocetamide 15 % Botol 0 0 0 0
44 Cendotropin Tetes Mata Botol 0 0 0 0
45 Centabio Tube 0 0 0 0
46 Cephadroxil Kap 250 mg Kapsul 0 0 0 0
47 Cephadroxil Kap 500 mg Kapsul 0 0 0 0
48 Cephadroxil Syr Botol 0 0 0 0
49 Cetirizine Tablet 2300 0 300 1000 30 BOX
50 Chefalexin Kap 500 mg Tablet 0 0 0 0
51 Cimetidine 200 mg Tablet 0 0 0 0
52 Cinolon N 10 gr Tube 0 0 0 0
53 Ciprofloxacin Tab 500 mg Tablet 0 0 0 0
54 Cohistin Syrup Botol 0 0 0 0
56 CTM Tab 4 mg Tablet 5200 0 500 4700 50 BOX
57 Curcuma Tablet 0 0 0 0 20 BOTOL
58 Curliv Syrup/Multivitamin syr Botol 0 0 0 0
59 Deksametason Inj 5 mg/ml Ampul 13 0 2 11 10 AMPUL
60 Deksametason Tab 0,5 mg Tablet 0 0 0 0 50 BOX
61 Dekstrometorfan HBr 15 mg Tablet 0 0 0 0
62 Dekstrometorfan Syr Botol 0 0 0 0
63 Diazepam Inj 5 mg/ml Ampul 0 0 0 0
64 Diazepam Tab 2 mg Tablet 0 0 0 0
65 Diclofam 50 mg Tablet 0 0 0 0
66 Digoksin Tab 0,25 mg Tablet 0 0 0 0
 STOK SISA STOK KETERANGAN
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAN PEMAKAIAN PERMINTAAN
AWAL STOK OPS EXD
67 Diltiazem Tab 30 Mg Tablet 0 0 0 0
68 Domperidon Tab Tablet 500 0 0 0 20 BOX
69 Doxycicline Kaps 100 mg Kapsul 0 0 0 0
70 Dulcolax Supp Anak Supp 0 0 0 0 20 SUPP
71 Dulcolax/bisakodil Tab 5 mg Tablet 0 0 0 0 10 BOX
72 Dumin Tablet 0 0 0 0
73 Efedrin Tab 25 mg Tablet 0 0 0 0
74 Efinefrin Inj 0,1 % Ampul 0 0 0 0
75 Ekstrak Belladon Tab 10 mg Tablet 0 0 0 0
76 Elkana Tablet 0 0 0 0
77 Ergotamin Koffein Tab Tablet 0 0 0 0
78 Erlamicetine Botol 0 0 0 0
79 Erytromisin Kap 500 mg Kapsul 0 0 0 0 5 BOX
80 Erytromisin Syr 125 mg/ 5 ml Botol 0 0 0 0
81 Etambutol Tab 500 mg Tablet 0 0 0 0
82 Famotidin 20 mg/40 mg Tablet 0 0 0 0
83 Fenobarbital Inj 50 mg/ml Ampul 0 0 0 0
84 Fenobarbital Tab 30 mg Tablet 0 0 0 0
85 Fenol Gliserol Tts Telinga 10 % Botol 32 0 2 30
86 Ferrous Sulfat Tab Tablet 0 0 0 0 50 BOX
87 Fitomenadion (Vit.K) Inj Ampul 0 0 0 0
88 Fitomenadion (Vit.K) Tab Tablet 0 0 0 0
89 Fitomenadion (Vit.K3) Inj Ampul 0 0 0 0
90 Fluoroscein Tetes Mata 2 % Botol 0 0 0 0
91 Furosemid Inj 10 ml Ampul 0 0 0 0
92 Furosemid Tab 40 mg Tablet 0 0 0 0
93 Gamexan Emulsi 1 % Botol 0 0 0 0
94 Garam Oralit 200 ml Sachet 1000 0 300 700
95 Genoit Salep Mata Tube 0 0 0 0 250 TUBE
96 Gentamisin Salep Kulit Tube 0 0 0 0 250 TUBE
98 Gentamisin Tetes Mata Botol 0 0 0 0 250 TUBE
99 Gentian Violet Lar 1 % Botol 0 0 0 0
100 GG Tab 100 mg Tablet 2000 0 500 1500 50 BOX
101 Glibenklamid Tab 5 mg Tablet 0 0 0 0
102 Glimepiride 2 mg Tablet 0 0 0 0
 STOK SISA STOK KETERANGAN
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAN PEMAKAIAN PERMINTAAN
AWAL STOK OPS EXD
103 Glimepiride 4 mg Tablet 0 0 0 0
104 Griseofulvin Tab 125 mg Tablet 0 0 0 0
105 Griseofulvin Tab 500 mg Tablet 0 0 0 0
106 Haloperidol Tab 0,5 mg Tablet 0 0 0 0
107 Hidrokortison Cream 2,5 % Tube 166 0 24 142
108 Ibuprofen syr botol 29 0 5 24 5 KOTAK
109 Ibuprofen Tab 400 mg Tablet 0 0 0 0 20 BOX
110 Ichtiyol Salep Pot 0 0 0 0 10 POT
111 INH Tab 100 mg Tablet 0 0 0 0
112 INH Tab 300 mg Tablet 0 0 0 0
113 Inmatrol Tetes Mata Botol 0 0 0 0
114 Inpepsa Sirup Botol 0 0 0 0
115 Isosorbid Dinitrat Tab 10mg Tablet 0 0 0 0
116 Kalium Diklofenak Tab 50 mg Tablet 0 0 0 0 20 BOX
117 Kalium Permanganat Tablet 0 0 0 0
118 Kalsium Laktat Tab 500 mg Tablet 0 0 0 0 20 BOX
119 Kanamicyn Inj Vial 0 0 0 0
120 Ketokonazole Cream 2 % Tube 0 0 0 0
121 Ketokonazole Tab 200 mg Tablet 0 0 0 0 20 BOX
122 Kinina Tab 222 mg Tablet 0 0 0 0
123 Klindamisin 150 mg Kapsul 0 0 0 0
124 Klindamisin 300 mg Kapsul 0 0 0 0
125 Kloramfenikol Kaps 250 mg Kapsul 0 0 0 0 10 BOX
126 Kloramfenikol Salep Mata 1 % Tube 0 0 0 0 100 TUBE
127 Kloramfenikol Syr 125 mg/5 ml Botol 0 0 0 0
128 Kloramfenikol Tetes Mata Botol 0 0 0 0 20 BOTOL
129 Kloramfenikol Tetes Telinga 3 Botol 0 0 0 0 20 BOTOL
130 Klorpromazin 100 mg Tablet 0 0 0 0
131 Kodein Tab 10 mg Tablet 0 0 0 0
132 Kotrimoksazol syr 240 mg/5 ml Botol 0 0 0 0 1 KOTAK
133 Kotrimoksazol Tab 120 mg Tablet 0 0 0 0
134 Kotrimoksazol Tab 400 mg Tablet 0 0 0 0
135 Lidokain komb Inj Inj 0 0 0 0
136 Lanzoprazole Kapsul 0 0 0 0
137 Levertran Salep Tube 0 0 0 0
 STOK SISA STOK KETERANGAN
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAN PEMAKAIAN PERMINTAAN
AWAL STOK OPS EXD
138 Levofloxacin Tab 500 mg Tablet 0 0 0 0
139 Lidokain komb Inj Ampul 245 0 5 240
140 Livron B Plex Tablet 0 0 0 0
141 Lodia Tablet 0 0 0 0
142 Loperamid Tablet 0 0 0 0 20 BOX
143 Loratadin 10 mg Tablet 0 0 0 0 10 BOX
144 Lubricating Jelly Tube 0 0 0 0 10 TUBE
145 Mebendazol Tab 100 mg Tablet 0 0 0 0
146 Mediamere Tablet 0 0 0 0 10 BOX
147 Meloxicam 15 mg Tablet 0 0 0 0 10 BOX
148 Meloxicam 7,5 mg Tablet 0 0 0 0 20 BOX
149 Metformin 500 mg Tablet 0 0 0 0 10 BOX
150 Methil Prednisolon Tab 4 mg Tablet 0 0 0 0 50 BOX
151 Methil Prednisolon Tab 8 mg Tablet 0 0 0 0
152 Metil Ergometrin Inj Ampul 0 0 0 0
153 Metil ergometrin Tab 0,125 mg Tablet 0 0 0 0
154 Metoch / Ethiferan Inj 5 mg Ampul 0 0 0 0
155 Metoklopramid Tab 10 mg Tablet 0 0 0 0
156 Metronidazol Tab 250 mg Tablet 0 0 0 0 20 BOX
157 Metronidazol Tab 500 mg Tablet 0 0 0 0
158 Miconazol Salep Tube 0 0 0 0 5 KOTAK
159 Minyak Kayu Putih Botol 0 0 0 0 24 BOTOL
160 Molagit Tablet 0 0 0 0 20 BOX EXP 30-09-2022
161 Molexdryl Sirup Botol 0 0 0 0
162 Na.Diklofenak Tab 25 mg Tablet 300 0 100 200
163 Na.Diklofenak Tab 50 mg Tablet 300 0 100 200
164 Nifedipin Tab Tablet 0 0 0 0
165 Nistatin Supp Supp 0 0 0 0
166 Nistatin Tab Tablet 0 0 0 0
167 Nitral Vial 0 0 0 0
168 Obat Tambah Darah Tablet 0 0 0 0 50 BOX
169 OBH Sirup Botol 0 0 0 0
170 Ofloxacin Tab 200 mg Tablet 0 0 0 0
171 Ofloxacin Tab 400 mg Tablet 0 0 0 0
172 Oksitetrasiklin Inj 50 mg/vial Vial 0 0 0 0
 STOK SISA STOK KETERANGAN
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAN PEMAKAIAN PERMINTAAN
AWAL STOK OPS EXD
173 Oksitetrasiklin Salep Kulit 3 % Tube 0 0 0 0
174 Oksitetrasiklin Salep Mata 1 % Tube 0 0 0 0
175 Oksitosin Inj 10 iu/ml Ampul 0 10 0 0 3 KOTAK
176 Omeprazole Kaps 20 mg Tablet 3700 0 200 3500 20 BOX
177 ondasteron inj ampul 0 0 0 0
178 Papaverin Tab 40 mg Tablet 0 0 0 0
179 Paracetamol drops Botol 420 0 10 410 3 KOTAK
180 Paracetamol Syr 120 mg/5 ml Botol 330 0 10 320 3 KOTAK
181 Paracetamol Tab 100 mg Tablet 0 0 0 0
182 Paracetamol Tab 500 mg Tablet 6800 0 500 6300 50 BOX
183 Peditox Botol 0 0 0 0
184 Piracetam Inj Ampul 0 0 0 0
185 Pirantel Pamoat Tab 125 mg Tablet 1500 0 100 1400 2 KOTAK EXP 15-09-2022
186 Pirazinamid Tab 500 mg Tablet 0 0 0 0
187 Pirimetamin Sulfadoksin Tab Tablet 0 0 0 0
188 Piroxicam Kap 20 mg Tablet 0 0 0 0
189 Prednison Tab 5 mg Tablet 700 0 100 600 20 BOX
190 Primakina Tab 15 mg Tablet 0 0 0 0
191 Propanolol Tab 40 mg Tablet 0 0 0 0
192 Propiltiourasil Tab 100 mg Tablet 0 0 0 0
193 Pyridoksin (Vit.B6) Tab 10 mg Tablet 0 0 0 0
194 Ranitidin Inj Ampul 404 0 5 399
195 Ranitidin Tab 150 mg Tablet 1300 0 300 1000 10 BOX
196 Reserpin Tab 0,25 mg Tablet 0 0 0 0
197 Rifampisin 300 mg Kapsul 0 0 0 0
198 Rifampisin 450 mg Kapsul 0 0 0 0
199 Rifampisin 600 mg Kapsul 0 0 0 0
200 Risperidon Tablet 0 0 0 0
201 Salbutamol Tab 2 mg Tablet 0 0 0 0 20 BOX
202 Salbutamol Tab 4mg Tablet 0 0 0 0
203 Salep 2-4 Komb Pot 5 0 0 0
204 Salisil Bedak 2% kotak 0 0 0 0 20 KOTAK
205 Sangobion Tablet 0 0 0 0 10 KOTAK
206 Serum Anti Tetanus (ATS) 150 Vial 0 0 0 0
207 Sianokobalamin (Vit.B12) Inj Ampul 0 0 0 0 10 KOTAK
 STOK SISA STOK KETERANGAN
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAN PEMAKAIAN PERMINTAAN
AWAL STOK OPS EXD
208 Sianokobalamin Tab 50 mg Tablet 0 0 0 0
209 Simvastatin Tablet 3600 0 300 3300 30 BOX
210 Stesolid Rectal Tube 0 0 0 0
211 Streptomicin Inj Vial 0 0 0 0
212 Sulfacetamid Tts Mata 15 % Botol 0 0 0 0
213 Tetrasiklin Kaps 500 mg Kapsul 0 0 0 0
214 Thiamin (Vit.B1) Inj Ampul 0 0 0 0
215 Thiamin (Vit.B1) Tab 50 mg Tablet 700 0 200 500
216 Tiamphenikol Kap 500 mg Kapsul 0 0 0 0
217 Tiamphenikol Syrup Botol 0 0 0 0
218 Tramadol Tab 50 mg Tablet 0 0 0 0
219 Triheksifenidil Tab 2 mg Tablet 0 0 0 0
220 Ventolin 2,5 mg Tube 0 0 0 0
221 Vit. A Biru Kapsul 0 0 0 0
222 Vit. A merah Kapsul 0 0 0 0
223 Vit. B com Injeksi Tablet 0 0 0 0
224 Vit. B kompleks Tab Tablet 2500 0 500 2000 50 BOX
225 Xylomidon Inj Vial 0 0 0 0
226 Zinc Dispersible 20 mg Tablet 2600 0 200 2400
Cairan dan Larutan
226 Alkohol 70 % Liter 5 0 0 0 10 BOTOL
227 Alkohol Swabs kotak 0 0 0 0 50 KOTAK
228 Aquabidest 500 ml Botol 0 0 0 0 10 BOTOL
229 Aquadest 100 ml Botol 0 0 0 0 10 BOTOL
230 Aquadest 25 ml Botol 0 0 0 0 10 BOTOL
231 ASK Botol 0 0 0 0
232 Glukosa Infus 10 % Botol 0 0 0 0
233 Glukosa Infus 5 % Botol 0 0 0 0
234 HCL 0,1 N 100 ML Botol 0 0 0 0
235 H2O2 3 % Botol 0 0 0 0 5 BOTOL
236 Lisol 50 % Botol 0 0 0 0 5 BOTOL
237 NaCl Infus 0,9 % Botol 15 0 0 15
238 Povidon Iodida 10% Botol 0 0 0 0 10 BOTOL
239 Ringer Laktat Infus Botol 115 0 5 110
240 Rivanol Lar 0,1 % 300ml Botol 0 0 0 0 20 BOTOL
 STOK SISA STOK KETERANGAN
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAN PEMAKAIAN PERMINTAAN
AWAL STOK OPS EXD
241 Yodium Povidon 1000 ml Botol 0 0 0 0
242 Yodium Povidon 30 ml Botol 0 0 0 0
243 Yodium Povidon 300 ml kotak 0 0 0 0
Alat Kesehatan
243 Abbocath 16 G vasofix pcs 0 0 0 0
244 Abbocath 18 G vasofix pcs 0 0 0 0
245 Abbocath 20 G vasofix pcs 0 0 0 0
246 Abbocath 21 G vasofix pcs 0 0 0 0
247 Abbocath 24 G vasofix pcs 0 0 0 0
248 Abbocath 25 G vasofix pcs 0 0 0 0
249 Abbocath 27 G vasofix pcs 0 0 0 0
250 Alat Suntik Dispo 0,05 ml pcs 0 0 0 0 5 KOTAK
251 Alat Suntik Dispo 0,5 ml pcs 0 0 0 0
252 Alat Suntik Dispo 1 ml pcs 100 0 0 0 5 KOTAK
253 Alat Suntik Dispo 3 ml pcs 0 0 0 0 20 KOTAK
254 Alat Suntik Dispo 10 ml pcs 0 0 0 0
255 Alat Suntik Dispo 5 ml pcs 0 0 0 0 5 KOTAK
256 Aesculap blades Bisturi pcs 0 0 0 0
257 Catgut 2/0 (2 metric) pcs 0 0 0 0 2 KOTAK
258 Catgut 2/0 (3 metric) pcs 0 0 0 0 2 KOTAK
259 Catgut 2/0 (3,5 metric)DS-19 pcs 0 0 0 0 2 KOTAK
260 Catgut 2/0 (3,5 metric)DS-30 pcs 0 0 0 0
261 Catgut 2/0 with needle pcs 0 0 0 0 2 KOTAK
262 Catgut 3/0 (2 metric) pcs 0 0 0 0
263 Catgut Chromic no 3 pcs 0 0 0 0 1 KOTAK
264 Catgut chromic no 6 pcs 0 0 0 0 1 KOTAK
265 Coverplast pcs 0 0 0 0
266 Daryant Tulle kotak 0 0 0 0
268 Handschon M kotak 0 0 0 0 10 KOTAK
269 Handschon No.7 Steril pcs 0 0 0 0
270 Handschon No.7,5 pcs 0 0 0 0 1 KOTAK
271 Handschon S kotak 0 0 0 0 10 KOTAK
272 Handschoon 6,5 kotak 0 0 0 0
273 Handschoon L kotak 0 0 0 0 10 KOTAK
274 Hypapix Plester pcs 0 0 0 0 10 KOTAK
 STOK SISA STOK KETERANGAN
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAN PEMAKAIAN PERMINTAAN
AWAL STOK OPS EXD
275 Infusion Set Anak pcs 0 0 0 0
276 Infusion Set Dewasa pcs 0 0 0 0
277 Kapas Pembalut 1000 mg Rol 0 0 0 0
278 Kapas Pembalut 250 mg Rol 0 0 0 0
279 Kapas Pembalut 500 mg Rol 0 0 0 0
280 Kasa Hidrofil 4 m x 10 cm Elastikotak 0 0 0 0
281 Kasa Hidrofil 4 y x 80 cm Rol 0 0 0 0
282 Kasa Kompres Steril 40/40 kotak 0 0 0 0 50 KOTAK
283 Kasa Pembalut 2 m X 80 cm Rol 0 0 0 0
284 Kertas puyer perkamen Rim 0 0 0 0 50 RIM
285 Kasa Panjang 40 x 80 cm rol 0 0 0 0
286 Lancet kotak 0 0 0 0
287 Supratule kotak 0 0 0 0 20 KOTAK
287 Masker Earloop pcs 25 0 5 20 80 KOTAK
288 Medicet 20 G pcs 0 0 0 0
289 Medicet 24 G pcs 0 0 0 0
290 Needle 23 G X 1 1/4 pcs 0 0 0 0
291 Needle BR 10 pcs 0 0 0 0
292 Needle BR 13 pcs 0 0 0 0
293 Needle BR 16 pcs 0 0 0 0
294 Needle BT 27 pcs 0 0 0 0
295 Needle GT 10 pcs 0 0 0 0
296 Needle GT 12 pcs 0 0 0 0
297 Needle GT 14 pcs 0 0 0 0
298 Otopain Tube 0 0 0 0
299 Pembalut Gibs pcs 0 0 0 0
300 Plastik Obat 5 x 8 kotak 0 0 0 0 100 RIM
301 Plastik Obat 7 x 10 kotak 0 0 0 0 100 RIM
302 Plastik Obat 8,7 x 13 kotak 0 0 0 100 RIM
Plester 5 y X 2 Inch / leukoplas
303 Rol 0 0 0 0
7,5 x 4,5 cm
304 Stick Rapid IMS / Syipilis pcs 0 0 0 0 3 KOTAK
305 Stick Rapid HIV Pcs 0 0 0 0 5 KOTAK
306 Stick HBsAg pcs 0 0 0 1 5 KOTAK
307 Silk No 2/0 pcs 0 0 0 0 1 PCS
 STOK SISA STOK KETERANGAN
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAN PEMAKAIAN PERMINTAAN
AWAL STOK OPS EXD
308 Strip Hb famili pcs 450 0 50 400
305 Strip Test Cholestrol pcs 0 0 0 0 350 KOTAK
306 Strip test Glucose pcs 0 0 0 0 350 KOTAK
307 Strip test Uric Acid pcs 0 0 0 0 350 KOTAK
308 Surgical Blade No. 11 pcs 0 0 0 0
309 Surgical Blade No. 15 pcs 0 0 0 0
310 Surgical Blade No. 21 pcs 0 0 0 0
311 Rapid test NS 1 pcs 0 0 0 0 5 KOTAK
312 Wing Needle No.21 G x 3/4 kotak 0 0 0 0
313 Wing Needle No.23 G kotak 0 0 0 0
314 Wing Needle No.25 G kotak 0 0 0 0
315 Wing Needle No.27 G kotak 0 0 0 0
Obat Gigi
316 champhenol kotak 0 0 0 0 5 KOTAK
317 Cresotin kotak 0 0 0 0 5 KOTAK
318 master bond kotak 0 0 0 0 5 KOTAK
319 Paramon chlorofenol kotak 0 0 0 0 5 KOTAK
320 Cimento de zinco Botol 0 0 0 0
321 Devitec Botol 0 0 0 0
322 Duron Group pcs 0 0 0 0
323 Etil Klorid Spray Botol 0 0 0 0 5 KOTAK
324 Eugenol cair Botol 0 0 0 0 5 KOTAK
325 Farmacol Forte Botol 0 0 0 0
326 Fletcher Liquid Botol 0 0 0 0
327 Fletcher Powder Botol 0 0 0 0
328 Glass Ionemer Liquid 7,5 kotak 0 0 0 0 5 KOTAK
329 Glass Ionemer Powder 100 gr Kotak 0 0 0 0 5 KOTAK
330 iodotin Botol 0 0 0 0 5 KOTAK
331 Klorfenol Kamfer Mentol(CHK Botol 0 0 0 0
332 Multifix Liquid Kotak 0 0 0 0
333 Multifix Powder Kotak 0 0 0 0
334 Natural Lock pcs 0 0 0 0
335 Pehacain inj Ampul 0 0 0 0
336 Phosphoric Acid Etchan 6 Kotak 0 0 0 0 5 KOTAK
337 Zitemp Botol 0 0 0 0 5 KOTAK
 STOK SISA STOK KETERANGAN
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAN PEMAKAIAN PERMINTAAN
AWAL STOK OPS EXD
technew hydcal -paste base and
378 box 0 0
catalyst 0
denpro orafil plus temporary
339 Botol 0 0
filling 0 0
0 0 0
Laboratorium
340 Coverglass 18 X 18 pcs 0 0 0 0
341 Kartu Golda Lembar 0 0 0 0
342 Lancet pcs 0 0 0 0
343 Larutan HCl 1 % Botol 0 0 0 0
344 Pot sampel pcs 0 0 0 0
345 Rak Tabung reaksi pcs 0 0 0 0
346 Reagen Widal pcs 0 0 0 0
347 Slide pcs 0 0 0 0
348 Tabung Centrifuge pcs 0 0 0 0
349 One Med Test Kehamilan Instanpcs 0 0 0 0
350 0bjek glass 7105 box 0 0 0 0
351 Tabung EDTA 3 cc pcs 0 0 0 0
352 Anti A 10 ml (Gol-Darah) Botol 0 0 0 0
353 Anti AB 10 ml (Gol-Darah) Botol 0 0 0 0
354 Anti B 10 ml (Gol-Darah) Botol 0 0 0 0
356 Anti D 10 ml (Gol-Darah) Botol 0 0 0 0
0
0 0
0
0
Obat Tambahan 0
351 Batugin Tablet 0 0 0 0 10 BOX
352 Caviplex Tablet 0 0 0 0 10 BOX
353 Fondazen Tablet 0 0 0 0
354 Jeli USG Botol 0 0 0 0 10 BOTOL
357 Trombopop Tube 0 0 0 0 5 KOTAK
358 Vit. B com Injeksi Ampul 0 0 0 0
359 Tramadol Injeksi Ampul 0 0 0 0
360 Loratadine Tablet 0 0 0 0
 STOK SISA STOK KETERANGAN
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAN PEMAKAIAN PERMINTAAN
AWAL STOK OPS EXD
361 Dextral tablet 0 0 0 0
362 Antiseptic Botol 0 0 0 0
363 Doxycycline Tablet 0 0 0 0
364 Difenhidramin Injeksi Ampul 0 0 0 0
365 Zink Syrup Botol 0 0 0 0 2 KOTAK
366 Acetyl Sistem tab tablet 0 0 0 0
367 Alco Plus Syr btl 0 0 0 0
368 Curcuma Plus/Vitamin btl 0 0 0 0 20 BOX
369 ETABION Kapsul 0 0 0 0
370 reagen golongan darah kotak 0 0 0 0 5 KOTAK
371 silk surgiroll roll 0 0 0 0 10 BOX
372 Ambubag pcs 0 0 0 0
373 neek chler dewasa pcs 0 0 0 0
374 neek chler anak pcs 0 0 0 0
masker oksigen non rebreating
375 psc 0 0 0 0
Anak

0 0 0 0
376 nassal canule 02 'L' pcs
377 spalak psc 0 0 0 0
378 perlak underpad pcs 0 0 0 0
378 curcuma sharpy blackcurent botol 0 0 0 0
200 ml 20 BOTOL

0 0 0 0
379 Cuticell Clasic 10 cm x 10cm pcs
380 Aesculap Blades (Bisturi) box 0 0 0 0
381 Plesterin bulat non woven pcs 0 0 0 0
382 Hansaplas pcs 0 0 0 0 3 KOTAK
383 I.V Catheter 20G (STERACTH)Pcs 0 0 0 0
384 Vasofik I.V Chateter No 18 pcs 0 0 0 0
389 Lumpang pcs 0 0 0 0
390 mortir pcs 0 0 0 0
391 suture needle hecting pcs 0 0 0 0
392 hipavix pcs 0 0 0 0 10 PCS
393 dermafix pcs 0 0 0 0
 STOK SISA STOK KETERANGAN
NO NAMA OBAT SATUAN PENERIMAAN PERSEDIAN PEMAKAIAN PERMINTAAN
AWAL STOK OPS EXD

394 Curcuma sharpy strawbery 60 botol 0

ml 0 0 0 10 KOTAK
395 Curcuma Grow orange 200 ml botol 0 0 0 0
396 Metformin 850 mg tablet 0 0 0 0
397 Trepocheck sypilis pcs 0 0 0 0
Mengetahui Mengetahui Mengetahui Mengetahui
Kepala Puskesmas Sesua Kepala UPTD GFK Malinau Petugas UPTD GFK Malinau Petugas Gudang Obat Puskesmas

Eddy Aryadie. A.Md.,Kl Selfie Palalangan S.Si Faris Dwi S. A.Md.,Far Trifena, A.Md.Farm
Nip. 19750218 200502 1001 Nip. 19731127 200604 2 004 Nip. 19900805 201403 1 001 PTT