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LAPORAN PEMAKAIAN DAN LEMBARAN

PERMINTAAN OBAT ( LPLPO )

KODE PUSKESMAS :18051501


PUSKESMAS : MAELANG
KECAMATAN : SANG TOMBOLANG
KABUPATEN : BOLAANG MONGONDOW
PROPINSI : SULAWESI UTARA
BULAN : JANUARI
TAHUN : 2021

STOK PENERI PEMAK STOK


NO NAMA OBAT SATUAN
AWAL MAAN AIAN AKHIR
KET

1 Abbocath18 PCS 530 0 10 520


2 Abbocath 20 PCS 248 0 66 182
3 Abbocath 22 PCS 25 0 5 20
4 Abbocath 24 PCS 4 0 4 0
5 Ajitab Tab Kotak 100 Tab 0 0 0
6 Alat Suntik 1,0 ml Kotak 100 PCS 600 0 0 600
7 Alat Suntik 2,5 ml Kotak 100 PCS 0 0 0 0
8 Alat Suntik 3,0 ml Kotak 100 PCS 225 0 60 165
9 Alat Suntik 5,0 ml Kotak 100 PCS 1200 0 100 1100
10 Alat Suntik 10 ml Kotak 100 PCS 500 0 0 500
11 Albendazole 400 mg Kotak 100 100 0 0 100
12 Allopurinol 100 mg Kotak 100 Tab 0 0 0 0
13 Alprazolam 0,5 mg Kotak 100 Tab 0 0 0 0
14 Alprazolam 1,0 mg Kotak 100 Tab 0 0 0 0
15 Ambroxol 30 mg Kotak 100 Tab 6500 0 2000 4500
16 Aminophyilin inj Kotak 30 Amp 0 0 0 0
17 Aminophyilin Tab 200 mg Botol 100 Tab 1000 0 0 1000
18 Amitriptilin tab Kotak 100 Tab 0 0 0 0
19 Amlodipin 10 mg Kotak 30 Tab 100 0 0 100
20 Amlodipin 5,0 mg Kotak 30 Tab 0 0 0 0
21 Ampicilin inj Kotak 10 Vial 0 0 0 0
22 Ampicilin Cap 500 mg Kotak 100 Cap 0 0 0 0
23 Amoksisilin 500 mg Kotak 100 Cap 18500 0 3000 15500
24 Amoksisilin Syrp Kering 125 mg/5 ml Btl 60 ml 0 0 0 0
25 Ampicilin Syrp Kering 125 mg/5 ml Btl 100 ml 0 0 0 0
26 Antalgin 500 mg Kotak 100 Tab 0 0 0 0
27 Antalgin 500 mg Botol 1000 Tab 0 0 0 0
28 Antasida DOEN Kotak 100 Tab 200 0 200 0
29 Antasida DOEN Botol 1000 Tab 0 0 0 0
30 Antides New Kotak 100 100 0 0 100
31 Antihemoroid DOEN Kotak 10 supp 200 0 0 200
32 Antihemoroid Supp Kotak 6 144 0 6 138
33 Anti malaria DOEN Kotak 100 Tab 0 0 0 0
34 Antasida DOEN Syrp Botol 100 ml 0 0 0 0
35 Acyclovir tab 200 mg Kotak 50 Tab 800 0 0 800
36 Acyclovir tab 400 mg Kotak 50 Tab 900 0 0 900
37 Acyclovir Cream 5 g Kotak 24 Tube 0 0 0 0
38 Asam folat 1 mg Botol100 Tab 100 0 100 0
39 Asam ascorbat 50 mg Kotak 100Tab 2700 0 1000 1700
40 Aqua Pro inj Steril Kotak 10 Vial 0 0 0 0
41 Alkohol 70 % Botol 100 ml 0 0 0 0
42 Alkohol 70 % Botol 1 Liter 12 0 2 10
43 Alkohol Swab Kotak @100pcs 0 0 0 0
44 Artesunat inj 60 mg Kotak 1 Vial 0 0 0 0
45 Asam mefenamat 500 mg Kotak 100 Tab 0 0 0 0
46 Aseptan Botol 0 0 0 0
47 Atropin Sulfat Tab 0,5 mg Kotak 100 Tab 0 0 0 0
48 Basitrasin + polimiksin (anti bakteri salep) Kotak 24 Tube 0 0 0 0
49 Betahistin tablet Kotak 30 tab 0 0 0 0
50 Bisoprolol 5 mg Kotak 30 Tab 0 0 0 0
51 Bromhexin 8 mg Tab Kotak 100 Tab 0 0 0 0
52 Brochifar Kotak 100 Tab 0 0 0 0
53 Bromifar Plus Syr Botol 60 ml 0 0 0 0
54 Bedak Salisyl 2 % Kotak 0 0 0 0
55 Betametason krim Ktk 25 tube 239 0 78 161
56 Bexicom C Kotak 100 Tab 0 0 0 0
57 Brocon Tab Kotak 100 Tab 0 0 0 0
58 Bufacetin Salep (kloramfenicol 2%) Tube 15 Gram 0 0 0 0
59 Cat Gut Plain no.3/0 Dos @ 24's 24 24 5 43
60 Cat Gut Plain no.2/0 Dos @ 24's 19 24 5 38
61 Cat Gut Cromic no.3/0 Dos @ 24's 24 24 0 48
62 Cat Gut Cromic no.2/0 Dos @ 24's 24 24 0 48
63 Captopril 12,5 mg Tab Kotak 100 Tab 700 0 0 700
64 Captopril 25 mg Tab Kotak 100 Tab 0 0 0 0
65 Carbamazepin Tab 200 mg Kotak 100 Tab 0 0 0 0
66 Clorpheniramin Malet 4 mg Tab/CTM Botol1000Tab 700 0 300 400
67 Cefixime Kota 50 Tab 0 0 0 0
68 Cimetidin 200 mg tab Kotak 100 Tab 0 0 0 0
69 Cianocobalamin Tab 50 mg Kotak 100 Tab 25700 0 2000 23700
70 Cetrizin 10 mg tab Kotak 50 Tab 0 0 0 0
71 Cetrizin Hcl syrup Botol 46 0 20 26
72 Cefadroxil 500 mg Cap Kotak 100 caps 0 0 0 0
73 Cefadroxil 500 mg Cap Kotak 100 Caps 500 0 500 0
74 Cianocobalamin inj 500 MCg Kotak 100 amp 0 0 0 0
75 Ciprofloxasin 50 mg Kotak 100 0 0 0 0
76 Clorpromazin 100 mg Tab Kotak 100 Tab 0 0 0 0
77 Cloramphenicol TTS Telinga 3 % Botol 5 ml 0 0 0 0
78 Cloramphenicol TTS Mata 1 % Kotak 24 Tube 0 0 0 0
79 Cloramphenicol Salep Mata 1 % Tube 5 g 0 0 0 0
80 Cloramphenicol Caps 250 mg Kotak 100 Kaps 0 0 0 0
81 Cloroquin Botol 1000 Tab 0 0 0 0
82 Cotrimoxazol 480 mg Tab Kotak 100 Tab 0 0 0 0
83 Cotimoxazol 120 mg Tab Kotak 100 tab 0 0 0 0
84 Cotimoxazol Susp Botol 60 ml 0 0 0 0
85 Colfin Kotak 100 0 0 0 0
86 Co Amoxiclav Ktk @ 30 tab 0 0 0 0
87 Curbion syrup Btl 60 mL 0 0 0 0
88 Dapyrin tab kotak 100 Tab 0 0 0 0
89 Dextrose 5% Botol 500 ml 40 0 0 40
90 Dexametason Inj Kotak 100 amp 0 0 0 0
91 Dexametason Tab 0,5 mg Botol 1000 tab 0 0 0 0
92 Dexametason Tab 0,5 mg Kotak 100 Tab 4000 0 0 4000
93 Dextrometorpan syrp 10 mg/5 ml botol 60 ml 0 0 0 0
94 Dextrometorpan Tab Kotak 100 Tab 0 0 0 0
95 Devosix Drops Botol 15 ml 0 0 0 0
96 Dextrometorpan Tab Botol 1000 Tab 0 0 0 0
97 Diazepam inj 5 mg/ml Kotak 30 Amp 30 0 0 30
98 Diazepam 2 mg tab Kotak 100 Tab 0 0 0 0
99 Diazepam 2 mg tab Botol 1000 Tab 0 0 0 0
100 Diazepam 5 mg tab botol 250 Tab 0 0 0 0
101 Diazepam (valdimex)tablet kotak 100 tab 1970 0 0 1970
102 Diethylcarbamazepin 100 mg Kotak 100 Tab 0 0 0 0
103 Diphenhydramin Inj I.M 10 mg/ml Kotak 30 amp 413 0 20 393
104 Digoxin TAB 0,25 mg Kotak 100 tab 0 0 0 0
105 Doxicylin 100 mg Kaps Kotak 100 caps 0 0 0 0
106 Donperidon Tab 10 mg Kotak 100 tab 0 0 0 0
107 Diltiazem HCL Tab 30 mg Kotak 100 Tab 500 0 0 500
108 Epedrin HCL TAB Botol 250 Tab 0 0 0 0
109 Epedrin HCL TAB Botol 1000 Tab 0 0 0 0
110 Ephinefrin Inj 0,1 % Kotak 100 Amp 0 0 0 0
111 Ehtylclor Semprot Botol 0 0 0 0
112 Erytromicin 500 mg Kaps Kotak 100 caps 0 0 0 0
113 Examination Glove Kotak 100 pcs 0 0 0 0
114 Farsifen Plus Kotak 100 Tab 0 0 0 0
115 Fenol gliserol tetes telinga botol 5 ml 0 0 0 0
116 Fenorbarbital Inj 50 ml Kotak 30 Amp 0 0 0 0
117 Fenorbarbital 30 mg Tab Botol 100 Tab 0 0 0 0
118 Fenorbarbital 30 mg Tab Botol 1000 Tab 0 0 0 0
119 Fytomenadion Inj 10 mg/ml Kotak 30 Amp 0 0 0 0
120 Fytomenadion 10 mg Kotak 100 Tab 0 0 0 0
121 Furosemide 40 mg tab kotak 200 Tab 0 0 0 0
122 Fenilbutazon 200 mg Botol 1000 Tab 0 0 0 0
123 Fenitoin 100 mg kaps Botol 100 cabs 1000 0 0 1000
124 Flunadin Tab Kotak 100 Tab 0 0 0 0
125 Folley Catheter No.24 PCS 0 0 0 0
126 Folley Catheter No.20 PCS 10 psg 199 0 0 199
127 Folley Catheter No.18 PCS 10 psg 318 0 28 290
128 Ferosulfat 300 mg Botol 1000 Tab 0 0 0 0
129 Garam Oralit Kotak 100 saset 0 0 0 0
130 Gastricid Tab Kotak 100 Tab 0 0 0 0
131 Gentamicin Inj 80 mg Kotak 5 amp 0 0 0 0
132 Gentian Violet Lart 1% Botol 10 ml 0 0 0 0
133 Glibenclamide 5 mg Kotak 100 Tab 0 0 0 0
134 Glass lonomer Btl/Set 0 0 0 0
135 Glyseril Guayakolat Botol 1000 Tab 0 0 0 0
136 Glucotrol xl Tab 10 mg Kotak 30 Tab 0 0 0 0
137 Grisiofulvin 500mg Kotak 100 Tab 0 0 0 0
138 HydroclortiazidTab 25 mg Botol 1000 Tab 0 0 0 0
139 Hydrocortison Krim 2,5 % Kotak 24 Tube 113 0 50 63
140 Halloperidol 1,5 mg tab Kotak 100 tab 0 0 0 0
141 Halloperidol 0,5 mg tab Kotak 100 Tab 0 0 0 0
142 Halloperidol inj 50mg/ml kotak 10 ampul 8 0 0 8
143 Haidol DC 50 Mg Inj Kotak 5 Ampul 40 0 0 40
144 Handscun No.8.0 (Sateglove Surgical) Kotak 50 PCS 0 0 0 0
145 Handscun No.7,5 (Sateglove Surgical) Kotak 50 PCS 0 0 0 0
146 Handscun No.7 Kotak 50 PCS 0 0 0 0
147 Infuset DWS Sak 0 0 0 0
148 Infuset anak Sak 200 0 25 175
149 Insulatard Kotak 10 Vial 0 0 0 0
150 Insuman Comb Kotak 5pen@3m/ 0 0 0 0
151 Ichtiyol SK 15 gr Kotak 12 pot 0 0 0 0
152 Ibupropen Syrp 100 Mg Botol 60 ml 0 0 0 0
153 Ibupropen 400 Kotak 100 Tab 0 0 0 0
154 Ibupropen 200 Kotak 100 tab 0 0 0 0
155 Isosorbit Dinitrit TAB Kotak 100 tab 0 0 0 0
156 Indo Obat Cacing Kotak 25 Tab 0 0 0 0
157 Kalcium Lactat 500 mg Tab Kotak 100 Tab 0 0 0 0
158 Kapas 250 mg ROLL 148 0 15 133
159 Kapas 500 mg ROLL 0 0 0 0
160 Kasa steril 16 x 16 cm ROLL 0 0 0 0
161 Kasa pembalut 4 x 5 cm ROLL 0 0 0 0
162 Kasa Kompres 4 x 10 cm ROLL 0 0 0 0
163 Kasa Kompres 2 x 80 cm ROLL 28 0 10 18
164 Kasa Hydrophyl 4 x 15 cm ROLL 0 0 0 0
165 Kasa Hydrophyl 40 x 80 cm ROLL 0 0 0 0
166 Kasa Penyerap luka Bakar pcs 0 0 0 0
167 Ketoconazole Tab 200mg Kotak 50 Tab 0 0 0 0
168 Ketoconazole Cream 2 % tube 5 g 0 0 0 0
169 Kuinina 222 mg Tab Botol 1000 Tab 540 0 0 540
170 Lansoprazole Kaps 30 mg Ktak 20 kaps 0 0 0 0
171 Lantus Solostan Kotak 5 pen 0 0 0 0
172 Lidocain Inj 2% (pehacain) Kotak 20 Amp 400 0 75 325
173 Lidocain Inj 2% (pehacain) Kotak 20 Amp 0 0 0
174 Lidocain Inj 2% kotak 10 Amp 0 0 0
175 Levofloxacin 500mg Tab Kotak 50 tab 0 0 0
176 Lisol Botol 100 ml 0 0 0
177 Loratadin 10 mg Kotak 100 tab 650 0 0 650
178 Meloxicam 15 Mg Kotak 50 tab 0 0 0 0
179 Multivitamin utk ibu hamil (Prenase) Kotak 100 tab 0 0 0 0
180 Metyl Ergometri Maleat Tab 0,125 mg Kotak 100 tab 0 0 0 0
181 Metil Prednisolon Kotak 100 tab 0 0 0 0
182 Metyl Ergometri Inj kotak 100 Amp 0 0 0 0
183 Metacetin syrup Btl 60 mL 0 0 0 0
184 Metformin Kotak 100 tab 0 0 0 0
185 Metronidazole tab 250 mg Kotak 100 tab 0 0 0 0
186 Metronidazole tab 500 mg (Omenizol) Kotak 100 tab 0 0 0 0
187 Metronodazol sirup botol 0 0 0 0

188 Metronidazole ovula 500mg/vagisol kotak 5 ovula 145 0 0 145


189 Mulsanol Syr Botol 60 ml 0 0 0 0
190 Mykonazole Cream 2% Tube 5 g 395 0 25 370
191 Masker Kotak 50 pcs 0 0 0 0
192 Neo Envios kotak. 100 kpl 0 0 0
193 NaCL 0,9% Botol 500 ml 342 0 0 342
194 Nat. Diclofenak 50 mg Kotak 50 tab 0 0 0 0
195 Nifedipin Tab 10 mg Kotak 100 tab 0 0 0 0
196 Novomix 30 fkx pen Kotak 5 Vial 0 0 0 0
197 Nystatin Vaginal Tab 100.000 IU Kotak 100 Tab 300 0 10 290
198 Obat Cairan Untuk Luka Bakar Botol 40 ml 0 0 0 0
199 Obat Cairan Untuk Sariawan Botol 40 ml 0 0 0 0
200 OBH Syirup Botol100 ml 0 0 0 0
201 Omeneuron Kotak. 100 kpl 0 0 0 0
202 Oxytetracyclin S.K 3% Tube 5 g 0 0 0 0
203 Omegavit Kotak. 100 kpl 0 0 0 0
204 Omegesic Kotak 100 tab 0 0 0 0
205 Omegdiar Kotak. 100 kpl 0 0 0 0
206 Omegdiar Syr Botol 60 ml 0 0 0 0
207 Omecal. D Kotak. 100 tab 0 0 0 0
208 Omeprazol Caps Kotak. 30 Caps 0 0 0 0
209 Omesolvon Syr Botol 0 0 0 0
210 Oxyflow Nasal oxygin Anak Pcs 150 0 5 145
211 Oxyflow Nasal oxygin Bayi Pcs 200 0 5 195
212 Oxyflow Nasal oxygin Dewasa Pcs 217 0 17 200
213 Oxytocin inj (Tiacinon) Kotak 10 Amp 0 0 0 0
214 Pacdin Baby Cough Syr Botol 60 ml 0 0 0 0
215 Papaverin 40 mg Tab Botol 1000 Tab 0 0 0 0
216 Paracetamol Syrp 120ml/5mg Botol 60 ml 25 0 10 15
217 Panvit. C Kotak. 100 tab 0 0 0 0
218 Paracetamol 500 mg Tab Kotak 100 tab 500 0 500 0
219 Paracetamol 500 mg Tab Botol 1000 Tab 0 0 0 0
220 Paracetamol Syrp 120ml/5mg Botol 60 ml 0 0 0 0
221 Panviton Kotak 50 kapl 0 0 0 0
222 Pharmafix 100 mg Kotak 50 tab 0 0 0 0
223 Pirazinamid 500 mg Kotak 100 tab 0 0 0 0
224 Pyridoxin Tab 10 mg (vit.B6) botol 1000 tab 0 0 0 0
225 Pyridoxin Tab 10 mg (vit.B6) botol 1000 tab 500 0 0 500
226 Plester 5 Yard x 2 Inc ROLL 0 0 0 0
227 Phenobarbital 30 Mg Kotak 100 200 0 0 200
228 Povidon Lodida 10% Botol 30 ml 0 0 0 0
229 Povidon Lodida 10% botol 60 ml 48 0 5 43
230 Povidon Lodida 10% Botol 300 ml 0 0 0 0
231 Povidon Lodida 10% Botol 1000 ml 0 0 0 0
232 Prednison Tab 5 mg Botol 1000 tab 0 0 0 0
233 Prednison 5 mg Kotak 100 tab 0 0 0 0
234 Piroxicam 20 mg Kotak 100 Tab 0 0 0 0
235 Piroxicam 20 mg Kotak 120 caps 0 0 0 0
236 Propanolol 40 mg Botol 100 tab 0 0 0 0
237 Pyrantel Tab 125 mg Kotak 60 Tab 700 0 0 700
238 Propyltiorasyl 100 mg (PTU) Botol 100 Tab 400 0 0 400
239 Ranitidin 150 mg Tab Kotak 100 Tab 0 0 0 0
240 Ranitidin Inj 25 mg/2 ml Kotak 5 amp 0 0 0 0
241 Ringer Laktat Botol. 500 ml 437 0 25 412
242 Rivanol Botol 300 cc 0 0 0 0
243 Retinol (Vit.A) 100.000 IU Botol. 50 kps 0 0 0 0
244 Retinol (Vit.A) 200.000 IU Botol. 50 kps 0 0 0 0
245 Stavit kpl Kotak. 100 kpl 0 0 0 0
247 Simvastatin 10 mg Kotak 30 tab 3710 0 1000 2710
249 Simvastatin 20 mg Kotak 30 tab 500 0 0 500
250 Salbutamol 2 mg Kotak 100 tab 0 0 0 0
251 Salbutamol 4 mg Kotak 100 Tab 0 0 0 0
252 Salep 2-4 pot @30 Gram 580 0 30 550
253 Salicil Bedak Kotak @ 50 gram 0 0 0 0
254 Silk Benang Bedah 3/0 (suture) Dos @ 36's 0 0 0 0
255 Seltifort Kids Sirop Botol. 60 ml 0 0 0 0

256 Selesbion Plus Kotak 100 Tab 0 0 0 0


257 Seviplex Kotak 100 tab 0 0 0 0
258 Stolax Supositoria (Bisacody) Kotak 6 Supp 0 0 0 0
259 Stomach tab Kotak 100 Tab 0 0 0 0
260 Tablet Tambah Darah kotak 30 tab 6420 0 0 6420
261 Tramadol 50 mg Kaps Kotak 50 caps 0 0 0 0
262 Tetracyclin 250 mg Kaps Botol 1000 caps 500 0 0 500
263 Tetracyclin 500 mg Kaps Kotak 100 caps 5400 0 500 4900
264 Tilomix Tab Kotak 100 Tab 0 0 0 0
265 Thiamin 50 mg Tab Botol 1000 tab 0 0 0 0
266 Thiamin Inj 100 mg/ml Kotak 30 Amp 0 0 0 0
267 Thiamphenicol Kaps 500 mg Kotak 100 kaps 0 0 0 0
268 Trihexyphenidil Tab 2 mg Kotak 100 tab 0 0 0 0
269 Vidabion Tab Kotak 100 Tab 0 0 0 0
270 Vitalamin Tab Kotak 100 Tab 0 0 0 0
271 Vit B. Comp Botol 1000 tab 0 0 0 0
272 Vit B. Comp Kotak 100 Tab 0 0 0 0
274 Vit Ever Kotak 100 Tab 0 0 0 0
275 Urine Bag Sak 180 0 0 180
276 Vaksin Rabies Vero Vial 0 0 0 0
278 Zinc Tab 20 mg Kotak 100 Tab 700 0 0 700
279 OAT FDC Kategori Anak Paket 0 0 0 0
280 OAT FDC Kategori.I. Dws Paket 0 0 0 0
281 OAT FDC Kategori.II Dws Paket 0 0 0 0
282 OAT FDC Sisipan Dws Paket 0 0 0 0
283 Ticomac Tablet 0 0 0 0
284 Solasic Tablet 0 0 0 0
285 Guaifenetisin Tablet 1500 0 500 1000
286 Kamolas Tablet 2200 0 800 1400
287 Selkon Tablet 0 0 0 0
288 Plester 15 x 5 cm Rol 46 0 4 42
289 Waterfor Injeksi Botol 70 0 10 60

UMUM BPJS JAM


PKH KADER JUMLAH
JUMLAH KUNJUNGAN RESEP BAYAR KIS KESDA
274 114 0 0 0 388

Kepala UPTD Puskesmas Maelang


Kecamatan Sang Tombolang

JUNAIDI MAMONTO, SKM .-


NIP. 19690405 199103 1 010 .-
LAPORAN PEMAKAIAN DAN LEMBARAN
PERMINTAAN OBAT ( LPLPO )

KODE PUSKESMAS :18051501


PUSKESMAS : MAELANG
KECAMATAN : SANG TOMBOLANG
KABUPATEN : BOLAANG MONGONDOW
PROPINSI : SULAWESI UTARA
BULAN : FEBRUARI
TAHUN : 2021

STOK PENERI PEMAK STOK


NO NAMA OBAT SATUAN
AWAL MAAN AIAN AKHIR
KET

1 Abbocath18 PCS 520 0 10 510


2 Abbocath 20 PCS 182 0 66 116
3 Abbocath 22 PCS 20 0 10 10
4 Abbocath 24 PCS 0 0 0 0
5 Ajitab Tab Kotak 100 Tab 0 0 0
6 Alat Suntik 1,0 ml Kotak 100 PCS 600 0 0 600
7 Alat Suntik 2,5 ml Kotak 100 PCS 0 0 0 0
8 Alat Suntik 3,0 ml Kotak 100 PCS 165 0 100 65
9 Alat Suntik 5,0 ml Kotak 100 PCS 1100 0 100 1000
10 Alat Suntik 10 ml Kotak 100 PCS 500 0 0 500
11 Albendazole 400 mg Kotak 100 100 0 0 100
12 Allopurinol 100 mg Kotak 100 Tab 0 0 0 0
13 Alprazolam 0,5 mg Kotak 100 Tab 0 0 0 0
14 Alprazolam 1,0 mg Kotak 100 Tab 0 0 0 0
15 Ambroxol 30 mg Kotak 100 Tab 4500 0 2000 2500
16 Aminophyilin inj Kotak 30 Amp 0 0 0 0
17 Aminophyilin Tab 200 mg Botol 100 Tab 1000 0 0 1000
18 Amitriptilin tab Kotak 100 Tab 0 0 0 0
19 Amlodipin 10 mg Kotak 30 Tab 100 0 100 0
20 Amlodipin 5,0 mg Kotak 30 Tab 0 0 0 0
21 Ampicilin inj Kotak 10 Vial 0 0 0 0
22 Ampicilin Cap 500 mg Kotak 100 Cap 0 0 0 0
23 Amoksisilin 500 mg Kotak 100 Cap 15500 0 0 15500
24 Amoksisilin Syrp Kering 125 mg/5 ml Btl 60 ml 0 0 0 0
25 Ampicilin Syrp Kering 125 mg/5 ml Btl 100 ml 0 0 0 0
26 Antalgin 500 mg Kotak 100 Tab 0 0 0 0
27 Antalgin 500 mg Botol 1000 Tab 0 0 0 0
28 Antasida DOEN Kotak 100 Tab 0 0 0 0
29 Antasida DOEN Botol 1000 Tab 0 0 0 0
30 Antides New Kotak 100 100 0 0 100
31 Antihemoroid DOEN Kotak 10 supp 200 0 0 200
32 Antihemoroid Supp Kotak 6 138 0 8 130
33 Anti malaria DOEN Kotak 100 Tab 0 0 0 0
34 Antasida DOEN Syrp Botol 100 ml 0 0 0 0
35 Acyclovir tab 200 mg Kotak 50 Tab 800 0 0 800
36 Acyclovir tab 400 mg Kotak 50 Tab 900 0 0 900
37 Acyclovir Cream 5 g Kotak 24 Tube 0 0 0 0
38 Asam folat 1 mg Botol100 Tab 0 0 0 0
39 Asam ascorbat 50 mg Kotak 100Tab 1700 0 1000 700
40 Aqua Pro inj Steril Kotak 10 Vial 0 0 0 0
41 Alkohol 70 % Botol 100 ml 0 0 0 0
42 Alkohol 70 % Botol 1 Liter 10 0 2 8
43 Alkohol Swab Kotak @100pcs 0 0 0 0
44 Artesunat inj 60 mg Kotak 1 Vial 0 0 0 0
45 Asam mefenamat 500 mg Kotak 100 Tab 0 0 0 0
46 Aseptan Botol 0 0 0 0
47 Atropin Sulfat Tab 0,5 mg Kotak 100 Tab 0 0 0 0
48 Basitrasin + polimiksin (anti bakteri salep) Kotak 24 Tube 0 0 0 0
49 Betahistin tablet Kotak 30 tab 0 0 0 0
50 Bisoprolol 5 mg Kotak 30 Tab 0 0 0 0
51 Bromhexin 8 mg Tab Kotak 100 Tab 0 0 0 0
52 Brochifar Kotak 100 Tab 0 0 0 0
53 Bromifar Plus Syr Botol 60 ml 0 0 0 0
54 Bedak Salisyl 2 % Kotak 0 0 0 0
55 Betametason krim Ktk 25 tube 161 0 78 83
56 Bexicom C Kotak 100 Tab 0 0 0 0
57 Brocon Tab Kotak 100 Tab 0 0 0 0
58 Bufacetin Salep (kloramfenicol 2%) Tube 15 Gram 0 0 0 0
59 Cat Gut Plain no.3/0 Dos @ 24's 43 0 5 38
60 Cat Gut Plain no.2/0 Dos @ 24's 38 0 5 33
61 Cat Gut Cromic no.3/0 Dos @ 24's 48 0 5 43
62 Cat Gut Cromic no.2/0 Dos @ 24's 48 0 5 43
63 Captopril 12,5 mg Tab Kotak 100 Tab 700 0 300 400
64 Captopril 25 mg Tab Kotak 100 Tab 0 0 0 0
65 Carbamazepin Tab 200 mg Kotak 100 Tab 0 0 0 0
66 Clorpheniramin Malet 4 mg Tab/CTM Botol1000Tab 400 0 400 0
67 Cefixime Kota 50 Tab 0 0 0 0
68 Cimetidin 200 mg tab Kotak 100 Tab 0 0 0 0
69 Cianocobalamin Tab 50 mg Kotak 100 Tab 23700 0 2700 21000
70 Cetrizin 10 mg tab Kotak 50 Tab 0 0 0 0
71 Cetrizin Hcl syrup Botol 26 0 20 6
72 Cefadroxil 500 mg Cap Kotak 100 caps 0 0 0 0
73 Cefadroxil 500 mg Cap Kotak 100 Caps 0 0 0 0
74 Cianocobalamin inj 500 MCg Kotak 100 amp 0 0 0 0
75 Ciprofloxasin 50 mg Kotak 100 0 0 0 0
76 Clorpromazin 100 mg Tab Kotak 100 Tab 0 0 0 0
77 Cloramphenicol TTS Telinga 3 % Botol 5 ml 0 0 0 0
78 Cloramphenicol TTS Mata 1 % Kotak 24 Tube 0 0 0 0
79 Cloramphenicol Salep Mata 1 % Tube 5 g 0 0 0 0
80 Cloramphenicol Caps 250 mg Kotak 100 Kaps 0 0 0 0
81 Cloroquin Botol 1000 Tab 0 0 0 0
82 Cotrimoxazol 480 mg Tab Kotak 100 Tab 0 0 0 0
83 Cotimoxazol 120 mg Tab Kotak 100 tab 0 0 0 0
84 Cotimoxazol Susp Botol 60 ml 0 0 0 0
85 Colfin Kotak 100 0 0 0 0
86 Co Amoxiclav Ktk @ 30 tab 0 0 0 0
87 Curbion syrup Btl 60 mL 0 0 0 0
88 Dapyrin tab kotak 100 Tab 0 0 0 0
89 Dextrose 5% Botol 500 ml 40 0 0 40
90 Dexametason Inj Kotak 100 amp 0 0 0 0
91 Dexametason Tab 0,5 mg Botol 1000 tab 0 0 0 0
92 Dexametason Tab 0,5 mg Kotak 100 Tab 4000 0 0 4000
93 Dextrometorpan syrp 10 mg/5 ml botol 60 ml 0 0 0 0
94 Dextrometorpan Tab Kotak 100 Tab 0 0 0 0
95 Devosix Drops Botol 15 ml 0 0 0 0
96 Dextrometorpan Tab Botol 1000 Tab 0 0 0 0
97 Diazepam inj 5 mg/ml Kotak 30 Amp 30 0 0 30
98 Diazepam 2 mg tab Kotak 100 Tab 0 0 0 0
99 Diazepam 2 mg tab Botol 1000 Tab 0 0 0 0
100 Diazepam 5 mg tab botol 250 Tab 0 0 0 0
101 Diazepam (valdimex)tablet kotak 100 tab 1970 0 0 1970
102 Diethylcarbamazepin 100 mg Kotak 100 Tab 0 0 0 0
103 Diphenhydramin Inj I.M 10 mg/ml Kotak 30 amp 393 0 20 373
104 Digoxin TAB 0,25 mg Kotak 100 tab 0 0 0 0
105 Doxicylin 100 mg Kaps Kotak 100 caps 0 0 0 0
106 Donperidon Tab 10 mg Kotak 100 tab 0 0 0 0
107 Diltiazem HCL Tab 30 mg Kotak 100 Tab 500 0 0 500
108 Epedrin HCL TAB Botol 250 Tab 0 0 0 0
109 Epedrin HCL TAB Botol 1000 Tab 0 0 0 0
110 Ephinefrin Inj 0,1 % Kotak 100 Amp 0 0 0 0
111 Ehtylclor Semprot Botol 0 0 0 0
112 Erytromicin 500 mg Kaps Kotak 100 caps 0 0 0 0
113 Examination Glove Kotak 100 pcs 0 0 0 0
114 Farsifen Plus Kotak 100 Tab 0 0 0 0
115 Fenol gliserol tetes telinga botol 5 ml 0 0 0 0
116 Fenorbarbital Inj 50 ml Kotak 30 Amp 0 0 0 0
117 Fenorbarbital 30 mg Tab Botol 100 Tab 0 0 0 0
118 Fenorbarbital 30 mg Tab Botol 1000 Tab 0 0 0 0
119 Fytomenadion Inj 10 mg/ml Kotak 30 Amp 0 0 0 0
120 Fytomenadion 10 mg Kotak 100 Tab 0 0 0 0
121 Furosemide 40 mg tab kotak 200 Tab 0 0 0 0
122 Fenilbutazon 200 mg Botol 1000 Tab 0 0 0 0
123 Fenitoin 100 mg kaps Botol 100 cabs 1000 0 0 1000
124 Flunadin Tab Kotak 100 Tab 0 0 0 0
125 Folley Catheter No.24 PCS 0 0 0 0
126 Folley Catheter No.20 PCS 10 psg 199 0 0 199
127 Folley Catheter No.18 PCS 10 psg 290 0 20 270
128 Ferosulfat 300 mg Botol 1000 Tab 0 0 0 0
129 Garam Oralit Kotak 100 saset 0 0 0 0
130 Gastricid Tab Kotak 100 Tab 0 0 0 0
131 Gentamicin Inj 80 mg Kotak 5 amp 0 0 0 0
132 Gentian Violet Lart 1% Botol 10 ml 0 0 0 0
133 Glibenclamide 5 mg Kotak 100 Tab 0 0 0 0
134 Glass lonomer Btl/Set 0 0 0 0
135 Glyseril Guayakolat Botol 1000 Tab 0 0 0 0
136 Glucotrol xl Tab 10 mg Kotak 30 Tab 0 0 0 0
137 Grisiofulvin 500mg Kotak 100 Tab 0 0 0 0
138 HydroclortiazidTab 25 mg Botol 1000 Tab 0 0 0 0
139 Hydrocortison Krim 2,5 % Kotak 24 Tube 63 0 30 33
140 Halloperidol 1,5 mg tab Kotak 100 tab 0 0 0 0
141 Halloperidol 0,5 mg tab Kotak 100 Tab 0 0 0 0
142 Halloperidol inj 50mg/ml kotak 10 ampul 8 0 0 8
143 Haidol DC 50 Mg Inj Kotak 5 Ampul 40 0 0 40
144 Handscun No.8.0 (Sateglove Surgical) Kotak 50 PCS 0 0 0 0
145 Handscun No.7,5 (Sateglove Surgical) Kotak 50 PCS 0 0 0 0
146 Handscun No.7 Kotak 50 PCS 0 0 0 0
147 Infuset DWS Sak 0 0 0 0
148 Infuset anak Sak 175 0 25 150
149 Insulatard Kotak 10 Vial 0 0 0 0
150 Insuman Comb Kotak 5pen@3m/ 0 0 0 0
151 Ichtiyol SK 15 gr Kotak 12 pot 0 0 0 0
152 Ibupropen Syrp 100 Mg Botol 60 ml 0 0 0 0
153 Ibupropen 400 Kotak 100 Tab 0 0 0 0
154 Ibupropen 200 Kotak 100 tab 0 0 0 0
155 Isosorbit Dinitrit TAB Kotak 100 tab 0 0 0 0
156 Indo Obat Cacing Kotak 25 Tab 0 0 0 0
157 Kalcium Lactat 500 mg Tab Kotak 100 Tab 0 0 0 0
158 Kapas 250 mg ROLL 133 0 13 120
159 Kapas 500 mg ROLL 0 0 0 0
160 Kasa steril 16 x 16 cm ROLL 0 0 0 0
161 Kasa pembalut 4 x 5 cm ROLL 0 0 0 0
162 Kasa Kompres 4 x 10 cm ROLL 0 0 0 0
163 Kasa Kompres 2 x 80 cm ROLL 18 0 8 10
164 Kasa Hydrophyl 4 x 15 cm ROLL 0 0 0 0
165 Kasa Hydrophyl 40 x 80 cm ROLL 0 0 0 0
166 Kasa Penyerap luka Bakar pcs 0 0 0 0
167 Ketoconazole Tab 200mg Kotak 50 Tab 0 0 0 0
168 Ketoconazole Cream 2 % tube 5 g 0 0 0 0
169 Kuinina 222 mg Tab Botol 1000 Tab 540 0 0 540
170 Lansoprazole Kaps 30 mg Ktak 20 kaps 0 0 0 0
171 Lantus Solostan Kotak 5 pen 0 0 0 0
172 Lidocain Inj 2% (pehacain) Kotak 20 Amp 290 0 30 260
173 Lidocain Inj 2% (pehacain) Kotak 20 Amp 0 0 0
174 Lidocain Inj 2% kotak 10 Amp 0 0 0
175 Levofloxacin 500mg Tab Kotak 50 tab 0 0 0
176 Lisol Botol 100 ml 0 0 0
177 Loratadin 10 mg Kotak 100 tab 650 0 0 650
178 Meloxicam 15 Mg Kotak 50 tab 0 0 0 0
179 Multivitamin utk ibu hamil (Prenase) Kotak 100 tab 0 0 0 0
180 Metyl Ergometri Maleat Tab 0,125 mg Kotak 100 tab 0 0 0 0
181 Metil Prednisolon Kotak 100 tab 0 0 0 0
182 Metyl Ergometri Inj kotak 100 Amp 0 0 0 0
183 Metacetin syrup Btl 60 mL 0 0 0 0
184 Metformin Kotak 100 tab 0 0 0 0
185 Metronidazole tab 250 mg Kotak 100 tab 0 0 0 0
186 Metronidazole tab 500 mg (Omenizol) Kotak 100 tab 0 0 0 0
187 Metronodazol sirup botol 0 0 0 0

188 Metronidazole ovula 500mg/vagisol kotak 5 ovula 145 0 0 145


189 Mulsanol Syr Botol 60 ml 0 0 0 0
190 Mykonazole Cream 2% Tube 5 g 370 0 57 313
191 Masker Kotak 50 pcs 0 0 0 0
192 Neo Envios kotak. 100 kpl 0 0 0
193 NaCL 0,9% Botol 500 ml 342 0 0 342
194 Nat. Diclofenak 50 mg Kotak 50 tab 0 0 0 0
195 Nifedipin Tab 10 mg Kotak 100 tab 0 0 0 0
196 Novomix 30 fkx pen Kotak 5 Vial 0 0 0 0
197 Nystatin Vaginal Tab 100.000 IU Kotak 100 Tab 290 0 0 290
198 Obat Cairan Untuk Luka Bakar Botol 40 ml 0 0 0 0
199 Obat Cairan Untuk Sariawan Botol 40 ml 0 0 0 0
200 OBH Syirup Botol100 ml 0 0 0 0
201 Omeneuron Kotak. 100 kpl 0 0 0 0
202 Oxytetracyclin S.K 3% Tube 5 g 0 0 0 0
203 Omegavit Kotak. 100 kpl 0 0 0 0
204 Omegesic Kotak 100 tab 0 0 0 0
205 Omegdiar Kotak. 100 kpl 0 0 0 0
206 Omegdiar Syr Botol 60 ml 0 0 0 0
207 Omecal. D Kotak. 100 tab 0 0 0 0
208 Omeprazol Caps Kotak. 30 Caps 0 0 0 0
209 Omesolvon Syr Botol 0 0 0 0
210 Oxyflow Nasal oxygin Anak Pcs 145 0 5 140
211 Oxyflow Nasal oxygin Bayi Pcs 195 0 5 190
212 Oxyflow Nasal oxygin Dewasa Pcs 184 0 10 174
213 Oxytocin inj (Tiacinon) Kotak 10 Amp 0 0 0 0
214 Pacdin Baby Cough Syr Botol 60 ml 0 0 0 0
215 Papaverin 40 mg Tab Botol 1000 Tab 0 0 0 0
216 Paracetamol Syrp 120ml/5mg Botol 60 ml 15 0 10 5
217 Panvit. C Kotak. 100 tab 0 0 0 0
218 Paracetamol 500 mg Tab Kotak 100 tab 0 0 0 0
219 Paracetamol 500 mg Tab Botol 1000 Tab 0 0 0 0
220 Paracetamol Syrp 120ml/5mg Botol 60 ml 0 0 0 0
221 Panviton Kotak 50 kapl 0 0 0 0
222 Pharmafix 100 mg Kotak 50 tab 0 0 0 0
223 Pirazinamid 500 mg Kotak 100 tab 0 0 0 0
224 Pyridoxin Tab 10 mg (vit.B6) botol 1000 tab 0 0 0 0
225 Pyridoxin Tab 10 mg (vit.B6) botol 1000 tab 500 0 500 0
226 Plester 5 Yard x 2 Inc ROLL 0 0 0 0
227 Phenobarbital 30 Mg Kotak 100 200 0 0 200
228 Povidon Lodida 10% Botol 30 ml 0 0 0 0
229 Povidon Lodida 10% botol 60 ml 43 0 3 40
230 Povidon Lodida 10% Botol 300 ml 0 0 0 0
231 Povidon Lodida 10% Botol 1000 ml 0 0 0 0
232 Prednison Tab 5 mg Botol 1000 tab 0 0 0 0
233 Prednison 5 mg Kotak 100 tab 0 0 0 0
234 Piroxicam 20 mg Kotak 100 Tab 0 0 0 0
235 Piroxicam 20 mg Kotak 120 caps 0 0 0 0
236 Propanolol 40 mg Botol 100 tab 0 0 0 0
237 Pyrantel Tab 125 mg Kotak 60 Tab 700 0 0 700
238 Propyltiorasyl 100 mg (PTU) Botol 100 Tab 400 0 0 400
239 Ranitidin 150 mg Tab Kotak 100 Tab 0 0 0 0
240 Ranitidin Inj 25 mg/2 ml Kotak 5 amp 0 0 0 0
241 Ringer Laktat Botol. 500 ml 412 0 27 385
242 Rivanol Botol 300 cc 0 0 0 0
243 Retinol (Vit.A) 100.000 IU Botol. 50 kps 0 0 0 0
244 Retinol (Vit.A) 200.000 IU Botol. 50 kps 0 0 0 0
245 Stavit kpl Kotak. 100 kpl 0 0 0 0
247 Simvastatin 10 mg Kotak 30 tab 2710 0 510 2200
249 Simvastatin 20 mg Kotak 30 tab 500 0 0 500
250 Salbutamol 2 mg Kotak 100 tab 0 0 0 0
251 Salbutamol 4 mg Kotak 100 Tab 0 0 0 0
252 Salep 2-4 pot @30 Gram 550 0 40 510
253 Salicil Bedak Kotak @ 50 gram 0 0 0 0
254 Silk Benang Bedah 3/0 (suture) Dos @ 36's 0 0 0 0
255 Seltifort Kids Sirop Botol. 60 ml 0 0 0 0

256 Selesbion Plus Kotak 100 Tab 0 0 0 0


257 Seviplex Kotak 100 tab 0 0 0 0
258 Stolax Supositoria (Bisacody) Kotak 6 Supp 0 0 0 0
259 Stomach tab Kotak 100 Tab 0 0 0 0
260 Tablet Tambah Darah kotak 30 tab 6420 0 0 6420
261 Tramadol 50 mg Kaps Kotak 50 caps 0 0 0 0
262 Tetracyclin 250 mg Kaps Botol 1000 caps 500 0 0 500
263 Tetracyclin 500 mg Kaps Kotak 100 caps 4900 0 500 4400
264 Tilomix Tab Kotak 100 Tab 0 0 0 0
265 Thiamin 50 mg Tab Botol 1000 tab 0 0 0 0
266 Thiamin Inj 100 mg/ml Kotak 30 Amp 0 0 0 0
267 Thiamphenicol Kaps 500 mg Kotak 100 kaps 0 0 0 0
268 Trihexyphenidil Tab 2 mg Kotak 100 tab 0 0 0 0
269 Vidabion Tab Kotak 100 Tab 0 0 0 0
270 Vitalamin Tab Kotak 100 Tab 0 0 0 0
271 Vit B. Comp Botol 1000 tab 0 0 0 0
272 Vit B. Comp Kotak 100 Tab 0 0 0 0
274 Vit Ever Kotak 100 Tab 0 0 0 0
275 Urine Bag Sak 180 0 0 180
276 Vaksin Rabies Vero Vial 0 0 0 0
278 Zinc Tab 20 mg Kotak 100 Tab 700 0 0 700
279 OAT FDC Kategori Anak Paket 0 0 0 0
280 OAT FDC Kategori.I. Dws Paket 0 0 0 0
281 OAT FDC Kategori.II Dws Paket 0 0 0 0
282 OAT FDC Sisipan Dws Paket 0 0 0 0
283 Ticomac Tablet 0 0 0 0
284 Solasic Tablet 0 0 0 0
285 Guaifenetisin Tablet 1000 0 300 700
286 Kamolas Tablet 1400 0 1400 0
287 Selkon Tablet 0 0 0 0
288 Plester 15 x 5 cm Rol 42 0 2 40
289 Waterfor Injeksi Botol 60 0 10 50

UMUM BPJS JAM


PKH KADER JUMLAH
JUMLAH KUNJUNGAN RESEP BAYAR KIS KESDA
236 117 0 0 0 353

Kepala UPTD Puskesmas Maelang


Kecamatan Sang Tombolang

JUNAIDI MAMONTO, SKM .-


NIP. 19690405 199103 1 010 .-
257

167

11
3

65

2
LAPORAN PEMAKAIAN DAN LEMBARAN
PERMINTAAN OBAT ( LPLPO )

KODE PUSKESMAS :18051501


PUSKESMAS : MAELANG
KECAMATAN : SANG TOMBOLANG
KABUPATEN : BOLAANG MONGONDOW
PROPINSI : SULAWESI UTARA
BULAN : 01 S/D 18 MARET
TAHUN : 2021

STOK PENERI PEMAK STOK


NO NAMA OBAT SATUAN
AWAL MAAN AIAN AKHIR
KET

1 Abbocath18 PCS 510 0 20 490 Expride


2 Abbocath 20 PCS 116 0 66 50
3 Abbocath 22 PCS 10 0 10 0
4 Abbocath 24 PCS 0 0 0 0
5 Ajitab Tab Kotak 100 Tab 0 0 0 0
6 Alat Suntik 1,0 ml Kotak 100 PCS 600 0 0 600
7 Alat Suntik 2,5 ml Kotak 100 PCS 0 0 0 0
8 Alat Suntik 3,0 ml Kotak 100 PCS 65 0 65 0
9 Alat Suntik 5,0 ml Kotak 100 PCS 1000 0 0 1000
10 Alat Suntik 10 ml Kotak 100 PCS 500 0 0 500
11 Albendazole 400 mg Kotak 100 100 0 0 100
12 Allopurinol 100 mg Kotak 100 Tab 0 0 0 0
13 Alprazolam 0,5 mg Kotak 100 Tab 0 0 0 0
14 Alprazolam 1,0 mg Kotak 100 Tab 0 0 0 0
15 Ambroxol 30 mg Kotak 100 Tab 2500 0 1800 700
16 Aminophyilin inj Kotak 30 Amp 0 0 0 0
17 Aminophyilin Tab 200 mg Botol 100 Tab 1000 0 0 1000
18 Amitriptilin tab Kotak 100 Tab 0 0 0 0
19 Amlodipin 10 mg Kotak 30 Tab 0 0 0 0
20 Amlodipin 5,0 mg Kotak 30 Tab 0 0 0 0
21 Ampicilin inj Kotak 10 Vial 0 0 0 0
22 Ampicilin Cap 500 mg Kotak 100 Cap 0 0 0 0
23 Amoksisilin 500 mg Kotak 100 Cap 15500 0 0 15500
24 Amoksisilin Syrp Kering 125 mg/5 ml Btl 60 ml 0 0 0 0
25 Ampicilin Syrp Kering 125 mg/5 ml Btl 100 ml 0 0 0 0
26 Antalgin 500 mg Kotak 100 Tab 0 0 0 0
27 Antalgin 500 mg Botol 1000 Tab 0 0 0 0
28 Antasida DOEN Kotak 100 Tab 0 0 0 0
29 Antasida DOEN Botol 1000 Tab 0 0 0 0
30 Antides New Kotak 100 100 0 0 100
31 Antihemoroid DOEN Kotak 10 supp 200 0 0 200
32 Antihemoroid Supp Kotak 6 130 0 0 130
33 Anti malaria DOEN Kotak 100 Tab 0 0 0 0
34 Antasida DOEN Syrp Botol 100 ml 0 0 0 0
35 Acyclovir tab 200 mg Kotak 50 Tab 800 0 0 800
36 Acyclovir tab 400 mg Kotak 50 Tab 900 0 0 900
37 Acyclovir Cream 5 g Kotak 24 Tube 0 0 0 0
38 Asam folat 1 mg Botol100 Tab 0 0 0 0
39 Asam ascorbat 50 mg Kotak 100Tab 700 0 700 0
40 Aqua Pro inj Steril Kotak 10 Vial 0 0 0 0
41 Alkohol 70 % Botol 100 ml 0 0 0 0
42 Alkohol 70 % Botol 1 Liter 8 0 1 7
43 Alkohol Swab Kotak @100pcs 0 0 0 0
44 Artesunat inj 60 mg Kotak 1 Vial 0 0 0 0
45 Asam mefenamat 500 mg Kotak 100 Tab 0 0 0 0
46 Aseptan Botol 0 0 0 0
47 Atropin Sulfat Tab 0,5 mg Kotak 100 Tab 0 0 0 0
48 Basitrasin + polimiksin (anti bakteri salep) Kotak 24 Tube 0 0 0 0
49 Betahistin tablet Kotak 30 tab 0 0 0 0
50 Bisoprolol 5 mg Kotak 30 Tab 0 0 0 0
51 Bromhexin 8 mg Tab Kotak 100 Tab 0 0 0 0
52 Brochifar Kotak 100 Tab 0 0 0 0
53 Bromifar Plus Syr Botol 60 ml 0 0 0 0
54 Bedak Salisyl 2 % Kotak 0 0 0 0
55 Betametason krim Ktk 25 tube 83 0 78 5
56 Bexicom C Kotak 100 Tab 0 0 0 0
57 Brocon Tab Kotak 100 Tab 0 0 0 0
58 Bufacetin Salep (kloramfenicol 2%) Tube 15 Gram 0 0 0 0
59 Cat Gut Plain no.3/0 Dos @ 24's 38 0 0 38
60 Cat Gut Plain no.2/0 Dos @ 24's 33 0 0 33
61 Cat Gut Cromic no.3/0 Dos @ 24's 43 0 0 43
62 Cat Gut Cromic no.2/0 Dos @ 24's 43 0 0 43
63 Captopril 12,5 mg Tab Kotak 100 Tab 400 0 0 400
64 Captopril 25 mg Tab Kotak 100 Tab 0 0 0 0
65 Carbamazepin Tab 200 mg Kotak 100 Tab 0 0 0 0
66 Clorpheniramin Malet 4 mg Tab/CTM Botol1000Tab 0 0 0 0
67 Cefixime Kota 50 Tab 0 0 0 0
68 Cimetidin 200 mg tab Kotak 100 Tab 0 0 0 0
69 Cianocobalamin Tab 50 mg Kotak 100 Tab 21000 0 2700 18300
70 Cetrizin 10 mg tab Kotak 50 Tab 0 0 0 0
71 Cetrizin Hcl syrup Botol 6 0 6 0
72 Cefadroxil 500 mg Cap Kotak 100 caps 0 0 0 0
73 Cefadroxil 500 mg Cap Kotak 100 Caps 0 0 0 0
74 Cianocobalamin inj 500 MCg Kotak 100 amp 0 0 0 0
75 Ciprofloxasin 50 mg Kotak 100 0 0 0 0
76 Clorpromazin 100 mg Tab Kotak 100 Tab 0 0 0 0
77 Cloramphenicol TTS Telinga 3 % Botol 5 ml 0 0 0 0
78 Cloramphenicol TTS Mata 1 % Kotak 24 Tube 0 0 0 0
79 Cloramphenicol Salep Mata 1 % Tube 5 g 0 0 0 0
80 Cloramphenicol Caps 250 mg Kotak 100 Kaps 0 0 0 0
81 Cloroquin Botol 1000 Tab 0 0 0 0
82 Cotrimoxazol 480 mg Tab Kotak 100 Tab 0 0 0 0
83 Cotimoxazol 120 mg Tab Kotak 100 tab 0 0 0 0
84 Cotimoxazol Susp Botol 60 ml 0 0 0 0
85 Colfin Kotak 100 0 0 0 0
86 Co Amoxiclav Ktk @ 30 tab 0 0 0 0
87 Curbion syrup Btl 60 mL 0 0 0 0
88 Dapyrin tab kotak 100 Tab 0 0 0 0
89 Dextrose 5% Botol 500 ml 40 0 0 40
90 Dexametason Inj Kotak 100 amp 0 0 0 0
91 Dexametason Tab 0,5 mg Botol 1000 tab 0 0 0 0
92 Dexametason Tab 0,5 mg Kotak 100 Tab 4000 0 0 4000
93 Dextrometorpan syrp 10 mg/5 ml botol 60 ml 0 0 0 0
94 Dextrometorpan Tab Kotak 100 Tab 0 0 0 0
95 Devosix Drops Botol 15 ml 0 0 0 0
96 Dextrometorpan Tab Botol 1000 Tab 0 0 0 0
97 Diazepam inj 5 mg/ml Kotak 30 Amp 30 0 0 30
98 Diazepam 2 mg tab Kotak 100 Tab 0 0 0 0
99 Diazepam 2 mg tab Botol 1000 Tab 0 0 0 0
100 Diazepam 5 mg tab botol 250 Tab 0 0 0 0
101 Diazepam (valdimex)tablet kotak 100 tab 1970 0 0 1970
102 Diethylcarbamazepin 100 mg Kotak 100 Tab 0 0 0 0
103 Diphenhydramin Inj I.M 10 mg/ml Kotak 30 amp 373 0 13 360
104 Digoxin TAB 0,25 mg Kotak 100 tab 0 0 0 0
105 Doxicylin 100 mg Kaps Kotak 100 caps 0 0 0 0
106 Donperidon Tab 10 mg Kotak 100 tab 0 0 0 0
107 Diltiazem HCL Tab 30 mg Kotak 100 Tab 500 0 0 500
108 Epedrin HCL TAB Botol 250 Tab 0 0 0 0
109 Epedrin HCL TAB Botol 1000 Tab 0 0 0 0
110 Ephinefrin Inj 0,1 % Kotak 100 Amp 0 0 0 0
111 Ehtylclor Semprot Botol 0 0 0 0
112 Erytromicin 500 mg Kaps Kotak 100 caps 0 0 0 0
113 Examination Glove Kotak 100 pcs 0 0 0 0
114 Farsifen Plus Kotak 100 Tab 0 0 0 0
115 Fenol gliserol tetes telinga botol 5 ml 0 0 0 0
116 Fenorbarbital Inj 50 ml Kotak 30 Amp 0 0 0 0
117 Fenorbarbital 30 mg Tab Botol 100 Tab 0 0 0 0
118 Fenorbarbital 30 mg Tab Botol 1000 Tab 0 0 0 0
119 Fytomenadion Inj 10 mg/ml Kotak 30 Amp 0 0 0 0
120 Fytomenadion 10 mg Kotak 100 Tab 0 0 0 0
121 Furosemide 40 mg tab kotak 200 Tab 0 0 0 0
122 Fenilbutazon 200 mg Botol 1000 Tab 0 0 0 0
123 Fenitoin 100 mg kaps Botol 100 cabs 1000 0 0 1000
124 Flunadin Tab Kotak 100 Tab 0 0 0 0
125 Folley Catheter No.24 PCS 0 0 0 0
126 Folley Catheter No.20 PCS 10 psg 199 0 0 199
127 Folley Catheter No.18 PCS 10 psg 270 0 10 260
128 Ferosulfat 300 mg Botol 1000 Tab 0 0 0 0
129 Garam Oralit Kotak 100 saset 0 0 0 0
130 Gastricid Tab Kotak 100 Tab 0 0 0 0
131 Gentamicin Inj 80 mg Kotak 5 amp 0 0 0 0
132 Gentian Violet Lart 1% Botol 10 ml 0 0 0 0
133 Glibenclamide 5 mg Kotak 100 Tab 0 0 0 0
134 Glass lonomer Btl/Set 0 0 0 0
135 Glyseril Guayakolat Botol 1000 Tab 0 0 0 0
136 Glucotrol xl Tab 10 mg Kotak 30 Tab 0 0 0 0
137 Grisiofulvin 500mg Kotak 100 Tab 0 0 0 0
138 HydroclortiazidTab 25 mg Botol 1000 Tab 0 0 0 0
139 Hydrocortison Krim 2,5 % Kotak 24 Tube 33 0 23 10
140 Halloperidol 1,5 mg tab Kotak 100 tab 0 0 0 0
141 Halloperidol 0,5 mg tab Kotak 100 Tab 0 0 0 0
142 Halloperidol inj 50mg/ml kotak 10 ampul 8 0 0 8
143 Haidol DC 50 Mg Inj Kotak 5 Ampul 40 0 0 40
144 Handscun No.8.0 (Sateglove Surgical) Kotak 50 PCS 0 0 0 0
145 Handscun No.7,5 (Sateglove Surgical) Kotak 50 PCS 0 0 0 0
146 Handscun No.7 Kotak 50 PCS 0 0 0 0
147 Infuset DWS Sak 0 0 0 0
148 Infuset anak Sak 150 0 25 125
149 Insulatard Kotak 10 Vial 0 0 0 0
150 Insuman Comb Kotak 5pen@3m/ 0 0 0 0
151 Ichtiyol SK 15 gr Kotak 12 pot 0 0 0 0
152 Ibupropen Syrp 100 Mg Botol 60 ml 0 0 0 0
153 Ibupropen 400 Kotak 100 Tab 0 0 0 0
154 Ibupropen 200 Kotak 100 tab 0 0 0 0
155 Isosorbit Dinitrit TAB Kotak 100 tab 0 0 0 0
156 Indo Obat Cacing Kotak 25 Tab 0 0 0 0
157 Kalcium Lactat 500 mg Tab Kotak 100 Tab 0 0 0 0
158 Kapas 250 mg ROLL 120 0 5 115
159 Kapas 500 mg ROLL 0 0 0 0
160 Kasa steril 16 x 16 cm ROLL 0 0 0 0
161 Kasa pembalut 4 x 5 cm ROLL 0 0 0 0
162 Kasa Kompres 4 x 10 cm ROLL 0 0 0 0
163 Kasa Kompres 2 x 80 cm ROLL 10 0 0 10
164 Kasa Hydrophyl 4 x 15 cm ROLL 0 0 0 0
165 Kasa Hydrophyl 40 x 80 cm ROLL 0 0 0 0
166 Kasa Penyerap luka Bakar pcs 0 0 0 0
167 Ketoconazole Tab 200mg Kotak 50 Tab 0 0 0 0
168 Ketoconazole Cream 2 % tube 5 g 0 0 0 0
169 Kuinina 222 mg Tab Botol 1000 Tab 540 0 0 540
170 Lansoprazole Kaps 30 mg Ktak 20 kaps 0 0 0 0
171 Lantus Solostan Kotak 5 pen 0 0 0 0
172 Lidocain Inj 2% (pehacain) Kotak 20 Amp 260 0 20 240
173 Lidocain Inj 2% (pehacain) Kotak 20 Amp 0 0 0 0
174 Lidocain Inj 2% kotak 10 Amp 0 0 0 0
175 Levofloxacin 500mg Tab Kotak 50 tab 0 0 0 0
176 Lisol Botol 100 ml 0 0 0 0
177 Loratadin 10 mg Kotak 100 tab 650 0 150 500
178 Meloxicam 15 Mg Kotak 50 tab 0 0 0 0
179 Multivitamin utk ibu hamil (Prenase) Kotak 100 tab 0 0 0 0
180 Metyl Ergometri Maleat Tab 0,125 mg Kotak 100 tab 0 0 0 0
181 Metil Prednisolon Kotak 100 tab 0 0 0 0
182 Metyl Ergometri Inj kotak 100 Amp 0 0 0 0
183 Metacetin syrup Btl 60 mL 0 0 0 0
184 Metformin Kotak 100 tab 0 0 0 0
185 Metronidazole tab 250 mg Kotak 100 tab 0 0 0 0
186 Metronidazole tab 500 mg (Omenizol) Kotak 100 tab 0 0 0 0
187 Metronodazol sirup botol 0 0 0 0
188 Metronidazole ovula 500mg/vagisol kotak 5 ovula 145 0 0 145
189 Mulsanol Syr Botol 60 ml 0 0 0 0
190 Mykonazole Cream 2% Tube 5 g 313 0 57 256
191 Masker Kotak 50 pcs 0 0 0 0
192 Neo Envios kotak. 100 kpl 0 0 0
193 NaCL 0,9% Botol 500 ml 342 0 0 342
194 Nat. Diclofenak 50 mg Kotak 50 tab 0 0 0 0
195 Nifedipin Tab 10 mg Kotak 100 tab 0 0 0 0
196 Novomix 30 fkx pen Kotak 5 Vial 0 0 0 0
197 Nystatin Vaginal Tab 100.000 IU Kotak 100 Tab 290 0 0 290
198 Obat Cairan Untuk Luka Bakar Botol 40 ml 0 0 0 0
199 Obat Cairan Untuk Sariawan Botol 40 ml 0 0 0 0
200 OBH Syirup Botol100 ml 0 0 0 0
201 Omeneuron Kotak. 100 kpl 0 0 0 0
202 Oxytetracyclin S.K 3% Tube 5 g 0 0 0 0
203 Omegavit Kotak. 100 kpl 0 0 0 0
204 Omegesic Kotak 100 tab 0 0 0 0
205 Omegdiar Kotak. 100 kpl 0 0 0 0
206 Omegdiar Syr Botol 60 ml 0 0 0 0
207 Omecal. D Kotak. 100 tab 0 0 0 0
208 Omeprazol Caps Kotak. 30 Caps 0 0 0 0
209 Omesolvon Syr Botol 0 0 0 0
210 Oxyflow Nasal oxygin Anak Pcs 140 0 0 140
211 Oxyflow Nasal oxygin Bayi Pcs 190 0 0 190
212 Oxyflow Nasal oxygin Dewasa Pcs 174 0 0 174
213 Oxytocin inj (Tiacinon) Kotak 10 Amp 0 0 0 0
214 Pacdin Baby Cough Syr Botol 60 ml 0 0 0 0
215 Papaverin 40 mg Tab Botol 1000 Tab 0 0 0 0
216 Paracetamol Syrp 120ml/5mg Botol 60 ml 5 0 3 2
217 Panvit. C Kotak. 100 tab 0 0 0 0
218 Paracetamol 500 mg Tab Kotak 100 tab 0 0 0 0
219 Paracetamol 500 mg Tab Botol 1000 Tab 0 0 0 0
220 Paracetamol Syrp 120ml/5mg Botol 60 ml 0 0 0 0
221 Panviton Kotak 50 kapl 0 0 0 0
222 Pharmafix 100 mg Kotak 50 tab 0 0 0 0
223 Pirazinamid 500 mg Kotak 100 tab 0 0 0 0
224 Pyridoxin Tab 10 mg (vit.B6) botol 1000 tab 0 0 0 0
225 Pyridoxin Tab 10 mg (vit.B6) botol 1000 tab 0 0 0 0
226 Plester 5 Yard x 2 Inc ROLL 0 0 0 0
227 Phenobarbital 30 Mg Kotak 100 200 0 0 200
228 Povidon Lodida 10% Botol 30 ml 0 0 0 0
229 Povidon Lodida 10% botol 60 ml 40 0 0 40
230 Povidon Lodida 10% Botol 300 ml 0 0 0 0
231 Povidon Lodida 10% Botol 1000 ml 0 0 0 0
232 Prednison Tab 5 mg Botol 1000 tab 0 0 0 0
233 Prednison 5 mg Kotak 100 tab 0 0 0 0
234 Piroxicam 20 mg Kotak 100 Tab 0 0 0 0
235 Piroxicam 20 mg Kotak 120 caps 0 0 0 0
236 Propanolol 40 mg Botol 100 tab 0 0 0 0
237 Pyrantel Tab 125 mg Kotak 60 Tab 700 0 0 700
238 Propyltiorasyl 100 mg (PTU) Botol 100 Tab 400 0 0 400
239 Ranitidin 150 mg Tab Kotak 100 Tab 0 0 0 0
240 Ranitidin Inj 25 mg/2 ml Kotak 5 amp 0 0 0 0
241 Ringer Laktat Botol. 500 ml 385 0 21 364
242 Rivanol Botol 300 cc 0 0 0 0
243 Retinol (Vit.A) 100.000 IU Botol. 50 kps 0 0 0 0
244 Retinol (Vit.A) 200.000 IU Botol. 50 kps 0 0 0 0
245 Stavit kpl Kotak. 100 kpl 0 0 0 0
247 Simvastatin 10 mg Kotak 30 tab 2200 0 220 1980
249 Simvastatin 20 mg Kotak 30 tab 500 0 0 500
250 Salbutamol 2 mg Kotak 100 tab 0 0 0 0
251 Salbutamol 4 mg Kotak 100 Tab 0 0 0 0
252 Salep 2-4 pot @30 Gram 510 0 12 498
253 Salicil Bedak Kotak @ 50 gram 0 0 0 0
254 Silk Benang Bedah 3/0 (suture) Dos @ 36's 0 0 0 0
255 Seltifort Kids Sirop Botol. 60 ml 0 0 0 0

256 Selesbion Plus Kotak 100 Tab 0 0 0 0


257 Seviplex Kotak 100 tab 0 0 0 0
258 Stolax Supositoria (Bisacody) Kotak 6 Supp 0 0 0 0
259 Stomach tab Kotak 100 Tab 0 0 0 0
260 Tablet Tambah Darah kotak 30 tab 6420 0 0 6420
261 Tramadol 50 mg Kaps Kotak 50 caps 0 0 0 0
262 Tetracyclin 250 mg Kaps Botol 1000 caps 500 0 0 500
263 Tetracyclin 500 mg Kaps Kotak 100 caps 4400 0 200 4200
264 Tilomix Tab Kotak 100 Tab 0 0 0 0
265 Thiamin 50 mg Tab Botol 1000 tab 0 0 0 0
266 Thiamin Inj 100 mg/ml Kotak 30 Amp 0 0 0 0
267 Thiamphenicol Kaps 500 mg Kotak 100 kaps 0 0 0 0
268 Trihexyphenidil Tab 2 mg Kotak 100 tab 0 0 0 0
269 Vidabion Tab Kotak 100 Tab 0 0 0 0
270 Vitalamin Tab Kotak 100 Tab 0 0 0 0
271 Vit B. Comp Botol 1000 tab 0 0 0 0
272 Vit B. Comp Kotak 100 Tab 0 0 0 0
274 Vit Ever Kotak 100 Tab 0 0 0 0
275 Urine Bag Sak 180 0 0 180
276 Vaksin Rabies Vero Vial 0 0 0 0
278 Zinc Tab 20 mg Kotak 100 Tab 700 0 0 700
279 OAT FDC Kategori Anak Paket 0 0 0 0
280 OAT FDC Kategori.I. Dws Paket 0 0 0 0
281 OAT FDC Kategori.II Dws Paket 0 0 0 0
282 OAT FDC Sisipan Dws Paket 0 0 0 0
283 Ticomac Tablet 0 0 0 0
284 Solasic Tablet 0 0 0 0
285 Guaifenetisin Tablet 700 0 0 700
286 Kamolas Tablet 0 0 0 0
287 Selkon Tablet 0 0 0 0
288 Plester 15 x 5 cm Rol 40 0 0 40
289 Waterfor Injeksi Botol 50 0 0 50

UMUM BPJS JAM


PKH KADER JUMLAH
JUMLAH KUNJUNGAN RESEP BAYAR KIS KESDA
299 190 0 0 4 493

Yang Menerima / Melapor


Kepala UPTD Puskesmas Maelang
Kecamatan Sang Tombolang

JUNAIDI MAMONTO, SKM .-


NIP. 19690405 199103 1 010 .-
LAPORAN PEMAKAIAN DAN LEMBARAN
PERMINTAAN OBAT ( LPLPO )

KODE PUSKESMAS :18051501


PUSKESMAS : MAELANG
KECAMATAN : SANG TOMBOLANG
KABUPATEN : BOLAANG MONGONDOW
PROPINSI : SULAWESI UTARA
BULAN : 01 S/D 18 MARET
TAHUN : 2021

STOK PENERI PEMAK STOK


NO NAMA OBAT SATUAN
AWAL MAAN AIAN AKHIR
KET

1 Abbocath18 PCS 510 0 20 490 Expride


2 Abbocath 20 PCS 116 0 66 50 Expride
3 Abbocath 22 PCS 10 0 10 0
4 Abbocath 24 PCS 0 0 0 0
5 Ajitab Tab Kotak 100 Tab 0 0 0 0
6 Alat Suntik 1,0 ml Kotak 100 PCS 600 0 0 600
7 Alat Suntik 2,5 ml Kotak 100 PCS 0 0 0 0
8 Alat Suntik 3,0 ml Kotak 100 PCS 65 0 65 0
9 Alat Suntik 5,0 ml Kotak 100 PCS 1000 0 200 800
10 Alat Suntik 10 ml Kotak 100 PCS 500 0 0 500
11 Albendazole 400 mg Kotak 100 100 0 0 100 Expride
12 Allopurinol 100 mg Kotak 100 Tab 0 0 0 0
13 Alprazolam 0,5 mg Kotak 100 Tab 0 0 0 0
14 Alprazolam 1,0 mg Kotak 100 Tab 0 0 0 0
15 Ambroxol 30 mg Kotak 100 Tab 2500 0 2000 500
16 Aminophyilin inj Kotak 30 Amp 0 0 0 0
17 Aminophyilin Tab 200 mg Botol 100 Tab 1000 0 0 1000
18 Amitriptilin tab Kotak 100 Tab 0 0 0 0
19 Amlodipin 10 mg Kotak 30 Tab 0 0 0 0
20 Amlodipin 5,0 mg Kotak 30 Tab 0 0 0 0
21 Ampicilin inj Kotak 10 Vial 0 0 0 0
22 Ampicilin Cap 500 mg Kotak 100 Cap 0 0 0 0
23 Amoksisilin 500 mg Kotak 100 Cap 15500 0 700 14800
24 Amoksisilin Syrp Kering 125 mg/5 ml Btl 60 ml 0 0 0 0
25 Ampicilin Syrp Kering 125 mg/5 ml Btl 100 ml 0 0 0 0
26 Antalgin 500 mg Kotak 100 Tab 0 0 0 0
27 Antalgin 500 mg Botol 1000 Tab 0 0 0 0
28 Antasida DOEN Kotak 100 Tab 0 0 0 0
29 Antasida DOEN Botol 1000 Tab 0 0 0 0
30 Antides New Kotak 100 100 0 0 100
31 Antihemoroid DOEN Kotak 10 supp 200 0 0 200
32 Antihemoroid Supp Kotak 6 130 0 0 130
33 Anti malaria DOEN Kotak 100 Tab 0 0 0 0
34 Antasida DOEN Syrp Botol 100 ml 0 0 0 0
35 Acyclovir tab 200 mg Kotak 50 Tab 800 0 0 800
36 Acyclovir tab 400 mg Kotak 50 Tab 900 0 0 900
37 Acyclovir Cream 5 g Kotak 24 Tube 0 0 0 0
38 Asam folat 1 mg Botol100 Tab 0 0 0 0
39 Asam ascorbat 50 mg Kotak 100Tab 700 0 700 0
40 Aqua Pro inj Steril Kotak 10 Vial 0 0 0 0
41 Alkohol 70 % Botol 100 ml 0 0 0 0
42 Alkohol 70 % Botol 1 Liter 8 0 1 7
43 Alkohol Swab Kotak @100pcs 0 0 0 0
44 Artesunat inj 60 mg Kotak 1 Vial 0 0 0 0
45 Asam mefenamat 500 mg Kotak 100 Tab 0 0 0 0
46 Aseptan Botol 0 0 0 0
47 Atropin Sulfat Tab 0,5 mg Kotak 100 Tab 0 0 0 0
48 Basitrasin + polimiksin (anti bakteri salep) Kotak 24 Tube 0 0 0 0
49 Betahistin tablet Kotak 30 tab 0 0 0 0
50 Bisoprolol 5 mg Kotak 30 Tab 0 0 0 0
51 Bromhexin 8 mg Tab Kotak 100 Tab 0 0 0 0
52 Brochifar Kotak 100 Tab 0 0 0 0
53 Bromifar Plus Syr Botol 60 ml 0 0 0 0
54 Bedak Salisyl 2 % Kotak 0 0 0 0
55 Betametason krim Ktk 25 tube 83 0 28 55
56 Bexicom C Kotak 100 Tab 0 0 0 0
57 Brocon Tab Kotak 100 Tab 0 0 0 0
58 Bufacetin Salep (kloramfenicol 2%) Tube 15 Gram 0 0 0 0
59 Cat Gut Plain no.3/0 Dos @ 24's 38 0 8 30
60 Cat Gut Plain no.2/0 Dos @ 24's 33 0 13 20
61 Cat Gut Cromic no.3/0 Dos @ 24's 43 0 3 40
62 Cat Gut Cromic no.2/0 Dos @ 24's 43 0 0 43
63 Captopril 12,5 mg Tab Kotak 100 Tab 400 0 100 300
64 Captopril 25 mg Tab Kotak 100 Tab 0 0 0 0
65 Carbamazepin Tab 200 mg Kotak 100 Tab 0 0 0 0
66 Clorpheniramin Malet 4 mg Tab/CTM Botol1000Tab 0 0 0 0
67 Cefixime Kota 50 Tab 0 0 0 0
68 Cimetidin 200 mg tab Kotak 100 Tab 0 0 0 0
69 Cianocobalamin Tab 50 mg Kotak 100 Tab 21000 0 2700 18300
70 Cetrizin 10 mg tab Kotak 50 Tab 0 0 0 0
71 Cetrizin Hcl syrup Botol 6 0 6 0
72 Cefadroxil 500 mg Cap Kotak 100 caps 0 0 0 0
73 Cefadroxil 500 mg Cap Kotak 100 Caps 0 0 0 0
74 Cianocobalamin inj 500 MCg Kotak 100 amp 0 0 0 0
75 Ciprofloxasin 50 mg Kotak 100 0 0 0 0
76 Clorpromazin 100 mg Tab Kotak 100 Tab 0 0 0 0
77 Cloramphenicol TTS Telinga 3 % Botol 5 ml 0 0 0 0
78 Cloramphenicol TTS Mata 1 % Kotak 24 Tube 0 0 0 0
79 Cloramphenicol Salep Mata 1 % Tube 5 g 0 0 0 0
80 Cloramphenicol Caps 250 mg Kotak 100 Kaps 0 0 0 0
81 Cloroquin Botol 1000 Tab 0 0 0 0
82 Cotrimoxazol 480 mg Tab Kotak 100 Tab 0 0 0 0
83 Cotimoxazol 120 mg Tab Kotak 100 tab 0 0 0 0
84 Cotimoxazol Susp Botol 60 ml 0 0 0 0
85 Colfin Kotak 100 0 0 0 0
86 Co Amoxiclav Ktk @ 30 tab 0 0 0 0
87 Curbion syrup Btl 60 mL 0 0 0 0
88 Dapyrin tab kotak 100 Tab 0 0 0 0
89 Dextrose 5% Botol 500 ml 40 0 0 40
90 Dexametason Inj Kotak 100 amp 0 0 0 0
91 Dexametason Tab 0,5 mg Botol 1000 tab 0 0 0 0
92 Dexametason Tab 0,5 mg Kotak 100 Tab 4000 0 0 4000
93 Dextrometorpan syrp 10 mg/5 ml botol 60 ml 0 0 0 0
94 Dextrometorpan Tab Kotak 100 Tab 0 0 0 0
95 Devosix Drops Botol 15 ml 0 0 0 0
96 Dextrometorpan Tab Botol 1000 Tab 0 0 0 0
97 Diazepam inj 5 mg/ml Kotak 30 Amp 30 0 0 30
98 Diazepam 2 mg tab Kotak 100 Tab 0 0 0 0
99 Diazepam 2 mg tab Botol 1000 Tab 0 0 0 0
100 Diazepam 5 mg tab botol 250 Tab 0 0 0 0
101 Diazepam (valdimex)tablet kotak 100 tab 1970 0 0 1970
102 Diethylcarbamazepin 100 mg Kotak 100 Tab 0 0 0 0
103 Diphenhydramin Inj I.M 10 mg/ml Kotak 30 amp 373 0 13 360
104 Digoxin TAB 0,25 mg Kotak 100 tab 0 0 0 0
105 Doxicylin 100 mg Kaps Kotak 100 caps 0 0 0 0
106 Donperidon Tab 10 mg Kotak 100 tab 0 0 0 0
107 Diltiazem HCL Tab 30 mg Kotak 100 Tab 500 0 0 500
108 Epedrin HCL TAB Botol 250 Tab 0 0 0 0
109 Epedrin HCL TAB Botol 1000 Tab 0 0 0 0
110 Ephinefrin Inj 0,1 % Kotak 100 Amp 0 0 0 0
111 Ehtylclor Semprot Botol 0 0 0 0
112 Erytromicin 500 mg Kaps Kotak 100 caps 0 0 0 0
113 Examination Glove Kotak 100 pcs 0 0 0 0
114 Farsifen Plus Kotak 100 Tab 0 0 0 0
115 Fenol gliserol tetes telinga botol 5 ml 0 0 0 0
116 Fenorbarbital Inj 50 ml Kotak 30 Amp 0 0 0 0
117 Fenorbarbital 30 mg Tab Botol 100 Tab 0 0 0 0
118 Fenorbarbital 30 mg Tab Botol 1000 Tab 0 0 0 0
119 Fytomenadion Inj 10 mg/ml Kotak 30 Amp 0 0 0 0
120 Fytomenadion 10 mg Kotak 100 Tab 0 0 0 0
121 Furosemide 40 mg tab kotak 200 Tab 0 0 0 0
122 Fenilbutazon 200 mg Botol 1000 Tab 0 0 0 0
123 Fenitoin 100 mg kaps Botol 100 cabs 1000 0 0 1000
124 Flunadin Tab Kotak 100 Tab 0 0 0 0
125 Folley Catheter No.24 PCS 0 0 0 0
126 Folley Catheter No.20 PCS 10 psg 199 0 0 199
127 Folley Catheter No.18 PCS 10 psg 270 0 10 260
128 Ferosulfat 300 mg Botol 1000 Tab 0 0 0 0
129 Garam Oralit Kotak 100 saset 0 0 0 0
130 Gastricid Tab Kotak 100 Tab 0 0 0 0
131 Gentamicin Inj 80 mg Kotak 5 amp 0 0 0 0
132 Gentian Violet Lart 1% Botol 10 ml 0 0 0 0
133 Glibenclamide 5 mg Kotak 100 Tab 0 0 0 0
134 Glass lonomer Btl/Set 0 0 0 0
135 Glyseril Guayakolat Botol 1000 Tab 0 0 0 0
136 Glucotrol xl Tab 10 mg Kotak 30 Tab 0 0 0 0
137 Grisiofulvin 500mg Kotak 100 Tab 0 0 0 0
138 HydroclortiazidTab 25 mg Botol 1000 Tab 0 0 0 0
139 Hydrocortison Krim 2,5 % Kotak 24 Tube 33 0 23 10
140 Halloperidol 1,5 mg tab Kotak 100 tab 0 0 0 0
141 Halloperidol 0,5 mg tab Kotak 100 Tab 0 0 0 0
142 Halloperidol inj 50mg/ml kotak 10 ampul 8 0 0 8
143 Haidol DC 50 Mg Inj Kotak 5 Ampul 40 0 0 40
144 Handscun No.8.0 (Sateglove Surgical) Kotak 50 PCS 0 0 0 0
145 Handscun No.7,5 (Sateglove Surgical) Kotak 50 PCS 0 0 0 0
146 Handscun No.7 Kotak 50 PCS 0 0 0 0
147 Infuset DWS Sak 0 0 0 0
148 Infuset anak Sak 150 0 25 125
149 Insulatard Kotak 10 Vial 0 0 0 0
150 Insuman Comb Kotak 5pen@3m/ 0 0 0 0
151 Ichtiyol SK 15 gr Kotak 12 pot 0 0 0 0
152 Ibupropen Syrp 100 Mg Botol 60 ml 0 0 0 0
153 Ibupropen 400 Kotak 100 Tab 0 0 0 0
154 Ibupropen 200 Kotak 100 tab 0 0 0 0
155 Isosorbit Dinitrit TAB Kotak 100 tab 0 0 0 0
156 Indo Obat Cacing Kotak 25 Tab 0 0 0 0
157 Kalcium Lactat 500 mg Tab Kotak 100 Tab 0 0 0 0
158 Kapas 250 mg ROLL 120 0 5 115
159 Kapas 500 mg ROLL 0 0 0 0
160 Kasa steril 16 x 16 cm ROLL 0 0 0 0
161 Kasa pembalut 4 x 5 cm ROLL 0 0 0 0
162 Kasa Kompres 4 x 10 cm ROLL 0 0 0 0
163 Kasa Kompres 2 x 80 cm ROLL 10 0 0 10
164 Kasa Hydrophyl 4 x 15 cm ROLL 0 0 0 0
165 Kasa Hydrophyl 40 x 80 cm ROLL 0 0 0 0
166 Kasa Penyerap luka Bakar pcs 0 0 0 0
167 Ketoconazole Tab 200mg Kotak 50 Tab 0 0 0 0
168 Ketoconazole Cream 2 % tube 5 g 0 0 0 0
169 Kuinina 222 mg Tab Botol 1000 Tab 540 0 0 540
170 Lansoprazole Kaps 30 mg Ktak 20 kaps 0 0 0 0
171 Lantus Solostan Kotak 5 pen 0 0 0 0
172 Lidocain Inj 2% (pehacain) Kotak 20 Amp 260 0 20 240
173 Lidocain Inj 2% (pehacain) Kotak 20 Amp 0 0 0 0
174 Lidocain Inj 2% kotak 10 Amp 0 0 0 0
175 Levofloxacin 500mg Tab Kotak 50 tab 0 0 0 0
176 Lisol Botol 100 ml 0 0 0 0
177 Loratadin 10 mg Kotak 100 tab 650 0 150 500
178 Meloxicam 15 Mg Kotak 50 tab 0 0 0 0
179 Multivitamin utk ibu hamil (Prenase) Kotak 100 tab 0 0 0 0
180 Metyl Ergometri Maleat Tab 0,125 mg Kotak 100 tab 0 0 0 0
181 Metil Prednisolon Kotak 100 tab 0 0 0 0
182 Metyl Ergometri Inj kotak 100 Amp 0 0 0 0
183 Metacetin syrup Btl 60 mL 0 0 0 0
184 Metformin Kotak 100 tab 0 0 0 0
185 Metronidazole tab 250 mg Kotak 100 tab 0 0 0 0
186 Metronidazole tab 500 mg (Omenizol) Kotak 100 tab 0 0 0 0
187 Metronodazol sirup botol 0 0 0 0
188 Metronidazole ovula 500mg/vagisol kotak 5 ovula 145 0 0 145
189 Mulsanol Syr Botol 60 ml 0 0 0 0
190 Mykonazole Cream 2% Tube 5 g 313 0 57 256
191 Masker Kotak 50 pcs 0 0 0 0
192 Neo Envios kotak. 100 kpl 0 0 0
193 NaCL 0,9% Botol 500 ml 342 0 0 342
194 Nat. Diclofenak 50 mg Kotak 50 tab 0 0 0 0
195 Nifedipin Tab 10 mg Kotak 100 tab 0 0 0 0
196 Novomix 30 fkx pen Kotak 5 Vial 0 0 0 0
197 Nystatin Vaginal Tab 100.000 IU Kotak 100 Tab 290 0 0 290
198 Obat Cairan Untuk Luka Bakar Botol 40 ml 0 0 0 0
199 Obat Cairan Untuk Sariawan Botol 40 ml 0 0 0 0
200 OBH Syirup Botol100 ml 0 0 0 0
201 Omeneuron Kotak. 100 kpl 0 0 0 0
202 Oxytetracyclin S.K 3% Tube 5 g 0 0 0 0
203 Omegavit Kotak. 100 kpl 0 0 0 0
204 Omegesic Kotak 100 tab 0 0 0 0
205 Omegdiar Kotak. 100 kpl 0 0 0 0
206 Omegdiar Syr Botol 60 ml 0 0 0 0
207 Omecal. D Kotak. 100 tab 0 0 0 0
208 Omeprazol Caps Kotak. 30 Caps 0 0 0 0
209 Omesolvon Syr Botol 0 0 0 0
210 Oxyflow Nasal oxygin Anak Pcs 140 0 0 140
211 Oxyflow Nasal oxygin Bayi Pcs 190 0 0 190
212 Oxyflow Nasal oxygin Dewasa Pcs 174 0 0 174
213 Oxytocin inj (Tiacinon) Kotak 10 Amp 0 0 0 0
214 Pacdin Baby Cough Syr Botol 60 ml 0 0 0 0
215 Papaverin 40 mg Tab Botol 1000 Tab 0 0 0 0
216 Paracetamol Syrp 120ml/5mg Botol 60 ml 5 0 3 2
217 Panvit. C Kotak. 100 tab 0 0 0 0
218 Paracetamol 500 mg Tab Kotak 100 tab 0 0 0 0
219 Paracetamol 500 mg Tab Botol 1000 Tab 0 0 0 0
220 Paracetamol Syrp 120ml/5mg Botol 60 ml 0 0 0 0
221 Panviton Kotak 50 kapl 0 0 0 0
222 Pharmafix 100 mg Kotak 50 tab 0 0 0 0
223 Pirazinamid 500 mg Kotak 100 tab 0 0 0 0
224 Pyridoxin Tab 10 mg (vit.B6) botol 1000 tab 0 0 0 0
225 Pyridoxin Tab 10 mg (vit.B6) botol 1000 tab 0 0 0 0
226 Plester 5 Yard x 2 Inc ROLL 0 0 0 0
227 Phenobarbital 30 Mg Kotak 100 200 0 0 200
228 Povidon Lodida 10% Botol 30 ml 0 0 0 0
229 Povidon Lodida 10% botol 60 ml 40 0 0 40
230 Povidon Lodida 10% Botol 300 ml 0 0 0 0
231 Povidon Lodida 10% Botol 1000 ml 0 0 0 0
232 Prednison Tab 5 mg Botol 1000 tab 0 0 0 0
233 Prednison 5 mg Kotak 100 tab 0 0 0 0
234 Piroxicam 20 mg Kotak 100 Tab 0 0 0 0
235 Piroxicam 20 mg Kotak 120 caps 0 0 0 0
236 Propanolol 40 mg Botol 100 tab 0 0 0 0
237 Pyrantel Tab 125 mg Kotak 60 Tab 700 0 0 700
238 Propyltiorasyl 100 mg (PTU) Botol 100 Tab 400 0 0 400
239 Ranitidin 150 mg Tab Kotak 100 Tab 0 0 0 0
240 Ranitidin Inj 25 mg/2 ml Kotak 5 amp 0 0 0 0
241 Ringer Laktat Botol. 500 ml 385 0 21 364
242 Rivanol Botol 300 cc 0 0 0 0
243 Retinol (Vit.A) 100.000 IU Botol. 50 kps 0 0 0 0
244 Retinol (Vit.A) 200.000 IU Botol. 50 kps 0 0 0 0
245 Stavit kpl Kotak. 100 kpl 0 0 0 0
247 Simvastatin 10 mg Kotak 30 tab 2200 0 220 1980
249 Simvastatin 20 mg Kotak 30 tab 500 0 0 500
250 Salbutamol 2 mg Kotak 100 tab 0 0 0 0
251 Salbutamol 4 mg Kotak 100 Tab 0 0 0 0
252 Salep 2-4 pot @30 Gram 510 0 12 498
253 Salicil Bedak Kotak @ 50 gram 0 0 0 0
254 Silk Benang Bedah 3/0 (suture) Dos @ 36's 0 0 0 0
255 Seltifort Kids Sirop Botol. 60 ml 0 0 0 0

256 Selesbion Plus Kotak 100 Tab 0 0 0 0


257 Seviplex Kotak 100 tab 0 0 0 0
258 Stolax Supositoria (Bisacody) Kotak 6 Supp 0 0 0 0
259 Stomach tab Kotak 100 Tab 0 0 0 0
260 Tablet Tambah Darah kotak 30 tab 6420 0 0 6420
261 Tramadol 50 mg Kaps Kotak 50 caps 0 0 0 0
262 Tetracyclin 250 mg Kaps Botol 1000 caps 500 0 0 500
263 Tetracyclin 500 mg Kaps Kotak 100 caps 4400 0 200 4200
264 Tilomix Tab Kotak 100 Tab 0 0 0 0
265 Thiamin 50 mg Tab Botol 1000 tab 0 0 0 0
266 Thiamin Inj 100 mg/ml Kotak 30 Amp 0 0 0 0
267 Thiamphenicol Kaps 500 mg Kotak 100 kaps 0 0 0 0
268 Trihexyphenidil Tab 2 mg Kotak 100 tab 0 0 0 0
269 Vidabion Tab Kotak 100 Tab 0 0 0 0
270 Vitalamin Tab Kotak 100 Tab 0 0 0 0
271 Vit B. Comp Botol 1000 tab 0 0 0 0
272 Vit B. Comp Kotak 100 Tab 0 0 0 0
274 Vit Ever Kotak 100 Tab 0 0 0 0
275 Urine Bag Sak 180 0 0 180
276 Vaksin Rabies Vero Vial 0 0 0 0
278 Zinc Tab 20 mg Kotak 100 Tab 700 0 0 700
279 OAT FDC Kategori Anak Paket 0 0 0 0
280 OAT FDC Kategori.I. Dws Paket 0 0 0 0
281 OAT FDC Kategori.II Dws Paket 0 0 0 0
282 OAT FDC Sisipan Dws Paket 0 0 0 0
283 Ticomac Tablet 0 0 0 0
284 Solasic Tablet 0 0 0 0
285 Guaifenetisin Tablet 700 0 0 700
286 Kamolas Tablet 0 0 0 0
287 Selkon Tablet 0 0 0 0
288 Plester 15 x 5 cm Rol 40 0 0 40
289 Waterfor Injeksi Botol 50 0 0 50

UMUM BPJS JAM


PKH KADER JUMLAH
JUMLAH KUNJUNGAN RESEP BAYAR KIS KESDA
299 0 0 0 0 299

Yang Menerima / Melapor


Kepala UPTD Puskesmas Maelang
Kecamatan Sang Tombolang

JUNAIDI MAMONTO, SKM .-


NIP. 19690405 199103 1 010 .-
LAPORAN PEMAKAIAN DAN LEMBARAN
PERMINTAAN OBAT ( LPLPO )

KODE PUSKESMAS :18051501


PUSKESMAS : MAELANG
KECAMATAN : SANG TOMBOLANG
KABUPATEN : BOLAANG MONGONDOW
PROPINSI : SULAWESI UTARA
BULAN : MARET
TAHUN : 2021

STOK PENERI PEMAK STOK


NO NAMA OBAT SATUAN
AWAL MAAN AIAN AKHIR
KET

1 Abbocath18 PCS 510 0 20 490 Expride


2 Abbocath 20 PCS 116 0 66 50 Expride
6 Alat Suntik 1,0 ml Kotak 100 PCS 600 0 50 550
9 Alat Suntik 5,0 ml Kotak 100 PCS 1000 0 200 800
10 Alat Suntik 10 ml Kotak 100 PCS 500 0 0 500
11 Albendazole 400 mg Kotak 100 100 0 0 100 Expride
15 Ambroxol 30 mg Kotak 100 Tab 2500 0 2000 500
17 Aminophyilin Tab 200 mg Botol 100 Tab 1000 0 0 1000
23 Amoksisilin 500 mg Kotak 100 Cap 15500 0 1000 14500
30 Antides New Kotak 100 100 0 0 100
31 Antihemoroid DOEN Kotak 10 supp 200 0 50 150
35 Acyclovir tab 200 mg Kotak 50 Tab 800 0 200 600
36 Acyclovir tab 400 mg Kotak 50 Tab 900 0 100 800
55 Betametason krim Ktk 25 tube 83 0 28 55
59 Cat Gut Plain no.3/0 Dos @ 24's 38 0 10 28
60 Cat Gut Plain no.2/0 Dos @ 24's 33 0 5 28
61 Cat Gut Cromic no.3/0 Dos @ 24's 43 0 5 38
62 Cat Gut Cromic no.2/0 Dos @ 24's 43 0 10 33
63 Captopril 12,5 mg Tab Kotak 100 Tab 400 0 300 100
69 Cianocobalamin Tab 50 mg Kotak 100 Tab 21000 0 3000 18000
92 Dexametason Tab 0,5 mg Kotak 100 Tab 4000 0 1000 3000
101 Diazepam (valdimex)tablet kotak 100 tab 1970 0 0 1970
103 Diphenhydramin Inj I.M 10 mg/ml Kotak 30 amp 373 0 13 360
107 Diltiazem HCL Tab 30 mg Kotak 100 Tab 500 0 100 400
123 Fenitoin 100 mg kaps Botol 100 cabs 1000 0 100 900
126 Folley Catheter No.20 PCS 10 psg 199 0 0 199
127 Folley Catheter No.18 PCS 10 psg 270 0 20 250
139 Hydrocortison Krim 2,5 % Kotak 24 Tube 33 0 23 10
143 Haidol DC 50 Mg Inj Kotak 5 Ampul 40 0 0 40
148 Infuset anak Sak 150 0 30 120
158 Kapas 250 mg ROLL 120 0 10 110
163 Kasa Kompres 2 x 80 cm ROLL 10 0 10 0
169 Kuinina 222 mg Tab Botol 1000 Tab 540 0 0 540
172 Lidocain Inj 2% (pehacain) Kotak 20 Amp 260 0 50 210
177 Loratadin 10 mg Kotak 100 tab 650 0 250 400
188 Metronidazole ovula 500mg/vagisol kotak 5 ovula 145 0 10 135
190 Mykonazole Cream 2% Tube 5 g 313 0 65 248
193 NaCL 0,9% Botol 500 ml 342 0 50 292
197 Nystatin Vaginal Tab 100.000 IU Kotak 100 Tab 290 0 0 290
210 Oxyflow Nasal oxygin Anak Pcs 140 0 0 140
211 Oxyflow Nasal oxygin Bayi Pcs 190 0 0 190
212 Oxyflow Nasal oxygin Dewasa Pcs 174 0 0 174
216 Paracetamol Syrp 120ml/5mg Botol 60 ml 5 0 5 0
227 Phenobarbital 30 Mg Kotak 100 200 0 0 200
229 Povidon Lodida 10% botol 60 ml 40 0 10 30
237 Pyrantel Tab 125 mg Kotak 60 Tab 700 0 700 0
238 Propyltiorasyl 100 mg (PTU) Botol 100 Tab 400 0 200 200
241 Ringer Laktat Botol. 500 ml 385 0 50 335
247 Simvastatin 10 mg Kotak 30 tab 2200 0 300 1900
249 Simvastatin 20 mg Kotak 30 tab 500 0 0 500
252 Salep 2-4 pot @30 Gram 510 0 30 480
260 Tablet Tambah Darah kotak 30 tab 6420 0 0 6420
262 Tetracyclin 250 mg Kaps Botol 1000 caps 500 0 0 500
263 Tetracyclin 500 mg Kaps Kotak 100 caps 4400 0 200 4200
275 Urine Bag Sak 180 0 0 180
278 Zinc Tab 20 mg Kotak 100 Tab 700 0 0 700
285 Guaifenetisin Tablet 700 0 200 500
288 Plester 15 x 5 cm Rol 40 0 10 30
289 Waterfor Injeksi Botol 50 0 0 50
Expayer
Expayer

Expayer Feb

Di Tarik Ke Dinas
Expayer Feb 2021

Expayer
Expayer

Expayer
LAPORAN PEMAKAIAN DAN LEMBARAN
PERMINTAAN OBAT ( LPLPO )

KODE PUSKESMAS :18051501


PUSKESMAS : MAELANG
KECAMATAN : SANG TOMBOLANG
KABUPATEN : BOLAANG MONGONDOW
PROPINSI : SULAWESI UTARA
BULAN : MARET
TAHUN : 2021

STOK PENERI PEMAK STOK


NO NAMA OBAT SATUAN
AWAL MAAN AIAN AKHIR
KET

1 Abbocath18 PCS 0 0 0 0 Expride Feb


2 Abbocath 20 PCS 0 0 0 0 Expride Feb
3 Abbocath 22 PCS 10 0 10 0
4 Abbocath 24 PCS 0 0 0 0
5 Ajitab Tab Kotak 100 Tab 0 0 0 0
6 Alat Suntik 1,0 ml Kotak 100 PCS 600 0 50 550
7 Alat Suntik 2,5 ml Kotak 100 PCS 0 0 0 0
8 Alat Suntik 3,0 ml Kotak 100 PCS 65 0 65 0
9 Alat Suntik 5,0 ml Kotak 100 PCS 1000 0 100 900
10 Alat Suntik 10 ml Kotak 100 PCS 500 0 20 480
11 Albendazole 400 mg Kotak 100 100 0 0 100
12 Allopurinol 100 mg Kotak 100 Tab 0 0 0 0
13 Alprazolam 0,5 mg Kotak 100 Tab 0 0 0 0
14 Alprazolam 1,0 mg Kotak 100 Tab 0 0 0 0
15 Ambroxol 30 mg Kotak 100 Tab 2500 0 1800 700
16 Aminophyilin inj Kotak 30 Amp 0 0 0 0
17 Aminophyilin Tab 200 mg Botol 100 Tab 1000 0 0 1000
18 Amitriptilin tab Kotak 100 Tab 0 0 0 0
19 Amlodipin 10 mg Kotak 30 Tab 0 0 0 0
20 Amlodipin 5,0 mg Kotak 30 Tab 0 0 0 0
21 Ampicilin inj Kotak 10 Vial 0 0 0 0
22 Ampicilin Cap 500 mg Kotak 100 Cap 0 0 0 0
23 Amoksisilin 500 mg Kotak 100 Cap 15500 0 0 15500
24 Amoksisilin Syrp Kering 125 mg/5 ml Btl 60 ml 0 0 0 0
25 Ampicilin Syrp Kering 125 mg/5 ml Btl 100 ml 0 0 0 0
26 Antalgin 500 mg Kotak 100 Tab 0 0 0 0
27 Antalgin 500 mg Botol 1000 Tab 0 0 0 0
28 Antasida DOEN Kotak 100 Tab 0 0 0 0
29 Antasida DOEN Botol 1000 Tab 0 0 0 0
30 Antides New Kotak 100 100 0 0 100
31 Antihemoroid DOEN Kotak 10 supp 200 0 0 200
32 Antihemoroid Supp Kotak 6 130 0 0 130
33 Anti malaria DOEN Kotak 100 Tab 0 0 0 0
34 Antasida DOEN Syrp Botol 100 ml 0 0 0 0
35 Acyclovir tab 200 mg Kotak 50 Tab 800 0 200 600
36 Acyclovir tab 400 mg Kotak 50 Tab 900 0 200 700
37 Acyclovir Cream 5 g Kotak 24 Tube 0 0 0 0
38 Asam folat 1 mg Botol100 Tab 0 0 0 0
39 Asam ascorbat 50 mg Kotak 100Tab 700 0 700 0
40 Aqua Pro inj Steril Kotak 10 Vial 0 0 0 0
41 Alkohol 70 % Botol 100 ml 0 0 0 0
42 Alkohol 70 % Botol 1 Liter 8 0 1 7
43 Alkohol Swab Kotak @100pcs 0 0 0 0
44 Artesunat inj 60 mg Kotak 1 Vial 0 0 0 0
45 Asam mefenamat 500 mg Kotak 100 Tab 0 0 0 0
46 Aseptan Botol 0 0 0 0
47 Atropin Sulfat Tab 0,5 mg Kotak 100 Tab 0 0 0 0
48 Basitrasin + polimiksin (anti bakteri salep) Kotak 24 Tube 0 0 0 0
49 Betahistin tablet Kotak 30 tab 0 0 0 0
50 Bisoprolol 5 mg Kotak 30 Tab 0 0 0 0
51 Bromhexin 8 mg Tab Kotak 100 Tab 0 0 0 0
52 Brochifar Kotak 100 Tab 0 0 0 0
53 Bromifar Plus Syr Botol 60 ml 0 0 0 0
54 Bedak Salisyl 2 % Kotak 0 0 0 0
55 Betametason krim Ktk 25 tube 83 0 78 5
56 Bexicom C Kotak 100 Tab 0 0 0 0
57 Brocon Tab Kotak 100 Tab 0 0 0 0
58 Bufacetin Salep (kloramfenicol 2%) Tube 15 Gram 0 0 0 0
59 Cat Gut Plain no.3/0 Dos @ 24's 38 0 0 38
60 Cat Gut Plain no.2/0 Dos @ 24's 33 0 0 33
61 Cat Gut Cromic no.3/0 Dos @ 24's 43 0 0 43
62 Cat Gut Cromic no.2/0 Dos @ 24's 43 0 0 43
63 Captopril 12,5 mg Tab Kotak 100 Tab 400 0 0 400
64 Captopril 25 mg Tab Kotak 100 Tab 0 0 0 0
65 Carbamazepin Tab 200 mg Kotak 100 Tab 0 0 0 0
66 Clorpheniramin Malet 4 mg Tab/CTM Botol1000Tab 0 0 0 0
67 Cefixime Kota 50 Tab 0 0 0 0
68 Cimetidin 200 mg tab Kotak 100 Tab 0 0 0 0
69 Cianocobalamin Tab 50 mg Kotak 100 Tab 21000 0 2700 18300
70 Cetrizin 10 mg tab Kotak 50 Tab 0 0 0 0
71 Cetrizin Hcl syrup Botol 6 0 6 0
72 Cefadroxil 500 mg Cap Kotak 100 caps 0 0 0 0
73 Cefadroxil 500 mg Cap Kotak 100 Caps 0 0 0 0
74 Cianocobalamin inj 500 MCg Kotak 100 amp 0 0 0 0
75 Ciprofloxasin 50 mg Kotak 100 0 0 0 0
76 Clorpromazin 100 mg Tab Kotak 100 Tab 0 0 0 0
77 Cloramphenicol TTS Telinga 3 % Botol 5 ml 0 0 0 0
78 Cloramphenicol TTS Mata 1 % Kotak 24 Tube 0 0 0 0
79 Cloramphenicol Salep Mata 1 % Tube 5 g 0 0 0 0
80 Cloramphenicol Caps 250 mg Kotak 100 Kaps 0 0 0 0
81 Cloroquin Botol 1000 Tab 0 0 0 0
82 Cotrimoxazol 480 mg Tab Kotak 100 Tab 0 0 0 0
83 Cotimoxazol 120 mg Tab Kotak 100 tab 0 0 0 0
84 Cotimoxazol Susp Botol 60 ml 0 0 0 0
85 Colfin Kotak 100 0 0 0 0
86 Co Amoxiclav Ktk @ 30 tab 0 0 0 0
87 Curbion syrup Btl 60 mL 0 0 0 0
88 Dapyrin tab kotak 100 Tab 0 0 0 0
89 Dextrose 5% Botol 500 ml 40 0 0 40
90 Dexametason Inj Kotak 100 amp 0 0 0 0
91 Dexametason Tab 0,5 mg Botol 1000 tab 0 0 0 0
92 Dexametason Tab 0,5 mg Kotak 100 Tab 4000 0 0 4000
93 Dextrometorpan syrp 10 mg/5 ml botol 60 ml 0 0 0 0
94 Dextrometorpan Tab Kotak 100 Tab 0 0 0 0
95 Devosix Drops Botol 15 ml 0 0 0 0
96 Dextrometorpan Tab Botol 1000 Tab 0 0 0 0
97 Diazepam inj 5 mg/ml Kotak 30 Amp 30 0 0 30
98 Diazepam 2 mg tab Kotak 100 Tab 0 0 0 0
99 Diazepam 2 mg tab Botol 1000 Tab 0 0 0 0
100 Diazepam 5 mg tab botol 250 Tab 0 0 0 0
101 Diazepam (valdimex)tablet kotak 100 tab 1970 0 0 1970
102 Diethylcarbamazepin 100 mg Kotak 100 Tab 0 0 0 0
103 Diphenhydramin Inj I.M 10 mg/ml Kotak 30 amp 373 0 13 360
104 Digoxin TAB 0,25 mg Kotak 100 tab 0 0 0 0
105 Doxicylin 100 mg Kaps Kotak 100 caps 0 0 0 0
106 Donperidon Tab 10 mg Kotak 100 tab 0 0 0 0
107 Diltiazem HCL Tab 30 mg Kotak 100 Tab 500 0 0 500
108 Epedrin HCL TAB Botol 250 Tab 0 0 0 0
109 Epedrin HCL TAB Botol 1000 Tab 0 0 0 0
110 Ephinefrin Inj 0,1 % Kotak 100 Amp 0 0 0 0
111 Ehtylclor Semprot Botol 0 0 0 0
112 Erytromicin 500 mg Kaps Kotak 100 caps 0 0 0 0
113 Examination Glove Kotak 100 pcs 0 0 0 0
114 Farsifen Plus Kotak 100 Tab 0 0 0 0
115 Fenol gliserol tetes telinga botol 5 ml 0 0 0 0
116 Fenorbarbital Inj 50 ml Kotak 30 Amp 0 0 0 0
117 Fenorbarbital 30 mg Tab Botol 100 Tab 0 0 0 0
118 Fenorbarbital 30 mg Tab Botol 1000 Tab 0 0 0 0
119 Fytomenadion Inj 10 mg/ml Kotak 30 Amp 0 0 0 0
120 Fytomenadion 10 mg Kotak 100 Tab 0 0 0 0
121 Furosemide 40 mg tab kotak 200 Tab 0 0 0 0
122 Fenilbutazon 200 mg Botol 1000 Tab 0 0 0 0
123 Fenitoin 100 mg kaps Botol 100 cabs 1000 0 0 1000
124 Flunadin Tab Kotak 100 Tab 0 0 0 0
125 Folley Catheter No.24 PCS 0 0 0 0
126 Folley Catheter No.20 PCS 10 psg 199 0 0 199
127 Folley Catheter No.18 PCS 10 psg 270 0 10 260
128 Ferosulfat 300 mg Botol 1000 Tab 0 0 0 0
129 Garam Oralit Kotak 100 saset 0 0 0 0
130 Gastricid Tab Kotak 100 Tab 0 0 0 0
131 Gentamicin Inj 80 mg Kotak 5 amp 0 0 0 0
132 Gentian Violet Lart 1% Botol 10 ml 0 0 0 0
133 Glibenclamide 5 mg Kotak 100 Tab 0 0 0 0
134 Glass lonomer Btl/Set 0 0 0 0
135 Glyseril Guayakolat Botol 1000 Tab 0 0 0 0
136 Glucotrol xl Tab 10 mg Kotak 30 Tab 0 0 0 0
137 Grisiofulvin 500mg Kotak 100 Tab 0 0 0 0
138 HydroclortiazidTab 25 mg Botol 1000 Tab 0 0 0 0
139 Hydrocortison Krim 2,5 % Kotak 24 Tube 33 0 23 10
140 Halloperidol 1,5 mg tab Kotak 100 tab 0 0 0 0
141 Halloperidol 0,5 mg tab Kotak 100 Tab 0 0 0 0
142 Halloperidol inj 50mg/ml kotak 10 ampul 8 0 0 8
143 Haidol DC 50 Mg Inj Kotak 5 Ampul 40 0 0 40
144 Handscun No.8.0 (Sateglove Surgical) Kotak 50 PCS 0 0 0 0
145 Handscun No.7,5 (Sateglove Surgical) Kotak 50 PCS 0 0 0 0
146 Handscun No.7 Kotak 50 PCS 0 0 0 0
147 Infuset DWS Sak 0 0 0 0
148 Infuset anak Sak 150 0 25 125
149 Insulatard Kotak 10 Vial 0 0 0 0
150 Insuman Comb Kotak 5pen@3m/ 0 0 0 0
151 Ichtiyol SK 15 gr Kotak 12 pot 0 0 0 0
152 Ibupropen Syrp 100 Mg Botol 60 ml 0 0 0 0
153 Ibupropen 400 Kotak 100 Tab 0 0 0 0
154 Ibupropen 200 Kotak 100 tab 0 0 0 0
155 Isosorbit Dinitrit TAB Kotak 100 tab 0 0 0 0
156 Indo Obat Cacing Kotak 25 Tab 0 0 0 0
157 Kalcium Lactat 500 mg Tab Kotak 100 Tab 0 0 0 0
158 Kapas 250 mg ROLL 120 0 5 115
159 Kapas 500 mg ROLL 0 0 0 0
160 Kasa steril 16 x 16 cm ROLL 0 0 0 0
161 Kasa pembalut 4 x 5 cm ROLL 0 0 0 0
162 Kasa Kompres 4 x 10 cm ROLL 0 0 0 0
163 Kasa Kompres 2 x 80 cm ROLL 10 0 0 10
164 Kasa Hydrophyl 4 x 15 cm ROLL 0 0 0 0
165 Kasa Hydrophyl 40 x 80 cm ROLL 0 0 0 0
166 Kasa Penyerap luka Bakar pcs 0 0 0 0
167 Ketoconazole Tab 200mg Kotak 50 Tab 0 0 0 0
168 Ketoconazole Cream 2 % tube 5 g 0 0 0 0
169 Kuinina 222 mg Tab Botol 1000 Tab 540 0 0 540
170 Lansoprazole Kaps 30 mg Ktak 20 kaps 0 0 0 0
171 Lantus Solostan Kotak 5 pen 0 0 0 0
172 Lidocain Inj 2% (pehacain) Kotak 20 Amp 260 0 20 240
173 Lidocain Inj 2% (pehacain) Kotak 20 Amp 0 0 0 0
174 Lidocain Inj 2% kotak 10 Amp 0 0 0 0
175 Levofloxacin 500mg Tab Kotak 50 tab 0 0 0 0
176 Lisol Botol 100 ml 0 0 0 0
177 Loratadin 10 mg Kotak 100 tab 650 0 150 500
178 Meloxicam 15 Mg Kotak 50 tab 0 0 0 0
179 Multivitamin utk ibu hamil (Prenase) Kotak 100 tab 0 0 0 0
180 Metyl Ergometri Maleat Tab 0,125 mg Kotak 100 tab 0 0 0 0
181 Metil Prednisolon Kotak 100 tab 0 0 0 0
182 Metyl Ergometri Inj kotak 100 Amp 0 0 0 0
183 Metacetin syrup Btl 60 mL 0 0 0 0
184 Metformin Kotak 100 tab 0 0 0 0
185 Metronidazole tab 250 mg Kotak 100 tab 0 0 0 0
186 Metronidazole tab 500 mg (Omenizol) Kotak 100 tab 0 0 0 0
187 Metronodazol sirup botol 0 0 0 0
188 Metronidazole ovula 500mg/vagisol kotak 5 ovula 145 0 0 145
189 Mulsanol Syr Botol 60 ml 0 0 0 0
190 Mykonazole Cream 2% Tube 5 g 313 0 57 256
191 Masker Kotak 50 pcs 0 0 0 0
192 Neo Envios kotak. 100 kpl 0 0 0
193 NaCL 0,9% Botol 500 ml 342 0 0 342
194 Nat. Diclofenak 50 mg Kotak 50 tab 0 0 0 0
195 Nifedipin Tab 10 mg Kotak 100 tab 0 0 0 0
196 Novomix 30 fkx pen Kotak 5 Vial 0 0 0 0
197 Nystatin Vaginal Tab 100.000 IU Kotak 100 Tab 290 0 0 290
198 Obat Cairan Untuk Luka Bakar Botol 40 ml 0 0 0 0
199 Obat Cairan Untuk Sariawan Botol 40 ml 0 0 0 0
200 OBH Syirup Botol100 ml 0 0 0 0
201 Omeneuron Kotak. 100 kpl 0 0 0 0
202 Oxytetracyclin S.K 3% Tube 5 g 0 0 0 0
203 Omegavit Kotak. 100 kpl 0 0 0 0
204 Omegesic Kotak 100 tab 0 0 0 0
205 Omegdiar Kotak. 100 kpl 0 0 0 0
206 Omegdiar Syr Botol 60 ml 0 0 0 0
207 Omecal. D Kotak. 100 tab 0 0 0 0
208 Omeprazol Caps Kotak. 30 Caps 0 0 0 0
209 Omesolvon Syr Botol 0 0 0 0
210 Oxyflow Nasal oxygin Anak Pcs 140 0 0 140
211 Oxyflow Nasal oxygin Bayi Pcs 190 0 0 190
212 Oxyflow Nasal oxygin Dewasa Pcs 174 0 0 174
213 Oxytocin inj (Tiacinon) Kotak 10 Amp 0 0 0 0
214 Pacdin Baby Cough Syr Botol 60 ml 0 0 0 0
215 Papaverin 40 mg Tab Botol 1000 Tab 0 0 0 0
216 Paracetamol Syrp 120ml/5mg Botol 60 ml 5 0 3 2
217 Panvit. C Kotak. 100 tab 0 0 0 0
218 Paracetamol 500 mg Tab Kotak 100 tab 0 0 0 0
219 Paracetamol 500 mg Tab Botol 1000 Tab 0 0 0 0
220 Paracetamol Syrp 120ml/5mg Botol 60 ml 0 0 0 0
221 Panviton Kotak 50 kapl 0 0 0 0
222 Pharmafix 100 mg Kotak 50 tab 0 0 0 0
223 Pirazinamid 500 mg Kotak 100 tab 0 0 0 0
224 Pyridoxin Tab 10 mg (vit.B6) botol 1000 tab 0 0 0 0
225 Pyridoxin Tab 10 mg (vit.B6) botol 1000 tab 0 0 0 0
226 Plester 5 Yard x 2 Inc ROLL 0 0 0 0
227 Phenobarbital 30 Mg Kotak 100 200 0 0 200
228 Povidon Lodida 10% Botol 30 ml 0 0 0 0
229 Povidon Lodida 10% botol 60 ml 40 0 0 40
230 Povidon Lodida 10% Botol 300 ml 0 0 0 0
231 Povidon Lodida 10% Botol 1000 ml 0 0 0 0
232 Prednison Tab 5 mg Botol 1000 tab 0 0 0 0
233 Prednison 5 mg Kotak 100 tab 0 0 0 0
234 Piroxicam 20 mg Kotak 100 Tab 0 0 0 0
235 Piroxicam 20 mg Kotak 120 caps 0 0 0 0
236 Propanolol 40 mg Botol 100 tab 0 0 0 0
237 Pyrantel Tab 125 mg Kotak 60 Tab 700 0 0 700
238 Propyltiorasyl 100 mg (PTU) Botol 100 Tab 400 0 0 400
239 Ranitidin 150 mg Tab Kotak 100 Tab 0 0 0 0
240 Ranitidin Inj 25 mg/2 ml Kotak 5 amp 0 0 0 0
241 Ringer Laktat Botol. 500 ml 385 0 21 364
242 Rivanol Botol 300 cc 0 0 0 0
243 Retinol (Vit.A) 100.000 IU Botol. 50 kps 0 0 0 0
244 Retinol (Vit.A) 200.000 IU Botol. 50 kps 0 0 0 0
245 Stavit kpl Kotak. 100 kpl 0 0 0 0
247 Simvastatin 10 mg Kotak 30 tab 2200 0 220 1980
249 Simvastatin 20 mg Kotak 30 tab 500 0 0 500
250 Salbutamol 2 mg Kotak 100 tab 0 0 0 0
251 Salbutamol 4 mg Kotak 100 Tab 0 0 0 0
252 Salep 2-4 pot @30 Gram 510 0 12 498
253 Salicil Bedak Kotak @ 50 gram 0 0 0 0
254 Silk Benang Bedah 3/0 (suture) Dos @ 36's 0 0 0 0
255 Seltifort Kids Sirop Botol. 60 ml 0 0 0 0

256 Selesbion Plus Kotak 100 Tab 0 0 0 0


257 Seviplex Kotak 100 tab 0 0 0 0
258 Stolax Supositoria (Bisacody) Kotak 6 Supp 0 0 0 0
259 Stomach tab Kotak 100 Tab 0 0 0 0
260 Tablet Tambah Darah kotak 30 tab 6420 0 0 6420
261 Tramadol 50 mg Kaps Kotak 50 caps 0 0 0 0
262 Tetracyclin 250 mg Kaps Botol 1000 caps 500 0 0 500
263 Tetracyclin 500 mg Kaps Kotak 100 caps 4400 0 200 4200
264 Tilomix Tab Kotak 100 Tab 0 0 0 0
265 Thiamin 50 mg Tab Botol 1000 tab 0 0 0 0
266 Thiamin Inj 100 mg/ml Kotak 30 Amp 0 0 0 0
267 Thiamphenicol Kaps 500 mg Kotak 100 kaps 0 0 0 0
268 Trihexyphenidil Tab 2 mg Kotak 100 tab 0 0 0 0
269 Vidabion Tab Kotak 100 Tab 0 0 0 0
270 Vitalamin Tab Kotak 100 Tab 0 0 0 0
271 Vit B. Comp Botol 1000 tab 0 0 0 0
272 Vit B. Comp Kotak 100 Tab 0 0 0 0
274 Vit Ever Kotak 100 Tab 0 0 0 0
275 Urine Bag Sak 180 0 0 180
276 Vaksin Rabies Vero Vial 0 0 0 0
278 Zinc Tab 20 mg Kotak 100 Tab 700 0 0 700
279 OAT FDC Kategori Anak Paket 0 0 0 0
280 OAT FDC Kategori.I. Dws Paket 0 0 0 0
281 OAT FDC Kategori.II Dws Paket 0 0 0 0
282 OAT FDC Sisipan Dws Paket 0 0 0 0
283 Ticomac Tablet 0 0 0 0
284 Solasic Tablet 0 0 0 0
285 Guaifenetisin Tablet 0 0 0 0
286 Kamolas Tablet 0 0 0 0
287 Selkon Tablet 0 0 0 0
288 Plester 15 x 5 cm Rol 40 0 0 40
289 Waterfor Injeksi Botol 50 0 0 50

UMUM BPJS JAM


PKH KADER JUMLAH
JUMLAH KUNJUNGAN RESEP BAYAR KIS KESDA
299 190 0 0 4 493

Yang Menerima / Melapor


Kepala UPTD Puskesmas Maelang
Kecamatan Sang Tombolang

JUNAIDI MAMONTO, SKM .-


NIP. 19690405 199103 1 010 .-
490
50
0
0
0
550
0
0
900
480
100
0
0
0
700
0
1000
0
0
0
0
0
15500
0
0
0
0
0
0
100
200
130
0
0
800
900
0
0
0
0
0
7
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
38
33
43
43
400
0
0
0
0
0
18300
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
40
0
0
4000
0
0
0
0
30
0
0
0
1970
0
0 Expayer
0
0
0
500
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
100
0
0
199
260
0
0
0
0
0
0
0
0
0
0
0
10
0
0
8
40
0
0
0
0
125
0
0
0
0
0
0
0
0
0
115
0
0
0
0
10
0
0
0
0
0
540
0
0
240
0
0
0
0
500
0
0
0
0
0
0
0
0
0
0
145
0
256
0
0
342
0
0
0
290
0
0
0
0
0
0
0
0
0
0
0
0
140
190
174
0
0
0
2
0
0
0
0
0
0
0
0
0
0
200
0
40
0
0
0
0
0
0
0
700
400
0
0
364
0
0
0
0
1980
500
0
0
498
0
0
0

0
0
0
0
6420
0
500
4200
0
0
0
0
0
0
0
0
0
0
180
0
700
0
0
0
0
0
0
700 Expayer Feb
0
0
40
50
LAPORAN PEMAKAIAN DAN LEMBARAN
PERMINTAAN OBAT ( LPLPO )

KODE PUSKESMAS :18051501


PUSKESMAS : MAELANG
KECAMATAN : SANG TOMBOLANG
KABUPATEN : BOLAANG MONGONDOW
PROPINSI : SULAWESI UTARA
BULAN : APRIL
TAHUN : 2021

STOK PENERI
NO NAMA OBAT SATUAN
AWAL MAAN
1 Abbocath18 PCS 510 0
2 Abbocath 20 PCS 116 0
3 Abbocath 22 PCS 10 0
4 Abbocath 24 PCS 0 0
5 Ajitab Tab Kotak 100 Tab 0 0
6 Alat Suntik 1,0 ml Kotak 100 PCS 600 0
7 Alat Suntik 2,5 ml Kotak 100 PCS 0 0
8 Alat Suntik 3,0 ml Kotak 100 PCS 65 0
9 Alat Suntik 5,0 ml Kotak 100 PCS 1000 0
10 Alat Suntik 10 ml Kotak 100 PCS 500 0
11 Albendazole 400 mg Kotak 100 100 0
12 Allopurinol 100 mg Kotak 100 Tab 0 0
13 Alprazolam 0,5 mg Kotak 100 Tab 0 0
14 Alprazolam 1,0 mg Kotak 100 Tab 0 0
15 Ambroxol 30 mg Kotak 100 Tab 2500 0
16 Aminophyilin inj Kotak 30 Amp 0 0
17 Aminophyilin Tab 200 mg Botol 100 Tab 1000 0
18 Amitriptilin tab Kotak 100 Tab 0 0
19 Amlodipin 100 mg Kotak 30 Tab 0 600
20 Amlodipin 5,0 mg Kotak 30 Tab 0 0
21 Ampicilin inj Kotak 10 Vial 0 0
22 Ampicilin Cap 500 mg Kotak 100 Cap 0 0
23 Amoksisilin 500 mg Kotak 100 Cap 15500 500
24 Amoksisilin Syrp Kering 125 mg/5 ml Btl 60 ml 0 0
25 Ampicilin Syrp Kering 125 mg/5 ml Btl 100 ml 0 0
26 Antalgin 500 mg Kotak 100 Tab 0 0
27 Antalgin 500 mg Botol 1000 Tab 0 0
28 Antasida DOEN Kotak 100 Tab 0 0
Antasida DOEN Kotak 100 Tab 0 1500
29 Antasida DOEN Botol 1000 Tab 0 0
30 Antides New Kotak 100 100 0
31 Antihemoroid DOEN Kotak 10 supp 200 0
32 Antihemoroid Supp Kotak 6 130 0
33 Anti malaria DOEN Kotak 100 Tab 0 0
34 Antasida DOEN Syrp Botol 100 ml 0 0
35 Acyclovir tab 200 mg Kotak 50 Tab 800 0
36 Acyclovir tab 400 mg Kotak 50 Tab 900 0
37 Acyclovir Cream 5 g Kotak 24 Tube 0 0
38 Asam folat 1 mg Botol100 Tab 0 0
39 Asam ascorbat 50 mg Kotak 100Tab 700 0
40 Aqua Pro inj Steril Kotak 10 Vial 0 0
41 Alkohol 70 % Botol 100 ml 0 0
42 Alkohol 70 % Botol 1 Liter 8 0
43 Alkohol Swab Kotak @100pcs 0 0
44 Artesunat inj 60 mg Kotak 1 Vial 0 0
45 Asam mefenamat 500 mg Kotak 100 Tab 0 0
46 Aseptan Botol 0 0
47 Atropin Sulfat Tab 0,5 mg Kotak 100 Tab 0 0
48 Basitrasin + polimiksin (anti bakteri salep) Kotak 24 Tube 0 0
49 Betahistin tablet Kotak 30 tab 0 0
50 Bisoprolol 5 mg Kotak 30 Tab 0 0
51 Bromhexin 8 mg Tab Kotak 100 Tab 0 0
52 Brochifar Kotak 100 Tab 0 0
53 Bromifar Plus Syr Botol 60 ml 0 0
54 Bedak Salisyl 2 % Kotak 0 0
55 Betametason krim Ktk 25 tube 83 0

56 Bexicom C Kotak 100 Tab 0 0


57 Brocon Tab Kotak 100 Tab 0 0
58 Bufacetin Salep (kloramfenicol 2%) Tube 15 Gram 0 0
59 Cat Gut Plain no.3/0 Dos @ 24's 38 0
60 Cat Gut Plain no.2/0 Dos @ 24's 33 0
61 Cat Gut Cromic no.3/0 Dos @ 24's 43 0
62 Cat Gut Cromic no.2/0 Dos @ 24's 43 0
63 Captopril 12,5 mg Tab Kotak 100 Tab 400 0
64 Captopril 25 mg Tab Kotak 100 Tab 0 0
65 Carbamazepin Tab 200 mg Kotak 100 Tab 0 0
66 Clorpheniramin Malet 4 mg Tab/CTM Botol1000Tab 0 0
67 Cefixime Kota 50 Tab 0 0
Cetrine 10 mg 150
68 Cimetidin 200 mg tab Kotak 100 Tab 0 200
69 Cianocobalamin Tab 50 mg Kotak 100 Tab 21000 0
70 Cetrizin 10 mg tab Kotak 50 Tab 0 0
71 Cetrizin Hcl syrup Botol 6 0
72 Cefadroxil 500 mg Cap Kotak 100 caps 0 0
73 Cefadroxil 500 mg Cap Kotak 100 Caps 0 0
74 Cianocobalamin inj 500 MCg Kotak 100 amp 0 0
75 Ciprofloxasin 50 mg Kotak 100 0 0
76 Clorpromazin 100 mg Tab Kotak 100 Tab 0 0
77 Cloramphenicol TTS Telinga 3 % Botol 5 ml 0 0
78 Cloramphenicol TTS Mata 1 % Kotak 24 Tube 0 0
79 Cloramphenicol Salep Mata 1 % Tube 5 g 0 0
80 Cloramphenicol Caps 250 mg Kotak 100 Kaps 0 0
81 Cloroquin Botol 1000 Tab 0 0
82 Cotrimoxazol 480 mg Tab Kotak 100 Tab 0 0
83 Cotimoxazol 120 mg Tab Kotak 100 tab 0 0
84 Cotimoxazol Susp Botol 60 ml 0 0
85 Colfin Kotak 100 0 0
86 Co Amoxiclav Ktk @ 30 tab 0 0
87 Curbion syrup Btl 60 mL 0 0
88 Dapyrin tab kotak 100 Tab 0 0
89 Dextrose 5% Botol 500 ml 40 0
90 Dexametason Inj Kotak 100 amp 0 0
91 Dexametason Tab 0,5 mg Botol 1000 tab 0 0
92 Dexametason Tab 0,5 mg Kotak 100 Tab 4000 0
93 Dextrometorpan syrp 10 mg/5 ml botol 60 ml 0 0
94 Dextrometorpan Tab Kotak 100 Tab 0 0
95 Devosix Drops Botol 15 ml 0 0
96 Dextrometorpan Tab Botol 1000 Tab 0 0
97 Diazepam inj 5 mg/ml Kotak 30 Amp 30 0
98 Diazepam 2 mg tab Kotak 100 Tab 0 0
99 Diazepam 2 mg tab Botol 1000 Tab 0 0
100 Diazepam 5 mg tab botol 250 Tab 0 0
101 Diazepam (valdimex)tablet kotak 100 tab 1970 0
102 Diethylcarbamazepin 100 mg Kotak 100 Tab 0 0
103 Diphenhydramin Inj I.M 10 mg/ml Kotak 30 amp 373 0
104 Digoxin TAB 0,25 mg Kotak 100 tab 0 0
105 Doxicylin 100 mg Kaps Kotak 100 caps 0 0
106 Donperidon Tab 10 mg Kotak 100 tab 0 0
107 Diltiazem HCL Tab 30 mg Kotak 100 Tab 500 0
108 Epedrin HCL TAB Botol 250 Tab 0 0
109 Epedrin HCL TAB Botol 1000 Tab 0 0
110 Ephinefrin Inj 0,1 % Kotak 100 Amp 0 0
111 Ehtylclor Semprot Botol 0 0
112 Erytromicin 500 mg Kaps Kotak 100 caps 0 0
113 Examination Glove Kotak 100 pcs 0 0
Ergotamine 50 mg / 100 mg Tablet 800
114 Farsifen Plus Kotak 100 Tab 0 0
115 Fenol gliserol tetes telinga botol 5 ml 0 0
116 Fenorbarbital Inj 50 ml Kotak 30 Amp 0 0
117 Fenorbarbital 30 mg Tab Botol 100 Tab 0 0
118 Fenorbarbital 30 mg Tab Botol 1000 Tab 0 0
119 Fytomenadion Inj 10 mg/ml Kotak 30 Amp 0 0
120 Fytomenadion 10 mg Kotak 100 Tab 0 0
121 Furosemide 40 mg tab kotak 200 Tab 0 0

122 Fenilbutazon 200 mg Botol 1000 Tab 0 0


123 Fenitoin 100 mg kaps Botol 100 cabs 1000 0
124 Flunadin Tab Kotak 100 Tab 0 0
125 Folley Catheter No.24 PCS 0 0
126 Folley Catheter No.20 PCS 10 psg 199 0
127 Folley Catheter No.18 PCS 10 psg 270 0
128 Ferosulfat 300 mg Botol 1000 Tab 0 0
129 Garam Oralit Kotak 100 saset 0 100
130 Gastricid Tab Kotak 100 Tab 0 0
131 Gentamicin Inj 80 mg Kotak 5 amp 0 0
132 Gentian Violet Lart 1% Botol 10 ml 0 0
133 Glibenclamide 5 mg Kotak 100 Tab 0 0
134 Glass lonomer Btl/Set 0 0
135 Glyseril Guayakolat Botol 1000 Tab 0 0
136 Glucotrol xl Tab 10 mg Kotak 30 Tab 0 0
137 Grisiofulvin 500mg Kotak 100 Tab 0 0
138 HydroclortiazidTab 25 mg Botol 1000 Tab 0 0
139 Hydrocortison Krim 2,5 % Kotak 24 Tube 33 0
140 Halloperidol 1,5 mg tab Kotak 100 tab 0 0
141 Halloperidol 0,5 mg tab Kotak 100 Tab 0 0
142 Halloperidol inj 50mg/ml kotak 10 ampul 8 0
143 Haidol DC 50 Mg Inj Kotak 5 Ampul 40 0
144 Handscun No.8.0 (Sateglove Surgical) Kotak 50 PCS 0 0
145 Handscun No.7,5 (Sateglove Surgical) Kotak 50 PCS 0 0
146 Handscun No.7 Kotak 50 PCS 0 0
147 Infuset DWS Sak 0 0
148 Infuset anak Sak 150 0
149 Insulatard Kotak 10 Vial 0 0
150 Insuman Comb Kotak 5pen@3m/ 0 0
151 Ichtiyol SK 15 gr Kotak 12 pot 0 0
152 Ibupropen Syrp 100 Mg Botol 60 ml 0 0
153 Ibupropen 400 Kotak 100 Tab 0 0
154 Ibupropen 200 Kotak 100 tab 0 0
155 Isosorbit Dinitrit TAB Kotak 100 tab 0 0
156 Indo Obat Cacing Kotak 25 Tab 0 0
157 Kalcium Lactat 500 mg Tab Kotak 100 Tab 0 0
158 Kapas 250 mg ROLL 120 0
159 Kapas 500 mg ROLL 0 0
160 Kasa steril 16 x 16 cm ROLL 0 0
161 Kasa pembalut 4 x 5 cm ROLL 0 0
162 Kasa Kompres 4 x 10 cm ROLL 0 0
163 Kasa Kompres 2 x 80 cm ROLL 10 0
164 Kasa Hydrophyl 4 x 15 cm ROLL 0 0
165 Kasa Hydrophyl 40 x 80 cm ROLL 0 0
166 Kasa Penyerap luka Bakar pcs 0 0
167 Ketoconazole Tab 200mg Kotak 50 Tab 0 0
168 Ketoconazole Cream 2 % tube 5 g 0 0
169 Kuinina 222 mg Tab Botol 1000 Tab 540 0
170 Lansoprazole Kaps 30 mg Ktak 20 kaps 0 0
171 Lantus Solostan Kotak 5 pen 0 0
172 Lidocain Inj 2% (pehacain) Kotak 20 Amp 260 0
173 Lidocain Inj 2% (pehacain) Kotak 20 Amp 0 0
174 Lidocain Inj 2% kotak 10 Amp 0 0
175 Levofloxacin 500mg Tab Kotak 50 tab 0 0
176 Lisol Botol 100 ml 0 0
177 Loratadin 10 mg Kotak 100 tab 650 0
Loratadine Tablet 250
178 Meloxicam 15 Mg Kotak 50 tab 0 0
179 Multivitamin utk ibu hamil (Prenase) Kotak 100 tab 0 0
180 Metyl Ergometri Maleat Tab 0,125 mg Kotak 100 tab 0 0
181 Metil Prednisolon Kotak 100 tab 0 400
182 Metyl Ergometri Inj kotak 100 Amp 0 0
183 Metacetin syrup Btl 60 mL 0 0
184 Metformin Kotak 100 tab 0 0
185 Metronidazole tab 250 mg Kotak 100 tab 0 0
186 Metronidazole tab 500 mg (Omenizol) Kotak 100 tab 0 0
187 Metronodazol sirup botol 0 0

188 Metronidazole ovula 500mg/vagisol kotak 5 ovula 145 0


189 Mulsanol Syr Botol 60 ml 0 0
190 Mykonazole Cream 2% Tube 5 g 313 0
191 Masker Kotak 50 pcs 0 0
192 Neo Envios kotak. 100 kpl 0
193 NaCL 0,9% Botol 500 ml 342 0
194 Nat. Diclofenak 50 mg Kotak 50 tab 0 0
195 Nifedipin Tab 10 mg Kotak 100 tab 0 0
196 Novomix 30 fkx pen Kotak 5 Vial 0 0
197 Nystatin Vaginal Tab 100.000 IU Kotak 100 Tab 290 0
198 Obat Cairan Untuk Luka Bakar Botol 40 ml 0 0
199 Obat Cairan Untuk Sariawan Botol 40 ml 0 0
200 OBH Syirup Botol100 ml 0 0
201 Omeneuron Kotak. 100 kpl 0 0
202 Oxytetracyclin S.K 3% Tube 5 g 0 0
203 Omegavit Kotak. 100 kpl 0 0
204 Omegesic Kotak 100 tab 0 0
205 Omegdiar Kotak. 100 kpl 0 0
206 Omegdiar Syr Botol 60 ml 0 0
207 Omecal. D Kotak. 100 tab 0 0
208 Omeprazol Caps Kotak. 30 Caps 0 0
209 Omesolvon Syr Botol 0 0
210 Oxyflow Nasal oxygin Anak Pcs 140 0
211 Oxyflow Nasal oxygin Bayi Pcs 190 0
212 Oxyflow Nasal oxygin Dewasa Pcs 174 0
213 Oxytocin inj (Tiacinon) Kotak 10 Amp 0 0
214 Pacdin Baby Cough Syr Botol 60 ml 0 0
215 Papaverin 40 mg Tab Botol 1000 Tab 0 0
216 Paracetamol Syrp 120ml/5mg Botol 60 ml 5 0
217 Panvit. C Kotak. 100 tab 0 0
218 Paracetamol 500 mg Tab Kotak 100 tab 0 0
Paracetamol 500 mg Tab Kotak 100 tab 1000
219 Paracetamol 500 mg Tab Botol 1000 Tab 0 0
220 Paracetamol Syrp 120ml/5mg Botol 60 ml 0 0
221 Panviton Kotak 50 kapl 0 0
222 Pharmafix 100 mg Kotak 50 tab 0 0
223 Pirazinamid 500 mg Kotak 100 tab 0 0
224 Pyridoxin Tab 10 mg (vit.B6) botol 1000 tab 0 0
225 Pyridoxin Tab 10 mg (vit.B6) botol 1000 tab 0 0
226 Plester 5 Yard x 2 Inc ROLL 0 0
227 Phenobarbital 30 Mg Kotak 100 200 0
Phenobarbital 30 Mg Kotak 100 1000
228 Povidon Lodida 10% Botol 30 ml 0 0
229 Povidon Lodida 10% botol 60 ml 40 0
230 Povidon Lodida 10% Botol 300 ml 0 0
231 Povidon Lodida 10% Botol 1000 ml 0 0
232 Prednison Tab 5 mg Botol 1000 tab 0 0
233 Prednison 5 mg Kotak 100 tab 0 0
234 Piroxicam 20 mg Kotak 100 Tab 0 0
235 Piroxicam 20 mg Kotak 120 caps 0 0
236 Propanolol 40 mg Botol 100 tab 0 0
237 Pyrantel Tab 125 mg Kotak 60 Tab 700 0
238 Propyltiorasyl 100 mg (PTU) Botol 100 Tab 400 0
239 Ranitidin 150 mg Tab Kotak 100 Tab 0 0
240 Ranitidin Inj 25 mg/2 ml Kotak 5 amp 0 0
241 Ringer Laktat Botol. 500 ml 385 0
242 Rivanol Botol 300 cc 0 0
243 Retinol (Vit.A) 100.000 IU Botol. 50 kps 0 0
244 Retinol (Vit.A) 200.000 IU Botol. 50 kps 0 0
245 Stavit kpl Kotak. 100 kpl 0 0
247 Simvastatin 10 mg Kotak 30 tab 2200 0
249 Simvastatin 20 mg Kotak 30 tab 500 0
250 Salbutamol 2 mg Kotak 100 tab 0 0
251 Salbutamol 4 mg Kotak 100 Tab 0 0
252 Salep 2-4 pot @30 Gram 510 0
253 Salicil Bedak Kotak @ 50 gram 0 0
254 Silk Benang Bedah 3/0 (suture) Dos @ 36's 0 26
255 Seltifort Kids Sirop Botol. 60 ml 0 0

256 Selesbion Plus Kotak 100 Tab 0 0


257 Seviplex Kotak 100 tab 0 0
258 Stolax Supositoria (Bisacody) Kotak 6 Supp 0 0
259 Stomach tab Kotak 100 Tab 0 0
260 Tablet Tambah Darah kotak 30 tab 6420 0
261 Tramadol 50 mg Kaps Kotak 50 caps 0 0
262 Tetracyclin 250 mg Kaps Botol 1000 caps 500 0
263 Tetracyclin 500 mg Kaps Kotak 100 caps 4400 0
264 Tilomix Tab Kotak 100 Tab 0 0
265 Thiamin 50 mg Tab Botol 1000 tab 0 0
266 Thiamin Inj 100 mg/ml Kotak 30 Amp 0 0
267 Thiamphenicol Kaps 500 mg Kotak 100 kaps 0 0
268 Trihexyphenidil Tab 2 mg Kotak 100 tab 0 0
269 Vidabion Tab Kotak 100 Tab 0 0
270 Vitalamin Tab Kotak 100 Tab 0 0
271 Vit B. Comp Botol 1000 tab 0 0
272 Vit B. Comp Kotak 100 Tab 0 300
274 Vit Ever Kotak 100 Tab 0 0
275 Urine Bag Sak 180 0
276 Vaksin Rabies Vero Vial 0 0
278 Zinc Tab 20 mg Kotak 100 Tab 700 0
279 OAT FDC Kategori Anak Paket 0 0
280 OAT FDC Kategori.I. Dws Paket 0 0
281 OAT FDC Kategori.II Dws Paket 0 0
282 OAT FDC Sisipan Dws Paket 0 0
283 Ticomac Tablet 0 0
284 Solasic Tablet 0 0
285 Guaifenetisin Tablet 700 0
286 Kamolas Tablet 0 0
287 Selkon Tablet 0 0
288 Plester 15 x 5 cm Rol 40 0
289 Waterfor Injeksi Botol 50 0

Anbroxol 300 Mg Tablet 1500


Amblodipin 100 mg Tablet 600
Amoksilin Tablet 500
Antasida Doen Tablet 1500
Ergotamine 50 mg / 100 mg Tablet 800
Garam Oralit Saset 100
Cimetidin Tablet Tabelt 200
Parasetamol 500 mg Tablet 1000
Phenobarbital 30 mg Kapsul 1000
Vitamin B Compleks Tablet 300
Silk 3
Cat Gut Chromic 3/0 Pack 1
Cat Gut Chromic 2/0 Pack 1
Cetrine 10 mg Tablet 150
Loratadine Tablet 250
Metyl Prednisolon 4 mg Tablet 400

UMUM BPJS JAM


JUMLAH KUNJUNGAN RESEP BAYAR KIS KESDA
299 190 0

Yang Menerima / Melapor


Kepala UPTD Puskesmas Maelang
Kecamatan Sang Tombolang
JUNAIDI MAMONTO, SKM .-
NIP. 19690405 199103 1 010 .-
N

PEMAK STOK
AIAN AKHIR
KET

20 490 Expride FebExpayer


66 50 Expayer
10 0
0 0
0 0
50 550
0 0
65 0
100 900
20 480
0 100
0 0
0 0
0 0
1800 700
0 0
0 1000
0 0
0 600 Obat Masuk
0 0
0 0
0 0
0 16000 Obat Masuk
0 0
0 0
0 0
0 0
0 0
1500 Obat Masuk
0 0
0 100
0 200
0 130
0 0
0 0
0 800
0 900
0 0
0 0
700 0
0 0
0 0
1 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
78 5

0 0
0 0
0 0
0 38
0 33
0 43
0 43
0 400
0 0
0 0
0 0
0 0
150 Obat Masuk
0 200 Obat Masuk
2700 18300
0 0
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
0 0
0 0
0 0
0 0
0 0
0 40
0 0
0 0
0 4000
0 0
0 0
0 0
0 0
0 30
0 0
0 0
0 0
0 1970
0 0
13 360
0 0
0 0
0 0
0 500
0 0
0 0
0 0
0 0
0 0
0 0
800 Obat Masuk
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

0 0
0 1000
0 0
0 0
0 199
10 260
0 0
0 100 Obat Masuk
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
23 10
0 0
0 0
0 8
0 40
0 0
0 0
0 0
0 0
25 125
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
5 115
0 0
0 0
0 0
0 0
0 10
0 0
0 0
0 0
0 0
0 0
0 540
0 0
0 0
20 240
0 0
0 0
0 0
0 0
150 500
250 Obat Masuk
0 0
0 0
0 0
0 400 Obat Masuk
0 0
0 0
0 0
0 0
0 0
0 0

0 145
0 0
57 256
0 0
0 0
0 342
0 0
0 0
0 0
0 290
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 140
0 190
0 174
0 0
0 0
0 0
3 2
0 0
0 0
1000 Obat Masuk
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 200
1000 Obat Masuk
0 0
0 40
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 700
0 400
0 0
0 0
21 364
0 0
0 0
0 0
0 0
220 1980
0 500
0 0
0 0
12 498
0 0
0 26 Obat Masuk
0 0

0 0
0 0
0 0
0 0
0 6420
0 0
0 500
200 4200
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 300
0 0
0 180
0 0
0 700
0 0
0 0
0 0
0 0
0 0
0 0
0 700
0 0
0 0
0 40
0 50

500 1000 755 484


100 500 95
500 265
500 1000 60
100 700 300
20 80 2940
0 200 459 91800
500 500 485
100 900 26
100 200 135
0 3 110
0 1 55,000
0 1 55,000 12 4583.3333
0 150 900 24 2291.6667
50 200 659
100 300 136

PKH KADER JUMLAH

0 4 493

Menerima / Melapor
TD Puskesmas Maelang
atan Sang Tombolang
I MAMONTO, SKM .-
90405 199103 1 010 .-
LAPORAN PEMAKAIAN DAN LEMBARAN
PERMINTAAN OBAT ( LPLPO )

KODE PUSKESMAS :18051501


PUSKESMAS : MAELANG
KECAMATAN : SANG TOMBOLANG
KABUPATEN : BOLAANG MONGONDOW
PROPINSI : SULAWESI UTARA
BULAN : MARET
TAHUN : 2021

STOK PENERI PEMAK


NO NAMA OBAT SATUAN
AWAL MAAN AIAN
1 Abbocath18 PCS 0 0 0
2 Abbocath 20 PCS 0 0 0
3 Abbocath 22 PCS 0 0 0
4 Abbocath 24 PCS 0 0 0
5 Ajitab Tab Kotak 100 Tab 0 0 0
6 Alat Suntik 1,0 ml Kotak 100 PCS 550 0 100
7 Alat Suntik 2,5 ml Kotak 100 PCS 0 0 0
8 Alat Suntik 3,0 ml Kotak 100 PCS 0 0 0
9 Alat Suntik 5,0 ml Kotak 100 PCS 900 0 100
10 Alat Suntik 10 ml Kotak 100 PCS 480 0 20
11 Albendazole 400 mg Kotak 100 100 0 100
12 Allopurinol 100 mg Kotak 100 Tab 0 0 0
13 Alprazolam 0,5 mg Kotak 100 Tab 0 0 0
14 Alprazolam 1,0 mg Kotak 100 Tab 0 0 0
15 Ambroxol 30 mg Kotak 100 Tab 700 0 300
16 Aminophyilin inj Kotak 30 Amp 0 0 0
17 Aminophyilin Tab 200 mg Botol 100 Tab 1000 0 100
18 Amitriptilin tab Kotak 100 Tab 0 0 0
19 Amlodipin 10 mg Kotak 30 Tab 0 0 0
20 Amlodipin 5,0 mg Kotak 30 Tab 0 0 0
21 Ampicilin inj Kotak 10 Vial 0 0 0
22 Ampicilin Cap 500 mg Kotak 100 Cap 0 0 0
23 Amoksisilin 500 mg Kotak 100 Cap 15500 0 1500
24 Amoksisilin Syrp Kering 125 mg/5 ml Btl 60 ml 0 0 0
25 Ampicilin Syrp Kering 125 mg/5 ml Btl 100 ml 0 0 0
26 Antalgin 500 mg Kotak 100 Tab 0 0 0
27 Antalgin 500 mg Botol 1000 Tab 0 0 0
28 Antasida DOEN Kotak 100 Tab 0 0 0
29 Antasida DOEN Botol 1000 Tab 0 0 0
30 Antides New Kotak 100 100 0 0
31 Antihemoroid DOEN Kotak 10 supp 200 0 20
32 Antihemoroid Supp Kotak 6 130 0 20
33 Anti malaria DOEN Kotak 100 Tab 0 0 0
34 Antasida DOEN Syrp Botol 100 ml 0 0 0
35 Acyclovir tab 200 mg Kotak 50 Tab 800 0 500
36 Acyclovir tab 400 mg Kotak 50 Tab 900 0 400
37 Acyclovir Cream 5 g Kotak 24 Tube 0 0 0
38 Asam folat 1 mg Botol100 Tab 0 0 0
39 Asam ascorbat 50 mg Kotak 100Tab 0 0 0
40 Aqua Pro inj Steril Kotak 10 Vial 0 0 0
41 Alkohol 70 % Botol 100 ml 0 0 0
42 Alkohol 70 % Botol 1 Liter 7 0 1
43 Alkohol Swab Kotak @100pcs 0 0 0
44 Artesunat inj 60 mg Kotak 1 Vial 0 0 0
45 Asam mefenamat 500 mg Kotak 100 Tab 0 0 0
46 Aseptan Botol 0 0 0
47 Atropin Sulfat Tab 0,5 mg Kotak 100 Tab 0 0 0
48 Basitrasin + polimiksin (anti bakteri salep) Kotak 24 Tube 0 0 0
49 Betahistin tablet Kotak 30 tab 0 0 0
50 Bisoprolol 5 mg Kotak 30 Tab 0 0 0
51 Bromhexin 8 mg Tab Kotak 100 Tab 0 0 0
52 Brochifar Kotak 100 Tab 0 0 0
53 Bromifar Plus Syr Botol 60 ml 0 0 0
54 Bedak Salisyl 2 % Kotak 0 0 0
55 Betametason krim Ktk 25 tube 5 0 5

56 Bexicom C Kotak 100 Tab 0 0 0


57 Brocon Tab Kotak 100 Tab 0 0 0
58 Bufacetin Salep (kloramfenicol 2%) Tube 15 Gram 0 0 0
59 Cat Gut Plain no.3/0 Dos @ 24's 38 0 18
60 Cat Gut Plain no.2/0 Dos @ 24's 33 0 15
61 Cat Gut Cromic no.3/0 Dos @ 24's 43 0 10
62 Cat Gut Cromic no.2/0 Dos @ 24's 43 0 10
63 Captopril 12,5 mg Tab Kotak 100 Tab 400 0 400
64 Captopril 25 mg Tab Kotak 100 Tab 0 0 0
65 Carbamazepin Tab 200 mg Kotak 100 Tab 0 0 0
66 Clorpheniramin Malet 4 mg Tab/CTM Botol1000Tab 0 0 0
67 Cefixime Kota 50 Tab 0 0 0
68 Cimetidin 200 mg tab Kotak 100 Tab 0 0 0
69 Cianocobalamin Tab 50 mg Kotak 100 Tab 18300 0 1000
70 Cetrizin 10 mg tab Kotak 50 Tab 0 0 0
71 Cetrizin Hcl syrup Botol 0 0 0
72 Cefadroxil 500 mg Cap Kotak 100 caps 0 0 0
73 Cefadroxil 500 mg Cap Kotak 100 Caps 0 0 0
74 Cianocobalamin inj 500 MCg Kotak 100 amp 0 0 0
75 Ciprofloxasin 50 mg Kotak 100 0 0 0
76 Clorpromazin 100 mg Tab Kotak 100 Tab 0 0 0
77 Cloramphenicol TTS Telinga 3 % Botol 5 ml 0 0 0
78 Cloramphenicol TTS Mata 1 % Kotak 24 Tube 0 0 0
79 Cloramphenicol Salep Mata 1 % Tube 5 g 0 0 0
80 Cloramphenicol Caps 250 mg Kotak 100 Kaps 0 0 0
81 Cloroquin Botol 1000 Tab 0 0 0
82 Cotrimoxazol 480 mg Tab Kotak 100 Tab 0 0 0
83 Cotimoxazol 120 mg Tab Kotak 100 tab 0 0 0
84 Cotimoxazol Susp Botol 60 ml 0 0 0
85 Colfin Kotak 100 0 0 0
86 Co Amoxiclav Ktk @ 30 tab 0 0 0
87 Curbion syrup Btl 60 mL 0 0 0
88 Dapyrin tab kotak 100 Tab 0 0 0
89 Dextrose 5% Botol 500 ml 40 0 10
90 Dexametason Inj Kotak 100 amp 0 0 0
91 Dexametason Tab 0,5 mg Botol 1000 tab 0 0 0
92 Dexametason Tab 0,5 mg Kotak 100 Tab 4000 0 1000
93 Dextrometorpan syrp 10 mg/5 ml botol 60 ml 0 0 0
94 Dextrometorpan Tab Kotak 100 Tab 0 0 0
95 Devosix Drops Botol 15 ml 0 0 0
96 Dextrometorpan Tab Botol 1000 Tab 0 0 0
97 Diazepam inj 5 mg/ml Kotak 30 Amp 30 0 0
98 Diazepam 2 mg tab Kotak 100 Tab 0 0 0
99 Diazepam 2 mg tab Botol 1000 Tab 0 0 0
100 Diazepam 5 mg tab botol 250 Tab 0 0 0
101 Diazepam (valdimex)tablet kotak 100 tab 0 0 0
102 Diethylcarbamazepin 100 mg Kotak 100 Tab 0 0 0
103 Diphenhydramin Inj I.M 10 mg/ml Kotak 30 amp 0 0 0
104 Digoxin TAB 0,25 mg Kotak 100 tab 0 0 0
105 Doxicylin 100 mg Kaps Kotak 100 caps 0 0 0
106 Donperidon Tab 10 mg Kotak 100 tab 0 0 0
107 Diltiazem HCL Tab 30 mg Kotak 100 Tab 500 0 0
108 Epedrin HCL TAB Botol 250 Tab 0 0 0
109 Epedrin HCL TAB Botol 1000 Tab 0 0 0
110 Ephinefrin Inj 0,1 % Kotak 100 Amp 0 0 0
111 Ehtylclor Semprot Botol 0 0 0
112 Erytromicin 500 mg Kaps Kotak 100 caps 0 0 0
113 Examination Glove Kotak 100 pcs 0 0 0
114 Farsifen Plus Kotak 100 Tab 0 0 0
115 Fenol gliserol tetes telinga botol 5 ml 0 0 0
116 Fenorbarbital Inj 50 ml Kotak 30 Amp 0 0 0
117 Fenorbarbital 30 mg Tab Botol 100 Tab 0 0 0
118 Fenorbarbital 30 mg Tab Botol 1000 Tab 0 0 0
119 Fytomenadion Inj 10 mg/ml Kotak 30 Amp 0 0 0
120 Fytomenadion 10 mg Kotak 100 Tab 0 0 0
121 Furosemide 40 mg tab kotak 200 Tab 0 0 0

122 Fenilbutazon 200 mg Botol 1000 Tab 0 0 0


123 Fenitoin 100 mg kaps Botol 100 cabs 100 0 0
124 Flunadin Tab Kotak 100 Tab 0 0 0
125 Folley Catheter No.24 PCS 0 0 0
126 Folley Catheter No.20 PCS 10 psg 199 0 5
127 Folley Catheter No.18 PCS 10 psg 260 0 10
128 Ferosulfat 300 mg Botol 1000 Tab 0 0 0
129 Garam Oralit Kotak 100 saset 0 0 0
130 Gastricid Tab Kotak 100 Tab 0 0 0
131 Gentamicin Inj 80 mg Kotak 5 amp 0 0 0
132 Gentian Violet Lart 1% Botol 10 ml 0 0 0
133 Glibenclamide 5 mg Kotak 100 Tab 0 0 0
134 Glass lonomer Btl/Set 0 0 0
135 Glyseril Guayakolat Botol 1000 Tab 0 0 0
136 Glucotrol xl Tab 10 mg Kotak 30 Tab 0 0 0
137 Grisiofulvin 500mg Kotak 100 Tab 0 0 0
138 HydroclortiazidTab 25 mg Botol 1000 Tab 0 0 0
139 Hydrocortison Krim 2,5 % Kotak 24 Tube 10 0 10
140 Halloperidol 1,5 mg tab Kotak 100 tab 0 0 0
141 Halloperidol 0,5 mg tab Kotak 100 Tab 0 0 0
142 Halloperidol inj 50mg/ml kotak 10 ampul 8 0 0
143 Haidol DC 50 Mg Inj Kotak 5 Ampul 40 0 0
144 Handscun No.8.0 (Sateglove Surgical) Kotak 50 PCS 0 0 0
145 Handscun No.7,5 (Sateglove Surgical) Kotak 50 PCS 0 0 0
146 Handscun No.7 Kotak 50 PCS 0 0 0
147 Infuset DWS Sak 0 0 0
148 Infuset anak Sak 125 0 25
149 Insulatard Kotak 10 Vial 0 0 0
150 Insuman Comb Kotak 5pen@3m/ 0 0 0
151 Ichtiyol SK 15 gr Kotak 12 pot 0 0 0
152 Ibupropen Syrp 100 Mg Botol 60 ml 0 0 0
153 Ibupropen 400 Kotak 100 Tab 0 0 0
154 Ibupropen 200 Kotak 100 tab 0 0 0
155 Isosorbit Dinitrit TAB Kotak 100 tab 0 0 0
156 Indo Obat Cacing Kotak 25 Tab 0 0 0
157 Kalcium Lactat 500 mg Tab Kotak 100 Tab 0 0 0
158 Kapas 250 mg ROLL 115 0 15
159 Kapas 500 mg ROLL 0 0 0
160 Kasa steril 16 x 16 cm ROLL 0 0 0
161 Kasa pembalut 4 x 5 cm ROLL 0 0 0
162 Kasa Kompres 4 x 10 cm ROLL 0 0 0
163 Kasa Kompres 2 x 80 cm ROLL 10 0 0
164 Kasa Hydrophyl 4 x 15 cm ROLL 0 0 0
165 Kasa Hydrophyl 40 x 80 cm ROLL 0 0 0
166 Kasa Penyerap luka Bakar pcs 0 0 0
167 Ketoconazole Tab 200mg Kotak 50 Tab 0 0 0
168 Ketoconazole Cream 2 % tube 5 g 0 0 0
169 Kuinina 222 mg Tab Botol 1000 Tab 540 0 0
170 Lansoprazole Kaps 30 mg Ktak 20 kaps 0 0 0
171 Lantus Solostan Kotak 5 pen 0 0 0
172 Lidocain Inj 2% (pehacain) Kotak 20 Amp 240 0 20
173 Lidocain Inj 2% (pehacain) Kotak 20 Amp 0 0 0
174 Lidocain Inj 2% kotak 10 Amp 0 0 0
175 Levofloxacin 500mg Tab Kotak 50 tab 0 0 0
176 Lisol Botol 100 ml 0 0 0
177 Loratadin 10 mg Kotak 100 tab 500 0 500
178 Meloxicam 15 Mg Kotak 50 tab 0 0 0
179 Multivitamin utk ibu hamil (Prenase) Kotak 100 tab 0 0 0
180 Metyl Ergometri Maleat Tab 0,125 mg Kotak 100 tab 0 0 0
181 Metil Prednisolon Kotak 100 tab 0 0 0
182 Metyl Ergometri Inj kotak 100 Amp 0 0 0
183 Metacetin syrup Btl 60 mL 0 0 0
184 Metformin Kotak 100 tab 0 0 0
185 Metronidazole tab 250 mg Kotak 100 tab 0 0 0
186 Metronidazole tab 500 mg (Omenizol) Kotak 100 tab 0 0 0
187 Metronodazol sirup botol 0 0 0
188 Metronidazole ovula 500mg/vagisol kotak 5 ovula 145 0 0
189 Mulsanol Syr Botol 60 ml 0 0 0
190 Mykonazole Cream 2% Tube 5 g 0 0 0
191 Masker Kotak 50 pcs 0 0 0
192 Neo Envios kotak. 100 kpl 0 0
193 NaCL 0,9% Botol 500 ml 0 0 0
194 Nat. Diclofenak 50 mg Kotak 50 tab 0 0 0
195 Nifedipin Tab 10 mg Kotak 100 tab 0 0 0
196 Novomix 30 fkx pen Kotak 5 Vial 0 0 0
197 Nystatin Vaginal Tab 100.000 IU Kotak 100 Tab 290 0 0
198 Obat Cairan Untuk Luka Bakar Botol 40 ml 0 0 0
199 Obat Cairan Untuk Sariawan Botol 40 ml 0 0 0
200 OBH Syirup Botol100 ml 0 0 0
201 Omeneuron Kotak. 100 kpl 0 0 0
202 Oxytetracyclin S.K 3% Tube 5 g 0 0 0
203 Omegavit Kotak. 100 kpl 0 0 0
204 Omegesic Kotak 100 tab 0 0 0
205 Omegdiar Kotak. 100 kpl 0 0 0
206 Omegdiar Syr Botol 60 ml 0 0 0
207 Omecal. D Kotak. 100 tab 0 0 0
208 Omeprazol Caps Kotak. 30 Caps 0 0 0
209 Omesolvon Syr Botol 0 0 0
210 Oxyflow Nasal oxygin Anak Pcs 140 10 0
211 Oxyflow Nasal oxygin Bayi Pcs 190 15 0
212 Oxyflow Nasal oxygin Dewasa Pcs 174 15 0
213 Oxytocin inj (Tiacinon) Kotak 10 Amp 0 0 0
214 Pacdin Baby Cough Syr Botol 60 ml 0 0 0
215 Papaverin 40 mg Tab Botol 1000 Tab 0 0 0
216 Paracetamol Syrp 120ml/5mg Botol 60 ml 2 0 2
217 Panvit. C Kotak. 100 tab 0 0 0
218 Paracetamol 500 mg Tab Kotak 100 tab 0 0 0
219 Paracetamol 500 mg Tab Botol 1000 Tab 0 0 0
220 Paracetamol Syrp 120ml/5mg Botol 60 ml 0 0 0
221 Panviton Kotak 50 kapl 0 0 0
222 Pharmafix 100 mg Kotak 50 tab 0 0 0
223 Pirazinamid 500 mg Kotak 100 tab 0 0 0
224 Pyridoxin Tab 10 mg (vit.B6) botol 1000 tab 0 0 0
225 Pyridoxin Tab 10 mg (vit.B6) botol 1000 tab 0 0 0
226 Plester 5 Yard x 2 Inc ROLL 0 0 0
227 Phenobarbital 30 Mg Kotak 100 200 0 0
228 Povidon Lodida 10% Botol 30 ml 0 0 0
229 Povidon Lodida 10% botol 60 ml 40 0 0
230 Povidon Lodida 10% Botol 300 ml 0 0 0
231 Povidon Lodida 10% Botol 1000 ml 0 0 0
232 Prednison Tab 5 mg Botol 1000 tab 0 0 0
233 Prednison 5 mg Kotak 100 tab 0 0 0
234 Piroxicam 20 mg Kotak 100 Tab 0 0 0
235 Piroxicam 20 mg Kotak 120 caps 0 0 0
236 Propanolol 40 mg Botol 100 tab 0 0 0
237 Pyrantel Tab 125 mg Kotak 60 Tab 700 0 0
238 Propyltiorasyl 100 mg (PTU) Botol 100 Tab 400 0 0
239 Ranitidin 150 mg Tab Kotak 100 Tab 0 0 0
240 Ranitidin Inj 25 mg/2 ml Kotak 5 amp 0 0 0
241 Ringer Laktat Botol. 500 ml 364 0 50
242 Rivanol Botol 300 cc 0 0 0
243 Retinol (Vit.A) 100.000 IU Botol. 50 kps 0 0 0
244 Retinol (Vit.A) 200.000 IU Botol. 50 kps 0 0 0
245 Stavit kpl Kotak. 100 kpl 0 0 0
247 Simvastatin 10 mg Kotak 30 tab 1980 0 200
249 Simvastatin 20 mg Kotak 30 tab 500 0 500
250 Salbutamol 2 mg Kotak 100 tab 0 0 0
251 Salbutamol 4 mg Kotak 100 Tab 0 0 0
252 Salep 2-4 pot @30 Gram 498 0 50
253 Salicil Bedak Kotak @ 50 gram 0 0 0
254 Silk Benang Bedah 3/0 (suture) Dos @ 36's 0 0 0
255 Seltifort Kids Sirop Botol. 60 ml 0 0 0

256 Selesbion Plus Kotak 100 Tab 0 0 0


257 Seviplex Kotak 100 tab 0 0 0
258 Stolax Supositoria (Bisacody) Kotak 6 Supp 0 0 0
259 Stomach tab Kotak 100 Tab 0 0 0
260 Tablet Tambah Darah kotak 30 tab 0 0 0
261 Tramadol 50 mg Kaps Kotak 50 caps 0 0 0
262 Tetracyclin 250 mg Kaps Botol 1000 caps 500 0 0
263 Tetracyclin 500 mg Kaps Kotak 100 caps 0 0 0
264 Tilomix Tab Kotak 100 Tab 0 0 0
265 Thiamin 50 mg Tab Botol 1000 tab 0 0 0
266 Thiamin Inj 100 mg/ml Kotak 30 Amp 0 0 0
267 Thiamphenicol Kaps 500 mg Kotak 100 kaps 0 0 0
268 Trihexyphenidil Tab 2 mg Kotak 100 tab 0 0 0
269 Vidabion Tab Kotak 100 Tab 0 0 0
270 Vitalamin Tab Kotak 100 Tab 0 0 0
271 Vit B. Comp Botol 1000 tab 0 0 0
272 Vit B. Comp Kotak 100 Tab 0 0 0
274 Vit Ever Kotak 100 Tab 0 0 0
275 Urine Bag Sak 180 0 50
276 Vaksin Rabies Vero Vial 0 0 0
278 Zinc Tab 20 mg Kotak 100 Tab 700 0 0
279 OAT FDC Kategori Anak Paket 0 0 0
280 OAT FDC Kategori.I. Dws Paket 0 0 0
281 OAT FDC Kategori.II Dws Paket 0 0 0
282 OAT FDC Sisipan Dws Paket 0 0 0
283 Ticomac Tablet 0 0 0
284 Solasic Tablet 0 0 0
285 Guaifenetisin Tablet 700 0 500
286 Kamolas Tablet 0 0 0
287 Selkon Tablet 0 0 0
288 Plester 15 x 5 cm Rol 40 0 10
289 Waterfor Injeksi Botol 50 0 20

UMUM BPJS JAM


PKH
JUMLAH KUNJUNGAN RESEP BAYAR KIS KESDA
299 190 0 0

Yang Menerima / Melapor


Kepala UPTD Puskesmas Maelang
Kecamatan Sang Tombolang

JUNAIDI MAMONTO, SKM .-


NIP. 19690405 199103 1 010 .-
STOK
AKHIR
KET

0 Expride Expayer
0 Expayer
0
0
0
450
0
0
800
460
0
0
0
0
400
0
900
0
0
0
0
0
14000
0
0
0
0
0
0
100
180
110
0
0
300
500
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
20
18
33
33
0
0
0
0
0
0
17300
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
30
0
0
3000
0
0
0
0
30
0
0
0
0 Ditarik
0
0 Expayer
0
0
0
500
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
100
0
0
194
250
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
40
0
0
0
0
100
0
0
0
0
0
0
0
0
0
100
0
0
0
0
10
0
0
0
0
0
540
0
0
220
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
145
0
0 Expayer
0
0
0
0
0
0
290
0
0
0
0
0
0
0
0
0
0
0
0
150
205
189
0
0
0
0
0
0
0
0
0
0
0
0
0
0
200
0
40
0
0
0
0
0
0
0
700
400
0
0
314
0
0
0
0
1780
0
0
0
448
0
0
0

0
0
0
0
0
0
500
0 Expayer
0
0
0
0
0
0
0
0
0
0
130
0
700
0
0
0
0
0
0
200
0
0
30
30

KADER JUMLAH

4 493

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