Lap. Bulanan Obat Sep

LAPORAN BULANAN PEMAKAIAN OBAT
PUSKESMAS GILIRENG
BULAN :
TAHUN :
SISA BLN TERIMA PEMAKAIAN TANGGAL JML PEMA SISA

NO NAMA OBAT
LALU BLN INI 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 KAIAN STOK
1 Allopurinol 4 15 10 15
2 Aminofilin 200 mg tab.
3 Amoksisilin 250 mg tab
4 Amoksisilin 500 mg tab 120 80 60 10
5 Amoksisilin 125 mg/5 ml 2
6 Ampicilin 500
7 Ampicilin Syrup
Amlodipin 5
8 Antalgin 500 mg tab 20
9 Antasida tab 10 10
10 Antasida Syrup 3 8 4 1 6
11 Asam ascorbat 50 mg tab 10 10 10
12 Asam Mefenamat 500 mg 10
13 Asetosal 100 mg tab
14 Asetosal 500 mg tab
15 Betamethason zalf kulit 2
16 Basitrasin salf 3
Bioron 30
17 Chlortrimeton (CTM) 4 mg 100 50 50
18 Cat Gut
19 Captopril 25 mg tab.
20 Cimetidine 200 mg tab
21 Dexamethason 0,5 mg tab 10 20
22 Dexamethason inj. 10
23 Dektromethorphan 5 mg tb
24 Dextromethorpan syrup
25 Diphenhydramin injeksi
26 Diazepam 2 mg tab
27 Ergotamin Cafein 200 mg tb
28 Ephedrin Hcl 25 mg tab
29 Ekstrak Belladon 10 mg tb
30 Fenobarbital 30 mg tab
31 Fitomenadion 10 mg tab 10
32 Fitomenadion injeksi
33 Furosemida 40 mg tab
SISA BLN TERIMA PEMAKAIAN TANGGAL JML PEMA SISA

NO NAMA OBAT
LALU BLN INI 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 KAIAN STOK
34 Garam Oralit 200 ml
35 Gentian Violet 1%
36 Glibenklamida 5 mg tab
37 Gliseril Guaikolat 100 mg tb 20 30 35
38 Griseopulvin 125 mg tab
Hyosine butil bromida 20 10
39 Hidroklortiazid 25 mg tab
40 hidrokortison cream 2,5%
41 Ibuprofen 200 mg tab 30 25 20 10
42 Kalium Permanganat
43 Kalsium Laktat 500 mg tab 10 10 20
44 Kloramfenikol 250 mg caps 20
45 Kloramfenikol 1% e.oint
46 Kloramfenikol 3% tts.tel
47 Kotrimoksazole suspensi 1
48 Kotrimoksazol 120 mg tab
49 Kotrimoksazol 480 mg tab 10 24
50 metoclorpramide 10 10
51 Methyl Ergometrin tab
52 Metronidazol 250 mg tab
Miconazole s.kulit 1
53 Metronidazol 500 mg tab 50 50
Natrium diklofenak 10
Neomisin salf 1
Oralit 10 6
54 Obat Batuk Hitam 60 ml
55 Oksitetrasiklin injeksi
56 Oksitetrasiklin 1% e.oint 2
57 Oksitetrasiklin 3% s.kulit
58 Oksitosin injeksi
59 Parasetamol 100 mg tab
60 Parasetamol 500 mg Tab 160 155 50 40 85
61 Parasetamol syrup
62 Pirantel pamoat 365 mg tb
63 Piridoksin Hcl 10 mg tab
64 Piroksikam 10 mg caps
65 Prednison 5 mg tab 20 10
66 Papaverin Hcl tab
67 Propilthiourasil (PTU)
Ranitidin tab 60 100 20 20 30
Reserpin 0,25 mg tab
68 Simvastatin 14 18 15
69 Salbutamol 2 mg tab
70 Salf 2-4
71 Salicyl Talk
SISA BLN TERIMA PEMAKAIAN TANGGAL

NO NAMA OBAT
LALU BLN INI 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 JUMLAH SISA
72 Sulfadimidin 500 mg tab
73 Tablet Tambah Darah
74 Tetrasiklin 250 mg caps.
75 Tetrasiklin 500 mg caps.
76 Thiamin HCl 50 mg tab 10 20 10
77 Thiamin HCl injeksi
78 Vitamin B Kompleks tab 50 95 60 40
79 Vitamin B12 injeksi
80 Calcidol syrup
81 Indo SKP
82 Livron B.plex 20 15
Vitamin B6 tab 10 10
CPZ 30 60
Haloperidol 60 120
THP 60 120
KB 3 bulan 1
Yang Membuat Laporan,
PUSKESMAS GILIRENG
BULAN : MARET
TAHUN : 2017
PEMAKAIAN TANGGAL
NO NAMA OBAT SATUAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
1 ACT Tab tablet 0

2 Obat Suntik KB I : inj depo
Medroxyprogesteron Acetat 150 mg 150 mg
3 Air untuk irigasi 1000 ml botol 1000ml
4 Albendazol tablet 400 mg tablet
5 Alopurinol Tablet 100 mg tablet 4 15 10 15 25 20 10 30 5 20 15
6 Alopurinol Tablet 300 mg tablet
7 Ambroxol tablet 30mg tablet
8 Ambroxol sirup 15 mg/ 5 ml btl 60 ml
9 Aminofilin injeksi 24 mg/ml ampul
10 Aminofilin tablet 200 mg tablet
11 Amitriptilin tablet salut 25 mg (HCl) tablet
12 Amlodipin tablet 5 mg tablet 5 10 30 20 10 40 10 10 10
13 Amlodipin tablet 10 mg tablet
14 Amoksisilin kapsul 250 mg kapsul 10
15 Amoksisilin kaplet 500 mg kaplet 120 90 60 10 40 170 70 10 90 70 115 40 40 70 45 140 32 30
16 Amoksisilin sirup kering 125 mg/5 ml btl 60 ml 2 2 2
17 Amoksisilin sirup kering forte 250 mg/5 ml btl 60 ml
18 Ampisillin serbuk inj. i.v. 1000 mg/vial ktk 10 vial

19 Ampisilin sirup kering 125 mg/ 5 ml btl 60 ml
20 Antasida DOEN Tab tablet 20 10 30 20 10 30 2 50 10 20 10 110 30 30
21 Antasida DOEN II suspensi btl 60 ml 3 10 1 5 6 4 1 3 1 1
Anti Bakteri DOEN salep (Basitrasin-
22 tube @ 5 g
neomicin
23 Antifungi DOEN pot @ 30 g
24 Antihemoroid DOEN supp @ 2 g
25 Antimigren tablet
26 Antiparkinson DOEN tablet tablet
27 Aqua pro injeksi steril, bebas pirogen vial @ 20 ml
28 Artemether injeksi 1 ml : 80 ml ampul
29 Asam asetilsalisilat tablet 80 mg tablet
32 Asam askorbat (Vit.C) tablet 50 mg tablet 10 10 10 20 10 40 15 10 10 50 18 20
33 Asam askorbat (Vit.C) tablet 100 mg tablet
35 Asam Mefenamat kaplet 500 mg tablet 10 40 50 20 10 10 40 10 10
36 Attapulgite tablet 600 mg tablet
37 Asiklovir krim 5 % tube 5 g 1
38 Asiklovir tablet 200 mg tablet
39 Asiklovir tablet 400 mg tablet 30
40 Atropin injeksi 0,25 mg/ml ampul
41 Becefort sir sirup 1 2 3
42 Basitrasin salf salep 3
43 Betametason krim 0,1 % tube @ 5 g 5 1 2 1
44 Betametason tetes mata 1 mg/ml botol @ 5 ml
45 Bisakodil suppositoria 5 mg Suppositoria
47 Ciprofloxacin tablet 10
48 CTM tablet 100 60 35 143 10 30 43 55 30 11 30 33 100 12 20
49 Dehidro Atemisin + Piperakuin (DHP) tablet
50 Deksametason injeksi i.v 0,5 mg/ml ampul
51 Deksametason tablet 0,5 mg tablet 10 20 5 40 10 10 24 10 20 10 30 50 2 30
52 Dekstrometorfan sirup 10 mg/5 ml btl 60 ml
Dekstrometorfan sirup 10 mg/5 ml
53 btl 60 ml
kombinasi (Dextrofen) 1
54 Dekstrometorfan tablet 15 mg (HBr) tablet
55 Diazepam injeksi 5 mg/ml ampul
56 Diazepam larutan rektal 5 mg/2,5 ml tube @ 2,5 ml
57 Diazepam tablet 2 mg tablet 10
58 Difenhidramin injeksi i.m 10 mg/ml (HCl) ampul
59 Digoksin tablet 0,25 mg tablet

60 Diltiazem HCl tablet 30 mg tablet
61 Dimenhidrinat tablet 50 mg tablet
62 Doksisiklin 100 mg kapsul
63 Domperidon tablet 10 mg tablet
64 Efedrin tablet 25 mg (HCl) tablet
65 Ekstraks Belladona tablet 10 mg tablet
Epinefrin (Adrenalin) injeksi 0,1 % (sebagai
66 ampul
HCl)
67 Eritromisin kapsul 250 mg kapsul
68 Eritromisin kapsul 500 mg tablet
69 Eritromisin sirup kering 200 mg/ 5 ml btl 60 ml
70 Etanol 70 % btl 100 ml
71 Fenilbutason tablet 200 mg tablet
72 Fenobarbital injeksi i.m/i.v 50 mg/ml ampul
73 Fenobarbital tablet 30 mg tablet
74 Fenol Gliserol tetes telinga 10% botol 5 ml
75 Fitomenadion (Vit K) tablet salut gula 10 mg tablet

10 10 10
76 Fitomenadion (Vit K) injeksi 10 mg/ml ampul
77 Fitomenadion (Vit K) injeksi i.m.2 mg/ml ampul
78 Furosemid tab 40 mg tablet

79 Garam Oralit serbuk 200 ml sachet
80 Gentamisin inj.40 mg/ml ampul
81 Gentian violet larutan 1 % btl 10 ml
82 Glibenklamida tablet 5 mg tablet 10
83 Glimepiride tablet 1 mg tablet
85 Gliseril Guaiakolat tablet 100 mg tablet 20 30 30 62 10 50 33 35 30 11 20 23 60 1
86 Glukosa larutan infus 10% steril btl 500 ml
87 Glukosa larutan infus 5% btl 500 ml
88 Griseofulvin tablet 125mg Micorinized tablet 40 10
89 Haloperidol tablet 1,5 mg tablet 60 120 60 60
90 Haloperidol tablet 5 mg tablet
91 Haloperidol inj 50 mg/ml ampul @ 1 ml
92 Hidroklortiazid tablet 25 mg tablet
93 Hidrokortison krim 2,5% tube @ 5 g
94 Hyosicine-N-Butilbromide tablet 10mg tablet 20 10
95 Ibuprofen sirup 100 mg/ 5 ml btl 60 ml
96 Ibuprofen tablet 200 mg tablet
97 Ibuprofen tablet 400 mg tablet 30 25 10 31 30 20 40 10
98 Iodiol kapsul lunak kapsul
99 Isoniazid tablet 100 mg tablet
101 Isosorbid Dinitrat tablet sublingual 5mg tablet
102 Kalsium Laktat (Kalk) tablet 500 mg tablet 10 20 35 10
Kalsium Glukonat injeksi i.v. 10%
103 ampul
(100mg/ml)
104 Kaptopril 25 mg tablet
105 Karbamazepin tablet 200 mg tablet
106 Ketokonazol tablet 200mg tablet
107 Kloramfenikol kapsul 250 mg kapsul 40 20 20 20
108 Kloramfenikol salep kulit 2 % tube @ 15 g
109 Kloramfenikol salep mata 1 % tube @ 5 g 2 1
110 Kloramfenikol suspensi 125 mg/5 ml btl 60 ml
111 Kloramfenikol tetes telinga 3% btl @ 10 ml
112 Klorfeniramin Maleat (CTM) tablet 4 mg tablet
113 Klorpromazin injeksi i.m 5 mg/ml - 2 ml ampul
114 Klorpromazin tablet salut 25 mg (HCl) tablet
115 Klorpromazin tablet salut 100 mg (HCl) tablet 30 60 30 30
116 Kodein tablet 10 mg tablet
118 Kotrimoksazol DOEN (dewasa) tablet 20 20 10 10 10
119 Kotrimoksazol DOEN (Pediatrik) tablet
120 Kotrimoksazol suspensi btl 60 ml 1 1 1 1 1 1
121 Kuinin dihidroklorida injeksi 25% - 2ml ampul
122 Kuinin (kina) tablet 222 mg tablet
123 Lidokain injeksi 2% ampul @ 2 ml
Lidokain injeksi 2% (HCl) + Epinefrin 1 :
124 ampul
80.000 - 2 ml
125 Livron B.Plex tablet 20 25 5 30 10
126 Loratadin tablet 10 mg tablet
127 Magnesium sulfat inj 20% vial 25 ml
129 Mebendazol sirup 100 mg/ 5ml btl 30 ml
130 Mebendazol tablet 500 mg tablet
131 Metampiron injeksi 250 mg/ml ampul
132 Metampiron tablet 500 mg tablet
133 Metformin HCl tablet 500 mg tablet 30
Metil Ergometrin Maleat (Metilergometrin)
134 tablet
tablet salut 0,125 mg 10 10
135 Metilergometrin Maleat injeksi 0.200 mg/ml ampul
136 Metoklopramide tablet 5 mg tablet 10 20 10

137 Metoklopramide tablet 10 mg tablet 10
138 Metronidazol tablet 500 mg tablet 50 50 20 10 15 10
139 Metronidazol infus 500 mg/100 ml botol @ 100 ml
140 Metronidazol sirup 125 mg/5 ml botol @ 60 ml
141 Mikonazol krim/salep 2 % (Nitrat) tube @ 10 g 1 3 1
142 Mineral Mix sachet
Multivitamin sirup
_ Corovit sirup botol @ 60 ml
143
_ Becefort sirup botol @ 60 ml 2
_ Anagens sirup botol @ 60 ml
Multivitamin Tablet
_ Corovit tablet tablet
144
_ Corobion tablet tablet
_ Bioron tablet tablet 10
145 Natrium Bikarbonat tablet 500 mg tablet
146 Natrium Bikarbonat injeksi i.v. 8,4% ampul 25 ml
147 Natrium Diklofenak tablet 50 mg tablet
148 Natrium Diklofenak tablet 25 mg tablet 10 10
149 Natrium Diklofenak Gel emulsi Tube
150 Natrium Klorida larutan infus 0,9% btl 500 ml
151 Natrium Tiroksin 100 mcg tablet
152 Neomisin salf 1
153 N.B Topical Oint tube 5 g
154 Nifedipin tablet 10 mg tablet
155 Nistatin tablet salut 100.000 IU/g tablet
156 Nistatin tablet 500.000 IU/g tablet
157 N-asetil sistein kapsul 200 mg tablet
158 Obat antituberkulosis kategori 1 dewasa paket
160 Kombipak Kategori 1 paket

161 Obat antituberkulosis kategori anak paket
162 Obat antituberkulosis sisipan dewasa paket
163 Obat Batuk Hitam ( O.B.H ) cairan btl 100 ml 1 1 1
164 Obat Batuk Hitam ( OBH Itra) btl 120 ml
165 Obat gigi :
166 Bahan Tumpatan sementara (Ceivitron) pot @ 30 g
167 Etil Klorida Spray btl 100 ml

168 Eugenol cairan Botol @ 10 ml
169 Glass Ionomer Cement ART set
170 Hemospon set
171 Kalsium Hidroksida Pasta set
172 Klorfenol kamfer Menthol (CHKM) set
173 Mummiffying pasta set
174 Semen seng Fosfat serbuk dan cairan set
175 Silver Amalgam set

Temporary Stopping Fletcher serbuk dan
176 set
cairan
177 Oksimetazolin tetes hidung 0,025% Botol @ 10 ml
178 Oksitetrasiklin salep mata 1% (HCl) tube @ 3,5 g
179 Oksitetrasiklin salep kulit 3% tube @ 5 g
180 Oksitosin injeksi 10 IU/ml - ml ampul @ 1 ml
181 Omeprazol kapsul 20 mg kapsul 20
182 Omeprazol injeksi 40 mg/10 ml vial
183 Oralit 10 6
184 Paracetamol drops 100 mg/ml btl 15 ml
185 Parasetamol sirup 120 mg/ 5 ml btl 60 ml 1 1 1 2 2 1 2 2 1
186 Parasetamol tablet 100 mg tablet
187 Parasetamol tablet 500 mg tablet 150 165 40 85 140 90 10 80 80 175 50 20 40 30 150 51 40
188 Perak sulfadiazin krim 1% tube @ 35 g
189 Permetrin krim 5% tube @ 10 g
190 Pirantel suspensi 125 mg/ 5 ml btl 60 ml
191 Pirantel tab.Score (base) 125 mg tablet 10 4
192 Piridoksin (Vit. B6) tablet 10 mg (HCl) tablet 10 10 10 20 20 10 10
193 Piroksikam tablet 10 mg tablet
195 Polikresulen cairan btl 10 ml
196 Povidon Iodida larutan 10% btl @ 300 ml
197 Prednison tablet 5 mg tablet 20 10 10 10
198 Primakuin tablet 15 mg tablet
199 Prokain Benzil Penisilin injeksi 3 jt IU vial
200 Propanolol tablet 10 mg (HCl) tablet
201 Propranolol 40 mg tablet
202 Propiltiourasil tablet 100 mg tablet
203 Ranitidin tablet 150 mg tablet 60 20 30 50 50 20 20 10 10 60 20
204 Reserpin tablet 0,25 mg tablet
205 Retinol (Vit.A) 100.000 IU kapsul lunak kapsul 10
206 Retinol (Vit.A) 200.000 IU kapsul lunak kapsul 2 1
207 Ringer Laktat larutan infus btl 500 ml
208 Salbutamol tablet 2 mg (sebagai sulfat) tablet

30 10
210 Salbutamol cairan ih 0,1% botol @ 2,5 ml
Salep 2-4,kombinasi : Asam sulfat 2 % +
211 pot @ 30 g
Belerang endap 4 %
212 Salisil bedak serbuk 2 % ktk 50 gram
Botol @ 60
213 Setirizin sirup 5 mg/5 ml
ml
214 Sianokobalamin (Vit.B 12) tablet 50 mcg tablet
216 Sianokobalamin (Vit.B 12) injeksi 500 mcg ampul
217 Simetidine tablet 200 mg tablet

218 Simvastatin tablet 10 mg tablet 14 18 15 15 40 10 10 30 15 40 30 18 10
219 Simvastatin tablet 20 mg tablet
220 Siprofloksasin tablet 500 mg (HCl) tablet
221 Spironolakton tablet 25 mg tablet
222 Tablet tambah darah : tablet
_ Besi (II) sulfat 200 mg, asam folat 0,25
tablet
mcg 20 10 13 20 10 30 3
_ Livron B plex tablet 10
_ Ferrous Fumarate 180 mg, Folic Acid 400
tablet
mcg
223 Taburia sachet
224 Tetrakain HCl tetes mata 0,5% botol 5 ml
225 Tetrasiklin kapsul 250 mg kapsul
226 Tiamin (Vit.B1) tablet 50 mg tablet 10 10 10 15 10 10 20
227 Tiamin (Vit.B1) injeksi 100 mg/ml ampul
228 Triheksifenidil tablet 2 mg tablet
229 Triheksifenidil tablet 2 mg (Arkine) tablet 60 120 60 60
230 Vaksin BCG serb inj. 0,75 mg/ml + pelarut vial
231 Vaksin campak serb inj. + pelarut vial

232 Vaksin kombinasi DPT-HB-Hib inj vial
Vaksin jerap difteri tetanus (DT) inj. 40/15 If
234 vial
per ml
Vaksin jerap difteri tetanus pertusis (DPT)
235 vial
inj.
Vaksin jerap tetanus (tetanus adsorbed
236 vial
toxoid)
237 Vaksin polio t-OPV drops 10 dosis vial
238 Vaksin polio IPV inj. 0,5 ml vial
239 Vaksin rabies serb inj. 2,5 IU vial
240 Vaksin rabies serb inj +booster vial
241 Vitamin B Kompleks tablet tablet 40 95 40 30 40 80 40 80 45 80 40 22 50 60 30 20 10
242 Zinc Tab 20 mg tablet 10
243 Zinc drop 10 mg/ml botol @ 15 ml
244 Zinc sirup 10 mg/ml botol 100 ml
245 Zinc sirup 20 mg/5 ml botol 60 ml
246 Superhoid suppo 1
247 Scopamin 20 50 10 10
JML PEMA
22 23 24 25 26 27 28 29 30 31 KAIAN
0
0
0
0
0
70 60 6 10 315
0
0
0
0
0
0
5 10 10 10 10 190
0
10 20
50 95 20 60 40 120 55 20 1702
1 1 1 9
0
0
0
30 50 40 60 110 60 50 10 792
35
0
0
0
0
0
0
0
0
0
0
23 70 14 330
0
0
10 30 10 20 270
0
1
0
30
0
3 9
3
1 5 1 16
0
0
10 20
43 73 14 30 30 134 60 10 1106
0
0
20 25 10 74 20 420
0
1 2
0
0
0
20 30
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10 40
0
0
0
0
0
1 1
10
10 10
0
34 70 4 20 20 80 45 10 698
0
0
20 10 80
60 360
0
0
0
0
30
0
0
20 20 236
0
0
0
0
75
0
0
0
0
100
0
2 1 1 7
0
0
0
0
0
30 180
0
0
40 10 120
0
1 7
0
0
0
0
20 40 60 210
0
0
0
0
0
0
0
30
10 10 40
0
10 50
10
40 40 235
0
0
2 7
0
0
0
2
0
0
0
0
10 20
0
0
0
10 10 40
0
0
0
0
0
0
0
0
0
0
0
0
1 4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
20
0
5
0
1 1 1 1 17
0
20 190 20 90 110 120 75 20 2041
0
0
0
6 20
10 10 10 10 130
0
0
0
0
50
0
0
0
0
60 10 70
35 30 60 50 25 550
0
10 10 30
1 1 5
0
0
30 10 80
0
0
1 1
0
0
5 60 58 6 10 404
0
0
0
0
10 10 30 156
10
0
0
0
0
10 5 100
0
0
60 360
0
0
0
0
0
0
0
0
0
23 85 24 30 50 84 10 40 1148
10
0
0
0
1
30 10 10 140
0
0
0
0
0
PUSKESMAS GILIRENG
BULAN :
TAHUN :
PEMAKAIAN TANGGAL
NO NAMA OBAT SATUAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27
1 ACT Tab tablet

5 Alopurinol Tablet 100 mg tablet 10 45 10 10 30 39 35 10 35 10 70 70 25
12 Amlodipin tablet 5 mg tablet 40 10 30 10 70 30 10 15 10 70 15 20 30
14 Amoksisilin kapsul 250 mg kapsul 20 10
15 Amoksisilin kaplet 500 mg kaplet 50 84 30 40 80 10 30 50 30 60 90 20 30 40 40 185 40 20 90 10 160
16 Amoksisilin sirup kering 125 mg/5 ml btl 60 ml 1 3 2 1 1 2 1 1 3

20 Antasida DOEN Tab tablet 14 10 52 20 20 20 54 30 42 10 10 33 70 40 155 10 50 143 85 60
21 Antasida DOEN II suspensi btl 60 ml 1
22 tube @ 5 g
neomicin 38
32 Asam askorbat (Vit.C) tablet 50 mg tablet 3 10 10 37 3 30 30 10
35 Asam Mefenamat kaplet 500 mg tablet 20 10 40 20 40 10 35 20 20 10 55
37 Asiklovir krim 5 % tube 5 g
41 Betametason krim 0,1 % tube @ 5 g 1 1 1 1 2 2 4 1 1 1 1 2

1

47 Deksametason tablet 0,5 mg tablet 42 10 15 10 13 3 29 50 13 40 25 20 15 10 12 20 80
49 btl 60 ml
kombinasi (Dekstrofen) 1
53 Diazepam tablet 2 mg tablet 10

59 Domperidon tablet 10 mg tablet
62 Epinefrin (Adrenalin) injeksi 0,1 % ampul

10 30 10 5

75 Garam Oralit serbuk 200 ml sachet 6 2 6
80 Glimepiride tablet 2 mg tablet 30
81 Gliseril Guaiakolat tablet 100 mg tablet 29 30 33 3 42 3 20 10 13 30 12 20 23 55 15 3 55 10 50
84 Griseofulvin tablet 125mg Micorinized tablet 30 10 10
85 Haloperidol tablet 1,5 mg tablet 130 120 120
89 Hidrokortison krim 2,5% tube @ 5 g 2 1 1
90 Hyosicine-N-Butilbromide tablet 10mg tablet 10 10 4 10 20 10 18 35
91 Ibuprofen sirup 100 mg/ 5 ml btl 60 ml 1
92 Ibuprofen tablet 200 mg tablet 10 10 20 80 20 20 40 20 30
93 Ibuprofen tablet 400 mg tablet 20
98 Kalsium Laktat (Kalk) tablet 500 mg tablet 20 10 10 30 30 5 10 30 20

99 ampul
(100mg/ml)
100 Kaptopril 25 mg tablet 5 10 10
102 Ketokonazol tablet 200mg tablet 10
103 Kloramfenikol kapsul 250 mg kapsul 20 20
105 Kloramfenikol salep mata 1 % tube @ 5 g 1 2 1 1
108 Klorfeniramin Maleat (CTM) tablet 4 mg tablet 65 40 53 33 53 30 20 60 59 80 63 20 60 25 30 70 40 13 102 50 110
111 Klorpromazin tablet salut 100 mg (HCl) tablet 70 60 60
114 Kotrimoksazol DOEN (dewasa) tablet 10 10 10 20 20 20 20 10 40 20
116 Kotrimoksazol suspensi btl 60 ml 4 1 3 1 1 2 1 1 2
120 ampul
80.000 - 2 ml
128 Metformin HCl tablet 500 mg tablet 10 10 10 20 5
129 tablet
tablet salut 0,125 mg
131 Metoklopramide tablet 5 mg tablet 4 10 10 10 6 10 10 10

132 Metoklopramide tablet 10 mg tablet
133 Metronidazol tablet 500 mg tablet 10 10 30 10 35 20 105 10 30 15 20
136 Mikonazol krim/salep 2 % (Nitrat) tube @ 10 g 1 1 1 2
Multivitamin sirup
138
_ Becefort sirup botol @ 60 ml 1 1 1 1 2 1 2 2 1
Multivitamin Tablet
139
_ Bioron tablet tablet 20 10
143 Natrium Diklofenak tablet 25 mg tablet 10 10
147 N.B Topical Oint tube 5 g 1


157 Obat Batuk Hitam ( O.B.H ) cairan btl 100 ml
Obat gigi :

163 Hemospon set

169 set
cairan
171 Oksitetrasiklin salep mata 1% (HCl) tube @ 3,5 g 1
174 Omeprazol kapsul 20 mg kapsul
177 Parasetamol sirup 120 mg/ 5 ml btl 60 ml 4 1 2 2 2 1 2 1 1 2 3 3 1 2
179 Parasetamol tablet 500 mg tablet 73 90 60 40 100 30 80 100 70 80 110 20 20 81 122 70 210 30 20 200 115 200
182 Pirantel suspensi 125 mg/ 5 ml btl 60 ml 1
183 Pirantel tab.Score (base) 125 mg tablet 8 4 4
184 Piridoksin (Vit. B6) tablet 10 mg (HCl) tablet 15 20 30 20 10 40
194 Propiltiourasil tablet 100 mg tablet 30 10 30
195 Ranitidin tablet 150 mg tablet 20 10 10 10 20 30 10 40 10 70 20 105 95
197 Retinol (Vit.A) 100.000 IU kapsul lunak kapsul
198 Retinol (Vit.A) 200.000 IU kapsul lunak kapsul 1 1 1 2

20 50 30
203 pot @ 30 g
Belerang endap 4 % 2
204 Salisil bedak serbuk 2 % ktk 50 gram 2 4 1 1 1
Botol @ 60
ml

210 Simvastatin tablet 10 mg tablet 10 75 10 10 40 29 35 10 10 20 50 114 10 10 70 11
212 Siprofloksasin tablet 500 mg (HCl) tablet 20 3 10 10 10 10 10 10 30
tablet
mcg 10 10 10 10 30 10 10 10
_ Livron B plex tablet 20 20 10 10 40 40 10 80 10 70 90 10
tablet
mcg
215 Taburia sachet
218 Tiamin (Vit.B1) tablet 50 mg tablet 10 10 20 20 40 20 10 10 10 20 10 10 10 30 20
221 Triheksifenidil tablet 2 mg (Arkine) tablet 90 120 120

225 vial
per ml
226 vial
inj.
227 vial
toxoid)
232 Vitamin B Kompleks tablet tablet 66 50 38 23 88 33 80 80 86 90 103 20 20 50 20 10 10 30 122 20 45
233 Zinc Tab 20 mg tablet 10 10 20
237 Albotil 1 1 1
238
JML PEMA
28 29 30 31 KAIAN
0
0
0
0
0
10 409
0
0
0
0
0
0
16 30 406
0
30
80 1269
2 17
0
0
0
65 40 1033
5 1 7
38
0
0
0
0
0
0
0
0
0
36 169
0
0
10 290
0
0
0
0
0
18
0
0
0
0
12 419
0
1
0
0
0
10
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
55
0
0
0
14
0
0
15 25
0
30
10 20 486
0
0
50
60 430
0
0
0
4
14 131
1
20 270
20
0
0
0
0
40 205
0
10 35
0
10
40 80
0
5
0
0
35 20 1131
0
0
30 220
0
0
20 200
0
1 17
0
0
0
0
0
0
0
0
0
0
0
10 65
0
15 85
0
25 320
0
0
5
0
0
0
12
0
0
0
0
30
0
0
0
40 60
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
2 29
0
155 50 2126
0
0
16
40 10 185
0
0
0
0
35
0
0
0
0
70
10 20 480
0
0
1 6
0
10 110
0
2
9
0
0
20 534
0
113
0
0
10 110
10 420
0
0
0
0
110 10 370
0
0
60 390
0
0
0
0
0
0
0
0
96 30 1210
10 50
0
0
0
3
0
0
0
0
0
0
LAPORAN BULANAN PEM
PUSKESMAS GILI
BULAN : MEI
TAHUN : 2017
NO NAMA OBAT SATUAN
1 2 3 4 5 6 7 8 9
1 ACT Tab tablet

5 Alopurinol Tablet 100 mg tablet 20 10 25 10 20 80
12 Amlodipin tablet 5 mg tablet 10 10 10
14 Amoksisilin kapsul 250 mg kapsul 20 12 10
15 Amoksisilin kaplet 500 mg kaplet 20 60 50 55 60 50 15 125 40
16 Amoksisilin sirup kering 125 mg/5 ml btl 60 ml 1 1

20 Antasida DOEN Tab tablet 65 50 10 10 10 20 8
21 Antasida DOEN II suspensi btl 60 ml 1 4 2 5 6
22 tube @ 5 g
neomicin
32 Asam askorbat (Vit.C) tablet 50 mg tablet 60 52 20 5 40 80
35 Asam Mefenamat kaplet 500 mg tablet 10 10 30 20
41 Becefort sir sirup
42 Basitrasin salf salep
43 Betametason krim 0,1 % tube @ 5 g 1

47 Ciprofloxacin tablet
51 Deksametason tablet 0,5 mg tablet 10 15 30 15 29 10
53 btl 60 ml
kombinasi (Dextrofen)
57 Diazepam tablet 2 mg tablet

63 Domperidon tablet 10 mg tablet 5 8
66 ampul
HCl)

20 20

79 Garam Oralit serbuk 200 ml sachet 6 5 5 10
85 Gliseril Guaiakolat tablet 100 mg tablet 50 40 10 20 25 23
88 Griseofulvin tablet 125mg Micorinized tablet 20
89 Haloperidol tablet 1,5 mg tablet
93 Hidrokortison krim 2,5% tube @ 5 g 1
94 Hyosicine-N-Butilbromide tablet 10mg tablet 40 10
96 Ibuprofen tablet 200 mg tablet 50 30 10 10 20 20
102 Kalsium Laktat (Kalk) tablet 500 mg tablet 10 20 20 10 20 10

103 ampul
(100mg/ml)
104 Kaptopril 25 mg tablet 10
107 Kloramfenikol kapsul 250 mg kapsul 20
112 Klorfeniramin Maleat (CTM) tablet 4 mg tablet 30 40 40 59 60 145 23
118 Kotrimoksazol DOEN (dewasa) tablet 40 10 10
120 Kotrimoksazol suspensi btl 60 ml 1 1 1 1 1 2 2
124 ampul
80.000 - 2 ml
125 Livron B.Plex tablet 10 30 10
134 tablet

137 Metoklopramide tablet 10 mg tablet 10 10 2
138 Metronidazol tablet 500 mg tablet
139 Metronidazol infus 500 mg/100 ml botol @ 100 ml 20 10
141 Mikonazol krim/salep 2 % (Nitrat) tube @ 10 g
Multivitamin sirup
143
_ Becefort sirup botol @ 60 ml
Multivitamin Tablet
144
_ Bioron tablet tablet
148 Natrium Diklofenak tablet 25 mg tablet 10
152 Neomisin salf 1

165 Obat gigi :

170 Hemospon set

176 set
cairan
183 Oralit
185 Parasetamol sirup 120 mg/ 5 ml btl 60 ml 1 1 1 1 1 4 2
187 Parasetamol tablet 500 mg tablet 10 100 70 85 43 70 15 165 185
191 Pirantel tab.Score (base) 125 mg tablet
192 Piridoksin (Vit. B6) tablet 10 mg (HCl) tablet 10
197 Prednison tablet 5 mg tablet
202 Propiltiourasil tablet 100 mg tablet 40
203 Ranitidin tablet 150 mg tablet 40 30 20 30 15 20 50

10 20
211 pot @ 30 g
Belerang endap 4 %
Botol @ 60
ml

218 Simvastatin tablet 10 mg tablet 30 6 60 15 10 10 35 110
tablet
mcg 20 20
_ Livron B plex tablet
tablet
mcg
223 Taburia sachet
229 Triheksifenidil tablet 2 mg (Arkine) tablet

234 vial
per ml
235 vial
inj.
236 vial
toxoid)
241 Vitamin B Kompleks tablet tablet 10 50 32 40 50 20 100 195
242 Zinc Tab 20 mg tablet 10 10 15 10
246 Superhoid suppo
247 Scopamin
248 Albotil 1
249 Hotin DCL
250 Nasal Drop
RAN BULANAN PEMAKAIAN OBAT
PUSKESMAS GILIRENG
PEMAKAIAN TANGGAL
10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
10 10 10 74 4 4 20 40 90 40 20
10 10 10 20 40 40 10
70
10 10 10 10
35 20 60 160 10 20 80 50 90 40 30 91 10
1 2 1 3 1
10 20 30 20 10 20 10 10 20 30
6 2 3 1 12 3 4 9 6 14 7 9 13 2
10 20 20 82 10 10 10 20 27 5
10 40 20 10 10 10 10
4 1 2 1 1 1
1
2 1 3 1 1 4
30 20
10 13 30 10 11 10 10 10 20 5 22
10 10 10 10 10
10 10 20 20 30 33 10 10 20
2 10
4 6 10 11 10 6 26
13 10 80 22 20 20 53 15 20
10 10 120
60 120 90
40 10 10 30 8 30 26 10 40 10 20
10 10 10 10 30 20
10 10 35 50 10 60 30
10 10 10 5 10
10
50 10
2 1 2 1
25 43 40 100 32 30 54 30 105 40 40 152 5 20
30 30 30 30
10 10 20 40 30 90 22 10
1 1 1 2 2 1 1 1 3
10 20 10 80 40 10 40 10 30
10 10 10 10 30 30 30
10 5
10
20 10 20 20 13 10 30 25 10 20
1 1 2 3
20 10 10 10
20 30 130 20
1 2 1 2 2 1 1 1 1 1 3
55 40 70 10 210 140 65 130 120 275 65 140 230 25 20
10 10 20 20
5
90
20 30 10 120 20 80 30 60 40 70 30 10
1
1 1 2 2 1 1 1
10 50
10 10 10 61 10 7 19 10 50 110 55 20
10 30 30
20 10 40 30 30 20 10 20 40
60 30 120 90
20 34 10 110 70 30 60 60 90 50 80 211 30
10 10 20 20 10 10 10
5 2
2
JML PEMA
30 31 KAIAN
5 492
10 180
40 110
82
70 35 1276
10
60 33 446
11 2 122
471
25 205
2 12
1
1 14
20 70
60 10 330
50
5 181
52
6 105
1 2
10
50 15 486
160
270
1
50 334
230
295
55
10
80
1 9
70 15 1198
120
50 20 362
1 23
20 320
10 10
140
15
32
10 188
30
7
10 70
30 20 270
1 1 29
170 65 2573
12 12
10 80
5
130
90 815
1 3
11
50 140
3 3
50 20 718
30 140
10 430
300
50 40 1442
5 140
1
6 13
2
LAPORAN BULANAN PEMA
PUSKESMAS GILIRE
BULAN : JUNI
TAHUN : 2017
NO NAMA OBAT SATUAN
1 2 3 4 5 6 7 8 9 10
1 ACT Tab tablet

5 Alopurinol Tablet 100 mg tablet 10 10 11
8 Ambroxol sirup 15 mg/ 5 ml btl 60 ml 1
12 Amlodipin tablet 5 mg tablet 10 10 20 20 10 10 10 30
15 Amoksisilin kaplet 500 mg kaplet 50 25 70 30 50 60 30 50
16 Amoksisilin sirup kering 125 mg/5 ml btl 60 ml 1

19 Anagens sirup btl 60 ml
20 Antasida DOEN Tab tablet 20 95 45 100 35 72 50 25 65
21 Antasida DOEN II suspensi btl 60 ml 2 2
22 tube @ 5 g
neomicin
32 Asam askorbat (Vit.C) tablet 50 mg tablet 30 23 60 10 20 40 50
35 Asam Mefenamat kaplet 500 mg tablet 10 30 40 20 30 10
37 Asiklovir krim 5 % tube 5 g 5
39 Asiklovir tablet 400 mg tablet 20
41 Becefort sir sirup 1
42 Basitrasin salf salep 2
47 Ciprofloxacin tablet 10
53 btl 60 ml
kombinasi (Dextrofen)

63 Domperidon tablet 10 mg tablet 5 45 10 10 10
66 ampul
HCl)
74 Fenol Gliserol tetes telinga 10% botol 5 ml 2 2
10 10

79 Garam Oralit serbuk 200 ml sachet 5
81 Gentian violet larutan 1 % btl 10 ml 1
85 Gliseril Guaiakolat tablet 100 mg tablet 23 21 10 20
88 Griseofulvin tablet 125mg Micorinized tablet 20
89 Haloperidol tablet 1,5 mg tablet 90
94 Hyosicine-N-Butilbromide tablet 10mg tablet 10 5 20 10
96 Ibuprofen tablet 200 mg tablet 10 10
102 Kalsium Laktat (Kalk) tablet 500 mg tablet 5 10 20 10

103 ampul
(100mg/ml)
107 Kloramfenikol kapsul 250 mg kapsul
109 Kloramfenikol salep mata 1 % tube @ 5 g 1
115 Klorpromazin tablet salut 100 mg (HCl) tablet 30
118 Kotrimoksazol DOEN (dewasa) tablet 10 30 40 20 10
120 Kotrimoksazol suspensi btl 60 ml 1 1 1 1 2
124 ampul
80.000 - 2 ml
125 Livron B.Plex tablet 20 35 10 10 10 10 20
134 tablet
tablet salut 0,125 mg 25
136 Metoklopramide tablet 5 mg tablet 5 5

138 Metronidazol tablet 500 mg tablet 10 10 30 20 20
141 Mikonazol krim/salep 2 % (Nitrat) tube @ 10 g 1
Multivitamin sirup
143
Multivitamin Tablet
144
148 Natrium Diklofenak tablet 25 mg tablet 10 30 20
152 Neomisin salf

165 Obat gigi :

170 Hemospon set

176 set
cairan
179 Oksitetrasiklin salep kulit 3% tube @ 5 g 1
183 Oralit
191 Pirantel tab.Score (base) 125 mg tablet
192 Piridoksin (Vit. B6) tablet 10 mg (HCl) tablet 30 10 10 13
197 Prednison tablet 5 mg tablet 10
203 Ranitidin tablet 150 mg tablet 50 50 10 30 40 10

30 10
211 pot @ 30 g
Belerang endap 4 %
212 Salisil bedak serbuk 2 % ktk 50 gram 1
Botol @ 60
ml

218 Simvastatin tablet 10 mg tablet 15 10 10
tablet
mcg 30 20 20
tablet
mcg
223 Taburia sachet
229 Triheksifenidil tablet 2 mg (Arkine) tablet 90

234 vial
per ml
235 vial
inj.
236 vial
toxoid)
241 Vitamin B Kompleks tablet tablet 33 64 20 70 20 40 40 10 60
242 Zinc Tab 20 mg tablet 5 10
246 Superhoid suppo 6
247 Scopamin
248 Albotil 1
249 Hotin DCL 7 1
250 Nasal Drop 1
N BULANAN PEMAKAIAN OBAT
USKESMAS GILIRENG
PEMAKAIAN TANGGAL
11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
20 25 5 30 60
10 30 25 40 40
60 10 20 60 20 30 40 10 20 20 20 40
3 1 1
2 1 1
7 80 133 40 50 25 40 40 10 25 70
1 3 4 7 2 1 12 3 5 7
20 10 13 10 10 10 10
10 20 10 10 10 20 10
2 1 1 3 1 2 1
1 1
1
10 50 70 20
10 20 13 23 10 10 10
18
4 20 6 10 10 25 15
10
11 10
10
42 16 10 30 12 10 30 50 20
10
90
1 1 2 1
10 10 10 10 2
20 10 10 10 10 20
10 30 40
20
1 2 2 1
42 26 20 23 123 20 44 70 90 40
30
10 20 10 20 10 10 10
2 4 1 1 1 2 2
20 10 10 70 40 10 50 40 30
10
10 30
3
20
10 20 42
30
1 2 1 1
10 20
20 20 20 30 40 20
2 2 4 2 2 1 2 2
80 110 60 80 170 100 100 170 141 100 30 20
4 4
2 20
10
20 80 20 30 30 10 60 20 10 20
2 3 2 2 1 12
3 10 20 10 10 30
10 5 55 10 45 80 20
10 20 10 10 50
20 30 20 10 70 20 40
90
82 93 40 50 23 60 70 100 43 30 40
20 10 10 10
3 5 5
JML PEMA
KAIAN
171
265
40
715
6
4
1027
49
316
230
24
12
4
2
160
194
18
170
30
26
1
20
294
30
180
7
87
100
125
10
10
20
706
60
200
19
395
40
65
13
20
162
30
6
90
170
26
1771
8
63
32
70
490
26
123
260
170
330
180
988
65
1
21
1
LAPORAN BULANAN PEMA
PUSKESMAS GILIRE
BULAN : JULI
TAHUN : 2017
NO NAMA OBAT SATUAN
1 2 3 4 5 6 7 8 9 10
1 ACT Tab tablet

5 Alopurinol Tablet 100 mg tablet 100 34 20 10 53
8 Ambroxol sirup 15 mg/ 5 ml btl 60 ml 2 1
12 Amlodipin tablet 5 mg tablet 5 90 20 10 10 25
14 Amoksisilin kapsul 250 mg kapsul
15 Amoksisilin kaplet 500 mg kaplet 130 51 90 100 80 20 60 20 110

19 Anagens sirup btl 60 ml 1 1
20 Antasida DOEN Tab tablet 100 10 30 20 41 30 10 7
21 Antasida DOEN II suspensi btl 60 ml 12 14 2 4 1 3 8
22 tube @ 5 g
neomicin
29 Asetil Systein tablet 70 80 10 24
32 Asam askorbat (Vit.C) tablet 50 mg tablet 73 23 5 25 46 10 10 3
35 Asam Mefenamat kaplet 500 mg tablet 10 20 10 10 10 10 30
41 Becefort sir sirup 2 1 1
42 Basitrasin salf salep 1 1
44 Bioron tablet
45 Corobion tablet 20
46 Corovit tablet 20 20
47 Ciprofloxacin tablet 60 70 10
53 btl 60 ml
kombinasi (Dextrofen) 1 4 1

63 Domperidon tablet 10 mg tablet 10 20 20
66 ampul
HCl)
68 Eritromisin kapsul 500 mg tablet 10

10

82 Glibenklamida tablet 5 mg tablet
84 Glimepiride tablet 2 mg tablet 30
85 Gliseril Guaiakolat tablet 100 mg tablet 43 20 30 64 23 23 10
88 Griseofulvin tablet 125mg Micorinized tablet
89 Haloperidol tablet 1,5 mg tablet 90
93 Hidrokortison krim 2,5% tube @ 5 g 1 2 2 1
94 Hyosicine-N-Butilbromide tablet 10mg tablet 10 10 10
96 Ibuprofen tablet 200 mg tablet 10 20 30
102 Kalsium Laktat (Kalk) tablet 500 mg tablet 30 10 10 10 20

103 ampul
(100mg/ml)
112 Klorfeniramin Maleat (CTM) tablet 4 mg tablet 147 115 50 116 73 46 50 76
115 Klorpromazin tablet salut 100 mg (HCl) tablet 120
118 Kotrimoksazol DOEN (dewasa) tablet 10 10
120 Kotrimoksazol suspensi btl 60 ml 2 1 3 1 2 2
124 ampul
80.000 - 2 ml
125 Livron B.Plex tablet 80 110 30 10 10 80
126 Loratadin tablet 10 mg tablet 10 20
133 Metformin HCl tablet 500 mg tablet 60 60
134 tablet

138 Metronidazol tablet 500 mg tablet 20 10 10 50
Multivitamin sirup
143
Multivitamin Tablet
144
148 Natrium Diklofenak tablet 25 mg tablet 10 10 10 10
152 Neomisin salf

165 Obat gigi :

170 Hemospon set

176 set
cairan
181 Omeprazol kapsul 20 mg kapsul 20 10 60
183 Oralit
192 Piridoksin (Vit. B6) tablet 10 mg (HCl) tablet
197 Prednison tablet 5 mg tablet 4 3 10
200 Propanolol tablet 10 mg (HCl) tablet 10
203 Ranitidin tablet 150 mg tablet 130 160 20 30 30 40 10 90

15 10 15 2
211 pot @ 30 g
Belerang endap 4 %
Botol @ 60
ml

218 Simvastatin tablet 10 mg tablet 108 49 16 10 10
tablet
mcg 10 10
tablet
mcg
223 Taburia sachet
229 Triheksifenidil tablet 2 mg (Arkine) tablet 90

234 vial
per ml
235 vial
inj.
236 vial
toxoid)
242 Zinc Tab 20 mg tablet
246 Superhoid suppo
247 Albotil
248 Hotin DCL
249 Nasal Drop 1 4
N BULANAN PEMAKAIAN OBAT
USKESMAS GILIRENG
PEMAKAIAN TANGGAL
11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
50 20 10 10 30 20 10 10 15 45 10 10
1 1 1 4 5 3 1 4 1
50 10 10 25 20 10 10 40 130 20 10
10 10 10
90 30 50 50 20 10 165 60 72 20 110 50 100 50 80 115 30 40 10 50
1 1 1 1 1 1
3 1 1 1 1 3
44 40 3 40 54 30 20 20 50 10 40 2 10 20
5 13 6 2 2 5 12 5 3 5 2
50 25 20 43 10 79 30 61 30 10 20 10 50 3 10 30 40
10 6 40 10 15 40 10 10 10 40 30 30 10 16 10 10 20
10 20 10 20 10 10 10 40 10 20
1 1 2 1 1 3
2 1
10
10 20 10 60 10
10 10 20
20 10 10 30
60 7 30 33 5 10 13 10 10 10 10 10 33 10 40
1 1 1 1
10
10 10 10 5 10 10 10
10 10
10
12 4 6 6 4
1
5 10
30 20
30
90 90 90 450 150 100 90 90

5 10 30 10 1 10 10 10
20 20 10 10 10 10 10 20 10
10 10 20 20 10 30 30 30 20
20
20
1 1 1 1 1 2 1
50 6 15 20 14 10 20 10 20 40 10 30 10 20
30 30 30 30 150 50 30 30 30
10 20 10 10 10 10 10 20
3 1 3 1 1 3 1 1
40 40 10 20 10 10 20 20 35 10 40 40 10
20 10 27 70 20 45 20 40 15 10 20
30 200
10 10
10
20 50 10 30 20 35 2 70
2
10 10 10 10 20
60 10 50 20 10 10 20 40 10 20 10 10
3 1 1 4 1 2 1 3 1 2 1 1
60 133 80 55 60 10 170 70 110 40 130 33 240 81 90 220 50 50 70
4 4 4
10 10
10 40 10 10
60 10
10 10 20 20 10 30 10 20 10 10 10
1 1 1 2 1 3
20 30 10 10 20 10
1 1
2 5
24 20 20 20 27 50 75 10 10 20
10 30 10 20 10 10 30 10 10
10 50 40 20 20 30 20 20 40 10 50 10 20
90 90 90 90 360 150 100 90 90
30 109 50 23 60 10 76 80 53 40 100 62 30 193 20 60 40

10
2
JML PEMA
KAIAN
457
24
495
30
1863
10
12
631
104
705
512
260
4
11
4
10
130
80
210
448
10
10
115
10
30
10
37
2
15
80
243
1240
6
116
180
260
10
30
20
10
948
530
120
25
625
327
350
30
18
327
3
100
360
35
2903
24
20
87
10
80
670
10
142
469
160
484
1240
1807
10
2
5
LAPORAN BULANAN PEM
PUSKESMAS GILI
BULAN : AGUSTUS
TAHUN : 2017
NO NAMA OBAT SATUAN
1 2 3 4 5 6 7 8 9
1 ACT Tab tablet

5 Alopurinol Tablet 100 mg tablet 10 10 39
8 Ambroxol sirup 15 mg/ 5 ml btl 60 ml 2 1 2 2 3
12 Amlodipin tablet 5 mg tablet 10 60
13 Amlodipin tablet 10 mg tablet 8 20
15 Amoksisilin kaplet 500 mg kaplet 73 80 30 30 60 61 60 90

19 Anagens sirup btl 60 ml 2 2 2 1 1 2
20 Antasida DOEN Tab tablet 50 33 20 40 30 40 23
21 Antasida DOEN II suspensi btl 60 ml 2 1 1 1 2
22 tube @ 5 g
neomicin
29 Asetil Systein tablet 30 20 20 10 20
32 Asam askorbat (Vit.C) tablet 50 mg tablet 24 30 10 40 30 30
34 Asam askorbat (Vit.C) tablet 250 mg tablet 15
35 Asam Mefenamat kaplet 500 mg tablet 20 10 10 10
41 Becefort sir sirup
43 Betametason krim 0,1 % tube @ 5 g 1 1 1
Burnazin salep
44 Bioron tablet
45 Corobion tablet 10
46 Corovit tablet 30 30 30 20 50
47 Ciprofloxacin tablet 30 10
51 Deksametason tablet 0,5 mg tablet 42 20 10 10 20 10 40 38
53 btl 60 ml
kombinasi (Dextrofen) 2

63 Domperidon tablet 10 mg tablet 10 20 10
66 ampul
HCl)

10

82 Glibenklamida tablet 5 mg tablet
85 Gliseril Guaiakolat tablet 100 mg tablet
88 Griseofulvin tablet 125mg Micorinized tablet
89 Haloperidol tablet 1,5 mg tablet 90 90
92 Hidroklortiazid tablet 25 mg tablet 1
94 Hyosicine-N-Butilbromide tablet 10mg tablet 10 10 10
102 Kalsium Laktat (Kalk) tablet 500 mg tablet 10

103 ampul
(100mg/ml)
109 Kloramfenikol salep mata 1 % tube @ 5 g 2
110 Kloramfenikol suspensi 125 mg/5 ml btl 60 ml 3
115 Klorpromazin tablet salut 100 mg (HCl) tablet 30 30
118 Kotrimoksazol DOEN (dewasa) tablet 12 20 20
120 Kotrimoksazol suspensi btl 60 ml 2 1 3
124 ampul
80.000 - 2 ml
125 Livron B.Plex tablet 30 40
126 Loratadin tablet 10 mg tablet 10
134 tablet

138 Metronidazol tablet 500 mg tablet 30 10 10 10
139 Metronidazol infus 500 mg/100 ml botol @ 100 ml 10 20
Multivitamin sirup
143
Multivitamin Tablet
144
148 Natrium Diklofenak tablet 25 mg tablet 20
152 Neomisin salf

165 Obat gigi :

170 Hemospon set

176 set
cairan
179 Oksitetrasiklin salep kulit 3% tube @ 5 g 1
183 Oralit
185 Parasetamol sirup 120 mg/ 5 ml btl 60 ml 1 1 2 2 1 3
187 Parasetamol tablet 500 mg tablet 122 120 50 30 80 80 110 90
192 Piridoksin (Vit. B6) tablet 10 mg (HCl) tablet 10 10
202 Propiltiourasil tablet 100 mg tablet
203 Ranitidin tablet 150 mg tablet 10 20 10 20 40

211 pot @ 30 g
Belerang endap 4 %
212 Salisil bedak serbuk 2 % ktk 50 gram 1 2
Botol @ 60
ml

218 Simvastatin tablet 10 mg tablet 15 10 20 20 10 29
220 Siprofloksasin tablet 500 mg (HCl) tablet 20
tablet
mcg
tablet
mcg
223 Taburia sachet
226 Tiamin (Vit.B1) tablet 50 mg tablet 30 10 10 10 10
229 Triheksifenidil tablet 2 mg (Arkine) tablet 90 90

234 vial
per ml
235 vial
inj.
236 vial
toxoid)
242 Zinc Tab 20 mg tablet 10 2
244 Zinc sirup 10 mg/ml botol 100 ml 1
246 Superhoid suppo 12 12
247 Albotil 1
248 Hotin DCL 2
249 Nasal Drop
RAN BULANAN PEMAKAIAN OBAT
PUSKESMAS GILIRENG
PEMAKAIAN TANGGAL
10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
10 10 10 20
2 3
10 15
80 50 60 10 60 120
1 1 1 1 1
30 40 10 10 90 20
1 2 1 1
20 10 21 30 20
10 30 51 20 10
20 10
10
10
10
10 10
1 3
10
5 10 10
10
1
10 10
10
20 10
10 10 20
20 30 20
10 50 32 10 60 40
20 10 10
20 30 15 110 15
30 10 20
10
10
2
10 10
2 1 1 1
80 70 100 20 110 150
10
10 20 60 10
10 10
5 15 20 15
10 20 20 10 60
10 20 20 50
JML PEMA
30 31 KAIAN
PUSKESMAS GILIRENG
BULAN : SEPTEMBER
TAHUN : 2017
PEMAKAIAN TANGGAL JUM
NO NAMA OBAT SATUAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 LAH
1 ACT Tab tablet

5 Alopurinol Tablet 100 mg tablet 20 40 10 10 10 30 20 36 24 5 10 105 10 10 340
8 Ambroxol sirup 15 mg/ 5 ml btl 60 ml 1 1 1 1 4 1 1 10
12 Amlodipin tablet 5 mg tablet 20 10 10 10 10 30 10 10 70 180
14 Amoksisilin kapsul 250 mg kapsul 20 30 30 30 10 20 140
15 Amoksisilin kaplet 500 mg kaplet 10 10 20 40 30 40 30 20 40 40 100 30 30 90 40 50 40 140 40 110 40 30 30 90 70 40 1250
16 Amoksisilin sirup kering 125 mg/5 ml btl 60 ml 1 1 2 1 5 1 11
1 1
19 Anagens sirup btl 60 ml 1 3 1 3 1 2 2 2 1 2 1 1 20
20 Antasida DOEN Tab tablet 3 10 10 20 20 10 10 20 10 30 40 50 40 60 10 40 30 3 30 10 23 10 5 50 40 584
21 Antasida DOEN II suspensi btl 60 ml 2 1 1 4 2 2 1 1 2 1 3 1 7 9 3 1 6 1 2 2 52
22 tube @ 5 g
neomicin
29 Asetil Systein tablet 10 30 10 20 30 13 30 45 70 20 23 4 52 10 22 15 45 45 494
32 Asam askorbat (Vit.C) tablet 50 mg tablet 20 30 20 40 35 10 15 10 40 33 10 13 10 38 30 354
33 Asam askorbat (Vit.C) tablet 100 mg tablet 60 10 10 80
34 Asam askorbat (Vit.C) tablet 250 mg tablet 30 30 60
35 Asam Mefenamat kaplet 500 mg tablet 10 10 10 10 20 30 30 20 10 20 20 20 20 230
37 Asiklovir krim 5 % tube 5 g 1 1
38 Asiklovir tablet 200 mg tablet 10 10
NO NAMA OBAT SATUAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 LAH
41 Becefort sir sirup 3 1 1 2 1 8
43 Betametason krim 0,1 % tube @ 5 g 1 2 1 1 2 2 9
Burnazin salep 1 1
44 Bioron tablet 10 10 20 30 40 10 120
45 Corobion tablet 10 20 10 40
46 Corovit tablet
47 Ciprofloxacin tablet 10 10 20
51 Deksametason tablet 0,5 mg tablet 10 10 40 10 10 10 40 10 53 14 13 10 3 10 243
53 btl 60 ml
kombinasi (Dextrofen) 1 1 1 1 4
57 Diazepam tablet 2 mg tablet 10 10 20 40

63 Domperidon tablet 10 mg tablet 26 10 10 10 10 10 10 5 10 30 10 20 10 10 10 10 201
Epinefrin (Adrenalin) injeksi 0,1 %
66 ampul
(sebagai HCl)
Fitomenadion (Vit K) tablet salut gula 10
75 tablet
mg 10 10 10 30

79 Garam Oralit serbuk 200 ml sachet
81 Gentian violet larutan 1 % btl 10 ml 1 1
82 Glibenklamida tablet 5 mg tablet 20 20 10 20 10 10 10 100
NO NAMA OBAT SATUAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 LAH
84 Glimepiride tablet 2 mg tablet 20 20
85 Gliseril Guaiakolat tablet 100 mg tablet 1 10 11
88 Griseofulvin tablet 125mg Micorinized tablet 10 10 20
89 Haloperidol tablet 1,5 mg tablet 90 90 180
90 Haloperidol tablet 5 mg tablet 60 90 150
93 Hidrokortison krim 2,5% tube @ 5 g 1 1 1 3
94 Hyosicine-N-Butilbromide tablet 10mg tablet
10 10 10 30
96 Ibuprofen tablet 200 mg tablet 10 30 30 10 10 10 60 30 20 10 70 10 10 310
102 Kalsium Laktat (Kalk) tablet 500 mg tablet 10 10 10 40 10 10 20 10 120

103 ampul
(100mg/ml)
104 Kaptopril 25 mg tablet 10 10 10 10 10 50
109 Kloramfenikol salep mata 1 % tube @ 5 g 1 1 1 1 2 1 1 1 9
112 Klorfeniramin Maleat (CTM) tablet 4 mg tablet

3 10 70 20 45 80 40 10 30 20 35 30 100 40 80 127 14 103 10 43 10 33 78 60 10 1101
114 Klorpromazin tablet salut 25 mg (HCl) tablet 10 10 30 120 170

60 30 90
118 Kotrimoksazol DOEN (dewasa) tablet 10 12 22 10 10 30 12 10 116
120 Kotrimoksazol suspensi btl 60 ml 1 2 1 1 3 1 1 1 2 13

NO NAMA OBAT SATUAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 LAH
124 kapsul
80.000 - 2 ml
125 Livron B.Plex tablet 10 10 30 20 10 10 20 10 50 40 105 50 30 10 50 20 10 30 10 525
132 Metampiron tablet 500 mg tablet 40 40
133 Metformin HCl tablet 500 mg tablet 10 10 10 10 70 30 160 300

134 tablet
10 10
Metilergometrin Maleat injeksi 0.200
135 ampul
mg/ml
138 Metronidazol tablet 500 mg tablet 10 10 10 10 10 20 30 30 130
139 Metronidazol infus 500 mg/100 ml botol @ 100 ml 0
141 Mikonazol krim/salep 2 % (Nitrat) tube @ 10 g 1 1 2
Multivitamin sirup
143
Multivitamin Tablet
144
148 Natrium Diklofenak tablet 25 mg tablet 10 10 10 10 10 10 10 70
152 Neomisin salf

NO NAMA OBAT SATUAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 LAH

165 Obat gigi :

170 Hemospon set

176 set
cairan
181 Omeprazol kapsul 20 mg kapsul
183 Oralit 5 5
185 Parasetamol sirup 120 mg/ 5 ml btl 60 ml 1 1 4 1 2 1 1 4 3 1 3 3 1 2 1 2 1 1 33
187 Parasetamol tablet 500 mg tablet 21 10 10 20 10 30 30 10 20 10 10 70 70 192 50 120 90 50 40 275 90 50 1278
191 Pirantel tab.Score (base) 125 mg tablet 4 4 8
192 Piridoksin (Vit. B6) tablet 10 mg (HCl) tablet 20 40 10 35 5 110
197 Prednison tablet 5 mg tablet 10 10 20
202 Propiltiourasil tablet 100 mg tablet 10 10 60 90 170
203 Ranitidin tablet 150 mg tablet 20 10 20 20 10 10 80 20 20 10 10 50 20 300
NO NAMA OBAT SATUAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 LAH

1 4 1 1 1 1 9

10 30 20 30 30 120
211 pot @ 30 g
Belerang endap 4 %
212 Salisil bedak serbuk 2 % ktk 50 gram 1 4 1 6
Botol @
60 ml 2 2

218 Simvastatin tablet 10 mg tablet 10 10 10 40 10 30 40 30 10 25 20 69 20 12 15 10 153 20 534
tablet
mcg 10 10 10 10 20 60
_ Ferrous Fumarate 180 mg, Folic Acid
tablet
400 mcg
223 Taburia sachet
226 Tiamin (Vit.B1) tablet 50 mg tablet 30 10 30 20 20 20 40 60 10 10 70 10 50 10 20 10 30 20 10 480
229 Triheksifenidil tablet 2 mg (Arkine) tablet 90 90 60 90 330

Vaksin jerap difteri tetanus (DT) inj. 40/15
234 vial
If per ml
Vaksin jerap difteri tetanus pertusis
235 vial
(DPT) inj.
NO NAMA OBAT SATUAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 LAH
236 vial
toxoid)
241 Vitamin B Kompleks tablet tablet 10 60 40 30 40 40 30 10 20 5 40 30 60 10 32 5 63 50 20 3 203 85 50 936
242 Zinc Tab 20 mg tablet
245 Zinc sirup 20 mg/5 ml botol 60 ml 1 3 10 14
246 Superhoid suppo
247 Albotil 1 1 2 1 1 6
248 Hotin DCL 2 4 2 1 1 1 1 1 13
249 Nasal Drop

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LAPORAN BULANAN PEMAKAIAN OBAT

SISA BLN TERIMA PEMAKAIAN TANGGAL JML PEMA SISA

SISA BLN TERIMA PEMAKAIAN TANGGAL JML PEMA SISA

SISA BLN TERIMA PEMAKAIAN TANGGAL

1 ACT Tab tablet 0

18 Ampisillin serbuk inj. i.v. 1000 mg/vial ktk 10 vial

45 Bisakodil suppositoria 5 mg Suppositoria

46 Bisakodil suppositoria 10 mg Suppositoria

59 Digoksin tablet 0,25 mg tablet

75 Fitomenadion (Vit K) tablet salut gula 10 mg tablet

77 Fitomenadion (Vit K) injeksi i.m.2 mg/ml ampul

78 Furosemid tab 40 mg tablet

136 Metoklopramide tablet 5 mg tablet 10 20 10

158 Obat antituberkulosis kategori 1 dewasa paket

159 Obat antituberkulosis kategori 2 dewasa paket

160 Kombipak Kategori 1 paket

166 Bahan Tumpatan sementara (Ceivitron) pot @ 30 g

167 Etil Klorida Spray btl 100 ml

174 Semen seng Fosfat serbuk dan cairan set

175 Silver Amalgam set

209 Salbutamol tablet 4 mg (sebagai sulfat) tablet

214 Sianokobalamin (Vit.B 12) tablet 50 mcg tablet

215 Sianokobalamin (Vit.B 12) tablet 10 mcg tablet

216 Sianokobalamin (Vit.B 12) injeksi 500 mcg ampul

217 Simetidine tablet 200 mg tablet

231 Vaksin campak serb inj. + pelarut vial

1 ACT Tab tablet

18 Ampisillin serbuk inj. i.v. 1000 mg/vial ktk 10 vial

43 Bisakodil suppositoria 5 mg Suppositoria

44 Bisakodil suppositoria 10 mg Suppositoria

45 Dehidro Atemisin + Piperakuin (DHP) tablet

55 Digoksin tablet 0,25 mg tablet

71 Fitomenadion (Vit K) tablet salut gula 10 mg tablet

73 Fitomenadion (Vit K) injeksi i.m.2 mg/ml ampul

74 Furosemid tab 40 mg tablet

97 Isosorbid Dinitrat tablet sublingual 5mg tablet

98 Kalsium Laktat (Kalk) tablet 500 mg tablet 20 10 10 30 30 5 10 30 20

130 Metilergometrin Maleat injeksi 0.200 mg/ml ampul

131 Metoklopramide tablet 5 mg tablet 4 10 10 10 6 10 10 10

152 Obat antituberkulosis kategori 1 dewasa paket

154 Kombipak Kategori 1 paket

159 Bahan Tumpatan sementara (Ceivitron) pot @ 30 g

160 Etil Klorida Spray btl 100 ml

167 Semen seng Fosfat serbuk dan cairan set

168 Silver Amalgam set

200 Salbutamol tablet 2 mg (sebagai sulfat) tablet

201 Salbutamol tablet 4 mg (sebagai sulfat) tablet

206 Sianokobalamin (Vit.B 12) tablet 50 mcg tablet

207 Sianokobalamin (Vit.B 12) tablet 10 mcg tablet

208 Sianokobalamin (Vit.B 12) injeksi 500 mcg ampul

209 Simetidine tablet 200 mg tablet

223 Vaksin campak serb inj. + pelarut vial

1 ACT Tab tablet

18 Ampisillin serbuk inj. i.v. 1000 mg/vial ktk 10 vial

45 Bisakodil suppositoria 5 mg Suppositoria

58 Difenhidramin injeksi i.m 10 mg/ml (HCl) ampul

59 Digoksin tablet 0,25 mg tablet

75 Fitomenadion (Vit K) tablet salut gula 10 mg tablet

77 Fitomenadion (Vit K) injeksi i.m.2 mg/ml ampul

78 Furosemid tab 40 mg tablet

101 Isosorbid Dinitrat tablet sublingual 5mg tablet

102 Kalsium Laktat (Kalk) tablet 500 mg tablet 10 20 20 10 20 10