PEMERINTAH KABUPATEN SUMEDANG

DINAS KESEHATAN KABUPATEN SUMEDANG

UPTD PUSKESMAS TANJUNGKERTA
POLINDES TANJUNGMULYA

LAPORAN PEMAKAIAN OBAT POLINDES

Tanggal : 31 Januari

STOK PENERIM PERSEDI PEMAK SISA

NO NAMA OBAT SATUAN
AWAL AAN AAN AIAN STOK

1 2 3 4 5 6 7 8

1 Acetylcysteine 200 mg Tablet 32 - 32 20 12

Acyclovir Cream
2 Tube 5 - 5 - 5
Alat Suntik Sekali Pakai 1 ml
3 Syringe 6 - 6 - 6
Alat Suntik Sekali Pakai 2,5 ml
4 Syringe - -
Alat Suntik Sekali Pakai 3 ml
5 Syringe 10 - 10 - 10
Alat Suntik Sekali Pakai 5 ml
6 Syringe - -
Amoxisilin 500 mg
7 Tablet 218 - 218 79 139
Amoxisilin Kapsul 250 mg
8 Kapsul - -
Amoxisilin Syrup 125 mg/ml
9 Botol 13 - 13 - 13

10 Amoxisilin syrup Forte 250mg/ml Botol - -

Antalgin (Metampiron) 500 mg
11 Tablet 160 - 160 - 160
Antasida Doen Suspensi
12 Buah - -
Antasida Doen Tablet
13 Tablet 304 - 304 186 118
Antifungi Doen Kombinasi
14 Pot - -
Asam folat Tablet/Kaplet/Kapsul
15 Tablet - -
Asam Mefenamat 500 mg
16 Tablet 80 - 80 - 80
Bethametasone Cream 0,1%
17 Tube 12 - 12 3 9

18 Bundavin Tablet - -
Captopril 12,5 mg
19 Tablet 140 - 140 16 124
Captopril 25 mg
20 Tablet - -
Catgut Chromic 2/0 100m
21 Pcs - -

22 Dekstrofen Sirup Botol - -

Dexamethason 0,5 mg
23 Tablet 64 - 64 50 14

24 Dopamet/ Metildopa Tablet 50 - 50 - 50

 Ethanol 70% 1 Liter
25 Botol - -
Ethanol 70% 100 ml
26 Botol - -
Garam Oralite
27 Sachet - -
Gentamicin Salep Kulit
28 Tube - -
Gentamicin Salep Mata
30 Tube 6 - 6 - 6
Gentamicin Tetes Mata 0,3%
31 Botol 8 - 8 1 7
Gentian Violet Larutan 1%-10 ml
32 Botol - -
Gliseril Guayakolat 100 mg
33 Tablet - -
Glukosa Larutan Infus 5%-500 ml
34 Botol 2 - 2 - 2
Hidrokortison Cream 2,5%
35 Tube 6 - 6 2 4
Ibuprofen 200 mg
36 Tablet - -
Ibuprofen 400 mg
37 Tablet 70 - 70 40 30
Ibuprofen syrup
38 Botol - -
Infusion Set anak
39 Pcs - -
Infusion Set Dewasa
40 Pcs 4 - 4 - 4
IV Cateter No. 18
41 Pcs 5 - 5 - 5
IV Cateter No. 20
42 Pcs 4 - 4 - 4
IV Cateter No. 22
43 Pcs - -
IV Cateter No. 24
44 Pcs - -
Kalsium Laktat (Kalk) 500 mg
45 Tablet 374 - 374 140 234
Kapas Pembalut/Absorben 100 mg
46 Pcs - -
Kapas Pembalut/Absorben 250 mg
47 Pcs - -
Karbogliserin tetes Telinga
48 Botol - -

49 Kasa hidrofile 3yard X 10cm Pcs 10 - 10 - 10

Kasa Pembalut Hidrofil 4 m x 10 cm
50 Pcs - -
Kloramfenicol Salep Kulit
51 Tube - -
Kloramfenicol Salep Mata 1%
52 Botol 1 - 1 - 1
Kloramfenicol Susp 125 mg
53 Botol - -
Kloramfenicol Tetes Telinga
54 Botol 4 - 4 1 3
Klorfeniramin Maleat (CTM) 4 mg
55 Tablet - -
Kotrimoksazol Anak
56 Tablet - -
Kotrimoksazol Doen 480 mg
57 Tablet 130 - 130 - 130
Kotrimoksazol Susp
58 Botol 5 - 5 - 5
Lidocain Compositum inj
60 Ampul 4 - 4 - 4
Magnesium Sulfat inj 20%
61 Botol - -
Magnesium Sulfat inj 40%
62 Botol - -
 Metilergometrin Maleat inj
63 Ampul 5 - 5 - 5
Metilergometrin Maleat
64 Tablet 60 - 60 - 60
Metronidazol 250 mg
65 Tablet - -
Metronidazol 500 mg
66 Tablet 120 - 120 - 120

67 Metronidazol Sirup Botol - -

Nasal Oksigen, Canula "M"
68 Pcs - -
Nasal Oksigen, Canula "L"
69 Pcs 1 - 1 - 1
Natrium Bikarbonat 500 mg
70 Tablet 100 - 100 - 100
Natrium Klorida Lar. Infus 0,9%
71 Botol 1 - 1 - 1
Nistatin vaginal 100.000 IU/g
72 Tablet - -
Obat Batuk Hitam (OBH) 100 ml
73 Botol - -
OBH Plus
74 Botol - -

75 Oksigen Nasal cannula (CHILD) Pcs - -

76 Oksigen Nasal cannula L (Adult) Pcs - -

Oksitetrasiklin HCL 3% Salep Kulit
77 Tube - -
Oksitetrasiklin HCL Salep Mata
78 Tube - -
Oksitosin inj 10 ml
79 Ampul - -
Papaverin
80 Tablet - -
Parasetamol 500 mg
81 Tablet 424 - 424 384 40
Parasetamol Drops
82 Botol 3 - 3 - 3
Parasetamol Syrup 120 mg
83 Botol 10 - 10 4 6
Phytomenadione (Vit K) 10 mg
84 Tablet - -
Phytomenadione (Vit K) Inj
85 Ampul 5 - 5 - 5

86 Povidon 10%- 60 ml Botol - -

Povidone Iodine 10% - 30 ml
87 Botol - -
Prednison 5 mg
88 Tablet 100 - 100 10 90
Ringer Laktat Larutan Infus
90 Botol 3 - 3 - 3
Salbutamol 2 mg
91 Tablet 36 - 36 - 36
Salep 24 Kombinasi 2%
92 POT 5 - 5 - 5
Salisil Bedak 2% - 50 gr
93 Pcs 5 - 5 3 2
Sarung Tangan No. 6,5 Steril
94 Pcs - -
Sarung Tangan No. 7 non Steril
95 Pcs - -
Sarung Tangan No. 7 Steril
96 Pcs 5 - 5 - 5
Sarung Tangan No. 7,5 non Steril
97 Pcs - -
Sarung Tangan No. 7,5 Steril
98 Pcs - -
Sarung Tangan Non Steril
99 Pcs - -
100 Sarung Tangan Obgyn Steril Pcs - -

101 Sarung tangan steril Psg - -

Sulfasetamid Tetes Mata
102 Botol - -
Tablet Tambah Darah
103 Tablet 900 - 900 240 660
Umbilical Cord Clamp
104 Pcs 2 - 2 - 2
Vitamin B Complek
105 Tablet 264 - 264 91 173
Vitamin B1 (Thiamin)
106 Tablet 204 - 204 60 144
Vitamin B12 (Cyanocobalamine)
107 Tablet 104 - 104 50 54
Vitamin B6 (Pyridoxine)
108 Tablet 100 - 100 - 100

109 Vitamin B6 25 mg Tablet - -

Vitamin C (Asam Askorbat) 50 mg
110 Tablet 83 - 83 - 83

111 Vitamin C 250 mg Tablet - -

112 Vitamin C 500 MG Tablet - -

Zink
113 Tablet 100 - 100 - 100

- -

- -

- -

- -

- -

Tanjungkerta, 31 Januari 2023

Mengetahui,

Kepala UPTD Puskesmas Tanjungkerta Petugas Pelaksana Polindes

Abu Bakar Sidik, SKM Mira Huzaimah K, AM.Keb

NIP. 19830224 200604 1 003 NIP. 19890725 201704 2 004

KET

9
 PEMERINTAH KABUPATEN SUMEDANG
DINAS KESEHATAN KABUPATEN SUMEDANG
UPTD PUSKESMAS TANJUNGKERTA
POLINDES TANJUNGMULYA

LAPORAN PEMAKAIAN OBAT POLINDES

Tanggal :

STOK PENERIM PERSEDI PEMAK SISA

NO NAMA OBAT SATUAN
AWAL AAN AAN AIAN STOK

1 2 3 4 5 6 7 8

1 Acetylcysteine 200 mg Tablet 12 - 12 12

Acyclovir Cream
2 Tube 5 - 5 5
Alat Suntik Sekali Pakai 1 ml
3 Syringe 6 - 6 6
Alat Suntik Sekali Pakai 2,5 ml
4 Syringe - - -
Alat Suntik Sekali Pakai 3 ml
5 Syringe 10 - 10 10
Alat Suntik Sekali Pakai 5 ml
6 Syringe - - -
Amoxisilin 500 mg
7 Tablet 139 - 139 139
Amoxisilin Kapsul 250 mg
8 Kapsul - - -
Amoxisilin Syrup 125 mg/ml
9 Botol 13 - 13 13

10 Amoxisilin syrup Forte 250mg/ml Botol - - -

Antalgin (Metampiron) 500 mg
11 Tablet 160 - 160 160
Antasida Doen Suspensi
12 Buah - - -
Antasida Doen Tablet
13 Tablet 118 100 218 218
Antifungi Doen Kombinasi
14 Pot - - -
Asam folat Tablet/Kaplet/Kapsul
15 Tablet - - -
Asam Mefenamat 500 mg
16 Tablet 80 - 80 80
Bethametasone Cream 0,1%
17 Tube 9 - 9 9

18 Bundavin Tablet - - -
Captopril 12,5 mg
19 Tablet 124 - 124 124
Captopril 25 mg
20 Tablet - - -
Catgut Chromic 2/0 100m
21 Pcs - - -

22 Dekstrofen Sirup Botol - - -

Dexamethason 0,5 mg
23 Tablet 14 - 14 14

24 Dopamet/ Metildopa Tablet 50 - 50 50

 Ethanol 70% 1 Liter
25 Botol - - -
Ethanol 70% 100 ml
26 Botol - - -
Garam Oralite
27 Sachet - - -
Gentamicin Salep Kulit
28 Tube - - -
Gentamicin Salep Mata
30 Tube 6 - 6 6
Gentamicin Tetes Mata 0,3%
31 Botol 7 - 7 7
Gentian Violet Larutan 1%-10 ml
32 Botol - - -
Gliseril Guayakolat 100 mg
33 Tablet - - -
Glukosa Larutan Infus 5%-500 ml
34 Botol 2 - 2 2
Hidrokortison Cream 2,5%
35 Tube 4 - 4 4
Ibuprofen 200 mg
36 Tablet - - -
Ibuprofen 400 mg
37 Tablet 30 100 130 130
Ibuprofen syrup
38 Botol - - -
Infusion Set anak
39 Pcs - - -
Infusion Set Dewasa
40 Pcs 4 - 4 4
IV Cateter No. 18
41 Pcs 5 - 5 5
IV Cateter No. 20
42 Pcs 4 - 4 4
IV Cateter No. 22
43 Pcs - - -
IV Cateter No. 24
44 Pcs - - -
Kalsium Laktat (Kalk) 500 mg
45 Tablet 234 - 234 234
Kapas Pembalut/Absorben 100 mg
46 Pcs - - -
Kapas Pembalut/Absorben 250 mg
47 Pcs - - -
Karbogliserin tetes Telinga
48 Botol - - -

49 Kasa hidrofile 3yard X 10cm Pcs 10 - 10 10

Kasa Pembalut Hidrofil 4 m x 10 cm
50 Pcs - - -
Kloramfenicol Salep Kulit
51 Tube - - -
Kloramfenicol Salep Mata 1%
52 Botol 1 - 1 1
Kloramfenicol Susp 125 mg
53 Botol - - -
Kloramfenicol Tetes Telinga
54 Botol 3 - 3 3
Klorfeniramin Maleat (CTM) 4 mg
55 Tablet 100 100 100
Kotrimoksazol Anak
56 Tablet - - -
Kotrimoksazol Doen 480 mg
57 Tablet 130 - 130 130
Kotrimoksazol Susp
58 Botol 5 - 5 5
Lidocain Compositum inj
60 Ampul 4 - 4 4
Magnesium Sulfat inj 20%
61 Botol - - -
Magnesium Sulfat inj 40%
62 Botol - - -
 Metilergometrin Maleat inj
63 Ampul 5 - 5 5
Metilergometrin Maleat
64 Tablet 60 - 60 60
Metronidazol 250 mg
65 Tablet - - -
Metronidazol 500 mg
66 Tablet 120 - 120 120

67 Metronidazol Sirup Botol - - -

Nasal Oksigen, Canula "M"
68 Pcs - - -
Nasal Oksigen, Canula "L"
69 Pcs 1 - 1 1
Natrium Bikarbonat 500 mg
70 Tablet 100 - 100 100
Natrium Klorida Lar. Infus 0,9%
71 Botol 1 - 1 1
Nistatin vaginal 100.000 IU/g
72 Tablet - - -
Obat Batuk Hitam (OBH) 100 ml
73 Botol - - -
OBH Plus
74 Botol - - -

75 Oksigen Nasal cannula (CHILD) Pcs - - -

76 Oksigen Nasal cannula L (Adult) Pcs - - -

Oksitetrasiklin HCL 3% Salep Kulit
77 Tube - - -
Oksitetrasiklin HCL Salep Mata
78 Tube - - -
Oksitosin inj 10 ml
79 Ampul - - -
Papaverin
80 Tablet - - -
Parasetamol 500 mg
81 Tablet 40 100 140 140
Parasetamol Drops
82 Botol 3 - 3 3
Parasetamol Syrup 120 mg
83 Botol 6 - 6 6
Phytomenadione (Vit K) 10 mg
84 Tablet - - -
Phytomenadione (Vit K) Inj
85 Ampul 5 - 5 5

86 Povidon 10%- 60 ml Botol - - -

Povidone Iodine 10% - 30 ml
87 Botol - - -
Prednison 5 mg
88 Tablet 90 - 90 90
Ringer Laktat Larutan Infus
90 Botol 3 - 3 3
Salbutamol 2 mg
91 Tablet 36 - 36 36
Salep 24 Kombinasi 2%
92 POT 5 - 5 5
Salisil Bedak 2% - 50 gr
93 Pcs 2 - 2 2
Sarung Tangan No. 6,5 Steril
94 Pcs - - -
Sarung Tangan No. 7 non Steril
95 Pcs - - -
Sarung Tangan No. 7 Steril
96 Pcs 5 - 5 5
Sarung Tangan No. 7,5 non Steril
97 Pcs - - -
Sarung Tangan No. 7,5 Steril
98 Pcs - - -
Sarung Tangan Non Steril
99 Pcs - - -
100 Sarung Tangan Obgyn Steril Pcs - - -

101 Sarung tangan steril Psg - - -

Sulfasetamid Tetes Mata
102 Botol - - -
Tablet Tambah Darah
103 Tablet 660 - 660 660
Umbilical Cord Clamp
104 Pcs 2 - 2 2
Vitamin B Complek
105 Tablet 173 - 173 173
Vitamin B1 (Thiamin)
106 Tablet 144 - 144 144
Vitamin B12 (Cyanocobalamine)
107 Tablet 54 - 54 54
Vitamin B6 (Pyridoxine)
108 Tablet 100 - 100 100

109 Vitamin B6 25 mg Tablet - - -

Vitamin C (Asam Askorbat) 50 mg
110 Tablet 83 - 83 83

111 Vitamin C 250 mg Tablet - - -

112 Vitamin C 500 MG Tablet - - -

Zink
113 Tablet 100 - 100 100

- -

- -

- -

- -

- -

Tanjungkerta,

Mengetahui,

Kepala UPTD Puskesmas Tanjungkerta Petugas Pelaksana Polindes

Abu Bakar Sidik, SKM Mira Huzaimah K, AM.Keb

NIP. 19830224 200604 1 003 NIP. 19890725 201704 2 004

 Isi sisa stok saja
KET