Lplpo 2023 (LB 2)

Formulir 16
LAPORAN BULANAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
Kode : Bulan JANUARI
Puskesmas Labuhan Ratu Tahun 2023
No NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN

1 3 4 5 6 7=5+6 8
1 ACT ( Artesunete & Amodiaquin ) Tab - 0 0
2 Acyclovir 200 mg Tab - 0 0
4 Acyclovir Zalf Tube 25 25 10
5 ADS 1 ml set - 0 0
6 Alat Pelindung Diri untuk penyemprot set - 0 0
7 Alat Suntik sekali pakai 0.05 ml set 200 200 0
9 Alat Suntik sekali pakai 1 ml set 600 600 200
10 Alat suntik sekali pakai 10 ml set 85 85 0
11 Alat suntik sekali pakai 2.5 ml set - 0 0
14 Albendazol 400 mg tablet 4,887 4887 0
15 Albendazole syr btl - 0 0
16 Alkohol Swab sachet - 14 14 14
17 Alkohol Swab kotak 307 307 10
18 Allopurinol tablet 100 mg tablet 500 500 300
19 Alprazolam 0,5 mg tablet - 0 0
20 Ambroxol 30 mg tablet - 0 0
21 Ambroxol syrup botol - 0 0
22 Aminofillin inj 24 mg/ml - 10ml ampul - 0 0
23 Aminofillin tablet 200 mg tablet - 0 0
24 Amitriptilin 25 mg tablet - 0 0
25 Amlodipin 10 mg tablet 4,800 4800 700
27 Amoxicillyn 500 mg tablet 3,200 3200 1800
28 Amoxicillyn sirup kering 125 mg/5 ml botol 248 248 0
29 Amoxicillyn sirup kering 250 mg/5 ml botol - 0 0
30 Amoxiclav (Amoxicillyn+As. klavulanat 625 mg tablet - 0 0
31 Ampicillin injeksi ampul - 0 0
32 Antasida doen suspensi botol - 0 0
33 Antasida doen tablet kombinasi tablet 1,700 1700 1400
34 Antibakteri doen salep topikal tube - 0 0
35 Antifungi doen kombinasi pot 96 96 0
36 Antihaemoroid ( Bismuth Subgallate ) suppos 25 25 25
37 Antimigrain doen kombinasi tablet - 0 0
38 Antiparkinson tab ( Levopar ) tab - 0 0
39 Antispasme Tablet ( Hiopar ) tablet - 0 0
40 Aqua pro injeksi steril bebas pirogen botol - 0 0
41 Artemeter inj ampul - 0 0
42 Arterakine ( anti malaria ) tablet - 0 0
43 Artesunat inj ampul - 0 0
44 Asam Asetilsalisilat tab 100 mg (Aspilet) tablet - 0 0
45 Asam Asetilsalisilat tab 80 mg tablet 300 300 300
46 Asam askorbat (vit c) tablet 50 mg tablet 900 1000 1900 1700
47 Asam Askorbat (vit c) tablet 250 mg tablet - 0 0
48 Asam Askorbat (vit c) tablet 500 mg tablet 2,100 2100 400
49 Asam Folat tablet 2,000 2000 500
50 Asam mefenamat 250 mg tablet - 0 0
51 Asam mefenamat 500 mg tablet 1,100 1,000 2100 1400
52 Asam Pipemidic kaps kapsul - 0 0
53 Asam Traneksamat inj ampul - 0 0
54 Asam Tranexamat 250 mg tablet - 0 0
55 Asam Tranexamat 500 mg tablet 400 400 100
56 Atenolol tab 50 mg tablet - 0 0
57 Atripla ktk - 0 0
58 Atropin sulfat 0,5 mg tablet - 0 0
59 Atropin sulfat 1 % ( Cendotropin tts mata ) botol - 0 0
60 Atropin sulfat injeksi 0,25 mg/ml-1ml vial - 0 0
61 Azithromycin 250 mg tablet - 0 0
62 Azytromycin 500 mg tablet 140 140 40
63 Bactivec btl - 0 0
64 Baju Pelindung Biru pcs - 0 0
65 Baju Pelindung Putih pcs - 0 0
66 BD Vactnr Flashback Blood Collc Needle pcs - 0 0
67 Benzatin Benzil Penisillin 1,2 jt iu/vial Inj vial - 0 0
68 Benzatin Benzil Penisillin 2,4 jt iu/vial Inj vial 2 2 0
69 Betahistin Mesilat 6 mg tablet 600 600 100
70 Betamethasone + Neomycin krim tube - 0 0
71 Betamethasone krim 0,1 % tube 17 17 17
72 Bisoprolol 5 mg tablet - 0 0
73 Blood Lancet ktk 294 294 6
74 Borax Gliserin (GOM) pot 52 52 18
75 Box Slide pcs - 0 0
76 Bromhexin syr botol - 0 0
77 Budesonide Liquid ( Pulmicort Respiration ) botol - 0 0
78 Budesonide Spray ( Simbicort Turbohaler ) botol 45 45 7
79 Calcium Carbonate 500mg+Vit D100iu ( Calporos tablet - 0 0
80 Calcetin calcium Hydroxide Paste box 0 0 0
81 Calcium Gluconate 100mg/ml im/iv botol - 0 0
82 Cal lc - 0
83 Cal Plus - 0
84 Calcium Lactate 500 mg tablet 1,600 1600 1200
85 Camphenol dus - 0 0
86 Candasartan tab tab - 0 0
87 Captopril 12,5 mg tablet 2,200 2200 200
88 Captopril 25 mg tablet - 0 0
89 Catgut chromic 2/0 set - 0 0
91 Catgut plain 2/0 set - 0 0
93 Cavit G - 0
94 Cavit W - 0
95 Cefadroxil 125 mg Syr botol 168 168 0
96 Cefadroxil 500 mg tablet - 0 0
97 Cefixim 100 mg tablet - 0 0
98 Cefixim kaps 200 mg kapsul 1,200 1200 450
99 Cefixim Syr 100 mg / 5 ml botol 50 50 0
100 Cefotaxim inj vial - 0 0
101 Ceftriaxon inj vial - 0 0
102 Cetirizin syr 5 mg / 5 ml botol 250 250 0
103 Cetrizin tab 10 mg tablet 7,900 7900 1100
104 Ciprofloxacin Tab 500 mg tablet 1,400 1400 700
105 Clindamycin 150 mg kap tablet - 0 0
106 Clindamycin 300 mg kap tablet 350 350 100
107 Cover Glass ktk - 0 0
108 Cream Luka Bakar tube - 0 0
109 Cresotin Liquid No. 2 btl - 0 0
110 Darflex / DHP ( dihydro artemisin ) tablet 9 9 0
111 Deksametason inj 5 mg/ml - 1 ml ampul 5 5 0
112 Deksametason tablet 0,5 mg tablet - 0 0
113 Desinfectan C / Lisol botol 4 4 0
114 Devitalisasi pasta (non arsen) botol - 0 0
115 Diazepam 2 mg tab tablet 16 16 13
116 Diazepam 5 mg tab tablet - 0 0
117 Diazepam inj 5 mg/ml - 2 ml ampul - 0 0
118 Diazepam rectal suppos 3 3 0
119 Dietilkarbamazepin tablet - 0 0
120 Difenhidramin hcl inj 10 mg/ml - 1 ml ampul - 0 0
121 Diflucan tab tab - 0 0
122 Digoksin tablet 0,25 mg tablet - 0 0
123 Diltiazem 30 mg tablet - 0 0
124 Disposible Needle set - 0 0
125 Doksisiklin 100 mg tablet - 0 0
126 Domperidon syr botol - 0 0
127 Domperidon Tab 10 mg tablet 500 500 500
128 Duviral ktk - 0 0
129 Efavirenz ktk - 0 0
130 Ekstrak Placenta Kombinasi (Bioplacenton) Gel tube - 0 0
131 Ekstrak belladon tablet 10 mg tablet - 0 0
132 Emersi Oil botol - 0 0
133 Epinefrin hcl/bitatrat (adrenalin) inj 0,1 % - 1 ml ampul - 0 0
134 Erithromycin 250 mg tablet - 0 0
135 Erithromycin 500 mg tablet 200 200 200
136 Erithromycin syr botol 10 10 0
137 Etakridin (rivanol) larutan 0,1 % botol 22 22 8
138 Etanol 70 % ( 100 ml ) botol - 0 0
139 Etanol 70 % ( 300 ml ) botol 0 0 0
140 Etanol 70 % ( 1000 ml ) botol 16 16 1
141 Ethambutol 250 mg Tab tablet - 0 0
142 Etil klorida semprot botol 1 2 3 0
143 Eugenol cairan botol - 0 0
144 FDC Anak ktk - 0 0
145 Fenitoin natrium kapsul 100 mg kapsul - 0 0
146 Fenobarbital inj ampul - 0 0
147 Fenobarbital tablet 30 mg tablet 300 300 0
148 Fitomenadion (vit k) injeksi 10 mg/ml - 1 ml ampul - 0 0
149 Fitomenadion (vit k) tablet salut 10 mg tablet - 0 0
150 Flukonazol tab tab - 0 0
151 Focus Syphylis Cassette test - 0 0
152 Furosemid inj ampul - 0 0
153 Furosemid tablet 40 mg tablet - 0 0
154 Gabapentin tab - 0 0
155 Garam oralit untuk 200 ml air sachet 4,900 4900 400
156 Gentamisin inj 80 mg / 2ml ampul - 0 0
157 Gentamisin salep kulit tube - 0 0
158 Gentamicin salep mata tube 96 96 0
159 Gentamisin tetes mata 0.3% botol 166 166 0
160 Gentian violet larutan 1 % botol - 0 0
161 Glass ionomer cement (gc ix) botol - 0 0
162 Glibenklamid tablet 5 mg tablet 1,600 1600 300
163 Gliklazide 80 mg tab tablet - 0 0
164 Glimepirid 3 mg tablet - 0 0
165 Glimepirid tab 2 mg tab - 0 0
166 Gliseril guayakolat tablet 100 mg tablet - 0 0
167 Glukosa Cairan infus 10 % steril botol - 0 0
170 Griseofulvin tablet 125 mg, micronized tablet 100 100 0
171 Halloperidol 1,5 mg tablet - 0 0
172 Halloperidol 5 mg tablet - 0 0
173 Halloperidol inj. ampul - 0 0
174 Hands Rub gel btl 41 41 2
175 Handscoon Latex ( powder gloves ) set - 0 0
176 Handscoon Non Steril psg 250 1,000 1250 650
177 Handscoon Steril psg 150 150 0
178 Hidroklortiazid 25 mg ( HCT ) tablet - 0 0
179 Hidrokortison krim 1 % tube - 0 0
180 Hidrokortison krim 2,5 % tube 72 72 19
181 Hufagripp Forte tab tab - 0
182 Hydcal Paste, base dan Catalyst dus - 0 0
183 I.V.Cateter (abbocath) 18 set - 0 0
184 I.V.Cateter (abbocath) 20 set 4 4 0
188 Ibuprofen 200 mg tablet tablet - 0 0
190 Ibuprofen susp 100 mg btl - 0 0
192 Ichtyol salep botol 17 17 0
193 Infusion set anak set 1 1 0
194 Infusion set dewasa set - 0 0
195 INH 100 mg tablet - 0 0
196 INH 300mg tablet 390 390 20
197 Inhaler Berotec botol - 0 0
198 Isosorbid dinitrat tablet sublingual 5 mg tablet - 0 0
199 Jarum kulit lusin - 0 0
200 Jarum otot lusin - 0 0
201 Kalium aspartat (Aspar-K) tablet - 0 0
202 Kapas 100 gr roll - 0 0
203 Kapas pembalut 250 gr roll 14 14 0
204 Karbamazepin 200 mg tablet - 0 0
205 Kassa 4 m x 15 cm roll 30 30 30
206 Kassa 4 x 10 roll - 0 0
207 Kassa 40 x 80 cm roll - 0 0
208 Kassa / Perban elastis kotak - 0 0
209 Kassa 15 cm x 3 roll - 0 0
210 Kassa 36 x 80 cm roll - 0 0
211 Kassa Steril kotak 23 23 0
212 Kassa Steril + Antibiotik ( Cuticell ) pieces 10 10 5
213 Kassa Steril + Antibiotik ( Lomattul ) pieces - 0 0
214 Ketokonazole 200 mg tablet 300 300 100
215 Ketokonazole krim tube 54 54 28
216 Ketoprofen 100 mg tablet - 0 0
217 Ketoprofen inj ampul - 0 0
218 Ketorolac inj ampul - 0 0
219 Klonidin 0.5 mg tablet - 0 0
221 Kloramfenicol salep kulit 2% tube 65 65 46
222 Kloramfenicol kapsul 250 mg kapsul - 0 0
223 Kloramfenicol salep mata tube - 0 0
224 Kloramfenicol syrup 125mg/5ml botol - 0 0
225 Kloramfenicol tetes mata botol - 0 0
226 Kloramfenicol tetes Telinga 3% botol 45 45 5
227 Kloramfenikol kapsul 500 mg kapsul - 0 0
228 Klorfeniramin maleat ( CTM ) tablet 4 mg tablet 2,880 2880 1020
229 Klorokuin fosfat tablet 250 mg tablet 20 20 0
230 Klorpromazin 100 mg ( CPZ ) tablet - 0 0
231 Kombipak Azithromicin paket - 0 0
232 Kondom pcs 144 144 0
233 Kotrimoxazol dewasa 480 mg tablet 1,000 1000 100
234 Kotrimoxazol paed 120 mg tablet - 0 0
235 Kotrimoxazol suspensi botol 50 50 0
236 Kuinina 200 mg tablet - 0 0
237 Kuinina Hcl inj 25% - 2 ml ampul - 0 0
238 Lab Anti A Monoclonal Gol Darah vial - 0 0
239 Lab Anti B Monoclonal Gol Darah vial - 0 0
240 Lab Salmonella Paratyphi AO Widal Test vial - 0 0
241 Lab Salmonella Paratyphi BO Widal Test vial - 0 0
242 Lab Salmonella Typhi H Widal Test vial - 0 0
243 Lab Salmonella Typhi O Widal Test vial - 0 0
244 Lamivudin tab ktk - 0 0
245 Lansoprazole 30 mg tablet 1,550 1550 600
246 Larutan benedict botol - 0 0
247 Larutan eosin 2 % botol - 0 0
248 Larutan etanol asam botol - 0 0
249 Larutan giemsa stain botol - 0 0
250 Larutan H2O2 botol 4 4 2
251 Larutan karbol fuksin botol - 0 0
252 Larutan metilen biru botol - 0 0
253 Larvasida cairan ( Cynof 1 liter ) liter - 0 0
255 Larvasida serbuk ( abatte 1 kg ) kg - 0 0
256 Larvasida serbuk ( abatte 25 kg ) galon - 0 0
257 Laxatif enema tube - 0 0
258 Laxatif suppositoria (Bisacodil supp) suppos 22 22 0
259 Laxatif tablet (Bisacodil tab) tablet 16 16 0
260 Levertran salep pot - 0 0
261 Levofloxacin tab tab - 0 0
262 Levotyroxin sodium ( Natrium Tyroxin ) tablet - 0 0
263 Lidokain kompositum injeksi (pehacain) ampul - 0 0
264 Loperamid HCL 2 mg tablet - 0 0
265 Loratadine 10 mg tablet 400 400 0
266 Lorazepam tablet - 0 0
267 Magnesium sulfat injeksi (iv) 20 % - 25 ml botol - 0 0
269 Marker pen pcs - 0 0
270 Masker Hijau pieces 1,600 1,500 3100 400
271 Masker N.95 pieces - 0 0
272 Masker Nebul Anak set - 0 0
273 Masker Nebul Dewasa set - 0 0
274 Masker Sugiral pieces - 0 0
275 Masker With Visor pieces - 0 0
276 Meloxicam 7,5 mg tablet 2,520 2520 570
277 Mesin Centrifuge set - 0 0
278 Metampiron 500 mg ( antalgin ) tablet - 0 0
279 Metformin 500 mg tablet 2,800 2800 800
280 Metformin 850 mg tablet - 0 0
281 Methylprednisolone 4 mg tablet 1,800 1800 1600
282 Methylprednisolone 8 mg tablet - 0 0
283 Methylprednisolone inj ampul - 0 0
284 Metilergometrin maleat inj 0,200 mg - 1 ml ampul - 0 0
285 Metilergometrin Maleat tab tablet - 0 0
286 Metoklopramide inj 5mg/ml ampul - 0 0
287 Metoklopramide tab tablet - 0 0
288 Metronidazol 250 mg tablet - 0 0
290 Metronidazol infus botol - 0 0
291 Miconazol krim tube 24 24 0
292 Mikropipet pcs - 0 0
293 Mineral Mix sachet - 0 0
294 Mirapect tab 30 mg tab - 0 0
295 Multivitamin + zat besi (Siobion) tablet - 0 0
296 Multivitamin drop botol - 0 0
297 Multivitamin Kombinasi Syrup botol - 0 0
298 Multivitamin kombinasi tab tablet - 0 0
299 Mummifying pasta botol - 0 0
300 Mycamine 50 mg tablet - 0 0
301 Nasal Oxygen adult set - 0 0
302 Nasal Oxygen child set - 0 0
303 Natrium Bikarbonat tablet 500 mg tablet 400 400 100
304 Natrium Diklofenak 25 mg tab tablet - 0 0
305 Natrium Diklofenak 50 mg tab tablet 1,800 1800 1000
306 Natrium Diklofenak Gel tube - 0 0
307 Natrium Klorida Cairanan infus 0,9 % steril botol 16 16 6
308 Natrium Walfarin 2 mg ( Simarc ) tablet - 0 0
309 Needle set - 0 0
310 Neurotropik inj / Neurobion inj ampul - 0 0
311 Neurotropik tablet / Miraneuro tablet - 0 0
312 Nevirafine ktk - 0 0
313 Nifedifine 10 mg ( Farmalat ) tablet - 0 0
314 Nistatin 100.000 UI Vaginal suppos 125 125 0
315 Nistatin 500.000 UI Oral tablet - 0 0
316 Nitrile Examination Glove box - 0 0
317 OAT Kategori Anak paket - 4 4 4
318 OAT Kategori I paket 11 16 27 5
319 OAT Kategori II paket 0 0 0
320 OAT Kategori Sisipan paket - 0 0
321 OAT Kombipak kategori I paket - 0 0
322 Obat diare kombinasi tab tablet - 0 0
323 Obat diare syrup botol - 0 0
324 Obat Herbal ( penambah ASI ) tablet - 0 0
325 Obat Kusta MB Anak bister - 0 0
326 Obat Kusta MB Dewasa bister - 3 3 1
327 Obat Kusta PB Anak blister - 0 0
328 Obat Kusta tipe PB ( dewasa ) blister - 0 0
329 Oksitetrasiklin HCL inj 50 mg/ml ampul - 0 0
330 Oksitetrasiklin HCL salep Kulit 3% tube - 0 0
331 Oksitetrasiklin HCL salep mata tube - 0 0
332 Oksitosin injeksi 10 iu/ml - 1 ml ampul 2 2 0
333 Omeprazol 20 mg kaps tablet 150 150 150
334 Omeprazol Inj ampul - 0 0
335 Ondansetron inj ampul 5 5 1
336 Ondansetron tab tablet 780 780 240
337 Oxyflow Anak pcs - 0 0
338 Oxyflow Dewasa pcs - 0 0
339 Parasetamol Drop 100 mg/ml botol - 0 0
340 Parasetamol syrup 120 mg / 5 ml botol 314 314 0
341 Parasetamol tablet 500 mg tablet 4,300 4300 3000
342 Pasaba Cough & flu susp btl - 0 0
343 PCT, CTM, GG, EFED ( syrup ) botol - 0 0
344 PCT, CTM, GG, EFED ( Coparcetin ) tablet - 0 0
345 Pehavral Tablet Salut Gula (Suplemen makanan) pcs - 0 0
346 Perak sulfat ( Burnazin cream ) botol 28 28 8
347 Permethrin 5 % ( Scabies cream ) pot 110 110 20
348 Pharmacoll Thick 10cm x 10 cm buah - 0 0
349 Pharmafix buah - 0 0
350 Phenol Gliserol tetes telinga btl - 0 0
351 Pirantel score (base) 125 mg tablet 100 100 0
352 Pirantel syrup 125 mg / 5 ml botol - 0 0
353 Piridoksin HCL tablet ( Vit B6 ) tablet 3,200 3200 1000
354 Piroksikam 10 mg tablet - 0 0
356 Pisau bisturi pieces - 0 0
357 PK / Serbuk anti septik pot - 0 0
358 Plester ( medical adhesive tape ) roll - 0 0
359 Plester ( Ultrafik ) roll 17 17 2
360 Plester Bulat non woven Kotak - 0 0
361 Plester in Bulat T 100 E Cat ktk - 0 0
362 Plester Microfore roll - 0 0
363 Poley Balon cateter no 16 set - 0 0
365 Poliren No. 1 Polishing Paste box - 0 0
366 Postofix - PU 6 cm x 7 cm buah - 0 0
367 Pot Sputum pot 260 300 560 260
368 Prednison tablet 5 mg tablet 4,150 4150 150
369 Primakuin tablet 15 mg tablet 30 30 0
370 Procain Benzil Penisilin inj ampul - 0 0
371 Profil Tio Urasil tablet 100 mg tablet - 0 0
372 Propanolol hcl tablet 10 mg tablet - 0 0
374 Pyridoksin tab 25 mg tab - 0 0
375 Ranitidin inj ampul - 0 0
376 Ranitidin tab tablet 3,200 3200 400
377 Rapid test pieces - 0 0
378 Rapid test Spillis pieces - 0 0
379 RDT Anti HCV test - 25 25 25
380 RDT DBD pieces - 0 0
381 RDT HIV 1 ( Diagnostar ) test - 0 0
382 RDT HIV 1 ( KHB ) test - 0 0
383 RDT HIV 2 ( Focus ) test - 0 0
384 RDT Malaria pieces - 0 0
385 Reagen Bead Control CD4 PIMA test - 0 0
386 Reagen CD4 Mobile Mesin PIMA test - 0 0
387 Reagen tes kehamilan box - 0 0
388 Reagent Colesterol test - 0 0
389 Reagent Glukosa test 384 384 14
390 Reagent HIV - intec test - 0 0
391 Reagent HIV - oncoprobe test - 0 0
392 Reagent HIV - vikia test - 0 0
393 Reagent Rapid tes HBSAG test - 500 500 50
394 Reagen SD-HIV (SD BIOLINE) test - 0 0
395 Reagent Tes Urin test - 0 0
396 Reagent Typoid test - 0 0
397 Reagent Uric Acid test - 0 0
398 Reagent Ziehlneelsen botol 4 4 0
399 Reserpin 0.1 mg Tab tablet - 0 0
401 Resperidon tab tab - 0 0
402 Retinol 100.000iu kap tablet 1,500 1500 0
404 Rilpivirine ktk - 0 0
405 Ringer Laktat Cairan infus steril botol 3 3 0
406 RPR Antigen Syphilis Fokus test - 0 0
407 Sabun Antiseptik botol 12 12 8
408 Safety Box pcs 33 33 3
409 Salbutamol 2 mg tablet 100 100 100
410 Salbutamol inhaler set 8 8 1
411 Salbutamol nebules set - 0 0
412 Salep 2-4 kombinasi pot 13 13 0
413 Salisil bedak 2 % ktk 42 42 18
414 Serum anti bisa ular polivalen inj 5 ml (abu i) ampul - 0 0
415 Serum anti tetanus inj 1.500 iu/ampul (a.t.s) ampul 25 25 1
416 Sianokobalamin (vit B 12) inj 500 mcg/ml ampul - 0 0
417 Silk (benang bedah sutera) No 3/0 pieces - 0 0
418 Simvastatin 10 mg tablet - 0 0
419 Simvastatin 20 mg tablet 1,500 1500 600
420 Slide / Glass object Kotak - 0 0
421 Spalk kayu set 3 3 0
422 Spironolactone 25 mg tablet - 0 0
424 Stera Sharp Container 1L pcs - 0 0
425 Sukralfat susp 100 mg btl 89 89 0
426 Sulfasetamid Natrium tetes mata 15 % botol - 0 0
427 Surgical Optime pcs - 0 0
428 Tablet tambah darah kombinasi tablet 194,300 109,800 304100 6600
429 Tehnodent Antiseptik Liquid No. 2 btl - 0 0
430 Tenovofir ktk - 0 0
431 Tenovofir + Emtracitabine ktk - 0 0
432 Thiamfenicol tab 250 mg tablet - 0 0
434 Thiamin inj 100 mg/ml ampul - 0 0
435 Thiamin tab (vit B1) tablet 1,600 1600 400
436 Tramadol Hidrocloride 50 mg tablet - 0 0
437 Tramadol inj ampul - 0 0
438 Tranfusion set set - 0 0
439 Tricresolformalina dus - 0 0
440 Trihexiphenidil 2 mg tablet - 0 0
441 Tuberkulin PPD RT 23 SSI vial 5 5 0
442 Tyrozol tab tab - 0 0
443 Underpad pcs - 0 0
444 Urine Bag set 2 2 0
445 Urocare Folley cath. No 16 set - 0 0
447 Vaccum Tube Steril EDTA pack - 0 0
448 Vaksin Anti Rabies ampul 4 4 8 7
449 Vaksin BCG ampul 30 15 45 24
450 Vaksin Campak ampul - 0 0
451 Vaksin DPT-HB Combo ampul 30 20 50 35
452 Vaksin DT ( adsorbed ) ampul 10 10 0
453 Vaksin Hepatitis B Imuno Globullin ampul - 2 2 2
454 Vaksin Hepatitis B uniject ampul 13 25 38 19
455 Vaksin IPV ampul 30 5 35 21
456 Vaksin Polio ampul 29 20 49 33
457 Vaksin TD ( difteri toxoid ) ampul 20 20 40 18
458 Vaksin TT ampul - 0 0
459 Vaksin Meningitis vial - 0 0
460 Vaksin MR ampul 32 10 42 28
461 Vitamin B 12 tablet tab 300 300 200
462 Vitamin B Compleks tablet - 1,000 1000 1000
463 Wing Nedle no 25 set - 0 0
465 Wrapping paper ktk - 0 0
466 Xylocain gel btl - 0 0
467 Xylocain Spray btl - 0 0
468 Yodium povidon 10% - 1000 ml botol - 0 0
469 Yodium povidon 10% - 30 ml botol 34 34 3
471 Yodium Povidon 60 ml btl - 0 0
472 Zidovudin tab ktk - 0 0
473 Zinc drop botol - 0 0
474 Zinc Sulphate 20 mg tablet 3,700 3700 400
475 Zinc syrup botol 108 108 0
476 Zink F dus - 0 0
477 Masker TB box 2,000 2000 0
478 ADS 0,5 ml (vaksin covid) pcs - 0 0
479 Alkohol Swab (Vaksin covid) sachet 54 54 54
480 Safety box (covid) pcs 21 21 1
481 Masker bedah pcs 1,300 1300 200
482 Larvasida btl - 0 0
483 FAVIPIRAVIR 200 mg tab 80 80 0
484 Objek glass malaria pcs - 0 0
485 Objek glass TB pcs 41 41 0
486 Masker KN95 pcs 1,573 1573 73
487 Masker N95 pcs 95 95 0
488 Oxygen Mask Dewasa pcs 3 3 0
489 Vaksin Moderna vial - 0 0
490 Vaksin Pfizer vial 9 9 9
491 Vaksin Aztrazeneka vial - 0 0
492 Spuit 0,3 ml (pfizer) pcs 54 54 54
493 Spuid 3 ml (pfizer) pcs 9 9 9
494 Diluent Dirui Galon - 0 0
495 Cleanser BCC 3600 btl - 0 0
496 Lyse BCC 3600 btl - 0 0
497 glimepiride 1 mg pcs 700 700 200
498 TDF+3TC+EFV(300/300/600)/TLE pcs 4 4 0
499 TDF(300)+3TC(300)+DTG(50)/TLD pcs 1 3 4 1
500 RDT HIV R1 (VIROCEK) pcs 1,200 1200 250
501 RDT Sifilis Trepocheck pcs 750 750 100
502 Oxygen Mask Anak tab 3 3 0
503 Lidocain inj amp 55 55 20
504 RDT HIV R2 (StandarQ) tab 25 25 0
505 RDT HIV R3 (Diagnostar) tab 25 25 0
506 Dolute gravir btl 2 2 0
507 Vitamin B6 25 mg tab 180 180 0
508 Kotrimoxazol 960mg tab 500 500 0
509 Lubrikan tab 100 100 0
510 Guaifenesin 100 mg tab 2,000 2000 1200
511 Vaksin PCV vial 12 12 8
512 Tabung EDTA pcs 300 300 100
513 Curcuma Force tab 1,440 1440 240
514 USG Gel btl 2 2 1
515 Tabung EDTA (steril HIV) 1 1 0
516 Cryotube 40 40 3
517 Microtrainer EDTA 10 10 0
518 Flashback Needle 22 G 30 30 3
519 Yellow Holder 30 30 1
520 Wings Needle 27G 2 2 0
521 Tip Pipet 1 ml (steril) 1 1 0
522 Plastik Clip 5x7cm 1 1 0
523 Plastik Clip 16x24cm 1 1 0
524 Ice Pack 8 8 0
525 Ice Gel 6 6 0
526 Lakban 1 1 0
527 Styrofoam 1 1 0
528 - 0
529 - 0
PEMBELIAN SENDIRI SATUAN
1 Acyclovir 5% cream tube 0 0
2 Abate Kg 0 0
3 Acyclovir 400 mg tab 200 200 200
4 Allopurinol tablet tab 0 0
5 Ambroxol syrup Btl 87 87 0
6 Ambroxol tab tab 2,300 2300 600
7 Amlodipin 10 mg tab 0 0
8 Amlodipin 5 mg Tab 0 0
9 Amoxicillin 500 mg Tab 0 0
10 Antasida tab tab 0 0
11 Asam Folat tab 300 300 0
12 Asam mefenamat 500 mg Tab 0 0
13 Asam urat strip ktk 0 0
14 Azithromycin 500 mg tab 0 0
15 Betahistin Mesilat (Lexigo) Tab 0 0
16 Catgut chromic 2/0 pcs 0 0
17 Catgut plain 3/0 pcs 10 10 1
18 Catheter pcs 0 0
19 Cefadroxil 500 mg tab 0 0
20 Cetirizin tab tab 0 0
21 Cholesterol strep ktk 6 10 16 9
22 Ciprofloxacin 500 mg tab 0 0
23 Cleanser pcs 1 1 1
24 Clindamicin cap 300 mg caps 0 0
25 CTM Tab 0 0
26 Cuticell pcs 0 0
27 Deksametason 0,5 mg Tab 0 0
28 Desinfectan ltr 15 15 0
29 Dexamethasone inj amp 0 0
30 Diluent Galon - 1 1 1
31 Domperidone tab Tab 0 0
32 Dulcolax Tab 0 0
33 Epinefrin inj amp 0 0
34 Etambutol tab 500mg Tab 0 0
35 Etil klorida semprot btl 0 0
36 Furosemid tab 100 100 0
37 Garam orali (Ramolit) Sacc 0 0
38 Gentamisin salep kulit tube 0 0
39 Gentamisin salep mata (Genoint) tube 0 0
40 Gentian Violet Btl 0 0
41 Glibenclamide Tab 0 0
42 Gliseri Guaiacolat 50 mg TAb 0 0
43 Glucosa strep ktk 0 0
44 Guafenesin 100 mg tab 0 0
45 H2O2 btl 0 0
46 Handsanitizer ltr 0 0
47 Handscoon non steril Pcs 0 0
49 Hydrocortison 2.5 % Tube 0 0
50 Ichtyol salep Pot 0 0
51 infus set anak pcs 0 0
52 infus set dewasa pcs 0 0
53 Iodium test btl 0 0
54 Isosorbide dinitrat (ISDN) tab 100 100 100
55 IV catheter no 18 pcs 0 0
56 IV catheter no 22 pcs 0 0
57 jarum jahit set 0 0
58 Kalsium laktat 500 mg tab 0 0
59 Kassa steril Kotak 0 0
60 Kertas puyer pack 0 0
61 Ketoconazole krim tube 0 0
62 Kloramfenicol Tetes Telinga (Erlamycin) Btl 0 0
63 Kloramfenicol salep mata tube 0 0
64 Kloramfenicol tts mata(Reco) Btl 0 0
65 Larutan H2O2 Btl 0 0
66 Loperamide (Primodiar) tab Tab 700 700 100
67 Lyse dirui Btl 0 0
68 Masker ktk 0 0
69 Masker nebul anak pcs 4 4 0
70 Masker Nebul Dewasa pcs 4 4 0
71 Metformin tab 500 mg Tab 0 0
72 Metilprednisolon Tab 0 0
73 Metronidazol 500 mg Tab 300 300 300
74 Muktivitamin syr (Procurma) Btl 185 185 0
75 Multivitamin syr (Tyalisin) Btl 0 0
76 Multivitamin tab (Caviplex) tab 0 0
77 Natrium Bikarbonat tablet 500 mg Tab 0 0
78 Natrium Diclovenak 50 mg tab 0 0
79 Neurotropik tab (Hufaneuron) Tab 0 0
80 Obat batuk flu (Coparcetin) tab 900 900 900
81 Obat batuk flu (Hustab tab) Tab 0 0
82 Obat batuk flu anak (anacetin Baby cough sirup) Btl 0 0
83 Obat batuk flu syr (Corpacetin) Btl 189 189 0
84 Obat Diare komb (Diapecta) Tab 0 0
85 Obat flu (Dextral) tab tab 0 0
86 Omeprazol caps caps 0 0
87 Ondancentron Inj amp 0 0
88 Paracetamol 500 mg Tab 0 0
89 Paracetamol sirup btl 0 0
90 Pehacain inj amp 0 0
91 Perban elastis roll 0 0
92 Pisau bisturi no 10 pcs 27 27 10
93 Pisau Bisturi no 11 pcs 25 25 0
94 Plastik Infeksius 40x60 pack 0 0
95 Plastik infeksius kecil pack 0 0
96 Plastik klip obat 7 x 10 pack 0 0
97 Plastik klip obat 8 x 12 pack 0 0
98 Plastik medis 60 x 100 pack 2 2 0
99 Plester Dermatix T 25x10 cm roll 0 0
100 Plester Hypafix roll 0 0
101 Ranitidin tab 0 0
102 Ranitidine inj amp 0 0
103 Sabun Antiseptik ltr 0 0
104 Salbutamol 2 mg tab Tab 0 0
105 Salicyl talk ktk 0 0
107 Silk 2/0 pcs 0 0
108 silk 3/0 pcs 10 10 3
109 Simvastatin tab Tab 0 0
110 Spalk anak pcs 0 0
111 Spatel Tongue ktk 2 2 0
112 Spuit 1 ml set 0 0
113 Tablet tambah darah kombinasi tab 0 0
114 Tabung EDTA pcs 0 0
115 Tes Kehamilan pcs 0 0
116 Thiamfenicol tab 400 400 100
117 Thiamin HCl tab (Vit B1) tab 0 0
118 transofix pcs 0 0
119 Ventolin nebu amp 15 15 0
120 Vit B.comp tab 800 800 300
121 Vitamin B6 tab 0 0
122 Vitamin C 50 mg tab 0 0
123 Winner tape/isopore roll 10 10 3
124 Yellow tip pack 1 1 1
125 Zink tablet tab 0 0
125
Umum
Jumlah Kunjungan Resep JKN
Bayar Tidak
PKM 200 283 599

PUSTU 9 56 30
POSKESKEL 59 17 47
TOTAL 268 356 676
Mengetahui
Kepala Puskesmas Labuhan Ratu
dr. Kartika Tri Handayani

Nip : 19761121 200701 2 008
Formulir 16
AN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
Jml Poskesdes/ bidan desa 6
Jml melapor 6
KETERANGAN (RUSAK,
STOK AKHIR PERMINTAAN PEMBERIAN
ED/SAMPLING, DLL)
9=7-8 11 12 13
0
0
0
15
0
0
200
200
400
85
0
300
100
4887
0
0
297
200
0
0
0
0
0
0
4100
2400
1400
248
0
0
0
0
300
0
96
0
0
0
0
0
0
0
0
0
0
200
0
1700
1500
0
700
0
0
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
300
0
0
0
0
0
0
100
0
0
0
0
0
2
500
0
0
0
288
34
0
0
0
38
0
0
0
0
0
400
0
0
2000
0
0
0
0
0
0
0
168
0
0
750
50
0
0
250
6800
700
0
250
0
0
0
9
5
0
4
0
3
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10
14
0
0
15
0
3
0
0
0
0
300
0
0
0
0
0
0
0
4500
0
0
96
166
0
0
1300
0
0
0
0
0
0
0
100
0
0
0
39
0
600
150
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
53
0
0
0
4
3
2
0
0
0
0
0
17
1
0
0
370
0
0
0
0
0
0
14
0
0
0
0
0
0
0
23
5
0
200
26
0
0
0
0
0
19
0
0
0
0
40
0
1860
20
0
0
144
900
0
50
0
0
0
0
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
0
0
0
950
0
0
0
0
2
0
0
0
0
0
0
0
22
16
0
0
0
0
0
400
0
0
0
0
2700
0
0
0
0
0
1950
0
0
2000
0
200
0
0
0
0
0
0
0
0
0
24
0
0
0
0
0
0
0
0
0
0
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
300
0
800
0
10
0
0
0
0
0
0
125
0
0
0
22
0
0
0
0
0
0
0
2
0
0
0
0
0
2
0
0
4
540
0
0
0
314
1300
0
0
0
0
20
90
0
0
0
100
0
2200
0
0
0
0
0
15
0
0
0
0
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
0
300
4000
30
0
0
0
0
0
0
2800
0
0
0
0
0
0
0
0
0
0
0
0
370
0
0
0
450
0
0
0
0
4
0
0
0
1500
11350
0
3
0
4
30
0
7
0
13
24
0
24
0
0
0
900
0
3
0
0
0
89
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
297500
0
0
0
0
0
0
1200
0
0
0
0
0
5
0
0
2
0
0
0
1
21
0
15
10
0
19
14
16
22
0
0
14
100
0
0
0
0
0
0
0
31
0
0
0
0
3300
108
0
2000
0
0
20
1100
0
80
0
41
1500
95
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
3
0
0
0
0
0
0
0
0
500
4
3
950
650
3
35
25
25
2
180
500
100
800
4
200
1200
1
1
37
10
27
29
2
1
1
1
8
6
1
1
0
0
0
0
0
0
87
1700
0
0
0
0
300
0
0
0
0
0
9
0
0
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
7
0
0
0
0
0
0
15
0
0
0
0
0
0
0
100
0
0
0
0
0
0
0
0
0
0
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
600
0
0
4
4
0
0
0
185
0
0
0
0
0
0
0
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
189
0
0
0
0
0
0
0
0
17
25
0
0
0
0
2
0
0
0
0
0
0
0
0
7
0
0
2
0
0
0
0
300
0
0
15
500
0
0
7
0
0
JKN TOTAL
599 1082
30 95
47 123
676 1300
Bandar Lampung, Januari 2023

Penanggung Jawab Obat dan Perbekes
Apt. Yunita Amriana ,S.Farm

NIP. 19940630 202012 2 024
Formulir 16
Kode : Bulan FEBRUARI

1 3 4 5 6 7=5+6 8
4 Acyclovir Zalf Tube 15 100 115 8
8 Alat Suntik sekali pakai 0.5 ml set 200 280 480 80
9 Alat Suntik sekali pakai 1 ml set 400 200 600 100
12 Alat suntik sekali pakai 3 ml set 300 100 400 0
14 Albendazol 400 mg tablet 4,887 4887 4887
16 Alkohol Swab sachet - 0 0
18 Allopurinol tablet 100 mg tablet 200 200 200
20 Ambroxol 30 mg tablet - 5,000 5000 400
25 Amlodipin 10 mg tablet 4,100 3,900 8000 900
26 Amlodipin 5 mg tablet 2,400 4,800 7200 1200
27 Amoxicillyn 500 mg tablet 1,400 9,000 10400 1600
28 Amoxicillyn sirup kering 125 mg/5 ml botol 248 250 498 0
33 Antasida doen tablet kombinasi tablet 300 12,000 12300 1600
36 Antihaemoroid ( Bismuth Subgallate ) suppos - 150 150 22
45 Asam Asetilsalisilat tab 80 mg tablet - 3,000 3000 200
51 Asam mefenamat 500 mg tablet 700 6,000 6700 1500
53 Asam Traneksamat inj ampul - 4 4 0
55 Asam Tranexamat 500 mg tablet 300 100 400 0
62 Azytromycin 500 mg tablet 100 600 700 40
69 Betahistin Mesilat 6 mg tablet 500 600 1100 200
71 Betamethasone krim 0,1 % tube - 150 150 31
82 Cal lc - 0
83 Cal Plus - 0
84 Calcium Lactate 500 mg tablet 400 4,800 5200 1000
93 Cavit G - 0
94 Cavit W - 0
98 Cefixim kaps 200 mg kapsul 750 750 350
104 Ciprofloxacin Tab 500 mg tablet 700 3,500 4200 400
106 Clindamycin 300 mg kap tablet 250 800 1050 50
113 Desinfectan C / Lisol botol 4 2 6 0
115 Diazepam 2 mg tab tablet 3 500 503 27
127 Domperidon Tab 10 mg tablet - 2,000 2000 100
137 Etakridin (rivanol) larutan 0,1 % botol 14 48 62 5
138 Etanol 70 % ( 100 ml ) botol - 0 0
139 Etanol 70 % ( 300 ml ) botol 0 0 0
140 Etanol 70 % ( 1000 ml ) botol 15 15 1
150 Flukonazol tab tab - 0 0
162 Glibenklamid tablet 5 mg tablet 1,300 2,000 3300 200
176 Handscoon Non Steril psg 600 600 500
180 Hidrokortison krim 2,5 % tube 53 240 293 35
189 Ibuprofen 400 mg tablet tablet - 4,000 4000 400
192 Ichtyol salep botol 17 - 17 0
196 INH 300mg tablet 370 370 37
202 Kapas 100 gr roll - 0 0
203 Kapas pembalut 250 gr roll 14 14 14
205 Kassa 4 m x 15 cm roll - 20 20 20
206 Kassa 4 x 10 roll - 0 0
207 Kassa 40 x 80 cm roll - 0 0
210 Kassa 36 x 80 cm roll - 0 0
211 Kassa Steril kotak 23 12 35 15
212 Kassa Steril + Antibiotik ( Cuticell ) pieces 5 5 5
215 Ketokonazole krim tube 26 108 134 8
221 Kloramfenicol salep kulit 2% tube 19 73 92 37
226 Kloramfenicol tetes Telinga 3% botol 40 50 90 15
228 Klorfeniramin maleat ( CTM ) tablet 4 mg tablet 1,860 4,896 6756 1572
232 Kondom pcs 144 144 0
233 Kotrimoxazol dewasa 480 mg tablet 900 3,000 3900 200
245 Lansoprazole 30 mg tablet 950 950 300
253 Larvasida cairan ( Cynof 1 liter ) liter - 5 5 5
255 Larvasida serbuk ( abatte 1 kg ) kg - 5 5 5
259 Laxatif tablet (Bisacodil tab) tablet 16 100 116 16
263 Lidokain kompositum injeksi (pehacain) ampul - 60 60 30
264 Loperamid HCL 2 mg tablet - 100 100 100
270 Masker Hijau pieces 2,700 2700 200
279 Metformin 500 mg tablet 2,000 5,000 7000 800
281 Methylprednisolone 4 mg tablet 200 8,000 8200 1200
305 Natrium Diklofenak 50 mg tab tablet 800 6,000 6800 1100
307 Natrium Klorida Cairanan infus 0,9 % steril botol 10 40 50 2
326 Obat Kusta MB Dewasa bister 2 2 0
332 Oksitosin injeksi 10 iu/ml - 1 ml ampul 2 2 2
333 Omeprazol 20 mg kaps tablet - 0 0
336 Ondansetron tab tablet 540 1,200 1740 120
341 Parasetamol tablet 500 mg tablet 1,300 1300 1300
346 Perak sulfat ( Burnazin cream ) botol 20 2 22 0
353 Piridoksin HCL tablet ( Vit B6 ) tablet 2,200 100 2300 600
358 Plester ( medical adhesive tape ) roll - 2 2 0
367 Pot Sputum pot 300 300 120
379 RDT Anti HCV test - 0 0
393 Reagent Rapid tes HBSAG test 450 450 0
398 Reagent Ziehlneelsen botol 4 12 16 0
405 Ringer Laktat Cairan infus steril botol 3 60 63 0
408 Safety Box pcs 30 1 31 3
409 Salbutamol 2 mg tablet - 0 0
413 Salisil bedak 2 % ktk 24 90 114 9
419 Simvastatin 20 mg tablet 900 2,000 2900 1200
428 Tablet tambah darah kombinasi tablet 297,500 297500 11200
435 Thiamin tab (vit B1) tablet 1,200 2,000 3200 300
448 Vaksin Anti Rabies ampul 1 4 5 2
461 Vitamin B 12 tablet tab 100 100 100
462 Vitamin B Compleks tablet - 10,000 10000 1300
471 Yodium Povidon 60 ml btl - 7 7 0
477 Masker TB box 2,000 1,250 3250 50
479 Alkohol Swab (Vaksin covid) sachet - 60 60 60
480 Safety box (covid) pcs 20 1 21 1
481 Masker bedah pcs 1,100 1100 150
483 FAVIPIRAVIR 200 mg tab 80 80 80
486 Masker KN95 pcs 1,500 1500 0
487 Masker N95 pcs 95 95 0
490 Vaksin Pfizer vial - 10 10 10
492 Spuit 0,3 ml (pfizer) pcs - 60 60 60
493 Spuid 3 ml (pfizer) pcs - 10 10 10
496 Lyse BCC 3600 btl - 0 0
497 glimepiride 1 mg pcs 500 2,000 2500 200
498 TDF+3TC+EFV(300/300/600)/TLE pcs 4 4 0
499 TDF(300)+3TC(300)+DTG(50)/TLD pcs 3 5 8 2
500 RDT HIV R1 (VIROCEK) pcs 950 950 125
503 Lidocain inj amp 35 100 135 5
504 RDT HIV R2 (StandarQ) tab 25 25 25
505 RDT HIV R3 (Diagnostar) tab 25 25 25
507 Vitamin B6 25 mg tab 180 180 37
508 Kotrimoxazol 960mg tab 500 500 8
510 Guaifenesin 100 mg tab 800 3,000 3800 900
511 Vaksin PCV vial 4 20 24 10
512 Tabung EDTA pcs 200 500 700 100
515 Tabung EDTA (steril HIV) pcs 1 1 1
516 Cryotube pcs 37 37 37
517 Microtrainer EDTA pcs 10 10 10
518 Flashback Needle 22 G pcs 27 27 27
519 Yellow Holder pcs 29 29 29
520 Wings Needle 27G pcs 2 2 2
521 Tip Pipet 1 ml (steril) pcs 1 1 1
522 Plastik Clip 5x7cm pcs 1 1 1
524 Ice Pack pcs 8 8 8
525 Ice Gel pcs 6 6 6
526 Lakban pcs 1 1 1
527 Styrofoam pcs 1 1 1
528 Banner tb pcs 1 1 1
529 Plester ( Pharmafik) ktk 10 10 0
530 0
1 Acyclovir 5% cream tube - 0 0
2 Abate Kg - 0 0
3 Acyclovir 400 mg tab - 450 450 150
4 Allopurinol tablet tab - 1000 1000 0
7 Amlodipin 10 mg tab - 0 0
8 Amlodipin 5 mg Tab - 0 0
9 Amoxicillin 500 mg Tab - 0 0
10 Antasida tab tab - 0 0
12 Asam mefenamat 500 mg Tab - 0 0
13 Asam urat strip ktk - 0 0
14 Azithromycin 500 mg tab - 0 0
15 Betahistin Mesilat (Lexigo) Tab - 0 0
16 Catgut chromic 2/0 pcs - 0 0
18 Catheter pcs - 0 0
19 Cefadroxil 500 mg tab - 1000 1000 100
20 Cetirizin tab tab - 0 0
21 Cholesterol strep ktk 7 7 3
22 Ciprofloxacin 500 mg tab - 0 0
23 Cleanser pcs - 0 0
24 Clindamicin cap 300 mg caps - 0 0
25 CTM Tab - 0 0
26 Cuticell pcs - 0 0
27 Deksametason 0,5 mg Tab - 0 0
28 Desinfectan ltr 15 15 15
29 Dexamethasone inj amp - 0 0
30 Diluent Galon - 0 0
31 Domperidone tab Tab - 0 0
32 Dipenhidramin inj amp - 5 5 0
33 Epinefrin inj amp - 5 5 0
34 Etambutol tab 500mg Tab - 0 0
35 Etil klorida semprot btl - 0 0
37 Garam orali (Ramolit) Sacc - 0 0
39 Gentamisin salep mata (Genoint) tube - 0 0
40 Gentian Violet Btl - 0 0
41 Glibenclamide Tab - 0 0
42 Gliseri Guaiacolat 50 mg TAb - 0 0
43 Glucosa strep ktk - 0 0
44 Guafenesin 100 mg tab - 0 0
45 H2O2 btl - 0 0
46 Handsanitizer ltr - 0 0
47 Handscoon non steril Pcs - 0 0
49 Hydrocortison 2.5 % Tube - 0 0
50 Ichtyol salep Pot - 0 0
51 infus set anak pcs - 0 0
52 infus set dewasa pcs - 0 0
53 Iodium test btl - 0 0
54 Isosorbide dinitrat (ISDN) tab - 100 100 0
55 IV catheter no 18 pcs - 0 0
57 jarum jahit set - 0 0
58 Kalsium laktat 500 mg tab - 0 0
59 Kassa steril Kotak - 0 0
60 Kertas puyer pack - 0 0
61 Ketoconazole krim tube - 0 0
62 Kloramfenicol Tetes Telinga (Erlamycin) Btl - 0 0
64 Kloramfenicol tts mata(Reco) Btl - 0 0
65 Larutan H2O2 Btl - 0 0
67 Lyse dirui Btl - 0 0
68 Masker ktk - 0 0
71 Metformin tab 500 mg Tab - 0 0
72 Metilprednisolon Tab - 0 0
73 Metronidazol 500 mg Tab - 1500 1500 200
75 Multivitamin syr (Tyalisin) Btl - 0 0
76 Multivitamin tab (Caviplex) tab - 0 0
77 Natrium Bikarbonat tablet 500 mg Tab - 0 0
78 Natrium Diclovenak 50 mg tab - 0 0
79 Neurotropik tab (Hufaneuron) Tab - 0 0
80 Obat batuk flu (Coparcetin) tab - 2500 2500 400
81 Obat batuk flu (Hustab tab) Tab - 0 0
82 Obat batuk flu anak (anacetin Baby cough sirup) Btl - 0 0
84 Obat Diare komb (Diapecta) Tab - 0 0
85 Obat flu (Dextral) tab tab - 0 0
86 Omeprazol caps caps - 0 0
87 Ondancentron Inj amp - 0 0
88 Paracetamol 500 mg Tab - 10000 10000 2000
89 Paracetamol sirup btl - 0 0
90 Pehacain inj amp - 0 0
91 Perban elastis roll - 0 0
94 Plastik Infeksius 40x60 pack - 0 0
95 Plastik infeksius kecil pack - 0 0
96 Plastik klip obat 7 x 10 pack - 0 0
99 Plester Dermatix T 25x10 cm roll - 0 0
100 Plester Hypafix roll - 0 0
101 Ranitidin tab - 0 0
102 Ranitidine inj amp - 0 0
103 Sabun Antiseptik ltr - 0 0
104 Salbutamol 2 mg tab Tab - 500 500 100
105 Salicyl talk ktk - 0 0
107 Silk 2/0 pcs - 0 0
108 silk 3/0 pcs 7 7 0
109 Simvastatin tab Tab - 0 0
110 Spalk anak pcs - 0 0
112 Spuit 1 ml set - 0 0
113 Tablet tambah darah kombinasi tab - 0 0
114 Tabung EDTA pcs - 0 0
115 Tes Kehamilan pcs - 0 0
117 Thiamin HCl tab (Vit B1) tab - 0 0
118 transofix pcs - 0 0
120 Vit B.comp tab 500 500 500
121 Vitamin B6 tab - 0 0
122 Vitamin C 50 mg tab - 0 0
124 Yellow tip pack - 0 0
125 Zink tablet tab - 0 0
126 Vaseline swab (cuticel) pcs - 30 30 10
127 0
128 0
129 0
Umum
Bayar Tidak
PKM 172 238 633

PUSTU 7 59 30
POSKESKEL 50 21 55
TOTAL 229 318 718
Mengetahui
Kepala Puskesmas Labuhan Ratu
dr. Kartika Tri Handayani
Nip : 19761121 200701 2 008
Formulir 16
Jml melapor 6
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
9=7-8 11 12 13
0
0
0
107
0
0
200
400
500
83
0
400
100
0
0
0
291
0
0
4600
0
0
0
0
7100
6000
8800
498
0
0
0
0
10700
0
96
128
0
0
0
0
0
0
0
0
2800
13500
0
1200
1200
0
5200
0
4
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
400
0
0
0
0
0
0
660
0
0
0
0
0
1
900
0
119
0
287
16
0
0
0
34
0
0
0
0
0
4200
0
0
1800
0
0
0
0
0
0
0
168
0
0
400
50
0
0
250
5900
3800
0
1000
0
0
0
9
5
0
6
0
476
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
3
0
0
0
0
0
0
0
0
1900
0
0
0
0
0
0
0
0
10
57
0
0
14
0
12
0
0
0
0
295
0
0
0
0
0
0
0
4300
0
0
96
160
0
0
3100
0
0
0
0
0
0
0
100
0
0
0
35
0
100
150
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
258
0
0
0
4
3
2
0
0
3600
0
0
17
1
0
0
333
0
0
0
0
0
0
0
0
0
0
0
0
0
0
20
0
0
100
126
0
0
0
0
0
55
0
0
0
0
75
0
5184
20
0
0
144
3700
0
50
0
0
0
0
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
0
0
0
650
0
0
0
0
2
0
0
0
0
0
0
0
22
100
0
0
0
30
0
400
0
0
0
0
2500
0
0
0
0
0
1860
0
0
6200
0
7000
0
0
0
0
0
0
0
0
0
19
0
0
0
0
0
0
0
0
0
0
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
300
0
5700
0
48
0
0
0
0
0
0
120
0
0
1
102
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
3
1620
0
0
0
314
0
0
0
0
0
22
70
0
0
0
100
0
1700
0
0
0
0
2
14
0
0
0
0
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
0
180
3400
30
0
0
0
0
0
0
2400
0
0
0
0
0
0
0
0
0
0
0
0
358
0
0
0
450
0
0
0
0
16
0
0
0
1250
8150
0
63
0
0
28
0
5
0
13
105
0
20
0
0
0
1700
0
3
0
0
0
85
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
286300
0
0
0
0
0
0
2900
0
0
0
0
0
4
0
0
2
0
0
0
3
41
0
10
10
1
41
18
18
24
0
0
29
0
8700
0
0
0
0
0
0
29
0
7
0
0
3100
108
0
3200
0
0
20
950
0
0
0
41
1500
95
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
3
0
0
0
0
0
0
0
0
2300
4
6
825
450
3
130
0
0
2
143
492
100
2900
14
600
1080
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10
0
0
0
300
1000
87
1500
0
0
0
0
300
0
0
0
0
0
9
0
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
900
0
4
0
0
0
0
0
0
0
0
0
0
5
5
0
0
100
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
100
0
0
0
0
0
0
0
0
0
0
0
600
0
0
2
3
0
0
1300
185
0
0
0
0
0
2100
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
189
0
0
0
0
8000
0
0
0
17
25
0
0
0
0
2
0
0
0
0
0
400
0
0
7
0
0
1
0
0
0
0
300
0
0
11
0
0
0
7
0
0
20
0
0
0
JKN TOTAL
633 1043
30 96
55 126
718 1265
Bandar Lampung, Februari 2023

KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
NIP. 19940630 202012 2 024
Formulir 16
Kode : Bulan MARET

1 3 4 5 6 7=5+6 8
14 Albendazol 400 mg tablet - 0 0
17 Alkohol Swab kotak 291 192 483 11
18 Allopurinol tablet 100 mg tablet - 0 0
20 Ambroxol 30 mg tablet 4,600 4600 800
45 Asam Asetilsalisilat tab 80 mg tablet 2,800 2800 400
46 Asam askorbat (vit c) tablet 50 mg tablet 13500 13500 1400
51 Asam mefenamat 500 mg tablet 5,200 5200 1600
53 Asam Traneksamat inj ampul 4 4 0
82 Cal lc - 0
83 Cal Plus - 0
93 Cavit G - 0
94 Cavit W - 0
98 Cefixim kaps 200 mg kapsul 400 400 400
106 Clindamycin 300 mg kap tablet 1,000 1000 200
127 Domperidon Tab 10 mg tablet 1,900 1900 300
138 Etanol 70 % ( 100 ml ) botol - 0 0
139 Etanol 70 % ( 300 ml ) botol 0 0 0
140 Etanol 70 % ( 1000 ml ) botol 14 14 0
142 Etil klorida semprot botol 12 12 1
150 Flukonazol tab tab - 50 50 0
174 Hands Rub gel btl 35 72 107 13
176 Handscoon Non Steril psg 100 5,000 5100 600
177 Handscoon Steril psg 150 150 300 0
189 Ibuprofen 400 mg tablet tablet 3,600 3600 100
196 INH 300mg tablet 333 1,000 1333 153
202 Kapas 100 gr roll - 5 5 0
203 Kapas pembalut 250 gr roll - 0 0
205 Kassa 4 m x 15 cm roll - 0 0
206 Kassa 4 x 10 roll - 0 0
207 Kassa 40 x 80 cm roll - 0 0
210 Kassa 36 x 80 cm roll - 0 0
212 Kassa Steril + Antibiotik ( Cuticell ) pieces - 0 0
221 Kloramfenicol salep kulit 2% tube 55 55 55
232 Kondom pcs 144 288 432 0
263 Lidokain kompositum injeksi (pehacain) ampul 30 30 30
317 OAT Kategori Anak paket 1 1 1
318 OAT Kategori I paket 102 102 5
332 Oksitosin injeksi 10 iu/ml - 1 ml ampul - 0 0
336 Ondansetron tab tablet 1,620 1620 360
341 Parasetamol tablet 500 mg tablet - 0 0
353 Piridoksin HCL tablet ( Vit B6 ) tablet 1,700 1700 800
358 Plester ( medical adhesive tape ) roll 2 2 0
407 Sabun Antiseptik botol - 7 7 3
408 Safety Box pcs 28 75 103 20
448 Vaksin Anti Rabies ampul 3 3 2
453 Vaksin Hepatitis B Imuno Globullin ampul 1 1 1
461 Vitamin B 12 tablet tab - 0 0
462 Vitamin B Compleks tablet 8,700 8700 1700
471 Yodium Povidon 60 ml btl 7 7 0
477 Masker TB box 3,200 3200 0
481 Masker bedah pcs 950 950 300
483 FAVIPIRAVIR 200 mg tab - 0 0
486 Masker KN95 pcs 1,500 1500 100
487 Masker N95 pcs 95 95 0
496 Lyse BCC 3600 btl - 0 0
497 glimepiride 1 mg pcs 2,300 2300 300
498 TDF+3TC+EFV(300/300/600)/TLE (atripla) pcs 4 4 0
499 TDF(300)+3TC(300)+DTG(50)/TLD pcs 6 5 11 4
504 RDT HIV R2 (StandarQ) tab - 0 0
505 RDT HIV R3 (Diagnostar) tab - 0 0
507 Vitamin B6 25 mg tab 143 143 93
508 Kotrimoxazol 960mg tab 492 2,000 2492 30
515 Tabung EDTA (steril HIV) pcs - 2 2 0
516 Cryotube pcs - 100 100 0
517 Microtrainer EDTA pcs - 10 10 0
518 Flashback Needle 22 G pcs - 50 50 0
519 Yellow Holder pcs - 50 50 0
520 Wings Needle 27G pcs - 5 5 0
521 Tip Pipet 1 ml (steril) pcs - 2 2 0
522 Plastik Clip 5x7cm pcs - 2 2 0
523 Plastik Clip 16x24cm pcs - 0 0
524 Ice Pack pcs - 10 10 0
525 Ice Gel pcs - 5 5 0
526 Lakban pcs - 1 1 0
527 Styrofoam pcs - 2 2 0
528 Banner tb pcs - 0 0
530 Etanol 95 % botol 8 8 0
531 Vitamin D3 tablet 90 90 30
532 Masker Earloop pcs 8,000 8000 0
533 Masker bedah hiv pcs 50 50 50
534 Plastik Clip 15x24cm pack 1 1 0
535
536
537
538
539
540
2 Abate Kg - 0 0
3 Acyclovir 400 mg tab 300 1350 1650 300
4 Allopurinol tablet tab 1,000 1000 200
13 Asam urat strip ktk - 2 2 2
19 Cefadroxil 500 mg tab 900 900 100
25 CTM Tab - 0 0
28 Desinfectan ltr - 0 0
32 Dipenhidramin inj amp 5 5 0
33 Epinefrin inj amp 5 5 0
38 Gentamisin salep kulit tube - 160 160 0
45 H2O2 btl - 0 0
48 Handscoon Steril psg - 0 0
54 Isosorbide dinitrat (ISDN) tab 100 100 200 100
60 Kassa hidrofill roll - 100 100 0
67 Lyse dirui Btl - 1 1 1
68 Masker ktk - 0 0
73 Metronidazol 500 mg Tab 1,300 1300 300
80 Obat batuk flu (Coparcetin) tab 2,100 2100 1400
81 Obat batuk flu (Hustab tab) Tab - 3300 3300 0
88 Paracetamol 500 mg Tab 8,000 8000 3100
90 Pehacain inj amp - 140 140 0
104 Salbutamol 2 mg tab Tab 400 400 100
107 Silk 2/0 pcs - 0 0
108 silk 3/0 pcs 7 7 3
120 Vit B.comp tab - 0 0
121 Vitamin B6 tab - 3000 3000 0
126 Vaseline swab (cuticel) pcs 20 20 0
127
128
129
130
Umum
Bayar Tidak
PKM 146 291 721

PUSTU 7 60 22
POSKESKEL 70 10 28
TOTAL 223 361 771
Mengetahui
Plt. Kepala Puskesmas Labuhan Ratu
Ns. Sumiyati, S.Kep

NIP. 19680304 198812 2 002
Formulir 16
Jml melapor 6
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
9=7-8 11 12 13
0
0
0
75
0
0
200
400
500
83
0
400
100
0
0
0
472
0
0
3800
0
0
0
0
6400
5100
6600
490
0
0
0
0
9100
0
72
107
0
0
0
0
0
0
0
0
2400
12100
0
900
800
0
3600
0
4
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
400
0
0
0
0
0
0
580
0
0
0
0
0
0
600
0
109
0
284
0
0
0
0
26
0
0
0
0
0
2800
0
0
1700
0
0
0
0
0
0
0
160
0
0
0
48
0
0
250
4700
3400
0
800
0
0
0
9
5
0
5
0
449
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
2
0
0
0
0
0
0
0
0
1600
0
0
0
0
0
0
0
0
10
50
0
0
14
0
11
0
0
0
0
165
0
0
50
0
0
0
0
3800
0
0
20
48
0
0
2900
0
0
0
0
0
0
0
100
0
0
0
94
0
4500
300
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
192
0
0
0
4
3
2
0
0
3500
0
0
17
1
0
0
1180
0
0
0
0
0
5
0
0
0
0
0
0
0
0
18
0
0
0
96
0
0
0
0
0
0
0
0
0
0
72
0
4032
20
0
0
432
3400
0
50
0
0
0
0
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
0
0
0
650
0
0
0
0
1
0
0
0
0
0
0
0
22
100
0
0
0
0
0
400
0
0
0
0
2050
0
0
0
0
0
1530
0
0
5400
0
5200
0
0
0
0
0
0
0
0
0
10
0
0
0
0
0
0
0
0
0
0
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
200
0
5100
0
46
0
0
0
0
0
0
115
0
0
0
97
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
3
1260
0
0
0
314
0
0
0
0
0
20
50
0
0
0
96
0
900
0
0
0
0
2
12
0
0
0
0
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
0
120
3000
30
0
0
0
0
0
0
1000
0
0
0
0
0
0
0
0
0
0
0
0
330
0
0
0
450
0
0
0
0
16
0
0
0
1250
7850
0
63
0
4
83
0
2
0
13
90
0
20
0
0
0
1200
0
3
0
0
0
74
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
182400
0
0
0
0
0
0
2500
0
0
0
0
0
0
0
0
2
0
0
0
1
29
0
11
10
0
29
10
11
7
0
0
8
0
7000
0
0
0
0
0
0
26
0
7
0
0
2700
108
0
3200
0
0
19
650
0
0
0
41
1400
95
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
3
0
0
0
0
0
0
0
0
2000
4
7
750
400
3
110
0
0
2
50
2462
100
1900
1
500
840
1
2
100
10
50
50
5
2
2
0
10
5
1
2
0
10
8
60
8000
0
1
0
0
1350
800
87
1500
0
0
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
300
0
0
0
0
0
9
0
800
0
1
0
0
0
0
0
0
0
0
0
0
5
5
0
0
100
0
160
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
100
0
0
0
0
0
100
0
0
0
0
0
550
0
0
2
3
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
1000
185
0
0
0
0
0
700
3300
0
189
0
0
0
0
4900
0
140
0
17
25
0
0
0
0
1
0
0
0
0
0
300
0
0
4
0
0
1
0
0
0
0
200
0
0
9
0
3000
0
7
0
0
20
JKN TOTAL
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
721 1158
22 89
28 108
771 1355
Bandar Lampung, Maret 2023


NIP. 19940630 202012 2 024
Formulir 16
Kode : Bulan APRIL

1 3 4 5 6 7=5+6 8
48 Asam Askorbat (vit c) tablet 500 mg tablet 900 900 400
49 Asam Folat tablet 800 800 300
74 Borax Gliserin (GOM) pot - 0 0
82 Cal lc - 0
83 Cal Plus - 0
93 Cavit G - 0
94 Cavit W - 0
98 Cefixim kaps 200 mg kapsul - 0 0
115 Diazepam 2 mg tab tablet 449 - 449 34
138 Etanol 70 % ( 100 ml ) botol - 0 0
139 Etanol 70 % ( 300 ml ) botol 0 0 0
140 Etanol 70 % ( 1000 ml ) botol 14 14 1
150 Flukonazol tab tab 50 50 10
176 Handscoon Non Steril psg 4,500 4500 250
196 INH 300mg tablet 1,180 1180 60
202 Kapas 100 gr roll 5 5 0
206 Kassa 4 x 10 roll - 0 0
207 Kassa 40 x 80 cm roll - 0 0
210 Kassa 36 x 80 cm roll - 0 0
214 Ketokonazole 200 mg tablet - 0 0
221 Kloramfenicol salep kulit 2% tube - 0 0
232 Kondom pcs 432 432 0
317 OAT Kategori Anak paket - 0 0
353 Piridoksin HCL tablet ( Vit B6 ) tablet 900 900 200
441 Tuberkulin PPD RT 23 SSI vial - 0 0
448 Vaksin Anti Rabies ampul 1 1 1
453 Vaksin Hepatitis B Imuno Globullin ampul - 0 0
477 Masker TB box 3,200 3200 0
479 Alkohol Swab (Vaksin covid) sachet - 0 0
486 Masker KN95 pcs 1,400 1400 0
487 Masker N95 pcs 95 95 0
490 Vaksin Pfizer vial - 0 0
492 Spuit 0,3 ml (pfizer) pcs - 0 0
493 Spuid 3 ml (pfizer) pcs - 0 0
496 Lyse BCC 3600 btl - 0 0
499 TDF(300)+3TC(300)+DTG(50)/TLD pcs 7 7 2
507 Vitamin B6 25 mg tab 50 50 30
508 Kotrimoxazol 960mg tab 2,462 2462 62
513 Curcuma Force tab 840 840 0
533 Masker bedah hiv pcs - 0 0
535 Safety box (bian) pcs - 12 12 0
536
537
538
539
540
2 Abate Kg - 0 0
3 Acyclovir 400 mg tab 1,350 1350 150
4 Allopurinol tablet tab 800 800 300
25 CTM Tab - 0 0
38 Gentamisin salep kulit tube 160 160 40
45 H2O2 btl - 0 0
60 Kassa hidrofill roll 100 100 60
68 Masker ktk - 0 0
73 Metronidazol 500 mg Tab 1,000 1000 100
80 Obat batuk flu (Coparcetin) tab 700 700 700
81 Obat batuk flu (Hustab tab) Tab 3,300 3300 900
88 Paracetamol 500 mg Tab 4,900 4900 1700
90 Pehacain inj amp 140 140 20
107 Silk 2/0 pcs - 0 0
108 silk 3/0 pcs 4 4 0
121 Vitamin B6 tab 3,000 3000 0
127 Reagent golongan darah set - 1 1 1
128
129
130
Umum
Bayar Tidak
PKM 142 165 487

PUSTU 0 41 16
POSKESKEL 51 9 29
TOTAL 193 215 532
Mengetahui
Ns. Sumiyati, S.Kep

NIP. 19680304 198812 2 003
Formulir 16
Jml melapor 6
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
9=7-8 11 12 13
0
0
0
75
0
0
200
400
400
83
0
300
200
0
0
0
468
0
0
3300
0
0
0
0
5700
4200
5800
475
0
0
0
0
7500
0
72
69
0
0
0
0
0
0
0
0
2000
10500
0
500
500
0
2700
0
4
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
400
0
0
0
0
0
0
480
0
0
0
0
0
0
500
0
90
0
284
0
0
0
0
20
0
0
0
0
0
2600
0
0
1300
0
0
0
0
0
0
0
130
0
0
0
25
0
0
250
3700
2900
0
500
0
0
0
9
5
0
4
0
415
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
2
0
0
0
0
0
0
0
0
1500
0
0
0
0
0
0
0
0
7
47
0
0
13
0
11
0
0
0
0
0
0
0
40
0
0
0
0
3400
0
0
15
42
0
0
2800
0
0
0
0
0
0
0
100
0
0
0
94
0
4250
300
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
168
0
0
0
4
3
2
0
0
3100
0
0
17
1
0
0
1120
0
0
0
0
0
5
0
0
0
0
0
0
0
0
10
0
0
0
90
0
0
0
0
0
0
0
0
0
0
66
0
3744
20
0
0
432
3200
0
50
0
0
0
0
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
0
0
0
650
0
0
0
0
1
0
0
0
0
0
0
0
22
100
0
0
0
0
0
300
0
0
0
0
1900
0
0
0
0
0
1440
0
0
4800
0
4000
0
0
0
0
0
0
0
0
0
10
0
0
0
0
0
0
0
0
0
0
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
200
0
4300
0
44
0
0
0
0
0
0
115
0
0
0
92
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
1020
0
0
0
314
0
0
0
0
0
15
40
0
0
0
90
0
700
0
0
0
0
2
11
0
0
0
0
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
0
60
2600
30
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
330
0
0
0
400
0
0
0
0
16
0
0
0
1250
7700
0
63
0
3
75
0
0
0
10
78
0
7
0
0
0
1000
0
3
0
0
0
70
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
177000
0
0
0
0
0
0
2200
0
0
0
0
0
0
0
0
2
0
0
0
0
24
0
19
10
0
32
19
15
15
0
0
17
0
6000
0
0
0
0
0
0
26
0
7
0
0
2500
108
0
3200
0
0
19
600
0
0
0
41
1400
95
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
3
0
0
0
0
0
0
0
0
1600
4
5
700
0
3
90
0
0
2
20
2400
100
1200
17
500
840
1
2
100
10
50
50
5
2
2
0
10
5
1
2
0
10
8
60
8000
0
1
12
0
0
1200
500
87
1500
0
0
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
300
0
0
0
0
0
9
0
300
0
0
0
0
0
0
0
0
0
0
0
0
5
5
0
0
100
0
120
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
100
0
0
0
0
0
40
0
0
0
0
0
400
0
0
2
2
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
900
185
0
0
0
0
0
0
2400
0
189
0
0
0
0
3200
0
120
0
17
25
0
0
0
0
1
0
0
0
0
0
300
0
0
4
0
0
1
0
0
0
0
200
0
0
8
0
3000
0
6
0
0
10
0
JKN TOTAL
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
487 794
16 57
29 89
532 940
Bandar Lampung, April 2023


NIP. 19940630 202012 2 024
Formulir 16
Kode : Bulan MEI

1 3 4 5 6 7=5+6 8
48 Asam Askorbat (vit c) tablet 500 mg tablet 500 500 400
49 Asam Folat tablet 500 500 500
73 Blood Lancet ktk 284 340 624 4
74 Borax Gliserin (GOM) pot - 0 0
82 Cal lc - 0
83 Cal Plus - 0
93 Cavit G - 0
94 Cavit W - 0
98 Cefixim kaps 200 mg kapsul - 0 0
138 Etanol 70 % ( 100 ml ) botol - 0 0
139 Etanol 70 % ( 300 ml ) botol 0 0 0
140 Etanol 70 % ( 1000 ml ) botol 13 13 1
147 Fenobarbital tablet 30 mg tablet - 0 0
150 Flukonazol tab tab 40 40 0
176 Handscoon Non Steril psg 4,250 4250 550
196 INH 300mg tablet 1,120 1120 160
202 Kapas 100 gr roll 5 5 1
206 Kassa 4 x 10 roll - 0 0
207 Kassa 40 x 80 cm roll - 0 0
210 Kassa 36 x 80 cm roll - 0 0
214 Ketokonazole 200 mg tablet - 0 0
221 Kloramfenicol salep kulit 2% tube - 0 0
232 Kondom pcs 432 432 0
238 Lab Anti A Monoclonal Gol Darah vial - 2 2 0
239 Lab Anti B Monoclonal Gol Darah vial - 2 2 0
240 Lab Salmonella Paratyphi AO Widal Test vial - 4 4 0
241 Lab Salmonella Paratyphi BO Widal Test vial - 4 4 0
242 Lab Salmonella Typhi H Widal Test vial - 4 4 0
243 Lab Salmonella Typhi O Widal Test vial - 4 4 0
326 Obat Kusta MB Dewasa bister - 0 0
353 Piridoksin HCL tablet ( Vit B6 ) tablet 700 700 700
367 Pot Sputum pot 60 200 260 160
376 Ranitidin tab tablet - 0 0
389 Reagent Glukosa test 330 510 840 90
410 Salbutamol inhaler set - 0 0
428 Tablet tambah darah kombinasi tablet 177,000 95,000 272000 6800
441 Tuberkulin PPD RT 23 SSI vial - 0 0
448 Vaksin Anti Rabies ampul - 0 0
453 Vaksin Hepatitis B Imuno Globullin ampul - 0 0
477 Masker TB box 3,200 3200 0
478 ADS 0,5 ml (vaksin covid) pcs - 80 80 80
486 Masker KN95 pcs 1,400 1400 175
487 Masker N95 pcs 95 95 0
490 Vaksin Pfizer vial - 0 0
492 Spuit 0,3 ml (pfizer) pcs - 0 0
493 Spuid 3 ml (pfizer) pcs - 0 0
496 Lyse BCC 3600 btl - 0 0
499 TDF(300)+3TC(300)+DTG(50)/TLD pcs 5 5 10 5
501 RDT Sifilis Trepocheck pcs - 0 0
507 Vitamin B6 25 mg tab 20 20 20
508 Kotrimoxazol 960mg tab 2,400 2400 100
513 Curcuma Force tab 840 840 240
533 Masker bedah hiv pcs - 0 0
535 Safety box (bian) pcs 12 12 0
536 Vaksin Indovac vial 8 8 8
537 RDT HIV R3 (Rapidan) pcs 0 0
538
539
540
2 Abate Kg - 0 0
3 Acyclovir 400 mg tab 1,200 1200 200
4 Allopurinol tablet tab 500 1000 1500 400
21 Cholesterol strep ktk - 0 0
25 CTM Tab - 0 0
38 Gentamisin salep kulit tube 120 120 50
40 Gentian Violet Btl - 48 48 6
45 H2O2 btl - 0 0
59 Kassa steril Kotak - 50 50 10
60 Kassa hidrofill roll 40 40 40
61 Ketoconazole tab - 1000 1000 100
68 Masker ktk - 0 0
69 Masker nebul anak pcs 2 10 12 1
70 Masker Nebul Dewasa pcs 2 10 12 1
73 Metronidazol 500 mg Tab 900 900 300
80 Obat batuk flu (Coparcetin) tab - 0 0
81 Obat batuk flu (Hustab tab) Tab 2,400 2400 1500
86 Omeprazol caps caps - 2100 2100 0
88 Paracetamol 500 mg Tab 3,200 10000 13200 3400
90 Pehacain inj amp 120 120 80
107 Silk 2/0 pcs - 0 0
108 silk 3/0 pcs 4 4 1
115 Tes Kehamilan pcs - 100 100 50
119 Ventolin nebu amp 8 20 28 2
121 Vitamin B6 tab 3,000 3000 100
127 Reagent golongan darah set - 0 0
128 kassa 15 cm roll 100 100 13
129 double spike Pcs 4 4 0
130 dermafix tulle Pcs 50 50 0
Umum
Bayar Tidak
PKM 175 287 815

PUSTU 27 51 21
POSKESKEL 32 48 38
TOTAL 234 386 874
Mengetahui
Ns. Sumiyati, S.Kep

NIP. 19680304 198812 2 003
Formulir 16
Jml melapor 6
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
9=7-8 11 12 13
0
0
0
55
0
0
100
400
300
83
0
300
200
0
0
0
472
0
0
2300
0
0
0
0
4600
2700
3800
445
0
0
0
0
5300
0
72
47
0
0
0
0
0
0
0
0
1400
8200
0
100
0
0
1000
0
4
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
200
0
0
0
0
0
0
320
0
0
0
0
0
0
200
0
65
0
620
0
0
0
0
14
0
0
0
0
0
1500
0
0
700
0
0
0
0
0
0
0
60
0
0
0
9
0
0
250
2100
2400
0
200
0
0
0
9
5
0
4
0
353
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
2
0
0
0
0
0
0
0
0
1300
0
0
0
0
0
0
0
0
7
39
0
0
12
0
10
0
0
0
0
0
0
0
40
0
0
0
0
2900
0
0
10
24
0
0
2400
0
0
0
0
0
0
0
0
0
0
0
89
0
3700
300
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
120
0
0
0
4
3
2
0
0
2500
0
0
12
0
0
0
960
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
60
0
0
0
0
0
0
0
0
0
0
63
0
2592
20
0
0
432
3100
0
50
0
0
2
2
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
4
4
4
4
0
300
0
0
0
0
1
0
0
0
0
0
0
0
22
100
0
0
0
0
0
300
0
0
0
0
1100
0
0
0
0
0
1080
0
0
3600
0
2000
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
200
0
3100
0
41
0
0
0
0
0
0
115
0
0
5
92
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
750
0
0
0
314
0
0
0
0
0
15
25
0
0
0
90
0
0
0
0
0
0
2
10
0
0
0
0
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
0
100
1300
30
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
750
0
0
0
400
0
0
0
0
16
0
0
0
1250
7500
0
9
0
0
73
0
0
0
6
54
0
7
0
0
0
500
0
3
0
0
0
0
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
265200
0
0
0
0
0
0
1700
0
0
0
0
0
0
0
0
2
0
0
0
0
12
0
8
10
0
29
15
13
23
0
0
13
0
4000
0
0
0
0
0
0
7
0
7
0
0
1400
108
0
3200
0
0
19
400
0
0
0
41
1225
95
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
2
0
0
0
0
0
0
0
0
1400
4
5
600
0
3
75
0
0
2
0
2300
100
400
7
400
600
1
2
100
10
50
50
5
2
2
0
10
5
1
2
0
10
8
60
8000
0
1
12
0
0
0
0
1000
1100
80
1500
0
0
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
300
0
0
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
5
0
0
0
0
70
0
42
0
0
0
0
0
0
0
0
0
0
0
0
0
100
0
0
0
0
40
0
900
0
0
0
0
300
0
0
11
11
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
0
0
600
154
0
0
0
0
0
0
900
0
142
0
0
2100
0
9800
0
40
0
15
25
0
0
0
0
1
0
0
0
0
0
200
0
0
3
0
0
1
0
0
0
50
100
0
0
26
0
2900
0
6
0
0
0
0
87
4
50
JKN TOTAL
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
815 1277
21 99
38 118
874 1494
Bandar Lampung, Mei 2023


NIP. 19940630 202012 2 024
Formulir 16
Kode : Bulan JUNI Jml Poskesdes/ bidan desa
Puskesmas Labuhan Ratu Tahun 2023 Jml melapor
STOK
No NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR
AWAL
1 3 4 5 6 7=5+6 8 9=7-8
1 ACT ( Artesunete & Amodiaquin ) Tab - 0 0 0
2 Acyclovir 200 mg Tab - 0 0 0
5 ADS 1 ml set - 0 0 0
6 Alat Pelindung Diri untuk penyemprot set - 0 0 0
11 Alat suntik sekali pakai 2.5 ml set - 0 0 0
14 Albendazol 400 mg tablet - 0 0 0
15 Albendazole syr btl - 0 0 0
18 Allopurinol tablet 100 mg tablet - 1,000 1000 100 900
19 Alprazolam 0,5 mg tablet - 0 0 0
20 Ambroxol 30 mg tablet 2,300 2300 350 1950
21 Ambroxol syrup botol - 0 0 0
22 Aminofillin inj 24 mg/ml - 10ml ampul - 0 0 0
23 Aminofillin tablet 200 mg tablet - 0 0 0
24 Amitriptilin 25 mg tablet - 0 0 0
25 Amlodipin 10 mg tablet 4,600 4600 800 3800
27 Amoxicillyn 500 mg tablet 3,800 3800 1800 2000
29 Amoxicillyn sirup kering 250 mg/5 ml botol - 0 0 0
30 Amoxiclav (Amoxicillyn+As. klavulanat 625 mg tablet - 0 0 0
31 Ampicillin injeksi ampul - 0 0 0
32 Antasida doen suspensi botol - 0 0 0
33 Antasida doen tablet kombinasi tablet 5,300 5300 1500 3800
34 Antibakteri doen salep topikal tube - 0 0 0
35 Antifungi doen kombinasi pot 72 72 24 48
36 Antihaemoroid ( Bismuth Subgallate ) suppos 47 50 97 19 78
37 Antimigrain doen kombinasi tablet - 0 0 0
38 Antiparkinson tab ( Levopar ) tab - 0 0 0
39 Antispasme Tablet ( Hiopar ) tablet - 0 0 0
40 Aqua pro injeksi steril bebas pirogen botol - 0 0 0
41 Artemeter inj ampul - 0 0 0
42 Arterakine ( anti malaria ) tablet - 0 0 0
43 Artesunat inj ampul - 0 0 0
44 Asam Asetilsalisilat tab 100 mg (Aspilet) tablet - 0 0 0
45 Asam Asetilsalisilat tab 80 mg tablet 1,400 1400 700 700
47 Asam Askorbat (vit c) tablet 250 mg tablet - 0 0 0
48 Asam Askorbat (vit c) tablet 500 mg tablet 100 100 100 0
49 Asam Folat tablet - 0 0 0
50 Asam mefenamat 250 mg tablet - 0 0 0
51 Asam mefenamat 500 mg tablet 1,000 1000 700 300
52 Asam Pipemidic kaps kapsul - 0 0 0
53 Asam Traneksamat inj ampul 4 4 0 4
STOK
AWAL
54 Asam Tranexamat 250 mg tablet - 0 0 0
56 Atenolol tab 50 mg tablet - 0 0 0
57 Atripla ktk - 0 0 0
58 Atropin sulfat 0,5 mg tablet - 0 0 0
59 Atropin sulfat 1 % ( Cendotropin tts mata ) botol - 0 0 0
60 Atropin sulfat injeksi 0,25 mg/ml-1ml vial - 0 0 0
61 Azithromycin 250 mg tablet - 0 0 0
62 Azytromycin 500 mg tablet 320 320 120 200
63 Bactivec btl - 0 0 0
64 Baju Pelindung Biru pcs - 0 0 0
65 Baju Pelindung Putih pcs - 0 0 0
66 BD Vactnr Flashback Blood Collc Needle pcs - 0 0 0
67 Benzatin Benzil Penisillin 1,2 jt iu/vial Inj vial - 0 0 0
70 Betamethasone + Neomycin krim tube - 0 0 0
71 Betamethasone krim 0,1 % tube 65 65 15 50
72 Bisoprolol 5 mg tablet - 0 0 0
74 Borax Gliserin (GOM) pot - 0 0 0
75 Box Slide pcs - 0 0 0
76 Bromhexin syr botol - 0 0 0
77 Budesonide Liquid ( Pulmicort Respiration ) botol - 0 0 0
78 Budesonide Spray ( Simbicort Turbohaler ) botol 14 14 10 4
79 Calcium Carbonate 500mg+Vit D100iu ( Calporos tablet - 0 0 0
80 Calcetin calcium Hydroxide Paste box 0 0 0 0
81 Calcium Gluconate 100mg/ml im/iv botol - 0 0 0
82 Cal lc - 0 0
83 Cal Plus - 0 0
84 Calcium Lactate 500 mg tablet 1,500 1500 400 1100
85 Camphenol dus - 0 0 0
86 Candasartan tab tab - 0 0 0
87 Captopril 12,5 mg tablet 700 700 200 500
88 Captopril 25 mg tablet - 0 0 0
89 Catgut chromic 2/0 set - 0 0 0
91 Catgut plain 2/0 set - 0 0 0
93 Cavit G - 0 0
94 Cavit W - 0 0
95 Cefadroxil 125 mg Syr botol 60 60 20 40
96 Cefadroxil 500 mg tablet - 0 0 0
97 Cefixim 100 mg tablet - 0 0 0
98 Cefixim kaps 200 mg kapsul - 0 0 0
99 Cefixim Syr 100 mg / 5 ml botol 9 9 9 0
100 Cefotaxim inj vial - 0 0 0
101 Ceftriaxon inj vial - 0 0 0
102 Cetirizin syr 5 mg / 5 ml botol 250 250 0 250
103 Cetrizin tab 10 mg tablet 2,100 2100 900 1200
104 Ciprofloxacin Tab 500 mg tablet 2,400 2400 1000 1400
105 Clindamycin 150 mg kap tablet - 0 0 0
106 Clindamycin 300 mg kap tablet 200 1,000 1200 150 1050
107 Cover Glass ktk - 0 0 0
108 Cream Luka Bakar tube - 0 0 0
109 Cresotin Liquid No. 2 btl - 0 0 0
110 Darflex / DHP ( dihydro artemisin ) tablet 9 9 0 9
111 Deksametason inj 5 mg/ml - 1 ml ampul 5 5 0 5
112 Deksametason tablet 0,5 mg tablet - 0 0 0
114 Devitalisasi pasta (non arsen) botol - 0 0 0
STOK
AWAL
116 Diazepam 5 mg tab tablet - 0 0 0
117 Diazepam inj 5 mg/ml - 2 ml ampul - 0 0 0
118 Diazepam rectal suppos 2 2 0 2
119 Dietilkarbamazepin tablet - 0 0 0
120 Difenhidramin hcl inj 10 mg/ml - 1 ml ampul - 0 0 0
121 Diflucan tab tab - 0 0 0
122 Digoksin tablet 0,25 mg tablet - 0 0 0
123 Diltiazem 30 mg tablet - 0 0 0
124 Disposible Needle set - 0 0 0
125 Doksisiklin 100 mg tablet - 0 0 0
126 Domperidon syr botol - 0 0 0
127 Domperidon Tab 10 mg tablet 1,300 1300 300 1000
128 Duviral ktk - 0 0 0
129 Efavirenz ktk - 0 0 0
130 Ekstrak Placenta Kombinasi (Bioplacenton) Gel tube - 0 0 0
131 Ekstrak belladon tablet 10 mg tablet - 0 0 0
132 Emersi Oil botol - 0 0 0
133 Epinefrin hcl/bitatrat (adrenalin) inj 0,1 % - 1 ml ampul - 0 0 0
134 Erithromycin 250 mg tablet - 0 0 0
136 Erithromycin syr botol 7 7 7 0
138 Etanol 70 % ( 100 ml ) botol - 0 0 0
139 Etanol 70 % ( 300 ml ) botol 0 0 0 0
140 Etanol 70 % ( 1000 ml ) botol 12 12 0 12
141 Ethambutol 250 mg Tab tablet - 0 0 0
143 Eugenol cairan botol - 0 0 0
144 FDC Anak ktk - 0 0 0
145 Fenitoin natrium kapsul 100 mg kapsul - 0 0 0
146 Fenobarbital inj ampul - 0 0 0
147 Fenobarbital tablet 30 mg tablet - 0 0 0
148 Fitomenadion (vit k) injeksi 10 mg/ml - 1 ml ampul - 0 0 0
149 Fitomenadion (vit k) tablet salut 10 mg tablet - 0 0 0
150 Flukonazol tab tab 40 40 0 40
151 Focus Syphylis Cassette test - 0 0 0
152 Furosemid inj ampul - 0 0 0
153 Furosemid tablet 40 mg tablet - 0 0 0
154 Gabapentin tab - 0 0 0
155 Garam oralit untuk 200 ml air sachet 2,900 2900 600 2300
156 Gentamisin inj 80 mg / 2ml ampul - 0 0 0
158 Gentamicin salep mata tube 10 10 10 0
159 Gentamisin tetes mata 0.3% botol 24 24 10 14
160 Gentian violet larutan 1 % botol - 0 0 0
161 Glass ionomer cement (gc ix) botol - 0 0 0
162 Glibenklamid tablet 5 mg tablet 2,400 2400 100 2300
163 Gliklazide 80 mg tab tablet - 0 0 0
164 Glimepirid 3 mg tablet - 0 0 0
165 Glimepirid tab 2 mg tab - 0 0 0
166 Gliseril guayakolat tablet 100 mg tablet - 0 0 0
167 Glukosa Cairan infus 10 % steril botol - 0 0 0
170 Griseofulvin tablet 125 mg, micronized tablet - 0 0 0
171 Halloperidol 1,5 mg tablet - 0 0 0
172 Halloperidol 5 mg tablet - 0 0 0
173 Halloperidol inj. ampul - 0 0 0
175 Handscoon Latex ( powder gloves ) set - 0 0 0
176 Handscoon Non Steril psg 3,700 3700 400 3300
STOK
AWAL
178 Hidroklortiazid 25 mg ( HCT ) tablet - 0 0 0
179 Hidrokortison krim 1 % tube - 0 0 0
181 Hufagripp Forte tab tab - 0 0
182 Hydcal Paste, base dan Catalyst dus - 0 0 0
183 I.V.Cateter (abbocath) 18 set - 0 0 0
184 I.V.Cateter (abbocath) 20 set 4 4 0 4
188 Ibuprofen 200 mg tablet tablet - 0 0 0
189 Ibuprofen 400 mg tablet tablet 2,500 2500 500 2000
190 Ibuprofen susp 100 mg btl - 0 0 0
192 Ichtyol salep botol 12 12 0 12
193 Infusion set anak set - 0 0 0
194 Infusion set dewasa set - 0 0 0
195 INH 100 mg tablet - 0 0 0
196 INH 300mg tablet 960 960 740 220
197 Inhaler Berotec botol - 0 0 0
198 Isosorbid dinitrat tablet sublingual 5 mg tablet - 0 0 0
199 Jarum kulit lusin - 0 0 0
200 Jarum otot lusin - 0 0 0
201 Kalium aspartat (Aspar-K) tablet - 0 0 0
202 Kapas 100 gr roll 4 4 0 4
203 Kapas pembalut 250 gr roll - 0 0 0
204 Karbamazepin 200 mg tablet - 0 0 0
205 Kassa 4 m x 15 cm roll - 0 0 0
206 Kassa 4 x 10 roll - 0 0 0
207 Kassa 40 x 80 cm roll - 0 0 0
208 Kassa / Perban elastis kotak - 0 0 0
209 Kassa 15 cm x 3 roll - 0 0 0
210 Kassa 36 x 80 cm roll - 0 0 0
211 Kassa Steril kotak - 0 0 0
212 Kassa Steril + Antibiotik ( Cuticell ) pieces - 0 0 0
213 Kassa Steril + Antibiotik ( Lomattul ) pieces - 0 0 0
214 Ketokonazole 200 mg tablet - 0 0 0
215 Ketokonazole krim tube 60 60 120 24 96
216 Ketoprofen 100 mg tablet - 0 0 0
217 Ketoprofen inj ampul - 0 0 0
218 Ketorolac inj ampul - 0 0 0
219 Klonidin 0.5 mg tablet - 0 0 0
221 Kloramfenicol salep kulit 2% tube - 0 0 0
222 Kloramfenicol kapsul 250 mg kapsul - 0 0 0
223 Kloramfenicol salep mata tube - 24 24 6 18
224 Kloramfenicol syrup 125mg/5ml botol - 0 0 0
225 Kloramfenicol tetes mata botol - 0 0 0
227 Kloramfenikol kapsul 500 mg kapsul - 0 0 0
228 Klorfeniramin maleat ( CTM ) tablet 4 mg tablet 2,592 2592 576 2016
229 Klorokuin fosfat tablet 250 mg tablet 20 20 0 20
230 Klorpromazin 100 mg ( CPZ ) tablet - 0 0 0
231 Kombipak Azithromicin paket - 0 0 0
232 Kondom pcs 432 432 0 432
233 Kotrimoxazol dewasa 480 mg tablet 3,100 3100 0 3100
234 Kotrimoxazol paed 120 mg tablet - 0 0 0
235 Kotrimoxazol suspensi botol 50 50 0 50
236 Kuinina 200 mg tablet - 0 0 0
237 Kuinina Hcl inj 25% - 2 ml ampul - 0 0 0
238 Lab Anti A Monoclonal Gol Darah vial 2 2 0 2
239 Lab Anti B Monoclonal Gol Darah vial 2 2 0 2
STOK
AWAL
240 Lab Salmonella Paratyphi AO Widal Test vial 4 4 0 4
241 Lab Salmonella Paratyphi BO Widal Test vial 4 4 0 4
242 Lab Salmonella Typhi H Widal Test vial 4 4 0 4
243 Lab Salmonella Typhi O Widal Test vial 4 4 0 4
244 Lamivudin tab ktk - 0 0 0
245 Lansoprazole 30 mg tablet 300 300 300 0
246 Larutan benedict botol - 0 0 0
247 Larutan eosin 2 % botol - 0 0 0
248 Larutan etanol asam botol - 0 0 0
249 Larutan giemsa stain botol - 0 0 0
250 Larutan H2O2 botol 1 3 4 0 4
251 Larutan karbol fuksin botol - 0 0 0
252 Larutan metilen biru botol - 0 0 0
256 Larvasida serbuk ( abatte 25 kg ) galon - 0 0 0
257 Laxatif enema tube - 0 0 0
258 Laxatif suppositoria (Bisacodil supp) suppos 22 22 7 15
260 Levertran salep pot - 0 0 0
261 Levofloxacin tab tab - 0 0 0
262 Levotyroxin sodium ( Natrium Tyroxin ) tablet - 0 0 0
265 Loratadine 10 mg tablet 300 300 100 200
266 Lorazepam tablet - 0 0 0
267 Magnesium sulfat injeksi (iv) 20 % - 25 ml botol - 0 0 0
269 Marker pen pcs - 0 0 0
270 Masker Hijau pieces 1,100 1100 850 250
271 Masker N.95 pieces - 0 0 0
272 Masker Nebul Anak set - 0 0 0
273 Masker Nebul Dewasa set - 0 0 0
274 Masker Sugiral pieces - 0 0 0
275 Masker With Visor pieces - 0 0 0
276 Meloxicam 7,5 mg tablet 1,080 1080 570 510
277 Mesin Centrifuge set - 0 0 0
278 Metampiron 500 mg ( antalgin ) tablet - 0 0 0
279 Metformin 500 mg tablet 3,600 3600 800 2800
280 Metformin 850 mg tablet - 0 0 0
281 Methylprednisolone 4 mg tablet 2,000 2000 1400 600
282 Methylprednisolone 8 mg tablet - 0 0 0
283 Methylprednisolone inj ampul - 0 0 0
284 Metilergometrin maleat inj 0,200 mg - 1 ml ampul - 0 0 0
285 Metilergometrin Maleat tab tablet - 0 0 0
286 Metoklopramide inj 5mg/ml ampul - 0 0 0
287 Metoklopramide tab tablet - 0 0 0
288 Metronidazol 250 mg tablet - 0 0 0
290 Metronidazol infus botol - 0 0 0
291 Miconazol krim tube - 0 0 0
292 Mikropipet pcs - 0 0 0
293 Mineral Mix sachet - 0 0 0
294 Mirapect tab 30 mg tab - 0 0 0
295 Multivitamin + zat besi (Siobion) tablet - 0 0 0
296 Multivitamin drop botol - 0 0 0
297 Multivitamin Kombinasi Syrup botol - 0 0 0
298 Multivitamin kombinasi tab tablet - 0 0 0
299 Mummifying pasta botol - 0 0 0
300 Mycamine 50 mg tablet - 0 0 0
301 Nasal Oxygen adult set - 0 0 0
STOK
AWAL
302 Nasal Oxygen child set - 0 0 0
303 Natrium Bikarbonat tablet 500 mg tablet 200 200 0 200
304 Natrium Diklofenak 25 mg tab tablet - 0 0 0
305 Natrium Diklofenak 50 mg tab tablet 3,100 3100 800 2300
306 Natrium Diklofenak Gel tube - 0 0 0
308 Natrium Walfarin 2 mg ( Simarc ) tablet - 0 0 0
309 Needle set - 0 0 0
310 Neurotropik inj / Neurobion inj ampul - 0 0 0
311 Neurotropik tablet / Miraneuro tablet - 0 0 0
312 Nevirafine ktk - 0 0 0
313 Nifedifine 10 mg ( Farmalat ) tablet - 0 0 0
314 Nistatin 100.000 UI Vaginal suppos 115 115 0 115
315 Nistatin 500.000 UI Oral tablet - 0 0 0
316 Nitrile Examination Glove box - 0 0 0
317 OAT Kategori Anak paket 5 5 0 5
319 OAT Kategori II paket 0 0 0 0
320 OAT Kategori Sisipan paket - 0 0 0
321 OAT Kombipak kategori I paket - 0 0 0
322 Obat diare kombinasi tab tablet - 0 0 0
323 Obat diare syrup botol - 0 0 0
324 Obat Herbal ( penambah ASI ) tablet - 0 0 0
325 Obat Kusta MB Anak bister - 0 0 0
327 Obat Kusta PB Anak blister - 0 0 0
328 Obat Kusta tipe PB ( dewasa ) blister - 0 0 0
329 Oksitetrasiklin HCL inj 50 mg/ml ampul - 0 0 0
330 Oksitetrasiklin HCL salep Kulit 3% tube - 0 0 0
331 Oksitetrasiklin HCL salep mata tube - 0 0 0
332 Oksitosin injeksi 10 iu/ml - 1 ml ampul - 0 0 0
333 Omeprazol 20 mg kaps tablet - 0 0 0
334 Omeprazol Inj ampul - 0 0 0
335 Ondansetron inj ampul 2 5 7 0 7
336 Ondansetron tab tablet 750 750 240 510
337 Oxyflow Anak pcs - 0 0 0
338 Oxyflow Dewasa pcs - 0 0 0
339 Parasetamol Drop 100 mg/ml botol - 0 0 0
340 Parasetamol syrup 120 mg / 5 ml botol 314 314 0 314
341 Parasetamol tablet 500 mg tablet - 5,000 5000 0 5000
342 Pasaba Cough & flu susp btl - 0 0 0
343 PCT, CTM, GG, EFED ( syrup ) botol - 0 0 0
344 PCT, CTM, GG, EFED ( Coparcetin ) tablet - 0 0 0
345 Pehavral Tablet Salut Gula (Suplemen makanan) pcs - 0 0 0
347 Permethrin 5 % ( Scabies cream ) pot 25 25 0 25
348 Pharmacoll Thick 10cm x 10 cm buah - 0 0 0
349 Pharmafix buah - 0 0 0
350 Phenol Gliserol tetes telinga btl - 0 0 0
351 Pirantel score (base) 125 mg tablet 90 90 0 90
352 Pirantel syrup 125 mg / 5 ml botol - 0 0 0
353 Piridoksin HCL tablet ( Vit B6 ) tablet - 0 0 0
354 Piroksikam 10 mg tablet - 0 0 0
356 Pisau bisturi pieces - 0 0 0
357 PK / Serbuk anti septik pot - 0 0 0
358 Plester ( medical adhesive tape ) roll 2 2 0 2
359 Plester ( Ultrafik ) roll 10 10 1 9
360 Plester Bulat non woven Kotak - 0 0 0
361 Plester in Bulat T 100 E Cat ktk - 0 0 0
362 Plester Microfore roll - 0 0 0
363 Poley Balon cateter no 16 set - 0 0 0
STOK
AWAL
365 Poliren No. 1 Polishing Paste box - 0 0 0
366 Postofix - PU 6 cm x 7 cm buah - 0 0 0
367 Pot Sputum pot 100 200 300 40 260
368 Prednison tablet 5 mg tablet 1,300 1300 1300 0
369 Primakuin tablet 15 mg tablet 30 30 0 30
370 Procain Benzil Penisilin inj ampul - 0 0 0
371 Profil Tio Urasil tablet 100 mg tablet - 0 0 0
372 Propanolol hcl tablet 10 mg tablet - 0 0 0
374 Pyridoksin tab 25 mg tab - 0 0 0
375 Ranitidin inj ampul - 0 0 0
376 Ranitidin tab tablet - 0 0 0
377 Rapid test pieces - 0 0 0
378 Rapid test Spillis pieces - 0 0 0
380 RDT DBD pieces - 0 0 0
381 RDT HIV 1 ( Diagnostar ) test - 0 0 0
382 RDT HIV 1 ( KHB ) test - 0 0 0
383 RDT HIV 2 ( Focus ) test - 0 0 0
384 RDT Malaria pieces - 0 0 0
385 Reagen Bead Control CD4 PIMA test - 0 0 0
386 Reagen CD4 Mobile Mesin PIMA test - 0 0 0
387 Reagen tes kehamilan box - 0 0 0
388 Reagent Colesterol test - 0 0 0
390 Reagent HIV - intec test - 0 0 0
391 Reagent HIV - oncoprobe test - 0 0 0
392 Reagent HIV - vikia test - 0 0 0
393 Reagent Rapid tes HBSAG test 400 400 100 300
394 Reagen SD-HIV (SD BIOLINE) test - 0 0 0
395 Reagent Tes Urin test - 0 0 0
396 Reagent Typoid test - 0 0 0
397 Reagent Uric Acid test - 0 0 0
399 Reserpin 0.1 mg Tab tablet - 0 0 0
401 Resperidon tab tab - 0 0 0
402 Retinol 100.000iu kap tablet 1,250 1250 0 1250
404 Rilpivirine ktk - 0 0 0
406 RPR Antigen Syphilis Fokus test - 0 0 0
409 Salbutamol 2 mg tablet - 0 0 0
410 Salbutamol inhaler set - 0 0 0
411 Salbutamol nebules set - 0 0 0
412 Salep 2-4 kombinasi pot 6 6 6 0
414 Serum anti bisa ular polivalen inj 5 ml (abu i) ampul - 0 0 0
415 Serum anti tetanus inj 1.500 iu/ampul (a.t.s) ampul 7 7 2 5
416 Sianokobalamin (vit B 12) inj 500 mcg/ml ampul - 0 0 0
417 Silk (benang bedah sutera) No 3/0 pieces - 0 0 0
418 Simvastatin 10 mg tablet - 0 0 0
419 Simvastatin 20 mg tablet 500 500 1000 450 550
420 Slide / Glass object Kotak - 0 0 0
421 Spalk kayu set 3 3 0 3
422 Spironolactone 25 mg tablet - 0 0 0
424 Stera Sharp Container 1L pcs - 0 0 0
425 Sukralfat susp 100 mg btl - 48 48 20 28
STOK
AWAL
426 Sulfasetamid Natrium tetes mata 15 % botol - 0 0 0
427 Surgical Optime pcs - 0 0 0
428 Tablet tambah darah kombinasi tablet 265,200 265200 29700 235500
429 Tehnodent Antiseptik Liquid No. 2 btl - 0 0 0
430 Tenovofir ktk - 0 0 0
431 Tenovofir + Emtracitabine ktk - 0 0 0
432 Thiamfenicol tab 250 mg tablet - 0 0 0
434 Thiamin inj 100 mg/ml ampul - 0 0 0
435 Thiamin tab (vit B1) tablet 1,700 1700 300 1400
436 Tramadol Hidrocloride 50 mg tablet - 0 0 0
437 Tramadol inj ampul - 0 0 0
438 Tranfusion set set - 0 0 0
439 Tricresolformalina dus - 0 0 0
440 Trihexiphenidil 2 mg tablet - 0 0 0
441 Tuberkulin PPD RT 23 SSI vial - 0 0 0
442 Tyrozol tab tab - 0 0 0
443 Underpad pcs - 0 0 0
444 Urine Bag set 2 2 0 2
445 Urocare Folley cath. No 16 set - 0 0 0
447 Vaccum Tube Steril EDTA pack - 0 0 0
448 Vaksin Anti Rabies ampul - 4 4 4 0
449 Vaksin BCG ampul 12 25 37 19 18
450 Vaksin Campak ampul - 0 0 0
451 Vaksin DPT-HB Combo ampul 8 45 53 44 9
452 Vaksin DT ( adsorbed ) ampul 10 10 0 10
454 Vaksin Hepatitis B uniject ampul 29 20 49 26 23
455 Vaksin IPV ampul 15 20 35 25 10
456 Vaksin Polio ampul 13 30 43 32 11
457 Vaksin TD ( difteri toxoid ) ampul 23 15 38 15 23
458 Vaksin TT ampul - 0 0 0
459 Vaksin Meningitis vial - 0 0 0
460 Vaksin MR ampul 13 30 43 32 11
461 Vitamin B 12 tablet tab - 0 0 0
462 Vitamin B Compleks tablet 4,000 3,000 7000 1700 5300
463 Wing Nedle no 25 set - 0 0 0
465 Wrapping paper ktk - 0 0 0
466 Xylocain gel btl - 0 0 0
467 Xylocain Spray btl - 0 0 0
468 Yodium povidon 10% - 1000 ml botol - 0 0 0
469 Yodium povidon 10% - 30 ml botol 7 7 7 0
471 Yodium Povidon 60 ml btl 7 7 0 7
472 Zidovudin tab ktk - 0 0 0
473 Zinc drop botol - 0 0 0
474 Zinc Sulphate 20 mg tablet 1,400 1400 100 1300
475 Zinc syrup botol 108 108 0 108
476 Zink F dus - 0 0 0
477 Masker TB box 3,200 3200 0 3200
478 ADS 0,5 ml (vaksin covid) pcs - 30 30 30 0
479 Alkohol Swab (Vaksin covid) sachet - 30 30 30 0
480 Safety box (covid) pcs 19 1 20 1 19
481 Masker bedah pcs 400 400 200 200
482 Larvasida btl - 0 0 0
483 FAVIPIRAVIR 200 mg tab - 0 0 0
484 Objek glass malaria pcs - 0 0 0
485 Objek glass TB pcs 41 41 0 41
486 Masker KN95 pcs 1,225 1225 225 1000
487 Masker N95 pcs 95 95 0 95
STOK
AWAL
488 Oxygen Mask Dewasa pcs 2 2 1 1
489 Vaksin Moderna vial - 0 0 0
491 Vaksin Aztrazeneka vial - 0 0 0
494 Diluent Dirui Galon - 0 0 0
495 Cleanser BCC 3600 btl - 0 0 0
496 Lyse BCC 3600 btl - 0 0 0
497 glimepiride 1 mg pcs 1,400 1400 300 1100
498 TDF+3TC+EFV(300/300/600)/TLE (atripla) pcs 4 4 0 4
499 TDF(300)+3TC(300)+DTG(50)/TLD pcs 5 5 2 3
500 RDT HIV R1 (VIROCEK) pcs 600 600 150 450
501 RDT Sifilis Trepocheck pcs - 0 0 0
502 Oxygen Mask Anak tab 3 3 0 3
504 RDT HIV R2 (StandarQ) tab - 50 50 0 50
505 RDT HIV R3 (Diagnostar) tab - 0 0 0
506 Dolute gravir btl 2 2 0 2
507 Vitamin B6 25 mg tab - 0 0 0
508 Kotrimoxazol 960mg tab 2,300 2300 0 2300
509 Lubrikan tab 100 100 0 100
510 Guaifenesin 100 mg tab 400 400 0 400
512 Tabung EDTA pcs 400 400 0 400
513 Curcuma Force tab 600 600 120 480
514 USG Gel btl 1 1 1 0
515 Tabung EDTA (steril HIV) pcs 2 2 0 2
516 Cryotube pcs 100 100 0 100
517 Microtrainer EDTA pcs 10 10 0 10
518 Flashback Needle 22 G pcs 50 50 0 50
519 Yellow Holder pcs 50 50 0 50
520 Wings Needle 27G pcs 5 5 0 5
521 Tip Pipet 1 ml (steril) pcs 2 2 0 2
522 Plastik Clip 5x7cm pcs 2 2 0 2
524 Ice Pack pcs 10 10 0 10
525 Ice Gel pcs 5 5 0 5
526 Lakban pcs 1 1 0 1
527 Styrofoam pcs 2 2 0 2
528 Banner tb pcs - 0 0 0
529 Plester ( Pharmafik) ktk 10 10 0 10
530 Etanol 95 % botol 8 8 0 8
531 Vitamin D3 tablet 60 60 60 0
532 Masker Earloop pcs 8,000 8000 0 8000
533 Masker bedah hiv pcs - 0 0 0
534 Plastik Clip 15x24cm pack 1 1 0 1
535 Safety box (bian) pcs 12 12 0 12
536 Vaksin Indovac vial - 3 3 3 0
537 RDT HIV R3 (Rapidan) pcs 50 50 0 50
538 Masker headloop (Hijab) pcs 0 0 0
539 Salbutamol cairan inhalasi (inhavent) amp 0 0 0
1 Acyclovir 5% cream tube - 0 0 0
2 Abate Kg - 0 0 0
3 Acyclovir 400 mg tab 1,000 1000 300 700
4 Allopurinol tablet tab 1,100 1100 100 1000
5 Ambroxol syrup Btl 80 80 0 80
6 Ambroxol tab tab 1,500 1500 0 1500
7 Amlodipin 10 mg tab - 0 0 0
8 Amlodipin 5 mg Tab - 0 0 0
9 Amoxicillin 500 mg Tab - 0 0 0
STOK
AWAL
10 Antasida tab tab - 0 0 0
11 Asam Folat tab 300 300 100 200
12 Asam mefenamat 500 mg Tab - 0 0 0
14 Azithromycin 500 mg tab - 0 0 0
15 Betahistin Mesilat (Lexigo) Tab - 0 0 0
16 Catgut chromic 2/0 pcs - 0 0 0
17 Catgut plain 3/0 pcs 8 8 0 8
18 Catheter pcs - 0 0 0
20 Cetirizin tab tab - 0 0 0
21 Cholesterol strep ktk - 0 0 0
22 Ciprofloxacin 500 mg tab - 0 0 0
23 Cleanser pcs - 1 1 1 0
24 Clindamicin cap 300 mg caps - 0 0 0
25 CTM Tab - 0 0 0
26 Cuticell pcs - 0 0 0
27 Deksametason 0,5 mg Tab - 0 0 0
28 Desinfectan ltr - 0 0 0
29 Dexamethasone inj amp - 0 0 0
30 Diluent Galon - 1 1 1 0
31 Domperidone tab Tab - 0 0 0
32 Dipenhidramin inj amp 5 5 0 5
33 Epinefrin inj amp 5 5 0 5
34 Etambutol tab 500mg Tab - 0 0 0
35 Etil klorida semprot btl - 0 0 0
36 Furosemid tab - 0 0 0
37 Garam orali (Ramolit) Sacc - 0 0 0
38 Gentamisin salep kulit tube 70 70 40 30
39 Gentamisin salep mata (Genoint) tube - 0 0 0
40 Gentian Violet Btl 42 42 5 37
41 Glibenclamide Tab - 0 0 0
42 Gliseri Guaiacolat 50 mg TAb - 0 0 0
43 Glucosa strep ktk - 0 0 0
44 Guafenesin 100 mg tab - 0 0 0
45 H2O2 btl - 0 0 0
46 Handsanitizer ltr - 0 0 0
47 Handscoon non steril Pcs - 0 0 0
48 Handscoon Steril psg - 0 0 0
49 Hydrocortison 2.5 % Tube - 0 0 0
50 Ichtyol salep Pot - 0 0 0
51 infus set anak pcs - 0 0 0
52 infus set dewasa pcs - 0 0 0
53 Iodium test btl - 0 0 0
55 IV catheter no 18 pcs - 0 0 0
57 jarum jahit set - 0 0 0
58 Kalsium laktat 500 mg tab - 0 0 0
59 Kassa steril Kotak 40 40 6 34
61 Ketoconazole tab 900 900 100 800
62 Kloramfenicol Tetes Telinga (Erlamycin) Btl - 0 0 0
63 Kloramfenicol salep mata tube - 0 0 0
64 Kloramfenicol tts mata(Reco) Btl - 0 0 0
65 Larutan H2O2 Btl - 0 0 0
66 Loperamide (Primodiar) tab Tab 300 300 100 200
68 Masker ktk - 0 0 0
71 Metformin tab 500 mg Tab - 0 0 0
STOK
AWAL
72 Metilprednisolon Tab - 0 0 0
73 Metronidazol 500 mg Tab 600 600 100 500
74 Muktivitamin syr (Procurma) Btl 154 154 29 125
75 Multivitamin syr (Tyalisin) Btl - 0 0 0
76 Multivitamin tab (Caviplex) tab - 0 0 0
77 Natrium Bikarbonat tablet 500 mg Tab - 0 0 0
78 Natrium Diclovenak 50 mg tab - 0 0 0
79 Neurotropik tab (Hufaneuron) Tab - 0 0 0
81 Obat batuk flu (Hustab tab) Tab 900 900 900 0
82 Obat batuk flu anak (anacetin Baby cough sirup) Btl - 0 0 0
83 Obat batuk flu syr (Corpacetin) Btl 142 142 52 90
84 Obat Diare komb (Diapecta) Tab - 0 0 0
85 Obat flu (Dextral) tab tab - 0 0 0
86 Omeprazol caps caps 2,100 2100 90 2010
87 Ondancentron Inj amp - 0 0 0
89 Paracetamol sirup btl - 0 0 0
90 Pehacain inj amp 40 40 40 0
91 Perban elastis roll - 0 0 0
92 Pisau bisturi no 10 pcs 15 15 0 15
93 Pisau Bisturi no 11 pcs 25 25 0 25
94 Plastik Infeksius 40x60 pack - 0 0 0
95 Plastik infeksius kecil pack - 0 0 0
96 Plastik klip obat 7 x 10 pack - 0 0 0
98 Plastik medis 60 x 100 pack 1 1 0 1
99 Plester Dermatix T 25x10 cm roll - 0 0 0
100 Plester Hypafix roll - 0 0 0
101 Ranitidin tab - 0 0 0
102 Ranitidine inj amp - 0 0 0
103 Sabun Antiseptik ltr - 0 0 0
104 Salbutamol 2 mg tab Tab 200 200 200 0
105 Salicyl talk ktk - 0 0 0
107 Silk 2/0 pcs - 0 0 0
108 silk 3/0 pcs 3 3 0 3
109 Simvastatin tab Tab - 0 0 0
110 Spalk anak pcs - 0 0 0
111 Spatel Tongue ktk 1 1 0 1
112 Spuit 1 ml set - 0 0 0
113 Tablet tambah darah kombinasi tab - 0 0 0
114 Tabung EDTA pcs - 0 0 0
115 Tes Kehamilan pcs 50 50 0 50
116 Thiamfenicol tab 100 100 100 0
117 Thiamin HCl tab (Vit B1) tab - 0 0 0
118 transofix pcs - 0 0 0
120 Vit B.comp tab - 0 0 0
121 Vitamin B6 tab 2,900 2900 700 2200
122 Vitamin C 50 mg tab - 0 0 0
123 Winner tape/isopore roll 6 6 0 6
124 Yellow tip pack - 0 0 0
125 Zink tablet tab - 0 0 0
128 kassa 15 cm roll 87 87 52 35
129 double spike Pcs 4 4 2 2
130 dermafix tulle Pcs 50 50 10 40
Umum
Bayar Tidak
STOK
AWAL
PKM 139 240 673
PUSTU 0 50 22
POSKESKEL 44 18 48
TOTAL 183 308 743
Mengetahui Bandar Lampung,

Plt. Kepala Puskesmas Labuhan Ratu Penanggung Jawab O
Ns. Sumiyati, S.Kep Apt. Yunita Amri

NIP. 19680304 198812 2 003 NIP. 19940630 2
Formulir 16
MAKAIAN DAN LEMBAR PERMINTAAN OBAT
KETERANGAN (RUSAK,
PERMINTAAN PEMBERIAN
ED/SAMPLING, DLL)
11 12 13
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
TOTAL
KETERANGAN (RUSAK,
ED/SAMPLING, DLL)
1052
72
110
1234
Bandar Lampung, Juni 2023


NIP. 19940630 202012 2 024
Formulir 16
Kode : Bulan JULI Jml Poskesdes/ bidan desa 6
Puskesmas Labuhan Ratu Tahun 2023 Jml melapor 6
STOK KETERANGAN (RUSAK,

No NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR PERMINTAAN PEMBERIAN
AWAL ED/SAMPLING, DLL)
1 3 4 5 6 7=5+6 8 9=7-8 11 12 13
3 Acyclovir 400 mg Tab - 3,000 3000 0 3000
5 ADS 1 ml set - 0 0 0
9 Alat Suntik sekali pakai 1 ml set 300 200 500 100 400
12 Alat suntik sekali pakai 3 ml set 300 1,000 1300 0 1300
13 Alat suntik sekali pakai 5 ml set 100 700 800 100 700
14 Albendazol 400 mg tablet - 0 0 0
17 Alkohol Swab kotak 460 158 618 9 609
18 Allopurinol tablet 100 mg tablet 900 6,000 6900 200 6700
20 Ambroxol 30 mg tablet 1,950 18,000 19950 1150 18800
26 Amlodipin 5 mg tablet 2,100 1,200 3300 1250 2050
27 Amoxicillyn 500 mg tablet 2,000 7,000 9000 2000 7000
28 Amoxicillyn sirup kering 125 mg/5 ml botol 410 400 810 60 750
33 Antasida doen tablet kombinasi tablet 3,800 1,500 5300 1600 3700
35 Antifungi doen kombinasi pot 48 100 148 48 100
36 Antihaemoroid ( Bismuth Subgallate ) suppos 78 100 178 11 167
45 Asam Asetilsalisilat tab 80 mg tablet 700 3,000 3700 500 3200
47 Asam Askorbat (vit c) tablet 250 mg tablet - 3,000 3000 200 2800
48 Asam Askorbat (vit c) tablet 500 mg tablet - 1,500 1500 0 1500
51 Asam mefenamat 500 mg tablet 300 7,700 8000 300 7700
62 Azytromycin 500 mg tablet 200 2,200 2400 80 2320
69 Betahistin Mesilat 6 mg tablet 100 200 300 0 300
71 Betamethasone krim 0,1 % tube 50 168 218 30 188
73 Blood Lancet ktk 615 79 694 2 692
78 Budesonide Spray ( Simbicort Turbohaler ) botol 4 4 4 0
82 Cal lc - 0 0
83 Cal Plus - 0 0
84 Calcium Lactate 500 mg tablet 1,100 1100 500 600
90 Catgut chromic 3/0 set - 1 1 1 0
93 Cavit G - 0 0
94 Cavit W - 0 0
95 Cefadroxil 125 mg Syr botol 40 40 40 0
96 Cefadroxil 500 mg tablet - 4,500 4500 200 4300
97 Cefixim 100 mg tablet - 3,500 3500 0 3500
99 Cefixim Syr 100 mg / 5 ml botol - 0 0 0
103 Cetrizin tab 10 mg tablet 1,200 1200 1200 0
104 Ciprofloxacin Tab 500 mg tablet 1,400 1400 600 800
106 Clindamycin 300 mg kap tablet 1,050 1,000 2050 300 1750
118 Diazepam rectal suppos 2 5 7 1 6
127 Domperidon Tab 10 mg tablet 1,000 1000 300 700
136 Erithromycin syr botol - 0 0 0
138 Etanol 70 % ( 100 ml ) botol - 0 0 0
139 Etanol 70 % ( 300 ml ) botol 0 0 0 0
140 Etanol 70 % ( 1000 ml ) botol 12 4 16 0 16
142 Etil klorida semprot botol 9 4 13 2 11
150 Flukonazol tab tab 40 40 40 0
158 Gentamicin salep mata tube - 0 0 0
159 Gentamisin tetes mata 0.3% botol 14 24 38 31 7
162 Glibenklamid tablet 5 mg tablet 2,300 2,900 5200 400 4800
176 Handscoon Non Steril psg 3,300 3,000 6300 700 5600
180 Hidrokortison krim 2,5 % tube 107 312 419 25 394
184 I.V.Cateter (abbocath) 20 set 4 14 18 0 18
189 Ibuprofen 400 mg tablet tablet 2,000 300 2300 600 1700
192 Ichtyol salep botol 12 168 180 0 180
194 Infusion set dewasa set - 10 10 0 10
195 INH 100 mg tablet - 0 0 0
196 INH 300mg tablet 220 220 40 180
202 Kapas 100 gr roll 4 4 0 4
203 Kapas pembalut 250 gr roll - 10 10 0 10
205 Kassa 4 m x 15 cm roll - 0 0 0
206 Kassa 4 x 10 roll - 0 0 0
207 Kassa 40 x 80 cm roll - 0 0 0
209 Kassa 15 cm x 3 roll - 0 0 0
210 Kassa 36 x 80 cm roll - 0 0 0
214 Ketokonazole 200 mg tablet - 500 500 0 500
215 Ketokonazole krim tube 96 180 276 12 264
223 Kloramfenicol salep mata tube 18 48 66 10 56
228 Klorfeniramin maleat ( CTM ) tablet 4 mg tablet 2,016 8,352 10368 924 9444
232 Kondom pcs 432 432 0 432
245 Lansoprazole 30 mg tablet - 3,000 3000 0 3000
250 Larutan H2O2 botol 4 2 6 0 6
270 Masker Hijau pieces 250 250 100 150
276 Meloxicam 7,5 mg tablet 510 510 450 60
279 Metformin 500 mg tablet 2,800 3,800 6600 1200 5400
281 Methylprednisolone 4 mg tablet 600 600 600 0
317 OAT Kategori Anak paket 5 5 2 3
333 Omeprazol 20 mg kaps tablet - 5,000 5000 0 5000
335 Ondansetron inj ampul 7 7 0 7
336 Ondansetron tab tablet 510 1,200 1710 330 1380
341 Parasetamol tablet 500 mg tablet 5,000 44,100 49100 0 49100
351 Pirantel score (base) 125 mg tablet 90 500 590 0 590
358 Plester ( medical adhesive tape ) roll 2 3 5 0 5
367 Pot Sputum pot 260 260 120 140
368 Prednison tablet 5 mg tablet - 0 0 0
369 Primakuin tablet 15 mg tablet 30 30 60 30 30
376 Ranitidin tab tablet - 700 700 0 700
382 RDT HIV 1 ( KHB ) test - 0 0 0
389 Reagent Glukosa test 750 316 1066 90 976
408 Safety Box pcs 64 24 88 4 84
417 Silk (benang bedah sutera) No 3/0 pieces - 5 5 0 5
419 Simvastatin 20 mg tablet 550 550 250 300
425 Sukralfat susp 100 mg btl 28 28 28 0
435 Thiamin tab (vit B1) tablet 1,400 5,000 6400 300 6100
448 Vaksin Anti Rabies ampul - 4 4 1 3
453 Vaksin Hepatitis B Imuno Globullin ampul - 1 1 1 0
455 Vaksin IPV ampul 10 14 24 18 6
460 Vaksin MR ampul 11 40 51 18 33
462 Vitamin B Compleks tablet 5,300 13,600 18900 1400 17500
471 Yodium Povidon 60 ml btl 7 7 5 2
474 Zinc Sulphate 20 mg tablet 1,300 1300 500 800
476 Zink F dus - 0 0 0
477 Masker TB box 3,200 3200 0 3200
481 Masker bedah pcs 200 200 200 0
486 Masker KN95 pcs 1,000 1000 300 700
487 Masker N95 pcs 95 80 175 0 175
496 Lyse BCC 3600 btl - 0 0 0
497 glimepiride 1 mg pcs 1,100 1100 300 800
499 TDF(300)+3TC(300)+DTG(50)/TLD pcs 3 2 5 2 3
504 RDT HIV R2 (StandarQ) tab 50 50 0 50
509 Lubrikan (pelicin) tab 100 100 0 100
510 Guaifenesin 100 mg tab 400 400 400 0
511 Vaksin PCV vial - 0 0 0
512 Tabung EDTA pcs 400 400 200 200
514 USG Gel btl - 0 0 0
516 Cryotube pcs 100 100 0 100
524 Ice Pack pcs 10 10 0 10
525 Ice Gel pcs 5 5 0 5
530 Etanol 95 % botol 8 8 0 8
531 Vitamin D3 tablet - 0 0 0
536 Vaksin Indovac vial - 0 0 0
538 Masker headloop (Hijab) pcs - 5,000 5000 650 4350
539 Salbutamol cairan inhalasi (inhavent) amp - 10 10 0 10
540 Kassa 16x16 pcs 20 20 2 18
541 Disinfektan Spray btl 6 6 1 5
1 Acyclovir 5% cream tube - 50 50 0 50
2 Abate Kg - 0 0 0
3 Acyclovir 400 mg tab 700 700 100 600
4 Allopurinol tablet tab 1,000 1000 100 900
6 Ambroxol tab tab 1,500 1500 0 1500
9 Amoxicillin 500 mg Tab - 5000 5000 0 5000
11 Asam Folat tab 200 200 200 0
12 Asam mefenamat 500 mg Tab - 5000 5000 800 4200
23 Cleanser pcs - 0 0 0
25 CTM Tab - 0 0 0
27 Deksametason 0,5 mg Tab - 5000 5000 1000 4000
38 Gentamisin salep kulit tube 30 144 174 40 134
44 Guafenesin 100 mg tab - 5000 5000 400 4600
45 H2O2 btl - 0 0 0
54 Isosorbide dinitrat (ISDN) tab - 200 200 0 200
78 Natrium Diclovenak 50 mg tab - 4000 4000 0 4000
81 Obat batuk flu (Hustab tab) Tab - 4500 4500 900 3600
90 Pehacain inj amp - 300 300 60 240
96 Plastik klip obat 7 x 10 pack - 6 6 6 0
97 Plastik klip obat 8 x 12 pack - 4 4 4 0
104 Salbutamol 2 mg tab Tab - 500 500 100 400
107 Silk 2/0 pcs - 0 0 0
108 silk 3/0 pcs 3 3 2 1
112 Spuit 1 ml set - 0 0 0
116 Thiamfenicol tab - 300 300 0 300
121 Vitamin B6 tab 2,200 2200 300 1900
128 kassa 15 cm roll 35 35 0 35
Umum
Jumlah Kunjungan Resep JKN TOTAL
Bayar Tidak
PKM 159 283 753 1195

PUSTU 12 57 19 88
POSKESKEL 50 20 44 114
TOTAL 221 360 816 1397
Mengetahui Bandar Lampung, Juli 2023

Plt. Kepala Puskesmas Labuhan Ratu Penanggung Jawab Obat dan Perbekes
Ns. Sumiyati, S.Kep apt. Yunita Amriana, S.Farm

NIP. 19680304 198812 2 003 NIP. 19940630 202012 2 024
Formulir 16
Kode : Bulan AGUSTUS Jml Poskesdes/ bidan desa 6
Puskesmas Labuhan Ratu Tahun 2023 Jml melapor 6

1 3 4 5 6 7=5+6 8 9=7-8 11 12 13
3 Acyclovir 400 mg Tab 3,000 3000 200 2800
4 Acyclovir Zalf Tube - 0 0 0
5 ADS 1 ml set - 0 0 0
12 Alat suntik sekali pakai 3 ml set 1,300 1300 0 1300
14 Albendazol 400 mg tablet - 6,200 6200 6150 50
18 Allopurinol tablet 100 mg tablet 6,700 6700 300 6400
20 Ambroxol 30 mg tablet 18,800 18800 900 17900
27 Amoxicillyn 500 mg tablet 7,000 7000 2200 4800
33 Antasida doen tablet kombinasi tablet 3,700 3700 2100 1600
35 Antifungi doen kombinasi pot 100 100 0 100
36 Antihaemoroid ( Bismuth Subgallate ) suppos 167 167 17 150
45 Asam Asetilsalisilat tab 80 mg tablet 3,200 3200 600 2600
47 Asam Askorbat (vit c) tablet 250 mg tablet 2,800 2800 900 1900
48 Asam Askorbat (vit c) tablet 500 mg tablet 1,500 1500 500 1000
51 Asam mefenamat 500 mg tablet 7,700 7700 0 7700
62 Azytromycin 500 mg tablet 2,320 2320 240 2080
71 Betamethasone krim 0,1 % tube 188 188 48 140
78 Budesonide Spray ( Simbicort Turbohaler ) botol - 0 0 0
82 Cal lc - 0 0
83 Cal Plus - 0 0
84 Calcium Lactate 500 mg tablet 600 2,000 2600 650 1950
93 Cavit G - 0 0
94 Cavit W - 0 0
95 Cefadroxil 125 mg Syr botol - 0 0 0
96 Cefadroxil 500 mg tablet 4,300 4300 300 4000
97 Cefixim 100 mg tablet 3,500 3500 500 3000
99 Cefixim Syr 100 mg / 5 ml botol - 0 0 0
103 Cetrizin tab 10 mg tablet - 0 0 0
104 Ciprofloxacin Tab 500 mg tablet 800 800 800 0
106 Clindamycin 300 mg kap tablet 1,750 1750 200 1550
118 Diazepam rectal suppos 6 6 1 5
127 Domperidon Tab 10 mg tablet 700 700 300 400
136 Erithromycin syr botol - 0 0 0
138 Etanol 70 % ( 100 ml ) botol - 0 0 0
139 Etanol 70 % ( 300 ml ) botol 0 0 0 0
140 Etanol 70 % ( 1000 ml ) botol 16 16 0 16
150 Flukonazol tab tab - 0 0 0
158 Gentamicin salep mata tube - 0 0 0
159 Gentamisin tetes mata 0.3% botol 7 7 7 0
162 Glibenklamid tablet 5 mg tablet 4,800 4800 300 4500
176 Handscoon Non Steril psg 5,600 5600 550 5050
189 Ibuprofen 400 mg tablet tablet 1,700 1700 900 800
192 Ichtyol salep botol 180 180 12 168
194 Infusion set dewasa set 10 10 1 9
195 INH 100 mg tablet - 0 0 0
196 INH 300mg tablet 180 180 60 120
202 Kapas 100 gr roll 4 4 0 4
203 Kapas pembalut 250 gr roll 10 10 0 10
205 Kassa 4 m x 15 cm roll - 0 0 0
206 Kassa 4 x 10 roll - 0 0 0
207 Kassa 40 x 80 cm roll - 0 0 0
209 Kassa 15 cm x 3 roll - 0 0 0
210 Kassa 36 x 80 cm roll - 0 0 0
214 Ketokonazole 200 mg tablet 500 500 100 400
215 Ketokonazole krim tube 264 264 12 252
223 Kloramfenicol salep mata tube 56 56 5 51
228 Klorfeniramin maleat ( CTM ) tablet 4 mg tablet 9,444 9444 1668 7776
232 Kondom pcs 432 432 0 432
245 Lansoprazole 30 mg tablet 3,000 3000 0 3000
250 Larutan H2O2 botol 6 6 1 5
270 Masker Hijau pieces 150 150 150 0
276 Meloxicam 7,5 mg tablet 60 1,000 1060 460 600
279 Metformin 500 mg tablet 5,400 5400 1000 4400
317 OAT Kategori Anak paket 3 2 5 5 0
318 OAT Kategori I paket 89 12 101 3 98
333 Omeprazol 20 mg kaps tablet 5,000 5000 0 5000
335 Ondansetron inj ampul 7 7 2 5
336 Ondansetron tab tablet 1,380 1380 420 960
341 Parasetamol tablet 500 mg tablet 49,100 49100 0 49100
351 Pirantel score (base) 125 mg tablet 590 590 3 587
358 Plester ( medical adhesive tape ) roll 5 5 0 5
367 Pot Sputum pot 140 140 140 0
368 Prednison tablet 5 mg tablet - 0 0 0
369 Primakuin tablet 15 mg tablet 30 30 0 30
376 Ranitidin tab tablet 700 700 200 500
382 RDT HIV 1 ( KHB ) test - 0 0 0
417 Silk (benang bedah sutera) No 3/0 pieces 5 5 3 2
419 Simvastatin 20 mg tablet 300 300 300 0
425 Sukralfat susp 100 mg btl - 0 0 0
435 Thiamin tab (vit B1) tablet 6,100 6100 400 5700
448 Vaksin Anti Rabies ampul 3 22 25 14 11
453 Vaksin Hepatitis B Imuno Globullin ampul - 2 2 1 1
460 Vaksin MR ampul 33 81 114 76 38
462 Vitamin B Compleks tablet 17,500 17500 2100 15400
471 Yodium Povidon 60 ml btl 2 10 12 5 7
474 Zinc Sulphate 20 mg tablet 800 800 400 400
476 Zink F dus - 0 0 0
477 Masker TB box 3,200 2,000 5200 1200 4000
481 Masker bedah pcs - 0 0 0
486 Masker KN95 pcs 700 700 375 325
487 Masker N95 pcs 175 175 0 175
496 Lyse BCC 3600 btl - 0 0 0
497 glimepiride 1 mg pcs 800 800 300 500
499 TDF(300)+3TC(300)+DTG(50)/TLD pcs 3 3 3 0
504 RDT HIV R2 (StandarQ) tab 50 50 0 50
509 Lubrikan (pelicin) tab 100 100 0 100
510 Guaifenesin 100 mg tab - 0 0 0
511 Vaksin PCV vial - 0 0 0
512 Tabung EDTA pcs 200 200 0 200
514 USG Gel btl - 0 0 0
516 Cryotube pcs 100 100 0 100
524 Ice Pack pcs 10 10 0 10
525 Ice Gel pcs 5 5 0 5
530 Etanol 95 % botol 8 8 0 8
531 Vitamin D3 tablet - 0 0 0
536 Vaksin Indovac vial - 0 0 0
538 Masker headloop (Hijab) pcs 4,350 4350 850 3500
539 Salbutamol cairan inhalasi (inhavent) amp 10 10 0 10
540 Kassa 16x16 pcs 18 18 0 18
541 Disinfektan Spray btl 5 5 1 4
542 RDT Duo (Hiv Sifilis) pcs 700 700 0 700
543 Vaksin HPV Bias vial 200 200 194 6
544 Ads 0,5 ml (vaksin MR Bias) pcs 2,000 2000 654 1346
545 Ads 5 ml (vaksin MR Bias) pcs 150 150 54 96
546 Safety box Bias pcs 25 25 19 6
547 Vaksin Rotavirus vial 46 46 2 44
548 Tenofovir+Emtricitabine (Tanoem) btl 4 4 0 4
549 Aluvia btl 4 4 0 4
550
551
1 Acyclovir 5% cream tube 50 50 0 50
2 Abate Kg - 0 0 0
3 Acyclovir 400 mg tab 600 600 0 600
4 Allopurinol tablet tab 900 900 0 900
6 Ambroxol tab tab 1,500 1500 0 1500
9 Amoxicillin 500 mg Tab 5,000 5000 0 5000
11 Asam Folat tab - 0 0 0
12 Asam mefenamat 500 mg Tab 4,200 4200 1200 3000
23 Cleanser pcs - 0 0 0
25 CTM Tab - 0 0 0
27 Deksametason 0,5 mg Tab 4,000 4000 2100 1900
38 Gentamisin salep kulit tube 134 134 58 76
44 Guafenesin 100 mg tab 4,600 4600 1400 3200
45 H2O2 btl - 0 0 0
78 Natrium Diclovenak 50 mg tab 4,000 4000 0 4000
81 Obat batuk flu (Hustab tab) Tab 3,600 3600 2400 1200
90 Pehacain inj amp 240 240 0 240
104 Salbutamol 2 mg tab Tab 400 400 100 300
107 Silk 2/0 pcs - 0 0 0
108 silk 3/0 pcs 1 1 1 0
112 Spuit 1 ml set - 0 0 0
116 Thiamfenicol tab 300 300 0 300
121 Vitamin B6 tab 1,900 1900 600 1300
128 kassa 15 cm roll 35 35 15 20
Umum
Jumlah Kunjungan Resep JKN TOTAL
Bayar Tidak
PKM 184 305 811 1300

PUSTU 10 58 22 90
POSKESKEL 57 23 50 130
TOTAL 251 386 883 1520
Mengetahui Bandar Lampung, Agustus 2023

Plt. Kepala Puskesmas Labuhan Ratu Penanggung Jawab Obat dan Perbekes
Ns. Sumiyati, S.Kep apt. Yunita Amriana, S.Farm

NIP. 19680304 198812 2 003 NIP. 19940630 202012 2 024

Lplpo 2023 (LB 2)

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Formulir 16

LAPORAN BULANAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

Kode : Bulan JANUARI

Puskesmas Labuhan Ratu Tahun 2023

No NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN

PKM 200 283 599

dr. Kartika Tri Handayani

AN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

Jml Poskesdes/ bidan desa 6

Bandar Lampung, Januari 2023

Apt. Yunita Amriana ,S.Farm

LAPORAN BULANAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

Kode : Bulan FEBRUARI

Puskesmas Labuhan Ratu Tahun 2023

No NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN

PKM 172 238 633

AN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

Jml Poskesdes/ bidan desa 6

Bandar Lampung, Februari 2023

LAPORAN BULANAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

Kode : Bulan MARET

Puskesmas Labuhan Ratu Tahun 2023

No NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN

PKM 146 291 721

Ns. Sumiyati, S.Kep

AN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

Jml Poskesdes/ bidan desa 6

Bandar Lampung, Maret 2023

Apt. Yunita Amriana ,S.Farm

LAPORAN BULANAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

Kode : Bulan APRIL

Puskesmas Labuhan Ratu Tahun 2023

No NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN

PKM 142 165 487

Ns. Sumiyati, S.Kep

AN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

Jml Poskesdes/ bidan desa 6

Bandar Lampung, April 2023

Apt. Yunita Amriana ,S.Farm

LAPORAN BULANAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

Kode : Bulan MEI

Puskesmas Labuhan Ratu Tahun 2023

No NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN

PKM 175 287 815

Ns. Sumiyati, S.Kep

AN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

Jml Poskesdes/ bidan desa 6

Bandar Lampung, Mei 2023

Apt. Yunita Amriana ,S.Farm

LAPORAN BULANAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

Kode : Bulan JUNI Jml Poskesdes/ bidan desa

Puskesmas Labuhan Ratu Tahun 2023 Jml melapor

Mengetahui Bandar Lampung,

Ns. Sumiyati, S.Kep Apt. Yunita Amri

MAKAIAN DAN LEMBAR PERMINTAAN OBAT

Jml Poskesdes/ bidan desa 6

Bandar Lampung, Juni 2023

Apt. Yunita Amriana ,S.Farm

LAPORAN BULANAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

Kode : Bulan JULI Jml Poskesdes/ bidan desa 6

Puskesmas Labuhan Ratu Tahun 2023 Jml melapor 6

STOK KETERANGAN (RUSAK,

PKM 159 283 753 1195