LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT/BMHP REGULER

KODE PUSKESMAS : 1071242

PUSKESMAS : TAMPA PADANG BULAN PELAPORAN

KECAMATAN : KALUKKU BULAN PEMAKAIAN
KABUPATEN : MAMUJU TAHUN
PROPINSI : SULAWESI BARAT

PEMBER
STOK
NO NAMA OBAT/BMHP SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR PERMINTAAN
PENGAMAN
PKD

1 2 3 4 5 6 (4+5) 7 8 (6-7) 9 (7X20%) 10 11

1 Accugence Blood Glukosa Box/50 - 2 2 2 -
2 Accugence Blood Uric Acid Box/25 - 4 4 4 -
3 Acyclovir tab 200 mg Tablet 940 1,800 2,740 2,090 650
4 Acyclovir tab 400 mg Tablet 1,100 1,500 2,600 2,130 470
5 Adhesive Wound Strip 5 cm X 5 m (Plester) Roll 18 40 58 58 -
6 Alat Suntik Sekali Pakai 1 ml (Stera) Pieces 258 3,400 3,658 3,140 518
7 Alat Suntik Sekali Pakai 3 ml Pieces 100 5,000 5,100 4,795 305
8 Alat Suntik Sekali Pakai 5 ml Pieces 100 2,000 2,100 1,706 394
9 Allopurinol 100 mg Tablet 1,455 8,200 9,655 8,265 1,390
10 Allopurinol 300 mg Tablet - 4,500 4,500 2,800 1,700
11 Aminophyllin 200 mg tab Tablet - 200 200 100 100
12 Aminophyllin 24 mg/ml Injeksi Ampul 10 - 10 10 -
13 Aminophyllin Injeksi Ampul - - - -
14 Amlodipin tablet 10 mg Tablet 1,375 23,100 24,475 23,475 1,000
15 Amlodipin tablet 5 mg Tablet 1,980 13,100 15,080 13,915 1,165
16 Amoxicillin 500 mg Tablet 5,450 63,200 68,650 67,220 1,430
17 Amoxicillin Sirup 125 mg/5 ml Botol 328 800 1,128 992 136
18 Antacida suspensi btl /60 ml 167 1,900 2,067 2,067 -
19 Antasida Tab Tablet 5,620 46,600 52,220 50,070 2,150
20 Antihaemorrid Supp Supp/2 g 76 190 266 242 24
21 Antimigrain : ergotamine + coffeine tablet 200 1,500 1,700 1,696 4
22 Antiseptik hand rub 500 ml Botol 24 114 138 138 -
23 Antiseptik hand rub 500 ml (Henclin 2%) Botol - 20 20 4 16
24 Aqua Pro Injeksi 25 ml Btl/25 ml 118 - 118 37 81
25 Asam Asetilsasilisilat tab 80 mg Tablet 100 100 200 200 -
26 Asam Askorbat tab 250 mg Tablet 1,725 7,000 8,725 6,835 1,890
27 Asam Askorbat tab 50 mg Tablet 3,000 37,500 40,500 36,640 3,860
28 Asam Folat Tab. 1 mg Tablet 1,100 7,000 8,100 6,225 1,875
29 Asam Mefenamat tab 500 mg Tablet 6,020 39,000 45,020 41,630 3,390
30 Asering Infus Btl/500 ml - 240 240 240 -
31 Atapulgit tab 600 mg Tablet 300 400 700 500 200
32 Atropin sulfat Injeksi 0,25 mg/ml Ampul - 20 20 - 20
33 Bedak Salisil Pot 23 300 323 305 18
34 Betahistin 6 mg Tablet 1,000 1,500 2,500 2,500 -
35 Betametason 0,1% krim Tube - 240 240 145 95
36 Bisturi No. 10 Pcs 200 - 200 200 -
37 Blood Lancet Box - 300 300 300 -
38 Captopril 12,5 mg Tablet 2,000 14,700 16,700 14,910 1,790
39 Captopril 25 mg tablet 2,430 10,700 13,130 11,676 1,454
40 Carbamazepin tab 200 mg Tablet 160 - 160 - 160
41 Catgut Chromic 2/0 HR 30 MM Pcs 24 168 192 144 48
42 Catgut Chromic 3/0 HR 30 MM Pcs 12 156 168 118 50
43 Cefadroxil 500 mg Tablet - - - - -
44 Ciprofloxacin tab 500 mg Tablet - 4,800 4,800 2,410 2,390
45 Dexamethasone 0,5 mg tablet Tablet 2,815 48,900 51,715 50,609 1,106
46 Dexamethasone Injeksi Ampul - 190 190 160 30
47 Diazepam 2 mg Tablet 392 600 992 609 383
48 Diazepam 5 mg Tablet 340 200 540 40 500
49 Diazepam Injeksi Ampul 30 110 140 110 30
50 Difenhidramin Injeksi 10 mg/ml Ampul 30 - 30 10 20
51 Digoxin tablet 0,25 mg Tablet 180 200 380 280 100
52 Diltiazem tab 30 mg Tablet 100 - 100 - 100
53 Dimenhidrinat tab 50 mg Tablet 500 2,500 3,000 3,000 -
54 Domperidon tablet 10 mg Tablet 316 9,000 9,316 6,780 2,536
55 Efinefrin Injeksi 0,1% Ampul 50 150 200 170 30
56 Eritromisin kapsul 250 mg Tablet 100 - 100 100 -
57 Eritromisin kapsul 500 mg Capsul 100 400 500 222 278
58 Eritromisin Syrup Botol 10 90 100 22 78
59 Ethanol 70 % 1.000 ml Botol 7 112 119 116 3
60 Etylchlorida semprot Btl/100 3 16 19 19 -
61 Fenobarbital tab 30 mg Tablet 202 1,200 1,402 999 403
62 Fitomenadion (Vit. K1) Injeksi 10 mg/ml Ampul - 60 60 60 -
63 Fitomenadion (Vit. K1) Injeksi 2 mg/ml Ampul 65 630 695 520 175
64 Fitomenadion 10 mg Tablet 1,000 5,600 6,600 5,510 1,090
65 Furosemide Tablet 40 mg Tablet 265 700 965 568 397
66 Gentamicin Salep Mata (Genoint) 0.3 % Tube - 57 57 51 6
67 Gentamicin sulfat TM 0,3% Btl/ 5 ml 25 110 135 135 -
68 Glibenklamid tab 5 mg Tablet 2,399 8,200 10,599 9,257 1,342
69 Glimepiride 2 mg Tablet 2,370 10,000 12,370 9,755 2,615
70 Glukosa 10 % Botol 20 40 60 29 31
71 Glukosa 5 % Botol 161 400 561 441 120
72 Griseofulvin 125 mg Tablet 1,000 6,600 7,600 6,960 640
73 Haloperidol tab 0,5 mg Tablet 600 5,500 6,100 4,790 1,310
74 Haloperidol tab 1,5 mg Tablet 10 - 10 10 -
75 Hidroklorothiazid (HCT) tab Tablet 350 400 750 350 400
76 Hidrokortison Cream 2,5% Tube 48 672 720 663 57
77 Hiosina butilbromida tab 10 mg Tablet 300 8,000 8,300 7,242 1,058
78 Hypafix 5 cm x 5 m Roll - 2 2 2 -
79 Ibuprofen 200 mg Tablet 3,560 18,500 22,060 20,290 1,770
80 Ibuprofen 400 mg Tablet 1,500 26,000 27,500 26,571 929
81 Infus Set Dewasa Pieces - - - - -
82 Infus Set Dewasa Pieces - - - - -
83 Infusion set anak Pcs 144 - 144 144 -
84 Infusion set makro Pcs 329 2,700 3,029 2,920 109
85 Isosorbide Dinitrate tab 5 mg Tablet 360 500 860 705 155
86 IV Canula 18 G Pcs 252 900 1,152 920 232
87 IV Canula 20 G Pieces 276 1,850 2,126 1,896 230
88 IV Canula 22 G Pieces 203 1,030 1,233 1,233 -
89 IV Canula 24 G Pieces 100 930 1,030 890 140
90 Jarum Jahit bedah No. 11 Bungkus 72 - 72 72 -
91 Jarum Jahit bedah No. 12 Bungkus 71 - 71 71 -
92 Jarum Jahit bedah No. 9 Bungkus 72 - 72 72 -
93 Ka-en 3B Larutan infus botol 68 120 188 188 -
94 Kalsium Laktat 500 mg Tablet 2,400 21,700 24,100 21,518 2,582
95 Kapas 250 gram Roll 15 57 72 67 5
96 Karbogliserin Tetes Telinga (Fenol Gliserol 10%) btl/ 5 ml 35 10 45 41 4
97 Kasa Kompres 40 x 40 cm Pieces 111 480 591 591 -
98 Kasa Roll 3,6 x 15 cm Roll 74 410 484 484 -
99 Kasa Roll 3,6 x 5 cm Roll - - - - -
100 Kasa Roll Panjang 40 Y x 80 cm Roll 11 42 53 53 -
101 Kasa Steril 16 x 16 cm Box 21 500 521 521 -
102 Ketoconazole 200 mg Tablet 165 1,200 1,365 591 774
103 Khlorpheniramin Maleat 4 mg (CTM) Tablet - 38,240 38,240 35,826 2,414
104 Kloramfenikol caps 250 mg Kapsul - 200 200 - 200
105 Kloramfenikol Salep kulit 2% Tube - 160 160 107 53
106 Kloramfenikol Salep Mata 1 % (Erlamycetine) Tube - 170 170 113 57
107 Kloramfenikol Tetes Telinga Botol/5 ml 7 150 157 135 22
108 Klorpromazin Tab. 100 mg Tablet - 1,400 1,400 1,217 183
109 Kotrimoxazole 480 mg Tablet 2,970 6,700 9,670 8,967 703
110 Kotrimoxazole Suspensi Botol - 150 150 149 1
111 Leukoplast (Plester ) Roll 4 155 159 155 4
112 Lidocain HCl Compositum Injeksi Ampul 45 1,170 1,215 1,059 156
113 Lidocain HCl injeksi 2% Ampul 600 500 1,100 1,017 83
114 Lisol Botol 18 55 73 72 1
115 Loperamid tablet Tablet 557 6,500 7,057 5,957 1,100
116 Loratadine Tablet 10 mg Tab 1,000 17,200 18,200 17,359 841
117 Masker Bedah Pieces 300 - 300 300 -
118 Masker Bedah Earloop Pieces 450 5,850 6,300 5,500 800
119 Masker Bedah Hijab Pieces 1,000 10,400 11,400 11,195 205
120 Masker N95 Box - - - - -
121 Metformin 500 mg Tablet 1,540 18,200 19,740 18,528 1,212
122 Metformin 850 mg Tablet - - - - -
123 Methylprednisolon 4 mg Tablet 2,516 20,500 23,016 21,828 1,188
124 Metoklorpropamide Injeksi Ampul 20 150 170 170 -
125 Metoklorpropamide tab 10 mg Tablet - 500 500 - 500
126 Metoklorpropamide tab 5 mg Tablet 1,000 5,300 6,300 5,050 1,250
127 Metronidazole 500 mg Tablet - 1,920 1,920 1,210 710
128 Metylergometrin Maleat Inj Ampul 25 100 125 125 -
129 Metylergometrin Maleat tab. Tablet 100 500 600 300 300
130 Miconazole krim Tube 111 672 783 708 75
131 Mission HB Strip Box/50 - 2 2 2 -
132 Mission Ultra Total Cholesterol Box/25 - 37 37 37 -
133 M-Y Jelly 82 Gram Tube - 12 12 12 -
134 N-Asetil Sistein 200 mg Tablet 2,320 2,700 5,020 3,520 1,500
135 Natrium Diklofenak 25 mg Tablet 2,000 12,000 14,000 11,066 2,934
136 Natrium Diklofenak 50 mg Tablet 2,635 18,000 20,635 18,501 2,134
137 Natrium Klorida Inf 0,9% Btl/ 500 ml 214 1,420 1,634 1,303 331
138 Nifedipine 10 mg tablet Tablet 120 1,700 1,820 680 1,140
139 Nistatin Tab. Vag 100.000 UI Tablet vag 178 100 278 98 180
140 Nistatin Tab. Vag 500.000 UI Tablet 100 400 500 200 300
141 Omeprazole capsul 20 mg Kapsul - 6,600 6,600 5,600 1,000
142 Omeprazole Injeksi Vial - - - - -
143 Oxytetracycline Salep Mata Tube 20 - 20 20 -
144 Oxytocin Inj 10 mg/ml Ampul - 30 30 30 -
145 Paracetamol syrup Btl/ 60 ml 157 1,300 1,457 1,319 138
146 Parasetamol tablet 500 mg Tablet 4,530 67,600 72,130 70,990 1,140
147 Plester 5 cm x 5 m Roll - 3 3 3 -
148 Prednison tablet 5 mg Tablet 4,311 8,200 12,511 10,392 2,119
149 Propanolol 10 mg Tablet 500 1,200 1,700 1,000 700
150 Propiltiuourasil (PTU) Tablet 470 2,700 3,170 2,170 1,000
151 Pyridoksin Hcl (Vitamin B6) Tab. 10 mg Tablet 2,000 8,200 10,200 10,081 119
152 Rapid Antigen (Egens) Test - - - - -
153 Reagen Golda Botol 4 - 4 4 -
154 Ringer Laktat Infus Btl/ 500 ml 140 4,400 4,540 4,356 184
155 Salbutamol tab 4 mg Tablet - 1,500 1,500 1,000 500
156 Salep 2-4 Pot 33 236 269 246 23
157 Salep Antifungi 30 gram Pot - - - - -
158 Sarung Tangan L Box - 124 124 104 20
159 Sarung Tangan M Box - 169 169 169 -
160 Sarung Tangan S Box - 145 145 141 4
161 Sarung tangan steril 7 Pcs 109 10 119 119 -
162 Sarung Tangan Steril No. 6,5 Pasang - 70 70 70 -
163 Sarung Tangan Steril no. 7 Pieces - 30 30 30 -
164 Sarung Tangan Steril no. 7,5 Pasang 130 250 380 380 -
165 Sianocobalamin (Vit. B12) Injeksi 500 mcg Ampul 9 - 9 9 -
166 Sianocobalamin (Vit. B12) tablet 500 mcg Tablet - 8,500 8,500 6,230 2,270
167 Silk Black 2/0 HR 30 MM Pcs 100 286 386 386 -
168 Silk Black 3/0 HR 30 MM Pcs 165 384 549 549 -
169 Simvastatin 10 mg Tablet - 3,800 3,800 2,400 1,400
170 Simvastatin 20 mg Tablet 3,375 11,500 14,875 13,365 1,510
171 Strip Asam Urat Botol - - - - -
172 Strip Glukosa Botol - - - - -
173 Strip Kolestrol Botol - - - - -
174 Thiamin 50 mg Tablet 1,700 17,000 18,700 17,340 1,360
175 Vitamin B Complex tab Tablet 1,600 57,200 58,800 58,100 700
176 Yodium 300 ml Botol 6 72 78 68 10
177 Atenolol 100 mg Tablet - - - - -
178 Atenolol 50 mg Tablet - - - - -
179 Ranitidine 150 mg tablet 11,400 11,400 10,100 1,300
180 Kasa 4 x 15 cm (prokasa) 750 750 740 10
181 Kasa Hidrofil Lipat 40 x 40 cm 320 320 320 -
182 freestyle Strip Glukosa 388 388 190 198
183 Yodium 1000 ml 11 11 6 5
184 Diazepam enema 5 mg 7 7 7 -
185 Zink tab disp 20 mg 1,000 1,000 1,000 -
186 IV Canula 24 G (tipe pen) 70 70 70 -
187 Becefort (multivitamin) 200 200 200 -
188 IV Canula 22 G (Tipe Pen) 200 200 150 50
189 salep whitefield 30 gram 10 10 - 10

JUMLAH KUNJUNGAN RESEP KET

NO FASILITAS KESEHATAN
JML
BPJS NON BPJS
1 PUSKESMAS

2 PUSKESMAS PEMBANTU

3 POSKESDES

4 PUSKESMAS KELILING

5 PELAYANAN LUAR GEDUNG

TOTAL
0 0 0

Mengetahui, Menyetujui : Mengetahui

Plt. Kepala Dinas kesehatan Kab. Mamuju Plt. Kepala Instalasi Farmasi Kab. Mamuju Kepala Puskesmas Tampapadang

dr. Acong Fatmawati, S.Si., Apt NURHAEDAH, Amd.Keb

NIP.19651105 200012 1 003 NIP. 19810807 201503 2 003 NIP.19760101 200502 2 010
BAR PERMINTAAN OBAT/BMHP REGULER

: FEBRUARI
: JANUARI
: 2022

PEMBERIAN
JUMLAH TOTAL
KET
PEMBERIAN
PROG/DKP LAIN2

12 13 14 15
ED . Januari 2022
Tampa Padang, 31 Januari 2022

Yang Membuat Laporan

Apt. Hasmira Hasanuddin, S.Farm

NIP.19880902 202012 2 003