LAPORAN PENGGUNAAN OBAT GENERIK DI PUSKESMAS

NAMA PUSKESMAS : SUAK TAPEH

ALAMAT : SUAK TAPEH
PERIODE BULAN : MEI 2017

% PENGGUNAAN OBAT
ITEM OBAT DALAM RESEP
GENERIK
TANGGAL NO RESEP
TOTAL ITEM OBAT JUMLAH ITEM =4/3 x 100 %
DALAM RESEP OBAT GEENERIK
5/2/2017 1 6 5 83.3333333333333
2 2 2 100
3 5 5 100
4 5 5 100
5 5 4 80
6 5 5 100.0
7 5 4 80
8 5 3 60.0
9 2 1 50.0
10 7 6 85.7
11 5 4 80.0
5/3/2017 12 3 1 33.3
13 4 4 100.0
14 1 0 0.0
15 3 2 66.7
16 5 5 100.0
17 4 4 100.0
18 3 2 66.7
19 5 3 60.0
20 3 2 66.7
21 5 5 100.0
5/4/2017 22 3 1 33.3
23 3 3 100.0
24 5 4 80.0
25 3 1 33.3
26 4 3 75.0
5/5/2017 27 4 4 100.0
28 4 3 75.0
29 3 2 66.7
30 2 2 100.0
31 3 2 66.7
32 5 5 100.0
33 3 3 100.0
34 4 4 100.0
35 3 3 100.0
36 3 3 100.0
37 3 3 100.0
38 3 2 66.7
39 2 2 100.0
40 3 3 100.0
41 6 4 66.7
5/8/2017 42 3 2 66.7
43 3 2 66.7
44 1 0 0.0
45 3 2 66.7
46 5 5 100.0
47 4 3 75.0
48 3 3 100.0
49 4 3 75.0
50 3 2 66.7
51 2 1 50.0
52 3 3 100.0
53 3 3 100.0
54 3 2 66.7
55 2 2 100.0
56 5 5 100.0
57 4 4 100.0
58 3 2 66.7
59 3 3 100.0
60 1 0 0.0
61 4 4 100.0
62 5 5 100.0
63 2 1 50.0
5/9/2017 64 5 5 100.0
65 5 4 80.0
 FORM -POR.1
ATOR PERESEPAN PADA ISPA ATAS DAN BATUK-PILEK (COMMON COLD)

PUSKESMAS : BETUNG KOTA LAPORAN BULAN Oktober

KABUPATEN : BANYUASIN TAHUN : 2021
PROPINSI : SUMATERA SELATAN

TGL NO. NAMA UMUR JUMLAH ITEM OBAT ANTIBIOTIK NAMA OBAT DOSIS LAMAPEMAKAIAN(Hari) SESUAI PEDOMAN

1 2 3 4 6 7 10 11 12 13
4/10/2021 1 sopiah 36 th 3 tidak a.pct 3x1
b.pehavral 1x1
c. Ctm 3x1

4/10/2021 2 steven 4 th 4 ya a. Amox 3x1

b.pct 3x1
c.ctm 2x1
D.Ambroxol 3x1

11/10/2021 3 sopiah 35 th 4 tidak a. Pct 3x1

b.ctm 2x1
c.ambroxol 3x1
d.Vit c 1x1

11/10/2021 4 M. Arizki 10 th 2 tidak a. Ambroxol 3x1

b. Vit C 1x1

12/10/2021 5 sopiah 25 th 2 tidak a. Pct 3x1

b. Pehavral 1x1

12/10/2021 6 irawati 34 th 2 tidak a. Ctm 2x1

b.ambroxol 2x1

21/10/2021 7 Meicin 6 th 2 tidak a. Pct 3x1/2

b. Ambroxol 2x1
25/10/2021 8 eko P 45 th 3 tidak a.pct 3x1
b.pehavral 1x1
c.ambroxol 3x1

26/10/2021 8-Jan priyono 9 th 2 tidak a.pct 3x1

b.ambroxol 3x1

28/10/2021 10 sri w 29 th 3 tidak a. Ctm 2x1

b.Pct 3x1
c. Ambroxol 3x1

30/10/2021 11 Zakaria 3 th 4 tidak a.Amox 3x1

b.Pct 3x1
c.Ctm 2x1
d.Ambroxol 3x1
 N = 11 TOTAL ITEM OBAT 31 1
RERATA ITEM OBAT 3,59 N = JUMLAH LEMBAR RESEP 11
PRESENTASE AB 909.00 A = JUMLAH ITEM OBAT PADA SEMUA LEMBAR RESEP 31
B = JUMLAH PASIEN DENGAN AB `1
RERATA ITEM OBAT = A/N 3.59
PRESENTASE AB = B/N x 100% 90900.00
Yang Melaporakan
Mengetahui, Pengelola Obat
Kepala Puskesmas

dr.liceniati Elizabet
NIP. 1979120 901001 2 002 NIP. 19670308199003 2 006
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
LPLPO
KODE PUSKESMAS : 03750008 LAPORAN BULAN : MEI 2017
PUSKESMAS : SUAK TAPEH
KECAMATAN : SUAK TAPEH
KABUPATEN : BANYUASIN
PROPINSI : SUMATERA SELATAN
No. Nama Obat Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir STOK OPTIMAL PERMINTAAN PEMBERIAN Keterangan
Satuan
APBD INPRES ASKS APBD LAIN JUMLAH
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
I OBAT GENERIK
1 Ambroxol sirup 15 mg/ ml botol 0 0 0 0 0 300
2 Ambroxol tablet 30 mg tablet 130 100 230 230 0 5000
3 Ampicillin kaplet 500 mg kaplet 798 200 998 405 593 1000
4 Ampicillin sirup kering 125 mg/ 5 ml botol 0 0 0 0 0 150
5 Antalgin (Metampiron) tablet 500 mg tablet 0 0 0 0 0 5000
6 Antifungi salep, Kombinasi : Asam Benzoat6% + Asam pot 22 0 22 2 20 0
7 Acylovir krim 5 % tube 80 10 90 30 60 50
8 Betahistin Maleat Tablet 6 mg tablet 65 30 95 45 50 500
9 Gentian violet larutan 1 % botol 0 0 0 0 0 100
10 Gliseril guaiakolat tablet 100 mg tablet 8 0 8 8 0 3000
11 Hidrogen Peroksida cairan 3 % botol 3 0 3 0 3 0
12 Hidrokortison krim 2.5% tube 28 0 28 0 28 24
13 Hidroklortiazide tablet 25 mg tablet 2011 0 2011 10 2001 0
14 Kalium Diklofenak tablet 50 mg tablet 110 50 160 70 90 500
15 Kalsium Laktat (Kalk) tablet 500 mg tablet 3689 0 3689 289 3400 0
16 Kloram fenikol Kapsul 250 mg kapsul 2327 0 2327 172 2155 0
17 Kloramfenikol Tetes Telinga 3% botol 0 0 0 0 0 100
18 Klorfeniramin Maleat (CTM) 4 mg tab tablet 1883 0 1883 283 1600 1000
19 Klorpromazin tablet salut 100 mg tablet 895 30 925 60 865 1000 ED
20 Lisol Mengandung Kresol Tersabun 50 % botol 0 0 0 0 0 5
21 Meloxikam tablet 15 mg tablet 0 0 0 0 0 4000
22 Methisoprinol sirup 250 mg/5ml botol 0 0 0 0 0 400
23 Methisoprinol tablet 500 mg tablet 0 0 0 0 0 3000
24 Obat Batuk Hitam (OBH) cairan botol 18 7 25 25 0 200
25 Oksitetrasiklin Salep Mata 1 % tube 137 0 137 65 72 50 ED
26 Oksitetrasiklin Salep Kulit 3 % tube 219 0 219 64 155 50 ED
27 Piracetam tablet 400 mg tablet 54 0 54 0 54 0
28 Piridoksin (vitamin B6) tablet 10 mg tablet 274 100 374 125 249 2000
29 Piroksikam tablet 25 mg tablet 0 0 0 0 0 4000
30 Prednison tablet 5 mg tablet 1504 0 1504 24 1480 0
31 Prupiltiourasil tablet 100 mg tablet 100 0 100 0 100 0
32 Rivanol (Etakridin) Laruta 0.1 % botol 42 2 44 4 40 0
33 Biosave (ABU) vial 0 0 0 0 0 0
34 Biosat-1.5 (ATS1500 U) vial 0 0 0 0 0 0
35 Tetrasilin kapsul 500 mg kapsul 184 100 284 101 183 1000
36 basitrasin tube 72 10 82 19 63 50
 Obat gigi 0 0 0 0
1 Etil Klorida Semprot botol 4 0 4 0 4 0
Alat kesehatan 0 0 0 0
1 Alat Suntik Sekali Pakai 3 ml set 94 0 94 38 56 500
2 Alat Suntik Sekali Pakai 5 ml set 172 0 172 0 172 300
3 Handscound Steril No. 7,5 dan 8 ml set 0 0 0 0 0 25
4 Mess No. 10/11/15/20/21 set 138 0 138 0 138 0
5 Plester 5 yard x 2 inchi set 1 0 1 0 1 30
6 Silk No. 3/0 dengan jarum bedah set 18 0 18 0 18 0
7 Nald Hecting set 10 0 10 0 10 0
8 Wing Needle No. 20/22 set 24 0 24 0 24 0
II OBAT NON GENERIK 0 0 0 0
1 Akita tablet tablet 455 150 605 358 247 2000
2 Albothyl tube 4 0 4 0 4 25
3 Ternix Plus syrup botol 0 0 0 0 0 150
4 Pehavral tablet tablet 655 230 885 485 400 5000
5 Momilen Baby Gold botol 1 0 1 0 1 300
6 Pitogin S Injeksi ampul 4 0 4 0 4 30
7 Vit. K. Infant ampul 0 0 0 0 0 60
8 Nisagon Cream tube 1 1 2 2 0 50
9 Novabion Kapsul kapsul 110 0 110 80 30 1000
10 Starbion tube 1090 200 1290 440 850 3000
11 Good life for Diab Kaplet kapsul 0 0 0 0 0 300
12 Superhoid botol 0 0 0 0 0 50
13 Caranal Kapsul kaplet 1850 200 2050 600 1450 4000
14 OBH FM tablet 0 0 0 0 0 200
15 Dionicol Kalpet tube 390 160 550 140 410 500
16 Norvom tablet tube 0 0 0 0 0 0
17 Neocenta cream tube 5 2 7 4 3 50
18 Hidrovit tablet 297 24 321 225 96 60 ED
19 Hico gel tube 4 1 5 0 5 25
20 Mexon tablet tablet 100 10 110 20 90 4000
21 Miniospi tablet 200 50 250 100 150 0
22 Tiocin (oxytosin) ampul 15 0 15 0 15 0
DAK 0 0 0 0
1 Air untuk injeksi 25 ml Vial 7 0 7 0 7 0
2 Alkohol 70% 1 L botol 19 0 19 1 18 0
3 Alopurinol tablet 100 mg Tablet 884 100 984 324 660 500
4 Alprazolam tablet 0,25 mg Tablet 0 0 0 0 0 0
5 Alprazolam tablet 0,5 mg Tablet 538 0 538 0 538 0
6 Alprazolam tablet 1 mg Tablet 0 0 0 0 0 0
7 Amoksisilin sirup kering 125 mg/ 5 ml Botol 256 121 377 233 144 240
8 Amoksisilin tablet 500 mg Tablet 1879 1100 2979 1804 1175 5000
9 Amitriptilin tablet salut 25mg (HCl) Tablet 150 0 150 0 150 0
10 Amlodipin tablet 5 mg Tablet 0 0 0 0 0 1000
11 Asam Asetil salisilat (Asetosal) tablet 80 mg Tablet 0 0 0 0 0 0
12 Asam Mefenamat Kapsul/ Kaplet 500 mg Kaplet 1760 770 2530 1290 1240 4000
13 Acyclovir tablet 400 mg Tablet 683 40 723 341 382 500
14 Antasida Doen Tablet KombinasiMg Hidroksida 200 Tablet 1910 690 2600 1520 1080 4000
15 Antasida DOEN II Suspensi Botol 239 8 247 27 220 0
Antifungi Doen salep, Kombinasi : Asam tube
16 Benzoat6% + Asam Salisilat 48 0 48 22 26 0

Antihemoroid Kombinasi Bismuth Subgalat 150 mg

heksaklorofen 2,5 mg lidokain 10 mg seng Oksida Supp
17 120 mg 91 15 106 17 89 0
18 Antibakteri DOEN Salp pot 24 0 24 0 24 0
19 Anti Malaria DOEN Kombinasi Primetamin 25 mg, S Tablet 600 120 720 100 620 0
20 Atropin Injeksi 5 mg/ml Ampul 5 0 5 0 5 0
21 Asam Askorbat (VIT.C) tablet 50 mg Tablet 1661 450 2111 1075 1036 4000
22 asam fusidat krim 20mg/g TUbe 26 10 36 19 17 50
23 Betahistin Maleat Tablet 6 mg tablet 60 60 120 40 80 900
24 Betametason krim 0.1 % Tube 46 22 68 44 24 50
25 Clobazam tablet 10 mg Tablet 630 0 630 0 630 0
26 Deksamethason tablet 0.5 mg Tablet 0 0 0 0 0 4000
27 Deksamethason Injeksi 5 mg/ml Ampul 199 0 199 20 179 0
28 Desoksimetason krim 0,25% tube 117 12 129 41 88 50
29 Diazepam tablet 5mg tablet 998 90 1088 180 908 0
30 Digoksin tablet 0.25 mg Tablet 260 100 360 100 260 0
31 Difenhidramin injeksi 10 mg/ml Ampul 53 0 53 27 26 0
32 Domperidone Suspensi 5mg/ 5 ml Botol 71 3 74 18 56 50
33 Domperidone tablet 10 mg Tablet 743 200 943 270 673 500
34 Epinefrin (Adrenalin) Injeksi 0.1 % Ampul 39 0 39 1 38 0
35 Etanol cairan 70 % Botol 41 1 42 2 40 50
36 Fenofibrat kaps 100mg tablet 0 0 0 0 0 0
37 Fitomenadion (VIT.K1) Tablet 10 mg Tablet 630 90 720 200 520 500
38 Fitomenadion (VIT.K1) Injeksi 10 mg/ml-1ml Ampul 59 0 59 7 52 50
39 Furosemide tablet 40 mg Tablet 282 0 282 0 282 0
40 Garam oralit serbuk kombinasi sachet 2170 0 2170 93 2077 0
41 Glukosa larutan infus 5 % Steril Botol 15 0 15 3 12 0
42 Glibenklamide tablet 5 mg Tablet 20 0 20 10 10 1000
43 Glimepiride tablet 1 mg Tablet 854 90 944 80 864 500
44 Haloperidol tablet 0.5 mg Tablet 940 0 940 0 940 0
45 Haloperidol tablet 5 mg Tablet 1030 60 1090 120 970 0
46 Haloperidol injeksi 50 mg/ml Ampul 0 0 0 0 0 0
47 Hidrokortison krim2.5 % Tube 48 10 58 2 56 50
48 Hidroclortiazid 25 mg Tablet 0 0 0 0 0 0
49 Ibuprofen suspensi 100mg/5ml botol 50 5 55 19 36 100
50 Ibuprofen tablet 400 mg Tablet 1100 200 1300 340 960 3000
51 Isosorbid dinitrat 5 mg Tablet 188 0 188 18 170 0
52 Jellco 24 G pcs 24 0 24 0 24 0
53 Jellco 22 G pcs 22 0 22 0 22 0
54 Jelco 20 G pcs 24 0 24 0 24 0
55 Kalsium Laktat (Kalk) tablet 500 mg Tablet 2870 0 2870 250 2620 0
56 Kaptopril 25 mg Tablet 1039 460 1499 750 749 3000
57 Ketokonazole Krim 2 % Tube 49 10 59 22 37 50
58 Ketokonazole tablet 200 mg Tablet 0 0 0 0 0 2000
59 Ketorolac injeksi 30 mg Ampul 40 0 40 2 38 0
60 Klindamisin Kapsul 150 mg kapsul 140 20 160 20 140 1000
61 Kloramfenikol salp mata 1 % Tube 0 0 0 0 0 50
62 Kloramfenicol suspnsi125mg/5ml Botol 72 7 79 23 56 100
63 Klorpromazin tablet salut 100 mg(HCL) Tablet 0 0 0 0 0 0
64 Klorfeniramin Maleat (CTM) 4 mg tablet Tablet 4440 100 4540 560 3980 0

Kotrimoksazole Suspensi Kombinasi Botol

65 Sulfametoksazole 200 mg +Trimetropim 40 mg/5ml 154 10 164 26 138 100

Kotrimoxsazole Tablet Kombinasi Sulfametoksazole Tablet

66 400 mg + Trimetropim 80 mg 1047 200 1247 323 924 1000
67 Lansoprazol kapsul 30mg kapsul 530 140 670 150 520 400
68 Lisol 1 litrer Botol 8 1 9 1 8 5
69 Loperamid tablet 2 mg Tablet 774 100 874 186 688 500
70 Magnesium Sulfat Injeksi 20 % Ampul 77 0 77 52 25 0
71 Magnesium Sulfat Injeksi 40 % Ampul 74 0 74 40 34 0
72 Metformin HCL tablet 500 mg tablet 945 100 1045 260 785 0
73 Methilprednisolon tablet 4 mg Tablet 480 120 600 178 422 1000
74 Metoklorpropamide 10mg Tablet 218 0 218 0 218 0
75 Metoklorpropamide sirup 5mg/5ml botol 0 0 0 0 0 0
76 Metronidazol ovula 500mg tablet 0 0 0 0 0 1000
77 Mometason furoate 0,1% krim tube 0 0 0 0 0 100
78 Natrium Klorida Larutan infus 0.9% steril Botol 26 0 26 4 22 12
79 Natrium Diklofenak tablet 25 mg Tablet 832 250 1082 540 542 2000
80 Nistatin tablet salut 500.000 iu/g Tablet 710 100 810 100 710 0
81 Nistatin Vaginal tablet 100.000 iu/g Supp 105 0 105 0 105 0
82 Oksitosin Injeksi 10 IU/ml Ampul 0 0 0 0 0 30
83 Omeprazol kapsul 20 mg kapsul 830 390 1220 670 550 300
84 Ondanstron kaplet 4 mg Tablet 0 0 0 0 0 1000
85 Parasetamol drops Botol 133 6 139 13 126 56
86 Parasetamol sirup 120 mg/5 ml Botol 288 75 363 156 207 150
87 Parasetamol tablet 500 mg Tablet 2156 1100 3256 2198 1058 5000
88 Pirantel tablet score (base) 125 mg Tablet 878 100 978 400 578 200
89 Piridoksin (vitamin B6) tablet 10 mg Tablet 10 0 10 0 10 500
90 Prednison tablet 5 mg Tablet 3375 50 3425 190 3235 0
91 Propiltiourasil tablet 100 mg Tablet 1000 0 1000 0 1000 0
92 Povidon Iodida larutan 10 % Botol 12 0 12 0 12 6
93 Ranitidin injeksi 25 mg/2ml Ampul 185 7 192 14 178 50
94 Ranitidin tablet 150 mg Tablet 1710 250 1960 600 1360 500
95 Ringer Laktat Lrutan Infus Steril Botol 31 2 33 6 27 12
96 Risperidon tablet 1 mg Tablet 590 0 590 0 590 0
97 Risperidon tablet 2 mg Tablet 0 0 0 0 0 500
98 Rivanol 300 cc Tablet 9 0 9 0 9 6
99 Salbutamol tablet 2 mg Botol 164 0 164 102 62 2000
100 salbutamol sirup Botol 78 6 84 21 63 50
salep 24,Kombinasi: Asam salisilat 2%+belerang Tube
101 endap 4% 48 48 10 38 0
102 Salisil Bedak 2 % Kotak 16 5 21 18 3 200
103 Sefadroksil Kapsul 500 mg kapsul 751 120 871 220 651 300
104 Sefiksim kapsul 100 mg kapsul 710 150 860 270 590 500
105 Sefiksim sirup kering 100 mg/5 ml Botol 48 8 56 16 40 50
106 Sefotaxim injeksi 1 gram Vial 4 0 4 0 4 0
107 Setrizin sirup 5mg/5ml Botol 102 16 118 27 91 150
108 Setrizin tablet 10mg Tablet 100 50 150 150 0 3000
109 Sianokobalamin (VIT B12) injeksi 500 mcg-ml Ampul 94 0 94 7 87 50
110 Simvastatin tablet 10 mg Tablet 510 90 600 100 500 600
111 Siprofloksasin tablet 500 mg Tablet 1000 300 1300 626 674 400
112 Sukralfat susp 500mg/5ml,100ml botol 0 0 0 0 0 0
113 Sukralfat Tablet 500mg Tablet 0 0 0 0 0
114 Tetrasiklin HCL Kapsul 250 mg Kapsul 0 0 0 0 0 0
115 Tetrasiklin HCL Kapsul 500 mg Kapsul 0 0 0 0 0 500
116 Thiamin (vitamin B1 ) tablet 50mg Tablet 300 100 400 250 150 500
117 Triheksifenidil 2mg Tablet 840 80 920 0 920 0
118 Valsartan tab 80mg Tablet 477 60 537 72 465 0
119 vitamin B kompleks tablet Tablet 1301 350 1651 496 1155 3000
120 zinc pro drop botol 94 4 98 6 92 0
121 Zinc syrup 10 mg/ml Botol 124 5 129 4 125 50
122 Zinc tablet 20 mg tablet 1130 120 1250 253 997 400
Alat Kesehatan 0 0 0 0
1 Alat Suntik Sekali Pakai 3 ml set 795 125 920 214 706 500
2 Alat Suntik Sekali Pakai 5 ml set 576 0 576 66 510 300
3 Alkohol Swab pcs 290 0 290 0 290 100
4 Aseptic Gel 500cc+dispenser Botol 13 1 14 2 12 12
5 Catgut chromic 2/0 + /jarum 1/2 GT 35 mm set 34 0 34 2 32 0
6 Catgut chromic 3/0 + /jarum 1/2 GT 35 mm SET 22 0 22 3 19 0
7 Catgut plain 2/0+jarum 1/2 GT 35mm SET 27 0 27 5 22 0
8 Catgut plain 3/0+jarum 1/2 GT 35mm SET 43 0 43 0 43 0
9 Catheter 2 way no 16 SET 12 0 12 2 10 0
10 Catheter 2 way no 18 SET 16 0 16 0 16 0
11 Infusion set Anak SET 13 0 13 0 13 0
12 Infusion set dewasa SET 50 0 50 15 35 0
13 Kapas Pembalut Absorben 250 mg SET 11 1 12 2 10 0
14 Kapas Pembalut Absorben 500 g SET 10 1 11 2 9 0
15 Kassa Kompres 40/40 steril SET 26 0 26 2 24 30
16 Kassa Pembalut 2 x 80 cm SET 26 2 28 6 22 30
17 Kasa Hidrofil 4 x 15 cm SET 49 0 49 2 47 50
18 Maxter exam Non Powder L SET 100 0 100 0 100 0
19 Maxter exam Non Powder M SET 157 57 214 76 138 200
20 Maxter exam Non Powder s SET 0 0 0 0 0 0
21 New DRCT 40 Y X 80 CM plain SET 0 0 0 0 0 0
22 Pembalut elastis 10cmx4,55m roll 10 0 10 0 10 0
23 Pembalut elastis 7,5cmx4,55m roll 10 0 10 0 10 0
24 Polifix 10 cm x 5 m roll 10 0 10 0 10 0
25 Polifix 5 cm x 5 m roll 9 0 9 0 9 0
26 Poligyp 7,5 cmx 2,7 m roll 5 0 5 0 5 0
27 safeglove PF no.7 psg 12 0 12 0 12 50
28 silk 2/0 + jarum 1/2 GT 35mm set 60 0 60 6 54 0
29 Surgical Mask-3ply Earloop SET 150 0 150 0 150 0
30 Surgical Mask-3ply Tie on SET 144 44 188 78 110 100
31 Urin Bag buah 3 0 3 0 3 0
Kasie. Farmakmin Ka.UPTD Farmasi Ka. UPT. Puskesmas Suak Tapeh Penanggung Jawab Apotik

Hj.Nurhasanah, SKM, M. Kes dr. Liceniati Soliana Am. Keb

NIP. 197407121993012001 NIP.19791209010012002 NIP. 19901229 201212 2 002
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
LPLPO

LAPORAN BULAN : MEI 2017

PUSKESMAS : SUAK TAPEH
No. Nama Obat Satuan Stok awal Penerimaan Pengeluaran stok akhir

APBD gudang apotik Bides Total gudang apotik Bides Total gudang apotik Bides Total gudang apotik Bides Total
1 2 3 4 5 6 8 9 10 11 13 12 13 14 15 16 17 18 19
I OBAT GENERIK
1 Ambroxol sirup 15 mg/ ml botol 0 0 0 0 0 0 0 0 0 0 0 - 0 0 0 -
2 Ambroxol tablet 30 mg tablet 100 0 30 130 0 100 0 100 100 100 30 230 0 0 0 -
3 Ampicillin kaplet 500 mg kaplet 400 208 190 798 0 200 0 200 200 15 190 405 200 393 0 593
4 Ampicillin sirup kering 125 mg/ 5 ml botol 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
5 Antalgin (Metampiron) tablet 500 mg tablet 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
6 Antifungi salep, Kombinasi : Asam Benzoat6% + Asam pot 16 2 4 22 0 0 0 0 0 0 2 2 16 2 2 20
7 Acylovir krim 5 % tube 35 1 44 80 0 10 0 10 10 6 14 30 25 5 30 60
8 Betahistin Maleat Tablet 6 mg tablet 30 20 15 65 0 30 0 30 30 0 15 45 0 50 0 50
9 Gentian violet larutan 1 % botol 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
10 Gliseril guaiakolat tablet 100 mg tablet 0 8 0 8 0 0 0 0 0 8 0 8 0 0 0 -
11 Hidrogen Peroksida cairan 3 % botol 3 0 0 3 0 0 0 0 0 0 0 - 3 0 0 3
12 Hidrokortison krim 2.5% tube 28 0 0 28 0 0 0 0 0 0 0 - 28 0 0 28
13 Hidroklortiazide tablet 25 mg tablet 1100 650 261 2,011 0 0 0 0 0 0 10 10 1100 650 251 2,001
14 Kalium Diklofenak tablet 50 mg tablet 50 60 0 110 0 50 0 50 50 20 0 70 0 90 0 90
15 Kalsium Laktat (Kalk) tablet 500 mg tablet 2000 380 1309 3,689 0 0 0 0 0 180 109 289 2000 200 1200 3,400
16 Kloram fenikol Kapsul 250 mg kapsul 1000 150 1177 2,327 0 0 0 0 0 0 172 172 1000 150 1005 2,155
17 Kloramfenikol Tetes Telinga 3% botol 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
18 Klorfeniramin Maleat (CTM) 4 mg tab tablet 0 0 1883 1,883 0 0 0 0 0 0 283 283 0 0 1600 1,600
19 Klorpromazin tablet salut 100 mg tablet 895 0 0 895 0 30 0 30 30 30 0 60 865 0 0 865
20 Lisol Mengandung Kresol Tersabun 50 % botol 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
21 Meloxikam tablet 15 mg tablet 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
22 Methisoprinol sirup 250 mg/5ml botol 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
23 Methisoprinol tablet 500 mg tablet 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
24 Obat Batuk Hitam (OBH) cairan botol 7 1 10 18 0 7 0 7 7 8 10 25 0 0 0 -
25 Oksitetrasiklin Salep Mata 1 % tube 35 11 91 137 0 0 0 0 0 6 59 65 35 5 32 72
26 Oksitetrasiklin Salep Kulit 3 % tube 83 24 112 219 0 0 0 0 0 0 64 64 83 24 48 155
27 Piracetam tablet 400 mg tablet 0 54 0 54 0 0 0 0 0 0 0 - 0 54 0 54
28 Piridoksin (vitamin B6) tablet 10 mg tablet 240 34 0 274 0 100 0 100 100 25 0 125 140 109 0 249
29 Piroksikam tablet 25 mg tablet 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
30 Prednison tablet 5 mg tablet 0 1000 504 1,504 0 0 0 0 0 0 24 24 0 1000 480 1,480
31 Prupiltiourasil tablet 100 mg tablet 0 100 0 100 0 0 0 0 0 0 0 - 0 100 0 100
32 Rivanol (Etakridin) Laruta 0.1 % botol 41 0 1 42 0 2 0 2 2 2 0 4 39 0 1 40
33 Biosave (ABU) vial 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
34 Biosat-1.5 (ATS1500 U) vial 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
35 Tetrasilin kapsul 500 mg kapsul 100 74 10 184 0 100 0 100 100 1 0 101 0 173 10 183
36 basitrasin tube 35 3 34 72 0 10 0 10 10 2 7 19 25 11 27 63
 Obat gigi 0 0 0 0 0 0 0 - 0 -
1 Etil Klorida Semprot botol 4 0 0 4 0 0 0 0 0 0 0 - 4 0 0 4
Alat kesehatan 0 0 0 0 0 0 0 - 0 -
1 Alat Suntik Sekali Pakai 3 ml set 0 0 94 94 0 0 0 0 0 0 38 38 0 0 56 56
2 Alat Suntik Sekali Pakai 5 ml set 0 0 172 172 0 0 0 0 0 0 0 - 0 0 172 172
3 Handscound Steril No. 7,5 dan 8 ml set 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
4 Mess No. 10/11/15/20/21 set 38 0 100 138 0 0 0 0 0 0 0 - 38 0 100 138
5 Plester 5 yard x 2 inchi set 1 0 0 1 0 0 0 0 0 0 0 - 1 0 0 1
6 Silk No. 3/0 dengan jarum bedah set 0 0 18 18 0 0 0 0 0 0 0 - 0 0 18 18
7 Nald Hecting set 0 0 10 10 0 0 0 0 0 0 0 - 0 0 10 10
8 Wing Needle No. 20/22 set 4 0 20 24 0 0 0 0 0 0 0 - 4 0 20 24
II OBAT NON GENERIK 0 0 0 0 0 0 0 0 0 0 - 0 0 0 -
1 Akita tablet tablet 270 137 48 455 0 100 50 150 150 150 58 358 120 87 40 247
2 Albothyl tube 4 0 0 4 0 0 0 0 0 0 0 - 4 0 0 4
3 Ternix Plus syrup botol 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
4 Pehavral tablet tablet 400 65 190 655 0 200 30 230 230 185 70 485 170 80 150 400
5 Momilen Baby Gold botol 1 0 0 1 0 0 0 0 0 0 0 - 1 0 0 1
6 Pitogin S Injeksi ampul 0 4 0 4 0 0 0 0 0 0 0 - 0 4 0 4
7 Vit. K. Infant ampul 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
8 Nisagon Cream tube 1 0 0 1 0 1 0 1 1 1 0 2 0 0 0 -
9 Novabion Kapsul kapsul 0 0 110 110 0 0 0 0 0 0 80 80 0 0 30 30
10 Starbion tube 900 90 100 1,090 0 200 0 200 200 140 100 440 700 150 0 850
11 Good life for Diab Kaplet kapsul 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
12 Superhoid botol 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
13 Caranal Kapsul kaplet 1100 170 580 1,850 0 200 0 200 100 120 380 600 1000 250 200 1,450
14 OBH FM tablet 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
15 Dionicol Kalpet tube 360 30 0 390 0 160 0 160 60 80 0 140 300 110 0 410
16 Norvom tablet tube 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
17 Neocenta cream tube 5 0 0 5 0 2 0 2 2 2 0 4 3 0 0 3
18 Hidrovit tablet 24 3 270 297 0 24 0 24 24 27 174 225 0 0 96 96
19 Hico gel tube 4 0 0 4 0 1 0 1 0 0 0 - 4 1 0 5
20 Mexon tablet tablet 100 0 0 100 0 10 0 10 10 10 0 20 90 0 0 90
21 Miniospi tablet 200 0 0 200 0 50 0 50 50 50 0 100 150 0 0 150
22 Tiocin (oxytosin) ampul 15 0 0 15 0 0 0 0 0 0 0 - 15 0 0 15
DAK 0 0 0 0 0 0 0 0 0 0 - 0 0 0 -
1 Air untuk injeksi 25 ml Vial 5 0 2 7 0 0 0 0 0 0 0 - 5 0 2 7
2 Alkohol 70% 1 L botol 17 0 4 - 0 0 0 0 0 0 3 3 17 0 1 18
3 Alopurinol tablet 100 mg Tablet 460 34 390 884 0 100 0 100 100 64 160 324 360 70 230 660
4 Alprazolam tablet 0,25 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 - 0 0 0 -
5 Alprazolam tablet 0,5 mg Tablet 538 0 0 538 0 0 0 0 0 0 0 - 538 0 0 538
6 Alprazolam tablet 1 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 - 0 0 0 -
7 Amoksisilin sirup kering 125 mg/ 5 ml Botol 229 9 18 256 0 81 40 121 121 74 38 233 108 16 20 144
8 Amoksisilin tablet 500 mg Tablet 1850 29 0 1,879 0 950 150 1100 1100 554 150 1,804 750 425 0 1,175
9 Amitriptilin tablet salut 25mg (HCl) Tablet 150 0 0 150 0 0 0 0 0 0 0 - 150 0 0 150
10 Amlodipin tablet 5 mg Tablet 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
11 Asam Asetil salisilat (Asetosal) tablet 80 mg Tablet 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
12 Asam Mefenamat Kapsul/ Kaplet 500 mg Kaplet 1650 60 50 1,760 0 550 220 770 770 260 260 1,290 880 350 10 1,240
13 Acyclovir tablet 400 mg Tablet 140 143 400 683 0 40 0 40 40 21 280 341 100 162 120 382
14 Antasida Doen Tablet KombinasiMg Hidroksida 200 Tablet 1650 80 180 1,910 0 550 140 690 690 510 320 1,520 960 120 0 1,080
15 Antasida DOEN II Suspensi Botol 208 6 25 239 0 8 0 8 8 9 10 27 200 5 15 220
Antifungi Doen salep, Kombinasi : Asam tube
16 Benzoat6% + Asam Salisilat 24 0 6 - 0 0 0 0 0 0 4 4 24 0 2 26

Antihemoroid Kombinasi Bismuth Subgalat 150 mg

heksaklorofen 2,5 mg lidokain 10 mg seng Oksida Supp
17 120 mg 75 10 6 91 0 15 0 15 15 0 2 17 60 25 4 89
18 Antibakteri DOEN Salp pot 24 0 0 24 0 0 0 0 0 0 0 - 24 0 0 24
19 Anti Malaria DOEN Kombinasi Primetamin 25 mg, S Tablet 500 100 0 600 0 120 0 120 100 0 0 100 400 220 0 620
20 Atropin Injeksi 5 mg/ml Ampul 5 0 0 5 0 0 0 0 0 0 0 - 5 0 0 5
21 Asam Askorbat (VIT.C) tablet 50 mg Tablet 1050 151 460 1,661 0 450 0 450 450 415 210 1,075 600 186 250 1,036
22 asam fusidat krim 20mg/g TUbe 23 2 1 26 0 10 0 10 10 8 1 19 13 4 0 17
23 Betahistin Maleat Tablet 6 mg tablet 0 20 0 - 0 60 0 60 0 0 0 - 0 80 0 80
24 Betametason krim 0.1 % Tube 35 11 0 46 0 22 0 22 22 22 0 44 13 11 0 24
25 Clobazam tablet 10 mg Tablet 630 0 0 630 0 0 0 0 0 0 0 - 630 0 0 630
26 Deksamethason tablet 0.5 mg Tablet 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
27 Deksamethason Injeksi 5 mg/ml Ampul 152 0 47 199 0 0 0 0 0 0 20 20 152 0 27 179
28 Desoksimetason krim 0,25% tube 57 1 59 117 0 10 2 12 12 6 23 41 45 5 38 88
29 Diazepam tablet 5mg tablet 998 0 0 - 0 90 0 90 90 90 0 180 908 0 0 908
30 Digoksin tablet 0.25 mg Tablet 100 30 130 260 0 100 0 100 100 0 0 100 0 130 130 260
31 Difenhidramin injeksi 10 mg/ml Ampul 22 4 27 53 0 0 0 0 0 0 27 27 22 4 0 26
32 Domperidone Suspensi 5mg/ 5 ml Botol 55 9 7 71 0 0 3 3 3 7 8 18 52 2 2 56
33 Domperidone tablet 10 mg Tablet 560 63 120 743 0 200 0 200 200 40 30 270 360 223 90 673
34 Epinefrin (Adrenalin) Injeksi 0.1 % Ampul 38 0 1 39 0 0 0 0 0 0 1 1 38 0 0 38
35 Etanol cairan 70 % Botol 41 0 0 41 0 1 0 1 1 1 0 2 40 0 0 40
36 Fenofibrat kaps 100mg tablet 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
37 Fitomenadion (VIT.K1) Tablet 10 mg Tablet 390 60 180 630 0 90 0 90 90 10 100 200 300 140 80 520
38 Fitomenadion (VIT.K1) Injeksi 10 mg/ml-1ml Ampul 52 0 7 59 0 0 0 0 0 0 7 7 52 0 0 52
39 Furosemide tablet 40 mg Tablet 200 62 20 282 0 0 0 0 0 0 0 - 200 62 20 282
40 Garam oralit serbuk kombinasi sachet 1900 20 250 2,170 0 0 0 0 0 13 80 93 1900 7 170 2,077
41 Glukosa larutan infus 5 % Steril Botol 12 0 3 15 0 0 0 0 0 0 3 3 12 0 0 12
42 Glibenklamide tablet 5 mg Tablet 0 0 20 20 0 0 0 0 0 0 10 10 0 0 10 10
43 Glimepiride tablet 1 mg Tablet 610 74 170 854 0 90 0 90 0 20 60 80 610 144 110 864
44 Haloperidol tablet 0.5 mg Tablet 940 0 0 940 0 0 0 0 0 0 0 - 940 0 0 940
45 Haloperidol tablet 5 mg Tablet 1030 0 0 1,030 0 60 0 60 60 60 0 120 970 0 0 970
46 Haloperidol injeksi 50 mg/ml Ampul 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
47 Hidrokortison krim2.5 % Tube 48 0 0 48 0 10 0 10 0 2 0 2 48 8 0 56
48 Hidroclortiazid 25 mg Tablet 1000 0 83 0 0 0 0 0 0 0 18 18 1000 0 65 1,065
49 Ibuprofen suspensi 100mg/5ml botol 40 0 0 0 0 5 0 5 5 4 0 9 35 1 0 36
50 Ibuprofen tablet 400 mg Tablet 1000 70 30 1,100 0 150 50 200 200 90 50 340 800 130 30 960
51 Isosorbid dinitrat 5 mg Tablet 0 80 108 188 0 0 0 0 0 0 18 18 0 80 90 170
52 Jellco 24 G pcs 24 0 0 24 0 0 0 0 0 0 0 - 24 0 0 24
53 Jellco 22 G pcs 22 0 0 22 0 0 0 0 0 0 0 - 22 0 0 22
54 Jelco 20 G pcs 24 0 0 24 0 0 0 0 0 0 0 - 24 0 0 24
55 Kalsium Laktat (Kalk) tablet 500 mg Tablet 2300 0 456 0 0 0 0 0 0 0 136 136 2300 0 320 2,620
56 Kaptopril 25 mg Tablet 890 49 100 1,039 0 410 50 460 460 140 150 750 430 319 0 749
57 Ketokonazole Krim 2 % Tube 43 1 5 49 0 10 0 10 10 7 5 22 33 4 0 37
58 Ketokonazole tablet 200 mg Tablet 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
59 Ketorolac injeksi 30 mg Ampul 20 0 20 40 0 0 0 0 0 0 2 2 20 0 18 38
60 Klindamisin Kapsul 150 mg kapsul 20 0 120 140 0 20 0 20 20 0 0 20 0 20 120 140
61 Kloramfenikol salp mata 1 % Tube 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
62 Kloramfenicol suspnsi125mg/5ml Botol 19 2 51 72 0 7 0 7 7 3 13 23 12 6 38 56

63 Klorpromazin tablet salut 100 mg(HCL) Tablet 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -

64 Klorfeniramin Maleat (CTM) 4 mg tablet Tablet 3500 180 760 4,440 0 0 100 100 100 50 410 100 3400 130 450 3,980

Kotrimoksazole Suspensi Kombinasi Botol

65 Sulfametoksazole 200 mg +Trimetropim 40 mg/5ml 124 3 27 154 0 10 0 10 10 7 9 26 114 6 18 138

Kotrimoxsazole Tablet Kombinasi Sulfametoksazole Tablet

66 400 mg + Trimetropim 80 mg 850 137 60 1,047 0 200 0 200 200 63 60 323 650 274 0 924
67 Lansoprazol kapsul 30mg kapsul 490 40 0 530 0 100 40 140 110 20 20 150 380 120 20 520
68 Lisol 1 litrer Botol 8 0 1 - 0 1 0 1 1 1 0 2 7 0 1 8
69 Loperamid tablet 2 mg Tablet 400 134 240 774 0 100 0 100 100 31 55 186 300 203 185 688
70 Magnesium Sulfat Injeksi 20 % Ampul 3 0 74 77 0 0 0 0 0 0 52 52 3 0 22 25
71 Magnesium Sulfat Injeksi 40 % Ampul 0 0 74 74 0 0 0 0 0 0 40 40 0 0 34 34
72 Metformin HCL tablet 500 mg tablet 400 85 460 945 0 100 0 100 100 30 130 260 300 155 330 785
73 Methilprednisolon tablet 4 mg Tablet 400 80 0 480 0 100 20 120 120 38 20 178 280 142 0 422
74 Metoklorpropamide 10mg Tablet 130 88 0 218 0 0 0 0 0 0 0 - 130 88 0 218
75 Metoklorpropamide sirup 5mg/5ml botol 0 0 0 0 0 0 0 0 0 0 0 - 0 0 0 -
76 Metronidazol ovula 500mg tablet 0 0 0 0 0 0 0 0 0 0 0 - 0 0 0 -
77 Mometason furoate 0,1% krim tube 0 0 0 0 0 0 0 0 0 0 0 - 0 0 0 -
78 Natrium Klorida Larutan infus 0.9% steril Botol 5 0 21 26 0 0 0 0 0 0 4 4 5 0 17 22
79 Natrium Diklofenak tablet 25 mg Tablet 650 2 180 832 0 200 50 250 250 90 200 540 400 112 30 542
80 Nistatin tablet salut 500.000 iu/g Tablet 400 80 230 710 0 100 0 100 100 0 0 100 300 180 230 710
81 Nistatin Vaginal tablet 100.000 iu/g Supp 100 5 0 105 0 0 0 0 0 0 0 - 100 5 0 105
82 Oksitosin Injeksi 10 IU/ml Ampul 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
83 Omeprazol kapsul 20 mg kapsul 780 50 0 830 0 330 60 390 390 220 60 670 390 160 0 550
84 Ondanstron kaplet 4 mg Tablet 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
85 Parasetamol drops Botol 87 8 38 133 0 4 2 6 6 5 2 13 81 7 38 126
86 Parasetamol sirup 120 mg/5 ml Botol 250 5 33 288 0 50 25 75 75 48 33 156 175 7 25 207
87 Parasetamol tablet 500 mg Tablet 2000 136 20 2,156 0 700 400 1100 1100 708 390 2,198 900 128 30 1,058
88 Pirantel tablet score (base) 125 mg Tablet 420 108 350 878 0 0 100 100 100 0 300 400 320 108 150 578
89 Piridoksin (vitamin B6) tablet 10 mg Tablet 0 0 10 10 0 0 0 0 0 0 0 - 0 0 10 10
90 Prednison tablet 5 mg Tablet 2950 0 425 3,375 0 0 50 50 0 0 190 190 2950 0 285 3,235
91 Propiltiourasil tablet 100 mg Tablet 900 100 0 0 0 0 0 0 0 0 0 - 900 100 0 1,000
92 Povidon Iodida larutan 10 % Botol 12 0 0 12 0 0 0 0 0 0 0 - 12 0 0 12
93 Ranitidin injeksi 25 mg/2ml Ampul 117 0 68 185 0 7 0 7 7 7 0 14 110 0 68 178
94 Ranitidin tablet 150 mg Tablet 1350 120 240 1,710 0 150 100 250 250 110 240 600 1100 160 100 1,360
95 Ringer Laktat Lrutan Infus Steril Botol 26 0 5 31 0 1 1 2 2 1 3 6 24 0 3 27
96 Risperidon tablet 1 mg Tablet 590 0 0 590 0 0 0 0 0 0 0 - 590 0 0 590
97 Risperidon tablet 2 mg Tablet 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
98 Rivanol 300cc Tablet 9 0 0 0 0 0 0 0 0 0 0 - 9 0 0 9
99 Salbutamol tablet 2 mg Botol 0 74 90 164 0 0 0 0 0 72 30 102 0 2 60 62
100 salbutamol sirup Botol 61 2 15 78 0 6 0 6 6 8 7 21 55 0 8 63
salep 24,Kombinasi: Asam salisilat 2%+belerang Tube
101 endap 4% 48 0 0 0 0 10 0 10 0 10 38 0 0 38
102 Salisil Bedak 2 % Kotak 5 0 11 16 0 5 0 5 5 8 13 0 0 3 3
103 Sefadroksil Kapsul 500 mg kapsul 400 51 300 751 0 100 20 120 120 10 90 220 280 141 230 651
104 Sefiksim kapsul 100 mg kapsul 400 80 230 710 0 150 0 150 150 30 90 270 250 200 140 590
105 Sefiksim sirup kering 100 mg/5 ml Botol 48 0 0 48 0 8 0 8 8 8 0 16 40 0 0 40
106 Sefotaxim injeksi 1 gram Vial 0 4 0 4 0 0 0 0 0 0 0 - 0 4 0 4
107 Setrizin sirup 5mg/5ml Botol 102 3 3 20 0 16 0 16 16 14 3 33 86 5 0 91
108 Setrizin tablet 10mg Tablet 50 30 20 100 0 50 0 50 50 80 20 150 0 0 0 -
109 Sianokobalamin (VIT B12) injeksi 500 mcg-ml Ampul 75 0 19 94 0 0 0 0 0 0 7 7 75 0 12 87
110 Simvastatin tablet 10 mg Tablet 490 20 0 510 0 90 0 90 90 10 0 100 400 100 0 500
111 Siprofloksasin tablet 500 mg Tablet 700 70 230 1,000 0 200 100 300 300 76 250 626 400 194 80 674
112 Sukralfat susp 500mg/5ml,100ml botol 0 0 0 - 0 0 0 0 0 0 0 - 0 0 0 -
113 Sukralfat Tablet 500mg Tablet 0 0 0 0 0 0 0 0 0 0 0 - 0 0 0 -
114 Tetrasiklin HCL Kapsul 250 mg Kapsul 0 0 0 0 0 0 0 0 0 0 0 - 0 0 0 -
115 Tetrasiklin HCL Kapsul 500 mg Kapsul 0 0 50 0 0 0 0 0 0 0 50 50 0 0 0 -
116 Thiamin (vitamin B1 ) tablet 50mg Tablet 200 0 100 300 0 100 0 100 100 100 50 250 100 0 50 150
117 Triheksifenidil 2mg Tablet 1000 0 0 0 80 0 80 80 80 0 160 920 0 0 920
118 Valsartan tab 80mg Tablet 450 27 0 477 0 60 0 60 60 12 0 72 390 75 0 465
119 vitamin B kompleks tablet Tablet 1150 151 0 1,301 0 350 0 350 350 146 0 496 800 355 0 1,155
120 zinc pro drop botol 90 4 0 0 0 4 0 4 4 2 0 6 86 6 0 92
121 Zinc syrup 10 mg/ml Botol 124 5 0 - 0 5 0 5 5 4 0 9 119 6 0 125
122 Zinc tablet 20 mg tablet 470 130 530 1,130 0 120 0 120 0 8 245 253 470 242 285 997
Alat Kesehatan 0 0 0 0 0 0 0 0 0 - 0 0 -
1 Alat Suntik Sekali Pakai 3 ml set 795 0 123 - 0 100 25 125 125 100 112 337 670 0 36 706
2 Alat Suntik Sekali Pakai 5 ml set 405 0 320 - 0 0 0 0 0 0 70 70 405 0 250 655
3 Alkohol Swab pcs 290 0 0 290 0 0 0 0 0 0 0 - 290 0 0 290
4 Aseptic Gel 500cc+dispenser Botol 13 0 0 13 0 1 0 1 1 1 0 2 12 0 0 12
5 Catgut chromic 2/0 + /jarum 1/2 GT 35 mm set 28 0 6 34 0 0 0 0 0 0 2 2 28 0 4 32
6 Catgut chromic 3/0 + /jarum 1/2 GT 35 mm SET 12 0 10 22 0 0 0 0 0 0 3 3 12 0 7 19
7 Catgut plain 2/0+jarum 1/2 GT 35mm SET 20 0 7 27 0 0 0 0 0 0 5 5 20 0 2 22
8 Catgut plain 3/0+jarum 1/2 GT 35mm SET 38 0 5 43 0 0 0 0 0 0 0 - 38 0 5 43
9 Catheter 2 way no 16 SET 10 0 2 12 0 0 0 0 0 0 2 2 10 0 0 10
10 Catheter 2 way no 18 SET 16 0 0 16 0 0 0 0 0 0 0 - 16 0 0 16
11 Infusion set Anak SET 13 0 0 13 0 0 0 0 0 0 0 - 13 0 0 13
12 Infusion set dewasa SET 13 0 37 50 0 0 0 0 0 0 15 15 13 0 22 35
13 Kapas Pembalut Absorben 250 mg SET 9 0 2 11 0 1 0 1 1 1 0 2 8 0 2 10
14 Kapas Pembalut Absorben 500 g SET 10 0 0 10 0 1 0 1 1 1 0 2 9 0 0 9
15 Kassa Kompres 40/40 steril SET 20 0 6 26 0 0 0 0 0 0 2 2 20 0 4 24
16 Kassa Pembalut 2 x 80 cm SET 12 0 14 26 0 2 0 2 2 2 2 6 10 0 12 22
17 Kasa Hidrofil 4 x 15 cm SET 41 1 7 49 0 0 0 0 0 1 1 2 41 0 6 47
18 Maxter exam Non Powder L SET 100 0 0 - 0 0 0 0 0 0 0 - 100 0 0 100
19 Maxter exam Non Powder M SET 157 0 0 157 0 57 0 57 57 19 0 76 100 38 0 138
20 Maxter exam Non Powder s SET 0 0 0 0 0 0 0 0 0 0 0 - 0 0 0 -
21 New DRCT 40 Y X 80 CM plain SET 0 0 0 0 0 0 0 0 0 0 0 - 0 0 0 -
22 Pembalut elastis 10cmx4,55m roll 10 0 0 10 0 0 0 0 0 0 0 - 10 0 0 10
23 Pembalut elastis 7,5cmx4,55m roll 10 0 0 10 0 0 0 0 0 0 0 - 10 0 0 10
24 Polifix 10 cm x 5 m roll 10 0 0 10 0 0 0 0 0 0 0 - 10 0 0 10
25 Polifix 5 cm x 5 m roll 9 0 0 9 0 0 0 0 0 0 0 - 9 0 0 9
26 Poligyp 7,5 cmx 2,7 m roll 5 0 0 5 0 0 0 0 0 0 0 - 5 0 0 5
27 safeglove PF no.7 psg 12 0 0 12 0 0 0 0 0 0 0 - 12 0 0 12
28 silk 2/0 + jarum 1/2 GT 35mm set 52 0 8 60 0 0 0 0 0 0 6 6 52 0 2 54
29 Surgical Mask-3ply Earloop SET 150 0 0 150 0 0 0 0 0 0 0 - 150 0 0 150
30 Surgical Mask-3ply Tie on SET 144 0 0 144 0 44 0 44 44 34 0 78 100 10 0 110
31 Urin Bag buah 2 0 1 3 0 0 0 0 0 0 0 - 2 0 1 3

Kasie. Farmakmin Ka.UPT instalasi Farmasi Ka. UPT. Puskesmas Suak Tapeh Penanggung Jawab Apotik

Hj.Nurhasanah, SKM, M. Kes dr. Liceniati Soliana Am. Keb

NIP. 197407121993012001 NIP.19791209010012002 NIP. 19901229 201212 2 002
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
LPLPO PUSTU

KODE PUSKESMAS : 03750008 LAPORAN BULAN : MARET 2017

PUSKESMAS : SUAK TAPEH
KECAMATAN : SUAK TAPEH
KABUPATEN : BANYUASIN
PROPINSI : SUMATERA SELATAN

No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir STOK OPTIMAL PERMINTAAN PEMBERIAN Keterangan
APBD INPRES ASKS APBD LAIN JUMLAH
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
I OBAT GENERIK
1 Ambroxol sirup 15 mg/ ml botol 0 0 0 0
2 Ambroxol tablet 30 mg tablet 0 0 0 0
3 Ampicillin kaplet 500 mg kaplet 10 50 60 20 40
4 Ampicillin sirup kering 125 mg/ 5 ml botol 0 0
5 Antalgin (Metampiron) tablet 500 mg tablet 0 0
6 Antifungi salep, Kombinasi : Asam Benzoat6% + Asam pot 0 0 0
7 Acylovir krim 5 % tube 12 12 0 12
8 Betahistin Maleat Tablet 6 mg tablet 0 0
9 Gentian violet larutan 1 % botol 3 3 0 3
10 Gliseril guaiakolat tablet 100 mg tablet 0 0
11 Hidrogen Peroksida cairan 3 % botol 0 0
12 Hidrokortison krim 2.5% tube 5 5 0 5
13 Hidroklortiazide tablet 25 mg tablet 0 30 30 0 30
14 Kalium Diklofenak tablet 50 mg tablet 0 0 0
15 Kalsium Laktat (Kalk) tablet 500 mg tablet 800 800 150 650
16 Kloram fenikol Kapsul 250 mg kapsul 898 898 18 880
17 Kloramfenikol Tetes Telinga 3% botol 0 0
18 Klorfeniramin Maleat (CTM) 4 mg tab tablet 130 130 0 130
19 Klorpromazin tablet salut 100 mg tablet 0 0
20 Lisol Mengandung Kresol Tersabun 50 % botol 0 0
21 Meloxikam tablet 15 mg tablet 0 0
22 Methisoprinol sirup 250 mg/5ml botol 0 0
23 Methisoprinol tablet 500 mg tablet 0 0
24 Obat Batuk Hitam (OBH) cairan botol 7 7 1 6
25 Oksitetrasiklin Salep Mata 1 % tube 26 26 0 26
26 Oksitetrasiklin Salep Kulit 3 % tube 23 23 2 21
27 Piracetam tablet 400 mg tablet 0 0
28 Piridoksin (vitamin B6) tablet 10 mg tablet 0 0
29 Piroksikam tablet 25 mg tablet 0 0
30 Prednison tablet 5 mg tablet 80 80 0 80
31 Prupiltiourasil tablet 100 mg tablet 0 0
32 Rivanol (Etakridin) Laruta 0.1 % botol 0 0
33 Biosave (ABU) vial 0 0
34 Biosat-1.5 (ATS1500 U) vial 0 0
35 Tetrasilin kapsul 500 mg kapsul 0 0
36 basitrasin tube 5 5 0 5
Obat gigi 0 0
1 Etil Klorida Semprot botol 0 0
Alat kesehatan 0 0
1 Alat Suntik Sekali Pakai 3 ml set 20 20 7 13
2 Alat Suntik Sekali Pakai 5 ml set 8 20 28 8 20
3 Handscound Steril No. 7,5 dan 8 ml set 4 4 0 4
4 Mess No. 10/11/15/20/21 set 5 5 10 0 10
5 Plester 5 yard x 2 inchi set 0 0
6 Silk No. 2/0 dengan jarum bedah set 2 2 0 2
7 Nald Hecting set 9 9 0 9
8 Wing Needle No. 20/22 set 20 20 0 20
II OBAT NON GENERIK 0 0
1 Akita tablet tablet 70 70 30 40
2 Albothyl tube 0 0
3 Ternix Plus syrup botol 0 0
4 Pehavral tablet tablet 20 20 20 0
5 Momilen Baby Gold botol 0 0
6 Pitogin S Injeksi ampul 0 0
7 Vit. K. Infant ampul 0 0
8 Nisagon Cream tube 0 0
9 Novabion Kapsul kapsul 0 0
10 Starbion tube 70 70 0 70
11 Good life for Diab Kaplet kapsul 0 0
12 Superhoid botol 2 2 0 2
13 Caranal Kapsul kaplet 100 100 200 0 200
14 OBH FM tablet 0 0
15 Dionicol Kalpet tube 0 0
16 Norvom tablet tube 0 0
17 Neocenta cream tube 1 1 1 0
18 Hidrovit tablet 0 0
19 Hico gel tube 1 1 0 1
20 Mexon tablet tablet 0 0
21 Miniospi tablet 0 0
22 Tiocin (oxytosin) ampul 0 0
DAK 0 0
1 Air untuk injeksi 25 ml Vial 0 0
2 Alkohol 70% 1 L botol 0 0
3 Alopurinol tablet 100 mg Tablet 70 20 90 0 90
4 Alprazolam tablet 0,25 mg Tablet 0 0
5 Alprazolam tablet 0,5 mg Tablet 0 0
6 Alprazolam tablet 1 mg Tablet 0 0
7 Amoksisilin sirup kering 125 mg/ 5 ml Botol 2 2 2 0
8 Amoksisilin tablet 500 mg Tablet 80 80 80 0
9 Amitriptilin tablet salut 25mg (HCl) Tablet 0 0
10 Amlodipin tablet 5 mg Tablet 0 0
11 Asam Asetil salisilat (Asetosal) tablet 80 mg Tablet 0 0
12 Asam Mefenamat Kapsul/ Kaplet 500 mg Kaplet 20 20 20 0
13 Acyclovir tablet 400 mg Tablet 100 30 130 0 130
14 Antasida Doen Tablet KombinasiMg Hidroksida 200 Tablet 20 20 20 0
15 Antasida DOEN II Suspensi Botol 7 7 2 5
Antifungi Doen salep, Kombinasi : Asam tube
16 Benzoat6% + Asam Salisilat 2 2 0 2

Antihemoroid Kombinasi Bismuth Subgalat 150 mg

heksaklorofen 2,5 mg lidokain 10 mg seng Oksida Supp
17 120 mg 2 1 3 0 3
18 Antibakteri DOEN Salp pot 0 0
19 Anti Malaria DOEN Kombinasi Primetamin 25 mg, S Tablet 0 0
20 Atropin Injeksi 5 mg/ml Ampul 0 0
21 Asam Askorbat (VIT.C) tablet 50 mg Tablet 80 50 130 0 130
22 asam fusidat krim 20mg/g TUbe 2 2 0 2
23 Betahistin Maleat Tablet 6 mg tablet 0 0
24 Betametason krim 0.1 % Tube 0 0
25 Clobazam tablet 10 mg Tablet 0 0
26 Deksamethason tablet 0.5 mg Tablet 0 0
27 Deksamethason Injeksi 5 mg/ml Ampul 5 5 0 5
28 Desoksimetason krim 0,25% tube 3 3 0 3
29 Diazepam tablet 5mg tablet 0 0
30 Digoksin tablet 0.25 mg Tablet 0 0
31 Difenhidramin injeksi 10 mg/ml Ampul 3 3 0 3
32 Domperidone Suspensi 5mg/ 5 ml Botol 0 0
33 Domperidone tablet 10 mg Tablet 70 20 90 30 60
34 Epinefrin (Adrenalin) Injeksi 0.1 % Ampul 1 1 0 1
35 Etanol cairan 70 % Botol 0 0
36 Fenofibrat kaps 100mg tablet 0 0
37 Fitomenadion (VIT.K1) Tablet 10 mg Tablet 70 70 0 70
38 Fitomenadion (VIT.K1) Injeksi 10 mg/ml-1ml Ampul 0 0
39 Furosemide tablet 40 mg Tablet 0 0
40 Garam oralit serbuk kombinasi sachet 0 0
41 Glukosa larutan infus 5 % Steril Botol 1 1 2 0 2
42 Glibenklamide tablet 5 mg Tablet 80 80 0 80
43 Glimepiride tablet 1 mg Tablet 0 0
44 Haloperidol tablet 0.5 mg Tablet 0 0
45 Haloperidol tablet 5 mg Tablet 0 0
46 Haloperidol injeksi 50 mg/ml Ampul 0 0
47 Hidrokortison krim2.5 % Tube 0 0
48 Hidroclortiazid 25 mg Tablet 0 0
49 Ibuprofen suspensi 100mg/5ml botol 0 0
50 Ibuprofen tablet 400 mg Tablet 60 60 60 0
51 Isosorbid dinitrat 5 mg Tablet 100 100 0 100
52 Jellco 24 G pcs 0 0
53 Jellco 22 G pcs 0 0
54 Jelco 20 G pcs 0 0
55 Kalsium Laktat (Kalk) tablet 500 mg Tablet 0 0
56 Kaptopril 25 mg Tablet 0 0
57 Ketokonazole Krim 2 % Tube 0 0
58 Ketokonazole tablet 200 mg Tablet 0 0
59 Ketorolac injeksi 30 mg Ampul 4 4 0 4
60 Klindamisin Kapsul 150 mg kapsul 50 50 0 50
61 Kloramfenikol salp mata 1 % Tube 0 0
62 Kloramfenicol suspnsi125mg/5ml Botol 11 11 0 11
63 Klorpromazin tablet salut 100 mg(HCL) Tablet 0 0
64 Klorfeniramin Maleat (CTM) 4 mg tablet Tablet 150 150 20 130

Kotrimoksazole Suspensi Kombinasi Botol

65 Sulfametoksazole 200 mg +Trimetropim 40 mg/5ml 15 15 8 7

Kotrimoxsazole Tablet Kombinasi Sulfametoksazole Tablet

66 400 mg + Trimetropim 80 mg 70 70 20 50
67 Lansoprazol kapsul 30mg kapsul 0 0
68 Lisol 1 litrer Botol 0 0
69 Loperamid tablet 2 mg Tablet 40 40 0 40
70 Magnesium Sulfat Injeksi 20 % 0 0
71 Magnesium Sulfat Injeksi 40 % Ampul 0 0
72 Metformin HCL tablet 500 mg Ampul 120 50 170 0 170
73 Methilprednisolon tablet 4 mg Tablet 0 0
74 Metoklorpropamide 10mg Tablet 0 0
75 Metoklorpropamide sirup 5mg/5ml botol 0 0
76 Metronidazol ovula 500mg tablet 0 0
77 Mometason furoate 0,1% krim tube 0 0
78 Natrium Klorida Larutan infus 0.9% steril Botol 1 1 0 1
79 Natrium Diklofenak tablet 25 mg Tablet 20 20 0 20
80 Nistatin tablet salut 500.000 iu/g Tablet 20 20 0 20
81 Nistatin Vaginal tablet 100.000 iu/g Supp 0 0
82 Oksitosin Injeksi 10 IU/ml Ampul 0 0
83 Omeprazol kapsul 20 mg kapsul 20 20 0 20
84 Ondanstron kaplet 4 mg Tablet 0 0
85 Parasetamol drops Botol 2 2 2 0
86 Parasetamol sirup 120 mg/5 ml Botol 9 9 9 0
87 Parasetamol tablet 500 mg Tablet 0 0
88 Pirantel tablet score (base) 125 mg Tablet 11 20 31 0 31
89 Piridoksin (vitamin B6) tablet 10 mg 70 70 0 70
90 Prednison tablet 5 mg Tablet 0 0
91 Propiltiourasil tablet 100 mg Tablet 0 0
92 Povidon Iodida larutan 10 % Botol 0 0
93 Ranitidin injeksi 25 mg/2ml Ampul 7 7 1 6
94 Ranitidin tablet 150 mg Tablet 40 50 90 30 60
95 Ringer Laktat Lrutan Infus Steril Botol 2 2 0 2
 96 Risperidon tablet 1 mg Tablet 0 0
97 Risperidon tablet 2 mg Tablet 0 0
98 Rivanol 300 cc Tablet 0 0
99 Salbutamol tablet 2 mg Botol 100 20 120 20 100
100 salbutamol sirup Botol 5 5 0 5
salep 24,Kombinasi: Asam salisilat 2%+belerang Tube
101 endap 4% 0 0
102 Salisil Bedak 2 % Kotak 2 1 3 0 3
103 Sefadroksil Kapsul 500 mg kapsul 90 40 130 60 70
104 Sefiksim kapsul 100 mg kapsul 50 50 0 50
105 Sefiksim sirup kering 100 mg/5 ml Botol 0 0 0 0
106 Sefotaxim injeksi 1 gram Vial 0 0
107 Setrizin sirup 5mg/5ml Botol 3 3 0 3
108 Setrizin tablet 10mg Tablet 80 80 0 80
109 Sianokobalamin (VIT B12) injeksi 500 mcg-ml Ampul 4 4 0 4
110 Simvastatin tablet 10 mg Tablet 0 0
111 Siprofloksasin tablet 500 mg Tablet 50 50 0 50
112 Sukralfat susp 500mg/5ml,100ml botol 0 0
113 Sukralfat Tablet 500mg Tablet 0 0
114 Tetrasiklin HCL Kapsul 250 mg Kapsul 0 0
115 Tetrasiklin HCL Kapsul 500 mg Kapsul 0 0
116 Thiamin (vitamin B1 ) tablet 50mg Tablet 20 10 30 0 30
117 Triheksifenidil 2mg Tablet 0 0
118 Valsartan tab 80mg Tablet 0 0
119 vitamin B kompleks tablet Tablet 0 0
120 zinc pro drop botol 0 0
121 Zinc syrup 10 mg/ml Botol 3 3 0 3
122 Zinc tablet 20 mg tablet 120 50 170 0 170
Alat Kesehatan 0 0
1 Alat Suntik Sekali Pakai 3 ml set 0 0
2 Alat Suntik Sekali Pakai 5 ml set 0 0
3 Alkohol Swab pcs 0 0
4 Aseptic Gel 500cc+dispenser Botol 0 0
5 Catgut chromic 2/0 + /jarum 1/2 GT 35 mm set 1 1 0 1
6 Catgut chromic 3/0 + /jarum 1/2 GT 35 mm SET 5 5 0 5
7 Catgut plain 2/0+jarum 1/2 GT 35mm SET 1 1 0 1
8 Catgut plain 3/0+jarum 1/2 GT 35mm SET 1 1 0 1
9 Catheter 2 way no 16 SET 0 0
10 Catheter 2 way no 18 SET 0 0
11 Infusion set Anak SET 0 0
12 Infusion set dewasa SET 2 2 0 2
13 Kapas Pembalut Absorben 250 mg SET 0 0
14 Kapas Pembalut Absorben 500 g SET 0 0
15 Kassa Kompres 40/40 steril SET 5 5 0 5
16 Kassa Pembalut 2 x 80 cm SET 0 0
17 Kasa Hidrofil 4 x 15 cm SET 3 3 0 3
18 Maxter exam Non Powder L SET 0 0
19 Maxter exam Non Powder M SET 0 0
20 Maxter exam Non Powder s SET 0 0
21 New DRCT 40 Y X 80 CM plain SET 0 0
22 Pembalut elastis 10cmx4,55m roll 0 0
23 Pembalut elastis 7,5cmx4,55m roll 0 0
24 Polifix 10 cm x 5 m roll 0 0
25 Polifix 5 cm x 5 m roll 0 0
26 Poligyp 7,5 cmx 2,7 m roll 0 0
27 safeglove PF no.7 psg 0 0
28 silk 2/0 + jarum 1/2 GT 35mm set 0 0
29 Surgical Mask-3ply Earloop SET 0 0
30 Surgical Mask-3ply Tie on SET 0 0
31 Urin Bag buah 0 0

Kasie. Farmakmin Ka. UPT. Puskesmas Suak Tapeh Penanggung Jawab Apotik

Hj.Nurhasanah, SKM, M. Kes dr. Liceniati Soliana Am. Keb

NIP. 197407121993012001 NIP.19791209010012002 NIP. 19901229 201212 2 002
PUSKESMAS : UPT PUSKESMAS SUAK TAPEH
KECAMATAN : SUAK TAPEH
JUMLAH PUSTU : 1 PUSTU
KABUPATEN : BANYUASIN BULAN : MEI 2017
PROPINSI : SUMATERA SELATAN

PERSED PENAMBAHAN JUMLAH PENGELUARAN PERSED

NO NAMA OBAT SATUAN KET
IAAN TGL DARI JUMLAH TOTAL TGL JUMLAH IAAN
1 2 3 4 5 6 7 8 9 10 11 12
1 Efedrin HCl TAB 0 0 1 S/D 31 0 0
2 Kodein Fosfat tab 10 mg TAB 0 0 1 S/D 31 0 0
3
4

Mengetahui
Kepala UPT Puskesmas Suak Tapeh Penanggung Jawab Apotik

dr. Liceniati Soliana Am. Keb

NIP.19791209010012002 NIP. 19901229 201212 2 002
 LAPORAN SEDIAAN PSIKOTROPIKA

PUSKESMAS : UPT PUSKESMAS SUAK TAPEH

KECAMATAN : SUAK TAPEH
JUMLAH PUSTU : 1 PUSTU
KABUPATEN : BANYUASIN
PROPINSI : SUMATERA SELATAN BULAN : MEI 2017

PENAMBAHAN JUMLAH PENGELUARAN PERMINTAAN

NO UNIT SATUAN PERSEDIAAN PERSEDIAAN KET
TGL DARI JUMLAH TOTAL TGL JUMLAH OBAT
1 2 3 4 5 6 7 8 9 10 11 12
1 Amitriptilin HCL salut TAB 150 0 150 1 S/D 31 0 150
2 Alprazolam TAB 538 0 538 1 S/D 31 0 538
3 Diazepam injeksi 5 mg/ml-1ml AMP 0 0 0 1 S/D 31 0 0
4 Diazepam tablet2 mg TAB 998 0 998 1 S/D 31 90 908
5 Fenobarbital injeksi 50 mg/ml-2ml AMP 30 0 30 1 S/D 31 0 30
6 Fenobarbital tablet 30 mg TAB 75 0 75 1 S/D 31 0 75
7 Haloperidol tab 0,5 mg TAB 940 0 940 1 S/D 31 0 940
8 Haloperidol 5 mg TAB 1030 0 1030 1 S/D 31 60 970
9 Klobazam TAB 630 0 630 1 S/D 31 0 630
10 Klorpromazin HCL TAB 895 0 895 1 S/D 31 30 865 500
11 Tramadol Tablet TAB 86 0 86 1 S/D 31 0 86
12 Tramadol injeksi AMP 0 0 0 1 S/D 31 0 0
13 Trihexilpenidyl TAB 1000 0 1000 1 S/D 31 80 920
14 Risperidon 1 MG TAB 590 0 590 1 S/D 31 0 590
15 Risperidon 2 MG TAB 0 0 0 1 S/D 31 0 0 200
16 Klozapin tab 60 0 60 1 S/D 31 10 50 200
17 Stesoli tab 100 0 100 1 S/D 31 0 100

Mengetahui
Kepala UPT Puskesmas Suak Tapeh Pengelola Obat dan Apotik

dr. Liceniati Soliana Am. Keb

NIP.19791209010012002 NIP. 19901229 201212 2 002
 FORM -POR.2
FORMULIR PELAPORAN INDIKATOR PERESEPAN DIARE NON SPESIFIK

PUSKESMAS : BETUNG KOTA BULAN November

KABUPATEN : BANYUASIN TAHUN 2021
PROPINSI : SUMATERA SELATAN

SESUAI
JUMLAH ITEM LAMAPEMAKAIAN(Ha PEDOMAN
TGL NO. NAMA UMUR ANTIBIOTIK NAMA OBAT DOSIS
OBAT ri) (YA/TIDAK)
1 2 3 4 5 6 7 8 9 10
1/11/2021 1 Elang 7 th 3 ya a.cotry syr 2x1
b.Domperi 3x1
c.zinc syr 1x1
4/11/2021 2 Nafit 12 th 4 tidak a.antasid 3x1
b.pct 3x1/2
c.cotry 2x1
d.domperidon 2x1
20/11/2021 3 cerli 3 th 2 ya a. Pct syr 3x1
b. Coty syr 2x1
29/11/2021 4 jaun 11 th 4 ya a. Pct 3x1/2
b.cotry 2x1/2
c. Antasid 3x1/2
oralit 1x1
TOTAL ITEM 13 3 N = JUMLAH LEMBAR RESEP 4
N =4 RERATA ITEM3,25 A = JUMLAH ITEM OBAT PADA SEMUA LEMBAR RESEP 13
PRESENTASE AB 75.00 B = JUMLAH PASIEN DENGAN AB 3
RERATA ITEM OBAT = A/N 3,25
PRESENTASE AB = B/N x 100% 75.00
Yang Melaporakan
Mengetahui, Pengelola Obat
Kepala Puskesmas

dr.licniati Elizabet
NIP. 19670308199003 2 006
 LAPORAN INDIKATOR PERESEPAN DI PUSKESMAS

NAMA PUSKESMAS BETUNG KOTA BULAN Oktober

JENIS PUSKESMAS : NON RAWAT INAP TAHUN :2021
JUMLAH APOTEKER ;0
JUMLAH AA/D3 FARMASI :2
JUMLAH DOKTER :2
KABUPATEN/KOTA : BANYUASIN
PROVINSI : SUMATERA SELATAN

% Penggunaan AB pada ISPA atas dan batuk- Rerata Item / Lembar Resep
pilel(common cold) (X1) % Penggunaan AB pada Diare Non Spesifik
NO ISPA atas dan batuk-pilel(common
(Y1) Diare Non Spesifik (Zb) Rata-Rata (Z1)
cold) (Za)
1 2 3 4 5
1 909.00 75.00 3,59 3,25 359.00

Yang Melaporakan
Mengetahui, Pengelola Obat
Kepala Puskesmas

dr.liceniati Elizabet
NIP. 1979120 901001 2 002 NIP. 19670308199003 2 006