LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

(LPLPO)
PUSTU/POLINDES : PULAU TENGAH BULAN
KECAMATAN : JANGKAT TAHUN
STOK PENERI- PERSE- PEMA- SISA
NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK
1 2 3 5 6 7 = (5+6) 8 9
1 Air Raksa Dental Use Set 0 0 0 0 0
2 Alat Suntik sekali pakai 1 ml set 8 150 158 65 93
3 Alat suntik sekali pakai 2,5 ml Set 10 150 160 75 85
4 Alat suntik sekali pakai 5 ml Set 17 100 117 10 107
5 Albendazol tab 400 mg Tablet 0 0 0 0 0
6 Alopurinol tab 100 mg Tablet 0 100 100 100 0
7 Aminofilina tablet 200 mg Tablet 0 0 0 0 0
8 Aminofilina inj 24 mg/ml -10 ml Ampul 1 0 1 0 1
9 Amitriptilina HCl 25 mg Tablet 0 0 0 0 0
10 Amoksisilina sir kering 250 mg/5ml Botol 0 29 29 0 29
11 Amoksisilina kap 250 mg Kapsul 0 300 300 200 100
12 Ampisilina Kaplet 500 mg Kaplet 0 0 0 0 0
13 Ampisilina Inj Vial 0 0 0 0 0
14 Antalgin 500 mg tablet Tablet 0 0 0 0 0
15 Antalgin inj 250 mg / ml -2 ml Ampul 0 0 0 0 0
16 Antacida DOEN Kombinasi Tablet 0 1,000 1000 410 590
17 Antibakteri DOEN salap Kombinasi Pot 0 10 10 1 9
18 Anti Hemmoroid Suppositoria Supp 1 10 11 10 1
19 Antifungi DOEN Salep (Whitefield). Pot 1 10 11 5 6
20 Antimigrain DOEN Kombinasi Tablet 0 0 0 0 0
21 Antiparkinson doen tab, komb. Tablet 0 0 0 0 0
22 Aqua Pro injeksi steril Ampul 0 0 0 0 0
23 Aquadest steril 500 ml Botol 0 0 0 0 0
24 Asam Ascorbat (Vit.C) tab. 250 mg Tablet 0 100 100 0 100
25 Asam Ascorbat (Vit.C) tab. 50 mg Tablet 0 100 100 0 100
26 Asam Klorida 0,1% Botol 0 0 0 0 0
27 Asam sulfosalisilat 20% Botol 0 0 0 0 0
28 Asetosal 100 mg tablet Tablet 0 0 0 0 0
29 Asetosal tab 500 mg Tablet 0 0 0 0 0
30 Atropin Sulpat inj 0,25 mg/ml-1 ml Ampul 0 10 10 6 4
31 Atropin Sulpat tab 0,5 mg Tablet 0 0 0 0 0
32 Atropin Sulpat tetes mata 0,5% Botol 0 0 0 0 0
33 Benza Benzil Penisilina inj 1,2 Juta IU Vial 0 0 0 0 0
34 Blood Set Set 0 0 0 0 0
35 Burnazin 35 mg Tube 0 0 0 0 0
36 Betametason Krim 0,1 % Tube 0 25 25 20 5
37 Cat Gut / benang bedah no. 2/0-3/0 Sachet 0 0 0 0 0
38 Dapson tablet 100 mg Tablet 0 0 0 0 0
39 Deksametason inj 5 mg/ml -1ml Ampul 0 20 20 10 10
40 Deksametason tablet 0,5 mg Tablet 0 600 600 300 300
41 Dekstrans 70- lar infus 6 % steril Botol 0 0 0 0 0
42 Dektrometropan HBr sirup Botol 0 0 0 0 0
43 Dekstrometorfan HBr tablet 15 mg Tablet 0 0 0 0 0
44 Devitalisasi Pasta Pot 0 0 0 0 0
45 Diazepam inj 5 mg / ml-2 ml Ampul 0 0 0 0 0
46 Diazepam tab 2 mg Tablet 0 0 0 0 0
47 Diazepam tablet 5 mg Tablet 0 0 0 0 0
48 Dietilkarbamazin sitrat tab 100 mg Tablet 0 0 0 0 0
49 Difenhidramin inj 10 mg/ml-1ml Ampul 0 0 0 0 0
50 Digoksin tab 0.25 mg Tablet 0 0 0 0 0
51 Efedrin tablet 25 mg Tablet 0 0 0 0 0
52 Ekstrak Belladona tab 25 mg Tablet 0 0 0 0 0
53 Efineprina HCl/Bitartrat inj 0,1 %- 1 ml Ampul 0 0 0 0 0
54 Etakridini laktas larutan 0,1 % Botol 0 5 5 4 1
55 Etambutol tab 250 mg Tablet 0 0 0 0 0
56 Etanol 70 % 100 ml Botol 0 4 4 2 2
57 Eter Anestesi Botol 0 0 0 0 0
58 Etil Klorida Semprot Botol 0 1 1 0 1
59 Eugenol Cairan Botol 0 0 0 0 0
60 Fenitoin injeksi 10 mg mg/ml Ampul 0 0 0 0 0
61 Fenitoin Natrium Kapsul 100 mg Kapsul 0 0 0 0 0
62 Fenitoin Natrium Kapsul 30 mg Kapsul 0 0 0 0 0
63 Fenobarbital inj 50 mg/ml-2ml Ampul 0 0 0 0 0
64 Fenobarbital tablet 100 mg Tablet 0 0 0 0 0
65 Fenobarbital tablet 30 mg Tablet 0 0 0 0 0
66 Fenoksimetil Penisilin tab 250 mg Tablet 0 0 0 0 0
67 Fenoksimetil Penisilin Tab 500 mg Tablet 0 0 0 0 0
68 Fenol Gliserol Tts Telinga 10 % Botol 1 8 9 0 9
69 Fitomenadion Inj 10 mg/ml-1ml Ampul 0 0 0 0 0
70 Fitomenadion tab salut 10 mg Tablet 30 100 130 30 100
71 Fluor tablet Tablet 0 0 0 0 0
72 Furosemida tablet 40 mg Tablet 50 0 50 10 40
73 Gameksan Emulsi 1 % Botol 0 0 0 0 0
74 Garam oralit untuk 1000 ml air Bungkus 0 0 0 0 0
75 Garam Oralit 200 ml air Bungkus 0 100 100 20 80
76 Gentian Violet larutan 1 % Botol 0 0 0 0 0
77 Glass Ionomer cement Set 0 0 0 0 0
78 Glibenklamida tab 5 mg Tablet 0 100 100 70 30
79 Guafenesin tablet 100 mg Tablet 0 200 200 0 200
80 Gliserin Botol 0 0 0 0 0
81 Glukosa lar infus 10 % steril Botol 0 0 0 0 0
82 Glukosa lar infus 40 % steril Botol 0 0 0 0 0
 83 Glukosa lar infus 5 % steril Botol 0 0 0 0 0
84 Griseofulvin tab 125 mg micrinized Tablet 0 0 0 0 0
85 Haloperidol tablet 0,5 mg Tablet 0 0 0 0 0
86 Haloperidol tablet 1,5 mg Tablet 0 0 0 0 0
87 Haloperidol tablet 5 mg Tablet 0 0 0 0 0
88 Hidroklortiazid Tab 25 mg Tablet 0 0 0 0 0
89 Hidrokortison Krim 2.5 % Tube 0 48 48 12 36
90 Ibuprofen tablet 200 mg Tablet 0 300 300 150 150
91 Ibuprofen tablet 400 mg Tablet 0 0 0 0 0
92 Infus set anak Set 0 0 0 0 0
93 Infus set Dewasa Set 0 24 24 1 23
94 Insulin reguler inj 40 IU Ampul 0 0 0 0 0
95 Iodiol Kapsul Lunak Kapsul 0 0 0 0 0
96 Ipeka sirup 0,14 % Botol 0 0 0 0 0
97 Isoniazida (iINH) tab 300 mg Tablet 0 0 0 0 0
98 Isosorbid dinitrat tablet Sublingual 5 mg Tablet 0 0 0 0 0
99 Jarum Jahit (bedah) No. 9 s/d 14 Biji 0 0 0 0 0
100 Kalium Permanganat serbuk Pot 0 0 0 0 0
101 Kalsium Hidroksida pasta Set 0 0 0 0 0
102 Kalsium Laktat tablet 500 mg Tablet 0 600 600 300 300
103 Kapas berlemak 50 mg Bungkus 0 0 0 0 0
104 Kapas pembalut 250 gram Bungkus 0 3 3 1 2
105 Karbamazepin tablet 200 g Tablet 0 0 0 0 0
106 Kasa kompres 40/40 steril Bungkus 0 0 0 0 0
107 Kasa Pembalut 2 x 80 Bungkus 0 0 0 0 0
108 Kasa pembalut hidropil 10x10 Rol 0 0 0 0 0
109 Kasa pembalut hidropil 6x6 Rol 0 0 0 0 0
110 Ketorolak inj Ampul 0 0 0 0 0
111 Klafazimin kap 100 mg/ml Kapsul 0 0 0 0 0
112 Kloramfenikol kap 250 mg Kapsul 0 100 100 50 50
113 Kloramfenikol Salap mata 1% Tube 0 0 0 0 0
114 Kloramfenikol tetes telinga 3 % Botol 0 10 10 1 9
115 Klorfeniramini Maleas 4 mg tab Tablet 0 1,000 1000 400 600
116 Klorkina Pospat tab 250 mg Tablet 0 0 0 0 0
117 Klorpromazin HCl 25 mg/ml-1ml Ampul 0 0 0 0 0
118 Klorpromazin HCl 5 mg / ml-2ml Ampul 0 0 0 0 0
119 Klorpromazin HCl 100 mg Tablet 0 0 0 0 0
120 Klorpromazin HCl tab 25 mg Tablet 0 0 0 0 0
121 Klorpropamida tab 100 mg Tablet 0 0 0 0 0
122 Kodein HCl tab 10 mg Tablet 0 0 0 0 0
123 Komb.Piremetamin 2 mg + Sulfadoksin Tablet 0 0 0 0 0
124 Kotrimoksazol tab 120 mg Pediatrik Tablet 0 0 0 0 0
125 Kotrimoksazol suspensi Botol 0 0 0 0 0
126 Kotrimoksazol tab Komb. 480 mg Tablet 0 0 0 0 0
127 Kuinina HCl inj 25 %-2ml Ampul 0 0 0 0 0
128 Kuinina Sulfat Tablet 222 mg ( 7 H2O ) Tablet 0 0 0 0 0
129 Larutan Benedit Botol 0 0 0 0 0
130 Larutan Eosin 2% Botol 0 0 0 0 0
131 Larutan Etanol Botol 0 0 0 0 0
132 Larutan Giemsa Stain Botol 0 0 0 0 0
133 Larutan Karbol Fuksin Botol 0 0 0 0 0
134 Larutan Metilen Biru Botol 0 0 0 0 0
135 Larutan Turk Botol 0 0 0 0 0
136 Lidokain comp inj Komb. Ampul 10 30 40 12 28
137 Lisol Botol 0 0 0 0 0
138 Magnesium Sulpat inj (iv) 20%-25 ml Vial 0 0 0 0 0
139 Magnesium Sulfat Inj (iv) 40 % -25 ml Vial 0 0 0 0 0
140 Mebendazol sir 100 mg/5 ml Botol 0 0 0 0 0
141 Mebendazol tab 100 mg Tablet 0 0 0 0 0
142 Metanol Botol 0 0 0 0 0
143 Metil Ergometrin tab. 0.125 mg Tablet 0 25 25 12 13
144 Metil Ergometrin inj 0,200mg/1 ml Ampul 0 0 0 0 0
145 Metronidazol tab 250 mg Tablet 0 0 0 0 0
146 MonoKlorkamfer Mentol Cairan Botol 0 0 0 0 0
147 Mummifying Pasta Pot 0 0 0 0 0
148 Natrium bicarbonat tablet 500 mg Tablet 0 0 0 0 0
149 Natrium fluoresin tts mata 2 % Botol 0 0 0 0 0
150 Natrium Klorida Lar Inf 0,9% Steril Kolf 0 20 20 5 15
151 Natrium Thio Sulpat inj 25%-10ml Ampul 0 0 0 0 0
152 Nistatin 100.000 IU /G Tab Vagina Supp 0 1 1 0 1
153 Nistatin 500.000 IU tablet salut Tablet 0 0 0 0 0
154 Obat Antituberkulosis Katagori 1 Paket 0 0 0 0 0
155 Obat Antituberkulosis Katagori 2 Paket 0 0 0 0 0
156 Obat Batuk Hitam (OBH) Botol 0 0 0 0 0
157 OAT Katagori anak paker 0 0 0 0 0
158 Oksitetrasiklin HCl inj 50 mg/ml - 10 ml Vial 0 0 0 0 0
159 Oksitetrasiklin Salep Kulit 3% Tube 0 2 2 2 0
160 Oksitetrasiklin salep mata 1% Tube 0 0 0 0 0
161 Oksitoksin inj 10 IU/ml - ml Ampul 0 10 10 2 8
162 Paraformaldehide 1 gram Tablet 0 0 0 0 0
163 Parasetalmol sir 120 mg/ 5 ml Botol 0 48 48 12 36
164 Parasetamol 100 mg tablet Tablet 0 0 0 0 0
165 Parasetamol 500 mg tablet Tablet 0 1,200 1200 500 700
166 Pembalut gibs Botol 0 0 0 0 0
167 Papaverin 40 mg Tablet 0 0 0 0 0
168 Perphenazin 4mg Tablet 0 0 0 0 0
169 Pethidin hcl injeksi 50 mg/ml - 2 ml Ampul 0 0 0 0 0
170 Pilokarpin HCl/nitrat tetes mata 2% Botol 0 0 0 0 0
171 Pirantel Pamoat tab. 125mg Tablet 0 0 0 0 0
172 Piridoksin HCl Tab 10 mg Tablet 0 200 200 100 100
173 Plaster 5 Yard x 2 inchi Rol 0 0 0 0 0
174 Polikresulen Botol 0 0 0 0 0
175 Polipeptida komb doen Tablet 0 0 0 0 0
176 prazikuantel tab 600 mg Tablet 0 0 0 0 0
177 Prednison tab 5 mg Tablet 0 600 600 300 300
178 Primakin tab 15 mg Tablet 0 0 0 0 0
179 Prokaina Penisilina G inj 3 Juta IU Vial 0 0 0 0 0
180 Propil Thio Urasil 100 mg tablet Tablet 0 0 0 0 0
181 Propranolol tab 40 mg Tablet 0 100 100 35 65
182 Rabies Imuneglobulin ( HUMAN ) 150 IU Set 0 0 0 0 0
183 Reserpin 0,1 mg tabler Tablet 0 0 0 0 0
184 Reserpin 0,25 mg tablet Tablet 0 0 0 0 0
185 Retinol Kapsul Lunak 200.000 IU Kapsul 0 0 0 0 0
186 Rifampisin Kaplet 600 mg Tablet 0 0 0 0 0
187 Rifampisin Kapsul 300 mg Kapsul 0 0 0 0 0
188 Rifampisin Kapsul 450 mg Kapsul 0 0 0 0 0
189 Ringer Laktat inf steril Kolf 0 40 40 20 20
190 Salbutamol tab 2mg Tablet 0 100 100 50 50
191 Salep 2 - 4 Kombinasi Pot 0 0 0 0 0
192 Salisill Bedak 2% Bungkus 0 24 24 8 16
193 Salisil Spiritus 10 % Botol 0 0 0 0 0
194 Semen Seng Fosfat serbuk & cairan Set 0 0 0 0 0
195 Serum Anti Bisa Ular Polipalen inj 5 ml ( Ampul 0 0 0 0 0
196 Serum Anti bisa Ular Polipalen inj 50 ml Vial 0 0 0 0 0
197 Serum Anti Difteri INJ 20.000 IU / ampu Ampul 0 0 0 0 0
198 Serum Antitetanus inj 1500 IU/ampul ( Ampul 0 0 0 0 0
199 Serum Antitetanus inj 20.000 IU/vial (A Vial 0 0 0 0 0
200 Sianokobalamin inj 500 mcg Ampul 0 30 30 10 20
201 Silk No 3/0 Sachet 0 12 12 1 11
202 Silver Amalgam Serbuk 65 - 70% Set 0 0 0 0 0
203 Spon Gelatin Kotak 0 0 0 0 0
204 Streptomisin SO4 inj 1000 mg/ Vial Vial 0 0 0 0 0
205 Streptomisin SO4 inj 1500 mg/ Vial Vial 0 0 0 0 0
206 Sulpadimidin 500 mg tablet Tablet 0 0 0 0 0
207 Sulpasetamida tetes mata 15% Botol 0 0 0 0 0
208 Suspensi seng insulin inj. 40 iu/ml Ampul 0 0 0 0 0
209 Tablet Tambah Darah Kombinasi Tablet 0 0 0 0 0
210 Temporary stoping fletcher dan cairan Set 0 0 0 0 0
211 Tetrakaina HCL tetes mata 0,5% Botol 0 0 0 0 0
212 Tetrasiklin HCl Kap. 250 mg Kapsul 0 0 0 0 0
213 Tetrasiklin HCl Kap. 500 mg Kapsul 0 0 0 0 0
214 Thiamin HCl inj 100 mg /ml-1ml Ampul 0 600 600 300 300
215 Thiamin HCl tab 50 mg Tablet 0 600 600 250 350
216 Tiopental Na serbuk inj. 1000 mg/amp Ampul 0 0 0 0 0
217 Triheksil penidil HCl 2 mg tab Tablet 0 0 0 0 0
218 Trikresol Formalin (TKF) Cairan Botol 0 0 0 0 0
219 Vaksin rabies vero kuur 0 0 0 0 0
220 Vitamin B Kompleks Tablet 0 0 0 0 0
221 Yodium Povidon lart 10% 60 ml Botol 0 3 3 2 1
222 Yodium Povidon lart 10%m 300 ml Botol 0 3 3 1 2
223 Abocatch 18 Pcs 0 24 24 5 19
224 Abocath 20 Pcs 0 24 24 6 18
225 Abocath 24 Pcs 0 24 24 8 16
226 Acycklovir 200 mg Tablet 0 100 100 80 20
227 Acycklovir 400 mg Tablet 0 0 0 0 0
228 Acycklovir Cream Tube 2 24 26 12 14
229 Ambroxol Syrup Botol 0 0 0 0 0
230 Ambroxol Tab Tablet 0 0 0 0 0
231 Amlodipin 10 mg Tablet 0 500 500 160 340
232 Amlodipin 5 mg Tablet 0 500 500 160 340
233 Amoksisilin kap 500 mg Tablet 0 1,000 1000 500 500
234 Antasida Syrup Botol 0 0 0 0 0
235 As.Traneksanat 500 mg Tablet 0 0 0 0 0
236 As.Traneksanat 250 mg Inj Ampul 0 1 1 0 1
237 Asam Asetat 6 % Botol 0 0 0 0 0
238 Asam Mefenamat 500 mg tablet Tablet 0 600 600 200 400
239 Betazon N krim Tube 0 0 0 0 0
240 Bioneuron Tab Tablet 0 0 0 0 0
241 Bromhexin tab Tablet 0 0 0 0 0
242 Captopril 25 mg tablet 0 500 500 200 300
243 Catopril 12,5 mg Tablet 30 500 530 240 290
244 Cefotaxim Inj Vial 0 12 12 2 10
245 Cetirizin tab Tablet 0 500 500 140 360
246 Dexran 70 % Botol 0 0 0 0 0
247 Doksisiklin tab Tablet 0 0 0 0 0
248 Domperidon Susp 60 ml Botol 0 0 0 0 0
249 Erytromisin Kapsul 250 mg Kapsul 0 0 0 0 0
250 Erytromisin kapsul 500 mg Tablet 0 300 300 60 240
251 Erytromisin Syrup Botol 0 5 5 2 3
252 Eter Alkohol Botol 0 0 0 0 0
253 Gentamisin inj Vial 0 2 2 1 1
254 Gentamisin Salap Kulit tube 0 0 0 0 0
255 Glukosa kalsikus Ampul 0 0 0 0 0
256 H2O2 Botl 0 0 0 0 0
257 Hand Scoon pasang 0 50 50 32 18
258 Ibuprofen sirup Botol 0 0 0 0 0
259 Kasa 4 m x 10 cm Rol 0 0 0 0 0
260 KASA 3 M X 10 CM ROL 0 10 10 1 9
261 Kasa 4 x 5 cm Rol 0 0 0 0 0
262 Kasa Pembalut 40 x 80 Rol 0 3 3 2 1
263 Ketokonazol Krim Tube 0 0 0 0 0
264 Ketokonazol tab Tablet 0 100 100 40 60
265 Klorampenicol Syrup Botol 0 0 0 0 0
266 Klorampenicol Tts mata 1 % Botol 0 0 0 0 0
267 KOH Sol Botol 0 0 0 0 0
268 Lar Hayem Botol 0 0 0 0 0
269 Lar HCL Botol 0 0 0 0 0
270 Lart Fochet Botol 0 0 0 0 0
271 Lart Reessecker Botol 0 0 0 0 0
272 Loperamid Tablet 0 0 0 0 0
273 Masker set 0 0 0 0 0
274 Metformin Tablet 0 300 300 100 200
275 Methoklorpamida Tablet 0 200 200 100 100
276 Metoklorpamid Inj Ampul 0 4 4 2 2
277 Meylon Botol 0 0 0 0 0
278 Mikonazol krim 2% Tube 0 24 24 12 12
279 Multivitamin anak sirup botol 0 5 5 2 3
280 Multivitamin plus mineral Tablet 0 0 0 0 0
281 Natrium bicarbonat inj botol 0 0 0 0 0
282 Natrium Diklofenat 25 mg Tablet 0 300 300 130 170
283 Natrium Diklofenat 50 mg Tablet 0 500 500 200 300
284 Nipedipin tablet Tablet 0 0 0 0 0
285 Parasetamol Drop 15 ml Botol 0 0 0 0 0
286 Pehapral Tablet 0 300 300 120 180
287 Pirantel Pamoat sirup Botol 0 0 0 0 0
288 Piroksikam 10 mg tablet Tablet 0 0 0 0 0
289 Piroksikam 20 mg tab Tablet 0 0 0 0 0
290 Ranitidin Inj Ampul 0 15 15 6 9
291 Ranitidin tab 150 mg Tablet 0 500 500 250 250
292 Retinol Kapsul Lunak 100.000 IU Kapsul 0 0 0 0 0
293 SALBUTAMOL 4 MG Tablet 0 0 0 0 0
294 Sefadroksil sirup kering Botol 0 0 0 0 0
295 Sianokobalamin tab 50 mcg Tablet 0 200 200 20 180
296 Simetidin tab 200 mg Tablet 0 0 0 0 0
297 Siproploksasin 500 mg Tablet 0 300 300 90 210
298 Aqua 500 ml Kotak 0 0 0 0 0
299 Sofratulle Bks 0 0 0 0 0
300 Tramadol inj Ampul 0 0 0 0 0
301 Urin Bag pcs 4 2 6 3 3
302 Wing Nidle 18-21 set 0 0 0 0 0
303 Zink Tablet 0 300 300 140 160
304 Abocath 22 set 5 24 29 16 13
305 Becefort Syrup Botol 0 0 0 0 0
306 Curcuma plus imun Botol 0 0 0 0 0
307 DeXtrofen syrup Botol 0 0 0 0 0
308 LORATADINE TAB 10 MG Tablet 0 0 0 0 0
309 Hemaford Tablet 0 0 0 0 0
310 Hepagard Tablet 0 0 0 0 0
311 Imbost syrup Botol 0 0 0 0 0
312 Litacur syrup Botol 0 0 0 0 0
313 Livron b Plek Tablet 0 0 0 0 0
314 Methiosoprinol Tablet 0 0 0 0 0
315 Methiosoprinol 250 mg/5ml Botol 0 0 0 0 0
316 Pehacain Inj Ampul 0 0 0 0 0
317 Tensigard Tablet 0 0 0 0 0
318 Alat suntik 10 ml set 0 10 10 4 6
319 Reagen Gol Darah 0 0 0 0 0
320 Masker Ear Loop kotak 0 2 2 1 1
321 Permetrin Krim tube 0 12 12 4 8
322 Poli kateter no 14 set 1 5 6 3 3
323 Poli kateter no 18 set 3 3 6 2 4
324 Gentamisin Salap Mata Tube 0 5 5 2 3
325 Bisacodil supp Supp 0 0 0 0 0
326 Atapulgit tab 600 mg Tablet 0 200 200 80 120
327 KASA 16 X 16 Kotak 0 32 32 13 19
329 Omeprazol tab Tablet 0 0 0 0 0
330 Simvastatin 20 Tablet 0 100 100 40 60
331 Simvastatin 10 Tablet 0 200 200 160 40
332 Geriavita tablet Tablet 0 0 0 0 0
333 Stimuno kapsul Kapsul 0 0 0 0 0
334 Stimuno syrup Grape botol 0 0 0 0 0
335 Cavicur syrup botol 0 0 0 0 0
336 Paper tape 5.0 cm x 9.14 m(farmafix) Rol 0 0 0 0 0
337 Gentamisin Tetes Mata TUBE 0 0 0 0 0
338 Cetirizin Sirup Botol 0 10 10 4 6
339 Cairan Desinpektan Botol 0 0 0 0 0
340 Plaster merah (leukoples) 2,5 x 4,5 m Rol 0 3 3 1 2
341 Plaster merah (leukoples) 7,5 x 4,5 m Rol 0 0 0 0 0
342 ALOpurinol tab 300 mg Tablet 0 0 0 0 0
343 Stesolit Rektal 5 mg SUB 0 0 0 0 0
344 KOMPOLAX BOTOL 0 2 2 1 1
345 LIDOKAIN SPRAY BOTOL 0 0 0 0 0
346 LIDOKAIN GEL TUBE 0 0 0 0 0
347 SULFADIAZIN SILVER TUBE 0 0 0 0 0
348 ALKOHOl SWAP KTK 0 2 2 1 1
349 GLIMEPIRIDE KAPS 2 MG Tablet 0 200 200 90 110
350 FUROSEMID INJ 10 MG/ML Ampul 2 0 2 0 2
351 DOMPERIDON TAB 10 MG Tablet 0 200 200 70 130
352 METIL PREDNISOLON 4 MG Tablet 0 300 300 100 200
353 SALBUTAMOL MDI 100 MCG/DOS BTL 0 0 0 0 0
354 FENETEROLHIDROMIDE 100 MCG/FUFF BTL 0 0 0 0 0
355 HANDSCOON MRB PCS 0 100 100 30 70
356 KLORAMFENIKOL SK Tube 0 0 0 0 0
358 BETAHISTIN TAB 24 MG Tablet 0 0 0 0 0
359 SEFADROKSIL KAPS 250 MG Tablet 0 0 0 0 0
360 ZINK SYR BOTOL 0 0 0 0 0
362 ACETYLCYSITEIN 200 MG KAPS Kapsul 20 600 620 230 390
363 DIMENHIDRATE 50 MG TAB Tablet 0 0 0 0 0
364 PARASETAMOL INFUS BOTOL 0 0 0 0 0
365 METOKLORPAMID DROP BOTOL 0 0 0 0 0
366 Handscoon steril Pcs 0 0 0 0 0
367 OMEPRAZOLE INJ Ampul 0 10 10 6 4
369 ASETOSAL 80 MG Tablet 0 0 0 0 0
370 HERBACOF Kotak 0 48 48 12 36
371 HERBACOLD Tablet 0 0 0 0 0
Umum BPJS
UKS/Gratis/SKTM
Jumlah Kunjungan Resep Bayar PBI/NONPBI
167 332 89

Yang Melapor
Petugas Pustu Pulau Te

(Hj. Siti Komiah, Amd.K

Nip. 19750713200212
OBAT

: Januari
: 2024
STOK PERMIN-
OPT TAAN
10 17
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JUMLAH

588

Yang Melapor
Petugas Pustu Pulau Tengah

(Hj. Siti Komiah, Amd.Keb)

Nip. 197507132002122001
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)
PUSTU/POL: PULAU TENGAH BULAN : Februari
KECAMATA: JANGKAT TAHUN : 2024
STOK PENERI- PERSE- PEMA- SISA STOK PERMIN-
NO NAMA OBATSATUAN
AWAL MAAN DIAAN KAIAN STOK OPT TAAN
1 2 3 5 6 7 = (5+6) 8 9 10 17
1 Air Raksa Set 0 0 0 0 0 0
2 Alat Sunti set 8 150 158 65 93 0
3 Alat suntik Set 10 150 160 75 85 0
4 Alat suntik Set 17 100 117 10 107 0
5 Albendazo Tablet 0 0 0 0 0 0
6 Alopurinol Tablet 0 100 100 100 0 0
7 Aminofilin Tablet 0 0 0 0 0 0
8 Aminofilin Ampul 1 0 1 0 1 0
9 Amitriptil Tablet 0 0 0 0 0 0
10 Amoksisili Botol 0 29 29 0 29 0
11 Amoksisil Kapsul 0 300 300 200 100 0
12 Ampisilina Kaplet 0 0 0 0 0 0
13 Ampisilina Vial 0 0 0 0 0 0
14 Antalgin 5 Tablet 0 0 0 0 0 0
15 Antalgin i Ampul 0 0 0 0 0 0
16 Antacida Tablet 0 1,000 1000 410 590 0
17 Antibakte Pot 0 10 10 1 9 0
18 Anti Hemm Supp 1 10 11 10 1 0
19 Antifungi Pot 1 10 11 5 6 0
20 Antimigra Tablet 0 0 0 0 0 0
21 Antiparkin Tablet 0 0 0 0 0 0
22 Aqua Pro in Ampul 0 0 0 0 0 0
23 Aquadest s Botol 0 0 0 0 0 0
24 Asam Ascor Tablet 0 100 100 0 100 0
25 Asam Ascor Tablet 0 100 100 0 100 0
26 Asam Klor Botol 0 0 0 0 0 0
27 Asam sulfo Botol 0 0 0 0 0 0
28 Asetosal 1 Tablet 0 0 0 0 0 0
29 Asetosal Tablet 0 0 0 0 0 0
30 Atropin Su Ampul 0 10 10 6 4 0
31 Atropin Su Tablet 0 0 0 0 0 0
32 Atropin Su Botol 0 0 0 0 0 0
33 Benza Benz Vial 0 0 0 0 0 0
34 Blood Set Set 0 0 0 0 0 0
35 Burnazin Tube 0 0 0 0 0 0
36 Betametas Tube 0 25 25 20 5 0
37 Cat Gut / Sachet 0 0 0 0 0 0
38 Dapson ta Tablet 0 0 0 0 0 0
39 Deksameta Ampul 0 20 20 10 10 0
40 Deksameta Tablet 0 600 600 300 300 0
41 Dekstrans 7 Botol 0 0 0 0 0 0
42 Dektromet Botol 0 0 0 0 0 0
43 Dekstrome Tablet 0 0 0 0 0 0
44 Devitalisa Pot 0 0 0 0 0 0
45 Diazepam i Ampul 0 0 0 0 0 0
46 Diazepam Tablet 0 0 0 0 0 0
47 Diazepam Tablet 0 0 0 0 0 0
48 Dietilkarb Tablet 0 0 0 0 0 0
49 Difenhidra Ampul 0 0 0 0 0 0
50 Digoksin t Tablet 0 0 0 0 0 0
51 Efedrin ta Tablet 0 0 0 0 0 0
52 Ekstrak B Tablet 0 0 0 0 0 0
53 Efineprina Ampul 0 0 0 0 0 0
54 Etakridini Botol 0 5 5 4 1 0
55 Etambutol Tablet 0 0 0 0 0 0
56 Etanol 70 Botol 0 4 4 2 2 0
57 Eter Anest Botol 0 0 0 0 0 0
58 Etil Klori Botol 0 1 1 0 1 0
59 Eugenol C Botol 0 0 0 0 0 0
60 Fenitoin i Ampul 0 0 0 0 0 0
61 Fenitoin Kapsul 0 0 0 0 0 0
62 Fenitoin Kapsul 0 0 0 0 0 0
63 Fenobarbit Ampul 0 0 0 0 0 0
64 Fenobarbit Tablet 0 0 0 0 0 0
65 Fenobarbit Tablet 0 0 0 0 0 0
66 Fenoksimet Tablet 0 0 0 0 0 0
67 Fenoksimet Tablet 0 0 0 0 0 0
68 Fenol Glis Botol 1 8 9 0 9 0
69 Fitomenad Ampul 0 0 0 0 0 0
70 Fitomenadi Tablet 30 100 130 30 100 0
71 Fluor table Tablet 0 0 0 0 0 0
72 Furosemid Tablet 50 0 50 10 40 0
73 Gameksan Botol 0 0 0 0 0 0
74 Garam oralBungkus 0 0 0 0 0 0
75 Garam OralBungkus 0 100 100 20 80 0
76 Gentian Vi Botol 0 0 0 0 0 0
77 Glass Ion Set 0 0 0 0 0 0
78 Glibenkla Tablet 0 100 100 70 30 0
79 Guafenesi Tablet 0 200 200 0 200 0
80 Gliserin Botol 0 0 0 0 0 0
81 Glukosa lar Botol 0 0 0 0 0 0
82 Glukosa lar Botol 0 0 0 0 0 0
 83 Glukosa lar Botol 0 0 0 0 0 0
84 Griseofulv Tablet 0 0 0 0 0 0
85 Haloperido Tablet 0 0 0 0 0 0
86 Haloperido Tablet 0 0 0 0 0 0
87 Haloperido Tablet 0 0 0 0 0 0
88 Hidroklort Tablet 0 0 0 0 0 0
89 Hidrokorti Tube 0 48 48 12 36 0
90 Ibuprofen Tablet 0 300 300 150 150 0
91 Ibuprofen Tablet 0 0 0 0 0 0
92 Infus set Set 0 0 0 0 0 0
93 Infus set Set 0 24 24 1 23 0
94 Insulin reg Ampul 0 0 0 0 0 0
95 Iodiol Kap Kapsul 0 0 0 0 0 0
96 Ipeka siru Botol 0 0 0 0 0 0
97 Isoniazida Tablet 0 0 0 0 0 0
98 Isosorbid Tablet 0 0 0 0 0 0
99 Jarum Jahi Biji 0 0 0 0 0 0
100 Kalium Pe Pot 0 0 0 0 0 0
101 Kalsium Hi Set 0 0 0 0 0 0
102 Kalsium La Tablet 0 600 600 300 300 0
103 Kapas ber Bungkus 0 0 0 0 0 0
104 Kapas pemBungkus 0 3 3 1 2 0
105 Karbamaze Tablet 0 0 0 0 0 0
106 Kasa komprBungkus 0 0 0 0 0 0
107 Kasa PembBungkus 0 0 0 0 0 0
108 Kasa pemba Rol 0 0 0 0 0 0
109 Kasa pemba Rol 0 0 0 0 0 0
110 Ketorolak Ampul 0 0 0 0 0 0
111 Klafazimi Kapsul 0 0 0 0 0 0
112 Kloramfen Kapsul 0 100 100 50 50 0
113 Kloramfen Tube 0 0 0 0 0 0
114 Kloramfeni Botol 0 10 10 1 9 0
115 Klorfenira Tablet 0 1,000 1000 400 600 0
116 Klorkina P Tablet 0 0 0 0 0 0
117 Klorproma Ampul 0 0 0 0 0 0
118 Klorpromaz Ampul 0 0 0 0 0 0
119 Klorproma Tablet 0 0 0 0 0 0
120 Klorproma Tablet 0 0 0 0 0 0
121 Klorpropa Tablet 0 0 0 0 0 0
122 Kodein HC Tablet 0 0 0 0 0 0
123 Komb.Pire Tablet 0 0 0 0 0 0
124 Kotrimoksa Tablet 0 0 0 0 0 0
125 Kotrimoksa Botol 0 0 0 0 0 0
126 Kotrimoks Tablet 0 0 0 0 0 0
127 Kuinina HC Ampul 0 0 0 0 0 0
128 Kuinina Su Tablet 0 0 0 0 0 0
129 Larutan Be Botol 0 0 0 0 0 0
130 Larutan E Botol 0 0 0 0 0 0
131 Larutan Et Botol 0 0 0 0 0 0
132 Larutan G Botol 0 0 0 0 0 0
133 Larutan Ka Botol 0 0 0 0 0 0
134 Larutan Me Botol 0 0 0 0 0 0
135 Larutan Tu Botol 0 0 0 0 0 0
136 Lidokain c Ampul 10 30 40 12 28 0
137 Lisol Botol 0 0 0 0 0 0
138 Magnesium Vial 0 0 0 0 0 0
139 Magnesium Vial 0 0 0 0 0 0
140 Mebendazo Botol 0 0 0 0 0 0
141 Mebendazo Tablet 0 0 0 0 0 0
142 Metanol Botol 0 0 0 0 0 0
143 Metil Ergo Tablet 0 25 25 12 13 0
144 Metil Ergo Ampul 0 0 0 0 0 0
145 Metronida Tablet 0 0 0 0 0 0
146 MonoKlork Botol 0 0 0 0 0 0
147 Mummifyin Pot 0 0 0 0 0 0
148 Natrium bi Tablet 0 0 0 0 0 0
149 Natrium fl Botol 0 0 0 0 0 0
150 Natrium Kl Kolf 0 20 20 5 15 0
151 Natrium Th Ampul 0 0 0 0 0 0
152 Nistatin 1 Supp 0 1 1 0 1 0
153 Nistatin 50 Tablet 0 0 0 0 0 0
154 Obat Antit Paket 0 0 0 0 0 0
155 Obat Antit Paket 0 0 0 0 0 0
156 Obat Batu Botol 0 0 0 0 0 0
157 OAT Katag paker 0 0 0 0 0 0
158 Oksitetras Vial 0 0 0 0 0 0
159 Oksitetras Tube 0 2 2 2 0 0
160 Oksitetras Tube 0 0 0 0 0 0
161 Oksitoksin Ampul 0 10 10 2 8 0
162 Paraforma Tablet 0 0 0 0 0 0
163 Parasetalm Botol 0 48 48 12 36 0
164 Parasetamo Tablet 0 0 0 0 0 0
165 Parasetam Tablet 0 1,200 1200 500 700 0
166 Pembalut Botol 0 0 0 0 0 0
167 Papaverin Tablet 0 0 0 0 0 0
168 Perphenaz Tablet 0 0 0 0 0 0
169 Pethidin h Ampul 0 0 0 0 0 0
170 Pilokarpin Botol 0 0 0 0 0 0
171 Pirantel Tablet 0 0 0 0 0 0
172 Piridoksin Tablet 0 200 200 100 100 0
173 Plaster 5 Y Rol 0 0 0 0 0 0
174 Polikresul Botol 0 0 0 0 0 0
175 Polipepti Tablet 0 0 0 0 0 0
176 prazikuant Tablet 0 0 0 0 0 0
177 Prednison Tablet 0 600 600 300 300 0
178 Primakin t Tablet 0 0 0 0 0 0
179 Prokaina P Vial 0 0 0 0 0 0
180 Propil Thi Tablet 0 0 0 0 0 0
181 Propranolo Tablet 0 100 100 35 65 0
182 Rabies Im Set 0 0 0 0 0 0
183 Reserpin 0 Tablet 0 0 0 0 0 0
184 Reserpin 0 Tablet 0 0 0 0 0 0
185 Retinol K Kapsul 0 0 0 0 0 0
186 Rifampisin Tablet 0 0 0 0 0 0
187 Rifampisin Kapsul 0 0 0 0 0 0
188 Rifampisin Kapsul 0 0 0 0 0 0
189 Ringer Lakt Kolf 0 40 40 20 20 0
190 Salbutamo Tablet 0 100 100 50 50 0
191 Salep 2 - Pot 0 0 0 0 0 0
192 Salisill B Bungkus 0 24 24 8 16 0
193 Salisil Sp Botol 0 0 0 0 0 0
194 Semen Sen Set 0 0 0 0 0 0
195 Serum Anti Ampul 0 0 0 0 0 0
196 Serum Anti Vial 0 0 0 0 0 0
197 Serum Anti Ampul 0 0 0 0 0 0
198 Serum Anti Ampul 0 0 0 0 0 0
199 Serum Anti Vial 0 0 0 0 0 0
200 Sianokoba Ampul 0 30 30 10 20 0
201 Silk No 3/0 Sachet 0 12 12 1 11 0
202 Silver Am Set 0 0 0 0 0 0
203 Spon Gelat Kotak 0 0 0 0 0 0
204 Streptomis Vial 0 0 0 0 0 0
205 Streptomis Vial 0 0 0 0 0 0
206 Sulpadimid Tablet 0 0 0 0 0 0
207 Sulpaseta Botol 0 0 0 0 0 0
208 Suspensi s Ampul 0 0 0 0 0 0
209 Tablet Ta Tablet 0 0 0 0 0 0
210 Temporary Set 0 0 0 0 0 0
211 Tetrakain Botol 0 0 0 0 0 0
212 Tetrasikli Kapsul 0 0 0 0 0 0
213 Tetrasikli Kapsul 0 0 0 0 0 0
214 Thiamin HC Ampul 0 600 600 300 300 0
215 Thiamin H Tablet 0 600 600 250 350 0
216 Tiopental Ampul 0 0 0 0 0 0
217 Triheksil Tablet 0 0 0 0 0 0
218 Trikresol Botol 0 0 0 0 0 0
219 Vaksin rab kuur 0 0 0 0 0 0
220 Vitamin B Tablet 0 0 0 0 0 0
221 Yodium Po Botol 0 3 3 2 1 0
222 Yodium Po Botol 0 3 3 1 2 0
223 Abocatch Pcs 0 24 24 5 19 0
224 Abocath 2 Pcs 0 24 24 6 18 0
225 Abocath 2 Pcs 0 24 24 8 16 0
226 Acycklovir Tablet 0 100 100 80 20 0
227 Acycklovir Tablet 0 0 0 0 0 0
228 Acycklovir Tube 2 24 26 12 14 0
229 Ambroxol Botol 0 0 0 0 0 0
230 Ambroxol Tablet 0 0 0 0 0 0
231 Amlodipin 1 Tablet 0 500 500 160 340 0
232 Amlodipin 5 Tablet 0 500 500 160 340 0
233 Amoksisil Tablet 0 1,000 1000 500 500 0
234 Antasida S Botol 0 0 0 0 0 0
235 As.Tranek Tablet 0 0 0 0 0 0
236 As.Tranek Ampul 0 1 1 0 1 0
237 Asam Asetat Botol 0 0 0 0 0 0
238 Asam Mefe Tablet 0 600 600 200 400 0
239 Betazon N Tube 0 0 0 0 0 0
240 Bioneuron Tablet 0 0 0 0 0 0
241 Bromhexin Tablet 0 0 0 0 0 0
242 Captopril tablet 0 500 500 200 300 0
243 Catopril 12 Tablet 30 500 530 240 290 0
244 Cefotaxim In Vial 0 12 12 2 10 0
245 Cetirizin tab Tablet 0 500 500 140 360 0
246 Dexran 70 Botol 0 0 0 0 0 0
247 Doksisiklin Tablet 0 0 0 0 0 0
248 Domperidon Botol 0 0 0 0 0 0
249 Erytromis Kapsul 0 0 0 0 0 0
250 Erytromisi Tablet 0 300 300 60 240 0
251 Erytromisi Botol 0 5 5 2 3 0
252 Eter Alkohol Botol 0 0 0 0 0 0
253 Gentamisin Vial 0 2 2 1 1 0
254 Gentamisin S tube 0 0 0 0 0 0
255 Glukosa kals Ampul 0 0 0 0 0 0
256 H2O2 Botl 0 0 0 0 0 0
257 Hand Scoon pasang 0 50 50 32 18 0
258 Ibuprofen si Botol 0 0 0 0 0 0
259 Kasa 4 m x Rol 0 0 0 0 0 0
260 KASA 3 M X ROL 0 10 10 1 9 0
261 Kasa 4 x 5 Rol 0 0 0 0 0 0
262 Kasa Pembal Rol 0 3 3 2 1 0
263 Ketokonazol Tube 0 0 0 0 0 0
264 Ketokonazol Tablet 0 100 100 40 60 0
265 Klorampeni Botol 0 0 0 0 0 0
266 Klorampen Botol 0 0 0 0 0 0
267 KOH Sol Botol 0 0 0 0 0 0
268 Lar Hayem Botol 0 0 0 0 0 0
269 Lar HCL Botol 0 0 0 0 0 0
270 Lart Fochet Botol 0 0 0 0 0 0
271 Lart Reessec Botol 0 0 0 0 0 0
272 Loperamid Tablet 0 0 0 0 0 0
273 Masker set 0 0 0 0 0 0
274 Metformin Tablet 0 300 300 100 200 0
275 Methoklor Tablet 0 200 200 100 100 0
276 Metoklorpa Ampul 0 4 4 2 2 0
277 Meylon Botol 0 0 0 0 0 0
278 Mikonazol Tube 0 24 24 12 12 0
279 Multivitamin botol 0 5 5 2 3 0
280 Multivitamin Tablet 0 0 0 0 0 0
281 Natrium bica botol 0 0 0 0 0 0
282 Natrium Dik Tablet 0 300 300 130 170 0
283 Natrium Dik Tablet 0 500 500 200 300 0
284 Nipedipin t Tablet 0 0 0 0 0 0
285 Parasetamol Botol 0 0 0 0 0 0
286 Pehapral Tablet 0 300 300 120 180 0
287 Pirantel Pam Botol 0 0 0 0 0 0
288 Piroksikam Tablet 0 0 0 0 0 0
289 Piroksika Tablet 0 0 0 0 0 0
290 Ranitidin I Ampul 0 15 15 6 9 0
291 Ranitidin Tablet 0 500 500 250 250 0
292 Retinol Kap Kapsul 0 0 0 0 0 0
293 SALBUTA Tablet 0 0 0 0 0 0
294 Sefadroksil Botol 0 0 0 0 0 0
295 Sianokoba Tablet 0 200 200 20 180 0
296 Simetidin Tablet 0 0 0 0 0 0
297 Siproplok Tablet 0 300 300 90 210 0
298 Aqua 500 m Kotak 0 0 0 0 0 0
299 Sofratulle Bks 0 0 0 0 0 0
300 Tramadol in Ampul 0 0 0 0 0 0
301 Urin Bag pcs 4 2 6 3 3 0
302 Wing Nidle set 0 0 0 0 0 0
303 Zink Tablet 0 300 300 140 160 0
304 Abocath 2set 5 24 29 16 13 0
305 Becefort Sy Botol 0 0 0 0 0 0
306 Curcuma pluBotol 0 0 0 0 0 0
307 DeXtrofen sBotol 0 0 0 0 0 0
308 LORATADINETablet 0 0 0 0 0 0
309 Hemaford Tablet 0 0 0 0 0 0
310 Hepagard Tablet 0 0 0 0 0 0
311 Imbost syru Botol 0 0 0 0 0 0
312 Litacur syru Botol 0 0 0 0 0 0
313 Livron b Ple Tablet 0 0 0 0 0 0
314 MethiosopriTablet 0 0 0 0 0 0
315 MethiosopriBotol 0 0 0 0 0 0
316 Pehacain InjAmpul 0 0 0 0 0 0
317 Tensigard Tablet 0 0 0 0 0 0
318 Alat suntik set 0 10 10 4 6 0
319 Reagen Gol Darah 0 0 0 0 0 0
320 Masker Ear kotak 0 2 2 1 1 0
321 Permetrin Ktube 0 12 12 4 8 0
322 Poli kateter set 1 5 6 3 3 0
323 Poli kateter set 3 3 6 2 4 0
324 Gentamisin Tube 0 5 5 2 3 0
325 Bisacodil su Supp 0 0 0 0 0 0
326 Atapulgit t Tablet 0 200 200 80 120 0
327 KASA 16 X 1Kotak 0 32 32 13 19 0
329 Omeprazol Tablet 0 0 0 0 0 0
330 SimvastatinTablet 0 100 100 40 60 0
331 SimvastatinTablet 0 200 200 160 40 0
332 Geriavita taTablet 0 0 0 0 0 0
333 Stimuno kapKapsul 0 0 0 0 0 0
334 Stimuno syrbotol 0 0 0 0 0 0
335 Cavicur syrubotol 0 0 0 0 0 0
336 Paper tape 5Rol 0 0 0 0 0 0
337 Gentamisin TUBE 0 0 0 0 0 0
338 Cetirizin Sir Botol 0 10 10 4 6 0
339 Cairan Desi Botol 0 0 0 0 0 0
340 Plaster meraRol 0 3 3 1 2 0
341 Plaster meraRol 0 0 0 0 0 0
342 ALOpurinol Tablet 0 0 0 0 0 0
343 Stesolit Rek SUB 0 0 0 0 0 0
344 KOMPOLAX BOTOL 0 2 2 1 1 0
345 LIDOKAIN S BOTOL 0 0 0 0 0 0
346 LIDOKAIN GTUBE 0 0 0 0 0 0
347 SULFADIAZITUBE 0 0 0 0 0 0
348 ALKOHOl S KTK 0 2 2 1 1 0
349 GLIMEPIRIDTablet 0 200 200 90 110 0
350 FUROSEMIDAmpul 2 0 2 0 2 0
351 DOMPERIDOTablet 0 200 200 70 130 0
352 METIL PREDTablet 0 300 300 100 200 0
353 SALBUTAMOBTL 0 0 0 0 0 0
 354 FENETEROL BTL 0 0 0 0 0 0
355 HANDSCOONPCS 0 100 100 30 70 0
356 KLORAMFENI
Tube 0 0 0 0 0 0
358 BETAHISTIN Tablet 0 0 0 0 0 0
359 SEFADROKSILTablet 0 0 0 0 0 0
360 ZINK SYR BOTOL 0 0 0 0 0 0
362 ACETYLCYSIT Kapsul 20 600 620 230 390 0
363 DIMENHID Tablet 0 0 0 0 0 0
364 PARASETAMOBOTOL 0 0 0 0 0 0
365 METOKLORPABOTOL 0 0 0 0 0 0
366 Pcs
Handscoon ste 0 0 0 0 0 0
367 OMEPRAZOLEAmpul 0 10 10 6 4 0
369 ASETOSAL 80Tablet 0 0 0 0 0 0
370 HERBACOF Kotak 0 48 48 12 36 0
371 HERBACOLD Tablet 0 0 0 0 0 0
Umum BPJS
UKS/Gratis/SKTM JUMLAH
Jumlah Kunjungan ResepBayar PBI/NONPBI
167 332 89 588

Yang Melapor
Petugas Pustu Pulau Tengah

(Hj. Siti Komiah, Amd.Keb)

Nip. 197507132002122001
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)
PUSTU/POLINDES : PULAU TENGAH BULAN : Maret
KECAMATAN : JANGKAT TAHUN : 2024
STOK PENERI- PERSE- PEMA- SISA STOK PERMIN-
NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK OPT TAAN
1 2 3 5 6 7 = (5+6) 8 9 10 17
1 Air Raksa Dental Use Set 0 0 0 0 0 0
2 Alat Suntik sekali pakai 1 ml set 8 150 158 65 93 200
3 Alat suntik sekali pakai 2,5 ml Set 10 150 160 75 85 300
4 Alat suntik sekali pakai 5 ml Set 17 100 117 10 107 100
5 Albendazol tab 400 mg Tablet 0 0 0 0 0 100
6 Alopurinol tab 100 mg Tablet 0 100 100 100 0 600
7 Aminofilina tablet 200 mg Tablet 0 0 0 0 0 100
8 Aminofilina inj 24 mg/ml -10 ml Ampul 1 0 1 0 1 2
9 Amitriptilina HCl 25 mg Tablet 0 0 0 0 0 100
10 Amoksisilina sir kering 250 mg/5ml Botol 0 29 29 0 29 60
11 Amoksisilina kap 250 mg Kapsul 0 300 300 200 100 600
12 Ampisilina Kaplet 500 mg Kaplet 0 0 0 0 0 300
13 Ampisilina Inj Vial 0 0 0 0 0 24
14 Antalgin 500 mg tablet Tablet 0 0 0 0 0 600
15 Antalgin inj 250 mg / ml -2 ml Ampul 0 0 0 0 0 60
16 Antacida DOEN Kombinasi Tablet 0 1,000 1000 410 590 1000
17 Antibakteri DOEN salap Kombinasi Pot 0 10 10 1 9 48
18 Anti Hemmoroid Suppositoria Supp 1 10 11 10 1 50
19 Antifungi DOEN Salep (Whitefield). Pot 1 10 11 5 6 48
20 Antimigrain DOEN Kombinasi Tablet 0 0 0 0 0 100
21 Antiparkinson doen tab, komb. Tablet 0 0 0 0 0 100
22 Aqua Pro injeksi steril Ampul 0 0 0 0 0 10
23 Aquadest steril 500 ml Botol 0 0 0 0 0 1
24 Asam Ascorbat (Vit.C) tab. 250 mg Tablet 0 100 100 0 100 300
25 Asam Ascorbat (Vit.C) tab. 50 mg Tablet 0 100 100 0 100 1000
26 Asam Klorida 0,1% Botol 0 0 0 0 0 0
27 Asam sulfosalisilat 20% Botol 0 0 0 0 0 0
28 Asetosal 100 mg tablet Tablet 0 0 0 0 0 300
29 Asetosal tab 500 mg Tablet 0 0 0 0 0 500
30 Atropin Sulpat inj 0,25 mg/ml-1 ml Ampul 0 10 10 6 4 30
31 Atropin Sulpat tab 0,5 mg Tablet 0 0 0 0 0 500
32 Atropin Sulpat tetes mata 0,5% Botol 0 0 0 0 0 3
33 Benza Benzil Penisilina inj 1,2 Juta I Vial 0 0 0 0 0 6
34 Blood Set Set 0 0 0 0 0 2
35 Burnazin 35 mg Tube 0 0 0 0 0 6
36 Betametason Krim 0,1 % Tube 0 25 25 20 5 48
37 Cat Gut / benang bedah no. 2/0-3/0 Sachet 0 0 0 0 0 6
38 Dapson tablet 100 mg Tablet 0 0 0 0 0 0
39 Deksametason inj 5 mg/ml -1ml Ampul 0 20 20 10 10 24
40 Deksametason tablet 0,5 mg Tablet 0 600 600 300 300 600
41 Dekstrans 70- lar infus 6 % steril Botol 0 0 0 0 0 0
42 Dektrometropan HBr sirup Botol 0 0 0 0 0 24
43 Dekstrometorfan HBr tablet 15 mg Tablet 0 0 0 0 0 300
44 Devitalisasi Pasta Pot 0 0 0 0 0 0
45 Diazepam inj 5 mg / ml-2 ml Ampul 0 0 0 0 0 0
46 Diazepam tab 2 mg Tablet 0 0 0 0 0 0
47 Diazepam tablet 5 mg Tablet 0 0 0 0 0 0
48 Dietilkarbamazin sitrat tab 100 mg Tablet 0 0 0 0 0 0
49 Difenhidramin inj 10 mg/ml-1ml Ampul 0 0 0 0 0 30
50 Digoksin tab 0.25 mg Tablet 0 0 0 0 0 100
51 Efedrin tablet 25 mg Tablet 0 0 0 0 0 100
52 Ekstrak Belladona tab 25 mg Tablet 0 0 0 0 0 300
53 Efineprina HCl/Bitartrat inj 0,1 %- 1 Ampul 0 0 0 0 0 12
54 Etakridini laktas larutan 0,1 % Botol 0 5 5 4 1 60
55 Etambutol tab 250 mg Tablet 0 0 0 0 0 0
56 Etanol 70 % 100 ml Botol 0 4 4 2 2 24
57 Eter Anestesi Botol 0 0 0 0 0 0
58 Etil Klorida Semprot Botol 0 1 1 0 1 3
59 Eugenol Cairan Botol 0 0 0 0 0 2
60 Fenitoin injeksi 10 mg mg/ml Ampul 0 0 0 0 0 0
61 Fenitoin Natrium Kapsul 100 mg Kapsul 0 0 0 0 0 0
62 Fenitoin Natrium Kapsul 30 mg Kapsul 0 0 0 0 0 100
63 Fenobarbital inj 50 mg/ml-2ml Ampul 0 0 0 0 0 12
64 Fenobarbital tablet 100 mg Tablet 0 0 0 0 0 100
65 Fenobarbital tablet 30 mg Tablet 0 0 0 0 0 300
66 Fenoksimetil Penisilin tab 250 mg Tablet 0 0 0 0 0 200
67 Fenoksimetil Penisilin Tab 500 mg Tablet 0 0 0 0 0 300
68 Fenol Gliserol Tts Telinga 10 % Botol 1 8 9 0 9 12
69 Fitomenadion Inj 10 mg/ml-1ml Ampul 0 0 0 0 0 30
70 Fitomenadion tab salut 10 mg Tablet 30 100 130 30 100 300
71 Fluor tablet Tablet 0 0 0 0 0 100
72 Furosemida tablet 40 mg Tablet 50 0 50 10 40 300
73 Gameksan Emulsi 1 % Botol 0 0 0 0 0 48
74 Garam oralit untuk 1000 ml air Bungkus 0 0 0 0 0 0
75 Garam Oralit 200 ml air Bungkus 0 100 100 20 80 300
76 Gentian Violet larutan 1 % Botol 0 0 0 0 0 48
77 Glass Ionomer cement Set 0 0 0 0 0 50
78 Glibenklamida tab 5 mg Tablet 0 100 100 70 30 200
79 Guafenesin tablet 100 mg Tablet 0 200 200 0 200 200
80 Gliserin Botol 0 0 0 0 0 12
81 Glukosa lar infus 10 % steril Botol 0 0 0 0 0 6
82 Glukosa lar infus 40 % steril Botol 0 0 0 0 0 5
83 Glukosa lar infus 5 % steril Botol 0 0 0 0 0 24
84 Griseofulvin tab 125 mg micrinized Tablet 0 0 0 0 0 300
85 Haloperidol tablet 0,5 mg Tablet 0 0 0 0 0 100
86 Haloperidol tablet 1,5 mg Tablet 0 0 0 0 0 100
87 Haloperidol tablet 5 mg Tablet 0 0 0 0 0 100
88 Hidroklortiazid Tab 25 mg Tablet 0 0 0 0 0 100
89 Hidrokortison Krim 2.5 % Tube 0 48 48 12 36 48
90 Ibuprofen tablet 200 mg Tablet 0 300 300 150 150 600
91 Ibuprofen tablet 400 mg Tablet 0 0 0 0 0 600
92 Infus set anak Set 0 0 0 0 0 24
 93 Infus set Dewasa Set 0 24 24 1 23 24
94 Insulin reguler inj 40 IU Ampul 0 0 0 0 0 2
95 Iodiol Kapsul Lunak Kapsul 0 0 0 0 0 50
96 Ipeka sirup 0,14 % Botol 0 0 0 0 0 2
97 Isoniazida (iINH) tab 300 mg Tablet 0 0 0 0 0 0
98 Isosorbid dinitrat tablet Sublingual 5 Tablet 0 0 0 0 0 100
99 Jarum Jahit (bedah) No. 9 s/d 14 Biji 0 0 0 0 0 3
100 Kalium Permanganat serbuk Pot 0 0 0 0 0 24
101 Kalsium Hidroksida pasta Set 0 0 0 0 0 0
102 Kalsium Laktat tablet 500 mg Tablet 0 600 600 300 300 1000
103 Kapas berlemak 50 mg Bungkus 0 0 0 0 0 3
104 Kapas pembalut 250 gram Bungkus 0 3 3 1 2 3
105 Karbamazepin tablet 200 g Tablet 0 0 0 0 0 0
106 Kasa kompres 40/40 steril Bungkus 0 0 0 0 0 6
107 Kasa Pembalut 2 x 80 Bungkus 0 0 0 0 0 6
108 Kasa pembalut hidropil 10x10 Rol 0 0 0 0 0 12
109 Kasa pembalut hidropil 6x6 Rol 0 0 0 0 0 12
110 Ketorolak inj Ampul 0 0 0 0 0 24
111 Klafazimin kap 100 mg/ml Kapsul 0 0 0 0 0 0
112 Kloramfenikol kap 250 mg Kapsul 0 100 100 50 50 400
113 Kloramfenikol Salap mata 1% Tube 0 0 0 0 0 24
114 Kloramfenikol tetes telinga 3 % Botol 0 10 10 1 9 24
115 Klorfeniramini Maleas 4 mg tab Tablet 0 1,000 1000 400 600 1000
116 Klorkina Pospat tab 250 mg Tablet 0 0 0 0 0 300
117 Klorpromazin HCl 25 mg/ml-1ml Ampul 0 0 0 0 0 0
118 Klorpromazin HCl 5 mg / ml-2ml Ampul 0 0 0 0 0 0
119 Klorpromazin HCl 100 mg Tablet 0 0 0 0 0 100
120 Klorpromazin HCl tab 25 mg Tablet 0 0 0 0 0 0
121 Klorpropamida tab 100 mg Tablet 0 0 0 0 0 0
122 Kodein HCl tab 10 mg Tablet 0 0 0 0 0 0
123 Komb.Piremetamin 2 mg + Sulfadoks Tablet 0 0 0 0 0 50
124 Kotrimoksazol tab 120 mg Pediatrik Tablet 0 0 0 0 0 100
125 Kotrimoksazol suspensi Botol 0 0 0 0 0 48
126 Kotrimoksazol tab Komb. 480 mg Tablet 0 0 0 0 0 600
127 Kuinina HCl inj 25 %-2ml Ampul 0 0 0 0 0 0
128 Kuinina Sulfat Tablet 222 mg ( 7 H2O Tablet 0 0 0 0 0 100
129 Larutan Benedit Botol 0 0 0 0 0 0
130 Larutan Eosin 2% Botol 0 0 0 0 0 0
131 Larutan Etanol Botol 0 0 0 0 0 0
132 Larutan Giemsa Stain Botol 0 0 0 0 0 0
133 Larutan Karbol Fuksin Botol 0 0 0 0 0 0
134 Larutan Metilen Biru Botol 0 0 0 0 0 0
135 Larutan Turk Botol 0 0 0 0 0 0
136 Lidokain comp inj Komb. Ampul 10 30 40 12 28 30
137 Lisol Botol 0 0 0 0 0 2
138 Magnesium Sulpat inj (iv) 20%-25 ml Vial 0 0 0 0 0 0
139 Magnesium Sulfat Inj (iv) 40 % -25 m Vial 0 0 0 0 0 0
140 Mebendazol sir 100 mg/5 ml Botol 0 0 0 0 0 12
141 Mebendazol tab 100 mg Tablet 0 0 0 0 0 100
142 Metanol Botol 0 0 0 0 0 0
143 Metil Ergometrin tab. 0.125 mg Tablet 0 25 25 12 13 200
144 Metil Ergometrin inj 0,200mg/1 ml Ampul 0 0 0 0 0 30
145 Metronidazol tab 250 mg Tablet 0 0 0 0 0 300
146 MonoKlorkamfer Mentol Cairan Botol 0 0 0 0 0 0
147 Mummifying Pasta Pot 0 0 0 0 0 0
148 Natrium bicarbonat tablet 500 mg Tablet 0 0 0 0 0 500
149 Natrium fluoresin tts mata 2 % Botol 0 0 0 0 0 0
150 Natrium Klorida Lar Inf 0,9% Steril Kolf 0 20 20 5 15 30
151 Natrium Thio Sulpat inj 25%-10ml Ampul 0 0 0 0 0 0
152 Nistatin 100.000 IU /G Tab Vagina Supp 0 1 1 0 1 12
153 Nistatin 500.000 IU tablet salut Tablet 0 0 0 0 0 100
154 Obat Antituberkulosis Katagori 1 Paket 0 0 0 0 0 0
155 Obat Antituberkulosis Katagori 2 Paket 0 0 0 0 0 0
156 Obat Batuk Hitam (OBH) Botol 0 0 0 0 0 48
157 OAT Katagori anak paker 0 0 0 0 0 0
158 Oksitetrasiklin HCl inj 50 mg/ml - 10 Vial 0 0 0 0 0 5
159 Oksitetrasiklin Salep Kulit 3% Tube 0 2 2 2 0 48
160 Oksitetrasiklin salep mata 1% Tube 0 0 0 0 0 48
161 Oksitoksin inj 10 IU/ml - ml Ampul 0 10 10 2 8 30
162 Paraformaldehide 1 gram Tablet 0 0 0 0 0 100
163 Parasetalmol sir 120 mg/ 5 ml Botol 0 48 48 12 36 60
164 Parasetamol 100 mg tablet Tablet 0 0 0 0 0 300
165 Parasetamol 500 mg tablet Tablet 0 1,200 1200 500 700 1200
166 Pembalut gibs Botol 0 0 0 0 0 0
167 Papaverin 40 mg Tablet 0 0 0 0 0 500
168 Perphenazin 4mg Tablet 0 0 0 0 0 100
169 Pethidin hcl injeksi 50 mg/ml - 2 ml Ampul 0 0 0 0 0 10
170 Pilokarpin HCl/nitrat tetes mata 2% Botol 0 0 0 0 0 2
171 Pirantel Pamoat tab. 125mg Tablet 0 0 0 0 0 100
172 Piridoksin HCl Tab 10 mg Tablet 0 200 200 100 100 600
173 Plaster 5 Yard x 2 inchi Rol 0 0 0 0 0 3
174 Polikresulen Botol 0 0 0 0 0 0
175 Polipeptida komb doen Tablet 0 0 0 0 0 12
176 prazikuantel tab 600 mg Tablet 0 0 0 0 0 0
177 Prednison tab 5 mg Tablet 0 600 600 300 300 600
178 Primakin tab 15 mg Tablet 0 0 0 0 0 0
179 Prokaina Penisilina G inj 3 Juta IU Vial 0 0 0 0 0 6
180 Propil Thio Urasil 100 mg tablet Tablet 0 0 0 0 0 300
181 Propranolol tab 40 mg Tablet 0 100 100 35 65 300
182 Rabies Imuneglobulin ( HUMAN ) 15 Set 0 0 0 0 0 0
183 Reserpin 0,1 mg tabler Tablet 0 0 0 0 0 0
184 Reserpin 0,25 mg tablet Tablet 0 0 0 0 0 0
185 Retinol Kapsul Lunak 200.000 IU Kapsul 0 0 0 0 0 0
186 Rifampisin Kaplet 600 mg Tablet 0 0 0 0 0 0
187 Rifampisin Kapsul 300 mg Kapsul 0 0 0 0 0 0
188 Rifampisin Kapsul 450 mg Kapsul 0 0 0 0 0 0
189 Ringer Laktat inf steril Kolf 0 40 40 20 20 40
190 Salbutamol tab 2mg Tablet 0 100 100 50 50 30
191 Salep 2 - 4 Kombinasi Pot 0 0 0 0 0 60
192 Salisill Bedak 2% Bungkus 0 24 24 8 16 60
193 Salisil Spiritus 10 % Botol 0 0 0 0 0 24
194 Semen Seng Fosfat serbuk & cairan Set 0 0 0 0 0 0
195 Serum Anti Bisa Ular Polipalen inj 5 Ampul 0 0 0 0 0 0
196 Serum Anti bisa Ular Polipalen inj 5 Vial 0 0 0 0 0 0
197 Serum Anti Difteri INJ 20.000 IU / Ampul 0 0 0 0 0 0
198 Serum Antitetanus inj 1500 IU/amp Ampul 0 0 0 0 0 0
199 Serum Antitetanus inj 20.000 IU/via Vial 0 0 0 0 0 0
200 Sianokobalamin inj 500 mcg Ampul 0 30 30 10 20 48
201 Silk No 3/0 Sachet 0 12 12 1 11 3
202 Silver Amalgam Serbuk 65 - 70% Set 0 0 0 0 0 0
203 Spon Gelatin Kotak 0 0 0 0 0 0
204 Streptomisin SO4 inj 1000 mg/ Vial Vial 0 0 0 0 0 0
205 Streptomisin SO4 inj 1500 mg/ Vial Vial 0 0 0 0 0 0
206 Sulpadimidin 500 mg tablet Tablet 0 0 0 0 0 300
207 Sulpasetamida tetes mata 15% Botol 0 0 0 0 0 12
208 Suspensi seng insulin inj. 40 iu/ml Ampul 0 0 0 0 0 0
209 Tablet Tambah Darah Kombinasi Tablet 0 0 0 0 0 300
210 Temporary stoping fletcher dan caira Set 0 0 0 0 0 0
211 Tetrakaina HCL tetes mata 0,5% Botol 0 0 0 0 0 3
212 Tetrasiklin HCl Kap. 250 mg Kapsul 0 0 0 0 0 600
213 Tetrasiklin HCl Kap. 500 mg Kapsul 0 0 0 0 0 600
214 Thiamin HCl inj 100 mg /ml-1ml Ampul 0 600 600 300 300 30
215 Thiamin HCl tab 50 mg Tablet 0 600 600 250 350 600
216 Tiopental Na serbuk inj. 1000 mg/am Ampul 0 0 0 0 0 0
217 Triheksil penidil HCl 2 mg tab Tablet 0 0 0 0 0 0
218 Trikresol Formalin (TKF) Cairan Botol 0 0 0 0 0 0
219 Vaksin rabies vero kuur 0 0 0 0 0 0
220 Vitamin B Kompleks Tablet 0 0 0 0 0 600
221 Yodium Povidon lart 10% 60 ml Botol 0 3 3 2 1 6
222 Yodium Povidon lart 10%m 300 ml Botol 0 3 3 1 2 3
223 Abocatch 18 Pcs 0 24 24 5 19 24
224 Abocath 20 Pcs 0 24 24 6 18 24
225 Abocath 24 Pcs 0 24 24 8 16 24
226 Acycklovir 200 mg Tablet 0 100 100 80 20 300
227 Acycklovir 400 mg Tablet 0 0 0 0 0 300
228 Acycklovir Cream Tube 2 24 26 12 14 24
229 Ambroxol Syrup Botol 0 0 0 0 0 24
230 Ambroxol Tab Tablet 0 0 0 0 0 500
231 Amlodipin 10 mg Tablet 0 500 500 160 340 500
232 Amlodipin 5 mg Tablet 0 500 500 160 340 500
233 Amoksisilin kap 500 mg Tablet 0 1,000 1000 500 500 1000
234 Antasida Syrup Botol 0 0 0 0 0 50
235 As.Traneksanat 500 mg Tablet 0 0 0 0 0 50
236 As.Traneksanat 250 mg Inj Ampul 0 1 1 0 1 3
237 Asam Asetat 6 % Botol 0 0 0 0 0 0
238 Asam Mefenamat 500 mg tablet Tablet 0 600 600 200 400 600
239 Betazon N krim Tube 0 0 0 0 0 12
240 Bioneuron Tab Tablet 0 0 0 0 0 600
241 Bromhexin tab Tablet 0 0 0 0 0 500
242 Captopril 25 mg tablet 0 500 500 200 300 500
243 Catopril 12,5 mg Tablet 30 500 530 240 290 500
244 Cefotaxim Inj Vial 0 12 12 2 10 12
245 Cetirizin tab Tablet 0 500 500 140 360 500
246 Dexran 70 % Botol 0 0 0 0 0 0
247 Doksisiklin tab Tablet 0 0 0 0 0 500
248 Domperidon Susp 60 ml Botol 0 0 0 0 0 48
249 Erytromisin Kapsul 250 mg Kapsul 0 0 0 0 0 500
250 Erytromisin kapsul 500 mg Tablet 0 300 300 60 240 500
251 Erytromisin Syrup Botol 0 5 5 2 3 24
252 Eter Alkohol Botol 0 0 0 0 0 0
253 Gentamisin inj Vial 0 2 2 1 1 12
254 Gentamisin Salap Kulit tube 0 0 0 0 0 48
255 Glukosa kalsikus Ampul 0 0 0 0 0 0
256 H2O2 Botl 0 0 0 0 0 6
257 Hand Scoon pasang 0 50 50 32 18 50
258 Ibuprofen sirup Botol 0 0 0 0 0 24
259 Kasa 4 m x 10 cm Rol 0 0 0 0 0 24
260 KASA 3 M X 10 CM ROL 0 10 10 1 9 24
261 Kasa 4 x 5 cm Rol 0 0 0 0 0 24
262 Kasa Pembalut 40 x 80 Rol 0 3 3 2 1 12
263 Ketokonazol Krim Tube 0 0 0 0 0 24
264 Ketokonazol tab Tablet 0 100 100 40 60 300
265 Klorampenicol Syrup Botol 0 0 0 0 0 30
266 Klorampenicol Tts mata 1 % Botol 0 0 0 0 0 6
267 KOH Sol Botol 0 0 0 0 0 0
268 Lar Hayem Botol 0 0 0 0 0 0
269 Lar HCL Botol 0 0 0 0 0 0
270 Lart Fochet Botol 0 0 0 0 0 0
271 Lart Reessecker Botol 0 0 0 0 0 0
272 Loperamid Tablet 0 0 0 0 0 300
273 Masker set 0 0 0 0 0 200
274 Metformin Tablet 0 300 300 100 200 300
275 Methoklorpamida Tablet 0 200 200 100 100 300
276 Metoklorpamid Inj Ampul 0 4 4 2 2 12
277 Meylon Botol 0 0 0 0 0 2
278 Mikonazol krim 2% Tube 0 24 24 12 12 24
279 Multivitamin anak sirup botol 0 5 5 2 3 48
280 Multivitamin plus mineral Tablet 0 0 0 0 0 48
281 Natrium bicarbonat inj botol 0 0 0 0 0 2
282 Natrium Diklofenat 25 mg Tablet 0 300 300 130 170 500
283 Natrium Diklofenat 50 mg Tablet 0 500 500 200 300 500
284 Nipedipin tablet Tablet 0 0 0 0 0 100
285 Parasetamol Drop 15 ml Botol 0 0 0 0 0 24
286 Pehapral Tablet 0 300 300 120 180 500
287 Pirantel Pamoat sirup Botol 0 0 0 0 0 100
288 Piroksikam 10 mg tablet Tablet 0 0 0 0 0 500
289 Piroksikam 20 mg tab Tablet 0 0 0 0 0 500
290 Ranitidin Inj Ampul 0 15 15 6 9 30
291 Ranitidin tab 150 mg Tablet 0 500 500 250 250 500
292 Retinol Kapsul Lunak 100.000 IU Kapsul 0 0 0 0 0 0
293 SALBUTAMOL 4 MG Tablet 0 0 0 0 0 300
294 Sefadroksil sirup kering Botol 0 0 0 0 0 24
295 Sianokobalamin tab 50 mcg Tablet 0 200 200 20 180 500
296 Simetidin tab 200 mg Tablet 0 0 0 0 0 500
297 Siproploksasin 500 mg Tablet 0 300 300 90 210 800
298 Aqua 500 ml Kotak 0 0 0 0 0 24
299 Sofratulle Bks 0 0 0 0 0 12
300 Tramadol inj Ampul 0 0 0 0 0 24
301 Urin Bag pcs 4 2 6 3 3 2
302 Wing Nidle 18-21 set 0 0 0 0 0 2
303 Zink Tablet 0 300 300 140 160 500
304 Abocath 22 set 5 24 29 16 13 24
305 Becefort Syrup Botol 0 0 0 0 0 48
306 Curcuma plus imun Botol 0 0 0 0 0 48
307 DeXtrofen syrup Botol 0 0 0 0 0 48
308 LORATADINE TAB 10 MG Tablet 0 0 0 0 0 500
309 Hemaford Tablet 0 0 0 0 0 300
310 Hepagard Tablet 0 0 0 0 0 300
311 Imbost syrup Botol 0 0 0 0 0 24
312 Litacur syrup Botol 0 0 0 0 0 24
313 Livron b Plek Tablet 0 0 0 0 0 12
314 Methiosoprinol Tablet 0 0 0 0 0 0
315 Methiosoprinol 250 mg/5ml Botol 0 0 0 0 0 2
316 Pehacain Inj Ampul 0 0 0 0 0 24
317 Tensigard Tablet 0 0 0 0 0 300
318 Alat suntik 10 ml set 0 10 10 4 6 24
319 Reagen Gol Darah 0 0 0 0 0 0
320 Masker Ear Loop kotak 0 2 2 1 1 100
321 Permetrin Krim tube 0 12 12 4 8 12
322 Poli kateter no 14 set 1 5 6 3 3 5
323 Poli kateter no 18 set 3 3 6 2 4 3
324 Gentamisin Salap Mata Tube 0 5 5 2 3 24
325 Bisacodil supp Supp 0 0 0 0 0 24
326 Atapulgit tab 600 mg Tablet 0 200 200 80 120 500
327 KASA 16 X 16 Kotak 0 32 32 13 19 24
329 Omeprazol tab Tablet 0 0 0 0 0 500
330 Simvastatin 20 Tablet 0 100 100 40 60 500
331 Simvastatin 10 Tablet 0 200 200 160 40 500
332 Geriavita tablet Tablet 0 0 0 0 0 300
333 Stimuno kapsul Kapsul 0 0 0 0 0 300
334 Stimuno syrup Grape botol 0 0 0 0 0 24
335 Cavicur syrup botol 0 0 0 0 0 24
336 Paper tape 5.0 cm x 9.14 m(farmafix) Rol 0 0 0 0 0 3
337 Gentamisin Tetes Mata TUBE 0 0 0 0 0 6
338 Cetirizin Sirup Botol 0 10 10 4 6 24
339 Cairan Desinpektan Botol 0 0 0 0 0 12
340 Plaster merah (leukoples) 2,5 x 4,5 m Rol 0 3 3 1 2 3
341 Plaster merah (leukoples) 7,5 x 4,5 m Rol 0 0 0 0 0 3
342 ALOpurinol tab 300 mg Tablet 0 0 0 0 0 300
343 Stesolit Rektal 5 mg SUB 0 0 0 0 0 6
344 KOMPOLAX BOTOL 0 2 2 1 1 12
345 LIDOKAIN SPRAY BOTOL 0 0 0 0 0 6
346 LIDOKAIN GEL TUBE 0 0 0 0 0 3
347 SULFADIAZIN SILVER TUBE 0 0 0 0 0 6
348 ALKOHOl SWAP KTK 0 2 2 1 1 2
349 GLIMEPIRIDE KAPS 2 MG Tablet 0 200 200 90 110 300
350 FUROSEMID INJ 10 MG/ML Ampul 2 0 2 0 2 2
351 DOMPERIDON TAB 10 MG Tablet 0 200 200 70 130 300
352 METIL PREDNISOLON 4 MG Tablet 0 300 300 100 200 500
353 SALBUTAMOL MDI 100 MCG/DOS BTL 0 0 0 0 0 3
354 FENETEROLHIDROMIDE 100 MCG/FUFF BTL 0 0 0 0 0 3
355 HANDSCOON MRB PCS 0 100 100 30 70 100
356 KLORAMFENIKOL SK Tube 0 0 0 0 0 24
358 BETAHISTIN TAB 24 MG Tablet 0 0 0 0 0 300
359 SEFADROKSIL KAPS 250 MG Tablet 0 0 0 0 0 600
360 ZINK SYR BOTOL 0 0 0 0 0 24
362 ACETYLCYSITEIN 200 MG KAPS Kapsul 20 600 620 230 390 500
363 DIMENHIDRATE 50 MG TAB Tablet 0 0 0 0 0 300
364 PARASETAMOL INFUS BOTOL 0 0 0 0 0 24
365 METOKLORPAMID DROP BOTOL 0 0 0 0 0 24
366 Handscoon steril Pcs 0 0 0 0 0 50
367 OMEPRAZOLE INJ Ampul 0 10 10 6 4 24
369 ASETOSAL 80 MG Tablet 0 0 0 0 0 100
370 HERBACOF Kotak 0 48 48 12 36 24
371 HERBACOLD Tablet 0 0 0 0 0 100
Umum BPJS
UKS/Gratis/SKTM JUMLAH
Jumlah Kunjungan Resep Bayar PBI/NONPBI
167 332 89 588

Yang Melapor
Petugas Pustu Pulau Tengah

(Hj. Siti Komiah, Amd.Keb)

Nip. 197507132002122001
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)
PUSTU/POLINDES : PULAU TENGAH BULAN
KECAMATAN : JANGKAT TAHUN
STOK PENERI- PERSE- PEMA- SISA
NO NAMA OBAT SATUAN
AWAL MAAN DIAAN KAIAN STOK
1 2 3 5 6 7 = (5+6) 8 9
1 Air Raksa Dental Use Set 0 0 0 0 0
2 Alat Suntik sekali pakai 1 ml set 93 0 93 65 28
3 Alat suntik sekali pakai 2,5 ml Set 85 0 85 75 10
4 Alat suntik sekali pakai 5 ml Set 107 0 107 10 97
5 Albendazol tab 400 mg Tablet 0 0 0 0 0
6 Alopurinol tab 100 mg Tablet 0 0 0 0 0
7 Aminofilina tablet 200 mg Tablet 0 0 0 0 0
8 Aminofilina inj 24 mg/ml -10 ml Ampul 1 0 1 0 1
9 Amitriptilina HCl 25 mg Tablet 0 0 0 0 0
10 Amoksisilina sir kering 250 mg/5ml Botol 29 0 29 0 29
11 Amoksisilina kap 250 mg Kapsul 100 0 100 100 0
12 Ampisilina Kaplet 500 mg Kaplet 0 0 0 0 0
13 Ampisilina Inj Vial 0 0 0 0 0
14 Antalgin 500 mg tablet Tablet 0 0 0 0 0
15 Antalgin inj 250 mg / ml -2 ml Ampul 0 0 0 0 0
16 Antacida DOEN Kombinasi Tablet 590 0 590 410 180
17 Antibakteri DOEN salap Kombinasi Pot 9 0 9 1 8
18 Anti Hemmoroid Suppositoria Supp 1 0 1 1 0
19 Antifungi DOEN Salep (Whitefield). Pot 6 0 6 5 1
20 Antimigrain DOEN Kombinasi Tablet 0 0 0 0 0
21 Antiparkinson doen tab, komb. Tablet 0 0 0 0 0
22 Aqua Pro injeksi steril Ampul 0 0 0 0 0
23 Aquadest steril 500 ml Botol 0 0 0 0 0
24 Asam Ascorbat (Vit.C) tab. 250 mg Tablet 100 0 100 0 100
25 Asam Ascorbat (Vit.C) tab. 50 mg Tablet 100 0 100 0 100
26 Asam Klorida 0,1% Botol 0 0 0 0 0
27 Asam sulfosalisilat 20% Botol 0 0 0 0 0
28 Asetosal 100 mg tablet Tablet 0 0 0 0 0
29 Asetosal tab 500 mg Tablet 0 0 0 0 0
30 Atropin Sulpat inj 0,25 mg/ml-1 ml Ampul 4 0 4 3 1
31 Atropin Sulpat tab 0,5 mg Tablet 0 0 0 0 0
32 Atropin Sulpat tetes mata 0,5% Botol 0 0 0 0 0
33 Benza Benzil Penisilina inj 1,2 Juta IU Vial 0 0 0 0 0
34 Blood Set Set 0 0 0 0 0
35 Burnazin 35 mg Tube 0 0 0 0 0
36 Betametason Krim 0,1 % Tube 5 0 5 5 0
37 Cat Gut / benang bedah no. 2/0-3/0 Sachet 0 0 0 0 0
38 Dapson tablet 100 mg Tablet 0 0 0 0 0
39 Deksametason inj 5 mg/ml -1ml Ampul 10 0 10 10 0
40 Deksametason tablet 0,5 mg Tablet 300 0 300 300 0
41 Dekstrans 70- lar infus 6 % steril Botol 0 0 0 0 0
42 Dektrometropan HBr sirup Botol 0 0 0 0 0
43 Dekstrometorfan HBr tablet 15 mg Tablet 0 0 0 0 0
44 Devitalisasi Pasta Pot 0 0 0 0 0
45 Diazepam inj 5 mg / ml-2 ml Ampul 0 0 0 0 0
46 Diazepam tab 2 mg Tablet 0 0 0 0 0
47 Diazepam tablet 5 mg Tablet 0 0 0 0 0
48 Dietilkarbamazin sitrat tab 100 mg Tablet 0 0 0 0 0
49 Difenhidramin inj 10 mg/ml-1ml Ampul 0 0 0 0 0
50 Digoksin tab 0.25 mg Tablet 0 0 0 0 0
51 Efedrin tablet 25 mg Tablet 0 0 0 0 0
52 Ekstrak Belladona tab 25 mg Tablet 0 0 0 0 0
53 Efineprina HCl/Bitartrat inj 0,1 %- 1 ml Ampul 0 0 0 0 0
54 Etakridini laktas larutan 0,1 % Botol 1 0 1 1 0
55 Etambutol tab 250 mg Tablet 0 0 0 0 0
56 Etanol 70 % 100 ml Botol 2 0 2 2 0
57 Eter Anestesi Botol 0 0 0 0 0
58 Etil Klorida Semprot Botol 1 0 1 0 1
59 Eugenol Cairan Botol 0 0 0 0 0
60 Fenitoin injeksi 10 mg mg/ml Ampul 0 0 0 0 0
61 Fenitoin Natrium Kapsul 100 mg Kapsul 0 0 0 0 0
62 Fenitoin Natrium Kapsul 30 mg Kapsul 0 0 0 0 0
63 Fenobarbital inj 50 mg/ml-2ml Ampul 0 0 0 0 0
64 Fenobarbital tablet 100 mg Tablet 0 0 0 0 0
65 Fenobarbital tablet 30 mg Tablet 0 0 0 0 0
66 Fenoksimetil Penisilin tab 250 mg Tablet 0 0 0 0 0
67 Fenoksimetil Penisilin Tab 500 mg Tablet 0 0 0 0 0
68 Fenol Gliserol Tts Telinga 10 % Botol 9 0 9 0 9
69 Fitomenadion Inj 10 mg/ml-1ml Ampul 0 0 0 0 0
70 Fitomenadion tab salut 10 mg Tablet 100 0 100 30 70
71 Fluor tablet Tablet 0 0 0 0 0
72 Furosemida tablet 40 mg Tablet 40 0 40 10 30
73 Gameksan Emulsi 1 % Botol 0 0 0 0 0
74 Garam oralit untuk 1000 ml air Bungkus 0 0 0 0 0
75 Garam Oralit 200 ml air Bungkus 80 0 80 20 60
76 Gentian Violet larutan 1 % Botol 0 0 0 0 0
77 Glass Ionomer cement Set 0 0 0 0 0
78 Glibenklamida tab 5 mg Tablet 30 0 30 20 10
79 Guafenesin tablet 100 mg Tablet 200 0 200 0 200
80 Gliserin Botol 0 0 0 0 0
81 Glukosa lar infus 10 % steril Botol 0 0 0 0 0
82 Glukosa lar infus 40 % steril Botol 0 0 0 0 0
 83 Glukosa lar infus 5 % steril Botol 0 0 0 0 0
84 Griseofulvin tab 125 mg micrinized Tablet 0 0 0 0 0
85 Haloperidol tablet 0,5 mg Tablet 0 0 0 0 0
86 Haloperidol tablet 1,5 mg Tablet 0 0 0 0 0
87 Haloperidol tablet 5 mg Tablet 0 0 0 0 0
88 Hidroklortiazid Tab 25 mg Tablet 0 0 0 0 0
89 Hidrokortison Krim 2.5 % Tube 36 0 36 12 24
90 Ibuprofen tablet 200 mg Tablet 150 0 150 150 0
91 Ibuprofen tablet 400 mg Tablet 0 0 0 0 0
92 Infus set anak Set 0 0 0 0 0
93 Infus set Dewasa Set 23 0 23 1 22
94 Insulin reguler inj 40 IU Ampul 0 0 0 0 0
95 Iodiol Kapsul Lunak Kapsul 0 0 0 0 0
96 Ipeka sirup 0,14 % Botol 0 0 0 0 0
97 Isoniazida (iINH) tab 300 mg Tablet 0 0 0 0 0
98 Isosorbid dinitrat tablet Sublingual 5 mg Tablet 0 0 0 0 0
99 Jarum Jahit (bedah) No. 9 s/d 14 Biji 0 0 0 0 0
100 Kalium Permanganat serbuk Pot 0 0 0 0 0
101 Kalsium Hidroksida pasta Set 0 0 0 0 0
102 Kalsium Laktat tablet 500 mg Tablet 300 0 300 300 0
103 Kapas berlemak 50 mg Bungkus 0 0 0 0 0
104 Kapas pembalut 250 gram Bungkus 2 0 2 1 1
105 Karbamazepin tablet 200 g Tablet 0 0 0 0 0
106 Kasa kompres 40/40 steril Bungkus 0 0 0 0 0
107 Kasa Pembalut 2 x 80 Bungkus 0 0 0 0 0
108 Kasa pembalut hidropil 10x10 Rol 0 0 0 0 0
109 Kasa pembalut hidropil 6x6 Rol 0 0 0 0 0
110 Ketorolak inj Ampul 0 0 0 0 0
111 Klafazimin kap 100 mg/ml Kapsul 0 0 0 0 0
112 Kloramfenikol kap 250 mg Kapsul 50 0 50 50 0
113 Kloramfenikol Salap mata 1% Tube 0 0 0 0 0
114 Kloramfenikol tetes telinga 3 % Botol 9 0 9 1 8
115 Klorfeniramini Maleas 4 mg tab Tablet 600 0 600 400 200
116 Klorkina Pospat tab 250 mg Tablet 0 0 0 0 0
117 Klorpromazin HCl 25 mg/ml-1ml Ampul 0 0 0 0 0
118 Klorpromazin HCl 5 mg / ml-2ml Ampul 0 0 0 0 0
119 Klorpromazin HCl 100 mg Tablet 0 0 0 0 0
120 Klorpromazin HCl tab 25 mg Tablet 0 0 0 0 0
121 Klorpropamida tab 100 mg Tablet 0 0 0 0 0
122 Kodein HCl tab 10 mg Tablet 0 0 0 0 0
123 Komb.Piremetamin 2 mg + Sulfadoksin Tablet 0 0 0 0 0
124 Kotrimoksazol tab 120 mg Pediatrik Tablet 0 0 0 0 0
125 Kotrimoksazol suspensi Botol 0 0 0 0 0
126 Kotrimoksazol tab Komb. 480 mg Tablet 0 0 0 0 0
127 Kuinina HCl inj 25 %-2ml Ampul 0 0 0 0 0
128 Kuinina Sulfat Tablet 222 mg ( 7 H2O ) Tablet 0 0 0 0 0
129 Larutan Benedit Botol 0 0 0 0 0
130 Larutan Eosin 2% Botol 0 0 0 0 0
131 Larutan Etanol Botol 0 0 0 0 0
132 Larutan Giemsa Stain Botol 0 0 0 0 0
133 Larutan Karbol Fuksin Botol 0 0 0 0 0
134 Larutan Metilen Biru Botol 0 0 0 0 0
135 Larutan Turk Botol 0 0 0 0 0
136 Lidokain comp inj Komb. Ampul 28 0 28 12 16
137 Lisol Botol 0 0 0 0 0
138 Magnesium Sulpat inj (iv) 20%-25 ml Vial 0 0 0 0 0
139 Magnesium Sulfat Inj (iv) 40 % -25 ml Vial 0 0 0 0 0
140 Mebendazol sir 100 mg/5 ml Botol 0 0 0 0 0
141 Mebendazol tab 100 mg Tablet 0 0 0 0 0
142 Metanol Botol 0 0 0 0 0
143 Metil Ergometrin tab. 0.125 mg Tablet 13 0 13 12 1
144 Metil Ergometrin inj 0,200mg/1 ml Ampul 0 0 0 0 0
145 Metronidazol tab 250 mg Tablet 0 0 0 0 0
146 MonoKlorkamfer Mentol Cairan Botol 0 0 0 0 0
147 Mummifying Pasta Pot 0 0 0 0 0
148 Natrium bicarbonat tablet 500 mg Tablet 0 0 0 0 0
149 Natrium fluoresin tts mata 2 % Botol 0 0 0 0 0
150 Natrium Klorida Lar Inf 0,9% Steril Kolf 15 0 15 5 10
151 Natrium Thio Sulpat inj 25%-10ml Ampul 0 0 0 0 0
152 Nistatin 100.000 IU /G Tab Vagina Supp 1 0 1 0 1
153 Nistatin 500.000 IU tablet salut Tablet 0 0 0 0 0
154 Obat Antituberkulosis Katagori 1 Paket 0 0 0 0 0
155 Obat Antituberkulosis Katagori 2 Paket 0 0 0 0 0
156 Obat Batuk Hitam (OBH) Botol 0 0 0 0 0
157 OAT Katagori anak paker 0 0 0 0 0
158 Oksitetrasiklin HCl inj 50 mg/ml - 10 ml Vial 0 0 0 0 0
159 Oksitetrasiklin Salep Kulit 3% Tube 0 0 0 0 0
160 Oksitetrasiklin salep mata 1% Tube 0 0 0 0 0
161 Oksitoksin inj 10 IU/ml - ml Ampul 8 0 8 2 6
162 Paraformaldehide 1 gram Tablet 0 0 0 0 0
163 Parasetalmol sir 120 mg/ 5 ml Botol 36 0 36 12 24
164 Parasetamol 100 mg tablet Tablet 0 0 0 0 0
165 Parasetamol 500 mg tablet Tablet 700 0 700 500 200
166 Pembalut gibs Botol 0 0 0 0 0
167 Papaverin 40 mg Tablet 0 0 0 0 0
168 Perphenazin 4mg Tablet 0 0 0 0 0
169 Pethidin hcl injeksi 50 mg/ml - 2 ml Ampul 0 0 0 0 0
170 Pilokarpin HCl/nitrat tetes mata 2% Botol 0 0 0 0 0
171 Pirantel Pamoat tab. 125mg Tablet 0 0 0 0 0
172 Piridoksin HCl Tab 10 mg Tablet 100 0 100 100 0
173 Plaster 5 Yard x 2 inchi Rol 0 0 0 0 0
174 Polikresulen Botol 0 0 0 0 0
175 Polipeptida komb doen Tablet 0 0 0 0 0
176 prazikuantel tab 600 mg Tablet 0 0 0 0 0
177 Prednison tab 5 mg Tablet 300 0 300 300 0
178 Primakin tab 15 mg Tablet 0 0 0 0 0
179 Prokaina Penisilina G inj 3 Juta IU Vial 0 0 0 0 0
180 Propil Thio Urasil 100 mg tablet Tablet 0 0 0 0 0
181 Propranolol tab 40 mg Tablet 65 0 65 35 30
182 Rabies Imuneglobulin ( HUMAN ) 150 I Set 0 0 0 0 0
183 Reserpin 0,1 mg tabler Tablet 0 0 0 0 0
184 Reserpin 0,25 mg tablet Tablet 0 0 0 0 0
185 Retinol Kapsul Lunak 200.000 IU Kapsul 0 0 0 0 0
186 Rifampisin Kaplet 600 mg Tablet 0 0 0 0 0
187 Rifampisin Kapsul 300 mg Kapsul 0 0 0 0 0
188 Rifampisin Kapsul 450 mg Kapsul 0 0 0 0 0
189 Ringer Laktat inf steril Kolf 20 0 20 20 0
190 Salbutamol tab 2mg Tablet 50 0 50 50 0
191 Salep 2 - 4 Kombinasi Pot 0 0 0 0 0
192 Salisill Bedak 2% Bungkus 16 0 16 8 8
193 Salisil Spiritus 10 % Botol 0 0 0 0 0
194 Semen Seng Fosfat serbuk & cairan Set 0 0 0 0 0
195 Serum Anti Bisa Ular Polipalen inj 5 ml Ampul 0 0 0 0 0
196 Serum Anti bisa Ular Polipalen inj 50 m Vial 0 0 0 0 0
197 Serum Anti Difteri INJ 20.000 IU / amp Ampul 0 0 0 0 0
198 Serum Antitetanus inj 1500 IU/ampul Ampul 0 0 0 0 0
199 Serum Antitetanus inj 20.000 IU/vial ( Vial 0 0 0 0 0
200 Sianokobalamin inj 500 mcg Ampul 20 0 20 10 10
201 Silk No 3/0 Sachet 11 0 11 1 10
202 Silver Amalgam Serbuk 65 - 70% Set 0 0 0 0 0
203 Spon Gelatin Kotak 0 0 0 0 0
204 Streptomisin SO4 inj 1000 mg/ Vial Vial 0 0 0 0 0
205 Streptomisin SO4 inj 1500 mg/ Vial Vial 0 0 0 0 0
206 Sulpadimidin 500 mg tablet Tablet 0 0 0 0 0
207 Sulpasetamida tetes mata 15% Botol 0 0 0 0 0
208 Suspensi seng insulin inj. 40 iu/ml Ampul 0 0 0 0 0
209 Tablet Tambah Darah Kombinasi Tablet 0 0 0 0 0
210 Temporary stoping fletcher dan cairan Set 0 0 0 0 0
211 Tetrakaina HCL tetes mata 0,5% Botol 0 0 0 0 0
212 Tetrasiklin HCl Kap. 250 mg Kapsul 0 0 0 0 0
213 Tetrasiklin HCl Kap. 500 mg Kapsul 0 0 0 0 0
214 Thiamin HCl inj 100 mg /ml-1ml Ampul 300 0 300 300 0
215 Thiamin HCl tab 50 mg Tablet 350 0 350 250 100
216 Tiopental Na serbuk inj. 1000 mg/amp Ampul 0 0 0 0 0
217 Triheksil penidil HCl 2 mg tab Tablet 0 0 0 0 0
218 Trikresol Formalin (TKF) Cairan Botol 0 0 0 0 0
219 Vaksin rabies vero kuur 0 0 0 0 0
220 Vitamin B Kompleks Tablet 0 0 0 0 0
221 Yodium Povidon lart 10% 60 ml Botol 1 0 1 0 1
222 Yodium Povidon lart 10%m 300 ml Botol 2 0 2 1 1
223 Abocatch 18 Pcs 19 0 19 5 14
224 Abocath 20 Pcs 18 0 18 6 12
225 Abocath 24 Pcs 16 0 16 8 8
226 Acycklovir 200 mg Tablet 20 0 20 10 10
227 Acycklovir 400 mg Tablet 0 0 0 0 0
228 Acycklovir Cream Tube 14 0 14 12 2
229 Ambroxol Syrup Botol 0 0 0 0 0
230 Ambroxol Tab Tablet 0 0 0 0 0
231 Amlodipin 10 mg Tablet 340 0 340 160 180
232 Amlodipin 5 mg Tablet 340 0 340 160 180
233 Amoksisilin kap 500 mg Tablet 500 0 500 500 0
234 Antasida Syrup Botol 0 0 0 0 0
235 As.Traneksanat 500 mg Tablet 0 0 0 0 0
236 As.Traneksanat 250 mg Inj Ampul 1 0 1 0 1
237 Asam Asetat 6 % Botol 0 0 0 0 0
238 Asam Mefenamat 500 mg tablet Tablet 400 0 400 200 200
239 Betazon N krim Tube 0 0 0 0 0
240 Bioneuron Tab Tablet 0 0 0 0 0
241 Bromhexin tab Tablet 0 0 0 0 0
242 Captopril 25 mg tablet 300 0 300 200 100
243 Catopril 12,5 mg Tablet 290 0 290 240 50
244 Cefotaxim Inj Vial 10 0 10 2 8
245 Cetirizin tab Tablet 360 0 360 140 220
246 Dexran 70 % Botol 0 0 0 0 0
247 Doksisiklin tab Tablet 0 0 0 0 0
248 Domperidon Susp 60 ml Botol 0 0 0 0 0
249 Erytromisin Kapsul 250 mg Kapsul 0 0 0 0 0
250 Erytromisin kapsul 500 mg Tablet 240 0 240 60 180
251 Erytromisin Syrup Botol 3 0 3 2 1
252 Eter Alkohol Botol 0 0 0 0 0
253 Gentamisin inj Vial 1 0 1 1 0
254 Gentamisin Salap Kulit tube 0 0 0 0 0
255 Glukosa kalsikus Ampul 0 0 0 0 0
256 H2O2 Botl 0 0 0 0 0
257 Hand Scoon pasang 18 0 18 12 6
258 Ibuprofen sirup Botol 0 0 0 0 0
259 Kasa 4 m x 10 cm Rol 0 0 0 0 0
260 KASA 3 M X 10 CM ROL 9 0 9 1 8
261 Kasa 4 x 5 cm Rol 0 0 0 0 0
262 Kasa Pembalut 40 x 80 Rol 1 0 1 1 0
263 Ketokonazol Krim Tube 0 0 0 0 0
264 Ketokonazol tab Tablet 60 0 60 40 20
265 Klorampenicol Syrup Botol 0 0 0 0 0
266 Klorampenicol Tts mata 1 % Botol 0 0 0 0 0
267 KOH Sol Botol 0 0 0 0 0
268 Lar Hayem Botol 0 0 0 0 0
269 Lar HCL Botol 0 0 0 0 0
270 Lart Fochet Botol 0 0 0 0 0
271 Lart Reessecker Botol 0 0 0 0 0
272 Loperamid Tablet 0 0 0 0 0
273 Masker set 0 0 0 0 0
274 Metformin Tablet 200 0 200 100 100
275 Methoklorpamida Tablet 100 0 100 100 0
276 Metoklorpamid Inj Ampul 2 0 2 2 0
277 Meylon Botol 0 0 0 0 0
278 Mikonazol krim 2% Tube 12 0 12 12 0
279 Multivitamin anak sirup botol 3 0 3 2 1
280 Multivitamin plus mineral Tablet 0 0 0 0 0
281 Natrium bicarbonat inj botol 0 0 0 0 0
282 Natrium Diklofenat 25 mg Tablet 170 0 170 130 40
283 Natrium Diklofenat 50 mg Tablet 300 0 300 200 100
284 Nipedipin tablet Tablet 0 0 0 0 0
285 Parasetamol Drop 15 ml Botol 0 0 0 0 0
286 Pehapral Tablet 180 0 180 120 60
287 Pirantel Pamoat sirup Botol 0 0 0 0 0
288 Piroksikam 10 mg tablet Tablet 0 0 0 0 0
289 Piroksikam 20 mg tab Tablet 0 0 0 0 0
290 Ranitidin Inj Ampul 9 0 9 6 3
291 Ranitidin tab 150 mg Tablet 250 0 250 250 0
292 Retinol Kapsul Lunak 100.000 IU Kapsul 0 0 0 0 0
293 SALBUTAMOL 4 MG Tablet 0 0 0 0 0
294 Sefadroksil sirup kering Botol 0 0 0 0 0
295 Sianokobalamin tab 50 mcg Tablet 180 0 180 20 160
296 Simetidin tab 200 mg Tablet 0 0 0 0 0
297 Siproploksasin 500 mg Tablet 210 0 210 90 120
298 Aqua 500 ml Kotak 0 0 0 0 0
299 Sofratulle Bks 0 0 0 0 0
300 Tramadol inj Ampul 0 0 0 0 0
301 Urin Bag pcs 3 0 3 3 0
302 Wing Nidle 18-21 set 0 0 0 0 0
303 Zink Tablet 160 0 160 140 20
304 Abocath 22 set 13 0 13 5 8
305 Becefort Syrup Botol 0 0 0 0 0
306 Curcuma plus imun Botol 0 0 0 0 0
307 DeXtrofen syrup Botol 0 0 0 0 0
308 LORATADINE TAB 10 MG Tablet 0 0 0 0 0
309 Hemaford Tablet 0 0 0 0 0
310 Hepagard Tablet 0 0 0 0 0
311 Imbost syrup Botol 0 0 0 0 0
312 Litacur syrup Botol 0 0 0 0 0
313 Livron b Plek Tablet 0 0 0 0 0
314 Methiosoprinol Tablet 0 0 0 0 0
315 Methiosoprinol 250 mg/5ml Botol 0 0 0 0 0
316 Pehacain Inj Ampul 0 0 0 0 0
317 Tensigard Tablet 0 0 0 0 0
318 Alat suntik 10 ml set 6 0 6 4 2
319 Reagen Gol Darah 0 0 0 0 0
320 Masker Ear Loop kotak 1 0 1 1 0
321 Permetrin Krim tube 8 0 8 4 4
322 Poli kateter no 14 set 3 0 3 3 0
323 Poli kateter no 18 set 4 0 4 2 2
324 Gentamisin Salap Mata Tube 3 0 3 2 1
325 Bisacodil supp Supp 0 0 0 0 0
326 Atapulgit tab 600 mg Tablet 120 0 120 80 40
327 KASA 16 X 16 Kotak 19 0 19 13 6
329 Omeprazol tab Tablet 0 0 0 0 0
330 Simvastatin 20 Tablet 60 0 60 40 20
331 Simvastatin 10 Tablet 40 0 40 30 10
332 Geriavita tablet Tablet 0 0 0 0 0
333 Stimuno kapsul Kapsul 0 0 0 0 0
334 Stimuno syrup Grape botol 0 0 0 0 0
335 Cavicur syrup botol 0 0 0 0 0
336 Paper tape 5.0 cm x 9.14 m(farmafix) Rol 0 0 0 0 0
337 Gentamisin Tetes Mata TUBE 0 0 0 0 0
338 Cetirizin Sirup Botol 6 0 6 4 2
339 Cairan Desinpektan Botol 0 0 0 0 0
340 Plaster merah (leukoples) 2,5 x 4,5 m Rol 2 0 2 1 1
341 Plaster merah (leukoples) 7,5 x 4,5 m Rol 0 0 0 0 0
342 ALOpurinol tab 300 mg Tablet 0 0 0 0 0
343 Stesolit Rektal 5 mg SUB 0 0 0 0 0
344 KOMPOLAX BOTOL 1 0 1 1 0
345 LIDOKAIN SPRAY BOTOL 0 0 0 0 0
346 LIDOKAIN GEL TUBE 0 0 0 0 0
347 SULFADIAZIN SILVER TUBE 0 0 0 0 0
348 ALKOHOl SWAP KTK 1 0 1 1 0
349 GLIMEPIRIDE KAPS 2 MG Tablet 110 0 110 90 20
350 FUROSEMID INJ 10 MG/ML Ampul 2 0 2 0 2
351 DOMPERIDON TAB 10 MG Tablet 130 0 130 70 60
352 METIL PREDNISOLON 4 MG Tablet 200 0 200 100 100
353 SALBUTAMOL MDI 100 MCG/DOS BTL 0 0 0 0 0
354 FENETEROLHIDROMIDE 100 MCG/FUFF BTL 0 0 0 0 0
355 HANDSCOON MRB PCS 70 0 70 30 40
356 KLORAMFENIKOL SK Tube 0 0 0 0 0
358 BETAHISTIN TAB 24 MG Tablet 0 0 0 0 0
359 SEFADROKSIL KAPS 250 MG Tablet 0 0 0 0 0
360 ZINK SYR BOTOL 0 0 0 0 0
362 ACETYLCYSITEIN 200 MG KAPS Kapsul 390 0 390 230 160
363 DIMENHIDRATE 50 MG TAB Tablet 0 0 0 0 0
364 PARASETAMOL INFUS BOTOL 0 0 0 0 0
365 METOKLORPAMID DROP BOTOL 0 0 0 0 0
366 Handscoon steril Pcs 0 0 0 0 0
367 OMEPRAZOLE INJ Ampul 4 0 4 3 1
369 ASETOSAL 80 MG Tablet 0 0 0 0 0
370 HERBACOF Kotak 36 0 36 12 24
371 HERBACOLD Tablet 0 0 0 0 0
Umum BPJS
UKS/Gratis/SKTM
Jumlah Kunjungan Resep Bayar PBI/NONPBI
166 336 87

Yang Melapor
Petugas Pustu Pulau Ten

(Hj. Siti Komiah, Amd.K

Nip. 19750713200212
OBAT

: April
: 2024
STOK PERMIN-
OPT TAAN
10 17
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JUMLAH

589

Yang Melapor
Petugas Pustu Pulau Tengah

(Hj. Siti Komiah, Amd.Keb)

Nip. 197507132002122001