LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

PUSTU/ POSKESDES
PUSTU/ POSKESDES : PELAPORAN BLN:
KECAMATAN : WALEA BESAR PERMINTAAN BLN:
KABUPATEN : TOJO UNA - UNA
PROPINSI : SULAWESI TENGAH

NO NAMA OBAT SATUAN Stok Awal Penerimaan Persediaan Pemakaian Stok Akhir Permintaan Ket

1 2 3 4 5 6 7 8 9 10
1 Albendazol tab 400 mg Tablet
2 Alopurinol tab 100 mg* Tablet
3 Alopurinol tab 300 mg Tablet
4 Aminofilin inj 24 mg/mL vial
5 Amlodipin* tab 10 mg Tablet
6 Amlodipin* tab 5 mg Tablet
7 amoksisilin sir kering 125 mg/5 mL Botol
8 amoksisilin sir kering 250 mg/5 mL Botol
9 amoksisilin tab 250 mg Tablet
10 amoksisilin tab 500 mg Tablet
11 antasida, kombinasi suspensi Botol
12 antasida, kombinasi tab kunyah Tablet
13 antifungi, kombinasi salep Tube
14 antihemoroid, kombinasi Suppo
15 asam askorbat (vitamin C) tab 250 mg Tablet
16 asam askorbat (vitamin C) tab 50 mg Tablet
17 asam mefenamat kaps 500 mg kaps
18 asiklovir tab 200 mg Tablet
19 asiklovir tab 400 mg Tablet
20 bedak salisil serb 2% Botol
21 betametason krim 0,1% Tube
22 betametason salep 0,1% Tube
23 bisakodil sup 10 mg Suppo
24 bisakodil sup 5 mg Suppo
25 bisakodil tab sal 5 mg Tablet
26 deksametason inj 5 mg/mL (i.v./i.m.) Ampul
27 deksametason tab 0,5 mg Tablet
28 difenhidramin inj 10 mg/mL (i.v./i.m.) Ampul
29 dimenhidrinat tab 50 mg Tablet
30 doksisiklin kaps 100 mg Kaps
31 domperidon sir 5 mg/5 mL Botol
32 domperidon tab 10 mg Tablet
33 eritromisin kaps 250 mg Kaps
34 eritromisin sir kering 200 mg/5 mL Botol
35 eritromisin tab 500 mg Tablet
36 fitomenadion (vitamin K1) inj 10 mg/mL Ampul
(i.m.)
37 fitomenadion (vitamin K1) inj 2 mg/mL (i.m.) Ampul
38 fitomenadion (vitamin K1) tab sal gula 10 mg Tablet
39 garam oralit, kombinasi serbuk Sachset
40 griseofulvin (micronized) tab 125 mg Tablet
41 griseofulvin (micronized) tab 250 mg Tablet
42 griseofulvin (micronized) tab 500 mg Tablet
43 hidrokortison krim 1% Tube
44 hidrokortison krim 2,5% Tube
45 ibuprofen susp 100 mg/5 Ml Botol
46 ibuprofen susp 200 mg/5 mL Botol
47 ibuprofen tab 200 mg Tablet
48 ibuprofen tab 400 mg Tablet
49 kalsium laktat (kalk) tab 500 mg Tablet
50 kaptopril* tab 12,5 mg Tablet
51 kaptopril* tab 25 mg Tablet
52 kaptopril* tab 50 mg Tablet
53 ketokonazol krim 2% Tube
54 ketokonazol tab 200 mg Tablet
55 kloramfenikol salep mata 1% Tube
56 kloramfenikol susp 125 mg/5 mL Botol
57 kloramfenikol tts mata 0,5% Botol
58 kloramfenikol tts mata 1% Botol
59 kloramfenikol tts telinga Tablet
60 klorfeniramin tab 4 mg (CTM) Tablet
61 kotrimoksazol kombinasi tiap 5 mL susp 240 Botol
mg
62 kotrimoksazol tab 480 mg Tablet
63 lidokain 2% + epinefrin 1 : 80.000 inj 2 mL Ampul
64 loratadin tab 10 mg Tablet
65 metformin* tab 500 mg Tablet
66 metilergometrin inj 0,2 mg/mL Ampul
67 metilergometrin tab sal selaput 0,125 mg Tablet
68 metilprednisolon tab 4 mg* Tablet
69 metoklopramid inj 5 mg/mL Ampul
70 metoklopramid tab 10 mg Tablet
71 metronidazol tab 250 mg Tablet
72 metronidazol tab 500 mg Tablet
73 mikonazol krim 2% Tube
74 n-asetil sistein kaps 200 mg* Kaps
75 natrium diklofenak tab sal enterik 25 mg Tablet
76 natrium diklofenak tab sal enterik 50 mg Tablet
77 nifedipin* tab 10 mg Tablet
78 omeprazol kaps 20 mg Kaps
79 parasetamol drops 100 mg/mL Botol
80 parasetamol sir 120 mg/5 mL Botol
81 parasetamol tab 500 mg Tablet
82 pirantel pamoat tab 125 mg Tablet
83 pirantel pamoat tab 250 mg Tablet
84 piridoksin (vitamin B6) inj 50 mg/mL Tablet
85 piridoksin (vitamin B6) tab 10 mg* Tablet
86 povidon iodin cairan 70% Botol
87 povidon iodin etanol 70% Botol
88 Povidon iodin lar 100 mg/ml Botol
89 prednison* tab 5 mg Tablet
90 primakuin tab 15 mg Tablet
91 ranitidin tab 150 mg Tablet
92 retinol (vitamin A) kaps lunak 100.000 IU Kaps
93 retinol (vitamin A) kaps lunak 200.000 IU Kaps
94 salbutamol tab 2 mg* Tablet
95 salbutamol tab 4 mg* Tablet
96 salep 2-4, kombinasi salep Tube
97 sefadroksil kaps 250 mg kaps
98 sefadroksil kaps 500 mg kaps
99 sefadroksil sir kering 125 mg/5 mL Botol
100 sefadroksil sir kering 250 mg/5 mL Botol
101 setirizin sir 5 mg/5 mL Botol
102 sianokobalamin (vitamin B12) inj 500 Ampul
mcg/mL
103 sianokobalamin (vitamin B12) tab 50 mcg Tablet
104 simvastatin 10 mg* Tablet
105 simvastatin 20 mg* Tablet
106 simvastatin 40 mg Tablet
107 siprofloksasin tab sal selaput 500 mg Tablet
108 tetrasiklin kaps 250 mg Kaps
109 tetrasiklin kaps 500 mg Kaps
110 tiamin (vitamin B1)* tab 50 mg Tablet
111 vitamin B kompleks tab Tablet
112 zinc sir 20 mg/5 mL Botol
113 zinc tab dispersible 20 mg Tablet
114 Dopamet Tablet
115 Siobion tab Tablet
116 Selcom-C Tablet
117 Selfiplex tab Tablet
118 Pritagesic tab Tablet
119 Seven Seas Syr Botol
120 Acyclovir Cream (Acifar) Tube
121 Gentamisin Salep Kulit (Gentalex) Tube
122 Kloramfenikol tts mata (Reco eye drop) Botol
123 Kloramfenikol tts telinga (Reco ear drop) Botol
124 Ambroxol 30 mg Tablet
125 Ambroxol Syr Botol
126 Asam Traneksamat 250 mg Tablet
127 Betahistin 6 mg Tablet
128 Biocombin tab Tablet
129 Biocombin injeksi Ampul
130 Curcuma tab Tablet
131 Diphenhidramin Injeksi 10 mg/ml Ampul
132 Enbatic salep Tube
133 Erlamicetin tts Telinga Botol
134 Gemfibrozil 300 mg Tablet
135 Gentian Violet Tube
136 Gliseril Guaiacolat 100 mg Tablet
137 Glukosa Lar. Infus 5 % Steril Botol
138 Hemafort tab Tablet
139 Ichtyol Botol
140 Iodina Test Botol
141 Kloramphenicol Kapsul 500 mg kaps
142 Lisol Botol
143 Loperamide 2 mg Tablet
144 NaCl 0,9% Botol
145 OBH Syr Botol
146 Oksitetrasiklin salep kulit 3% Tube
147 Phenol Gliserol Tetes Telinga Botol
148 Piracetam 400 mg Tablet
149 Piroksikam 20 mg Tablet
150 Ranitidin Injeksi 25 mg/ml Ampul
151 Ringer Laktat Infus Botol
152 Setrizin Tablet 10 mg Tablet
153 tiamin (vitamin B1) injeksi vial
154 vitamin B kompleks injeksi vial
155 Metoklorpramide 5 mg/ml syr (Primpen) Botol
156 Scopamin 10 mg Tablet
157 Teramisin injeksi vial
158 Colcitine 0.5 mg Tablet
159 Ultracarbon tab Tablet
160 Atorvastatin 20 mg Tablet
161 Ketorolac 30 mg/ml Ampul
162 Asam Traneksamat injeksi Ampul
163 Scopamin Injeksi Ampul
164 New Antides Tablet
165 Diatabs tab Tablet
166 Nystin drops dus
167 Kanamicyn Inj vial
168 Hyoscine butylbromide 20 mg/ml injeksi Ampul
169 Oksitetrasiklin salep mata 1% Tube
170 Salep Whitfield Tube
No BMHP Satuan Stok Awal Penerimaan Persediaan Pemakaian Stok Akhir Permintaan Ket
1 abbocath No. 18 Piece
2 abbocath No. 20 Piece
3 Abbocath no. 22 Piece
4 Abocath no. 24 Piece
5 Abocath no. 26 Piece
6 Alat Suntik 10 ml Piece
7 Alat Suntik 20 ml Piece
8 Alat suntik 3 ml Piece
9 Alat suntik 5 ml Piece
10 Antiseptik E-Care 500 ml (Hand rub) Botol
11 Catgut plain 3/0 100 M Piece
12 Etakridin (rivanol Lar 0,1 %) botol
13 Etanol botol 70% 100 ml botol
14 Etanol botol 70% 300 ml Botol
15 Handscan no. 7 steril Piece
16 Handscan no. 7,5 Biasa (M) Piece
17 Handscan no. 7,5 steril Piece
18 hypafix 10 cm x 5 cm Dus
19 Kapas pembalut 250 mg Piece
20 Kasa hydrofil Steril 16x16 cm Dus
21 Kasa Pembalut hidrofil 2x80 cm Piece
22 Needle No. 23 Piece
23 Plano Test (Testpack) Dus
24 Plester 7,5 cm x 4,5 m Piece
25 Plester 2,5 Yard x 4,5 cm Piece
26 Povidon lodida 10%-300 ml botol
27 Povidon lodida 10%-60 ml botol
28 Urin bag Piece
29 Handscond Non Steril ((L) Piece
30 Infusion Set Anak Piece
31 Infusion Set Dewasa Piece
32 Plesterin Bulat Non Woven Dus
33 Povidon lodida 10%-30 ml Botol
34 Handscond Non Steril (S) Piece
35 Handscond Non Steril (M) Piece
36 Catgut Chromic 2-0 73 CM - 30 mm Piece
37 Catgut Plain 2/0 37 HR Piece

Mengetahui/menyetujui Yang Menerima/ Menyerahkan Yang Melapor

Kepala Puskesmas Pasokan Pengelola Obat PKM Pasokan Penanggungjawab Pustu/ Poskesdes
Muznah A.M Salilung, A.Md.Kep Yulinda A.Patalongi A.Md.Farm ………………………………………..
NIP. 19680306 198901 2 004 Nip- NIP.