Blangko Lplpo Kosong.xlsx
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LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT RUTIN/APBD ( LPLPO ) PUSTU/SUB UNIT PUSTU/SUB UNIT : TANJUNGAN 1 PUSKESMAS : CIKEUSIK KECAMATAN : CIKEUSIK KABUPATEN : PANDEGLANG PROPINSI : BANTEN
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT
PELAPORAN BULAN : JANUA PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
0 0 0 0 0 0 40 0 50 0 0 0 0 0 50 0 0 0 0 0 0 0 0 20 20 0 0 0 30 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 50 0 0 300 0 0 10 0 0 200 10 0 0 0 0 0 0 3 100 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 50 40 0 350 0 0 10 0 0 250 10 0 0 0 0 0 0 3 120 20 0 0 0 230 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 5 0
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
0 10 10 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 10 60 0 0 0 0 0 100 0 0 230 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 510 0 0 0 0 0
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
0 0 0 0 20 0 0 0 0 0 0 0 0 0 20 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 20 5 0 0 0 0 0 0 50 0 120 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 120 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 4 0 0 0 0 0 0 0 0 0 0 0
6 0 4 0 0 0 0 0 0 0 0 0 0 0
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
0 0 0 0 0 0 0 0 0 0 0 18 20 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 10 20 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 18 170 0 0 0 0 0 2 0 0 10 0 170 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 110 120 0 0 0 1 0 0 0 0 0 0 0
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
0 0 0 0
0 0 0 0
0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 0 0 0 0 100 0 0 0 0 100 0 50
6 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN : JANUARI 2019 TAAN BULAN/PERIODE : februari PEMAKAIAN 0 0 0 0 0 40 30 0 265 0 0 10 0 0 210 10 0 0 0 0 0 0 0 90 20 0 0 0 185 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 50 50 10 0 0 0 0 0 85 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 200 200 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 3 3 30 100 100 0 0 0 0 0 0 0 0 0 0 0 0 45 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 5 5 0 0 0
0 10 30 0 0 0 0 0 80 0 0 170 0 0 0 0 0 0
0 0 30 0 0 0 0 0 20 0 0 60 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 70 0
0 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
7 0 4 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 4 0 0 0 0 0 0 0 0 0 0 0
10 0 4 0 0 0 0 0 0 0 0 0 0 0
0 0 80 0 0 0 0 0 0 0 0 18 145 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 80 70 0 0 0 1 0 0 0 0 0 0 0
0 0 20 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 50 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0 0 0 80 0 0 0 0 80 0 50
8 0 0 0 0 0 20 0 0 0 0 20 0 0
9 0 0 0 0 0 100 0 0 0 0 100 0 50
10 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Yang Meminta : Pengelola
SITI ROHMAH, Amd.kep NTKK. 6202 1046
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT RUTIN/APBD ( LPLPO ) PUSTU/SUB UNIT PUSTU/SUB UNIT : TANJUNGAN 1 PUSKESMAS : CIKEUSIK KECAMATAN : CIKEUSIK KABUPATEN : PANDEGLANG PROPINSI : BANTEN
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT
PELAPORAN BULAN : februar PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
4
5
6
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
4
5
6
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
4
5
6
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN : februari 2019 TAAN BULAN/PERIODE : maret PEMAKAIAN
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH
7
8
9
10
7
8
9
10
7
8
9
10
Yang Meminta : Pengelola
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT RUTIN/APBD ( LPLPO ) PUSTU/SUB UNIT PUSTU/SUB UNIT : TANJUNGAN 1 PUSKESMAS : CIKEUSIK KECAMATAN : CIKEUSIK KABUPATEN : PANDEGLANG PROPINSI : BANTEN
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT
PELAPORAN BULAN : maret 2 PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
0 0 0 0 0 10 10 0 85 0 0 0 0 0 40 10 0 0 0 0 0 0 3 30 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 50 0 0 300 0 0 10 0 0 200 10 0 0 0 0 0 0 3 100 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 60 10 0 385 0 0 10 0 0 240 20 0 0 0 0 0 0 6 130 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
0 0 30 0 0 0 0 0 20 0 0 60 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 80 0 0 0 0 0 120 0 0 260 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
0 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 150 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 4 0 0 0 0 0 0 0 0 0 0 0
6 0 4 0 0 0 0 0 0 0 0 0 0 0
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
0 0 20 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 50 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 1 0 0 0 0 0 0 0
0 0 120 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 150 0 0 0 1 0 0 0 0 0 0 0
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
0 0 0 0
0 0 0 0
0 0 0 0
4 0 0 0 0 0 20 0 0 0 0 20 0 0
5 0 0 0 0 0 100 0 0 0 0 100 0 50
6 0 0 0 0 0 120 0 0 0 0 120 0 50
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN : maret 2019 TAAN BULAN/PERIODE : april PEMAKAIAN 0 0 0 0 0 40 30 0 265 0 0 10 0 0 210 10 0 0 0 0 0 0 0 90 20 0 0 0 185 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 50 50 -20 0 0 0 0 0 120 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 200 200 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 3 3 40 100 100 0 0 0 0 0 0 0 0 0 0 0 0 60 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 5 5 0 0 0
0 10 30 0 0 0 0 0 80 0 0 170 0 0 0 0 0 0
0 -10 50 0 0 0 0 0 40 0 0 90 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 70 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
7 0 4 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 4 0 0 0 0 0 0 0 0 0 0 0
10 0 4 0 0 0 0 0 0 0 0 0 0 0
0 0 80 0 0 0 0 0 0 0 0 18 145 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 80 70 0 0 0 1 0 0 0 0 0 0 0
0 0 40 0 0 0 0 0 0 0 0 -18 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -20 0 0 0 0 0 0 0 0 0 0 0 0 0 50 80 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0 0 0 80 0 0 0 0 80 0 50
8 0 0 0 0 0 40 0 0 0 0 40 0 0
9 0 0 0 0 0 100 0 0 0 0 100 0 50
10 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Yang Meminta : Pengelola
SITI ROHMAH, Amd.kep NTKK. 6202 1046
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT RUTIN/APBD ( LPLPO ) PUSTU/SUB UNIT PUSTU/SUB UNIT : TANJUNGAN 1 PUSKESMAS : CIKEUSIK KECAMATAN : CIKEUSIK KABUPATEN : PANDEGLANG PROPINSI : BANTEN
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT
PELAPORAN BULAN : april 20 PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
0 0 0 0 0 10 10 0 85 0 0 0 0 0 40 10 0 0 0 0 0 0 3 30 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 50 0 0 300 0 0 10 0 0 200 10 0 0 0 0 0 0 3 100 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 60 10 0 385 0 0 10 0 0 240 20 0 0 0 0 0 0 6 130 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
0 0 30 0 0 0 0 0 20 0 0 60 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 80 0 0 0 0 0 120 0 0 260 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
0 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 150 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 4 0 0 0 0 0 0 0 0 0 0 0
6 0 4 0 0 0 0 0 0 0 0 0 0 0
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
0 0 20 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 50 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 1 0 0 0 0 0 0 0
0 0 120 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 150 0 0 0 1 0 0 0 0 0 0 0
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
0 0 0 0
0 0 0 0
0 0 0 0
4 0 0 0 0 0 20 0 0 0 0 20 0 0
5 0 0 0 0 0 100 0 0 0 0 100 0 50
6 0 0 0 0 0 120 0 0 0 0 120 0 50
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN : april 2019 TAAN BULAN/PERIODE : mei PEMAKAIAN 0 0 0 0 0 40 30 0 265 0 0 10 0 0 210 10 0 0 0 0 0 0 0 90 20 0 0 0 185 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 50 50 -20 0 0 0 0 0 120 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 200 200 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 3 3 40 100 100 0 0 0 0 0 0 0 0 0 0 0 0 60 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 5 5 0 0 0
0 10 30 0 0 0 0 0 80 0 0 170 0 0 0 0 0 0
0 -10 50 0 0 0 0 0 40 0 0 90 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 70 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
7 0 4 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 4 0 0 0 0 0 0 0 0 0 0 0
10 0 4 0 0 0 0 0 0 0 0 0 0 0
0 0 80 0 0 0 0 0 0 0 0 18 145 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 80 70 0 0 0 1 0 0 0 0 0 0 0
0 0 40 0 0 0 0 0 0 0 0 -18 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -20 0 0 0 0 0 0 0 0 0 0 0 0 0 50 80 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0 0 0 80 0 0 0 0 80 0 50
8 0 0 0 0 0 40 0 0 0 0 40 0 0
9 0 0 0 0 0 100 0 0 0 0 100 0 50
10 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Yang Meminta : Pengelola
SITI ROHMAH, Amd.kep NTKK. 6202 1046
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT RUTIN/APBD ( LPLPO ) PUSTU/SUB UNIT PUSTU/SUB UNIT : TANJUNGAN 1 PUSKESMAS : CIKEUSIK KECAMATAN : CIKEUSIK KABUPATEN : PANDEGLANG PROPINSI : BANTEN
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT
PELAPORAN BULAN : mei 20 PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
0 0 0 0 0 10 10 0 85 0 0 0 0 0 40 10 0 0 0 0 0 0 3 30 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 50 0 0 300 0 0 10 0 0 200 10 0 0 0 0 0 0 3 100 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 60 10 0 385 0 0 10 0 0 240 20 0 0 0 0 0 0 6 130 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
0 0 30 0 0 0 0 0 20 0 0 60 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 80 0 0 0 0 0 120 0 0 260 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
0 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 150 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 4 0 0 0 0 0 0 0 0 0 0 0
6 0 4 0 0 0 0 0 0 0 0 0 0 0
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
0 0 20 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 50 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 1 0 0 0 0 0 0 0
0 0 120 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 150 0 0 0 1 0 0 0 0 0 0 0
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
0 0 0 0
0 0 0 0
0 0 0 0
4 0 0 0 0 0 20 0 0 0 0 20 0 0
5 0 0 0 0 0 100 0 0 0 0 100 0 50
6 0 0 0 0 0 120 0 0 0 0 120 0 50
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN : mei 2019 TAAN BULAN/PERIODE : juni PEMAKAIAN 0 0 0 0 0 40 30 0 265 0 0 10 0 0 210 10 0 0 0 0 0 0 0 90 20 0 0 0 185 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 50 50 -20 0 0 0 0 0 120 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 200 200 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 3 3 40 100 100 0 0 0 0 0 0 0 0 0 0 0 0 60 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 5 5 0 0 0
0 10 30 0 0 0 0 0 80 0 0 170 0 0 0 0 0 0
0 -10 50 0 0 0 0 0 40 0 0 90 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 70 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
7 0 4 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 4 0 0 0 0 0 0 0 0 0 0 0
10 0 4 0 0 0 0 0 0 0 0 0 0 0
0 0 80 0 0 0 0 0 0 0 0 18 145 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 80 70 0 0 0 1 0 0 0 0 0 0 0
0 0 40 0 0 0 0 0 0 0 0 -18 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -20 0 0 0 0 0 0 0 0 0 0 0 0 0 50 80 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0 0 0 80 0 0 0 0 80 0 50
8 0 0 0 0 0 40 0 0 0 0 40 0 0
9 0 0 0 0 0 100 0 0 0 0 100 0 50
10 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Yang Meminta : Pengelola
SITI ROHMAH, Amd.kep NTKK. 6202 1046
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT RUTIN/APBD ( LPLPO ) PUSTU/SUB UNIT PUSTU/SUB UNIT : TANJUNGAN 1 PUSKESMAS : CIKEUSIK KECAMATAN : CIKEUSIK KABUPATEN : PANDEGLANG PROPINSI : BANTEN
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT
PELAPORAN BULAN :juni 201 PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
0 0 0 0 0 10 10 0 85 0 0 0 0 0 40 10 0 0 0 0 0 0 3 30 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 50 0 0 300 0 0 10 0 0 200 10 0 0 0 0 0 0 3 100 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 60 10 0 385 0 0 10 0 0 240 20 0 0 0 0 0 0 6 130 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
0 0 30 0 0 0 0 0 20 0 0 60 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 80 0 0 0 0 0 120 0 0 260 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
0 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 150 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 4 0 0 0 0 0 0 0 0 0 0 0
6 0 4 0 0 0 0 0 0 0 0 0 0 0
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
0 0 20 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 50 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 1 0 0 0 0 0 0 0
0 0 120 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 150 0 0 0 1 0 0 0 0 0 0 0
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
0 0 0 0
0 0 0 0
0 0 0 0
4 0 0 0 0 0 20 0 0 0 0 20 0 0
5 0 0 0 0 0 100 0 0 0 0 100 0 50
6 0 0 0 0 0 120 0 0 0 0 120 0 50
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN :juni 2019 TAAN BULAN/PERIODE : juli PEMAKAIAN 0 0 0 0 0 40 30 0 265 0 0 10 0 0 210 10 0 0 0 0 0 0 0 90 20 0 0 0 185 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 50 50 -20 0 0 0 0 0 120 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 200 200 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 3 3 40 100 100 0 0 0 0 0 0 0 0 0 0 0 0 60 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 5 5 0 0 0
0 10 30 0 0 0 0 0 80 0 0 170 0 0 0 0 0 0
0 -10 50 0 0 0 0 0 40 0 0 90 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 70 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
7 0 4 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 4 0 0 0 0 0 0 0 0 0 0 0
10 0 4 0 0 0 0 0 0 0 0 0 0 0
0 0 80 0 0 0 0 0 0 0 0 18 145 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 80 70 0 0 0 1 0 0 0 0 0 0 0
0 0 40 0 0 0 0 0 0 0 0 -18 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -20 0 0 0 0 0 0 0 0 0 0 0 0 0 50 80 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0 0 0 80 0 0 0 0 80 0 50
8 0 0 0 0 0 40 0 0 0 0 40 0 0
9 0 0 0 0 0 100 0 0 0 0 100 0 50
10 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Yang Meminta : Pengelola
SITI ROHMAH, Amd.kep NTKK. 6202 1046
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT RUTIN/APBD ( LPLPO ) PUSTU/SUB UNIT PUSTU/SUB UNIT : TANJUNGAN 1 PUSKESMAS : CIKEUSIK KECAMATAN : CIKEUSIK KABUPATEN : PANDEGLANG PROPINSI : BANTEN
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT
PELAPORAN BULAN : juli 201 PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
0 0 0 0 0 10 10 0 85 0 0 0 0 0 40 10 0 0 0 0 0 0 3 30 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 50 0 0 300 0 0 10 0 0 200 10 0 0 0 0 0 0 3 100 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 60 10 0 385 0 0 10 0 0 240 20 0 0 0 0 0 0 6 130 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
0 0 30 0 0 0 0 0 20 0 0 60 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 80 0 0 0 0 0 120 0 0 260 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
0 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 150 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 4 0 0 0 0 0 0 0 0 0 0 0
6 0 4 0 0 0 0 0 0 0 0 0 0 0
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
0 0 20 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 50 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 1 0 0 0 0 0 0 0
0 0 120 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 150 0 0 0 1 0 0 0 0 0 0 0
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
0 0 0 0
0 0 0 0
0 0 0 0
4 0 0 0 0 0 20 0 0 0 0 20 0 0
5 0 0 0 0 0 100 0 0 0 0 100 0 50
6 0 0 0 0 0 120 0 0 0 0 120 0 50
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN : juli 2019 TAAN BULAN/PERIODE : agusts PEMAKAIAN 0 0 0 0 0 40 30 0 265 0 0 10 0 0 210 10 0 0 0 0 0 0 0 90 20 0 0 0 185 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 50 50 -20 0 0 0 0 0 120 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 200 200 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 3 3 40 100 100 0 0 0 0 0 0 0 0 0 0 0 0 60 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 5 5 0 0 0
0 10 30 0 0 0 0 0 80 0 0 170 0 0 0 0 0 0
0 -10 50 0 0 0 0 0 40 0 0 90 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 70 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
7 0 4 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 4 0 0 0 0 0 0 0 0 0 0 0
10 0 4 0 0 0 0 0 0 0 0 0 0 0
0 0 80 0 0 0 0 0 0 0 0 18 145 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 80 70 0 0 0 1 0 0 0 0 0 0 0
0 0 40 0 0 0 0 0 0 0 0 -18 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -20 0 0 0 0 0 0 0 0 0 0 0 0 0 50 80 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0 0 0 80 0 0 0 0 80 0 50
8 0 0 0 0 0 40 0 0 0 0 40 0 0
9 0 0 0 0 0 100 0 0 0 0 100 0 50
10 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Yang Meminta : Pengelola
SITI ROHMAH, Amd.kep NTKK. 6202 1046
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT RUTIN/APBD ( LPLPO ) PUSTU/SUB UNIT PUSTU/SUB UNIT : TANJUNGAN 1 PUSKESMAS : CIKEUSIK KECAMATAN : CIKEUSIK KABUPATEN : PANDEGLANG PROPINSI : BANTEN
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT
PELAPORAN BULAN : agustus PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
0 0 0 0 0 10 10 0 85 0 0 0 0 0 40 10 0 0 0 0 0 0 3 30 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 50 0 0 300 0 0 10 0 0 200 10 0 0 0 0 0 0 3 100 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 60 10 0 385 0 0 10 0 0 240 20 0 0 0 0 0 0 6 130 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
0 0 30 0 0 0 0 0 20 0 0 60 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 80 0 0 0 0 0 120 0 0 260 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
0 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 150 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 4 0 0 0 0 0 0 0 0 0 0 0
6 0 4 0 0 0 0 0 0 0 0 0 0 0
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
0 0 20 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 50 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 1 0 0 0 0 0 0 0
0 0 120 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 150 0 0 0 1 0 0 0 0 0 0 0
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
0 0 0 0
0 0 0 0
0 0 0 0
4 0 0 0 0 0 20 0 0 0 0 20 0 0
5 0 0 0 0 0 100 0 0 0 0 100 0 50
6 0 0 0 0 0 120 0 0 0 0 120 0 50
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN : agustus 2019 TAAN BULAN/PERIODE : septm PEMAKAIAN 0 0 0 0 0 40 30 0 265 0 0 10 0 0 210 10 0 0 0 0 0 0 0 90 20 0 0 0 185 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 50 50 -20 0 0 0 0 0 120 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 200 200 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 3 3 40 100 100 0 0 0 0 0 0 0 0 0 0 0 0 60 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 5 5 0 0 0
0 10 30 0 0 0 0 0 80 0 0 170 0 0 0 0 0 0
0 -10 50 0 0 0 0 0 40 0 0 90 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 70 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
7 0 4 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 4 0 0 0 0 0 0 0 0 0 0 0
10 0 4 0 0 0 0 0 0 0 0 0 0 0
0 0 80 0 0 0 0 0 0 0 0 18 145 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 80 70 0 0 0 1 0 0 0 0 0 0 0
0 0 40 0 0 0 0 0 0 0 0 -18 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -20 0 0 0 0 0 0 0 0 0 0 0 0 0 50 80 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0 0 0 80 0 0 0 0 80 0 50
8 0 0 0 0 0 40 0 0 0 0 40 0 0
9 0 0 0 0 0 100 0 0 0 0 100 0 50
10 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Yang Meminta : Pengelola
SITI ROHMAH, Amd.kep NTKK. 6202 1046
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT RUTIN/APBD ( LPLPO ) PUSTU/SUB UNIT PUSTU/SUB UNIT : TANJUNGAN 1 PUSKESMAS : CIKEUSIK KECAMATAN : CIKEUSIK KABUPATEN : PANDEGLANG PROPINSI : BANTEN
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT PELAPORAN BULAN : septm PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
0 0 0 0 0 10 10 0 85 0 0 0 0 0 40 10 0 0 0 0 0 0 3 30 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 50 0 0 300 0 0 10 0 0 200 10 0 0 0 0 0 0 3 100 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 60 10 0 385 0 0 10 0 0 240 20 0 0 0 0 0 0 6 130 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
0 0 30 0 0 0 0 0 20 0 0 60 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 80 0 0 0 0 0 120 0 0 260 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
0 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 150 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 4 0 0 0 0 0 0 0 0 0 0 0
6 0 4 0 0 0 0 0 0 0 0 0 0 0
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
0 0 20 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 50 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 1 0 0 0 0 0 0 0
0 0 120 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 150 0 0 0 1 0 0 0 0 0 0 0
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
0 0 0 0
0 0 0 0
0 0 0 0
4 0 0 0 0 0 20 0 0 0 0 20 0 0
5 0 0 0 0 0 100 0 0 0 0 100 0 50
6 0 0 0 0 0 120 0 0 0 0 120 0 50
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN : septm 2019 TAAN BULAN/PERIODE : oktobr PEMAKAIAN 0 0 0 0 0 40 30 0 265 0 0 10 0 0 210 10 0 0 0 0 0 0 0 90 20 0 0 0 185 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 50 50 -20 0 0 0 0 0 120 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 200 200 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 3 3 40 100 100 0 0 0 0 0 0 0 0 0 0 0 0 60 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 5 5 0 0 0
0 10 30 0 0 0 0 0 80 0 0 170 0 0 0 0 0 0
0 -10 50 0 0 0 0 0 40 0 0 90 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 70 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
7 0 4 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 4 0 0 0 0 0 0 0 0 0 0 0
10 0 4 0 0 0 0 0 0 0 0 0 0 0
0 0 80 0 0 0 0 0 0 0 0 18 145 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 80 70 0 0 0 1 0 0 0 0 0 0 0
0 0 40 0 0 0 0 0 0 0 0 -18 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -20 0 0 0 0 0 0 0 0 0 0 0 0 0 50 80 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0 0 0 80 0 0 0 0 80 0 50
8 0 0 0 0 0 40 0 0 0 0 40 0 0
9 0 0 0 0 0 100 0 0 0 0 100 0 50
10 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Yang Meminta : Pengelola
SITI ROHMAH, Amd.kep NTKK. 6202 1046
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT RUTIN/APBD ( LPLPO ) PUSTU/SUB UNIT PUSTU/SUB UNIT : TANJUNGAN 1 PUSKESMAS : CIKEUSIK KECAMATAN : CIKEUSIK KABUPATEN : PANDEGLANG PROPINSI : BANTEN
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT
PELAPORAN BULAN : okrobe PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
0 0 0 0 0 10 10 0 85 0 0 0 0 0 40 10 0 0 0 0 0 0 3 30 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 50 0 0 300 0 0 10 0 0 200 10 0 0 0 0 0 0 3 100 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 60 10 0 385 0 0 10 0 0 240 20 0 0 0 0 0 0 6 130 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
0 0 30 0 0 0 0 0 20 0 0 60 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 80 0 0 0 0 0 120 0 0 260 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
0 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 150 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 4 0 0 0 0 0 0 0 0 0 0 0
6 0 4 0 0 0 0 0 0 0 0 0 0 0
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
0 0 20 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 50 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 1 0 0 0 0 0 0 0
0 0 120 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 150 0 0 0 1 0 0 0 0 0 0 0
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
0 0 0 0
0 0 0 0
0 0 0 0
4 0 0 0 0 0 20 0 0 0 0 20 0 0
5 0 0 0 0 0 100 0 0 0 0 100 0 50
6 0 0 0 0 0 120 0 0 0 0 120 0 50
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN : okrober 2019 TAAN BULAN/PERIODE : november PEMAKAIAN 0 0 0 0 0 40 30 0 265 0 0 10 0 0 210 10 0 0 0 0 0 0 0 90 20 0 0 0 185 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 50 50 -20 0 0 0 0 0 120 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 200 200 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 3 3 40 100 100 0 0 0 0 0 0 0 0 0 0 0 0 60 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 5 5 0 0 0
0 10 30 0 0 0 0 0 80 0 0 170 0 0 0 0 0 0
0 -10 50 0 0 0 0 0 40 0 0 90 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 70 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
7 0 4 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 4 0 0 0 0 0 0 0 0 0 0 0
10 0 4 0 0 0 0 0 0 0 0 0 0 0
0 0 80 0 0 0 0 0 0 0 0 18 145 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 80 70 0 0 0 1 0 0 0 0 0 0 0
0 0 40 0 0 0 0 0 0 0 0 -18 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -20 0 0 0 0 0 0 0 0 0 0 0 0 0 50 80 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0 0 0 80 0 0 0 0 80 0 50
8 0 0 0 0 0 40 0 0 0 0 40 0 0
9 0 0 0 0 0 100 0 0 0 0 100 0 50
10 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Yang Meminta : Pengelola
SITI ROHMAH, Amd.kep NTKK. 6202 1046
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT RUTIN/APBD ( LPLPO ) PUSTU/SUB UNIT PUSTU/SUB UNIT : TANJUNGAN 1 PUSKESMAS : CIKEUSIK KECAMATAN : CIKEUSIK KABUPATEN : PANDEGLANG PROPINSI : BANTEN
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT
PELAPORAN BULAN : desemb PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
0 0 0 0 0 10 10 0 85 0 0 0 0 0 40 10 0 0 0 0 0 0 3 30 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 50 0 0 300 0 0 10 0 0 200 10 0 0 0 0 0 0 3 100 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 60 10 0 385 0 0 10 0 0 240 20 0 0 0 0 0 0 6 130 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
0 0 30 0 0 0 0 0 20 0 0 60 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 80 0 0 0 0 0 120 0 0 260 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
0 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 150 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 4 0 0 0 0 0 0 0 0 0 0 0
6 0 4 0 0 0 0 0 0 0 0 0 0 0
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
0 0 20 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 50 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 1 0 0 0 0 0 0 0
0 0 120 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 150 0 0 0 1 0 0 0 0 0 0 0
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
0 0 0 0
0 0 0 0
0 0 0 0
4 0 0 0 0 0 20 0 0 0 0 20 0 0
5 0 0 0 0 0 100 0 0 0 0 100 0 50
6 0 0 0 0 0 120 0 0 0 0 120 0 50
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN : desembr 2019 TAAN BULAN/PERIODE : januari PEMAKAIAN 0 0 0 0 0 40 30 0 265 0 0 10 0 0 210 10 0 0 0 0 0 0 0 90 20 0 0 0 185 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 50 50 -20 0 0 0 0 0 120 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 200 200 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 3 3 40 100 100 0 0 0 0 0 0 0 0 0 0 0 0 60 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 5 5 0 0 0
0 10 30 0 0 0 0 0 80 0 0 170 0 0 0 0 0 0
0 -10 50 0 0 0 0 0 40 0 0 90 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 70 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
7 0 4 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 4 0 0 0 0 0 0 0 0 0 0 0
10 0 4 0 0 0 0 0 0 0 0 0 0 0
0 0 80 0 0 0 0 0 0 0 0 18 145 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 80 70 0 0 0 1 0 0 0 0 0 0 0
0 0 40 0 0 0 0 0 0 0 0 -18 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -20 0 0 0 0 0 0 0 0 0 0 0 0 0 50 80 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0 0 0 80 0 0 0 0 80 0 50
8 0 0 0 0 0 40 0 0 0 0 40 0 0
9 0 0 0 0 0 100 0 0 0 0 100 0 50
10 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Yang Meminta : Pengelola
SITI ROHMAH, Amd.kep NTKK. 6202 1046
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT RUTIN/APBD ( LPLPO ) PUSTU/SUB UNIT PUSTU/SUB UNIT : TANJUNGAN 1 PUSKESMAS : CIKEUSIK KECAMATAN : CIKEUSIK KABUPATEN : PANDEGLANG PROPINSI : BANTEN
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT
PELAPORAN BULAN : februar PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
0 0 0 0 0 10 10 0 85 0 0 0 0 0 40 10 0 0 0 0 0 0 3 30 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 50 0 0 300 0 0 10 0 0 200 10 0 0 0 0 0 0 3 100 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 60 10 0 385 0 0 10 0 0 240 20 0 0 0 0 0 0 6 130 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
0 0 30 0 0 0 0 0 20 0 0 60 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 80 0 0 0 0 0 120 0 0 260 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
0 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 150 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 4 0 0 0 0 0 0 0 0 0 0 0
6 0 4 0 0 0 0 0 0 0 0 0 0 0
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
0 0 20 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 50 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 1 0 0 0 0 0 0 0
0 0 120 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 150 0 0 0 1 0 0 0 0 0 0 0
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
0 0 0 0
0 0 0 0
0 0 0 0
4 0 0 0 0 0 20 0 0 0 0 20 0 0
5 0 0 0 0 0 100 0 0 0 0 100 0 50
6 0 0 0 0 0 120 0 0 0 0 120 0 50
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN : februari 2019 TAAN BULAN/PERIODE : maret PEMAKAIAN 0 0 0 0 0 40 30 0 265 0 0 10 0 0 210 10 0 0 0 0 0 0 0 90 20 0 0 0 185 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 50 50 -20 0 0 0 0 0 120 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 200 200 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 3 3 40 100 100 0 0 0 0 0 0 0 0 0 0 0 0 60 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 5 5 0 0 0
0 10 30 0 0 0 0 0 80 0 0 170 0 0 0 0 0 0
0 -10 50 0 0 0 0 0 40 0 0 90 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 70 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
7 0 4 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 4 0 0 0 0 0 0 0 0 0 0 0
10 0 4 0 0 0 0 0 0 0 0 0 0 0
0 0 80 0 0 0 0 0 0 0 0 18 145 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 80 70 0 0 0 1 0 0 0 0 0 0 0
0 0 40 0 0 0 0 0 0 0 0 -18 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -20 0 0 0 0 0 0 0 0 0 0 0 0 0 50 80 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0 0 0 80 0 0 0 0 80 0 50
8 0 0 0 0 0 40 0 0 0 0 40 0 0
9 0 0 0 0 0 100 0 0 0 0 100 0 50
10 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Yang Meminta : Pengelola
SITI ROHMAH, Amd.kep NTKK. 6202 1046
PEMERINTAH KABUPATEN PANDEGLANG DINAS KESEHATAN
Saldo per 31 Desember 2018
UPT. PUSKESMAS CIKEUSIK Alamat : Jl. Alun-alun Selatan No.4 Cikeusik-Pandeglang. Kode pos 42286 NO
NAMA / JENIS BARANG
SATUAN
I
OBAT-OBATAN (APBD)
1
PUSTU TANJUNGAN 1
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Feranc
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml
Btl
HARGA SATUAN (Rp)
JUMLAH KUANTITAS PERSEDIAAN Opname Fisik
Mutasi (+)
(-)
Saldo 31/12/2018
Nilai Persediaan 31/12/2018
99
#REF!
#REF!
#REF!
91
#REF!
#REF!
#REF!
404
#REF!
#REF!
#REF!
3,245
#REF!
#REF!
#REF!
167
#REF!
#REF!
#REF!
93
#REF!
#REF!
#REF!
70
#REF!
#REF!
#REF!
2,702,700
#REF!
#REF!
#REF!
233
#REF!
#REF!
#REF!
1,881
#REF!
#REF!
#REF!
801,000
#REF!
#REF!
#REF!
3,400
#REF!
#REF!
#REF!
#REF!
#REF!
11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte
Tab
13 Ampisillin Injeksi 1 gram
Vial
3,850
#REF!
14 Antalgin (Metampiron) Tab. 500 mg
Tab
205
#REF!
#REF!
#REF!
15 Antasida DOEN tablet
Tab
54
#REF!
#REF!
#REF!
16 Antasida DOEN suspensi
Btl
1,923
#REF!
#REF!
#REF!
17 Anti Bakteri DOEN Salep Kombinasi (basitrasin)
Tube
3,035
#REF!
#REF!
#REF!
18 Anti Hemoroid DOEN Kombinasi
Supp
3,167
#REF!
#REF!
#REF!
19 Antifungi DOEN Kombinasi
Pot
3,035
#REF!
#REF!
#REF!
20 Antimigren DOEN Kombinasi
Tab
135
#REF!
#REF!
#REF!
21 Antiparkinson DOEN tab. Kombinasi
Tab
1,500
#REF!
#REF!
#REF!
22 Aqua roinjek Steril
Btl
2,860
#REF!
#REF!
#REF!
8,800
#REF!
#REF!
#REF!
237
#REF!
#REF!
#REF!
380
#REF!
#REF!
#REF!
450
#REF!
#REF!
#REF!
305
#REF!
#REF!
#REF!
#REF!
#REF!
23 Acyclopir Krim 5%- 5gr
Tube
24 Acyclopir Tablet 200mg
Tab
25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet
Tab
27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet
Tab
130
#REF!
29 Asam Mefenamat 500mg
Tab
103
#REF!
#REF!
#REF!
30 Alprazolam 1mg
Tab
233
#REF!
#REF!
#REF!
31 Ambroksol tab
tab
169
#REF!
#REF!
#REF!
32 Ambroksol syr
Btl
9,883
#REF!
#REF!
#REF!
33 Asam Askorbat (Vit. C) Tablet 50 mg
Tab
105
#REF!
#REF!
#REF!
34 Asering Infus
Tab
9,646
#REF!
#REF!
#REF!
35 Asam Folat tablet 01mg
Tab
63
#REF!
#REF!
#REF!
36 Asam Folat tablet 5 mg
Tab
55
#REF!
#REF!
#REF!
37 Artesunat Inj
Vial
14,250
#REF!
#REF!
#REF!
38 Asam traneksamat Inj 5 %
Amp
24,449
#REF!
#REF!
#REF!
39 Asetosal Tablet 500 mg
Tab
#REF!
#REF!
#REF!
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml
Amp
1,595
#REF!
#REF!
#REF!
41 Atropin Sulfat Tablet 0,5 mg
Tab
74
#REF!
#REF!
#REF!
42 Atropin Sulfat Tetes Mata 1% - 5 ml
Btl
-
#REF!
#REF!
#REF!
43 Alkohol 70% 1 Liter
Btl
#REF!
#REF!
-
24,992
#REF!
44 Betadin Salf Antiseptik
Tube
7,039
#REF!
#REF!
#REF!
45 Betametason Krim 0,1% - 5 gr
Tube
1,349
#REF!
#REF!
#REF!
46 Bisacodril sup
Supp
5,800
#REF!
#REF!
#REF!
650
#REF!
#REF!
#REF!
47 Bisoprolol 2,5mg tab
Tab
48 Captopril Tablet 12,5 mg
Tab
62
#REF!
#REF!
49 Captopril Tablet 25 mg
#REF!
Tab
72
#REF!
#REF!
#REF!
50 Carbamazefine
Tab
269
#REF!
#REF!
#REF!
51 Cefadroxil 500mg
Tab
516
#REF!
#REF!
#REF!
52 Cetrizin syr
Btl
2,849
#REF!
#REF!
#REF!
53 Cefixim
Tab
590
#REF!
#REF!
#REF!
54 Ciprofloxacin Infus
Btl
39,900
#REF!
#REF!
#REF!
55 Ciprofloxacin Tablet 500mg
Tab
255
#REF!
#REF!
#REF!
56 D-Artepp Tab
Tab
1,000
#REF!
#REF!
#REF!
57 Deksametasone Injeksi 5 mg/ml - 1ml
Amp
1,097
#REF!
#REF!
#REF!
58 Deksametasone Tablet 0,5 mg
Tab
32
#REF!
#REF!
#REF!
59 Dekstromethorfan Sirup 10 mg/ 60 ml
Btl
6,600
#REF!
#REF!
#REF!
11,516
#REF!
#REF!
#REF!
17,350
#REF!
#REF!
#REF!
#REF!
#REF!
60 Diazetpam Rectal 2mg
Tube
61 Diazepam Injeksi 5 mg/ml - 2ml
Amp
62 Diazepam Tablet 2 mg
Tab
45
#REF!
63 Diazepam Tablet 5 mg
Tab
-
#REF!
#REF!
#REF!
64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
-
#REF!
#REF!
#REF!
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml
Amp
1,176
#REF!
#REF!
#REF!
66 Digoksin Tablet 0,25 mg
Tab
105
#REF!
#REF!
#REF!
67 Domperidon 10 mgtablet
Tab
85
#REF!
#REF!
#REF!
68 Dimenhidrinat Tablet 50 mg
Tab
-
#REF!
#REF!
#REF!
69 Dasabion Tablet
Tab
-
#REF!
#REF!
#REF!
70 Domperidon Suspensi 5mg/ 5ml- 60ml
Btl
3,333
#REF!
#REF!
#REF!
71 Efedrin HCL Tablet 25 mg
Tab
51
#REF!
#REF!
#REF!
72 Ekstrak Belladona Tablet 10 mg
Tab
31
#REF!
#REF!
#REF!
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml
Amp
1,408
#REF!
#REF!
#REF!
1,800
#REF!
#REF!
#REF!
448
#REF!
#REF!
#REF!
375
#REF!
#REF!
#REF!
#REF!
#REF!
74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Btl
75 Lisinofril 10 mg
Tab
76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml
Btl
2,500
#REF!
78 Eritromisin Kapsul 500 mg
Kap
730
#REF!
#REF!
#REF!
79 Eritromisin Syrup 200 mg/5 ml-60 ml
Btl
6,700
#REF!
#REF!
#REF!
80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Amp
-
#REF!
#REF!
#REF!
81 Fenitoin Natrium Kapsul 100 mg
Kap
154
#REF!
#REF!
#REF!
82 Fenitoin Natrium Kapsul 30 mg
Kap
-
#REF!
#REF!
#REF!
83 Fenobarbital Injeksi- 2ml
Amp
1,740
#REF!
#REF!
#REF!
84 Fenobarbital Tablet 30 mg
Tab
165
#REF!
#REF!
#REF!
85 Fenobarbital Tablet 30 mg
Tab
-
#REF!
#REF!
#REF!
86 Fenoksimetil Penisilina Tablet 250 mg
Tab
-
#REF!
#REF!
#REF!
87 Fluflenazine decanoat inj 25mg/ml
Amp
57,500
#REF!
#REF!
#REF!
88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
3,550
#REF!
#REF!
#REF!
89 Fitomenadion (Vit. K1) Tab. 10 mg
Tab
710
#REF!
#REF!
#REF!
90 Gentamisin SM
Tube
2,600
#REF!
#REF!
#REF!
91 Furosemida Tablet 40 mg
Tab
75
#REF!
#REF!
#REF!
92 Garam Oralit 200 ml air
Ktg
264
#REF!
#REF!
#REF!
93 Glimepirid 2mg Tablet
Tab
288
#REF!
#REF!
#REF!
94 Glibenklamida Tablet 5 mg
Tab
119
#REF!
#REF!
#REF!
95 Asetil Sistein 200mg
Tab
358
#REF!
#REF!
#REF!
96 Glikazid 80 mg
Btl
235
#REF!
#REF!
#REF!
97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
6,900
#REF!
#REF!
#REF!
98 Glukosa Lar. Infus 10% Steril - 500 ml
Btl
5,700
#REF!
#REF!
#REF!
99 Griseofulvin Tablet 500 mg,
Tab
2,200
#REF!
#REF!
#REF!
100 Griseofulvin Tablet 125 mg, Micron
Tab
210
#REF!
#REF!
#REF!
101 Gentamisin S.K 0.1%-5 gr
Tube
2,800
#REF!
#REF!
#REF!
102 Gentamisin Injeksi
Vial
3,696
#REF!
#REF!
#REF!
103 Haloperidol 2 mg Tablet
Tab
126
#REF!
#REF!
#REF!
104 Haloperidol 5 mg Tablet
Tab
96
#REF!
#REF!
#REF!
105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr
Tab
107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg
Tab
109 Ibufropen syr
Btl
149
#REF!
#REF!
#REF!
2,639
#REF!
#REF!
#REF!
105
#REF!
#REF!
#REF!
205
#REF!
#REF!
#REF!
3,499
#REF!
#REF!
#REF!
9,750
#REF!
#REF!
#REF!
89
#REF!
#REF!
#REF!
2,545
#REF!
#REF!
#REF!
270
#REF!
#REF!
#REF!
#REF!
#REF!
110 Haloporidol Decanoate Inj 50mg
Amp
111 Isosorbid Dinitrat Tab. Sub. 5 mg
Tab
112 Ketokonazol krem
Tube
113 Ketokonazol tab 200mg
Tab
114 Ketorolac Inj 30mg
Vial
1,045
#REF!
115 Kalsium Laktat (Kalk) Tablet 500 mg
Tab
59
#REF!
#REF!
#REF!
116 KN-3B
Labu
10,050
#REF!
#REF!
#REF!
117 Karbihidrat +Elektrolit
Labu
1,007
#REF!
#REF!
#REF!
Btl
2,500
#REF!
#REF!
#REF!
119 Kloramfenikol tetes Mata
Btl
3,250
#REF!
#REF!
#REF!
120 Klorfeniramin Maleat (CTM) Tab. 4 mg
Tab
22
#REF!
#REF!
#REF!
121 Klozapine 25 Mg
Tab
1,121
#REF!
#REF!
#REF!
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml
Amp
-
#REF!
#REF!
#REF!
123 Klorpromazin HCL Tablet Salut 25 mg
Tab
148
#REF!
#REF!
#REF!
124 Klorpromazin HCL Tablet Salut 100 mg
Tab
147
#REF!
#REF!
#REF!
125 klorpeson Slasf
tube
7,750
#REF!
#REF!
#REF!
-
#REF!
#REF!
#REF!
125
#REF!
#REF!
#REF!
2,052
#REF!
#REF!
#REF!
#REF!
#REF!
118 Karbogliserin Tetes telinga
126 Komb. Artesunate 50mg+Amodiaquin 200mg
Pkt
127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi
Btl
129 Metpormin 500mg
Tab
100
#REF!
130 Methyilprednisolon 8mg
Tab
150
#REF!
#REF!
#REF!
131 Kloramfenikol Salep Mata 1%-5gram
Tube
1,881
#REF!
#REF!
#REF!
132 Kloramfenikol Tetes Telinga 3%-5ml
Btl
1,797
#REF!
#REF!
#REF!
Amp
6,200
#REF!
#REF!
#REF!
134 Levoploxasin 500mh
Dus
528
#REF!
#REF!
#REF!
135 Lidokain Komp. Injeksi, Kombinasi
Amp
1,140
#REF!
#REF!
#REF!
136 Lisol, Kresol Tersabun 50%- 1000ml
Btl
3,360
#REF!
#REF!
#REF!
137 Loperamide Hcl 2mg Tanlet
Tab
85
#REF!
#REF!
#REF!
138 Magnesium Sulfat Injk 25 ml
Vial
3,328
#REF!
#REF!
#REF!
139 Metamizol 500mg
Tab
473
#REF!
#REF!
#REF!
140 Metilergometrin Maleat Tab. 0,125 g
Tab
210
#REF!
#REF!
#REF!
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
2,840
#REF!
#REF!
#REF!
142 Metoklorpropamid Tablet 10 mg
Tab
91
#REF!
#REF!
#REF!
143 Mikonazol Krim/ Salep 2%-10gram
Tube
3,414
#REF!
#REF!
#REF!
#REF!
#REF!
133 Kuinin Injeksi 25%-2ml
144 Multivitamin Anak
Btl
12,100
#REF!
145 Multivitamin Dewasa
Tab
1,316
#REF!
#REF!
#REF!
146 Metronidazol Infus 500mg/100ml
Btl
9,950
#REF!
#REF!
#REF!
147 Metronidazol Tablet 500mg
Tab
113
#REF!
#REF!
#REF!
148 Metokloramid Syr
Btl
2,345
#REF!
#REF!
#REF!
149 Metronidazol syr
Btl
3,799
#REF!
#REF!
#REF!
150 Natrium Bikarbonat Tablet 500mg
Tab
514
#REF!
#REF!
#REF!
151 Natrum Klorida Lar. Inf. 0,9% -500ml
Btl
6,410
#REF!
#REF!
#REF!
145
#REF!
#REF!
#REF!
480
#REF!
#REF!
#REF!
-
#REF!
#REF!
#REF!
115
#REF!
#REF!
#REF!
108
#REF!
#REF!
#REF!
1,440
#REF!
#REF!
#REF!
317,018
#REF!
#REF!
#REF!
#REF!
#REF!
152 Natrium Diclopenac 20mg
Amp
153 Nistatin Vaginal
sup
154 Nistatin Tablet Salut 500.000 IU
tab
155 Natrium Diclopenac 50mg
Tab
156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan
Tab
158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Pkt
159 Obat Anti Tuberkulosis Kat. 2
Pkt
1,297,894
#REF!
160 Obat Anti Tuberkulosis Kat.Anak
Pkt
214,985
#REF!
#REF!
#REF!
161 Ofloksasin Tetes telinga
Btl
45,089
#REF!
#REF!
#REF!
162 Omeprazol inj 40mg/10ml
Btl
16,997
#REF!
#REF!
163 Omeprazol Kapsul 20mg
Kap
#REF!
130
#REF!
#REF!
164 Ondansetron Inj 4mg
Vial
#REF!
1,660
#REF!
#REF!
165 Onadansetron 8mg Tablet
Tab
#REF!
1,189
#REF!
#REF!
166 Onadansetron 4mg Tablet
Tab
#REF!
471
#REF!
#REF!
167 Obat Batuk Flu Dewasa
Pkt
#REF!
413
#REF!
#REF!
168 Obat Batuk Hitam (OBH) Cairan
Btl
#REF!
5,000
#REF!
#REF!
169 Obat Batuk Dewasa syr
Btl
#REF!
5,500
#REF!
#REF!
170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Vial
#REF!
7,840
#REF!
#REF!
171 Oksitetrasiklin HCL SM 1%-3,5gram
Tube
#REF!
1,920
#REF!
#REF!
172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
#REF!
1,545
#REF!
#REF!
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
#REF!
1,199
#REF!
#REF!
#REF!
174 OBAT Anti Diare suspensi
Btl
6,500
#REF!
#REF!
#REF!
175 parasetamol drops 15 ml
btl
6,649
#REF!
#REF!
#REF!
176 Parasetamol Syrup 120mg/ 5ml-60ml
Btl
1,107
#REF!
#REF!
#REF!
177 Parasetamol tab 100mg
Tab
41
#REF!
#REF!
#REF!
178 Parasetamol Tablet 500mg
Tab
53
#REF!
#REF!
#REF!
179 Permetin Krim/Skabisid 5 %
Tube
12,155
#REF!
#REF!
#REF!
9,700
#REF!
#REF!
#REF!
291
#REF!
#REF!
#REF!
234
#REF!
#REF!
#REF!
105
#REF!
#REF!
#REF!
319
#REF!
#REF!
#REF!
123
#REF!
#REF!
#REF!
17,996
#REF!
#REF!
#REF!
#REF!
#REF!
180 pirantel syr
Btl
181 Pirantel Tablet 125mg
Tab
182 piroksikam Tablet 10 mg
Tab
183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg
Tab
185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml
Btl
187 Povidon Iodida 10% 1000ml
Btl
-
#REF!
188 Prednison Tablet 5mg
Tab
68
#REF!
#REF!
#REF!
189 Primakuin Tablet 15mg
Tab
224
#REF!
#REF!
#REF!
190 Prokain Benzil Penisilin 3 Juta IU Inj.
Vial
6,016
#REF!
#REF!
#REF!
191 propanolol HCL Tablet 10mg
Tab
60
#REF!
#REF!
#REF!
192 Propanolol HCL Tablet 40mg
Tab
121
#REF!
#REF!
#REF!
6,550
#REF!
#REF!
#REF!
284
#REF!
#REF!
#REF!
505
#REF!
#REF!
#REF!
30,595
#REF!
#REF!
#REF!
9,770
#REF!
#REF!
#REF!
347
#REF!
#REF!
#REF!
1,155
#REF!
#REF!
#REF!
105
#REF!
#REF!
#REF!
#REF!
#REF!
193 Povidon Iodida 10% 60ml
Botol
194 Retinol (Vitamin A) Kapsul 100.000 IU
Kap
195 Retinol (Vitamin A) Kapsul 200.000 IU
Kap
196 MDT MB/ Kusta Dewasa
Blister
197 MDT PB/ Kusta Dewasa
Blister
198 Risperidon 2mg
Tab
199 Ranitidin Injeksi 25 mg/ 2ml
Vial
200 Ranitidin Tablet 150 mg
Tab
201 Ringer Laktat Lar. Inf. Steril - 500ml
Btl
7,150
#REF!
202 Salbutamol Tablet 2mg
Tab
63
#REF!
#REF!
#REF!
203 Salbutamol Tablet 4mg
Tab
70
#REF!
#REF!
#REF!
204 Salep 2-4, Kombinasi
Pot
2,621
#REF!
#REF!
#REF!
205 Salisil Bedak 2%
Ktk
1,025
#REF!
#REF!
#REF!
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
479,996
#REF!
#REF!
#REF!
23,540
#REF!
#REF!
#REF!
170,000
#REF!
#REF!
#REF!
368
#REF!
#REF!
#REF!
1,035
#REF!
#REF!
#REF!
205
#REF!
#REF!
#REF!
110
#REF!
#REF!
#REF!
8,338
#REF!
#REF!
#REF!
3,226
#REF!
#REF!
#REF!
110
#REF!
#REF!
#REF!
#REF!
#REF!
207 Stimuno
Botol
208 Serum Anti Tetanus Inj. 1500 IU/amp.
Amp
209 Sukrafat 500mg
Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg
Amp
211 Simvastatin Tablet 20 mg
Tab
212 Simvastatin Tablet 10 mg
Tab
213 Sukralfat Syr 214 Sulfasetamida Natrium TM 15%- 5ml
Botol Btl
215 Sabutamol Nebulizer
Amp
216 Spiranolakton tab
tab
217 Salf Kombinasi 218 Sinbio
899
#REF!
Tube
11,000
#REF!
#REF!
#REF!
Set
4,500
#REF!
#REF!
#REF!
219 Setrizin tablet 10 mg
Tab
220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml
Btl
222 Tetrasiklin HCL Kapsul 250 mg
Kap
223 Tetrasiklin HCL Kapsul 500 mg
Kap
224 Tiamin HCL/(Vit. B1) Tab. 50mg
Tab
225 Tiopental Natrium Serbuk Inj 1.000mg
Amp
226 Vitalex (penambah darah)kapsul
Tab
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml
vial
228 Triheksifenidil Hidroklorida Tab. 2mg
Tab
229 Vitamin B Komplek Tablet
Tab
230 Zink Syr 231 Zink Tablet 20mg
Botol Tab
90
#REF!
#REF!
#REF!
352
#REF!
#REF!
#REF!
-
#REF!
#REF!
#REF!
163
#REF!
#REF!
#REF!
300
#REF!
#REF!
#REF!
85
#REF!
#REF!
#REF!
1,455
#REF!
#REF!
#REF!
88
#REF!
#REF!
#REF!
1,455
#REF!
#REF!
#REF!
88
#REF!
#REF!
#REF!
118
#REF!
#REF!
#REF!
2,972
#REF!
#REF!
#REF!
514
#REF!
#REF!
#REF!
#REF!
#REF!
#REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF!
JML 2
BARANG HABIS PAKAI
1
Alat Suntik Sekali Pakai 1 ml
Set
777
#REF!
#REF!
2
Alat Suntik Sekali Pakai 3 ml
Set
825
#REF!
#REF!
3
Alat Suntik Sekali Pakai 5 ml
Set
856
#REF!
#REF!
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
60,622
#REF!
#REF!
5
I.V. Catheter No. 20
Set
4,783
#REF!
#REF!
6
I.V. Catheter No. 22
Set
12,232
#REF!
#REF!
7
I.V. Catheter No. 24
Set
4,784
#REF!
#REF!
8
I.V. Cateter No 26
set
13,464
#REF!
#REF!
9
Infusion Set Anak
Set
3,498
#REF!
#REF!
10 Infusion Set Dewasa
Set
4,147
#REF!
#REF!
11 E.Care Film I.V Dresing
Pcs
6,850
#REF!
#REF!
12 Silk (Benang Bedah Sutera) No. 3/0
Biji
44,953
#REF!
#REF!
Botol
72,047
#REF!
#REF!
13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram
Set
12,250
#REF!
#REF!
lembar
1,800
#REF!
#REF!
16 Kasa Pembalut 2 m x 80 cm
pak
9,400
#REF!
#REF!
17 Kasa Pembalut Hidrofil 36 m x 80 cm
rol
127,600
#REF!
#REF!
15 Kasa Kompres 40/40
18 Kasa Steril 16/16
7,370
#REF!
#REF!
19 Masker
biji
549
#REF!
#REF!
20 Plester 5 yard x 2 inch
rol
8,167
#REF!
#REF!
kotak
21 Sarung Tangan No 7 Steril
pasang
792
#REF!
#REF!
22 Sarung Tangan No 6.5 Steril
pasang
7,931
#REF!
#REF!
23 Sarung tangan no 6 1/2
Pasng
924
#REF!
#REF!
24 Folly cateter No 16
Pcs
12,036
#REF!
#REF!
25 Folly cateter No 14
Pcs
16,610
#REF!
#REF!
Sashet
17,748
#REF!
#REF!
bok
32,600
#REF!
#REF!
28 Underpad
Lembar
4,162
#REF!
#REF!
29 Urine Bag
Biji
7,038
#REF!
#REF!
30 Catgut/ Benang Bedah No. 3/0
Botol
68,433
#REF!
#REF!
31 Antiseptik Surgical Hand Scrab
Botol
74,000
#REF!
#REF!
32 Cairan pembersih
Botol
22,000
#REF!
#REF!
33 Jely kateter
biji
41,600
#REF!
#REF!
34 Jarum Insulin
Biji
2,083
#REF!
#REF!
26 Sarung tangan Gynecolog no 7 27 Alkohol Swab
JML
#REF!
ber
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT
PELAPORAN BULAN : JANUA PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
0 0 0 0 0 0 40 0 50 0 0 0 0 0 50 0 0 0 0 0 0 0 0 20 20 0 0 0 30 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 50 0 0 300 0 0 10 0 0 200 10 0 0 0 0 0 0 3 100 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 50 40 0 350 0 0 10 0 0 250 10 0 0 0 0 0 0 3 120 20 0 0 0 230 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 5 0
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
0 10 10 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 10 60 0 0 0 0 0 100 0 0 230 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 510 0 0 0 0 0
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
0 0 0 0 20 0 0 0 0 0 0 0 0 0 20 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 20 5 0 0 0 0 0 0 50 0 120 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 120 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 4 0 0 0 0 0 0 0 0 0 0 0
6 0 4 0 0 0 0 0 0 0 0 0 0 0
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
0 0 0 0 0 0 0 0 0 0 0 18 20 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 10 20 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 18 170 0 0 0 0 0 2 0 0 10 0 170 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 110 120 0 0 0 1 0 0 0 0 0 0 0
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
0 0 0 0
0 0 0 0
0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 0 0 0 0 100 0 0 0 0 100 0 50
6 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN : JANUARI 2019 TAAN BULAN/PERIODE : februari PEMAKAIAN 0 0 0 0 0 40 30 0 265 0 0 10 0 0 210 10 0 0 0 0 0 0 0 90 20 0 0 0 185 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 50 50 10 0 0 0 0 0 85 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 200 200 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 3 3 30 100 100 0 0 0 0 0 0 0 0 0 0 0 0 45 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 5 5 0 0 0
0 10 30 0 0 0 0 0 80 0 0 170 0 0 0 0 0 0
0 0 30 0 0 0 0 0 20 0 0 60 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 70 0
0 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
7 0 4 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 4 0 0 0 0 0 0 0 0 0 0 0
10 0 4 0 0 0 0 0 0 0 0 0 0 0
0 0 80 0 0 0 0 0 0 0 0 18 145 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 80 70 0 0 0 1 0 0 0 0 0 0 0
0 0 20 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 50 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0 0 0 80 0 0 0 0 80 0 50
8 0 0 0 0 0 20 0 0 0 0 20 0 0
9 0 0 0 0 0 100 0 0 0 0 100 0 50
10 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Yang Meminta : Pengelola
SITI ROHMAH, Amd.kep NTKK. 6202 1046
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT RUTIN/APBD ( LPLPO ) PUSTU/SUB UNIT PUSTU/SUB UNIT : TANJUNGAN 1 PUSKESMAS : CIKEUSIK KECAMATAN : CIKEUSIK KABUPATEN : PANDEGLANG PROPINSI : BANTEN
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT
PELAPORAN BULAN : februar PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
4
5
6
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
4
5
6
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
4
5
6
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN : februari 2019 TAAN BULAN/PERIODE : maret PEMAKAIAN
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH
7
8
9
10
7
8
9
10
7
8
9
10
Yang Meminta : Pengelola
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT RUTIN/APBD ( LPLPO ) PUSTU/SUB UNIT PUSTU/SUB UNIT : TANJUNGAN 1 PUSKESMAS : CIKEUSIK KECAMATAN : CIKEUSIK KABUPATEN : PANDEGLANG PROPINSI : BANTEN
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT
PELAPORAN BULAN : maret 2 PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
0 0 0 0 0 10 10 0 85 0 0 0 0 0 40 10 0 0 0 0 0 0 3 30 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 50 0 0 300 0 0 10 0 0 200 10 0 0 0 0 0 0 3 100 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 60 10 0 385 0 0 10 0 0 240 20 0 0 0 0 0 0 6 130 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
0 0 30 0 0 0 0 0 20 0 0 60 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 80 0 0 0 0 0 120 0 0 260 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
0 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 150 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 4 0 0 0 0 0 0 0 0 0 0 0
6 0 4 0 0 0 0 0 0 0 0 0 0 0
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
0 0 20 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 50 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 1 0 0 0 0 0 0 0
0 0 120 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 150 0 0 0 1 0 0 0 0 0 0 0
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
0 0 0 0
0 0 0 0
0 0 0 0
4 0 0 0 0 0 20 0 0 0 0 20 0 0
5 0 0 0 0 0 100 0 0 0 0 100 0 50
6 0 0 0 0 0 120 0 0 0 0 120 0 50
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN : maret 2019 TAAN BULAN/PERIODE : april PEMAKAIAN 0 0 0 0 0 40 30 0 265 0 0 10 0 0 210 10 0 0 0 0 0 0 0 90 20 0 0 0 185 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 50 50 -20 0 0 0 0 0 120 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 200 200 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 3 3 40 100 100 0 0 0 0 0 0 0 0 0 0 0 0 60 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 5 5 0 0 0
0 10 30 0 0 0 0 0 80 0 0 170 0 0 0 0 0 0
0 -10 50 0 0 0 0 0 40 0 0 90 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 70 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
7 0 4 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 4 0 0 0 0 0 0 0 0 0 0 0
10 0 4 0 0 0 0 0 0 0 0 0 0 0
0 0 80 0 0 0 0 0 0 0 0 18 145 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 80 70 0 0 0 1 0 0 0 0 0 0 0
0 0 40 0 0 0 0 0 0 0 0 -18 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -20 0 0 0 0 0 0 0 0 0 0 0 0 0 50 80 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0 0 0 80 0 0 0 0 80 0 50
8 0 0 0 0 0 40 0 0 0 0 40 0 0
9 0 0 0 0 0 100 0 0 0 0 100 0 50
10 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Yang Meminta : Pengelola
SITI ROHMAH, Amd.kep NTKK. 6202 1046
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT RUTIN/APBD ( LPLPO ) PUSTU/SUB UNIT PUSTU/SUB UNIT : TANJUNGAN 1 PUSKESMAS : CIKEUSIK KECAMATAN : CIKEUSIK KABUPATEN : PANDEGLANG PROPINSI : BANTEN
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT
PELAPORAN BULAN : april 20 PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
0 0 0 0 0 10 10 0 85 0 0 0 0 0 40 10 0 0 0 0 0 0 3 30 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 50 0 0 300 0 0 10 0 0 200 10 0 0 0 0 0 0 3 100 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 60 10 0 385 0 0 10 0 0 240 20 0 0 0 0 0 0 6 130 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
0 0 30 0 0 0 0 0 20 0 0 60 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 80 0 0 0 0 0 120 0 0 260 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
0 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 150 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 4 0 0 0 0 0 0 0 0 0 0 0
6 0 4 0 0 0 0 0 0 0 0 0 0 0
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
0 0 20 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 50 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 1 0 0 0 0 0 0 0
0 0 120 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 150 0 0 0 1 0 0 0 0 0 0 0
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
0 0 0 0
0 0 0 0
0 0 0 0
4 0 0 0 0 0 20 0 0 0 0 20 0 0
5 0 0 0 0 0 100 0 0 0 0 100 0 50
6 0 0 0 0 0 120 0 0 0 0 120 0 50
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN : april 2019 TAAN BULAN/PERIODE : mei PEMAKAIAN 0 0 0 0 0 40 30 0 265 0 0 10 0 0 210 10 0 0 0 0 0 0 0 90 20 0 0 0 185 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 50 50 -20 0 0 0 0 0 120 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 200 200 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 3 3 40 100 100 0 0 0 0 0 0 0 0 0 0 0 0 60 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 5 5 0 0 0
0 10 30 0 0 0 0 0 80 0 0 170 0 0 0 0 0 0
0 -10 50 0 0 0 0 0 40 0 0 90 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 70 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
7 0 4 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 4 0 0 0 0 0 0 0 0 0 0 0
10 0 4 0 0 0 0 0 0 0 0 0 0 0
0 0 80 0 0 0 0 0 0 0 0 18 145 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 80 70 0 0 0 1 0 0 0 0 0 0 0
0 0 40 0 0 0 0 0 0 0 0 -18 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -20 0 0 0 0 0 0 0 0 0 0 0 0 0 50 80 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0 0 0 80 0 0 0 0 80 0 50
8 0 0 0 0 0 40 0 0 0 0 40 0 0
9 0 0 0 0 0 100 0 0 0 0 100 0 50
10 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Yang Meminta : Pengelola
SITI ROHMAH, Amd.kep NTKK. 6202 1046
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT RUTIN/APBD ( LPLPO ) PUSTU/SUB UNIT PUSTU/SUB UNIT : TANJUNGAN 1 PUSKESMAS : CIKEUSIK KECAMATAN : CIKEUSIK KABUPATEN : PANDEGLANG PROPINSI : BANTEN
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT
PELAPORAN BULAN : mei 20 PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
0 0 0 0 0 10 10 0 85 0 0 0 0 0 40 10 0 0 0 0 0 0 3 30 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 50 0 0 300 0 0 10 0 0 200 10 0 0 0 0 0 0 3 100 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 60 10 0 385 0 0 10 0 0 240 20 0 0 0 0 0 0 6 130 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
0 0 30 0 0 0 0 0 20 0 0 60 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 80 0 0 0 0 0 120 0 0 260 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
0 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 150 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 4 0 0 0 0 0 0 0 0 0 0 0
6 0 4 0 0 0 0 0 0 0 0 0 0 0
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
0 0 20 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 50 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 1 0 0 0 0 0 0 0
0 0 120 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 150 0 0 0 1 0 0 0 0 0 0 0
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
0 0 0 0
0 0 0 0
0 0 0 0
4 0 0 0 0 0 20 0 0 0 0 20 0 0
5 0 0 0 0 0 100 0 0 0 0 100 0 50
6 0 0 0 0 0 120 0 0 0 0 120 0 50
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN : mei 2019 TAAN BULAN/PERIODE : juni PEMAKAIAN 0 0 0 0 0 40 30 0 265 0 0 10 0 0 210 10 0 0 0 0 0 0 0 90 20 0 0 0 185 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 50 50 -20 0 0 0 0 0 120 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 200 200 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 3 3 40 100 100 0 0 0 0 0 0 0 0 0 0 0 0 60 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 5 5 0 0 0
0 10 30 0 0 0 0 0 80 0 0 170 0 0 0 0 0 0
0 -10 50 0 0 0 0 0 40 0 0 90 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 70 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
7 0 4 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 4 0 0 0 0 0 0 0 0 0 0 0
10 0 4 0 0 0 0 0 0 0 0 0 0 0
0 0 80 0 0 0 0 0 0 0 0 18 145 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 80 70 0 0 0 1 0 0 0 0 0 0 0
0 0 40 0 0 0 0 0 0 0 0 -18 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -20 0 0 0 0 0 0 0 0 0 0 0 0 0 50 80 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0 0 0 80 0 0 0 0 80 0 50
8 0 0 0 0 0 40 0 0 0 0 40 0 0
9 0 0 0 0 0 100 0 0 0 0 100 0 50
10 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Yang Meminta : Pengelola
SITI ROHMAH, Amd.kep NTKK. 6202 1046
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT RUTIN/APBD ( LPLPO ) PUSTU/SUB UNIT PUSTU/SUB UNIT : TANJUNGAN 1 PUSKESMAS : CIKEUSIK KECAMATAN : CIKEUSIK KABUPATEN : PANDEGLANG PROPINSI : BANTEN
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT
PELAPORAN BULAN :juni 201 PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
0 0 0 0 0 10 10 0 85 0 0 0 0 0 40 10 0 0 0 0 0 0 3 30 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 50 0 0 300 0 0 10 0 0 200 10 0 0 0 0 0 0 3 100 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 60 10 0 385 0 0 10 0 0 240 20 0 0 0 0 0 0 6 130 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
0 0 30 0 0 0 0 0 20 0 0 60 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 80 0 0 0 0 0 120 0 0 260 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
0 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 150 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 4 0 0 0 0 0 0 0 0 0 0 0
6 0 4 0 0 0 0 0 0 0 0 0 0 0
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
0 0 20 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 50 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 1 0 0 0 0 0 0 0
0 0 120 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 150 0 0 0 1 0 0 0 0 0 0 0
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
0 0 0 0
0 0 0 0
0 0 0 0
4 0 0 0 0 0 20 0 0 0 0 20 0 0
5 0 0 0 0 0 100 0 0 0 0 100 0 50
6 0 0 0 0 0 120 0 0 0 0 120 0 50
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN :juni 2019 TAAN BULAN/PERIODE : juli PEMAKAIAN 0 0 0 0 0 40 30 0 265 0 0 10 0 0 210 10 0 0 0 0 0 0 0 90 20 0 0 0 185 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 50 50 -20 0 0 0 0 0 120 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 200 200 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 3 3 40 100 100 0 0 0 0 0 0 0 0 0 0 0 0 60 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 5 5 0 0 0
0 10 30 0 0 0 0 0 80 0 0 170 0 0 0 0 0 0
0 -10 50 0 0 0 0 0 40 0 0 90 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 70 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
7 0 4 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 4 0 0 0 0 0 0 0 0 0 0 0
10 0 4 0 0 0 0 0 0 0 0 0 0 0
0 0 80 0 0 0 0 0 0 0 0 18 145 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 80 70 0 0 0 1 0 0 0 0 0 0 0
0 0 40 0 0 0 0 0 0 0 0 -18 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -20 0 0 0 0 0 0 0 0 0 0 0 0 0 50 80 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0 0 0 80 0 0 0 0 80 0 50
8 0 0 0 0 0 40 0 0 0 0 40 0 0
9 0 0 0 0 0 100 0 0 0 0 100 0 50
10 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Yang Meminta : Pengelola
SITI ROHMAH, Amd.kep NTKK. 6202 1046
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT RUTIN/APBD ( LPLPO ) PUSTU/SUB UNIT PUSTU/SUB UNIT : TANJUNGAN 1 PUSKESMAS : CIKEUSIK KECAMATAN : CIKEUSIK KABUPATEN : PANDEGLANG PROPINSI : BANTEN
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT
PELAPORAN BULAN : juli 201 PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
0 0 0 0 0 10 10 0 85 0 0 0 0 0 40 10 0 0 0 0 0 0 3 30 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 50 0 0 300 0 0 10 0 0 200 10 0 0 0 0 0 0 3 100 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 60 10 0 385 0 0 10 0 0 240 20 0 0 0 0 0 0 6 130 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
0 0 30 0 0 0 0 0 20 0 0 60 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 80 0 0 0 0 0 120 0 0 260 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
0 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 150 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 4 0 0 0 0 0 0 0 0 0 0 0
6 0 4 0 0 0 0 0 0 0 0 0 0 0
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
0 0 20 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 50 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 1 0 0 0 0 0 0 0
0 0 120 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 150 0 0 0 1 0 0 0 0 0 0 0
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
0 0 0 0
0 0 0 0
0 0 0 0
4 0 0 0 0 0 20 0 0 0 0 20 0 0
5 0 0 0 0 0 100 0 0 0 0 100 0 50
6 0 0 0 0 0 120 0 0 0 0 120 0 50
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN : juli 2019 TAAN BULAN/PERIODE : agusts PEMAKAIAN 0 0 0 0 0 40 30 0 265 0 0 10 0 0 210 10 0 0 0 0 0 0 0 90 20 0 0 0 185 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 50 50 -20 0 0 0 0 0 120 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 200 200 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 3 3 40 100 100 0 0 0 0 0 0 0 0 0 0 0 0 60 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 5 5 0 0 0
0 10 30 0 0 0 0 0 80 0 0 170 0 0 0 0 0 0
0 -10 50 0 0 0 0 0 40 0 0 90 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 70 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
7 0 4 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 4 0 0 0 0 0 0 0 0 0 0 0
10 0 4 0 0 0 0 0 0 0 0 0 0 0
0 0 80 0 0 0 0 0 0 0 0 18 145 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 80 70 0 0 0 1 0 0 0 0 0 0 0
0 0 40 0 0 0 0 0 0 0 0 -18 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -20 0 0 0 0 0 0 0 0 0 0 0 0 0 50 80 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0 0 0 80 0 0 0 0 80 0 50
8 0 0 0 0 0 40 0 0 0 0 40 0 0
9 0 0 0 0 0 100 0 0 0 0 100 0 50
10 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Yang Meminta : Pengelola
SITI ROHMAH, Amd.kep NTKK. 6202 1046
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT RUTIN/APBD ( LPLPO ) PUSTU/SUB UNIT PUSTU/SUB UNIT : TANJUNGAN 1 PUSKESMAS : CIKEUSIK KECAMATAN : CIKEUSIK KABUPATEN : PANDEGLANG PROPINSI : BANTEN
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT
PELAPORAN BULAN : agustus PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
0 0 0 0 0 10 10 0 85 0 0 0 0 0 40 10 0 0 0 0 0 0 3 30 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 50 0 0 300 0 0 10 0 0 200 10 0 0 0 0 0 0 3 100 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 60 10 0 385 0 0 10 0 0 240 20 0 0 0 0 0 0 6 130 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
0 0 30 0 0 0 0 0 20 0 0 60 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 80 0 0 0 0 0 120 0 0 260 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
0 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 150 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 4 0 0 0 0 0 0 0 0 0 0 0
6 0 4 0 0 0 0 0 0 0 0 0 0 0
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
0 0 20 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 50 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 1 0 0 0 0 0 0 0
0 0 120 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 150 0 0 0 1 0 0 0 0 0 0 0
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
0 0 0 0
0 0 0 0
0 0 0 0
4 0 0 0 0 0 20 0 0 0 0 20 0 0
5 0 0 0 0 0 100 0 0 0 0 100 0 50
6 0 0 0 0 0 120 0 0 0 0 120 0 50
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN : agustus 2019 TAAN BULAN/PERIODE : septm PEMAKAIAN 0 0 0 0 0 40 30 0 265 0 0 10 0 0 210 10 0 0 0 0 0 0 0 90 20 0 0 0 185 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 50 50 -20 0 0 0 0 0 120 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 200 200 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 3 3 40 100 100 0 0 0 0 0 0 0 0 0 0 0 0 60 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 5 5 0 0 0
0 10 30 0 0 0 0 0 80 0 0 170 0 0 0 0 0 0
0 -10 50 0 0 0 0 0 40 0 0 90 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 70 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
7 0 4 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 4 0 0 0 0 0 0 0 0 0 0 0
10 0 4 0 0 0 0 0 0 0 0 0 0 0
0 0 80 0 0 0 0 0 0 0 0 18 145 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 80 70 0 0 0 1 0 0 0 0 0 0 0
0 0 40 0 0 0 0 0 0 0 0 -18 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -20 0 0 0 0 0 0 0 0 0 0 0 0 0 50 80 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0 0 0 80 0 0 0 0 80 0 50
8 0 0 0 0 0 40 0 0 0 0 40 0 0
9 0 0 0 0 0 100 0 0 0 0 100 0 50
10 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Yang Meminta : Pengelola
SITI ROHMAH, Amd.kep NTKK. 6202 1046
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT RUTIN/APBD ( LPLPO ) PUSTU/SUB UNIT PUSTU/SUB UNIT : TANJUNGAN 1 PUSKESMAS : CIKEUSIK KECAMATAN : CIKEUSIK KABUPATEN : PANDEGLANG PROPINSI : BANTEN
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT PELAPORAN BULAN : septm PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
0 0 0 0 0 10 10 0 85 0 0 0 0 0 40 10 0 0 0 0 0 0 3 30 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 50 0 0 300 0 0 10 0 0 200 10 0 0 0 0 0 0 3 100 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 60 10 0 385 0 0 10 0 0 240 20 0 0 0 0 0 0 6 130 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
0 0 30 0 0 0 0 0 20 0 0 60 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 80 0 0 0 0 0 120 0 0 260 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
0 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 150 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 4 0 0 0 0 0 0 0 0 0 0 0
6 0 4 0 0 0 0 0 0 0 0 0 0 0
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
0 0 20 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 50 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 1 0 0 0 0 0 0 0
0 0 120 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 150 0 0 0 1 0 0 0 0 0 0 0
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
0 0 0 0
0 0 0 0
0 0 0 0
4 0 0 0 0 0 20 0 0 0 0 20 0 0
5 0 0 0 0 0 100 0 0 0 0 100 0 50
6 0 0 0 0 0 120 0 0 0 0 120 0 50
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN : septm 2019 TAAN BULAN/PERIODE : oktobr PEMAKAIAN 0 0 0 0 0 40 30 0 265 0 0 10 0 0 210 10 0 0 0 0 0 0 0 90 20 0 0 0 185 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 50 50 -20 0 0 0 0 0 120 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 200 200 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 3 3 40 100 100 0 0 0 0 0 0 0 0 0 0 0 0 60 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 5 5 0 0 0
0 10 30 0 0 0 0 0 80 0 0 170 0 0 0 0 0 0
0 -10 50 0 0 0 0 0 40 0 0 90 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 70 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
7 0 4 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 4 0 0 0 0 0 0 0 0 0 0 0
10 0 4 0 0 0 0 0 0 0 0 0 0 0
0 0 80 0 0 0 0 0 0 0 0 18 145 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 80 70 0 0 0 1 0 0 0 0 0 0 0
0 0 40 0 0 0 0 0 0 0 0 -18 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -20 0 0 0 0 0 0 0 0 0 0 0 0 0 50 80 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0 0 0 80 0 0 0 0 80 0 50
8 0 0 0 0 0 40 0 0 0 0 40 0 0
9 0 0 0 0 0 100 0 0 0 0 100 0 50
10 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Yang Meminta : Pengelola
SITI ROHMAH, Amd.kep NTKK. 6202 1046
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT RUTIN/APBD ( LPLPO ) PUSTU/SUB UNIT PUSTU/SUB UNIT : TANJUNGAN 1 PUSKESMAS : CIKEUSIK KECAMATAN : CIKEUSIK KABUPATEN : PANDEGLANG PROPINSI : BANTEN
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT
PELAPORAN BULAN : okrobe PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
0 0 0 0 0 10 10 0 85 0 0 0 0 0 40 10 0 0 0 0 0 0 3 30 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 50 0 0 300 0 0 10 0 0 200 10 0 0 0 0 0 0 3 100 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 60 10 0 385 0 0 10 0 0 240 20 0 0 0 0 0 0 6 130 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
0 0 30 0 0 0 0 0 20 0 0 60 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 80 0 0 0 0 0 120 0 0 260 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
0 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 150 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 4 0 0 0 0 0 0 0 0 0 0 0
6 0 4 0 0 0 0 0 0 0 0 0 0 0
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
0 0 20 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 50 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 1 0 0 0 0 0 0 0
0 0 120 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 150 0 0 0 1 0 0 0 0 0 0 0
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
0 0 0 0
0 0 0 0
0 0 0 0
4 0 0 0 0 0 20 0 0 0 0 20 0 0
5 0 0 0 0 0 100 0 0 0 0 100 0 50
6 0 0 0 0 0 120 0 0 0 0 120 0 50
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN : okrober 2019 TAAN BULAN/PERIODE : november PEMAKAIAN 0 0 0 0 0 40 30 0 265 0 0 10 0 0 210 10 0 0 0 0 0 0 0 90 20 0 0 0 185 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 50 50 -20 0 0 0 0 0 120 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 200 200 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 3 3 40 100 100 0 0 0 0 0 0 0 0 0 0 0 0 60 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 5 5 0 0 0
0 10 30 0 0 0 0 0 80 0 0 170 0 0 0 0 0 0
0 -10 50 0 0 0 0 0 40 0 0 90 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 70 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
7 0 4 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 4 0 0 0 0 0 0 0 0 0 0 0
10 0 4 0 0 0 0 0 0 0 0 0 0 0
0 0 80 0 0 0 0 0 0 0 0 18 145 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 80 70 0 0 0 1 0 0 0 0 0 0 0
0 0 40 0 0 0 0 0 0 0 0 -18 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -20 0 0 0 0 0 0 0 0 0 0 0 0 0 50 80 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0 0 0 80 0 0 0 0 80 0 50
8 0 0 0 0 0 40 0 0 0 0 40 0 0
9 0 0 0 0 0 100 0 0 0 0 100 0 50
10 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Yang Meminta : Pengelola
SITI ROHMAH, Amd.kep NTKK. 6202 1046
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT RUTIN/APBD ( LPLPO ) PUSTU/SUB UNIT PUSTU/SUB UNIT : TANJUNGAN 1 PUSKESMAS : CIKEUSIK KECAMATAN : CIKEUSIK KABUPATEN : PANDEGLANG PROPINSI : BANTEN
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT
PELAPORAN BULAN : desemb PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
0 0 0 0 0 10 10 0 85 0 0 0 0 0 40 10 0 0 0 0 0 0 3 30 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 50 0 0 300 0 0 10 0 0 200 10 0 0 0 0 0 0 3 100 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 60 10 0 385 0 0 10 0 0 240 20 0 0 0 0 0 0 6 130 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
0 0 30 0 0 0 0 0 20 0 0 60 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 80 0 0 0 0 0 120 0 0 260 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
0 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 150 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 4 0 0 0 0 0 0 0 0 0 0 0
6 0 4 0 0 0 0 0 0 0 0 0 0 0
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
0 0 20 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 50 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 1 0 0 0 0 0 0 0
0 0 120 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 150 0 0 0 1 0 0 0 0 0 0 0
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
0 0 0 0
0 0 0 0
0 0 0 0
4 0 0 0 0 0 20 0 0 0 0 20 0 0
5 0 0 0 0 0 100 0 0 0 0 100 0 50
6 0 0 0 0 0 120 0 0 0 0 120 0 50
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN : desembr 2019 TAAN BULAN/PERIODE : januari PEMAKAIAN 0 0 0 0 0 40 30 0 265 0 0 10 0 0 210 10 0 0 0 0 0 0 0 90 20 0 0 0 185 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 50 50 -20 0 0 0 0 0 120 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 200 200 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 3 3 40 100 100 0 0 0 0 0 0 0 0 0 0 0 0 60 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 5 5 0 0 0
0 10 30 0 0 0 0 0 80 0 0 170 0 0 0 0 0 0
0 -10 50 0 0 0 0 0 40 0 0 90 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 70 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
7 0 4 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 4 0 0 0 0 0 0 0 0 0 0 0
10 0 4 0 0 0 0 0 0 0 0 0 0 0
0 0 80 0 0 0 0 0 0 0 0 18 145 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 80 70 0 0 0 1 0 0 0 0 0 0 0
0 0 40 0 0 0 0 0 0 0 0 -18 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -20 0 0 0 0 0 0 0 0 0 0 0 0 0 50 80 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0 0 0 80 0 0 0 0 80 0 50
8 0 0 0 0 0 40 0 0 0 0 40 0 0
9 0 0 0 0 0 100 0 0 0 0 100 0 50
10 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Yang Meminta : Pengelola
SITI ROHMAH, Amd.kep NTKK. 6202 1046
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT RUTIN/APBD ( LPLPO ) PUSTU/SUB UNIT PUSTU/SUB UNIT : TANJUNGAN 1 PUSKESMAS : CIKEUSIK KECAMATAN : CIKEUSIK KABUPATEN : PANDEGLANG PROPINSI : BANTEN
NO
NAMA OBAT
DOKUMEN PUSTU/SUB UNIT
PELAPORAN BULAN : februar PERMINTAAN BULAN/PERIODE :
SATUAN
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Ferance)
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml 11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte 13 Ampisillin Injeksi 1 gram
Vial
14 Antalgin (Metampiron) Tab. 500 mg 15 Antasida DOEN tablet 16 Antasida DOEN suspensi
Btl Tab Tab Tab Btl
17 Anti Bakteri DOEN Salep Kombinasi
Tube
18 Anti Hemoroid DOEN Kombinasi 19 Antifungi DOEN Kombinasi
Supp Pot
20 Antimigren DOEN Kombinasi
Tab
21 Antiparkinson DOEN tab. Kombinasi
Tab
22 Aqua roinjek Steril 23 Acyclopir Krim 5%- 5gr
Btl Tube
24 Acyclopir Tablet 200mg 25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet 27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet 29 Asam Mefenamat 500mg
Tab
30 Alprazolam 1mg 31 Ambroksol tab
Tab
32 Ambroksol syr 33 Asam Askorbat (Vit. C) Tablet 50 mg 34 Asering Infus 35 Asam Folat tablet 01mg 36 Asam Folat tablet 5 mg 37 Artesunat Inj
Tab Tab Tab tab Btl Tab Tab Tab Tab Vial
38 Asam traneksamat Inj 5 % 39 Asetosal Tablet 500 mg
Amp
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml 41 Atropin Sulfat Tablet 0,5 mg
Amp
42 Atropin Sulfat Tetes Mata 1% - 5 ml 43 Alkohol 70% 1 Liter
Btl
Tab Tab Btl
44 Benzatin Benzil Penisilin Inj. 2,4 Juta 45 Betametason Krim 0,1% - 5 gr
Tube
Vial
46 Bisacodril sup
Supp
STOK AWAL
PENERIMAAN
PERSEDIAAN
0 0 0 0 0 10 10 0 85 0 0 0 0 0 40 10 0 0 0 0 0 0 3 30 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 50 0 0 300 0 0 10 0 0 200 10 0 0 0 0 0 0 3 100 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0
0 0 0 0 0 60 10 0 385 0 0 10 0 0 240 20 0 0 0 0 0 0 6 130 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0
47 Bisoprolol 2,5mg tab 48 Captopril Tablet 12,5 mg
Tab
49 Captopril Tablet 25 mg 50 Carbamazefine
Tab
51 Cefadroxil 500mg 52 Cetrizin syr
Tab
53 Cefixim 54 Ciprofloxacin Infus
Tab
55 Ciprofloxacin Tablet 500mg 56 D-Artepp Tab
Tab
57 Deksametasone Injeksi 5 mg/ml - 1ml 58 Deksametasone Tablet 0,5 mg
Amp
59 Dekstromethorfan Sirup 10 mg/ 60 ml 60 Diazetpam Rectal 2mg
Btl
Tab Tab Btl Btl Tab Tab Tube
61 Diazepam Injeksi 5 mg/ml - 2ml 62 Diazepam Tablet 2 mg
Amp
63 Diazepam Tablet 5 mg 64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
1
2
Tab Tab
3
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml 66 Digoksin Tablet 0,25 mg
Amp
67 Domperidon 10 mgtablet 68 Dimenhidrinat Tablet 50 mg
Tab
69 Dasabion Tablet 70 Domperidon Suspensi 5mg/ 5ml- 60ml
Tab
71 Efedrin HCL Tablet 25 mg 72 Ekstrak Belladona Tablet 10 mg
Tab
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml 74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Amp
75 Lisinofril 10 mg 76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml 78 Eritromisin Kapsul 500 mg
Btl
79 Eritromisin Syrup 200 mg/5 ml-60 ml 80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Tab Tab Btl Tab Btl Tab Kap Btl Amp
81 Fenitoin Natrium Kapsul 100 mg 82 Fenitoin Natrium Kapsul 30 mg
Kap
83 Fenobarbital Injeksi- 2ml 84 Fenobarbital Tablet 30 mg
Amp
85 Fenobarbital Tablet 30 mg 86 Fenoksimetil Penisilina Tablet 250 mg
Tab
87 Fluflenazine decanoat inj 25mg/ml 88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
89 Fitomenadion (Vit. K1) Tab. 10 mg 90 Gentamisin SM
Tab
Kap Tab Tab Amp Tube
91 Furosemida Tablet 40 mg 92 Garam Oralit 200 ml air
Tab
93 Glimepirid 2mg Tablet
Tab
94 Glibenklamida Tablet 5 mg 95 Gliseril Guaiakolat Tablet 100 mg
Tab
96 Glikazid 80 mg 97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
98 Glukosa Lar. Infus 10% Steril - 500 ml 99 Griseofulvin Tablet 500 mg,
Btl Tab
100 Griseofulvin Tablet 125 mg, Micron
Tab
Ktg
Tab Btl
0 0 30 0 0 0 0 0 20 0 0 60 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 80 0 0 0 0 0 120 0 0 260 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0
101 Gentamisin S.K 0.1%-5 gr
Tube
102 Gentamisin Injeksi 103 Haloperidol 2 mg Tablet
Vial
104 Haloperidol 5 mg Tablet 105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr 107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg 109 Ibufropen syr
Tab
110 Haloporidol Decanoate Inj 50mg 111 Isosorbid Dinitrat Tab. Sub. 5 mg
Amp
112 Ketokonazol krem 113 Ketokonazol tab 200mg
Tube
114 Ketorolac Inj 30mg 115 Kalsium Laktat (Kalk) Tablet 500 mg
Vial
116 KN-3B 117 Karbihidrat +Elektrolit
Labu
Tab Tab Tab Btl Tab Tab Tab Labu
118 Karbogliserin Tetes telinga 119 Kloramfenikol tetes Mata
Btl
120 Klorfeniramin Maleat (CTM) Tab. 4 mg 121 Klozapine 25 Mg
Tab
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml 123 Klorpromazin HCL Tablet Salut 25 mg
Amp
124 Klorpromazin HCL Tablet Salut 100 mg 125 klorpeson Slasf
Btl Tab Tab Tab tube Pkt
126 Komb. Artesunate 50mg+Amodiaquin 200mg 127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi 129 Metpormin 500mg
Tab
130 Methyilprednisolon 8mg
Tab
131 Kloramfenikol Salep Mata 1%-5gram 132 Kloramfenikol Tetes Telinga 3%-5ml
Tube
133 Kuinin Injeksi 25%-2ml 134 Levoploxasin 500mh
Amp
135 Lidokain Komp. Injeksi, Kombinasi 136 Lisol, Kresol Tersabun 50%- 1000ml
Amp
137 Loperamide Hcl 2mg Tanlet 138 Magnesium Sulfat Injk 25 ml
Tab
Btl
Btl Dus Btl Vial
139 Metamizol 500mg 140 Metilergometrin Maleat Tab. 0,125 g
Tab
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
1
2
142 Metoklorpropamid Tablet 10 mg 143 Mikonazol Krim/ Salep 2%-10gram
Tab
3 Tab Tube
144 Multivitamin Anak 145 Multivitamin Dewasa
Btl Tab
146 Metronidazol Infus 500mg/100ml 147 Metronidazol Tablet 500mg
Tab
Btl
148 Metokloramid Syr 149 Metronidazol syr
Btl
150 Natrium Bikarbonat Tablet 500mg 151 Natrum Klorida Lar. Inf. 0,9% -500ml
Tab
152 Natrium Diclopenac 20mg 153 Nistatin Vaginal
Amp
154 Nistatin Tablet Salut 500.000 IU
tab
Btl Btl sup
0 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 150 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 4 0 0 0 0 0 0 0 0 0 0 0
6 0 4 0 0 0 0 0 0 0 0 0 0 0
155 Natrium Diclopenac 50mg 156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan 158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Tab
159 Obat Anti Tuberkulosis Kat. 2 160 Obat Anti Tuberkulosis Kat.Anak
Pkt
161 Ofloksasin Tetes telinga 162 Omeprazol inj 40mg/10ml
Btl
163 Omeprazol Kapsul 20mg 164 Ondansetron Inj 4mg
Kap
165 Onadansetron 8mg Tablet 166 Onadansetron 4mg Tablet
Tab
167 Obat Batuk Flu Dewasa 168 Obat Batuk Hitam (OBH) Cairan
Pkt
169 Obat Batuk Dewasa syr 170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Btl
Tab Pkt Pkt Btl Vial Tab Btl Vial
171 Oksitetrasiklin HCL SM 1%-3,5gram 172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
Tube
174 OBAT Anti Diare suspensi 175 parasetamol drops 15 ml
Btl
176 Parasetamol Syrup 120mg/ 5ml-60ml 177 Parasetamol tab 100mg
Btl Tab
178 Parasetamol Tablet 500mg 179 Permetin Krim/Skabisid 5 %
Tube
180 pirantel syr 181 Pirantel Tablet 125mg
btl
Tab Btl Tab
182 piroksikam Tablet 10 mg 183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg 185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml 187 Povidon Iodida 10% 1000ml
Btl
188 Prednison Tablet 5mg 189 Primakuin Tablet 15mg
Tab
190 Prokain Benzil Penisilin 3 Juta IU Inj. 191 propanolol HCL Tablet 10mg
Vial
192 Propanolol HCL Tablet 40mg 193 Povidon Iodida 10% 60ml
Tab
194 Retinol (Vitamin A) Kapsul 100.000 IU 195 Retinol (Vitamin A) Kapsul 200.000 IU 196 MDT MB/ Kusta Dewasa 197 MDT PB/ Kusta Dewasa 198 Risperidon 2mg 199 Ranitidin Injeksi 25 mg/ 2ml
Tab Tab Btl Tab Tab Botol Kap Kap Blister Blister Tab Vial
200 Ranitidin Tablet 150 mg 201 Ringer Laktat Lar. Inf. Steril - 500ml
Tab
202 Salbutamol Tablet 2mg 203 Salbutamol Tablet 4mg
Tab
204 Salep 2-4, Kombinasi 205 Salisil Bedak 2%
Pot
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
207 Stimuno 208 Serum Anti Tetanus Inj. 1500 IU/amp. 209 Sukrafat 500mg
Btl Tab Ktk Botol Amp Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg 211 Simvastatin Tablet 20 mg
Amp
212 Simvastatin Tablet 10 mg 213 Sukralfat Syr
Tab
214 Sulfasetamida Natrium TM 15%- 5ml
Tab Botol Btl
0 0 20 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 50 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 1 0 0 0 0 0 0 0
0 0 120 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 150 0 0 0 1 0 0 0 0 0 0 0
215 Sabutamol Nebulizer 216 Spiranolakton tab
Amp
217 Salf Kombinasi 218 Sinbio
Tube
1
tab Set
2
3
219 Setrizin tablet 10 mg 220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml 222 Tetrasiklin HCL Kapsul 250 mg
Btl
Tab Kap
223 Tetrasiklin HCL Kapsul 500 mg 224 Tiamin HCL/(Vit. B1) Tab. 50mg
Kap
225 Tiopental Natrium Serbuk Inj 1.000mg 226 Vitalex (penambah darah)kapsul
Amp
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml 228 Triheksifenidil Hidroklorida Tab. 2mg
vial
229 Vitamin B Komplek Tablet 230 Zink Syr
Tab
231 Zink Tablet 20mg
Tab Tab Tab Botol Tab
0 0 0 0
0 0 0 0
0 0 0 0
4 0 0 0 0 0 20 0 0 0 0 20 0 0
5 0 0 0 0 0 100 0 0 0 0 100 0 50
6 0 0 0 0 0 120 0 0 0 0 120 0 50
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PERBEKALAN KESEHATAN 1
Alat Suntik Sekali Pakai 1 ml
Set
2
Alat Suntik Sekali Pakai 3 ml
Set
3
Alat Suntik Sekali Pakai 5 ml
Set
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
5
I.V. Catheter No. 20
Set
6
I.V. Catheter No. 22
Set
7
I.V. Catheter No. 24
Set
8
I.V. Cateter No 26
set
9
Infusion Set Anak
Set
10 Infusion Set Dewasa 11 E.Care Film I.V Dresing
Set
12 Silk (Benang Bedah Sutera) No. 3/0 13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram 15 Kasa Kompres 40/40 16 Kasa Pembalut 2 m x 80 cm 17 Kasa Pembalut Hidrofil 36 m x 80 cm 18 Kasa Steril 16/16 19 Masker 20 Plester 5 yard x 2 inch
Set Biji Botol Set lembar pak rol kotak biji rol
21 Sarung Tangan No 7 Steril 22 Sarung Tangan No 6.5 Steril
pasang
23 Sarung tangan no 6 1/2 24 Folly cateter No 16
Pasng
25 Folly cateter No 14 26 Sarung tangan Gynecolog no 7 27 Alkohol Swab 28 Underpad
pasang Biji Biji Sashet Sachet Lembar
29 Urine Bag 30 Catgut/ Benang Bedah No. 3/0
Biji Botol
31 Antiseptik Surgical Hand Scrab 32 Cairan pembersih
Botol
33 Jely kateter 34 Jarum Insulin
Botol
Botol Biji
Mengetahuai/Menyetujui :
Cikeusik,
Kepala Puskesmas 2018
Hj.IYOT SA'DIAH,S.ST NIP.19710804 199103 2 002
Yang Menyerahkan : Pengelola Obat Puskesmas
YUYUN YUNENGSIH,S.Kep NIP. 19820422 200801 2 006
N OBAT RUTIN/APBD
DOKUMEN PUSTU/SUB UNIT
TANGGAL
RAN BULAN : februari 2019 TAAN BULAN/PERIODE : maret PEMAKAIAN 0 0 0 0 0 40 30 0 265 0 0 10 0 0 210 10 0 0 0 0 0 0 0 90 20 0 0 0 185 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0
PEMBERI STOK PERAN AKHIR MINTAAN JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 50 50 -20 0 0 0 0 0 120 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 200 200 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 3 3 40 100 100 0 0 0 0 0 0 0 0 0 0 0 0 60 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 5 5 0 0 0
0 10 30 0 0 0 0 0 80 0 0 170 0 0 0 0 0 0
0 -10 50 0 0 0 0 0 40 0 0 90 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
0 0 50 0 0 0 0 0 100 0 0 200 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0
0 0 0 0 10 5 0 0 0 0 0 0 50 0 110 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 70 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
0 0 0 0 0 5 0 0 0 0 0 0 50 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0
7 0 4 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 4 0 0 0 0 0 0 0 0 0 0 0
10 0 4 0 0 0 0 0 0 0 0 0 0 0
0 0 80 0 0 0 0 0 0 0 0 18 145 0 0 0 0 0 2 0 0 10 0 135 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 80 70 0 0 0 1 0 0 0 0 0 0 0
0 0 40 0 0 0 0 0 0 0 0 -18 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -20 0 0 0 0 0 0 0 0 0 0 0 0 0 50 80 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 2 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 100` 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0 0 0 80 0 0 0 0 80 0 50
8 0 0 0 0 0 40 0 0 0 0 40 0 0
9 0 0 0 0 0 100 0 0 0 0 100 0 50
10 0 0 0 0 0 100 0 0 0 0 100 0 50
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 2 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Yang Meminta : Pengelola
SITI ROHMAH, Amd.kep NTKK. 6202 1046
PEMERINTAH KABUPATEN PANDEGLANG DINAS KESEHATAN
Saldo per 31 Desember 2018
UPT. PUSKESMAS CIKEUSIK Alamat : Jl. Alun-alun Selatan No.4 Cikeusik-Pandeglang. Kode pos 42286 NO
NAMA / JENIS BARANG
SATUAN
I
OBAT-OBATAN (APBD)
1
PUSTU TANJUNGAN 1
1
Alopurinol tablet 100 mg
Tab
2
Aminofilin tablet 200 mg
Tab
3
Albendazol
Tab
4
Aminofilin injeksi 24mg/ml-10ml
Amp
5
Amitriptilin HCL Tab. Salut 25 mg
Tab
6
Amlodipine 10 mg Tablet
Tab
7
Amlodipine Besilate 5mg tablet
Tab
8
Alkacide 1 L High Level Desinfectant(Alkapham Feranc
Btl
9
Amoksisillin Kapsul 500 mg
Tab
10 Amoksisillin SK 125 mg/5 ml-60 ml
Btl
HARGA SATUAN (Rp)
JUMLAH KUANTITAS PERSEDIAAN Opname Fisik
Mutasi (+)
(-)
Saldo 31/12/2018
Nilai Persediaan 31/12/2018
99
#REF!
#REF!
#REF!
91
#REF!
#REF!
#REF!
404
#REF!
#REF!
#REF!
3,245
#REF!
#REF!
#REF!
167
#REF!
#REF!
#REF!
93
#REF!
#REF!
#REF!
70
#REF!
#REF!
#REF!
2,702,700
#REF!
#REF!
#REF!
233
#REF!
#REF!
#REF!
1,881
#REF!
#REF!
#REF!
801,000
#REF!
#REF!
#REF!
3,400
#REF!
#REF!
#REF!
#REF!
#REF!
11 Alkazyme Sachet 25mg(Alkapham France)
Pack
12 Amoksilin sk Forte
Tab
13 Ampisillin Injeksi 1 gram
Vial
3,850
#REF!
14 Antalgin (Metampiron) Tab. 500 mg
Tab
205
#REF!
#REF!
#REF!
15 Antasida DOEN tablet
Tab
54
#REF!
#REF!
#REF!
16 Antasida DOEN suspensi
Btl
1,923
#REF!
#REF!
#REF!
17 Anti Bakteri DOEN Salep Kombinasi (basitrasin)
Tube
3,035
#REF!
#REF!
#REF!
18 Anti Hemoroid DOEN Kombinasi
Supp
3,167
#REF!
#REF!
#REF!
19 Antifungi DOEN Kombinasi
Pot
3,035
#REF!
#REF!
#REF!
20 Antimigren DOEN Kombinasi
Tab
135
#REF!
#REF!
#REF!
21 Antiparkinson DOEN tab. Kombinasi
Tab
1,500
#REF!
#REF!
#REF!
22 Aqua roinjek Steril
Btl
2,860
#REF!
#REF!
#REF!
8,800
#REF!
#REF!
#REF!
237
#REF!
#REF!
#REF!
380
#REF!
#REF!
#REF!
450
#REF!
#REF!
#REF!
305
#REF!
#REF!
#REF!
#REF!
#REF!
23 Acyclopir Krim 5%- 5gr
Tube
24 Acyclopir Tablet 200mg
Tab
25 Acyclopir Tablet 400 mg
Tab
26 Akita/Molagit Tablet
Tab
27 Antalgin (Metampiron) Inj. 250mg/2ml
Tab
28 Asam asetilsalisilat 100mg tablet
Tab
130
#REF!
29 Asam Mefenamat 500mg
Tab
103
#REF!
#REF!
#REF!
30 Alprazolam 1mg
Tab
233
#REF!
#REF!
#REF!
31 Ambroksol tab
tab
169
#REF!
#REF!
#REF!
32 Ambroksol syr
Btl
9,883
#REF!
#REF!
#REF!
33 Asam Askorbat (Vit. C) Tablet 50 mg
Tab
105
#REF!
#REF!
#REF!
34 Asering Infus
Tab
9,646
#REF!
#REF!
#REF!
35 Asam Folat tablet 01mg
Tab
63
#REF!
#REF!
#REF!
36 Asam Folat tablet 5 mg
Tab
55
#REF!
#REF!
#REF!
37 Artesunat Inj
Vial
14,250
#REF!
#REF!
#REF!
38 Asam traneksamat Inj 5 %
Amp
24,449
#REF!
#REF!
#REF!
39 Asetosal Tablet 500 mg
Tab
#REF!
#REF!
#REF!
40 Atropin Sulfat Inj. 0,25 mg/ml - 1 ml
Amp
1,595
#REF!
#REF!
#REF!
41 Atropin Sulfat Tablet 0,5 mg
Tab
74
#REF!
#REF!
#REF!
42 Atropin Sulfat Tetes Mata 1% - 5 ml
Btl
-
#REF!
#REF!
#REF!
43 Alkohol 70% 1 Liter
Btl
#REF!
#REF!
-
24,992
#REF!
44 Betadin Salf Antiseptik
Tube
7,039
#REF!
#REF!
#REF!
45 Betametason Krim 0,1% - 5 gr
Tube
1,349
#REF!
#REF!
#REF!
46 Bisacodril sup
Supp
5,800
#REF!
#REF!
#REF!
650
#REF!
#REF!
#REF!
47 Bisoprolol 2,5mg tab
Tab
48 Captopril Tablet 12,5 mg
Tab
62
#REF!
#REF!
49 Captopril Tablet 25 mg
#REF!
Tab
72
#REF!
#REF!
#REF!
50 Carbamazefine
Tab
269
#REF!
#REF!
#REF!
51 Cefadroxil 500mg
Tab
516
#REF!
#REF!
#REF!
52 Cetrizin syr
Btl
2,849
#REF!
#REF!
#REF!
53 Cefixim
Tab
590
#REF!
#REF!
#REF!
54 Ciprofloxacin Infus
Btl
39,900
#REF!
#REF!
#REF!
55 Ciprofloxacin Tablet 500mg
Tab
255
#REF!
#REF!
#REF!
56 D-Artepp Tab
Tab
1,000
#REF!
#REF!
#REF!
57 Deksametasone Injeksi 5 mg/ml - 1ml
Amp
1,097
#REF!
#REF!
#REF!
58 Deksametasone Tablet 0,5 mg
Tab
32
#REF!
#REF!
#REF!
59 Dekstromethorfan Sirup 10 mg/ 60 ml
Btl
6,600
#REF!
#REF!
#REF!
11,516
#REF!
#REF!
#REF!
17,350
#REF!
#REF!
#REF!
#REF!
#REF!
60 Diazetpam Rectal 2mg
Tube
61 Diazepam Injeksi 5 mg/ml - 2ml
Amp
62 Diazepam Tablet 2 mg
Tab
45
#REF!
63 Diazepam Tablet 5 mg
Tab
-
#REF!
#REF!
#REF!
64 Dietilkarbamazin Sitrat Tablet 100 mg
Tab
-
#REF!
#REF!
#REF!
65 Difenhidramin HCL Inj. 10 mg/ml- 1 ml
Amp
1,176
#REF!
#REF!
#REF!
66 Digoksin Tablet 0,25 mg
Tab
105
#REF!
#REF!
#REF!
67 Domperidon 10 mgtablet
Tab
85
#REF!
#REF!
#REF!
68 Dimenhidrinat Tablet 50 mg
Tab
-
#REF!
#REF!
#REF!
69 Dasabion Tablet
Tab
-
#REF!
#REF!
#REF!
70 Domperidon Suspensi 5mg/ 5ml- 60ml
Btl
3,333
#REF!
#REF!
#REF!
71 Efedrin HCL Tablet 25 mg
Tab
51
#REF!
#REF!
#REF!
72 Ekstrak Belladona Tablet 10 mg
Tab
31
#REF!
#REF!
#REF!
73 Epinefrina HCL/Bitartrat Inj. 0,1%- 1ml
Amp
1,408
#REF!
#REF!
#REF!
1,800
#REF!
#REF!
#REF!
448
#REF!
#REF!
#REF!
375
#REF!
#REF!
#REF!
#REF!
#REF!
74 Etakridin (Rivanol) Lar. 0,1%-300 ml
Btl
75 Lisinofril 10 mg
Tab
76 Lisinofril 5mg
Tab
77 Etanol 70%- 100 ml
Btl
2,500
#REF!
78 Eritromisin Kapsul 500 mg
Kap
730
#REF!
#REF!
#REF!
79 Eritromisin Syrup 200 mg/5 ml-60 ml
Btl
6,700
#REF!
#REF!
#REF!
80 Fenitoin Natrium Injeksi 50 mg/ 1 ml
Amp
-
#REF!
#REF!
#REF!
81 Fenitoin Natrium Kapsul 100 mg
Kap
154
#REF!
#REF!
#REF!
82 Fenitoin Natrium Kapsul 30 mg
Kap
-
#REF!
#REF!
#REF!
83 Fenobarbital Injeksi- 2ml
Amp
1,740
#REF!
#REF!
#REF!
84 Fenobarbital Tablet 30 mg
Tab
165
#REF!
#REF!
#REF!
85 Fenobarbital Tablet 30 mg
Tab
-
#REF!
#REF!
#REF!
86 Fenoksimetil Penisilina Tablet 250 mg
Tab
-
#REF!
#REF!
#REF!
87 Fluflenazine decanoat inj 25mg/ml
Amp
57,500
#REF!
#REF!
#REF!
88 Fitomenadion (Vit. K1) Inj. 10 mg/1 ml
Amp
3,550
#REF!
#REF!
#REF!
89 Fitomenadion (Vit. K1) Tab. 10 mg
Tab
710
#REF!
#REF!
#REF!
90 Gentamisin SM
Tube
2,600
#REF!
#REF!
#REF!
91 Furosemida Tablet 40 mg
Tab
75
#REF!
#REF!
#REF!
92 Garam Oralit 200 ml air
Ktg
264
#REF!
#REF!
#REF!
93 Glimepirid 2mg Tablet
Tab
288
#REF!
#REF!
#REF!
94 Glibenklamida Tablet 5 mg
Tab
119
#REF!
#REF!
#REF!
95 Asetil Sistein 200mg
Tab
358
#REF!
#REF!
#REF!
96 Glikazid 80 mg
Btl
235
#REF!
#REF!
#REF!
97 Glukosa Lar. Infus 5% Steril - 500 ml
Btl
6,900
#REF!
#REF!
#REF!
98 Glukosa Lar. Infus 10% Steril - 500 ml
Btl
5,700
#REF!
#REF!
#REF!
99 Griseofulvin Tablet 500 mg,
Tab
2,200
#REF!
#REF!
#REF!
100 Griseofulvin Tablet 125 mg, Micron
Tab
210
#REF!
#REF!
#REF!
101 Gentamisin S.K 0.1%-5 gr
Tube
2,800
#REF!
#REF!
#REF!
102 Gentamisin Injeksi
Vial
3,696
#REF!
#REF!
#REF!
103 Haloperidol 2 mg Tablet
Tab
126
#REF!
#REF!
#REF!
104 Haloperidol 5 mg Tablet
Tab
96
#REF!
#REF!
#REF!
105 Hidroklortiazid (HCT) Tablet 25 mg
Tab
106 Hidrokortison Krim 2,5%-5 gr
Tab
107 Ibuprofen Tablet 200 mg
Tab
108 Ibuprofen Tablet 400 mg
Tab
109 Ibufropen syr
Btl
149
#REF!
#REF!
#REF!
2,639
#REF!
#REF!
#REF!
105
#REF!
#REF!
#REF!
205
#REF!
#REF!
#REF!
3,499
#REF!
#REF!
#REF!
9,750
#REF!
#REF!
#REF!
89
#REF!
#REF!
#REF!
2,545
#REF!
#REF!
#REF!
270
#REF!
#REF!
#REF!
#REF!
#REF!
110 Haloporidol Decanoate Inj 50mg
Amp
111 Isosorbid Dinitrat Tab. Sub. 5 mg
Tab
112 Ketokonazol krem
Tube
113 Ketokonazol tab 200mg
Tab
114 Ketorolac Inj 30mg
Vial
1,045
#REF!
115 Kalsium Laktat (Kalk) Tablet 500 mg
Tab
59
#REF!
#REF!
#REF!
116 KN-3B
Labu
10,050
#REF!
#REF!
#REF!
117 Karbihidrat +Elektrolit
Labu
1,007
#REF!
#REF!
#REF!
Btl
2,500
#REF!
#REF!
#REF!
119 Kloramfenikol tetes Mata
Btl
3,250
#REF!
#REF!
#REF!
120 Klorfeniramin Maleat (CTM) Tab. 4 mg
Tab
22
#REF!
#REF!
#REF!
121 Klozapine 25 Mg
Tab
1,121
#REF!
#REF!
#REF!
122 Klorpromazin HCL Inj. 25 mg/ml- 1ml
Amp
-
#REF!
#REF!
#REF!
123 Klorpromazin HCL Tablet Salut 25 mg
Tab
148
#REF!
#REF!
#REF!
124 Klorpromazin HCL Tablet Salut 100 mg
Tab
147
#REF!
#REF!
#REF!
125 klorpeson Slasf
tube
7,750
#REF!
#REF!
#REF!
-
#REF!
#REF!
#REF!
125
#REF!
#REF!
#REF!
2,052
#REF!
#REF!
#REF!
#REF!
#REF!
118 Karbogliserin Tetes telinga
126 Komb. Artesunate 50mg+Amodiaquin 200mg
Pkt
127 Kotrimoksazol Tablet 480mg
Tab
128 Kotrimoksazol Suspensi Kombinasi
Btl
129 Metpormin 500mg
Tab
100
#REF!
130 Methyilprednisolon 8mg
Tab
150
#REF!
#REF!
#REF!
131 Kloramfenikol Salep Mata 1%-5gram
Tube
1,881
#REF!
#REF!
#REF!
132 Kloramfenikol Tetes Telinga 3%-5ml
Btl
1,797
#REF!
#REF!
#REF!
Amp
6,200
#REF!
#REF!
#REF!
134 Levoploxasin 500mh
Dus
528
#REF!
#REF!
#REF!
135 Lidokain Komp. Injeksi, Kombinasi
Amp
1,140
#REF!
#REF!
#REF!
136 Lisol, Kresol Tersabun 50%- 1000ml
Btl
3,360
#REF!
#REF!
#REF!
137 Loperamide Hcl 2mg Tanlet
Tab
85
#REF!
#REF!
#REF!
138 Magnesium Sulfat Injk 25 ml
Vial
3,328
#REF!
#REF!
#REF!
139 Metamizol 500mg
Tab
473
#REF!
#REF!
#REF!
140 Metilergometrin Maleat Tab. 0,125 g
Tab
210
#REF!
#REF!
#REF!
141 Metilergometrin M inj. 0,200mg- 1ml
Amp
2,840
#REF!
#REF!
#REF!
142 Metoklorpropamid Tablet 10 mg
Tab
91
#REF!
#REF!
#REF!
143 Mikonazol Krim/ Salep 2%-10gram
Tube
3,414
#REF!
#REF!
#REF!
#REF!
#REF!
133 Kuinin Injeksi 25%-2ml
144 Multivitamin Anak
Btl
12,100
#REF!
145 Multivitamin Dewasa
Tab
1,316
#REF!
#REF!
#REF!
146 Metronidazol Infus 500mg/100ml
Btl
9,950
#REF!
#REF!
#REF!
147 Metronidazol Tablet 500mg
Tab
113
#REF!
#REF!
#REF!
148 Metokloramid Syr
Btl
2,345
#REF!
#REF!
#REF!
149 Metronidazol syr
Btl
3,799
#REF!
#REF!
#REF!
150 Natrium Bikarbonat Tablet 500mg
Tab
514
#REF!
#REF!
#REF!
151 Natrum Klorida Lar. Inf. 0,9% -500ml
Btl
6,410
#REF!
#REF!
#REF!
145
#REF!
#REF!
#REF!
480
#REF!
#REF!
#REF!
-
#REF!
#REF!
#REF!
115
#REF!
#REF!
#REF!
108
#REF!
#REF!
#REF!
1,440
#REF!
#REF!
#REF!
317,018
#REF!
#REF!
#REF!
#REF!
#REF!
152 Natrium Diclopenac 20mg
Amp
153 Nistatin Vaginal
sup
154 Nistatin Tablet Salut 500.000 IU
tab
155 Natrium Diclopenac 50mg
Tab
156 Nifedipine Tab 10mg
Tab
157 Multivitamin Anti Oksidan
Tab
158 Obat Anti Tuberkulosis Kat. 1 (FDC)
Pkt
159 Obat Anti Tuberkulosis Kat. 2
Pkt
1,297,894
#REF!
160 Obat Anti Tuberkulosis Kat.Anak
Pkt
214,985
#REF!
#REF!
#REF!
161 Ofloksasin Tetes telinga
Btl
45,089
#REF!
#REF!
#REF!
162 Omeprazol inj 40mg/10ml
Btl
16,997
#REF!
#REF!
163 Omeprazol Kapsul 20mg
Kap
#REF!
130
#REF!
#REF!
164 Ondansetron Inj 4mg
Vial
#REF!
1,660
#REF!
#REF!
165 Onadansetron 8mg Tablet
Tab
#REF!
1,189
#REF!
#REF!
166 Onadansetron 4mg Tablet
Tab
#REF!
471
#REF!
#REF!
167 Obat Batuk Flu Dewasa
Pkt
#REF!
413
#REF!
#REF!
168 Obat Batuk Hitam (OBH) Cairan
Btl
#REF!
5,000
#REF!
#REF!
169 Obat Batuk Dewasa syr
Btl
#REF!
5,500
#REF!
#REF!
170 Oksitetrasiklin HCL Inj. i.m 50mg10ml
Vial
#REF!
7,840
#REF!
#REF!
171 Oksitetrasiklin HCL SM 1%-3,5gram
Tube
#REF!
1,920
#REF!
#REF!
172 Oksitetrasiklin HCL Salep 3%- 5gram
Tube
#REF!
1,545
#REF!
#REF!
173 Oksitosin Injeksi 10 IU/ml- 1ml
Amp
#REF!
1,199
#REF!
#REF!
#REF!
174 OBAT Anti Diare suspensi
Btl
6,500
#REF!
#REF!
#REF!
175 parasetamol drops 15 ml
btl
6,649
#REF!
#REF!
#REF!
176 Parasetamol Syrup 120mg/ 5ml-60ml
Btl
1,107
#REF!
#REF!
#REF!
177 Parasetamol tab 100mg
Tab
41
#REF!
#REF!
#REF!
178 Parasetamol Tablet 500mg
Tab
53
#REF!
#REF!
#REF!
179 Permetin Krim/Skabisid 5 %
Tube
12,155
#REF!
#REF!
#REF!
9,700
#REF!
#REF!
#REF!
291
#REF!
#REF!
#REF!
234
#REF!
#REF!
#REF!
105
#REF!
#REF!
#REF!
319
#REF!
#REF!
#REF!
123
#REF!
#REF!
#REF!
17,996
#REF!
#REF!
#REF!
#REF!
#REF!
180 pirantel syr
Btl
181 Pirantel Tablet 125mg
Tab
182 piroksikam Tablet 10 mg
Tab
183 Piroksikam Tablet 20 mg
Tab
184 Propiltiourasil Tablet 100mg
Tab
185 Piridoksin HCL (Vit. B6) Tablet 10mg
Tab
186 Povidon Iodida 10% 300ml
Btl
187 Povidon Iodida 10% 1000ml
Btl
-
#REF!
188 Prednison Tablet 5mg
Tab
68
#REF!
#REF!
#REF!
189 Primakuin Tablet 15mg
Tab
224
#REF!
#REF!
#REF!
190 Prokain Benzil Penisilin 3 Juta IU Inj.
Vial
6,016
#REF!
#REF!
#REF!
191 propanolol HCL Tablet 10mg
Tab
60
#REF!
#REF!
#REF!
192 Propanolol HCL Tablet 40mg
Tab
121
#REF!
#REF!
#REF!
6,550
#REF!
#REF!
#REF!
284
#REF!
#REF!
#REF!
505
#REF!
#REF!
#REF!
30,595
#REF!
#REF!
#REF!
9,770
#REF!
#REF!
#REF!
347
#REF!
#REF!
#REF!
1,155
#REF!
#REF!
#REF!
105
#REF!
#REF!
#REF!
#REF!
#REF!
193 Povidon Iodida 10% 60ml
Botol
194 Retinol (Vitamin A) Kapsul 100.000 IU
Kap
195 Retinol (Vitamin A) Kapsul 200.000 IU
Kap
196 MDT MB/ Kusta Dewasa
Blister
197 MDT PB/ Kusta Dewasa
Blister
198 Risperidon 2mg
Tab
199 Ranitidin Injeksi 25 mg/ 2ml
Vial
200 Ranitidin Tablet 150 mg
Tab
201 Ringer Laktat Lar. Inf. Steril - 500ml
Btl
7,150
#REF!
202 Salbutamol Tablet 2mg
Tab
63
#REF!
#REF!
#REF!
203 Salbutamol Tablet 4mg
Tab
70
#REF!
#REF!
#REF!
204 Salep 2-4, Kombinasi
Pot
2,621
#REF!
#REF!
#REF!
205 Salisil Bedak 2%
Ktk
1,025
#REF!
#REF!
#REF!
206 Serum Anti Bisa Ular Polivalen Inj.5ml
Vial
479,996
#REF!
#REF!
#REF!
23,540
#REF!
#REF!
#REF!
170,000
#REF!
#REF!
#REF!
368
#REF!
#REF!
#REF!
1,035
#REF!
#REF!
#REF!
205
#REF!
#REF!
#REF!
110
#REF!
#REF!
#REF!
8,338
#REF!
#REF!
#REF!
3,226
#REF!
#REF!
#REF!
110
#REF!
#REF!
#REF!
#REF!
#REF!
207 Stimuno
Botol
208 Serum Anti Tetanus Inj. 1500 IU/amp.
Amp
209 Sukrafat 500mg
Tab
210 Sianokobalamin (Vit. B12) Inj 500mcg
Amp
211 Simvastatin Tablet 20 mg
Tab
212 Simvastatin Tablet 10 mg
Tab
213 Sukralfat Syr 214 Sulfasetamida Natrium TM 15%- 5ml
Botol Btl
215 Sabutamol Nebulizer
Amp
216 Spiranolakton tab
tab
217 Salf Kombinasi 218 Sinbio
899
#REF!
Tube
11,000
#REF!
#REF!
#REF!
Set
4,500
#REF!
#REF!
#REF!
219 Setrizin tablet 10 mg
Tab
220 Tablet Tambah Darah Komb.
Tab
221 Tetrakain HCL Tetes Mata 0.5%- 5ml
Btl
222 Tetrasiklin HCL Kapsul 250 mg
Kap
223 Tetrasiklin HCL Kapsul 500 mg
Kap
224 Tiamin HCL/(Vit. B1) Tab. 50mg
Tab
225 Tiopental Natrium Serbuk Inj 1.000mg
Amp
226 Vitalex (penambah darah)kapsul
Tab
227 Tiamin HCL (Vit. B1) Inj. 100mg/ 1ml
vial
228 Triheksifenidil Hidroklorida Tab. 2mg
Tab
229 Vitamin B Komplek Tablet
Tab
230 Zink Syr 231 Zink Tablet 20mg
Botol Tab
90
#REF!
#REF!
#REF!
352
#REF!
#REF!
#REF!
-
#REF!
#REF!
#REF!
163
#REF!
#REF!
#REF!
300
#REF!
#REF!
#REF!
85
#REF!
#REF!
#REF!
1,455
#REF!
#REF!
#REF!
88
#REF!
#REF!
#REF!
1,455
#REF!
#REF!
#REF!
88
#REF!
#REF!
#REF!
118
#REF!
#REF!
#REF!
2,972
#REF!
#REF!
#REF!
514
#REF!
#REF!
#REF!
#REF!
#REF!
#REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF!
JML 2
BARANG HABIS PAKAI
1
Alat Suntik Sekali Pakai 1 ml
Set
777
#REF!
#REF!
2
Alat Suntik Sekali Pakai 3 ml
Set
825
#REF!
#REF!
3
Alat Suntik Sekali Pakai 5 ml
Set
856
#REF!
#REF!
4
Catgut/ Benang Bedah No. 2/0 - 3/0
Set
60,622
#REF!
#REF!
5
I.V. Catheter No. 20
Set
4,783
#REF!
#REF!
6
I.V. Catheter No. 22
Set
12,232
#REF!
#REF!
7
I.V. Catheter No. 24
Set
4,784
#REF!
#REF!
8
I.V. Cateter No 26
set
13,464
#REF!
#REF!
9
Infusion Set Anak
Set
3,498
#REF!
#REF!
10 Infusion Set Dewasa
Set
4,147
#REF!
#REF!
11 E.Care Film I.V Dresing
Pcs
6,850
#REF!
#REF!
12 Silk (Benang Bedah Sutera) No. 3/0
Biji
44,953
#REF!
#REF!
Botol
72,047
#REF!
#REF!
13 Saraya Alsof A 500 ml 14 Kapas Pembalut/Absorben 250 gram
Set
12,250
#REF!
#REF!
lembar
1,800
#REF!
#REF!
16 Kasa Pembalut 2 m x 80 cm
pak
9,400
#REF!
#REF!
17 Kasa Pembalut Hidrofil 36 m x 80 cm
rol
127,600
#REF!
#REF!
15 Kasa Kompres 40/40
18 Kasa Steril 16/16
7,370
#REF!
#REF!
19 Masker
biji
549
#REF!
#REF!
20 Plester 5 yard x 2 inch
rol
8,167
#REF!
#REF!
kotak
21 Sarung Tangan No 7 Steril
pasang
792
#REF!
#REF!
22 Sarung Tangan No 6.5 Steril
pasang
7,931
#REF!
#REF!
23 Sarung tangan no 6 1/2
Pasng
924
#REF!
#REF!
24 Folly cateter No 16
Pcs
12,036
#REF!
#REF!
25 Folly cateter No 14
Pcs
16,610
#REF!
#REF!
Sashet
17,748
#REF!
#REF!
bok
32,600
#REF!
#REF!
28 Underpad
Lembar
4,162
#REF!
#REF!
29 Urine Bag
Biji
7,038
#REF!
#REF!
30 Catgut/ Benang Bedah No. 3/0
Botol
68,433
#REF!
#REF!
31 Antiseptik Surgical Hand Scrab
Botol
74,000
#REF!
#REF!
32 Cairan pembersih
Botol
22,000
#REF!
#REF!
33 Jely kateter
biji
41,600
#REF!
#REF!
34 Jarum Insulin
Biji
2,083
#REF!
#REF!
26 Sarung tangan Gynecolog no 7 27 Alkohol Swab
JML
#REF!
ber
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