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LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) PUSTU/POLINDES KOTA / KODYA

: : KOTA TIDORE KEPULAUAN

LAPORAN BULANAN / TAHUN

: Maret

NO NAMA OBAT 1 1 2 3 4 5 6 7 8 9 10 10 11 12 13 14 15 16

2 ALLOPURINOL 100 mg AMBROXOL 30 MG AMBROXOL SYRUP AMOKCILLIN 500 MG AMOKCILLIN SYRUP 125 MG/5 ANTASIDA SYRUP ANTASIDA TABLET ANTIHEMOROID SUPP ASAM ASKORBAT 50 MG(VIT C) ASAM MEFENAMAT AQUA PRO INJEKSI BETAMETASONE CREAM CA.GLUKONAS INJEKSI CAPTOPRIL 12,5 MG CAPTOPRIL 25 MG CAVIPLEX CAVIPLEX SYR

2019

SUMBER ANGGA PENE STOK HARGA STOK PERSE PEMAK RUSA STOK STOK PERMIN PEMBE SATUAN RIMA PENYAN APB SATUAN AWAL DIAAN AIAN K/ ED AKHIR OPT TAAN RIAN AN GGA N 3 4 5 4+5=6 7 8 6-7-8=9 10 11 12 13 14 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 BOTOL 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 BOTOL 0 0 0 0 0 0 0 0 0 BOTOL 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 SUPP 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 BOTOL 0 0 0 0 0 0 0 0 0 TUBE 0 0 0 0 0 0 0 0 0 AMPUL 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 BOTOL 0 0 0 0 0 0 0 0 0

NO NAMA OBAT 1 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40

2 CEFADROXIL 500 MG CETIRIZIN 10 MG CETIRIZIN SYRUP CHLORAMPENICOL SM CHLORAMPENOCOL TM CHLORAMPENOCOL TTS TLNGA CIMETIDIN COTRIMOKSASOL 480 MG COTRIMOKSASOL SYRUP DEXAMETASONE INJEKSI DEXAMETASONE TAB DEXSTROSE 10 % INF DEXTROSE 5 % INF DIMENHIDRINAT TAB DOMPERIDONE SYRUP DOMPERIDONE TAB EPINERPIN INJEKSI FENOL GLYCEROL TTS TELINGA FUROSEMIDA 40 MG GARAM ORALIT GENTAMICIN INJ GENTAMICIN SM GENTAMICIN TM GENTIAN VIOLET

SUMBER ANGGA PENE STOK HARGA STOK PERSE PEMAK RUSA STOK STOK PERMIN PEMBE SATUAN RIMA PENYAN APB SATUAN AWAL DIAAN AIAN K/ ED AKHIR OPT TAAN RIAN AN GGA N 3 4 5 4+5=6 7 8 6-7-8=9 10 11 12 13 14 KAPSUL 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 BOTOL 0 0 0 0 0 0 0 0 0 TUBE 0 0 0 0 0 0 0 0 0 TUBE 0 0 0 0 0 0 0 0 0 BOTOL 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 BOTOL 0 0 0 0 0 0 0 0 0 AMPUL 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 BOTOL 0 0 0 0 0 0 0 0 0 BOTOL 0 0 0 0 0 0 0 0 0 KAPLET 0 0 0 0 0 0 0 0 0 BOTOL 0 0 0 0 0 0 0 0 0 BOTOL 0 0 0 0 0 0 0 0 0 AMPUL 0 0 0 0 0 0 0 0 0 BOTOL 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 SACHET 0 0 0 0 0 0 0 0 0 AMPUL 0 0 0 0 0 0 0 0 0 TUBE 0 0 0 0 0 0 0 0 0 BOTOL 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0

NO NAMA OBAT 1 41 42 43 44 45 46 47 48 49 50 50 51 52 52 52 53 54 55 56 57 58 59 60 61

2 GLIBENCLAMID 5 MG GLIMEPIRID 2 MG GLISEOFULVIN 125 MG GLISERIL GUAKOLAT 100 MG GLISERIN HYDROCLORTIAZID 25 MG HYDROCORTISON CREAM IBUPROFEN 200 MG IBUPROFEN 400 MG IBUPROFEN SYR IMPLANT KALSIUM LAKTAT KB INJEKSI 1 BLN KB INJEKSI 3 BLN KETOKONAZOLE TAB KETOROLAK INJ KHLORFENIRAMIN MALEAT (CTM) LIDOCAIN INJEKSI LIDOCAIN INJEKSI+EPINERPIN LORATADINE 10 MG METFORMIN TAB METHILERGOMETRIN INJEKSI METHILERGOMETRIN TAB METHYLPREDNISOLONE 4 MG

SUMBER ANGGA PENE STOK HARGA STOK PERSE PEMAK RUSA STOK STOK PERMIN PEMBE SATUAN RIMA PENYAN APB SATUAN AWAL DIAAN AIAN K/ ED AKHIR OPT TAAN RIAN AN GGA N 3 4 5 4+5=6 7 8 6-7-8=9 10 11 12 13 14 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 BOTOL 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TUBE 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 AMPUL 0 0 0 0 0 0 0 0 0 AMPUL 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 AMPUL 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 AMPUL 0 0 0 0 0 0 0 0 0 AMPUL 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0

NO NAMA OBAT 1 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 83 84

2 METOCLOPRAMID 10 MG METOCLOPRAMID 5 MG METOCLOPRAMID INJEKSI METRONIDAZOLE 500 MG MGSO4 20% MGSO4 40 % MICONAZOLE SALEP KULIT MINERAL MIX NATRIUM DIKLOFENAT 50 MG NATRIUM KLORIDA 0,9 % INF NISTATIN TAB 100.000 IU NISTATIN TAB 500.000 IU OMEPRAZOLE KAPSUL OXYTETRASIKLIN SK OXYTETRASIKLIN SM OXYTOCIN INJEKSI PARACETAMOL 500 MG PARACETAMOL DROPS PARACETAMOL SYRUP 125 MG PHYTOMENADION INJEKSI PHYTOMENADION TAB PIL KB PIRACETAM INJ PIROXICAM 20 MG

SUMBER ANGGA PENE STOK HARGA STOK PERSE PEMAK RUSA STOK STOK PERMIN PEMBE SATUAN RIMA PENYAN APB SATUAN AWAL DIAAN AIAN K/ ED AKHIR OPT TAAN RIAN AN GGA N 3 4 5 4+5=6 7 8 6-7-8=9 10 11 12 13 14 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 VIAL 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 VIAL 0 0 0 0 0 0 0 0 0 VIAL 0 0 0 0 0 0 0 0 0 TUBE 0 0 0 0 0 0 0 0 0 SACHET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 BOTOL 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 KAPSUL 0 0 0 0 0 0 0 0 0 TUBE 0 0 0 0 0 0 0 0 0 TUBE 0 0 0 0 0 0 0 0 0 AMPUL 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 BOTOL 0 0 0 0 0 0 0 0 0 BOTOL 0 0 0 0 0 0 0 0 0 AMPUL 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 AMPUL 0 0 0 0 0 0 0 0 0 AMPUL 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0

NO NAMA OBAT 1 2 85 PREDNISONE TAB 86 PYRANTEL PAMOAT TAB 87 RANITIDIN 150 MG 88 RANITIDIN INJEKSI 89 RINGER LAKTAT INF 90 SALBUTANOL 2 MG 91 SALBUTANOL 4 MG 92 SALISIL BEDAK 93 SCABICID CREAM 94 SIMVASTATIN 10 MG 95 SIMVASTATIN 20 MG 96 TABLET TAMBAH DARAH 97 TABURIA 98 VITAMIN A 100.000 IU 99 VITAMIN A 200.000 IU 100 VITAMIN B COM 101 VITAMIN B1 TAB 102 VITAMIN B12 TAB 103 VITAMIN B6 TAB 10 MG 104 ZINK 20 MG 105 ZINK SYRUP

SUMBER ANGGA PENE STOK HARGA STOK PERSE PEMAK RUSA STOK STOK PERMIN PEMBE SATUAN RIMA PENYAN APB SATUAN AWAL DIAAN AIAN K/ ED AKHIR OPT TAAN RIAN AN GGA N 3 4 5 4+5=6 7 8 6-7-8=9 10 11 12 13 14 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 VIAL 0 0 0 0 0 0 0 0 0 BOTOL 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 KALENG 0 0 0 0 0 0 0 0 0 TUBE 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 TABLET 0 0 0 0 0 0 0 0 0 BOTOL 0 0 0 0 0 0 0 0 0

NO NAMA OBAT 1 1 2 3 4 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22

2 ALAT KESEHATAN ABOCATH NO 18 ABOCATH NO 20 ABOCATH NO 22 ABOCATH NO 24 AKDR (IUD) ALAT SUNTIK 20 CC ALAT SUNTIK 10 CC ALAT SUNTIK 1 CC ALAT SUNTIK 5 CC ALAT SUNTIK 3 CC HANDSCOEND NO 6,5 HANDSCOEND NO 7 HANDSCOEND NO 7,5 HANDSCOEND NO 8 HANDSKOEN NON STERIL INFUSET DEWASA INFUSET ANAK CATGUT CROMIC CATGUT PLAIN CATGUT SILK CATHETER NO 20 CATHETER NO 18 CATHETER NO 16

SUMBER ANGGA PENE STOK HARGA STOK PERSE PEMAK RUSA STOK STOK PERMIN PEMBE SATUAN RIMA PENYAN APB SATUAN AWAL DIAAN AIAN K/ ED AKHIR OPT TAAN RIAN AN GGA N 3 4 5 4+5=6 7 8 6-7-8=9 10 11 12 13 14 PIECES PIECES PIECES PIECES TABLET PIECES PIECES PIECES PIECES PIECES BUAH BUAH BUAH BUAH BUAH SET SET PIECES PIECES PIECES BUAH BUAH BUAH

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

NO 1 23 24 25 26 26 27 28 29 30 31 32 33 34 35 36 37 38

SUMBER ANGGA PENE STOK HARGA STOK PERSE PEMAK RUSA STOK STOK PERMIN PEMBE NAMA OBAT SATUAN RIMA PENYAN APB SATUAN AWAL DIAAN AIAN K/ ED AKHIR OPT TAAN RIAN AN GGA N 2 3 4 5 4+5=6 7 8 6-7-8=9 10 11 12 13 14 KAPAS 500 GRAM BUAH 0 0 0 0 0 0 0 0 0 KAPAS 25O GRAM BUAH 0 0 0 0 0 0 0 0 0 KASSA STERIL 16 X 16 KOTAK 0 0 0 0 0 0 0 0 0 KASSA HYDROFIL 36 X 80 ROLL 0 0 0 0 0 0 0 0 0 KONDOM PIECES 0 0 0 0 0 0 0 0 0 PLESTER LEUKOPLAS 7,5 X 4,5 MG ROLL 0 0 0 0 0 0 0 0 0 MASKER BUAH 0 0 0 0 0 0 0 0 0 JARUM KULIT PIECES 0 0 0 0 0 0 0 0 0 URIN BAG BUAH 0 0 0 0 0 0 0 0 0 RIVANOL 300 ML BOTOL 0 0 0 0 0 0 0 0 0 POVIDONE IODINE 300 ML BOTOL 0 0 0 0 0 0 0 0 0 POVIDONE IODINE 60 ML BOTOL 0 0 0 0 0 0 0 0 0 LISOL 1 L BOTOL 0 0 0 0 0 0 0 0 0 ALKOHOL 1000 ML BOTOL 0 0 0 0 0 0 0 0 0 CHLOR ETHYL SPRAY BOTOL 0 0 0 0 0 0 0 0 0 TRANFUSI SET PIECES 0 0 0 0 0 0 0 0 0 POLICRAPE 0 0 0 0 0 0 0 0 0

SUMBER ANGGARANTOTAL APB LAIN HARG A D LAIN 15 16 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

SUMBER ANGGARANTOTAL APB LAIN HARG A D LAIN 15 16 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

SUMBER ANGGARANTOTAL APB LAIN HARG A D LAIN 15 16 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

SUMBER ANGGARANTOTAL APB LAIN HARG A D LAIN 15 16 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

SUMBER ANGGARANTOTAL APB LAIN HARG A D LAIN 15 16 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

SUMBER ANGGARANTOTAL APB LAIN HARG A D LAIN 15 16 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

SUMBER ANGGARANTOTAL APB LAIN HARG A D LAIN 15 16 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

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