Format Lplpo S.o.xlsx

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO )

FORM : LPL

UPTD PUSKESMAS KOPO PUSKESMAS

: KOPO

KECAMATAN

: KOPO

PELAPORAN BULAN / PERIODE

:FEBRUARY 2017

KABUPATEN

: SERANG

PERMINTAAN BULAN / PERIODE

:MEI 2017

PROVINSI

: BANTEN

DOKUMEN

TANGGAL

GUDANG FARMASI PUSKESMAS

NO

NAMA OBAT

SATUAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

1 1

2

4

5

6

7

8

Alat Suntik 1 ml

3 Set

2 3

Alat suntik 20 ml

STOK OPT PERMINTA AN

1,100

-

1,100

770

330

9 1,128

Set

11

-

11

9

2

13

300

Alat Suntik 3 ml

Set

925

200

1,125

311

814

456

800

4 5

Alat suntik 5 ml

set

290

-

290

125

165

183

300

Albendazole

Tablet

210

-

210

-

210

-

6 7

Allopurinol 100 mg

Tablet

1,950

200

2,150

1,030

1,120

1,509

5,000

Ambroxol sirup 15 mg/ml

Botol

823

-

823

516

307

756

500

8 9

Ambroxol tablet 30 mg

Tablet

1,085

-

1,085

825

260

1,209

5,000

Aminophilin 200 mg

Tablet

-

-

-

-

-

-

-

10 Aminophilin inj 11 Amitriptillin tab 25 mg

Ampul

-

-

-

-

-

-

-

Tablet

4,050

-

4,050

2,110

1,940

3,092

-

12 Amlodipin 13 Amlodipin 10 Mg

Tablet

120

-

120

120

-

176

-

Tablet

-

150

150

20

130

29

Vial

-

-

-

-

-

-

-

-

-

-

-

-

-

-

14 Amoxicillin Inj 15 Amoxicillin forte 250 mg/ml

NOMOR

Botol

10 500

-

1,500

28-Feb-17

APBD II

APBD I

11

12

PEMBERIAAN LAIN ASKES LAIN 13

14

16 Amoxisilin 125 mg syr 17 Amoxisilin 250 mg

Botol

224

96

320

232

88

340

360

Kapsul

5,420

-

5,420

2,776

2,644

4,068

5,000

18 Amoxisilin 500 mg 19 Ampicillin 1 gr inj

Kapsul

26,604

2,000

28,604

16,437

12,167

24,087

10,000

-

-

-

-

-

-

20 Antalgin 500 mg 21 Antasida Doen

Tablet

590

-

590

540

50

791

3,000

Tablet

7,476

1,000

8,476

5,050

3,426

7,400

7,000

22 Antasida Doen Sirup 23 Anti vertigo (Betahistin maleat)

Botol

299

-

299

174

125

255

150

Tablet

370

-

370

210

160

308

600

Tube

-

-

-

-

-

-

96

Supp

150

-

150

77

73

113

36

Tablet

-

-

-

-

-

-

Ampul

242

-

242

192

50

281

28 Artesunate inj 29 Asam Aselilsalisilat 100mg

Ampul

-

-

-

-

-

-

Tablet

3,240

-

3,240

1,230

2,010

1,802

3,000

30 Asam Askorbat 250 mg 31 Asam Askorbat 50 mg

Tablet

1,780

-

1,780

800

980

1,172

1,500

Tablet

3,342

300

3,642

1,833

1,809

2,686

2,000

32 Asam Mefenamat 500 mg 33 Asam Traneksamat inj 250 mg / ml

Tablet

3,558

1,500

5,058

3,514

1,544

5,149

6,000

Ampul

-

-

-

-

-

-

-

Botol

-

-

-

-

-

-

-

Tablet

2,130

-

2,130

940

1,190

1,377

1,000

Tube

97

-

97

41

56

60

50

Ampul

-

-

-

-

-

-

Tablet

-

-

-

-

-

-

Tablet

196

-

196

147

49

-

-

-

-

-

24 Antibakteri Doen Salep 25 Antihaemoroid Doen Komb. Supp 26 Antimigrain Doen Komb. 27 Aqua Pro inj Steril 20 ml

34 Asering 500 cc 35 Asiclovir 400 mg 36 Asiclovir cream 37 Atrofin Sulfat inj 0,25 mg / ml 38 Attapulgit 600 mg 39 Azythromycin 500 mg 40 Benzatin Benzilpenisillin 1,2 Juta IU/Vial

Vial

Vial

-

30 -

3,000 -

-

-

41 Betamethason Krim

Tube

-

-

-

-

-

-

96

42 Bisacodyl 43 Bisturi

Tablet

-

-

-

-

-

-

-

pcs

535

-

535

335

200

491

Vial

2

-

2

2

-

3

-

Set

4

-

4

2

2

3

-

Tablet

350

-

350

350

-

513

Tablet

2,000

-

2,000

1,020

980

1,495

169

-

169

121

48

177

72

Kapsul

-

-

-

-

-

-

500

Botol

-

-

-

-

-

-

50

Kapsul

-

-

-

-

-

-

3,000

52 Cefixime 100 mg Kapsul 53 Cendo Lyteers

Kapsul

-

-

-

-

-

-

500

Botol

42

5

47

27

20

40

50

54 Cetirizine 55 Cetirizine 5 mg/ml syrup 60 ml

Tablet

50

-

50

50

-

73

3,000

Botol

267

50

317

174

143

255

500

56 Cimetidine 200 mg 57 Clobazam 10 mg

Tablet

-

-

-

-

-

-

-

Tablet

1,340

-

1,340

600

740

879

-

58 Clozapine 59 Composit (Diafil)

Tablet

-

-

-

-

-

-

Tube

-

-

-

-

-

-

-

60 Cresophene 61 Deksametason 0,5 mg

Botol

-

-

-

-

-

-

-

Tablet

4,688

800

5,488

3,049

2,439

4,468

62 Deksametason inj 5 mg 63 Devitalisasi pasta (non arsen)

Ampul

515

-

515

333

182

488

-

Botol

2

-

2

1

1

1

-

64 Dextrose 40% inj 65 Diazepam inj 5 mg / ml

Ampul

-

-

-

-

-

-

-

Ampul

30

-

30

15

15

22

-

44 Ca glukonas 45 Calsium Hidroksida Pasta (Dorident) 46 Captopril 12,5 mg 47 Captopril 25 mg 48 Cat- Gut/Benang Bedah 49 Cefadroxyl 250 mg 50 Cefadroxyl sirup kering 125mg/ml 51 Cefadroxyl 500 mg

Set

200

3,000 -

1,000

5,000

66 Diazepam rektal 5 mg /2,5 ml 67 Dietylcarbamazin Sitrat 100 mg

Tube

6

-

6

3

3

4

-

Tablet

-

-

-

-

-

-

-

68 Difenhidramin HCL inj 10 mg/ml 69 Digoksin 0,25 mg

Ampul

85

-

85

30

55

44

30

Tablet

960

-

960

510

450

747

600

70 Diltiazem HCl 30 mg 71 Doksisiklin 100 mg

Tablet

1,710

-

1,710

800

910

1,172

Capsul

280

-

280

-

280

-

500

Botol

248

-

248

65

183

95

150

Tablet

1,175

-

1,175

433

742

635

1,000

Tablet

-

-

-

-

-

-

500

Ampul

60

-

60

30

30

44

30

76 Erythromycin 500 mg Tablet Salut 77 Erytromisin syr

Tablet

1,000

200

1,200

500

700

733

500

Botol

100

-

100

50

50

73

-

78 Etakridin ( Rivanol ) 0.1% 79 Etanol 70% - 1.000 ml

Botol

51

-

51

36

15

53

15

Botol

34

-

34

25

9

37

6

80 Etanol 70% - 100 ml 81 Etilklorida Semprot - 100 ml

Botol

91

-

91

47

44

69

16

Botol

-

-

-

-

-

-

2

82 Eugenol cairan 83 FDC KAT II

Botol

2

-

2

1

1

1

-

Paket

-

-

-

-

-

-

-

Paket

23

-

23

-

23

-

-

Ampul

-

-

-

-

-

-

-

Botol

-

-

-

-

-

-

-

Tablet

1,857

100

1,957

717

1,240

1,051

1,000

88 Fitomenadion inj 10 mg / ml 89 Fluconazole 150 mg

Ampul

-

-

-

-

-

-

30

Tablet

60

-

60

50

10

-

90 Fluoxetine /Foransi10 mg

Tablet

-

-

-

-

-

-

72 Domperidon susp 5mg/ml 73 Domperidone tab 74 Ekstraks Belladona tab 10 mg 75 Epinefrin HCL inj 0,1%-1 ml

84 FDC Kat. I 85 Fenobarbital inj 86 Fenol Glicerol TT 87 Fitomenadion 10 mg

-

91 Fluphenazine Decanoate

194

-

194

107

87

157

Pcs

8

-

8

5

3

7

-

Pcs

10

-

10

-

5

-

-

-

-

-

-

-

-

-

Tablet

640

-

640

330

310

484

300

Ampul

50

-

50

25

25

37

-

Sachet

1,131

300

1,431

617

814

904

600

Botol

-

-

-

-

-

-

-

Ampul

-

-

-

-

-

-

-

Tube

-

-

-

-

-

-

144

Botol

-

-

-

-

-

-

60

Set

-

-

-

-

-

-

-

Tablet

780

-

780

210

570

308

1,000

104 Gliseril Guaiacolat 100 mg 105 Glucosa 5%

Tablet

7,366

-

7,366

3,656

3,710

5,357

8,000

Botol

21

-

21

13

8

19

-

106 Glukosa 10 % 107 Griseovulfin 125 mg

Botol

-

-

-

-

-

-

-

Tablet

-

-

-

-

-

-

300

Tablet

8,215

-

8,215

4,000

4,215

5,862

-

Ampul

20

-

20

10

10

15

-

110 Haloperidol inj 111 Hand schoon non steril

Ampul

9

-

9

-

9

-

-

Kotak

40

-

40

30

10

44

20

112 Handscrub (Cutisoft) 113 Hidrocortison Cream 2,5%

Botol

9

-

9

5

4

7

6

Tube

94

72

166

118

48

173

216

114 Hidrochlorthiazide (HCT) 115 Hyoscine-N-Butilbromide 20 mg/ml inj

Tablet

1,160

-

1,160

500

660

733

200

Ampul

-

-

-

-

-

-

20

92 Foley Catheter 16 93 Foley Catheter 18 94 Furalex 95 Furosemida 40 mg 96 Furosemida inj 10 mg/ml 97 Garam Oralit 200 ml 98 Gentamycine TT 2 % 99 Gentamycine inj 100 Gentamycine salep kulit 0,1 % 101 Gentamysin tetes mata 102 Glass Ionomer Semen 103 Glibenklamid 5 mg

108 Haloperidol 5 mg 109 Haloperidol decanoat

Ampul

30

116 Hyoscine-N-Butilbromide 10 mg 117 I.V catheter no : 18

Tablet

500

200

700

103

597

151

3,000

Pcs

64

-

64

42

22

62

30

118 I.V catheter no : 20 119 I.V catheter no : 24

Pcs

107

-

107

102

5

149

30

Set

-

-

-

-

-

-

-

120 I.V catheter no 26 121 I.V catheter No.22

Set

-

-

-

-

-

-

-

Set

79

-

79

37

42

54

30

122 Ibuprofen 200 mg 123 Ibuprofen 400 mg

Tablet

-

-

-

-

-

-

3,000

Tablet

110

400

510

143

367

210

3,000

124 Infus Set Anak 125 Infus Set Dewasa

Set

30

-

30

15

15

22

5

Set

114

-

114

55

59

81

30

Tablet

932

-

932

230

702

337

300

Set

-

-

-

-

-

-

-

Pot

-

-

-

-

-

-

300

3,866

500

4,366

1,390

2,976

2,037

6,000

126 Isosorbit Dinitrat 5 mg 127 I.V catheter No.16 128 Kalium Permanganat Serbuk 129 Kalsium Laktas 500 mg

Tablet

130 Kanamycin inj 131 Kapas Pembalut Adsorben

Vial

-

-

-

-

-

-

-

Rol

11

-

11

6

5

9

5

132 Kasa 36 m x 80 cm 133 Kasa Elastis 4 Inch

Rol

4

-

4

2

2

3

2

Roll

20

-

20

10

10

15

-

134 Kasa Kompres 40/40 Steril 135 Kasa Pemb.Hidropil 4mx10 cm

Bungkus

180

-

180

100

80

147

80

Rol

-

-

-

136 Kasa Pemb.Hidropil 4mx15cm 137 Kassa 16 x 16 cm Steril

Rol

179

-

179

94

85

138

50

Kotak

81

10

91

44

47

64

60

-

-

138 Ketokonazol cream 2 % 139 Ketokonazol Tab

Tube

44

25

69

42

27

62

75

Tablet

-

500

500

10

490

15

1,500

140 Ketorolac

Ampul

-

-

-

-

-

-

-

141 Klindamisin kap 150 mg

Kapsul

-

-

-

-

-

-

142 Klindamisin kap 300 mg 143 Kloramfenikol 250 mg

Kapsul

-

200

200

-

200

-

1,200

Kapsul

2,740

300

3,040

1,270

1,770

1,861

2,000

144 Kloramfenikol SM 1% 145 Kloramfenikol Suspensi

Tube

-

-

-

-

-

-

216

Botol

-

50

50

-

50

-

100

Botol

3

-

3

3

-

4

144

Tablet

3,583

2,000

5,583

4,762

821

6,978

8,000

148 Klorpromazin tab 100 mg 149 Kotrimoksazol 480 mg

Tablet

1,527

-

1,527

17

1,510

25

500

Tablet

-

-

-

-

-

700

-

150 Kotrimoksazol susp. 151 Laxadine Emulsi 60 ml

Botol

316

50

366

233

133

341

100

Botol

24

-

24

-

24

-

152 Levofloxacin tab 500 mg 153 Lidokain Jelly 2 %

Tablet

-

-

-

Tube

-

-

-

-

-

-

154 Lidocain kombinasi inj : lidokain HCl 2% 155 Lidokain inj

Ampul

360

-

360

290

70

425

60

Ampul

195

-

195

195

-

286

60

156 Loperamide 2 mg tab 157 Loratadine 10 mg

Tablet

-

-

-

Tablet

-

-

-

-

-

-

1,000

158 Lysol 1 L 159 Magnesium Sulfat 20 %

Botol Ampul

6

1

7

3

4

4

4

-

-

-

-

-

-

10

160 MgSo4 40 % 161 Masker

Vial

18

10

28

18

10

26

30

1,150

100

1,250

450

800

659

1,000

146 Kloramfenikol TT 147 Klorfeniramin Maleat ( CTM ) 4 mg

pcs

-

-

-

-

150

-

162 MDT MB Anak 163 MDT MB Dewasa

Blister

-

-

-

-

-

-

-

Blister

-

-

-

-

-

-

-

164 MDT PB Anak 165 MDT PB Dewasa

blister

-

-

-

-

-

-

-

Blister

-

-

-

-

-

-

-

166 Meloxicam 15 167 Metformin 500 mg

Tablet

216

-

216

216

-

317

Tablet

-

-

-

-

-

-

168 Metildopa tab 250 mg 169 Metilergometrin Maleat 0,125 mg

Tablet

370

-

370

100

270

147

Tablet

-

-

-

-

-

-

-

170 Metilergometrin Maleat inj 171 Metilprednisolon 8 mg

Ampul

-

-

-

-

-

-

60

Tablet

-

-

-

-

-

-

500

172 Metoclorpropamid injeksi 173 Metoclorpropamid 10 mg

Ampul

-

-

-

-

-

-

10

Tablet

2,268

-

2,268

1,240

1,028

1,817

600

174 Metronidazol 250mg 175 Metronidazole 500 mg/ml 176 Metronidazol 500mg

Tablet

-

-

-

-

-

-

1,000

Botol Tablet

-

-

-

-

-

-

150

2,040

200

2,240

1,233

1,007

1,807

3,000

177 Miconazole cream

Tube

141

24

165

74

91

108

72

178 Mumifying Pasta 179 Nalokson Hcl inj

Botol

-

-

-

-

-

-

-

Vial

-

-

-

-

-

-

-

Set

7

3

10

3

7

4

3

Set

8

3

11

4

7

6

3

182 Natrium Bicarbonat 500 mg 183 Natrium Bicarbonat lar 8,4 %

Tablet

-

-

-

-

-

-

-

Botol

-

-

-

-

-

-

-

184 Natrium dikloffenak tab 25 mg 185 Natrium dikloffenak tab 50 mg

Tablet

-

-

-

-

-

-

-

Tablet

1,120

200

1,320

810

510

1,187

3,000

186 Natrium Klorida 0,9% 187 Neo K (fitomenadion 2mg/ml)

Botol

57

-

57

37

20

54

60

Ampul

240

120

360

150

210

220

120

180 Nasal Cannula Anak 181 Nasal Cannula Dewasa

1,000 200

188 Neokolina syr 189 Nifedipin tab

Botol

-

-

-

-

-

-

-

Tablet

2,182

500

2,682

1,267

1,415

1,857

3,000

190 Nistatin Vaginal tab 100.000 IU

Tablet

641

-

641

216

425

317

1,000

191 Nistatin Vaginal tab 500.000 IU

Tablet

840

-

840

310

530

192 O.B.H.Sirup 193 OAT Kat Anak

Botol

51

-

51

20

31

29

192

Paket

24

-

24

20

4

29

-

194 Ofloxacin 195 Oksitetrasiklin HCL inj

Tablet

-

-

-

-

-

-

-

Vial

-

-

-

-

-

-

-

196 Oksitetrasiklin HCL SK 3% 197 Oksitetrasiklin HCL SM 1%

Tube

3

-

3

2

1

3

144

Tube

-

-

-

-

-

-

144

Vial Kapsul

1,212

-

1,212

612

600

897

-

512

90

602

170

432

249

600

200 Papaverin 40 mg 201 Parasetamol 100 mg

Tablet

-

-

-

-

-

-

1,000

Tablet

50

-

50

4

46

6

3,000

202 Parasetamol 160 mg supp 203 Parasetamol 240 mg supp

supp

-

-

-

-

-

-

12

supp

-

-

-

-

-

-

12

204 Parasetamol 500 mg 205 Parasetamol 80 mg supp

Tablet

17,127

4,000

21,127

14,175

6,952

20,772

30,000

supp

-

-

-

-

-

-

12

206 Parasetamol Sirup 207 Peahavral

Botol

-

-

-

-

-

-

756

Tablet

-

-

-

-

-

-

-

Tube

-

-

-

-

-

-

-

Botol

-

-

-

-

-

-

-

210 Pirantel Pamoat 125 mg 211 Piridoksin HCL 10 mg

Tablet

2,768

-

2,768

1,321

1,447

1,936

-

Tablet

7,190

2,000

9,190

3,989

5,201

5,845

212 Piridoksin HCL 25 mg 213 Piroksikam 20 mg

Tablet

-

-

-

-

-

-

Tablet

-

-

-

-

-

-

3,000

Roll

58

5

63

35

28

51

20

Roll

1

-

1

1

-

1

10

198 Oksitosin injeks 199 Omeprazol kap 20 mg

208 Perak Sulfadiazin 1 % 209 Pine oil 7,0%+benzyl clorophenol 0,6%

214 Plester 10 yards x 1 inc 215 Plester 5 yards x 1 inc

1,000

3,000 -

216 Povidon Yodida 30 ml 217 Povidon Yodida 300 ml

Botol

100

-

100

50

50

73

-

Botol

29

2

31

24

7

35

15

218 Prednison 5 mg 219 Primaquine

Tablet

3,513

300

3,813

2,305

1,508

3,378

1,000

Tablet

-

-

-

-

-

-

-

220 Propanolol HCL 40 mg 221 Ranitidine

Tablet

70

-

70

-

70

-

-

Tablet

3,940

400

4,340

2,280

2,060

3,341

222 Ranitidine inj 223 Retinol 100.000 IU

Ampul

-

-

-

-

-

-

-

Kapsul

-

-

-

-

-

-

-

224 Retinol 200.000 iu 225 Ringer Laktat

Kapsul

-

-

-

-

-

-

-

Botol

178

20

198

99

99

145

80

226 Risperidon tab 20 mg 227 Salbutamol 2 mg

Tablet

920

300

1,220

535

685

784

1,500

Tablet

1,030

200

1,230

971

259

1,423

1,500

228 Salbutamol 4 mg 229 Salep 2-4 Kombinasi 230 Salisil Bedak 2% - 50 gr

Tablet

512

-

512

12

500

18

1,500

Pot Kotak

96

-

96

51

45

75

144

142

-

142

70

72

103

15

Botol

-

-

-

-

-

-

-

-

-

-

-

-

-

-

Set

-

-

-

-

-

-

-

Vial

8

-

8

4

4

6

3

Ampul

-

-

-

-

-

-

-

Vial

20

-

20

10

10

15

10

Ampul

370

-

370

370

-

542

-

Tablet

-

-

-

-

-

-

3,000

Set

319

-

319

247

72

362

72

Capsul

470

-

470

220

250

322

-

231 Sanadryl sy 232 Sanvita B Sy 233 Semen Seng Fosfat 234 Serum ABU I 235 Serum ADS 236 Serum ATS 1.500 IU 237 Sianokobalamin inj. 238 Sianokobalamin tab 239 Silk Benang Bedah Sutra 240 Simvastatin 10 mg

3,000

241 Siprofloksasin 250 mg

Tablet

2,000

-

2,000

1,000

1,000

1,465

242 Siprofloxacin 500 mg 243 Spironolactone

Tablet

920

-

920

650

270

953

-

Tablet

-

-

-

-

-

-

-

244 Tablet tambah darah 245 Temporary Stopping Fletcher

Tablet

-

-

-

-

-

-

-

Set

-

-

-

-

-

-

-

246 Tetrakain 0,5 % T.M (PANTOCAIN) 247 Tetrasiklin 250 mg

Botol

-

-

-

-

-

-

30

Tablet

235

-

235

-

235

-

200

Tablet Tablet

-

-

-

-

-

-

-

-

-

-

-

-

-

-

250 Thiamin HCL inj 251 Tiamfenikol kap 500 mg

Ampul

-

-

-

-

-

-

-

Kapsul

-

-

-

-

-

-

500

252 Tramadol inj 253 Transfusi set

Ampul

-

-

-

-

-

-

-

Set

-

-

-

-

-

-

-

248 Tertacsiclyn 500 mg 249 Thiamin HCL 50 mg

3,000

254 Triamcinolone asetonide cream 255 Trifluoperazine

Tube

24

-

24

24

-

35

Tablet

600

-

600

-

600

-

-

Tablet

4,620

-

4,620

2,325

2,295

3,407

-

Set

13

-

13

11

2

16

6

Vial

-

-

-

-

-

-

1

Ampul

18

-

18

17

1

25

30

260 Vitamin B.Komplek 261 Zinc Dispersible tab

Tablet

5,996

1,000

6,996

3,894

3,102

5,706

8,000

Tablet

680

-

680

200

480

293

3,000

262 Zink Syrup (Zirkumkid Sirup) 263 PERMETHRIN CREAM

Botol

-

-

-

-

-

-

50

Tube

79

10

89

79

10

116

60

264 SIMVASTATIN 20 Mg 265 XYLOCAIN GEL 2%

Tablet

600

200

800

300

500

GEL

9

-

9

5

4

-

6

266 ACETYLCYSTEIN 267 PARACETAMOL DROPS

Kapsul

-

1,020

1,020

162

858

-

3,060

Botol

-

10

10

1

9

-

100

268 PENITOIN 269 OMEPRAZOLE INJEKS

Kapsul

-

-

-

-

Ampul

-

10

10

10

270 Ampisilin inj 271 Gliserin

Ampul

-

-

-

-

-

-

-

Botol

-

-

-

-

-

-

-

272 Klorpromazin 25 mg 273 Metokloropamid sirup

Tablet

-

-

-

-

-

-

-

Botol

-

-

-

-

-

-

-

274 Tetrasiklin 500 mg 275 Tramadol 50 mg

Kapsul

-

-

-

-

-

-

-

Kapsul

-

-

-

-

-

-

-

276 Gentian Violet Lar, 1% - 10 ml

Botol

-

-

-

-

-

-

-

256 Trihexyphenidryl 2 mg 257 Urine Bag 258 Vaksin rabies verro 259 Ventolin Nebules 2,5 mg

144

600

30

UMUM 492

JUMLAH KUNJUNGAN RESEP

ASTEK

JPS/ GAKIN 456

IMUNISASI 0

GRATIS / KTP 30

Mengetahui/Menyetujui : Kepala Dinas Kesehatan Kab/ Kota

Yang Menyerahkan :

Mengetahui

Yang Menerima

An. Kabid SDA

Kepala seksi Penyimpanan dan Distribusi

Kepala Puskesmas Kopo

Petugas Puskesmas

Hj. Siti Juhaeni. S.S.IT ……………………………………………............. NIP.

………………………………………………............................. NIP.

NIP: 19660102,198603,2,007

PONI SUPARTINI S.Si,Apt

RM : LPLPO

ANGGAL

8-Feb-17

JUMLAH KET 15

16

,Apt

JUMLAH 978

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTA UPTD PUSKESMAS KOPO PUSKESMAS KECAMATAN KABUPATEN PROVINSI

: : : :

KOPO KOPO SERANG BANTEN

NO

NAMA OBAT

1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32

2 Alat Suntik 1 ml Alat suntik 20 ml Alat Suntik 3 ml Alat suntik 5 ml Albendazole Allopurinol 100 mg Ambroxol sirup 15 mg/ml Ambroxol tablet 30 mg Aminophilin 200 mg Aminophilin inj Amitriptillin tab 25 mg Amlodipin Amlodipin 10 Mg Amoxicillin Inj Amoxicillin forte 250 mg/ml Amoxisilin 125 mg syr Amoxisilin 250 mg Amoxisilin 500 mg Ampicillin 1 gr inj Antalgin 500 mg Antasida Doen Antasida Doen Sirup Anti vertigo (Betahistin maleat) Antibakteri Doen Salep Antihaemoroid Doen Komb. Supp Antimigrain Doen Komb. Aqua Pro inj Steril 20 ml Artesunate inj Asam Aselilsalisilat 100mg Asam Askorbat 250 mg Asam Askorbat 50 mg Asam Mefenamat 500 mg

PELAPORAN BULAN / PERIODE PERMINTAAN BULAN / PERIODE

SATUAN 3 Set Set Set set Tablet Tablet Botol Tablet Tablet Ampul Tablet Tablet Tablet Vial Botol Botol Kapsul Kapsul Vial Tablet Tablet Botol Tablet Tube Supp Tablet Ampul Ampul Tablet Tablet Tablet Tablet

STOK AWAL

PENERIMAAN

4

5

250 200 500 300 1,500 50 100 3,900 1,000 500 50 42 20 200 -

-

33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75

Asam Traneksamat inj 250 mg / ml Asering 500 cc Asiclovir 400 mg Asiclovir cream Atrofin Sulfat inj 0,25 mg / ml Attapulgit 600 mg Azythromycin 500 mg Benzatin Benzilpenisillin 1,2 Juta IU/Vial Betamethason Krim Bisacodyl Bisturi Ca glukonas Calsium Hidroksida Pasta (Dorident) Captopril 12,5 mg Captopril 25 mg Cat- Gut/Benang Bedah Cefadroxyl 250 mg Cefadroxyl sirup kering 125mg/ml Cefadroxyl 500 mg Cefixime 100 mg Kapsul Cendo Lyteers Cetirizine Cetirizine 5 mg/ml syrup 60 ml Cimetidine 200 mg Clobazam 10 mg Clozapine Composit (Diafil) Cresophene Deksametason 0,5 mg Deksametason inj 5 mg Devitalisasi pasta (non arsen) Dextrose 40% inj Diazepam inj 5 mg / ml Diazepam rektal 5 mg /2,5 ml Dietylcarbamazin Sitrat 100 mg Difenhidramin HCL inj 10 mg/ml Digoksin 0,25 mg Diltiazem HCl 30 mg Doksisiklin 100 mg Domperidon susp 5mg/ml Domperidone tab Ekstraks Belladona tab 10 mg Epinefrin HCL inj 0,1%-1 ml

Ampul Botol Tablet Tube Ampul Tablet Tablet Vial Tube Tablet pcs Vial Set Tablet Tablet Set Kapsul Botol Kapsul Kapsul Botol Tablet Botol Tablet Tablet Tablet Tube Botol Tablet Ampul Botol Ampul Ampul Tube Tablet Ampul Tablet Tablet Capsul Botol Tablet Tablet Ampul

200 30 30 700 100 1 500 48 15 -

-

800 300 1 387 15

-

60 300 400 -

-

76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118

Erythromycin 500 mg Tablet Salut Erytromisin syr Etakridin ( Rivanol ) 0.1% Etanol 70% - 1.000 ml Etanol 70% - 100 ml Etilklorida Semprot - 100 ml Eugenol cairan FDC KAT II FDC Kat. I Fenobarbital inj Fenol Glicerol TT Fitomenadion 10 mg Fitomenadion inj 10 mg / ml Fluconazole 150 mg Fluoxetine /Foransi10 mg Fluphenazine Decanoate Foley Catheter Furalex Furosemida 40 mg Furosemida inj 10 mg/ml Garam Oralit 200 ml Gentamycine TT 2 % Gentamycine inj Gentamycine salep kulit 0,1 % Gentamysin tetes mata Glass Ionomer Semen Glibenklamid 5 mg Gliseril Guaiacolat 100 mg Glucosa 5% Glukosa 10 % Griseovulfin 125 mg Haloperidol 5 mg Haloperidol decanoat Haloperidol inj Hand schoon non steril Handscrub (Cutisoft) Hidrocortison Cream 2,5% Hidrochlorthiazide (HCT) Hyoscine-N-Butilbromide 20 mg/ml inj Hyoscine-N-Butilbromide 10 mg I.V catheter no : 18 I.V catheter no : 20 I.V catheter no : 24

Tablet Botol Botol Botol Botol Botol Botol Paket Paket Ampul Botol Tablet Ampul Tablet Tablet Ampul Pcs

72 5 6 41 1 13 500 -

-

30 -

-

Tablet Ampul Sachet Botol Ampul Tube Botol Set Tablet Tablet Botol Botol Tablet Tablet Ampul Ampul Kotak Botol Tube Tablet Ampul Tablet Pcs Pcs Set

600 500

-

400 1,600 20 10 6 3 -

-

10 60 90 194

-

119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161

I.V catheter no 26 Set I.V catheter No.22 Set Ibuprofen 200 mg Tablet Ibuprofen 400 mg Tablet Infus Set Anak Set Infus Set Dewasa Set Isosorbit Dinitrat 5 mg Tablet I.V catheter No.16 Set Kalium Permanganat Serbuk Pot Kalsium Laktas 500 mg Tablet Kanamycin inj Vial Kapas Pembalut Adsorben Rol Kasa 36 m x 80 cm Rol Kasa Elastis 4 Inch Roll Kasa Kompres 40/40 Steril Bungkus Kasa Pemb.Hidropil 4mx10 cm Rol Kasa Pemb.Hidropil 4mx15cm Rol Kassa 16 x 16 cm Steril Kotak Ketokonazol cream 2 % Tube Ketokonazol Tab Tablet Ketorolac Ampul Klindamisin kap 150 mg Kapsul Klindamisin kap 300 mg Kapsul Kloramfenikol 250 mg Kapsul Kloramfenikol SM 1% Tube Kloramfenikol Suspensi Botol Kloramfenikol TT Botol Klorfeniramin Maleat ( CTM ) 4 mg Tablet Klorpromazin tab 100 mg Tablet Kotrimoksazol 480 mg Tablet Kotrimoksazol susp. Botol Laxadine Emulsi 60 ml Botol Levofloxacin tab 500 mg Tablet Lidokain Jelly 2 % Tube Lidocain kombinasi inj : lidokain HCl 2% + Epi Ampul Lidokain inj Ampul Loperamide 2 mg tab Tablet Loratadine 10 mg Tablet Lysol 1 L Botol Magnesium Sulfat 20 % Ampul MgSo4 40 % Vial Masker pcs MDT MB Anak Blister

27 200

-

100 5 1 8 49

-

58 27 50 200 250 1,100 -

-

2,000 1,900 700 50

-

200

-

12 14 350 -

-

162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204

MDT MB Dewasa MDT PB Anak MDT PB Dewasa Meloxicam 15 Metformin 500 mg Metildopa tab 250 mg Metilergometrin Maleat 0,125 mg Metilergometrin Maleat inj Metilprednisolon 8 mg Metoclorpropamid injeksi Metoclorpropamid 10 mg Metronidazol 250mg Metronidazole 500 mg/ml Metronidazol 500mg Miconazole cream Mumifying Pasta Nalokson Hcl inj Nasal Cannula Anak Nasal Cannula Dewasa Natrium Bicarbonat 500 mg Natrium Bicarbonat lar 8,4 % Natrium dikloffenak tab 25 mg Natrium dikloffenak tab 50 mg Natrium Klorida 0,9% Neo K (fitomenadion 2mg/ml) Neokolina syr Nifedipin tab Nistatin Vaginal tab 100.000 IU Nistatin Vaginal tab 500.000 IU O.B.H.Sirup OAT Kat Anak Ofloxacin Oksitetrasiklin HCL inj Oksitetrasiklin HCL SK 3% Oksitetrasiklin HCL SM 1% Oksitosin injeks Omeprazol kap 20 mg Papaverin 40 mg Parasetamol 100 mg Parasetamol 160 mg supp Parasetamol 240 mg supp Parasetamol 500 mg Parasetamol 80 mg supp

Blister blister Blister Tablet Tablet Tablet Tablet Ampul Tablet Ampul Tablet Tablet Botol Tablet Tube Botol Vial Set Set Tablet Botol Tablet Tablet Botol Ampul Botol Tablet Tablet Tablet Botol Paket Tablet Vial Tube Tube Vial Kapsul Tablet Tablet supp supp Tablet supp

51 10 300 55 -

-

400 17 12 4,600 12

-

205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247

Parasetamol Sirup Peahavral Perak Sulfadiazin 1 % Pine oil 7,0%+benzyl clorophenol 0,6% Pirantel Pamoat 125 mg Piridoksin HCL 10 mg Piridoksin HCL 25 mg Piroksikam 20 mg Plester 10 yards x 1 inc Plester 5 yards x 1 inc Povidon Yodida 30 ml Povidon Yodida 300 ml Prednison 5 mg Primaquine Propanolol HCL 40 mg Ranitidine Ranitidine inj Retinol 100.000 IU Retinol 200.000 iu Ringer Laktat Risperidon tab 20 mg Salbutamol 2 mg Salbutamol 4 mg Salep 2-4 Kombinasi Salisil Bedak 2% - 50 gr Sanadryl sy Sanvita B Sy Semen Seng Fosfat Serum ABU I Serum ADS Serum ATS 1.500 IU Sianokobalamin inj. Sianokobalamin tab Silk Benang Bedah Sutra Simvastatin 10 mg Siprofloksasin 250 mg Siprofloxacin 500 mg Spironolactone Tablet tambah darah Temporary Stopping Fletcher Tetrakain 0,5 % T.M (PANTOCAIN) Tetrasiklin 250 mg Tertacsiclyn 500 mg

Botol Tablet Tube Botol Tablet Tablet Tablet Tablet Roll Roll Botol Botol Tablet Tablet Tablet Tablet Ampul Kapsul Kapsul Botol Tablet Tablet Tablet Pot Kotak Botol Set Vial Ampul Vial Ampul Tablet Set Capsul Tablet Tablet Tablet Tablet Set Botol Tablet Tablet

-

-

280 3,000 -

-

11 28 9 500 42 300 21

-

1 8 200 1,000 36 5,670 300 -

-

248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268

Thiamin HCL 50 mg Thiamin HCL inj Tiamfenikol kap 500 mg Tramadol inj Transfusi set Triamcinolone asetonide cream Trifluoperazine Trihexyphenidryl 2 mg Urine Bag Vaksin rabies verro Ventolin Nebules 2,5 mg Vitamin B.Komplek Zinc Dispersible tab Zink Syrup (Zirkumkid Sirup) Ampisilin inj Gliserin Klorpromazin 25 mg Metokloropamid sirup Tetrasiklin 500 mg Tramadol 50 mg Gentian Violet Lar, 1% - 10 ml

JUMLAH KUNJUNGAN RESEP Mengetahui/Menyetujui : Kepala Dinas Kesehatan Kab/ Kota An. Kepala Sub Dinas Farmasi dan makanan

……………………………………………............. NIP.

Tablet Ampul Kapsul Ampul Set Tube Tablet Tablet Set Vial Ampul Tablet Tablet Botol Ampul Botol Tablet Botol Kapsul Kapsul Botol

3,000 2,000 24 300

-

3 1 5 1,000 500 25 250 -

-

UMUM 0

Yang Menyerahkan : Kepala seksi Penyimpanan dan Distribusi

………………………………………………............................. NIP.

AKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) UPTD PUSKESMAS KOPO DOKUMEN GUDANG FARMASI PUSKESMAS

: JANUARI- 2016 : FEBRUARY- 2016

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

6

7

8

250 200 500 300 1,500 50 100 3,900 1,000 500 50 42 20 200 -

-

250 200 500 300 1,500 50 100 3,900 1,000 500 50 42 20 200 -

NOMOR

PEMBERIAAN STOK OPT

PERMINTAAN

9

10 -

-

APBD II

APBD I

11

12

200 30 30 700 100 1 500 48 15 -

-

200 30 30 700 100 1 500 48 15 -

-

-

800 300 1 387 15

-

800 300 1 387 15

-

-

60 300 400 -

-

60 300 400 -

-

-

72 5 6 41 1 13 500 -

-

72 5 6 41 1 13 500 -

-

-

30 -

-

30 -

-

-

600 500

-

600 500

-

-

400 1,600 20 10 6 3 -

-

400 1,600 20 10 6 3 -

-

-

10 60 90 194

-

10 60 90 194

-

-

27 200

-

27 200

-

-

100 5 1 8 49

-

100 5 1 8 49

-

-

58 27 50 200 250 1,100 -

-

58 27 50 200 250 1,100 -

-

-

2,000 1,900 700 50

-

2,000 1,900 700 50

-

-

200

-

200

-

-

-

-

12 14 350 -

-

-

12 14 350 -

51 10 300 55 -

-

51 10 300 55 -

-

-

400 17 12 4,600 12

-

400 17 12 4,600 12

-

-

-

-

-

-

-

280 3,000 -

-

280 3,000 -

-

-

11 28 9 500 42 300 21

-

11 28 9 500 42 300 21

-

-

1 8 200 1,000 36 5,670 300 -

-

1 8 200 1,000 36 5,670 300 -

-

-

3,000 2,000 24 300

-

3,000 2,000 24 300

-

-

3 1 5 1,000 500 25 250 -

-

3 1 5 1,000 500 25 250 -

-

-

UMUM 0

nyerahkan : mpanan dan Distribusi

…………….............................

ASTEK 0

-

JPS/ GAKIN 0

IMUNISASI 0

Yang Meminta : Kepala Puskesmas Kopo

Hj. Siti Juhaeni. S.S.IT NIP: 19660102,198603,2,007

PONI SUPARTINI S.S

FORM : LPLPO NOMOR

TANGGAL 31-Jan-16

PEMBERIAAN ASKES LAIN - LAIN JUMLAH KET 13

14

15

16

GRATIS / KTP 0

Yang Menerima Petugas Puskesmas

PONI SUPARTINI S.Si,Apt

JUMLAH 0

lplpo

Alat Suntik 1 ml Alat suntik 20 ml Alat Suntik 3 ml Alat suntik 5 ml Albendazole Allopurinol 100 mg Ambroxol sirup 15 mg/ml Ambroxol tablet 30 mg Aminophilin 200 mg Aminophilin inj Amitriptillin tab 25 mg Amlodipin Amlodipin 10 Mg Amoxicillin Inj Amoxicillin forte 250 mg/ml Amoxisilin 125 mg syr Amoxisilin 250 mg Amoxisilin 500 mg Ampicillin 1 gr inj Antalgin 500 mg Antasida Doen Antasida Doen Sirup Anti vertigo (Betahistin maleat) Antibakteri Doen Salep Antihaemoroid Doen Komb. Supp Antimigrain Doen Komb. Aqua Pro inj Steril 20 ml Artesunate inj Asam Aselilsalisilat 100mg Asam Askorbat 250 mg Asam Askorbat 50 mg Asam Mefenamat 500 mg Asam Traneksamat inj 250 mg / ml Asering 500 cc Asiclovir 400 mg Asiclovir cream Atrofin Sulfat inj 0,25 mg / ml Attapulgit 600 mg Azythromycin 500 mg Benzatin Benzilpenisillin 1,2 Juta IU/Vial

bulanan

250 200 500 300 1,500 50 100 3,900 1,000 500 50 42 20 200 200 30 700 -

Alat Suntik 1 ml Alat suntik 20 ml Alat Suntik 3 ml Alat suntik 5 ml Albendazole Allopurinol 100 mg Ambroxol sirup 15 mg/ml Ambroxol tablet 30 mg Aminophilin 200 mg Aminophilin inj Amitriptillin tab 25 mg Amlodipin Amoxicillin Inj Amoxisilin 125 mg syr Amoxisilin 250 mg Amoxisilin 500 mg Antalgin 500 mg Antasida Doen Antasida Doen Sirup Anti vertigo (Betahistin maleat) Antibakteri Doen Salep

250 200 500 300 1,500 100 3,900 1,000 500 50 -

Antihaemoroid Doen Komb. Supp Antimigrain Doen Komb. Aqua Pro inj Steril 20 ml Artesunate inj Asam Aselilsalisilat 100mg Asam Askorbat 250 mg Asam Askorbat 50 mg Asam Mefenamat 500 mg

42 20 200 -

Asam Traneksamat inj 250 mg / ml Asering 500 cc Asiclovir 400 mg Asiclovir cream Atrofin Sulfat inj 0,25 mg / ml Attapulgit 600 mg Azythromycin 500 mg Benzatin Benzilpenisillin 1,2 Juta IU/ Betamethason Krim Bisacodyl Bisturi

200 30 700 100

Betamethason Krim Bisacodyl Bisturi Ca glukonas Calsium Hidroksida Pasta (Dorident) Captopril 12,5 mg Captopril 25 mg Cat- Gut/Benang Bedah Cefadroxyl 250 mg Cefadroxyl sirup kering 125mg/ml Cefadroxyl 500 mg Cefixime 100 mg Kapsul Cendo Lyteers Cetirizine Cetirizine 5 mg/ml syrup 60 ml Cimetidine 200 mg Clobazam 10 mg Clozapine Composit (Diafil) Cresophene Deksametason 0,5 mg Deksametason inj 5 mg Devitalisasi pasta (non arsen) Dextrose 40% inj Diazepam inj 5 mg / ml Diazepam rektal 5 mg /2,5 ml Dietylcarbamazin Sitrat 100 mg Difenhidramin HCL inj 10 mg/ml Digoksin 0,25 mg Diltiazem HCl 30 mg Doksisiklin 100 mg Domperidon susp 5mg/ml Domperidone tab Ekstraks Belladona tab 10 mg Epinefrin HCL inj 0,1%-1 ml Erythromycin 500 mg Tablet Salut Erytromisin syr Etakridin ( Rivanol ) 0.1% Etanol 70% - 1.000 ml Etanol 70% - 100 ml Etilklorida Semprot - 100 ml Eugenol cairan

100 1

Ca glukonas Calsium Hidroksida Pasta (Dorident) Captopril 12,5 mg Captopril 25 mg Cat- Gut/Benang Bedah

1 500 48

500 48 15 -

Cefadroxyl sirup kering 125mg/ml Cefadroxyl 500 mg Cefixime 100 mg Kapsul Cendo Lyteers Cetirizine Cimetidine 200 mg Clobazam 10 mg Clozapine Composit (Diafil) Cresophene Deksametason 0,5 mg Deksametason inj 5 mg Devitalisasi pasta (non arsen) Dextrose 40% inj Diazepam inj 5 mg / ml Dietylcarbamazin Sitrat 100 mg Difenhidramin HCL inj 10 mg/ml Digoksin 0,25 mg Diltiazem HCl 30 mg Doksisiklin 100 mg Domperidon susp 5mg/ml Domperidone tab Ekstraks Belladona tab 10 mg Epinefrin HCL inj 0,1%-1 ml Erythromycin 500 mg Tablet Salut Erytromisin syr Etakridin ( Rivanol ) 0.1% Etanol 70% - 1.000 ml Etanol 70% - 100 ml Etilklorida Semprot - 100 ml Eugenol cairan FDC KAT II FDC Kat. I Fenobarbital inj Fenol Glicerol TT Fitomenadion 10 mg Fitomenadion inj 10 mg / ml

15 800 300 1 387 15 300 400 72 5 6 41 1 13 500 -

800 300 1 387 15 300 400 72 5 6 41 1

FDC KAT II FDC Kat. I Fenobarbital inj Fenol Glicerol TT Fitomenadion 10 mg Fitomenadion inj 10 mg / ml Fluconazole 150 mg Fluoxetine /Foransi10 mg Fluphenazine Decanoate Foley Catheter Furalex Furosemida 40 mg Furosemida inj 10 mg/ml Garam Oralit 200 ml Gentamycine TT 2 % Gentamycine inj Gentamycine salep kulit 0,1 % Gentamysin tetes mata Glass Ionomer Semen Glibenklamid 5 mg Gliseril Guaiacolat 100 mg Glucosa 5% Glukosa 10 % Griseovulfin 125 mg Haloperidol 5 mg Haloperidol decanoat Haloperidol inj Hand schoon non steril Handscrub (Cutisoft) Hidrocortison Cream 2,5% Hidrochlorthiazide (HCT) Hyoscine-N-Butilbromide 20 mg/ml inj Hyoscine-N-Butilbromide 10 mg I.V catheter no : 18 I.V catheter no : 20 I.V catheter no : 24 I.V catheter no 26 I.V catheter No.22 Ibuprofen 200 mg Ibuprofen 400 mg Infus Set Anak Infus Set Dewasa Isosorbit Dinitrat 5 mg

13 500 30 600 500 8 400 1,600 20 10 6 4 10 60 90 189 10 27 200

Fluconazole 150 mg Fluphenazine Decanoate Foley Catheter Furosemida 40 mg Furosemida inj 10 mg/ml Garam Oralit 200 ml Gentamycine inj Gentamycine salep kulit 0,1 % Gentamysin tetes mata Glass Ionomer Semen Glibenklamid 5 mg Gliseril Guaiacolat 100 mg Glucosa 5% Glukosa 10 % Griseovulfin 125 mg Haloperidol 5 mg Haloperidol decanoat Haloperidol inj Hand schoon non steril Handscrub (Cutisoft) Hidrocortison Cream 2,5% Hyoscine-N-Butilbromide 20 mg/ml Hyoscine-N-Butilbromide 10 mg I.V catheter no : 18 I.V catheter no : 20 I.V catheter no : 24 I.V catheter no 26 I.V catheter No.22 Ibuprofen 200 mg Ibuprofen 400 mg Infus Set Anak Infus Set Dewasa Isosorbit Dinitrat 5 mg Kalium Permanganat Serbuk Kalsium Laktas 500 mg Kanamycin inj Kapas Pembalut Adsorben Kasa 36 m x 80 cm Kasa Elastis 4 Inch Kasa Kompres 40/40 Steril Kasa Pemb.Hidropil 4mx15cm Kassa 16 x 16 cm Steril Ketokonazol cream 2 %

30 600 500 8 400 1,600 20 10 6 4 10 60 90 189 10 27 200 100 5 1 8 49 58 27 50

I.V catheter No.16 Kalium Permanganat Serbuk Kalsium Laktas 500 mg Kanamycin inj Kapas Pembalut Adsorben Kasa 36 m x 80 cm Kasa Elastis 4 Inch Kasa Kompres 40/40 Steril Kasa Pemb.Hidropil 4mx10 cm Kasa Pemb.Hidropil 4mx15cm Kassa 16 x 16 cm Steril Ketokonazol cream 2 % Ketokonazol Tab Ketorolac Klindamisin kap 150 mg Klindamisin kap 300 mg Kloramfenikol 250 mg Kloramfenikol SM 1% Kloramfenikol Suspensi Kloramfenikol TT Klorfeniramin Maleat ( CTM ) 4 mg Klorpromazin tab 100 mg Kotrimoksazol 480 mg Kotrimoksazol susp. Laxadine Emulsi 60 ml Levofloxacin tab 500 mg Lidokain Jelly 2 % Lidocain kombinasi inj : lidokain HCl 2% + Lidokain inj Loperamide 2 mg tab Loratadine 10 mg Lysol 1 L Magnesium Sulfat 20 % MgSo4 40 % Masker MDT MB Anak MDT MB Dewasa MDT PB Anak MDT PB Dewasa Meloxicam 15 Metformin 500 mg

100 5 1 8 49 58 27 50 200 250 1,100 2,000 1,900 200 50

Ketokonazol Tab Ketorolac Klindamisin kap 150 mg Klindamisin kap 300 mg Kloramfenikol 250 mg Kloramfenikol SM 1% Kloramfenikol TT Klorfeniramin Maleat ( CTM ) 4 mg Klorpromazin tab 100 mg Kotrimoksazol 480 mg Kotrimoksazol susp. Levofloxacin tab 500 mg Lidocain kombinasi inj : lidokain HC Lidokain inj Loperamide 2 mg tab Loratadine 10 mg Magnesium Sulfat 20 % Masker MDT MB Anak MDT MB Dewasa MDT PB Anak MDT PB Dewasa Meloxicam 15 Metformin 500 mg Metildopa tab 250 mg

200 Metilergometrin Maleat 0,125 mg Metilergometrin Maleat inj - Metilprednisolon 8 mg - Metoclorpropamid injeksi - Metoclorpropamid 10 mg - Metronidazol 250mg - Metronidazol 500mg 12 Miconazole cream 14 Mumifying Pasta 350 Nalokson Hcl inj - Nasal Cannula Anak - Nasal Cannula Dewasa - Natrium Bicarbonat 500 mg - Natrium Bicarbonat lar 8,4 % - Natrium dikloffenak tab 25 mg - Natrium dikloffenak tab 50 mg

200 250 1,100 2,000 1,900 200 50 200 12 350 51 10 300 -

Metildopa tab 250 mg Metilergometrin Maleat 0,125 mg Metilergometrin Maleat inj Metilprednisolon 8 mg Metoclorpropamid injeksi Metoclorpropamid 10 mg Metronidazol 250mg Metronidazole 500 mg/ml Metronidazol 500mg Miconazole cream Mumifying Pasta Nalokson Hcl inj Nasal Cannula Anak Nasal Cannula Dewasa Natrium Bicarbonat 500 mg Natrium Bicarbonat lar 8,4 % Natrium dikloffenak tab 25 mg Natrium dikloffenak tab 50 mg Natrium Klorida 0,9% Neo K (fitomenadion 2mg/ml) Neokolina syr Nifedipin tab Nistatin Vaginal tab 100.000 IU Nistatin Vaginal tab 500.000 IU O.B.H.Sirup OAT Kat Anak Ofloxacin Oksitetrasiklin HCL inj Oksitetrasiklin HCL SK 3% Oksitetrasiklin HCL SM 1% Oksitosin injeks Omeprazol kap 20 mg Papaverin 40 mg Parasetamol 100 mg Parasetamol 160 mg supp Parasetamol 240 mg supp Parasetamol 500 mg Parasetamol 80 mg supp Parasetamol Sirup Peahavral Perak Sulfadiazin 1 % Pine oil 7,0%+benzyl clorophenol 0,6% Pirantel Pamoat 125 mg

51 10 300 55 400 17 12 4,600 12 280

Natrium Klorida 0,9% Neo K (fitomenadion 2mg/ml) Nifedipin tab Nistatin Vaginal tab 100.000 IU Nistatin Vaginal tab 500.000 IU O.B.H.Sirup OAT Kat Anak Ofloxacin Oksitetrasiklin HCL inj Oksitetrasiklin HCL SK 3% Oksitetrasiklin HCL SM 1% Omeprazol kap 20 mg Papaverin 40 mg Parasetamol 100 mg Parasetamol 160 mg supp Parasetamol 240 mg supp Parasetamol 500 mg Parasetamol 80 mg supp Parasetamol Sirup Perak Sulfadiazin 1 % Pine oil 7,0%+benzyl clorophenol 0, Pirantel Pamoat 125 mg Piridoksin HCL 10 mg Piridoksin HCL 25 mg Piroksikam 20 mg Plester 5 yards x 1 inc Povidon Yodida 30 ml Povidon Yodida 300 ml Prednison 5 mg Primaquine Propanolol HCL 40 mg Ranitidine Ranitidine inj Retinol 100.000 IU Retinol 200.000 iu Ringer Laktat Risperidon tab 20 mg Salbutamol 2 mg Salbutamol 4 mg Salisil Bedak 2% - 50 gr Semen Seng Fosfat Serum ABU I Serum ADS

55 400 17 12 4,600 12 280 3,000 11 28 9 500 42 300 21 1 -

Piridoksin HCL 10 mg Piridoksin HCL 25 mg Piroksikam 20 mg Plester 10 yards x 1 inc Plester 5 yards x 1 inc Povidon Yodida 30 ml Povidon Yodida 300 ml Prednison 5 mg Primaquine Propanolol HCL 40 mg Ranitidine Ranitidine inj Retinol 100.000 IU Retinol 200.000 iu Ringer Laktat Risperidon tab 20 mg Salbutamol 2 mg Salbutamol 4 mg Salep 2-4 Kombinasi Salisil Bedak 2% - 50 gr Sanadryl sy Sanvita B Sy Semen Seng Fosfat Serum ABU I Serum ADS Serum ATS 1.500 IU Sianokobalamin inj. Sianokobalamin tab Silk Benang Bedah Sutra Simvastatin 10 mg Siprofloksasin 250 mg Siprofloxacin 500 mg Spironolactone Tablet tambah darah Temporary Stopping Fletcher Tetrakain 0,5 % T.M (PANTOCAIN) Tetrasiklin 250 mg Tertacsiclyn 500 mg Thiamin HCL 50 mg Thiamin HCL inj Tiamfenikol kap 500 mg Tramadol inj Transfusi set

3,000 Serum ATS 1.500 IU - Sianokobalamin inj. - Sianokobalamin tab Silk Benang Bedah Sutra 11 Siprofloksasin 250 mg 28 Siprofloxacin 500 mg 9 Spironolactone 500 Tablet tambah darah - Temporary Stopping Fletcher - Tetrakain 0,5 % T.M (PANTOCAIN) - Tetrasiklin 250 mg - Thiamin HCL 50 mg - Thiamin HCL inj - Tiamfenikol kap 500 mg 42 Tramadol inj - Transfusi set - Triamcinolone asetonide cream 300 Trifluoperazine - Urine Bag 21 Vaksin rabies verro Ventolin Nebules 2,5 mg Vitamin B.Komplek - Zinc Dispersible tab 1 Zink Syrup (Zirkumkid Sirup) - Ampisilin inj 8 Gliserin 200 Klorpromazin 25 mg 1,000 Metokloropamid sirup 36 Tetrasiklin 500 mg - Tramadol 50 mg - Gentian Violet Lar, 1% - 10 ml - Amoxicillin forte 250 mg/ml - Tertacsiclyn 500 mg 5,670 Salep 2-40 - MgSo4 40 % - Oksitosin injeks 300 IV Cateter 16 - Metronidazole 500 mg/ml 3,000 Simvastatin 10 mg - Lysol 1 L 2,000 Foransi/Fluoxetine - Cetirizine 5 mg/5 ml syrup 60 ml - Amlodipine 10 mg

8 200 1,000 36 5,670 300 3,000 2,000 24 300 3 1 5 1,000 500 25 250 50 14 -

Triamcinolone asetonide cream Trifluoperazine Trihexyphenidryl 2 mg Urine Bag Vaksin rabies verro Ventolin Nebules 2,5 mg Vitamin B.Komplek Zinc Dispersible tab Zink Syrup (Zirkumkid Sirup) Ampisilin inj Gliserin Klorpromazin 25 mg Metokloropamid sirup Tetrasiklin 500 mg Tramadol 50 mg Gentian Violet Lar, 1% - 10 ml

24 Furalex 300 Cefadroxil 250 mg syrup Gentamicin TT 2% 3 Neokolina syrup 1 Sanvita B syrup 5 Sanadril syrup 1,000 Peahavral Tablet 500 Hidroclortiazid (HCT) 25 Ampisilin inj - Diazepam rektal 5 mg/2.5 ml (stesoli - Lidokain jelly 2 % 250 Laxadin Emulsi 60 ml - Plaster 10 yard x 1 inch Micropore - Chloramphenichol suspensi - Trihexyphenidyl 2 mg 47,356

47,356

STOK OPNAME PER 28 FEBRUARI 2019 UPTD PUSKESMAS KOPO PUSKESMAS KECAMATAN KABUPATEN PROVINSI

: : : :

KOPO KOPO SERANG BANTEN

NO

NAMA OBAT

1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

2 Alat suntik 1 ml Alat suntik 20 ml Alat Suntik 3 ml Alat suntik 5 ml Albendazole Allopurinol 100 mg Aminophilin 200 mg Aminophilin inj Amitriptillin tab 25 mg Amlodipin 5 Mg Amlodipin 10 Mg Amoxicillin forte 250 mg/ml Amoxisilin 125 mg syr Amoxisilin 250 mg Amoxisilin 500 mg Antasida Doen Antasida Doen Sirup Antihaemoroid Doen Komb. Supp Antimigrain Doen Komb.

Set Set Set set Tablet Tablet Tablet Ampul Tablet Tablet Tablet Botol Botol Kapsul Kapsul Tablet Botol Supp Tablet

1

2

3

4

5

6

7

GUDANG

UGD

KIA

APOTEK

PUSLING

POSKESDES

TB N KUSTA

4

5

6

7

9

-

8

9

POSYANDU LIMA GARUT

RC SUMUR

20 21 22 23 24 25 26 27 28 29 30

Aqua Pro inj Steril 20 ml Asam Asetilsalisilat 100mg Asam Askorbat 250 mg Asam Askorbat 50 mg Asam Mefenamat 500 mg Asiclovir 400 mg Asiclovir cream Attapulgit 600 mg Betamethason Krim Bisacodyl Bisturi

Ampul Tablet Tablet Tablet Tablet Tablet Tube Tablet Tube Tablet pcs

31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62

Ca glukonas Captopril 12,5 mg Captopril 25 mg Cat- Gut/Benang Bedah Cendo Lyteers Cetirizine 5 mg/ml syrup 60 ml Clobazam 10 mg CLOZAPINE Deksametason 0,5 mg Deksametason inj 5 mg Diazepam inj 5 mg / ml Diazepam rektal 5 mg /2,5 ml Difenhidramin HCL inj 10 mg/ml Digoksin 0,25 mg Diltiazem HCl 30 mg Doksisiklin 100 mg Domperidon susp 5mg/ml Domperidone tab Epinefrin HCL inj 0,1%-1 ml Erythromycin 500 mg Tablet Salut Erytromisin syr Etakridin ( Rivanol ) 0.1% Etanol 70% - 1.000 ml Etanol 70% - 100 ml Etilklorida Semprot - 100 ml Eugenol cairan FDC KAT II FDC Kat. I Fenol Glicerol TT Fitomenadion 10 mg Fitomenadion inj 10 mg / ml Fluphenazine Decanoate

Vial Tablet Tablet Set Botol Botol Tablet Tablet Tablet Ampul Ampul Tube Ampul Tablet Tablet Capsul Botol Tablet Ampul Tablet Botol Botol Botol Botol Botol Botol Paket Paket Botol Tablet Ampul Ampul

63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94

Foley Catheter 16 Foley Catheter 18 Furosemida 40 mg Furosemida inj 10 mg/ml Garam Oralit 200 ml Gentamycine TT 2 % Gentamycine inj Gentamycine salep kulit 0,1 % Gentamysin tetes mata Glibenklamid 5 mg Glucosa 5% Griseovulfin 125 mg Haloperidol 5 mg Hand schoon non steril S Hand schoon non steril M Hand schoon non steril L Handscrub (Cutisoft) Hidrocortison Cream 2,5% Hidrochlorthiazide (HCT) Hyoscine-N-Butilbromide 10 mg I.V catheter no : 18 I.V catheter no : 20 I.V catheter no : 24 I.V catheter no 26 I.V catheter No.22 Ibuprofen 200 mg/5 ml SUSPENSI Ibuprofen 400 mg Infus Set Anak Infus Set Dewasa Isosorbit Dinitrat 5 mg I.V catheter No.16 Kalsium Laktas 500 mg

Pcs Pcs Tablet Ampul Sachet Botol Ampul Tube Botol Tablet Botol Tablet Tablet Kotak Kotak Kotak Botol Tube Tablet Tablet Pcs Pcs Set Set Set BOTOL Tablet Set Set Tablet Set Tablet

95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126

Kapas Pembalut Adsorben Rol Kasa 36 m x 80 cm Rol Kasa Elastis 4 Inch Roll Kasa Kompres 40/40 Steril Bungkus Kasa Pemb.Hidropil 4mx15cm Rol Kassa 16 x 16 cm Steril Kotak Ketokonazol cream 2 % Tube Ketokonazol Tab Tablet Klindamisin kap 150 mg Kapsul Klindamisin kap 300 mg Kapsul Kloramfenikol 250 mg Kapsul Kloramfenikol SM 1% Tube Kloramfenikol Suspensi Botol Kloramfenikol TT Botol Klorfeniramin Maleat ( CTM ) 4 mg Tablet Klorpromazin tab 100 mg Tablet Kotrimoksazol 480 mg Tablet Kotrimoksazol susp. Botol Lidocain kombinasi inj : lidokain HCl 2% + Epine Ampul Lidokain inj Ampul Lysol 1 L Magnesium Sulfat 20 % MgSo4 40 % Masker MDT MB Anak MDT MB Dewasa MDT PB Anak MDT PB Dewasa Metformin 500 mg Metilergometrin Maleat 0,125 mg Metilergometrin Maleat inj Metilprednisolon 4 mg

Botol Ampul Vial pcs Blister Blister blister Blister Tablet Tablet Ampul Tablet

127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158

Metoclorpropamid injeksi Metoclorpropamid 10 mg Metronidazol 500mg Miconazole cream Nasal Cannula Anak Nasal Cannula Dewasa Natrium dikloffenak tab 50 mg Natrium Klorida 0,9% Neo K (fitomenadion 2mg/ml) Nifedipin tab Nistatin Vaginal tab 100.000 IU Nistatin Vaginal tab 500.000 IU OAT Kat Anak Ofloxacin Oksitetrasiklin HCL inj Oksitetrasiklin HCL SK 3% Oksitetrasiklin HCL SM 1% Oksitosin injeks Omeprazol kap 20 mg Parasetamol 500 mg Parasetamol Sirup Piridoksin HCL 10 mg Piridoksin HCL 25 mg Plester 10 yards x 1 inc Plester 5 yards x 1 inc Povidon Yodida 30 ml Povidon Yodida 300 ml Prednison 5 mg Propanolol HCL 40 mg Ranitidine Ranitidine inj Retinol 100.000 IU

Ampul Tablet Tablet Tube Set Set Tablet Botol Ampul Tablet Tablet Tablet Paket Tablet Vial Tube Tube Vial Kapsul Tablet Botol Tablet Tablet Roll Roll Botol Botol Tablet Tablet Tablet Ampul Kapsul

159 Retinol 200.000 iu

Kapsul

160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191

Ringer Laktat Risperidon tab 20 mg Salbutamol 2 mg Salbutamol 4 mg Salep 2-4 Kombinasi Salisil Bedak 2% - 50 gr Serum ABU I Serum ATS 1.500 IU Sianokobalamin inj. Sianokobalamin tab Silk Benang Bedah Sutra Simvastatin 10 mg Siprofloksasin 250 mg Siprofloxacin 500 mg Spironolactone Tablet tambah darah Tetrasiklin 250 mg Tertacsiclyn 500 mg Thiamin HCL 50 mg Thiamin HCL inj Trihexyphenidryl 2 mg Urine Bag Vitamin B.Komplek Zinc Dispersible tab Zink Syrup (Zirkumkid Sirup) PERMETHRIN CREAM SIMVASTATIN 20 Mg XYLOCAIN GEL 2% ACETYLCYSTEIN PARACETAMOL DROPS PENITOIN OMEPRAZOLE INJEKS

Botol Tablet Tablet Tablet Pot Kotak Vial Vial Ampul Tablet Set Capsul Tablet Tablet Tablet Tablet Tablet Tablet Tablet Ampul Tablet Set Tablet Tablet Botol Tube Tablet GEL Kapsul Botol Kapsul Ampul

192 193 194 195 196 197 198 199 200 201 202 203 204 205 206

ALBENDAZOLE SYRUP BOTOL BUFACETIN SALEP(CHLORAMPENICOL) TUBE LYTACUR SYRUP BOTOL ASEPTIC GEL Botol ALKOHOL SWAB PCS UNDER PAD PCS SARUNG TANGAN OBGYN PASANG COMBIVENT 2,5 ml (Ipratropium Bromide+albute Vial LEUCOMED Botol STERIZYME Kapsul USG GELL Kapsul ALBENDAZOLE PROGRAM GLUCOSE TEST STRIP@50 UNIT TOTAL CHOLESTEROL TEST STRIP@10 UNIT URIC TEST STRIP@25 UNIT

TABLET KOTAK KOTAK KOTAK

207 208 209 210 211

MINERAL MIX TUMPATAN SEMENTARA PASTA DESINFEKSI SALURAN AKAR PASTA DESINFEKSI SALURAN AKAR ETCHING+BONDING

PCS POT TUBE BOTOL BOTOL

212 213 214 215

GLASS IONOMER COMENT UNTUK GIGI POSTERIOR DESINFEKSI SALURAN AKAR MUMMIYING PASTA CAIRAN PEMBERSIH GIGI POLIIREN

BOTOL BOTOL BOTOL BOTOL

PASTA DESINFEKSI SALURAN AKAR YANG TIDAK

216 MENGANDUNG ARSEN

10

11

12 TOTAL

POSYANDU LIMA DESA NANGGUNG

KOPO

MEKARBARU

Albendazole

Allopurinol 100 mg

Aminophilin 200 mg

Amitriptillin tab 25 mg

Amlodipin 5 Mg

Amlodipin 10 Mg

Amoxicillin forte 250 mg/ml Amoxisilin 125 mg syr

Amoxisilin 250 mg

Amoxisilin 500 mg

Antasida Doen

Antasida Doen Sirup

Anti vertigo (Betahistin maleat)

Antihaemoroid Doen Komb. Supp

Asam Askorbat 250 mg

Asam Askorbat 50 mg

Asam Mefenamat 500 mg

Asering 500 cc

Asiclovir 400 mg

Asiclovir cream

Atrofin Sulfat inj 0,25 mg / ml

Attapulgit 600 mg

Betamethason Krim

Captopril 12,5 mg

Captopril 25 mg

Cetirizine 5 mg/ml syrup 60 ml

Clobazam 10 mg

CLOZAPINE

Deksametason 0,5 mg

Deksametason inj 5 mg

Digoksin 0,25 mg

Diltiazem HCl 30 mg

Doksisiklin 100 mg

Domperidon susp 5mg/ml

Domperidone tab

Erythromycin 500 mg Tablet Salut

Erytromisin syr

FDC KAT II

FDC Kat. I

Fenol Glicerol TT

Fitomenadion 10 mg

Fluphenazine Decanoate

Foley Catheter 16

Furosemida 40 mg

Garam Oralit 200 ml

Glibenklamid 5 mg

Griseovulfin 125 mg

Haloperidol 5 mg

Hidrocortison Cream 2,5%

Hidrochlorthiazide (HCT)

Hyoscine-N-Butilbromide 10 mg

Ibuprofen syrup 200 mg/ml

Ibuprofen 400 mg

Isosorbit Dinitrat 5 mg

Kalsium Laktas 500 mg

Kasa 36 m x 80 cm

Ketokonazol cream 2 %

Ketokonazol Tab

Klindamisin kap 300 mg

Kloramfenikol 250 mg

Kloramfenikol SM 1%

Kloramfenikol Suspensi

Klorfeniramin Maleat ( CTM ) 4 mg

Klorpromazin tab 100 mg

Kotrimoksazol 480 mg

Kotrimoksazol susp.

Laxadine Emulsi 60 ml

MDT MB Anak

MDT MB Dewasa

Metformin 500 mg

Metilprednisolon 4 mg

Metoclorpropamid injeksi

Metoclorpropamid 10 mg

Metronidazol 500mg

Miconazole cream

Natrium dikloffenak tab 50 mg

Nifedipin tab

Nistatin Vaginal tab 100.000 IU

Nistatin Vaginal tab 500.000 IU

OAT Kat Anak

Omeprazol kap 20 mg

Parasetamol 500 mg

Parasetamol Sirup

Pirantel Pamoat 125 mg

Piridoksin HCL 10 mg

Piridoksin HCL 25 mg

Prednison 5 mg

Propanolol HCL 40 mg

Ranitidine

Retinol 100.000 IU

Retinol 200.000 iu

Risperidon tab 20 mg

Salbutamol 2 mg

Salbutamol 4 mg

Salep 2-4 Kombinasi Salisil Bedak 2% - 50 gr

Siprofloxacin 500 mg

Tablet tambah darah

Tetrasiklin 250 mg

Tertacsiclyn 500 mg Thiamin HCL 50 mg

Trihexyphenidryl 2 mg

Vitamin B.Komplek

Zinc Dispersible tab

Zink Syrup (Zirkumkid Sirup)

PERMETHRIN CREAM

SIMVASTATIN 20 Mg

ACETYLCYSTEIN

BUFACETIN SALEP(CHLORAMPENICOL) HYDROCHLOROTHYAZIDE

ASAM ASETYLSALISILAT