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    Mengetahui, Karangjaya, 25 JULI 2019 Kepala UPT Puskesmas Karangjaya Penanggung Jawab Pengelola Obat

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    Anggraeni M.J
    This document is a form for monitoring the availability of drugs and vaccines at the Karangjaya Community Health Center in July 2019. It lists 20 essential drugs and vaccines that should be available and indicates that all 20 were in stock. It was signed by the head of the health center and the person responsible for drug management, verifying the report.

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    Mengetahui, Karangjaya, 25 JULI 2019 Kepala UPT Puskesmas Karangjaya Penanggung Jawab Pengelola Obat

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    Anggraeni M.J
    34 views2 pages
    This document is a form for monitoring the availability of drugs and vaccines at the Karangjaya Community Health Center in July 2019. It lists 20 essential drugs and vaccines that should be available and indicates that all 20 were in stock. It was signed by the head of the health center and the person responsible for drug management, verifying the report.

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    This document is a form for monitoring the availability of drugs and vaccines at the Karangjaya Community Health Center in July 2019. It lists 20 essential drugs and vaccines that should be available and indicates that all 20 were in stock. It was signed by the head of the health center and the person responsible for drug management, verifying the report.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Download as xlsx, pdf, or txt
    34 views2 pages

    Mengetahui, Karangjaya, 25 JULI 2019 Kepala UPT Puskesmas Karangjaya Penanggung Jawab Pengelola Obat

    Uploaded by

    Anggraeni M.J
    This document is a form for monitoring the availability of drugs and vaccines at the Karangjaya Community Health Center in July 2019. It lists 20 essential drugs and vaccines that should be available and indicates that all 20 were in stock. It was signed by the head of the health center and the person responsible for drug management, verifying the report.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
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    FORM PEMANTAUAN KETERSEDIAAN OBAT DAN VAKSIN INDIKATOR DI PUSKESMAS

    PERIODEPELAPORAN : BULAN JULI 2019


    NAMA PUSKESMAS : KARANGJAYA Penanggungjawab Farmasi : Anggraeni Apt.
    ALAMAT : Jl. Sirnajaya ds. sirnajaya kec. Karangjaya No Hp : 081220590338
    Kab / Kota : Tasikmalaya Email : nenkanggi@gmail.com
    Provinsi : Jawa Barat

    Bentuk Ketersediaan
    No. Nama Obat Ket
    Sediaan Ada/Tidak
    (1) (2) (3) (4) (5)
    1 Albendazol Tablet Tablet 1
    2 Amoxicillin 500 mg Tablet Tablet 1
    3 Amoxicillin Syrup Sirup 1
    4 Deksametason Tablet Tablet 1
    5 Diazepam 5 mg/mL Injeksi Injeksi 1
    6 Epinefrin (Adrenalin) 0,1% (sebagai HCL) Injeksi Injeksi 1
    7 Fitomenadion (Vitamin K) Injeksi Injeksi 1
    8 Furosemid 40 mg Tablet / Hidroklorotiazid (HCT) Tablet 1
    9 Garam Oralit Serbuk Serbuk 1
    10 Glibenklamid Tablet / Metformin Tablet 1
    11 Kaptopril Tablet Tablet 1
    12 Magnesium Sulfat 20 % / 40% Injeksi Injeksi 1
    13 Metilergometrin Maleat 0,200 mg-1 ml Injeksi Injeksi 1
    14 Obat Anti Tuberculosis dewasa Tablet Tablet 1
    15 Oksitosin Injeksi Injeksi 1
    16 Parasetamol 500 mg Tablet Tablet 1
    17 Tablet Tambah Darah Tablet Tablet 1
    18 Vaksin BCG Injeksi Injeksi 1
    19 Vaksin TT/TD Injeksi Injeksi 1
    20 Vaksin DPT/ DPT-HB/ DPT-HB-Hib Injeksi Injeksi 1
    Jumlah item obat indikator yang tersedia di Puskesmas 20

    Mengetahui, Karangjaya, 25 JULI 2019


    Kepala UPT Puskesmas Karangjaya Penanggung Jawab Pengelola Obat

    Yayat Priatna, AMK., S.KM Anggraeni, S.Farm., Apt.


    NIP. 196507201986031009 NRPK. 10.7.0502057

    file:///conversion/tmp/scratch/432762779.xlsx
    FORM PEMANTAUAN KETERSEDIAAN OBAT DAN VAKSIN INDIKATOR DI PUSKESMAS

    PERIODE PELAPORAN : BULAN………………


    NAMA PUSKESMAS : .................... Penanggungjawab Farmasi : .................
    ALAMAT : ..................... No Hp : .................
    Kab / Kota : .................... Email :...................
    Provinsi : .....................

    Bentuk Ketersediaan
    No. Nama Obat Ket
    Sediaan Ada/Tidak
    (1) (2) (3) (4) (5)
    1 Albendazol Tablet Tablet
    2 Amoxicillin 500 mg Tablet Tablet
    3 Amoxicillin Syrup Sirup
    4 Deksametason Tablet Tablet
    5 Diazepam 5 mg/mL Injeksi Injeksi
    6 Epinefrin (Adrenalin) 0,1% (sebagai HCL) Injeksi Injeksi
    7 Fitomenadion (Vitamin K) Injeksi Injeksi
    8 Furosemid 40 mg Tablet / Hidroklorotiazid (HCT) Tablet
    9 Garam Oralit Serbuk Serbuk
    10 Glibenklamid Tablet / Metformin Tablet
    11 Kaptopril Tablet Tablet
    12 Magnesium Sulfat 20 % / 40% Injeksi Injeksi
    13 Metilergometrin Maleat 0,200 mg-1 ml Injeksi Injeksi
    14 Obat Anti Tuberculosis dewasa Tablet Tablet
    15 Oksitosin Injeksi Injeksi
    16 Parasetamol 500 mg Tablet Tablet
    17 Tablet Tambah Darah Tablet Tablet
    18 Vaksin BCG Injeksi Injeksi
    19 Vaksin TT/TD Injeksi Injeksi
    20 Vaksin DPT/ DPT-HB/ DPT-HB-Hib Injeksi Injeksi
    Jumlah item obat indikator yang tersedia di Puskesmas 0

    ............................., ....................... 2015

    Mengetahui yang melapor


    Kepala UPTD Puskesmas ......

    n a m a n a m a
    NIP. NIP.

    file:///conversion/tmp/scratch/432762779.xlsx

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