Lplpo Ranap Poned 2018

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LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

( LPLPO RAWAT INAP PONED )
KD PUSKESMAS :P33210301
PUSKESMAS : GUNTUR I LAPORAN BULAN : DESEMBER
KECAMATAN : GUNTUR TAHUN 2018
KAB / KODYA : DEMAK
PROPINSI : JAWA TENGAH
NO. KODE NAMA OBAT SATU STOK PENERI PERSE PEMA SISA PERMIN
AN AWAL MAAN DIAAN KAIAN STOK TAAN
1 2 3 4 5 6 7 8 9 10
1 A025 Aciclovir Tablet 200 mg TAB 0 0 0 0 0
2 A013 Aciclovir Salep Kulit TUBE 0 0 0 0 0
4 A001 Alat Suntik Sekali Pakai 0,05 ml BUAH 0 0 0 0 0
5 A002 Alat Suntik Sekali Pakai 0,5 ml SET 0 0 0 0 0
6 A003 Alat Suntik Sekali Pakai 3 ml SET 0 0 0 0 0
10 A005 Albendazole Tablet 400 mg TAB 0 0 0 0 0
11 A038 Alkohol larutan BTL 0 0 0 0 0
12 A006 Alupurinol Tablet 100 mg TAB 122 0 122 37 85
14 A050 ALPRAZOLAM 0,5 MG TAB 0 0 0 0 0
15 A030 Ambroxol Syrup 15mg/5ml BTL 0 0 0 0 0
16 A029 Ambroxol Tablet TAB 227 0 227 55 172
17 A007 Aminofilina Injeksi 24 mg/ml - 10 ml AMP 0 0 0 0 0
18 A008 Aminofilina Tablet 200 mg TAB 0 0 0 0 0
19 A045 Amitriptilin 25 mg TAB 0 0 0 0 0
20 A047 Amoksisilin Syr Forte 250 mg/ 5 ml BTL 0 0 0 0 0
21 A010 Amoksisilina Kapsul 500 mg Kap 44 1000 1044 786 258
22 A012 Amoksisilina Sirup kering 125 mg/5 ml TAB 0 30 30 20 10
23 A054 AMLODIPIN 10 MG TAB 0 300 300 0 300
. .
25 A046 Ampisilin inj 1000 mg VIAL 0 0 0 0 0

26 A014 Ampisilin kapsul 500 mg Kap 0 0 0 0 0
27 A017 Antalgin ( Metampiron ) Tablet 500 mg TAB 30 100 130 70 60
28 A018 Antasida Doen suspensi btl. 60 ml BTL 0 27 27 15 12
29 A019 Antasida DOEN Tablet 500 mg TAB 287 800 1087 878 209
30 A020 Anti Bakteri DOEN Salep kombinasi TUBE 6 0 6 4 2
31 A021 Anti Hemoroid DOEN Kombinasi SUPP 32 0 32 0 32
32 A022 Antifungi DOEN Kombinasi TUBE 0 0 0 0 0
33 A041 Aqua Pro Injeksi BTL 4 0 4 0 4
34 A056 ASETOSAL 80 MG/Miniaspi TAB 58 0 58 0 58
35 A059 Asam Asetat BTL 0 0 0 0 0
36 A027 Asam Askorbat (VitC ) Tablet 250 mg TAB 0 0 0 0 0
38 A037 Asam Folat Tablet TAB 0 0 0 0 0
39 A036 Asam Mefenamat 500 mg Kap 0 600 600 340 260
40 A023 Asam Tranexamat Injeksi AMP 0 0 0 0 0
41 A049 ASERING INFUS BTL 0 0 0 0 0
42 A035 Atrofin Sulfat Injeksi 0,25 mg AMP 20 0 20 0 20
43 A058 Attapulgite 600 mg/New Antides TAB 222 0 222 70 152
44 B004 Betametason 0,1% krim TUBE 4 0 4 4 0
45 B018 BETAHISTIN 6 MG TAB 20 0 20 20 0
46 B019 BENZATIN BENZIL PENISILIN INJ VIAL 0 0 0 0 0
47 B001 Bisturi PCS 0 0 0 0 0
48 B017 Bisacodil TAB 5 mg TAB 0 0 0 0 0
49 B015 Bisacodil supp 10 mg SUPP 0 0 0 0 0
50 B021 BLOOD LANCET 26 G BOX 0 0 0 0 0
51 B013 Bromhexin tab TAB 0 0 0 0 0
52 C002 Captopril Tablet 12,5 mg Tab 37 0 37 10 27
53 C003 Captopril Tablet 25 mg Tab 0 0 0 0 0
54 C021 CAPTOPRIL 50 MG TAB 0 0 0 0 0
55 C001 Catgut / Benang Bedah No.2/0 - 3/0 dengan Jarum Bedah SET 0 0 0 0 0
56 C011 Cefotaxim Injeksi 1 g VIAL 0 0 0 0 0
57 C014 Ceftriaxone Injeksi VIAL 1 10 11 2 9
58 C007 Ciprofloksacin tablet 500 mg TAB 98 0 98 63 35
59 C018 Clozapine 100 mg tab TAB 0 0 0 0 0
. .
61 C020 CLOBAZAM 10 MG TAB 0 0 0 0 0

62 C022 COTTON SWAB SET 0 0 0 0 0
63 C023 COVER GLASS 20 X 20 BOX 0 0 0 0 0
64 C019 CUTICELL CLASSIC 10 CM X 10 CM BUAH 0 0 0 0 0
65 D002 Deksametason Injeksi 5 mg / ml - 1 ml AMP 5 0 5 0 5
66 D003 Deksametason Tablet 0,5 mg TAB 139 0 139 112 27
67 D008 Diazepam Injeksi 5 mg / Ml - 2 ml AMP 1 0 1 0 1
68 D022 Diazepam Rectal Tube/Stesolit TUBE 4 0 4 2 2
69 D009 Diazepam Tablet 2 mg TAB 0 0 0 0 0
71 D019 DIETHIL CARBAMAZINE 100 MG TAB 0 0 0 0 0
72 D012 Difenhidramin HCL Injeksi 10 mg/ml - 1 ml AMP 0 0 0 0 0
73 D013 Digoksin Tablet 0,25 mg TAB 38 100 138 17 121
74 D018 Dimenhidrinate 50 mg TAB 80 100 180 122 58
75 D023 Domperidon Syr 5mg/5 ml BTL 0 0 0 0 0
76 D025 Domperidon 10 MG TAB TAB 70 0 70 10 60
77 D020 Doxycicline 100 mg TAB 0 0 0 0 0
78 E001 Efedrin HCL Tablet 25 mg TAB 0 0 0 0 0
79 E002 Ekstrak belladon tablet 10 mg TAB 0 0 0 0 0
80 E003 Epinefrina Hcl/Bitatrat ( ADRENALIN) AMP 0 0 0 0 0
81 E010 Erythromicin 250 mg Cap 0 0 0 0 0
83 E005 Etakridin ( Rivanol ) Larutan 0,1 % BTL 0 0 0 0 0
84 E008 Etylchloride Spray 100 ml BTL 0 0 0 0 0
85 E009 Eugenol cairan BTL 0 0 0 0 0
86 F001 Furosemida Tablet 40 mg TAB 13 0 13 13 0
87 F003 Fitomenadion (Vit K1) Tablet.s TAB 56 0 56 45 11
88 F004 Fenobarbital Inj 50 mg/ ml - 2 ml AMP 0 0 0 0 0
89 F007 Fitomenadion (Vit K1) Inj, 10 AMP 0 60 60 0 60
90 F012 Fitomenadion Inj 2 mg/ ml AMP 9 0 9 9 0
91 F008 Fenol Gliserol Tetes Telinga BTL 0 0 0 0 0
92 F013 Fluphenazine Decanoat 25 mg/ml AMP 0 0 0 0 0
93 F014 Fluconazol 150 mg TAB 0 0 0 0 0
94 F015 FIXOMULL STRETCH 5 CM X 5 CM ROLL 0 0 0 0 0
95 G003 Garam Oralit untuk 200 ml air BKS 0 0 0 0 0
96 Gentamisin Tetes mata BTL 0 0 0 0 0
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97 G004 Gentian Violet larutan 1 % BTL 10 0 10 9 1

98 G016 GEMFIBROZIL 300 MG TAB 0 0 0 0 0
99 G006 Glibenklamid Tablet 5 mg TAB 100 0 100 28 72
100 G007 Gliseril Guaiakolat Tablet 100 mg TAB 187 0 187 124 63
101 G014 GLIMEPIRIDE 2 MG TAB 2 0 102 2 100
102 GLUKONAS CALCII FLAC 24 0 24 0 24
103 G011 Glukose larutan Infus 5 % steril BTL 0 0 0 0 0
104 G012 Griseofulvin Tablet 125 mg Micronized TAB 0 0 0 0 0
105 H014 Haloperidol inj 50 mg/ml AMP 0 0 0 0 0
106 H001 Haloperidol Tablet 0,5 mg TAB 0 0 0 0 0
108 H003 Haloperidol Tablet 5 mg TAB 0 0 0 0 0
109 H016 HAND RUB BTL 0 0 0 0 0
110 H008 Hes 6 % BTL 0 0 0 0 0
111 H006 Hidroklorotiazid ( HCT ) Tablet 25 mg TAB 0 0 0 0 0
112 H004 Hidrokortison krim 2,5 % TUBE 5 0 5 5 0
113 H013 Hyoscin-N-Butilbromid tab 10 mg TAB 98 0 98 15 83
114 I001 Ibuprofen Tablet 200 mg TAB 0 0 0 0 0
116 I003 Infusion set anak SET 0 0 0 0 0
117 I004 Infusion set dewasa SET 0 0 0 0 0
118 I012 Iodium Test BTL 0 0 0 0 0
119 I010 Isosorbit Dinitrat Tablet Sublingual 5 mg TAB 77 0 77 0 77
120 I016 IV Cateter No. 18 BUAH 0 0 0 0 0
124 I019 IBUPROFEN SUSP BTL 0 0 0 0 0
125 J001 Jarum Jahit (bedah) BIJI 0 0 0 0 0
126 K001 Ketokonazol 200 mg TAB 0 0 0 0 0
127 K004 Kalsium Laktat (kalk) Tablet 500 mg TAB 187 0 187 187 0
128 K005 Kapas Berlemak 500 gr ROL 0 0 0 0 0
129 K006 Kapas Pembalut / Absorben 250 gr ROL 0 0 0 0 0
130 Kapas Pembalut / Absorben 50 gr ROL 0 0 0 0 0
131 K007 Karbamazepin Tablet 200 mg TAB 0 0 0 0 0
132 K008 Kasa Kompres 40/40 Steril LBR 0 0 0 0 0
. .
133 K010 Kasa Pembalut Hidrofil 4 x 15 cm BUAH 0 0 0 0 0

135 K037 Kasa Pembalut Hidrofil 4 M x 10 cm BUAH 0 0 0 0 0
136 K041 Kasa Steril 16 cm x 16 cm BOX 0 0 0 0 0
137 K042 Kaca Sediaan (Obyek Glass/SLIDE) BOX 0 0 0 0 0
138 K043 Kotak Sediaan/ BOX SLIDE BOX 0 0 0 0 0
139 K040 Kalsium Gluconat inj in 10 % (100 mg/100ml) AMP 0 0 0 0 0
140 K028 Kotrimoksazol Susp 240 mg / 5 ml BTL 1 0 1 0 1
141 K029 Kotrimoksazol 480 mg Tablet TAB 4 0 4 4 0
142 K012 Ketokonazol salep TUBE 0 0 0 0 0
143 K039 Ketorolac inj 10 mg AMP 6 12 18 6 12
144 K014 Kloramfenikol Kapsul 250 mg KAP 70 700 970 911 59
145 K015 Kloramfenikol Salep mata 1 % TUBE 0 0 0 0 0
146 K016 Kloramfenikol tetes telinga 3 % BTL 0 0 0 0 0
147 K024 Kloramfenikol tetes Mata BTL 4 0 4 3 1
148 K044 Kloramfenikol Susp 125 mg/ 5 ml BTL 4 15 19 10 9
149 K048 Kloramfenikol Salep kulit 2 % TUBE 0 0 0 0 0
150 K017 Klorfeniramin Maleat (CTM ) Tablet 4 mg TAB 185 0 185 141 44
151 K025 Kodein HCl tab 10 mg TAB 0 0 0 0 0
152 K019 Klorpromazin HCL inj 25 mg/ml-1ml AMP 0 0 0 0 0
153 K022 Klorpromazin HCL Tablet salut 100 mg TAB 0 0 0 0 0
155 K045 KA-EN 3A SOL/K BTL 0 0 0 0 0
156 K046 KA-EN 3B SOL/K BTL 0 0 0 0 0
157 K047 KLINDAMISIN 300 MG KAP 0 0 0 0 0
158 L010 Lidokain HCL Injeksi AMP 50 0 50 50 0
159 L008 Lidokain Komp.Inj, Kombinasi : Lidokain HCl 2% + EpinepriAMP 0 30 30 20 10
160 L009 Lizol Mengandung Kresol tersabun 50 % BTL 0 0 0 0 0
161 L014 Loperamid Tablet 2 mg TAB 25 0 25 0 25
162 L015 Loratadin TAB 80 0 80 5 75
163 M002 Magnesium Sulfat Injeksi/MgSo4 AMP 50 0 50 0 50
164 M016 Masker BUAH 0 50 50 0 50
165 M024 Masker N95 BUAH 0 0 0 0 0
166 M017 Mercury Liquid BTL 0 0 0 0 0
167 M015 Metformin TAB 11 100 111 111 0
168 M007 Metilergometrin Maleat (Metilergometrin) Tablet Salut 0,125TAB
m 30 100 130 57 73
. .
169 M006 Metilergometrin Maleat Inj 0,200 mg 1 ml AMP 190 0 190 0 190
170 M022 Metoklopramid inj 5 mg/ml AMP 0 0 0 0 0
171 M023 Metoklopramid tab 10 mg TAB 0 0 0 0 0
172 M008 Metronidazol Tablet 250 mg TAB 0 0 0 0 0
173 M014 Metronidazole 500 mg TAB 0 300 300 100 200
174 M018 Mikonazole Cream TUBE 1 0 1 1 0
175 M025 Metilprednisolon 4 mg TAB 200 300 500 31 469
177 M021 Mineral Mix Bungkus 0 0 0 0 0
178 N011 Natrium Diklofenak Tablet 25 mg TAB 73 0 73 65 8
180 N002 Natrium Klorida larutan Infus 0, 9 % BTL 2 0 2 2 0
181 N013 Nifedipine 10 mg TAB 0 0 0 0 0
182 N004 Nistatin Tablet salut 500.000 IU TAB 0 0 0 0 0
183 Nistatin drop 0 0 0 0 0
184 N005 Nistatin Tablet Vaginal 100.000 IU / g TAB 0 0 0 0 0
185 N020 N-Asetil Sistein 200 mg KAP 163 0 163 23 140
186 O001 Obat anti tuberkulosis kategori I BOX 0 0 0 0 0
187 O002 Obat anti tuberkulosis kategori II BOX 0 0 0 0 0
188 O003 obat anti tuberkulosis sisipan BOX 0 0 0 0 0
189 O004 Obat anti tuberkulosis anak BOX 0 0 0 0 0
190 O011 Obat Batuk Hitam ( O B H ) BTL 8 0 8 8 0
191 O012 Obat Kusta PB Dewasa Blister 0 0 0 0 0
192 O013 Obat Kusta PB Anak Blister 0 0 0 0 0
193 O014 Obat Kusta MB Dewasa Blister 0 0 0 0 0
194 O015 Obat Kusta MB Anak Blister 0 0 0 0 0
195 O022 OAT Kategori I Dewasa-KOMBIPAK BOX 0 0 0 0 0
196 O007 Oksitertrasiklin HCL Salep 3 % Salep Kulit TUBE 0 0 0 0 0
197 O008 Oksitetrasiklin HCL mata 1 % TUBE 0 0 0 0 0
198 O009 Oksitosin Injeksi 10 IU / ml - 1 ml AMP 60 100 160 33 127
199 O023 Omeprazol kapsul 20 mg KAP 91 90 181 52 129
200 O017 Ondansetron injeksi 4 mg/2 ml AMP 1 20 21 15 6
201 P020 Papaverin 40 mg Tab 73 100 173 5 168
202 P002 Parasetamol Sirup 120 mg / 5 ml BTL 0 32 32 22 10
203 P004 Parasetamol Tablet 500 mg TAB 190 800 1290 838 452
204 P033 parasetamol drop 100 mg/ ml BTL 0 0 0 0 0
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205 P021 Phenilbutazon 200 mg Tab 0 0 0 0 0

206 P028 Phenobarbital 30 mg TAB 25 0 25 0 25
207 P036 Phenytoin 100 mg KAP 0 0 0 0 0
208 P010 Piridoksin HCL ( Vit.B6 ) Tablet 10 mg TAB 93 200 293 194 99
209 P006 Piroxicam Tablet 10 mg TAB 0 0 0 0 0
211 P011 Plester 5 Yard x 2 Inch ROL 7 7 14 0 14
212 P012 Plastik klip PCS 0 0 0 0 0
213 P034 Pot Sputum (Pot Dahak) BUAH 0 0 0 0 0
214 P015 Prednison Tablet 5 mg TAB 14 0 14 14 0
215 P018 Propanolol HCL Tablet 100 mg TAB 0 0 0 0 0
217 P035 Propanolol tab 10 mg TAB 0 30 30 6 24
218 P019 Propiltiourasil Tablet 100 mg TAB 0 0 0 0 0
219 R009 Ranitidin 150 mg Tab 140 500 640 606 34
220 R013 Ranitidine Injeksi AMP 9 10 19 11 8
221 R011 Retinol ( Vitamin A ) Kapsul 200. 000 IU KAP 0 0 0 0 0
222 R012 Retinol (Vitamin A) Kapsul 100.000 UI Kap 0 0 0 0 0
223 R008 Ringer Laktat larutan Infus Steril BTL 17 40 57 39 17
224 R014 Risperidon 2 mg TAB 0 0 0 0 0
225 R016 Reagen ZN-BTA SET 0 0 0 0 0
226 R017 Reagen HIV SD 1 (ke-1) SET 0 0 0 0 0
227 R018 Reagen HBs-AG (VIKIA) BOX 0 0 0 0 0
228 R019 Reagen HIV 1 & 2 Antibody (ke-2) SET 0 0 0 0 0
229 R020 Reagen Rapid 1/2 HIV (ke-3) SET 0 0 0 0 0
230 R021 Reagen Syphilis 3.0 SET 0 0 0 0 0
231 R022 Reagen HAV (HEPATITIS A) BOX 0 0 0 0 0
232 Reagen Intec Sac 0 0 0 0 0
233 S031 Safety Box BUAH 0 0 0 0 0
234 S001 Salbutamol Tablet 2 mg TAB 0 0 0 0 0
236 S004 Salep 2-4 TUBE 0 0 0 0 0
237 S023 Salicyl Talk BUAH 0 0 0 0 0
238 S054 Salbutamol nebules AMP 4 0 4 1 3
239 S026 Sarung Tangan no 7 BUAH 70 0 70 10 60
240 S050 Sarung Tangan No. 7,5 BUAH 30 50 80 10 70
. .
241 S028 SARUNG TANGAN NO 8 BUAH 0 0 0 0 0

242 S051 Sarung Tangan M BUAH 100 100 200 20 180
243 S021 Sendok Obat pCS 0 0 0 0 0
244 S005 Sefadroksil KAP 156 200 356 259 97
245 S009 Serum Anti tetanus Injeksi 1.500 IU / Amp. AMP 3 5 8 6 2
246 S006 Serum Anti Bisa Ular Polivalen Injeksi 5 ml vial vial 0 0 0 0 0
247 S011 Sianokobalamin ( Vit B 12 ) Injeksi 500 mcq/ml-1ml AMP 0 0 0 0 0
248 S012 Silk ( Benang Bedah Sutera ) No.3/0 12x3x75 cm de SET 0 0 0 0 0
249 S014 Simetidin 200 mg TAB 0 0 0 0 0
250 S058 Speculum Vagina S SET 0 0 0 0 0
251 S059 Speculum Vagina M SET 0 0 0 0 0
252 S060 Speculum Vagina L SET 0 0 0 0 0
253 S030 Simvastatin 10 mg TAB 16 0 16 5 11
254 S020 Sulfasetamida Natrium tetes mata 15 % BTL 0 0 0 0 0
255 T026 Tambah Darah NEO TAB 0 0 0 0 0
256 T016 Tablet zinc TAB 140 0 140 10 130
257 T004 Tetrasiklin HCL Kapsul 250 mg KAP 0 0 0 0 0
259 T012 Thiamphenicol 500 mg KAP 0 0 0 0 0
260 T006 Tiamin HCL ( Vit. B 1 ) Injeksi 100 mg / ml -1 ml AMP 0 0 0 0 0
261 T007 Tiamin HCL/ Monontrat (Vit .B1) Tablet 50 mg TAB 217 0 217 172 45
262 T008 Tramadol 50 mg Tablet TAB 0 0 0 0 0
263 T021 Tramadol inj AMP 0 0 0 0 0
264 T024 Trifluoperazin tab 5 mg Tab 0 0 0 0 0
265 T027 Tabung Reaksi Vacutainer (Tutup Merah) Box 0 0 0 0 0
266 T010 Triheksilfenidil Hidroklorida Tablet 2 mg TAB 0 0 0 0 0
267 V003 Vitamin B Klompek TAB 38 0 38 5 33
268 Vitamin C 90 0 90 10 80
269 V005 Vitamin B12 Tablet TAB 80 0 80 10 70
270 Y002 Yodium Povidon larutan 10 % 30 ml BTL 0 0 0 0 0
MENGETAHUI YANG MEMINTA LAPORAN YANG MENYERAHKAN
KEPALA PUSKESMAS GUNTUR I PETUGAS SUB UNIT PETUGAS PONED
ROKHIS SAIDAH NURA MARITA SANDRA DYAH SUSANTI

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NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
. .

( LPLPO ) NON GENERIK
PUSKESMAS : GUNTUR I
KECAMATAN : GUNTUR
KAB / KODYA DEMAK
PROPINSI JAWA
: TENGAH
1 2 3 4 5 6 7 8 9 11
1 A058 Anaria Syrup BTL 3 0 3 0 3
Alkohol swab 2 1700 2202 500 1702
Sulfadiazine Silver 0 0 0 0 0
2 B016 Burnazin Krim TUBE 0 0 0 0 0
3 B020 Bioplacenton Jelly TUBE 0 0 0 0 0
4 D004 Dulcolax Supp Supp 0 0 0 0 0
5 D016 Dextrofen Syr. SYR 0 0 0 0 0
6 D024 Dextral Kaplet KAP 58 0 58 20 38
7 G015 Guanistrep Syrup BTL 3 5 8 2 6
8 H005 Hemorograd Tablet TAB 0 0 0 0 0
9 I017 Iliadin Drops-Oksimetazolin tetes hidung BTL 0 0 0 0 0
10 I018 Iliadin Spray-Oksimetazolin tetes hidung BTL 0 0 0 0 0
11 Oralit SACHET 0 30 30 5 25
12 Pulmicort 0 0 0 0 0
13 Jovial SACHET 0 0 0 0 0
14 M019 Minyak Kayu Putih BTL 0 0 0 0 0
15 M020 Minyak Telon BTL 0 0 0 0 0
16 S053 Samcobion Kap 0300 300 244 56
17 S048 Scabimite cr TUBE 0 0 0 0 0
18 S019 Spashi Injeksi AMP 0 0 0 0 0
19 T025 Tetagam 250 IU AMP 0 0 0 0 0
JUMLAH KUNJUNGAN RESEP Umum BPJS
62 15 47

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NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
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PUSKESMAS : GUNTUR I LAPORAN BULAN : NOVEMBER
KAB / KODYA : DEMAK
1 2 3 4 5 6 7 8 9 10
. .

47 B001 Bisturi PCS 0 0 0 0 0
. .
61 C020 CLOBAZAM 10 MG TAB 0 0 0 0 0

. .

102 GLUKONAS CALCII FLAC 0 24 24 0 24
109 H016 HAND RUB BTL 0 0 0 0 0
110 H008 Hes 6 % BTL 0 0 0 0 0
114 I001 Ibuprofen Tablet 200 mg TAB 0 0 0 0
. .

155 K045 KA-EN 3A SOL/K BTL 0 0 0 0 0
156 K046 KA-EN 3B SOL/K BTL 0 0 0 0 0
162 L015 Loratadin TAB 80 0 80 0 80
164 M016 Masker BUAH 0 0 0 0 0
165 M024 Masker N95 BUAH 0 0 0 0 0
167 M015 Metformin TAB 41 0 41 30 11
m 40 0 40 10 30
. .
183 Nistatin drop 0 0 0 0 0
. .

236 S004 Salep 2-4 TUBE 0 0 0 0 0
. .

256 T016 Tablet zinc TAB 200 0 200 60 140
268 Vitamin C 100 0 100 10 90

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NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
. .

KECAMATAN : GUNTUR
KAB / KODYA DEMAK
PROPINSI JAWA
: TENGAH
1 2 3 4 5 6 7 8 9 11
Alkohol swab 7 0 7 5 2
Pulmicort 8 0 8 8 0
14 S053 Samcobion Kap 127 0 127 127 0
17 T025 Tetagam 250 IU AMP 0 0 0 0 0
JUMLAH KUNJUNGAN RESEP Rawat jalan Umum BPJS
93 35 8 50


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NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
. .
. .

KD PUSKESMAS : P33210301
PUSKESMAS : GUNTUR I LAPORAN BULAN : OKTOBER
KAB / KODYA : DEMAK
1 2 3 4 5 6 7 8 9 10
4 A001 Alat Suntik Sekali Pakai 0,05 ml BUAH 0 0 0 0
. .

47 B001 Bisturi PCS 0 0 0 0 0
. .
61 C020 CLOBAZAM 10 MG TAB 0 0 0 0 0

. .

108 H016 HAND RUB BTL 0 0 0 0 0
109 H008 Hes 6 % BTL 0 0 0 0 0
. .

154 K045 KA-EN 3A SOL/K BTL 0 0 0 0 0
155 K046 KA-EN 3B SOL/K BTL 0 0 0 0 0
161 L015 Loratadin TAB 100 100 200 120 80
163 M016 Masker BUAH 0 0 0 0 0
164 M024 Masker N95 BUAH 0 0 0 0 0
166 M015 Metformin TAB 68 200 268 227 41
m 110 0 110 70 40
. .

Nistatin drop 1 2 3 3 0
. .

234 S004 Salep 2-4 TUBE 0 0 0 0 0
. .
254 T016 Tablet zinc TAB 140 100 240 40 200
Vitamin C 100 100 200 100 100


. .
NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
. .

KECAMATAN : GUNTUR
KAB / KODYA DEMAK
PROPINSI JAWA
: TENGAH
1 2 3 4 5 6 7 8 9 11
Pulmicort 9 0 9 1 8
14 S053 Samcobion Kap 172 200 372 245 127
17 T025 Tetagam 250 IU AMP 4 0 4 4 0
JUMLAH KUNJUNGAN RESEP Rawat jalan Gratis Jamkesmas
78 10 29 7 32


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NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
. .
. .

PUSKESMAS : GUNTUR I LAPORAN BULAN : SEPTEMBER
KAB / KODYA : DEMAK
1 2 3 4 5 6 7 8 9 10
. .

47 B001 Bisturi PCS 0 0 0 0 0
. .
61 C020 CLOBAZAM 10 MG TAB 0 0 0 0 0

. .

108 H016 HAND RUB BTL 0 0 0 0 0
109 H008 Hes 6 % BTL 0 0 0 0 0
. .

154 K045 KA-EN 3A SOL/K BTL 0 0 0 0 0
155 K046 KA-EN 3B SOL/K BTL 0 0 0 0 0
161 L015 Loratadin TAB 0 100 100 0 100
163 M016 Masker BUAH 0 0 0 0 0
164 M024 Masker N95 BUAH 0 0 0 0 0
166 M015 Metformin TAB 52 100 152 84 68
m 36 100 136 26 110
. .

Nistatin drop 0 2 2 1 1
. .

234 S004 Salep 2-4 TUBE 0 0 0 0 0
. .

254 T016 Tablet zinc TAB 70 100 170 30 140
Vitamin C 0 100 100 0 100


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NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
. .

KECAMATAN : GUNTUR
KAB / KODYA DEMAK
PROPINSI JAWA
: TENGAH
1 2 3 4 5 6 7 8 9 11
Pulmicort 10 0 10 1 9
13 M020 Minyak Telon BTL 0 0 0 0 0 c
14 S053 Samcobion Kap 150 200 350 178 172
17 T025 Tetagam 250 IU AMP 6 0 6 2 4
JUMLAH KUNJUNGAN RESEP Bayar Gratis Jamkesmas
51 11 40


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NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
. .
. .

( LPLPO PONED )
PUSKESMAS : GUNTUR I LAPORAN BULAN : AGUSTUS
KAB / KODYA : DEMAK
1 2 3 4 5 6 7 8 9 10
. .

47 B001 Bisturi PCS 0 0 0 0 0
. .
61 C020 CLOBAZAM 10 MG TAB 0 0 0 0 0

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108 H016 HAND RUB BTL 0 0 0 0 0
109 H008 Hes 6 % BTL 0 0 0 0 0
. .

154 K045 KA-EN 3A SOL/K BTL 0 0 0 0 0
155 K046 KA-EN 3B SOL/K BTL 0 0 0 0 0
161 L015 Loratadin TAB 0 0 0 0 0
163 M016 Masker BUAH 0 0 0 0 0
164 M024 Masker N95 BUAH 0 0 0 0 0
166 M015 Metformin TAB 68 0 68 16 52
m 36 0 36 0 36
. .

. .

234 S004 Salep 2-4 TUBE 0 0 0 0 0
. .

254 T016 Tablet zinc TAB 70 0 70 0 70


NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
. .
. .

KECAMATAN : GUNTUR
KAB / KODYA DEMAK
PROPINSI JAWA
: TENGAH
1 2 3 4 5 6 7 8 9 11
13 M020 Minyak Telon BTL 0 0 0 0 0 +
14 S053 Samcobion Kap 160 200 360 210 150
17 T025 Tetagam 250 IU AMP 2 6 8 2 6
36 8 28


NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
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1
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. .

( LPLPO PONED )
PUSKESMAS : GUNTUR I LAPORAN BULAN : JULI
KAB / KODYA : DEMAK
1 2 3 4 5 6 7 8 9 10
. .

47 B001 Bisturi PCS 0 0 0 0 0
. .
61 C020 CLOBAZAM 10 MG TAB 0 0 0 0 0

. .

108 H016 HAND RUB BTL 0 0 0 0 0
109 H008 Hes 6 % BTL 0 0 0 0 0
. .

154 K045 KA-EN 3A SOL/K BTL 0 0 0 0 0
155 K046 KA-EN 3B SOL/K BTL 0 0 0 0 0
163 M016 Masker BUAH 0 0 0 0 0
164 M024 Masker N95 BUAH 0 0 0 0 0
166 M015 Metformin TAB 114 0 114 46 68
m 36 200 236 200 36
. .

. .

234 S004 Salep 2-4 TUBE 0 0 0 0 0
240 S051 Sarung Tangan M BUAH 0 300 300 200 1E+104
. .

254 T016 Tablet zinc TAB 0 100 100 30 70


NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
. .
. .

KECAMATAN : GUNTUR
KAB / KODYA DEMAK
PROPINSI JAWA
: TENGAH
1 2 3 4 5 6 7 8 9 11
13 M020 Minyak Telon BTL 0 0 0 0 0 +
14 S053 Samcobion Kap 60 100 160 0 160
17 T025 Tetagam 250 IU AMP 2 0 2 0 2
57 14 43


NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
. .
. .
. .

( LPLPO PONED )
PUSKESMAS : GUNTUR I LAPORAN BULAN : JUNI
KAB / KODYA : DEMAK
1 2 3 4 5 6 7 8 9 10
. .

47 B001 Bisturi PCS 0 0 0 0 0
. .

61 C020 CLOBAZAM 10 MG TAB 0 0 0 0 0
. .

108 H016 HAND RUB BTL 0 0 0 0 0
109 H008 Hes 6 % BTL 0 0 0 0 0
. .

154 K045 KA-EN 3A SOL/K BTL 0 0 0 0 0
. .
155 K046 KA-EN 3B SOL/K BTL 0 0 0 0 0

163 M016 Masker BUAH 0 0 0 0 0
164 M024 Masker N95 BUAH 0 0 0 0 0
166 M015 Metformin TAB 114 0 114 0 114
m 36 0 36 0 36
. .

. .
234 S004 Salep 2-4 TUBE 0 0 0 0 0
. .
254 T016 Tablet zinc TAB 0 0 0 0 0



NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
. .

KECAMATAN : GUNTUR
KAB / KODYA DEMAK
PROPINSI JAWA
: TENGAH
1 2 3 4 5 6 7 8 9 11
14 S053 Samcobion Kap 0 100 100 40 60
17 T025 Tetagam 250 IU AMP 2 0 2 0 2
98 47 51


. .
NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
. .
. .

( LPLPO PONED )
PUSKESMAS : GUNTUR I LAPORAN BULAN : MEI
KAB / KODYA : DEMAK
1 2 3 4 5 6 7 8 9 10
. .

47 B001 Bisturi PCS 0 0 0 0 0
. .

61 C020 CLOBAZAM 10 MG TAB 0 0 0 0 0
. .

108 H016 HAND RUB BTL 0 0 0 0 0
109 H008 Hes 6 % BTL 6 0 6 6 0
. .

154 K045 KA-EN 3A SOL/K BTL 0 0 0 0 0
. .
155 K046 KA-EN 3B SOL/K BTL 0 0 0 0 0

163 M016 Masker BUAH 0 0 0 0 0
164 M024 Masker N95 BUAH 0 0 0 0 0
166 M015 Metformin TAB 160 0 160 46 114
m 45 0 45 9 36
. .

. .
234 S004 Salep 2-4 TUBE 0 0 0 0 0
. .



NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
. .

KECAMATAN : GUNTUR
KAB / KODYA DEMAK
PROPINSI JAWA
: TENGAH
1 2 3 4 5 6 7 8 9 11
14 S053 Samcobion Kap 0 0 0 0 0
17 T025 Tetagam 250 IU AMP 2 0 2 0 2
55 11 44


. .
NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
. .

( LPLPO PONED )
PUSKESMAS : GUNTUR I LAPORAN BULAN :: APRIL
KAB / KODYA : DEMAK
1 2 3 4 5 6 7 8 9 10
. .

47 B001 Bisturi PCS 0 0 0 0 0
. .

61 C020 CLOBAZAM 10 MG TAB 0 0 0 0 0
. .

108 H016 HAND RUB BTL 0 0 0 0 0
109 H008 Hes 6 % BTL 6 0 6 0 6
. .

154 K045 KA-EN 3A SOL/K BTL 0 0 0 0 0
155 K046 KA-EN 3B SOL/K BTL 0 0 0 0 0
. .

163 M016 Masker BUAH 15 0 15 15 0
164 M024 Masker N95 BUAH 0 0 0 0 0
166 M015 Metformin TAB 150 100 250 90 160
m 49 0 49 4 45
. .

. .

234 S004 Salep 2-4 TUBE 0 0 0 0 0
. .



NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
. .

KECAMATAN : GUNTUR
KAB / KODYA DEMAK
PROPINSI JAWA
: TENGAH
1 2 3 4 5 6 7 8 9 11
17 T025 Tetagam 250 IU AMP 2 0 2 0 2


NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
. .

( LPLPO PONED )
PUSKESMAS : GUNTUR I LAPORAN BULAN :: MARET
KAB / KODYA : DEMAK
1 2 3 4 5 6 7 8 9 10
. .

34 A056 ASETOSAL 80 MG TAB 60 0 60 0 60
47 B001 Bisturi PCS 0 0 0 0 0
. .

61 C020 CLOBAZAM 10 MG TAB 0 0 0 0 0
68 D022 Diazepam Rectal Tube TUBE 0 0 0 0 0
. .

108 H016 HAND RUB BTL 0 0 0 0 0
109 H008 Hes 6 % BTL 7 0 7 1 6
. .

154 K045 KA-EN 3A SOL/K BTL 0 0 0 0 0
155 K046 KA-EN 3B SOL/K BTL 0 0 0 0 0
. .

163 M016 Masker BUAH 35 0 35 20 15
164 M024 Masker N95 BUAH 0 0 0 0 0
166 M015 Metformin TAB 200 0 200 50 150
m 85 0 85 36 49
. .

. .

234 S004 Salep 2-4 TUBE 0 0 0 0 0
. .



NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
. .

KECAMATAN : GUNTUR
KAB / KODYA DEMAK
PROPINSI JAWA
: TENGAH
1 2 3 4 5 6 7 8 9 11
17 T025 Tetagam 250 IU AMP 2 0 2 0 2
72 39 33


NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
. .
( LPLPO PONED )
PUSKESMAS : GUNTUR I LAPORAN BULAN :: FEBRUARI
KAB / KODYA : DEMAK
1 2 3 4 5 6 7 8 9 10
. .
34 A056 ASETOSAL 80 MG TAB 60 0 60 0 60
47 B001 Bisturi PCS 0 0 0 0 0
. .
61 C020 CLOBAZAM 10 MG TAB 0 0 0 0 0
. .
108 H016 HAND RUB BTL 0 0 0 0 0
109 H008 Hes 6 % BTL 7 0 7 0 7
. .
154 K045 KA-EN 3A SOL/K BTL 0 0 0 0 0
155 K046 KA-EN 3B SOL/K BTL 0 0 0 0 0
163 M016 Masker BUAH 0 50 50 15 35
164 M024 Masker N95 BUAH 0 0 0 0 0
. .
166 M015 Metformin TAB 29 200 229 29 200
m 85 0 85 0 85
. .
234 S004 Salep 2-4 TUBE 0 0 0 0
. .
. .

NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
. .
KECAMATAN : GUNTUR
KAB / KODYA DEMAK
PROPINSI JAWA
: TENGAH
1 2 3 4 5 6 7 8 9 11
17 T025 Tetagam 250 IU AMP 2 0 2 0 2
97 32 65


NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
. .
( LPLPO PONED )
PUSKESMAS : GUNTUR I LAPORAN BULAN :: JANUARI
KAB / KODYA : DEMAK
1 2 3 4 5 6 7 8 9 10
. .
34 A056 ASETOSAL 80 MG / Miniaspi TAB 60 0 60 0 60
47 B001 Bisturi PCS 0 0 0 0 0
. .
61 C020 CLOBAZAM 10 MG TAB 0 0 0 0 0
. .
108 H016 HAND RUB BTL 0 0 0 0 0
109 H008 Hes 6 % BTL 9 0 9 2 7
. .
154 K045 KA-EN 3A SOL/K BTL 0 0 0 0 0
155 K046 KA-EN 3B SOL/K BTL 0 0 0 0 0
163 M016 Masker BUAH 0 0 0 0 0
164 M024 Masker N95 BUAH 0 0 0 0 0
. .
166 M015 Metformin TAB 187 200 387 358 29
m 85 0 85 0 85
. .
202 P033 Parasetamol drop 100 mg/ ml BTL 0 0 0 0 0
234 S004 Salep 2-4 TUBE 0 0 0 0 0
. .
243 S009 Serum Anti tetanus Injeksi 1.500 IU / Amp. AMP 0 0 0 0
. .

NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP:19840604 200903 2 009
. .
KECAMATAN : GUNTUR
KAB / KODYA DEMAK
PROPINSI JAWA
: TENGAH
1 2 3 4 5 6 7 8 9 11
17 T025 Tetagam 250 IU AMP 2 0 2 0 2


NIP. 19690113 200212 2 003 NIP. 19830302 200603 2 007 NIP: 19840604 200903 2 009
LAPORAN PEMAKAIAN DAN LEMBAR PERMINT
( LPLPO )
KD PUSKESMAS P3321120101
PUSKESMAS MIJEN I
KECAMATAN MIJEN
:
KAB / KODYA : DEMAK
NO. KODE NAMA OBAT SATU STOK PENERI PERSE

AN AWAL MAAN DIAAN
1 2 3 4 5 6 7
1 A025 Aciclovir Tablet 200 mg TAB 0
2 A013 Aciclovir Salep Kulit TUBE 0
3 A026 Aciclovir Tablet 400 mg TAB 0
4 A001 Alat Suntik Sekali Pakai 0,05 ml BUAH 0
5 A002 Alat Suntik Sekali Pakai 0,5 ml SET 0
6 A003 Alat Suntik Sekali Pakai 3 ml SET 0
10 A005 Albendazole Tablet 400 mg TAB 0
11 A038 Alkohol larutan BTL 0
12 A006 Alupurinol Tablet 100 mg TAB 0
13 A051 Alupurinol Tablet 300 mg TAB 0
14 A050 ALPRAZOLAM 0,5 MG TAB 0
15 A030 Ambroxol Syrup 15mg/5ml BTL 0
16 A029 Ambroxol Tablet TAB 0
17 A007 Aminofilina Injeksi 24 mg/ml - 10 ml AMP 0
18 A008 Aminofilina Tablet 200 mg TAB 0
19 A045 Amitriptilin 25 mg TAB 0
20 A047 Amoksisilin Syr Forte 250 mg/ 5 ml BTL 0
21 A010 Amoksisilina Kapsul 500 mg Kap 0
22 A012 Amoksisilina Sirup kering 125 mg/5 ml TAB 0
23 A054 AMLODIPIN 10 MG TAB 0
24 A055 AMLODIPIN 5 MG TAB 0
25 A046 Ampisilin inj 1000 mg VIAL 0
26 A014 Ampisilin kapsul 500 mg Kap 0
27 A017 Antalgin ( Metampiron ) Tablet 500 mg TAB 0
28 A018 Antasida Doen suspensi btl. 60 ml BTL 0
29 A019 Antasida DOEN Tablet 500 mg TAB 0
30 A020 Anti Bakteri DOEN Salep kombinasi TUBE 0
31 A021 Anti Hemoroid DOEN Kombinasi SUPP 0
32 A022 Antifungi DOEN Kombinasi TUBE 0
33 A041 Aqua Pro Injeksi BTL 0
34 A056 ASETOSAL 80 MG TAB 0
35 A027 Asam Askorbat (VitC ) Tablet 250 mg TAB 0
36 A028 Asam Askorbat (VitC ) Tablet 50 mg TAB 0
37 A037 Asam Folat Tablet TAB 0
38 A036 Asam Mefenamat 500 mg Kap 0
39 A023 Asam Tranexamat Injeksi AMP 0
40 A049 ASERING INFUS BTL 0
41 A035 Atrofin Sulfat Injeksi 0,25 mg AMP 0
42 A058 Attapulgite 600 mg TAB 0
43 B004 Betametason 0,1% krim TUBE 0
44 B018 BETAHISTIN 6 MG TAB 0
45 B019 BENZATIN BENZIL PENISILIN INJ VIAL 0
46 B001 Bisturi PCS 0
47 B017 Bisacodil TAB 5 mg TAB 0
48 B015 Bisacodil supp 10 mg SUPP 0
49 B021 BLOOD LANCET 26 G BOX 0
50 B013 Bromhexin tab TAB 0
51 C002 Captopril Tablet 12,5 mg Tab 0
52 C003 Captopril Tablet 25 mg Tab 0
53 C021 CAPTOPRIL 50 MG TAB 0
54 C001 Catgut / Benang Bedah No.2/0 - 3/0 dengan Jarum Bedah SET 0
55 C011 Cefotaxim Injeksi 1 g VIAL 0
56 C014 Ceftriaxone Injeksi VIAL 0
57 C007 Ciprofloksacin tablet 500 mg TAB 0
58 C018 Clozapine 100 mg tab TAB 0
59 C007 Clozapine 25 mg tab TAB 0
60 C020 CLOBAZAM 10 MG TAB 0
61 C022 COTTON SWAB SET 0
62 C023 COVER GLASS 20 X 20 BOX 0
63 C019 CUTICELL CLASSIC 10 CM X 10 CM BUAH 0
64 D002 Deksametason Injeksi 5 mg / ml - 1 ml AMP 0
65 D003 Deksametason Tablet 0,5 mg TAB 0
66 D008 Diazepam Injeksi 5 mg / Ml - 2 ml AMP 0
67 D022 Diazepam Rectal Tube TUBE 0
68 D009 Diazepam Tablet 2 mg TAB 0
69 D010 Diazepam Tablet 5 mg TAB 0
70 D019 DIETHIL CARBAMAZINE 100 MG TAB 0
71 D012 Difenhidramin HCL Injeksi 10 mg/ml - 1 ml AMP 0
72 D013 Digoksin Tablet 0,25 mg TAB 0
73 D018 Dimenhidrinate 50 mg TAB 0
74 D023 Domperidon Syr 5mg/5 ml BTL 0
75 D025 Domperidon 10 MG TAB TAB 0
76 D020 Doxycicline 100 mg TAB 0
77 E001 Efedrin HCL Tablet 25 mg TAB 0
78 E002 Ekstrak belladon tablet 10 mg TAB 0
79 E003 Epinefrina Hcl/Bitatrat ( ADRENALIN) AMP 0
80 E010 Erythromicin 250 mg Cap 0
81 E011 Erythromicin 500 mg Cap 0
82 E005 Etakridin ( Rivanol ) Larutan 0,1 % BTL 0
83 E008 Etylchloride Spray 100 ml BTL 0
84 E009 Eugenol cairan BTL 0
85 F001 Furosemida Tablet 40 mg TAB 0
86 F003 Fitomenadion (Vit K1) Tablet.s TAB 0
87 F004 Fenobarbital Inj 50 mg/ ml - 2 ml AMP 0
88 F007 Fitomenadion (Vit K1) Inj, 10 AMP 0
89 F012 Fitomenadion Inj 2 mg/ ml AMP 0
90 F008 Fenol Gliserol Tetes Telinga BTL 0
91 F013 Fluphenazine Decanoat 25 mg/ml AMP 0
92 F014 Fluconazol 150 mg TAB 0
93 F015 FIXOMULL STRETCH 5 CM X 5 CM ROLL 0
94 G003 Garam Oralit untuk 200 ml air BKS 0
95 G004 Gentian Violet larutan 1 % BTL 0
96 G016 GEMFIBROZIL 300 MG TAB 0
97 G006 Glibenklamid Tablet 5 mg TAB 0
98 G007 Gliseril Guaiakolat Tablet 100 mg TAB 0
99 G014 GLIMEPIRIDE 2 MG TAB 0
100 G011 Glukose larutan Infus 5 % steril BTL 0
101 G012 Griseofulvin Tablet 125 mg Micronized TAB 0
102 H0014 Haloperidol inj 50 mg/ml AMP 0
103 H001 Haloperidol Tablet 0,5 mg TAB 0
104 H002 Haloperidol Tablet 1,5 mg TAB 0
105 H003 Haloperidol Tablet 5 mg TAB 0
106 H016 HAND RUB BTL 0
107 H008 Hes 6 % BTL 0
108 H006 Hidroklorotiazid ( HCT ) Tablet 25 mg TAB 0
109 H004 Hidrokortison krim 2,5 % TUBE 0
110 H013 Hyoscin-N-Butilbromid tab 10 mg TAB 0
111 I001 Ibuprofen Tablet 200 mg TAB 0
112 I002 Ibuprofen Tablet 400 mg TAB 0
113 I003 Infusion set anak SET 0
114 I004 Infusion set dewasa SET 0
115 I012 Iodium Test BTL 0
116 I010 Isosorbit Dinitrat Tablet Sublingual 5 mg TAB 0
117 I016 IV Cateter No. 18 BUAH 0
121 I017 ILIADIN DROP BTL 0
122 I018 ILIADIN SPRAY BTL 0
123 I019 IBUPROFEN SUSP BTL 0
124 J001 Jarum Jahit (bedah) BIJI 0
125 K001 Ketokonazol 200 mg 0
126 K002 Kalsium Glukonat inj 10 % (100mg/ml) AMP 0
127 K004 Kalsium Laktat (kalk) Tablet 500 mg TAB 0
128 K005 Kapas Berlemak 500 gr ROL 0
129 K006 Kapas Pembalut / Absorben 250 gr ROL 0
130 K007 Karbamazepin Tablet 200 mg TAB 0
131 K008 Kasa Kompres 40/40 Steril LBR 0
132 K010 Kasa Pembalut Hidrofil 4 x 15 cm BUAH 0
133 K011 Kasa Pembalut Hidrofil 4 x 3 cm BUAH 0
134 K037 Kasa Pembalut Hidrofil 4 M x 10 cm BUAH 0
135 K041 Kasa Steril 16 cm x 16 cm BOX 0
136 K042 Kaca Sediaan (Obyek Glass/SLIDE) BOX 0
137 K043 Kotak Sediaan/ BOX SLIDE BOX 0
138 K040 Kalisium Gluconat inj in 10 % (100 mg/100ml) AMP 0
139 K012 Ketokonazol salep TUBE 0
140 K039 Ketorolac inj 10 mg AMP 0
141 K014 Kloramfenikol Kapsul 250 mg KAP 0
142 K015 Kloramfenikol Salep mata 1 % TUBE 0
143 K016 Kloramfenikol tetes telinga 3 % BTL 0
144 K024 Kloramfenikol tetes Mata BTL 0
145 K044 Kloramfenikol Susp 125 mg/ 5 ml BTL 0
146 K048 Kloramfenikol Salep kulit 2 % TUBE 0
147 K017 Klorfeniramin Maleat (CTM ) Tablet 4 mg TAB 0
148 K025 Kodein HCl tab 10 mg TAB 0
149 K019 Klorpromazin HCL inj 25 mg/ml-1ml AMP 0
150 K022 Klorpromazin HCL Tablet salut 100 mg TAB 0
151 K021 Klorpromazin HCL Tablet salut 25 mg TAB 0
152 K045 KA-EN 3A SOL/K BTL 0
153 K046 KA-EN 3B SOL/K BTL 0
154 K047 KLINDAMISIN 300 MG KAP 0
155 L010 Lidokain HCL Injeksi AMP 0
156 L008 Lidokain Komp.Inj, Kombinasi : Lidokain HCl 2% + EpineprinAMP 0
157 L009 Lizol Mengandung Kresol tersabun 50 % BTL 0
158 L014 Loperamid Tablet 2 mg TAB 0
159 L015 Loratadin TAB 0
160 M002 Magnesium Sulfat Injeksi AMP 0
161 M016 Masker BUAH 0
162 M024 Masker N95 BUAH 0
163 M017 Mercury Liquid BTL 0
164 M015 Metformin TAB 0
165 M007 Metilergometrin Maleat (Metilergometrin) Tablet Salut 0,125
TAB 0
166 M006 Metilergometrin Maleat Inj 0,200 mg 1 ml AMP 0
167 M022 Metoklopramid inj 5 mg/ml AMP 0
168 M023 Metoklopramid tab 10 mg TAB 0
169 M008 Metronidazol Tablet 250 mg TAB 0
170 M014 Metronidazole 500 mg TAB 0
171 M018 Mikonazole Cream TUBE 0
172 M019 Minyak Kayu Putih BTL 0
173 M020 Minyak Telon BTL 0
174 M025 Metilprednisolon 4 mg TAB 0
175 M026 Metilprednisolon 8 mg TAB 0
176 M021 Mineral Mix Bungkus 0
177 N011 Natrium Diklofenak Tablet 25 mg TAB 0
178 N012 Natrium Diklofenak Tablet 50 mg TAB 0
179 N002 Natrium Klorida larutan Infus 0, 9 % BTL 0
180 N013 Nifedipine 10 mg TAB 0
181 N004 Nistatin Tablet salut 500.000 IU TAB 0
182 N005 Nistatin Tablet Vaginal 100.000 IU / g TAB 0
183 N020 N-Asetil Sistein 200 mg KAP 0
184 O001 Obat anti tuberkulosis kategori I BOX 0
185 O002 Obat anti tuberkulosis kategori II BOX 0
186 O003 obat anti tuberkulosis sisipan BOX 0
187 O004 Obat anti tuberkulosis anak BOX 0
188 O011 Obat Batuk Hitam ( O B H ) BTL 0
189 O012 Obat Kusta PB Dewasa Blister 0
190 O013 Obat Kusta PB Anak Blister 0
191 O014 Obat Kusta MB Dewasa Blister 0
192 O015 Obat Kusta MB Anak Blister 0
193 O022 OAT Kategori I Dewasa-KOMBIPAK BOX 0
194 O007 Oksitertrasiklin HCL Salep 3 % Salep Kulit TUBE 0
195 O008 Oksitetrasiklin HCL mata 1 % TUBE 0
196 O009 Oksitosin Injeksi 10 IU / ml - 1 ml AMP 0
197 O023 Omeprazol kapsul 20 mg KAP 0
198 O017 Ondansetron injeksi 4 mg/2 ml AMP 0
199 P020 Papaverin 40 mg Tab 0
200 P002 Parasetamol Sirup 120 mg / 5 ml BTL 0
201 P004 Parasetamol Tablet 500 mg TAB 0
202 p033 parasetamol drop 100 mg/ ml BTL 0
203 P021 Phenilbutazon 200 mg Tab 0
204 P028 Phenobarbital 30 mg TAB 0
205 P036 Phenytoin 100 mg KAP 0
206 P010 Piridoksin HCL ( Vit.B6 ) Tablet 10 mg TAB 0
207 P006 Piroxicam Tablet 10 mg TAB 0
208 P007 Piroxicam Tablet 20 mg TAB 0
209 P011 Plester 5 Yard x 2 Inch ROL 0
210 P012 Plastik klip PCS 0
211 P034 Pot Sputum (Pot Dahak) BUAH 0
212 P015 Prednison Tablet 5 mg TAB 0
213 P018 Propanolol HCL Tablet 100 mg TAB 0
214 P030 Propanolol HCL Tablet 40 mg TAB 0
215 P035 Propanolol tab 10 mg TAB 0
216 P019 Propiltiourasil Tablet 100 mg TAB 0
217 R009 Ranitidin 150 mg Tab 0
218 R013 Ranitidine Injeksi AMP 0
219 R011 Retinol ( Vitamin A ) Kapsul 200. 000 IU KAP 0
220 R012 Retinol (Vitamin A) Kapsul 100.000 UI Kap 0
221 R008 Ringer Laktat larutan Infus Steril BTL 0
222 R014 Risperidon 2 mg TAB 0
223 R016 Reagen ZN-BTA SET 0
224 R017 Reagen HIV SD 1 (ke-1) SET 0
225 R018 Reagen HBs-AG (VIKIA) BOX 0
226 R019 Reagen HIV 1 & 2 Antibody (ke-3) SET 0
227 R020 Reagen Rapid 1/2 HIV (ke-2) SET 0
228 R021 Reagen Syphilis 3.0 SET 0
229 R022 Reagen HAV (HEPATITIS A) BOX 0
230 S031 Safety Box BUAH 0
231 S001 Salbutamol Tablet 2 mg TAB 0
232 S002 Salbutamol Tablet 4 mg TAB 0
233 S004 Salep 2-4 TUBE 0
234 S023 Salicyl Talk BUAH 0
235 S054 Salbutamol nebules AMP 0
236 S026 Sarung Tangan no 7 BUAH 0
237 S050 Sarung Tangan No. 7,5 BUAH 0
238 S028 SARUNG TANGAN NO 8 BUAH 0
239 S051 Sarung Tangan M BUAH 0
240 S021 Sendok Obat pCS 0
241 S005 Sefadroksil KAP 0
242 S0009 Serum Anti tetanus Injeksi 1.500 IU / Amp. AMP 0
243 S006 Serum Anti Bisa Ular Polivalen Injeksi 5 ml vial vial 0
244 S011 Sianokobalamin ( Vit B 12 ) Injeksi 500 mcq/ml-1ml AMP 0
245 S012 Silk ( Benang Bedah Sutera ) No.3/0 12x3x75 cm de SET 0
246 S014 Simetidin 200 mg TAB 0
247 S030 Simvastatin 10 mg TAB 0
248 S020 Sulfasetamida Natrium tetes mata 15 % BTL 0
249 T026 Tambah Darah NEO TAB 0
250 T016 Tablet zinc TAB 0
251 T004 Tetrasiklin HCL Kapsul 250 mg KAP 0
252 T005 Tetrasiklin HCL Kapsul 500 mg KAP 0
253 T012 Thiamphenicol 500 mg KAP 0
254 T006 Tiamin HCL ( Vit. B 1 ) Injeksi 100 mg / ml -1 ml AMP 0
255 T007 Tiamin HCL/ Monontrat (Vit .B1) Tablet 50 mg TAB 0
256 T008 Tramadol 50 mg Tablet TAB 0
257 T021 Tramadol inj AMP 0
258 T024 Trifluoperazin tab 5 mg Tab 0
259 T027 Tabung Reaksi Vacutainer (Tutup Merah) Box 0
260 T010 Triheksilfenidil Hidroklorida Tablet 2 mg TAB 0
261 V003 Vitamin B Klompek TAB 0
262 V005 Vitamin B12 Tablet TAB 0
263 Y002 Yodium Povidon larutan 10 % 30 ml BTL 0
264 Y004 Yodium Povidon larutan 10 % 300 ml BTL 0
Mengetahui / Menyetujui Yang Menyerahkan

Kepala Dinas Kesehatan Kab.Demak Kabid.Bind.Farmasi dan Perbekes
LAPORAN PEMAKAIAN DAN LEMBAR PERMINT

( LPLPO ) NON GENERI
KD PUSKESMAS P3321120101
PUSKESMAS MIJEN I
KECAMATAN MIJEN
:
KAB / KODYA DEMAK
PROPINSI :JAWA TENGAH
NO. KODE NAMA OBAT SATU STOK PENERI PERSE

AN AWAL MAAN DIAAN
1 2 3 4 5 6 7
1 A058 Anaria Syrup BTL 0
2 B016 Burnazin Krim TUBE 0
3 D004 Dulcolax Supp Supp 0
4 D016 Dextrofen Syr. SYR 0
5 G015 Guanistrep Syrup BTL 0
6 H005 Hemorograd Tablet TAB 0
7 I017 Iliadin Drops-Oksimetazolin tetes hidung BTL 0
8 I018 Iliadin Spray-Oksimetazolin tetes hidung BTL 0
9 M019 Minyak Kayu Putih BTL 0
10 S053 Samcobion Kap 0
11 S048 Scabimite cr TUBE 0
12 S019 Spashi Injeksi AMP 0
13 T025 Tetagam 250 IU AMP 0
14 V012 Vidabion Cal CAP 0
Mengetahui / Menyetujui Yang Menyerahkan

Kepala Dinas Kesehatan Kab.Demak Kabid.Bind.Farmasi dan Perbekes
AIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )
LAPORAN BULAN : 01
TAHUN : 2012
PERMINTAAN BLN : -
TAHUN : 2012
PEMA SISA STOK PERMIN PEMBERIAN KET

KAIAN STOK OPT TAAN PKD PHB APBD LAIN JML
8 9 10 11 12 13 14 15 16 17
0
0
0
0
0
0
0
0
0
0
0
0
0
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0
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0
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0
0
0
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0
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0
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0
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Melaporkan / Meminta Yang menerima

an Perbekes Kepala Puskesmas Mijen I Pengelola Obat
AIAN DAN LEMBAR PERMINTAAN OBAT

LAPORAN BULAN :
TAHUN : 2012
PERMINTAAN BLN : -
TAHUN : 2011
PEMA SISA STOK PERMIN PEMBERIAN KET

KAIAN STOK OPT TAAN PKD PHB APBD LAIN JML
8 9 10 11 12 13 14 15 16 17
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Jamkesmas UKS ASKES JUMLAH

0
Melaporkan / Meminta Yang menerima

an Perbekes Kepala Puskesmas Mijen I Pengelola Obat

Lplpo Ranap Poned 2018

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. .

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

25 A046 Ampisilin inj 1000 mg VIAL 0 0 0 0 0

61 C020 CLOBAZAM 10 MG TAB 0 0 0 0 0

97 G004 Gentian Violet larutan 1 % BTL 10 0 10 9 1

133 K010 Kasa Pembalut Hidrofil 4 x 15 cm BUAH 0 0 0 0 0

205 P021 Phenilbutazon 200 mg Tab 0 0 0 0 0

241 S028 SARUNG TANGAN NO 8 BUAH 0 0 0 0 0

ROKHIS SAIDAH NURA MARITA SANDRA DYAH SUSANTI

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

ROKHIS SAIDAH NURA MARITA SANDRA DYAH SUSANTI

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

25 A046 Ampisilin inj 1000 mg VIAL 0 0 0 0 0

61 C020 CLOBAZAM 10 MG TAB 0 0 0 0 0

97 G004 Gentian Violet larutan 1 % BTL 10 0 10 0 10

133 K010 Kasa Pembalut Hidrofil 4 x 15 cm BUAH 0 0 0 0 0

205 P021 Phenilbutazon 200 mg Tab 0 0 0 0 0

241 S028 SARUNG TANGAN NO 8 BUAH 0 0 0 0 0

ROKHIS SAIDAH NURA MARITA SANDRA DYAH SUSANTI

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

MENGETAHUI YANG MEMINTA LAPORAN YANG MENYERAHKAN

ROKHIS SAIDAH NURA MARITA SANDRA DYAH SUSANTI

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

25 A046 Ampisilin inj 1000 mg VIAL 0 0 0 0 0

61 C020 CLOBAZAM 10 MG TAB 0 0 0 0 0

97 G004 Gentian Violet larutan 1 % BTL 11 0 11 1 10

133 K011 Kasa Pembalut Hidrofil 4 x 3 cm BUAH 0 0 0 0 0

169 M022 Metoklopramid inj 5 mg/ml AMP 0 0 0 0 0

204 P028 Phenobarbital 30 mg TAB 28 0 28 0 28

MENGETAHUI YANG MEMINTA LAPORAN YANG MENYERAHKAN

ROKHIS SAIDAH NURA MARITA SANDRA DYAH SUSANTI

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

MENGETAHUI YANG MEMINTA LAPORAN YANG MENYERAHKAN

ROKHIS SAIDAH NURA MARITA SANDRA DYAH SUSANTI

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

25 A046 Ampisilin inj 1000 mg VIAL 0 0 0 0 0

61 C020 CLOBAZAM 10 MG TAB 0 0 0 0 0

97 G004 Gentian Violet larutan 1 % BTL 12 0 12 1 11

133 K011 Kasa Pembalut Hidrofil 4 x 3 cm BUAH 0 0 0 0 0

169 M022 Metoklopramid inj 5 mg/ml AMP 0 0 0 0 0

204 P028 Phenobarbital 30 mg TAB 31 0 31 3 28

240 S051 Sarung Tangan M BUAH 0 400 400 300 100

MENGETAHUI YANG MEMINTA LAPORAN YANG MENYERAHKAN

ROKHIS SAIDAH NURA MARITA SANDRA DYAH SUSANTI

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

MENGETAHUI YANG MEMINTA LAPORAN YANG MENYERAHKAN

ROKHIS SAIDAH NURA MARITA SANDRA DYAH SUSANTI

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

25 A046 Ampisilin inj 1000 mg VIAL 0 1 1 1 0

61 C020 CLOBAZAM 10 MG TAB 0 0 0 0 0

97 G004 Gentian Violet larutan 1 % BTL 12 0 12 0 12

133 K011 Kasa Pembalut Hidrofil 4 x 3 cm BUAH 0 0 0 0 0

169 M022 Metoklopramid inj 5 mg/ml AMP 0 0 0 0 0

205 P036 Phenytoin 100 mg KAP 0 0 0 0 0

241 S021 Sendok Obat pCS 0 0 0 0 0

MENGETAHUI YANG MEMINTA LAPORAN YANG MENYERAHKAN

ROKHIS SAIDAH NURA MARITA SANDRA DYAH SUSANTI

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT