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  • Lplpo 2019

    Încărcat de

    Abraham Famai
    11 vizualizări948 pagini
    The document is a report on the usage and request for medicine supplies (LPL) from Lembur Public Health Center in Alor Regency, East Nusa Tenggara Province, Indonesia. It contains a table listing 102 different medicines with information on initial stock, receipts, inventory, and usage. The report is addressed to the Health Office of Alor Regency and signed by the head of Lembur Public Health Center.

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    LPLPO PUSKESMAS LEMBUR

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    LPLPO 2019

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    The document is a report on the usage and request for medicine supplies (LPL) from Lembur Public Health Center in Alor Regency, East Nusa Tenggara Province, Indonesia. It contains a table listing 102 different medicines with information on initial stock, receipts, inventory, and usage. The report is addressed to the Health Office of Alor Regency and signed by the head of Lembur Public Health Center.

    Drepturi de autor:

    © All Rights Reserved
    Descărcați ca XLSX, PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    11 vizualizări948 pagini

    Lplpo 2019

    Încărcat de

    Abraham Famai
    The document is a report on the usage and request for medicine supplies (LPL) from Lembur Public Health Center in Alor Regency, East Nusa Tenggara Province, Indonesia. It contains a table listing 102 different medicines with information on initial stock, receipts, inventory, and usage. The report is addressed to the Health Office of Alor Regency and signed by the head of Lembur Public Health Center.

    Drepturi de autor:

    © All Rights Reserved
    Descărcați ca XLSX, PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    din 948

    PEMERINTAH KABUPATEN ALOR

    D I N A S K E S E H A T A N
    Jl. Prof. DR. W. Z. Yohanes. No. - Telp. (0386) 21052
    K A L A B A H I

    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPL

    NAMA PUSKESMAS : LEMBUR


    KABUPATEN : ALOR
    KECAMATAN : LEMBUR

    No Nama Obat Satuan Stok awal Penerimaan Persediaan Pemakaian

    1 2 3 4 5 6 7

    1 Adona Injensi - -
    Amp
    2 Alat Suntik Sekali Pakai 2,5 ml Pcs 170 500 670 80

    3 Alat Suntik Sekali Pakai 5 ml Pcs 125 200 325 25

    4 Alat suntik sekali pakai 0,5 ml Pcs - - -

    5 Alat suntik sekali pakai 0,5 ml / E - Katalog Pcs 600 600

    6 Alat suntik sekali pakai 0,05 ml /non e-katalog pcs - -

    7 Alat suntik sekali pakai 0,05 ml / e-katalog Pcs 400 400


    8 Alat suntik sekali pakai 1 ml Pcs 200 300 500

    9 Alat suntik sekali pakai10 ml Pcs - -

    10 Albendazol 400 mg / non e-katalog Tab 650 650

    11 Allupurinol 100 mg Tab 1,200 1,200

    12 Amalgam solila / Silver Amalgam Powder + Liquid Tube - -

    13 Ambroxol syrup 15 mg/ml Btl 42 42

    14 Ambroxol 30 mg Tab 3,100 2,000 5,100 800

    15 Aminofilin Injeksi 24 mg/ml Amp 9 9

    16 Aminofilin 200 mg / e-katalog Tab 180 100 280

    17 Aminofilin 200 mg / non e-katalog tab - -

    18 Amitriptilin HCL 25 mg Tab - -

    19 Amlodipin 5 mg Tab 150 150 100

    20 Amoksisilin 250 mg Kaps 2,500 3,000 5,500 1,100

    21 Amoksisilin 500 mg Kapl 2,500 3,000 5,500 900

    22 Amoksisilin syrup Btl 21 60 81 5

    23 Ampisillin injeksi 1000 mg/ml Vial - -

    24 Ampisillin syrup Btl - -

    25 Antacida DOEN Tab - -

    26 Antacida DOEN Suspensi Btl 35 50 85

    27 Antalgin 500 mg Tab 1,200 2,000 3,200 600


    28 Antalgin injeksi Amp 30 30 15

    29 Anti Bakteri DOEN / Basitrasin Polimiksin Tube 21 25 46

    30 Anti Fungi DOEN Salep 30 g ( Salp 3 - 6 ) Pot - 24 24

    31 Anti Haemoroid DOEN Suppositoria Supp - -

    32 Anti Malaria DOEN ( SulDox ) Tab 1,000 1,000

    33 Anti Migraen / Ergotamin 1 mg + Coffein 50 mg Tab - -

    34 Anti Sera A Btl - -

    35 Anti Sera B Btl - -

    36 Anti Sera AB Btl - -

    37 Anti Sera D Btl - -

    38 Aqua pro injeksi 20 ml Vial - -

    39 Aquadestilata 1000 ml Btl 3 3

    40 Aqua DM Bidestilata IKA ml 1 1

    41 Aqua DM Brataco ltr - -

    42 Arsen / Devitalisasi Pasta Btl - -

    43 Arterakin tab Tab - -

    44 Artesunat injeksi 60 mg Vial - -

    45 Artemeter injeksi Amp - -

    46 Asetosal 100 mg Tab - -

    47 Asetosal 500 mg Tab - -


    48 Asam Ascorbat 50 mg Tab 6,900 7,000 13,900 1,300

    49 Asam Mefenamat 500 mg Kapl - -

    50 Asiklovir cream 5 % 5 g Tube 15 20 35 5

    51 Asiklovir 200 mg Tab 1,250 1,250 200

    52 Asiklovir 400 mg Tab - -

    53 Atropin Sulfat injeksi 0,25 mg/ml Amp - -

    54 Atropin sulfat 0,5 mg Tab - -

    55 Baby Cough syrup Btl - -

    56 Bahan Fissur Sealent / Fuji VII Dos - -

    57 Baraclude 1 mg btl/30 tab - -

    58 Baraclude 0,5 mg box/30 tab - -

    59 Barotec Inhaler Btl - -

    60 Baycline 1 Liter Btl - -

    61 Benzatin Benzil Penicillin 1,2 juta IU Vial - -

    62 Besi II Sulfat 7 H2O 300 mg Tab - -

    63 Besi II Sulfat + Asam Folat Tab 4,920 4,920 2,600

    64 Betametason Cream 0,1 % Tube 35 25 60 20

    65 Betason N Tube - -

    66 Bidan Kit paket - -

    67 Bioplacenton 15 gram Tube - -


    68 Bisolvon Nebulizer btl - -

    69 Bisturi / non e-katalog Pcs 143 143 60

    70 Blood lanset / non e-katalog Pcs - -

    71 Calsidor / Dycal Dentsply / Hydcal Technew Btl - -

    72 Calsydol syrup Btl - -

    73 Cat gut 3/0 Pcs 90 90 24

    74 Cat gut 3/0 / E-katalog Pcs - 96 96

    75 Cat gut 2/0 Pcs 38 38 38

    76 Cat gut 2/0 / E-katalog Pcs - 96 96

    77 Cavit / Caviton Btl - -

    78 Cement Powder + Liquid / Elite Cement 100 Dos - -

    79 Cefadroxil 500 mg Kaps 900 2,000 2,900 400

    80 Ceftriaxon Injeksi Vial - -

    81 Cefotaxime injeksi 0,5 gram Vial 6 6

    82 Cefotaxime injeksi 1 gram Vial - -

    83 Chlor Fenol Champer menthol /CHKM Btl - -

    84 Chloramfecort Tube - 5 5

    85 Chloramfecort H Tube - 5 5

    86 Cimetidine 200 mg Tab 3,100 3,100

    87 Ciprofloksasine 500 mg Tab 2,200 2,200 700


    88 Counterpain 30 gram Tube - -

    89 Curcuma Plus Syrup Btl - -

    90 Darplex Tab 179 179 54

    91 Dasabion Kaps - -

    92 Deksamethasone injeksi 5 mg/ml Amp 93 100 193 40

    93 Deksamethasone 0,5 mg Tab 700 5,000 5,700 300

    94 Dekstran 70 - Larutan Infus 6 % steril Btl - -

    95 Dental Cotton Roll Bks - -

    96 Dental Plak Disclosing Gel / Disclosing Solution Btl - -

    97 Diazepam injeksi 5 mg/ml Amp - -

    98 Diazepam 2 mg Tab - -

    99 Diazepam 5 mg Tab 5 5

    100 Dietilkarbamsin 100 mg / NON E-KATALOG Tab - -

    101 Difenhidramine Injeksi 10 mg/ml Amp 98 98 19

    102 Digoksin 0,25 mg Tab - -

    103 Diltiazem HCL 30 mg Tab - -

    104 Dimenhidrinat 50 mg Tab - -

    105 Doksisiklin 100 mg Kaps - -

    106 Domperidon Tab - -

    107 Dulcolax 5 mg Tab - 30 30


    108 Efedrin HCL 25 mg Tab 200 200 6

    109 Elastis verban 3 inci Roll - -

    110 Elastis verban 4 inci Roll - -

    111 Elastis verban 6 inci Roll - -

    112 Elkana Multivitamin Tab - -

    113 Enervon - C Kapl - -

    114 Epineprin HCL 0,1 % injeksi Amp 30 30

    115 Eritromicin 250 mg Kapl - -

    116 Eritromicin 500 mg Kapl - -

    117 Eritromicin syrup Btl - -

    118 Etakridin Larutan 0,1 % 300 ml Btl 3 24 27 2

    119 Etanol 70 % 1 liter Btl 14 14

    120 Ethilklorda Semprot Btl 9 9 3

    121 Endomethasone (endosel) btl - -

    122 Eugenol Btl - -

    123 Fehling A Btl - -

    124 Fehling B Btl - -

    125 Fenobarbital injeksi 50 mg/ml Amp - -

    126 Fenobarbital 30 mg Tab 200 200

    127 Fenobarbital 100 mg Tab - -


    128 Fenoksimetil Penisilin 250 mg Tab - -

    129 Fenoksimetil Penisilin 500 mg Tab - -

    130 Fenol gliserol TT Btl 24 24 10

    131 Fitomenadion 10 mg Tab 260 260

    132 Fitomenadion injeksi 10 mg/ml Amp 27 27 5

    133 Flecher Powder + Liquid Btl - -

    134 Foley cateter no 16 Pcs - -

    135 Foley cateter no 18 Pcs 4 4

    136 Foley cateter no 20 Pcs 5 5

    137 Formalin solution liter - -

    138 Formaldehide Merk Test kit - -

    139 Formokresol Btl - -

    140 Furosemida Tab - -

    141 Garam Oralit Sac 425 200 625 100

    142 Gamexan Btl - -

    143 Gentamicin Injeksi 80 mg/ml Amp - -

    144 Gentamicin Salep Kulit 0,1 % Tube 25 100 125

    145 Gentian Violet 1 % Btl 47 47 5

    146 Gic Art / Fuji IX Dos - -

    147 Glibenclamida 5 mg Tab 800 500 1,300 300


    148 Gliceril Guayacolat 100 mg Tab 2,100 5,000 7,100 1,200

    149 Glucosa Larutan Infus 10 % steril Btl - 60 60

    150 Glucosa Larutan Infus 40 % steril Btl - -

    151 Glucosa Larutan Infus 5 % steril Btl 12 100 112 10

    152 Gloves "S" Pcs - -

    153 Gloves "M" Pcs - -

    154 Gloves "L" Pcs - -

    155 Grisofulvin 250 mg Tab - -

    156 Grisofulvin 125 mg tab 2,500 2,500 200

    157 Haloperidol 0,5 mg Tab - -

    158 Haloperidol 1,5 mg Tab - -

    159 Haloperidol 5 mg Tab - -

    160 Handscoen no 6,5 Pcs 140 200 340 90

    161 Handscoen no 7,5 Pcs - -

    162 Handscoen no 7,5 / E-katalog Pcs 200 200 400 70

    163 Handscoen No.7 Pcs - -

    164 Handscoen no 8 Pcs - -

    165 Handscoen no 8 / E-katalog Pcs - -

    166 Handscoen Ginecolog Panjang Steril Pcs 10 10

    167 HB Sahli Pkt - -


    168 Hemaviton Action Kaps - -

    169 Hidrokortison Cream 2,5 % Tube 59 59

    170 Hidroklortiazida 25 mg Tab 1,000 1,000

    171 Ibuprofen 200 mg Tab 3,400 5,000 8,400 1,800

    172 Ibuprofen 400 mg Tab - -

    173 Ibuprofen syrup/Buffec Syrup Btl 43 43

    174 Ictiol salep Pot 24 12 36 5

    175 Implant susuk KB Pcs - -

    176 Infuset Micro Pcs 70 70 27

    177 Infuset Micro / e-katalog Pcs 400 400

    178 Infuset Macro Pcs 405 405 45

    179 Infuset Macro / e-katalog Pcs - -

    180 Iodium test Btl - -

    181 indikator universal ktk - -

    182 IV Kateter no 18 Pcs 50 50 10

    183 IV Kateter no 18 / e-katalog Pcs - -

    184 IV Kateter no 20 Pcs 298 298 12

    185 IV Kateter no 20 / E-katalog Pcs - 50 50

    186 IV Kateter no 22 / E-katalog Pcs 270 270

    187 IV Kateter no 24 / E - katalog Pcs 500 500


    188 IV Canula No.18 Pcs - -

    189 Isosorbit Dinitrat sublingual 5 mg Tab - -

    190 Jarum Jahit Otot Lusin 9 9

    191 Jarum Jahit Kulit Lusin 9 9

    192 Jelly untuk USG / non e-katalog Btl 4 4 2

    193 Jelly untuk Catheter Komb. Lidokain Btl - 1 1

    194 Kalsium Laktat 500 mg Tab 300 300 100

    195 Kalsium Gluconas Injeksi / non e-katalog Amp - 5 5

    196 Kalnex 250 mg Kaps - -

    197 Kalnex injeksi Amp - -

    198 Kapas berlemak 500 gram Roll - -

    199 Kapas pemb. Absorben 200 gram Roll - -

    200 Kapas Pemb. Absorben 250 gram Roll 11 11 1

    201 Kapas pemb. Absorben 1000 gram Roll - -

    202 Kaptopril 12,5 mg Tab - -

    203 Kaptopril 25 mg Tab 1,100 1,100 300

    204 Karbamazepin 200 mg Tab - -

    205 Kartu Stock Lbr - 10 10

    206 Kasa 4 x 10 cm Roll - -

    207 Kasa 4 x 6 cm Roll - -


    208 Kasa 40 x 80 cm Roll - -

    209 Kasa 40 x 80 cm / E-katalog 14 14 1

    210 Kasa Kompres 40/40 cm Roll - -

    211 Kasa Kompres 40/40 cm / E-katalog Roll - -

    212 Kasa Pembalut 2 m x 80 cm Roll - -

    213 Kasa Pembalut Hidrofil 4 m x 3 cm Roll - -

    214 Kasa Pembalut Hidrofil 4 m x 3 cm / E-katalog Roll - 250 250

    215 Kasa Pembalut Hidrofil 4 m x 15 cm Roll - -

    216 Kasa Pembalut Hidrofil 4 m x 15 cm / E-Katalog Roll - -

    217 Kasa 16 x 16 Roll - -

    218 Kasa pembalut 14 x 8 cm Roll - -

    219 Kasa pembalut 10 cm Roll - -

    220 Kasa pembalut 4 x 18 Roll - -

    221 Kelambu Pcs - -

    222 Ketamine Injeksi 10 mg/ml Vial - -

    223 Ketokonazol cream 2 % Tube 34 34 25

    224 Ketokonazol 200 mg Tab 1,550 1,550 300

    225 Ketorolac Injeksi Ampul - 5 5

    226 Kertas EKG 3 Ukuran Roll - -

    227 Kertas Perkamen / Non e-katalog Lbr - 10 10


    228 Kina Dihidroklorida injeksi 25 % - 2 ml Amp - -

    229 Kina 222 mg Tab - -

    230 Klip Plastik Kecil tanpa sablon Pcs - -

    231 Klip Plastik Sedang tanpa sablon Pcs - -

    232 Klip Plastik Besar sablon 10 x 15 Pcs - -

    233 Klip Plastik Sedang sablon 8,7 x 15 Pcs - -

    234 Klip Plastik kecil sablon Pcs - -

    235 Kloramfenicol 250 mg Kaps 1,100 1,100 500

    236 Kloramfenicol Salp Mata 1 % Tube 19 19 10

    237 Kloramfenicol Tetes Telinga 3 % Btl - 40 40

    238 Klorfeniraminimaleat 4 mg Tab 7,000 7,000 1,000

    239 Klorokuin 150 mg Tab - -

    240 Klorpromazin HCL injeksi i.m 25 mg/ml Amp - -

    241 Klorpromazin HCL 25 mg Tab - -

    242 Kodein 10 mg Tab 100 100

    243 Kotrimoksasol Adult 480 mg Tab - -

    244 Kotrimoksasol Pedriatic 120 mg Tab 1,200 3,000 4,200

    245 Kotrimoksasol suspensi Btl 72 72 5

    246 Lab.Kit Pkt - -

    247 Lacbon 17 Tab - -


    248 Lansoprazole 30 mg Kaps - -

    249 Larutan Benedict Btl - -

    250 Larutan Etanol Asam Btl - -

    251 Larutan Gimsa stain / non e-katalog Btl - -

    252 Larutan Carbofuksin Btl - -

    253 Larutan Methilen Biru Btl - -

    254 Larutan H2O2 Btl - -

    255 Larutan xilol Btl - -

    256 Larutan HCl 0,1 N / Non e-katalog Btl - -

    257 Levetran Salp Pot - 12 12

    258 Levofloksasin 500 mg Tab - -

    259 Lidocain Injeksi HCl 2 % Amp 272 100 372 92

    260 Lidocain Injeksi 2 % + Epineprin 1 : 80.000 - 2 ml Amp 30 30

    261 Livron B plex Tab - -

    262 Loperamid 2 mg Tab 300 300

    263 Loratadin 10 mg Tab 700 700

    264 Lysol Btl 2 2

    265 Light cure Composite (etsa & bondingnya) Set - -

    266 Magnesium Sulfat injeksi 20 % - 25 ml Amp - 10 10

    267 Magnesium Sulfat injeksi 40 % - 25 ml Amp - 500 500


    268 Masker Mulut Pcs 300 300 60

    269 MDT MB Adult Blist - -

    270 MDT PB Adult Blist - -

    271 MDT MB Anak Blist - -

    272 MDT PB Anak Blist - -

    273 Mebendazole syrup 100 mg/5 ml Btl - -

    274 Mebendazole 100 mg Tab - -

    275 Meloxicam 15 mg Tab - -

    276 Metformin Tab - -

    277 Metapex Box - -

    278 Methanil Yellow Chen Kit ktk - -

    279 Methilergometrin maleat 0,125 mg Tab - -

    280 Methilergometrin maleat 0,200 mg - 1 ml Amp 20 20

    281 Methilprednisolon 4 mg Tab - -

    282 Methilprednisolon 8 mg tab 1,000 300 1,300 300

    283 Metoclopramide injeksi 5 mg/5 ml Amp - -

    284 Metoclopramide 10 mg Tab 200 500 700

    285 Metronidazol 250 mg Tab - 100 100

    286 Metronidazol 500 mg Tab - -

    287 Metronidazol infus Btl - 5 5


    288 Mikonazole cream salp 2 % / e-katalog Tube 84 24 108 25

    289 Mikonazole cream salp 2 % / non e-katalog Tube - -

    290 Mineral Mix Sac 40 40

    291 Morfin injeksi 10 mg/ml Amp - -

    292 Natrium Bicarbonat 500 mg Tab - -

    293 Natrium Diklofenak 25 mg Tab - -

    294 Natrium Diklofenak 50 mg Tab - -

    295 Natrium Klorida Larutan infus 0,9 % / e-katalog Btl - 200 200

    296 Natrium Klorida Larutan infus 0,9 / non e-katalog Btl 161 161 30

    297 Natrium Fenitoin 100 mg Kaps - -

    298 Natrium Fenitoin Injeksi / Non e-katalog Amp - -

    299 Nicolin injeksi / Citicolin inj Amp - -

    300 Nifedipin 10 mg Tab - -

    301 Nistatin 100 000 UI Tab - -

    302 Nistatin 500 000 UI Vaginal tab Tab - -

    303 Nitrit Test Merk ktk - -

    304 Neurovit- E Tab - -

    305 Neurobion / Neurosanbe 5000 Tab - -

    306 Neurobion / Neurosanbe Injeksi Amp - -

    307 Obat Batuk Hitam syrup 100 ml Btl - -


    308 Obat FDC Anak Pkt - -

    309 Obat FDC Kategori 1 Pkt - -

    310 Obat FDC Kategori 2 Pkt - -

    311 Obat FDC TB sisipan Pkt - -

    312 OAT Kombipak anak Pkt - -

    313 OAT Kategori 1 & 3 Pkt - -

    314 Oil Emersi Btl - -

    315 Obat suntik KB 3 bulanan Vial - -

    316 Oksitetrasiklin HCL 1 % salp mata Tube 25 25 50 20

    317 Oksitetrasiklin HCL 3 % salp Kulit Tube 90 25 115 35

    318 Oksitetrasiklin injeksi Vial - -

    319 Oksitosin injeksi 10 IU/ml - 1 ml Amp 103 103 30

    320 Omeprazole 20 mg Kaps 780 780 210

    321 Papaverin injeksi 40 mg/ml Amp - -

    322 Papaverin 40 mg Tab 2,000 2,000

    323 Paracetamol syrup 120 mg/5 ml Btl 29 25 54 29

    324 Paracetamol 500 mg Tab 1,100 1,100 1,100

    325 Parasetamol drop Btl - -

    326 Parasetamol suppositoria Supp - -

    327 Penisilin procain / Procain Benzil Penicillin injeksi Vial 11 11 3


    328 Petidin injeksi 50 mg/ml Amp - -

    329 Pil KB I Kombinasi Set - -

    330 Pilokarpin Tetes mata 2 % Btl - -

    331 Piracetam injeksi 3 g/15 ml Amp - -

    332 Piracetam 1200 mg Tab - -

    333 Piracetam 400 mg Tab - -

    334 Pirasetam 800 mg Tab - -

    335 Pirantel score base 125 mg Tab - -

    336 Pirantel Syrup Btl - -

    337 Piridoksin HCL 10 mg Tab 800 2,000 2,800 400

    338 Piroxicam 10 mg Tab 3,200 3,200 1,100

    339 Piroxicam 20 mg Tab - 1,000 1,000

    340 Plester besar 5 yard x 2 inch Roll 2 2 1

    341 Plester sedang 1,5 Inch x 5 cm Roll - -

    342 Plester kecil 1,25 x 5 cm roll - 5 5

    343 Plester ( Leukoplast) 7,5 x 4,5 cm Roll 2 5 7 2

    344 Poligips 7,5cm Roll - 5 5

    345 Poligips 10 cm Roll - 5 5

    346 Poligips 15 cm Roll - 5 5

    347 Povidon iodida larutan 10 % 30 ml Btl 4 4


    348 Povidon iodida larutan 10 % 300 ml Btl 1 5 6 1

    349 Povidon iodida larutan 10 % 1000 ml Btl 3 3

    350 Prednison 5 mg Tab 5,200 5,200 500

    351 Primakuin 15 mg Tab - -

    352 Propanolol 40 mg Tab - 100 100

    353 Propilitiourasil 100 mg Tab - 100 100

    354 Ranitidin 150 mg Tab 1,300 3,000 4,300 400

    355 Ranitidin injeksi 25 mg/2 ml Amp 9 20 29 10

    356 Rapid Diagnostic Test (RDT) Pcs - -

    357 Reagen zealnelsen Pkt - -

    358 Reserpin 0,1 mg Tab - -

    359 Reserpin 0,25 mg Tab - -

    360 Retinol 100.000 IU Kaps 1,000 1,000 1,000

    361 Retinol 200.000 IU Kaps 100 100 100

    362 Ringer Lactat larutan infus Btl 144 100 244 35

    363 Rodamin B Test Chem ktk - -

    364 Safety box Lbr - -

    365 Salicyl Spritus 55 ml Btl - -

    366 Salbutamol 2 mg Tab - 200 200

    367 Salbutamol 4 mg Tab - -


    368 Salep 2 - 4,Komb.As.Salisilat 2% + Sulfur Praicip Pot 27 24 51 10

    369 Salisil Bedak Ktk 31 31 5

    370 Sanbe B-Plex Btl - -

    371 Sangobion Kaps - 250 250

    372 Santa E Tab - -

    373 Scabisid Cream Tube - -

    374 Serum Antibisa Ular Polivalen ( ABU I ) Vial 1 1

    375 Serum Antitetanus injeksi 1.500 IU ( ATS ) Vial 1 1

    376 Sianocobalamine injeksi 500 mcg Amp - 100 100

    377 Sianocobalamine 50 mcg Tab 300 1,000 1,300

    378 Silk ( Benang Bedah Sutera ) Pcs - -

    379 Silk ( Benang Bedah Sutera ) / e-katalog Pcs 62 62

    380 Slide Pcs 792 792

    381 Sputum pot / Non e-katalog Bh - -

    382 Spongostan Ktk - -

    383 Streptomisin injeksi Vial - -

    384 Simvastatin 10 mg Tab - -

    385 Test Kehamilan Pcs - -

    386 Tetrasiklin 250 mg Kaps - -

    387 Tetrasiklin 500 mg Kaps - -


    388 Thiamphenicol 500 mg Kaps - -

    389 Tiamin injeksi 100 mg/ml Amp 30 100 130 19

    390 Tiamin HCL 50 mg Tab 1,100 2,000 3,100 700

    391 Topicaina topical gel / Anastesi anak Btl - -

    392 Tooth stain Remover btl - -

    393 Triheksifenidil 2 mg Tab - -

    394 Tri Kresol Formalin /TKF Btl - -

    395 Tramadol 50 mg / ml Injeksi Amp - -

    396 Transfusi Set Pcs - -

    397 Transfusi Set / E-katalog Pcs - -

    398 Tremenza Tab - -

    399 Tissue Lensa pcs - -

    400 Urine bag / e-katalog Pcs 10 20 30

    401 Urine Test / Gluco Protein Test Pcs - -

    402 Vitamin B - complex Tab 3,300 3,000 6,300 2,100

    403 Ventolin inj. amp - 6 6

    404 Wing Needle no 27 Pcs - -

    405 Zink Oxide Eugenol (powder+liquid/kalzinol) Btl - -

    406 Zinc Dispersible 120 mg Tab 1,050 1,000 2,050 700

    407 Slide box Pcs - -


    408 Acarbose 50 mg Tab - -

    409 Asam Traneksamat Injeksi amp - -

    410 Asam Traneksamat 500 mg kapl - 500 500

    411 Bumer Pcs - -

    412 Etanol 70 % 100 ml btl - -

    413 Furosemide 10mg/ml injeksi Amp - -

    414 Glimepiride 2 mg Tab - -

    415 Jarum jahit Combinasi otot & Kulit Lusin 11 11

    416 Plester Besar 5 m x 4,5 cm (Leukoplast) Roll - 5 5

    417 Povidon iodida Larutan 10 % 60 ml Btl - -

    418 Semprong Pcs - -

    419 Sumbu bh - -

    420 Termometer Ruangan Kayu Pcs 2 2

    421 Sofero caps - -

    422 Disposible dental needle no. 18 pcs - -

    423 Disposible dental needle no. 20 Pcs - -

    424 Disposible dental needle no. 25 Pcs - -

    425 Jarum Citojek No. 12 Pcs - -

    426 Jarum Citojek No. 16 Pcs - -

    427 Resin Composite (A2+A3) Btl - -


    428 Suction Rip Pcs - -

    429 Levemir Injeksi / non e-katalog paket - -

    430 Borax Test ktk - -

    431 Novabion caps - -

    432 Larutan Metanol btl - -

    433 Larutan Oil Imersion 50 ml btl - -

    434 Alkohol Swap Pkt - -

    435 Aquadest 600 ml Btl - -

    436 Alat Tes Darah Multifungsi Pkt - -

    437 Stik Gula Darah Pkt - -

    438 Stik Kolesterol Pkt - -

    439 Stik Asam Urat Pkt - -

    440 Miniaspi 80 mg (Asetosal 80 mg) Tab 500 500

    441 Isoniazid 100 mg Tab - -

    442 Rantin injeksi (Ranitidin inj. 25 mg/ml)Non E. Amp - -

    443 Nexa 500 mg (Asam Traneksamat) Non E. Tab - -

    444 Sotatic Injeksi (Metoclopramide inj. 5 mg/ml) Non E. Amp - -

    445 Salbron 2 mg (Salbutamol 2 mg) Non E. Tab - -

    446 Pehacain Inj. (Lidocain Comb.) Amp - -

    447 Otoryl 25 Mg (Kaptopril 25 mg) Tab - -


    448 Asam Folat 1 mg Tab 900 900

    449 Azitromycin 500 mg Tab - -

    450 Ciprofloksasine Injeksi Btl - -

    451 Amlodipin 10 mg Tab -

    452 Dentin Conditioner Minipack Box -

    453 Stesolit Rectal / Diazepam rectal Supp -

    454 Paracetamol Infus 100 ml Btl -

    455 Cetrizine 10 mg Tab -

    VAKSIN
    1 HBo Vial 5 5

    2 BCG Amp 2 2

    3 Polio Vial 6 6

    4 DPT-HB Vial 3 3

    5 Pantavalen Vial - -

    6 Campak Vial 2 2

    7 TT Vial - -

    8 DT Vial 8 8

    9 TD Vial - -

    10 ADS 0,5 Vial - -

    11 ADS 0,05 Vial - -


    12 Pelarut BCG Amp 2 2

    13 Pelarut Campak Amp 3 3

    Sumber / Asal Resep


    Poli Umum Poli Gigi KIA KB
    Kunjungan Resep
    382 - 26 71

    UMUM
    ASKES JUMLAH
    BAYAR TIDAK BAYAR
    JUMLAH KUNJUNGAN RESEP
    78 - - 479

    Mengetahui Yang Menyerahkan Yang Mem


    Kepala Dinas Kesehatan Kab. Alor Petugas IFK Kepala Pus

    Yusmiati M.E
    NIP. NIP. NIP.1974032
    PEMERINTAH KABUPATEN ALOR
    D I N A S K E S E H A T A N
    of. DR. W. Z. Yohanes. No. - Telp. (0386) 21052
    K A L A B A H I

    KAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    LAP. PEMAKAIAN OBAT BULAN : JANUARI


    LEMBAR PERMINTAAN OBAT BULAN :
    TAHUN : 2019
    TRIWULAN :

    Sisa Stok Stok Optimum permintaan pemberian KET

    9 11 12 14 16

    590

    300

    600

    400
    500

    650

    1,200

    42

    4,300

    280

    50

    4,400

    4,600

    76

    85

    2,600
    15

    46

    24

    1,000

    -
    12,600

    30

    1,050

    2,320

    40

    -
    -

    83

    66

    96

    96

    2,500

    3,100

    1,500
    -

    125

    153

    5,400

    79

    30
    194

    30

    25

    14

    200

    -
    -

    14

    260

    22

    525

    125

    42

    1,000
    5,900

    60

    102

    2,300

    250

    330

    10

    -
    -

    59

    1,000

    6,600

    43

    31

    43

    400

    360

    40

    286

    50

    270

    500
    -

    200

    10

    800

    10

    -
    -

    13

    250

    1,250

    10
    -

    600

    40

    6,000

    100

    4,200

    67

    -
    -

    12

    280

    30

    300

    700

    10

    500
    240

    20

    1,000

    700

    100

    5
    83

    40

    200

    131

    -
    -

    30

    80

    73

    570

    2,000

    25

    8
    -

    2,400

    2,100

    1,000

    4
    5

    4,700

    100

    100

    3,900

    19

    209

    200

    -
    41

    26

    250

    100

    1,300

    62

    792

    -
    -

    111

    2,400

    30

    4,200

    1,350

    -
    -

    500

    11

    -
    -

    500

    -
    900

    -
    2

    Sumber / Asal Resep Total Resep ke Apotik


    Pusling, Posyandu, Kumulatif s/d Bulan
    Raeat Inap UGD Bulan Ini
    dll ini

    - - - 479 479

    Pemberi Resep
    Dokter Perawat Bidan Perawat Gigi

    382 - 96

    Yang Meminta Yang Menerima


    Kepala Puskesmas Petugas Puskesmas

    Yusmiati M.E. Belly Oriana W. Manilang


    NIP.197403261994032003 NIP.19831013 200904 2 002
    ……………………….,
    …………………………………………………………
    PEMERINTAH KABUPATEN ALOR
    D I N A S K E S E H A T A N
    Jl. Prof. DR. W. Z. Yohanes. No. - Telp. (0386) 21052
    K A L A B A H I

    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPL

    NAMA PUSKESMAS LEMBUR


    KABUPATEN : ALOR
    KECAMATAN : LEMBUR

    No Nama Obat Satuan Stok awal Penerimaan Persediaan Pemakaian Sisa Stok

    1 2 3 4 5 6 7 9

    1 Adona Injensi - - -
    Amp
    2 Alat Suntik Sekali Pakai 2,5 ml Pcs 590 590 140 450

    3 Alat Suntik Sekali Pakai 5 ml Pcs 300 300 20 280

    4 Alat suntik sekali pakai 0,5 ml Pcs - - -


    5 Alat suntik sekali pakai 0,5 ml / E - Katalog Pcs 600 600 200 400

    6 Alat suntik sekali pakai 0,05 ml /non e-katalog pcs - - -

    7 Alat suntik sekali pakai 0,05 ml / e-katalog Pcs 400 400 400

    8 Alat suntik sekali pakai 1 ml Pcs 500 500 500

    9 Alat suntik sekali pakai10 ml Pcs - - -

    10 Albendazol 400 mg / non e-katalog Tab 650 650 650

    11 Allupurinol 100 mg Tab 1,200 1,200 1,200

    12 Amalgam solila / Silver Amalgam Powder + Liquid Tube - - -

    13 Ambroxol syrup 15 mg/ml Btl 42 42 32 10

    14 Ambroxol 30 mg Tab 4,300 4,300 1,900 2,400

    15 Aminofilin Injeksi 24 mg/ml Amp 9 9 9

    16 Aminofilin 200 mg / e-katalog Tab 280 280 280

    17 Aminofilin 200 mg / non e-katalog tab - - -

    18 Amitriptilin HCL 25 mg Tab - - -

    19 Amlodipin 5 mg Tab 50 50 50

    20 Amoksisilin 250 mg Kaps 4,400 4,400 1,900 2,500

    21 Amoksisilin 500 mg Kapl 4,600 4,600 2,600 2,000

    22 Amoksisilin syrup Btl 76 76 26 50

    23 Ampisillin injeksi 1000 mg/ml Vial - - -

    24 Ampisillin syrup Btl - - -


    25 Antacida DOEN Tab - 3,000 3,000 - 3,000

    26 Antacida DOEN Suspensi Btl 85 85 39 46

    27 Antalgin 500 mg Tab 2,600 2,600 1,000 1,600

    28 Antalgin injeksi Amp 15 15 15

    29 Anti Bakteri DOEN / Basitrasin Polimiksin Tube 46 46 5 41

    30 Anti Fungi DOEN Salep 30 g ( Salp 3 - 6 ) Pot 24 24 24

    31 Anti Haemoroid DOEN Suppositoria Supp - - -

    32 Anti Malaria DOEN ( SulDox ) Tab 1,000 1,000 1,000

    33 Anti Migraen / Ergotamin 1 mg + Coffein 50 mg Tab - - -

    34 Anti Sera A Btl - - -

    35 Anti Sera B Btl - - -

    36 Anti Sera AB Btl - - -

    37 Anti Sera D Btl - - -

    38 Aqua pro injeksi 20 ml Vial - 5 5 - 5

    39 Aquadestilata 1000 ml Btl 3 3 3

    40 Aqua DM Bidestilata IKA ml 1 1 1

    41 Aqua DM Brataco ltr - - -

    42 Arsen / Devitalisasi Pasta Btl - - -

    43 Arterakin tab Tab - - -

    44 Artesunat injeksi 60 mg Vial - - -


    45 Artemeter injeksi Amp - - -

    46 Asetosal 100 mg Tab - - -

    47 Asetosal 500 mg Tab - - -

    48 Asam Ascorbat 50 mg Tab 12,600 12,600 4,000 8,600

    49 Asam Mefenamat 500 mg Kapl - 3,000 3,000 500 2,500

    50 Asiklovir cream 5 % 5 g Tube 30 30 60 3 57

    51 Asiklovir 200 mg Tab 1,050 1,050 1,050

    52 Asiklovir 400 mg Tab - - -

    53 Atropin Sulfat injeksi 0,25 mg/ml Amp - - -

    54 Atropin sulfat 0,5 mg Tab - - -

    55 Baby Cough syrup Btl - - -

    56 Bahan Fissur Sealent / Fuji VII Dos - - -

    57 Baraclude 1 mg btl/30 tab - - -

    58 Baraclude 0,5 mg box/30 tab - - -

    59 Barotec Inhaler Btl - - -

    60 Baycline 1 Liter Btl - - -

    61 Benzatin Benzil Penicillin 1,2 juta IU Vial - - -

    62 Besi II Sulfat 7 H2O 300 mg Tab - - -

    63 Besi II Sulfat + Asam Folat Tab 2,320 2,320 2,320 -

    64 Betametason Cream 0,1 % Tube 40 40 15 25


    65 Betason N Tube - - -

    66 Bidan Kit paket - - -

    67 Bioplacenton 15 gram Tube - - -

    68 Bisolvon Nebulizer btl - - -

    69 Bisturi / non e-katalog Pcs 83 83 83

    70 Blood lanset / non e-katalog Pcs - - -

    71 Calsidor / Dycal Dentsply / Hydcal Technew Btl - - -

    72 Calsydol syrup Btl - - -

    73 Cat gut 3/0 Pcs 66 66 66 -

    74 Cat gut 3/0 / E-katalog Pcs 96 96 96

    75 Cat gut 2/0 Pcs - - -

    76 Cat gut 2/0 / E-katalog Pcs 96 24 120 120

    77 Cavit / Caviton Btl - - -

    78 Cement Powder + Liquid / Elite Cement 100 Dos - - -

    79 Cefadroxil 500 mg Kaps 2,500 2,500 800 1,700

    80 Ceftriaxon Injeksi Vial - - -

    81 Cefotaxime injeksi 0,5 gram Vial 6 6 6

    82 Cefotaxime injeksi 1 gram Vial - - -

    83 Chlor Fenol Champer menthol /CHKM Btl - - -

    84 Chloramfecort Tube 5 5 5
    85 Chloramfecort H Tube 5 5 5

    86 Cimetidine 200 mg Tab 3,100 3,100 3,100

    87 Ciprofloksasine 500 mg Tab 1,500 1,500 1,500

    88 Counterpain 30 gram Tube - 1 1 1 -

    89 Curcuma Plus Syrup Btl - - -

    90 Darplex Tab 125 270 395 179 216

    91 Dasabion Kaps - - -

    92 Deksamethasone injeksi 5 mg/ml Amp 153 153 153

    93 Deksamethasone 0,5 mg Tab 5,400 5,400 2,600 2,800

    94 Dekstran 70 - Larutan Infus 6 % steril Btl - - -

    95 Dental Cotton Roll Bks - - -

    96 Dental Plak Disclosing Gel / Disclosing Solution Btl - - -

    97 Diazepam injeksi 5 mg/ml Amp - - -

    98 Diazepam 2 mg Tab - - -

    99 Diazepam 5 mg Tab 5 5 5

    100 Dietilkarbamsin 100 mg / NON E-KATALOG Tab - - -

    101 Difenhidramine Injeksi 10 mg/ml Amp 79 79 79

    102 Digoksin 0,25 mg Tab - - -

    103 Diltiazem HCL 30 mg Tab - - -

    104 Dimenhidrinat 50 mg Tab - - -


    105 Doksisiklin 100 mg Kaps - - -

    106 Domperidon Tab - 200 200 200

    107 Dulcolax 5 mg Tab 30 30 30

    108 Efedrin HCL 25 mg Tab 194 194 34 160

    109 Elastis verban 3 inci Roll - - -

    110 Elastis verban 4 inci Roll - - -

    111 Elastis verban 6 inci Roll - - -

    112 Elkana Multivitamin Tab - - -

    113 Enervon - C Kapl - - -

    114 Epineprin HCL 0,1 % injeksi Amp 30 30 30

    115 Eritromicin 250 mg Kapl - - -

    116 Eritromicin 500 mg Kapl - - -

    117 Eritromicin syrup Btl - - -

    118 Etakridin Larutan 0,1 % 300 ml Btl 25 25 25

    119 Etanol 70 % 1 liter Btl 14 14 2 12

    120 Ethilklorda Semprot Btl 6 6 6

    121 Endomethasone (endosel) btl - - -

    122 Eugenol Btl - - -

    123 Fehling A Btl - - -

    124 Fehling B Btl - - -


    125 Fenobarbital injeksi 50 mg/ml Amp - - -

    126 Fenobarbital 30 mg Tab 200 200 200

    127 Fenobarbital 100 mg Tab - - -

    128 Fenoksimetil Penisilin 250 mg Tab - - -

    129 Fenoksimetil Penisilin 500 mg Tab - - -

    130 Fenol gliserol TT Btl 14 14 14

    131 Fitomenadion 10 mg Tab 260 260 260

    132 Fitomenadion injeksi 10 mg/ml Amp 22 22 22

    133 Flecher Powder + Liquid Btl - - -

    134 Foley cateter no 16 Pcs - - -

    135 Foley cateter no 18 Pcs 4 4 4

    136 Foley cateter no 20 Pcs 5 5 5

    137 Formalin solution liter - - -

    138 Formaldehide Merk Test kit - - -

    139 Formokresol Btl - - -

    140 Furosemida Tab - - -

    141 Garam Oralit Sac 525 525 525

    142 Gamexan Btl - - -

    143 Gentamicin Injeksi 80 mg/ml Amp - - -

    144 Gentamicin Salep Kulit 0,1 % Tube 125 125 60 65


    145 Gentian Violet 1 % Btl 42 42 1 41

    146 Gic Art / Fuji IX Dos - - -

    147 Glibenclamida 5 mg Tab 1,000 1,000 500 500

    148 Gliceril Guayacolat 100 mg Tab 5,900 5,900 1,700 4,200

    149 Glucosa Larutan Infus 10 % steril Btl 60 60 60

    150 Glucosa Larutan Infus 40 % steril Btl - - -

    151 Glucosa Larutan Infus 5 % steril Btl 102 102 102

    152 Gloves "S" Pcs - - -

    153 Gloves "M" Pcs - - -

    154 Gloves "L" Pcs - - -

    155 Grisofulvin 250 mg Tab - - -

    156 Grisofulvin 125 mg tab 2,300 2,300 800 1,500

    157 Haloperidol 0,5 mg Tab - - -

    158 Haloperidol 1,5 mg Tab - - -

    159 Haloperidol 5 mg Tab - - -

    160 Handscoen no 6,5 Pcs 250 250 30 220

    161 Handscoen no 7,5 Pcs - - -

    162 Handscoen no 7,5 / E-katalog Pcs 330 330 121 209

    163 Handscoen No.7 Pcs - - -

    164 Handscoen no 8 Pcs - - -


    165 Handscoen no 8 / E-katalog Pcs - - -

    166 Handscoen Ginecolog Panjang Steril Pcs 10 10 10

    167 HB Sahli Pkt - - -

    168 Hemaviton Action Kaps - - -

    169 Hidrokortison Cream 2,5 % Tube 59 59 11 48

    170 Hidroklortiazida 25 mg Tab 1,000 1,000 1,000

    171 Ibuprofen 200 mg Tab 6,600 6,600 3,400 3,200

    172 Ibuprofen 400 mg Tab - - -

    173 Ibuprofen syrup/Buffec Syrup Btl 43 43 38 5

    174 Ictiol salep Pot 31 31 31

    175 Implant susuk KB Pcs - - -

    176 Infuset Micro Pcs 43 43 43

    177 Infuset Micro / e-katalog Pcs 400 400 400

    178 Infuset Macro Pcs 360 360 360

    179 Infuset Macro / e-katalog Pcs - - -

    180 Iodium test Btl - - -

    181 indikator universal ktk - - -

    182 IV Kateter no 18 Pcs 40 40 40

    183 IV Kateter no 18 / e-katalog Pcs - - -

    184 IV Kateter no 20 Pcs 286 286 286


    185 IV Kateter no 20 / E-katalog Pcs 50 50 50

    186 IV Kateter no 22 / E-katalog Pcs 270 270 270

    187 IV Kateter no 24 / E - katalog Pcs 500 500 36 464

    188 IV Canula No.18 Pcs - - -

    189 Isosorbit Dinitrat sublingual 5 mg Tab - - -

    190 Jarum Jahit Otot Lusin 9 9 9

    191 Jarum Jahit Kulit Lusin 9 9 9

    192 Jelly untuk USG / non e-katalog Btl 2 2 2

    193 Jelly untuk Catheter Komb. Lidokain Btl 1 1 1

    194 Kalsium Laktat 500 mg Tab 200 500 700 600 100

    195 Kalsium Gluconas Injeksi / non e-katalog Amp 5 5 5

    196 Kalnex 250 mg Kaps - - -

    197 Kalnex injeksi Amp - - -

    198 Kapas berlemak 500 gram Roll - - -

    199 Kapas pemb. Absorben 200 gram Roll - - -

    200 Kapas Pemb. Absorben 250 gram Roll 10 10 10

    201 Kapas pemb. Absorben 1000 gram Roll - - -

    202 Kaptopril 12,5 mg Tab - - -

    203 Kaptopril 25 mg Tab 800 800 800

    204 Karbamazepin 200 mg Tab - - -


    205 Kartu Stock Lbr 10 10 10

    206 Kasa 4 x 10 cm Roll - - -

    207 Kasa 4 x 6 cm Roll - - -

    208 Kasa 40 x 80 cm Roll - - -

    209 Kasa 40 x 80 cm / E-katalog 13 13 2 11

    210 Kasa Kompres 40/40 cm Roll - - -

    211 Kasa Kompres 40/40 cm / E-katalog Roll - - -

    212 Kasa Pembalut 2 m x 80 cm Roll - - -

    213 Kasa Pembalut Hidrofil 4 m x 3 cm Roll - - -

    214 Kasa Pembalut Hidrofil 4 m x 3 cm / E-katalog Roll 250 250 50 200

    215 Kasa Pembalut Hidrofil 4 m x 15 cm Roll - - -

    216 Kasa Pembalut Hidrofil 4 m x 15 cm / E-Katalog Roll - - -

    217 Kasa 16 x 16 Roll - - -

    218 Kasa pembalut 14 x 8 cm Roll - - -

    219 Kasa pembalut 10 cm Roll - - -

    220 Kasa pembalut 4 x 18 Roll - - -

    221 Kelambu Pcs - - -

    222 Ketamine Injeksi 10 mg/ml Vial - - -

    223 Ketokonazol cream 2 % Tube 9 9 9 -

    224 Ketokonazol 200 mg Tab 1,250 1,250 1,250


    225 Ketorolac Injeksi Ampul 5 5 5

    226 Kertas EKG 3 Ukuran Roll - - -

    227 Kertas Perkamen / Non e-katalog Lbr 10 10 10

    228 Kina Dihidroklorida injeksi 25 % - 2 ml Amp - - -

    229 Kina 222 mg Tab - - -

    230 Klip Plastik Kecil tanpa sablon Pcs - - -

    231 Klip Plastik Sedang tanpa sablon Pcs - - -

    232 Klip Plastik Besar sablon 10 x 15 Pcs - - -

    233 Klip Plastik Sedang sablon 8,7 x 15 Pcs - - -

    234 Klip Plastik kecil sablon Pcs - - -

    235 Kloramfenicol 250 mg Kaps 600 600 600

    236 Kloramfenicol Salp Mata 1 % Tube 9 9 9

    237 Kloramfenicol Tetes Telinga 3 % Btl 40 40 40

    238 Klorfeniraminimaleat 4 mg Tab 6,000 6,000 2,000 4,000

    239 Klorokuin 150 mg Tab - - -

    240 Klorpromazin HCL injeksi i.m 25 mg/ml Amp - - -

    241 Klorpromazin HCL 25 mg Tab - - -

    242 Kodein 10 mg Tab 100 100 15 85

    243 Kotrimoksasol Adult 480 mg Tab - 1,000 1,000 300 700

    244 Kotrimoksasol Pedriatic 120 mg Tab 4,200 4,200 1,800 2,400


    245 Kotrimoksasol suspensi Btl 67 67 67

    246 Lab.Kit Pkt - - -

    247 Lacbon 17 Tab - - -

    248 Lansoprazole 30 mg Kaps - - -

    249 Larutan Benedict Btl - - -

    250 Larutan Etanol Asam Btl - - -

    251 Larutan Gimsa stain / non e-katalog Btl - - -

    252 Larutan Carbofuksin Btl - - -

    253 Larutan Methilen Biru Btl - - -

    254 Larutan H2O2 Btl - 1 1 1

    255 Larutan xilol Btl - - -

    256 Larutan HCl 0,1 N / Non e-katalog Btl - - -

    257 Levetran Salp Pot 12 12 12

    258 Levofloksasin 500 mg Tab - - -

    259 Lidocain Injeksi HCl 2 % Amp 280 280 15 265

    260 Lidocain Injeksi 2 % + Epineprin 1 : 80.000 - 2 ml Amp 30 30 30

    261 Livron B plex Tab - - -

    262 Loperamid 2 mg Tab 300 300 300

    263 Loratadin 10 mg Tab 700 700 100 600

    264 Lysol Btl 2 2 2


    265 Light cure Composite (etsa & bondingnya) Set - - -

    266 Magnesium Sulfat injeksi 20 % - 25 ml Amp 10 10 10

    267 Magnesium Sulfat injeksi 40 % - 25 ml Amp - -

    268 Masker Mulut Pcs 240 500 740 90 650

    269 MDT MB Adult Blist - - -

    270 MDT PB Adult Blist - - -

    271 MDT MB Anak Blist - 4 4 4

    272 MDT PB Anak Blist - - -

    273 Mebendazole syrup 100 mg/5 ml Btl - - -

    274 Mebendazole 100 mg Tab - - -

    275 Meloxicam 15 mg Tab - - -

    276 Metformin Tab - - -

    277 Metapex Box - - -

    278 Methanil Yellow Chen Kit ktk - - -

    279 Methilergometrin maleat 0,125 mg Tab - - -

    280 Methilergometrin maleat 0,200 mg - 1 ml Amp 20 20 20

    281 Methilprednisolon 4 mg Tab - - -

    282 Methilprednisolon 8 mg tab 1,000 1,000 100 900

    283 Metoclopramide injeksi 5 mg/5 ml Amp - - -

    284 Metoclopramide 10 mg Tab 700 700 500 200


    285 Metronidazol 250 mg Tab 100 100 100

    286 Metronidazol 500 mg Tab - - -

    287 Metronidazol infus Btl 5 5 5

    288 Mikonazole cream salp 2 % / e-katalog Tube 83 83 83

    289 Mikonazole cream salp 2 % / non e-katalog Tube - - -

    290 Mineral Mix Sac 40 40 40

    291 Morfin injeksi 10 mg/ml Amp - - -

    292 Natrium Bicarbonat 500 mg Tab - - -

    293 Natrium Diklofenak 25 mg Tab - - -

    294 Natrium Diklofenak 50 mg Tab - - -

    295 Natrium Klorida Larutan infus 0,9 % / e-katalog Btl 200 200 200

    296 Natrium Klorida Larutan infus 0,9 / non e-katalog Btl 131 131 11 120

    297 Natrium Fenitoin 100 mg Kaps - - -

    298 Natrium Fenitoin Injeksi / Non e-katalog Amp - - -

    299 Nicolin injeksi / Citicolin inj Amp - - -

    300 Nifedipin 10 mg Tab - - -

    301 Nistatin 100 000 UI Tab - - -

    302 Nistatin 500 000 UI Vaginal tab Tab - - -

    303 Nitrit Test Merk ktk - - -

    304 Neurovit- E Tab - - -


    305 Neurobion / Neurosanbe 5000 Tab - - -

    306 Neurobion / Neurosanbe Injeksi Amp - - -

    307 Obat Batuk Hitam syrup 100 ml Btl - - -

    308 Obat FDC Anak Pkt - - -

    309 Obat FDC Kategori 1 Pkt - - -

    310 Obat FDC Kategori 2 Pkt - - -

    311 Obat FDC TB sisipan Pkt - - -

    312 OAT Kombipak anak Pkt - - -

    313 OAT Kategori 1 & 3 Pkt - - -

    314 Oil Emersi Btl - - -

    315 Obat suntik KB 3 bulanan Vial - - -

    316 Oksitetrasiklin HCL 1 % salp mata Tube 30 30 5 25

    317 Oksitetrasiklin HCL 3 % salp Kulit Tube 80 80 5 75

    318 Oksitetrasiklin injeksi Vial - - -

    319 Oksitosin injeksi 10 IU/ml - 1 ml Amp 73 73 10 63

    320 Omeprazole 20 mg Kaps 570 570 - 570

    321 Papaverin injeksi 40 mg/ml Amp - - -

    322 Papaverin 40 mg Tab 2,000 2,000 2,000

    323 Paracetamol syrup 120 mg/5 ml Btl 25 50 75 35 40

    324 Paracetamol 500 mg Tab - 3,000 3,000 500 2,500


    325 Parasetamol drop Btl - 5 5 5

    326 Parasetamol suppositoria Supp - - -

    327 Penisilin procain / Procain Benzil Penicillin injeksi Vial 8 8 8

    328 Petidin injeksi 50 mg/ml Amp - - -

    329 Pil KB I Kombinasi Set - - -

    330 Pilokarpin Tetes mata 2 % Btl - - -

    331 Piracetam injeksi 3 g/15 ml Amp - - -

    332 Piracetam 1200 mg Tab - - -

    333 Piracetam 400 mg Tab - - -

    334 Pirasetam 800 mg Tab - - -

    335 Pirantel score base 125 mg Tab - - -

    336 Pirantel Syrup Btl - - -

    337 Piridoksin HCL 10 mg Tab 2,400 2,400 600 1,800

    338 Piroxicam 10 mg Tab 2,100 2,100 2,100

    339 Piroxicam 20 mg Tab 1,000 1,000 1,000

    340 Plester besar 5 yard x 2 inch Roll 1 1 1 -

    341 Plester sedang 1,5 Inch x 5 cm Roll - - -

    342 Plester kecil 1,25 x 5 cm roll 5 5 5 -

    343 Plester ( Leukoplast) 7,5 x 4,5 cm Roll 5 5 1 4

    344 Poligips 7,5cm Roll 5 5 5


    345 Poligips 10 cm Roll 5 5 5

    346 Poligips 15 cm Roll 5 5 5

    347 Povidon iodida larutan 10 % 30 ml Btl 4 4 1 3

    348 Povidon iodida larutan 10 % 300 ml Btl 5 5 - 5

    349 Povidon iodida larutan 10 % 1000 ml Btl 3 3 1 2

    350 Prednison 5 mg Tab 4,700 4,700 2,900 1,800

    351 Primakuin 15 mg Tab - 100 100 100

    352 Propanolol 40 mg Tab 100 100 100

    353 Propilitiourasil 100 mg Tab 100 100 100

    354 Ranitidin 150 mg Tab 3,900 3,900 3,900

    355 Ranitidin injeksi 25 mg/2 ml Amp 19 19 19

    356 Rapid Diagnostic Test (RDT) Pcs - - -

    357 Reagen zealnelsen Pkt - - -

    358 Reserpin 0,1 mg Tab - - -

    359 Reserpin 0,25 mg Tab - - -

    360 Retinol 100.000 IU Kaps - - -

    361 Retinol 200.000 IU Kaps - - -

    362 Ringer Lactat larutan infus Btl 209 209 14 195

    363 Rodamin B Test Chem ktk - - -

    364 Safety box Lbr - - -


    365 Salicyl Spritus 55 ml Btl - - -

    366 Salbutamol 2 mg Tab 200 200 200

    367 Salbutamol 4 mg Tab - - -

    368 Salep 2 - 4,Komb.As.Salisilat 2% + Sulfur Praicip Pot 41 41 41

    369 Salisil Bedak Ktk 26 26 20 6

    370 Sanbe B-Plex Btl - - -

    371 Sangobion Kaps 250 250 250

    372 Santa E Tab - - -

    373 Scabisid Cream Tube - - -

    374 Serum Antibisa Ular Polivalen ( ABU I ) Vial 1 1 1

    375 Serum Antitetanus injeksi 1.500 IU ( ATS ) Vial 1 1 1

    376 Sianocobalamine injeksi 500 mcg Amp 100 100 10 90

    377 Sianocobalamine 50 mcg Tab 1,300 1,300 500 800

    378 Silk ( Benang Bedah Sutera ) Pcs - - -

    379 Silk ( Benang Bedah Sutera ) / e-katalog Pcs 62 62 62

    380 Slide Pcs 792 792 792

    381 Sputum pot / Non e-katalog Bh - - -

    382 Spongostan Ktk - - -

    383 Streptomisin injeksi Vial - - -

    384 Simvastatin 10 mg Tab - - -


    385 Test Kehamilan Pcs - 50 50 50

    386 Tetrasiklin 250 mg Kaps - - -

    387 Tetrasiklin 500 mg Kaps - - -

    388 Thiamphenicol 500 mg Kaps - - -

    389 Tiamin injeksi 100 mg/ml Amp 111 111 11 100

    390 Tiamin HCL 50 mg Tab 2,400 2,400 2,400

    391 Topicaina topical gel / Anastesi anak Btl - - -

    392 Tooth stain Remover btl - - -

    393 Triheksifenidil 2 mg Tab - - -

    394 Tri Kresol Formalin /TKF Btl - - -

    395 Tramadol 50 mg / ml Injeksi Amp - - -

    396 Transfusi Set Pcs - - -

    397 Transfusi Set / E-katalog Pcs - - -

    398 Tremenza Tab - - -

    399 Tissue Lensa pcs - - -

    400 Urine bag / e-katalog Pcs 30 30 30

    401 Urine Test / Gluco Protein Test Pcs - - -

    402 Vitamin B - complex Tab 4,200 4,200 1,600 2,600

    403 Ventolin inj. amp 6 6 6

    404 Wing Needle no 27 Pcs - - -


    405 Zink Oxide Eugenol (powder+liquid/kalzinol) Btl - - -

    406 Zinc Dispersible 120 mg Tab 1,350 1,350 1,350

    407 Slide box Pcs - - -

    408 Acarbose 50 mg Tab - - -

    409 Asam Traneksamat Injeksi amp - - -

    410 Asam Traneksamat 500 mg kapl 500 500 500

    411 Bumer Pcs - - -

    412 Etanol 70 % 100 ml btl - - -

    413 Furosemide 10mg/ml injeksi Amp - - -

    414 Glimepiride 2 mg Tab - - -

    415 Jarum jahit Combinasi otot & Kulit Lusin 11 11 11

    416 Plester Besar 5 m x 4,5 cm (Leukoplast) Roll 5 5 5

    417 Povidon iodida Larutan 10 % 60 ml Btl - - -

    418 Semprong Pcs - - -

    419 Sumbu bh - - -

    420 Termometer Ruangan Kayu Pcs 2 2 2

    421 Sofero caps - - -

    422 Disposible dental needle no. 18 pcs - - -

    423 Disposible dental needle no. 20 Pcs - - -

    424 Disposible dental needle no. 25 Pcs - - -


    425 Jarum Citojek No. 12 Pcs - - -

    426 Jarum Citojek No. 16 Pcs - - -

    427 Resin Composite (A2+A3) Btl - - -

    428 Suction Rip Pcs - - -

    429 Levemir Injeksi / non e-katalog paket - - -

    430 Borax Test ktk - - -

    431 Novabion caps - - -

    432 Larutan Metanol btl - - -

    433 Larutan Oil Imersion 50 ml btl - - \

    434 Alkohol Swap Pkt - - -

    435 Aquadest 600 ml Btl - - -

    436 Alat Tes Darah Multifungsi Pkt - - -

    437 Stik Gula Darah Pkt - - -

    438 Stik Kolesterol Pkt - - -

    439 Stik Asam Urat Pkt - - -

    440 Miniaspi 80 mg (Asetosal 80 mg) Tab 500 500 500

    441 Isoniazid 100 mg Tab - - -

    442 Rantin injeksi (Ranitidin inj. 25 mg/ml)Non E. Amp - - -

    443 Nexa 500 mg (Asam Traneksamat) Non E. Tab - - -

    444 Sotatic Injeksi (Metoclopramide inj. 5 mg/ml) Non E. Amp - - -


    445 Salbron 2 mg (Salbutamol 2 mg) Non E. Tab - - -

    446 Pehacain Inj. (Lidocain Comb.) Amp - - -

    447 Otoryl 25 Mg (Kaptopril 25 mg) Tab - - -

    448 Asam Folat 1 mg Tab 900 900 900

    449 Azitromycin 500 mg Tab - - -

    450 Ciprofloksasine Injeksi Btl - - -

    451 Amlodipin 10 mg Tab - - -

    452 Dentin Conditioner Minipack Box - - -

    453 Stesolit Rectal / Diazepam rectal Supp - - -

    454 Paracetamol Infus 100 ml Btl - - -

    455 Cetrizine 10 mg Tab - - -

    VAKSIN
    1 HBo Vial 5 5 5

    2 BCG Amp 2 2 2

    3 Polio Vial 6 6 6

    4 DPT-HB Vial 3 3 3

    5 Pantavalen Vial - - -

    6 Campak Vial 2 2 2

    7 TT Vial - - -

    8 DT Vial 8 8 8
    9 TD Vial - - -

    10 ADS 0,5 Vial - - -

    11 ADS 0,05 Vial - - -

    12 Pelarut BCG Amp 2 2 2

    13 Pelarut Campak Amp 3 3 3

    Sumber / Asal Resep


    Poli Umum Poli Gigi KIA KB Raeat Inap
    Kunjungan Resep
    682 - 25 50 -

    UMUM
    ASKES JUMLAH
    BAYAR TIDAK BAYAR
    JUMLAH KUNJUNGAN RESEP
    83 - 625 757
    Mengetahui Yang Menyerahkan Yang Meminta
    Kepala Dinas Kesehatan Kab. Alor Petugas IFK Kepala Puskesmas

    Yusmiati M. E. Belly A.Md.Keb


    NIP. NIP. NIP.19740326 199303 2 003
    TAH KABUPATEN ALOR
    S K E S E H A T A N
    Yohanes. No. - Telp. (0386) 21052
    A L A B A H I

    N LEMBAR PERMINTAAN OBAT (LPLPO)

    LAP. PEMAKAIAN OBAT BULAN : FEBRUARI


    LEMBAR PERMINTAAN OBAT BULAN :
    TAHUN : 2019
    TRIWULAN :

    Stok Optimum permintaan pemberian KET

    11 12 14 16
    -
    -
    Sumber / Asal Resep Total Resep ke Apotik
    UGD Pusling, Posyandu, dll Bulan Ini Kumulatif s/d Bulan ini

    - - 757 1,234

    Pemberi Resep
    Dokter Perawat Bidan Perawat Gigi

    682 - 75 -
    Yang Menerima
    Petugas Puskesmas

    Oriana W. Manilang, A.Md.Far


    NIP.19831013 200904 2 002
    ……………………….,
    …………………………………………………………
    LA

    NAMA PUSKESMAS :
    KABUPATEN : ALOR
    KECAMATAN :

    No Nama Obat Satuan Stok awal

    1 2 3 4

    1 Adona Injensi -
    Amp
    2 Alat Suntik Sekali Pakai 2,5 ml Pcs 450

    3 Alat Suntik Sekali Pakai 5 ml Pcs 280

    4 Alat suntik sekali pakai 0,5 ml Pcs -

    5 Alat suntik sekali pakai 0,5 ml / E - Katalog Pcs 400

    6 Alat suntik sekali pakai 0,05 ml /non e-katalog pcs -

    7 Alat suntik sekali pakai 0,05 ml / e-katalog Pcs 400

    8 Alat suntik sekali pakai 1 ml Pcs 500

    9 Alat suntik sekali pakai10 ml Pcs -

    10 Albendazol 400 mg / non e-katalog Tab 650

    11 Allupurinol 100 mg Tab 1,200

    12 Amalgam solila / Silver Amalgam Powder + Liquid Tube -


    13 Ambroxol syrup 15 mg/ml Btl 10

    14 Ambroxol 30 mg Tab 2,400

    15 Aminofilin Injeksi 24 mg/ml Amp 9

    16 Aminofilin 200 mg / e-katalog Tab 280

    17 Aminofilin 200 mg / non e-katalog tab -

    18 Amitriptilin HCL 25 mg Tab -

    19 Amlodipin 5 mg Tab 50

    20 Amoksisilin 250 mg Kaps 2,500

    21 Amoksisilin 500 mg Kapl 2,000

    22 Amoksisilin syrup Btl 50

    23 Ampisillin injeksi 1000 mg/ml Vial -

    24 Ampisillin syrup Btl -

    25 Antacida DOEN Tab 3,000

    26 Antacida DOEN Suspensi Btl 46

    27 Antalgin 500 mg Tab 1,600

    28 Antalgin injeksi Amp 15

    29 Anti Bakteri DOEN / Basitrasin Polimiksin Tube 41

    30 Anti Fungi DOEN Salep 30 g ( Salp 3 - 6 ) Pot 24

    31 Anti Haemoroid DOEN Suppositoria Supp -

    32 Anti Malaria DOEN ( SulDox ) Tab 1,000

    33 Anti Migraen / Ergotamin 1 mg + Coffein 50 mg Tab -

    34 Anti Sera A Btl -

    35 Anti Sera B Btl -

    36 Anti Sera AB Btl -

    37 Anti Sera D Btl -

    38 Aqua pro injeksi 20 ml Vial 5

    39 Aquadestilata 1000 ml Btl 3


    40 Aqua DM Bidestilata IKA ml 1

    41 Aqua DM Brataco ltr -

    42 Arsen / Devitalisasi Pasta Btl -

    43 Arterakin tab Tab -

    44 Artesunat injeksi 60 mg Vial -

    45 Artemeter injeksi Amp -

    46 Asetosal 100 mg Tab -

    47 Asetosal 500 mg Tab -

    48 Asam Ascorbat 50 mg Tab 8,600

    49 Asam Mefenamat 500 mg Kapl 2,500

    50 Asiklovir cream 5 % 5 g Tube 57

    51 Asiklovir 200 mg Tab 1,050

    52 Asiklovir 400 mg Tab -

    53 Atropin Sulfat injeksi 0,25 mg/ml Amp -

    54 Atropin sulfat 0,5 mg Tab -

    55 Baby Cough syrup Btl -

    56 Bahan Fissur Sealent / Fuji VII Dos -

    57 Baraclude 1 mg btl/30 tab -

    58 Baraclude 0,5 mg box/30 tab -

    59 Barotec Inhaler Btl -

    60 Baycline 1 Liter Btl -

    61 Benzatin Benzil Penicillin 1,2 juta IU Vial -

    62 Besi II Sulfat 7 H2O 300 mg Tab -

    63 Besi II Sulfat + Asam Folat Tab -

    64 Betametason Cream 0,1 % Tube 25

    65 Betason N Tube -

    66 Bidan Kit paket -


    67 Bioplacenton 15 gram Tube -

    68 Bisolvon Nebulizer btl -

    69 Bisturi / non e-katalog Pcs 83

    70 Blood lanset / non e-katalog Pcs -

    71 Calsidor / Dycal Dentsply / Hydcal Technew Btl -

    72 Calsydol syrup Btl -

    73 Cat gut 3/0 Pcs -

    74 Cat gut 3/0 / E-katalog Pcs 96

    75 Cat gut 2/0 Pcs -

    76 Cat gut 2/0 / E-katalog Pcs 120

    77 Cavit / Caviton Btl -

    78 Cement Powder + Liquid / Elite Cement 100 Dos -

    79 Cefadroxil 500 mg Kaps 1,700

    80 Ceftriaxon Injeksi Vial -

    81 Cefotaxime injeksi 0,5 gram Vial 6

    82 Cefotaxime injeksi 1 gram Vial -

    83 Chlor Fenol Champer menthol /CHKM Btl -

    84 Chloramfecort Tube 5

    85 Chloramfecort H Tube 5

    86 Cimetidine 200 mg Tab 3,100

    87 Ciprofloksasine 500 mg Tab 1,500

    88 Counterpain 30 gram Tube -

    89 Curcuma Plus Syrup Btl -

    90 Darplex Tab 216

    91 Dasabion Kaps -

    92 Deksamethasone injeksi 5 mg/ml Amp 153

    93 Deksamethasone 0,5 mg Tab 2,800


    94 Dekstran 70 - Larutan Infus 6 % steril Btl -

    95 Dental Cotton Roll Bks -

    96 Dental Plak Disclosing Gel / Disclosing Solution Btl -

    97 Diazepam injeksi 5 mg/ml Amp -

    98 Diazepam 2 mg Tab -

    99 Diazepam 5 mg Tab 5

    100 Dietilkarbamsin 100 mg / NON E-KATALOG Tab -

    101 Difenhidramine Injeksi 10 mg/ml Amp 79

    102 Digoksin 0,25 mg Tab -

    103 Diltiazem HCL 30 mg Tab -

    104 Dimenhidrinat 50 mg Tab -

    105 Doksisiklin 100 mg Kaps -

    106 Domperidon Tab 200

    107 Dulcolax 5 mg Tab 30

    108 Efedrin HCL 25 mg Tab 160

    109 Elastis verban 3 inci Roll -

    110 Elastis verban 4 inci Roll -

    111 Elastis verban 6 inci Roll -

    112 Elkana Multivitamin Tab -

    113 Enervon - C Kapl -

    114 Epineprin HCL 0,1 % injeksi Amp 30

    115 Eritromicin 250 mg Kapl -

    116 Eritromicin 500 mg Kapl -

    117 Eritromicin syrup Btl -

    118 Etakridin Larutan 0,1 % 300 ml Btl 25

    119 Etanol 70 % 1 liter Btl 12

    120 Ethilklorda Semprot Btl 6


    121 Endomethasone (endosel) btl -

    122 Eugenol Btl -

    123 Fehling A Btl -

    124 Fehling B Btl -

    125 Fenobarbital injeksi 50 mg/ml Amp -

    126 Fenobarbital 30 mg Tab 200

    127 Fenobarbital 100 mg Tab -

    128 Fenoksimetil Penisilin 250 mg Tab -

    129 Fenoksimetil Penisilin 500 mg Tab -

    130 Fenol gliserol TT Btl 14

    131 Fitomenadion 10 mg Tab 260

    132 Fitomenadion injeksi 10 mg/ml Amp 22

    133 Flecher Powder + Liquid Btl -

    134 Foley cateter no 16 Pcs -

    135 Foley cateter no 18 Pcs 4

    136 Foley cateter no 20 Pcs 5

    137 Formalin solution liter -

    138 Formaldehide Merk Test kit -

    139 Formokresol Btl -

    140 Furosemida Tab -

    141 Garam Oralit Sac 525

    142 Gamexan Btl -

    143 Gentamicin Injeksi 80 mg/ml Amp -

    144 Gentamicin Salep Kulit 0,1 % Tube 65

    145 Gentian Violet 1 % Btl 41

    146 Gic Art / Fuji IX Dos -

    147 Glibenclamida 5 mg Tab 500


    148 Gliceril Guayacolat 100 mg Tab 4,200

    149 Glucosa Larutan Infus 10 % steril Btl 60

    150 Glucosa Larutan Infus 40 % steril Btl -

    151 Glucosa Larutan Infus 5 % steril Btl 102

    152 Gloves "S" Pcs -

    153 Gloves "M" Pcs -

    154 Gloves "L" Pcs -

    155 Grisofulvin 250 mg Tab -

    156 Grisofulvin 125 mg tab 1,500

    157 Haloperidol 0,5 mg Tab -

    158 Haloperidol 1,5 mg Tab -

    159 Haloperidol 5 mg Tab -

    160 Handscoen no 6,5 Pcs 220

    161 Handscoen no 7,5 Pcs -

    162 Handscoen no 7,5 / E-katalog Pcs 209

    163 Handscoen No.7 Pcs -

    164 Handscoen no 8 Pcs -

    165 Handscoen no 8 / E-katalog Pcs -

    166 Handscoen Ginecolog Panjang Steril Pcs 10

    167 HB Sahli Pkt -

    168 Hemaviton Action Kaps -

    169 Hidrokortison Cream 2,5 % Tube 48

    170 Hidroklortiazida 25 mg Tab 1,000

    171 Ibuprofen 200 mg Tab 3,200

    172 Ibuprofen 400 mg Tab -

    173 Ibuprofen syrup/Buffec Syrup Btl 5

    174 Ictiol salep Pot 31


    175 Implant susuk KB Pcs -

    176 Infuset Micro Pcs 43

    177 Infuset Micro / e-katalog Pcs 400

    178 Infuset Macro Pcs 360

    179 Infuset Macro / e-katalog Pcs -

    180 Iodium test Btl -

    181 indikator universal ktk -

    182 IV Kateter no 18 Pcs 40

    183 IV Kateter no 18 / e-katalog Pcs -

    184 IV Kateter no 20 Pcs 286

    185 IV Kateter no 20 / E-katalog Pcs 50

    186 IV Kateter no 22 / E-katalog Pcs 270

    187 IV Kateter no 24 / E - katalog Pcs 464

    188 IV Canula No.18 Pcs -

    189 Isosorbit Dinitrat sublingual 5 mg Tab -

    190 Jarum Jahit Otot Lusin 9

    191 Jarum Jahit Kulit Lusin 9

    192 Jelly untuk USG / non e-katalog Btl 2

    193 Jelly untuk Catheter Komb. Lidokain Btl 1

    194 Kalsium Laktat 500 mg Tab 100

    195 Kalsium Gluconas Injeksi / non e-katalog Amp 5

    196 Kalnex 250 mg Kaps -

    197 Kalnex injeksi Amp -

    198 Kapas berlemak 500 gram Roll -

    199 Kapas pemb. Absorben 200 gram Roll -

    200 Kapas Pemb. Absorben 250 gram Roll 10

    201 Kapas pemb. Absorben 1000 gram Roll -


    202 Kaptopril 12,5 mg Tab -

    203 Kaptopril 25 mg Tab 800

    204 Karbamazepin 200 mg Tab -

    205 Kartu Stock Lbr 10

    206 Kasa 4 x 10 cm Roll -

    207 Kasa 4 x 6 cm Roll -

    208 Kasa 40 x 80 cm Roll -

    209 Kasa 40 x 80 cm / E-katalog 11

    210 Kasa Kompres 40/40 cm Roll -

    211 Kasa Kompres 40/40 cm / E-katalog Roll -

    212 Kasa Pembalut 2 m x 80 cm Roll -

    213 Kasa Pembalut Hidrofil 4 m x 3 cm Roll -

    214 Kasa Pembalut Hidrofil 4 m x 3 cm / E-katalog Roll 200

    215 Kasa Pembalut Hidrofil 4 m x 15 cm Roll -

    216 Kasa Pembalut Hidrofil 4 m x 15 cm / E-Katalog Roll -

    217 Kasa 16 x 16 Roll -

    218 Kasa pembalut 14 x 8 cm Roll -

    219 Kasa pembalut 10 cm Roll -

    220 Kasa pembalut 4 x 18 Roll -

    221 Kelambu Pcs -

    222 Ketamine Injeksi 10 mg/ml Vial -

    223 Ketokonazol cream 2 % Tube -

    224 Ketokonazol 200 mg Tab 1,250

    225 Ketorolac Injeksi Ampul 5

    226 Kertas EKG 3 Ukuran Roll -

    227 Kertas Perkamen / Non e-katalog Lbr 10

    228 Kina Dihidroklorida injeksi 25 % - 2 ml Amp -


    229 Kina 222 mg Tab -

    230 Klip Plastik Kecil tanpa sablon Pcs -

    231 Klip Plastik Sedang tanpa sablon Pcs -

    232 Klip Plastik Besar sablon 10 x 15 Pcs -

    233 Klip Plastik Sedang sablon 8,7 x 15 Pcs -

    234 Klip Plastik kecil sablon Pcs -

    235 Kloramfenicol 250 mg Kaps 600

    236 Kloramfenicol Salp Mata 1 % Tube 9

    237 Kloramfenicol Tetes Telinga 3 % Btl 40

    238 Klorfeniraminimaleat 4 mg Tab 4,000

    239 Klorokuin 150 mg Tab -

    240 Klorpromazin HCL injeksi i.m 25 mg/ml Amp -

    241 Klorpromazin HCL 25 mg Tab -

    242 Kodein 10 mg Tab 85

    243 Kotrimoksasol Adult 480 mg Tab 700

    244 Kotrimoksasol Pedriatic 120 mg Tab 2,400

    245 Kotrimoksasol suspensi Btl 67

    246 Lab.Kit Pkt -

    247 Lacbon 17 Tab -

    248 Lansoprazole 30 mg Kaps -

    249 Larutan Benedict Btl -

    250 Larutan Etanol Asam Btl -

    251 Larutan Gimsa stain / non e-katalog Btl -

    252 Larutan Carbofuksin Btl -

    253 Larutan Methilen Biru Btl -

    254 Larutan H2O2 Btl 1

    255 Larutan xilol Btl -


    256 Larutan HCl 0,1 N / Non e-katalog Btl -

    257 Levetran Salp Pot 12

    258 Levofloksasin 500 mg Tab -

    259 Lidocain Injeksi HCl 2 % Amp 265

    260 Lidocain Injeksi 2 % + Epineprin 1 : 80.000 - 2 ml Amp 30

    261 Livron B plex Tab -

    262 Loperamid 2 mg Tab 300

    263 Loratadin 10 mg Tab 600

    264 Lysol Btl 2

    265 Light cure Composite (etsa & bondingnya) Set -

    266 Magnesium Sulfat injeksi 20 % - 25 ml Amp 10

    267 Magnesium Sulfat injeksi 40 % - 25 ml Amp -

    268 Masker Mulut Pcs 650

    269 MDT MB Adult Blist -

    270 MDT PB Adult Blist -

    271 MDT MB Anak Blist 4

    272 MDT PB Anak Blist -

    273 Mebendazole syrup 100 mg/5 ml Btl -

    274 Mebendazole 100 mg Tab -

    275 Meloxicam 15 mg Tab -

    276 Metformin Tab -

    277 Metapex Box -

    278 Methanil Yellow Chen Kit ktk -

    279 Methilergometrin maleat 0,125 mg Tab -

    280 Methilergometrin maleat 0,200 mg - 1 ml Amp 20

    281 Methilprednisolon 4 mg Tab -

    282 Methilprednisolon 8 mg tab 900


    283 Metoclopramide injeksi 5 mg/5 ml Amp -

    284 Metoclopramide 10 mg Tab 200

    285 Metronidazol 250 mg Tab 100

    286 Metronidazol 500 mg Tab -

    287 Metronidazol infus Btl 5

    288 Mikonazole cream salp 2 % / e-katalog Tube 83

    289 Mikonazole cream salp 2 % / non e-katalog Tube -

    290 Mineral Mix Sac 40

    291 Morfin injeksi 10 mg/ml Amp -

    292 Natrium Bicarbonat 500 mg Tab -

    293 Natrium Diklofenak 25 mg Tab -

    294 Natrium Diklofenak 50 mg Tab -

    295 Natrium Klorida Larutan infus 0,9 % / e-katalog Btl 200

    296 Natrium Klorida Larutan infus 0,9 / non e-katalog Btl 120

    297 Natrium Fenitoin 100 mg Kaps -

    298 Natrium Fenitoin Injeksi / Non e-katalog Amp -

    299 Nicolin injeksi / Citicolin inj Amp -

    300 Nifedipin 10 mg Tab -

    301 Nistatin 100 000 UI Tab -

    302 Nistatin 500 000 UI Vaginal tab Tab -

    303 Nitrit Test Merk ktk -

    304 Neurovit- E Tab -

    305 Neurobion / Neurosanbe 5000 Tab -

    306 Neurobion / Neurosanbe Injeksi Amp -

    307 Obat Batuk Hitam syrup 100 ml Btl -

    308 Obat FDC Anak Pkt -

    309 Obat FDC Kategori 1 Pkt -


    310 Obat FDC Kategori 2 Pkt -

    311 Obat FDC TB sisipan Pkt -

    312 OAT Kombipak anak Pkt -

    313 OAT Kategori 1 & 3 Pkt -

    314 Oil Emersi Btl -

    315 Obat suntik KB 3 bulanan Vial -

    316 Oksitetrasiklin HCL 1 % salp mata Tube 25

    317 Oksitetrasiklin HCL 3 % salp Kulit Tube 75

    318 Oksitetrasiklin injeksi Vial -

    319 Oksitosin injeksi 10 IU/ml - 1 ml Amp 63

    320 Omeprazole 20 mg Kaps 570

    321 Papaverin injeksi 40 mg/ml Amp -

    322 Papaverin 40 mg Tab 2,000

    323 Paracetamol syrup 120 mg/5 ml Btl 40

    324 Paracetamol 500 mg Tab 2,500

    325 Parasetamol drop Btl 5

    326 Parasetamol suppositoria Supp -

    327 Penisilin procain / Procain Benzil Penicillin injeksi Vial 8

    328 Petidin injeksi 50 mg/ml Amp -

    329 Pil KB I Kombinasi Set -

    330 Pilokarpin Tetes mata 2 % Btl -

    331 Piracetam injeksi 3 g/15 ml Amp -

    332 Piracetam 1200 mg Tab -

    333 Piracetam 400 mg Tab -

    334 Pirasetam 800 mg Tab -

    335 Pirantel score base 125 mg Tab -

    336 Pirantel Syrup Btl -


    337 Piridoksin HCL 10 mg Tab 1,800

    338 Piroxicam 10 mg Tab 2,100

    339 Piroxicam 20 mg Tab 1,000

    340 Plester besar 5 yard x 2 inch Roll -

    341 Plester sedang 1,5 Inch x 5 cm Roll -

    342 Plester kecil 1,25 x 5 cm roll -

    343 Plester ( Leukoplast) 7,5 x 4,5 cm Roll 4

    344 Poligips 7,5cm Roll 5

    345 Poligips 10 cm Roll 5

    346 Poligips 15 cm Roll 5

    347 Povidon iodida larutan 10 % 30 ml Btl 3

    348 Povidon iodida larutan 10 % 300 ml Btl 5

    349 Povidon iodida larutan 10 % 1000 ml Btl 2

    350 Prednison 5 mg Tab 1,800

    351 Primakuin 15 mg Tab 100

    352 Propanolol 40 mg Tab 100

    353 Propilitiourasil 100 mg Tab 100

    354 Ranitidin 150 mg Tab 3,900

    355 Ranitidin injeksi 25 mg/2 ml Amp 19

    356 Rapid Diagnostic Test (RDT) Pcs -

    357 Reagen zealnelsen Pkt -

    358 Reserpin 0,1 mg Tab -

    359 Reserpin 0,25 mg Tab -

    360 Retinol 100.000 IU Kaps -

    361 Retinol 200.000 IU Kaps -

    362 Ringer Lactat larutan infus Btl 195

    363 Rodamin B Test Chem ktk -


    364 Safety box Lbr -

    365 Salicyl Spritus 55 ml Btl -

    366 Salbutamol 2 mg Tab 200

    367 Salbutamol 4 mg Tab -

    368 Salep 2 - 4,Komb.As.Salisilat 2% + Sulfur Praicip Pot 41

    369 Salisil Bedak Ktk 6

    370 Sanbe B-Plex Btl -

    371 Sangobion Kaps 250

    372 Santa E Tab -

    373 Scabisid Cream Tube -

    374 Serum Antibisa Ular Polivalen ( ABU I ) Vial 1

    375 Serum Antitetanus injeksi 1.500 IU ( ATS ) Vial 1

    376 Sianocobalamine injeksi 500 mcg Amp 90

    377 Sianocobalamine 50 mcg Tab 800

    378 Silk ( Benang Bedah Sutera ) Pcs -

    379 Silk ( Benang Bedah Sutera ) / e-katalog Pcs 62

    380 Slide Pcs 792

    381 Sputum pot / Non e-katalog Bh -

    382 Spongostan Ktk -

    383 Streptomisin injeksi Vial -

    384 Simvastatin 10 mg Tab -

    385 Test Kehamilan Pcs 50

    386 Tetrasiklin 250 mg Kaps -

    387 Tetrasiklin 500 mg Kaps -

    388 Thiamphenicol 500 mg Kaps -

    389 Tiamin injeksi 100 mg/ml Amp 100

    390 Tiamin HCL 50 mg Tab 2,400


    391 Topicaina topical gel / Anastesi anak Btl -

    392 Tooth stain Remover btl -

    393 Triheksifenidil 2 mg Tab -

    394 Tri Kresol Formalin /TKF Btl -

    395 Tramadol 50 mg / ml Injeksi Amp -

    396 Transfusi Set Pcs -

    397 Transfusi Set / E-katalog Pcs -

    398 Tremenza Tab -

    399 Tissue Lensa pcs -

    400 Urine bag / e-katalog Pcs 30

    401 Urine Test / Gluco Protein Test Pcs -

    402 Vitamin B - complex Tab 2,600

    403 Ventolin inj. amp 6

    404 Wing Needle no 27 Pcs -

    405 Zink Oxide Eugenol (powder+liquid/kalzinol) Btl -

    406 Zinc Dispersible 120 mg Tab 1,350

    407 Slide box Pcs -

    408 Acarbose 50 mg Tab -

    409 Asam Traneksamat Injeksi amp -

    410 Asam Traneksamat 500 mg kapl 500

    411 Bumer Pcs -

    412 Etanol 70 % 100 ml btl -

    413 Furosemide 10mg/ml injeksi Amp -

    414 Glimepiride 2 mg Tab -

    415 Jarum jahit Combinasi otot & Kulit Lusin 11

    416 Plester Besar 5 m x 4,5 cm (Leukoplast) Roll 5

    417 Povidon iodida Larutan 10 % 60 ml Btl -


    418 Semprong Pcs -

    419 Sumbu bh -

    420 Termometer Ruangan Kayu Pcs 2

    421 Sofero caps -

    422 Disposible dental needle no. 18 pcs -

    423 Disposible dental needle no. 20 Pcs -

    424 Disposible dental needle no. 25 Pcs -

    425 Jarum Citojek No. 12 Pcs -

    426 Jarum Citojek No. 16 Pcs -

    427 Resin Composite (A2+A3) Btl -

    428 Suction Rip Pcs -

    429 Levemir Injeksi / non e-katalog paket -

    430 Borax Test ktk -

    431 Novabion caps -

    432 Larutan Metanol btl -

    433 Larutan Oil Imersion 50 ml btl -

    434 Alkohol Swap Pkt -

    435 Aquadest 600 ml Btl -

    436 Alat Tes Darah Multifungsi Pkt -

    437 Stik Gula Darah Pkt -

    438 Stik Kolesterol Pkt -

    439 Stik Asam Urat Pkt -

    440 Miniaspi 80 mg (Asetosal 80 mg) Tab 500

    441 Isoniazid 100 mg Tab -

    442 Rantin injeksi (Ranitidin inj. 25 mg/ml)Non E. Amp -

    443 Nexa 500 mg (Asam Traneksamat) Non E. Tab -

    444 Sotatic Injeksi (Metoclopramide inj. 5 mg/ml) Non E. Amp -


    445 Salbron 2 mg (Salbutamol 2 mg) Non E. Tab -

    446 Pehacain Inj. (Lidocain Comb.) Amp -

    447 Otoryl 25 Mg (Kaptopril 25 mg) Tab -

    448 Asam Folat 1 mg Tab 900

    449 Azitromycin 500 mg Tab -

    450 Ciprofloksasine Injeksi Btl -

    451 Amlodipin 10 mg Tab -

    452 Dentin Conditioner Minipack Box -

    453 Stesolit Rectal / Diazepam rectal Supp -

    454 Paracetamol Infus 100 ml Btl -

    455 Cetrizine 10 mg Tab -

    VAKSIN
    1 HBo Vial 5

    2 BCG Amp 2

    3 Polio Vial 6

    4 DPT-HB Vial 3

    5 Pantavalen Vial -

    6 Campak Vial 2

    7 TT Vial -

    8 DT Vial 8

    9 TD Vial -

    10 ADS 0,5 Vial -

    11 ADS 0,05 Vial -

    12 Pelarut BCG Amp 2

    13 Pelarut Campak Amp 3


    Poli Umum
    Kunjungan Resep

    UMUM

    BAYAR
    JUMLAH KUNJUNGAN RESEP

    Mengetahui Yang Menyera


    Kepala Dinas Kesehatan Kab. Alor Petugas IF

    NIP. NIP.
    PEMERINTAH KABUPATEN ALOR
    D I N A S K E S E H A T A N
    Jl. Prof. DR. W. Z. Yohanes. No. - Telp. (0386) 21052
    K A L A B A H I

    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    LAP. PEMAKAIAN O
    LEMBAR PERMINTA
    TAHUN
    TRIWULAN

    Penerimaan Persediaan Pemakaian Sisa Stok Stok Optimum

    5 6 7 9 11

    - -

    450 450

    280 280

    - -

    400 400

    - -

    400 400

    500 500

    - -

    650 650

    1,200 1,200

    - -
    10 10

    2,400 2,400

    9 9

    280 280

    - -

    - -

    50 50

    2,500 2,500

    2,000 2,000

    50 50

    - -

    - -

    3,000 3,000

    46 46

    1,600 1,600

    15 15

    41 41

    24 24

    - -

    1,000 1,000

    - -

    - -

    - -

    - -

    - -

    5 5

    3 3
    1 1

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    8,600 8,600

    2,500 2,500

    57 57

    1,050 1,050

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    25 25

    - -

    - -
    - -

    - -

    83 83

    - -

    - -

    - -

    - -

    96 96

    - -

    120 120

    - -

    - -

    1,700 1,700

    - -

    6 6

    - -

    - -

    5 5

    5 5

    3,100 3,100

    1,500 1,500

    - -

    - -

    216 216

    - -

    153 153

    2,800 2,800
    - -

    - -

    - -

    - -

    - -

    5 5

    - -

    79 79

    - -

    - -

    - -

    - -

    200 200

    30 30

    160 160

    - -

    - -

    - -

    - -

    - -

    30 30

    - -

    - -

    - -

    25 25

    12 12

    6 6
    - -

    - -

    - -

    - -

    - -

    200 200

    - -

    - -

    - -

    14 14

    260 260

    22 22

    - -

    - -

    4 4

    5 5

    - -

    - -

    - -

    - -

    525 525

    - -

    - -

    65 65

    41 41

    - -

    500 500
    4,200 4,200

    60 60

    - -

    102 102

    - -

    - -

    - -

    - -

    1,500 1,500

    - -

    - -

    - -

    220 220

    - -

    209 209

    - -

    - -

    - -

    10 10

    - -

    - -

    48 48

    1,000 1,000

    3,200 3,200

    - -

    5 5

    31 31
    - -

    43 43

    400 400

    360 360

    - -

    - -

    - -

    40 40

    - -

    286 286

    50 50

    270 270

    464 464

    - -

    - -

    9 9

    9 9

    2 2

    1 1

    100 100

    5 5

    - -

    - -

    - -

    - -

    10 10

    - -
    - -

    800 800

    - -

    10 10

    - -

    - -

    - -

    11 11

    - -

    - -

    - -

    - -

    200 200

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    1,250 1,250

    5 5

    - -

    10 10

    - -
    - -

    - -

    - -

    - -

    - -

    - -

    600 600

    9 9

    40 40

    4,000 4,000

    - -

    - -

    - -

    85 85

    700 700

    2,400 2,400

    67 67

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    1 1

    - -
    - -

    12 12

    - -

    265 265

    30 30

    - -

    300 300

    600 600

    2 2

    - -

    10 10

    - -

    650 650

    - -

    - -

    4 4

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    20 20

    - -

    900 900
    - -

    200 200

    100 100

    - -

    5 5

    83 83

    - -

    40 40

    - -

    - -

    - -

    - -

    200 200

    120 120

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -
    - -

    - -

    - -

    - -

    - -

    - -

    25 25

    75 75

    - -

    63 63

    570 570

    - -

    2,000 2,000

    40 40

    2,500 2,500

    5 5

    - -

    8 8

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -
    1,800 1,800

    2,100 2,100

    1,000 1,000

    - -

    - -

    - -

    4 4

    5 5

    5 5

    5 5

    3 3

    5 5

    2 2

    1,800 1,800

    100 100

    100 100

    100 100

    3,900 3,900

    19 19

    - -

    - -

    - -

    - -

    - -

    - -

    195 195

    - -
    - -

    - -

    200 200

    - -

    41 41

    6 6

    - -

    250 250

    - -

    - -

    1 1

    1 1

    90 90

    800 800

    - -

    62 62

    792 792

    - -

    - -

    - -

    - -

    50 50

    - -

    - -

    - -

    100 100

    2,400 2,400
    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    30 30

    - -

    2,600 2,600

    6 6

    - -

    - -

    1,350 1,350

    - -

    - -

    - -

    500 500

    - -

    - -

    - -

    - -

    11 11

    5 5

    - -
    - -

    - -

    2 2

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    500 500

    - -

    - -

    - -

    - -
    - -

    - -

    - -

    900 900

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    5 5

    2 2

    6 6

    3 3

    - -

    2 2

    - -

    8 8

    - -

    - -

    - -

    2 2

    3 3
    Sumber / Asal Resep
    Poli Gigi KIA KB Raeat Inap UGD

    MUM
    ASKES JUMLAH
    TIDAK BAYAR Dokter

    ang Menyerahkan Yang Meminta


    Petugas IFK Kepala Puskesmas

    NIP.
    LPO)

    P. PEMAKAIAN OBAT BULAN : MARET


    MBAR PERMINTAAN OBAT BULAN :
    : 2019
    :

    permintaan pemberian KET

    12 14 16
    Total Resep ke Apotik
    Pusling, Posyandu, dll Bulan Ini Kumulatif s/d Bulan ini

    - #VALUE!

    Pemberi Resep
    Perawat Bidan Perawat Gigi

    Yang Menerima
    Petugas Puskesmas

    NIP.
    ……………………….,
    ………………………………………
    ……………………….,
    …………………………………………………………
    LA

    NAMA PUSKESMAS :
    KABUPATEN : ALOR
    KECAMATAN :

    No Nama Obat Satuan Stok awal

    1 2 3 4

    1 Adona Injensi -
    Amp
    2 Alat Suntik Sekali Pakai 2,5 ml Pcs 170

    3 Alat Suntik Sekali Pakai 5 ml Pcs 125

    4 Alat suntik sekali pakai 0,5 ml Pcs -

    5 Alat suntik sekali pakai 0,5 ml / E - Katalog Pcs 600

    6 Alat suntik sekali pakai 0,05 ml /non e-katalog pcs -

    7 Alat suntik sekali pakai 0,05 ml / e-katalog Pcs 400

    8 Alat suntik sekali pakai 1 ml Pcs 200

    9 Alat suntik sekali pakai10 ml Pcs -

    10 Albendazol 400 mg / non e-katalog Tab 650

    11 Allupurinol 100 mg Tab 1,200

    12 Amalgam solila / Silver Amalgam Powder + Liquid Tube -


    13 Ambroxol syrup 15 mg/ml Btl 42

    14 Ambroxol 30 mg Tab 3,100

    15 Aminofilin Injeksi 24 mg/ml Amp 9

    16 Aminofilin 200 mg / e-katalog Tab 180

    17 Aminofilin 200 mg / non e-katalog tab -

    18 Amitriptilin HCL 25 mg Tab -

    19 Amlodipin 5 mg Tab 150

    20 Amoksisilin 250 mg Kaps 2,500

    21 Amoksisilin 500 mg Kapl 2,500

    22 Amoksisilin syrup Btl 21

    23 Ampisillin injeksi 1000 mg/ml Vial -

    24 Ampisillin syrup Btl -

    25 Antacida DOEN Tab -

    26 Antacida DOEN Suspensi Btl 35

    27 Antalgin 500 mg Tab 1,200

    28 Antalgin injeksi Amp 30

    29 Anti Bakteri DOEN / Basitrasin Polimiksin Tube 21

    30 Anti Fungi DOEN Salep 30 g ( Salp 3 - 6 ) Pot -

    31 Anti Haemoroid DOEN Suppositoria Supp -

    32 Anti Malaria DOEN ( SulDox ) Tab 1,000

    33 Anti Migraen / Ergotamin 1 mg + Coffein 50 mg Tab -

    34 Anti Sera A Btl -

    35 Anti Sera B Btl -

    36 Anti Sera AB Btl -

    37 Anti Sera D Btl -

    38 Aqua pro injeksi 20 ml Vial -

    39 Aquadestilata 1000 ml Btl 3


    40 Aqua DM Bidestilata IKA ml 1

    41 Aqua DM Brataco ltr -

    42 Arsen / Devitalisasi Pasta Btl -

    43 Arterakin tab Tab -

    44 Artesunat injeksi 60 mg Vial -

    45 Artemeter injeksi Amp -

    46 Asetosal 100 mg Tab -

    47 Asetosal 500 mg Tab -

    48 Asam Ascorbat 50 mg Tab 6,900

    49 Asam Mefenamat 500 mg Kapl -

    50 Asiklovir cream 5 % 5 g Tube 15

    51 Asiklovir 200 mg Tab 1,250

    52 Asiklovir 400 mg Tab -

    53 Atropin Sulfat injeksi 0,25 mg/ml Amp -

    54 Atropin sulfat 0,5 mg Tab -

    55 Baby Cough syrup Btl -

    56 Bahan Fissur Sealent / Fuji VII Dos -

    57 Baraclude 1 mg btl/30 tab -

    58 Baraclude 0,5 mg box/30 tab -

    59 Barotec Inhaler Btl -

    60 Baycline 1 Liter Btl -

    61 Benzatin Benzil Penicillin 1,2 juta IU Vial -

    62 Besi II Sulfat 7 H2O 300 mg Tab -

    63 Besi II Sulfat + Asam Folat Tab 4,920

    64 Betametason Cream 0,1 % Tube 35

    65 Betason N Tube -

    66 Bidan Kit paket -


    67 Bioplacenton 15 gram Tube -

    68 Bisolvon Nebulizer btl -

    69 Bisturi / non e-katalog Pcs 143

    70 Blood lanset / non e-katalog Pcs -

    71 Calsidor / Dycal Dentsply / Hydcal Technew Btl -

    72 Calsydol syrup Btl -

    73 Cat gut 3/0 Pcs 90

    74 Cat gut 3/0 / E-katalog Pcs -

    75 Cat gut 2/0 Pcs 38

    76 Cat gut 2/0 / E-katalog Pcs -

    77 Cavit / Caviton Btl -

    78 Cement Powder + Liquid / Elite Cement 100 Dos -

    79 Cefadroxil 500 mg Kaps 900

    80 Ceftriaxon Injeksi Vial -

    81 Cefotaxime injeksi 0,5 gram Vial 6

    82 Cefotaxime injeksi 1 gram Vial -

    83 Chlor Fenol Champer menthol /CHKM Btl -

    84 Chloramfecort Tube -

    85 Chloramfecort H Tube -

    86 Cimetidine 200 mg Tab 3,100

    87 Ciprofloksasine 500 mg Tab 2,200

    88 Counterpain 30 gram Tube -

    89 Curcuma Plus Syrup Btl -

    90 Darplex Tab 179

    91 Dasabion Kaps -

    92 Deksamethasone injeksi 5 mg/ml Amp 93

    93 Deksamethasone 0,5 mg Tab 700


    94 Dekstran 70 - Larutan Infus 6 % steril Btl -

    95 Dental Cotton Roll Bks -

    96 Dental Plak Disclosing Gel / Disclosing Solution Btl -

    97 Diazepam injeksi 5 mg/ml Amp -

    98 Diazepam 2 mg Tab -

    99 Diazepam 5 mg Tab 5

    100 Dietilkarbamsin 100 mg / NON E-KATALOG Tab -

    101 Difenhidramine Injeksi 10 mg/ml Amp 98

    102 Digoksin 0,25 mg Tab -

    103 Diltiazem HCL 30 mg Tab -

    104 Dimenhidrinat 50 mg Tab -

    105 Doksisiklin 100 mg Kaps -

    106 Domperidon Tab -

    107 Dulcolax 5 mg Tab -

    108 Efedrin HCL 25 mg Tab 200

    109 Elastis verban 3 inci Roll -

    110 Elastis verban 4 inci Roll -

    111 Elastis verban 6 inci Roll -

    112 Elkana Multivitamin Tab -

    113 Enervon - C Kapl -

    114 Epineprin HCL 0,1 % injeksi Amp 30

    115 Eritromicin 250 mg Kapl -

    116 Eritromicin 500 mg Kapl -

    117 Eritromicin syrup Btl -

    118 Etakridin Larutan 0,1 % 300 ml Btl 3

    119 Etanol 70 % 1 liter Btl 14

    120 Ethilklorda Semprot Btl 9


    121 Endomethasone (endosel) btl -

    122 Eugenol Btl -

    123 Fehling A Btl -

    124 Fehling B Btl -

    125 Fenobarbital injeksi 50 mg/ml Amp -

    126 Fenobarbital 30 mg Tab 200

    127 Fenobarbital 100 mg Tab -

    128 Fenoksimetil Penisilin 250 mg Tab -

    129 Fenoksimetil Penisilin 500 mg Tab -

    130 Fenol gliserol TT Btl 24

    131 Fitomenadion 10 mg Tab 260

    132 Fitomenadion injeksi 10 mg/ml Amp 27

    133 Flecher Powder + Liquid Btl -

    134 Foley cateter no 16 Pcs -

    135 Foley cateter no 18 Pcs 4

    136 Foley cateter no 20 Pcs 5

    137 Formalin solution liter -

    138 Formaldehide Merk Test kit -

    139 Formokresol Btl -

    140 Furosemida Tab -

    141 Garam Oralit Sac 425

    142 Gamexan Btl -

    143 Gentamicin Injeksi 80 mg/ml Amp -

    144 Gentamicin Salep Kulit 0,1 % Tube 25

    145 Gentian Violet 1 % Btl 47

    146 Gic Art / Fuji IX Dos -

    147 Glibenclamida 5 mg Tab 800


    148 Gliceril Guayacolat 100 mg Tab 2,100

    149 Glucosa Larutan Infus 10 % steril Btl -

    150 Glucosa Larutan Infus 40 % steril Btl -

    151 Glucosa Larutan Infus 5 % steril Btl 12

    152 Gloves "S" Pcs -

    153 Gloves "M" Pcs -

    154 Gloves "L" Pcs -

    155 Grisofulvin 250 mg Tab -

    156 Grisofulvin 125 mg tab 2,500

    157 Haloperidol 0,5 mg Tab -

    158 Haloperidol 1,5 mg Tab -

    159 Haloperidol 5 mg Tab -

    160 Handscoen no 6,5 Pcs 140

    161 Handscoen no 7,5 Pcs -

    162 Handscoen no 7,5 / E-katalog Pcs 200

    163 Handscoen No.7 Pcs -

    164 Handscoen no 8 Pcs -

    165 Handscoen no 8 / E-katalog Pcs -

    166 Handscoen Ginecolog Panjang Steril Pcs 10

    167 HB Sahli Pkt -

    168 Hemaviton Action Kaps -

    169 Hidrokortison Cream 2,5 % Tube 59

    170 Hidroklortiazida 25 mg Tab 1,000

    171 Ibuprofen 200 mg Tab 3,400

    172 Ibuprofen 400 mg Tab -

    173 Ibuprofen syrup/Buffec Syrup Btl 43

    174 Ictiol salep Pot 24


    175 Implant susuk KB Pcs -

    176 Infuset Micro Pcs 70

    177 Infuset Micro / e-katalog Pcs 400

    178 Infuset Macro Pcs 405

    179 Infuset Macro / e-katalog Pcs -

    180 Iodium test Btl -

    181 indikator universal ktk -

    182 IV Kateter no 18 Pcs 50

    183 IV Kateter no 18 / e-katalog Pcs -

    184 IV Kateter no 20 Pcs 298

    185 IV Kateter no 20 / E-katalog Pcs -

    186 IV Kateter no 22 / E-katalog Pcs 270

    187 IV Kateter no 24 / E - katalog Pcs 500

    188 IV Canula No.18 Pcs -

    189 Isosorbit Dinitrat sublingual 5 mg Tab -

    190 Jarum Jahit Otot Lusin 9

    191 Jarum Jahit Kulit Lusin 9

    192 Jelly untuk USG / non e-katalog Btl 4

    193 Jelly untuk Catheter Komb. Lidokain Btl -

    194 Kalsium Laktat 500 mg Tab 300

    195 Kalsium Gluconas Injeksi / non e-katalog Amp -

    196 Kalnex 250 mg Kaps -

    197 Kalnex injeksi Amp -

    198 Kapas berlemak 500 gram Roll -

    199 Kapas pemb. Absorben 200 gram Roll -

    200 Kapas Pemb. Absorben 250 gram Roll 11

    201 Kapas pemb. Absorben 1000 gram Roll -


    202 Kaptopril 12,5 mg Tab -

    203 Kaptopril 25 mg Tab 1,100

    204 Karbamazepin 200 mg Tab -

    205 Kartu Stock Lbr -

    206 Kasa 4 x 10 cm Roll -

    207 Kasa 4 x 6 cm Roll -

    208 Kasa 40 x 80 cm Roll -

    209 Kasa 40 x 80 cm / E-katalog 14

    210 Kasa Kompres 40/40 cm Roll -

    211 Kasa Kompres 40/40 cm / E-katalog Roll -

    212 Kasa Pembalut 2 m x 80 cm Roll -

    213 Kasa Pembalut Hidrofil 4 m x 3 cm Roll -

    214 Kasa Pembalut Hidrofil 4 m x 3 cm / E-katalog Roll -

    215 Kasa Pembalut Hidrofil 4 m x 15 cm Roll -

    216 Kasa Pembalut Hidrofil 4 m x 15 cm / E-Katalog Roll -

    217 Kasa 16 x 16 Roll -

    218 Kasa pembalut 14 x 8 cm Roll -

    219 Kasa pembalut 10 cm Roll -

    220 Kasa pembalut 4 x 18 Roll -

    221 Kelambu Pcs -

    222 Ketamine Injeksi 10 mg/ml Vial -

    223 Ketokonazol cream 2 % Tube 34

    224 Ketokonazol 200 mg Tab 1,550

    225 Ketorolac Injeksi Ampul -

    226 Kertas EKG 3 Ukuran Roll -

    227 Kertas Perkamen / Non e-katalog Lbr -

    228 Kina Dihidroklorida injeksi 25 % - 2 ml Amp -


    229 Kina 222 mg Tab -

    230 Klip Plastik Kecil tanpa sablon Pcs -

    231 Klip Plastik Sedang tanpa sablon Pcs -

    232 Klip Plastik Besar sablon 10 x 15 Pcs -

    233 Klip Plastik Sedang sablon 8,7 x 15 Pcs -

    234 Klip Plastik kecil sablon Pcs -

    235 Kloramfenicol 250 mg Kaps 1,100

    236 Kloramfenicol Salp Mata 1 % Tube 19

    237 Kloramfenicol Tetes Telinga 3 % Btl -

    238 Klorfeniraminimaleat 4 mg Tab 7,000

    239 Klorokuin 150 mg Tab -

    240 Klorpromazin HCL injeksi i.m 25 mg/ml Amp -

    241 Klorpromazin HCL 25 mg Tab -

    242 Kodein 10 mg Tab 100

    243 Kotrimoksasol Adult 480 mg Tab -

    244 Kotrimoksasol Pedriatic 120 mg Tab 1,200

    245 Kotrimoksasol suspensi Btl 72

    246 Lab.Kit Pkt -

    247 Lacbon 17 Tab -

    248 Lansoprazole 30 mg Kaps -

    249 Larutan Benedict Btl -

    250 Larutan Etanol Asam Btl -

    251 Larutan Gimsa stain / non e-katalog Btl -

    252 Larutan Carbofuksin Btl -

    253 Larutan Methilen Biru Btl -

    254 Larutan H2O2 Btl -

    255 Larutan xilol Btl -


    256 Larutan HCl 0,1 N / Non e-katalog Btl -

    257 Levetran Salp Pot -

    258 Levofloksasin 500 mg Tab -

    259 Lidocain Injeksi HCl 2 % Amp 272

    260 Lidocain Injeksi 2 % + Epineprin 1 : 80.000 - 2 ml Amp 30

    261 Livron B plex Tab -

    262 Loperamid 2 mg Tab 300

    263 Loratadin 10 mg Tab 700

    264 Lysol Btl 2

    265 Light cure Composite (etsa & bondingnya) Set -

    266 Magnesium Sulfat injeksi 20 % - 25 ml Amp -

    267 Magnesium Sulfat injeksi 40 % - 25 ml Amp -

    268 Masker Mulut Pcs 300

    269 MDT MB Adult Blist -

    270 MDT PB Adult Blist -

    271 MDT MB Anak Blist -

    272 MDT PB Anak Blist -

    273 Mebendazole syrup 100 mg/5 ml Btl -

    274 Mebendazole 100 mg Tab -

    275 Meloxicam 15 mg Tab -

    276 Metformin Tab -

    277 Metapex Box -

    278 Methanil Yellow Chen Kit ktk -

    279 Methilergometrin maleat 0,125 mg Tab -

    280 Methilergometrin maleat 0,200 mg - 1 ml Amp 20

    281 Methilprednisolon 4 mg Tab -

    282 Methilprednisolon 8 mg tab 1,000


    283 Metoclopramide injeksi 5 mg/5 ml Amp -

    284 Metoclopramide 10 mg Tab 200

    285 Metronidazol 250 mg Tab -

    286 Metronidazol 500 mg Tab -

    287 Metronidazol infus Btl -

    288 Mikonazole cream salp 2 % / e-katalog Tube 84

    289 Mikonazole cream salp 2 % / non e-katalog Tube -

    290 Mineral Mix Sac 40

    291 Morfin injeksi 10 mg/ml Amp -

    292 Natrium Bicarbonat 500 mg Tab -

    293 Natrium Diklofenak 25 mg Tab -

    294 Natrium Diklofenak 50 mg Tab -

    295 Natrium Klorida Larutan infus 0,9 % / e-katalog Btl -

    296 Natrium Klorida Larutan infus 0,9 / non e-katalog Btl 161

    297 Natrium Fenitoin 100 mg Kaps -

    298 Natrium Fenitoin Injeksi / Non e-katalog Amp -

    299 Nicolin injeksi / Citicolin inj Amp -

    300 Nifedipin 10 mg Tab -

    301 Nistatin 100 000 UI Tab -

    302 Nistatin 500 000 UI Vaginal tab Tab -

    303 Nitrit Test Merk ktk -

    304 Neurovit- E Tab -

    305 Neurobion / Neurosanbe 5000 Tab -

    306 Neurobion / Neurosanbe Injeksi Amp -

    307 Obat Batuk Hitam syrup 100 ml Btl -

    308 Obat FDC Anak Pkt -

    309 Obat FDC Kategori 1 Pkt -


    310 Obat FDC Kategori 2 Pkt -

    311 Obat FDC TB sisipan Pkt -

    312 OAT Kombipak anak Pkt -

    313 OAT Kategori 1 & 3 Pkt -

    314 Oil Emersi Btl -

    315 Obat suntik KB 3 bulanan Vial -

    316 Oksitetrasiklin HCL 1 % salp mata Tube 25

    317 Oksitetrasiklin HCL 3 % salp Kulit Tube 90

    318 Oksitetrasiklin injeksi Vial -

    319 Oksitosin injeksi 10 IU/ml - 1 ml Amp 103

    320 Omeprazole 20 mg Kaps 780

    321 Papaverin injeksi 40 mg/ml Amp -

    322 Papaverin 40 mg Tab 2,000

    323 Paracetamol syrup 120 mg/5 ml Btl 29

    324 Paracetamol 500 mg Tab 1,100

    325 Parasetamol drop Btl -

    326 Parasetamol suppositoria Supp -

    327 Penisilin procain / Procain Benzil Penicillin injeksi Vial 11

    328 Petidin injeksi 50 mg/ml Amp -

    329 Pil KB I Kombinasi Set -

    330 Pilokarpin Tetes mata 2 % Btl -

    331 Piracetam injeksi 3 g/15 ml Amp -

    332 Piracetam 1200 mg Tab -

    333 Piracetam 400 mg Tab -

    334 Pirasetam 800 mg Tab -

    335 Pirantel score base 125 mg Tab -

    336 Pirantel Syrup Btl -


    337 Piridoksin HCL 10 mg Tab 800

    338 Piroxicam 10 mg Tab 3,200

    339 Piroxicam 20 mg Tab -

    340 Plester besar 5 yard x 2 inch Roll 2

    341 Plester sedang 1,5 Inch x 5 cm Roll -

    342 Plester kecil 1,25 x 5 cm roll -

    343 Plester ( Leukoplast) 7,5 x 4,5 cm Roll 2

    344 Poligips 7,5cm Roll -

    345 Poligips 10 cm Roll -

    346 Poligips 15 cm Roll -

    347 Povidon iodida larutan 10 % 30 ml Btl 4

    348 Povidon iodida larutan 10 % 300 ml Btl 1

    349 Povidon iodida larutan 10 % 1000 ml Btl 3

    350 Prednison 5 mg Tab 5,200

    351 Primakuin 15 mg Tab -

    352 Propanolol 40 mg Tab -

    353 Propilitiourasil 100 mg Tab -

    354 Ranitidin 150 mg Tab 1,300

    355 Ranitidin injeksi 25 mg/2 ml Amp 9

    356 Rapid Diagnostic Test (RDT) Pcs -

    357 Reagen zealnelsen Pkt -

    358 Reserpin 0,1 mg Tab -

    359 Reserpin 0,25 mg Tab -

    360 Retinol 100.000 IU Kaps 1,000

    361 Retinol 200.000 IU Kaps 100

    362 Ringer Lactat larutan infus Btl 144

    363 Rodamin B Test Chem ktk -


    364 Safety box Lbr -

    365 Salicyl Spritus 55 ml Btl -

    366 Salbutamol 2 mg Tab -

    367 Salbutamol 4 mg Tab -

    368 Salep 2 - 4,Komb.As.Salisilat 2% + Sulfur Praicip Pot 27

    369 Salisil Bedak Ktk 31

    370 Sanbe B-Plex Btl -

    371 Sangobion Kaps -

    372 Santa E Tab -

    373 Scabisid Cream Tube -

    374 Serum Antibisa Ular Polivalen ( ABU I ) Vial 1

    375 Serum Antitetanus injeksi 1.500 IU ( ATS ) Vial 1

    376 Sianocobalamine injeksi 500 mcg Amp -

    377 Sianocobalamine 50 mcg Tab 300

    378 Silk ( Benang Bedah Sutera ) Pcs -

    379 Silk ( Benang Bedah Sutera ) / e-katalog Pcs 62

    380 Slide Pcs 792

    381 Sputum pot / Non e-katalog Bh -

    382 Spongostan Ktk -

    383 Streptomisin injeksi Vial -

    384 Simvastatin 10 mg Tab -

    385 Test Kehamilan Pcs -

    386 Tetrasiklin 250 mg Kaps -

    387 Tetrasiklin 500 mg Kaps -

    388 Thiamphenicol 500 mg Kaps -

    389 Tiamin injeksi 100 mg/ml Amp 30

    390 Tiamin HCL 50 mg Tab 1,100


    391 Topicaina topical gel / Anastesi anak Btl -

    392 Tooth stain Remover btl -

    393 Triheksifenidil 2 mg Tab -

    394 Tri Kresol Formalin /TKF Btl -

    395 Tramadol 50 mg / ml Injeksi Amp -

    396 Transfusi Set Pcs -

    397 Transfusi Set / E-katalog Pcs -

    398 Tremenza Tab -

    399 Tissue Lensa pcs -

    400 Urine bag / e-katalog Pcs 10

    401 Urine Test / Gluco Protein Test Pcs -

    402 Vitamin B - complex Tab 3,300

    403 Ventolin inj. amp -

    404 Wing Needle no 27 Pcs -

    405 Zink Oxide Eugenol (powder+liquid/kalzinol) Btl -

    406 Zinc Dispersible 120 mg Tab 1,050

    407 Slide box Pcs -

    408 Acarbose 50 mg Tab -

    409 Asam Traneksamat Injeksi amp -

    410 Asam Traneksamat 500 mg kapl -

    411 Bumer Pcs -

    412 Etanol 70 % 100 ml btl -

    413 Furosemide 10mg/ml injeksi Amp -

    414 Glimepiride 2 mg Tab -

    415 Jarum jahit Combinasi otot & Kulit Lusin 11

    416 Plester Besar 5 m x 4,5 cm (Leukoplast) Roll -

    417 Povidon iodida Larutan 10 % 60 ml Btl -


    418 Semprong Pcs -

    419 Sumbu bh -

    420 Termometer Ruangan Kayu Pcs 2

    421 Sofero caps -

    422 Disposible dental needle no. 18 pcs -

    423 Disposible dental needle no. 20 Pcs -

    424 Disposible dental needle no. 25 Pcs -

    425 Jarum Citojek No. 12 Pcs -

    426 Jarum Citojek No. 16 Pcs -

    427 Resin Composite (A2+A3) Btl -

    428 Suction Rip Pcs -

    429 Levemir Injeksi / non e-katalog paket -

    430 Borax Test ktk -

    431 Novabion caps -

    432 Larutan Metanol btl -

    433 Larutan Oil Imersion 50 ml btl -

    434 Alkohol Swap Pkt -

    435 Aquadest 600 ml Btl -

    436 Alat Tes Darah Multifungsi Pkt -

    437 Stik Gula Darah Pkt -

    438 Stik Kolesterol Pkt -

    439 Stik Asam Urat Pkt -

    440 Miniaspi 80 mg (Asetosal 80 mg) Tab 500

    441 Isoniazid 100 mg Tab -

    442 Rantin injeksi (Ranitidin inj. 25 mg/ml)Non E. Amp -

    443 Nexa 500 mg (Asam Traneksamat) Non E. Tab -

    444 Sotatic Injeksi (Metoclopramide inj. 5 mg/ml) Non E. Amp -


    445 Salbron 2 mg (Salbutamol 2 mg) Non E. Tab -

    446 Pehacain Inj. (Lidocain Comb.) Amp -

    447 Otoryl 25 Mg (Kaptopril 25 mg) Tab -

    448 Asam Folat 1 mg Tab 900

    449 Azitromycin 500 mg Tab -

    450 Ciprofloksasine Injeksi Btl -

    451 Amlodipin 10 mg Tab -

    452 Dentin Conditioner Minipack Box -

    453 Stesolit Rectal / Diazepam rectal Supp -

    454 Paracetamol Infus 100 ml Btl -

    455 Cetrizine 10 mg Tab -

    VAKSIN -

    1 HBo Vial 5

    2 BCG Amp 2

    3 Polio Vial 6

    4 DPT-HB Vial 3

    5 Pantavalen Vial -

    6 Campak Vial 2

    7 TT Vial -

    8 DT Vial 8

    9 TD Vial -

    10 ADS 0,5 Vial -

    11 ADS 0,05 Vial -

    12 Pelarut BCG Amp 2

    13 Pelarut Campak Amp 3


    Poli Umum
    Kunjungan Resep
    #VALUE!

    UMUM

    BAYAR
    JUMLAH KUNJUNGAN RESEP
    #VALUE!

    Mengetahui Yang Menyera


    Kepala Dinas Kesehatan Kab. Alor Petugas IF

    NIP. NIP.
    PEMERINTAH KABUPATEN ALOR
    D I N A S K E S E H A T A N
    Jl. Prof. DR. W. Z. Yohanes. No. - Telp. (0386) 21052
    K A L A B A H I

    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    LAP. PEMAKAIAN O
    LEMBAR PERMINTA
    TAHUN
    TRIWULAN

    Penerimaan Persediaan Pemakaian Sisa Stok Stok Optimum

    5 6 7 9 11

    - - - -

    500 670 220 450

    200 325 45 280

    - - - -

    - 600 200 400

    - - - -

    - 400 - 400

    300 500 - 500

    - - - -

    - 650 - 650

    - 1,200 - 1,200

    - - - -
    - 42 32 10

    2,000 5,100 2,700 2,400

    - 9 - 9

    100 280 - 280

    - - - -

    - - - -

    - 150 100 50

    3,000 5,500 3,000 2,500

    3,000 5,500 3,500 2,000

    60 81 31 50

    - - - -

    - - - -

    3,000 3,000 - 3,000

    50 85 39 46

    2,000 3,200 1,600 1,600

    - 30 15 15

    25 46 5 41

    24 24 - 24

    - - - -

    - 1,000 - 1,000

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    5 5 - 5

    - 3 - 3
    - 1 - 1

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    7,000 13,900 5,300 8,600

    3,000 3,000 500 2,500

    50 65 8 57

    - 1,250 200 1,050

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 4,920 4,920 -

    25 60 35 25

    - - - -

    - - - -
    - - - -

    - - - -

    - 143 60 83

    - - - -

    - - - -

    - - - -

    - 90 90 -

    96 96 - 96

    - 38 38 -

    120 120 - 120

    - - - -

    - - - -

    2,000 2,900 1,200 1,700

    - - - -

    - 6 - 6

    - - - -

    - - - -

    5 5 - 5

    5 5 - 5

    - 3,100 - 3,100

    - 2,200 700 1,500

    1 1 1 -

    - - - -

    270 449 233 216

    - - - -

    100 193 40 153

    5,000 5,700 2,900 2,800


    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 5 - 5

    - - - -

    - 98 19 79

    - - - -

    - - - -

    - - - -

    - - - -

    200 200 - 200

    30 30 - 30

    - 200 40 160

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 30 - 30

    - - - -

    - - - -

    - - - -

    24 27 2 25

    - 14 2 12

    - 9 3 6
    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 200 - 200

    - - - -

    - - - -

    - - - -

    - 24 10 14

    - 260 - 260

    - 27 5 22

    - - - -

    - - - -

    - 4 - 4

    - 5 - 5

    - - - -

    - - - -

    - - - -

    - - - -

    200 625 100 525

    - - - -

    - - - -

    100 125 60 65

    - 47 6 41

    - - - -

    500 1,300 800 500


    5,000 7,100 2,900 4,200

    60 60 - 60

    - - - -

    100 112 10 102

    - - - -

    - - - -

    - - - -

    - - - -

    - 2,500 1,000 1,500

    - - - -

    - - - -

    - - - -

    200 340 120 220

    - - - -

    200 400 191 209

    - - - -

    - - - -

    - - - -

    - 10 - 10

    - - - -

    - - - -

    - 59 11 48

    - 1,000 - 1,000

    5,000 8,400 5,200 3,200

    - - - -

    - 43 38 5

    12 36 5 31
    - - - -

    - 70 27 43

    - 400 - 400

    - 405 45 360

    - - - -

    - - - -

    - - - -

    - 50 10 40

    - - - -

    - 298 12 286

    50 50 - 50

    - 270 - 270

    - 500 36 464

    - - - -

    - - - -

    - 9 - 9

    - 9 - 9

    - 4 2 2

    1 1 - 1

    500 800 700 100

    5 5 - 5

    - - - -

    - - - -

    - - - -

    - - - -

    - 11 1 10

    - - - -
    - - - -

    - 1,100 300 800

    - - - -

    10 10 - 10

    - - - -

    - - - -

    - - - -

    - 14 3 11

    - - - -

    - - - -

    - - - -

    - - - -

    250 250 50 200

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 34 34 -

    - 1,550 300 1,250

    5 5 - 5

    - - - -

    10 10 - 10

    - - - -
    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 1,100 500 600

    - 19 10 9

    40 40 - 40

    - 7,000 3,000 4,000

    - - - -

    - - - -

    - - - -

    - 100 15 85

    1,000 1,000 300 700

    3,000 4,200 1,800 2,400

    - 72 5 67

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    1 1 - 1

    - - - -
    - - - -

    12 12 - 12

    - - - -

    100 372 107 265

    - 30 - 30

    - - - -

    - 300 - 300

    - 700 100 600

    - 2 - 2

    - - - -

    10 10 - 10

    500 500 - 500

    500 800 150 650

    - - - -

    - - - -

    4 4 - 4

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 20 - 20

    - - - -

    300 1,300 400 900


    - - - -

    500 700 500 200

    100 100 - 100

    - - - -

    5 5 - 5

    24 108 25 83

    - - - -

    - 40 - 40

    - - - -

    - - - -

    - - - -

    - - - -

    200 200 - 200

    - 161 41 120

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -
    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    25 50 25 25

    25 115 40 75

    - - - -

    - 103 40 63

    - 780 210 570

    - - - -

    - 2,000 - 2,000

    75 104 64 40

    3,000 4,100 1,600 2,500

    5 5 - 5

    - - - -

    - 11 3 8

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -
    2,000 2,800 1,000 1,800

    - 3,200 1,100 2,100

    1,000 1,000 - 1,000

    - 2 2 -

    - - - -

    5 5 5 -

    5 7 3 4

    5 5 - 5

    5 5 - 5

    5 5 - 5

    - 4 1 3

    5 6 1 5

    - 3 1 2

    - 5,200 3,400 1,800

    100 100 - 100

    100 100 - 100

    100 100 - 100

    3,000 4,300 400 3,900

    20 29 10 19

    - - - -

    - - - -

    - - - -

    - - - -

    - 1,000 1,000 -

    - 100 100 -

    100 244 49 195

    - - - -
    - - - -

    - - - -

    200 200 - 200

    - - - -

    24 51 10 41

    - 31 25 6

    - - - -

    250 250 - 250

    - - - -

    - - - -

    - 1 - 1

    - 1 - 1

    100 100 10 90

    1,000 1,300 500 800

    - - - -

    - 62 - 62

    - 792 - 792

    - - - -

    - - - -

    - - - -

    - - - -

    50 50 - 50

    - - - -

    - - - -

    - - - -

    100 130 30 100

    2,000 3,100 700 2,400


    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    20 30 - 30

    - - - -

    3,000 6,300 3,700 2,600

    6 6 - 6

    - - - -

    - - - -

    1,000 2,050 700 1,350

    - - - -

    - - - -

    - - - -

    500 500 - 500

    - - - -

    - - - -

    - - - -

    - - - -

    - 11 - 11

    5 5 - 5

    - - - -
    - - - -

    - - - -

    - 2 - 2

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - #VALUE! #VALUE!

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 500 - 500

    - - - -

    - - - -

    - - - -

    - - - -
    - - - -

    - - - -

    - - - -

    - 900 - 900

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - -

    - 5 - 5

    - 2 - 2

    - 6 - 6

    - 3 - 3

    - - - -

    - 2 - 2

    - - - -

    - 8 - 8

    - - - -

    - - - -

    - - - -

    - 2 - 2

    - 3 - 3
    Sumber / Asal Resep
    Poli Gigi KIA KB Raeat Inap UGD

    #VALUE! #VALUE! #VALUE! #VALUE! #VALUE!

    MUM
    ASKES JUMLAH
    TIDAK BAYAR Dokter

    #VALUE! #VALUE! #VALUE! #VALUE!

    ang Menyerahkan Yang Meminta


    Petugas IFK Kepala Puskesmas

    NIP.
    LPO)

    P. PEMAKAIAN OBAT BULAN : JANUARI S/D MARET


    MBAR PERMINTAAN OBAT BULAN : APRIL S/D JUNI
    : 2019
    : II (DUA)

    permintaan pemberian KET

    12 14 16
    Total Resep ke Apotik
    Pusling, Posyandu, dll Bulan Ini Kumulatif s/d Bulan ini

    #VALUE! #VALUE! #VALUE!

    Pemberi Resep
    Perawat Bidan Perawat Gigi

    #VALUE! #VALUE! #VALUE!

    Yang Menerima
    Petugas Puskesmas

    NIP.
    ……………………….,
    ………………………………………
    ……………………….,
    …………………………………………………………
    LA

    NAMA PUSKESMAS :
    KABUPATEN : ALOR
    KECAMATAN :

    No Nama Obat Satuan Stok awal

    1 2 3 4

    1 Adona Injensi -
    Amp
    2 Alat Suntik Sekali Pakai 2,5 ml Pcs 450

    3 Alat Suntik Sekali Pakai 5 ml Pcs 280

    4 Alat suntik sekali pakai 0,5 ml Pcs -

    5 Alat suntik sekali pakai 0,5 ml / E - Katalog Pcs 400

    6 Alat suntik sekali pakai 0,05 ml /non e-katalog pcs -

    7 Alat suntik sekali pakai 0,05 ml / e-katalog Pcs 400

    8 Alat suntik sekali pakai 1 ml Pcs 500

    9 Alat suntik sekali pakai10 ml Pcs -

    10 Albendazol 400 mg / non e-katalog Tab 650

    11 Allupurinol 100 mg Tab 1,200

    12 Amalgam solila / Silver Amalgam Powder + Liquid Tube -


    13 Ambroxol syrup 15 mg/ml Btl 10

    14 Ambroxol 30 mg Tab 2,400

    15 Aminofilin Injeksi 24 mg/ml Amp 9

    16 Aminofilin 200 mg / e-katalog Tab 280

    17 Aminofilin 200 mg / non e-katalog tab -

    18 Amitriptilin HCL 25 mg Tab -

    19 Amlodipin 5 mg Tab 50

    20 Amoksisilin 250 mg Kaps 2,500

    21 Amoksisilin 500 mg Kapl 2,000

    22 Amoksisilin syrup Btl 50

    23 Ampisillin injeksi 1000 mg/ml Vial -

    24 Ampisillin syrup Btl -

    25 Antacida DOEN Tab 3,000

    26 Antacida DOEN Suspensi Btl 46

    27 Antalgin 500 mg Tab 1,600

    28 Antalgin injeksi Amp 15

    29 Anti Bakteri DOEN / Basitrasin Polimiksin Tube 41

    30 Anti Fungi DOEN Salep 30 g ( Salp 3 - 6 ) Pot 24

    31 Anti Haemoroid DOEN Suppositoria Supp -

    32 Anti Malaria DOEN ( SulDox ) Tab 1,000

    33 Anti Migraen / Ergotamin 1 mg + Coffein 50 mg Tab -

    34 Anti Sera A Btl -

    35 Anti Sera B Btl -

    36 Anti Sera AB Btl -

    37 Anti Sera D Btl -

    38 Aqua pro injeksi 20 ml Vial 5

    39 Aquadestilata 1000 ml Btl 3


    40 Aqua DM Bidestilata IKA ml 1

    41 Aqua DM Brataco ltr -

    42 Arsen / Devitalisasi Pasta Btl -

    43 Arterakin tab Tab -

    44 Artesunat injeksi 60 mg Vial -

    45 Artemeter injeksi Amp -

    46 Asetosal 100 mg Tab -

    47 Asetosal 500 mg Tab -

    48 Asam Ascorbat 50 mg Tab 8,600

    49 Asam Mefenamat 500 mg Kapl 2,500

    50 Asiklovir cream 5 % 5 g Tube 57

    51 Asiklovir 200 mg Tab 1,050

    52 Asiklovir 400 mg Tab -

    53 Atropin Sulfat injeksi 0,25 mg/ml Amp -

    54 Atropin sulfat 0,5 mg Tab -

    55 Baby Cough syrup Btl -

    56 Bahan Fissur Sealent / Fuji VII Dos -

    57 Baraclude 1 mg btl/30 tab -

    58 Baraclude 0,5 mg box/30 tab -

    59 Barotec Inhaler Btl -

    60 Baycline 1 Liter Btl -

    61 Benzatin Benzil Penicillin 1,2 juta IU Vial -

    62 Besi II Sulfat 7 H2O 300 mg Tab -

    63 Besi II Sulfat + Asam Folat Tab -

    64 Betametason Cream 0,1 % Tube 25

    65 Betason N Tube -

    66 Bidan Kit paket -


    67 Bioplacenton 15 gram Tube -

    68 Bisolvon Nebulizer btl -

    69 Bisturi / non e-katalog Pcs 83

    70 Blood lanset / non e-katalog Pcs -

    71 Calsidor / Dycal Dentsply / Hydcal Technew Btl -

    72 Calsydol syrup Btl -

    73 Cat gut 3/0 Pcs -

    74 Cat gut 3/0 / E-katalog Pcs 96

    75 Cat gut 2/0 Pcs -

    76 Cat gut 2/0 / E-katalog Pcs 120

    77 Cavit / Caviton Btl -

    78 Cement Powder + Liquid / Elite Cement 100 Dos -

    79 Cefadroxil 500 mg Kaps 1,700

    80 Ceftriaxon Injeksi Vial -

    81 Cefotaxime injeksi 0,5 gram Vial 6

    82 Cefotaxime injeksi 1 gram Vial -

    83 Chlor Fenol Champer menthol /CHKM Btl -

    84 Chloramfecort Tube 5

    85 Chloramfecort H Tube 5

    86 Cimetidine 200 mg Tab 3,100

    87 Ciprofloksasine 500 mg Tab 1,500

    88 Counterpain 30 gram Tube -

    89 Curcuma Plus Syrup Btl -

    90 Darplex Tab 216

    91 Dasabion Kaps -

    92 Deksamethasone injeksi 5 mg/ml Amp 153

    93 Deksamethasone 0,5 mg Tab 2,800


    94 Dekstran 70 - Larutan Infus 6 % steril Btl -

    95 Dental Cotton Roll Bks -

    96 Dental Plak Disclosing Gel / Disclosing Solution Btl -

    97 Diazepam injeksi 5 mg/ml Amp -

    98 Diazepam 2 mg Tab -

    99 Diazepam 5 mg Tab 5

    100 Dietilkarbamsin 100 mg / NON E-KATALOG Tab -

    101 Difenhidramine Injeksi 10 mg/ml Amp 79

    102 Digoksin 0,25 mg Tab -

    103 Diltiazem HCL 30 mg Tab -

    104 Dimenhidrinat 50 mg Tab -

    105 Doksisiklin 100 mg Kaps -

    106 Domperidon Tab 200

    107 Dulcolax 5 mg Tab 30

    108 Efedrin HCL 25 mg Tab 160

    109 Elastis verban 3 inci Roll -

    110 Elastis verban 4 inci Roll -

    111 Elastis verban 6 inci Roll -

    112 Elkana Multivitamin Tab -

    113 Enervon - C Kapl -

    114 Epineprin HCL 0,1 % injeksi Amp 30

    115 Eritromicin 250 mg Kapl -

    116 Eritromicin 500 mg Kapl -

    117 Eritromicin syrup Btl -

    118 Etakridin Larutan 0,1 % 300 ml Btl 25

    119 Etanol 70 % 1 liter Btl 12

    120 Ethilklorda Semprot Btl 6


    121 Endomethasone (endosel) btl -

    122 Eugenol Btl -

    123 Fehling A Btl -

    124 Fehling B Btl -

    125 Fenobarbital injeksi 50 mg/ml Amp -

    126 Fenobarbital 30 mg Tab 200

    127 Fenobarbital 100 mg Tab -

    128 Fenoksimetil Penisilin 250 mg Tab -

    129 Fenoksimetil Penisilin 500 mg Tab -

    130 Fenol gliserol TT Btl 14

    131 Fitomenadion 10 mg Tab 260

    132 Fitomenadion injeksi 10 mg/ml Amp 22

    133 Flecher Powder + Liquid Btl -

    134 Foley cateter no 16 Pcs -

    135 Foley cateter no 18 Pcs 4

    136 Foley cateter no 20 Pcs 5

    137 Formalin solution liter -

    138 Formaldehide Merk Test kit -

    139 Formokresol Btl -

    140 Furosemida Tab -

    141 Garam Oralit Sac 525

    142 Gamexan Btl -

    143 Gentamicin Injeksi 80 mg/ml Amp -

    144 Gentamicin Salep Kulit 0,1 % Tube 65

    145 Gentian Violet 1 % Btl 41

    146 Gic Art / Fuji IX Dos -

    147 Glibenclamida 5 mg Tab 500


    148 Gliceril Guayacolat 100 mg Tab 4,200

    149 Glucosa Larutan Infus 10 % steril Btl 60

    150 Glucosa Larutan Infus 40 % steril Btl -

    151 Glucosa Larutan Infus 5 % steril Btl 102

    152 Gloves "S" Pcs -

    153 Gloves "M" Pcs -

    154 Gloves "L" Pcs -

    155 Grisofulvin 250 mg Tab -

    156 Grisofulvin 125 mg tab 1,500

    157 Haloperidol 0,5 mg Tab -

    158 Haloperidol 1,5 mg Tab -

    159 Haloperidol 5 mg Tab -

    160 Handscoen no 6,5 Pcs 220

    161 Handscoen no 7,5 Pcs -

    162 Handscoen no 7,5 / E-katalog Pcs 209

    163 Handscoen No.7 Pcs -

    164 Handscoen no 8 Pcs -

    165 Handscoen no 8 / E-katalog Pcs -

    166 Handscoen Ginecolog Panjang Steril Pcs 10

    167 HB Sahli Pkt -

    168 Hemaviton Action Kaps -

    169 Hidrokortison Cream 2,5 % Tube 48

    170 Hidroklortiazida 25 mg Tab 1,000

    171 Ibuprofen 200 mg Tab 3,200

    172 Ibuprofen 400 mg Tab -

    173 Ibuprofen syrup/Buffec Syrup Btl 5

    174 Ictiol salep Pot 31


    175 Implant susuk KB Pcs -

    176 Infuset Micro Pcs 43

    177 Infuset Micro / e-katalog Pcs 400

    178 Infuset Macro Pcs 360

    179 Infuset Macro / e-katalog Pcs -

    180 Iodium test Btl -

    181 indikator universal ktk -

    182 IV Kateter no 18 Pcs 40

    183 IV Kateter no 18 / e-katalog Pcs -

    184 IV Kateter no 20 Pcs 286

    185 IV Kateter no 20 / E-katalog Pcs 50

    186 IV Kateter no 22 / E-katalog Pcs 270

    187 IV Kateter no 24 / E - katalog Pcs 464

    188 IV Canula No.18 Pcs -

    189 Isosorbit Dinitrat sublingual 5 mg Tab -

    190 Jarum Jahit Otot Lusin 9

    191 Jarum Jahit Kulit Lusin 9

    192 Jelly untuk USG / non e-katalog Btl 2

    193 Jelly untuk Catheter Komb. Lidokain Btl 1

    194 Kalsium Laktat 500 mg Tab 100

    195 Kalsium Gluconas Injeksi / non e-katalog Amp 5

    196 Kalnex 250 mg Kaps -

    197 Kalnex injeksi Amp -

    198 Kapas berlemak 500 gram Roll -

    199 Kapas pemb. Absorben 200 gram Roll -

    200 Kapas Pemb. Absorben 250 gram Roll 10

    201 Kapas pemb. Absorben 1000 gram Roll -


    202 Kaptopril 12,5 mg Tab -

    203 Kaptopril 25 mg Tab 800

    204 Karbamazepin 200 mg Tab -

    205 Kartu Stock Lbr 10

    206 Kasa 4 x 10 cm Roll -

    207 Kasa 4 x 6 cm Roll -

    208 Kasa 40 x 80 cm Roll -

    209 Kasa 40 x 80 cm / E-katalog 11

    210 Kasa Kompres 40/40 cm Roll -

    211 Kasa Kompres 40/40 cm / E-katalog Roll -

    212 Kasa Pembalut 2 m x 80 cm Roll -

    213 Kasa Pembalut Hidrofil 4 m x 3 cm Roll -

    214 Kasa Pembalut Hidrofil 4 m x 3 cm / E-katalog Roll 200

    215 Kasa Pembalut Hidrofil 4 m x 15 cm Roll -

    216 Kasa Pembalut Hidrofil 4 m x 15 cm / E-Katalog Roll -

    217 Kasa 16 x 16 Roll -

    218 Kasa pembalut 14 x 8 cm Roll -

    219 Kasa pembalut 10 cm Roll -

    220 Kasa pembalut 4 x 18 Roll -

    221 Kelambu Pcs -

    222 Ketamine Injeksi 10 mg/ml Vial -

    223 Ketokonazol cream 2 % Tube -

    224 Ketokonazol 200 mg Tab 1,250

    225 Ketorolac Injeksi Ampul 5

    226 Kertas EKG 3 Ukuran Roll -

    227 Kertas Perkamen / Non e-katalog Lbr 10

    228 Kina Dihidroklorida injeksi 25 % - 2 ml Amp -


    229 Kina 222 mg Tab -

    230 Klip Plastik Kecil tanpa sablon Pcs -

    231 Klip Plastik Sedang tanpa sablon Pcs -

    232 Klip Plastik Besar sablon 10 x 15 Pcs -

    233 Klip Plastik Sedang sablon 8,7 x 15 Pcs -

    234 Klip Plastik kecil sablon Pcs -

    235 Kloramfenicol 250 mg Kaps 600

    236 Kloramfenicol Salp Mata 1 % Tube 9

    237 Kloramfenicol Tetes Telinga 3 % Btl 40

    238 Klorfeniraminimaleat 4 mg Tab 4,000

    239 Klorokuin 150 mg Tab -

    240 Klorpromazin HCL injeksi i.m 25 mg/ml Amp -

    241 Klorpromazin HCL 25 mg Tab -

    242 Kodein 10 mg Tab 85

    243 Kotrimoksasol Adult 480 mg Tab 700

    244 Kotrimoksasol Pedriatic 120 mg Tab 2,400

    245 Kotrimoksasol suspensi Btl 67

    246 Lab.Kit Pkt -

    247 Lacbon 17 Tab -

    248 Lansoprazole 30 mg Kaps -

    249 Larutan Benedict Btl -

    250 Larutan Etanol Asam Btl -

    251 Larutan Gimsa stain / non e-katalog Btl -

    252 Larutan Carbofuksin Btl -

    253 Larutan Methilen Biru Btl -

    254 Larutan H2O2 Btl 1

    255 Larutan xilol Btl -


    256 Larutan HCl 0,1 N / Non e-katalog Btl -

    257 Levetran Salp Pot 12

    258 Levofloksasin 500 mg Tab -

    259 Lidocain Injeksi HCl 2 % Amp 265

    260 Lidocain Injeksi 2 % + Epineprin 1 : 80.000 - 2 ml Amp 30

    261 Livron B plex Tab -

    262 Loperamid 2 mg Tab 300

    263 Loratadin 10 mg Tab 600

    264 Lysol Btl 2

    265 Light cure Composite (etsa & bondingnya) Set -

    266 Magnesium Sulfat injeksi 20 % - 25 ml Amp 10

    267 Magnesium Sulfat injeksi 40 % - 25 ml Amp -

    268 Masker Mulut Pcs 650

    269 MDT MB Adult Blist -

    270 MDT PB Adult Blist -

    271 MDT MB Anak Blist 4

    272 MDT PB Anak Blist -

    273 Mebendazole syrup 100 mg/5 ml Btl -

    274 Mebendazole 100 mg Tab -

    275 Meloxicam 15 mg Tab -

    276 Metformin Tab -

    277 Metapex Box -

    278 Methanil Yellow Chen Kit ktk -

    279 Methilergometrin maleat 0,125 mg Tab -

    280 Methilergometrin maleat 0,200 mg - 1 ml Amp 20

    281 Methilprednisolon 4 mg Tab -

    282 Methilprednisolon 8 mg tab 900


    283 Metoclopramide injeksi 5 mg/5 ml Amp -

    284 Metoclopramide 10 mg Tab 200

    285 Metronidazol 250 mg Tab 100

    286 Metronidazol 500 mg Tab -

    287 Metronidazol infus Btl 5

    288 Mikonazole cream salp 2 % / e-katalog Tube 83

    289 Mikonazole cream salp 2 % / non e-katalog Tube -

    290 Mineral Mix Sac 40

    291 Morfin injeksi 10 mg/ml Amp -

    292 Natrium Bicarbonat 500 mg Tab -

    293 Natrium Diklofenak 25 mg Tab -

    294 Natrium Diklofenak 50 mg Tab -

    295 Natrium Klorida Larutan infus 0,9 % / e-katalog Btl 200

    296 Natrium Klorida Larutan infus 0,9 / non e-katalog Btl 120

    297 Natrium Fenitoin 100 mg Kaps -

    298 Natrium Fenitoin Injeksi / Non e-katalog Amp -

    299 Nicolin injeksi / Citicolin inj Amp -

    300 Nifedipin 10 mg Tab -

    301 Nistatin 100 000 UI Tab -

    302 Nistatin 500 000 UI Vaginal tab Tab -

    303 Nitrit Test Merk ktk -

    304 Neurovit- E Tab -

    305 Neurobion / Neurosanbe 5000 Tab -

    306 Neurobion / Neurosanbe Injeksi Amp -

    307 Obat Batuk Hitam syrup 100 ml Btl -

    308 Obat FDC Anak Pkt -

    309 Obat FDC Kategori 1 Pkt -


    310 Obat FDC Kategori 2 Pkt -

    311 Obat FDC TB sisipan Pkt -

    312 OAT Kombipak anak Pkt -

    313 OAT Kategori 1 & 3 Pkt -

    314 Oil Emersi Btl -

    315 Obat suntik KB 3 bulanan Vial -

    316 Oksitetrasiklin HCL 1 % salp mata Tube 25

    317 Oksitetrasiklin HCL 3 % salp Kulit Tube 75

    318 Oksitetrasiklin injeksi Vial -

    319 Oksitosin injeksi 10 IU/ml - 1 ml Amp 63

    320 Omeprazole 20 mg Kaps 570

    321 Papaverin injeksi 40 mg/ml Amp -

    322 Papaverin 40 mg Tab 2,000

    323 Paracetamol syrup 120 mg/5 ml Btl 40

    324 Paracetamol 500 mg Tab 2,500

    325 Parasetamol drop Btl 5

    326 Parasetamol suppositoria Supp -

    327 Penisilin procain / Procain Benzil Penicillin injeksi Vial 8

    328 Petidin injeksi 50 mg/ml Amp -

    329 Pil KB I Kombinasi Set -

    330 Pilokarpin Tetes mata 2 % Btl -

    331 Piracetam injeksi 3 g/15 ml Amp -

    332 Piracetam 1200 mg Tab -

    333 Piracetam 400 mg Tab -

    334 Pirasetam 800 mg Tab -

    335 Pirantel score base 125 mg Tab -

    336 Pirantel Syrup Btl -


    337 Piridoksin HCL 10 mg Tab 1,800

    338 Piroxicam 10 mg Tab 2,100

    339 Piroxicam 20 mg Tab 1,000

    340 Plester besar 5 yard x 2 inch Roll -

    341 Plester sedang 1,5 Inch x 5 cm Roll -

    342 Plester kecil 1,25 x 5 cm roll -

    343 Plester ( Leukoplast) 7,5 x 4,5 cm Roll 4

    344 Poligips 7,5cm Roll 5

    345 Poligips 10 cm Roll 5

    346 Poligips 15 cm Roll 5

    347 Povidon iodida larutan 10 % 30 ml Btl 3

    348 Povidon iodida larutan 10 % 300 ml Btl 5

    349 Povidon iodida larutan 10 % 1000 ml Btl 2

    350 Prednison 5 mg Tab 1,800

    351 Primakuin 15 mg Tab 100

    352 Propanolol 40 mg Tab 100

    353 Propilitiourasil 100 mg Tab 100

    354 Ranitidin 150 mg Tab 3,900

    355 Ranitidin injeksi 25 mg/2 ml Amp 19

    356 Rapid Diagnostic Test (RDT) Pcs -

    357 Reagen zealnelsen Pkt -

    358 Reserpin 0,1 mg Tab -

    359 Reserpin 0,25 mg Tab -

    360 Retinol 100.000 IU Kaps -

    361 Retinol 200.000 IU Kaps -

    362 Ringer Lactat larutan infus Btl 195

    363 Rodamin B Test Chem ktk -


    364 Safety box Lbr -

    365 Salicyl Spritus 55 ml Btl -

    366 Salbutamol 2 mg Tab 200

    367 Salbutamol 4 mg Tab -

    368 Salep 2 - 4,Komb.As.Salisilat 2% + Sulfur Praicip Pot 41

    369 Salisil Bedak Ktk 6

    370 Sanbe B-Plex Btl -

    371 Sangobion Kaps 250

    372 Santa E Tab -

    373 Scabisid Cream Tube -

    374 Serum Antibisa Ular Polivalen ( ABU I ) Vial 1

    375 Serum Antitetanus injeksi 1.500 IU ( ATS ) Vial 1

    376 Sianocobalamine injeksi 500 mcg Amp 90

    377 Sianocobalamine 50 mcg Tab 800

    378 Silk ( Benang Bedah Sutera ) Pcs -

    379 Silk ( Benang Bedah Sutera ) / e-katalog Pcs 62

    380 Slide Pcs 792

    381 Sputum pot / Non e-katalog Bh -

    382 Spongostan Ktk -

    383 Streptomisin injeksi Vial -

    384 Simvastatin 10 mg Tab -

    385 Test Kehamilan Pcs 50

    386 Tetrasiklin 250 mg Kaps -

    387 Tetrasiklin 500 mg Kaps -

    388 Thiamphenicol 500 mg Kaps -

    389 Tiamin injeksi 100 mg/ml Amp 100

    390 Tiamin HCL 50 mg Tab 2,400


    391 Topicaina topical gel / Anastesi anak Btl -

    392 Tooth stain Remover btl -

    393 Triheksifenidil 2 mg Tab -

    394 Tri Kresol Formalin /TKF Btl -

    395 Tramadol 50 mg / ml Injeksi Amp -

    396 Transfusi Set Pcs -

    397 Transfusi Set / E-katalog Pcs -

    398 Tremenza Tab -

    399 Tissue Lensa pcs -

    400 Urine bag / e-katalog Pcs 30

    401 Urine Test / Gluco Protein Test Pcs -

    402 Vitamin B - complex Tab 2,600

    403 Ventolin inj. amp 6

    404 Wing Needle no 27 Pcs -

    405 Zink Oxide Eugenol (powder+liquid/kalzinol) Btl -

    406 Zinc Dispersible 120 mg Tab 1,350

    407 Slide box Pcs -

    408 Acarbose 50 mg Tab -

    409 Asam Traneksamat Injeksi amp -

    410 Asam Traneksamat 500 mg kapl 500

    411 Bumer Pcs -

    412 Etanol 70 % 100 ml btl -

    413 Furosemide 10mg/ml injeksi Amp -

    414 Glimepiride 2 mg Tab -

    415 Jarum jahit Combinasi otot & Kulit Lusin 11

    416 Plester Besar 5 m x 4,5 cm (Leukoplast) Roll 5

    417 Povidon iodida Larutan 10 % 60 ml Btl -


    418 Semprong Pcs -

    419 Sumbu bh -

    420 Termometer Ruangan Kayu Pcs 2

    421 Sofero caps -

    422 Disposible dental needle no. 18 pcs -

    423 Disposible dental needle no. 20 Pcs -

    424 Disposible dental needle no. 25 Pcs -

    425 Jarum Citojek No. 12 Pcs -

    426 Jarum Citojek No. 16 Pcs -

    427 Resin Composite (A2+A3) Btl -

    428 Suction Rip Pcs -

    429 Levemir Injeksi / non e-katalog paket -

    430 Borax Test ktk -

    431 Novabion caps -

    432 Larutan Metanol btl -

    433 Larutan Oil Imersion 50 ml btl -

    434 Alkohol Swap Pkt -

    435 Aquadest 600 ml Btl -

    436 Alat Tes Darah Multifungsi Pkt -

    437 Stik Gula Darah Pkt -

    438 Stik Kolesterol Pkt -

    439 Stik Asam Urat Pkt -

    440 Miniaspi 80 mg (Asetosal 80 mg) Tab 500

    441 Isoniazid 100 mg Tab -

    442 Rantin injeksi (Ranitidin inj. 25 mg/ml)Non E. Amp -

    443 Nexa 500 mg (Asam Traneksamat) Non E. Tab -

    444 Sotatic Injeksi (Metoclopramide inj. 5 mg/ml) Non E. Amp -


    445 Salbron 2 mg (Salbutamol 2 mg) Non E. Tab -

    446 Pehacain Inj. (Lidocain Comb.) Amp -

    447 Otoryl 25 Mg (Kaptopril 25 mg) Tab -

    448 Asam Folat 1 mg Tab 900

    449 Azitromycin 500 mg Tab -

    450 Ciprofloksasine Injeksi Btl -

    451 Amlodipin 10 mg Tab -

    452 Dentin Conditioner Minipack Box -

    453 Stesolit Rectal / Diazepam rectal Supp -

    454 Paracetamol Infus 100 ml Btl -

    455 Cetrizine 10 mg Tab -

    VAKSIN
    1 HBo Vial 5

    2 BCG Amp 2

    3 Polio Vial 6

    4 DPT-HB Vial 3

    5 Pantavalen Vial -

    6 Campak Vial 2

    7 TT Vial -

    8 DT Vial 8

    9 TD Vial -

    10 ADS 0,5 Vial -

    11 ADS 0,05 Vial -

    12 Pelarut BCG Amp 2

    13 Pelarut Campak Amp 3


    Poli Umum
    Kunjungan Resep

    UMUM

    BAYAR
    JUMLAH KUNJUNGAN RESEP

    Mengetahui Yang Menyera


    Kepala Dinas Kesehatan Kab. Alor Petugas IF

    NIP. NIP.
    PEMERINTAH KABUPATEN ALOR
    D I N A S K E S E H A T A N
    Jl. Prof. DR. W. Z. Yohanes. No. - Telp. (0386) 21052
    K A L A B A H I

    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    LAP. PEMAKAIAN O
    LEMBAR PERMINTA
    TAHUN
    TRIWULAN

    Penerimaan Persediaan Pemakaian Sisa Stok Stok Optimum

    5 6 7 9 11

    - -

    450 450

    280 280

    - -

    400 400

    - -

    400 400

    500 500

    - -

    650 650

    1,200 1,200

    - -
    10 10

    2,400 2,400

    9 9

    280 280

    - -

    - -

    50 50

    2,500 2,500

    2,000 2,000

    50 50

    - -

    - -

    3,000 3,000

    46 46

    1,600 1,600

    15 15

    41 41

    24 24

    - -

    1,000 1,000

    - -

    - -

    - -

    - -

    - -

    5 5

    3 3
    1 1

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    8,600 8,600

    2,500 2,500

    57 57

    1,050 1,050

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    25 25

    - -

    - -
    - -

    - -

    83 83

    - -

    - -

    - -

    - -

    96 96

    - -

    120 120

    - -

    - -

    1,700 1,700

    - -

    6 6

    - -

    - -

    5 5

    5 5

    3,100 3,100

    1,500 1,500

    - -

    - -

    216 216

    - -

    153 153

    2,800 2,800
    - -

    - -

    - -

    - -

    - -

    5 5

    - -

    79 79

    - -

    - -

    - -

    - -

    200 200

    30 30

    160 160

    - -

    - -

    - -

    - -

    - -

    30 30

    - -

    - -

    - -

    25 25

    12 12

    6 6
    - -

    - -

    - -

    - -

    - -

    200 200

    - -

    - -

    - -

    14 14

    260 260

    22 22

    - -

    - -

    4 4

    5 5

    - -

    - -

    - -

    - -

    525 525

    - -

    - -

    65 65

    41 41

    - -

    500 500
    4,200 4,200

    60 60

    - -

    102 102

    - -

    - -

    - -

    - -

    1,500 1,500

    - -

    - -

    - -

    220 220

    - -

    209 209

    - -

    - -

    - -

    10 10

    - -

    - -

    48 48

    1,000 1,000

    3,200 3,200

    - -

    5 5

    31 31
    - -

    43 43

    400 400

    360 360

    - -

    - -

    - -

    40 40

    - -

    286 286

    50 50

    270 270

    464 464

    - -

    - -

    9 9

    9 9

    2 2

    1 1

    100 100

    5 5

    - -

    - -

    - -

    - -

    10 10

    - -
    - -

    800 800

    - -

    10 10

    - -

    - -

    - -

    11 11

    - -

    - -

    - -

    - -

    200 200

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    1,250 1,250

    5 5

    - -

    10 10

    - -
    - -

    - -

    - -

    - -

    - -

    - -

    600 600

    9 9

    40 40

    4,000 4,000

    - -

    - -

    - -

    85 85

    700 700

    2,400 2,400

    67 67

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    1 1

    - -
    - -

    12 12

    - -

    265 265

    30 30

    - -

    300 300

    600 600

    2 2

    - -

    10 10

    - -

    650 650

    - -

    - -

    4 4

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    20 20

    - -

    900 900
    - -

    200 200

    100 100

    - -

    5 5

    83 83

    - -

    40 40

    - -

    - -

    - -

    - -

    200 200

    120 120

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -
    - -

    - -

    - -

    - -

    - -

    - -

    25 25

    75 75

    - -

    63 63

    570 570

    - -

    2,000 2,000

    40 40

    2,500 2,500

    5 5

    - -

    8 8

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -
    1,800 1,800

    2,100 2,100

    1,000 1,000

    - -

    - -

    - -

    4 4

    5 5

    5 5

    5 5

    3 3

    5 5

    2 2

    1,800 1,800

    100 100

    100 100

    100 100

    3,900 3,900

    19 19

    - -

    - -

    - -

    - -

    - -

    - -

    195 195

    - -
    - -

    - -

    200 200

    - -

    41 41

    6 6

    - -

    250 250

    - -

    - -

    1 1

    1 1

    90 90

    800 800

    - -

    62 62

    792 792

    - -

    - -

    - -

    - -

    50 50

    - -

    - -

    - -

    100 100

    2,400 2,400
    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    30 30

    - -

    2,600 2,600

    6 6

    - -

    - -

    1,350 1,350

    - -

    - -

    - -

    500 500

    - -

    - -

    - -

    - -

    11 11

    5 5

    - -
    - -

    - -

    2 2

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    500 500

    - -

    - -

    - -

    - -
    - -

    - -

    - -

    900 900

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    5 5

    2 2

    6 6

    3 3

    - -

    2 2

    - -

    8 8

    - -

    - -

    - -

    2 2

    3 3
    Sumber / Asal Resep
    Poli Gigi KIA KB Raeat Inap UGD

    MUM
    ASKES JUMLAH
    TIDAK BAYAR Dokter

    ang Menyerahkan Yang Meminta


    Petugas IFK Kepala Puskesmas

    NIP.
    LPO)

    P. PEMAKAIAN OBAT BULAN : APRIL


    MBAR PERMINTAAN OBAT BULAN :
    : 2019
    :

    permintaan pemberian KET

    12 14 16
    Total Resep ke Apotik
    Pusling, Posyandu, dll Bulan Ini Kumulatif s/d Bulan ini

    - #VALUE!

    Pemberi Resep
    Perawat Bidan Perawat Gigi

    Yang Menerima
    Petugas Puskesmas

    NIP.
    ……………………….,
    ………………………………………
    ……………………….,
    …………………………………………………………
    LA

    NAMA PUSKESMAS :
    KABUPATEN : ALOR
    KECAMATAN :

    No Nama Obat Satuan Stok awal

    1 2 3 4

    1 Adona Injensi -
    Amp
    2 Alat Suntik Sekali Pakai 2,5 ml Pcs 450

    3 Alat Suntik Sekali Pakai 5 ml Pcs 280

    4 Alat suntik sekali pakai 0,5 ml Pcs -

    5 Alat suntik sekali pakai 0,5 ml / E - Katalog Pcs 400

    6 Alat suntik sekali pakai 0,05 ml /non e-katalog pcs -

    7 Alat suntik sekali pakai 0,05 ml / e-katalog Pcs 400

    8 Alat suntik sekali pakai 1 ml Pcs 500

    9 Alat suntik sekali pakai10 ml Pcs -

    10 Albendazol 400 mg / non e-katalog Tab 650

    11 Allupurinol 100 mg Tab 1,200

    12 Amalgam solila / Silver Amalgam Powder + Liquid Tube -


    13 Ambroxol syrup 15 mg/ml Btl 10

    14 Ambroxol 30 mg Tab 2,400

    15 Aminofilin Injeksi 24 mg/ml Amp 9

    16 Aminofilin 200 mg / e-katalog Tab 280

    17 Aminofilin 200 mg / non e-katalog tab -

    18 Amitriptilin HCL 25 mg Tab -

    19 Amlodipin 5 mg Tab 50

    20 Amoksisilin 250 mg Kaps 2,500

    21 Amoksisilin 500 mg Kapl 2,000

    22 Amoksisilin syrup Btl 50

    23 Ampisillin injeksi 1000 mg/ml Vial -

    24 Ampisillin syrup Btl -

    25 Antacida DOEN Tab 3,000

    26 Antacida DOEN Suspensi Btl 46

    27 Antalgin 500 mg Tab 1,600

    28 Antalgin injeksi Amp 15

    29 Anti Bakteri DOEN / Basitrasin Polimiksin Tube 41

    30 Anti Fungi DOEN Salep 30 g ( Salp 3 - 6 ) Pot 24

    31 Anti Haemoroid DOEN Suppositoria Supp -

    32 Anti Malaria DOEN ( SulDox ) Tab 1,000

    33 Anti Migraen / Ergotamin 1 mg + Coffein 50 mg Tab -

    34 Anti Sera A Btl -

    35 Anti Sera B Btl -

    36 Anti Sera AB Btl -

    37 Anti Sera D Btl -

    38 Aqua pro injeksi 20 ml Vial 5

    39 Aquadestilata 1000 ml Btl 3


    40 Aqua DM Bidestilata IKA ml 1

    41 Aqua DM Brataco ltr -

    42 Arsen / Devitalisasi Pasta Btl -

    43 Arterakin tab Tab -

    44 Artesunat injeksi 60 mg Vial -

    45 Artemeter injeksi Amp -

    46 Asetosal 100 mg Tab -

    47 Asetosal 500 mg Tab -

    48 Asam Ascorbat 50 mg Tab 8,600

    49 Asam Mefenamat 500 mg Kapl 2,500

    50 Asiklovir cream 5 % 5 g Tube 57

    51 Asiklovir 200 mg Tab 1,050

    52 Asiklovir 400 mg Tab -

    53 Atropin Sulfat injeksi 0,25 mg/ml Amp -

    54 Atropin sulfat 0,5 mg Tab -

    55 Baby Cough syrup Btl -

    56 Bahan Fissur Sealent / Fuji VII Dos -

    57 Baraclude 1 mg btl/30 tab -

    58 Baraclude 0,5 mg box/30 tab -

    59 Barotec Inhaler Btl -

    60 Baycline 1 Liter Btl -

    61 Benzatin Benzil Penicillin 1,2 juta IU Vial -

    62 Besi II Sulfat 7 H2O 300 mg Tab -

    63 Besi II Sulfat + Asam Folat Tab -

    64 Betametason Cream 0,1 % Tube 25

    65 Betason N Tube -

    66 Bidan Kit paket -


    67 Bioplacenton 15 gram Tube -

    68 Bisolvon Nebulizer btl -

    69 Bisturi / non e-katalog Pcs 83

    70 Blood lanset / non e-katalog Pcs -

    71 Calsidor / Dycal Dentsply / Hydcal Technew Btl -

    72 Calsydol syrup Btl -

    73 Cat gut 3/0 Pcs -

    74 Cat gut 3/0 / E-katalog Pcs 96

    75 Cat gut 2/0 Pcs -

    76 Cat gut 2/0 / E-katalog Pcs 120

    77 Cavit / Caviton Btl -

    78 Cement Powder + Liquid / Elite Cement 100 Dos -

    79 Cefadroxil 500 mg Kaps 1,700

    80 Ceftriaxon Injeksi Vial -

    81 Cefotaxime injeksi 0,5 gram Vial 6

    82 Cefotaxime injeksi 1 gram Vial -

    83 Chlor Fenol Champer menthol /CHKM Btl -

    84 Chloramfecort Tube 5

    85 Chloramfecort H Tube 5

    86 Cimetidine 200 mg Tab 3,100

    87 Ciprofloksasine 500 mg Tab 1,500

    88 Counterpain 30 gram Tube -

    89 Curcuma Plus Syrup Btl -

    90 Darplex Tab 216

    91 Dasabion Kaps -

    92 Deksamethasone injeksi 5 mg/ml Amp 153

    93 Deksamethasone 0,5 mg Tab 2,800


    94 Dekstran 70 - Larutan Infus 6 % steril Btl -

    95 Dental Cotton Roll Bks -

    96 Dental Plak Disclosing Gel / Disclosing Solution Btl -

    97 Diazepam injeksi 5 mg/ml Amp -

    98 Diazepam 2 mg Tab -

    99 Diazepam 5 mg Tab 5

    100 Dietilkarbamsin 100 mg / NON E-KATALOG Tab -

    101 Difenhidramine Injeksi 10 mg/ml Amp 79

    102 Digoksin 0,25 mg Tab -

    103 Diltiazem HCL 30 mg Tab -

    104 Dimenhidrinat 50 mg Tab -

    105 Doksisiklin 100 mg Kaps -

    106 Domperidon Tab 200

    107 Dulcolax 5 mg Tab 30

    108 Efedrin HCL 25 mg Tab 160

    109 Elastis verban 3 inci Roll -

    110 Elastis verban 4 inci Roll -

    111 Elastis verban 6 inci Roll -

    112 Elkana Multivitamin Tab -

    113 Enervon - C Kapl -

    114 Epineprin HCL 0,1 % injeksi Amp 30

    115 Eritromicin 250 mg Kapl -

    116 Eritromicin 500 mg Kapl -

    117 Eritromicin syrup Btl -

    118 Etakridin Larutan 0,1 % 300 ml Btl 25

    119 Etanol 70 % 1 liter Btl 12

    120 Ethilklorda Semprot Btl 6


    121 Endomethasone (endosel) btl -

    122 Eugenol Btl -

    123 Fehling A Btl -

    124 Fehling B Btl -

    125 Fenobarbital injeksi 50 mg/ml Amp -

    126 Fenobarbital 30 mg Tab 200

    127 Fenobarbital 100 mg Tab -

    128 Fenoksimetil Penisilin 250 mg Tab -

    129 Fenoksimetil Penisilin 500 mg Tab -

    130 Fenol gliserol TT Btl 14

    131 Fitomenadion 10 mg Tab 260

    132 Fitomenadion injeksi 10 mg/ml Amp 22

    133 Flecher Powder + Liquid Btl -

    134 Foley cateter no 16 Pcs -

    135 Foley cateter no 18 Pcs 4

    136 Foley cateter no 20 Pcs 5

    137 Formalin solution liter -

    138 Formaldehide Merk Test kit -

    139 Formokresol Btl -

    140 Furosemida Tab -

    141 Garam Oralit Sac 525

    142 Gamexan Btl -

    143 Gentamicin Injeksi 80 mg/ml Amp -

    144 Gentamicin Salep Kulit 0,1 % Tube 65

    145 Gentian Violet 1 % Btl 41

    146 Gic Art / Fuji IX Dos -

    147 Glibenclamida 5 mg Tab 500


    148 Gliceril Guayacolat 100 mg Tab 4,200

    149 Glucosa Larutan Infus 10 % steril Btl 60

    150 Glucosa Larutan Infus 40 % steril Btl -

    151 Glucosa Larutan Infus 5 % steril Btl 102

    152 Gloves "S" Pcs -

    153 Gloves "M" Pcs -

    154 Gloves "L" Pcs -

    155 Grisofulvin 250 mg Tab -

    156 Grisofulvin 125 mg tab 1,500

    157 Haloperidol 0,5 mg Tab -

    158 Haloperidol 1,5 mg Tab -

    159 Haloperidol 5 mg Tab -

    160 Handscoen no 6,5 Pcs 220

    161 Handscoen no 7,5 Pcs -

    162 Handscoen no 7,5 / E-katalog Pcs 209

    163 Handscoen No.7 Pcs -

    164 Handscoen no 8 Pcs -

    165 Handscoen no 8 / E-katalog Pcs -

    166 Handscoen Ginecolog Panjang Steril Pcs 10

    167 HB Sahli Pkt -

    168 Hemaviton Action Kaps -

    169 Hidrokortison Cream 2,5 % Tube 48

    170 Hidroklortiazida 25 mg Tab 1,000

    171 Ibuprofen 200 mg Tab 3,200

    172 Ibuprofen 400 mg Tab -

    173 Ibuprofen syrup/Buffec Syrup Btl 5

    174 Ictiol salep Pot 31


    175 Implant susuk KB Pcs -

    176 Infuset Micro Pcs 43

    177 Infuset Micro / e-katalog Pcs 400

    178 Infuset Macro Pcs 360

    179 Infuset Macro / e-katalog Pcs -

    180 Iodium test Btl -

    181 indikator universal ktk -

    182 IV Kateter no 18 Pcs 40

    183 IV Kateter no 18 / e-katalog Pcs -

    184 IV Kateter no 20 Pcs 286

    185 IV Kateter no 20 / E-katalog Pcs 50

    186 IV Kateter no 22 / E-katalog Pcs 270

    187 IV Kateter no 24 / E - katalog Pcs 464

    188 IV Canula No.18 Pcs -

    189 Isosorbit Dinitrat sublingual 5 mg Tab -

    190 Jarum Jahit Otot Lusin 9

    191 Jarum Jahit Kulit Lusin 9

    192 Jelly untuk USG / non e-katalog Btl 2

    193 Jelly untuk Catheter Komb. Lidokain Btl 1

    194 Kalsium Laktat 500 mg Tab 100

    195 Kalsium Gluconas Injeksi / non e-katalog Amp 5

    196 Kalnex 250 mg Kaps -

    197 Kalnex injeksi Amp -

    198 Kapas berlemak 500 gram Roll -

    199 Kapas pemb. Absorben 200 gram Roll -

    200 Kapas Pemb. Absorben 250 gram Roll 10

    201 Kapas pemb. Absorben 1000 gram Roll -


    202 Kaptopril 12,5 mg Tab -

    203 Kaptopril 25 mg Tab 800

    204 Karbamazepin 200 mg Tab -

    205 Kartu Stock Lbr 10

    206 Kasa 4 x 10 cm Roll -

    207 Kasa 4 x 6 cm Roll -

    208 Kasa 40 x 80 cm Roll -

    209 Kasa 40 x 80 cm / E-katalog 11

    210 Kasa Kompres 40/40 cm Roll -

    211 Kasa Kompres 40/40 cm / E-katalog Roll -

    212 Kasa Pembalut 2 m x 80 cm Roll -

    213 Kasa Pembalut Hidrofil 4 m x 3 cm Roll -

    214 Kasa Pembalut Hidrofil 4 m x 3 cm / E-katalog Roll 200

    215 Kasa Pembalut Hidrofil 4 m x 15 cm Roll -

    216 Kasa Pembalut Hidrofil 4 m x 15 cm / E-Katalog Roll -

    217 Kasa 16 x 16 Roll -

    218 Kasa pembalut 14 x 8 cm Roll -

    219 Kasa pembalut 10 cm Roll -

    220 Kasa pembalut 4 x 18 Roll -

    221 Kelambu Pcs -

    222 Ketamine Injeksi 10 mg/ml Vial -

    223 Ketokonazol cream 2 % Tube -

    224 Ketokonazol 200 mg Tab 1,250

    225 Ketorolac Injeksi Ampul 5

    226 Kertas EKG 3 Ukuran Roll -

    227 Kertas Perkamen / Non e-katalog Lbr 10

    228 Kina Dihidroklorida injeksi 25 % - 2 ml Amp -


    229 Kina 222 mg Tab -

    230 Klip Plastik Kecil tanpa sablon Pcs -

    231 Klip Plastik Sedang tanpa sablon Pcs -

    232 Klip Plastik Besar sablon 10 x 15 Pcs -

    233 Klip Plastik Sedang sablon 8,7 x 15 Pcs -

    234 Klip Plastik kecil sablon Pcs -

    235 Kloramfenicol 250 mg Kaps 600

    236 Kloramfenicol Salp Mata 1 % Tube 9

    237 Kloramfenicol Tetes Telinga 3 % Btl 40

    238 Klorfeniraminimaleat 4 mg Tab 4,000

    239 Klorokuin 150 mg Tab -

    240 Klorpromazin HCL injeksi i.m 25 mg/ml Amp -

    241 Klorpromazin HCL 25 mg Tab -

    242 Kodein 10 mg Tab 85

    243 Kotrimoksasol Adult 480 mg Tab 700

    244 Kotrimoksasol Pedriatic 120 mg Tab 2,400

    245 Kotrimoksasol suspensi Btl 67

    246 Lab.Kit Pkt -

    247 Lacbon 17 Tab -

    248 Lansoprazole 30 mg Kaps -

    249 Larutan Benedict Btl -

    250 Larutan Etanol Asam Btl -

    251 Larutan Gimsa stain / non e-katalog Btl -

    252 Larutan Carbofuksin Btl -

    253 Larutan Methilen Biru Btl -

    254 Larutan H2O2 Btl 1

    255 Larutan xilol Btl -


    256 Larutan HCl 0,1 N / Non e-katalog Btl -

    257 Levetran Salp Pot 12

    258 Levofloksasin 500 mg Tab -

    259 Lidocain Injeksi HCl 2 % Amp 265

    260 Lidocain Injeksi 2 % + Epineprin 1 : 80.000 - 2 ml Amp 30

    261 Livron B plex Tab -

    262 Loperamid 2 mg Tab 300

    263 Loratadin 10 mg Tab 600

    264 Lysol Btl 2

    265 Light cure Composite (etsa & bondingnya) Set -

    266 Magnesium Sulfat injeksi 20 % - 25 ml Amp 10

    267 Magnesium Sulfat injeksi 40 % - 25 ml Amp -

    268 Masker Mulut Pcs 650

    269 MDT MB Adult Blist -

    270 MDT PB Adult Blist -

    271 MDT MB Anak Blist 4

    272 MDT PB Anak Blist -

    273 Mebendazole syrup 100 mg/5 ml Btl -

    274 Mebendazole 100 mg Tab -

    275 Meloxicam 15 mg Tab -

    276 Metformin Tab -

    277 Metapex Box -

    278 Methanil Yellow Chen Kit ktk -

    279 Methilergometrin maleat 0,125 mg Tab -

    280 Methilergometrin maleat 0,200 mg - 1 ml Amp 20

    281 Methilprednisolon 4 mg Tab -

    282 Methilprednisolon 8 mg tab 900


    283 Metoclopramide injeksi 5 mg/5 ml Amp -

    284 Metoclopramide 10 mg Tab 200

    285 Metronidazol 250 mg Tab 100

    286 Metronidazol 500 mg Tab -

    287 Metronidazol infus Btl 5

    288 Mikonazole cream salp 2 % / e-katalog Tube 83

    289 Mikonazole cream salp 2 % / non e-katalog Tube -

    290 Mineral Mix Sac 40

    291 Morfin injeksi 10 mg/ml Amp -

    292 Natrium Bicarbonat 500 mg Tab -

    293 Natrium Diklofenak 25 mg Tab -

    294 Natrium Diklofenak 50 mg Tab -

    295 Natrium Klorida Larutan infus 0,9 % / e-katalog Btl 200

    296 Natrium Klorida Larutan infus 0,9 / non e-katalog Btl 120

    297 Natrium Fenitoin 100 mg Kaps -

    298 Natrium Fenitoin Injeksi / Non e-katalog Amp -

    299 Nicolin injeksi / Citicolin inj Amp -

    300 Nifedipin 10 mg Tab -

    301 Nistatin 100 000 UI Tab -

    302 Nistatin 500 000 UI Vaginal tab Tab -

    303 Nitrit Test Merk ktk -

    304 Neurovit- E Tab -

    305 Neurobion / Neurosanbe 5000 Tab -

    306 Neurobion / Neurosanbe Injeksi Amp -

    307 Obat Batuk Hitam syrup 100 ml Btl -

    308 Obat FDC Anak Pkt -

    309 Obat FDC Kategori 1 Pkt -


    310 Obat FDC Kategori 2 Pkt -

    311 Obat FDC TB sisipan Pkt -

    312 OAT Kombipak anak Pkt -

    313 OAT Kategori 1 & 3 Pkt -

    314 Oil Emersi Btl -

    315 Obat suntik KB 3 bulanan Vial -

    316 Oksitetrasiklin HCL 1 % salp mata Tube 25

    317 Oksitetrasiklin HCL 3 % salp Kulit Tube 75

    318 Oksitetrasiklin injeksi Vial -

    319 Oksitosin injeksi 10 IU/ml - 1 ml Amp 63

    320 Omeprazole 20 mg Kaps 570

    321 Papaverin injeksi 40 mg/ml Amp -

    322 Papaverin 40 mg Tab 2,000

    323 Paracetamol syrup 120 mg/5 ml Btl 40

    324 Paracetamol 500 mg Tab 2,500

    325 Parasetamol drop Btl 5

    326 Parasetamol suppositoria Supp -

    327 Penisilin procain / Procain Benzil Penicillin injeksi Vial 8

    328 Petidin injeksi 50 mg/ml Amp -

    329 Pil KB I Kombinasi Set -

    330 Pilokarpin Tetes mata 2 % Btl -

    331 Piracetam injeksi 3 g/15 ml Amp -

    332 Piracetam 1200 mg Tab -

    333 Piracetam 400 mg Tab -

    334 Pirasetam 800 mg Tab -

    335 Pirantel score base 125 mg Tab -

    336 Pirantel Syrup Btl -


    337 Piridoksin HCL 10 mg Tab 1,800

    338 Piroxicam 10 mg Tab 2,100

    339 Piroxicam 20 mg Tab 1,000

    340 Plester besar 5 yard x 2 inch Roll -

    341 Plester sedang 1,5 Inch x 5 cm Roll -

    342 Plester kecil 1,25 x 5 cm roll -

    343 Plester ( Leukoplast) 7,5 x 4,5 cm Roll 4

    344 Poligips 7,5cm Roll 5

    345 Poligips 10 cm Roll 5

    346 Poligips 15 cm Roll 5

    347 Povidon iodida larutan 10 % 30 ml Btl 3

    348 Povidon iodida larutan 10 % 300 ml Btl 5

    349 Povidon iodida larutan 10 % 1000 ml Btl 2

    350 Prednison 5 mg Tab 1,800

    351 Primakuin 15 mg Tab 100

    352 Propanolol 40 mg Tab 100

    353 Propilitiourasil 100 mg Tab 100

    354 Ranitidin 150 mg Tab 3,900

    355 Ranitidin injeksi 25 mg/2 ml Amp 19

    356 Rapid Diagnostic Test (RDT) Pcs -

    357 Reagen zealnelsen Pkt -

    358 Reserpin 0,1 mg Tab -

    359 Reserpin 0,25 mg Tab -

    360 Retinol 100.000 IU Kaps -

    361 Retinol 200.000 IU Kaps -

    362 Ringer Lactat larutan infus Btl 195

    363 Rodamin B Test Chem ktk -


    364 Safety box Lbr -

    365 Salicyl Spritus 55 ml Btl -

    366 Salbutamol 2 mg Tab 200

    367 Salbutamol 4 mg Tab -

    368 Salep 2 - 4,Komb.As.Salisilat 2% + Sulfur Praicip Pot 41

    369 Salisil Bedak Ktk 6

    370 Sanbe B-Plex Btl -

    371 Sangobion Kaps 250

    372 Santa E Tab -

    373 Scabisid Cream Tube -

    374 Serum Antibisa Ular Polivalen ( ABU I ) Vial 1

    375 Serum Antitetanus injeksi 1.500 IU ( ATS ) Vial 1

    376 Sianocobalamine injeksi 500 mcg Amp 90

    377 Sianocobalamine 50 mcg Tab 800

    378 Silk ( Benang Bedah Sutera ) Pcs -

    379 Silk ( Benang Bedah Sutera ) / e-katalog Pcs 62

    380 Slide Pcs 792

    381 Sputum pot / Non e-katalog Bh -

    382 Spongostan Ktk -

    383 Streptomisin injeksi Vial -

    384 Simvastatin 10 mg Tab -

    385 Test Kehamilan Pcs 50

    386 Tetrasiklin 250 mg Kaps -

    387 Tetrasiklin 500 mg Kaps -

    388 Thiamphenicol 500 mg Kaps -

    389 Tiamin injeksi 100 mg/ml Amp 100

    390 Tiamin HCL 50 mg Tab 2,400


    391 Topicaina topical gel / Anastesi anak Btl -

    392 Tooth stain Remover btl -

    393 Triheksifenidil 2 mg Tab -

    394 Tri Kresol Formalin /TKF Btl -

    395 Tramadol 50 mg / ml Injeksi Amp -

    396 Transfusi Set Pcs -

    397 Transfusi Set / E-katalog Pcs -

    398 Tremenza Tab -

    399 Tissue Lensa pcs -

    400 Urine bag / e-katalog Pcs 30

    401 Urine Test / Gluco Protein Test Pcs -

    402 Vitamin B - complex Tab 2,600

    403 Ventolin inj. amp 6

    404 Wing Needle no 27 Pcs -

    405 Zink Oxide Eugenol (powder+liquid/kalzinol) Btl -

    406 Zinc Dispersible 120 mg Tab 1,350

    407 Slide box Pcs -

    408 Acarbose 50 mg Tab -

    409 Asam Traneksamat Injeksi amp -

    410 Asam Traneksamat 500 mg kapl 500

    411 Bumer Pcs -

    412 Etanol 70 % 100 ml btl -

    413 Furosemide 10mg/ml injeksi Amp -

    414 Glimepiride 2 mg Tab -

    415 Jarum jahit Combinasi otot & Kulit Lusin 11

    416 Plester Besar 5 m x 4,5 cm (Leukoplast) Roll 5

    417 Povidon iodida Larutan 10 % 60 ml Btl -


    418 Semprong Pcs -

    419 Sumbu bh -

    420 Termometer Ruangan Kayu Pcs 2

    421 Sofero caps -

    422 Disposible dental needle no. 18 pcs -

    423 Disposible dental needle no. 20 Pcs -

    424 Disposible dental needle no. 25 Pcs -

    425 Jarum Citojek No. 12 Pcs -

    426 Jarum Citojek No. 16 Pcs -

    427 Resin Composite (A2+A3) Btl -

    428 Suction Rip Pcs -

    429 Levemir Injeksi / non e-katalog paket -

    430 Borax Test ktk -

    431 Novabion caps -

    432 Larutan Metanol btl -

    433 Larutan Oil Imersion 50 ml btl -

    434 Alkohol Swap Pkt -

    435 Aquadest 600 ml Btl -

    436 Alat Tes Darah Multifungsi Pkt -

    437 Stik Gula Darah Pkt -

    438 Stik Kolesterol Pkt -

    439 Stik Asam Urat Pkt -

    440 Miniaspi 80 mg (Asetosal 80 mg) Tab 500

    441 Isoniazid 100 mg Tab -

    442 Rantin injeksi (Ranitidin inj. 25 mg/ml)Non E. Amp -

    443 Nexa 500 mg (Asam Traneksamat) Non E. Tab -

    444 Sotatic Injeksi (Metoclopramide inj. 5 mg/ml) Non E. Amp -


    445 Salbron 2 mg (Salbutamol 2 mg) Non E. Tab -

    446 Pehacain Inj. (Lidocain Comb.) Amp -

    447 Otoryl 25 Mg (Kaptopril 25 mg) Tab -

    448 Asam Folat 1 mg Tab 900

    449 Azitromycin 500 mg Tab -

    450 Ciprofloksasine Injeksi Btl -

    451 Amlodipin 10 mg Tab -

    452 Dentin Conditioner Minipack Box -

    453 Stesolit Rectal / Diazepam rectal Supp -

    454 Paracetamol Infus 100 ml Btl -

    455 Cetrizine 10 mg Tab -

    VAKSIN
    1 HBo Vial 5

    2 BCG Amp 2

    3 Polio Vial 6

    4 DPT-HB Vial 3

    5 Pantavalen Vial -

    6 Campak Vial 2

    7 TT Vial -

    8 DT Vial 8

    9 TD Vial -

    10 ADS 0,5 Vial -

    11 ADS 0,05 Vial -

    12 Pelarut BCG Amp 2

    13 Pelarut Campak Amp 3


    Poli Umum
    Kunjungan Resep

    UMUM

    BAYAR
    JUMLAH KUNJUNGAN RESEP

    Mengetahui Yang Menyera


    Kepala Dinas Kesehatan Kab. Alor Petugas IF

    NIP. NIP.
    PEMERINTAH KABUPATEN ALOR
    D I N A S K E S E H A T A N
    Jl. Prof. DR. W. Z. Yohanes. No. - Telp. (0386) 21052
    K A L A B A H I

    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    LAP. PEMAKAIAN O
    LEMBAR PERMINTA
    TAHUN
    TRIWULAN

    Penerimaan Persediaan Pemakaian Sisa Stok Stok Optimum

    5 6 7 9 11

    - -

    450 450

    280 280

    - -

    400 400

    - -

    400 400

    500 500

    - -

    650 650

    1,200 1,200

    - -
    10 10

    2,400 2,400

    9 9

    280 280

    - -

    - -

    50 50

    2,500 2,500

    2,000 2,000

    50 50

    - -

    - -

    3,000 3,000

    46 46

    1,600 1,600

    15 15

    41 41

    24 24

    - -

    1,000 1,000

    - -

    - -

    - -

    - -

    - -

    5 5

    3 3
    1 1

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    8,600 8,600

    2,500 2,500

    57 57

    1,050 1,050

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    25 25

    - -

    - -
    - -

    - -

    83 83

    - -

    - -

    - -

    - -

    96 96

    - -

    120 120

    - -

    - -

    1,700 1,700

    - -

    6 6

    - -

    - -

    5 5

    5 5

    3,100 3,100

    1,500 1,500

    - -

    - -

    216 216

    - -

    153 153

    2,800 2,800
    - -

    - -

    - -

    - -

    - -

    5 5

    - -

    79 79

    - -

    - -

    - -

    - -

    200 200

    30 30

    160 160

    - -

    - -

    - -

    - -

    - -

    30 30

    - -

    - -

    - -

    25 25

    12 12

    6 6
    - -

    - -

    - -

    - -

    - -

    200 200

    - -

    - -

    - -

    14 14

    260 260

    22 22

    - -

    - -

    4 4

    5 5

    - -

    - -

    - -

    - -

    525 525

    - -

    - -

    65 65

    41 41

    - -

    500 500
    4,200 4,200

    60 60

    - -

    102 102

    - -

    - -

    - -

    - -

    1,500 1,500

    - -

    - -

    - -

    220 220

    - -

    209 209

    - -

    - -

    - -

    10 10

    - -

    - -

    48 48

    1,000 1,000

    3,200 3,200

    - -

    5 5

    31 31
    - -

    43 43

    400 400

    360 360

    - -

    - -

    - -

    40 40

    - -

    286 286

    50 50

    270 270

    464 464

    - -

    - -

    9 9

    9 9

    2 2

    1 1

    100 100

    5 5

    - -

    - -

    - -

    - -

    10 10

    - -
    - -

    800 800

    - -

    10 10

    - -

    - -

    - -

    11 11

    - -

    - -

    - -

    - -

    200 200

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    1,250 1,250

    5 5

    - -

    10 10

    - -
    - -

    - -

    - -

    - -

    - -

    - -

    600 600

    9 9

    40 40

    4,000 4,000

    - -

    - -

    - -

    85 85

    700 700

    2,400 2,400

    67 67

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    1 1

    - -
    - -

    12 12

    - -

    265 265

    30 30

    - -

    300 300

    600 600

    2 2

    - -

    10 10

    - -

    650 650

    - -

    - -

    4 4

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    20 20

    - -

    900 900
    - -

    200 200

    100 100

    - -

    5 5

    83 83

    - -

    40 40

    - -

    - -

    - -

    - -

    200 200

    120 120

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -
    - -

    - -

    - -

    - -

    - -

    - -

    25 25

    75 75

    - -

    63 63

    570 570

    - -

    2,000 2,000

    40 40

    2,500 2,500

    5 5

    - -

    8 8

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -
    1,800 1,800

    2,100 2,100

    1,000 1,000

    - -

    - -

    - -

    4 4

    5 5

    5 5

    5 5

    3 3

    5 5

    2 2

    1,800 1,800

    100 100

    100 100

    100 100

    3,900 3,900

    19 19

    - -

    - -

    - -

    - -

    - -

    - -

    195 195

    - -
    - -

    - -

    200 200

    - -

    41 41

    6 6

    - -

    250 250

    - -

    - -

    1 1

    1 1

    90 90

    800 800

    - -

    62 62

    792 792

    - -

    - -

    - -

    - -

    50 50

    - -

    - -

    - -

    100 100

    2,400 2,400
    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    30 30

    - -

    2,600 2,600

    6 6

    - -

    - -

    1,350 1,350

    - -

    - -

    - -

    500 500

    - -

    - -

    - -

    - -

    11 11

    5 5

    - -
    - -

    - -

    2 2

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    500 500

    - -

    - -

    - -

    - -
    - -

    - -

    - -

    900 900

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    5 5

    2 2

    6 6

    3 3

    - -

    2 2

    - -

    8 8

    - -

    - -

    - -

    2 2

    3 3
    Sumber / Asal Resep
    Poli Gigi KIA KB Raeat Inap UGD

    MUM
    ASKES JUMLAH
    TIDAK BAYAR Dokter

    ang Menyerahkan Yang Meminta


    Petugas IFK Kepala Puskesmas

    NIP.
    LPO)

    P. PEMAKAIAN OBAT BULAN : MEI


    MBAR PERMINTAAN OBAT BULAN :
    : 2019
    :

    permintaan pemberian KET

    12 14 16
    Total Resep ke Apotik
    Pusling, Posyandu, dll Bulan Ini Kumulatif s/d Bulan ini

    - #VALUE!

    Pemberi Resep
    Perawat Bidan Perawat Gigi

    Yang Menerima
    Petugas Puskesmas

    NIP.
    ……………………….,
    ………………………………………
    ……………………….,
    …………………………………………………………
    LA

    NAMA PUSKESMAS :
    KABUPATEN : ALOR
    KECAMATAN :

    No Nama Obat Satuan Stok awal

    1 2 3 4

    1 Adona Injensi -
    Amp
    2 Alat Suntik Sekali Pakai 2,5 ml Pcs 450

    3 Alat Suntik Sekali Pakai 5 ml Pcs 280

    4 Alat suntik sekali pakai 0,5 ml Pcs -

    5 Alat suntik sekali pakai 0,5 ml / E - Katalog Pcs 400

    6 Alat suntik sekali pakai 0,05 ml /non e-katalog pcs -

    7 Alat suntik sekali pakai 0,05 ml / e-katalog Pcs 400

    8 Alat suntik sekali pakai 1 ml Pcs 500

    9 Alat suntik sekali pakai10 ml Pcs -

    10 Albendazol 400 mg / non e-katalog Tab 650

    11 Allupurinol 100 mg Tab 1,200

    12 Amalgam solila / Silver Amalgam Powder + Liquid Tube -


    13 Ambroxol syrup 15 mg/ml Btl 10

    14 Ambroxol 30 mg Tab 2,400

    15 Aminofilin Injeksi 24 mg/ml Amp 9

    16 Aminofilin 200 mg / e-katalog Tab 280

    17 Aminofilin 200 mg / non e-katalog tab -

    18 Amitriptilin HCL 25 mg Tab -

    19 Amlodipin 5 mg Tab 50

    20 Amoksisilin 250 mg Kaps 2,500

    21 Amoksisilin 500 mg Kapl 2,000

    22 Amoksisilin syrup Btl 50

    23 Ampisillin injeksi 1000 mg/ml Vial -

    24 Ampisillin syrup Btl -

    25 Antacida DOEN Tab 3,000

    26 Antacida DOEN Suspensi Btl 46

    27 Antalgin 500 mg Tab 1,600

    28 Antalgin injeksi Amp 15

    29 Anti Bakteri DOEN / Basitrasin Polimiksin Tube 41

    30 Anti Fungi DOEN Salep 30 g ( Salp 3 - 6 ) Pot 24

    31 Anti Haemoroid DOEN Suppositoria Supp -

    32 Anti Malaria DOEN ( SulDox ) Tab 1,000

    33 Anti Migraen / Ergotamin 1 mg + Coffein 50 mg Tab -

    34 Anti Sera A Btl -

    35 Anti Sera B Btl -

    36 Anti Sera AB Btl -

    37 Anti Sera D Btl -

    38 Aqua pro injeksi 20 ml Vial 5

    39 Aquadestilata 1000 ml Btl 3


    40 Aqua DM Bidestilata IKA ml 1

    41 Aqua DM Brataco ltr -

    42 Arsen / Devitalisasi Pasta Btl -

    43 Arterakin tab Tab -

    44 Artesunat injeksi 60 mg Vial -

    45 Artemeter injeksi Amp -

    46 Asetosal 100 mg Tab -

    47 Asetosal 500 mg Tab -

    48 Asam Ascorbat 50 mg Tab 8,600

    49 Asam Mefenamat 500 mg Kapl 2,500

    50 Asiklovir cream 5 % 5 g Tube 57

    51 Asiklovir 200 mg Tab 1,050

    52 Asiklovir 400 mg Tab -

    53 Atropin Sulfat injeksi 0,25 mg/ml Amp -

    54 Atropin sulfat 0,5 mg Tab -

    55 Baby Cough syrup Btl -

    56 Bahan Fissur Sealent / Fuji VII Dos -

    57 Baraclude 1 mg btl/30 tab -

    58 Baraclude 0,5 mg box/30 tab -

    59 Barotec Inhaler Btl -

    60 Baycline 1 Liter Btl -

    61 Benzatin Benzil Penicillin 1,2 juta IU Vial -

    62 Besi II Sulfat 7 H2O 300 mg Tab -

    63 Besi II Sulfat + Asam Folat Tab -

    64 Betametason Cream 0,1 % Tube 25

    65 Betason N Tube -

    66 Bidan Kit paket -


    67 Bioplacenton 15 gram Tube -

    68 Bisolvon Nebulizer btl -

    69 Bisturi / non e-katalog Pcs 83

    70 Blood lanset / non e-katalog Pcs -

    71 Calsidor / Dycal Dentsply / Hydcal Technew Btl -

    72 Calsydol syrup Btl -

    73 Cat gut 3/0 Pcs -

    74 Cat gut 3/0 / E-katalog Pcs 96

    75 Cat gut 2/0 Pcs -

    76 Cat gut 2/0 / E-katalog Pcs 120

    77 Cavit / Caviton Btl -

    78 Cement Powder + Liquid / Elite Cement 100 Dos -

    79 Cefadroxil 500 mg Kaps 1,700

    80 Ceftriaxon Injeksi Vial -

    81 Cefotaxime injeksi 0,5 gram Vial 6

    82 Cefotaxime injeksi 1 gram Vial -

    83 Chlor Fenol Champer menthol /CHKM Btl -

    84 Chloramfecort Tube 5

    85 Chloramfecort H Tube 5

    86 Cimetidine 200 mg Tab 3,100

    87 Ciprofloksasine 500 mg Tab 1,500

    88 Counterpain 30 gram Tube -

    89 Curcuma Plus Syrup Btl -

    90 Darplex Tab 216

    91 Dasabion Kaps -

    92 Deksamethasone injeksi 5 mg/ml Amp 153

    93 Deksamethasone 0,5 mg Tab 2,800


    94 Dekstran 70 - Larutan Infus 6 % steril Btl -

    95 Dental Cotton Roll Bks -

    96 Dental Plak Disclosing Gel / Disclosing Solution Btl -

    97 Diazepam injeksi 5 mg/ml Amp -

    98 Diazepam 2 mg Tab -

    99 Diazepam 5 mg Tab 5

    100 Dietilkarbamsin 100 mg / NON E-KATALOG Tab -

    101 Difenhidramine Injeksi 10 mg/ml Amp 79

    102 Digoksin 0,25 mg Tab -

    103 Diltiazem HCL 30 mg Tab -

    104 Dimenhidrinat 50 mg Tab -

    105 Doksisiklin 100 mg Kaps -

    106 Domperidon Tab 200

    107 Dulcolax 5 mg Tab 30

    108 Efedrin HCL 25 mg Tab 160

    109 Elastis verban 3 inci Roll -

    110 Elastis verban 4 inci Roll -

    111 Elastis verban 6 inci Roll -

    112 Elkana Multivitamin Tab -

    113 Enervon - C Kapl -

    114 Epineprin HCL 0,1 % injeksi Amp 30

    115 Eritromicin 250 mg Kapl -

    116 Eritromicin 500 mg Kapl -

    117 Eritromicin syrup Btl -

    118 Etakridin Larutan 0,1 % 300 ml Btl 25

    119 Etanol 70 % 1 liter Btl 12

    120 Ethilklorda Semprot Btl 6


    121 Endomethasone (endosel) btl -

    122 Eugenol Btl -

    123 Fehling A Btl -

    124 Fehling B Btl -

    125 Fenobarbital injeksi 50 mg/ml Amp -

    126 Fenobarbital 30 mg Tab 200

    127 Fenobarbital 100 mg Tab -

    128 Fenoksimetil Penisilin 250 mg Tab -

    129 Fenoksimetil Penisilin 500 mg Tab -

    130 Fenol gliserol TT Btl 14

    131 Fitomenadion 10 mg Tab 260

    132 Fitomenadion injeksi 10 mg/ml Amp 22

    133 Flecher Powder + Liquid Btl -

    134 Foley cateter no 16 Pcs -

    135 Foley cateter no 18 Pcs 4

    136 Foley cateter no 20 Pcs 5

    137 Formalin solution liter -

    138 Formaldehide Merk Test kit -

    139 Formokresol Btl -

    140 Furosemida Tab -

    141 Garam Oralit Sac 525

    142 Gamexan Btl -

    143 Gentamicin Injeksi 80 mg/ml Amp -

    144 Gentamicin Salep Kulit 0,1 % Tube 65

    145 Gentian Violet 1 % Btl 41

    146 Gic Art / Fuji IX Dos -

    147 Glibenclamida 5 mg Tab 500


    148 Gliceril Guayacolat 100 mg Tab 4,200

    149 Glucosa Larutan Infus 10 % steril Btl 60

    150 Glucosa Larutan Infus 40 % steril Btl -

    151 Glucosa Larutan Infus 5 % steril Btl 102

    152 Gloves "S" Pcs -

    153 Gloves "M" Pcs -

    154 Gloves "L" Pcs -

    155 Grisofulvin 250 mg Tab -

    156 Grisofulvin 125 mg tab 1,500

    157 Haloperidol 0,5 mg Tab -

    158 Haloperidol 1,5 mg Tab -

    159 Haloperidol 5 mg Tab -

    160 Handscoen no 6,5 Pcs 220

    161 Handscoen no 7,5 Pcs -

    162 Handscoen no 7,5 / E-katalog Pcs 209

    163 Handscoen No.7 Pcs -

    164 Handscoen no 8 Pcs -

    165 Handscoen no 8 / E-katalog Pcs -

    166 Handscoen Ginecolog Panjang Steril Pcs 10

    167 HB Sahli Pkt -

    168 Hemaviton Action Kaps -

    169 Hidrokortison Cream 2,5 % Tube 48

    170 Hidroklortiazida 25 mg Tab 1,000

    171 Ibuprofen 200 mg Tab 3,200

    172 Ibuprofen 400 mg Tab -

    173 Ibuprofen syrup/Buffec Syrup Btl 5

    174 Ictiol salep Pot 31


    175 Implant susuk KB Pcs -

    176 Infuset Micro Pcs 43

    177 Infuset Micro / e-katalog Pcs 400

    178 Infuset Macro Pcs 360

    179 Infuset Macro / e-katalog Pcs -

    180 Iodium test Btl -

    181 indikator universal ktk -

    182 IV Kateter no 18 Pcs 40

    183 IV Kateter no 18 / e-katalog Pcs -

    184 IV Kateter no 20 Pcs 286

    185 IV Kateter no 20 / E-katalog Pcs 50

    186 IV Kateter no 22 / E-katalog Pcs 270

    187 IV Kateter no 24 / E - katalog Pcs 464

    188 IV Canula No.18 Pcs -

    189 Isosorbit Dinitrat sublingual 5 mg Tab -

    190 Jarum Jahit Otot Lusin 9

    191 Jarum Jahit Kulit Lusin 9

    192 Jelly untuk USG / non e-katalog Btl 2

    193 Jelly untuk Catheter Komb. Lidokain Btl 1

    194 Kalsium Laktat 500 mg Tab 100

    195 Kalsium Gluconas Injeksi / non e-katalog Amp 5

    196 Kalnex 250 mg Kaps -

    197 Kalnex injeksi Amp -

    198 Kapas berlemak 500 gram Roll -

    199 Kapas pemb. Absorben 200 gram Roll -

    200 Kapas Pemb. Absorben 250 gram Roll 10

    201 Kapas pemb. Absorben 1000 gram Roll -


    202 Kaptopril 12,5 mg Tab -

    203 Kaptopril 25 mg Tab 800

    204 Karbamazepin 200 mg Tab -

    205 Kartu Stock Lbr 10

    206 Kasa 4 x 10 cm Roll -

    207 Kasa 4 x 6 cm Roll -

    208 Kasa 40 x 80 cm Roll -

    209 Kasa 40 x 80 cm / E-katalog 11

    210 Kasa Kompres 40/40 cm Roll -

    211 Kasa Kompres 40/40 cm / E-katalog Roll -

    212 Kasa Pembalut 2 m x 80 cm Roll -

    213 Kasa Pembalut Hidrofil 4 m x 3 cm Roll -

    214 Kasa Pembalut Hidrofil 4 m x 3 cm / E-katalog Roll 200

    215 Kasa Pembalut Hidrofil 4 m x 15 cm Roll -

    216 Kasa Pembalut Hidrofil 4 m x 15 cm / E-Katalog Roll -

    217 Kasa 16 x 16 Roll -

    218 Kasa pembalut 14 x 8 cm Roll -

    219 Kasa pembalut 10 cm Roll -

    220 Kasa pembalut 4 x 18 Roll -

    221 Kelambu Pcs -

    222 Ketamine Injeksi 10 mg/ml Vial -

    223 Ketokonazol cream 2 % Tube -

    224 Ketokonazol 200 mg Tab 1,250

    225 Ketorolac Injeksi Ampul 5

    226 Kertas EKG 3 Ukuran Roll -

    227 Kertas Perkamen / Non e-katalog Lbr 10

    228 Kina Dihidroklorida injeksi 25 % - 2 ml Amp -


    229 Kina 222 mg Tab -

    230 Klip Plastik Kecil tanpa sablon Pcs -

    231 Klip Plastik Sedang tanpa sablon Pcs -

    232 Klip Plastik Besar sablon 10 x 15 Pcs -

    233 Klip Plastik Sedang sablon 8,7 x 15 Pcs -

    234 Klip Plastik kecil sablon Pcs -

    235 Kloramfenicol 250 mg Kaps 600

    236 Kloramfenicol Salp Mata 1 % Tube 9

    237 Kloramfenicol Tetes Telinga 3 % Btl 40

    238 Klorfeniraminimaleat 4 mg Tab 4,000

    239 Klorokuin 150 mg Tab -

    240 Klorpromazin HCL injeksi i.m 25 mg/ml Amp -

    241 Klorpromazin HCL 25 mg Tab -

    242 Kodein 10 mg Tab 85

    243 Kotrimoksasol Adult 480 mg Tab 700

    244 Kotrimoksasol Pedriatic 120 mg Tab 2,400

    245 Kotrimoksasol suspensi Btl 67

    246 Lab.Kit Pkt -

    247 Lacbon 17 Tab -

    248 Lansoprazole 30 mg Kaps -

    249 Larutan Benedict Btl -

    250 Larutan Etanol Asam Btl -

    251 Larutan Gimsa stain / non e-katalog Btl -

    252 Larutan Carbofuksin Btl -

    253 Larutan Methilen Biru Btl -

    254 Larutan H2O2 Btl 1

    255 Larutan xilol Btl -


    256 Larutan HCl 0,1 N / Non e-katalog Btl -

    257 Levetran Salp Pot 12

    258 Levofloksasin 500 mg Tab -

    259 Lidocain Injeksi HCl 2 % Amp 265

    260 Lidocain Injeksi 2 % + Epineprin 1 : 80.000 - 2 ml Amp 30

    261 Livron B plex Tab -

    262 Loperamid 2 mg Tab 300

    263 Loratadin 10 mg Tab 600

    264 Lysol Btl 2

    265 Light cure Composite (etsa & bondingnya) Set -

    266 Magnesium Sulfat injeksi 20 % - 25 ml Amp 10

    267 Magnesium Sulfat injeksi 40 % - 25 ml Amp -

    268 Masker Mulut Pcs 650

    269 MDT MB Adult Blist -

    270 MDT PB Adult Blist -

    271 MDT MB Anak Blist 4

    272 MDT PB Anak Blist -

    273 Mebendazole syrup 100 mg/5 ml Btl -

    274 Mebendazole 100 mg Tab -

    275 Meloxicam 15 mg Tab -

    276 Metformin Tab -

    277 Metapex Box -

    278 Methanil Yellow Chen Kit ktk -

    279 Methilergometrin maleat 0,125 mg Tab -

    280 Methilergometrin maleat 0,200 mg - 1 ml Amp 20

    281 Methilprednisolon 4 mg Tab -

    282 Methilprednisolon 8 mg tab 900


    283 Metoclopramide injeksi 5 mg/5 ml Amp -

    284 Metoclopramide 10 mg Tab 200

    285 Metronidazol 250 mg Tab 100

    286 Metronidazol 500 mg Tab -

    287 Metronidazol infus Btl 5

    288 Mikonazole cream salp 2 % / e-katalog Tube 83

    289 Mikonazole cream salp 2 % / non e-katalog Tube -

    290 Mineral Mix Sac 40

    291 Morfin injeksi 10 mg/ml Amp -

    292 Natrium Bicarbonat 500 mg Tab -

    293 Natrium Diklofenak 25 mg Tab -

    294 Natrium Diklofenak 50 mg Tab -

    295 Natrium Klorida Larutan infus 0,9 % / e-katalog Btl 200

    296 Natrium Klorida Larutan infus 0,9 / non e-katalog Btl 120

    297 Natrium Fenitoin 100 mg Kaps -

    298 Natrium Fenitoin Injeksi / Non e-katalog Amp -

    299 Nicolin injeksi / Citicolin inj Amp -

    300 Nifedipin 10 mg Tab -

    301 Nistatin 100 000 UI Tab -

    302 Nistatin 500 000 UI Vaginal tab Tab -

    303 Nitrit Test Merk ktk -

    304 Neurovit- E Tab -

    305 Neurobion / Neurosanbe 5000 Tab -

    306 Neurobion / Neurosanbe Injeksi Amp -

    307 Obat Batuk Hitam syrup 100 ml Btl -

    308 Obat FDC Anak Pkt -

    309 Obat FDC Kategori 1 Pkt -


    310 Obat FDC Kategori 2 Pkt -

    311 Obat FDC TB sisipan Pkt -

    312 OAT Kombipak anak Pkt -

    313 OAT Kategori 1 & 3 Pkt -

    314 Oil Emersi Btl -

    315 Obat suntik KB 3 bulanan Vial -

    316 Oksitetrasiklin HCL 1 % salp mata Tube 25

    317 Oksitetrasiklin HCL 3 % salp Kulit Tube 75

    318 Oksitetrasiklin injeksi Vial -

    319 Oksitosin injeksi 10 IU/ml - 1 ml Amp 63

    320 Omeprazole 20 mg Kaps 570

    321 Papaverin injeksi 40 mg/ml Amp -

    322 Papaverin 40 mg Tab 2,000

    323 Paracetamol syrup 120 mg/5 ml Btl 40

    324 Paracetamol 500 mg Tab 2,500

    325 Parasetamol drop Btl 5

    326 Parasetamol suppositoria Supp -

    327 Penisilin procain / Procain Benzil Penicillin injeksi Vial 8

    328 Petidin injeksi 50 mg/ml Amp -

    329 Pil KB I Kombinasi Set -

    330 Pilokarpin Tetes mata 2 % Btl -

    331 Piracetam injeksi 3 g/15 ml Amp -

    332 Piracetam 1200 mg Tab -

    333 Piracetam 400 mg Tab -

    334 Pirasetam 800 mg Tab -

    335 Pirantel score base 125 mg Tab -

    336 Pirantel Syrup Btl -


    337 Piridoksin HCL 10 mg Tab 1,800

    338 Piroxicam 10 mg Tab 2,100

    339 Piroxicam 20 mg Tab 1,000

    340 Plester besar 5 yard x 2 inch Roll -

    341 Plester sedang 1,5 Inch x 5 cm Roll -

    342 Plester kecil 1,25 x 5 cm roll -

    343 Plester ( Leukoplast) 7,5 x 4,5 cm Roll 4

    344 Poligips 7,5cm Roll 5

    345 Poligips 10 cm Roll 5

    346 Poligips 15 cm Roll 5

    347 Povidon iodida larutan 10 % 30 ml Btl 3

    348 Povidon iodida larutan 10 % 300 ml Btl 5

    349 Povidon iodida larutan 10 % 1000 ml Btl 2

    350 Prednison 5 mg Tab 1,800

    351 Primakuin 15 mg Tab 100

    352 Propanolol 40 mg Tab 100

    353 Propilitiourasil 100 mg Tab 100

    354 Ranitidin 150 mg Tab 3,900

    355 Ranitidin injeksi 25 mg/2 ml Amp 19

    356 Rapid Diagnostic Test (RDT) Pcs -

    357 Reagen zealnelsen Pkt -

    358 Reserpin 0,1 mg Tab -

    359 Reserpin 0,25 mg Tab -

    360 Retinol 100.000 IU Kaps -

    361 Retinol 200.000 IU Kaps -

    362 Ringer Lactat larutan infus Btl 195

    363 Rodamin B Test Chem ktk -


    364 Safety box Lbr -

    365 Salicyl Spritus 55 ml Btl -

    366 Salbutamol 2 mg Tab 200

    367 Salbutamol 4 mg Tab -

    368 Salep 2 - 4,Komb.As.Salisilat 2% + Sulfur Praicip Pot 41

    369 Salisil Bedak Ktk 6

    370 Sanbe B-Plex Btl -

    371 Sangobion Kaps 250

    372 Santa E Tab -

    373 Scabisid Cream Tube -

    374 Serum Antibisa Ular Polivalen ( ABU I ) Vial 1

    375 Serum Antitetanus injeksi 1.500 IU ( ATS ) Vial 1

    376 Sianocobalamine injeksi 500 mcg Amp 90

    377 Sianocobalamine 50 mcg Tab 800

    378 Silk ( Benang Bedah Sutera ) Pcs -

    379 Silk ( Benang Bedah Sutera ) / e-katalog Pcs 62

    380 Slide Pcs 792

    381 Sputum pot / Non e-katalog Bh -

    382 Spongostan Ktk -

    383 Streptomisin injeksi Vial -

    384 Simvastatin 10 mg Tab -

    385 Test Kehamilan Pcs 50

    386 Tetrasiklin 250 mg Kaps -

    387 Tetrasiklin 500 mg Kaps -

    388 Thiamphenicol 500 mg Kaps -

    389 Tiamin injeksi 100 mg/ml Amp 100

    390 Tiamin HCL 50 mg Tab 2,400


    391 Topicaina topical gel / Anastesi anak Btl -

    392 Tooth stain Remover btl -

    393 Triheksifenidil 2 mg Tab -

    394 Tri Kresol Formalin /TKF Btl -

    395 Tramadol 50 mg / ml Injeksi Amp -

    396 Transfusi Set Pcs -

    397 Transfusi Set / E-katalog Pcs -

    398 Tremenza Tab -

    399 Tissue Lensa pcs -

    400 Urine bag / e-katalog Pcs 30

    401 Urine Test / Gluco Protein Test Pcs -

    402 Vitamin B - complex Tab 2,600

    403 Ventolin inj. amp 6

    404 Wing Needle no 27 Pcs -

    405 Zink Oxide Eugenol (powder+liquid/kalzinol) Btl -

    406 Zinc Dispersible 120 mg Tab 1,350

    407 Slide box Pcs -

    408 Acarbose 50 mg Tab -

    409 Asam Traneksamat Injeksi amp -

    410 Asam Traneksamat 500 mg kapl 500

    411 Bumer Pcs -

    412 Etanol 70 % 100 ml btl -

    413 Furosemide 10mg/ml injeksi Amp -

    414 Glimepiride 2 mg Tab -

    415 Jarum jahit Combinasi otot & Kulit Lusin 11

    416 Plester Besar 5 m x 4,5 cm (Leukoplast) Roll 5

    417 Povidon iodida Larutan 10 % 60 ml Btl -


    418 Semprong Pcs -

    419 Sumbu bh -

    420 Termometer Ruangan Kayu Pcs 2

    421 Sofero caps -

    422 Disposible dental needle no. 18 pcs -

    423 Disposible dental needle no. 20 Pcs -

    424 Disposible dental needle no. 25 Pcs -

    425 Jarum Citojek No. 12 Pcs -

    426 Jarum Citojek No. 16 Pcs -

    427 Resin Composite (A2+A3) Btl -

    428 Suction Rip Pcs -

    429 Levemir Injeksi / non e-katalog paket -

    430 Borax Test ktk -

    431 Novabion caps -

    432 Larutan Metanol btl -

    433 Larutan Oil Imersion 50 ml btl -

    434 Alkohol Swap Pkt -

    435 Aquadest 600 ml Btl -

    436 Alat Tes Darah Multifungsi Pkt -

    437 Stik Gula Darah Pkt -

    438 Stik Kolesterol Pkt -

    439 Stik Asam Urat Pkt -

    440 Miniaspi 80 mg (Asetosal 80 mg) Tab 500

    441 Isoniazid 100 mg Tab -

    442 Rantin injeksi (Ranitidin inj. 25 mg/ml)Non E. Amp -

    443 Nexa 500 mg (Asam Traneksamat) Non E. Tab -

    444 Sotatic Injeksi (Metoclopramide inj. 5 mg/ml) Non E. Amp -


    445 Salbron 2 mg (Salbutamol 2 mg) Non E. Tab -

    446 Pehacain Inj. (Lidocain Comb.) Amp -

    447 Otoryl 25 Mg (Kaptopril 25 mg) Tab -

    448 Asam Folat 1 mg Tab 900

    449 Azitromycin 500 mg Tab -

    450 Ciprofloksasine Injeksi Btl -

    451 Amlodipin 10 mg Tab -

    452 Dentin Conditioner Minipack Box -

    453 Stesolit Rectal / Diazepam rectal Supp -

    454 Paracetamol Infus 100 ml Btl -

    455 Cetrizine 10 mg Tab -

    VAKSIN
    1 HBo Vial 5

    2 BCG Amp 2

    3 Polio Vial 6

    4 DPT-HB Vial 3

    5 Pantavalen Vial -

    6 Campak Vial 2

    7 TT Vial -

    8 DT Vial 8

    9 TD Vial -

    10 ADS 0,5 Vial -

    11 ADS 0,05 Vial -

    12 Pelarut BCG Amp 2

    13 Pelarut Campak Amp 3


    Poli Umum
    Kunjungan Resep

    UMUM

    BAYAR
    JUMLAH KUNJUNGAN RESEP

    Mengetahui Yang Menyera


    Kepala Dinas Kesehatan Kab. Alor Petugas IF

    NIP. NIP.
    PEMERINTAH KABUPATEN ALOR
    D I N A S K E S E H A T A N
    Jl. Prof. DR. W. Z. Yohanes. No. - Telp. (0386) 21052
    K A L A B A H I

    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    LAP. PEMAKAIAN O
    LEMBAR PERMINTA
    TAHUN
    TRIWULAN

    Penerimaan Persediaan Pemakaian Sisa Stok Stok Optimum

    5 6 7 9 11

    - -

    450 450

    280 280

    - -

    400 400

    - -

    400 400

    500 500

    - -

    650 650

    1,200 1,200

    - -
    10 10

    2,400 2,400

    9 9

    280 280

    - -

    - -

    50 50

    2,500 2,500

    2,000 2,000

    50 50

    - -

    - -

    3,000 3,000

    46 46

    1,600 1,600

    15 15

    41 41

    24 24

    - -

    1,000 1,000

    - -

    - -

    - -

    - -

    - -

    5 5

    3 3
    1 1

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    8,600 8,600

    2,500 2,500

    57 57

    1,050 1,050

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    25 25

    - -

    - -
    - -

    - -

    83 83

    - -

    - -

    - -

    - -

    96 96

    - -

    120 120

    - -

    - -

    1,700 1,700

    - -

    6 6

    - -

    - -

    5 5

    5 5

    3,100 3,100

    1,500 1,500

    - -

    - -

    216 216

    - -

    153 153

    2,800 2,800
    - -

    - -

    - -

    - -

    - -

    5 5

    - -

    79 79

    - -

    - -

    - -

    - -

    200 200

    30 30

    160 160

    - -

    - -

    - -

    - -

    - -

    30 30

    - -

    - -

    - -

    25 25

    12 12

    6 6
    - -

    - -

    - -

    - -

    - -

    200 200

    - -

    - -

    - -

    14 14

    260 260

    22 22

    - -

    - -

    4 4

    5 5

    - -

    - -

    - -

    - -

    525 525

    - -

    - -

    65 65

    41 41

    - -

    500 500
    4,200 4,200

    60 60

    - -

    102 102

    - -

    - -

    - -

    - -

    1,500 1,500

    - -

    - -

    - -

    220 220

    - -

    209 209

    - -

    - -

    - -

    10 10

    - -

    - -

    48 48

    1,000 1,000

    3,200 3,200

    - -

    5 5

    31 31
    - -

    43 43

    400 400

    360 360

    - -

    - -

    - -

    40 40

    - -

    286 286

    50 50

    270 270

    464 464

    - -

    - -

    9 9

    9 9

    2 2

    1 1

    100 100

    5 5

    - -

    - -

    - -

    - -

    10 10

    - -
    - -

    800 800

    - -

    10 10

    - -

    - -

    - -

    11 11

    - -

    - -

    - -

    - -

    200 200

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    1,250 1,250

    5 5

    - -

    10 10

    - -
    - -

    - -

    - -

    - -

    - -

    - -

    600 600

    9 9

    40 40

    4,000 4,000

    - -

    - -

    - -

    85 85

    700 700

    2,400 2,400

    67 67

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    1 1

    - -
    - -

    12 12

    - -

    265 265

    30 30

    - -

    300 300

    600 600

    2 2

    - -

    10 10

    - -

    650 650

    - -

    - -

    4 4

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    20 20

    - -

    900 900
    - -

    200 200

    100 100

    - -

    5 5

    83 83

    - -

    40 40

    - -

    - -

    - -

    - -

    200 200

    120 120

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -
    - -

    - -

    - -

    - -

    - -

    - -

    25 25

    75 75

    - -

    63 63

    570 570

    - -

    2,000 2,000

    40 40

    2,500 2,500

    5 5

    - -

    8 8

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -
    1,800 1,800

    2,100 2,100

    1,000 1,000

    - -

    - -

    - -

    4 4

    5 5

    5 5

    5 5

    3 3

    5 5

    2 2

    1,800 1,800

    100 100

    100 100

    100 100

    3,900 3,900

    19 19

    - -

    - -

    - -

    - -

    - -

    - -

    195 195

    - -
    - -

    - -

    200 200

    - -

    41 41

    6 6

    - -

    250 250

    - -

    - -

    1 1

    1 1

    90 90

    800 800

    - -

    62 62

    792 792

    - -

    - -

    - -

    - -

    50 50

    - -

    - -

    - -

    100 100

    2,400 2,400
    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    30 30

    - -

    2,600 2,600

    6 6

    - -

    - -

    1,350 1,350

    - -

    - -

    - -

    500 500

    - -

    - -

    - -

    - -

    11 11

    5 5

    - -
    - -

    - -

    2 2

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    500 500

    - -

    - -

    - -

    - -
    - -

    - -

    - -

    900 900

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    5 5

    2 2

    6 6

    3 3

    - -

    2 2

    - -

    8 8

    - -

    - -

    - -

    2 2

    3 3
    Sumber / Asal Resep
    Poli Gigi KIA KB Raeat Inap UGD

    MUM
    ASKES JUMLAH
    TIDAK BAYAR Dokter

    ang Menyerahkan Yang Meminta


    Petugas IFK Kepala Puskesmas

    NIP.
    LPO)

    P. PEMAKAIAN OBAT BULAN : JUNI


    MBAR PERMINTAAN OBAT BULAN :
    : 2019
    :

    permintaan pemberian KET

    12 14 16
    Total Resep ke Apotik
    Pusling, Posyandu, dll Bulan Ini Kumulatif s/d Bulan ini

    - #VALUE!

    Pemberi Resep
    Perawat Bidan Perawat Gigi

    Yang Menerima
    Petugas Puskesmas

    NIP.
    ……………………….,
    ………………………………………
    ……………………….,
    …………………………………………………………
    LA

    NAMA PUSKESMAS :
    KABUPATEN : ALOR
    KECAMATAN :

    No Nama Obat Satuan Stok awal

    1 2 3 4

    1 Adona Injensi -
    Amp
    2 Alat Suntik Sekali Pakai 2,5 ml Pcs 450

    3 Alat Suntik Sekali Pakai 5 ml Pcs 280

    4 Alat suntik sekali pakai 0,5 ml Pcs -

    5 Alat suntik sekali pakai 0,5 ml / E - Katalog Pcs 400

    6 Alat suntik sekali pakai 0,05 ml /non e-katalog pcs -

    7 Alat suntik sekali pakai 0,05 ml / e-katalog Pcs 400

    8 Alat suntik sekali pakai 1 ml Pcs 500

    9 Alat suntik sekali pakai10 ml Pcs -

    10 Albendazol 400 mg / non e-katalog Tab 650

    11 Allupurinol 100 mg Tab 1,200

    12 Amalgam solila / Silver Amalgam Powder + Liquid Tube -


    13 Ambroxol syrup 15 mg/ml Btl 10

    14 Ambroxol 30 mg Tab 2,400

    15 Aminofilin Injeksi 24 mg/ml Amp 9

    16 Aminofilin 200 mg / e-katalog Tab 280

    17 Aminofilin 200 mg / non e-katalog tab -

    18 Amitriptilin HCL 25 mg Tab -

    19 Amlodipin 5 mg Tab 50

    20 Amoksisilin 250 mg Kaps 2,500

    21 Amoksisilin 500 mg Kapl 2,000

    22 Amoksisilin syrup Btl 50

    23 Ampisillin injeksi 1000 mg/ml Vial -

    24 Ampisillin syrup Btl -

    25 Antacida DOEN Tab 3,000

    26 Antacida DOEN Suspensi Btl 46

    27 Antalgin 500 mg Tab 1,600

    28 Antalgin injeksi Amp 15

    29 Anti Bakteri DOEN / Basitrasin Polimiksin Tube 41

    30 Anti Fungi DOEN Salep 30 g ( Salp 3 - 6 ) Pot 24

    31 Anti Haemoroid DOEN Suppositoria Supp -

    32 Anti Malaria DOEN ( SulDox ) Tab 1,000

    33 Anti Migraen / Ergotamin 1 mg + Coffein 50 mg Tab -

    34 Anti Sera A Btl -

    35 Anti Sera B Btl -

    36 Anti Sera AB Btl -

    37 Anti Sera D Btl -

    38 Aqua pro injeksi 20 ml Vial 5

    39 Aquadestilata 1000 ml Btl 3


    40 Aqua DM Bidestilata IKA ml 1

    41 Aqua DM Brataco ltr -

    42 Arsen / Devitalisasi Pasta Btl -

    43 Arterakin tab Tab -

    44 Artesunat injeksi 60 mg Vial -

    45 Artemeter injeksi Amp -

    46 Asetosal 100 mg Tab -

    47 Asetosal 500 mg Tab -

    48 Asam Ascorbat 50 mg Tab 8,600

    49 Asam Mefenamat 500 mg Kapl 2,500

    50 Asiklovir cream 5 % 5 g Tube 57

    51 Asiklovir 200 mg Tab 1,050

    52 Asiklovir 400 mg Tab -

    53 Atropin Sulfat injeksi 0,25 mg/ml Amp -

    54 Atropin sulfat 0,5 mg Tab -

    55 Baby Cough syrup Btl -

    56 Bahan Fissur Sealent / Fuji VII Dos -

    57 Baraclude 1 mg btl/30 tab -

    58 Baraclude 0,5 mg box/30 tab -

    59 Barotec Inhaler Btl -

    60 Baycline 1 Liter Btl -

    61 Benzatin Benzil Penicillin 1,2 juta IU Vial -

    62 Besi II Sulfat 7 H2O 300 mg Tab -

    63 Besi II Sulfat + Asam Folat Tab -

    64 Betametason Cream 0,1 % Tube 25

    65 Betason N Tube -

    66 Bidan Kit paket -


    67 Bioplacenton 15 gram Tube -

    68 Bisolvon Nebulizer btl -

    69 Bisturi / non e-katalog Pcs 83

    70 Blood lanset / non e-katalog Pcs -

    71 Calsidor / Dycal Dentsply / Hydcal Technew Btl -

    72 Calsydol syrup Btl -

    73 Cat gut 3/0 Pcs -

    74 Cat gut 3/0 / E-katalog Pcs 96

    75 Cat gut 2/0 Pcs -

    76 Cat gut 2/0 / E-katalog Pcs 120

    77 Cavit / Caviton Btl -

    78 Cement Powder + Liquid / Elite Cement 100 Dos -

    79 Cefadroxil 500 mg Kaps 1,700

    80 Ceftriaxon Injeksi Vial -

    81 Cefotaxime injeksi 0,5 gram Vial 6

    82 Cefotaxime injeksi 1 gram Vial -

    83 Chlor Fenol Champer menthol /CHKM Btl -

    84 Chloramfecort Tube 5

    85 Chloramfecort H Tube 5

    86 Cimetidine 200 mg Tab 3,100

    87 Ciprofloksasine 500 mg Tab 1,500

    88 Counterpain 30 gram Tube -

    89 Curcuma Plus Syrup Btl -

    90 Darplex Tab 216

    91 Dasabion Kaps -

    92 Deksamethasone injeksi 5 mg/ml Amp 153

    93 Deksamethasone 0,5 mg Tab 2,800


    94 Dekstran 70 - Larutan Infus 6 % steril Btl -

    95 Dental Cotton Roll Bks -

    96 Dental Plak Disclosing Gel / Disclosing Solution Btl -

    97 Diazepam injeksi 5 mg/ml Amp -

    98 Diazepam 2 mg Tab -

    99 Diazepam 5 mg Tab 5

    100 Dietilkarbamsin 100 mg / NON E-KATALOG Tab -

    101 Difenhidramine Injeksi 10 mg/ml Amp 79

    102 Digoksin 0,25 mg Tab -

    103 Diltiazem HCL 30 mg Tab -

    104 Dimenhidrinat 50 mg Tab -

    105 Doksisiklin 100 mg Kaps -

    106 Domperidon Tab 200

    107 Dulcolax 5 mg Tab 30

    108 Efedrin HCL 25 mg Tab 160

    109 Elastis verban 3 inci Roll -

    110 Elastis verban 4 inci Roll -

    111 Elastis verban 6 inci Roll -

    112 Elkana Multivitamin Tab -

    113 Enervon - C Kapl -

    114 Epineprin HCL 0,1 % injeksi Amp 30

    115 Eritromicin 250 mg Kapl -

    116 Eritromicin 500 mg Kapl -

    117 Eritromicin syrup Btl -

    118 Etakridin Larutan 0,1 % 300 ml Btl 25

    119 Etanol 70 % 1 liter Btl 12

    120 Ethilklorda Semprot Btl 6


    121 Endomethasone (endosel) btl -

    122 Eugenol Btl -

    123 Fehling A Btl -

    124 Fehling B Btl -

    125 Fenobarbital injeksi 50 mg/ml Amp -

    126 Fenobarbital 30 mg Tab 200

    127 Fenobarbital 100 mg Tab -

    128 Fenoksimetil Penisilin 250 mg Tab -

    129 Fenoksimetil Penisilin 500 mg Tab -

    130 Fenol gliserol TT Btl 14

    131 Fitomenadion 10 mg Tab 260

    132 Fitomenadion injeksi 10 mg/ml Amp 22

    133 Flecher Powder + Liquid Btl -

    134 Foley cateter no 16 Pcs -

    135 Foley cateter no 18 Pcs 4

    136 Foley cateter no 20 Pcs 5

    137 Formalin solution liter -

    138 Formaldehide Merk Test kit -

    139 Formokresol Btl -

    140 Furosemida Tab -

    141 Garam Oralit Sac 525

    142 Gamexan Btl -

    143 Gentamicin Injeksi 80 mg/ml Amp -

    144 Gentamicin Salep Kulit 0,1 % Tube 65

    145 Gentian Violet 1 % Btl 41

    146 Gic Art / Fuji IX Dos -

    147 Glibenclamida 5 mg Tab 500


    148 Gliceril Guayacolat 100 mg Tab 4,200

    149 Glucosa Larutan Infus 10 % steril Btl 60

    150 Glucosa Larutan Infus 40 % steril Btl -

    151 Glucosa Larutan Infus 5 % steril Btl 102

    152 Gloves "S" Pcs -

    153 Gloves "M" Pcs -

    154 Gloves "L" Pcs -

    155 Grisofulvin 250 mg Tab -

    156 Grisofulvin 125 mg tab 1,500

    157 Haloperidol 0,5 mg Tab -

    158 Haloperidol 1,5 mg Tab -

    159 Haloperidol 5 mg Tab -

    160 Handscoen no 6,5 Pcs 220

    161 Handscoen no 7,5 Pcs -

    162 Handscoen no 7,5 / E-katalog Pcs 209

    163 Handscoen No.7 Pcs -

    164 Handscoen no 8 Pcs -

    165 Handscoen no 8 / E-katalog Pcs -

    166 Handscoen Ginecolog Panjang Steril Pcs 10

    167 HB Sahli Pkt -

    168 Hemaviton Action Kaps -

    169 Hidrokortison Cream 2,5 % Tube 48

    170 Hidroklortiazida 25 mg Tab 1,000

    171 Ibuprofen 200 mg Tab 3,200

    172 Ibuprofen 400 mg Tab -

    173 Ibuprofen syrup/Buffec Syrup Btl 5

    174 Ictiol salep Pot 31


    175 Implant susuk KB Pcs -

    176 Infuset Micro Pcs 43

    177 Infuset Micro / e-katalog Pcs 400

    178 Infuset Macro Pcs 360

    179 Infuset Macro / e-katalog Pcs -

    180 Iodium test Btl -

    181 indikator universal ktk -

    182 IV Kateter no 18 Pcs 40

    183 IV Kateter no 18 / e-katalog Pcs -

    184 IV Kateter no 20 Pcs 286

    185 IV Kateter no 20 / E-katalog Pcs 50

    186 IV Kateter no 22 / E-katalog Pcs 270

    187 IV Kateter no 24 / E - katalog Pcs 464

    188 IV Canula No.18 Pcs -

    189 Isosorbit Dinitrat sublingual 5 mg Tab -

    190 Jarum Jahit Otot Lusin 9

    191 Jarum Jahit Kulit Lusin 9

    192 Jelly untuk USG / non e-katalog Btl 2

    193 Jelly untuk Catheter Komb. Lidokain Btl 1

    194 Kalsium Laktat 500 mg Tab 100

    195 Kalsium Gluconas Injeksi / non e-katalog Amp 5

    196 Kalnex 250 mg Kaps -

    197 Kalnex injeksi Amp -

    198 Kapas berlemak 500 gram Roll -

    199 Kapas pemb. Absorben 200 gram Roll -

    200 Kapas Pemb. Absorben 250 gram Roll 10

    201 Kapas pemb. Absorben 1000 gram Roll -


    202 Kaptopril 12,5 mg Tab -

    203 Kaptopril 25 mg Tab 800

    204 Karbamazepin 200 mg Tab -

    205 Kartu Stock Lbr 10

    206 Kasa 4 x 10 cm Roll -

    207 Kasa 4 x 6 cm Roll -

    208 Kasa 40 x 80 cm Roll -

    209 Kasa 40 x 80 cm / E-katalog 11

    210 Kasa Kompres 40/40 cm Roll -

    211 Kasa Kompres 40/40 cm / E-katalog Roll -

    212 Kasa Pembalut 2 m x 80 cm Roll -

    213 Kasa Pembalut Hidrofil 4 m x 3 cm Roll -

    214 Kasa Pembalut Hidrofil 4 m x 3 cm / E-katalog Roll 200

    215 Kasa Pembalut Hidrofil 4 m x 15 cm Roll -

    216 Kasa Pembalut Hidrofil 4 m x 15 cm / E-Katalog Roll -

    217 Kasa 16 x 16 Roll -

    218 Kasa pembalut 14 x 8 cm Roll -

    219 Kasa pembalut 10 cm Roll -

    220 Kasa pembalut 4 x 18 Roll -

    221 Kelambu Pcs -

    222 Ketamine Injeksi 10 mg/ml Vial -

    223 Ketokonazol cream 2 % Tube -

    224 Ketokonazol 200 mg Tab 1,250

    225 Ketorolac Injeksi Ampul 5

    226 Kertas EKG 3 Ukuran Roll -

    227 Kertas Perkamen / Non e-katalog Lbr 10

    228 Kina Dihidroklorida injeksi 25 % - 2 ml Amp -


    229 Kina 222 mg Tab -

    230 Klip Plastik Kecil tanpa sablon Pcs -

    231 Klip Plastik Sedang tanpa sablon Pcs -

    232 Klip Plastik Besar sablon 10 x 15 Pcs -

    233 Klip Plastik Sedang sablon 8,7 x 15 Pcs -

    234 Klip Plastik kecil sablon Pcs -

    235 Kloramfenicol 250 mg Kaps 600

    236 Kloramfenicol Salp Mata 1 % Tube 9

    237 Kloramfenicol Tetes Telinga 3 % Btl 40

    238 Klorfeniraminimaleat 4 mg Tab 4,000

    239 Klorokuin 150 mg Tab -

    240 Klorpromazin HCL injeksi i.m 25 mg/ml Amp -

    241 Klorpromazin HCL 25 mg Tab -

    242 Kodein 10 mg Tab 85

    243 Kotrimoksasol Adult 480 mg Tab 700

    244 Kotrimoksasol Pedriatic 120 mg Tab 2,400

    245 Kotrimoksasol suspensi Btl 67

    246 Lab.Kit Pkt -

    247 Lacbon 17 Tab -

    248 Lansoprazole 30 mg Kaps -

    249 Larutan Benedict Btl -

    250 Larutan Etanol Asam Btl -

    251 Larutan Gimsa stain / non e-katalog Btl -

    252 Larutan Carbofuksin Btl -

    253 Larutan Methilen Biru Btl -

    254 Larutan H2O2 Btl 1

    255 Larutan xilol Btl -


    256 Larutan HCl 0,1 N / Non e-katalog Btl -

    257 Levetran Salp Pot 12

    258 Levofloksasin 500 mg Tab -

    259 Lidocain Injeksi HCl 2 % Amp 265

    260 Lidocain Injeksi 2 % + Epineprin 1 : 80.000 - 2 ml Amp 30

    261 Livron B plex Tab -

    262 Loperamid 2 mg Tab 300

    263 Loratadin 10 mg Tab 600

    264 Lysol Btl 2

    265 Light cure Composite (etsa & bondingnya) Set -

    266 Magnesium Sulfat injeksi 20 % - 25 ml Amp 10

    267 Magnesium Sulfat injeksi 40 % - 25 ml Amp 500

    268 Masker Mulut Pcs 650

    269 MDT MB Adult Blist -

    270 MDT PB Adult Blist -

    271 MDT MB Anak Blist 4

    272 MDT PB Anak Blist -

    273 Mebendazole syrup 100 mg/5 ml Btl -

    274 Mebendazole 100 mg Tab -

    275 Meloxicam 15 mg Tab -

    276 Metformin Tab -

    277 Metapex Box -

    278 Methanil Yellow Chen Kit ktk -

    279 Methilergometrin maleat 0,125 mg Tab -

    280 Methilergometrin maleat 0,200 mg - 1 ml Amp 20

    281 Methilprednisolon 4 mg Tab -

    282 Methilprednisolon 8 mg tab 900


    283 Metoclopramide injeksi 5 mg/5 ml Amp -

    284 Metoclopramide 10 mg Tab 200

    285 Metronidazol 250 mg Tab 100

    286 Metronidazol 500 mg Tab -

    287 Metronidazol infus Btl 5

    288 Mikonazole cream salp 2 % / e-katalog Tube 83

    289 Mikonazole cream salp 2 % / non e-katalog Tube -

    290 Mineral Mix Sac 40

    291 Morfin injeksi 10 mg/ml Amp -

    292 Natrium Bicarbonat 500 mg Tab -

    293 Natrium Diklofenak 25 mg Tab -

    294 Natrium Diklofenak 50 mg Tab -

    295 Natrium Klorida Larutan infus 0,9 % / e-katalog Btl 200

    296 Natrium Klorida Larutan infus 0,9 / non e-katalog Btl 120

    297 Natrium Fenitoin 100 mg Kaps -

    298 Natrium Fenitoin Injeksi / Non e-katalog Amp -

    299 Nicolin injeksi / Citicolin inj Amp -

    300 Nifedipin 10 mg Tab -

    301 Nistatin 100 000 UI Tab -

    302 Nistatin 500 000 UI Vaginal tab Tab -

    303 Nitrit Test Merk ktk -

    304 Neurovit- E Tab -

    305 Neurobion / Neurosanbe 5000 Tab -

    306 Neurobion / Neurosanbe Injeksi Amp -

    307 Obat Batuk Hitam syrup 100 ml Btl -

    308 Obat FDC Anak Pkt -

    309 Obat FDC Kategori 1 Pkt -


    310 Obat FDC Kategori 2 Pkt -

    311 Obat FDC TB sisipan Pkt -

    312 OAT Kombipak anak Pkt -

    313 OAT Kategori 1 & 3 Pkt -

    314 Oil Emersi Btl -

    315 Obat suntik KB 3 bulanan Vial -

    316 Oksitetrasiklin HCL 1 % salp mata Tube 25

    317 Oksitetrasiklin HCL 3 % salp Kulit Tube 75

    318 Oksitetrasiklin injeksi Vial -

    319 Oksitosin injeksi 10 IU/ml - 1 ml Amp 63

    320 Omeprazole 20 mg Kaps 570

    321 Papaverin injeksi 40 mg/ml Amp -

    322 Papaverin 40 mg Tab 2,000

    323 Paracetamol syrup 120 mg/5 ml Btl 40

    324 Paracetamol 500 mg Tab 2,500

    325 Parasetamol drop Btl 5

    326 Parasetamol suppositoria Supp -

    327 Penisilin procain / Procain Benzil Penicillin injeksi Vial 8

    328 Petidin injeksi 50 mg/ml Amp -

    329 Pil KB I Kombinasi Set -

    330 Pilokarpin Tetes mata 2 % Btl -

    331 Piracetam injeksi 3 g/15 ml Amp -

    332 Piracetam 1200 mg Tab -

    333 Piracetam 400 mg Tab -

    334 Pirasetam 800 mg Tab -

    335 Pirantel score base 125 mg Tab -

    336 Pirantel Syrup Btl -


    337 Piridoksin HCL 10 mg Tab 1,800

    338 Piroxicam 10 mg Tab 2,100

    339 Piroxicam 20 mg Tab 1,000

    340 Plester besar 5 yard x 2 inch Roll -

    341 Plester sedang 1,5 Inch x 5 cm Roll -

    342 Plester kecil 1,25 x 5 cm roll -

    343 Plester ( Leukoplast) 7,5 x 4,5 cm Roll 4

    344 Poligips 7,5cm Roll 5

    345 Poligips 10 cm Roll 5

    346 Poligips 15 cm Roll 5

    347 Povidon iodida larutan 10 % 30 ml Btl 3

    348 Povidon iodida larutan 10 % 300 ml Btl 5

    349 Povidon iodida larutan 10 % 1000 ml Btl 2

    350 Prednison 5 mg Tab 1,800

    351 Primakuin 15 mg Tab 100

    352 Propanolol 40 mg Tab 100

    353 Propilitiourasil 100 mg Tab 100

    354 Ranitidin 150 mg Tab 3,900

    355 Ranitidin injeksi 25 mg/2 ml Amp 19

    356 Rapid Diagnostic Test (RDT) Pcs -

    357 Reagen zealnelsen Pkt -

    358 Reserpin 0,1 mg Tab -

    359 Reserpin 0,25 mg Tab -

    360 Retinol 100.000 IU Kaps -

    361 Retinol 200.000 IU Kaps -

    362 Ringer Lactat larutan infus Btl 195

    363 Rodamin B Test Chem ktk -


    364 Safety box Lbr -

    365 Salicyl Spritus 55 ml Btl -

    366 Salbutamol 2 mg Tab 200

    367 Salbutamol 4 mg Tab -

    368 Salep 2 - 4,Komb.As.Salisilat 2% + Sulfur Praicip Pot 41

    369 Salisil Bedak Ktk 6

    370 Sanbe B-Plex Btl -

    371 Sangobion Kaps 250

    372 Santa E Tab -

    373 Scabisid Cream Tube -

    374 Serum Antibisa Ular Polivalen ( ABU I ) Vial 1

    375 Serum Antitetanus injeksi 1.500 IU ( ATS ) Vial 1

    376 Sianocobalamine injeksi 500 mcg Amp 90

    377 Sianocobalamine 50 mcg Tab 800

    378 Silk ( Benang Bedah Sutera ) Pcs -

    379 Silk ( Benang Bedah Sutera ) / e-katalog Pcs 62

    380 Slide Pcs 792

    381 Sputum pot / Non e-katalog Bh -

    382 Spongostan Ktk -

    383 Streptomisin injeksi Vial -

    384 Simvastatin 10 mg Tab -

    385 Test Kehamilan Pcs 50

    386 Tetrasiklin 250 mg Kaps -

    387 Tetrasiklin 500 mg Kaps -

    388 Thiamphenicol 500 mg Kaps -

    389 Tiamin injeksi 100 mg/ml Amp 100

    390 Tiamin HCL 50 mg Tab 2,400


    391 Topicaina topical gel / Anastesi anak Btl -

    392 Tooth stain Remover btl -

    393 Triheksifenidil 2 mg Tab -

    394 Tri Kresol Formalin /TKF Btl -

    395 Tramadol 50 mg / ml Injeksi Amp -

    396 Transfusi Set Pcs -

    397 Transfusi Set / E-katalog Pcs -

    398 Tremenza Tab -

    399 Tissue Lensa pcs -

    400 Urine bag / e-katalog Pcs 30

    401 Urine Test / Gluco Protein Test Pcs -

    402 Vitamin B - complex Tab 2,600

    403 Ventolin inj. amp 6

    404 Wing Needle no 27 Pcs -

    405 Zink Oxide Eugenol (powder+liquid/kalzinol) Btl -

    406 Zinc Dispersible 120 mg Tab 1,350

    407 Slide box Pcs -

    408 Acarbose 50 mg Tab -

    409 Asam Traneksamat Injeksi amp -

    410 Asam Traneksamat 500 mg kapl 500

    411 Bumer Pcs -

    412 Etanol 70 % 100 ml btl -

    413 Furosemide 10mg/ml injeksi Amp -

    414 Glimepiride 2 mg Tab -

    415 Jarum jahit Combinasi otot & Kulit Lusin 11

    416 Plester Besar 5 m x 4,5 cm (Leukoplast) Roll 5

    417 Povidon iodida Larutan 10 % 60 ml Btl -


    418 Semprong Pcs -

    419 Sumbu bh -

    420 Termometer Ruangan Kayu Pcs 2

    421 Sofero caps -

    422 Disposible dental needle no. 18 pcs -

    423 Disposible dental needle no. 20 Pcs -

    424 Disposible dental needle no. 25 Pcs -

    425 Jarum Citojek No. 12 Pcs -

    426 Jarum Citojek No. 16 Pcs -

    427 Resin Composite (A2+A3) Btl -

    428 Suction Rip Pcs -

    429 Levemir Injeksi / non e-katalog paket -

    430 Borax Test ktk -

    431 Novabion caps -

    432 Larutan Metanol btl -

    433 Larutan Oil Imersion 50 ml btl #VALUE!

    434 Alkohol Swap Pkt -

    435 Aquadest 600 ml Btl -

    436 Alat Tes Darah Multifungsi Pkt -

    437 Stik Gula Darah Pkt -

    438 Stik Kolesterol Pkt -

    439 Stik Asam Urat Pkt -

    440 Miniaspi 80 mg (Asetosal 80 mg) Tab 500

    441 Isoniazid 100 mg Tab -

    442 Rantin injeksi (Ranitidin inj. 25 mg/ml)Non E. Amp -

    443 Nexa 500 mg (Asam Traneksamat) Non E. Tab -

    444 Sotatic Injeksi (Metoclopramide inj. 5 mg/ml) Non E. Amp -


    445 Salbron 2 mg (Salbutamol 2 mg) Non E. Tab -

    446 Pehacain Inj. (Lidocain Comb.) Amp -

    447 Otoryl 25 Mg (Kaptopril 25 mg) Tab -

    448 Asam Folat 1 mg Tab 900

    449 Azitromycin 500 mg Tab -

    450 Ciprofloksasine Injeksi Btl -

    451 Amlodipin 10 mg Tab -

    452 Dentin Conditioner Minipack Box -

    453 Stesolit Rectal / Diazepam rectal Supp -

    454 Paracetamol Infus 100 ml Btl -

    455 Cetrizine 10 mg Tab -

    VAKSIN -

    1 HBo Vial 5

    2 BCG Amp 2

    3 Polio Vial 6

    4 DPT-HB Vial 3

    5 Pantavalen Vial -

    6 Campak Vial 2

    7 TT Vial -

    8 DT Vial 8

    9 TD Vial -

    10 ADS 0,5 Vial -

    11 ADS 0,05 Vial -

    12 Pelarut BCG Amp 2

    13 Pelarut Campak Amp 3


    Poli Umum
    Kunjungan Resep
    -

    UMUM

    BAYAR
    JUMLAH KUNJUNGAN RESEP
    -

    Mengetahui Yang Menyera


    Kepala Dinas Kesehatan Kab. Alor Petugas IF

    NIP. NIP.
    PEMERINTAH KABUPATEN ALOR
    D I N A S K E S E H A T A N
    Jl. Prof. DR. W. Z. Yohanes. No. - Telp. (0386) 21052
    K A L A B A H I

    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    LAP. PEMAKAIAN O
    LEMBAR PERMINTA
    TAHUN
    TRIWULAN

    Penerimaan Persediaan Pemakaian Sisa Stok Stok Optimum

    5 6 7 9 11

    - - - -

    - 450 - 450

    - 280 - 280

    - - - -

    - 400 - 400

    - - - -

    - 400 - 400

    - 500 - 500

    - - - -

    - 650 - 650

    - 1,200 - 1,200

    - - - -
    - 10 - 10

    - 2,400 - 2,400

    - 9 - 9

    - 280 - 280

    - - - -

    - - - -

    - 50 - 50

    - 2,500 - 2,500

    - 2,000 - 2,000

    - 50 - 50

    - - - -

    - - - -

    - 3,000 - 3,000

    - 46 - 46

    - 1,600 - 1,600

    - 15 - 15

    - 41 - 41

    - 24 - 24

    - - - -

    - 1,000 - 1,000

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 5 - 5

    - 3 - 3
    - 1 - 1

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 8,600 - 8,600

    - 2,500 - 2,500

    - 57 - 57

    - 1,050 - 1,050

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 25 - 25

    - - - -

    - - - -
    - - - -

    - - - -

    - 83 - 83

    - - - -

    - - - -

    - - - -

    - - - -

    - 96 - 96

    - - - -

    - 120 - 120

    - - - -

    - - - -

    - 1,700 - 1,700

    - - - -

    - 6 - 6

    - - - -

    - - - -

    - 5 - 5

    - 5 - 5

    - 3,100 - 3,100

    - 1,500 - 1,500

    - - - -

    - - - -

    - 216 - 216

    - - - -

    - 153 - 153

    - 2,800 - 2,800
    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 5 - 5

    - - - -

    - 79 - 79

    - - - -

    - - - -

    - - - -

    - - - -

    - 200 - 200

    - 30 - 30

    - 160 - 160

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 30 - 30

    - - - -

    - - - -

    - - - -

    - 25 - 25

    - 12 - 12

    - 6 - 6
    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 200 - 200

    - - - -

    - - - -

    - - - -

    - 14 - 14

    - 260 - 260

    - 22 - 22

    - - - -

    - - - -

    - 4 - 4

    - 5 - 5

    - - - -

    - - - -

    - - - -

    - - - -

    - 525 - 525

    - - - -

    - - - -

    - 65 - 65

    - 41 - 41

    - - - -

    - 500 - 500
    - 4,200 - 4,200

    - 60 - 60

    - - - -

    - 102 - 102

    - - - -

    - - - -

    - - - -

    - - - -

    - 1,500 - 1,500

    - - - -

    - - - -

    - - - -

    - 220 - 220

    - - - -

    - 209 - 209

    - - - -

    - - - -

    - - - -

    - 10 - 10

    - - - -

    - - - -

    - 48 - 48

    - 1,000 - 1,000

    - 3,200 - 3,200

    - - - -

    - 5 - 5

    - 31 - 31
    - - - -

    - 43 - 43

    - 400 - 400

    - 360 - 360

    - - - -

    - - - -

    - - - -

    - 40 - 40

    - - - -

    - 286 - 286

    - 50 - 50

    - 270 - 270

    - 464 - 464

    - - - -

    - - - -

    - 9 - 9

    - 9 - 9

    - 2 - 2

    - 1 - 1

    - 100 - 100

    - 5 - 5

    - - - -

    - - - -

    - - - -

    - - - -

    - 10 - 10

    - - - -
    - - - -

    - 800 - 800

    - - - -

    - 10 - 10

    - - - -

    - - - -

    - - - -

    - 11 - 11

    - - - -

    - - - -

    - - - -

    - - - -

    - 200 - 200

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 1,250 - 1,250

    - 5 - 5

    - - - -

    - 10 - 10

    - - - -
    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 600 - 600

    - 9 - 9

    - 40 - 40

    - 4,000 - 4,000

    - - - -

    - - - -

    - - - -

    - 85 - 85

    - 700 - 700

    - 2,400 - 2,400

    - 67 - 67

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 1 - 1

    - - - -
    - - - -

    - 12 - 12

    - - - -

    - 265 - 265

    - 30 - 30

    - - - -

    - 300 - 300

    - 600 - 600

    - 2 - 2

    - - - -

    - 10 - 10

    - 500 - 500

    - 650 - 650

    - - - -

    - - - -

    - 4 - 4

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 20 - 20

    - - - -

    - 900 - 900
    - - - -

    - 200 - 200

    - 100 - 100

    - - - -

    - 5 - 5

    - 83 - 83

    - - - -

    - 40 - 40

    - - - -

    - - - -

    - - - -

    - - - -

    - 200 - 200

    - 120 - 120

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -
    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 25 - 25

    - 75 - 75

    - - - -

    - 63 - 63

    - 570 - 570

    - - - -

    - 2,000 - 2,000

    - 40 - 40

    - 2,500 - 2,500

    - 5 - 5

    - - - -

    - 8 - 8

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -
    - 1,800 - 1,800

    - 2,100 - 2,100

    - 1,000 - 1,000

    - - - -

    - - - -

    - - - -

    - 4 - 4

    - 5 - 5

    - 5 - 5

    - 5 - 5

    - 3 - 3

    - 5 - 5

    - 2 - 2

    - 1,800 - 1,800

    - 100 - 100

    - 100 - 100

    - 100 - 100

    - 3,900 - 3,900

    - 19 - 19

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 195 - 195

    - - - -
    - - - -

    - - - -

    - 200 - 200

    - - - -

    - 41 - 41

    - 6 - 6

    - - - -

    - 250 - 250

    - - - -

    - - - -

    - 1 - 1

    - 1 - 1

    - 90 - 90

    - 800 - 800

    - - - -

    - 62 - 62

    - 792 - 792

    - - - -

    - - - -

    - - - -

    - - - -

    - 50 - 50

    - - - -

    - - - -

    - - - -

    - 100 - 100

    - 2,400 - 2,400
    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 30 - 30

    - - - -

    - 2,600 - 2,600

    - 6 - 6

    - - - -

    - - - -

    - 1,350 - 1,350

    - - - -

    - - - -

    - - - -

    - 500 - 500

    - - - -

    - - - -

    - - - -

    - - - -

    - 11 - 11

    - 5 - 5

    - - - -
    - - - -

    - - - -

    - 2 - 2

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - #VALUE! - #VALUE!

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 500 - 500

    - - - -

    - - - -

    - - - -

    - - - -
    - - - -

    - - - -

    - - - -

    - 900 - 900

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - -

    - 5 - 5

    - 2 - 2

    - 6 - 6

    - 3 - 3

    - - - -

    - 2 - 2

    - - - -

    - 8 - 8

    - - - -

    - - - -

    - - - -

    - 2 - 2

    - 3 - 3
    Sumber / Asal Resep
    Poli Gigi KIA KB Raeat Inap UGD

    - - - - -

    MUM
    ASKES JUMLAH
    TIDAK BAYAR Dokter

    - - - -

    ang Menyerahkan Yang Meminta


    Petugas IFK Kepala Puskesmas

    NIP.
    LPO)

    P. PEMAKAIAN OBAT BULAN : APRIL S/D JUNI


    MBAR PERMINTAAN OBAT BULAN : JULI S/D SEPTEMBER
    : 2019
    : III (TIGA)

    permintaan pemberian KET

    12 14 16
    Total Resep ke Apotik
    Pusling, Posyandu, dll Bulan Ini Kumulatif s/d Bulan ini

    - - #VALUE!

    Pemberi Resep
    Perawat Bidan Perawat Gigi

    - - -

    Yang Menerima
    Petugas Puskesmas

    NIP.
    ……………………….,
    ………………………………………
    ……………………….,
    …………………………………………………………
    LA

    NAMA PUSKESMAS :
    KABUPATEN : ALOR
    KECAMATAN :

    No Nama Obat Satuan Stok awal

    1 2 3 4

    1 Adona Injensi -
    Amp
    2 Alat Suntik Sekali Pakai 2,5 ml Pcs 450

    3 Alat Suntik Sekali Pakai 5 ml Pcs 280

    4 Alat suntik sekali pakai 0,5 ml Pcs -

    5 Alat suntik sekali pakai 0,5 ml / E - Katalog Pcs 400

    6 Alat suntik sekali pakai 0,05 ml /non e-katalog pcs -

    7 Alat suntik sekali pakai 0,05 ml / e-katalog Pcs 400

    8 Alat suntik sekali pakai 1 ml Pcs 500

    9 Alat suntik sekali pakai10 ml Pcs -

    10 Albendazol 400 mg / non e-katalog Tab 650

    11 Allupurinol 100 mg Tab 1,200

    12 Amalgam solila / Silver Amalgam Powder + Liquid Tube -


    13 Ambroxol syrup 15 mg/ml Btl 10

    14 Ambroxol 30 mg Tab 2,400

    15 Aminofilin Injeksi 24 mg/ml Amp 9

    16 Aminofilin 200 mg / e-katalog Tab 280

    17 Aminofilin 200 mg / non e-katalog tab -

    18 Amitriptilin HCL 25 mg Tab -

    19 Amlodipin 5 mg Tab 50

    20 Amoksisilin 250 mg Kaps 2,500

    21 Amoksisilin 500 mg Kapl 2,000

    22 Amoksisilin syrup Btl 50

    23 Ampisillin injeksi 1000 mg/ml Vial -

    24 Ampisillin syrup Btl -

    25 Antacida DOEN Tab 3,000

    26 Antacida DOEN Suspensi Btl 46

    27 Antalgin 500 mg Tab 1,600

    28 Antalgin injeksi Amp 15

    29 Anti Bakteri DOEN / Basitrasin Polimiksin Tube 41

    30 Anti Fungi DOEN Salep 30 g ( Salp 3 - 6 ) Pot 24

    31 Anti Haemoroid DOEN Suppositoria Supp -

    32 Anti Malaria DOEN ( SulDox ) Tab 1,000

    33 Anti Migraen / Ergotamin 1 mg + Coffein 50 mg Tab -

    34 Anti Sera A Btl -

    35 Anti Sera B Btl -

    36 Anti Sera AB Btl -

    37 Anti Sera D Btl -

    38 Aqua pro injeksi 20 ml Vial 5

    39 Aquadestilata 1000 ml Btl 3


    40 Aqua DM Bidestilata IKA ml 1

    41 Aqua DM Brataco ltr -

    42 Arsen / Devitalisasi Pasta Btl -

    43 Arterakin tab Tab -

    44 Artesunat injeksi 60 mg Vial -

    45 Artemeter injeksi Amp -

    46 Asetosal 100 mg Tab -

    47 Asetosal 500 mg Tab -

    48 Asam Ascorbat 50 mg Tab 8,600

    49 Asam Mefenamat 500 mg Kapl 2,500

    50 Asiklovir cream 5 % 5 g Tube 57

    51 Asiklovir 200 mg Tab 1,050

    52 Asiklovir 400 mg Tab -

    53 Atropin Sulfat injeksi 0,25 mg/ml Amp -

    54 Atropin sulfat 0,5 mg Tab -

    55 Baby Cough syrup Btl -

    56 Bahan Fissur Sealent / Fuji VII Dos -

    57 Baraclude 1 mg btl/30 tab -

    58 Baraclude 0,5 mg box/30 tab -

    59 Barotec Inhaler Btl -

    60 Baycline 1 Liter Btl -

    61 Benzatin Benzil Penicillin 1,2 juta IU Vial -

    62 Besi II Sulfat 7 H2O 300 mg Tab -

    63 Besi II Sulfat + Asam Folat Tab -

    64 Betametason Cream 0,1 % Tube 25

    65 Betason N Tube -

    66 Bidan Kit paket -


    67 Bioplacenton 15 gram Tube -

    68 Bisolvon Nebulizer btl -

    69 Bisturi / non e-katalog Pcs 83

    70 Blood lanset / non e-katalog Pcs -

    71 Calsidor / Dycal Dentsply / Hydcal Technew Btl -

    72 Calsydol syrup Btl -

    73 Cat gut 3/0 Pcs -

    74 Cat gut 3/0 / E-katalog Pcs 96

    75 Cat gut 2/0 Pcs -

    76 Cat gut 2/0 / E-katalog Pcs 120

    77 Cavit / Caviton Btl -

    78 Cement Powder + Liquid / Elite Cement 100 Dos -

    79 Cefadroxil 500 mg Kaps 1,700

    80 Ceftriaxon Injeksi Vial -

    81 Cefotaxime injeksi 0,5 gram Vial 6

    82 Cefotaxime injeksi 1 gram Vial -

    83 Chlor Fenol Champer menthol /CHKM Btl -

    84 Chloramfecort Tube 5

    85 Chloramfecort H Tube 5

    86 Cimetidine 200 mg Tab 3,100

    87 Ciprofloksasine 500 mg Tab 1,500

    88 Counterpain 30 gram Tube -

    89 Curcuma Plus Syrup Btl -

    90 Darplex Tab 216

    91 Dasabion Kaps -

    92 Deksamethasone injeksi 5 mg/ml Amp 153

    93 Deksamethasone 0,5 mg Tab 2,800


    94 Dekstran 70 - Larutan Infus 6 % steril Btl -

    95 Dental Cotton Roll Bks -

    96 Dental Plak Disclosing Gel / Disclosing Solution Btl -

    97 Diazepam injeksi 5 mg/ml Amp -

    98 Diazepam 2 mg Tab -

    99 Diazepam 5 mg Tab 5

    100 Dietilkarbamsin 100 mg / NON E-KATALOG Tab -

    101 Difenhidramine Injeksi 10 mg/ml Amp 79

    102 Digoksin 0,25 mg Tab -

    103 Diltiazem HCL 30 mg Tab -

    104 Dimenhidrinat 50 mg Tab -

    105 Doksisiklin 100 mg Kaps -

    106 Domperidon Tab 200

    107 Dulcolax 5 mg Tab 30

    108 Efedrin HCL 25 mg Tab 160

    109 Elastis verban 3 inci Roll -

    110 Elastis verban 4 inci Roll -

    111 Elastis verban 6 inci Roll -

    112 Elkana Multivitamin Tab -

    113 Enervon - C Kapl -

    114 Epineprin HCL 0,1 % injeksi Amp 30

    115 Eritromicin 250 mg Kapl -

    116 Eritromicin 500 mg Kapl -

    117 Eritromicin syrup Btl -

    118 Etakridin Larutan 0,1 % 300 ml Btl 25

    119 Etanol 70 % 1 liter Btl 12

    120 Ethilklorda Semprot Btl 6


    121 Endomethasone (endosel) btl -

    122 Eugenol Btl -

    123 Fehling A Btl -

    124 Fehling B Btl -

    125 Fenobarbital injeksi 50 mg/ml Amp -

    126 Fenobarbital 30 mg Tab 200

    127 Fenobarbital 100 mg Tab -

    128 Fenoksimetil Penisilin 250 mg Tab -

    129 Fenoksimetil Penisilin 500 mg Tab -

    130 Fenol gliserol TT Btl 14

    131 Fitomenadion 10 mg Tab 260

    132 Fitomenadion injeksi 10 mg/ml Amp 22

    133 Flecher Powder + Liquid Btl -

    134 Foley cateter no 16 Pcs -

    135 Foley cateter no 18 Pcs 4

    136 Foley cateter no 20 Pcs 5

    137 Formalin solution liter -

    138 Formaldehide Merk Test kit -

    139 Formokresol Btl -

    140 Furosemida Tab -

    141 Garam Oralit Sac 525

    142 Gamexan Btl -

    143 Gentamicin Injeksi 80 mg/ml Amp -

    144 Gentamicin Salep Kulit 0,1 % Tube 65

    145 Gentian Violet 1 % Btl 41

    146 Gic Art / Fuji IX Dos -

    147 Glibenclamida 5 mg Tab 500


    148 Gliceril Guayacolat 100 mg Tab 4,200

    149 Glucosa Larutan Infus 10 % steril Btl 60

    150 Glucosa Larutan Infus 40 % steril Btl -

    151 Glucosa Larutan Infus 5 % steril Btl 102

    152 Gloves "S" Pcs -

    153 Gloves "M" Pcs -

    154 Gloves "L" Pcs -

    155 Grisofulvin 250 mg Tab -

    156 Grisofulvin 125 mg tab 1,500

    157 Haloperidol 0,5 mg Tab -

    158 Haloperidol 1,5 mg Tab -

    159 Haloperidol 5 mg Tab -

    160 Handscoen no 6,5 Pcs 220

    161 Handscoen no 7,5 Pcs -

    162 Handscoen no 7,5 / E-katalog Pcs 209

    163 Handscoen No.7 Pcs -

    164 Handscoen no 8 Pcs -

    165 Handscoen no 8 / E-katalog Pcs -

    166 Handscoen Ginecolog Panjang Steril Pcs 10

    167 HB Sahli Pkt -

    168 Hemaviton Action Kaps -

    169 Hidrokortison Cream 2,5 % Tube 48

    170 Hidroklortiazida 25 mg Tab 1,000

    171 Ibuprofen 200 mg Tab 3,200

    172 Ibuprofen 400 mg Tab -

    173 Ibuprofen syrup/Buffec Syrup Btl 5

    174 Ictiol salep Pot 31


    175 Implant susuk KB Pcs -

    176 Infuset Micro Pcs 43

    177 Infuset Micro / e-katalog Pcs 400

    178 Infuset Macro Pcs 360

    179 Infuset Macro / e-katalog Pcs -

    180 Iodium test Btl -

    181 indikator universal ktk -

    182 IV Kateter no 18 Pcs 40

    183 IV Kateter no 18 / e-katalog Pcs -

    184 IV Kateter no 20 Pcs 286

    185 IV Kateter no 20 / E-katalog Pcs 50

    186 IV Kateter no 22 / E-katalog Pcs 270

    187 IV Kateter no 24 / E - katalog Pcs 464

    188 IV Canula No.18 Pcs -

    189 Isosorbit Dinitrat sublingual 5 mg Tab -

    190 Jarum Jahit Otot Lusin 9

    191 Jarum Jahit Kulit Lusin 9

    192 Jelly untuk USG / non e-katalog Btl 2

    193 Jelly untuk Catheter Komb. Lidokain Btl 1

    194 Kalsium Laktat 500 mg Tab 100

    195 Kalsium Gluconas Injeksi / non e-katalog Amp 5

    196 Kalnex 250 mg Kaps -

    197 Kalnex injeksi Amp -

    198 Kapas berlemak 500 gram Roll -

    199 Kapas pemb. Absorben 200 gram Roll -

    200 Kapas Pemb. Absorben 250 gram Roll 10

    201 Kapas pemb. Absorben 1000 gram Roll -


    202 Kaptopril 12,5 mg Tab -

    203 Kaptopril 25 mg Tab 800

    204 Karbamazepin 200 mg Tab -

    205 Kartu Stock Lbr 10

    206 Kasa 4 x 10 cm Roll -

    207 Kasa 4 x 6 cm Roll -

    208 Kasa 40 x 80 cm Roll -

    209 Kasa 40 x 80 cm / E-katalog 11

    210 Kasa Kompres 40/40 cm Roll -

    211 Kasa Kompres 40/40 cm / E-katalog Roll -

    212 Kasa Pembalut 2 m x 80 cm Roll -

    213 Kasa Pembalut Hidrofil 4 m x 3 cm Roll -

    214 Kasa Pembalut Hidrofil 4 m x 3 cm / E-katalog Roll 200

    215 Kasa Pembalut Hidrofil 4 m x 15 cm Roll -

    216 Kasa Pembalut Hidrofil 4 m x 15 cm / E-Katalog Roll -

    217 Kasa 16 x 16 Roll -

    218 Kasa pembalut 14 x 8 cm Roll -

    219 Kasa pembalut 10 cm Roll -

    220 Kasa pembalut 4 x 18 Roll -

    221 Kelambu Pcs -

    222 Ketamine Injeksi 10 mg/ml Vial -

    223 Ketokonazol cream 2 % Tube -

    224 Ketokonazol 200 mg Tab 1,250

    225 Ketorolac Injeksi Ampul 5

    226 Kertas EKG 3 Ukuran Roll -

    227 Kertas Perkamen / Non e-katalog Lbr 10

    228 Kina Dihidroklorida injeksi 25 % - 2 ml Amp -


    229 Kina 222 mg Tab -

    230 Klip Plastik Kecil tanpa sablon Pcs -

    231 Klip Plastik Sedang tanpa sablon Pcs -

    232 Klip Plastik Besar sablon 10 x 15 Pcs -

    233 Klip Plastik Sedang sablon 8,7 x 15 Pcs -

    234 Klip Plastik kecil sablon Pcs -

    235 Kloramfenicol 250 mg Kaps 600

    236 Kloramfenicol Salp Mata 1 % Tube 9

    237 Kloramfenicol Tetes Telinga 3 % Btl 40

    238 Klorfeniraminimaleat 4 mg Tab 4,000

    239 Klorokuin 150 mg Tab -

    240 Klorpromazin HCL injeksi i.m 25 mg/ml Amp -

    241 Klorpromazin HCL 25 mg Tab -

    242 Kodein 10 mg Tab 85

    243 Kotrimoksasol Adult 480 mg Tab 700

    244 Kotrimoksasol Pedriatic 120 mg Tab 2,400

    245 Kotrimoksasol suspensi Btl 67

    246 Lab.Kit Pkt -

    247 Lacbon 17 Tab -

    248 Lansoprazole 30 mg Kaps -

    249 Larutan Benedict Btl -

    250 Larutan Etanol Asam Btl -

    251 Larutan Gimsa stain / non e-katalog Btl -

    252 Larutan Carbofuksin Btl -

    253 Larutan Methilen Biru Btl -

    254 Larutan H2O2 Btl 1

    255 Larutan xilol Btl -


    256 Larutan HCl 0,1 N / Non e-katalog Btl -

    257 Levetran Salp Pot 12

    258 Levofloksasin 500 mg Tab -

    259 Lidocain Injeksi HCl 2 % Amp 265

    260 Lidocain Injeksi 2 % + Epineprin 1 : 80.000 - 2 ml Amp 30

    261 Livron B plex Tab -

    262 Loperamid 2 mg Tab 300

    263 Loratadin 10 mg Tab 600

    264 Lysol Btl 2

    265 Light cure Composite (etsa & bondingnya) Set -

    266 Magnesium Sulfat injeksi 20 % - 25 ml Amp 10

    267 Magnesium Sulfat injeksi 40 % - 25 ml Amp -

    268 Masker Mulut Pcs 650

    269 MDT MB Adult Blist -

    270 MDT PB Adult Blist -

    271 MDT MB Anak Blist 4

    272 MDT PB Anak Blist -

    273 Mebendazole syrup 100 mg/5 ml Btl -

    274 Mebendazole 100 mg Tab -

    275 Meloxicam 15 mg Tab -

    276 Metformin Tab -

    277 Metapex Box -

    278 Methanil Yellow Chen Kit ktk -

    279 Methilergometrin maleat 0,125 mg Tab -

    280 Methilergometrin maleat 0,200 mg - 1 ml Amp 20

    281 Methilprednisolon 4 mg Tab -

    282 Methilprednisolon 8 mg tab 900


    283 Metoclopramide injeksi 5 mg/5 ml Amp -

    284 Metoclopramide 10 mg Tab 200

    285 Metronidazol 250 mg Tab 100

    286 Metronidazol 500 mg Tab -

    287 Metronidazol infus Btl 5

    288 Mikonazole cream salp 2 % / e-katalog Tube 83

    289 Mikonazole cream salp 2 % / non e-katalog Tube -

    290 Mineral Mix Sac 40

    291 Morfin injeksi 10 mg/ml Amp -

    292 Natrium Bicarbonat 500 mg Tab -

    293 Natrium Diklofenak 25 mg Tab -

    294 Natrium Diklofenak 50 mg Tab -

    295 Natrium Klorida Larutan infus 0,9 % / e-katalog Btl 200

    296 Natrium Klorida Larutan infus 0,9 / non e-katalog Btl 120

    297 Natrium Fenitoin 100 mg Kaps -

    298 Natrium Fenitoin Injeksi / Non e-katalog Amp -

    299 Nicolin injeksi / Citicolin inj Amp -

    300 Nifedipin 10 mg Tab -

    301 Nistatin 100 000 UI Tab -

    302 Nistatin 500 000 UI Vaginal tab Tab -

    303 Nitrit Test Merk ktk -

    304 Neurovit- E Tab -

    305 Neurobion / Neurosanbe 5000 Tab -

    306 Neurobion / Neurosanbe Injeksi Amp -

    307 Obat Batuk Hitam syrup 100 ml Btl -

    308 Obat FDC Anak Pkt -

    309 Obat FDC Kategori 1 Pkt -


    310 Obat FDC Kategori 2 Pkt -

    311 Obat FDC TB sisipan Pkt -

    312 OAT Kombipak anak Pkt -

    313 OAT Kategori 1 & 3 Pkt -

    314 Oil Emersi Btl -

    315 Obat suntik KB 3 bulanan Vial -

    316 Oksitetrasiklin HCL 1 % salp mata Tube 25

    317 Oksitetrasiklin HCL 3 % salp Kulit Tube 75

    318 Oksitetrasiklin injeksi Vial -

    319 Oksitosin injeksi 10 IU/ml - 1 ml Amp 63

    320 Omeprazole 20 mg Kaps 570

    321 Papaverin injeksi 40 mg/ml Amp -

    322 Papaverin 40 mg Tab 2,000

    323 Paracetamol syrup 120 mg/5 ml Btl 40

    324 Paracetamol 500 mg Tab 2,500

    325 Parasetamol drop Btl 5

    326 Parasetamol suppositoria Supp -

    327 Penisilin procain / Procain Benzil Penicillin injeksi Vial 8

    328 Petidin injeksi 50 mg/ml Amp -

    329 Pil KB I Kombinasi Set -

    330 Pilokarpin Tetes mata 2 % Btl -

    331 Piracetam injeksi 3 g/15 ml Amp -

    332 Piracetam 1200 mg Tab -

    333 Piracetam 400 mg Tab -

    334 Pirasetam 800 mg Tab -

    335 Pirantel score base 125 mg Tab -

    336 Pirantel Syrup Btl -


    337 Piridoksin HCL 10 mg Tab 1,800

    338 Piroxicam 10 mg Tab 2,100

    339 Piroxicam 20 mg Tab 1,000

    340 Plester besar 5 yard x 2 inch Roll -

    341 Plester sedang 1,5 Inch x 5 cm Roll -

    342 Plester kecil 1,25 x 5 cm roll -

    343 Plester ( Leukoplast) 7,5 x 4,5 cm Roll 4

    344 Poligips 7,5cm Roll 5

    345 Poligips 10 cm Roll 5

    346 Poligips 15 cm Roll 5

    347 Povidon iodida larutan 10 % 30 ml Btl 3

    348 Povidon iodida larutan 10 % 300 ml Btl 5

    349 Povidon iodida larutan 10 % 1000 ml Btl 2

    350 Prednison 5 mg Tab 1,800

    351 Primakuin 15 mg Tab 100

    352 Propanolol 40 mg Tab 100

    353 Propilitiourasil 100 mg Tab 100

    354 Ranitidin 150 mg Tab 3,900

    355 Ranitidin injeksi 25 mg/2 ml Amp 19

    356 Rapid Diagnostic Test (RDT) Pcs -

    357 Reagen zealnelsen Pkt -

    358 Reserpin 0,1 mg Tab -

    359 Reserpin 0,25 mg Tab -

    360 Retinol 100.000 IU Kaps -

    361 Retinol 200.000 IU Kaps -

    362 Ringer Lactat larutan infus Btl 195

    363 Rodamin B Test Chem ktk -


    364 Safety box Lbr -

    365 Salicyl Spritus 55 ml Btl -

    366 Salbutamol 2 mg Tab 200

    367 Salbutamol 4 mg Tab -

    368 Salep 2 - 4,Komb.As.Salisilat 2% + Sulfur Praicip Pot 41

    369 Salisil Bedak Ktk 6

    370 Sanbe B-Plex Btl -

    371 Sangobion Kaps 250

    372 Santa E Tab -

    373 Scabisid Cream Tube -

    374 Serum Antibisa Ular Polivalen ( ABU I ) Vial 1

    375 Serum Antitetanus injeksi 1.500 IU ( ATS ) Vial 1

    376 Sianocobalamine injeksi 500 mcg Amp 90

    377 Sianocobalamine 50 mcg Tab 800

    378 Silk ( Benang Bedah Sutera ) Pcs -

    379 Silk ( Benang Bedah Sutera ) / e-katalog Pcs 62

    380 Slide Pcs 792

    381 Sputum pot / Non e-katalog Bh -

    382 Spongostan Ktk -

    383 Streptomisin injeksi Vial -

    384 Simvastatin 10 mg Tab -

    385 Test Kehamilan Pcs 50

    386 Tetrasiklin 250 mg Kaps -

    387 Tetrasiklin 500 mg Kaps -

    388 Thiamphenicol 500 mg Kaps -

    389 Tiamin injeksi 100 mg/ml Amp 100

    390 Tiamin HCL 50 mg Tab 2,400


    391 Topicaina topical gel / Anastesi anak Btl -

    392 Tooth stain Remover btl -

    393 Triheksifenidil 2 mg Tab -

    394 Tri Kresol Formalin /TKF Btl -

    395 Tramadol 50 mg / ml Injeksi Amp -

    396 Transfusi Set Pcs -

    397 Transfusi Set / E-katalog Pcs -

    398 Tremenza Tab -

    399 Tissue Lensa pcs -

    400 Urine bag / e-katalog Pcs 30

    401 Urine Test / Gluco Protein Test Pcs -

    402 Vitamin B - complex Tab 2,600

    403 Ventolin inj. amp 6

    404 Wing Needle no 27 Pcs -

    405 Zink Oxide Eugenol (powder+liquid/kalzinol) Btl -

    406 Zinc Dispersible 120 mg Tab 1,350

    407 Slide box Pcs -

    408 Acarbose 50 mg Tab -

    409 Asam Traneksamat Injeksi amp -

    410 Asam Traneksamat 500 mg kapl 500

    411 Bumer Pcs -

    412 Etanol 70 % 100 ml btl -

    413 Furosemide 10mg/ml injeksi Amp -

    414 Glimepiride 2 mg Tab -

    415 Jarum jahit Combinasi otot & Kulit Lusin 11

    416 Plester Besar 5 m x 4,5 cm (Leukoplast) Roll 5

    417 Povidon iodida Larutan 10 % 60 ml Btl -


    418 Semprong Pcs -

    419 Sumbu bh -

    420 Termometer Ruangan Kayu Pcs 2

    421 Sofero caps -

    422 Disposible dental needle no. 18 pcs -

    423 Disposible dental needle no. 20 Pcs -

    424 Disposible dental needle no. 25 Pcs -

    425 Jarum Citojek No. 12 Pcs -

    426 Jarum Citojek No. 16 Pcs -

    427 Resin Composite (A2+A3) Btl -

    428 Suction Rip Pcs -

    429 Levemir Injeksi / non e-katalog paket -

    430 Borax Test ktk -

    431 Novabion caps -

    432 Larutan Metanol btl -

    433 Larutan Oil Imersion 50 ml btl -

    434 Alkohol Swap Pkt -

    435 Aquadest 600 ml Btl -

    436 Alat Tes Darah Multifungsi Pkt -

    437 Stik Gula Darah Pkt -

    438 Stik Kolesterol Pkt -

    439 Stik Asam Urat Pkt -

    440 Miniaspi 80 mg (Asetosal 80 mg) Tab 500

    441 Isoniazid 100 mg Tab -

    442 Rantin injeksi (Ranitidin inj. 25 mg/ml)Non E. Amp -

    443 Nexa 500 mg (Asam Traneksamat) Non E. Tab -

    444 Sotatic Injeksi (Metoclopramide inj. 5 mg/ml) Non E. Amp -


    445 Salbron 2 mg (Salbutamol 2 mg) Non E. Tab -

    446 Pehacain Inj. (Lidocain Comb.) Amp -

    447 Otoryl 25 Mg (Kaptopril 25 mg) Tab -

    448 Asam Folat 1 mg Tab 900

    449 Azitromycin 500 mg Tab -

    450 Ciprofloksasine Injeksi Btl -

    451 Amlodipin 10 mg Tab -

    452 Dentin Conditioner Minipack Box -

    453 Stesolit Rectal / Diazepam rectal Supp -

    454 Paracetamol Infus 100 ml Btl -

    455 Cetrizine 10 mg Tab -

    VAKSIN
    1 HBo Vial 5

    2 BCG Amp 2

    3 Polio Vial 6

    4 DPT-HB Vial 3

    5 Pantavalen Vial -

    6 Campak Vial 2

    7 TT Vial -

    8 DT Vial 8

    9 TD Vial -

    10 ADS 0,5 Vial -

    11 ADS 0,05 Vial -

    12 Pelarut BCG Amp 2

    13 Pelarut Campak Amp 3


    Poli Umum
    Kunjungan Resep

    UMUM

    BAYAR
    JUMLAH KUNJUNGAN RESEP

    Mengetahui Yang Menyera


    Kepala Dinas Kesehatan Kab. Alor Petugas IF

    NIP. NIP.
    PEMERINTAH KABUPATEN ALOR
    D I N A S K E S E H A T A N
    Jl. Prof. DR. W. Z. Yohanes. No. - Telp. (0386) 21052
    K A L A B A H I

    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    LAP. PEMAKAIAN O
    LEMBAR PERMINTA
    TAHUN
    TRIWULAN

    Penerimaan Persediaan Pemakaian Sisa Stok Stok Optimum

    5 6 7 9 11

    - -

    450 450

    280 280

    - -

    400 400

    - -

    400 400

    500 500

    - -

    650 650

    1,200 1,200

    - -
    10 10

    2,400 2,400

    9 9

    280 280

    - -

    - -

    50 50

    2,500 2,500

    2,000 2,000

    50 50

    - -

    - -

    3,000 3,000

    46 46

    1,600 1,600

    15 15

    41 41

    24 24

    - -

    1,000 1,000

    - -

    - -

    - -

    - -

    - -

    5 5

    3 3
    1 1

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    8,600 8,600

    2,500 2,500

    57 57

    1,050 1,050

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    25 25

    - -

    - -
    - -

    - -

    83 83

    - -

    - -

    - -

    - -

    96 96

    - -

    120 120

    - -

    - -

    1,700 1,700

    - -

    6 6

    - -

    - -

    5 5

    5 5

    3,100 3,100

    1,500 1,500

    - -

    - -

    216 216

    - -

    153 153

    2,800 2,800
    - -

    - -

    - -

    - -

    - -

    5 5

    - -

    79 79

    - -

    - -

    - -

    - -

    200 200

    30 30

    160 160

    - -

    - -

    - -

    - -

    - -

    30 30

    - -

    - -

    - -

    25 25

    12 12

    6 6
    - -

    - -

    - -

    - -

    - -

    200 200

    - -

    - -

    - -

    14 14

    260 260

    22 22

    - -

    - -

    4 4

    5 5

    - -

    - -

    - -

    - -

    525 525

    - -

    - -

    65 65

    41 41

    - -

    500 500
    4,200 4,200

    60 60

    - -

    102 102

    - -

    - -

    - -

    - -

    1,500 1,500

    - -

    - -

    - -

    220 220

    - -

    209 209

    - -

    - -

    - -

    10 10

    - -

    - -

    48 48

    1,000 1,000

    3,200 3,200

    - -

    5 5

    31 31
    - -

    43 43

    400 400

    360 360

    - -

    - -

    - -

    40 40

    - -

    286 286

    50 50

    270 270

    464 464

    - -

    - -

    9 9

    9 9

    2 2

    1 1

    100 100

    5 5

    - -

    - -

    - -

    - -

    10 10

    - -
    - -

    800 800

    - -

    10 10

    - -

    - -

    - -

    11 11

    - -

    - -

    - -

    - -

    200 200

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    1,250 1,250

    5 5

    - -

    10 10

    - -
    - -

    - -

    - -

    - -

    - -

    - -

    600 600

    9 9

    40 40

    4,000 4,000

    - -

    - -

    - -

    85 85

    700 700

    2,400 2,400

    67 67

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    1 1

    - -
    - -

    12 12

    - -

    265 265

    30 30

    - -

    300 300

    600 600

    2 2

    - -

    10 10

    - -

    650 650

    - -

    - -

    4 4

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    20 20

    - -

    900 900
    - -

    200 200

    100 100

    - -

    5 5

    83 83

    - -

    40 40

    - -

    - -

    - -

    - -

    200 200

    120 120

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -
    - -

    - -

    - -

    - -

    - -

    - -

    25 25

    75 75

    - -

    63 63

    570 570

    - -

    2,000 2,000

    40 40

    2,500 2,500

    5 5

    - -

    8 8

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -
    1,800 1,800

    2,100 2,100

    1,000 1,000

    - -

    - -

    - -

    4 4

    5 5

    5 5

    5 5

    3 3

    5 5

    2 2

    1,800 1,800

    100 100

    100 100

    100 100

    3,900 3,900

    19 19

    - -

    - -

    - -

    - -

    - -

    - -

    195 195

    - -
    - -

    - -

    200 200

    - -

    41 41

    6 6

    - -

    250 250

    - -

    - -

    1 1

    1 1

    90 90

    800 800

    - -

    62 62

    792 792

    - -

    - -

    - -

    - -

    50 50

    - -

    - -

    - -

    100 100

    2,400 2,400
    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    30 30

    - -

    2,600 2,600

    6 6

    - -

    - -

    1,350 1,350

    - -

    - -

    - -

    500 500

    - -

    - -

    - -

    - -

    11 11

    5 5

    - -
    - -

    - -

    2 2

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    500 500

    - -

    - -

    - -

    - -
    - -

    - -

    - -

    900 900

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    5 5

    2 2

    6 6

    3 3

    - -

    2 2

    - -

    8 8

    - -

    - -

    - -

    2 2

    3 3
    Sumber / Asal Resep
    Poli Gigi KIA KB Raeat Inap UGD

    MUM
    ASKES JUMLAH
    TIDAK BAYAR Dokter

    ang Menyerahkan Yang Meminta


    Petugas IFK Kepala Puskesmas

    NIP.
    LPO)

    P. PEMAKAIAN OBAT BULAN : JULI


    MBAR PERMINTAAN OBAT BULAN :
    : 2019
    :

    permintaan pemberian KET

    12 14 16
    Total Resep ke Apotik
    Pusling, Posyandu, dll Bulan Ini Kumulatif s/d Bulan ini

    - #VALUE!

    Pemberi Resep
    Perawat Bidan Perawat Gigi

    Yang Menerima
    Petugas Puskesmas

    NIP.
    ……………………….,
    ………………………………………
    ……………………….,
    …………………………………………………………
    LA

    NAMA PUSKESMAS :
    KABUPATEN : ALOR
    KECAMATAN :

    No Nama Obat Satuan Stok awal

    1 2 3 4

    1 Adona Injensi -
    Amp
    2 Alat Suntik Sekali Pakai 2,5 ml Pcs 450

    3 Alat Suntik Sekali Pakai 5 ml Pcs 280

    4 Alat suntik sekali pakai 0,5 ml Pcs -

    5 Alat suntik sekali pakai 0,5 ml / E - Katalog Pcs 400

    6 Alat suntik sekali pakai 0,05 ml /non e-katalog pcs -

    7 Alat suntik sekali pakai 0,05 ml / e-katalog Pcs 400

    8 Alat suntik sekali pakai 1 ml Pcs 500

    9 Alat suntik sekali pakai10 ml Pcs -

    10 Albendazol 400 mg / non e-katalog Tab 650

    11 Allupurinol 100 mg Tab 1,200

    12 Amalgam solila / Silver Amalgam Powder + Liquid Tube -


    13 Ambroxol syrup 15 mg/ml Btl 10

    14 Ambroxol 30 mg Tab 2,400

    15 Aminofilin Injeksi 24 mg/ml Amp 9

    16 Aminofilin 200 mg / e-katalog Tab 280

    17 Aminofilin 200 mg / non e-katalog tab -

    18 Amitriptilin HCL 25 mg Tab -

    19 Amlodipin 5 mg Tab 50

    20 Amoksisilin 250 mg Kaps 2,500

    21 Amoksisilin 500 mg Kapl 2,000

    22 Amoksisilin syrup Btl 50

    23 Ampisillin injeksi 1000 mg/ml Vial -

    24 Ampisillin syrup Btl -

    25 Antacida DOEN Tab 3,000

    26 Antacida DOEN Suspensi Btl 46

    27 Antalgin 500 mg Tab 1,600

    28 Antalgin injeksi Amp 15

    29 Anti Bakteri DOEN / Basitrasin Polimiksin Tube 41

    30 Anti Fungi DOEN Salep 30 g ( Salp 3 - 6 ) Pot 24

    31 Anti Haemoroid DOEN Suppositoria Supp -

    32 Anti Malaria DOEN ( SulDox ) Tab 1,000

    33 Anti Migraen / Ergotamin 1 mg + Coffein 50 mg Tab -

    34 Anti Sera A Btl -

    35 Anti Sera B Btl -

    36 Anti Sera AB Btl -

    37 Anti Sera D Btl -

    38 Aqua pro injeksi 20 ml Vial 5

    39 Aquadestilata 1000 ml Btl 3


    40 Aqua DM Bidestilata IKA ml 1

    41 Aqua DM Brataco ltr -

    42 Arsen / Devitalisasi Pasta Btl -

    43 Arterakin tab Tab -

    44 Artesunat injeksi 60 mg Vial -

    45 Artemeter injeksi Amp -

    46 Asetosal 100 mg Tab -

    47 Asetosal 500 mg Tab -

    48 Asam Ascorbat 50 mg Tab 8,600

    49 Asam Mefenamat 500 mg Kapl 2,500

    50 Asiklovir cream 5 % 5 g Tube 57

    51 Asiklovir 200 mg Tab 1,050

    52 Asiklovir 400 mg Tab -

    53 Atropin Sulfat injeksi 0,25 mg/ml Amp -

    54 Atropin sulfat 0,5 mg Tab -

    55 Baby Cough syrup Btl -

    56 Bahan Fissur Sealent / Fuji VII Dos -

    57 Baraclude 1 mg btl/30 tab -

    58 Baraclude 0,5 mg box/30 tab -

    59 Barotec Inhaler Btl -

    60 Baycline 1 Liter Btl -

    61 Benzatin Benzil Penicillin 1,2 juta IU Vial -

    62 Besi II Sulfat 7 H2O 300 mg Tab -

    63 Besi II Sulfat + Asam Folat Tab -

    64 Betametason Cream 0,1 % Tube 25

    65 Betason N Tube -

    66 Bidan Kit paket -


    67 Bioplacenton 15 gram Tube -

    68 Bisolvon Nebulizer btl -

    69 Bisturi / non e-katalog Pcs 83

    70 Blood lanset / non e-katalog Pcs -

    71 Calsidor / Dycal Dentsply / Hydcal Technew Btl -

    72 Calsydol syrup Btl -

    73 Cat gut 3/0 Pcs -

    74 Cat gut 3/0 / E-katalog Pcs 96

    75 Cat gut 2/0 Pcs -

    76 Cat gut 2/0 / E-katalog Pcs 120

    77 Cavit / Caviton Btl -

    78 Cement Powder + Liquid / Elite Cement 100 Dos -

    79 Cefadroxil 500 mg Kaps 1,700

    80 Ceftriaxon Injeksi Vial -

    81 Cefotaxime injeksi 0,5 gram Vial 6

    82 Cefotaxime injeksi 1 gram Vial -

    83 Chlor Fenol Champer menthol /CHKM Btl -

    84 Chloramfecort Tube 5

    85 Chloramfecort H Tube 5

    86 Cimetidine 200 mg Tab 3,100

    87 Ciprofloksasine 500 mg Tab 1,500

    88 Counterpain 30 gram Tube -

    89 Curcuma Plus Syrup Btl -

    90 Darplex Tab 216

    91 Dasabion Kaps -

    92 Deksamethasone injeksi 5 mg/ml Amp 153

    93 Deksamethasone 0,5 mg Tab 2,800


    94 Dekstran 70 - Larutan Infus 6 % steril Btl -

    95 Dental Cotton Roll Bks -

    96 Dental Plak Disclosing Gel / Disclosing Solution Btl -

    97 Diazepam injeksi 5 mg/ml Amp -

    98 Diazepam 2 mg Tab -

    99 Diazepam 5 mg Tab 5

    100 Dietilkarbamsin 100 mg / NON E-KATALOG Tab -

    101 Difenhidramine Injeksi 10 mg/ml Amp 79

    102 Digoksin 0,25 mg Tab -

    103 Diltiazem HCL 30 mg Tab -

    104 Dimenhidrinat 50 mg Tab -

    105 Doksisiklin 100 mg Kaps -

    106 Domperidon Tab 200

    107 Dulcolax 5 mg Tab 30

    108 Efedrin HCL 25 mg Tab 160

    109 Elastis verban 3 inci Roll -

    110 Elastis verban 4 inci Roll -

    111 Elastis verban 6 inci Roll -

    112 Elkana Multivitamin Tab -

    113 Enervon - C Kapl -

    114 Epineprin HCL 0,1 % injeksi Amp 30

    115 Eritromicin 250 mg Kapl -

    116 Eritromicin 500 mg Kapl -

    117 Eritromicin syrup Btl -

    118 Etakridin Larutan 0,1 % 300 ml Btl 25

    119 Etanol 70 % 1 liter Btl 12

    120 Ethilklorda Semprot Btl 6


    121 Endomethasone (endosel) btl -

    122 Eugenol Btl -

    123 Fehling A Btl -

    124 Fehling B Btl -

    125 Fenobarbital injeksi 50 mg/ml Amp -

    126 Fenobarbital 30 mg Tab 200

    127 Fenobarbital 100 mg Tab -

    128 Fenoksimetil Penisilin 250 mg Tab -

    129 Fenoksimetil Penisilin 500 mg Tab -

    130 Fenol gliserol TT Btl 14

    131 Fitomenadion 10 mg Tab 260

    132 Fitomenadion injeksi 10 mg/ml Amp 22

    133 Flecher Powder + Liquid Btl -

    134 Foley cateter no 16 Pcs -

    135 Foley cateter no 18 Pcs 4

    136 Foley cateter no 20 Pcs 5

    137 Formalin solution liter -

    138 Formaldehide Merk Test kit -

    139 Formokresol Btl -

    140 Furosemida Tab -

    141 Garam Oralit Sac 525

    142 Gamexan Btl -

    143 Gentamicin Injeksi 80 mg/ml Amp -

    144 Gentamicin Salep Kulit 0,1 % Tube 65

    145 Gentian Violet 1 % Btl 41

    146 Gic Art / Fuji IX Dos -

    147 Glibenclamida 5 mg Tab 500


    148 Gliceril Guayacolat 100 mg Tab 4,200

    149 Glucosa Larutan Infus 10 % steril Btl 60

    150 Glucosa Larutan Infus 40 % steril Btl -

    151 Glucosa Larutan Infus 5 % steril Btl 102

    152 Gloves "S" Pcs -

    153 Gloves "M" Pcs -

    154 Gloves "L" Pcs -

    155 Grisofulvin 250 mg Tab -

    156 Grisofulvin 125 mg tab 1,500

    157 Haloperidol 0,5 mg Tab -

    158 Haloperidol 1,5 mg Tab -

    159 Haloperidol 5 mg Tab -

    160 Handscoen no 6,5 Pcs 220

    161 Handscoen no 7,5 Pcs -

    162 Handscoen no 7,5 / E-katalog Pcs 209

    163 Handscoen No.7 Pcs -

    164 Handscoen no 8 Pcs -

    165 Handscoen no 8 / E-katalog Pcs -

    166 Handscoen Ginecolog Panjang Steril Pcs 10

    167 HB Sahli Pkt -

    168 Hemaviton Action Kaps -

    169 Hidrokortison Cream 2,5 % Tube 48

    170 Hidroklortiazida 25 mg Tab 1,000

    171 Ibuprofen 200 mg Tab 3,200

    172 Ibuprofen 400 mg Tab -

    173 Ibuprofen syrup/Buffec Syrup Btl 5

    174 Ictiol salep Pot 31


    175 Implant susuk KB Pcs -

    176 Infuset Micro Pcs 43

    177 Infuset Micro / e-katalog Pcs 400

    178 Infuset Macro Pcs 360

    179 Infuset Macro / e-katalog Pcs -

    180 Iodium test Btl -

    181 indikator universal ktk -

    182 IV Kateter no 18 Pcs 40

    183 IV Kateter no 18 / e-katalog Pcs -

    184 IV Kateter no 20 Pcs 286

    185 IV Kateter no 20 / E-katalog Pcs 50

    186 IV Kateter no 22 / E-katalog Pcs 270

    187 IV Kateter no 24 / E - katalog Pcs 464

    188 IV Canula No.18 Pcs -

    189 Isosorbit Dinitrat sublingual 5 mg Tab -

    190 Jarum Jahit Otot Lusin 9

    191 Jarum Jahit Kulit Lusin 9

    192 Jelly untuk USG / non e-katalog Btl 2

    193 Jelly untuk Catheter Komb. Lidokain Btl 1

    194 Kalsium Laktat 500 mg Tab 100

    195 Kalsium Gluconas Injeksi / non e-katalog Amp 5

    196 Kalnex 250 mg Kaps -

    197 Kalnex injeksi Amp -

    198 Kapas berlemak 500 gram Roll -

    199 Kapas pemb. Absorben 200 gram Roll -

    200 Kapas Pemb. Absorben 250 gram Roll 10

    201 Kapas pemb. Absorben 1000 gram Roll -


    202 Kaptopril 12,5 mg Tab -

    203 Kaptopril 25 mg Tab 800

    204 Karbamazepin 200 mg Tab -

    205 Kartu Stock Lbr 10

    206 Kasa 4 x 10 cm Roll -

    207 Kasa 4 x 6 cm Roll -

    208 Kasa 40 x 80 cm Roll -

    209 Kasa 40 x 80 cm / E-katalog 11

    210 Kasa Kompres 40/40 cm Roll -

    211 Kasa Kompres 40/40 cm / E-katalog Roll -

    212 Kasa Pembalut 2 m x 80 cm Roll -

    213 Kasa Pembalut Hidrofil 4 m x 3 cm Roll -

    214 Kasa Pembalut Hidrofil 4 m x 3 cm / E-katalog Roll 200

    215 Kasa Pembalut Hidrofil 4 m x 15 cm Roll -

    216 Kasa Pembalut Hidrofil 4 m x 15 cm / E-Katalog Roll -

    217 Kasa 16 x 16 Roll -

    218 Kasa pembalut 14 x 8 cm Roll -

    219 Kasa pembalut 10 cm Roll -

    220 Kasa pembalut 4 x 18 Roll -

    221 Kelambu Pcs -

    222 Ketamine Injeksi 10 mg/ml Vial -

    223 Ketokonazol cream 2 % Tube -

    224 Ketokonazol 200 mg Tab 1,250

    225 Ketorolac Injeksi Ampul 5

    226 Kertas EKG 3 Ukuran Roll -

    227 Kertas Perkamen / Non e-katalog Lbr 10

    228 Kina Dihidroklorida injeksi 25 % - 2 ml Amp -


    229 Kina 222 mg Tab -

    230 Klip Plastik Kecil tanpa sablon Pcs -

    231 Klip Plastik Sedang tanpa sablon Pcs -

    232 Klip Plastik Besar sablon 10 x 15 Pcs -

    233 Klip Plastik Sedang sablon 8,7 x 15 Pcs -

    234 Klip Plastik kecil sablon Pcs -

    235 Kloramfenicol 250 mg Kaps 600

    236 Kloramfenicol Salp Mata 1 % Tube 9

    237 Kloramfenicol Tetes Telinga 3 % Btl 40

    238 Klorfeniraminimaleat 4 mg Tab 4,000

    239 Klorokuin 150 mg Tab -

    240 Klorpromazin HCL injeksi i.m 25 mg/ml Amp -

    241 Klorpromazin HCL 25 mg Tab -

    242 Kodein 10 mg Tab 85

    243 Kotrimoksasol Adult 480 mg Tab 700

    244 Kotrimoksasol Pedriatic 120 mg Tab 2,400

    245 Kotrimoksasol suspensi Btl 67

    246 Lab.Kit Pkt -

    247 Lacbon 17 Tab -

    248 Lansoprazole 30 mg Kaps -

    249 Larutan Benedict Btl -

    250 Larutan Etanol Asam Btl -

    251 Larutan Gimsa stain / non e-katalog Btl -

    252 Larutan Carbofuksin Btl -

    253 Larutan Methilen Biru Btl -

    254 Larutan H2O2 Btl 1

    255 Larutan xilol Btl -


    256 Larutan HCl 0,1 N / Non e-katalog Btl -

    257 Levetran Salp Pot 12

    258 Levofloksasin 500 mg Tab -

    259 Lidocain Injeksi HCl 2 % Amp 265

    260 Lidocain Injeksi 2 % + Epineprin 1 : 80.000 - 2 ml Amp 30

    261 Livron B plex Tab -

    262 Loperamid 2 mg Tab 300

    263 Loratadin 10 mg Tab 600

    264 Lysol Btl 2

    265 Light cure Composite (etsa & bondingnya) Set -

    266 Magnesium Sulfat injeksi 20 % - 25 ml Amp 10

    267 Magnesium Sulfat injeksi 40 % - 25 ml Amp -

    268 Masker Mulut Pcs 650

    269 MDT MB Adult Blist -

    270 MDT PB Adult Blist -

    271 MDT MB Anak Blist 4

    272 MDT PB Anak Blist -

    273 Mebendazole syrup 100 mg/5 ml Btl -

    274 Mebendazole 100 mg Tab -

    275 Meloxicam 15 mg Tab -

    276 Metformin Tab -

    277 Metapex Box -

    278 Methanil Yellow Chen Kit ktk -

    279 Methilergometrin maleat 0,125 mg Tab -

    280 Methilergometrin maleat 0,200 mg - 1 ml Amp 20

    281 Methilprednisolon 4 mg Tab -

    282 Methilprednisolon 8 mg tab 900


    283 Metoclopramide injeksi 5 mg/5 ml Amp -

    284 Metoclopramide 10 mg Tab 200

    285 Metronidazol 250 mg Tab 100

    286 Metronidazol 500 mg Tab -

    287 Metronidazol infus Btl 5

    288 Mikonazole cream salp 2 % / e-katalog Tube 83

    289 Mikonazole cream salp 2 % / non e-katalog Tube -

    290 Mineral Mix Sac 40

    291 Morfin injeksi 10 mg/ml Amp -

    292 Natrium Bicarbonat 500 mg Tab -

    293 Natrium Diklofenak 25 mg Tab -

    294 Natrium Diklofenak 50 mg Tab -

    295 Natrium Klorida Larutan infus 0,9 % / e-katalog Btl 200

    296 Natrium Klorida Larutan infus 0,9 / non e-katalog Btl 120

    297 Natrium Fenitoin 100 mg Kaps -

    298 Natrium Fenitoin Injeksi / Non e-katalog Amp -

    299 Nicolin injeksi / Citicolin inj Amp -

    300 Nifedipin 10 mg Tab -

    301 Nistatin 100 000 UI Tab -

    302 Nistatin 500 000 UI Vaginal tab Tab -

    303 Nitrit Test Merk ktk -

    304 Neurovit- E Tab -

    305 Neurobion / Neurosanbe 5000 Tab -

    306 Neurobion / Neurosanbe Injeksi Amp -

    307 Obat Batuk Hitam syrup 100 ml Btl -

    308 Obat FDC Anak Pkt -

    309 Obat FDC Kategori 1 Pkt -


    310 Obat FDC Kategori 2 Pkt -

    311 Obat FDC TB sisipan Pkt -

    312 OAT Kombipak anak Pkt -

    313 OAT Kategori 1 & 3 Pkt -

    314 Oil Emersi Btl -

    315 Obat suntik KB 3 bulanan Vial -

    316 Oksitetrasiklin HCL 1 % salp mata Tube 25

    317 Oksitetrasiklin HCL 3 % salp Kulit Tube 75

    318 Oksitetrasiklin injeksi Vial -

    319 Oksitosin injeksi 10 IU/ml - 1 ml Amp 63

    320 Omeprazole 20 mg Kaps 570

    321 Papaverin injeksi 40 mg/ml Amp -

    322 Papaverin 40 mg Tab 2,000

    323 Paracetamol syrup 120 mg/5 ml Btl 40

    324 Paracetamol 500 mg Tab 2,500

    325 Parasetamol drop Btl 5

    326 Parasetamol suppositoria Supp -

    327 Penisilin procain / Procain Benzil Penicillin injeksi Vial 8

    328 Petidin injeksi 50 mg/ml Amp -

    329 Pil KB I Kombinasi Set -

    330 Pilokarpin Tetes mata 2 % Btl -

    331 Piracetam injeksi 3 g/15 ml Amp -

    332 Piracetam 1200 mg Tab -

    333 Piracetam 400 mg Tab -

    334 Pirasetam 800 mg Tab -

    335 Pirantel score base 125 mg Tab -

    336 Pirantel Syrup Btl -


    337 Piridoksin HCL 10 mg Tab 1,800

    338 Piroxicam 10 mg Tab 2,100

    339 Piroxicam 20 mg Tab 1,000

    340 Plester besar 5 yard x 2 inch Roll -

    341 Plester sedang 1,5 Inch x 5 cm Roll -

    342 Plester kecil 1,25 x 5 cm roll -

    343 Plester ( Leukoplast) 7,5 x 4,5 cm Roll 4

    344 Poligips 7,5cm Roll 5

    345 Poligips 10 cm Roll 5

    346 Poligips 15 cm Roll 5

    347 Povidon iodida larutan 10 % 30 ml Btl 3

    348 Povidon iodida larutan 10 % 300 ml Btl 5

    349 Povidon iodida larutan 10 % 1000 ml Btl 2

    350 Prednison 5 mg Tab 1,800

    351 Primakuin 15 mg Tab 100

    352 Propanolol 40 mg Tab 100

    353 Propilitiourasil 100 mg Tab 100

    354 Ranitidin 150 mg Tab 3,900

    355 Ranitidin injeksi 25 mg/2 ml Amp 19

    356 Rapid Diagnostic Test (RDT) Pcs -

    357 Reagen zealnelsen Pkt -

    358 Reserpin 0,1 mg Tab -

    359 Reserpin 0,25 mg Tab -

    360 Retinol 100.000 IU Kaps -

    361 Retinol 200.000 IU Kaps -

    362 Ringer Lactat larutan infus Btl 195

    363 Rodamin B Test Chem ktk -


    364 Safety box Lbr -

    365 Salicyl Spritus 55 ml Btl -

    366 Salbutamol 2 mg Tab 200

    367 Salbutamol 4 mg Tab -

    368 Salep 2 - 4,Komb.As.Salisilat 2% + Sulfur Praicip Pot 41

    369 Salisil Bedak Ktk 6

    370 Sanbe B-Plex Btl -

    371 Sangobion Kaps 250

    372 Santa E Tab -

    373 Scabisid Cream Tube -

    374 Serum Antibisa Ular Polivalen ( ABU I ) Vial 1

    375 Serum Antitetanus injeksi 1.500 IU ( ATS ) Vial 1

    376 Sianocobalamine injeksi 500 mcg Amp 90

    377 Sianocobalamine 50 mcg Tab 800

    378 Silk ( Benang Bedah Sutera ) Pcs -

    379 Silk ( Benang Bedah Sutera ) / e-katalog Pcs 62

    380 Slide Pcs 792

    381 Sputum pot / Non e-katalog Bh -

    382 Spongostan Ktk -

    383 Streptomisin injeksi Vial -

    384 Simvastatin 10 mg Tab -

    385 Test Kehamilan Pcs 50

    386 Tetrasiklin 250 mg Kaps -

    387 Tetrasiklin 500 mg Kaps -

    388 Thiamphenicol 500 mg Kaps -

    389 Tiamin injeksi 100 mg/ml Amp 100

    390 Tiamin HCL 50 mg Tab 2,400


    391 Topicaina topical gel / Anastesi anak Btl -

    392 Tooth stain Remover btl -

    393 Triheksifenidil 2 mg Tab -

    394 Tri Kresol Formalin /TKF Btl -

    395 Tramadol 50 mg / ml Injeksi Amp -

    396 Transfusi Set Pcs -

    397 Transfusi Set / E-katalog Pcs -

    398 Tremenza Tab -

    399 Tissue Lensa pcs -

    400 Urine bag / e-katalog Pcs 30

    401 Urine Test / Gluco Protein Test Pcs -

    402 Vitamin B - complex Tab 2,600

    403 Ventolin inj. amp 6

    404 Wing Needle no 27 Pcs -

    405 Zink Oxide Eugenol (powder+liquid/kalzinol) Btl -

    406 Zinc Dispersible 120 mg Tab 1,350

    407 Slide box Pcs -

    408 Acarbose 50 mg Tab -

    409 Asam Traneksamat Injeksi amp -

    410 Asam Traneksamat 500 mg kapl 500

    411 Bumer Pcs -

    412 Etanol 70 % 100 ml btl -

    413 Furosemide 10mg/ml injeksi Amp -

    414 Glimepiride 2 mg Tab -

    415 Jarum jahit Combinasi otot & Kulit Lusin 11

    416 Plester Besar 5 m x 4,5 cm (Leukoplast) Roll 5

    417 Povidon iodida Larutan 10 % 60 ml Btl -


    418 Semprong Pcs -

    419 Sumbu bh -

    420 Termometer Ruangan Kayu Pcs 2

    421 Sofero caps -

    422 Disposible dental needle no. 18 pcs -

    423 Disposible dental needle no. 20 Pcs -

    424 Disposible dental needle no. 25 Pcs -

    425 Jarum Citojek No. 12 Pcs -

    426 Jarum Citojek No. 16 Pcs -

    427 Resin Composite (A2+A3) Btl -

    428 Suction Rip Pcs -

    429 Levemir Injeksi / non e-katalog paket -

    430 Borax Test ktk -

    431 Novabion caps -

    432 Larutan Metanol btl -

    433 Larutan Oil Imersion 50 ml btl -

    434 Alkohol Swap Pkt -

    435 Aquadest 600 ml Btl -

    436 Alat Tes Darah Multifungsi Pkt -

    437 Stik Gula Darah Pkt -

    438 Stik Kolesterol Pkt -

    439 Stik Asam Urat Pkt -

    440 Miniaspi 80 mg (Asetosal 80 mg) Tab 500

    441 Isoniazid 100 mg Tab -

    442 Rantin injeksi (Ranitidin inj. 25 mg/ml)Non E. Amp -

    443 Nexa 500 mg (Asam Traneksamat) Non E. Tab -

    444 Sotatic Injeksi (Metoclopramide inj. 5 mg/ml) Non E. Amp -


    445 Salbron 2 mg (Salbutamol 2 mg) Non E. Tab -

    446 Pehacain Inj. (Lidocain Comb.) Amp -

    447 Otoryl 25 Mg (Kaptopril 25 mg) Tab -

    448 Asam Folat 1 mg Tab 900

    449 Azitromycin 500 mg Tab -

    450 Ciprofloksasine Injeksi Btl -

    451 Amlodipin 10 mg Tab -

    452 Dentin Conditioner Minipack Box -

    453 Stesolit Rectal / Diazepam rectal Supp -

    454 Paracetamol Infus 100 ml Btl -

    455 Cetrizine 10 mg Tab -

    VAKSIN
    1 HBo Vial 5

    2 BCG Amp 2

    3 Polio Vial 6

    4 DPT-HB Vial 3

    5 Pantavalen Vial -

    6 Campak Vial 2

    7 TT Vial -

    8 DT Vial 8

    9 TD Vial -

    10 ADS 0,5 Vial -

    11 ADS 0,05 Vial -

    12 Pelarut BCG Amp 2

    13 Pelarut Campak Amp 3


    Poli Umum
    Kunjungan Resep

    UMUM

    BAYAR
    JUMLAH KUNJUNGAN RESEP

    Mengetahui Yang Menyera


    Kepala Dinas Kesehatan Kab. Alor Petugas IF

    NIP. NIP.
    PEMERINTAH KABUPATEN ALOR
    D I N A S K E S E H A T A N
    Jl. Prof. DR. W. Z. Yohanes. No. - Telp. (0386) 21052
    K A L A B A H I

    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    LAP. PEMAKAIAN O
    LEMBAR PERMINTA
    TAHUN
    TRIWULAN

    Penerimaan Persediaan Pemakaian Sisa Stok Stok Optimum

    5 6 7 9 11

    - -

    450 450

    280 280

    - -

    400 400

    - -

    400 400

    500 500

    - -

    650 650

    1,200 1,200

    - -
    10 10

    2,400 2,400

    9 9

    280 280

    - -

    - -

    50 50

    2,500 2,500

    2,000 2,000

    50 50

    - -

    - -

    3,000 3,000

    46 46

    1,600 1,600

    15 15

    41 41

    24 24

    - -

    1,000 1,000

    - -

    - -

    - -

    - -

    - -

    5 5

    3 3
    1 1

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    8,600 8,600

    2,500 2,500

    57 57

    1,050 1,050

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    25 25

    - -

    - -
    - -

    - -

    83 83

    - -

    - -

    - -

    - -

    96 96

    - -

    120 120

    - -

    - -

    1,700 1,700

    - -

    6 6

    - -

    - -

    5 5

    5 5

    3,100 3,100

    1,500 1,500

    - -

    - -

    216 216

    - -

    153 153

    2,800 2,800
    - -

    - -

    - -

    - -

    - -

    5 5

    - -

    79 79

    - -

    - -

    - -

    - -

    200 200

    30 30

    160 160

    - -

    - -

    - -

    - -

    - -

    30 30

    - -

    - -

    - -

    25 25

    12 12

    6 6
    - -

    - -

    - -

    - -

    - -

    200 200

    - -

    - -

    - -

    14 14

    260 260

    22 22

    - -

    - -

    4 4

    5 5

    - -

    - -

    - -

    - -

    525 525

    - -

    - -

    65 65

    41 41

    - -

    500 500
    4,200 4,200

    60 60

    - -

    102 102

    - -

    - -

    - -

    - -

    1,500 1,500

    - -

    - -

    - -

    220 220

    - -

    209 209

    - -

    - -

    - -

    10 10

    - -

    - -

    48 48

    1,000 1,000

    3,200 3,200

    - -

    5 5

    31 31
    - -

    43 43

    400 400

    360 360

    - -

    - -

    - -

    40 40

    - -

    286 286

    50 50

    270 270

    464 464

    - -

    - -

    9 9

    9 9

    2 2

    1 1

    100 100

    5 5

    - -

    - -

    - -

    - -

    10 10

    - -
    - -

    800 800

    - -

    10 10

    - -

    - -

    - -

    11 11

    - -

    - -

    - -

    - -

    200 200

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    1,250 1,250

    5 5

    - -

    10 10

    - -
    - -

    - -

    - -

    - -

    - -

    - -

    600 600

    9 9

    40 40

    4,000 4,000

    - -

    - -

    - -

    85 85

    700 700

    2,400 2,400

    67 67

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    1 1

    - -
    - -

    12 12

    - -

    265 265

    30 30

    - -

    300 300

    600 600

    2 2

    - -

    10 10

    - -

    650 650

    - -

    - -

    4 4

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    20 20

    - -

    900 900
    - -

    200 200

    100 100

    - -

    5 5

    83 83

    - -

    40 40

    - -

    - -

    - -

    - -

    200 200

    120 120

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -
    - -

    - -

    - -

    - -

    - -

    - -

    25 25

    75 75

    - -

    63 63

    570 570

    - -

    2,000 2,000

    40 40

    2,500 2,500

    5 5

    - -

    8 8

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -
    1,800 1,800

    2,100 2,100

    1,000 1,000

    - -

    - -

    - -

    4 4

    5 5

    5 5

    5 5

    3 3

    5 5

    2 2

    1,800 1,800

    100 100

    100 100

    100 100

    3,900 3,900

    19 19

    - -

    - -

    - -

    - -

    - -

    - -

    195 195

    - -
    - -

    - -

    200 200

    - -

    41 41

    6 6

    - -

    250 250

    - -

    - -

    1 1

    1 1

    90 90

    800 800

    - -

    62 62

    792 792

    - -

    - -

    - -

    - -

    50 50

    - -

    - -

    - -

    100 100

    2,400 2,400
    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    30 30

    - -

    2,600 2,600

    6 6

    - -

    - -

    1,350 1,350

    - -

    - -

    - -

    500 500

    - -

    - -

    - -

    - -

    11 11

    5 5

    - -
    - -

    - -

    2 2

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    500 500

    - -

    - -

    - -

    - -
    - -

    - -

    - -

    900 900

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    5 5

    2 2

    6 6

    3 3

    - -

    2 2

    - -

    8 8

    - -

    - -

    - -

    2 2

    3 3
    Sumber / Asal Resep
    Poli Gigi KIA KB Raeat Inap UGD

    MUM
    ASKES JUMLAH
    TIDAK BAYAR Dokter

    ang Menyerahkan Yang Meminta


    Petugas IFK Kepala Puskesmas

    NIP.
    LPO)

    P. PEMAKAIAN OBAT BULAN : AGUSTUS


    MBAR PERMINTAAN OBAT BULAN :
    : 2019
    :

    permintaan pemberian KET

    12 14 16
    Total Resep ke Apotik
    Pusling, Posyandu, dll Bulan Ini Kumulatif s/d Bulan ini

    - #VALUE!

    Pemberi Resep
    Perawat Bidan Perawat Gigi

    Yang Menerima
    Petugas Puskesmas

    NIP.
    ……………………….,
    ………………………………………
    ……………………….,
    …………………………………………………………
    LA

    NAMA PUSKESMAS :
    KABUPATEN : ALOR
    KECAMATAN :

    No Nama Obat Satuan Stok awal

    1 2 3 4

    1 Adona Injensi -
    Amp
    2 Alat Suntik Sekali Pakai 2,5 ml Pcs 450

    3 Alat Suntik Sekali Pakai 5 ml Pcs 280

    4 Alat suntik sekali pakai 0,5 ml Pcs -

    5 Alat suntik sekali pakai 0,5 ml / E - Katalog Pcs 400

    6 Alat suntik sekali pakai 0,05 ml /non e-katalog pcs -

    7 Alat suntik sekali pakai 0,05 ml / e-katalog Pcs 400

    8 Alat suntik sekali pakai 1 ml Pcs 500

    9 Alat suntik sekali pakai10 ml Pcs -

    10 Albendazol 400 mg / non e-katalog Tab 650

    11 Allupurinol 100 mg Tab 1,200

    12 Amalgam solila / Silver Amalgam Powder + Liquid Tube -


    13 Ambroxol syrup 15 mg/ml Btl 10

    14 Ambroxol 30 mg Tab 2,400

    15 Aminofilin Injeksi 24 mg/ml Amp 9

    16 Aminofilin 200 mg / e-katalog Tab 280

    17 Aminofilin 200 mg / non e-katalog tab -

    18 Amitriptilin HCL 25 mg Tab -

    19 Amlodipin 5 mg Tab 50

    20 Amoksisilin 250 mg Kaps 2,500

    21 Amoksisilin 500 mg Kapl 2,000

    22 Amoksisilin syrup Btl 50

    23 Ampisillin injeksi 1000 mg/ml Vial -

    24 Ampisillin syrup Btl -

    25 Antacida DOEN Tab 3,000

    26 Antacida DOEN Suspensi Btl 46

    27 Antalgin 500 mg Tab 1,600

    28 Antalgin injeksi Amp 15

    29 Anti Bakteri DOEN / Basitrasin Polimiksin Tube 41

    30 Anti Fungi DOEN Salep 30 g ( Salp 3 - 6 ) Pot 24

    31 Anti Haemoroid DOEN Suppositoria Supp -

    32 Anti Malaria DOEN ( SulDox ) Tab 1,000

    33 Anti Migraen / Ergotamin 1 mg + Coffein 50 mg Tab -

    34 Anti Sera A Btl -

    35 Anti Sera B Btl -

    36 Anti Sera AB Btl -

    37 Anti Sera D Btl -

    38 Aqua pro injeksi 20 ml Vial 5

    39 Aquadestilata 1000 ml Btl 3


    40 Aqua DM Bidestilata IKA ml 1

    41 Aqua DM Brataco ltr -

    42 Arsen / Devitalisasi Pasta Btl -

    43 Arterakin tab Tab -

    44 Artesunat injeksi 60 mg Vial -

    45 Artemeter injeksi Amp -

    46 Asetosal 100 mg Tab -

    47 Asetosal 500 mg Tab -

    48 Asam Ascorbat 50 mg Tab 8,600

    49 Asam Mefenamat 500 mg Kapl 2,500

    50 Asiklovir cream 5 % 5 g Tube 57

    51 Asiklovir 200 mg Tab 1,050

    52 Asiklovir 400 mg Tab -

    53 Atropin Sulfat injeksi 0,25 mg/ml Amp -

    54 Atropin sulfat 0,5 mg Tab -

    55 Baby Cough syrup Btl -

    56 Bahan Fissur Sealent / Fuji VII Dos -

    57 Baraclude 1 mg btl/30 tab -

    58 Baraclude 0,5 mg box/30 tab -

    59 Barotec Inhaler Btl -

    60 Baycline 1 Liter Btl -

    61 Benzatin Benzil Penicillin 1,2 juta IU Vial -

    62 Besi II Sulfat 7 H2O 300 mg Tab -

    63 Besi II Sulfat + Asam Folat Tab -

    64 Betametason Cream 0,1 % Tube 25

    65 Betason N Tube -

    66 Bidan Kit paket -


    67 Bioplacenton 15 gram Tube -

    68 Bisolvon Nebulizer btl -

    69 Bisturi / non e-katalog Pcs 83

    70 Blood lanset / non e-katalog Pcs -

    71 Calsidor / Dycal Dentsply / Hydcal Technew Btl -

    72 Calsydol syrup Btl -

    73 Cat gut 3/0 Pcs -

    74 Cat gut 3/0 / E-katalog Pcs 96

    75 Cat gut 2/0 Pcs -

    76 Cat gut 2/0 / E-katalog Pcs 120

    77 Cavit / Caviton Btl -

    78 Cement Powder + Liquid / Elite Cement 100 Dos -

    79 Cefadroxil 500 mg Kaps 1,700

    80 Ceftriaxon Injeksi Vial -

    81 Cefotaxime injeksi 0,5 gram Vial 6

    82 Cefotaxime injeksi 1 gram Vial -

    83 Chlor Fenol Champer menthol /CHKM Btl -

    84 Chloramfecort Tube 5

    85 Chloramfecort H Tube 5

    86 Cimetidine 200 mg Tab 3,100

    87 Ciprofloksasine 500 mg Tab 1,500

    88 Counterpain 30 gram Tube -

    89 Curcuma Plus Syrup Btl -

    90 Darplex Tab 216

    91 Dasabion Kaps -

    92 Deksamethasone injeksi 5 mg/ml Amp 153

    93 Deksamethasone 0,5 mg Tab 2,800


    94 Dekstran 70 - Larutan Infus 6 % steril Btl -

    95 Dental Cotton Roll Bks -

    96 Dental Plak Disclosing Gel / Disclosing Solution Btl -

    97 Diazepam injeksi 5 mg/ml Amp -

    98 Diazepam 2 mg Tab -

    99 Diazepam 5 mg Tab 5

    100 Dietilkarbamsin 100 mg / NON E-KATALOG Tab -

    101 Difenhidramine Injeksi 10 mg/ml Amp 79

    102 Digoksin 0,25 mg Tab -

    103 Diltiazem HCL 30 mg Tab -

    104 Dimenhidrinat 50 mg Tab -

    105 Doksisiklin 100 mg Kaps -

    106 Domperidon Tab 200

    107 Dulcolax 5 mg Tab 30

    108 Efedrin HCL 25 mg Tab 160

    109 Elastis verban 3 inci Roll -

    110 Elastis verban 4 inci Roll -

    111 Elastis verban 6 inci Roll -

    112 Elkana Multivitamin Tab -

    113 Enervon - C Kapl -

    114 Epineprin HCL 0,1 % injeksi Amp 30

    115 Eritromicin 250 mg Kapl -

    116 Eritromicin 500 mg Kapl -

    117 Eritromicin syrup Btl -

    118 Etakridin Larutan 0,1 % 300 ml Btl 25

    119 Etanol 70 % 1 liter Btl 12

    120 Ethilklorda Semprot Btl 6


    121 Endomethasone (endosel) btl -

    122 Eugenol Btl -

    123 Fehling A Btl -

    124 Fehling B Btl -

    125 Fenobarbital injeksi 50 mg/ml Amp -

    126 Fenobarbital 30 mg Tab 200

    127 Fenobarbital 100 mg Tab -

    128 Fenoksimetil Penisilin 250 mg Tab -

    129 Fenoksimetil Penisilin 500 mg Tab -

    130 Fenol gliserol TT Btl 14

    131 Fitomenadion 10 mg Tab 260

    132 Fitomenadion injeksi 10 mg/ml Amp 22

    133 Flecher Powder + Liquid Btl -

    134 Foley cateter no 16 Pcs -

    135 Foley cateter no 18 Pcs 4

    136 Foley cateter no 20 Pcs 5

    137 Formalin solution liter -

    138 Formaldehide Merk Test kit -

    139 Formokresol Btl -

    140 Furosemida Tab -

    141 Garam Oralit Sac 525

    142 Gamexan Btl -

    143 Gentamicin Injeksi 80 mg/ml Amp -

    144 Gentamicin Salep Kulit 0,1 % Tube 65

    145 Gentian Violet 1 % Btl 41

    146 Gic Art / Fuji IX Dos -

    147 Glibenclamida 5 mg Tab 500


    148 Gliceril Guayacolat 100 mg Tab 4,200

    149 Glucosa Larutan Infus 10 % steril Btl 60

    150 Glucosa Larutan Infus 40 % steril Btl -

    151 Glucosa Larutan Infus 5 % steril Btl 102

    152 Gloves "S" Pcs -

    153 Gloves "M" Pcs -

    154 Gloves "L" Pcs -

    155 Grisofulvin 250 mg Tab -

    156 Grisofulvin 125 mg tab 1,500

    157 Haloperidol 0,5 mg Tab -

    158 Haloperidol 1,5 mg Tab -

    159 Haloperidol 5 mg Tab -

    160 Handscoen no 6,5 Pcs 220

    161 Handscoen no 7,5 Pcs -

    162 Handscoen no 7,5 / E-katalog Pcs 209

    163 Handscoen No.7 Pcs -

    164 Handscoen no 8 Pcs -

    165 Handscoen no 8 / E-katalog Pcs -

    166 Handscoen Ginecolog Panjang Steril Pcs 10

    167 HB Sahli Pkt -

    168 Hemaviton Action Kaps -

    169 Hidrokortison Cream 2,5 % Tube 48

    170 Hidroklortiazida 25 mg Tab 1,000

    171 Ibuprofen 200 mg Tab 3,200

    172 Ibuprofen 400 mg Tab -

    173 Ibuprofen syrup/Buffec Syrup Btl 5

    174 Ictiol salep Pot 31


    175 Implant susuk KB Pcs -

    176 Infuset Micro Pcs 43

    177 Infuset Micro / e-katalog Pcs 400

    178 Infuset Macro Pcs 360

    179 Infuset Macro / e-katalog Pcs -

    180 Iodium test Btl -

    181 indikator universal ktk -

    182 IV Kateter no 18 Pcs 40

    183 IV Kateter no 18 / e-katalog Pcs -

    184 IV Kateter no 20 Pcs 286

    185 IV Kateter no 20 / E-katalog Pcs 50

    186 IV Kateter no 22 / E-katalog Pcs 270

    187 IV Kateter no 24 / E - katalog Pcs 464

    188 IV Canula No.18 Pcs -

    189 Isosorbit Dinitrat sublingual 5 mg Tab -

    190 Jarum Jahit Otot Lusin 9

    191 Jarum Jahit Kulit Lusin 9

    192 Jelly untuk USG / non e-katalog Btl 2

    193 Jelly untuk Catheter Komb. Lidokain Btl 1

    194 Kalsium Laktat 500 mg Tab 100

    195 Kalsium Gluconas Injeksi / non e-katalog Amp 5

    196 Kalnex 250 mg Kaps -

    197 Kalnex injeksi Amp -

    198 Kapas berlemak 500 gram Roll -

    199 Kapas pemb. Absorben 200 gram Roll -

    200 Kapas Pemb. Absorben 250 gram Roll 10

    201 Kapas pemb. Absorben 1000 gram Roll -


    202 Kaptopril 12,5 mg Tab -

    203 Kaptopril 25 mg Tab 800

    204 Karbamazepin 200 mg Tab -

    205 Kartu Stock Lbr 10

    206 Kasa 4 x 10 cm Roll -

    207 Kasa 4 x 6 cm Roll -

    208 Kasa 40 x 80 cm Roll -

    209 Kasa 40 x 80 cm / E-katalog 11

    210 Kasa Kompres 40/40 cm Roll -

    211 Kasa Kompres 40/40 cm / E-katalog Roll -

    212 Kasa Pembalut 2 m x 80 cm Roll -

    213 Kasa Pembalut Hidrofil 4 m x 3 cm Roll -

    214 Kasa Pembalut Hidrofil 4 m x 3 cm / E-katalog Roll 200

    215 Kasa Pembalut Hidrofil 4 m x 15 cm Roll -

    216 Kasa Pembalut Hidrofil 4 m x 15 cm / E-Katalog Roll -

    217 Kasa 16 x 16 Roll -

    218 Kasa pembalut 14 x 8 cm Roll -

    219 Kasa pembalut 10 cm Roll -

    220 Kasa pembalut 4 x 18 Roll -

    221 Kelambu Pcs -

    222 Ketamine Injeksi 10 mg/ml Vial -

    223 Ketokonazol cream 2 % Tube -

    224 Ketokonazol 200 mg Tab 1,250

    225 Ketorolac Injeksi Ampul 5

    226 Kertas EKG 3 Ukuran Roll -

    227 Kertas Perkamen / Non e-katalog Lbr 10

    228 Kina Dihidroklorida injeksi 25 % - 2 ml Amp -


    229 Kina 222 mg Tab -

    230 Klip Plastik Kecil tanpa sablon Pcs -

    231 Klip Plastik Sedang tanpa sablon Pcs -

    232 Klip Plastik Besar sablon 10 x 15 Pcs -

    233 Klip Plastik Sedang sablon 8,7 x 15 Pcs -

    234 Klip Plastik kecil sablon Pcs -

    235 Kloramfenicol 250 mg Kaps 600

    236 Kloramfenicol Salp Mata 1 % Tube 9

    237 Kloramfenicol Tetes Telinga 3 % Btl 40

    238 Klorfeniraminimaleat 4 mg Tab 4,000

    239 Klorokuin 150 mg Tab -

    240 Klorpromazin HCL injeksi i.m 25 mg/ml Amp -

    241 Klorpromazin HCL 25 mg Tab -

    242 Kodein 10 mg Tab 85

    243 Kotrimoksasol Adult 480 mg Tab 700

    244 Kotrimoksasol Pedriatic 120 mg Tab 2,400

    245 Kotrimoksasol suspensi Btl 67

    246 Lab.Kit Pkt -

    247 Lacbon 17 Tab -

    248 Lansoprazole 30 mg Kaps -

    249 Larutan Benedict Btl -

    250 Larutan Etanol Asam Btl -

    251 Larutan Gimsa stain / non e-katalog Btl -

    252 Larutan Carbofuksin Btl -

    253 Larutan Methilen Biru Btl -

    254 Larutan H2O2 Btl 1

    255 Larutan xilol Btl -


    256 Larutan HCl 0,1 N / Non e-katalog Btl -

    257 Levetran Salp Pot 12

    258 Levofloksasin 500 mg Tab -

    259 Lidocain Injeksi HCl 2 % Amp 265

    260 Lidocain Injeksi 2 % + Epineprin 1 : 80.000 - 2 ml Amp 30

    261 Livron B plex Tab -

    262 Loperamid 2 mg Tab 300

    263 Loratadin 10 mg Tab 600

    264 Lysol Btl 2

    265 Light cure Composite (etsa & bondingnya) Set -

    266 Magnesium Sulfat injeksi 20 % - 25 ml Amp 10

    267 Magnesium Sulfat injeksi 40 % - 25 ml Amp -

    268 Masker Mulut Pcs 650

    269 MDT MB Adult Blist -

    270 MDT PB Adult Blist -

    271 MDT MB Anak Blist 4

    272 MDT PB Anak Blist -

    273 Mebendazole syrup 100 mg/5 ml Btl -

    274 Mebendazole 100 mg Tab -

    275 Meloxicam 15 mg Tab -

    276 Metformin Tab -

    277 Metapex Box -

    278 Methanil Yellow Chen Kit ktk -

    279 Methilergometrin maleat 0,125 mg Tab -

    280 Methilergometrin maleat 0,200 mg - 1 ml Amp 20

    281 Methilprednisolon 4 mg Tab -

    282 Methilprednisolon 8 mg tab 900


    283 Metoclopramide injeksi 5 mg/5 ml Amp -

    284 Metoclopramide 10 mg Tab 200

    285 Metronidazol 250 mg Tab 100

    286 Metronidazol 500 mg Tab -

    287 Metronidazol infus Btl 5

    288 Mikonazole cream salp 2 % / e-katalog Tube 83

    289 Mikonazole cream salp 2 % / non e-katalog Tube -

    290 Mineral Mix Sac 40

    291 Morfin injeksi 10 mg/ml Amp -

    292 Natrium Bicarbonat 500 mg Tab -

    293 Natrium Diklofenak 25 mg Tab -

    294 Natrium Diklofenak 50 mg Tab -

    295 Natrium Klorida Larutan infus 0,9 % / e-katalog Btl 200

    296 Natrium Klorida Larutan infus 0,9 / non e-katalog Btl 120

    297 Natrium Fenitoin 100 mg Kaps -

    298 Natrium Fenitoin Injeksi / Non e-katalog Amp -

    299 Nicolin injeksi / Citicolin inj Amp -

    300 Nifedipin 10 mg Tab -

    301 Nistatin 100 000 UI Tab -

    302 Nistatin 500 000 UI Vaginal tab Tab -

    303 Nitrit Test Merk ktk -

    304 Neurovit- E Tab -

    305 Neurobion / Neurosanbe 5000 Tab -

    306 Neurobion / Neurosanbe Injeksi Amp -

    307 Obat Batuk Hitam syrup 100 ml Btl -

    308 Obat FDC Anak Pkt -

    309 Obat FDC Kategori 1 Pkt -


    310 Obat FDC Kategori 2 Pkt -

    311 Obat FDC TB sisipan Pkt -

    312 OAT Kombipak anak Pkt -

    313 OAT Kategori 1 & 3 Pkt -

    314 Oil Emersi Btl -

    315 Obat suntik KB 3 bulanan Vial -

    316 Oksitetrasiklin HCL 1 % salp mata Tube 25

    317 Oksitetrasiklin HCL 3 % salp Kulit Tube 75

    318 Oksitetrasiklin injeksi Vial -

    319 Oksitosin injeksi 10 IU/ml - 1 ml Amp 63

    320 Omeprazole 20 mg Kaps 570

    321 Papaverin injeksi 40 mg/ml Amp -

    322 Papaverin 40 mg Tab 2,000

    323 Paracetamol syrup 120 mg/5 ml Btl 40

    324 Paracetamol 500 mg Tab 2,500

    325 Parasetamol drop Btl 5

    326 Parasetamol suppositoria Supp -

    327 Penisilin procain / Procain Benzil Penicillin injeksi Vial 8

    328 Petidin injeksi 50 mg/ml Amp -

    329 Pil KB I Kombinasi Set -

    330 Pilokarpin Tetes mata 2 % Btl -

    331 Piracetam injeksi 3 g/15 ml Amp -

    332 Piracetam 1200 mg Tab -

    333 Piracetam 400 mg Tab -

    334 Pirasetam 800 mg Tab -

    335 Pirantel score base 125 mg Tab -

    336 Pirantel Syrup Btl -


    337 Piridoksin HCL 10 mg Tab 1,800

    338 Piroxicam 10 mg Tab 2,100

    339 Piroxicam 20 mg Tab 1,000

    340 Plester besar 5 yard x 2 inch Roll -

    341 Plester sedang 1,5 Inch x 5 cm Roll -

    342 Plester kecil 1,25 x 5 cm roll -

    343 Plester ( Leukoplast) 7,5 x 4,5 cm Roll 4

    344 Poligips 7,5cm Roll 5

    345 Poligips 10 cm Roll 5

    346 Poligips 15 cm Roll 5

    347 Povidon iodida larutan 10 % 30 ml Btl 3

    348 Povidon iodida larutan 10 % 300 ml Btl 5

    349 Povidon iodida larutan 10 % 1000 ml Btl 2

    350 Prednison 5 mg Tab 1,800

    351 Primakuin 15 mg Tab 100

    352 Propanolol 40 mg Tab 100

    353 Propilitiourasil 100 mg Tab 100

    354 Ranitidin 150 mg Tab 3,900

    355 Ranitidin injeksi 25 mg/2 ml Amp 19

    356 Rapid Diagnostic Test (RDT) Pcs -

    357 Reagen zealnelsen Pkt -

    358 Reserpin 0,1 mg Tab -

    359 Reserpin 0,25 mg Tab -

    360 Retinol 100.000 IU Kaps -

    361 Retinol 200.000 IU Kaps -

    362 Ringer Lactat larutan infus Btl 195

    363 Rodamin B Test Chem ktk -


    364 Safety box Lbr -

    365 Salicyl Spritus 55 ml Btl -

    366 Salbutamol 2 mg Tab 200

    367 Salbutamol 4 mg Tab -

    368 Salep 2 - 4,Komb.As.Salisilat 2% + Sulfur Praicip Pot 41

    369 Salisil Bedak Ktk 6

    370 Sanbe B-Plex Btl -

    371 Sangobion Kaps 250

    372 Santa E Tab -

    373 Scabisid Cream Tube -

    374 Serum Antibisa Ular Polivalen ( ABU I ) Vial 1

    375 Serum Antitetanus injeksi 1.500 IU ( ATS ) Vial 1

    376 Sianocobalamine injeksi 500 mcg Amp 90

    377 Sianocobalamine 50 mcg Tab 800

    378 Silk ( Benang Bedah Sutera ) Pcs -

    379 Silk ( Benang Bedah Sutera ) / e-katalog Pcs 62

    380 Slide Pcs 792

    381 Sputum pot / Non e-katalog Bh -

    382 Spongostan Ktk -

    383 Streptomisin injeksi Vial -

    384 Simvastatin 10 mg Tab -

    385 Test Kehamilan Pcs 50

    386 Tetrasiklin 250 mg Kaps -

    387 Tetrasiklin 500 mg Kaps -

    388 Thiamphenicol 500 mg Kaps -

    389 Tiamin injeksi 100 mg/ml Amp 100

    390 Tiamin HCL 50 mg Tab 2,400


    391 Topicaina topical gel / Anastesi anak Btl -

    392 Tooth stain Remover btl -

    393 Triheksifenidil 2 mg Tab -

    394 Tri Kresol Formalin /TKF Btl -

    395 Tramadol 50 mg / ml Injeksi Amp -

    396 Transfusi Set Pcs -

    397 Transfusi Set / E-katalog Pcs -

    398 Tremenza Tab -

    399 Tissue Lensa pcs -

    400 Urine bag / e-katalog Pcs 30

    401 Urine Test / Gluco Protein Test Pcs -

    402 Vitamin B - complex Tab 2,600

    403 Ventolin inj. amp 6

    404 Wing Needle no 27 Pcs -

    405 Zink Oxide Eugenol (powder+liquid/kalzinol) Btl -

    406 Zinc Dispersible 120 mg Tab 1,350

    407 Slide box Pcs -

    408 Acarbose 50 mg Tab -

    409 Asam Traneksamat Injeksi amp -

    410 Asam Traneksamat 500 mg kapl 500

    411 Bumer Pcs -

    412 Etanol 70 % 100 ml btl -

    413 Furosemide 10mg/ml injeksi Amp -

    414 Glimepiride 2 mg Tab -

    415 Jarum jahit Combinasi otot & Kulit Lusin 11

    416 Plester Besar 5 m x 4,5 cm (Leukoplast) Roll 5

    417 Povidon iodida Larutan 10 % 60 ml Btl -


    418 Semprong Pcs -

    419 Sumbu bh -

    420 Termometer Ruangan Kayu Pcs 2

    421 Sofero caps -

    422 Disposible dental needle no. 18 pcs -

    423 Disposible dental needle no. 20 Pcs -

    424 Disposible dental needle no. 25 Pcs -

    425 Jarum Citojek No. 12 Pcs -

    426 Jarum Citojek No. 16 Pcs -

    427 Resin Composite (A2+A3) Btl -

    428 Suction Rip Pcs -

    429 Levemir Injeksi / non e-katalog paket -

    430 Borax Test ktk -

    431 Novabion caps -

    432 Larutan Metanol btl -

    433 Larutan Oil Imersion 50 ml btl -

    434 Alkohol Swap Pkt -

    435 Aquadest 600 ml Btl -

    436 Alat Tes Darah Multifungsi Pkt -

    437 Stik Gula Darah Pkt -

    438 Stik Kolesterol Pkt -

    439 Stik Asam Urat Pkt -

    440 Miniaspi 80 mg (Asetosal 80 mg) Tab 500

    441 Isoniazid 100 mg Tab -

    442 Rantin injeksi (Ranitidin inj. 25 mg/ml)Non E. Amp -

    443 Nexa 500 mg (Asam Traneksamat) Non E. Tab -

    444 Sotatic Injeksi (Metoclopramide inj. 5 mg/ml) Non E. Amp -


    445 Salbron 2 mg (Salbutamol 2 mg) Non E. Tab -

    446 Pehacain Inj. (Lidocain Comb.) Amp -

    447 Otoryl 25 Mg (Kaptopril 25 mg) Tab -

    448 Asam Folat 1 mg Tab 900

    449 Azitromycin 500 mg Tab -

    450 Ciprofloksasine Injeksi Btl -

    451 Amlodipin 10 mg Tab -

    452 Dentin Conditioner Minipack Box -

    453 Stesolit Rectal / Diazepam rectal Supp -

    454 Paracetamol Infus 100 ml Btl -

    455 Cetrizine 10 mg Tab -

    VAKSIN
    1 HBo Vial 5

    2 BCG Amp 2

    3 Polio Vial 6

    4 DPT-HB Vial 3

    5 Pantavalen Vial -

    6 Campak Vial 2

    7 TT Vial -

    8 DT Vial 8

    9 TD Vial -

    10 ADS 0,5 Vial -

    11 ADS 0,05 Vial -

    12 Pelarut BCG Amp 2

    13 Pelarut Campak Amp 3


    Poli Umum
    Kunjungan Resep

    UMUM

    BAYAR
    JUMLAH KUNJUNGAN RESEP

    Mengetahui Yang Menyera


    Kepala Dinas Kesehatan Kab. Alor Petugas IF

    NIP. NIP.
    PEMERINTAH KABUPATEN ALOR
    D I N A S K E S E H A T A N
    Jl. Prof. DR. W. Z. Yohanes. No. - Telp. (0386) 21052
    K A L A B A H I

    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    LAP. PEMAKAIAN O
    LEMBAR PERMINTA
    TAHUN
    TRIWULAN

    Penerimaan Persediaan Pemakaian Sisa Stok Stok Optimum

    5 6 7 9 11

    - -

    450 450

    280 280

    - -

    400 400

    - -

    400 400

    500 500

    - -

    650 650

    1,200 1,200

    - -
    10 10

    2,400 2,400

    9 9

    280 280

    - -

    - -

    50 50

    2,500 2,500

    2,000 2,000

    50 50

    - -

    - -

    3,000 3,000

    46 46

    1,600 1,600

    15 15

    41 41

    24 24

    - -

    1,000 1,000

    - -

    - -

    - -

    - -

    - -

    5 5

    3 3
    1 1

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    8,600 8,600

    2,500 2,500

    57 57

    1,050 1,050

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    25 25

    - -

    - -
    - -

    - -

    83 83

    - -

    - -

    - -

    - -

    96 96

    - -

    120 120

    - -

    - -

    1,700 1,700

    - -

    6 6

    - -

    - -

    5 5

    5 5

    3,100 3,100

    1,500 1,500

    - -

    - -

    216 216

    - -

    153 153

    2,800 2,800
    - -

    - -

    - -

    - -

    - -

    5 5

    - -

    79 79

    - -

    - -

    - -

    - -

    200 200

    30 30

    160 160

    - -

    - -

    - -

    - -

    - -

    30 30

    - -

    - -

    - -

    25 25

    12 12

    6 6
    - -

    - -

    - -

    - -

    - -

    200 200

    - -

    - -

    - -

    14 14

    260 260

    22 22

    - -

    - -

    4 4

    5 5

    - -

    - -

    - -

    - -

    525 525

    - -

    - -

    65 65

    41 41

    - -

    500 500
    4,200 4,200

    60 60

    - -

    102 102

    - -

    - -

    - -

    - -

    1,500 1,500

    - -

    - -

    - -

    220 220

    - -

    209 209

    - -

    - -

    - -

    10 10

    - -

    - -

    48 48

    1,000 1,000

    3,200 3,200

    - -

    5 5

    31 31
    - -

    43 43

    400 400

    360 360

    - -

    - -

    - -

    40 40

    - -

    286 286

    50 50

    270 270

    464 464

    - -

    - -

    9 9

    9 9

    2 2

    1 1

    100 100

    5 5

    - -

    - -

    - -

    - -

    10 10

    - -
    - -

    800 800

    - -

    10 10

    - -

    - -

    - -

    11 11

    - -

    - -

    - -

    - -

    200 200

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    1,250 1,250

    5 5

    - -

    10 10

    - -
    - -

    - -

    - -

    - -

    - -

    - -

    600 600

    9 9

    40 40

    4,000 4,000

    - -

    - -

    - -

    85 85

    700 700

    2,400 2,400

    67 67

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    1 1

    - -
    - -

    12 12

    - -

    265 265

    30 30

    - -

    300 300

    600 600

    2 2

    - -

    10 10

    - -

    650 650

    - -

    - -

    4 4

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    20 20

    - -

    900 900
    - -

    200 200

    100 100

    - -

    5 5

    83 83

    - -

    40 40

    - -

    - -

    - -

    - -

    200 200

    120 120

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -
    - -

    - -

    - -

    - -

    - -

    - -

    25 25

    75 75

    - -

    63 63

    570 570

    - -

    2,000 2,000

    40 40

    2,500 2,500

    5 5

    - -

    8 8

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -
    1,800 1,800

    2,100 2,100

    1,000 1,000

    - -

    - -

    - -

    4 4

    5 5

    5 5

    5 5

    3 3

    5 5

    2 2

    1,800 1,800

    100 100

    100 100

    100 100

    3,900 3,900

    19 19

    - -

    - -

    - -

    - -

    - -

    - -

    195 195

    - -
    - -

    - -

    200 200

    - -

    41 41

    6 6

    - -

    250 250

    - -

    - -

    1 1

    1 1

    90 90

    800 800

    - -

    62 62

    792 792

    - -

    - -

    - -

    - -

    50 50

    - -

    - -

    - -

    100 100

    2,400 2,400
    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    30 30

    - -

    2,600 2,600

    6 6

    - -

    - -

    1,350 1,350

    - -

    - -

    - -

    500 500

    - -

    - -

    - -

    - -

    11 11

    5 5

    - -
    - -

    - -

    2 2

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    500 500

    - -

    - -

    - -

    - -
    - -

    - -

    - -

    900 900

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    5 5

    2 2

    6 6

    3 3

    - -

    2 2

    - -

    8 8

    - -

    - -

    - -

    2 2

    3 3
    Sumber / Asal Resep
    Poli Gigi KIA KB Raeat Inap UGD

    MUM
    ASKES JUMLAH
    TIDAK BAYAR Dokter

    ang Menyerahkan Yang Meminta


    Petugas IFK Kepala Puskesmas

    NIP.
    LPO)

    P. PEMAKAIAN OBAT BULAN : SEPTEMBER


    MBAR PERMINTAAN OBAT BULAN :
    : 2019
    :

    permintaan pemberian KET

    12 14 16
    Total Resep ke Apotik
    Pusling, Posyandu, dll Bulan Ini Kumulatif s/d Bulan ini

    - #VALUE!

    Pemberi Resep
    Perawat Bidan Perawat Gigi

    Yang Menerima
    Petugas Puskesmas

    NIP.
    ……………………….,
    ………………………………………
    ……………………….,
    …………………………………………………………
    LA

    NAMA PUSKESMAS :
    KABUPATEN : ALOR
    KECAMATAN :

    No Nama Obat Satuan Stok awal

    1 2 3 4

    1 Adona Injensi -
    Amp
    2 Alat Suntik Sekali Pakai 2,5 ml Pcs 450

    3 Alat Suntik Sekali Pakai 5 ml Pcs 280

    4 Alat suntik sekali pakai 0,5 ml Pcs -

    5 Alat suntik sekali pakai 0,5 ml / E - Katalog Pcs 400

    6 Alat suntik sekali pakai 0,05 ml /non e-katalog pcs -

    7 Alat suntik sekali pakai 0,05 ml / e-katalog Pcs 400

    8 Alat suntik sekali pakai 1 ml Pcs 500

    9 Alat suntik sekali pakai10 ml Pcs -

    10 Albendazol 400 mg / non e-katalog Tab 650

    11 Allupurinol 100 mg Tab 1,200

    12 Amalgam solila / Silver Amalgam Powder + Liquid Tube -


    13 Ambroxol syrup 15 mg/ml Btl 10

    14 Ambroxol 30 mg Tab 2,400

    15 Aminofilin Injeksi 24 mg/ml Amp 9

    16 Aminofilin 200 mg / e-katalog Tab 280

    17 Aminofilin 200 mg / non e-katalog tab -

    18 Amitriptilin HCL 25 mg Tab -

    19 Amlodipin 5 mg Tab 50

    20 Amoksisilin 250 mg Kaps 2,500

    21 Amoksisilin 500 mg Kapl 2,000

    22 Amoksisilin syrup Btl 50

    23 Ampisillin injeksi 1000 mg/ml Vial -

    24 Ampisillin syrup Btl -

    25 Antacida DOEN Tab 3,000

    26 Antacida DOEN Suspensi Btl 46

    27 Antalgin 500 mg Tab 1,600

    28 Antalgin injeksi Amp 15

    29 Anti Bakteri DOEN / Basitrasin Polimiksin Tube 41

    30 Anti Fungi DOEN Salep 30 g ( Salp 3 - 6 ) Pot 24

    31 Anti Haemoroid DOEN Suppositoria Supp -

    32 Anti Malaria DOEN ( SulDox ) Tab 1,000

    33 Anti Migraen / Ergotamin 1 mg + Coffein 50 mg Tab -

    34 Anti Sera A Btl -

    35 Anti Sera B Btl -

    36 Anti Sera AB Btl -

    37 Anti Sera D Btl -

    38 Aqua pro injeksi 20 ml Vial 5

    39 Aquadestilata 1000 ml Btl 3


    40 Aqua DM Bidestilata IKA ml 1

    41 Aqua DM Brataco ltr -

    42 Arsen / Devitalisasi Pasta Btl -

    43 Arterakin tab Tab -

    44 Artesunat injeksi 60 mg Vial -

    45 Artemeter injeksi Amp -

    46 Asetosal 100 mg Tab -

    47 Asetosal 500 mg Tab -

    48 Asam Ascorbat 50 mg Tab 8,600

    49 Asam Mefenamat 500 mg Kapl 2,500

    50 Asiklovir cream 5 % 5 g Tube 57

    51 Asiklovir 200 mg Tab 1,050

    52 Asiklovir 400 mg Tab -

    53 Atropin Sulfat injeksi 0,25 mg/ml Amp -

    54 Atropin sulfat 0,5 mg Tab -

    55 Baby Cough syrup Btl -

    56 Bahan Fissur Sealent / Fuji VII Dos -

    57 Baraclude 1 mg btl/30 tab -

    58 Baraclude 0,5 mg box/30 tab -

    59 Barotec Inhaler Btl -

    60 Baycline 1 Liter Btl -

    61 Benzatin Benzil Penicillin 1,2 juta IU Vial -

    62 Besi II Sulfat 7 H2O 300 mg Tab -

    63 Besi II Sulfat + Asam Folat Tab -

    64 Betametason Cream 0,1 % Tube 25

    65 Betason N Tube -

    66 Bidan Kit paket -


    67 Bioplacenton 15 gram Tube -

    68 Bisolvon Nebulizer btl -

    69 Bisturi / non e-katalog Pcs 83

    70 Blood lanset / non e-katalog Pcs -

    71 Calsidor / Dycal Dentsply / Hydcal Technew Btl -

    72 Calsydol syrup Btl -

    73 Cat gut 3/0 Pcs -

    74 Cat gut 3/0 / E-katalog Pcs 96

    75 Cat gut 2/0 Pcs -

    76 Cat gut 2/0 / E-katalog Pcs 120

    77 Cavit / Caviton Btl -

    78 Cement Powder + Liquid / Elite Cement 100 Dos -

    79 Cefadroxil 500 mg Kaps 1,700

    80 Ceftriaxon Injeksi Vial -

    81 Cefotaxime injeksi 0,5 gram Vial 6

    82 Cefotaxime injeksi 1 gram Vial -

    83 Chlor Fenol Champer menthol /CHKM Btl -

    84 Chloramfecort Tube 5

    85 Chloramfecort H Tube 5

    86 Cimetidine 200 mg Tab 3,100

    87 Ciprofloksasine 500 mg Tab 1,500

    88 Counterpain 30 gram Tube -

    89 Curcuma Plus Syrup Btl -

    90 Darplex Tab 216

    91 Dasabion Kaps -

    92 Deksamethasone injeksi 5 mg/ml Amp 153

    93 Deksamethasone 0,5 mg Tab 2,800


    94 Dekstran 70 - Larutan Infus 6 % steril Btl -

    95 Dental Cotton Roll Bks -

    96 Dental Plak Disclosing Gel / Disclosing Solution Btl -

    97 Diazepam injeksi 5 mg/ml Amp -

    98 Diazepam 2 mg Tab -

    99 Diazepam 5 mg Tab 5

    100 Dietilkarbamsin 100 mg / NON E-KATALOG Tab -

    101 Difenhidramine Injeksi 10 mg/ml Amp 79

    102 Digoksin 0,25 mg Tab -

    103 Diltiazem HCL 30 mg Tab -

    104 Dimenhidrinat 50 mg Tab -

    105 Doksisiklin 100 mg Kaps -

    106 Domperidon Tab 200

    107 Dulcolax 5 mg Tab 30

    108 Efedrin HCL 25 mg Tab 160

    109 Elastis verban 3 inci Roll -

    110 Elastis verban 4 inci Roll -

    111 Elastis verban 6 inci Roll -

    112 Elkana Multivitamin Tab -

    113 Enervon - C Kapl -

    114 Epineprin HCL 0,1 % injeksi Amp 30

    115 Eritromicin 250 mg Kapl -

    116 Eritromicin 500 mg Kapl -

    117 Eritromicin syrup Btl -

    118 Etakridin Larutan 0,1 % 300 ml Btl 25

    119 Etanol 70 % 1 liter Btl 12

    120 Ethilklorda Semprot Btl 6


    121 Endomethasone (endosel) btl -

    122 Eugenol Btl -

    123 Fehling A Btl -

    124 Fehling B Btl -

    125 Fenobarbital injeksi 50 mg/ml Amp -

    126 Fenobarbital 30 mg Tab 200

    127 Fenobarbital 100 mg Tab -

    128 Fenoksimetil Penisilin 250 mg Tab -

    129 Fenoksimetil Penisilin 500 mg Tab -

    130 Fenol gliserol TT Btl 14

    131 Fitomenadion 10 mg Tab 260

    132 Fitomenadion injeksi 10 mg/ml Amp 22

    133 Flecher Powder + Liquid Btl -

    134 Foley cateter no 16 Pcs -

    135 Foley cateter no 18 Pcs 4

    136 Foley cateter no 20 Pcs 5

    137 Formalin solution liter -

    138 Formaldehide Merk Test kit -

    139 Formokresol Btl -

    140 Furosemida Tab -

    141 Garam Oralit Sac 525

    142 Gamexan Btl -

    143 Gentamicin Injeksi 80 mg/ml Amp -

    144 Gentamicin Salep Kulit 0,1 % Tube 65

    145 Gentian Violet 1 % Btl 41

    146 Gic Art / Fuji IX Dos -

    147 Glibenclamida 5 mg Tab 500


    148 Gliceril Guayacolat 100 mg Tab 4,200

    149 Glucosa Larutan Infus 10 % steril Btl 60

    150 Glucosa Larutan Infus 40 % steril Btl -

    151 Glucosa Larutan Infus 5 % steril Btl 102

    152 Gloves "S" Pcs -

    153 Gloves "M" Pcs -

    154 Gloves "L" Pcs -

    155 Grisofulvin 250 mg Tab -

    156 Grisofulvin 125 mg tab 1,500

    157 Haloperidol 0,5 mg Tab -

    158 Haloperidol 1,5 mg Tab -

    159 Haloperidol 5 mg Tab -

    160 Handscoen no 6,5 Pcs 220

    161 Handscoen no 7,5 Pcs -

    162 Handscoen no 7,5 / E-katalog Pcs 209

    163 Handscoen No.7 Pcs -

    164 Handscoen no 8 Pcs -

    165 Handscoen no 8 / E-katalog Pcs -

    166 Handscoen Ginecolog Panjang Steril Pcs 10

    167 HB Sahli Pkt -

    168 Hemaviton Action Kaps -

    169 Hidrokortison Cream 2,5 % Tube 48

    170 Hidroklortiazida 25 mg Tab 1,000

    171 Ibuprofen 200 mg Tab 3,200

    172 Ibuprofen 400 mg Tab -

    173 Ibuprofen syrup/Buffec Syrup Btl 5

    174 Ictiol salep Pot 31


    175 Implant susuk KB Pcs -

    176 Infuset Micro Pcs 43

    177 Infuset Micro / e-katalog Pcs 400

    178 Infuset Macro Pcs 360

    179 Infuset Macro / e-katalog Pcs -

    180 Iodium test Btl -

    181 indikator universal ktk -

    182 IV Kateter no 18 Pcs 40

    183 IV Kateter no 18 / e-katalog Pcs -

    184 IV Kateter no 20 Pcs 286

    185 IV Kateter no 20 / E-katalog Pcs 50

    186 IV Kateter no 22 / E-katalog Pcs 270

    187 IV Kateter no 24 / E - katalog Pcs 464

    188 IV Canula No.18 Pcs -

    189 Isosorbit Dinitrat sublingual 5 mg Tab -

    190 Jarum Jahit Otot Lusin 9

    191 Jarum Jahit Kulit Lusin 9

    192 Jelly untuk USG / non e-katalog Btl 2

    193 Jelly untuk Catheter Komb. Lidokain Btl 1

    194 Kalsium Laktat 500 mg Tab 100

    195 Kalsium Gluconas Injeksi / non e-katalog Amp 5

    196 Kalnex 250 mg Kaps -

    197 Kalnex injeksi Amp -

    198 Kapas berlemak 500 gram Roll -

    199 Kapas pemb. Absorben 200 gram Roll -

    200 Kapas Pemb. Absorben 250 gram Roll 10

    201 Kapas pemb. Absorben 1000 gram Roll -


    202 Kaptopril 12,5 mg Tab -

    203 Kaptopril 25 mg Tab 800

    204 Karbamazepin 200 mg Tab -

    205 Kartu Stock Lbr 10

    206 Kasa 4 x 10 cm Roll -

    207 Kasa 4 x 6 cm Roll -

    208 Kasa 40 x 80 cm Roll -

    209 Kasa 40 x 80 cm / E-katalog 11

    210 Kasa Kompres 40/40 cm Roll -

    211 Kasa Kompres 40/40 cm / E-katalog Roll -

    212 Kasa Pembalut 2 m x 80 cm Roll -

    213 Kasa Pembalut Hidrofil 4 m x 3 cm Roll -

    214 Kasa Pembalut Hidrofil 4 m x 3 cm / E-katalog Roll 200

    215 Kasa Pembalut Hidrofil 4 m x 15 cm Roll -

    216 Kasa Pembalut Hidrofil 4 m x 15 cm / E-Katalog Roll -

    217 Kasa 16 x 16 Roll -

    218 Kasa pembalut 14 x 8 cm Roll -

    219 Kasa pembalut 10 cm Roll -

    220 Kasa pembalut 4 x 18 Roll -

    221 Kelambu Pcs -

    222 Ketamine Injeksi 10 mg/ml Vial -

    223 Ketokonazol cream 2 % Tube -

    224 Ketokonazol 200 mg Tab 1,250

    225 Ketorolac Injeksi Ampul 5

    226 Kertas EKG 3 Ukuran Roll -

    227 Kertas Perkamen / Non e-katalog Lbr 10

    228 Kina Dihidroklorida injeksi 25 % - 2 ml Amp -


    229 Kina 222 mg Tab -

    230 Klip Plastik Kecil tanpa sablon Pcs -

    231 Klip Plastik Sedang tanpa sablon Pcs -

    232 Klip Plastik Besar sablon 10 x 15 Pcs -

    233 Klip Plastik Sedang sablon 8,7 x 15 Pcs -

    234 Klip Plastik kecil sablon Pcs -

    235 Kloramfenicol 250 mg Kaps 600

    236 Kloramfenicol Salp Mata 1 % Tube 9

    237 Kloramfenicol Tetes Telinga 3 % Btl 40

    238 Klorfeniraminimaleat 4 mg Tab 4,000

    239 Klorokuin 150 mg Tab -

    240 Klorpromazin HCL injeksi i.m 25 mg/ml Amp -

    241 Klorpromazin HCL 25 mg Tab -

    242 Kodein 10 mg Tab 85

    243 Kotrimoksasol Adult 480 mg Tab 700

    244 Kotrimoksasol Pedriatic 120 mg Tab 2,400

    245 Kotrimoksasol suspensi Btl 67

    246 Lab.Kit Pkt -

    247 Lacbon 17 Tab -

    248 Lansoprazole 30 mg Kaps -

    249 Larutan Benedict Btl -

    250 Larutan Etanol Asam Btl -

    251 Larutan Gimsa stain / non e-katalog Btl -

    252 Larutan Carbofuksin Btl -

    253 Larutan Methilen Biru Btl -

    254 Larutan H2O2 Btl 1

    255 Larutan xilol Btl -


    256 Larutan HCl 0,1 N / Non e-katalog Btl -

    257 Levetran Salp Pot 12

    258 Levofloksasin 500 mg Tab -

    259 Lidocain Injeksi HCl 2 % Amp 265

    260 Lidocain Injeksi 2 % + Epineprin 1 : 80.000 - 2 ml Amp 30

    261 Livron B plex Tab -

    262 Loperamid 2 mg Tab 300

    263 Loratadin 10 mg Tab 600

    264 Lysol Btl 2

    265 Light cure Composite (etsa & bondingnya) Set -

    266 Magnesium Sulfat injeksi 20 % - 25 ml Amp 10

    267 Magnesium Sulfat injeksi 40 % - 25 ml Amp 500

    268 Masker Mulut Pcs 650

    269 MDT MB Adult Blist -

    270 MDT PB Adult Blist -

    271 MDT MB Anak Blist 4

    272 MDT PB Anak Blist -

    273 Mebendazole syrup 100 mg/5 ml Btl -

    274 Mebendazole 100 mg Tab -

    275 Meloxicam 15 mg Tab -

    276 Metformin Tab -

    277 Metapex Box -

    278 Methanil Yellow Chen Kit ktk -

    279 Methilergometrin maleat 0,125 mg Tab -

    280 Methilergometrin maleat 0,200 mg - 1 ml Amp 20

    281 Methilprednisolon 4 mg Tab -

    282 Methilprednisolon 8 mg tab 900


    283 Metoclopramide injeksi 5 mg/5 ml Amp -

    284 Metoclopramide 10 mg Tab 200

    285 Metronidazol 250 mg Tab 100

    286 Metronidazol 500 mg Tab -

    287 Metronidazol infus Btl 5

    288 Mikonazole cream salp 2 % / e-katalog Tube 83

    289 Mikonazole cream salp 2 % / non e-katalog Tube -

    290 Mineral Mix Sac 40

    291 Morfin injeksi 10 mg/ml Amp -

    292 Natrium Bicarbonat 500 mg Tab -

    293 Natrium Diklofenak 25 mg Tab -

    294 Natrium Diklofenak 50 mg Tab -

    295 Natrium Klorida Larutan infus 0,9 % / e-katalog Btl 200

    296 Natrium Klorida Larutan infus 0,9 / non e-katalog Btl 120

    297 Natrium Fenitoin 100 mg Kaps -

    298 Natrium Fenitoin Injeksi / Non e-katalog Amp -

    299 Nicolin injeksi / Citicolin inj Amp -

    300 Nifedipin 10 mg Tab -

    301 Nistatin 100 000 UI Tab -

    302 Nistatin 500 000 UI Vaginal tab Tab -

    303 Nitrit Test Merk ktk -

    304 Neurovit- E Tab -

    305 Neurobion / Neurosanbe 5000 Tab -

    306 Neurobion / Neurosanbe Injeksi Amp -

    307 Obat Batuk Hitam syrup 100 ml Btl -

    308 Obat FDC Anak Pkt -

    309 Obat FDC Kategori 1 Pkt -


    310 Obat FDC Kategori 2 Pkt -

    311 Obat FDC TB sisipan Pkt -

    312 OAT Kombipak anak Pkt -

    313 OAT Kategori 1 & 3 Pkt -

    314 Oil Emersi Btl -

    315 Obat suntik KB 3 bulanan Vial -

    316 Oksitetrasiklin HCL 1 % salp mata Tube 25

    317 Oksitetrasiklin HCL 3 % salp Kulit Tube 75

    318 Oksitetrasiklin injeksi Vial -

    319 Oksitosin injeksi 10 IU/ml - 1 ml Amp 63

    320 Omeprazole 20 mg Kaps 570

    321 Papaverin injeksi 40 mg/ml Amp -

    322 Papaverin 40 mg Tab 2,000

    323 Paracetamol syrup 120 mg/5 ml Btl 40

    324 Paracetamol 500 mg Tab 2,500

    325 Parasetamol drop Btl 5

    326 Parasetamol suppositoria Supp -

    327 Penisilin procain / Procain Benzil Penicillin injeksi Vial 8

    328 Petidin injeksi 50 mg/ml Amp -

    329 Pil KB I Kombinasi Set -

    330 Pilokarpin Tetes mata 2 % Btl -

    331 Piracetam injeksi 3 g/15 ml Amp -

    332 Piracetam 1200 mg Tab -

    333 Piracetam 400 mg Tab -

    334 Pirasetam 800 mg Tab -

    335 Pirantel score base 125 mg Tab -

    336 Pirantel Syrup Btl -


    337 Piridoksin HCL 10 mg Tab 1,800

    338 Piroxicam 10 mg Tab 2,100

    339 Piroxicam 20 mg Tab 1,000

    340 Plester besar 5 yard x 2 inch Roll -

    341 Plester sedang 1,5 Inch x 5 cm Roll -

    342 Plester kecil 1,25 x 5 cm roll -

    343 Plester ( Leukoplast) 7,5 x 4,5 cm Roll 4

    344 Poligips 7,5cm Roll 5

    345 Poligips 10 cm Roll 5

    346 Poligips 15 cm Roll 5

    347 Povidon iodida larutan 10 % 30 ml Btl 3

    348 Povidon iodida larutan 10 % 300 ml Btl 5

    349 Povidon iodida larutan 10 % 1000 ml Btl 2

    350 Prednison 5 mg Tab 1,800

    351 Primakuin 15 mg Tab 100

    352 Propanolol 40 mg Tab 100

    353 Propilitiourasil 100 mg Tab 100

    354 Ranitidin 150 mg Tab 3,900

    355 Ranitidin injeksi 25 mg/2 ml Amp 19

    356 Rapid Diagnostic Test (RDT) Pcs -

    357 Reagen zealnelsen Pkt -

    358 Reserpin 0,1 mg Tab -

    359 Reserpin 0,25 mg Tab -

    360 Retinol 100.000 IU Kaps -

    361 Retinol 200.000 IU Kaps -

    362 Ringer Lactat larutan infus Btl 195

    363 Rodamin B Test Chem ktk -


    364 Safety box Lbr -

    365 Salicyl Spritus 55 ml Btl -

    366 Salbutamol 2 mg Tab 200

    367 Salbutamol 4 mg Tab -

    368 Salep 2 - 4,Komb.As.Salisilat 2% + Sulfur Praicip Pot 41

    369 Salisil Bedak Ktk 6

    370 Sanbe B-Plex Btl -

    371 Sangobion Kaps 250

    372 Santa E Tab -

    373 Scabisid Cream Tube -

    374 Serum Antibisa Ular Polivalen ( ABU I ) Vial 1

    375 Serum Antitetanus injeksi 1.500 IU ( ATS ) Vial 1

    376 Sianocobalamine injeksi 500 mcg Amp 90

    377 Sianocobalamine 50 mcg Tab 800

    378 Silk ( Benang Bedah Sutera ) Pcs -

    379 Silk ( Benang Bedah Sutera ) / e-katalog Pcs 62

    380 Slide Pcs 792

    381 Sputum pot / Non e-katalog Bh -

    382 Spongostan Ktk -

    383 Streptomisin injeksi Vial -

    384 Simvastatin 10 mg Tab -

    385 Test Kehamilan Pcs 50

    386 Tetrasiklin 250 mg Kaps -

    387 Tetrasiklin 500 mg Kaps -

    388 Thiamphenicol 500 mg Kaps -

    389 Tiamin injeksi 100 mg/ml Amp 100

    390 Tiamin HCL 50 mg Tab 2,400


    391 Topicaina topical gel / Anastesi anak Btl -

    392 Tooth stain Remover btl -

    393 Triheksifenidil 2 mg Tab -

    394 Tri Kresol Formalin /TKF Btl -

    395 Tramadol 50 mg / ml Injeksi Amp -

    396 Transfusi Set Pcs -

    397 Transfusi Set / E-katalog Pcs -

    398 Tremenza Tab -

    399 Tissue Lensa pcs -

    400 Urine bag / e-katalog Pcs 30

    401 Urine Test / Gluco Protein Test Pcs -

    402 Vitamin B - complex Tab 2,600

    403 Ventolin inj. amp 6

    404 Wing Needle no 27 Pcs -

    405 Zink Oxide Eugenol (powder+liquid/kalzinol) Btl -

    406 Zinc Dispersible 120 mg Tab 1,350

    407 Slide box Pcs -

    408 Acarbose 50 mg Tab -

    409 Asam Traneksamat Injeksi amp -

    410 Asam Traneksamat 500 mg kapl 500

    411 Bumer Pcs -

    412 Etanol 70 % 100 ml btl -

    413 Furosemide 10mg/ml injeksi Amp -

    414 Glimepiride 2 mg Tab -

    415 Jarum jahit Combinasi otot & Kulit Lusin 11

    416 Plester Besar 5 m x 4,5 cm (Leukoplast) Roll 5

    417 Povidon iodida Larutan 10 % 60 ml Btl -


    418 Semprong Pcs -

    419 Sumbu bh -

    420 Termometer Ruangan Kayu Pcs 2

    421 Sofero caps -

    422 Disposible dental needle no. 18 pcs -

    423 Disposible dental needle no. 20 Pcs -

    424 Disposible dental needle no. 25 Pcs -

    425 Jarum Citojek No. 12 Pcs -

    426 Jarum Citojek No. 16 Pcs -

    427 Resin Composite (A2+A3) Btl -

    428 Suction Rip Pcs -

    429 Levemir Injeksi / non e-katalog paket -

    430 Borax Test ktk -

    431 Novabion caps -

    432 Larutan Metanol btl -

    433 Larutan Oil Imersion 50 ml btl #VALUE!

    434 Alkohol Swap Pkt -

    435 Aquadest 600 ml Btl -

    436 Alat Tes Darah Multifungsi Pkt -

    437 Stik Gula Darah Pkt -

    438 Stik Kolesterol Pkt -

    439 Stik Asam Urat Pkt -

    440 Miniaspi 80 mg (Asetosal 80 mg) Tab 500

    441 Isoniazid 100 mg Tab -

    442 Rantin injeksi (Ranitidin inj. 25 mg/ml)Non E. Amp -

    443 Nexa 500 mg (Asam Traneksamat) Non E. Tab -

    444 Sotatic Injeksi (Metoclopramide inj. 5 mg/ml) Non E. Amp -


    445 Salbron 2 mg (Salbutamol 2 mg) Non E. Tab -

    446 Pehacain Inj. (Lidocain Comb.) Amp -

    447 Otoryl 25 Mg (Kaptopril 25 mg) Tab -

    448 Asam Folat 1 mg Tab 900

    449 Azitromycin 500 mg Tab -

    450 Ciprofloksasine Injeksi Btl -

    451 Amlodipin 10 mg Tab -

    452 Dentin Conditioner Minipack Box -

    453 Stesolit Rectal / Diazepam rectal Supp -

    454 Paracetamol Infus 100 ml Btl -

    455 Cetrizine 10 mg Tab -

    VAKSIN
    1 HBo Vial 5

    2 BCG Amp 2

    3 Polio Vial 6

    4 DPT-HB Vial 3

    5 Pantavalen Vial -

    6 Campak Vial 2

    7 TT Vial -

    8 DT Vial 8

    9 TD Vial -

    10 ADS 0,5 Vial -

    11 ADS 0,05 Vial -

    12 Pelarut BCG Amp 2

    13 Pelarut Campak Amp 3


    Poli Umum
    Kunjungan Resep
    -

    UMUM

    BAYAR
    JUMLAH KUNJUNGAN RESEP
    -

    Mengetahui Yang Menyera


    Kepala Dinas Kesehatan Kab. Alor Petugas IF

    NIP. NIP.
    PEMERINTAH KABUPATEN ALOR
    D I N A S K E S E H A T A N
    Jl. Prof. DR. W. Z. Yohanes. No. - Telp. (0386) 21052
    K A L A B A H I

    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    LAP. PEMAKAIAN O
    LEMBAR PERMINTA
    TAHUN
    TRIWULAN

    Penerimaan Persediaan Pemakaian Sisa Stok Stok Optimum

    5 6 7 9 11

    - - - -

    - 450 - 450

    - 280 - 280

    - - - -

    - 400 - 400

    - - - -

    - 400 - 400

    - 500 - 500

    - - - -

    - 650 - 650

    - 1,200 - 1,200

    - - - -
    - 10 - 10

    - 2,400 - 2,400

    - 9 - 9

    - 280 - 280

    - - - -

    - - - -

    - 50 - 50

    - 2,500 - 2,500

    - 2,000 - 2,000

    - 50 - 50

    - - - -

    - - - -

    - 3,000 - 3,000

    - 46 - 46

    - 1,600 - 1,600

    - 15 - 15

    - 41 - 41

    - 24 - 24

    - - - -

    - 1,000 - 1,000

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 5 - 5

    - 3 - 3
    - 1 - 1

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 8,600 - 8,600

    - 2,500 - 2,500

    - 57 - 57

    - 1,050 - 1,050

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 25 - 25

    - - - -

    - - - -
    - - - -

    - - - -

    - 83 - 83

    - - - -

    - - - -

    - - - -

    - - - -

    - 96 - 96

    - - - -

    - 120 - 120

    - - - -

    - - - -

    - 1,700 - 1,700

    - - - -

    - 6 - 6

    - - - -

    - - - -

    - 5 - 5

    - 5 - 5

    - 3,100 - 3,100

    - 1,500 - 1,500

    - - - -

    - - - -

    - 216 - 216

    - - - -

    - 153 - 153

    - 2,800 - 2,800
    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 5 - 5

    - - - -

    - 79 - 79

    - - - -

    - - - -

    - - - -

    - - - -

    - 200 - 200

    - 30 - 30

    - 160 - 160

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 30 - 30

    - - - -

    - - - -

    - - - -

    - 25 - 25

    - 12 - 12

    - 6 - 6
    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 200 - 200

    - - - -

    - - - -

    - - - -

    - 14 - 14

    - 260 - 260

    - 22 - 22

    - - - -

    - - - -

    - 4 - 4

    - 5 - 5

    - - - -

    - - - -

    - - - -

    - - - -

    - 525 - 525

    - - - -

    - - - -

    - 65 - 65

    - 41 - 41

    - - - -

    - 500 - 500
    - 4,200 - 4,200

    - 60 - 60

    - - - -

    - 102 - 102

    - - - -

    - - - -

    - - - -

    - - - -

    - 1,500 - 1,500

    - - - -

    - - - -

    - - - -

    - 220 - 220

    - - - -

    - 209 - 209

    - - - -

    - - - -

    - - - -

    - 10 - 10

    - - - -

    - - - -

    - 48 - 48

    - 1,000 - 1,000

    - 3,200 - 3,200

    - - - -

    - 5 - 5

    - 31 - 31
    - - - -

    - 43 - 43

    - 400 - 400

    - 360 - 360

    - - - -

    - - - -

    - - - -

    - 40 - 40

    - - - -

    - 286 - 286

    - 50 - 50

    - 270 - 270

    - 464 - 464

    - - - -

    - - - -

    - 9 - 9

    - 9 - 9

    - 2 - 2

    - 1 - 1

    - 100 - 100

    - 5 - 5

    - - - -

    - - - -

    - - - -

    - - - -

    - 10 - 10

    - - - -
    - - - -

    - 800 - 800

    - - - -

    - 10 - 10

    - - - -

    - - - -

    - - - -

    - 11 - 11

    - - - -

    - - - -

    - - - -

    - - - -

    - 200 - 200

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 1,250 - 1,250

    - 5 - 5

    - - - -

    - 10 - 10

    - - - -
    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 600 - 600

    - 9 - 9

    - 40 - 40

    - 4,000 - 4,000

    - - - -

    - - - -

    - - - -

    - 85 - 85

    - 700 - 700

    - 2,400 - 2,400

    - 67 - 67

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 1 - 1

    - - - -
    - - - -

    - 12 - 12

    - - - -

    - 265 - 265

    - 30 - 30

    - - - -

    - 300 - 300

    - 600 - 600

    - 2 - 2

    - - - -

    - 10 - 10

    - 500 - 500

    - 650 - 650

    - - - -

    - - - -

    - 4 - 4

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 20 - 20

    - - - -

    - 900 - 900
    - - - -

    - 200 - 200

    - 100 - 100

    - - - -

    - 5 - 5

    - 83 - 83

    - - - -

    - 40 - 40

    - - - -

    - - - -

    - - - -

    - - - -

    - 200 - 200

    - 120 - 120

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -
    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 25 - 25

    - 75 - 75

    - - - -

    - 63 - 63

    - 570 - 570

    - - - -

    - 2,000 - 2,000

    - 40 - 40

    - 2,500 - 2,500

    - 5 - 5

    - - - -

    - 8 - 8

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -
    - 1,800 - 1,800

    - 2,100 - 2,100

    - 1,000 - 1,000

    - - - -

    - - - -

    - - - -

    - 4 - 4

    - 5 - 5

    - 5 - 5

    - 5 - 5

    - 3 - 3

    - 5 - 5

    - 2 - 2

    - 1,800 - 1,800

    - 100 - 100

    - 100 - 100

    - 100 - 100

    - 3,900 - 3,900

    - 19 - 19

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 195 - 195

    - - - -
    - - - -

    - - - -

    - 200 - 200

    - - - -

    - 41 - 41

    - 6 - 6

    - - - -

    - 250 - 250

    - - - -

    - - - -

    - 1 - 1

    - 1 - 1

    - 90 - 90

    - 800 - 800

    - - - -

    - 62 - 62

    - 792 - 792

    - - - -

    - - - -

    - - - -

    - - - -

    - 50 - 50

    - - - -

    - - - -

    - - - -

    - 100 - 100

    - 2,400 - 2,400
    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 30 - 30

    - - - -

    - 2,600 - 2,600

    - 6 - 6

    - - - -

    - - - -

    - 1,350 - 1,350

    - - - -

    - - - -

    - - - -

    - 500 - 500

    - - - -

    - - - -

    - - - -

    - - - -

    - 11 - 11

    - 5 - 5

    - - - -
    - - - -

    - - - -

    - 2 - 2

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - #VALUE! - #VALUE!

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 500 - 500

    - - - -

    - - - -

    - - - -

    - - - -
    - - - -

    - - - -

    - - - -

    - 900 - 900

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 5 - 5

    - 2 - 2

    - 6 - 6

    - 3 - 3

    - - - -

    - 2 - 2

    - - - -

    - 8 - 8

    - - - -

    - - - -

    - - - -

    - 2 - 2

    - 3 - 3
    Sumber / Asal Resep
    Poli Gigi KIA KB Raeat Inap UGD

    - - - - -

    MUM
    ASKES JUMLAH
    TIDAK BAYAR Dokter

    - - - -

    ang Menyerahkan Yang Meminta


    Petugas IFK Kepala Puskesmas

    NIP.
    LPO)

    P. PEMAKAIAN OBAT BULAN : JULI S/D SEPTEMBER


    MBAR PERMINTAAN OBAT BULAN : OKTOBER S/D DESEMBER
    : 2019
    : IV (EMPAT)

    permintaan pemberian KET

    12 14 16
    Total Resep ke Apotik
    Pusling, Posyandu, dll Bulan Ini Kumulatif s/d Bulan ini

    - - -

    Pemberi Resep
    Perawat Bidan Perawat Gigi

    - - -

    Yang Menerima
    Petugas Puskesmas

    NIP.
    ……………………….,
    ………………………………………
    ……………………….,
    …………………………………………………………
    LA

    NAMA PUSKESMAS :
    KABUPATEN : ALOR
    KECAMATAN :

    No Nama Obat Satuan Stok awal

    1 2 3 4

    1 Adona Injensi -
    Amp
    2 Alat Suntik Sekali Pakai 2,5 ml Pcs 450

    3 Alat Suntik Sekali Pakai 5 ml Pcs 280

    4 Alat suntik sekali pakai 0,5 ml Pcs -

    5 Alat suntik sekali pakai 0,5 ml / E - Katalog Pcs 400

    6 Alat suntik sekali pakai 0,05 ml /non e-katalog pcs -

    7 Alat suntik sekali pakai 0,05 ml / e-katalog Pcs 400

    8 Alat suntik sekali pakai 1 ml Pcs 500

    9 Alat suntik sekali pakai10 ml Pcs -

    10 Albendazol 400 mg / non e-katalog Tab 650

    11 Allupurinol 100 mg Tab 1,200

    12 Amalgam solila / Silver Amalgam Powder + Liquid Tube -


    13 Ambroxol syrup 15 mg/ml Btl 10

    14 Ambroxol 30 mg Tab 2,400

    15 Aminofilin Injeksi 24 mg/ml Amp 9

    16 Aminofilin 200 mg / e-katalog Tab 280

    17 Aminofilin 200 mg / non e-katalog tab -

    18 Amitriptilin HCL 25 mg Tab -

    19 Amlodipin 5 mg Tab 50

    20 Amoksisilin 250 mg Kaps 2,500

    21 Amoksisilin 500 mg Kapl 2,000

    22 Amoksisilin syrup Btl 50

    23 Ampisillin injeksi 1000 mg/ml Vial -

    24 Ampisillin syrup Btl -

    25 Antacida DOEN Tab 3,000

    26 Antacida DOEN Suspensi Btl 46

    27 Antalgin 500 mg Tab 1,600

    28 Antalgin injeksi Amp 15

    29 Anti Bakteri DOEN / Basitrasin Polimiksin Tube 41

    30 Anti Fungi DOEN Salep 30 g ( Salp 3 - 6 ) Pot 24

    31 Anti Haemoroid DOEN Suppositoria Supp -

    32 Anti Malaria DOEN ( SulDox ) Tab 1,000

    33 Anti Migraen / Ergotamin 1 mg + Coffein 50 mg Tab -

    34 Anti Sera A Btl -

    35 Anti Sera B Btl -

    36 Anti Sera AB Btl -

    37 Anti Sera D Btl -

    38 Aqua pro injeksi 20 ml Vial 5

    39 Aquadestilata 1000 ml Btl 3


    40 Aqua DM Bidestilata IKA ml 1

    41 Aqua DM Brataco ltr -

    42 Arsen / Devitalisasi Pasta Btl -

    43 Arterakin tab Tab -

    44 Artesunat injeksi 60 mg Vial -

    45 Artemeter injeksi Amp -

    46 Asetosal 100 mg Tab -

    47 Asetosal 500 mg Tab -

    48 Asam Ascorbat 50 mg Tab 8,600

    49 Asam Mefenamat 500 mg Kapl 2,500

    50 Asiklovir cream 5 % 5 g Tube 57

    51 Asiklovir 200 mg Tab 1,050

    52 Asiklovir 400 mg Tab -

    53 Atropin Sulfat injeksi 0,25 mg/ml Amp -

    54 Atropin sulfat 0,5 mg Tab -

    55 Baby Cough syrup Btl -

    56 Bahan Fissur Sealent / Fuji VII Dos -

    57 Baraclude 1 mg btl/30 tab -

    58 Baraclude 0,5 mg box/30 tab -

    59 Barotec Inhaler Btl -

    60 Baycline 1 Liter Btl -

    61 Benzatin Benzil Penicillin 1,2 juta IU Vial -

    62 Besi II Sulfat 7 H2O 300 mg Tab -

    63 Besi II Sulfat + Asam Folat Tab -

    64 Betametason Cream 0,1 % Tube 25

    65 Betason N Tube -

    66 Bidan Kit paket -


    67 Bioplacenton 15 gram Tube -

    68 Bisolvon Nebulizer btl -

    69 Bisturi / non e-katalog Pcs 83

    70 Blood lanset / non e-katalog Pcs -

    71 Calsidor / Dycal Dentsply / Hydcal Technew Btl -

    72 Calsydol syrup Btl -

    73 Cat gut 3/0 Pcs -

    74 Cat gut 3/0 / E-katalog Pcs 96

    75 Cat gut 2/0 Pcs -

    76 Cat gut 2/0 / E-katalog Pcs 120

    77 Cavit / Caviton Btl -

    78 Cement Powder + Liquid / Elite Cement 100 Dos -

    79 Cefadroxil 500 mg Kaps 1,700

    80 Ceftriaxon Injeksi Vial -

    81 Cefotaxime injeksi 0,5 gram Vial 6

    82 Cefotaxime injeksi 1 gram Vial -

    83 Chlor Fenol Champer menthol /CHKM Btl -

    84 Chloramfecort Tube 5

    85 Chloramfecort H Tube 5

    86 Cimetidine 200 mg Tab 3,100

    87 Ciprofloksasine 500 mg Tab 1,500

    88 Counterpain 30 gram Tube -

    89 Curcuma Plus Syrup Btl -

    90 Darplex Tab 216

    91 Dasabion Kaps -

    92 Deksamethasone injeksi 5 mg/ml Amp 153

    93 Deksamethasone 0,5 mg Tab 2,800


    94 Dekstran 70 - Larutan Infus 6 % steril Btl -

    95 Dental Cotton Roll Bks -

    96 Dental Plak Disclosing Gel / Disclosing Solution Btl -

    97 Diazepam injeksi 5 mg/ml Amp -

    98 Diazepam 2 mg Tab -

    99 Diazepam 5 mg Tab 5

    100 Dietilkarbamsin 100 mg / NON E-KATALOG Tab -

    101 Difenhidramine Injeksi 10 mg/ml Amp 79

    102 Digoksin 0,25 mg Tab -

    103 Diltiazem HCL 30 mg Tab -

    104 Dimenhidrinat 50 mg Tab -

    105 Doksisiklin 100 mg Kaps -

    106 Domperidon Tab 200

    107 Dulcolax 5 mg Tab 30

    108 Efedrin HCL 25 mg Tab 160

    109 Elastis verban 3 inci Roll -

    110 Elastis verban 4 inci Roll -

    111 Elastis verban 6 inci Roll -

    112 Elkana Multivitamin Tab -

    113 Enervon - C Kapl -

    114 Epineprin HCL 0,1 % injeksi Amp 30

    115 Eritromicin 250 mg Kapl -

    116 Eritromicin 500 mg Kapl -

    117 Eritromicin syrup Btl -

    118 Etakridin Larutan 0,1 % 300 ml Btl 25

    119 Etanol 70 % 1 liter Btl 12

    120 Ethilklorda Semprot Btl 6


    121 Endomethasone (endosel) btl -

    122 Eugenol Btl -

    123 Fehling A Btl -

    124 Fehling B Btl -

    125 Fenobarbital injeksi 50 mg/ml Amp -

    126 Fenobarbital 30 mg Tab 200

    127 Fenobarbital 100 mg Tab -

    128 Fenoksimetil Penisilin 250 mg Tab -

    129 Fenoksimetil Penisilin 500 mg Tab -

    130 Fenol gliserol TT Btl 14

    131 Fitomenadion 10 mg Tab 260

    132 Fitomenadion injeksi 10 mg/ml Amp 22

    133 Flecher Powder + Liquid Btl -

    134 Foley cateter no 16 Pcs -

    135 Foley cateter no 18 Pcs 4

    136 Foley cateter no 20 Pcs 5

    137 Formalin solution liter -

    138 Formaldehide Merk Test kit -

    139 Formokresol Btl -

    140 Furosemida Tab -

    141 Garam Oralit Sac 525

    142 Gamexan Btl -

    143 Gentamicin Injeksi 80 mg/ml Amp -

    144 Gentamicin Salep Kulit 0,1 % Tube 65

    145 Gentian Violet 1 % Btl 41

    146 Gic Art / Fuji IX Dos -

    147 Glibenclamida 5 mg Tab 500


    148 Gliceril Guayacolat 100 mg Tab 4,200

    149 Glucosa Larutan Infus 10 % steril Btl 60

    150 Glucosa Larutan Infus 40 % steril Btl -

    151 Glucosa Larutan Infus 5 % steril Btl 102

    152 Gloves "S" Pcs -

    153 Gloves "M" Pcs -

    154 Gloves "L" Pcs -

    155 Grisofulvin 250 mg Tab -

    156 Grisofulvin 125 mg tab 1,500

    157 Haloperidol 0,5 mg Tab -

    158 Haloperidol 1,5 mg Tab -

    159 Haloperidol 5 mg Tab -

    160 Handscoen no 6,5 Pcs 220

    161 Handscoen no 7,5 Pcs -

    162 Handscoen no 7,5 / E-katalog Pcs 209

    163 Handscoen No.7 Pcs -

    164 Handscoen no 8 Pcs -

    165 Handscoen no 8 / E-katalog Pcs -

    166 Handscoen Ginecolog Panjang Steril Pcs 10

    167 HB Sahli Pkt -

    168 Hemaviton Action Kaps -

    169 Hidrokortison Cream 2,5 % Tube 48

    170 Hidroklortiazida 25 mg Tab 1,000

    171 Ibuprofen 200 mg Tab 3,200

    172 Ibuprofen 400 mg Tab -

    173 Ibuprofen syrup/Buffec Syrup Btl 5

    174 Ictiol salep Pot 31


    175 Implant susuk KB Pcs -

    176 Infuset Micro Pcs 43

    177 Infuset Micro / e-katalog Pcs 400

    178 Infuset Macro Pcs 360

    179 Infuset Macro / e-katalog Pcs -

    180 Iodium test Btl -

    181 indikator universal ktk -

    182 IV Kateter no 18 Pcs 40

    183 IV Kateter no 18 / e-katalog Pcs -

    184 IV Kateter no 20 Pcs 286

    185 IV Kateter no 20 / E-katalog Pcs 50

    186 IV Kateter no 22 / E-katalog Pcs 270

    187 IV Kateter no 24 / E - katalog Pcs 464

    188 IV Canula No.18 Pcs -

    189 Isosorbit Dinitrat sublingual 5 mg Tab -

    190 Jarum Jahit Otot Lusin 9

    191 Jarum Jahit Kulit Lusin 9

    192 Jelly untuk USG / non e-katalog Btl 2

    193 Jelly untuk Catheter Komb. Lidokain Btl 1

    194 Kalsium Laktat 500 mg Tab 100

    195 Kalsium Gluconas Injeksi / non e-katalog Amp 5

    196 Kalnex 250 mg Kaps -

    197 Kalnex injeksi Amp -

    198 Kapas berlemak 500 gram Roll -

    199 Kapas pemb. Absorben 200 gram Roll -

    200 Kapas Pemb. Absorben 250 gram Roll 10

    201 Kapas pemb. Absorben 1000 gram Roll -


    202 Kaptopril 12,5 mg Tab -

    203 Kaptopril 25 mg Tab 800

    204 Karbamazepin 200 mg Tab -

    205 Kartu Stock Lbr 10

    206 Kasa 4 x 10 cm Roll -

    207 Kasa 4 x 6 cm Roll -

    208 Kasa 40 x 80 cm Roll -

    209 Kasa 40 x 80 cm / E-katalog 11

    210 Kasa Kompres 40/40 cm Roll -

    211 Kasa Kompres 40/40 cm / E-katalog Roll -

    212 Kasa Pembalut 2 m x 80 cm Roll -

    213 Kasa Pembalut Hidrofil 4 m x 3 cm Roll -

    214 Kasa Pembalut Hidrofil 4 m x 3 cm / E-katalog Roll 200

    215 Kasa Pembalut Hidrofil 4 m x 15 cm Roll -

    216 Kasa Pembalut Hidrofil 4 m x 15 cm / E-Katalog Roll -

    217 Kasa 16 x 16 Roll -

    218 Kasa pembalut 14 x 8 cm Roll -

    219 Kasa pembalut 10 cm Roll -

    220 Kasa pembalut 4 x 18 Roll -

    221 Kelambu Pcs -

    222 Ketamine Injeksi 10 mg/ml Vial -

    223 Ketokonazol cream 2 % Tube -

    224 Ketokonazol 200 mg Tab 1,250

    225 Ketorolac Injeksi Ampul 5

    226 Kertas EKG 3 Ukuran Roll -

    227 Kertas Perkamen / Non e-katalog Lbr 10

    228 Kina Dihidroklorida injeksi 25 % - 2 ml Amp -


    229 Kina 222 mg Tab -

    230 Klip Plastik Kecil tanpa sablon Pcs -

    231 Klip Plastik Sedang tanpa sablon Pcs -

    232 Klip Plastik Besar sablon 10 x 15 Pcs -

    233 Klip Plastik Sedang sablon 8,7 x 15 Pcs -

    234 Klip Plastik kecil sablon Pcs -

    235 Kloramfenicol 250 mg Kaps 600

    236 Kloramfenicol Salp Mata 1 % Tube 9

    237 Kloramfenicol Tetes Telinga 3 % Btl 40

    238 Klorfeniraminimaleat 4 mg Tab 4,000

    239 Klorokuin 150 mg Tab -

    240 Klorpromazin HCL injeksi i.m 25 mg/ml Amp -

    241 Klorpromazin HCL 25 mg Tab -

    242 Kodein 10 mg Tab 85

    243 Kotrimoksasol Adult 480 mg Tab 700

    244 Kotrimoksasol Pedriatic 120 mg Tab 2,400

    245 Kotrimoksasol suspensi Btl 67

    246 Lab.Kit Pkt -

    247 Lacbon 17 Tab -

    248 Lansoprazole 30 mg Kaps -

    249 Larutan Benedict Btl -

    250 Larutan Etanol Asam Btl -

    251 Larutan Gimsa stain / non e-katalog Btl -

    252 Larutan Carbofuksin Btl -

    253 Larutan Methilen Biru Btl -

    254 Larutan H2O2 Btl 1

    255 Larutan xilol Btl -


    256 Larutan HCl 0,1 N / Non e-katalog Btl -

    257 Levetran Salp Pot 12

    258 Levofloksasin 500 mg Tab -

    259 Lidocain Injeksi HCl 2 % Amp 265

    260 Lidocain Injeksi 2 % + Epineprin 1 : 80.000 - 2 ml Amp 30

    261 Livron B plex Tab -

    262 Loperamid 2 mg Tab 300

    263 Loratadin 10 mg Tab 600

    264 Lysol Btl 2

    265 Light cure Composite (etsa & bondingnya) Set -

    266 Magnesium Sulfat injeksi 20 % - 25 ml Amp 10

    267 Magnesium Sulfat injeksi 40 % - 25 ml Amp -

    268 Masker Mulut Pcs 650

    269 MDT MB Adult Blist -

    270 MDT PB Adult Blist -

    271 MDT MB Anak Blist 4

    272 MDT PB Anak Blist -

    273 Mebendazole syrup 100 mg/5 ml Btl -

    274 Mebendazole 100 mg Tab -

    275 Meloxicam 15 mg Tab -

    276 Metformin Tab -

    277 Metapex Box -

    278 Methanil Yellow Chen Kit ktk -

    279 Methilergometrin maleat 0,125 mg Tab -

    280 Methilergometrin maleat 0,200 mg - 1 ml Amp 20

    281 Methilprednisolon 4 mg Tab -

    282 Methilprednisolon 8 mg tab 900


    283 Metoclopramide injeksi 5 mg/5 ml Amp -

    284 Metoclopramide 10 mg Tab 200

    285 Metronidazol 250 mg Tab 100

    286 Metronidazol 500 mg Tab -

    287 Metronidazol infus Btl 5

    288 Mikonazole cream salp 2 % / e-katalog Tube 83

    289 Mikonazole cream salp 2 % / non e-katalog Tube -

    290 Mineral Mix Sac 40

    291 Morfin injeksi 10 mg/ml Amp -

    292 Natrium Bicarbonat 500 mg Tab -

    293 Natrium Diklofenak 25 mg Tab -

    294 Natrium Diklofenak 50 mg Tab -

    295 Natrium Klorida Larutan infus 0,9 % / e-katalog Btl 200

    296 Natrium Klorida Larutan infus 0,9 / non e-katalog Btl 120

    297 Natrium Fenitoin 100 mg Kaps -

    298 Natrium Fenitoin Injeksi / Non e-katalog Amp -

    299 Nicolin injeksi / Citicolin inj Amp -

    300 Nifedipin 10 mg Tab -

    301 Nistatin 100 000 UI Tab -

    302 Nistatin 500 000 UI Vaginal tab Tab -

    303 Nitrit Test Merk ktk -

    304 Neurovit- E Tab -

    305 Neurobion / Neurosanbe 5000 Tab -

    306 Neurobion / Neurosanbe Injeksi Amp -

    307 Obat Batuk Hitam syrup 100 ml Btl -

    308 Obat FDC Anak Pkt -

    309 Obat FDC Kategori 1 Pkt -


    310 Obat FDC Kategori 2 Pkt -

    311 Obat FDC TB sisipan Pkt -

    312 OAT Kombipak anak Pkt -

    313 OAT Kategori 1 & 3 Pkt -

    314 Oil Emersi Btl -

    315 Obat suntik KB 3 bulanan Vial -

    316 Oksitetrasiklin HCL 1 % salp mata Tube 25

    317 Oksitetrasiklin HCL 3 % salp Kulit Tube 75

    318 Oksitetrasiklin injeksi Vial -

    319 Oksitosin injeksi 10 IU/ml - 1 ml Amp 63

    320 Omeprazole 20 mg Kaps 570

    321 Papaverin injeksi 40 mg/ml Amp -

    322 Papaverin 40 mg Tab 2,000

    323 Paracetamol syrup 120 mg/5 ml Btl 40

    324 Paracetamol 500 mg Tab 2,500

    325 Parasetamol drop Btl 5

    326 Parasetamol suppositoria Supp -

    327 Penisilin procain / Procain Benzil Penicillin injeksi Vial 8

    328 Petidin injeksi 50 mg/ml Amp -

    329 Pil KB I Kombinasi Set -

    330 Pilokarpin Tetes mata 2 % Btl -

    331 Piracetam injeksi 3 g/15 ml Amp -

    332 Piracetam 1200 mg Tab -

    333 Piracetam 400 mg Tab -

    334 Pirasetam 800 mg Tab -

    335 Pirantel score base 125 mg Tab -

    336 Pirantel Syrup Btl -


    337 Piridoksin HCL 10 mg Tab 1,800

    338 Piroxicam 10 mg Tab 2,100

    339 Piroxicam 20 mg Tab 1,000

    340 Plester besar 5 yard x 2 inch Roll -

    341 Plester sedang 1,5 Inch x 5 cm Roll -

    342 Plester kecil 1,25 x 5 cm roll -

    343 Plester ( Leukoplast) 7,5 x 4,5 cm Roll 4

    344 Poligips 7,5cm Roll 5

    345 Poligips 10 cm Roll 5

    346 Poligips 15 cm Roll 5

    347 Povidon iodida larutan 10 % 30 ml Btl 3

    348 Povidon iodida larutan 10 % 300 ml Btl 5

    349 Povidon iodida larutan 10 % 1000 ml Btl 2

    350 Prednison 5 mg Tab 1,800

    351 Primakuin 15 mg Tab 100

    352 Propanolol 40 mg Tab 100

    353 Propilitiourasil 100 mg Tab 100

    354 Ranitidin 150 mg Tab 3,900

    355 Ranitidin injeksi 25 mg/2 ml Amp 19

    356 Rapid Diagnostic Test (RDT) Pcs -

    357 Reagen zealnelsen Pkt -

    358 Reserpin 0,1 mg Tab -

    359 Reserpin 0,25 mg Tab -

    360 Retinol 100.000 IU Kaps -

    361 Retinol 200.000 IU Kaps -

    362 Ringer Lactat larutan infus Btl 195

    363 Rodamin B Test Chem ktk -


    364 Safety box Lbr -

    365 Salicyl Spritus 55 ml Btl -

    366 Salbutamol 2 mg Tab 200

    367 Salbutamol 4 mg Tab -

    368 Salep 2 - 4,Komb.As.Salisilat 2% + Sulfur Praicip Pot 41

    369 Salisil Bedak Ktk 6

    370 Sanbe B-Plex Btl -

    371 Sangobion Kaps 250

    372 Santa E Tab -

    373 Scabisid Cream Tube -

    374 Serum Antibisa Ular Polivalen ( ABU I ) Vial 1

    375 Serum Antitetanus injeksi 1.500 IU ( ATS ) Vial 1

    376 Sianocobalamine injeksi 500 mcg Amp 90

    377 Sianocobalamine 50 mcg Tab 800

    378 Silk ( Benang Bedah Sutera ) Pcs -

    379 Silk ( Benang Bedah Sutera ) / e-katalog Pcs 62

    380 Slide Pcs 792

    381 Sputum pot / Non e-katalog Bh -

    382 Spongostan Ktk -

    383 Streptomisin injeksi Vial -

    384 Simvastatin 10 mg Tab -

    385 Test Kehamilan Pcs 50

    386 Tetrasiklin 250 mg Kaps -

    387 Tetrasiklin 500 mg Kaps -

    388 Thiamphenicol 500 mg Kaps -

    389 Tiamin injeksi 100 mg/ml Amp 100

    390 Tiamin HCL 50 mg Tab 2,400


    391 Topicaina topical gel / Anastesi anak Btl -

    392 Tooth stain Remover btl -

    393 Triheksifenidil 2 mg Tab -

    394 Tri Kresol Formalin /TKF Btl -

    395 Tramadol 50 mg / ml Injeksi Amp -

    396 Transfusi Set Pcs -

    397 Transfusi Set / E-katalog Pcs -

    398 Tremenza Tab -

    399 Tissue Lensa pcs -

    400 Urine bag / e-katalog Pcs 30

    401 Urine Test / Gluco Protein Test Pcs -

    402 Vitamin B - complex Tab 2,600

    403 Ventolin inj. amp 6

    404 Wing Needle no 27 Pcs -

    405 Zink Oxide Eugenol (powder+liquid/kalzinol) Btl -

    406 Zinc Dispersible 120 mg Tab 1,350

    407 Slide box Pcs -

    408 Acarbose 50 mg Tab -

    409 Asam Traneksamat Injeksi amp -

    410 Asam Traneksamat 500 mg kapl 500

    411 Bumer Pcs -

    412 Etanol 70 % 100 ml btl -

    413 Furosemide 10mg/ml injeksi Amp -

    414 Glimepiride 2 mg Tab -

    415 Jarum jahit Combinasi otot & Kulit Lusin 11

    416 Plester Besar 5 m x 4,5 cm (Leukoplast) Roll 5

    417 Povidon iodida Larutan 10 % 60 ml Btl -


    418 Semprong Pcs -

    419 Sumbu bh -

    420 Termometer Ruangan Kayu Pcs 2

    421 Sofero caps -

    422 Disposible dental needle no. 18 pcs -

    423 Disposible dental needle no. 20 Pcs -

    424 Disposible dental needle no. 25 Pcs -

    425 Jarum Citojek No. 12 Pcs -

    426 Jarum Citojek No. 16 Pcs -

    427 Resin Composite (A2+A3) Btl -

    428 Suction Rip Pcs -

    429 Levemir Injeksi / non e-katalog paket -

    430 Borax Test ktk -

    431 Novabion caps -

    432 Larutan Metanol btl -

    433 Larutan Oil Imersion 50 ml btl -

    434 Alkohol Swap Pkt -

    435 Aquadest 600 ml Btl -

    436 Alat Tes Darah Multifungsi Pkt -

    437 Stik Gula Darah Pkt -

    438 Stik Kolesterol Pkt -

    439 Stik Asam Urat Pkt -

    440 Miniaspi 80 mg (Asetosal 80 mg) Tab 500

    441 Isoniazid 100 mg Tab -

    442 Rantin injeksi (Ranitidin inj. 25 mg/ml)Non E. Amp -

    443 Nexa 500 mg (Asam Traneksamat) Non E. Tab -

    444 Sotatic Injeksi (Metoclopramide inj. 5 mg/ml) Non E. Amp -


    445 Salbron 2 mg (Salbutamol 2 mg) Non E. Tab -

    446 Pehacain Inj. (Lidocain Comb.) Amp -

    447 Otoryl 25 Mg (Kaptopril 25 mg) Tab -

    448 Asam Folat 1 mg Tab 900

    449 Azitromycin 500 mg Tab -

    450 Ciprofloksasine Injeksi Btl -

    451 Amlodipin 10 mg Tab -

    452 Dentin Conditioner Minipack Box -

    453 Stesolit Rectal / Diazepam rectal Supp -

    454 Paracetamol Infus 100 ml Btl -

    455 Cetrizine 10 mg Tab -

    VAKSIN
    1 HBo Vial 5

    2 BCG Amp 2

    3 Polio Vial 6

    4 DPT-HB Vial 3

    5 Pantavalen Vial -

    6 Campak Vial 2

    7 TT Vial -

    8 DT Vial 8

    9 TD Vial -

    10 ADS 0,5 Vial -

    11 ADS 0,05 Vial -

    12 Pelarut BCG Amp 2

    13 Pelarut Campak Amp 3


    Poli Umum
    Kunjungan Resep

    UMUM

    BAYAR
    JUMLAH KUNJUNGAN RESEP

    Mengetahui Yang Menyera


    Kepala Dinas Kesehatan Kab. Alor Petugas IF

    NIP. NIP.
    PEMERINTAH KABUPATEN ALOR
    D I N A S K E S E H A T A N
    Jl. Prof. DR. W. Z. Yohanes. No. - Telp. (0386) 21052
    K A L A B A H I

    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    LAP. PEMAKAIAN O
    LEMBAR PERMINTA
    TAHUN
    TRIWULAN

    Penerimaan Persediaan Pemakaian Sisa Stok Stok Optimum

    5 6 7 9 11

    - -

    450 450

    280 280

    - -

    400 400

    - -

    400 400

    500 500

    - -

    650 650

    1,200 1,200

    - -
    10 10

    2,400 2,400

    9 9

    280 280

    - -

    - -

    50 50

    2,500 2,500

    2,000 2,000

    50 50

    - -

    - -

    3,000 3,000

    46 46

    1,600 1,600

    15 15

    41 41

    24 24

    - -

    1,000 1,000

    - -

    - -

    - -

    - -

    - -

    5 5

    3 3
    1 1

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    8,600 8,600

    2,500 2,500

    57 57

    1,050 1,050

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    25 25

    - -

    - -
    - -

    - -

    83 83

    - -

    - -

    - -

    - -

    96 96

    - -

    120 120

    - -

    - -

    1,700 1,700

    - -

    6 6

    - -

    - -

    5 5

    5 5

    3,100 3,100

    1,500 1,500

    - -

    - -

    216 216

    - -

    153 153

    2,800 2,800
    - -

    - -

    - -

    - -

    - -

    5 5

    - -

    79 79

    - -

    - -

    - -

    - -

    200 200

    30 30

    160 160

    - -

    - -

    - -

    - -

    - -

    30 30

    - -

    - -

    - -

    25 25

    12 12

    6 6
    - -

    - -

    - -

    - -

    - -

    200 200

    - -

    - -

    - -

    14 14

    260 260

    22 22

    - -

    - -

    4 4

    5 5

    - -

    - -

    - -

    - -

    525 525

    - -

    - -

    65 65

    41 41

    - -

    500 500
    4,200 4,200

    60 60

    - -

    102 102

    - -

    - -

    - -

    - -

    1,500 1,500

    - -

    - -

    - -

    220 220

    - -

    209 209

    - -

    - -

    - -

    10 10

    - -

    - -

    48 48

    1,000 1,000

    3,200 3,200

    - -

    5 5

    31 31
    - -

    43 43

    400 400

    360 360

    - -

    - -

    - -

    40 40

    - -

    286 286

    50 50

    270 270

    464 464

    - -

    - -

    9 9

    9 9

    2 2

    1 1

    100 100

    5 5

    - -

    - -

    - -

    - -

    10 10

    - -
    - -

    800 800

    - -

    10 10

    - -

    - -

    - -

    11 11

    - -

    - -

    - -

    - -

    200 200

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    1,250 1,250

    5 5

    - -

    10 10

    - -
    - -

    - -

    - -

    - -

    - -

    - -

    600 600

    9 9

    40 40

    4,000 4,000

    - -

    - -

    - -

    85 85

    700 700

    2,400 2,400

    67 67

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    1 1

    - -
    - -

    12 12

    - -

    265 265

    30 30

    - -

    300 300

    600 600

    2 2

    - -

    10 10

    - -

    650 650

    - -

    - -

    4 4

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    20 20

    - -

    900 900
    - -

    200 200

    100 100

    - -

    5 5

    83 83

    - -

    40 40

    - -

    - -

    - -

    - -

    200 200

    120 120

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -
    - -

    - -

    - -

    - -

    - -

    - -

    25 25

    75 75

    - -

    63 63

    570 570

    - -

    2,000 2,000

    40 40

    2,500 2,500

    5 5

    - -

    8 8

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -
    1,800 1,800

    2,100 2,100

    1,000 1,000

    - -

    - -

    - -

    4 4

    5 5

    5 5

    5 5

    3 3

    5 5

    2 2

    1,800 1,800

    100 100

    100 100

    100 100

    3,900 3,900

    19 19

    - -

    - -

    - -

    - -

    - -

    - -

    195 195

    - -
    - -

    - -

    200 200

    - -

    41 41

    6 6

    - -

    250 250

    - -

    - -

    1 1

    1 1

    90 90

    800 800

    - -

    62 62

    792 792

    - -

    - -

    - -

    - -

    50 50

    - -

    - -

    - -

    100 100

    2,400 2,400
    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    30 30

    - -

    2,600 2,600

    6 6

    - -

    - -

    1,350 1,350

    - -

    - -

    - -

    500 500

    - -

    - -

    - -

    - -

    11 11

    5 5

    - -
    - -

    - -

    2 2

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    500 500

    - -

    - -

    - -

    - -
    - -

    - -

    - -

    900 900

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    5 5

    2 2

    6 6

    3 3

    - -

    2 2

    - -

    8 8

    - -

    - -

    - -

    2 2

    3 3
    Sumber / Asal Resep
    Poli Gigi KIA KB Raeat Inap UGD

    MUM
    ASKES JUMLAH
    TIDAK BAYAR Dokter

    ang Menyerahkan Yang Meminta


    Petugas IFK Kepala Puskesmas

    NIP.
    LPO)

    P. PEMAKAIAN OBAT BULAN : OKTOBER


    MBAR PERMINTAAN OBAT BULAN :
    : 2019
    :

    permintaan pemberian KET

    12 14 16
    Total Resep ke Apotik
    Pusling, Posyandu, dll Bulan Ini Kumulatif s/d Bulan ini

    - #VALUE!

    Pemberi Resep
    Perawat Bidan Perawat Gigi

    Yang Menerima
    Petugas Puskesmas

    NIP.
    ……………………….,
    ………………………………………
    ……………………….,
    …………………………………………………………
    LA

    NAMA PUSKESMAS :
    KABUPATEN : ALOR
    KECAMATAN :

    No Nama Obat Satuan Stok awal

    1 2 3 4

    1 Adona Injensi -
    Amp
    2 Alat Suntik Sekali Pakai 2,5 ml Pcs 450

    3 Alat Suntik Sekali Pakai 5 ml Pcs 280

    4 Alat suntik sekali pakai 0,5 ml Pcs -

    5 Alat suntik sekali pakai 0,5 ml / E - Katalog Pcs 400

    6 Alat suntik sekali pakai 0,05 ml /non e-katalog pcs -

    7 Alat suntik sekali pakai 0,05 ml / e-katalog Pcs 400

    8 Alat suntik sekali pakai 1 ml Pcs 500

    9 Alat suntik sekali pakai10 ml Pcs -

    10 Albendazol 400 mg / non e-katalog Tab 650

    11 Allupurinol 100 mg Tab 1,200

    12 Amalgam solila / Silver Amalgam Powder + Liquid Tube -


    13 Ambroxol syrup 15 mg/ml Btl 10

    14 Ambroxol 30 mg Tab 2,400

    15 Aminofilin Injeksi 24 mg/ml Amp 9

    16 Aminofilin 200 mg / e-katalog Tab 280

    17 Aminofilin 200 mg / non e-katalog tab -

    18 Amitriptilin HCL 25 mg Tab -

    19 Amlodipin 5 mg Tab 50

    20 Amoksisilin 250 mg Kaps 2,500

    21 Amoksisilin 500 mg Kapl 2,000

    22 Amoksisilin syrup Btl 50

    23 Ampisillin injeksi 1000 mg/ml Vial -

    24 Ampisillin syrup Btl -

    25 Antacida DOEN Tab 3,000

    26 Antacida DOEN Suspensi Btl 46

    27 Antalgin 500 mg Tab 1,600

    28 Antalgin injeksi Amp 15

    29 Anti Bakteri DOEN / Basitrasin Polimiksin Tube 41

    30 Anti Fungi DOEN Salep 30 g ( Salp 3 - 6 ) Pot 24

    31 Anti Haemoroid DOEN Suppositoria Supp -

    32 Anti Malaria DOEN ( SulDox ) Tab 1,000

    33 Anti Migraen / Ergotamin 1 mg + Coffein 50 mg Tab -

    34 Anti Sera A Btl -

    35 Anti Sera B Btl -

    36 Anti Sera AB Btl -

    37 Anti Sera D Btl -

    38 Aqua pro injeksi 20 ml Vial 5

    39 Aquadestilata 1000 ml Btl 3


    40 Aqua DM Bidestilata IKA ml 1

    41 Aqua DM Brataco ltr -

    42 Arsen / Devitalisasi Pasta Btl -

    43 Arterakin tab Tab -

    44 Artesunat injeksi 60 mg Vial -

    45 Artemeter injeksi Amp -

    46 Asetosal 100 mg Tab -

    47 Asetosal 500 mg Tab -

    48 Asam Ascorbat 50 mg Tab 8,600

    49 Asam Mefenamat 500 mg Kapl 2,500

    50 Asiklovir cream 5 % 5 g Tube 57

    51 Asiklovir 200 mg Tab 1,050

    52 Asiklovir 400 mg Tab -

    53 Atropin Sulfat injeksi 0,25 mg/ml Amp -

    54 Atropin sulfat 0,5 mg Tab -

    55 Baby Cough syrup Btl -

    56 Bahan Fissur Sealent / Fuji VII Dos -

    57 Baraclude 1 mg btl/30 tab -

    58 Baraclude 0,5 mg box/30 tab -

    59 Barotec Inhaler Btl -

    60 Baycline 1 Liter Btl -

    61 Benzatin Benzil Penicillin 1,2 juta IU Vial -

    62 Besi II Sulfat 7 H2O 300 mg Tab -

    63 Besi II Sulfat + Asam Folat Tab -

    64 Betametason Cream 0,1 % Tube 25

    65 Betason N Tube -

    66 Bidan Kit paket -


    67 Bioplacenton 15 gram Tube -

    68 Bisolvon Nebulizer btl -

    69 Bisturi / non e-katalog Pcs 83

    70 Blood lanset / non e-katalog Pcs -

    71 Calsidor / Dycal Dentsply / Hydcal Technew Btl -

    72 Calsydol syrup Btl -

    73 Cat gut 3/0 Pcs -

    74 Cat gut 3/0 / E-katalog Pcs 96

    75 Cat gut 2/0 Pcs -

    76 Cat gut 2/0 / E-katalog Pcs 120

    77 Cavit / Caviton Btl -

    78 Cement Powder + Liquid / Elite Cement 100 Dos -

    79 Cefadroxil 500 mg Kaps 1,700

    80 Ceftriaxon Injeksi Vial -

    81 Cefotaxime injeksi 0,5 gram Vial 6

    82 Cefotaxime injeksi 1 gram Vial -

    83 Chlor Fenol Champer menthol /CHKM Btl -

    84 Chloramfecort Tube 5

    85 Chloramfecort H Tube 5

    86 Cimetidine 200 mg Tab 3,100

    87 Ciprofloksasine 500 mg Tab 1,500

    88 Counterpain 30 gram Tube -

    89 Curcuma Plus Syrup Btl -

    90 Darplex Tab 216

    91 Dasabion Kaps -

    92 Deksamethasone injeksi 5 mg/ml Amp 153

    93 Deksamethasone 0,5 mg Tab 2,800


    94 Dekstran 70 - Larutan Infus 6 % steril Btl -

    95 Dental Cotton Roll Bks -

    96 Dental Plak Disclosing Gel / Disclosing Solution Btl -

    97 Diazepam injeksi 5 mg/ml Amp -

    98 Diazepam 2 mg Tab -

    99 Diazepam 5 mg Tab 5

    100 Dietilkarbamsin 100 mg / NON E-KATALOG Tab -

    101 Difenhidramine Injeksi 10 mg/ml Amp 79

    102 Digoksin 0,25 mg Tab -

    103 Diltiazem HCL 30 mg Tab -

    104 Dimenhidrinat 50 mg Tab -

    105 Doksisiklin 100 mg Kaps -

    106 Domperidon Tab 200

    107 Dulcolax 5 mg Tab 30

    108 Efedrin HCL 25 mg Tab 160

    109 Elastis verban 3 inci Roll -

    110 Elastis verban 4 inci Roll -

    111 Elastis verban 6 inci Roll -

    112 Elkana Multivitamin Tab -

    113 Enervon - C Kapl -

    114 Epineprin HCL 0,1 % injeksi Amp 30

    115 Eritromicin 250 mg Kapl -

    116 Eritromicin 500 mg Kapl -

    117 Eritromicin syrup Btl -

    118 Etakridin Larutan 0,1 % 300 ml Btl 25

    119 Etanol 70 % 1 liter Btl 12

    120 Ethilklorda Semprot Btl 6


    121 Endomethasone (endosel) btl -

    122 Eugenol Btl -

    123 Fehling A Btl -

    124 Fehling B Btl -

    125 Fenobarbital injeksi 50 mg/ml Amp -

    126 Fenobarbital 30 mg Tab 200

    127 Fenobarbital 100 mg Tab -

    128 Fenoksimetil Penisilin 250 mg Tab -

    129 Fenoksimetil Penisilin 500 mg Tab -

    130 Fenol gliserol TT Btl 14

    131 Fitomenadion 10 mg Tab 260

    132 Fitomenadion injeksi 10 mg/ml Amp 22

    133 Flecher Powder + Liquid Btl -

    134 Foley cateter no 16 Pcs -

    135 Foley cateter no 18 Pcs 4

    136 Foley cateter no 20 Pcs 5

    137 Formalin solution liter -

    138 Formaldehide Merk Test kit -

    139 Formokresol Btl -

    140 Furosemida Tab -

    141 Garam Oralit Sac 525

    142 Gamexan Btl -

    143 Gentamicin Injeksi 80 mg/ml Amp -

    144 Gentamicin Salep Kulit 0,1 % Tube 65

    145 Gentian Violet 1 % Btl 41

    146 Gic Art / Fuji IX Dos -

    147 Glibenclamida 5 mg Tab 500


    148 Gliceril Guayacolat 100 mg Tab 4,200

    149 Glucosa Larutan Infus 10 % steril Btl 60

    150 Glucosa Larutan Infus 40 % steril Btl -

    151 Glucosa Larutan Infus 5 % steril Btl 102

    152 Gloves "S" Pcs -

    153 Gloves "M" Pcs -

    154 Gloves "L" Pcs -

    155 Grisofulvin 250 mg Tab -

    156 Grisofulvin 125 mg tab 1,500

    157 Haloperidol 0,5 mg Tab -

    158 Haloperidol 1,5 mg Tab -

    159 Haloperidol 5 mg Tab -

    160 Handscoen no 6,5 Pcs 220

    161 Handscoen no 7,5 Pcs -

    162 Handscoen no 7,5 / E-katalog Pcs 209

    163 Handscoen No.7 Pcs -

    164 Handscoen no 8 Pcs -

    165 Handscoen no 8 / E-katalog Pcs -

    166 Handscoen Ginecolog Panjang Steril Pcs 10

    167 HB Sahli Pkt -

    168 Hemaviton Action Kaps -

    169 Hidrokortison Cream 2,5 % Tube 48

    170 Hidroklortiazida 25 mg Tab 1,000

    171 Ibuprofen 200 mg Tab 3,200

    172 Ibuprofen 400 mg Tab -

    173 Ibuprofen syrup/Buffec Syrup Btl 5

    174 Ictiol salep Pot 31


    175 Implant susuk KB Pcs -

    176 Infuset Micro Pcs 43

    177 Infuset Micro / e-katalog Pcs 400

    178 Infuset Macro Pcs 360

    179 Infuset Macro / e-katalog Pcs -

    180 Iodium test Btl -

    181 indikator universal ktk -

    182 IV Kateter no 18 Pcs 40

    183 IV Kateter no 18 / e-katalog Pcs -

    184 IV Kateter no 20 Pcs 286

    185 IV Kateter no 20 / E-katalog Pcs 50

    186 IV Kateter no 22 / E-katalog Pcs 270

    187 IV Kateter no 24 / E - katalog Pcs 464

    188 IV Canula No.18 Pcs -

    189 Isosorbit Dinitrat sublingual 5 mg Tab -

    190 Jarum Jahit Otot Lusin 9

    191 Jarum Jahit Kulit Lusin 9

    192 Jelly untuk USG / non e-katalog Btl 2

    193 Jelly untuk Catheter Komb. Lidokain Btl 1

    194 Kalsium Laktat 500 mg Tab 100

    195 Kalsium Gluconas Injeksi / non e-katalog Amp 5

    196 Kalnex 250 mg Kaps -

    197 Kalnex injeksi Amp -

    198 Kapas berlemak 500 gram Roll -

    199 Kapas pemb. Absorben 200 gram Roll -

    200 Kapas Pemb. Absorben 250 gram Roll 10

    201 Kapas pemb. Absorben 1000 gram Roll -


    202 Kaptopril 12,5 mg Tab -

    203 Kaptopril 25 mg Tab 800

    204 Karbamazepin 200 mg Tab -

    205 Kartu Stock Lbr 10

    206 Kasa 4 x 10 cm Roll -

    207 Kasa 4 x 6 cm Roll -

    208 Kasa 40 x 80 cm Roll -

    209 Kasa 40 x 80 cm / E-katalog 11

    210 Kasa Kompres 40/40 cm Roll -

    211 Kasa Kompres 40/40 cm / E-katalog Roll -

    212 Kasa Pembalut 2 m x 80 cm Roll -

    213 Kasa Pembalut Hidrofil 4 m x 3 cm Roll -

    214 Kasa Pembalut Hidrofil 4 m x 3 cm / E-katalog Roll 200

    215 Kasa Pembalut Hidrofil 4 m x 15 cm Roll -

    216 Kasa Pembalut Hidrofil 4 m x 15 cm / E-Katalog Roll -

    217 Kasa 16 x 16 Roll -

    218 Kasa pembalut 14 x 8 cm Roll -

    219 Kasa pembalut 10 cm Roll -

    220 Kasa pembalut 4 x 18 Roll -

    221 Kelambu Pcs -

    222 Ketamine Injeksi 10 mg/ml Vial -

    223 Ketokonazol cream 2 % Tube -

    224 Ketokonazol 200 mg Tab 1,250

    225 Ketorolac Injeksi Ampul 5

    226 Kertas EKG 3 Ukuran Roll -

    227 Kertas Perkamen / Non e-katalog Lbr 10

    228 Kina Dihidroklorida injeksi 25 % - 2 ml Amp -


    229 Kina 222 mg Tab -

    230 Klip Plastik Kecil tanpa sablon Pcs -

    231 Klip Plastik Sedang tanpa sablon Pcs -

    232 Klip Plastik Besar sablon 10 x 15 Pcs -

    233 Klip Plastik Sedang sablon 8,7 x 15 Pcs -

    234 Klip Plastik kecil sablon Pcs -

    235 Kloramfenicol 250 mg Kaps 600

    236 Kloramfenicol Salp Mata 1 % Tube 9

    237 Kloramfenicol Tetes Telinga 3 % Btl 40

    238 Klorfeniraminimaleat 4 mg Tab 4,000

    239 Klorokuin 150 mg Tab -

    240 Klorpromazin HCL injeksi i.m 25 mg/ml Amp -

    241 Klorpromazin HCL 25 mg Tab -

    242 Kodein 10 mg Tab 85

    243 Kotrimoksasol Adult 480 mg Tab 700

    244 Kotrimoksasol Pedriatic 120 mg Tab 2,400

    245 Kotrimoksasol suspensi Btl 67

    246 Lab.Kit Pkt -

    247 Lacbon 17 Tab -

    248 Lansoprazole 30 mg Kaps -

    249 Larutan Benedict Btl -

    250 Larutan Etanol Asam Btl -

    251 Larutan Gimsa stain / non e-katalog Btl -

    252 Larutan Carbofuksin Btl -

    253 Larutan Methilen Biru Btl -

    254 Larutan H2O2 Btl 1

    255 Larutan xilol Btl -


    256 Larutan HCl 0,1 N / Non e-katalog Btl -

    257 Levetran Salp Pot 12

    258 Levofloksasin 500 mg Tab -

    259 Lidocain Injeksi HCl 2 % Amp 265

    260 Lidocain Injeksi 2 % + Epineprin 1 : 80.000 - 2 ml Amp 30

    261 Livron B plex Tab -

    262 Loperamid 2 mg Tab 300

    263 Loratadin 10 mg Tab 600

    264 Lysol Btl 2

    265 Light cure Composite (etsa & bondingnya) Set -

    266 Magnesium Sulfat injeksi 20 % - 25 ml Amp 10

    267 Magnesium Sulfat injeksi 40 % - 25 ml Amp -

    268 Masker Mulut Pcs 650

    269 MDT MB Adult Blist -

    270 MDT PB Adult Blist -

    271 MDT MB Anak Blist 4

    272 MDT PB Anak Blist -

    273 Mebendazole syrup 100 mg/5 ml Btl -

    274 Mebendazole 100 mg Tab -

    275 Meloxicam 15 mg Tab -

    276 Metformin Tab -

    277 Metapex Box -

    278 Methanil Yellow Chen Kit ktk -

    279 Methilergometrin maleat 0,125 mg Tab -

    280 Methilergometrin maleat 0,200 mg - 1 ml Amp 20

    281 Methilprednisolon 4 mg Tab -

    282 Methilprednisolon 8 mg tab 900


    283 Metoclopramide injeksi 5 mg/5 ml Amp -

    284 Metoclopramide 10 mg Tab 200

    285 Metronidazol 250 mg Tab 100

    286 Metronidazol 500 mg Tab -

    287 Metronidazol infus Btl 5

    288 Mikonazole cream salp 2 % / e-katalog Tube 83

    289 Mikonazole cream salp 2 % / non e-katalog Tube -

    290 Mineral Mix Sac 40

    291 Morfin injeksi 10 mg/ml Amp -

    292 Natrium Bicarbonat 500 mg Tab -

    293 Natrium Diklofenak 25 mg Tab -

    294 Natrium Diklofenak 50 mg Tab -

    295 Natrium Klorida Larutan infus 0,9 % / e-katalog Btl 200

    296 Natrium Klorida Larutan infus 0,9 / non e-katalog Btl 120

    297 Natrium Fenitoin 100 mg Kaps -

    298 Natrium Fenitoin Injeksi / Non e-katalog Amp -

    299 Nicolin injeksi / Citicolin inj Amp -

    300 Nifedipin 10 mg Tab -

    301 Nistatin 100 000 UI Tab -

    302 Nistatin 500 000 UI Vaginal tab Tab -

    303 Nitrit Test Merk ktk -

    304 Neurovit- E Tab -

    305 Neurobion / Neurosanbe 5000 Tab -

    306 Neurobion / Neurosanbe Injeksi Amp -

    307 Obat Batuk Hitam syrup 100 ml Btl -

    308 Obat FDC Anak Pkt -

    309 Obat FDC Kategori 1 Pkt -


    310 Obat FDC Kategori 2 Pkt -

    311 Obat FDC TB sisipan Pkt -

    312 OAT Kombipak anak Pkt -

    313 OAT Kategori 1 & 3 Pkt -

    314 Oil Emersi Btl -

    315 Obat suntik KB 3 bulanan Vial -

    316 Oksitetrasiklin HCL 1 % salp mata Tube 25

    317 Oksitetrasiklin HCL 3 % salp Kulit Tube 75

    318 Oksitetrasiklin injeksi Vial -

    319 Oksitosin injeksi 10 IU/ml - 1 ml Amp 63

    320 Omeprazole 20 mg Kaps 570

    321 Papaverin injeksi 40 mg/ml Amp -

    322 Papaverin 40 mg Tab 2,000

    323 Paracetamol syrup 120 mg/5 ml Btl 40

    324 Paracetamol 500 mg Tab 2,500

    325 Parasetamol drop Btl 5

    326 Parasetamol suppositoria Supp -

    327 Penisilin procain / Procain Benzil Penicillin injeksi Vial 8

    328 Petidin injeksi 50 mg/ml Amp -

    329 Pil KB I Kombinasi Set -

    330 Pilokarpin Tetes mata 2 % Btl -

    331 Piracetam injeksi 3 g/15 ml Amp -

    332 Piracetam 1200 mg Tab -

    333 Piracetam 400 mg Tab -

    334 Pirasetam 800 mg Tab -

    335 Pirantel score base 125 mg Tab -

    336 Pirantel Syrup Btl -


    337 Piridoksin HCL 10 mg Tab 1,800

    338 Piroxicam 10 mg Tab 2,100

    339 Piroxicam 20 mg Tab 1,000

    340 Plester besar 5 yard x 2 inch Roll -

    341 Plester sedang 1,5 Inch x 5 cm Roll -

    342 Plester kecil 1,25 x 5 cm roll -

    343 Plester ( Leukoplast) 7,5 x 4,5 cm Roll 4

    344 Poligips 7,5cm Roll 5

    345 Poligips 10 cm Roll 5

    346 Poligips 15 cm Roll 5

    347 Povidon iodida larutan 10 % 30 ml Btl 3

    348 Povidon iodida larutan 10 % 300 ml Btl 5

    349 Povidon iodida larutan 10 % 1000 ml Btl 2

    350 Prednison 5 mg Tab 1,800

    351 Primakuin 15 mg Tab 100

    352 Propanolol 40 mg Tab 100

    353 Propilitiourasil 100 mg Tab 100

    354 Ranitidin 150 mg Tab 3,900

    355 Ranitidin injeksi 25 mg/2 ml Amp 19

    356 Rapid Diagnostic Test (RDT) Pcs -

    357 Reagen zealnelsen Pkt -

    358 Reserpin 0,1 mg Tab -

    359 Reserpin 0,25 mg Tab -

    360 Retinol 100.000 IU Kaps -

    361 Retinol 200.000 IU Kaps -

    362 Ringer Lactat larutan infus Btl 195

    363 Rodamin B Test Chem ktk -


    364 Safety box Lbr -

    365 Salicyl Spritus 55 ml Btl -

    366 Salbutamol 2 mg Tab 200

    367 Salbutamol 4 mg Tab -

    368 Salep 2 - 4,Komb.As.Salisilat 2% + Sulfur Praicip Pot 41

    369 Salisil Bedak Ktk 6

    370 Sanbe B-Plex Btl -

    371 Sangobion Kaps 250

    372 Santa E Tab -

    373 Scabisid Cream Tube -

    374 Serum Antibisa Ular Polivalen ( ABU I ) Vial 1

    375 Serum Antitetanus injeksi 1.500 IU ( ATS ) Vial 1

    376 Sianocobalamine injeksi 500 mcg Amp 90

    377 Sianocobalamine 50 mcg Tab 800

    378 Silk ( Benang Bedah Sutera ) Pcs -

    379 Silk ( Benang Bedah Sutera ) / e-katalog Pcs 62

    380 Slide Pcs 792

    381 Sputum pot / Non e-katalog Bh -

    382 Spongostan Ktk -

    383 Streptomisin injeksi Vial -

    384 Simvastatin 10 mg Tab -

    385 Test Kehamilan Pcs 50

    386 Tetrasiklin 250 mg Kaps -

    387 Tetrasiklin 500 mg Kaps -

    388 Thiamphenicol 500 mg Kaps -

    389 Tiamin injeksi 100 mg/ml Amp 100

    390 Tiamin HCL 50 mg Tab 2,400


    391 Topicaina topical gel / Anastesi anak Btl -

    392 Tooth stain Remover btl -

    393 Triheksifenidil 2 mg Tab -

    394 Tri Kresol Formalin /TKF Btl -

    395 Tramadol 50 mg / ml Injeksi Amp -

    396 Transfusi Set Pcs -

    397 Transfusi Set / E-katalog Pcs -

    398 Tremenza Tab -

    399 Tissue Lensa pcs -

    400 Urine bag / e-katalog Pcs 30

    401 Urine Test / Gluco Protein Test Pcs -

    402 Vitamin B - complex Tab 2,600

    403 Ventolin inj. amp 6

    404 Wing Needle no 27 Pcs -

    405 Zink Oxide Eugenol (powder+liquid/kalzinol) Btl -

    406 Zinc Dispersible 120 mg Tab 1,350

    407 Slide box Pcs -

    408 Acarbose 50 mg Tab -

    409 Asam Traneksamat Injeksi amp -

    410 Asam Traneksamat 500 mg kapl 500

    411 Bumer Pcs -

    412 Etanol 70 % 100 ml btl -

    413 Furosemide 10mg/ml injeksi Amp -

    414 Glimepiride 2 mg Tab -

    415 Jarum jahit Combinasi otot & Kulit Lusin 11

    416 Plester Besar 5 m x 4,5 cm (Leukoplast) Roll 5

    417 Povidon iodida Larutan 10 % 60 ml Btl -


    418 Semprong Pcs -

    419 Sumbu bh -

    420 Termometer Ruangan Kayu Pcs 2

    421 Sofero caps -

    422 Disposible dental needle no. 18 pcs -

    423 Disposible dental needle no. 20 Pcs -

    424 Disposible dental needle no. 25 Pcs -

    425 Jarum Citojek No. 12 Pcs -

    426 Jarum Citojek No. 16 Pcs -

    427 Resin Composite (A2+A3) Btl -

    428 Suction Rip Pcs -

    429 Levemir Injeksi / non e-katalog paket -

    430 Borax Test ktk -

    431 Novabion caps -

    432 Larutan Metanol btl -

    433 Larutan Oil Imersion 50 ml btl -

    434 Alkohol Swap Pkt -

    435 Aquadest 600 ml Btl -

    436 Alat Tes Darah Multifungsi Pkt -

    437 Stik Gula Darah Pkt -

    438 Stik Kolesterol Pkt -

    439 Stik Asam Urat Pkt -

    440 Miniaspi 80 mg (Asetosal 80 mg) Tab 500

    441 Isoniazid 100 mg Tab -

    442 Rantin injeksi (Ranitidin inj. 25 mg/ml)Non E. Amp -

    443 Nexa 500 mg (Asam Traneksamat) Non E. Tab -

    444 Sotatic Injeksi (Metoclopramide inj. 5 mg/ml) Non E. Amp -


    445 Salbron 2 mg (Salbutamol 2 mg) Non E. Tab -

    446 Pehacain Inj. (Lidocain Comb.) Amp -

    447 Otoryl 25 Mg (Kaptopril 25 mg) Tab -

    448 Asam Folat 1 mg Tab 900

    449 Azitromycin 500 mg Tab -

    450 Ciprofloksasine Injeksi Btl -

    451 Amlodipin 10 mg Tab -

    452 Dentin Conditioner Minipack Box -

    453 Stesolit Rectal / Diazepam rectal Supp -

    454 Paracetamol Infus 100 ml Btl -

    455 Cetrizine 10 mg Tab -

    VAKSIN
    1 HBo Vial 5

    2 BCG Amp 2

    3 Polio Vial 6

    4 DPT-HB Vial 3

    5 Pantavalen Vial -

    6 Campak Vial 2

    7 TT Vial -

    8 DT Vial 8

    9 TD Vial -

    10 ADS 0,5 Vial -

    11 ADS 0,05 Vial -

    12 Pelarut BCG Amp 2

    13 Pelarut Campak Amp 3


    Poli Umum
    Kunjungan Resep

    UMUM

    BAYAR
    JUMLAH KUNJUNGAN RESEP

    Mengetahui Yang Menyera


    Kepala Dinas Kesehatan Kab. Alor Petugas IF

    NIP. NIP.
    PEMERINTAH KABUPATEN ALOR
    D I N A S K E S E H A T A N
    Jl. Prof. DR. W. Z. Yohanes. No. - Telp. (0386) 21052
    K A L A B A H I

    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    LAP. PEMAKAIAN O
    LEMBAR PERMINTA
    TAHUN
    TRIWULAN

    Penerimaan Persediaan Pemakaian Sisa Stok Stok Optimum

    5 6 7 9 11

    - -

    450 450

    280 280

    - -

    400 400

    - -

    400 400

    500 500

    - -

    650 650

    1,200 1,200

    - -
    10 10

    2,400 2,400

    9 9

    280 280

    - -

    - -

    50 50

    2,500 2,500

    2,000 2,000

    50 50

    - -

    - -

    3,000 3,000

    46 46

    1,600 1,600

    15 15

    41 41

    24 24

    - -

    1,000 1,000

    - -

    - -

    - -

    - -

    - -

    5 5

    3 3
    1 1

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    8,600 8,600

    2,500 2,500

    57 57

    1,050 1,050

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    25 25

    - -

    - -
    - -

    - -

    83 83

    - -

    - -

    - -

    - -

    96 96

    - -

    120 120

    - -

    - -

    1,700 1,700

    - -

    6 6

    - -

    - -

    5 5

    5 5

    3,100 3,100

    1,500 1,500

    - -

    - -

    216 216

    - -

    153 153

    2,800 2,800
    - -

    - -

    - -

    - -

    - -

    5 5

    - -

    79 79

    - -

    - -

    - -

    - -

    200 200

    30 30

    160 160

    - -

    - -

    - -

    - -

    - -

    30 30

    - -

    - -

    - -

    25 25

    12 12

    6 6
    - -

    - -

    - -

    - -

    - -

    200 200

    - -

    - -

    - -

    14 14

    260 260

    22 22

    - -

    - -

    4 4

    5 5

    - -

    - -

    - -

    - -

    525 525

    - -

    - -

    65 65

    41 41

    - -

    500 500
    4,200 4,200

    60 60

    - -

    102 102

    - -

    - -

    - -

    - -

    1,500 1,500

    - -

    - -

    - -

    220 220

    - -

    209 209

    - -

    - -

    - -

    10 10

    - -

    - -

    48 48

    1,000 1,000

    3,200 3,200

    - -

    5 5

    31 31
    - -

    43 43

    400 400

    360 360

    - -

    - -

    - -

    40 40

    - -

    286 286

    50 50

    270 270

    464 464

    - -

    - -

    9 9

    9 9

    2 2

    1 1

    100 100

    5 5

    - -

    - -

    - -

    - -

    10 10

    - -
    - -

    800 800

    - -

    10 10

    - -

    - -

    - -

    11 11

    - -

    - -

    - -

    - -

    200 200

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    1,250 1,250

    5 5

    - -

    10 10

    - -
    - -

    - -

    - -

    - -

    - -

    - -

    600 600

    9 9

    40 40

    4,000 4,000

    - -

    - -

    - -

    85 85

    700 700

    2,400 2,400

    67 67

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    1 1

    - -
    - -

    12 12

    - -

    265 265

    30 30

    - -

    300 300

    600 600

    2 2

    - -

    10 10

    - -

    650 650

    - -

    - -

    4 4

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    20 20

    - -

    900 900
    - -

    200 200

    100 100

    - -

    5 5

    83 83

    - -

    40 40

    - -

    - -

    - -

    - -

    200 200

    120 120

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -
    - -

    - -

    - -

    - -

    - -

    - -

    25 25

    75 75

    - -

    63 63

    570 570

    - -

    2,000 2,000

    40 40

    2,500 2,500

    5 5

    - -

    8 8

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -
    1,800 1,800

    2,100 2,100

    1,000 1,000

    - -

    - -

    - -

    4 4

    5 5

    5 5

    5 5

    3 3

    5 5

    2 2

    1,800 1,800

    100 100

    100 100

    100 100

    3,900 3,900

    19 19

    - -

    - -

    - -

    - -

    - -

    - -

    195 195

    - -
    - -

    - -

    200 200

    - -

    41 41

    6 6

    - -

    250 250

    - -

    - -

    1 1

    1 1

    90 90

    800 800

    - -

    62 62

    792 792

    - -

    - -

    - -

    - -

    50 50

    - -

    - -

    - -

    100 100

    2,400 2,400
    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    30 30

    - -

    2,600 2,600

    6 6

    - -

    - -

    1,350 1,350

    - -

    - -

    - -

    500 500

    - -

    - -

    - -

    - -

    11 11

    5 5

    - -
    - -

    - -

    2 2

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    500 500

    - -

    - -

    - -

    - -
    - -

    - -

    - -

    900 900

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    5 5

    2 2

    6 6

    3 3

    - -

    2 2

    - -

    8 8

    - -

    - -

    - -

    2 2

    3 3
    Sumber / Asal Resep
    Poli Gigi KIA KB Raeat Inap UGD

    MUM
    ASKES JUMLAH
    TIDAK BAYAR Dokter

    ang Menyerahkan Yang Meminta


    Petugas IFK Kepala Puskesmas

    NIP.
    LPO)

    P. PEMAKAIAN OBAT BULAN : NOVEMBER


    MBAR PERMINTAAN OBAT BULAN :
    : 2019
    :

    permintaan pemberian KET

    12 14 16
    Total Resep ke Apotik
    Pusling, Posyandu, dll Bulan Ini Kumulatif s/d Bulan ini

    - #VALUE!

    Pemberi Resep
    Perawat Bidan Perawat Gigi

    Yang Menerima
    Petugas Puskesmas

    NIP.
    ……………………….,
    ………………………………………
    ……………………….,
    …………………………………………………………
    LA

    NAMA PUSKESMAS :
    KABUPATEN : ALOR
    KECAMATAN :

    No Nama Obat Satuan Stok awal

    1 2 3 4

    1 Adona Injensi -
    Amp
    2 Alat Suntik Sekali Pakai 2,5 ml Pcs 450

    3 Alat Suntik Sekali Pakai 5 ml Pcs 280

    4 Alat suntik sekali pakai 0,5 ml Pcs -

    5 Alat suntik sekali pakai 0,5 ml / E - Katalog Pcs 400

    6 Alat suntik sekali pakai 0,05 ml /non e-katalog pcs -

    7 Alat suntik sekali pakai 0,05 ml / e-katalog Pcs 400

    8 Alat suntik sekali pakai 1 ml Pcs 500

    9 Alat suntik sekali pakai10 ml Pcs -

    10 Albendazol 400 mg / non e-katalog Tab 650

    11 Allupurinol 100 mg Tab 1,200

    12 Amalgam solila / Silver Amalgam Powder + Liquid Tube -


    13 Ambroxol syrup 15 mg/ml Btl 10

    14 Ambroxol 30 mg Tab 2,400

    15 Aminofilin Injeksi 24 mg/ml Amp 9

    16 Aminofilin 200 mg / e-katalog Tab 280

    17 Aminofilin 200 mg / non e-katalog tab -

    18 Amitriptilin HCL 25 mg Tab -

    19 Amlodipin 5 mg Tab 50

    20 Amoksisilin 250 mg Kaps 2,500

    21 Amoksisilin 500 mg Kapl 2,000

    22 Amoksisilin syrup Btl 50

    23 Ampisillin injeksi 1000 mg/ml Vial -

    24 Ampisillin syrup Btl -

    25 Antacida DOEN Tab 3,000

    26 Antacida DOEN Suspensi Btl 46

    27 Antalgin 500 mg Tab 1,600

    28 Antalgin injeksi Amp 15

    29 Anti Bakteri DOEN / Basitrasin Polimiksin Tube 41

    30 Anti Fungi DOEN Salep 30 g ( Salp 3 - 6 ) Pot 24

    31 Anti Haemoroid DOEN Suppositoria Supp -

    32 Anti Malaria DOEN ( SulDox ) Tab 1,000

    33 Anti Migraen / Ergotamin 1 mg + Coffein 50 mg Tab -

    34 Anti Sera A Btl -

    35 Anti Sera B Btl -

    36 Anti Sera AB Btl -

    37 Anti Sera D Btl -

    38 Aqua pro injeksi 20 ml Vial 5

    39 Aquadestilata 1000 ml Btl 3


    40 Aqua DM Bidestilata IKA ml 1

    41 Aqua DM Brataco ltr -

    42 Arsen / Devitalisasi Pasta Btl -

    43 Arterakin tab Tab -

    44 Artesunat injeksi 60 mg Vial -

    45 Artemeter injeksi Amp -

    46 Asetosal 100 mg Tab -

    47 Asetosal 500 mg Tab -

    48 Asam Ascorbat 50 mg Tab 8,600

    49 Asam Mefenamat 500 mg Kapl 2,500

    50 Asiklovir cream 5 % 5 g Tube 57

    51 Asiklovir 200 mg Tab 1,050

    52 Asiklovir 400 mg Tab -

    53 Atropin Sulfat injeksi 0,25 mg/ml Amp -

    54 Atropin sulfat 0,5 mg Tab -

    55 Baby Cough syrup Btl -

    56 Bahan Fissur Sealent / Fuji VII Dos -

    57 Baraclude 1 mg btl/30 tab -

    58 Baraclude 0,5 mg box/30 tab -

    59 Barotec Inhaler Btl -

    60 Baycline 1 Liter Btl -

    61 Benzatin Benzil Penicillin 1,2 juta IU Vial -

    62 Besi II Sulfat 7 H2O 300 mg Tab -

    63 Besi II Sulfat + Asam Folat Tab -

    64 Betametason Cream 0,1 % Tube 25

    65 Betason N Tube -

    66 Bidan Kit paket -


    67 Bioplacenton 15 gram Tube -

    68 Bisolvon Nebulizer btl -

    69 Bisturi / non e-katalog Pcs 83

    70 Blood lanset / non e-katalog Pcs -

    71 Calsidor / Dycal Dentsply / Hydcal Technew Btl -

    72 Calsydol syrup Btl -

    73 Cat gut 3/0 Pcs -

    74 Cat gut 3/0 / E-katalog Pcs 96

    75 Cat gut 2/0 Pcs -

    76 Cat gut 2/0 / E-katalog Pcs 120

    77 Cavit / Caviton Btl -

    78 Cement Powder + Liquid / Elite Cement 100 Dos -

    79 Cefadroxil 500 mg Kaps 1,700

    80 Ceftriaxon Injeksi Vial -

    81 Cefotaxime injeksi 0,5 gram Vial 6

    82 Cefotaxime injeksi 1 gram Vial -

    83 Chlor Fenol Champer menthol /CHKM Btl -

    84 Chloramfecort Tube 5

    85 Chloramfecort H Tube 5

    86 Cimetidine 200 mg Tab 3,100

    87 Ciprofloksasine 500 mg Tab 1,500

    88 Counterpain 30 gram Tube -

    89 Curcuma Plus Syrup Btl -

    90 Darplex Tab 216

    91 Dasabion Kaps -

    92 Deksamethasone injeksi 5 mg/ml Amp 153

    93 Deksamethasone 0,5 mg Tab 2,800


    94 Dekstran 70 - Larutan Infus 6 % steril Btl -

    95 Dental Cotton Roll Bks -

    96 Dental Plak Disclosing Gel / Disclosing Solution Btl -

    97 Diazepam injeksi 5 mg/ml Amp -

    98 Diazepam 2 mg Tab -

    99 Diazepam 5 mg Tab 5

    100 Dietilkarbamsin 100 mg / NON E-KATALOG Tab -

    101 Difenhidramine Injeksi 10 mg/ml Amp 79

    102 Digoksin 0,25 mg Tab -

    103 Diltiazem HCL 30 mg Tab -

    104 Dimenhidrinat 50 mg Tab -

    105 Doksisiklin 100 mg Kaps -

    106 Domperidon Tab 200

    107 Dulcolax 5 mg Tab 30

    108 Efedrin HCL 25 mg Tab 160

    109 Elastis verban 3 inci Roll -

    110 Elastis verban 4 inci Roll -

    111 Elastis verban 6 inci Roll -

    112 Elkana Multivitamin Tab -

    113 Enervon - C Kapl -

    114 Epineprin HCL 0,1 % injeksi Amp 30

    115 Eritromicin 250 mg Kapl -

    116 Eritromicin 500 mg Kapl -

    117 Eritromicin syrup Btl -

    118 Etakridin Larutan 0,1 % 300 ml Btl 25

    119 Etanol 70 % 1 liter Btl 12

    120 Ethilklorda Semprot Btl 6


    121 Endomethasone (endosel) btl -

    122 Eugenol Btl -

    123 Fehling A Btl -

    124 Fehling B Btl -

    125 Fenobarbital injeksi 50 mg/ml Amp -

    126 Fenobarbital 30 mg Tab 200

    127 Fenobarbital 100 mg Tab -

    128 Fenoksimetil Penisilin 250 mg Tab -

    129 Fenoksimetil Penisilin 500 mg Tab -

    130 Fenol gliserol TT Btl 14

    131 Fitomenadion 10 mg Tab 260

    132 Fitomenadion injeksi 10 mg/ml Amp 22

    133 Flecher Powder + Liquid Btl -

    134 Foley cateter no 16 Pcs -

    135 Foley cateter no 18 Pcs 4

    136 Foley cateter no 20 Pcs 5

    137 Formalin solution liter -

    138 Formaldehide Merk Test kit -

    139 Formokresol Btl -

    140 Furosemida Tab -

    141 Garam Oralit Sac 525

    142 Gamexan Btl -

    143 Gentamicin Injeksi 80 mg/ml Amp -

    144 Gentamicin Salep Kulit 0,1 % Tube 65

    145 Gentian Violet 1 % Btl 41

    146 Gic Art / Fuji IX Dos -

    147 Glibenclamida 5 mg Tab 500


    148 Gliceril Guayacolat 100 mg Tab 4,200

    149 Glucosa Larutan Infus 10 % steril Btl 60

    150 Glucosa Larutan Infus 40 % steril Btl -

    151 Glucosa Larutan Infus 5 % steril Btl 102

    152 Gloves "S" Pcs -

    153 Gloves "M" Pcs -

    154 Gloves "L" Pcs -

    155 Grisofulvin 250 mg Tab -

    156 Grisofulvin 125 mg tab 1,500

    157 Haloperidol 0,5 mg Tab -

    158 Haloperidol 1,5 mg Tab -

    159 Haloperidol 5 mg Tab -

    160 Handscoen no 6,5 Pcs 220

    161 Handscoen no 7,5 Pcs -

    162 Handscoen no 7,5 / E-katalog Pcs 209

    163 Handscoen No.7 Pcs -

    164 Handscoen no 8 Pcs -

    165 Handscoen no 8 / E-katalog Pcs -

    166 Handscoen Ginecolog Panjang Steril Pcs 10

    167 HB Sahli Pkt -

    168 Hemaviton Action Kaps -

    169 Hidrokortison Cream 2,5 % Tube 48

    170 Hidroklortiazida 25 mg Tab 1,000

    171 Ibuprofen 200 mg Tab 3,200

    172 Ibuprofen 400 mg Tab -

    173 Ibuprofen syrup/Buffec Syrup Btl 5

    174 Ictiol salep Pot 31


    175 Implant susuk KB Pcs -

    176 Infuset Micro Pcs 43

    177 Infuset Micro / e-katalog Pcs 400

    178 Infuset Macro Pcs 360

    179 Infuset Macro / e-katalog Pcs -

    180 Iodium test Btl -

    181 indikator universal ktk -

    182 IV Kateter no 18 Pcs 40

    183 IV Kateter no 18 / e-katalog Pcs -

    184 IV Kateter no 20 Pcs 286

    185 IV Kateter no 20 / E-katalog Pcs 50

    186 IV Kateter no 22 / E-katalog Pcs 270

    187 IV Kateter no 24 / E - katalog Pcs 464

    188 IV Canula No.18 Pcs -

    189 Isosorbit Dinitrat sublingual 5 mg Tab -

    190 Jarum Jahit Otot Lusin 9

    191 Jarum Jahit Kulit Lusin 9

    192 Jelly untuk USG / non e-katalog Btl 2

    193 Jelly untuk Catheter Komb. Lidokain Btl 1

    194 Kalsium Laktat 500 mg Tab 100

    195 Kalsium Gluconas Injeksi / non e-katalog Amp 5

    196 Kalnex 250 mg Kaps -

    197 Kalnex injeksi Amp -

    198 Kapas berlemak 500 gram Roll -

    199 Kapas pemb. Absorben 200 gram Roll -

    200 Kapas Pemb. Absorben 250 gram Roll 10

    201 Kapas pemb. Absorben 1000 gram Roll -


    202 Kaptopril 12,5 mg Tab -

    203 Kaptopril 25 mg Tab 800

    204 Karbamazepin 200 mg Tab -

    205 Kartu Stock Lbr 10

    206 Kasa 4 x 10 cm Roll -

    207 Kasa 4 x 6 cm Roll -

    208 Kasa 40 x 80 cm Roll -

    209 Kasa 40 x 80 cm / E-katalog 11

    210 Kasa Kompres 40/40 cm Roll -

    211 Kasa Kompres 40/40 cm / E-katalog Roll -

    212 Kasa Pembalut 2 m x 80 cm Roll -

    213 Kasa Pembalut Hidrofil 4 m x 3 cm Roll -

    214 Kasa Pembalut Hidrofil 4 m x 3 cm / E-katalog Roll 200

    215 Kasa Pembalut Hidrofil 4 m x 15 cm Roll -

    216 Kasa Pembalut Hidrofil 4 m x 15 cm / E-Katalog Roll -

    217 Kasa 16 x 16 Roll -

    218 Kasa pembalut 14 x 8 cm Roll -

    219 Kasa pembalut 10 cm Roll -

    220 Kasa pembalut 4 x 18 Roll -

    221 Kelambu Pcs -

    222 Ketamine Injeksi 10 mg/ml Vial -

    223 Ketokonazol cream 2 % Tube -

    224 Ketokonazol 200 mg Tab 1,250

    225 Ketorolac Injeksi Ampul 5

    226 Kertas EKG 3 Ukuran Roll -

    227 Kertas Perkamen / Non e-katalog Lbr 10

    228 Kina Dihidroklorida injeksi 25 % - 2 ml Amp -


    229 Kina 222 mg Tab -

    230 Klip Plastik Kecil tanpa sablon Pcs -

    231 Klip Plastik Sedang tanpa sablon Pcs -

    232 Klip Plastik Besar sablon 10 x 15 Pcs -

    233 Klip Plastik Sedang sablon 8,7 x 15 Pcs -

    234 Klip Plastik kecil sablon Pcs -

    235 Kloramfenicol 250 mg Kaps 600

    236 Kloramfenicol Salp Mata 1 % Tube 9

    237 Kloramfenicol Tetes Telinga 3 % Btl 40

    238 Klorfeniraminimaleat 4 mg Tab 4,000

    239 Klorokuin 150 mg Tab -

    240 Klorpromazin HCL injeksi i.m 25 mg/ml Amp -

    241 Klorpromazin HCL 25 mg Tab -

    242 Kodein 10 mg Tab 85

    243 Kotrimoksasol Adult 480 mg Tab 700

    244 Kotrimoksasol Pedriatic 120 mg Tab 2,400

    245 Kotrimoksasol suspensi Btl 67

    246 Lab.Kit Pkt -

    247 Lacbon 17 Tab -

    248 Lansoprazole 30 mg Kaps -

    249 Larutan Benedict Btl -

    250 Larutan Etanol Asam Btl -

    251 Larutan Gimsa stain / non e-katalog Btl -

    252 Larutan Carbofuksin Btl -

    253 Larutan Methilen Biru Btl -

    254 Larutan H2O2 Btl 1

    255 Larutan xilol Btl -


    256 Larutan HCl 0,1 N / Non e-katalog Btl -

    257 Levetran Salp Pot 12

    258 Levofloksasin 500 mg Tab -

    259 Lidocain Injeksi HCl 2 % Amp 265

    260 Lidocain Injeksi 2 % + Epineprin 1 : 80.000 - 2 ml Amp 30

    261 Livron B plex Tab -

    262 Loperamid 2 mg Tab 300

    263 Loratadin 10 mg Tab 600

    264 Lysol Btl 2

    265 Light cure Composite (etsa & bondingnya) Set -

    266 Magnesium Sulfat injeksi 20 % - 25 ml Amp 10

    267 Magnesium Sulfat injeksi 40 % - 25 ml Amp -

    268 Masker Mulut Pcs 650

    269 MDT MB Adult Blist -

    270 MDT PB Adult Blist -

    271 MDT MB Anak Blist 4

    272 MDT PB Anak Blist -

    273 Mebendazole syrup 100 mg/5 ml Btl -

    274 Mebendazole 100 mg Tab -

    275 Meloxicam 15 mg Tab -

    276 Metformin Tab -

    277 Metapex Box -

    278 Methanil Yellow Chen Kit ktk -

    279 Methilergometrin maleat 0,125 mg Tab -

    280 Methilergometrin maleat 0,200 mg - 1 ml Amp 20

    281 Methilprednisolon 4 mg Tab -

    282 Methilprednisolon 8 mg tab 900


    283 Metoclopramide injeksi 5 mg/5 ml Amp -

    284 Metoclopramide 10 mg Tab 200

    285 Metronidazol 250 mg Tab 100

    286 Metronidazol 500 mg Tab -

    287 Metronidazol infus Btl 5

    288 Mikonazole cream salp 2 % / e-katalog Tube 83

    289 Mikonazole cream salp 2 % / non e-katalog Tube -

    290 Mineral Mix Sac 40

    291 Morfin injeksi 10 mg/ml Amp -

    292 Natrium Bicarbonat 500 mg Tab -

    293 Natrium Diklofenak 25 mg Tab -

    294 Natrium Diklofenak 50 mg Tab -

    295 Natrium Klorida Larutan infus 0,9 % / e-katalog Btl 200

    296 Natrium Klorida Larutan infus 0,9 / non e-katalog Btl 120

    297 Natrium Fenitoin 100 mg Kaps -

    298 Natrium Fenitoin Injeksi / Non e-katalog Amp -

    299 Nicolin injeksi / Citicolin inj Amp -

    300 Nifedipin 10 mg Tab -

    301 Nistatin 100 000 UI Tab -

    302 Nistatin 500 000 UI Vaginal tab Tab -

    303 Nitrit Test Merk ktk -

    304 Neurovit- E Tab -

    305 Neurobion / Neurosanbe 5000 Tab -

    306 Neurobion / Neurosanbe Injeksi Amp -

    307 Obat Batuk Hitam syrup 100 ml Btl -

    308 Obat FDC Anak Pkt -

    309 Obat FDC Kategori 1 Pkt -


    310 Obat FDC Kategori 2 Pkt -

    311 Obat FDC TB sisipan Pkt -

    312 OAT Kombipak anak Pkt -

    313 OAT Kategori 1 & 3 Pkt -

    314 Oil Emersi Btl -

    315 Obat suntik KB 3 bulanan Vial -

    316 Oksitetrasiklin HCL 1 % salp mata Tube 25

    317 Oksitetrasiklin HCL 3 % salp Kulit Tube 75

    318 Oksitetrasiklin injeksi Vial -

    319 Oksitosin injeksi 10 IU/ml - 1 ml Amp 63

    320 Omeprazole 20 mg Kaps 570

    321 Papaverin injeksi 40 mg/ml Amp -

    322 Papaverin 40 mg Tab 2,000

    323 Paracetamol syrup 120 mg/5 ml Btl 40

    324 Paracetamol 500 mg Tab 2,500

    325 Parasetamol drop Btl 5

    326 Parasetamol suppositoria Supp -

    327 Penisilin procain / Procain Benzil Penicillin injeksi Vial 8

    328 Petidin injeksi 50 mg/ml Amp -

    329 Pil KB I Kombinasi Set -

    330 Pilokarpin Tetes mata 2 % Btl -

    331 Piracetam injeksi 3 g/15 ml Amp -

    332 Piracetam 1200 mg Tab -

    333 Piracetam 400 mg Tab -

    334 Pirasetam 800 mg Tab -

    335 Pirantel score base 125 mg Tab -

    336 Pirantel Syrup Btl -


    337 Piridoksin HCL 10 mg Tab 1,800

    338 Piroxicam 10 mg Tab 2,100

    339 Piroxicam 20 mg Tab 1,000

    340 Plester besar 5 yard x 2 inch Roll -

    341 Plester sedang 1,5 Inch x 5 cm Roll -

    342 Plester kecil 1,25 x 5 cm roll -

    343 Plester ( Leukoplast) 7,5 x 4,5 cm Roll 4

    344 Poligips 7,5cm Roll 5

    345 Poligips 10 cm Roll 5

    346 Poligips 15 cm Roll 5

    347 Povidon iodida larutan 10 % 30 ml Btl 3

    348 Povidon iodida larutan 10 % 300 ml Btl 5

    349 Povidon iodida larutan 10 % 1000 ml Btl 2

    350 Prednison 5 mg Tab 1,800

    351 Primakuin 15 mg Tab 100

    352 Propanolol 40 mg Tab 100

    353 Propilitiourasil 100 mg Tab 100

    354 Ranitidin 150 mg Tab 3,900

    355 Ranitidin injeksi 25 mg/2 ml Amp 19

    356 Rapid Diagnostic Test (RDT) Pcs -

    357 Reagen zealnelsen Pkt -

    358 Reserpin 0,1 mg Tab -

    359 Reserpin 0,25 mg Tab -

    360 Retinol 100.000 IU Kaps -

    361 Retinol 200.000 IU Kaps -

    362 Ringer Lactat larutan infus Btl 195

    363 Rodamin B Test Chem ktk -


    364 Safety box Lbr -

    365 Salicyl Spritus 55 ml Btl -

    366 Salbutamol 2 mg Tab 200

    367 Salbutamol 4 mg Tab -

    368 Salep 2 - 4,Komb.As.Salisilat 2% + Sulfur Praicip Pot 41

    369 Salisil Bedak Ktk 6

    370 Sanbe B-Plex Btl -

    371 Sangobion Kaps 250

    372 Santa E Tab -

    373 Scabisid Cream Tube -

    374 Serum Antibisa Ular Polivalen ( ABU I ) Vial 1

    375 Serum Antitetanus injeksi 1.500 IU ( ATS ) Vial 1

    376 Sianocobalamine injeksi 500 mcg Amp 90

    377 Sianocobalamine 50 mcg Tab 800

    378 Silk ( Benang Bedah Sutera ) Pcs -

    379 Silk ( Benang Bedah Sutera ) / e-katalog Pcs 62

    380 Slide Pcs 792

    381 Sputum pot / Non e-katalog Bh -

    382 Spongostan Ktk -

    383 Streptomisin injeksi Vial -

    384 Simvastatin 10 mg Tab -

    385 Test Kehamilan Pcs 50

    386 Tetrasiklin 250 mg Kaps -

    387 Tetrasiklin 500 mg Kaps -

    388 Thiamphenicol 500 mg Kaps -

    389 Tiamin injeksi 100 mg/ml Amp 100

    390 Tiamin HCL 50 mg Tab 2,400


    391 Topicaina topical gel / Anastesi anak Btl -

    392 Tooth stain Remover btl -

    393 Triheksifenidil 2 mg Tab -

    394 Tri Kresol Formalin /TKF Btl -

    395 Tramadol 50 mg / ml Injeksi Amp -

    396 Transfusi Set Pcs -

    397 Transfusi Set / E-katalog Pcs -

    398 Tremenza Tab -

    399 Tissue Lensa pcs -

    400 Urine bag / e-katalog Pcs 30

    401 Urine Test / Gluco Protein Test Pcs -

    402 Vitamin B - complex Tab 2,600

    403 Ventolin inj. amp 6

    404 Wing Needle no 27 Pcs -

    405 Zink Oxide Eugenol (powder+liquid/kalzinol) Btl -

    406 Zinc Dispersible 120 mg Tab 1,350

    407 Slide box Pcs -

    408 Acarbose 50 mg Tab -

    409 Asam Traneksamat Injeksi amp -

    410 Asam Traneksamat 500 mg kapl 500

    411 Bumer Pcs -

    412 Etanol 70 % 100 ml btl -

    413 Furosemide 10mg/ml injeksi Amp -

    414 Glimepiride 2 mg Tab -

    415 Jarum jahit Combinasi otot & Kulit Lusin 11

    416 Plester Besar 5 m x 4,5 cm (Leukoplast) Roll 5

    417 Povidon iodida Larutan 10 % 60 ml Btl -


    418 Semprong Pcs -

    419 Sumbu bh -

    420 Termometer Ruangan Kayu Pcs 2

    421 Sofero caps -

    422 Disposible dental needle no. 18 pcs -

    423 Disposible dental needle no. 20 Pcs -

    424 Disposible dental needle no. 25 Pcs -

    425 Jarum Citojek No. 12 Pcs -

    426 Jarum Citojek No. 16 Pcs -

    427 Resin Composite (A2+A3) Btl -

    428 Suction Rip Pcs -

    429 Levemir Injeksi / non e-katalog paket -

    430 Borax Test ktk -

    431 Novabion caps -

    432 Larutan Metanol btl -

    433 Larutan Oil Imersion 50 ml btl -

    434 Alkohol Swap Pkt -

    435 Aquadest 600 ml Btl -

    436 Alat Tes Darah Multifungsi Pkt -

    437 Stik Gula Darah Pkt -

    438 Stik Kolesterol Pkt -

    439 Stik Asam Urat Pkt -

    440 Miniaspi 80 mg (Asetosal 80 mg) Tab 500

    441 Isoniazid 100 mg Tab -

    442 Rantin injeksi (Ranitidin inj. 25 mg/ml)Non E. Amp -

    443 Nexa 500 mg (Asam Traneksamat) Non E. Tab -

    444 Sotatic Injeksi (Metoclopramide inj. 5 mg/ml) Non E. Amp -


    445 Salbron 2 mg (Salbutamol 2 mg) Non E. Tab -

    446 Pehacain Inj. (Lidocain Comb.) Amp -

    447 Otoryl 25 Mg (Kaptopril 25 mg) Tab -

    448 Asam Folat 1 mg Tab 900

    449 Azitromycin 500 mg Tab -

    450 Ciprofloksasine Injeksi Btl -

    451 Amlodipin 10 mg Tab -

    452 Dentin Conditioner Minipack Box -

    453 Stesolit Rectal / Diazepam rectal Supp -

    454 Paracetamol Infus 100 ml Btl -

    455 Cetrizine 10 mg Tab -

    VAKSIN
    1 HBo Vial 5

    2 BCG Amp 2

    3 Polio Vial 6

    4 DPT-HB Vial 3

    5 Pantavalen Vial -

    6 Campak Vial 2

    7 TT Vial -

    8 DT Vial 8

    9 TD Vial -

    10 ADS 0,5 Vial -

    11 ADS 0,05 Vial -

    12 Pelarut BCG Amp 2

    13 Pelarut Campak Amp 3


    Poli Umum
    Kunjungan Resep

    UMUM

    BAYAR
    JUMLAH KUNJUNGAN RESEP

    Mengetahui Yang Menyera


    Kepala Dinas Kesehatan Kab. Alor Petugas IF

    NIP. NIP.
    PEMERINTAH KABUPATEN ALOR
    D I N A S K E S E H A T A N
    Jl. Prof. DR. W. Z. Yohanes. No. - Telp. (0386) 21052
    K A L A B A H I

    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    LAP. PEMAKAIAN O
    LEMBAR PERMINTA
    TAHUN
    TRIWULAN

    Penerimaan Persediaan Pemakaian Sisa Stok Stok Optimum

    5 6 7 9 11

    - -

    450 450

    280 280

    - -

    400 400

    - -

    400 400

    500 500

    - -

    650 650

    1,200 1,200

    - -
    10 10

    2,400 2,400

    9 9

    280 280

    - -

    - -

    50 50

    2,500 2,500

    2,000 2,000

    50 50

    - -

    - -

    3,000 3,000

    46 46

    1,600 1,600

    15 15

    41 41

    24 24

    - -

    1,000 1,000

    - -

    - -

    - -

    - -

    - -

    5 5

    3 3
    1 1

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    8,600 8,600

    2,500 2,500

    57 57

    1,050 1,050

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    25 25

    - -

    - -
    - -

    - -

    83 83

    - -

    - -

    - -

    - -

    96 96

    - -

    120 120

    - -

    - -

    1,700 1,700

    - -

    6 6

    - -

    - -

    5 5

    5 5

    3,100 3,100

    1,500 1,500

    - -

    - -

    216 216

    - -

    153 153

    2,800 2,800
    - -

    - -

    - -

    - -

    - -

    5 5

    - -

    79 79

    - -

    - -

    - -

    - -

    200 200

    30 30

    160 160

    - -

    - -

    - -

    - -

    - -

    30 30

    - -

    - -

    - -

    25 25

    12 12

    6 6
    - -

    - -

    - -

    - -

    - -

    200 200

    - -

    - -

    - -

    14 14

    260 260

    22 22

    - -

    - -

    4 4

    5 5

    - -

    - -

    - -

    - -

    525 525

    - -

    - -

    65 65

    41 41

    - -

    500 500
    4,200 4,200

    60 60

    - -

    102 102

    - -

    - -

    - -

    - -

    1,500 1,500

    - -

    - -

    - -

    220 220

    - -

    209 209

    - -

    - -

    - -

    10 10

    - -

    - -

    48 48

    1,000 1,000

    3,200 3,200

    - -

    5 5

    31 31
    - -

    43 43

    400 400

    360 360

    - -

    - -

    - -

    40 40

    - -

    286 286

    50 50

    270 270

    464 464

    - -

    - -

    9 9

    9 9

    2 2

    1 1

    100 100

    5 5

    - -

    - -

    - -

    - -

    10 10

    - -
    - -

    800 800

    - -

    10 10

    - -

    - -

    - -

    11 11

    - -

    - -

    - -

    - -

    200 200

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    1,250 1,250

    5 5

    - -

    10 10

    - -
    - -

    - -

    - -

    - -

    - -

    - -

    600 600

    9 9

    40 40

    4,000 4,000

    - -

    - -

    - -

    85 85

    700 700

    2,400 2,400

    67 67

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    1 1

    - -
    - -

    12 12

    - -

    265 265

    30 30

    - -

    300 300

    600 600

    2 2

    - -

    10 10

    - -

    650 650

    - -

    - -

    4 4

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    20 20

    - -

    900 900
    - -

    200 200

    100 100

    - -

    5 5

    83 83

    - -

    40 40

    - -

    - -

    - -

    - -

    200 200

    120 120

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -
    - -

    - -

    - -

    - -

    - -

    - -

    25 25

    75 75

    - -

    63 63

    570 570

    - -

    2,000 2,000

    40 40

    2,500 2,500

    5 5

    - -

    8 8

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -
    1,800 1,800

    2,100 2,100

    1,000 1,000

    - -

    - -

    - -

    4 4

    5 5

    5 5

    5 5

    3 3

    5 5

    2 2

    1,800 1,800

    100 100

    100 100

    100 100

    3,900 3,900

    19 19

    - -

    - -

    - -

    - -

    - -

    - -

    195 195

    - -
    - -

    - -

    200 200

    - -

    41 41

    6 6

    - -

    250 250

    - -

    - -

    1 1

    1 1

    90 90

    800 800

    - -

    62 62

    792 792

    - -

    - -

    - -

    - -

    50 50

    - -

    - -

    - -

    100 100

    2,400 2,400
    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    30 30

    - -

    2,600 2,600

    6 6

    - -

    - -

    1,350 1,350

    - -

    - -

    - -

    500 500

    - -

    - -

    - -

    - -

    11 11

    5 5

    - -
    - -

    - -

    2 2

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    500 500

    - -

    - -

    - -

    - -
    - -

    - -

    - -

    900 900

    - -

    - -

    - -

    - -

    - -

    - -

    - -

    5 5

    2 2

    6 6

    3 3

    - -

    2 2

    - -

    8 8

    - -

    - -

    - -

    2 2

    3 3
    Sumber / Asal Resep
    Poli Gigi KIA KB Raeat Inap UGD

    MUM
    ASKES JUMLAH
    TIDAK BAYAR Dokter

    ang Menyerahkan Yang Meminta


    Petugas IFK Kepala Puskesmas

    NIP.
    LPO)

    P. PEMAKAIAN OBAT BULAN : DESEMBER


    MBAR PERMINTAAN OBAT BULAN :
    : 2019
    :

    permintaan pemberian KET

    12 14 16
    Total Resep ke Apotik
    Pusling, Posyandu, dll Bulan Ini Kumulatif s/d Bulan ini

    - #VALUE!

    Pemberi Resep
    Perawat Bidan Perawat Gigi

    Yang Menerima
    Petugas Puskesmas

    NIP.
    ……………………….,
    ………………………………………
    ……………………….,
    …………………………………………………………
    LA

    NAMA PUSKESMAS :
    KABUPATEN : ALOR
    KECAMATAN :

    No Nama Obat Satuan Stok awal

    1 2 3 4

    1 Adona Injensi -
    Amp
    2 Alat Suntik Sekali Pakai 2,5 ml Pcs 450

    3 Alat Suntik Sekali Pakai 5 ml Pcs 280

    4 Alat suntik sekali pakai 0,5 ml Pcs -

    5 Alat suntik sekali pakai 0,5 ml / E - Katalog Pcs 400

    6 Alat suntik sekali pakai 0,05 ml /non e-katalog pcs -

    7 Alat suntik sekali pakai 0,05 ml / e-katalog Pcs 400

    8 Alat suntik sekali pakai 1 ml Pcs 500

    9 Alat suntik sekali pakai10 ml Pcs -

    10 Albendazol 400 mg / non e-katalog Tab 650

    11 Allupurinol 100 mg Tab 1,200

    12 Amalgam solila / Silver Amalgam Powder + Liquid Tube -


    13 Ambroxol syrup 15 mg/ml Btl 10

    14 Ambroxol 30 mg Tab 2,400

    15 Aminofilin Injeksi 24 mg/ml Amp 9

    16 Aminofilin 200 mg / e-katalog Tab 280

    17 Aminofilin 200 mg / non e-katalog tab -

    18 Amitriptilin HCL 25 mg Tab -

    19 Amlodipin 5 mg Tab 50

    20 Amoksisilin 250 mg Kaps 2,500

    21 Amoksisilin 500 mg Kapl 2,000

    22 Amoksisilin syrup Btl 50

    23 Ampisillin injeksi 1000 mg/ml Vial -

    24 Ampisillin syrup Btl -

    25 Antacida DOEN Tab 3,000

    26 Antacida DOEN Suspensi Btl 46

    27 Antalgin 500 mg Tab 1,600

    28 Antalgin injeksi Amp 15

    29 Anti Bakteri DOEN / Basitrasin Polimiksin Tube 41

    30 Anti Fungi DOEN Salep 30 g ( Salp 3 - 6 ) Pot 24

    31 Anti Haemoroid DOEN Suppositoria Supp -

    32 Anti Malaria DOEN ( SulDox ) Tab 1,000

    33 Anti Migraen / Ergotamin 1 mg + Coffein 50 mg Tab -

    34 Anti Sera A Btl -

    35 Anti Sera B Btl -

    36 Anti Sera AB Btl -

    37 Anti Sera D Btl -

    38 Aqua pro injeksi 20 ml Vial 5

    39 Aquadestilata 1000 ml Btl 3


    40 Aqua DM Bidestilata IKA ml 1

    41 Aqua DM Brataco ltr -

    42 Arsen / Devitalisasi Pasta Btl -

    43 Arterakin tab Tab -

    44 Artesunat injeksi 60 mg Vial -

    45 Artemeter injeksi Amp -

    46 Asetosal 100 mg Tab -

    47 Asetosal 500 mg Tab -

    48 Asam Ascorbat 50 mg Tab 8,600

    49 Asam Mefenamat 500 mg Kapl 2,500

    50 Asiklovir cream 5 % 5 g Tube 57

    51 Asiklovir 200 mg Tab 1,050

    52 Asiklovir 400 mg Tab -

    53 Atropin Sulfat injeksi 0,25 mg/ml Amp -

    54 Atropin sulfat 0,5 mg Tab -

    55 Baby Cough syrup Btl -

    56 Bahan Fissur Sealent / Fuji VII Dos -

    57 Baraclude 1 mg btl/30 tab -

    58 Baraclude 0,5 mg box/30 tab -

    59 Barotec Inhaler Btl -

    60 Baycline 1 Liter Btl -

    61 Benzatin Benzil Penicillin 1,2 juta IU Vial -

    62 Besi II Sulfat 7 H2O 300 mg Tab -

    63 Besi II Sulfat + Asam Folat Tab -

    64 Betametason Cream 0,1 % Tube 25

    65 Betason N Tube -

    66 Bidan Kit paket -


    67 Bioplacenton 15 gram Tube -

    68 Bisolvon Nebulizer btl -

    69 Bisturi / non e-katalog Pcs 83

    70 Blood lanset / non e-katalog Pcs -

    71 Calsidor / Dycal Dentsply / Hydcal Technew Btl -

    72 Calsydol syrup Btl -

    73 Cat gut 3/0 Pcs -

    74 Cat gut 3/0 / E-katalog Pcs 96

    75 Cat gut 2/0 Pcs -

    76 Cat gut 2/0 / E-katalog Pcs 120

    77 Cavit / Caviton Btl -

    78 Cement Powder + Liquid / Elite Cement 100 Dos -

    79 Cefadroxil 500 mg Kaps 1,700

    80 Ceftriaxon Injeksi Vial -

    81 Cefotaxime injeksi 0,5 gram Vial 6

    82 Cefotaxime injeksi 1 gram Vial -

    83 Chlor Fenol Champer menthol /CHKM Btl -

    84 Chloramfecort Tube 5

    85 Chloramfecort H Tube 5

    86 Cimetidine 200 mg Tab 3,100

    87 Ciprofloksasine 500 mg Tab 1,500

    88 Counterpain 30 gram Tube -

    89 Curcuma Plus Syrup Btl -

    90 Darplex Tab 216

    91 Dasabion Kaps -

    92 Deksamethasone injeksi 5 mg/ml Amp 153

    93 Deksamethasone 0,5 mg Tab 2,800


    94 Dekstran 70 - Larutan Infus 6 % steril Btl -

    95 Dental Cotton Roll Bks -

    96 Dental Plak Disclosing Gel / Disclosing Solution Btl -

    97 Diazepam injeksi 5 mg/ml Amp -

    98 Diazepam 2 mg Tab -

    99 Diazepam 5 mg Tab 5

    100 Dietilkarbamsin 100 mg / NON E-KATALOG Tab -

    101 Difenhidramine Injeksi 10 mg/ml Amp 79

    102 Digoksin 0,25 mg Tab -

    103 Diltiazem HCL 30 mg Tab -

    104 Dimenhidrinat 50 mg Tab -

    105 Doksisiklin 100 mg Kaps -

    106 Domperidon Tab 200

    107 Dulcolax 5 mg Tab 30

    108 Efedrin HCL 25 mg Tab 160

    109 Elastis verban 3 inci Roll -

    110 Elastis verban 4 inci Roll -

    111 Elastis verban 6 inci Roll -

    112 Elkana Multivitamin Tab -

    113 Enervon - C Kapl -

    114 Epineprin HCL 0,1 % injeksi Amp 30

    115 Eritromicin 250 mg Kapl -

    116 Eritromicin 500 mg Kapl -

    117 Eritromicin syrup Btl -

    118 Etakridin Larutan 0,1 % 300 ml Btl 25

    119 Etanol 70 % 1 liter Btl 12

    120 Ethilklorda Semprot Btl 6


    121 Endomethasone (endosel) btl -

    122 Eugenol Btl -

    123 Fehling A Btl -

    124 Fehling B Btl -

    125 Fenobarbital injeksi 50 mg/ml Amp -

    126 Fenobarbital 30 mg Tab 200

    127 Fenobarbital 100 mg Tab -

    128 Fenoksimetil Penisilin 250 mg Tab -

    129 Fenoksimetil Penisilin 500 mg Tab -

    130 Fenol gliserol TT Btl 14

    131 Fitomenadion 10 mg Tab 260

    132 Fitomenadion injeksi 10 mg/ml Amp 22

    133 Flecher Powder + Liquid Btl -

    134 Foley cateter no 16 Pcs -

    135 Foley cateter no 18 Pcs 4

    136 Foley cateter no 20 Pcs 5

    137 Formalin solution liter -

    138 Formaldehide Merk Test kit -

    139 Formokresol Btl -

    140 Furosemida Tab -

    141 Garam Oralit Sac 525

    142 Gamexan Btl -

    143 Gentamicin Injeksi 80 mg/ml Amp -

    144 Gentamicin Salep Kulit 0,1 % Tube 65

    145 Gentian Violet 1 % Btl 41

    146 Gic Art / Fuji IX Dos -

    147 Glibenclamida 5 mg Tab 500


    148 Gliceril Guayacolat 100 mg Tab 4,200

    149 Glucosa Larutan Infus 10 % steril Btl 60

    150 Glucosa Larutan Infus 40 % steril Btl -

    151 Glucosa Larutan Infus 5 % steril Btl 102

    152 Gloves "S" Pcs -

    153 Gloves "M" Pcs -

    154 Gloves "L" Pcs -

    155 Grisofulvin 250 mg Tab -

    156 Grisofulvin 125 mg tab 1,500

    157 Haloperidol 0,5 mg Tab -

    158 Haloperidol 1,5 mg Tab -

    159 Haloperidol 5 mg Tab -

    160 Handscoen no 6,5 Pcs 220

    161 Handscoen no 7,5 Pcs -

    162 Handscoen no 7,5 / E-katalog Pcs 209

    163 Handscoen No.7 Pcs -

    164 Handscoen no 8 Pcs -

    165 Handscoen no 8 / E-katalog Pcs -

    166 Handscoen Ginecolog Panjang Steril Pcs 10

    167 HB Sahli Pkt -

    168 Hemaviton Action Kaps -

    169 Hidrokortison Cream 2,5 % Tube 48

    170 Hidroklortiazida 25 mg Tab 1,000

    171 Ibuprofen 200 mg Tab 3,200

    172 Ibuprofen 400 mg Tab -

    173 Ibuprofen syrup/Buffec Syrup Btl 5

    174 Ictiol salep Pot 31


    175 Implant susuk KB Pcs -

    176 Infuset Micro Pcs 43

    177 Infuset Micro / e-katalog Pcs 400

    178 Infuset Macro Pcs 360

    179 Infuset Macro / e-katalog Pcs -

    180 Iodium test Btl -

    181 indikator universal ktk -

    182 IV Kateter no 18 Pcs 40

    183 IV Kateter no 18 / e-katalog Pcs -

    184 IV Kateter no 20 Pcs 286

    185 IV Kateter no 20 / E-katalog Pcs 50

    186 IV Kateter no 22 / E-katalog Pcs 270

    187 IV Kateter no 24 / E - katalog Pcs 464

    188 IV Canula No.18 Pcs -

    189 Isosorbit Dinitrat sublingual 5 mg Tab -

    190 Jarum Jahit Otot Lusin 9

    191 Jarum Jahit Kulit Lusin 9

    192 Jelly untuk USG / non e-katalog Btl 2

    193 Jelly untuk Catheter Komb. Lidokain Btl 1

    194 Kalsium Laktat 500 mg Tab 100

    195 Kalsium Gluconas Injeksi / non e-katalog Amp 5

    196 Kalnex 250 mg Kaps -

    197 Kalnex injeksi Amp -

    198 Kapas berlemak 500 gram Roll -

    199 Kapas pemb. Absorben 200 gram Roll -

    200 Kapas Pemb. Absorben 250 gram Roll 10

    201 Kapas pemb. Absorben 1000 gram Roll -


    202 Kaptopril 12,5 mg Tab -

    203 Kaptopril 25 mg Tab 800

    204 Karbamazepin 200 mg Tab -

    205 Kartu Stock Lbr 10

    206 Kasa 4 x 10 cm Roll -

    207 Kasa 4 x 6 cm Roll -

    208 Kasa 40 x 80 cm Roll -

    209 Kasa 40 x 80 cm / E-katalog 11

    210 Kasa Kompres 40/40 cm Roll -

    211 Kasa Kompres 40/40 cm / E-katalog Roll -

    212 Kasa Pembalut 2 m x 80 cm Roll -

    213 Kasa Pembalut Hidrofil 4 m x 3 cm Roll -

    214 Kasa Pembalut Hidrofil 4 m x 3 cm / E-katalog Roll 200

    215 Kasa Pembalut Hidrofil 4 m x 15 cm Roll -

    216 Kasa Pembalut Hidrofil 4 m x 15 cm / E-Katalog Roll -

    217 Kasa 16 x 16 Roll -

    218 Kasa pembalut 14 x 8 cm Roll -

    219 Kasa pembalut 10 cm Roll -

    220 Kasa pembalut 4 x 18 Roll -

    221 Kelambu Pcs -

    222 Ketamine Injeksi 10 mg/ml Vial -

    223 Ketokonazol cream 2 % Tube -

    224 Ketokonazol 200 mg Tab 1,250

    225 Ketorolac Injeksi Ampul 5

    226 Kertas EKG 3 Ukuran Roll -

    227 Kertas Perkamen / Non e-katalog Lbr 10

    228 Kina Dihidroklorida injeksi 25 % - 2 ml Amp -


    229 Kina 222 mg Tab -

    230 Klip Plastik Kecil tanpa sablon Pcs -

    231 Klip Plastik Sedang tanpa sablon Pcs -

    232 Klip Plastik Besar sablon 10 x 15 Pcs -

    233 Klip Plastik Sedang sablon 8,7 x 15 Pcs -

    234 Klip Plastik kecil sablon Pcs -

    235 Kloramfenicol 250 mg Kaps 600

    236 Kloramfenicol Salp Mata 1 % Tube 9

    237 Kloramfenicol Tetes Telinga 3 % Btl 40

    238 Klorfeniraminimaleat 4 mg Tab 4,000

    239 Klorokuin 150 mg Tab -

    240 Klorpromazin HCL injeksi i.m 25 mg/ml Amp -

    241 Klorpromazin HCL 25 mg Tab -

    242 Kodein 10 mg Tab 85

    243 Kotrimoksasol Adult 480 mg Tab 700

    244 Kotrimoksasol Pedriatic 120 mg Tab 2,400

    245 Kotrimoksasol suspensi Btl 67

    246 Lab.Kit Pkt -

    247 Lacbon 17 Tab -

    248 Lansoprazole 30 mg Kaps -

    249 Larutan Benedict Btl -

    250 Larutan Etanol Asam Btl -

    251 Larutan Gimsa stain / non e-katalog Btl -

    252 Larutan Carbofuksin Btl -

    253 Larutan Methilen Biru Btl -

    254 Larutan H2O2 Btl 1

    255 Larutan xilol Btl -


    256 Larutan HCl 0,1 N / Non e-katalog Btl -

    257 Levetran Salp Pot 12

    258 Levofloksasin 500 mg Tab -

    259 Lidocain Injeksi HCl 2 % Amp 265

    260 Lidocain Injeksi 2 % + Epineprin 1 : 80.000 - 2 ml Amp 30

    261 Livron B plex Tab -

    262 Loperamid 2 mg Tab 300

    263 Loratadin 10 mg Tab 600

    264 Lysol Btl 2

    265 Light cure Composite (etsa & bondingnya) Set -

    266 Magnesium Sulfat injeksi 20 % - 25 ml Amp 10

    267 Magnesium Sulfat injeksi 40 % - 25 ml Amp 500

    268 Masker Mulut Pcs 650

    269 MDT MB Adult Blist -

    270 MDT PB Adult Blist -

    271 MDT MB Anak Blist 4

    272 MDT PB Anak Blist -

    273 Mebendazole syrup 100 mg/5 ml Btl -

    274 Mebendazole 100 mg Tab -

    275 Meloxicam 15 mg Tab -

    276 Metformin Tab -

    277 Metapex Box -

    278 Methanil Yellow Chen Kit ktk -

    279 Methilergometrin maleat 0,125 mg Tab -

    280 Methilergometrin maleat 0,200 mg - 1 ml Amp 20

    281 Methilprednisolon 4 mg Tab -

    282 Methilprednisolon 8 mg tab 900


    283 Metoclopramide injeksi 5 mg/5 ml Amp -

    284 Metoclopramide 10 mg Tab 200

    285 Metronidazol 250 mg Tab 100

    286 Metronidazol 500 mg Tab -

    287 Metronidazol infus Btl 5

    288 Mikonazole cream salp 2 % / e-katalog Tube 83

    289 Mikonazole cream salp 2 % / non e-katalog Tube -

    290 Mineral Mix Sac 40

    291 Morfin injeksi 10 mg/ml Amp -

    292 Natrium Bicarbonat 500 mg Tab -

    293 Natrium Diklofenak 25 mg Tab -

    294 Natrium Diklofenak 50 mg Tab -

    295 Natrium Klorida Larutan infus 0,9 % / e-katalog Btl 200

    296 Natrium Klorida Larutan infus 0,9 / non e-katalog Btl 120

    297 Natrium Fenitoin 100 mg Kaps -

    298 Natrium Fenitoin Injeksi / Non e-katalog Amp -

    299 Nicolin injeksi / Citicolin inj Amp -

    300 Nifedipin 10 mg Tab -

    301 Nistatin 100 000 UI Tab -

    302 Nistatin 500 000 UI Vaginal tab Tab -

    303 Nitrit Test Merk ktk -

    304 Neurovit- E Tab -

    305 Neurobion / Neurosanbe 5000 Tab -

    306 Neurobion / Neurosanbe Injeksi Amp -

    307 Obat Batuk Hitam syrup 100 ml Btl -

    308 Obat FDC Anak Pkt -

    309 Obat FDC Kategori 1 Pkt -


    310 Obat FDC Kategori 2 Pkt -

    311 Obat FDC TB sisipan Pkt -

    312 OAT Kombipak anak Pkt -

    313 OAT Kategori 1 & 3 Pkt -

    314 Oil Emersi Btl -

    315 Obat suntik KB 3 bulanan Vial -

    316 Oksitetrasiklin HCL 1 % salp mata Tube 25

    317 Oksitetrasiklin HCL 3 % salp Kulit Tube 75

    318 Oksitetrasiklin injeksi Vial -

    319 Oksitosin injeksi 10 IU/ml - 1 ml Amp 63

    320 Omeprazole 20 mg Kaps 570

    321 Papaverin injeksi 40 mg/ml Amp -

    322 Papaverin 40 mg Tab 2,000

    323 Paracetamol syrup 120 mg/5 ml Btl 40

    324 Paracetamol 500 mg Tab 2,500

    325 Parasetamol drop Btl 5

    326 Parasetamol suppositoria Supp -

    327 Penisilin procain / Procain Benzil Penicillin injeksi Vial 8

    328 Petidin injeksi 50 mg/ml Amp -

    329 Pil KB I Kombinasi Set -

    330 Pilokarpin Tetes mata 2 % Btl -

    331 Piracetam injeksi 3 g/15 ml Amp -

    332 Piracetam 1200 mg Tab -

    333 Piracetam 400 mg Tab -

    334 Pirasetam 800 mg Tab -

    335 Pirantel score base 125 mg Tab -

    336 Pirantel Syrup Btl -


    337 Piridoksin HCL 10 mg Tab 1,800

    338 Piroxicam 10 mg Tab 2,100

    339 Piroxicam 20 mg Tab 1,000

    340 Plester besar 5 yard x 2 inch Roll -

    341 Plester sedang 1,5 Inch x 5 cm Roll -

    342 Plester kecil 1,25 x 5 cm roll -

    343 Plester ( Leukoplast) 7,5 x 4,5 cm Roll 4

    344 Poligips 7,5cm Roll 5

    345 Poligips 10 cm Roll 5

    346 Poligips 15 cm Roll 5

    347 Povidon iodida larutan 10 % 30 ml Btl 3

    348 Povidon iodida larutan 10 % 300 ml Btl 5

    349 Povidon iodida larutan 10 % 1000 ml Btl 2

    350 Prednison 5 mg Tab 1,800

    351 Primakuin 15 mg Tab 100

    352 Propanolol 40 mg Tab 100

    353 Propilitiourasil 100 mg Tab 100

    354 Ranitidin 150 mg Tab 3,900

    355 Ranitidin injeksi 25 mg/2 ml Amp 19

    356 Rapid Diagnostic Test (RDT) Pcs -

    357 Reagen zealnelsen Pkt -

    358 Reserpin 0,1 mg Tab -

    359 Reserpin 0,25 mg Tab -

    360 Retinol 100.000 IU Kaps -

    361 Retinol 200.000 IU Kaps -

    362 Ringer Lactat larutan infus Btl 195

    363 Rodamin B Test Chem ktk -


    364 Safety box Lbr -

    365 Salicyl Spritus 55 ml Btl -

    366 Salbutamol 2 mg Tab 200

    367 Salbutamol 4 mg Tab -

    368 Salep 2 - 4,Komb.As.Salisilat 2% + Sulfur Praicip Pot 41

    369 Salisil Bedak Ktk 6

    370 Sanbe B-Plex Btl -

    371 Sangobion Kaps 250

    372 Santa E Tab -

    373 Scabisid Cream Tube -

    374 Serum Antibisa Ular Polivalen ( ABU I ) Vial 1

    375 Serum Antitetanus injeksi 1.500 IU ( ATS ) Vial 1

    376 Sianocobalamine injeksi 500 mcg Amp 90

    377 Sianocobalamine 50 mcg Tab 800

    378 Silk ( Benang Bedah Sutera ) Pcs -

    379 Silk ( Benang Bedah Sutera ) / e-katalog Pcs 62

    380 Slide Pcs 792

    381 Sputum pot / Non e-katalog Bh -

    382 Spongostan Ktk -

    383 Streptomisin injeksi Vial -

    384 Simvastatin 10 mg Tab -

    385 Test Kehamilan Pcs 50

    386 Tetrasiklin 250 mg Kaps -

    387 Tetrasiklin 500 mg Kaps -

    388 Thiamphenicol 500 mg Kaps -

    389 Tiamin injeksi 100 mg/ml Amp 100

    390 Tiamin HCL 50 mg Tab 2,400


    391 Topicaina topical gel / Anastesi anak Btl -

    392 Tooth stain Remover btl -

    393 Triheksifenidil 2 mg Tab -

    394 Tri Kresol Formalin /TKF Btl -

    395 Tramadol 50 mg / ml Injeksi Amp -

    396 Transfusi Set Pcs -

    397 Transfusi Set / E-katalog Pcs -

    398 Tremenza Tab -

    399 Tissue Lensa pcs -

    400 Urine bag / e-katalog Pcs 30

    401 Urine Test / Gluco Protein Test Pcs -

    402 Vitamin B - complex Tab 2,600

    403 Ventolin inj. amp 6

    404 Wing Needle no 27 Pcs -

    405 Zink Oxide Eugenol (powder+liquid/kalzinol) Btl -

    406 Zinc Dispersible 120 mg Tab 1,350

    407 Slide box Pcs -

    408 Acarbose 50 mg Tab -

    409 Asam Traneksamat Injeksi amp -

    410 Asam Traneksamat 500 mg kapl 500

    411 Bumer Pcs -

    412 Etanol 70 % 100 ml btl -

    413 Furosemide 10mg/ml injeksi Amp -

    414 Glimepiride 2 mg Tab -

    415 Jarum jahit Combinasi otot & Kulit Lusin 11

    416 Plester Besar 5 m x 4,5 cm (Leukoplast) Roll 5

    417 Povidon iodida Larutan 10 % 60 ml Btl -


    418 Semprong Pcs -

    419 Sumbu bh -

    420 Termometer Ruangan Kayu Pcs 2

    421 Sofero caps -

    422 Disposible dental needle no. 18 pcs -

    423 Disposible dental needle no. 20 Pcs -

    424 Disposible dental needle no. 25 Pcs -

    425 Jarum Citojek No. 12 Pcs -

    426 Jarum Citojek No. 16 Pcs -

    427 Resin Composite (A2+A3) Btl -

    428 Suction Rip Pcs -

    429 Levemir Injeksi / non e-katalog paket -

    430 Borax Test ktk -

    431 Novabion caps -

    432 Larutan Metanol btl -

    433 Larutan Oil Imersion 50 ml btl #VALUE!

    434 Alkohol Swap Pkt -

    435 Aquadest 600 ml Btl -

    436 Alat Tes Darah Multifungsi Pkt -

    437 Stik Gula Darah Pkt -

    438 Stik Kolesterol Pkt -

    439 Stik Asam Urat Pkt -

    440 Miniaspi 80 mg (Asetosal 80 mg) Tab 500

    441 Isoniazid 100 mg Tab -

    442 Rantin injeksi (Ranitidin inj. 25 mg/ml)Non E. Amp -

    443 Nexa 500 mg (Asam Traneksamat) Non E. Tab -

    444 Sotatic Injeksi (Metoclopramide inj. 5 mg/ml) Non E. Amp -


    445 Salbron 2 mg (Salbutamol 2 mg) Non E. Tab -

    446 Pehacain Inj. (Lidocain Comb.) Amp -

    447 Otoryl 25 Mg (Kaptopril 25 mg) Tab -

    448 Asam Folat 1 mg Tab 900

    449 Azitromycin 500 mg Tab -

    450 Ciprofloksasine Injeksi Btl -

    451 Amlodipin 10 mg Tab -

    452 Dentin Conditioner Minipack Box -

    453 Stesolit Rectal / Diazepam rectal Supp -

    454 Paracetamol Infus 100 ml Btl -

    455 Cetrizine 10 mg Tab -

    VAKSIN
    1 HBo Vial 5

    2 BCG Amp 2

    3 Polio Vial 6

    4 DPT-HB Vial 3

    5 Pantavalen Vial -

    6 Campak Vial 2

    7 TT Vial -

    8 DT Vial 8

    9 TD Vial -

    10 ADS 0,5 Vial -

    11 ADS 0,05 Vial -

    12 Pelarut BCG Amp 2

    13 Pelarut Campak Amp 3


    Poli Umum
    Kunjungan Resep
    -

    UMUM

    BAYAR
    JUMLAH KUNJUNGAN RESEP
    -

    Mengetahui Yang Menyera


    Kepala Dinas Kesehatan Kab. Alor Petugas IF

    NIP. NIP.
    PEMERINTAH KABUPATEN ALOR
    D I N A S K E S E H A T A N
    Jl. Prof. DR. W. Z. Yohanes. No. - Telp. (0386) 21052
    K A L A B A H I

    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    LAP. PEMAKAIAN O
    LEMBAR PERMINTA
    TAHUN
    TRIWULAN

    Penerimaan Persediaan Pemakaian Sisa Stok Stok Optimum

    5 6 7 9 11

    - - - -

    - 450 - 450

    - 280 - 280

    - - - -

    - 400 - 400

    - - - -

    - 400 - 400

    - 500 - 500

    - - - -

    - 650 - 650

    - 1,200 - 1,200

    - - - -
    - 10 - 10

    - 2,400 - 2,400

    - 9 - 9

    - 280 - 280

    - - - -

    - - - -

    - 50 - 50

    - 2,500 - 2,500

    - 2,000 - 2,000

    - 50 - 50

    - - - -

    - - - -

    - 3,000 - 3,000

    - 46 - 46

    - 1,600 - 1,600

    - 15 - 15

    - 41 - 41

    - 24 - 24

    - - - -

    - 1,000 - 1,000

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 5 - 5

    - 3 - 3
    - 1 - 1

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 8,600 - 8,600

    - 2,500 - 2,500

    - 57 - 57

    - 1,050 - 1,050

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 25 - 25

    - - - -

    - - - -
    - - - -

    - - - -

    - 83 - 83

    - - - -

    - - - -

    - - - -

    - - - -

    - 96 - 96

    - - - -

    - 120 - 120

    - - - -

    - - - -

    - 1,700 - 1,700

    - - - -

    - 6 - 6

    - - - -

    - - - -

    - 5 - 5

    - 5 - 5

    - 3,100 - 3,100

    - 1,500 - 1,500

    - - - -

    - - - -

    - 216 - 216

    - - - -

    - 153 - 153

    - 2,800 - 2,800
    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 5 - 5

    - - - -

    - 79 - 79

    - - - -

    - - - -

    - - - -

    - - - -

    - 200 - 200

    - 30 - 30

    - 160 - 160

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 30 - 30

    - - - -

    - - - -

    - - - -

    - 25 - 25

    - 12 - 12

    - 6 - 6
    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 200 - 200

    - - - -

    - - - -

    - - - -

    - 14 - 14

    - 260 - 260

    - 22 - 22

    - - - -

    - - - -

    - 4 - 4

    - 5 - 5

    - - - -

    - - - -

    - - - -

    - - - -

    - 525 - 525

    - - - -

    - - - -

    - 65 - 65

    - 41 - 41

    - - - -

    - 500 - 500
    - 4,200 - 4,200

    - 60 - 60

    - - - -

    - 102 - 102

    - - - -

    - - - -

    - - - -

    - - - -

    - 1,500 - 1,500

    - - - -

    - - - -

    - - - -

    - 220 - 220

    - - - -

    - 209 - 209

    - - - -

    - - - -

    - - - -

    - 10 - 10

    - - - -

    - - - -

    - 48 - 48

    - 1,000 - 1,000

    - 3,200 - 3,200

    - - - -

    - 5 - 5

    - 31 - 31
    - - - -

    - 43 - 43

    - 400 - 400

    - 360 - 360

    - - - -

    - - - -

    - - - -

    - 40 - 40

    - - - -

    - 286 - 286

    - 50 - 50

    - 270 - 270

    - 464 - 464

    - - - -

    - - - -

    - 9 - 9

    - 9 - 9

    - 2 - 2

    - 1 - 1

    - 100 - 100

    - 5 - 5

    - - - -

    - - - -

    - - - -

    - - - -

    - 10 - 10

    - - - -
    - - - -

    - 800 - 800

    - - - -

    - 10 - 10

    - - - -

    - - - -

    - - - -

    - 11 - 11

    - - - -

    - - - -

    - - - -

    - - - -

    - 200 - 200

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 1,250 - 1,250

    - 5 - 5

    - - - -

    - 10 - 10

    - - - -
    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 600 - 600

    - 9 - 9

    - 40 - 40

    - 4,000 - 4,000

    - - - -

    - - - -

    - - - -

    - 85 - 85

    - 700 - 700

    - 2,400 - 2,400

    - 67 - 67

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 1 - 1

    - - - -
    - - - -

    - 12 - 12

    - - - -

    - 265 - 265

    - 30 - 30

    - - - -

    - 300 - 300

    - 600 - 600

    - 2 - 2

    - - - -

    - 10 - 10

    - 500 - 500

    - 650 - 650

    - - - -

    - - - -

    - 4 - 4

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 20 - 20

    - - - -

    - 900 - 900
    - - - -

    - 200 - 200

    - 100 - 100

    - - - -

    - 5 - 5

    - 83 - 83

    - - - -

    - 40 - 40

    - - - -

    - - - -

    - - - -

    - - - -

    - 200 - 200

    - 120 - 120

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -
    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 25 - 25

    - 75 - 75

    - - - -

    - 63 - 63

    - 570 - 570

    - - - -

    - 2,000 - 2,000

    - 40 - 40

    - 2,500 - 2,500

    - 5 - 5

    - - - -

    - 8 - 8

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -
    - 1,800 - 1,800

    - 2,100 - 2,100

    - 1,000 - 1,000

    - - - -

    - - - -

    - - - -

    - 4 - 4

    - 5 - 5

    - 5 - 5

    - 5 - 5

    - 3 - 3

    - 5 - 5

    - 2 - 2

    - 1,800 - 1,800

    - 100 - 100

    - 100 - 100

    - 100 - 100

    - 3,900 - 3,900

    - 19 - 19

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 195 - 195

    - - - -
    - - - -

    - - - -

    - 200 - 200

    - - - -

    - 41 - 41

    - 6 - 6

    - - - -

    - 250 - 250

    - - - -

    - - - -

    - 1 - 1

    - 1 - 1

    - 90 - 90

    - 800 - 800

    - - - -

    - 62 - 62

    - 792 - 792

    - - - -

    - - - -

    - - - -

    - - - -

    - 50 - 50

    - - - -

    - - - -

    - - - -

    - 100 - 100

    - 2,400 - 2,400
    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 30 - 30

    - - - -

    - 2,600 - 2,600

    - 6 - 6

    - - - -

    - - - -

    - 1,350 - 1,350

    - - - -

    - - - -

    - - - -

    - 500 - 500

    - - - -

    - - - -

    - - - -

    - - - -

    - 11 - 11

    - 5 - 5

    - - - -
    - - - -

    - - - -

    - 2 - 2

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - #VALUE! - #VALUE!

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 500 - 500

    - - - -

    - - - -

    - - - -

    - - - -
    - - - -

    - - - -

    - - - -

    - 900 - 900

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - - - -

    - 5 - 5

    - 2 - 2

    - 6 - 6

    - 3 - 3

    - - - -

    - 2 - 2

    - - - -

    - 8 - 8

    - - - -

    - - - -

    - - - -

    - 2 - 2

    - 3 - 3
    Sumber / Asal Resep
    Poli Gigi KIA KB Raeat Inap UGD

    - - - - -

    MUM
    ASKES JUMLAH
    TIDAK BAYAR Dokter

    - - #VALUE! -

    ang Menyerahkan Yang Meminta


    Petugas IFK Kepala Puskesmas

    NIP.
    LPO)

    P. PEMAKAIAN OBAT BULAN : OKTOBER S/DESEMBER


    MBAR PERMINTAAN OBAT BULAN : JANUARI S/D MARET
    : 2020
    : I (SATU)

    permintaan pemberian KET

    12 14 16
    Total Resep ke Apotik
    Pusling, Posyandu, dll Bulan Ini Kumulatif s/d Bulan ini

    - #VALUE! #VALUE!

    Pemberi Resep
    Perawat Bidan Perawat Gigi

    - - -

    Yang Menerima
    Petugas Puskesmas

    NIP.
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