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This document is a report on drug usage and request form (LPLPO) for a community health center/village clinic in Babang Subdistrict, Maluku Province for 2023. It includes a table listing 152 drug items with columns for initial stock, receipts, usage, remaining stock, and requests. The report aims to track inventory and plan future orders of pharmaceutical supplies for the clinic.

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sitra anna
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44 views

Format Lplpo

This document is a report on drug usage and request form (LPLPO) for a community health center/village clinic in Babang Subdistrict, Maluku Province for 2023. It includes a table listing 152 drug items with columns for initial stock, receipts, usage, remaining stock, and requests. The report aims to track inventory and plan future orders of pharmaceutical supplies for the clinic.

Uploaded by

sitra anna
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSTU/POLINDES

TAHUN 2023

POLINDES : KABUPATEN : HAL-SEL


PUSKESMAS : BABANG PROVINSI : MALUT
KECAMATAN : BACAN TIMUR BULAN :

No NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN KET

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1 Abbocath No. 18 Set
2 Abbocath No. 20 Set
3 Abbocath No. 22 Set
4 Abbocath No. 24 Set
5 Abbocath No. 26 pcs
6 Acyclovir 200 mg Tablet
7 Acyclovir cream Tube
8 Alat suntik 1 ml Set
10 Alat suntik 3 ml Set
11 Alat suntik 5 ml Set
12 Alat suntik 10 ml Set
13 Albendazole 400 mg Tablet
14 Alkohol 70% Botol 300 ml
15 Allopurinol tablet 100 mg Tablet
16 Ambroxol 30 mg Tablet
17 Ambroxol syrup 15 mg/ml Botol
18 Amlodipin 5 mg Tablet
19 Amoxicilin 250 mg Tablet
20 Amoxicilin 500 mg Tablet
21 Amoxicilin Sirup kering 125 mg/5 ml Botol
22 Andalan inj Vial
23 Antalgin (Metampiron) tablet 500 mg Tablet
24 Antalgin inj Ampul
25 Antasida DOEN Suspensi Botol
26 Antasida DOEN tablet kombinasi Tablet
27 Antifungi DOEN kombinasi Pot
28 Asam askorbat (Vit. C) 250 mg Tablet
29 Asam askorbat (Vit. C) 50 mg Tablet
30 Asam Folat 1 mg Tablet
31 Asam Mefenamat Tablet 500 mg Tablet
32 Asam tranexamat inj Ampul
33 Besi (II) sulfat tablet salut kombinasi Tablet
34 Betahistin 6 mg Tablet
35 Betametason cream tube
36 Bioplacenton Tube
37 Bisturi pcs
38 Blood lancet pcs
39 Captopril Tablet 12.5 mg Tablet
40 Captopril Tablet 25 mg Tablet
41 Caviplex Tablet
42 Caviplex syrup Botol
43 Cefadroxil 500 mg Tablet Kapsul
44 Cefadroxyl syr botol
45 Cefixim 100 mg Tablet
46 Cefixim Syrup Botol
47 Cendo Carpine TM Botol
48 Cetrizin syr 5mg/5 ml Botol
49 Cetrizin tab 10 mg Tablet
50 Chloramfenicol tetes telinga Botol
51 Chlorampenicol Capsul 250 mg Kapsul
52 Chlorampenicol Salap mata 1 % Tube
53 Chlorampenicol Syrup 60 ml Botol
54 Chlorampenicol Tetes Mata Botol
55 Cimetidin Tablet 200 mg Tablet
56 Clindamycin 150 mg Tablet
57 Clindamycin 300 mg Tablet
No NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN KET

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58 Clonidin Tablet
59 Curcuma Tab Tablet
60 Cutgut chromic Set
61 Cutgut silk Set
62 Cyprofloxasin infus Botol
63 Cyprofoxacin Tablet 500 mg Tablet
64 Darplex/DHP Tablet
65 Dexametason Injeksi 5 mg / 1 mL Ampul
66 Dexametason Tablet 0.5 mg Tablet
67 Difenhidramin Ampul
68 Domperidon 10 mg Tablet
69 Domperidon Syrup Botol
70 Dulcolax Tablet Tablet
71 Efedrin HcL Tablet 25 mg Tablet
72 Ephynefrin Injeksi Ampul
73 Erytomisin 500 mg Tablet
74 Erytromisin Syrup Botol
75 Etakridina (Rivanol) Larutan 0.1 % Botol
76 Farbion 5000 Ampul
77 Fenol Gliserol Botol
78 Fitomenadion (Vit-K) 10 mg/ml- 1ml injeksi Ampul
79 Fitomenadion (Vit-K) Tablet Salut 10 mg Tablet
80 Furosemid Tablet 40 mg Tablet
81 Garam Oralit untuk 200 ml air Sachet
82 Gentamisin SM/Genoit Tube
83 Gentamysin injeksi Ampul
84 Gentamysin Salep Kulit Tube
85 Gentamysin Tetes mata 5 ml Botol
86 Gentian Violet Larutan 1 % Botol
87 Glibenclamida Tablet Tablet
88 Glimepiride Tablet
89 Gliseryl guaycolate 100 mg Tablet
90 Glukosa Larutan 10 % steril Botol
91 Glukosa Larutan 5 % steril Botol
92 Griseovulvin/Gricin Tablet 125 mg Tablet
93 Handscoon non steril Pcs
94 Handscoon Obgyn steril Pcs
95 Hanscoon Steril No. 8 Pcs
96 Hanscoon Steril No.7 Pcs
97 Hanscoon Steril No.7,5 Pcs
98 Hidrocortisone Cream 1 % Tube
99 Hidroklortisida (HCT) Tablet 25 mg Tablet
100 Ibuprofen syr Botol
101 Ibuprofen Tablet 400 mg Tablet
102 Infusion set Anak Set
103 Infusion Set Dewasa Set
104 Kalsium Laktat Tablet 500 mg Tablet
105 Kapas Pembalut / Atsorben 250 g Bks
106 Kassa Pembalut Hydrofil 16 x 16 cm Bks
107 Ketokonazole 200 mg Tablet
108 Ketokonazole Kream 2 % Tube
109 Ketorolac 30 mg/ml Ampul
110 Khlorampeniramin Maleat (CTM) Tablet 4 m Tablet
111 Kotrimoxasole Suspensi Botol
112 Kotrimoxasole Tablet Komb 480 mg Tablet
113 Kotrimoxasole Tablet Pediatrik komb 120 m Tablet
114 Levoploksasin 500 mg Tablet
115 Lidocain Ampul
116 Livron B-Plex Tablet
117 Loperamid Tablet Tablet
118 Loratadin Tablet
119 Masker pcs
120 Meloxicam 15 mg Tablet
121 Meloxicam 7,5 mg Tablet
No NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN KET

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122 Metformin 500 mg Tablet
123 Methyl Prednisolon 4 mg Tablet
124 Methyl Prednisolon 8 mg Tablet
125 Metilergometrina Maleat Injeksi 0.0002mg/m Ampul
126 Metilergometrina Maleat Tablet 0.125 mg Tablet
127 Metoclopramid inj 5 mg/ml Ampul
128 Metoclopramid syr 5 mg/ml Botol
129 Metoclopramide 10 mg Tablet
130 Metronidasole tablet 500 mg Tablet
131 Miconazole Cream Tube
132 Mineral mix Sachet
133 Na. cklorida larutan infus 0.9% steril (NACL) Botol
134 Na. Diklofenak 25 mg Tablet
135 Na. Diklofenak 50 mg Tablet
136 NOZA Tablet
137 Oksitetrasiklin Salep Kulit 3% Tube
138 Oksitetrasiklin Salep Mata 1% Tube
139 Omeprazol Tablet
140 Ondansetron Inj Ampul
141 Papaverin Tablet
142 Paracetamol Tablet 500mg Tablet
143 Parasetamol drops Botol
144 Parasetamol Syrup Botol
145 Piridoksina HcL (Vit. B6) Inj Ampul
146 Piridoksina HcL (Vit. B6) Tablet 10 mg Tablet
147 Piroksicam Kapsul 10 mg Kapsul
148 Pitogin Injeksi/Oksitosin Ampul
149 Plester 2,5 yards x 4,5 inci Rol
150 PP Tes Kehamilan pcs
151 Prednisone Tablet 5 mg Tablet
152 Primakuin Tablet
153 Pyrantel Pamoat (Pyrantel) syr 125mg Botol
154 Pyrantel Pamoat (Pyrantel) tab 125mg Tablet
155 Ranitidin 150 mg Tablet
156 Ranitidin Injeksi Ampul
157 RDT PCS
158 Retinol (Vit.A) Kapsul lunak 100.000 mg Kapsul
159 Retinol (Vit.A) Kapsul lunak 200.000 mg Kapsul
160 Ringer Laktat Larutan Infus Steril Botol
161 Salbutamol 2 mg Tablet
162 Salbutamol 4 mg Tablet
163 Salisil Bedak 2.5 % Kotak
164 Sianocobalamin (Vit. B 12) 50 mg Tablet
165 Sianocobalamin (Vit. B 12) 500 mg/ml injeks Ampul
166 Simvastatin 10 Tablet
167 Simvastatin 20 Tablet
168 Tiamin HcL (Vit. B1) Tablet 50 mg Tablet
169 Tiamin inj 100 mg/ml Ampul
170 Usg Gel 250 ml Botol
171 Vitamin B Compleks Tablet
172 Yodium Pavidon 10 % 300 ml Botol
173 Yodium Pavidon 10 % 60 ml Botol
174 Zalf 2-4 cream Pot
175 Zink Dispersible Tablet
176 Zink Syr Botol

JUMLAH KUNJUNGAN RESEP


BPJS JAMKESDA UMUM TOTAL

Yang meminta/Melaporkan Yang Menerima Mengetahui


Pengelola obat Puskesmas Pengelola Obat Pustu/Polindes Kepala UPTD. Puskesmas
No NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN KET

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Sitra Anna S,farm.,Apt Rasmi Ode Djaerudin, SKM


NIP. 19880824 201903 2 004 Nip : 19831129 201101 2 005
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSTU/POLINDES
TAHUN 2023

POLINDES : KABUPATEN : HAL-SEL


PUSKESMAS : BABANG PROVINSI : MALUT
KECAMATAN : BACAN TIMUR BULAN :

No NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN KET

a b c d e f g h i j
No NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN KET

a b c d e f g h i j
No NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN KET

a b c d e f g h i j
"PUSKESMAS BABANG" "PUSKESMAS BABANG"
KARTU STOK KARTU STOK
NAMA OBAT : NAMA OBAT :
SATUAN : SATUAN :
TGL TERIMA KELUAR SISA EXP KET TGL TERIMA KELUAR
SKESMAS BABANG"
ARTU STOK

SISA EXP KET

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