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The report summarizes the receipt and request of medicines (LPLPO) at the POSKESDES BARU health clinic for the month of February. It shows the initial stock, receipts, current stock, expirations, issues and remaining stock for 71 different medicines and medical supplies. Several items like amlodipin, cefixime and ciprofloxacin tablets were not received or issued during the month. The largest receipt was 200 tablets of chlorpheniramin maleate and issues were 225 tablets, leaving a remaining stock of 201 tablets.

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magvira vira
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30 views

Format LPLPO-6

The report summarizes the receipt and request of medicines (LPLPO) at the POSKESDES BARU health clinic for the month of February. It shows the initial stock, receipts, current stock, expirations, issues and remaining stock for 71 different medicines and medical supplies. Several items like amlodipin, cefixime and ciprofloxacin tablets were not received or issued during the month. The largest receipt was 200 tablets of chlorpheniramin maleate and issues were 225 tablets, leaving a remaining stock of 201 tablets.

Uploaded by

magvira vira
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
You are on page 1/ 18

PEMERINTAH KABUPATEN PASANGKAYU

DINAS KESEHATAN
UPT PUSKESMAS BAMBAIRA
Jalan Trans Sulawesi Desa Bambaira Kec. Bambaira Kab. Pasangkayu
Kode Pos 91751 Telp. 0812 4364 8343 Email: [email protected]

LAPORAN PENERIMAAN DAN PERMINTAAN OBAT (LPLPO)

Nama Faskes : POSKESDES BARUGA BARU


Bulan : FEBRUARI

STOK PENERIMA PERSEDIA EXP. PENGELUAR SISA PERMINTA


NO NAMA BARANG SATUAN KET
AWAL - AN - AN DATE - AN STOK - AN
1 2 3 4 5 6 = 4+5 7 8 9=6-8 10 11

1 Afolat (Asam folat) tab 0,4 mg Tablet 20 100 120 60 60


2 Aquades Pro inj Steril Botol 0 0 0 0 0
3 Alat suntik sekali pakai 0,05 ml Pcs 50 0 50 0 50
4 Alat suntik sekali pakai 0,5 ml Pcs 0 0 0
5 Alat suntik sekali pakai 1 ml Pcs 0 0 0
6 Alat suntik sekali pakai 2,5 ml Pcs 0 0 0
7 Alat suntik sekali pakai 3 ml Pcs 16 16 2 14
8 Alat suntik sekali pakai 5 ml Pcs 0 0 0
9 Alat suntik sekali pakai 10 ml Pcs 0 0 0
10 Alat suntik sekali pakai 50 ml Pcs 0 0 0
11 Albendazol tab 400 mg Tablet 30 30 0 30
12 Alkohol 70 % 100 ml (kecil) Botol 0 0 0
13 Alkohol 70 % 1000 ml (besar) Botol 0 0 0
14 Alkohol Swab Pcs 0 0 0
15 Alopurinol tab 100 mg Tablet 0 0 0
16 Alopurinol tab 300 mg Tablet 0 0 0
17 Ambroxol sir 15 mg/ml Sirup 3 3 2 1
18 Ambroxol tab Tablet 0 0 0
19 Amlodipin tab 10 mg Tablet 0 0 0
20 Amlodipin tab 5 mg Tablet 0 0 0
21 Amoksisillin Drop Drop 0 0 0
22 Amoksisilin sir125 mg/5 ml Susp. 0 0 0
23 Amoksisilin sir forte 250 mg/5 ml Susp. 0 0 0
24 Amoksisilin tab 500 mg Tablet 50 100 150 30 120
25 Antalgin tab 500 mg Tablet 0 0 0
26 Antasida Doen Susp. Tablet 1 5 6 3 3
27 Antasida Doen Tablet kunyah Tablet 160 160 60 100
28 Arcapec Attapulgit Susp. 0 0 0 0
29 Asam askorbat (Vit.C) 50 mg Tablet 0 0
30 Asam askorbat (Vit.C) 25 mg Tablet 0 300 300 50 250
31 Asam mefenamat 500 mg Tablet 60 100 160 87 73
32 Asam salisilat 3% Pot 15 gr Pot 0 0 0
33 Asiklovir 5% krim Tube 0 0 0
34 Asiklovir tab 200 mg Tablet 0 0 0
35 Asiklovir tab 400 mg Tablet 0 0 0
36 Attapulgite tab (New antides) Tablet 100 100 0 100
37 Aximed Examination Gloves M Pcs 0 0 0
38 Basitrasin salep Tube 0 0 0
39 Baquinor tetes mata 3 mg / ml Botol 0 0 0
40 Bedak salisil serb 2% Pcs 0 4 4 1 3
41 Betam-optal (tetes mata) Botol 0 0 0 0
42 Betadine 10% 300 ml Botol 0 0 0 0
STOK PENERIMA PERSEDIA EXP. PENGELUAR SISA PERMINTA
NO NAMA BARANG SATUAN KET
AWAL - AN - AN DATE - AN STOK - AN
1 2 3 4 5 6 = 4+5 7 8 9=6-8 10 11

43 Betahistin tab 6 mg Tablet 0 0 0


Betametason krim 0,5 mg/g Tube
44 0 0 0 0
45 Bioplasenton Krim 15 gr Tube 0 0 0

46 Bisacodyl 5 mg Tablet 0 0 0
47 Captopril 12,5 mg Tablet 0 0 0
48 Captopril 25 mg Tablet 105 105 100 5
49 Captopril 50 mg Tablet 0 0 0
50 Catgut Plain 35 mm Pcs 0 0 0
51 Catgut Chrom 35 mm Pcs 0 0 0
52 Catgut Chrom 1 (Demetech) Pcs 3 3 3
53 Cefixime 100 mg Tablet 0 0 0
54 Cefriaxone 1 gr inj Vial 0 0 0
55 Cefadroxil Sirup 125 mg/ 5 mL Botol 0 0 0
56 Cefadroxil 500 mg Tablet 0 0 0
57 Cetrizine 10 mg Tablet 0 0 0
58 Cetrizine 5 mg/5 mL Botol 0 0 0
59 Chloramphenicol Tetes Mata Tube 0 0 0
60 Chloramphenicol Tetes Telinga Tube 0 0 0
61 Chloramphenicol salep kulit Tube 0 3 3 1 2
62 Chloramphenicol salep mata Tube 0 0 0
63 Chloramphenicol 125 mg/ 5 mL Botol 0 0 0
64 Chlorpheniramin Maleat (CTM) Tablet 226 200 426 225 201
65 Cotrimoxazole 480 mg Tablet 60 60 20 40
66 Cotrimoxazole 120 mg Tablet 0 0 0
67 Cotrimoxazole 240 mg/5 mL Botol 3 3 2 1
68 Cutimed (sorbact) swab Pcs 0 0 0
69 Deksametason inj 5 mg/ml) Ampul 0 0 0
70 Deksametason tab 0,5 mg Tablet 233 200 433 198 235
71 Dietilkarbamazin tab 100 mg Tablet 0 0 0
72 Diphenhydramine Inj Ampul 0 0 0
73 Domperidon susp 5 mg/5 ml Botol 0 0 0
74 Domperidon tab 10 mg Tablet 0 0 0
75 Domesik 2/0 Pcs 0 0 0
76 Domesik 3/0 75 c 26NC Pcs 0 0 0
79 Fitomenadion (vitamin K 1) inj Ampul 0 0 0
80 Fitomenadion (vitamin K) tab Tablet 0 0 0
81 Folley Catheter 18 Pcs 0 0 0
82 Folley Catheter 2 w ac No. 16 Pcs 0 0 0
Garam oralit
83 Pcs 0 15 15 3 12
84 Gel USG Botol 0 1 1 1
85 Gentamisin 40 mg/ml injeksi Ampul 0 0 0
86 Gentamisin 0,1% salep kulit Tube 0 0 0
87 Glibenklamid tab 5 mg Tablet 200 200 30 170
88 Glimepirid tab 1 mg Tablet 0 0 0
89 Glimepirid tab 2 mg Tablet 0 0 0
90 Gliseril Guyakolat (GG) Tablet 453 0 453 133 320
91 Glukosa Larutan Infus 10% steril Botol 0 0 0
92 Glukosa Larutan Infus 5% steril Botol 2 2 2
93 Griseofulvin tab 125 mg Tablet 0 0 0
94 Handscoon 6 Pcs 7 7 7
95 Handscoon 7 Pcs 0 0 0
96 Handscone 7,5 Pcs 0 0 0
97 Handscone 8 Pcs 13 13 2 11
STOK PENERIMA PERSEDIA EXP. PENGELUAR SISA PERMINTA
NO NAMA BARANG SATUAN KET
AWAL - AN - AN DATE - AN STOK - AN
1 2 3 4 5 6 = 4+5 7 8 9=6-8 10 11

98 Handscone M (non steril) Pcs 0 0 0


99 Hidrokortison krim 2,5% Tube 1 1 1
100 Ibuprofen sir 200 mg/5 ml Botol 0 0 0
101 Ibuprofen tab 200 mg Tablet 0 0 0
102 Ibuprofen tab 400 mg Tablet 130 130 10 120
103 Infus set Mikro (anak) Pcs 0 0 0
104 Infus set Makro (dewasa) Pcs 1 1 1
105 IV Catheter No. 18 G Pcs 3 3 3
106 IV Catheter No. 20 G Pcs 2 2 2
107 IV Catheter No. 22 G Pcs 3 3 3
108 IV Catheter No. 24 G Pcs 0 0 0
109 IV Catheter No. 26 G Pcs 0 0 0
110 Kalium Diklofenak 50 mg Tablet 0 0 0
111 Kalium Pemangat Pk Larutan Pot 0 0 0
112 Kalsium laktat 500 mg Tablet 0 0 0
113 Kapas 1000 gr Pcs 0 0 0
114 Kapas 250 gr Pcs 0 0 0
115 Kapas 500 gr Pcs 0 0 0
116 Kartu Stok Lembar 0 0 0
117 Kasa Hidrofil 36 x 80 cm Roll 0 0 0
118 Kasa Hidrofil 40 x 80 cm Roll 0 0 0
119 Kasa Pembalut 4 x 10 cm Roll 0 5 5 5
120 Kertas Puyer Lembar 0 250 250 40 210
121 Ketokonazol tab 200 mg Tablet 0 0 0
122 Ketokonazol krim 2% Tube 0 3 3 3
123 Ketorolac Inj 30 mg/1ml Ampul 0 0 0
124 Lidokain inj 2% epineprin 2 ml Ampul 4 4 4
125 Loperamid (HCL) 2 mg Tablet 0 0 0
126 Loratadin tab 10 mg Tablet 0 0 0
127 Masker Tali (Ties On) Pcs 0 0 0
128 Masker Karet (Ear loop) Pcs 19 19 2 17
129 Magnnesium Sulfat (MGSO4) Tablet 0 0 0
130 Mebendazol sir 50 mg/ml Botol 0 0 0
131 Mebendazol tab 500 mg Tablet 0 0 0
132 Meloksikam 15 mg tab Tablet 0 0 0
133 Meloksikam 7,5 mg tab Tablet 0 0 0
134 Metformin tab 500 mg Tablet 0 0 0
135 Metilprednisolon 4 mg Tablet 70 70 70
136 Metilergometrin tab 0,125 mg Tablet 20 20 20
137 Metronidazol tab 250 mg Tablet 0 0 0
138 Metronidazol tab 500 mg Tablet 0 0 0
139 Mineral Mix serbuk 8 gram Pcs 0 0 0
140 Mikonazol krim 2% Tube 5 5 1 4
141 NaCl 0,9% Larutan Tablet 0 0 0
142 Nasal Oksigen L (adult) Tablet 0 0 0
143 Nasal oksigen M Tablet 0 0 0
144 Nasal Oksigen Xs Tablet 0 0 0
145 Natrium diklofenak tab 25 mg Tablet 0 0 0
146 Natrium diklofenak tab 50 mg Tablet 0 0 0
147 Nebulizer Mask Anak Pcs 0 0 0
148 Nebulizer Mask Dewasa Pcs 0 0 0
149 Nifedipin 10 mg Tablet 0 0 0
150 Obat Batuk Hitam (OBH) Botol 0 0 0
151 Oksitosin inj 10 UI/ml Ampul 4 4 1 3
STOK PENERIMA PERSEDIA EXP. PENGELUAR SISA PERMINTA
NO NAMA BARANG SATUAN KET
AWAL - AN - AN DATE - AN STOK - AN
1 2 3 4 5 6 = 4+5 7 8 9=6-8 10 11

152 Omeprazol kaps 20 mg Tablet 0 0 0


153 Ondansetron HCL Dihidrate Inj Ampul 0 0 0
154 Paracetamol Drop Tablet 0 0 0
155 Parasetamol sir 120 mg/5 ml Tablet 2 3 5 4 1
156 Parasetamol tab 500 mg Tablet 56 200 256 76 180
157 Phenol glycerol 10 % Tablet 0 0 0
158 Piridoksin (vitamin B6) tab 10 mg Tablet 140 140 60 80
159 Piroxicam 10 mg kaps Tablet 0 0 0
160 Plester 2,50 CM x 4,5 M Roll 0 0 0
161 Povidon Iodin (300mL) Botol 0 0 0
162 Povidon iodin (60 mL) Botol 0 0 0
163 Povidon Iodin (30 mL) Botol 0 2 2 2
164 Prednison tab 5 mg Tablet 173 173 19 154
165 Pyrantel 125 mg Tablet 0 0 0
166 Pyrantel syrp Botol 0 0
167 Ranitidin inj 25 mg/ml Ampul 0 0
168 Ranitidin tab 150 mg Tablet 100 100 10 90
169 Retinol (vit. A biru) Kaps Lunak Tablet 0 0
170 Retinol (vit. A merah) Kaps Lunak Tablet 30 30 2 28
171 RDT dengue lgG/lgM Antibodi test Pcs 0 0
172 Ringer Laktat Larutan Botol 0 0 0
173 Sak obat 6 cm x 10 cm Lembar 0 0
174 Sak obat 10 cm x 15 cm Lembar 0 0
175 Sak obat 8 cm x 12 cm Lembar 0 0
176 Sak obat sedang 8 cm x 5 cm Lembar 0 0
177 Salbutamol 2 mg Tablet 40 40 40 0
178 Salbutamol 4 mg Tablet 30 30 30
179 Salbutamol Sirup 2 mg/5 ml Tablet 0 0 0
180 Salep 2-4, kombinasi Pot 0 0
181 Salep 3-6 Pot 0 0
182 Scabimite Tube 0 0
183 Sianokobalamin (vitamin B12) inj Ampul 0 0
184 Sianokobalamin (vitamin B12) tab Tablet 0 0
185 Simvastatin tab sal 10 mg Tablet 0 0 0
186 Surgical blade No 11 Bisturi Pcs 0 0
187 Surgical blade No 15 Bisturi Pcs 0 0
188 Tablet Tambah Darah Tablet 200 200 200 0
189 Tiamfenikol 500 ml (Tiamex) Tablet 0 0
190 Tiamin (vitamin B1) tab 50 mg Tablet 148 148 30 118
191 Ultra one test hamil strip Pcs 22 22 3 19
192 Umbilical cord clem plastik Pcs 0 0
193 Vermox Tablet 0 0
194 Vicanatal Tablet 0 0
195 Vitamin B kompleks Tablet 0 0
196 Zinc tab dispersibel 20 mg Tablet 50 50 10 40
197 Zinc kid 10 mg/5 ml Botol 0 0
198
199
200
201
202
203
204
205
STOK PENERIMA PERSEDIA EXP. PENGELUAR SISA PERMINTA
NO NAMA BARANG SATUAN KET
AWAL - AN - AN DATE - AN STOK - AN
1 2 3 4 5 6 = 4+5 7 8 9=6-8 10 11

206
207
208
209
210
211
212

Umum BPJS Askes Kis Total


69
40 0 0 29 69

Bambaira, 28 FEB 2019


Mengetahui, Yang Melaporkan
Kepala UPT Kesehatan Bambaira Pengelola Pustu/Polindes/Poskesdes

Anita, S.Kep, Ns.


Nip. 19820611 200502 2 002 Nip.
PEMERINTAH KABUPATEN PASANGKAYU
DINAS KESEHATAN
UPT PUSKESMAS BAMBAIRA
Jalan Trans Sulawesi Desa Bambaira Kec. Bambaira Kab. Pasangkayu
Kode Pos 91751 Telp. 0812 4364 8343 Email: [email protected]

LAPORAN PENERIMAAN DAN PERMINTAAN OBAT (LPLPO)

Nama Faskes : POSKESDES BARUGA BARU


Bulan : MARET

STOK PENERIMA PERSEDIA EXP. PENGELUAR SISA PERMINTA


NO NAMA BARANG SATUAN KET
AWAL - AN - AN DATE - AN STOK - AN
1 2 3 4 5 6 = 4+5 7 8 9=6-8 10 11

1 Afolat (Asam folat) tab 0,4 mg Tablet 20 100 120 120 0


2 Aquades Pro inj Steril Botol 0 0 0
3 Alat suntik sekali pakai 0,05 ml Pcs 50 50 0 50 EXP
4 Alat suntik sekali pakai 0,5 ml Pcs 0 0 0
5 Alat suntik sekali pakai 1 ml Pcs 0 0 0
6 Alat suntik sekali pakai 2,5 ml Pcs 0 0 0
7 Alat suntik sekali pakai 3 ml Pcs 14 14 0 14
8 Alat suntik sekali pakai 5 ml Pcs 0 0 0
9 Alat suntik sekali pakai 10 ml Pcs 0 0 0
10 Alat suntik sekali pakai 50 ml Pcs 0 0 0
11 Albendazol tab 400 mg Tablet 30 30 1 29
12 Alkohol 70 % 100 ml (kecil) Botol 0 0 0
13 Alkohol 70 % 1000 ml (besar) Botol 0 0 0
14 Alkohol Swab Pcs 0 0 0
15 Alopurinol tab 100 mg Tablet 0 0 0
16 Alopurinol tab 300 mg Tablet 0 0 0
17 Ambroxol sir 15 mg/ml Sirup 1 1 0 1
18 Ambroxol tab Tablet 0 0 0
19 Amlodipin tab 10 mg Tablet 0 0 0
20 Amlodipin tab 5 mg Tablet 0 0 0
21 Amoksisillin Drop Drop 0 0 0
22 Amoksisilin sir125 mg/5 ml Susp. 0 0 0
23 Amoksisilin sir forte 250 mg/5 ml Susp. 0 0 0
24 Amoksisilin tab 500 mg Tablet 120 120 33 87
25 Antalgin tab 500 mg Tablet 0 0 0
26 Antasida Doen Susp. Tablet 3 4 7 7
27 Antasida Doen Tablet kunyah Tablet 100 100 0 100
28 Arcapec Attapulgit Susp. 0 0 0
29 Asam askorbat (Vit.C) 50 mg Tablet 0 0
30 Asam askorbat (Vit.C) 25 mg Tablet 250 250 34 216
31 Asam mefenamat 500 mg Tablet 73 100 173 87 86
32 Asam salisilat 3% Pot 15 gr Pot 0 0 0
33 Asiklovir 5% krim Tube 0 0 0
34 Asiklovir tab 200 mg Tablet 0 0 0
35 Asiklovir tab 400 mg Tablet 0 0 0
36 Attapulgite tab (New antides) Tablet 100 100 0 100
37 Aximed Examination Gloves M Pcs 0 0 0
38 Basitrasin salep Tube 0 0 0
39 Baquinor tetes mata 3 mg / ml Botol 0 0 0
40 Bedak salisil serb 2% Pcs 3 3 1 2
41 Betam-optal (tetes mata) Botol 0 0 0
42 Betadine 10% 300 ml Botol 0 0 0
43 Betahistin tab 6 mg Tablet 0 0 0
44 Betametason krim 0,5 mg/g Tube 0 0 0
45 Bioplasenton Krim 15 gr Tube 0 0 0
46 Bisacodyl 5 mg Tablet 0 0 0
47 Captopril 12,5 mg Tablet 0 0 0
48 Captopril 25 mg Tablet 5 100 105 25 80
49 Captopril 50 mg Tablet 0 100 100 18 82
50 Catgut Plain 35 mm Pcs 0 0 0
51 Catgut Chrom 35 mm Pcs 0 0 0
52 Catgut Chrom 1 (Demetech) Pcs 3 3 1 2
53 Cefixime 100 mg Tablet 0 0 0
54 Cefriaxone 1 gr inj Vial 0 0 0
55 Cefadroxil Sirup 125 mg/ 5 mL Botol 0 0 0
56 Cefadroxil 500 mg Tablet 0 0 0
57 Cetrizine 10 mg Tablet 0 0 0
58 Cetrizine 5 mg/5 mL Botol 0 0 0
59 Chloramphenicol Tetes Mata Tube 0 0 0
60 Chloramphenicol Tetes Telinga Tube 0 0 0
61 Chloramphenicol salep kulit Tube 2 2 0 2
62 Chloramphenicol salep mata Tube 0 0 0
63 Chloramphenicol 125 mg/ 5 mL Botol 0 0 0
64 Chlorpheniramin Maleat (CTM) Tablet 201 201 134 67
65 Cotrimoxazole 480 mg Tablet 40 40 0 40
66 Cotrimoxazole 120 mg Tablet 0 0 0
67 Cotrimoxazole 240 mg/5 mL Botol 1 5 6 0 6
68 Cutimed (sorbact) swab Pcs 0 0 0
69 Deksametason inj 5 mg/ml) Ampul 0 0 0
70 Deksametason tab 0,5 mg Tablet 235 235 121 114
71 Dietilkarbamazin tab 100 mg Tablet 0 0 0
72 Diphenhydramine Inj Ampul 0 0 0
73 Domperidon susp 5 mg/5 ml Botol 0 0 0
74 Domperidon tab 10 mg Tablet 0 0 0
75 Domesik 2/0 Pcs 0 0 0
76 Domesik 3/0 75 c 26NC Pcs 0 0 0
79 Fitomenadion (vitamin K 1) inj Ampul 0 0 0
80 Fitomenadion (vitamin K) tab Tablet 0 0 0
81 Folley Catheter 18 Pcs 0 0 0
82 Folley Catheter 2 w ac No. 16 Pcs 0 0 0
Garam oralit
83 Pcs 12 12 0 12
84 Gel USG Botol 1 1 0 1
85 Gentamisin 40 mg/ml injeksi Ampul 0 0 0
86 Gentamisin 0,1% salep kulit Tube 0 0 0
87 Glibenklamid tab 5 mg Tablet 170 170 10 160
88 Glimepirid tab 1 mg Tablet 0 0 0
89 Glimepirid tab 2 mg Tablet 0 0 0
90 Gliseril Guyakolat (GG) Tablet 320 320 77 243
91 Glukosa Larutan Infus 10% steril Botol 0 0 0
92 Glukosa Larutan Infus 5% steril Botol 2 2 0 2
93 Griseofulvin tab 125 mg Tablet 0 0 0
94 Handscoon 6 Pcs 7 7 0 7
95 Handscoon 7 Pcs 0 0 0
96 Handscone 7,5 Pcs 0 0 0
97 Handscone 8 Pcs 11 11 0 11
98 Handscone M (non steril) Pcs 0 0 0
99 Hidrokortison krim 2,5% Tube 1 1 0 1
100 Ibuprofen sir 200 mg/5 ml Botol 0 0 0
101 Ibuprofen tab 200 mg Tablet 0 0 0
102 Ibuprofen tab 400 mg Tablet 120 120 40 80
103 Infus set Mikro (anak) Pcs 0 0 0
104 Infus set Makro (dewasa) Pcs 1 1 0 1
105 IV Catheter No. 18 G Pcs 3 3 0 3
106 IV Catheter No. 20 G Pcs 2 2 0 2
107 IV Catheter No. 22 G Pcs 3 3 0 3
108 IV Catheter No. 24 G Pcs 0 0 0 0
109 IV Catheter No. 26 G Pcs 0 0 0 0
110 Kalium Diklofenak 50 mg Tablet 0 0 0
111 Kalium Pemangat Pk Larutan Pot 0 0 0
112 Kalsium laktat 500 mg Tablet 0 0 0
113 Kapas 1000 gr Pcs 0 0 0
114 Kapas 250 gr Pcs 0 0 0
115 Kapas 500 gr Pcs 0 0 0
116 Kartu Stok Lembar 0 0 0
117 Kasa Hidrofil 36 x 80 cm Roll 0 0 0
118 Kasa Hidrofil 40 x 80 cm Roll 0 0 0
119 Kasa Pembalut 4 x 10 cm Roll 5 5 0 5
120 Kertas Puyer Lembar 210 210 70 140
121 Ketokonazol tab 200 mg Tablet 0 0 0
122 Ketokonazol krim 2% Tube 3 3 1 2
123 Ketorolac Inj 30 mg/1ml Ampul 0 0 0
124 Lidokain inj 2% epineprin 2 ml Ampul 4 4 1 3
125 Loperamid (HCL) 2 mg Tablet 0 0 0

126 Loratadin tab 10 mg Tablet 0 0 0


127 Masker Tali (Ties On) Pcs 0 0 0
128 Masker Karet (Ear loop) Pcs 17 17 0 17
129 Magnnesium Sulfat (MGSO4) Tablet 0 0 0
130 Mebendazol sir 50 mg/ml Botol 0 0 0
131 Mebendazol tab 500 mg Tablet 0 0 0
132 Meloksikam 15 mg tab Tablet 0 0 0
133 Meloksikam 7,5 mg tab Tablet 0 0 0
134 Metformin tab 500 mg Tablet 0 0 0
135 Metilprednisolon 4 mg Tablet 70 70 20 50
136 Metilergometrin tab 0,125 mg Tablet 20 20 0 20
137 Metronidazol tab 250 mg Tablet 0 50 50 0 50
138 Metronidazol tab 500 mg Tablet 0 0 0
139 Mineral Mix serbuk 8 gram Pcs 0 0 0
140 Mikonazol krim 2% Tube 4 4 1 3
141 NaCl 0,9% Larutan Tablet 0 0 0
142 Nasal Oksigen L (adult) Tablet 0 0 0
143 Nasal oksigen M Tablet 0 0 0
144 Nasal Oksigen Xs Tablet 0 0 0
145 Natrium diklofenak tab 25 mg Tablet 0 0 0
146 Natrium diklofenak tab 50 mg Tablet 0 0 0
147 Nebulizer Mask Anak Pcs 0 0 0
148 Nebulizer Mask Dewasa Pcs 0 0 0
149 Nifedipin 10 mg Tablet 0 0 0
150 Obat Batuk Hitam (OBH) Botol 0 0 0
151 Oksitosin inj 10 UI/ml Ampul 3 3 0 3
152 Omeprazol kaps 20 mg Tablet 0 0 0
153 Ondansetron HCL Dihidrate Inj Ampul 0 0 0
154 Paracetamol Drop Tablet 0 3 3 0 3
155 Parasetamol sir 120 mg/5 ml Tablet 1 4 5 2 3
156 Parasetamol tab 500 mg Tablet 180 180 77 103
157 Phenol glycerol 10 % Tablet 0 0 0 0
158 Piridoksin (vitamin B6) tab 10 mg Tablet 80 100 180 60 120
159 Piroxicam 10 mg kaps Tablet 0 0 0 0
160 Plester 2,50 CM x 4,5 M Roll 0 0 0
161 Povidon Iodin (300mL) Botol 0 0 0
162 Povidon iodin (60 mL) Botol 0 0 0
163 Povidon Iodin (30 mL) Botol 2 2 0 2
164 Prednison tab 5 mg Tablet 154 154 10 144
165 Pyrantel 125 mg Tablet 0 0 0
166 Pyrantel syrp Botol 0 0
167 Ranitidin inj 25 mg/ml Ampul 0 0
168 Ranitidin tab 150 mg Tablet 90 90 20 70
169 Retinol (vit. A biru) Kaps Lunak Tablet 0 0
170 Retinol (vit. A merah) Kaps Lunak Tablet 28 28 0 28 EXP
171 RDT dengue lgG/lgM Antibodi test Pcs 0 0
172 Ringer Laktat Larutan Botol 0 0 0
173 Sak obat 6 cm x 10 cm Lembar 0 0
174 Sak obat 10 cm x 15 cm Lembar 0 0
175 Sak obat 8 cm x 12 cm Lembar 0 0
176 Sak obat sedang 8 cm x 5 cm Lembar 0 0
177 Salbutamol 2 mg Tablet 0 0 0
178 Salbutamol 4 mg Tablet 30 30 30 0
179 Salbutamol Sirup 2 mg/5 ml Tablet 0 0 0
180 Salep 2-4, kombinasi Pot 0 0
181 Salep 3-6 Pot 0 0
182 Scabimite Tube 0 0
183 Sianokobalamin (vitamin B12) inj Ampul 0 0
184 Sianokobalamin (vitamin B12) tab Tablet 0 0
185 Simvastatin tab sal 10 mg Tablet 150 150 10 140
186 Surgical blade No 11 Bisturi Pcs 0 0
187 Surgical blade No 15 Bisturi Pcs 0 0
188 Tablet Tambah Darah Tablet 0 200 200 175 25
189 Tiamfenikol 500 ml (Tiamex) Tablet 0 0
190 Tiamin (vitamin B1) tab 50 mg Tablet 118 118 30 88
191 Ultra one test hamil strip Pcs 19 19 0 19
192 Umbilical cord clem plastik Pcs 0 0
193 Vermox Tablet 0 0
194 Vicanatal Tablet 0 0

195 Vitamin B kompleks Tablet 0 0


196 Zinc tab dispersibel 20 mg Tablet 40 40 0 40
197 Zinc kid 10 mg/5 ml Botol 0 0
198 Procuma Botol 0 2 2 0 2

Umum BPJS Askes Kis Total


91
63 0 0 28 91

Bambaira, 28 maret 2019


Mengetahui, Yang Melaporkan
Kepala UPT Kesehatan Bambaira Pengelola Pustu/Polindes/Poskesdes

Anita, S.Kep, Ns. Rahmaniah A.Md.Keb


Nip. 19820611 200502 2 002 Nip. 199202292015032004
PEMERINTAH KABUPATEN PASANGKAYU
DINAS KESEHATAN
UPT PUSKESMAS BAMBAIRA
Jalan Trans Sulawesi Desa Bambaira Kec. Bambaira Kab. Pasangkayu
Kode Pos 91751 Telp. 0812 4364 8343 Email: [email protected]

LAPORAN PENERIMAAN DAN PERMINTAAN OBAT (LPLPO)

Nama Faskes : POSKESDES BARUGA BARU


Bulan : APRIL

STOK PENERIMA PERSEDIA EXP. PENGELUAR SISA PERMINTA


NO NAMA BARANG SATUAN KET
AWAL - AN - AN DATE - AN STOK - AN
1 2 3 4 5 6 = 4+5 7 8 9=6-8 10 11

1 Afolat (Asam folat) tab 0,4 mg Tablet 0 100 100 40 60


2 Aquades Pro inj Steril Botol 0 0 0
3 Alat suntik sekali pakai 0,05 ml Pcs 50 50 0 50 EXP
4 Alat suntik sekali pakai 0,5 ml Pcs 0 0 0
5 Alat suntik sekali pakai 1 ml Pcs 0 20 20 5 15
6 Alat suntik sekali pakai 2,5 ml Pcs 0 0 0
7 Alat suntik sekali pakai 3 ml Pcs 14 14 0 14
8 Alat suntik sekali pakai 5 ml Pcs 0 0 0
9 Alat suntik sekali pakai 10 ml Pcs 0 0 0
10 Alat suntik sekali pakai 50 ml Pcs 0 0 0
11 Albendazol tab 400 mg Tablet 29 29 2 27
12 Alkohol 70 % 100 ml (kecil) Botol 0 0 0
13 Alkohol 70 % 1000 ml (besar) Botol 0 0 0
14 Alkohol Swab Pcs 0 0 0
15 Alopurinol tab 100 mg Tablet 0 0 0
16 Alopurinol tab 300 mg Tablet 0 0 0
17 Ambroxol sir 15 mg/ml Sirup 1 1 1 0
18 Ambroxol tab Tablet 0 0 0
19 Amlodipin tab 10 mg Tablet 0 0 0
20 Amlodipin tab 5 mg Tablet 0 0 0
21 Amoksisillin Drop Drop 0 0 0
22 Amoksisilin sir125 mg/5 ml Susp. 0 0 0
23 Amoksisilin sir forte 250 mg/5 ml Susp. 0 0 0
24 Amoksisilin tab 500 mg Tablet 87 87 20 67
25 Antalgin tab 500 mg Tablet 0 0 0
26 Antasida Doen Susp. Tablet 7 4 11 8 3
27 Antasida Doen Tablet kunyah Tablet 100 100 20 80
28 Arcapec Attapulgit Susp. 0 0 0
29 Asam askorbat (Vit.C) 50 mg Tablet 0 0 0
30 Asam askorbat (Vit.C) 25 mg Tablet 216 216 56 160
31 Asam mefenamat 500 mg Tablet 86 86 20 66
32 Asam salisilat 3% Pot 15 gr Pot 0 0 0
33 Asiklovir 5% krim Tube 0 0 0
34 Asiklovir tab 200 mg Tablet 0 0 0
35 Asiklovir tab 400 mg Tablet 0 0 0
36 Attapulgite tab (New antides) Tablet 100 100 0 100
37 Aximed Examination Gloves M Pcs 0 0 0
38 Basitrasin salep Tube 0 0 0
39 Baquinor tetes mata 3 mg / ml Botol 0 0 0
40 Bedak salisil serb 2% Pcs 2 2 1 1
41 Betam-optal (tetes mata) Botol 0 0 0
42 Betadine 10% 300 ml Botol 0 0 0
43 Betahistin tab 6 mg Tablet 0 0 0
44 Betametason krim 0,5 mg/g Tube 0 0 0
45 Bioplasenton Krim 15 gr Tube 0 0 0
46 Bisacodyl 5 mg Tablet 0 0 0
47 Captopril 12,5 mg Tablet 0 0 0
48 Captopril 25 mg Tablet 80 80 5 75
49 Captopril 50 mg Tablet 82 82 15 67
50 Catgut Plain 35 mm Pcs 0 0 0
51 Catgut Chrom 35 mm Pcs 0 0 0
52 Catgut Chrom 1 (Demetech) Pcs 2 2 0 2
53 Cefixime 100 mg Tablet 0 0 0
54 Cefriaxone 1 gr inj Vial 0 0 0
55 Cefadroxil Sirup 125 mg/ 5 mL Botol 0 0 0
56 Cefadroxil 500 mg Tablet 0 0 0
57 Cetrizine 10 mg Tablet 0 0 0
58 Cetrizine 5 mg/5 mL Botol 0 0 0
59 Chloramphenicol Tetes Mata Tube 0 0 0
60 Chloramphenicol Tetes Telinga Tube 0 0 0
61 Chloramphenicol salep kulit Tube 2 2 0 2
62 Chloramphenicol salep mata Tube 0 0 0
63 Chloramphenicol 125 mg/ 5 mL Botol 0 0 0
64 Chlorpheniramin Maleat (CTM) Tablet 67 200 267 98 169
65 Cotrimoxazole 480 mg Tablet 40 40 0 40
66 Cotrimoxazole 120 mg Tablet 0 0 0
67 Cotrimoxazole 240 mg/5 mL Botol 6 6 0 6
68 Cutimed (sorbact) swab Pcs 0 0 0
69 Deksametason inj 5 mg/ml) Ampul 0 0 0
70 Deksametason tab 0,5 mg Tablet 114 114 34 80
71 Dietilkarbamazin tab 100 mg Tablet 0 0 0
72 Diphenhydramine Inj Ampul 0 0 0
73 Domperidon susp 5 mg/5 ml Botol 0 0 0
74 Domperidon tab 10 mg Tablet 0 0 0
75 Domesik 2/0 Pcs 0 0 0
76 Domesik 3/0 75 c 26NC Pcs 0 0 0
79 Fitomenadion (vitamin K 1) inj Ampul 0 0 0
80 Fitomenadion (vitamin K) tab Tablet 0 0 0
81 Folley Catheter 18 Pcs 0 0 0
82 Folley Catheter 2 w ac No. 16 Pcs 0 0 0
Garam oralit
83 Pcs 12 12 1 11
84 Gel USG Botol 1 1 0 1
85 Gentamisin 40 mg/ml injeksi Ampul 0 0 0
86 Gentamisin 0,1% salep kulit Tube 0 0 0
87 Glibenklamid tab 5 mg Tablet 160 160 10 150
88 Glimepirid tab 1 mg Tablet 0 0 0
89 Glimepirid tab 2 mg Tablet 0 0 0
90 Gliseril Guyakolat (GG) Tablet 243 243 87 156
91 Glukosa Larutan Infus 10% steril Botol 0 0 0
92 Glukosa Larutan Infus 5% steril Botol 2 2 0 2
93 Griseofulvin tab 125 mg Tablet 0 0 0
94 Handscoon 6 Pcs 7 7 0 7
95 Handscoon 7 Pcs 0 0 0
96 Handscone 7,5 Pcs 0 0 0
97 Handscone 8 Pcs 11 11 0 11
98 Handscone M (non steril) Pcs 0 0 0
99 Hidrokortison krim 2,5% Tube 1 1 0 1
100 Ibuprofen sir 200 mg/5 ml Botol 0 0 0
101 Ibuprofen tab 200 mg Tablet 0 0 0
102 Ibuprofen tab 400 mg Tablet 80 80 10 70
103 Infus set Mikro (anak) Pcs 0 0 0
104 Infus set Makro (dewasa) Pcs 1 1 0 1
105 IV Catheter No. 18 G Pcs 3 3 0 3
106 IV Catheter No. 20 G Pcs 2 2 0 2
107 IV Catheter No. 22 G Pcs 3 3 0 3
108 IV Catheter No. 24 G Pcs 0 0 0 0
109 IV Catheter No. 26 G Pcs 0 0 0 0
110 Kalium Diklofenak 50 mg Tablet 0 0 0
111 Kalium Pemangat Pk Larutan Pot 0 0 0
112 Kalsium laktat 500 mg Tablet 0 0 0
113 Kapas 1000 gr Pcs 0 0 0
114 Kapas 250 gr Pcs 0 0 0
115 Kapas 500 gr Pcs 0 0 0
116 Kartu Stok Lembar 0 0 0
117 Kasa Hidrofil 36 x 80 cm Roll 0 0 0
118 Kasa Hidrofil 40 x 80 cm Roll 0 0 0
119 Kasa Pembalut 4 x 10 cm Roll 5 5 0 5
120 Kertas Puyer Lembar 140 140 30 110
121 Ketokonazol tab 200 mg Tablet 0 0 0
122 Ketokonazol krim 2% Tube 2 2 0 2
123 Ketorolac Inj 30 mg/1ml Ampul 0 0 0
124 Lidokain inj 2% epineprin 2 ml Ampul 3 3 0 3
125 Loperamid (HCL) 2 mg Tablet 0 0 0

126 Loratadin tab 10 mg Tablet 0 0 0


127 Masker Tali (Ties On) Pcs 0 0 0
128 Masker Karet (Ear loop) Pcs 17 17 1 16
129 Magnnesium Sulfat (MGSO4) Tablet 0 0 0
130 Mebendazol sir 50 mg/ml Botol 0 0 0
131 Mebendazol tab 500 mg Tablet 0 0 0
132 Meloksikam 15 mg tab Tablet 0 0 0
133 Meloksikam 7,5 mg tab Tablet 0 0 0
134 Metformin tab 500 mg Tablet 0 0 0
135 Metilprednisolon 4 mg Tablet 50 50 0 50
136 Metilergometrin tab 0,125 mg Tablet 20 20 0 20
137 Metronidazol tab 250 mg Tablet 50 50 0 50
138 Metronidazol tab 500 mg Tablet 0 0 0
139 Mineral Mix serbuk 8 gram Pcs 0 0 0
140 Mikonazol krim 2% Tube 3 3 0 3
141 NaCl 0,9% Larutan Tablet 0 0 0
142 Nasal Oksigen L (adult) Tablet 0 0 0
143 Nasal oksigen M Tablet 0 0 0
144 Nasal Oksigen Xs Tablet 0 0 0
145 Natrium diklofenak tab 25 mg Tablet 0 0 0
146 Natrium diklofenak tab 50 mg Tablet 0 0 0
147 Nebulizer Mask Anak Pcs 0 0 0
148 Nebulizer Mask Dewasa Pcs 0 0 0
149 Nifedipin 10 mg Tablet 0 0 0
150 Obat Batuk Hitam (OBH) Botol 0 0 0
151 Oksitosin inj 10 UI/ml Ampul 0 5 5 1 4
152 Omeprazol kaps 20 mg Tablet 0 0 0
153 Ondansetron HCL Dihidrate Inj Ampul 0 0 0
154 Paracetamol Drop Tablet 3 3 0 3
155 Parasetamol sir 120 mg/5 ml Tablet 3 3 1 2
156 Parasetamol tab 500 mg Tablet 103 103 34 69
157 Phenol glycerol 10 % Tablet 0 0 0 0
158 Piridoksin (vitamin B6) tab 10 mg Tablet 120 120 30 90
159 Piroxicam 10 mg kaps Tablet 0 0 0 0
160 Plester 2,50 CM x 4,5 M Roll 0 0 0
161 Povidon Iodin (300mL) Botol 0 0 0
162 Povidon iodin (60 mL) Botol 0 0 0
163 Povidon Iodin (30 mL) Botol 2 2 0 2
164 Prednison tab 5 mg Tablet 144 144 0 144
165 Pyrantel 125 mg Tablet 0 0 0
166 Pyrantel syrp Botol 0 0 0
167 Ranitidin inj 25 mg/ml Ampul 0 0 0
168 Ranitidin tab 150 mg Tablet 70 70 10 60
169 Retinol (vit. A biru) Kaps Lunak Tablet 0 0 0
170 Retinol (vit. A merah) Kaps Lunak Tablet 0 25 25 2 23
171 RDT dengue lgG/lgM Antibodi test Pcs 0 0 0
172 Ringer Laktat Larutan Botol 0 5 5 5
173 Sak obat 6 cm x 10 cm Lembar 0 0 0
174 Sak obat 10 cm x 15 cm Lembar 0 0 0
175 Sak obat 8 cm x 12 cm Lembar 0 0 0
176 Sak obat sedang 8 cm x 5 cm Lembar 0 0 0
177 Salbutamol 2 mg Tablet 0 0 0
178 Salbutamol 4 mg Tablet 0 200 200 70 130
179 Salbutamol Sirup 2 mg/5 ml Tablet 0 0 0
180 Salep 2-4, kombinasi Pot 0 0 0
181 Salep 3-6 Pot 0 0 0
182 Scabimite Tube 0 0 0
183 Sianokobalamin (vitamin B12) inj Ampul 0 0 0
184 Sianokobalamin (vitamin B12) tab Tablet 0 0 0
185 Simvastatin tab sal 10 mg Tablet 140 140 10 130
186 Surgical blade No 11 Bisturi Pcs 0 0 0
187 Surgical blade No 15 Bisturi Pcs 0 0 0
188 Tablet Tambah Darah Tablet 25 200 225 130 95
189 Tiamfenikol 500 ml (Tiamex) Tablet 0 0 0
190 Tiamin (vitamin B1) tab 50 mg Tablet 88 88 20 68
191 Ultra one test hamil strip Pcs 19 19 0 19 exp
192 Umbilical cord clem plastik Pcs 0 3 3 0 3
193 Vermox Tablet 0 0 0
194 Vicanatal Tablet 0 0 0

195 Vitamin B kompleks Tablet 0 0 0


196 Zinc tab dispersibel 20 mg Tablet 40 40 0 40
197 Zinc kid 10 mg/5 ml Botol 0 0 0
198 Procuma Botol 2 2 0 2
199 Pot Urin Pot 0 3 3 0 3
200 Safety Box Pcs 0 1 1 0 1

Umum BPJS Askes Kis Total


47
27 0 0 27 47

Bambaira, 28 APRIL 2019


Mengetahui, Yang Melaporkan
Kepala UPT Kesehatan Bambaira Pengelola Pustu/Polindes/Poskesdes

Anita, S.Kep, Ns. Rahmaniah A.Md.Keb


Nip. 19820611 200502 2 002 Nip. 199202292015032004
PEMERINTAH KABUPATEN PASANGKAYU
DINAS KESEHATAN
UPT PUSKESMAS BAMBAIRA
Jalan Trans Sulawesi Desa Bambaira Kec. Bambaira Kab. Pasangkayu
Kode Pos 91751 Telp. 0812 4364 8343 Email: [email protected]

LAPORAN PENERIMAAN DAN PERMINTAAN OBAT (LPLPO)

Nama Faskes : POSKESDES SALUIRA


Bulan : Februari 2022

STOK PENERIMA PERSEDIA EXP. PENGELUAR SISA PERMINTA


NO NAMA BARANG SATUAN KET
AWAL - AN - AN DATE - AN STOK - AN
1 2 3 4 5 6 = 4+5 7 8 9=6-8 10 11

1 Afolat (Asam folat) tab 0,4 mg Tablet


2 Aquades Pro inj Steril Botol
3 Alat suntik sekali pakai 0,05 ml Pcs
4 Alat suntik sekali pakai 0,5 ml Pcs
5 Alat suntik sekali pakai 1 ml Pcs
6 Alat suntik sekali pakai 2,5 ml Pcs
7 Alat suntik sekali pakai 3 ml Pcs 9 0 9 3 6 10
8 Alat suntik sekali pakai 5 ml Pcs
9 Alat suntik sekali pakai 10 ml Pcs
10 Alat suntik sekali pakai 50 ml Pcs
11 Albendazol tab 400 mg Tablet 10 0 10 0 10 0
12 Alkohol 70 % 100 ml (kecil) Botol
13 Alkohol 70 % 1000 ml (besar) Botol
14 Alkohol Swab Pcs
15 Alopurinol tab 100 mg Tablet
16 Alopurinol tab 300 mg Tablet
17 Ambroxol sir 15 mg/ml Sirup 3 0 3 0 0 3 2
18 Ambroxol tab Tablet 220 0 220 85 135 0
19 Amlodipin tab 10 mg Tablet
20 Amlodipin tab 5 mg Tablet
21 Amoksisillin Drop Drop

22 Amoksisilin sir125 mg/5 ml Susp.

23 Amoksisilin sir forte 250 mg/5 ml Susp.


24 Amoksisilin tab 500 mg Tablet
25 Antalgin tab 500 mg Tablet 0 0 0 0 0 0
26 Antasida Doen Susp. Tablet 0 0 0 0 0 5
27 Antasida Doen Tablet kunyah Tablet 50 0 50 50 0 100
28 Arcapec Attapulgit Susp.
29 Asam askorbat (Vit.C) 250 mg Tablet 240 0 240 80 160 0
30 Asam askorbat (Vit.C) 25 mg Tablet 0 0 0 0 0 50
31 Asam mefenamat 500 mg Tablet 20 0 20 0 20 0
32 Asam salisilat 3% Pot 15 gr Pot
33 Asiklovir 5% krim Tube 0 0 0
34 Asiklovir tab 200 mg Tablet
35 Asiklovir tab 400 mg Tablet
36 Attapulgite tab (New antides) Tablet 50 0 50 0 50 0
37 Aximed Examination Gloves M Pcs
38 Basitrasin salep Tube 2 0
39 Baquinor tetes mata 3 mg / ml Botol
40 Bedak salisil serb 2% Pcs 0 0 5
41 Betam-optal (tetes mata) Botol 0 0 2
42 Betadine 10% 300 ml Botol
43 Betahistin tab 6 mg Tablet

44 Betametason krim 0,5 mg/g Tube 7


45 Bioplasenton Krim 15 gr Tube 0 0 5
46 Bisacodyl 5 mg Tablet
47 Captopril 12,5 mg Tablet 100 0 100 0 100 0 exd
48 Captopril 25 mg Tablet 190 0 190 0 190 0
49 Captopril 50 mg Tablet 0 0 0 0 0
50 Catgut Plain 35 mm Pcs
51 Catgut Chrom 35 mm Pcs
52 Catgut Chrom 1 (Demetech) Pcs
53 Cefixime 100 mg Tablet
54 Cefriaxone 1 gr inj Vial

55 Cefadroxil Sirup 125 mg/ 5 mL Botol


56 Cefadroxil 500 mg Tablet
57 Cetrizine 10 mg Tablet 0 0 0
58 Cetrizine 5 mg/5 mL Botol 0 0 5
59 Chloramphenicol Tetes Mata Tube 0 0 5
60 Chloramphenicol Tetes Telinga Tube 0 0 5
61 Chloramphenicol salep kulit Tube 4 0 0
62 Chloramphenicol salep mata Tube 0 0 5
63 Chloramphenicol 125 mg/ 5 mL Botol
64 Chlorpheniramin Maleat (CTM) Tablet 120 0 120 20 100
65 Cotrimoxazole 480 mg Tablet 0 0 50
66 Cotrimoxazole 120 mg Tablet 0 0 0
67 Cotrimoxazole 240 mg/5 mL Botol 0 0 5
68 Cutimed (sorbact) swab Pcs 0 0 3
69 Deksametason inj 5 mg/ml) Ampul
70 Deksametason tab 0,5 mg Tablet 240 0 240 0 240 0
71 Dietilkarbamazin tab 100 mg Tablet
72 Diphenhydramine Inj Ampul
73 Domperidon susp 5 mg/5 ml Botol
74 Domperidon tab 10 mg Tablet 50 0 0 0 0 0
75 Domesik 2/0 Pcs
76 Domesik 3/0 75 c 26NC Pcs
79 Fitomenadion (vitamin K 1) inj Ampul 2 0 2 0 2 0
80 Fitomenadion (vitamin K) tab Tablet 0 0 0
81 Folley Catheter 18 Pcs
82 Folley Catheter 2 w ac No. 16 Pcs
Garam oralit
83 Pcs 48 48 15 33 0
84 Gel USG Botol 0 1 0 0 1 0
85 Gentamisin 40 mg/ml injeksi Ampul
86 Gentamisin 0,1% salep kulit Tube 0 0 5
87 Glibenklamid tab 5 mg Tablet
88 Glimepirid tab 1 mg Tablet
89 Glimepirid tab 2 mg Tablet
90 Gliseril Guyakolat (GG) Tablet 0 0 0 0 50
91 Glukosa Larutan Infus 10% steril Botol 2 0 0
92 Glukosa Larutan Infus 5% steril Botol 0 0 0
93 Griseofulvin tab 125 mg Tablet 60 0 60 0 60 0 exd
94 Handscoon 6 Pcs
95 Handscoon 7 Pcs 0 0 5
96 Handscone 7,5 Pcs 0 0 5
97 Handscone 8 Pcs
98 Handscone M (non steril) Pcs 0 4
99 Hidrokortison krim 2,5% Tube 4 0
100 Ibuprofen sir 200 mg/5 ml Botol
101 Ibuprofen tab 200 mg Tablet 0 0
102 Ibuprofen tab 400 mg Tablet 50 0 50 0 50 0 exd
103 Infus set Mikro (anak) Pcs
104 Infus set Makro (dewasa) Pcs 2 0 0
105 IV Catheter No. 18 G Pcs
106 IV Catheter No. 20 G Pcs
107 IV Catheter No. 22 G Pcs
108 IV Catheter No. 24 G Pcs
109 IV Catheter No. 26 G Pcs
110 Kalium Diklofenak 50 mg Tablet 0 0 0
111 Kalium Pemangat Pk Larutan Pot 0 0 0
112 Kalsium laktat 500 mg Tablet 130 0 130 0 130 0
113 Kapas 1000 gr Pcs
114 Kapas 250 gr Pcs 0 0 1
115 Kapas 500 gr Pcs
116 Kartu Stok Lembar
117 Kasa Hidrofil 36 x 80 cm Roll 0 0 2
118 Kasa Hidrofil 40 x 80 cm Roll 0 0 2
119 Kasa Pembalut 4 x 10 cm Roll 0 0 1
120 Kertas Puyer Lembar 50 0 0 0 50 0
121 Ketokonazol tab 200 mg Tablet
122 Ketokonazol krim 2% Tube 0 2 2 0 2
123 Ketorolac Inj 30 mg/1ml Ampul
124 Lidokain inj 2% epineprin 2 ml Ampul 2 0 0 0 2 0

125 Loperamid (HCL) 2 mg Tablet


126 Loratadin tab 10 mg Tablet 50 0 0
127 Masker Tali (Ties On) Pcs 0 5 5 0 5 0 10
128 Masker Karet (Ear loop) Pcs 0 0 0 0 0 0 0
129 Magnnesium Sulfat (MGSO4) Tablet
130 Mebendazol sir 50 mg/ml Botol
131 Mebendazol tab 500 mg Tablet
132 Meloksikam 15 mg tab Tablet
133 Meloksikam 7,5 mg tab Tablet
134 Metformin tab 500 mg Tablet
135 Metilprednisolon 4 mg Tablet
136 Metilergometrin tab 0,125 mg Tablet 30 0 30 0 30 0
137 Metronidazol tab 250 mg Tablet
138 Metronidazol tab 500 mg Tablet
139 Mineral Mix serbuk 8 gram Pcs
140 Mikonazol krim 2% Tube
141 NaCl 0,9% Larutan Tablet
142 Nasal Oksigen L (adult) Tablet
143 Nasal oksigen M Tablet
144 Nasal Oksigen Xs Tablet
145 Natrium diklofenak tab 25 mg Tablet 0 50 50 50 0 100
146 Natrium diklofenak tab 50 mg Tablet 0 0 0 0 0 0
147 Nebulizer Mask Anak Pcs
148 Nebulizer Mask Dewasa Pcs
149 Nifedipin 10 mg Tablet 0 0 0 0 0 0
150 Obat Batuk Hitam (OBH) Botol
151 Oksitosin inj 10 UI/ml Ampul
152 Omeprazol kaps 20 mg Tablet
153 Ondansetron HCL Dihidrate Inj Ampul
154 Paracetamol Drop Tablet 3 0 3 1 2 3
155 Parasetamol sir 120 mg/5 ml Tablet 2 0 2 2 0 3
156 Parasetamol tab 500 mg Tablet 80 50 140 80 50 50
157 Phenol glycerol 10 % Tablet
158 Piridoksin (vitamin B6) tab 10 mg Tablet 240 0 240 0 0 240 0
159 Piroxicam 10 mg kaps Tablet
160 Plester 2,50 CM x 4,5 M Roll
161 Povidon Iodin (300mL) Botol 0 1 1 0 1 0
162 Povidon iodin (60 mL) Botol 1
163 Povidon Iodin (30 mL) Botol
164 Prednison tab 5 mg Tablet 110 0 110 0 110 0 exd
165 Pyrantel 125 mg Tablet 4 0 4 0 4 0
166 Pyrantel syrp Botol 2
167 Ranitidin inj 25 mg/ml Ampul
168 Ranitidin tab 150 mg Tablet
169 Retinol (vit. A biru) Kaps Lunak Tablet
170 Retinol (vit. A merah) Kaps Lunak Tablet
171 RDT dengue lgG/lgM Antibodi test Pcs
172 Ringer Laktat Larutan Botol
173 Sak obat 6 cm x 10 cm Lembar 70 0 70 0 70 0
174 Sak obat 10 cm x 15 cm Lembar 0 0 0
175 Sak obat 8 cm x 12 cm Lembar 0 0 0
176 Sak obat sedang 8 cm x 5 cm Lembar 0 0 0
177 Salbutamol 2 mg Tablet 0 0 0 0 0 0
178 Salbutamol 4 mg Tablet 40 0 40 10 30 50
179 Salbutamol Sirup 2 mg/5 ml Tablet
180 Salep 2-4, kombinasi Pot
181 Salep 3-6 Pot
182 Scabimite Tube
183 Sianokobalamin (vitamin B12) inj Ampul
184 Sianokobalamin (vitamin B12) tab Tablet
185 Simvastatin tab sal 10 mg Tablet 20 0 20 0 20
186 Surgical blade No 11 Bisturi Pcs
187 Surgical blade No 15 Bisturi Pcs
188 Tablet Tambah Darah Tablet 110 150 260 20 240 0
189 Tiamfenikol 500 ml (Tiamex) Tablet
190 Tiamin (vitamin B1) tab 50 mg Tablet 0 0 0 0 0 100
191 Ultra one test hamil strip Pcs 0 0 0 0 0 10
192 Umbilical cord clem plastik Pcs 0 0 10
192 PTU Tablet 30 0 0
192 Diclofenat sodium Tablet 0 0 100
193 Vermox Tablet 0 0 100
194 Vicanatal Tablet
195 Vitamin B kompleks Tablet 0 100 100 20 80 0
196 Zinc tab dispersibel 20 mg Tablet 20 100 120 0 120 0
197 Zinc kid 10 mg/5 ml /zinc sirup Botol 3 0 3 1 2 3
198 Procuma / TRUVIT Botol 0 0 5
199 Pot Urin Pot 0 0 5
200 safeti box box 0 0 1 0 1 0
201 Lanzoprasole tablet 0 0 0

Umum BPJS Askes Kis Total


3 20 0 20 23

Bambaira, 28 Februari 2022


Mengetahui, Yang Melaporkan
Kepala UPT Kesehatan Bambaira Pengelola Poskesdes Saluira

Anita, S.Kep, Ns. Magvira,Amd,Keb.


Nip. 19820611 200502 2 002 Nip:

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