LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

(LPLPO)

PUSKESMAS : RANOMUT PELAPORAN BULAN : OKTOBER

KECAMATAN : PALDUA PERMINTAAN BULAN : NOVEMBER
KOTA : MANADO TAHUN : 2018

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOCK AKHIR PERMINTAAN

1 2 3 4 5 6(4+5) 7 8(6-7) 9
1 Acyclovir 200 mg tablet 0 0 0 0 0 300
2 Acyclovir 400 mg tablet 0 0 0 0 0 1000
3 Acyclovir Krim tube 25 0 25 10 15 0
4 *Albendazole 400 mg tablet 0 0 0 0 0 0
5 Allopurinol 100 mg tablet 0 0 0 0 0 300
6 Allopurinol 300 mg tablet 0 100 100 0 100 0
7 Alkohol 70% 1 L botol 5 0 5 0 5 0
8 Amalgam (powder & liquid) botol 0 0 0 0 0 0
9 Ambroksol 30 mg tablet 500 1000 1500 1100 400 1000
10 Ambroksol Sirup botol 12 20 32 6 26 0
11 Aminofillin 200 mg tablet 100 0 100 0 100 0
12 Amlodipin Tablet 5 mg tablet 210 150 360 90 270 150
13 Amlodipin Tablet 10 mg tablet 0 0 0 0 0 300
14 *Amoksisillin 500 mg tablet 1000 0 1000 1000 0 2000
15 *Amoksisillin Sirup botol 8 20 28 13 15 10
16 Amoksisillin 500 mg, Asam Clavulanat 125 mg tablet 0 90 90 30 60 0
17 Ampisillin 500 mg tablet 400 0 400 0 400 0
18 Antalgin/Metampiron 500 mg tablet 200 0 200 100 100 500
19 Antasida Doen tablet 300 1000 1300 900 400 1000
20 Antasida Sirup botol 0 0 0 0 0 30
21 Aqua pro Injeksi botol 0 0 0 0 0 20
22 Arsen botol 0 0 0 0 0 0
23 Artesunate injeksi 60 mg ampul 0 0 0 0 0 0
24 Asam Askorbat 50 mg tablet 0 0 0 0 0 1000
25 Asam Mefenamat 500 mg tablet 600 1000 1600 600 1000 0
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOCK AKHIR PERMINTAAN

1 2 3 4 5 6(4+5) 7 8(6-7) 9
26 Atorvastatin 40 mg tablet 0 0 0 0 0 0
27 Betahistin tablet 0 0 0 0 0 1000
28 Betametason Krim tube 0 0 0 0 0 20
29 Bisoprolol Fumarate 5 mg tablet 0 0 0 0 0 200
30 Bromheksin 8 mg tablet 200 0 200 200 0 500
31 CHKM botol 1 0 1 0 1 0
32 *Captopril 12,5 mg tablet 0 0 0 0 0 0
33 *Captopril 25 mg tablet 0 0 0 0 0 500
34 Captopril 50 mg tablet 0 0 0 0 0 0
35 Catgut Plain 2/0 buah 0 0 0 0 0 0
36 Catgut Plain 3/0 buah 0 0 0 0 0 0
37 Catgut Chromic 2/0 buah 0 0 0 0 0 0
38 Catgut Chromic 3/0 buah 0 0 0 0 0 0
39 Cefadroxil 500 mg kapsul 1300 0 1300 550 750 500
40 Cefadroxil sirup botol 0 10 10 10 0 10
41 Cetirizin 10 mg kapsul 0 0 0 0 0 300
42 Cetirizin Syr botol 7 0 7 3 4 0
43 Ciprofloksasin 500 mg tablet 0 0 0 0 0 1000
44 Colchicine 0.5 mg tablet 0 0 0 0 0 0
45 *Deksametason 0,5 mg tablet 0 0 0 0 0 3000
46 Deksametason + Dekslorfeniramin tablet 0 300 300 0 300 0
47 Deksametason , Neomycin Sulfat,Polimiksin B TM botol 0 10 10 10 0 10
48 Dental Mercury (Air Raksa) botol 0 0 0 0 0 0
49 Dentorit buah 0 0 0 0 0 0
50 Devitalisasi Pasta/Caustiner buah 0 0 0 0 0 0
51 Diazepam 5 mg tablet 0 0 0 0 0 0
52 *Diazepam 5 mg/ml ampul 0 0 0 0 0 0
53 Digoksin 0,25 mg tablet 0 0 0 0 0 0
54 Diltiazem 30 mg tablet 0 0 0 0 0 0
55 Difenhiramin Injeksi ampul 0 0 0 0 0 0
56 Spuit / Disposible 0.05 ml buah 0 0 0 0 0 0
57 Spuit / Disposible 0.5 ml buah 0 0 0 0 0 0
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOCK AKHIR PERMINTAAN

1 2 3 4 5 6(4+5) 7 8(6-7) 9
58 Spuit / Disposible 1 ml buah 300 0 300 100 200 0
59 Spuit / Disposible 2,5 ml buah 200 0 200 0 200 0
60 Spuit / Disposible 5 ml buah 200 0 200 0 200 0
61 Doksisiklin 100 mg tablet 0 0 0 0 0 0
62 Domperidon 10 mg tablet 0 0 0 0 0 500
63 Efedrin HCl 25 mg tablet 0 0 0 0 0 0
64 *Ephineprin Injeksi ampul 20 0 20 0 20 0
65 Erytromicin 500 mg kapsul 0 0 0 0 0 0
66 Erytromicin Sirup botol 0 0 0 0 0 0
67 Etakridin Liquid /Rivanol botol 9 0 9 5 4 5
68 Etil Klorida botol 1 1 2 1 1 1
69 Eugenol cairan botol 0 1 1 0 1 0
70 Fenobarbital 30 mg tablet 0 0 0 0 0 0
71 Fitomenadion tablet 0 0 0 0 0 100
72 *Fitomenadion Injeksi ampul 0 0 0 0 0 0
73 Fletcher serbuk & Cairan botol 0 0 0 0 0 0
74 Folic Acid tablet 0 0 0 0 0 0
75 Foley Catheter buah 0 0 0 0 0 0
76 Formaldehyd Phenol Liquid / Cresophen botol 0 0 0 0 0 0
77 Fuji GC 1x Mini/Glass Ionomer buah 0 1 1 0 1 0
78 Fuji GC IX Universal buah 0 0 0 0 0 0
79 *Furosemida 40 mg tablet 100 0 100 0 100 0
80 *Garam Oralit sak 0 0 0 0 0 500
81 Gemfibrosil 300 mg tablet 0 0 0 0 0 0
82 Gentamisin Sulfat Tetes mata botol 0 0 0 0 0 0
83 *Glibenklamide 5 mg tablet 200 0 200 0 200 0
84 Gliseril Guaiakolat 30 mg tablet 2000 0 2000 0 2000 1000
85 Glukose 40 % botol 0 0 0 0 0 0
86 Glukose 5 % botol 0 10 10 1 9 0
87 Griseofulvin 125 mg tablet 200 0 200 0 200 0
88 Hidroklorotiaside 25 mg tablet 0 0 0 0 0 0
89 Hidrokortison krim tube 20 0 20 20 0 20
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOCK AKHIR PERMINTAAN

1 2 3 4 5 6(4+5) 7 8(6-7) 9
90 Hidroklorotiaside 25 mg tablet 0 0 0 0 0 0
91 Hidrokortison krim tube 0 0 0 0 0 0
92 Ibuprofen 200 mg tablet 100 0 100 0 100 0
93 Ibuprofen 400 mg tablet 0 0 0 0 0 0
94 Infusion set adult Pcs 0 0 0 0 0 0
95 Infusion Set Pediatric Pcs 0 0 0 0 0 0
96 Iodoform Pastae/Mumyfing buah 1 0 1 0 1 0
97 Ipratropium Bromida+Salbutamol Sulfat tablet 0 0 0 0 0 0
98 Isosorbid Dinitrat tablet 200 0 200 0 200 0
99 Kalsium Hidroksida Pasta buah 0 0 0 0 0 0
100 Kalsium Laktat 500 mg tablet 400 0 400 0 400 0
101 Kapas 250 mg buah 1 2 3 1 2 2
102 Kasa Kompres 40x40 buah 7 10 17 14 3 10
103 Kasa Pembalut 4 x 15 buah 0 0 0 0 0 10
104 Kasa Steril 16 x 16 (isi 16 lembar) buah 4 10 14 14 0 10
105 Ketokonazole 200 mg tablet 50 100 150 50 100 100
106 Ketokonazole Krim tube 0 0 0 0 0 20
107 Klindamisin 150 mg kapsul 0 0 0 0 0 200
108 Kloramfenikol 250 mg kapsul 0 0 0 0 0 0
109 Kloramfenikol Salep Mata tube 0 0 0 0 0 10
110 Kloramfenikol sirup botol 0 0 0 0 0 0
111 Kloramfenikol Tetes Mata botol 0 0 0 0 0 10
112 Kloramfenikol Tetes Telinga botol 0 0 0 0 0 10
113 Klorfeniramin Maleat 4 mg tablet 1200 1000 2200 2200 0 3000
114 Kotrimoksasol 120 mg tablet 0 0 0 0 0 0
115 Kotrimoksasol 480 mg tablet 0 0 0 0 0 1000
116 Kotrimoksasol Sirup botol 9 10 19 19 0 20
117 Lanzoprasol 30 mg tablet 0 0 0 0 0 100
118 Larutan Benedict botol 0 0 0 0 0 0
119 Larutan H2O2 3 % botol 1 0 1 0 1 0
120 Larutan NaCl Infus botol 4 0 4 4 0 10
121 Lidokain Comp. Injeksi botol 0 10 10 0 10 0
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOCK AKHIR PERMINTAAN

1 2 3 4 5 6(4+5) 7 8(6-7) 9
122 Lincomisin 500 mg ampul 0 0 0 0 0 100
123 Lisol kapsul 5 0 5 1 4 0
124 Loperamide 2mg botol 0 0 0 0 0 300
125 Loratadine 10 mg tablet 100 0 100 0 100 0
126 *Magnesium Sulfat 20 % botol 0 0 0 0 0 0
127 Masker tablet 2 5 7 7 0 6
128 Meloksikam 15 mg buah 0 0 0 0 0 0
129 Meloksikam 7,5 mg tablet 0 0 0 0 0 300
130 Metformin 500 mg botol 0 0 0 0 0 0
131 Metilergometrin botol 0 0 0 0 0 0
132 *Metilergometrin Injeksi tablet 0 0 0 0 0 0
133 Metilprednisolon tablet 4 mg ampul 0 100 100 100 0 1000
134 Miconazole Krim tablet 0 24 24 24 0 20
135 Multivitamin sirup tube 0 0 0 0 0 0
136 Multivitamin tablet botol 0 0 0 0 0 300
137 Multivitamin Ibu hamil tablet 0 0 0 0 0 0
138 Natrium Diklofenak 50 mg tablet 0 300 300 100 200 100
139 Neomycin Sulfat, Placenta Extract (Bioplacenton) tube 7 0 7 0 7 0
140 Nifedipin 10 mg tablet 0 0 0 0 0 100
141 Nistatin Vaginal 100,000 ui tablet 0 0 0 0 0 0
142 *Obat Anti Tubercolosis tablet 0 0 0 0 0 0
143 Ofloksasin 400 mg tablet 0 0 0 0 0 0
144 Oksitetrasiklin Salep 3% Salep Kulit tube 0 0 0 0 0 20
145 Oksitetrasiklin Salep 1% Salep Mata tube 0 0 0 0 0 20
146 *Oksitocin Injeksi ampul 0 0 0 0 0 0
147 Omeprasole 20 mg kapsul 0 150 150 150 0 200
148 Papaverin 40mg kapsul 0 0 0 0 0 0
149 *Parasetamol 500 mg tablet 1100 1000 2100 1500 600 1000
150 Parasetamol Sirup tablet 0 20 20 20 0 30
151 Piracetam 800 mg botol 0 0 0 0 0 0
152 Pirantel 125 mg tablet 0 0 0 0 0 0
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOCK AKHIR PERMINTAAN

1 2 3 4 5 6(4+5) 7 8(6-7) 9
153 Piridoksin 10 mg tablet 0 0 0 0 0 0
154 Piroksikam 20 mg tablet 0 0 0 0 0 0
155 Plester 5 x 2 tablet 0 5 5 1 4 2
156 Policresulen Liquid ( Albothyl) botol 0 0 0 0 0 0
157 Povidon Iodida 30 ml buah 2 10 12 5 7 0
158 Povidon Iodida 300 ml botol 0 0 0 0 0 0
159 Povidon Iodida 60 ml botol 0 0 0 0 0 5
160 Prednison 5 mg botol 0 0 0 0 0 0
161 Propanolol 40 mg tablet 0 0 0 0 0 0
162 Pseudoefedrin + Tripolidin tablet 0 0 0 0 0 0
163 Ranitidin 150 mg tablet 0 0 0 0 0 1000
164 Ringer Laktat Infus tablet 4 5 9 8 1 10
165 Salbutamol 2 mg botol 0 0 0 0 0 0
166 Salbutamol 4 mg tablet 0 0 0 0 0 100
167 Salep 2-4 Salep kulit tablet 2 0 2 0 2 0
168 Salisil Bedak buah 0 0 0 0 0 10
169 Sarung Tangan pasang 10 5 15 0 15 0
170 Sefiksim 100 mg buah 0 0 0 0 0 0
171 Sefiksim sirup kapsul 0 0 0 0 0 0
172 Semen Seng Fosfat Serbuk&Cairan botol 0 0 0 0 0 0
173 Sianokobalamin 50 mcg buah 900 0 900 0 900 0
174 Simetidin 200 mg tablet 0 500 500 0 500 0
175 Simvastatin 10 mg tablet 0 180 180 120 60 200
176 *Sulfas Ferrosus 300 mg buah 0 0 0 0 0 0
177 Tetrasiklin 250 mg ampul 0 0 0 0 0 0
178 Tramadol 50 mg tablet 100 50 150 0 150 0
179 Urine Bag buah 0 0 0 0 0 0
180 Valsartan 80 mg buah 0 0 0 0 0 0
181 Vitamin B1 / Thiamin HCl 50 mg tablet 0 0 0 0 0 0
182 Vitamin B Kompleks tablet 0 0 0 0 0 300
183 Vitamin B1, B6, B12/ Neurotropik tablet 800 500 1300 500 800 500
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOCK AKHIR PERMINTAAN

1 2 3 4 5 6(4+5) 7 8(6-7) 9
184 Zinc 20 mg tablet 0 0 0 0 0 500
185 Obat Batuk Kombinasi tablet 0 0 0 0 0 0
186 (Dextromethorphan HBr, CTM, Noscapin) tablet 200 0 200 200 0 0
187 Acytromycin dycitrate tablet 0 0 0 0 0 0
188 Acytromycin tablet 120 0 120 0 120 0
189 Telmisartan tablet 40 0 40 0 40 0
190 Resuvastatin Calcium tablet 0 0 0 0 0 0

Ket : Obat yang bertanda * harus tersedia di Puskesmas apabila habis wajib diminta di LPLPO

Manado,
Kepala Puskesmas Petugas Puskesmas

dr. Anastasya Sampaleng Mia Puspita Hasan Amd. Far

NIP. 19800416 2010 01 2 004 NIP. 19871119 2010 01 2 002
: OKTOBER
: NOVEMBER
: 2018

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