LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

UNIT PENERIMA : KECAMATAN :

KOTA : AMBON BULAN :
PROVINSI : MALUKU TAHUN :
STOK RUSAK/ SISA STOK
NO NAMA OBAT SEDIAAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KET
AWAL KADALUARSA STOK OPTIMUM
1 2 3 4 5 6=4+5 7 8 9 = 6 - (7+8) 10 11 13

1 Acetylstein kapsul 200 mg Kaps 0 0 0 0

2 Albendazol 400 mg Tab 0 0 0 0
3 Allopurinol tab 100 mg Tab 0 0 0 0
4 Allopurinol tab 300 mg Tab 0 0 0 0
5 Alprazolam 0,25 mg Tab 0 0 0 0
6 Alprazolam 1 mg Tab 0 0 0 0
7 Ambroksol 30 mg Tab 0 0 0 0
8 Aminophilin inj Amp 0 0 0 0
9 Aminophilin tab 200 mg Tab 0 0 0 0
10 Amlodipin 10 mg Tab 0 0 0 0
11 Amlodipin 5 mg Tab 0 0 0 0
12 Amoksisilin 250 mg Tab 0 0 0 0
13 Amoksisilin 500 mg Tab 0 0 0 0
14 Amoksisilin Syr Kering 125 mg/5ml Btl 0 0 0 0
15 Amoksisilin Sirup Forte Btl 0 0 0 0
16 Anaton Tablet Tab 0 0 0 0
17 Anaton Sirup Btl 0 0 0 0
18 Antalgin tab 500 mg Tab 0 0 0 0
19 Antalgin Injeksi Amp 0 0 0 0
20 Antasida Sirup Btl 0 0 0 0
21 Antasida Tablet Tab 0 0 0 0
22 Anti Bakteri Doen (Bacitrasin Salep) Tube 0 0 0 0
23 Anti Fungi Salep Pot 0 0 0 0
24 Anti Hemoroid Suppositoria Suppo 0 0 0 0
25 Anti Migren Komb Tab 0 0 0 0
 STOK RUSAK/ SISA STOK
NO NAMA OBAT SEDIAAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KET
AWAL KADALUARSA STOK OPTIMUM
26 AquaPro Injeksi steril Vial 0 0 0 0
27 Arkine Tab 0 0 0 0
28 Asam Askorbat (Vit C) tablet 50 mg Tab 0 0 0 0
29 Asam Askorbat (Vit C) tablet 250 mg Tab 0 0 0 0
30 Asam Mefenamat 500 mg Tab 0 0 0 0
31 Asam Traneksamat inj Amp 0 0 0 0
32 Asam Folat Tab 0 0 0 0
33 Asetosal 100 mg Tab 0 0 0 0
34 Asiklovir 200 mg Tab 0 0 0 0
35 Asiklovir 400 mg Tab 0 0 0 0
36 Asiklovir cream Tube 0 0 0 0
37 Atorvastatin 20 mg Tab 0 0 0 0
38 Atropin Injeksi 0.25 mg/ml Amp 0 0 0 0
39 Azytromicyn tab Tab 0 0 0 0
40 Benzatin Benzil Injeksi Vial 0 0 0 0
41 Betadine Solution - 60 ml Btl 0 0 0 0
42 Betadine Solution - 1000 ml Btl 0 0 0 0
43 Besi II Sulfat (Tablet tambah darah) Tab 0 0 0 0
44 Betahistin Mesilat 6 mg Tab 0 0 0 0
45 Betametason Cream Tube 0 0 0 0
46 Bisakodil 5 mg Tab 0 0 0 0
47 Buscopan Tab 0 0 0 0
48 Buscopan 10 mg Tab Tab 0 0 0 0
49 Buscopan Plus Tab 0 0 0 0
50 Buscopan Injeksi Amp 0 0 0 0
51 Calcium Gluconate Injeksi Amp 0 0 0 0
52 Carbamazepin tablet 200mg Tab 0 0 0 0
53 Caviplex tablet Tab 0 0 0 0
54 Caviplex Sirup Btl 0 0 0 0
55 Caviplex Drops Btl 0 0 0 0
 STOK RUSAK/ SISA STOK
NO NAMA OBAT SEDIAAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KET
AWAL KADALUARSA STOK OPTIMUM
56 CD Asthenof Tetes Mata MD 0.6 ml Strip 0 0 0 0
57 CD Augenthonic Tetes Mata MD 0,6ml Strip 0 0 0 0
58 CD Carpine 1% Tetes Mata Btl 0 0 0 0
59 CD Catarlent Tetes Mata Btl 0 0 0 0
60 CD Catarlent Tetes Mata MD 0.6ml Strip 0 0 0 0
61 CD Efrisel 10% Tetes Mata Btl 0 0 0 0
62 CD Fenicol 0.25% Tetes Mata Btl 0 0 0 0
63 CD Floxa Tetes Mata MD 0.6 ml Strip 0 0 0 0
64 CD Genta 0.3% Tetes Mata Btl 0 0 0 0
65 CD Lyteers Tetes Mata Btl 0 0 0 0
66 CD Lyteers Tetes Mata MD 0.6 ml Strip 0 0 0 0
67 CD Mydriatil 0.5% Tetes Mata Btl 0 0 0 0
68 CD Pantocaine 0.5% Tetes Mata Btl 0 0 0 0
69 CD Pantocaine 2% Tetes Mata Btl 0 0 0 0
70 CD Polydek Tetes Mata Btl 0 0 0 0
71 CD Timol 0.5% Tetes Mata Btl 0 0 0 0
72 CD Tropin 0.5% Tetes Mata Btl 0 0 0 0
73 CD Xitrol Salep Mata Tube 0 0 0 0
74 CD Xitrol Tetes Mata MD 0.6 ml Strip 0 0 0 0
75 CD Xitrol Tetes Mata Btl 0 0 0 0
76 Cetrizin 10 mg Tab 0 0 0 0
77 Chloramex/Kloramfenicol 500 mg Tab 0 0 0 0
78 Citicolin Injeksi Amp 0 0 0 0
79 Ciprofloksasin 500 mg Tab 0 0 0 0
80 Clyndamisin 300 mg Kaps 0 0 0 0
81 Combivent UDV 0.5 mg Vial 0 0 0 0
82 Colcitine Tab 0 0 0 0
83 Daryantulle Lembar 0 0 0 0
84 Demacolin Tablet Tab 0 0 0 0
85 Dexametason 0,5 mg tab Tab 0 0 0 0
 STOK RUSAK/ SISA STOK
NO NAMA OBAT SEDIAAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KET
AWAL KADALUARSA STOK OPTIMUM
86 Dexametason injeksi 5 mg/ml - 1ml Amp 0 0 0 0
87 Diazepam 2 mg tab Tab 0 0 0 0
88 Diazepam Injeksi Amp 0 0 0 0
89 Difenhidramin Inj. 10 mg/ml- 1ml Amp 0 0 0 0
90 Digoksin 0.25 mg Tab 0 0 0 0
91 Diltiazem HCl Tab 0 0 0 0
92 Dimenhidrinat 50 mg Tab 0 0 0 0
93 Doksisiklin kapsl 100 mg Kaps 0 0 0 0
94 Domperidon 10 mg Tab 0 0 0 0
95 Domperidone Sirup Btl 0 0 0 0
96 Domperidon Tetes 5 mg/ml Btl 0 0 0 0
97 Dores Tab 0 0 0 0
98 Dulcolax Suppo 5 mg Suppo 0 0 0 0
99 Dulcolax Suppo 10 mg Suppo 0 0 0 0
100 Efedrin HCl 25mg/Bromifar Tab 0 0 0 0
101 Epinephrine Injeksi 0.1% Amp 0 0 0 0
102 Erytromicine 250 mg Tab 0 0 0 0
103 Erytromicine 500 mg Tab 0 0 0 0
104 Erytromicine Sirup Kering Btl 0 0 0 0
105 Etanol 70 % - 60 ml Btl 0 0 0 0
106 Etanol 70 % - 100 ml Btl 0 0 0 0
107 Etanol 70 % - 300 ml Btl 0 0 0 0
108 Etanol 70 % - 1000 ml Btl 0 0 0 0
109 Fenobarbital tab. 30 mg Tab 0 0 0 0
110 Fenol Gliserol Tetes Telinga Btl 0 0 0 0
111 Fitomenadion Inj 2 mg Amp 0 0 0 0
112 Fitomenadion Inj 10 mg Amp 0 0 0 0
113 Fitomenadion 10 mg Tablet Tab 0 0 0 0
114 Fluconazole 150 mg Tab 0 0 0 0
115 Furosemid 40 mg tab Tab 0 0 0 0
 STOK RUSAK/ SISA STOK
NO NAMA OBAT SEDIAAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KET
AWAL KADALUARSA STOK OPTIMUM
116 Furosemid inj Amp 0 0 0 0
117 Garam Oralit Sase 0 0 0 0
118 Genoint/Gentamisin Tetes Mata Btl 0 0 0 0
119 Gentamisin inj Amp 0 0 0 0
120 Gentamisin Salep Kulit Tube 0 0 0 0
121 Gentian Violet 1% Btl 0 0 0 0
122 Glibenklamid tablet 5 mg Tab 0 0 0 0
123 Gliseril Guayakolat tablet 100 mg/Guaifenesin Tab 0 0 0 0
124 Glimepirid 1 mg Tab 0 0 0 0
125 Glukosa Infus 10 % steril Btl 0 0 0 0
126 Glukosa Infus 5 % steril Btl 0 0 0 0
127 Griseovulfin 125 mg Tab 0 0 0 0
128 Haloperidol tablet 1,5 mg Tab 0 0 0 0
129 Hidroklortiaside (HCT) tablet 25 mg Tab 0 0 0 0
130 Hidrokortison cream 2,5 % Tube 0 0 0 0
131 H2O2 Cairan Btl 0 0 0 0
132 Ibuprofen 200 mg Tab 0 0 0 0
133 Ibuprofen 400 mg Tab 0 0 0 0
134 Ibuprofen suspensi Btl 0 0 0 0
135 Interzinc Sirup Btl 0 0 0 0
136 Isonat Tab 0 0 0 0
137 Isosorbid dinitrat sub lingual 5 mg Tab 0 0 0 0
138 KAEN 3B infus Btl 0 0 0 0
139 Kalsium Laktat (kalk) tab 500 mg Tab 0 0 0 0
140 Kaptopril 25 mg Tab 0 0 0 0
141 Kaptopril 50 mg Tab 0 0 0 0
142 Ketokonasole 200 mg Tab 0 0 0 0
143 Ketokonazole Krim Tube 0 0 0 0
144 Ketorolac Injeksi Amp 0 0 0 0
145 Klorampenicol 250 mg Kaps 0 0 0 0
 STOK RUSAK/ SISA STOK
NO NAMA OBAT SEDIAAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KET
AWAL KADALUARSA STOK OPTIMUM
146 Klorampenicol Salep Mata Tube 0 0 0 0
147 Klorampenikol susp 125 mg/ 5 ml Btl 0 0 0 0
148 Klorampenikol Tetes Telinga Btl 0 0 0 0
149 Klorfeniramin maleat (CTM) tab 4 mg Tab 0 0 0 0
150 Klorpromazin HCl tablet salut 25 mg Tab 0 0 0 0
151 Kodein Fosfat tab 10 mg Tab 0 0 0 0
152 Kodein Fosfat tab 15 mg Tab 0 0 0 0
153 Kombipak (Azyt-Cefix) Paket 0 0 0 0
154 Komb. Injeksi Depot G Vial 0 0 0 0
155 Kotrimoksazol Suspensi Btl 0 0 0 0
156 Kotrimoksazol 480 mg Tab 0 0 0 0
157 Kotrimoksazol 120 mg Tab 0 0 0 0
158 Laxamet 200 mg Tab 0 0 0 0
159 Lexavit Tab Tab 0 0 0 0
160 Lidokain injeksi Amp 0 0 0 0
161 Lisol - 1000 ml Btl 0 0 0 0
162 Livitan Sirup Btl 0 0 0 0
163 Lodomer 2 mg Tab 0 0 0 0
164 Loperamid 2 mg Tab 0 0 0 0
165 Loratadin 10mg Tab 0 0 0 0
166 Magnesium Sulfat (MgSO4) 20 Vial 0 0 0 0
167 Magnesium Sulfat (MgSO4) 40 Amp 0 0 0 0
168 Mersibion Injeksi Amp 0 0 0 0
169 Metaneuron Tab 0 0 0 0
170 Metformin HCl 500 mg Tab 0 0 0 0
171 Metformin HCl 850 mg Tab 0 0 0 0
172 Metilergometrin maleat injeksi Amp 0 0 0 0
173 Metilprednisolon 4 mg Tab 0 0 0 0
174 Metilprednisolon 8 mg Tab 0 0 0 0
175 Metoklopramide 10 mg Tab 0 0 0 0
 STOK RUSAK/ SISA STOK
NO NAMA OBAT SEDIAAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KET
AWAL KADALUARSA STOK OPTIMUM
176 Metrodinasole tab 250 mg Tab 0 0 0 0
177 Metrodinasole tab 500 mg Tab 0 0 0 0
178 Mikonasole Krim Tube 0 0 0 0
179 Mikrodial (Pil KB) Strip 0 0 0 0
180 Miniaspi 80 mg Tab 0 0 0 0
181 Molaneuron Tab 0 0 0 0
182 Natrium Diklofenak tab 50 mg Tab 0 0 0 0
183 Natrium klorida lar.Infus 0,9 % steril Btl 0 0 0 0
184 Neuraxon Tablet Tab 0 0 0 0
185 Neurodex Tab 0 0 0 0
186 Neurobion 5000 mg tab Tab 0 0 0 0
187 New Antides Tab 0 0 0 0
188 New Baby Cough Sirup Btl 0 0 0 0
189 Nifedipin tab 10 mg Tab 0 0 0 0
190 Nistatin 500.000 IU Tab 0 0 0 0
191 Nistatin 100.000 IU Tab 0 0 0 0
192 Noza Tab 0 0 0 0
193 OAT I FDC Paket 0 0 0 0
194 Obat Anti Tuberkulosis Kat. II Paket 0 0 0 0
195 Obat Anti Tuberkulosis Kat. Anak Paket 0 0 0 0
196 Obat FDC Anak Paket 0 0 0 0
197 OBH Combi Anak Btl 0 0 0 0
198 OBH Itra Btl 0 0 0 0
199 Oksitetrasiklin HCl inj 50 mg/ml-10 ml Vial 0 0 0 0
200 Oksitetrasiklin HCl Salep mata Tube 0 0 0 0
201 Oksitosin inj 10 IU/ml-1ml Amp 0 0 0 0
202 Omeprazole 20 mg Kaps 0 0 0 0
203 Ondansentron inj Amp 0 0 0 0
204 Oxibiotic Injeksi Vial 0 0 0 0
205 Papaverin 40 mg Tab 0 0 0 0
 STOK RUSAK/ SISA STOK
NO NAMA OBAT SEDIAAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KET
AWAL KADALUARSA STOK OPTIMUM
206 Parasetamol Drops Btl 0 0 0 0
207 Parasetamol Syrup 120 mg/ 5 ml Btl 0 0 0 0
208 Parasetamol 500 mg Tab 0 0 0 0
209 Pehacain inj Amp 0 0 0 0
210 Pharmaton Formula Tab 0 0 0 0
211 Piracetam 400 mg Tab 0 0 0 0
212 Piracetam Injeksi Amp 0 0 0 0
213 Piroksikam 10 mg Tab 0 0 0 0
214 Piroksikam 20 mg Tab 0 0 0 0
215 Povidon iodida 10 % - 30 ml Btl 0 0 0 0
216 Povidon iodida 10 % - 60 ml Btl 0 0 0 0
217 Povidon iodida 10 % - 300 ml Btl 0 0 0 0
218 Povidon iodida 10 % - 1000 ml Btl 0 0 0 0
219 Prednison tablet 5 mg Tab 0 0 0 0
220 Primakuin Tab 0 0 0 0
221 Probenid 500 mg Tab 0 0 0 0
222 Propranolol HCl 40 mg Tab 0 0 0 0
223 Propil tiouracil tablet 100 mg Tab 0 0 0 0
224 Pyrantel tab 125 mg Tab 0 0 0 0
225 Pyrantel Sirup Btl 0 0 0 0
226 Pyridoxin 10 mg (vit.B6) tablet Tab 0 0 0 0
227 Ranitidin inj Amp 0 0 0 0
228 Ranitidin tablet 150 mg Tab 0 0 0 0
229 Resperidon 2 mg Tab 0 0 0 0
230 Retinol 100.000 IU Softkaps 0 0 0 0
231 Retinol 200.000 IU Softkaps 0 0 0 0
232 Rimfampicin 450 mg Kap 0 0 0 0
233 Ringer lactat lar.infus Btl 0 0 0 0
234 Rivanol larutan 0,1 % Btl 0 0 0 0
235 Salbutamol 4 mg tab Tab 0 0 0 0
 STOK RUSAK/ SISA STOK
NO NAMA OBAT SEDIAAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KET
AWAL KADALUARSA STOK OPTIMUM
236 Salep 2-4 Pot 0 0 0 0
237 Salicyl bedak 2 % Ktk 0 0 0 0
238 Sefadroksil 500 mg Tab 0 0 0 0
239 Sefadroksil Sirup Btl 0 0 0 0
240 Sefiksim 100mg Kaps 0 0 0 0
241 Sefiksim Azitromisin Paket 0 0 0 0
242 Sefotaksim inj Vial 0 0 0 0
243 Seftriakson inj Vial 0 0 0 0
244 Sianokobalamin ( Vit.B12) Injeksi Amp 0 0 0 0
245 Simetidin 200 mg Tab 0 0 0 0
246 Simvastatin tab 10 mg Tab 0 0 0 0
247 Simvastatin tab 20 mg Tab 0 0 0 0
248 Spironolactone 100 mg Tab 0 0 0 0
249 Stesolid supp Tube 0 0 0 0
250 Sulfadiazine Krim Tube 0 0 0 0
251 Tamofen 10 mg Tab 0 0 0 0
252 Teosal Tab 0 0 0 0
253 Tetraciklin HCL kap 500 mg Kaps 0 0 0 0
254 Thiamin HCL injeksi Amp 0 0 0 0
255 Thiamin HCL/Mononitrat (Vit. B1) tab 50 mg Tab 0 0 0 0
256 Thyrax Tab 0 0 0 0
257 Triheksifenidil Tablet 2 mg Tab 0 0 0 0
258 Valisanbe Tablet 2 mg Tab 0 0 0 0
259 Valisanbe Tablet 5 mg Tab 0 0 0 0
260 Vaksin Verorab/Rabies Vial 0 0 0 0
261 Vaksin BCG Vial 0 0 0 0
262 Vitamin B compleks tab Tab 0 0 0 0
263 Vitamin B 12 Tablet Tab 0 0 0 0
264 Wibrom Tab 0 0 0 0
265 Zinkid Sirup Btl 0 0 0 0
 STOK RUSAK/ SISA STOK
NO NAMA OBAT SEDIAAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KET
AWAL KADALUARSA STOK OPTIMUM
266 Zink Tablet Tab 0 0 0 0
267 Zink Sirup Btl 0 0 0 0
OBAT GIGI
268 Calsium Hidroksida Pasta Tube 0 0 0 0
269 Caviton Ktk 0 0 0 0
270 Clorfenol Khamfer Menthol (CHKM) Btl 0 0 0 0
271 Devitalisasi Pasta (non arsen) Btl 0 0 0 0
272 Ethyl kloride semprot Btl 0 0 0 0
273 Eugenol Cairan Btl 0 0 0 0
274 Glass Ionomer Cement Btl 0 0 0 0
275 Mummifying pasta Btl/ktk 0 0 0 0
276 Semen Seng fosfat serbuk dan cairan Btl/ Set 0 0 0 0
277 Xylocain Spray Btl 0 0 0 0
ALAT KESEHATAN
278 Alat Suntik Sekali Pakai 0.05 ml Pcs 0 0 0 0
279 Alat Suntik Sekali Pakai 0.5 ml Pcs 0 0 0 0
280 Alat Suntik sekali pakai 1 ml Pcs 0 0 0 0
281 Alat suntik sekali pakai 3ml Pcs 0 0 0 0
282 Alat suntik sekali pakai 5 ml Pcs 0 0 0 0
283 Alkohol Swab Pcs 0 0 0 0
284 Aseptic Gel 500cc + Dispenser Btl 0 0 0 0
285 Blood Lancet Pcs 0 0 0 0
286 Blood Transfusi Set Pcs 0 0 0 0
287 Catgut Cromic No. 3/0 Pcs 0 0 0 0
288 Catgut Cromic No. 2/0 Pcs 0 0 0 0
289 Catgut Plain No. 3/0 Pcs 0 0 0 0
290 Catgut Plain No. 2/0 Pcs 0 0 0 0
291 Cover Glass Pcs 0 0 0 0
292 Cuticell 10 x 10 cm Pcs 0 0 0 0
293 Fixomul Rol 0 0 0 0
 STOK RUSAK/ SISA STOK
NO NAMA OBAT SEDIAAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KET
AWAL KADALUARSA STOK OPTIMUM
294 Folley Cateter No. 16 Set 0 0 0 0
295 Folley Cateter No. 18 Pcs 0 0 0 0
296 HCl 0.1N Btl 0 0 0 0
297 Infusion set anak Set 0 0 0 0
298 Infusion set dewasa Set 0 0 0 0
299 IV Cateter No. 20 G Pcs 0 0 0 0
300 IV Cateter No. 22 G Pcs 0 0 0 0
301 IV Cateter No. 24 G Pcs 0 0 0 0
302 Jelly 82 gram Tube 0 0 0 0
303 Kapas 250 gr Bks 0 0 0 0
304 Kapas 500 gr Bks 0 0 0 0
305 Kapas 1000 gr Bks 0 0 0 0
306 Kasa Hydrofil steril 16 x 16 cm Lembar 0 0 0 0
307 Kasa Hydrofil steril 10 x 10 cm Rol 0 0 0 0
308 Kasa Hydrofil steril 5 x 5 cm Rol 0 0 0 0
309 Kasa Pembalut Hydrofil 4 x 3 cm Rol 0 0 0 0
310 Kasa Pembalut Hydrofil 4 x 5cm Rol 0 0 0 0
311 Kasa Pembalut Hydrofil 4 x 10 cm Rol 0 0 0 0
312 Kasa Pembalut Hydrofil 4 x 15cm Rol 0 0 0 0
313 Kasa Pembalut Hydrofil 40 x 80 yard Rol 0 0 0 0
314 Klip Obat 8 x 15 cm Pcs 0 0 0 0
315 Klip Obat 10 x 15 cm Pcs 0 0 0 0
316 Klip Obat 5 x 8 cm Pcs 0 0 0 0
317 Klip Obat 6 x 10 cm Pcs 0 0 0 0
318 Masker Nebulizer Anak Buah 0 0 0 0
319 Masker Nebulizer Dewasa Buah 0 0 0 0
320 Leukoplast 1625H Rol 0 0 0 0
321 Maxter Exam Non Powder L Pcs 0 0 0 0
322 Maxter Exam Non Powder M Pcs 0 0 0 0
323 Maxter Exam Non Powder S Pcs 0 0 0 0
 STOK RUSAK/ SISA STOK
NO NAMA OBAT SEDIAAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KET
AWAL KADALUARSA STOK OPTIMUM
324 My Jelly 82 gram Tube 0 0 0 0
325 Nurce Cap Pcs 0 0 0 0
326 Object Glass Pcs 0 0 0 0
327 One Scrub 500 cc + Dispenser Btl 0 0 0 0
328 One scrub 5 L Galon 0 0 0 0
329 Safa Gloves No. 6 Pasang 0 0 0 0
330 Safa Gloves No. 7 Pasang 0 0 0 0
331 Safa Gloves No. 7,5 Pasang 0 0 0 0
332 Safa Gloves No. 8 Pasang 0 0 0 0
333 Safety Box Buah 0 0 0 0
334 Sarung Tangan Obgyn Pasang 0 0 0 0
335 Silk 2/0 Pcs 0 0 0 0
336 Silk 3/0 Pcs 0 0 0 0
337 Stera Syringe 10cc Pcs 0 0 0 0
338 Surgical Blades No 11 Pcs 0 0 0 0
339 Surgical Blades No 12 Pcs 0 0 0 0
340 Surgical Mask Earloop Plus Pcs 0 0 0 0
341 Surgical Mask Earloop Pcs 0 0 0 0
342 Surgical Mask With Visor Pcs 0 0 0 0
343 Surgical Mask Tie On Pcs 0 0 0 0
344 Surgical Grown Spulance Pcs 0 0 0 0
345 Surgical Gown Non Woven Pcs 0 0 0 0
346 Test Glukosa Stik 0 0 0 0
347 Test Uric Acid Stik 0 0 0 0
348 Test Hemoglobin Stik 0 0 0 0
349 Test Kolesterol Stik 0 0 0 0
350 Ultra/Ultraone Tes Hamil Pcs 0 0 0 0
351 Urine Bag Steril Pcs 0 0 0 0
352 USG Jelly 250 ml Btl 0 0 0 0
OBAT BPJS
 STOK RUSAK/ SISA STOK
NO NAMA OBAT SEDIAAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KET
AWAL KADALUARSA STOK OPTIMUM
353 Alpara Tab
354 Ambeven Kaps
355 Ambroksol Suspensi Btl
356 Aminophylin 100 mg Tab
357 Amoxsan Drop Btl
358 Analsik Tab
359 Andalan I Vial
360 Andalan II Vial
361 Andalan III Vial
362 Asam Traneksamat 500 mg Tab
363 Askamex Tab
364 Aspilet Thrombo Tab
365 Atofar 20 mg Tab
366 Avil 25 mg Tab
367 B Com. C Tab
368 Baby Cough Sirup Btl
369 Batugin Sirup 120 ml Btl
370 Batugin Sirup 300 ml Btl
371 Betadine Salep Tube
372 Betason-N Cream 5 gr Tube
373 Biolysin Sirup Btl
374 Bioplacenton Jelly Tube
375 Bisolvon Sirup Btl
376 Bisolvon Solution 50 ml Btl
377 Bisolvon Tab
378 Bisoprolol Tab
379 Bodrex Tab
380 Buffect Sirup Btl
381 Canderin 8 mg Tab
382 Candersartan 16 mg Tab
 STOK RUSAK/ SISA STOK
NO NAMA OBAT SEDIAAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KET
AWAL KADALUARSA STOK OPTIMUM
383 Candersartan 8 mg Tab
384 Cardio Aspirin Tab
385 Cataflam 25 mg Tab
386 Cataflam 50 mg Tab
387 Cataflam tab 12,5 mg Tab
388 Cefixim tab 200 mg Tab
389 Cendo Cenfresh Btl
390 Cendo Cortihist 5 cc Btl
391 Cendohyaluph EyeDrop Btl
392 Cetrizine Drops Btl
393 Cetrizine Sirup 60 ml Btl
394 Clindamicin 150 mg Kaps
395 Clopidogrel Tab
396 Costil Sirup Btl
397 Counterpain Cream Tube
398 Curcuma Plus Sirup Btl
399 Curcuma Sirup Btl
400 Curcuma Tab
401 Curvit Sirup Btl
402 Decadryl Eksp Btl
403 Dexanta Sirup Btl
404 Dextafen Kaps
405 Dietylcarbamazepin Tab
406 Duramycin Tab
407 Efiline Tab
408 Elkana Sirup Btl
409 Enervon - C Tab
410 Epexol Drops Btl
411 Epsonal Tab
412 Erlamycetin Ear Drop Btl
 STOK RUSAK/ SISA STOK
NO NAMA OBAT SEDIAAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KET
AWAL KADALUARSA STOK OPTIMUM
413 Erlamycetin Plus Salep Mata Tube
414 Erlamycetin Plus Tetes Telinga Btl
415 Erphafilin Tab
416 Esperson Cream Tube
417 Estin Drops Btl
418 Fasidol 500 mg Kaps
419 Fasidol Drops Btl
420 Fervital Tab
421 FG Troches Tab
422 Flutamol Plus Tab
423 Flutamol Sirup Btl
424 Flutamol Tab
425 Gabapentin 300 mg Tab
426 Gamexan Tube
427 Genoint Salep Kulit Tube
428 Glaucon Tab
429 Glimepiride 2 mg Tab
430 Glimepiride tab 3 mg Tab
431 Griseofulvin 500 mg Tab
432 H2 O2 3% 800 ml Btl
433 Haloperidol tab 2 mg Tab
434 Haloperidol tablet 0,5 mg Tab
435 Hervis Eye Oint Tube
436 Hufagrip Flu Sirup Btl
437 Hufagrip Sirup Btl
438 Ichtiol Salep Pot
439 Ifison tab Tab
440 Imboost Force Caplet Kap
441 Imboost Force Sirup Btl
442 Imboost Kids Sirup Btl
 STOK RUSAK/ SISA STOK
NO NAMA OBAT SEDIAAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KET
AWAL KADALUARSA STOK OPTIMUM
443 Imboost Syrup Btl
444 Imboost Tab
445 Imudator Sirup Btl
446 Imudator Tab
447 Imunvit Plus Kaps
448 Inerson Salep 15 gram Tube
449 Inpepsa Sirup Btl
450 Intunal - F Tab
451 Intunal Sirup Btl
452 Intunal Tab
453 Irgapan tab 200 mg Tab
454 Izoniasid ( INH ) 100 mg Tab
455 Izoniasid ( INH ) 300 mg Tab
456 Kalium Diklofenak 25 mg Tab
457 Kalium Diklofenak 50 mg Tab
458 Kanamycin 1 GK injeksi Vial
459 Kaptopril 12,5 mg Tab
460 Klorpromazin 25 mg Tab
461 Lacto - B Sase
462 Lando 300 mg Tab
463 Lansoprazole Kaps
464 Leukoplast 7,5 x 4,5 Rol
465 Levofloxacin Tab
466 Little Ulysin 100 ml Btl
467 Livron B Plex Tab
468 Lodia Tab
469 Lycalvit Sirup Btl
470 Matovit Tab
471 Matrix tab 1 mg Tab
472 Mefinal 500 mg Tab
 STOK RUSAK/ SISA STOK
NO NAMA OBAT SEDIAAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KET
AWAL KADALUARSA STOK OPTIMUM
473 Megabal Kaps
474 Meloxicam 15 mg Tab
475 Meloxicam 7.5 mg Tab
476 Merislon 12 mg Tab
477 Merislon 6 mg Tab
478 Mertigo Tab
479 Mesol 4 mg Tab
480 Mesol 8 mg Tab
481 Methylcobal 500 mg Tab
482 Metoklopramide 5 mg Tab
483 Microlax Tube
484 Mixagrip Flu & Batuk Tab
485 Mucera Drops Btl
486 Mucera Sirup Btl
487 Mucohexin / Wibron Tab
488 Mucopect Sirup Btl
489 Mucos Drops 20 ml Btl
490 Mylanta Sirup 50 ml Btl
491 Natabion Tab
492 Natrium Diklofenak tab 25 mg Tab
493 Nebacetin Powder Btl
494 Neo Kaolana Sirup Btl
495 Neuralgin tab Tab
496 Neurobion 5000 injeksi Amp
497 Neurobion Putih Tab
498 Neurohax Tab
499 Neurosanbe 5000 Tab
500 Neurosanbe Inj Amp
501 New Diatab Tab
502 Nonflamin Kaps
 STOK RUSAK/ SISA STOK
NO NAMA OBAT SEDIAAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KET
AWAL KADALUARSA STOK OPTIMUM
503 Obat Batuk Ibu Dan Anak 75 ml Btl
504 Oksaderm Salep Kulit Tube
505 Ondansentron 5 mg Tab
506 Ondansentron 8 mg Tab
507 Opthalgon 5 ml Btl
508 Osteor Kaps
509 Otopain Tetes Telinga Btl
510 Oxytetra Salep Kulit 5 gr Tube
511 Pamol Drops Btl
512 Paratusin Tab
513 Phenitoin Sodium 100 mg Tab
514 Pimacolin Sirup Btl
515 Pimtrakol Sirup Btl
516 Piracetam 1200 mg Tab
517 Piracetam 800 mg Tab
518 Pirexin Supp 160 mg Suppo
519 Pirexin Supp 80 mg Suppo
520 Polysilane Sirup Btl
521 Propepsa Sirup Btl
522 Proris Sirup Btl
523 Protocin Liquid Btl
524 Protogenta 5 ml Btl
525 Pyrazinamide 500 mg Tab
526 Pytramic 500 mg Tab
527 Redoxon Eff Zinc Tab
528 Regumen Tab
529 Renadinac 25 mg Tab
530 Rhinofed Tab
531 Rhinos Kaps
532 Rhinos Drops Btl
 STOK RUSAK/ SISA STOK
NO NAMA OBAT SEDIAAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KET
AWAL KADALUARSA STOK OPTIMUM
533 Rhinos Junior Sirup Btl
534 Risperidone 2 mg Tab
535 Sagestam Cream 10 gr Tube
536 Salbulin CFC ( Inhaler ) Btl
537 Salbutamol tab 2 mg Tab
538 San - B Plex Tab
539 Sanadryl DMP Syr Btl
540 Sanadryl Exp Sirup Btl
541 San-B Plex Drops Btl
542 Sanmol 500 mg Tab
543 Sanmol Drops Btl
544 Sanmol Sirup Btl
545 Scabimite Cream 10 gr Tube
546 Scabimite Cream 30 gr Tube
547 Scabimite Cream 5 gr Tube
548 Scopamin Plus Tab
549 Scopamin Tab
550 Scopma Plus Tab
551 Selviplex Tab
552 Siloxan EyeDrop 5 ml Btl
553 Simcobal 500 mg Kaps
554 Simdrol 4 mg Tab
555 Simprofen 25 mg Tab
556 Sohobion 5000 Tab
557 Starbion Tab
558 Stimuno Sirup Btl
559 Supertin Kaps
560 Suprafit Kaps
561 Thrombopop Gel Tube
562 Tobradex 5 ml Btl
 STOK RUSAK/ SISA STOK
NO NAMA OBAT SEDIAAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KET
AWAL KADALUARSA STOK OPTIMUM
563 Tobroson 5 ml Btl
564 Tranec 500 mg Tab
565 Transamin Tab
566 Univit Plus Lysin Btl
567 Univit Sirup Btl
568 Vasacon A Eye Drop Btl
569 Vasacon A. 15 ml Btl
570 Ventolin Nebuleser 2,5 mg Btl
571 Vernacel Eye Drop Btl
572 Vertigosan Tab
573 Vicolsin Sirup Btl
574 Vit B. Complex Injeksi Vial
575 Vitrolenta Eye Drop Btl
576 Voltaren Emulgel 1% 10 gr Tube
577 Vomistop Sirup Btl
578 Vomitas Sirup Btl
579 Zecaneron Kaps
580 Zircum Kids Sirup Btl
OBAT TAMBAHAN
 STOK RUSAK/ SISA STOK
NO NAMA OBAT SEDIAAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN KET
AWAL KADALUARSA STOK OPTIMUM

UMUM
BPJS JUMLAH
JUMLAH KUNJUNGAN RESEP BULAN…................. BAYAR GRATIS/KTP JAMKESMAS

Mengetahui / Menyetujui Yang Meminta/Melapor

Pimpinan Puskesmas Penanggung jawab farmasi Puskesmas

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