LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBA

PUSKESMAS KAB. TAPANULI TENGAH

PUSKESMAS :
KECAMATAN :
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN

1 2 3 4 5 6 = (4 + 5 ) 7
1 AIR UNTUK INJEKSI BOTOL
2 ALAT SUNTIK DISP. 3 ML SET
3 ALAT SUNTIK DISP. 5 ML SET
4 ALCOHOL SWAB PCS
5 ALKACIDE 1 LITER BOTOL
6 ALKAZYME SAK
7 ALKOHOL 70% 1 LITER BOTOL
8 ALOPURINOL 100 MG TABLET
9 AMINOFILIN 150 MGTABLET TABLET
10 AMLODIPIN 10 MG TABLET TABLET
11 AMLODIPIN 5 MG TABLET
12 AMOKSISILIN 500 MG KAPLET
13 AMOKSISILIN SYRUP KERING FORTE 250MG/5ML BOTOL
14 AMPHETAMIN CHECK TEST PCS
15 ANTACIDA DOEN I TAB TABLET
16 ANTACIDA DOEN II SUSPENSI BOTOL
17 ANTIFUNGI SALEP POT
18 ANTIHEMMOROID SUPP SUPP
19 ASAM ASKORBAT (VIT C) 250 MG TABLET
20 ASAM ASKORBAT (VIT C) 50 MG TABLET
21 ASAM FOLAT (A FOLAT) 0,4 MG TABLET
22 ASAM MEFENAMAT 500 MG TABLET
23 ASAM TRANEKSAMAT INJEKSI AMPUL
24 ASEPTAN BOTOL
25 ASERING BOTOL
26 ASETIL SISTEIN 200 MG KAPSUL
27 ASIKLOVIR TABLET 200 MG TABLET
28 ASIKLOVIR TABLET 400 MG TABLET
29 ATROPIN INJEKSI 0,35 MG/ ML AMPUL
30 BEROTEC INHALER BOTOL
31 BETAHISTIN TAB 6 MG TABLET
32 BETAMETASON KRIM 0,1% (SBG VALERAT) TUBE
33 BISAKODIL 5 MG TABLET (DULCOLAX) TABLET
34 BISAKODIL SUSP (DULCOLAX SUPP) SUPP
35 BRACKET PCS
36 BURNAZIN (PERAK SULFADIAZIN KRIM 1%) TUBE
37 OSTOVEL (KALSITROL) TABLET
38 CAPTOPRIL 12,5 MG TABLET
39 CAPTOPRIL 25 MG TABLET
40 CATGUT CHROMIC 2/0 PCS
41 CEFADROXIL 500 MG SYRUP SYRUP
42 CEFOTAXIM INJ VIAL
43 CEFTRIAXONE INJ VIAL
44 CETIRIZINE SYRUP BOTOL
45 CETIRIZINE TABLET TABLET
46 CHLORAMPHENICOL SALEP KULIT 2% (BUFACETIN) TUBE
47 CHLORPHENIRAMIN MALEAT (CTM) TABLET
48 CIPROFLOXACIN 500 MG TABLET
49 CLINDAMYCIN 300 MG CAPSUL
50 CLOPIDOGREL TABLET 75 MG TABLET
51 CODEIN 10 MG TABLET
52 CONCOR (BISOPROLOL) 1,25 MG TABLET
53 COTRIMOXAZOLE SUSPENSI BOTOL
54 COTRIMOXAZOLE TABLET DEWASA 480 mg TABLET
55 DARYANT TULE PCS
56 DEKSTROFEN SYRUP BOTOL
57 DENOMIX CREAM 10 GRAM TUBE
58 DEXAMETASONE INJEKSI IV/IM 5MG/ML AMPUL
59 DEXAMETASONE TABLET 0,5 MG TABLET
60 DEXOCORT KRIM TUBE
61 DIAZEPAM LAR.REKTAL (STESOLID) 10MG/2,5ML TUBE
62 DOMPERIDON 10 MG TABLET TABLET
63 DOMPERIDON SYRUP BOTOL
64 EPINEFRIN INJEKSI AMPUL
65 EUGENOL BOTOL
66 FOLLEY CATHETER SET
67 FUROSEMID 40 MG TABLET
68 GARAM ORALIT SAK
69 GENTAMYCIN TETES MATA 0,3% BOTOL
70 GLIBENKLAMIDE 5 MG TAB TABLET
71 GLIMEPIRID 2 MG TABLET
72 GLUKOSA LARUTAN INFUS 5% STERIL BOTOL
73 GRISEOFULVIN 125 MG TAB TABLET
74 GRISEOFULVIN 500 MG TABLET
75 HANDSCHOON NON STERIL L PCS
76 HANDSCHOON NON STERIL M PCS
77 HANDSCHOON OBSGYN PCS
78 HANDSCHOON STERIL PASANG
79 HIDROKLORTIAZID 25 MG TABLET
80 HIDROKORTISON 2,5% KRIM TUBE
81 HUSTAB SIRUP BOTOL
82 HUSTAB TABLET TABLET
83 IBUPROFEN 200 MG TABLET TABLET
84 IBUPROFEN 400 MG TABLET TABLET
85 IBUPROFEN SUSPENSI BOTOL
86 ILLIADIN (OKSIMETAZOLIN) TETES HIDUNG 0,050% BOTOL
87 INFUSION SET ANAK (PEDIATRIC) PCS
88 INFUSION SET DEWASA SET
89 ISOSORBID DINITRAT 5MG (FASORBID) TABLET
90 IV CATH PEN 18 PCS
91 IV CATH PEN 20 PCS
92 IV TROVENOCATH 18 PCS
93 IV TROVENOCATH 20 PCS
94 IV TROVENOCATH 22 PCS
95 IV TROVENOCATH 24 PCS
96 KALSIUM LAKTAT 500 MG TABLET
97 KAPAS PEMBALUT 250 GRAM PCS
98 KARBOGLISERIN TETES TELINGA 10% BOTOL
99 KASA PEMBALUT HIDROFIL 4 M X 15 CM ROL
100 KASSA HIDROFIL STERIL 16X16 KTK
101 KETOKONAZOLE 200 MG TABLET
102 KETOKONAZOLE KRIM TUBE
103 KETOPROPEN SUPP SUPP
104 KETOROLAC INJEKSI 30 MG/ML AMPUL
105 LANSOPRAZOLE 30 MG KAPSUL
106 LIDOKAIN 2% + EPINEFRIN 1 : 80.000 AMPUL
107 LIDOKAIN INJEKSI 2% (HCL) AMPUL
108 LOPERAMIDE TAB 2 MG TABLET
109 LORATADINE 10 MG TABLET
110 LYSOL 1 LITER BOTOL
111 MARIYUANA RAPID TEST PCS
112 MASKER PCS
113 MEBENDAZOLE 500 MG (VERMOX) TABLET
114 METFORMIN 500 MG TABLET
115 METHYL PREDNISOLON 4 MG TABLET
116 METIL ERGOMETRIN INJEKSI 0,2MG/ML AMPUL
117 METIL ERGOMETRIN MALEAT 0,175 MG TABLET
118 METOKLOPAMID DROP BOTOL
119 METOKLOPRAMID 5 MG TABLET TABLET
120 METRONIDAZOLE 500 MG TABLET
121 METRONIDAZOLE OVULA (VAGIZOL) SUPP
122 METRONIDAZOLE SUSPENSI BOTOL
123 MIKONAZOLE KRIM 2% (SBG NITRAT) TUBE 10 GR
124 MINERAL MIX SAK
125 NACL 0,9% LARUTAN INFUS BOTOL
126 NATRIUM DIKLOFENAK 25 MG TABLET
127 NATRIUM DIKLOFENAK 50 MG TABLET
128 NEW ANTIDWTS (ATAPULGIT) TABLET
129 NIFEDIPIN 10 MG TAB TABLET
130 OKSITETRASIKLIN SALEP MATA TUBE
131 OKSITOSIN INJEKSI AMPUL
132 OMEPRAZOLE 20 MG CAPSUL KAPSUL
133 ONDANSETRON INJEKSI 2MG/ ML AMPUL
134 PARACETAMOL DROP 100MG/ML BOTOL
135 PARACETAMOL SYRUP 120MG/5ML BOTOL
136 PARASETAMOL TABLET 500 MG TABLET
137 PHYTOMENADION INJEKSI AMPUL
138 PHYTOMENADION TABLET TABLET
139 PIRANTEL PAMOAT 125 MG TABLET TABLET
140 PIRANTEL PAMOAT SUSPENSI 125 MG BOTOL
141 PIRIDOKSIN (VIT B6) INJEKSI AMPUL
142 PIRIDOKSIN (VIT B6) TAB 10 MG (HCL) TABLET
143 PLESTER ISOPLAST 5YARD X 2 INCH ROL
144 PLESTER PHARMAFIX 10 CM X 500 CM ROL
145 PLESTER POLIFIX 5 CM X 1 M ROL
146 POVIDON IODIDA 10% 300 ML BOTOL
147 PREDNISON 5 MG TABLET
148 PULMICORT TURBUHALER 200 TURB
149 RANITIDIN INJEKSI AMPUL
150 RISTONAT 35 MG TABLET
151 SAFETY BOX PCS
152 SALBUTAMOL 4 MG TABLET
153 SALBUTAMOL SYRUP BOTOL
154 SALEP ANTIFUNGI POT
155 SALISIL BEDAK SERBUK 2% SAK
156 SCABIMITE CREAM TUBE
157 SELANG OKSIGEN M PCS
158 SELANG OKSIGEN XS PCS
159 SIANOKOBALAMIN (VIT B12) 50 MCG TABLET
160 SIANOKOBALAMIN (VIT B12) INJ 500MCG AMPUL
161 SILK BLACK PCS
162 SIMVASTATIN TABLET 10 MG TABLET
163 SOFTAMAN HAND 1 LITER BOTOL
164 SUCRALFAT SUSPENSI ( ULSAFATE) BOTOL
165 SYMBICORT TURBUHALER 180 TURB
166 TABLET TAMBAH DARAH TABLET
167 TETAGAM P. SYRINGE 1 ML AMPUL
168 THIAMIN 50 MG TABLET
169 UMBILICAL CORD PCS
170 USG GEL BOTOL
171 VITAMIN B KOMPLEKS TABLET
172 XYLOCAINE SPRAY TUBE
173 ZINK TAB DISPERSIBEL 20 MG TABLET
 BPJS PUSTU BKIA LANSIA
JUMLAH KUNJUNGAN RESEP

DIKETAHUI, YANG MENYERAHKAN

KEPALA DINAS KESEHATAN TAP.TENGAH KEPALA SEKSI KEFARMASIAN

NURSYAM, SKM., M.Kes. DESI HOTNIDA, S.Farm.,Apt.

NIP. 19690909 199103 2 005 NIP. 19831109 20101 2 028
MINTAAN OBAT
NGAH

LAPORAN BULAN / PERIODE : MARET 2019

PERMINTAAN BULAN / PERIODE : APRIL 2019
STOK PEMBERIAN
SISA STOK OPTIMUM PERMINTAAN KET
DAK PROP JUMLAH
8=(6-7) 9 10 11 12 13 14
 TDK ADA KARTU JUMLAH

RAHKAN YANG MEMINTA

ARMASIAN PIMPINAN PUSKESMAS

Farm.,Apt.
0101 2 028