MONITORING PENGGUNAAN OBAT GENERIK DI SARANA PELAYANAN KESEHATAN

TAHUN 2013

PUSKESMAS Jun-13
NAMA PUSKESMAS : RIMBA MELINTANG
ALAMAT : RIMBA MELINTANG
STATUS PASIEN : UMUM / JAMKESDA

ITEM OBAT DALAM RESEP NAMA OBAT

NO
TOTAL ITEM OBAT JUMLAH ITEM OBAT % OBAT GENERIK = 3/4 NON
RESEP
DALAM RESEP GENERIK x 100% GENERIK
1 2 3 4 5
1 7 7 7/7 x 100% = 100%
2 7 7 7/7 x 100% = 100%
3 6 6 6/6 x 100% = 100%
4 5 5 5/5 x 100% = 100%
5 3 3 3/3 x 100% = 100%
6 7 7 7/7 x 100% = 100%
7 6 6 6/6 x 100% = 100%
8 4 4 4/4 x 100% = 100%
9 7 7 7/7 x 100% = 100%
10 7 7 7/7 x 100% = 100%
11 4 3 3/4 x 100% = 75% Erla Tetes Mata
12 3 3 3/3 x 100% = 100%
13 2 2 2/2 x 100% = 100%
14 3 3 3/3 x 100% = 100%
15 4 3 3/4 x 100% = 75% neurodex
16 7 6 6/7 x 100% = 85.71% Nodiar
17 6 6 6/6 x 100% = 100%
18 3 3 3/3 x 100% = 100%
19 3 3 3/3 x 100% = 100%
20 4 4 4/4 x 100% = 100%
21 5 5 5/5 x 100% = 100%
22 5 5 5/5 x 100% = 100%
23 5 5 5/5 x 100% = 100%
24 4 3 3/4 x 100% = 75% myloxan susp
25 6 6 6/6x100%=100%
26 6 5 5/6 x 100% = 80% Neurodex
27 3 3 3/3 x 100% = 100%
28 5 4 4/5 x 100% = 80% Anelat
29 6 6 6/6 x 100% = 100%
30 3 3 3/3 x 100% = 100%
31 4 4 4/4 x 100% = 100%
32 3 3 3/3 x 100% = 100%
33 8 7 7/8 x 100% = 87.50% Nodiar
34 4 4 4/4 x 100% = 100%
35 4 4 4/4 x 100% = 100%
36 4 4 4/4 x 100% = 100%
37 5 5 5/5 x 100% = 100%
38 3 3 3/3 x 100% = 100%
39 4 3 3/4 x 100% = 75% vical sirup
40 6 6 6/6 x 100% = 100%
41 6 6 6/6 x 100% = 100%
42 5 5 5/5 x 100% = 100%
43 3 3 3/3 x 100% = 100%
44 5 5 5/5 x 100% = 100%
45 7 6 6/7 x 100% = 85,71% Diaform
46 5 5 5/5 x 100% = 100%
47 5 4 4/5 x 100% = 80% Diaform
48 4 4 4/4 x 100% = 100%
49 4 4 4/4 x 100% = 100%
50 3 3 3/3 x 100% = 100%
238 228 228/238 x 100% = 95.70%
 MONITORING PENGGUNAAN OBAT GENERIK DI SARANA PELAYANAN KESEHATAN
TAHUN 2013

PUSKESMAS Jun-13
NAMA PUSKESMAS : RIMBA MELINTANG
ALAMAT : RIMBA MELINTANG
STATUS PASIEN : JAMKESMAS

ITEM OBAT DALAM RESEP NAMA OBAT

NO
TOTAL ITEM OBAT JUMLAH ITEM OBAT % OBAT GENERIK = 3/4 NON
RESEP
DALAM RESEP GENERIK x 100% GENERIK
1 2 3 4 5
1 4 3 3/4 x 100% = 75% ALBION
2 4 3 3/4 x 100% = 75% Neurodex
3 3 3 3/3 x 100% = 100%
4 5 4 4/5 x 100% = 80% Spasminal
5 7 5 5/7 x 100% = 71,42% Neurodex/Erla tetes mata
6 5 5 5/5 x 100% = 100%
7 3 2 2/3 x 100% = 66,6% Solvitral
8 3 2 2/3 x 100% = 100% Noza
9 4 4 4/4 x 100% = 80%
10 4 3 3/4 x 100% = 100% Noza
11 4 4 4/4 x 100% = 100%
12 4 3 3/4 x 100% = 75% erla tetes telinga
13 4 4 4/4 x 100% = 100%
14 4 4 4/4 x 100% = 100%
15 4 4 4/4 x 100% = 100%
16 4 4 4/4 x 100% = 100%
17 3 3 3/3 x 100% = 75%
18 3 3 3/3 x 100% = 100%
19 3 3 3/3 x 100% = 100%
20 3 3 3/3 x 100% = 80%
21 3 3 3/3 x 100% = 100%
22 3 3 3/3 x 100% = 100%
23 3 3 3/3 x 100% = 100%
24 3 3 3/3 x 100% = 75%
25 3 3 3/3 x 100% = 100%
26 4 3 3/4 x 100% = 50% Neurodex
27 4 4 4/4 x 100% = 100%
28 5 5 5/5 x 100% = 100%
29 5 5 5/5 x 100% = 100%
30 5 3 3/5 x 100% = 60% nodiar/spasminal
31 5 5 5/5 x 100% = 100%
32 3 3 3/3 x 100% = 100%
33 3 2 2/3 x 100% = 100% Solvitral
34 5 4 4/5 x 100% = 66% Diaform
35 4 4 4/4 x 100% = 100%
36 5 5 5/5 x 100% = 100%
37 6 5 5/6 x 100% = 83,3% lytamin
38 4 4 4/4 x 100% = 100%
39 4 4 4/4 x 100% = 100%
40 5 5 5/5 x 100% = 66%
41 3 3 3/3 x 100% = 100%
42 6 6 6/6 x 100% = 66%
43 4 2 2/4 x 100% = 50% Solvitral/transamin
44 3 3 3/3 x 100% = 100%
45 3 3 3/3 x 100% = 100%
46 3 3 3/3 x 100% = 100%
47 4 4 4/4 x 100% = 100%
48 4 3 3/4 x 100% = 100%
49 5 4 4/5 x 100% = 100% solvitral
50 4 4 4/4 x 100% = 100%
 LAPORAN NARKOTIKA BULAN juni 2013
Unit Layanan : Puskesmas Rimba Melintang
Data ini sudah diverifikasi oleh Kepala Puskesmas
29 juni 2013

Saldo Awal PEMASUKAN PEMASUKAN PENGGUNAAN PENGGUNAAN Saldo Akhir

Nama Satuan Dari Jumlah Untuk Jumlah
Codein 10 mg Tablet Tablet 250 GFK 0 0 0 0
Codein 15 mg Tablet Tablet
Codein 20 mg Tablet Tablet
Codein Pulvis mg
Codipront Capsul Kapsul
Codipront Cum Exp Kapsul Kapsul
Codipront Cum Exp Syrup Botol
Codipront Syrup Botol
Doveri 100 mg Tablet Tablet
Doveri 150 mg Tablet Tablet
Doveri 200 mg Tablet Tablet
Doveri Pulvis mg
Durogesic 25 MU Ampul
Durogesic 50 MU Ampul
Fentanyl 0.05 mg/ml Inj Ampul
Fentanyl 0.5 mg/ml 2 ml Inj Ampul
Morphine HCI 10 mg/ml Inj Ampul
Morphine Syrup Botol
MST Continous 10 mg Tablet
MST Continous 15 mg Tablet
MST Continous 30 mg Tablet
Pethidine HCI 50 mg/ml Inj Ampul
Sufenta 0.005 Inj Ampul
Coditam 30 mg Tab Tablet
Coditam Tab. (Askes) Tablet
Durogesic Matrix 12.5 MU Ampul
Fentanyl Inj (Abbot) Vial
Morphine 20 mg Tablet
MST Continous 60 mg Tablet
MST Continous 100 mg Tablet
Sufenta 0.005 mg Inj (forte) Ampul 0 0 0 0 0 0

PENANGGUNG JAWAB LAPORAN KEPALA PUSKESMAS,

( RAHMAD JOHAR, AMK. ) ( dr. RIZA MAYANG SARI )

NIP. 19870503 201001 1 002 NIP. 19790725 201001 2 004
 LAPORAN PSIKOTROPIKA BULAN APRIL 2013
Unit Layanan : Puskesmas Rimba Melintang
Data ini sudah diverifikasi oleh Kepala Puskesmas
29 juni 2013

Saldo Awal PEMASUKAN PEMASUKAN PENGGUNAAN PENGGUNAAN Saldo Akhir

Nama Satuan Dari Jumlah Untuk Jumlah
Alganax 0.25 mg Tablet
Alganax 0.5 mg Tablet
Alganax 1 mg Tablet s
Alprazolam 0.25 mg Tablet
Alprazolam 0.5 mg Tablet
Alprazolam 1 mg Tablet
Alviz 0.25 mg Tablet
Alviz 0.5 mg Tablet
Alviz 1 mg Tablet
Analsik Tab Tablet
Apisate Tab Tablet
Asabium 10 mg Tab Tablet
Atarax 0.25 mg Tablet
Atarax 0.5 mg Tab Tablet
Ativan 0.5 mg Tablet
Ativan 1 mg Tablet
Ativan 2 mg Tablet
Bellaphen Tab Tablet
Braxidin Tab Tablet
Calmlet 0.25 mg Tab Tablet
Calmlet 0.5 mg Tablet
Calmlet 1 mg Tablet
Calmlet 2 mg Tablet
Ce Tabrium 10 mg Tablet
Ce Tabrium 5 mg Tablet
Cetalgin Tablet
Cliad Tablet
Clobazam 10 mg Tablet
Danalgin Tab Tablet
Decazepam 5 mg Tab Tablet
Diacazepam 10 ml Inj Ampul
Diacazepam 2 mg Tablet 4300 - - R/ 300tab 4000
Diacazepam 5 mg Tablet
Diobrium 10 mg Caps Kapsul
Diobrium 5 mg Caps Kapsul
Ditalin Tab Tablet
Dormicum 15 mg/ampul Inj Ampul
Dormicum 5 mg/ampul Inj Ampul
Dumolid 5 mg Tab Tablet
Esilgan 1 mg Tablet
Esilgan 2 mg Tablet
Fortanest 15 mg Ampul
Fortanest 5 mg Ampul
Frisium 10 mg Tablet
Frixitas 0.25 mg Tablet
Frixitas 0.5 mg Tablet
Frixitas 1 mg Ampul
Hedix Tablet
Klidibrax Tablet
Lexotan 1.5 mg Tablet
Lexotan 3 mg Tablet
Librax Tablet
Luminal 100 mg Tablet
Melidox Tablet
Mentalium 10 mg Tablet

Mentalium 2 mg Tablet
Mentalium 5 mg Tablet
Merlopam 0.5 mg Tab Tablet
Merlopam 2 mg Tab Tablet
Melaneuron Tablet
Midazolam 15 mg Inj Ampul
Midazolam 5 mg Inj Ampul
Miloz 15 mg/3ml Inj Ampul
Miloz 5 mg/3ml Inj Ampul
Neo Protal Tab Tablet
Neoroval Tablet
Neurodial 5 mg Tab Tablet
Neurogen Tab Tablet
Neuropyron Tab Tablet
Luminal 30 mg Tablet 1780 Tab - - R/ - 1780 Tab
Luminal 50 mg Tablet
Luminal 60 mg/ml Inj Ampul
Piptal Pet drops 0.5 ml Tablet
Proclozam 10 mg Tab Tablet
Proneuron Tablet
Prozepam 2 mg Tab Tablet
Prozepam 5 mg Tablet
Renagas 6 mg Tab Tablet
Renaquil 1 mg Tab Tablet
Ritalin 10 mg Tab Tablet
Ritalin 5 mg Tablet
Rivotril 2 mg Tablet
Sedacum inj 5 mg Ampul Ampul
Sibital Inj Ampul
Spasmium 5 mg Tab Tablet
Stesolid 2 mg Tablet
Stesolid 5 mg Tablet
Stesolid Inj. 10 ml Ampul
Stesolid rectal 10 mg Tube Tube
Stesolid rectal 5 mg Tube Tube
Stesolid Syrup Botol
Teronac Tab Tablet
Trazep Rectal Tube 5 mg/2. Tube
Valdimex 10 mg/2ml Inj Ampul
Valdimex 5 mg Tab Tablet
Valium 10 mg Tablet
Valium 10 mg Inj Ampul
Valium 2 mg Tablet
Valium 5 mg Tab Tablet
Valizanbe 2 mg Tab Tablet
Valizanbe 5 mg Tab Tablet
Xanax 0.25 mg Tab Tablet
Xanax 0.5 mg Tab Tablet
Xanax 1 mg Tab Tablet
Yekalgin Kaplet Kaplet
Zolastin 1 mg Tab Tablet
Zolmia 10 mg Tab Tablet
Zyparon Tablet
Zypraz 0.25 mg Tab Tablet
Zypraz 0.5 mg Tab Tablet
Zypraz 1 mg Tab Tablet
Hufralgin Tablet
Lexotan 6 mg Tablet
Librium 5 mg Tablet
Librium 10 mg Tablet
Limbritol Tablet
Omegastri Tablet
Pehaspas Tablet
Ritalin 30 mg Tab Tablet
Ritalin 40 mg Tab Tablet
Ritalin SR 20 mg Tab Tablet
Riklona 2 mg Tablet
Soxietas 2 mg Tablet
Stilnox Tablet
Tranquam 5 mg Tablet
Unagen with AMR UAP Tablet

PENANGGUNG JAWAB LAPORAN KEPALA PUSKESMAS,

( RAHMAD JOHAR, AMK. ) ( dr. RIZA MAYANG SARI )

NIP. 19870503 201001 1 002 NIP. 19790725 201001 2 004
 LAPORAN PENGGUNAAN RESEP OBAT GENERIK DI PUSKESMAS
TAHUN 2013

PUSKESMAS : RIMBA MELINTANG JUNI 2013

KABUPATEN : ROKAN HILIR
TAHUN 2013

R/ OBAT
JUMLAH LEMBAR
NO TOTAL R/ OBAT % R/ OBAT GENERIK KET
RESEP TOTAL R/ GENERIK TERHADAP TOTAL R/

1 jamkesda 680 2843 2437 2437/2843 x 100% = 85,71%

2 Askes = 4 15 15 15/15 x 1oo% = 100%

3 jamkesmas 69 258 249 249/258 x 100% =96,51%

KEPALA PUSKESMAS, PENANGGUNG JAWAB LAPORAN,

( dr. RIZA MAYANG SARI ) ( DEWI MARISA SARI )

NIP. 19790725 201001 2 004
 FORMULIR MONITORING INDIKATOR PERESAPAN
Puskesmas : Rimba Melintang
Kabupaten : Rokan Hilir Bulan juni
Propinsi : Riau Tahun : 2013
Antibiotik
Jumlah Item Injeksi Jumlah Jumlah Sesuai Pedoman
No Tgl No Nama Umur Diagnosa Nama Obat Dosis
Obat Generik obat
Ya / Tidak Ya / Tidak
(1) (2) (3) (4) (5) (6) (7) Ya /(8)Tidak (9) (10) (11) (12) (13) (14)
a. Cotry syrp 60ml 1btl
b. pct 500mg 5tab
1 guntur 6,5 diare 7 √ - 7 c. bicnat 500mg 5tab
d. nodiar 575mg 5tab
e.oralit 20mg 3bks
a.amox syrp 500 mg 1btl
b. pct 500mg 3tab
1 01/06- 2013 2 mei mei 3th ISPA 5 √ - 5 c. CTm 4mg 3tab
d. gg 100mg 3tab
e. vit c 50mg 3tab
a.
b.
3 c.
d.
e.
a. Amoxicilin 125mg 1btl
b. ambroxol 500mg 5tab
1 afria 5th ISPA 4 √ - 4 c. ctm 100mg 5tab
d. pct 4mg 5tab
e. 50mg 5tab
a. cotry syrp 60mg 1btl
b. neokolana syrp 120mg 1btl
2 03/06- 2013 2 sri rahayu 1th Diare 7 v - 6 c. bicnat 575mg 2tab
d.B.6 8,5mg 2tab
e.Zink +Oralit 20mg/200mg 2tab/10tab
a.
b.
3 c.
d.
e.
a. amox syrp 125mg 1BTL
b. pct 500mg 2TAB
1 jainudin 1,5 Ispa 6 √ - 6 c. ctm 100mg 2TAB
d. gg 4mg 2TAB
e. gg 50mg 2TAB
a. Cotry syrp 60mg 1 btl
b. pct 500mg 3tac
3 04/06- 2013 2 jumianti 5 DIARE 5 v - 4 c. bicnat 575mg 3tab
d. diaform 8,5mg 3tab
e. oralit 200kg 5bks
a.
b.
3 c.
d.
e.
a. amox syrp 125ml 1BTL
b. ctm 4mg 5tab
1 alpredo 5th ISPA 5 √ - 5 c. dexa 0,5mg 5tab
d. gg 100mg 5tab
e. -
a. ad syrp 60 mg 1 btl
b. pct 500mg 4tab
4 05/06 - 2013 2 nur haliya 52th DIARE 5 √ - 3 c. omeprazole - 4tab
d. albion 500mg 4tab
e. nodiatab - 4tab
a.
b.
3 c.
 3
d.
e.
a. cotry syrp 60ml 1 btl
b. pct 500mg 2tab
1 aura 3,5 Diare 5 √ - 5 c. ad 4mg 2tab
d. bicnat 100mg 2tab
e.nodiar + oralit 500mg 2tab
a.renalit 60ml 1btl
b.neokolana 575mg 1tab
5 05/06 - 2013 2 angel 1,5 Diare 2 v - c. 100mg 1tab
d. - 1tab
e. 500ml 3bks/1btl
a.
b.
3 c.
d.
e.
a.amox syrp 500ml 1BTL
b. pct 500mg 4tab
1 Mila 3,5 ISPA 5 √ - 5 c. CTM 4 mg 4tab
d. gg 100mg 4tab
e.bicnat 500mg 4tab
a.cotry syrp 60ml 1BTL
b. pct 500mg 2tab
6 07/6 - 2013 2 Luki 1th DIARE 7 v - 7 c.ctm 4mg 2tab
d.diaform 575mg 2tab
e.zink 10mg 3bks
a.
b.
3 c.
d.
e.
a.cotry syrp 60mg 5tab
b. PCT 500 mg 5tab
1 mardi ardika 5th ISPA 5 √ - 5 c. ctm 4mg 5tab
d. gg 100mg 5tab
e. Bicnat 500mg 5tab
a.
b.
7 10/6 - 2013 2 c.
d.
e.
a.
b.
3 c.
d.
e.
a. cotry syrp 60ml 1btl
b. pct 500ml 5tab
1 elly 4thn ISPA 5 √ - 5 c. CTM 4mg 5tab
d. gg 100mg 5tab
e.b.com 8,5mg 5tab
a.
b.
8 11/6 - 2013 2 c.
d.
e.
a.
b.
3 c.
d.
e.
a. Amox syrp 500mg 1 btl
b. PCT 500 mg 3tab
1 khairul akbar 2th ISPA 6 √ - 6 c.GG 100mg 3tab
d. Vit. C 50mg 3tab
e. CTM 4mg 3tab
a.cotry syrp 60mg 1BTL
b.pct 500mg 3tab
9 12/6 - 2013 2 khairudin 2,5th DIARE 6 V - 6 c.ad - 3tab
d.Bicnat 500mg 3tab
e.nodiar + oralit 200kg 3tab
 a.
b.
3 c.
d.
e.
a. cotry syrp 125 mg 1 btl
b. PCT 500 mg 10tab
1 fariba 7th ISPA 5 √ - 5 c. GG 100 mg 10tab
d.dexa 0,5mg 10tab
e. Bicnat 500mg 10tab
a.cotry syrp 60ml 1btl
b. pct 500ml 3tab
10 13/6 - 2013 2 maura 3th DIARE v s 5 c. bicnat 500mg 3tab
d.oralit 200mg 3tab
e.zink 20mg 3tab
a.
b.
3 c.
d.
e.
a. cotry syrp 60ml 1 btl
b. PCT 500ml 1tab
1 zaskia 6Bln ISPA 5 √ - 5 c. gg 100mg 1tab
d.b com 8,5mg 1tab
e. ctm 4mg 1tab
a. Cotry syrp 60ml 1btl
b. PCT syrp 500ml 1BTL
11 14/6 - 2013 2 hadira 9bln DIARE 7 √ - 7 c. ctm 4mg 1tab
d. diaform 575mg 1tab
e.
a.
b.
3 c.
d.
e.
a. Cotry syrp 60mg 1 btl
b. PCT 500 mg 1tab
1 jainudin 1,5 ISPA 7 √ - 7 c. CTM 4mg 1tab
d. GG 100mg 1tab
e. dexa + vit c 0,5 1tab
a. Amox syrp 500ml 1BTL
12 15/6 - 2013 b. pct 500ml 1tab
2 sofahri 5bln DIARE 6 v - 6 c. ctm 4mg 1tab
d.Bicnat 500mg 1tab
e. zink +oralit 10/3bks
a.
b.
3 c.
d.
e.
a. Amox syrp 500ml 1btl
b. PCT 500mg 2 tab
1 raisa 1,4bln ISPA 5 √ - 5 c.vit c 50mg 2 tab
d. dexa 0,5mg 2 tab
e. ctm 4mg 2 tab
a. Cotry syrp 60ml 1btl
b. pct 500ml 2tab
13 17/6- 2013 2 Etio fani 1,5th DIARE 6 √ - 6 c. bicnat 500mg 2tab
d. diaform 575mg 2tab
e. zink 10 mg 10 tab
a.
b.
3 c.
d.
e.
a. Cotry syrp 60 mg 1 btl
b. PCT 500 mg 5 tab
1 yuni ambar wati 2,2th ISPA 5 √ - 5 c. gg 100mg 5 tab
d. CTM 4mg 5 tab
e. Bicnat 500mg 5 tab
a. cotry syrp 60mg 1btl
b. vical syrp 500mg 1btl
14 18/6 - 2013 2 zaskia ernita 2th DIARE 7 √ - 7
14 18/6 - 2013 2 zaskia ernita 2th DIARE 7 √ - 7 c.oralit 500mg 3bk
d.pct + nodiar 4mg 2tab
e.ctm + metro 500mg 2tab
a.
b.
3 c.
d.
e.
a. amox syrp 60 mg 1 btl
b. PCT 500 mg 2 tab
1 aliya zahra 2,5 th ISPA 5 √ - 5 c. ctm 4 mg 2 tab
d. ad 100 mg 2 tab
e. gg - 2 tab
a. Cotry syrp 60ml 1BTL
b. pct 500mg 2tab
15 19/6-2013 2 satrio 2,3th DIARE 6 v - 6 c.ad - 2tab
d. diaform 575mg 2tab
e. gg + b com 100mg/8,5mg 2tab
a.
b.
3 c.
d.
e.
a. Amox syrp 60ml 1 btl
b.pct 500mg 2tab
1 refan 2th DIARE 6 √ - 6 c. gg 100mg 2tab
d. diaform 575mg 2tab
e. ad/ctm 4mg 2tab
a. Cotry syrp 60mg 1btl
b. pct 500mg 3tab
16 20/6- 2013 2 reno 3,5 ISPA 6 v - 6 c. gg 100mg 3tab
d. CTM 4mg 3tab
e. dexa + bicnat 0,5/500mg 3tab
a.
b.
3 c.
d.
e.
a. amox syrp 60 mg 1 btl
b. PCT 500 mg 2tab
1 m.rafa 2,10 ISPA 6 √ - 6 c. CTM 4 mg 2tab
d. gg 100mg 2tab
e. b com 8,5mg 2tab
a.cotry syrp 60mg 1BTL
b.pct 500mg 2tab
17 21/6 - 2013 2 Dia ayu 1,5 DIARE 7 v - 7 c.ctm 4mg 2tab
d.gg +diaform 100mg 2tab
e.bicnat +oralit 0,5mg 2tab/2bkg
a.
b.
3 c.
d.
e.
a. Cotry syrp 60mg 1 btl
b. PCT syrp 500mg 1btl
1 jesica 7 ISPA 7 √ - 7 c. CTM 4mg 4tab
d. gg 0,5mg 4tab
e. b6/ Bicnat 400mg/500mg 4tab
a.cotry syrp 60 mg 1 btl
18 22/6 - 2013 b. PCT syrp 500 mg 1btl
2 Novita 7bln DIARE 8 √ - 8 c. gg/CTM 100mg/4mg 1tab
d. diaform +zink 5mg 1tab
e. metro +oralit 500mg 1tab
a.
b.
3 c.
d.
e.
a. amox syrp 60ml 1 btl
b.pct 500mg 2tab
1 melani 1,4 ISPA 5 √ - 5 c.gg 100mg 2tab
d. Vit. C 50mg 2tab
s 4mg 2tab
 a.Neocolana sy 60ml b
b.pct +ctm 500mg 2tab
19 24/6- 2013 2 vita 1th DIARE 6 v - 6 c.bicnat 575mg 2tab
d.B6 20mg 2tab
e.
a.
b.
3 c.
d.
e.
a. Amox syrp 500mg 1 btl
b. PCT 500mg 2tab
1 sugiardi 2th ISPA 5 √ - 5 c. gg 100mg 2tab
d.ctm 4mg 2tab
e. B.com - 2tab
a. Cotry syrp 500mg 1btl
b.pct 500mg 3tab
20 25/6- 2013 2 M daviq 2,10 DIARE 7 √ - 8 c.ctm 4mg 3tab
d. ad +oralit - 3tab
e. Diaform +zink 575mg 3tab/3buks
a.
b.
3 c.
d.
e.
a. Cotry sy 60 mg 1 btl
b. PCT 500mg 1tab
1 Adit 3th DIARE 7 √ - 7 c. CTM 4mg 1tab
d. ad/nodiar 575mg 1tab
e. oralit /zink - 3bks
a. Cotry syrp 60mg 1btl
b. pct 500mg 1tab
21 26/6 - 2013 2 simon 9bln ISPA 6 √ - 6 c. ctm 4mg 1tab
d. bicnat 500mg 1tab
e. gg 100mg 1tab
a.
b.
3 c.
d.
e.
a. Amox syrp 500 mg 1btl
b. pct 500mg 2tab
1 zaenudin 1,5 ISPA 6 v - 6 c.ad.gg 100mg 2tab/2tab
d. CTM 4mg 2tab
e. vit c 50mg 2tab
a. cotry syrp 60mg 1botl
b. PCT + oralit 500 mg 2tab/3bks
22 27/6 - 2013 2 softia 9bln DIARE 7 √ v 7 c. CTM +zink 4mg 2tab/10tab
d.diaform 575 mg 2tab
e.gg 100 mg 2tab

a.amox syrp 500mg 1btl

b. pct 500mg 1tab
1 keyla 11bln ISPA 5 v - 5 c.vit c 50mg 1tab
d.gg 100mg 1tab
e.ad - 1tab
a.cotry syrp 60ml 1btl
b.pct 500mg 7tab
23 28-6-2013 2 fanda 7th DIARE 5 v - 5 c.ctm 4mg 7tab
d.gg 100mg 7tab
e.diaform 575mg 7tab

1
 1

24 2

25 2

26 2

27 2

Jumlah Pasien (Sampel) : 46 orang

Jumlah Item Obat 267
Jumlah Pasien Yang Mendapat antibiotik 44 orang
Jumlah Pasien Yang Mendapat injeksi -

Mengetahui PENANGGUNG JAWAB LAPORAN,

KEPALA PUSKESMAS,

( DEWI MARISA SARI )

 ( dr. RIZA MAYANG SARI )
NIP. 19790725 201001 2 004