LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO )

PUSKESMAS : MERAMBANG
KECAMATAN : BULIK TIMUR
KABUPATEN : LAMANDAU BULAN : AGUSTUS
PROPINSI : KALIMANTAN TENGAH TAHUN : 2020

STOK AWAL PENERIMAAN PEMAKAIAN SISA STOK PEMBERIAN

No NAMA OBAT KEMASAN PROGRAM/ PROGRAM/HI PROGRAM/HI PROGRAM/HI PERMINTAAN PROGRAM/H KET
APBD APBD APBD APBD APBD
HIBAH BAH BAH BAH IBAH
1 2 3 4 5 6 7 8 9 10=4+6-8 11=5+7-9 12 13 14 15
OBAT
1 Acifar cream/ Acyclovir Tube 0 0 0 0
2 Acyclovir Tablet 200 mg Tablet 0 0 0 0
3 Acyclovir Tablet 400 mg Tablet 240 0 40 200
4 Albendazole suspensi Botol 60ml 0 0 0 0
5 Albendazole tablet 400 mg Tablet 810 0 0 810
6 Allopurinol 100 mg Tablet 1000 0 350 650
7 Allopurinol 300 mg Tablet 0 0 0 0
8 Alprazolam 1 mg Tablet 0 0 0 0
9 Ambroxol 30 mg tab Tablet 0 0 0 0
10 Ambroxol Sirup Botol 60ml 41 0 4 37
11 Aminofilin injeksi 24 mg/ml-10 ml Ampul 0 0 0 0
12 Aminofilin tablet 200 mg Tablet 300 0 0 300
13 Amitriptilin hcl tablet 25 mg Tablet 0 0 0 0
14 Amlodipine 10 mg Tablet 300 0 0 300
15 Amlodipine 5 mg Tablet 0 0 0 0
16 Amoxicillin kapsul 250 mg Kapsul 500 0 100 400
17 Amoxicillin kapsul 500 mg Tablet 5600 0 350 5250
18 Amoxicillin sirup kering 250 mg/ 5 ml Botol 60ml 46 0 8 38
19 Antalgin injeksi 250 mg/ml-2 ml Ampul 0 0 0 0
20 Antalgin tablet 500 mg Tablet 600 0 100 500
21 Antasida Doen tablet Tablet 600 0 300 300
22 Antasida Suspensi Botol 60ml 39 0 3 36
23 Anti bakteri Salep Bacitracin Tube 75 0 6 69
24 Anti Hemoroid supp Tube 0 0 0 0
25 Antifungi doen Salep Whitfield Pot 48 0 7 41
26 Aqua proinjeksi steril, bebas pirogen btl 10 ml 0 0 0 0
27 Arcavit C Tablet 0 0 0 0
28 Artesunate Injeksi Ampul 0 0 0 0
29 Asam askorbat ( Vit C ) tablet 50 mg Tablet 500 0 50 450
30 Asam Folat/Afolat Tablet 0 0 0 0
31 Asam Mefenamat 500 mg Tablet 1000 0 300 700
32 Asam Tranexamat Injeksi Ampul 0 0 0 0
33 Asetosal tablet 500 mg Tablet 0 0 0 0
34 Asetosal tablet 100 mg Tablet 0 0 0 0
35 Atropin sulfat injeksi Ampul 0 0 0 0
36 Benzatin Benzil Penisilin inj Vial 0 0 0 0
37 Betahistin Mesilat 6 mg Tablet 0 0 0 0
38 Betametason krim 0,1 % Tube 50 0 12 38
39 Bioviton sirup Botol 5 0 0 5
40 Brochifar Plus Tablet 0 0 0 0
41 Bromifar Plus Syrup Botol 0 0 0 0
42 Calcium Laktat ( kalk ) tablet 500 mg Tablet 500 0 250 250
43 Camabion (program MCAI) Tablet 0 0 0 0
44 Captopril 12,5 mg tab Tablet 600 0 300 300
45 Captopril 25 mg tab Tablet 0 0 0 0
46 Captopril 50 mg tab Tablet 0 0 0 0
47 Cefadroxil 250 mg Tablet 0 0 0 0
48 Cefadroxil 500 mg tab Kapsul 300 0 0 300
49 Cefadroxil Sirup Botol 60ml 25 0 6 19
50 Cefixime 100mg/ml sirup Botol 60ml 0 0 0 0
51 Cefixime 400 mg + Azitrhromicin 100 mg Ktk 0 0 0 0
52 Cefixime kap 100 mg Kapsul 0 0 0 0
53 Cefotaxime injeksi Vial 0 0 0 0
54 Ceftriaxone inj vial 0 0 0 0
55 Cetirizine 10 mg Tablet 0 0 0 0
56 Cetirizine Sirup Botol 60ml 27 0 3 24
57 Chloramfenicol 125mg/ml Sirup btl 60 ml 50 0 50 0
58 Chloramfenicol kapsul 250 mg Kapsul 0 0 0 0
59 Chloramfenicol kapsul 500 mg/ Chloramex Kapsul 400 0 0 400
60 Chloramfenicol salep Kulit /Bufacetin Tube 53 0 9 44
61 Chloramfenicol salep mata 1 % Tube 48 0 9 39
62 Chlorfeniramin Maleat ( ctm ) tablet 4 mg Tablet 500 0 200 300
63 Chlorpromazine 100 mg Tablet 0 0 0 0
64 Cimetidin 200 mg Tablet 400 0 0 400
65 Ciprofloxacin 500mg Tablet 300 0 100 200
66 Clindamycin 150 mg Kapsul 100 0 0 100
67 Clindamycin 300 mg Kapsul 0 0 0 0
68 Clobazam tablet 10 mg Tablet 0 0 0 0
69 Clorpromazin 25 mg inj Ampul 0 0 0 0
70 Clozapine 25 mg tablet Tablet 0 0 0 0
71 Codein hcl tablet 10 mg Tablet 0 0 0 0
72 Cotrimoksazol dewasa tablet 480 mg Tablet 0 0 0 0
73 Cotrimoksazole tablet 960 mg Tablet 500 0 150 350
74 Cotrimoksazol suspensi btl 60 ml 90 0 0 90
75 Cyanocobalamin ( Vit B 12 ) inj 500 mg/ml Ampul 213 0 20 193
76 D-Artepd Tablet 0 0 0 0
77 Daryant Tulle ktk 0 0 0 0
78 Deksametason inj 5 mg /ml-1 ml amp 20 0 10 10
79 Deksametason tablet 0,5 mg Tablet 600 0 600 0
80 Denomix Cream Tube 0 0 0 0
81 Dermasolon 10 gr Tube 0 0 0 0
82 DHP Frimal Tablet 0 0 0 0
83 Dionicol Tablet 0 0 0 0
 84 Diazepam 5 mg Tablet 0 0 0 0
85 Diazepam 2 mg Tablet 0 0 0 0
86 Diazepam inj 5 mg/ml- 2 ml amp 0 0 0 0
87 Dietilcarbamazine tablet 100 mg Tablet 0 0 0 0
88 Difenhidramin Tablet 0 0 0 0
89 Digoksin tablet 0,25 mg Tablet 300 0 0 300
90 Dimenhidrinat 50 mg Tablet 800 0 0 800
91 Domperidon 10 mg tab Tablet 300 0 0 300
92 Domperidon Suspensi btl 60 ml 50 0 0 50
93 Dulcolax 10 mg Dewasa Supp 0 0 0 0
94 Dulcolax 5 mgAnak Supp 0 0 0 0
95 Epinefrin hcl ( adrenalin ) inj 0,1 % - ml amp 0 0 0 0
96 Eritromicin 500 mg kapsul kap 500 0 0 500
97 Eritromicin sirup btl 0 0 0 0
99 Etambutol hcl tablet 250 mg Tablet 0 0 0 0
100 Etambutol hcl tablet 500 mg Tablet 0 0 0 0
101 Etanol 70 % 300 ml btl 300 ml 0 0 0 0
102 Etanol 70 % 100 ml btl 100ml 24 0 24 0
103 Eugenol cairan Botol 0 0 0 0
104 Fasidol Drop Botol 0 0 0 0
105 FDC Katagori I Paket 0 0 0 0
106 Flukonazol Tablet 0 0 0 0
107 Flutamol Sirup btl 60 ml 48 0 48 0
108 Flutop-C Sirup Botol 0 0 0 0
109 Furosemid inj 10 mg Ampul 0 0 0 0
110 Furosemid tablet 40 mg Tablet 200 0 0 200
111 Garam Oralit untuk 200 ml air sase 190 0 0 190
112 Gemfibrozil 300 mgTab Tablet 100 0 0 100
113 Gentamicin inj amp 0 0 0 0
114 Gentamicin Salep Kulit tube 0 0 0 0
115 Gentamicin salep mata (GenOint) tube 0 0 0 0
116 Gentamicin tetes mata btl 10 ml 36 0 5 31
117 Gentian Violet larutan 1 % btl 10 ml 0 0 0 0
118 Geriavita Tablet 30 0 0 30
119 Glibenklamid tablet 5 mg Tablet 700 0 0 700
120 Glibenklamid tablet 10 mg Tablet 0 0 0 0
121 Glimepiride 2 mg Tablet 100 0 0 100
122 Gliseril Guayakolat tablet 100 mg Tablet 0 0 0 0
123 Glukonas Kalsicus vial 0 0 0 0
124 Glukosa larutan infus 10 % steril btl 500 ml 0 0 0 0
125 Glukosa larutan infus 5 % steril btl 500 ml 50 0 50 0
126 Griseofulvin tablet 125 mg Tablet 500 0 0 500
127 Guanefenesin Tablet 0 0 0 0
128 H2O2 btl 0 0 0 0
129 Haloperidol inj 5 mg/ml buah 0 0 0 0
130 Haloperidol tablet 0,5 mg Tablet 0 0 0 0
131 Hidroklorotiazid (HCT) tabl 25 mg Tablet 500 0 0 500
132 Hidrokortison krim 2,5 % tube 27 0 7 20
133 Hyoscine 10 mg (Hyorex) Tablet 0 0 0 0
134 Ibu Profen Suspensi btl 60 ml 124 0 10 114
135 Ibuprofen tablet 200 mg Tablet 0 0 0 0
136 Ibuprofen tablet 400 mg Tablet 50 0 0 50
137 Isoniazid 100 mg Tablet 0 0 0 0
138 Isosorrbid dinitrat tablet sublingual 5 mg Tablet 0 0 0 0
139 KAEN 3 A Botol 0 0 0 0
140 KAEN 3 B Botol 0 0 0 0
141 Kalium Permanganat (PK) pot 0 0 0 0
142 Kanamicyn Inj 1 gram vial 3 0 0 3
143 Kanina Sirup Botol 0 0 0 0
144 Keterolac Inj ampul 0 0 0 0
145 Ketokonazole 200 mg Tablet 350 0 0 350
146 Ketokonazole krim 2% Tube 34 0 0 34
147 Kombinasi pirimetamin 25mg+sulfadoksin 500mg Tablet 0 0 0 0
148 Lactulosa Sirup btl 60 ml 0 0 0 0
149 Lanzoprazol 30 mg Kapsul 0 0 0 0
150 Lidokain + Epineprin injeksi Botol 0 0 0 0
151 Lidokain injeksi ampul 90 0 2 88
152 Lisinopril 5 mg Tablet 0 0 0 0
153 Livron B Plek Tablet 0 0 0 0
154 Lodomer mg injeksi Ampul 0 0 0 0
155 Loperamid 2mg Tablet 0 0 0 0
156 Loratadin 10 mg Tablet 50 0 0 50
159 Meloksicam tab Tablet 0 0 0 0
160 Metformin 500 mg Tablet 500 0 0 500
161 Metformin 850 mg Tablet 0 0 0 0
162 Metilergometrin maleat inj 0,200 mg – 1 ml Ampul 0 0 0 0
163 Metilergometrin maleat tablet salut 0,125 Tablet 600 0 100 500
164 Metilprednisolon 4 mg Tablet 0 0 0 0
165 Metilprednisolon 8 mg Tablet 0 0 0 0
166 Metoklorpramide 5mg tab Tablet 600 0 0 600
167 Metronidazol infus 5 mg / ml Btl 0 0 0 0
168 Metronidazol sirup 125 mg/5 ml btl 60 ml 62 0 3 59
169 Metronidazol tablet 500 mg Tablet 100 0 0 100
170 Meylon inj Vial 0 0 0 0
171 MgSO4 20% btl 10 ml 0 0 0 0
172 MgSO4 40% btl 10 ml 18 0 18 0
173 Miconazol Krim tube 14 0 0 14
174 Mineral Mix Sacchet 30 0 0 30
175 Mulsanol sirup Botol 60 ml 0 0 0 0
176 Natrium Chlorida (NaCl) larutan infus 0,9 % steril Botol 500 ml 62 0 62 0
177 Natrium Diklofenak 25 mg Tablet 0 0 0 0
178 Neo Diagon 650 mg Tablet 200 0 0 200
179 Nifedipin tab 10 mg Tablet 200 0 200 0
180 Nistatin 100.000 iu tablet salut vaginal Tablet 300 0 300 0
181 Nistatin 500.000 iu tablet Tablet 600 0 0 600
182 Novaparid(insulin inj) pen 0 0 0 0
183 OAM Tablet 0 0 0 0
184 OAT Anak kotak 0 0 0 0
185 OAT Kategori I Paket 0 0 0 0
186 OAT Kategori II Paket 0 0 0 0
187 Obat Kusta MB Dewasa Blist 0 0 0 0
188 Ofloxasin 200 mg Tablet 0 0 0 0
189 Omeprazole 20 mg Kapsul 360 0 120 240
190 Ondansentron injeksi Ampul 0 0 0 0
191 Ondansentron tab 4 mg Tablet 0 0 0 0
192 Optiflok (levofloksasin tts mata 0,5%) Botol 0 0 0 0
193 OTSU Water inj 25 mg btl 25 ml 0 0 0 0
194 Oxytetrasiklin hcl salep kulit 3 % tube 0 0 0 0
195 Oxytetrasiklin Hcl salep mata tube 23 0 0 23
196 Oxytocin injeksi 10 iu/ml- 1 ml (Pitogin) Ampul 0 0 0 0
197 Papaverin Tab Tablet 400 0 50 350
198 Paracetamol infus btl 0 0 0 0
199 Paracetamol drop Botol 64 0 0 64
200 Paracetamol sirup 125 mg/5 ml Botol 60ml 103 0 4 99
201 Paracetamol tablet 500 mg Tablet 0 0 0 0
202 Paracetamol tablet 100 mg Tablet 0 0 0 0
203 Pehacain Injeksi Ampul 0 0 0 0
204 Perak Sulfadiazin krim 1% Tube 0 0 0 0
205 Phenobarbital injeksi 50 mg/ml – 2ml Ampul 0 0 0 0
206 Phenobarbital tablet 30 mg Tablet 0 0 0 0
207 Phenogliserol tts telinga (karbogliserin) btl 10 ml 0 0 0 0
208 Phenoxy Metil Penisilin Tablet 0 0 0 0
209 Phenytoin kap Kapsul 0 0 0 0
210 Phenzacol Tablet 0 0 0 0
211 Phytomenadion ( Vit K 1 ) injeksi 10 mg/ml- 1ml Ampul 35 0 1 34
212 Phytomenadion ( Vit K 1 ) tablet salut 10 mg Tablet 600 0 0 600
213 Piracetam inj Ampul 0 0 0 0
214 Piracetam tab 1200 mg Tablet 0 0 0 0
215 Pirantel pamoat tablet 125 mg Tablet 0 0 0 0
216 Pirantel suspensi Botol 60ml 42 0 0 42
217 Piridoksin hcl 10 mg (vitamin B6) Tablet 400 0 0 400
218 Piroxicam 10 mg tabl Tablet 500 0 500 0
219 Pitogin injeksi Ampul 0 0 0 0
220 Prednison tablet 5 mg Tablet 600 0 300 300
221 Primakuin tablet 15 mg ' Tablet 0 0 0 0
222 Prosagan inj (Lanzoprazol ) Vial 6 0 6 0
223 Prozine Expextoran Btl 33 0 2 31
224 Pyrazinamid 500 mg tab Tablet 0 0 0 0
225 Pyriemethamine 25 mg Tablet 0 0 0 0
226 Quinin inj Ampul 0 0 0 0
227 Quinin Tablet 222 mg Tablet 0 0 0 0
228 Ranitidin 150mg tab Tablet 0 0 0 0
229 Ranitidin Injeksi Ampul 0 0 0 0
230 Retinol ( vitamin A ) kapsul 100.000 iu Kapsul Biru 200 0 200 0
231 Retinol ( vitamin A ) kapsul 200.000 iu Kapsul Merah 500 0 500 0
232 Rifampicin kaplet 300 mg Kaplet 0 0 0 0
233 Ringer Laktat larutan infus steril Botol 500ml 44 0 44 0
234 Risperidone 1 mg Tablet 0 0 0 0
235 Risperidone 2 mg Tablet 0 0 0 0
236 Roverton Tablet 0 0 0 0
237 Salbutamol sirup Btl 0 0 0 0
238 Salbutamol tablet 4 mg Tablet 400 0 100 300
239 Salep 2-4 kombinasi Pot 24 0 0 24
240 Salisil bedak 2 % Kotak 0 0 0 0
241 Scopma Tablet 0 0 0 0
242 Serum anti bisa ular polivalen inj.5 ml ( abu I ) Ampul 0 0 0 0
243 Serum Anti tetanus (a.t.s) Ampul 0 0 0 0
244 Sikzonoate injeksi 25 mg Ampul 0 0 0 0
245 Simvastatin 10 mg tab Tablet 0 0 0 0
246 Simvastatin 20 mg tab Tablet 0 0 0 0
247 Spironolactone 100 mg Tablet 0 0 0 0
248 Sukralfat sirup Botol 17 0 0 17
249 Sulfadiazin Silver salep Tube 0 0 0 0
250 Suprabion Tablet 0 0 0 0
251 Tablet Tambah Darah Tablet 8760 0 4980 3780
252 Tarivid Tetes Telinga Tube 0 0 0 0
253 Tetrasiklin hcl kapsul 250 mg Kapsul 0 0 0 0
254 Tetrasiklin hcl kapsul 500 mg Kapsul 500 0 50 450
255 Thiamfenikol 500 mg/ Troviakol Tablet 800 0 800 0
256 Tiamin hcl ( vit.B1) injeksi 100 mg /ml-1 ml Ampul 7 0 0 7
257 Tiamin hcl mononirat ( vit B1) tablet 50 mg Tablet 300 0 200 100
258 Tramadol 50 mg kap Kapsul 0 0 0 0
259 Triheksifenidil 2 mg Ampul 0 0 0 0
260 Urinter Kapsul 0 0 0 0
261 Vaksin Rabies Verorab /Rabipur Kotak 0 0 0 0
262 Ventolin Nebule vial 5 0 0 5
263 Vit Ever Kapsul 0 0 0 0
264 Vitamin B complek tablet Tablet 0 0 0 0
265 Vitamin B12 Tablet 0 0 0 0
266 WDN3TE (WIDA 1/4 NS TM) Botol 0 0 0 0
267 WDNZTE (WIDA 1/2 NS TM) Botol 0 0 0 0
268 Yodium Test Kotak 0 0 0 0
269 Zink Tablet 20 mg Tablet 200 0 100 100
270 Zink Sirup Botol 50 0 3 47
271 Calortusin Tablet 0 0 0 0
272 Abate Saset 0 0 0 0
273 Difenhidramin injeksi Ampul 54 0 0 54
274 Ergotamin caffein Tablet 200 0 0 200
 275 Papaverin injeksi Ampul 83 0 0 83
276 Novadiar suspensi Botol 77 0 50 27
277 Pantrin Pirantel 130 mg Tablet 200 0 0 200
BMHP
1 Alat Suntik sekali Pakai 0,05 ml Buah 407 0 0 407
2 Alat Suntik sekali Pakai 0,5 ml Buah 0 0 0 0
3 Alat Suntik sekali Pakai 1 ml Buah 300 0 0 300
4 Alat Suntik sekali Pakai 10 ml Buah 100 0 0 100
5 Alat Suntik sekali Pakai 3 ml Buah 377 0 0 377
6 Alat Suntik sekali Pakai 5 ml Buah 301 0 0 301
7 Alkacide 1L btl 1 0 0 1
8 Alkazyme powder 25 btl 1 0 0 1
9 Alkohol 70 % btl 1000 ml 0 0 0 0
10 Alkohol Swab Kotak 5 0 0 5
11 Aluminium Tes btl 0 0 0 0
12 Amonium Oxalat 0,1% btl 0 0 0 0
13 Amonium test ktk 0 0 0 0
14 Anti A Monoclonal Vial 0 0 0 0
15 Anti AB Monoclonal Vial 0 0 0 0
16 Anti B Monoclonal Vial 0 0 0 0
17 Anti D Duoclonal Vial 0 0 0 0
18 Aseptic Gel Botol 1 0 0 1
19 Autoclick Lancing Device Buah 0 0 0 0
20 Blood Lancet Kotak 14 0 0 14
21 Bracket hand wash plastik buah 0 0 0 0
22 Bunsen Spirtus Buah 0 0 0 0
23 Cairan Spirtus botol 0 0 0 0
24 Cartridge Genexpert Kit ktk 0 0 0 0
25 Catgut chromic No.2/0 Buah 50 0 0 50
26 Catgut chromic No.3/0 Buah 48 0 0 48
27 Catgut Plain No.2/0 Buah 0 0 0 0
28 Catgut Plain No.3/0 Buah 0 0 0 0
29 Caviton 30G ktk 0 0 0 0
30 Chromocuit Coliform Agar Botol 0 0 0 0
31 Cover Glass 18x18mm Pak 0 0 0 0
32 Dentinconditioner 6 Gr ktk 0 0 0 0
33 Dermafix Pcs 0 0 0 0
34 ECG Gel btl 0 0 0 0
35 Emertian Oil Botol 0 0 0 0
36 Eosin Methylene Blue Agar btl 0 0 0 0
37 Etakridin ( rivanol ) larutan 0,1 % btl 300 ml 13 0 0 13
38 Foleycateter No. 10 Buah 10 0 0 10
39 Foleycateter No. 20 buah 10 0 0 10
40 Foleycateter No.16 buah 10 0 0 10
41 Foleycateter No.18 buah 8 0 0 8
42 Fuji VII ktk 0 0 0 0
43 Fuji II ktk 0 0 0 0
44 Fuji IX ktk 0 0 0 0
45 G.Bond 5 ml btl 0 0 0 0
46 Gelas Kumur Pak 0 0 0 0
47 GG Colo Label Mini Xtra A3 ktk 0 0 0 0
48 Handscoon Steril Safeglove PP no.7 Psg 50 0 0 50
49 Handscoon Steril Safeglove PP no.7,5 Psg 50 0 0 50
50 Handscoon Steril Safeglove PP no.8 Psg 50 0 0 50
51 Handscoon Non Steril Aximed buah 0 0 0 0
52 Handscoon Non Steril CosmoMed buah 2200 0 200 2000
53 Handscoon Non Steril Maxter buah 0 0 0 0
54 Handscoon Non Steril Safeguard buah 0 0 0 0
55 Hb S Ag( RDT Hepatitis) Buah 0 0 0 0
56 Hb Sahli Buah 3 0 0 3
57 Hemospon Buah 0 0 0 0
58 Humasens Reffil Stik Cholesterol / Autocheck Kotak 2 0 0 2
59 Humasens Reffil Stik Glucose / Autocheck Kotak 2 0 0 2
60 Humasens Reffil Stik Uric Acid / Autocheck Kotak 2 0 0 2
61 Infuset Anak Pcs 50 0 0 50
62 Infuset Dewasa Pcs 91 0 0 91
63 Insektisida (Lamda Sihalotrin) Botol 0 0 0 0
64 Intec strip (Tes Narkoba) Pcs 0 0 0 0
65 IV Cateter No. 20G buah 145 0 0 145
66 IV Cateter No. 22G buah 54 0 0 54
67 IV Cateter No. 24G buah 3 0 0 3
68 IV Cateter No. 26G buah 43 0 0 43
69 IV.Canula Pen No.20 G Pcs 0 0 0 0
70 IV.Canula Pen No.22 G Pcs 0 0 0 0
71 IV.Canula Pen No.26 G Pcs 0 0 0 0
72 Jarum BD VACUTAINER buah 0 0 0 0
73 Kaca Slide box 0 0 0 0
74 Kaca Slide (program Malaria) box 0 0 0 0
75 Kaca Slide (program TB) box 0 0 0 0
76 Kapas pembalut /adsorben 250g roll 27 0 0 27
77 Kapas pembalut /adsorben 500 g Roll 5 0 0 5
78 Kasa hidrofil 40cm x 80 cm roll 6 0 0 6
79 Kasa Pembalut 4cm x 10 cm roll 0 0 0 0
80 Kasa Steril 16x16cm Kotak 195 0 195 0
81 Kertas Lakmus Biru Kotak 0 0 0 0
82 Kertas Puyer Biasa Pax 0 0 0 0
83 Kertas Puyer Sel pcs 0 0 0 0
84 Kertas Saring pax 0 0 0 0
85 Kotak Kaca Slide (program TB) box 0 0 0 0
86 Kotak Kaca Slide (program malaria) Kotak 0 0 0 0
87 Lab Kit Set 0 0 0 0
88 Labu Ukur Leher Panjang Buah 0 0 0 0
89 Lampu spirtus btl 0 0 0 0
90 Larutan Amonium Oxalat Btl 250 ml 0 0 0 0
 91 Larutan giemsa stain btl 0 0 0 0
92 Larutan giemsa stain cat 1.09204.0500 btl 0 0 0 0
93 Larutan HCL 0,1N 100 ml btl 0 0 0 0
94 Larutan Metanol Btl 250 ml 0 0 0 0
95 Larutan Natrium Citrat 3,8% Btl 250 ml 0 0 0 0
96 Larutan Nitrat btl 0 0 0 0
97 Larutan Spirtus btl 0 0 0 0
98 Larutan Turk Btl 250 ml 0 0 0 0
99 Lisol Botol 1L 6 0 0 6
100 Masker Buah 179 0 0 179
101 Masker N95 Pcs 20 0 0 20
102 Media agar briliant green bile 2%(bronth) 500 gram 0 0 0 0
103 Media agar EMB cat 1.01347.0501 500 gram 0 0 0 0
104 Media laktose Bronth CM 0137 500 gram 0 0 0 0
105 Methanyl Yellow ktk 0 0 0 0
106 Minyak Emersi cat 1.04699.0100 botol 0 0 0 0
107 Mucus Extractor buah 0 0 0 0
108 Nebulizer Mask Dewasa CosmoMed Buah 0 0 0 0
109 Nierbekken Stainlees pcs 0 0 0 0
110 Oxygen Mask Pcs 0 0 0 0
111 Paket Alat Deteksi Resiko Kehamilan (ADRK)1 Paket 0 0 0 0
112 Paket Alat Deteksi Resiko Kehamilan (ADRK)2 Paket 0 0 0 0
113 Papsmear Kit L Buah 0 0 0 0
114 Papsmear Kit M Buah 0 0 0 0
115 Pembalut Elastis Procrepe Roll 0 0 0 0
116 Penjepit Tali Pusar Buah 50 0 0 50
117 Plesterin Roll 5x5 Buah 0 0 0 0
118 Poliban 15cm x 2,7 roll 0 0 0 0
119 Polifix 5 x 5 cm roll 0 0 0 0
120 Pot Sputum Buah 0 0 0 0
121 Rapid Hexagon Siphilis Test 0 0 0 0
122 Rapid Sipilys Ab 0 0 0 0
123 SD Bioline HIV 1/2 3.0 Test 0 0 0 0
124 Rapid Test 2 Focus Test 0 0 0 0
125 Rapid Test 2 Intec Test 0 0 0 0
126 Rapid Test 3 ONCOPROBE Test 0 0 0 0
127 Rapid Test 3 Vikia HIV Test 0 0 0 0
128 RDT Malaria Buah 0 0 0 0
129 Reagen Albumin CLR Pak 0 0 0 0
130 Reagen Alkaline Phosphat Pak 0 0 0 0
131 Reagen Bilirubin T DCLR Pak 0 0 0 0
132 Reagen Cholesterol ENZ CLR Pak 0 0 0 0
133 Reagen CK-MB Pak 0 0 0 0
134 Reagen Creatinin Pak 0 0 0 0
135 Reagen Gamma GT CLR Pak 0 0 0 0
136 Reagen Glucose GOD PAP Pak 0 0 0 0
137 Reagen GOT (ASAT) UV Pak 0 0 0 0
138 Reagen GPT (ALAT) UV Pak 0 0 0 0
139 Reagen HDL Cholesterol Pak 0 0 0 0
140 Reagen Hemoglobin Pak 0 0 0 0
141 Reagen LDH ktk 0 0 0 0
142 Reagen LDH Choles Pak 0 0 0 0
143 Reagen LDL Cholesterol ktk 0 0 0 0
144 Reagen Total Protein Pak 0 0 0 0
145 Reagen Triglycerid Pak 0 0 0 0
146 Reagen Urea Enzy Pak 0 0 0 0
147 Reagen Uric Acid LCF Pak 0 0 0 0
148 Reagen Zn (Basil Tahan Asam) TB (program TB) Buah 0 0 0 0
149 RPR KIT 0 0 0 0
150 RPR Sypilis Buah 0 0 0 0
151 Safety Box Pcs 0 0 0 0
152 Salmonella Paratyphi AH Vial 0 0 0 0
153 Salmonella Paratyphi AO Vial 0 0 0 0
154 Salmonella Paratyphi BH Vial 0 0 0 0
155 Salmonella Paratyphi BO Vial 0 0 0 0
156 Salmonella Typhi H Vial 0 0 0 0
157 Salmonella Typhi O Vial 0 0 0 0
158 Sarung Tangan Gynecolog Steril Psg 50 0 0 0
159 Silk Black No.2/0 Buah 0 0 0 0
160 Silk Black No.3/0 Buah 3 0 0 0
161 Solarex ktk 0 0 0 0
162 Spekulum Buah 0 0 0 0
163 Spyhilis Ab Test Buah 0 0 0 0
164 Stik Pan PlasticDeluxe Biru pcs 0 0 0 0
165 Tabung BD VACUTAINER Buah 0 0 0 0
166 Tehnodent Antiseptic Liguid No.20 Botol 0 0 0 0
167 Tehnodent Cresotin Paste Pot 0 0 0 0
168 Tehnodent Iodotin Paste Pot 0 0 0 0
169 Tehnodent Rootdent root canal sase 0 0 0 0
170 Tes Kehamilan UltraOne Buah 100 0 0 100
171 Thermometer Clinical CosmoMed Buah 0 0 0 0
172 Tourniquet buah 0 0 0 0
173 Tube EDTA Set 0 0 0 0
174 Underpads CosmoMed Buah 40 0 0 40
175 Urinal Plastik+tutup pcs 0 0 0 0
176 Urine Bag pcs 10 0 0 10
177 Uritest Reagent Strip Tube 0 0 0 0
178 USG Gel btl 5 0 0 5
179 Vikia HBsAG ktk 0 0 0 0
180 Vikia HIV 1/2 ktk 0 0 0 0
181 Water One btl 0 0 0 0
182 Wing Needle 23G Buah 0 0 0 0
183 Wing Needle 27G Buah 0 0 0 0
184 Yodium providon 10 % 30 ml Botol 30ml 48 0 0 48
185 Yodium providon 10 % 300 ml Botol 300ml 0 0 0 0

MERAMBANG, 30 AGUSTUS 2020

PIMPINAN PUSKESMAS MERAMBANG PENGELOLA OBAT

SUMBANG, Amd.Kep DEWI, S.Farm., Apt

NIP. 19710719 199303 1 005 NIP.19920602 201903 2 021
 PEMERINTAH KABUPATEN LAMANDAU
DINAS KESEHATAN
PUSKESMAS MERAMBANG
Alamat : Jl. Batu Bukung No. 02 Desa Merambang
Kecamatan Bulik Timur Kabupaten Lamandau Provinsi Kalimantan Tengah

SURAT PENGANTAR
Nomor : 442.4 / / VIII / PKM / 2020

Kepada Yth.
Kepala Dinas Kesehatan
Kabupaten Lamandau
di-
Nanga Bulik

No. URAIAN BANYAKNYA KETERANGAN

1. Pengiriman LPLPO 1 (satu) jepitan
Puskesmas Merambang Disampaikan dengan hormat
untuk dapat diketahui dan
Bulan : Agustus diperiksa sebagaimana
Tahun : 2020 mestinya. Terima kasih.

Merambang, 30 Agustus 2020

Kepala Puskesmas Merambang,

SUMBANG, Amd. Kep

NIP. 19710719 199303 1 005
 LAPORAN BULANAN OBAT NARKOTIKA

PUSKESMAS : MERAMBANG
KECAMATAN : BULIK TIMUR
KABUPATEN/KOTA : LAMANDAU
PROPINSI : KALIMANTAN TENGAH

STOK AWAL PENERIMAAN PEMAKAIAN

NO NAMA OBAT SEDIAAN ASKES/ ASKES/
APBD BUFFER APBD BUFFER APBD
BPJS BPJS
1 CODEIN TABLET 0 0 0

Mengetahui,
Kepala Puskesmas Merambang

SUMBANG, Amd.Kep
NIP. 19710719 199303 1 005
AT NARKOTIKA

BULAN : AGUSTUS
TAHUN : 2020

PEMAKAIAN SISA STOK

ASKES/ ASKES/ PERMINTAAN KET
BUFFER APBD BUFFER
BPJS BPJS
0

MERAMBANG, 30 AGUSTUS 2020

Yang melapor

DEWI, S.Farm. Apt

NIP.19920602 201903 2 021
 LAPORAN BULANAN OBAT PSIKOTROPIKA

PUSKESMAS : MERAMBANG
KECAMATAN : BULIK TIMUR
KABUPATEN/KOTA : LAMANDAU
PROPINSI : KALIMANTAN TENGAH

STOK AWAL PENERIMAAN PEMAKAIAN

NO NAMA OBAT SEDIAAN ASKES/ ASKES/
APBD BPJS BUFFER APBD BPJS BUFFER APBD
1 ALPRAZOLAM TABLET 0 0 0
2 DIAZEPAM 2 MG TABLET 0 0 0
3 DIAZEPAM 5 MG TABLET 0 0 0
4 DIAZEPAM INJ AMPUL 10 0 0
5 PHENOBARBITAL TAB TABLET 0 0 0
6 PHENOBARBITAL INJ AMPUL 0 0 0
7 STESOLID RECTAL SUPPO TUBE 0 0 0

Mengetahui,
Kepala Puskesmas Merambang

SUMBANG, Amd.Kep
NIP. 19710719 199303 1 005
T PSIKOTROPIKA

BULAN : AGUSTUS
TAHUN : 2020

PEMAKAIAN SISA STOK

ASKES/ ASKES/ PERMINTAAN KET
BPJS BUFFER APBD BPJS BUFFER
0
0
0
10
0
0
0

MERAMBANG, 30 AGUSTUS 2020

Yang melapor

DEWI, S.Farm. Apt

NIP.19920602 201903 2 021