LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSKESMAS

PUSKESMAS : AIR SUGIHAN 27 PELAPORAN BULAN : DESEMBER 2020 DOKUMEN NOMOR TANGGAL
KECAMATAN : AIR SUGIHAN PERMINTAAS BULAN : JAN, FEB, MRT 2021 DINKES KAB/KOTA
KABUPATEN : OGAN KOMERING ILIR IFK KAB/KOTA
PROPINSI : SUMATERA SELATAN PUSKESMAS

STOK STOK STOK

NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AWAL AKHIR OPTIMUM

1 2 3 4 5 6 7 8 9 10 11 12
1 Absorbent tipped applicator (alcohol swab) Pcs 400 - 400 300 100 720 620 - -
2 Acetylcystein Kapsul 200mg Kapsul 1,500 - 1,500 600 900 1,320 420 - -
3 Acyclovir tab 200 mg Tablet - - - - - 1,500 1,500 - -
4 Acyclovir cream Tube - - - - - 120 120 - -
5 Albendazol tab 400 mg Tablet 200 - 200 - 200 - - - -
6 Alkohol Liquid (etanol) 70%-1000 ml Btl 6 - 6 5 1 12 11 - -
7 Allopurinol 100 mg Tablet 1,900 - 1,900 1,000 900 2,160 1,260 - -
8 Aminophylline Inj 24 mg/ml-10 ml Ampul 19 - 19 19 - 37.2 37.2 - -
9 Aminophylline tab 200 mg Tablet - - - - - 1,500 1,500 - -
10 Amitriptyline 25 mg tab Tablet 400 - 400 100 300 120 - - -
11 Amlodipine tab 5 mg Tablet 3,000 - 3,000 1,800 1,200 5,760 4,560 - -
12 Amoxycillin Syr Btl 105 - 105 38 67 130.8 63.8 - -
13 Amoxycillin 250 mg Kapsul - - - - - 1,200 1,200 - -
14 Amoxycillin 500 mg Kaptab 1,800 - 1,800 1,800 - 4,560 4,560 - -
15 Ampicilin 1 gr Inj Vial 7 - 7 5 2 8.4 6.4 - -
16 Antasida Syr DOEN Btl 88 - 88 78 10 288 278 - -
17 Antasida DOEN Kombinasi Tablet 4,800 - 4,800 1,700 3,100 3,600 2,500 - -
18 Anti Bisa Ular 5 ml (ABU I)/ Biosave Vial 1 - 1 - 1 1.2 - - -
19 Asam Mefenamat 500 mg tab Tablet 1,100 - 1,100 1,100 - 3,600 3,600 - -
20 Ascorbic acid (Vit.C) 50 mg Tablet 800 - 800 800 - 1,440 1,440 - -
21 Ascorbic acid |calsium carbonate 500 mg (Pehavral) Tablet - - - - - - 2,000 - -
22 Aspirin (miniaspi) 100 mg tab Tablet - - - - - 1,500 1,500 - -
23 Atropine inj 0,25 mg/ml Ampul - - - - - - 120 - -
24 Attapulgite Tablet (Pularex) Tablet 600 - 600 - 600 - - - -
25 Attapulgite Tablet 600 mg (New Antides) Tablet 600 - 600 - 600 120 - - -
26 Automated blood grouping (Tes Gol. Darah) Paket - - - - - - - - -
27 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs - - - - - 5 5 - -
28 Bedak Salisil 2% Btl - - - - - 120 120 - -
29 Benzoic acid |salicylic acid salep (anti fungi) pot 42 - 42 23 19 40.8 21.8 - -
30 Betahistine Mesylate 6 mg tab Tablet 1,600 - 1,600 700 900 1,320 420 - -
31 Betamethasone 0,1% krim Tube 99 - 99 57 42 147.6 105.6 - -
 HALAMAN : 2 LPLPO No : 0 LAPORAN BULAN : DESEMBER 2020
STOK STOK STOK
NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
32 Bisacodyl 5mg Tablet - - - - - 1,000 1,000 - -
33 Bismuth subgallas (antihemoroid) Supp 50 - 50 20 30 24 - - -
34 Calcium chloride lactate infus (RL) Botol 340 - 340 220 120 576 456 - -
35 Calsium Laktat (Kalk) 500 mg Tablet 1,800 - 1,800 1,100 700 3,360 2,660 - -
36 Captopril 12,5 mg Tablet - - - - - 2,500 2,500 - -
37 Captopril 25 mg Tablet - - - - - 4,000 4,000 - -
38 Carbamazepin tab Tablet 500 - 500 - 500 - - - -
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 33 - 33 10 23 30 48 - -
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 31 - 31 7 24 26.4 48 - -
41 Cefadroxil 500mg Tablet - - - - - 2,000 2,000 - -
42 Cetirizine 5 mg/5 ml sirup Botol - - - - - 150 150 - -
43 Chloramhenicol Salep Mata 1% Tube 48 - 48 25 23 50.4 27.4 - -
44 Chloramphenicol Suspensi 125 mg/ml Btl - - - - - 150 150 - -
45 Chloramphenicol 250 mg caps Tablet - - - - - 2,000 2,000 - -
46 Chloramphenicol TT 3% Botol - - - - - 48 48 - -
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 19 - 19 10 9 18 24 - -
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 9,200 - 9,200 1,500 7,700 2,760 - - -
49 Chlorpromazine HCl 100 mg Tablet 800 - 800 300 500 720 220 - -
50 Cimetidin 200 tab Tablet - - - - - 2,000 2,000 - -
51 Ciprofloxacin 500 mg tab Tablet - - - - - 3,500 3,500 - -
52 Ciprofloxacin Infus Botol - - - - - - - - -
53 Clindamycin 300mg Kapsul - - - - - 2,000 2,000 - -
54 Cresol liquid 1 Liter (lysol) Botol 4 - 4 2 2 6 4 - -
55 Cyanocobalamin (Vit B12) inj 500 mcg/ml Ampul 224 - 224 110 114 223.2 109.2 - -
56 Devitalisasi pasta pot - - - - - 5 5 - -
57 Dexamethasone 0,5 mg Tablet - - - - - - - - -
58 Dexamethasone inj 5mg/ml-1ml Ampul 62 - 62 32 30 98.4 68.4 - -
59 Diazepam 5mg/ml-2 ml inj Ampul - - - - - 60 60 - -
60 Diazepam 2 mg Tablet - - - - - 1,000 1,000 - -
61 Diclofenac sodium 25 mg tab Tablet 4,500 - 4,500 2,800 1,700 4,680 2,980 - -
62 Digoxin 0,25 mg Tablet 1,000 - 1,000 200 800 480 - - -
63 Dimenhydrinate 50mg Tablet 1,000 - 1,000 200 800 720 - - -
64 Dipenhidramine HCl inj 10mg/ml Ampul 90 - 90 30 60 108 48 - -
65 Domperidone 10 mg Tablet 1,700 - 1,700 1,200 500 2,640 2,140 - -
66 Doxycycline 100 mg Kapsul Kapsul - - - - - 1,000 1,000 - -
67 Epinephrine HCl/bitartrat inj 0,1% Ampul - - - - - 30 30 - -
68 Erythromicin Syr Btl 6 - 6 2 4 10.8 - - -
 HALAMAN : 3 LPLPO No : 0 LAPORAN BULAN : DESEMBER 2020
STOK STOK STOK
NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
69 Erythromicin 500 mg capsul Kapsul 200 - 200 200 - 480 1,000 - -
70 Ethacridine (Rivanol) 0,1% Btl 4 - 4 1 3 1.2 - - -
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 8 - 8 2 6 4.8 - - -
72 Eugenol cairan Btl - - - - - - - - -
73 Ferrous fumarate ( Tab. Tambah Darah ) Tablet - - - - - - - - -
74 Folic acid 1mg ( asam folat) Tablet - - - - - 1,500 1,500 - -
75 Folley Catheter No.16 Pcs 14 - 14 2 12 2.4 - - -
76 Furosemida Injeksi Ampul 20 - 20 2 18 2.4 - - -
77 Furosemida 40 mg Tablet 1,800 - 1,800 300 1,500 720 - - -
78 Garam Oralit Sachet - - - - - - - - -
79 Gentamicyn 0,3% TM Botol 51 - 51 17 34 28.8 - - -
80 Gentamicyn Inj 40 mg/ml Ampul 23 - 23 - 23 - - - -
81 Gentamicyn 0,1% SK Tube - - - - - 150 150 - -
82 Glass lonomer Paket - - - - - - - - -
83 Glibenclamide 5 mg Tablet 1,000 - 1,000 200 800 720 - - -
84 Glimepiride 1 mg Tablet 1,300 - 1,300 100 1,200 120 - - -
85 Glukosa larutan infus 10% Botol 35 - 35 3 32 9.6 - - -
86 Glukosa larutan infus 5% Botol 30 - 30 5 25 18 - - -
87 Griseofulvin 125 mg Tablet - - - - - - - - -
88 Guaifenesin 100 Tab (GG tab) Tablet 11,000 - 11,000 1,800 9,200 3,360 - - -
89 Haloperidol 0,5 mg tab Tablet - - - - - - - - -
90 Haloperidol 5 mg tab Tablet 2,600 - 2,600 200 2,400 840 - - -
91 Human chorionic (HCG/Tes kehamilan ) Strip 101 - 101 15 86 45.6 - - -
92 Hydrochlorotiazide (HCT) 25 mg Tablet - - - - - - - - -
93 Ibuprofen sirup Botol 198 - 198 42 156 172.8 - - -
94 Ibuprofen 200 mg Tablet - - - - - - - - -
95 Ibuprofen 400 mg Tablet - - - - - 4,000 4,000 - -
96 Ichthyol salep 10% pot - - - - - 48 48 - -
97 Immunoglobulin human anti-tetanus (Tetagam) Ampul 2 - 2 - 2 1.2 - - -
98 Infus set dewasa Pcs 494 - 494 73 421 246 - - -
99 Infusi set anak Pcs 110 - 110 15 95 36 - - -
100 Iodium Povidon 10% 30 ml Botol 40 - 40 8 32 21.6 - - -
101 Isosorbide tablet Tablet 400 - 400 100 300 120 - - -
102 IV Catheter No.20 Pcs 208 - 208 48 160 151.2 - - -
103 IV Catheter No.22 Pcs 4 - 4 4 - 33.6 150 - -
104 IV Catheter No.24 Pcs 42 - 42 42 - 124.4 150 - -
105 Jarum Jahit Kulit Pcs - - - - - - - - -
 HALAMAN : 4 LPLPO No : 0 LAPORAN BULAN : DESEMBER 2020
STOK STOK STOK
NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
106 Kalium Permanganat Serbuk pot - - - - - - - - -
107 Kapas pembalut/Absorben 250 g Pcs 17 - 17 12 5 20.4 15.4 - -
108 Kasa pembalut 2x80 Pcs 115 - 115 56 59 169.2 110.2 - -
109 Kasa pembalut hidrofil 4 m x 15 cm Pcs 142 - 142 48 94 127.2 33.2 - -
110 Kasa pembalut hidrofil 4 m x 3 cm Pcs 158 - 158 52 106 112.8 6.8 - -
111 Kasa kompres 40/40 steril Pcs 87 - 87 35 52 72 20 - -
112 Ketoconazole 200 mg Cream Tube 69 - 69 25 44 63.6 19.6 - -
113 Ketoconazole 200 mg tab Tablet - - - - - 2,500 2,500 - -
114 Klorokina Fosfat 250 mg Tablet - - - - - - - - -
115 Levertran Salep/ Salep Luka Bakar pot 7 - 7 - 7 2.4 - - -
116 Lidocain 2% Ampul - - - - - - - - -
117 Lidokain Comp. inj Kombinasi Ampul 150 - 150 150 - 216 216 - -
118 Lidocaine spray (Xylocaine spray) Botol - - - - - 12 12 - -
119 Liquorice liquid extract (OBH) Botol - - - - - 100 100 - -
120 Locoriz Cream Tube - - - - - 48 48 - -
121 Loperamid 2 m tab Tablet - - - - - 1,500 1,500 - -
122 Loratadine 10 mg tab Tablet 1,900 - 1,900 1,300 600 3,360 2,760 - -
123 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 10 - 10 2 8 7.2 - - -
124 Magnesium Sulfat Injeksi 40% (MgSO4) Ampul 7 - 7 2 5 10.8 5.8 - -
125 Masker Pcs - - - - - 1,000 1,000 - -
126 Medical adhesive tape (dermafix/leukomed) Pcs - - - - - - - - -
127 Metamizole injeksi (antalgin 1000) Ampul - - - - - 200 200 - -
128 Metformin 500mg tab Tablet 900 - 900 200 700 600 - - -
129 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 6 - 6 - 6 - - - -
130 Methyl Ergometrin Maleat 0,125 mg Tab 200 - 200 - 200 - - - -
131 Methyl Prednisolon tab 4 mg Tablet 1,700 - 1,700 1,200 500 3,360 2,860 - -
132 Methyl Rosanilinium (gentian violet) Botol - - - - - 48 48 - -
133 Metronidazol 250 mg tab Tablet 100 - 100 100 - 360 500 - -
134 Metronidazol 500 mg tab Tablet - - - - - 2,000 2,000 - -
135 Metronidazol Infus Botol - - - - - - - - -
136 Metronidazol syr Botol 21 - 21 - 21 - - - -
137 Miconazole 2% Salep Kulit Tube 57 - 57 10 47 30 - - -
138 Momilen Baby Gold Sirup Botol - - - - - 100 100 - -
139 Natrium Bikarbonat 500 mg Tablet - - - - - - - - -
140 Nifedipin 10 mg tab Kapsul - - - - - 2,500 2,500 - -
141 Nystatin Tab Vag 10.000 iu/g Tablet 100 - 100 - 100 - - - -
142 Omeprazole inj Vial - - - - - 120 120 - -
 HALAMAN : 5 LPLPO No : 0 LAPORAN BULAN : DESEMBER 2020
STOK STOK STOK
NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
143 Omeprazole kaps Kapsul - - - - - 720 720 - -
144 Oxytetracycline HCl 1% Salep Mata Tube 8 - 8 - 8 2.4 - - -
145 Oxytetracycline HCl 3% Salep Kulit Tube - - - - - 48 48 - -
146 Oxytocin inj 10 IU Ampul - - - - - 200 200 - -
147 Papaverin 40 mg tab Tablet - - - - - - - - -
148 Papaverin inj Tablet - - - - - - - - -
149 Paracetamol Drops 15 ml Botol - - - - - - - - -
150 Parasetamol 120 mg/5 ml Syr Botol 182 - 182 74 108 210 102 - -
151 Parasetamol 500 mg Tablet 9,000 - 9,000 3,500 5,500 9,720 4,220 - -
152 Patient Lubricant (My Jelly ) Tube - - - - - - - - -
153 Permethrin (Scabimite Cream) Tube - - - - - 144 144 - -
154 Phenobarbital inj 50mg/ml-2ml Ampul - - - - - 60 60 - -
155 Phenobarbital 100 mg / 30 mg Tablet 700 - 700 200 500 480 - - -
156 Phenol gliserol 10% TT Botol - - - - - 120 120 - -
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 60 - 60 - 60 36 - - -
158 Phytomenadione (Vit.K1) 10 mg Tablet 900 - 900 200 700 480 - - -
159 Piracetam 400 mg Tablet 1,600 - 1,600 100 1,500 120 - - -
160 Piroxicam 20 mg tab Tablet - - - - - 4,000 4,000 - -
161 Pisau Disposable (Mess No.14/21) Pcs - - - - - 25 25 - -
162 Plesterku (Leukoplast) Pcs 6 - 6 6 - 12 24 - -
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul - - - - - - - - -
164 Povidon iodium 10% 300 ml Botol 9 - 9 3 6 8.4 2.4 - -
165 Prednison 5 mg Tablet 800 - 800 - 800 - - - -
166 Primaquin 15 mg tab Tablet 200 - 200 - 200 - - - -
167 Profolat tab Tablet - - - - - 1,000 1,000 - -
168 Prokaina Penisilin G inj 3.000.000 iu Ampul - - - - - 10 10 - -
169 Propranolol HCl 10 mg Tablet 700 - 700 - 700 120 - - -
170 Propranolol HCl 40 mg Tablet 700 - 700 100 600 480 - - -
171 Propylthiouracil 100 mg Tablet - - - - - - - - -
172 Protein Gluco Test Strip - - - - - 48 48 - -
173 Pyrantel Pamoat 125 mg Tablet 800 - 800 100 700 120 - - -
174 Pyridoxine HCl 10 mg Tablet - - - - - 1,500 1,500 - -
175 Ranitidin 150 mg Tablet - - - - - 2,500 2,500 - -
176 Ranitidin Injeksi Ampul - - - - - 100 100 - -
177 Retinol (Vit.A) kaps 100.000 iu Kapsul - - - - - 1,000 1,000 - -
178 Retinol (Vit.A) kaps 200.000 iu Kapsul - - - - - 2,200 2,200 - -
179 Risperidone 2mg Tablet 1,000 - 1,000 200 800 1,080 - - -
 HALAMAN : 6 LPLPO No : 0 LAPORAN BULAN : DESEMBER 2020
STOK STOK STOK
NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
180 Salbutamol 2 mg Tablet 1,900 - 1,900 1,100 800 2,280 1,480 - -
181 Salep 2-4 Kombinasi pot 100 - 100 28 72 57.6 - - -
182 Sarung tangan (HandScuun) No.7,5 Pcs - - - - - 1,000 1,000 - -
183 Sarung tangan (HandScuun Steril) No. 6,5 / L Pcs - - - - - 1,000 1,000 - -
184 Sarung tangan (HandScuun Steril) No.7 Pcs - - - - - 1,000 1,000 - -
185 Sarung tangan (HandScuun Steril) No.7,5 Pcs - - - - - 1,000 1,000 - -
186 Semen Seng Fosfat Serbuk & Cairan Set - - - - - - - - -
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 2,700 - 2,700 1,400 1,300 3,240 1,940 - -
188 Silk (Benang Bedah) No. 3/0 Pcs 29 - 29 29 - 43.2 43.2 - -
189 Silver Sulfadiazine Tube - - - - - 48 48 - -
190 Simvastatin 10 mg tab Tablet - - - - - 2,000 2,000 - -
191 Sodium cloride infus 0,9% ( NACL ) Botol 48 - 48 20 28 38.4 - - -
192 Spuit 1 ml Pcs 100 - 100 - 100 120 - - -
193 Spuit 3 ml Pcs 800 - 800 400 400 1,440 1,040 - -
194 Spuit 5 ml Pcs 100 - 100 100 - 240 240 - -
195 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 300 - 300 - 300 - - - -
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 160 - 160 67 93 164.4 71.4 - -
197 Sulfasetamida 15% TM Botol - - - - - 48 48 - -
198 Tetracycline 250 mg Tablet - - - - - - - - -
199 Tetracycline 500 mg Tablet 1,200 - 1,200 - 1,200 - - - -
200 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul - - - - - 60 60 - -
201 Thiamine HCl (Vit B1) 50 mg Tablet 3,500 - 3,500 400 3,100 1,560 - - -
202 Trihexyphenidyl tab 2 mg Tablet 4,100 - 4,100 500 3,600 1,680 - - -
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 1,200 - 1,200 200 1,000 840 - - -
204 Urin Bag Pcs 12 - 12 1 11 1.2 - - -
205 Usg Gel Botol - - - - - - - - -
206 Vaksin Rabies Vero/ Verorab Paket - - - - - - - - -
207 Vitamin B Kompleks Tablet 2,400 - 2,400 1,500 900 3,000 2,100 - -
208 Vitamin K Infant Inj Ampul - - - - - - - - -
209 Water liquid (aqua P,I) Botol 88 - 88 - 88 6 - - -
210 Wing Needle No.21 Pcs 18 - 18 - 18 - - - -
211 Wing Needle No.27 Pcs - - - - - - - - -
212 Zinc Sulphate Suppositoria (Superhoid) Kapsul - - - - - - - - -
213 Zinc tab Tablet 1,300 - 1,300 100 1,200 600 - - -
214 Ondansetron iv/im 4 mg Ampul 28 - 28 5 23 20.4 - - -
215 Tranexamic Acid inj 5% Ampul 25 - 25 5 20 12 - - -
216 Poliwash 500 ml Botol - - - - - 12 12 - -
 HALAMAN : 7 LPLPO No : 0 LAPORAN BULAN : DESEMBER 2020
STOK STOK STOK
NO. NAMA OBAT SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN PERMINTAAN PEMBERIAAN KET
AWAL AKHIR OPTIMUM
1 2 3 4 5 6 7 8 9 10 11 12
217 Policlean Handrub Botol - - - - - 12 12 - -
218 Sarung Tangan (Handscuun) L Pcs - - - - - 1,000 1,000 - -
219 Cefotaxime Sodium inj 1 gr Vial 47 - 47 2 45 12 - - -
220 Methyl Prednisolon tab 16 mg Tablet - - - - - 2,000 2,000 - -
221 Lancet Pcs 100 - 100 - 100 - - - -
222 Strip Kolestrol Pcs - - - - - - - - -
223 Strip Gula Darah Pcs - - - - - - - - -
224 Strip Asam Urat Pcs - - - - - - - - -
225 Nonwoven Fixation Rol Pcs 1 - 1 - 1 - - - -
226 Paracetamol 1000 mg /100 ml Botol - - - - - 10 10 - -
227 Otsu D-40 25 ml Botol 90 - 90 - 90 - - - -
228 Ketorolac inj 30 mg Ampul - - - - - 120 120 - -
229 Dulcolax tab Tablet - - - - - 100 100 - -
230 Ibuprofen 400 mg.1 Tablet - - - - - 2,000 2,000 - -
231 Permethrin (Scabimite Cream).1 Tube - - - - - - - - -
232 Masker Plus Pcs - - - - - 500 500 - -
233 Haloperidol Injeksi Ampul - - - - - - - - -
234 Eritromisin 250 mg Kapsul 1,000 - 1,000 - 1,000 - - - -
235 Acyclovir 400 mg Tab 2,000 - 2,000 - 2,000 - - - -
236 - - - - - - - - -
237 - - - - - - - - -
238 - - - - - - - - -
239 - - - - - - - - -
240 - - - - - - - - -
241 - - - - - - - - -

UMUM JAMSOSKES BPJS JUMLAH

JUMLAH KUNJUNGAN RESEP

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

Kepala Dinas Kesehatan Kab. OKI Kepala Instalasi Farmasi Dinkes OKI Pimpinan Puskesmas Pengelola Obat Puskesmas

………………………………….. ……………………………………. ETI LENITA, SKM FATMAWATI, Am.Keb

NIP. 197606262000122002 NIP. 197209052000122003