LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSKESMAS

PUSKESMAS : CAHYA MAJU PELAPORAN BULAN : SEPTEMBER 2020 DOKUMEN NOMOR TANGGAL
KECAMATAN : LEMPUING PERMINTAAS BULAN : 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 80 80 0 80 100 100
2 Acetylcystein Kapsul 200mg Kapsul 0 0 0 0 0 0
3 Acyclovir tab 200 mg Tablet 0 0 0 0 2000 2000
4 Acyclovir cream Tube 0 0 0 0 100 100
5 Albendazol tab 400 mg Tablet 0 0 0 0 0 0
6 Alkohol Liquid (etanol) 70%-1000 ml Btl 4 4 2 2 18 18
7 Allopurinol 100 mg Tablet 4410 4410 1910 2500 6600 4100
8 Aminophylline Inj 24 mg/ml-10 ml Ampul 0 0 0 0 0 0
9 Aminophylline tab 200 mg Tablet 0 0 0 0 0 0
10 Amitriptyline 25 mg tab Tablet 0 0 0 0 0 0
11 Amlodipine tab 5 mg Tablet 3580 3580 250 3330 0 0
12 Amoxycillin Syr Btl 214 214 81 133 204 204
13 Amoxycillin 250 mg Kapsul 0 0 0 0 0 0
14 Amoxycillin 500 mg Kaptab 17740 17740 3050 14690 0 0
15 Ampicilin 1 gr Inj Vial 0 0 0 0 0 0
16 Antasida Syr DOEN Btl 124 124 63 61 200 200
17 Antasida DOEN Kombinasi Tablet 13450 13450 1850 11600 0 0
18 Anti Bisa Ular 5 ml (ABU I)/ Biosave Vial 0 0 0 0 0 0
19 Asam Mefenamat 500 mg tab Tablet 850 850 850 0 5000 5000
20 Ascorbic acid (Vit.C) 50 mg Tablet 0 0 0 0 6000 6000
21 Ascorbic acid |calsium carbonate 500 mg (Pehavral) Tablet 0 0 0 0 0 0
22 Aspirin (miniaspi) 100 mg tab Tablet 0 0 0 0 2000 2000
23 Atropine inj 0,25 mg/ml Ampul 0 0 0 0 0 0
24 Attapulgite Tablet (Pularex) Tablet 0 0 0 0 0 0
25 Attapulgite Tablet 600 mg (New Antides) Tablet 0 0 0 0 0 0
26 Automated blood grouping (Tes Gol. Darah) Paket 0 0 0 0 0 0
27 Bahan Tambal Gigi Sementara (Fletcher/Caviton) Pcs 0 0 0 0 0 0
28 Bedak Salisil 2% Btl 0 0 0 0 100 100
29 Benzoic acid |salicylic acid salep (anti fungi) pot 48 48 45 3 96 96
30 Betahistine Mesylate 6 mg tab Tablet 3800 3800 1000 2800 3840 1100
31 Betamethasone 0,1% krim Tube 192 192 67 125 240 115
 HALAMAN : 2 LPLPO No: 0 LAPORAN BULAN : SEPTEMBER 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 0 0 0 0 0 0
33 Bismuth subgallas (antihemoroid) Supp 0 0 0 0 100 100
34 Calcium chloride lactate infus (RL) Botol 87 87 79 8 220 220
35 Calsium Laktat (Kalk) 500 mg Tablet 2020 2020 1090 930 3000 3000
36 Captopril 12,5 mg Tablet 0 0 0 0 0 0
37 Captopril 25 mg Tablet 0 0 0 0 5000 5000
38 Carbamazepin tab Tablet 3100 3100 400 2700 0 0
39 Catgut/Benang Chromic Bedah No.2/0-3/0 Pcs 38 38 19 19 96 96
40 Catgut/Benang Plain Bedah No.2/0-3/0 Pcs 153 153 21 132 0 0
41 Cefadroxil 500mg Tablet 0 0 0 0 3000 3000
42 Cetirizine 5 mg/5 ml sirup Botol 0 0 0 0 0 0
43 Chloramhenicol Salep Mata 1% Tube 77 77 29 48 0 0
44 Chloramphenicol Suspensi 125 mg/ml Btl 0 0 0 0 200 200
45 Chloramphenicol 250 mg caps Tablet 0 0 0 0 5000 5000
46 Chloramphenicol TT 3% Botol 0 0 0 0 0 0
47 Chloramphenicol/ Hidrokortison krim 2,5% Tube 123 123 43 80 100 100
48 Chlorpheniramine Maleat (CTM) 4 mg Tablet 0 0 0 0 12000 12000
49 Chlorpromazine HCl 100 mg Tablet 4000 4000 500 3500 0 0
50 Cimetidin 200 tab Tablet 0 0 0 0 3000 3000
51 Ciprofloxacin 500 mg tab Tablet 0 0 0 0 4000 4000
52 Ciprofloxacin Infus Botol 0 0 0 0 0 0
53 Clindamycin 300mg Kapsul 0 0 0 0 0 0
54 Cresol liquid 1 Liter (lysol) Botol 6 6 3 3 200 200
55 Cyanocobalamin (Vit B12) inj 500 mcg/ml Ampul 0 0 0 0 0 0
56 Devitalisasi pasta pot 0 0 0 0 0 0
57 Dexamethasone 0,5 mg Tablet 0 0 0 0 8000 8000
58 Dexamethasone inj 5mg/ml-1ml Ampul 338 338 111 227 100 100
59 Diazepam 5mg/ml-2 ml inj Ampul 0 0 0 0 60 60
60 Diazepam 2 mg Tablet 0 0 0 0 6000 6000
61 Diclofenac sodium 25 mg tab Tablet 0 0 0 0 6000 6000
62 Digoxin 0,25 mg Tablet 200 200 0 200 0 0
63 Dimenhydrinate 50mg Tablet 0 0 0 0 0 0
64 Dipenhidramine HCl inj 10mg/ml Ampul 0 0 0 0 60 60
65 Domperidone 10 mg Tablet 0 0 0 0 3000 3000
66 Doxycycline 100 mg Kapsul Kapsul 0 0 0 0 0 0
67 Epinephrine HCl/bitartrat inj 0,1% Ampul 0 0 0 0 100 100
68 Erythromicin Syr Btl 99 99 27 72 230.4 158.4
 HALAMAN : 3 LPLPO No: 0 LAPORAN BULAN : SEPTEMBER 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 1040 1040 1040 0 4800 4800
70 Ethacridine (Rivanol) 0,1% Btl 3 3 3 0 20 20
71 Ethanol ( Aseptan ) 500 cc+ Pump Botol 8 8 8 0 20 20
72 Eugenol cairan Btl 0 0 0 0 0 0
73 Ferrous fumarate ( Tab. Tambah Darah ) Tablet 0 0 0 0 0 0
74 Folic acid 1mg ( asam folat) Tablet 0 0 0 0 0 0
75 Folley Catheter No.16 Pcs 34 34 3 31 0 0
76 Furosemida Injeksi Ampul 0 0 0 0 0 0
77 Furosemida 40 mg Tablet 760 760 100 660 0 0
78 Garam Oralit Sachet 0 0 0 0 0 0
79 Gentamicyn 0,3% TM Botol 142 142 22 120 0 0
80 Gentamicyn Inj 40 mg/ml Ampul 0 0 0 0 60 60
81 Gentamicyn 0,1% SK Tube 0 0 0 0 150 150
82 Glass lonomer Paket 0 0 0 0 0 0
83 Glibenclamide 5 mg Tablet 0 0 0 0 0 0
84 Glimepiride 1 mg Tablet 0 0 0 0 0 0
85 Glukosa larutan infus 10% Botol 20 20 0 20 0 0
86 Glukosa larutan infus 5% Botol 27 27 27 0 80 80
87 Griseofulvin 125 mg Tablet 0 0 0 0 1000 1000
88 Guaifenesin 100 Tab (GG tab) Tablet 0 0 0 0 10000 10000
89 Haloperidol 0,5 mg tab Tablet 0 0 0 0 0 0
90 Haloperidol 5 mg tab Tablet 3000 3000 500 2500 0 0
91 Human chorionic (HCG/Tes kehamilan ) Strip 57 57 47 10 100 100
92 Hydrochlorotiazide (HCT) 25 mg Tablet 0 0 0 0 0 0
93 Ibuprofen sirup Botol 0 0 0 0 200 200
94 Ibuprofen 200 mg Tablet 0 0 0 0 0 0
95 Ibuprofen 400 mg Tablet 0 0 0 0 0 0
96 Ichthyol salep 10% pot 0 0 0 0 0 0
97 Immunoglobulin human anti-tetanus (Tetagam) Ampul 0 0 0 0 0 0
98 Infus set dewasa Pcs 27 27 27 0 150 150
99 Infusi set anak Pcs 0 0 0 0 0 0
100 Iodium Povidon 10% 30 ml Botol 83 83 53 30 100 100
101 Isosorbide tablet Tablet 300 300 0 300 0 0
102 IV Catheter No.20 Pcs 192 192 19 173 0 0
103 IV Catheter No.22 Pcs 86 86 24 62 0 0
104 IV Catheter No.24 Pcs 184 184 28 156 0 0
105 Jarum Jahit Kulit Pcs 0 0 0 0 0 0
 HALAMAN : 4 LPLPO No: 0 LAPORAN BULAN : SEPTEMBER 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 0 0 0 0 0 0
107 Kapas pembalut/Absorben 250 g Pcs 15 15 8 7 10 10
108 Kasa pembalut 2x80 Pcs 35 35 0 35 0 0
109 Kasa pembalut hidrofil 4 m x 15 cm Pcs 64 64 14 50 0 0
110 Kasa pembalut hidrofil 4 m x 3 cm Pcs 13 13 13 0 50 50
111 Kasa kompres 40/40 steril Pcs 74 74 27 47 0 0
112 Ketoconazole 200 mg Cream Tube 132 132 41 91 0 0
113 Ketoconazole 200 mg tab Tablet 0 0 0 0 1500 1500
114 Klorokina Fosfat 250 mg Tablet 0 0 0 0 0 0
115 Levertran Salep/ Salep Luka Bakar pot 0 0 0 0 0 0
116 Lidocain 2% Ampul 0 0 0 0 0 0
117 Lidokain Comp. inj Kombinasi Ampul 0 0 0 0 300 300
118 Lidocaine spray (Xylocaine spray) Botol 0 0 0 0 20 20
119 Liquorice liquid extract (OBH) Botol 0 0 0 0 200 200
120 Locoriz Cream Tube 0 0 0 0 0 0
121 Loperamid 2 m tab Tablet 0 0 0 0 2000 2000
122 Loratadine 10 mg tab Tablet 0 0 0 0 2000 2000
123 Magnesium Sulfat Injeksi 20% (MgSO4) Ampul 0 0 0 0 0 0
124 Magnesium Sulfat Injeksi 40% (MgSO4) Ampul 0 0 0 0 0 0
125 Masker Pcs 0 0 0 0 200 200
126 Medical adhesive tape (dermafix/leukomed) Pcs 0 0 0 0 0 0
127 Metamizole injeksi (antalgin 1000) Ampul 0 0 0 0 200 200
128 Metformin 500mg tab Tablet 7280 7280 1350 5930 0 0
129 Methyl Ergometrin Maleat inj 0,2 mg/ml Ampul 0 0 0 0 0 0
130 Methyl Ergometrin Maleat 0,125 mg Tab 200 200 0 200 0 0
131 Methyl Prednisolon tab 4 mg Tablet 3180 3180 480 2700 0 0
132 Methyl Rosanilinium (gentian violet) Botol 0 0 0 0 0 0
133 Metronidazol 250 mg tab Tablet 0 0 0 0 0 0
134 Metronidazol 500 mg tab Tablet 0 0 0 0 3000 3000
135 Metronidazol Infus Botol 0 0 0 0 0 0
136 Metronidazol syr Botol 0 0 0 0 0 0
137 Miconazole 2% Salep Kulit Tube 140 140 22 118 0 0
138 Momilen Baby Gold Sirup Botol 0 0 0 0 0 0
139 Natrium Bikarbonat 500 mg Tablet 0 0 0 0 2000 2000
140 Nifedipin 10 mg tab Kapsul 0 0 0 0 1000 1000
141 Nystatin Tab Vag 10.000 iu/g Tablet 110 110 0 110 0 0
142 Omeprazole inj Vial 0 0 0 0 0 0
 HALAMAN : 5 LPLPO No: 0 LAPORAN BULAN : SEPTEMBER 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 0 0 0 0 200 200
144 Oxytetracycline HCl 1% Salep Mata Tube 158 158 0 158 0 0
145 Oxytetracycline HCl 3% Salep Kulit Tube 0 0 0 0 0 0
146 Oxytocin inj 10 IU Ampul 0 0 0 0 300 300
147 Papaverin 40 mg tab Tablet 0 0 0 0 0 0
148 Papaverin inj Tablet 0 0 0 0 0 0
149 Paracetamol Drops 15 ml Botol 0 0 0 0 0 0
150 Parasetamol 120 mg/5 ml Syr Botol 419 419 78 341 0 0
151 Parasetamol 500 mg Tablet 15000 15000 3800 11200 0 0
152 Patient Lubricant (My Jelly ) Tube 0 0 0 0 0 0
153 Permethrin (Scabimite Cream) Tube 0 0 0 0 100 100
154 Phenobarbital inj 50mg/ml-2ml Ampul 0 0 0 0 0 0
155 Phenobarbital 100 mg Tablet 0 0 0 0 0 0
156 Phenol gliserol 10% TT Botol 0 0 0 0 0 0
157 Phytomenadione (Vit.K1) inj 10 mg/ml Ampul 192 192 37 155 30 30
158 Phytomenadione (Vit.K1) 10 mg Tablet 2890 2890 190 2700 0 0
159 Piracetam 400 mg Tablet 0 0 0 0 0 0
160 Piroxicam 20 mg tab Tablet 0 0 0 0 4000 4000
161 Pisau Disposable (Mess No.14/21) Pcs 0 0 0 0 0 0
162 Plesterku (Leukoplast) Pcs 0 0 0 0 20 20
163 Polivalen serum (Anti Tetanus Inj. 1500 iu/Biosat) Ampul 0 0 0 0 0 0
164 Povidon iodium 10% 300 ml Botol 20 20 0 20 0 0
165 Prednison 5 mg Tablet 4000 4000 1460 2540 3200 3200
166 Primaquin 15 mg tab Tablet 0 0 0 0 0 0
167 Profolat tab Tablet 0 0 0 0 0 0
168 Prokaina Penisilin G inj 3.000.000 iu Ampul 0 0 0 0 0 0
169 Propranolol HCl 10 mg Tablet 100 100 0 100 0 0
170 Propranolol HCl 40 mg Tablet 0 0 0 0 0 0
171 Propylthiouracil 100 mg Tablet 0 0 0 0 0 0
172 Protein Gluco Test Strip 0 0 0 0 0 0
173 Pyrantel Pamoat 125 mg Tablet 0 0 0 0 0 0
174 Pyridoxine HCl 10 mg Tablet 890 890 890 0 5000 5000
175 Ranitidin 150 mg Tablet 0 0 0 0 2000 2000
176 Ranitidin Injeksi Ampul 0 0 0 0 0 0
177 Retinol (Vit.A) kaps 100.000 iu Kapsul 2400 2400 0 2400 0 0
178 Retinol (Vit.A) kaps 200.000 iu Kapsul 4000 4000 0 4000 0 0
179 Risperidone 2mg Tablet 2200 2200 300 1900 0 0
 HALAMAN : 6 LPLPO No: 0 LAPORAN BULAN : SEPTEMBER 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 5600 5600 1600 4000 0 0
181 Salep 2-4 Kombinasi pot 0 0 0 0 96 96
182 Sarung tangan (HandScuun) No.7,5 Pcs 0 0 0 0 100 100
183 Sarung tangan (HandScuun Steril) No. 6,5 Pcs 0 0 0 0 0 0
184 Sarung tangan (HandScuun Steril) No.7 Pcs 0 0 0 0 0 0
185 Sarung tangan (HandScuun Steril) No.7,5 Pcs 0 0 0 0 100 100
186 Semen Seng Fosfat Serbuk & Cairan Set 0 0 0 0 0 0
187 Sianocobalamin (Vit B12) 50 mg tab Tablet 5950 5950 1850 4100 0 0
188 Silk (Benang Bedah) No. 3/0 Pcs 0 0 0 0 0 0
189 Silver Sulfadiazine Tube 0 0 0 0 0 0
190 Simvastatin 10 mg tab Tablet 0 0 0 0 3000 3000
191 Sodium cloride infus 0,9% ( NACL ) Botol 48 48 8 40 0 0
192 Spuit 1 ml Pcs 0 0 0 0 0 0
193 Spuit 3 ml Pcs 630 630 270 360 1200 1200
194 Spuit 5 ml Pcs 770 770 225 545 300 300
195 Sulfadoxine | Pyrimethamine Tablet 500mg|25mg Tablet 0 0 0 0 0 0
196 Sulfamethoxazole | trimethoprim (cotri) syr Botol 421 421 80 341 0 0
197 Sulfasetamida 15% TM Botol 0 0 0 0 0 0
198 Tetracycline 250 mg Tablet 0 0 0 0 0 0
199 Tetracycline 500 mg Tablet 0 0 0 0 4000 4000
200 Thiamine HCl (Vit B1) inj 100 mg/ml Ampul 0 0 0 0 60 60
201 Thiamine HCl (Vit B1) 50 mg Tablet 0 0 0 0 8000 8000
202 Trihexyphenidyl tab 2 mg Tablet 0 0 0 0 0 0
203 Trimethoprim (cotrimoxazol 480 mg) tablet Tablet 10190 10190 1090 9100 0 0
204 Urin Bag Pcs 0 0 0 0 0 0
205 Usg Gel Botol 0 0 0 0 0 0
206 Vaksin Rabies Vero/ Verorab Paket 0 0 0 0 0 0
207 Vitamin B Kompleks Tablet 6400 6400 1600 4800 0 0
208 Vitamin K Infant Inj Ampul 0 0 0 0 0 0
209 Water liquid (aqua P,I) Botol 0 0 0 0 0 0
210 Wing Needle No.21 Pcs 0 0 0 0 0 0
211 Wing Needle No.27 Pcs 0 0 0 0 0 0
212 Zinc Sulphate Suppositoria (Superhoid) Kapsul 0 0 0 0 0 0
213 Zinc tab Tablet 0 0 0 0 4000 4000
214 Ondansetron iv/im 4 mg Ampul 11 11 3 8 0 0
215 Tranexamic Acid inj 5% Ampul 0 0 0 0 0 0
216 Poliwash 500 ml Botol 0 0 0 0 0 0
 HALAMAN : 7 LPLPO No: 0 LAPORAN BULAN : SEPTEMBER 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 0 0 0 0 0 0
218 Sarung Tangan (Handscuun) L Pcs 0 0 0 0 0 0
219 Cefotaxime Sodium inj 1 gr Vial 20 20 7 13 0 0
220 Methyl Prednisolon tab 16 mg Tablet 0 0 0 0 0 0
221 Lancet Pcs 0 0 0 0 0 0
222 Strip Kolesterol Pcs 0 0 0 0 0 0
223 Strip Gula Darah Pcs 0 0 0 0 0 0
224 Strip Asam Urat Pcs 0 0 0 0 0 0
225 Nonwoven Fixation Rol Pcs 0 0 0 0 0 0
226 Paracetamol 1000 mg /100 ml Botol 0 0 0 0 0 0
227 Otsu D-40 25 ml Botol 0 0 0 0 0 0
228 Ketorolac inj 30 mg Ampul 0 0 0 0 30 30
229 Dulcolax tab Tablet 0 0 0 0 2000 2000
230 Ibuprofen 400 mg.1 Tablet 1530 1530 1420 110 5500 5500
231 Permethrin (Scabimite Cream).1 Tube 0 0 0 0 0 0
232 Masker Plus Pcs 0 0 0 0 0 0
233
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235
236
237
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239
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UMUM JAMSOSKES BPJS JUMLAH

JUMLAH KUNJUNGAN RESEP
0

Mengetahui Mengetahui Mengetahui/ Menyetujui Yang Membuat

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

Iwan Setiawan.SKM.M.Kes Himayanti.S.Si.,Apt TITIK SUSWATININGSIH, Am.Keb FRIDA ROSPITA PURBA

NIP. 197303051998031005 NIP. 197702212005012005 NIP. 19680713 198812 2 001 NIP. 19660317 198712 2 001
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