NO Nama Obat Penerimaan Bulanan 29/12/2020 28/12/2020 04/01/2021 Satua N

You might also like

Download as xlsx, pdf, or txt
Download as xlsx, pdf, or txt
You are on page 1of 676

SATUA

NO NAMA OBAT
N

29/12/2020 28/12/2020 04/01/2021

1 Alopurinol 100mg tablet


2 Ambroxol 15mg/5 ml botol
3 Aminophillin 200mg tablet
4 Aminophillin injeksi 24mg/ml ampul
5 Amlodipin 10mg tablet
6 Amlodipin 5mg tablet
7 Amoksisilin (sirup kering) 125mg/5ml botol
8 Amoksisilin (sirup kering) 250mg/5ml botol
9 Amoksisilin 500mg tablet
10 Ampisilin injeksi (serbuk kering) 250mg vial 2
11 Antasida DOEN (MgSO4+AlOH Tersuspensi) botol
12 Antasida DOEN (MgSO4+AlOH) tablet
13 Anti Hemoroid DOEN suppos
14 Anti Tetanus Serum (ATS) 1500IU ampul 5
15 Aquades pro injeksi @25ml respule
16 Asam Askorbat (Vit C) 250mg tablet
17 Asam Askorbat (Vit C) 50mg tablet 7000
18 Asam Folat 1mg tablet 700
19 Asam Mefenamat 500mg tablet
20 Asetosal (Ascardia/Miniaspi) 80mg tablet
21 Asiklovir 200mg tablet
22 Asiklovir 400mg tablet
23 Asiklovir krim 5% tube
24 Atropin Sulfas injeksi 0,25mg/ml ampul
25 Azitromisin 500 mg tablet
26 Bedak salisil serbuk 2% ktk
27 Benzatin benzil penicilin serbuk injeksi 2,4juta IU/ml vial
28 Betahistin mesilate 6mg tablet
29 Betametason krim 0,1% tube 75
30 Bisakodil 5mg tablet 20
31 Budesonide (Cairan inhalasi) 0,25mg/ml respule
32 Deksametason 0,5mg tablet
33 Deksametason injeksi 5mg/ml ampul 10
34 Difenhidramin injeksi 10mg/ml ampul
35 Digoksin 0,25mg tablet
36 Doksisiklin 100mg kapsul
37 Domperidon 10mg tablet
38 Domperidon sirup 5mg/5ml botol 50
39 Epinefrin Bitatrat/Adrenalin Injeksi 1mg/ml ampul
40 Eritromisin (sirup kering) 200mg/5ml botol
41 Eritromisin 250mg kapsul
42 Eritromisin 500mg kapsul
43 Fenofibrat 100mg tablet
44 Ferro sulfat 15mg/5ml botol
45 Fitomenadion (Vit K1) 10mg tablet
46 Fitomenadion (Vit.K1) injeksi 2mg/ml ampul
47 Flukonazol 150mg kapsul
48 Framisetin sulfat kassa steril 1% lembar 30
49 Furosemid 40mg tablet
50 Garam Oralit serbuk untuk 200ml sach
51 Gentamisin Salep 0,1% tube
52 Gentian Violet larutan 1% botol
53 Glibenklamid 5mg tablet
54 Glimepirid 1mg tablet
55 Gliseril Guaiakolat 100mg tablet
56 Glukosa larutan infus 10 % botol
57 Glukosa larutan infus 40 % botol
58 Glukosa larutan infus 5 % botol
59 Griseofulvin 125mg tablet
60 Hidroklortiazid 25mg tablet
61 Hidrokotison krim 2,5% tube 48
62 Hiosin N Butylbromide 10mg tablet
63 Ibuprofen 200mg tablet 1000
64 Ikhtamol salep 10% pot
65 Isosorbid dinitrat (ISDN) 5mg tablet 100
66 Kalsium glukonat injeksi 10% vial
67 Kalsium Laktat 500mg tablet 5000
68 Kaptopril 12,5 mg tablet
69 Kaptopril 25mg tablet
70 Karbo Adsorben (Norit) 125mg tablet
71 Karbogliserin (Fenol Gliserol) tetes telinga 10% botol
72 Ketokonazol 200mg tablet
73 Ketokonazol krim 2% tube
74 Ketoprofen 100mg/Supp suppos
75 Khlofeniramin Maleat (CTM) 4mg tablet
76 Klindamisin 150mg kapsul
77 Klopidogrel 75mg tablet
78 Kloramfenikol tetes mata 0,5% botol
79 Kloramfenikol 250mg kapsul
80 Kloramfenikol 500mg kapsul
81 Kloramfenikol salep kulit 2% tube 72
82 Kloramfenikol salep mata 1% tube
83 Kloramfenikol suspensi 125mg/5ml botol
84 Kloramfenikol tetes telinga 3% botol
85 Kolkisin 500mg tablet
86 Komb.ferro sulfat+as.folat (tablet tambah darah) tablet 5600
87 Komb.kaolin 550mg+pektin 20mg tablet
88 Kombipak Azitromisin + Cefixim amplop
89 Kotrimoksazol 240mg/5 mL botol
90 Kotrimoksazol 480mg tablet 1000
91 Lactulosa 3,335mg/5ml botol
92 Lidokain injeksi 2% ampul
93 Lincomisin kapsul 500mg kapsul
94 Loratadin 10mg tablet 1500
95 Metformin 500mg tablet
96 Metil Ergometrin injeksi 0,2mg/ml ampul 30
97 Metil Ergometrin 0,125mg tablet
98 Metoklorpropamid 10mg tablet
99 Metronidazol 250mg tablet
100 Metronidazol 500mg tablet
101 MgSO4 injeksi 40% vial
102 Mikonazol krim 2% tube
103 NaCl larutan infus 0,9% botol 10
104 N-Asetil Sistein 200mg kapsul 2000
105 Natrium Bicarbonat 500mg tablet
106 Natrium Diklofenak 25mg tablet
107 Natrium Diklofenak 50mg tablet
108 Neomisin 0,5% & Plasenta sapi 10% tube
109 Nifedipin tablet 10mg tablet
110 Nistatin 100.000IU/ml botol
111 Nistatin vaginal 100.000IU tablet
112 Nitrofurantoin 50mg tablet
113 Oksitetrasiklin HCl salep mata 1% tube
114 Oksitosin Injeksi 10IU/ml ampul
115 Omeprazole 20mg kapsul
116 Omeprazole serbuk injeksi 40mg vial
117 Pantocain 0,5% botol
118 Papaverin 40mg tablet
119 Papaverin injeksi 40mg/ml ampul
120 Paracetamol supp 125mg suppos
121 Parasetamol 100mg/ml botol
122 Parasetamol 120mg/5ml botol
123 Parasetamol 500mg tablet 16500
124 Perak sufadiazin krim (Burnazin) 1% tube
125 Permetrin krim 5% (Scabimied) tube
126 Pirantel Pamoat 125mg tablet
127 Pirantel Pamoat 125mg/5ml botol
128 Piridoxin (Vit B6) 10mg tablet
129 Prednison 5mg tablet
130 Ranitidin 150mg tablet
131 Retinol (Vit A. Biru) 100.000 IU kapsul
132 Retinol (Vit A. Merah) 200.000 IU kapsul
133 Ringer Laktat larutan Elektrolit infus botol 60
134 Salbutamol 2mg tablet
135 Salbutamol 4mg tablet
136 Salbutamol cairan iihalasi (Ventolin Nebules) 2,5mg ampul
137 Salep 2-4 (As.Salisilat2%+Sulfur4%) pot
138 Salep Whitfield/Antifungi (As.Benzoat6%+As.Salisilat3%) pot
139 Sefiksim 200mg kapsul
140 Setirizine 5mg/5ml botol
141 Sianokobalamin (Vit.B12) 50 µg tablet
142 Simvastatin 10mg tablet
143 Siprofloxasin 500mg tablet
144 Tetrasiklin 250mg kapsul
145 Tetrasiklin kapsul 500mg kapsul
146 Tiamfenikol 500mg kapsul 500
147 Tiamin (Vitamin B1) 100mg tablet
148 Tiamin (Vitamin B1) 50mg tablet
149 Vitamin B kompleks tablet
150 Zink 20mg/5ml botol
151 Zink dispersibel 20mg tablet 1000
152 Amitriptilin HCl 25mg tablet 200
153 Anti Migrain DOEN tablet (ergotamin1mg+kafein50mg) tablet
154 Diazepam 2mg tablet
155 Diazepam 5mg tablet
156 Diazepam injeksi 5mg/ml ampul
157 Diazepam enema (Stesolid rectal tube) 10mg/2,5ml tube
158 Diazepam enema (Stesolid rectal tube) 5mg/2,5ml tube
159 Fenobarbital 30mg tablet
160 Haloperidol tablet 5mg tablet
161 Klorpromazin 100mg tablet 600
162 Risperidon 2mg tablet 1000
163 Triheksipenidil 2mg tablet 1000
164 Kodein 10mg tablet
165 Bahan tumpatan sementara (Cavit/Caviton) set
166 Bonding botol
167 Celluloid Strip Gigi Pak
168 Composit Light Curing (Tambal Sinar ) A2 tube
169 Composit Light Curing (Tambal Sinar ) A3 tube
170 Composit Light Curing (Tambal Sinar ) A3,5 tube
171 Cresophene (cresotin) botol
172 Dycal (Dycal/Hydcal) set
173 Ecing (Ecing/Ethacant) botol
174 Endometason (Endoseal) tube
175 Etil Chlorida Spray (Etil Clorida/Endoice) botol
176 Eugenol botol
177 Formokresol botol
178 Glass Ionomert ART (Fuji IX) set
179 Kalsium Hidroksida Pasta (Metapex/Calcetin/Vitapex) ktk
180 Klorfenol kamfer mentol (CHKM) botol
181 Lidocain spray 10% (Xylocaine) botol
182 Lidokain 2%+Epinefrin1:80.000 injeksi 2ml (Pehacain) ampul
183 Lidokain krim anestesi topical pot
184 Pasta devitalisasi non arsen (Depulpin) botol
185 Scandonest botol
186 Zinc Pospat Cement set
187 Tuberkulin protein purified derivative (Mantoux test) vial 5
188 Vaksin BCG kering + Pelarut vial
189 Vaksin HB0 (Hepatitis rekombinan) Dewasa vial
190 Vaksin HB0 (Hepatitis rekombinan) vial
191 Vaksin HPV vial
192 Vaksin Polio Oral + droppler (OPV) vial 20
193 Vaksin jerap difteri tetanus (DT) <7thn vial
194 Vaksin jerap tetanus difteri (Td) >7thn vial 20
195 Vaksin kombinasi DPT-HB-Hib vial
196 Vaksin Polio injeksi (IPV) vial 20
197 Vaksin Meningitis vial
198 Vaksin MR Kering + Pelarut Vial
199 Vaksin HBIg ampul 10
200 Efavirenz (EFV) 600mg tablet
201 Lamivudine (3TC) 150mg tablet
202 Lopinovir/ritonavir (LPV/r) 200/50mg tablet
203 Nevirapine (NVP) 200mg tablet
204 Tenofovir (TDF) 300mg tablet
205 Zidovudine (ZDV)+ Lamivudine (3TC) 300/150mg tablet
206 Triple FDC (TDF+3TC+EFV) 300/300/600mg tablet
207 Ped Triple FDC(ZDV+3TC+NVP) 60/30/50mg tablet
208 Ziduvudin Sirup botol
209 Albendazol 400mg tablet
210 MDT Combi (MB-Adult) blister 6
211 MDT Combi (MB-Child) blister 6
212 MDT Combi (PB- Adult) blister
213 MDT Combi (PB- Child)) blister 6
214 Isoniasid 100 mg tablet
215 Isoniazid 300 mg tablet
216 Obat Anti Tuberkulose kategori Anak paket
217 Obat Anti Tuberkulose kategori I & III paket
218 Obat Anti Tuberkulose kategori II paket
219 Obat Anti Tuberkulose kombipak paket
220 Piridoksin (Vit B6) 25mg tablet
221 OAT TB + HIV Intensif paket
222 OAT TB + HIV Lanjutan paket
223 Sterptomycin sulfat serbuk injeksi 1000mg vial
224 Bedaquilin 100 mg tablet
225 Ethambutol 400. mg tablet
226 Etionamid 250 mg tablet
227 Kanamisin injeksi 1000mg vial
228 Kapreomisin 1 g injeksi vial
229 Klofazimin 100 mg kapsul
230 Kloserin 250 mg tablet
231 Levofloksasin 250 mg tablet
232 Moksifloksasin 400 mg tablet
233 P-aminosalisilat sodium 5.52 g sachet
234 Linizolid 600 mg capsul
235 Pirazinamid 400 mg tablet
236 Pirazinamid 500 mg tablet
237 Piridoksin 100 mg tablet
238 Pil KB komb.I (Levonogestrol 150mg+Etinil Estradiol 30µg) blister
239 Suntik KB 1 bulan (Medoksi 150mg+Estradiol 5mg) vial
240 Suntik KB 3 bulan (Medoksiprogesteron Asetat 150mg/3ml) vial
241 Implan KB 3 tahun (Levonogestrol 25mg) pcs
242 Dekstro+GG+CTM+Phenyl Syr Botol
243 Oxycan botol
244 Parasetamol 100mg tablet tablet
245 Bisoprolol 5 mg tablet
246 candesartan tablet
247 Kotrimoxazole 960mg tablet
248 Becomzet tablet
249 ZEGAVIT tablet
250 DANEURON tablet
251 Becefort tablet
252 Vitamin Ultra C tablet
253 Zidovudin 100 mg tablet
254 Delanamid 50 mg tablet
255 Furosemide inj tablet
256 Albendazole syr 200 mg/ml tablet
257 Dolutegravir 50 mg tablet
258 Triple FDC (TDF+3TC+DTG) 300/300/50mg tablet
259 Spironolactone 100 mg tablet
260 Acarbose 50 mg tablet
261 Ramipril 5 mg tablet
262 Valsartan 160 mg tablet
263 Ramipril 10 mg tablet
264 Adalat Oros 30 mg tablet
265 Glikuidone 30 mg tablet
266 Levofloksasin 100 mg tablet
267 Xylocain Jelly Tube 4
268 Gabapentin tablet
269 Rifampentin tablet
270 Vitamin C 500 mg tablet
271 Sinovac vial
PENERIMAAN BULANAN

05/01/2020 8/1/2021 13/1/2021 14/1/2021 15/01/2021 17/01/2021

50

7200

5000

2000

300
200

200
20

2000

1000

30

29

500

48
1000
1000
4000
48
100

10

1000
90

1000
500

1500

10

900 300

1000

200

2500
20

50
4000

5000

1000
10
720
480

1140
3360

500
1
6 1 1
1

500

2000

300
100
1800

100
672

700
2000 5000
120
BPG 1 BPG2 GADAR

20/01/2021 21/01/2021 25/01/2021

3000
200

100

200
3000

300

600
48
20

200
5

15
5

5
1
1
120
GADAR

22/12/2020 23/12/2020 28/12/2020 29/12/2020


1

1 1

1
1 1 2 1
1 1 1

1
IMUNISASI

30/12/2020 04/01/2021 05/01/2021 06/01/2021 07/01/2021 08/01/2021 11/01/2021 12/01/2021 25/01/2021


1 1 1

1 1 1

1 1 1 1 2 1
2 1 1 1 1 1 2
1 1 1 1

1 1 1
NISASI

14/01/2021 15/01/2021 18/01/2021 19/01/2021 20/01/2021 22/01/2021


2 1 1 1 1 1
RB KI

23/12/2020 28/12/2020 05/01/2021 14/01/2021 18/01/2021

5
30
20
5
20 10 20 20
10

10
KESLING KB TINDAKAN MTBS

12/01/2020 23/12/2020
1 1
22/12/2020 23/12/2020 24/12/2020 26/12/2020 27/12/2020 28/12/2020 29/12/2020 30/12/2020 31/12/2020 1/12021 02/01/2021

5 10

1500
1500 600

500 300 500

5
500 500 500
20

500 500
500 600 2000

600 500
100 170

60
8
200

300 600

200 200
10

90

100

300 500

500 1000
400

100

600 300 1000

500 1000

24 24

1000 500 300 1000


100 100 100
10

500

250
1000
24
1 1 1
300

250 250

90 120 120 60

300 300

20 10 10
1000 500 500 500 1000
2

500 700

200 500
1
3

5 5 6
1000
150 300
200

100

500
500 1000 1000

200 300 200


100

300
300
400
100 400
6
6

88
300
RF

03/01/2021 04/01/2021 05/01/2021 06/01/2021 08/01/2021 09/01/2021 11/01/2021 12/01/2021 13/01/2021 14/010/2021 15/1/2021

100 200
10 10

1500 600 600


1500 600
10
20
1000 500

10
1000

600 200 200 500


1900 1000
300 300
500 500
200 200

20
16 8
400
25

1000 500

200
10 10

150
4
50

50
100 100

24

500
1000 100 800

90
24
100
200

1700 500 1000 1000


300
330

24

1000 100 1000 300


200

240

24 24

1500 500 800


100 200

500

500 250
500 1000 1000
100

24

500

250 500

60 240 90 150

10
31 44 50 50
1000 2000 500 100 1000 1000

1000 1000
600
500
100

5
5

7 5
800
300

200

500
1000 2000

200 300

300
300
720
480

1140
3360

200

500
16/01/2021 17/01/2021 18/01/2021 19/01/2021 20/01/2021 21/01/2021 22/01/2021 23/01/2021 24/01/2021 25/01/2021 14/01/2021

6 5

300 300
300 300 300 600
10

1000 500 500

10
500
20 20

300 400
1000 500 1000

500 500 500

20 40 20
8
25 25
20

500 500

300
10 5

100 100

3
100

10

50
100 100 100

300 300
500 500 500
24
100
100

50

500

500 1000

240

24
24
4

1000 500
100 100
10

100

150
300 1000
1
200 400

150 250

150 90 150

100

1
5
5 20
1000 1000 500
4

500 300
500
200 500
50

200
130

10
500
150 90
200

200

500
500 1000

300 100 300


100

200

300
300
6
12
PTM LAB
COVID

15/01/2021 18/01/2021 19/01/2021 20/01/2021 21/01/2021 22/01/2021 25/01/2021


28 12 9 6 16 18 1
TB

08/01/2021 11/01/2021 14/01/2021 15/01/2021 20/01/2021 22/12/2020 23/12/2020

100

500

10
50
5

500
5

30
10
1 1
6 1 1 1
1

2000

300
100
1800

100
672
POLI 24JAM

29/12/2020 30/12/2020 01/01/2021 04/01/2021 08/01/2021 10/01/2021 11/01/2021 12/01/2021 14/01/2021

1 1 1
2

10
2
10

9
4

3
5
1

2
GIZI KARYAWAN

16/01/2021 18/01/2021 22/01/2021 30/12/2020 04/01/2021 05/01/2021 08/01/2021

200 300
1
7 2

1
3
28 3164
TOTAL
KARYAWAN GUDANG LANTAI 5 GUDANG (ED)
DISTRIBUSI

12/01/2021 13/01/0221 20/01/2021 24/01/2021 25/01/2021

400
46
0
0
4800
5700
20
20
5300
0
25
3000
60
3
8
3700
8500
600
3600
690
0
0
0
0
160
40
0
600
75
20
0
3400
0
6 7
0
0
900
45
0
0
200
0
240
7
200
30
10
2
100
600
0
24
800
1100
4900
0
0
0
0
90
48
200
700
0
160
0
6600
300
330
0
24
0
0
1 1
5400
200
0
0
480
0
120
24
9
0
0
7100
800
20
0
1100
0
34
0
1150
5300
0
0
0
0
100
5
48
22
1400
0
1650
0
0
0
5
0
0
0
0
1350
2
0
700
0
4
15
240
11600
6
4
0
0
4000
1100
1900
0
150
88
200
130
1
8
5
0
38
2300
990
400
0
0
500
0
1500
7000
0
1900
200
0
0
0
0
0
0
0
500
300
1000
1100
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
4
0
11
0
5
0
15
14
7
0
4
10
0
0
720
480
0
1140
3360
0
0
0
12
6
0
0
88
500
2
9
1
0
500
0
0
0
0
0
2000
0
0
300
100
1800
0
0
100
0
672
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
2
0
0
14 84 14 56 28 3388
102
( LPLPO )

PENERIMAAN
NO NAMA OBAT SATUAN STOCK AWAL
GUDANG
1 2 3 4 5

1 Alopurinol 100mg tablet 1,000 -


2 Ambroxol 15mg/5 ml tablet 41 50
3 Aminophillin 200mg botol -
4 Aminophillin injeksi 24mg/ml tablet -
5 Amlodipin 10mg ampul 13500 -
6 Amlodipin 5mg tablet 9,000 7,200
7 Amoksisilin (sirup kering) 125mg/5ml tablet 240 -
8 Amoksisilin (sirup kering) 250mg/5ml botol 160 -
9 Amoksisilin 500mg botol 4,000 5,000
10 Ampisilin injeksi (serbuk kering) 250mg tablet 2
11 Antasida DOEN (MgSO4+AlOH Tersuspensi) vial 61 -
12 Antasida DOEN (MgSO4+AlOH) botol 7,500 -
13 Anti Hemoroid DOEN tablet 70 -
14 Anti Tetanus Serum (ATS) 1500IU suppos 3 5
15 Aquades pro injeksi @25ml respule 8 -
16 Asam Askorbat (Vit C) 250mg tablet 4,200 2,000
17 Asam Askorbat (Vit C) 50mg tablet 5,000 10,000
18 Asam Folat 1mg tablet 600 700
19 Asam Mefenamat 500mg tablet 6,300 -
20 Asetosal (Ascardia/Miniaspi) 80mg tablet 880 300
21 Asiklovir 200mg tablet 1,200 200
22 Asiklovir 400mg tablet 200 -
23 Asiklovir krim 5% tube 75 -
24 Atropin Sulfas injeksi 0,25mg/ml ampul -
25 Azitromisin 500 mg ampul 100 200
26 Bedak salisil serbuk 2% ktk 80 -
27 Benzatin benzil penicilin serbuk injeksi 2,4juta IU/ml vial 20
28 Betahistin mesilate 6mg tablet 1,400 -
29 Betametason krim 0,1% tube 75 75
30 Bisakodil 5mg tablet 30 20
31 Budesonide (Cairan inhalasi) 0,25mg/ml respule -
32 Deksametason 0,5mg tablet 3,700 2,000
33 Deksametason injeksi 5mg/ml ampul 3 10
34 Difenhidramin injeksi 10mg/ml ampul 17 -
35 Digoksin 0,25mg tablet -
36 Doksisiklin 100mg kapsul 200 -
37 Domperidon 10mg botol 1,300 1,000
38 Domperidon sirup 5mg/5ml tablet 45 50
39 Epinefrin Bitatrat/Adrenalin Injeksi 1mg/ml ampul 19 -
40 Eritromisin (sirup kering) 200mg/5ml botol -
41 Eritromisin 250mg kapsul 200 200
42 Eritromisin 500mg kapsul -
43 Fenofibrat 100mg tablet 900 30
44 Ferro sulfat 15mg/5ml botol 12 -
45 Fitomenadion (Vit K1) 10mg tablet 200 -
46 Fitomenadion (Vit.K1) injeksi 2mg/ml ampul 30 29
47 Flukonazol 150mg kapsul 100
48 Framisetin sulfat kassa steril 1% lembar 16 30
49 Furosemid 40mg tablet 250 -
50 Garam Oralit serbuk untuk 200ml sach 700 500
51 Gentamisin Salep 0,1% tube -
52 Gentian Violet larutan 1% botol 24 48
53 Glibenklamid 5mg tablet 1,000 1,000
54 Glimepirid 1mg tablet 1,700 1,000
55 Gliseril Guaiakolat 100mg tablet 6,400 4,000
56 Glukosa larutan infus 10 % botol 5 -
57 Glukosa larutan infus 40 % botol -
58 Glukosa larutan infus 5 % botol -
59 Griseofulvin 125mg tablet 600 -
60 Hidroklortiazid 25mg tablet 190 200
61 Hidrokotison krim 2,5% tube 48 48
62 Hiosin N Butylbromide 10mg tablet 350 -
63 Ibuprofen 200mg tablet 900 1,000
64 Ikhtamol salep 10% pot -
65 Isosorbid dinitrat (ISDN) 5mg tablet 100 100
66 Kalsium glukonat injeksi 10% vial 2 -
67 Kalsium Laktat 500mg tablet 4,600 8,000
68 Kaptopril 12,5 mg tablet 1,800 -
69 Kaptopril 25mg tablet 1,830 -
70 Karbo Adsorben (Norit) 125mg tablet -
71 Karbogliserin (Fenol Gliserol) tetes telinga 10% botol 24 48
72 Ketokonazol 200mg tablet 100 100
73 Ketokonazol krim 2% tube 25 -
74 Ketoprofen 100mg/Supp tablet 4 -
75 Khlofeniramin Maleat (CTM) 4mg suppos 8,200 -
76 Klindamisin 150mg tablet 400 300
77 Klopidogrel 75mg kapsul -
78 Kloramfenikol tetes mata 0,5% kapsul 50 -
79 Kloramfenikol 250mg kapsul 600 600
80 Kloramfenikol 500mg tube 0 -
81 Kloramfenikol salep kulit 2% tube 96 72
82 Kloramfenikol salep mata 1% botol 48 -
83 Kloramfenikol suspensi 125mg/5ml botol 5 10
84 Kloramfenikol tetes telinga 3% botol 25 -
85 Kolkisin 500mg tablet -
86 Komb.ferro sulfat+as.folat (tablet tambah darah) amplop 8,600 5,600
87 Komb.kaolin 550mg+pektin 20mg tablet 1,100 1,000
88 Kombipak Azitromisin + Cefixim tablet 100 90
89 Kotrimoksazol 240mg/5 mL tablet 88 -
90 Kotrimoksazol 480mg botol 1,000 2,000
91 Lactulosa 3,335mg/5ml tablet -
92 Lidokain injeksi 2% botol 95 -
93 Lincomisin kapsul 500mg ampul -
94 Loratadin 10mg kapsul 750 1,500
95 Metformin 500mg tablet 10,000 -
96 Metil Ergometrin injeksi 0,2mg/ml tablet 3 30
97 Metil Ergometrin 0,125mg ampul -
98 Metoklorpropamid 10mg tablet 300 -
99 Metronidazol 250mg tablet -
100 Metronidazol 500mg tablet 300 500
101 MgSO4 injeksi 40% tablet 13 -
102 Mikonazol krim 2% vial 48 48
103 NaCl larutan infus 0,9% tube 12 10
104 N-Asetil Sistein 200mg botol 2,000
105 Natrium Bicarbonat 500mg tablet -
106 Natrium Diklofenak 25mg tablet 1,350 1,500
107 Natrium Diklofenak 50mg tablet -
108 Neomisin 0,5% & Plasenta sapi 10% tube -
109 Nifedipin tablet 10mg tablet 300 -
110 Nistatin 100.000IU/ml botol 7 10
111 Nistatin vaginal 100.000IU tablet 80 -
112 Nitrofurantoin 50mg tablet -
113 Oksitetrasiklin HCl salep mata 1% kapsul 15 -
114 Oksitosin Injeksi 10IU/ml tube 64 -
115 Omeprazole 20mg ampul 450 1,200
116 Omeprazole serbuk injeksi 40mg kapsul 2 -
117 Pantocain 0,5% vial -
118 Papaverin 40mg botol 600 1,000
119 Papaverin injeksi 40mg/ml tablet -
120 Paracetamol supp 125mg ampul 9 -
121 Parasetamol 100mg/ml botol 58 -
122 Parasetamol 120mg/5ml botol 175 200
123 Parasetamol 500mg suppos 12,000 16,500
124 Perak sufadiazin krim (Burnazin) 1% tablet 6 4
125 Permetrin krim 5% (Scabimied) tube 10 -
126 Pirantel Pamoat 125mg tube -
127 Pirantel Pamoat 125mg/5ml tablet 6 -
128 Piridoxin (Vit B6) 10mg botol 8,000 -
129 Prednison 5mg tablet 1,400 2,500
130 Ranitidin 150mg tablet 3,600 -
131 Retinol (Vit A. Biru) 100.000 IU tablet 450 -
132 Retinol (Vit A. Merah) 200.000 IU kapsul 400 -
133 Ringer Laktat larutan Elektrolit infus kapsul 10 100
134 Salbutamol 2mg botol 500 -
135 Salbutamol 4mg tablet 130 -
136 Salbutamol cairan iihalasi (Ventolin Nebules) 2,5mg tablet 92 -
137 Salep 2-4 (As.Salisilat2%+Sulfur4%) ampul 15 -
138 Salep Whitfield/Antifungi (As.Benzoat6%+As.Salisilat pot 18 -
139 Sefiksim 200mg pot -
140 Setirizine 5mg/5ml botol 34 50
141 Sianokobalamin (Vit.B12) 50 µg tablet 4,000 4,000
142 Simvastatin 10mg tablet 1,500 -
143 Siprofloxasin 500mg tablet 800 -
144 Tetrasiklin 250mg kapsul -
145 Tetrasiklin kapsul 500mg kapsul 300 -
146 Tiamfenikol 500mg tablet 700
147 Tiamin (Vitamin B1) 100mg tablet -
148 Tiamin (Vitamin B1) 50mg kapsul 3,300 -
149 Vitamin B kompleks tablet 7,100 5,000
150 Zink 20mg/5ml tablet -
151 Zink dispersibel 20mg botol 700 2,000
152 Amitriptilin HCl 25mg tablet 200 200
153 Anti Migrain DOEN tablet (ergotamin1mg+kafein50mg) tablet -
154 Diazepam 2mg tablet -
155 Diazepam 5mg tablet 200 -
156 Diazepam injeksi 5mg/ml ampul 2 -
157 Diazepam enema (Stesolid rectal tube) 10mg/2,5ml tube 2 -
158 Diazepam enema (Stesolid rectal tube) 5mg/2,5ml tube 1 -
159 Fenobarbital 30mg tablet 80 -
160 Haloperidol tablet 5mg tablet 1,100 -
161 Klorpromazin 100mg tablet 600 600
162 Risperidon 2mg tablet 800 1,000
163 Triheksipenidil 2mg tablet 900 1,000
164 Kodein 10mg tablet 100 -
165 Bahan tumpatan sementara (Cavit/Caviton) vial 2 -
166 Bonding vial 2 -
167 Celluloid Strip Gigi vial 3 -
168 Composit Light Curing (Tambal Sinar ) A2 vial -
169 Composit Light Curing (Tambal Sinar ) A3 vial 1 -
170 Composit Light Curing (Tambal Sinar ) A3,5 vial 2 -
171 Cresophene (cresotin) vial 4 -
172 Dycal (Dycal/Hydcal) vial -
173 Ecing (Ecing/Ethacant) vial -
174 Endometason (Endoseal) vial -
175 Etil Chlorida Spray (Etil Clorida/Endoice) vial 2 -
176 Eugenol Vial 4 -
177 Formokresol ampul -
178 Glass Ionomert ART (Fuji IX) tablet 2 -
179 Kalsium Hidroksida Pasta (Metapex/Calcetin/Vitapex) tablet 2 -
180 Klorfenol kamfer mentol (CHKM) tablet -
181 Lidocain spray 10% (Xylocaine) tablet -
182 Lidokain 2%+Epinefrin1:80.000 injeksi 2ml (Pehacain) tablet 30 -
183 Lidokain krim anestesi topical tablet -
184 Pasta devitalisasi non arsen (Depulpin) tablet 2 -
185 Scandonest tablet -
186 Zinc Pospat Cement set 1 -
187 Tuberkulin protein purified derivative (Mantoux test) botol 2 5
188 Vaksin BCG kering + Pelarut tube 19 5
189 Vaksin HB0 (Hepatitis rekombinan) Dewasa tube -
190 Vaksin HB0 (Hepatitis rekombinan) tube 64 -
191 Vaksin HPV botol -
192 Vaksin Polio Oral + droppler (OPV) set 11 25
193 Vaksin jerap difteri tetanus (DT) <7thn botol -
194 Vaksin jerap tetanus difteri (Td) >7thn tube 12 20
195 Vaksin kombinasi DPT-HB-Hib botol 16 25
196 Vaksin Polio injeksi (IPV) botol 10 25
197 Vaksin Meningitis botol 1 -
198 Vaksin MR Kering + Pelarut set 22 5
199 Vaksin HBIg ktk 10 10
200 Efavirenz (EFV) 600mg botol -
201 Lamivudine (3TC) 150mg botol -
202 Lopinovir/ritonavir (LPV/r) 200/50mg ampul 720
203 Nevirapine (NVP) 200mg pot 480
204 Tenofovir (TDF) 300mg botol -
205 Zidovudine (ZDV)+ Lamivudine (3TC) 300/150mg botol 1,140
206 Triple FDC (TDF+3TC+EFV) 300/300/600mg set 3,360
207 Ped Triple FDC(ZDV+3TC+NVP) 60/30/50mg tablet -
208 Ziduvudin Sirup tablet -
209 Albendazol 400mg paket 140 -
210 MDT Combi (MB-Adult) paket 18 6
211 MDT Combi (MB-Child) paket 6
212 MDT Combi (PB- Adult) paket 6 -
213 MDT Combi (PB- Child)) tablet 6
214 Isoniasid 100 mg paket 188 -
215 Isoniazid 300 mg paket 600 500
216 Obat Anti Tuberkulose kategori Anak vial 2
217 Obat Anti Tuberkulose kategori I & III blister 9
218 Obat Anti Tuberkulose kategori II vial 1
219 Obat Anti Tuberkulose kombipak vial -
220 Piridoksin (Vit B6) 25mg pcs 500
221 OAT TB + HIV Intensif blister -
222 OAT TB + HIV Lanjutan blister -
223 Sterptomycin sulfat serbuk injeksi 1000mg blister -
224 Bedaquilin 100 mg blister -
225 Ethambutol 400. mg tablet -
226 Etionamid 250 mg tablet 2,000
227 Kanamisin injeksi 1000mg tablet -
228 Kapreomisin 1 g injeksi vial -
229 Klofazimin 100 mg vial 300
230 Kloserin 250 mg kapsul 100
231 Levofloksasin 250 mg tablet 1,800
232 Moksifloksasin 400 mg tablet -
233 P-aminosalisilat sodium 5.52 g tablet -
234 Linizolid 600 mg sachet 100
235 Pirazinamid 400 mg capsul -
236 Pirazinamid 500 mg tablet 672
237 Piridoksin 100 mg tablet -
238 Pil KB komb.I (Levonogestrol 150mg+Etinil Estradiol 3 kapsul 790 -
239 Suntik KB 1 bulan (Medoksi 150mg+Estradiol 5mg) botol -
240 Suntik KB 3 bulan (Medoksiprogesteron Asetat 150mg Pak 60 -
241 Implan KB 3 tahun (Levonogestrol 25mg) Botol -
242 Dekstro+GG+CTM+Phenyl Syr botol -
243 Oxycan tablet 9 -
244 Parasetamol 100mg tablet ktk -
245 Bisoprolol 5 mg tablet -
246 candesartan vial -
247 Kotrimoxazole 960mg tablet 700
248 Becomzet tube -
249 ZEGAVIT tablet -
250 DANEURON tablet 300 -
251 Becefort tablet -
252 Vitamin Ultra C ampul -
253 Zidovudin 100 mg ampul -
254 Delanamid 50 mg tablet -
255 Furosemide inj kapsul 2 -
256 Albendazole syr 200 mg/ml tablet -
257 Dolutegravir 50 mg botol -
258 Triple FDC (TDF+3TC+DTG) 300/300/50mg ampul -
259 Spironolactone 100 mg botol 100 -
260 Acarbose 50 mg kapsul -
261 Ramipril 5 mg kapsul -
262 Valsartan 160 mg tablet -
263 Ramipril 10 mg tablet -
264 Adalat Oros 30 mg tablet -
265 Glikuidone 30 mg tablet -
266 Levofloksasin 100 mg tablet -
267 Xylocain Jelly tablet 4
268 Gabapentin tablet -
269 Rifampentin tablet -
270 Vitamin C 500 mg tablet 7,000
271 Sinovac tablet 240

Mengetahui
PJ Farmasi PKM Cakung
Windi Wikandari, S.Farm., Apt
NIP 19860813211012014
PENERIMAAN PENGELUARAN
PERSEDIAAN
RETUR PEMAKAIAN RETUR ED/RUSAK PENYESUAIAN
6 7 8

1,000 400
91 46
- 0
- 0
13,500 4800
16,200 5700
240 20
160 20
9,000 5300
2 0
61 25
7,500 3000
70 60
8 3
8 8
6,200 3700
15,000 8500
1,300 600
6,300 3600
1,180 690
1,400 0
200 0
75 0
- 0
300 160
80 40
20 0
1,400 600
150 75
50 20
- 0
5,700 3400
13 0
17 7
- 0
200 0
2,300 900
95 45
19 0
- 0
400 200
- 0
930 240
12 7
200 200
59 30
100 10
46 2
250 100
1,200 600
- 0
72 24
2,000 800
2,700 1100
10,400 4900
5 0
- 0
- 0
600 0
390 90
96 48
350 200
1,900 700
- 0
200 160
2 0
12,600 6600
1,800 300
1,830 330
- 0
72 24
200 0
25 0
4 1
8,200 5400
700 200
- 0
50 0
1,200 480
- 0
168 120
48 24
15 9
25 0
- 0
14,200 7100
2,100 800
190 20
88 0
3,000 1100
- 0
95 34
- 0
2,250 1150
10,000 5300
33 0
- 0
300 0
- 0
800 100
13 5
96 48
22 22
2,000 1400
- 0
2,850 1650
- 0
- 0
300 0
17 5
80 0
- 0
15 0
64 0
1,650 1350
2 2
- 0
1,600 700
- 0
9 4
58 15
375 240
28,500 11600
10 6
10 4
- 0
6 0
8,000 4000
3,900 1100
3,600 1900
450 0
400 150 250
110 88
500 200
130 130
92 1
15 8
18 5
- 0
84 38
8,000 2300
1,500 990
800 400
- 0
300 0
700 500
- 0
3,300 1500
12,100 7000
- 0
2,700 1900
400 200
- 0
- 0
200 0
2 0
2 0
1 0
80 0
1,100 500
1,200 300
1,800 1000
1,900 1100
100 0
2 0
2 0
3 0
- 0
1 0
2 0
4 0
- 0
- 0
- 0
2 0
4 0
- 0
2 0
2 0 2
- 0
- 0
30 0
- 0
2 0
- 0
1 0
7 2
24 4 16
- 0
64 11
- 0
36 5 27
- 0
32 15
41 14 14
35 7 24
1 0
27 4 18
20 10
- 0
- 0
720 720
480 480
- 0
1,140 1140
3,360 3360
- 0
- 0
140 0
24 12
6 6
6 0
6 0
188 88
1,100 500
2 2
9 9
1 1
- 0
500 500
- 0
- 0
- 0
- 0
- 0
2,000 2000
- 0
- 0
300 300
100 100
1,800 1800
- 0
- 0
100 100
- 0
672 672
- 0
790 0
- 0
60 0
- 0
- 0
9 0
- 0
- 0
- 0
700 0
- 0
- 0
300 0
- 0
- 0
- 0
- 0
2 1
- 0
- 0
- 0
100 0
- 0
- 0
- 0
- 0
- 0
- 0
- 0
4 2
- 0
- 0
7,000 3388
240 102
DROPING
SISA STOCK STOK OPNAME SELISIH
STOK OPTIMUM PERMINTAAN I II
9 10 11 12 13

600 600 - 800 200


45 45 - 92 47
- - 0 -
- - 0 -
8,700 8700 - 9600 900
10,500 10500 - 11400 900
220 220 - 40 (180)
140 140 - 40 (100)
3,700 3700 - 10600 6,900
2 2 - 0 (2)
36 36 - 50 14
4,500 4500 - 6000 1,500
10 10 - 120 110
5 5 - 6 1
- - 16 16
2,500 2500 - 7400 4,900
6,500 6500 - 17000 10,500
700 700 - 1200 500
2,700 2700 - 7200 4,500
490 490 - 1380 890
1,400 1400 - 0 (1,400)
200 200 - 0 (200)
75 75 - 0 (75)
- - 0 -
140 140 - 320 180
40 40 - 80 40
20 20 - 0 (20)
800 800 - 1200 400
75 75 - 150 75
30 30 - 40 10
- - 0 -
2,300 2300 - 6800 4,500
13 13 - 0 (13)
10 10 - 14 4
- - 0 -
200 200 - 0 (200)
1,400 1400 - 1800 400
50 50 - 90 40
19 19 - 0 (19)
- - 0 -
200 200 - 400 200
- - 0 -
690 690 - 480 (210)
5 5 - 14 9
- - 400 400
29 29 - 60 31
90 90 - 20 (70)
44 44 - 4 (40)
150 150 - 200 50
600 600 - 1200 600
- - 0 -
48 48 - 48 -
1,200 1200 - 1600 400
1,600 1600 - 2200 600
5,500 5500 - 9800 4,300
5 5 - 0 (5)
- - 0 -
- - 0 -
600 600 - 0 (600)
300 300 - 180 (120)
48 48 - 96 48
150 150 - 400 250
1,200 1200 - 1400 200
- - 0 -
40 40 - 320 280
2 2 - 0 (2)
6,000 6000 - 13200 7,200
1,500 1500 - 600 (900)
1,500 1500 - 660 (840)
- - 0 -
48 48 - 48 -
200 200 - 0 (200)
25 25 - 0 (25)
3 3 - 2 (1)
2,800 2800 - 10800 8,000
500 500 - 400 (100)
- - 0 -
50 50 - 0 (50)
720 720 - 960 240
- - 0 -
48 48 - 240 192
24 24 - 48 24
6 6 - 18 12
25 25 - 0 (25)
- - 0 -
7,100 7100 - 14200 7,100
1,300 1300 - 1600 300
170 170 - 40 (130)
88 88 - 0 (88)
1,900 1900 - 2200 300
- - 0 -
61 61 - 68 7
- - 0 -
1,100 1100 - 2300 1,200
4,700 4700 - 10600 5,900
33 33 - 0 (33)
- - 0 -
300 300 - 0 (300)
- - 0 -
700 700 - 200 (500)
8 8 - 10 2
48 48 - 96 48
- - 44 44
600 600 - 2800 2,200
- - 0 -
1,200 1200 - 3300 2,100
- - 0 -
- - 0 -
300 300 - 0 (300)
12 12 - 10 (2)
80 80 - 0 (80)
- - 0 -
15 15 - 0 (15)
64 64 - 0 (64)
300 300 - 2700 2,400
- - 4 4
- - 0 -
900 900 - 1400 500
- - 0 -
5 5 - 8 3
43 43 - 30 (13)
135 135 - 480 345
16,900 16900 - #VALUE!
4 4 - 12 8
6 6 - 8 2
- - 0 -
6 6 - 0 (6)
4,000 4000 - 8000 4,000
2,800 2800 - 2200 (600)
1,700 1700 - 3800 2,100
450 450 - 0 (450)
- 0 - 300 300
22 22 - 176 154
300 300 - 400 100
- - 260 260
91 91 - 2 (89)
7 7 - 16 9
13 13 - 10 (3)
- - 0 -
46 46 - 76 30
5,700 5700 - 4600 (1,100)
510 510 - 1980 1,470
400 400 - 800 400
- - 0 -
300 300 - 0 (300)
200 200 - 1000 800
- - 0 -
1,800 1800 - 3000 1,200
5,100 5100 - 14000 8,900
- - 0 -
800 800 - 3800 3,000
200 200 - 400 200
- - 0 -
- - 0 -
200 200 - 0 (200)
2 2 - 0 (2)
2 2 - 0 (2)
1 1 - 0 (1)
80 80 - 0 (80)
600 600 - 1000 400
900 900 - 600 (300)
800 800 - 2000 1,200
800 800 - 2200 1,400
100 100 - 0 (100)
2 2 - 0 (2)
2 2 - 0 (2)
3 3 - 0 (3)
- - 0 -
1 1 - 0 (1)
2 2 - 0 (2)
4 4 - 0 (4)
- - 0 -
- - 0 -
- - 0 -
2 2 - 0 (2)
4 4 - 0 (4)
- - 0 -
2 2 - 0 (2)
- 0 - 0 -
- - 0 -
- - 0 -
30 30 - 0 (30)
- - 0 -
2 2 - 0 (2)
- - 0 -
1 1 - 0 (1)
5 5 - 4 (1)
4 4 - 8 4
- - 0 -
53 53 - 22 (31)
- - 0 -
4 4 - 10 6
- - 0 -
17 17 - 30 13
13 13 - 28 15
4 4 - 14 10
1 1 - 0 (1)
5 5 - 8 3
10 10 - 20 10
- - 0 -
- - 0 -
- - 1440 1,440
- - 960 960
- - 0 -
- - 2280 2,280
- - 6720 6,720
- - 0 -
- - 0 -
140 140 - 0 (140)
12 12 - 24 12
- - 12 12
6 6 - 0 (6)
6 6 - 0 (6)
100 100 - 176 76
600 600 - 1000 400
- - 4 4
- - 18 18
- - 2 2
- - 0 -
- - 1000 1,000
- - 0 -
- - 0 -
- - 0 -
- - 0 -
- - 0 -
- - 4000 4,000
- - 0 -
- - 0 -
- - 600 600
- - 200 200
- - 3600 3,600
- - 0 -
- - 0 -
- - 200 200
- - 0 -
- - 1344 1,344
- - 0 -
790 790 - 0 (790)
- - 0 -
60 60 - 0 (60)
- - 0 -
- - 0 -
9 9 - 0 (9)
- - 0 -
- - -
- - 0 -
700 700 - 0 (700)
- - -
- - -
300 300 - (300)
- - -
- - -
- - -
- - -
1 1 - (1)
- - -
- - -
- - -
100 100 - (100)
- - -
- - -
- - -
- - -
- - -
- - -
- - -
2 2 - (2)
- - -
- - -
3,612 3612 - (3,612)
138 138 - (138)

Jakarta, Januari 2021


Yang Membuat Laporan
Tria Annisa, S.Farm., Apt
NIP. 10205819920502199205262
DROPING
PENERIMAAN GUDANG
III IV

0
50
0
0
0
7200
0
0
5000
0
0
0
0
5
0
2000
15000 TGL 4 DAN 12 ini harus cek form cito dan ka
700
0
300
200
0
0
0
200
0
20
0
75
20
0
2000
10
0
0
0
1000
50
0
0
200
0
30
0
0
29
100
30
0
500
0
48
1000
1000
4000
0
0
0
0
200
48
0
1000
0
100
0
8000
0
0
0
48
100
0
0
0
300
0
0
600
0
72
0
10
0
0
5600
1000
90
0
2000
0
0
0
1500
0
30
0
0
0
500
0
48
10
2000
0
1500
0
0
0
10
0
0
0
0
1200
0
0
1000
0
0
0
200
16500
4
0
0
0
0
2500
0
0
0
100
0
0
0
0
0
0
50
4000
0
0
0
0
700
0
0
5000
0
2000
200
0
0
0
0
0
0
0
0
600
1000
1000
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
5
0
0
0
25
0
20
25
25
0
5
10
0
0
360
480
0
0
3360
0
0
0
6
6
0
0
0
500
2
7
1
0
0
0
0
0
0
0
2000
0
0
300
100
1800
0
0
100
0
672
0
0
0
0
0
0
0
0
0
0
700
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
500
2000 tgl 5 dan 12
4
2000
ini harus cek form cito dan kartu stok
PUSKESMAS : KECAMATAN CAKUNG
UNIT : LPLPO
KECAMATAN : CAKUNG
KABUPATEN / KODYA : JAKARTA TIMUR
PROVINSI : DKI JAKARTA
NO NAMA OBAT SATUAN STOCK AWAL
1 2 3 4

1 Alopurinol 100mg tablet 1240


2 Ambroxol 15mg/5 ml botol 98
3 Aminophillin 200mg tablet 0
4 Aminophillin injeksi 24mg/ml ampul 0
5 Amlodipin 10mg tablet 16564
6 Amlodipin 5mg tablet 9724
7 Amoksisilin (sirup kering) 125mg/5ml botol 279
8 Amoksisilin (sirup kering) 250mg/5ml botol 173
9 Amoksisilin 500mg tablet 7600
10 Ampisilin injeksi (serbuk kering) 250mg vial 4
11 Antasida DOEN (MgSO4+AlOH Tersuspensi) botol 67
12 Antasida DOEN (MgSO4+AlOH) tablet 9566
13 Anti Hemoroid DOEN suppos 80
14 Anti Tetanus Serum (ATS) 1500IU ampul 3
15 Aquades pro injeksi @25ml respule 31
16 Asam Askorbat (Vit C) 250mg tablet 5260
17 Asam Askorbat (Vit C) 50mg tablet 8985
18 Asam Folat 1mg tablet 690
19 Asam Mefenamat 500mg tablet 9715
20 Asetosal (Ascardia/Miniaspi) 80mg tablet 918
21 Asiklovir 200mg tablet 1362
22 Asiklovir 400mg tablet 1018
23 Asiklovir krim 5% tube 96
24 Atropin Sulfas injeksi 0,25mg/ml ampul 0
25 Azitromisin 500 mg tablet 116
26 Bedak salisil serbuk 2% ktk 129
27 Benzatin benzil penicilin serbuk injeksi 2,4juta IU/ml vial 7
28 Betahistin mesilate 6mg tablet 1606
29 Betametason krim 0,1% tube 164
30 Bisakodil 5mg tablet 63
31 Budesonide (Cairan inhalasi) 0,25mg/ml respule 0
32 Deksametason 0,5mg tablet 7262
33 Deksametason injeksi 5mg/ml ampul 27
34 Difenhidramin injeksi 10mg/ml ampul 37
35 Digoksin 0,25mg tablet 0
36 Doksisiklin 100mg kapsul 341
37 Domperidon 10mg tablet 2681
38 Domperidon sirup 5mg/5ml botol 51
39 Epinefrin Bitatrat/Adrenalin Injeksi 1mg/ml ampul 49
40 Eritromisin (sirup kering) 200mg/5ml botol 5
41 Eritromisin 250mg kapsul 317
42 Eritromisin 500mg kapsul 0
43 Fenofibrat 100mg tablet 942
44 Ferro sulfat 15mg/5ml botol 15
45 Fitomenadion (Vit K1) 10mg tablet 241
46 Fitomenadion (Vit.K1) injeksi 2mg/ml ampul 60
47 Flukonazol 150mg kapsul 16
48 Framisetin sulfat kassa steril 1% lembar 29
49 Furosemid 40mg tablet 283
50 Garam Oralit serbuk untuk 200ml sach 1397
51 Gentamisin Salep 0,1% tube 0
52 Gentian Violet larutan 1% botol 34
53 Glibenklamid 5mg tablet 1494
54 Glimepirid 1mg tablet 2234
55 Gliseril Guaiakolat 100mg tablet 9973
56 Glukosa larutan infus 10 % botol 8
57 Glukosa larutan infus 40 % botol 0
58 Glukosa larutan infus 5 % botol 0
59 Griseofulvin 125mg tablet 1839
60 Hidroklortiazid 25mg tablet 250
61 Hidrokotison krim 2,5% tube 59
62 Hiosin N Butylbromide 10mg tablet 444
63 Ibuprofen 200mg tablet 1042
64 Ikhtamol salep 10% pot 0
65 Isosorbid dinitrat (ISDN) 5mg tablet 256
66 Kalsium glukonat injeksi 10% vial 4
67 Kalsium Laktat 500mg tablet 6340
68 Kaptopril 12,5 mg tablet 2923
69 Kaptopril 25mg tablet 2620
70 Karbo Adsorben (Norit) 125mg tablet 0
71 Karbogliserin (Fenol Gliserol) tetes telinga 10% botol 38
72 Ketokonazol 200mg tablet 261
73 Ketokonazol krim 2% tube 48
74 Ketoprofen 100mg/Supp suppos 7
75 Khlofeniramin Maleat (CTM) 4mg tablet 12235
76 Klindamisin 150mg kapsul 520
77 Klopidogrel 75mg tablet 1488
78 Kloramfenikol tetes mata 0,5% botol 81
79 Kloramfenikol 250mg kapsul 753
80 Kloramfenikol 500mg kapsul 0
81 Kloramfenikol salep kulit 2% tube 253
82 Kloramfenikol salep mata 1% tube 100
83 Kloramfenikol suspensi 125mg/5ml botol 7
84 Kloramfenikol tetes telinga 3% botol 58
85 Kolkisin 500mg tablet 0
86 Komb.ferro sulfat+as.folat (tablet tambah darah) tablet 9458
87 Komb.kaolin 550mg+pektin 20mg tablet 2695
88 Kombipak Azitromisin + Cefixim amplop 126
89 Kotrimoksazol 240mg/5 mL botol 119
90 Kotrimoksazol 480mg tablet 1775
91 Lactulosa 3,335mg/5ml botol 0
92 Lidokain injeksi 2% ampul 202
93 Lincomisin kapsul 500mg kapsul 0
94 Loratadin 10mg tablet 932
95 Metformin 500mg tablet 12465
96 Metil Ergometrin injeksi 0,2mg/ml ampul 34
97 Metil Ergometrin 0,125mg tablet 0
98 Metoklorpropamid 10mg tablet 471
99 Metronidazol 250mg tablet 0
100 Metronidazol 500mg tablet 445
101 MgSO4 injeksi 40% vial 23
102 Mikonazol krim 2% tube 144
103 NaCl larutan infus 0,9% botol 42
104 N-Asetil Sistein 200mg kapsul 1060
105 Natrium Bicarbonat 500mg tablet 0
106 Natrium Diklofenak 25mg tablet 1800
107 Natrium Diklofenak 50mg tablet 0
108 Neomisin 0,5% & Plasenta sapi 10% tube 0
109 Nifedipin tablet 10mg tablet 420
110 Nistatin 100.000IU/ml botol 10
111 Nistatin vaginal 100.000IU tablet 101
112 Nitrofurantoin 50mg tablet 0
113 Oksitetrasiklin HCl salep mata 1% tube 39
114 Oksitosin Injeksi 10IU/ml ampul 97
115 Omeprazole 20mg kapsul 681
116 Omeprazole serbuk injeksi 40mg vial 2
117 Pantocain 0,5% botol 0
118 Papaverin 40mg tablet 1142
119 Papaverin injeksi 40mg/ml ampul 0
120 Paracetamol supp 125mg suppos 10
121 Parasetamol 100mg/ml botol 75
122 Parasetamol 120mg/5ml botol 362
123 Parasetamol 500mg tablet 16537
124 Perak sufadiazin krim (Burnazin) 1% tube 19
125 Permetrin krim 5% (Scabimied) tube 17
126 Pirantel Pamoat 125mg tablet 0
127 Pirantel Pamoat 125mg/5ml botol 7
128 Piridoxin (Vit B6) 10mg tablet 8771
129 Prednison 5mg tablet 2375
130 Ranitidin 150mg tablet 4241
131 Retinol (Vit A. Biru) 100.000 IU kapsul 489
132 Retinol (Vit A. Merah) 200.000 IU kapsul 478
133 Ringer Laktat larutan Elektrolit infus botol 63
134 Salbutamol 2mg tablet 887
135 Salbutamol 4mg tablet 266
136 Salbutamol cairan iihalasi (Ventolin Nebules) 2,5mg ampul 99
137 Salep 2-4 (As.Salisilat2%+Sulfur4%) pot 162
138 Salep Whitfield/Antifungi (As.Benzoat6%+As.Salisilat3%) pot 25
139 Sefiksim 200mg kapsul 0
140 Setirizine 5mg/5ml botol 42
141 Sianokobalamin (Vit.B12) 50 µg tablet 5310
142 Simvastatin 10mg tablet 1789
143 Siprofloxasin 500mg tablet 929
144 Tetrasiklin 250mg kapsul 0
145 Tetrasiklin kapsul 500mg kapsul 439
146 Tiamfenikol 500mg kapsul 200
147 Tiamin (Vitamin B1) 100mg tablet 0
148 Tiamin (Vitamin B1) 50mg tablet 4333
149 Vitamin B kompleks tablet 10935
150 Zink 20mg/5ml botol 0
151 Zink dispersibel 20mg tablet 2070
152 Amitriptilin HCl 25mg tablet 295
153 Anti Migrain DOEN tablet (ergotamin1mg+kafein50mg) tablet 0
154 Diazepam 2mg tablet 0
155 Diazepam 5mg tablet 355
156 Diazepam injeksi 5mg/ml ampul 3
157 Diazepam enema (Stesolid rectal tube) 10mg/2,5ml tube 6
158 Diazepam enema (Stesolid rectal tube) 5mg/2,5ml tube 3
159 Fenobarbital 30mg tablet 80
160 Haloperidol tablet 5mg tablet 1329
161 Klorpromazin 100mg tablet 756
162 Risperidon 2mg tablet 1090
163 Triheksipenidil 2mg tablet 1176
164 Kodein 10mg tablet 130
165 Bahan tumpatan sementara (Cavit/Caviton) set 4
166 Bonding botol 2
167 Celluloid Strip Gigi Pak 3
168 Composit Light Curing (Tambal Sinar ) A2 tube 1
169 Composit Light Curing (Tambal Sinar ) A3 tube 1
170 Composit Light Curing (Tambal Sinar ) A3,5 tube 3
171 Cresophene (cresotin) botol 4
172 Dycal (Dycal/Hydcal) set 0
173 Ecing (Ecing/Ethacant) botol 0
174 Endometason (Endoseal) tube 0
175 Etil Chlorida Spray (Etil Clorida/Endoice) botol 6
176 Eugenol botol 4
177 Formokresol botol 0
178 Glass Ionomert ART (Fuji IX) set 6
179 Kalsium Hidroksida Pasta (Metapex/Calcetin/Vitapex) ktk 4
180 Klorfenol kamfer mentol (CHKM) botol 0
181 Lidocain spray 10% (Xylocaine) botol 0
182 Lidokain 2%+Epinefrin1:80.000 injeksi 2ml (Pehacain) ampul 95
183 Lidokain krim anestesi topical pot 0
184 Pasta devitalisasi non arsen (Depulpin) botol 2
185 Scandonest botol 0
186 Zinc Pospat Cement set 4
187 Tuberkulin protein purified derivative (Mantoux test) vial 2
188 Vaksin BCG kering + Pelarut vial 19
189 Vaksin HB0 (Hepatitis rekombinan) Dewasa vial 0
190 Vaksin HB0 (Hepatitis rekombinan) vial 94
191 Vaksin HPV vial 0
192 Vaksin Polio Oral + droppler (OPV) vial 11
193 Vaksin jerap difteri tetanus (DT) <7thn vial 0
194 Vaksin jerap tetanus difteri (Td) >7thn vial 12
195 Vaksin kombinasi DPT-HB-Hib vial 16
196 Vaksin Polio injeksi (IPV) vial 10
197 Vaksin Meningitis vial 1
198 Vaksin MR Kering + Pelarut Vial 22
199 Vaksin HBIg ampul 19
200 Efavirenz (EFV) 600mg tablet 2664
201 Lamivudine (3TC) 150mg tablet 4938
202 Lopinovir/ritonavir (LPV/r) 200/50mg tablet 1475
203 Nevirapine (NVP) 200mg tablet 1541
204 Tenofovir (TDF) 300mg tablet 2458
205 Zidovudine (ZDV)+ Lamivudine (3TC) 300/150mg tablet 1607
206 Triple FDC (TDF+3TC+EFV) 300/300/600mg tablet 6287
207 Ped Triple FDC(ZDV+3TC+NVP) 60/30/50mg tablet 120
208 Ziduvudin Sirup botol 0
209 Albendazol 400mg tablet 248
210 MDT Combi (MB-Adult) blister 24
211 MDT Combi (MB-Child) blister 0
212 MDT Combi (PB- Adult) blister 9
213 MDT Combi (PB- Child)) blister 0
214 Isoniasid 100 mg tablet 188
215 Isoniazid 300 mg tablet 1391
216 Obat Anti Tuberkulose kategori Anak paket 0
217 Obat Anti Tuberkulose kategori I & III paket 0
218 Obat Anti Tuberkulose kategori II paket 0
219 Obat Anti Tuberkulose kombipak paket 0
220 Piridoksin (Vit B6) 25mg tablet 500
221 OAT TB + HIV Intensif paket 0
222 OAT TB + HIV Lanjutan paket 0
223 Sterptomycin sulfat serbuk injeksi 1000mg vial 0
224 Bedaquilin 100 mg tablet 202
225 Ethambutol 400. mg tablet 2274
226 Etionamid 250 mg tablet 1270
227 Kanamisin injeksi 1000mg vial 540
228 Kapreomisin 1 g injeksi vial 242
229 Klofazimin 100 mg kapsul 176
230 Kloserin 250 mg tablet 789
231 Levofloksasin 250 mg tablet 507
232 Moksifloksasin 400 mg tablet 818
233 P-aminosalisilat sodium 5.52 g sachet 72
234 Linizolid 600 mg capsul 79
235 Pirazinamid 400 mg tablet 0
236 Pirazinamid 500 mg tablet 541
237 Piridoksin 100 mg tablet 1697
238 Pil KB komb.I (Levonogestrol 150mg+Etinil Estradiol 30µg) blister 797
239 Suntik KB 1 bulan (Medoksi 150mg+Estradiol 5mg) vial 0
240 Suntik KB 3 bulan (Medoksiprogesteron Asetat 150mg/3ml) vial 96
241 Implan KB 3 tahun (Levonogestrol 25mg) pcs 10
242 Dekstro+GG+CTM+Phenyl Syr Botol 0
243 Oxycan botol 9
244 Parasetamol 100mg tablet tablet 0
245 Bisoprolol 5 mg tablet 2330
246 candesartan tablet 735
247 Kotrimoxazole 960mg tablet 0
248 Becomzet tablet 0
249 ZEGAVIT tablet 0
250 DANEURON tablet 300
251 Becefort tablet 0
252 Vitamin Ultra C tablet 0
253 Zidovudin 100 mg tablet 40
254 Delanamid 50 mg tablet 593
255 Furosemide inj tablet 5
256 Albendazole syr 200 mg/ml tablet 0
257 Dolutegravir 50 mg tablet 882
258 Triple FDC (TDF+3TC+DTG) 300/300/50mg tablet 1526
259 Spironolactone 100 mg tablet 176
260 Acarbose 50 mg tablet 900
261 Ramipril 5 mg tablet 300
262 Valsartan 160 mg tablet 330
263 Ramipril 10 mg tablet 450
264 Adalat Oros 30 mg tablet 180
265 Glikuidone 30 mg tablet 570
266 Levofloksasin 100 mg Tube 140
267 Xylocain Jelly tablet 0
268 Gabapentin tablet 200
269 Rifampentin tablet 480
270 Vitamin C 500 mg vial
271 Sinovac 0
Mengetahui
PJ Farmasi PKM Cakung

Windi Wikandari, S.Farm., Apt


NIP 19860813211012014
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )

PENERIMAAN PENGELUARAN
PERSEDIAAN
GUDANG PENYESUAIAN PEMAKAIAN RETUR ED/RUSAK
5 6 7 8 9 10

- 1,240 170
50 148 52
- - 0
- - 0
- 16,564 5384
7,200 16,924 5561
- 279 47
- 173 22
5,000 12,600 4949
2 6 2
- 67 17
- 9,566 2795
- 80 50
5 8 3
- 31 16
2,000 7,260 4500
10,000 18,985 8585
700 1,390 220
- 9,715 3280
300 1,218 596
200 1,562 23
- 1,018 175
- 96 10
- - 0
200 316 136
- 129 41
20 27 2
- 1,606 465
75 239 63
20 83 26
- - 0
2,000 9,262 3879
10 1 38 1
- 37 9
- - 0
- 341 21
1,000 3,681 758
50 101 42
- 49 1
- 5 2
200 517 184
- - 0
30 972 210
- 15 6
- 241 65
29 89 15
100 116 14
30 59 9
- 9 292 78
500 1,897 512
- - 0
48 82 18
1,000 2,494 720
1,000 3,234 991
4,000 13,973 4964
- 8 0
- - 0
- - 0
- 1,839 155
200 450 50
48 107 36
- 444 172
1,000 2,042 571
- - 0
100 356 188
- 4 0
8,000 14,340 7030
- 2,923 339
- 2,620 290
- - 0
48 86 14
100 361 19
- 48 15
- 7 2
- 12,235 5455
300 820 222
- 1,488 180
- 81 29
600 1,353 337
- - 0
72 325 99
- 100 17
10 17 6
- 58 19
- - 0
5,600 15,058 6508
1,000 3,695 656
90 216 4
- 119 3
2,000 3,775 1336
- - 0
- 202 50
- - 0
1,500 2,432 822
- 12,465 6240
30 64 4
- - 0
- 471 118
- - 0
500 945 170
- 23 2
48 192 38
10 1 53 19
2,000 3,060 1450
- - 0
1,500 3,300 1382
- - 0
- - 0
- 420 0
10 20 6
- 101 0
- - 0
- 5 44 0
- 97 23
1,200 1,881 1421
- 2 2
- - 0
1,000 2,142 424
- - 0
- 10 2
- 75 24
200 562 242
16,500 33,037 11722
4 23 6
- 17 6
- - 0
- 7 0
- 8,771 3212
2,500 4,875 1584
- 4,241 1855
- 489 0
- 478 73 250
100 2 165 91
- 887 119
- 266 172
- 10 109 1
- 162 7
- 25 2
- - 0
50 92 40
4,000 9,310 3120
- 1,789 1094
- 929 348
- - 0
- 439 19
700 900 360
- - 0
- 326 4,659 1489
5,000 15,935 7105
- - 0
2,000 4,070 1633
200 495 188
- - 0
- - 0
- 355 66
- 3 0
- 6 0
- 3 0
- 80 0
- 1,329 693
600 1,356 223
1,000 2,090 1078
1,000 2,176 1250
- 130 0
- 4 0
- 2 0
- 3 0
- 1 0
- 1 0
- 3 0
- 4 0
- - 0
- - 0
- - 0
- 6 0
- 4 0
- - 0
- 6 0
- 4 2 2
- - 0
- - 0
- 95 0
- - 0
- 2 0
- - 0 0
- 4 0
5 7 2
5 24 4 16
- - 0
- 94 31
- - 0
25 36 5 27
- - 0
20 32 15
25 41 14 14 0
25 35 7 24
- 1 0
5 27 4 18
10 29 12
- 2,664 600
- 4,938 1620
720 2,195 840
480 2,021 1020
- 2,458 812
1,140 2,747 1140
3,360 9,647 3640
- 120 0
- - 0
- 24 272 0
6 30 12
6 6 2
- 9 0
6 6 0
- 39 227 70
500 1,891 363
2 2 2
9 9 9
1 1 1
- - 0
500 1,000 0
- - 0
- - 0
- - 0
- 202 26
- 2,274 139
2,000 3,270 338
- 540 31
- 242 0
300 476 155
100 889 338
1,800 2,307 369
- 818 62
- 72 0
100 179 31
- - 0
672 1,213 277
- 1,697 154
- 797 2
- - 0
- 96 23
- 18 28 0
- - 0
- 9 0
- - 0
- 2,330 605
- 735 375
700 700 0
- - 0
- - 0
- 300 0
- - 0
- - 0
- 40 2
- 593 0
- 5 1
- - 0
- 882 90
- 1,526 449
- 176 8
- 900 790
- 300 120
- 330 60
- 450 0
- 180 180
- 570 90
- 140 0
4 4 2
- 200 30
- 480 0
7,000 7,000 3388
240 240 102
-
Jakarta, Januari 2021
Yang Membuat Laporan

Tria Annisa, S.Farm., Apt


NIP. 102058199205021992052
OBAT

LB 2
BULAN : JANUARI
TAHUN : 2021

RAN STOK
SISA STOCK PERMINTAAN PEMBERIAN KET. stok opname
PENYESUAIAN OPTIMUM
11 12 13 14 15 16 17

1070 1070
96 96
0 0
0 0
11180 11180
11363 11363
232 232
151 151
7651 7651
4 4
50 50
6771 6771
30 30
5 5
15 15
2760 2760
10400 10400
1170 1170
6435 6435
622 622
1539 1539
843 843
86 86
0 0
180 180
88 88
25 25
1141 1141
176 176
57 57
0 0
5383 5383
37 gadar +1 37
28 28
0 0
320 320
2923 2923
59 59
48 48
3 3
333 333
0 0
762 762
9 9
176 176
74 74
102 102
50 50
214 UGD 214
1385 1385
0 0
64 64
1774 1774
2243 2243
9009 9009
8 8
0 0
0 0
1684 1684
400 400
71 71
272 272
1471 1471
0 0
168 168
4 4
7310 7310
2584 2584
2330 2330
0 0
72 72
342 342
33 33
5 5
6780 6780
598 598
1308 1308
52 52
1016 1016
0 0
226 226
83 83
11 11
39 39
0 0
8550 8550
3039 3039
212 212
116 116
2439 2439
0 0
152 152
0 0
1610 1610
6225 6225
60 60
0 0
353 353
0 0
775 775
21 21
154 154
34 TINDAKAN 34
1610 1610
0 0
1918 1918
0 0
0 0
420 420
14 14
101 101
0 0
44 GADAR 44
74 74
460 460
0 0
0 0
1718 1718
0 0
8 8
51 51
320 320
21315 21315
17 17
11 11
0 0
7 7
5559 5559
3291 3291
2386 2386
489 489
155 155
74 TINDAKAN 74
768 768
94 94
108 UGD 108
155 155
23 23
0 0
52 52
6190 6190
695 695
581 581
0 0
420 420
540 540
0 0
3170 RF 3170
8830 8830
0 0
2437 2437
307 307
0 0
0 0
289 289
3 3
6 6
3 3
80 80
636 636
1133 1133
1012 1012
926 926
130 130
4 4
2 2
3 3
1 1
1 1
3 3
4 4
0 0
0 0
0 0
6 6
4 4
0 0
6 6
0 0
0 0
0 0
95 95
0 0
2 2
0 0
4 4
5 5
4 4
0 0
63 63
0 0
4 4
0 0
17 17
13 13
4 4
1 1
5 5
17 17
2064 2064
3318 3318
1355 1355
1001 1001
1646 1646
1607 1607
6007 6007
120 120
0 0
272 RF 272
18 18
4 4
9 9
6 6
157 RF 157
1528 1528
0 0
0 0
0 0
0 0
1000 1000
0 0
0 0
0 0
176 176
2135 2135
2932 2932
509 509
242 242
321 321
551 551
1938 1938
756 756
72 72
148 148
0 0
936 936
1543 1543
795 795
0 0
73 73
28 KB 28
0 0
9 9
0 0
1725 3,025 1,300 1725
360 1,875 1500 360
700 0 700
0 0 0
0 0 0
300 0 300
0 0 0
0 0 0
38 10 38
593 0 593
4 5 4
0 0 0
792 450 792
1077 2,245 1077
168 40 168
110 3,950 3,840 110
180 600 420 180
270 300 30 270
450 0 450
0 900 900 0
480 450 480
140 0 140
2 10 8 2
170 150 170
480 0 480
3612 16,940 13,328 3612
138 510 372 138
Jakarta, Januari 2021
Yang Membuat Laporan

Tria Annisa, S.Farm., Apt


NIP. 10205819920502199205262
selisih
18

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
DISTRIBUSI OBAT BULAN : DESEMBER

SATUA
NO NAMA OBAT
N 24 JAM RB

1 Alopurinol 100mg tablet 0 0


2 Ambroxol 15mg/5 ml botol 0 0
3 Aminophillin 200mg tablet 0 0
4 Aminophillin injeksi 24mg/ml ampul 0 0
5 Amlodipin 10mg tablet 0 0
6 Amlodipin 5mg tablet 0 0
7 Amoksisilin (sirup kering) 125mg/5ml botol 0 0
8 Amoksisilin (sirup kering) 250mg/5ml botol 0 0
9 Amoksisilin 500mg tablet 0 0
10 Ampisilin injeksi (serbuk kering) 250mg vial 0 2
11 Antasida DOEN (MgSO4+AlOH Tersuspensi) botol 0 0
12 Antasida DOEN (MgSO4+AlOH) tablet 0 0
13 Anti Hemoroid DOEN suppos 0 0
14 Anti Tetanus Serum (ATS) 1500IU ampul 3 0
15 Aquades pro injeksi @25ml respule 6 10
16 Asam Askorbat (Vit C) 250mg tablet 0 0
17 Asam Askorbat (Vit C) 50mg tablet 0 0
18 Asam Folat 1mg tablet 0 0
19 Asam Mefenamat 500mg tablet 0 0
20 Asetosal (Ascardia/Miniaspi) 80mg tablet 0 0
21 Asiklovir 200mg tablet 0 0
22 Asiklovir 400mg tablet 0 0
23 Asiklovir krim 5% tube 0 0
24 Atropin Sulfas injeksi 0,25mg/ml ampul 0 0
25 Azitromisin 500 mg tablet 0 0
26 Bedak salisil serbuk 2% ktk 0 0
27 Benzatin benzil penicilin serbuk injeksi 2,4juta IU/ml vial 0 0
28 Betahistin mesilate 6mg tablet 0 0
29 Betametason krim 0,1% tube 0 0
30 Bisakodil 5mg tablet 0 0
31 Budesonide (Cairan inhalasi) 0,25mg/ml respule 0 0
32 Deksametason 0,5mg tablet 0 0
33 Deksametason injeksi 5mg/ml ampul 1 0
34 Difenhidramin injeksi 10mg/ml ampul 1 0
35 Digoksin 0,25mg tablet 0 0
36 Doksisiklin 100mg kapsul 0 0
37 Domperidon 10mg tablet 0 0
38 Domperidon sirup 5mg/5ml botol 0 0
39 Epinefrin Bitatrat/Adrenalin Injeksi 1mg/ml ampul 0 1
40 Eritromisin (sirup kering) 200mg/5ml botol 0 0
41 Eritromisin 250mg kapsul 0 0
42 Eritromisin 500mg kapsul 0 0
43 Fenofibrat 100mg tablet 0 0
44 Ferro sulfat 15mg/5ml botol 0 0
45 Fitomenadion (Vit K1) 10mg tablet 0 0
46 Fitomenadion (Vit.K1) injeksi 2mg/ml ampul 0 15
47 Flukonazol 150mg kapsul 0 0
48 Framisetin sulfat kassa steril 1% lembar 9 0
49 Furosemid 40mg tablet 10 0
50 Garam Oralit serbuk untuk 200ml sach 0 0
51 Gentamisin Salep 0,1% tube 0 0
52 Gentian Violet larutan 1% botol 0 0
53 Glibenklamid 5mg tablet 0 0
54 Glimepirid 1mg tablet 0 0
55 Gliseril Guaiakolat 100mg tablet 0 0
56 Glukosa larutan infus 10 % botol 0 0
57 Glukosa larutan infus 40 % botol 0 0
58 Glukosa larutan infus 5 % botol 0 0
59 Griseofulvin 125mg tablet 0 0
60 Hidroklortiazid 25mg tablet 0 0
61 Hidrokotison krim 2,5% tube 0 0
62 Hiosin N Butylbromide 10mg tablet 0 0
63 Ibuprofen 200mg tablet 0 0
64 Ikhtamol salep 10% pot 0 0
65 Isosorbid dinitrat (ISDN) 5mg tablet 3 0
66 Kalsium glukonat injeksi 10% vial 0 0
67 Kalsium Laktat 500mg tablet 0 0
68 Kaptopril 12,5 mg tablet 0 0
69 Kaptopril 25mg tablet 0 0
70 Karbo Adsorben (Norit) 125mg tablet 0 0
71 Karbogliserin (Fenol Gliserol) tetes telinga 10% botol 0 0
72 Ketokonazol 200mg tablet 0 0
73 Ketokonazol krim 2% tube 0 0
74 Ketoprofen 100mg/Supp suppos 0 1
75 Khlofeniramin Maleat (CTM) 4mg tablet 0 0
76 Klindamisin 150mg kapsul 0 0
77 Klopidogrel 75mg tablet 0 0
78 Kloramfenikol tetes mata 0,5% botol 0 0
79 Kloramfenikol 250mg kapsul 0 0
80 Kloramfenikol 500mg kapsul 0 0
81 Kloramfenikol salep kulit 2% tube 0 0
82 Kloramfenikol salep mata 1% tube 0 0
83 Kloramfenikol suspensi 125mg/5ml botol 0 0
84 Kloramfenikol tetes telinga 3% botol 0 0
85 Kolkisin 500mg tablet 0 0
86 Komb.ferro sulfat+as.folat (tablet tambah darah) tablet 0 0
87 Komb.kaolin 550mg+pektin 20mg tablet 0 0
88 Kombipak Azitromisin + Cefixim amplop 0 0
89 Kotrimoksazol 240mg/5 mL botol 0 0
90 Kotrimoksazol 480mg tablet 0 0
91 Lactulosa 3,335mg/5ml botol 0 0
92 Lidokain injeksi 2% ampul 26 12
93 Lincomisin kapsul 500mg kapsul 0 0
94 Loratadin 10mg tablet 0 0
95 Metformin 500mg tablet 0 0
96 Metil Ergometrin injeksi 0,2mg/ml ampul 0 4
97 Metil Ergometrin 0,125mg tablet 0 0
98 Metoklorpropamid 10mg tablet 0 0
99 Metronidazol 250mg tablet 0 0
100 Metronidazol 500mg tablet 0 0
101 MgSO4 injeksi 40% vial 0 2
102 Mikonazol krim 2% tube 0 0
103 NaCl larutan infus 0,9% botol 15 0
104 N-Asetil Sistein 200mg kapsul 0 0
105 Natrium Bicarbonat 500mg tablet 0 0
106 Natrium Diklofenak 25mg tablet 0 0
107 Natrium Diklofenak 50mg tablet 0 0
108 Neomisin 0,5% & Plasenta sapi 10% tube 0 0
109 Nifedipin tablet 10mg tablet 0 0
110 Nistatin 100.000IU/ml botol 0 0
111 Nistatin vaginal 100.000IU tablet 0 0
112 Nitrofurantoin 50mg tablet 0 0
113 Oksitetrasiklin HCl salep mata 1% tube 0 0
114 Oksitosin Injeksi 10IU/ml ampul 0 23
115 Omeprazole 20mg kapsul 0 0
116 Omeprazole serbuk injeksi 40mg vial 2 0
117 Pantocain 0,5% botol 0 0
118 Papaverin 40mg tablet 0 0
119 Papaverin injeksi 40mg/ml ampul 0 0
120 Paracetamol supp 125mg suppos 1 0
121 Parasetamol 100mg/ml botol 0 0
122 Parasetamol 120mg/5ml botol 0 0
123 Parasetamol 500mg tablet 0 0
124 Perak sufadiazin krim (Burnazin) 1% tube 0 0
125 Permetrin krim 5% (Scabimied) tube 0 0
126 Pirantel Pamoat 125mg tablet 0 0
127 Pirantel Pamoat 125mg/5ml botol 0 0
128 Piridoxin (Vit B6) 10mg tablet 0 0
129 Prednison 5mg tablet 0 0
130 Ranitidin 150mg tablet 0 0
131 Retinol (Vit A. Biru) 100.000 IU kapsul 0 0
132 Retinol (Vit A. Merah) 200.000 IU kapsul 0 0
133 Ringer Laktat larutan Elektrolit infus botol 20 71
134 Salbutamol 2mg tablet 0 0
135 Salbutamol 4mg tablet 0 0
136 Salbutamol cairan iihalasi (Ventolin Nebules) 2,5mg ampul 0 0
137 Salep 2-4 (As.Salisilat2%+Sulfur4%) pot 0 0
138 Salep Whitfield/Antifungi (As.Benzoat6%+As.Salisilat3%) pot 0 0
139 Sefiksim 200mg kapsul 0 0
140 Setirizine 5mg/5ml botol 0 0
141 Sianokobalamin (Vit.B12) 50 µg tablet 0 0
142 Simvastatin 10mg tablet 0 0
143 Siprofloxasin 500mg tablet 0 0
144 Tetrasiklin 250mg kapsul 0 0
145 Tetrasiklin kapsul 500mg kapsul 0 0
146 Tiamfenikol 500mg kapsul 0 0
147 Tiamin (Vitamin B1) 100mg tablet 0 0
148 Tiamin (Vitamin B1) 50mg tablet 0 0
149 Vitamin B kompleks tablet 0 0
150 Zink 20mg/5ml botol 0 0
151 Zink dispersibel 20mg tablet 0 0
152 Amitriptilin HCl 25mg tablet 0 0
153 Anti Migrain DOEN tablet (ergotamin1mg+kafein50mg) tablet 0 0
154 Diazepam 2mg tablet 0 0
155 Diazepam 5mg tablet 0 0
156 Diazepam injeksi 5mg/ml ampul 0 0
157 Diazepam enema (Stesolid rectal tube) 10mg/2,5ml tube 0 0
158 Diazepam enema (Stesolid rectal tube) 5mg/2,5ml tube 0 0
159 Fenobarbital 30mg tablet 0 0
160 Haloperidol tablet 5mg tablet 0 0
161 Klorpromazin 100mg tablet 0 0
162 Risperidon 2mg tablet 0 0
163 Triheksipenidil 2mg tablet 0 0
164 Kodein 10mg tablet 0 0
165 Bahan tumpatan sementara (Cavit/Caviton) set 0 0
166 Bonding botol 0 0
167 Celluloid Strip Gigi Pak 0 0
168 Composit Light Curing (Tambal Sinar ) A2 tube 0 0
169 Composit Light Curing (Tambal Sinar ) A3 tube 0 0
170 Composit Light Curing (Tambal Sinar ) A3,5 tube 0 0
171 Cresophene (cresotin) botol 0 0
172 Dycal (Dycal/Hydcal) set 0 0
173 Ecing (Ecing/Ethacant) botol 0 0
174 Endometason (Endoseal) tube 0 0
175 Etil Chlorida Spray (Etil Clorida/Endoice) botol 0 0
176 Eugenol botol 0 0
177 Formokresol botol 0 0
178 Glass Ionomert ART (Fuji IX) set 0 0
179 Kalsium Hidroksida Pasta (Metapex/Calcetin/Vitapex) ktk 0 0
180 Klorfenol kamfer mentol (CHKM) botol 0 0
181 Lidocain spray 10% (Xylocaine) botol 0 0
182 Lidokain 2%+Epinefrin1:80.000 injeksi 2ml (Pehacain) ampul 0 0
183 Lidokain krim anestesi topical pot 0 0
184 Pasta devitalisasi non arsen (Depulpin) botol 0 0
185 Scandonest botol 0 0
186 Zinc Pospat Cement set 0 0
187 Tuberkulin protein purified derivative (Mantoux test) vial 0 0
188 Vaksin BCG kering + Pelarut vial 0 0
189 Vaksin HB0 (Hepatitis rekombinan) Dewasa vial 0 0
190 Vaksin HB0 (Hepatitis rekombinan) vial 0 30
191 Vaksin HPV vial 0 0
192 Vaksin Polio Oral + droppler (OPV) vial 0 0
193 Vaksin jerap difteri tetanus (DT) <7thn vial 0 0
194 Vaksin jerap tetanus difteri (Td) >7thn vial 0 0
195 Vaksin kombinasi DPT-HB-Hib vial 0 0
196 Vaksin Polio injeksi (IPV) vial 0 0
197 Vaksin Meningitis vial 0 0
198 Vaksin MR Kering + Pelarut Vial 0 0
199 Vaksin HBIg ampul 0 12
200 Efavirenz (EFV) 600mg tablet 0 0
201 Lamivudine (3TC) 150mg tablet 0 0
202 Lopinovir/ritonavir (LPV/r) 200/50mg tablet 0 0
203 Nevirapine (NVP) 200mg tablet 0 0
204 Tenofovir (TDF) 300mg tablet 0 0
205 Zidovudine (ZDV)+ Lamivudine (3TC) 300/150mg tablet 0 0
206 Triple FDC (TDF+3TC+EFV) 300/300/600mg tablet 0 0
207 Ped Triple FDC(ZDV+3TC+NVP) 60/30/50mg tablet 0 0
208 Ziduvudin Sirup botol 0 0
209 Albendazol 400mg tablet 0 0
210 MDT Combi (MB-Adult) blister 0 0
211 MDT Combi (MB-Child) blister 0 0
212 MDT Combi (PB- Adult) blister 0 0
213 MDT Combi (PB- Child)) blister 0 0
214 Isoniasid 100 mg tablet 0 0
215 Isoniazid 300 mg tablet 0 0
216 Obat Anti Tuberkulose kategori Anak paket 0 0
217 Obat Anti Tuberkulose kategori I & III paket 0 0
218 Obat Anti Tuberkulose kategori II paket 0 0
219 Obat Anti Tuberkulose kombipak paket 0 0
220 Piridoksin (Vit B6) 25mg tablet 0 0
221 OAT TB + HIV Intensif paket 0 0
222 OAT TB + HIV Lanjutan paket 0 0
223 Sterptomycin sulfat serbuk injeksi 1000mg vial 0 0
224 Bedaquilin 100 mg tablet 0 0
225 Ethambutol 400. mg tablet 0 0
226 Etionamid 250 mg tablet 0 0
227 Kanamisin injeksi 1000mg vial 0 0
228 Kapreomisin 1 g injeksi vial 0 0
229 Klofazimin 100 mg kapsul 0 0
230 Kloserin 250 mg tablet 0 0
231 Levofloksasin 250 mg tablet 0 0
232 Moksifloksasin 400 mg tablet 0 0
233 P-aminosalisilat sodium 5.52 g sachet 0 0
234 Linizolid 600 mg capsul 0 0
235 Pirazinamid 400 mg tablet 0 0
236 Pirazinamid 500 mg tablet 0 0
237 Piridoksin 100 mg tablet 0 0
238 Pil KB komb.I (Levonogestrol 150mg+Etinil Estradiol 30µg) blister 0 0
239 Suntik KB 1 bulan (Medoksi 150mg+Estradiol 5mg) vial 0 0
240 Suntik KB 3 bulan (Medoksiprogesteron Asetat 150mg/3ml) vial 0 0
241 Implan KB 3 tahun (Levonogestrol 25mg) pcs 0 0
242 Dekstro+GG+CTM+Phenyl Syr Botol 0 0
243 Oxycan botol 0 0
244 Parasetamol 100mg tablet tablet 0 0
245 Bisoprolol 5 mg tablet 0 0
246 candesartan tablet 0 0
247 Kotrimoxazole 960mg tablet 0 0
248 Becomzet tablet 0 0
249 ZEGAVIT tablet 0 0
250 DANEURON tablet 0 0
251 Becefort tablet 0 0
252 Vitamin Ultra C tablet 0 0
253 Zidovudin 100 mg tablet 0 0
254 Delanamid 50 mg tablet 0 0
255 Furosemide inj tablet 1 0
256 Albendazole syr 200 mg/ml tablet 0 0
257 Dolutegravir 50 mg tablet 0 0
258 Triple FDC (TDF+3TC+DTG) 300/300/50mg tablet 0 0
259 Spironolactone 100 mg tablet 0 0
260 Acarbose 50 mg tablet 0 0
261 Ramipril 5 mg tablet 0 0
262 Valsartan 160 mg tablet 0 0
263 Ramipril 10 mg tablet 0 0
264 Adalat Oros 30 mg tablet 0 0
265 Glikuidone 30 mg tablet 0 0
266 Levofloksasin 100 mg tablet 0 0
267 Xylocain Jelly Tube 2 0
268 Gabapentin tablet 0 0
269 Rifampentin tablet 0 0
270 Vitamin C 500 mg tablet 0 0
271 Sinovac vial 0 0
0
PENGELUARAN

BPG TB/MDR TINDAKAN GADAR KB KA APOTEK

0 10 0 0 0 0 160
0 0 0 0 0 0 52
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 4 0 0 5380
0 0 0 0 0 0 5561
0 0 0 0 0 0 47
0 0 0 0 0 0 22
0 193 0 13 0 0 4743
0 0 0 0 0 0 0
0 0 0 0 0 0 17
0 10 0 50 0 0 2735
0 0 0 0 0 0 50
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 20 0 0 0 0 3980
0 0 0 30 0 0 8555
0 0 0 0 0 0 220
0 20 0 10 0 0 3250
0 0 0 0 0 0 596
0 0 0 0 0 0 23
0 0 0 0 0 0 175
0 0 0 1 0 0 9
0 0 0 0 0 0 0
0 0 0 0 0 0 136
0 0 0 1 0 0 40
0 0 0 0 0 0 2
0 0 0 0 0 0 465
0 0 0 2 0 0 61
0 0 0 0 0 0 26
0 0 0 0 0 0 0
0 20 0 0 0 0 3859
0 0 0 0 0 0 0
0 0 0 2 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 21
0 0 0 3 0 0 755
0 0 0 0 0 0 42
0 0 0 0 0 0 0
0 0 0 0 0 0 2
0 0 0 0 0 0 184
0 0 0 0 0 0 0
0 0 0 0 0 0 210
0 0 0 0 0 0 6
0 4 0 0 0 0 61
0 0 0 0 0 0 0
0 0 0 0 0 0 14
0 0 0 0 0 0 0
0 0 0 0 0 0 68
0 0 0 0 0 0 512
0 0 0 0 0 0 0
0 0 0 0 0 0 18
0 30 0 0 0 0 690
0 0 0 0 0 0 991
0 100 0 20 0 0 4844
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 155
0 0 0 0 0 0 50
0 0 0 0 0 0 36
0 0 0 0 0 0 172
0 0 0 0 0 0 571
0 0 0 0 0 0 0
0 0 0 0 0 0 185
0 0 0 0 0 0 0
0 0 0 0 0 0 7030
0 0 0 0 0 0 339
0 0 0 10 0 0 280
0 0 0 0 0 0 0
0 0 0 0 0 0 14
0 0 0 0 0 0 19
0 0 0 0 0 0 15
0 0 0 0 0 0 0
0 20 0 20 0 0 5415
0 0 0 0 0 0 222
0 0 0 0 0 0 180
0 0 0 0 0 0 29
0 0 0 0 0 0 337
0 0 0 0 0 0 0
0 0 0 1 0 0 98
0 0 0 5 0 0 12
0 0 0 0 0 0 6
0 0 0 0 0 0 19
0 0 0 0 0 0 0
0 0 0 0 0 0 6508
0 0 0 20 0 0 636
0 0 0 0 0 0 4
0 0 0 0 0 0 3
0 0 0 0 0 0 1336
0 0 0 0 0 0 0
0 0 1 11 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 822
0 265 0 20 0 0 5955
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 118
0 0 0 0 0 0 0
0 0 0 0 0 0 170
0 0 0 0 0 0 0
0 0 0 5 0 0 33
0 0 0 0 0 0 4
0 0 0 10 0 0 1440
0 0 0 0 0 0 0
0 0 0 0 0 0 1382
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 6
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 1421
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 424
0 0 0 0 0 0 0
0 0 0 0 0 0 1
0 0 0 0 0 0 24
0 0 0 2 0 0 240
0 38 0 12 0 0 11672
0 0 0 0 0 0 6
0 0 0 1 0 0 5
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 3212
0 0 0 0 0 0 1584
0 10 0 9 0 0 1836
0 0 0 0 0 0 0
0 0 0 0 0 0 73
0 0 0 0 0 0 0
0 10 0 0 0 0 109
0 0 0 72 0 0 100
0 0 0 0 0 0 1
0 0 0 1 0 0 6
0 0 0 1 0 0 1
0 0 0 0 0 0 0
0 0 0 0 0 0 40
0 0 0 0 0 0 3120
0 0 0 6 0 0 1088
0 0 0 0 0 0 348
0 0 0 0 0 0 0
0 0 0 0 0 0 19
0 0 0 0 0 0 360
0 0 0 0 0 0 0
0 0 0 0 0 0 1489
0 132 0 27 0 0 6946
0 0 0 0 0 0 0
0 0 0 10 0 0 1623
0 0 0 0 0 0 188
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 66
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 693
0 0 0 0 0 0 223
0 0 0 0 0 0 1078
0 0 0 0 0 0 1250
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
2 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 4 0
0 0 0 0 0 0 0
0 0 0 0 0 1 0
0 0 0 0 0 0 0
0 0 0 0 0 5 0
0 0 0 0 0 0 0
0 0 0 0 0 15 0
0 0 0 0 0 14 0
0 0 0 0 0 7 0
0 0 0 0 0 0 0
0 0 0 0 0 4 0
0 0 0 0 0 0 0
0 0 0 0 0 0 600
0 0 0 0 0 0 1620
0 0 0 0 0 0 840
0 0 0 0 0 0 1020
0 0 0 0 0 0 812
0 0 0 0 0 0 1140
0 0 0 0 0 0 3640
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 12
0 0 0 0 0 0 2
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 70
0 0 0 0 0 0 363
0 2 0 0 0 0 0
0 9 0 0 0 0 0
0 1 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 26 0 0 0 0 0
0 139 0 0 0 0 0
0 338 0 0 0 0 0
0 31 0 0 0 0 0
0 0 0 0 0 0 0
0 155 0 0 0 0 0
0 338 0 0 0 0 0
0 369 0 0 0 0 0
0 62 0 0 0 0 0
0 0 0 0 0 0 0
0 31 0 0 0 0 0
0 0 0 0 0 0 0
0 277 0 0 0 0 0
0 154 0 0 0 0 0
0 0 0 0 2 0 0
0 0 0 0 0 0 0
0 0 0 0 23 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 605
0 0 0 0 0 0 375
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 2
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 90
0 0 0 0 0 0 449
0 0 0 0 0 0 8
0 0 0 0 0 0 790
0 0 0 0 0 0 120
0 0 0 0 0 0 60
0 0 0 0 0 0 0
0 0 0 0 0 0 180
0 0 0 0 0 0 90
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 30
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
PTM KI MTBS GIZI LAB KARYAWAN GUDANG

0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 500 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 6
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 2 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 3388 0
0 0 0 0 0 0 0
TOTAL
COVID PENGELUARAN Gudang 24 JAM RB BPG

0 170 600 0 0 0
0 52 45 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 5384 8700 0 0 0
0 5561 10500 0 0 0
0 47 220 0 0 0
0 22 140 0 0 0
0 4949 3700 0 0 0
0 2 2 0 2 0
0 17 36 0 0 0
0 2795 4500 0 0 0
0 50 10 0 0 0
0 3 5 0 0 0
0 16 0 7 7 0
0 4500 2500 0 0 0
0 8585 6500 0 0 0
0 220 700 0 0 0
0 3280 2700 0 0 0
0 596 490 20 0 0
0 23 1400 0 0 0
0 175 200 0 0 0
0 10 75 0 0 0
0 0 0 0 0 0
0 136 140 0 0 0
0 41 40 0 0 0
0 2 20 0 0 0
0 465 800 0 0 0
0 63 75 0 0 0
0 26 30 0 0 0
0 0 0 0 0 0
0 3879 2300 0 0 0
0 1 13 4 2 4
0 9 10 2 2 4
0 0 0 0 0 0
0 21 200 0 0 0
0 758 1400 0 0 0
0 42 50 0 0 0
0 1 19 5 2 4
0 2 0 0 0 0
0 184 200 0 0 0
0 0 0 0 0 0
0 210 690 0 0 0
0 6 5 0 0 0
0 65 0 0 0 0
0 15 29 0 44 0
0 14 90 0 0 0
0 9 44 4 0 0
0 78 150 8 0 0
0 512 600 0 0 0
0 0 0 0 0 0
0 18 48 0 0 0
0 720 1200 0 0 0
0 991 1600 0 0 0
0 4964 5500 0 0 0
0 0 5 0 3 0
0 0 0 0 0 0
0 0 0 0 0 0
0 155 600 0 0 0
0 50 300 10 0 0
0 36 48 0 0 0
0 172 150 0 0 0
0 571 1200 0 0 0
0 0 0 0 0 0
0 188 40 10 0 0
0 0 2 1 1 0
0 7030 6000 0 0 0
0 339 1500 0 0 0
0 290 1500 40 0 0
0 0 0 0 0 0
0 14 48 0 0 0
0 19 200 0 0 0
0 15 25 0 0 0
0 2 3 0 2 0
0 5455 2800 0 0 0
0 222 500 0 0 0
0 180 0 0 0 0
0 29 50 0 0 0
0 337 720 0 0 0
0 0 0 0 0 0
0 99 48 0 0 0
0 17 24 0 0 0
0 6 6 0 0 0
0 19 25 0 0 0
0 0 0 0 0 0
0 6508 7100 0 0 0
0 656 1300 0 0 0
0 4 170 0 0 0
0 3 88 0 0 0
0 1336 1900 0 0 0
0 0 0 0 0 0
0 50 61 6 45 0
0 0 0 0 0 0
0 822 1100 0 0 0
0 6240 4700 0 0 0
0 4 33 0 27 0
0 0 0 0 0 0
0 118 300 0 0 0
0 0 0 0 0 0
0 170 700 0 0 0
0 2 8 4 9 0
0 38 48 0 0 0
0 19 0 9 4 4
0 1450 600 0 0 0
0 0 0 0 0 0
0 1382 1200 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 300 0 0 0
0 6 12 0 0 0
0 0 80 0 0 0
0 0 0 0 0 0
0 0 15 0 28 0
0 23 64 0 10 0
0 1421 300 0 0 0
0 2 0 0 0 0
0 0 0 0 0 0
0 424 900 0 0 0
0 0 0 0 0 0
0 2 5 3 0 0
0 24 43 0 0 0
0 242 135 0 0 0
0 11722 16900 0 0 0
0 6 4 0 0 0
0 6 6 0 0 0
0 0 0 0 0 0
0 0 6 0 0 0
0 3212 4000 0 0 0
0 1584 2800 0 0 0
0 1855 1700 0 0 0
0 0 450 0 0 0
0 73 0 0 0 0
0 91 22 13 31 0
0 119 300 0 0 0
0 172 0 0 0 0
0 1 91 17 0 0
0 7 7 0 0 0
0 2 13 0 0 0
0 0 0 0 0 0
0 40 46 0 0 0
0 3120 5700 0 0 0
0 1094 510 0 0 0
0 348 400 0 0 0
0 0 0 0 0 0
0 19 300 0 0 0
0 360 200 0 0 0
0 0 0 0 0 0
0 1489 1800 0 0 0
0 7105 5100 0 0 0
0 0 0 0 0 0
0 1633 800 0 0 0
0 188 200 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 66 200 0 0 0
0 0 2 1 0 0
0 0 2 4 0 0
0 0 1 2 0 0
0 0 80 0 0 0
0 693 600 0 0 0
0 223 900 0 0 0
0 1078 800 0 0 0
0 1250 800 0 0 0
0 0 100 0 0 0
0 0 2 0 0 2
0 0 2 0 0 0
0 0 3 0 0 0
0 0 0 0 0 1
0 0 1 0 0 0
0 0 2 0 0 1
0 0 4 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 2 0 0 2
0 0 4 0 0 0
0 0 0 0 0 0
0 0 2 0 0 4
0 2 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 30 0 0 65
0 0 0 0 0 0
0 0 2 0 0 0
0 0 0 0 0 0
0 0 1 0 0 3
0 2 5 0 0 0
0 4 4 0 0 0
0 0 0 0 0 0
0 31 53 0 10 0
0 0 0 0 0 0
0 5 4 0 0 0
0 0 0 0 0 0
0 15 17 0 0 0
0 14 13 0 0 0
0 7 4 0 0 0
0 0 1 0 0 0
0 4 5 0 0 0
0 12 10 0 7 0
0 600 0 0 0 0
0 1620 0 0 0 0
0 840 0 0 0 0
0 1020 0 0 0 0
0 812 0 0 0 0
0 1140 0 0 0 0
0 3640 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 140 0 0 0
0 12 12 0 0 0
0 2 0 0 0 0
0 0 6 0 0 0
0 0 6 0 0 0
0 70 100 0 0 0
0 363 600 0 0 0
0 2 0 0 0 0
0 9 0 0 0 0
0 1 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 26 0 0 0 0
0 139 0 0 0 0
0 338 0 0 0 0
0 31 0 0 0 0
0 0 0 0 0 0
0 155 0 0 0 0
0 338 0 0 0 0
0 369 0 0 0 0
0 62 0 0 0 0
0 0 0 0 0 0
0 31 0 0 0 0
0 0 0 0 0 0
0 277 0 0 0 0
0 154 0 0 0 0
0 2 790 0 0 0
0 0 0 0 0 0
0 23 60 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 9 0 0 0
0 0 0 0 0 0
0 605 0 0 0 0
0 375 0 0 0 0
0 0 700 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 300 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 2 0 0 0 0
0 0 0 0 0 0
0 1 1 3 0 0
0 0 0 0 0 0
0 90 0 0 0 0
0 449 0 0 0 0
0 8 100 0 0 0
0 790 0 0 0 0
0 120 0 0 0 0
0 60 0 0 0 0
0 0 0 0 0 0
0 180 0 0 0 0
0 90 0 0 0 0
0 0 0 0 0 0
0 2 2 0 0 0
0 30 0 0 0 0
0 0 0 0 0 0
0 3388 3612 0 0 0
102 102 138 0 0 0
Stok opname

TB/MDR TINDAKAN GADAR KB KA PTM

120 0 100 0 0 0
0 0 50 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 1530 0 0 0
0 0 150 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
1173 0 2050 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
150 0 1516 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 1 0 0 0 0
40 0 0 0 0 0
120 0 2532 0 0 0
0 0 0 0 0 0
27 0 2290 258 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 500 0 0 0
0 0 4 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 40 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 82 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
80 0 2600 0 0 0
2 2 2 2 2 0
0 2 0 2 2 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 1180 0 0 0
0 0 0 0 0 0
2 2 6 2 2 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
56 0 0 0 0 0
0 1 0 0 0 0
0 0 0 0 0 0
0 2 0 0 0 0
0 0 0 0 0 0
0 0 624 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
70 0 192 0 0 0
100 0 0 0 0 0
108 0 2315 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 1000 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 60 0 0 0
0 0 0 0 0 0
0 0 780 0 0 0
0 0 494 0 0 0
0 0 220 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 4 0 0 0
0 0 0 0 0 0
160 0 2656 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 150 0 0 0
0 0 27 0 0 0
0 0 0 0 0 0
0 0 4 0 0 0
0 0 0 0 0 0
0 0 820 0 0 0
48 0 1498 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
70 0 100 0 0 0
0 0 0 0 0 0
0 10 8 22 0 0
0 0 0 0 0 0
0 0 0 0 0 0
340 680 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 90 0 0 0
2 3 4 2 2 0
0 0 550 0 0 0
0 0 0 0 0 0
0 0 370 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
50 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 500 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 108 0 0 0
108 0 3160 0 0 0
0 0 12 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 539 0 0 0
0 0 0 0 0 0
58 0 270 0 0 0
0 0 0 0 27 0
0 0 0 0 28 0
0 2 6 0 0 0
40 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 146 0 0 0
0 0 4 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 95 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 500 0 0 0
290 0 1976 0 0 0
0 0 0 0 0 0
0 0 1140 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 2 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
771 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
500 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
176 0 0 0 0 0
2135 0 0 0 0 0
2932 0 0 0 0 0
509 0 0 0 0 0
242 0 0 0 0 0
321 0 0 0 0 0
551 0 0 0 0 0
1938 0 0 0 0 0
756 0 0 0 0 0
72 0 0 0 0 0
148 0 0 0 0 0
0 0 0 0 0 0
936 0 0 0 0 0
1543 0 0 0 0 0
0 0 0 5 0 0
0 0 0 0 0 0
0 0 0 13 0 0
0 0 0 28 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
593 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
140 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
480 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
RF KI MTBS GIZI LAB KARYAWAN GUDANG Total

Total
250 0 0 0 0 0 0 1070
1 0 0 0 0 0 0 96
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
950 0 0 0 0 0 0 11180
713 0 0 0 0 0 0 11363
12 0 0 0 0 0 0 232
11 0 0 0 0 0 0 151
728 0 0 0 0 0 0 7651
0 0 0 0 0 0 0 4
14 0 0 0 0 0 0 50
605 0 0 0 0 0 0 6771
20 0 0 0 0 0 0 30
0 0 0 0 0 0 0 5
0 0 0 0 0 0 0 15
220 0 0 0 0 0 0 2760
1248 0 0 0 0 0 0 10400
470 0 0 0 0 0 0 1170
1160 0 0 0 0 0 0 6435
112 0 0 0 0 0 0 622
139 0 0 0 0 0 0 1539
143 0 0 0 0 0 0 843
7 0 0 0 0 0 0 86
0 0 0 0 0 0 0 0
40 0 0 0 0 0 0 180
8 0 0 0 0 0 0 88
5 0 0 0 0 0 0 25
341 0 0 0 0 0 0 1141
19 0 0 0 0 0 0 176
27 0 0 0 0 0 0 57
0 0 0 0 0 0 0 0
403 0 0 0 0 0 0 5383
0 2 2 0 0 0 0 37
0 2 2 0 0 0 0 28
0 0 0 0 0 0 0 0
120 0 0 0 0 0 0 320
343 0 0 0 0 0 0 2923
9 0 0 0 0 0 0 59
0 2 2 0 0 0 0 48
3 0 0 0 0 0 0 3
133 0 0 0 0 0 0 333
0 0 0 0 0 0 0 0
72 0 0 0 0 0 0 762
4 0 0 0 0 0 0 9
120 0 0 0 0 0 0 176
0 0 0 0 0 0 0 74
12 0 0 0 0 0 0 102
0 0 0 0 0 0 0 50
56 0 0 0 0 0 0 214
158 0 3 0 0 0 0 1385
0 0 0 0 0 0 0 0
16 0 0 0 0 0 0 64
312 0 0 0 0 0 0 1774
543 0 0 0 0 0 0 2243
1086 0 0 0 0 0 0 9009
0 0 0 0 0 0 0 8
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
84 0 0 0 0 0 0 1684
90 0 0 0 0 0 0 400
23 0 0 0 0 0 0 71
122 0 0 0 0 0 0 272
271 0 0 0 0 0 0 1471
0 0 0 0 0 0 0 0
58 0 0 0 0 0 0 168
0 0 0 0 0 0 0 4
530 0 0 0 0 0 0 7310
590 0 0 0 0 0 0 2584
570 0 0 0 0 0 0 2330
0 0 0 0 0 0 0 0
24 0 0 0 0 0 0 72
142 0 0 0 0 0 0 342
4 0 0 0 0 0 0 33
0 0 0 0 0 0 0 5
1164 0 0 0 0 0 0 6780
98 0 0 0 0 0 0 598
1308 0 0 0 0 0 0 1308
2 0 0 0 0 0 0 52
296 0 0 0 0 0 0 1016
0 0 0 0 0 0 0 0
28 0 0 0 0 0 0 226
32 0 0 0 0 0 0 83
5 0 0 0 0 0 0 11
10 0 0 0 0 0 0 39
0 0 0 0 0 0 0 0
630 0 0 0 0 0 0 8550
193 0 0 0 0 0 0 3039
42 0 0 0 0 0 0 212
28 0 0 0 0 0 0 116
369 0 0 0 0 0 0 2439
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 152
0 0 0 0 0 0 0 0
510 0 0 0 0 0 0 1610
505 0 0 0 0 0 0 6225
0 0 0 0 0 0 0 60
0 0 0 0 0 0 0 0
53 0 0 0 0 0 0 353
0 0 0 0 0 0 0 0
75 0 0 0 0 0 0 775
0 0 0 0 0 0 0 21
16 0 0 0 0 0 0 154
0 2 2 0 0 0 0 34
460 0 0 0 0 0 0 1610
0 0 0 0 0 0 0 0
348 0 0 0 0 0 0 1918
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
120 0 0 0 0 0 0 420
2 0 0 0 0 0 0 14
21 0 0 0 0 0 0 101
0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 44
0 0 0 0 0 0 0 74
110 0 0 0 0 0 0 460
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
318 0 0 0 0 0 0 1718
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 8
8 0 0 0 0 0 0 51
74 0 3 0 0 0 0 320
1147 0 0 0 0 0 0 21315
1 0 0 0 0 0 0 17
5 0 0 0 0 0 0 11
0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 7
1020 0 0 0 0 0 0 5559
491 0 0 0 0 0 0 3291
358 0 0 0 0 0 0 2386
12 0 0 0 0 0 0 489
127 0 0 0 0 0 0 155
0 0 0 0 0 0 0 74
428 0 0 0 0 0 0 768
94 0 0 0 0 0 0 94
0 0 0 0 0 0 0 108
2 0 0 0 0 0 0 155
6 0 0 0 0 0 0 23
0 0 0 0 0 0 0 0
6 0 0 0 0 0 0 52
490 0 0 0 0 0 0 6190
90 0 0 0 0 0 0 695
181 0 0 0 0 0 0 581
0 0 0 0 0 0 0 0
120 0 0 0 0 0 0 420
340 0 0 0 0 0 0 540
0 0 0 0 0 0 0 0
870 0 0 0 0 0 0 3170
1464 0 0 0 0 0 0 8830
0 0 0 0 0 0 0 0
487 0 10 0 0 0 0 2437
107 0 0 0 0 0 0 307
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
89 0 0 0 0 0 0 289
0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 80
36 0 0 0 0 0 0 636
233 0 0 0 0 0 0 1133
212 0 0 0 0 0 0 1012
126 0 0 0 0 0 0 926
30 0 0 0 0 0 0 130
0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 2
0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 95
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 2
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 5
0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 63
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 17
0 0 0 0 0 0 0 13
0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 5
0 0 0 0 0 0 0 17
2064 0 0 0 0 0 0 2064
3318 0 0 0 0 0 0 3318
1355 0 0 0 0 0 0 1355
1001 0 0 0 0 0 0 1001
1646 0 0 0 0 0 0 1646
1607 0 0 0 0 0 0 1607
6007 0 0 0 0 0 0 6007
120 0 0 0 0 0 0 120
0 0 0 0 0 0 0 0
132 0 0 0 0 0 0 272
6 0 0 0 0 0 0 18
4 0 0 0 0 0 0 4
3 0 0 0 0 0 0 9
0 0 0 0 0 0 0 6
57 0 0 0 0 0 0 157
157 0 0 0 0 0 0 1528
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
500 0 0 0 0 0 0 1000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 176
0 0 0 0 0 0 0 2135
0 0 0 0 0 0 0 2932
0 0 0 0 0 0 0 509
0 0 0 0 0 0 0 242
0 0 0 0 0 0 0 321
0 0 0 0 0 0 0 551
0 0 0 0 0 0 0 1938
0 0 0 0 0 0 0 756
0 0 0 0 0 0 0 72
0 0 0 0 0 0 0 148
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 936
0 0 0 0 0 0 0 1543
0 0 0 0 0 0 0 795
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 73
0 0 0 0 0 0 0 28
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 9
0 0 0 0 0 0 0 0
1725 0 0 0 0 0 0 1725
360 0 0 0 0 0 0 360
0 0 0 0 0 0 0 700
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 300
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
38 0 0 0 0 0 0 38
0 0 0 0 0 0 0 593
0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0
792 0 0 0 0 0 0 792
1077 0 0 0 0 0 0 1077
68 0 0 0 0 0 0 168
110 0 0 0 0 0 0 110
180 0 0 0 0 0 0 180
270 0 0 0 0 0 0 270
450 0 0 0 0 0 0 450
0 0 0 0 0 0 0 0
480 0 0 0 0 0 0 480
0 0 0 0 0 0 0 140
0 0 0 0 0 0 0 2
170 0 0 0 0 0 0 170
0 0 0 0 0 0 0 480
0 0 0 0 0 0 0 3612
0 0 0 0 0 0 0 138
0
0
0
0
0
0
0
STOK PENERIMA
NO NAMA OBAT SATUAN
AWAL AN

TOTAL

1 Alopurinol 100mg tablet 110 300


2 Ambroxol 15mg/5 ml botol 7 46
3 Aminophillin 200mg tablet 0
4 Aminophillin injeksi 24mg/ml ampul 0
5 Amlodipin 10mg tablet 1530 4800
6 Amlodipin 5mg tablet 574 5700
7 Amoksisilin (sirup kering) 125mg/5ml botol 39 20
8 Amoksisilin (sirup kering) 250mg/5ml botol 13 20
9 Amoksisilin 500mg tablet 671 4800
10 Ampisilin injeksi (serbuk kering) 250mg vial 0
11 Antasida DOEN (MgSO4+AlOH Tersuspensi) botol 6 25
12 Antasida DOEN (MgSO4+AlOH) tablet 340 3000
13 Anti Hemoroid DOEN suppos 10 60
14 Anti Tetanus Serum (ATS) 1500IU ampul 0
15 Aquades pro injeksi @25ml respule 0
16 Asam Askorbat (Vit C) 250mg tablet 1000 3200
17 Asam Askorbat (Vit C) 50mg tablet 1303 8500
18 Asam Folat 1mg tablet 90 600
19 Asam Mefenamat 500mg tablet 810 3600
20 Asetosal (Ascardia/Miniaspi) 80mg tablet 38 670
21 Asiklovir 200mg tablet 162 0
22 Asiklovir 400mg tablet 318 0
23 Asiklovir krim 5% tube 16 0
24 Atropin Sulfas injeksi 0,25mg/ml ampul 0
25 Azitromisin 500 mg tablet 16 160
26 Bedak salisil serbuk 2% ktk 8 40
27 Benzatin benzil penicilin serbuk injeksi 2,4juta IU/ml vial 7 0
28 Betahistin mesilate 6mg tablet 206 600
29 Betametason krim 0,1% tube 5 75
30 Bisakodil 5mg tablet 33 20
31 Budesonide (Cairan inhalasi) 0,25mg/ml respule 0
32 Deksametason 0,5mg tablet 862 3400
33 Deksametason injeksi 5mg/ml ampul 0
34 Difenhidramin injeksi 10mg/ml ampul 0
35 Digoksin 0,25mg tablet 0
36 Doksisiklin 100mg kapsul 141 0
37 Domperidon 10mg tablet 198 900
38 Domperidon sirup 5mg/5ml botol 6 45
39 Epinefrin Bitatrat/Adrenalin Injeksi 1mg/ml ampul 0
40 Eritromisin (sirup kering) 200mg/5ml botol 5 0
41 Eritromisin 250mg kapsul 117 200
42 Eritromisin 500mg kapsul 0
43 Fenofibrat 100mg tablet 42 240
44 Ferro sulfat 15mg/5ml botol 3 7
45 Fitomenadion (Vit K1) 10mg tablet 31 150
46 Fitomenadion (Vit.K1) injeksi 2mg/ml ampul 0
47 Flukonazol 150mg kapsul 16 10
48 Framisetin sulfat kassa steril 1% lembar 0
49 Furosemid 40mg tablet 24 100
50 Garam Oralit serbuk untuk 200ml sach 70 600
51 Gentamisin Salep 0,1% tube 0
52 Gentian Violet larutan 1% botol 10 24
53 Glibenklamid 5mg tablet 202 800
54 Glimepirid 1mg tablet 434 1100
55 Gliseril Guaiakolat 100mg tablet 1030 4900
56 Glukosa larutan infus 10 % botol 0
57 Glukosa larutan infus 40 % botol 0
58 Glukosa larutan infus 5 % botol 0
59 Griseofulvin 125mg tablet 239 0
60 Hidroklortiazid 25mg tablet 50 90
61 Hidrokotison krim 2,5% tube 11 48
62 Hiosin N Butylbromide 10mg tablet 94 200
63 Ibuprofen 200mg tablet 142 700
64 Ikhtamol salep 10% pot 0
65 Isosorbid dinitrat (ISDN) 5mg tablet 93 150
66 Kalsium glukonat injeksi 10% vial 0
67 Kalsium Laktat 500mg tablet 960 6600
68 Kaptopril 12,5 mg tablet 629 300
69 Kaptopril 25mg tablet 520 330
70 Karbo Adsorben (Norit) 125mg tablet 0
71 Karbogliserin (Fenol Gliserol) tetes telinga 10% botol 14 24
72 Ketokonazol 200mg tablet 161 0
73 Ketokonazol krim 2% tube 19 0
74 Ketoprofen 100mg/Supp suppos 0
75 Khlofeniramin Maleat (CTM) 4mg tablet 1179 5400
76 Klindamisin 150mg kapsul 120 200
77 Klopidogrel 75mg tablet 1488 0
78 Kloramfenikol tetes mata 0,5% botol 31 0
79 Kloramfenikol 250mg kapsul 153 480
80 Kloramfenikol 500mg kapsul 0
81 Kloramfenikol salep kulit 2% tube 6 120
82 Kloramfenikol salep mata 1% tube 20 24
83 Kloramfenikol suspensi 125mg/5ml botol 2 9
84 Kloramfenikol tetes telinga 3% botol 29 0
85 Kolkisin 500mg tablet 0
86 Komb.ferro sulfat+as.folat (tablet tambah darah) tablet 38 7100
87 Komb.kaolin 550mg+pektin 20mg tablet 29 800
88 Kombipak Azitromisin + Cefixim amplop 26 20
89 Kotrimoksazol 240mg/5 mL botol 31 0
90 Kotrimoksazol 480mg tablet 605 1100
91 Lactulosa 3,335mg/5ml botol 0
92 Lidokain injeksi 2% ampul 0
93 Lincomisin kapsul 500mg kapsul 0
94 Loratadin 10mg tablet 182 1150
95 Metformin 500mg tablet 1660 4800
96 Metil Ergometrin injeksi 0,2mg/ml ampul 0
97 Metil Ergometrin 0,125mg tablet 0
98 Metoklorpropamid 10mg tablet 171 0
99 Metronidazol 250mg tablet 0
100 Metronidazol 500mg tablet 145 100
101 MgSO4 injeksi 40% vial 0
102 Mikonazol krim 2% tube 1 48
103 NaCl larutan infus 0,9% botol 4
104 N-Asetil Sistein 200mg kapsul 500 1400
105 Natrium Bicarbonat 500mg tablet 0
106 Natrium Diklofenak 25mg tablet 80 1650
107 Natrium Diklofenak 50mg tablet 0
108 Neomisin 0,5% & Plasenta sapi 10% tube 0
109 Nifedipin tablet 10mg tablet 120 0
110 Nistatin 100.000IU/ml botol 3 5
111 Nistatin vaginal 100.000IU tablet 21 0
112 Nitrofurantoin 50mg tablet 0
113 Oksitetrasiklin HCl salep mata 1% tube 1 0
114 Oksitosin Injeksi 10IU/ml ampul 0
115 Omeprazole 20mg kapsul 211 1320
116 Omeprazole serbuk injeksi 40mg vial 0
117 Pantocain 0,5% botol 0
118 Papaverin 40mg tablet 42 700
119 Papaverin injeksi 40mg/ml ampul 0
120 Paracetamol supp 125mg suppos 1
121 Parasetamol 100mg/ml botol 17 15
122 Parasetamol 120mg/5ml botol 74 240
123 Parasetamol 500mg tablet 1219 11600
124 Perak sufadiazin krim (Burnazin) 1% tube 1 6
125 Permetrin krim 5% (Scabimied) tube 6 4
126 Pirantel Pamoat 125mg tablet 0
127 Pirantel Pamoat 125mg/5ml botol 1 0
128 Piridoxin (Vit B6) 10mg tablet 232 4000
129 Prednison 5mg tablet 975 1100
130 Ranitidin 150mg tablet 294 1900
131 Retinol (Vit A. Biru) 100.000 IU kapsul 12 0
132 Retinol (Vit A. Merah) 200.000 IU kapsul 50 150
133 Ringer Laktat larutan Elektrolit infus botol 0
134 Salbutamol 2mg tablet 337 200
135 Salbutamol 4mg tablet 64 130
136 Salbutamol cairan iihalasi (Ventolin Nebules) 2,5mg ampul 1
137 Salep 2-4 (As.Salisilat2%+Sulfur4%) pot 8
138 Salep Whitfield/Antifungi (As.Benzoat6%+As.Salisilat3%) pot 2 5
139 Sefiksim 200mg kapsul 0
140 Setirizine 5mg/5ml botol 8 38
141 Sianokobalamin (Vit.B12) 50 µg tablet 1310 2300
142 Simvastatin 10mg tablet 188 990
143 Siprofloxasin 500mg tablet 129 400
144 Tetrasiklin 250mg kapsul 0
145 Tetrasiklin kapsul 500mg kapsul 139 0
146 Tiamfenikol 500mg kapsul 200 500
147 Tiamin (Vitamin B1) 100mg tablet 0
148 Tiamin (Vitamin B1) 50mg tablet 533 1500
149 Vitamin B kompleks tablet 1410 7000
150 Zink 20mg/5ml botol 0
151 Zink dispersibel 20mg tablet 210 1900
152 Amitriptilin HCl 25mg tablet 95 200
153 Anti Migrain DOEN tablet (ergotamin1mg+kafein50mg) tablet 0
154 Diazepam 2mg tablet 0
155 Diazepam 5mg tablet 155 0
156 Diazepam injeksi 5mg/ml ampul 0
157 Diazepam enema (Stesolid rectal tube) 10mg/2,5ml tube 0
158 Diazepam enema (Stesolid rectal tube) 5mg/2,5ml tube 0
159 Fenobarbital 30mg tablet 0
160 Haloperidol tablet 5mg tablet 229 500
161 Klorpromazin 100mg tablet 156 300
162 Risperidon 2mg tablet 290 1000
163 Triheksipenidil 2mg tablet 276 1100
164 Kodein 10mg tablet 30 0
165 Bahan tumpatan sementara (Cavit/Caviton) set 0
166 Bonding botol 0
167 Celluloid Strip Gigi Pak 0
168 Composit Light Curing (Tambal Sinar ) A2 tube 0
169 Composit Light Curing (Tambal Sinar ) A3 tube 0
170 Composit Light Curing (Tambal Sinar ) A3,5 tube 0
171 Cresophene (cresotin) botol 0
172 Dycal (Dycal/Hydcal) set 0
173 Ecing (Ecing/Ethacant) botol 0
174 Endometason (Endoseal) tube 0
175 Etil Chlorida Spray (Etil Clorida/Endoice) botol 0
176 Eugenol botol 0
177 Formokresol botol 0
178 Glass Ionomert ART (Fuji IX) set 0
179 Kalsium Hidroksida Pasta (Metapex/Calcetin/Vitapex) ktk 0
180 Klorfenol kamfer mentol (CHKM) botol 0
181 Lidocain spray 10% (Xylocaine) botol 0
182 Lidokain 2%+Epinefrin1:80.000 injeksi 2ml (Pehacain) ampul 0
183 Lidokain krim anestesi topical pot 0
184 Pasta devitalisasi non arsen (Depulpin) botol 0
185 Scandonest botol 0
186 Zinc Pospat Cement set 0
187 Tuberkulin protein purified derivative (Mantoux test) vial 0
188 Vaksin BCG kering + Pelarut vial 0
189 Vaksin HB0 (Hepatitis rekombinan) Dewasa vial 0
190 Vaksin HB0 (Hepatitis rekombinan) vial 0
191 Vaksin HPV vial 0
192 Vaksin Polio Oral + droppler (OPV) vial 0
193 Vaksin jerap difteri tetanus (DT) <7thn vial 0
194 Vaksin jerap tetanus difteri (Td) >7thn vial 0
195 Vaksin kombinasi DPT-HB-Hib vial 0
196 Vaksin Polio injeksi (IPV) vial 0
197 Vaksin Meningitis vial 0
198 Vaksin MR Kering + Pelarut Vial 0
199 Vaksin HBIg ampul 0
200 Efavirenz (EFV) 600mg tablet 2664 0
201 Lamivudine (3TC) 150mg tablet 4938 0
202 Lopinovir/ritonavir (LPV/r) 200/50mg tablet 1475 720
203 Nevirapine (NVP) 200mg tablet 1541 480
204 Tenofovir (TDF) 300mg tablet 2458 0
205 Zidovudine (ZDV)+ Lamivudine (3TC) 300/150mg tablet 1607 1140
206 Triple FDC (TDF+3TC+EFV) 300/300/600mg tablet 6287 3360
207 Ped Triple FDC(ZDV+3TC+NVP) 60/30/50mg tablet 120 0
208 Ziduvudin Sirup botol 0
209 Albendazol 400mg tablet 108 0
210 MDT Combi (MB-Adult) blister 6 12
211 MDT Combi (MB-Child) blister 6
212 MDT Combi (PB- Adult) blister 3 0
213 MDT Combi (PB- Child)) blister 0
214 Isoniasid 100 mg tablet 0 88
215 Isoniazid 300 mg tablet 20 500
216 Obat Anti Tuberkulose kategori Anak paket 0
217 Obat Anti Tuberkulose kategori I & III paket 0
218 Obat Anti Tuberkulose kategori II paket 0
219 Obat Anti Tuberkulose kombipak paket 0
220 Piridoksin (Vit B6) 25mg tablet 500
221 OAT TB + HIV Intensif paket 0
222 OAT TB + HIV Lanjutan paket 0
223 Sterptomycin sulfat serbuk injeksi 1000mg vial 0
224 Bedaquilin 100 mg tablet 0
225 Ethambutol 400. mg tablet 0
226 Etionamid 250 mg tablet 0
227 Kanamisin injeksi 1000mg vial 0
228 Kapreomisin 1 g injeksi vial 0
229 Klofazimin 100 mg kapsul 0
230 Kloserin 250 mg tablet 0
231 Levofloksasin 250 mg tablet 0
232 Moksifloksasin 400 mg tablet 0
233 P-aminosalisilat sodium 5.52 g sachet 0
234 Linizolid 600 mg capsul 0
235 Pirazinamid 400 mg tablet 0
236 Pirazinamid 500 mg tablet 0
237 Piridoksin 100 mg tablet 0
238 Pil KB komb.I (Levonogestrol 150mg+Etinil Estradiol 30µg blister 0
239 Suntik KB 1 bulan (Medoksi 150mg+Estradiol 5mg) vial 0
240 Suntik KB 3 bulan (Medoksiprogesteron Asetat 150mg/3ml vial 0
241 Implan KB 3 tahun (Levonogestrol 25mg) pcs 0
242 Dekstro+GG+CTM+Phenyl Syr Botol 0
243 Oxycan botol 0
244 Parasetamol 100mg tablet tablet 0
245 Bisoprolol 5 mg tablet 2330 0
246 candesartan tablet 735 0
247 Kotrimoxazole 960mg tablet 0
248 Becomzet tablet 0
249 ZEGAVIT tablet 0
250 DANEURON tablet 0
251 Becefort tablet 0
252 Vitamin Ultra C tablet 0
253 Zidovudin 100 mg tablet 40 0
254 Delanamid 50 mg tablet 0
255 Furosemide inj tablet 0
256 Albendazole syr 200 mg/ml tablet 0
257 Dolutegravir 50 mg tablet 882 0
258 Triple FDC (TDF+3TC+DTG) 300/300/50mg tablet 1526 0
259 Spironolactone 100 mg tablet 76 0
260 Acarbose 50 mg tablet 900 0
261 Ramipril 5 mg tablet 300 0
262 Valsartan 160 mg tablet 330 0
263 Ramipril 10 mg tablet 450 0
264 Adalat Oros 30 mg tablet 180 0
265 Glikuidone 30 mg tablet 570 0
266 Levofloksasin 100 mg tablet 0
267 Xylocain Jelly tablet 0
268 Gabapentin tablet 200 0
269 Rifampentin tablet 0 0
270 Vitamin C 500 mg tablet 0
271 Sinovac tablet
PERSEDIA
AN

22 23 24 25 26 27

P S M P S M P S M P S M P S M P S
410 10 30
53 1 2 2 1
0
0
6330 180 30 270 85 40 60 30 60 30 5 60 30 180
6274 270 30 30 120 20 74 40 20 30 45 80
59 1 1 1 1 2 1
33 1 1 1
5471 84 45 15 60 60 30 60 30 15 30 38 45 15 53
0
31 1 1 1
3340 60 20 70 40 30 30 10 60 50 10 20
70
0
0
4200 128 20 95 10 10 20 20 20 10 20 5 35 30
9803 624 20 30 266 20 30 50 10 10 20
690
4410 80 30 10 90 50 20 40 20 20 20 20 10 20 10 50
708 65
162
318
16
0
176
48 1 1 1
7
806 10 10 10 20 10 20
80 2 1 1 2 1 1
53
0
4262 57 45 10 66 70 5 60 30 10 10 50 10 30 15 85
0
0
0
141
1098 6 12 1 18 12 18 6 6 6 12 12 4 18 6
51 3 1 1
0
5
317
0
282 40
10 1
181
0
26
0
124 5
670 16 6 12 4 6 6 6 6 18 18 6
0
34 1 1 1 1 2 1
1002 10 90 60 30
1534 60 120
5930 10 10 40 97 35 15 20 10 35 80 20 45 15 30 40 135
0
0
0
239 20
140
59 1 2 2 1
294 20 10
842 10 20 10 10
0
243 5 5
0
7560 539 20 302 20 10 10 10 50
929 10
850 30
0
38
161 10
19 2 2
0
6579 33 10 30 79 43 35 30 10 45 100 10 90 30 10 50 100
320 20 15
1488 30
31 1 1 1
633 24
0
126 3 2 1 1 2 1 2 1
44 1 1
11 4
29 1 1
0
7138 710 30 150 30
829 10 20 10 10 16 40 20 20 12
46 2
31 1
1705 60 168
0
0
0
1332 10 5 10 30 5 10 5 5 10 10 10 10
6460 130 120 340 120 70 60
0
0
171 10 10 20 10
0
245
0
49 2 3 1 1
4
1900 67 20 10 10 10 40 10 10 20 20 10 20
0
1730 20 10 20 12 22 6 10 12 6 16 12 6
0
0
120
8 1
21
0
1
0
1531 12 18 6 27 12 12 24 6 6 18 24 12 18
0
0
742 10 15 10 20 20 10 10 10 10 20
0
1
32 1 1 1 1
314 6 4 1 6 1 2 2 6 1 5 1 5
12819 185 90 60 335 115 55 115 50 40 65 160 75 55 50 75 120
7
10 1
0
1
4232 105 62 10 10 20 20
2075 28 193
2194 12 6 6 54 28 12 24 18 6 18 12 6 30 6 6 12
12
200 1
0
537 10 10
194
1
8 2 1
7
0
46 2 1 1 2 2
3610 104 10 102 15 10 30 10 50 10 40
1178 10 10 20 30 20 10
529 10 10
0
139 19
700 15 15
0
2033 84 5 82 10 10 20 10 10
8410 180 90 45 330 111 40 35 10 30 20 40 30 10 40
0
2110 10 20 20 1 10 10 10 20 30 30 10 20 40
295 62
0
0
155 14 3
0
0
0
0
729 182
456 32
1290 224
1376 266
30
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2664
4938
2195
2021
2458
2747
9647
120
0
108
18 2
6 1
3
0
88 42
520
0
0
0
0
500
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2330
735
0
0
0
0
0
0
40
0
0
0
882
1526
76
900 180
300 60
330
450
180
570
0
0
200
0
0
27 28 29 30 31 1 2 3

M P S M P S M P S M P S M P S M P S M P
20
1 1 2 1

210 208 30 110 30 30 60 30 10 60


30 150 60 10 10 30 30 60 30 55 30 30 15 30 60
2 2 3 2 2 1 1 1 1
1 1
60 90 56 15 30 83 50 75 15 15 45 15 30 75 45 60 15

1 1
60 60 20 80 30 20 50 50 20 40 25 10 10 100 10
3 3

17 49 20 10 50 35 20 5 30 45 30 50 110
30 340 30 228 64 144 65 30 10 15 10 10 15 35 40
90
20 20 30 80 10 95 70 40 10 40 10 40
30 60 5

10 10
1 2 1 1 1 1

20 10 10 12 10 10 10 10
1 1 1 1 2 1 1 1
4

10 30 48 10 72 86 3 110 5 20 30 10 85 36 20 30
18 12 6 11 6 6 30 12 12 6 6 16 12 6 18 4
1 1 1 1 1 1

10 10

10

10 5
6 6 6 3 12 6 6 6 6 12 18 6

1
30 60 30 100
30 30 30
50 76 28 29 40 60 13 41 66 5 10 43 10 120 33 50 90 10 7

25
10
1 2 2 2 1
30
10 30 30 22 10 10 10 10 10

25 10 5

20 222 20 224 111 178 10 20 10 10 5


20
90

80 62 29 38 35 91 25 39 64 13 20 62 30 120 29 50 90 10 20

30
1 1 1 1 1
40

3 1 4 1 1 2 1 1 2 1
1 1

250 10 100 30 150 30


26 20 20 10 10 10 20
2

10 300 60 20

5 19 13 10 30 10 5 10 5
290 60 60 100 90 120 60

10

10 15

2 1

40 10 10 10 30 40 20 20 10 10 30 10 10

26 6 30 24 10 6 24 18 6 6 30

6 24 24 6 12 34 12 12 24 6 12 18 24 8 36 24 6

10 10 20 10 10

2 1 1 1
3 1 2 3 7 3 2 6 1 3 2 1 3 2 1 3 1 2
30 277 95 31 150 180 30 105 130 35 90 115 70 165 60 65 150 35 60
1 1 1
1 1 1
224 20 82 43 204 5 10 10 30 10
5 112 56 14
12 124 24 24 24 6 25 42 6 18 12 12 18 12 24 12 12

7 7 7 2

5 10

3 1 1 1 1 1
72 10 10 86 86 34 30 10 20 50 10
10 10 80 20 6 10 20
20 10 10 10 10

20 20 20 20

92 66 66 29 20
40 129 50 10 223 45 104 55 10 70 70 5 105 30 105 50 10 20

10 20 5 20 10 10 30 40 60 10 10 40 30 10
42

14

28
29

39
60
120
0
120
60
120
30 780

30 90
15 15
15
3 4 5 6 7 8 9

S M P S M P S M P S M P S M P S M P S
10 10 10
1 2 1 1 3

10 132 60 60 60 120 60 226 30 160 30 30 60 30


558 30 240 30 120 60 90 170 15 135 30 30
1 2 2 1 1 2
1 1 1
15 15 105 180 53 30 45 30 15 60 60 15 38 105 46

1 1 2 1
10 20 50 20 30 40 50 20 20 10 50 20 60 90 50 20 10
3 3

40 150 10 110 40 30 55 30 40 30 85 40 120 20


20 10 404 70 10 374 54 290 180 190 120 15 352 30 10
30 30 30
100 10 70 50 50 22 30 20 30 40 10 10
152 60 10 31 30

20 40
1 2

10 5
1 1 1 1 1

10 10 10 10 10
2 2 1 1 1 1 1 1
3

40 74 120 15 79 44 53 40 23 32 60 10 6 60 20 48 10

10
6 6 4 6 6 18 12 12 18 12
1 6 1 1

30

10 20 20
1 1

30
12 6 6 6 12 6 6 6 6 12

1 1 1
90 30 30
90 90 30
230 10 136 157 10 26 50 20 24 80 10 93 125 24 98 110 20 55 10

20
5
1 1 2 1
16
20 10 10 18 20 20 10

10

60 10 401 40 337 47 209 80 12 182 100 340 24


90 14
90

1 1 1 1
7
1 1

200 10 63 120 25 69 50 10 31 30 13 44 100 43 73 100 30 58 20


10
30 30
2 1 1 2
50

1 1 1 3 1 3 2 1 1
1 1 1 2

1 2 1

30 340 270 240 60 150 60 300 6


6 6 6 16 10 6 4 12 10

360

38 35 5 6 15 10 20 15
162 60 180 210 60 242 210 240 90 10

6 12

15 21

1 2 1 2 1 1

20 30 10 10 10 40 10 10

30 12 40 6 44 10 16 56 6 50 30 20 12

18 6 21 12 10 18 18 6 12 18 6 24 54 60 24 6 12 12

10 6 10 6 10 10

1 1
1 3 5 1 6 3 3 2 1 5 2 1 3 1 1
120 10 343 265 50 165 130 30 120 150 40 70 175 70 245 200 45 140 80
10 72 10 56 66 10 81 40 20 48 20 40 44
91 28 49 77 14 28
12 12 52 30 12 12 42 18 36 18 6 6 36 30 18 12

10
10 10

1
10 147 35 76 66 76 10 88 50 104 10
44 60 20 20 30 30 10 10
10 10 10 10 10

35

10 42 76 56 10 56 25 38 34 14
30 20 165 120 123 75 10 75 40 40 112 60 20 144 60 10 30 30

10 10 20 10 10 10 20 20 30 20 10
21

14 1 10

56
9
280
266
90 180
540 360
480 120
660 180
270 1 180
540 300
450 1050

28
120
150 60 30 30
150 52

30 30
44 210
8
90
30 30
30

30
9 10 11 12 13 14 15 16

M P S M P S M P S M P S M P S M P S M P
20 10 20
1 1 2 1 2 2 1 2

60 45 60 110 60 80 30 210 30 330 150 25


90 10 150 210 10 10 370 10 130 70 20 10
1 3 1
2 1
30 128 53 128 8 90 75 30 30 90 30 45 15 90

1 1 1 1 1
20 8 30 40 15 10 30 10 30 40 20 30 10 30 10
6 3 3

10 40 40 5 45 40 45 25 35 20 10 45 20 50 10 45 5 164
10 25 10 399 30 487 24 5 250 30 10 330 20 218 56
30
10 20 20 80 60 85 20 20 45 60 70 40 20 70 20 20
30 60

40 15
1 2

20
3 2 1 1 1 2 1 2
1
10 10 16 10 10 10 10 20 12
1 2 2 1 2 1 2 1 1
8

15 10 43 35 90 17 26 20 30 90 50 40 70 30 10 30 30 109
6 16 6 6 12 6 6 12 10 18 6 12 12
1 1 2 1 1 1

40 10

10 20
1 1
3 5 10 10

5 5
12 12 6 6 6 3 6 18 20 6 6

1 1
20 20 30
30 30 30 30 30
20 52 80 56 85 70 55 40 26 43 30 30 86 20 50 20 10 40 79

20
15
1 1 1 1
20 20 10
10 16 20 10 10 10 10 10

10 10 52 297 75 528 10 208 20 30 240 30 183 44 16 32


15 60
30

1 1 1 1
2
1 1

30 80 95 10 38 124 10 26 33 19 32 45 50 44 40 20 30 40 185
30 20 30
30
2 1 1
40 40 40

1 4 1 1 2 2 1 2 2 3 1 1
1 1
2
1 1 1

10 360 90 480 210 345 320 30 30 30


10 6 10 18 16 10 6 16 20

28 20 20 60

5 18 10 5 10 13 24 5 35 10 3 10
120 2 200 150 360 190

10 35 30

1 1

20 10 15 20 10 20 10 20 104

10 6 6 50 12 10 12 6 6 34 10 28 20

6 6 24 2 6 6 12 1 12 30 18 15 6 19

10 10 10 20 10

2 1 1 1
2 1 6 6 1 5 1 2 4 1 2 1 1 3 4
25 125 125 10 187 200 25 165 75 40 220 130 70 150 110 50 180 80 60 175

1
10 6 82 34 43 28 49 40 10 10 20 10 378 48 50
18 35 42 70 14 14 42
18 12 18 12 6 12 48 6 24 40 12 12 6 30

12 2 7 2 2 2

24 10 10
10

2 1 1 2
20 20 10 92 98 38 10 24 50 20 25 100 15 58 48 20 60
16 10 20 20 60 10 70 30
10 10 10 10 10

20 35 15 30

10 72 14 34 28 38 15 10 38 28
30 30 80 10 170 70 5 245 30 85 50 30 145 40 183 40 20

65 10 20 20 10 10 10 30 10 10 60 10 10
3

119
83
252
231
60 150
120 300

60
1 60 150
60
30 150 550

90
45 15 30 60
30 23

30 15 60

180 180
30 30
90

30
16 17 18 19 20 21 22

S M P S M P S M P S M P S M P S M P
10 10
2 1 3 1 3 3 1

70 30 10 90 10 40 150 40 150 90 60 120


10 70 10 10 120 130 3 180 160 210 310
1 1 1 1 2 1
1 1 2 1 2
40 30 30 45 30 80 120 30 45 75 98 60 128 15 30 75

1 1
10 10 30 60 60 10 20 10 40 30 30 10
10 3 6

26 50 15 2 175 110 3 69 40 35 50 140 50 60 75 20 139


30 10 20 302 74 10 167 160 176 100 150 280 95 20 99
10
60 10 20 20 30 75 20 65 50 20 55 30 60 10 30 110
30 30

40
1

20 10
1 1 1 1 1 2
1
10 10 10 10 10 10
2 1 3 1 1 1 1 1 3
3 4

30 30 60 15 58 70 10 42 30 40 48 50 40 31 53 40 63

10
6 6 20 18 6 12 6 18 18 12 12 6 12
2 1 2 1 2 1 1 1 3

2
10 20 14

20 30

6 10 3

5
6 6 12 6 6 3 9 10 6 6

1 1
30 30
30 60 90
79 19 30 4 24 93 20 59 64 13 93 50 10 61 35 13 110

20 20
5 5 5
1 1 1 3 3 1 1 1
10 16
70 5 20 10 10 20

10 10 90

10 10 20 212 34 160 90 119 55 10 250 40 30 86


30 10 60 10 10
10 15 15

1 1 1

1 2

88 28 45 13 33 62 10 51 113 32 90 75 30 65 78 30 98
15 10 10
30
1 1 1 1 1 2
40 40

2 1 5 4 1 3 1 2 2 1
2 1 2

30 290 80 120 36 280 30 300 90


20 20 16 20 4 6 6 10 10 12 6 10

1
60 60

5 15 5 4 10 14 35 15 15 5 5 20 20 10
20 30 146 60 132 120 195 90 130

10 10

15

1 2 2 1 3 1

30 40 30 10 54 20 20 30 40 10 20

6 12 16 6 12 20 6 30 20 6 30 6 18 12 10 54

1 1 1

6 18 12 13 39 16 16 6 60 12 18 56 17 17

26 6 20 20

1 1 1 1 2 1
3 1 5 2 1 2 3 2 1 7 1 2 3 1 3 2 5
195 25 95 95 25 180 260 50 240 190 10 170 165 40 151 90 60 130
1
5 20 20 81 30 24 10 20 80 10 180 70 10 100
7 20 70 56 105 105 28
24 6 6 6 42 12 72 12 6 18 18 6 32 12 12 63

2 2 2 12

10 10
20

1 1 1 1 1 1 2 1 1 1
30 50 15 20 66 100 10 34 10 110 10 16 55 40 110
10 20 30 10 60 10
10 18 40 40

15 50

15 56 10 14 140 16
40 30 20 15 145 98 30 166 148 10 172 70 45 185 20 20 105

20 60 20 10 75 10 120 40 10 45 30 10 10
56 4

308
70
322
448
60
60 120
240

30 60
120
330 210

1 2 1
1

30
65 60
15 60

30
60 30
30

60
22 23 24 25
PENYESUAIAN

S M P S M P S M P S M KARYAWAN P

1 1 2 3

30 30 10 30 30 10 210 70 4
30 50 30 210 40 1
1 1 1 1
1 1 1 1
90 45 30 30 150 120 165 90 84

20 80 10 10 20 20 367
3 4

96 20 110 40 30 10 60 10 30 45 122
50 15 30 40 20 110 60 10 316 32

80 10 30 30 10 10 20 110 50 178
3
20 3
20
2

51
1 1 1 1 1

10 10 10 25 20
1 2 2 2
4

10 20 80 10 93 33 88 90 88

1
6 3 24 6 12 6
1

30 30

10 10
1
4

3
12 12 12 6 6 18

1 1 1

31 150
14 50 100 59 4 20 78 4 130 10

28 2
5
1
10 10
10 15 5 10

15

24 52 30 266 30 84
10

1 1 1

41 30 145 68 23 10 68 46 113 20 258


60 2

1 1 1 1
23

2 4 1 2 1 1
1

2 1 2

10 30 60 90 210 1
10 12 12

1
60 50

20 10 15 20 10 5 45
360 120 360 10 76

10 10

15 4

1 1 1
4
20 50 20 10 10 10 30 120

6 6 50 40 6 6 22 6 96

6 12 60 6 6 18 12 12

30 5 10

1
1
3 1 4 2 3 3 2 7 3 4
105 45 140 80 50 120 142 38 200 110 303
1 1
10 110 60 40 10 61 61
72 10 154 27
6 6 18 24 18 36 24 30 18 38

20 10 10 10

1 1

2 3 1
10 30 20 55 50 81 19
10 20 30 80 92
10 10 30 10

50

20 66
110 10 190 20 10 240 25 10 182 90 171

10 10 50 40 10 10 10 10 10 22

3
60

penyesuaian +24
5

penyesuaian +39
3
30
30

160
30
TOTAL
STOK AKHIR SO SELISIH
PEMAKAIAN

ED

S
160 250 250 0
52 1 1 0
0 0 0 0
0 0 0 0
5380 950 950 0
5561 713 713 0
47 12 12 0
22 11 11 0
4743 728 728 0
0 0 0 0
17 14 14 0
2735 605 605 0
50 20 20 0
0 0 0 0
0 0 0 0
3980 220 220 0
8555 1248 1248 0
220 470 470 0
3250 1160 1160 0
596 112 112 0
23 139 139 0
175 143 143 0
9 7 7 0
0 0 0 0
136 40 40 0
40 8 8 0
2 5 5 0
465 341 341 0
61 19 19 0
26 27 27 0
0 0 0 0
3859 403 403 0
0 0 0 0
0 0 0 0
0 0 0 0
21 120 120 0
755 343 343 0
42 9 9 0
0 0 0 0
2 3 3 0
184 133 133 0
0 0 0 0
210 72 72 0
6 4 4 0
61 120 120 0
0 0 0 0
14 12 12 0
0 0 0 0
68 56 56 0
512 158 158 0
0 0 0 0
18 16 16 0
690 312 312 0
991 543 543 0
4844 1086 1086 0
0 0 0 0
0 0 0 0
0 0 0 0
155 84 84 0
50 90 90 0
36 23 23 0
172 122 122 0
571 271 271 0
0 0 0 0
185 58 58 0
0 0 0 0
7030 530 530 0
339 590 590 0
280 570 570 0
0 0 0 0
14 24 24 0
19 142 142 0
15 4 4 0
0 0 0 0
5415 1164 1164 0
222 98 98 0
180 1308 1308 0
29 2 2 0
337 296 296 0
0 0 0 0
98 28 28 0
12 32 32 0
6 5 5 0
19 10 10 0
0 0 0 0
6508 630 630 0
636 193 193 0
4 42 42 0
3 28 28 0
1336 369 369 0
0 0 0 0
0 0 0 0
0 0 0 0
822 510 510 0
5955 505 505 0
0 0 0 0
0 0 0 0
118 53 53 0
0 0 0 0
170 75 75 0
0 0 0 0
33 16 16 0
4 0 0 0
1440 460 460 0
0 0 0 0
1382 348 348 0
0 0 0 0
0 0 0 0
0 120 120 0
6 2 2 0
0 21 21 0
0 0 0 0
0 1 1 0
0 0 0 0
1421 110 110 0
0 0 0 0
0 0 0 0
424 318 318 0
0 0 0 0
1 0 0 0
24 8 8 0
240 74 74 0
11672 1147 1147 0
6 1 1 0
5 5 5 0
0 0 0 0
0 1 1 0
3212 1020 1020 0
1584 491 491 0
1836 358 358 0
0 12 12 0
73 127 127 0
0 0 0 0
109 428 428 0
100 94 94 0
1 0 0 0
6 2 2 0
1 6 6 0
0 0 0 0
40 6 6 0
3120 490 490 0
1088 90 90 0
348 181 181 0
0 0 0 0
19 120 120 0
360 340 340 0
0 0 0 0
penyesuaian +326 1489 870 870 0
6946 1464 1464 0
0 0 0 0
1623 487 487 0
188 107 107 0
0 0 0
0 0 0 0
66 89 89 0
0 0 0
0 0 0
0 0 0
0 0 0
693 36 36 0
223 233 233 0
1078 212 212 0
1250 126 126 0
0 30 30 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
600 2064 2064 0
1620 3318 3318 0
840 1355 1355 0
1020 1001 1001 0
812 1646 1646 0
1140 1607 1607 0
3640 6007 6007 0
0 120 120 0
0 0 0
suaian +24 0 132 132 0
12 6 6 0
2 4 4 0
0 3 3 0
0 0 0 0
suaian +39 70 57 57 0
363 157 157 0
0 0 0
0 0 0
0 0 0
0 0 0
0 500 500 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
605 1725 1725 0
375 360 360 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
2 38 38 0
0 0 0
0 0 0
0 0 0
90 792 792 0
449 1077 1077 0
8 68 68 0
790 110 110 0
120 180 180 0
60 270 270 0
0 450 450 0
180 0 0 0
90 480 480 0
0 0 0
0 0 0 0
30 170 170 0
0 0 0
0 0 0
LAPORAN PEMAKAIAN DAN LEMBAR PERMINT
( LPLPO )

PUSKESMAS : KECAMATAN CAKUNG


UNIT : POLI 24 JAM
KECAMATAN : CAKUNG
KABUPATEN / KODYA : JAKARTA TIMUR
PROVINSI : DKI JAKARTA
PENERIMAAN
NO NAMA OBAT SATUAN STOCK AWAL PERSEDIAAN
GUDANG PENYESUAIAN
1 2 3 4 5 6 7

1 Alopurinol 100mg tablet 0 - -


2 Ambroxol 15mg/5 ml botol 0 - -
3 Aminophillin 200mg tablet 0 - -
4 Aminophillin injeksi 24mg/ml ampul 0 - -
5 Amlodipin 10mg tablet 0 - -
6 Amlodipin 5mg tablet 0 - -
7 Amoksisilin (sirup kering) 125mg/5ml botol 0 - -
8 Amoksisilin (sirup kering) 250mg/5ml botol 0 - -
9 Amoksisilin 500mg tablet 0 - -
10 Ampisilin injeksi (serbuk kering) 250mg vial 0 - -
11 Antasida DOEN (MgSO4+AlOH Tersuspensi) botol 0 - -
12 Antasida DOEN (MgSO4+AlOH) tablet 0 - -
13 Anti Hemoroid DOEN suppos 0 - -
14 Anti Tetanus Serum (ATS) 1500IU ampul 0 3 3
15 Aquades pro injeksi @25ml respule 10 3 13
16 Asam Askorbat (Vit C) 250mg tablet 0 - -
17 Asam Askorbat (Vit C) 50mg tablet 0 - -
18 Asam Folat 1mg tablet 0 - -
19 Asam Mefenamat 500mg tablet 0 - -
20 Asetosal (Ascardia/Miniaspi) 80mg tablet 0 20 20
21 Asiklovir 200mg tablet 0 - -
22 Asiklovir 400mg tablet 0 - -
23 Asiklovir krim 5% tube 0 - -
24 Atropin Sulfas injeksi 0,25mg/ml ampul 0 - -
25 Azitromisin 500 mg tablet 0 - -
26 Bedak salisil serbuk 2% ktk 0 - -
27 Benzatin benzil penicilin serbuk injeksi 2,4juta IU/ml vial 0 - -
28 Betahistin mesilate 6mg tablet 0 - -
29 Betametason krim 0,1% tube 0 - -
30 Bisakodil 5mg tablet 0 - -
31 Budesonide (Cairan inhalasi) 0,25mg/ml respule 0 - -
32 Deksametason 0,5mg tablet 0 - -
33 Deksametason injeksi 5mg/ml ampul 5 - 5
34 Difenhidramin injeksi 10mg/ml ampul 2 1 3
35 Digoksin 0,25mg tablet 0 - -
36 Doksisiklin 100mg kapsul 0 - -
37 Domperidon 10mg tablet 0 - -
38 Domperidon sirup 5mg/5ml botol 0 - -
39 Epinefrin Bitatrat/Adrenalin Injeksi 1mg/ml ampul 5 - 5
40 Eritromisin (sirup kering) 200mg/5ml botol 0 - -
41 Eritromisin 250mg kapsul 0 - -
42 Eritromisin 500mg kapsul 0 - -
43 Fenofibrat 100mg tablet 0 - -
44 Ferro sulfat 15mg/5ml botol 0 - -
45 Fitomenadion (Vit K1) 10mg tablet 0 - -
46 Fitomenadion (Vit.K1) injeksi 2mg/ml ampul 0 - -
47 Flukonazol 150mg kapsul 0 - -
48 Framisetin sulfat kassa steril 1% lembar 11 2 13
49 Furosemid 40mg tablet 9 - 9 18
50 Garam Oralit serbuk untuk 200ml sach 0 - -
51 Gentamisin Salep 0,1% tube 0 - -
52 Gentian Violet larutan 1% botol 0 - -
53 Glibenklamid 5mg tablet 0 - -
54 Glimepirid 1mg tablet 0 - -
55 Gliseril Guaiakolat 100mg tablet 0 - -
56 Glukosa larutan infus 10 % botol 0 - -
57 Glukosa larutan infus 40 % botol 0 - -
58 Glukosa larutan infus 5 % botol 0 - -
59 Griseofulvin 125mg tablet 0 - -
60 Hidroklortiazid 25mg tablet 10 - 10
61 Hidrokotison krim 2,5% tube 0 - -
62 Hiosin N Butylbromide 10mg tablet 0 - -
63 Ibuprofen 200mg tablet 0 - -
64 Ikhtamol salep 10% pot 0 - -
65 Isosorbid dinitrat (ISDN) 5mg tablet 3 10 13
66 Kalsium glukonat injeksi 10% vial 1 - 1
67 Kalsium Laktat 500mg tablet 0 - -
68 Kaptopril 12,5 mg tablet 0 - -
69 Kaptopril 25mg tablet 40 - 40
70 Karbo Adsorben (Norit) 125mg tablet 0 - -
71 Karbogliserin (Fenol Gliserol) tetes telinga 10% botol 0 - -
72 Ketokonazol 200mg tablet 0 - -
73 Ketokonazol krim 2% tube 0 - -
74 Ketoprofen 100mg/Supp suppos 0 - -
75 Khlofeniramin Maleat (CTM) 4mg tablet 0 - -
76 Klindamisin 150mg kapsul 0 - -
77 Klopidogrel 75mg tablet 0 - -
78 Kloramfenikol tetes mata 0,5% botol 0 - -
79 Kloramfenikol 250mg kapsul 0 - -
80 Kloramfenikol 500mg kapsul 0 - -
81 Kloramfenikol salep kulit 2% tube 0 - -
82 Kloramfenikol salep mata 1% tube 0 - -
83 Kloramfenikol suspensi 125mg/5ml botol 0 - -
84 Kloramfenikol tetes telinga 3% botol 0 - -
85 Kolkisin 500mg tablet 0 - -
86 Komb.ferro sulfat+as.folat (tablet tambah darah) tablet 0 - -
87 Komb.kaolin 550mg+pektin 20mg tablet 0 - -
88 Kombipak Azitromisin + Cefixim amplop 0 - -
89 Kotrimoksazol 240mg/5 mL botol 0 - -
90 Kotrimoksazol 480mg tablet 0 - -
91 Lactulosa 3,335mg/5ml botol 0 - -
92 Lidokain injeksi 2% ampul 18 14 32
93 Lincomisin kapsul 500mg kapsul 0 - -
94 Loratadin 10mg tablet 0 - -
95 Metformin 500mg tablet 0 - -
96 Metil Ergometrin injeksi 0,2mg/ml ampul 0 - -
97 Metil Ergometrin 0,125mg tablet 0 - -
98 Metoklorpropamid 10mg tablet 0 - -
99 Metronidazol 250mg tablet 0 - -
100 Metronidazol 500mg tablet 0 - -
101 MgSO4 injeksi 40% vial 4 - 4
102 Mikonazol krim 2% tube 0 - -
103 NaCl larutan infus 0,9% botol 6 18 24
104 N-Asetil Sistein 200mg kapsul 0 - -
105 Natrium Bicarbonat 500mg tablet 0 - -
106 Natrium Diklofenak 25mg tablet 0 - -
107 Natrium Diklofenak 50mg tablet 0 - -
108 Neomisin 0,5% & Plasenta sapi 10% tube 0 - -
109 Nifedipin tablet 10mg tablet 0 - -
110 Nistatin 100.000IU/ml botol 0 - -
111 Nistatin vaginal 100.000IU tablet 0 - -
112 Nitrofurantoin 50mg tablet 0 - -
113 Oksitetrasiklin HCl salep mata 1% tube 0 - -
114 Oksitosin Injeksi 10IU/ml ampul 0 - -
115 Omeprazole 20mg kapsul 0 - -
116 Omeprazole serbuk injeksi 40mg vial 0 2 2
117 Pantocain 0,5% botol 0 - -
118 Papaverin 40mg tablet 0 - -
119 Papaverin injeksi 40mg/ml ampul 0 - -
120 Paracetamol supp 125mg suppos 1 3 4
121 Parasetamol 100mg/ml botol 0 - -
122 Parasetamol 120mg/5ml botol 0 - -
123 Parasetamol 500mg tablet 0 - -
124 Perak sufadiazin krim (Burnazin) 1% tube 0 - -
125 Permetrin krim 5% (Scabimied) tube 0 - -
126 Pirantel Pamoat 125mg tablet 0 - -
127 Pirantel Pamoat 125mg/5ml botol 0 - -
128 Piridoxin (Vit B6) 10mg tablet 0 - -
129 Prednison 5mg tablet 0 - -
130 Ranitidin 150mg tablet 0 - -
131 Retinol (Vit A. Biru) 100.000 IU kapsul 0 - -
132 Retinol (Vit A. Merah) 200.000 IU kapsul 0 - -
133 Ringer Laktat larutan Elektrolit infus botol 15 18 33
134 Salbutamol 2mg tablet 0 - -
135 Salbutamol 4mg tablet 0 - -
136 Salbutamol cairan iihalasi (Ventolin Nebules) 2,5mg ampul 7 - 10 17
137 Salep 2-4 (As.Salisilat2%+Sulfur4%) pot 0 - -
138 Salep Whitfield/Antifungi (As.Benzoat6%+As.Salisilat pot 0 - -
139 Sefiksim 200mg kapsul 0 - -
140 Setirizine 5mg/5ml botol 0 - -
141 Sianokobalamin (Vit.B12) 50 µg tablet 0 - -
142 Simvastatin 10mg tablet 0 - -
143 Siprofloxasin 500mg tablet 0 - -
144 Tetrasiklin 250mg kapsul 0 - -
145 Tetrasiklin kapsul 500mg kapsul 0 - -
146 Tiamfenikol 500mg kapsul 0 - -
147 Tiamin (Vitamin B1) 100mg tablet 0 - -
148 Tiamin (Vitamin B1) 50mg tablet 0 - -
149 Vitamin B kompleks tablet 0 - -
150 Zink 20mg/5ml botol 0 - -
151 Zink dispersibel 20mg tablet 0 - -
152 Amitriptilin HCl 25mg tablet 0 - -
153 Anti Migrain DOEN tablet (ergotamin1mg+kafein50mg) tablet 0 - -
154 Diazepam 2mg tablet 0 - -
155 Diazepam 5mg tablet 0 - -
156 Diazepam injeksi 5mg/ml ampul 1 - 1
157 Diazepam enema (Stesolid rectal tube) 10mg/2,5ml tube 4 - 4
158 Diazepam enema (Stesolid rectal tube) 5mg/2,5ml tube 2 - 2
159 Fenobarbital 30mg tablet 0 - -
160 Haloperidol tablet 5mg tablet 0 - -
161 Klorpromazin 100mg tablet 0 - -
162 Risperidon 2mg tablet 0 - -
163 Triheksipenidil 2mg tablet 0 - -
164 Kodein 10mg tablet 0 - -
165 Bahan tumpatan sementara (Cavit/Caviton) set 0 - -
166 Bonding botol 0 - -
167 Celluloid Strip Gigi Pak 0 - -
168 Composit Light Curing (Tambal Sinar ) A2 tube 0 - -
169 Composit Light Curing (Tambal Sinar ) A3 tube 0 - -
170 Composit Light Curing (Tambal Sinar ) A3,5 tube 0 - -
171 Cresophene (cresotin) botol 0 - -
172 Dycal (Dycal/Hydcal) set 0 - -
173 Ecing (Ecing/Ethacant) botol 0 - -
174 Endometason (Endoseal) tube 0 - -
175 Etil Chlorida Spray (Etil Clorida/Endoice) botol 0 - -
176 Eugenol botol 0 - -
177 Formokresol botol 0 - -
178 Glass Ionomert ART (Fuji IX) set 0 - -
179 Kalsium Hidroksida Pasta (Metapex/Calcetin/Vitapex) ktk 0 - -
180 Klorfenol kamfer mentol (CHKM) botol 0 - -
181 Lidocain spray 10% (Xylocaine) botol 0 - -
182 Lidokain 2%+Epinefrin1:80.000 injeksi 2ml (Pehacain) ampul 0 - -
183 Lidokain krim anestesi topical pot 0 - -
184 Pasta devitalisasi non arsen (Depulpin) botol 0 - -
185 Scandonest botol 0 - -
186 Zinc Pospat Cement set 0 - -
187 Tuberkulin protein purified derivative (Mantoux test) vial 0 - -
188 Vaksin BCG kering + Pelarut vial 0 - -
189 Vaksin HB0 (Hepatitis rekombinan) Dewasa vial 0 - -
190 Vaksin HB0 (Hepatitis rekombinan) vial 0 - -
191 Vaksin HPV vial 0 - -
192 Vaksin Polio Oral + droppler (OPV) vial 0 - -
193 Vaksin jerap difteri tetanus (DT) <7thn vial 0 - -
194 Vaksin jerap tetanus difteri (Td) >7thn vial 0 - -
195 Vaksin kombinasi DPT-HB-Hib vial 0 - -
196 Vaksin Polio injeksi (IPV) vial 0 - -
197 Vaksin Meningitis vial 0 - -
198 Vaksin MR Kering + Pelarut Vial 0 - -
199 Vaksin HBIg ampul 0 - -
200 Efavirenz (EFV) 600mg tablet 0 - -
201 Lamivudine (3TC) 150mg tablet 0 - -
202 Lopinovir/ritonavir (LPV/r) 200/50mg tablet 0 - -
203 Nevirapine (NVP) 200mg tablet 0 - -
204 Tenofovir (TDF) 300mg tablet 0 - -
205 Zidovudine (ZDV)+ Lamivudine (3TC) 300/150mg tablet 0 - -
206 Triple FDC (TDF+3TC+EFV) 300/300/600mg tablet 0 - -
207 Ped Triple FDC(ZDV+3TC+NVP) 60/30/50mg tablet 0 - -
208 Ziduvudin Sirup botol 0 - -
209 Albendazol 400mg tablet 0 - -
210 MDT Combi (MB-Adult) blister 0 - -
211 MDT Combi (MB-Child) blister 0 - -
212 MDT Combi (PB- Adult) blister 0 - -
213 MDT Combi (PB- Child)) blister 0 - -
214 Isoniasid 100 mg tablet 0 - -
215 Isoniazid 300 mg tablet 0 - -
216 Obat Anti Tuberkulose kategori Anak paket 0 - -
217 Obat Anti Tuberkulose kategori I & III paket 0 - -
218 Obat Anti Tuberkulose kategori II paket 0 - -
219 Obat Anti Tuberkulose kombipak paket 0 - -
220 Piridoksin (Vit B6) 25mg tablet 0 - -
221 OAT TB + HIV Intensif paket 0 - -
222 OAT TB + HIV Lanjutan paket 0 - -
223 Sterptomycin sulfat serbuk injeksi 1000mg vial 0 - -
224 Bedaquilin 100 mg tablet 0 - -
225 Ethambutol 400. mg tablet 0 - -
226 Etionamid 250 mg tablet 0 - -
227 Kanamisin injeksi 1000mg vial 0 - -
228 Kapreomisin 1 g injeksi vial 0 - -
229 Klofazimin 100 mg kapsul 0 - -
230 Kloserin 250 mg tablet 0 - -
231 Levofloksasin 250 mg tablet 0 - -
232 Moksifloksasin 400 mg tablet 0 - -
233 P-aminosalisilat sodium 5.52 g sachet 0 - -
234 Linizolid 600 mg capsul 0 - -
235 Pirazinamid 400 mg tablet 0 - -
236 Pirazinamid 500 mg tablet 0 - -
237 Piridoksin 100 mg tablet 0 - -
238 Pil KB komb.I (Levonogestrol 150mg+Etinil Estradiol 3 blister 0 - -
239 Suntik KB 1 bulan (Medoksi 150mg+Estradiol 5mg) vial 0 - -
240 Suntik KB 3 bulan (Medoksiprogesteron Asetat 150mg vial 0 - -
241 Implan KB 3 tahun (Levonogestrol 25mg) pcs 0 - -
242 Dekstro+GG+CTM+Phenyl Syr Botol 0 - -
243 Oxycan botol 0 - -
244 Parasetamol 100mg tablet tablet 0 - -
245 Bisoprolol 5 mg tablet 0 - -
246 candesartan tablet 0 - -
247 Kotrimoxazole 960mg tablet 0 - -
248 Becomzet tablet 0 - -
249 ZEGAVIT tablet 0 - -
250 DANEURON tablet 0 - -
251 Becefort tablet 0 - -
252 Vitamin Ultra C tablet 0 - -
253 Zidovudin 100 mg tablet 0 - -
254 Delanamid 50 mg tablet 0 - -
255 Furosemide inj tablet 3 1 4
256 Albendazole syr 200 mg/ml tablet 0 - -
257 Dolutegravir 50 mg tablet 0 - -
258 Triple FDC (TDF+3TC+DTG) 300/300/50mg tablet 0 - -
259 Spironolactone 100 mg tablet 0 - -
260 Acarbose 50 mg tablet 0 - -
261 Ramipril 5 mg tablet 0 - -
262 Valsartan 160 mg tablet 0 - -
263 Ramipril 10 mg tablet 0 - -
264 Adalat Oros 30 mg tablet 0 - -
265 Glikuidone 30 mg tablet 0 - -
266 Levofloksasin 100 mg tablet 0 - -
267 Xylocain Jelly Tube 0 2 2
268 Gabapentin tablet 0 - -
269 Rifampentin tablet 0 - -

Mengetahui
PJ Farmasi PKM Cakung

Windi Wikandari, S.Farm., Apt


NIP 19860813211012014
MAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )

LB 2
BULAN : JANUARI
TAHUN 2020

PENGELUARAN STOK
SISA STOCK PERMINTAAN PEMBERIAN KET.
PEMAKAIAN RETUR ED/RUSAK PENYESUAIAN OPTIMUM
8 9 10 11 12 13 14 15 16

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
3 0 9
6 7
0 0
0 0
0 0
0 0
20 -20
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
1 4 -1
1 2 1
0 0
0 0
0 0
0 0
5 -5
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
9 4 23
10 8 22
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
10 -10
0 0
0 0
0 0
0 0
3 10 -1
1 -1
0 0
0 0
40 -40
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
26 6 72
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
4 -4
0 0
15 9 36
0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
2 0 6
0 0
0 0
0 0
1 3 0
0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
20 13 47
0
0 0
17 -17
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
1 -1
4 -4
2 -2
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0
0
0
0
0
0
0
0
0
0 0
0 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1 3
0
0
0
0
0
0
0
0
0
0
0
2 0
0
0

Jakarta, Januari 2021


Yang Membuat Laporan

Tria Annisa, S.Farm., Apt


NIP. 10205819920502199205262
STOCK OPNAMESELISIH
17 18

0
0
0
0
0
0
0
0
0
0
0
0
0
0
7 0
0
0
0
0
20 0
0
0
0
0
0
0
0
0
0
0
0
0
4 0
2 0
0
0
0
0
5 0
0
0
0
0
0
0
0
0
4 0
8 0
0
0
0
0
0
0
0
0
0
0
10 0
0
0
0
0
10 0
1 0
0
0
40 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6 0
0
0
0
0
0
0
0
0
4 0
0
9 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3 0
0
0
0
0
0
0
0
0
0
0
0
0
13 0
0
0
17 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1 0
4 0
2 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3 0
0
0
0
0
0
0
0
0
0
0
0
0 0
0
0
LAPORAN PEMAKAIAN DAN LEMBAR PERMINT
( LPLPO )

PUSKESMAS : KECAMATAN CAKUNG


UNIT : RB
KECAMATAN : CAKUNG
KABUPATEN / KODYA : JAKARTA TIMUR
PROVINSI : DKI JAKARTA
PENERIMAAN
NO NAMA OBAT SATUAN STOCK AWAL PERSEDIAAN
GUDANG PENYESUAIAN
1 2 3 4 5 6 7

1 Alopurinol 100mg tablet 0 - -


2 Ambroxol 15mg/5 ml botol 0 - -
3 Aminophillin 200mg tablet 0 - -
4 Aminophillin injeksi 24mg/ml ampul 0 - -
5 Amlodipin 10mg tablet 0 - -
6 Amlodipin 5mg tablet 0 - -
7 Amoksisilin (sirup kering) 125mg/5ml botol 0 - -
8 Amoksisilin (sirup kering) 250mg/5ml botol 0 - -
9 Amoksisilin 500mg tablet 0 - -
10 Ampisilin injeksi (serbuk kering) 250mg vial 4 - 4
11 Antasida DOEN (MgSO4+AlOH Tersuspensi) botol 0 - -
12 Antasida DOEN (MgSO4+AlOH) tablet 0 - -
13 Anti Hemoroid DOEN suppos 0 - -
14 Anti Tetanus Serum (ATS) 1500IU ampul 0 - -
15 Aquades pro injeksi @25ml respule 12 5 17
16 Asam Askorbat (Vit C) 250mg tablet 0 - -
17 Asam Askorbat (Vit C) 50mg tablet 0 - -
18 Asam Folat 1mg tablet 0 - -
19 Asam Mefenamat 500mg tablet 0 - -
20 Asetosal (Ascardia/Miniaspi) 80mg tablet 0 - -
21 Asiklovir 200mg tablet 0 - -
22 Asiklovir 400mg tablet 0 - -
23 Asiklovir krim 5% tube 0 - -
24 Atropin Sulfas injeksi 0,25mg/ml ampul 0 - -
25 Azitromisin 500 mg tablet 0 - -
26 Bedak salisil serbuk 2% ktk 0 - -
27 Benzatin benzil penicilin serbuk injeksi 2,4juta IU/ml vial 0 - -
28 Betahistin mesilate 6mg tablet 0 - -
29 Betametason krim 0,1% tube 0 - -
30 Bisakodil 5mg tablet 0 - -
31 Budesonide (Cairan inhalasi) 0,25mg/ml respule 0 - -
32 Deksametason 0,5mg tablet 0 - -
33 Deksametason injeksi 5mg/ml ampul 2 - 2
34 Difenhidramin injeksi 10mg/ml ampul 2 - 2
35 Digoksin 0,25mg tablet 0 - -
36 Doksisiklin 100mg kapsul 0 - -
37 Domperidon 10mg tablet 0 - -
38 Domperidon sirup 5mg/5ml botol 0 - -
39 Epinefrin Bitatrat/Adrenalin Injeksi 1mg/ml ampul 3 - 3
40 Eritromisin (sirup kering) 200mg/5ml botol 0 - -
41 Eritromisin 250mg kapsul 0 - -
42 Eritromisin 500mg kapsul 0 - -
43 Fenofibrat 100mg tablet 0 - -
44 Ferro sulfat 15mg/5ml botol 0 - -
45 Fitomenadion (Vit K1) 10mg tablet 0 - -
46 Fitomenadion (Vit.K1) injeksi 2mg/ml ampul 29 30 59
47 Flukonazol 150mg kapsul 0 - -
48 Framisetin sulfat kassa steril 1% lembar 0 - -
49 Furosemid 40mg tablet 0 - -
50 Garam Oralit serbuk untuk 200ml sach 0 - -
51 Gentamisin Salep 0,1% tube 0 - -
52 Gentian Violet larutan 1% botol 0 - -
53 Glibenklamid 5mg tablet 0 - -
54 Glimepirid 1mg tablet 0 - -
55 Gliseril Guaiakolat 100mg tablet 0 - -
56 Glukosa larutan infus 10 % botol 3 - 3
57 Glukosa larutan infus 40 % botol 0 - -
58 Glukosa larutan infus 5 % botol 0 - -
59 Griseofulvin 125mg tablet 0 - -
60 Hidroklortiazid 25mg tablet 0 - -
61 Hidrokotison krim 2,5% tube 0 - -
62 Hiosin N Butylbromide 10mg tablet 0 - -
63 Ibuprofen 200mg tablet 0 - -
64 Ikhtamol salep 10% pot 0 - -
65 Isosorbid dinitrat (ISDN) 5mg tablet 0 - -
66 Kalsium glukonat injeksi 10% vial 1 - 1
67 Kalsium Laktat 500mg tablet 0 - -
68 Kaptopril 12,5 mg tablet 0 - -
69 Kaptopril 25mg tablet 0 - -
70 Karbo Adsorben (Norit) 125mg tablet 0 - -
71 Karbogliserin (Fenol Gliserol) tetes telinga 10% botol 0 - -
72 Ketokonazol 200mg tablet 0 - -
73 Ketokonazol krim 2% tube 0 - -
74 Ketoprofen 100mg/Supp suppos 3 - 3
75 Khlofeniramin Maleat (CTM) 4mg tablet 0 - -
76 Klindamisin 150mg kapsul 0 - -
77 Klopidogrel 75mg tablet 0 - -
78 Kloramfenikol tetes mata 0,5% botol 0 - -
79 Kloramfenikol 250mg kapsul 0 - -
80 Kloramfenikol 500mg kapsul 0 - -
81 Kloramfenikol salep kulit 2% tube 0 - -
82 Kloramfenikol salep mata 1% tube 0 - -
83 Kloramfenikol suspensi 125mg/5ml botol 0 - -
84 Kloramfenikol tetes telinga 3% botol 0 - -
85 Kolkisin 500mg tablet 0 - -
86 Komb.ferro sulfat+as.folat (tablet tambah darah) tablet 0 - -
87 Komb.kaolin 550mg+pektin 20mg tablet 0 - -
88 Kombipak Azitromisin + Cefixim amplop 0 - -
89 Kotrimoksazol 240mg/5 mL botol 0 - -
90 Kotrimoksazol 480mg tablet 0 - -
91 Lactulosa 3,335mg/5ml botol 0 - -
92 Lidokain injeksi 2% ampul 37 20 57
93 Lincomisin kapsul 500mg kapsul 0 - -
94 Loratadin 10mg tablet 0 - -
95 Metformin 500mg tablet 0 - -
96 Metil Ergometrin injeksi 0,2mg/ml ampul 31 - 31
97 Metil Ergometrin 0,125mg tablet 0 - -
98 Metoklorpropamid 10mg tablet 0 - -
99 Metronidazol 250mg tablet 0 - -
100 Metronidazol 500mg tablet 0 - -
101 MgSO4 injeksi 40% vial 6 5 11
102 Mikonazol krim 2% tube 0 - -
103 NaCl larutan infus 0,9% botol 4 - 4
104 N-Asetil Sistein 200mg kapsul 0 - -
105 Natrium Bicarbonat 500mg tablet 0 - -
106 Natrium Diklofenak 25mg tablet 0 - -
107 Natrium Diklofenak 50mg tablet 0 - -
108 Neomisin 0,5% & Plasenta sapi 10% tube 0 - -
109 Nifedipin tablet 10mg tablet 0 - -
110 Nistatin 100.000IU/ml botol 0 - -
111 Nistatin vaginal 100.000IU tablet 0 - -
112 Nitrofurantoin 50mg tablet 0 - -
113 Oksitetrasiklin HCl salep mata 1% tube 23 - 5 28
114 Oksitosin Injeksi 10IU/ml ampul 33 - 33
115 Omeprazole 20mg kapsul 0 - -
116 Omeprazole serbuk injeksi 40mg vial 0 - -
117 Pantocain 0,5% botol 0 - -
118 Papaverin 40mg tablet 0 - -
119 Papaverin injeksi 40mg/ml ampul 0 - -
120 Paracetamol supp 125mg suppos 0 - -
121 Parasetamol 100mg/ml botol 0 - -
122 Parasetamol 120mg/5ml botol 0 - -
123 Parasetamol 500mg tablet 0 - -
124 Perak sufadiazin krim (Burnazin) 1% tube 0 - -
125 Permetrin krim 5% (Scabimied) tube 0 - -
126 Pirantel Pamoat 125mg tablet 0 - -
127 Pirantel Pamoat 125mg/5ml botol 0 - -
128 Piridoxin (Vit B6) 10mg tablet 0 - -
129 Prednison 5mg tablet 0 - -
130 Ranitidin 150mg tablet 0 - -
131 Retinol (Vit A. Biru) 100.000 IU kapsul 0 - -
132 Retinol (Vit A. Merah) 200.000 IU kapsul 0 - -
133 Ringer Laktat larutan Elektrolit infus botol 32 70 102
134 Salbutamol 2mg tablet 0 - -
135 Salbutamol 4mg tablet 0 - -
136 Salbutamol cairan iihalasi (Ventolin Nebules) 2,5mg ampul 0 - -
137 Salep 2-4 (As.Salisilat2%+Sulfur4%) pot 0 - -
138 Salep Whitfield/Antifungi (As.Benzoat6%+As.Salisilat pot 0 - -
139 Sefiksim 200mg kapsul 0 - -
140 Setirizine 5mg/5ml botol 0 - -
141 Sianokobalamin (Vit.B12) 50 µg tablet 0 - -
142 Simvastatin 10mg tablet 0 - -
143 Siprofloxasin 500mg tablet 0 - -
144 Tetrasiklin 250mg kapsul 0 - -
145 Tetrasiklin kapsul 500mg kapsul 0 - -
146 Tiamfenikol 500mg kapsul 0 - -
147 Tiamin (Vitamin B1) 100mg tablet 0 - -
148 Tiamin (Vitamin B1) 50mg tablet 0 - -
149 Vitamin B kompleks tablet 0 - -
150 Zink 20mg/5ml botol 0 - -
151 Zink dispersibel 20mg tablet 0 - -
152 Amitriptilin HCl 25mg tablet 0 - -
153 Anti Migrain DOEN tablet (ergotamin1mg+kafein50mg) tablet 0 - -
154 Diazepam 2mg tablet 0 - -
155 Diazepam 5mg tablet 0 - -
156 Diazepam injeksi 5mg/ml ampul 0 - -
157 Diazepam enema (Stesolid rectal tube) 10mg/2,5ml tube 0 - -
158 Diazepam enema (Stesolid rectal tube) 5mg/2,5ml tube 0 - -
159 Fenobarbital 30mg tablet 0 - -
160 Haloperidol tablet 5mg tablet 0 - -
161 Klorpromazin 100mg tablet 0 - -
162 Risperidon 2mg tablet 0 - -
163 Triheksipenidil 2mg tablet 0 - -
164 Kodein 10mg tablet 0 - -
165 Bahan tumpatan sementara (Cavit/Caviton) set 0 - -
166 Bonding botol 0 - -
167 Celluloid Strip Gigi Pak 0 - -
168 Composit Light Curing (Tambal Sinar ) A2 tube 0 - -
169 Composit Light Curing (Tambal Sinar ) A3 tube 0 - -
170 Composit Light Curing (Tambal Sinar ) A3,5 tube 0 - -
171 Cresophene (cresotin) botol 0 - -
172 Dycal (Dycal/Hydcal) set 0 - -
173 Ecing (Ecing/Ethacant) botol 0 - -
174 Endometason (Endoseal) tube 0 - -
175 Etil Chlorida Spray (Etil Clorida/Endoice) botol 0 - -
176 Eugenol botol 0 - -
177 Formokresol botol 0 - -
178 Glass Ionomert ART (Fuji IX) set 0 - -
179 Kalsium Hidroksida Pasta (Metapex/Calcetin/Vitapex) ktk 0 - -
180 Klorfenol kamfer mentol (CHKM) botol 0 - -
181 Lidocain spray 10% (Xylocaine) botol 0 - -
182 Lidokain 2%+Epinefrin1:80.000 injeksi 2ml (Pehacain) ampul 0 - -
183 Lidokain krim anestesi topical pot 0 - -
184 Pasta devitalisasi non arsen (Depulpin) botol 0 - -
185 Scandonest botol 0 - -
186 Zinc Pospat Cement set 0 - -
187 Tuberkulin protein purified derivative (Mantoux test) vial 0 - -
188 Vaksin BCG kering + Pelarut vial 0 - -
189 Vaksin HB0 (Hepatitis rekombinan) Dewasa vial 0 - -
190 Vaksin HB0 (Hepatitis rekombinan) vial 30 10 40
191 Vaksin HPV vial 0 - -
192 Vaksin Polio Oral + droppler (OPV) vial 0 - -
193 Vaksin jerap difteri tetanus (DT) <7thn vial 0 - -
194 Vaksin jerap tetanus difteri (Td) >7thn vial 0 - -
195 Vaksin kombinasi DPT-HB-Hib vial 0 - -
196 Vaksin Polio injeksi (IPV) vial 0 - -
197 Vaksin Meningitis vial 0 - -
198 Vaksin MR Kering + Pelarut Vial 0 - -
199 Vaksin HBIg ampul 9 10 19
200 Efavirenz (EFV) 600mg tablet 0 - -
201 Lamivudine (3TC) 150mg tablet 0 - -
202 Lopinovir/ritonavir (LPV/r) 200/50mg tablet 0 - -
203 Nevirapine (NVP) 200mg tablet 0 - -
204 Tenofovir (TDF) 300mg tablet 0 - -
205 Zidovudine (ZDV)+ Lamivudine (3TC) 300/150mg tablet 0 - -
206 Triple FDC (TDF+3TC+EFV) 300/300/600mg tablet 0 - -
207 Ped Triple FDC(ZDV+3TC+NVP) 60/30/50mg tablet 0 - -
208 Ziduvudin Sirup botol 0 - -
209 Albendazol 400mg tablet 0 - -
210 MDT Combi (MB-Adult) blister 0 - -
211 MDT Combi (MB-Child) blister 0 - -
212 MDT Combi (PB- Adult) blister 0 - -
213 MDT Combi (PB- Child)) blister 0 - -
214 Isoniasid 100 mg tablet 0 - -
215 Isoniazid 300 mg tablet 0 - -
216 Obat Anti Tuberkulose kategori Anak paket 0 - -
217 Obat Anti Tuberkulose kategori I & III paket 0 - -
218 Obat Anti Tuberkulose kategori II paket 0 - -
219 Obat Anti Tuberkulose kombipak paket 0 - -
220 Piridoksin (Vit B6) 25mg tablet 0 - -
221 OAT TB + HIV Intensif paket 0 - -
222 OAT TB + HIV Lanjutan paket 0 - -
223 Sterptomycin sulfat serbuk injeksi 1000mg vial 0 - -
224 Bedaquilin 100 mg tablet 0 - -
225 Ethambutol 400. mg tablet 0 - -
226 Etionamid 250 mg tablet 0 - -
227 Kanamisin injeksi 1000mg vial 0 - -
228 Kapreomisin 1 g injeksi vial 0 - -
229 Klofazimin 100 mg kapsul 0 - -
230 Kloserin 250 mg tablet 0 - -
231 Levofloksasin 250 mg tablet 0 - -
232 Moksifloksasin 400 mg tablet 0 - -
233 P-aminosalisilat sodium 5.52 g sachet 0 - -
234 Linizolid 600 mg capsul 0 - -
235 Pirazinamid 400 mg tablet 0 - -
236 Pirazinamid 500 mg tablet 0 - -
237 Piridoksin 100 mg tablet 0 - -
238 Pil KB komb.I (Levonogestrol 150mg+Etinil Estradiol 3 blister 0 - -
239 Suntik KB 1 bulan (Medoksi 150mg+Estradiol 5mg) vial 0 - -
240 Suntik KB 3 bulan (Medoksiprogesteron Asetat 150mg vial 0 - -
241 Implan KB 3 tahun (Levonogestrol 25mg) pcs 0 - -
242 Dekstro+GG+CTM+Phenyl Syr Botol 0 - -
243 Oxycan botol 0 - -
244 Parasetamol 100mg tablet tablet 0 - -
245 Bisoprolol 5 mg tablet 0 - -
246 candesartan tablet 0 - -
247 Kotrimoxazole 960mg tablet 0 - -
248 Becomzet tablet 0 - -
249 ZEGAVIT tablet 0 - -
250 DANEURON tablet 0 - -
251 Becefort tablet 0 - -
252 Vitamin Ultra C tablet 0 - -
253 Zidovudin 100 mg tablet 0 - -
254 Delanamid 50 mg tablet 0 - -
255 Furosemide inj tablet 0 - -
256 Albendazole syr 200 mg/ml tablet 0 - -
257 Dolutegravir 50 mg tablet 0 - -
258 Triple FDC (TDF+3TC+DTG) 300/300/50mg tablet 0 - -
259 Spironolactone 100 mg tablet 0 - -
260 Acarbose 50 mg tablet 0 - -
261 Ramipril 5 mg tablet 0 - -
262 Valsartan 160 mg tablet 0 - -
263 Ramipril 10 mg tablet 0 - -
264 Adalat Oros 30 mg tablet 0 - -
265 Glikuidone 30 mg tablet 0 - -
266 Levofloksasin 100 mg tablet 0 - -
267 Xylocain Jelly Tube 0 - -
268 Gabapentin tablet 0 - -

Mengetahui
PJ Farmasi PKM Cakung

Windi Wikandari, S.Farm., Apt


NIP 19860813211012014
EMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )

LB 2
BULAN : JANUARI
TAHUN : 2021

PENGELUARAN STOK
SISA STOCK 0 PEMBERIAN KET.
PEMAKAIAN RETUR ED/RUSAK PENYESUAIAN OPTIMUM
8 9 10 11 12 13 14 15 16

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
2 2 4
0 0
0 0
0 0
0 0
10 7 23
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
2 -2
2 -2
0 0
0 0
0 0
0 0
1 2 1
0 0
0 0
0 0
0 0
0 0
0 0
15 44 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
3 -3
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
1 -1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
1 2 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
12 45 -9
0 0
0 0
0 0
4 27 -15
0 0
0 0
0 0
0 0
2 9 -3
0 0
4 -4
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
28 -28
23 10 59
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
71 31 182
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
30 10 80
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
12 7 29
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0
0
0
0
0
0
0
0
0
0 0
0 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Jakarta, Januari 2021


Yang Membuat Laporan

Tria Annisa, S.Farm., Apt


NIP. 10205819920502199205262
stok opname selisih
17 18 18

0
0
0
0
0
0
0
0
0
2 0
0
0
0
0
7 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2 0
2 0
0
0
0
0
2 0
0
0
0
0
0
0
44 0
0
0
0
0
0
0
0
0
0
3 0
0
0
0
0
0
0
0
0
0
1 0
0
0
0
0
0
0
0
2 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
45 0
0
0
0
27 0
0
0
0
0
9 0
0
4 0
0
0
0
0
0
0
0
0
0
28 0
10 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
31 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10 0
0
0
0
0
0
0
0
0
7 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
LAPORAN PEMAKAIAN DAN LEMBAR PERMINT
( LPLPO )

PUSKESMAS : KECAMATAN CAKUNG


UNIT : BPG
KECAMATAN : CAKUNG
KABUPATEN / KODYA : JAKARTA TIMUR
PROVINSI : DKI JAKARTA
PENERIMAAN
NO NAMA OBAT SATUAN STOCK AWAL PERSEDIAAN
GUDANG PENYESUAIAN
1 2 3 4 5 6 7

1 Alopurinol 100mg tablet 0 - -


2 Ambroxol 15mg/5 ml botol 0 - -
3 Aminophillin 200mg tablet 0 - -
4 Aminophillin injeksi 24mg/ml ampul 0 - -
5 Amlodipin 10mg tablet 0 - -
6 Amlodipin 5mg tablet 0 - -
7 Amoksisilin (sirup kering) 125mg/5ml botol 0 - -
8 Amoksisilin (sirup kering) 250mg/5ml botol 0 - -
9 Amoksisilin 500mg tablet 0 - -
10 Ampisilin injeksi (serbuk kering) 250mg vial 0 - -
11 Antasida DOEN (MgSO4+AlOH Tersuspensi) botol 0 - -
12 Antasida DOEN (MgSO4+AlOH) tablet 0 - -
13 Anti Hemoroid DOEN suppos 0 - -
14 Anti Tetanus Serum (ATS) 1500IU ampul 0 - -
15 Aquades pro injeksi @25ml respule 0 - -
16 Asam Askorbat (Vit C) 250mg tablet 0 - -
17 Asam Askorbat (Vit C) 50mg tablet 0 - -
18 Asam Folat 1mg tablet 0 - -
19 Asam Mefenamat 500mg tablet 0 - -
20 Asetosal (Ascardia/Miniaspi) 80mg tablet 0 - -
21 Asiklovir 200mg tablet 0 - -
22 Asiklovir 400mg tablet 0 - -
23 Asiklovir krim 5% tube 0 - -
24 Atropin Sulfas injeksi 0,25mg/ml ampul 0 - -
25 Azitromisin 500 mg tablet 0 - -
26 Bedak salisil serbuk 2% ktk 0 - -
27 Benzatin benzil penicilin serbuk injeksi 2,4juta IU/ml vial 0 - -
28 Betahistin mesilate 6mg tablet 0 - -
29 Betametason krim 0,1% tube 0 - -
30 Bisakodil 5mg tablet 0 - -
31 Budesonide (Cairan inhalasi) 0,25mg/ml respule 0 - -
32 Deksametason 0,5mg tablet 0 - -
33 Deksametason injeksi 5mg/ml ampul 4 - 4
34 Difenhidramin injeksi 10mg/ml ampul 4 - 4
35 Digoksin 0,25mg tablet 0 - -
36 Doksisiklin 100mg kapsul 0 - -
37 Domperidon 10mg tablet 0 - -
38 Domperidon sirup 5mg/5ml botol 0 - -
39 Epinefrin Bitatrat/Adrenalin Injeksi 1mg/ml ampul 4 - 4
40 Eritromisin (sirup kering) 200mg/5ml botol 0 - -
41 Eritromisin 250mg kapsul 0 - -
42 Eritromisin 500mg kapsul 0 - -
43 Fenofibrat 100mg tablet 0 - -
44 Ferro sulfat 15mg/5ml botol 0 - -
45 Fitomenadion (Vit K1) 10mg tablet 0 - -
46 Fitomenadion (Vit.K1) injeksi 2mg/ml ampul 0 - -
47 Flukonazol 150mg kapsul 0 - -
48 Framisetin sulfat kassa steril 1% lembar 0 - -
49 Furosemid 40mg tablet 0 - -
50 Garam Oralit serbuk untuk 200ml sach 0 - -
51 Gentamisin Salep 0,1% tube 0 - -
52 Gentian Violet larutan 1% botol 0 - -
53 Glibenklamid 5mg tablet 0 - -
54 Glimepirid 1mg tablet 0 - -
55 Gliseril Guaiakolat 100mg tablet 0 - -
56 Glukosa larutan infus 10 % botol 0 - -
57 Glukosa larutan infus 40 % botol 0 - -
58 Glukosa larutan infus 5 % botol 0 - -
59 Griseofulvin 125mg tablet 0 - -
60 Hidroklortiazid 25mg tablet 0 - -
61 Hidrokotison krim 2,5% tube 0 - -
62 Hiosin N Butylbromide 10mg tablet 0 - -
63 Ibuprofen 200mg tablet 0 - -
64 Ikhtamol salep 10% pot 0 - -
65 Isosorbid dinitrat (ISDN) 5mg tablet 0 - -
66 Kalsium glukonat injeksi 10% vial 0 - -
67 Kalsium Laktat 500mg tablet 0 - -
68 Kaptopril 12,5 mg tablet 0 - -
69 Kaptopril 25mg tablet 0 - -
70 Karbo Adsorben (Norit) 125mg tablet 0 - -
71 Karbogliserin (Fenol Gliserol) tetes telinga 10% botol 0 - -
72 Ketokonazol 200mg tablet 0 - -
73 Ketokonazol krim 2% tube 0 - -
74 Ketoprofen 100mg/Supp suppos 0 - -
75 Khlofeniramin Maleat (CTM) 4mg tablet 0 - -
76 Klindamisin 150mg kapsul 0 - -
77 Klopidogrel 75mg tablet 0 - -
78 Kloramfenikol tetes mata 0,5% botol 0 - -
79 Kloramfenikol 250mg kapsul 0 - -
80 Kloramfenikol 500mg kapsul 0 - -
81 Kloramfenikol salep kulit 2% tube 0 - -
82 Kloramfenikol salep mata 1% tube 0 - -
83 Kloramfenikol suspensi 125mg/5ml botol 0 - -
84 Kloramfenikol tetes telinga 3% botol 0 - -
85 Kolkisin 500mg tablet 0 - -
86 Komb.ferro sulfat+as.folat (tablet tambah darah) tablet 0 - -
87 Komb.kaolin 550mg+pektin 20mg tablet 0 - -
88 Kombipak Azitromisin + Cefixim amplop 0 - -
89 Kotrimoksazol 240mg/5 mL botol 0 - -
90 Kotrimoksazol 480mg tablet 0 - -
91 Lactulosa 3,335mg/5ml botol 0 - -
92 Lidokain injeksi 2% ampul 0 - -
93 Lincomisin kapsul 500mg kapsul 0 - -
94 Loratadin 10mg tablet 0 - -
95 Metformin 500mg tablet 0 - -
96 Metil Ergometrin injeksi 0,2mg/ml ampul 0 - -
97 Metil Ergometrin 0,125mg tablet 0 - -
98 Metoklorpropamid 10mg tablet 0 - -
99 Metronidazol 250mg tablet 0 - -
100 Metronidazol 500mg tablet 0 - -
101 MgSO4 injeksi 40% vial 0 - -
102 Mikonazol krim 2% tube 0 - -
103 NaCl larutan infus 0,9% botol 4 - 4
104 N-Asetil Sistein 200mg kapsul 0 - -
105 Natrium Bicarbonat 500mg tablet 0 - -
106 Natrium Diklofenak 25mg tablet 0 - -
107 Natrium Diklofenak 50mg tablet 0 - -
108 Neomisin 0,5% & Plasenta sapi 10% tube 0 - -
109 Nifedipin tablet 10mg tablet 0 - -
110 Nistatin 100.000IU/ml botol 0 - -
111 Nistatin vaginal 100.000IU tablet 0 - -
112 Nitrofurantoin 50mg tablet 0 - -
113 Oksitetrasiklin HCl salep mata 1% tube 0 - -
114 Oksitosin Injeksi 10IU/ml ampul 0 - -
115 Omeprazole 20mg kapsul 0 - -
116 Omeprazole serbuk injeksi 40mg vial 0 - -
117 Pantocain 0,5% botol 0 - -
118 Papaverin 40mg tablet 0 - -
119 Papaverin injeksi 40mg/ml ampul 0 - -
120 Paracetamol supp 125mg suppos 0 - -
121 Parasetamol 100mg/ml botol 0 - -
122 Parasetamol 120mg/5ml botol 0 - -
123 Parasetamol 500mg tablet 0 - -
124 Perak sufadiazin krim (Burnazin) 1% tube 0 - -
125 Permetrin krim 5% (Scabimied) tube 0 - -
126 Pirantel Pamoat 125mg tablet 0 - -
127 Pirantel Pamoat 125mg/5ml botol 0 - -
128 Piridoxin (Vit B6) 10mg tablet 0 - -
129 Prednison 5mg tablet 0 - -
130 Ranitidin 150mg tablet 0 - -
131 Retinol (Vit A. Biru) 100.000 IU kapsul 0 - -
132 Retinol (Vit A. Merah) 200.000 IU kapsul 0 - -
133 Ringer Laktat larutan Elektrolit infus botol 0 - -
134 Salbutamol 2mg tablet 0 - -
135 Salbutamol 4mg tablet 0 - -
136 Salbutamol cairan iihalasi (Ventolin Nebules) 2,5mg ampul 0 - -
137 Salep 2-4 (As.Salisilat2%+Sulfur4%) pot 0 - -
138 Salep Whitfield/Antifungi (As.Benzoat6%+As.Salisilat pot 0 - -
139 Sefiksim 200mg kapsul 0 - -
140 Setirizine 5mg/5ml botol 0 - -
141 Sianokobalamin (Vit.B12) 50 µg tablet 0 - -
142 Simvastatin 10mg tablet 0 - -
143 Siprofloxasin 500mg tablet 0 - -
144 Tetrasiklin 250mg kapsul 0 - -
145 Tetrasiklin kapsul 500mg kapsul 0 - -
146 Tiamfenikol 500mg kapsul 0 - -
147 Tiamin (Vitamin B1) 100mg tablet 0 - -
148 Tiamin (Vitamin B1) 50mg tablet 0 - -
149 Vitamin B kompleks tablet 0 - -
150 Zink 20mg/5ml botol 0 - -
151 Zink dispersibel 20mg tablet 0 - -
152 Amitriptilin HCl 25mg tablet 0 - -
153 Anti Migrain DOEN tablet (ergotamin1mg+kafein50mg) tablet 0 - -
154 Diazepam 2mg tablet 0 - -
155 Diazepam 5mg tablet 0 - -
156 Diazepam injeksi 5mg/ml ampul 0 - -
157 Diazepam enema (Stesolid rectal tube) 10mg/2,5ml tube 0 - -
158 Diazepam enema (Stesolid rectal tube) 5mg/2,5ml tube 0 - -
159 Fenobarbital 30mg tablet 0 - -
160 Haloperidol tablet 5mg tablet 0 - -
161 Klorpromazin 100mg tablet 0 - -
162 Risperidon 2mg tablet 0 - -
163 Triheksipenidil 2mg tablet 0 - -
164 Kodein 10mg tablet 0 - -
165 Bahan tumpatan sementara (Cavit/Caviton) set 2 - 2
166 Bonding botol 0 - -
167 Celluloid Strip Gigi Pak 0 - -
168 Composit Light Curing (Tambal Sinar ) A2 tube 1 - 1
169 Composit Light Curing (Tambal Sinar ) A3 tube 0 - -
170 Composit Light Curing (Tambal Sinar ) A3,5 tube 1 - 1
171 Cresophene (cresotin) botol 0 - -
172 Dycal (Dycal/Hydcal) set 0 - -
173 Ecing (Ecing/Ethacant) botol 0 - -
174 Endometason (Endoseal) tube 0 - -
175 Etil Chlorida Spray (Etil Clorida/Endoice) botol 2 - 2
176 Eugenol botol 0 - -
177 Formokresol botol 0 - -
178 Glass Ionomert ART (Fuji IX) set 4 - 4
179 Kalsium Hidroksida Pasta (Metapex/Calcetin/Vitapex) ktk 2 - 2
180 Klorfenol kamfer mentol (CHKM) botol 0 - -
181 Lidocain spray 10% (Xylocaine) botol 0 - -
182 Lidokain 2%+Epinefrin1:80.000 injeksi 2ml (Pehacain) ampul 65 - 65
183 Lidokain krim anestesi topical pot 0 - -
184 Pasta devitalisasi non arsen (Depulpin) botol 0 - -
185 Scandonest botol 0 - -
186 Zinc Pospat Cement set 3 - 3
187 Tuberkulin protein purified derivative (Mantoux test) vial 0 - -
188 Vaksin BCG kering + Pelarut vial 0 - -
189 Vaksin HB0 (Hepatitis rekombinan) Dewasa vial 0 - -
190 Vaksin HB0 (Hepatitis rekombinan) vial 0 - -
191 Vaksin HPV vial 0 - -
192 Vaksin Polio Oral + droppler (OPV) vial 0 - -
193 Vaksin jerap difteri tetanus (DT) <7thn vial 0 - -
194 Vaksin jerap tetanus difteri (Td) >7thn vial 0 - -
195 Vaksin kombinasi DPT-HB-Hib vial 0 - -
196 Vaksin Polio injeksi (IPV) vial 0 - -
197 Vaksin Meningitis vial 0 - -
198 Vaksin MR Kering + Pelarut Vial 0 - -
199 Vaksin HBIg ampul 0 - -
200 Efavirenz (EFV) 600mg tablet 0 - -
201 Lamivudine (3TC) 150mg tablet 0 - -
202 Lopinovir/ritonavir (LPV/r) 200/50mg tablet 0 - -
203 Nevirapine (NVP) 200mg tablet 0 - -
204 Tenofovir (TDF) 300mg tablet 0 - -
205 Zidovudine (ZDV)+ Lamivudine (3TC) 300/150mg tablet 0 - -
206 Triple FDC (TDF+3TC+EFV) 300/300/600mg tablet 0 - -
207 Ped Triple FDC(ZDV+3TC+NVP) 60/30/50mg tablet 0 - -
208 Ziduvudin Sirup botol 0 - -
209 Albendazol 400mg tablet 0 - -
210 MDT Combi (MB-Adult) blister 0 - -
211 MDT Combi (MB-Child) blister 0 - -
212 MDT Combi (PB- Adult) blister 0 - -
213 MDT Combi (PB- Child)) blister 0 - -
214 Isoniasid 100 mg tablet 0 - -
215 Isoniazid 300 mg tablet 0 - -
216 Obat Anti Tuberkulose kategori Anak paket 0 - -
217 Obat Anti Tuberkulose kategori I & III paket 0 - -
218 Obat Anti Tuberkulose kategori II paket 0 - -
219 Obat Anti Tuberkulose kombipak paket 0 - -
220 Piridoksin (Vit B6) 25mg tablet 0 - -
221 OAT TB + HIV Intensif paket 0 - -
222 OAT TB + HIV Lanjutan paket 0 - -
223 Sterptomycin sulfat serbuk injeksi 1000mg vial 0 - -
224 Bedaquilin 100 mg tablet 0 - -
225 Ethambutol 400. mg tablet 0 - -
226 Etionamid 250 mg tablet 0 - -
227 Kanamisin injeksi 1000mg vial 0 - -
228 Kapreomisin 1 g injeksi vial 0 - -
229 Klofazimin 100 mg kapsul 0 - -
230 Kloserin 250 mg tablet 0 - -
231 Levofloksasin 250 mg tablet 0 - -
232 Moksifloksasin 400 mg tablet 0 - -
233 P-aminosalisilat sodium 5.52 g sachet 0 - -
234 Linizolid 600 mg capsul 0 - -
235 Pirazinamid 400 mg tablet 0 - -
236 Pirazinamid 500 mg tablet 0 - -
237 Piridoksin 100 mg tablet 0 - -
238 Pil KB komb.I (Levonogestrol 150mg+Etinil Estradiol 3 blister 0 - -
239 Suntik KB 1 bulan (Medoksi 150mg+Estradiol 5mg) vial 0 - -
240 Suntik KB 3 bulan (Medoksiprogesteron Asetat 150mg vial 0 - -
241 Implan KB 3 tahun (Levonogestrol 25mg) pcs 0 - -
242 Dekstro+GG+CTM+Phenyl Syr Botol 0 - -
243 Oxycan botol 0 - -
244 Parasetamol 100mg tablet tablet 0 - -
245 Bisoprolol 5 mg tablet 0 - -
246 candesartan tablet 0 - -
247 Kotrimoxazole 960mg tablet 0 - -
248 Becomzet tablet 0 - -
249 ZEGAVIT tablet 0 - -
250 DANEURON tablet 0 - -
251 Becefort tablet 0 - -
252 Vitamin Ultra C tablet 0 - -
253 Zidovudin 100 mg tablet 0 - -
254 Delanamid 50 mg tablet 0 - -
255 Furosemide inj tablet 0 - -
256 Albendazole syr 200 mg/ml tablet 0 - -
257 Dolutegravir 50 mg tablet 0 - -
258 Triple FDC (TDF+3TC+DTG) 300/300/50mg tablet 0 - -
259 Spironolactone 100 mg tablet 0 - -
260 Acarbose 50 mg tablet 0 - -
261 Ramipril 5 mg tablet 0 - -
262 Valsartan 160 mg tablet 0 - -
263 Ramipril 10 mg tablet 0 - -
264 Adalat Oros 30 mg tablet 0 - -
265 Glikuidone 30 mg tablet 0 - -
266 Levofloksasin 100 mg tablet 0 - -
267 Xylocain Jelly Tube 0 -
268 Gabapentin tablet 0 -
269 Rifampentin tablet 0 -
270 Vitamin C 500 mg tablet 0 -
271 Sinovac vial 0 -

Mengetahui
PJ Farmasi PKM Cakung

Windi Wikandari, S.Farm., Apt


NIP 19860813211012014
EMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )

LB 2
BULAN : JANUARI
TAHUN : 2021

PENGELUARAN STOK
SISA STOCK PERMINTAAN PEMBERIAN KET.
PEMAKAIAN RETUR ED/RUSAK PENYESUAIAN OPTIMUM
8 9 10 11 12 13 14 15 16

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
4
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
1
0
1
0
0
0
0
2
0
0
4
2 0
0
0
65
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Jakarta, Januari 2021


Yang Membuat Laporan

Tria Annisa, S.Farm., Apt


NIP. 10205819920502199205262
stok opname selisih
17 18

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4 0
4 0
0
0
0
0
4 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2 0
0
0
1 0
0
1 0
0
0
0
0
2 0
0
0
4 0
0 0
0
0
65 0
0
0
0
3 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
LAPORAN PEMAKAIAN DAN LEMBAR PERMINT
( LPLPO )

PUSKESMAS : KECAMATAN CAKUNG


UNIT : TINDAKAN
KECAMATAN : CAKUNG
KABUPATEN / KODYA : JAKARTA TIMUR
PROVINSI : DKI JAKARTA
PENERIMAAN
NO NAMA OBAT SATUAN STOCK AWAL PERSEDIAAN
GUDANG PENYESUAIAN
1 2 3 4 5 6 7

1 Alopurinol 100mg tablet 0 - -


2 Ambroxol 15mg/5 ml botol 0 - -
3 Aminophillin 200mg tablet 0 - -
4 Aminophillin injeksi 24mg/ml ampul 0 - -
5 Amlodipin 10mg tablet 0 - -
6 Amlodipin 5mg tablet 0 - -
7 Amoksisilin (sirup kering) 125mg/5ml botol 0 - -
8 Amoksisilin (sirup kering) 250mg/5ml botol 0 - -
9 Amoksisilin 500mg tablet 0 - -
10 Ampisilin injeksi (serbuk kering) 250mg vial 0 - -
11 Antasida DOEN (MgSO4+AlOH Tersuspensi) botol 0 - -
12 Antasida DOEN (MgSO4+AlOH) tablet 0 - -
13 Anti Hemoroid DOEN suppos 0 - -
14 Anti Tetanus Serum (ATS) 1500IU ampul 0 - -
15 Aquades pro injeksi @25ml respule 1 - 1
16 Asam Askorbat (Vit C) 250mg tablet 0 - -
17 Asam Askorbat (Vit C) 50mg tablet 0 - -
18 Asam Folat 1mg tablet 0 - -
19 Asam Mefenamat 500mg tablet 0 - -
20 Asetosal (Ascardia/Miniaspi) 80mg tablet 0 - -
21 Asiklovir 200mg tablet 0 - -
22 Asiklovir 400mg tablet 0 - -
23 Asiklovir krim 5% tube 0 - -
24 Atropin Sulfas injeksi 0,25mg/ml ampul 0 - -
25 Azitromisin 500 mg tablet 0 - -
26 Bedak salisil serbuk 2% ktk 0 - -
27 Benzatin benzil penicilin serbuk injeksi 2,4juta IU/ml vial 0 - -
28 Betahistin mesilate 6mg tablet 0 - -
29 Betametason krim 0,1% tube 0 - -
30 Bisakodil 5mg tablet 0 - -
31 Budesonide (Cairan inhalasi) 0,25mg/ml respule 0 - -
32 Deksametason 0,5mg tablet 0 - -
33 Deksametason injeksi 5mg/ml ampul 2 - 2
34 Difenhidramin injeksi 10mg/ml ampul 2 - 2
35 Digoksin 0,25mg tablet 0 - -
36 Doksisiklin 100mg kapsul 0 - -
37 Domperidon 10mg tablet 0 - -
38 Domperidon sirup 5mg/5ml botol 0 - -
39 Epinefrin Bitatrat/Adrenalin Injeksi 1mg/ml ampul 2 - 2
40 Eritromisin (sirup kering) 200mg/5ml botol 0 - -
41 Eritromisin 250mg kapsul 0 - -
42 Eritromisin 500mg kapsul 0 - -
43 Fenofibrat 100mg tablet 0 - -
44 Ferro sulfat 15mg/5ml botol 0 - -
45 Fitomenadion (Vit K1) 10mg tablet 0 - -
46 Fitomenadion (Vit.K1) injeksi 2mg/ml ampul 1 - 1
47 Flukonazol 150mg kapsul 0 - -
48 Framisetin sulfat kassa steril 1% lembar 2 - 2
49 Furosemid 40mg tablet 0 - -
50 Garam Oralit serbuk untuk 200ml sach 0 - -
51 Gentamisin Salep 0,1% tube 0 - -
52 Gentian Violet larutan 1% botol 0 - -
53 Glibenklamid 5mg tablet 0 - -
54 Glimepirid 1mg tablet 0 - -
55 Gliseril Guaiakolat 100mg tablet 0 - -
56 Glukosa larutan infus 10 % botol 0 - -
57 Glukosa larutan infus 40 % botol 0 - -
58 Glukosa larutan infus 5 % botol 0 - -
59 Griseofulvin 125mg tablet 0 - -
60 Hidroklortiazid 25mg tablet 0 - -
61 Hidrokotison krim 2,5% tube 0 - -
62 Hiosin N Butylbromide 10mg tablet 0 - -
63 Ibuprofen 200mg tablet 0 - -
64 Ikhtamol salep 10% pot 0 - -
65 Isosorbid dinitrat (ISDN) 5mg tablet 0 - -
66 Kalsium glukonat injeksi 10% vial 0 - -
67 Kalsium Laktat 500mg tablet 0 - -
68 Kaptopril 12,5 mg tablet 0 - -
69 Kaptopril 25mg tablet 0 - -
70 Karbo Adsorben (Norit) 125mg tablet 0 - -
71 Karbogliserin (Fenol Gliserol) tetes telinga 10% botol 0 - -
72 Ketokonazol 200mg tablet 0 - -
73 Ketokonazol krim 2% tube 0 - -
74 Ketoprofen 100mg/Supp suppos 0 - -
75 Khlofeniramin Maleat (CTM) 4mg tablet 0 - -
76 Klindamisin 150mg kapsul 0 - -
77 Klopidogrel 75mg tablet 0 - -
78 Kloramfenikol tetes mata 0,5% botol 0 - -
79 Kloramfenikol 250mg kapsul 0 - -
80 Kloramfenikol 500mg kapsul 0 - -
81 Kloramfenikol salep kulit 2% tube 0 - -
82 Kloramfenikol salep mata 1% tube 0 - -
83 Kloramfenikol suspensi 125mg/5ml botol 0 - -
84 Kloramfenikol tetes telinga 3% botol 0 - -
85 Kolkisin 500mg tablet 0 - -
86 Komb.ferro sulfat+as.folat (tablet tambah darah) tablet 0 - -
87 Komb.kaolin 550mg+pektin 20mg tablet 0 - -
88 Kombipak Azitromisin + Cefixim amplop 0 - -
89 Kotrimoksazol 240mg/5 mL botol 0 - -
90 Kotrimoksazol 480mg tablet 0 - -
91 Lactulosa 3,335mg/5ml botol 0 - -
92 Lidokain injeksi 2% ampul 11 - 11
93 Lincomisin kapsul 500mg kapsul 0 - -
94 Loratadin 10mg tablet 0 - -
95 Metformin 500mg tablet 0 - -
96 Metil Ergometrin injeksi 0,2mg/ml ampul 0 - -
97 Metil Ergometrin 0,125mg tablet 0 - -
98 Metoklorpropamid 10mg tablet 0 - -
99 Metronidazol 250mg tablet 0 - -
100 Metronidazol 500mg tablet 0 - -
101 MgSO4 injeksi 40% vial 0 - -
102 Mikonazol krim 2% tube 0 - -
103 NaCl larutan infus 0,9% botol 2 - 1 3
104 N-Asetil Sistein 200mg kapsul 0 - -
105 Natrium Bicarbonat 500mg tablet 0 - -
106 Natrium Diklofenak 25mg tablet 0 - -
107 Natrium Diklofenak 50mg tablet 0 - -
108 Neomisin 0,5% & Plasenta sapi 10% tube 0 - -
109 Nifedipin tablet 10mg tablet 0 - -
110 Nistatin 100.000IU/ml botol 0 - -
111 Nistatin vaginal 100.000IU tablet 0 - -
112 Nitrofurantoin 50mg tablet 0 - -
113 Oksitetrasiklin HCl salep mata 1% tube 0 - -
114 Oksitosin Injeksi 10IU/ml ampul 0 - -
115 Omeprazole 20mg kapsul 0 - -
116 Omeprazole serbuk injeksi 40mg vial 0 - -
117 Pantocain 0,5% botol 0 - -
118 Papaverin 40mg tablet 0 - -
119 Papaverin injeksi 40mg/ml ampul 0 - -
120 Paracetamol supp 125mg suppos 0 - -
121 Parasetamol 100mg/ml botol 0 - -
122 Parasetamol 120mg/5ml botol 0 - -
123 Parasetamol 500mg tablet 0 - -
124 Perak sufadiazin krim (Burnazin) 1% tube 0 - -
125 Permetrin krim 5% (Scabimied) tube 0 - -
126 Pirantel Pamoat 125mg tablet 0 - -
127 Pirantel Pamoat 125mg/5ml botol 0 - -
128 Piridoxin (Vit B6) 10mg tablet 0 - -
129 Prednison 5mg tablet 0 - -
130 Ranitidin 150mg tablet 0 - -
131 Retinol (Vit A. Biru) 100.000 IU kapsul 0 - -
132 Retinol (Vit A. Merah) 200.000 IU kapsul 0 - -
133 Ringer Laktat larutan Elektrolit infus botol 0 - 2 2
134 Salbutamol 2mg tablet 0 - -
135 Salbutamol 4mg tablet 0 - -
136 Salbutamol cairan iihalasi (Ventolin Nebules) 2,5mg ampul 0 - -
137 Salep 2-4 (As.Salisilat2%+Sulfur4%) pot 0 - -
138 Salep Whitfield/Antifungi (As.Benzoat6%+As.Salisilat pot 0 - -
139 Sefiksim 200mg kapsul 0 - -
140 Setirizine 5mg/5ml botol 0 - -
141 Sianokobalamin (Vit.B12) 50 µg tablet 0 - -
142 Simvastatin 10mg tablet 0 - -
143 Siprofloxasin 500mg tablet 0 - -
144 Tetrasiklin 250mg kapsul 0 - -
145 Tetrasiklin kapsul 500mg kapsul 0 - -
146 Tiamfenikol 500mg kapsul 0 - -
147 Tiamin (Vitamin B1) 100mg tablet 0 - -
148 Tiamin (Vitamin B1) 50mg tablet 0 - -
149 Vitamin B kompleks tablet 0 - -
150 Zink 20mg/5ml botol 0 - -
151 Zink dispersibel 20mg tablet 0 - -
152 Amitriptilin HCl 25mg tablet 0 - -
153 Anti Migrain DOEN tablet (ergotamin1mg+kafein50mg) tablet 0 - -
154 Diazepam 2mg tablet 0 - -
155 Diazepam 5mg tablet 0 - -
156 Diazepam injeksi 5mg/ml ampul 0 - -
157 Diazepam enema (Stesolid rectal tube) 10mg/2,5ml tube 0 - -
158 Diazepam enema (Stesolid rectal tube) 5mg/2,5ml tube 0 - -
159 Fenobarbital 30mg tablet 0 - -
160 Haloperidol tablet 5mg tablet 0 - -
161 Klorpromazin 100mg tablet 0 - -
162 Risperidon 2mg tablet 0 - -
163 Triheksipenidil 2mg tablet 0 - -
164 Kodein 10mg tablet 0 - -
165 Bahan tumpatan sementara (Cavit/Caviton) set 0 - -
166 Bonding botol 0 - -
167 Celluloid Strip Gigi Pak 0 - -
168 Composit Light Curing (Tambal Sinar ) A2 tube 0 - -
169 Composit Light Curing (Tambal Sinar ) A3 tube 0 - -
170 Composit Light Curing (Tambal Sinar ) A3,5 tube 0 - -
171 Cresophene (cresotin) botol 0 - -
172 Dycal (Dycal/Hydcal) set 0 - -
173 Ecing (Ecing/Ethacant) botol 0 - -
174 Endometason (Endoseal) tube 0 - -
175 Etil Chlorida Spray (Etil Clorida/Endoice) botol 0 - -
176 Eugenol botol 0 - -
177 Formokresol botol 0 - -
178 Glass Ionomert ART (Fuji IX) set 0 - -
179 Kalsium Hidroksida Pasta (Metapex/Calcetin/Vitapex) ktk 0 - -
180 Klorfenol kamfer mentol (CHKM) botol 0 - -
181 Lidocain spray 10% (Xylocaine) botol 0 - -
182 Lidokain 2%+Epinefrin1:80.000 injeksi 2ml (Pehacain) ampul 0 - -
183 Lidokain krim anestesi topical pot 0 - -
184 Pasta devitalisasi non arsen (Depulpin) botol 0 - -
185 Scandonest botol 0 - -
186 Zinc Pospat Cement set 0 - -
187 Tuberkulin protein purified derivative (Mantoux test) vial 0 - -
188 Vaksin BCG kering + Pelarut vial 0 - -
189 Vaksin HB0 (Hepatitis rekombinan) Dewasa vial 0 - -
190 Vaksin HB0 (Hepatitis rekombinan) vial 0 - -
191 Vaksin HPV vial 0 - -
192 Vaksin Polio Oral + droppler (OPV) vial 0 - -
193 Vaksin jerap difteri tetanus (DT) <7thn vial 0 - -
194 Vaksin jerap tetanus difteri (Td) >7thn vial 0 - -
195 Vaksin kombinasi DPT-HB-Hib vial 0 - -
196 Vaksin Polio injeksi (IPV) vial 0 - -
197 Vaksin Meningitis vial 0 - -
198 Vaksin MR Kering + Pelarut Vial 0 - -
199 Vaksin HBIg ampul 0 - -
200 Efavirenz (EFV) 600mg tablet 0 - -
201 Lamivudine (3TC) 150mg tablet 0 - -
202 Lopinovir/ritonavir (LPV/r) 200/50mg tablet 0 - -
203 Nevirapine (NVP) 200mg tablet 0 - -
204 Tenofovir (TDF) 300mg tablet 0 - -
205 Zidovudine (ZDV)+ Lamivudine (3TC) 300/150mg tablet 0 - -
206 Triple FDC (TDF+3TC+EFV) 300/300/600mg tablet 0 - -
207 Ped Triple FDC(ZDV+3TC+NVP) 60/30/50mg tablet 0 - -
208 Ziduvudin Sirup botol 0 - -
209 Albendazol 400mg tablet 0 - -
210 MDT Combi (MB-Adult) blister 0 - -
211 MDT Combi (MB-Child) blister 0 - -
212 MDT Combi (PB- Adult) blister 0 - -
213 MDT Combi (PB- Child)) blister 0 - -
214 Isoniasid 100 mg tablet 0 - -
215 Isoniazid 300 mg tablet 0 - -
216 Obat Anti Tuberkulose kategori Anak paket 0 - -
217 Obat Anti Tuberkulose kategori I & III paket 0 - -
218 Obat Anti Tuberkulose kategori II paket 0 - -
219 Obat Anti Tuberkulose kombipak paket 0 - -
220 Piridoksin (Vit B6) 25mg tablet 0 - -
221 OAT TB + HIV Intensif paket 0 - -
222 OAT TB + HIV Lanjutan paket 0 - -
223 Sterptomycin sulfat serbuk injeksi 1000mg vial 0 - -
224 Bedaquilin 100 mg tablet 0 - -
225 Ethambutol 400. mg tablet 0 - -
226 Etionamid 250 mg tablet 0 - -
227 Kanamisin injeksi 1000mg vial 0 - -
228 Kapreomisin 1 g injeksi vial 0 - -
229 Klofazimin 100 mg kapsul 0 - -
230 Kloserin 250 mg tablet 0 - -
231 Levofloksasin 250 mg tablet 0 - -
232 Moksifloksasin 400 mg tablet 0 - -
233 P-aminosalisilat sodium 5.52 g sachet 0 - -
234 Linizolid 600 mg capsul 0 - -
235 Pirazinamid 400 mg tablet 0 - -
236 Pirazinamid 500 mg tablet 0 - -
237 Piridoksin 100 mg tablet 0 - -
238 Pil KB komb.I (Levonogestrol 150mg+Etinil Estradiol 3 blister 0 - -
239 Suntik KB 1 bulan (Medoksi 150mg+Estradiol 5mg) vial 0 - -
240 Suntik KB 3 bulan (Medoksiprogesteron Asetat 150mg vial 0 - -
241 Implan KB 3 tahun (Levonogestrol 25mg) pcs 0 - -
242 Dekstro+GG+CTM+Phenyl Syr Botol 0 - -
243 Oxycan botol 0 - -
244 Parasetamol 100mg tablet tablet 0 - -
245 Bisoprolol 5 mg tablet 0 - -
246 candesartan tablet 0 - -
247 Kotrimoxazole 960mg tablet 0 - -
248 Becomzet tablet 0 - -
249 ZEGAVIT tablet 0 - -
250 DANEURON tablet 0 - -
251 Becefort tablet 0 - -
252 Vitamin Ultra C tablet 0 - -
253 Zidovudin 100 mg tablet 0 - -
254 Delanamid 50 mg tablet 0 - -
255 Furosemide inj tablet 0 - -
256 Albendazole syr 200 mg/ml tablet 0 - -
257 Dolutegravir 50 mg tablet 0 - -
258 Triple FDC (TDF+3TC+DTG) 300/300/50mg tablet 0 - -
259 Spironolactone 100 mg tablet 0 - -
260 Acarbose 50 mg tablet 0 - -
261 Ramipril 5 mg tablet 0 - -
262 Valsartan 160 mg tablet 0 - -
263 Ramipril 10 mg tablet 0 - -
264 Adalat Oros 30 mg tablet 0 - -
265 Glikuidone 30 mg tablet 0 - -
266 Levofloksasin 100 mg tablet 0 - -
267 Xylocain Jelly Tube 0 - -
268 Gabapentin tablet 0 - -
269 Rifampentin tablet 0 - -
270 Vitamin C 500 mg tablet 0 - -
271 Sinovac vial 0 - -

Mengetahui
PJ Farmasi PKM Cakung

Windi Wikandari, S.Farm., Apt


NIP 19860813211012014
EMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )

LB 2
BULAN : JANUARI
TAHUN : 2021

PEMAKAIAN STOK
SISA STOCK PERMINTAAN PEMBERIAN KET.
PEMAKAIAN RETUR ED/RUSAK PENYESUAIAN OPTIMUM
8 9 10 11 12 13 14 15 16

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
1 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
2 0
2 0
0 0
0 0
0 0
0 0
2 0
0 0
0 0
0 0
0 0
0 0
0 0
1 0
0 0
2 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
1 10 2
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
3 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
2 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0
0

Jakarta, Januari 2021


Yang Membuat Laporan

Tria Annisa, S.Farm., Apt


NIP. 10205819920502199205262
stok opname selisih
17 18

0
0
0
0
0
0
0
0
0
0
0
0
0
0
1 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2 0
2 0
0
0
0
0
2 0
0
0
0
0
0
0
1 0
0
2 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10 0
0
0
#VALUE!
0
0
0
0
0
0
0
3 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
LAPORAN PEMAKAIAN DAN LEMB
( LPLPO )

PUSKESMAS : KECAMATAN CAKUNG


UNIT : TB/MDR
KECAMATAN : CAKUNG
KABUPATEN / KODYA : JAKARTA TIMUR
PROVINSI : DKI JAKARTA
PENERIMAAN
NO NAMA OBAT SATUAN STOCK AWAL PERSEDIAAN
GUDANG PENYESUAIAN
1 2 3 4 5 6 7

1 Alopurinol 100mg tablet 30 100 130


2 Ambroxol 15mg/5 ml botol 0 - -
3 Aminophillin 200mg tablet 0 - -
4 Aminophillin injeksi 24mg/ml ampul 0 - -
5 Amlodipin 10mg tablet 0 - -
6 Amlodipin 5mg tablet 0 - -
7 Amoksisilin (sirup kering) 125mg/5ml botol 0 - -
8 Amoksisilin (sirup kering) 250mg/5ml botol 0 - -
9 Amoksisilin 500mg tablet 866 500 1,366
10 Ampisilin injeksi (serbuk kering) 250mg vial 0 - -
11 Antasida DOEN (MgSO4+AlOH Tersuspensi) botol 0 - -
12 Antasida DOEN (MgSO4+AlOH) tablet 160 - 160
13 Anti Hemoroid DOEN suppos 0 - -
14 Anti Tetanus Serum (ATS) 1500IU ampul 0 - -
15 Aquades pro injeksi @25ml respule 0 - -
16 Asam Askorbat (Vit C) 250mg tablet 60 - 60
17 Asam Askorbat (Vit C) 50mg tablet 120 - 120
18 Asam Folat 1mg tablet 0 - -
19 Asam Mefenamat 500mg tablet 47 - 47
20 Asetosal (Ascardia/Miniaspi) 80mg tablet 0 - -
21 Asiklovir 200mg tablet 0 - -
22 Asiklovir 400mg tablet 0 - -
23 Asiklovir krim 5% tube 0 - -
24 Atropin Sulfas injeksi 0,25mg/ml ampul 0 - -
25 Azitromisin 500 mg tablet 0 - -
26 Bedak salisil serbuk 2% ktk 0 - -
27 Benzatin benzil penicilin serbuk injeksi 2,4juta IU/ml vial 0 - -
28 Betahistin mesilate 6mg tablet 0 - -
29 Betametason krim 0,1% tube 0 - -
30 Bisakodil 5mg tablet 0 - -
31 Budesonide (Cairan inhalasi) 0,25mg/ml respule 0 - -
32 Deksametason 0,5mg tablet 100 - 100
33 Deksametason injeksi 5mg/ml ampul 2 - 2
34 Difenhidramin injeksi 10mg/ml ampul 0 - -
35 Digoksin 0,25mg tablet 0 - -
36 Doksisiklin 100mg kapsul 0 - -
37 Domperidon 10mg tablet 0 - -
38 Domperidon sirup 5mg/5ml botol 0 - -
39 Epinefrin Bitatrat/Adrenalin Injeksi 1mg/ml ampul 2 - 2
40 Eritromisin (sirup kering) 200mg/5ml botol 0 - -
41 Eritromisin 250mg kapsul 0 - -
42 Eritromisin 500mg kapsul 0 - -
43 Fenofibrat 100mg tablet 0 - -
44 Ferro sulfat 15mg/5ml botol 0 - -
45 Fitomenadion (Vit K1) 10mg tablet 10 50 60
46 Fitomenadion (Vit.K1) injeksi 2mg/ml ampul 0 - -
47 Flukonazol 150mg kapsul 0 - -
48 Framisetin sulfat kassa steril 1% lembar 0 - -
49 Furosemid 40mg tablet 0 - -
50 Garam Oralit serbuk untuk 200ml sach 0 - -
51 Gentamisin Salep 0,1% tube 0 - -
52 Gentian Violet larutan 1% botol 0 - -
53 Glibenklamid 5mg tablet 100 - 100
54 Glimepirid 1mg tablet 100 - 100
55 Gliseril Guaiakolat 100mg tablet 208 - 208
56 Glukosa larutan infus 10 % botol 0 - -
57 Glukosa larutan infus 40 % botol 0 - -
58 Glukosa larutan infus 5 % botol 0 - -
59 Griseofulvin 125mg tablet 0 - -
60 Hidroklortiazid 25mg tablet 0 - -
61 Hidrokotison krim 2,5% tube 0 - -
62 Hiosin N Butylbromide 10mg tablet 0 - -
63 Ibuprofen 200mg tablet 0 - -
64 Ikhtamol salep 10% pot 0 - -
65 Isosorbid dinitrat (ISDN) 5mg tablet 0 - -
66 Kalsium glukonat injeksi 10% vial 0 - -
67 Kalsium Laktat 500mg tablet 0 - -
68 Kaptopril 12,5 mg tablet 0 - -
69 Kaptopril 25mg tablet 0 - -
70 Karbo Adsorben (Norit) 125mg tablet 0 - -
71 Karbogliserin (Fenol Gliserol) tetes telinga 10% botol 0 - -
72 Ketokonazol 200mg tablet 0 - -
73 Ketokonazol krim 2% tube 0 - -
74 Ketoprofen 100mg/Supp suppos 0 - -
75 Khlofeniramin Maleat (CTM) 4mg tablet 180 - 180
76 Klindamisin 150mg kapsul 0 - -
77 Klopidogrel 75mg tablet 0 - -
78 Kloramfenikol tetes mata 0,5% botol 0 - -
79 Kloramfenikol 250mg kapsul 0 - -
80 Kloramfenikol 500mg kapsul 0 - -
81 Kloramfenikol salep kulit 2% tube 0 - -
82 Kloramfenikol salep mata 1% tube 0 - -
83 Kloramfenikol suspensi 125mg/5ml botol 0 - -
84 Kloramfenikol tetes telinga 3% botol 0 - -
85 Kolkisin 500mg tablet 0 - -
86 Komb.ferro sulfat+as.folat (tablet tambah darah) tablet 0 - -
87 Komb.kaolin 550mg+pektin 20mg tablet 48 - 48
88 Kombipak Azitromisin + Cefixim amplop 0 - -
89 Kotrimoksazol 240mg/5 mL botol 0 - -
90 Kotrimoksazol 480mg tablet 70 - 70
91 Lactulosa 3,335mg/5ml botol 0 - -
92 Lidokain injeksi 2% ampul 0 - -
93 Lincomisin kapsul 500mg kapsul 0 - -
94 Loratadin 10mg tablet 0 - -
95 Metformin 500mg tablet 105 500 605
96 Metil Ergometrin injeksi 0,2mg/ml ampul 0 - -
97 Metil Ergometrin 0,125mg tablet 0 - -
98 Metoklorpropamid 10mg tablet 0 - -
99 Metronidazol 250mg tablet 0 - -
100 Metronidazol 500mg tablet 0 - -
101 MgSO4 injeksi 40% vial 0 - -
102 Mikonazol krim 2% tube 0 - -
103 NaCl larutan infus 0,9% botol 2 - 2
104 N-Asetil Sistein 200mg kapsul 0 - -
105 Natrium Bicarbonat 500mg tablet 0 - -
106 Natrium Diklofenak 25mg tablet 0 - -
107 Natrium Diklofenak 50mg tablet 0 - -
108 Neomisin 0,5% & Plasenta sapi 10% tube 0 - -
109 Nifedipin tablet 10mg tablet 0 - -
110 Nistatin 100.000IU/ml botol 0 - -
111 Nistatin vaginal 100.000IU tablet 0 - -
112 Nitrofurantoin 50mg tablet 0 - -
113 Oksitetrasiklin HCl salep mata 1% tube 0 - -
114 Oksitosin Injeksi 10IU/ml ampul 0 - -
115 Omeprazole 20mg kapsul 20 30 50
116 Omeprazole serbuk injeksi 40mg vial 0 - -
117 Pantocain 0,5% botol 0 - -
118 Papaverin 40mg tablet 0 - -
119 Papaverin injeksi 40mg/ml ampul 0 - -
120 Paracetamol supp 125mg suppos 0 - -
121 Parasetamol 100mg/ml botol 0 - -
122 Parasetamol 120mg/5ml botol 0 - -
123 Parasetamol 500mg tablet 146 - 146
124 Perak sufadiazin krim (Burnazin) 1% tube 0 - -
125 Permetrin krim 5% (Scabimied) tube 0 - -
126 Pirantel Pamoat 125mg tablet 0 - -
127 Pirantel Pamoat 125mg/5ml botol 0 - -
128 Piridoxin (Vit B6) 10mg tablet 0 - -
129 Prednison 5mg tablet 0 - -
130 Ranitidin 150mg tablet 68 - 68
131 Retinol (Vit A. Biru) 100.000 IU kapsul 0 - -
132 Retinol (Vit A. Merah) 200.000 IU kapsul 0 - -
133 Ringer Laktat larutan Elektrolit infus botol 0 - -
134 Salbutamol 2mg tablet 50 - 50
135 Salbutamol 4mg tablet 0 - -
136 Salbutamol cairan iihalasi (Ventolin Nebules) 2,5mg ampul 0 - -
137 Salep 2-4 (As.Salisilat2%+Sulfur4%) pot 0 - -
138 Salep Whitfield/Antifungi (As.Benzoat6%+As.Salisilat pot 0 - -
139 Sefiksim 200mg kapsul 0 - -
140 Setirizine 5mg/5ml botol 0 - -
141 Sianokobalamin (Vit.B12) 50 µg tablet 0 - -
142 Simvastatin 10mg tablet 0 - -
143 Siprofloxasin 500mg tablet 0 - -
144 Tetrasiklin 250mg kapsul 0 - -
145 Tetrasiklin kapsul 500mg kapsul 0 - -
146 Tiamfenikol 500mg kapsul 0 - -
147 Tiamin (Vitamin B1) 100mg tablet 0 - -
148 Tiamin (Vitamin B1) 50mg tablet 0 - -
149 Vitamin B kompleks tablet 422 - 422
150 Zink 20mg/5ml botol 0 - -
151 Zink dispersibel 20mg tablet 0 - -
152 Amitriptilin HCl 25mg tablet 0 - -
153 Anti Migrain DOEN tablet (ergotamin1mg+kafein50mg) tablet 0 - -
154 Diazepam 2mg tablet 0 - -
155 Diazepam 5mg tablet 0 - -
156 Diazepam injeksi 5mg/ml ampul 0 - -
157 Diazepam enema (Stesolid rectal tube) 10mg/2,5ml tube 0 - -
158 Diazepam enema (Stesolid rectal tube) 5mg/2,5ml tube 0 - -
159 Fenobarbital 30mg tablet 0 - -
160 Haloperidol tablet 5mg tablet 0 - -
161 Klorpromazin 100mg tablet 0 - -
162 Risperidon 2mg tablet 0 - -
163 Triheksipenidil 2mg tablet 0 - -
164 Kodein 10mg tablet 0 - -
165 Bahan tumpatan sementara (Cavit/Caviton) set 0 - -
166 Bonding botol 0 - -
167 Celluloid Strip Gigi Pak 0 - -
168 Composit Light Curing (Tambal Sinar ) A2 tube 0 - -
169 Composit Light Curing (Tambal Sinar ) A3 tube 0 - -
170 Composit Light Curing (Tambal Sinar ) A3,5 tube 0 - -
171 Cresophene (cresotin) botol 0 - -
172 Dycal (Dycal/Hydcal) set 0 - -
173 Ecing (Ecing/Ethacant) botol 0 - -
174 Endometason (Endoseal) tube 0 - -
175 Etil Chlorida Spray (Etil Clorida/Endoice) botol 0 - -
176 Eugenol botol 0 - -
177 Formokresol botol 0 - -
178 Glass Ionomert ART (Fuji IX) set 0 - -
179 Kalsium Hidroksida Pasta (Metapex/Calcetin/Vitapex) ktk 0 - -
180 Klorfenol kamfer mentol (CHKM) botol 0 - -
181 Lidocain spray 10% (Xylocaine) botol 0 - -
182 Lidokain 2%+Epinefrin1:80.000 injeksi 2ml (Pehacain) ampul 0 - -
183 Lidokain krim anestesi topical pot 0 - -
184 Pasta devitalisasi non arsen (Depulpin) botol 0 - -
185 Scandonest botol 0 - -
186 Zinc Pospat Cement set 0 - -
187 Tuberkulin protein purified derivative (Mantoux test) vial 0 - -
188 Vaksin BCG kering + Pelarut vial 0 - -
189 Vaksin HB0 (Hepatitis rekombinan) Dewasa vial 0 - -
190 Vaksin HB0 (Hepatitis rekombinan) vial 0 - -
191 Vaksin HPV vial 0 - -
192 Vaksin Polio Oral + droppler (OPV) vial 0 - -
193 Vaksin jerap difteri tetanus (DT) <7thn vial 0 - -
194 Vaksin jerap tetanus difteri (Td) >7thn vial 0 - -
195 Vaksin kombinasi DPT-HB-Hib vial 0 - -
196 Vaksin Polio injeksi (IPV) vial 0 - -
197 Vaksin Meningitis vial 0 - -
198 Vaksin MR Kering + Pelarut Vial 0 - -
199 Vaksin HBIg ampul 0 - -
200 Efavirenz (EFV) 600mg tablet 0 - -
201 Lamivudine (3TC) 150mg tablet 0 - -
202 Lopinovir/ritonavir (LPV/r) 200/50mg tablet 0 - -
203 Nevirapine (NVP) 200mg tablet 0 - -
204 Tenofovir (TDF) 300mg tablet 0 - -
205 Zidovudine (ZDV)+ Lamivudine (3TC) 300/150mg tablet 0 - -
206 Triple FDC (TDF+3TC+EFV) 300/300/600mg tablet 0 - -
207 Ped Triple FDC(ZDV+3TC+NVP) 60/30/50mg tablet 0 - -
208 Ziduvudin Sirup botol 0 - -
209 Albendazol 400mg tablet 0 - -
210 MDT Combi (MB-Adult) blister 0 - -
211 MDT Combi (MB-Child) blister 0 - -
212 MDT Combi (PB- Adult) blister 0 - -
213 MDT Combi (PB- Child)) blister 0 - -
214 Isoniasid 100 mg tablet 0 - -
215 Isoniazid 300 mg tablet 771 - 771
216 Obat Anti Tuberkulose kategori Anak paket 0 2 2
217 Obat Anti Tuberkulose kategori I & III paket 0 9 9
218 Obat Anti Tuberkulose kategori II paket 0 1 1
219 Obat Anti Tuberkulose kombipak paket 0 - -
220 Piridoksin (Vit B6) 25mg tablet 500 - 500
221 OAT TB + HIV Intensif paket 0 - -
222 OAT TB + HIV Lanjutan paket 0 - -
223 Sterptomycin sulfat serbuk injeksi 1000mg vial 0 - -
224 Bedaquilin 100 mg tablet 202 - 202
225 Ethambutol 400. mg tablet 2274 - 2,274
226 Etionamid 250 mg tablet 1270 2,000 3,270
227 Kanamisin injeksi 1000mg vial 540 - 540
228 Kapreomisin 1 g injeksi vial 242 - 242
229 Klofazimin 100 mg kapsul 176 300 476
230 Kloserin 250 mg tablet 789 100 889
231 Levofloksasin 250 mg tablet 507 1,800 2,307
232 Moksifloksasin 400 mg tablet 818 - 818
233 P-aminosalisilat sodium 5.52 g sachet 72 - 72
234 Linizolid 600 mg capsul 79 100 179
235 Pirazinamid 400 mg tablet 0 - -
236 Pirazinamid 500 mg tablet 541 672 1,213
237 Piridoksin 100 mg tablet 1697 - 1,697
238 Pil KB komb.I (Levonogestrol 150mg+Etinil Estradiol 3 blister 0 - -
239 Suntik KB 1 bulan (Medoksi 150mg+Estradiol 5mg) vial 0 - -
240 Suntik KB 3 bulan (Medoksiprogesteron Asetat 150mg vial 0 - -
241 Implan KB 3 tahun (Levonogestrol 25mg) pcs 0 - -
242 Dekstro+GG+CTM+Phenyl Syr Botol 0 - -
243 Oxycan botol 0 - -
244 Parasetamol 100mg tablet tablet 0 - -
245 Bisoprolol 5 mg tablet 0 - -
246 candesartan tablet 0 - -
247 Kotrimoxazole 960mg tablet 0 - -
248 Becomzet tablet 0 - -
249 ZEGAVIT tablet 0 - -
250 DANEURON tablet 0 - -
251 Becefort tablet 0 - -
252 Vitamin Ultra C tablet 0 - -
253 Zidovudin 100 mg tablet 0 - -
254 Delanamid 50 mg tablet 593 - 593
255 Furosemide inj tablet 0 - -
256 Albendazole syr 200 mg/ml tablet 0 - -
257 Dolutegravir 50 mg tablet 0 - -
258 Triple FDC (TDF+3TC+DTG) 300/300/50mg tablet 0 - -
259 Spironolactone 100 mg tablet 0 - -
260 Acarbose 50 mg tablet 0 - -
261 Ramipril 5 mg tablet 0 - -
262 Valsartan 160 mg tablet 0 - -
263 Ramipril 10 mg tablet 0 - -
264 Adalat Oros 30 mg tablet 0 - -
265 Glikuidone 30 mg tablet 0 - -
266 Levofloksasin 100 mg tablet 140 - 140
267 Xylocain Jelly Tube 0 - -
268 Gabapentin tablet 0 - -
269 Rifampentin tablet 480 - 480
270 Vitamin C 500 mg tablet 0 - -
271 Sinovac vial 0 - -

Windi Wikandari, S.Farm., Apt


NIP 19860813211012014
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )

LB 2
BULAN : JANUARI
TAHUN : 2021

PENGELUARAN STOK
SISA STOCK PERMINTAAN PEMBERIAN KET.
PEMAKAIAN RETUR ED/RUSAK PENYESUAIAN OPTIMUM
8 9 10 11 12 13 14 15 16

10 120 -90
0 0
0 0
0 0
0 0
0 0
0 0
0 0
193 1173 -594
0 0
0 0
10 150 -120
0 0
0 0
0 0
20 40 20
120 -120
0 0
20 27 33
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
20 80 -20
2 -2
0 0
0 0
0 0
0 0
0 0
2 -2
0 0
0 0
0 0
0 0
0 0
4 56 -44
0 0
0 0
0 0
0 0
0 0
0 0
0 0
30 70 20
100 -100
100 108 192
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
20 160 -100
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
48 -48
0 0
0 0
70 -70
0 0
0 0
0 0
0 0
265 340 455
0 0
0 0
0 0
0 0
0 0
0 0
0 0
2 -2
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
50 -50
0 0
0 0
0 0
0 0
0 0
0 0
0 0
38 108 6
0 0
0 0
0 0
0 0
0 0
0 0
10 58 -28
0 0
0 0
0 0
10 40 -10
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
132 290 106
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
771 -771
2 0 6
9 0 27
1 0 3
0 0
500 -500
0 0
0 0
0 0
26 176 -98
139 2135
338 2932
31 509
242
155 321
338 551
369 1938
62 756
72
31 148
0
277 936
154 1543 -1081
0 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
593
0
0
0
0
0
0
0
0
0
0
0
140
0
0
480
0
0

Jakarta, Januari 2021


Yang Membuat Laporan

Tria Annisa, S.Farm., Apt


NIP. 10205819920502199205262
stok opname selisih
17 18

120 0
0
0
0
0
0
0
0
1173 0
0
0
150 0
0
0
0
40 0
120 0
0
27 0
0
0
0
0
0
0
0
0
0
0
0
0
80 0
2 0
0
0
0
0
0
2 0
0
0
0
0
0
56 0
0
0
0
0
0
0
0
70 0
100 0
108 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
160 0
0
0
0
0
0
0
0
0
0
0
0
48 0
0
0
70 0
0
0
0
0
340 0
0
0
0
0
0
0
0
2 0
0
0
0
0
0
0
0
0
0
0
0
50 0
0
0
0
0
0
0
0
108 0
0
0
0
0
0
0
58 0
0
0
0
40 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
290 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
771 0
0 0
0 0
0
0
500 0
0
0
0
176 0
2135 0
2932 0
509 0
242 0
321 0
551 0
1938 0
756 0
72 0
148 0
0
936 0
1543 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
593 0
0
0
0
0
0
0
0
0
0
0
0
140 0
0
0
480 0
0
0
LAPORAN PEMAKAIAN DAN LEMBAR PERMINT
( LPLPO )

PUSKESMAS : KECAMATAN CAKUNG


UNIT : GADAR
KECAMATAN : CAKUNG
KABUPATEN / KODYA : JAKARTA TIMUR
PROVINSI : DKI JAKARTA
PENERIMAAN
NO NAMA OBAT SATUAN STOCK AWAL PERSEDIAAN
GUDANG PENYESUAIAN
1 2 3 4 5 6 7

1 Alopurinol 100mg tablet 100 - 100


2 Ambroxol 15mg/5 ml botol 50 - 50
3 Aminophillin 200mg tablet 0 - -
4 Aminophillin injeksi 24mg/ml ampul 0 - -
5 Amlodipin 10mg tablet 1534 - 1,534
6 Amlodipin 5mg tablet 150 - 150
7 Amoksisilin (sirup kering) 125mg/5ml botol 0 - -
8 Amoksisilin (sirup kering) 250mg/5ml botol 0 - -
9 Amoksisilin 500mg tablet 2063 - 2,063
10 Ampisilin injeksi (serbuk kering) 250mg vial 0 - -
11 Antasida DOEN (MgSO4+AlOH Tersuspensi) botol 0 - -
12 Antasida DOEN (MgSO4+AlOH) tablet 1566 - 1,566
13 Anti Hemoroid DOEN suppos 0 - -
14 Anti Tetanus Serum (ATS) 1500IU ampul 0 - -
15 Aquades pro injeksi @25ml respule 0 - -
16 Asam Askorbat (Vit C) 250mg tablet 0 - -
17 Asam Askorbat (Vit C) 50mg tablet 2562 - 2,562
18 Asam Folat 1mg tablet 0 - -
19 Asam Mefenamat 500mg tablet 2300 - 2,300
20 Asetosal (Ascardia/Miniaspi) 80mg tablet 0 - -
21 Asiklovir 200mg tablet 0 - -
22 Asiklovir 400mg tablet 500 - 500
23 Asiklovir krim 5% tube 5 - 5
24 Atropin Sulfas injeksi 0,25mg/ml ampul 0 - -
25 Azitromisin 500 mg tablet 0 - -
26 Bedak salisil serbuk 2% ktk 41 - 41
27 Benzatin benzil penicilin serbuk injeksi 2,4juta IU/ml vial 0 - -
28 Betahistin mesilate 6mg tablet 0 - -
29 Betametason krim 0,1% tube 84 - 84
30 Bisakodil 5mg tablet 0 - -
31 Budesonide (Cairan inhalasi) 0,25mg/ml respule 0 - -
32 Deksametason 0,5mg tablet 2600 - 2,600
33 Deksametason injeksi 5mg/ml ampul 1 - 1 2
34 Difenhidramin injeksi 10mg/ml ampul 2 - 2
35 Digoksin 0,25mg tablet 0 - -
36 Doksisiklin 100mg kapsul 0 - -
37 Domperidon 10mg tablet 1183 - 1,183
38 Domperidon sirup 5mg/5ml botol 0 - -
39 Epinefrin Bitatrat/Adrenalin Injeksi 1mg/ml ampul 6 - 6
40 Eritromisin (sirup kering) 200mg/5ml botol 0 - -
41 Eritromisin 250mg kapsul 0 - -
42 Eritromisin 500mg kapsul 0 - -
43 Fenofibrat 100mg tablet 0 - -
44 Ferro sulfat 15mg/5ml botol 0 - -
45 Fitomenadion (Vit K1) 10mg tablet 0 - -
46 Fitomenadion (Vit.K1) injeksi 2mg/ml ampul 0 - -
47 Flukonazol 150mg kapsul 0 - -
48 Framisetin sulfat kassa steril 1% lembar 0 - -
49 Furosemid 40mg tablet 0 - -
50 Garam Oralit serbuk untuk 200ml sach 624 - 624
51 Gentamisin Salep 0,1% tube 0 - -
52 Gentian Violet larutan 1% botol 0 - -
53 Glibenklamid 5mg tablet 192 - 192
54 Glimepirid 1mg tablet 0 - -
55 Gliseril Guaiakolat 100mg tablet 2335 - 2,335
56 Glukosa larutan infus 10 % botol 0 - -
57 Glukosa larutan infus 40 % botol 0 - -
58 Glukosa larutan infus 5 % botol 0 - -
59 Griseofulvin 125mg tablet 1000 - 1,000
60 Hidroklortiazid 25mg tablet 0 - -
61 Hidrokotison krim 2,5% tube 0 - -
62 Hiosin N Butylbromide 10mg tablet 0 - -
63 Ibuprofen 200mg tablet 0 - -
64 Ikhtamol salep 10% pot 0 - -
65 Isosorbid dinitrat (ISDN) 5mg tablet 60 - 60
66 Kalsium glukonat injeksi 10% vial 0 - -
67 Kalsium Laktat 500mg tablet 780 - 780
68 Kaptopril 12,5 mg tablet 494 - 494
69 Kaptopril 25mg tablet 230 - 230
70 Karbo Adsorben (Norit) 125mg tablet 0 - -
71 Karbogliserin (Fenol Gliserol) tetes telinga 10% botol 0 - -
72 Ketokonazol 200mg tablet 0 - -
73 Ketokonazol krim 2% tube 4 - 4
74 Ketoprofen 100mg/Supp suppos 0 - -
75 Khlofeniramin Maleat (CTM) 4mg tablet 2676 - 2,676
76 Klindamisin 150mg kapsul 0 - -
77 Klopidogrel 75mg tablet 0 - -
78 Kloramfenikol tetes mata 0,5% botol 0 - -
79 Kloramfenikol 250mg kapsul 0 - -
80 Kloramfenikol 500mg kapsul 0 - -
81 Kloramfenikol salep kulit 2% tube 151 - 151
82 Kloramfenikol salep mata 1% tube 32 - 32
83 Kloramfenikol suspensi 125mg/5ml botol 0 - -
84 Kloramfenikol tetes telinga 3% botol 4 - 4
85 Kolkisin 500mg tablet 0 - -
86 Komb.ferro sulfat+as.folat (tablet tambah darah) tablet 820 - 820
87 Komb.kaolin 550mg+pektin 20mg tablet 1518 - 1,518
88 Kombipak Azitromisin + Cefixim amplop 0 - -
89 Kotrimoksazol 240mg/5 mL botol 0 - -
90 Kotrimoksazol 480mg tablet 100 - 100
91 Lactulosa 3,335mg/5ml botol 0 - -
92 Lidokain injeksi 2% ampul 19 - 19
93 Lincomisin kapsul 500mg kapsul 0 - -
94 Loratadin 10mg tablet 0 - -
95 Metformin 500mg tablet 700 - 700
96 Metil Ergometrin injeksi 0,2mg/ml ampul 0 - -
97 Metil Ergometrin 0,125mg tablet 0 - -
98 Metoklorpropamid 10mg tablet 0 - -
99 Metronidazol 250mg tablet 0 - -
100 Metronidazol 500mg tablet 0 - -
101 MgSO4 injeksi 40% vial 0 - -
102 Mikonazol krim 2% tube 95 - 95
103 NaCl larutan infus 0,9% botol 4 - 4
104 N-Asetil Sistein 200mg kapsul 560 - 560
105 Natrium Bicarbonat 500mg tablet 0 - -
106 Natrium Diklofenak 25mg tablet 370 - 370
107 Natrium Diklofenak 50mg tablet 0 - -
108 Neomisin 0,5% & Plasenta sapi 10% tube 0 - -
109 Nifedipin tablet 10mg tablet 0 - -
110 Nistatin 100.000IU/ml botol 0 - -
111 Nistatin vaginal 100.000IU tablet 0 - -
112 Nitrofurantoin 50mg tablet 0 - -
113 Oksitetrasiklin HCl salep mata 1% tube 0 - -
114 Oksitosin Injeksi 10IU/ml ampul 0 - -
115 Omeprazole 20mg kapsul 0 - -
116 Omeprazole serbuk injeksi 40mg vial 0 - -
117 Pantocain 0,5% botol 0 - -
118 Papaverin 40mg tablet 500 - 500
119 Papaverin injeksi 40mg/ml ampul 0 - -
120 Paracetamol supp 125mg suppos 0 - -
121 Parasetamol 100mg/ml botol 0 - -
122 Parasetamol 120mg/5ml botol 110 - 110
123 Parasetamol 500mg tablet 3172 - 3,172
124 Perak sufadiazin krim (Burnazin) 1% tube 12 - 12
125 Permetrin krim 5% (Scabimied) tube 1 - 1
126 Pirantel Pamoat 125mg tablet 0 - -
127 Pirantel Pamoat 125mg/5ml botol 0 - -
128 Piridoxin (Vit B6) 10mg tablet 539 - 539
129 Prednison 5mg tablet 0 - -
130 Ranitidin 150mg tablet 279 - 279
131 Retinol (Vit A. Biru) 100.000 IU kapsul 0 - -
132 Retinol (Vit A. Merah) 200.000 IU kapsul 0 - -
133 Ringer Laktat larutan Elektrolit infus botol 6 - 6
134 Salbutamol 2mg tablet 0 - -
135 Salbutamol 4mg tablet 72 - 72
136 Salbutamol cairan iihalasi (Ventolin Nebules) 2,5mg ampul 0 - -
137 Salep 2-4 (As.Salisilat2%+Sulfur4%) pot 147 - 147
138 Salep Whitfield/Antifungi (As.Benzoat6%+As.Salisilat pot 5 - 5
139 Sefiksim 200mg kapsul 0 - -
140 Setirizine 5mg/5ml botol 0 - -
141 Sianokobalamin (Vit.B12) 50 µg tablet 0 - -
142 Simvastatin 10mg tablet 101 - 101
143 Siprofloxasin 500mg tablet 0 - -
144 Tetrasiklin 250mg kapsul 0 - -
145 Tetrasiklin kapsul 500mg kapsul 0 - -
146 Tiamfenikol 500mg kapsul 0 - -
147 Tiamin (Vitamin B1) 100mg tablet 0 - -
148 Tiamin (Vitamin B1) 50mg tablet 500 - 500
149 Vitamin B kompleks tablet 2003 - 2,003
150 Zink 20mg/5ml botol 0 - -
151 Zink dispersibel 20mg tablet 1150 - 1,150
152 Amitriptilin HCl 25mg tablet 0 - -
153 Anti Migrain DOEN tablet (ergotamin1mg+kafein50mg) tablet 0 - -
154 Diazepam 2mg tablet 0 - -
155 Diazepam 5mg tablet 0 - -
156 Diazepam injeksi 5mg/ml ampul 0 - -
157 Diazepam enema (Stesolid rectal tube) 10mg/2,5ml tube 0 - -
158 Diazepam enema (Stesolid rectal tube) 5mg/2,5ml tube 0 - -
159 Fenobarbital 30mg tablet 0 - -
160 Haloperidol tablet 5mg tablet 0 - -
161 Klorpromazin 100mg tablet 0 - -
162 Risperidon 2mg tablet 0 - -
163 Triheksipenidil 2mg tablet 0 - -
164 Kodein 10mg tablet 0 - -
165 Bahan tumpatan sementara (Cavit/Caviton) set 0 - -
166 Bonding botol 0 - -
167 Celluloid Strip Gigi Pak 0 - -
168 Composit Light Curing (Tambal Sinar ) A2 tube 0 - -
169 Composit Light Curing (Tambal Sinar ) A3 tube 0 - -
170 Composit Light Curing (Tambal Sinar ) A3,5 tube 0 - -
171 Cresophene (cresotin) botol 0 - -
172 Dycal (Dycal/Hydcal) set 0 - -
173 Ecing (Ecing/Ethacant) botol 0 - -
174 Endometason (Endoseal) tube 0 - -
175 Etil Chlorida Spray (Etil Clorida/Endoice) botol 2 - 2
176 Eugenol botol 0 - -
177 Formokresol botol 0 - -
178 Glass Ionomert ART (Fuji IX) set 0 - -
179 Kalsium Hidroksida Pasta (Metapex/Calcetin/Vitapex) ktk 0 - -
180 Klorfenol kamfer mentol (CHKM) botol 0 - -
181 Lidocain spray 10% (Xylocaine) botol 0 - -
182 Lidokain 2%+Epinefrin1:80.000 injeksi 2ml (Pehacain) ampul 0 - -
183 Lidokain krim anestesi topical pot 0 - -
184 Pasta devitalisasi non arsen (Depulpin) botol 0 - -
185 Scandonest botol 0 - -
186 Zinc Pospat Cement set 0 - -
187 Tuberkulin protein purified derivative (Mantoux test) vial 0 - -
188 Vaksin BCG kering + Pelarut vial 0 - -
189 Vaksin HB0 (Hepatitis rekombinan) Dewasa vial 0 - -
190 Vaksin HB0 (Hepatitis rekombinan) vial 0 - -
191 Vaksin HPV vial 0 - -
192 Vaksin Polio Oral + droppler (OPV) vial 0 - -
193 Vaksin jerap difteri tetanus (DT) <7thn vial 0 - -
194 Vaksin jerap tetanus difteri (Td) >7thn vial 0 - -
195 Vaksin kombinasi DPT-HB-Hib vial 0 - -
196 Vaksin Polio injeksi (IPV) vial 0 - -
197 Vaksin Meningitis vial 0 - -
198 Vaksin MR Kering + Pelarut Vial 0 - -
199 Vaksin HBIg ampul 0 - -
200 Efavirenz (EFV) 600mg tablet 0 - -
201 Lamivudine (3TC) 150mg tablet 0 - -
202 Lopinovir/ritonavir (LPV/r) 200/50mg tablet 0 - -
203 Nevirapine (NVP) 200mg tablet 0 - -
204 Tenofovir (TDF) 300mg tablet 0 - -
205 Zidovudine (ZDV)+ Lamivudine (3TC) 300/150mg tablet 0 - -
206 Triple FDC (TDF+3TC+EFV) 300/300/600mg tablet 0 - -
207 Ped Triple FDC(ZDV+3TC+NVP) 60/30/50mg tablet 0 - -
208 Ziduvudin Sirup botol 0 - -
209 Albendazol 400mg tablet 0 - -
210 MDT Combi (MB-Adult) blister 0 - -
211 MDT Combi (MB-Child) blister 0 - -
212 MDT Combi (PB- Adult) blister 0 - -
213 MDT Combi (PB- Child)) blister 0 - -
214 Isoniasid 100 mg tablet 0 - -
215 Isoniazid 300 mg tablet 0 - -
216 Obat Anti Tuberkulose kategori Anak paket 0 - -
217 Obat Anti Tuberkulose kategori I & III paket 0 - -
218 Obat Anti Tuberkulose kategori II paket 0 - -
219 Obat Anti Tuberkulose kombipak paket 0 - -
220 Piridoksin (Vit B6) 25mg tablet 0 - -
221 OAT TB + HIV Intensif paket 0 - -
222 OAT TB + HIV Lanjutan paket 0 - -
223 Sterptomycin sulfat serbuk injeksi 1000mg vial 0 - -
224 Bedaquilin 100 mg tablet 0 - -
225 Ethambutol 400. mg tablet 0 - -
226 Etionamid 250 mg tablet 0 - -
227 Kanamisin injeksi 1000mg vial 0 - -
228 Kapreomisin 1 g injeksi vial 0 - -
229 Klofazimin 100 mg kapsul 0 - -
230 Kloserin 250 mg tablet 0 - -
231 Levofloksasin 250 mg tablet 0 - -
232 Moksifloksasin 400 mg tablet 0 - -
233 P-aminosalisilat sodium 5.52 g sachet 0 - -
234 Linizolid 600 mg capsul 0 - -
235 Pirazinamid 400 mg tablet 0 - -
236 Pirazinamid 500 mg tablet 0 - -
237 Piridoksin 100 mg tablet 0 - -
238 Pil KB komb.I (Levonogestrol 150mg+Etinil Estradiol 3 blister 0 - -
239 Suntik KB 1 bulan (Medoksi 150mg+Estradiol 5mg) vial 0 - -
240 Suntik KB 3 bulan (Medoksiprogesteron Asetat 150mg vial 0 - -
241 Implan KB 3 tahun (Levonogestrol 25mg) pcs 0 - -
242 Dekstro+GG+CTM+Phenyl Syr Botol 0 - -
243 Oxycan botol 0 - -
244 Parasetamol 100mg tablet tablet 0 - -
245 Bisoprolol 5 mg tablet 0 - -
246 candesartan tablet 0 - -
247 Kotrimoxazole 960mg tablet 0 - -
248 Becomzet tablet 0 - -
249 ZEGAVIT tablet 0 - -
250 DANEURON tablet 0 - -
251 Becefort tablet 0 - -
252 Vitamin Ultra C tablet 0 - -
253 Zidovudin 100 mg tablet 0 - -
254 Delanamid 50 mg tablet 0 - -
255 Furosemide inj tablet 0 - -
256 Albendazole syr 200 mg/ml tablet 0 - -
257 Dolutegravir 50 mg tablet 0 - -
258 Triple FDC (TDF+3TC+DTG) 300/300/50mg tablet 0 - -
259 Spironolactone 100 mg tablet 0 - -
260 Acarbose 50 mg tablet 0 - -
261 Ramipril 5 mg tablet 0 - -
262 Valsartan 160 mg tablet 0 - -
263 Ramipril 10 mg tablet 0 - -
264 Adalat Oros 30 mg tablet 0 - -
265 Glikuidone 30 mg tablet 0 - -
266 Levofloksasin 100 mg tablet 0 - -
267 Xylocain Jelly Tube 0 - -
268 Gabapentin tablet 0 - -
269 Rifampentin tablet 0 - -
270 Vitamin C 500 mg tablet 0 - -
271 Sinovac vial 0 - -

Mengetahui
PJ Farmasi PKM Cakung

Windi Wikandari, S.Farm., Apt


NIP 19860813211012014
EMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )

LB 2
BULAN : JANUARI
TAHUN : 2021

PEMAKAIAN STOK
SISA STOCK PERMINTAAN PEMBERIAN KET.
PEMAKAIAN RETUR ED/RUSAK PENYESUAIAN OPTIMUM
8 9 10 11 12 13 14 15 16

100
50
0
0
4 1530
150
0
0
13 2050
0
0
50 1516
0
0
0
0
30 2532
0
10 2290
0
0
500
1 4
0
0
1 40
0
0
2 82
0
0
2600
2
2 0
0
0
3 1180
0
6
0
0
0
0
0
0
0
0
0
0
624
0
0
192
0
20 2315
0
0
0
1000
0
0
0
0
0
60
0
780
494
10 220
0
0
0
4
0
20 2656
0
0
0
0
0
1 150
5 27
0
4
0
820
20 1498
0
0
100
0
11 8
0
0
20 680
0
0
0
0
0
0
5 90
4
10 550
0
370
0
0
0
0
0
0
0
0
0
0
0
500
0
0
0
2 108
12 3160
12
1 0
0
0
539
0
9 270
0
0
6
0
72 0
0
1 146
1 4
0
0
0
6 95
0
0
0
0
0
500
27 1976
0
10 1140
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Jakarta, Januari 2021


Yang Membuat Laporan

Tria Annisa, S.Farm., Apt


NIP. 10205819920502199205262
stok opname selisih
17 18

100 0
50 0
0
0
1530 0
150 0
0
0
2050 0
0
0
1516 0
0
0
0
0
2532 0
0
2290 0
0
0
500 0
4 0
0
0
40 0
0
0
82 0
0
0
2600 0
2 0
0
0
0
1180 0
0
6 0
0
0
0
0
0
0
0
0
0
0
624 0
0
0
192 0
0
2315 0
0
0
0
1000 0
0
0
0
0
0
60 0
0
780 0
494 0
220 0
0
0
0
4 0
0
2656 0
0
0
0
0
0
150 0
27 0
0
4 0
0
820 0
1498 0
0
0
100 0
0
8 0
0
0
680 0
0
0
0
0
0
0
90 0
4 0
550 0
0
370 0
0
0
0
0
0
0
0
0
0
0
0
500 0
0
0
0
108 0
3160 0
12 0
0
0
0
539 0
0
270 0
0
0
6 0
0
0
0
146 0
4 0
0
0
0
95 0
0
0
0
0
0
500 0
1976 0
0
1140 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
LAPORAN PEMAKAIAN DAN LEMBAR PERMINT
( LPLPO )

PUSKESMAS : KECAMATAN CAKUNG


UNIT : KB
KECAMATAN : CAKUNG
KABUPATEN / KODYA : JAKARTA TIMUR
PROVINSI : DKI JAKARTA
PENERIMAAN
NO NAMA OBAT SATUAN STOCK AWAL PERSEDIAAN
GUDANG PENYESUAIAN
1 2 3 4 5 6 7

1 Alopurinol 100mg tablet 0 - - -


2 Ambroxol 15mg/5 ml botol 0 - - -
3 Aminophillin 200mg tablet 0 - - -
4 Aminophillin injeksi 24mg/ml ampul 0 - - -
5 Amlodipin 10mg tablet 0 - - -
6 Amlodipin 5mg tablet 0 - - -
7 Amoksisilin (sirup kering) 125mg/5ml botol 0 - - -
8 Amoksisilin (sirup kering) 250mg/5ml botol 0 - - -
9 Amoksisilin 500mg tablet 0 - - -
10 Ampisilin injeksi (serbuk kering) 250mg vial 0 - - -
11 Antasida DOEN (MgSO4+AlOH Tersuspensi) botol 0 - - -
12 Antasida DOEN (MgSO4+AlOH) tablet 0 - - -
13 Anti Hemoroid DOEN suppos 0 - - -
14 Anti Tetanus Serum (ATS) 1500IU ampul 0 - - -
15 Aquades pro injeksi @25ml respule 0 - - -
16 Asam Askorbat (Vit C) 250mg tablet 0 - - -
17 Asam Askorbat (Vit C) 50mg tablet 0 - - -
18 Asam Folat 1mg tablet 0 - - -
19 Asam Mefenamat 500mg tablet 258 - - 258
20 Asetosal (Ascardia/Miniaspi) 80mg tablet 0 - - -
21 Asiklovir 200mg tablet 0 - - -
22 Asiklovir 400mg tablet 0 - - -
23 Asiklovir krim 5% tube 0 - - -
24 Atropin Sulfas injeksi 0,25mg/ml ampul 0 - - -
25 Azitromisin 500 mg tablet 0 - - -
26 Bedak salisil serbuk 2% ktk 0 - - -
27 Benzatin benzil penicilin serbuk injeksi 2,4juta IU/ml vial 0 - - -
28 Betahistin mesilate 6mg tablet 0 - - -
29 Betametason krim 0,1% tube 0 - - -
30 Bisakodil 5mg tablet 0 - - -
31 Budesonide (Cairan inhalasi) 0,25mg/ml respule 0 - - -
32 Deksametason 0,5mg tablet 0 - - -
33 Deksametason injeksi 5mg/ml ampul 2 - - 2
34 Difenhidramin injeksi 10mg/ml ampul 2 - - 2
35 Digoksin 0,25mg tablet 0 - - -
36 Doksisiklin 100mg kapsul 0 - - -
37 Domperidon 10mg tablet 0 - - -
38 Domperidon sirup 5mg/5ml botol 0 - - -
39 Epinefrin Bitatrat/Adrenalin Injeksi 1mg/ml ampul 2 - - 2
40 Eritromisin (sirup kering) 200mg/5ml botol 0 - - -
41 Eritromisin 250mg kapsul 0 - - -
42 Eritromisin 500mg kapsul 0 - - -
43 Fenofibrat 100mg tablet 0 - - -
44 Ferro sulfat 15mg/5ml botol 0 - - -
45 Fitomenadion (Vit K1) 10mg tablet 0 - - -
46 Fitomenadion (Vit.K1) injeksi 2mg/ml ampul 0 - - -
47 Flukonazol 150mg kapsul 0 - - -
48 Framisetin sulfat kassa steril 1% lembar 0 - - -
49 Furosemid 40mg tablet 0 - - -
50 Garam Oralit serbuk untuk 200ml sach 0 - - -
51 Gentamisin Salep 0,1% tube 0 - - -
52 Gentian Violet larutan 1% botol 0 - - -
53 Glibenklamid 5mg tablet 0 - - -
54 Glimepirid 1mg tablet 0 - - -
55 Gliseril Guaiakolat 100mg tablet 0 - - -
56 Glukosa larutan infus 10 % botol 0 - - -
57 Glukosa larutan infus 40 % botol 0 - - -
58 Glukosa larutan infus 5 % botol 0 - - -
59 Griseofulvin 125mg tablet 0 - - -
60 Hidroklortiazid 25mg tablet 0 - - -
61 Hidrokotison krim 2,5% tube 0 - - -
62 Hiosin N Butylbromide 10mg tablet 0 - - -
63 Ibuprofen 200mg tablet 0 - - -
64 Ikhtamol salep 10% pot 0 - - -
65 Isosorbid dinitrat (ISDN) 5mg tablet 0 - - -
66 Kalsium glukonat injeksi 10% vial 0 - - -
67 Kalsium Laktat 500mg tablet 0 - - -
68 Kaptopril 12,5 mg tablet 0 - - -
69 Kaptopril 25mg tablet 0 - - -
70 Karbo Adsorben (Norit) 125mg tablet 0 - - -
71 Karbogliserin (Fenol Gliserol) tetes telinga 10% botol 0 - - -
72 Ketokonazol 200mg tablet 0 - - -
73 Ketokonazol krim 2% tube 0 - - -
74 Ketoprofen 100mg/Supp suppos 0 - - -
75 Khlofeniramin Maleat (CTM) 4mg tablet 0 - - -
76 Klindamisin 150mg kapsul 0 - - -
77 Klopidogrel 75mg tablet 0 - - -
78 Kloramfenikol tetes mata 0,5% botol 0 - - -
79 Kloramfenikol 250mg kapsul 0 - - -
80 Kloramfenikol 500mg kapsul 0 - - -
81 Kloramfenikol salep kulit 2% tube 0 - - -
82 Kloramfenikol salep mata 1% tube 0 - - -
83 Kloramfenikol suspensi 125mg/5ml botol 0 - - -
84 Kloramfenikol tetes telinga 3% botol 0 - - -
85 Kolkisin 500mg tablet 0 - - -
86 Komb.ferro sulfat+as.folat (tablet tambah darah) tablet 0 - - -
87 Komb.kaolin 550mg+pektin 20mg tablet 0 - - -
88 Kombipak Azitromisin + Cefixim amplop 0 - - -
89 Kotrimoksazol 240mg/5 mL botol 0 - - -
90 Kotrimoksazol 480mg tablet 0 - - -
91 Lactulosa 3,335mg/5ml botol 0 - - -
92 Lidokain injeksi 2% ampul 22 - - 22
93 Lincomisin kapsul 500mg kapsul 0 - - -
94 Loratadin 10mg tablet 0 - - -
95 Metformin 500mg tablet 0 - - -
96 Metil Ergometrin injeksi 0,2mg/ml ampul 0 - - -
97 Metil Ergometrin 0,125mg tablet 0 - - -
98 Metoklorpropamid 10mg tablet 0 - - -
99 Metronidazol 250mg tablet 0 - - -
100 Metronidazol 500mg tablet 0 - - -
101 MgSO4 injeksi 40% vial 0 - - -
102 Mikonazol krim 2% tube 0 - - -
103 NaCl larutan infus 0,9% botol 2 - - 2
104 N-Asetil Sistein 200mg kapsul 0 - - -
105 Natrium Bicarbonat 500mg tablet 0 - - -
106 Natrium Diklofenak 25mg tablet 0 - - -
107 Natrium Diklofenak 50mg tablet 0 - - -
108 Neomisin 0,5% & Plasenta sapi 10% tube 0 - - -
109 Nifedipin tablet 10mg tablet 0 - - -
110 Nistatin 100.000IU/ml botol 0 - - -
111 Nistatin vaginal 100.000IU tablet 0 - - -
112 Nitrofurantoin 50mg tablet 0 - - -
113 Oksitetrasiklin HCl salep mata 1% tube 0 - - -
114 Oksitosin Injeksi 10IU/ml ampul 0 - - -
115 Omeprazole 20mg kapsul 0 - - -
116 Omeprazole serbuk injeksi 40mg vial 0 - - -
117 Pantocain 0,5% botol 0 - - -
118 Papaverin 40mg tablet 0 - - -
119 Papaverin injeksi 40mg/ml ampul 0 - - -
120 Paracetamol supp 125mg suppos 0 - - -
121 Parasetamol 100mg/ml botol 0 - - -
122 Parasetamol 120mg/5ml botol 0 - - -
123 Parasetamol 500mg tablet 0 - - -
124 Perak sufadiazin krim (Burnazin) 1% tube 0 - - -
125 Permetrin krim 5% (Scabimied) tube 0 - - -
126 Pirantel Pamoat 125mg tablet 0 - - -
127 Pirantel Pamoat 125mg/5ml botol 0 - - -
128 Piridoxin (Vit B6) 10mg tablet 0 - - -
129 Prednison 5mg tablet 0 - - -
130 Ranitidin 150mg tablet 0 - - -
131 Retinol (Vit A. Biru) 100.000 IU kapsul 0 - - -
132 Retinol (Vit A. Merah) 200.000 IU kapsul 0 - - -
133 Ringer Laktat larutan Elektrolit infus botol 0 - - -
134 Salbutamol 2mg tablet 0 - - -
135 Salbutamol 4mg tablet 0 - - -
136 Salbutamol cairan iihalasi (Ventolin Nebules) 2,5mg ampul 0 - - -
137 Salep 2-4 (As.Salisilat2%+Sulfur4%) pot 0 - - -
138 Salep Whitfield/Antifungi (As.Benzoat6%+As.Salisilat pot 0 - - -
139 Sefiksim 200mg kapsul 0 - - -
140 Setirizine 5mg/5ml botol 0 - - -
141 Sianokobalamin (Vit.B12) 50 µg tablet 0 - - -
142 Simvastatin 10mg tablet 0 - - -
143 Siprofloxasin 500mg tablet 0 - - -
144 Tetrasiklin 250mg kapsul 0 - - -
145 Tetrasiklin kapsul 500mg kapsul 0 - - -
146 Tiamfenikol 500mg kapsul 0 - - -
147 Tiamin (Vitamin B1) 100mg tablet 0 - - -
148 Tiamin (Vitamin B1) 50mg tablet 0 - - -
149 Vitamin B kompleks tablet 0 - - -
150 Zink 20mg/5ml botol 0 - - -
151 Zink dispersibel 20mg tablet 0 - - -
152 Amitriptilin HCl 25mg tablet 0 - - -
153 Anti Migrain DOEN tablet (ergotamin1mg+kafein50mg) tablet 0 - - -
154 Diazepam 2mg tablet 0 - - -
155 Diazepam 5mg tablet 0 - - -
156 Diazepam injeksi 5mg/ml ampul 0 - - -
157 Diazepam enema (Stesolid rectal tube) 10mg/2,5ml tube 0 - - -
158 Diazepam enema (Stesolid rectal tube) 5mg/2,5ml tube 0 - - -
159 Fenobarbital 30mg tablet 0 - - -
160 Haloperidol tablet 5mg tablet 0 - - -
161 Klorpromazin 100mg tablet 0 - - -
162 Risperidon 2mg tablet 0 - - -
163 Triheksipenidil 2mg tablet 0 - - -
164 Kodein 10mg tablet 0 - - -
165 Bahan tumpatan sementara (Cavit/Caviton) set 0 - - -
166 Bonding botol 0 - - -
167 Celluloid Strip Gigi Pak 0 - - -
168 Composit Light Curing (Tambal Sinar ) A2 tube 0 - - -
169 Composit Light Curing (Tambal Sinar ) A3 tube 0 - - -
170 Composit Light Curing (Tambal Sinar ) A3,5 tube 0 - - -
171 Cresophene (cresotin) botol 0 - - -
172 Dycal (Dycal/Hydcal) set 0 - - -
173 Ecing (Ecing/Ethacant) botol 0 - - -
174 Endometason (Endoseal) tube 0 - - -
175 Etil Chlorida Spray (Etil Clorida/Endoice) botol 0 - - -
176 Eugenol botol 0 - - -
177 Formokresol botol 0 - - -
178 Glass Ionomert ART (Fuji IX) set 0 - - -
179 Kalsium Hidroksida Pasta (Metapex/Calcetin/Vitapex) ktk 0 - - -
180 Klorfenol kamfer mentol (CHKM) botol 0 - - -
181 Lidocain spray 10% (Xylocaine) botol 0 - - -
182 Lidokain 2%+Epinefrin1:80.000 injeksi 2ml (Pehacain) ampul 0 - - -
183 Lidokain krim anestesi topical pot 0 - - -
184 Pasta devitalisasi non arsen (Depulpin) botol 0 - - -
185 Scandonest botol 0 - - -
186 Zinc Pospat Cement set 0 - - -
187 Tuberkulin protein purified derivative (Mantoux test) vial 0 - - -
188 Vaksin BCG kering + Pelarut vial 0 - - -
189 Vaksin HB0 (Hepatitis rekombinan) Dewasa vial 0 - - -
190 Vaksin HB0 (Hepatitis rekombinan) vial 0 - - -
191 Vaksin HPV vial 0 - - -
192 Vaksin Polio Oral + droppler (OPV) vial 0 - - -
193 Vaksin jerap difteri tetanus (DT) <7thn vial 0 - - -
194 Vaksin jerap tetanus difteri (Td) >7thn vial 0 - - -
195 Vaksin kombinasi DPT-HB-Hib vial 0 - - -
196 Vaksin Polio injeksi (IPV) vial 0 - - -
197 Vaksin Meningitis vial 0 - - -
198 Vaksin MR Kering + Pelarut Vial 0 - - -
199 Vaksin HBIg ampul 0 - - -
200 Efavirenz (EFV) 600mg tablet 0 - - -
201 Lamivudine (3TC) 150mg tablet 0 - - -
202 Lopinovir/ritonavir (LPV/r) 200/50mg tablet 0 - - -
203 Nevirapine (NVP) 200mg tablet 0 - - -
204 Tenofovir (TDF) 300mg tablet 0 - - -
205 Zidovudine (ZDV)+ Lamivudine (3TC) 300/150mg tablet 0 - - -
206 Triple FDC (TDF+3TC+EFV) 300/300/600mg tablet 0 - - -
207 Ped Triple FDC(ZDV+3TC+NVP) 60/30/50mg tablet 0 - - -
208 Ziduvudin Sirup botol 0 - - -
209 Albendazol 400mg tablet 0 - - -
210 MDT Combi (MB-Adult) blister 0 - - -
211 MDT Combi (MB-Child) blister 0 - - -
212 MDT Combi (PB- Adult) blister 0 - - -
213 MDT Combi (PB- Child)) blister 0 - - -
214 Isoniasid 100 mg tablet 0 - - -
215 Isoniazid 300 mg tablet 0 - - -
216 Obat Anti Tuberkulose kategori Anak paket 0 - - -
217 Obat Anti Tuberkulose kategori I & III paket 0 - - -
218 Obat Anti Tuberkulose kategori II paket 0 - - -
219 Obat Anti Tuberkulose kombipak paket 0 - - -
220 Piridoksin (Vit B6) 25mg tablet 0 - - -
221 OAT TB + HIV Intensif paket 0 - - -
222 OAT TB + HIV Lanjutan paket 0 - - -
223 Sterptomycin sulfat serbuk injeksi 1000mg vial 0 - - -
224 Bedaquilin 100 mg tablet 0 - - -
225 Ethambutol 400. mg tablet 0 - - -
226 Etionamid 250 mg tablet 0 - - -
227 Kanamisin injeksi 1000mg vial 0 - - -
228 Kapreomisin 1 g injeksi vial 0 - - -
229 Klofazimin 100 mg kapsul 0 - - -
230 Kloserin 250 mg tablet 0 - - -
231 Levofloksasin 250 mg tablet 0 - - -
232 Moksifloksasin 400 mg tablet 0 - - -
233 P-aminosalisilat sodium 5.52 g sachet 0 - - -
234 Linizolid 600 mg capsul 0 - - -
235 Pirazinamid 400 mg tablet 0 - - -
236 Pirazinamid 500 mg tablet 0 - - -
237 Piridoksin 100 mg tablet 0 - - -
238 Pil KB komb.I (Levonogestrol 150mg+Etinil Estradiol 3 blister 7 - - 7
239 Suntik KB 1 bulan (Medoksi 150mg+Estradiol 5mg) vial 0 - - -
240 Suntik KB 3 bulan (Medoksiprogesteron Asetat 150mg vial 36 - - 36
241 Implan KB 3 tahun (Levonogestrol 25mg) pcs 10 - 18 28
242 Dekstro+GG+CTM+Phenyl Syr Botol 0 - - -
243 Oxycan botol 0 - - -
244 Parasetamol 100mg tablet tablet 0 - - -
245 Bisoprolol 5 mg tablet 0 - - -
246 candesartan tablet 0 - - -
247 Kotrimoxazole 960mg tablet 0 - - -
248 Becomzet tablet 0 - - -
249 ZEGAVIT tablet 0 - - -
250 DANEURON tablet 0 - - -
251 Becefort tablet 0 - - -
252 Vitamin Ultra C tablet 0 - - -
253 Zidovudin 100 mg tablet 0 - - -
254 Delanamid 50 mg tablet 0 - - -
255 Furosemide inj tablet 0 - - -
256 Albendazole syr 200 mg/ml tablet 0 - - -
257 Dolutegravir 50 mg tablet 0 - - -
258 Triple FDC (TDF+3TC+DTG) 300/300/50mg tablet 0 - - -
259 Spironolactone 100 mg tablet 0 - - -
260 Acarbose 50 mg tablet 0 - - -
261 Ramipril 5 mg tablet 0 - - -
262 Valsartan 160 mg tablet 0 - - -
263 Ramipril 10 mg tablet 0 - - -
264 Adalat Oros 30 mg tablet 0 - - -
265 Glikuidone 30 mg tablet 0 - - -
266 Levofloksasin 100 mg tablet 0 - - -
267 Xylocain Jelly Tube 0 - - -
268 Gabapentin tablet 0 - - -
269 Rifampentin tablet 0 - - -
270 Vitamin C 500 mg tablet 0 - - -
271 Sinovac vial 0 - - -

Mengetahui
PJ Farmasi PKM Cakung

Windi Wikandari, S.Farm., Apt


NIP 19860813211012014
EMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )

LB 2
BULAN : JANUARI
TAHUN : 2021

PEMAKAIAN STOK
SISA STOCK PERMINTAAN PEMBERIAN KET.
PEMAKAIAN RETUR ED/RUSAK PENYESUAIAN OPTIMUM
8 9 10 11 12 13 14 15 16

- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 258 -258
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 2 -2
- - - - 2 -2
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 2 -2
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 22 -22
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 2 -2
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0 0
2 - - - 5 1
- - - - 0
3 20 - - 13
- - - - 28 dari RB
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0
- - - - 0

Jakarta, Januari 2021


Yang Membuat Laporan

Tria Annisa, S.Farm., Apt


NIP. 10205819920502199205262
STOCK
SELISIH
OPNAME
17 18

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
258 0
0
0
0
0
0
0
0
0
0
0
0
0
0
2 0
2 0
0
0
0
0
2 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
22 0
0
0
0
0
0
0
0
0
0
0
2 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5 0
0
13 0
28 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
LAPORAN PEMAKAIAN DAN LEMBAR PERMINT
( LPLPO )

PUSKESMAS : KECAMATAN CAKUNG


UNIT : PTM
KECAMATAN : CAKUNG
KABUPATEN / KODYA : JAKARTA TIMUR
PROVINSI : DKI JAKARTA
PENERIMAAN
NO NAMA OBAT SATUAN STOCK AWAL PERSEDIAAN
GUDANG PENYESUAIAN
1 2 3 4 5 6 7

1 Alopurinol 100mg tablet 0 - -


2 Ambroxol 15mg/5 ml botol 0 - -
3 Aminophillin 200mg tablet 0 - -
4 Aminophillin injeksi 24mg/ml ampul 0 - -
5 Amlodipin 10mg tablet 0 - -
6 Amlodipin 5mg tablet 0 - -
7 Amoksisilin (sirup kering) 125mg/5ml botol 0 - -
8 Amoksisilin (sirup kering) 250mg/5ml botol 0 - -
9 Amoksisilin 500mg tablet 0 - -
10 Ampisilin injeksi (serbuk kering) 250mg vial 0 - -
11 Antasida DOEN (MgSO4+AlOH Tersuspensi) botol 0 - -
12 Antasida DOEN (MgSO4+AlOH) tablet 0 - -
13 Anti Hemoroid DOEN suppos 0 - -
14 Anti Tetanus Serum (ATS) 1500IU ampul 0 - -
15 Aquades pro injeksi @25ml respule 0 - -
16 Asam Askorbat (Vit C) 250mg tablet 0 - -
17 Asam Askorbat (Vit C) 50mg tablet 0 - -
18 Asam Folat 1mg tablet 0 - -
19 Asam Mefenamat 500mg tablet 0 - -
20 Asetosal (Ascardia/Miniaspi) 80mg tablet 0 - -
21 Asiklovir 200mg tablet 0 - -
22 Asiklovir 400mg tablet 0 - -
23 Asiklovir krim 5% tube 0 - -
24 Atropin Sulfas injeksi 0,25mg/ml ampul 0 - -
25 Azitromisin 500 mg tablet 0 - -
26 Bedak salisil serbuk 2% ktk 0 - -
27 Benzatin benzil penicilin serbuk injeksi 2,4juta IU/ml vial 0 - -
28 Betahistin mesilate 6mg tablet 0 - -
29 Betametason krim 0,1% tube 0 - -
30 Bisakodil 5mg tablet 0 - -
31 Budesonide (Cairan inhalasi) 0,25mg/ml respule 0 - -
32 Deksametason 0,5mg tablet 0 - -
33 Deksametason injeksi 5mg/ml ampul 0 - -
34 Difenhidramin injeksi 10mg/ml ampul 0 - -
35 Digoksin 0,25mg tablet 0 - -
36 Doksisiklin 100mg kapsul 0 - -
37 Domperidon 10mg tablet 0 - -
38 Domperidon sirup 5mg/5ml botol 0 - -
39 Epinefrin Bitatrat/Adrenalin Injeksi 1mg/ml ampul 0 - -
40 Eritromisin (sirup kering) 200mg/5ml botol 0 - -
41 Eritromisin 250mg kapsul 0 - -
42 Eritromisin 500mg kapsul 0 - -
43 Fenofibrat 100mg tablet 0 - -
44 Ferro sulfat 15mg/5ml botol 0 - -
45 Fitomenadion (Vit K1) 10mg tablet 0 - -
46 Fitomenadion (Vit.K1) injeksi 2mg/ml ampul 0 - -
47 Flukonazol 150mg kapsul 0 - -
48 Framisetin sulfat kassa steril 1% lembar 0 - -
49 Furosemid 40mg tablet 0 - -
50 Garam Oralit serbuk untuk 200ml sach 0 - -
51 Gentamisin Salep 0,1% tube 0 - -
52 Gentian Violet larutan 1% botol 0 - -
53 Glibenklamid 5mg tablet 0 - -
54 Glimepirid 1mg tablet 0 - -
55 Gliseril Guaiakolat 100mg tablet 0 - -
56 Glukosa larutan infus 10 % botol 0 - -
57 Glukosa larutan infus 40 % botol 0 - -
58 Glukosa larutan infus 5 % botol 0 - -
59 Griseofulvin 125mg tablet 0 - -
60 Hidroklortiazid 25mg tablet 0 - -
61 Hidrokotison krim 2,5% tube 0 - -
62 Hiosin N Butylbromide 10mg tablet 0 - -
63 Ibuprofen 200mg tablet 0 - -
64 Ikhtamol salep 10% pot 0 - -
65 Isosorbid dinitrat (ISDN) 5mg tablet 0 - -
66 Kalsium glukonat injeksi 10% vial 0 - -
67 Kalsium Laktat 500mg tablet 0 - -
68 Kaptopril 12,5 mg tablet 0 - -
69 Kaptopril 25mg tablet 0 - -
70 Karbo Adsorben (Norit) 125mg tablet 0 - -
71 Karbogliserin (Fenol Gliserol) tetes telinga 10% botol 0 - -
72 Ketokonazol 200mg tablet 0 - -
73 Ketokonazol krim 2% tube 0 - -
74 Ketoprofen 100mg/Supp suppos 0 - -
75 Khlofeniramin Maleat (CTM) 4mg tablet 0 - -
76 Klindamisin 150mg kapsul 0 - -
77 Klopidogrel 75mg tablet 0 - -
78 Kloramfenikol tetes mata 0,5% botol 0 - -
79 Kloramfenikol 250mg kapsul 0 - -
80 Kloramfenikol 500mg kapsul 0 - -
81 Kloramfenikol salep kulit 2% tube 0 - -
82 Kloramfenikol salep mata 1% tube 0 - -
83 Kloramfenikol suspensi 125mg/5ml botol 0 - -
84 Kloramfenikol tetes telinga 3% botol 0 - -
85 Kolkisin 500mg tablet 0 - -
86 Komb.ferro sulfat+as.folat (tablet tambah darah) tablet 0 - -
87 Komb.kaolin 550mg+pektin 20mg tablet 0 - -
88 Kombipak Azitromisin + Cefixim amplop 0 - -
89 Kotrimoksazol 240mg/5 mL botol 0 - -
90 Kotrimoksazol 480mg tablet 0 - -
91 Lactulosa 3,335mg/5ml botol 0 - -
92 Lidokain injeksi 2% ampul 0 - -
93 Lincomisin kapsul 500mg kapsul 0 - -
94 Loratadin 10mg tablet 0 - -
95 Metformin 500mg tablet 0 - -
96 Metil Ergometrin injeksi 0,2mg/ml ampul 0 - -
97 Metil Ergometrin 0,125mg tablet 0 - -
98 Metoklorpropamid 10mg tablet 0 - -
99 Metronidazol 250mg tablet 0 - -
100 Metronidazol 500mg tablet 0 - -
101 MgSO4 injeksi 40% vial 0 - -
102 Mikonazol krim 2% tube 0 - -
103 NaCl larutan infus 0,9% botol 0 - -
104 N-Asetil Sistein 200mg kapsul 0 - -
105 Natrium Bicarbonat 500mg tablet 0 - -
106 Natrium Diklofenak 25mg tablet 0 - -
107 Natrium Diklofenak 50mg tablet 0 - -
108 Neomisin 0,5% & Plasenta sapi 10% tube 0 - -
109 Nifedipin tablet 10mg tablet 0 - -
110 Nistatin 100.000IU/ml botol 0 - -
111 Nistatin vaginal 100.000IU tablet 0 - -
112 Nitrofurantoin 50mg tablet 0 - -
113 Oksitetrasiklin HCl salep mata 1% tube 0 - -
114 Oksitosin Injeksi 10IU/ml ampul 0 - -
115 Omeprazole 20mg kapsul 0 - -
116 Omeprazole serbuk injeksi 40mg vial 0 - -
117 Pantocain 0,5% botol 0 - -
118 Papaverin 40mg tablet 0 - -
119 Papaverin injeksi 40mg/ml ampul 0 - -
120 Paracetamol supp 125mg suppos 0 - -
121 Parasetamol 100mg/ml botol 0 - -
122 Parasetamol 120mg/5ml botol 0 - -
123 Parasetamol 500mg tablet 0 - -
124 Perak sufadiazin krim (Burnazin) 1% tube 0 - -
125 Permetrin krim 5% (Scabimied) tube 0 - -
126 Pirantel Pamoat 125mg tablet 0 - -
127 Pirantel Pamoat 125mg/5ml botol 0 - -
128 Piridoxin (Vit B6) 10mg tablet 0 - -
129 Prednison 5mg tablet 0 - -
130 Ranitidin 150mg tablet 0 - -
131 Retinol (Vit A. Biru) 100.000 IU kapsul 0 - -
132 Retinol (Vit A. Merah) 200.000 IU kapsul 0 - -
133 Ringer Laktat larutan Elektrolit infus botol 0 - -
134 Salbutamol 2mg tablet 0 - -
135 Salbutamol 4mg tablet 0 - -
136 Salbutamol cairan iihalasi (Ventolin Nebules) 2,5mg ampul 0 - -
137 Salep 2-4 (As.Salisilat2%+Sulfur4%) pot 0 - -
138 Salep Whitfield/Antifungi (As.Benzoat6%+As.Salisilat pot 0 - -
139 Sefiksim 200mg kapsul 0 - -
140 Setirizine 5mg/5ml botol 0 - -
141 Sianokobalamin (Vit.B12) 50 µg tablet 0 - -
142 Simvastatin 10mg tablet 0 - -
143 Siprofloxasin 500mg tablet 0 - -
144 Tetrasiklin 250mg kapsul 0 - -
145 Tetrasiklin kapsul 500mg kapsul 0 - -
146 Tiamfenikol 500mg kapsul 0 - -
147 Tiamin (Vitamin B1) 100mg tablet 0 - -
148 Tiamin (Vitamin B1) 50mg tablet 0 - -
149 Vitamin B kompleks tablet 0 - -
150 Zink 20mg/5ml botol 0 - -
151 Zink dispersibel 20mg tablet 0 - -
152 Amitriptilin HCl 25mg tablet 0 - -
153 Anti Migrain DOEN tablet (ergotamin1mg+kafein50mg) tablet 0 - -
154 Diazepam 2mg tablet 0 - -
155 Diazepam 5mg tablet 0 - -
156 Diazepam injeksi 5mg/ml ampul 0 - -
157 Diazepam enema (Stesolid rectal tube) 10mg/2,5ml tube 0 - -
158 Diazepam enema (Stesolid rectal tube) 5mg/2,5ml tube 0 - -
159 Fenobarbital 30mg tablet 0 - -
160 Haloperidol tablet 5mg tablet 0 - -
161 Klorpromazin 100mg tablet 0 - -
162 Risperidon 2mg tablet 0 - -
163 Triheksipenidil 2mg tablet 0 - -
164 Kodein 10mg tablet 0 - -
165 Bahan tumpatan sementara (Cavit/Caviton) set 0 - -
166 Bonding botol 0 - -
167 Celluloid Strip Gigi Pak 0 - -
168 Composit Light Curing (Tambal Sinar ) A2 tube 0 - -
169 Composit Light Curing (Tambal Sinar ) A3 tube 0 - -
170 Composit Light Curing (Tambal Sinar ) A3,5 tube 0 - -
171 Cresophene (cresotin) botol 0 - -
172 Dycal (Dycal/Hydcal) set 0 - -
173 Ecing (Ecing/Ethacant) botol 0 - -
174 Endometason (Endoseal) tube 0 - -
175 Etil Chlorida Spray (Etil Clorida/Endoice) botol 0 - -
176 Eugenol botol 0 - -
177 Formokresol botol 0 - -
178 Glass Ionomert ART (Fuji IX) set 0 - -
179 Kalsium Hidroksida Pasta (Metapex/Calcetin/Vitapex) ktk 0 - -
180 Klorfenol kamfer mentol (CHKM) botol 0 - -
181 Lidocain spray 10% (Xylocaine) botol 0 - -
182 Lidokain 2%+Epinefrin1:80.000 injeksi 2ml (Pehacain) ampul 0 - -
183 Lidokain krim anestesi topical pot 0 - -
184 Pasta devitalisasi non arsen (Depulpin) botol 0 - -
185 Scandonest botol 0 - -
186 Zinc Pospat Cement set 0 - -
187 Tuberkulin protein purified derivative (Mantoux test) vial 0 - -
188 Vaksin BCG kering + Pelarut vial 0 - -
189 Vaksin HB0 (Hepatitis rekombinan) Dewasa vial 0 - -
190 Vaksin HB0 (Hepatitis rekombinan) vial 0 - -
191 Vaksin HPV vial 0 - -
192 Vaksin Polio Oral + droppler (OPV) vial 0 - -
193 Vaksin jerap difteri tetanus (DT) <7thn vial 0 - -
194 Vaksin jerap tetanus difteri (Td) >7thn vial 0 - -
195 Vaksin kombinasi DPT-HB-Hib vial 0 - -
196 Vaksin Polio injeksi (IPV) vial 0 - -
197 Vaksin Meningitis vial 0 - -
198 Vaksin MR Kering + Pelarut Vial 0 - -
199 Vaksin HBIg ampul 0 - -
200 Efavirenz (EFV) 600mg tablet 0 - -
201 Lamivudine (3TC) 150mg tablet 0 - -
202 Lopinovir/ritonavir (LPV/r) 200/50mg tablet 0 - -
203 Nevirapine (NVP) 200mg tablet 0 - -
204 Tenofovir (TDF) 300mg tablet 0 - -
205 Zidovudine (ZDV)+ Lamivudine (3TC) 300/150mg tablet 0 - -
206 Triple FDC (TDF+3TC+EFV) 300/300/600mg tablet 0 - -
207 Ped Triple FDC(ZDV+3TC+NVP) 60/30/50mg tablet 0 - -
208 Ziduvudin Sirup botol 0 - -
209 Albendazol 400mg tablet 0 - -
210 MDT Combi (MB-Adult) blister 0 - -
211 MDT Combi (MB-Child) blister 0 - -
212 MDT Combi (PB- Adult) blister 0 - -
213 MDT Combi (PB- Child)) blister 0 - -
214 Isoniasid 100 mg tablet 0 - -
215 Isoniazid 300 mg tablet 0 - -
216 Obat Anti Tuberkulose kategori Anak paket 0 - -
217 Obat Anti Tuberkulose kategori I & III paket 0 - -
218 Obat Anti Tuberkulose kategori II paket 0 - -
219 Obat Anti Tuberkulose kombipak paket 0 - -
220 Piridoksin (Vit B6) 25mg tablet 0 - -
221 OAT TB + HIV Intensif paket 0 - -
222 OAT TB + HIV Lanjutan paket 0 - -
223 Sterptomycin sulfat serbuk injeksi 1000mg vial 0 - -
224 Bedaquilin 100 mg tablet 0 - -
225 Ethambutol 400. mg tablet 0 - -
226 Etionamid 250 mg tablet 0 - -
227 Kanamisin injeksi 1000mg vial 0 - -
228 Kapreomisin 1 g injeksi vial 0 - -
229 Klofazimin 100 mg kapsul 0 - -
230 Kloserin 250 mg tablet 0 - -
231 Levofloksasin 250 mg tablet 0 - -
232 Moksifloksasin 400 mg tablet 0 - -
233 P-aminosalisilat sodium 5.52 g sachet 0 - -
234 Linizolid 600 mg capsul 0 - -
235 Pirazinamid 400 mg tablet 0 - -
236 Pirazinamid 500 mg tablet 0 - -
237 Piridoksin 100 mg tablet 0 - -
238 Pil KB komb.I (Levonogestrol 150mg+Etinil Estradiol 3 blister 0 - -
239 Suntik KB 1 bulan (Medoksi 150mg+Estradiol 5mg) vial 0 - -
240 Suntik KB 3 bulan (Medoksiprogesteron Asetat 150mg vial 0 - -
241 Implan KB 3 tahun (Levonogestrol 25mg) pcs 0 - -
242 Dekstro+GG+CTM+Phenyl Syr Botol 0 - -
243 Oxycan botol 0 - -
244 Parasetamol 100mg tablet tablet 0 - -
245 Bisoprolol 5 mg tablet 0 - -
246 candesartan tablet 0 - -
247 Kotrimoxazole 960mg tablet 0 - -
248 Becomzet tablet 0 - -
249 ZEGAVIT tablet 0 - -
250 DANEURON tablet 0 - -
251 Becefort tablet 0 - -
252 Vitamin Ultra C tablet 0 - -
253 Zidovudin 100 mg tablet 0 - -
254 Delanamid 50 mg tablet 0 - -
255 Furosemide inj tablet 0 - -
256 Albendazole syr 200 mg/ml tablet 0 - -
257 Dolutegravir 50 mg tablet 0 - -
258 Triple FDC (TDF+3TC+DTG) 300/300/50mg tablet 0 - -
259 Spironolactone 100 mg tablet 0 - -
260 Acarbose 50 mg tablet 0 - -
261 Ramipril 5 mg tablet 0 - -
262 Valsartan 160 mg tablet 0 - -
263 Ramipril 10 mg tablet 0 - -
264 Adalat Oros 30 mg tablet 0 - -
265 Glikuidone 30 mg tablet 0 - -
266 Levofloksasin 100 mg tablet 0 - -

Mengetahui
PJ Farmasi PKM Cakung

Windi Wikandari, S.Farm., Apt


NIP 19860813211012014
EMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )

LB 2
BULAN : JANUARI
TAHUN : 2021

PEMAKAIAN STOK
SISA STOCK PERMINTAAN PEMBERIAN KET.
PEMAKAIAN RETUR ED/RUSAK PENYESUAIAN OPTIMUM
8 9 10 11 12 13 14 15 16

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0
0
0
0
0
0
0
0
0
0 0
0 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Jakarta, Januari 2021


Yang Membuat Laporan

Tria Annisa, S.Farm., Apt


NIP. 10205819920502199205262
stok opname selisih
17 18

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OB
( LPLPO )

PUSKESMAS : KECAMATAN CAKUNG


UNIT : KA
KECAMATAN : CAKUNG
KABUPATEN / KODYA : JAKARTA TIMUR
PROVINSI : DKI JAKARTA
PENERIMAAN PERSEDIAA PEMAKA
NO NAMA OBAT SATUAN STOCK AWAL
GUDANG PENYESUAIAN N PEMAKAIAN
1 2 3 4 5 6 7 8

1 Alopurinol 100mg tablet 0 - -


2 Ambroxol 15mg/5 ml botol 0 - -
3 Aminophillin 200mg tablet 0 - -
4 Aminophillin injeksi 24mg/ml ampul 0 - -
5 Amlodipin 10mg tablet 0 - -
6 Amlodipin 5mg tablet 0 - -
7 Amoksisilin (sirup kering) 125mg/5ml botol 0 - -
8 Amoksisilin (sirup kering) 250mg/5ml botol 0 - -
9 Amoksisilin 500mg tablet 0 - -
10 Ampisilin injeksi (serbuk kering) 250mg vial 0 - -
11 Antasida DOEN (MgSO4+AlOH Tersuspensi) botol 0 - -
12 Antasida DOEN (MgSO4+AlOH) tablet 0 - -
13 Anti Hemoroid DOEN suppos 0 - -
14 Anti Tetanus Serum (ATS) 1500IU ampul 0 - -
15 Aquades pro injeksi @25ml respule 0 - -
16 Asam Askorbat (Vit C) 250mg tablet 0 - -
17 Asam Askorbat (Vit C) 50mg tablet 0 - -
18 Asam Folat 1mg tablet 0 - -
19 Asam Mefenamat 500mg tablet 0 - -
20 Asetosal (Ascardia/Miniaspi) 80mg tablet 0 - -
21 Asiklovir 200mg tablet 0 - -
22 Asiklovir 400mg tablet 0 - -
23 Asiklovir krim 5% tube 0 - -
24 Atropin Sulfas injeksi 0,25mg/ml ampul 0 - -
25 Azitromisin 500 mg tablet 0 - -
26 Bedak salisil serbuk 2% ktk 0 - -
27 Benzatin benzil penicilin serbuk injeksi 2,4juta IU/ml vial 0 - -
28 Betahistin mesilate 6mg tablet 0 - -
29 Betametason krim 0,1% tube 0 - -
30 Bisakodil 5mg tablet 0 - -
31 Budesonide (Cairan inhalasi) 0,25mg/ml respule 0 - -
32 Deksametason 0,5mg tablet 0 - -
33 Deksametason injeksi 5mg/ml ampul 2 - 2
34 Difenhidramin injeksi 10mg/ml ampul 2 - 2
35 Digoksin 0,25mg tablet 0 - -
36 Doksisiklin 100mg kapsul 0 - -
37 Domperidon 10mg tablet 0 - -
38 Domperidon sirup 5mg/5ml botol 0 - -
39 Epinefrin Bitatrat/Adrenalin Injeksi 1mg/ml ampul 2 - 2
40 Eritromisin (sirup kering) 200mg/5ml botol 0 - -
41 Eritromisin 250mg kapsul 0 - -
42 Eritromisin 500mg kapsul 0 - -
43 Fenofibrat 100mg tablet 0 - -
44 Ferro sulfat 15mg/5ml botol 0 - -
45 Fitomenadion (Vit K1) 10mg tablet 0 - -
46 Fitomenadion (Vit.K1) injeksi 2mg/ml ampul 0 - -
47 Flukonazol 150mg kapsul 0 - -
48 Framisetin sulfat kassa steril 1% lembar 0 - -
49 Furosemid 40mg tablet 0 - -
50 Garam Oralit serbuk untuk 200ml sach 0 - -
51 Gentamisin Salep 0,1% tube 0 - -
52 Gentian Violet larutan 1% botol 0 - -
53 Glibenklamid 5mg tablet 0 - -
54 Glimepirid 1mg tablet 0 - -
55 Gliseril Guaiakolat 100mg tablet 0 - -
56 Glukosa larutan infus 10 % botol 0 - -
57 Glukosa larutan infus 40 % botol 0 - -
58 Glukosa larutan infus 5 % botol 0 - -
59 Griseofulvin 125mg tablet 0 - -
60 Hidroklortiazid 25mg tablet 0 - -
61 Hidrokotison krim 2,5% tube 0 - -
62 Hiosin N Butylbromide 10mg tablet 0 - -
63 Ibuprofen 200mg tablet 0 - -
64 Ikhtamol salep 10% pot 0 - -
65 Isosorbid dinitrat (ISDN) 5mg tablet 0 - -
66 Kalsium glukonat injeksi 10% vial 0 - -
67 Kalsium Laktat 500mg tablet 0 - -
68 Kaptopril 12,5 mg tablet 0 - -
69 Kaptopril 25mg tablet 0 - -
70 Karbo Adsorben (Norit) 125mg tablet 0 - -
71 Karbogliserin (Fenol Gliserol) tetes telinga 10% botol 0 - -
72 Ketokonazol 200mg tablet 0 - -
73 Ketokonazol krim 2% tube 0 - -
74 Ketoprofen 100mg/Supp suppos 0 - -
75 Khlofeniramin Maleat (CTM) 4mg tablet 0 - -
76 Klindamisin 150mg kapsul 0 - -
77 Klopidogrel 75mg tablet 0 - -
78 Kloramfenikol tetes mata 0,5% botol 0 - -
79 Kloramfenikol 250mg kapsul 0 - -
80 Kloramfenikol 500mg kapsul 0 - -
81 Kloramfenikol salep kulit 2% tube 0 - -
82 Kloramfenikol salep mata 1% tube 0 - -
83 Kloramfenikol suspensi 125mg/5ml botol 0 - -
84 Kloramfenikol tetes telinga 3% botol 0 - -
85 Kolkisin 500mg tablet 0 - -
86 Komb.ferro sulfat+as.folat (tablet tambah darah) tablet 0 - -
87 Komb.kaolin 550mg+pektin 20mg tablet 0 - -
88 Kombipak Azitromisin + Cefixim amplop 0 - -
89 Kotrimoksazol 240mg/5 mL botol 0 - -
90 Kotrimoksazol 480mg tablet 0 - -
91 Lactulosa 3,335mg/5ml botol 0 - -
92 Lidokain injeksi 2% ampul 0 - -
93 Lincomisin kapsul 500mg kapsul 0 - -
94 Loratadin 10mg tablet 0 - -
95 Metformin 500mg tablet 0 - -
96 Metil Ergometrin injeksi 0,2mg/ml ampul 0 - -
97 Metil Ergometrin 0,125mg tablet 0 - -
98 Metoklorpropamid 10mg tablet 0 - -
99 Metronidazol 250mg tablet 0 - -
100 Metronidazol 500mg tablet 0 - -
101 MgSO4 injeksi 40% vial 0 - -
102 Mikonazol krim 2% tube 0 - -
103 NaCl larutan infus 0,9% botol 2 - 2
104 N-Asetil Sistein 200mg kapsul 0 - -
105 Natrium Bicarbonat 500mg tablet 0 - -
106 Natrium Diklofenak 25mg tablet 0 - -
107 Natrium Diklofenak 50mg tablet 0 - -
108 Neomisin 0,5% & Plasenta sapi 10% tube 0 - -
109 Nifedipin tablet 10mg tablet 0 - -
110 Nistatin 100.000IU/ml botol 0 - -
111 Nistatin vaginal 100.000IU tablet 0 - -
112 Nitrofurantoin 50mg tablet 0 - -
113 Oksitetrasiklin HCl salep mata 1% tube 0 - -
114 Oksitosin Injeksi 10IU/ml ampul 0 - -
115 Omeprazole 20mg kapsul 0 - -
116 Omeprazole serbuk injeksi 40mg vial 0 - -
117 Pantocain 0,5% botol 0 - -
118 Papaverin 40mg tablet 0 - -
119 Papaverin injeksi 40mg/ml ampul 0 - -
120 Paracetamol supp 125mg suppos 0 - -
121 Parasetamol 100mg/ml botol 0 - -
122 Parasetamol 120mg/5ml botol 0 - -
123 Parasetamol 500mg tablet 0 - -
124 Perak sufadiazin krim (Burnazin) 1% tube 0 - -
125 Permetrin krim 5% (Scabimied) tube 0 - -
126 Pirantel Pamoat 125mg tablet 0 - -
127 Pirantel Pamoat 125mg/5ml botol 0 - -
128 Piridoxin (Vit B6) 10mg tablet 0 - -
129 Prednison 5mg tablet 0 - -
130 Ranitidin 150mg tablet 0 - -
131 Retinol (Vit A. Biru) 100.000 IU kapsul 27 - 27
132 Retinol (Vit A. Merah) 200.000 IU kapsul 28 - 28
133 Ringer Laktat larutan Elektrolit infus botol 0 - -
134 Salbutamol 2mg tablet 0 - -
135 Salbutamol 4mg tablet 0 - -
136 Salbutamol cairan iihalasi (Ventolin Nebules) 2,5mg ampul 0 - -
137 Salep 2-4 (As.Salisilat2%+Sulfur4%) pot 0 - -
138 Salep Whitfield/Antifungi (As.Benzoat6%+As.Salisilat pot 0 - -
139 Sefiksim 200mg kapsul 0 - -
140 Setirizine 5mg/5ml botol 0 - -
141 Sianokobalamin (Vit.B12) 50 µg tablet 0 - -
142 Simvastatin 10mg tablet 0 - -
143 Siprofloxasin 500mg tablet 0 - -
144 Tetrasiklin 250mg kapsul 0 - -
145 Tetrasiklin kapsul 500mg kapsul 0 - -
146 Tiamfenikol 500mg kapsul 0 - -
147 Tiamin (Vitamin B1) 100mg tablet 0 - -
148 Tiamin (Vitamin B1) 50mg tablet 0 - -
149 Vitamin B kompleks tablet 0 - -
150 Zink 20mg/5ml botol 0 - -
151 Zink dispersibel 20mg tablet 0 - -
152 Amitriptilin HCl 25mg tablet 0 - -
153 Anti Migrain DOEN tablet (ergotamin1mg+kafein50mg) tablet 0 - -
154 Diazepam 2mg tablet 0 - -
155 Diazepam 5mg tablet 0 - -
156 Diazepam injeksi 5mg/ml ampul 0 - -
157 Diazepam enema (Stesolid rectal tube) 10mg/2,5ml tube 0 - -
158 Diazepam enema (Stesolid rectal tube) 5mg/2,5ml tube 0 - -
159 Fenobarbital 30mg tablet 0 - -
160 Haloperidol tablet 5mg tablet 0 - -
161 Klorpromazin 100mg tablet 0 - -
162 Risperidon 2mg tablet 0 - -
163 Triheksipenidil 2mg tablet 0 - -
164 Kodein 10mg tablet 0 - -
165 Bahan tumpatan sementara (Cavit/Caviton) set 0 - -
166 Bonding botol 0 - -
167 Celluloid Strip Gigi Pak 0 - -
168 Composit Light Curing (Tambal Sinar ) A2 tube 0 - -
169 Composit Light Curing (Tambal Sinar ) A3 tube 0 - -
170 Composit Light Curing (Tambal Sinar ) A3,5 tube 0 - -
171 Cresophene (cresotin) botol 0 - -
172 Dycal (Dycal/Hydcal) set 0 - -
173 Ecing (Ecing/Ethacant) botol 0 - -
174 Endometason (Endoseal) tube 0 - -
175 Etil Chlorida Spray (Etil Clorida/Endoice) botol 0 - -
176 Eugenol botol 0 - -
177 Formokresol botol 0 - -
178 Glass Ionomert ART (Fuji IX) set 0 - -
179 Kalsium Hidroksida Pasta (Metapex/Calcetin/Vitapex) ktk 0 - -
180 Klorfenol kamfer mentol (CHKM) botol 0 - -
181 Lidocain spray 10% (Xylocaine) botol 0 - -
182 Lidokain 2%+Epinefrin1:80.000 injeksi 2ml (Pehacain) ampul 0 - -
183 Lidokain krim anestesi topical pot 0 - -
184 Pasta devitalisasi non arsen (Depulpin) botol 0 - -
185 Scandonest botol 0 - -
186 Zinc Pospat Cement set 0 - -
187 Tuberkulin protein purified derivative (Mantoux test) vial 0 - -
188 Vaksin BCG kering + Pelarut vial 0 4 4 4
189 Vaksin HB0 (Hepatitis rekombinan) Dewasa vial 0 - -
190 Vaksin HB0 (Hepatitis rekombinan) vial 0 1 1 1
191 Vaksin HPV vial 0 - -
192 Vaksin Polio Oral + droppler (OPV) vial 0 5 5 5
193 Vaksin jerap difteri tetanus (DT) <7thn vial 0 - -
194 Vaksin jerap tetanus difteri (Td) >7thn vial 0 15 15 15
195 Vaksin kombinasi DPT-HB-Hib vial 0 14 14 14
196 Vaksin Polio injeksi (IPV) vial 0 7 7 7
197 Vaksin Meningitis vial 0 - -
198 Vaksin MR Kering + Pelarut Vial 0 4 4 4
199 Vaksin HBIg ampul 0 - -
200 Efavirenz (EFV) 600mg tablet 0 - -
201 Lamivudine (3TC) 150mg tablet 0 - -
202 Lopinovir/ritonavir (LPV/r) 200/50mg tablet 0 - -
203 Nevirapine (NVP) 200mg tablet 0 - -
204 Tenofovir (TDF) 300mg tablet 0 - -
205 Zidovudine (ZDV)+ Lamivudine (3TC) 300/150mg tablet 0 - -
206 Triple FDC (TDF+3TC+EFV) 300/300/600mg tablet 0 - -
207 Ped Triple FDC(ZDV+3TC+NVP) 60/30/50mg tablet 0 - -
208 Ziduvudin Sirup botol 0 - -
209 Albendazol 400mg tablet 0 - -
210 MDT Combi (MB-Adult) blister 0 - -
211 MDT Combi (MB-Child) blister 0 - -
212 MDT Combi (PB- Adult) blister 0 - -
213 MDT Combi (PB- Child)) blister 0 - -
214 Isoniasid 100 mg tablet 0 - -
215 Isoniazid 300 mg tablet 0 - -
216 Obat Anti Tuberkulose kategori Anak paket 0 - -
217 Obat Anti Tuberkulose kategori I & III paket 0 - -
218 Obat Anti Tuberkulose kategori II paket 0 - -
219 Obat Anti Tuberkulose kombipak paket 0 - -
220 Piridoksin (Vit B6) 25mg tablet 0 - -
221 OAT TB + HIV Intensif paket 0 - -
222 OAT TB + HIV Lanjutan paket 0 - -
223 Sterptomycin sulfat serbuk injeksi 1000mg vial 0 - -
224 Bedaquilin 100 mg tablet 0 - -
225 Ethambutol 400. mg tablet 0 - -
226 Etionamid 250 mg tablet 0 - -
227 Kanamisin injeksi 1000mg vial 0 - -
228 Kapreomisin 1 g injeksi vial 0 - -
229 Klofazimin 100 mg kapsul 0 - -
230 Kloserin 250 mg tablet 0 - -
231 Levofloksasin 250 mg tablet 0 - -
232 Moksifloksasin 400 mg tablet 0 - -
233 P-aminosalisilat sodium 5.52 g sachet 0 - -
234 Linizolid 600 mg capsul 0 - -
235 Pirazinamid 400 mg tablet 0 - -
236 Pirazinamid 500 mg tablet 0 - -
237 Piridoksin 100 mg tablet 0 - -
238 Pil KB komb.I (Levonogestrol 150mg+Etinil Estradiol 3 blister 0 - -
239 Suntik KB 1 bulan (Medoksi 150mg+Estradiol 5mg) vial 0 - -
240 Suntik KB 3 bulan (Medoksiprogesteron Asetat 150mg vial 0 - -
241 Implan KB 3 tahun (Levonogestrol 25mg) pcs 0 - -
242 Dekstro+GG+CTM+Phenyl Syr Botol 0 - -
243 Oxycan botol 0 - -
244 Parasetamol 100mg tablet tablet 0 - -
245 Bisoprolol 5 mg tablet 0 - -
246 candesartan tablet 0 - -
247 Kotrimoxazole 960mg tablet 0 - -
248 Becomzet tablet 0 - -
249 ZEGAVIT tablet 0 - -
250 DANEURON tablet 0 - -
251 Becefort tablet 0 - -
252 Vitamin Ultra C tablet 0 - -
253 Zidovudin 100 mg tablet 0 - -
254 Delanamid 50 mg tablet 0 - -
255 Furosemide inj tablet 0 - -
256 Albendazole syr 200 mg/ml tablet 0 - -
257 Dolutegravir 50 mg tablet 0 - -
258 Triple FDC (TDF+3TC+DTG) 300/300/50mg tablet 0 - -
259 Spironolactone 100 mg tablet 0 - -
260 Acarbose 50 mg tablet 0 - -
261 Ramipril 5 mg tablet 0 - -
262 Valsartan 160 mg tablet 0 - -
263 Ramipril 10 mg tablet 0 - -
264 Adalat Oros 30 mg tablet 0 - -
265 Glikuidone 30 mg tablet 0 - -
266 Levofloksasin 100 mg Tube 0 - -
267 Xylocain Jelly tablet 0 - -
268 Gabapentin tablet 0 - -
269 Rifampentin tablet 0 - -
270 Vitamin C 500 mg vial 0 - -
271 Sinovac 0 0 - -

Mengetahui
PJ Farmasi PKM Cakung

Windi Wikandari, S.Farm., Apt


NIP 19860813211012014
LEMBAR PERMINTAAN OBAT
PO )

LB 2
BULAN : JANUARI
TAHUN : 2021

PEMAKAIAN STOK
SISA STOCK PERMINTAAN PEMBERIAN KET. stok opname selisih
RETUR ED/RUSAK PENYESUAIAN OPTIMUM
9 10 11 12 13 14 15 16 17 18

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
2 -2 2 0
2 -2 2 0
0 0 0
0 0 0
0 0 0
0 0 0
2 -2 2 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
2 -2 2 0
0 0 0
0 0 0
0 0 0
0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
27 -27 27 0
28 -28 28 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 12 0
0 0 0
0 3 0
0 0 0
0 15 0
0 0 0
0 45 0
0 42 0
0 21 0
0 0 0
0 12 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

Jakarta, Januari 2021


Yang Membuat Laporan

Tria Annisa, S.Farm., Apt


NIP. 10205819920502199205262
LAPORAN PEMAKAIAN DAN LEMBAR PERMINT
( LPLPO )

PUSKESMAS : KECAMATAN CAKUNG


UNIT : KI
KECAMATAN : CAKUNG
KABUPATEN / KODYA : JAKARTA TIMUR
PROVINSI : DKI JAKARTA
PENERIMAAN
NO NAMA OBAT SATUAN STOCK AWAL PERSEDIAAN
GUDANG PENYESUAIAN
1 2 3 4 5 6 7

1 Alopurinol 100mg tablet 0 - -


2 Ambroxol 15mg/5 ml botol 0 - -
3 Aminophillin 200mg tablet 0 - -
4 Aminophillin injeksi 24mg/ml ampul 0 - -
5 Amlodipin 10mg tablet 0 - -
6 Amlodipin 5mg tablet 0 - -
7 Amoksisilin (sirup kering) 125mg/5ml botol 0 - -
8 Amoksisilin (sirup kering) 250mg/5ml botol 0 - -
9 Amoksisilin 500mg tablet 0 - -
10 Ampisilin injeksi (serbuk kering) 250mg vial 0 - -
11 Antasida DOEN (MgSO4+AlOH Tersuspensi) botol 0 - -
12 Antasida DOEN (MgSO4+AlOH) tablet 0 - -
13 Anti Hemoroid DOEN suppos 0 - -
14 Anti Tetanus Serum (ATS) 1500IU ampul 0 - -
15 Aquades pro injeksi @25ml respule 0 - -
16 Asam Askorbat (Vit C) 250mg tablet 0 - -
17 Asam Askorbat (Vit C) 50mg tablet 0 - -
18 Asam Folat 1mg tablet 0 - -
19 Asam Mefenamat 500mg tablet 0 - -
20 Asetosal (Ascardia/Miniaspi) 80mg tablet 0 - -
21 Asiklovir 200mg tablet 0 - -
22 Asiklovir 400mg tablet 0 - -
23 Asiklovir krim 5% tube 0 - -
24 Atropin Sulfas injeksi 0,25mg/ml ampul 0 - -
25 Azitromisin 500 mg tablet 0 - -
26 Bedak salisil serbuk 2% ktk 0 - -
27 Benzatin benzil penicilin serbuk injeksi 2,4juta IU/ml vial 0 - -
28 Betahistin mesilate 6mg tablet 0 - -
29 Betametason krim 0,1% tube 0 - -
30 Bisakodil 5mg tablet 0 - -
31 Budesonide (Cairan inhalasi) 0,25mg/ml respule 0 - -
32 Deksametason 0,5mg tablet 0 - -
33 Deksametason injeksi 5mg/ml ampul 2 - 2
34 Difenhidramin injeksi 10mg/ml ampul 2 - 2
35 Digoksin 0,25mg tablet 0 - -
36 Doksisiklin 100mg kapsul 0 - -
37 Domperidon 10mg tablet 0 - -
38 Domperidon sirup 5mg/5ml botol 0 - -
39 Epinefrin Bitatrat/Adrenalin Injeksi 1mg/ml ampul 2 - 2
40 Eritromisin (sirup kering) 200mg/5ml botol 0 - -
41 Eritromisin 250mg kapsul 0 - -
42 Eritromisin 500mg kapsul 0 - -
43 Fenofibrat 100mg tablet 0 - -
44 Ferro sulfat 15mg/5ml botol 0 - -
45 Fitomenadion (Vit K1) 10mg tablet 0 - -
46 Fitomenadion (Vit.K1) injeksi 2mg/ml ampul 0 - -
47 Flukonazol 150mg kapsul 0 - -
48 Framisetin sulfat kassa steril 1% lembar 0 - -
49 Furosemid 40mg tablet 0 - -
50 Garam Oralit serbuk untuk 200ml sach 0 - -
51 Gentamisin Salep 0,1% tube 0 - -
52 Gentian Violet larutan 1% botol 0 - -
53 Glibenklamid 5mg tablet 0 - -
54 Glimepirid 1mg tablet 0 - -
55 Gliseril Guaiakolat 100mg tablet 0 - -
56 Glukosa larutan infus 10 % botol 0 - -
57 Glukosa larutan infus 40 % botol 0 - -
58 Glukosa larutan infus 5 % botol 0 - -
59 Griseofulvin 125mg tablet 0 - -
60 Hidroklortiazid 25mg tablet 0 - -
61 Hidrokotison krim 2,5% tube 0 - -
62 Hiosin N Butylbromide 10mg tablet 0 - -
63 Ibuprofen 200mg tablet 0 - -
64 Ikhtamol salep 10% pot 0 - -
65 Isosorbid dinitrat (ISDN) 5mg tablet 0 - -
66 Kalsium glukonat injeksi 10% vial 0 - -
67 Kalsium Laktat 500mg tablet 0 - -
68 Kaptopril 12,5 mg tablet 0 - -
69 Kaptopril 25mg tablet 0 - -
70 Karbo Adsorben (Norit) 125mg tablet 0 - -
71 Karbogliserin (Fenol Gliserol) tetes telinga 10% botol 0 - -
72 Ketokonazol 200mg tablet 0 - -
73 Ketokonazol krim 2% tube 0 - -
74 Ketoprofen 100mg/Supp suppos 0 - -
75 Khlofeniramin Maleat (CTM) 4mg tablet 0 - -
76 Klindamisin 150mg kapsul 0 - -
77 Klopidogrel 75mg tablet 0 - -
78 Kloramfenikol tetes mata 0,5% botol 0 - -
79 Kloramfenikol 250mg kapsul 0 - -
80 Kloramfenikol 500mg kapsul 0 - -
81 Kloramfenikol salep kulit 2% tube 0 - -
82 Kloramfenikol salep mata 1% tube 0 - -
83 Kloramfenikol suspensi 125mg/5ml botol 0 - -
84 Kloramfenikol tetes telinga 3% botol 0 - -
85 Kolkisin 500mg tablet 0 - -
86 Komb.ferro sulfat+as.folat (tablet tambah darah) tablet 0 - -
87 Komb.kaolin 550mg+pektin 20mg tablet 0 - -
88 Kombipak Azitromisin + Cefixim amplop 0 - -
89 Kotrimoksazol 240mg/5 mL botol 0 - -
90 Kotrimoksazol 480mg tablet 0 - -
91 Lactulosa 3,335mg/5ml botol 0 - -
92 Lidokain injeksi 2% ampul 0 - -
93 Lincomisin kapsul 500mg kapsul 0 - -
94 Loratadin 10mg tablet 0 - -
95 Metformin 500mg tablet 0 - -
96 Metil Ergometrin injeksi 0,2mg/ml ampul 0 - -
97 Metil Ergometrin 0,125mg tablet 0 - -
98 Metoklorpropamid 10mg tablet 0 - -
99 Metronidazol 250mg tablet 0 - -
100 Metronidazol 500mg tablet 0 - -
101 MgSO4 injeksi 40% vial 0 - -
102 Mikonazol krim 2% tube 0 - -
103 NaCl larutan infus 0,9% botol 2 - 2
104 N-Asetil Sistein 200mg kapsul 0 - -
105 Natrium Bicarbonat 500mg tablet 0 - -
106 Natrium Diklofenak 25mg tablet 0 - -
107 Natrium Diklofenak 50mg tablet 0 - -
108 Neomisin 0,5% & Plasenta sapi 10% tube 0 - -
109 Nifedipin tablet 10mg tablet 0 - -
110 Nistatin 100.000IU/ml botol 0 - -
111 Nistatin vaginal 100.000IU tablet 0 - -
112 Nitrofurantoin 50mg tablet 0 - -
113 Oksitetrasiklin HCl salep mata 1% tube 0 - -
114 Oksitosin Injeksi 10IU/ml ampul 0 - -
115 Omeprazole 20mg kapsul 0 - -
116 Omeprazole serbuk injeksi 40mg vial 0 - -
117 Pantocain 0,5% botol 0 - -
118 Papaverin 40mg tablet 0 - -
119 Papaverin injeksi 40mg/ml ampul 0 - -
120 Paracetamol supp 125mg suppos 0 - -
121 Parasetamol 100mg/ml botol 0 - -
122 Parasetamol 120mg/5ml botol 0 - -
123 Parasetamol 500mg tablet 0 - -
124 Perak sufadiazin krim (Burnazin) 1% tube 0 - -
125 Permetrin krim 5% (Scabimied) tube 0 - -
126 Pirantel Pamoat 125mg tablet 0 - -
127 Pirantel Pamoat 125mg/5ml botol 0 - -
128 Piridoxin (Vit B6) 10mg tablet 0 - -
129 Prednison 5mg tablet 0 - -
130 Ranitidin 150mg tablet 0 - -
131 Retinol (Vit A. Biru) 100.000 IU kapsul 0 - -
132 Retinol (Vit A. Merah) 200.000 IU kapsul 0 - -
133 Ringer Laktat larutan Elektrolit infus botol 0 - -
134 Salbutamol 2mg tablet 0 - -
135 Salbutamol 4mg tablet 0 - -
136 Salbutamol cairan iihalasi (Ventolin Nebules) 2,5mg ampul 0 - -
137 Salep 2-4 (As.Salisilat2%+Sulfur4%) pot 0 - -
138 Salep Whitfield/Antifungi (As.Benzoat6%+As.Salisilat pot 0 - -
139 Sefiksim 200mg kapsul 0 - -
140 Setirizine 5mg/5ml botol 0 - -
141 Sianokobalamin (Vit.B12) 50 µg tablet 0 - -
142 Simvastatin 10mg tablet 0 - -
143 Siprofloxasin 500mg tablet 0 - -
144 Tetrasiklin 250mg kapsul 0 - -
145 Tetrasiklin kapsul 500mg kapsul 0 - -
146 Tiamfenikol 500mg kapsul 0 - -
147 Tiamin (Vitamin B1) 100mg tablet 0 - -
148 Tiamin (Vitamin B1) 50mg tablet 0 - -
149 Vitamin B kompleks tablet 0 - -
150 Zink 20mg/5ml botol 0 - -
151 Zink dispersibel 20mg tablet 0 - -
152 Amitriptilin HCl 25mg tablet 0 - -
153 Anti Migrain DOEN tablet (ergotamin1mg+kafein50mg) tablet 0 - -
154 Diazepam 2mg tablet 0 - -
155 Diazepam 5mg tablet 0 - -
156 Diazepam injeksi 5mg/ml ampul 0 - -
157 Diazepam enema (Stesolid rectal tube) 10mg/2,5ml tube 0 - -
158 Diazepam enema (Stesolid rectal tube) 5mg/2,5ml tube 0 - -
159 Fenobarbital 30mg tablet 0 - -
160 Haloperidol tablet 5mg tablet 0 - -
161 Klorpromazin 100mg tablet 0 - -
162 Risperidon 2mg tablet 0 - -
163 Triheksipenidil 2mg tablet 0 - -
164 Kodein 10mg tablet 0 - -
165 Bahan tumpatan sementara (Cavit/Caviton) set 0 - -
166 Bonding botol 0 - -
167 Celluloid Strip Gigi Pak 0 - -
168 Composit Light Curing (Tambal Sinar ) A2 tube 0 - -
169 Composit Light Curing (Tambal Sinar ) A3 tube 0 - -
170 Composit Light Curing (Tambal Sinar ) A3,5 tube 0 - -
171 Cresophene (cresotin) botol 0 - -
172 Dycal (Dycal/Hydcal) set 0 - -
173 Ecing (Ecing/Ethacant) botol 0 - -
174 Endometason (Endoseal) tube 0 - -
175 Etil Chlorida Spray (Etil Clorida/Endoice) botol 0 - -
176 Eugenol botol 0 - -
177 Formokresol botol 0 - -
178 Glass Ionomert ART (Fuji IX) set 0 - -
179 Kalsium Hidroksida Pasta (Metapex/Calcetin/Vitapex) ktk 0 - -
180 Klorfenol kamfer mentol (CHKM) botol 0 - -
181 Lidocain spray 10% (Xylocaine) botol 0 - -
182 Lidokain 2%+Epinefrin1:80.000 injeksi 2ml (Pehacain) ampul 0 - -
183 Lidokain krim anestesi topical pot 0 - -
184 Pasta devitalisasi non arsen (Depulpin) botol 0 - -
185 Scandonest botol 0 - -
186 Zinc Pospat Cement set 0 - -
187 Tuberkulin protein purified derivative (Mantoux test) vial 0 - -
188 Vaksin BCG kering + Pelarut vial 0 - -
189 Vaksin HB0 (Hepatitis rekombinan) Dewasa vial 0 - -
190 Vaksin HB0 (Hepatitis rekombinan) vial 0 - -
191 Vaksin HPV vial 0 - -
192 Vaksin Polio Oral + droppler (OPV) vial 0 - -
193 Vaksin jerap difteri tetanus (DT) <7thn vial 0 - -
194 Vaksin jerap tetanus difteri (Td) >7thn vial 0 - -
195 Vaksin kombinasi DPT-HB-Hib vial 0 - -
196 Vaksin Polio injeksi (IPV) vial 0 - -
197 Vaksin Meningitis vial 0 - -
198 Vaksin MR Kering + Pelarut Vial 0 - -
199 Vaksin HBIg ampul 0 - -
200 Efavirenz (EFV) 600mg tablet 0 - -
201 Lamivudine (3TC) 150mg tablet 0 - -
202 Lopinovir/ritonavir (LPV/r) 200/50mg tablet 0 - -
203 Nevirapine (NVP) 200mg tablet 0 - -
204 Tenofovir (TDF) 300mg tablet 0 - -
205 Zidovudine (ZDV)+ Lamivudine (3TC) 300/150mg tablet 0 - -
206 Triple FDC (TDF+3TC+EFV) 300/300/600mg tablet 0 - -
207 Ped Triple FDC(ZDV+3TC+NVP) 60/30/50mg tablet 0 - -
208 Ziduvudin Sirup botol 0 - -
209 Albendazol 400mg tablet 0 - -
210 MDT Combi (MB-Adult) blister 0 - -
211 MDT Combi (MB-Child) blister 0 - -
212 MDT Combi (PB- Adult) blister 0 - -
213 MDT Combi (PB- Child)) blister 0 - -
214 Isoniasid 100 mg tablet 0 - -
215 Isoniazid 300 mg tablet 0 - -
216 Obat Anti Tuberkulose kategori Anak paket 0 - -
217 Obat Anti Tuberkulose kategori I & III paket 0 - -
218 Obat Anti Tuberkulose kategori II paket 0 - -
219 Obat Anti Tuberkulose kombipak paket 0 - -
220 Piridoksin (Vit B6) 25mg tablet 0 - -
221 OAT TB + HIV Intensif paket 0 - -
222 OAT TB + HIV Lanjutan paket 0 - -
223 Sterptomycin sulfat serbuk injeksi 1000mg vial 0 - -
224 Bedaquilin 100 mg tablet 0 - -
225 Ethambutol 400. mg tablet 0 - -
226 Etionamid 250 mg tablet 0 - -
227 Kanamisin injeksi 1000mg vial 0 - -
228 Kapreomisin 1 g injeksi vial 0 - -
229 Klofazimin 100 mg kapsul 0 - -
230 Kloserin 250 mg tablet 0 - -
231 Levofloksasin 250 mg tablet 0 - -
232 Moksifloksasin 400 mg tablet 0 - -
233 P-aminosalisilat sodium 5.52 g sachet 0 - -
234 Linizolid 600 mg capsul 0 - -
235 Pirazinamid 400 mg tablet 0 - -
236 Pirazinamid 500 mg tablet 0 - -
237 Piridoksin 100 mg tablet 0 - -
238 Pil KB komb.I (Levonogestrol 150mg+Etinil Estradiol 3 blister 0 - -
239 Suntik KB 1 bulan (Medoksi 150mg+Estradiol 5mg) vial 0 - -
240 Suntik KB 3 bulan (Medoksiprogesteron Asetat 150mg vial 0 - -
241 Implan KB 3 tahun (Levonogestrol 25mg) pcs 0 - -
242 Dekstro+GG+CTM+Phenyl Syr Botol 0 - -
243 Oxycan botol 0 - -
244 Parasetamol 100mg tablet tablet 0 - -
245 Bisoprolol 5 mg tablet 0 - -
246 candesartan tablet 0 - -
247 Kotrimoxazole 960mg tablet 0 - -
248 Becomzet tablet 0 - -
249 ZEGAVIT tablet 0 - -
250 DANEURON tablet 0 - -
251 Becefort tablet 0 - -
252 Vitamin Ultra C tablet 0 - -
253 Zidovudin 100 mg tablet 0 - -
254 Delanamid 50 mg tablet 0 - -
255 Furosemide inj tablet 0 - -
256 Albendazole syr 200 mg/ml tablet 0 - -
257 Dolutegravir 50 mg tablet 0 - -
258 Triple FDC (TDF+3TC+DTG) 300/300/50mg tablet 0 - -
259 Spironolactone 100 mg tablet 0 - -
260 Acarbose 50 mg tablet 0 - -
261 Ramipril 5 mg tablet 0 - -
262 Valsartan 160 mg tablet 0 - -
263 Ramipril 10 mg tablet 0 - -
264 Adalat Oros 30 mg tablet 0 - -
265 Glikuidone 30 mg tablet 0 - -
266 Levofloksasin 100 mg tablet 0 - -

Mengetahui
PJ Farmasi PKM Cakung

Windi Wikandari, S.Farm., Apt


NIP 19860813211012014
EMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )

LB 2
BULAN JANUARI
TAHUN : 2021

PEMAKAIAN STOK
SISA STOCK PERMINTAAN PEMBERIAN KET.
PEMAKAIAN RETUR ED/RUSAK PENYESUAIAN OPTIMUM
8 9 10 11 12 13 14 15 16

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
2 -2
2 -2
0 0
0 0
0 0
0 0
2 -2
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
2 -2
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0
0
0
0
0
0
0
0
0
0 0
0 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Jakarta, Januari 2021


Yang Membuat Laporan

Tria Annisa, S.Farm., Apt


NIP. 10205819920502199205262
stok opname selisih
17 18

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2 0
2 0
0
0
0
0
2 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
LAPORAN PEMAKAIAN DAN LEMBAR PERMIN
( LPLPO )

PUSKESMAS : KECAMATAN CAKUNG


UNIT : MTBS
KECAMATAN : CAKUNG
KABUPATEN / KODYA : JAKARTA TIMUR
PROVINSI : DKI JAKARTA
PENERIMAAN
NO NAMA OBAT SATUAN STOCK AWAL PERSEDIAAN
GUDANG PENYESUAIAN
1 2 3 4 5 6 7

1 Alopurinol 100mg tablet 0 - -


2 Ambroxol 15mg/5 ml botol 0 - -
3 Aminophillin 200mg tablet 0 - -
4 Aminophillin injeksi 24mg/ml ampul 0 - -
5 Amlodipin 10mg tablet 0 - -
6 Amlodipin 5mg tablet 0 - -
7 Amoksisilin (sirup kering) 125mg/5ml botol 0 - -
8 Amoksisilin (sirup kering) 250mg/5ml botol 0 - -
9 Amoksisilin 500mg tablet 0 - -
10 Ampisilin injeksi (serbuk kering) 250mg vial 0 - -
11 Antasida DOEN (MgSO4+AlOH Tersuspensi) botol 0 - -
12 Antasida DOEN (MgSO4+AlOH) tablet 0 - -
13 Anti Hemoroid DOEN suppos 0 - -
14 Anti Tetanus Serum (ATS) 1500IU ampul 0 - -
15 Aquades pro injeksi @25ml respule 0 - -
16 Asam Askorbat (Vit C) 250mg tablet 0 - -
17 Asam Askorbat (Vit C) 50mg tablet 0 - -
18 Asam Folat 1mg tablet 0 - -
19 Asam Mefenamat 500mg tablet 0 - -
20 Asetosal (Ascardia/Miniaspi) 80mg tablet 0 - -
21 Asiklovir 200mg tablet 0 - -
22 Asiklovir 400mg tablet 0 - -
23 Asiklovir krim 5% tube 0 - -
24 Atropin Sulfas injeksi 0,25mg/ml ampul 0 - -
25 Azitromisin 500 mg tablet 0 - -
26 Bedak salisil serbuk 2% ktk 0 - -
27 Benzatin benzil penicilin serbuk injeksi 2,4juta IU/ml vial 0 - -
28 Betahistin mesilate 6mg tablet 0 - -
29 Betametason krim 0,1% tube 0 - -
30 Bisakodil 5mg tablet 0 - -
31 Budesonide (Cairan inhalasi) 0,25mg/ml respule 0 - -
32 Deksametason 0,5mg tablet 0 - -
33 Deksametason injeksi 5mg/ml ampul 2 - 2
34 Difenhidramin injeksi 10mg/ml ampul 2 - 2
35 Digoksin 0,25mg tablet 0 - -
36 Doksisiklin 100mg kapsul 0 - -
37 Domperidon 10mg tablet 0 - -
38 Domperidon sirup 5mg/5ml botol 0 - -
39 Epinefrin Bitatrat/Adrenalin Injeksi 1mg/ml ampul 2 - 2
40 Eritromisin (sirup kering) 200mg/5ml botol 0 - -
41 Eritromisin 250mg kapsul 0 - -
42 Eritromisin 500mg kapsul 0 - -
43 Fenofibrat 100mg tablet 0 - -
44 Ferro sulfat 15mg/5ml botol 0 - -
45 Fitomenadion (Vit K1) 10mg tablet 0 - -
46 Fitomenadion (Vit.K1) injeksi 2mg/ml ampul 0 - -
47 Flukonazol 150mg kapsul 0 - -
48 Framisetin sulfat kassa steril 1% lembar 0 - -
49 Furosemid 40mg tablet 0 - -
50 Garam Oralit serbuk untuk 200ml sach 3 - 3
51 Gentamisin Salep 0,1% tube 0 - -
52 Gentian Violet larutan 1% botol 0 - -
53 Glibenklamid 5mg tablet 0 - -
54 Glimepirid 1mg tablet 0 - -
55 Gliseril Guaiakolat 100mg tablet 0 - -
56 Glukosa larutan infus 10 % botol 0 - -
57 Glukosa larutan infus 40 % botol 0 - -
58 Glukosa larutan infus 5 % botol 0 - -
59 Griseofulvin 125mg tablet 0 - -
60 Hidroklortiazid 25mg tablet 0 - -
61 Hidrokotison krim 2,5% tube 0 - -
62 Hiosin N Butylbromide 10mg tablet 0 - -
63 Ibuprofen 200mg tablet 0 - -
64 Ikhtamol salep 10% pot 0 - -
65 Isosorbid dinitrat (ISDN) 5mg tablet 0 - -
66 Kalsium glukonat injeksi 10% vial 0 - -
67 Kalsium Laktat 500mg tablet 0 - -
68 Kaptopril 12,5 mg tablet 0 - -
69 Kaptopril 25mg tablet 0 - -
70 Karbo Adsorben (Norit) 125mg tablet 0 - -
71 Karbogliserin (Fenol Gliserol) tetes telinga 10% botol 0 - -
72 Ketokonazol 200mg tablet 0 - -
73 Ketokonazol krim 2% tube 0 - -
74 Ketoprofen 100mg/Supp suppos 0 - -
75 Khlofeniramin Maleat (CTM) 4mg tablet 0 - -
76 Klindamisin 150mg kapsul 0 - -
77 Klopidogrel 75mg tablet 0 - -
78 Kloramfenikol tetes mata 0,5% botol 0 - -
79 Kloramfenikol 250mg kapsul 0 - -
80 Kloramfenikol 500mg kapsul 0 - -
81 Kloramfenikol salep kulit 2% tube 0 - -
82 Kloramfenikol salep mata 1% tube 0 - -
83 Kloramfenikol suspensi 125mg/5ml botol 0 - -
84 Kloramfenikol tetes telinga 3% botol 0 - -
85 Kolkisin 500mg tablet 0 - -
86 Komb.ferro sulfat+as.folat (tablet tambah darah) tablet 0 - -
87 Komb.kaolin 550mg+pektin 20mg tablet 0 - -
88 Kombipak Azitromisin + Cefixim amplop 0 - -
89 Kotrimoksazol 240mg/5 mL botol 0 - -
90 Kotrimoksazol 480mg tablet 0 - -
91 Lactulosa 3,335mg/5ml botol 0 - -
92 Lidokain injeksi 2% ampul 0 - -
93 Lincomisin kapsul 500mg kapsul 0 - -
94 Loratadin 10mg tablet 0 - -
95 Metformin 500mg tablet 0 - -
96 Metil Ergometrin injeksi 0,2mg/ml ampul 0 - -
97 Metil Ergometrin 0,125mg tablet 0 - -
98 Metoklorpropamid 10mg tablet 0 - -
99 Metronidazol 250mg tablet 0 - -
100 Metronidazol 500mg tablet 0 - -
101 MgSO4 injeksi 40% vial 0 - -
102 Mikonazol krim 2% tube 0 - -
103 NaCl larutan infus 0,9% botol 2 - 2
104 N-Asetil Sistein 200mg kapsul 0 - -
105 Natrium Bicarbonat 500mg tablet 0 - -
106 Natrium Diklofenak 25mg tablet 0 - -
107 Natrium Diklofenak 50mg tablet 0 - -
108 Neomisin 0,5% & Plasenta sapi 10% tube 0 - -
109 Nifedipin tablet 10mg tablet 0 - -
110 Nistatin 100.000IU/ml botol 0 - -
111 Nistatin vaginal 100.000IU tablet 0 - -
112 Nitrofurantoin 50mg tablet 0 - -
113 Oksitetrasiklin HCl salep mata 1% tube 0 - -
114 Oksitosin Injeksi 10IU/ml ampul 0 - -
115 Omeprazole 20mg kapsul 0 - -
116 Omeprazole serbuk injeksi 40mg vial 0 - -
117 Pantocain 0,5% botol 0 - -
118 Papaverin 40mg tablet 0 - -
119 Papaverin injeksi 40mg/ml ampul 0 - -
120 Paracetamol supp 125mg suppos 0 - -
121 Parasetamol 100mg/ml botol 0 - -
122 Parasetamol 120mg/5ml botol 3 - 3
123 Parasetamol 500mg tablet 0 - -
124 Perak sufadiazin krim (Burnazin) 1% tube 0 - -
125 Permetrin krim 5% (Scabimied) tube 0 - -
126 Pirantel Pamoat 125mg tablet 0 - -
127 Pirantel Pamoat 125mg/5ml botol 0 - -
128 Piridoxin (Vit B6) 10mg tablet 0 - -
129 Prednison 5mg tablet 0 - -
130 Ranitidin 150mg tablet 0 - -
131 Retinol (Vit A. Biru) 100.000 IU kapsul 0 - -
132 Retinol (Vit A. Merah) 200.000 IU kapsul 0 - -
133 Ringer Laktat larutan Elektrolit infus botol 0 - -
134 Salbutamol 2mg tablet 0 - -
135 Salbutamol 4mg tablet 0 - -
136 Salbutamol cairan iihalasi (Ventolin Nebules) 2,5mg ampul 0 - -
137 Salep 2-4 (As.Salisilat2%+Sulfur4%) pot 0 - -
138 Salep Whitfield/Antifungi (As.Benzoat6%+As.Salisilat pot 0 - -
139 Sefiksim 200mg kapsul 0 - -
140 Setirizine 5mg/5ml botol 0 - -
141 Sianokobalamin (Vit.B12) 50 µg tablet 0 - -
142 Simvastatin 10mg tablet 0 - -
143 Siprofloxasin 500mg tablet 0 - -
144 Tetrasiklin 250mg kapsul 0 - -
145 Tetrasiklin kapsul 500mg kapsul 0 - -
146 Tiamfenikol 500mg kapsul 0 - -
147 Tiamin (Vitamin B1) 100mg tablet 0 - -
148 Tiamin (Vitamin B1) 50mg tablet 0 - -
149 Vitamin B kompleks tablet 0 - -
150 Zink 20mg/5ml botol 0 - -
151 Zink dispersibel 20mg tablet 10 - 10
152 Amitriptilin HCl 25mg tablet 0 - -
153 Anti Migrain DOEN tablet (ergotamin1mg+kafein50mg) tablet 0 - -
154 Diazepam 2mg tablet 0 - -
155 Diazepam 5mg tablet 0 - -
156 Diazepam injeksi 5mg/ml ampul 0 - -
157 Diazepam enema (Stesolid rectal tube) 10mg/2,5ml tube 0 - -
158 Diazepam enema (Stesolid rectal tube) 5mg/2,5ml tube 0 - -
159 Fenobarbital 30mg tablet 0 - -
160 Haloperidol tablet 5mg tablet 0 - -
161 Klorpromazin 100mg tablet 0 - -
162 Risperidon 2mg tablet 0 - -
163 Triheksipenidil 2mg tablet 0 - -
164 Kodein 10mg tablet 0 - -
165 Bahan tumpatan sementara (Cavit/Caviton) set 0 - -
166 Bonding botol 0 - -
167 Celluloid Strip Gigi Pak 0 - -
168 Composit Light Curing (Tambal Sinar ) A2 tube 0 - -
169 Composit Light Curing (Tambal Sinar ) A3 tube 0 - -
170 Composit Light Curing (Tambal Sinar ) A3,5 tube 0 - -
171 Cresophene (cresotin) botol 0 - -
172 Dycal (Dycal/Hydcal) set 0 - -
173 Ecing (Ecing/Ethacant) botol 0 - -
174 Endometason (Endoseal) tube 0 - -
175 Etil Chlorida Spray (Etil Clorida/Endoice) botol 0 - -
176 Eugenol botol 0 - -
177 Formokresol botol 0 - -
178 Glass Ionomert ART (Fuji IX) set 0 - -
179 Kalsium Hidroksida Pasta (Metapex/Calcetin/Vitapex) ktk 0 - -
180 Klorfenol kamfer mentol (CHKM) botol 0 - -
181 Lidocain spray 10% (Xylocaine) botol 0 - -
182 Lidokain 2%+Epinefrin1:80.000 injeksi 2ml (Pehacain) ampul 0 - -
183 Lidokain krim anestesi topical pot 0 - -
184 Pasta devitalisasi non arsen (Depulpin) botol 0 - -
185 Scandonest botol 0 - -
186 Zinc Pospat Cement set 0 - -
187 Tuberkulin protein purified derivative (Mantoux test) vial 0 2 2
188 Vaksin BCG kering + Pelarut vial 0 - -
189 Vaksin HB0 (Hepatitis rekombinan) Dewasa vial 0 - -
190 Vaksin HB0 (Hepatitis rekombinan) vial 0 - -
191 Vaksin HPV vial 0 - -
192 Vaksin Polio Oral + droppler (OPV) vial 0 - -
193 Vaksin jerap difteri tetanus (DT) <7thn vial 0 - -
194 Vaksin jerap tetanus difteri (Td) >7thn vial 0 - -
195 Vaksin kombinasi DPT-HB-Hib vial 0 - -
196 Vaksin Polio injeksi (IPV) vial 0 - -
197 Vaksin Meningitis vial 0 - -
198 Vaksin MR Kering + Pelarut Vial 0 - -
199 Vaksin HBIg ampul 0 - -
200 Efavirenz (EFV) 600mg tablet 0 - -
201 Lamivudine (3TC) 150mg tablet 0 - -
202 Lopinovir/ritonavir (LPV/r) 200/50mg tablet 0 - -
203 Nevirapine (NVP) 200mg tablet 0 - -
204 Tenofovir (TDF) 300mg tablet 0 - -
205 Zidovudine (ZDV)+ Lamivudine (3TC) 300/150mg tablet 0 - -
206 Triple FDC (TDF+3TC+EFV) 300/300/600mg tablet 0 - -
207 Ped Triple FDC(ZDV+3TC+NVP) 60/30/50mg tablet 0 - -
208 Ziduvudin Sirup botol 0 - -
209 Albendazol 400mg tablet 0 - -
210 MDT Combi (MB-Adult) blister 0 - -
211 MDT Combi (MB-Child) blister 0 - -
212 MDT Combi (PB- Adult) blister 0 - -
213 MDT Combi (PB- Child)) blister 0 - -
214 Isoniasid 100 mg tablet 0 - -
215 Isoniazid 300 mg tablet 0 - -
216 Obat Anti Tuberkulose kategori Anak paket 0 - -
217 Obat Anti Tuberkulose kategori I & III paket 0 - -
218 Obat Anti Tuberkulose kategori II paket 0 - -
219 Obat Anti Tuberkulose kombipak paket 0 - -
220 Piridoksin (Vit B6) 25mg tablet 0 - -
221 OAT TB + HIV Intensif paket 0 - -
222 OAT TB + HIV Lanjutan paket 0 - -
223 Sterptomycin sulfat serbuk injeksi 1000mg vial 0 - -
224 Bedaquilin 100 mg tablet 0 - -
225 Ethambutol 400. mg tablet 0 - -
226 Etionamid 250 mg tablet 0 - -
227 Kanamisin injeksi 1000mg vial 0 - -
228 Kapreomisin 1 g injeksi vial 0 - -
229 Klofazimin 100 mg kapsul 0 - -
230 Kloserin 250 mg tablet 0 - -
231 Levofloksasin 250 mg tablet 0 - -
232 Moksifloksasin 400 mg tablet 0 - -
233 P-aminosalisilat sodium 5.52 g sachet 0 - -
234 Linizolid 600 mg capsul 0 - -
235 Pirazinamid 400 mg tablet 0 - -
236 Pirazinamid 500 mg tablet 0 - -
237 Piridoksin 100 mg tablet 0 - -
238 Pil KB komb.I (Levonogestrol 150mg+Etinil Estradiol 3 blister 0 - -
239 Suntik KB 1 bulan (Medoksi 150mg+Estradiol 5mg) vial 0 - -
240 Suntik KB 3 bulan (Medoksiprogesteron Asetat 150mg vial 0 - -
241 Implan KB 3 tahun (Levonogestrol 25mg) pcs 0 - -
242 Dekstro+GG+CTM+Phenyl Syr Botol 0 - -
243 Oxycan botol 0 - -
244 Parasetamol 100mg tablet tablet 0 - -
245 Bisoprolol 5 mg tablet 0 - -
246 candesartan tablet 0 - -
247 Kotrimoxazole 960mg tablet 0 - -
248 Becomzet tablet 0 - -
249 ZEGAVIT tablet 0 - -
250 DANEURON tablet 0 - -
251 Becefort tablet 0 - -
252 Vitamin Ultra C tablet 0 - -
253 Zidovudin 100 mg tablet 0 - -
254 Delanamid 50 mg tablet 0 - -
255 Furosemide inj tablet 0 - -
256 Albendazole syr 200 mg/ml tablet 0 - -
257 Dolutegravir 50 mg tablet 0 - -
258 Triple FDC (TDF+3TC+DTG) 300/300/50mg tablet 0 - -
259 Spironolactone 100 mg tablet 0 - -
260 Acarbose 50 mg tablet 0 - -
261 Ramipril 5 mg tablet 0 - -
262 Valsartan 160 mg tablet 0 - -
263 Ramipril 10 mg tablet 0 - -
264 Adalat Oros 30 mg tablet 0 - -
265 Glikuidone 30 mg tablet 0 - -
266 Levofloksasin 100 mg tablet 0 - -
267 Xylocain Jelly Tube 0 - -
268 Gabapentin tablet 0 - -
269 Rifampentin tablet 0 - -
270 Vitamin C 500 mg tablet 0 - -
271 Sinovac vial 0 - -

Mengetahui
PJ Farmasi PKM Cakung

Windi Wikandari, S.Farm., Apt


NIP 19860813211012014
EMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )

LB 2
BULAN JANUARI
TAHUN 2021

PEMAKAIAN STOK
SISA STOCK PERMINTAAN PEMBERIAN
PEMAKAIAN RETUR ED/RUSAK PENYESUAIAN OPTIMUM
8 9 10 11 12 13 14 15

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
2 -2
2 -2
0 0
0 0
0 0
0 0
2 -2
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
3 -3
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
2 -2
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
3 -3
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
10 -10
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
2 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0
0
0
0
0
0
0
0
0
0 0
0 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Jakarta, Januari 2021


Yang Membuat Laporan

Tria Annisa, S.Farm., Apt


NIP. 10205819920502199205262
KET. stok opname selisih
16 17 18

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2 0
2 0
0
0
0
0
2 0
0
0
0
0
0
0
0
0
0
0
3 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
LAPORAN
LAPORAN

PUSKESMAS : KECAMATAN CAKUNG


UNIT : GIZI
KECAMATAN : CAKUNG
KABUPATEN / KODYA : JAKARTA TIMUR
PROVINSI : DKI JAKARTA
PENERIMAAN
NO NAMA OBAT SATUAN STOCK AWAL
GUDANG
1 2 3 4 5

1 Alopurinol 100mg tablet 0 -


2 Ambroxol 15mg/5 ml botol 0 -
3 Aminophillin 200mg tablet 0 -
4 Aminophillin injeksi 24mg/ml ampul 0 -
5 Amlodipin 10mg tablet 0 -
6 Amlodipin 5mg tablet 0 -
7 Amoksisilin (sirup kering) 125mg/5ml botol 0 -
8 Amoksisilin (sirup kering) 250mg/5ml botol 0 -
9 Amoksisilin 500mg tablet 0 -
10 Ampisilin injeksi (serbuk kering) 250mg vial 0 -
11 Antasida DOEN (MgSO4+AlOH Tersuspensi) botol 0 -
12 Antasida DOEN (MgSO4+AlOH) tablet 0 -
13 Anti Hemoroid DOEN suppos 0 -
14 Anti Tetanus Serum (ATS) 1500IU ampul 0 -
15 Aquades pro injeksi @25ml respule 0 -
16 Asam Askorbat (Vit C) 250mg tablet 0 -
17 Asam Askorbat (Vit C) 50mg tablet 0 -
18 Asam Folat 1mg tablet 0 -
19 Asam Mefenamat 500mg tablet 0 -
20 Asetosal (Ascardia/Miniaspi) 80mg tablet 0 -
21 Asiklovir 200mg tablet 0 -
22 Asiklovir 400mg tablet 0 -
23 Asiklovir krim 5% tube 0 -
24 Atropin Sulfas injeksi 0,25mg/ml ampul 0 -
25 Azitromisin 500 mg tablet 0 -
26 Bedak salisil serbuk 2% ktk 0 -
27 Benzatin benzil penicilin serbuk injeksi 2,4juta IU/ml vial 0 -
28 Betahistin mesilate 6mg tablet 0 -
29 Betametason krim 0,1% tube 0 -
30 Bisakodil 5mg tablet 0 -
31 Budesonide (Cairan inhalasi) 0,25mg/ml respule 0 -
32 Deksametason 0,5mg tablet 0 -
33 Deksametason injeksi 5mg/ml ampul 0 -
34 Difenhidramin injeksi 10mg/ml ampul 0 -
35 Digoksin 0,25mg tablet 0 -
36 Doksisiklin 100mg kapsul 0 -
37 Domperidon 10mg tablet 0 -
38 Domperidon sirup 5mg/5ml botol 0 -
39 Epinefrin Bitatrat/Adrenalin Injeksi 1mg/ml ampul 0 -
40 Eritromisin (sirup kering) 200mg/5ml botol 0 -
41 Eritromisin 250mg kapsul 0 -
42 Eritromisin 500mg kapsul 0 -
43 Fenofibrat 100mg tablet 0 -
44 Ferro sulfat 15mg/5ml botol 0 -
45 Fitomenadion (Vit K1) 10mg tablet 0 -
46 Fitomenadion (Vit.K1) injeksi 2mg/ml ampul 0 -
47 Flukonazol 150mg kapsul 0 -
48 Framisetin sulfat kassa steril 1% lembar 0 -
49 Furosemid 40mg tablet 0 -
50 Garam Oralit serbuk untuk 200ml sach 0 -
51 Gentamisin Salep 0,1% tube 0 -
52 Gentian Violet larutan 1% botol 0 -
53 Glibenklamid 5mg tablet 0 -
54 Glimepirid 1mg tablet 0 -
55 Gliseril Guaiakolat 100mg tablet 0 -
56 Glukosa larutan infus 10 % botol 0 -
57 Glukosa larutan infus 40 % botol 0 -
58 Glukosa larutan infus 5 % botol 0 -
59 Griseofulvin 125mg tablet 0 -
60 Hidroklortiazid 25mg tablet 0 -
61 Hidrokotison krim 2,5% tube 0 -
62 Hiosin N Butylbromide 10mg tablet 0 -
63 Ibuprofen 200mg tablet 0 -
64 Ikhtamol salep 10% pot 0 -
65 Isosorbid dinitrat (ISDN) 5mg tablet 0 -
66 Kalsium glukonat injeksi 10% vial 0 -
67 Kalsium Laktat 500mg tablet 0 -
68 Kaptopril 12,5 mg tablet 0 -
69 Kaptopril 25mg tablet 0 -
70 Karbo Adsorben (Norit) 125mg tablet 0 -
71 Karbogliserin (Fenol Gliserol) tetes telinga 10% botol 0 -
72 Ketokonazol 200mg tablet 0 -
73 Ketokonazol krim 2% tube 0 -
74 Ketoprofen 100mg/Supp suppos 0 -
75 Khlofeniramin Maleat (CTM) 4mg tablet 0 -
76 Klindamisin 150mg kapsul 0 -
77 Klopidogrel 75mg tablet 0 -
78 Kloramfenikol tetes mata 0,5% botol 0 -
79 Kloramfenikol 250mg kapsul 0 -
80 Kloramfenikol 500mg kapsul 0 -
81 Kloramfenikol salep kulit 2% tube 0 -
82 Kloramfenikol salep mata 1% tube 0 -
83 Kloramfenikol suspensi 125mg/5ml botol 0 -
84 Kloramfenikol tetes telinga 3% botol 0 -
85 Kolkisin 500mg tablet 0 -
86 Komb.ferro sulfat+as.folat (tablet tambah darah) tablet 0 -
87 Komb.kaolin 550mg+pektin 20mg tablet 0 -
88 Kombipak Azitromisin + Cefixim amplop 0 -
89 Kotrimoksazol 240mg/5 mL botol 0 -
90 Kotrimoksazol 480mg tablet 0 -
91 Lactulosa 3,335mg/5ml botol 0 -
92 Lidokain injeksi 2% ampul 0 -
93 Lincomisin kapsul 500mg kapsul 0 -
94 Loratadin 10mg tablet 0 -
95 Metformin 500mg tablet 0 -
96 Metil Ergometrin injeksi 0,2mg/ml ampul 0 -
97 Metil Ergometrin 0,125mg tablet 0 -
98 Metoklorpropamid 10mg tablet 0 -
99 Metronidazol 250mg tablet 0 -
100 Metronidazol 500mg tablet 0 -
101 MgSO4 injeksi 40% vial 0 -
102 Mikonazol krim 2% tube 0 -
103 NaCl larutan infus 0,9% botol 0 -
104 N-Asetil Sistein 200mg kapsul 0 -
105 Natrium Bicarbonat 500mg tablet 0 -
106 Natrium Diklofenak 25mg tablet 0 -
107 Natrium Diklofenak 50mg tablet 0 -
108 Neomisin 0,5% & Plasenta sapi 10% tube 0 -
109 Nifedipin tablet 10mg tablet 0 -
110 Nistatin 100.000IU/ml botol 0 -
111 Nistatin vaginal 100.000IU tablet 0 -
112 Nitrofurantoin 50mg tablet 0 -
113 Oksitetrasiklin HCl salep mata 1% tube 0 -
114 Oksitosin Injeksi 10IU/ml ampul 0 -
115 Omeprazole 20mg kapsul 0 -
116 Omeprazole serbuk injeksi 40mg vial 0 -
117 Pantocain 0,5% botol 0 -
118 Papaverin 40mg tablet 0 -
119 Papaverin injeksi 40mg/ml ampul 0 -
120 Paracetamol supp 125mg suppos 0 -
121 Parasetamol 100mg/ml botol 0 -
122 Parasetamol 120mg/5ml botol 0 -
123 Parasetamol 500mg tablet 0 -
124 Perak sufadiazin krim (Burnazin) 1% tube 0 -
125 Permetrin krim 5% (Scabimied) tube 0 -
126 Pirantel Pamoat 125mg tablet 0 -
127 Pirantel Pamoat 125mg/5ml botol 0 -
128 Piridoxin (Vit B6) 10mg tablet 0 -
129 Prednison 5mg tablet 0 -
130 Ranitidin 150mg tablet 0 -
131 Retinol (Vit A. Biru) 100.000 IU kapsul 0 -
132 Retinol (Vit A. Merah) 200.000 IU kapsul 0 -
133 Ringer Laktat larutan Elektrolit infus botol 0 -
134 Salbutamol 2mg tablet 0 -
135 Salbutamol 4mg tablet 0 -
136 Salbutamol cairan iihalasi (Ventolin Nebules) 2,5mg ampul 0 -
137 Salep 2-4 (As.Salisilat2%+Sulfur4%) pot 0 -
138 Salep Whitfield/Antifungi (As.Benzoat6%+As.Salisilat pot 0 -
139 Sefiksim 200mg kapsul 0 -
140 Setirizine 5mg/5ml botol 0 -
141 Sianokobalamin (Vit.B12) 50 µg tablet 0 -
142 Simvastatin 10mg tablet 0 -
143 Siprofloxasin 500mg tablet 0 -
144 Tetrasiklin 250mg kapsul 0 -
145 Tetrasiklin kapsul 500mg kapsul 0 -
146 Tiamfenikol 500mg kapsul 0 -
147 Tiamin (Vitamin B1) 100mg tablet 0 -
148 Tiamin (Vitamin B1) 50mg tablet 0 -
149 Vitamin B kompleks tablet 0 -
150 Zink 20mg/5ml botol 0 -
151 Zink dispersibel 20mg tablet 0 -
152 Amitriptilin HCl 25mg tablet 0 -
153 Anti Migrain DOEN tablet (ergotamin1mg+kafein50mg) tablet 0 -
154 Diazepam 2mg tablet 0 -
155 Diazepam 5mg tablet 0 -
156 Diazepam injeksi 5mg/ml ampul 0 -
157 Diazepam enema (Stesolid rectal tube) 10mg/2,5ml tube 0 -
158 Diazepam enema (Stesolid rectal tube) 5mg/2,5ml tube 0 -
159 Fenobarbital 30mg tablet 0 -
160 Haloperidol tablet 5mg tablet 0 -
161 Klorpromazin 100mg tablet 0 -
162 Risperidon 2mg tablet 0 -
163 Triheksipenidil 2mg tablet 0 -
164 Kodein 10mg tablet 0 -
165 Bahan tumpatan sementara (Cavit/Caviton) set 0 -
166 Bonding botol 0 -
167 Celluloid Strip Gigi Pak 0 -
168 Composit Light Curing (Tambal Sinar ) A2 tube 0 -
169 Composit Light Curing (Tambal Sinar ) A3 tube 0 -
170 Composit Light Curing (Tambal Sinar ) A3,5 tube 0 -
171 Cresophene (cresotin) botol 0 -
172 Dycal (Dycal/Hydcal) set 0 -
173 Ecing (Ecing/Ethacant) botol 0 -
174 Endometason (Endoseal) tube 0 -
175 Etil Chlorida Spray (Etil Clorida/Endoice) botol 0 -
176 Eugenol botol 0 -
177 Formokresol botol 0 -
178 Glass Ionomert ART (Fuji IX) set 0 -
179 Kalsium Hidroksida Pasta (Metapex/Calcetin/Vitapex) ktk 0 -
180 Klorfenol kamfer mentol (CHKM) botol 0 -
181 Lidocain spray 10% (Xylocaine) botol 0 -
182 Lidokain 2%+Epinefrin1:80.000 injeksi 2ml (Pehacain) ampul 0 -
183 Lidokain krim anestesi topical pot 0 -
184 Pasta devitalisasi non arsen (Depulpin) botol 0 -
185 Scandonest botol 0 -
186 Zinc Pospat Cement set 0 -
187 Tuberkulin protein purified derivative (Mantoux test) vial 0 -
188 Vaksin BCG kering + Pelarut vial 0 -
189 Vaksin HB0 (Hepatitis rekombinan) Dewasa vial 0 -
190 Vaksin HB0 (Hepatitis rekombinan) vial 0 -
191 Vaksin HPV vial 0 -
192 Vaksin Polio Oral + droppler (OPV) vial 0 -
193 Vaksin jerap difteri tetanus (DT) <7thn vial 0 -
194 Vaksin jerap tetanus difteri (Td) >7thn vial 0 -
195 Vaksin kombinasi DPT-HB-Hib vial 0 -
196 Vaksin Polio injeksi (IPV) vial 0 -
197 Vaksin Meningitis vial 0 -
198 Vaksin MR Kering + Pelarut Vial 0 -
199 Vaksin HBIg ampul 0 -
200 Efavirenz (EFV) 600mg tablet 0 -
201 Lamivudine (3TC) 150mg tablet 0 -
202 Lopinovir/ritonavir (LPV/r) 200/50mg tablet 0 -
203 Nevirapine (NVP) 200mg tablet 0 -
204 Tenofovir (TDF) 300mg tablet 0 -
205 Zidovudine (ZDV)+ Lamivudine (3TC) 300/150mg tablet 0 -
206 Triple FDC (TDF+3TC+EFV) 300/300/600mg tablet 0 -
207 Ped Triple FDC(ZDV+3TC+NVP) 60/30/50mg tablet 0 -
208 Ziduvudin Sirup botol 0 -
209 Albendazol 400mg tablet 0 -
210 MDT Combi (MB-Adult) blister 0 -
211 MDT Combi (MB-Child) blister 0 -
212 MDT Combi (PB- Adult) blister 0 -
213 MDT Combi (PB- Child)) blister 0 -
214 Isoniasid 100 mg tablet 0 -
215 Isoniazid 300 mg tablet 0 -
216 Obat Anti Tuberkulose kategori Anak paket 0 -
217 Obat Anti Tuberkulose kategori I & III paket 0 -
218 Obat Anti Tuberkulose kategori II paket 0 -
219 Obat Anti Tuberkulose kombipak paket 0 -
220 Piridoksin (Vit B6) 25mg tablet 0 -
221 OAT TB + HIV Intensif paket 0 -
222 OAT TB + HIV Lanjutan paket 0 -
223 Sterptomycin sulfat serbuk injeksi 1000mg vial 0 -
224 Bedaquilin 100 mg tablet 0 -
225 Ethambutol 400. mg tablet 0 -
226 Etionamid 250 mg tablet 0 -
227 Kanamisin injeksi 1000mg vial 0 -
228 Kapreomisin 1 g injeksi vial 0 -
229 Klofazimin 100 mg kapsul 0 -
230 Kloserin 250 mg tablet 0 -
231 Levofloksasin 250 mg tablet 0 -
232 Moksifloksasin 400 mg tablet 0 -
233 P-aminosalisilat sodium 5.52 g sachet 0 -
234 Linizolid 600 mg capsul 0 -
235 Pirazinamid 400 mg tablet 0 -
236 Pirazinamid 500 mg tablet 0 -
237 Piridoksin 100 mg tablet 0 -
238 Pil KB komb.I (Levonogestrol 150mg+Etinil Estradiol 3 blister 0 -
239 Suntik KB 1 bulan (Medoksi 150mg+Estradiol 5mg) vial 0 -
240 Suntik KB 3 bulan (Medoksiprogesteron Asetat 150mg vial 0 -
241 Implan KB 3 tahun (Levonogestrol 25mg) pcs 0 -
242 Dekstro+GG+CTM+Phenyl Syr Botol 0 -
243 Oxycan botol 0 -
244 Parasetamol 100mg tablet tablet 0 -
245 Bisoprolol 5 mg tablet 0 -
246 candesartan tablet 0 -
247 Kotrimoxazole 960mg tablet 0 -
248 Becomzet tablet 0 -
249 ZEGAVIT tablet 0 -
250 DANEURON tablet 0 -
251 Becefort tablet 0 -
252 Vitamin Ultra C tablet 0 -
253 Zidovudin 100 mg tablet 0 -
254 Delanamid 50 mg tablet 0 -
255 Furosemide inj tablet 0 -
256 Albendazole syr 200 mg/ml tablet 0 -
257 Dolutegravir 50 mg tablet 0 -
258 Triple FDC (TDF+3TC+DTG) 300/300/50mg tablet 0 -
259 Spironolactone 100 mg tablet 0 -
260 Acarbose 50 mg tablet 0 -
261 Ramipril 5 mg tablet 0 -
262 Valsartan 160 mg tablet 0 -
263 Ramipril 10 mg tablet 0 -
264 Adalat Oros 30 mg tablet 0 -
265 Glikuidone 30 mg tablet 0 -
266 Levofloksasin 100 mg tablet 0 -
267 Xylocain Jelly Tube 0 -
268 Gabapentin tablet 0 -
269 Rifampentin tablet 0 -
270 Vitamin C 500 mg tablet 0 -
271 Sinovac vial 0 -

Mengetahui
PJ Farmasi PKM Cakung

Windi Wikandari, S.Farm., Apt


NIP 19860813211012014
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )

PENERIMAAN PEMAKAIAN
PERSEDIAAN
PENYESUAIAN PEMAKAIAN RETUR ED/RUSAK PENYESUAIAN
6 7 8 9 10 11

-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-

Jakarta, Januari 2021


Yang Membuat Laporan

Tria Annisa, S.Farm., Apt


NIP. 10205819920502199205262
LB 2
BULAN : JANUARI
TAHUN : 2021

STOK
SISA STOCK PERMINTAAN PEMBERIAN KET. stok opname selisih
OPTIMUM
12 13 14 15 16 17 18

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

Januari 2021
mbuat Laporan

a, S.Farm., Apt
9920502199205262
LAPORAN PEMAKAIAN DAN LEMBAR PERMINT
( LPLPO )

PUSKESMAS : KECAMATAN CAKUNG


UNIT : LAB
KECAMATAN : CAKUNG
KABUPATEN / KODYA : JAKARTA TIMUR
PROVINSI : DKI JAKARTA
PENERIMAAN
NO NAMA OBAT SATUAN STOCK AWAL PERSEDIAAN
GUDANG PENYESUAIAN
1 2 3 4 5 6 7

1 Alopurinol 100mg tablet 0 - -


2 Ambroxol 15mg/5 ml botol 0 - -
3 Aminophillin 200mg tablet 0 - -
4 Aminophillin injeksi 24mg/ml ampul 0 - -
5 Amlodipin 10mg tablet 0 - -
6 Amlodipin 5mg tablet 0 - -
7 Amoksisilin (sirup kering) 125mg/5ml botol 0 - -
8 Amoksisilin (sirup kering) 250mg/5ml botol 0 - -
9 Amoksisilin 500mg tablet 0 - -
10 Ampisilin injeksi (serbuk kering) 250mg vial 0 - -
11 Antasida DOEN (MgSO4+AlOH Tersuspensi) botol 0 - -
12 Antasida DOEN (MgSO4+AlOH) tablet 0 - -
13 Anti Hemoroid DOEN suppos 0 - -
14 Anti Tetanus Serum (ATS) 1500IU ampul 0 - -
15 Aquades pro injeksi @25ml respule 0 - -
16 Asam Askorbat (Vit C) 250mg tablet 0 - -
17 Asam Askorbat (Vit C) 50mg tablet 0 - -
18 Asam Folat 1mg tablet 0 - -
19 Asam Mefenamat 500mg tablet 0 - -
20 Asetosal (Ascardia/Miniaspi) 80mg tablet 0 - -
21 Asiklovir 200mg tablet 0 - -
22 Asiklovir 400mg tablet 0 - -
23 Asiklovir krim 5% tube 0 - -
24 Atropin Sulfas injeksi 0,25mg/ml ampul 0 - -
25 Azitromisin 500 mg tablet 0 - -
26 Bedak salisil serbuk 2% ktk 0 - -
27 Benzatin benzil penicilin serbuk injeksi 2,4juta IU/ml vial 0 - -
28 Betahistin mesilate 6mg tablet 0 - -
29 Betametason krim 0,1% tube 0 - -
30 Bisakodil 5mg tablet 0 - -
31 Budesonide (Cairan inhalasi) 0,25mg/ml respule 0 - -
32 Deksametason 0,5mg tablet 0 - -
33 Deksametason injeksi 5mg/ml ampul 0 - -
34 Difenhidramin injeksi 10mg/ml ampul 0 - -
35 Digoksin 0,25mg tablet 0 - -
36 Doksisiklin 100mg kapsul 0 - -
37 Domperidon 10mg tablet 0 - -
38 Domperidon sirup 5mg/5ml botol 0 - -
39 Epinefrin Bitatrat/Adrenalin Injeksi 1mg/ml ampul 0 - -
40 Eritromisin (sirup kering) 200mg/5ml botol 0 - -
41 Eritromisin 250mg kapsul 0 - -
42 Eritromisin 500mg kapsul 0 - -
43 Fenofibrat 100mg tablet 0 - -
44 Ferro sulfat 15mg/5ml botol 0 - -
45 Fitomenadion (Vit K1) 10mg tablet 0 - -
46 Fitomenadion (Vit.K1) injeksi 2mg/ml ampul 0 - -
47 Flukonazol 150mg kapsul 0 - -
48 Framisetin sulfat kassa steril 1% lembar 0 - -
49 Furosemid 40mg tablet 0 - -
50 Garam Oralit serbuk untuk 200ml sach 0 - -
51 Gentamisin Salep 0,1% tube 0 - -
52 Gentian Violet larutan 1% botol 0 - -
53 Glibenklamid 5mg tablet 0 - -
54 Glimepirid 1mg tablet 0 - -
55 Gliseril Guaiakolat 100mg tablet 0 - -
56 Glukosa larutan infus 10 % botol 0 - -
57 Glukosa larutan infus 40 % botol 0 - -
58 Glukosa larutan infus 5 % botol 0 - -
59 Griseofulvin 125mg tablet 0 - -
60 Hidroklortiazid 25mg tablet 0 - -
61 Hidrokotison krim 2,5% tube 0 - -
62 Hiosin N Butylbromide 10mg tablet 0 - -
63 Ibuprofen 200mg tablet 0 - -
64 Ikhtamol salep 10% pot 0 - -
65 Isosorbid dinitrat (ISDN) 5mg tablet 0 - -
66 Kalsium glukonat injeksi 10% vial 0 - -
67 Kalsium Laktat 500mg tablet 0 - -
68 Kaptopril 12,5 mg tablet 0 - -
69 Kaptopril 25mg tablet 0 - -
70 Karbo Adsorben (Norit) 125mg tablet 0 - -
71 Karbogliserin (Fenol Gliserol) tetes telinga 10% botol 0 - -
72 Ketokonazol 200mg tablet 0 - -
73 Ketokonazol krim 2% tube 0 - -
74 Ketoprofen 100mg/Supp suppos 0 - -
75 Khlofeniramin Maleat (CTM) 4mg tablet 0 - -
76 Klindamisin 150mg kapsul 0 - -
77 Klopidogrel 75mg tablet 0 - -
78 Kloramfenikol tetes mata 0,5% botol 0 - -
79 Kloramfenikol 250mg kapsul 0 - -
80 Kloramfenikol 500mg kapsul 0 - -
81 Kloramfenikol salep kulit 2% tube 0 - -
82 Kloramfenikol salep mata 1% tube 0 - -
83 Kloramfenikol suspensi 125mg/5ml botol 0 - -
84 Kloramfenikol tetes telinga 3% botol 0 - -
85 Kolkisin 500mg tablet 0 - -
86 Komb.ferro sulfat+as.folat (tablet tambah darah) tablet 0 - -
87 Komb.kaolin 550mg+pektin 20mg tablet 0 - -
88 Kombipak Azitromisin + Cefixim amplop 0 - -
89 Kotrimoksazol 240mg/5 mL botol 0 - -
90 Kotrimoksazol 480mg tablet 0 - -
91 Lactulosa 3,335mg/5ml botol 0 - -
92 Lidokain injeksi 2% ampul 0 - -
93 Lincomisin kapsul 500mg kapsul 0 - -
94 Loratadin 10mg tablet 0 - -
95 Metformin 500mg tablet 0 - -
96 Metil Ergometrin injeksi 0,2mg/ml ampul 0 - -
97 Metil Ergometrin 0,125mg tablet 0 - -
98 Metoklorpropamid 10mg tablet 0 - -
99 Metronidazol 250mg tablet 0 - -
100 Metronidazol 500mg tablet 0 - -
101 MgSO4 injeksi 40% vial 0 - -
102 Mikonazol krim 2% tube 0 - -
103 NaCl larutan infus 0,9% botol 0 - -
104 N-Asetil Sistein 200mg kapsul 0 - -
105 Natrium Bicarbonat 500mg tablet 0 - -
106 Natrium Diklofenak 25mg tablet 0 - -
107 Natrium Diklofenak 50mg tablet 0 - -
108 Neomisin 0,5% & Plasenta sapi 10% tube 0 - -
109 Nifedipin tablet 10mg tablet 0 - -
110 Nistatin 100.000IU/ml botol 0 - -
111 Nistatin vaginal 100.000IU tablet 0 - -
112 Nitrofurantoin 50mg tablet 0 - -
113 Oksitetrasiklin HCl salep mata 1% tube 0 - -
114 Oksitosin Injeksi 10IU/ml ampul 0 - -
115 Omeprazole 20mg kapsul 0 - -
116 Omeprazole serbuk injeksi 40mg vial 0 - -
117 Pantocain 0,5% botol 0 - -
118 Papaverin 40mg tablet 0 - -
119 Papaverin injeksi 40mg/ml ampul 0 - -
120 Paracetamol supp 125mg suppos 0 - -
121 Parasetamol 100mg/ml botol 0 - -
122 Parasetamol 120mg/5ml botol 0 - -
123 Parasetamol 500mg tablet 0 - -
124 Perak sufadiazin krim (Burnazin) 1% tube 0 - -
125 Permetrin krim 5% (Scabimied) tube 0 - -
126 Pirantel Pamoat 125mg tablet 0 - -
127 Pirantel Pamoat 125mg/5ml botol 0 - -
128 Piridoxin (Vit B6) 10mg tablet 0 - -
129 Prednison 5mg tablet 0 - -
130 Ranitidin 150mg tablet 0 - -
131 Retinol (Vit A. Biru) 100.000 IU kapsul 0 - -
132 Retinol (Vit A. Merah) 200.000 IU kapsul 0 - -
133 Ringer Laktat larutan Elektrolit infus botol 0 - -
134 Salbutamol 2mg tablet 0 - -
135 Salbutamol 4mg tablet 0 - -
136 Salbutamol cairan iihalasi (Ventolin Nebules) 2,5mg ampul 0 - -
137 Salep 2-4 (As.Salisilat2%+Sulfur4%) pot 0 - -
138 Salep Whitfield/Antifungi (As.Benzoat6%+As.Salisilat pot 0 - -
139 Sefiksim 200mg kapsul 0 - -
140 Setirizine 5mg/5ml botol 0 - -
141 Sianokobalamin (Vit.B12) 50 µg tablet 0 - -
142 Simvastatin 10mg tablet 0 - -
143 Siprofloxasin 500mg tablet 0 - -
144 Tetrasiklin 250mg kapsul 0 - -
145 Tetrasiklin kapsul 500mg kapsul 0 - -
146 Tiamfenikol 500mg kapsul 0 - -
147 Tiamin (Vitamin B1) 100mg tablet 0 - -
148 Tiamin (Vitamin B1) 50mg tablet 0 - -
149 Vitamin B kompleks tablet 0 - -
150 Zink 20mg/5ml botol 0 - -
151 Zink dispersibel 20mg tablet 0 - -
152 Amitriptilin HCl 25mg tablet 0 - -
153 Anti Migrain DOEN tablet (ergotamin1mg+kafein50mg) tablet 0 - -
154 Diazepam 2mg tablet 0 - -
155 Diazepam 5mg tablet 0 - -
156 Diazepam injeksi 5mg/ml ampul 0 - -
157 Diazepam enema (Stesolid rectal tube) 10mg/2,5ml tube 0 - -
158 Diazepam enema (Stesolid rectal tube) 5mg/2,5ml tube 0 - -
159 Fenobarbital 30mg tablet 0 - -
160 Haloperidol tablet 5mg tablet 0 - -
161 Klorpromazin 100mg tablet 0 - -
162 Risperidon 2mg tablet 0 - -
163 Triheksipenidil 2mg tablet 0 - -
164 Kodein 10mg tablet 0 - -
165 Bahan tumpatan sementara (Cavit/Caviton) set 0 - -
166 Bonding botol 0 - -
167 Celluloid Strip Gigi Pak 0 - -
168 Composit Light Curing (Tambal Sinar ) A2 tube 0 - -
169 Composit Light Curing (Tambal Sinar ) A3 tube 0 - -
170 Composit Light Curing (Tambal Sinar ) A3,5 tube 0 - -
171 Cresophene (cresotin) botol 0 - -
172 Dycal (Dycal/Hydcal) set 0 - -
173 Ecing (Ecing/Ethacant) botol 0 - -
174 Endometason (Endoseal) tube 0 - -
175 Etil Chlorida Spray (Etil Clorida/Endoice) botol 0 - -
176 Eugenol botol 0 - -
177 Formokresol botol 0 - -
178 Glass Ionomert ART (Fuji IX) set 0 - -
179 Kalsium Hidroksida Pasta (Metapex/Calcetin/Vitapex) ktk 0 - -
180 Klorfenol kamfer mentol (CHKM) botol 0 - -
181 Lidocain spray 10% (Xylocaine) botol 0 - -
182 Lidokain 2%+Epinefrin1:80.000 injeksi 2ml (Pehacain) ampul 0 - -
183 Lidokain krim anestesi topical pot 0 - -
184 Pasta devitalisasi non arsen (Depulpin) botol 0 - -
185 Scandonest botol 0 - -
186 Zinc Pospat Cement set 0 - -
187 Tuberkulin protein purified derivative (Mantoux test) vial 0 - -
188 Vaksin BCG kering + Pelarut vial 0 - -
189 Vaksin HB0 (Hepatitis rekombinan) Dewasa vial 0 - -
190 Vaksin HB0 (Hepatitis rekombinan) vial 0 - -
191 Vaksin HPV vial 0 - -
192 Vaksin Polio Oral + droppler (OPV) vial 0 - -
193 Vaksin jerap difteri tetanus (DT) <7thn vial 0 - -
194 Vaksin jerap tetanus difteri (Td) >7thn vial 0 - -
195 Vaksin kombinasi DPT-HB-Hib vial 0 - -
196 Vaksin Polio injeksi (IPV) vial 0 - -
197 Vaksin Meningitis vial 0 - -
198 Vaksin MR Kering + Pelarut Vial 0 - -
199 Vaksin HBIg ampul 0 - -
200 Efavirenz (EFV) 600mg tablet 0 - -
201 Lamivudine (3TC) 150mg tablet 0 - -
202 Lopinovir/ritonavir (LPV/r) 200/50mg tablet 0 - -
203 Nevirapine (NVP) 200mg tablet 0 - -
204 Tenofovir (TDF) 300mg tablet 0 - -
205 Zidovudine (ZDV)+ Lamivudine (3TC) 300/150mg tablet 0 - -
206 Triple FDC (TDF+3TC+EFV) 300/300/600mg tablet 0 - -
207 Ped Triple FDC(ZDV+3TC+NVP) 60/30/50mg tablet 0 - -
208 Ziduvudin Sirup botol 0 - -
209 Albendazol 400mg tablet 0 - -
210 MDT Combi (MB-Adult) blister 0 - -
211 MDT Combi (MB-Child) blister 0 - -
212 MDT Combi (PB- Adult) blister 0 - -
213 MDT Combi (PB- Child)) blister 0 - -
214 Isoniasid 100 mg tablet 0 - -
215 Isoniazid 300 mg tablet 0 - -
216 Obat Anti Tuberkulose kategori Anak paket 0 - -
217 Obat Anti Tuberkulose kategori I & III paket 0 - -
218 Obat Anti Tuberkulose kategori II paket 0 - -
219 Obat Anti Tuberkulose kombipak paket 0 - -
220 Piridoksin (Vit B6) 25mg tablet 0 - -
221 OAT TB + HIV Intensif paket 0 - -
222 OAT TB + HIV Lanjutan paket 0 - -
223 Sterptomycin sulfat serbuk injeksi 1000mg vial 0 - -
224 Bedaquilin 100 mg tablet 0 - -
225 Ethambutol 400. mg tablet 0 - -
226 Etionamid 250 mg tablet 0 - -
227 Kanamisin injeksi 1000mg vial 0 - -
228 Kapreomisin 1 g injeksi vial 0 - -
229 Klofazimin 100 mg kapsul 0 - -
230 Kloserin 250 mg tablet 0 - -
231 Levofloksasin 250 mg tablet 0 - -
232 Moksifloksasin 400 mg tablet 0 - -
233 P-aminosalisilat sodium 5.52 g sachet 0 - -
234 Linizolid 600 mg capsul 0 - -
235 Pirazinamid 400 mg tablet 0 - -
236 Pirazinamid 500 mg tablet 0 - -
237 Piridoksin 100 mg tablet 0 - -
238 Pil KB komb.I (Levonogestrol 150mg+Etinil Estradiol 3 blister 0 - -
239 Suntik KB 1 bulan (Medoksi 150mg+Estradiol 5mg) vial 0 - -
240 Suntik KB 3 bulan (Medoksiprogesteron Asetat 150mg vial 0 - -
241 Implan KB 3 tahun (Levonogestrol 25mg) pcs 0 - -
242 Dekstro+GG+CTM+Phenyl Syr Botol 0 - -
243 Oxycan botol 0 - -
244 Parasetamol 100mg tablet tablet 0 - -
245 Bisoprolol 5 mg tablet 0 - -
246 candesartan tablet 0 - -
247 Kotrimoxazole 960mg tablet 0 - -
248 Becomzet tablet 0 - -
249 ZEGAVIT tablet 0 - -
250 DANEURON tablet 0 - -
251 Becefort tablet 0 - -
252 Vitamin Ultra C tablet 0 - -
253 Zidovudin 100 mg tablet 0 - -
254 Delanamid 50 mg tablet 0 - -
255 Furosemide inj tablet 0 - -
256 Albendazole syr 200 mg/ml tablet 0 - -
257 Dolutegravir 50 mg tablet 0 - -
258 Triple FDC (TDF+3TC+DTG) 300/300/50mg tablet 0 - -
259 Spironolactone 100 mg tablet 0 - -
260 Acarbose 50 mg tablet 0 - -
261 Ramipril 5 mg tablet 0 - -
262 Valsartan 160 mg tablet 0 - -
263 Ramipril 10 mg tablet 0 - -
264 Adalat Oros 30 mg tablet 0 - -
265 Glikuidone 30 mg tablet 0 - -
266 Levofloksasin 100 mg tablet 0 - -
267 Xylocain Jelly Tube 0 - -
268 Gabapentin tablet 0 - -
269 Rifampentin tablet 0 - -
270 Vitamin C 500 mg tablet 0 - -
271 Sinovac vial 0 - -
0
Mengetahui
PJ Farmasi PKM Cakung

Windi Wikandari, S.Farm., Apt


NIP 19860813211012014
EMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )

LB 2
BULAN : JANUARI
TAHUN : 2021

PEMAKAIAN STOK
SISA STOCK PERMINTAAN PEMBERIAN KET.
PEMAKAIAN RETUR ED/RUSAK PENYESUAIAN OPTIMUM
8 9 10 11 12 13 14 15 16

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0
0
0
0
0
0
0
0
0
0 0
0 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Jakarta, Januari 2021


Yang Membuat Laporan

Tria Annisa, S.Farm., Apt


NIP. 10205819920502199205262
stok opname selisih
17 18

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
LAPO

PUSKESMAS : KECAMATAN CAKUNG


UNIT : KARYAWAN
KECAMATAN : CAKUNG
KABUPATEN / KODYA : JAKARTA TIMUR
PROVINSI : DKI JAKARTA
STOCK PENERIMAAN
NO NAMA OBAT SATUAN
AWAL GUDANG
1 2 3 4 5

1 Alopurinol 100mg tablet 0 -


2 Ambroxol 15mg/5 ml botol 0 -
3 Aminophillin 200mg tablet 0 -
4 Aminophillin injeksi 24mg/ml ampul 0 -
5 Amlodipin 10mg tablet 0 -
6 Amlodipin 5mg tablet 0 -
7 Amoksisilin (sirup kering) 125mg/5ml botol 0 -
8 Amoksisilin (sirup kering) 250mg/5ml botol 0 -
9 Amoksisilin 500mg tablet 0 -
10 Ampisilin injeksi (serbuk kering) 250mg vial 0 -
11 Antasida DOEN (MgSO4+AlOH Tersuspensi) botol 0 -
12 Antasida DOEN (MgSO4+AlOH) tablet 0 -
13 Anti Hemoroid DOEN suppos 0 -
14 Anti Tetanus Serum (ATS) 1500IU ampul 0 -
15 Aquades pro injeksi @25ml respule 0 -
16 Asam Askorbat (Vit C) 250mg tablet 0 500
17 Asam Askorbat (Vit C) 50mg tablet 0 -
18 Asam Folat 1mg tablet 0 -
19 Asam Mefenamat 500mg tablet 0 -
20 Asetosal (Ascardia/Miniaspi) 80mg tablet 0 -
21 Asiklovir 200mg tablet 0 -
22 Asiklovir 400mg tablet 0 -
23 Asiklovir krim 5% tube 0 -
24 Atropin Sulfas injeksi 0,25mg/ml ampul 0 -
25 Azitromisin 500 mg tablet 0 -
26 Bedak salisil serbuk 2% ktk 0 -
27 Benzatin benzil penicilin serbuk injeksi 2,4juta IU/ml vial 0 -
28 Betahistin mesilate 6mg tablet 0 -
29 Betametason krim 0,1% tube 0 -
30 Bisakodil 5mg tablet 0 -
31 Budesonide (Cairan inhalasi) 0,25mg/ml respule 0 -
32 Deksametason 0,5mg tablet 0 -
33 Deksametason injeksi 5mg/ml ampul 0 -
34 Difenhidramin injeksi 10mg/ml ampul 0 -
35 Digoksin 0,25mg tablet 0 -
36 Doksisiklin 100mg kapsul 0 -
37 Domperidon 10mg tablet 0 -
38 Domperidon sirup 5mg/5ml botol 0 -
39 Epinefrin Bitatrat/Adrenalin Injeksi 1mg/ml ampul 0 -
40 Eritromisin (sirup kering) 200mg/5ml botol 0 -
41 Eritromisin 250mg kapsul 0 -
42 Eritromisin 500mg kapsul 0 -
43 Fenofibrat 100mg tablet 0 -
44 Ferro sulfat 15mg/5ml botol 0 -
45 Fitomenadion (Vit K1) 10mg tablet 0 -
46 Fitomenadion (Vit.K1) injeksi 2mg/ml ampul 0 -
47 Flukonazol 150mg kapsul 0 -
48 Framisetin sulfat kassa steril 1% lembar 0 -
49 Furosemid 40mg tablet 0 -
50 Garam Oralit serbuk untuk 200ml sach 0 -
51 Gentamisin Salep 0,1% tube 0 -
52 Gentian Violet larutan 1% botol 0 -
53 Glibenklamid 5mg tablet 0 -
54 Glimepirid 1mg tablet 0 -
55 Gliseril Guaiakolat 100mg tablet 0 -
56 Glukosa larutan infus 10 % botol 0 -
57 Glukosa larutan infus 40 % botol 0 -
58 Glukosa larutan infus 5 % botol 0 -
59 Griseofulvin 125mg tablet 0 -
60 Hidroklortiazid 25mg tablet 0 -
61 Hidrokotison krim 2,5% tube 0 -
62 Hiosin N Butylbromide 10mg tablet 0 -
63 Ibuprofen 200mg tablet 0 -
64 Ikhtamol salep 10% pot 0 -
65 Isosorbid dinitrat (ISDN) 5mg tablet 0 -
66 Kalsium glukonat injeksi 10% vial 0 -
67 Kalsium Laktat 500mg tablet 0 -
68 Kaptopril 12,5 mg tablet 0 -
69 Kaptopril 25mg tablet 0 -
70 Karbo Adsorben (Norit) 125mg tablet 0 -
71 Karbogliserin (Fenol Gliserol) tetes telinga 10% botol 0 -
72 Ketokonazol 200mg tablet 0 -
73 Ketokonazol krim 2% tube 0 -
74 Ketoprofen 100mg/Supp suppos 0 -
75 Khlofeniramin Maleat (CTM) 4mg tablet 0 -
76 Klindamisin 150mg kapsul 0 -
77 Klopidogrel 75mg tablet 0 -
78 Kloramfenikol tetes mata 0,5% botol 0 -
79 Kloramfenikol 250mg kapsul 0 -
80 Kloramfenikol 500mg kapsul 0 -
81 Kloramfenikol salep kulit 2% tube 0 -
82 Kloramfenikol salep mata 1% tube 0 -
83 Kloramfenikol suspensi 125mg/5ml botol 0 -
84 Kloramfenikol tetes telinga 3% botol 0 -
85 Kolkisin 500mg tablet 0 -
86 Komb.ferro sulfat+as.folat (tablet tambah darah) tablet 0 -
87 Komb.kaolin 550mg+pektin 20mg tablet 0 -
88 Kombipak Azitromisin + Cefixim amplop 0 -
89 Kotrimoksazol 240mg/5 mL botol 0 -
90 Kotrimoksazol 480mg tablet 0 -
91 Lactulosa 3,335mg/5ml botol 0 -
92 Lidokain injeksi 2% ampul 0 -
93 Lincomisin kapsul 500mg kapsul 0 -
94 Loratadin 10mg tablet 0 -
95 Metformin 500mg tablet 0 -
96 Metil Ergometrin injeksi 0,2mg/ml ampul 0 -
97 Metil Ergometrin 0,125mg tablet 0 -
98 Metoklorpropamid 10mg tablet 0 -
99 Metronidazol 250mg tablet 0 -
100 Metronidazol 500mg tablet 0 -
101 MgSO4 injeksi 40% vial 0 -
102 Mikonazol krim 2% tube 0 -
103 NaCl larutan infus 0,9% botol 0 -
104 N-Asetil Sistein 200mg kapsul 0 -
105 Natrium Bicarbonat 500mg tablet 0 -
106 Natrium Diklofenak 25mg tablet 0 -
107 Natrium Diklofenak 50mg tablet 0 -
108 Neomisin 0,5% & Plasenta sapi 10% tube 0 -
109 Nifedipin tablet 10mg tablet 0 -
110 Nistatin 100.000IU/ml botol 0 -
111 Nistatin vaginal 100.000IU tablet 0 -
112 Nitrofurantoin 50mg tablet 0 -
113 Oksitetrasiklin HCl salep mata 1% tube 0 -
114 Oksitosin Injeksi 10IU/ml ampul 0 -
115 Omeprazole 20mg kapsul 0 -
116 Omeprazole serbuk injeksi 40mg vial 0 -
117 Pantocain 0,5% botol 0 -
118 Papaverin 40mg tablet 0 -
119 Papaverin injeksi 40mg/ml ampul 0 -
120 Paracetamol supp 125mg suppos 0 -
121 Parasetamol 100mg/ml botol 0 -
122 Parasetamol 120mg/5ml botol 0 -
123 Parasetamol 500mg tablet 0 -
124 Perak sufadiazin krim (Burnazin) 1% tube 0 -
125 Permetrin krim 5% (Scabimied) tube 0 -
126 Pirantel Pamoat 125mg tablet 0 -
127 Pirantel Pamoat 125mg/5ml botol 0 -
128 Piridoxin (Vit B6) 10mg tablet 0 -
129 Prednison 5mg tablet 0 -
130 Ranitidin 150mg tablet 0 -
131 Retinol (Vit A. Biru) 100.000 IU kapsul 0 -
132 Retinol (Vit A. Merah) 200.000 IU kapsul 0 -
133 Ringer Laktat larutan Elektrolit infus botol 0 -
134 Salbutamol 2mg tablet 0 -
135 Salbutamol 4mg tablet 0 -
136 Salbutamol cairan iihalasi (Ventolin Nebules) 2,5mg ampul 0 -
137 Salep 2-4 (As.Salisilat2%+Sulfur4%) pot 0 -
138 Salep Whitfield/Antifungi (As.Benzoat6%+As.Salisilat pot 0 -
139 Sefiksim 200mg kapsul 0 -
140 Setirizine 5mg/5ml botol 0 -
141 Sianokobalamin (Vit.B12) 50 µg tablet 0 -
142 Simvastatin 10mg tablet 0 -
143 Siprofloxasin 500mg tablet 0 -
144 Tetrasiklin 250mg kapsul 0 -
145 Tetrasiklin kapsul 500mg kapsul 0 -
146 Tiamfenikol 500mg kapsul 0 -
147 Tiamin (Vitamin B1) 100mg tablet 0 -
148 Tiamin (Vitamin B1) 50mg tablet 0 -
149 Vitamin B kompleks tablet 0 -
150 Zink 20mg/5ml botol 0 -
151 Zink dispersibel 20mg tablet 0 -
152 Amitriptilin HCl 25mg tablet 0 -
153 Anti Migrain DOEN tablet (ergotamin1mg+kafein50mg tablet 0 -
154 Diazepam 2mg tablet 0 -
155 Diazepam 5mg tablet 0 -
156 Diazepam injeksi 5mg/ml ampul 0 -
157 Diazepam enema (Stesolid rectal tube) 10mg/2,5ml tube 0 -
158 Diazepam enema (Stesolid rectal tube) 5mg/2,5ml tube 0 -
159 Fenobarbital 30mg tablet 0 -
160 Haloperidol tablet 5mg tablet 0 -
161 Klorpromazin 100mg tablet 0 -
162 Risperidon 2mg tablet 0 -
163 Triheksipenidil 2mg tablet 0 -
164 Kodein 10mg tablet 0 -
165 Bahan tumpatan sementara (Cavit/Caviton) set 0 -
166 Bonding botol 0 -
167 Celluloid Strip Gigi Pak 0 -
168 Composit Light Curing (Tambal Sinar ) A2 tube 0 -
169 Composit Light Curing (Tambal Sinar ) A3 tube 0 -
170 Composit Light Curing (Tambal Sinar ) A3,5 tube 0 -
171 Cresophene (cresotin) botol 0 -
172 Dycal (Dycal/Hydcal) set 0 -
173 Ecing (Ecing/Ethacant) botol 0 -
174 Endometason (Endoseal) tube 0 -
175 Etil Chlorida Spray (Etil Clorida/Endoice) botol 0 -
176 Eugenol botol 0 -
177 Formokresol botol 0 -
178 Glass Ionomert ART (Fuji IX) set 0 -
179 Kalsium Hidroksida Pasta (Metapex/Calcetin/Vitapex) ktk 0 -
180 Klorfenol kamfer mentol (CHKM) botol 0 -
181 Lidocain spray 10% (Xylocaine) botol 0 -
182 Lidokain 2%+Epinefrin1:80.000 injeksi 2ml (Pehacain) ampul 0 -
183 Lidokain krim anestesi topical pot 0 -
184 Pasta devitalisasi non arsen (Depulpin) botol 0 -
185 Scandonest botol 0 -
186 Zinc Pospat Cement set 0 -
187 Tuberkulin protein purified derivative (Mantoux test) vial 0 -
188 Vaksin BCG kering + Pelarut vial 0 -
189 Vaksin HB0 (Hepatitis rekombinan) Dewasa vial 0 -
190 Vaksin HB0 (Hepatitis rekombinan) vial 0 -
191 Vaksin HPV vial 0 -
192 Vaksin Polio Oral + droppler (OPV) vial 0 -
193 Vaksin jerap difteri tetanus (DT) <7thn vial 0 -
194 Vaksin jerap tetanus difteri (Td) >7thn vial 0 -
195 Vaksin kombinasi DPT-HB-Hib vial 0 -
196 Vaksin Polio injeksi (IPV) vial 0 -
197 Vaksin Meningitis vial 0 -
198 Vaksin MR Kering + Pelarut Vial 0 -
199 Vaksin HBIg ampul 0 -
200 Efavirenz (EFV) 600mg tablet 0 -
201 Lamivudine (3TC) 150mg tablet 0 -
202 Lopinovir/ritonavir (LPV/r) 200/50mg tablet 0 -
203 Nevirapine (NVP) 200mg tablet 0 -
204 Tenofovir (TDF) 300mg tablet 0 -
205 Zidovudine (ZDV)+ Lamivudine (3TC) 300/150mg tablet 0 -
206 Triple FDC (TDF+3TC+EFV) 300/300/600mg tablet 0 -
207 Ped Triple FDC(ZDV+3TC+NVP) 60/30/50mg tablet 0 -
208 Ziduvudin Sirup botol 0 -
209 Albendazol 400mg tablet 0 -
210 MDT Combi (MB-Adult) blister 0 -
211 MDT Combi (MB-Child) blister 0 -
212 MDT Combi (PB- Adult) blister 0 -
213 MDT Combi (PB- Child)) blister 0 -
214 Isoniasid 100 mg tablet 0 -
215 Isoniazid 300 mg tablet 0 -
216 Obat Anti Tuberkulose kategori Anak paket 0 -
217 Obat Anti Tuberkulose kategori I & III paket 0 -
218 Obat Anti Tuberkulose kategori II paket 0 -
219 Obat Anti Tuberkulose kombipak paket 0 -
220 Piridoksin (Vit B6) 25mg tablet 0 -
221 OAT TB + HIV Intensif paket 0 -
222 OAT TB + HIV Lanjutan paket 0 -
223 Sterptomycin sulfat serbuk injeksi 1000mg vial 0 -
224 Bedaquilin 100 mg tablet 0 -
225 Ethambutol 400. mg tablet 0 -
226 Etionamid 250 mg tablet 0 -
227 Kanamisin injeksi 1000mg vial 0 -
228 Kapreomisin 1 g injeksi vial 0 -
229 Klofazimin 100 mg kapsul 0 -
230 Kloserin 250 mg tablet 0 -
231 Levofloksasin 250 mg tablet 0 -
232 Moksifloksasin 400 mg tablet 0 -
233 P-aminosalisilat sodium 5.52 g sachet 0 -
234 Linizolid 600 mg capsul 0 -
235 Pirazinamid 400 mg tablet 0 -
236 Pirazinamid 500 mg tablet 0 -
237 Piridoksin 100 mg tablet 0 -
238 Pil KB komb.I (Levonogestrol 150mg+Etinil Estradiol blister 0 -
239 Suntik KB 1 bulan (Medoksi 150mg+Estradiol 5mg) vial 0 -
240 Suntik KB 3 bulan (Medoksiprogesteron Asetat 150mg vial 0 -
241 Implan KB 3 tahun (Levonogestrol 25mg) pcs 0 -
242 Dekstro+GG+CTM+Phenyl Syr Botol 0 -
243 Oxycan botol 0 -
244 Parasetamol 100mg tablet tablet 0 -
245 Bisoprolol 5 mg tablet 0 -
246 candesartan tablet 0 -
247 Kotrimoxazole 960mg tablet 0 -
248 Becomzet tablet 0 -
249 ZEGAVIT tablet 0 -
250 DANEURON tablet 0 -
251 Becefort tablet 0 -
252 Vitamin Ultra C tablet 0 -
253 Zidovudin 100 mg tablet 0 -
254 Delanamid 50 mg tablet 0 -
255 Furosemide inj tablet 0 -
256 Albendazole syr 200 mg/ml tablet 0 -
257 Dolutegravir 50 mg tablet 0 -
258 Triple FDC (TDF+3TC+DTG) 300/300/50mg tablet 0 -
259 Spironolactone 100 mg tablet 0 -
260 Acarbose 50 mg tablet 0 -
261 Ramipril 5 mg tablet 0 -
262 Valsartan 160 mg tablet 0 -
263 Ramipril 10 mg tablet 0 -
264 Adalat Oros 30 mg tablet 0 -
265 Glikuidone 30 mg tablet 0 -
266 Levofloksasin 100 mg tablet 0 -
267 Xylocain Jelly Tube 0 -
268 Gabapentin tablet 0 -
269 Rifampentin tablet 0 -
270 Vitamin C 500 mg tablet 0 3,388
271 Sinovac vial 0 -
0
Mengetahui
PJ Farmasi PKM Cakung

Windi Wikandari, S.Farm., Apt


NIP 19860813211012014
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )

PENERIMAAN PEMAKAIAN
PERSEDIAAN
PENYESUAIAN PEMAKAIAN RETUR ED/RUSAK PENYESUAIAN
6 7 8 9 10 11

-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
500 500
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
3,388 3388
-

Jakarta, Januari 2021


Yang Membuat Laporan

Tria Annisa, S.Farm., Apt


NIP. 10205819920502199205262
LB 2
BULAN : JANUARI
TAHUN : 2021

SISA STOCK STOK OPTIMUM PERMINTAAN PEMBERIAN KET. stok opname

12 13 14 15 16 17

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 1500
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0
0
0
0
0
0
0
0
0
0 0
0 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Januari 2021
mbuat Laporan

a, S.Farm., Apt
9920502199205262
selisih

18

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
LAPO

PUSKESMAS : KECAMATAN CAKUNG


UNIT : GUDANG
KECAMATAN : CAKUNG
KABUPATEN / KODYA : JAKARTA TIMUR
PROVINSI : DKI JAKARTA
PENERIMAAN
NO NAMA OBAT SATUAN STOCK AWAL
GUDANG
1 2 3 4 5

1 Alopurinol 100mg tablet 0 -


2 Ambroxol 15mg/5 ml botol 0 -
3 Aminophillin 200mg tablet 0 -
4 Aminophillin injeksi 24mg/ml ampul 0 -
5 Amlodipin 10mg tablet 0 -
6 Amlodipin 5mg tablet 0 -
7 Amoksisilin (sirup kering) 125mg/5ml botol 0 -
8 Amoksisilin (sirup kering) 250mg/5ml botol 0 -
9 Amoksisilin 500mg tablet 0 -
10 Ampisilin injeksi (serbuk kering) 250mg vial 0 -
11 Antasida DOEN (MgSO4+AlOH Tersuspensi) botol 0 -
12 Antasida DOEN (MgSO4+AlOH) tablet 0 -
13 Anti Hemoroid DOEN suppos 0 -
14 Anti Tetanus Serum (ATS) 1500IU ampul 0 -
15 Aquades pro injeksi @25ml respule 0 -
16 Asam Askorbat (Vit C) 250mg tablet 0 -
17 Asam Askorbat (Vit C) 50mg tablet 0 -
18 Asam Folat 1mg tablet 0 -
19 Asam Mefenamat 500mg tablet 0 -
20 Asetosal (Ascardia/Miniaspi) 80mg tablet 0 -
21 Asiklovir 200mg tablet 0 -
22 Asiklovir 400mg tablet 0 -
23 Asiklovir krim 5% tube 0 -
24 Atropin Sulfas injeksi 0,25mg/ml ampul 0 -
25 Azitromisin 500 mg tablet 0 -
26 Bedak salisil serbuk 2% ktk 0 -
27 Benzatin benzil penicilin serbuk injeksi 2,4juta IU/ vial 0 -
28 Betahistin mesilate 6mg tablet 0 -
29 Betametason krim 0,1% tube 0 -
30 Bisakodil 5mg tablet 0 -
31 Budesonide (Cairan inhalasi) 0,25mg/ml respule 0 -
32 Deksametason 0,5mg tablet 0 -
33 Deksametason injeksi 5mg/ml ampul 0 -
34 Difenhidramin injeksi 10mg/ml ampul 0 6
35 Digoksin 0,25mg tablet 0 -
36 Doksisiklin 100mg kapsul 0 -
37 Domperidon 10mg tablet 0 -
38 Domperidon sirup 5mg/5ml botol 0 -
39 Epinefrin Bitatrat/Adrenalin Injeksi 1mg/ml ampul 0 -
40 Eritromisin (sirup kering) 200mg/5ml botol 0 -
41 Eritromisin 250mg kapsul 0 -
42 Eritromisin 500mg kapsul 0 -
43 Fenofibrat 100mg tablet 0 -
44 Ferro sulfat 15mg/5ml botol 0 -
45 Fitomenadion (Vit K1) 10mg tablet 0 -
46 Fitomenadion (Vit.K1) injeksi 2mg/ml ampul 0 -
47 Flukonazol 150mg kapsul 0 -
48 Framisetin sulfat kassa steril 1% lembar 0 -
49 Furosemid 40mg tablet 0 -
50 Garam Oralit serbuk untuk 200ml sach 0 -
51 Gentamisin Salep 0,1% tube 0 -
52 Gentian Violet larutan 1% botol 0 -
53 Glibenklamid 5mg tablet 0 -
54 Glimepirid 1mg tablet 0 -
55 Gliseril Guaiakolat 100mg tablet 0 -
56 Glukosa larutan infus 10 % botol 0 -
57 Glukosa larutan infus 40 % botol 0 -
58 Glukosa larutan infus 5 % botol 0 -
59 Griseofulvin 125mg tablet 0 -
60 Hidroklortiazid 25mg tablet 0 -
61 Hidrokotison krim 2,5% tube 0 -
62 Hiosin N Butylbromide 10mg tablet 0 -
63 Ibuprofen 200mg tablet 0 -
64 Ikhtamol salep 10% pot 0 -
65 Isosorbid dinitrat (ISDN) 5mg tablet 0 -
66 Kalsium glukonat injeksi 10% vial 0 -
67 Kalsium Laktat 500mg tablet 0 -
68 Kaptopril 12,5 mg tablet 0 -
69 Kaptopril 25mg tablet 0 -
70 Karbo Adsorben (Norit) 125mg tablet 0 -
71 Karbogliserin (Fenol Gliserol) tetes telinga 10% botol 0 -
72 Ketokonazol 200mg tablet 0 -
73 Ketokonazol krim 2% tube 0 -
74 Ketoprofen 100mg/Supp suppos 0 1
75 Khlofeniramin Maleat (CTM) 4mg tablet 0 -
76 Klindamisin 150mg kapsul 0 -
77 Klopidogrel 75mg tablet 0 -
78 Kloramfenikol tetes mata 0,5% botol 0 -
79 Kloramfenikol 250mg kapsul 0 -
80 Kloramfenikol 500mg kapsul 0 -
81 Kloramfenikol salep kulit 2% tube 0 -
82 Kloramfenikol salep mata 1% tube 0 -
83 Kloramfenikol suspensi 125mg/5ml botol 0 -
84 Kloramfenikol tetes telinga 3% botol 0 -
85 Kolkisin 500mg tablet 0 -
86 Komb.ferro sulfat+as.folat (tablet tambah darah) tablet 0 -
87 Komb.kaolin 550mg+pektin 20mg tablet 0 -
88 Kombipak Azitromisin + Cefixim amplop 0 -
89 Kotrimoksazol 240mg/5 mL botol 0 -
90 Kotrimoksazol 480mg tablet 0 -
91 Lactulosa 3,335mg/5ml botol 0 -
92 Lidokain injeksi 2% ampul 0 -
93 Lincomisin kapsul 500mg kapsul 0 -
94 Loratadin 10mg tablet 0 -
95 Metformin 500mg tablet 0 -
96 Metil Ergometrin injeksi 0,2mg/ml ampul 0 -
97 Metil Ergometrin 0,125mg tablet 0 -
98 Metoklorpropamid 10mg tablet 0 -
99 Metronidazol 250mg tablet 0 -
100 Metronidazol 500mg tablet 0 -
101 MgSO4 injeksi 40% vial 0 -
102 Mikonazol krim 2% tube 0 -
103 NaCl larutan infus 0,9% botol 0 -
104 N-Asetil Sistein 200mg kapsul 0 -
105 Natrium Bicarbonat 500mg tablet 0 -
106 Natrium Diklofenak 25mg tablet 0 -
107 Natrium Diklofenak 50mg tablet 0 -
108 Neomisin 0,5% & Plasenta sapi 10% tube 0 -
109 Nifedipin tablet 10mg tablet 0 -
110 Nistatin 100.000IU/ml botol 0 -
111 Nistatin vaginal 100.000IU tablet 0 -
112 Nitrofurantoin 50mg tablet 0 -
113 Oksitetrasiklin HCl salep mata 1% tube 0 -
114 Oksitosin Injeksi 10IU/ml ampul 0 -
115 Omeprazole 20mg kapsul 0 -
116 Omeprazole serbuk injeksi 40mg vial 0 -
117 Pantocain 0,5% botol 0 -
118 Papaverin 40mg tablet 0 -
119 Papaverin injeksi 40mg/ml ampul 0 -
120 Paracetamol supp 125mg suppos 0 -
121 Parasetamol 100mg/ml botol 0 -
122 Parasetamol 120mg/5ml botol 0 -
123 Parasetamol 500mg tablet 0 -
124 Perak sufadiazin krim (Burnazin) 1% tube 0 -
125 Permetrin krim 5% (Scabimied) tube 0 -
126 Pirantel Pamoat 125mg tablet 0 -
127 Pirantel Pamoat 125mg/5ml botol 0 -
128 Piridoxin (Vit B6) 10mg tablet 0 -
129 Prednison 5mg tablet 0 -
130 Ranitidin 150mg tablet 0 -
131 Retinol (Vit A. Biru) 100.000 IU kapsul 0 -
132 Retinol (Vit A. Merah) 200.000 IU kapsul 0 -
133 Ringer Laktat larutan Elektrolit infus botol 0 -
134 Salbutamol 2mg tablet 0 -
135 Salbutamol 4mg tablet 0 -
136 Salbutamol cairan iihalasi (Ventolin Nebules) 2,5 ampul 0 -
137 Salep 2-4 (As.Salisilat2%+Sulfur4%) pot 0 -
138 Salep Whitfield/Antifungi (As.Benzoat6%+As.Salis pot 0 -
139 Sefiksim 200mg kapsul 0 -
140 Setirizine 5mg/5ml botol 0 -
141 Sianokobalamin (Vit.B12) 50 µg tablet 0 -
142 Simvastatin 10mg tablet 0 -
143 Siprofloxasin 500mg tablet 0 -
144 Tetrasiklin 250mg kapsul 0 -
145 Tetrasiklin kapsul 500mg kapsul 0 -
146 Tiamfenikol 500mg kapsul 0 -
147 Tiamin (Vitamin B1) 100mg tablet 0 -
148 Tiamin (Vitamin B1) 50mg tablet 0 -
149 Vitamin B kompleks tablet 0 -
150 Zink 20mg/5ml botol 0 -
151 Zink dispersibel 20mg tablet 0 -
152 Amitriptilin HCl 25mg tablet 0 -
153 Anti Migrain DOEN tablet (ergotamin1mg+kafein5 tablet 0 -
154 Diazepam 2mg tablet 0 -
155 Diazepam 5mg tablet 0 -
156 Diazepam injeksi 5mg/ml ampul 0 -
157 Diazepam enema (Stesolid rectal tube) 10mg/2,5m tube 0 -
158 Diazepam enema (Stesolid rectal tube) 5mg/2,5ml tube 0 -
159 Fenobarbital 30mg tablet 0 -
160 Haloperidol tablet 5mg tablet 0 -
161 Klorpromazin 100mg tablet 0 -
162 Risperidon 2mg tablet 0 -
163 Triheksipenidil 2mg tablet 0 -
164 Kodein 10mg tablet 0 -
165 Bahan tumpatan sementara (Cavit/Caviton) set 0 -
166 Bonding botol 0 -
167 Celluloid Strip Gigi Pak 0 -
168 Composit Light Curing (Tambal Sinar ) A2 tube 0 -
169 Composit Light Curing (Tambal Sinar ) A3 tube 0 -
170 Composit Light Curing (Tambal Sinar ) A3,5 tube 0 -
171 Cresophene (cresotin) botol 0 -
172 Dycal (Dycal/Hydcal) set 0 -
173 Ecing (Ecing/Ethacant) botol 0 -
174 Endometason (Endoseal) tube 0 -
175 Etil Chlorida Spray (Etil Clorida/Endoice) botol 0 -
176 Eugenol botol 0 -
177 Formokresol botol 0 -
178 Glass Ionomert ART (Fuji IX) set 0 -
179 Kalsium Hidroksida Pasta (Metapex/Calcetin/Vitap ktk 0 -
180 Klorfenol kamfer mentol (CHKM) botol 0 -
181 Lidocain spray 10% (Xylocaine) botol 0 -
182 Lidokain 2%+Epinefrin1:80.000 injeksi 2ml (Pehac ampul 0 -
183 Lidokain krim anestesi topical pot 0 -
184 Pasta devitalisasi non arsen (Depulpin) botol 0 -
185 Scandonest botol 0 -
186 Zinc Pospat Cement set 0 -
187 Tuberkulin protein purified derivative (Mantoux tes vial 0 -
188 Vaksin BCG kering + Pelarut vial 0 -
189 Vaksin HB0 (Hepatitis rekombinan) Dewasa vial 0 -
190 Vaksin HB0 (Hepatitis rekombinan) vial 0 -
191 Vaksin HPV vial 0 -
192 Vaksin Polio Oral + droppler (OPV) vial 0 -
193 Vaksin jerap difteri tetanus (DT) <7thn vial 0 -
194 Vaksin jerap tetanus difteri (Td) >7thn vial 0 -
195 Vaksin kombinasi DPT-HB-Hib vial 0 -
196 Vaksin Polio injeksi (IPV) vial 0 -
197 Vaksin Meningitis vial 0 -
198 Vaksin MR Kering + Pelarut Vial 0 -
199 Vaksin HBIg ampul 0 -
200 Efavirenz (EFV) 600mg tablet 0 -
201 Lamivudine (3TC) 150mg tablet 0 -
202 Lopinovir/ritonavir (LPV/r) 200/50mg tablet 0 -
203 Nevirapine (NVP) 200mg tablet 0 -
204 Tenofovir (TDF) 300mg tablet 0 -
205 Zidovudine (ZDV)+ Lamivudine (3TC) 300/150mg tablet 0 -
206 Triple FDC (TDF+3TC+EFV) 300/300/600mg tablet 0 -
207 Ped Triple FDC(ZDV+3TC+NVP) 60/30/50mg tablet 0 -
208 Ziduvudin Sirup botol 0 -
209 Albendazol 400mg tablet 0 -
210 MDT Combi (MB-Adult) blister 0 -
211 MDT Combi (MB-Child) blister 0 -
212 MDT Combi (PB- Adult) blister 0 -
213 MDT Combi (PB- Child)) blister 0 -
214 Isoniasid 100 mg tablet 0 -
215 Isoniazid 300 mg tablet 0 -
216 Obat Anti Tuberkulose kategori Anak paket 0 -
217 Obat Anti Tuberkulose kategori I & III paket 0 -
218 Obat Anti Tuberkulose kategori II paket 0 -
219 Obat Anti Tuberkulose kombipak paket 0 -
220 Piridoksin (Vit B6) 25mg tablet 0 -
221 OAT TB + HIV Intensif paket 0 -
222 OAT TB + HIV Lanjutan paket 0 -
223 Sterptomycin sulfat serbuk injeksi 1000mg vial 0 -
224 Bedaquilin 100 mg tablet 0 -
225 Ethambutol 400. mg tablet 0 -
226 Etionamid 250 mg tablet 0 -
227 Kanamisin injeksi 1000mg vial 0 -
228 Kapreomisin 1 g injeksi vial 0 -
229 Klofazimin 100 mg kapsul 0 -
230 Kloserin 250 mg tablet 0 -
231 Levofloksasin 250 mg tablet 0 -
232 Moksifloksasin 400 mg tablet 0 -
233 P-aminosalisilat sodium 5.52 g sachet 0 -
234 Linizolid 600 mg capsul 0 -
235 Pirazinamid 400 mg tablet 0 -
236 Pirazinamid 500 mg tablet 0 -
237 Piridoksin 100 mg tablet 0 -
238 Pil KB komb.I (Levonogestrol 150mg+Etinil Estrad blister 0 -
239 Suntik KB 1 bulan (Medoksi 150mg+Estradiol 5mg vial 0 -
240 Suntik KB 3 bulan (Medoksiprogesteron Asetat 1 vial 0 -
241 Implan KB 3 tahun (Levonogestrol 25mg) pcs 0 -
242 Dekstro+GG+CTM+Phenyl Syr Botol 0 -
243 Oxycan botol 0 -
244 Parasetamol 100mg tablet tablet 0 -
245 Bisoprolol 5 mg tablet 0 -
246 candesartan tablet 0 -
247 Kotrimoxazole 960mg tablet 0 -
248 Becomzet tablet 0 -
249 ZEGAVIT tablet 0 -
250 DANEURON tablet 0 -
251 Becefort tablet 0 -
252 Vitamin Ultra C tablet 0 -
253 Zidovudin 100 mg tablet 0 -
254 Delanamid 50 mg tablet 0 -
255 Furosemide inj tablet 0 -
256 Albendazole syr 200 mg/ml tablet 0 -
257 Dolutegravir 50 mg tablet 0 -
258 Triple FDC (TDF+3TC+DTG) 300/300/50mg tablet 0 -
259 Spironolactone 100 mg tablet 0 -
260 Acarbose 50 mg tablet 0 -
261 Ramipril 5 mg tablet 0 -
262 Valsartan 160 mg tablet 0 -
263 Ramipril 10 mg tablet 0 -
264 Adalat Oros 30 mg tablet 0 -
265 Glikuidone 30 mg tablet 0 -
266 Levofloksasin 100 mg tablet 0 -
267 Xylocain Jelly Tube 0 -
268 Gabapentin tablet 0 -
269 Rifampentin tablet 0 -
270 Vitamin C 500 mg tablet 0 -
271 Sinovac vial 0 -
0
Mengetahui
PJ Farmasi PKM Cakung

Windi Wikandari, S.Farm., Apt


NIP 19860813211012014
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )

PENERIMAAN PEMAKAIAN
PERSEDIAAN
PENYESUAIAN PEMAKAIAN RETUR ED/RUSAK PENYESUAIAN
6 7 8 9 10 11

-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
6 6
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
1 1
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-

Jakarta, Januari 2021


Yang Membuat Laporan

Tria Annisa, S.Farm., Apt


NIP. 10205819920502199205262
LB 2
BULAN : JANUARI
TAHUN : 2021

SISA STOCK STOK OPTIMUM PERMINTAAN PEMBERIAN KET. stok opname selisih

12 13 14 15 16 17 18

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 18 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 3 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

Januari 2021
mbuat Laporan

a, S.Farm., Apt
9920502199205262
UKP 6. LPLPO

Kode Puskesmas : P3172080101 Bulan 12


Puskesmas Kecamatan Cakung Tahun 2019
Jumlah Pustu : 0 Jumlah Pustu Lapor 0
Jumlah Poskesdes :0 Jumlah Poskesdes Lapor 0

No Obat ID Nama Obat Satuan Stok Awal Penerimaan


1 10 Kloramfenikol Suspensi 125 ml/5 ml Botol 40 0
2 11 Kloramfenikol Salep Mata 1% Tube 83 48
3 12 Kloramfenikol Salep Kulit 2% Tube 183 288
4 13 Kloramfenikol Kapsul 500 mg Kapsul 0 0
4 14 Kloramfenikol Kapsul 250 mg Kapsul 200 500
5 15 Klindamisin kapsul 300 mg Kapsul 0 0
6 16 Klindamisin kapsul 150 mg Kapsul 857 0
7 17 Khlofeniramin Maleat (CTM) tablet 4 mg Tablet 12190 10000
8 18 Ketokonazol Tablet 200 mg Tablet 699 0
9 19 Ketokonazol krim Tube 71 35
10 20 Karbon Aktif Tablet 250 mg (Norit) Tablet 0 0
10 21 Karbogliserin Tetes Telinga 10% (Fenol Gliserol) Botol 49 48
12 24 kaptopril tablet 25 mg Tablet 1005 1000
13 25 kaptopril tablet 12,5 mg Tablet 714 1000
14 26 Kanamisin Inj 1g Vial 0 0
14 27 Kalsium Laktat Tablet 500 mg Tablet 6634 10000
15 28 Kalsium Hidroksida Pasta Gigi (Metapex) Kotak 1 2
16 29 Kalsium glukonat inj. 10% Ampul 1 0
17 30 IUD Copper T Buah 0 0
17 32 isoniasid tablet 100 mg Tablet 350 500
18 33 Ikhtamol Salep (Salep Hitam) Pot 14 0
19 36 Hiosin N Butylbromide Tablet 10 mg Tablet 722 0
20 38 Hidroklortiazid tablet 25 mg Tablet 341 0
21 39 Hidrogen Peroxyda 3% 100 cc Botol 0 0
21 40 Haloperidol Tablet 5 mg Botol 1241 1000
22 47 MDT Combi (MB-Adult) PCS 18 36
23 48 MDT Combi (MB-Child) PCS 9 0
24 49 MDT Combi (PB-Adult) PCS 6 0
25 52 MgSO4 inj. 40% Vial 24 0
26 53 Nistatin Suspension Oral Botol 37 0
27 58 Pasta devitalisasi (non arsen) Botol 3 0
28 59 Perak sufadiazin krim (Burnazin) Tube 17 0
29 60 Pil KB Kombinasi I PCS 175 0
30 61 Pirantel suspensi 125 mg/5 ml Botol 0 0
30 62 Pirazinamide tablet 500mg Tablet 0 140
31 67 Suntik KB 1 bulan Vial 19 0
32 68 Suntik KB 3 bulan Vial 45 0
33 69 Susuk KB 3 tahun (KB Implan II) UNIT 20 0
34 70 TKF (Trikresol Formalin) Botol 0 0
34 71 Tuberkulin protein purified derivative (Mantoux te Vial 2 10
35 72 Vaksin BCG Vial 14 0
36 76 Vaksin jerap difteri tetanus (DT) > 7 thn Vial 17 40
37 77 Vaksin jerap difteri tetanus pertusis (DTP) Vial 0 0
37 78 Vaksin Kombinasi DPT-HB-Hib Vial 5 20
38 79 Vaksin Polio IPV Vial 10 0
39 80 Vaksin TT Vial 0 0
39 81 Zinc Pospat Cement SET 4 0
40 82 ZDV 300 mg (Zidovudine) +3TC 150 mg (Lamivudine) Tablet 1651 360
41 83 NVP 200 mg (Nevirapine) Tablet 1324 300
42 84 EFV 600 mg (Efavirenz) Tablet 907 330
43 85 3TC 150 mg (Lamivudine) Tablet 2460 0
44 86 TDF 300mg (Tenofovir Disoproxil Fumarate) Tablet 1246 0
45 87 FDC ARV Paed ZDV 60mg (Zidovudine)+3TC 30mg (Lamiv Tablet 300 0
46 88 FDC ARV TDF 300mg (Tenofovir Disoproxil Fumarate)+ Tablet 0 0
46 89 N-asetil sistein 200 mg Tablet 693 0
47 90 Permetrin krim 5% Tube 18 3
48 1 Albendazol tablet 400 mg Tablet 43 0
49 2 Alopurinol tablet 100 mg Tablet 372 500
50 26 Salep Whitfield ( Salep Antifungi) Pot 0 0
50 3 Ambroxol sirup 15 mg/ 5 mL Botol 155 0
51 33 Asiklovir tablet 200 mg Tablet 0 0
51 34 Asiklovir tablet 400 mg Tablet 872 3000
52 5 Aminophillin 200 mg tablet Tablet 102 0
53 7 Amitriptilin HCl tablet 25 mg Tablet 541 0
54 78 Furosemid tablet 40 mg Tablet 0 0
54 8 Amlodipin tablet 5 mg Tablet 6552 7200
55 80 Garam Oralit 200ml Pak 0 0
55 94 Hidrokortison 2,5 % krim Tube 30 208
56 95 Ibuprofen tablet 200 mg Tablet 1518 400
57 96 Ibuprofen tablet 400 mg Tablet 0 0
58 99 Isosorbid Dinitrat Tablet 5 mg Tablet 370 0
59 10 Amoksisilin 125mg / 5ml sirup Kering Botol 0 0
59 100 Simetidin 200 mg Tablet 0 0
59 1001 Albendazol 400mg Tablet 43 0
60 1002 Alopurinol 100mg Tablet 372 500
61 1003 Aminophillin 200mg Tablet 102 0
62 1004 Aminophillin injeksi 24mg/ml Ampul 0 0
62 1005 Amitriptilin HCl 25mg Tablet 541 0
63 1006 Amlodipin 10mg Tablet 5768 8700
64 1007 Amlodipin 5mg Tablet 6552 7200
65 1008 Amoksisilin (sirup kering) 125mg/5ml Botol 159 200
66 1009 Amoksisilin (sirup kering) 250mg/5ml Botol 90 60
67 1010 Amoksisilin 500mg Tablet 9205 12500
68 1011 Ampisilin injeksi (serbuk kering) 250mg Vial 3 0
69 1012 Antasida DOEN (MgSO4+AlOH Tersuspensi) Botol 57 50
70 1013 Antasida DOEN (MgSO4+AlOH) Tablet 11672 0
71 1014 Anti Hemoroid DOEN Suppositoria 140 0
72 1015 Anti Migrain DOEN tablet (ergotamin1mg+kafein50mg) Tablet 0 0
72 1016 Anti Tetanus Serum (ATS) 1500IU Ampul 5 2
73 1017 Asam Askorbat (Vit C) 250mg Tablet 716 1000
74 1018 Asam Askorbat (Vit C) 50mg Tablet 8485 7000
75 1019 Asam Mefenamat 500mg Tablet 2700 10100
76 1020 Asetosal (Ascardia/Miniaspi) 80mg Tablet 267 0
77 1021 Asiklovir 200mg Tablet 1248 1000
78 1022 Asiklovir 400mg Tablet 872 3000
79 1023 Atropin Sulfas injeksi 0,25mg/ml Ampul 5 2
80 1024 Bahan tumpatan sementara (Cavit/Caviton) Sachet 4 2
81 1025 Bedak salisil serbuk 2% Kotak 144 60
82 1026 Bedaquilin 100 mg Tablet 20 0
83 1027 Benzatin benzil penicilin serbuk injeksi 2,4juta IU/ml Vial 21 10
85 1028 Bisakodil 5mg Tablet 13 60
86 1029 Bonding Botol 2 0
87 1030 Composit Light Curing (Tambal Sinar ) A2 Tube 4 0
88 1031 Composit Light Curing (Tambal Sinar ) A3 Tube 2 2
89 1032 Composit Light Curing (Tambal Sinar ) A3,5 Tube 4 0
90 1033 Cresophene (cresotin) Botol 4 0
91 1034 Deksametason 0,5mg Tablet 8802 10000
92 1035 Deksametason injeksi 5mg/ml Ampul 26 20
93 1036 Diazepam 2mg Tablet 260 17
94 1037 Diazepam 5mg Tablet 311 0
95 1038 Diazepam enema (Stesolid rectal tube) 10mg/2,5ml Tube 14 0
96 1039 Diazepam enema (Stesolid rectal tube) 5mg/2,5ml Tube 9 0
97 1040 Diazepam injeksi 5mg/ml Ampul 4 0
98 1041 Difenhidramin injeksi 10mg/ml Ampul 21 10
99 1042 Digoksin 0,25mg Tablet 157 0
100 1043 Doksisiklin 100mg Kapsul 218 0
101 1044 Domperidon 10mg Tablet 1688 1000
102 1045 Domperidon sirup 5mg/5ml Botol 64 150
103 1046 Dycal (Dycal/Hydcal) Sachet 1 0
104 1047 Ecing (Ecing/Ethacant) Botol 3 0
105 1048 Efavirenz (EFV) 600mg Tablet 907 330
106 1049 Endometason (Endoseal) Tube 0 0
106 1050 Epinefrin Bitatrat/Adrenalin Injeksi 1mg/ml Ampul 24 20
107 1051 Eritromisin (sirup kering) 200mg/5ml Botol 0 0
107 1052 Eritromisin 250mg Kapsul 453 500
108 1053 Eritromisin 500mg Kapsul 0 0
108 1054 Ethambutol 400. mg Tablet 0 1126
109 1055 Etil Chlorida Spray (Etil Clorida/Endoice) Botol 5 5
110 1056 Etionamid 250 mg Tablet 0 933
111 1057 Eugenol Botol 3 0
112 1058 Fenobarbital 30mg Tablet 100 0
113 1059 Ferro sulfat 15mg/5ml Botol 16 10
114 1060 Fitomenadion (Vit K1) 10mg Tablet 331 0
115 1061 Formokresol Botol 0 0
115 1062 Furosemid 40mg Tablet 230 0
116 1063 Garam Oralit serbuk untuk 200ml Sachet 1776 0
117 1064 Gentian Violet larutan 1% Botol 53 0
118 1065 Glass Ionomert ART (Fuji IX) Sachet 3 6
119 1066 Glibenklamid 5mg Tablet 1628 2000
120 1067 Glimepirid 1mg Tablet 323 800
121 1068 Glukosa larutan infus 10 % Botol 6 0
122 1071 Griseofulvin 125mg Tablet 684 0
123 1072 Haloperidol tablet 5mg Tablet 1241 1000
124 1073 Hidroklortiazid 25mg Tablet 341 0
125 1074 Hidrokotison krim 2,5% Tube 30 208
126 1075 Hiosin N Butylbromide 10mg Tablet 722 0
127 1076 Ibuprofen 200mg Tablet 1518 400
128 1077 Ikhtamol salep 10% Paket 14 0
129 1078 Implan KB 3 tahun (Levonogestrol 25mg) Paket 20 0
130 1079 Isoniasid 100 mg Tablet 350 500
131 1080 Isoniazid 300 mg Tablet 1526 100
132 1081 Isosorbid dinitrat (ISDN) 5mg Tablet 370 0
133 1082 Kalsium glukonat injeksi 10% Vial 1 0
134 1083 Kalsium Hidroksida Pasta (Metapex/Calcetin/Vitapex) Kotak 1 2
135 1084 Kalsium Laktat 500mg Tablet 6334 10000
136 1085 Kanamisin injeksi 1000mg Vial 0 0
136 1086 Kanamisin injeksi 1000mg Vial 0 127
137 1087 Kapreomisin 1 g injeksi Tablet 0 37
138 1088 Kaptopril 12,5mg Tablet 714 1000
139 1089 Kaptopril 25mg Tablet 1005 1000
140 1090 Karbo Adsorben (Norit) 125mg Tablet 0 0
140 1091 Karbogliserin (Fenol Gliserol) tetes telinga 10% Botol 49 48
141 1092 Ketokonazol 200mg Tablet 699 0
142 1093 Ketokonazol krim 2% Tube 71 35
143 1094 Khlofeniramin Maleat (CTM) 4mg Tablet 12190 10000
144 1095 Klindamisin 300mg Kapsul 857 0
145 1096 Klofazimin 100 mg Tablet 0 70
146 1097 Klopidogrel 75mg Tablet 74 0
147 1098 Kloramfenikol tetes mata 0,5% Botol 100 76
148 1099 Kloramfenikol 250mg Kapsul 200 500
149 1101 Kloramfenikol salep kulit 2% Tube 183 288
150 1102 Kloramfenikol salep mata 1% Tube 83 48
151 1103 Kloramfenikol suspensi 125mg/5ml Botol 40 0
152 1104 Kloramfenikol tetes telinga 3% Botol 61 75
153 1105 Klorfenol kamfer mentol (CHKM) Botol 0 0
153 1106 Klorpromazin 100mg Tablet 1933 0
154 1107 Kloserin 250 mg Tablet 0 670
155 1108 Kodein 10mg Tablet 70 0
156 1109 Kolkisin 500mg Tablet 0 0
156 1110 Komb.ferro sulfat+as.folat (tablet tambah darah) Tablet 6832 16800
157 1111 Komb.kaolin 550mg+pektin 20mg Tablet 2021 1000
158 1112 Kombipak Azitromisin + Cefixim Ampul 40 10
159 1113 Kotrimoksazol 240mg/5 mL Botol 78 0
160 1114 Kotrimoksazol 480mg Tablet 2132 0
161 1115 Lactulosa 3,335mg/5ml Botol 0 0
162 1116 Lamivudine (3TC) 150mg Tablet 2460 0
163 1117 Levofloksasin 250 mg Tablet 0 1840
164 1118 Lidocain spray 10% (Xylocaine) Botol 1 0
165 1119 Lidokain 2%+Epinefrin1:80.000 injeksi 2ml (Pehacain) Ampul 173 0
166 1120 Lidokain injeksi 2% Ampul 144 100
167 1121 Lidokain krim anestesi topical Paket 0 0
167 1122 Lincomisin kapsul 500mg Kapsul 0 0
167 1123 Lopinovir/ritonavir (LPV/r) 200/50mg Tablet 519 960
168 1124 Loratadin 10mg Tablet 452 1500
169 1125 MDT Combi (MB-Adult) Paket 18 36
170 1126 MDT Combi (MB-Child) Paket 9 0
171 1127 MDT Combi (PB- Adult) Paket 6 0
172 1129 Metformin 500mg Tablet 7443 5000
173 1130 Metil Ergometrin injeksi 0,2mg/ml Ampul 47 0
174 1131 Metil Ergometrin 0,125mg Tablet 0 0
174 1132 Metoklorpropamid 10mg Tablet 216 0
175 1133 Metronidazol 250mg Tablet 0 0
175 1134 Metronidazol 500mg Tablet 533 500
176 1135 MgSO4 injeksi 40% Vial 24 0
177 1136 Mikonazol krim 2% Tube 59 0
178 1137 Moksifloksasin 400 mg Tablet 0 730
179 1138 N-Asetil Sistein 200mg Kapsul 693 0
180 1139 NaCl larutan infus 0,9% Botol 36 12
181 1140 Natrium Bicarbonat 500mg Tablet 0 0
181 1141 Natrium Diklofenak 25mg Tablet 3160 2800
182 1142 Natrium Diklofenak 50mg Tablet 793 1000
183 1143 Neomisin 0,5% & Plasenta sapi 10% Tube 0 0
183 1144 Nevirapine (NVP) 200mg Tablet 1324 300
184 1145 Nifedipin tablet 10mg Tablet 90 100
185 1146 Nistatin 100.000IU/ml Botol 37 0
186 1147 Nistatin vaginal 100.000IU Tablet 89 0
187 1151 Obat Anti Tuberkulose kategori II Paket 0 2
188 1152 Obat Anti Tuberkulose kategori Anak Paket 0 8
189 1153 Obat Anti Tuberkulose kategori I & III Paket 0 13
190 1154 Obat Anti Tuberkulose kombipak Paket 0 0
190 1155 Oksitetrasiklin HCl salep mata 1% Tube 83 0
191 1156 Oksitosin Injeksi 10IU/ml Ampul 133 0
192 1157 Omeprazole 20mg Kapsul 2439 2400
193 1158 Omeprazole serbuk injeksi 40mg Vial 11 0
194 1159 P-aminosalisilat sodium 5.52 g Tablet 0 0
194 1160 Papaverin 40mg Tablet 787 2000
195 1161 Papaverin injeksi 40mg/ml Ampul 0 0
195 1162 Paracetamol supp 125mg Suppositoria 7 0
196 1163 Parasetamol 100 mg Tablet 3 0
197 1164 Parasetamol 100mg/ml Botol 113 224
198 1165 Parasetamol 120mg/5ml Botol 275 600
199 1166 Parasetamol 500mg Tablet 13843 33700
200 1167 Pasta devitalisasi non arsen (Depulpin) Botol 3 0
201 1168 Ped Triple FDC(ZDV+3TC+NVP) 60/30/50mg Tablet 300 0
202 1169 Perak sufadiazin krim (Burnazin) 1% Tube 17 0
203 1170 Permetrin krim 5% Tube 0 0
203 1171 Pil KB komb.I (Levonogestrol 150mg+Etinil Estradiol 30µg) 175 0
204 1173 Pirantel Pamoat 125mg/5ml Botol 9 0
205 1174 Pirazinamid 500 mg Tablet 0 140
206 1178 Prednison 5mg Tablet 3320 0
207 1179 Ranitidin 150mg Tablet 7927 0
208 1180 Retinol (Vit A. Biru) 100.000 IU Kapsul 122 0
209 1181 Retinol (Vit A. Merah) 200.000 IU Kapsul 2198 0
210 1182 Ringer Laktat larutan Elektrolit infus Botol 53 80
211 1183 Risperidon 2mg Tablet 1349 500
212 1184 Salbutamol 2mg Tablet 702 0
213 1185 Salbutamol 4mg Tablet 609 500
214 1186 Salbutamol cairan iihalasi (Ventolin Nebules) 2,5mg Ampul 162 0
215 1187 Salep 2-4 (As.Salisilat2%+Sulfur4%) Paket 0 24
216 1188 Salep Whitfield/Antifungi (As.Benzoat6%+As.Salisilat3%) Paket 6 24
218 1192 Sianokobalamin (Vit.B12) 50 µg Tablet 6159 9600
219 1193 Simvastatin 10mg Tablet 2254 0
220 1194 Siprofloxasin 500mg Tablet 544 500
221 1195 Sterptomycin sulfat serbuk injeksi 1000mg Vial 0 0
221 1196 Suntik KB 1 bulan (Medoksi 150mg+Estradiol 5mg) Vial 19 0
222 1197 Suntik KB 3 bulan (Medoksiprogesteron Asetat 150mg/3ml) Vial 45 0
223 1198 Tenofovir (TDF) 300mg Tablet 1246 0
224 1199 Tetrasiklin 250mg Kapsul 0 0
224 1200 Tetrasiklin kapsul 500mg Kapsul 245 0
225 1201 Tiamfenikol 500mg Kapsul 779 0
226 1202 Tiamin (Vitamin B1) 100mg Tablet 0 0
227 1203 Tiamin (Vitamin B1) 50mg Tablet 2730 3000
228 1204 Triple FDC (TDF+3TC+EFV) 300/300/600mg Tablet 0 0
228 1205 Trixehsipenidil 2mg Tablet 808 500
229 1206 Tuberkulin protein purified derivative (Mantoux test) Vial 10 10
230 1207 Vaksin BCG kering + Pelarut Vial 14 0
231 1208 Vaksin Campak kering + Pelarut Vial 0 0
231 1209 Vaksin HB0 (Hepatitis rekombinan) Vial 82 0
232 121 Klofenol Kamfer Menthol ( CHKM ) Botol 0 0
232 1210 Vaksin HBIg Ampul 17 0
233 1211 Vaksin HPV Vial 0 0
233 1212 Vaksin jerap difteri tetanus (DT) <7thn Vial 0 0
233 1213 Vaksin jerap tetanus difteri (Td) >7thn Vial 17 40
234 1214 Vaksin kombinasi DPT-HB-Hib Vial 5 20
235 1215 Vaksin Meningitis Vial 7 0
236 1216 Vaksin MR Kering + Pelarut Vial 2 15
237 1217 Vaksin Polio injeksi (IPV) Vial 10 0
238 1218 Vaksin Polio Oral + droppler (OPV) Vial 9 10
239 1219 Vitamin B kompleks Tablet 9356 9400
240 1220 Zidovudin Syr Tablet 0 0
240 1221 Zidovudine (ZDV)+ Lamivudine (3TC) 300/150mg Tablet 1651 360
241 1222 Zinc Pospat Cement Sachet 4 0
242 1223 Zink 20mg/5ml Botol 0 0
242 1224 Zink dispersibel 20mg Tablet 926 1200
243 124 Kloramfenikol tetes mata 0,5% Botol 100 76
244 125 Kloramfenikol tetes telinga 3% Botol 61 75
246 129 Kodein tablet 10 mg Tablet 70 0
247 132 Kotrimoksazol tablet Dewasa Tablet 0 0
247 135 Kotrimoksazol Suspensi 240 mg/ 5 mL Botol 78 0
248 14 Antalgin (Methampiron) tablet 500 mg Tablet 0 0
248 140 Lidokain 2% + epinefrin inj. 2 mL (Pehacain) Ampul 173 0
249 141 Lidokain komp. Injeksi, Kombinasi : Ampul 144 100
250 142 Loratadin tablet 10 mg Tablet 452 1500
251 147 Metformin tablet 500 mg Kotak 7443 5000
252 148 Metil Ergometrin inj. 0,2 mg/mL Ampul 47 0
253 149 Metilergometrin Maleat tablet 0,125 mg Tablet 0 0
253 15 Antasida DOEN suspensi Botol 0 0
253 150 Metilprednisolon tablet 16 mg Tablet 0 0
253 151 Metoklopramide 10mg Kotak 216 0
254 152 Metronidazol tablet 250 mg Tablet 0 0
254 153 Metronidazol tablet 500 mg Tablet 533 500
255 154 Mikonazol krim Tube 59 0
256 157 Natrium klorida infus 0,9% Botol 36 12
257 158 Nifedipin 10 mg Kotak 90 100
258 166 Oksitosin Injeksi 10 IU/mL Ampul 133 0
259 167 Omeprazole kapsul 20 mg Kapsul 2439 2400
260 17 Anti Hemoroid DOEN Supos. Suppositoria 0 0
260 170 Papaverin tablet 40 mg Tablet 787 2000
261 171 Parasetamol sirup 120 mg/5ml Buah 275 600
262 172 Parasetamol tablet 500 mg Tablet 13843 33700
263 177 Pirantel pamoat tablet 125 mg Tablet 0 0
263 178 Piridoxin ( Vit B6 ) tablet 10 mg Tablet 8631 10000
264 187 Prednison tablet Tablet 3320 0
265 195 Ranitidin tablet 150 mg Tablet 7927 0
266 198 Ringer Laktat cairan infus Botol 53 80
267 2001 Aquades pro injeksi @25ml 69 0
268 201 Salbutamol 4 mg Kotak 609 500
269 203 Salisil bedak 2 % Pak 144 60
270 207 Serum Anti Tetanus inj. 1.500 IU/amp (ATS) Ampul 0 0
270 208 Sianokobalamin (Vit.B12) tablet 50 mcg Tablet 6159 9600
271 212 Simvastatin tablet 10 mg Tablet 2254 0
272 213 Siprofloxasin tablet 500 mg Kotak 544 500
273 22 Artikulating Paper Kotak 0 0
273 225 Tetrasiklin kapsul 250 mg Kapsul 0 0
273 226 Tetrasiklin kapsul 500 mg Kapsul 245 0
274 227 Tiamfenikol kapsul 500 mg Kotak 779 0
275 243 betahistin mesilat tablet 6 mg Tablet 971 500
276 245 Bisakodil tablet 5 mg Tablet 13 60
277 249 Sefiksim tablet 200 mg Tablet 0 0
277 25 Asam Folat tablet 1 mg Tablet 0 0
277 250 cetrizin sirup 5 mg/5ml Botol 0 50
278 26 Asam Mefenamat tablet 500 mg Tablet 0 0
278 262 Kombinasi kaolin 550 mg + pektin 20 mg Tablet 2021 1000
280 268 Klorpromazin tablet 100 mg Tablet 1933 0
281 269 Lincomisin kapsul 500 mg Kapsul 0 0
281 27 Asetosal tablet 80 mg (Ascardia) Tablet 0 0
281 271 Mebendazol tablet 400 mg Tablet 0 0
281 275 Nistatin tablet vagina 100.000 IU Tablet 89 0
282 276 Nistatin tablet salut gula 500.000 IU Tablet 0 0
282 277 obat antituberkulosis kategori 1/FDC 1 Paket 0 13
283 278 obat antituberkulosis kategori 2/FDC 2 Paket 0 2
284 279 obat antituberkulosis kategori anak Paket 0 8
285 281 parasetamol tablet 100 mg Tablet 0 3
286 283 Retinol (Vit A) kapsul 100.000 IU Kapsul 122 0
287 284 Retinol (Vit A) kapsul 200.000 IU Kapsul 2198 0
288 285 risperidon tablet 2 mg Tablet 1349 500
289 286 Spironolactone tablet 25 mg Tablet 0 0
289 287 Kombinasi ferro sulfat + asam folat (Tablet tambah Tablet 6832 16800
290 288 Trihexiphenidil tablet 2 mg Tablet 808 500
291 289 Zink dispersibel tablet 20 mg Tablet 926 1200
292 296 Polikresulen ( Albothyl ) Botol 0 0
292 30 Asiklovir krim Tube 0 0
292 3001 Ambroxol 15mg/5 ml Botol 155 0
293 3002 Asam Folat 1mg Tablet 210 0
294 3003 Asiklovir krim 5% Tube 43 100
295 3004 Betahistin mesilate 6mg Tablet 971 500
296 3005 Betametason krim 0,1% Tube 164 7
297 3006 Budesonide (Cairan inhalasi) 0,25mg/ml 0 0
297 3007 Fenofibrat 100mg Tablet 340 0
298 3008 Fitomenadion (Vit.K1) injeksi 2mg/ml Ampul 90 0
299 3009 Flukonazol 150mg Kapsul 26 0
300 3010 Framisetin sulfat kassa steril 1% Lembar 30 20
301 3011 Gentamisin Salep 0,1% Tube 0 0
301 3012 Gliseril Guaiakolat 100mg Tablet 4693 26300
302 3013 Ketoprofen 100mg/Supp Suppositoria 0 0
302 3014 Pantocain 0,5% Botol 7 0
303 308 ventolin nebules Buah 0 0
304 309 parasetamol drop Botol 113 224
305 31 ATS 1500 IU Ampul 0 0
305 316 Natrium diklofenak tablet 25 mg Tablet 3160 2800
306 318 Silver Sulfadiazin 10 mg (Burnazin) Tube 17 0
307 35 Benzatin Benzil Penisilin 2,4Juta IU Vial 21 10
308 37 Betametason krim 0,1% Tube 164 7
309 91 Glibenklamid Tablet 5 mg Tablet 1628 2000
310 92 Glimepirid Tablet 1 mg Tablet 323 800
311 93 Gliseril Guaiakolat Tablet 100 mg Tablet 4693 26300
312 97 Griseofulvin Tablet 125 mg Tablet 684 0

Mengetahui
PJ Farmasi PKM Cakung

Windi Wikandari, S.Farm., Apt


NIP.198608132011012014
Persediaan Pemakaian Akhir Stok
40 1 39
131 77 54
471 254 217
0 0 0
700 250 450
0 0 0
857 240 617
22190 18298 3892
699 34 665
106 42 64
0 0 0
97 46 51
2005 686 1319
1714 686 1028
0 0 0
16634 11740 4894
3 1 2
1 0 1
0 0 0
850 250 600
14 8 6
722 330 392
341 16 325
0 0 0
2241 1009 1232
54 25 29
9 1 8
6 2 4
24 7 17
37 6 31
3 0 3
17 10 7
175 35 140
0 0 0
140 0 140
19 0 19
45 8 37
20 8 12
0 0 0
12 4 8
14 0 14
57 0 57
0 0 0
25 0 25
10 0 10
0 0 0
4 0 4
2011 781 1230
1624 600 1024
1237 850 387
2460 1880 580
1246 970 276
300 0 300
0 0 0
693 143 550
21 17 4
43 0 43
872 485 387
0 0 0
155 78 77
0 0 0
3872 2218 1654
102 10 92
541 274 267
0 0 0
13752 8252 5500
0 0 0
238 66 172
1918 1131 787
0 0 0
370 120 250
0 0 0
0 0 0
43 0 43
872 485 387
102 10 92
0 0 0
541 274 267
14468 9805 4663
13752 8252 5500
359 231 128
150 78 72
21705 16979 4726
3 0 3
107 18 89
11672 8804 2868
140 90 50
0 0 0
7 5 2
1716 505 1211
15485 11224 4261
12800 10054 2746
267 46 221
2248 613 1635
3872 2218 1654
7 5 2
6 2 4
204 166 38
20 0 20
31 14 17
73 28 45
2 0 2
4 0 4
4 0 4
4 1 3
4 0 4
18802 12043 6759
46 13 33
277 102 175
311 1 310
14 1 13
9 1 8
4 0 4
31 0 31
157 0 157
218 20 198
2688 1710 978
214 130 84
1 0 1
3 0 3
1237 850 387
0 0 0
44 3 41
0 0 0
953 239 714
0 0 0
1126 691 435
10 7 3
933 865 68
3 0 3
100 0 100
26 9 17
331 157 174
0 0 0
230 11 219
1776 940 836
53 14 39
9 2 7
3628 2002 1626
1123 696 427
6 0 6
684 385 299
2241 1009 1232
341 16 325
238 66 172
722 330 392
1918 1131 787
14 8 6
20 8 12
850 250 600
1626 799 827
370 120 250
1 0 1
3 1 2
16334 11740 4594
0 0 0
127 104 23
37 31 6
1714 978 736
2005 686 1319
0 0 0
97 46 51
699 34 665
106 42 64
22190 18298 3892
857 210 647
70 56 14
74 22 52
176 94 82
700 250 450
471 254 217
131 77 124
40 1 39
136 38 98
0 0 0
1933 221 1712
670 508 162
70 0 70
0 0 0
23632 14773 8859
3021 1863 1158
50 27 23
78 6 72
2132 1392 740
0 0 0
2460 1880 580
1840 1588 252
1 0 1
173 43 130
244 69 175
0 0 0
0 0 0
1479 600 879
1952 1150 802
54 25 29
9 1 8
6 2 4
12443 10456 1987
47 3 44
0 0 0
216 52 164
0 0 0
1033 684 349
24 7 17
59 0 59
730 716 14
693 143 550
48 6 42
0 0 0
5960 4043 1917
1793 915 878
0 0 0
1624 600 1024
190 60 130
37 6 31
89 50 39
2 8 -6
8 8 0
13 13 0
0 0 0
83 0 83
133 40 93
4839 3619 1220
11 1 10
0 0 0
2787 1467 1320
0 0 0
7 7 0
3 0 3
337 187 150
875 674 201
47543 29980 17563
3 0 3
300 0 300
17 10 7
0 0 0
175 35 140
9 1 8
140 70 70
3320 2819 501
7927 353 7574
122 2 120
2198 201 1997
133 74 59
1849 924 925
702 547 155
1109 443 666
162 84 78
24 8 16
30 3 27
15759 11613 4146
2254 1095 1159
1044 493 551
0 0 0
19 0 19
45 8 37
1246 970 276
0 0 0
245 30 215
779 310 469
0 0 0
5730 3577 5373
0 0 0
1308 949 359
20 4 16
14 0 14
0 0 0
82 35 47
0 0 0
17 7 10
0 0 0
0 0 0
57 0 57
25 0 25
7 0 7
17 0 17
10 0 10
19 0 19
18756 12956 5800
0 0 0
2011 781 1230
4 0 4
0 0 0
2126 1536 590
176 94 167
136 38 98
70 0 70
0 0 0
78 6 72
0 0 0
173 43 130
244 69 175
1952 1150 802
12443 10546 1897
47 3 44
0 0 0
0 0 0
0 0 0
216 52 164
0 0 0
1033 684 349
59 0 59
48 6 42
190 60 130
133 40 93
4839 3619 1220
0 0 0
2787 1467 1320
875 674 201
47543 29980 17563
0 0 0
18631 9488 9143
3320 2819 501
7927 353 7892
133 74 59
69 29 40
1109 443 666
204 166 38
0 0 0
15759 11613 4146
2254 1095 1159
1044 493 551
0 0 0
0 0 0
245 30 215
779 310 469
1471 765 706
73 28 45
0 0 0
0 0 0
50 4 46
0 0 0
3021 1863 1158
1933 221 1712
0 0 0
0 0 0
0 0 0
89 50 39
0 0 0
13 13 0
2 2 0
8 8 0
3 0 3
122 2 120
2198 201 1997
1849 924 925
0 0 0
23632 14773 8859
1308 949 359
2126 1536 590
0 0 0
0 0 0
155 78 77
210 70 140
143 63 80
1471 765 706
171 159 12
0 0 0
340 111 229
90 17 73
26 23 3
50 16 34
0 0 0
30993 16435 14558
0 0 0
7 0 7
0 0 0
337 187 150
0 0 0
5960 4043 1917
17 10 7
31 14 17
171 159 12
3628 2002 1626
1123 696 427
30993 16435 14558
684 385 299

Jakarta 5 Desember 2019


Yang Membuat Laporan

Nurlisa Purnamawati, S.Farm., Apt


NIK 10205819890616201708210
CATATAN PEMAKAIAN RESEP HARIAN

TGL :
NO NAMA OBAT PEMAKAIAN
1 Alopurinol 100mg
2 Ambroxol 15mg/5 ml

5 Amlodipin 10mg

6 Amlodipin 5mg
7 Amoksisilin (sirup kering) 125mg/5ml
8 Amoksisilin (sirup kering) 250mg/5ml

9 Amoksisilin 500mg
11 Antasida DOEN (MgSO4+AlOH Tersuspensi)

12 Antasida DOEN (MgSO4+AlOH)


13 Anti Hemoroid DOEN
15 Aquades pro injeksi @25ml
16 Asam Askorbat (Vit C) 250mg

17 Asam Askorbat (Vit C) 50mg


18 Asam Folat 1mg

19 Asam Mefenamat 500mg


21 Asiklovir 200mg
22 Asiklovir 400mg
23 Asiklovir krim 5%
26 Bedak salisil serbuk 2%
27 Benzatin benzil penicilin serbuk injeksi 2,4juta IU/ml
28 Betahistin mesilate 6mg
29 Betametason krim 0,1%
32 Deksametason 0,5mg
36 Doksisiklin 100mg
37 Domperidon 10mg
38 Domperidon sirup 5mg/5ml
42 Eritromisin 500mg
43 Fenofibrat 100mg
44 Ferro sulfat 15mg/5ml
45 Fitomenadion (Vit K1) 10mg
50 Garam Oralit serbuk untuk 200ml
52 Gentian Violet larutan 1%
53 Glibenklamid 5mg
54 Glimepirid 1mg

55 Gliseril Guaiakolat 100mg


59 Griseofulvin 125mg
61 Hidrokotison krim 2,5%
62 Hiosin N Butylbromide 10mg
63 Ibuprofen 200mg

67 Kalsium Laktat 500mg


68 Kaptopril 12,5 mg
69 Kaptopril 25mg
71 Karbogliserin (Fenol Gliserol) tetes telinga 10%

75 Khlofeniramin Maleat (CTM) 4mg


76 Klindamisin 150mg
78 Kloramfenikol tetes mata 0,5%
79 Kloramfenikol 250mg
81 Kloramfenikol salep kulit 2%
82 Kloramfenikol salep mata 1%
84 Kloramfenikol tetes telinga 3%

86 Komb.ferro sulfat+as.folat (tablet tambah darah)


87 Komb.kaolin 550mg+pektin 20mg
90 Kotrimoksazol 480mg
94 Loratadin 10mg

95 Metformin 500mg
100 Metronidazol 500mg
102 Mikonazol krim 2%
104 N-Asetil Sistein 200mg
106 Natrium Diklofenak 25mg
107 Natrium Diklofenak 50mg
110 Nistatin 100.000IU/ml
115 Omeprazole 20mg
118 Papaverin 40mg
121 Parasetamol 100mg/ml
122 Parasetamol 120mg/5ml

123 Parasetamol 500mg


125 Permetrin krim 5% (Scabimied)

128 Piridoxin (Vit B6) 10mg

129 Prednison 5mg


130 Ranitidin 150mg
132 Retinol (Vit A. Merah) 200.000 IU
134 Salbutamol 2mg
135 Salbutamol 4mg
137 Salep 2-4 (As.Salisilat2%+Sulfur4%)
140 Setirizine 5mg/5ml

141 Sianokobalamin (Vit.B12) 50 µg


142 Simvastatin 10mg
143 Siprofloxasin 500mg
146 Tiamfenikol 500mg

148 Tiamin (Vitamin B1) 50mg

149 Vitamin B kompleks


151 Zink dispersibel 20mg
210 MDT Combi (MB-Adult)
214 Isoniasid 100 mg
215 Isoniazid 300 mg
216 Kotrimoksazol 960 mg
TOTAL
PUSKESMAS KECAMATAN CAKUNG

BULAN : JANUARI 2021


STOK OPNAME
NO NAMA OBAT SATUAN
JUMLAH NO. BATCH ED

1 Alopurinol 100mg tablet


2 Ambroxol 15mg/5 ml botol
3 Aminophillin 200mg tablet
4 Aminophillin injeksi 24mg/ml ampul
5 Amlodipin 10mg tablet
6 Amlodipin 5mg tablet
7 Amoksisilin (sirup kering) 125mg/5ml botol
8 Amoksisilin (sirup kering) 250mg/5ml botol
9 Amoksisilin 500mg tablet
10 Ampisilin injeksi (serbuk kering) 250mg vial
11 Antasida DOEN (MgSO4+AlOH Tersuspensi) botol
12 Antasida DOEN (MgSO4+AlOH) tablet
13 Anti Hemoroid DOEN suppos
14 Anti Tetanus Serum (ATS) 1500IU ampul
15 Aquades pro injeksi @25ml respule
16 Asam Askorbat (Vit C) 250mg tablet
17 Asam Askorbat (Vit C) 50mg tablet
18 Asam Folat 1mg tablet
19 Asam Mefenamat 500mg tablet
20 Asetosal (Ascardia/Miniaspi) 80mg tablet
21 Asiklovir 200mg tablet
22 Asiklovir 400mg tablet
23 Asiklovir krim 5% tube
24 Atropin Sulfas injeksi 0,25mg/ml ampul
25 Azitromisin 500 mg tablet
26 Bedak salisil serbuk 2% ktk
27 Benzatin benzil penicilin serbuk injeksi 2,4juta IU/ml vial
28 Betahistin mesilate 6mg tablet
29 Betametason krim 0,1% tube
30 Bisakodil 5mg tablet
31 Budesonide (Cairan inhalasi) 0,25mg/ml respule
32 Deksametason 0,5mg tablet
33 Deksametason injeksi 5mg/ml ampul
34 Difenhidramin injeksi 10mg/ml ampul
35 Digoksin 0,25mg tablet
36 Doksisiklin 100mg kapsul
37 Domperidon 10mg tablet
38 Domperidon sirup 5mg/5ml botol
39 Epinefrin Bitatrat/Adrenalin Injeksi 1mg/ml ampul
40 Eritromisin (sirup kering) 200mg/5ml botol
41 Eritromisin 250mg kapsul
42 Eritromisin 500mg kapsul
43 Fenofibrat 100mg tablet
44 Ferro sulfat 15mg/5ml botol
45 Fitomenadion (Vit K1) 10mg tablet
46 Fitomenadion (Vit.K1) injeksi 2mg/ml ampul
47 Flukonazol 150mg kapsul
48 Framisetin sulfat kassa steril 1% lembar
49 Furosemid 40mg tablet
50 Garam Oralit serbuk untuk 200ml sach
51 Gentamisin Salep 0,1% tube
52 Gentian Violet larutan 1% botol
53 Glibenklamid 5mg tablet
54 Glimepirid 1mg tablet
55 Gliseril Guaiakolat 100mg tablet
56 Glukosa larutan infus 10 % botol
57 Glukosa larutan infus 40 % botol
58 Glukosa larutan infus 5 % botol
59 Griseofulvin 125mg tablet
60 Hidroklortiazid 25mg tablet
61 Hidrokotison krim 2,5% tube
62 Hiosin N Butylbromide 10mg tablet
63 Ibuprofen 200mg tablet
64 Ikhtamol salep 10% pot
65 Isosorbid dinitrat (ISDN) 5mg tablet
66 Kalsium glukonat injeksi 10% vial
67 Kalsium Laktat 500mg tablet
68 Kaptopril 12,5 mg tablet
69 Kaptopril 25mg tablet
70 Karbo Adsorben (Norit) 125mg tablet
71 Karbogliserin (Fenol Gliserol) tetes telinga 10% botol
72 Ketokonazol 200mg tablet
73 Ketokonazol krim 2% tube
74 Ketoprofen 100mg/Supp suppos
75 Khlofeniramin Maleat (CTM) 4mg tablet
76 Klindamisin 150mg kapsul
77 Klopidogrel 75mg tablet
78 Kloramfenikol tetes mata 0,5% botol
79 Kloramfenikol 250mg kapsul
80 Kloramfenikol 500mg kapsul
81 Kloramfenikol salep kulit 2% tube
82 Kloramfenikol salep mata 1% tube
83 Kloramfenikol suspensi 125mg/5ml botol
84 Kloramfenikol tetes telinga 3% botol
85 Kolkisin 500mg tablet
86 Komb.ferro sulfat+as.folat (tablet tambah darah) tablet
87 Komb.kaolin 550mg+pektin 20mg tablet
88 Kombipak Azitromisin + Cefixim amplop
89 Kotrimoksazol 240mg/5 mL botol
90 Kotrimoksazol 480mg tablet
91 Lactulosa 3,335mg/5ml botol
92 Lidokain injeksi 2% ampul
93 Lincomisin kapsul 500mg kapsul
94 Loratadin 10mg tablet
95 Metformin 500mg tablet
96 Metil Ergometrin injeksi 0,2mg/ml ampul
97 Metil Ergometrin 0,125mg tablet
98 Metoklorpropamid 10mg tablet
99 Metronidazol 250mg tablet
100 Metronidazol 500mg tablet
101 MgSO4 injeksi 40% vial
102 Mikonazol krim 2% tube
103 NaCl larutan infus 0,9% botol
104 N-Asetil Sistein 200mg kapsul
105 Natrium Bicarbonat 500mg tablet
106 Natrium Diklofenak 25mg tablet
107 Natrium Diklofenak 50mg tablet
108 Neomisin 0,5% & Plasenta sapi 10% tube
109 Nifedipin tablet 10mg tablet
110 Nistatin 100.000IU/ml botol
111 Nistatin vaginal 100.000IU tablet
112 Nitrofurantoin 50mg tablet
113 Oksitetrasiklin HCl salep mata 1% tube
114 Oksitosin Injeksi 10IU/ml ampul
115 Omeprazole 20mg kapsul
116 Omeprazole serbuk injeksi 40mg vial
117 Pantocain 0,5% botol
118 Papaverin 40mg tablet
119 Papaverin injeksi 40mg/ml ampul
120 Paracetamol supp 125mg suppos
121 Parasetamol 100mg/ml botol
122 Parasetamol 120mg/5ml botol
123 Parasetamol 500mg tablet
124 Perak sufadiazin krim (Burnazin) 1% tube
125 Permetrin krim 5% (Scabimied) tube
126 Pirantel Pamoat 125mg tablet
127 Pirantel Pamoat 125mg/5ml botol
128 Piridoxin (Vit B6) 10mg tablet
129 Prednison 5mg tablet
130 Ranitidin 150mg tablet
131 Retinol (Vit A. Biru) 100.000 IU kapsul
132 Retinol (Vit A. Merah) 200.000 IU kapsul
133 Ringer Laktat larutan Elektrolit infus botol
134 Salbutamol 2mg tablet
135 Salbutamol 4mg tablet
136 Salbutamol cairan iihalasi (Ventolin Nebules) 2,5mg ampul
137 Salep 2-4 (As.Salisilat2%+Sulfur4%) pot
138 Salep Whitfield/Antifungi (As.Benzoat6%+As.Salisilat pot
139 Sefiksim 200mg kapsul
140 Setirizine 5mg/5ml botol
141 Sianokobalamin (Vit.B12) 50 µg tablet
142 Simvastatin 10mg tablet
143 Siprofloxasin 500mg tablet
144 Tetrasiklin 250mg kapsul
145 Tetrasiklin kapsul 500mg kapsul
146 Tiamfenikol 500mg kapsul
147 Tiamin (Vitamin B1) 100mg tablet
148 Tiamin (Vitamin B1) 50mg tablet
149 Vitamin B kompleks tablet
150 Zink 20mg/5ml botol
151 Zink dispersibel 20mg tablet
152 Amitriptilin HCl 25mg tablet
153 Anti Migrain DOEN tablet (ergotamin1mg+kafein50mg tablet
154 Diazepam 2mg tablet
155 Diazepam 5mg tablet
156 Diazepam injeksi 5mg/ml ampul
157 Diazepam enema (Stesolid rectal tube) 10mg/2,5ml tube
158 Diazepam enema (Stesolid rectal tube) 5mg/2,5ml tube
159 Fenobarbital 30mg tablet
160 Haloperidol tablet 5mg tablet
161 Klorpromazin 100mg tablet
162 Risperidon 2mg tablet
163 Trixehsipenidil 2mg tablet
164 Kodein 10mg tablet
165 Bahan tumpatan sementara (Cavit/Caviton) set
166 Bonding botol
167 Celluloid Strip Gigi Pak
168 Composit Light Curing (Tambal Sinar ) A2 tube
169 Composit Light Curing (Tambal Sinar ) A3 tube
170 Composit Light Curing (Tambal Sinar ) A3,5 tube
171 Cresophene (cresotin) botol
172 Dycal (Dycal/Hydcal) set
173 Ecing (Ecing/Ethacant) botol
174 Endometason (Endoseal) tube
175 Etil Chlorida Spray (Etil Clorida/Endoice) botol
176 Eugenol botol
177 Formokresol botol
178 Glass Ionomert ART (Fuji IX) set
179 Kalsium Hidroksida Pasta (Metapex/Calcetin/Vitapex) ktk
180 Klorfenol kamfer mentol (CHKM) botol
181 Lidocain spray 10% (Xylocaine) botol
182 Lidokain 2%+Epinefrin1:80.000 injeksi 2ml (Pehacain) ampul
183 Lidokain krim anestesi topical pot
184 Pasta devitalisasi non arsen (Depulpin) botol
185 Scandonest botol
186 Zinc Pospat Cement set
187 Tuberkulin protein purified derivative (Mantoux test) vial
188 Vaksin BCG kering + Pelarut vial
189 Vaksin HB0 (Hepatitis rekombinan) Dewasa vial
190 Vaksin HB0 (Hepatitis rekombinan) vial
191 Vaksin HPV vial
192 Vaksin Polio Oral + droppler (OPV) vial
193 Vaksin jerap difteri tetanus (DT) <7thn vial
194 Vaksin jerap tetanus difteri (Td) >7thn vial
195 Vaksin kombinasi DPT-HB-Hib vial
196 Vaksin Polio injeksi (IPV) vial
197 Vaksin Meningitis vial
198 Vaksin MR Kering + Pelarut Vial
199 Vaksin HBIg ampul
200 Efavirenz (EFV) 600mg tablet
201 Lamivudine (3TC) 150mg tablet
202 Lopinovir/ritonavir (LPV/r) 200/50mg tablet
203 Nevirapine (NVP) 200mg tablet
204 Tenofovir (TDF) 300mg tablet
205 Zidovudine (ZDV)+ Lamivudine (3TC) 300/150mg tablet
206 Triple FDC (TDF+3TC+EFV) 300/300/600mg tablet
207 Ped Triple FDC(ZDV+3TC+NVP) 60/30/50mg tablet
208 Ziduvudin Sirup botol
209 Albendazol 400mg tablet
210 MDT Combi (MB-Adult) blister
211 MDT Combi (MB-Child) blister
212 MDT Combi (PB- Adult) blister
213 MDT Combi (PB- Child)) blister
214 Isoniasid 100 mg tablet
215 Isoniazid 300 mg tablet
216 Obat Anti Tuberkulose kategori Anak paket
217 Obat Anti Tuberkulose kategori I & III paket
218 Obat Anti Tuberkulose kategori II paket
219 Obat Anti Tuberkulose kombipak paket
220 Piridoksin (Vit B6) 25mg tablet
221 OAT TB + HIV Intensif paket
222 OAT TB + HIV Lanjutan paket
223 Sterptomycin sulfat serbuk injeksi 1000mg vial
224 Bedaquilin 100 mg tablet
225 Ethambutol 400. mg tablet
226 Etionamid 250 mg tablet
227 Kanamisin injeksi 1000mg vial
228 Kapreomisin 1 g injeksi vial
229 Klofazimin 100 mg kapsul
230 Kloserin 250 mg tablet
231 Levofloksasin 250 mg tablet
232 Moksifloksasin 400 mg tablet
233 P-aminosalisilat sodium 5.52 g sachet
234 Linizolid 600 mg capsul
235 Pirazinamid 400 mg tablet
236 Pirazinamid 500 mg tablet
237 Piridoksin 100 mg tablet
238 Pil KB komb.I (Levonogestrol 150mg+Etinil Estradiol blister
239 Suntik KB 1 bulan (Medoksi 150mg+Estradiol 5mg) vial
240 Suntik KB 3 bulan (Medoksiprogesteron Asetat 150mg vial
241 Implan KB 3 tahun (Levonogestrol 25mg) pcs
242 Dekstro+GG+CTM+Phenyl Syr Botol
243 Oxycan botol
244 Parasetamol 100mg tablet tablet
245 candesartan tablet
246 Kotrimoxazole 960mg tablet
247 Bisoprolol 5 mg tablet
248 BECOMZET tablet
249 ZEGAVIT tablet
250
Yang Membuat Laporan

Ryan Fajar Yunanto


NIK 102058198908092016010
TOTAL
Laporan

unanto
09201601095
BULAN : UNIT : GADAR/BANKES
STOK OPNAME
NO NAMA OBAT SATUAN TOTAL
Ambulans Set Banjir Tas Merah Box Orange Box Hijau
1 Alopurinol 100mg tablet
2 Ambroxol 15mg/5 ml botol
3 Aminophillin 200mg tablet
4 Aminophillin injeksi 24mg/ml ampul
5 Amlodipin 10mg tablet
6 Amlodipin 5mg tablet
7 Amoksisilin (sirup kering) 125mg/5ml botol
8 Amoksisilin (sirup kering) 250mg/5ml botol
9 Amoksisilin 500mg tablet
10 Ampisilin injeksi (serbuk kering) 250mg vial
11 Antasida DOEN (MgSO4+AlOH Tersuspensi) botol
12 Antasida DOEN (MgSO4+AlOH) tablet
13 Anti Hemoroid DOEN suppos
14 Anti Tetanus Serum (ATS) 1500IU ampul
15 Aquades pro injeksi @25ml respule
16 Asam Askorbat (Vit C) 250mg tablet
17 Asam Askorbat (Vit C) 50mg tablet
18 Asam Folat 1mg tablet
19 Asam Mefenamat 500mg tablet
20 Asetosal (Ascardia/Miniaspi) 80mg tablet
21 Asiklovir 200mg tablet
22 Asiklovir 400mg tablet
23 Asiklovir krim 5% tube
24 Atropin Sulfas injeksi 0,25mg/ml ampul
25 Azitromisin 500 mg tablet
26 Bedak salisil serbuk 2% ktk
27 Benzatin benzil penicilin serbuk injeksi 2,4juta vial
28 Betahistin mesilate 6mg tablet
29 Betametason krim 0,1% tube
30 Bisakodil 5mg tablet
31 Budesonide (Cairan inhalasi) 0,25mg/ml respule
32 Deksametason 0,5mg tablet
33 Deksametason injeksi 5mg/ml ampul
34 Difenhidramin injeksi 10mg/ml ampul
35 Digoksin 0,25mg tablet
36 Doksisiklin 100mg kapsul
37 Domperidon 10mg tablet
38 Domperidon sirup 5mg/5ml botol
39 Epinefrin Bitatrat/Adrenalin Injeksi 1mg/ml ampul
40 Eritromisin (sirup kering) 200mg/5ml botol
41 Eritromisin 250mg kapsul
42 Eritromisin 500mg kapsul
43 Fenofibrat 100mg tablet
44 Ferro sulfat 15mg/5ml botol
45 Fitomenadion (Vit K1) 10mg tablet
46 Fitomenadion (Vit.K1) injeksi 2mg/ml ampul
47 Flukonazol 150mg kapsul
48 Framisetin sulfat kassa steril 1% lembar
49 Furosemid 40mg tablet
50 Garam Oralit serbuk untuk 200ml sach
51 Gentamisin Salep 0,1% tube
52 Gentian Violet larutan 1% botol
53 Glibenklamid 5mg tablet
54 Glimepirid 1mg tablet
55 Gliseril Guaiakolat 100mg tablet
56 Glukosa larutan infus 10 % botol
57 Glukosa larutan infus 40 % botol
58 Glukosa larutan infus 5 % botol
59 Griseofulvin 125mg tablet
60 Hidroklortiazid 25mg tablet
61 Hidrokotison krim 2,5% tube
62 Hiosin N Butylbromide 10mg tablet
63 Ibuprofen 200mg tablet
STOK OPNAME
NO NAMA OBAT SATUAN TOTAL
Ambulans Set Banjir Tas Merah Box Orange Box Hijau
64 Ikhtamol salep 10% pot
65 Isosorbid dinitrat (ISDN) 5mg tablet
66 Kalsium glukonat injeksi 10% vial
67 Kalsium Laktat 500mg tablet
68 Kaptopril 12,5 mg tablet
69 Kaptopril 25mg tablet
70 Karbo Adsorben (Norit) 125mg tablet
71 Karbogliserin (Fenol Gliserol) tetes telinga 10 botol
72 Ketokonazol 200mg tablet
73 Ketokonazol krim 2% tube
74 Ketoprofen 100mg/Supp suppos
75 Khlofeniramin Maleat (CTM) 4mg tablet
76 Klindamisin 150mg kapsul
77 Klopidogrel 75mg tablet
78 Kloramfenikol tetes mata 0,5% botol
79 Kloramfenikol 250mg kapsul
80 Kloramfenikol 500mg kapsul
81 Kloramfenikol salep kulit 2% tube
82 Kloramfenikol salep mata 1% tube
83 Kloramfenikol suspensi 125mg/5ml botol
84 Kloramfenikol tetes telinga 3% botol
85 Kolkisin 500mg tablet
86 Komb.ferro sulfat+as.folat (tablet tambah dara tablet
87 Komb.kaolin 550mg+pektin 20mg tablet
88 Kombipak Azitromisin + Cefixim amplop
89 Kotrimoksazol 240mg/5 mL botol
90 Kotrimoksazol 480mg tablet
91 Lactulosa 3,335mg/5ml botol
92 Lidokain injeksi 2% ampul
93 Lincomisin kapsul 500mg kapsul
94 Loratadin 10mg tablet
95 Metformin 500mg tablet
96 Metil Ergometrin injeksi 0,2mg/ml ampul
97 Metil Ergometrin 0,125mg tablet
98 Metoklorpropamid 10mg tablet
99 Metronidazol 250mg tablet
100 Metronidazol 500mg tablet
101 MgSO4 injeksi 40% vial
102 Mikonazol krim 2% tube
103 NaCl larutan infus 0,9% botol
104 N-Asetil Sistein 200mg kapsul
105 Natrium Bicarbonat 500mg tablet
106 Natrium Diklofenak 25mg tablet
107 Natrium Diklofenak 50mg tablet
108 Neomisin 0,5% & Plasenta sapi 10% tube
109 Nifedipin tablet 10mg tablet
110 Nistatin 100.000IU/ml botol
111 Nistatin vaginal 100.000IU tablet
112 Nitrofurantoin 50mg tablet
113 Oksitetrasiklin HCl salep mata 1% tube
114 Oksitosin Injeksi 10IU/ml ampul
115 Omeprazole 20mg kapsul
116 Omeprazole serbuk injeksi 40mg vial
117 Pantocain 0,5% botol
118 Papaverin 40mg tablet
119 Papaverin injeksi 40mg/ml ampul
120 Paracetamol supp 125mg suppos
121 Parasetamol 100mg/ml botol
122 Parasetamol 120mg/5ml botol
123 Parasetamol 500mg tablet
124 Perak sufadiazin krim (Burnazin) 1% tube
125 Permetrin krim 5% (Scabimied) tube
126 Pirantel Pamoat 125mg tablet
127 Pirantel Pamoat 125mg/5ml botol
STOK OPNAME
NO NAMA OBAT SATUAN TOTAL
Ambulans Set Banjir Tas Merah Box Orange Box Hijau
128 Piridoxin (Vit B6) 10mg tablet
129 Prednison 5mg tablet
130 Ranitidin 150mg tablet
131 Retinol (Vit A. Biru) 100.000 IU kapsul
132 Retinol (Vit A. Merah) 200.000 IU kapsul
133 Ringer Laktat larutan Elektrolit infus botol
134 Salbutamol 2mg tablet
135 Salbutamol 4mg tablet
136 ampul
Salbutamol cairan iihalasi (Ventolin Nebules)
137 Salep 2-4 (As.Salisilat2%+Sulfur4%) pot
138 Salep Whitfield/Antifungi (As.Benzoat6%+As.S pot
139 Sefiksim 200mg kapsul
140 Setirizine 5mg/5ml botol
141 Sianokobalamin (Vit.B12) 50 µg tablet
142 Simvastatin 10mg tablet
143 Siprofloxasin 500mg tablet
144 Tetrasiklin 250mg kapsul
145 Tetrasiklin kapsul 500mg kapsul
146 Tiamfenikol 500mg kapsul
147 Tiamin (Vitamin B1) 100mg tablet
148 Tiamin (Vitamin B1) 50mg tablet
149 Vitamin B kompleks tablet
150 Zink 20mg/5ml botol
151 Zink dispersibel 20mg tablet

You might also like