LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) JKN

PUSKESMAS MOMBOK
BULAN : FEBRUARI
TAHUN : 2022

No NAMA OBAT Satuan Stok Pene Perse Pema sisa Ket

Awal rimaan diaan kain stok
1 2 3 4 5 6 7 8 9
1 Silk 2/0 + jarum Pcs 360 0 360 0 360 ED 07/2022
2 Urine Bag Pcs 9 0 9 6 3
3 Abocat 20 Pcs 6 0 6 0 6
4 Abocat 22 Pcs 0 0 0 0 0
5 Abocat 24 Pcs 37 0 37 0 37
6 Abocat 26 Pcs 0 0 0 0 0
7 Alkohol 70%-1 ltr Botol 0 0 0 0 0
8 Rivanol 300 ml Botol 0 0 0 0 0
9 Infused Anak Pcs 0 0 0 0 0
10 Infused Dewasa Pcs 0 0 0 0 0
11 Hanscoen 6,5 Pcs 0 0 0 0 0
12 Hanscoen 7 Pcs 0 0 0 0 0
13 Umbilical Cord klem Pcs 0 0 0 0 0
14 Cat Gut 2/0 Pcs 0 0 0 0 0
15 Dispo 0,5 ml Pcs 300 0 300 0 300
16 Dispo 1 ml Pcs 200 0 200 0 200
17 Dispo 3 ml Pcs 0 0 0 0 0
18 Dispo 10 ml Pcs 0 0 0 0 0
19 Tes Kehamilan Pcs 20 0 20 3 17
20 Alkohol Swabs Pcs 4400 0 4400 200 4200
21 Povidon 300 ml Botol 0 0 0 0 0
22 Vit B Compleks Tablet 0 0 0 0 0
23 Vit B6 Tablet 0 0 0 0 0
24 Simvastatin Tablet 0 0 0 0 0
25 Oxitocin Ampul 0 0 0 0 0
26 Ketokonasol Tube 0 0 0 0 0
27 Hidrocortison krim Tube 0 0 0 0 0
28 Betametason Krim Tube 0 0 0 0 0
29 Lisol Botol 0 0 0 0 0
30 Folley Cateter Pcs 0 0 0 0 0
31 Amoksilin sirup kering Botol 0 0 0 0 0
32 Kotri ped suspensi Botol 0 0 0 0 0
33 Domperidon Tablet 0 0 0 0 0
34 Zink Tablet 0 0 0 0 0
35 Ibuprofen 200 mg Tablet 0 0 0 0 0
36 Allopurinol Tablet 0 0 0 0 0
37 Ketokonasol tab 200 mg Tablet 0 0 0 0 0
38 Tiamin (Vit B1) Tablet 6400 0 6400 1600 4800
39 Salbutamol Tablet 2700 0 2700 0 2700
40 Aminofilin Ampul 0 0 0 0 0
41 Metilergometrin 0,2 Ampul 100 0 100 0 100
42 Bioplacenton tube 93 0 93 3 90
43 Ambroxol tab Tablet 3730 0 3730 230 3500
44 Dexamethasone 0,5 mg Tablet 10600 0 10,600 400 10200
45 Natrium Diklofenak 50 mg Tablet 1000 0 1000 100 900
46 Kasa Hydrofil 40x80 Roll 20 0 20 2 18
47 Kasa Pembalut 2x80 Roll 0 0 0 0 0
48 Kasa Steril 16x16 Roll 0 0 0 0 0
49 Kasa Steril 18x22 Roll 0 0 0 0 0
 50 Kapas Pembalut 250 Roll 0 0 0 0 0

51 Larutan HCL 0,1% 100 ml Botol 0 0 0 0 0

52 Antasida Doen Tablet 1790 0 1790 420 1370
53 Sarung Tangan Obgyn Steril Psg 50 0 50 0 50
54 Urine Bag Standar Steril Pcs 0 0 0 0 0
55 Folley Cateter No 16 Pcs 13 0 13 0 13
56 Folley Cateter No 18 Pcs 0 0 0 0 0
57 Glukosa Protein Urine Tes Box 0 0 0 0 0
58 Onemed Aseptic Gel Botol 0 0 0 0 0
59 Nystatin 500.000 Tablet 0 0 0 0 0
60 Phytomenadione Injek Ampul 0 0 0 0 0
61 Ibuprofen Susp Botol 0 0 0 0 0
62 Tablet Tambah Darah Tablet 0 0 0 0 0
63 Furosemide 40 mg Tablet 0 0 0 0 0
64 Azithromycin 500 mg Tablet 120 0 120 0 120
65 Dulkolax Suppo 0 0 0 0 0
66 Amoksilin 250 mg Kapsul 0 0 0 0 0
67 Griseofulvin Tablet 0 0 0 0 0
68 Dymenhydrinat Tablet 161 0 161 61 100
69 Bacytracin polimycin salep Tube 1 0 1 1 0
70 Parasetamol Drops 100 mg/m Botol 0 0 0 0 0
71 Guaifenesin 100 mg Tablet 1780 0 1780 480 1300
72 Kaptopril 25 mg Tablet 1040 0 1040 200 840
73 Pirantel Pamoat Tablet 0 0 0 0 0
74 Parasetamol 500 mg Tablet 8790 0 8790 990 7800
75 Asam Mefenamat Tablet 0 0 0 0 0
76 Vitamin C Tablet 0 0 0 0 0
77 Ziehl Nelsen Paket 4 0 4 0 4
78 Winner Adhesif Wound Box 0 0 0 0 0
79 Lampu Spiritus Pcs 1 0 1 0 1
80 Siritus II Bratachem Botol 1 0 1 0 1
81 Object Glass Box 5 0 5 0 5
82 Sputum Pot Pcs 380 0 380 0 380
83 Box Object Glass Pcs 4 0 4 0 4
84 Chlorfeniramine Maleat (CTM Tablet 1200 0 1200 400 800
85 Lidokain Ampul 100 0 100 0 100

Mombok ,07 Maret 2022

Mengetahui Yang Melapor
Kepala UPTD Puskesmas Mombok Pengelola Apotik

Agustinus Jarut S.Kep Verona A. Aristina, Amd. Kep.

Nip : 19680414 199203 1 013
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) JKN
PUSKESMAS MOMBOK
BULAN : Maret
TAHUN : 2022

No NAMA OBAT Satuan Stok Pene Perse Pema sisa Ket

Awal rimaan diaan kain stok
1 2 3 4 5 6 7 8 9
1 Silk 2/0 + Pcs 0 0 0 0 0
2 Urine Bag Pcs 3 0 3 1 2
3 Abocat 20 Pcs 6 0 6 0 6
4 Abocat 22 Pcs 0 0 0 0 0
5 Abocat 24 Pcs 37 0 37 0 37
6 Abocat 26 Pcs 0 0 0 0 0
7 Alkohol 70% Botol 0 0 0 0 0
8 Rivanol 30 Botol 0 0 0 0 0
9 Infused An Pcs 0 0 0 0 0
10 Infused De Pcs 0 0 0 0 0
11 Hanscoen 6 Pcs 0 0 0 0 0
12 Hanscoen Pcs 0 0 0 0 0
13 Umbilical Pcs 0 0 0 0 0
14 Cat Gut 2/ Pcs 0 0 0 0 0
15 Dispo 0,5 m Pcs 300 0 300 0 300
16 Dispo 1 ml Pcs 200 0 200 0 200
17 Dispo 3 ml Pcs 0 0 0 0 0
18 Dispo 10 m Pcs 0 0 0 0 0
19 Tes Kehami Pcs 17 0 17 0 17
20 Alkohol Sw Pcs 4200 0 4200 1400 2800
21 Povidon 30 Botol 0 0 0 0 0
22 Vit B Comp Tablet 0 0 0 0 0
23 Vit B6 Tablet 0 0 0 0 0
24 Simvastati Tablet 0 0 0 0 0
25 Oxitocin Ampul 0 0 0 0 0
26 Ketokonaso Tube 0 0 0 0 0
27 Hidrocorti Tube 0 0 0 0 0
28 Betametas Tube 0 0 0 0 0
29 Lisol Botol 0 0 0 0 0
30 Folley Cate Pcs 0 0 0 0 0
31 Amoksilin s Botol 0 0 0 0 0
32 Kotri ped s Botol 0 0 0 0 0
33 Domperido Tablet 0 0 0 0 0
34 Zink Tablet 0 0 0 0 0
35 Ibuprofen Tablet 0 0 0 0 0
36 Allopurinol Tablet 0 0 0 0 0
37 Ketokonaso Tablet 0 0 0 0 0
38 Tiamin (Vit Tablet 4800 0 4800 0 4800
39 Salbutamol Tablet 2700 0 2700 1000 1700
40 Aminofilin Ampul 0 0 0 0 0
41 Metilergom Ampul 100 0 100 0 100
42 Bioplacent tube 90 0 90 11 79
43 Ambroxol t Tablet 3500 0 3500 1000 2500
44 Dexametha Tablet 10200 0 10,200 200 10000
45 Natrium Di Tablet 900 0 900 210 690
46 Kasa Hydro Roll 18 0 18 18 0
47 Kasa Pemba Roll 0 0 0 0 0
48 Kasa Steril Roll 0 0 0 0 0
49 Kasa Steril Roll 0 0 0 0 0
50 Kapas Pemb Roll 0 0 0 0 0

51 Larutan HC Botol 0 0 0 0 0
52 Antasida D Tablet 1370 0 1370 0 1370
53 Sarung Tan Psg 50 0 50 0 50
54 Urine Bag S Pcs 0 0 0 0 0
55 Folley Cate Pcs 13 0 13 0 13
56 Folley Cate Pcs 0 0 0 0 0
57 Glukosa Pr Box 0 0 0 0 0
58 Onemed Ase Botol 0 0 0 0 0
59 Nystatin 5 Tablet 0 0 0 0 0
60 PhytomenadAmpul 0 0 0 0 0
61 Ibuprofen Botol 0 0 0 0 0
62 Tablet Tam Tablet 0 0 0 0 0
63 Furosemid Tablet 0 0 0 0 0
64 Azithromyc Tablet 120 0 120 0 120
65 Dulkolax Suppo 0 0 0 0 0
66 Amoksilin Kapsul 0 0 0 0 0
67 Griseofulvi Tablet 0 0 0 0 0
68 Dymenhydr Tablet 161 0 161 61 100
69 Bacytracin Tube 0 0 0 0 0
70 Parasetamo Botol 0 0 0 0 0
71 Guaifenesi Tablet 1300 0 1300 200 1100
72 Kaptopril Tablet 840 0 840 0 840
73 Pirantel P Tablet 0 0 0 0 0
74 Parasetamo Tablet 7800 0 7800 4900 2900
75 Asam Mefe Tablet 0 0 0 0 0
76 Vitamin C Tablet 0 0 0 0 0
77 Ziehl Nelse Paket 4 0 4 0 4
78 Winner Ad Box 0 0 0 0 0
79 Lampu Spir Pcs 1 0 1 0 1
80 Siritus II Botol 1 0 1 0 1
81 Object Glas Box 5 0 5 0 5
 82 Sputum Po Pcs 380 0 380 0 380
83 Box Object Pcs 4 0 4 0 4
84 Chlorfenir Tablet 800 0 800 100 700
85 Lidokain Ampul 100 0 100 0 100

Mombok ,06 April 2022

Mengetahui Yang Melapor
Kepala UPTD Puskesmas Mombok Pengelola Apotik

Agustinus Jarut S.Kep Verona A. Aristina, Amd. Kep.

Nip : 19680414 199203 1 013