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  • Lplpo Ponkesdes Tugu 2022

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    Yündâ Dâmâyântî Rürâ
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    This document reports on the usage and request for drug supplies (LPLPO) at a health clinic for the month of January 2022. It includes a table listing 56 drugs including Albendazol 400 mg tablets. The table shows the initial stock, receipts, usage, remaining stock, and requested additional stock for each drug. For some Albendazol entries, usage of 80, 2, 100, 100, 30 tablets are reported, reducing the remaining stock by those amounts. The document requests additional stocks of 120, 150, 150, 45 tablets of Albendazol to meet needs.

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    This document reports on the usage and request for drug supplies (LPLPO) at a health clinic for the month of January 2022. It includes a table listing 56 drugs including Albendazol 400 mg tablets. The table shows the initial stock, receipts, usage, remaining stock, and requested additional stock for each drug. For some Albendazol entries, usage of 80, 2, 100, 100, 30 tablets are reported, reducing the remaining stock by those amounts. The document requests additional stocks of 120, 150, 150, 45 tablets of Albendazol to meet needs.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as xls, pdf, or txt
    10 views79 pages

    Lplpo Ponkesdes Tugu 2022

    Uploaded by

    Yündâ Dâmâyântî Rürâ
    This document reports on the usage and request for drug supplies (LPLPO) at a health clinic for the month of January 2022. It includes a table listing 56 drugs including Albendazol 400 mg tablets. The table shows the initial stock, receipts, usage, remaining stock, and requested additional stock for each drug. For some Albendazol entries, usage of 80, 2, 100, 100, 30 tablets are reported, reducing the remaining stock by those amounts. The document requests additional stocks of 120, 150, 150, 45 tablets of Albendazol to meet needs.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as xls, pdf, or txt
    of 79

    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    POLINDES/PUSTU/UNIT PELAYANAN: TUGU PELAPORAN BULAN / PERIODE : JANUARI 2022


    PERMINTAAN BULAN / PERIODE : ………………………………………..

    NOMOR : ...............................................
    TANGGAL : ………………………………………

    STOK PENERI PERSE HARGA SISA PERMIN


    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK STOK OPT KET.
    AWAL MAAN DIAAN STOK TAAN PEMBERIAN
    N

    1 Albendazol 400 mg tablet - - - - - -


    2 Albendazol 400 mg tablet - - - - - -
    3 Albendazol 400 mg tablet - - - - - -
    4 Albendazol 400 mg tablet - - - - - -
    5 Albendazol 400 mg tablet - - - - - -
    6 Albendazol 400 mg tablet - - - 80 (80) - 120
    7 Albendazol 400 mg tablet - - - - - -
    8 Albendazol 400 mg tablet - - - - - -
    9 Albendazol 400 mg tablet - - - - - -
    10 Albendazol 400 mg tablet - - - 2 (2) -
    11 Albendazol 400 mg tablet - - - 100 (100) - 150
    12 Albendazol 400 mg tablet - - - - - -
    13 Albendazol 400 mg tablet - - - - - -
    14 Albendazol 400 mg tablet - - - - - -
    15 Albendazol 400 mg tablet - - - - - -
    16 Albendazol 400 mg tablet - - - - - -
    17 Albendazol 400 mg tablet - - - - - -
    18 Albendazol 400 mg tablet - - - - - -
    19 Albendazol 400 mg tablet - - - 100 (100) - 150
    20 Albendazol 400 mg tablet - - - - - -
    21 Albendazol 400 mg tablet - - - - - -
    22 Albendazol 400 mg tablet - - - - - -
    23 Albendazol 400 mg tablet - - - - - -
    24 Albendazol 400 mg tablet - - - - - -
    25 Albendazol 400 mg tablet - - - - - -
    26 Albendazol 400 mg tablet - - - - - -
    27 Albendazol 400 mg tablet - - - - - -
    28 Albendazol 400 mg tablet - - - - - -
    29 Albendazol 400 mg tablet - - - - - -
    30 Albendazol 400 mg tablet - - - - - -
    31 Albendazol 400 mg tablet - - - - - -
    32 Albendazol 400 mg tablet - - - - - -
    33 Albendazol 400 mg tablet - - - - - -
    34 Albendazol 400 mg tablet - - - - - -
    35 Albendazol 400 mg tablet - - - - - -
    36 Albendazol 400 mg tablet - - - - - -
    37 Albendazol 400 mg tablet - - - - - -
    38 Albendazol 400 mg tablet - - - - - -
    39 Albendazol 400 mg tablet - - - - - -
    40 Albendazol 400 mg tablet - - - - - -
    41 Albendazol 400 mg tablet - - - - - -
    42 Albendazol 400 mg tablet - - - - - -
    43 Albendazol 400 mg tablet - - - - -
    STOK PENERI PERSE HARGA SISA PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK STOK OPT KET.
    AWAL MAAN DIAAN STOK TAAN PEMBERIAN
    N

    44 Albendazol 400 mg tablet - - - - - -


    45 Albendazol 400 mg tablet - - - - - - -
    46 Albendazol 400 mg tablet - - - - - -
    47 Albendazol 400 mg tablet - - - - - -
    48 Albendazol 400 mg tablet - - - - - -
    49 Albendazol 400 mg tablet - - - - - -
    50 Albendazol 400 mg tablet - - - - - -
    51 Albendazol 400 mg tablet - - - - - -
    52 Albendazol 400 mg tablet - - - - - -
    53 Albendazol 400 mg tablet - - - - - -
    54 Albendazol 400 mg tablet - - - 30 (30) - 45
    55 Albendazol 400 mg tablet - - - - - -
    56 Albendazol 400 mg tablet - - - - - -
    57 Albendazol 400 mg tablet - - - - - -
    58 Albendazol 400 mg tablet - - - - - -
    59 Albendazol 400 mg tablet - - - - -
    60 Albendazol 400 mg tablet - - - - - -
    61 Albendazol 400 mg tablet - - - - - -
    62 Albendazol 400 mg tablet - - - - - -
    63 Albendazol 400 mg tablet - - - - - -
    64 Albendazol 400 mg tablet - - - - - -
    65 Albendazol 400 mg tablet - - - 80 (80) - 120
    66 Albendazol 400 mg tablet - - - - - -
    67 Albendazol 400 mg tablet - - - - - -
    68 Albendazol 400 mg tablet - - - - - -
    69 Albendazol 400 mg tablet - - - - - -
    70 Albendazol 400 mg tablet - - - - - -
    71 Albendazol 400 mg tablet - - - - -
    72 Albendazol 400 mg tablet - - - - - -
    73 Albendazol 400 mg tablet - - - - - -
    74 Albendazol 400 mg tablet - - - - -
    75 Albendazol 400 mg tablet - - - - - -
    76 Albendazol 400 mg tablet - - - - -
    77 Albendazol 400 mg tablet - - - - - -
    78 Albendazol 400 mg tablet - - - - -
    79 Albendazol 400 mg tablet - - - - - -
    80 Albendazol 400 mg tablet - - - - - -
    81 Albendazol 400 mg tablet - - - - - -
    82 Albendazol 400 mg tablet - - - - - -
    83 Albendazol 400 mg tablet - - - - - -
    84 Albendazol 400 mg tablet - - - - - -
    85 Albendazol 400 mg tablet - - - - - - -
    86 Albendazol 400 mg tablet - - - - - -
    87 Albendazol 400 mg tablet - - - 14 (14) - 21
    88 Albendazol 400 mg tablet - - - - - -
    89 Albendazol 400 mg tablet - - - - - -
    90 Albendazol 400 mg tablet - - - - - -
    91 Albendazol 400 mg tablet - - - - - -
    92 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE HARGA SISA PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK STOK OPT KET.
    AWAL MAAN DIAAN STOK TAAN PEMBERIAN
    N

    93 Albendazol 400 mg tablet - - - - - -


    94 Albendazol 400 mg tablet - - - - - -
    95 Albendazol 400 mg tablet - - - - - -
    96 Albendazol 400 mg tablet - - - - - -
    97 Albendazol 400 mg tablet - - - - - -
    98 Albendazol 400 mg tablet - - - - - -
    99 Albendazol 400 mg tablet - - - - - -
    100 Albendazol 400 mg tablet - - - - - -
    101 Albendazol 400 mg tablet - - - - - -
    102 Albendazol 400 mg tablet - - - - - -
    103 Albendazol 400 mg tablet - - - - - -
    104 Albendazol 400 mg tablet - - - - -
    105 Albendazol 400 mg tablet - - - - - -
    106 Albendazol 400 mg tablet - - - - - -
    107 Albendazol 400 mg tablet - - - - -
    108 Albendazol 400 mg tablet - - - - - -
    109 Albendazol 400 mg tablet - - - - - -
    110 Albendazol 400 mg tablet - - - - - -
    111 Albendazol 400 mg tablet - - - - - -
    112 Albendazol 400 mg tablet - - - - -
    113 Albendazol 400 mg tablet - - - 100 (100) - 150
    114 Albendazol 400 mg tablet - - - - - -
    115 Albendazol 400 mg tablet - - - - - -
    Albendazol 400 mg tablet - - - - - -
    116 Albendazol 400 mg tablet - - - - - -
    117 Albendazol 400 mg tablet - - - - - -
    118 Albendazol 400 mg tablet - - - - - -
    119 Albendazol 400 mg tablet - - - - - -
    120 Albendazol 400 mg tablet - - - - - -
    121 Albendazol 400 mg tablet - - - - - -
    122 Albendazol 400 mg tablet - - - - - -
    123 Albendazol 400 mg tablet - - - - - -
    124 Albendazol 400 mg tablet - - - - -
    125 Albendazol 400 mg tablet - - - - - -
    126 Albendazol 400 mg tablet - - - - - -
    127 Albendazol 400 mg tablet - - - - - -
    128 Albendazol 400 mg tablet - - - - - -
    129 Albendazol 400 mg tablet - - - - -
    130 Albendazol 400 mg tablet - - - - - -
    131 Albendazol 400 mg tablet - - - - - -

    132
    Albendazol 400 mg tablet - - - - - -
    133 Albendazol 400 mg tablet - - - - - -
    134 Albendazol 400 mg tablet - - - - - -
    135 Dimenhidrinate tablet - - - - -
    136 Albendazol 400 mg tablet - - - - -
    137 Albendazol 400 mg tablet - - - - -
    Albendazol 400 mg tablet - - - - - -
    138 Albendazol 400 mg tablet - - - - - -
    139 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE HARGA SISA PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK STOK OPT KET.
    AWAL MAAN DIAAN STOK TAAN PEMBERIAN
    N

    140 Albendazol 400 mg tablet - - - - - -


    141 Albendazol 400 mg tablet - - - - -
    Albendazol 400 mg tablet - - - - -
    JUMLAH : - - (506) - -

    JKN NON JKN JUMLAH Generik Paten


    JML. KUNJUNGAN RESEP BULAN INI
    0

    Tulungagung, Januari 2022


    mengetahui, Yang menyerahkan Yang melaporkan
    Kepala UPT Puskesmas Dono Petugas UPT Puskesmas Dono Petugas Pustu / Polindes

    HERI SUSANTO, S.Gz SUSIANIK, Amd. Farm YUYUN DAMAYANTI


    NIP. 19851206 201001 1 017 NIP. 19700706 199303 2 008
    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    POLINDES/PUSTU/UNIT PELAYANAN: TUGU PELAPORAN BULAN / PERIODE : FEBRUARI 2022


    PERMINTAAN BULAN / PERIODE : MARET 2022

    NOMOR : ...............................................
    TANGGAL : ………………………………………

    STOK PENERI PERSE PERMIN


    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT PEMBERIAN KET.
    AWAL MAAN DIAAN TAAN
    N

    1 Albendazol 400 mg tablet - - - - - -


    2 Albendazol 400 mg tablet - - - - - -
    3 Albendazol 400 mg tablet - - - - - -
    4 Albendazol 400 mg tablet - - - - - -
    5 Albendazol 400 mg tablet - - - - - -
    6 Albendazol 400 mg tablet - (80) (80) 50 (130) - 75 500
    7 Albendazol 400 mg tablet - - - - - -
    8 Albendazol 400 mg tablet - - - - - -
    9 Albendazol 400 mg tablet - - - - - -
    10 Albendazol 400 mg tablet - (2) (2) 10 (12) - 15 30
    11 Albendazol 400 mg tablet - (100) (100) 100 (200) - 150 500
    12 Albendazol 400 mg tablet - - - - - -
    13 Albendazol 400 mg tablet - - - - - -
    14 Albendazol 400 mg tablet - - - - - -
    15 Albendazol 400 mg tablet - - - - - -
    16 Albendazol 400 mg tablet - - - - - -
    17 Albendazol 400 mg tablet - - - - - -
    18 Albendazol 400 mg tablet - - - - - -
    19 Albendazol 400 mg tablet - (100) (100) 20 (120) - 30 700
    20 Albendazol 400 mg tablet - - - - - -
    21 Albendazol 400 mg tablet - - - - - -
    22 Albendazol 400 mg tablet - - - - - -
    23 Albendazol 400 mg tablet - - - - - -
    24 Albendazol 400 mg tablet - - - - - -
    25 Albendazol 400 mg tablet - - - - - -
    26 Albendazol 400 mg tablet - - - - - -
    27 Albendazol 400 mg tablet - - - - - -
    28 Albendazol 400 mg tablet - - - - - -
    29 Albendazol 400 mg tablet - - - - - -
    30 Albendazol 400 mg tablet - - - - - -
    31 Albendazol 400 mg tablet - - - - - -
    32 Albendazol 400 mg tablet - - - - - -
    33 Albendazol 400 mg tablet - - - - - -
    34 Albendazol 400 mg tablet - - - - - -
    35 Albendazol 400 mg tablet - - - - - -
    36 Albendazol 400 mg tablet - - - - - -
    37 Albendazol 400 mg tablet - - - - - -
    38 Albendazol 400 mg tablet - - - - - -
    39 Albendazol 400 mg tablet - - - - - -
    40 Albendazol 400 mg tablet - - - - - -
    41 Albendazol 400 mg tablet - - - - - -
    42 Albendazol 400 mg tablet - - - - - -
    43 Albendazol 400 mg tablet - - - - - -
    44 Albendazol 400 mg tablet - - - - - -
    45 Albendazol 400 mg tablet - - - - - - -
    46 Albendazol 400 mg tablet - - - - - -
    47 Albendazol 400 mg tablet - - - - - -
    48 Albendazol 400 mg tablet - - - - - -
    49 Albendazol 400 mg tablet - - - - - -
    50 Albendazol 400 mg tablet - - - - - -
    51 Albendazol 400 mg tablet - - - - - -
    52 Albendazol 400 mg tablet - - - - - -
    53 Albendazol 400 mg tablet - - - - - -
    54 Albendazol 400 mg tablet - (30) (30) (30) - -
    55 Albendazol 400 mg tablet - - - - - -
    56 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT PEMBERIAN KET.
    AWAL MAAN DIAAN TAAN
    N

    57 Albendazol 400 mg tablet - - - - - -


    58 Albendazol 400 mg tablet - - - - - -
    59 Albendazol 400 mg tablet - - - - - -
    60 Albendazol 400 mg tablet - - - - - -
    61 Albendazol 400 mg tablet - - - - - -
    62 Albendazol 400 mg tablet - - - - - - 15
    63 Albendazol 400 mg tablet - - - - - -
    64 Albendazol 400 mg tablet - - - - - -
    65 Albendazol 400 mg tablet - (80) (80) (80) - -
    66 Albendazol 400 mg tablet - - - - - -
    67 Albendazol 400 mg tablet - - - - - -
    68 Albendazol 400 mg tablet - - - - - -
    69 Albendazol 400 mg tablet - - - - - -
    70 Albendazol 400 mg tablet - - - - - -
    71 Albendazol 400 mg tablet - - - - - -
    72 Albendazol 400 mg tablet - - - - - -
    73 Albendazol 400 mg tablet - - - - - - 100
    74 Albendazol 400 mg tablet - - - - - -
    75 Albendazol 400 mg tablet - - - - - - 20
    76 Albendazol 400 mg tablet - - - - - -
    77 Albendazol 400 mg tablet - - - - - -
    78 Albendazol 400 mg tablet - - - - - -
    79 Albendazol 400 mg tablet - - - - - -
    80 Albendazol 400 mg tablet - - - - - -
    81 Albendazol 400 mg tablet - - - - - -
    82 Albendazol 400 mg tablet - - - - - -
    83 Albendazol 400 mg tablet - - - - - -
    84 Albendazol 400 mg tablet - - - - - -
    85 Albendazol 400 mg tablet - - - 2 (2) - 3
    86 Albendazol 400 mg tablet - - - - - -
    87 Albendazol 400 mg tablet - (14) (14) 14 (28) - 21
    88 Albendazol 400 mg tablet - - - - - -
    89 Albendazol 400 mg tablet - - - - - -
    90 Albendazol 400 mg tablet - - - - - -
    91 Albendazol 400 mg tablet - - - - - -
    92 Albendazol 400 mg tablet - - - - - -
    93 Albendazol 400 mg tablet - - - - - -
    94 Albendazol 400 mg tablet - - - - - -
    95 Albendazol 400 mg tablet - - - - - -
    96 Albendazol 400 mg tablet - - - - - -
    97 Albendazol 400 mg tablet - - - - - -
    98 Albendazol 400 mg tablet - - - - - -
    99 Albendazol 400 mg tablet - - - - - -
    100 Albendazol 400 mg tablet - - - - - -
    101 Albendazol 400 mg tablet - - - - - -
    102 Albendazol 400 mg tablet - - - - - -
    103 Albendazol 400 mg tablet - - - - - -
    104 Albendazol 400 mg tablet - - - - - -
    105 Albendazol 400 mg tablet - - - - - - 300
    106 Albendazol 400 mg tablet - - - - - -
    107 Albendazol 400 mg tablet - - - - - -
    108 Albendazol 400 mg tablet - - - - - -
    109 Albendazol 400 mg tablet - - - - - -
    110 Albendazol 400 mg tablet - - - - - - 200
    111 Albendazol 400 mg tablet - - - - - -
    112 Albendazol 400 mg tablet - - - - - -
    113 Albendazol 400 mg tablet - (100) (100) (100) - -
    114 Albendazol 400 mg tablet - - - - - -
    115 Albendazol 400 mg tablet - - - - - -
    Albendazol 400 mg tablet - - - - - -
    116 Albendazol 400 mg tablet - - - - - -
    117 Albendazol 400 mg tablet - - - - - -
    118 Albendazol 400 mg tablet - - - - - -
    119 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT PEMBERIAN KET.
    AWAL MAAN DIAAN TAAN
    N

    120 Albendazol 400 mg tablet - - - - - -


    121 Albendazol 400 mg tablet - - - - - -
    122 Albendazol 400 mg tablet - - - - - -
    123 Albendazol 400 mg tablet - - - - - -
    124 Albendazol 400 mg tablet - - - - - -
    125 Albendazol 400 mg tablet - - - - - -
    126 Albendazol 400 mg tablet - - - - - -
    127 Albendazol 400 mg tablet - - - - - -
    128 Albendazol 400 mg tablet - - - - - -
    129 Albendazol 400 mg tablet - - - - - -
    130 Albendazol 400 mg tablet - - - - - -
    131 Albendazol 400 mg tablet - - - - - -
    132 Albendazol 400 mg tablet - - - - - -
    133 Albendazol 400 mg tablet - - - - - -
    134 Albendazol 400 mg tablet - - - - - -
    135 Dimenhidrinate tablet - - - - - -
    136 Albendazol 400 mg tablet - - - - - -
    137 Albendazol 400 mg tablet - - - - - -
    Albendazol 400 mg tablet - - - - - -
    138 Albendazol 400 mg tablet - - - - - -
    139 Albendazol 400 mg tablet - - - - - -
    140 Albendazol 400 mg tablet - - - - - -
    141 Albendazol 400 mg tablet -
    142 Albendazol 400 mg tablet - - - - - -
    JUMLAH : (506) (506) (506) -

    JKN NON JKN JUMLAH Generik Paten


    JML. KUNJUNGAN RESEP BULAN INI
    0

    Tulungagung, Februari 2022


    mengetahui, Yang menyerahkan Yang melaporkan
    Kepala UPT Puskesmas Dono Petugas UPT Puskesmas Dono Petugas Pustu / Polindes

    HERI SUSANTO, S.Gz SUSIANIK, Amd. Farm YUYUN DAMAYANTI


    NIP. 19851206 201001 1 017 NIP. 19700706 199303 2 008

    A
    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    POLINDES/PUSTU/UNIT PELAYANAN: TUGU PELAPORAN BULAN / PERIODE : MARET 2022


    PERMINTAAN BULAN / PERIODE :

    NOMOR : ...............................................
    TANGGAL : …………………………………..

    STOK PENERI PERSE


    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT
    AWAL MAAN DIAAN
    N

    1 Albendazol 400 mg tablet - - - - - -


    2 Albendazol 400 mg tablet - - - - - -
    3 Albendazol 400 mg tablet - - - - - -
    4 Albendazol 400 mg tablet - - - - - - -
    5 Albendazol 400 mg tablet - - - - - -
    6 Albendazol 400 mg tablet - (130) (130) (130) - -
    7 Albendazol 400 mg tablet - - - - - -
    8 Albendazol 400 mg tablet - - - - - -
    9 Albendazol 400 mg tablet - - - - - -
    10 Albendazol 400 mg tablet - (12) 30 18 14 4 - 21
    11 Albendazol 400 mg tablet - (200) 400 200 200 - -
    12 Albendazol 400 mg tablet - - - - - -
    13 Albendazol 400 mg tablet - - - - - -
    14 Albendazol 400 mg tablet - - - - - -
    15 Albendazol 400 mg tablet - - - - - -
    16 Albendazol 400 mg tablet - - - - - -
    17 Albendazol 400 mg tablet - - - - - -
    18 Albendazol 400 mg tablet - - - - - -
    19 Albendazol 400 mg tablet - (120) 700 580 230 350 - 345
    20 Albendazol 400 mg tablet - - - - - -
    21 Albendazol 400 mg tablet - - - - - -
    22 Albendazol 400 mg tablet - - - - - -
    23 Albendazol 400 mg tablet - - - - - -
    24 Albendazol 400 mg tablet - - - - - -
    25 Albendazol 400 mg tablet - - - - - -
    26 Albendazol 400 mg tablet - - - - - -
    27 Albendazol 400 mg tablet - - - - - -
    28 Albendazol 400 mg tablet - - - - - -
    29 Albendazol 400 mg tablet - - - - - -
    30 Albendazol 400 mg tablet - - - - - - -
    31 Albendazol 400 mg tablet - - - - - -
    32 Albendazol 400 mg tablet - - - - - -
    33 Albendazol 400 mg tablet - - - - - - -
    34 Albendazol 400 mg tablet - - - - - - -
    35 Albendazol 400 mg tablet - - - - - -
    36 Albendazol 400 mg tablet - - - - - -
    37 Albendazol 400 mg tablet - - - - - -
    38 Albendazol 400 mg tablet - - - - - -
    39 Albendazol 400 mg tablet - - - - - -
    40 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT
    AWAL MAAN DIAAN
    N

    41 Albendazol 400 mg tablet - - - - - -


    42 Albendazol 400 mg tablet - - - - - -
    43 Albendazol 400 mg tablet - - - - - -
    44 Albendazol 400 mg tablet - - - - - -
    45 Albendazol 400 mg tablet - - - 1 (1) - 2
    46 Albendazol 400 mg tablet - - - - - -
    47 Albendazol 400 mg tablet - - - - - -
    48 Albendazol 400 mg tablet - - - - - -
    49 Albendazol 400 mg tablet - - - - - -
    50 Albendazol 400 mg tablet - - - - - -
    51 Albendazol 400 mg tablet - - - - - -
    52 Albendazol 400 mg tablet - - - - - -
    53 Albendazol 400 mg tablet - - - - - -
    54 Albendazol 400 mg tablet - (30) (30) (30) - -
    55 Albendazol 400 mg tablet - - - - - -
    56 Albendazol 400 mg tablet - - - - - -
    57 Albendazol 400 mg tablet - - - - - -
    58 Albendazol 400 mg tablet - - - - - -
    59 Albendazol 400 mg tablet - - - - - -
    60 Albendazol 400 mg tablet - - - - - -
    61 Albendazol 400 mg tablet - - - - - -
    62 Albendazol 400 mg tablet - - 15 15 4 11 - 6
    63 Albendazol 400 mg tablet - - - - - -
    64 Albendazol 400 mg tablet - - - - - -
    65 Albendazol 400 mg tablet - (80) (80) (80) - -
    66 Albendazol 400 mg tablet - - - - - -
    67 Albendazol 400 mg tablet - - - - - -
    68 Albendazol 400 mg tablet - - - - - -
    69 Albendazol 400 mg tablet - - - - - -
    70 Albendazol 400 mg tablet - - - - - -
    71 Albendazol 400 mg tablet - - - - - -
    72 Albendazol 400 mg tablet - - - - - -
    73 Albendazol 400 mg tablet - - 100 100 20 80 - 30
    74 Albendazol 400 mg tablet - - - - - -
    75 Albendazol 400 mg tablet - - 10 10 2 8 - 3
    76 Albendazol 400 mg tablet - - - - - -
    77 Albendazol 400 mg tablet - - - - - -
    78 Albendazol 400 mg tablet - - - - - -
    79 Albendazol 400 mg tablet - - - - - -
    80 Albendazol 400 mg tablet - - - - - -
    81 Albendazol 400 mg tablet - - - - - -
    82 Albendazol 400 mg tablet - - - - - -
    83 Albendazol 400 mg tablet - - - - - -
    84 Albendazol 400 mg tablet - - - - - -
    85 Albendazol 400 mg tablet - (2) (2) 1 (3) - 2
    86 Albendazol 400 mg tablet - - - - - -
    87 Albendazol 400 mg tablet - (28) (28) 14 (42) - 21
    88 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT
    AWAL MAAN DIAAN
    N

    89 Albendazol 400 mg tablet - - - - - -


    90 Albendazol 400 mg tablet - - - - - -
    91 Albendazol 400 mg tablet - - - - - -
    92 Albendazol 400 mg tablet - - - - - -
    93 Albendazol 400 mg tablet - - - - - -
    94 Albendazol 400 mg tablet - - - - - -
    95 Albendazol 400 mg tablet - - - - - -
    96 Albendazol 400 mg tablet - - - - - -
    97 Albendazol 400 mg tablet - - - - - -
    98 Albendazol 400 mg tablet - - - - - -
    99 Albendazol 400 mg tablet - - - - - -
    100 Albendazol 400 mg tablet - - - - - -
    101 Albendazol 400 mg tablet - - - - - -
    102 Albendazol 400 mg tablet - - - - - -
    103 Albendazol 400 mg tablet - - - - - -
    104 Albendazol 400 mg tablet - - - - - -
    105 Albendazol 400 mg tablet - - 300 300 30 270 - 45
    106 Albendazol 400 mg tablet - - - - - -
    107 Albendazol 400 mg tablet - - - - - -
    108 Albendazol 400 mg tablet - - - - - -
    109 Albendazol 400 mg tablet - - - - - -
    110 Albendazol 400 mg tablet - - 200 200 200 - -
    111 Albendazol 400 mg tablet - - - - - -
    112 Albendazol 400 mg tablet - - - - - -
    113 Albendazol 400 mg tablet - (100) (100) (100) - -
    114 Albendazol 400 mg tablet - - - - - -
    115 Albendazol 400 mg tablet - - - - - -
    Albendazol 400 mg tablet - - - - - -
    116 Albendazol 400 mg tablet - - - - - -
    117 Albendazol 400 mg tablet - - - - - -
    118 Albendazol 400 mg tablet - - - - - -
    119 Albendazol 400 mg tablet - - - - - -
    120 Albendazol 400 mg tablet - - - - - -
    121 Albendazol 400 mg tablet - - - - - -
    122 Albendazol 400 mg tablet - - - - - -
    123 Albendazol 400 mg tablet - - - - - -
    124 Albendazol 400 mg tablet -
    125 Albendazol 400 mg tablet - - - - - -
    126 Albendazol 400 mg tablet - - - - - -
    127 Albendazol 400 mg tablet - - - - - -
    128 Albendazol 400 mg tablet - - - - - -
    129 Albendazol 400 mg tablet - - - - - -
    130 Albendazol 400 mg tablet - - - - - -
    131 Albendazol 400 mg tablet - - - - - -
    132 Albendazol 400 mg tablet - - - - - -
    133 Albendazol 400 mg tablet - - - - - -
    134 Albendazol 400 mg tablet - - - - - -
    135 Ketokonazole sk tablet - - - - - -
    STOK PENERI PERSE
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT
    AWAL MAAN DIAAN
    N

    136 Dimenhidrinate tablet - - 100 100 50 50 - 75


    137 Albendazol 400 mg tablet - - - - - -
    Albendazol 400 mg tablet - - - - - -
    138 Albendazol 400 mg tablet - - - - - -
    139 Albendazol 400 mg tablet - - - - - -
    140 Albendazol 400 mg tablet - - - - - -
    141 Albendazol 400 mg tablet -
    142 Albendazol 400 mg tablet - - - - - -
    JUMLAH : (702) (702) (702) -

    JKN NON JKN JUMLAH Generik


    JML. KUNJUNGAN RESEP BULAN INI
    0

    Tulungagung, Maret 2022


    mengetahui, Yang menyerahkan Yang melaporkan
    Kepala UPT Puskesmas Dono Petugas UPT Puskesmas Dono Petugas Pustu / Polindes

    HERI SUSANTO, S.Gz SUSIANIK, Amd. Farm YUYUN DAMAYANTI


    NIP. 19851206 201001 1 017 NIP. 19700706 199303 2 008
    AKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    NOMOR : ...............................................
    TANGGAL : …………………………………..

    PERMIN
    KET.
    TAAN PEMBERIAN
    PERMIN
    KET.
    TAAN PEMBERIAN
    PERMIN
    KET.
    TAAN PEMBERIAN
    PERMIN
    KET.
    TAAN PEMBERIAN

    Paten

    Tulungagung, Maret 2022


    Yang melaporkan
    Petugas Pustu / Polindes

    YUYUN DAMAYANTI
    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    POLINDES/PUSTU/UNIT PELAYANAN: TUGU PELAPORAN BULAN / PERIODE : APRIL 2022


    PERMINTAAN BULAN / PERIODE : …………………………………..

    NOMOR : ...............................................
    TANGGAL : ………………………………….

    STOK PENERI PERSE PERMIN


    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    1 Albendazol 400 mg tablet - - - - - -


    2 Albendazol 400 mg tablet - - - - - -
    3 Albendazol 400 mg tablet - - - - - -
    4 Albendazol 400 mg tablet - - - - - -
    5 Albendazol 400 mg tablet - - - - - -
    6 Albendazol 400 mg tablet - (130) (130) (130) - -
    7 Albendazol 400 mg tablet - - - - - -
    8 Albendazol 400 mg tablet - - - - - -
    9 Albendazol 400 mg tablet - - - - - -
    10 Albendazol 400 mg tablet - 4 4 8 (4) - 12
    11 Albendazol 400 mg tablet - 200 200 60 140 - 90
    12 Albendazol 400 mg tablet - - - - - -
    13 Albendazol 400 mg tablet - - - - - -
    14 Albendazol 400 mg tablet - - - - - -
    15 Albendazol 400 mg tablet - - - - - -
    16 Albendazol 400 mg tablet - - - - - -
    17 Albendazol 400 mg tablet - - - - - -
    18 Albendazol 400 mg tablet - - - - - -
    19 Albendazol 400 mg tablet - 350 350 200 150 - 300
    20 Albendazol 400 mg tablet - - - - - -
    21 Albendazol 400 mg tablet - - - - - -
    22 Albendazol 400 mg tablet - - - - - -
    23 Albendazol 400 mg tablet - - - - - -
    24 Albendazol 400 mg tablet - - - - - -
    25 Albendazol 400 mg tablet - - - - - -
    26 Albendazol 400 mg tablet - - - - - -
    27 Albendazol 400 mg tablet - - - - - -
    28 Albendazol 400 mg tablet - - - - - -
    29 Albendazol 400 mg tablet - - - - - -
    30 Albendazol 400 mg tablet - - - - - -
    31 Albendazol 400 mg tablet - - - - - -
    32 Albendazol 400 mg tablet - - - - - -
    33 Albendazol 400 mg tablet - - - - - -
    34 Albendazol 400 mg tablet - - - - - -
    35 Albendazol 400 mg tablet - - - - - -
    36 Albendazol 400 mg tablet - - - - - -
    37 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    38 Albendazol 400 mg tablet - - - - - -


    39 Albendazol 400 mg tablet - - - - - -
    40 Albendazol 400 mg tablet - - - - - -
    41 Albendazol 400 mg tablet - - - - - -
    42 Albendazol 400 mg tablet - - - - - -
    43 Albendazol 400 mg tablet - - - - - -
    44 Albendazol 400 mg tablet - - - - - -
    45 Albendazol 400 mg tablet - (1) (1) 1 (2) - 2
    46 Albendazol 400 mg tablet - - - - - -
    47 Albendazol 400 mg tablet - - - - - -
    48 Albendazol 400 mg tablet - - - - - -
    49 Albendazol 400 mg tablet - - - - - -
    50 Albendazol 400 mg tablet - - - - - -
    51 Albendazol 400 mg tablet - - - - - -
    52 Albendazol 400 mg tablet - - - - - -
    53 Albendazol 400 mg tablet - - - - - -
    54 Albendazol 400 mg tablet - (30) (30) (30) - -
    55 Albendazol 400 mg tablet - - - - - -
    56 Albendazol 400 mg tablet - - - - - -
    57 Albendazol 400 mg tablet - - - - - -
    58 Albendazol 400 mg tablet - - - - - -
    59 Albendazol 400 mg tablet - - - - - -
    60 Albendazol 400 mg tablet - - - - - -
    61 Albendazol 400 mg tablet - - - - - -
    62 Albendazol 400 mg tablet - 11 11 5 6 - 8
    63 Albendazol 400 mg tablet - - - - - -
    64 Albendazol 400 mg tablet - - - - - -
    65 Albendazol 400 mg tablet - (80) (80) (80) - -
    66 Albendazol 400 mg tablet - - - - - -
    67 Albendazol 400 mg tablet - - - - - -
    68 Albendazol 400 mg tablet - - - - - -
    69 Albendazol 400 mg tablet - - - - - -
    70 Albendazol 400 mg tablet - - - - - -
    71 Albendazol 400 mg tablet - - - - - -
    72 Albendazol 400 mg tablet - - - - - -
    73 Albendazol 400 mg tablet - 80 80 20 60 - 30
    74 Albendazol 400 mg tablet - - - - - -
    75 Albendazol 400 mg tablet - 8 8 5 3 - 8
    76 Albendazol 400 mg tablet - - - - - -
    77 Albendazol 400 mg tablet - - - - - -
    78 Albendazol 400 mg tablet - - - - - -
    79 Albendazol 400 mg tablet - - - - - -
    80 Albendazol 400 mg tablet - - - - - -
    81 Albendazol 400 mg tablet - - - - - -
    82 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    83 Albendazol 400 mg tablet - - - - - -


    84 Albendazol 400 mg tablet - - - - - -
    85 Albendazol 400 mg tablet - (3) (3) (3) - -
    86 Albendazol 400 mg tablet - - - - - -
    87 Albendazol 400 mg tablet - (42) (42) 14 (56) - 21
    88 Albendazol 400 mg tablet - - - - - -
    89 Albendazol 400 mg tablet - - - - - -
    90 Albendazol 400 mg tablet - - - - - -
    91 Albendazol 400 mg tablet - - - - - -
    92 Albendazol 400 mg tablet - - - - - -
    93 Albendazol 400 mg tablet - - - - - -
    94 Albendazol 400 mg tablet - - - - - -
    95 Albendazol 400 mg tablet - - - - - -
    96 Albendazol 400 mg tablet - - - - - -
    97 Albendazol 400 mg tablet - - - - - -
    98 Albendazol 400 mg tablet - - - - - -
    99 Albendazol 400 mg tablet - - - - - -
    100 Albendazol 400 mg tablet - - - - - -
    101 Albendazol 400 mg tablet - - - - - -
    102 Albendazol 400 mg tablet - - - - - -
    103 Albendazol 400 mg tablet - - - - - -
    104 Albendazol 400 mg tablet - - - - - -
    105 Albendazol 400 mg tablet - 270 270 40 230 - 60
    106 Albendazol 400 mg tablet - - - - - -
    107 Albendazol 400 mg tablet - - - - - -
    108 Albendazol 400 mg tablet - - - - - -
    109 Albendazol 400 mg tablet - - - - - -
    110 Albendazol 400 mg tablet - 200 200 200 - -
    111 Albendazol 400 mg tablet - - - - - -
    112 Albendazol 400 mg tablet - - - - - -
    113 Albendazol 400 mg tablet - (100) (100) (100) - -
    114 Albendazol 400 mg tablet - - - - - -
    115 Albendazol 400 mg tablet - - - - - -
    Albendazol 400 mg tablet - - - - - -
    116 Albendazol 400 mg tablet - - - - - -
    117 Albendazol 400 mg tablet - - - - - -
    118 Albendazol 400 mg tablet - - - - - -
    119 Albendazol 400 mg tablet - - - - - -
    120 Albendazol 400 mg tablet - - - - - -
    121 Albendazol 400 mg tablet - - - - - -
    122 Albendazol 400 mg tablet - - - - - -
    123 Albendazol 400 mg tablet - - - - - -
    124 Albendazol 400 mg tablet -
    125 Albendazol 400 mg tablet - - - - - -
    126 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    127 Albendazol 400 mg tablet - - - - - -


    128 Albendazol 400 mg tablet - - - - - -
    129 Albendazol 400 mg tablet - - - - - -
    130 Albendazol 400 mg tablet - - - - - -
    131 Albendazol 400 mg tablet - - - - - -
    132 Albendazol 400 mg tablet - - - - - -
    133 Albendazol 400 mg tablet - - - - - -
    134 Albendazol 400 mg tablet - - - - - -
    135 Ketokonazole sk tablet - - - - - -
    136 Dimenhidrinate tablet - 50 50 50 - - 75
    137 Albendazol 400 mg tablet - - - - - -
    Albendazol 400 mg tablet - - - - - -
    138 Albendazol 400 mg tablet - - - - - -
    139 Albendazol 400 mg tablet - - - - - -
    140 Albendazol 400 mg tablet - - - - - -
    141 Albendazol 400 mg tablet -
    142 Albendazol 400 mg tablet - - - - - -
    JUMLAH : 787 - 787 384 -

    JKN NON JKN JUMLAH Generik Paten


    JML. KUNJUNGAN RESEP BULAN INI
    0

    Tulungagung, Maret 2022


    mengetahui, Yang menyerahkan Yang melaporkan
    Kepala UPT Puskesmas Dono Petugas UPT Puskesmas Dono Petugas Pustu / Polindes

    HERI SUSANTO, S.Gz SUSIANIK, Amd. Farm YUYUN DAMAYANTI


    NIP. 19851206 201001 1 017 NIP. 19700706 199303 2 008
    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    POLINDES/PUSTU/UNIT PELAYANAN: TUGU PELAPORAN BULAN / PERIODE : MEI 2022


    PERMINTAAN BULAN / PERIODE : JUNI 2022

    NOMOR : ...............................................
    TANGGAL : ………………………………….

    STOK PENERI PERSE PERMIN


    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    1 Albendazol 400 mg tablet - - - - - -


    2 Albendazol 400 mg tablet - - - - - -
    3 Albendazol 400 mg tablet - - - - - -
    4 Albendazol 400 mg tablet - - - - - -
    5 Albendazol 400 mg tablet - - - - - -
    6 Albendazol 400 mg tablet - (130) (130) - (130) - - 500
    7 Albendazol 400 mg tablet - - - - - -
    8 Albendazol 400 mg tablet - - - - - -
    9 Albendazol 400 mg tablet - - - - - -
    10 Albendazol 400 mg tablet - (4) (4) 5 (9) - 8 30
    11 Albendazol 400 mg tablet - 140 140 60 80 - 90
    12 Albendazol 400 mg tablet - - - - - -
    13 Albendazol 400 mg tablet - - - - - -
    14 Albendazol 400 mg tablet - - - - - -
    15 Albendazol 400 mg tablet - - - - - -
    16 Albendazol 400 mg tablet - - - - - -
    17 Albendazol 400 mg tablet - - - - - -
    18 Albendazol 400 mg tablet - - - - - -
    19 Albendazol 400 mg tablet - 150 150 214 (64) - 321 700
    20 Albendazol 400 mg tablet - - - - - -
    21 Albendazol 400 mg tablet - - - - - -
    22 Albendazol 400 mg tablet - - - - - -
    23 Albendazol 400 mg tablet - - - - - -
    24 Albendazol 400 mg tablet - - - - - -
    25 Albendazol 400 mg tablet - - - - - -
    26 Albendazol 400 mg tablet - - - - - -
    27 Albendazol 400 mg tablet - - - - - -
    28 Albendazol 400 mg tablet - - - - - -
    29 Albendazol 400 mg tablet - - - - - -
    30 Albendazol 400 mg tablet - - - - - -
    31 Albendazol 400 mg tablet - - - - - -
    32 Albendazol 400 mg tablet - - - - - -
    33 Albendazol 400 mg tablet - - - - - -
    34 Albendazol 400 mg tablet - - - - - -
    35 Albendazol 400 mg tablet - - - - - -
    36 Albendazol 400 mg tablet - - - - - -
    37 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    38 Albendazol 400 mg tablet - - - - - -


    39 Albendazol 400 mg tablet - - - - - -
    40 Albendazol 400 mg tablet - - - - - -
    41 Albendazol 400 mg tablet - - - - - -
    42 Albendazol 400 mg tablet - - - - - -
    43 Albendazol 400 mg tablet - - - - - -
    44 Albendazol 400 mg tablet - - - - - -
    45 Albendazol 400 mg tablet - (2) (2) (2) - -
    46 Albendazol 400 mg tablet - - - - - -
    47 Albendazol 400 mg tablet - - - - - -
    48 Albendazol 400 mg tablet - - - - - -
    49 Albendazol 400 mg tablet - - - - - -
    50 Albendazol 400 mg tablet - - - - - -
    51 Albendazol 400 mg tablet - - - - - -
    52 Albendazol 400 mg tablet - - - - - -
    53 Albendazol 400 mg tablet - - - - - -
    54 Albendazol 400 mg tablet - (30) (30) (30) - -
    55 Albendazol 400 mg tablet - - - - - -
    56 Albendazol 400 mg tablet - - - - - -
    57 Albendazol 400 mg tablet - - - - - -
    58 Albendazol 400 mg tablet - - - - - -
    59 Albendazol 400 mg tablet - - - - - -
    60 Albendazol 400 mg tablet - - - - - -
    61 Albendazol 400 mg tablet - - - - - -
    62 Albendazol 400 mg tablet - 6 6 3 3 - 5 10
    63 Albendazol 400 mg tablet - - - - - -
    64 Albendazol 400 mg tablet - - - - - -
    65 Albendazol 400 mg tablet - (80) (80) (80) - - 500
    66 Albendazol 400 mg tablet - - - - - -
    67 Albendazol 400 mg tablet - - - - - -
    68 Albendazol 400 mg tablet - - - - - -
    69 Albendazol 400 mg tablet - - - - - -
    70 Albendazol 400 mg tablet - - - - - -
    71 Albendazol 400 mg tablet - - - - - -
    72 Albendazol 400 mg tablet - - - - - -
    73 Albendazol 400 mg tablet - 60 60 10 50 - 15
    74 Albendazol 400 mg tablet - - - - - -
    75 Albendazol 400 mg tablet - 3 3 3 - - 5 18
    76 Albendazol 400 mg tablet - - - - - -
    77 Albendazol 400 mg tablet - - - - - -
    78 Albendazol 400 mg tablet - - - - - -
    79 Albendazol 400 mg tablet - - - - - -
    80 Albendazol 400 mg tablet - - - - - -
    81 Albendazol 400 mg tablet - - - - - -
    82 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    83 Albendazol 400 mg tablet - - - - - -


    84 Albendazol 400 mg tablet - - - - - -
    85 Albendazol 400 mg tablet - (3) (3) (3) - - 10
    86 Albendazol 400 mg tablet - - - - - -
    87 Albendazol 400 mg tablet - (56) (56) 14 (70) - 21 500
    88 Albendazol 400 mg tablet - - - - - -
    89 Albendazol 400 mg tablet - - - - - -
    90 Albendazol 400 mg tablet - - - - - -
    91 Albendazol 400 mg tablet - - - - - -
    92 Albendazol 400 mg tablet - - - - - -
    93 Albendazol 400 mg tablet - - - - - -
    94 Albendazol 400 mg tablet - - - - - -
    95 Albendazol 400 mg tablet - - - - - -
    96 Albendazol 400 mg tablet - - - - - -
    97 Albendazol 400 mg tablet - - - - - -
    98 Albendazol 400 mg tablet - - - - - -
    99 Albendazol 400 mg tablet - - - - - -
    100 Albendazol 400 mg tablet - - - - - -
    101 Albendazol 400 mg tablet - - - - - -
    102 Albendazol 400 mg tablet - - - - - -
    103 Albendazol 400 mg tablet - - - - - - 5
    104 Albendazol 400 mg tablet - - - - - -
    105 Albendazol 400 mg tablet - 230 230 30 200 - 45
    106 Albendazol 400 mg tablet - - - - - -
    107 Albendazol 400 mg tablet - - - - - -
    108 Albendazol 400 mg tablet - - - - - -
    109 Albendazol 400 mg tablet - - - - - -
    110 Albendazol 400 mg tablet - 200 200 50 150 - 75
    111 Albendazol 400 mg tablet - - - - - -
    112 Albendazol 400 mg tablet - - - - - -
    113 Albendazol 400 mg tablet - (100) (100) (100) - - 500
    114 Albendazol 400 mg tablet - - - - - -
    115 Albendazol 400 mg tablet - - - - - -
    Albendazol 400 mg tablet - - - - - -
    116 Albendazol 400 mg tablet - - - - - -
    117 Albendazol 400 mg tablet - - - - - -
    118 Albendazol 400 mg tablet - - - - - -
    119 Albendazol 400 mg tablet - - - - - -
    120 Albendazol 400 mg tablet - - - - - -
    121 Albendazol 400 mg tablet - - - - - -
    122 Albendazol 400 mg tablet - - - - - -
    123 Albendazol 400 mg tablet - - - - - -
    124 Albendazol 400 mg tablet -
    125 Albendazol 400 mg tablet - - - - - -
    126 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    127 Albendazol 400 mg tablet - - - - - -


    128 Albendazol 400 mg tablet - - - - - -
    129 Albendazol 400 mg tablet - - - - - -
    130 Albendazol 400 mg tablet - - - - - -
    131 Albendazol 400 mg tablet - - - - - -
    132 Albendazol 400 mg tablet - - - - - -
    133 Albendazol 400 mg tablet - - - - - -
    134 Albendazol 400 mg tablet - - - - - -
    135 Ketokonazole sk tablet - - - - - -
    136 Dimenhidrinate tablet - - - - - - 200
    137 Albendazol 400 mg tablet - - - - - -
    Albendazol 400 mg tablet - - - - - -
    138 Albendazol 400 mg tablet - - - - - -
    139 Albendazol 400 mg tablet - - - - - -
    140 Albendazol 400 mg tablet - - - - - -
    141 Albendazol 400 mg tablet -
    142 Albendazol 400 mg tablet - - - -
    JUMLAH : 384 - 384 (5) -

    JKN NON JKN JUMLAH Generik Paten


    JML. KUNJUNGAN RESEP BULAN INI
    0

    Tulungagung, Mei 2022


    mengetahui, Yang menyerahkan Yang melaporkan
    Kepala UPT Puskesmas Dono Petugas UPT Puskesmas Dono Petugas Pustu / Polindes

    HERI SUSANTO, S.Gz SUSIANIK, Amd. Farm YUYUN DAMAYANTI


    NIP. 19851206 201001 1 017 NIP. 19700706 199303 2 008
    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    POLINDES/PUSTU/UNIT PELAYANAN: TUGU PELAPORAN BULAN / PERIODE : JUNI 2022


    PERMINTAAN BULAN / PERIODE :

    NOMOR : ...............................................
    TANGGAL : ………………………………….

    STOK PENERI PERSE PERMIN


    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT
    AWAL MAAN DIAAN TAAN
    N

    1 Albendazol 400 mg tablet - - - - - -


    2 Albendazol 400 mg tablet - - - - - -
    3 Albendazol 400 mg tablet - - - - - -
    4 Albendazol 400 mg tablet - - - - - -
    5 Albendazol 400 mg tablet - - - - - -
    6 Albendazol 400 mg tablet - (130) (130) (130) - -
    7 Albendazol 400 mg tablet - - - - - -
    8 Albendazol 400 mg tablet - - - - - -
    9 Albendazol 400 mg tablet - - - - - -
    10 Albendazol 400 mg tablet - (9) 30 21 13 8 - 20
    11 Albendazol 400 mg tablet - 80 80 80 - - 120
    12 Albendazol 400 mg tablet - - - - - -
    13 Albendazol 400 mg tablet - - - - - -
    14 Albendazol 400 mg tablet - - - - - -
    15 Albendazol 400 mg tablet - - - - - -
    16 Albendazol 400 mg tablet - - - - - -
    17 Albendazol 400 mg tablet - - - - - -
    18 Albendazol 400 mg tablet - - - - - -
    19 Albendazol 400 mg tablet - (64) 700 636 220 416 - 330
    20 Albendazol 400 mg tablet - - - - - -
    21 Albendazol 400 mg tablet - - - - - -
    22 Albendazol 400 mg tablet - - - - - -
    23 Albendazol 400 mg tablet - - - - - -
    24 Albendazol 400 mg tablet - - - - - -
    25 Albendazol 400 mg tablet - - - - - -
    26 Albendazol 400 mg tablet - - - - - -
    27 Albendazol 400 mg tablet - - - - - -
    28 Albendazol 400 mg tablet - - - - - -
    29 Albendazol 400 mg tablet - - - - - -
    30 Albendazol 400 mg tablet - - - - - -
    31 Albendazol 400 mg tablet - - - - - -
    32 Albendazol 400 mg tablet - - - - - -
    33 Albendazol 400 mg tablet - - - - - -
    34 Albendazol 400 mg tablet - - - - - -
    35 Albendazol 400 mg tablet - - - - - -
    36 Albendazol 400 mg tablet - - - - - -
    37 Albendazol 400 mg tablet - - - - - -
    38 Albendazol 400 mg tablet - - - - - -
    39 Albendazol 400 mg tablet - - - - - -
    40 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT
    AWAL MAAN DIAAN TAAN
    N

    41 Albendazol 400 mg tablet - - - - - -


    42 Albendazol 400 mg tablet - - - - - -
    43 Albendazol 400 mg tablet - - - - - -
    44 Albendazol 400 mg tablet - - - - - -
    45 Albendazol 400 mg tablet - (2) (2) (2) - -
    46 Albendazol 400 mg tablet - - - - - -
    47 Albendazol 400 mg tablet - - - - - -
    48 Albendazol 400 mg tablet - - - - - -
    49 Albendazol 400 mg tablet - - - - - -
    50 Albendazol 400 mg tablet - - - - - -
    51 Albendazol 400 mg tablet - - - - - -
    52 Albendazol 400 mg tablet - - - - - -
    53 Albendazol 400 mg tablet - - - - - -
    54 Albendazol 400 mg tablet - (30) (30) (30) - -
    55 Albendazol 400 mg tablet - - - - - -
    56 Albendazol 400 mg tablet - - - - - -
    57 Albendazol 400 mg tablet - - - - - -
    58 Albendazol 400 mg tablet - - - - - -
    59 Albendazol 400 mg tablet - - - - - -
    60 Albendazol 400 mg tablet - - - - - -
    61 Albendazol 400 mg tablet - - - - - -
    62 Albendazol 400 mg tablet - 3 10 13 2 11 - 3
    63 Albendazol 400 mg tablet - - - - - -
    64 Albendazol 400 mg tablet - - - - - -
    65 Albendazol 400 mg tablet - (80) (80) (80) - -
    66 Albendazol 400 mg tablet - - - - - -
    67 Albendazol 400 mg tablet - - - - - -
    68 Albendazol 400 mg tablet - - - - - -
    69 Albendazol 400 mg tablet - - - - - -
    70 Albendazol 400 mg tablet - - - - - -
    71 Albendazol 400 mg tablet - - - - - -
    72 Albendazol 400 mg tablet - - - - - -
    73 Albendazol 400 mg tablet - 50 50 10 40 - 15
    74 Albendazol 400 mg tablet - - - - - -
    75 Albendazol 400 mg tablet - - 18 18 5 13 - 8
    76 Albendazol 400 mg tablet - - - - - -
    77 Albendazol 400 mg tablet - - - - - -
    78 Albendazol 400 mg tablet - - - - - -
    79 Albendazol 400 mg tablet - - - - - -
    80 Albendazol 400 mg tablet - - - - - -
    81 Albendazol 400 mg tablet - - - - - -
    82 Albendazol 400 mg tablet - - - - - -
    83 Albendazol 400 mg tablet - - - - - -
    84 Albendazol 400 mg tablet - - - - - -
    85 Albendazol 400 mg tablet - (3) (3) (3) - -
    86 Albendazol 400 mg tablet - - - - - -
    87 Albendazol 400 mg tablet - (70) (70) 14 (84) - 21
    88 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT
    AWAL MAAN DIAAN TAAN
    N

    89 Albendazol 400 mg tablet - - - - - -


    90 Albendazol 400 mg tablet - - - - - -
    91 Albendazol 400 mg tablet - - - - - -
    92 Albendazol 400 mg tablet - - - - - -
    93 Albendazol 400 mg tablet - - - - - -
    94 Albendazol 400 mg tablet - - - - - -
    95 Albendazol 400 mg tablet - - - - - -
    96 Albendazol 400 mg tablet - - - - - -
    97 Albendazol 400 mg tablet - - - - - -
    98 Albendazol 400 mg tablet - - - - - -
    99 Albendazol 400 mg tablet - - - - - -
    100 Albendazol 400 mg tablet - - - - - -
    101 Albendazol 400 mg tablet - - - - - -
    102 Albendazol 400 mg tablet - - - - - -
    103 Albendazol 400 mg tablet - - 4 4 1 3 - 2
    104 Albendazol 400 mg tablet - - - - - -
    105 Albendazol 400 mg tablet - 200 200 30 170 - 45
    106 Albendazol 400 mg tablet - - - - - -
    107 Albendazol 400 mg tablet - - - - - -
    108 Albendazol 400 mg tablet - - - - - -
    109 Albendazol 400 mg tablet - - - - - -
    110 Albendazol 400 mg tablet - 150 150 - 150 - -
    111 Albendazol 400 mg tablet - - - - - -
    112 Albendazol 400 mg tablet - - - - - -
    113 Albendazol 400 mg tablet - (100) (100) (100) - -
    114 Albendazol 400 mg tablet - - - - - -
    115 Albendazol 400 mg tablet - - - - - -
    Albendazol 400 mg tablet - - - - - -
    116 Albendazol 400 mg tablet - - - - - -
    117 Albendazol 400 mg tablet - - - - - -
    118 Albendazol 400 mg tablet - - - - - -
    119 Albendazol 400 mg tablet - - - - - -
    120 Albendazol 400 mg tablet - - - - - -
    121 Albendazol 400 mg tablet - - - - - -
    122 Albendazol 400 mg tablet - - - - - -
    123 Albendazol 400 mg tablet - - - - - -
    124 Albendazol 400 mg tablet -
    125 Albendazol 400 mg tablet - - - - - -
    126 Albendazol 400 mg tablet - - - - - -
    127 Albendazol 400 mg tablet - - - - - -
    128 Albendazol 400 mg tablet - - - - - -
    129 Albendazol 400 mg tablet - - - - - -
    130 Albendazol 400 mg tablet - - - - - -
    131 Albendazol 400 mg tablet - - - - - -
    132 Albendazol 400 mg tablet - - - - - -
    133 Albendazol 400 mg tablet - - - - - -
    134 Albendazol 400 mg tablet - - - - - -
    135 Ketokonazole sk tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT
    AWAL MAAN DIAAN TAAN
    N

    136 Dimenhidrinate tablet - - 200 200 100 100 - 150


    137 Albendazol 400 mg tablet - - - - - -
    Albendazol 400 mg tablet - - - - - -
    138 Albendazol 400 mg tablet - - - - - -
    139 Albendazol 400 mg tablet - - - - - -
    140 Albendazol 400 mg tablet - - - - - -
    141 Albendazol 400 mg tablet -
    142 Albendazol 400 mg tablet - - - - -
    JUMLAH : (5) 962 957 482 -

    JKN NON JKN JUMLAH Generik Paten


    JML. KUNJUNGAN RESEP BULAN INI
    0

    Tulungagung,
    mengetahui, Yang menyerahkan Yang melaporkan
    Kepala UPT Puskesmas Dono Petugas UPT Puskesmas Dono Petugas Pustu / Polindes

    HERI SUSANTO, S.Gz SUSIANIK, Amd. Farm YUYUN DAMAYANTI


    NIP. 19851206 201001 1 017 NIP. 19700706 199303 2 008
    AIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    KET.
    PEMBERIAN
    KET.
    PEMBERIAN
    KET.
    PEMBERIAN
    KET.
    PEMBERIAN

    Yang melaporkan
    Petugas Pustu / Polindes

    YUYUN DAMAYANTI
    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    POLINDES/PUSTU/UNIT PELAYANAN: TUGU PELAPORAN BULAN / PERIODE : JULI 2022


    PERMINTAAN BULAN / PERIODE : …………………………………

    NOMOR : ...............................................
    TANGGAL : ………………………………….

    STOK PENERI PERSE PERMIN


    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    1 Albendazol 400 mg tablet - - - - - -


    2 Albendazol 400 mg tablet - - - - - -
    3 Albendazol 400 mg tablet - - - - - -
    4 Albendazol 400 mg tablet - - - - - -
    5 Albendazol 400 mg tablet - - - - - -
    6 Albendazol 400 mg tablet - (130) (130) (130) - -
    7 Albendazol 400 mg tablet - - - - - -
    8 Albendazol 400 mg tablet - - - - - -
    9 Albendazol 400 mg tablet - - - - - -
    10 Albendazol 400 mg tablet - 8 8 12 (4) - 18
    11 Albendazol 400 mg tablet - - - 70 (70) - 105
    12 Albendazol 400 mg tablet - - - - - -
    13 Albendazol 400 mg tablet - - - - - -
    14 Albendazol 400 mg tablet - - - - - -
    15 Albendazol 400 mg tablet - - - - - -
    16 Albendazol 400 mg tablet - - - - - -
    17 Albendazol 400 mg tablet - - - - - -
    18 Albendazol 400 mg tablet - - - - - -
    19 Albendazol 400 mg tablet - 416 416 230 186 - 345
    20 Albendazol 400 mg tablet - - - - - -
    21 Albendazol 400 mg tablet - - - - - -
    22 Albendazol 400 mg tablet - - - - - -
    23 Albendazol 400 mg tablet - - - - - -
    24 Albendazol 400 mg tablet - - - - - -
    25 Albendazol 400 mg tablet - - - - - -
    26 Albendazol 400 mg tablet - - - - - -
    27 Albendazol 400 mg tablet - - - - - -
    28 Albendazol 400 mg tablet - - - - - -
    29 Albendazol 400 mg tablet - - - - - -
    30 Albendazol 400 mg tablet - - - - - -
    31 Albendazol 400 mg tablet - - - - - -
    32 Albendazol 400 mg tablet - - - - - -
    33 Albendazol 400 mg tablet - - - - - -
    34 Albendazol 400 mg tablet - - - - - -
    35 Albendazol 400 mg tablet - - - - - -
    36 Albendazol 400 mg tablet - - - - - -
    37 Albendazol 400 mg tablet - - - - - -
    38 Albendazol 400 mg tablet - - - - - -
    39 Albendazol 400 mg tablet - - - - - -
    40 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    41 Albendazol 400 mg tablet - - - - - -


    42 Albendazol 400 mg tablet - - - - - -
    43 Albendazol 400 mg tablet - - - - - -
    44 Albendazol 400 mg tablet - - - - - -
    45 Albendazol 400 mg tablet - (2) (2) (2) - -
    46 Albendazol 400 mg tablet - - - - - -
    47 Albendazol 400 mg tablet - - - - - -
    48 Albendazol 400 mg tablet - - - - - -
    49 Albendazol 400 mg tablet - - - - - -
    50 Albendazol 400 mg tablet - - - - - -
    51 Albendazol 400 mg tablet - - - - - -
    52 Albendazol 400 mg tablet - - - - - -
    53 Albendazol 400 mg tablet - - - - - -
    54 Albendazol 400 mg tablet - (30) (30) (30) - -
    55 Albendazol 400 mg tablet - - - - - -
    56 Albendazol 400 mg tablet - - - - - -
    57 Albendazol 400 mg tablet - - - - - -
    58 Albendazol 400 mg tablet - - - - - -
    59 Albendazol 400 mg tablet - - - - - -
    60 Albendazol 400 mg tablet - - - - - -
    61 Albendazol 400 mg tablet - - - - - -
    62 Albendazol 400 mg tablet - 11 11 2 9 - 3
    63 Albendazol 400 mg tablet - - - - - -
    64 Albendazol 400 mg tablet - - - - - -
    65 Albendazol 400 mg tablet - (80) (80) (80) - -
    66 Albendazol 400 mg tablet - - - - - -
    67 Albendazol 400 mg tablet - - - - - -
    68 Albendazol 400 mg tablet - - - - - -
    69 Albendazol 400 mg tablet - - - - - -
    70 Albendazol 400 mg tablet - - - - - -
    71 Albendazol 400 mg tablet - - - - - -
    72 Albendazol 400 mg tablet - - - - - -
    73 Albendazol 400 mg tablet - 40 40 10 30 - 15
    74 Albendazol 400 mg tablet - - - - - -
    75 Albendazol 400 mg tablet - 13 13 4 9 - 6
    76 Albendazol 400 mg tablet - - - - - -
    77 Albendazol 400 mg tablet - - - - - -
    78 Albendazol 400 mg tablet - - - - - -
    79 Albendazol 400 mg tablet - - - - - -
    80 Albendazol 400 mg tablet - - - - - -
    81 Albendazol 400 mg tablet - - - - - -
    82 Albendazol 400 mg tablet - - - - - -
    83 Albendazol 400 mg tablet - - - - - -
    84 Albendazol 400 mg tablet - - - - - -
    85 Albendazol 400 mg tablet - (3) (3) (3) - -
    86 Albendazol 400 mg tablet - - - - - -
    87 Albendazol 400 mg tablet - (84) (84) 14 (98) - 21
    88 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    89 Albendazol 400 mg tablet - - - - - -


    90 Albendazol 400 mg tablet - - - - - -
    91 Albendazol 400 mg tablet - - - - - -
    92 Albendazol 400 mg tablet - - - - - -
    93 Albendazol 400 mg tablet - - - - - -
    94 Albendazol 400 mg tablet - - - - - -
    95 Albendazol 400 mg tablet - - - - - -
    96 Albendazol 400 mg tablet - - - - - -
    97 Albendazol 400 mg tablet - - - - - -
    98 Albendazol 400 mg tablet - - - - - -
    99 Albendazol 400 mg tablet - - - - - -
    100 Albendazol 400 mg tablet - - - - - -
    101 Albendazol 400 mg tablet - - - - - -
    102 Albendazol 400 mg tablet - - - - - -
    103 Albendazol 400 mg tablet - 3 3 1 2 - 2
    104 Albendazol 400 mg tablet - - - - - -
    105 Albendazol 400 mg tablet - 170 170 40 130 - 60
    106 Albendazol 400 mg tablet - - - - - -
    107 Albendazol 400 mg tablet - - - - - -
    108 Albendazol 400 mg tablet - - - - - -
    109 Albendazol 400 mg tablet - - - - - -
    110 Albendazol 400 mg tablet - 150 150 - 150 - -
    111 Albendazol 400 mg tablet - - - - - -
    112 Albendazol 400 mg tablet - - - - - -
    113 Albendazol 400 mg tablet - (100) (100) (100) - -
    114 Albendazol 400 mg tablet - - - - - -
    115 Albendazol 400 mg tablet - - - - - -
    Albendazol 400 mg tablet - - - - - -
    116 Albendazol 400 mg tablet - - - - - -
    117 Albendazol 400 mg tablet - - - - - -
    118 Albendazol 400 mg tablet - - - - - -
    119 Albendazol 400 mg tablet - - - - - -
    120 Albendazol 400 mg tablet - - - - - -
    121 Albendazol 400 mg tablet - - - - - -
    122 Albendazol 400 mg tablet - - - - - -
    123 Albendazol 400 mg tablet - - - - - -
    124 Albendazol 400 mg tablet -
    125 Albendazol 400 mg tablet - - - - - -
    126 Albendazol 400 mg tablet - - - - - -
    127 Albendazol 400 mg tablet - - - - - -
    128 Albendazol 400 mg tablet - - - - - -
    129 Albendazol 400 mg tablet - - - - - -
    130 Albendazol 400 mg tablet - - - - - -
    131 Albendazol 400 mg tablet - - - - - -
    132 Albendazol 400 mg tablet - - - - - -
    133 Albendazol 400 mg tablet - - - - - -
    134 Albendazol 400 mg tablet - - - - - -
    135 Ketokonazole sk tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    136 Dimenhidrinate tablet - 100 100 100 - - 150


    137 Albendazol 400 mg tablet - - - - - -
    Albendazol 400 mg tablet - - - - - -
    138 Albendazol 400 mg tablet - - - - - -
    139 Albendazol 400 mg tablet - - - - - -
    140 Albendazol 400 mg tablet - - - - - -
    141 Albendazol 400 mg tablet - -
    142 Albendazol 400 mg tablet - - - - - -
    JUMLAH : 482 - 482 (1) -

    JKN NON JKN JUMLAH Generik Paten


    JML. KUNJUNGAN RESEP BULAN INI
    0

    Tulungagung, Juli 2022


    mengetahui, Yang menyerahkan Yang melaporkan
    Kepala UPT Puskesmas Dono Petugas UPT Puskesmas Dono Petugas Pustu / Polindes

    HERI SUSANTO, S.Gz SUSIANIK, Amd. Farm YUYUN DAMAYANTI


    NIP. 19851206 201001 1 017 NIP. 19700706 199303 2 008
    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    POLINDES/PUSTU/UNIT PELAYANAN: TUGU PELAPORAN BULAN / PERIODE : AGUSTUS 2022


    PERMINTAAN BULAN / PERIODE : SEPTEMBER 2022

    NOMOR : ...............................................
    TANGGAL : ………………………………….

    STOK PENERI PERSE SISA STOK PERMIN


    No. NAMA OBAT SATUAN HARGA PEMAKAIA HARGA STOK OPT PEMBERI KET.
    AWAL MAAN DIAAN TAAN
    N AN

    1 Albendazol 400 mg tablet - - - - - -


    2 Albendazol 400 mg tablet - - - - - -
    3 Albendazol 400 mg tablet - - - - - -
    4 Albendazol 400 mg tablet - - - - - -
    5 Albendazol 400 mg tablet - - - - - -
    6 Albendazol 400 mg tablet - (130) (130) (130) - - 500
    7 Albendazol 400 mg tablet - - - - - -
    8 Albendazol 400 mg tablet - - - - - -
    9 Albendazol 400 mg tablet - - - - - -
    10 Albendazol 400 mg tablet - (4) (4) 8 (12) - 12 30
    11 Albendazol 400 mg tablet - (70) (70) (70) - - 500
    12 Albendazol 400 mg tablet - - - - - -
    13 Albendazol 400 mg tablet - - - - - -
    14 Albendazol 400 mg tablet - - - - - -
    15 Albendazol 400 mg tablet - - - - - -
    16 Albendazol 400 mg tablet - - - - - -
    17 Albendazol 400 mg tablet - - - - - -
    18 Albendazol 400 mg tablet - - - - - -
    19 Albendazol 400 mg tablet - 186 186 200 (14) - 300 600
    20 Albendazol 400 mg tablet - - - - - -
    21 Albendazol 400 mg tablet - - - - - -
    22 Albendazol 400 mg tablet - - - - - -
    23 Albendazol 400 mg tablet - - - - - -
    24 Albendazol 400 mg tablet - - - - - -
    25 Albendazol 400 mg tablet - - - - - -
    26 Albendazol 400 mg tablet - - - - - -
    27 Albendazol 400 mg tablet - - - - - -
    28 Albendazol 400 mg tablet - - - - - -
    29 Albendazol 400 mg tablet - - - - - -
    30 Albendazol 400 mg tablet - - - - - -
    31 Albendazol 400 mg tablet - - - - - -
    32 Albendazol 400 mg tablet - - - - - -
    33 Albendazol 400 mg tablet - - - - - -
    34 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE SISA STOK PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA HARGA STOK OPT PEMBERI KET.
    AWAL MAAN DIAAN TAAN
    N AN

    35 Albendazol 400 mg tablet - - - - - -


    36 Albendazol 400 mg tablet - - - - - -
    37 Albendazol 400 mg tablet - - - - - -
    38 Albendazol 400 mg tablet - - - - - -
    39 Albendazol 400 mg tablet - - - - - -
    40 Albendazol 400 mg tablet - - - - - -
    41 Albendazol 400 mg tablet - - - - - -
    42 Albendazol 400 mg tablet - - - - - -
    43 Albendazol 400 mg tablet - - - - - -
    44 Albendazol 400 mg tablet - - - - - -
    45 Albendazol 400 mg tablet - (2) (2) (2) - -
    46 Albendazol 400 mg tablet - - - - - -
    47 Albendazol 400 mg tablet - - - - - -
    48 Albendazol 400 mg tablet - - - - - -
    49 Albendazol 400 mg tablet - - - - - -
    50 Albendazol 400 mg tablet - - - - - -
    51 Albendazol 400 mg tablet - - - - - -
    52 Albendazol 400 mg tablet - - - - - -
    53 Albendazol 400 mg tablet - - - - - -
    54 Albendazol 400 mg tablet - (30) (30) - (30) - -
    55 Albendazol 400 mg tablet - - - - - -
    56 Albendazol 400 mg tablet - - - - - -
    57 Albendazol 400 mg tablet - - - - - -
    58 Albendazol 400 mg tablet - - - - - -
    59 Albendazol 400 mg tablet - - - - - -
    60 Albendazol 400 mg tablet - - - - - -
    61 Albendazol 400 mg tablet - - - - - -
    62 Albendazol 400 mg tablet - 9 9 3 6 - 5
    63 Albendazol 400 mg tablet - - - - - -
    64 Albendazol 400 mg tablet - - - - - -
    65 Albendazol 400 mg tablet - (80) (80) (80) - - 500
    66 Albendazol 400 mg tablet - - - - - -
    67 Albendazol 400 mg tablet - - - - - -
    68 Albendazol 400 mg tablet - - - - - -
    69 Albendazol 400 mg tablet - - - - - -
    70 Albendazol 400 mg tablet - - - - - -
    71 Albendazol 400 mg tablet - - - - - -
    72 Albendazol 400 mg tablet - - - - - -
    73 Albendazol 400 mg tablet - 30 30 10 20 - 15
    74 Albendazol 400 mg tablet - - - - - -
    75 Albendazol 400 mg tablet - 9 9 5 4 - 8 18
    76 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE SISA STOK PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA HARGA STOK OPT PEMBERI KET.
    AWAL MAAN DIAAN TAAN
    N AN

    77 Albendazol 400 mg tablet - - - - - -


    78 Albendazol 400 mg tablet - - - - - -
    79 Albendazol 400 mg tablet - - - - - -
    80 Albendazol 400 mg tablet - - - - - -
    81 Albendazol 400 mg tablet - - - - - -
    82 Albendazol 400 mg tablet - - - - - -
    83 Albendazol 400 mg tablet - - - - - -
    84 Albendazol 400 mg tablet - - - - - -
    85 Albendazol 400 mg tablet - (3) (3) (3) - - 20
    86 Albendazol 400 mg tablet - - - - - -
    87 Albendazol 400 mg tablet - (98) (98) 15 (113) - 23 500
    88 Albendazol 400 mg tablet - - - - - -
    89 Albendazol 400 mg tablet - - - - - -
    90 Albendazol 400 mg tablet - - - - - -
    91 Albendazol 400 mg tablet - - - - - -
    92 Albendazol 400 mg tablet - - - - - -
    93 Albendazol 400 mg tablet - - - - - -
    94 Albendazol 400 mg tablet - - - - - -
    95 Albendazol 400 mg tablet - - - - - -
    96 Albendazol 400 mg tablet - - - - - -
    97 Albendazol 400 mg tablet - - - - - -
    98 Albendazol 400 mg tablet - - - - - -
    99 Albendazol 400 mg tablet - - - - - -
    100 Albendazol 400 mg tablet - - - - - -
    101 Albendazol 400 mg tablet - - - - - -
    102 Albendazol 400 mg tablet - - - - - -
    103 Albendazol 400 mg tablet - 2 2 1 1 - 2
    104 Albendazol 400 mg tablet - - - - - -
    105 Albendazol 400 mg tablet - 130 130 30 100 - 45
    106 Albendazol 400 mg tablet - - - - - -
    107 Albendazol 400 mg tablet - - - - - -
    108 Albendazol 400 mg tablet - - - - - -
    109 Albendazol 400 mg tablet - - - - - -
    110 Albendazol 400 mg tablet - 150 150 50 100 - 75 500
    111 Albendazol 400 mg tablet - - - - - -
    112 Albendazol 400 mg tablet - - - - - -
    113 Albendazol 400 mg tablet - (100) (100) (100) - - 500
    114 Albendazol 400 mg tablet - - - - - -
    115 Albendazol 400 mg tablet - - - - - -
    Albendazol 400 mg tablet - - - - - -
    116 Albendazol 400 mg tablet - - - - - -
    117 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE SISA STOK PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA HARGA STOK OPT PEMBERI KET.
    AWAL MAAN DIAAN TAAN
    N AN

    118 Albendazol 400 mg tablet - - - - - -


    119 Albendazol 400 mg tablet - - - - - -
    120 Albendazol 400 mg tablet - - - - - -
    121 Albendazol 400 mg tablet - - - - - -
    122 Albendazol 400 mg tablet - - - - - -
    123 Albendazol 400 mg tablet - - - - - -
    124 Albendazol 400 mg tablet -
    125 Albendazol 400 mg tablet - - - - - -
    126 Albendazol 400 mg tablet - - - - - -
    127 Albendazol 400 mg tablet - - - - - -
    128 Albendazol 400 mg tablet - - - - - -
    129 Albendazol 400 mg tablet - - - - - -
    130 Albendazol 400 mg tablet - - - - - -
    131 Albendazol 400 mg tablet - - - - - -
    132 Albendazol 400 mg tablet - - - - - -
    133 Albendazol 400 mg tablet - - - - - -
    134 Albendazol 400 mg tablet - - - - - -
    135 Ketokonazole sk tablet - - - - - - -
    136 Dimenhidrinate tablet - - - - - - 200
    137 Albendazol 400 mg tablet - - - - - -
    Albendazol 400 mg tablet - - - - - -
    138 Albendazol 400 mg tablet - - - - - -
    139 Albendazol 400 mg tablet - - - - - -
    140 Albendazol 400 mg tablet - - - - - -
    141 Albendazol 400 mg tablet - -
    142 Albendazol 400 mg tablet - - - - - -
    JUMLAH : (1) - (1) (323) -

    JKN NON JKN JUMLAH Generik Paten


    JML. KUNJUNGAN RESEP BULAN INI
    0

    Tulungagung,
    mengetahui, Yang menyerahkan Yang melaporkan
    Kepala UPT Puskesmas Dono Petugas UPT Puskesmas Dono Petugas Pustu / Polindes

    HERI SUSANTO, S.Gz SUSIANIK, Amd. Farm YUYUN DAMAYANTI


    NIP. 19851206 201001 1 017 NIP. 19700706 199303 2 008
    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    POLINDES/PUSTU/UNIT PELAYANAN: TUGU PELAPORAN BULAN / PERIODE : SEPTEMBER 2020


    PERMINTAAN BULAN / PERIODE :

    NOMOR : ...............................................
    TANGGAL : ………………………………….

    STOK PENERI PERSE PERMIN


    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    1 Albendazol 400 mg tablet - - - - - -


    2 Albendazol 400 mg tablet - - - - - -
    3 Albendazol 400 mg tablet - - - - - -
    4 Albendazol 400 mg tablet - - - - - -
    5 Albendazol 400 mg tablet - - - - - -
    6 Albendazol 400 mg tablet - (130) (130) (130) - -
    7 Albendazol 400 mg tablet - - - - - -
    8 Albendazol 400 mg tablet - - - - - -
    9 Albendazol 400 mg tablet - - - - - -
    10 Albendazol 400 mg tablet - (12) 30 18 15 3 - 23
    11 Albendazol 400 mg tablet - (70) (70) (70) - -
    12 Albendazol 400 mg tablet - - - - - -
    13 Albendazol 400 mg tablet - - - - - -
    14 Albendazol 400 mg tablet - - - - - -
    15 Albendazol 400 mg tablet - - - - - -
    16 Albendazol 400 mg tablet - - - - - -
    17 Albendazol 400 mg tablet - - - - - -
    18 Albendazol 400 mg tablet - - - - - -
    19 Albendazol 400 mg tablet - (14) 600 586 170 416 - 255
    20 Albendazol 400 mg tablet - - - - - -
    21 Albendazol 400 mg tablet - - - - - -
    22 Albendazol 400 mg tablet - - - - - -
    23 Albendazol 400 mg tablet - - - - - -
    24 Albendazol 400 mg tablet - - - - - -
    25 Albendazol 400 mg tablet - - - - - -
    26 Albendazol 400 mg tablet - - - - - -
    27 Albendazol 400 mg tablet - - - - - -
    28 Albendazol 400 mg tablet - - - - - -
    29 Albendazol 400 mg tablet - - - - - -
    30 Albendazol 400 mg tablet - - - - - -
    31 Albendazol 400 mg tablet - - - - - -
    32 Albendazol 400 mg tablet - - - - - -
    33 Albendazol 400 mg tablet - - - - - -
    34 Albendazol 400 mg tablet - - - - - -
    35 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    36 Albendazol 400 mg tablet - - - - - -


    37 Albendazol 400 mg tablet - - - - - -
    38 Albendazol 400 mg tablet - - - - - -
    39 Albendazol 400 mg tablet - - - - - -
    40 Albendazol 400 mg tablet - - - - - -
    41 Albendazol 400 mg tablet - - - - - -
    42 Albendazol 400 mg tablet - - - - - -
    43 Albendazol 400 mg tablet - - - - - -
    44 Albendazol 400 mg tablet - - - - - -
    45 Albendazol 400 mg tablet - (2) (2) (2) - -
    46 Albendazol 400 mg tablet - - - - - -
    47 Albendazol 400 mg tablet - - - - - -
    48 Albendazol 400 mg tablet - - - - - -
    49 Albendazol 400 mg tablet - - - - - -
    50 Albendazol 400 mg tablet - - - - - -
    51 Albendazol 400 mg tablet - - - - - -
    52 Albendazol 400 mg tablet - - - - - -
    53 Albendazol 400 mg tablet - - - - - -
    54 Albendazol 400 mg tablet - (30) (30) (30) - -
    55 Albendazol 400 mg tablet - - - - - -
    56 Albendazol 400 mg tablet - - - - - -
    57 Albendazol 400 mg tablet - - - - - -
    58 Albendazol 400 mg tablet - - - - - -
    59 Albendazol 400 mg tablet - - - - - -
    60 Albendazol 400 mg tablet - - - - - -
    61 Albendazol 400 mg tablet - - - - - -
    62 Albendazol 400 mg tablet - 6 6 1 5 - 2
    63 Albendazol 400 mg tablet - - - - - -
    64 Albendazol 400 mg tablet - - - - - -
    65 Albendazol 400 mg tablet - (80) (80) (80) - -
    66 Albendazol 400 mg tablet - - - - - -
    67 Albendazol 400 mg tablet - - - - - -
    68 Albendazol 400 mg tablet - - - - - -
    69 Albendazol 400 mg tablet - - - - - -
    70 Albendazol 400 mg tablet - - - - - -
    71 Albendazol 400 mg tablet - - - - - -
    72 Albendazol 400 mg tablet - - - - - -
    73 Albendazol 400 mg tablet - 20 20 20 - - 30
    74 Albendazol 400 mg tablet - - - - - -
    75 Albendazol 400 mg tablet - 4 18 22 3 19 - 5
    76 Albendazol 400 mg tablet - - - - - -
    77 Albendazol 400 mg tablet - - - - - -
    78 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    79 Albendazol 400 mg tablet - - - - - -


    80 Albendazol 400 mg tablet - - - - - -
    81 Albendazol 400 mg tablet - - - - - -
    82 Albendazol 400 mg tablet - - - - - -
    83 Albendazol 400 mg tablet - - - - - -
    84 Albendazol 400 mg tablet - - - - - -
    85 Albendazol 400 mg tablet - (3) (3) (3) - -
    86 Albendazol 400 mg tablet - - - - - -
    87 Albendazol 400 mg tablet - (113) (113) 15 (128) - 23
    88 Albendazol 400 mg tablet - - - - - -
    89 Albendazol 400 mg tablet - - - - - -
    90 Albendazol 400 mg tablet - - - - - -
    91 Albendazol 400 mg tablet - - - - - -
    92 Albendazol 400 mg tablet - - - - - -
    93 Albendazol 400 mg tablet - - - - - -
    94 Albendazol 400 mg tablet - - - - - -
    95 Albendazol 400 mg tablet - - - - - -
    96 Albendazol 400 mg tablet - - - - - -
    97 Albendazol 400 mg tablet - - - - - -
    98 Albendazol 400 mg tablet - - - - - -
    99 Albendazol 400 mg tablet - - - - - -
    100 Albendazol 400 mg tablet - - - - - -
    101 Albendazol 400 mg tablet - - - - - -
    102 Albendazol 400 mg tablet - - - - - -
    103 Albendazol 400 mg tablet - 1 1 1 - - 2
    104 Albendazol 400 mg tablet - - - - - -
    105 Albendazol 400 mg tablet - 100 100 20 80 - 30
    106 Albendazol 400 mg tablet - - - - - -
    107 Albendazol 400 mg tablet - - - - - -
    108 Albendazol 400 mg tablet - - - - - -
    109 Albendazol 400 mg tablet - - - - - -
    110 Albendazol 400 mg tablet - 100 100 50 50 - 75
    111 Albendazol 400 mg tablet - - - - - -
    112 Albendazol 400 mg tablet - - - - - -
    113 Albendazol 400 mg tablet - (100) (100) (100) - -
    114 Albendazol 400 mg tablet - - - - - -
    115 Albendazol 400 mg tablet - - - - - -
    Albendazol 400 mg tablet - - - - - -
    116 Albendazol 400 mg tablet - - - - - -
    117 Albendazol 400 mg tablet - - - - - -
    118 Albendazol 400 mg tablet - - - - - -
    119 Albendazol 400 mg tablet - - - - - -
    120 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    121 Albendazol 400 mg tablet - - - - - -


    122 Albendazol 400 mg tablet - - - - - -
    123 Albendazol 400 mg tablet - - - - - -
    124 Albendazol 400 mg tablet - -
    125 Albendazol 400 mg tablet - - - - - -
    126 Albendazol 400 mg tablet - - - - - -
    127 Albendazol 400 mg tablet - - - - - -
    128 Albendazol 400 mg tablet - - - - - -
    129 Albendazol 400 mg tablet - - - - - -
    130 Albendazol 400 mg tablet - - - - - -
    131 Albendazol 400 mg tablet - - - - - -
    132 Albendazol 400 mg tablet - - - - - -
    133 Albendazol 400 mg tablet - - - - - -
    134 Albendazol 400 mg tablet - - - - - -
    135 Ketokonazole sk tablet - - - - - -
    136 Dimenhidrinate tablet - - 200 200 80 120 - 120
    137 Albendazol 400 mg tablet - - - - - -
    Albendazol 400 mg tablet - - - - - -
    138 Albendazol 400 mg tablet - - - - - -
    139 Albendazol 400 mg tablet - - - - - -
    140 Albendazol 400 mg tablet - - - - - -
    141 Albendazol 400 mg tablet - -
    142 Albendazol 400 mg tablet - - - - - -
    JUMLAH : (323) 848 525 375 150 -

    JKN NON JKN JUMLAH Generik Paten


    JML. KUNJUNGAN RESEP BULAN INI
    0
    Tulungagung, September 2021
    mengetahui, Yang menyerahkan Yang melaporkan
    Kepala UPT Puskesmas Dono Petugas UPT Puskesmas Dono Petugas Pustu / Polindes

    HERI SUSANTO, S.Gz SUSIANIK, Amd. Farm YUYUN DAMAYANTI


    NIP. 19851206 201001 1 017 NIP. 19700706 199303 2 008
    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    POLINDES/PUSTU/UNIT PELAYANAN: TUGU PELAPORAN BULAN / PERIODE : OKTOBER 2022


    PERMINTAAN BULAN / PERIODE : …………………………………

    NOMOR : ...............................................
    TANGGAL : ………………………………….

    STOK PENERI PERSE PERMIN


    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    1 Albendazol 400 mg tablet - - - - - -


    2 Albendazol 400 mg tablet - - - - - -
    3 Albendazol 400 mg tablet - - - - - -
    4 Albendazol 400 mg tablet - - - - - -
    5 Albendazol 400 mg tablet - - - - - -
    6 Albendazol 400 mg tablet - (130) (130) (130) - -
    7 Albendazol 400 mg tablet - - - - - -
    8 Albendazol 400 mg tablet - - - - - -
    9 Albendazol 400 mg tablet - - - - - -
    10 Albendazol 400 mg tablet - 3 3 8 (5) - 12
    11 Albendazol 400 mg tablet - (70) (70) (70) - -
    12 Albendazol 400 mg tablet - - - - - -
    13 Albendazol 400 mg tablet - - - - - -
    14 Albendazol 400 mg tablet - - - - - -
    15 Albendazol 400 mg tablet - - - - - -
    16 Albendazol 400 mg tablet - - - - - -
    17 Albendazol 400 mg tablet - - - - - -
    18 Albendazol 400 mg tablet - - - - - -
    19 Albendazol 400 mg tablet - 416 416 120 296 - 180
    20 Albendazol 400 mg tablet - - - - - -
    21 Albendazol 400 mg tablet - - - - - -
    22 Albendazol 400 mg tablet - - - - - -
    23 Albendazol 400 mg tablet - - - - - -
    24 Albendazol 400 mg tablet - - - - - -
    25 Albendazol 400 mg tablet - - - - - -
    26 Albendazol 400 mg tablet - - - - - -
    27 Albendazol 400 mg tablet - - - - - -
    28 Albendazol 400 mg tablet - - - - - -
    29 Albendazol 400 mg tablet - - - - - -
    30 Albendazol 400 mg tablet - - - - - -
    31 Albendazol 400 mg tablet - - - - - -
    32 Albendazol 400 mg tablet - - - - - -
    33 Albendazol 400 mg tablet - - - - - -
    34 Albendazol 400 mg tablet - - - - - -
    35 Albendazol 400 mg tablet - - - - - -
    36 Albendazol 400 mg tablet - - - - - -
    37 Albendazol 400 mg tablet - - - - - -
    38 Albendazol 400 mg tablet - - - - - -
    39 Albendazol 400 mg tablet - - - - - -
    40 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    41 Albendazol 400 mg tablet - - - - - -


    42 Albendazol 400 mg tablet - - - - - -
    43 Albendazol 400 mg tablet - - - - - -
    44 Albendazol 400 mg tablet - - - - - -
    45 Albendazol 400 mg tablet - (2) (2) (2) - -
    46 Albendazol 400 mg tablet - - - - - -
    47 Albendazol 400 mg tablet - - - - - -
    48 Albendazol 400 mg tablet - - - - - -
    49 Albendazol 400 mg tablet - - - - - -
    50 Albendazol 400 mg tablet - - - - - -
    51 Albendazol 400 mg tablet - - - - - -
    52 Albendazol 400 mg tablet - - - - - -
    53 Albendazol 400 mg tablet - - - - - -
    54 Albendazol 400 mg tablet - (30) (30) (30) - -
    55 Albendazol 400 mg tablet - - - - - -
    56 Albendazol 400 mg tablet - - - - - -
    57 Albendazol 400 mg tablet - - - - - -
    58 Albendazol 400 mg tablet - - - - - -
    59 Albendazol 400 mg tablet - - - - - -
    60 Albendazol 400 mg tablet - - - - - -
    61 Albendazol 400 mg tablet - - - - - -
    62 Albendazol 400 mg tablet - 5 5 - 5 - -
    63 Albendazol 400 mg tablet - - - - - -
    64 Albendazol 400 mg tablet - - - - - -
    65 Albendazol 400 mg tablet - (80) (80) (80) - -
    66 Albendazol 400 mg tablet - - - - - -
    67 Albendazol 400 mg tablet - - - - - -
    68 Albendazol 400 mg tablet - - - - - -
    69 Albendazol 400 mg tablet - - - - - -
    70 Albendazol 400 mg tablet - - - - - -
    71 Albendazol 400 mg tablet - - - - - -
    72 Albendazol 400 mg tablet - - - - - -
    73 Albendazol 400 mg tablet - - - - - -
    74 Albendazol 400 mg tablet - - - - - -
    75 Albendazol 400 mg tablet - 19 19 4 15 - 6
    76 Albendazol 400 mg tablet - - - - - -
    77 Albendazol 400 mg tablet - - - - - -
    78 Albendazol 400 mg tablet - - - - - -
    79 Albendazol 400 mg tablet - - - - - -
    80 Albendazol 400 mg tablet - - - - - -
    81 Albendazol 400 mg tablet - - - - - -
    82 Albendazol 400 mg tablet - - - - - -
    83 Albendazol 400 mg tablet - - - - - -
    84 Albendazol 400 mg tablet - - - - - -
    85 Albendazol 400 mg tablet - (3) (3) (3) - -
    86 Albendazol 400 mg tablet - - - - - -
    87 Albendazol 400 mg tablet - (128) (128) 14 (142) - 21
    88 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    89 Albendazol 400 mg tablet - - - - - -


    90 Albendazol 400 mg tablet - - - - - -
    91 Albendazol 400 mg tablet - - - - - -
    92 Albendazol 400 mg tablet - - - - - -
    93 Albendazol 400 mg tablet - - - - - -
    94 Albendazol 400 mg tablet - - - - - -
    95 Albendazol 400 mg tablet - - - - - -
    96 Albendazol 400 mg tablet - - - - - -
    97 Albendazol 400 mg tablet - - - - - -
    98 Albendazol 400 mg tablet - - - - - -
    99 Albendazol 400 mg tablet - - - - - -
    100 Albendazol 400 mg tablet - - - - - -
    101 Albendazol 400 mg tablet - - - - - -
    102 Albendazol 400 mg tablet - - - - - -
    103 Albendazol 400 mg tablet - - - - - -
    104 Albendazol 400 mg tablet - - - - - -
    105 Albendazol 400 mg tablet - 80 80 40 40 - 60
    106 Albendazol 400 mg tablet - - - - - -
    107 Albendazol 400 mg tablet - - - - - -
    108 Albendazol 400 mg tablet - - - - - -
    109 Albendazol 400 mg tablet - - - - - -
    110 Albendazol 400 mg tablet - 50 50 20 30 - 30
    111 Albendazol 400 mg tablet - - - - - -
    112 Albendazol 400 mg tablet - - - - - -
    113 Albendazol 400 mg tablet - (100) (100) (100) - -
    114 Albendazol 400 mg tablet - - - - - -
    115 Albendazol 400 mg tablet - - - - - -
    Albendazol 400 mg tablet - - - - - -
    116 Albendazol 400 mg tablet - - - - - -
    117 Albendazol 400 mg tablet - - - - - -
    118 Albendazol 400 mg tablet - - - - - -
    119 Albendazol 400 mg tablet - - - - - -
    120 Albendazol 400 mg tablet - - - - - -
    121 Albendazol 400 mg tablet - - - - - -
    122 Albendazol 400 mg tablet - - - - - -
    123 Albendazol 400 mg tablet - - - - - -
    124 Albendazol 400 mg tablet - - - - - -
    125 Albendazol 400 mg tablet - - - - - -
    126 Albendazol 400 mg tablet - - - - - -
    127 Albendazol 400 mg tablet - - - - - -
    128 Albendazol 400 mg tablet - - - - - -
    129 Albendazol 400 mg tablet - - - - - -
    130 Albendazol 400 mg tablet - - - - - -
    131 Albendazol 400 mg tablet - - - - - -
    132 Albendazol 400 mg tablet - - - - - -
    133 Albendazol 400 mg tablet - - - - - -
    134 Albendazol 400 mg tablet - - - - - -
    135 Ketokonazole sk tablet - - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    136 Dimenhidrinate tablet - 120 120 80 40 - 120


    137 Albendazol 400 mg tablet - - - - - -
    Albendazol 400 mg tablet - - - - - -
    138 Albendazol 400 mg tablet - - - - - -
    139 Albendazol 400 mg tablet - - - - - -
    140 Albendazol 400 mg tablet - - - - - -
    141 Albendazol 400 mg tablet - - - - - -
    142 Albendazol 400 mg tablet - - - - - -
    JUMLAH : 150 - 150 286 (136) -

    JKN NON JKN JUMLAH Generik Paten


    JML. KUNJUNGAN RESEP BULAN INI
    0

    Tulungagung, oktober 2022


    mengetahui, Yang menyerahkan Yang melaporkan
    Kepala UPT Puskesmas Dono Petugas UPT Puskesmas Dono Petugas Pustu / Polindes

    HERI SUSANTO, S.Gz SUSIANIK, Amd. Farm YUYUN DAMAYANTI


    NIP. 19851206 201001 1 017 NIP. 19700706 199303 2 008
    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    POLINDES/PUSTU/UNIT PELAYANAN: TUGU PELAPORAN BULAN / PERIODE : NOPEMBER 2022


    PERMINTAAN BULAN / PERIODE : …………………………………

    NOMOR : ...............................................
    TANGGAL : ………………………………….

    STOK PENERI PERSE PERMIN


    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    1 Albendazol 400 mg tablet - - - - - -


    2 Albendazol 400 mg tablet - - - - - -
    3 Albendazol 400 mg tablet - - - - - -
    4 Albendazol 400 mg tablet - - - - - -
    5 Albendazol 400 mg tablet - - - - - -
    6 Albendazol 400 mg tablet - (130) (130) (130) - -
    7 Albendazol 400 mg tablet - - - - - -
    8 Albendazol 400 mg tablet - - - - - -
    9 Albendazol 400 mg tablet - - - - - -
    10 Albendazol 400 mg tablet - (5) (5) 7 (12) - 11
    11 Albendazol 400 mg tablet - (70) (70) 40 (110) - 60
    12 Albendazol 400 mg tablet - - - - - -
    13 Albendazol 400 mg tablet - - - - - -
    14 Albendazol 400 mg tablet - - - - - -
    15 Albendazol 400 mg tablet - - - - - -
    16 Albendazol 400 mg tablet - - - - - -
    17 Albendazol 400 mg tablet - - - - - -
    18 Albendazol 400 mg tablet - - - - - -
    19 Albendazol 400 mg tablet - 296 296 130 166 - 195
    20 Albendazol 400 mg tablet - - - - - -
    21 Albendazol 400 mg tablet - - - - - -
    22 Albendazol 400 mg tablet - - - - - -
    23 Albendazol 400 mg tablet - - - - - -
    24 Albendazol 400 mg tablet - - - - - -
    25 Albendazol 400 mg tablet - - - - - -
    26 Albendazol 400 mg tablet - - - - - -
    27 Albendazol 400 mg tablet - - - - - -
    28 Albendazol 400 mg tablet - - - - - -
    29 Albendazol 400 mg tablet - - - - - -
    30 Albendazol 400 mg tablet - - - - - -
    31 Albendazol 400 mg tablet - - - - - -
    32 Albendazol 400 mg tablet - - - - - -
    33 Albendazol 400 mg tablet - - - - - -
    34 Albendazol 400 mg tablet - - - - - -
    35 Albendazol 400 mg tablet - - - - - -
    36 Albendazol 400 mg tablet - - - - - -
    37 Albendazol 400 mg tablet - - - - - -
    38 Albendazol 400 mg tablet - - - - - -
    39 Albendazol 400 mg tablet - - - - - -
    40 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    41 Albendazol 400 mg tablet - - - - - -


    42 Albendazol 400 mg tablet - - - - - -
    43 Albendazol 400 mg tablet - - - - - -
    44 Albendazol 400 mg tablet - - - - - -
    45 Albendazol 400 mg tablet - (2) (2) (2) - -
    46 Albendazol 400 mg tablet - - - - - -
    47 Albendazol 400 mg tablet - - - - - -
    48 Albendazol 400 mg tablet - - - - - -
    49 Albendazol 400 mg tablet - - - - - -
    50 Albendazol 400 mg tablet - - - - - -
    51 Albendazol 400 mg tablet - - - - - -
    52 Albendazol 400 mg tablet - - - - - -
    53 Albendazol 400 mg tablet - - - - - -
    54 Albendazol 400 mg tablet - (30) (30) (30) - -
    55 Albendazol 400 mg tablet - - - - - -
    56 Albendazol 400 mg tablet - - - - - -
    57 Albendazol 400 mg tablet - - - - - -
    58 Albendazol 400 mg tablet - - - - - -
    59 Albendazol 400 mg tablet - - - - - -
    60 Albendazol 400 mg tablet - - - - - -
    61 Albendazol 400 mg tablet - - - - - -
    62 Albendazol 400 mg tablet - 5 5 - 5 - -
    63 Albendazol 400 mg tablet - - - - - -
    64 Albendazol 400 mg tablet - - - - - -
    65 Albendazol 400 mg tablet - (80) (80) - (80) - -
    66 Albendazol 400 mg tablet - - - - - -
    67 Albendazol 400 mg tablet - - - - - -
    68 Albendazol 400 mg tablet - - - - - -
    69 Albendazol 400 mg tablet - - - - - -
    70 Albendazol 400 mg tablet - - - - - -
    71 Albendazol 400 mg tablet - - - - - -
    72 Albendazol 400 mg tablet - - - - - -
    73 Albendazol 400 mg tablet - - - - - -
    74 Albendazol 400 mg tablet - - - - - -
    75 Albendazol 400 mg tablet - 15 15 4 11 - 6
    76 Albendazol 400 mg tablet - - - - - -
    77 Albendazol 400 mg tablet - - - - - -
    78 Albendazol 400 mg tablet - - - - - -
    79 Albendazol 400 mg tablet - - - - - -
    80 Albendazol 400 mg tablet - - - - - -
    81 Albendazol 400 mg tablet - - - - - -
    82 Albendazol 400 mg tablet - - - - - -
    83 Albendazol 400 mg tablet - - - - - -
    84 Albendazol 400 mg tablet - - - - - -
    85 Albendazol 400 mg tablet - (3) (3) - (3) - -
    86 Albendazol 400 mg tablet - - - - - -
    87 Albendazol 400 mg tablet - (142) (142) 14 (156) - 21
    88 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    89 Albendazol 400 mg tablet - - - - - -


    90 Albendazol 400 mg tablet - - - - - -
    91 Albendazol 400 mg tablet - - - - - -
    92 Albendazol 400 mg tablet - - - - - -
    93 Albendazol 400 mg tablet - - - - - -
    94 Albendazol 400 mg tablet - - - - - -
    95 Albendazol 400 mg tablet - - - - - -
    96 Albendazol 400 mg tablet - - - - - -
    97 Albendazol 400 mg tablet - - - - - -
    98 Albendazol 400 mg tablet - - - - - -
    99 Albendazol 400 mg tablet - - - - - -
    100 Albendazol 400 mg tablet - - - - - -
    101 Albendazol 400 mg tablet - - - - - -
    102 Albendazol 400 mg tablet - - - - - -
    103 Albendazol 400 mg tablet - - - - - -
    104 Albendazol 400 mg tablet - - - - - -
    105 Albendazol 400 mg tablet - 40 40 - 40 - -
    106 Albendazol 400 mg tablet - - - - - -
    107 Albendazol 400 mg tablet - - - - - -
    108 Albendazol 400 mg tablet - - - - - -
    109 Albendazol 400 mg tablet - - - - - -
    110 Albendazol 400 mg tablet - 30 30 - 30 - -
    111 Albendazol 400 mg tablet - - - - - -
    112 Albendazol 400 mg tablet - - - - - -
    113 Albendazol 400 mg tablet - (100) (100) - (100) - -
    114 Albendazol 400 mg tablet - - - - - -
    115 Albendazol 400 mg tablet - - - - - -
    Albendazol 400 mg tablet - - - - - -
    116 Albendazol 400 mg tablet - - - - - -
    117 Albendazol 400 mg tablet - - - - - -
    118 Albendazol 400 mg tablet - - - - - -
    119 Albendazol 400 mg tablet - - - - - -
    120 Albendazol 400 mg tablet - - - - - -
    121 Albendazol 400 mg tablet - - - - - -
    122 Albendazol 400 mg tablet - - - - - -
    123 Albendazol 400 mg tablet - - - - - -
    124 Albendazol 400 mg tablet - - - - - -
    125 Albendazol 400 mg tablet - - - - - -
    126 Albendazol 400 mg tablet - - - - - -
    127 Albendazol 400 mg tablet - - - - - -
    128 Albendazol 400 mg tablet - - - - - -
    129 Albendazol 400 mg tablet - - - - - -
    130 Albendazol 400 mg tablet - - - - - -
    131 Albendazol 400 mg tablet - - - - - -
    132 Albendazol 400 mg tablet - - - - - -
    133 Albendazol 400 mg tablet - - - - - -
    134 Albendazol 400 mg tablet - - - - - -
    135 Ketokonazole sk tablet - - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    136 Dimenhidrinate tablet - 40 40 - 40 - -


    137 Albendazol 400 mg tablet - - - - - -
    Albendazol 400 mg tablet - - - - - -
    138 Albendazol 400 mg tablet - - - - - -
    139 Albendazol 400 mg tablet - - - - - -
    140 Albendazol 400 mg tablet - - - - - -
    141 Albendazol 400 mg tablet - - - - - -
    142 Albendazol 400 mg tablet - - - - - -
    JUMLAH : (136) - (136) (331) -

    JKN NON JKN JUMLAH Generik Paten


    JML. KUNJUNGAN RESEP BULAN INI
    0

    Tulungagung, Nopember 2022


    mengetahui, Yang menyerahkan Yang melaporkan
    Kepala UPT Puskesmas Dono Petugas UPT Puskesmas Dono Petugas Pustu / Polindes

    HERI SUSANTO, S.Gz SUSIANIK, Amd. Farm YUYUN DAMAYANTI


    NIP. 19851206 201001 1 017 NIP. 19700706 199303 2 008
    LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

    POLINDES/PUSTU/UNIT PELAYANAN: TUGU PELAPORAN BULAN / PERIODE : DESEMBER 2022


    PERMINTAAN BULAN / PERIODE : …………………………………

    NOMOR : ...............................................
    TANGGAL : ………………………………….

    STOK PENERI PERSE PERMIN


    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    1 Albendazol 400 mg tablet - - - - - -


    2 Albendazol 400 mg tablet - - - - - -
    3 Albendazol 400 mg tablet - - - - - -
    4 Albendazol 400 mg tablet - - - - - - 200
    5 Albendazol 400 mg tablet - - - - - -
    6 Albendazol 400 mg tablet - (130) (130) (130) - - 500
    7 Albendazol 400 mg tablet - - - - - -
    8 Albendazol 400 mg tablet - - - - - -
    9 Albendazol 400 mg tablet - - - - - -
    10 Albendazol 400 mg tablet - (12) (12) (12) - - 10
    11 Albendazol 400 mg tablet - (110) (110) - (110) - - 300
    12 Albendazol 400 mg tablet - - - - - -
    13 Albendazol 400 mg tablet - - - - - -
    14 Albendazol 400 mg tablet - - - - - -
    15 Albendazol 400 mg tablet - - - - - -
    16 Albendazol 400 mg tablet - - - - - -
    17 Albendazol 400 mg tablet - - - - - -
    18 Albendazol 400 mg tablet - - - - - -
    19 Albendazol 400 mg tablet - 166 166 200 (34) - 300 300
    20 Albendazol 400 mg tablet - - - - - -
    21 Albendazol 400 mg tablet - - - - - -
    22 Albendazol 400 mg tablet - - - - - -
    23 Albendazol 400 mg tablet - - - - - -
    24 Albendazol 400 mg tablet - - - - - -
    25 Albendazol 400 mg tablet - - - - - -
    26 Albendazol 400 mg tablet - - - - - - 10
    27 Albendazol 400 mg tablet - - - - - -
    28 Albendazol 400 mg tablet - - - - - -
    29 Albendazol 400 mg tablet - - - - - -
    30 Albendazol 400 mg tablet - - - - - - 300
    31 Albendazol 400 mg tablet - - - - - -
    32 Albendazol 400 mg tablet - - - - - -
    33 Albendazol 400 mg tablet - - - - - -
    34 Albendazol 400 mg tablet - - - - - -
    35 Albendazol 400 mg tablet - - - - - -
    36 Albendazol 400 mg tablet - - - - - -
    37 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    38 Albendazol 400 mg tablet - - - - - -


    39 Albendazol 400 mg tablet - - - - - -
    40 Albendazol 400 mg tablet - - - - - -
    41 Albendazol 400 mg tablet - - - - - -
    42 Albendazol 400 mg tablet - - - - - -
    43 Albendazol 400 mg tablet - - - - - -
    44 Albendazol 400 mg tablet - - - - - -
    45 Albendazol 400 mg tablet - (2) (2) (2) - -
    46 Albendazol 400 mg tablet - - - - - -
    47 Albendazol 400 mg tablet - - - - - -
    48 Albendazol 400 mg tablet - - - - - - 500
    49 Albendazol 400 mg tablet - - - - - -
    50 Albendazol 400 mg tablet - - - - - -
    51 Albendazol 400 mg tablet - - - - - -
    52 Albendazol 400 mg tablet - - - - - -
    53 Albendazol 400 mg tablet - - - - - -
    54 Albendazol 400 mg tablet - (30) (30) (30) - - 100
    55 Albendazol 400 mg tablet - - - - - -
    56 Albendazol 400 mg tablet - - - - - -
    57 Albendazol 400 mg tablet - - - - - -
    58 Albendazol 400 mg tablet - - - - - -
    59 Albendazol 400 mg tablet - - - - - -
    60 Albendazol 400 mg tablet - - - - - -
    61 Albendazol 400 mg tablet - - - - - -
    62 Albendazol 400 mg tablet - 5 5 - 5 - -
    63 Albendazol 400 mg tablet - - - - - -
    64 Albendazol 400 mg tablet - - - - - -
    65 Albendazol 400 mg tablet - (80) (80) - (80) - - 400
    66 Albendazol 400 mg tablet - - - - - -
    67 Albendazol 400 mg tablet - - - - - -
    68 Albendazol 400 mg tablet - - - - - -
    69 Albendazol 400 mg tablet - - - - - -
    70 Albendazol 400 mg tablet - - - - - -
    71 Albendazol 400 mg tablet - - - - - -
    72 Albendazol 400 mg tablet - - - - - -
    73 Albendazol 400 mg tablet - - - - - -
    74 Albendazol 400 mg tablet - - - - - -
    75 Albendazol 400 mg tablet - 11 11 7 4 - 11
    76 Albendazol 400 mg tablet - - - - - -
    77 Albendazol 400 mg tablet - - - - - -
    78 Albendazol 400 mg tablet - - - - - -
    79 Albendazol 400 mg tablet - - - - - -
    80 Albendazol 400 mg tablet - - - - - -
    81 Albendazol 400 mg tablet - - - - - -
    82 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    83 Albendazol 400 mg tablet - - - - - -


    84 Albendazol 400 mg tablet - - - - - -
    85 Albendazol 400 mg tablet - (3) (3) - (3) - - 10
    86 Albendazol 400 mg tablet - - - - - -
    87 Albendazol 400 mg tablet - (156) (156) 14 (170) - 21 500
    88 Albendazol 400 mg tablet - - - - - -
    89 Albendazol 400 mg tablet - - - - - -
    90 Albendazol 400 mg tablet - - - - - -
    91 Albendazol 400 mg tablet - - - - - -
    92 Albendazol 400 mg tablet - - - - - -
    93 Albendazol 400 mg tablet - - - - - -
    94 Albendazol 400 mg tablet - - - - - -
    95 Albendazol 400 mg tablet - - - - - -
    96 Albendazol 400 mg tablet - - - - - -
    97 Albendazol 400 mg tablet - - - - - -
    98 Albendazol 400 mg tablet - - - - - -
    99 Albendazol 400 mg tablet - - - - - -
    100 Albendazol 400 mg tablet - - - - - -
    101 Albendazol 400 mg tablet - - - - - -
    102 Albendazol 400 mg tablet - - - - - -
    103 Albendazol 400 mg tablet - - - - - -
    104 Albendazol 400 mg tablet - - - - - -
    105 Albendazol 400 mg tablet - 40 40 - 40 - -
    106 Albendazol 400 mg tablet - - - - - -
    107 Albendazol 400 mg tablet - - - - - -
    108 Albendazol 400 mg tablet - - - - - -
    109 Albendazol 400 mg tablet - - - - - -
    110 Albendazol 400 mg tablet - 30 30 30 - - 45 300
    111 Albendazol 400 mg tablet - - - - - -
    112 Albendazol 400 mg tablet - - - - - -
    113 Albendazol 400 mg tablet - (100) (100) - (100) - - 500
    114 Albendazol 400 mg tablet - - - - - -
    115 Albendazol 400 mg tablet - - - - - -
    116 Albendazol 400 mg tablet - - - - - -
    117 Albendazol 400 mg tablet - - - - - -
    118 Albendazol 400 mg tablet - - - - - -
    119 Albendazol 400 mg tablet - - - - - -
    120 Albendazol 400 mg tablet - - - - - -
    121 Albendazol 400 mg tablet - - - - - -
    122 Albendazol 400 mg tablet - - - - - -
    123 Albendazol 400 mg tablet - - - - - -
    124 Albendazol 400 mg tablet - - - - - -
    125 Albendazol 400 mg tablet - - - - - -
    126 Albendazol 400 mg tablet - - - - - -
    127 Albendazol 400 mg tablet - - - - - -
    STOK PENERI PERSE PERMIN
    No. NAMA OBAT SATUAN HARGA PEMAKAIA SISA STOK HARGA STOK OPT KET.
    AWAL MAAN DIAAN TAAN PEMBERIAN
    N

    128 Albendazol 400 mg tablet - - - - - -


    129 Albendazol 400 mg tablet - - - - - -
    130 Albendazol 400 mg tablet - - - - - -
    131 Albendazol 400 mg tablet - - - - - -
    132 Albendazol 400 mg tablet - - - - - -
    133 Albendazol 400 mg tablet - - - - - -
    134 Albendazol 400 mg tablet - - - - - -
    135 Albendazol 400 mg tablet - - - - - -
    136 Ketokonazole sk tablet - - - - - - -
    137 Dimenhidrinate tablet - 40 40 - 40 - -
    138 Albendazol 400 mg tablet - - - - - -
    139 Albendazol 400 mg tablet - - - - - -
    140 Albendazol 400 mg tablet - - - - - -
    141 Albendazol 400 mg tablet - - - - - -
    142 Albendazol 400 mg tablet - - - - - -
    143 Albendazol 400 mg tablet - - - - - -
    144 Albendazol 400 mg tablet - - - - - -
    JUMLAH : (331) - (331) (582) -

    JKN NON JKN JUMLAH Generik Paten


    JML. KUNJUNGAN RESEP BULAN INI
    0

    Tulungagung, Desember 2022


    mengetahui, Yang menyerahkan Yang melaporkan
    Kepala UPT Puskesmas Dono Petugas UPT Puskesmas Dono Petugas Pustu / Polindes

    HERI SUSANTO, S.Gz SUSIANIK, Amd. Farm YUYUN DAMAYANTI


    NIP. 19851206 201001 1 017 NIP. 19700706 199303 2 008
    REKAP TRIBULAN I

    POLINDES/PUSTU/UNIT PELAYANAN:

    harga
    STOK harga stok penerimaa harga HARGA
    No. NAMA OBAT SATUAN HARGA penerimaa pemakaian sisa stok
    AWAL awal n1 pemakaian SISA STOK
    n
    semester
    1 Albendazol 400 mg tablet - - - - - - - - -
    2 Albendazol 400 mg tablet - - - - - - - - -
    3 Albendazol 400 mg tablet - - - - - - - - -
    4 Albendazol 400 mg tablet - - - - - - - - -
    5 Albendazol 400 mg tablet - - - - - - - - -
    6 Albendazol 400 mg tablet - - - - - 130 - - -
    7 Albendazol 400 mg tablet - - - - - - - - -
    8 Albendazol 400 mg tablet - - - - - - - - -
    9 Albendazol 400 mg tablet - - - - - - - - -
    10 Albendazol 400 mg tablet - - - 400 - 200 - 400 -
    11 Albendazol 400 mg tablet - - - - - - - - -
    12 Albendazol 400 mg tablet - - - - - - - - -
    13 Albendazol 400 mg tablet - - - - - - - - -
    14 Albendazol 400 mg tablet - - - - - - - - -
    15 Albendazol 400 mg tablet - - - - - - - - -
    16 Albendazol 400 mg tablet - - - - - - - - -
    17 Albendazol 400 mg tablet - - - - - 100 - - -
    18 Albendazol 400 mg tablet - - - 700 - 250 - 700 -
    19 Albendazol 400 mg tablet - - - - - - - - -
    20 Albendazol 400 mg tablet - - - - - - - - -
    21 Albendazol 400 mg tablet - - - - - - - - -
    22 Albendazol 400 mg tablet - - - - - - - - -
    23 Albendazol 400 mg tablet - - - - - - - - -
    24 Albendazol 400 mg tablet - - - - - - - - -
    25 Albendazol 400 mg tablet - - - - - - - - -
    26 Albendazol 400 mg tablet - - - - - - - - -
    27 Albendazol 400 mg tablet - - - - - - - - -
    28 Albendazol 400 mg tablet - - - - - - - - -
    29 Albendazol 400 mg tablet - - - - - - - - -
    30 Albendazol 400 mg tablet - - - - - - - - -
    31 Albendazol 400 mg tablet - - - - - - - - -
    32 Albendazol 400 mg tablet - - - - - - - - -
    33 Albendazol 400 mg tablet - - - - - - - - -
    34 Albendazol 400 mg tablet - - - - - - - - -
    35 Albendazol 400 mg tablet - - - - - - - - -
    36 Albendazol 400 mg tablet - - - - - - - - -
    37 Albendazol 400 mg tablet - - - - - - - - -
    38 Albendazol 400 mg tablet - - - - - - - - -
    39 Albendazol 400 mg tablet - - - - - - - - -
    40 Albendazol 400 mg tablet - - - - - - - - -
    41 Albendazol 400 mg tablet - - - - - - - - -
    harga
    STOK harga stok penerimaa harga HARGA
    No. NAMA OBAT SATUAN HARGA penerimaa pemakaian sisa stok
    AWAL awal n1 pemakaian SISA STOK
    n
    semester
    42 Albendazol 400 mg tablet - - - - - - - - -
    43 Albendazol 400 mg tablet - - - - - - - - -
    44 Albendazol 400 mg tablet - - - - - - - - -
    45 Albendazol 400 mg tablet - - - - - - - - -
    46 Albendazol 400 mg tablet - - - - - - - - -
    47 Albendazol 400 mg tablet - - - - - - - - -
    48 Albendazol 400 mg tablet - - - - - 30 - - -
    49 Albendazol 400 mg tablet - - - - - - - - -
    50 Albendazol 400 mg tablet - - - - - - - - -
    51 Albendazol 400 mg tablet - - - - - - - - -
    52 Albendazol 400 mg tablet - - - - - - - - -
    53 Albendazol 400 mg tablet - - - - - - - - -
    54 Albendazol 400 mg tablet - - - - - - - - -
    55 Albendazol 400 mg tablet - - - - - - - - -
    56 Albendazol 400 mg tablet - - - - - 80 - - -
    57 Albendazol 400 mg tablet - - - - - - - - -
    58 Albendazol 400 mg tablet - - - - - - - - -
    59 Albendazol 400 mg tablet - - - - - - - - -
    60 Albendazol 400 mg tablet - - - - - - - - -
    61 Albendazol 400 mg tablet - - - - - - - - -
    62 Albendazol 400 mg tablet - - - - - - - - -
    63 Albendazol 400 mg tablet - - - - - - - - -
    64 Albendazol 400 mg tablet - - - - - - - - -
    65 Albendazol 400 mg tablet - - - - - - - - -
    66 Albendazol 400 mg tablet - - - - - - - - -
    67 Albendazol 400 mg tablet - - - 100 - 20 - 100 -
    68 Albendazol 400 mg tablet - - - - - - - - -
    69 Albendazol 400 mg tablet - - - 10 - 2 - 10 -
    70 Albendazol 400 mg tablet - - - - - - - - -
    71 Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - 14 - - -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - - - - -
    72 Albendazol 400 mg tablet - - - - - - - - -
    73 Albendazol 400 mg tablet - - - - - - - - -
    74 Albendazol 400 mg tablet - - - - - 3 - - -
    75 Albendazol 400 mg tablet - - - - - 28 - - -
    76 Albendazol 400 mg tablet - - - - - - - - -
    77 Albendazol 400 mg tablet - - - - - - - - -
    78 Albendazol 400 mg tablet - - - - - - - - -
    79 Albendazol 400 mg tablet - - - - - - - - -
    80 Albendazol 400 mg tablet - - - - - - - - -
    81 Albendazol 400 mg tablet - - - - - - - - -
    82 Albendazol 400 mg tablet - - - - - - - - -
    83 Albendazol 400 mg tablet - - - - - - - - -
    84 Albendazol 400 mg tablet - - - - - - - - -
    85 Albendazol 400 mg tablet - - - - - - - - -
    harga
    STOK harga stok penerimaa harga HARGA
    No. NAMA OBAT SATUAN HARGA penerimaa pemakaian sisa stok
    AWAL awal n1 pemakaian SISA STOK
    n
    semester
    86 Albendazol 400 mg tablet - - - - - - - - -
    87 Albendazol 400 mg tablet - - - - - - - - -
    88 Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - 300 - 30 - 300 -
    JUMLAH : - 887 -
    REKAP TRIBULAN I

    cek KET.

    -
    -
    -
    -
    -
    (130)
    -
    -
    -
    200
    -
    -
    -
    -
    -
    -
    -
    350
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    cek KET.

    -
    -
    -
    -
    -
    -
    -
    -
    (30)
    -
    -
    -
    -
    -
    -
    -
    -
    (80)
    -
    -
    -
    -
    -
    -
    -
    80
    -
    8
    -
    -
    -
    -
    -
    -
    -
    -
    -
    (3)
    (42)
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    cek KET.

    -
    -
    -
    -
    -
    -
    -
    270
    REKAP TRIBULAN II

    POLINDES/PUSTU/UNIT PELAYANAN:

    harga
    STOK harga stok penerimaa harga HARGA
    No. NAMA OBAT SATUAN HARGA penerimaa pemakaian sisa stok
    AWAL awal n1 pemakaian SISA STOK
    n
    semester
    1 Albendazol 400 mg tablet - - - - - - - - -
    2 Albendazol 400 mg tablet - - - - - - - - -
    3 Albendazol 400 mg tablet - #REF! #REF! - - - - #REF! #REF!
    4 Albendazol 400 mg tablet - - - - - - - - -
    5 Albendazol 400 mg tablet - - - - - - - - -
    6 Albendazol 400 mg tablet - - - - - 130 - - -
    7 Albendazol 400 mg tablet - - - - - - - - -
    8 Albendazol 400 mg tablet - - - - - - - - -
    9 Albendazol 400 mg tablet - - - - - - - - -
    10 Albendazol 400 mg tablet - - - 430 - 278 - 430 -
    11 Albendazol 400 mg tablet - - - - - 140 - - -
    12 Albendazol 400 mg tablet - - - - - - - - -
    13 Albendazol 400 mg tablet - - - - - - - - -
    14 Albendazol 400 mg tablet - - - - - - - - -
    15 Albendazol 400 mg tablet - - - - - - - - -
    16 Albendazol 400 mg tablet - - - - - - - - -
    17 Albendazol 400 mg tablet - - - - - 100 - - -
    18 Albendazol 400 mg tablet - - - 700 - 450 - 700 -
    19 Albendazol 400 mg tablet - - - - - - - - -
    20 Albendazol 400 mg tablet - - - - - - - - -
    21 Albendazol 400 mg tablet - - - - - - - - -
    22 Albendazol 400 mg tablet - - - - - - - - -
    23 Albendazol 400 mg tablet - - - - - - - - -
    24 Albendazol 400 mg tablet - - - - - - - - -
    25 Albendazol 400 mg tablet - - - - - - - - -
    26 Albendazol 400 mg tablet - - - - - - - - -
    27 Albendazol 400 mg tablet - - - - - - - - -
    28 Albendazol 400 mg tablet - - - - - - - - -
    29 Albendazol 400 mg tablet - - - - - - - - -
    30 Albendazol 400 mg tablet - - - - - - - - -
    31 Albendazol 400 mg tablet - - - - - - - - -
    32 Albendazol 400 mg tablet - - - - - - - - -
    33 Albendazol 400 mg tablet - - - - - - - - -
    34 Albendazol 400 mg tablet - - - - - - - - -
    35 Albendazol 400 mg tablet - - - - - - - - -
    36 Albendazol 400 mg tablet - - - - - - - - -
    37 Albendazol 400 mg tablet - - - - - - - - -
    38 Albendazol 400 mg tablet - - - - - - - - -
    39 Albendazol 400 mg tablet - - - - - - - - -
    40 Albendazol 400 mg tablet - - - - - - - - -
    41 Albendazol 400 mg tablet - - - - - - - - -
    harga
    STOK harga stok penerimaa harga HARGA
    No. NAMA OBAT SATUAN HARGA penerimaa pemakaian sisa stok
    AWAL awal n1 pemakaian SISA STOK
    n
    semester
    42 Albendazol 400 mg tablet - - - - - - - - -
    43 Albendazol 400 mg tablet - - - - - - - - -
    44 Albendazol 400 mg tablet - - - - - - - - -
    45 Albendazol 400 mg tablet - - - - - - - - -
    46 Albendazol 400 mg tablet - - - - - - - - -
    47 Albendazol 400 mg tablet - - - - - - - - -
    48 Albendazol 400 mg tablet - - - - - 30 - - -
    49 Albendazol 400 mg tablet - - - - - - - - -
    50 Albendazol 400 mg tablet - - - - - - - - -
    51 Albendazol 400 mg tablet - - - - - - - - -
    52 Albendazol 400 mg tablet - - - - - - - - -
    53 Albendazol 400 mg tablet - - - - - - - - -
    54 Albendazol 400 mg tablet - - - - - - - - -
    55 Albendazol 400 mg tablet - - - - - - - - -
    56 Albendazol 400 mg tablet - - - - - 80 - - -
    57 Albendazol 400 mg tablet - - - 10 - 5 - 10 -
    58 Albendazol 400 mg tablet - - - - - - - - -
    59 Albendazol 400 mg tablet - - - - - - - - -
    60 Albendazol 400 mg tablet - - - - - - - - -
    61 Albendazol 400 mg tablet - - - - - - - - -
    62 Albendazol 400 mg tablet - - - - - - - - -
    63 Albendazol 400 mg tablet - - - - - - - - -
    64 Albendazol 400 mg tablet - - - - - - - - -
    65 Albendazol 400 mg tablet - - - - - - - - -
    66 Albendazol 400 mg tablet - - - - - - - - -
    67 Albendazol 400 mg tablet - - - 100 - 40 - 100 -
    68 Albendazol 400 mg tablet - - - - - 20 - - -
    69 Albendazol 400 mg tablet - - - 10 - 7 - 10 -
    70 Albendazol 400 mg tablet - - - 18 - 8 - 18 -
    71 Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - 14 - - -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - - - - -
    72 Albendazol 400 mg tablet - - - - - - - - -
    73 Albendazol 400 mg tablet - - - - - - - - -
    74 Albendazol 400 mg tablet - - - - - 3 - - -
    75 Albendazol 400 mg tablet - - - - - 42 - - -
    76 Albendazol 400 mg tablet - - - - - 28 - - -
    77 Albendazol 400 mg tablet - - - - - - - - -
    78 Albendazol 400 mg tablet - - - - - - - - -
    79 Albendazol 400 mg tablet - - - - - - - - -
    80 Albendazol 400 mg tablet - - - - - - - - -
    81 Albendazol 400 mg tablet - - - - - - - - -
    82 Albendazol 400 mg tablet - - - - - - - - -
    83 Albendazol 400 mg tablet - - - - - - - - -
    84 Albendazol 400 mg tablet - - - - - - - - -
    85 Albendazol 400 mg tablet - - - - - - - - -
    harga
    STOK harga stok penerimaa harga HARGA
    No. NAMA OBAT SATUAN HARGA penerimaa pemakaian sisa stok
    AWAL awal n1 pemakaian SISA STOK
    n
    semester
    86 Albendazol 400 mg tablet - - - - - - - - -
    87 Albendazol 400 mg tablet - - - - - - - - -
    88 Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - 300 - 70 - 300 -
    JUMLAH : #REF! 1,445 -

    JKN NON JKN JUMLAH Generik Paten


    JML. KUNJUNGAN RESEP BULAN INI

    Tulungagung,
    mengetahui, Yang menyerahkan Yang melaporkan
    Kepala UPTD Puskesmas Dono Petugas UPTD Puskesmas Dono Petugas Pustu / Polindes

    SUPARNO, S.Sos. WIWIK WINARNI RHONI W.P.


    NIP. 19630717 198512 1 003 NIP. 19770829 200901 2 003
    REKAP TRIBULAN II

    cek KET.

    -
    -
    -
    -
    -
    (130)
    -
    -
    -
    8
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    cek KET.

    (2)
    -
    -
    -
    -
    -
    -
    -
    -
    (30)
    -
    -
    -
    -
    -
    11
    -
    -
    (80)
    -
    -
    -
    -
    -
    -
    -
    40
    -
    13
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    (84)
    -
    -
    -
    -
    -
    -
    -
    -
    -
    cek KET.

    -
    -
    -
    -
    -
    -
    -
    -

    Yang melaporkan
    Petugas Pustu / Polindes

    RHONI W.P.
    REKAP TRIBULAN III

    POLINDES/PUSTU/UNIT PELAYANAN:

    harga
    STOK harga stok penerimaa harga HARGA
    No. NAMA OBAT SATUAN HARGA penerimaa pemakaian sisa stok
    AWAL awal n1 pemakaian SISA STOK
    n
    semester
    1 Albendazol 400 mg tablet - - - - - - - - -
    2 Albendazol 400 mg tablet - - - - - - - - -
    3 Albendazol 400 mg tablet - #REF! #REF! - - - - #REF! #REF!
    4 Albendazol 400 mg tablet - - - - - - - - -
    5 Albendazol 400 mg tablet - - - - - - - - -
    6 Albendazol 400 mg tablet - - - - - 130 - - -
    7 Albendazol 400 mg tablet - - - - - - - - -
    8 Albendazol 400 mg tablet - - - - - - - - -
    9 Albendazol 400 mg tablet - - - - - - - - -
    10 Albendazol 400 mg tablet - - - 460 - 313 - 460 -
    11 Albendazol 400 mg tablet - - - - - 210 - - -
    12 Albendazol 400 mg tablet - - - - - - - - -
    13 Albendazol 400 mg tablet - - - - - - - - -
    14 Albendazol 400 mg tablet - - - - - - - - -
    15 Albendazol 400 mg tablet - - - - - - - - -
    16 Albendazol 400 mg tablet - - - - - - - - -
    17 Albendazol 400 mg tablet - - - - - 100 - - -
    18 Albendazol 400 mg tablet - - - 700 - 450 - 700 -
    19 Albendazol 400 mg tablet - - - - - - - - -
    20 Albendazol 400 mg tablet - - - - - - - - -
    21 Albendazol 400 mg tablet - - - - - - - - -
    22 Albendazol 400 mg tablet - - - - - - - - -
    23 Albendazol 400 mg tablet - - - - - - - - -
    24 Albendazol 400 mg tablet - - - - - - - - -
    25 Albendazol 400 mg tablet - - - - - - - - -
    26 Albendazol 400 mg tablet - - - - - - - - -
    27 Albendazol 400 mg tablet - - - - - - - - -
    28 Albendazol 400 mg tablet - - - - - - - - -
    29 Albendazol 400 mg tablet - - - - - - - - -
    30 Albendazol 400 mg tablet - - - - - - - - -
    31 Albendazol 400 mg tablet - - - - - - - - -
    32 Albendazol 400 mg tablet - - - - - - - - -
    33 Albendazol 400 mg tablet - - - - - - - - -
    34 Albendazol 400 mg tablet - - - - - - - - -
    35 Albendazol 400 mg tablet - - - - - - - - -
    36 Albendazol 400 mg tablet - - - - - - - - -
    37 Albendazol 400 mg tablet - - - - - - - - -
    38 Albendazol 400 mg tablet - - - - - - - - -
    39 Albendazol 400 mg tablet - - - - - - - - -
    40 Albendazol 400 mg tablet - - - - - - - - -
    41 Albendazol 400 mg tablet - - - - - - - - -
    harga
    STOK harga stok penerimaa harga HARGA
    No. NAMA OBAT SATUAN HARGA penerimaa pemakaian sisa stok
    AWAL awal n1 pemakaian SISA STOK
    n
    semester
    42 Albendazol 400 mg tablet - - - - - - - - -
    43 Albendazol 400 mg tablet - - - - - - - - -
    44 Albendazol 400 mg tablet - - - - - - - - -
    45 Albendazol 400 mg tablet - - - - - - - - -
    46 Albendazol 400 mg tablet - - - - - - - - -
    47 Albendazol 400 mg tablet - - - - - - - - -
    48 Albendazol 400 mg tablet - - - - - 30 - - -
    49 Albendazol 400 mg tablet - - - - - - - - -
    50 Albendazol 400 mg tablet - - - - - - - - -
    51 Albendazol 400 mg tablet - - - - - - - - -
    52 Albendazol 400 mg tablet - - - - - - - - -
    53 Albendazol 400 mg tablet - - - - - - - - -
    54 Albendazol 400 mg tablet - - - - - - - - -
    55 Albendazol 400 mg tablet - - - - - - - - -
    56 Albendazol 400 mg tablet - - - - - 80 - - -
    57 Albendazol 400 mg tablet - - - 10 - 7 - 10 -
    58 Albendazol 400 mg tablet - - - - - 4 - - -
    59 Albendazol 400 mg tablet - - - - - - - - -
    60 Albendazol 400 mg tablet - - - - - - - - -
    61 Albendazol 400 mg tablet - - - - - - - - -
    62 Albendazol 400 mg tablet - - - - - - - - -
    63 Albendazol 400 mg tablet - - - - - - - - -
    64 Albendazol 400 mg tablet - - - - - - - - -
    65 Albendazol 400 mg tablet - - - - - - - - -
    66 Albendazol 400 mg tablet - - - - - - - - -
    67 Albendazol 400 mg tablet - - - 100 - 40 - 100 -
    68 Albendazol 400 mg tablet - - - - - 30 - - -
    69 Albendazol 400 mg tablet - - - 10 - 37 - 10 -
    70 Albendazol 400 mg tablet - - - 18 - 12 - 18 -
    71 Albendazol 400 mg tablet - - - 18 - 8 - 18 -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - 14 - - -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - - - - -
    72 Albendazol 400 mg tablet - - - - - - - - -
    73 Albendazol 400 mg tablet - - - - - - - - -
    74 Albendazol 400 mg tablet - - - - - 3 - - -
    75 Albendazol 400 mg tablet - - - - - 42 - - -
    76 Albendazol 400 mg tablet - - - - - 42 - - -
    77 Albendazol 400 mg tablet - - - - - 30 - - -
    78 Albendazol 400 mg tablet - - - - - - - - -
    79 Albendazol 400 mg tablet - - - - - - - - -
    80 Albendazol 400 mg tablet - - - - - - - - -
    81 Albendazol 400 mg tablet - - - - - - - - -
    82 Albendazol 400 mg tablet - - - - - - - - -
    83 Albendazol 400 mg tablet - - - - - - - - -
    84 Albendazol 400 mg tablet - - - - - - - - -
    85 Albendazol 400 mg tablet - - - - - - - - -
    harga
    STOK harga stok penerimaa harga HARGA
    No. NAMA OBAT SATUAN HARGA penerimaa pemakaian sisa stok
    AWAL awal n1 pemakaian SISA STOK
    n
    semester
    86 Albendazol 400 mg tablet - - - - - - - - -
    87 Albendazol 400 mg tablet - - - - - - - - -
    88 Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - 1 - - -
    Albendazol 400 mg tablet - - - 300 - 72 - 300 -
    JUMLAH : #REF! 1,655 -

    JKN NON JKN JUMLAH Generik Paten


    JML. KUNJUNGAN RESEP BULAN INI
    126

    Tulungagung,
    mengetahui, Yang menyerahkan Yang melaporkan
    Kepala UPTD Puskesmas Dono Petugas UPTD Puskesmas Dono Petugas Pustu / Polindes

    SUPARNO, S.Sos. WIWIK WINARNI RHONI W.P.


    NIP. 19630717 198512 1 003 NIP. 19770829 200901 2 003
    REKAP TRIBULAN III

    cek KET.

    -
    -
    -
    -
    -
    (130)
    -
    -
    -
    3
    (70)
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    cek KET.

    (2)
    -
    -
    -
    -
    -
    -
    -
    -
    (30)
    -
    -
    -
    -
    -
    -
    5
    -
    -
    (80)
    -
    -
    -
    -
    -
    -
    -
    -
    -
    19
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    (128)
    -
    -
    -
    -
    -
    -
    -
    -
    cek KET.

    -
    -
    -
    -
    -
    -
    -
    -

    Yang melaporkan
    Petugas Pustu / Polindes

    RHONI W.P.
    REKAP TRIBULAN IV

    POLINDES/PUSTU/UNIT PELAYANAN:

    harga
    STOK harga stok penerimaa harga HARGA
    No. NAMA OBAT SATUAN HARGA penerimaa pemakaian sisa stok
    AWAL awal n1 pemakaian SISA STOK
    n
    semester
    1 Albendazol 400 mg tablet - - - - - - - - -
    2 Albendazol 400 mg tablet - - - - - - - - -
    3 Albendazol 400 mg tablet - #REF! #REF! - - - - #REF! #REF!
    4 Albendazol 400 mg tablet - - - - - - - - -
    5 Albendazol 400 mg tablet - - - - - - - - -
    6 Albendazol 400 mg tablet - - - - - 130 - - -
    7 Albendazol 400 mg tablet - - - - - - - - -
    8 Albendazol 400 mg tablet - - - - - - - - -
    9 Albendazol 400 mg tablet - - - - - - - - -
    10 Albendazol 400 mg tablet - - - 460 - 328 - 460 -
    11 Albendazol 400 mg tablet - - - - - 250 - - -
    12 Albendazol 400 mg tablet - - - - - - - - -
    13 Albendazol 400 mg tablet - - - - - - - - -
    14 Albendazol 400 mg tablet - - - - - - - - -
    15 Albendazol 400 mg tablet - - - - - - - - -
    16 Albendazol 400 mg tablet - - - - - - - - -
    17 Albendazol 400 mg tablet - - - - - 100 - - -
    18 Albendazol 400 mg tablet - - - 700 - 450 - 700 -
    19 Albendazol 400 mg tablet - - - - - 450 - - -
    20 Albendazol 400 mg tablet - - - - - - - - -
    21 Albendazol 400 mg tablet - - - - - - - - -
    22 Albendazol 400 mg tablet - - - - - - - - -
    23 Albendazol 400 mg tablet - - - - - - - - -
    24 Albendazol 400 mg tablet - - - - - - - - -
    25 Albendazol 400 mg tablet - - - - - - - - -
    26 Albendazol 400 mg tablet - - - - - - - - -
    27 Albendazol 400 mg tablet - - - - - - - - -
    28 Albendazol 400 mg tablet - - - - - - - - -
    29 Albendazol 400 mg tablet - - - - - - - - -
    30 Albendazol 400 mg tablet - - - - - - - - -
    31 Albendazol 400 mg tablet - - - - - - - - -
    32 Albendazol 400 mg tablet - - - - - - - - -
    33 Albendazol 400 mg tablet - - - - - - - - -
    34 Albendazol 400 mg tablet - - - - - - - - -
    35 Albendazol 400 mg tablet - - - - - - - - -
    36 Albendazol 400 mg tablet - - - - - - - - -
    37 Albendazol 400 mg tablet - - - - - - - - -
    38 Albendazol 400 mg tablet - - - - - - - - -
    39 Albendazol 400 mg tablet - - - - - - - - -
    40 Albendazol 400 mg tablet - - - - - - - - -
    41 Albendazol 400 mg tablet - - - - - - - - -
    harga
    STOK harga stok penerimaa harga HARGA
    No. NAMA OBAT SATUAN HARGA penerimaa pemakaian sisa stok
    AWAL awal n1 pemakaian SISA STOK
    n
    semester
    42 Albendazol 400 mg tablet - - - - - - - - -
    43 Albendazol 400 mg tablet - - - - - - - - -
    44 Albendazol 400 mg tablet - - - - - - - - -
    45 Albendazol 400 mg tablet - - - - - - - - -
    46 Albendazol 400 mg tablet - - - - - - - - -
    47 Albendazol 400 mg tablet - - - - - - - - -
    48 Albendazol 400 mg tablet - - - - - 30 - - -
    49 Albendazol 400 mg tablet - - - - - - - - -
    50 Albendazol 400 mg tablet - - - - - - - - -
    51 Albendazol 400 mg tablet - - - - - - - - -
    52 Albendazol 400 mg tablet - - - - - - - - -
    53 Albendazol 400 mg tablet - - - - - - - - -
    54 Albendazol 400 mg tablet - - - - - - - - -
    55 Albendazol 400 mg tablet - - - - - - - - -
    56 Albendazol 400 mg tablet - - - - - 80 - - -
    57 Albendazol 400 mg tablet - - - 10 - 7 - 10 -
    58 Albendazol 400 mg tablet - - - - - 4 - - -
    59 Albendazol 400 mg tablet - - - - - - - - -
    60 Albendazol 400 mg tablet - - - - - - - - -
    61 Albendazol 400 mg tablet - - - - - - - - -
    62 Albendazol 400 mg tablet - - - - - - - - -
    63 Albendazol 400 mg tablet - - - - - - - - -
    64 Albendazol 400 mg tablet - - - - - - - - -
    65 Albendazol 400 mg tablet - - - - - - - - -
    66 Albendazol 400 mg tablet - - - - - - - - -
    67 Albendazol 400 mg tablet - - - 100 - 40 - 100 -
    68 Albendazol 400 mg tablet - - - - - 30 - - -
    69 Albendazol 400 mg tablet - - - 10 - 37 - 10 -
    70 Albendazol 400 mg tablet - - - 18 - 12 - 18 -
    71 Albendazol 400 mg tablet - - - 18 - 8 - 18 -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - 22 - - -
    Albendazol 400 mg tablet - - - - - 7 - - -
    Albendazol 400 mg tablet - - - - - - - - -
    72 Albendazol 400 mg tablet - - - - - - - - -
    73 Albendazol 400 mg tablet - - - - - - - - -
    74 Albendazol 400 mg tablet - - - - - 3 - - -
    75 Albendazol 400 mg tablet - - - - - 42 - - -
    76 Albendazol 400 mg tablet - - - - - 42 - - -
    77 Albendazol 400 mg tablet - - - - - 30 - - -
    78 Albendazol 400 mg tablet - - - - - - - - -
    79 Albendazol 400 mg tablet - - - - - - - - -
    80 Albendazol 400 mg tablet - - - - - - - - -
    81 Albendazol 400 mg tablet - - - - - 28 - - -
    82 Albendazol 400 mg tablet - - - - - 14 - - -
    83 Albendazol 400 mg tablet - - - - - - - - -
    84 Albendazol 400 mg tablet - - - - - - - - -
    85 Albendazol 400 mg tablet - - - - - - - - -
    harga
    STOK harga stok penerimaa harga HARGA
    No. NAMA OBAT SATUAN HARGA penerimaa pemakaian sisa stok
    AWAL awal n1 pemakaian SISA STOK
    n
    semester
    86 Albendazol 400 mg tablet - - - - - - - - -
    87 Albendazol 400 mg tablet - - - - - - - - -
    88 Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - - - - -
    Albendazol 400 mg tablet - - - - - 1 - - -
    Albendazol 400 mg tablet - - - 300 - 72 - 300 -
    JUMLAH : #REF! 2,217 -

    JKN NON JKN JUMLAH Generik Paten


    JML. KUNJUNGAN RESEP BULAN INI
    126

    Tulungagung,
    mengetahui, Yang menyerahkan Yang melaporkan
    Kepala UPTD Puskesmas Dono Petugas UPTD Puskesmas Dono Petugas Pustu / Polindes

    SUPARNO, S.Sos. WIWIK WINARNI RHONI W.P.


    NIP. 19630717 198512 1 003 NIP. 19770829 200901 2 003
    REKAP TRIBULAN IV

    cek KET.

    -
    -
    -
    -
    -
    (130)
    -
    -
    -
    (12)
    (110)
    -
    -
    -
    -
    -
    -
    -
    (34)
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    -
    cek KET.

    -
    -
    -
    (2)
    -
    -
    -
    -
    -
    -
    -
    -
    (30)
    -
    -
    -
    -
    -
    -
    -
    5
    -
    -
    (80)
    -
    -
    -
    -
    -
    -
    -
    -
    -
    4
    -
    -
    -
    -
    -
    -
    -
    -
    -
    (3)
    -
    (170)
    -
    -
    -
    cek KET.

    -
    -
    -
    -
    -
    -
    -
    -

    Yang melaporkan
    Petugas Pustu / Polindes

    RHONI W.P.

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