7.juli 23

PEMERINTAH KABUPATEN JENEPONTO
DINAS KESEHATAN DAERAH

UPTD PUSKESMAS KAPITA
Jl.Sabang Dg. Sese Desa Kapita Kec.Bangkala Kab. Jeneponto
email. puskesmaskapita@gmail.com
STOK AKHIR OBAT, BHP DAN REAGENTIA DAK

BULAN AGUSTUS TAHUN 2019
KEMAS VOLUME HARGA SATUAN TOTAL
No. NAMA OBAT
AN
1 Albendazol 400 mg (Prov 2019) Tablet #NAME? 494.00 #NAME?
2 Albendazole Suepensi 200 mg/5 ml (2019) Botol #NAME? 4,600.00

#NAME?
3 Ca Gluconas Injeksi (prov 2017) Ampul #NAME? 9,955.00 #NAME?
4 Ca Gluconas 10 Inj (Prov 2019 ) Ampul #NAME? 10,351.00 #NAME?
5 Fenobarbital Injeksi (Prov 2017) Ampul #NAME? 2,265.00 #NAME?
6 OAT Kat. Anak (prov 2019) Paket #NAME? 267,397.00 #NAME?
7 OAT Kat. 1 (Prov 2019) Paket #NAME? 447,747.00 #NAME?
8 OAT Kat.2 (Prov 2019) Paket #NAME? 1,297,889.00 #NAME?
9 Reagen ZN (Prov 2018) Paket #NAME? 263,011.00 #NAME?
10 Garam Oralit (prov 2019) Sachet #NAME? 275.00 #NAME?
11 Handscun L (prov 2018) pcs #NAME? 496.10 #NAME?
12 Micropipet 60 (prov 2018) Pcs #NAME? 179,200.00 #NAME?
14 RPR Syphilis RPR Antigen Tes(prov 2019) Tes #NAME? 4,250.00

#NAME?
15 Rotator (prov 2018) Buah #NAME? 3,950,000.00 #NAME?
16 SD HIV 19 (Prov 2019) Tes #NAME? 11,975.00 #NAME?
18 Tablet Tambah Darah (Prov 2019) Tablet #NAME? 410.00 #NAME?
19 Vaksin Rabies Vero (Prov 2019) Vial #NAME? 165,000.00 #NAME?
20 VIT. A 100.000 IU (Prov 2019) Kapsul #NAME? 332.00 #NAME?
22 Zink Tablet (Prov 2019) Tablet #NAME? 604.00 #NAME?
23 AMPICILLIN INJ 1000 MG (Prov 2019) Vial #NAME? 9,473.00 #NAME?
24 Amitriptillin 25 mg(Prov 2019) Tablet #NAME? 167.00 #NAME?
25 Artesunate for Injection (Prov 2019) Vial #NAME? 57,585.00 #NAME?
26 Diazepam Inj (Prov 2019) Ampul #NAME? 3,310.00 #NAME?
27 Disposafe (Prov 2019) Pcs #NAME? 20,394.00 #NAME?
28 Diagnostar (Prov 2019) Test #NAME? 14,629.00 #NAME?
29 Evafirens (Prov 2019) Botol 500 228,750.00 114,375,000.00
30 FDC KAT. Dewasa (Prov 2019) Botol - 89,681.00 -
32 Fitomenadion Inj (Prov 2019) Ampul - 4,326.00 -
33 Focos diagnostik (Prov 2019) Tes - 14,490.00 -
34 GEntamisin Injeksi (Prov 2019) Ampul - 4,036.00 -
35 Hepatitis B (Prov 2019) Vial #NAME? 1,325,000.00 #NAME?
36 KHB ( Rapid 2 ) (Prov 2019) Test - 12,500.00 -
37 Klorpromazin HCL 100 Mg (Prov 2019) Tablet - 147.00 -
38 Kombipak Azithromicyn Sipilis (Prov 2019) Amplop #NAME? 30,030.00

#NAME?
Lamivudine 30 Mg/ Nevirapine 50 Mg/

39 Botol #NAME? 44,409.00
Zidovudine 60 Mg (FDC Anak) (Prov 2019)
#NAME?
40 Lamivudine 150 (Prov 2019) Botol #NAME? 90,000.00 #NAME?
Methyergometrin Maleat Inj. 0,2 (Prov
41 Botol #NAME? 3,399.00
2019) #NAME?
Metronidazole 50 mg mg/100 ml (Prov
42 Botol #NAME? 8,250.00
2019) #NAME?
43 Oksitosin Inj (Prov 2019) Ampul - 1,199.00 -
Oxitetracycline 1 % Salep Mata ( Prov
44 Tube #NAME? 2,600.00
2019 ) #NAME?
45 Otsuka MgSO4 25 ML (Prov 2019) Ampul #NAME? 3,796.00 #NAME?
46 Paduan OAT Kat. I (Prov 2019) Paket 30 317,018.00 9,510,540.00
47 Rapid 2 ( Fokus ) (Prov 2019) Test 5 13,655.00 68,275.00
48 Risperidone 2 Mg (Prov 2019) Tablet - 273.00 -
49 Sutra (Prov 2019) Pcs 8 358.00 2,864.00
50 Spoit 0,5 ml (Prov 2019) Pcs #NAME? 1,240.00 #NAME?
51 Spoit 5 ml (Prov 2019) Pcs #NAME? 1,583.00 #NAME?
Tenofovir Disoproxil Furmatare 300 Mg
52 Botol 5 279,450.00
(Prov 2019 1,397,250.00
53 Tre Pocheck Sypilis (Prov 2019) Tes #NAME? 9,900.00 #NAME?
54 Triheksifinidil 2 Mg (Prov 2019) Tablet #NAME? 85.00 #NAME?
55 Vikia HIV 1/2 (Prov 2019) Tes #NAME? 19,480.00 #NAME?
56 Ampicillin Sodium 1000 mg (Prov 2019) Vial #NAME? 9,473.00 #NAME?
57 Garam Oralit (prov 2018) Sachet #NAME? 10,672.00 #NAME?
58 Klorpromazin HCL 100 Mg (Prov 2020) Tablet #NAME? 157.00 #NAME?
#NAME?
PEMAKAIAN OBAT, BMHP DAN REAGENSIA DANA APBD BULAN

DESEMBER 2019
No. NAMA OBAT
AN
1 Albendazol 400 mg (Prov 2019) Tablet #NAME? 494.00 #NAME?
2 Albendazole Suepensi 200 mg/5 ml (2019) Botol #NAME? 4,600.00

#NAME?
3 Ca Gluconas Injeksi (prov 2017) Ampul #NAME? 9,955.00 #NAME?
4 Ca Gluconas 10 Inj (Prov 2019 ) Ampul #NAME? 10,351.00 #NAME?
5 Fenobarbital Injeksi (Prov 2017) Ampul #NAME? 2,265.00 #NAME?
6 OAT Kat. Anak (prov 2019) Paket #NAME? 267,397.00 #NAME?
7 OAT Kat. 1 (Prov 2019) Paket #NAME? 447,747.00 #NAME?
8 OAT Kat.2 (Prov 2019) Paket #NAME? 1,297,889.00 #NAME?
9 Reagen ZN (Prov 2018) Paket #NAME? 263,011.00 #NAME?
10 Garam Oralit (prov 2019) Sachet #NAME? 275.00 #NAME?
11 Handscun L (prov 2018) pcs #NAME? 496.10 #NAME?
14 RPR Syphilis RPR Antigen Tes(prov 2019) Tes #NAME? 4,250.00

#NAME?
15 Rotator (prov 2018) Buah #NAME? 3,950,000.00 #NAME?
18 Tablet Tambah Darah (Prov 2019) Tablet #NAME? 410.00 #NAME?
19 Vaksin Rabies Vero (Prov 2019) Vial #NAME? 165,000.00 #NAME?
22 Zink Tablet (Prov 2019) Tablet #NAME? 604.00 #NAME?
23 AMPICILLIN INJ 1000 MG (Prov 2019) Vial #NAME? 9,473.00 #NAME?
24 Amitriptillin 25 mg(Prov 2019) Tablet #NAME? 167.00 #NAME?
25 Artesunate for Injection (Prov 2019) Vial #NAME? 57,585.00 #NAME?
26 Diazepam Inj (Prov 2019) Ampul #NAME? 3,310.00 #NAME?
27 Disposafe (Prov 2019) Pcs #NAME? 20,394.00 #NAME?
28 Diagnostar (Prov 2019) Test #NAME? 14,629.00 #NAME?
29 Evafirens (Prov 2019) Botol - 228,750.00 -
35 Hepatitis B (Prov 2019) Vial #NAME? 1,325,000.00 #NAME?
36 KHB ( Rapid 2 ) (Prov 2019) Test 200 12,500.00 2,500,000.00
38 Kombipak Azithromicyn Sipilis (Prov 2019) Amplop #NAME? 30,030.00

#NAME?

39 Botol #NAME? 44,409.00
#NAME?
40 Lamivudine 150 (Prov 2019) Botol #NAME? 90,000.00 #NAME?
41 Botol #NAME? 3,399.00
2019) #NAME?
42 Botol #NAME? 8,250.00
2019) #NAME?
44 Tube #NAME? 2,600.00
2019 ) #NAME?
45 Otsuka MgSO4 25 ML (Prov 2019) Ampul #NAME? 3,796.00 #NAME?
46 Paduan OAT Kat. I (Prov 2019) Paket 70 317,018.00 22,191,260.00
47 Rapid 2 ( Fokus ) (Prov 2019) Test - 13,655.00 -
49 Sutra (Prov 2019) Pcs - 358.00 -
50 Spoit 0,5 ml (Prov 2019) Pcs #NAME? 1,240.00 #NAME?
51 Spoit 5 ml (Prov 2019) Pcs #NAME? 1,583.00 #NAME?
52 Botol - 279,450.00
(Prov 2019 -
53 Tre Pocheck Sypilis (Prov 2019) Tes #NAME? 9,900.00 #NAME?
55 Vikia HIV 1/2 (Prov 2019) Tes #NAME? 19,480.00 #NAME?
56 Ampicillin Sodium 1000 mg (Prov 2019) Vial #NAME? 9,473.00 #NAME?
57 Garam Oralit (prov 2018) Sachet #NAME? 10,672.00 #NAME?
58 Klorpromazin HCL 100 Mg (Prov 2020) Tablet #NAME? 157.00 #NAME?
#NAME?
BERITA ACARA PENYERAHAN BARANG

Nomor : /PKM-KPT/ VIII /2019
Pada Hari ini Kamis Tanggal Tiga Puluh Satu Bulan Desember Tahun Dua Ribu Sembilan Belas, kami telah
menyerahkan barang kepada Apotik dengan rincian sebagai berikut :

No. NAMA OBAT
AN
1 Albendazol 400 mg (Prov 2019) Tablet - 494.00 -
2 Albendazole Suepensi 200 mg/5 ml (2019) Botol - 4,600.00

-
3 Ca Gluconas Injeksi (prov 2017) Ampul - 9,955.00 -
4 Ca Gluconas 10 Inj (Prov 2019 ) Ampul - 10,351.00 -
5 Fenobarbital Injeksi (Prov 2017) Ampul - 2,265.00 -
6 OAT Kat. Anak (prov 2019) Paket - 267,397.00 -
7 OAT Kat. 1 (Prov 2019) Paket - 447,747.00 -
8 OAT Kat.2 (Prov 2019) Paket - 1,297,889.00 -
9 Reagen ZN (Prov 2018) Paket - 263,011.00 -
10 Garam Oralit (prov 2019) Sachet - 275.00 -
11 Handscun L (prov 2018) pcs - 496.10 -
12 Micropipet 60 (prov 2018) Pcs - 179,200.00 -
14 RPR Syphilis RPR Antigen Tes(prov 2019) Tes - 4,250.00

-
15 Rotator (prov 2018) Buah - 3,950,000.00 -
16 SD HIV 19 (Prov 2019) Tes - 11,975.00 -
17 SD HIV 19 (Prov 2019) Tes - 14,430.00 -
18 Tablet Tambah Darah (Prov 2019) Tablet - 410.00 -
19 Vaksin Rabies Vero (Prov 2019) Vial - 165,000.00 -
20 VIT. A 100.000 IU (Prov 2019) Kapsul - 332.00 -
22 Zink Tablet (Prov 2019) Tablet - 604.00 -
23 AMPICILLIN INJ 1000 MG (Prov 2019) Vial - 9,473.00 -
24 Amitriptillin 25 mg(Prov 2019) Tablet - 167.00 -
25 Artesunate for Injection (Prov 2019) Vial - 57,585.00 -
26 Diazepam Inj (Prov 2019) Ampul - 3,310.00 -
27 Disposafe (Prov 2019) Pcs - 20,394.00 -
28 Diagnostar (Prov 2019) Test - 14,629.00 -
35 Hepatitis B (Prov 2019) Vial - 1,325,000.00 -
38 Kombipak Azithromicyn Sipilis (Prov 2019) Amplop - 30,030.00

-

39 Botol - 44,409.00
-
40 Lamivudine 150 (Prov 2019) Botol - 90,000.00 -
41 Botol - 3,399.00
2019) -
42 Botol - 8,250.00
2019) -
44 Tube - 2,600.00
2019 ) -
45 Otsuka MgSO4 25 ML (Prov 2019) Ampul - 3,796.00 -
46 Paduan OAT Kat. I (Prov 2019) Paket - 317,018.00 -
49 Sutra (Prov 2019) Pcs - 358.00 -
50 Spoit 0,5 ml (Prov 2019) Pcs - 1,240.00 -
51 Spoit 5 ml (Prov 2019) Pcs - 1,583.00 -
52 Botol - 279,450.00
(Prov 2019 -
53 Tre Pocheck Sypilis (Prov 2019) Tes - 9,900.00 -
54 Triheksifinidil 2 Mg (Prov 2019) Tablet - 85.00 -
55 Vikia HIV 1/2 (Prov 2019) Tes - 19,480.00 -
56 Ampicillin Sodium 1000 mg (Prov 2019) Vial - 9,473.00 -
57 Garam Oralit (prov 2018) Sachet - 10,672.00 -
-


No. NAMA OBAT
AN

-

-
16 SD HIV 19 (Prov 2019) Tes - 11,975.00 -
17 SD HIV 19 (Prov 2019) Tes - 14,430.00 -

-

39 Botol - 44,409.00
-
41 Botol - 3,399.00
2019) -
42 Botol - 8,250.00
2019) -
44 Tube - 2,600.00
2019 ) -
49 Sutra (Prov 2019) Pcs - 358.00 -
50 Spoit 0,5 ml (Prov 2019) Pcs - 1,240.00 -
51 Spoit 5 ml (Prov 2019) Pcs - 1,583.00 -
52 Botol - 279,450.00
(Prov 2019 -
56 Ampicillin Sodium 1000 mg (Prov 2019) Vial - 9,473.00

-
-


No. NAMA OBAT
AN

-

-
16 SD HIV 19 (Prov 2019) Tes - 11,975.00 -
17 SD HIV 19 (Prov 2019) Tes - 14,430.00 -

-

39 Botol - 44,409.00
-
41 Botol - 3,399.00
2019) -
42 Botol - 8,250.00
2019) -
44 Tube - 2,600.00
2019 ) -
49 Sutra (Prov 2019) Pcs - 358.00 -
50 Spoit 0,5 ml (Prov 2019) Pcs - 1,240.00 -
51 Spoit 5 ml (Prov 2019) Pcs - 1,583.00 -
52 Botol - 279,450.00
(Prov 2019 -
-


No. NAMA OBAT
AN

-

-
16 SD HIV 19 (Prov 2019) Tes - 11,975.00 -
17 SD HIV 19 (Prov 2019) Tes - 14,430.00 -

-

39 Botol - 44,409.00
-
41 Botol - 3,399.00
2019) -
42 Botol - 8,250.00
2019) -
44 Tube - 2,600.00
2019 ) -
49 Sutra (Prov 2019) Pcs - 358.00 -
50 Spoit 0,5 ml (Prov 2019) Pcs - 1,240.00 -
51 Spoit 5 ml (Prov 2019) Pcs - 1,583.00 -
52 Botol - 279,450.00
(Prov 2019 -
-


No. NAMA OBAT
AN

-

-
16 SD HIV 19 (Prov 2019) Tes - 11,975.00 -
17 SD HIV 19 (Prov 2019) Tes - 14,430.00 -

-

39 Botol - 44,409.00
-
41 Botol - 3,399.00
2019) -
42 Botol - 8,250.00
2019) -
44 Tube - 2,600.00
2019 ) -
49 Sutra (Prov 2019) Pcs - 358.00 -
50 Spoit 0,5 ml (Prov 2019) Pcs - 1,240.00 -
51 Spoit 5 ml (Prov 2019) Pcs - 1,583.00 -
52 Botol - 279,450.00
(Prov 2019 -
-


No. NAMA OBAT
AN

-

-
16 SD HIV 19 (Prov 2019) Tes - 11,975.00 -
17 SD HIV 19 (Prov 2019) Tes - 14,430.00 -

-

39 Botol - 44,409.00
-
41 Botol - 3,399.00
2019) -
42 Botol - 8,250.00
2019) -
44 Tube - 2,600.00
2019 ) -
49 Sutra (Prov 2019) Pcs - 358.00 -
50 Spoit 0,5 ml (Prov 2019) Pcs - 1,240.00 -
51 Spoit 5 ml (Prov 2019) Pcs - 1,583.00 -
52 Botol - 279,450.00
(Prov 2019 -
-


No. NAMA OBAT
AN

-

-
16 SD HIV 19 (Prov 2019) Tes - 11,975.00 -
17 SD HIV 19 (Prov 2019) Tes - 14,430.00 -

-

39 Botol - 44,409.00
-
41 Botol - 3,399.00
2019) -
42 Botol - 8,250.00
2019) -
44 Tube - 2,600.00
2019 ) -
49 Sutra (Prov 2019) Pcs - 358.00 -
50 Spoit 0,5 ml (Prov 2019) Pcs - 1,240.00 -
51 Spoit 5 ml (Prov 2019) Pcs - 1,583.00 -
52 Botol - 279,450.00
(Prov 2019 -
-


No. NAMA OBAT
AN

-

-
16 SD HIV 19 (Prov 2019) Tes - 11,975.00 -
17 SD HIV 19 (Prov 2019) Tes - 14,430.00 -

-

39 Botol - 44,409.00
-
41 Botol - 3,399.00
2019) -
42 Botol - 8,250.00
2019) -
44 Tube - 2,600.00
2019 ) -
49 Sutra (Prov 2019) Pcs - 358.00 -
50 Spoit 0,5 ml (Prov 2019) Pcs - 1,240.00 -
51 Spoit 5 ml (Prov 2019) Pcs - 1,583.00 -
52 Botol - 279,450.00
(Prov 2019 -
-


No. NAMA OBAT
AN

-

-
16 SD HIV 19 (Prov 2019) Tes - 11,975.00 -
17 SD HIV 19 (Prov 2019) Tes - 14,430.00 -

-

39 Botol - 44,409.00
-
41 Botol - 3,399.00
2019) -
42 Botol - 8,250.00
2019) -
44 Tube - 2,600.00
2019 ) -
49 Sutra (Prov 2019) Pcs - 358.00 -
50 Spoit 0,5 ml (Prov 2019) Pcs - 1,240.00 -
51 Spoit 5 ml (Prov 2019) Pcs - 1,583.00 -
52 Botol - 279,450.00
(Prov 2019 -
-


No. NAMA OBAT
AN

-

-
16 SD HIV 19 (Prov 2019) Tes - 11,975.00 -
17 SD HIV 19 (Prov 2019) Tes - 14,430.00 -

-

39 Botol - 44,409.00
-
41 Botol - 3,399.00
2019) -
42 Botol - 8,250.00
2019) -
44 Tube - 2,600.00
2019 ) -
49 Sutra (Prov 2019) Pcs - 358.00 -
50 Spoit 0,5 ml (Prov 2019) Pcs - 1,240.00 -
51 Spoit 5 ml (Prov 2019) Pcs - 1,583.00 -
52 Botol - 279,450.00
(Prov 2019 -
-


No. NAMA OBAT
AN

-

-
16 SD HIV 19 (Prov 2019) Tes - 11,975.00 -
17 SD HIV 19 (Prov 2019) Tes - 14,430.00 -

-

39 Botol - 44,409.00
-
41 Botol - 3,399.00
2019) -
42 Botol - 8,250.00
2019) -
44 Tube - 2,600.00
2019 ) -
49 Sutra (Prov 2019) Pcs - 358.00 -
50 Spoit 0,5 ml (Prov 2019) Pcs - 1,240.00 -
51 Spoit 5 ml (Prov 2019) Pcs - 1,583.00 -
52 Botol - 279,450.00
(Prov 2019 -
-


No. NAMA OBAT
AN

-

-
16 SD HIV 19 (Prov 2019) Tes - 11,975.00 -
17 SD HIV 19 (Prov 2019) Tes - 14,430.00 -

-

39 Botol - 44,409.00
-
41 Botol - 3,399.00
2019) -
42 Botol - 8,250.00
2019) -
44 Tube - 2,600.00
2019 ) -
49 Sutra (Prov 2019) Pcs - 358.00 -
50 Spoit 0,5 ml (Prov 2019) Pcs - 1,240.00 -
51 Spoit 5 ml (Prov 2019) Pcs - 1,583.00 -
52 Botol - 279,450.00
(Prov 2019 -
-


No. NAMA OBAT
AN

-

-
16 SD HIV 19 (Prov 2019) Tes - 11,975.00 -
17 SD HIV 19 (Prov 2019) Tes - 14,430.00 -

-

39 Botol - 44,409.00
-
41 Botol - 3,399.00
2019) -
42 Botol - 8,250.00
2019) -
44 Tube - 2,600.00
2019 ) -
49 Sutra (Prov 2019) Pcs - 358.00 -
50 Spoit 0,5 ml (Prov 2019) Pcs - 1,240.00 -
51 Spoit 5 ml (Prov 2019) Pcs - 1,583.00 -
52 Botol - 279,450.00
(Prov 2019 -

Mengetahui ;
Kepala Puskesmas Kapita Pengelola Obat
ST. RATIKA YP, SKM., M. Kes PURWANTO, Am. AF

NIP. 19800814 201001 2 020 NIP. 19720506 200604 1 006
LAPORAN PEMAKAIAN OBAT DAN BAHAN MEDIS HABIS PAKAI PROVINSI
PUSKESMAS KAPITA
BULAN DESEMBER 2019
PUSTU PUSTU POSKESDES JUMLAH

STOK PUSTU PUSTU PUSKEL/ PUSKEL/ SISA
NO NAMA OBAT KEMASAN APOTIK MARAYOK GUNUNG GUNGUNG IMUNISASI KIA UGD LAB GIGI PENGELU
AWAL JENETALLASA
A
KAPITA
SILANU SILANU ED ED STOK
ARAN
1 Clobazam 10 mg (Prov 2018) tablet #NAME? - #NAME?

2 Triheksifenidil 2 mg ( Prov 2020 ) Tablet #NAME? - #NAME?
3 Triheksifinidil 2 Mg (Prov 2019) Tablet #NAME? - #NAME?
4 Otsuka MgSO4 25 ML (Prov 2019) Ampul #NAME? - #NAME?
5 Risperidone 2 Mg (Prov 2018) Tablet #NAME? - #NAME?
6 Closapine 25 mg (Prov 2018) Tablet #NAME? - #NAME?
7 Reagen ZN (Prov 2018) Paket #NAME? - #NAME?
8 Albendazol 400 mg (Prov 2019) Tablet #NAME? - #NAME?
9 OAT Kat. Anak (prov 2019) Paket #NAME? - #NAME?
10 Ca Gluconas 10 Inj (Prov 2019 ) Ampul #NAME? - #NAME?
11 VIT. A 100.000 IU (Prov 2019) Kapsul #NAME? - #NAME?
12 Risperidone 2 Mg (Prov 2019) Tablet #NAME? - #NAME?
13 Resperidon 2 mg (Prov 2020) Tablet #NAME? - #NAME?
14 Rapid Test HBSAG Test #NAME? - #NAME?
15 Tre Pocheck Sypilis (Prov 2019) Tes #NAME? - #NAME?
16 Sutra (Prov 2019) Pcs #NAME? - #NAME?
17 Diazepam Inj (Prov 2019) Ampul #NAME? - #NAME?
18 SD HIV 19 (Prov 2019) Tes #NAME? - #NAME?
19 Klorpromazin HCL 100 Mg (Prov 2019) Tablet #NAME? - #NAME?
20 RpR Syphilis RPR Antigen Tes(prov 2018) Tablet #NAME? - #NAME?
21 Oksitosin Inj (Prov 2019) Ampul #NAME? - #NAME?
22 OAT Kat. 1 (Prov 2019) Paket #NAME? - #NAME?
23 SD HIV 19 (Prov 2019) Tes #NAME? - #NAME?
24 Rapid Test HBSAG Test #NAME? - #NAME?
25 Tissu alkohol/ Descoderm pads (Prov 2018) Sachet #NAME? - #NAME?
26 Albendazole Suepensi 200 mg/5 ml (2019) Botol #NAME? - #NAME?
27 Ca Gluconas 10 Inj (Prov 2019 ) Ampul #NAME? - #NAME?
28 OAT Kat. 1 (Prov 2019) Paket #NAME? - #NAME?
29 Garam Oralit (prov 2019/2020) Sachet 500 - 500
30 Micropipet 60 (prov 2018) Pcs - - -
31 Micropipet 61 (prov 2018) Pcs - - -
AWAL JENETALLASA
A
KAPITA
ARAN
32 RPR Syphilis RPR Antigen Tes(prov 2019) Tes - - -

33 Rotator (prov 2018) Buah - - -
34 Vaksin Rabies Vero (Prov 2019) Vial - - -
35 VIT. A 200.000 IU (Prov 2019) Kapsul #NAME? - #NAME?
36 Zink Tablet (Prov 2019) Tablet 200 - 200
37 AMPICILLIN INJ 1000 MG (Prov 2019) Vial - - -
38 Amitriptillin (Prov 2019) Tablet #NAME? - #NAME?
39 Disposafe (Prov 2019) Pcs #NAME? - #NAME?
40 Diagnostar (Prov 2019) Test #NAME? - #NAME?
41 Hepatitis B (Prov 2019) Vial #NAME? - #NAME?
42 KHB ( Rapid 2 ) (Prov 2019) Test #NAME? - #NAME?
43 Oxitetracycline 1 % Salep Mata ( Prov 2019 ) Tube - - -
44 Paduan OAT Kat. I (Prov 2019) Paket #NAME? - #NAME?
45 Spoit 0,5 ml (Prov 2019) Pcs #NAME? - #NAME?
46 Spoit 5 ml (Prov 2019) Pcs 100 - 100
47 Tenofovir Disoproxil Furmatare 300 Mg (Prov 2019) Botol 5 - 5
48 Ampicillin Sodium 1000 mg (Prov 2019) Vial - - -
49 Zidovudine 300 mg+Lamivudine 150 mg (Prov 2020) Botol 8 - 8
50 Fenobarbital Injeksi (Prov 2020) Ampul #NAME? - #NAME?
51 Evafirens (Prov 2020) Botol #NAME? - #NAME?
52 Lamivudine 150 (Prov 2020) Botol 5 - 5
53 Tenofovir Disoproxil Furmatare 300 Mg (Prov 2020) Botol - - -
54 Trifluoperazine Hcl 5 mg (Prov 2020) Tablet 500 - 500
55 Klorpromazin HCL 100 Mg (Prov 2020) Tablet #NAME? - #NAME?
56 Flufenazine Decanoat Inj. 25mg/ml (Prov 2020) Ampul - - -
57 Clozapine 25 mg (Prov 2020) Tablet #NAME? - #NAME?
58 Clobazam 10 mg (Prov 2020) Tablet - - -
59 Amitriptillin 25 mg (Prov 2020) Tablet 300 - 300
60 Tablet Tambah Darah (Prov 2020) Tablet 5,000 670 670 4,330
61 OAT Kategori II (Prov 2020) Paket #NAME? - #NAME?
63 Albendazole Suepensi 200 mg/5 ml (2020) Botol #NAME? - #NAME?
64 VIT. A 100.000 IU (Prov 2020) Kapsul - 100 100 (100)
65 VIT. A 200.000 IU (Prov 2020) Kapsul 300 200 200 100
66 Diagnostar ( Rapid 3 ) (Prov 2020) Test - - -
67 Mineral Mix (Prov 2020) Sachet - - -
68 Zink Tablet (Prov 2020) Tablet #NAME? - #NAME?
AWAL JENETALLASA
A
KAPITA
ARAN
69 SD HIV 19 (Prov 2020) Tes - 100 100 (100)

70 Rapid 3 ( Diagnostar ) Test - - -
71 Rapid Test Typoid (Spot Typhi Igm) Test - - -
72 Rapid Test HBSAG virochek Test - - -
73 FDC Dewasa (Prov 2020) Botol - - -
74 FDC Dewasa (Prov 2020) Botol - - -
75 Tre Pocheck Sypilis (Prov 2020) Tes - - -
76 RAPID 2 (KHB) Tes - - -
77 Spoit 0,05 ml (Prov 2020) Pcs 80 - 80
78 Spoit 0,5 ml (Prov 2020) Pcs 500 - 500
79 Spoit 5 ml (Prov 2020) Pcs - - -
80 MgSO4 25 ML (Prov 2019/2020) Ampul - - -
81 Safety Box 5 L Pcs 9 - 9
82 Fitomenadion Injeksi (Prov 2020) Ampul 90 - 90
83 OAT Kat. Anak (prov 2020) Paket - - -
84 OAT Kat. 1 (Prov 2020) Paket - - -
85 Diazepam Inj (Prov 2019) Ampul 18 - 18
86 Oxitetracycline 1 % Salep Mata ( Prov 2020 Tube - - -
87 Fenobarbital Injeksi (Prov 2020) Ampul - - -
88 Isoniasida 300 Mg / INH Tablet - - -
89 Cotrmoxazole 960 mg tablet - - -
90 FDC Anak (Prov 2020) Botol - - -
91 Nevirapine 200 Mg Botol #NAME? - #NAME?
93 Albendazol Suspensi 200 Mg/5 Mg(Prov 2021) Botol - - -
94 Haloperidol Inj ( Prov 2021 ) Ampul - - -
95 Haloperidol Tab (Prov 2021 ) Tablet 500 - 500
96 Risperidone 2 mg (Prov 2021 ) Tablet - - -
97 Triheksifenidil 2 mg ( Prov 2021 ) Tablet - - -
98 FDC Dewasa ( Prov 2021 ) Btl 30/Tab - - -
99 Kondom ( Prov 2021 ) Pcs - - -
100 Endo Vacutube Steriel pcs #NAME? - #NAME?
101 Alkohol Swab Plastik pcs - - -
102 BD Vacutainer pcs - - -
103 Freezing Tubes pcs - - -
104 Steroform Box pcs - - -
105 Vaksin Rabies Vero (Prov 2021) Vial - - -
AWAL JENETALLASA
A
KAPITA
ARAN
106 Ephinefrin Inj Ampul - - -

107 APD Lengkap Set #NAME? - #NAME?
108 Baju APD Pcs - - -
109 Masker KN 95 Pcs - - -
110 Multivitamin Tablet - 110 110 (110)
111 Vitamin C 500 mg Tablet - - -
112 Abacavir 40 mg+ 3 Tc 60 mg Btl 30/Tab - - -
113 Lopinavir 40 Mg + Ritonavir 10 Mg box 120 #NAME? - #NAME?
114 Tablet Tambah Darah (Prov 2021) Tablet - - -
115 Vitamim A 100.000 IU Kapsul #NAME? - #NAME?
116 FDC OAT Kategori 1 (2021) Paket - - -
117 FDC OAT Kategori 1 (2021) Paket - - -
118 STOP TB KIT Paket - - -
119 KDT Dosis Harian (2021) Paket - - -
120 Fenobarbital Injeksi (Prov 2021) Ampul - - -
121 MgSO4 20 ML (Prov 2021) Ampul 6 - 6
122 MgSO4 40 ML (Prov 2021) Ampul - - -
123 Benzatine penisilin vial - - -
124 fluconazole 150 mg tablet - - -
125 Virochek HIV 1/2 Test 50 - 50
126 Kertas Saring DBS Test - - -
127 Rapid Diagnostar HIV 1/2 (Rapid 2) Test - - -
128 Standar Q HIV 1/2 Ab3 (Rapid 3) Test - - -
129 viro lot Paket - - -
130 Hepatitis B (Prov 2019/2021) Vial - - -
- -
Jeneponto, 13 Agustus 2019

AWAL JENETALLASA
A
KAPITA
ARAN
Mengetahui ;
Kepala Puskesmas Kapita Pengelola Obat Puskesmas
ST. RATIKA YP, SKM., M. Kes YAMRI,.S.Farm

NIP. 19800814 201001 2 020
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) PROVINSI
UNIT PENERIMA : PUSKESMAS KAPITA BULAN JULI
KECAMATAN : BANGKALA TAHUN 2023
KABUPATEN : JENEPONTO
PROVINSI : SULAWESI SELATAN
STOK
KEMASA STOK PERSEDIA PEMAKAI RUSAK/ PERMIN PEMBERI
NO NAMA OBAT PENERIMA SISA STOK OPTIMU KET
N AWAL AN AN ED TAAN AN
AN M
1 Garam Oralit (prov 2022) Sachet 500 500 500 500

2 Micropipet 60 (prov 2018) Pcs
3 Micropipet 61 (prov 2018) Pcs
4 RPR Syphilis RPR Antigen Tes(prov 2019) Tes
5 Rotator (prov 2022) Buah
6 Vaksin Rabies Vero (Prov 2022) Vial 2
7 Zink Tablet (Prov 2022) Tablet 200 200 200 - -
8 AMPICILLIN INJ 1000 MG (Prov 2019) Vial
9 Oxitetracycline 1 % Salep Mata ( Prov 2022 ) Tube 100
10 Spoit 5 ml (Prov 2019) Pcs 100 100 70 30 30 200
11 Tenofovir Disoproxil Furmatare 300 Mg (Prov 2019) Botol 5 5 5 5
12 Ampicillin Sodium 1000 mg (Prov 2019) Vial
13 Zidovudine 300 mg+Lamivudine 150 mg (Prov 2020) Botol 8 8 8 8
14 Lamivudine 150 (Prov 2020) Botol 5 5 5 5
15 Tenofovir Disoproxil Furmatare 300 Mg (Prov 2020) Botol
16 Trifluoperazine Hcl 5 mg (Prov 2020) Tablet 500 500 500 500
17 Flufenazine Decanoat Inj. 25mg/ml (Prov 2020) Ampul
18 Clobazam 10 mg (Prov 2020) Tablet
19 Amitriptillin 25 mg (Prov 2020) Tablet 300 300 300 300 300
20 Tablet Tambah Darah (Prov 2020) Tablet 5,000 5,000 5,000
21 VIT. A 100.000 IU (Prov 2020) Kapsul 1,200
22 VIT. A 200.000 IU (Prov 2020) Kapsul 300 300 300 300
23 Diagnostar ( Rapid 3 ) (Prov 2020) Test 1,000
24 Mineral Mix (Prov 2020) Sachet
STOK
AN M
25 SD HIV 19 (Prov 2020) Tes 100

26 Rapid 3 ( Diagnostar ) Test
27 Rapid Test Typoid (Spot Typhi Igm) Test
28 Rapid Test HBSAG virochek Test 100
29 FDC Dewasa (Prov 2020) Botol
30 FDC Dewasa (Prov 2020) Botol
31 Tre Pocheck Sypilis (Prov 2020) Tes
32 RAPID 2 (KHB) Tes 100
33 Spoit 0,05 ml (Prov 2020) Pcs 80 80 21 59 59
34 Spoit 0,5 ml (Prov 2020) Pcs 500 500 50 450 450
35 Spoit 5 ml (Prov 2020) Pcs
36 MgSO4 25 ML (Prov 2019/2020) Ampul
37 Safety Box 5 L Pcs 9 25 34 34 34
38 Phytomenadion Injeksi (Prov 2020) Ampul 90 90 30 60 60
39 OAT Kat. Anak (prov 2020) Paket
40 OAT Kat. 1 (Prov 2020) Paket
41 Diazepam Inj (Prov 2019) Ampul 18 18 ED ED 20
42 Oxitetracycline 1 % Salep Mata ( Prov 2020 Tube
43 Fenobarbital Injeksi (Prov 2020) Ampul 200
44 Isoniasida 300 Mg / INH Tablet
45 Cotrmoxazole 960 mg tablet
46 FDC Anak (Prov 2020) Botol
47 Albendazol Suspensi 200 Mg/5 Mg(Prov 2021) Botol
48 Haloperidol Inj ( Prov 2021 ) Ampul 20
49 Haloperidol Tab (Prov 2021 ) Tablet 500 500 300 200 200 1,000
50 Risperidone 2 mg (Prov 2021 ) Tablet 2,000
51 Triheksifenidil 2 mg ( Prov 2021 ) Tablet
52 FDC Dewasa ( Prov 2021 ) Btl 30/Tab
53 Kondom ( Prov 2021 ) Pcs
54 Alkohol Swab Plastik pcs
55 BD Vacutainer pcs
STOK
AN M
56 Freezing Tubes pcs

57 Steroform Box pcs
58 Vaksin Rabies Vero (Prov 2022) Vial 10
59 Ephinefrin Inj Ampul
60 Baju APD Pcs
61 Masker KN 95 Pcs
62 Multivitamin Tablet
63 Vitamin C 500 mg Tablet 1,000
64 Abacavir 40 mg+ 3 Tc 60 mg Btl 30/Tab 2,000
65 Tablet Tambah Darah (Prov 2021) Tablet
66 FDC OAT Kategori 1 (2022) Paket -
67 FDC OAT Kategori 1 (2021) Paket 30
68 STOP TB KIT Paket
69 KDT Dosis Harian (2021) Paket
70 Fenobarbital Injeksi (Prov 2021) Ampul
71 MgSO4 20 ML (Prov 2022) Ampul 6 6 ED ED 10
72 MgSO4 40 ML (Prov 2021) Ampul
73 Benzatine penisilin vial
74 fluconazole 150 mg tablet
75 Virochek HIV 1/2 2022 Test 50 50 50 50
76 Kertas Saring DBS Test
77 Rapid Diagnostar HIV 1/2 (Rapid 2) Test
78 Standar Q HIV 1/2 Ab3 (Rapid 3) Test
79 viro lot Paket
80 Hepatitis B (Prov 2022) Vial
81 OAT kategori 1 (2022) 3 3 3 - - 20
82 Rapid diagnostar HIV 1/2 (Rapid 2)(2022) 20
83 Rapid HBSAg (2022) 100 100 100 - - 200
84 Clozapine (2022) Tablet 500 500 500 - - 2,000
85 Resperidone (2022) Tablet 2,000
STOK
AN M
86 Triheksifenidil 2 mg ( Prov 2022 ) Tablet 200 200 200 - - 500

87 RDT 1
88 RDT 2
89 RDT MALARIA
90 INDEC (HIV1/2 & SYPHILIS COMBO)2023 100 30 130 105 25 25 100
91 Alprazolam 2 mg 50 50 50
92 Stesolid /Diazepam rectal 25 25 ED ED ED 1,000
93 Reagen HIV/2022
94 Vit B6 Tablet 50
95 Albendazole (2022) Tablet 15 15 2 13 13
96 Herbakof syrup 60 ml botol
97 Lytacur syrup 60 ml botol 20
98 Stimuno syrup 100 ml (OTC) botol 20
99 Kartu Golongan Darah 20
100 Ethylcloride spray botol 300
101 oxytetracyclin salep mata tube 20
102 alkohol Swab 400 400 400 - - 300
103 ALBENDAZOLE SUSPENSI (2022) BTL10 ML 70 70 70 70
104 VIROCHECK HBSAg 2022 TEST 100 100 100 100
105 Klorpromazin HCL (CPZ)100 Mg (Prov 2022) Tablet 100
108 Virotec DBD 2022 Test 25 25 25 - - 25
109 Test Narkoba/strip test
110 Hepatitis C Test 20
111 tenolom E Tablet 3 3 3 3
112 Codein Tablet 1,000
Jeneponto, Juli 2023

Mengetahui ;
STOK
AN M
Kepala Puskesmas Kapita Pengelola Obat Puskesmas
ST. RATIKA YP, SKM., M. Kes YAMRI,.S.Farm

NIP. 19800814 201001 2 020
LAPORAN PEMAKAIAN OBAT DAN BAHAN MEDIS HA
PUSKESMAS KAPITA
BULAN JULI 2020
PUSTU PUSTU
KEMASA STOK PUSTU PUSTU
NO NAMA OBAT APOTIK JENETALLAS GUNUNG
N AWAL A
MARAYOKA KAPITA
SILANU
Masker Tali ( HIV ) pcs -

Spoit 3 ml ( HIV ) pcs 500
Reagen Sifilis ( HIV ) 1
Reagen ( HIV ) 1
Lancet ( HIV ) 5
Alkohol Swab ( HIV ) 5
Handscun M ( HIV ) -
AN BAHAN MEDIS HABIS PAKAI PROVINSI HIV
SKESMAS KAPITA
ULAN JULI 2020
POSKESDES JUMLAH
PUSKEL/ PUSKEL/ SISA
GUNGUNG IMUNISASI KIA UGD LAB GIGI PENGELU
SILANU ED ED STOK
ARAN
- -
- 500
- 1
- 1
- 5
- 5
- -

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PEMERINTAH KABUPATEN JENEPONTO

DINAS KESEHATAN DAERAH

STOK AKHIR OBAT, BHP DAN REAGENTIA DAK

2 Albendazole Suepensi 200 mg/5 ml (2019) Botol #NAME? 4,600.00

14 RPR Syphilis RPR Antigen Tes(prov 2019) Tes #NAME? 4,250.00

38 Kombipak Azithromicyn Sipilis (Prov 2019) Amplop #NAME? 30,030.00

Lamivudine 30 Mg/ Nevirapine 50 Mg/

PEMAKAIAN OBAT, BMHP DAN REAGENSIA DANA APBD BULAN

2 Albendazole Suepensi 200 mg/5 ml (2019) Botol #NAME? 4,600.00

14 RPR Syphilis RPR Antigen Tes(prov 2019) Tes #NAME? 4,250.00

38 Kombipak Azithromicyn Sipilis (Prov 2019) Amplop #NAME? 30,030.00

Lamivudine 30 Mg/ Nevirapine 50 Mg/

BERITA ACARA PENYERAHAN BARANG

KEMAS VOLUME HARGA SATUAN TOTAL

2 Albendazole Suepensi 200 mg/5 ml (2019) Botol - 4,600.00

14 RPR Syphilis RPR Antigen Tes(prov 2019) Tes - 4,250.00

38 Kombipak Azithromicyn Sipilis (Prov 2019) Amplop - 30,030.00

Lamivudine 30 Mg/ Nevirapine 50 Mg/

BERITA ACARA PENYERAHAN BARANG

KEMAS VOLUME HARGA SATUAN TOTAL

2 Albendazole Suepensi 200 mg/5 ml (2019) Botol - 4,600.00

14 RPR Syphilis RPR Antigen Tes(prov 2019) Tes - 4,250.00

38 Kombipak Azithromicyn Sipilis (Prov 2019) Amplop - 30,030.00

Lamivudine 30 Mg/ Nevirapine 50 Mg/

56 Ampicillin Sodium 1000 mg (Prov 2019) Vial - 9,473.00

BERITA ACARA PENYERAHAN BARANG

KEMAS VOLUME HARGA SATUAN TOTAL

2 Albendazole Suepensi 200 mg/5 ml (2019) Botol - 4,600.00

14 RPR Syphilis RPR Antigen Tes(prov 2019) Tes - 4,250.00

38 Kombipak Azithromicyn Sipilis (Prov 2019) Amplop - 30,030.00

Lamivudine 30 Mg/ Nevirapine 50 Mg/

BERITA ACARA PENYERAHAN BARANG

KEMAS VOLUME HARGA SATUAN TOTAL

2 Albendazole Suepensi 200 mg/5 ml (2019) Botol - 4,600.00

14 RPR Syphilis RPR Antigen Tes(prov 2019) Tes - 4,250.00

38 Kombipak Azithromicyn Sipilis (Prov 2019) Amplop - 30,030.00

Lamivudine 30 Mg/ Nevirapine 50 Mg/

BERITA ACARA PENYERAHAN BARANG

KEMAS VOLUME HARGA SATUAN TOTAL

2 Albendazole Suepensi 200 mg/5 ml (2019) Botol - 4,600.00

14 RPR Syphilis RPR Antigen Tes(prov 2019) Tes - 4,250.00

38 Kombipak Azithromicyn Sipilis (Prov 2019) Amplop - 30,030.00

Lamivudine 30 Mg/ Nevirapine 50 Mg/

BERITA ACARA PENYERAHAN BARANG

KEMAS VOLUME HARGA SATUAN TOTAL

2 Albendazole Suepensi 200 mg/5 ml (2019) Botol - 4,600.00

14 RPR Syphilis RPR Antigen Tes(prov 2019) Tes - 4,250.00

38 Kombipak Azithromicyn Sipilis (Prov 2019) Amplop - 30,030.00

Lamivudine 30 Mg/ Nevirapine 50 Mg/

BERITA ACARA PENYERAHAN BARANG

KEMAS VOLUME HARGA SATUAN TOTAL

2 Albendazole Suepensi 200 mg/5 ml (2019) Botol - 4,600.00

14 RPR Syphilis RPR Antigen Tes(prov 2019) Tes - 4,250.00

38 Kombipak Azithromicyn Sipilis (Prov 2019) Amplop - 30,030.00

Lamivudine 30 Mg/ Nevirapine 50 Mg/

BERITA ACARA PENYERAHAN BARANG

KEMAS VOLUME HARGA SATUAN TOTAL

2 Albendazole Suepensi 200 mg/5 ml (2019) Botol - 4,600.00

14 RPR Syphilis RPR Antigen Tes(prov 2019) Tes - 4,250.00

38 Kombipak Azithromicyn Sipilis (Prov 2019) Amplop - 30,030.00

Lamivudine 30 Mg/ Nevirapine 50 Mg/

BERITA ACARA PENYERAHAN BARANG