LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

(LPLPO)

POSKESKEL : PURWOSARI : JANUARI

KECAMATAN : METRO UTARA : FEBRUARI
KAB/KOTA : METRO : 2024
PROPINSI : LAMPUNG

PERSEDIAAN TOTAL PERMINTA

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Acetyl cysteine kapsul 200 mg Tablet - - - - -
Allupurinol 100 mg Tablet - - - - -
Ambroxol Tab Tablet 77 - 77 - 77
Aminopilin 200 mg tab Tablet - - - - -
Amlodipin 5 Tablet - 300 300 40 260
Amlodipin tablet 10 mg Tablet - - - - -
Antalgin tab Tablet - - - - -
Antasida tab kunyah Tablet 50 100 150 80 70
Asam Folat 1 mg Tablet - - - - -
Asam Mefenamat kaplet 500 mg Tablet 44 100 144 44 100
Asam Traneksamat 500 mg Tablet - - - - -
Asiklovir tablet 200 mg Tablet - - - - -
Asiklovir tablet 400 mg Tablet - - - - -
Atapulgit 650mg Kaplet - - - - -
Betahistin Tablet Tablet 60 - 60 - 60
Bisakodil tab 5 mg Tablet - - - - -
Bisoprolol 5 mg Tab Tablet - - - - -

Page 1
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Calcimega Tablet - 200 200 20 180
Captopril 12,5 Tablet 290 - 290 - 290
Captopril 25 Tablet - - - - -
Cetirizine 10 mg Tablet 48 100 148 - 148
CTM Tablet 258 - 258 18 240
Deksametason tablet 0,5 mg Tablet 125 - 125 10 115
Domperidom tablet 10 mg Tablet - - - - -
Ergotamin 1 mg+Kafein 50 mg Tablet - - - - -
Fitomenadion (Vit.K1) tablet Tablet - - - - -
Fituno Tablet - - - - -
Furosemid tablet 40 mg Tablet - - - - -
Gabapentin 300 mg Tablet - - - - -
Garam Oralit Tablet - - - - -
Griseofulvin Tab Tablet - - - - -
Ibuprofen tab 200 mg Tablet 120 - 120 20 100
Kalsium Laktat (Kalk) Kapsul 500 mg Tablet - - - - -
Ketokonazole tab 200mg Tablet - - - - -
Lansoprazol Cap Tablet - - - - -
Loperamid tablet 2 mg Tablet - - - - -
Loratadin 10 mg Tab Tablet - - - - -
Meloksikam 7,5 mg Tablet - - - - -
Meloxicam 15 Tablet - - - - -
Metilergometrin Tab Tablet - - - - -
Metilprednisolon 8 Tablet - - - - -
Metilprednison 4 mg Tablet - 100 100 - 100
Page 2
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Metoklopramid Tablet 10 mg Tablet - - - - -
Natrium Diklofenak tablet 25 mg Tablet - - - - -
Natrium Diklofenak tablet 50 mg Tablet - - - - -
Nifedipin 10 mg tab Tablet - - - - -
Nistatin vaginal tablet 100.000 IU/g Tablet - - - - -
Obat Batuk Kombinasi (Lodecon Forte) Tablet 125 100 225 45 180
Ondansetron 4 mg Tab Tablet - - - - -
Parasetamol tablet 500 mg Tablet 300 - 300 120 180
Piroxicam 10 Tablet - - - - -
Piroxicam 20 Tablet - - - - -
Prednisone Kaptab 5 mg Kapsul - - - - -
Ranitidin Tab Tablet 100 - 100 - 100
Risperidon 2 mg Tab Tablet - - - - -
Salbutamol 4 mg Tablet 90 - 90 - - ED
Salbutamol tablet 2 mg Tablet - - - - -
Sianokobalamin tab 50mg (vitamin B12) Tablet - - - - -
Simvastatin Tablet 10 mg Tablet - - - - -
Simvastatin tablet 20 mg Tablet - - - - -
Solvitral Tab / Curcuma Force Tablet 48 - 48 - 48
Tablet Tambah Darah Tablet 140 - 140 - 140
Vitamin A 100.000 IU Tablet - - - - -
Vitamin A 200.000 IU Tablet - - - - -
Vitamin B 1 / Thiamine 100 mg Tablet 90 - 90 - 90
Vitamin B Kompleks tablet Tablet 120 - 120 40 80
Vitamin B6 Tab (Piridoksin) Tablet 180 - 180 - 180
Page 3
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Vitamin C 50 mg (Asam Askorbat) Kapsul 50 100 150 - 150
Zinc tablet 20 mg Tablet - - - - -
Herba Asimor Tablet 60 - 60 - 60

SYRUP - - - - -
Ambroxol Syr Botol - - - - -
Antasida suspensi Botol 5 2 7 - 7
Cetirizine HCl Syrup 5 mg/5 ml Botol 8 - 8 - 8
Domperidom suspensi 5 mg/5ml Botol - - - - -
Ibuprofen Syr 100 mg/5 ml Botol - - - - -
Obat Batuk Hitam (OBH) Botol 6 - 6 3 3
Obat Batuk Putih (OBP) Botol - - - - -
Obat Batuk Kombinasi Anak (Solaflus) Botol 4 - 4 1 3
Parasetamol Sirup 120 mg/ 5 ml Botol 9 - 9 3 6
Multivitamin Syrup (Solvita) Botol 1 3 4 1 3
Stimuno Syrup Botol - - - - -
Sukrafat Syrup Botol - - - - -
Zink Syrup Botol - - - - -
- - - - -
OBAT LUAR - - - - -
Acyclovir 5 % SK Tube 3 - 3 - 3
Anti Hemorroid Supp Tube - - - - -
Antibakteri salep Tube - - - - -
Antifungi Tube - - - - -
Betametason SK Tube - 3 3 - 3
Page 4
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Dulcolax Sup 10 mg Supp - - - - -
Dulcolax Sup 5 mg Supp - - - - -
Erladerm-N Tube 2 3 5 3 2
Erlamycetin Tetes Mata Drop Botol 4 - 4 1 3
Erlamycetin Tetes Telinga Drop Botol 3 - 3 - 3
Etanol 70% cairan 300 ml Botol - - - - -
Etanol 70% cairan 1000 ml Botol 1 - 1 - 1
Fenol Gliserol Tetes Telinga 10 % Botol - - - - -
Genoint /Gentamycin SM Tube 2 - 2 - 2
Gentamisin SK Tube 2 3 5 3 2
Gentamisin TM 0,3% Botol - - - - -
Hand Rub Botol - - - - -
Hidrokortison krim 2,5 % Tube 3 - 3 - 3
Ketokonazol krim 2% Tube 3 - 3 3 -
Kloramfenicol Tetes Telinga Botol - - - - -
Lisol 1000 ml/btl Botol - - - - -
Metronidazol ovula 500 mg Supp - - - - -
Mikonazole cream Tube 2 - 2 2 -
Mometason Furoat Krim Tube - - - - -
Povidon Iodida 300 ml Botol 1 - 1 - 1
Rivanol Botol - - - - -
Salep 2-4 Pot - - - - -
Salisil Bedak 2 % Kotak 2 - 2 - 2
Scabimite Tube - - - - -
- - - - -
Page 5
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
- - - - -
BMHP - - - - -
Masker Pcs - - - - -
Sarung Tangan Ukuran S Pcs - - - - -
Sarung Tangan Ukuran M Pcs - - - - -

UMUM BPJS Total Bidan Poskeskel

JUMLAH KUNJUNGAN RESEP POSKESKEL 30
3 33
PURWOSARI

Merry Khunchoroyati,A.Md.Keb

Page 6
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

POSKESKEL : PURWOSARI : FEBRUARI

KECAMATAN : METRO UTARA : MARET
KAB/KOTA : METRO : 2024
PROPINSI : LAMPUNG

PERSEDIAAN TOTAL PERMINTA

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Acetyl cysteine kapsul 200 mg Tablet - - - - -
Allupurinol 100 mg Tablet - - - - -
Ambroxol Tab Tablet 77 - 77 - 77
Aminopilin 200 mg tab Tablet - - - - -
Amlodipin 5 Tablet 260 - 260 - 260
Amlodipin tablet 10 mg Tablet - - - - -
Antalgin tab Tablet - - - - -
Antasida tab kunyah Tablet 70 - 70 30 40
Asam Folat 1 mg Tablet - - - - -
Asam Mefenamat kaplet 500 mg Tablet 100 - 100 - 100
Asam Traneksamat 500 mg Tablet - - - - -
Asiklovir tablet 200 mg Tablet - - - - -
Asiklovir tablet 400 mg Tablet - - - - -
Atapulgit 650mg Kaplet - - - - -
Betahistin Tablet Tablet 60 - 60 - 60
Bisakodil tab 5 mg Tablet - - - - -
Bisoprolol 5 mg Tab Tablet - - - - -
Calcimega Tablet 180 - 180 30 150
Captopril 12,5 Tablet 290 - 290 - 290
Captopril 25 Tablet - - - - -
Cetirizine 10 mg Tablet 148 - 148 30 118
CTM Tablet 240 - 240 - 240
Deksametason tablet 0,5 mg Tablet 115 - 115 30 85
Domperidom tablet 10 mg Tablet - - - - -
Ergotamin 1 mg+Kafein 50 mg Tablet - - - - -
Fitomenadion (Vit.K1) tablet Tablet - - - - -
Fituno Tablet - - - - -
Furosemid tablet 40 mg Tablet - - - - -
Gabapentin 300 mg Tablet - - - - -
Garam Oralit Tablet - - - - -
Page 7
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Griseofulvin Tab Tablet - - - - -
Ibuprofen tab 200 mg Tablet 100 - 100 10 90
Kalsium Laktat (Kalk) Kapsul 500 mg Tablet - - - - -
Ketokonazole tab 200mg Tablet - - - - -
Lansoprazol Cap Tablet - - - - -
Loperamid tablet 2 mg Tablet - - - - -
Loratadin 10 mg Tab Tablet - - - - -
Meloksikam 7,5 mg Tablet - - - - -
Meloxicam 15 Tablet - - - - -
Metilergometrin Tab Tablet - - - -
Metilprednisolon 8 Tablet 100 - 100 - -
Metilprednison 4 mg Tablet - - - - -
Metoklopramid Tablet 10 mg Tablet - - - - -
Natrium Diklofenak tablet 25 mg Tablet - - - - -
Natrium Diklofenak tablet 50 mg Tablet - - - - -
Nifedipin 10 mg tab Tablet - - - - -
Nistatin vaginal tablet 100.000 IU/g Tablet - - - - -
Obat Batuk Kombinasi (Lodecon Forte) Tablet 180 - 180 10 170
Ondansetron 4 mg Tab Tablet - - - - -
Parasetamol tablet 500 mg Tablet 180 - 180 60 120
Piroxicam 10 Tablet - - - - -
Piroxicam 20 Tablet - - - - -
Prednisone Kaptab 5 mg Kapsul - - - - -
Ranitidin Tab Tablet 100 - 100 - 100
Risperidon 2 mg Tab Tablet - - - - -
Salbutamol 4 mg Tablet - - - - -
Salbutamol tablet 2 mg Tablet - - - - -
Sianokobalamin tab 50mg (vitamin B12) Tablet - - - - -
Simvastatin Tablet 10 mg Tablet - - - - -
Simvastatin tablet 20 mg Tablet - - - - -
Solvitral Tab/ Curcuma Tablet Tablet 48 - 48 - 48
Tablet Tambah Darah Tablet 140 - 140 - 140
Vitamin A 100.000 IU Tablet - - - - -
Vitamin A 200.000 IU Tablet - - - - -
Vitamin B 1 / Thiamine 100 mg Tablet 90 - 90 - 90
Vitamin B Kompleks tablet Tablet 180 - 180 - 180
Vitamin B6 Tab (Piridoksin) Tablet 180 - 180 - 180
Vitamin C 50 mg (Asam Askorbat) Kapsul 150 - 150 - - ED
Zinc tablet 20 mg Tablet - - - - -
Page 8
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Herba Asimor Tablet 60 - 60 - 60

SYRUP - - - - -
Ambroxol Syr Botol - - - - -
Antasida suspensi Botol 7 - 7 3 4
Cetirizine HCl Syrup 5 mg/5 ml Botol 8 - 8 1 7
Domperidom suspensi 5 mg/5ml Botol - - - - -
Ibuprofen Syr 100 mg/5 ml Botol - - - - -
Obat Batuk Hitam (OBH) Botol 3 - 3 1 2
Obat Batuk Putih (OBP) Botol - - - - -
Obat Batuk Kombinasi Anak (Solaflus) Botol 3 - 3 - 3
Parasetamol Sirup 120 mg/ 5 ml Botol 6 - 6 4 2
Multivitamin Syrup (Tyalisin) Botol 3 - 3 - 3
Stimuno Syrup Botol - - - - -
Sukrafat Syrup Botol - - - - -
Zink Syrup Botol - - - - -
- - - - -
OBAT LUAR - - - - -
Acyclovir 5 % SK Tube 3 - 3 3 -
Anti Hemorroid Supp Tube - - - - -
Antibakteri salep Tube - - - - -
Antifungi Tube - - - - -
Betametason SK Tube 3 - 3 - 3
Dulcolax Sup 10 mg Supp - - - - -
Dulcolax Sup 5 mg Supp - - - - -
Erladerm-N Tube 2 - 2 1 1
Erlamycetin Tetes Mata Drop Botol 3 - 3 2 1
Erlamycetin Tetes Telinga Drop Botol 3 - 3 1 2
Etanol 70% cairan 300 ml Botol - - - - -
Etanol 70% cairan 1000 ml Botol 1 - 1 - 1
Fenol Gliserol Tetes Telinga 10 % Botol - - - - -
Genoint /Gentamycin SM Tube 2 - 2 1 1
Gentamisin SK Tube 2 - 2 2 -
Gentamisin TM 0,3% Botol - - - - -
Hand Rub Botol - - - - -
Hidrokortison krim 2,5 % Tube 3 - 3 - 3
Ketokonazol krim 2% Tube - - - - -
Kloramfenicol Tetes Telinga Botol - - - - -
Lisol 1000 ml/btl Botol - - - - -
Page 9
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Metronidazol ovula 500 mg Supp - - - - -
Mikonazole cream Tube - - - - -
Mometason Furoat Krim Tube - - - - -
Povidon Iodida 300 ml Botol 1 - 1 - 1
Rivanol Botol - - - - -
Salep 2-4 Pot - - - - -
Salisil Bedak 2 % Kotak 2 - 2 - 2
Scabimite Tube - - - - -
- - - - -
- - - - -
BMHP - - - - -
Masker Pcs - - - - -
Sarung Tangan Ukuran S Pcs - - - - -
Sarung Tangan Ukuran M Pcs - - - - -

UMUM BPJS Total Bidan Poskeskel Purwosari

JUMLAH KUNJUNGAN RESEP POSKESKEL 32
3 35
PURWOSARI

Merry Khunchoroyati,A.Md.Keb
NIP. 19950923 202012 2 016

Page 10
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

POSKESKEL : PURWOSARI : MARET

KECAMATAN : METRO UTARA : APRIL
KAB/KOTA : METRO : 2024
PROPINSI : LAMPUNG

PERSEDIAAN TOTAL PERMINTA

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Acetyl cysteine kapsul 200 mg Tablet - - - - -
Allupurinol 100 mg Tablet - - - - -
Ambroxol Tab Tablet 77 - 77 - 77
Aminopilin 200 mg tab Tablet - - - - -
Amlodipin 5 Tablet 260 - 260 20 240
Amlodipin tablet 10 mg Tablet - - - - -
Antalgin tab Tablet - - - - -
Antasida tab kunyah Tablet 40 100 140 40 100
Asam Folat 1 mg Tablet - - - - -
Asam Mefenamat kaplet 500 mg Tablet 100 - 100 - 100
Asam Traneksamat 500 mg Tablet - - - - -
Asiklovir tablet 200 mg Tablet - - - - -
Asiklovir tablet 400 mg Tablet - - - - -
Atapulgit 650mg Kaplet - - - - -
Betahistin Tablet Tablet 60 - 60 - 60
Bisakodil tab 5 mg Tablet - - - - -
Bisoprolol 5 mg Tab Tablet - - - - -
Calcimega Tablet 150 - 150 - 150
Captopril 12,5 Tablet 290 - 290 - 290
Captopril 25 Tablet - - - - -
Cetirizine 10 mg Tablet 118 - 118 - 118
CTM Tablet 240 - 240 12 228
Deksametason tablet 0,5 mg Tablet 85 - 85 - 85
Domperidom tablet 10 mg Tablet - - - - -
Ergotamin 1 mg+Kafein 50 mg Tablet - - - - -
Fitomenadion (Vit.K1) tablet Tablet - - - - -
Fituno Tablet - - - - -
Furosemid tablet 40 mg Tablet - - - - -
Gabapentin 300 mg Tablet - - - - -
Garam Oralit Tablet - - - - -
Griseofulvin Tab Tablet - - - - -
Ibuprofen tab 200 mg Tablet 90 - 90 - 90
Kalsium Laktat (Kalk) Kapsul 500 mg Tablet - 100 100 - 100
Ketokonazole tab 200mg Tablet - - - - -
Lansoprazol Cap Tablet - - - - -

Page 11
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Loperamid tablet 2 mg Tablet - - - - -
Loratadin 10 mg Tab Tablet - - - - -
Meloksikam 7,5 mg Tablet - - - - -
Meloxicam 15 Tablet - - - - -
Metilergometrin Tab Tablet - - - - -
Metilprednisolon 8 Tablet 100 - 100 - 100
Metilprednison 4 mg Tablet - - - - -
Metoklopramid Tablet 10 mg Tablet - - - - -
Natrium Diklofenak tablet 25 mg Tablet - - - - -
Natrium Diklofenak tablet 50 mg Tablet - - - - -
Nifedipin 10 mg tab Tablet - - - - -
Nistatin vaginal tablet 100.000 IU/g Tablet - - - - -
Obat Batuk Kombinasi (Lodecon Forte) Tablet 170 - 170 - 170
Ondansetron 4 mg Tab Tablet - - - - -
Parasetamol tablet 500 mg Tablet 120 - 120 20 100
Piroxicam 10 Tablet - - - - -
Piroxicam 20 Tablet - - - - -
Prednisone Kaptab 5 mg Kapsul - - - - -
Ranitidin Tab Tablet 100 - 100 - 100
Risperidon 2 mg Tab Tablet - - - - -
Salbutamol 4 mg Tablet - - - - -
Salbutamol tablet 2 mg Tablet - - - - -
Sianokobalamin tab 50mg (vitamin B12) Tablet - - - - -
Simvastatin Tablet 10 mg Tablet - - - - -
Simvastatin tablet 20 mg Tablet - - - - -
Solvitral Tab / Benovit Tablet 48 100 148 - 148
Tablet Tambah Darah Tablet 140 - 140 - 140
Vitamin A 100.000 IU Tablet - - - - -
Vitamin A 200.000 IU Tablet - - - - -
Vitamin B 1 / Thiamine 100 mg Tablet 90 - 90 - 90
Vitamin B Kompleks tablet Tablet 180 - 180 - 80 ED
Vitamin B6 Tab (Piridoksin) Tablet 180 - 180 - 180
Vitamin C 50 mg (Asam Askorbat) Kapsul - 100 100 - 100
Zinc tablet 20 mg Tablet 60 - 60 - 60
Herba Asimor Tablet 60 - 60 - - ED

SYRUP - - - - -
Ambroxol Syr Botol - - - - -
Antasida suspensi Botol 4 - 4 1 3
Cetirizine HCl Syrup 5 mg/5 ml Botol 7 - 7 - 7
Domperidom suspensi 5 mg/5ml Botol - - - - -
Ibuprofen Syr 100 mg/5 ml Botol - - - - -
Obat Batuk Hitam (OBH) Botol 2 - 2 - 2

Page 12
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Obat Batuk Putih (OBP) Botol - - - - -
Obat Batuk Kombinasi Anak (Solaflus) Botol 3 - 3 - 3
Parasetamol Sirup 120 mg/ 5 ml Botol 2 6 8 - 8
Multivitamin Syrup (Tyalisin) Botol 3 - 3 - 3
Stimuno Syrup Botol - - - - -
Sukrafat Syrup Botol - - - - -
Zink Syrup Botol - - - - -
- - - - -
OBAT LUAR - - - - -
Acyclovir 5 % SK Tube - - - - -
Anti Hemorroid Supp Tube - - - - -
Antibakteri salep Tube - - - - -
Antifungi Tube - - - - -
Betametason SK Tube 3 - 3 - 3
Dulcolax Sup 10 mg Supp - - - - -
Dulcolax Sup 5 mg Supp - - - - -
Erladerm-N Tube 1 3 4 - 4
Erlamycetin Tetes Mata Drop Botol 1 - 1 - 1
Erlamycetin Tetes Telinga Drop Botol 2 - 2 - 2
Etanol 70% cairan 300 ml Botol - - - - -
Etanol 70% cairan 1000 ml Botol 1 - 1 - 1
Fenol Gliserol Tetes Telinga 10 % Botol - - - - -
Genoint /Gentamycin SM Tube 1 - 1 - 1
Gentamisin SK Tube - - - - -
Gentamisin TM 0,3% Botol - 3 3 - 3
Hand Rub Botol - - - - -
Hidrokortison krim 2,5 % Tube 3 - 3 - 3
Ketokonazol krim 2% Tube - - - - -
Kloramfenicol Tetes Telinga Botol - - - - -
Lisol 1000 ml/btl Botol - - - - -
Metronidazol ovula 500 mg Supp - - - - -
Mikonazole cream Tube - - - - -
Mometason Furoat Krim Tube - - - - -
Povidon Iodida 300 ml Botol 1 - 1 - 1
Rivanol Botol - - - - -
Salep 2-4 Pot - - - - -
Salisil Bedak 2 % Kotak 1 - 1 - 1
Scabimite Tube - - - - -
- - - - -
- - - - -
BMHP - - - - -
Masker Pcs - - - - -
Sarung Tangan Ukuran S Pcs - - - - -

Page 13
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Sarung Tangan Ukuran M Pcs - - - - -

UMUM BPJS Total Bidan Poskeskel Purwosari

JUMLAH KUNJUNGAN RESEP POSKESKEL 30
5 35
PURWOSARI

Merry Khunchoroyati,A.Md.Keb
NIP. 19950923 202012 2 016

Page 14
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

PUSTU/POSKESKEL : PURWOSARI/PURWOASRI : APRIL

KECAMATAN : METRO UTARA : MEI
KAB/KOTA : METRO : 2024
PROPINSI : LAMPUNG

PERSEDIAAN TOTAL PERMINTA

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Acetyl cysteine kapsul 200 mg Tablet - - - - -
Allupurinol 100 mg Tablet - - - - -
Ambroxol Tab Tablet 77 - 77 - 77
Aminopilin 200 mg tab Tablet - - - - -
Amlodipin 5 Tablet 240 - 240 20 220
Amlodipin tablet 10 mg Tablet - - - - -
Antalgin tab Tablet - - - - -
Antasida tab kunyah Tablet 100 - 100 20 80
Asam Folat 1 mg Tablet - - - - -
Asam Mefenamat kaplet 500 mg Tablet 100 - 100 20 80
Asam Traneksamat 500 mg Tablet - - - - -
Asiklovir tablet 200 mg Tablet - - - - -
Asiklovir tablet 400 mg Tablet - - - - -
Atapulgit 650mg Kaplet - - - - -
Betahistin Tablet Tablet 60 - 60 - 60
Bisakodil tab 5 mg Tablet - - - - -
Bisoprolol 5 mg Tab Tablet - - - - -
Calcimega Tablet 150 - 150 10 150
Captopril 12,5 Tablet 290 - 290 - - ED
Captopril 25 Tablet - - - - -
Cetirizine 10 mg Tablet 118 - 118 - 118
CTM Tablet 228 - 228 12 216
Deksametason tablet 0,5 mg Tablet 85 - 85 - 85
Domperidom tablet 10 mg Tablet - - - - -
Ergotamin 1 mg+Kafein 50 mg Tablet - - - - -
Fitomenadion (Vit.K1) tablet Tablet - - - - -
Fituno Tablet - - - - -
Furosemid tablet 40 mg Tablet - - - - -
Gabapentin 300 mg Tablet - - - - -
Garam Oralit Tablet - - - - -
Griseofulvin Tab Tablet - - - - -
Ibuprofen tab 200 mg Tablet 90 - 90 - - ED
Kalsium Laktat (Kalk) Kapsul 500 mg Tablet 100 - 100 - - ED
Ketokonazole tab 200mg Tablet - - - - -
Lansoprazol Cap Tablet - - - - -
Loperamid tablet 2 mg Tablet - - - - -
Loratadin 10 mg Tab Tablet - - - - -
Meloksikam 7,5 mg Tablet - - - - -
Page 15
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

Meloxicam 15 Tablet - - - - -
Metilergometrin Tab Tablet - - - - -
Metilprednisolon 8 Tablet 100 - 100 - - ED
Metilprednison 4 mg Tablet - - - - -
Metoklopramid Tablet 10 mg Tablet - - - - -
Natrium Diklofenak tablet 25 mg Tablet - - - - -
Natrium Diklofenak tablet 50 mg Tablet - - - - -
Nifedipin 10 mg tab Tablet - - - - -
Nistatin vaginal tablet 100.000 IU/g Tablet - - - - -
Obat Batuk Kombinasi (Lodecon Forte) Tablet 170 - 170 20 150
Ondansetron 4 mg Tab Tablet - - - - -
Parasetamol tablet 500 mg Tablet 100 - 100 30 70
Piroxicam 10 Tablet - - - - -
Piroxicam 20 Tablet - - - - -
Prednisone Kaptab 5 mg Kapsul - - - - -
Ranitidin Tab Tablet 100 - 100 - - ED
Risperidon 2 mg Tab Tablet - - - - -
Salbutamol 4 mg Tablet - - - - -
Salbutamol tablet 2 mg Tablet - - - - -
Sianokobalamin tab 50mg (vitamin B12) Tablet - - - - -
Simvastatin Tablet 10 mg Tablet - - - - -
Simvastatin tablet 20 mg Tablet - - - - -
Solvitral Tab Tablet 148 - 148 58 90
Tablet Tambah Darah Tablet 140 - 140 20 120
Vitamin A 100.000 IU Tablet - - - - -
Vitamin A 200.000 IU Tablet - - - - -
Vitamin B 1 / Thiamine 100 mg Tablet 90 - 90 - 90
Vitamin B Kompleks tablet Tablet 80 - 80 40 40
Vitamin B6 Tab (Piridoksin) Tablet 180 - 180 - 180
Vitamin C 50 mg (Asam Askorbat) Kapsul 100 - 100 16 84
Zinc tablet 20 mg Tablet 60 - 60 - - ED
- - - - -
SYRUP - - - - -
Ambroxol Syr Botol - - - - -
Antasida suspensi Botol 3 - 3 1 2
Cetirizine HCl Syrup 5 mg/5 ml Botol 7 - 7 - 7
Domperidom suspensi 5 mg/5ml Botol - - - - -
Ibuprofen Syr 100 mg/5 ml Botol - - - - -
Obat Batuk Hitam (OBH) Botol 2 - 2 - 2
Obat Batuk Putih (OBP) Botol - - - - -
Obat Batuk Kombinasi Anak (Solaflus) Botol 3 - 3 - - ED
Parasetamol Sirup 120 mg/ 5 ml Botol 8 - 8 1 7
Multivitamin Syrup (Tyalisin) Botol 3 - 3 - 3
Stimuno Syrup Botol - - - - -
Sukrafat Syrup Botol - - - - -
Zink Syrup Botol - - - - -

Page 16
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

- - - - -
OBAT LUAR - - - - -
Acyclovir 5 % SK Tube - - - - -
Anti Hemorroid Supp Tube - - - - -
Antibakteri salep Tube - - - - -
Antifungi Tube - - - - -
Betametason SK Tube 3 - 3 - 3
Dulcolax Sup 10 mg Supp - - - - -
Dulcolax Sup 5 mg Supp - - - - -
Erladerm-N Tube 4 - 4 - 4
Erlamycetin Tetes Mata Drop Botol 1 - 1 1 -
Erlamycetin Tetes Telinga Drop Botol 2 - 2 - - ED
Etanol 70% cairan 300 ml Botol - - - - -
Etanol 70% cairan 1000 ml Botol 1 - 1 - 1
Fenol Gliserol Tetes Telinga 10 % Botol - - - - -
Genoint /Gentamycin SM Tube 1 - 1 - 1
Gentamisin SK Tube - - - - -
Gentamisin TM 0,3% Botol 3 - 3 - 3
Hand Rub Botol - - - - -

Page 17
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

Hidrokortison krim 2,5 % Tube 3 - 3 2 1

Ketokonazol krim 2% Tube - - - - -
Kloramfenicol Tetes Telinga Botol - - - - -
Lisol 1000 ml/btl Botol - - - - -
Metronidazol ovula 500 mg Supp - - - - -
Mikonazole cream Tube - - - - -
Mometason Furoat Krim Tube - - - - -
Povidon Iodida 300 ml Botol 1 - 1 - 1
Rivanol Botol - - - - -
Salep 2-4 Pot - - - - -
Salisil Bedak 2 % Kotak 1 - 1 - 1
Scabimite Tube - - - - -
- - - - -
- - - - -
BMHP - - - - -
Masker Pcs - - - - -
Sarung Tangan Ukuran S Pcs - - - - -
Sarung Tangan Ukuran M Pcs - - - - -

UMUM BPJS Total Bidan Poskeskel Purwosari

JUMLAH KUNJUNGAN RESEP POSKESKEL 20
5 25
PURWOSARI

Merry Khunchoroyati,A.Md.Keb
NIP. 19950923 202012 2 016

Page 18
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

POSKESKEL : PURWOSARI : MEI

KECAMATAN : METRO UTARA : JUNI
KAB/KOTA : METRO : 2024
PROPINSI : LAMPUNG

PERSEDIAAN TOTAL PERMINTA

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Acetyl cysteine kapsul 200 mg Tablet - - - - -
Allupurinol 100 mg Tablet - - - - -
Ambroxol Tab Tablet 87 77 - 77 - 77
Aminopilin 200 mg tab Tablet - - - - -
Amlodipin 5 Tablet 500 220 - 220 - - ED
Amlodipin tablet 10 mg Tablet - - - - -
Antalgin tab Tablet - - - - -
Antasida tab kunyah Tablet 20 80 - 80 40 40
Asam Folat 1 mg Tablet - - - - -
Asam Mefenamat kaplet 500 mg Tablet 0 80 - 80 - - ED
Asam Traneksamat 500 mg Tablet - - - - -
Asiklovir tablet 200 mg Tablet - - - - -
Asiklovir tablet 400 mg Tablet - - - - -
Atapulgit 650mg Kaplet - - - - -
Betahistin Tablet Tablet 60 60 - 60 - 60
Bisakodil tab 5 mg Tablet - - - - -
Bisoprolol 5 mg Tab Tablet - - - - -
Calcimega Tablet 0 140 - 140 10 130
Captopril 12,5 Tablet - - - - -
Captopril 25 Tablet - - - - -
Cetirizine 10 mg Tablet 118 118 - 118 - 118
CTM Tablet 228 216 - 216 12 204
Deksametason tablet 0,5 mg Tablet 95 85 - 85 - ED
Domperidom tablet 10 mg Tablet - - - - -
Ergotamin 1 mg+Kafein 50 mg Tablet - - - - -
Fitomenadion (Vit.K1) tablet Tablet - - - - -
Fituno Tablet - - - - -
Furosemid tablet 40 mg Tablet - - - - -
Gabapentin 300 mg Tablet - - - - -
Garam Oralit Tablet - - - - -
Griseofulvin Tab Tablet - - - - -
Ibuprofen tab 200 mg Tablet 0 - - - - -
Kalsium Laktat (Kalk) Kapsul 500 mg Tablet 100 - - - - -
Ketokonazole tab 200mg Tablet - - - - -
Lansoprazol Cap Tablet - - - - -
Loperamid tablet 2 mg Tablet - - - - -
Loratadin 10 mg Tab Tablet - - - - -
Meloksikam 7,5 mg Tablet - - - - -
Meloxicam 15 Tablet - - - - -
Metilergometrin Tab Tablet - - - - -
Page 19
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

Metilprednisolon 8 Tablet - - - - -
Metilprednison 4 mg Tablet - - - - -
Metoklopramid Tablet 10 mg Tablet - - - - -
Natrium Diklofenak tablet 25 mg Tablet - - - - -
Natrium Diklofenak tablet 50 mg Tablet - - - - -
Nifedipin 10 mg tab Tablet - - - - -
Nistatin vaginal tablet 100.000 IU/g Tablet - - - - -
Obat Batuk Kombinasi (Lodecon Forte) Tablet 150 150 - 150 20 130
Ondansetron 4 mg Tab Tablet - - - - -
Parasetamol tablet 500 mg Tablet 60 70 - 70 30 40
Piroxicam 10 Tablet - - - - -
Piroxicam 20 Tablet - - - - -
Prednisone Kaptab 5 mg Kapsul - - - - -
Ranitidin Tab Tablet 0 - - - - -
Risperidon 2 mg Tab Tablet - - - - -
Salbutamol 4 mg Tablet - - - - -
Salbutamol tablet 2 mg Tablet 0 - - - - -
Sianokobalamin tab 50mg (vitamin B12) Tablet - - - - -
Simvastatin Tablet 10 mg Tablet - - - - -
Simvastatin tablet 20 mg Tablet - - - - -
Solvitral Tab ( Benovin C) Tablet 90 90 - 90 10 80
Tablet Tambah Darah Tablet 120 120 - 120 30 90
Vitamin A 100.000 IU Tablet - - - - -
Vitamin A 200.000 IU Tablet - - - - -
Vitamin B 1 / Thiamine 100 mg Tablet 100 90 - 90 - 90
Vitamin B Kompleks tablet Tablet 0 40 - 40 20 20
Vitamin B6 Tab (Piridoksin) Tablet 190 180 - 180 - 180
Vitamin C 50 mg (Asam Askorbat) Kapsul 84 84 - 84 10 74
Zinc tablet 20 mg Tablet 0 - - - - -
Herba Asimor Tablet - - - - -

SYRUP - - - - -
Ambroxol Syr Botol - - - - -
Antasida suspensi Botol 4 3 - 3 1 2
Cetirizine HCl Syrup 5 mg/5 ml Botol 7 7 - 7 - 7
Domperidom suspensi 5 mg/5ml Botol - - - - -
Ibuprofen Syr 100 mg/5 ml Botol - - - - -
Obat Batuk Hitam (OBH) Botol 2 2 - 2 1 1
Obat Batuk Putih (OBP) Botol - - - - -
Obat Batuk Kombinasi Anak (Solaflus) Botol 0 - - - - -
Parasetamol Sirup 120 mg/ 5 ml Botol 7 - 7 2 5
Multivitamin Syrup (Tyalisin/ solvita) Botol 2 3 - 3 1 2
Stimuno Syrup Botol - - - - -
Sukrafat Syrup Botol - - - - -
Zink Syrup Botol - - - - -
- - - - -
OBAT LUAR - - - - -
Acyclovir 5 % SK Tube - - - - -

Page 20
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

Anti Hemorroid Supp Tube - - - - -

Antibakteri salep Tube - - - - -
Antifungi Tube - - - - -
Betametason SK Tube 3 3 - 3 - 3
Dulcolax Sup 10 mg Supp - - - - -
Dulcolax Sup 5 mg Supp - - - - -
Erladerm-N Tube 4 4 - 4 - 4
Erlamycetin Tetes Mata Drop Botol - - - - -
Erlamycetin Tetes Telinga Drop Botol 2 - - - - -
Etanol 70% cairan 300 ml Botol - - - - -
Etanol 70% cairan 1000 ml Botol 1 - 1 - 1
Fenol Gliserol Tetes Telinga 10 % Botol - - - - -
Genoint /Gentamycin SM Tube - - - - -
Gentamisin SK Tube - - - - -
Gentamisin TM 0,3% Botol 4 3 - 3 - 3
Hand Rub Botol - - - - -
Hidrokortison krim 2,5 % Tube 1 1 - 1 - - ED
Ketokonazol krim 2% Tube - - - - -
Kloramfenicol Tetes Telinga Botol - - - - -
Lisol 1000 ml/btl Botol - - - - -
Metronidazol ovula 500 mg Supp - - - - -
Mikonazole cream Tube - - - - -
Mometason Furoat Krim Tube - - - - -
Povidon Iodida 300 ml Botol 1 - 1 - 1
Rivanol Botol - - - - -
Salep 2-4 Pot - - - - -
Salisil Bedak 2 % Kotak 1 1 - 1 - 1
Scabimite Tube - - - - -
- - - - -
- - - - -
BMHP - - - - -
Masker Pcs - - - - -
Sarung Tangan Ukuran S Pcs - - - - -
Sarung Tangan Ukuran M Pcs - - - - -

UMUM BPJS Total Bidan Poskeskel

JUMLAH KUNJUNGAN RESEP POSKESKEL 25
4 29
PURWOSARI

Merry Khunchoroyati,A.Md.Keb
NIP. 19950923 202012 2 016

Page 21
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

POSKESKEL : PURWOSARI : JUNI

KECAMATAN : METRO UTARA : JULI
KAB/KOTA : METRO : 2024
PROPINSI : LAMPUNG

PERSEDIAAN TOTAL PERMINTA

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Acetyl cysteine kapsul 200 mg Tablet - - - - -
Allupurinol 100 mg Tablet - - - - -
Ambroxol Tab Tablet 77 - 77 - 77
Aminopilin 200 mg tab Tablet - - - - -
Amlodipin 5 Tablet - - - - - 100
Amlodipin tablet 10 mg Tablet - - - - -
Antalgin tab Tablet - - - - -
Antasida tab kunyah Tablet 40 - 40 40 - 200
Asam Folat 1 mg Tablet - - - - -
Asam Mefenamat kaplet 500 mg Tablet - - - - -
Asam Traneksamat 500 mg Tablet - - - - -
Asiklovir tablet 200 mg Tablet - - - - -
Asiklovir tablet 400 mg Tablet - - - - -
Atapulgit 650mg Kaplet - - - - -
Betahistin Tablet Tablet 60 - 60 - - 100 ED
Bisakodil tab 5 mg Tablet - - - - -
Bisoprolol 5 mg Tab Tablet - - - - -
Calcimega Tablet 130 - 130 10 120
Captopril 12,5 Tablet - - - - -
Captopril 25 Tablet - - - - -
Cetirizine 10 mg Tablet 118 - 118 - 118
CTM Tablet 204 - 204 - 204
Deksametason tablet 0,5 mg Tablet - - - - -
Domperidom tablet 10 mg Tablet - - - - -
Ergotamin 1 mg+Kafein 50 mg Tablet - - - - -
Fitomenadion (Vit.K1) tablet Tablet - - - - -
Fituno Tablet - - - - -
Furosemid tablet 40 mg Tablet - - - - -
Gabapentin 300 mg Tablet - - - - -
Garam Oralit Tablet - - - - -
Griseofulvin Tab Tablet - - - - -
Ibuprofen tab 200 mg Tablet - - - - - 100
Kalsium Laktat (Kalk) Kapsul 500 mg Tablet - - - - - 100
Ketokonazole tab 200mg Tablet - - - - -
Lansoprazol Cap Tablet - - - - -
Loperamid tablet 2 mg Tablet - - - - -
Loratadin 10 mg Tab Tablet - - - - -
Meloksikam 7,5 mg Tablet - - - - -

Page 22
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

Meloxicam 15 Tablet - - - - -
Metilergometrin Tab Tablet - - - - -
Metilprednisolon 8 Tablet - - - - -
Metilprednison 4 mg Tablet - - - - - 100
Metoklopramid Tablet 10 mg Tablet - - - - -
Natrium Diklofenak tablet 25 mg Tablet - - - - -
Natrium Diklofenak tablet 50 mg Tablet - - - - -
Nifedipin 10 mg tab Tablet - - - - -
Nistatin vaginal tablet 100.000 IU/g Tablet - - - - -
Obat Batuk Kombinasi (Lodecon Forte) Tablet 130 - 130 30 100
Ondansetron 4 mg Tab Tablet - - - - -
Parasetamol tablet 500 mg Tablet 40 - 40 30 10 200
Piroxicam 10 Tablet - - - - -
Piroxicam 20 Tablet - - - - -
Prednisone Kaptab 5 mg Kapsul - - - - -
Ranitidin Tab Tablet - - - - - 100
Risperidon 2 mg Tab Tablet - - - - -
Salbutamol 4 mg Tablet - - - - -
Salbutamol tablet 2 mg Tablet - - - - - 100
Sianokobalamin tab 50mg (vitamin B12) Tablet - - - - -
Simvastatin Tablet 10 mg Tablet - - - - -
Simvastatin tablet 20 mg Tablet - - - - -
Solvitral Tab (Benovit C) Tablet 80 - 80 - 80
Tablet Tambah Darah Tablet 90 - 90 - 90
Vitamin A 100.000 IU Tablet - - - - -
Vitamin A 200.000 IU Tablet - - - - -
Vitamin B 1 / Thiamine 100 mg Tablet 90 - 90 - 90
Vitamin B Kompleks tablet Tablet ### 20 - 20 20 - 100
Vitamin B6 Tab (Piridoksin) Tablet 180 - 180 - 180
Vitamin C 50 mg (Asam Askorbat) Kapsul 74 - 74 10 64 100
Zinc tablet 20 mg Tablet - - - - -
- - - - -
SYRUP - - - - -
Ambroxol Syr Botol - - - - - 3
Antasida suspensi Botol 1 - 1 - 1 3
Cetirizine HCl Syrup 5 mg/5 ml Botol 7 - 7 - - 3 ED
Domperidom suspensi 5 mg/5ml Botol - - - - -
Ibuprofen Syr 100 mg/5 ml Botol - - - - -
Obat Batuk Hitam (OBH) Botol 1 - 1 1 - 3
Obat Batuk Putih (OBP) Botol - - - - -
Obat Batuk Kombinasi Anak (Solaflus) Botol - - - - - 3
Parasetamol Sirup 120 mg/ 5 ml Botol 5 - 5 2 3
Multivitamin Syrup (Tyalisin) Botol 2 - 2 - 2
Stimuno Syrup Botol - - - - -
Sukrafat Syrup Botol - - - - -

Page 23
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

Zink Syrup Botol - - - - -

- - - - -
OBAT LUAR - - - - -
Acyclovir 5 % SK Tube - - - - - 3
Anti Hemorroid Supp Tube - - - - -
Antibakteri salep Tube - - - - -
Antifungi Tube - - - - -
Betametason SK Tube 3 - 3 - 3
Dulcolax Sup 10 mg Supp - - - - -
Dulcolax Sup 5 mg Supp - - - - -
Erladerm-N Tube 4 - 4 - 4
Erlamycetin Tetes Mata Drop Botol - - - - -
Erlamycetin Tetes Telinga Drop Botol - - - - - 3
Etanol 70% cairan 300 ml Botol - - - - -
Etanol 70% cairan 1000 ml Botol 1 - 1 - 1
Fenol Gliserol Tetes Telinga 10 % Botol - - - - -
Genoint /Gentamycin SM Tube - - - - - 3
Gentamisin SK Tube - - - - - 3
Gentamisin TM 0,3% Botol 4 - 4 - 4
Hand Rub Botol - - - - - 1
Hidrokortison krim 2,5 % Tube - - - - - 3
Ketokonazol krim 2% Tube - - - - - 3
Kloramfenicol Tetes Telinga Botol - - - - -
Lisol 1000 ml/btl Botol - - - - -
Metronidazol ovula 500 mg Supp - - - - -
Mikonazole cream Tube - - - - -
Mometason Furoat Krim Tube - - - - -
Povidon Iodida 300 ml Botol 1 - 1 - 1
Rivanol Botol - - - - -
Salep 2-4 Pot - - - - -
Salisil Bedak 2 % Kotak 1 - 1 - 1 3
Scabimite Tube - - - - -
- - - - -
- - - - -
BMHP - - - - -
Masker Pcs - - - - -
Sarung Tangan Ukuran S Pcs - - - - -
Sarung Tangan Ukuran M Pcs - - - - -
Alcohol swab Pcs 100

UMUM BPJS Total Bidan Poskeskel

JUMLAH KUNJUNGAN RESEP POSKESKEL 20
2 22
PURWOSARI

Merry Khunchoroyati,A.Md.Keb
NIP. 19950923 202012 2 016

Page 24
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

POSKESKEL : PURWOSARI : JULI

KECAMATAN : METRO UTARA : AGUSTUS
KAB/KOTA : METRO : 2023
PROPINSI : LAMPUNG

PERSEDIAAN TOTAL
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN PERMINTAAN KET
AWAL PERSEDIAAN

1 2 3 4 9 10 12 20 21 22

I TABLET
Acetyl cysteine kapsul 200 mg Tablet - - - - -
Allupurinol 100 mg Tablet - - - - -
Ambroxol Tab Tablet 97 - 97 - 97
Aminopilin 200 mg tab Tablet - - - - -
Amlodipin 5 Tablet 148 - 148 60 88
Amlodipin tablet 10 mg Tablet - - - - -
Antalgin tab Tablet - - - - -
Antasida tab kunyah Tablet 170 - 170 60 110
Asam Folat 1 mg Tablet - - - - -
Asam Mefenamat kaplet 500 mg Tablet 44 - 44 - 44
Asam Traneksamat 500 mg Tablet - - - - -
Asiklovir tablet 200 mg Tablet - - - - -
Asiklovir tablet 400 mg Tablet - - - - -
Atapulgit 650mg Kaplet - - - - -
Betahistin Tablet Tablet 100 - 100 - 100
Bisakodil tab 5 mg Tablet - - - - -
Bisoprolol 5 mg Tab Tablet - - - - -
Calcimega Tablet 100 - 100 5 95
Captopril 12,5 Tablet - - - - -
Captopril 25 Tablet - - - - -
Cetirizine 10 mg Tablet 118 - 118 30 88
CTM Tablet 258 - 258 - 258
Deksametason tablet 0,5 mg Tablet 125 - 125 - 125

Page 25
 PERSEDIAAN TOTAL
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN PERMINTAAN KET
AWAL PERSEDIAAN

1 2 3 4 9 10 12 20 21 22

I TABLET
Domperidom tablet 10 mg Tablet - - - - -
Ergotamin 1 mg+Kafein 50 mg Tablet - - - - -
Fitomenadion (Vit.K1) tablet Tablet - - - - -
Fituno Tablet - - - - -
Furosemid tablet 40 mg Tablet - - - - -
Gabapentin 300 mg Tablet - - - - -
Garam Oralit Tablet 13 - 13 - 13
Griseofulvin Tab Tablet - - - - -
Ibuprofen tab 200 mg Tablet 40 100 140 - 140
Kalsium Laktat (Kalk) Kapsul 500 mg Tablet 100 - 100 - 100
Ketokonazole tab 200mg Tablet - - - - -
Lansoprazol Cap Tablet - - - - -
Loperamid tablet 2 mg Tablet - - - - -
Loratadin 10 mg Tab Tablet - - - - -
Meloksikam 7,5 mg Tablet - - - - -
Meloxicam 15 Tablet - - - - -
Metilergometrin Tab Tablet - - - - -
Metilprednisolon 8 Tablet - - - - -
Metilprednison 4 mg Tablet - - - - -
Metoklopramid Tablet 10 mg Tablet - - - - -
Natrium Diklofenak tablet 25 mg Tablet - - - - -
Natrium Diklofenak tablet 50 mg Tablet - - - - -
Nifedipin 10 mg tab Tablet - - - - -
Nistatin vaginal tablet 100.000 IU/g Tablet - - - - -
Obat Batuk Kombinasi (Lodecon Forte) Tablet 116 100 216 51 165
Ondansetron 4 mg Tab Tablet - - - - -
Parasetamol tablet 500 mg Tablet 300 - 300 50 250
Piroxicam 10 Tablet - - - - -
Piroxicam 20 Tablet - - - - -
Prednisone Kaptab 5 mg Kapsul - - - - -

Page 26
 PERSEDIAAN TOTAL
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN PERMINTAAN KET
AWAL PERSEDIAAN

1 2 3 4 9 10 12 20 21 22

I TABLET
Ranitidin Tab Tablet - 100 100 - 100
Risperidon 2 mg Tab Tablet 100 - 100 - 100
Salbutamol 4 mg Tablet - - - - -
Salbutamol tablet 2 mg Tablet - - - - -
Sianokobalamin tab 50mg (vitamin B12) Tablet - - - - -
Simvastatin Tablet 10 mg Tablet - - - - -
Simvastatin tablet 20 mg Tablet - - - - -
Solvitral Tab Tablet 100 - 100 - 100
Tablet Tambah Darah Tablet 100 100 200 30 170
Vitamin A 100.000 IU Tablet - - - - -
Vitamin A 200.000 IU Tablet - - - - -
Vitamin B 1 / Thiamine 100 mg Tablet - 100 100 - 100
Vitamin B Kompleks tablet Tablet 210 - 210 30 180
Vitamin B6 Tab (Piridoksin) Tablet 190 - 190 - 190
Vitamin C 50 mg (Asam Askorbat) Kapsul 120 - 120 20 100
Zinc tablet 20 mg Tablet - - - - -
Herba Asimor Tablet 90 - 90 30 60

SYRUP - - - - -
Ambroxol Syr Botol 6 - 6 - 6
Antasida suspensi Botol 6 - 6 - 6
Cetirizine HCl Syrup 5 mg/5 ml Botol 6 - 6 2 4
Domperidom suspensi 5 mg/5ml Botol - - - - -
Ibuprofen Syr 100 mg/5 ml Botol - - - - -
Obat Batuk Hitam (OBH) Botol 5 6 11 1 10
Obat Batuk Putih (OBP) Botol - - - - -
Obat Batuk Kombinasi Anak (Solaflus) Botol 6 - 6 1 5
Parasetamol Sirup 120 mg/ 5 ml Botol 6 - 6 2 4
Multivitamin Syrup (Tyalisin) Botol 5 - 5 3 2 6
Stimuno Syrup Botol - - - - -
Sukrafat Syrup Botol - - - - -
Zink Syrup Botol - - - - -

Page 27
 PERSEDIAAN TOTAL
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN PERMINTAAN KET
AWAL PERSEDIAAN

1 2 3 4 9 10 12 20 21 22

I TABLET
- - - - -
OBAT LUAR - - - - -
Acyclovir 5 % SK Tube 3 - 3 - 3
Anti Hemorroid Supp Tube - - - - -
Antibakteri salep Tube - - - - -
Antifungi Tube - - - - -
Betametason SK Tube - - - - -
Dulcolax Sup 10 mg Supp - - - - -
Dulcolax Sup 5 mg Supp - - - - -
Erladerm-N Tube 4 - 4 - 4
Erlamycetin Tetes Mata Drop Botol 1 3 4 - 4
Erlamycetin Tetes Telinga Drop Botol 2 3 5 - 5
Etanol 70% cairan 300 ml Botol - - - - -
Etanol 70% cairan 1000 ml Botol - - - - - 1
Fenol Gliserol Tetes Telinga 10 % Botol - - - - -
Genoint /Gentamycin SM Tube - 3 3 - 3
Gentamisin SK Tube 3 - 3 - 3
Gentamisin TM 0,3% Botol - - - - -
Hand Rub Botol - - - - - 1
Hidrokortison krim 2,5 % Tube 3 - 3 - 3
Ketokonazol krim 2% Tube 3 - 3 - 3
Kloramfenicol Tetes Telinga Botol - - - - -
Lisol 1000 ml/btl Botol - - - - -
Metronidazol ovula 500 mg Supp - - - - -
Mikonazole cream Tube 2 - 2 - 2
Mometason Furoat Krim Tube - - - - -
Povidon Iodida 300 ml Botol - - - - - 1
Rivanol Botol - - - - -
Salep 2-4 Pot - - - - -
Salisil Bedak 2 % Kotak - 6 6 - 6
Scabimite Tube - - - - -
- - - - -

Page 28
 PERSEDIAAN TOTAL
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN PERMINTAAN KET
AWAL PERSEDIAAN

1 2 3 4 9 10 12 20 21 22

I TABLET
- - - - -
BMHP - - - - -
Masker Pcs - - - - - 1
Sarung Tangan Ukuran S Pcs - - - - -
Sarung Tangan Ukuran M Pcs - - - - -

UMUM Mengetahui,
BPJS
BAYAR Bidan Poskeskel
JUMLAH KUNJUNGAN RESEP POSKESKEL
PURWOSARI

Merry Khunchoroyati, A.Md.Keb

Page 29
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

PUSTU/POSKESKEL : PURWOSARI/PURWOASRI : JANUARI

KECAMATAN : METRO UTARA : FEBRUARI
KAB/KOTA : METRO : 2023
PROPINSI : LAMPUNG

PERSEDIAAN TOTAL PERMINTA

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Acetyl cysteine kapsul 200 mg Tablet - - - - -
Allupurinol 100 mg Tablet - - - - -
Ambroxol Tab Tablet - - - - -
Aminopilin 200 mg tab Tablet - - - - -
Amlodipin 5 Tablet - - - - -
Amlodipin tablet 10 mg Tablet - - - - -
Antalgin tab Tablet - - - - -
Antasida tab kunyah Tablet - - - - -
Asam Folat 1 mg Tablet - - - - -
Asam Mefenamat kaplet 500 mg Tablet - - - - -
Asam Traneksamat 500 mg Tablet - - - - -
Asiklovir tablet 200 mg Tablet - - - - -
Asiklovir tablet 400 mg Tablet - - - - -
Atapulgit 650mg Kaplet - - - - -
Betahistin Tablet Tablet - - - - -
Bisakodil tab 5 mg Tablet - - - - -
Bisoprolol 5 mg Tab Tablet - - - - -
Calcimega Tablet - - - - -
Captopril 12,5 Tablet - - - - -
Captopril 25 Tablet - - - - -
Cetirizine 10 mg Tablet - - - - -
CTM Tablet - - - - -
Deksametason tablet 0,5 mg Tablet - - - - -
Domperidom tablet 10 mg Tablet - - - - -
Ergotamin 1 mg+Kafein 50 mg Tablet - - - - -
Fitomenadion (Vit.K1) tablet Tablet - - - - -
Fituno Tablet - - - - -
Furosemid tablet 40 mg Tablet - - - - -
Gabapentin 300 mg Tablet - - - - -
Garam Oralit Tablet - - - - -
Griseofulvin Tab Tablet - - - - -
Ibuprofen tab 200 mg Tablet - - - - -
Kalsium Laktat (Kalk) Kapsul 500 mg Tablet - - - - -
Page 30
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Ketokonazole tab 200mg Tablet - - - - -
Lansoprazol Cap Tablet - - - - -
Loperamid tablet 2 mg Tablet - - - - -
Loratadin 10 mg Tab Tablet - - - - -
Meloksikam 7,5 mg Tablet - - - - -
Meloxicam 15 Tablet - - - - -
Metilergometrin Tab Tablet - - - - -
Metilprednisolon 8 Tablet - - - - -
Metilprednison 4 mg Tablet - - - - -
Metoklopramid Tablet 10 mg Tablet - - - - -
Natrium Diklofenak tablet 25 mg Tablet - - - - -
Natrium Diklofenak tablet 50 mg Tablet - - - - -
Nifedipin 10 mg tab Tablet - - - - -
Nistatin vaginal tablet 100.000 IU/g Tablet - - - - -
Obat Batuk Kombinasi (Lodecon Forte) Tablet - - - - -
Ondansetron 4 mg Tab Tablet - - - - -
Parasetamol tablet 500 mg Tablet - - - - -
Piroxicam 10 Tablet - - - - -
Piroxicam 20 Tablet - - - - -
Prednisone Kaptab 5 mg Kapsul - - - - -
Ranitidin Tab Tablet - - - - -
Risperidon 2 mg Tab Tablet - - - - -
Salbutamol 4 mg Tablet - - - - -
Salbutamol tablet 2 mg Tablet - - - - -
Sianokobalamin tab 50mg (vitamin B12) Tablet - - - - -
Simvastatin Tablet 10 mg Tablet - - - - -
Simvastatin tablet 20 mg Tablet - - - - -
Solvitral Tab Tablet - - - - -
Tablet Tambah Darah Tablet - - - - -
Vitamin A 100.000 IU Tablet - - - - -
Vitamin A 200.000 IU Tablet - - - - -
Vitamin B 1 / Thiamine 100 mg Tablet - - - - -
Vitamin B Kompleks tablet Tablet - - - - -
Vitamin B6 Tab (Piridoksin) Tablet - - - - -
Vitamin C 50 mg (Asam Askorbat) Kapsul - - - - -
Zinc tablet 20 mg Tablet - - - - -
- - - - -
SYRUP - - - - -
Ambroxol Syr Botol - - - - -
Antasida suspensi Botol - - - - -
Cetirizine HCl Syrup 5 mg/5 ml Botol - - - - -
Domperidom suspensi 5 mg/5ml Botol - - - - -
Page 31
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Ibuprofen Syr 100 mg/5 ml Botol - - - - -
Obat Batuk Hitam (OBH) Botol - - - - -
Obat Batuk Putih (OBP) Botol - - - - -
Obat Batuk Kombinasi Anak (Solaflus) Botol - - - - -
Parasetamol Sirup 120 mg/ 5 ml Botol - - - - -
Multivitamin Syrup (Tyalisin) Botol - - - - -
Stimuno Syrup Botol - - - - -
Sukrafat Syrup Botol - - - - -
Zink Syrup Botol - - - - -
- - - - -
OBAT LUAR - - - - -
Acyclovir 5 % SK Tube - - - - -
Anti Hemorroid Supp Tube - - - - -
Antibakteri salep Tube - - - - -
Antifungi Tube - - - - -
Betametason SK Tube - - - - -
Dulcolax Sup 10 mg Supp - - - - -
Dulcolax Sup 5 mg Supp - - - - -
Erladerm-N Tube - - - - -
Erlamycetin Tetes Mata Drop Botol - - - - -
Erlamycetin Tetes Telinga Drop Botol - - - - -
Etanol 70% cairan 300 ml Botol - - - - -
Etanol 70% cairan 1000 ml Botol - - - - -
Fenol Gliserol Tetes Telinga 10 % Botol - - - - -
Genoint /Gentamycin SM Tube - - - - -
Gentamisin SK Tube - - - - -
Gentamisin TM 0,3% Botol - - - - -
Hand Rub Botol - - - - -
Hidrokortison krim 2,5 % Tube - - - - -
Ketokonazol krim 2% Tube - - - - -
Kloramfenicol Tetes Telinga Botol - - - - -
Lisol 1000 ml/btl Botol - - - - -
Metronidazol ovula 500 mg Supp - - - - -
Mikonazole cream Tube - - - - -
Mometason Furoat Krim Tube - - - - -
Povidon Iodida 300 ml Botol - - - - -
Rivanol Botol - - - - -
Salep 2-4 Pot - - - - -
Salisil Bedak 2 % Kotak - - - - -
Scabimite Tube - - - - -
- - - - -
- - - - -
Page 32
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
BMHP - - - - -
Masker Pcs - - - - -
Sarung Tangan Ukuran S Pcs - - - - -
Sarung Tangan Ukuran M Pcs - - - - -

UMUM BPJS
JUMLAH KUNJUNGAN RESEP PUSTU PURWOASRI BAYAR

UMUM BPJS
JUMLAH KUNJUNGAN RESEP POSKESKEL
BAYAR
PURWOASRI

UMUM BPJS
JUMLAH KUNJUNGAN RESEP POSKESKEL
BAYAR
PURWOSARI

Page 33
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

PUSTU/POSKESKEL : PURWOSARI/PURWOASRI : JANUARI

KECAMATAN : METRO UTARA : FEBRUARI
KAB/KOTA : METRO : 2023
PROPINSI : LAMPUNG

PERSEDIAAN TOTAL PERMINTA

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Acetyl cysteine kapsul 200 mg Tablet - - - - -
Allupurinol 100 mg Tablet - - - - -
Ambroxol Tab Tablet - - - - -
Aminopilin 200 mg tab Tablet - - - - -
Amlodipin 5 Tablet - - - - -
Amlodipin tablet 10 mg Tablet - - - - -
Antalgin tab Tablet - - - - -
Antasida tab kunyah Tablet - - - - -
Asam Folat 1 mg Tablet - - - - -
Asam Mefenamat kaplet 500 mg Tablet - - - - -
Asam Traneksamat 500 mg Tablet - - - - -
Asiklovir tablet 200 mg Tablet - - - - -
Asiklovir tablet 400 mg Tablet - - - - -
Atapulgit 650mg Kaplet - - - - -
Betahistin Tablet Tablet - - - - -
Bisakodil tab 5 mg Tablet - - - - -
Bisoprolol 5 mg Tab Tablet - - - - -
Calcimega Tablet - - - - -
Captopril 12,5 Tablet - - - - -
Captopril 25 Tablet - - - - -
Cetirizine 10 mg Tablet - - - - -
CTM Tablet - - - - -
Deksametason tablet 0,5 mg Tablet - - - - -
Domperidom tablet 10 mg Tablet - - - - -
Ergotamin 1 mg+Kafein 50 mg Tablet - - - - -
Fitomenadion (Vit.K1) tablet Tablet - - - - -
Fituno Tablet - - - - -
Furosemid tablet 40 mg Tablet - - - - -
Gabapentin 300 mg Tablet - - - - -
Garam Oralit Tablet - - - - -
Griseofulvin Tab Tablet - - - - -
Ibuprofen tab 200 mg Tablet - - - - -
Kalsium Laktat (Kalk) Kapsul 500 mg Tablet - - - - -
Page 34
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Ketokonazole tab 200mg Tablet - - - - -
Lansoprazol Cap Tablet - - - - -
Loperamid tablet 2 mg Tablet - - - - -
Loratadin 10 mg Tab Tablet - - - - -
Meloksikam 7,5 mg Tablet - - - - -
Meloxicam 15 Tablet - - - - -
Metilergometrin Tab Tablet - - - - -
Metilprednisolon 8 Tablet - - - - -
Metilprednison 4 mg Tablet - - - - -
Metoklopramid Tablet 10 mg Tablet - - - - -
Natrium Diklofenak tablet 25 mg Tablet - - - - -
Natrium Diklofenak tablet 50 mg Tablet - - - - -
Nifedipin 10 mg tab Tablet - - - - -
Nistatin vaginal tablet 100.000 IU/g Tablet - - - - -
Obat Batuk Kombinasi (Lodecon Forte) Tablet - - - - -
Ondansetron 4 mg Tab Tablet - - - - -
Parasetamol tablet 500 mg Tablet - - - - -
Piroxicam 10 Tablet - - - - -
Piroxicam 20 Tablet - - - - -
Prednisone Kaptab 5 mg Kapsul - - - - -
Ranitidin Tab Tablet - - - - -
Risperidon 2 mg Tab Tablet - - - - -
Salbutamol 4 mg Tablet - - - - -
Salbutamol tablet 2 mg Tablet - - - - -
Sianokobalamin tab 50mg (vitamin B12) Tablet - - - - -
Simvastatin Tablet 10 mg Tablet - - - - -
Simvastatin tablet 20 mg Tablet - - - - -
Solvitral Tab Tablet - - - - -
Tablet Tambah Darah Tablet - - - - -
Vitamin A 100.000 IU Tablet - - - - -
Vitamin A 200.000 IU Tablet - - - - -
Vitamin B 1 / Thiamine 100 mg Tablet - - - - -
Vitamin B Kompleks tablet Tablet - - - - -
Vitamin B6 Tab (Piridoksin) Tablet - - - - -
Vitamin C 50 mg (Asam Askorbat) Kapsul - - - - -
Zinc tablet 20 mg Tablet - - - - -
- - - - -
SYRUP - - - - -
Ambroxol Syr Botol - - - - -
Antasida suspensi Botol - - - - -
Cetirizine HCl Syrup 5 mg/5 ml Botol - - - - -
Domperidom suspensi 5 mg/5ml Botol - - - - -
Page 35
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Ibuprofen Syr 100 mg/5 ml Botol - - - - -
Obat Batuk Hitam (OBH) Botol - - - - -
Obat Batuk Putih (OBP) Botol - - - - -
Obat Batuk Kombinasi Anak (Solaflus) Botol - - - - -
Parasetamol Sirup 120 mg/ 5 ml Botol - - - - -
Multivitamin Syrup (Tyalisin) Botol - - - - -
Stimuno Syrup Botol - - - - -
Sukrafat Syrup Botol - - - - -
Zink Syrup Botol - - - - -
- - - - -
OBAT LUAR - - - - -
Acyclovir 5 % SK Tube - - - - -
Anti Hemorroid Supp Tube - - - - -
Antibakteri salep Tube - - - - -
Antifungi Tube - - - - -
Betametason SK Tube - - - - -
Dulcolax Sup 10 mg Supp - - - - -
Dulcolax Sup 5 mg Supp - - - - -
Erladerm-N Tube - - - - -
Erlamycetin Tetes Mata Drop Botol - - - - -
Erlamycetin Tetes Telinga Drop Botol - - - - -
Etanol 70% cairan 300 ml Botol - - - - -
Etanol 70% cairan 1000 ml Botol - - - - -
Fenol Gliserol Tetes Telinga 10 % Botol - - - - -
Genoint /Gentamycin SM Tube - - - - -
Gentamisin SK Tube - - - - -
Gentamisin TM 0,3% Botol - - - - -
Hand Rub Botol - - - - -
Hidrokortison krim 2,5 % Tube - - - - -
Ketokonazol krim 2% Tube - - - - -
Kloramfenicol Tetes Telinga Botol - - - - -
Lisol 1000 ml/btl Botol - - - - -
Metronidazol ovula 500 mg Supp - - - - -
Mikonazole cream Tube - - - - -
Mometason Furoat Krim Tube - - - - -
Povidon Iodida 300 ml Botol - - - - -
Rivanol Botol - - - - -
Salep 2-4 Pot - - - - -
Salisil Bedak 2 % Kotak - - - - -
Scabimite Tube - - - - -
- - - - -
- - - - -
Page 36
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
BMHP - - - - -
Masker Pcs - - - - -
Sarung Tangan Ukuran S Pcs - - - - -
Sarung Tangan Ukuran M Pcs - - - - -

UMUM BPJS
JUMLAH KUNJUNGAN RESEP PUSTU PURWOASRI BAYAR

UMUM BPJS
JUMLAH KUNJUNGAN RESEP POSKESKEL
BAYAR
PURWOASRI

UMUM BPJS
JUMLAH KUNJUNGAN RESEP POSKESKEL
BAYAR
PURWOSARI

Page 37
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

PUSTU/POSKESKEL : PURWOSARI/PURWOASRI : JANUARI

KECAMATAN : METRO UTARA : FEBRUARI
KAB/KOTA : METRO : 2023
PROPINSI : LAMPUNG

PERSEDIAAN TOTAL PERMINTA

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Acetyl cysteine kapsul 200 mg Tablet - - - - -
Allupurinol 100 mg Tablet - - - - -
Ambroxol Tab Tablet - - - - -
Aminopilin 200 mg tab Tablet - - - - -
Amlodipin 5 Tablet - - - - -
Amlodipin tablet 10 mg Tablet - - - - -
Antalgin tab Tablet - - - - -
Antasida tab kunyah Tablet - - - - -
Asam Folat 1 mg Tablet - - - - -
Asam Mefenamat kaplet 500 mg Tablet - - - - -
Asam Traneksamat 500 mg Tablet - - - - -
Asiklovir tablet 200 mg Tablet - - - - -
Asiklovir tablet 400 mg Tablet - - - - -
Atapulgit 650mg Kaplet - - - - -
Betahistin Tablet Tablet - - - - -
Bisakodil tab 5 mg Tablet - - - - -
Bisoprolol 5 mg Tab Tablet - - - - -
Calcimega Tablet - - - - -
Captopril 12,5 Tablet - - - - -
Captopril 25 Tablet - - - - -
Cetirizine 10 mg Tablet - - - - -
CTM Tablet - - - - -
Deksametason tablet 0,5 mg Tablet - - - - -
Domperidom tablet 10 mg Tablet - - - - -
Ergotamin 1 mg+Kafein 50 mg Tablet - - - - -
Fitomenadion (Vit.K1) tablet Tablet - - - - -
Fituno Tablet - - - - -
Furosemid tablet 40 mg Tablet - - - - -
Gabapentin 300 mg Tablet - - - - -
Garam Oralit Tablet - - - - -
Griseofulvin Tab Tablet - - - - -
Ibuprofen tab 200 mg Tablet - - - - -

Page 38
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Kalsium Laktat (Kalk) Kapsul 500 mg Tablet - - - - -
Ketokonazole tab 200mg Tablet - - - - -
Lansoprazol Cap Tablet - - - - -
Loperamid tablet 2 mg Tablet - - - - -
Loratadin 10 mg Tab Tablet - - - - -
Meloksikam 7,5 mg Tablet - - - - -
Meloxicam 15 Tablet - - - - -
Metilergometrin Tab Tablet - - - - -
Metilprednisolon 8 Tablet - - - - -
Metilprednison 4 mg Tablet - - - - -
Metoklopramid Tablet 10 mg Tablet - - - - -
Natrium Diklofenak tablet 25 mg Tablet - - - - -
Natrium Diklofenak tablet 50 mg Tablet - - - - -
Nifedipin 10 mg tab Tablet - - - - -
Nistatin vaginal tablet 100.000 IU/g Tablet - - - - -
Obat Batuk Kombinasi (Lodecon Forte) Tablet - - - - -
Ondansetron 4 mg Tab Tablet - - - - -
Parasetamol tablet 500 mg Tablet - - - - -
Piroxicam 10 Tablet - - - - -
Piroxicam 20 Tablet - - - - -
Prednisone Kaptab 5 mg Kapsul - - - - -
Ranitidin Tab Tablet - - - - -
Risperidon 2 mg Tab Tablet - - - - -
Salbutamol 4 mg Tablet - - - - -
Salbutamol tablet 2 mg Tablet - - - - -
Sianokobalamin tab 50mg (vitamin B12) Tablet - - - - -
Simvastatin Tablet 10 mg Tablet - - - - -
Simvastatin tablet 20 mg Tablet - - - - -
Solvitral Tab Tablet - - - - -
Tablet Tambah Darah Tablet - - - - -
Vitamin A 100.000 IU Tablet - - - - -
Vitamin A 200.000 IU Tablet - - - - -
Vitamin B 1 / Thiamine 100 mg Tablet - - - - -
Vitamin B Kompleks tablet Tablet - - - - -
Vitamin B6 Tab (Piridoksin) Tablet - - - - -
Vitamin C 50 mg (Asam Askorbat) Kapsul - - - - -
Zinc tablet 20 mg Tablet - - - - -
- - - - -
SYRUP - - - - -
Ambroxol Syr Botol - - - - -
Antasida suspensi Botol - - - - -

Page 39
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Cetirizine HCl Syrup 5 mg/5 ml Botol - - - - -
Domperidom suspensi 5 mg/5ml Botol - - - - -
Ibuprofen Syr 100 mg/5 ml Botol - - - - -
Obat Batuk Hitam (OBH) Botol - - - - -
Obat Batuk Putih (OBP) Botol - - - - -
Obat Batuk Kombinasi Anak (Solaflus) Botol - - - - -
Parasetamol Sirup 120 mg/ 5 ml Botol - - - - -
Multivitamin Syrup (Tyalisin) Botol - - - - -
Stimuno Syrup Botol - - - - -
Sukrafat Syrup Botol - - - - -
Zink Syrup Botol - - - - -
- - - - -
OBAT LUAR - - - - -
Acyclovir 5 % SK Tube - - - - -
Anti Hemorroid Supp Tube - - - - -
Antibakteri salep Tube - - - - -
Antifungi Tube - - - - -
Betametason SK Tube - - - - -
Dulcolax Sup 10 mg Supp - - - - -
Dulcolax Sup 5 mg Supp - - - - -
Erladerm-N Tube - - - - -
Erlamycetin Tetes Mata Drop Botol - - - - -
Erlamycetin Tetes Telinga Drop Botol - - - - -
Etanol 70% cairan 300 ml Botol - - - - -
Etanol 70% cairan 1000 ml Botol - - - - -
Fenol Gliserol Tetes Telinga 10 % Botol - - - - -
Genoint /Gentamycin SM Tube - - - - -
Gentamisin SK Tube - - - - -
Gentamisin TM 0,3% Botol - - - - -
Hand Rub Botol - - - - -
Hidrokortison krim 2,5 % Tube - - - - -
Ketokonazol krim 2% Tube - - - - -
Kloramfenicol Tetes Telinga Botol - - - - -
Lisol 1000 ml/btl Botol - - - - -
Metronidazol ovula 500 mg Supp - - - - -
Mikonazole cream Tube - - - - -
Mometason Furoat Krim Tube - - - - -
Povidon Iodida 300 ml Botol - - - - -
Rivanol Botol - - - - -
Salep 2-4 Pot - - - - -
Salisil Bedak 2 % Kotak - - - - -

Page 40
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Scabimite Tube - - - - -
- - - - -
- - - - -
BMHP - - - - -
Masker Pcs - - - - -
Sarung Tangan Ukuran S Pcs - - - - -
Sarung Tangan Ukuran M Pcs - - - - -

UMUM BPJS
JUMLAH KUNJUNGAN RESEP PUSTU PURWOASRI BAYAR

UMUM BPJS
JUMLAH KUNJUNGAN RESEP POSKESKEL
BAYAR
PURWOASRI

UMUM BPJS
JUMLAH KUNJUNGAN RESEP POSKESKEL
BAYAR
PURWOSARI

Page 41
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

PUSTU/POSKESKEL : PURWOSARI/PURWOASRI : JANUARI

KECAMATAN : METRO UTARA : FEBRUARI
KAB/KOTA : METRO : 2023
PROPINSI : LAMPUNG

PERSEDIAAN TOTAL PERMINTA

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Acetyl cysteine kapsul 200 mg Tablet - - - - -
Allupurinol 100 mg Tablet - - - - -
Ambroxol Tab Tablet - - - - -
Aminopilin 200 mg tab Tablet - - - - -
Amlodipin 5 Tablet - - - - -
Amlodipin tablet 10 mg Tablet - - - - -
Antalgin tab Tablet - - - - -
Antasida tab kunyah Tablet - - - - -
Asam Folat 1 mg Tablet - - - - -
Asam Mefenamat kaplet 500 mg Tablet - - - - -
Asam Traneksamat 500 mg Tablet - - - - -
Asiklovir tablet 200 mg Tablet - - - - -
Asiklovir tablet 400 mg Tablet - - - - -
Atapulgit 650mg Kaplet - - - - -
Betahistin Tablet Tablet - - - - -
Bisakodil tab 5 mg Tablet - - - - -
Bisoprolol 5 mg Tab Tablet - - - - -
Calcimega Tablet - - - - -
Captopril 12,5 Tablet - - - - -
Captopril 25 Tablet - - - - -
Cetirizine 10 mg Tablet - - - - -
CTM Tablet - - - - -
Deksametason tablet 0,5 mg Tablet - - - - -
Domperidom tablet 10 mg Tablet - - - - -
Ergotamin 1 mg+Kafein 50 mg Tablet - - - - -
Fitomenadion (Vit.K1) tablet Tablet - - - - -
Fituno Tablet - - - - -
Furosemid tablet 40 mg Tablet - - - - -
Gabapentin 300 mg Tablet - - - - -
Garam Oralit Tablet - - - - -
Griseofulvin Tab Tablet - - - - -
Ibuprofen tab 200 mg Tablet - - - - -
Kalsium Laktat (Kalk) Kapsul 500 mg Tablet - - - - -
Ketokonazole tab 200mg Tablet - - - - -
Lansoprazol Cap Tablet - - - - -
Loperamid tablet 2 mg Tablet - - - - -
Loratadin 10 mg Tab Tablet - - - - -
Meloksikam 7,5 mg Tablet - - - - -
Meloxicam 15 Tablet - - - - -
Metilergometrin Tab Tablet - - - - -
Metilprednisolon 8 Tablet - - - - -

Page 42
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Metilprednison 4 mg Tablet - - - - -
Metoklopramid Tablet 10 mg Tablet - - - - -
Natrium Diklofenak tablet 25 mg Tablet - - - - -
Natrium Diklofenak tablet 50 mg Tablet - - - - -
Nifedipin 10 mg tab Tablet - - - - -
Nistatin vaginal tablet 100.000 IU/g Tablet - - - - -
Obat Batuk Kombinasi (Lodecon Forte) Tablet - - - - -
Ondansetron 4 mg Tab Tablet - - - - -
Parasetamol tablet 500 mg Tablet - - - - -
Piroxicam 10 Tablet - - - - -
Piroxicam 20 Tablet - - - - -
Prednisone Kaptab 5 mg Kapsul - - - - -
Ranitidin Tab Tablet - - - - -
Risperidon 2 mg Tab Tablet - - - - -
Salbutamol 4 mg Tablet - - - - -
Salbutamol tablet 2 mg Tablet - - - - -
Sianokobalamin tab 50mg (vitamin B12) Tablet - - - - -
Simvastatin Tablet 10 mg Tablet - - - - -
Simvastatin tablet 20 mg Tablet - - - - -
Solvitral Tab Tablet - - - - -
Tablet Tambah Darah Tablet - - - - -
Vitamin A 100.000 IU Tablet - - - - -
Vitamin A 200.000 IU Tablet - - - - -
Vitamin B 1 / Thiamine 100 mg Tablet - - - - -
Vitamin B Kompleks tablet Tablet - - - - -
Vitamin B6 Tab (Piridoksin) Tablet - - - - -
Vitamin C 50 mg (Asam Askorbat) Kapsul - - - - -
Zinc tablet 20 mg Tablet - - - - -
- - - - -
SYRUP - - - - -
Ambroxol Syr Botol - - - - -
Antasida suspensi Botol - - - - -
Cetirizine HCl Syrup 5 mg/5 ml Botol - - - - -
Domperidom suspensi 5 mg/5ml Botol - - - - -
Ibuprofen Syr 100 mg/5 ml Botol - - - - -
Obat Batuk Hitam (OBH) Botol - - - - -
Obat Batuk Putih (OBP) Botol - - - - -
Obat Batuk Kombinasi Anak (Solaflus) Botol - - - - -
Parasetamol Sirup 120 mg/ 5 ml Botol - - - - -
Multivitamin Syrup (Tyalisin) Botol - - - - -
Stimuno Syrup Botol - - - - -
Sukrafat Syrup Botol - - - - -
Zink Syrup Botol - - - - -
- - - - -
OBAT LUAR - - - - -
Acyclovir 5 % SK Tube - - - - -
Anti Hemorroid Supp Tube - - - - -
Antibakteri salep Tube - - - - -
Antifungi Tube - - - - -
Betametason SK Tube - - - - -

Page 43
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Dulcolax Sup 10 mg Supp - - - - -
Dulcolax Sup 5 mg Supp - - - - -
Erladerm-N Tube - - - - -
Erlamycetin Tetes Mata Drop Botol - - - - -
Erlamycetin Tetes Telinga Drop Botol - - - - -
Etanol 70% cairan 300 ml Botol - - - - -
Etanol 70% cairan 1000 ml Botol - - - - -
Fenol Gliserol Tetes Telinga 10 % Botol - - - - -
Genoint /Gentamycin SM Tube - - - - -
Gentamisin SK Tube - - - - -
Gentamisin TM 0,3% Botol - - - - -
Hand Rub Botol - - - - -
Hidrokortison krim 2,5 % Tube - - - - -
Ketokonazol krim 2% Tube - - - - -
Kloramfenicol Tetes Telinga Botol - - - - -
Lisol 1000 ml/btl Botol - - - - -
Metronidazol ovula 500 mg Supp - - - - -
Mikonazole cream Tube - - - - -
Mometason Furoat Krim Tube - - - - -
Povidon Iodida 300 ml Botol - - - - -
Rivanol Botol - - - - -
Salep 2-4 Pot - - - - -
Salisil Bedak 2 % Kotak - - - - -
Scabimite Tube - - - - -
- - - - -
- - - - -
BMHP - - - - -
Masker Pcs - - - - -
Sarung Tangan Ukuran S Pcs - - - - -
Sarung Tangan Ukuran M Pcs - - - - -

UMUM BPJS
JUMLAH KUNJUNGAN RESEP PUSTU PURWOASRI BAYAR

UMUM BPJS
JUMLAH KUNJUNGAN RESEP POSKESKEL BAYAR
PURWOASRI

UMUM BPJS
JUMLAH KUNJUNGAN RESEP POSKESKEL
BAYAR
PURWOSARI

Page 44
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

PUSTU/POSKESKEL : PURWOSARI/PURWOASRI : JANUARI

KECAMATAN : METRO UTARA : FEBRUARI
KAB/KOTA : METRO : 2023
PROPINSI : LAMPUNG

PERSEDIAAN TOTAL PERMINTA

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Acetyl cysteine kapsul 200 mg Tablet - - - - -
Allupurinol 100 mg Tablet - - - - -
Ambroxol Tab Tablet - - - - -
Aminopilin 200 mg tab Tablet - - - - -
Amlodipin 5 Tablet - - - - -
Amlodipin tablet 10 mg Tablet - - - - -
Antalgin tab Tablet - - - - -
Antasida tab kunyah Tablet - - - - -
Asam Folat 1 mg Tablet - - - - -
Asam Mefenamat kaplet 500 mg Tablet - - - - -
Asam Traneksamat 500 mg Tablet - - - - -
Asiklovir tablet 200 mg Tablet - - - - -
Asiklovir tablet 400 mg Tablet - - - - -
Atapulgit 650mg Kaplet - - - - -
Betahistin Tablet Tablet - - - - -
Bisakodil tab 5 mg Tablet - - - - -
Bisoprolol 5 mg Tab Tablet - - - - -
Calcimega Tablet - - - - -
Captopril 12,5 Tablet - - - - -
Captopril 25 Tablet - - - - -
Cetirizine 10 mg Tablet - - - - -
CTM Tablet - - - - -
Deksametason tablet 0,5 mg Tablet - - - - -
Domperidom tablet 10 mg Tablet - - - - -
Ergotamin 1 mg+Kafein 50 mg Tablet - - - - -
Fitomenadion (Vit.K1) tablet Tablet - - - - -
Fituno Tablet - - - - -
Furosemid tablet 40 mg Tablet - - - - -
Gabapentin 300 mg Tablet - - - - -
Garam Oralit Tablet - - - - -
Griseofulvin Tab Tablet - - - - -
Ibuprofen tab 200 mg Tablet - - - - -
Kalsium Laktat (Kalk) Kapsul 500 mg Tablet - - - - -
Ketokonazole tab 200mg Tablet - - - - -
Lansoprazol Cap Tablet - - - - -
Loperamid tablet 2 mg Tablet - - - - -
Loratadin 10 mg Tab Tablet - - - - -
Page 45
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Meloksikam 7,5 mg Tablet - - - - -
Meloxicam 15 Tablet - - - - -
Metilergometrin Tab Tablet - - - - -
Metilprednisolon 8 Tablet - - - - -
Metilprednison 4 mg Tablet - - - - -
Metoklopramid Tablet 10 mg Tablet - - - - -
Natrium Diklofenak tablet 25 mg Tablet - - - - -
Natrium Diklofenak tablet 50 mg Tablet - - - - -
Nifedipin 10 mg tab Tablet - - - - -
Nistatin vaginal tablet 100.000 IU/g Tablet - - - - -
Obat Batuk Kombinasi (Lodecon Forte) Tablet - - - - -
Ondansetron 4 mg Tab Tablet - - - - -
Parasetamol tablet 500 mg Tablet - - - - -
Piroxicam 10 Tablet - - - - -
Piroxicam 20 Tablet - - - - -
Prednisone Kaptab 5 mg Kapsul - - - - -
Ranitidin Tab Tablet - - - - -
Risperidon 2 mg Tab Tablet - - - - -
Salbutamol 4 mg Tablet - - - - -
Salbutamol tablet 2 mg Tablet - - - - -
Sianokobalamin tab 50mg (vitamin B12) Tablet - - - - -
Simvastatin Tablet 10 mg Tablet - - - - -
Simvastatin tablet 20 mg Tablet - - - - -
Solvitral Tab Tablet - - - - -
Tablet Tambah Darah Tablet - - - - -
Vitamin A 100.000 IU Tablet - - - - -
Vitamin A 200.000 IU Tablet - - - - -
Vitamin B 1 / Thiamine 100 mg Tablet - - - - -
Vitamin B Kompleks tablet Tablet - - - - -
Vitamin B6 Tab (Piridoksin) Tablet - - - - -
Vitamin C 50 mg (Asam Askorbat) Kapsul - - - - -
Zinc tablet 20 mg Tablet - - - - -
- - - - -
SYRUP - - - - -
Ambroxol Syr Botol - - - - -
Antasida suspensi Botol - - - - -
Cetirizine HCl Syrup 5 mg/5 ml Botol - - - - -
Domperidom suspensi 5 mg/5ml Botol - - - - -
Ibuprofen Syr 100 mg/5 ml Botol - - - - -
Obat Batuk Hitam (OBH) Botol - - - - -
Obat Batuk Putih (OBP) Botol - - - - -
Obat Batuk Kombinasi Anak (Solaflus) Botol - - - - -
Parasetamol Sirup 120 mg/ 5 ml Botol - - - - -
Multivitamin Syrup (Tyalisin) Botol - - - - -
Stimuno Syrup Botol - - - - -
Sukrafat Syrup Botol - - - - -
Page 46
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Zink Syrup Botol - - - - -
- - - - -
OBAT LUAR - - - - -
Acyclovir 5 % SK Tube - - - - -
Anti Hemorroid Supp Tube - - - - -
Antibakteri salep Tube - - - - -
Antifungi Tube - - - - -
Betametason SK Tube - - - - -
Dulcolax Sup 10 mg Supp - - - - -
Dulcolax Sup 5 mg Supp - - - - -
Erladerm-N Tube - - - - -
Erlamycetin Tetes Mata Drop Botol - - - - -
Erlamycetin Tetes Telinga Drop Botol - - - - -
Etanol 70% cairan 300 ml Botol - - - - -
Etanol 70% cairan 1000 ml Botol - - - - -
Fenol Gliserol Tetes Telinga 10 % Botol - - - - -
Genoint /Gentamycin SM Tube - - - - -
Gentamisin SK Tube - - - - -
Gentamisin TM 0,3% Botol - - - - -
Hand Rub Botol - - - - -
Hidrokortison krim 2,5 % Tube - - - - -
Ketokonazol krim 2% Tube - - - - -
Kloramfenicol Tetes Telinga Botol - - - - -
Lisol 1000 ml/btl Botol - - - - -
Metronidazol ovula 500 mg Supp - - - - -
Mikonazole cream Tube - - - - -
Mometason Furoat Krim Tube - - - - -
Povidon Iodida 300 ml Botol - - - - -
Rivanol Botol - - - - -
Salep 2-4 Pot - - - - -
Salisil Bedak 2 % Kotak - - - - -
Scabimite Tube - - - - -
- - - - -
- - - - -
BMHP - - - - -
Masker Pcs - - - - -
Sarung Tangan Ukuran S Pcs - - - - -
Sarung Tangan Ukuran M Pcs - - - - -

UMUM BPJS
JUMLAH KUNJUNGAN RESEP PUSTU PURWOASRI BAYAR

Page 47
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
JUMLAH KUNJUNGAN RESEP PUSTU PURWOASRI

UMUM BPJS
JUMLAH KUNJUNGAN RESEP POSKESKEL
BAYAR
PURWOASRI

UMUM BPJS
JUMLAH KUNJUNGAN RESEP POSKESKEL
BAYAR
PURWOSARI

Page 48
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

PUSTU/POSKESKEL : PURWOSARI/PURWOASRI : JANUARI

KECAMATAN : METRO UTARA : FEBRUARI
KAB/KOTA : METRO : 2023
PROPINSI : LAMPUNG

PERSEDIAAN TOTAL PERMINTA

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Acetyl cysteine kapsul 200 mg Tablet - - - - -
Allupurinol 100 mg Tablet - - - - -
Ambroxol Tab Tablet - - - - -
Aminopilin 200 mg tab Tablet - - - - -
Amlodipin 5 Tablet - - - - -
Amlodipin tablet 10 mg Tablet - - - - -
Antalgin tab Tablet - - - - -
Antasida tab kunyah Tablet - - - - -
Asam Folat 1 mg Tablet - - - - -
Asam Mefenamat kaplet 500 mg Tablet - - - - -
Asam Traneksamat 500 mg Tablet - - - - -
Asiklovir tablet 200 mg Tablet - - - - -
Asiklovir tablet 400 mg Tablet - - - - -
Atapulgit 650mg Kaplet - - - - -
Betahistin Tablet Tablet - - - - -
Bisakodil tab 5 mg Tablet - - - - -
Bisoprolol 5 mg Tab Tablet - - - - -
Calcimega Tablet - - - - -
Captopril 12,5 Tablet - - - - -
Captopril 25 Tablet - - - - -
Cetirizine 10 mg Tablet - - - - -
CTM Tablet - - - - -
Deksametason tablet 0,5 mg Tablet - - - - -
Domperidom tablet 10 mg Tablet - - - - -
Ergotamin 1 mg+Kafein 50 mg Tablet - - - - -
Fitomenadion (Vit.K1) tablet Tablet - - - - -
Fituno Tablet - - - - -
Furosemid tablet 40 mg Tablet - - - - -
Gabapentin 300 mg Tablet - - - - -
Garam Oralit Tablet - - - - -
Griseofulvin Tab Tablet - - - - -
Ibuprofen tab 200 mg Tablet - - - - -
Kalsium Laktat (Kalk) Kapsul 500 mg Tablet - - - - -
Ketokonazole tab 200mg Tablet - - - - -
Lansoprazol Cap Tablet - - - - -
Loperamid tablet 2 mg Tablet - - - - -
Loratadin 10 mg Tab Tablet - - - - -
Meloksikam 7,5 mg Tablet - - - - -
Meloxicam 15 Tablet - - - - -
Metilergometrin Tab Tablet - - - - -
Page 49
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Metilprednisolon 8 Tablet - - - - -
Metilprednison 4 mg Tablet - - - - -
Metoklopramid Tablet 10 mg Tablet - - - - -
Natrium Diklofenak tablet 25 mg Tablet - - - - -
Natrium Diklofenak tablet 50 mg Tablet - - - - -
Nifedipin 10 mg tab Tablet - - - - -
Nistatin vaginal tablet 100.000 IU/g Tablet - - - - -
Obat Batuk Kombinasi (Lodecon Forte) Tablet - - - - -
Ondansetron 4 mg Tab Tablet - - - - -
Parasetamol tablet 500 mg Tablet - - - - -
Piroxicam 10 Tablet - - - - -
Piroxicam 20 Tablet - - - - -
Prednisone Kaptab 5 mg Kapsul - - - - -
Ranitidin Tab Tablet - - - - -
Risperidon 2 mg Tab Tablet - - - - -
Salbutamol 4 mg Tablet - - - - -
Salbutamol tablet 2 mg Tablet - - - - -
Sianokobalamin tab 50mg (vitamin B12) Tablet - - - - -
Simvastatin Tablet 10 mg Tablet - - - - -
Simvastatin tablet 20 mg Tablet - - - - -
Solvitral Tab Tablet - - - - -
Tablet Tambah Darah Tablet - - - - -
Vitamin A 100.000 IU Tablet - - - - -
Vitamin A 200.000 IU Tablet - - - - -
Vitamin B 1 / Thiamine 100 mg Tablet - - - - -
Vitamin B Kompleks tablet Tablet - - - - -
Vitamin B6 Tab (Piridoksin) Tablet - - - - -
Vitamin C 50 mg (Asam Askorbat) Kapsul - - - - -
Zinc tablet 20 mg Tablet - - - - -
- - - - -
SYRUP - - - - -
Ambroxol Syr Botol - - - - -
Antasida suspensi Botol - - - - -
Cetirizine HCl Syrup 5 mg/5 ml Botol - - - - -
Domperidom suspensi 5 mg/5ml Botol - - - - -
Ibuprofen Syr 100 mg/5 ml Botol - - - - -
Obat Batuk Hitam (OBH) Botol - - - - -
Obat Batuk Putih (OBP) Botol - - - - -
Obat Batuk Kombinasi Anak (Solaflus) Botol - - - - -
Parasetamol Sirup 120 mg/ 5 ml Botol - - - - -
Multivitamin Syrup (Tyalisin) Botol - - - - -
Stimuno Syrup Botol - - - - -
Sukrafat Syrup Botol - - - - -
Zink Syrup Botol - - - - -
- - - - -
OBAT LUAR - - - - -
Acyclovir 5 % SK Tube - - - - -
Anti Hemorroid Supp Tube - - - - -

Page 50
 PERSEDIAAN TOTAL PERMINTA
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PEMAKAIAN KET
AWAL PERSEDIAAN AN

1 2 3 4 9 10 12 20 21 22

I TABLET
Antibakteri salep Tube - - - - -
Antifungi Tube - - - - -
Betametason SK Tube - - - - -
Dulcolax Sup 10 mg Supp - - - - -
Dulcolax Sup 5 mg Supp - - - - -
Erladerm-N Tube - - - - -
Erlamycetin Tetes Mata Drop Botol - - - - -
Erlamycetin Tetes Telinga Drop Botol - - - - -
Etanol 70% cairan 300 ml Botol - - - - -
Etanol 70% cairan 1000 ml Botol - - - - -
Fenol Gliserol Tetes Telinga 10 % Botol - - - - -
Genoint /Gentamycin SM Tube - - - - -
Gentamisin SK Tube - - - - -
Gentamisin TM 0,3% Botol - - - - -
Hand Rub Botol - - - - -
Hidrokortison krim 2,5 % Tube - - - - -
Ketokonazol krim 2% Tube - - - - -
Kloramfenicol Tetes Telinga Botol - - - - -
Lisol 1000 ml/btl Botol - - - - -
Metronidazol ovula 500 mg Supp - - - - -
Mikonazole cream Tube - - - - -
Mometason Furoat Krim Tube - - - - -
Povidon Iodida 300 ml Botol - - - - -
Rivanol Botol - - - - -
Salep 2-4 Pot - - - - -
Salisil Bedak 2 % Kotak - - - - -
Scabimite Tube - - - - -
- - - - -
- - - - -
BMHP - - - - -
Masker Pcs - - - - -
Sarung Tangan Ukuran S Pcs - - - - -
Sarung Tangan Ukuran M Pcs - - - - -

UMUM BPJS
JUMLAH KUNJUNGAN RESEP PUSTU PURWOASRI BAYAR

UMUM BPJS
JUMLAH KUNJUNGAN RESEP POSKESKEL
BAYAR
PURWOASRI

UMUM BPJS
JUMLAH KUNJUNGAN RESEP POSKESKEL BAYAR
PURWOSARI

Page 51
 STOK OPNAME OBAT

KODE PUSKESMAS : P 1872023202

PUSKESMAS : PURWOSARI
BULAN :
TAHUN :

NO NAMA OBAT SATUAN STOK APOTEK STOK GUDANG TOTAL KET

1 2 3 10 21 22
i TABLET
Acetyl cysteine kapsul 200 mg Tablet
Adalat Oros Tablet
Akarbose 100 mg Tablet
Akarbose 50 mg Tablet
Allupurinol 100 mg Tablet
Alprazolam tablet 0,25 mg Tablet
Alprazolam tablet 0,5 mg Tablet
Alprazolam tablet 1 mg Tablet
Ambroxol Tab Tablet
Aminopilin 200 mg tab Tablet
Amitriptilin tablet salut 25 mg (HCl) Tablet
Amlodipin 5 Tablet
Amlodipin tablet 10 mg Tablet
Amoksisilin 500 Kaplet
Amoxicillin 250 mg Tab Tablet
Antalgin tab Tablet
Antasida tab kunyah Tablet
Asam Folat 1 mg Tablet
Asam Mefenamat kaplet 500 mg Tablet
Asam Traneksamat 500 mg Tablet
Asiklovir tablet 200 mg Tablet
Asiklovir tablet 400 mg Tablet
Atapulgit 650mg Tablet
Betahistin Tablet Tablet
Bisakodil tab 5 mg Tablet
Bisoprolol 5 mg Tab Tablet
Captopril 12,5 Tablet
Captopril 25 Tablet
Cetirizine 10 mg Tablet
Clobazam 10 mg Tab Tablet
Clozapine 25 mg Tab Tablet
CTM Tablet
Deksametason tablet 0,5 mg Tablet
Depakote ER 250 mg Tablet
Diazepam 5 Tablet
Digoxin 0,25 mg Tablet
Diltiazem HCl tablet 30 mg Tablet
Dimenhidramin tablet 50 mg Tablet

Page 52
NO NAMA OBAT SATUAN STOK APOTEK STOK GUDANG TOTAL KET

1 2 3 10 21 22

Doksisiklin 100 mg Tab Tablet

Domperidom tablet 10 mg Tablet
Ergotamin 1 mg+Kafein 50 mg Tablet
Eritromisin kaplet 500 mg Tablet
Fenitoin 100 mg Tablet
Fenobarbital 30 mg Tablet
Fitomenadion (Vit.K1) tablet Tablet
Fituno Tablet
Flukonazol 150 mg Tablet
Fluoksetine 20 mg Tab Tablet
Furosemid tablet 40 mg Tablet
Gabapentin 100 mg Tablet
Gabapentin 300 mg Tablet
Garam Oralit Tablet
Gemfibrozil kapsul 300 mg Kapsul
Glibenclamid tablet 5 mg Tablet
Glikuidone 30 mg Tab Tablet
Glimepiride 1 mg Tablet
Glimepyride 2 mg Tablet
Griseofulvin Tab Tablet
Haloperidol tablet 5 mg Tablet
Haloperidol tablet 0,5 Tablet
Haloperidol tablet 1,5 mg Tablet
Hidroklortiazidea tablet 25 mg Tablet
Ibuprofen tab 200 mg Tablet
Irbesartan 150 Tablet
Isoniazid tablet 100 mg Tablet
Isosorbid Dinitrat 5 mg ( ISDN 5 mg ) Tablet
Isosorbid Dinitrat 10 mg ( ISDN 10 mg ) Tablet
Kalsium Laktat (Kalk) Kapsul 500 mg Kapsul
Karbamazepim 200 mg Tablet
Ketokonazole tab 200mg Tablet
Klindamisin 150 mg Tablet
Klonidin tablet 0,15 mg Tablet
Kloramfenikol Kapsul 500 mg (Chloramex) Kapsul
Klorokuin tablet 250 mg Tablet
Klorpromazin tablet salut 100 mg Tablet
Klorpromazin tablet salut 25 mg (HCl) Tablet
Kotrimoksazol DOEN I (dewasa) kombinasi Tablet
Lansoprazol Cap Kapsul
Loperamid tablet 2 mg Tablet
Loratadin 10 mg Tab Tablet
Meloksikam 7,5 mg Tablet
Meloxicam 15 Tablet
Metilergometrin Tab Tablet
Metilprednisolon 8 Tablet
Metilprednison 4 mg Tablet
Page 53
NO NAMA OBAT SATUAN STOK APOTEK STOK GUDANG TOTAL KET

1 2 3 10 21 22

Metoklopramid Tablet 10 mg Tablet

Miniaspi 80 mg Tablet
Natrium Diklofenak tablet 25 mg Tablet
Natrium Diklofenak tablet 50 mg Tablet
Nevirapin tablet 200 mg Tablet
Nifedipin 10 mg tab Tablet
Nistatin vaginal tablet 100.000 IU/g Tablet
Omeprazole Kaps 20 mg Kapsul
Ondansetron 4 mg Tab Tablet
Ondansetron 8 mg Tab Tablet
Parasetamol tablet 500 mg Tablet
Piroxicam 10 Tablet
Piroxicam 20 Tablet
Prednisone Kaptab 5 mg Kaplet
Propanolol tablet 10 mg ( HCl ) Tablet
Propilitiourasil tablet 100 mg Tablet
Ranitidin Tab Tablet
Risperidon 2 mg Tab Tablet
Salbutamol 4 mg Tablet
Salbutamol tablet 2 mg Tablet
Sefadroksil kapsul 500 mg Kapsul
Sefadroxil 250 mg Tablet
Sianokobalamin tab 50mg (vitamin B12) Tablet
Simvastatin Tablet 10 mg Tablet
Simvastatin tablet 20 mg Tablet
Siprofloksasin tablet 500 mg Tablet
Solvitral Tab Tablet
Spironolakton tablet 25 mg Tablet
Tetrasiclin 500 mg Tablet
THP Tablet
Vitamin B 1 / Thiamine 100 mg Tablet
Vitamin B Kompleks tablet Tablet
Vitamin B6 Tab (Piridoksin) Tablet
Vitamin C 50 mg (Asam Askorbat) Tablet
Zinc tablet 20 mg Tablet

II SYRUP
Albendazol suspensi 200mg/5ml Botol
Ambroxol Syr Botol
Amoksilin sirup kering forte 250 mg/5 ml Botol
Amoksisilin 100mg/ml drops sirup kering Botol
Amoxicillin sirup kering 125 mg / 5 ml Botol
Antasida suspensi Botol
Cefadroxil Sirup Kering 125 mg / 5 ml Botol
Cetirizine HCl Syrup 5 mg/5 ml Botol
Domperidom suspensi 5 mg/5ml Botol
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Eritromisin sirup kering 200mg/5ml Botol

Fortusin Syr Botol
Ibuprofen Syr 100 mg/5 ml Botol
Kloramfenikol Suspensi 125 mg/ml Botol
Kotrimoksazol Syr Botol
Obat Batuk Hitam (OBH) Botol
Obat Batuk Putih (OBP) Botol
Paraflu Syr Botol
Parasetamol Drop Botol
Parasetamol Sirup 120 mg/ 5 ml Botol
Pirantel pamoat suspensi 125mg/ml Botol
Sefadroksil 250ml/5ml sirup Botol
Solvita Plus Syr Botol
Stimuno Syrup Botol
Sukrafat Syrup Botol
Zink Syrup Drop Botol
Zinc Syrup Botol

III OBAT LUAR

Acyclovir 5 % SK Tube
Alkacide 1000 ml Botol
Anti Hemorroid Supp Supp
Antibakteri salep Tube
Antifungi Tube
Betametason SK Tube
BufacetinSK ( Kloramfenicol ) Tube
Combivent Vial
Decacetin TM 0,5 % ( Kloramfenicol TM ) Botol
Dulcolax Sup 10 mg Supp
Dulcolax Sup 5 mg Supp
Etanol 70% cairan 100 ml Botol
Etanol 70% cairan 300 ml Botol
Etanol 70% cairan 1000 ml Botol
Etil Klorida (Endofrost) Botol
Fenol Gliserol Tetes Telinga 10 % Botol
Genoint /Gentamycin SM Tube
Gentamisin SK Tube
Gentamisin TM 0,3% Botol
Hand Rub Botol
Hidrokortison krim 2,5 % Tube
Ketokonazol krim 2% Tube
Ketokonazole scalp sol 20% (fungasol) Botol
Ketoprofen supp Supp
Kloramfenicol Tetes Telinga Botol
Kloramfenikol SM 1% Tube
Lisol 1000 ml/btl Botol
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Metronidazol ovula 500 mg Ovula

Mikonazole cream Tube
Mometason Furoat Krim Tube
Povidon Iodida 30 ml Botol
Povidon Iodida 300 ml Botol
Rivanol Botol
Salep 2-4 Pot
Salisil Bedak 2 % Pot
Scabimite Tube
Soft U Derm Tube
Stesolid enema 10mg/2,5ml Tube
Stesolid enema 5mg/2,5ml Tube
Sulfadiazine krim 1% Tube
Xylocain Gel ( Lidokain Gel ) Syringe

IV INFUS
Nacl 0,9 % Botol
Ringer Laktat Botol

V INJEKSI
Aminopilin Inj Ampul
Aqua Inj 25 ml Botol
Asam Traneksamat Inj 5 % 250 mg/5ml Ampul
Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (Sulfat) Ampul
Deksametason injeksi i.v. 5 mg/ml Ampul
Diazepam Injeksi 5mg Ampul
Difenhidramin injeksi i.m. 10 mg/ml (HCl) Ampul
Efinefrin Inj Ampul
Fitomenadion Inj Ampul
Flixocide Nebules Ampul
Haldol Decanoas inj 50 mg/ml Ampul
Haldol Inj 5 mg/ml(Lodomer) Inj Ampul
Ketorolac inj 30mg Ampul
Lidokain injeksi 2% (HCL) Ampul
Lidokain injeksi 2% (HCL) + Ephinefrin 1:80.000 Ampul
MgSO4 Injeksi 20 % Ampul
MgSO4 Injeksi 40 % Ampul
Oksitosin Inj 10 IU Ampul
Ondasentron Inj Ampul
Ranitidin injeksi 50 mg/2 ml Ampul
Flunephenazine injeksi 5 mg/ml Ampul

VI BMHP
Alat suntik sekali pakai 5 cc pcs
Alat suntik sekali pakai 1cc pcs
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Alat suntik sekali pakai 3 cc pcs

Alkohol Swab pcs
Axiamed Foleycath 2 way Latex Foley Cath 16 Pcs
Axiamed paper Tape/2,5cm x 9.14 m Roll
Bactigras 10 x 10 cm Pcs
Bisturi Steril Scalpel Blade 11 Pcs
Bisturi Steril Scalpel Blade 15 Pcs
Bisturi Steril Scalpel Blade 23 Pcs
Bisturi Steril Scalpel Blade 24 Pcs
Bisturi Steril Scalpel Blade 36 Pcs
Catgut/ benang bedah ( Chromic ) no.2/0 pcs
Catgut/ benang bedah ( Chromic ) no.3/0 pcs
Catgut/ benang bedah ( plain ) no.2/0 pcs
Catgut/ benang bedah ( plain ) no.3/0 pcs
Cuticell Classic 10 x 10 cm Pcs
Dermafix T 10x8 Pcs
Dermafix T 5x7cm Pcs
Disposafe Safety box 5 liter box
Hydrogel Wound Dressing Pcs
Infus Set,IV,Wing needle (pediatrik) Pcs
Infusion set anak set
Infusion set dewasa set
IV Cannula No. 26 50 pcs/Ktk
IV Catheter No 26 Pcs
IV Catheter No 20 G Pcs
IV Catheter no.22 G Pcs
IV Catheter no.24 G Pcs
Kapas Pembalut 250 Gram Bungkus
Kasa Steril 16 X16 Lbr
Kasa pembalut 10 Cm Roll
Kasa pembalut 5 Cm Roll
Kasa pembalut Hidrofil 4 x 15 cm Rol
Kasa Pembalut Hidrofil 40m x 80cm Rol
Kassa kompres Steril 40 x 40 cm Rol
Leukoplast 1 x 5 cm Rol
Masker Pcs
Nasal OKsigen Anak Pcs
Nasal Oksigen Bayi Pcs
Nasal Oksigen Dewasa Pcs
Nonwoven Fixation 10cmx10m roll
Plain 3/0 HR - 27 Pcs
Plester 7,5 cm x 4,5 m (Leukoplast) Pcs
Polyprpyene 3/0 HR 22 Pcs
Sarung tangan - Size M Pcs
Sarung tangan Size L Pcs
Sarung tangan Size S Pcs
SERENITY Benang Operasi Plain Catgut With Needle 2.0
Kotak
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SERENITY Benang Operasi Plain Catgut With Needle 3.0

Kotak
SERENITY Benang Operasi Silk Braided Without Needle 2.0
Kotak
SERENITY Benang Operasi Silk Braided Without Needle 3.0
Kotak
Silk ( Benang Bedah Sutra ) no.2/0 dg jarum bedah Pcs
Silk ( Benang Bedah Sutra ) no.3/0 dg jarum bedah Pcs
Silk 3/0 TS - 27 Pcs
Surgical Gloves Steril Fr 7 Kotak
Surgical Gloves Steril Fr 7,5 Kotak

VII OBAT PROGRAM

MALARIA
Artesunate injeksi Vial
DHP tablet Tablet
Primakuin Tablet Tablet

KECACINGAN
Albendazol 400 mg Tab Tablet

TB PARU
OAT FDC Kategori 1 Paket
Azithromycin + Cefixime ( Kombipak) Paket
OAT FDC Kategori 2 Paket
OAT FDC Kategori ANAK Paket
Obat Antiberkulosis FDC Kategori Sisipan Paket

GIZI
Mineral Mix Sac
Tablet tambah darah Tablet
Vitamin A 100.000 IU Kapsul
Vitamin A 200.000 IU Kapsul

VIII OBAT KAPITASI

Ibuprofen 400 mg Tab Tablet
Calcimega Tablet
Metformin Tab Tablet
Metronidazole 500 mg Tablet
Neurotropik Vitamin Tab Tablet
Solvitron Kapsul Kapsul
Solafluz Syr Botol
Erladerm N Tube
Obat Batuk Kombinasi (HERBACOLD) Tablet
Multivitamin sirup (TYALISIN) Botol
Gentian Violet Tube
Nistatin Drop Botol
COPARCETIN Tablet

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IX OBAT GIGI
Eugenol Botol
Filtek Z250 Set
Biodinamika Clorexolar 2% Botol
Orafil Plus Temporary Filling Kotak

X OBAT HIV
Tenolam E Tablet
Vitamin B6 Tab (Piridoksin) Tablet

XII OBAT LAIN

Allupurinol 300 mg Tablet
Nistatin 500.000 IU Tablet
Eritromisin 250 mg Tablet
Azithromisin 500 mg Tablet
Oseltamivir Tablet
Favipiravir Tablet
Bexicom Z Tablet
Pehavit-D3 Tablet
MDT-Combi Kusta Blister
Herbakof Sirup Botol
Lancet pcs
Kassa hidrophile 16 cm x 16 cm Kotak
3HP Tablet
ASIMOR Tablet
Kilbag Wound Irrigation Botol
Pirantel Pamoat Tablet

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