LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

(LPLPO)

Unit Penerima : SENTOSA BARU Pelaporan : OKTOBER 2019 DOKUMEN NOMOR TANGGAL
Kecamatan : MEDAN PERJUANGAN Permintaan : NOVEMBER 2019 GFK
Kabupaten : KOTA MEDAN PUSKESMAS 06-11-2019
Provinsi : SUMATERA UTARA

Stok Perminta Pemberian

Kode Obat Nama Obat Sediaan Stok Awal Penerimaan Persediaan Pemakaian Rusak/Ed Sisa Stok Keterangan
Optimum an
10315 2 - 4 SALEP POT 0 0 0 0 - 0 0
119 ACYCLOVIR TABLET 200 MG TABLET 8023 0 8023 143 7,880 286 0
120 ACYCLOVIR TABLET 400 MG TABLET 0 0 0 0 - 0 0
175 ALBENDAZOLE TABLET 400 MG TABLET 2985 0 2985 0 2,985 0 0
247 ALLOPURINOL TABLET 100 MG TABLET 8033 0 8033 473 7,560 946 0
444 AMITRIPTYLINE TABLET 25 MG TABLET SALU 490 0 490 0 490 0 0
446 AMLODIPINE TABLET 5 MG TABLET 8,842 0 8842 395 8,447 790 0
540 AMOXYCILLIN SIRUP 125 MG/5 ML BOTOL 0 0 0 0 - 0 0
507 AMOXYCILLIN TABLET 250 MG CAPSUL 430 5000 5430 1,617 3,813 3,234 3,000
511 AMOXYCILLIN TABLET 500 MG CAPTABS 2049 0 2049 2,049 - 4,098 10,000
809 ANTASIDA TABLET 400 MG TABLET KUN 9352 0 9352 9,352 - 18,704 5,000
12424 ANTI-FUNGI DOEN Kombinasi : ASAM BENZOAPOT 0 0 0 0 - 0 0
12425 ASAM FOLAT 400 MCG Tablet 0 0 0 0 - 0 0
966 ASAM MEFENAMAT TABLET 500 MG CAPTABS SA 0 0 0 0 - 0 0
926 ASCORBIC ACID (VITAMIN C) TABLET 50 MG Tablet 2324 0 2324 2,324 - 4,648 10,000
12461 ASEPTIC GEL 500 CC BOTOL 10 0 10 0 10 0 0
1214 ATAPULGIT TABLET 600 MG TABLET 4,668 3000 7668 1,041 6,627 2,082 0
1277 ATROPINE SULPHATE TABLET 0.5 MG TABLET 0 0 0 0 - 0 0
1599 BETAMETHASONE SALEP 0.1% TUBE 315 0 315 43 272 86 0
1866 CALCIUM GLUCONATE INJEKSI 10 ML BOTOL 0 0 0 0 - 0 0
2005 CALCIUM LACTATE TABLET 500 MG TABLET 0 0 0 0 - 0 0
2073 CAPTOPRIL TABLET 12.5 MG TABLET 0 0 0 0 - 0 1,000
2075 CAPTOPRIL TABLET 25 MG TABLET 0 0 0 0 - 0 0
AK9002716 CAT GUT PLAIN 3 - 0 PCS 0 0 0 0 - 0 0
2518 CETIRIZINE SIRUP 1 MG/ML BOTOL 0 0 0 0 - 0 0
2574 CHLORAMPHENICOL DROPS 0.5% BOTOL 11 0 11 5 6 10 0
2601 CHLORAMPHENICOL SALEP KULIT 2% TUBE 353 0 353 61 292 122 0
2593 CHLORAMPHENICOL SIRUP 125 MG/5ML BOTOL 0 0 0 0 - 0 0
2745 CHLORPHENIRAMINE TABLET 4 MG TABLET 3938 10000 13938 8,658 5,280 17,316 10,000
2763 CHLORPROMAZINE TABLET 100 MG TABLET SALU 990 0 990 0 990 990 0 0
10499 CIPROFLOXACIN TABLET 500 MG /50 CAPL M CAPTABS SA 2777 0 2777 807 1,970 1,614 0
2988 CLINDAMYCIN TABLET 300 MG CAPSUL 0 0 0 0 - 0 0
 Stok Perminta Pemberian
Kode Obat Nama Obat Sediaan Stok Awal Penerimaan Persediaan Pemakaian Rusak/Ed Sisa Stok Keterangan
Optimum an
6644 COTRIMOXAZOLE SIRUP BOTOL 0 0 0 0 - 0 0
AK9003539 CUTICELL 10 CM X 10 CM PCS 20 0 20 1 19 2 0
11951 CYANOCOBALAMIN INJEKSI 500 MCG/ML AMPUL 490 0 490 0 490 0 0
3416 DEXAMETHASONE INJEKSI 5 MG/ML AMPUL 300 0 300 0 300 0 0
3443 DEXAMETHASONE TABLET 0.5 MG TABLET 10,298 5000 15298 4,716 10,582 9,432 5,000
3642 DIAZEPAM TABLET 5 MG TABLET 199 0 199 176 23 352 500
3964 DOMPERIDONE SIRUP 5 MG/5 ML BOTOL 0 0 0 0 - 0 0
4030 DOXYCYCLINE TABLET 100 MG CAPSUL 0 0 0 0 - 0 0
4306 EPINEPHRINE INJEKSI 1 MG\/ML AMPUL 15 0 15 0 15 0 0
4458 ERYTHROMYCIN TABLET 250 MG CAPSUL 0 0 0 0 - 0 0
12403 FDC ANAK : RHZ (75\/ 50\/ 150) mg RifampisiPAKET 0 0 0 0 - 0 0
12418 FDC Kat. I : RHZE (150\/75\/400\/275)mg+R PAKET 0 0 0 0 - 0 0
12416 FDC Kat.II : RHZE (150\/75\/400\/275) ms+S PAKET 0 0 0 0 - 0 0
4809 FERROUS SULPHATE TABLET 300 MG TABLET SALU 0 0 0 0 - 0 0
9260 FITOMENADION (VITAMIN K) INJEKSI 2 MG\/ AMPUL 0 0 0 0 - 0 0
AK9004635 FIXOMULL TRANSPARANT 5 X 10 ROLL 55 0 55 4 51 8 0
5167 GENTAMYCIN SALEP 0.3 % TUBE 0 0 0 0 - 0 0
5265 GLIMEPIRIDE TABLET 2 MG TABLET 0 0 0 0 - 0 500
5300 GLUCOSE INFUS 5 % BOTOL 0 0 0 0 - 0 0
5634 HALOPERIDOL DROPS 2 MG/ML BOTOL 5 0 5 0 5 0 0
5635 HALOPERIDOL INJEKSI 5 MG\/ML AMPUL 12 0 12 0 12 12 0 0
5641 HALOPERIDOL TABLET 2 MG TABLET 0 0 0 0 - 0 0
5642 HALOPERIDOL TABLET 5 MG TABLET 420 0 420 0 420 420 0 0
5837 HYDROCORTISONE SALEP 1 % TUBE 0 0 0 0 - 0 0
5949 IBUPROFEN SIRUP 100 MG/5 ML BOTOL 0 0 0 0 - 0 0
5964 IBUPROFEN TABLET 200 MG TABLET 0 0 0 0 - 0 0
12312 IODINE TEST BOTOL 0 0 0 0 - 0 0
6323 ISONIAZID TABLET 300 MG TABLET 0 0 0 0 - 0 0
6498 KAPAS PEMBALUT SET 250 G BUNGKUS 47 0 47 17 30 34 0
12392 KASA HYDROFIL 4 m x 5 cm ROLL 0 0 0 0 - 0 0
12318 Kasa Pembalut Hydrofil 4 x 10cm ROLL 0 0 0 0 - 0 0
12378 KASA STERIL DRC 16cm x 16cm (16Pads) BOX 136 0 136 35 101 70 0
6535 KETOCONAZOLE SALEP 2% TUBE 11 0 11 11 - 22 0
6920 LIDOCAINE INJEKSI AMPUL 484 0 484 156 328 312 0
6899 LIDOCAINE|EPINEPHRINE INJEKSI AMPUL 23 0 23 0 23 0 0
7013 LORATADINE TABLET 10 MG CAPTABS 0 0 0 0 - 0 3,000
7025 LORAZEPAM TABLET 1 MG TABLET 767 0 767 30 737 60 0
12753 LYSOL CONCENTRATE BOTOL 48 0 48 2 46 4 0
12389 MASKER (TALI) BOX 0 0 0 0 - 0 0
7491 METFORMIN HCL TABLET 500 MG TABLET SALU 0 0 0 0 - 0 1,000
7695 METRONIDAZOLE TABLET 250 MG TABLET 0 0 0 0 - 0 0
 Stok Perminta Pemberian
Kode Obat Nama Obat Sediaan Stok Awal Penerimaan Persediaan Pemakaian Rusak/Ed Sisa Stok Keterangan
Optimum an
7718 MICONAZOLE SERBUK 20 MG/G POT 0 0 0 0 - 0 0
8162 NIFEDIPINE TABLET 30 MG TABLET PEL 0 0 0 0 - 0 0
AK9007601 OBJECK GLASS 76 X 26 MM BOX 0 0 0 0 - 0 0
8373 OMEPRAZOLE KAPSUL 20 MG CAPSUL 7173 0 7173 2,004 5,169 4,008 3,000
8481 OXYTOCIN INJEKSI 10 IU\/ML AMPUL 5 0 5 0 5 0 0
8608 PARACETAMOL SIRUP 125 MG/5 ML BOTOL 0 0 0 0 - 0 0
9125 PHENOBARBITAL TABLET 30 MG TABLET 1860 0 1860 0 1,860 0 0
12368 PLESTER 5 CM X 4,5 M ROLL 13 0 13 0 13 0 0
12559 POT SPUTUM PCS 0 0 0 0 - 0 0
9494 POVIDONE IODINE 60 ML BOTOL 0 0 0 0 - 0 0
9583 PREDNISONE TABLET 5 MG TABLET 0 0 0 0 - 0 0
10014 RANITIDINE TABLET 150 MG TABLET SALU 0 0 0 0 - 0 0
12813 REAGEN TB PAKET 0 0 0 0 - 0 0
10087 RETINOL (VITAMIN A) 100.000 UI CAPSUL LUN 0 0 0 0 - 0 0
12932 RETINOL (VITAMIN A) 200.000 UI CAPSUL LUN 0 0 0 0 - 0 0
12877 RIFAMPICIN 300 MG | CLOFAMIZINE 100 MG TABLET 0 0 0 0 - 0 0
12946 RINGER LAKTAT 1000 ML BOTOL 0 0 0 0 - 0 0
10182 RIVANOL LIQUID BOTOL 28 0 28 1 27 2 0
10265 SALBUTAMOL SPRAY 100 MCG INHALER (PA 0 0 0 0 - 0 0
10307 SALBUTAMOL TABLET 4 MG (SEBAGAI SULFAT)TABLET 4500 0 4500 50 4,450 100 0
10331 SALICYLIC ACID SERBUK 2% BUNGKUS 0 0 0 0 - 0 0
AK9008942 SARUNG TANGAN KARET NON STERIL L BOX 12 0 12 5 7 10 10
AK9009378 SILK 3 - 0 PCS 2 0 2 0 2 0 0
10532 SODIUM CHLORIDE INFUS 0.9 % BOTOL 0 0 0 0 - 0 20
AK9009623 SPUIT 1 CC TUBERCULIN PCS 0 0 0 0 - 0 0
AK9009629 SPUIT 3 CC PCS 200 0 200 0 200 0 500
11115 TETRACYCLINE TABLET 250 MG CAPSUL 2100 0 2100 392 1,708 784 0
11116 TETRACYCLINE TABLET 500 MG CAPSUL 474 0 474 474 - 948 2,000
11328 THIAMINE (VITAMIN B1) TABLET 50 MG (HCL\TABLET 18194 0 18194 3,363 14,831 6,726 0
11921 VITAMIN B COMPLEX TABLET 25 MG TABLET 15752 0 15752 5,741 10,011 11,482 10,000
12192 ZINC SULPHATE TABLET 20 MG TABLET DISP 1,611 0 1611 41 1,500 1,570 82 2,000
Adalat Oros 30 tablet 300 0 300 0 300 0 0
Alkohol 70% Botol 43 0 43 5 38 10 0
Aminophillin 200 mg tablet 800 0 800 0 800 0 0
Amlodipin 10 mg tablet 8997 0 8997 805 8,192 1,610 0
Antihaemoroid Supp 9 50 59 0 59 0 0
Asetilsistein Tablet 2370 0 2370 30 2,340 60 0
CLINDAMYCIN TABLET 150 MG tablet 7600 0 7600 50 7,550 100 0
Cotrimoxazole 480 tablet 0 0 0 0 - 0 0
 Stok Perminta Pemberian
Kode Obat Nama Obat Sediaan Stok Awal Penerimaan Persediaan Pemakaian Rusak/Ed Sisa Stok Keterangan
Optimum an
Diazepam Injeksi Ampul 480 0 480 0 480 0 0
Dietilcarbamazepin tablet 3000 0 3000 0 3,000 3,000 0 0
ERYTHROMYCIN Syrup Botol 173 0 173 79 94 158 0
Eugenol Cairan Botol 0 0 0 0 - 0 0
FITOMENADION (VITAMIN K) Tablet Tablet 5482 0 5482 180 5,302 360 0
Glibenklamid 5 mg Tablet 10879 0 10879 603 10,276 1,206 0
Ketokonazole 200 mg Tablet 6207 0 6207 111 6,096 222 0
LORAZEPAM TABLET 0,5 MG/Merlopam tablet 850 0 850 0 850 0 0
METRONIDAZOLE TABLET 500 MG TABLET 0 0 0 0 - 0 0
Miconazol Krim Tube 244 0 244 57 187 114 0
Natrium Diklofenak 50 TABLET 0 0 0 0 - 0 5,000
Parasetamol TABLET 500 MG TABLET 0 0 0 0 - 0 0
Resperidone 2 mg tablet 0 0 0 0 - 0 1,000
Sarung Tangan Karet Steril Pcs 1435 0 1435 11 1,424 22 0
Simvastatin 10 mg tablet 1499 0 1499 517 982 1,034 500
Hidrokortison 2,5% Tube 979 0 979 101 878 202 0
Vit B6/Pyridoxin HCl tablet 39837 0 39837 278 39,559 556 0
Betadine Salep Antiseptik 10 g Tube 83 0 83 1 82 2 0
Blood Lancet Box 0 0 0 0 - 0 500
Haloperidol 1.5 mg tablet 70 0 70 0 70 0 0
Furosemid Tablet 1795 0 1795 115 1,680 230 0
Hidrochlortiazid Tablet 2000 0 2000 0 2,000 0 0
Isosorbid Dinitrat (ISDN) Tablet 1950 0 1950 0 1,950 0 0
Metoklopramid Tablet 831 0 831 183 648 366 0
Nistatin 500.000 tablet 1940 0 1940 0 1,940 0 0
Parasetamol Drops 100 mg/ml Btl 41 0 41 30 11 60 0
POVIDONE IODINE 30 ML Botol 87 0 87 3 84 6 0
POVIDONE IODINE 300 ML Botol 49 0 49 8 41 16 0
ADS 0,5 ml SOLOSOT MINI Kotak 0 0 0 0 - 0 0
RCW Unit 0 0 0 0 - 0 0
Griseofulvin 125 mg Tablet 0 0 0 0 - 0 1,000
Metronidazole Sirup Botol 0 0 0 0 - 0 100
Metilprednisolon 4 mg Tablet 0 0 0 0 - 0 2,000
Spuit 5 cc Pcs 0 0 0 0 - 0 300
Antasida Sirup Botol 0 0 0 0 - 0 200
 Stok Perminta Pemberian
Kode Obat Nama Obat Sediaan Stok Awal Penerimaan Persediaan Pemakaian Rusak/Ed Sisa Stok Keterangan
Optimum an
Cetirizine Tablet 0 0 0 0 - 0 1,000
Diazepam enema 5 mg (Stesolid Rectal) Pcs 0 0 0 0 - 0 10

JUMLAH KUNJUNGAN RESEP BAYAR UMUM PHB JUMLAH

817 2700 3517

Mengetahui/Menyetujui Yang Menyerahkan Yang Meminta Yang Menerima

a.n Kepala Dinas Kesehatan Kota Medan Kepala Gudang Farmasi Pimpinan Puskesmas Petugas Puskesmas
Kabid Sumber Daya Kesehatan

Drg.Mimi Defrina,MHSM Rusmanto, Ssi, Apt dr. Jusup Paska Ginting Lidya Faridawaty
NIP:19670129 199203 2 001 NIP:19650414 199703 1 004 NIP. 19800420 201101 1007 NIP. 19810222 200604 2 007
 Stok Perminta Pemberian
Kode Obat Nama Obat Sediaan Stok Awal Penerimaan Persediaan Pemakaian Rusak/Ed Sisa Stok Keterangan
Optimum an
 0 0 0
8668 0 8668
0 0 0
0 0 0
10200 1572 11772
500 0 500
9274 0 9274
0 0 0
6900 0 6900
20400 3840 24240
0 0 0
0 0 0
0 0 0
0 0 0
14950 3210 18160
14 0 14
7400 2654 10054
0 0 0
582 14 596
0 0 0
1120 650 1770
0 0 0
0 0 0
0 0 0
0 0 0
40 18 58
670 0 670
132 0 132
23240 0 23240
990 0 990
5900 300 6200
1326 0 1326
 0 0 0
35 0 35
500 0 500
300 0 300
22000 2050 24050
650 97 747
0 0 0
0 0 0
15 0 15
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
82 0 82
0 0 0
0 0 0
0 0 0
5 0 5
12 0 12
0 0 0
420 0 420
24 0 24
60 0 60
3200 2800 6000
0 0 0
0 0 0
61 7 68
0 0 0
0 0 0
190 4 194
9 79 88
500 0 500
30 0 30
0 0 0
1003 91 1094
60 0 60
0 0 0
700 900 1600
0 0 0
 0 0 0
0 0 0
0 0 0
6830 0 6830
5 0 5
0 0 0
1890 0 1890
20 0 20
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
20 0 20
48 0 48
0 0 0
4500 0 4500
0 0 0
40 0 40
2 0 2
0 8 8
0 0 0
400 0 400
2700 136 2836
3100 2440 5540
24790 0 24790
19400 4600 24000
1800 480 2280
360 90 450
62 0 62
800 0 800
10440 0 10440
70 0 70
2700 1000 3700
7600 0 7600
0 0 0
 480 0 480
3000 0 3000
285 74 359
0 0 0
5900 260 6160
12100 0 12100
4600 234 4834
870 0 870
0 0 0
480 0 480
2450 1700 4150
0 0 0
5 0 5
1440 0 1440
2960 0 2960
216 0 216
40960 0 40960
90 0 90
0 0 0
200 0 200
2000 0 2000
2000 0 2000
2000 0 2000
1240 0 1240
2000 0 2000
140 0 140
92 0 92
72 0 72