LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

(LPLPO)

SUB UNIT : LAPORAN LPLPO :

PUSKESMAS : PANAGUAN PERMINTAAN OBAT :

KECAMATAN : PROPPO TAHUN : 2024

KAB/KOTA : PAMEKASAN

STOK PENERIMA PERSEDIAA PEMAKAI PERMINT PEMBER

NO. NAMA OBAT SISA STOK KET
AWAL AN N AN AAN IAN

1 2 4 5 6 7 8 9 10 12

OBAT PKD

1 ACETYLSISTEINE 200 MG

2 ALLOPURINOL 100 MG

3 ALLOPURINOL 300 MG

4 AMBROXOL 30 MG

5 AMBROXOL SYR

6 AMLODIPIN 10 MG

7 AMLODIPIN 5 MG

8 AMOKSISILIN 250 mg

9 AMOKSISILIN 500 mg

10 AMOXICILIN 125 mg SYIRUP

11 AMOXICILIN 250 mg SYIRUP

12 ANTALGIN / METAMIZOL 500 MG

13 ANTASIDA DOEN TABLET

14 ANTITUSIF ANAK (SAMCODRIL SYRUP)

15 ASAM ASCORBAT 250 MG

16 ASAM ASCORBAT 50 MG

17 ASAM MEFENAMAT 500 MG

18 ASIKLOVIR 200 Mg

19 ASIKLOVIR 400 Mg

20 ASIKLOVIR CREAM

21 BETAHISTIN MESILAT 6 MG

22 BETAMETHASONE CREAM

23 CALORTUSIN TABLET

24 CAPTOPRIL 12,5 Mg

25 CAPTOPRIL 25 Mg

26 CAPTOPRIL 50 MG

27 CETIRIZINE 10 MG

28 CETIRIZINE SIRUP

29 CIPROFLOXACIN 500 mg

30 DEMACOLIN / ANTI INFLUENZA TABLET

31 DEXAMETHASONE 0,5 TAB

32 DEXAMETHASONE INJEKSI

33 DIFENHIDRAMIN HCL INJ

34 DIMENHIDRINAT 50 MG

35 DOMPERIDONE 10 MG

36 DOMPERIDONE SUSPENSI

37 ERITROMICIN SIRUP

38 GARAM ORALIT

39 GENTAMICIN SK

40 GENTAMICIN TM

41 GENTIAN VIOLET

42 GLIBENCLAMIDE 5Mg

43 GLIMEPIRIDE 1 MG

44 GLIMEPIRIDE 2 MG

45 GLIMEPIRIDE 3 MG

46 GLIMEPIRIDE 4 MG

47 GUAIFENESIN/GLISERIL GUAIAKOLAT TAB

48 HIDROCORTISONE CREAM 2,5%

49 IBU PROFEN 200 MG

50 IBU PROFEN 400 Mg

51 IBU PROFEN SYR 100 MG

52 KALSIUM LACTAT 500 MG

53 KETOKONAZOLE 200 Mg
54 KETOKONAZOLE CREAM 5 G

55 KLINDAMISIN KAPS 300 MG

56 KLINDAMISIN KAPS 150 MG

57 KLORAMPHENICOL 250 MG KAPSUL

58 KLORAMPHENICOL 500 MG KAPSUL

59 KLORAMPHENICOL SK/ BUFACETIN TUBE

60 KLORAMPHENICOL SYIRUP

61 KLORAMPHENICOL TM 0,5 % (RECO)

62 KLORAMPHENICOL TT 3% (RECO)

63 KLORPHENIRAMIN MALEAT 4 MG/CTM

64 KOTRIMOXAZOL 120 MG

65 KOTRIMOXAZOL 480 mg

66 KOTRIMOXAZOLE SYIRUP

67 LIDOCAIN COMB 2 % INJEKSI

68 LOPERAMID 2 MG/LEXADIUM

69 LORATADIN 10 MG

70 METFORMIN 500 MG

71 METIL ERGOMETRIN INJEKSI

72 METILPREDNISOLON 4 MG

73 METILPREDNISOLON INJ

74 METOCLOPRAMEDE/ SOTATIK INJEKSI

75 METOKLOPRAMIDE/GAVISTAL DROP

76 METOKLORPAMIDE 10 MG

77 METOKLORPAMIDE 5 MG

78 METOKLORPAMIDE/LEXAPRAM SIRUP

79 METRONIDAZOLE 250 MG

80 METRONIDAZOLE 500 Mg

81 METRONIDAZOLE INFUS

82 METRONIDAZOLE SIRUP

83 MGSO4 20%

84 MGSO4 40%

85 MICONAZOLE 2% CREAM

86 Na Cl INFUS

87 NATRIUM DIKLOFENAC 25 mg

88 NATRIUM DIKLOFENAC 50 mg

89 NEW ANTIDES (ATTAPULGITE)/PULAREX

90 OBH SIRUP

91 OMEPRAZOLE 20 MG

92 OXITOCIN INJ

93 OXYTETRACYCLIN 3% SK

94 PARASETAMOL 500 mg

95 PARASETAMOL DROP

96 PARASETAMOL SIRUP

97 PARASETAMOL SUPP (PROPYRETIC)

98 PIRIDOXIN (VIT B6) 10 MG

99 PIROKSIKAM 10 MG

100 PHYTOMENADIONE 10 MG (VIT K)

101 PHYTOMENADIONE INJEKSI (VIT K)

102 PREDNISON TABLET 5 MG

103 RINGER LAKTAT / RL INFUS

104 RANITIDIN 150 mg

105 RANITIDIN INJEKSI

106 SALBUTAMOL 2 mg

107 SALBUTAMOL 4 mg

108 SALBUTAMOL/VENTOLIN NEBULESER

109 SALEP 2-4

110 SALICYL BEDAK 2%

111 SCABIMET SK

112 SEFADROXIL 250 CAPSUL

113 SEFADROXIL 500 CAPSUL

114 SEFADROXIL SYIRUP KERING

115 SIANOKOBALAMIN HCL/B12 INJ.

116 SIMVASTATIN 10 Mg

117 SIMVASTATIN 20 Mg

118 TABLET TAMBAH DARAH

119 TETRACYCLIN HCL 250 mg

120 TETRACYCLIN HCL 500 mg

121 THIAMIN HCL (B1) 50 MG

122 THIAMIN HCL (B1) INJEKSI

123 THIAMPHENICOL 500 MG / SOLATHIM

124 THIAMPHENICOL SIRUP

125 VIT. B COMPLEKS INJEKSI

126 ZINK 20 MG TAB

127 ZINKID SIRUP

128 SUNTIK KB

129 PIL KB

BMHP PKD

1 ALAT SUNTIK 0,05 ML

2 ALAT SUNTIK 0,5 ML

3 ALAT SUNTIK 1 ML

4 ALAT SUNTIK 2,5 ML

5 ALAT SUNTIK 2,5 ML

6 ALAT SUNTIK 3 ML

7 ALAT SUNTIK 5 ML

8 ALAT SUNTIK 10 ML

9 AQUA PRO INJEKSI

10 CAT GUT CROMIC + PLAIN

11 FOLLEY CATETER NO 16

12 FOLLEY CATETER NO 18

13 FOLLEY CATETER NO 20

14 FOLLEY CATETER NO 24

15 INFUS SET ANAK

16 INFUS SET DEWASA

17 IV. CATHETER NO. 18

18 IV. CATHETER NO. 20

19 IV. CATHETER NO. 22

20 IV. CATHETER NO. 24

21 BENANG SILK

22 URINE BAG

23 SPUIT 3 CC KB

24 KASA 2X80

25 POVIDINE 300ML

26 MASKER

OBAT KAPITASI

1 ACETYLSISTEINE 200 MG

2 ALLOPURINOL 100 MG

3 ALLOPURINOL 300 MG

4 AMBROKSOL 30 MG

5 AMBROKSOL SYR

6 AMLODIPIN 10 MG

7 AMLODIPIN 5 MG

8 AMOKSISILIN 250 mg

9 AMOKSISILIN 500 mg

10 AMOXICILIN 125 mg SYRUP

11 AMOXICILIN 250 mg SYRUP

12 ANTALGIN / METAMIZOL 500 MG

13 ANTASIDA DOEN TABLET

14 ANTITUSIF ANAK (SAMCODRIL SYRUP)

15 ASAM ASCORBAT 250 MG

16 ASAM ASCORBAT 50 MG

17 ASAM MEFENAMAT 500 MG

18 ASIKLOVIR 200 Mg

19 ASIKLOVIR 400 Mg

20 ASIKLOVIR CREAM

21 BETAHISTIN MESILAT 6 MG

22 BETAMETHASONE CREAM

23 CALORTUSIN TABLET

24 CAPTOPRIL 12.5 Mg

25 CAPTOPRIL 25 Mg

26 CAPTOPRIL 50 MG
27 CETIRIZINE 10 MG

28 CETIRIZINE SIRUP

29 CIPROFLOXACIN 500 mg

30 DEMACOLIN / ANTI INFLUENZA TABLET

31 DEXAMETHASONE 0,5 TAB

32 DEXAMETHASONE INJEKSI

33 DIFENHIDRAMIN HCL INJ

34 DIMENHIDRINAT 50 MG

35 DOMPERIDONE 10 MG

36 DOMPERIDONE SUSPENSI

39 GENTAMICIN SK

40 GENTAMICIN TM

41 GENTIAN VIOLET

42 GLIBENCLAMIDE 5Mg

43 GLIMEPIRIDE 1 MG

44 GLIMEPIRIDE 2 MG

45 GLIMEPIRIDE 3 MG

46 GLIMEPIRIDE 4 MG

47 GUAIFENESIN/GLISERIL GUAIAKOLAT TAB

48 HEMAFORT

49 HIDROCORTISONE CREAM 2,5%

50 IBU PROFEN 200 MG

51 IBU PROFEN 400 Mg

52 IBU PROFEN SYR 100 MG

53 KALSIUM LACTAT 500 MG

54 KETOKONAZOLE 200 Mg

55 KETOKONAZOLE CREAM 5 G

56 KLINDAMISIN KAPS 300 MG

57 KLINDAMISIN KAPS I50 MG

58 KLORAMPHENICOL 250 MG KAPSUL

59 KLORAMPHENICOL 500 MG KAPSUL

60 KLORAMPHENICOL SK/ BUFACETIN TUBE

61 KLORAMPHENICOL SYIRUP

62 KLORAMPHENICOL TM 0,5 % (RECO)

63 KLORAMPHENICOL TT 3% (RECO)

64 KLORPHENIRAMIN MALEAT 4 MG/CTM

65 KOTRIMOXAZOL 120 MG

66 KOTRIMOXAZOL 480 mg

67 KOTRIMOXAZOLE SYIRUP

68 LIDOCAIN COMB 2 % INJEKSI

69 LOPERAMID 2 MG/LEXADIUM

70 LORATADIN 10 MG

71 METFORMIN 500 MG

72 METIL ERGOMETRIN INJEKSI

73 METILPREDNISOLON 4 MG

74 METILPREDNISOLON INJ

75 METOCLOPRAMEDE/ SOTATIK INJEKSI

76 METOKLOPRAMIDE/GAVISTAL DROP

77 METOKLORPAMIDE 10 MG

78 METOKLORPAMIDE 5 MG

79 METOKLORPAMIDE/LEXAPRAM SIRUP

80 METRONIDAZOLE 250 MG

81 METRONIDAZOLE 500 Mg

82 METRONIDAZOLE INFUS

83 METRONIDAZOLE SIRUP

84 MGSO4 20%

85 MGSO4 40%

86 MICONAZOLE 2% CREAM

87 Na Cl INFUS

88 NATRIUM DIKLOFENAC 25 mg

89 NATRIUM DIKLOFENAC 50 mg

90 NEW ANTIDES (ATTAPULGITE)/PULAREX

91 OBH SIRUP

92 OMEPRAZOLE 20 MG

93 OXITOCIN INJ

94 OXYTETRACYCLIN 3% SK

95 PARASETAMOL 500 mg
96 PARASETAMOL DROP

97 PARASETAMOL SIRUP

98 PARASETAMOL SUPP (PROPYRETIC)

99 PIRIDOXIN (VIT B6) 10 MG

100 PIROKSIKAM 10 MG

100 PHYTOMENADIONE 10 MG (VIT K)

101 PHYTOMENADIONE INJEKSI (VIT K)

101 PREDNISON TABLET 5 MG

102 RINGER LAKTAT / RL INFUS

103 RANITIDIN 150 mg

104 RANITIDIN INJEKSI

105 SALBUTAMOL 2 mg

106 SALBUTAMOL 4 mg

107 SALBUTAMOL/VENTOLIN NEBULESER

108 SALEP 2-4

109 SALICYL BEDAK 2%

110 SEFADROXIL 250 CAPSUL

111 SEFADROXIL 500 CAPSUL

112 SEFADROXIL SYIRUP KERING

113 SIANOKOBALAMIN HCL/B12 INJ.

114 SIMVASTATIN 10 Mg

115 SIMVASTATIN 20 Mg

116 TETRACYCLIN HCL 250 mg

117 TETRACYCLIN HCL 500 mg

118 THIAMIN HCL ( B1 ) 50 MG

119 THIAMIN HCL ( B1 ) INJEKSI

120 THIAMPHENICOL 500 MG / SOLATHIM

121 THIAMPHENICOL SIRUP

122 VIT.B.COMPLEX INJEKSI

123 ZINK 20 MG TAB

124 ZINKID SIRUP

BHP KAPITASI

1 ALAT SUNTIK 0.05 ML

2 ALAT SUNTIK 0.5 ML

3 ALAT SUNTIK 1 ML

4 ALAT SUNTIK 2.5 ML

5 ALAT SUNTIK 3 ML

6 ALAT SUNTIK 5 ML

7 ALAT SUNTIK 10 ML

8 ALKOHOL 70 % 1 LITER

9 CATGUT CHROMIC 2/0- 3/0 HR 24-26 MM

10 CATGUT PLAIN 2/0- 3/0 Ds 24-26 MM

11 DERMAFIX 10 X 8

12 DERMAFIX 5 X 7

13 ETHYL KLORIDA

14 FIXOMUL

15 FOLLEY CATETER NO 16

16 FOLLEY CATETER NO 18

17 FOLLEY CATETER NO 20

18 FOLLEY CATETER NO 24

19 HAND RUB 5 L

20 HAND RUB 500 ML

21 HAND SCOEN (PP)

22 HAND SCOEN Non Steril S,M, L free pwdr

23 HAND SCOEN STERIL (PF)

24 HAND SCOEN steril uk. 7/7,5

25 HAND SCRUB 5 L

26 HAND SCRUB 500 ML

27 HYPAFIX / ULTRAVIX 2,5X5

28 INFUS SET ANAK

29 INFUS SET DEWASA

30 IV DRESSING

31 IV. CATHETER NO 18

32 IV. CATHETER NO 20

33 IV. CATHETER NO 22

34 IV. CATHETER NO 24
35 KALIUM PERMANGANAT

36 KAPAS PEMBALUT 250 GR

37 KAPAS PEMBALUT 500 GR

38 KASA BESAR/ GULUNG (80 X 40)

39 KASA 2M X 80CM

40 KASA 4 X 15 CM

41 KASA 4 X 3 CM

42 KASA KOMPRES 40X40

43 KASA STERIL 16X16

44 MASKER 3 PLY/BEDAH

46 MASKER N95

47 PERHIDROL /H2O2 3 %

48 PLESTER 2.5 X 4.5

49 PLESTER 7.5 CM X 4.5 CM

50 PLESTER E CARE

51 POVIDON YODIDA 1 LITER

52 POVIDON YODIDA 30 ML

53 POVIDON YODIDA 300 ML

54 POVIDON YODIDA 60 ML

55 RIVANOL

56 SELANG O2 NEBUL ANAK

57 SELANG O2 NEBUL DEWASA

58 MASKER O2 ANAK

59 MASKER O2 DEWASA

60 SILK BLACK 2/0- 3/0 HR 26-30 MM

61 SILK BLACK 2/0-3/0 DS 24-26 MM

62 TEST KEHAMILAN

63 UNDERPAD

64 URINE BAG

YANG MENYERAHKAN YANG MENERIMA

PETUGAS GUDANG OBAT

NOVITA FATIMAH FAHMI, Amd

NIP. 19891030 201902 2 004

MENGETAHUI / MENYETUJUI

KEPALA PUSKESMAS PENANGGUNG JAWAB FARMASI

NURUL INAYAH, S.ST apt. JUMAHWI, S.Farm.

NIP. 19771103 200501 2 006 NIP. 19960603 202203 1 002