Timestamp Tanggal Pelaporan Penanggung Jawab Keterangan Password

AMOXICILLIN AMOXICILLIN COTRI COTRI COTRI PARACETAMOL PARACETAMOL

ANTASIDA
500 MG SYRUP AD PED SYR 500 MG DROP
PARACETAMOL VIT VIT VIT B VIT C VIT ACETIL
CTM GG PRED DEXA B COM
SYRUP B1 B6 12 50 250 SISTEIN
ACYCLOVIR ACYCLOVIR ALLUPURINOL ALLUPURINOL AMLODIPINE
ALBENDAZOLE
400 200 100 MG 300 MG 5
AMLODIPINE ADALAT ASAM
AMBROXOL AS.FOLAT ATORVASTATIN BETAHISTIN
10 OROS MEFENAMAT
 CIPRO CEFAD CHLORAMEX DOMPERIDON
CAPTOPRIL CEFIXINE CETRIZINE CIMETIDIN
500 TAB 500 TAB
DOXYCLLIN D-ARTEPP ERGOTAMIN ERITROMICIN FLUCONAZOLE
FUROSEMIDE
TAB (ANTI MLARIA) MALEAT 500 TAB
GEMFIBROZIL GLIMIPIRIDE
GLIMIPIRID I GLIBENCLAMIDE GRISEOFULVIN HIOREX HUSTAB
500 2
 IBUPROFEN IBUPROFEN KALSIUM KETOKENAZOLE
ISDN INH LANZOPRAZOLE
400 200 LAKTAT TAB
LEFOFLOXACIN LOPERAMIDE METFORMIN MELOXICAM METILERGOMETRIN
METOCLOPRAMIDA METRONIDAZOLE METYL NYSTATIN OFLOXASIN
NAT.DIKLOFENAK
TAB 500 PREDNISON TAB 400 MG
 PIRANTEL
OMEPRAZOL ORALIT PTU PAPAVERIN PHENILBUTAZON PIROXICAM RANITIDIN
PAMOAT
 SIMVASTATIN SIMVASTATIN THIAMFENICOL TETRA
SALBUTAMOL SCOPMA SF
10 MG 20 MG 500 250
VALSARTAN VALSARTAN AMOKS ANTASIDA AMBROXOL CEFAD
VIT. K ZINK
80 160 FORTE SYR SIRUP SRP SIRUP
CETRIZIN CHLORAMFENIKOL DOMPERIDON ELKANA IBUPROFEN LEXAPRAM NOVADIAR
SYR SIRUP SUSPENSI SYR SIRUP SIRUP SYR
PIRANTEL ZINK ANTIHEMOROID BASITRASIN ACYCLOVIR BETAMETASON
SYR SYR SUPP ZK ZK ZK
BETAMETASON TTS BUFACETIN CALADINE CHLORAMFENICOL CHLORO TTS DERMIFAR
MATA/BETAM ZK LOTION ZM TELINGA CREAM
FUCILEX GENTAMISIN GENTAMISIN GENTAMISIN HIDROKORTISON ILIADIN ILIADIN
SALEP SALEP KULIT SALEP MATA TETES MATA SALEP KULIT ANAK DEWASA
 KARBO KETOKENAZOLE MIKONAZOLE MOMETASON NYSTATIN OZY TETRA
GLISERIL TTS ZK ZK KREM VAGINA ZM
OXY TETRA SALEP SALISIL SCABIMITE TARIVID TTS ALPRAZOLAM
AMITRIPTILLIN ANALSIK
ZK 24 TALK CREAM TELINGA 0,5
DIAZEPAN DIAZEPAN HALOPERIDOL HALOPERIDOL CHLORPROMAZINE STESOLID
CODEIN
TAB INJ. 5 1,5 25 5
TRYHEXYPHENIDIL
SYMBICORT
TAB
 Tanggal Ambroxol Ambroxol Amlodipin Amlodipin
Timestamp
Pelaporan tablet 30 mg syrup tab 10 mg tab 5 mg

4/25/2019 13:34:35 5/27/2019

6/10/2019 13:38:22 5/28/2019
6/18/2019 14:16:02 5/29/2019
5/31/2019
5/31/2019
6/8/2019
6/10/2019
6/11/2019
6/12/2019
6/13/2019
6/14/2019
6/15/2019
6/17/2019
6/18/2019
6/19/2019
6/20/2019
6/21/2019
6/22/2019
6/24/2019
6/25/2019

Total Penggunaan 0 0 0 0
Jumlah persediaan 0 0 0 0
Stock 0 0 0 0
Permintaan 100 54 60 70
Realisasi Permintaan 80 10 50 60
 Antasida DOEN Asam Asam
Amoksisilin sirup Amoksisilin Antasida Asiklovir tab
II suspensi Askorbat mefenamat
kering 125 mg/5 ml 500mg tab 400 mg
kombinasi tab 50 mg 500 mg
10 0 12
0 9 0
0 0 0
0 9 9
10 0 12
0 0 0
0 0 6
0 0 0
10 0 6
10 0 12
0 6 9
20 0 0
0 0 0
0 9 9
0 0 12
10 0 0
0 0 12
0 0 0
0 15 9
0 12 12

0 70 0 60 120 0 0
0 0 0 0 0 0 0
0 -70 0 -60 -120 0 0
40 50 55 67 89 45 34
20 30 55 60 70 40 30
Bacitrasin- Domperidon
Betametason Bufacetin Dexamethason Domperidon Garam
polimiksin suspensi/sirup
salep kulit Salep Kulit tablet tablet Oralit
salep 5 mg/5 ml
3
3
6
0
10
0
9
0
0
12
0
0
15
0
6
0
0
10
0
6

0 0 0 80 0 0 0
0 0 0 0 0 0 0
0 0 0 -80 0 0 0
23 67 89 52 55 56 89
10 60 79 25 26 24 28
 Gliseril Kaptopril
Hidrokortison Ibuprofen Ibuprofen Kalsium Ketokonazole kloramphenicol
guayakolat 50 mg
Krim suspensi tab 400 mg Lactat 2 % krim susp.125 mg/ml
tab 100 mg tablet

0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
41 42 43 44 45 46 47 48
29 28 27 26 25 27 28 29
 Klorfeniramin Kotrimoksazol
kloramphenicol Kotri Adult Loperamid Loratadine / Meloksikam
maleat (CTM) suspensi 240
salep mata tablet tablet 2 mg Novadium 7,5 mg
tab 4 mg mg/5 ml
12
0
9
9
0
0
0
9
0
36
0
0
0
15
0
4
0
12
0
9

0 115 0 0 0 0 0
0 0 0 0 0 0 0
0 -115 0 0 0 0 0
48 50 51 25 30 30 50
30 31 25 24 25 27 42
 Mikonazol Natrium Paracetamol
Metronidazol N-Asetil Omeprazole Papaverin Parasetamol
krim/salep 2 Diklofenak sirup 120
500 mg Sistein tab tab 40 mg Drop
% Nitrat tablet 50 mg mg/10ml

0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
50 60 70 80 45 35 45 48
40 50 50 75 40 30 40 45
 Piridoksin(Vita Sefadroksil
Parasetamol Piroxicam Salep 2- Salisil
min B6) tablet Prednison Salbutamol kapsul/kaplet
tab 500 mg 10 mg 4 Talk
10 mg 500 mg
25 0
0 3
6 4
0 0
0 6
0 0
9 3
0 0
0 15
15 0
12 9
9 0
0 3
3 0
0 9
0 3
12 0
0 0
0 0
9 0

100 0 0 55 0 0 0 0
0 0 0 0 0 0 0 0
-100 0 0 -55 0 0 0 0
52 50 45 46 47 48 49 50
50 45 12 13 14 15 16 17
 Sefadroksil
Sianokobalamin Simvastatin Siprofloksasin Thiamin Vitamin Maker
sirup kering Zink
( Vit.B12 ) tab 10 mg tablet 500 mg (Vit. B1) Bcomp tab Ear-loop
125 mg/5 ml
0 9 0
0 15 0
0 9 3
0 18 0
0 6 6
3 9 0
0 15 0
0 18 0
0 9 6
3 0 0
0 0 0
0 6 0
0 9 6
0 0 0
0 9 0
4 0 0
0 0 0
0 9 0
0 0 6
0 9 3

0 10 0 0 150 30 0 0
0 0 0 0 0 0 0 0
0 -10 0 0 -150 -30 0 0
51 52 53 54 55 56 57 58
18 19 20 21 22 23 24 25
Penaggung Jawab Keterangan Password

Laporan Harian pkm.tamalate

Laporan Harian pkm.tamalate
 LAPORAN PENERIMAAN, PEMAKAIAN, DAN PER

UNIT PELAYANAN : PUSTU HARTAKO

PERIODE : Juni 2019

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN

1 Ambroxol tablet 30 mg Tablet
2 Ambroxol syrup Botol
3 Amlodipin tab 10 mg Tablet
4 Amlodipin tab 5 mg Tablet
5 Amoksisilin sirup kering 125 mg/5 ml Botol 60 ml
6 Amoksisilin 500mg Kapsul
8 Antasida DOEN II suspensi kombinasi Botol 60 ml
9 Antasida tab Tablet
10 Asam Askorbat tab 50 mg Tablet
11 Asam mefenamat 500 mg Tablet
12 Asiklovir tab 400 mg Tablet
13 Bacitrasin-polimiksin salep Tube
14 Betametason salep kulit Tablet
15 Bufacetin Salep Kulit Tube
16 Dexamethason tablet Tablet
17 Domperidon suspensi/sirup 5 mg/5 ml Botol 60 ml
18 Domperidon tablet Tablet
19 Garam Oralit Sacchet
20 Gliseril guayakolat tab 100 mg Tablet
21 Hidrokortison Krim Tube
22 Ibuprofen suspensi Botol 100 ml
23 Ibuprofen tab 400 mg Tablet
24 Kalsium Lactat Tablet
25 Kaptopril 50 mg tablet Tablet
26 Ketokonazole 2 % krim Tube 15 g
27 kloramphenicol susp.125 mg/ml Botol 60 ml
28 kloramphenicol salep mata Tube 15 g
29 Klorfeniramin maleat (CTM) tab 4 mg Tablet
30 Kotri Adult tablet Tablet
31 Kotrimoksazol suspensi 240 mg/5 ml Botol 60 ml
32 Loperamid tablet 2 mg Tablet
33 Loratadine / Novadium Tablet
34 Meloksikam 7,5 mg Tablet
35 Metronidazol 500 mg Tablet
36 Mikonazol krim/salep 2 % Nitrat Tube 10 g
37 Natrium Diklofenak tablet 50 mg Tablet
38 N-Asetil Sistein Tablet
39 Omeprazole tab Tablet
40 Papaverin tab 40 mg Tablet
41 Parasetamol Drop Botol
42 Paracetamol sirup 120 mg/10ml Botol 60 ml
43 Parasetamol tab 500 mg Tablet
44 Piridoksin(Vitamin B6) tablet 10 mg Tablet
45 Piroxicam 10 mg Tablet
46 Prednison Tablet
47 Salbutamol Tablet
48 Salep 2-4 Pot
49 Salisil Talk Dus
50 Sefadroksil kapsul/kaplet 500 mg Tablet
51 Sefadroksil sirup kering 125 mg/5 ml Botol 60 ml
52 Sianokobalamin ( Vit.B12 ) tab Tablet
53 Simvastatin 10 mg Tablet
54 Siprofloksasin tablet 500 mg Tablet
55 Thiamin (Vit. B1) Tablet
56 Vitamin Bcomp tab Tablet
57 Zink Tablet
58 Maker Ear-loop Pcs

Kepala Puskesmas Tamalate Penanggung Jawab Farmasi

dr. Hj. Tri Raparti Arifin, M.Kes. Sitti Sulaeha, S.Si, Apt.
Nip. 19611112 199509 2 001 Nip. 19760702 201101 2 003
N, PEMAKAIAN, DAN PERMINTAAN OBAT

PERMINTAAN : Juli 2019

JUMLAH PEMAKAIAN STOK PERMINTAAN REALISASI KET.

0 0 0 100 80
0 0 0 54 10
0 0 0 60 50
0 0 0 70 60
0 0 0 40 20
0 70 -70 50 30
0 0 0 55 55
0 60 -60 67 60
0 120 -120 89 70
0 0 0 45 40
0 0 0 34 30
0 0 0 23 10
0 0 0 67 60
0 0 0 89 79
0 80 -80 52 25
0 0 0 55 26
0 0 0 56 24
0 0 0 89 28
0 0 0 41 29
0 0 0 42 28
0 0 0 43 27
0 0 0 44 26
0 0 0 45 25
0 0 0 46 27
0 0 0 47 28
0 0 0 48 29
0 0 0 48 30
0 115 -115 50 31
0 0 0 51 25
0 0 0 25 24
0 0 0 30 25
0 0 0 30 27
0 0 0 50 42
0 0 0 50 40
0 0 0 60 50
0 0 0 70 50
0 0 0 80 75
0 0 0 45 40
0 0 0 35 30
 0 0 0 45 40
0 0 0 48 45
0 100 -100 52 50
0 0 0 50 45
0 0 0 45 12
0 55 -55 46 13
0 0 0 47 14
0 0 0 48 15
0 0 0 49 16
0 0 0 50 17
0 0 0 51 18
0 10 -10 52 19
0 0 0 53 20
0 0 0 54 21
0 150 -150 55 22
0 30 -30 56 23
0 0 0 57 24
0 0 0 58 25

Makassar, 2
enanggung Jawab Farmasi Penanggung Jawab Pustu Hartaco

Sitti Sulaeha, S.Si, Apt. Susi Fausiana, AMK

p. 19760702 201101 2 003 Nip. 19880421 201001 2 021
 Amlodipin Amlodipin tab Amoksisiklin Amoksisiklin
Timestamp Tanggal pelaporan Ambroxol
10 mg 5 mg 500 mg syrup 125 mg
4/25/2019 12:21:27 4/24/2019 1 2 3 4 5
6/10/2019 14:25:48 6/10/2019 7 7 8 9 8
6/18/2019 14:14:57 6/18/2019 10 5 5 15 2

Total Penggunaan 18 14 16 28 15
Jumlah persediaan 290 71 327 393 39
Stock 272 57 311 365 24
Permintaan 100 54 60 70 40
Realisasi Permintaan 80 10 50 60 20
 Asam Bacitrasin
Antasida Asam Askorbat Bedak Betametason Bufacetin Cefadroksil
mefenamat Polymiksin
tab tab 50 mg Salisil krem Salep Kulit 500 mg
500 mg 500 mg
6 7 8 9 9 8 7 6
7 6 5 7 8 9 9 8
10 10 10 2 3 2 2 10

23 23 23 18 20 19 18 24
82 647 178 78 38 43 46 227
59 624 155 60 18 24 28 203
50 55 67 89 45 34 23 67
30 55 60 70 40 30 10 60
 Cetrizine Dexamethason Domperidon Garam Hidrokortison Ibuprofen tab
Domperidon Hustab
10 mg tab tablet sirup Oralit salep kulit 400 mg
5 4 3 2 1 1 2 3
7 6 5 6 7 8 7 6
10 10 10 2 5 2 10 10

22 20 18 10 13 11 19 19
138 219 164 50 98 51 89 200
116 199 146 40 85 40 70 181
89 52 55 56 89 41 42 43
79 25 26 24 28 29 28 27
 Klorfeniramin Methyl
Kloramfenikol Kotrimoksazole Kotrimoksazole Mikonazole
maleat (CTM) Loratadine Predisolon
Salep mata 480 mg Syrup cream
tab 4 mg 4 mg
4 5 6 7 8 9 9
7 6 5 8 9 7 6
2 10 10 5 10 10 2

13 21 21 20 27 26 17
60 456 248 55 110 149 56
47 435 227 35 83 123 39
44 45 46 47 48 48 50
26 25 27 28 29 30 31
 Natrium
Oksitetrasiklin Parasetamol Parasetamol Parasetamol Piridoksin
Diklofenak Omeprazole
salep kulit drop syrup tab 500 mg (Vit. B6)
50 mg
9 8 8 7 6 5 4
8 8 7 8 8 8 8
10 2 10 1 2 1 6

27 18 25 16 16 14 18
99 96 95 65 53 492 251
72 78 70 49 37 478 233
51 25 30 30 50 50 60
25 24 25 27 42 40 50
 Ranitidin Salep 2- Sefadroxil sirup kering Sianokabalamin Thiamin Vitamin
Prednison
150 mg 4 250 mg/5 ml (Vit. B12) (Vit. B1) Bcomp tab
3 2 1 4 5 6 7
9 9 9 6 5 6 7
10 10 2 3 10 10 10

22 21 12 13 20 22 24
175 64 43 45 626 535 754
153 43 31 32 606 513 730
70 80 45 35 45 48 52
50 75 40 30 40 45 50
Handscoen Masker
Penaggung Jawab Keterangan Password
7,5 Tie-on
8 9
7 8 Yudi Laporan Harian pkm.tamalate
5 5 Nurhidayah Laporan Harian pkm.tamalate

20 22
89 86
69 64
50 45
45 12
 LAPORAN PENERIMAAN, PEMAKAIAN, DAN PE

UNIT PELAYANAN : PROGRAM PUSKEL KOMP. KUSTA

PERIODE :D

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN

1 Ambroxol Tablet 265 25
2 Amlodipin 10 mg Tablet 45 26
3 Amlodipin tab 5 mg Tablet 300 27
4 Amoksisiklin 500 mg Tablet 365 28
5 Amoksisiklin syrup 125 mg Botol 10 29
6 Antasida tab Tablet 52 30
7 Asam Askorbat tab 50 mg Tablet 616 31
8 Asam mefenamat 500 mg Tablet 146 32
9 Bacitrasin Polymiksin 500 mg Tube 45 33
10 Bedak Salisil Pot 4 34
11 Betametason krem Tube 8 35
12 Bufacetin Salep Kulit Tube 10 36
13 Cefadroksil 500 mg Kapsul 190 37
14 Cetrizine 10 mg tab Tablet 100 38
15 Dexamethason tablet Tablet 180 39
16 Domperidon Tablet 124 40
17 Domperidon sirup Botol 9 41
18 Garam Oralit Sachet 56 42
19 Hidrokortison salep kulit Tube 8 43
20 Hustab Tablet 45 44
21 Ibuprofen tab 400 mg Tablet 155 45
22 Kloramfenikol Salep mata Tube 14 46
23 Klorfeniramin maleat (CTM) tab 4 mg Tablet 409 47
24 Kotrimoksazole 480 mg Tablet 200 48
25 Kotrimoksazole Syrup Botol 6 49
26 Loratadine Tablet 60 50
27 Methyl Predisolon 4 mg Tablet 100 49
28 Mikonazole cream Tube 8 48
29 Natrium Diklofenak 50 mg Tablet 52 47
30 Oksitetrasiklin salep kulit Tube 50 46
31 Omeprazole Kapsul 50 45
32 Parasetamol drop Botol 21 44
33 Parasetamol syrup Botol 10 43
34 Parasetamol tab 500 mg Tablet 450 42
35 Piridoksin (Vit. B6) Tablet 210 41
36 Prednison Tablet 135 40
37 Ranitidin 150 mg Tablet 25 39
38 Salep 2-4 Pot 5 38
39 Sefadroxil sirup kering 250 mg/5 ml Botol 8 37
40 Sianokabalamin (Vit. B12) Tablet 590 36
41 Thiamin (Vit. B1) Tablet 500 35
41 Vitamin Bcomp tab Tablet 720 34
42 Handscoen 7,5 Pcs 56 33
43 Masker Tie-on Pcs 54 32

Kepala Puskesmas Tamalate Penanggung Jawab Farmasi

dr. Hj. Tri Raparti Arifin, M.Kes. Sitti Sulaeha, S.Si, Apt.
Nip. 19611112 199509 2 001 Nip. 19760702 201101 2 003
N, PEMAKAIAN, DAN PERMINTAAN OBAT

STA PERMINTAAN :J

JUMLAH PEMAKAIAN STOK PERMINTAAN REALISASI KET.

290 18 272 100 80
71 14 57 54 10
327 16 311 60 50
393 28 365 70 60
39 15 24 40 20
82 23 59 50 30
647 23 624 55 55
178 23 155 67 60
78 18 60 89 70
38 20 18 45 40
43 19 24 34 30
46 18 28 23 10
227 24 203 67 60
138 22 116 89 79
219 20 199 52 25
164 18 146 55 26
50 10 40 56 24
98 13 85 89 28
51 11 40 41 29
89 19 70 42 28
200 19 181 43 27
60 13 47 44 26
456 21 435 45 25
248 21 227 46 27
55 20 35 47 28
110 27 83 48 29
149 26 123 48 30
56 17 39 50 31
99 27 72 51 25
96 18 78 25 24
95 25 70 30 25
65 16 49 30 27
53 16 37 50 42
492 14 478 50 40
251 18 233 60 50
175 22 153 70 50
64 21 43 80 75
43 12 31 45 40
45 13 32 35 30
 626 20 606 45 40
535 22 513 48 45
754 24 730 52 50
89 20 69 50 45
86 22 64 45 12

Makassar, 2
nanggung Jawab Farmasi Penanggung Jawab Program Puskel Komp. Kusta

Sitti Sulaeha, S.Si, Apt. Abdul Rahman, S.Kep, Ns

19760702 201101 2 003 Nip. 19860112 200902 1 001
 Tanggal Amlodipin Amlodipin Amoksisillin Antasida
Timestamp Ambroxol
Pelaporan tab 10 mg tab 5 mg 500 mg Suspensi
3/5/2019 15:12:43 3/4/2019 2 4 5 6 7
3/5/2019 16:01:14 3/5/2019 6 7 8 7 6
3/5/2019 16:23:27 3/5/2019 10 2 2 2 2
6/10/2019 10:20:16 6/10/2019 5 5 5 5 5
6/18/2019 14:16:42 6/18/2019 0 0 0 10 3

Total Penggunaan 23 18 20 30 23
Jumlah persediaan 120 105 102 158 30
Stock 97 87 82 128 7
Permintaan 100 54 60 70 40
Realisasi Permintaan 80 10 50 60 20
 Asam Asam Gliseril
Antasida Cetirizin Dexamethason Hidrokortison
Askorbat tab mefenamat 500 guayakolat tab
tab 10 mg tablet krem
50 mg mg 100 mg
7 9 8 6 5 4 3
7 6 7 6 7 6 7
2 2 2 2 2 2 2
5 5 5 5 5 5 5
0 70 0 0 80 0 3

21 92 22 19 99 17 20
70 185 190 112 135 99 110
49 93 168 93 36 82 90
50 55 67 89 45 34 23
30 55 60 70 40 30 10
Ibuprofen tab Ibuprofen tab Kaptopril Ketokonazole Klorfeniramin maleat Kotrimoksazole Loperamida 2
400 mg 200 mg 50 mg Krim (CTM) tab 4 mg Adult mg
7 8 9 7 5 4 6
6 7 6 7 6 7 6
2 2 2 2 2 2 2
5 5 5 5 5 5 5
0 0 0 3 10 0 20

20 22 22 24 28 18 39
270 67 98 76 172 174 110
250 45 76 52 144 156 71
67 89 52 55 56 89 41
60 79 25 26 24 28 29
 Natrium
Parasetamol Ranitidin Sefadroksil Sianokobalamin Thiamin
Diklofenak Omeprazole Prednison
tab 500 mg 150 mg 500 mg (Vit.B12) tab tablet
50 mg
7 8 9 8 7 7 7 8
7 6 7 6 7 6 7 4
2 2 2 2 2 2 2 2
5 5 5 5 5 5 5 5
0 40 30 0 60 0 80 120

21 61 53 21 81 20 101 139
110 40 212 25 250 28 230 220
89 -21 159 4 169 8 129 81
42 43 44 45 46 47 48 48
28 27 26 25 27 28 29 30
 Vitamin
Zink Penanggung Jawab Keterangan Password
Bcomp tab
8 8
7 5
2 2
5 5 Yudi Laporan Harian pkm.tamalate
170 0 A.fitriani.s.kep.Ns Laporan Harian pkm.tamalate

192 20
210 260
18 240
50 51
31 25
 LAPORAN PENERIMAAN, PEMAKAIAN, DAN PE

UNIT PELAYANAN : PROGRAM PUSKEL LANSIA

PERIODE :D

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN

1 Ambroxol Tablet 70 50
2 Amlodipin tab 10 mg Tablet 60 45
3 Amlodipin tab 5 mg Tablet 52 50
4 Amoksisillin 500 mg Kapsul 58 100
5 Antasida Suspensi Botol 25 5
6 Antasida tab Tablet 25 45
7 Asam Askorbat tab 50 mg Tablet 140 45
8 Asam mefenamat 500 mg Tablet 90 100
9 Cetirizin 10 mg Tablet 62 50
10 Dexamethason tablet Tablet 90 45
11 Gliseril guayakolat tab 100 mg Tablet 52 47
12 Hidrokortison krem Tube 25 85
13 Ibuprofen tab 400 mg Tablet 70 200
14 Ibuprofen tab 200 mg Tablet 23 44
15 Kaptopril 50 mg Tablet 21 77
16 Ketokonazole Krim Tue 21 55
17 Klorfeniramin maleat (CTM) tab 4 mg Tablet 150 22
18 Kotrimoksazole Adult Tablet 130 44
19 Loperamida 2 mg Tablet 100 10
20 Natrium Diklofenak 50 mg Tablet 10 100
21 Omeprazole Kapsul 10 30
22 Parasetamol tab 500 mg Tablet 12 200
23 Prednison Tablet 15 10
24 Ranitidin 150 mg Tablet 150 100
25 Sefadroksil 500 mg Kapsul 18 10
26 Sianokobalamin (Vit.B12) tab Tablet 30 200
27 Thiamin tablet Tablet 20 200
28 Vitamin Bcomp tab Tablet 10 200
29 Zink Tablet 250 10

Kepala Puskesmas Tamalate Penanggung Jawab Farmasi

dr. Hj. Tri Raparti Arifin, M.Kes. Sitti Sulaeha, S.Si, Apt.
Nip. 19611112 199509 2 001 Nip. 19760702 201101 2 003
N, PEMAKAIAN, DAN PERMINTAAN OBAT

PERMINTAAN :k

JUMLAH PEMAKAIAN STOK PERMINTAAN REALISASI KET.

120 23 97 100 80
105 18 87 54 10
102 20 82 60 50
158 30 128 70 60
30 23 7 40 20
70 21 49 50 30
185 92 93 55 55
190 22 168 67 60
112 19 93 89 70
135 99 36 45 40
99 17 82 34 30
110 20 90 23 10
270 20 250 67 60
67 22 45 89 79
98 22 76 52 25
76 24 52 55 26
172 28 144 56 24
174 18 156 89 28
110 39 71 41 29
110 21 89 42 28
40 61 -21 43 27
212 53 159 44 26
25 21 4 45 25
250 81 169 46 27
28 20 8 47 28
230 101 129 48 29
220 139 81 48 30
210 192 18 50 31
260 20 240 51 25

Makassar, 26 Desember 2018

enanggung Jawab Farmasi Penanggung Jawab Program Puskel Lansia

Sitti Sulaeha, S.Si, Apt. A. Fitriani

p. 19760702 201101 2 003 Nip. 19851009 201001 2 015
 Acetil Amoksisiklin Antasida
Timestamp Tanggal Pelaporan Antasida
Sistein 500 mg Syr
3/1/2019 15:21:13 3/1/2019 6 3 0 5
6/10/2019 13:18:32 6/10/2019 5 6 7 8
6/18/2019 14:23:40 6/18/2019 0 0 10 10

Total Penggunaan 11 9 17 23
Jumlah persediaan 190 15 210 23
Stock 179 6 193 0
Permintaan 100 54 60 70
Realisasi Permintaan 80 10 50 60
 Asam Gliseril
Asam Askorbat Asam Askorbat tab Asam Folat Besi II
mefenamat Cetirizin guayakolat tab
tab 250 mg 50 mg 0,4 mg Sulfat
500 mg 100 mg
8 4 0 2 1 3 4
9 9 8 7 6 5 4
0 0 0 0 200 0 0

17 13 8 9 207 8 8
155 165 97 106 300 109 109
138 152 89 97 93 101 101
40 50 55 67 89 45 34
20 30 55 60 70 40 30
Kalsium Klorfeniramin
Parasetamol Piridoksin(Vitamin Sianokobalamin
Laktat maleat (CTM) Ondansetron
tab 500 mg B6) tablet 10 mg ( Vit.B12 ) tab
(Kalk) tab 4 mg
6 0 8 0 5 3
3 2 3 4 5 6
200 0 0 100 100 100

209 2 11 104 110 109

107 75 97 155 280 450
-102 73 86 51 170 341
23 67 89 52 55 56
10 60 79 25 26 24
 ADS 3
Thiamin ( Vit.B1 ) Vitamin Zink Suntik
ml Kondom Pil KB Penanggung Jawab
tab Bcomp tab tab KB
(KB)
6 8 7 0 5 2 3
7 8 9 8 7 6 5 Yudi
100 100 0 100 20 100 100 Rahmawati

113 116 16 108 32 108 108

210 660 158 55 33 21 78
97 544 142 -53 1 -87 -30
89 41 42 43 44 45 46
28 29 28 27 26 25 24
 Keterangan Password

Laporan Harian pkm.tamalate

Laporan Harian pkm.tamalate
 LAPORAN PENERIMAAN, PEMAKAIAN, DAN PER

UNIT PELAYANAN : POSYANDU BALANG BARU

PERIODE :D

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN

1 Acetil Sistein Kapsul 100 90
2 Amoksisiklin 500 mg Tablet 10 5
3 Antasida Tablet 110 100
4 Antasida Syr Botol 20 3
5 Asam Askorbat tab 250 mg Tablet 80 75
6 Asam Askorbat tab 50 mg Tablet 90 75
7 Asam Folat 0,4 mg Tablet 52 45
8 Asam mefenamat 500 mg Tablet 54 52
9 Besi II Sulfat Tablet 180 120
10 Cetirizin Tablet 58 51
11 Gliseril guayakolat tab 100 mg Tablet 59 50
12 Kalsium Laktat (Kalk) Tablet 57 50
13 Klorfeniramin maleat (CTM) tab 4 mg Tablet 40 35
14 Ondansetron Tablet 52 45
15 Parasetamol tab 500 mg Tablet 80 75
16 Piridoksin(Vitamin B6) tablet 10 mg Tablet 180 100
17 Sianokobalamin ( Vit.B12 ) tab Tablet 250 200
18 Thiamin ( Vit.B1 ) tab Tablet 110 100
19 Vitamin Bcomp tab Tablet 360 300
20 Zink tab Tablet 100 58
21 ADS 3 ml (KB) Pcs 35 20
22 Kondom Pcs 18 15
23 Pil KB Blister 11 10
24 Suntik KB Vial 58 20

Kepala Puskesmas Tamalate Penanggung Jawab Farmasi

dr. Hj. Tri Raparti Arifin, M.Kes. Sitti Sulaeha, S.Si, Apt.
Nip. 19611112 199509 2 001 Nip. 19760702 201101 2 003
AN, PEMAKAIAN, DAN PERMINTAAN OBAT

PERMINTAAN :J

JUMLAH PEMAKAIAN STOK PERMINTAAN REALISASI KET.

190 11 179 100 80
15 9 6 54 10
210 17 193 60 50
23 23 0 70 60
155 17 138 40 20
165 13 152 50 30
97 8 89 55 55
106 9 97 67 60
300 207 93 89 70
109 8 101 45 40
109 8 101 34 30
107 209 -102 23 10
75 2 73 67 60
97 11 86 89 79
155 104 51 52 25
280 110 170 55 26
450 109 341 56 24
210 113 97 89 28
660 116 544 41 29
158 16 142 42 28
55 108 -53 43 27
33 32 1 44 26
21 108 -87 45 25
78 108 -30 46 24

Makassar, 26 Desember 2018

enanggung Jawab Farmasi Penanggung Jawab Posyandu Balang Baru

Sitti Sulaeha, S.Si, Apt. Rahmawati, S.Tr.Keb.

p. 19760702 201101 2 003 Nip. 19800424 200604 2 021
 Acetil Amoksisiklin Antasida Asam Askorbat
Timestamp Tanggal Pelaporan
Sistein 500 mg tab tab 250 mg
3/1/2019 14:29:37 3/1/2019 1 6 9 4
6/10/2019 11:42:41 6/10/2019 5 7 8 0
6/18/2019 14:11:34 6/18/2019 0 0 20 0

Total Penggunaan 6 13 37 4
Jumlah persediaan 135 51 24 58
Stock 129 38 -13 54
Permintaan 100 54 60 70
Realisasi Permintaan 80 10 50 60
 Klorfeniramin
Asam Askorbat Besi II Kalsium Parasetamol
maleat (CTM) Ondansetron
tab 50 mg Sulfat Laktat tab 500 mg
tab 4 mg
0 3 7 5 9 2
8 6 5 4 3 6
0 100 100 0 0 10

8 109 112 9 12 18
90 24 48 17 90 40
82 -85 -64 8 78 22
40 50 55 67 89 45
20 30 55 60 70 40
 Vitamin ADS 3
Piridoksin(Vitamin B6) Sianokobalamin Thiamin Zink
Bcomp ml Kondom Pil KB
tablet 10 mg (Vit.B12) tab (Vit.B1) tab tab
tab (KB)
1 5 6 0 2 3 0 2
7 8 9 9 8 7 7 6
10 10 0 0 0 0 0 0

18 23 15 9 10 10 7 8
20 22 24 26 28 30 70 23
2 -1 9 17 18 20 63 15
34 23 67 89 52 55 56 89
30 10 60 79 25 26 24 28
Suntik
Penanggung Jawab Keterangan Password
KB
3
7 Yudi Laporan Harian pkm.tamalate
0 Khoiria insani Laporan Harian pkm.tamalate

10
22
12
41
29
 LAPORAN PENERIMAAN, PEMAKAIAN, DAN PE

UNIT PELAYANAN : POSYANDU PARANG TAMBUNG

PERIODE :D

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN

1 Acetil Sistein Kapsul 35 100
2 Amoksisiklin 500 mg Tablet 21 30
3 Antasida tab Tablet 20 4
4 Asam Askorbat tab 250 mg Tablet 56 2
5 Asam Askorbat tab 50 mg Tablet 85 5
6 Besi II Sulfat Tablet 12 12
7 Kalsium Laktat Tablet 42 6
8 Klorfeniramin maleat (CTM) tab 4 mg Tablet 10 7
9 Ondansetron Tablet 40 50
10 Parasetamol tab 500 mg Tablet 11 29
11 Piridoksin(Vitamin B6) tablet 10 mg Tablet 12 8
12 Sianokobalamin (Vit.B12) tab Tablet 13 9
13 Thiamin (Vit.B1) tab Tablet 14 10
14 Vitamin Bcomp tab Tablet 15 11
15 Zink tab Tablet 16 12
16 ADS 3 ml (KB) Pcs 17 13
17 Kondom Pcs 20 50
18 Pil KB Blister 18 5
19 Suntik KB Vial 19 3

Kepala Puskesmas Tamalate Penanggung Jawab Farmasi

dr. Hj. Tri Raparti Arifin, M.Kes. Sitti Sulaeha, S.Si, Apt.
Nip. 19611112 199509 2 001 Nip. 19760702 201101 2 003
N, PEMAKAIAN, DAN PERMINTAAN OBAT

PERMINTAAN :J

JUMLAH PEMAKAIAN STOK PERMINTAAN REALISASI KET.

135 6 129 100 80
51 13 38 54 10
24 37 -13 60 50
58 4 54 70 60
90 8 82 40 20
24 109 -85 50 30
48 112 -64 55 55
17 9 8 67 60
90 12 78 89 70
40 18 22 45 40
20 18 2 34 30
22 23 -1 23 10
24 15 9 67 60
26 9 17 89 79
28 10 18 52 25
30 10 20 55 26
70 7 63 56 24
23 8 15 89 28
22 10 12 41 29

enanggung Jawab Farmasi Penanggung Jawab Posyandu Parang Tambung

Sitti Sulaeha, S.Si, Apt. Khoiria Insani, A.md.Keb.

p. 19760702 201101 2 003 Nip. 19870901 201001 2 019
 Acetil Amoksisiklin Antasida
Timestamp Tanggal Pelaporan Ambroksol
Sistein 500 mg tab
3/1/2019 14:02:52 3/1/2019 2 0 8 5
6/18/2019 14:19:29 6/18/2019 0 0 0 100

Total Penggunaan 2 0 8 105

Jumlah persediaan 70 50 61 71
Stock 68 50 53 -34
Permintaan 45 56 32 34
Realisasi Permintaan 40 50 30 30
 Kalsium Klorfeniramin
Asam Askorbat Asam Askorbat Besi II Cetirizin
Laktat maleat (CTM) tab 4 Ondansetron
tab 250 mg tab 50 mg Sulfat Tablet
(Kalk) mg
0 4 6 8 3 7 8
100 50 600 0 100 0 0

100 54 606 8 103 7 8

57 59 405 40 90 200 66
-43 5 -201 32 -13 193 58
10 12 12 12 23 34 34
5 10 10 10 20 30 30
 Vitamin ADS 3
Parasetamol tab Piridoksin(Vitamin B6) Sianokobalamin ( Thiamin
Bcomp ml Kondom
500 mg tablet 10 mg Vit.B12 ) tab ( Vit.B1 ) tab
tab (KB)
4 5 7 8 2 1 2
50 100 100 100 100 20 10

54 105 107 108 102 21 12

112 80 61 62 62 52 71
58 -25 -46 -46 -40 31 59
53 23 34 45 20 30 33
50 20 30 40 15 25 30
 Suntik
Pil KB Penanggung Jawab Keterangan Password
KB
1 1
20 20 Isma hajriati Laporan Harian pkm.tamalate

21 21
45 54
24 33
33 33
30 30
 LAPORAN PENERIMAAN, PEMAKAIAN, DAN P

UNIT PELAYANAN : POSYANDU BONTO DURI

PERIODE :D

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN

1 Acetil Sistein Kapsul 45 25
2 Ambroksol Tablet 25 25
3 Amoksisiklin 500 mg Tablet 26 35
4 Antasida tab Tablet 35 36
5 Asam Askorbat tab 250 mg Tablet 25 32
6 Asam Askorbat tab 50 mg Tablet 25 34
7 Besi II Sulfat Tablet 300 105
8 Cetirizin Tablet Tablet 20 20
9 Kalsium Laktat (Kalk) Tablet 50 40
10 Klorfeniramin maleat (CTM) tab 4 mg Tablet 100 100
11 Ondansetron Tablet 56 10
12 Parasetamol tab 500 mg Tablet 12 100
13 Piridoksin(Vitamin B6) tablet 10 mg Tablet 45 35
14 Sianokobalamin ( Vit.B12 ) tab Tablet 41 20
15 Thiamin ( Vit.B1 ) tab Tablet 42 20
16 Vitamin Bcomp tab Tablet 42 20
17 ADS 3 ml (KB) Pcs 32 20
18 Kondom Pcs 36 35
19 Pil KB Blister 35 10
20 Suntik KB Vial 34 20

Kepala Puskesmas Tamalate Penanggung Jawab Farmasi

dr. Hj. Tri Raparti Arifin, M.Kes. Sitti Sulaeha, S.Si, Apt.
Nip. 19611112 199509 2 001 Nip. 19760702 201101 2 003

Cat :
Stok Awal = Stok Akhir pada bulan seselumnya
Penerimaan = Realisasi Permintaan
, PEMAKAIAN, DAN PERMINTAAN OBAT

PERMINTAAN :J

JUMLAH PEMAKAIAN STOK PERMINTAAN REALISASI KET.

70 2 68 45 40
50 0 50 56 50
61 8 53 32 30
71 105 -34 34 30
57 100 -43 10 5
59 54 5 12 10
405 606 -201 12 10
40 8 32 12 10
90 103 -13 23 20
200 7 193 34 30
66 8 58 34 30
112 54 58 53 50
80 105 -25 23 20
61 107 -46 34 30
62 108 -46 45 40
62 102 -40 20 15
52 21 31 30 25
71 12 59 33 30
45 21 24 33 30
54 21 33 33 30

Makassar, 26 Desember 2018

enanggung Jawab Farmasi Penanggung Jawab Posyandu Parang Tambung

Sitti Sulaeha, S.Si, Apt. Isma Hajriati, A.md.Keb.

p. 19760702 201101 2 003 Nip. 19850906 200901 2 004
 Alat Suntik Alat Suntik Anti Bakteri
Tanggal Alkohol Bufacetin
Timestamp Sekali Pakai Sekali Pakai Doen Salep
Pelaporan 70 % salep kulit
0,5 cc 3 cc (Bacitracin)
3/1/2019 10:34:21 3/1/2019 3 6 7 3 5
6/10/2019 9:18:45 6/10/2019 5 5 5 7 8
6/18/2019 14:13:19 6/18/2019 4 2 1 2 1

Total Penggunaan 12 13 13 12 14
Jumlah persediaan 135 51 24 58 90
Stock 123 38 11 46 76
Permintaan 100 54 60 70 40
Realisasi Permintaan 80 10 50 60 20
 Lidokain
Catgut Etil Handscoen Handscoen Infus Set Infus Set IV Catheter Kasa
Hypafix Komp.
3/0 Chlorida No. 7 No. 7,5 Anak Dewasa No. 26 hidrofil
Injeksi
8 9 5 6 9 4 3 2 0 7
9 9 6 4 6 8 4 7 8 4
0 0 0 8 1 0 0 1 2 2

17 18 11 18 16 12 7 10 10 13
24 48 17 90 40 20 22 24 26 28
7 30 6 72 24 8 15 14 16 15
50 55 67 89 45 34 23 67 89 52
30 55 60 70 40 30 10 60 79 25
 Povidon Ringer
Masker Masker NaCl Surgical Vaselin
Plester Iodida Laktat Rivanol Silk 3/0
Jilbab Tie-on 0,9 % Balde Swab
(Betadine) 500 ml
4 0 5 6 3 2 1 7 4 3
7 5 8 6 8 5 8 8 9 5
0 1 1 1 1 0 0 0 2 0

11 6 14 13 12 7 9 15 15 8
30 70 23 22 34 36 39 41 42 45
19 64 9 9 22 29 30 26 27 37
55 56 89 41 45 7 56 45 47 85
26 24 28 29 30 31 32 33 34 35
 Penanggung Jawab Keterangan Password

Yudi Laporan Harian pkm.tamalate

Abdul Rahman Laporan Harian pkm.tamalate
 LAPORAN PENERIMAAN, PEMAKAIAN, DAN PERM

UNIT PELAYANAN : RUANG TINDAKAN / UGD

PERIODE : D 2019

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN

1 Alat Suntik Sekali Pakai 0,5 cc Pcs 35 100
2 Alat Suntik Sekali Pakai 3 cc Pcs 21 30
3 Alkohol 70 % Botol 20 4
4 Anti Bakteri Doen Salep (Bacitracin) Tube 56 2
5 Bufacetin salep kulit Tube 85 5
6 Catgut 3/0 Pcs 12 12
7 Etil Chlorida Botol 42 6
8 Handscoen No. 7 Pcs 10 7
9 Handscoen No. 7,5 Pcs 40 50
10 Hypafix Pcs 11 29
11 Infus Set Anak Pcs 12 8
12 Infus Set Dewasa Pcs 13 9
13 IV Catheter No. 26 Pcs 14 10
14 Kasa hidrofil roll 15 11
15 Lidokain Komp. Injeksi Ampul 16 12
16 Masker Jilbab Pcs 17 13
17 Masker Tie-on Pcs 20 50
18 NaCl 0,9 % botol 500 ml 18 5
19 Plester Roll 19 3
20 Povidon Iodida (Betadine) Botol 20 14
21 Ringer Laktat 500 ml Botol 21 15
22 Rivanol Botol 22 17
23 Silk 3/0 Pcs 23 18
24 Surgical Balde Pcs 23 19
25 Vaselin Swab Pcs 25 20

Kepala Puskesmas Tamalate Penanggung Jawab Farmasi

dr. Hj. Tri Raparti Arifin, M.Kes. Sitti Sulaeha, S.Si, Apt.
Nip. 19611112 199509 2 001 Nip. 19760702 201101 2 003

Cat :
Stok Awal = Stok Akhir pada bulan seselumnya
Penerimaan = Realisasi Permintaan
AN, PEMAKAIAN, DAN PERMINTAAN OBAT

PERMINTAAN : J 2019

JUMLAH PEMAKAIAN STOK PERMINTAAN REALISASI KET.

135 12 123 100 80
51 13 38 54 10
24 13 11 60 50
58 12 46 70 60
90 14 76 40 20
24 17 7 50 30
48 18 30 55 55
17 11 6 67 60
90 18 72 89 70
40 16 24 45 40
20 12 8 34 30
22 7 15 23 10
24 10 14 67 60
26 10 16 89 79
28 13 15 52 25
30 11 19 55 26
70 6 64 56 24
23 14 9 89 28
22 13 9 41 29
34 12 22 45 30
36 7 29 7 31
39 9 30 56 32
41 15 26 45 33
42 15 27 47 34
45 8 37 85 35

Makassar,
enanggung Jawab Farmasi Penanggung Jawab UGD/Ruang Tindakan

Sitti Sulaeha, S.Si, Apt. Hermiati Tamsir, S.Kep, Ns

p. 19760702 201101 2 003 Nip. 19791024 200502 2 003
 Alat sunti Alat sunti Cat
Tanggal Alat Deteksi Blood
Timestamp sekali pakai sekali pakai 1 Alkohol Pewarna
Pelaporan kehamilan Lancet
3 cc cc Gram
2/28/2019 11:56:29 2/28/2019 6 8 9 6 5 8
3/12/2019 15:58:58 3/12/2019 4 5 7 8 5 6
6/18/2019 14:44:09 6/18/2019 1 0 0 1 24 0

Total Penggunaan 11 13 16 15 34 14
Jumlah persediaan 11 22 33 44 55 66
Stock 0 9 17 29 21 52
Permintaan 100 54 60 70 40 50
Realisasi Permintaan 80 10 50 60 20 30
 Reagen Reagen
Combur Dirui H- Handscoen Handscoen Masker Masker Objek
Hypafix Kapas Ziehl Gol.
Test 100 No. 7 No. 7,5 Tie-on Jilbab Glass
Neelsen Darah
7 6 8 7 9 5 6 7 9 5 4
5 5 7 6 5 4 5 4 5 7 6
0 2 0 4 0 0 0 2 1 0 4

12 13 15 17 14 9 11 13 15 12 14
77 88 99 100 91 82 73 64 55 46 37
65 75 84 83 77 73 62 51 40 34 23
55 67 89 45 34 23 67 89 52 55 56
55 60 70 40 30 10 60 79 25 26 24
 Strip
Pot Salmonella Salmonella Strip Strip Strip Tes Strip Strip
Uric
Dahak Thypi H Thypi O Cholesterol Glucose Kehamilan Widal HBSAg Anti-HIV
Acid
7 8 9 6 0 0 6 1 2 5
6 6 6 6 5 6 5 5 6 5
9 0 0 3 3 2 2 1 12 12

22 14 15 15 8 8 13 7 20 22
28 39 50 61 72 83 94 105 116 107
6 25 35 46 64 75 81 98 96 85
89 41 45 7 56 45 47 85 41 42
28 29 30 31 32 33 34 35 36 37
 Penanggung jawab Penanggung Jawab Keterangan Password
Tahir
Mail
Indra Dewi Indra Dewi Laporan Harian pkm.tamalate
 LAPORAN PENERIMAAN, PEMAKAIAN, DAN PERM

UNIT PELAYANAN : LABORATORIUM

PERIODE :D

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN JUMLAH

1 Alat Deteksi kehamilan Paket 1 10 11
2 Alat sunti sekali pakai 3 cc Pcs 2 20 22
3 Alat sunti sekali pakai 1 cc Pcs 3 30 33
4 Alkohol Botol 4 40 44
5 Blood Lancet Pcs 5 50 55
6 Cat Pewarna Gram Paket 6 60 66
7 Combur Test Pcs 7 70 77
8 Dirui H-100 Pcs 8 80 88
9 Handscoen No. 7 Pcs 9 90 99
10 Handscoen No. 7,5 Pcs 10 90 100
11 Hypafix Roll 11 80 91
12 Kapas Pcs 12 70 82
13 Masker Tie-on Pcs 13 60 73
14 Masker Jilbab Pcs 14 50 64
15 Reagen Ziehl Neelsen Paket 15 40 55
16 Reagen Gol. Darah Paket 16 30 46
17 Objek Glass pcs 17 20 37
18 Pot Dahak Botol 18 10 28
19 Salmonella Thypi H Vial 19 20 39
20 Salmonella Thypi O Vial 20 30 50
21 Strip Cholesterol Pcs 21 40 61
22 Strip Glucose Tube 22 50 72
23 Strip Kehamilan Pcs 23 60 83
24 Strip Uric Acid Pcs 24 70 94
25 Tes Widal 25 80 105
26 Strip HBSAg Pcs 26 90 116
27 Strip Anti-HIV Pcs 27 80 107

Kepala Puskesmas Tamalate Penanggung Jawab Farmasi

dr. Hj. Tri Raparti Arifin, M.Kes. Sitti Sulaeha, S.Si, Apt.
Nip. 19611112 199509 2 001 Nip. 19760702 201101 2 003

Cat :
Stok Awal = Stok Akhir pada bulan seselumnya
Penerimaan = Realisasi Permintaan
KAIAN, DAN PERMINTAAN OBAT

PERMINTAAN :J

PEMAKAIAN STOK PERMINTAAN REALISASI KET.

11 0 100 80
13 9 54 10
16 17 60 50
15 29 70 60
34 21 40 20
14 52 50 30
12 65 55 55
13 75 67 60
15 84 89 70
17 83 45 40
14 77 34 30
9 73 23 10
11 62 67 60
13 51 89 79
15 40 52 25
12 34 55 26
14 23 56 24
22 6 89 28
14 25 41 29
15 35 45 30
15 46 7 31
8 64 56 32
8 75 45 33
13 81 47 34
7 98 85 35
20 96 41 36
22 85 42 37

Makassar,
Farmasi Penanggung Jawab Laboratorium

, Apt. Indra Dewi

01 2 003 Nip. 19700404 199203 2 014
 Tanggal Etil Handscoen Handscoen Masker Masker
Timestamp Fuji
Pelaporan Chlorida No. 7 No. 7,5 Tie-on Jilbab
5/24/2019 14:59:30 5/24/2019 5 6 7 8 9 9
6/18/2019 14:12:57 6/18/2019 0 0 12 15 12 0

Total Penggunaan 5 6 19 23 21 9
Jumlah persediaan 97 103 134 101 101 101
Stock 92 97 115 78 80 92
Permintaan 100 54 60 70 40 50
Realisasi Permintaan 80 10 50 60 20 30
 Jarum Injeksi Larutan Injeksi Lidokain Povidon
Kasa Masker Polikresulen Spoit
untuk gigi sekali untuk Gigi Komp. Iodida
hidrofil Ear-loop (Albotyl) 1 cc
pakai (Artinibza) Injeksi (Betadine)
8 7 76 6 6 5 4 4
0 0 0 13 14 1 1 45

8 7 76 19 20 6 5 49
90 130 70 71 70 74 73 74
82 123 -6 52 50 68 68 25
55 67 89 45 34 23 67 89
55 60 70 40 30 10 60 79
 Penanggung jawab Penanggung Jawab Keterangan Password
Tahir
Drg sitti hamsiah Drg sitti hamsiah Laporan Harian pkm.tamalate
 LAPORAN PENERIMAAN, PEMAKAIAN, DAN PE

UNIT PELAYANAN : POLI GIGI

PERIODE : Bulan

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN

1 Etil Chlorida Botol Spray 52 45
2 Fuji Botol Spray 58 45
3 Handscoen No. 7 Pcs 89 45
4 Handscoen No. 7,5 Pcs 56 45
5 Masker Tie-on Pcs 56 45
6 Masker Jilbab Pcs 56 45
7 Jarum Injeksi untuk gigi sekali pakai Pcs 45 45
8 Kasa hidrofil roll 85 45
9 Larutan Injeksi untuk Gigi (Artinibza) Pcs 25 45
10 Lidokain Komp. Injeksi Ampul 26 45
11 Masker Ear-loop Pcs 25 45
12 Polikresulen (Albotyl) Botol 29 45
13 Povidon Iodida (Betadine) Pcs 28 45
14 Spoit 1 cc Pcs 29 45

Kepala Puskesmas Tamalate Penanggung Jawab Farmasi

dr. Hj. Tri Raparti Arifin, M.Kes. Sitti Sulaeha, S.Si, Apt.
Nip. 19611112 199509 2 001 Nip. 19760702 201101 2 003

Cat :
Stok Awal = Stok Akhir pada bulan seselumnya
Penerimaan = Realisasi Permintaan
N, PEMAKAIAN, DAN PERMINTAAN OBAT

PERMINTAAN : JANUARI 2019

JUMLAH PEMAKAIAN STOK PERMINTAAN REALISASI KET.

97 5 92 100 80
103 6 97 54 10
134 19 115 60 50
101 23 78 70 60
101 21 80 40 20
101 9 92 50 30
90 8 82 55 55
130 7 123 67 60
70 76 -6 89 70
71 19 52 45 40
70 20 50 34 30
74 6 68 23 10
73 5 68 67 60
74 49 25 89 79

Makassar,
enanggung Jawab Farmasi Penanggung Jawab Poli Gigi

Sitti Sulaeha, S.Si, Apt. drg. Sitti Hamsia

p. 19760702 201101 2 003 Nip. 19810507 200903 2 002
 Alat suntik
Tanggal Alkohol Handscoen Handscoen
Timestamp sekali pakai Atrinibza Hypafix
Pelapopran 70 % No. 7 No. 7,5
3 cc
3/20/2019 16:54:26 3/20/2019 5 5 5 6 7 8

Total Penggunaan 5 5 5 6 7 8
Jumlah persediaan 120 86 109 89 36 70
Stock 115 81 104 83 29 62
Permintaan 100 54 60 70 40 50
Realisasi Permintaan 80 10 50 60 20 30
 Lidokain Povidon Speculum
Kapas KY Masker Masker Plester Polikresulen Speculum
Komp. Iodida Disposible
Lidi Jelly Jilbab Tie on gulung (Albotyl) Disposible L
Injeksi (Betadine) M
9 73 3 5 3 5 7 8 8 5

9 73 3 5 3 5 7 8 8 5
86 99 95 115 128 100 53 136 88 99
77 26 92 110 125 95 46 128 80 94
55 67 89 45 34 23 67 89 23 23
55 60 70 40 30 10 60 79 20 10
 Speculum Tes Umbilical ADS 3 ml Susuk
Kondom I U D Pil KB Suntik KB
Disposible S Kehamilan Clem (KB) KB
3 5 6 6 8 6 7 8 7

3 5 6 6 8 6 7 8 7
76 73 96 99 98 103 126 124 99
73 68 90 93 90 97 119 116 92
23 34 35 36 56 56 78 80 80
10 20 30 30 50 50 60 60 70
 Penanggung Jawab Penaggung Jawab Keterangan Password
Aa
 LAPORAN PENERIMAAN, PEMAKAIAN, DAN PERMINT

UNIT PELAYANAN : POLI KIA

PERIODE : MARET 2019

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN JUMLAH

1 Alat suntik sekali pakai 3 cc Pcs 35 85 120
2 Alkohol 70 % Botol 41 45 86
3 Atrinibza Ampul 31 78 109
4 Handscoen No. 7 Pcs -6 95 89
5 Handscoen No. 7,5 Pcs -5 41 36
6 Hypafix Pcs 44 26 70
7 Kapas Lidi Pcs 28 58 86
8 KY Jelly Botol 43 56 99
9 Lidokain Komp. Injeksi Ampul 39 56 95
10 Masker Jilbab Pcs 37 78 115
11 Masker Tie on Pcs 39 89 128
12 Plester gulung Roll 43 57 100
13 Polikresulen (Albotyl) Botol 45 8 53
14 Povidon Iodida (Betadine) Botol 41 95 136
15 Speculum Disposible L Pcs 3 85 88
16 Speculum Disposible M Pcs 23 76 99
17 Speculum Disposible S Pcs 31 45 76
18 Tes Kehamilan pCS 20 53 73
19 Umbilical Clem Pcs 40 56 96
20 ADS 3 ml (KB) Pcs 43 56 99
21 Kondom Pcs 40 58 98
22 IUD Pcs 44 59 103
23 Pil KB Blister 37 89 126
24 Suntik KB Vial 44 80 124
25 Susuk KB Set 45 54 99

Kepala Puskesmas Tamalate Penanggung Jawab Farmasi

dr. Hj. Tri Raparti Arifin, M.Kes. Sitti Sulaeha, S.Si, Apt.
Nip. 19611112 199509 2 001 Nip. 19760702 201101 2 003

Cat :
Stok Awal = Stok Akhir pada bulan seselumnya
Penerimaan = Realisasi Permintaan
KAIAN, DAN PERMINTAAN OBAT

PERMINTAAN : APRIL 2019

PEMAKAIAN STOK PERMINTAAN REALISASI KET.

5 115 100 80
5 81 54 10
5 104 60 50
6 83 70 60
7 29 40 20
8 62 50 30
9 77 55 55
73 26 67 60
3 92 89 70
5 110 45 40
3 125 34 30
5 95 23 10
7 46 67 60
8 128 89 79
8 80 23 20
5 94 23 10
3 73 23 10
5 68 34 20
6 90 35 30
6 93 36 30
8 90 56 50
6 97 56 50
7 119 78 60
8 116 80 60
7 92 80 70

Makassar, 26 Maret 2019

Farmasi Penanggung Jawab Poli KIA

, Apt. Suhartyny, A.Md.Keb.

01 2 003 Nip. 19770609 200604 2 029