LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

(LPLPO)

KODE PUSKESMAS : P3402010101

PUSKESMAS : : PANGKALPINANG
KECAMATAN : PANGKALPINANG LPLPO BULAN 10
KABUPATEN : BENGKULU PERMINTAAN BULAN Nopember
PROPINSI : BENGKULU TAHUN 2018

SA STOK PENERI- PERSE- PEMA- KOSONG SISA STOK PERMIN- PEMBERIAN

NO NAMA OBAT ED
TUAN AWAL MAAN DIAAN KAIAN (HARI) STOK OPT TAAN DAK DAU BS ASKES Lain-lain
0
1 Acyclovir tab 400 mg Tablet
2 Albendazole 400 mg Tablet
3 Allopurinol tablet 100 mg Tablet 800 2,000 500 1,500 1,000 -
4 Aminofilina Tablet 200 mg Tablet 1,900 1,000 900 2,000 1,100
5 Amitriptilina HCl tab salut 25 mg Tablet 600 - 600 - -
6 Amlodipin tablet 5 mg Tablet 1,500 5,580 3,480 2,100 6,960 4,860
7 Amoksilina kaplet 500 mg Kaplet 2,000 5,700 5,700 - 11,400 11,400
8 Amoksilina Syrup Kering 125 mg/ 5ml, 250 mg/5 ml Botol 100 200 20 180 40 -
9 Antasida DOEN Tablet, Kombinasi Tablet 11,500 3,600 7,900 7,200 -
10 Asam Askorbat (vit C) tablet 250 mg Tablet 1,000 - 1,000 - -
11 Asam Askorbat (vit C) tablet 50 mg Tablet 5,200 2,700 2,500 5,400 2,900
12 Asam Folat 1 mg Tablet 2,000 3,600 700 2,900 1,400 -
13 Asam Mefenamat kaplet 500 mg Kaplet 2,000 3,000 1,800 1,200 3,600 2,400
14 Asetosal tablet 80 mg/ 100 mg Tablet 500 2,100 1,200 900 2,400 1,500
15 Atenolol tablet 50 mg Tablet - - - -
16 Attapulgit tablet 600 mg Tablet 1,800 500 1,300 1,000 300
17 Azytromycin tablet Tablet 870 - 870 - -
18 Besi (II) sulfas tablet salut, kombinasi Sachet - - - -
19 Betahistin Mesilat 6 mg Tablet - - - -
20 Bisakodil tablet 5 mg Tablet - - - -
21 Bisoprolol tablet 5 mg Tablet - - - -
22 Bromhexin tablet 8 mg Tablet - - - -
23 Captopril tablet 12,5 mg Tablet 2,000 6,600 3,400 3,200 6,800 3,600

file:///conversion/tmp/scratch/441099280.xlsx
 SA STOK PENERI- PERSE- PEMA- KOSONG SISA STOK PERMIN- PEMBERIAN
NO NAMA OBAT ED
TUAN AWAL MAAN DIAAN KAIAN (HARI) STOK OPT TAAN DAK DAU BS ASKES Lain-lain
24 Captopril tablet 25 mg Tablet 4,200 3,600 600 7,200 6,600
25 Cefadroxil kapsul 500 mg Kapsul - - - -
26 Cefixim 400 mg + Azytromycin 1000 mg (IMS) amplop - - - -
27 Cefixim kapsul 100 mg Kapsul 5,600 950 4,650 1,900 -
28 Cetirizine tab 10 mg Tablet - - - -
29 Cetirizine Syrup Botol 200 200 31 169 62 -
30 Cimetidine tablet 200 mg Tablet - - - -
31 Ciprofloxacin 500 mg Tablet 1,900 100 1,800 200 -
32 Clobazam tablet 10 mg Tablet - - - -
33 Clonidine tablet 0,15 mg Tablet - - - -
34 Deksametason tablet 0,5 mg Tablet 2,500 5,100 2,200 2,900 4,400 1,500
35 Diazepam tablet 2 mg Tablet 900 400 500 800 300
36 Diazepam tablet 5 mg Tablet 500 - 500 - -
37 Digoksin tablet 0,25 mg Tablet 300 500 200 300 400 100
38 Dihidroartemisin+Piperaquin (Darplex)(program) box - - - -
39 Diltiazem HCl tablet 30 mg Tablet 500 - 500 - -
40 Dimenhidrinat tablet 50 mg Tablet 500 800 100 700 200 -
41 Doksisiklin 100 mg Kapsul 200 - 200 - -
42 Domperidon 10 mg Tablet - - - -
43 Ergotamina tartrat 1 mg + Kofeina 50 mg tab Komb Tablet - - - -
44 Erythromycin kapsul 500 mg Kapsul 200 - 200 - -
45 Etambutol HCl tablet 500 mg Tablet - - - -
46 Fenobarbital tablet 100 mg Tablet 800 100 700 200 -
47 Fenobarbital tablet 30 mg Tablet - - - -
48 Fitomenadion ( Vit K ) tablet salut 10 mg Tablet 200 100 100 200 100
49 Flukonazol tablet 150 mg Tablet 80 - 80 - -
50 Furosemida tablet 40 mg Tablet 1,000 2,500 400 2,100 800 -
51 Garam Oralit untuk 200 ml air Sachet 900 100 800 200 300
52 Gemfibrozil kapsul 300 mg Kapsul 8,280 120 8,160 240 -
53 Glibenklamid tablet 5 mg Tablet 12,200 300 11,900 600 -
54 Glimepiride 2 mg Tablet 1,500 3,000 1,500 1,500 3,000 1,500
55 Gliquidon tablet 30 mg Tablet - - - -
56 Griseofulvin tablet 125 mg, micronized Tablet 100 200 200 - 400 400

file:///conversion/tmp/scratch/441099280.xlsx
 SA STOK PENERI- PERSE- PEMA- KOSONG SISA STOK PERMIN- PEMBERIAN
NO NAMA OBAT ED
TUAN AWAL MAAN DIAAN KAIAN (HARI) STOK OPT TAAN DAK DAU BS ASKES Lain-lain
57 Haloperidol tablet 0,5 mg Tablet - - - - -
58 Haloperidol tablet 1,5 mg Tablet 5,400 1,400 4,000 2,800 -
59 Haloperidol tablet 5 mg Tablet 1,000 200 800 400 -
60 Hidroklortiazida ( HCT ) tablet 25 mg Tablet - - - -
61 Hyosin N Buthyl B tablet 10 mg Tablet - - - -
62 Ibuprofen Tablet 200 mg Tablet 2,000 2,700 1,500 1,200 3,000 1,800
63 Ibuprofen tablet 400 mg Tablet 1,000 2,400 300 2,100 600 -
64 Isoniazida ( INH ) tablet 300 mg Tablet 500 500 200 300 400 100
65 Isosorbid Dinitrat tab sublingual 5 mg Tablet 800 500 300 1,000 700
66 Kalium Aspartat 300 mg Tablet 400 400 400 - 800 800
67 Kalsium Laktat (Kalk) tablet 500 mg Tablet 1,000 6,100 2,200 3,900 4,400 500
68 Karbamazepin tablet 200 mg Tablet - - - -
69 Ketoconazol tablet 200 mg Tablet - - - -
70 Kinina Sulfas tablet 222 mg Tablet - - - -
71 Kloramfenikol kapsul 250 mg Kapsul - - - -
72 Klorfeniramine Maleat (CTM) tablet 4 mg Tablet 6,500 12,500 1,900 10,600 3,800 -
73 Klorokina Fosfat (klorokina) tablet 250 mg Tablet - - - -
74 Klorpromazina HCl tablet salut 100 mg Tablet 2,100 2,600 300 2,300 600 -
75 Klorpromazina HCl tablet salut 25 mg Tablet 1,500 2,300 300 2,000 600 -
76 Kotrimoksazol suspensi 240 mg Botol 85 85 170 170
77 Kotrimoksazol tablet 480 mg Tablet 1,900 - 1,900 - -
78 Lisinopril tablet 10 mg Tablet - - - -
79 Loratadine tab 10 mg Tablet - - - -
80 Mebendazol syr 100 mg/ 5 ml Botol - - - -
81 Mebendazol tablet 100 mg Tablet - - - -
82 Metformin HCl tablet 500 mg Tablet 5,000 9,900 6,400 3,500 12,800 9,300
83 Metilergometrina maleat tablet salut 0,125 mg Tablet 400 200 200 400 200
84 Metilprednisolon 4 mg, 8 mg Tablet 500 1,300 200 1,100 400 -
85 Metoklopramida HCl tablet 5 mg Tablet 800 - 800 - -
86 Metronidazol tablet 250 mg Tablet - - - -
87 Metronidazole 500 mg Tablet 500 900 200 700 400 -
88 Multivitamin Bumil + Fe Kapsul 8,300 2,000 6,300 4,000 -
89 Multivitamin Neurotropik kaplet Kaplet - - - -

file:///conversion/tmp/scratch/441099280.xlsx
 SA STOK PENERI- PERSE- PEMA- KOSONG SISA STOK PERMIN- PEMBERIAN
NO NAMA OBAT ED
TUAN AWAL MAAN DIAAN KAIAN (HARI) STOK OPT TAAN DAK DAU BS ASKES Lain-lain
90 Multivitamin Suplemen TB Kaps/tab - - - -
91 Multivitamin Syrup Botol - - - -
92 Natrium bikarbonat tablet 500 mg Tablet - - - -
93 Natrium Diklofenak 25 mg Tablet - - - -
94 Natrium Diklofenak 50 mg Tablet 800 750 50 1,500 1,450
95 Natrium fenitoin kapsul 30 mg Kapsul - - - -
96 Natrium fenitoin kapsul 100 mg Kapsul 400 800 400 400 800 400
97 Nifedipin tablet 10 mg Tablet 5,000 7,600 - 7,600 - -
98 Nistatin 100.000 iu/g tablet vaginal Tablet 83 7 76 14 -
99 Nistatin 500.000 IU tab salut gula Tablet - - - -
100 OAT FDC Anak Paket - - - - -
101 OAT Kombipak Anak Paket - - - - -
102 OAT Kombipak Kategori I Paket - - - - -
103 OAT-FDC Kategori I Paket - - - - -
104 OAT-FDC Kategori II Paket - - - -
105 OAT-FDC Sisipan Paket - - - -
106 Obat Batuk Hitam Botol - - - 100
107 Omeprazol kapsul 20 mg Kapsul 1,080 660 420 1,320 900
108 Parasetamol sirup 120 mg/5ml Botol 84 119 119 238 350
109 Parasetamol tablet 500 mg Tablet 5,000 24,200 12,100 12,100 24,200 12,400
110 Pirantel pamoat (pirantel) tablet 125 mg Tablet - - - -
111 Piridoksin HCl (vit B6) tablet 10 mg Tablet 300 2,200 2,200 - 4,400 4,400
112 Piroksikam 20 mg Tablet - - - -
113 Prednison tablet 5 mg Tablet 2,000 - 2,000 - -
114 Primakina tablet 15 mg Tablet - - - -
115 Propanolol HCl (propanolol) tablet 40 mg, 10 mg Tablet 300 - 300 - -
116 Propiltiourasil (PTU) tablet 100 mg Tablet 200 - 200 - -
117 Pyrazinamida tablet 500 mg Tablet 200 - 200 - -
118 Ranitidin 150 mg Tablet 2,000 5,900 2,700 3,200 5,400 2,200
119 Retinol (Vit A) kapsul lunak 100.000 iu Kapsul 250 - 250 - -
120 Retinol (Vit A) kapsul lunak 200.000 iu Kapsul 100 - 100 - -
121 Rifampisin Kapsul 300 mg Kapsul - - - -
122 Risperidon Kapsul 900 500 400 1,000 600

file:///conversion/tmp/scratch/441099280.xlsx
 SA STOK PENERI- PERSE- PEMA- KOSONG SISA STOK PERMIN- PEMBERIAN
NO NAMA OBAT ED
TUAN AWAL MAAN DIAAN KAIAN (HARI) STOK OPT TAAN DAK DAU BS ASKES Lain-lain
123 Salbutamol tablet 2 mg Tablet - - - -
124 Salbutamol tablet 4 mg Tablet - - - -
125 Sianocobalamin ( Vitamin B12) tab 50 mcg Tablet 2,000 6,500 3,200 3,300 6,400 3,100
126 Simvastatin tab 10 mg Tablet 2,000 3,000 2,000 1,000 4,000 3,000
127 Spironolakton tablet 100 mg Tablet 300 100 200 200 -
128 Spironolakton tablet 25 mg Tablet - - - -
129 Thiamina HCl monohidrat (vit B1) tab 50 mg Tablet 6,000 1,000 5,000 2,000 -
130 Trifluoperazine tablet 5 mg Tablet 600 100 500 200 -
131 Trihexylphenidil HCl tablet 2 mg Tablet 2,000 2,000 - 4,000 4,000
132 Vitamin B kompleks Tablet 13,600 19,600 1,600 18,000 3,200 -
133 Zink tablet 20 mg Tablet 400 200 200 400 500
OBAT YANKESTRAD 200 - - - -
134 Anti Hipertensi Herbal Kapsul 120 360 30 330 60 -
135 Anti Keputihan Herbal Kapsul - - - -
136 Anti Kolesterol Herbal Kapsul 450 30 420 60 -
137 Anti Nyeri Haid Herbal Kapsul 270 30 240 60 -
138 Anti Nyeri Sendi Herbal Kapsul - - - -
139 Ekstrak Serat Herbal Sacchet - - - -
140 Ekstrak Standar Saw Palmetto 160 mg Kapsul - - - -
141 Immunomodulator Kapsul Herbal Kapsul - - - -
142 Immunomodulator Syrup Herbal Botol - - - -
143 Pelancar ASI Herbal Kapsul - - - -
144 Salep Luka Bakar Herbal Tube - - - -
145 Sonchi/Nephrolit kapsul/Calcusol kapsul Kapsul 1,000 100 900 200 -
OBAT LUAR 0 - - - -
146 Acyclovir Krim SK Tube - - - -
147 Antibakteri DOEN salep, kombinasi Tube 175 75 100 150 50
148 Antifungi DOEN salep Pot - - - -
149 Antihemmoroid Suppositoria Supp 20 70 24 46 48 2
150 As. Salisilat 2% + Belerang endap 4% (2-4 salep) Pot - - - -
151 Perak Sulfadiazin Tube - - - -
152 Betametason krim 0,1% Tube 150 75 75 150 75
153 Betametason valerat + Neomisina sulfat cream Tube 90 20 70 40 -

file:///conversion/tmp/scratch/441099280.xlsx
 SA STOK PENERI- PERSE- PEMA- KOSONG SISA STOK PERMIN- PEMBERIAN
NO NAMA OBAT ED
TUAN AWAL MAAN DIAAN KAIAN (HARI) STOK OPT TAAN DAK DAU BS ASKES Lain-lain
154 Diazepam Rectal 5 mg Tube 55 5 50 10 -
155 Etanol 70% 100 ml Botol - - - -
156 Etanol 70% 1000 ml Botol 8 2 6 4 -
157 Etil Klorida semprot Botol - - - -
158 Extract Placenta 10% Tube 40 10 30 20 -
159 Fenol Gliserol TT 10% Botol 96 24 72 48 -
160 Flucinolon + Neomisin cream Tube - - - -
161 Flucinolon Cream Tube 30 20 10 40 30
162 Framycetine sulfat 1 % Lembar - - - -
163 Gentamicin salep kulit 0,1% Tube - - - -
164 Gentamisin Sulfat tetes mata 0,3% Botol - - - -
165 Gentian Violet Botol - - - -
166 Hidrokortison Cream 2,5% Tube 24 24 - 48 48
167 Ketokonazol cream Tube - - - -
168 Kloramfenikol 0,5% Tetes Mata Botol - - - -
169 Kloramfenikol salep kulit Tube 120 - 120 - -
170 Kloramfenikol salep mata 1% Tube - - - -
171 Kloramfenikol tetes telinga Botol - - - -
172 Licocain Jelly Tube 15 - 15 - -
173 Licocain Spray Botol 21 3 18 6 -
174 Metakresol sulfonat /Policresuken/Aptil Botol 50 - 50 - -
175 Miconasol krim 2% Tube 48 90 42 48 84 36
176 Oksitetra Salep Kulit 3% Tube - - - -
177 Oksitetra Salep Mata 1% Tube - - - -
178 Salbutamol 2,5 mg/2,5 ml Nebulizer Ampul 140 40 100 80 -
179 Salisil bedak 2 % Kotak 61 10 51 20 -
180 Yodium Povidon lar 10 % 30 ml Botol 60 52 8 104 96
181 Yodium Povidon lar 10 % 300 ml Botol - - - -
BAHAN MEDIS HABIS PAKAI 31 - - - -
182 Alat suntik sekali pakai 1 ml Set 1,300 - 1,300 - -
183 Alat suntik sekali pakai 3/ 2,5 ml Set 9,800 500 9,300 1,000 -
184 Alat suntik sekali pakai 5 ml Set - - - -
185 Alkohol swab Box 4 18 5 13 10 -

file:///conversion/tmp/scratch/441099280.xlsx
 SA STOK PENERI- PERSE- PEMA- KOSONG SISA STOK PERMIN- PEMBERIAN
NO NAMA OBAT ED
TUAN AWAL MAAN DIAAN KAIAN (HARI) STOK OPT TAAN DAK DAU BS ASKES Lain-lain
186 Antiseptik Bilas (Surgical Scrub) Botol 4 1 3 2 -
187 Antiseptik Pencuci Tangan (Hand Rub) Botol 67 4 63 8 -
188 Aqua Jelly Tube - - - -
189 Box Slide box - - - -
190 Cat Ziehl Nellsen box - - - -
191 Catgut/ benang bedah no. 2/0 Sachet 526 166 360 332 -
192 Catgut/ benang bedah no. 3/0 Sachet 106 34 72 68 -
193 Foley Catheter No.16 Pcs 330 30 300 60 -
194 Foley Catheter No.18 Pcs - - - -
195 Infusion Set Anak Set 400 - 400 - -
196 Infusion Set Dewasa Set - - - -
197 Intravena Catheter anak (no.24) Set 650 50 600 100 -
198 Intravena Catheter dewasa (no. 20) Set 600 - 600 - -
199 Intravena Catheter dewasa (no. 22) Set 1,300 150 1,150 300 -
200 Kapas Pembalut/ adsorbent 250 gram Bungkus 96 3 93 6 -
201 Kasa Pembalut Hidrofil 4 m x 5 cm Roll 1,320 - 1,320 - -
202 Kasa Pembalut Hidrofil 4 m x 10 cm Roll - - - -
203 Kasa Pembalut Hidrofil 4 m x 15 cm Roll - - - -
204 Kassa gulung 40 yard x 80 cm Roll 73 2 71 4 -
205 Kassa Hidrofil Steril 16/16 steril Roll - - - -
206 Kassa Hidrofil Steril 18/22 steril Roll - - - -
207 Pembalut Elastis 7,5 Roll 32 1 31 2 -
208 Pembalut Elastis 10 Roll 36 - 36 - -
209 Pembalut Elastis 15 Roll 60 - 60 - -
210 Umbilical Cord Klem Steril pcs 100 - 100 - -
211 Urine bag pcs 175 - 175 - -
212 Kertas Saring box - - - -
213 Masker Biasa Pcs 8,450 200 8,250 400 -
214 Masker N95 Pcs - - - -
215 Masker Jilbab Pcs 5,200 1,300 3,900 2,600 -
216 Obyek Glass box 3 - 3 - -
217 Plester 5 yards x 2 inch Roll - - - -
218 Plester Non Woven Roll - - - -

file:///conversion/tmp/scratch/441099280.xlsx
 SA STOK PENERI- PERSE- PEMA- KOSONG SISA STOK PERMIN- PEMBERIAN
NO NAMA OBAT ED
TUAN AWAL MAAN DIAAN KAIAN (HARI) STOK OPT TAAN DAK DAU BS ASKES Lain-lain
219 Pot Sputum pcs 150 - 150 - -
220 Rapid Test 1 HIV box 400 - 400 - -
221 Rapid Test 2 HIV box 90 90 - 180 180
222 Rapid Test 3 HIV box 125 125 - 250 250
223 Rapid Test RPR Shyphillis box - - - -
224 Rapid Test Shyphillis box - - - -
225 Sarung Tangan Biasa Pcs 3,200 2,200 1,000 4,400 3,400
226 Sarung Tangan Steril Pcs 450 50 400 100 -
227 Silk (benang sutera) no 3/0 Sach 566 62 504 124 -
228 Spiritus 1000 ml Botol 4 1 3 2 -
229 Wing Needle No. 21 Pcs - - - -
230 Wing Needle No. 23 Pcs 4 - 4 - -
231 Wing Needle No. 25 Pcs 4 - 4 - -
232 Wing Needle No. 27 Pcs 2 - 2 - -
SEDIAAN INJEKSI / CAIRAN / SERUM 12 - - - -
233 Aminofilina injeksi 24 mg/ml - 10 mml Ampul - - - - -
234 Ampisiilin 1000mg/ vial inj Vial 90 - 90 - -
235 Aqua Pro Injeksi steril, bebas pirogen 20 ml Ampul - - - -
236 Atropin Sulfas injeksi 0,25 mg/ ml - 1 ml Ampul 52 22 30 44 14
237 Benzatin benzil-penisilina injeksi 2,4 juta iu/ vial Vial 12 - 12 - -
238 Ceftriaxon serbuk inj 1g/vial Vial - - - -
239 Deksametason injeksi 5 mg/ml - 1 ml Ampul 136 - 136 - -
240 Diazepam injeksi 5mg/ml - 2 ml Ampul 32 - 32 - -
241 Difenhidramin HCl injeksi 10 mg/ml - 1 ml Ampul 22 - 22 - -
242 Epinefrina HCl (adrenalina) inj. 0,1% - 1 ml Ampul 30 - 30 - -
243 Fenobarbital injeksi 50 mg/ml - 2 ml Ampul 60 14 46 28 -
244 Fitomenadion ( Vit K ) injeksi 10 mg/ml - 1 ml Ampul 60 60 - 60 - -
245 Gentamycin inj Ampul 5 5 10 10
246 Glukosa larutan infus 10% steril Botol - - - -
247 Glukosa larutan infus 5% steril Botol 30 - 30 - -
248 Haloperidol injeksi i.m 5 mg/ml Ampul 24 - 24 - -
249 Human Anti tetanus inj Ampul 41 3 38 6 -
250 Hyosin N Buthyl B inj 20 mg/ml Ampul 25 15 10 30 20
251 Kalsium Glukonas Injeksi Ampul 7 - 7 - -

file:///conversion/tmp/scratch/441099280.xlsx
 SA STOK PENERI- PERSE- PEMA- KOSONG SISA STOK PERMIN- PEMBERIAN
NO NAMA OBAT ED
TUAN AWAL MAAN DIAAN KAIAN (HARI) STOK OPT TAAN DAK DAU BS ASKES Lain-lain
252 Kinina Dihidroklotida (kinina) injeksi 25% - 2ml Ampul - - - -
253 Klorpromazina HCl injeksi 5 mg/ml - 1 ml, 5 mg Ampul 30 - 30 - -
254 Lidokaina 2% HCl (Lidocain murni) injeksi Ampul agustus #VALUE! - 100 - -
255 Lidokaina com (Lidocain HCl 2 %+ epinefrin) injeksi Ampul - - - -
256 Magnesium Sulfat inj 20% Ampul - - - -
257 Magnesium Sulfat inj (IV) 40%-25ml Vial 6 - 6 - -
258 Metilergometrina maleat injeksi 0,200 mg/ml - 1 ml Ampul - - - -
259 Metoklopramid inj. 5mg/ml Ampul - - - -
260 Natrium Klorida larutan infus 0,9% steril Botol 60 100 40 60 80 20
261 Natrium Tiosulfat injeksi 25% - 10 ml Ampul - - - -
262 Oksitosina injeksi 10 i.u/ml - 1 ml Ampul 230 - 230 - -
263 Ranitidin injeksi 25 mg/2 ml Ampul 390 30 360 60 -
264 Ringer Laktat Larutan infus steril Botol 460 40 420 80 -
265 Serum anti bisa ular polivalen inj 5 ml (ABU I) Ampul - - - -
266 Serum Anti Tetanus inj 1.500 i.u/ampul (ATS) Ampul 57 15 42 30 -
267 Sianokobalamin (vit B12) inj 500 mcg/ml -1 ml Ampul 400 - 400 - -
268 Streptomisin sulfat serbuk inj 1.000 mg/vial Vial - - - -
269 Thiamina HCl (vit B1) inj 100 mg/ml - 1 ml Ampul - - - -
270 Tramadol inj 50 mg/ml Ampul - - - -
TAMBAHAN - - - -
271 Mineral Mix sacch - - - -
272 Fenoksi Penisillina tablet 250 mg Tablet - - - -
273 Fenoksi Penisillina tablet 500 mg Tablet - - - -
274 Osetalmivir tablet kotak 10 10 - 10 - -
275 Sikat Pembersih Pcs 12 - 12 - -
276 Termometer Pcs - - - -
277 Tetrasiklin HCl kapsul 250 mg Kapsul - - - -
278 Tetrasiklin HCl kapsul 500 mg Kapsul - - - -
279 Taburia box 6 - 6 - -
280 Acethysistein Tablet 1,200 2,200 100 2,100 200 -

JUMLAH KUNJUNGAN RESEP BAYAR TIDAK BAYAR JUMLAH

file:///conversion/tmp/scratch/441099280.xlsx
 SA STOK PENERI- PERSE- PEMA- KOSONG SISA STOK PERMIN- PEMBERIAN
NO NAMA OBAT ED
TUAN AWAL MAAN DIAAN KAIAN (HARI) STOK OPT TAAN DAK DAU BS ASKES Lain-lain
BULAN oktober 2018 Jamkesos Jamkesda JKN Lain Lain
139 1942
49 63 1681 10

Mengetahui / Menyetujui Yang Menyerahkan Yang Meminta Yang Menerima

Kepala Dinas Kesehatan Kabupaten Petugas GFK a/n Pimpinan Puskesmas Petugas Puskesmas

TUGAS:
BUATLAH LPLPO MENGGUNAKAN DATA
BULAN september dengan metode
kombinasi

file:///conversion/tmp/scratch/441099280.xlsx
AIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

10
Nopember
2018
SEPTEMBER
PEMBERIAN SISA
KET STOK

1,200
1,900
600
4,080
3,700
100
11,500
1,000
5,200
1,600
1,000
1,600

1,800
870

4,600

file:///conversion/tmp/scratch/441099280.xlsx
PEMBERIAN SISA
KET STOK
4,200

5,600

1,900

2,600
900
500
200

500
300
200

200

800

200
80
1,500
900
8,280
12,200
1,500

100

file:///conversion/tmp/scratch/441099280.xlsx
PEMBERIAN SISA
KET STOK

5,400
1,000

700
1,400

800

5,100

6,000

500
800
85
1,900
-

4,900
400
800
800

400
8,300

file:///conversion/tmp/scratch/441099280.xlsx
PEMBERIAN SISA
KET STOK

800

400
2,600
83

1,080
35
19,200

1,900

2,000

300
200
200
3,900
250
100

900

file:///conversion/tmp/scratch/441099280.xlsx
PEMBERIAN SISA
KET STOK

4,500
1,000
300

6,000
600
2,000
6,000
400

240

450
270

1,000

175

50

150
90

file:///conversion/tmp/scratch/441099280.xlsx
PEMBERIAN SISA
KET STOK
55

40
96

30

24

120

15
21
50
42

140
61
60

1,300
9,800

14

file:///conversion/tmp/scratch/441099280.xlsx
PEMBERIAN SISA
KET STOK
4
67

526
106
330

400

650
600
1,300
96
1,320

73

32
36
60
100
175

8,450

5,200
3

file:///conversion/tmp/scratch/441099280.xlsx
PEMBERIAN SISA
KET STOK
150
400
90
125

3,200
450
566
4

4
4
2

90

52
12

136
32
22
30
60

30
24
41
25
7

file:///conversion/tmp/scratch/441099280.xlsx
PEMBERIAN SISA
KET STOK

30
100

6
-

40

230
390
460

57
400

12

6
1,000

file:///conversion/tmp/scratch/441099280.xlsx
PEMBERIAN SISA
KET STOK

file:///conversion/tmp/scratch/441099280.xlsx
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

KODE PUSKESMAS : P3402010101

PUSKESMAS : : PANGKALPINANG
KECAMATAN : PANGKALPINANG LPLPO BULAN 7
KABUPATEN : BENGKULU PERMINTAAN BULAN AGUSTUS
PROPINSI : BENGKULU TAHUN 2017

SA STOK PENERI- PERSE- PEMA- KOSONG SISA STOK PERMIN- PEMBERIAN

NO NAMA OBAT ED
TUAN AWAL MAAN DIAAN KAIAN (HARI) STOK OPT TAAN DAK DAU BS ASKES Lain-lain
0
1 Acyclovir tab 400 mg Tablet
2 Albendazole 400 mg Tablet
3 Allopurinol tablet 100 mg Tablet 1,200
4 Aminofilina Tablet 200 mg Tablet 1,900
5 Amitriptilina HCl tab salut 25 mg Tablet 600
6 Amlodipin tablet 5 mg Tablet 4,080
7 Amoksilina kaplet 500 mg Kaplet 3,700
8 Amoksilina Syrup Kering 125 mg/ 5ml, 250 mg/5 ml Botol 100
9 Antasida DOEN Tablet, Kombinasi Tablet 11,500
10 Asam Askorbat (vit C) tablet 250 mg Tablet 1,000
11 Asam Askorbat (vit C) tablet 50 mg Tablet 5,200
12 Asam Folat 1 mg Tablet 1,600
13 Asam Mefenamat kaplet 500 mg Kaplet 1,000
14 Asetosal tablet 80 mg/ 100 mg Tablet 1,600
15 Atenolol tablet 50 mg Tablet
16 Attapulgit tablet 600 mg Tablet 1,800
17 Azytromycin tablet Tablet 870
18 Besi (II) sulfas tablet salut, kombinasi Sachet
19 Betahistin Mesilat 6 mg Tablet
20 Bisakodil tablet 5 mg Tablet
21 Bisoprolol tablet 5 mg Tablet
22 Bromhexin tablet 8 mg Tablet
23 Captopril tablet 12,5 mg Tablet 4,600

file:///conversion/tmp/scratch/441099280.xlsx
 SA STOK PENERI- PERSE- PEMA- KOSONG SISA STOK PERMIN- PEMBERIAN
NO NAMA OBAT ED
TUAN AWAL MAAN DIAAN KAIAN (HARI) STOK OPT TAAN DAK DAU BS ASKES Lain-lain
24 Captopril tablet 25 mg Tablet 4,200
25 Cefadroxil kapsul 500 mg Kapsul
26 Cefixim 400 mg + Azytromycin 1000 mg (IMS) amplop
27 Cefixim kapsul 100 mg Kapsul 5,600
28 Cetirizine tab 10 mg Tablet
29 Cetirizine Syrup Botol
30 Cimetidine tablet 200 mg Tablet
31 Ciprofloxacin 500 mg Tablet 1,900
32 Clobazam tablet 10 mg Tablet
33 Clonidine tablet 0,15 mg Tablet
34 Deksametason tablet 0,5 mg Tablet 2,600
35 Diazepam tablet 2 mg Tablet 900
36 Diazepam tablet 5 mg Tablet 500
37 Digoksin tablet 0,25 mg Tablet 200
38 Dihidroartemisin+Piperaquin (Darplex)(program) box
39 Diltiazem HCl tablet 30 mg Tablet 500
40 Dimenhidrinat tablet 50 mg Tablet 300
41 Doksisiklin 100 mg Kapsul 200
42 Domperidon 10 mg Tablet
43 Ergotamina tartrat 1 mg + Kofeina 50 mg tab Komb Tablet
44 Erythromycin kapsul 500 mg Kapsul 200
45 Etambutol HCl tablet 500 mg Tablet
46 Fenobarbital tablet 100 mg Tablet 800
47 Fenobarbital tablet 30 mg Tablet
48 Fitomenadion ( Vit K ) tablet salut 10 mg Tablet 200
49 Flukonazol tablet 150 mg Tablet 80
50 Furosemida tablet 40 mg Tablet 1,500
51 Garam Oralit untuk 200 ml air Sachet 900
52 Gemfibrozil kapsul 300 mg Kapsul 8,280
53 Glibenklamid tablet 5 mg Tablet 12,200
54 Glimepiride 2 mg Tablet 1,500
55 Gliquidon tablet 30 mg Tablet
56 Griseofulvin tablet 125 mg, micronized Tablet 100

file:///conversion/tmp/scratch/441099280.xlsx
 SA STOK PENERI- PERSE- PEMA- KOSONG SISA STOK PERMIN- PEMBERIAN
NO NAMA OBAT ED
TUAN AWAL MAAN DIAAN KAIAN (HARI) STOK OPT TAAN DAK DAU BS ASKES Lain-lain
57 Haloperidol tablet 0,5 mg Tablet
58 Haloperidol tablet 1,5 mg Tablet 5,400
59 Haloperidol tablet 5 mg Tablet 1,000
60 Hidroklortiazida ( HCT ) tablet 25 mg Tablet
61 Hyosin N Buthyl B tablet 10 mg Tablet
62 Ibuprofen Tablet 200 mg Tablet 700
63 Ibuprofen tablet 400 mg Tablet 1,400
64 Isoniazida ( INH ) tablet 300 mg Tablet
65 Isosorbid Dinitrat tab sublingual 5 mg Tablet 800
66 Kalium Aspartat 300 mg Tablet
67 Kalsium Laktat (Kalk) tablet 500 mg Tablet 5,100
68 Karbamazepin tablet 200 mg Tablet
69 Ketoconazol tablet 200 mg Tablet
70 Kinina Sulfas tablet 222 mg Tablet
71 Kloramfenikol kapsul 250 mg Kapsul
72 Klorfeniramine Maleat (CTM) tablet 4 mg Tablet 6,000
73 Klorokina Fosfat (klorokina) tablet 250 mg Tablet
74 Klorpromazina HCl tablet salut 100 mg Tablet 500
75 Klorpromazina HCl tablet salut 25 mg Tablet 800
76 Kotrimoksazol suspensi 240 mg Botol 85
77 Kotrimoksazol tablet 480 mg Tablet 1,900
78 Lisinopril tablet 10 mg Tablet -
79 Loratadine tab 10 mg Tablet
80 Mebendazol syr 100 mg/ 5 ml Botol
81 Mebendazol tablet 100 mg Tablet
82 Metformin HCl tablet 500 mg Tablet 4,900
83 Metilergometrina maleat tablet salut 0,125 mg Tablet 400
84 Metilprednisolon 4 mg, 8 mg Tablet 800
85 Metoklopramida HCl tablet 5 mg Tablet 800
86 Metronidazol tablet 250 mg Tablet
87 Metronidazole 500 mg Tablet 400
88 Multivitamin Bumil + Fe Kapsul 8,300
89 Multivitamin Neurotropik kaplet Kaplet

file:///conversion/tmp/scratch/441099280.xlsx
 SA STOK PENERI- PERSE- PEMA- KOSONG SISA STOK PERMIN- PEMBERIAN
NO NAMA OBAT ED
TUAN AWAL MAAN DIAAN KAIAN (HARI) STOK OPT TAAN DAK DAU BS ASKES Lain-lain
90 Multivitamin Suplemen TB Kaps/tab
91 Multivitamin Syrup Botol
92 Natrium bikarbonat tablet 500 mg Tablet
93 Natrium Diklofenak 25 mg Tablet
94 Natrium Diklofenak 50 mg Tablet 800
95 Natrium fenitoin kapsul 30 mg Kapsul
96 Natrium fenitoin kapsul 100 mg Kapsul 400
97 Nifedipin tablet 10 mg Tablet 2,600
98 Nistatin 100.000 iu/g tablet vaginal Tablet 83
99 Nistatin 500.000 IU tab salut gula Tablet
100 OAT FDC Anak Paket
101 OAT Kombipak Anak Paket
102 OAT Kombipak Kategori I Paket
103 OAT-FDC Kategori I Paket
104 OAT-FDC Kategori II Paket
105 OAT-FDC Sisipan Paket
106 Obat Batuk Hitam Botol
107 Omeprazol kapsul 20 mg Kapsul 1,080
108 Parasetamol sirup 120 mg/5ml Botol 35
109 Parasetamol tablet 500 mg Tablet 19,200
110 Pirantel pamoat (pirantel) tablet 125 mg Tablet
111 Piridoksin HCl (vit B6) tablet 10 mg Tablet 1,900
112 Piroksikam 20 mg Tablet
113 Prednison tablet 5 mg Tablet 2,000
114 Primakina tablet 15 mg Tablet
115 Propanolol HCl (propanolol) tablet 40 mg, 10 mg Tablet 300
116 Propiltiourasil (PTU) tablet 100 mg Tablet 200
117 Pyrazinamida tablet 500 mg Tablet 200
118 Ranitidin 150 mg Tablet 3,900
119 Retinol (Vit A) kapsul lunak 100.000 iu Kapsul 250
120 Retinol (Vit A) kapsul lunak 200.000 iu Kapsul 100
121 Rifampisin Kapsul 300 mg Kapsul
122 Risperidon Kapsul 900

file:///conversion/tmp/scratch/441099280.xlsx
 SA STOK PENERI- PERSE- PEMA- KOSONG SISA STOK PERMIN- PEMBERIAN
NO NAMA OBAT ED
TUAN AWAL MAAN DIAAN KAIAN (HARI) STOK OPT TAAN DAK DAU BS ASKES Lain-lain
123 Salbutamol tablet 2 mg Tablet
124 Salbutamol tablet 4 mg Tablet
125 Sianocobalamin ( Vitamin B12) tab 50 mcg Tablet 4,500
126 Simvastatin tab 10 mg Tablet 1,000
127 Spironolakton tablet 100 mg Tablet 300
128 Spironolakton tablet 25 mg Tablet
129 Thiamina HCl monohidrat (vit B1) tab 50 mg Tablet 6,000
130 Trifluoperazine tablet 5 mg Tablet 600
131 Trihexylphenidil HCl tablet 2 mg Tablet 2,000
132 Vitamin B kompleks Tablet 6,000
133 Zink tablet 20 mg Tablet 400
OBAT YANKESTRAD 200
134 Anti Hipertensi Herbal Kapsul 240
135 Anti Keputihan Herbal Kapsul
136 Anti Kolesterol Herbal Kapsul 450
137 Anti Nyeri Haid Herbal Kapsul 270
138 Anti Nyeri Sendi Herbal Kapsul
139 Ekstrak Serat Herbal Sacchet
140 Ekstrak Standar Saw Palmetto 160 mg Kapsul
141 Immunomodulator Kapsul Herbal Kapsul
142 Immunomodulator Syrup Herbal Botol
143 Pelancar ASI Herbal Kapsul
144 Salep Luka Bakar Herbal Tube
145 Sonchi/Nephrolit kapsul/Calcusol kapsul Kapsul 1,000
OBAT LUAR 0
146 Acyclovir Krim SK Tube
147 Antibakteri DOEN salep, kombinasi Tube 175
148 Antifungi DOEN salep Pot
149 Antihemmoroid Suppositoria Supp 50
150 As. Salisilat 2% + Belerang endap 4% (2-4 salep) Pot
151 Perak Sulfadiazin Tube
152 Betametason krim 0,1% Tube 150
153 Betametason valerat + Neomisina sulfat cream Tube 90

file:///conversion/tmp/scratch/441099280.xlsx
 SA STOK PENERI- PERSE- PEMA- KOSONG SISA STOK PERMIN- PEMBERIAN
NO NAMA OBAT ED
TUAN AWAL MAAN DIAAN KAIAN (HARI) STOK OPT TAAN DAK DAU BS ASKES Lain-lain
154 Diazepam Rectal 5 mg Tube 55
155 Etanol 70% 100 ml Botol
156 Etanol 70% 1000 ml Botol 8
157 Etil Klorida semprot Botol
158 Extract Placenta 10% Tube 40
159 Fenol Gliserol TT 10% Botol 96
160 Flucinolon + Neomisin cream Tube
161 Flucinolon Cream Tube 30
162 Framycetine sulfat 1 % Lembar
163 Gentamicin salep kulit 0,1% Tube
164 Gentamisin Sulfat tetes mata 0,3% Botol
165 Gentian Violet Botol
166 Hidrokortison Cream 2,5% Tube 24
167 Ketokonazol cream Tube
168 Kloramfenikol 0,5% Tetes Mata Botol
169 Kloramfenikol salep kulit Tube 120
170 Kloramfenikol salep mata 1% Tube
171 Kloramfenikol tetes telinga Botol
172 Licocain Jelly Tube 15
173 Licocain Spray Botol 21
174 Metakresol sulfonat /Policresuken/Aptil Botol 50
175 Miconasol krim 2% Tube 42
176 Oksitetra Salep Kulit 3% Tube
177 Oksitetra Salep Mata 1% Tube
178 Salbutamol 2,5 mg/2,5 ml Nebulizer Ampul 140
179 Salisil bedak 2 % Kotak 61
180 Yodium Povidon lar 10 % 30 ml Botol 60
181 Yodium Povidon lar 10 % 300 ml Botol
BAHAN MEDIS HABIS PAKAI 31
182 Alat suntik sekali pakai 1 ml Set 1,300
183 Alat suntik sekali pakai 3/ 2,5 ml Set 9,800
184 Alat suntik sekali pakai 5 ml Set
185 Alkohol swab Box 14

file:///conversion/tmp/scratch/441099280.xlsx
 SA STOK PENERI- PERSE- PEMA- KOSONG SISA STOK PERMIN- PEMBERIAN
NO NAMA OBAT ED
TUAN AWAL MAAN DIAAN KAIAN (HARI) STOK OPT TAAN DAK DAU BS ASKES Lain-lain
186 Antiseptik Bilas (Surgical Scrub) Botol 4
187 Antiseptik Pencuci Tangan (Hand Rub) Botol 67
188 Aqua Jelly Tube
189 Box Slide box
190 Cat Ziehl Nellsen box
191 Catgut/ benang bedah no. 2/0 Sachet 526
192 Catgut/ benang bedah no. 3/0 Sachet 106
193 Foley Catheter No.16 Pcs 330
194 Foley Catheter No.18 Pcs
195 Infusion Set Anak Set 400
196 Infusion Set Dewasa Set
197 Intravena Catheter anak (no.24) Set 650
198 Intravena Catheter dewasa (no. 20) Set 600
199 Intravena Catheter dewasa (no. 22) Set 1,300
200 Kapas Pembalut/ adsorbent 250 gram Bungkus 96
201 Kasa Pembalut Hidrofil 4 m x 5 cm Roll 1,320
202 Kasa Pembalut Hidrofil 4 m x 10 cm Roll
203 Kasa Pembalut Hidrofil 4 m x 15 cm Roll
204 Kassa gulung 40 yard x 80 cm Roll 73
205 Kassa Hidrofil Steril 16/16 steril Roll
206 Kassa Hidrofil Steril 18/22 steril Roll
207 Pembalut Elastis 7,5 Roll 32
208 Pembalut Elastis 10 Roll 36
209 Pembalut Elastis 15 Roll 60
210 Umbilical Cord Klem Steril pcs 100
211 Urine bag pcs 175
212 Kertas Saring box
213 Masker Biasa Pcs 8,450
214 Masker N95 Pcs
215 Masker Jilbab Pcs 5,200
216 Obyek Glass box 3
217 Plester 5 yards x 2 inch Roll
218 Plester Non Woven Roll

file:///conversion/tmp/scratch/441099280.xlsx
 SA STOK PENERI- PERSE- PEMA- KOSONG SISA STOK PERMIN- PEMBERIAN
NO NAMA OBAT ED
TUAN AWAL MAAN DIAAN KAIAN (HARI) STOK OPT TAAN DAK DAU BS ASKES Lain-lain
219 Pot Sputum pcs 150
220 Rapid Test 1 HIV box 400
221 Rapid Test 2 HIV box 90
222 Rapid Test 3 HIV box 125
223 Rapid Test RPR Shyphillis box
224 Rapid Test Shyphillis box
225 Sarung Tangan Biasa Pcs 3,200
226 Sarung Tangan Steril Pcs 450
227 Silk (benang sutera) no 3/0 Sach 566
228 Spiritus 1000 ml Botol 4
229 Wing Needle No. 21 Pcs
230 Wing Needle No. 23 Pcs 4
231 Wing Needle No. 25 Pcs 4
232 Wing Needle No. 27 Pcs 2
SEDIAAN INJEKSI / CAIRAN / SERUM 12
233 Aminofilina injeksi 24 mg/ml - 10 mml Ampul
234 Ampisiilin 1000mg/ vial inj Vial 90
235 Aqua Pro Injeksi steril, bebas pirogen 20 ml Ampul
236 Atropin Sulfas injeksi 0,25 mg/ ml - 1 ml Ampul 52
237 Benzatin benzil-penisilina injeksi 2,4 juta iu/ vial Vial 12
238 Ceftriaxon serbuk inj 1g/vial Vial
239 Deksametason injeksi 5 mg/ml - 1 ml Ampul 136
240 Diazepam injeksi 5mg/ml - 2 ml Ampul 32
241 Difenhidramin HCl injeksi 10 mg/ml - 1 ml Ampul 22
242 Epinefrina HCl (adrenalina) inj. 0,1% - 1 ml Ampul 30
243 Fenobarbital injeksi 50 mg/ml - 2 ml Ampul 60
244 Fitomenadion ( Vit K ) injeksi 10 mg/ml - 1 ml Ampul
245 Gentamycin inj Ampul 5
246 Glukosa larutan infus 10% steril Botol
247 Glukosa larutan infus 5% steril Botol 30
248 Haloperidol injeksi i.m 5 mg/ml Ampul 24
249 Human Anti tetanus inj Ampul 41
250 Hyosin N Buthyl B inj 20 mg/ml Ampul 25
251 Kalsium Glukonas Injeksi Ampul 7

file:///conversion/tmp/scratch/441099280.xlsx
 SA STOK PENERI- PERSE- PEMA- KOSONG SISA STOK PERMIN- PEMBERIAN
NO NAMA OBAT ED
TUAN AWAL MAAN DIAAN KAIAN (HARI) STOK OPT TAAN DAK DAU BS ASKES Lain-lain
252 Kinina Dihidroklotida (kinina) injeksi 25% - 2ml Ampul
253 Klorpromazina HCl injeksi 5 mg/ml - 1 ml, 5 mg Ampul 30
254 Lidokaina 2% HCl (Lidocain murni) injeksi Ampul 100
255 Lidokaina com (Lidocain HCl 2 %+ epinefrin) injeksi Ampul
256 Magnesium Sulfat inj 20% Ampul
257 Magnesium Sulfat inj (IV) 40%-25ml Vial 6
258 Metilergometrina maleat injeksi 0,200 mg/ml - 1 ml Ampul -
259 Metoklopramid inj. 5mg/ml Ampul
260 Natrium Klorida larutan infus 0,9% steril Botol 40
261 Natrium Tiosulfat injeksi 25% - 10 ml Ampul
262 Oksitosina injeksi 10 i.u/ml - 1 ml Ampul 230
263 Ranitidin injeksi 25 mg/2 ml Ampul 390
264 Ringer Laktat Larutan infus steril Botol 460
265 Serum anti bisa ular polivalen inj 5 ml (ABU I) Ampul
266 Serum Anti Tetanus inj 1.500 i.u/ampul (ATS) Ampul 57
267 Sianokobalamin (vit B12) inj 500 mcg/ml -1 ml Ampul 400
268 Streptomisin sulfat serbuk inj 1.000 mg/vial Vial
269 Thiamina HCl (vit B1) inj 100 mg/ml - 1 ml Ampul
270 Tramadol inj 50 mg/ml Ampul
TAMBAHAN
271 Mineral Mix sacch
272 Fenoksi Penisillina tablet 250 mg Tablet
273 Fenoksi Penisillina tablet 500 mg Tablet
274 Osetalmivir tablet kotak
275 Sikat Pembersih Pcs 12
276 Termometer Pcs
277 Tetrasiklin HCl kapsul 250 mg Kapsul
278 Tetrasiklin HCl kapsul 500 mg Kapsul
279 Taburia box 6
280 Acethysistein Tablet 1,000

JUMLAH KUNJUNGAN RESEP BAYAR TIDAK BAYAR JUMLAH

file:///conversion/tmp/scratch/441099280.xlsx
 SA STOK PENERI- PERSE- PEMA- KOSONG SISA STOK PERMIN- PEMBERIAN
NO NAMA OBAT ED
TUAN AWAL MAAN DIAAN KAIAN (HARI) STOK OPT TAAN DAK DAU BS ASKES Lain-lain
BULAN Juli 2016 Jamkesos Jamkesda JKN Lain Lain
139 1942
49 63 1681 10

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AIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)

7
AGUSTUS
2017

PEMBERIAN
KET

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