Kebonagung 2016

LAPORAN PENERIMAAN DAN PENGELUARAN OBAT (LPPO)
POLINDES KEBONAGUNG
PELAPORAN BULAN / PERIODE
PERMINTAAN BULAN / PERIODE
:
:
JANUARI
FEBRUARI
No.
NAMA OBAT
SAT
OBAT GENERIK
a. Tablet/Kapsul
2 Albendazol 400 mg
3 Alopurinol 100 mg
4 Alopurinol 300 mg
5 Ambroxol 30 mg
6 Amlodipin 5 mg
7 Aminofilina 200 mg
9 Amoksilin 250 mg
10 Amoksilin 500 mg
11 Antalgin 500 mg
12 Antasida (MgOH 200mg+AlOH 200mg)
Antimigran (Ergotamin Tartrat 1mg +
14
Kofein 50mg)
15 Asam Askorbat ( Vit C ) 50 mg
16 Asam Askorbat (Vit C) 250 mg
17 Asam folat 1 mg
18 Asam mefenamat 500 mg
19 Asam Traneksamat 500 mg
20 Asetosal 100 mg
21 Asiklovir 400mg
22 Betahistin mesilat 5 mg
24 Cetirizin 10mg
25 Deksametason 0,5 mg
26 Digoksin 0,25 mg
28 Dimenhidrinat tablet 50mg
29 Doksisiklin 100mg
30 Domperidon tablet 10 mg
31 Efedrin HCL 25 mg
32 Eritromisin 500mg
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPLET
TABLET
TABLET
STOK
AWAL
5
PENERIMAAN
6
PERSEDIAAN
7
PEMAKAIAN
8
SISA
STOK
9
STOK
RIIL
10
110
-
110
-
20
20
20
66
70
66
70
66
70
195
20
60
195
20
60
195
20
60
70
70
70
70
70
70
80
80
80
60
60
60
86
86
86
110
100
110
100
110
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
TABLET
TABLET
KAPLET
2016
2016
110
100
PERMINTAAN
11
PKD
12
ASKES
13
PEMBERIAN
APBD
14
LAIN
15
JUMLAH
16
KET
17
No.
33
34
35
36
37
38
39
40
41
42
43
45
46
47
48
49
51
52
56
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
NAMA OBAT
SAT
Fitomenadion (Vit K1) 10mg

Furosemid 40 mg
Glibenklamid 5 mg
Glimepiride tablet 2 mg
Gliseril Guaiakolat 100 mg
Griseofulvin 125 mg
Hidroklorotiazid (HCT) 25 mg
Hyosin N Butilbromida 10mg
Ibuprofen 200 mg
Ibuprofen 400 mg
Isosorbid Dinitrat sublingual 5 mg
Kalsium Laktat (Kalk) 500 mg
Kaptopril 12,5 mg
Kaptopril 25 mg
Ketokonazol 200mg tablet
Klindamisin kapsul 150 mg
Kloramfenikol kapsul 250 mg
Klorfeniramin Maleat (CTM) 4 mg
Kotrimoksazol dewasa kombinasi :
Sulfametoksazol400mg+Trimetoprim8
0mg
Loratadin tablet 10 mg
Mebendazol tablet 100 mg
Meloksikam tablet 7,5 mg
Metformin 500mg tablet
Metil Prednisolon 4 mg
Metilergometrin Maleat 0,125 mg
Metoklopramid 5mg
Metronidazol 250 mg
Metronidazol 500mg
Natrium Diklofenac 25 mg
Nifedipin 10 mg tablet
Nistatin tablet vaginal 100.000 IU/g
Omeprazole 20mg
Parasetamol 100 mg
Parasetamol 500 mg
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
STOK
AWAL
PENERIMAAN
PERSEDIAAN
PEMAKAIAN
SISA
STOK
STOK
RIIL
100
100
100
50
50
50
80
80
80
650
650
650
1,000
1,000
40
30
100
40
30
100
80
1,000
40
30
100
80
80
56
56
56
47
47
47
200
200
200
30
30
30
110
110
110
30
30
-
30
-
20
60
60
100
50
40
20
60
60
100
50
40
20
60
60
100
50
40
30
30
30
120
120
120
40
40
30
30
40
30
PERMINTAAN
PKD
PEMBERIAN
ASKES
APBD
LAIN
JUMLAH
KET
No.
75
76
77
78
79
81
82
83
84
85
86
87
88
89
90
91
92
93
94
b.
4
5
8
9
10
11
12
15
17
18
19
20
21
24
30
32
NAMA OBAT
Parasetamol drop 100mg/ml btl @

15ml
Pirantel 125 mg
Pirasetam 800 mg tablet
Piridoksin HCL (Vit B6) tablet 10 mg
Prednison tablet 5 mg
Propanolol HCL tablet 10 mg
Propiltiourasil tablet 100 mg
Ranitidin tablet 150 mg
Salbutamol tablet 2 mg
Simvastatin 10 mg
Siprofloksazin tablet 500 mg
Tablet Tambah Darah Kombinasi : Besi
sulfat 200mg+Asam folat 0,25mg
Tetrasiklin HCL kapsul 250 mg
Thiamfenikol 500mg kapsul
Tiamin HCL (VitB1) 50 mg
Vitamin B Kompleks
Zinc 10 mg
Injeksi
Antalgin 250 mg/ml - 2 ml
Atropin sulfat 0,25mg/ml-1 ml
Deksametason injeksi 5 mg/ml-1ml
Difenhidramin HCL Inj 10mg/ml-1 ml
Epinefrin injeksi
Fitomenadion (Vit K1)inj 10mg/ml-1ml
Fitomenadion (Vit K1)inj infant
Hyosin n butilbromid inj 250mg/ml
Lidokain komp
injeksi,Kombinasi:Lidokain HCl2%
+Epinefrin1:80000-2ml
Magnesium sulfat injeksi (IV) 20 % 25 ml
Magnesium
sulfat injeksi (IV) 40 % 25
ml
Metilergometrin Maleat inj. 0,200mg1ml
Metoklopramid inj. 5mg / ml
Oksitosin injeksi 10 IU/ml - 1 ml
Sianokobalamin(VitB12)inj.500mcg/mlTiamin HCl (Vit.B1) injeksi 100 mg/ml1ml
1 ml
SAT
STOK
AWAL
PENERIMAAN
PERSEDIAAN
PEMAKAIAN
SISA
STOK
STOK
RIIL
BOTOL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
550
550
550
900
900
900
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
40
40
-
40
-
100
100
100
40
40
40
90
20
90
20
-
90
20
-
300
300
300
65
65
65
20
20
20
4
5
10
4
5
10
-
4
5
10
-
50
50
50
5
4
5
45
18
5
4
5
45
18
5
4
5
45
18
AMPUL
BOTOL
BOTOL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
PERMINTAAN
PKD
PEMBERIAN
ASKES
APBD
LAIN
JUMLAH
KET
No.
c.
1
2
3
4
5
6
7
8
9
10
11
12
13
d.
1
2
e.
1
2
3
4
5
7
NAMA OBAT
Salep
Antifungi (As. Benzoat6%+As. salisilat
POT
3%)
TUBE
Asiklovir krim 5%
TUBE
Betametason krim 0,1 %
TUBE
Gameksan emulsi 1 % 30ml
TUBE
Gentamisin salep kulit 0.1%-5gr
TUBE
Gentamisin salep mata 0,3%
TUBE
Hidrokortison krim 2,5 %
TUBE
Ketokonazol krim 2%
TUBE
Kloramfenikol salep mata 1 %
TUBE
Miconazol cream 2 %
TUBE
Oksitetrasiklin HCL 1 % salep mata
TUBE
Oksitetrasiklin HCL 3 % salep kulit
Salep 2-4 Komb: As salisilat2%
POT
+Belerang endap4%
Serbuk
SACHET
Garam oralit untuk 200 ml air
POT
Salisil Bedak 2 %
Sirup
VIAL
Amoksilin 125mg/5ml
Antasida syr (MgOH 200mg/5ml+AlOH
BOTOL
200mg/5ml)
BOTOL
Cetirizin syr
BOTOL
Dekstrometorfan 10 mg / 5 ml
BOTOL
Eritromisin sirup
BOTOL
Kloramfenikol suspensi 125mg/5ml
Kotrimoksazol Suspensi komb:

8 Sulfametoksazol
200mg+Trimetoprim40mg/5ml
10
11
d.
1
2
3
SAT
Obat Batuk Hitam ( O B H ) cairan

Parasetamol sirup 120mg/5ml
Tetes
Fenol Gliserol tetes telinga 10 %
Gentamisin tetes mata 0.3%
Gentian violet larutan 1 %
STOK
AWAL
PENERIMAAN
PERSEDIAAN
PEMAKAIAN
SISA
STOK
STOK
RIIL
-
3
-
3
-
30
30
30
4
-
BOTOL
4
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
4
3
-
10
10
10
PERMINTAAN
PKD
PEMBERIAN
ASKES
APBD
LAIN
JUMLAH
KET
No.
NAMA OBAT
SAT
BOTOL
5 Kloramfenikol tetes mata
BOTOL
6 Kloramfenikol tetes telinga 3 %
BOTOL
7 Polikresulen ( Albothyl )
8 Sulfasetamid Natrium tetes mata 15 % BOTOL
ALKES DAN CAIRAN LUAR
SET
1 Alat suntik sekali pakai 1 ml
SET
SET
BOTOL
6 Aqua pro injeksi, bebas pirogen
Catgut chromic/benang bedah No. 2/0SACHET
9
3/0
BOTOL
13 Etanol 70 % 1000 ml
PCS
14 Foley Catheter no.16
PCS
PCS
20 I.V. Catheter No 20
PCS
PCS
PCS
23 Infusion set anak
PCS
24 Infusion set dewasa
ROL
25 Kapas Pembalut / Absorben 250 gr
ROL
26 Kasa Pembalut 2 m x 80 cm
ROL
28 Kasa Pembalut Hidrofil 4 m x 15 cm
ROL
Lisol, mengandung Kresol tersabun
BOTOL
31
50%
PCS
32 Masker
BOTOL
37 One Med H- O 3 %
PCS
38 One Med Surgical Blade/ Mess
ROL
39 Plester 5 yards x 2 inch
BOTOL
41 Rivanol larutan 0,1 % 300ml
SACHET
42 Silk ( Benang Bedah Sutera ) No. 3/0
PCS
44 Urine Bag
BOTOL
46 Yodium Povidon larutan 10 % 30 ml
BOTOL
INFUS
BOTOL
4 Glukosa larutan infus 5 % steril
Natrium Klorida larutan infus 0,9 %
BOTOL
8
steril
STOK
AWAL
PENERIMAAN
PERSEDIAAN
PEMAKAIAN
SISA
STOK
STOK
RIIL
3
-
2
-
10
10
1
-
10
PERMINTAAN
PKD
PEMBERIAN
ASKES
APBD
LAIN
JUMLAH
KET
No.
NAMA OBAT
9 Ringer Lactate infus steril

OBAT PATEN
1 Aptil
2 Bioplasenton Jelly
4 Bravoderm
4 Bufacomb
6 Cendo Xitrol tetes mata
8 Demacolin
9 Lactodia
12 Mecobion tablet
16 Neurotropik injeksi 5000mcg
18 Noza
19 Obat Batuk Anak sirup
21 Pehacain injeksi
22 Permetrin/Scabicid krim 5%
23 Puralex
27 Ventolin nebuliser
OBAT KHUSUS
b.
Diare
1 Garam oralit untuk 200 ml air
f.
Gizi
1 Retinol ( Vit A ) kapsul 100.000 IU
3 Mineral Mix
SAT
STOK
AWAL
PENERIMAAN
BOTOL
Depo kombinasi
Indoplant
IUD COPER T
kondom
Pil. Kombinasi
sepet
STOK
RIIL
20
20
20
50
50
50
UMUM
R.JALAN
RINAP
11
JUMLAH
11
LAIN
11
PKD
PEMBERIAN
ASKES
APBD
KAPSUL
KAPSUL
PAKET
PERMINTAAN
1
-
UMUM
JUMLAH KUNJUNGAN
SACHET
vial
set
set
set
tab
set
SISA
STOK
KB
1
2
3
4
5
6
PEMAKAIAN
BOTOL
TUBE
TUBE
TUBE
BOTOL
TABLET
SACHET
TABLET
AMPUL
TABLET
BOTOL
AMPUL
TUBE
TABLET
BOTOL
PERSEDIAAN
JKN
TAK BAYAR
R.JALAN RINAP
YANDU LAIN2
TANPA
OBAT
JUMLAH
R. JALAN
R. INAP
-
KET
No.
NAMA OBAT
SAT
STOK
AWAL
PENERIMAAN
PERSEDIAAN
PEMAKAIAN
SISA
STOK
STOK
RIIL
PERMINTAAN
MENGETAHUI
KEPALA UPTD PUSKESMAS
PETUGAS PENGELOLA OBAT
dr. BAMBANG BUDI PRASTYA
DEDI DARMAWAN
NIP: 19590930 198511 1 001
NIP: 19831127 200904 1 002
PKD
PEMBERIAN
ASKES
APBD
LAIN
JUMLAH
KET
MALANG, 25 JANUARI 2016

BIDAN/ PERAWAT
LAPORAN PENERIMAAN DAN PENGELUARAN OBAT (LPPO)
POLINDES KEBONAGUNG
:
:
FEBRUARI
MARET
No.
NAMA OBAT
SAT
OBAT GENERIK
a. Tablet/Kapsul
2 Albendazol 400 mg
3 Alopurinol 100 mg
4 Alopurinol 300 mg
5 Ambroxol 30 mg
6 Amlodipin 5 mg
9 Amoksilin 250 mg
10 Amoksilin 500 mg
11 Antalgin 500 mg
14
Kofein 50mg)
17 Asam folat 1 mg
20 Asetosal 100 mg
21 Asiklovir 400mg
24 Cetirizin 10mg
26 Digoksin 0,25 mg
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
STOK
AWAL
5
2016
2016
PENERIMAAN
6
PERSEDIAAN
7
PEMAKAIAN
8
SISA
STOK
9
STOK
RIIL
10
PERMINTAAN
11
110
-
110
-
20
20
20
66
70
66
70
20
46
70
195
20
195
20
170
20
25
-
300
60
60
50
10
100
70
70
70
70
70
50
20
80
80
80
60
86
60
86
30
80
-
20
60
40
26
-
50
100
100
100
100
PKD
12
ASKES
13
PEMBERIAN
APBD
14
LAIN
15
JUMLAH
16
No.
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
45
46
47
48
49
51
52
56
59
60
61
62
63
64
65
66
67
68
NAMA OBAT
SAT
Dimenhidrinat tablet 50mg

Doksisiklin 100mg
Domperidon tablet 10 mg
Efedrin HCL 25 mg
Eritromisin 500mg
Fitomenadion (Vit K1) 10mg
Furosemid 40 mg
Glibenklamid 5 mg
Glimepiride tablet 2 mg
Gliseril Guaiakolat 100 mg
Griseofulvin 125 mg
Hidroklorotiazid (HCT) 25 mg
Hyosin N Butilbromida 10mg
Ibuprofen 200 mg
Ibuprofen 400 mg
Isosorbid Dinitrat sublingual 5 mg
Kalsium Laktat (Kalk) 500 mg
Kaptopril 12,5 mg
Kaptopril 25 mg
Klorfeniramin Maleat
4 mg:
Kotrimoksazol
dewasa(CTM)
kombinasi
0mg
Metoklopramid 5mg
Metronidazol 250 mg
Metronidazol 500mg
TABLET
KAPSUL
TABLET
TABLET
KAPLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
STOK
AWAL
PENERIMAAN
PERSEDIAAN
PEMAKAIAN
SISA
STOK
STOK
RIIL
110
100
110
100
100
100
100
50
50
50
80
80
80
650
650
PERMINTAAN
40
100
70
100
550
1,000
1,000
1,000
40
30
100
80
40
30
100
80
56
56
56
47
200
47
200
47
200
30
110
30
110
30
110
30
-
30
-
20
60
60
100
50
40
30
20
60
60
100
50
40
30
20
30
50
30
20
50
100
30
20
20
50
50
10
20
60
10
50
10
10
100
100
50
100
100
100
50
PKD
ASKES
PEMBERIAN
APBD
LAIN
JUMLAH
No.
NAMA OBAT
69
70
71
72
73
74
75
76
77
78
79
81
82
83
84
85
86
87
88
89
90
91
92
93
94
b.
4
5
8
9
10
11
12
Omeprazole 20mg
Parasetamol 100 mg
Parasetamol 500 mg
15ml
Pirantel 125 mg
Simvastatin 10 mg
Vitamin B Kompleks
Zinc 10 mg
Injeksi
Epinefrin injeksi
SAT
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
BOTOL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
STOK
AWAL
PENERIMAAN
PERSEDIAAN
PEMAKAIAN
SISA
STOK
STOK
RIIL
120
120
40
40
40
30
30
PERMINTAAN
30
30
90
550
550
900
900
900
40
100
40
100
40
40
20
20
90
20
-
90
20
-
40
50
20
-
200
50
30
500
10
100
100
100
300
300
50
250
65
65
60
20
20
20
4
5
4
5
10
-
10
-
100
100
4
5
10
30
PKD
ASKES
PEMBERIAN
APBD
LAIN
JUMLAH
No.
NAMA OBAT
SAT
15 Hyosin n butilbromid inj 250mg/ml

Lidokain komp
AMPUL
17 injeksi,Kombinasi:Lidokain HCl2%
Magnesium sulfat injeksi (IV) 20 % BOTOL
18
25
ml
Magnesium
sulfat injeksi (IV) 40 % BOTOL
19
25
ml
Metilergometrin
Maleat inj. 0,200mgAMPUL
20
1ml
AMPUL
21 Metoklopramid inj. 5mg / ml
AMPUL
24 Oksitosin injeksi 10 IU/ml - 1 ml
Sianokobalamin(VitB12)inj.500mcg/mlAMPUL
30
Tiamin HCl (Vit.B1) injeksi 100 mg/ml1ml
AMPUL
32
1 ml
c.
Salep
POT
1
3%)
TUBE
2 Asiklovir krim 5%
TUBE
3 Betametason krim 0,1 %
TUBE
4 Gameksan emulsi 1 % 30ml
TUBE
5 Gentamisin salep kulit 0.1%-5gr
TUBE
6 Gentamisin salep mata 0,3%
TUBE
7 Hidrokortison krim 2,5 %
TUBE
8 Ketokonazol krim 2%
TUBE
9 Kloramfenikol salep mata 1 %
TUBE
10 Miconazol cream 2 %
TUBE
11 Oksitetrasiklin HCL 1 % salep mata
TUBE
12 Oksitetrasiklin HCL 3 % salep kulit
POT
13
+Belerang endap4%
d.
Serbuk
SACHET
POT
2 Salisil Bedak 2 %
e.
Sirup
VIAL
1 Amoksilin 125mg/5ml
BOTOL
2
200mg/5ml)
AMPUL
STOK
AWAL
PENERIMAAN
PERSEDIAAN
PEMAKAIAN
SISA
STOK
STOK
RIIL
50
50
50
5
4
5
45
18
5
4
5
45
18
5
4
5
40
18
3
-
3
-
1
-
PERMINTAAN
30
30
30
PKD
ASKES
PEMBERIAN
APBD
LAIN
JUMLAH
No.
3
4
5
7
NAMA OBAT
Cetirizin syr
Dekstrometorfan 10 mg / 5 ml
Eritromisin sirup
Kloramfenikol suspensi 125mg/5ml

8 Sulfametoksazol
SAT
BOTOL
BOTOL
BOTOL
BOTOL
STOK
AWAL
PENERIMAAN
-
PERSEDIAAN
PEMAKAIAN
SISA
STOK
STOK
RIIL
PERMINTAAN
10
10
BOTOL
BOTOL
10 Obat Batuk Hitam ( O B H ) cairan
BOTOL
11 Parasetamol sirup 120mg/5ml
d.
Tetes
BOTOL
1 Fenol Gliserol tetes telinga 10 %
BOTOL
2 Gentamisin tetes mata 0.3%
BOTOL
3 Gentian violet larutan 1 %
BOTOL
BOTOL
BOTOL
8 Sulfasetamid Natrium tetes mata 15 % BOTOL
SET
SET
SET
BOTOL
Catgut chromic/benang bedah No. 2/0SACHET
9
3/0
BOTOL
13 Etanol 70 % 1000 ml
PCS
PCS
PCS
PCS
PCS
PCS
PCS
5
2
10
10
30
10
PKD
ASKES
PEMBERIAN
APBD
LAIN
JUMLAH
No.
NAMA OBAT

31
50%
32 Masker
37 One Med H- O 3 %
44 Urine Bag
INFUS
8
steril
OBAT PATEN
1 Aptil
4 Bravoderm
4 Bufacomb
8 Demacolin
9 Lactodia
12 Mecobion tablet
18 Noza
21 Pehacain injeksi
SAT
ROL
ROL
ROL
ROL
BOTOL
PCS
BOTOL
PCS
ROL
BOTOL
SACHET
PCS
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
TUBE
TUBE
TUBE
BOTOL
TABLET
SACHET
TABLET
AMPUL
TABLET
BOTOL
AMPUL
STOK
AWAL
PENERIMAAN
PERSEDIAAN
PEMAKAIAN
SISA
STOK
STOK
RIIL
10
10
20
20
20
PERMINTAAN
1
3
50
5
100
PKD
ASKES
PEMBERIAN
APBD
LAIN
JUMLAH
No.
NAMA OBAT
SAT
23 Puralex
OBAT KHUSUS
Diare
b.
Gizi
f.
3 Mineral Mix
TUBE
TABLET
BOTOL
STOK
AWAL
PEMAKAIAN
STOK
RIIL
50
50
40
10
11
11
KAPSUL
KAPSUL
PAKET
UMUM
JUMLAH KUNJUNGAN
SISA
STOK
SACHET
vial
set
set
set
tab
set
Depo kombinasi
Indoplant
IUD COPER T
kondom
Pil. Kombinasi
sepet
PERSEDIAAN
KB
1
2
3
4
5
6
PENERIMAAN
UMUM
R.JALAN
RINAP
PERMINTAAN
ASKES
PEMBERIAN
APBD
LAIN
JUMLAH
50
20
JKN
TAK BAYAR
R.JALAN RINAP
YANDU LAIN2
52
PKD
TANPA
OBAT
JUMLAH
R. JALAN
R. INAP
57
MALANG, 25 FEBRUARI 2016

BIDAN/ PERAWAT
DEDI DARMAWAN
ENY KURNIAWATI
NIP: 19590930 198511 1 001
NIP: 19831127 200904 1 002
MENGETAHUI
KET
17
KET
KET
KET
KET
KET
KET
FEBRUARI 2016
PERAWAT
RNIAWATI
LAPORAN PENERIMAAN DAN PENGELUAR
POLINDES KEBONAGUNG
:
:
MARET
APRIL
No.
NAMA OBAT
SAT
OBAT GENERIK
a. Tablet/Kapsul
2 Albendazol 400 mg
3 Alopurinol 100 mg
4 Alopurinol 300 mg
5 Ambroxol 30 mg
6 Amlodipin 5 mg
9 Amoksilin 250 mg
10 Amoksilin 500 mg
11 Antalgin 500 mg
14
Kofein 50mg)
17 Asam folat 1 mg
20 Asetosal 100 mg
21 Asiklovir 400mg
24 Cetirizin 10mg
26 Digoksin 0,25 mg
33 Fitomenadion (Vit K1) 10mg
34 Furosemid 40 mg
35 Glibenklamid 5 mg
36 Glimepiride tablet 2 mg
37 Gliseril Guaiakolat 100 mg
38 Griseofulvin 125 mg
39 Hidroklorotiazid (HCT) 25 mg
40 Hyosin N Butilbromida 10mg
41 Ibuprofen 200 mg
42 Ibuprofen 400 mg
43 Isosorbid Dinitrat sublingual 5 mg
45 Kalsium Laktat (Kalk) 500 mg
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
TABLET
TABLET
KAPLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
2016
2016
STOK
AWAL
5
PENERIMAAN
6
PERSEDIAAN
7
80
-
80
-
46
70
46
70
25
-
25
-
10
10
20
20
80
80
40
26
40
26
70
100
70
100
100
100
50
50
80
80
550
550
1,000
1,000
20
50
20
50
46
47
48
49
51
52
56
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
81
82
83
84
85
86
87
88
89
90
91
92
93
94
b.
4
5
8
9
10
11
12
15
Kaptopril 12,5 mg
Kaptopril 25 mg
4 mg:
Kotrimoksazol
dewasa(CTM)
kombinasi
0mg
Metoklopramid 5mg
Metronidazol 250 mg
Metronidazol 500mg
Omeprazole 20mg
Parasetamol 100 mg
Parasetamol 500 mg
15ml
Pirantel 125 mg
Simvastatin 10 mg
Vitamin B Kompleks
Zinc 10 mg
Injeksi
Epinefrin injeksi
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
BOTOL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
50
50
56
56
47
200
47
200
30
110
30
110
10
-
10
-
20
60
10
50
10
10
20
60
10
50
10
10
90
90
40
40
500
500
900
900
10
100
10
100
20
20
50
20
-
50
20
-
250
250
4
5
4
5
50
50
Lidokain komp
AMPUL
18
25 ml
Magnesium
19
25 ml
Metilergometrin
20
1ml
AMPUL
AMPUL
30
AMPUL
32
1 ml
c.
Salep
POT
1
3%)
TUBE
2 Asiklovir krim 5%
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
POT
13
+Belerang endap4%
d.
Serbuk
SACHET
POT
2 Salisil Bedak 2 %
e.
Sirup
VIAL
BOTOL
2
200mg/5ml)
BOTOL
3 Cetirizin syr
BOTOL
4 Dekstrometorfan 10 mg / 5 ml
BOTOL
5 Eritromisin sirup
BOTOL
7 Kloramfenikol suspensi 125mg/5ml
8 Sulfametoksazol
d.
Tetes
8 Sulfasetamid Natrium tetes mata 15 %
5
4
5
40
18
5
4
5
40
18
1
-
1
-
30
30
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL

Catgut chromic/benang bedah No. 2/09
3/0
13 Etanol 70 % 1000 ml
31
50%
32 Masker
37 One Med H- O 3 %
44 Urine Bag
INFUS
8
steril
OBAT PATEN
1 Aptil
4 Bravoderm
4 Bufacomb
8 Demacolin
9 Lactodia
12 Mecobion tablet
18 Noza
21 Pehacain injeksi
23 Puralex
OBAT KHUSUS
SET
SET
SET
BOTOL
SACHET
BOTOL
PCS
PCS
PCS
PCS
PCS
PCS
PCS
ROL
ROL
ROL
ROL
BOTOL
PCS
BOTOL
PCS
ROL
BOTOL
SACHET
PCS
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
TUBE
TUBE
TUBE
BOTOL
TABLET
SACHET
TABLET
AMPUL
TABLET
BOTOL
AMPUL
TUBE
TABLET
BOTOL
10
10
1
2
3
Diare
Gizi
Retinol ( Vit A ) kapsul 100.000 IU
Mineral Mix
1
2
3
4
5
6
Depo kombinasi
Indoplant
IUD COPER T
kondom
Pil. Kombinasi
sepet
b.
1
f.
SACHET
KAPSUL
KAPSUL
PAKET
KB
vial
set
set
set
tab
set
UMUM
JUMLAH KUNJUNGAN
UMUM
R.JALAN
MENGETAHUI
NIP: 19590930 198511 1 001
RINAP
TAK BAYAR
YANDU
MAAN DAN PENGELUARAN OBAT (LPPO)
OLINDES KEBONAGUNG
PEMAKAIAN
8
SISA
STOK
9
STOK
RIIL
10
-
80
46
70
25
10
20
80
40
26
70
100
100
50
80
550
1,000
20
50
PERMINTAAN
11
PKD
12
ASKES
13
PEMBERIAN
APBD
14
LAIN
15
JUMLAH
16
KET
17
50
56
47
200
30
110
10
20
60
10
50
10
10
90
40
2
500
900
10
100
20
50
20
250
5
4
5
50
2
2
5
4
5
40
18
3
3
1
1
3
5
3
5
3
4
30
3
4
-
4
5
2
1
2
-
2
2
2
1
2
1
1
5
2
2
2
1
1
2
1
2
10
-
5
7
JKN
TAK BAYAR
R.JALAN RINAP
LAIN2
TANPA
OBAT
JUMLAH
R. JALAN
R. INAP
-
DEDI DARMAWAN
NIP: 19831127 200904 1 002
MALANG, 25 MARET 2016

BIDAN/ PERAWAT
POLINDES KEBONAGUNG
:
:
APRIL
MEI
No.
NAMA OBAT
SAT
OBAT GENERIK
a. Tablet/Kapsul
2 Albendazol 400 mg
3 Alopurinol 100 mg
4 Alopurinol 300 mg
5 Ambroxol 30 mg
6 Amlodipin 5 mg
9 Amoksilin 250 mg
10 Amoksilin 500 mg
11 Antalgin 500 mg
14
Kofein 50mg)
17 Asam folat 1 mg
20 Asetosal 100 mg
21 Asiklovir 400mg
24 Cetirizin 10mg
26 Digoksin 0,25 mg
34 Furosemid 40 mg
41 Ibuprofen 200 mg
42 Ibuprofen 400 mg
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
TABLET
TABLET
KAPLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
2016
2016
STOK
AWAL
5
PENERIMAAN
6
PERSEDIAAN
7
80
-
80
-
46
70
46
70
25
-
25
-
10
10
20
20
80
80
40
26
40
26
70
100
70
100
100
100
50
50
80
80
550
550
1,000
1,000
20
50
20
50
46
47
48
49
51
52
56
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
81
82
83
84
85
86
87
88
89
90
91
92
93
94
b.
4
5
8
9
10
11
12
15
Kaptopril 12,5 mg
Kaptopril 25 mg
4 mg:
Kotrimoksazol
dewasa(CTM)
kombinasi
0mg
Metoklopramid 5mg
Metronidazol 250 mg
Metronidazol 500mg
Omeprazole 20mg
Parasetamol 100 mg
Parasetamol 500 mg
15ml
Pirantel 125 mg
Simvastatin 10 mg
Vitamin B Kompleks
Zinc 10 mg
Injeksi
Epinefrin injeksi
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
BOTOL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
50
50
56
56
47
200
47
200
30
110
30
110
10
-
10
-
20
60
10
50
10
10
20
60
10
50
10
10
90
90
40
40
500
500
900
900
10
100
10
100
20
20
50
20
-
50
20
-
250
250
4
5
4
5
50
50
Lidokain komp
AMPUL
18
25 ml
Magnesium
19
25 ml
Metilergometrin
20
1ml
AMPUL
AMPUL
30
AMPUL
32
1 ml
c.
Salep
POT
1
3%)
TUBE
2 Asiklovir krim 5%
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
POT
13
+Belerang endap4%
d.
Serbuk
SACHET
POT
2 Salisil Bedak 2 %
e.
Sirup
VIAL
BOTOL
2
200mg/5ml)
BOTOL
3 Cetirizin syr
BOTOL
BOTOL
5 Eritromisin sirup
BOTOL
8 Sulfametoksazol
d.
Tetes
5
4
5
40
18
5
4
5
40
18
1
-
1
-
30
30
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL

3/0
13 Etanol 70 % 1000 ml
31
50%
32 Masker
37 One Med H- O 3 %
44 Urine Bag
INFUS
8
steril
OBAT PATEN
1 Aptil
4 Bravoderm
4 Bufacomb
8 Demacolin
9 Lactodia
12 Mecobion tablet
18 Noza
21 Pehacain injeksi
23 Puralex
OBAT KHUSUS
SET
SET
SET
BOTOL
SACHET
BOTOL
PCS
PCS
PCS
PCS
PCS
PCS
PCS
ROL
ROL
ROL
ROL
BOTOL
PCS
BOTOL
PCS
ROL
BOTOL
SACHET
PCS
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
TUBE
TUBE
TUBE
BOTOL
TABLET
SACHET
TABLET
AMPUL
TABLET
BOTOL
AMPUL
TUBE
TABLET
BOTOL
10
10
1
2
3
Diare
Gizi
Mineral Mix
1
2
3
4
5
6
Depo kombinasi
Indoplant
IUD COPER T
kondom
Pil. Kombinasi
sepet
b.
1
f.
SACHET
KAPSUL
KAPSUL
PAKET
KB
vial
set
set
set
tab
set
UMUM
JUMLAH KUNJUNGAN
UMUM
R.JALAN
MENGETAHUI
NIP: 19590930 198511 1 001
RINAP
TAK BAYAR
YANDU
OLINDES KEBONAGUNG
PEMAKAIAN
8
SISA
STOK
9
STOK
RIIL
10
-
80
46
70
25
10
20
80
40
26
70
100
100
50
80
550
1,000
20
50
PERMINTAAN
11
PKD
12
ASKES
13
PEMBERIAN
APBD
14
LAIN
15
JUMLAH
16
KET
17
50
56
47
200
30
110
10
20
60
10
50
10
10
90
40
2
500
900
10
100
20
50
20
250
5
4
5
50
2
2
5
4
5
40
18
3
3
1
1
3
5
3
5
3
4
30
3
4
-
4
5
2
1
2
-
2
2
2
1
2
1
1
5
2
2
2
1
1
2
1
2
10
-
5
7
JKN
TAK BAYAR
R.JALAN RINAP
LAIN2
TANPA
OBAT
JUMLAH
R. JALAN
R. INAP
-
DEDI DARMAWAN
NIP: 19831127 200904 1 002
MALANG, 25 APRIL 2016

BIDAN/ PERAWAT
POLINDES KEBONAGUNG
:
:
MEI
JUNI
No.
NAMA OBAT
SAT
OBAT GENERIK
a. Tablet/Kapsul
2 Albendazol 400 mg
3 Alopurinol 100 mg
4 Alopurinol 300 mg
5 Ambroxol 30 mg
6 Amlodipin 5 mg
9 Amoksilin 250 mg
10 Amoksilin 500 mg
11 Antalgin 500 mg
14
Kofein 50mg)
17 Asam folat 1 mg
20 Asetosal 100 mg
21 Asiklovir 400mg
24 Cetirizin 10mg
26 Digoksin 0,25 mg
34 Furosemid 40 mg
41 Ibuprofen 200 mg
42 Ibuprofen 400 mg
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
TABLET
TABLET
KAPLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
2016
2016
STOK
AWAL
5
PENERIMAAN
6
PERSEDIAAN
7
40
-
40
-
31
50
-
120
200
31
170
200
-
40
40
50
50
80
200
280
10
10
90
90
31
31
100
100
-
100
100
100
100
100
100
50
50
80
80
300
300
1,000
1,000
120
70
60
120
70
260
200
46
47
48
49
51
52
56
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
81
82
83
84
85
86
87
88
89
90
91
92
93
94
b.
4
5
8
9
10
11
12
15
Kaptopril 12,5 mg
Kaptopril 25 mg
4 mg:
Kotrimoksazol
dewasa(CTM)
kombinasi
0mg
Metoklopramid 5mg
Metronidazol 250 mg
Metronidazol 500mg
Omeprazole 20mg
Parasetamol 100 mg
Parasetamol 500 mg
15ml
Pirantel 125 mg
Simvastatin 10 mg
Vitamin B Kompleks
Zinc 10 mg
Injeksi
Epinefrin injeksi
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
BOTOL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
170
-
100
170
100
56
56
47
200
47
200
30
110
30
110
10
-
10
-
60
100
100
58
-
60
100
100
58
-
20
50
70
70
70
40
40
60
100
160
400
400
900
900
100
100
120
120
20
-
600
620
-
150
5
150
200
205
40
40
4
5
4
5
5
-
30
35
-
50
50
Lidokain komp
AMPUL
18
25 ml
Magnesium
19
25 ml
Metilergometrin
20
1ml
AMPUL
AMPUL
30
AMPUL
32
1 ml
c.
Salep
POT
1
3%)
TUBE
2 Asiklovir krim 5%
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
POT
13
+Belerang endap4%
d.
Serbuk
SACHET
POT
2 Salisil Bedak 2 %
e.
Sirup
VIAL
BOTOL
2
200mg/5ml)
BOTOL
3 Cetirizin syr
BOTOL
BOTOL
5 Eritromisin sirup
BOTOL
8 Sulfametoksazol
d.
Tetes
5
4
5
35
13
5
4
5
35
13
4
-
4
-
20
20
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL

3/0
13 Etanol 70 % 1000 ml
31
50%
32 Masker
37 One Med H- O 3 %
44 Urine Bag
INFUS
8
steril
OBAT PATEN
1 Aptil
4 Bravoderm
4 Bufacomb
8 Demacolin
9 Lactodia
12 Mecobion tablet
18 Noza
21 Pehacain injeksi
23 Puralex
OBAT KHUSUS
SET
SET
SET
BOTOL
SACHET
BOTOL
PCS
PCS
PCS
PCS
PCS
PCS
PCS
ROL
ROL
ROL
ROL
BOTOL
PCS
BOTOL
PCS
ROL
BOTOL
SACHET
PCS
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
TUBE
TUBE
TUBE
BOTOL
TABLET
SACHET
TABLET
AMPUL
TABLET
BOTOL
AMPUL
TUBE
TABLET
BOTOL
5
12
30
42
1
2
1
3
30
30
1
-
50
50
1
2
3
Diare
Gizi
Mineral Mix
1
2
3
4
5
6
Depo kombinasi
Indoplant
IUD COPER T
kondom
Pil. Kombinasi
sepet
b.
1
f.
SACHET
KAPSUL
KAPSUL
PAKET
KB
vial
set
set
set
tab
set
14
14
16
16
UMUM
JUMLAH KUNJUNGAN
UMUM
R.JALAN
MENGETAHUI
NIP: 19590930 198511 1 001
RINAP
TAK BAYAR
YANDU
OLINDES KEBONAGUNG
PEMAKAIAN
8
SISA
STOK
9
STOK
RIIL
10
-
40
31
170
200
40
50
280
10
90
31
100
100
100
100
50
80
300
1,000
120
70
260
PERMINTAAN
11
PKD
12
ASKES
13
PEMBERIAN
APBD
14
LAIN
15
JUMLAH
16
KET
17
170
100
56
47
200
30
110
10
60
100
100
58
70
70
40
160
2
400
900
100
120
620
150
205
40
4
5
35
50
2
2
5
4
5
35
13
3
3
4
4
5
3
5
3
4
20
3
5
5
4
-
4
5
2
1
2
-
5
42
5
2
2
1
2
1
2
1
1
3
1
30
2
2
2
2
1
1
1
2
50
-
14
16
JKN
TAK BAYAR
R.JALAN RINAP
LAIN2
TANPA
OBAT
JUMLAH
R. JALAN
R. INAP
-
DEDI DARMAWAN
NIP: 19831127 200904 1 002
MALANG, 25 MEI 2016

BIDAN/ PERAWAT
POLINDES KEBONAGUNG
:
:
JUNI
JULI
No.
NAMA OBAT
SAT
OBAT GENERIK
a. Tablet/Kapsul
2 Albendazol 400 mg
3 Alopurinol 100 mg
4 Alopurinol 300 mg
5 Ambroxol 30 mg
6 Amlodipin 5 mg
9 Amoksilin 250 mg
10 Amoksilin 500 mg
11 Antalgin 500 mg
14
Kofein 50mg)
17 Asam folat 1 mg
20 Asetosal 100 mg
21 Asiklovir 400mg
24 Cetirizin 10mg
26 Digoksin 0,25 mg
34 Furosemid 40 mg
41 Ibuprofen 200 mg
42 Ibuprofen 400 mg
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
TABLET
TABLET
KAPLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
2016
2016
STOK
AWAL
5
PENERIMAAN
6
PERSEDIAAN
7
40
-
40
-
31
170
31
170
200
-
200
-
40
40
50
50
280
280
10
10
90
90
31
31
100
-
100
-
100
100
100
100
100
100
50
50
80
80
300
300
1,000
1,000
120
70
260
120
70
260
46
47
48
49
51
52
56
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
81
82
83
84
85
86
87
88
89
90
91
92
93
94
b.
4
5
8
9
10
11
12
15
Kaptopril 12,5 mg
Kaptopril 25 mg
4 mg:
Kotrimoksazol
dewasa(CTM)
kombinasi
0mg
Metoklopramid 5mg
Metronidazol 250 mg
Metronidazol 500mg
Omeprazole 20mg
Parasetamol 100 mg
Parasetamol 500 mg
15ml
Pirantel 125 mg
Simvastatin 10 mg
Vitamin B Kompleks
Zinc 10 mg
Injeksi
Epinefrin injeksi
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
BOTOL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
170
100
170
100
56
56
47
200
47
200
30
110
30
110
10
-
10
-
60
100
100
58
-
60
100
100
58
-
70
70
70
70
40
40
160
160
400
400
900
900
100
100
120
120
620
-
620
-
150
150
205
205
40
40
4
5
4
5
35
-
35
-
50
50
Lidokain komp
AMPUL
18
25 ml
Magnesium
19
25 ml
Metilergometrin
20
1ml
AMPUL
AMPUL
30
AMPUL
32
1 ml
c.
Salep
POT
1
3%)
TUBE
2 Asiklovir krim 5%
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
POT
13
+Belerang endap4%
d.
Serbuk
SACHET
POT
2 Salisil Bedak 2 %
e.
Sirup
VIAL
BOTOL
2
200mg/5ml)
BOTOL
3 Cetirizin syr
BOTOL
BOTOL
5 Eritromisin sirup
BOTOL
8 Sulfametoksazol
d.
Tetes
5
4
5
35
13
5
4
5
35
13
4
-
4
-
20
20
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL

3/0
13 Etanol 70 % 1000 ml
31
50%
32 Masker
37 One Med H- O 3 %
44 Urine Bag
INFUS
8
steril
OBAT PATEN
1 Aptil
4 Bravoderm
4 Bufacomb
8 Demacolin
9 Lactodia
12 Mecobion tablet
18 Noza
21 Pehacain injeksi
23 Puralex
OBAT KHUSUS
SET
SET
SET
BOTOL
SACHET
BOTOL
PCS
PCS
PCS
PCS
PCS
PCS
PCS
ROL
ROL
ROL
ROL
BOTOL
PCS
BOTOL
PCS
ROL
BOTOL
SACHET
PCS
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
TUBE
TUBE
TUBE
BOTOL
TABLET
SACHET
TABLET
AMPUL
TABLET
BOTOL
AMPUL
TUBE
TABLET
BOTOL
42
42
30
30
50
50
1
2
3
Diare
Gizi
Mineral Mix
1
2
3
4
5
6
Depo kombinasi
Indoplant
IUD COPER T
kondom
Pil. Kombinasi
sepet
b.
1
f.
SACHET
KAPSUL
KAPSUL
PAKET
KB
vial
set
set
set
tab
set
14
14
16
16
UMUM
JUMLAH KUNJUNGAN
UMUM
R.JALAN
MENGETAHUI
NIP: 19590930 198511 1 001
RINAP
TAK BAYAR
YANDU
OLINDES KEBONAGUNG
PEMAKAIAN
8
SISA
STOK
9
STOK
RIIL
10
-
40
31
170
200
40
50
280
10
90
31
100
100
100
100
50
80
300
1,000
120
70
260
PERMINTAAN
11
PKD
12
ASKES
13
PEMBERIAN
APBD
14
LAIN
15
JUMLAH
16
KET
17
170
100
56
47
200
30
110
10
60
100
100
58
70
70
40
160
2
400
900
100
120
620
150
205
40
4
5
35
50
2
2
5
4
5
35
13
3
3
4
4
5
3
5
3
4
20
3
5
5
4
-
4
5
2
1
2
-
5
42
5
2
2
1
2
1
2
1
1
3
1
30
2
2
2
2
1
1
1
2
50
-
14
16
JKN
TAK BAYAR
R.JALAN RINAP
LAIN2
TANPA
OBAT
JUMLAH
R. JALAN
R. INAP
-
DEDI DARMAWAN
NIP: 19831127 200904 1 002
MALANG, 25 JUNI 2016

BIDAN/ PERAWAT
POLINDES KEBONAGUNG
:
:
JULI
AGUSTUS
No.
NAMA OBAT
SAT
OBAT GENERIK
a. Tablet/Kapsul
2 Albendazol 400 mg
3 Alopurinol 100 mg
4 Alopurinol 300 mg
5 Ambroxol 30 mg
6 Amlodipin 5 mg
9 Amoksilin 250 mg
10 Amoksilin 500 mg
11 Antalgin 500 mg
14
Kofein 50mg)
17 Asam folat 1 mg
20 Asetosal 100 mg
21 Asiklovir 400mg
24 Cetirizin 10mg
26 Digoksin 0,25 mg
34 Furosemid 40 mg
41 Ibuprofen 200 mg
42 Ibuprofen 400 mg
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
TABLET
TABLET
KAPLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
STOK
AWAL
5
2016
2016
PENERIMAAN
6
PERSEDIAAN
7
40
-
40
-
31
170
31
170
200
-
200
-
40
40
50
50
280
280
10
10
90
90
31
31
100
-
100
-
100
100
100
100
100
100
50
50
80
80
300
300
1,000
1,000
120
70
260
120
70
260
46
47
48
49
51
52
56
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
81
82
83
84
85
86
87
88
89
90
91
92
93
94
b.
4
5
8
9
10
11
12
15
Kaptopril 12,5 mg
Kaptopril 25 mg
4 mg:
Kotrimoksazol
dewasa(CTM)
kombinasi
0mg
Metoklopramid 5mg
Metronidazol 250 mg
Metronidazol 500mg
Omeprazole 20mg
Parasetamol 100 mg
Parasetamol 500 mg
15ml
Pirantel 125 mg
Simvastatin 10 mg
Vitamin B Kompleks
Zinc 10 mg
Injeksi
Epinefrin injeksi
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
BOTOL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
170
100
170
100
56
56
47
200
47
200
30
110
30
110
10
-
10
-
60
100
100
58
-
60
100
100
58
-
70
70
70
70
40
40
160
160
400
400
900
900
100
100
120
120
620
-
620
-
150
150
205
205
40
40
4
5
4
5
35
-
35
-
50
50
Lidokain komp
AMPUL
18
25 ml
Magnesium
19
25 ml
Metilergometrin
20
1ml
AMPUL
AMPUL
30
AMPUL
32
1 ml
c.
Salep
POT
1
3%)
TUBE
2 Asiklovir krim 5%
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
POT
13
+Belerang endap4%
d.
Serbuk
SACHET
POT
2 Salisil Bedak 2 %
e.
Sirup
VIAL
BOTOL
2
200mg/5ml)
BOTOL
3 Cetirizin syr
BOTOL
BOTOL
5 Eritromisin sirup
BOTOL
8 Sulfametoksazol
d.
Tetes
5
4
5
35
13
5
4
5
35
13
4
-
4
-
20
20
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL

3/0
13 Etanol 70 % 1000 ml
31
50%
32 Masker
37 One Med H- O 3 %
44 Urine Bag
INFUS
8
steril
OBAT PATEN
1 Aptil
4 Bravoderm
4 Bufacomb
8 Demacolin
9 Lactodia
12 Mecobion tablet
18 Noza
21 Pehacain injeksi
23 Puralex
OBAT KHUSUS
SET
SET
SET
BOTOL
SACHET
BOTOL
PCS
PCS
PCS
PCS
PCS
PCS
PCS
ROL
ROL
ROL
ROL
BOTOL
PCS
BOTOL
PCS
ROL
BOTOL
SACHET
PCS
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
TUBE
TUBE
TUBE
BOTOL
TABLET
SACHET
TABLET
AMPUL
TABLET
BOTOL
AMPUL
TUBE
TABLET
BOTOL
42
42
30
30
50
50
1
2
3
Diare
Gizi
Mineral Mix
1
2
3
4
5
6
Depo kombinasi
Indoplant
IUD COPER T
kondom
Pil. Kombinasi
sepet
b.
1
f.
SACHET
KAPSUL
KAPSUL
PAKET
KB
vial
set
set
set
tab
set
14
14
16
16
UMUM
JUMLAH KUNJUNGAN
UMUM
R.JALAN
MENGETAHUI
NIP: 19590930 198511 1 001
RINAP
TAK BAYAR
YANDU
OLINDES KEBONAGUNG
PEMAKAIAN
8
SISA
STOK
9
STOK
RIIL
10
-
40
31
170
200
40
50
280
10
90
31
100
100
100
100
50
80
300
1,000
120
70
260
PERMINTAAN
11
PKD
12
ASKES
13
PEMBERIAN
APBD
14
LAIN
15
JUMLAH
16
KET
17
170
100
56
47
200
30
110
10
60
100
100
58
70
70
40
160
2
400
900
100
120
620
150
205
40
4
5
35
50
2
2
5
4
5
35
13
3
3
4
4
5
3
5
3
4
20
3
5
5
4
-
4
5
2
1
2
-
5
42
5
2
2
1
2
1
2
1
1
3
1
30
2
2
2
2
1
1
1
2
50
-
14
16
JKN
TAK BAYAR
R.JALAN RINAP
LAIN2
TANPA
OBAT
JUMLAH
R. JALAN
R. INAP
-
DEDI DARMAWAN
NIP: 19831127 200904 1 002
MALANG, 25 JULI 2016

BIDAN/ PERAWAT
POLINDES KEBONAGUNG
:
:
AGUSTUS
SEPTEMBE
No.
NAMA OBAT
SAT
OBAT GENERIK
a. Tablet/Kapsul
2 Albendazol 400 mg
3 Alopurinol 100 mg
4 Alopurinol 300 mg
5 Ambroxol 30 mg
6 Amlodipin 5 mg
9 Amoksilin 250 mg
10 Amoksilin 500 mg
11 Antalgin 500 mg
14
Kofein 50mg)
17 Asam folat 1 mg
20 Asetosal 100 mg
21 Asiklovir 400mg
24 Cetirizin 10mg
26 Digoksin 0,25 mg
34 Furosemid 40 mg
41 Ibuprofen 200 mg
42 Ibuprofen 400 mg
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
TABLET
TABLET
KAPLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
STOK
AWAL
5
2016
2016
PENERIMAAN
6
PERSEDIAAN
7
40
-
40
-
31
170
31
170
200
-
200
-
40
40
50
50
280
280
10
10
90
90
31
31
100
-
100
-
100
100
100
100
100
100
50
50
80
80
300
300
1,000
1,000
120
70
260
120
70
260
46
47
48
49
51
52
56
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
81
82
83
84
85
86
87
88
89
90
91
92
93
94
b.
4
5
8
9
10
11
12
15
Kaptopril 12,5 mg
Kaptopril 25 mg
4 mg:
Kotrimoksazol
dewasa(CTM)
kombinasi
0mg
Metoklopramid 5mg
Metronidazol 250 mg
Metronidazol 500mg
Omeprazole 20mg
Parasetamol 100 mg
Parasetamol 500 mg
15ml
Pirantel 125 mg
Simvastatin 10 mg
Vitamin B Kompleks
Zinc 10 mg
Injeksi
Epinefrin injeksi
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
BOTOL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
170
100
170
100
56
56
47
200
47
200
30
110
30
110
10
-
10
-
60
100
100
58
-
60
100
100
58
-
70
70
70
70
40
40
160
160
400
400
900
900
100
100
120
120
620
-
620
-
150
150
205
205
40
40
4
5
4
5
35
-
35
-
50
50
Lidokain komp
AMPUL
18
25 ml
Magnesium
19
25 ml
Metilergometrin
20
1ml
AMPUL
AMPUL
30
AMPUL
32
1 ml
c.
Salep
POT
1
3%)
TUBE
2 Asiklovir krim 5%
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
POT
13
+Belerang endap4%
d.
Serbuk
SACHET
POT
2 Salisil Bedak 2 %
e.
Sirup
VIAL
BOTOL
2
200mg/5ml)
BOTOL
3 Cetirizin syr
BOTOL
BOTOL
5 Eritromisin sirup
BOTOL
8 Sulfametoksazol
d.
Tetes
5
4
5
35
13
5
4
5
35
13
4
-
4
-
20
20
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL

3/0
13 Etanol 70 % 1000 ml
31
50%
32 Masker
37 One Med H- O 3 %
44 Urine Bag
INFUS
8
steril
OBAT PATEN
1 Aptil
4 Bravoderm
4 Bufacomb
8 Demacolin
9 Lactodia
12 Mecobion tablet
18 Noza
21 Pehacain injeksi
23 Puralex
OBAT KHUSUS
SET
SET
SET
BOTOL
SACHET
BOTOL
PCS
PCS
PCS
PCS
PCS
PCS
PCS
ROL
ROL
ROL
ROL
BOTOL
PCS
BOTOL
PCS
ROL
BOTOL
SACHET
PCS
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
TUBE
TUBE
TUBE
BOTOL
TABLET
SACHET
TABLET
AMPUL
TABLET
BOTOL
AMPUL
TUBE
TABLET
BOTOL
42
42
30
30
50
50
1
2
3
Diare
Gizi
Mineral Mix
1
2
3
4
5
6
Depo kombinasi
Indoplant
IUD COPER T
kondom
Pil. Kombinasi
sepet
b.
1
f.
SACHET
KAPSUL
KAPSUL
PAKET
KB
vial
set
set
set
tab
set
14
14
16
16
UMUM
JUMLAH KUNJUNGAN
UMUM
R.JALAN
MENGETAHUI
NIP: 19590930 198511 1 001
RINAP
TAK BAYAR
YANDU
OLINDES KEBONAGUNG
PEMAKAIAN
8
SISA
STOK
9
STOK
RIIL
10
-
40
31
170
200
40
50
280
10
90
31
100
100
100
100
50
80
300
1,000
120
70
260
PERMINTAAN
11
PKD
12
ASKES
13
PEMBERIAN
APBD
14
LAIN
15
JUMLAH
16
KET
17
170
100
56
47
200
30
110
10
60
100
100
58
70
70
40
160
2
400
900
100
120
620
150
205
40
4
5
35
50
2
2
5
4
5
35
13
3
3
4
4
5
3
5
3
4
20
3
5
5
4
-
4
5
2
1
2
-
5
42
5
2
2
1
2
1
2
1
1
3
1
30
2
2
2
2
1
1
1
2
50
-
14
16
JKN
TAK BAYAR
R.JALAN RINAP
LAIN2
TANPA
OBAT
JUMLAH
R. JALAN
R. INAP
-
DEDI DARMAWAN
NIP: 19831127 200904 1 002
MALANG, 25 AGUSTUS 2016

BIDAN/ PERAWAT
POLINDES KEBONAGUNG
:
:
SEPTEMBE
OKTOBER
No.
NAMA OBAT
SAT
OBAT GENERIK
a. Tablet/Kapsul
2 Albendazol 400 mg
3 Alopurinol 100 mg
4 Alopurinol 300 mg
5 Ambroxol 30 mg
6 Amlodipin 5 mg
9 Amoksilin 250 mg
10 Amoksilin 500 mg
11 Antalgin 500 mg
14
Kofein 50mg)
17 Asam folat 1 mg
20 Asetosal 100 mg
21 Asiklovir 400mg
24 Cetirizin 10mg
26 Digoksin 0,25 mg
34 Furosemid 40 mg
41 Ibuprofen 200 mg
42 Ibuprofen 400 mg
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
TABLET
TABLET
KAPLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
STOK
AWAL
5
2016
2016
PENERIMAAN
6
PERSEDIAAN
7
40
-
40
-
31
170
31
170
200
-
200
-
40
40
50
50
280
280
10
10
90
90
31
31
100
-
100
-
100
100
100
100
100
100
50
50
80
80
300
300
1,000
1,000
120
70
260
120
70
260
46
47
48
49
51
52
56
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
81
82
83
84
85
86
87
88
89
90
91
92
93
94
b.
4
5
8
9
10
11
12
15
Kaptopril 12,5 mg
Kaptopril 25 mg
4 mg:
Kotrimoksazol
dewasa(CTM)
kombinasi
0mg
Metoklopramid 5mg
Metronidazol 250 mg
Metronidazol 500mg
Omeprazole 20mg
Parasetamol 100 mg
Parasetamol 500 mg
15ml
Pirantel 125 mg
Simvastatin 10 mg
Vitamin B Kompleks
Zinc 10 mg
Injeksi
Epinefrin injeksi
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
BOTOL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
170
100
170
100
56
56
47
200
47
200
30
110
30
110
10
-
10
-
60
100
100
58
-
60
100
100
58
-
70
70
70
70
40
40
160
160
400
400
900
900
100
100
120
120
620
-
620
-
150
150
205
205
40
40
4
5
4
5
35
-
35
-
50
50
Lidokain komp
AMPUL
18
25 ml
Magnesium
19
25 ml
Metilergometrin
20
1ml
AMPUL
AMPUL
30
AMPUL
32
1 ml
c.
Salep
POT
1
3%)
TUBE
2 Asiklovir krim 5%
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
POT
13
+Belerang endap4%
d.
Serbuk
SACHET
POT
2 Salisil Bedak 2 %
e.
Sirup
VIAL
BOTOL
2
200mg/5ml)
BOTOL
3 Cetirizin syr
BOTOL
BOTOL
5 Eritromisin sirup
BOTOL
8 Sulfametoksazol
d.
Tetes
5
4
5
35
13
5
4
5
35
13
4
-
4
-
20
20
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL

3/0
13 Etanol 70 % 1000 ml
31
50%
32 Masker
37 One Med H- O 3 %
44 Urine Bag
INFUS
8
steril
OBAT PATEN
1 Aptil
4 Bravoderm
4 Bufacomb
8 Demacolin
9 Lactodia
12 Mecobion tablet
18 Noza
21 Pehacain injeksi
23 Puralex
OBAT KHUSUS
SET
SET
SET
BOTOL
SACHET
BOTOL
PCS
PCS
PCS
PCS
PCS
PCS
PCS
ROL
ROL
ROL
ROL
BOTOL
PCS
BOTOL
PCS
ROL
BOTOL
SACHET
PCS
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
TUBE
TUBE
TUBE
BOTOL
TABLET
SACHET
TABLET
AMPUL
TABLET
BOTOL
AMPUL
TUBE
TABLET
BOTOL
42
42
30
30
50
50
1
2
3
Diare
Gizi
Mineral Mix
1
2
3
4
5
6
Depo kombinasi
Indoplant
IUD COPER T
kondom
Pil. Kombinasi
sepet
b.
1
f.
SACHET
KAPSUL
KAPSUL
PAKET
KB
vial
set
set
set
tab
set
14
14
16
16
UMUM
JUMLAH KUNJUNGAN
UMUM
R.JALAN
MENGETAHUI
NIP: 19590930 198511 1 001
RINAP
TAK BAYAR
YANDU
OLINDES KEBONAGUNG
PEMAKAIAN
8
SISA
STOK
9
STOK
RIIL
10
-
40
31
170
200
40
50
280
10
90
31
100
100
100
100
50
80
300
1,000
120
70
260
PERMINTAAN
11
PKD
12
ASKES
13
PEMBERIAN
APBD
14
LAIN
15
JUMLAH
16
KET
17
170
100
56
47
200
30
110
10
60
100
100
58
70
70
40
160
2
400
900
100
120
620
150
205
40
4
5
35
50
2
2
5
4
5
35
13
3
3
4
4
5
3
5
3
4
20
3
5
5
4
-
4
5
2
1
2
-
5
42
5
2
2
1
2
1
2
1
1
3
1
30
2
2
2
2
1
1
1
2
50
-
14
16
JKN
TAK BAYAR
R.JALAN RINAP
LAIN2
TANPA
OBAT
JUMLAH
R. JALAN
R. INAP
-
DEDI DARMAWAN
NIP: 19831127 200904 1 002
MALANG, 25 SEPTEMBER 2016

BIDAN/ PERAWAT
POLINDES KEBONAGUNG
:
:
OKTOBER
NOPEMBER
No.
NAMA OBAT
SAT
OBAT GENERIK
a. Tablet/Kapsul
2 Albendazol 400 mg
3 Alopurinol 100 mg
4 Alopurinol 300 mg
5 Ambroxol 30 mg
6 Amlodipin 5 mg
9 Amoksilin 250 mg
10 Amoksilin 500 mg
11 Antalgin 500 mg
14
Kofein 50mg)
17 Asam folat 1 mg
20 Asetosal 100 mg
21 Asiklovir 400mg
24 Cetirizin 10mg
26 Digoksin 0,25 mg
34 Furosemid 40 mg
41 Ibuprofen 200 mg
42 Ibuprofen 400 mg
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
TABLET
TABLET
KAPLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
STOK
AWAL
5
2016
2016
PENERIMAAN
6
PERSEDIAAN
7
40
-
40
-
31
170
31
170
200
-
200
-
40
40
50
50
280
280
10
10
90
90
31
31
100
-
100
-
100
100
100
100
100
100
50
50
80
80
300
300
1,000
1,000
120
70
260
120
70
260
46
47
48
49
51
52
56
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
81
82
83
84
85
86
87
88
89
90
91
92
93
94
b.
4
5
8
9
10
11
12
15
Kaptopril 12,5 mg
Kaptopril 25 mg
4 mg:
Kotrimoksazol
dewasa(CTM)
kombinasi
0mg
Metoklopramid 5mg
Metronidazol 250 mg
Metronidazol 500mg
Omeprazole 20mg
Parasetamol 100 mg
Parasetamol 500 mg
15ml
Pirantel 125 mg
Simvastatin 10 mg
Vitamin B Kompleks
Zinc 10 mg
Injeksi
Epinefrin injeksi
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
BOTOL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
170
100
170
100
56
56
47
200
47
200
30
110
30
110
10
-
10
-
60
100
100
58
-
60
100
100
58
-
70
70
70
70
40
40
160
160
400
400
900
900
100
100
120
120
620
-
620
-
150
150
205
205
40
40
4
5
4
5
35
-
35
-
50
50
Lidokain komp
AMPUL
18
25 ml
Magnesium
19
25 ml
Metilergometrin
20
1ml
AMPUL
AMPUL
30
AMPUL
32
1 ml
c.
Salep
POT
1
3%)
TUBE
2 Asiklovir krim 5%
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
POT
13
+Belerang endap4%
d.
Serbuk
SACHET
POT
2 Salisil Bedak 2 %
e.
Sirup
VIAL
BOTOL
2
200mg/5ml)
BOTOL
3 Cetirizin syr
BOTOL
BOTOL
5 Eritromisin sirup
BOTOL
8 Sulfametoksazol
d.
Tetes
5
4
5
35
13
5
4
5
35
13
4
-
4
-
20
20
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL

3/0
13 Etanol 70 % 1000 ml
31
50%
32 Masker
37 One Med H- O 3 %
44 Urine Bag
INFUS
8
steril
OBAT PATEN
1 Aptil
4 Bravoderm
4 Bufacomb
8 Demacolin
9 Lactodia
12 Mecobion tablet
18 Noza
21 Pehacain injeksi
23 Puralex
OBAT KHUSUS
SET
SET
SET
BOTOL
SACHET
BOTOL
PCS
PCS
PCS
PCS
PCS
PCS
PCS
ROL
ROL
ROL
ROL
BOTOL
PCS
BOTOL
PCS
ROL
BOTOL
SACHET
PCS
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
TUBE
TUBE
TUBE
BOTOL
TABLET
SACHET
TABLET
AMPUL
TABLET
BOTOL
AMPUL
TUBE
TABLET
BOTOL
42
42
30
30
50
50
1
2
3
Diare
Gizi
Mineral Mix
1
2
3
4
5
6
Depo kombinasi
Indoplant
IUD COPER T
kondom
Pil. Kombinasi
sepet
b.
1
f.
SACHET
KAPSUL
KAPSUL
PAKET
KB
vial
set
set
set
tab
set
14
14
16
16
UMUM
JUMLAH KUNJUNGAN
UMUM
R.JALAN
MENGETAHUI
NIP: 19590930 198511 1 001
RINAP
TAK BAYAR
YANDU
OLINDES KEBONAGUNG
PEMAKAIAN
8
SISA
STOK
9
STOK
RIIL
10
-
40
31
170
200
40
50
280
10
90
31
100
100
100
100
50
80
300
1,000
120
70
260
PERMINTAAN
11
PKD
12
ASKES
13
PEMBERIAN
APBD
14
LAIN
15
JUMLAH
16
KET
17
170
100
56
47
200
30
110
10
60
100
100
58
70
70
40
160
2
400
900
100
120
620
150
205
40
4
5
35
50
2
2
5
4
5
35
13
3
3
4
4
5
3
5
3
4
20
3
5
5
4
-
4
5
2
1
2
-
5
42
5
2
2
1
2
1
2
1
1
3
1
30
2
2
2
2
1
1
1
2
50
-
14
16
JKN
TAK BAYAR
R.JALAN RINAP
LAIN2
TANPA
OBAT
JUMLAH
R. JALAN
R. INAP
-
DEDI DARMAWAN
NIP: 19831127 200904 1 002
MALANG, 25 OKTOBER 2016

BIDAN/ PERAWAT
POLINDES KEBONAGUNG
:
:
NOPEMBER
DESEMBER
No.
NAMA OBAT
SAT
OBAT GENERIK
a. Tablet/Kapsul
2 Albendazol 400 mg
3 Alopurinol 100 mg
4 Alopurinol 300 mg
5 Ambroxol 30 mg
6 Amlodipin 5 mg
9 Amoksilin 250 mg
10 Amoksilin 500 mg
11 Antalgin 500 mg
14
Kofein 50mg)
17 Asam folat 1 mg
20 Asetosal 100 mg
21 Asiklovir 400mg
24 Cetirizin 10mg
26 Digoksin 0,25 mg
34 Furosemid 40 mg
41 Ibuprofen 200 mg
42 Ibuprofen 400 mg
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
TABLET
TABLET
KAPLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
STOK
AWAL
5
2016
2016
PENERIMAAN
6
PERSEDIAAN
7
40
-
40
-
31
170
31
170
200
-
200
-
40
40
50
50
280
280
10
10
90
90
31
31
100
-
100
-
100
100
100
100
100
100
50
50
80
80
300
300
1,000
1,000
120
70
260
120
70
260
46
47
48
49
51
52
56
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
81
82
83
84
85
86
87
88
89
90
91
92
93
94
b.
4
5
8
9
10
11
12
15
Kaptopril 12,5 mg
Kaptopril 25 mg
4 mg:
Kotrimoksazol
dewasa(CTM)
kombinasi
0mg
Metoklopramid 5mg
Metronidazol 250 mg
Metronidazol 500mg
Omeprazole 20mg
Parasetamol 100 mg
Parasetamol 500 mg
15ml
Pirantel 125 mg
Simvastatin 10 mg
Vitamin B Kompleks
Zinc 10 mg
Injeksi
Epinefrin injeksi
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
BOTOL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
170
100
170
100
56
56
47
200
47
200
30
110
30
110
10
-
10
-
60
100
100
58
-
60
100
100
58
-
70
70
70
70
40
40
160
160
400
400
900
900
100
100
120
120
620
-
620
-
150
150
205
205
40
40
4
5
4
5
35
-
35
-
50
50
Lidokain komp
AMPUL
18
25 ml
Magnesium
19
25 ml
Metilergometrin
20
1ml
AMPUL
AMPUL
30
AMPUL
32
1 ml
c.
Salep
POT
1
3%)
TUBE
2 Asiklovir krim 5%
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
POT
13
+Belerang endap4%
d.
Serbuk
SACHET
POT
2 Salisil Bedak 2 %
e.
Sirup
VIAL
BOTOL
2
200mg/5ml)
BOTOL
3 Cetirizin syr
BOTOL
BOTOL
5 Eritromisin sirup
BOTOL
8 Sulfametoksazol
d.
Tetes
5
4
5
35
13
5
4
5
35
13
4
-
4
-
20
20
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL

3/0
13 Etanol 70 % 1000 ml
31
50%
32 Masker
37 One Med H- O 3 %
44 Urine Bag
INFUS
8
steril
OBAT PATEN
1 Aptil
4 Bravoderm
4 Bufacomb
8 Demacolin
9 Lactodia
12 Mecobion tablet
18 Noza
21 Pehacain injeksi
23 Puralex
OBAT KHUSUS
SET
SET
SET
BOTOL
SACHET
BOTOL
PCS
PCS
PCS
PCS
PCS
PCS
PCS
ROL
ROL
ROL
ROL
BOTOL
PCS
BOTOL
PCS
ROL
BOTOL
SACHET
PCS
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
TUBE
TUBE
TUBE
BOTOL
TABLET
SACHET
TABLET
AMPUL
TABLET
BOTOL
AMPUL
TUBE
TABLET
BOTOL
42
42
30
30
50
50
1
2
3
Diare
Gizi
Mineral Mix
1
2
3
4
5
6
Depo kombinasi
Indoplant
IUD COPER T
kondom
Pil. Kombinasi
sepet
b.
1
f.
SACHET
KAPSUL
KAPSUL
PAKET
KB
vial
set
set
set
tab
set
14
14
16
16
UMUM
JUMLAH KUNJUNGAN
UMUM
R.JALAN
MENGETAHUI
NIP: 19590930 198511 1 001
RINAP
TAK BAYAR
YANDU
OLINDES KEBONAGUNG
PEMAKAIAN
8
SISA
STOK
9
STOK
RIIL
10
-
40
31
170
200
40
50
280
10
90
31
100
100
100
100
50
80
300
1,000
120
70
260
PERMINTAAN
11
PKD
12
ASKES
13
PEMBERIAN
APBD
14
LAIN
15
JUMLAH
16
KET
17
170
100
56
47
200
30
110
10
60
100
100
58
70
70
40
160
2
400
900
100
120
620
150
205
40
4
5
35
50
2
2
5
4
5
35
13
3
3
4
4
5
3
5
3
4
20
3
5
5
4
-
4
5
2
1
2
-
5
42
5
2
2
1
2
1
2
1
1
3
1
30
2
2
2
2
1
1
1
2
50
-
14
16
JKN
TAK BAYAR
R.JALAN RINAP
LAIN2
TANPA
OBAT
JUMLAH
R. JALAN
R. INAP
-
DEDI DARMAWAN
NIP: 19831127 200904 1 002
MALANG, 25 NOPEMBER 2016

BIDAN/ PERAWAT
POLINDES KEBONAGUNG
:
:
DESEMBER
JANUARI
No.
NAMA OBAT
SAT
OBAT GENERIK
a. Tablet/Kapsul
2 Albendazol 400 mg
3 Alopurinol 100 mg
4 Alopurinol 300 mg
5 Ambroxol 30 mg
6 Amlodipin 5 mg
9 Amoksilin 250 mg
10 Amoksilin 500 mg
11 Antalgin 500 mg
14
Kofein 50mg)
17 Asam folat 1 mg
20 Asetosal 100 mg
21 Asiklovir 400mg
24 Cetirizin 10mg
26 Digoksin 0,25 mg
34 Furosemid 40 mg
41 Ibuprofen 200 mg
42 Ibuprofen 400 mg
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
TABLET
TABLET
KAPLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
STOK
AWAL
5
2016
2016
PENERIMAAN
6
PERSEDIAAN
7
40
-
40
-
31
170
31
170
200
-
200
-
40
40
50
50
280
280
10
10
90
90
31
31
100
-
100
-
100
100
100
100
100
100
50
50
80
80
300
300
1,000
1,000
120
70
260
120
70
260
46
47
48
49
51
52
56
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
81
82
83
84
85
86
87
88
89
90
91
92
93
94
b.
4
5
8
9
10
11
12
15
Kaptopril 12,5 mg
Kaptopril 25 mg
4 mg:
Kotrimoksazol
dewasa(CTM)
kombinasi
0mg
Metoklopramid 5mg
Metronidazol 250 mg
Metronidazol 500mg
Omeprazole 20mg
Parasetamol 100 mg
Parasetamol 500 mg
15ml
Pirantel 125 mg
Simvastatin 10 mg
Vitamin B Kompleks
Zinc 10 mg
Injeksi
Epinefrin injeksi
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
BOTOL
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
TABLET
KAPSUL
KAPSUL
KAPSUL
TABLET
TABLET
TABLET
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
AMPUL
170
100
170
100
56
56
47
200
47
200
30
110
30
110
10
-
10
-
60
100
100
58
-
60
100
100
58
-
70
70
70
70
40
40
160
160
400
400
900
900
100
100
120
120
620
-
620
-
150
150
205
205
40
40
4
5
4
5
35
-
35
-
50
50
Lidokain komp
AMPUL
18
25 ml
Magnesium
19
25 ml
Metilergometrin
20
1ml
AMPUL
AMPUL
30
AMPUL
32
1 ml
c.
Salep
POT
1
3%)
TUBE
2 Asiklovir krim 5%
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
TUBE
POT
13
+Belerang endap4%
d.
Serbuk
SACHET
POT
2 Salisil Bedak 2 %
e.
Sirup
VIAL
BOTOL
2
200mg/5ml)
BOTOL
3 Cetirizin syr
BOTOL
BOTOL
5 Eritromisin sirup
BOTOL
8 Sulfametoksazol
d.
Tetes
5
4
5
35
13
5
4
5
35
13
4
-
4
-
20
20
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL

3/0
13 Etanol 70 % 1000 ml
31
50%
32 Masker
37 One Med H- O 3 %
44 Urine Bag
INFUS
8
steril
OBAT PATEN
1 Aptil
4 Bravoderm
4 Bufacomb
8 Demacolin
9 Lactodia
12 Mecobion tablet
18 Noza
21 Pehacain injeksi
23 Puralex
OBAT KHUSUS
SET
SET
SET
BOTOL
SACHET
BOTOL
PCS
PCS
PCS
PCS
PCS
PCS
PCS
ROL
ROL
ROL
ROL
BOTOL
PCS
BOTOL
PCS
ROL
BOTOL
SACHET
PCS
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
BOTOL
TUBE
TUBE
TUBE
BOTOL
TABLET
SACHET
TABLET
AMPUL
TABLET
BOTOL
AMPUL
TUBE
TABLET
BOTOL
42
42
30
30
50
50
1
2
3
Diare
Gizi
Mineral Mix
1
2
3
4
5
6
Depo kombinasi
Indoplant
IUD COPER T
kondom
Pil. Kombinasi
sepet
b.
1
f.
SACHET
KAPSUL
KAPSUL
PAKET
KB
vial
set
set
set
tab
set
14
14
16
16
UMUM
JUMLAH KUNJUNGAN
UMUM
R.JALAN
MENGETAHUI
NIP: 19590930 198511 1 001
RINAP
TAK BAYAR
YANDU
OLINDES KEBONAGUNG
PEMAKAIAN
8
SISA
STOK
9
STOK
RIIL
10
-
40
31
170
200
40
50
280
10
90
31
100
100
100
100
50
80
300
1,000
120
70
260
PERMINTAAN
11
PKD
12
ASKES
13
PEMBERIAN
APBD
14
LAIN
15
JUMLAH
16
KET
17
170
100
56
47
200
30
110
10
60
100
100
58
70
70
40
160
2
400
900
100
120
620
150
205
40
4
5
35
50
2
2
5
4
5
35
13
3
3
4
4
5
3
5
3
4
20
3
5
5
4
-
4
5
2
1
2
-
5
42
5
2
2
1
2
1
2
1
1
3
1
30
2
2
2
2
1
1
1
2
50
-
14
16
JKN
TAK BAYAR
R.JALAN RINAP
LAIN2
TANPA
OBAT
JUMLAH
R. JALAN
R. INAP
-
DEDI DARMAWAN
NIP: 19831127 200904 1 002
MALANG, 25 DESEMBER 2016

BIDAN/ PERAWAT
halaman 3
Tgl
1
No Nama Pasien
2
### 11
### 12
### 13
### 14
### 15
n
ket :
Umur/
Jumlah Antibiotika Injeksi Jumlah
Diagnosis
kgBB
R/
(Ya/Tidak) (Ya/Tidak) Generik
4
Rinda
33 thCC + Anoreksia 3
Lianah
29 th
Supardi
Diare
Tidak
37 thMialgia + Neuritis 2
Indar S
Total
Rata-Rata
Persentase
A = Jumlah R/ untuk semua pasien
B = Jumlah pasien yang mendapat antibiotik
A
E
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
Dosis
Jmlh
Obat
10
11
12
Tidak
Tidak
Imam
Nama Obat
Tidak
a. Pamol
3X1
9
b. GG
3X1
9
c. Bc
3X1
9
d.
e.
a. Oralit
Sesuai A 12
b. Zinc
1 X 1 Ma 10
c.
d.
e.
a. Pamol
3X1
9
b. GG
3X1
9
c. Bc
3X1
9
d.
e.
a. Asam Mefenamat 3 X 1
9
b. B1
3X1
9
c.
d.
e.
a. Pamol
3X1
9
b. GG
3X1
9
c. Bc
3X1
9
d.
e.
C = Jumlah pasien yang mendapat injeksi

n = Jumlah pasien (sampel)
Aturan
Pakai
Sesuai Pedoman
Keterangan
(Ya / Tidak)*
13
14
3X1
3X1
3X1
Sesuai Aturan
1X1 Malam
3X1
3X1
3X1
3X1
3X1
3X1
3X1
3X1
E = A/n
G = C/n x 100 %
F = B/n x 100 %
H = D/A x 100 %
*Di isi petugas gudang
Mengetahui,
Kepala Puskesmas
Petugas Gudang
BIDAN/ PERAWAT
DEDI DARMAWAN
ENY KURNIAWATI
NIP: 19590930 198511 1 001
NIP: 19831127 200904 1 002
15

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LAPORAN PENERIMAAN DAN PENGELUARAN OBAT (LPPO)

Fitomenadion (Vit K1) 10mg

Parasetamol drop 100mg/ml btl @

Kotrimoksazol Suspensi komb:

Obat Batuk Hitam ( O B H ) cairan

9 Ringer Lactate infus steril

PETUGAS PENGELOLA OBAT

dr. BAMBANG BUDI PRASTYA

NIP: 19590930 198511 1 001

NIP: 19831127 200904 1 002

MALANG, 25 JANUARI 2016

LAPORAN PENERIMAAN DAN PENGELUARAN OBAT (LPPO)

Dimenhidrinat tablet 50mg

15 Hyosin n butilbromid inj 250mg/ml

Kotrimoksazol Suspensi komb:

25 Kapas Pembalut / Absorben 250 gr

KEPALA UPTD PUSKESMAS

PETUGAS PENGELOLA OBAT

MALANG, 25 FEBRUARI 2016

dr. BAMBANG BUDI PRASTYA

NIP: 19590930 198511 1 001

NIP: 19831127 200904 1 002

LAPORAN PENERIMAAN DAN PENGELUAR

1 Alat suntik sekali pakai 1 ml

dr. BAMBANG BUDI PRASTYA

NIP: 19590930 198511 1 001

MAAN DAN PENGELUARAN OBAT (LPPO)

PETUGAS PENGELOLA OBAT

MALANG, 25 MARET 2016

LAPORAN PENERIMAAN DAN PENGELUAR

1 Alat suntik sekali pakai 1 ml

dr. BAMBANG BUDI PRASTYA

NIP: 19590930 198511 1 001

MAAN DAN PENGELUARAN OBAT (LPPO)

PETUGAS PENGELOLA OBAT

MALANG, 25 APRIL 2016

LAPORAN PENERIMAAN DAN PENGELUAR

1 Alat suntik sekali pakai 1 ml

dr. BAMBANG BUDI PRASTYA

NIP: 19590930 198511 1 001

MAAN DAN PENGELUARAN OBAT (LPPO)

PETUGAS PENGELOLA OBAT

MALANG, 25 MEI 2016

LAPORAN PENERIMAAN DAN PENGELUAR

1 Alat suntik sekali pakai 1 ml

dr. BAMBANG BUDI PRASTYA

NIP: 19590930 198511 1 001

MAAN DAN PENGELUARAN OBAT (LPPO)

PETUGAS PENGELOLA OBAT

MALANG, 25 JUNI 2016

LAPORAN PENERIMAAN DAN PENGELUAR

1 Alat suntik sekali pakai 1 ml

dr. BAMBANG BUDI PRASTYA

NIP: 19590930 198511 1 001

MAAN DAN PENGELUARAN OBAT (LPPO)

PETUGAS PENGELOLA OBAT

MALANG, 25 JULI 2016