LPLPO2016

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )
Unit Penerima : UPTD Puskesmas Langsa Lama Bulan : Juli
Kecamatan : Langsa Lama Tahun : 2016
Kota : Langsa
Provinsi : Aceh
Kode Nama Obat Sediaan Stock Awal Penerimaan Persediaan Pemakaian Rusak/Ed Sisa Stock Stock Optimum Permintaan
1 2 3 4 5 6 7 8 9 10 11
1 Abbocat No.18 Set 167 167 62 0 105 105 0
2 Abbocat No. 20 Set 68 68 30 0 38 51 13
3 Abbocat No. 22 Set 30 30 0 0 30 0 0
4 Abbocat No. 24 Set 0 0 0 0 0 0 0
5 Alat Suntik sekali pakai 1 ml Set 110 110 75 0 35 128 93
6 Alat Suntik sekali pakai 2,5 ml Set 28 200 228 10 0 218 17 0
9 Allbendazol Tab 10 10 0 0 10 0 0
10 Alopurinol tablet 100 ml Tab 596 1900 2496 1924 0 572 3271 2699
11 Alprazolam 0,5 ml Tab 0 0 0 0 0 0 0
12 Ambroxol syrup 15 mg/ml - 60 ml Btl 0 0 0 0 0 0 0
13 Ambroxol tablet 30 ml Tab 0 200 200 200 0 0 340 340
14 Aminofilin Injeksi 24 mg/ml - 10 ml Amp 0 0 0 0 0 0 0
15 Aminofilin tablet 200 mg Tab 200 200 0 0 200 0 0
16 Amitriptilin HCL tablet salut 25 mg Tab 240 1300 1540 850 0 690 1445 755
Halaman 1 dari 47
1 2 3 4 5 6 7 8 9 10 11
17 Amlodipin tablet 5 mg Tab 136 60 196 56 0 140 95 0
18 Amoksisilin kaplet 500 mg Kap 1475 1475 1375 0 100 2338 2238
19 Amoksisilin kapsul 250 mg Kap 4757 12000 16757 8970 0 7787 15249 7462
20 Amoksisilin sirup kering 125 mg/5ml Btl 297 120 417 247 0 170 420 250
21 Ampisilin kaplet 250 mg Kap 0 0 0 0 0 0 0
22 Ampisilin kaplet 500 Kap 0 0 0 0 0 0 0
23 Ampisilin sirup kering 125 mg/5 ml Btl 0 0 0 0 0 0 0
24 Antalgin (metampiron) tablet 500 mg Tab 0 0 0 0 0 0 0
25 Antalgin injeksi 250 mg/ml-2ml Amp 0 0 0 0 0 0 0
26 Antasida DOEN suspensi Btl 285 200 485 303 0 182 515 333
27 Antasida DOEN tablet Tab 1960 1700 3660 2641 0 1019 4490 3471
28 Anti Bakteri Doen Salep (Bacitracin) Tube 21 21 21 0 0 36 36
29 Anti Hemoroid DOEN Sup 21 50 71 30 0 41 51 10
30 Antifungi DOEN Pot 12 24 36 36 0 0 61 61
31 Antimigren Tab 100 100 0 0 100 0 0
32 A.T.S 1500 ui/amp Btl 0 0 0 0 0 0 10
33 Aqua pro injeksi sterikl,bebas pirogen-20ml Vial 8 10 18 2 0 16 3 0
34 Aquades steril Btl 0 0 0 0 0 0 0
35 Asam Askorbat 50 mg Tab 3015 2000 5015 5015 0 0 8526 8526
36 Asam Mefenamat kaplet 500 mg Tab 1479 4000 5479 4731 0 748 8043 7295
Halaman 2 dari 47
1 2 3 4 5 6 7 8 9 10 11
37 Asam Traneksamat Injeksi 100 mg/ml Tab 8 8 0 0 8 0 0
38 Asiklovir krim 5% - 5 gram Tube 44 44 32 0 12 54 42
39 Asiklovir tablet 200 mg Tab 645 645 243 0 402 413 11
40 Almond sirup (OBP) Btl 0 0 0 0 0 0 0
41 Alvogil Tab 0 0 0 0 0 0 0
42 Attapulgite 600 mg/Diaform Tab 0 0 0 0 0 0 0
43 Besi ( II ) Sulfat Tablet 300 mg Tab 1421 6000 7421 3205 0 4216 5449 1233
44 Betadin Oin 5 gr Tube 0 12 12 12 0 0 20 20
45 Betahistin Mesilat tablet 6 mg Tab 8 90 98 18 0 80 31 0
46 Betametason Krim Tube 0 0 0 0 0 0 0
47 Bisturi Pcs 0 0 0 0 0 0 20
48 Burnazin Tube 6 6 1 0 5 2 0
49 Bekarbon Tab 0 0 0 0 0 0 0
50 Betametason N Tube 0 0 0 0 0 0 0
51 Captopril 12,5 mg Tab 487 1300 1787 1048 0 739 1782 1043
52 Captopril 25 mg Tab 527 527 248 0 279 422 143
53 Catgut Plain With nedle 3/0 Pcs 40 72 112 55 0 57 94 37
54 Catgut Cromic 3/0 Ktk 12 12 0 0 12 0 0
55 Catgut Cromic 4/0 Ktk 29 29 0 0 29 0 0
56 Clobazam tablet 10 mg Tab 160 160 30 0 130 51 0

Halaman 3 dari 47
1 2 3 4 5 6 7 8 9 10 11
57 Caviton White Ktk 0 0 0 0 0 0 0
58 Caviton Pink Btl 4 4 0 0 4 0 0
59 Dexamethason injeksi 5 mg/ml Amp 0 100 100 95 0 5 162 157
60 Dexamethason tablet 0,5 mg Tab 2363 6000 8363 7133 0 1230 12126 10896
61 Devitalisasi Pasta Ktk 0 0 0 0 0 0 0
62 Diazepam injeksi 5 mg/ml - 2 ml Amp 30 30 6 0 24 10 0
63 Diazepam tablet 2 mg Tab 376 376 96 0 280 163 0
64 Difenhidramin HCL inj 10 mg/ml - 1 ml Amp 37 37 0 0 37 0 0
65 Digoksin Tab 53 53 0 0 53 0 0
66 Diaform Tab 0 1000 1000 873 0 127 1484 1357
67 Dulcolax Tab 0 0 0 0 0 0 200
68 Efedrin HCL tablet 25 mg Tab 190 190 0 0 190 0 0
69 Ekstrak Belladon tablet 10 mg Tab 0 0 0 0 0 0 0
70 Epinefrina Inj 0,1% - 1 ml Amp 0 0 0 0 0 0 0
71 Erytromycin kaps 500 mg Tab 0 0 0 0 0 0 500
72 Erytromycin Syrup 200 mg/ 5 ml-60 ml Btl 0 0 0 0 0 0 50
73 Etakridin larutan 0,1% - 300 ml Btl 3 3 0 0 3 0 0
74 Etanol 70% - 100 ml Btl 21 60 81 43 0 38 73 35
75 Etanol 70% - 1000 ml Btl 2 2 0 0 2 0 0
76 Etil Klorida Spray - 100 ml Btl 0 0 0 0 0 0 5

Halaman 4 dari 47
1 2 3 4 5 6 7 8 9 10 11
77 Eugenol Cairan Vial 2 2 0 0 2 0 0
78 Fenobarbital tablet 30 mg Tab 740 740 28 0 712 48 0
79 Fenol Gliserol tetes telinga 10% - 5 ml Btl 52 52 0 0 52 0 0
80 Fitomenadion injeksi 10 mg/ml - 1 ml Amp 109 109 55 0 54 94 40
81 Fitomenadion table salut gula 10 mg Tab 20 200 220 150 0 70 255 185
82 Furosemide injeksi Amp 6 6 0 0 6 0 0
83 Furosemide tablet 40 ml Tab 25 200 225 64 0 161 109 0
84 Foley Cateter No. 18 Pcs 5 5 0 0 5 0 0
85 Foley Cateter No. 24 Pcs 0 0 0 0 0 0 0
86 Garam Oralit untuk 200 ml air Bks 131 100 231 171 0 60 291 231
87 Gentamicin salap kulit 5 gram Tube 0 0 0 0 0 0 0
88 Gentamicin sulfat tetes mata 0,3% - 5 ml Btl 62 62 38 0 24 65 41
89 Gentian Violet larutan 1% - 10 ml Btl 45 45 36 0 9 61 52
90 Glibenklamid tablet 5 mg Btl 0 500 500 500 0 0 850 850
91 Gliseril Guayakolat tablet 100 mg Btl 0 0 0 0 0 0 0
92 Glukosa larutan infus 10% steril Btl 108 108 10 0 98 17 0
93 Glucodex Tab 0 0 0 0 0 0 0
94 Griseofulvin tablet 125 mg micronized Tab 589 200 789 595 0 194 1012 818
95 Haloperidol tablet 0,5 mg Tab 420 300 720 350 0 370 595 225
96 Haloperidol tablet 1,5 mg Tab 300 1200 1500 480 0 1020 816 0
Halaman 5 dari 47
1 2 3 4 5 6 7 8 9 10 11
97 Haloperidol tablet 5 mg Tab 310 1200 1510 520 0 990 884 0
98 Hyosin Tab 50 50 0 0 50 0 0
99 Hidroklorotiazid (HCT) tablet 25 mg Tab 1019 1019 3 0 1016 5 0
100 Hidrocortison Krim 2,5% (Asetat) - 5 gram Tube 19 19 19 0 0 32 32
101 Handscoen Steril Ktk 0 50 50 50 0 0 85 85
102 Handscoen Non Steril Ktk 150 200 350 150 0 200 255 55
103 Ibuprofen tablet 400 mg Tab 0 0 0 0 0 0 0
104 Ibuprofen tablet 200 mg Tab 1279 2000 3279 2520 0 759 4284 3525
105 Ibuprofen sirup Btl 43 43 14 0 29 24 0
106 Ichtyol Pot 12 12 3 0 9 5 0
107 Infusion set anak Set 45 45 0 0 45 0 100
108 Infusion set dewasa Set 50 50 50 0 0 85 85
109 Isosorbit Dinitrat 5 mg Tab 90 90 80 0 10 136 126
110 Kalium Permanganat serbuk Pot 0 0 0 0 0 0 0
111 Kalsium Laktat (Kalk) tablet 500 gram Tab 1391 1300 2691 2491 0 200 4235 4035
112 Kapas berlemak 500 mg Rol 2 2 1 0 1 2 1
113 Kapas Pembalut / Absorben 250 gram Rol 0 10 10 1 0 9 2 0
114 Kassa Binda Bks 1 1 1 0 0 2 2
115 Kasa 16 x 16 Steril Ktk 9 20 29 29 0 0 49 49
116 Kasa Pembalut Hidrofil 4 m x 15 cm elastic Ktk 36 36 35 0 1 60 59

Halaman 6 dari 47
1 2 3 4 5 6 7 8 9 10 11
117 Ketokenazol Krim 2% Tube 21 25 46 10 0 36 17 0
118 Katokenazol tablet 200 mg Tab 110 110 2 0 108 3 0
119 Klindamisin Kaps 150 mg Kap 0 0 0 0 0 0 500
120 Klindamisin Kaps 300 mg Kap 0 0 0 0 0 0 0
121 Kloramfenikol Sirup Btl 11 11 11 0 0 19 19
122 Kloramfenikol Kaps 250 mg Kap 4438 4438 2730 0 1708 4641 2933
123 Kloramfenikol tetes telinga 3% - 5 ml Btl 0 0 0 0 0 0 0
124 Kloramfenikol Salap Mata 1% - 5 gram Tube 39 39 39 0 0 66 66
125 Kloramfenikol tetes mata 0,5% - 5 ml Btl 0 0 0 0 0 0 0
126 Klorfeniramin Malaet (CTM) tablet 4 mg Tab 5580 4000 9580 8809 0 771 14975 14204
127 CHKM Tube 0 0 0 0 0 0 0
128 Klorpomazin HCL injeksi Amp 9 9 0 0 9 0 0
129 Klorpomazin HCL tablet salut 100 mg Tab 395 900 1295 450 0 845 765 0
130 Klorpomazin HCL Tablet salut 25 mg Tab 170 500 670 250 0 420 425 5
131 Kodein HCL tablet 10 mg Tab 88 88 0 0 88 0 0
132 Kotrimoksazol tablet 480 mg Tab 839 300 1139 940 0 199 1598 1399
133 Kotrisoksazol sirup Btl 70 100 170 82 0 88 139 51
134 Laxadin sirup Btl 0 10 10 2 0 8 3 0
135 Lavertrans salap Pot 6 6 4 0 2 7 5
136 Lomatuel Pot 0 10 10 10 0 0 17 17

Halaman 7 dari 47
1 2 3 4 5 6 7 8 9 10 11
137 Pehacain injeksi Amp 0 0 0 0 0 0 0
138 Masker Pcs 45 50 95 20 0 75 34 0
139 Meloksikam Tab 0 0 0 0 0 0 500
140 Metformin Tab 117 500 617 331 0 286 563 277
141 Metillergometrin Maleat tablet salut 0,125 mg Tab 427 427 69 0 358 117 0
142 Metillergometrin Maleat inj 0,200 mg - 1 ml Amp 166 166 55 0 111 94 0
143 Metilprednisolon Tab 317 317 12 0 305 20 0
144 Metoklopropamide sirup 5 ml/ml - 60 ml Btl 0 96 96 51 0 45 87 42
145 Metoklopropamide tablet 10 mg Tab 274 300 574 446 0 128 758 630
146 Metronidazol sirup Btl 15 10 25 8 0 17 14 0
147 Metronidazol tablet 500 mg Tab 106 1000 1106 599 0 507 1018 511
148 Mikrolac Tube 4 4 0 0 4 0 0
149 Mikonazole krim/salap 2% - 10 gram Tube 148 24 172 109 0 63 185 122
150 Multivitamin sirup Btl 0 0 0 0 0 0 0
151 Natrium Bikarbonat tablet 500 mg Tab 271 4000 4271 2413 0 1858 4102 2244
152 Natrium Diklofenak tablet 25 mg Tab 0 0 0 0 0 0 0
153 Natrium Diklofenak 50 mg Tab 531 2000 2531 1223 0 1308 2079 771
154 Natrium Klorida larutan infus 0,9% steril 500 ml Btl 75 75 75 0 0 128 128
155 Nifedipin Tab 81 81 0 0 81 0 0
156 Nistatin tablet Supp Vagina 100.000 lu/g Tab 142 142 6 0 136 10 0
Halaman 8 dari 47
1 2 3 4 5 6 7 8 9 10 11
157 Nistatin tablet salut Oral 500.000 lu/g Tab 150 150 0 0 150 0 0
158 Nald 23 Pcs 0 100 100 100 0 0 170 170
159 Nald heating Pcs 0 0 0 0 0 0 0
160 Obat Antituberkolosis Katagori 1 dewasa Pkt 5 5 0 0 5 0 0
161 Obat Antituberkolosis Katagori 2 dewasa Pkt 2 2 0 0 2 0 0
162 Obat Antituberkolosis Katagori Anak Pkt 3 3 0 0 3 0 0
163 OBH Btl 0 0 0 0 0 0 0
164 Obat Batuk Putih (OBP) cairan - 100 ml Btl 0 0 0 0 0 0 0
165 Occo Tube 0 0 0 0 0 0 0
166 Oksitetrasiklin HCL Salap mata 1% - 3,5 gram Tube 0 0 0 0 0 0 0
167 Oksitetrasiklin HCL injeksi i.m 50 mg/ml Amp 0 0 0 0 0 0 0
168 Oksitetrasiklin HCL salap kulit Tube 36 36 36 0 0 61 61
169 Oksitosin inj 10 lu/ml - 1 ml Amp 0 100 100 70 0 30 119 89
170 Omeprazol Kaps 20 mg Kap 248 248 190 0 58 323 265
171 Ondasentron inj 4 mg/ml Amp 10 10 0 0 10 0 0
172 Papaverin injeksi Amp 0 0 0 0 0 0 0
173 Papaverin tablet 40 mg Tab 975 975 0 0 975 0 0
174 Paracetamol sirup 120 mg/ 5 ml - 60 ml Btl 295 250 545 314 0 231 534 303
175 Paracetamol tablet 100 mg Tab 10000 10000 0 0 10000 0 0
176 Paracetamol tablet 500 mg Tab 3595 5300 8895 8124 0 771 13811 13040
Halaman 9 dari 47
1 2 3 4 5 6 7 8 9 10 11
177 Pembalut gyps 3" Rol 0 0 0 0 0 0 0
180 Perak Sulfadiazin krim Tube 0 0 0 0 0 0 0
181 Piracetam injeksi Amp 10 10 0 0 10 0 0
182 Pirantel tab score Tab 66 66 58 0 8 99 91
183 Piridoksin (Vitamin B6) tablet 10 mg Tab 1072 1000 2072 1860 0 212 3162 2950
184 Piroksikam tablet 10 mg Tab 2152 2152 1657 0 495 2817 2322
185 Plester 5 yard x 2 inch Rol 5 10 15 6 0 9 10 1
186 Povidon iodida larutan 10% - 60 ml Tab 0 0 0 0 0 0 0
187 Povidon iodida larutan 10% - 30 ml Tab 0 20 20 0 0 20 0 0
188 Povidon iodida larutan 10% - 300 ml Tab 4 4 1 0 3 2 0
189 Prednison tablet 5 mg Tab 3536 3536 2511 0 1025 4269 3244
190 Propanolol Tab 130 130 20 0 110 34 0
191 Propiltiourasil tablet 50 mg Tab 175 100 275 50 0 225 85 0
192 Ranitidine injeksi 25 mg/ 2 ml Amp 24 24 10 0 14 17 3
193 Ranitidine tablet 150 mg Tab 2421 1200 3621 3126 0 495 5314 4819
194 Reserpin tablet 0,10 mg Tab 0 0 0 0 0 0 0
195 Resperidon tablet Tab 180 1200 1380 600 0 780 1020 240
196 Retinol (Vitamin A) Kaps 100.000 lu Kap 0 0 0 0 0 0 0

Halaman 10 dari 47
1 2 3 4 5 6 7 8 9 10 11
197 Retinol (Vitamin A) Kaps 200.000 lu Kap 0 0 0 0 0 0 0
198 Ringer Laktat larutan infus steril 500 ml Btl 136 136 55 0 81 94 13
199 Salbutamol tablet 2 mg Tab 493 493 337 0 156 573 417
200 Salap 2-4 30 gram Pot 40 24 64 38 0 26 65 39
201 Salicyl bedak 2% - 50 gr Ktk 155 144 299 204 0 95 347 252
202 Semen Seng Fosfat sebuk-cairan Vial 5 5 0 0 5 0 0
203 Sefriakson serbuk injeksi Vial 0 0 0 0 0 0 0
204 Serun Anti Tetanus Injeksi (ATS) Amp 0 0 0 0 0 0 10
205 Sianokobalamin (Vit.B12) inj 500 mcg-ml Amp 121 121 50 0 71 85 14
206 Sianokobalamin (Vit.B12) tablet 50 mg Tab 2000 2000 1342 0 658 2281 1623
207 Silk (Benang Sutera) no. 3/0 Pcs 16 16 0 0 16 0 0
208 Silk (Benang Sutera) no. 4/0 Pcs 26 26 0 0 26 0 0
209 Simvastatin Tab 0 500 500 139 0 361 236 0
210 Siprofloksasin tablet 500 mg Tab 792 792 257 0 535 437 0
211 Stesolid Rectal 5 mg Tube 3 3 0 0 3 0 0
212 Sulfasetamide tetes mata Btl 0 0 0 0 0 0 0
213 Sikzonoate Btl 10 10 0 0 10 0 0
214 Tetrasiklin HCL Kaps Kap 300 300 100 0 200 170 0
215 Tiamfenikol kaps 500 mg Kap 84 84 0 0 84 0 0
216 Tiamin HCL / monohidrat (Vit.B1) tablet 50 mg Tab 255 3000 3255 2284 0 971 3883 2912
Halaman 11 dari 47
1 2 3 4 5 6 7 8 9 10 11
217 Tramadol Kapsul 50 mg Kap 20 20 0 0 20 0 0
218 Triheksilfenidi Hidroklarida tablet 2 mg Tab 320 320 320 0 0 544 544
219 Urine Bag Pcs 4 4 0 0 4 0 0
220 Vit.B.komplek Tab 3693 2000 5693 4986 0 707 8476 7769
221 Zink tablet Tab 289 289 289 0 0 491 491
222 Zink sirup Btl 0 0 0 0 0 0 72
223 Etanol 96% Btl 0 0 0 0 0 0 0
224 Mecobalamin 250 Tab 60 60 0 0 60 0 0
225 Trombophop gel Tube 3 3 0 0 3 0 0
226 Aquades Btl 0 0 0 0 0 0 0
227 Fenilbutazon Tab 0 0 0 0 0 0 0
228 Pehacain injeksi Amp 20 100 120 91 0 29 155 126
229 Sefradoksil kapsul Kap 300 300 10 0 290 17 0
230 Diltiazem 30 mg Tab 0 0 0 0 0 0 0
231 Neuralgin tablet Tab 0 0 0 0 0 0 0
232 Nebacetin Powder Ktk 3 3 0 0 3 0 0
233 Cendo Xitrol tetes mata Btl 0 0 0 0 0 0 0
234 OBH Sirup Btl 0 0 0 0 0 0 0
235 Kasa Elastis Perban Ktk 3 3 0 0 3 0 0
236 Ventolin Nebuler Bks 15 15 0 0 15 0 0

Halaman 12 dari 47
1 2 3 4 5 6 7 8 9 10 11
237 Domperidon tab 10 mg Tab 200 200 31 0 169 53 0
238 Glimepirid tab 2 mg Tab 194 194 73 0 121 124 3
239 Kasa pembalut hidrofil 4m x 10 cm Bks 100 100 0 0 100 0 0
JKN
JUMLAH KUNJUNGAN RESEP
1781
Mengetahui / Menyetujui Yang Meminta Yang Menerima

Kepala Dinas Kesehatan Kabupaten kota Pimpinan Puskesmas Petugas Puskesmas
( Dr. Herman I ) ( NS. Edi Syahputra, S. Kep) ( Yunita, Amd. Far)

Pembina / NIP. 19630923 200003 1 001 NIP. 19731021 199503 1 001 NIP. 19770531 201003 2
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Pemberian Keterangan
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12 13
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12 13
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12 13
ED
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12 13
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12 13
ED
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12 13
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12 13
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12 13
ED
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12 13
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Yang Menerima
Petugas Puskesmas
( Yunita, Amd. Far)

NIP. 19770531 201003 2 001
Halaman 26 dari 47
LAPORAN PEMAKAIAN DAN LEMBAR PERM
(LPLPO)
Unit Penerima : UPTD Puskesmas Langsa Lama

Kecamatan : Langsa Lama
Kota : Langsa
Provinsi : Aceh
Kode Nama Obat Sediaan Stock Awal Penerimaan

1 2 3 4 5
1 Abbocat No.18 Set 167 0
2 Abbocat No. 20 Set 68 0
5 Alat Suntik sekali pakai 1 ml Set 30 100
6 Alat Suntik sekali pakai 2,5 ml Set 154 0
9 Allbendazol Tab 10 0
10 Alopurinol tablet 100 ml Tab 463 1600
11 Alprazolam 0,5 ml Tab 0 0
12 Ambroxol syrup 15 mg/ml - 60 ml Btl 0 0
13 Ambroxol tablet 30 ml Tab 0 1500
14 Aminofilin Injeksi 24 mg/ml - 10 ml Amp 0 0
15 Aminofilin tablet 200 mg Tab 200 0
16 Amitriptilin HCL tablet salut 25 mg Tab 440 700
17 Amlodipin tablet 5 mg Tab 0 240
18 Amoksisilin kaplet 500 mg Kap 175 2000
19 Amoksisilin kapsul 250 mg Kap 14667 0
20 Amoksisilin sirup kering 125 mg/5ml Btl 303 240
21 Ampisilin kaplet 250 mg Kap 0 0
22 Ampisilin kaplet 500 Kap 0 0
23 Ampisilin sirup kering 125 mg/5 ml Btl 0 0
24 Antalgin (metampiron) tablet 500 mg Tab 0 0
25 Antalgin injeksi 250 mg/ml-2ml Amp 0 0
26 Antasida DOEN suspensi Btl 292 300
27 Antasida DOEN tablet Tab 2705 1400
28 Anti Bakteri Doen Salep (Bacitracin) Tube 30 50
29 Anti Hemoroid DOEN Sup 41 30
30 Antifungi DOEN Pot 35 0
31 Antimigren Tab 100 0
32 A.T.S 1500 ui/amp Btl 2 0
33 Aqua pro injeksi sterikl,bebas pirogen-20ml Vial 20 0
34 Aquades steril Btl 0 0
35 Asam Askorbat 50 mg Tab 2307 3700
36 Asam Mefenamat kaplet 500 mg Tab 3302 1600
37 Asam Traneksamat Injeksi 100 mg/ml Tab 8 0
38 Asiklovir krim 5% - 5 gram Tube 23 50
39 Asiklovir tablet 200 mg Tab 252 600
40 Almond sirup (OBP) Btl 0 0
41 Alvogil Tab 0 0
42 Attapulgite 600 mg/Diaform Tab 1622 0
43 Besi ( II ) Sulfat Tablet 300 mg Tab 6145 0
44 Betadin Oin 5 gr Tube 5 2
45 Betahistin Mesilat tablet 6 mg Tab 32 30
46 Betametason Krim Tube 39 25
47 Bisturi Pcs 0 0
48 Burnazin Tube 6 0
49 Bekarbon Tab 0 0
50 Betametason N Tube 0
51 Captopril 12,5 mg Tab 650 900
52 Captopril 25 mg Tab 17 800
53 Catgut Plain With nedle 3/0 Pcs 45 72
54 Catgut Cromic 3/0 Ktk 12 0
55 Catgut Cromic 4/0 Ktk 29 0
56 Clobazam tablet 10 mg Tab 180 0
57 Caviton White Ktk 0 0
58 Caviton Pink Btl 4 0
59 Dexamethason injeksi 5 mg/ml Amp 56 0
60 Dexamethason tablet 0,5 mg Tab 3742 4000
61 Devitalisasi Pasta Ktk 0 0
62 Diazepam injeksi 5 mg/ml - 2 ml Amp 30 0
63 Diazepam tablet 2 mg Tab 0 400
64 Difenhidramin HCL inj 10 mg/ml - 1 ml Amp 47 0
65 Digoksin Tab 53 0
66 Diaform Tab 0 0
67 Dulcolax Tab 0 0
68 Efedrin HCL tablet 25 mg Tab 190 0
69 Ekstrak Belladon tablet 10 mg Tab 0 0
70 Epinefrina Inj 0,1% - 1 ml Amp 0 0
71 Erytromycin kaps 500 mg Tab 0 0
72 Erytromycin Syrup 200 mg/ 5 ml-60 ml Btl 0 0
73 Etakridin larutan 0,1% - 300 ml Btl 3 0
74 Etanol 70% - 100 ml Btl 23 45
75 Etanol 70% - 1000 ml Btl 2 0
76 Etil Klorida Spray - 100 ml Btl 6 2
77 Eugenol Cairan Vial 2 0
78 Fenobarbital tablet 30 mg Tab 784 0
79 Fenol Gliserol tetes telinga 10% - 5 ml Btl 52 0
80 Fitomenadion injeksi 10 mg/ml - 1 ml Amp 49 60
81 Fitomenadion table salut gula 10 mg Tab 118 0
82 Furosemide injeksi Amp 6 0
83 Furosemide tablet 40 ml Tab 40 100
84 Foley Cateter No. 18 Pcs 5 0
85 Foley Cateter No. 24 Pcs 0 0
86 Garam Oralit untuk 200 ml air Bks 64 200
87 Gentamicin salap kulit 5 gram Tube 0 0
88 Gentamicin sulfat tetes mata 0,3% - 5 ml Btl 0 120
89 Gentian Violet larutan 1% - 10 ml Btl 55 0
90 Glibenklamid tablet 5 mg Btl 277 0
91 Gliseril Guayakolat tablet 100 mg Btl 0 0
92 Glukosa larutan infus 10% steril Btl 113 0
93 Glucodex Tab 0 0
94 Griseofulvin tablet 125 mg micronized Tab 149 900
95 Haloperidol tablet 0,5 mg Tab 500 300
96 Haloperidol tablet 1,5 mg Tab 400 800
97 Haloperidol tablet 5 mg Tab 480 700
98 Hyosin Tab 50 0
99 Hidroklorotiazid (HCT) tablet 25 mg Tab 1025 0
100 Hidrocortison Krim 2,5% (Asetat) - 5 gram Tube 0 72
101 Handscoen Steril Ktk 42 0
102 Handscoen Non Steril Ktk 0 400
103 Ibuprofen tablet 400 mg Tab 0 0
104 Ibuprofen tablet 200 mg Tab 249 3300
105 Ibuprofen sirup Btl 38 25
106 Ichtyol Pot 1 12
107 Infusion set anak Set 45 0
108 Infusion set dewasa Set 62 0
109 Isosorbit Dinitrat 5 mg Tab 136 0
110 Kalium Permanganat serbuk Pot 0 0
111 Kalsium Laktat (Kalk) tablet 500 gram Tab 1218 1800
112 Kapas berlemak 500 mg Rol 0 2
113 Kapas Pembalut / Absorben 250 gram Rol 4 3
114 Kassa Binda Bks 0 1
115 Kasa 16 x 16 Steril Ktk 15 89
116 Kasa Pembalut Hidrofil 4 m x 15 cm elastic Ktk 56 100
117 Ketokenazol Krim 2% Tube 45 0
118 Katokenazol tablet 200 mg Tab 120 0
119 Klindamisin Kaps 150 mg Kap 0 0
120 Klindamisin Kaps 300 mg Kap 0 0
121 Kloramfenikol Sirup Btl 17 0
122 Kloramfenikol Kaps 250 mg Kap 4570 0
123 Kloramfenikol tetes telinga 3% - 5 ml Btl 0 0
124 Kloramfenikol Salap Mata 1% - 5 gram Tube 58 0
125 Kloramfenikol tetes mata 0,5% - 5 ml Btl 0 0
126 Klorfeniramin Malaet (CTM) tablet 4 mg Tab 4954 6400
127 CHKM Tube 0 0
128 Klorpomazin HCL injeksi Amp 9 0
129 Klorpomazin HCL tablet salut 100 mg Tab 1145 0
130 Klorpomazin HCL Tablet salut 25 mg Tab 330 200
131 Kodein HCL tablet 10 mg Tab 131 0
132 Kotrimoksazol tablet 480 mg Tab 1187 300
133 Kotrisoksazol sirup Btl 114 50
134 Laxadin sirup Btl 5 0
135 Lavertrans salap Pot 13 0
136 Lomatuel Pot 17 0
137 Pehacain injeksi Amp 0 0
138 Masker Pcs 95 0
139 Meloksikam Tab 0 0
140 Metformin Tab 347 100
141 Metillergometrin Maleat tablet salut 0,125 mg Tab 533 0
142 Metillergometrin Maleat inj 0,200 mg - 1 ml Amp 166 0
143 Metilprednisolon Tab 47 300
144 Metoklopropamide sirup 5 ml/ml - 60 ml Btl 32 24
145 Metoklopropamide tablet 10 mg Tab 375 200
146 Metronidazol sirup Btl 32 0
147 Metronidazol tablet 500 mg Tab 774 0
148 Mikrolac Tube 0 5
149 Mikonazole krim/salap 2% - 10 gram Tube 6 240
150 Multivitamin sirup Btl 0 0
151 Natrium Bikarbonat tablet 500 mg Tab 1 3000
152 Natrium Diklofenak tablet 25 mg Tab 0 0
153 Natrium Diklofenak 50 mg Tab 1961 700
154 Natrium Klorida larutan infus 0,9% steril 500 ml Btl 95 0
155 Nifedipin Tab 87 0
156 Nistatin tablet Supp Vagina 100.000 lu/g Tab 142 0
157 Nistatin tablet salut Oral 500.000 lu/g Tab 160 0
158 Nald 23 Pcs 63 0
159 Nald heating Pcs 0 0
160 Obat Antituberkolosis Katagori 1 dewasa Pkt 5 0
161 Obat Antituberkolosis Katagori 2 dewasa Pkt 0 0
162 Obat Antituberkolosis Katagori Anak Pkt 3 0
163 OBH Btl 0 0
164 Obat Batuk Putih (OBP) cairan - 100 ml Btl 0 0
165 Occo Tube 0 0
166 Oksitetrasiklin HCL Salap mata 1% - 3,5 gram Tube 0 0
167 Oksitetrasiklin HCL injeksi i.m 50 mg/ml Amp 0 0
168 Oksitetrasiklin HCL salap kulit Tube 0 100
169 Oksitosin inj 10 lu/ml - 1 ml Amp 65 0
170 Omeprazol Kaps 20 mg Kap 170 210
171 Ondasentron inj 4 mg/ml Amp 10 0
172 Papaverin injeksi Amp 0 0
173 Papaverin tablet 40 mg Tab 975 0
174 Paracetamol sirup 120 mg/ 5 ml - 60 ml Btl 314 300
175 Paracetamol tablet 100 mg Tab 10000 0
176 Paracetamol tablet 500 mg Tab 7241 1600
177 Pembalut gyps 3" Rol 0 0
180 Perak Sulfadiazin krim Tube 0 0
181 Piracetam injeksi Amp 10 0
182 Pirantel tab score Tab 96 0
183 Piridoksin (Vitamin B6) tablet 10 mg Tab 856 1000
184 Piroksikam tablet 10 mg Tab 113 2900
185 Plester 5 yard x 2 inch Rol 3 11
186 Povidon iodida larutan 10% - 60 ml Tab 0 0
189 Prednison tablet 5 mg Tab 1815 3700
190 Propanolol Tab 158 0
191 Propiltiourasil tablet 50 mg Tab 139 100
192 Ranitidine injeksi 25 mg/ 2 ml Amp 4 30
193 Ranitidine tablet 150 mg Tab 1975 2600
194 Reserpin tablet 0,10 mg Tab 0 0
195 Resperidon tablet Tab 80 1000
196 Retinol (Vitamin A) Kaps 100.000 lu Kap 0 0
197 Retinol (Vitamin A) Kaps 200.000 lu Kap 0 0
198 Ringer Laktat larutan infus steril 500 ml Btl 11 140
199 Salbutamol tablet 2 mg Tab 91 700
200 Salap 2-4 30 gram Pot 30 48
201 Salicyl bedak 2% - 50 gr Ktk 23 288
202 Semen Seng Fosfat sebuk-cairan Vial 5 0
203 Sefriakson serbuk injeksi Vial 0 0
204 Serun Anti Tetanus Injeksi (ATS) Amp 0 0
205 Sianokobalamin (Vit.B12) inj 500 mcg-ml Amp 123 0
206 Sianokobalamin (Vit.B12) tablet 50 mg Tab 22816 0
207 Silk (Benang Sutera) no. 3/0 Pcs 16 0
208 Silk (Benang Sutera) no. 4/0 Pcs 26 0
209 Simvastatin Tab 285 0
210 Siprofloksasin tablet 500 mg Tab 376 700
211 Stesolid Rectal 5 mg Tube 3 0
212 Sulfasetamide tetes mata Btl 0 0
213 Sikzonoate Btl 10 0
214 Tetrasiklin HCL Kaps Kap 300 0
215 Tiamfenikol kaps 500 mg Kap 84 0
216 Tiamin HCL / monohidrat (Vit.B1) tablet 50 mg Tab 3846 0
217 Tramadol Kapsul 50 mg Kap 120 0
218 Triheksilfenidi Hidroklarida tablet 2 mg Tab 720 1000
219 Urine Bag Pcs 4 0
220 Vit.B.komplek Tab 3367 3700
221 Zink tablet Tab 59 300
222 Zink sirup Btl 41 0
223 Etanol 96% Btl 0 0
224 Mecobalamin 250 Tab 60 0
225 Trombophop gel Tube 3 0
226 Aquades Btl 0 0
227 Fenilbutazon Tab 0 0
228 Pehacain injeksi Amp 15 160
229 Sefradoksil kapsul Kap 300 0
230 Diltiazem 30 mg Tab 0 0
231 Neuralgin tablet Tab 0 0
232 Nebacetin Powder Ktk 3 0
233 Cendo Xitrol tetes mata Btl 0 0
234 OBH Sirup Btl 0 0
235 Kasa Elastis Perban Ktk 3 0
236 Ventolin Nebuler Btl 0 20
237 Domperidon tab 10 mg Tab 200 0
238 Glimepirid tab 2 mg Tab 200 0
JKN
JUMLAH KUNJUNGAN RESEP
1825
Mengetahui / Menyetujui
Kepala Dinas Kesehatan Kabupaten kota
( Dr. Syarbaini, M. Kes )

Pembina / NIP. 19690602 200012 1 001
MAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)
Bulan : Mei
Tahun : 2016
Persediaan Pemakaian Rusak/Ed Sisa Stock Stock Optimum

6 7 8 9 10
167 0 0 167 10 17 0
68 0 0 68 10 17 0
30 0 0 30 10 17 0
23 0 0 23 10 17 0
130 20 0 110 10 17 34
154 126 0 28 10 17 214
330 0 0 330 10 17 0
132 30 0 102 10 17 51
10 0 0 10 10 17 0
2063 1467 0 596 10 17 2494
0 0 0 0 10 17 0
0 0 0 0 10 17 0
1500 1500 0 0 10 17 2550
0 0 0 0 10 17 0
200 0 0 200 10 17 0
1140 900 0 240 10 17 1530
240 104 0 136 10 17 177
2175 700 0 1475 10 17 1190
14667 9910 0 4757 10 17 16847
543 246 0 297 10 17 418
0 0 0 0 10 17 0
0 0 0 0 10 17 0
0 0 0 0 10 17 0
0 0 0 0 10 17 0
0 0 0 0 10 17 0
592 307 0 285 10 17 522
4105 2145 0 1960 10 17 3647
80 59 0 21 10 17 100
71 50 0 21 10 17 85
35 23 0 12 10 17 39
100 0 0 100 10 17 0
2 0 0 2 10 17 0
20 12 0 8 10 17 20
0 0 0 0 10 17 0
6007 2992 0 3015 10 17 5086
4902 3405 0 1497 10 17 5789
8 0 0 8 10 17 0
73 29 0 44 10 17 49
852 207 0 645 10 17 352
0 0 0 0 10 17 0
0 0 0 0 10 17 0
1622 796 0 826 10 17 1353
6145 4724 0 1421 10 80300
7 7 0 0 10 12
62 54 0 8 10 92
64 64 0 0 10 109
0 0 0 0 10 0
6 0 0 0 10 0
0 0 0 0 10 0
0 0 0 0 10 0
1550 1063 0 487 10 1807
817 290 0 527 10 493
117 77 0 40 10 131
12 0 0 12 10 0
29 0 0 29 10 0
180 20 0 160 10 34
0 0 0 0 10 0
4 0 0 4 10 0
56 0 0 56 10 0
7742 5379 0 2363 10 9144
0 0 0 0 10 0
30 0 0 30 10 0
400 24 0 376 10 41
47 10 0 37 10 17
53 0 0 53 10 0
0 0 0 0 10 0
0 0 0 0 10 0
190 0 0 190 10 0
0 0 0 0 10 0
0 0 0 0 10 0
0 0 0 0 10 0
0 0 0 0 10 0
3 0 0 3 10 0
68 47 0 21 10 80
2 0 0 2 10 0
8 8 0 0 10 14
2 0 0 2 10 0
784 44 0 740 10 75
52 0 0 52 10 0
109 0 0 109 10 0
118 98 0 20 10 167
6 0 0 6 10 0
140 115 0 25 10 196
5 0 0 5 10 0
0 0 0 0 10 0
264 133 0 131 10 226
0 0 0 0 10 0
120 58 0 62 10 99
55 10 0 45 10 17
277 277 0 0 10 471
0 0 0 0 10 0
113 5 0 108 10 9
0 0 0 0 10 0
1049 460 0 589 10 782
800 380 0 420 10 646
1200 900 0 300 10 1530
1180 870 0 310 10 1479
50 0 0 50 10 0
1025 6 0 1019 10 10
72 53 0 19 10 90
42 42 0 0 10 71
400 250 0 150 10 425
0 0 0 0 10 0
3549 2270 0 1279 10 3859
63 20 0 43 10 34
13 1 0 12 10 2
45 0 0 45 10 0
62 12 0 50 10 20
136 46 0 90 10 78
0 0 0 0 10 0
3018 1627 0 1391 10 2766
2 0 0 2 10 0
7 7 0 0 10 12
1 0 0 1 10 0
104 95 0 9 10 162
156 120 0 36 10 204
45 24 0 21 10 17 41
120 10 0 110 17
0 0 0 0 0
0 0 0 0 0
17 6 0 11 10
4570 132 0 4438 224
0 0 0 0 0
58 19 0 39 32
0 0 0 0 0
11354 5774 0 5580 9816
0 0 0 0 0
9 0 0 9 0
1145 750 0 395 1275
530 360 0 170 612
131 43 0 88 73
1487 648 0 839 1102
164 94 0 70 160
5 5 0 0 9
13 7 0 6 12
17 17 0 0 29
0 0 0 0 0
95 50 0 45 85
0 0 0 0 0
447 330 0 117 561
533 106 0 427 180
166 0 0 166 0
347 30 0 317 51
56 56 0 0 95
575 301 0 274 512
32 17 0 15 29
774 668 0 106 1139
5 1 0 4 2
246 98 0 148 167
0 0 0 0 0
3001 2730 0 271 4641
0 0 0 0 0
2661 2130 0 531 3621
95 20 0 75 34
87 6 0 81 10
142 0 0 142 0
160 10 0 150 17
63 63 0 0 107
0 0 0 0 0
5 0 0 5 0
0 0 0 2 0
3 0 0 3 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
100 64 0 36 109
65 0 0 65 0
380 132 0 248 224
10 0 0 10 0
0 0 0 0 0
975 0 0 975 0
614 319 0 295 542
10000 0 0 10000 0
8841 5246 0 3595 8918
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
10 0 0 10 0
96 30 0 66 51
1856 784 0 1072 1333
3013 861 0 2152 1464
14 9 0 5 15
0 0 0 0 0
20 20 0 0 23
4 0 0 4 0
5515 1979 0 3536 3364
158 28 0 130 48
239 64 0 175 109
34 10 0 24 17
4575 2154 0 2421 3662
0 0 0 0 0
1080 900 0 180 1530
0 0 0 0 0
0 0 0 0 0
151 15 0 136 26
791 298 0 493 507
78 38 0 40 65
311 156 0 155 265
5 0 0 5 0
0 0 0 0 0
0 0 0 0 0
123 2 0 121 3
22816 438 0 22378 745
16 0 0 16 0
26 0 0 26 0
285 285 0 0 485
1076 284 0 792 483
3 0 0 3 0
0 0 0 0 0
10 0 0 10 0
300 0 0 300 0
84 0 0 84 0
3846 3591 0 255 4599
120 100 0 20 170
1720 1400 0 320 2380
4 0 0 4 0
7067 3374 0 3693 5736
359 70 0 289 119
41 41 0 0 70
0 0 0 0 0
60 0 0 60 0
3 0 0 3 0
0 0 0 0 0
0 0 0 0 0
175 155 0 20 264
300 0 0 300 0
0 0 0 0 0
0 0 0 0 0
3 0 0 3 0
0 0 0 0 0
0 0 0 0 0
3 0 0 3 0
20 5 0 15 9
200 0 0 200 0
200 6 0 194 10
JKN
1825
Yang Meminta
Pimpinan Puskesmas
( NS. Edi Syahputra, S. Kep)

NIP. 19731021 199503 1 001
Permintaan Pemberian Keterangan
11 12 13
0
0
0
50 ED
0
186
0
0
0
1898
0
0
2550
0
0
1290
41
0
12090
121
0
0
0
0
0
237
1687
79
64
27
0
0
12
0
2071
4292
0
5
0
0
0
1000 ED
66098
12
84
109
0
0
0
0
1320
0
91
0
0
0
0
0
100 ED
6781
0
0
0
0
0
0
0
0
0
0
0
0
0
59
0
14
0
0
0
0
147
0
171
0
0
95
0
37
0
471
0
0
0
193
226
1230
1169
0
0
71
71
275
0
2580
0
0
0
0
0
0
1375
0
12
0
153
168
20
0
0
0
0
0
0
0
0
4236
0
0
880
442
0
263
90
9
6
29
0
40
0
444
0
0
0
95
238
14
1033
0
19
0
4370
0
3090
0
0
0
0
107
0
0
0
0
0
0
0
0
0
73
0 ED
0
0
0
0
247
0
5323
0
0
0
0
0
0
261
0
10
0
23
0
0
0
0
0
1241
0
1350
0
0
0
14
25
110
0
0
0
0
0
0
0
485
0
0
0
0
0
0
4344
150
2060
0
2043
0
70
0
0
0
0
0
244
0
0
0
0
0
0
0
0
0
0
Yang Menerima
Petugas Puskesmas
( Yunita, Amd. Far)

NIP. 19770531 201003 2 001

LPLPO2016

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LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

2 Abbocat No. 20 Set 68 68 30 0 38 51 13

3 Abbocat No. 22 Set 30 30 0 0 30 0 0

4 Abbocat No. 24 Set 0 0 0 0 0 0 0

5 Alat Suntik sekali pakai 1 ml Set 110 110 75 0 35 128 93

6 Alat Suntik sekali pakai 2,5 ml Set 28 200 228 10 0 218 17 0

7 Alat Suntik sekali pakai 3 ml Set 330 330 80 0 250 136 0

11 Alprazolam 0,5 ml Tab 0 0 0 0 0 0 0

12 Ambroxol syrup 15 mg/ml - 60 ml Btl 0 0 0 0 0 0 0

13 Ambroxol tablet 30 ml Tab 0 200 200 200 0 0 340 340

14 Aminofilin Injeksi 24 mg/ml - 10 ml Amp 0 0 0 0 0 0 0

15 Aminofilin tablet 200 mg Tab 200 200 0 0 200 0 0

21 Ampisilin kaplet 250 mg Kap 0 0 0 0 0 0 0

22 Ampisilin kaplet 500 Kap 0 0 0 0 0 0 0

23 Ampisilin sirup kering 125 mg/5 ml Btl 0 0 0 0 0 0 0

24 Antalgin (metampiron) tablet 500 mg Tab 0 0 0 0 0 0 0

25 Antalgin injeksi 250 mg/ml-2ml Amp 0 0 0 0 0 0 0

28 Anti Bakteri Doen Salep (Bacitracin) Tube 21 21 21 0 0 36 36

29 Anti Hemoroid DOEN Sup 21 50 71 30 0 41 51 10

30 Antifungi DOEN Pot 12 24 36 36 0 0 61 61

31 Antimigren Tab 100 100 0 0 100 0 0

32 A.T.S 1500 ui/amp Btl 0 0 0 0 0 0 10

33 Aqua pro injeksi sterikl,bebas pirogen-20ml Vial 8 10 18 2 0 16 3 0

34 Aquades steril Btl 0 0 0 0 0 0 0

35 Asam Askorbat 50 mg Tab 3015 2000 5015 5015 0 0 8526 8526

38 Asiklovir krim 5% - 5 gram Tube 44 44 32 0 12 54 42

39 Asiklovir tablet 200 mg Tab 645 645 243 0 402 413 11

40 Almond sirup (OBP) Btl 0 0 0 0 0 0 0

42 Attapulgite 600 mg/Diaform Tab 0 0 0 0 0 0 0

44 Betadin Oin 5 gr Tube 0 12 12 12 0 0 20 20

45 Betahistin Mesilat tablet 6 mg Tab 8 90 98 18 0 80 31 0

46 Betametason Krim Tube 0 0 0 0 0 0 0

52 Captopril 25 mg Tab 527 527 248 0 279 422 143

53 Catgut Plain With nedle 3/0 Pcs 40 72 112 55 0 57 94 37

54 Catgut Cromic 3/0 Ktk 12 12 0 0 12 0 0

55 Catgut Cromic 4/0 Ktk 29 29 0 0 29 0 0

56 Clobazam tablet 10 mg Tab 160 160 30 0 130 51 0

58 Caviton Pink Btl 4 4 0 0 4 0 0

59 Dexamethason injeksi 5 mg/ml Amp 0 100 100 95 0 5 162 157

61 Devitalisasi Pasta Ktk 0 0 0 0 0 0 0

62 Diazepam injeksi 5 mg/ml - 2 ml Amp 30 30 6 0 24 10 0

63 Diazepam tablet 2 mg Tab 376 376 96 0 280 163 0

64 Difenhidramin HCL inj 10 mg/ml - 1 ml Amp 37 37 0 0 37 0 0

66 Diaform Tab 0 1000 1000 873 0 127 1484 1357

67 Dulcolax Tab 0 0 0 0 0 0 200

68 Efedrin HCL tablet 25 mg Tab 190 190 0 0 190 0 0

69 Ekstrak Belladon tablet 10 mg Tab 0 0 0 0 0 0 0

70 Epinefrina Inj 0,1% - 1 ml Amp 0 0 0 0 0 0 0

71 Erytromycin kaps 500 mg Tab 0 0 0 0 0 0 500

72 Erytromycin Syrup 200 mg/ 5 ml-60 ml Btl 0 0 0 0 0 0 50

73 Etakridin larutan 0,1% - 300 ml Btl 3 3 0 0 3 0 0

74 Etanol 70% - 100 ml Btl 21 60 81 43 0 38 73 35

75 Etanol 70% - 1000 ml Btl 2 2 0 0 2 0 0

76 Etil Klorida Spray - 100 ml Btl 0 0 0 0 0 0 5

78 Fenobarbital tablet 30 mg Tab 740 740 28 0 712 48 0

79 Fenol Gliserol tetes telinga 10% - 5 ml Btl 52 52 0 0 52 0 0

80 Fitomenadion injeksi 10 mg/ml - 1 ml Amp 109 109 55 0 54 94 40

82 Furosemide injeksi Amp 6 6 0 0 6 0 0

83 Furosemide tablet 40 ml Tab 25 200 225 64 0 161 109 0

84 Foley Cateter No. 18 Pcs 5 5 0 0 5 0 0

85 Foley Cateter No. 24 Pcs 0 0 0 0 0 0 0

87 Gentamicin salap kulit 5 gram Tube 0 0 0 0 0 0 0