LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT DAK

( LPLPO ) DAK

UPT PKM : SIMPANG ULIM FEBRUARI

KECAMATAN : SIMPANG ULIM 2019
KABUPATEN : ACEH TIMUR
PROPINSI : PEMERINTAH ACEH

NO NAMA OBAT SATUAN STOK

KET
AKHIR
1 2 3 8 10
1 Acyclovir tab 200 mg Tablet 719
2 Acyclovir tab 400 mg Tablet 781
3 Acyclovir cream 5 % Tube 155
4 Albendazol 400 mg Tablet 3900
5 Alkohol 70 % 1 liter Botol 0
6 Allopurinol 100 mg Tablet 0
7 Ambroxol tab 30 mg Tablet 90
8 Ambroxol Syrup 60 ml Botol 171
9 Amlodipin 5 mg Tablet 0
10 Amoksisillina sirker 125 mg / 5 ml Botol 0
11 Antasida Doen Tab Tablet 793
12 Aqua Pro Inj 25 ml Steril Botol 103
13 Asam Ascorbat ( Vit.C ) 50 mg Tablet 10662
14 Asam Mefenamat 500 mg Tablet 0
15 Attapulgite tab 600 mg Tablet 171
16 Atropin Sulfat 0.5 mg Tablet 300
17 Besi II Sulfat Tablet 0
18 Betametason Krim Tube 0
19 Bromhexin HCL Syrup 60 ml Botol 165
20 Bromhexin HCL Tablet 8 mg Tablet 1801
21 Captopril 12.5 mg Tablet 0
22 Captopril 25 mg Tablet 0
23 Captopril 50 mg Tablet 0
24 Carbamazepin 200 mg Tablet 283
25 Deksametason 0,5 mg Tablet 5177
Dextromethorphan HBr 7.5 mg,
26 Dexchlorpheniramine Maleat 1 mg, Botol 145
Phenylphrine syrup 60 ml
27 Diltiazem HCL 30mg Tablet 1219
28 Dipenhidramin Inj Ampul 0
29 Doksisiklin 100 mg Tablet 0
30 Domperidom Tablet 0
31 Ergotamin tartrat 50 mg Tablet 0
32 Erytromicin Syr Botol 35
33 Etakridine kom Botol 6
34 Fituno Tablet Tablet 958
35 Furrosemida tab Tablet 634
36 Gentamicin Tetes Mata 0,3% Botol 68
37 Gentamicin Salep Kulit Tube 24
38 Glukosa Lar. Inf 5 % Botol 723
39 Griseofulvin tab 125 mg Tablet 1656
40 Halloperidol 1.5 mg Tablet 1830
41 Halloperidol 5 mg Tablet 0
42 Hidroklorotiazid ( HCT ) 25 mg Tablet 0
43 Hidrokortison Krim Tube 0
44 Ibuprofen 200 mg Tablet 0
45 Illiadin Drops 0.025 % Botol 0
46 Kalium Diclofenac 25 mg Tablet 1250
47 Kalium Permanganat 5 gr Pot 0
48 Kals Laktat tab.500 mg Tablet 0
49 Ketokonazol tablet 200 mg Tablet 845
50 Ketokonazol cream Tube 0
51 Kloramfenikol tetes telinga 10 ml Botol 25
52 Kloramfenicol + Hydrocortison Asetat SK 10 g Tube 205
53 Kloramfenikol salep mata Tube 0
54 Kloramfenikol 250 mg Tablet 401
55 Klorfeniramine Maleat 4 mg Tablet 14133
56 Kodein HCL 10 mg Tablet 0
57 Kotrimoksazol syrup Botol 245
58 Kotrimoksazol 480mg Tab Tablet 360
59 Lansoprazole 30 mg Kapsul 132
60 Larutan PK Botol 24
61 Levertrans Salp 10 gr Tube 0
62 Levofloxacin 500 mg Tablet 411
63 Loperamid 2 mg Tablet 0
64 Magnesium Sulfat Inj 20% Ampul 4
65 Magnesium Sulfat Inj 40% Ampul 12
66 Medroksi Progeston Asetat Vial 0
67 Meloxicam 15 mg Tablet 1012
68 Metformin 500 mg Tablet 0
69 Metilprednisolon 4 mg Tablet 0
70 Metoclopramide 10 mg Tablet 444
71 Metronidazole Syr Botol 229
72 Mikonazole Cream Tube 0
73 Multi Vitamin tablet Kapsul 0
74 Multi Vitamin Syr Botol 257
75 Natrium Bikarbonat Tablet 400
76 NaCl 0,9 % 500 ml Botol 0
77 Nifedipin 10 mg Tablet 0
 78 Obat Kategori II Paket 0
79 Obat Kategori Anak Paket 0
80 Obat Kategori Sisipan Paket 0
81 Omeprazole 20 mg Kapsul 0
82 Oksitetrasiklin Salep Kulit 3 % Tube 0
83 Parasetamol Syrup 120 mg / 5 ml Botol 31
84 Parasetamol Tablet 500 mg Tablet 8348
85 Pehacain Inj Ampul 238
86 Pelancar Asi Tablet 244
87 Pirantel tab 125 mg Tablet 377
88 Piridoksin (Vit B.6) 10 mg Tablet 0
89 Prednison 5 mg Tablet 1054
90 Propanolol 10 mg Tablet 100
91 Propiltiourasil 100 mg Tablet 0
92 Ranitidin Inj Ampul 0
93 Ringer Laktat 500 ml Botol 432
94 Salbutamol 4 mg Tablet 0
95 Salisil Bedak 2 % kotak 0
96 Sefotaxim 500 mg Inj vial 0
97 Serum Anti Tetanus (A.T.S) inj 1500 IU/ml Ampul 15
98 Serum Anti Bisa Ular A.B.U I inj (i.m/i.v) vial 6
99 Setirizine 10 mg Tablet 0
100 Sianocobalamin Inj 500 mcg/ml Ampul 95
101 Simvastatin 20 mg Tablet 502
102 Siprofloksasin 500 mg Tablet 328
103 Tetrasiklin 250 mg Kapsul 500
104 Thiamfenicol 500 mg Kapsul 0
105 Tiamin HCL ( Vit B1 ) 50 mg Tablet 0
106 Triheksifenidil 2 mg Tablet 284
107 Ventolin Nebule pcs 73
108 Vitamin B Complek Tablet 0
109 Yodium Povidon 30 ml Botol 133
110 Zink Syr Botol 31
111 Etil Klorida semprot Botol 0
112 Eugenol Cairan Botol 9
0
BMHP 0
113 Alat Cek Darah Paket 0
114 Alkohol Swab pcs 645
115 Alat Suntik 0,05 cc Unit 200
116 Alat Suntik 0,5 cc Unit 197
117 Alat Suntik 1 cc Unit 100
118 Alat Suntik 2,5 cc Unit 0
119 Alat Suntik 3 cc Unit 0
120 Alat Suntik 5 cc Unit 156
121 Alat Suntik 10 cc Unit 91
122 Benecheck Glucose 50s Strip 250
123 Benecheck Total Chol 10s Strip 210
124 Benecheck Urid Acid 25s Strip 175
125 Blood Lancet pcs 300
126 Blood Tranfusion Set Kantong 5
127 Catgut 2/0 Pcs 60
128 Catgut 3/0 Pcs 60
129 Catgut 5/0 Pcs 48
130 Foley Chateter Pediatrik Pcs 0
131 Foley Chateter Adult Pcs 56
132 Hand Scun Set 0
133 Handscun Non Steril Kotak 0
134 Handscun Obgyn Steril pcs 173
135 Hospitech ID Band Adult blue Pcs 400
136 Hospitech ID Band Adult Pink Pcs 380
137 Hospitech ID Band Child Yellow Pcs 199
138 Hydroactive Gel 15 g Pcs 23
139 Infusion set anak Kantong 168
140 Infusion set dewasa Kantong 0
141 Infusion Set Y-Type Pcs 134
142 I.V Cateter 18 G Buah 132
143 I.V Cateter 20 G Buah 100
144 I.V Cateter 22 G Buah 298
145 I.V Cateter 24 G Buah 50
146 I.V Cateter 26 G Buah 50
147 Kapas Rol 12
148 Kasa Pembalut 4m x 10 cm Rol 0
149 Kasa Pembalut 4m x 15 cm Rol 0
150 Kasa Steril 10 x10 cm pack 0
151 Kasa Steril 16 x16 cm Kotak 0
152 Masker Pcs 570
153 Nasal Oxygen Pcs 98
154 Oksigen Masker Pcs 38
155 Paper Tape (plester kertas) Rol 37
156 Pen Lancet Pcs 0
Plester mengandung sodium
157 Lembar 10
carboxymethylcellulosa 4 x 4 Inch
Plester mengandung sodium
158 Lembar 50
carboxymethylcellulosa 2 x 8 Inch
159 Plester 5 yard x 2 inch Rol 20
160 Policlean Handrub 500 ml Botol 0
161 Poliwash 500 ml Botol 0
162 Silk Pcs 12
163 Surgical Blade Steril Pcs 173
164 Spiritus 1000 ml Botol 4
165 Test Uji Kehamilan 25 MU/ml Strip 145
166 Urine Bag Pcs 11
167 USG Gel 250 ml Tube 4
168 Sterilmedical Guedel Airway 01 pcs 0
169 Sterilmedical Guedel Airway 02 pcs 0
170 Sterilmedical Guedel Airway 03 pcs 0
171 Sterilmedical Guedel Airway 04 pcs 0
172 Sterilmedical Guedel Airway 05 pcs 0
173 Salmonella Typhi H Widal Test Vial 0
174 Salmonella Typhi O Widal Test Vial 0
175 Salmonella Paratyphi AO Widal Test Vial 0
176 Salmonella Paratyphi BO Widal Test Vial 0
177 Salmonella Paratyphi CO Widal Test Vial 0
178 Salmonella Paratyphi AH Widal Test Vial 0
179 Salmonella Paratyphi BH Widal Test Vial 0
180 Salmonella Paratyphi CH Widal Test Vial 0
181 Anti-A Monoclonal Golongan Darah Vial 0
182 Anti-B Monoclonal Golongan Darah Vial 0
183 Anti-A,B Monoclonal Golongan Darah Vial 0
184 Anti-D Duoclone Golongan Darah Vial 0
185 Na Citrate 3,13% 1x100mL Botol 0
186 HCl 0,1N 1x100mL Botol 0
187 Hemoglobin C 1x500mL Botol 0
188 HCl 0,1N 1x500mL Botol 0
189 Benedict 1x500mL Botol 0
190 Rees Ecker 1x100mL Botol 0
191 Turk 1x500mL Botol 0
192 EDTA 10% 1x100mL Botol 0
193 KOH 10% 1x500mL Botol 0
194 SM Sedimen 1x100mL Botol 0
195 Hayem 1x500mL Botol 0
196 Barium Chlorida 10% 1x500mL Botol 0
197 Fouchet 1x100mL Botol 0
198 Eosin 2% 1x100mL Botol 0
199 Immersion Oil 1x50mL Botol 0
200 Wright 1x100mL Botol 0
201 Asam Sulfosalisilat 20% 1x100mL Botol 0
202 Pewarna Giemsa 1x100mL Botol 0
203 SM Sedimen 1x500mL Botol 0
204 Pewarna MDT 3x500mL Botol 0
205 HB Sahli Set 2

Mengetahui
Kepala UPTD.Puskesmas Simpang Ulim
 (dr.Dewi Suryati)
Nip.19810116 200911 2 001