Professional Documents
Culture Documents
Pemakaian
NO Nama Obat Kemasan Harga Satuan
Perbulan
Total Kebutuhan Jumlah Harga
1 2 3 4 5 6 7
14 Amitriptilin HCL tablet salut 25 mg Dus,10 Strip @ 10 tts 123 20 240 29520
15 Amoksisilin kaplet 500 mg kotak @ 10x10 Tab 279 7000 8400 2343600
16 Amoksisilin sirup kering 125 mg/5 ml Botol @ 60 ml 2.56 400 4800 12288
17 Amoksisilin sirup kering Forte 250 mg/5 m Dus,Botol 60 ml 4.73 100 1200 5676
22 Anti bakteri DOEN salap Basitrasin Dus 25 tube @ 5 g 2.767 50 600 1660.2
25 Antimigren DOEN kombinasi (Ergotamin) Botol 100 tablet 149 20 240 35760
26 Asam askorbat (vit.C) tablet 50 mg Dus 10 Strip x 10 Tab 105 5000 60000 6300000
1 2 3 4 5 6 7
41 Digoksin tablet 0,25 mg. Box 10x10 Tab 103 20 240 24720
44 Eritromisin kapsul 500mg Dus,10 blister @ 10 kss 1.023 2000 24000 24552
54 Fitomenadion (vit.K1) tab. salut gula 10 mBotol @ 100 Tablet Salut gula 698 30 360 251280
1 2 3 4 5 6 7
59 Garam oralit untuk 200 ml air Dus @ 100 Sachet 317 50 600 190200
61 Gentamisin Sulfat tetes mata 0,3% Dus, botol plastik 5 ml 3513 25 300 1053900
70 Griseofulvin tablet 125 mg, Micronized Dus 10 blister @ 10 Tablet 241 500 6000 1446000
78 Ibuprofen tablet 400 mg Strip 100 tablet 157 500 6000 942000
82 Isosorbit Dinitrat tablet Sublingual 5 ml Dus 10 blister @ 10 Tablet 98 100 1200 117600
85 Karbamazepin tablet 200 mg Dus 10 blister @ 10 Tablet 269 100 1200 322800
Pemakaian
NO Nama Obat Kemasan Harga Satuan
Perbulan
Total Kebutuhan Jumlah Harga
1 2 3 4 5 6 7
103 Kotrimaksazol tablet 480 mg dus 10 strip @ 10 tablet 152 1000 1200 182400
106 Lansoprazol 30 mg. kaps. Dus 2 strip @ 10 Capsul 521 500 6000 3126000
107 Lidokain HCL inj. 2% Dus 100 Amp@ 2 ml 929 30 360 334440
113 Metformin 500 mg Dus 10 blister @ 10 Tablet 125 100 1200 150000
1 2 3 4 5 6 7
117 Metronidazol tablet 250 mg 10 Strip@10 tab 116 200 2400 278400
118 Mikonazol krim / salap 2% nitrat tube 10 gram 3075 50 600 1845000
121 Natrium Diklofenac 50 mg kotak 5x10 tablet 216 300 3600 777600
130 Omeprazol 20 mg. kaps. Dus 10 x3,5 221 300 3600 795600
131 Parasetamol sirup 120 mg/5 ml Botol @ 60 ml 1535 200 2400 3684000
134 Pirantel tablet 125 mg dus,25 blister @ 4 tablet 318 50 600 190800
142 Propranolol HCL tablet 40 mg dus 10 strip @ 10 tablet 114 100 1200 136800
143 Ranitidin tab 150 mg Dus, 10 ampul @2 ml 132 2000 24000 3168000
Pemakaian
NO Nama Obat Kemasan Harga Satuan
Perbulan
Total Kebutuhan Jumlah Harga
1 2 3 4 5 6 7
145 Ringer laktat larutan infus steril botol 500 ml 5720 80 960 5491200
149 Sefadroksil kapsul 500 mg. dus,10 strip @ 10 kapsul 548 200 2400 1315200
156 Simvastatin tablet 10 mg. dus, 3 strip @ 10 kaplet salut selaput 177 60 720 127440
157 Siprofloksasin tablet 500 mg dus,10 blister 10 tab ss 290 200 2400 696000
158 Sulfasetamida Natrium tetes mata 15% ktk 24 btl @ 5 ml. 24 288
159 Tablet Tambah Darah besi II sulfat 1000 tablet 1000 12000
161 Tetrasiklin HCL kapsul 250 mg dus, 10 strip @ 10 kapsul 162 1000 12000 1944000
1 2 3 4 5 6 7
Kartini dr.H.T.Yusrizal
Nip.19671228 199703 2 001 Nip.19701030 200112 1 001
LAPORAN PEMAKAIAN DAN LEMBARAN PERMINTAAN OBAT (LPLPO) PUSTU
T A H U N …………
PUSKESMAS PEMBANTU :
KECAMATAN/PUSKESMAS : PELAPORAN PERIODE :
KABUPATEN : PIDIE PERMINTAAN PERIODE :
PROVINSI : ACEH
Presediaan Jumlah
NO Nama Obat Kemasan Awal
Penerimaan
Persediaan
Pemakaian Sisa Stock Permintaan Pemberian KET
1 2 3 4 5 6 7 8 9 10 11
1 Aminofilin tablet 200 mg ktk 10x10 tablet
35 Kotrimaksazol suspensi 60 ml
1 2 3 4 5 6 7 8 9 10 11
49 Pirantel tablet 125 mg 60 tablet
58 Salisil bedak 2% 50 gr
1 2 3 4 5 6 7
14 Amitriptilin HCL tablet salut 25 mg Dus,10 Strip @ 10 tts 123 20 120 14760
15 Amoksisilin kaplet 500 mg kotak @ 10x10 Tab 279 7000 42000 11718000
16 Amoksisilin sirup kering 125 mg/5 ml Botol @ 60 ml 2.56 400 2400 6144
17 Amoksisilin sirup kering Forte 250 mg/5 m Dus,Botol 60 ml 4.73 bn 600 2838
22 Anti bakteri DOEN salap Basitrasin Dus 25 tube @ 5 g 2.767 50 300 830.1
25 Antimigren DOEN kombinasi (Ergotamin) Botol 100 tablet 149 20 120 17880
26 Asam askorbat (vit.C) tablet 50 mg Dus 10 Strip x 10 Tab 105 5000 30000 3150000
41 Digoksin tablet 0,25 mg. Box 10x10 Tab 103 20 120 12360
44 Eritromisin kapsul 500mg Dus,10 blister @ 10 kss 1.023 2000 12000 12276
54 Fitomenadion (vit.K1) tab. salut gula 10 mBotol @ 100 Tablet Salut gula 698 30 180 125640
59 Garam oralit untuk 200 ml air Dus @ 100 Sachet 317 50 300 95100
61 Gentamisin Sulfat tetes mata 0,3% Dus, botol plastik 5 ml 3513 25 150 526950
70 Griseofulvin tablet 125 mg, Micronized Dus 10 blister @ 10 Tablet 241 500 3000 723000
73 Handscoon 50 pcs/ktk 10 60
78 Ibuprofen tablet 400 mg Strip 100 tablet 157 500 3000 471000
82 Isosorbit Dinitrat tablet Sublingual 5 ml Dus 10 blister @ 10 Tablet 98 100 600 58800
85 Karbamazepin tablet 200 mg Dus 10 blister @ 10 Tablet 269 100 600 161400
106 Lansoprazol 30 mg. kaps. Dus 2 strip @ 10 Capsul 521 500 3000 1563000
107 Lidokain HCL inj. 2% Dus 100 Amp@ 2 ml 929 30 180 167220
113 Metformin 500 mg Dus 10 blister @ 10 Tablet 125 100 600 75000
117 Metronidazol tablet 250 mg 10 Strip@10 tab 116 200 1200 139200
118 Mikonazol krim / salap 2% nitrat tube 10 gram 3075 50 300 922500
121 Natrium Diklofenac 50 mg kotak 5x10 tablet 216 300 1800 388800
130 Omeprazol 20 mg. kaps. Dus 10 x3,5 221 300 1800 397800
131 Parasetamol sirup 120 mg/5 ml Botol @ 60 ml 1535 200 1200 1842000
134 Pirantel tablet 125 mg dus,25 blister @ 4 tablet 318 50 300 95400
142 Propranolol HCL tablet 40 mg dus 10 strip @ 10 tablet 114 100 600 68400
143 Ranitidin tab 150 mg Dus, 10 ampul @2 ml 132 2000 12000 1584000
145 Ringer laktat larutan infus steril botol 500 ml 5720 80 480 2745600
149 Sefadroksil kapsul 500 mg. dus,10 strip @ 10 kapsul 548 200 1200 657600
156 Simvastatin tablet 10 mg. dus, 3 strip @ 10 kaplet salut selaput 177 60 360 63720
157 Siprofloksasin tablet 500 mg dus,10 blister 10 tab ss 290 200 1200 348000
158 Sulfasetamida Natrium tetes mata 15% ktk 24 btl @ 5 ml. 24 144
159 Tablet Tambah Darah besi II sulfat 1000 tablet 1000 6000
161 Tetrasiklin HCL kapsul 250 mg dus, 10 strip @ 10 kapsul 162 1000 6000 972000
Kartini dr.H.T.Yusrizal
Nip.19671228 199703 2 001 Nip.19701030 200112 1 001
294000
424800
15000
270000
10320
14760
11718000
6144
2838
1404000
1380
830.1
17100
17880
3150000
2286000
701.1
414000
582000
31284
2040000
417.6
12360
1044000
12276
1456.2
47250
109998
26280
125640
10080
95100
526950
54900
514800
723000
148800
228000
126000
1238976
726000
471000
2309400
58800
161400
236970
192000
912000
1563000
167220
471240
75000
139200
922500
388800
19800
397800
1842000
5280000
95400
70320
68400
1584000
40200
2745600
66000
546000
243000
657600
63720
348000
972000
51581691
Rencana Kebutuhan Obat
Puskesmas Muara Tiga
1 2 3 4 5 6 7
5 Gentamisin Sulfat tetes mata 0,3% Dus, botol plastik 5 ml 3513 25 150 526950
7 Kotrimaksazol tablet 480 mg dus 10 strip @ 10 tablet 152 1500 9000 1368000
8 Lansoprazol 30 mg. kaps. Dus 2 strip @ 10 Capsul 521 500 3000 1563000
12 Simvastatin tablet 10 mg. dus, 3 strip @ 10 kaplet salut selaput 177 200 1200 348000
Kartini dr.H.T.Yusrizal
Nip.19671228 199703 2 001 Nip.19701030 200112 1 001
15000
1380
148800
471240
PUSKESMAS MUARA TIGA
Harga
Satuan/ Pemakaian Total
NO Nama Obat Kemasan Jumlah Harga
Harga Perbulan Kebutuhan
Pasaran
1 2 3 4 5 6 7
Kartini dr.H.T.Yusrizal
Nip.19671228 199703 2 001 Nip.19701030 200112 1 001