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REKAPITULASI LAPORAN : PEGGUNAAN RESEP OBAT GE
Ruangan : Gudang obat
Puskesmas : Kampar Kiri
Kabupaten : KamparBulan : september 2015
TANGGAL
R!BAT
"#"# A$K%$
&"#LA'
L%#BAR T!TAL R T!TAL R !BAT ( R !BAT G%N%R)K T!TAL R T!TAL R !BAT ( R !BAT G%N%
R%$%P G%N%R)K T%R'A*AP T!TAL R G%N%R)K T%R'A*AP T!TA
1 2 3 4 5 6 7
2+ 1+ ,0 ,0 100( 11 11 100(2- 21 ,+ ,+ 100( 10 10 100(
agustus 2. 1/ 1. 1. 100( - - 100(
2 20 ,/ ,/ 100( 11 11 100(
,0 ,0 ,+ ,+ 100( 2/ 2/ 100(
,1 ,2 /+ /+ 100( 20 20 100(
1 2, +1 +1 100( 100(
2 22 -, -, 100( 1. 1. 100(
, 2+ +. +. 100( - - 100(
september / 22 +/ +/ 100( 1- 1- 100(
5 ,1 5- 5- 100( 10 10 100(+ 0 0 0 0( 0 0 0(
- 2 +5 +5 100( 10 10 100(
. 2/ ,5 ,5 100( 15 15 100(
2. /, /, 100( 2/ 2/ 100(
10 2. /. /. 100( 10 10 100(
11 22 /, /, 100( . . 100(
12 1/ 1- 1- 100( 1, 1, 100(
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1, 1 , , 0( 0 0 0(
1/ ,2 / / 100( 1/ 1/ 100(
15 2+ / / 100( 10 10 100(
1+ 2- ,. ,. 100( 20 20 100(
1- 2 ,2 ,2 100( 2- 2- 100(1. 2/ /5 /5 100( 100(
1 21 /2 /2 100( 10 10 100(
20 22 2/ 2/ 100( 10 10 100(
21 0 0 0 0( 0 0 0(
22 2+ ,5 ,5 100( 1/ 1/ 100(
2, 2/ 51 51 100( 20 20 100(
2/ 0 0 0 0( 0 0 0(
25 21 2+ 2+ 100( 10 10 100(
T!TAL
#%NG%TA'")Pl K%PALA "PT* P"$K%$#A$ KA#PAR K)R) Penanggunga3ab Pengelola Laporan
Nip 1-50.05 2000/ 2 001 N)P 1+/1011 1.-0, 1 00+
dr4 Pasni3ati *A#AN '"R)
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ESMAS
&"#LA'
&A#K%$#A$ T!TAL R
T!TAL R !BAT ( R !BAT G%N%R)K
G%N%R)K T%R'A*AP T!TAL R
T!TAL R !BAT ( R !BAT G%N%R)K "#"#6A$K%$6 "#"#6A$K%$6 "#"#6A$K%$6
G%N%R)K T%R'A*AP T!TAL R &A#K%$#A$ &A#K%$#A$ &A#K%$#A$
/7-7108 57.7118 1/ : 1, 9 100(810 11 12 13 14
10 100( 51 ,00( 1-21 100( +- ,00( 224,
15 100( /0 ,00( 1,4,
10 100( 55 ,00( 1.4,
20 100( .0 ,00( 2+4+
25 100( 1 ,00( ,04,
. 100( -. ,00( 2+
1 100( 110 ,00( ,+4+
- 100( .2 ,00( 2-4,
10 100( 1 ,00( ,04,
1/ 100( .1 ,00( 2-0 0( 0 0( 0
12 100( .- ,00( 2
1. 100( +. ,00( 224+
10 100( -- ,00( 254+
1+ 100( -/ ,00( 2/4+
10 100( +1 ,00( 204,
10 100( /0 ,00( 1,4,
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0 0( , 0( 0
20 100( ., ,00( 2-4+
1/ 100( -, ,00( 2/4,
15 100( -, ,00( 2/4,
20 100( - ,00( 2+4,11 100( +5 ,00( 214+
+ 100( 5. ,00( 14,
2/ 100( 5. ,00( 14,
0 0( 0 0( 0
20 100( + ,00( 2,
11 100( .2 ,00( 2-4,
0 0( 0 0( 0
2 100( +5 ,00( 214+
L)PATKA)N6 ,0 september 2015P%#B"AT LAP!RAN
N)P 1.1011, 201/0+ 2 00,
$"$)LAAT)46 A#K
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LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO)
K!*% P"$K%$#A$ 1/0+00--101
P"$K%$#A$ Kampar KiriK%;A#ATAN Kampar Kiri
KABK!TA Kampar
PR!ir =ream tube 0 ,00 ,00 200
5 A=i=lo>i 200 mg tab 2150 2500 /+50 /000
+ A=i=lo>i /00 mg tab 1200 2000 ,200 ,000
- Alat suntik 1 ml p=s 0 ,00 ,00 ,00
. Alat suntik 265 ml p=s 0 500 500 /50
Alat suntik , ml p=s 0 200 200 120
10 Alat suntik 5 ml p=s 20 0 0 0
11 Allupurinol 100 mg tab 0 0 0 0
12 Aminopilin 200 mg tab ,,00 500 ,.00 .00
1, Amitr?ptilin '=l 25 mg tab +-0 ,000 ,+-0 2-01/ Amo@i=illin 500 mg tab 11200 10000 21200 1000
15 Amo@i=illin 250 mg tab -00 ,00 1000 .00
1+ Amo@i=illin s?rup btl 1 0 0 0
1- Ampi=illin 500 mg tab 0 +000 +000 +000
1. Ambro@ol ,0 mg tab 000 ,00 ,00 .,00
1 Ambro@ol s?rup tab -0 0 -0 -0
20 Amlodipin 5 mg tab ,0 0 ,0 ,0
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21 Amlodipin 10 mg tab 0 1000 1000 1000
22 Antalgin #etampiron8 500 mg tab -,5 .000 .-,5 5-,5
2, Antasida doen tab 1,.50 50 1,00 1200
2/ Antasida s?rup tab ,00 0 ,00 ,00
25 Anti emoroid *oen tab 0 0 0 02+ Asam as=orbat
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/. ;aptropil 25 mg tab 0 /000 /000 /000
/ *e@amatason ineksi ampl 155 100 255 255
50 *e@ametason 065 mg tab 0 ,000 ,000 2500
51 *e@trometorpan 15 mg tab 0 0 0 0
52 *e@trometorpan s?rup btl 0 0 1000 /005, *e>italisasi pasta non arsen8 tab 0 0 0 0
5/ *iaEepam ineksi ampl 20 0 20 0
55 *ienidramin '=l )nk tab 0 0 0 0
5+ *igoksin 0625 mg tab 0 0 0 0
5- *omperidon $?rup btl -0 100 1-0 1,0
5. *omperidon tablet tab -00 100 .00 .00
5 %pedrin '=l 25 mg tab 2-00 0 2-00 -00
+0 %tanol -0 ( btl 0 2 2 2
+1 %til ;loride $pra? btl 0 12 12 12
N!4NA#A !BAT
$AT"AN $T!K AAL P%N%R)#AAN P%R$%*)AANP%#AKA)AN
$, BLN8
1 2 3 4 5 6 7
+2 %kstra beladon 10 mg tab ,500 ,000 +500 ,500
+, %ugenol tab -. 2 .0 10+/ Furosemid /0 mg tab 1000 1000 2000 2000
+5 Folle? kateter no420 G p=s 0 0 0 0
++ Fenol Gliserol tts telinga 10 ( btl 0 0 0 0
+- Garam oralit sa=et 100 ,00 /00 200
+. Glibenklamid tab ,000 2000 5000 /000
+ Gliaeril Guaia=olat 100 mg tab 2015 ,000 5015 /015
-0 Glukosa btl 0 0 0 0
-1 Gentami=in salap kulit tube 0 0 0 0
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-2 Grisioul>in 125 mg tab 0 2000 2000 1500
-, Glass lonomer =ement p=s 0 0 0 0
-/ 'alloperidol 165 mg tab 0 0 0 0
-5 'idro=lortiaEid ';T 8 25 mg tab 0 2000 2000 1000
-+ 'idro=ortison ;ream 265 ( tube 0 200 200 150-- )buproen 200 mg tab 0 0 0 0
-. )buproen /00 mg tab 0 2000 2000 1500
- )nusion set anak p=s .. 0 .. 10
.0 )nusion set de3asa makro 8 p=s 55 100 155 155
.1 Kalium *ikloenak 50 mg tab 0 0 0 0
.2 Klium Laktat ;aLa=t 8 500 mg tab +00 ,000 00 -000
., Kapas berlemak 500 mg p=s + 10 1+ +
./ Kapas pembalut 250 mg p=s , 20 2, .
.5 Kassa Pembalut 'idroDl /@, p=s 0 20 20 20
.+ Kassa steril 1+@1+ p=s 15 50 +5 55
.- Kassa ,[email protected] p=s 0 2 2 2
.. Ketoproen 100 mg tab 0 0 0 0
. KetokonaEole ,0 mg tab 50 0 50 50
0 LansopraEole ,0 mg tab 0 0 0 0
1 Le>oHo@a=in 500 mg tab 0 0 0 0
2 Lido=ain 2 ( ampl 0 0 0 0
, Lido=ain%pineprin ink ampl ,0 +0 0 0
/ Loratadin 10 mg tab 100 1000 1100 1100
N!4 NA#A !BAT $AT"AN $T!K AAL P%N%R)#AAN P%R$%*)AANP%#AKA)AN
$), BLN8
1 2 3 4 5 6 7 8
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5 #etil Prednisolon / mg tab 0 0 0 0
+ #etil %gometrin #aleat 062 mg ink ampl 0 0 0 0
- #etronidaEol 250 mg tab 500 ,000 ,500 ,000
. #eto=lorpramid tab ,00 2000 2,00 2,00
#etormin 500 mg tab 0 ,000 ,000 2000
100 #elo@i=am -65 mg tab 0 100 100 100
101 #asker *isposible p=s 0 .0 .0 .0
102 #i=onaEole =r tube 0 ,00 ,00 250
10, Natrium Bi=arbonat NaBi=8 500 mg tab 0 0 0 0
10/ Natrium ;lorida Na;l8 inus 06 ( tab 0 0 0 0
105 Natrium *ikloenak 50 mg tab 0 2500 2500 2500
10+ Nistatin 1004000 )"G kap 0 0 0 0
10- Niedipin 10 g tab 0 2500 2500 2,00
10. !mepraEole 20 mg kap 0 150 150 150
10 !@itetra=iklin '=l , ( $alap Kulit tube 0 200 200 150110 !9itetra=iklin '=l 1 ( $alap #ata tube 0 0 0 0
111 !bat Batuk 'itam !B'8 btl 100 100 200 200
112 Piridoksin '=l >it B+8 10 mg tab 1000 2000 ,000 2500
11, Para=etamol 500 mg tab ,-00 10000 1,-00 12-00
11/ Para=etamol s?rup btl 1.- 1+. ,55 ,00
115 Papa>erin /0 mg tab 2000 1000 ,000 2000
11+ Pembalut Gips p=s 0 0 0 0
11- Plaster 5 Iard 2 in=i3arna puti8 p=s 0 10 10 .
11. Prednison 5 mg tab 2000 2000 /000 ,000
11 Propiltiora=il 100 mg tab 0 0 0 0120 Pira=etam .00 mg tab 2000 1000 ,000 200
121 Piro@i=am 10 mg kap 550 0 550 550
122 Piro@i=am 20 mg kap +00 0 +00 550
12, Ranitdin 150 mg tab 0 ,000 ,000 ,000
12/ Ranitdin )neksi ampl +0 0 +0 +0
125 Ringer Laktat RL8 Hs 120 0 120 +0
12+ $i>astatin 10 mg tab 0 120 120 120
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12- $albutamol 2 mg tab ,000 2000 5000 5000
N!4 NA#A !BAT $AT"AN $T!K AAL P%N%R)#AAN P%R$%*)AANP%#AKA)AN
$)$, BLN8
1 2 3 4 5 6 7
12. $abutamol / mg tab 0 0 0 0
12 $ali=il Bedak 2 ( sa=et 0 +0 +0 20
1,0 $erum Anti Bisa "lar in AB"8 ampl 0 1 1 0
1,1 $erum Anti Tetanus inks4204000 )"
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151 Nutri>ita $?rup btl 0 0 0 0
152 No>akal tab 0 5000 5000 /000
15, !megtamin tab 0 ,000 ,000 ,000
15/ Papro@in tab 0 0 0 0
155 Pan>iton kps 0 0 0 0
15+ Probion kps 0 0 0 0
15- Piridol *rops 25 ml btl 0 0 0 0
15. Rema=ort tab 0 0 0 0
15 Re=o tts Telinga btl 0 0 0 0
1+0 $upra Li>ron tab 0 0 0 0
1+1 Tag?d tab 0 0 0 0
N!4 NA#A !BAT $AT"AN $T!K AAL P%N%R)#AAN P%R$%*)AANP%#AKA)AN
$), BLN8
1 2 3 4 5 6 7 8
1+2 Tuseli $?rup btl 0 0 0 0
1+, >itka )nant p=s 0 0 0 0
1+/
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Mengetahui /Menyetujui Yang Menyerahkan Me
Plt Kepala Dinas Kesehatan Kepala Instasi Farmasi Plh UPTD pus
dr.MUHAMMAD HAI! HAU".!KM dr.PA
"IP.$%&'(')$ $%%*(+ $ ((+ "IP.$%',(*"IP.$%'-$((, )((+$) $ ($'
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B"LAN : &"N)
TA'"N : 2015
P%R#)NTAANP%#B%R)AN
K%TAPB* LA)N
9 10 11 12
,00
,00
,00
,00
/000
/000
500
,00
500
200
10000
2000
50010000
+000
500
5000
5000
500
10000
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5000
5000
10000
500
,00
10000
10000
,0
P%R#)NTAANP%#B%R)AN
K%TAPB* LA)N
9 10 11 12
10000
,00,00
,00
10000
10000
10000
500
5000
100
+000
1000010000
,00
200
15000 %* 0+ 2015
+000
,00
10000
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10000
,00
10000
10000
500
200
0
100
200
,00
-000
,000
20
20
P%R#)NTAANP%#B%R)AN
K%TAPB* LA)N
9 10 11 12
5000
100
5000
15
100
500
10000
10000
200 %* 0- 2015
200
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10000
10
2000
5000
200
2000
10000
20
,00
+000
+000
15
20
20
10010
+000
+000
10000
5000
,00
100
10000
P%R#)NTAANP%#B%R)AN
K%TAPB* LA)N
9 10 11 12
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10000
+000
10000
+000
10000
10000
200
200
+000
200
10000
+000
+000
10000
,00,00
,00
10000
10000
500
5000
10
20
5000
1001000
5000 %* 0+ 2015
10000
15000
,00
500
10000
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10000 %* 0+ 2015
P%R#)NTAANP%#B%R)AN
K%TAPB* LA)N
9 10 11 12
10000
20
1
1
1
20500
5000
10000
,000
5000
10
15000
10
10
20
,0
,0
.000
,00
5000
.000
100
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Yang Melaprkan
mpar kiri Petugas Puskesmas
!U!IA#ATI.Amk
) (($ "IP.$%*$($$+ )($-(& ) ((+
