Indikator Peresepan Mei 2016

7/26/2019 Indikator Peresepan Mei 2016

1/12

FORMULIR PELAPORAN INDIKATOR PERESEPAN ISPA NO

Puskesmas : Mattiro Deceng

Kabupaten : Pinrang

Provinsi : Sulawesi Selatan

TGL

JUMLA

!" !AMA#T$M "%AT

&A'T#DAK !AMA "%AT

()'(*')(+, + Armi-a Ka.ir / 0 &a Amo1icillin *(( mg

Paracetamol *(( mg

2tm 0 mg

Gg +(( mg

(3'(*')(+, ) 4aki ) * &a Amo1icillin s5

Paracetamol *(( mg

$p6e.rine )* mg

2tm 0 mg

De1amet6a7on (8* mg

(9'(*')(+, 3 #rwans5a6 9 0 &a Amo1icillin *(( mg

Paracetamol *(( mg

Gg +(( mg

2tm 0 mg

('(*')(+, 0 !ur Ain amsa +, * &a Amo1icillin *(( mg

Paracetamol *(( mg

Gg +(( mg

2tm 0 mg

%comples

+('(*')(+, * Mu68 A-ka , bln 0 &a Amo1icillin s5

Paracetamol *(( mg

2tm 0 mg

Gg +(( mg

++'(*')(+, , A6ma. ;awwa7 3 bln 3 Ti.ak Paracetamol *(( mg

Gg +(( mg

2tm 0 mg

+3'(*')(+, 9 !abila + * &aAmo1icillin s5Paracetamol *(( mg

Gg +(( mg

2tm 0 mg

De1amet6a7on (8* mg

+,'(*')(+, / Sukma ) * &a Amo1icillin s5

Paracetamol *(( mg

Gg +(( mg

2tm 0 mg

%comples

+/'(*')(+, #rawat5 ) 0 &a Amo1icillin *(( mg

Gg +(( mg

2tm 0 mg

Paracetamol *(( mg

+'(*')(+, ++ ar.imas ) * &a Amo1icillin s5

Gg +(( mg

2tm 0 mg

Paracetamol *(( mg

A!T#%#"T#K

UMU=


2/12

)+'(*')(+, +3 Mu68 #srian ++ 3 Ti.ak Paracetamol *(( mg

Gg +(( mg

2tm 0 mg

)3'(*')(+, +0 Ani 3, 0 Ti.ak Paracetamol *(( mg

Gg +(( mg

%, *( mg

2tm 0 mg

)0'(*')(+, +* Mage 3 0 &a Amo1icillin *(( mg

#bu-ropen )(( mg

2tm 0 mg

Gg +(( mg

)*'(*')(+, +, >a65u * bln 0 &a Amo1icillin *(( mg

Gg +(( mg

2tm 0 mg

Paracetamol *(( mg

),'(*')(+, +9 ;a.6il , * &a Amo1icillin *(( mg

Gg +(( mg

2tm 0 mg

De1amet6a7on (8* mg

Paracetamol *(( mg

3('(*')(+, +/ Juriana bln 0 &a Amo1icillin *(( mg

Gg +(( mg

2tm 0 mg

Paracetamol *(( mg

Total item obat 93 )9

+/ =erata item oba 08(******,lembar =esep

Persentase A% +*(?

Petungas


3/12

PNEUMONIA

%ulan : M$#

Ta6un : )(+,

D"S#S

LAMA S$SUA#

"%AT

P$D"MA!

@A=# &A'T#DAK

31+') se6ari 3

31+') se6ari 3

31+') se6ari 3

31+') se6ari 3

31+se6ari 3

31se6ari + 3

bungkus

31+') se6ari 3

31+') se6ari 3

31+') se6ari 3

31+') se6ari 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

31se6ari + 3

bungkus

31se6ari + 3

bungkus

31+ se6ari 3

31se6ari + 3

bungkus

31+ se6ari 3

31se6ari + 3

bungkus

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

31se6ari + 3

bungkus

P$MAKA#A!


4/12

31+') se6ari 3

31+') se6ari 3

31+') se6ari 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 331+ se6ari 3

31+ se6ari 3

31se6ari + 3

bungkus

31+') se6ari 3

31+') se6ari 3

31+') se6ari 3

31+') se6ari 331+') se6ari 3

31se6ari + 3

bungkus


5/12

FORMULIR PELAPORAN INDIKATOR PERESEPAN DIARE NON S

%ulan

Kabupaten : Pinrang Ta6un


JUMLA A!T#%#"T#K D"S#S

TGL !" !AMA UMU= #T$M &A'T#DAK !AMA "%AT "%AT

"%AT

)'*')(+, + !urma.ina + 3 &a 2otri suspensi )B+ se6ari

Paracetamol s5 31+ se6ari

4inc )( mg +1+ se6ari

3'*')(+, ) Salemma ,( * &a 2otri 0/( mg )1) se6ari

Antasi.a Doen +(( mg 31+ se6ari

Paracetamol *(( mg 31+ se6ari


"ralit +gls +bgks

9'*')(+, 3 amsia6 3+ 0 &a 2otri 0/( mg )1) se6ari


"ralit +gls +bgks

Metokloprami.a Tab 31+ se6ari

+)'*')(+, 0 !a.ia ) * &a 2otri suspensi )B+ se6ari



"ralit +gls +bgks

+3'(*')(+, * $rik +) 0 &a 2otri 0/( mg )1) se6ari



"ralit +gls +bgks

+0'(*')(+, , Mu68 aris 03 , &a 2otri 0/( mg )1) se6ari


Papaverin Tab 31+ se6ari

%, *( mg 31+ se6ari


"ralit +gls +bgks

+,'(*')(+, * #minnong *+ * &a 2otri 0/( mg )1) se6ari


2tm 0 mg 31+ se6ariGg +(( mg 31+ se6ari

"ralit +gls +bgks

+'(*')(+, , J8 Maruase 03 3 &a 2otri 0/( mg )1) se6ari


"ralit +gls +bgks

)('(*')(+, 9 Ais5a Siluni + 3 2otri suspensi )B+ se6ari


"ralit +gls +bgks

)3'(*')(+, / Jumria ) 0 &a 2otri suspensi )B+ se6ari

Paracetamol *(( mg 31se6ari +

Gg +(( mg bungkus

2tm 0 mg

)*'(*')(+, A6ma. A.itia +) 0 &a 2otri 0/( mg )B+ se6ari



%, *( mg )B+ se6ari

Total item obat 0,



6/12


7/12

ESIFIK

: M$#

: )(+,

LAMA S$SUA#

P$MAKA#A! P$D"MA!

@A=# &A'T#DAK

3

3

+(

3

3

3

3

3

+(

3

3

+(

3

3

3

+(

3

3

3

3

+(

+(

3

33

3

+(

3

+(

+(

3

3

+(

3

3


8/12


9/12

FORMULIR PELAPORAN INDIKATOR PERESEPAN


Kabupaten : Pinrang


JUMLA #!J$KS#

TGL !" !AMA UMU= #T$M "%AT &A'T#DAK !AMA "%AT

'*')(+, + Larabbi 9( 0 Ti.ak Paracetamol *(( mg

Antasi.a Doen +(( mg

=aniti.in +*( mg

%comples

++'*')(+, ) 6a.aria 0, 3 Ti.ak #bu-ropen )(( mg

Pre.nison 0 mg

%comples

+)'*')(+, 3


10/12

MYALGIA

%ulan : M$#

Ta6un : )(+,

D"S#S LAMA S$SUA#

"%AT P$MAKA#A! P$D"MA!

@A=# &A'T#DAK

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

)1+ se6sri 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 331+ se6ari 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

31+ se6ari 3

)1+ se6sri 3

31+ se6ari 3


11/12

LAPORAN INDIKATOR PERESEPAN

DI PUSKESMAS

!ama Puskesmas : Mattiro Deceng %ulan :

Jenis Puskesmas : Perawatan Ta6un :Jumla6 Apoteker : )

Jumla6 AA'D3 ;armasi : ) @S+ ;armasi

Jumla6 Dokter : 3

Kabupaten'Kota : Pinrang


? Penggunaan ? Penggunaan =erate item '

Antibiotik pa.a Antibiotik pa.a #n


12/12

Mei

)(+,

lembar =esep

M5algia =atarata

9 /

3 08((

Indikator Peresepan Mei 2016

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