No Tgl Nama NO CM

BPJS/UMUM

JK Usia (thn)

Alamat Telp Pekerjaan Diagnosa Terapi Foto

1 4/5/15

Ny. Munafiah

691928

BPJS P 41 Wilalung 03/04 Gajah Demak

- IRT Impetigo - Simetidin 2X1- Cetirizin 2X1- Methylpredisolon 16 mg 2X2

2 Tn. Sukiman

709077

Umum L 51 Lindaan Lor Demak

087746205994 Petani Ulkus genital

- Ofloxacin 400mg 1X1- Lameson 16mg 2X1Fuson cr

3 Ny. Seidah

709076

Umum P - Prawoto Sukolilo 1/6 Pati

085727287271 IRT DKA - Ofloxacin 1X1- Lameson 16mg 2X1- Tiriz 2X1- Inerson cream, vectrin

4 An. M. Affan Hilmi

709081

Umum L 1 Prawoto 11/6 Pati

085865050903 - Folikulitis - Calestone 2X1/2- Cefat syr 2X1/2- Gentamisin cr- Lactasid

5 An. Dennis Arya Nugraha

568654

BPJS L 10 Bendan Pete 7/1 Nalomsari Jepara

- Pelajar Ulkus - Fuson cr- MP 16mg 1X1

6 Tn. Ayub Ali

374726

BPJS L 51 Jekulo 1/3 Kudus

- Op. Fotokopi

Tinea korporisPitriasis vulgaris

- Ketokonazol 2X1- Cetirizin 2X1- Mikonazol cr & Asam salisilat 5%