Form Resep

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Transcript of Form Resep

dr. Joko MulyonoSIP : 505/607/SIP III/2005

Praktek:Jl. RM Said Surakarta Pagi : Jam 07.00-09.00 WIBTelp. (0271) 322822 Sore : Jam 16.30-19.00 WIB

Surakarta, 18 September 2012

R/ captopril 12,5 mg No. X S1-0-1

R/ HCT No. XVS3 dd tab 1

R/ Digoxin No XS1-0-1

Pro : Bp. ArifinUmur : 56 thAlamat : Mojosongo

Dr. Ira RahmawatiSIP : 505/SIP-Dr/III/2010

Praktek:Jl. Gelatik 8D Surakarta Pagi : Jam 07.00-09.00 WIBTelp. (0271) 322329 Sore : Jam 16.30-19.00 WIB

Surakarta, 18 September 2012

R/ Teofilin tab ½ Salbuven tab ½ Alleron tab ½ Aminofilin tab ½ Mf cap dtd No. XV S3dd1

R/ Bisolvon elixir fl 1S3 dd c 1

R/ Imboost No XS2dd1

Pro : Tn. DarnoUmur :Alamat : Tangkisan Sukoharjo

Dr. SugengSIP : 505/SIP-Dr/V/2009

Praktek:Jl. RM Said Surakarta Pagi : Jam 07.00-09.00 WIBTelp. (0271) 322822 Sore : Jam 16.30-19.00 WIB

Surakarta, 20 September’12

R/ Zyloric No. XS3 dd 1

R/ Piroxicam tab No. XS2dd1

R/ Neurobion No. XS2dd1

Pro : Tn. AnggaUmur : Alamat :

Dr. SukardjoSIP : 505/607/SIP III/2007

Praktek:Jl. RM Said Surakarta Pagi : Jam 07.00-09.00 WIBTelp. (0271) 322822 Sore : Jam 16.30-19.00 WIB

Surakarta, 20 September’12

R/ Primperan syr fls 1S1 dd 1 cthBila muntah

R/ Bisolvon tab ½ Prednison tab ½ Pamol tab ½ Mf pulv. dtd No. XII

S3dd1

Pro : An ZilfaUmur : 8 thAlamat : Cemani