Form Resep
1
dr. Joko Mulyono SIP : 505/607/SIP III/2005 Praktek: Jl. RM Said Surakarta Pagi : Jam 07.00-09.00 WIB Telp. (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. XV S3 dd tab 1 R/ Digoxin No X S1-0-1 Dr. Ira Rahmawati SIP : 505/SIP-Dr/III/2010 Praktek: Jl. Gelatik 8D Surakarta Pagi : Jam 07.00-09.00 WIB Telp. (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 1 S3 dd c 1 R/ Imboost No X S2dd1 Dr. Sugeng SIP : 505/SIP-Dr/V/2009 Praktek: Jl. RM Said Surakarta Pagi : Jam 07.00-09.00 WIB Telp. (0271) 322822 Sore : Jam 16.30-19.00 WIB Surakarta, 20 September’12 R/ Zyloric No. X S3 dd 1 R/ Piroxicam tab No. X S2dd1 R/ Neurobion No. X S2dd1 Dr. Sukardjo SIP : 505/607/SIP III/2007 Praktek: Jl. RM Said Surakarta Pagi : Jam 07.00-09.00 WIB Telp. (0271) 322822 Sore : Jam 16.30-19.00 WIB Surakarta, 20 September’12 R/ Primperan syr fls 1 S1 dd 1 cth Bila muntah R/ Bisolvon tab ½ Prednison tab ½ Pamol tab ½ Mf pulv. dtd No. XII S3dd1
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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
