vivie apotik

8/18/2019 Vivie Apotik

1/88


2/88

10 T% K ,+.% L 5) Yo, S +#r,o N#y# R#%.(.+.%e 10 2*1 A+# A,-eA,me3 10 )*1 A+#

11 A% N r,8#$#8 P 11 No . 4.%+# P'( 9 )*1 A+# A,Amo* 9 2*1 A+#B /om 9 2*1 A+#

TANGGAL NO NAMAPASIEN JK UMU

RBB ALAMAT

NAMADOKTER

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

2 November

2015

12 Ny M#r(# P 90 Ge$#(.- N#y# Am$o+. .%e 10 1*1 A+# A,

Be(#8.,(.%e 10 )*1 T.+#- A+#A%(#,.+# 10 )*1 A+#B /om 10 2*1 A+#

1) A% A,,y3# P 1>)B$%

10 Je%+r#$S +.rm#%

De,y G& ?P [email protected] 1 )*1 A+#

/(m ?P [email protected] 1 )*1 A+#B /om ?P [email protected] 2 )*1 A+#


3/88

B /om 10 2*1 A+#20 A% H#.+#r L 5 21 M :#8.++.% J#m.$ ++.% P'( ?P [email protected] ! )*1 A+# A,-e

/(m ?P [email protected] 2 )*1 A+#G& ?P [email protected] 2 )*1 A+#Amo* Syr 1 )*1 A+#

21 T% M#r- , L 52 No . N#y# Amo* 10 2*1 A+# AG& 10 )*1 A+#/(m 10 2*1 A+#B /om 10 2*1 A+#

TANGGAL NO NAMAPASIEN JK

UMUR

BB ALAMAT

NAMADOKTER

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

2 November2015

22 A% Ery#%(. P 15 S#mr#( $#%&.

4.%+# A%(#,.+# Syr 1 )*1 A+#

A,me3 10 )*1 A+#B /om 10 2*1 A+#

2) A% A H#%,M#r(e%

L " )2 Mo8 S#$e8 J#m.$ ++.% P'( 10 )*1 A+# A

Amo* 10 )*1 A+#De*# 10 )*1 A+#B /om 10 2*1 A+#

2! T% J#m#$ +.% L )= 95 D& M#$$e J#m.$ ++.% Ome r# o$e 5 )*1 A+# A/(m 10 2*1 A+#Me(ro%.+# o$e 10 2*1 A+#

25 A%K8#.r %%.,#

P 5 1! D& M#$$e J#m.$ ++.% P'( ?P [email protected] ) )*1 A+#

/(m ?P [email protected] 1 )*1 A+#G& ?P [email protected] 1 ; )*1 A+#Amo* Syr 1 2*2

;A+#

29 T% Ab+ M -#r#m#

L 51 G#$#%& N#y# A,me3 10 )*1 A+#

R#%.(.+.%e 10 2*1 A+#Be+#- S#$.,.$T#$-

1 S e A+#

/(m 10 2*1 A+#2 Ny H#,%#(#%& P )= 52 D& M#$$e J#m.$ ++.% A,me3 10 )*1 A+# A


4/88

R#%.(.+.%e 10 )*1 A+#P'( 10 )*1 A+#

2= Ny Re(%o P )1 52 Per m%#, J#m.$ ++.% Amo* 10 )*1 A+# A,-eDe*# 10 )*1 A+#Imbo,( 1 1*1 T.+#- A+#

2" T% S r.#+. L )2 P. .( 4. .( R#%.(.+.%e 10 2*1 A+# A,-M##&me(# P$ , 10 )*1 A+#P'( 10 )*1 A+#/(m 10 1*1 A+#

)0 A% D#m#r L 9 10 K.$o 1 Re -. Amo* Syr 1 )*1

;

A+#

P'( Sr 1 )*1 A+#


R BB ALAMATNAMA

DOKTEROBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

2 November2015

)1 A%.(r.#%#

P ) 11 E$#%& De,y P'( ?P [email protected] 2 )*1 A+# P

/(m ?P [email protected] 1 )*1 A+#G& ?P [email protected] 1 )*1 A+#2 4rS r#(m#%

De,y P'( Syr 1 )* ; A+# P


5/88

)5 By A$v.(# P B$% 5>) K#m %&Ar#b

De,y Amo* Syr 1 )7 ; A+# P

P'( Syr 1 )7 ; A+#


6/88

B$%5 G#$#%& De,y P'( ?P [email protected] 2 )71 A+#

/(m ?P [email protected] 1 )71 A+#

G& ?P [email protected] 1 )71 A+#


7/88

M.'o%# o$eKe(o'o%# o$200 M&

20 1*1 A+#

I%(er8.,(.% 10 2*1 T.+#- A+#50 A% N#+.# P 2 J#$#% B#r De,y P'( ?P [email protected] 2 )*1 A+# P2K

/(m ?P [email protected] 1 )*1 A+#G& ?P [email protected] 1 )*1 A+#Amo* Syr 1 )*1 A+#5 M& 10 )*1 A+#Imbo,( 10 1*1 T.+#- A+#

52 By #.r , L ! B$% 5 A%&&re- De,y P'( ?P [email protected] 1 )71 A+# P2KG& ?P [email protected] ; )71 A+#/(m ?P [email protected] ; )71 A+#= P#%&e,#r Re -. Amo* Syr 1 )*1 A+# P2KP'( ?P [email protected] 2 )*1 A+#/(m ?P [email protected] 2 )*1 A+#


8/88

2015P'( ?P [email protected] 2 )*1 A+#/(m ?P [email protected] 1 )*1 A+#G& ?P [email protected] 1 )*1 A+#"B$%

19 T#+ $#-o ) De,y Amo* Syr 1 )*1 A+# P2K


9/88

2 November2015

9) A% A-b#r L 1>2 ">) Per m%#, De,y Amo* Syr 1 )*1 A+# JPS

P'( ?P [email protected] 2 )*1 A+#/(m ?P [email protected] 1 )*1 A+#


10/88


R BB ALAMATNAMA

DOKTEROBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

2 November2015

2 Ny Am#, P 52 T#+ $#-o ! N#y# Am$o+. .%e 5M&

10 1*1 A+#

P'( 10 )*1 A+#B /om 10 2*1 A+#

) A% Re&.%# P 1>! S#mr#( $#%&. De,y Amo* Syr 1 )71 A+# J


11/88

TANGGAL NO NAMA

PASIEN JK UMU

RBB ALAMAT NAMA

DOKTER

OBAT YANG

DIBERIKAN

JUML

AH

DOS

IS

KETERSEDI

AAN OBAT2 November

2015=2 A% Mo8 G#3

rL ! 1) D# #$#- De,y A'y'$ov.r S$

K $.(1 S e A+#



12/88

N r8#y#(.G& 10 )*1 A+#/(m 10 2*1 A+#Ge%(#m.,.% S$M#(#

1 S e A+#


13/88


14/88


15/88


RBB ALAMAT

NAMADOKTER

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAANOBAT

2 DESEMBER2015

1 A% #(8.r L = 4#8.+H#,y.m

Re -. P'( 5 )* ; A+#


16/88

B1 10 2*1 A+#B12 10 2*1 A+#

! T% I+r., L 99 K#r(.%. N.,m# P'( 10 )*1 A+# AB1 10 )*1 A+#B12 10 )*1 A+#

5 Ny Sr.N.rm# #(.

P !2 Me$#(. Re -. /. ro6o*#'.% 10 2*1 A+# A,-

/e(.r. .% 9 2*1 T.+#- A+#P'( 10 )*1 A+#De*# 10 )*1 A+#


17/88

M#(#11 Ny D.#% P M#,+#$.%

#Lo er#m.+e 10 )*1 A+#

P# #ver.% 10 )*1 A+#B9 10 )*1 A+#A%(#,.+# 10 )*1 #+#

12 NyN r,#--#8

P ) S $(#%H#,#% ++.%

Re -. Amo* 10 )*1 A+#

P'( 10 )*1 A+#G& 10 )*1 A+#/(m 10 )*1 A+#Dom er.+o% ! )*1 A+#

1) A% Mo S#+.r L " B$% >1

S $(#%H#,#% ++.%

J#m.$$ ++.%

/o(r.mo*# o$e Syr 1 2*1 A+#

P'( ?P [email protected] 2 )*1 A+#/(m ?P [email protected] 1 )*1 A+#G& ?P [email protected] 1 )*1 A+#

1! A% R. C.Am#$.#

P 9 #.+ Re -. Amo* Syr 1 )*1 A+#

P'( ?P [email protected] ! )*1 A+#/(m ?P [email protected] ) )*1 A+#G& ?P [email protected] ! )*1 A+#De*# ?P [email protected] ) )*1 A+#

15 Ny S 8#rm. P )" Mer #(. Re -. P'( 10 )*1 A+# BPJ/(m 10 )*1 A+#B /om 10 2*1 A+#

19 A% Mo8Re #

L = Mer #(. Re -. P'( 5 )* ; A+#

Dom er.+o% 5 )* ; A+#.%- 10 1*1 T.+#- A+#

1 A% A%+. M #+8e$

L 9 B(% No . Re -. Amo* Syr 1 )*2 A+#

P'( 5 )* ; A+#G& 5 )* ; A+#

TANGGAL NO NAMA JK UMU B ALAMAT NAMA OBAT YANG JUMLA DOSI KETERSEDI KETER


18/88

PASIEN R B DOKTER DIBERIKAN H S AAN OBAT2 DESEMBER

201510 Ny M#r.y#m P !1 M#$#( #%& Re -. /. ro6o*#'.% 10 2*1 A+# A,-e,

De*# 10 )*1 A+#G& 10 )*1 A+#/(m 10 )*1 A+#Ge%(#m.'.% Te(e,M#(#

1 )*2 T.+#- A+#

11 Ny D.#% P M#,+#$.%#

Lo er#m.+e 10 )*1 A+#

P# #ver.% 10 )*1 A+#B9 10 )*1 A+#A%(#,.+# 10 )*1 #+#

12 NyN r,#--#8

P ) S $(#%H#,#% ++.%

Re -. Amo* 10 )*1 A+#

P'( 10 )*1 A+#G& 10 )*1 A+#/(m 10 )*1 A+#Dom er.+o% ! )*1 A+#

1) A% Mo S#+.r L " B$% >1

S $(#%H#,#% ++.%

J#m.$$ ++.%

/o(r.mo*# o$e Syr 1 2*1 A+#

P'( ?P [email protected] 2 )*1 A+#

/(m ?P [email protected] 1 )*1 A+#G& ?P [email protected] 1 )*1 A+#1! A% R. C.

Am#$.#P 9 #.+ Re -. Amo* Syr 1 )*1 A+#

P'( ?P [email protected] ! )*1 A+#/(m ?P [email protected] ) )*1 A+#G& ?P [email protected] ! )*1 A+#De*# ?P [email protected] ) )*1 A+#

15 Ny S 8#rm. P )" Mer #(. Re -. P'( 10 )*1 A+# BPJ/(m 10 )*1 A+#B /om 10 2*1 A+#

19 A% Mo8Re #

L = Mer #(. Re -. P'( 5 )* ; A+#

Dom er.+o% 5 )* ; A+#.%- 10 1*1 T.+#- A+#1 A% A%+. M # L 9 B(% No . Re -. Amo* Syr 1 )*2 A+#


19/88

+8e$P'( 5 )* ; A+#G& 5 )* ; A+#


RBB ALAMAT

NAMADOKTE

R

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

2 DESEMBER2015

1= Ny H:P#(.m#%&

P 92 G#:#8 M#+# N.,m# G& 10 )*1 A+#

P'( 10 )*1 A+#/(m 10 )*1 A#Amo* 10 )*1 A+#

1" Ny R#m$.#%# P )9 So%# Re -. S.mv#,(#(.% 10 1*1 T.+#- A+# JPSN#+.' 10 2*1 A+#A%(#,.+# 10 )*1 A+#B /om 10 2*1 A+#

20 Ny S.(.N rm#$#

P 2" Yo, S +#r,o Re -. /. ro6o*#'.% 10 2*1 A+# JPS

P'( 10 )*1 A+#


20/88

25 Ny N r8#y#(. P 2= Sy#r.3 M#%,y r

Re -. P'( 10 )*1 A+#

B /om 9 2*1 A+#

B$%

10 S#$#m#e /o(r.mo*# o$e Syr 1 2*1 A+# P2

P'( ?P [email protected] 2 )*1 A+#/(m ?P [email protected] 1 )*1 A+#G& ?P [email protected] 1 ; )*1 A+#

)0 Ny H#b.b# P 5 L#%o%. N.,m# Dom er.+o% 10 )*1 A+# A,-A%(#,.+# 10 )*1 A+#P'( 10 )*1 A+#B /om 10 )*1 A+#

)1 A% N r $Am#%+#

P 1!


21/88


22/88

/(m 5 1*1 A+#N#+.' 10 2*1 A+#B /om 10 2*1 A+#

!2 A% I%-# P = B$% 9 M#m J#m.$$ ++.%

/(m ?P [email protected] 2 )*1 A+#

G& ?P [email protected] 1 )*1 A+#/o(r.mo*# o$e Syr 1 2*1 A+#

!) N% H.-m# P 1 J#$#% B#r E$$y P'( 10 )*1 A+# PAmo* 10 )*1 A+#

!

Yo, S +#r,o J#m.$$ ++.%

/o(r.mo*# o$e Syr 1 2*1 A+#


!5 A%Re,-.# #%

L 1 =>5

L mb# L mb# J#m.$$ ++.%

Amo* Syr 1 2*2 A+#

!9 By #,-.# P ) B$% 5>5

Yo, S +#r,o J#m.$$ ++.%

/o(r.mo*# o$e Syr 1 2* ; A+# P



R BB ALAMATNAMADOKTE

R

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

2 DESEMBER2015

! Ny De$.y#%# P !! Yo, S +#r,o Re -. /. ro6o*#'.% 10 2*1 A+# P2KPBR

P'( 10 )*1 A+#/(m 10 )*1 A+#G& 10 )*1 A+#

!= A% #+$#% L 1>10B$%

11>5

K.$o 2 J#m.$$ ++.%

/o(r.mo*# o$e Syr 1 2*1 ; A+# P



23/88

G& ?P [email protected] 1 ; )*1 A+#!" A% Rev#$.%# P " Ab+ M ., Amo* 5 )* ; A+# P2

P'( 5 2* ; A+#/(m 5 )* ; A+#

50 T% A8m#+ L 59 Per m%#, N.,m# /(m 10 )*1 A+# P2KDe*# 10 )*1 A+#Be(#me(#,o% S$ 1 S e A+#

51 T% Mo8A,%# .r

L 29 M :#8.+.% E$$y Po%'o$.% Syr 1 )*2 A+#

Amo* 10 )*1 A+#


24/88

Dom er.+o% 5 )* ; A+#5 Ny R#b#%.# P !2 L#%o%. Re -. D.# e #m 5 1*1 T.+#- A+# JP

A%(#,.+# 10 )*1 A+#B12 9 2*1 A+#

5= Ny Irm# P O&omo$. Amo* 10 )*1 A+#Nov#,(#% 10 )*1 A+#De*# 10 )*1 A+#

5" A% .(r.A.% %

P 5 B(% Mo. o, Re -. /o(r.mo*# o$e Syr 1 2*1 ; A+# A,-e,

P'( ?P [email protected] ) )*1 A+#/(m ?P [email protected] 2 )*1 A+#


25/88

) DESEMBER2015

1 T% Ir3#% L !5 B(% No . N.,m# P'( 10 )*1 A+#

A%(#,.+# 10 )*1 A+#B /om 10 )*1 A+#

2 By A.% % P = B$% 9>2

N#$ J#m.$$ ++.%

P'( Syr 1 !* ; A+#

/e3r. .% Syr 1 1* ; T.+#- A+#) Ny Ar.#(. P 51 M#$#( #%& N.,m# P'( 10 )*1 A+# A

D.# e #m ! 1*1 T.+#- A+#B /om 10 )*1 A+#

! T% H#er +.% L )= 4or(e$Mo%&.%,.+.

Re -. /. ro6o*#'.% 10 2*1 A+# P

G& 10 )*1 A+#

5

A%&&re- J#m.$$ ++.%

/o(r.mo*#o$e Syr 1 2* ; A+# P

P'( ?P [email protected] 1 )*1 A+#/(m ?P [email protected] 1 )*1 A+#G& ?P [email protected] ; )*1 A+#

9 T% Mo8H#((#

L 5= P#%#,#-#% N.,m# B1 10 2*1 A+#

B12 10 2*1 A+#P'( 10 )*1 A+#

A% A3+#$ L 10 T#+ $#-o ! E$$y De*# 10 )* ; A+#

/(m 10 1*1 A+#


26/88


RBB ALAMAT

NAMADOKTE

R

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

) DESEMBER2015

10 Ny Y %.(# P 2" T#+ $#-o ! Re -. /. ro6o*#'.% 10 2*1 A+# JPS

P'( 10 )*1 A+#De*# 10 )*1 A+#/(m 10 )*1 A+#

G& 10 )*1 A+#11 Ny #.+#r P 59 S P#rm#% N.,m# P'( 10 )*1 A+# A,-ISDN 10 )*1 A+#R#%.(.+.%e 10 2*1 A+#

12 T% Sy#r.3 L 5) M# #r N.,m# N#+.' 10 2*1 A+# P2KS.mv#,(#(.% 10 1*1 T.+#- A+#B /om 10 2*1 A+#

1) Ny A%+. P ) H. Mo8,e% Re -. Be(#8.,(.% 10 )*1 T.+#- A+# A,-e,R#%.(.+.%e 10 2*1 A+#B /om 10 2*1 A+#

1! Ny Am#%& P 50 K.$o 2 N.,m# Po%'o$.% Syr 1 )*1 A+# P2KB /om 10 2*1 A+#A%(#,.+# 10 )*1 A+#

15 Ny A(.-# P 90 B#r N.,m# B9 10 2*1 A+# P2B12 10 2*1 A+#P'( 10 )*1 A+#

19 Ny M# #r P 9) != So%# N.,m# P'( 10 )*1 A+# A,-eB /om 20 )*1 A+#S.mv#,(#(.% 10 1*1 T.+#- A+#

1 T%Sy#m, +.%

L 91 U,m#% B.%o$ N.,m# G& 10 )*1 A+#

/(m 10 )*1 A+#P'( 10 )*1 A+#

1= T% Mo8T# F-

L )= H. Mo8,e% Re -. /# (o r.$ 25 M& 10 2*1 A+# A

N#+.' 10 2*1 A+#B /om 10 2*1 A+#


27/88


RBB ALAMAT

NAMADOKTE

R

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

) DESEMBER2015

1" T%Sy#m, +.%

L 99 N#$ N.,m# Am$o+. .%e 5 M& 10 1*1 A+#

/(m 10 )*1 A+#Be(#me(#,o% S$ 1 S e A+#G& 10 )*1 A+#

20 Ny S.(.Am.%#8

P 20 48.+ H#,y.m Re -. Amo* 10 )*1 A+# J

De*# 10 )*1 A+#P'( 10 )*1 A+#R#%.(.+.%e 10 2*1 A+#

21 A% A$+# P = B#r Amo* Syr 1 )*1 A+#22 Ny A,m# P 52 K#-#( # N.,m# Am$o+. .%e 5 M& 10 1*1 A+# P2KP

R#%.(.+.%e 10 2*1 A+#P'( 10 )*1 A+#

2) A% Syer.$ P 2 10 S (oyo J#m.$$ ++.%

/o(r.mo*# o$e Syr 1 2*1 ; A+# P

P'( ?P [email protected] ) )*1 A+#/(m ?P [email protected] 1 )*1 A+#G& ?P [email protected] 1 ; )*1 A+#

2! T% S.mo% L 95 Lemb# N.,m# Am$o+. .%e 10 M& 10 1*1 A+# P2KN#+.' 10 2*1 A+#B /om 10 2*1 A+#

25 Ny #r.H#r.%.

P 50 M( H#ryo%o N.,m# P'( 10 )*1 A+#

/(m 10 )*1 A+#G& 10 )*1 A+#B /om 10 )*1 A+#

29 Ny Ir# #(. P !5


28/88

P'( ?P [email protected] ) )*1 A+#De*# ?P [email protected] ) )*1 A+#! " K#m %&Ke .(.%&

J#m.$$ ++.%

/o(r.mo*# o$e Syr 1 2*1 A+#


2" A% #$8# P 1>5 " K#r(.%. J#m.$$ ++.%

/o(r.mo*# o$e Syr 1 2*1 A+#

)0 Ny S(e3#%. P 25 Yo, S +#r,o Amo* 10 )*1 A+# P2KAmbro*o$ 10 )*1 T.+#- A+#B /om 10 2*1 A+#

)1 Ny R#m$#% P 2 K#m %&P#:#$#

De,y A%(#,.+# Syr 1 )71 A+#

B9 10 171 A+#)2 Ny Me.yeT e$e

P 5) S (oyo N.,m# P'( 10 )*1 A+# A

/(m 10 )*1 A+#G& 10 )*1 A+#B /om 10 )*1 A+#

)) A% M#r+.# P = Ke+o%+o%& Re -. Dom er.+o% 5 )* ; A+# A,-eP'( 5 )* ; A+#A%(#,.+# Syr 1 )* ; A+#

)! TT%G %# #%

L )" T#+ $#-o ! Amo* 12 )*1 A+# P

A,me3 10 )*1 A+#)5 A% A.,y#8 P 10

B$%"> B#%+e%& J#m.$$ ++

.%/o(r.mo*# o$e Syr 1 2*1 A+#

T8rombo ob S$ 1 S e T.+#- A+#)9 Ny M ,%# P 59 R m#8 100 N.,m# P'( 10 )*1 A+# P2KP

A%(# +# 10 )*1 A+#


29/88

A%(#,.+# 10 )*1 A+#B /om 10 )*1 A+#

) T% Be$ % L !! M( H#ryo%o Re -. /e(r. .% 10 2*1 T.+#- A+# A,-B /om 9 2*1 A+#

)= T% R#m$.Ab+ $$#8

L 51 Ab+ M ., N.,m# P'( 110 )*1 A+# P

A%(#,.+# 10 )*1 A+#/(m 10 )*1 A+#

)" Ny Sr. P !5 S#mr#( $#%&. Amo* 10 )*1 A+# P2A,me3 10 )*1 A+#Pre+%.,o% 10 )*1 A+#


R BB ALAMATNAMADOKT

ER

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

) DESEMBER2015

!0 Ny B %I%(#%

P )5 A8m#+ Y#%. Re -. P'( 10 )*1 A+# P

!1 NyM (m#.%#8

P 22 K#b.% #%&/.(y

A& , Le6o6o*#(.% 10 2*1 A+#

G& 10 2*1 A+#P'( 10 )*1 A+#

!2 A% J#,o% L ! M H#(# Amo* Syr 1 )*1 #+# PA$bo(8y$ 1 1*1 T.+#- A+#

!) A% A$.y# Y +.$#

P 5 K#r(.%. Re -. P'( Syr 1 )*1 ; A+# A

!! A% R#-# P ) 1! D#e%&B#$#mb#%&

J#m.$$ ++.%

P'( Syr 1 )*1 ; A+#

/o(r.mo*# o$e Syr 1 2*1 ; A+#!5 A% D#3# L ) 1)>

5RK 5 J#m.$$ +

+.%/o(r.mo*# o$e Syr 1 2*1 ; A+# P


!9 A%

B$%

">=


30/88

/o(r.mo*# o$e Syr 1 1* ; A+#! A% 8ev#%y# P ! 1=


31/88

B9 10 271 A+#B12 10 271 A+#

5! Ny H#rm. P 29 So%# Re -. Be(#8.,(.% 10 )*1 T.+#- A+# P2KPBOme r# o$e 10 2*1 T.+#- A+#N#+.' 10 2*1 A+#B /om 10 2*1 A+#

55 A% M#83 + L 2 N#$ J#m.$$ ++.%

/o(r.mo*# o$e Syr 1 2*1 ; A+# P


59 A% S(eF P ! 15 T#%#8 Ab#%& J#m.$$ ++.%

/o(r.mo*# o$e Syr 1 271 ; A+#

P'( ?P [email protected] ! )71 A+#/(m ?P [email protected] ) )71 A+#G& ?P [email protected] 2 )71 A+#


32/88

M#$#mb#%& .%B#'.(r#'.% S$ 1 S e A+#/e(.r. .% Syr 1 2* ; T.+#- A+#

91 A% M #+e$ L 5 19 N#$ Re -. /o(r.mo*# o$e Syr 1 2*2 A+# P2KPG& ?P [email protected] ) )*1 A+#/(m ?P [email protected] ) )*1 A+#


33/88

)A%(#,.+# 10 )*1 A+#

2 T% O,-#r L =! D. P#%:#.(#% N.,m# /# (o r.$ 10 2*1 A+# P2KBe(#me(#,o% S$ 1 S e A+#A%(#,.+# 10 )*1 A+#

) Ny S.(.H#,%# .y#8

P 51 R m#8So,.#$

A& , A,me3 10 )71 A+#

Amo* 10 271 A+#


34/88


RBB ALAMAT

NAMADOKTE

R

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

! DESEMBER2015

11 Ny Ir# #(. P )2 K#m %&P#:#$#

De,y A%(#,.+# Syr 1 )*1 A+#

B9 10 1*1 A+#12 A% A$$y L 9 S $(#%

H#,#% ++.%Re -. P'( 5 )* ; A+#

/(m ?P [email protected] ) )*1 A+#G& ?P [email protected] ! )*1 A+#

S#$b (#mo$ ?P [email protected] ! )*1 A+#De*# ?P [email protected] ) )*1 A+#1) A% H.-m# P 11 U: %&

P#%+#%&E$$y P'( 12 )*1 A+#

Amo* 10 )* ; A+#Po%'o$.% Syr 1 )*1 A+#A%(#,.+# Syr 1 )*1 A+#

1! T%Sy#m, +.%

L 2 Beo N.,m# Am$o+. .%e 10 1*1 A+#

G& 10 )*1 A+#/(m 10 )*1 A+#

15 T% H#ryo%o L !2 4##%. Re -. Lo er#m.+e 10 )*1 A+# JPA%(#,.+# 10 )*1 A+#

19 T% T#$.S#m#( L 1 N.,m# Ge%(#m.'.% S$M#(# 1 S e A+#P'( 10 )*1 A+#Amo* 10 )*1 A+#De*# 10 )*1 A+#

1 Ny S#$m# P ! Ab+ M ., N.,m# N#+.' 10 271 A+# P2KB1 10 271 A+#B12 10 271 A+#

1= Ny H:S#me$$#%&

P 5= 5) H. H#y % Re -. P.ro*.#m 5 1*1 A+# P

R#%.(.+.%e 9 2*1 A+#B /om 9 2*1 A+#S.mv#,(#(.% 10 1*1 T.+#- A+#

1" A% R.+8o L 10 S r# (o E$$y P'( 10 )7 ; A+# P2KAmo* 9 )7 ; A+#G& 9 )7 ; A+#


35/88


RBB ALAMAT

NAMADOKTE

R

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

! DESEMBER

2015

20 T% R.,m#% L )2 No . Re -. N#+.' 10 2*1 A+# A

B /om 10 2*1 A+#21 Ny S $#,(r. P != No . N.,m# P'( 10 )*1 A+# A,-

/(m 10 )*1 A+#G& 10 )*1 A+#Amo* 10 )*1 A+#

22 A% Sy#8+#% L 1>11 10 S#mr#( $#%&. J#m.$$ ++.%


/(m ?P [email protected] 1 )*1 A+#G& ?P [email protected] 1 )*1 A+#/o(r. Syr 1 2*1 ; A+#

2) A% .-8# P 2>5B$%

10 B(% Mo. o, J#m.$$ ++.%


/(m ?P [email protected] 1 )*1 A+#G& ?P [email protected] 1 )*1 A+#/o(r. Syr 1 2*1 ; A+#

2! Ny M#r #(. P !) So%# Amo* 10 )*1 A+# P225 A% Mo8

S#8r $L 11 L#(.mo:o%& E$$y P'( 12 )*1 A+#

Amo* 11 )* ; A+#De*# 5 )* ; A+#G& 12 )*1 A+#Tro'e, 12 )*1 T.+#- A+#

29 T% A$. S#%&o L 9" Ter- - r N.,m# Amo* 10 2*1 A+# AB /om 10 )*1 A+#

2 By I #% L 1=H#r.

!>)

/e%&-e8 J#m.$$ ++.%


De*# ?P [email protected] 1 )*1 A+#B /om ?P [email protected] 2 )*1 A+#

2= T% P#% e L ! M# #r Amo* 10 )*1 A+# P


36/88

P'( 10 )*1 A+#2" Ny

D#rm# #(.P !) S.+o#r:o Re -. A,me3 10 )*1 A+#

Am$o+. .%e 10 1*1 A+#/(m 10 1*1 A+#B /om 9 2*1 A+#



R

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

! DESEMBER2015

)0 A% A #$ L !>5 10 S#$#m#e J#m.$$ ++.%

/o(r. Syr 1 2*1 ; A+#


)1 Ny Sr.N ry#(.

P )5 T e$ey N.,m# Er.(rom.'.% 10 )*1 T.+#- A+# A,-e

P'( 10 )*1 A+#


37/88

Amo* 9 )* ; A+#


38/88

5 .%/(m ?P [email protected] 1 )*1 A+#G& ?P [email protected] ; )*1 A+#

!5 T% M#r(8e% L 5 S (oyo S r.y#%. Amo* 10 )*1 A+# AG& 10 )*1 A+#/(m 10 )*1 A+#/# (o r.$ 12>5 M& 20 )*1 A+#P'( 10 )*1 A+#

!9 T% I# D +e L 9) N.,m# P'( 10 )*1 A+# P2Amo* 10 )*1 A+#

A%(#,.+# 10 )*1 A+#! Ny S 8#rm. P )" Mer #(. Amo* 10 )*1 A+# P2KA,me3 10 )*1 A+#

KETERANGAN

ASKES JPS

BPJS P2KPBR



R

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

5 DESEMBER2015

1 Ny H#,%# P 92 A%&&re- N.,m# B /om 10 )*1 A+# P2K

P'( 10 )*1 A+#G& 10 )*1 A+#

2 T% M#-#,# L 9! Yo, S +#r,o N.,m# N#+.' 10 271 A+# A,-e,P'( 10 )71 A+#B12 10 271 A+#

) A% # .#8 P ) B(% No . A& , P'( 9 )* ; A+# AAmo* 9 )* ; A+#


39/88

9 A% P r%# #% L 11 K#m %&Ar#b

E$$y P ( 10 ) 1 A+#

Amo* 9 )* ; A+#A%(#,.+# Syr 1 )*1 A+#5B$%

1)>5

Yo, S +#r,o J#m.$$ ++.%

P'( ?P [email protected] ) )*1 A+#

/(m ?P [email protected] 1 )*1 A+#Imbo,( Syr 1 2*1 T.+#- A+#

= Ny N r,e8# P 55 G % %&

/e%&-e8

N.,m# R#%.(.+.%e 10 2*1 A+#

P'( 10 )*1 A+#B9 10 )*1 A+#

" Ny M#,.(# P 29 S +.rm#% Amo* 10 )*1 A+# JAMA,me3 10 )*1 A+#

10 Ny R.%# P )1 De,y B /om 10 1*1 A+#A%(#,.+# Syr 1 )*1 A+#

11 N% N r#. # P 25 A& , /(m 10 2*1 A+#Be(#me(#,o% S$ 1 S e A+#


RBB ALAMAT

NAMADOKTE

R

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

5 DESEMBER2015

12 A% Sr.4#8y %.

P 1) K#r(.%. Amo* 5 )* ; A+#

P'( 10 )*1 A+#De*# 5 )* ; A+#

1) T% Ab+ H#r., L 92 Per m%#, N.,m# Am$o+. .%e 10 M& 10 1*1 A+# A,-e,Po%'o$.% Syr 1 )*1 A+#B /om 10 )*1 A+#

1! A% B#.8#-. L ! 12 P. .( J#m.$$ ++.%

/o(r. Syr 1 2*1 ; A+#

S r#$.'y% Syr 1 1*1 T.+#- A+#15 A% #.8# P 1> " K#r(.%. J#m.$$ ++ P'( Syr 1 !*1 A+# P2

B$% .%Imbo ( Syr 1 1*1 T +#- A+#


40/88

Imbo,( Syr 1 1 1 T.+# A+#19 Ny K#m#r.# P 5)


41/88

25 Ny Jo8#%# P 99 Ge$#(. N.,m# N# . 10 2 1 A # A,B1 10 2*1 A+#B12 10 2*1 A+#Am$o+. .%e 10 M& 10 1*1 A+#

29 A% Mo8 Ab+R#:#b

L 1 Mer #(. E$$y /(m 5 1*1 A+#

De*# 10 )*1 A+# M# % J# $$ / ( S 1 2*1 A #


42/88

5 DESEMBER2015

)2 A% Pr.%'e, P 10B$%

=> M#.:e%S (oyo

J#m.$$ ++.%

/o(r. Syr 1 2*1 A+#


)) A% R#'8e$ L 9 E$#%& A& , P'( ?P [email protected] 2 )*1 A+#/(m ?P [email protected] 1 )*1 A+#G& ?P [email protected] 1 ; )*1 A+#

)

E$#%& J#m.$$ ++.%

/o(r. Syr 1 2*1 A+#


)5 Ny D: b#e+# P 52 S (oyo N.,m# P'( 10 )*1 A+# A,-e/(m 10 )*1 A+#G& 10 )*1 A+#

)9 Ny J#.%#b P !! Mer #(. A& , P'( 10 )*1 A+# A,A,me3 10 2*1 A+#B /om 10 2*1 A+#

) T% Ab+ $$#8 L !9 E$#%& N.,m# P'( 10 )*1 A+#/(m 10 )*1 A+#

G& 10 )*1 A+#B /om 10 )*1 A+#

)= A% Ar.3R#8m#%

L 9 E$#%& N..m# A'y'$ov.r S$ 1 S e A+#

P'( ?P [email protected] ! )*1 A+#/(m ?P [email protected] ! )*1 A+#G& ?P [email protected] ! )*1 A+#B /om ?P [email protected] ! )*1 A+#

)" T% S %#r%#m L )) A%o# Amo* 9 )*1 A+#A,me3 9 )*1 A+#

NAMA


43/88


RBB ALAMAT

NAMADOKTE

R

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

5 DESEMBER2015

!0 Ny Sr.H#%+#y#%.

P 25 T#+ $#-o ! De,y A%(#,.+# Syr 1 )71 A+# P2K

B9 10 171 A+#B12 10 171 A+#

!1 Ny O'(#v.# P 29 A%o# Amo* 9 )*1 A+# PP'( 9 )*1 A+#

!2 Ny #e%#b P 95 L#%o%. N.,m# Ib ro3e% 10 2*1 A+# AA%(#,.+# 10 )*1 A+#B9 10 )*1 A+#G& 10 )*1 A+#/(m 10 )*1 A+#

!) A% De# P (r. P 9 P#%#,#-#% A& , P'( ?P [email protected] ) )*1 A+# P2KP/(m ?P [email protected] 1 ; )*1 A+#G& ?P [email protected] 2 )*1 A+#


44/88

BPJS P2KPBR


RBB ALAMAT

NAMADOKTE

R

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

DESEMBER2015

1 Ny D.#%# P )" B#r A& , Be(#8.,(.% 10 )*1 T.+#- A+# P2KP

A,me3 10 2*1 A+#B /om 10 2*1 A+#

2 Ny K#r(.%. P 99 90 So%# N.,m# Am$o+. .%e 10 M& 20 171 A+# A,-G& 10 )71 A+#/(m 10 )71 A+#P'( 10 )71 A+#B12 10 271 A+#

) A% S8.ree% P S r.y#%. Ambro*o$ Syr 1 2* ; T.+#- A+# P2KPDom er.+o% 5 2* ; T.+#- A+#B /om 10 2*1 A+#Amo* Syr 1 )*1 A+#

! Ny S#r# Ror. P != 5! L#%(# #% N.,m# P'( 10 )*1 A+# JPS/(m 10 )*1 A+#G& 10 )*1 A+#Amo* 10 )*1 A+#A%(#,.+# 10 )*1 A+#

5 Ny S r.y#%. P S r.y#%. P'( 10 )*1 A+# PA,me3 10 )*1 A+#De*# 10 )*1 A+#Amo* 10 )*1 A+#

9 Ny E-# P )) R m#8 So,.#$ A& , Amo* 10 2*1 A+# P2KB /om 10 2*1 A+#G& 10 )*1 A+#

T% Ar.F% L 5! 5) So%# N.,m# P'( 10 )*1 A+# AR#%.(.+.%e 10 2*1 A+#B9 10 )*1 A+#Be(#8.,(.% 10 )*1 T.+#- A+#

= A% Mo8 .-r. L 12 50 K#m %&P#:#$#

J#m.$$ ++.%

De*# 10 )*1 A+#

Amo* 10 )*1 A+#Imbo,( 1 1*1 T.+#- A+#

& 10 2*1 T.+#- A+#


45/88


RBB ALAMAT

NAMADOKTE

R

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

DESEMBER2015

" Ny N rm#$# P 51 9= So%# N.,m# Am$o+. .%e 5 M& 10 1*1 A+# A,-

/# (o r.$ 20 2*1 A+#A%(#,.+# 10 )*1 A+#P'( 10 )*1 A+#

10 Ny M ,$.#%(. P 2= T.%.&. A& , R#%.(.+.%e 10 2*1 A+#B /om 10 2*1 A+#A,me3 10 2*1 A+#Amo* 10 2*1 A+#

11 Ny R b.#8 P 50 4##%. N.,m# N#+.' 10 21 A+# P2KB1 10 271 A+#B12 10 271 A+#

12 Ny J#m#$.# P ! M#m N.,m# Am$o+. .%e 10 M& 10 1*1 A+# P2KPR#%.(.+.%e 10 2*1 A+#Be(#8.,(.% 10 )*1 T.+#- A+#

1) T% A8m#+ L 59 M#m N.,m# /(m 10 )*1 A+# P2KDe*# 10 )*1 A+#Be(#me(#,o% S$ 1 S e A+#

1! Ny S..(.#,.r#8

P )0 H. H#m.+ Re -. Amo* 10 )*1 A+# P

A,me3 10 )*1 A+#


46/88

/(m 10 )71 A+#Am$o+. .%e 10 M& 10 171 A+#ISDN 10 S A+#

TANGGAL NONAMA

PASIEN JK UMU

RBB ALAMAT

NAMA

DOKTER

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

DESEMBER2015

1= By Le,(. P 1>! =>!

Ab+ M ., 4.%+# P'( ?P [email protected] 1 ; )*1 A+# P2

Dom er.+o%?P [email protected]

1 ; )*1 A+#

G& ?P [email protected] 1 ; )*1 A+#


47/88

29 T% Rober( L !! S#mr#( A& , A,me3 10 )*1 A+# P2KB /om 10 2*1 A+#

2 Ny R#b#,.# P 59 P#%#,#-#% N.,m# P'( 10 )*1 A+# JPSS.mv#,(#(.% 10 1*1 T.+#- A+#B12 10 2*1 A+#/(m 10 )*1 A+#


RBB ALAMAT

NAMADOKTE

R

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

DESEMBER2015

2= T% Mo8Am.%

L 92 M#$.%o R#y# N.,m# S.mv#,(#(.% 10 1*1 T.+#- A+# A,-

B /om 10 2*1 A+#2" A% M 8#F, L 9 29


48/88

RDom er.+o% Syr 1 )*1 T.+#- A+#

)! By P.(r# A r# P " B$% = K.$o 2 4.%+# Amo* Syr 1 )* A+# P2KPBP'( ?P [email protected] 1 ; )*1 A+#G& ?P [email protected] 1 )*1 A+#/(m ?P [email protected] 1 )*1 A+#


49/88

!" T% M ,(#m.% L 9) N.,m# S 10 1*1 A+#A%(#,.+# 10 )*1 A+#P'( 10 )*1 A+#


50/88

( )50 Ny De . P ) Yo, S +#r,o Re -. A%(#,.+# 10 )*1 A+# P2KPB

B /om 10 2*1 A+#51 A% #.-# P 5 Je%+r#$

S +.rm#%A& , /o(r. Syr 1 2*1 A+#

P'( ?P [email protected] ) )*1 A+#G& ?P [email protected] 2 )*1 A+#/(m ?P [email protected] 1 ; )*1 A+#

)

K#m %&P#:#$#

4.%+# /o(r. Syr 1 2* ; A+# P

G& ?P [email protected] 1 )*1 A+#


51/88

y @ )


52/88

/. ro6o*#'.% 10 2*1 T.+#- A+#B /om 10 2*1 A+#

95 A% Tr. P 9 S P#rm#% A& , P'( ?P [email protected] ) )*1 A+#/(m ?P [email protected] 2 )*1 A+#G& ?P [email protected] 2 )*1 A+#


53/88

= DESEMBER2015

1 Ny A:.b# P 5 T#+ $#-o N.,m# G& 10 ) 1 A+# P2

Amo* 10 )*1 A+#K$or#m3 T(, Te$.% 1 S T.+#- A+#

2 By A #8r# P 11B$%

= P.r.%& 4.%+# /o(r. Syr 1 2*1 A+#



54/88


RBB ALAMAT

NAMADOKTE

R

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

= DESEMBER2015

10 N% S(#r#S $.#

P 1= 2 I,m#.$B#%(.$#%

J#m.$$ ++.%

I%(er8.,(.% 10 2*1 T.+#- A+#

De*# 10 )*1 A+#B /om 10 )*1 A+#

11 T% Am.r +.% L 0 T#+ $#-o N.,m# Am$o+. .%e 10 M& 10 1*1 A+# P2KA%(#,.+# 10 )*1 A+#P'( 10 )*1 A+#

12 A% U'.( L 5 T#+ $#-o 2 A& , M.'o%# o$e S$ 1 S e A+# P2/(m 10 2* ; A+#" 10 S $(#%H#,#% ++.%

4.%+# /e3#+ro*.$ Syr 1 2*1 A+#

P'( ?P [email protected] 1 ; )*1 A+#G& ?P [email protected] 2 )*1 A+#


55/88

1" A% A$.3 L ) 12 D# #$#- 4.%+# /o(r. Syr 1 2*1 A+# P2K


RBB ALAMAT

NAMADOKTE

R

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

= DESEMBER2015

20 T% Yo8#%., L 90 L#%o%. N.,m# G& 10 )*1 A+#

/(m 10 )*1 A+#P'( 10 )*1 A+#Amo* 10 )*1 A+#

21 A% A+e3# P 1>11 12 M#+#-o 4.%+# P'( ?P [email protected] 1 ; )*1 A+# P2KPBG& ?P [email protected] 2 )*1 A+#


56/88

2 Ny S #r%# P 50 S (oyo N.,m# A%(#,.+# 10 )*1 A+# A,-B9 10 )*1 A+#Ib ro3e% 10 2*1 A+#

TANGGAL NO NAMAPASIEN JK UMUR BB ALAMATNAMADOKTE

ROBAT YANGDIBERIKAN JUMLAH DOSIS KETERSEDIAAN OBAT

= DESEMBER2015

2= T% D& MA%& % : %&.

L 5 S P#rm#% N.,m# G& 10 )*1 A+#

/(m 10 )*1 A+#P'( 10 )*1 A+#A%(#,.+# 10 )*1 A+#B /om 10 2*1 A+#

2" T% Ab+ L#(.3 L 51 L#%o%. N.,m# A%(#,.+# 10 )*1 A+#Ko(r. 10 2*1 A+#B /om 10 )*1 A+#P'( 10 )*1 A+#

)0 T% M N#,r % L !! A8m#+D#8$#% Amo* 10 )*1 A+#A,me3 10 )*1 A+#

)1 By S#83#%# P ) B$% 9>9

B#% 4.%+# /o(r. Syr 1 2* ; A+# P

G& ?P [email protected] 1 ; )*1 A+#


57/88

G& ?P [email protected] 2 ) 1 A+#


58/88

B1 10 271 A #B12 10 271 A+#

!1 A% Mo8#+8e$

L 5 N#$ A& , /o(r. Syr 1 2*1 ; A+# P

G& ?P [email protected] 2 )*1 A+#9B$%

10 4##%. N.,m# P'( ) )*1 A+#

/(m ) )*1 A+#G& ) )*1 A+#B /om ) )*1 A+#

!! Ny b#e+# P 95 M# #r N.,m# Am$o+. .%e 10 M& 10 1*1 A+# BPJS/(m 10 )*1 A+#

!5 Ny M %.r# P 2) Je%+r#$S +.rm#%

A,me3 10 )*1 A+#

Amo* 10 )*1 A+#/e3#+ro*.$ 10 )*1 T.+#- A+#

KETERANGAN

ASKES

BPJS

JPS


59/88

JPS

P2KPBR

TANGGAL NO NAMA

PASIEN JK UMU

R

B

BALAMAT

NAMADOKT

ER

OBAT YANG

DIBERIKAN

JUMLA

H

DOS

IS

KETERSEDI

AAN OBAT10 De,ember

20151 A% Ary#

S# (r#L = G#$#%& N.,m# P'( 9 )* ; A+#

/(m 9 )* ; A+#Amo* 9 )* ; A+#B /om 9 2*1 A+#

2 T% S#m, $ L 5! I,m#.$B#%(.$#%

A& , P'( 10 )*1 A+#

B /om 10 2*1 A+#G& 10 )*1 A+#

) Ny N rb#y# P != N r. N.,m# B#'.(r#'y% 10 )*1 T.+#- A+# JPSP'( 10 )*1 A+#


60/88

.%De*# 10 )*1 A+#I%(er8.,(.% 10 2*1 T.+#- A+#B /om 10 2*1 A+#


61/88

1) A% Mo #+.$ L 5 B#mb $#y#%&

A& , /o(r. Syr 1 2*1 ; A+#

/(m ?P [email protected] 1 ; )*1 A+#G& ?P [email protected] 2 )*1 A+#=B$%

" S#mr#( 4.%+# Ge%(#m.'.% S$K $.(

1 S e A+#



62/88

De*# 10 )*1 A+#/.(r. .%e 10 2*1 T.+#- A+#G& 10 )*1 A+#

20 T% A%+e, L 29 T#+ $#-o 1 A& , G& 10 )*1 A+# PB /om 10 2*1 A+#Amo* 10 2*1 A+#

21 A% N r#,.,#8 P 1>=B$%

" K#$#%&-#%%

4.%+# /o(r. Syr 1 2*1 A+#

G& ?P [email protected] 2 )*1 A+#/(m ?P [email protected] 1 )*1 A+#10 10 P.r.%& 4.%+# /e3#+ro*.$ Syr 1 2*1 A+# A,-eP'( ?P [email protected] 2 )*1 A+#G& ?P [email protected] 2 )*1 A+#


63/88

2015 N r,#F # .% K $.(P'( 10 )*1 A+#Imbo,( 1 1*1 T.+#- A+#De8#3 10 )*1 T.+#- A+#

2 By AC.3# P 1>!B$%

=>!

M :#8.++.% 4.%+# G& ?P [email protected] 1 )*1 A+#


64/88


RBB ALAMAT

NAMADOKTE

R

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

10 DESEMBER2015

)! A%N.,b#% +.%

L 1! )0 S#b#%& J#m.$$ ++.%

P'( 10 )*1 A+#

De8#3 10 )*1 T.+#- A+#

B /om 10 2*1 A+#M##&me(# 10 )*1 A+#)5 Ny

He$+# #(.P !2 G#$#%& A& , A,me3 10 )*1 A+#


65/88


RBB ALAMAT

NAMADOKTE

R

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

10 DESEMBER2015

!) A% S.%(.# P ! 12 B b#r# 4.%+# P'( Syr 1 )*1 A+# JP

R#%.(.+.%e 10 2*1 A+#O*y(e(r#'.$.% S$M#(#

1 S e A+#


66/88

50 Ny S ,#%(. P 2 H. H#y % A& , R#%.(.+.%e 10 ) 1 A+# P2B /om 10 2*1 A+#Me$o*.'#m 10 2*1 T.+#- A+#


RBB ALAMAT

NAMADOKTE

R

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

10 DESEMBER2015

51 T% A+r.#%o L )) P#%#,#-#% N#y# Amo* 10 )71 A+# P2K

A,me3 10 )71 A+#


67/88



R

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

11 DESEMBER2015

1 T% S#$.$#% L ) D# #$#- A& , P'( 10 )*1 A+#

1) Yo,S +#r,o

4.%+# P'( Syr 1 )*1 ; A+# P

G& ?P [email protected] ) )*1 A+#/(m ?P [email protected] 1 )*1 A+#10 12 B(%D# #$#-

4.%+# P'( ?P [email protected] 1 ; )*1 A+#



68/88

y )A% S +

#(.m#P 1>9 11>

!L#%o%. 4.%+# G& ?P [email protected] 2 )*1 A+#

= " K#-#- T # 4.%+# P'( ?P [email protected] 1 ; )*1 A+# P2KPBG& ?P [email protected] 2 )*1 A+#



69/88


70/88

G& ?P [email protected] 1 )*1 A+#/(m ?P [email protected] 1 )*1 A+#


71/88

G& 10 )*1 A+#P'( 10 )*1 A+#


72/88

)= A% N#6# P ) 10


73/88

y @ )/(m ?P [email protected] 1 )*1 A+#A%(#,.+# 10 )*1 A+#

!9 Ny D.#% P 25 Me$#(. Re -. P'( 10 )*1 A+# P2Dom er.+o% 10 )*1 A+#A%(#,.+# 10 )*1 A+#

!

L#%(# #% 4.%+# P'( ?P [email protected] 2 )*1 A+#


!

M#.:e% 4.%+# /o(r. Syr 1 2* A+#



74/88

11 DESEMBER2015

5! N% N.$# #(. P 22 N.,m# Lo er#m.+e 10 171 A+# A,-

A%(#,.+# 10 )71 A+#Ko(r. 10 271 A+#B9 10 )71 A+#

55 Ny Re%. P 9 P#%#,#-#% A& , S.mv#,(#(.% 10 )*1 T.+#- A+# P2KPBA$$o r.%o$ 10 2*1 A+#Me(3orm.% 10 2*1 A+#B /om 10 2*1 A+#Amo* Syr 1 )*1 A+#P'( Syr 1 )*1 A+#

59 N% D.# P 21 A& , G& 10 )*1 A+#Amo* 10 2*1 A+#


75/88

PASIEN R B R DIBERIKAN H S AAN OBAT11 DESEMBER2015

91 T% M#8m + L 59 S P#rm#% 4.%+# Me(ro%.+# o$e 10 )*1 A+# P2K

/e3#+ro*.$ 10 21 T.+#- A+#


76/88

PASIEN R R DIBERIKAN H S AAN OBAT12 DESEMBER2015

1 NyN r8#,#%#8

P ) A%&&&re- Re -. H.+ro-or(.,o% S$ 1 S e T.+#- A+# JP

B12 10 2*1 A+#B9 10 2*1 A+#


77/88


RBB ALAMAT

NAMADOKTE

R

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

12 DESEMBER2015

10 T% Jo,. , L 90 O&omo$. N.,m#


78/88

TANGGAL NONAMA

PASIEN JK UMU

RBB ALAMAT

NAMA

DOKTER

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

12 DESEMBER2015

1 Ny S#r#8 Je#%

P 5= S P#rm#% N.,m# Am$o+. .%e 10 M& 10 1*1 A+# A

B9 10 2*1 A+#R#%.(.+.%e 10 2*1 A+#P'( 10 2*1 A+#

1= A% GeFr# P ) 1) Ke$# # 1 4.%+# /o(r. Syr 1 2*1 A+# A,-eP'( ?P [email protected] 2 )*1 A+#G& ?P [email protected] ) )*1 A+#De*# ?P [email protected] 1 )*1 A+#


79/88

B /om 10 2*1 A+#


RBB ALAMAT

NAMADOKTE

ROBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

12 DESEMBER2015

25 A%M 8#mm#+R

L 12 )! M H#((# J#m.$$ ++.%

G& 10 2*1 A+#

B /om 10 2*1 A+#Amo* 10 )*1 A+#/e3(r. .%e 10 2*1 T.+#- A+#

29 Ny L (F#8 P 90 Yo, S +#r,o N.,m# K$or#m3 T(, Te$.% 1 S e T.+#- A+# A,-e,P'( 10 )*1 A+#/(m 10 )*1 A+#A%(#,.+# 10 )*1 A+#

2 Ny Yer$.% P 92 K#-#( # N.,m# G& 10 )*1 A+#/(m 10 )*1 A+#A%(#,.+# 10 )*1 A+#B /om 10 2*1 A+#

2= Ny N r#.%. P 55 M#$.%o R#y# N.,m# Am$o+. .%e 10 M& 20 1*1 A+# A,-eP'( 10 )*1 A+#R#%.(.+.%e 10 2*1 A+#

2" T% H#er $ L !2 J S +.rm#% A& , S.mv#,(#(.% 10 )*1 T.+#- A+# A,-eA$$o r.%o$ 10 2*1 A+#Ne r#+e* 10 2*1 T.+#- A+#

)0 Ny Be#(r.* P J S +.rm#% N.,m# A$ r# o$#m 10 1*1 T.+#- A+# A,-e,S.mv#,(#(.% 10 1*1 T.+#- A+#B /om 10 2*1 A+#

Po%'o$.% Syr 1 )*1 A+#

R#%.(.+.%e 10 2*1 A+#)1 A%

M.,b#8 +.%L 1! 2" G#$#%& J#m.$$ ++

.%Amo* 10 )*1 A+#

Imbo,( 1 1*1 T.+#- A+#)2 T% S %#r(o L !" M N#(,.r N.,m# R#%.(.+.%e 10 2*1 A+# P2K

P'( 10 )*1 A+#/( 10 )*1 A #


80/88

/(m 10 )*1 A+#G& 10 )*1 A+#

)) N% Sr.4 $#%+#r.

P )0 Ab+ M ., A& , B /om 10 2*1 A+# P

A,me3 10 )*1 A+#


RBB ALAMAT

NAMADOKTER

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

12 DESEMBER2015

)! Ny K#,,e P 0 M#m N.,m# P'( 10 )*1 A+# P2KP

/(m 10 )*1 A+#G& 10 )*1 A+#

)5 A% /#8y#%. P 2 12 Yo, S +#r,o A& , /o(r. Syr 1 2*1 A+# P2KPBDom er.+o% Syr 1 )*1 T.+#- A+#

)9 T% Tr.A r.y#%(o

L 22 L mb#L mb#

A& , A,me3 10 )*1 A+#

Amo* 10 2*1 A+#P'( 10 )*1 A+#/$or#m e%.'o$ TT 1 S e T.+#- A+#

) NyS#me$$#%&

P )= H. H#y % A& , P.ro*.'#m 10 )*1 A+# P

R#%.(.+.%e 10 )*1 A+#B /om 10 1*1 A+#

)= A% Se (.#% L 2 15 S#mr#( $#%&.

4.%+# P'( ? [email protected] 2 )*1 A+#

GG ? yer @ ) )*1 A+#


81/88


82/88

/(m ? [email protected] 1 )*1 A+#Amo* Syr 1 2* 1; A+#


RBB ALAMAT

NAMADOKTE

R

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

1! DESEMBER2015

1 Ny J mr.# P !! S +.rm#% N#y# Amo* 10 )*1 A+# JP

/e(.r. .%e 10 2*1 T.+#- #+#B'om 10 2*1 A+#

2 N% E$# P 2 B#% N#y# /8$or#m3e%.-o$ TT 1 2*1 T.+#- #+# JPA,#m me3e%#m#( 10 )*1 A+#A%(#,.+# 10 )*1 A+#

) A% So3y#% L 12 A8m#+ E$$y B#'.(r#'y% S#$e 1 S e A+#

D#8$#% K $.(Amo* 10 10 A+#A,#m me3e%#m#( 10 10 A+#


83/88


84/88

TANGGAL NONAMA

PASIEN JK

UMUR

BB ALAMAT

NAMADOKTE

R

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT

1! DESEMBER2015

1 A% A$F%o L S P#rm#% N#y# Amo* Syr 1 )*1 A+#

GG 9 )* ; A+#


85/88

, ( )/(m 10 )*1 A+#GG 10 )*1 A+#Ery(rom.'.% 10 )*1 T.+#- #+#De*# 10 )*1 A+#

5 T% Sevr.% L )" Yo, S +#r,o N#y# /e3#+ro*.$ '# , 10 2*1 T.+#- #+# BPJSGG 10 )*1 A+#P'( 10 )*1 A+#


86/88

Me(y$ re+%.,o$o% 9 2*1 A+#/$or#m3e%.-o$ TT 1 S e A+#

) Ny Er%yP#%+ey

P ! A%&&re- N.,m# GG 10 )*1 A+#

/(m 10 )*1 A+#De*# 10 )*1 A+#R#%.(.+.% 10 2*1 A+#

! Ny S m.#(y P !" Sy#r.3 m#%, r

N.,m# A,#m me3e%#m#( 10 )*1 A+#

Se3#+ro-,.$ 10 2*1 T.+#- A+#5 T% S# . . L 59 G %&

/e%&-e8N.,m# GG 10 )*1 A+#

/(m 10 )*1 A+#P'( 10 )*1 A+#

9 Ny % r#y#(. P 95 L#+# . N.,m# GG 10 )*1 A+# A/(m 10 )*1 A+#P'( 10 )*1 #+#

T% H ,#.% L 90 S.+o#r:o N.,m# /(m 10Ke(o-o%#,o$ 1

P'( 10 Gr.,eov $F% 15

TANGGAL NONAMA

PASIEN JK

UMUR

BB ALAMAT

NAMADOKTE

R

OBAT YANGDIBERIKAN

JUMLAH

DOSIS

KETERSEDIAAN OBAT


87/88

1! DESEMBER2015

1 Ny Ro,+.#%# P !1 T#mb % N#y# Amo* 10 2*1 A+# A,-e

P'( 10 )*1 A+#A%(#,.+# 10 )*1 A+#B'om 10 2*1 A+#

2 T% R#m$#% L !1 T#mb % N#y# /e3#+ro*.$ 10 2*1 A+# A,-A,#m Me3e%#m#( 10 )*1 A+#

(


88/88

R#%.(.+.% 10 2*1 A+#Me(y$ re+%.,o$o% 9 2*1 A+#/$or#m3e%.-o$ TT 1 S e A+#

) Ny Er%yP#%+ey

P ! A%&&re- N.,m# GG 10 )*1 A+#

/(m 10 )*1 A+#De*# 10 )*1 A+#R#%.(.+.% 10 2*1 A+#

! Ny S m.#(y P !" Sy#r.3 m#%, r

N.,m# A,#m me3e%#m#( 10 )*1 A+#

Se3#+ro-,.$ 10 2*1 T.+#- A+#5 T% S# . . L 59 G %&

/e%&-e8N.,m# GG 10 )*1 A+#

/(m 10 )*1 A+#P'( 10 )*1 A+#

9 Ny % r#y#(. P 95 L#+# . N.,m# GG 10 )*1 A+# A/(m 10 )*1 A+#P'( 10 )*1 #+#

T% H ,#.% L 90 S.+o#r:o N.,m# /(m 10

Ke(o-o%#,o$ 1P'( 10 Gr.,eov $F% 15

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