vivie apotik

Upload: didot-litratista

Post on 07-Jul-2018

233 views

Category:

Documents


0 download

TRANSCRIPT

  • 8/18/2019 Vivie Apotik

    1/88

  • 8/18/2019 Vivie Apotik

    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 yer@ 1 )*1 A+#

    /(m ?P yer@ 1 )*1 A+#B /om ?P yer@ 2 )*1 A+#

  • 8/18/2019 Vivie Apotik

    3/88

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

    /(m ?P yer@ 2 )*1 A+#G& ?P yer@ 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 yer@ ) )*1 A+#

    /(m ?P yer@ 1 )*1 A+#G& ?P yer@ 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

  • 8/18/2019 Vivie Apotik

    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+#

    TANGGAL NO NAMAPASIEN JK UMU

    R BB ALAMATNAMA

    DOKTEROBAT YANGDIBERIKAN

    JUMLAH

    DOSIS

    KETERSEDIAAN OBAT

    2 November2015

    )1 A%.(r.#%#

    P ) 11 E$#%& De,y P'( ?P yer@ 2 )*1 A+# P

    /(m ?P yer@ 1 )*1 A+#G& ?P yer@ 1 )*1 A+#2 4rS r#(m#%

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

  • 8/18/2019 Vivie Apotik

    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+#

  • 8/18/2019 Vivie Apotik

    6/88

    B$%5 G#$#%& De,y P'( ?P yer@ 2 )71 A+#

    /(m ?P yer@ 1 )71 A+#

    G& ?P yer@ 1 )71 A+#

  • 8/18/2019 Vivie Apotik

    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 yer@ 2 )*1 A+# P2K

    /(m ?P yer@ 1 )*1 A+#G& ?P yer@ 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 yer@ 1 )71 A+# P2KG& ?P yer@ ; )71 A+#/(m ?P yer@ ; )71 A+#= P#%&e,#r Re -. Amo* Syr 1 )*1 A+# P2KP'( ?P yer@ 2 )*1 A+#/(m ?P yer@ 2 )*1 A+#

  • 8/18/2019 Vivie Apotik

    8/88

    2015P'( ?P yer@ 2 )*1 A+#/(m ?P yer@ 1 )*1 A+#G& ?P yer@ 1 )*1 A+#"B$%

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

  • 8/18/2019 Vivie Apotik

    9/88

    2 November2015

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

    P'( ?P yer@ 2 )*1 A+#/(m ?P yer@ 1 )*1 A+#

  • 8/18/2019 Vivie Apotik

    10/88

    TANGGAL NO NAMAPASIEN JK UMU

    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

  • 8/18/2019 Vivie Apotik

    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+#

    P'( ?P yer@ 2 )*1 A+#/(m ?P yer@ 1 )*1 A+#

  • 8/18/2019 Vivie Apotik

    12/88

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

    1 S e A+#

  • 8/18/2019 Vivie Apotik

    13/88

  • 8/18/2019 Vivie Apotik

    14/88

  • 8/18/2019 Vivie Apotik

    15/88

    TANGGAL NO NAMAPASIEN JK UMU

    RBB ALAMAT

    NAMADOKTER

    OBAT YANGDIBERIKAN

    JUMLAH

    DOSIS

    KETERSEDIAANOBAT

    2 DESEMBER2015

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

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

  • 8/18/2019 Vivie Apotik

    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+#

  • 8/18/2019 Vivie Apotik

    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 yer@ 2 )*1 A+#/(m ?P yer@ 1 )*1 A+#G& ?P yer@ 1 )*1 A+#

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

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

    P'( ?P yer@ ! )*1 A+#/(m ?P yer@ ) )*1 A+#G& ?P yer@ ! )*1 A+#De*# ?P yer@ ) )*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

  • 8/18/2019 Vivie Apotik

    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 yer@ 2 )*1 A+#

    /(m ?P yer@ 1 )*1 A+#G& ?P yer@ 1 )*1 A+#1! A% R. C.

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

    P'( ?P yer@ ! )*1 A+#/(m ?P yer@ ) )*1 A+#G& ?P yer@ ! )*1 A+#De*# ?P yer@ ) )*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+#

  • 8/18/2019 Vivie Apotik

    19/88

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

    TANGGAL NO NAMAPASIEN JK UMU

    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+#

  • 8/18/2019 Vivie Apotik

    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 yer@ 2 )*1 A+#/(m ?P yer@ 1 )*1 A+#G& ?P yer@ 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!

  • 8/18/2019 Vivie Apotik

    21/88

  • 8/18/2019 Vivie Apotik

    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 yer@ 2 )*1 A+#

    G& ?P yer@ 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+#

    P'( ?P yer@ 2 )*1 A+#/(m ?P yer@ 1 )*1 A+#G& ?P yer@ 1 )*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

    P'( ?P yer@ 1 )*1 A+#/(m ?P yer@ 1 )*1 A+#G& ?P yer@ 1 )*1 A+#

    TANGGAL NO NAMAPASIEN JK UMU

    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

    P'( ?P yer@ 2 )*1 A+#/(m ?P yer@ 1 )*1 A+#

  • 8/18/2019 Vivie Apotik

    23/88

    G& ?P yer@ 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+#

  • 8/18/2019 Vivie Apotik

    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 yer@ ) )*1 A+#/(m ?P yer@ 2 )*1 A+#

  • 8/18/2019 Vivie Apotik

    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 yer@ 1 )*1 A+#/(m ?P yer@ 1 )*1 A+#G& ?P yer@ ; )*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+#

  • 8/18/2019 Vivie Apotik

    26/88

    TANGGAL NO NAMAPASIEN JK UMU

    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+#

  • 8/18/2019 Vivie Apotik

    27/88

    TANGGAL NO NAMAPASIEN JK UMU

    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 yer@ ) )*1 A+#/(m ?P yer@ 1 )*1 A+#G& ?P yer@ 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

  • 8/18/2019 Vivie Apotik

    28/88

    P'( ?P yer@ ) )*1 A+#De*# ?P yer@ ) )*1 A+#! " K#m %&Ke .(.%&

    J#m.$$ ++.%

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

    P'( ?P yer@ 2 )*1 A+#/(m ?P yer@ 1 )*1 A+#G& ?P yer@ 1 )*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+#

  • 8/18/2019 Vivie Apotik

    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+#

    TANGGAL NO NAMAPASIEN JK UMU

    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

    P'( ?P yer@ ) )*1 A+#/(m ?P yer@ 2 )*1 A+#G& ?P yer@ 1 ; )*1 A+#

    !9 A%

    B$%

    ">=

  • 8/18/2019 Vivie Apotik

    30/88

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

  • 8/18/2019 Vivie Apotik

    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

    P'( ?P yer@ ) )*1 A+#/(m ?P yer@ 2 )*1 A+#G& ?P yer@ 1 ; )*1 A+#

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

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

    P'( ?P yer@ ! )71 A+#/(m ?P yer@ ) )71 A+#G& ?P yer@ 2 )71 A+#

  • 8/18/2019 Vivie Apotik

    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 yer@ ) )*1 A+#/(m ?P yer@ ) )*1 A+#

  • 8/18/2019 Vivie Apotik

    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+#

  • 8/18/2019 Vivie Apotik

    34/88

    TANGGAL NO NAMAPASIEN JK UMU

    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 yer@ ) )*1 A+#G& ?P yer@ ! )*1 A+#

    S#$b (#mo$ ?P yer@ ! )*1 A+#De*# ?P yer@ ) )*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+#

  • 8/18/2019 Vivie Apotik

    35/88

    TANGGAL NO NAMAPASIEN JK UMU

    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.$$ ++.%

    P'( ?P yer@ 2 )*1 A+#

    /(m ?P yer@ 1 )*1 A+#G& ?P yer@ 1 )*1 A+#/o(r. Syr 1 2*1 ; A+#

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

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

    P'( ?P yer@ 2 )*1 A+#

    /(m ?P yer@ 1 )*1 A+#G& ?P yer@ 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.$$ ++.%

    /(m ?P yer@ 1 )*1 A+#

    De*# ?P yer@ 1 )*1 A+#B /om ?P yer@ 2 )*1 A+#

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

  • 8/18/2019 Vivie Apotik

    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+#

    TANGGAL NO NAMAPASIEN JK UMU

    R BB ALAMATNAMADOKTE

    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+#

    P'( ?P yer@ ) )*1 A+#/(m ?P yer@ 1 )*1 A+#G& ?P yer@ 1 ; )*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+#

  • 8/18/2019 Vivie Apotik

    37/88

    Amo* 9 )* ; A+#

  • 8/18/2019 Vivie Apotik

    38/88

    5 .%/(m ?P yer@ 1 )*1 A+#G& ?P yer@ ; )*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

    TANGGAL NO NAMAPASIEN JK UMU

    R BB ALAMATNAMADOKTE

    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+#

  • 8/18/2019 Vivie Apotik

    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 yer@ ) )*1 A+#

    /(m ?P yer@ 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+#

    TANGGAL NO NAMAPASIEN JK UMU

    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+#

  • 8/18/2019 Vivie Apotik

    40/88

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

  • 8/18/2019 Vivie Apotik

    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 #

  • 8/18/2019 Vivie Apotik

    42/88

    5 DESEMBER2015

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

    => M#.:e%S (oyo

    J#m.$$ ++.%

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

    P'( ?P yer@ 1 )*1 A+#/(m ?P yer@ 1 )*1 A+#G& ?P yer@ 1 )*1 A+#

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

    )

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

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

    P'( ?P yer@ 2 )*1 A+#/(m ?P yer@ 1 )*1 A+#G& ?P yer@ 1 )*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 yer@ ! )*1 A+#/(m ?P yer@ ! )*1 A+#G& ?P yer@ ! )*1 A+#B /om ?P yer@ ! )*1 A+#

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

    NAMA

  • 8/18/2019 Vivie Apotik

    43/88

    TANGGAL NO NAMAPASIEN JK UMU

    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 yer@ ) )*1 A+# P2KP/(m ?P yer@ 1 ; )*1 A+#G& ?P yer@ 2 )*1 A+#

  • 8/18/2019 Vivie Apotik

    44/88

    BPJS P2KPBR

    TANGGAL NO NAMAPASIEN JK UMU

    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+#

  • 8/18/2019 Vivie Apotik

    45/88

    TANGGAL NO NAMAPASIEN JK UMU

    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+#

  • 8/18/2019 Vivie Apotik

    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 yer@ 1 ; )*1 A+# P2

    Dom er.+o%?P yer@

    1 ; )*1 A+#

    G& ?P yer@ 1 ; )*1 A+#

  • 8/18/2019 Vivie Apotik

    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+#

    TANGGAL NO NAMAPASIEN JK UMU

    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

  • 8/18/2019 Vivie Apotik

    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 yer@ 1 ; )*1 A+#G& ?P yer@ 1 )*1 A+#/(m ?P yer@ 1 )*1 A+#

  • 8/18/2019 Vivie Apotik

    49/88

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

  • 8/18/2019 Vivie Apotik

    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 yer@ ) )*1 A+#G& ?P yer@ 2 )*1 A+#/(m ?P yer@ 1 ; )*1 A+#

    )

    K#m %&P#:#$#

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

    G& ?P yer@ 1 )*1 A+#

  • 8/18/2019 Vivie Apotik

    51/88

    y @ )

  • 8/18/2019 Vivie Apotik

    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 yer@ ) )*1 A+#/(m ?P yer@ 2 )*1 A+#G& ?P yer@ 2 )*1 A+#

  • 8/18/2019 Vivie Apotik

    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+#

    G& ?P yer@ 2 )*1 A+#

  • 8/18/2019 Vivie Apotik

    54/88

    TANGGAL NO NAMAPASIEN JK UMU

    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 yer@ 1 ; )*1 A+#G& ?P yer@ 2 )*1 A+#

  • 8/18/2019 Vivie Apotik

    55/88

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

    TANGGAL NO NAMAPASIEN JK UMU

    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 yer@ 1 ; )*1 A+# P2KPBG& ?P yer@ 2 )*1 A+#

  • 8/18/2019 Vivie Apotik

    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 yer@ 1 ; )*1 A+#

  • 8/18/2019 Vivie Apotik

    57/88

    G& ?P yer@ 2 ) 1 A+#

  • 8/18/2019 Vivie Apotik

    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 yer@ 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

  • 8/18/2019 Vivie Apotik

    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+#

  • 8/18/2019 Vivie Apotik

    60/88

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

  • 8/18/2019 Vivie Apotik

    61/88

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

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

    /(m ?P yer@ 1 ; )*1 A+#G& ?P yer@ 2 )*1 A+#=B$%

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

    1 S e A+#

    /(m ?P yer@ 2 )*1 A+#

  • 8/18/2019 Vivie Apotik

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

  • 8/18/2019 Vivie Apotik

    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 yer@ 1 )*1 A+#

  • 8/18/2019 Vivie Apotik

    64/88

    TANGGAL NO NAMAPASIEN JK UMU

    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+#

  • 8/18/2019 Vivie Apotik

    65/88

    TANGGAL NO NAMAPASIEN JK UMU

    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+#

  • 8/18/2019 Vivie Apotik

    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+#

    TANGGAL NO NAMAPASIEN JK UMU

    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+#

  • 8/18/2019 Vivie Apotik

    67/88

    TANGGAL NO NAMAPASIEN JK UMU

    R BB ALAMATNAMADOKTE

    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 yer@ ) )*1 A+#/(m ?P yer@ 1 )*1 A+#10 12 B(%D# #$#-

    4.%+# P'( ?P yer@ 1 ; )*1 A+#

    G& ?P yer@ 2 )*1 A+#

  • 8/18/2019 Vivie Apotik

    68/88

    y )A% S +

    #(.m#P 1>9 11>

    !L#%o%. 4.%+# G& ?P yer@ 2 )*1 A+#

    = " K#-#- T # 4.%+# P'( ?P yer@ 1 ; )*1 A+# P2KPBG& ?P yer@ 2 )*1 A+#

    /(m ?P yer@ 1 )*1 A+#

  • 8/18/2019 Vivie Apotik

    69/88

  • 8/18/2019 Vivie Apotik

    70/88

    G& ?P yer@ 1 )*1 A+#/(m ?P yer@ 1 )*1 A+#

  • 8/18/2019 Vivie Apotik

    71/88

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

  • 8/18/2019 Vivie Apotik

    72/88

    )= A% N#6# P ) 10

  • 8/18/2019 Vivie Apotik

    73/88

    y @ )/(m ?P yer@ 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 yer@ 2 )*1 A+#

    G& ?P yer@ 2 )*1 A+#

    !

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

    G& ?P yer@ 2 )*1 A+#

  • 8/18/2019 Vivie Apotik

    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+#

  • 8/18/2019 Vivie Apotik

    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+#

  • 8/18/2019 Vivie Apotik

    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+#

  • 8/18/2019 Vivie Apotik

    77/88

    TANGGAL NO NAMAPASIEN JK UMU

    RBB ALAMAT

    NAMADOKTE

    R

    OBAT YANGDIBERIKAN

    JUMLAH

    DOSIS

    KETERSEDIAAN OBAT

    12 DESEMBER2015

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

  • 8/18/2019 Vivie Apotik

    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 yer@ 2 )*1 A+#G& ?P yer@ ) )*1 A+#De*# ?P yer@ 1 )*1 A+#

  • 8/18/2019 Vivie Apotik

    79/88

    B /om 10 2*1 A+#

    TANGGAL NO NAMAPASIEN JK UMU

    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 #

  • 8/18/2019 Vivie Apotik

    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+#

    TANGGAL NO NAMAPASIEN JK UMU

    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'( ? yer@ 2 )*1 A+#

    GG ? yer @ ) )*1 A+#

  • 8/18/2019 Vivie Apotik

    81/88

  • 8/18/2019 Vivie Apotik

    82/88

    /(m ? yer@ 1 )*1 A+#Amo* Syr 1 2* 1; A+#

    TANGGAL NO NAMAPASIEN JK UMU

    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+#

  • 8/18/2019 Vivie Apotik

    83/88

  • 8/18/2019 Vivie Apotik

    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+#

  • 8/18/2019 Vivie Apotik

    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+#

  • 8/18/2019 Vivie Apotik

    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

  • 8/18/2019 Vivie Apotik

    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+#

    (

  • 8/18/2019 Vivie Apotik

    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