DINAS KESEHATAN
UPTD KESEHATAN PUSKESMAS PEKKAE
Jl. Sultan Hasanuddin No. 52 Pekkae Kec. Tanete Rilau Kab. Ba
JAM : JAM :
Penanggung Pembayaran
Terapi Pulang
Nama Obat Jumlah
KAE
b. Barru 90761
ALAMAT :
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3. PAPS 4. Meninggal
Rumah Sakit
Dosis
Pekkae, ............................... 201
Dokter Penanggung Jawab Pelayanan