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APOTEK APOTEK

Reseptor Pharma Reseptor Pharma


Reseptor Jl. Urip Sumoharjo No. 42 Reseptor Jl. Urip Sumoharjo No. 42
Pharma TLP : 08135481800 Pharma TLP : 08135481800
APOTEKER : APOTEKER :
SIPA No. : 15020150 SIPA No. : 15020150
Makassar, Sulawesi Selatan-Indonesia Makassar, Sulawesi Selatan-Indonesia

Salinan Resep Salinan Resep


No. :......................................................Tgl/Bln/Thn :................................ No. :......................................................Tgl/Bln/Thn :................................
Dari dr. : .............................................Tgl/Bln/Thn :............................... Dari dr. : .............................................Tgl/Bln/Thn :...............................
Untuk : (Tn/Ny/NN/Ank) ........................ Untuk : (Tn/Ny/NN/Ank) ........................
Umur : Umur :
Alamat : Alamat :

R/ R/

Pcc Pcc
Reseptor Reseptor
Pharma Pharma

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