Daftar Nama Pasien

No. Nama Pasien Umur Alamat Keluhan

 DAFTAR HADIR TENAGA KESEHATAN
Hari / Tanggal :
No. Nama Lengkap Profesi No. Telpon Tanda Tangan
 DAFTAR OBAT

No. Nama Obat Kandungan Jumlah Expired Date

A. Analgetik, Antipiretik
Parasetamol 500 mg Tablet Parasetamol 120
Sumagesic 500 mg Tablet Parasetamol 2
Parasetamol 120 mg/ml Sirup Parasetamol 22
Parasetamol 120 mg/ml Sirup (strawberi) Parasetamol 19
Novagesic 120 mg/ml Sirup Parasetamol 1
Itramol 120 mg/ml Sirup Parasetamol 3
Hufagrip TMP 100 mg/ml Sirup Ibuprofen 4
Asam Mefenamat 500 mg Tablet Asam Mefenamat 609
Dolorstan 500 mg Tablet Asam Mefenamat 15
Anastan 500 mg Tablet Asam Mefenamat 9
Trifastan 500 mg Tablet Asam Mefenamat 10
Ifitamol 500 mg Tablet Parasetamol 200
Piroxicam 20 mg Tablet Piroxicam 36

B. Antibiotik / Antijamur
Amoxicilin 500 mg Tablet Amoxicilin 500 mg Tablet 210
Amoxicilin 500 mg Tablet Amoxicilin 500 mg Tablet 100
Ciprofloxacin 500 mg Tablet Ciprofloxacin 500 mg 30
Floxigra 500 mg Tablet Ciprofloxacin 500 mg 50
Cotrimoxazole 480 mg Tablet Cotrimoxazole 480 mg 100
Metronidazol 500 mg Tablet Metronidazol 500 mg 10

C Obat Diabetes
Glibenklamid 5 mg Tablet Glibenklamid 5 mg 290
Metformin 500 mg Tablet Metformin 500 mg 125

D Obat Anti Hipertensi

Captopril 25 mg Tablet Captopril 25 mg 159
Amlodipin 5 mg Tablet Amlodipin 5 mg 115

E Obat Asam Urat, Kolesterol

Allopurinol 100 mg Tablet Allopurinol 100 mg 20
Simvastatin 10 mg Tablet Simvastatin 10 mg 70
F Obat Lambung
Ranitidine 150 mg Tablet Ranitidine 660
Antasida DOEN Tablet Antasida 800
Omeprazole 20 mg Kapsul Omeprazole 120

G Obat Anti Muntah

Domperidone 5 mg/5 ml Sirup Domperidon 7
Metoclopramide 500 mg Tablet Metoclopramide 80
Vesperum 10 mg Tablet Domperidon 80

H Obat Anti Diare

New Diatabs 600 mg Tablet Actived Attapulgite 184
Loperamid 2 mg Loperamid 100

I Obat ISPA, Sesak Nafas

Roverton 15 mg/5 ml Sirup Ambroxol 2
Mucosolvan Sirup Bromehexin 6
Ambroxol 30 mg Tablet Ambroxol 75
Gliseril Guaikolat 100 mg Tablet GG 90
Grafalin 2 mg Tablet Salbutamol 100
Baby Cough Sirup PCT, Guaifenisin, CTM 21
Pacdin Sirup PCT, GG, CTM 6

J Obat Anti Jamur dan Anti virus

Ketoconazole 200 mg Tablet Ketoconazole 40
Aciclovir 200 mg Tablet Aciclovir 10

K Obat Antihistamin, Anti inflamasi

Pallerskin Tablet CTM 10
Alleron Tablet CTM 8
Orphen Tablet CTM 49
Ifidex Tablet Dexametasone 1000
Mecoxon Tablet Dexametasone 10
Dexaharsen Dexametasone 32
Methylprednisolon 4 mg Tablet Methyl Prednisolon 10
Prednison Prednison 20
Zerion Tablet Fenilbutazon 50
Katergi Tablet Mebhydrolin 45
Lerzin 10 mg Tablet Cetirizine 5
Pronicy 60
 Gradine 5 mg Tablet Loratadine 60
L Multivitamin
Curviplex 8
Vitamin C Tablet 300
Calcium Lactat Tablet 900
Vitamin B Complex Tablet 900
Selfort Kids Sirup 12
Madurasa 8

M Obat Cacing
Askamex Tablet 26

N Salep
Hydrocotison 2,5% tube 4
Myconazole 2% tube 4
Genalten tube 1
Betametasone 0,1% tube 3
Ketoconazole tube 5
Gentamicin salep 7