SERI I - buat copy R/ - Talk 5g-0.7 g = 4.

3/2=2,15 +10%
RESEP 1 - MgO = ta;k = 2.15 g+10%
R/ standar
Dr. Ratna Indrayana
Acid salicyl 2g RESEP 2
Jl. Manggar no X Gebang Jember
ZnO 25 g Dr. Bayu Anggoro
Amylum tricici 25 g Jl. Teratai No 14 Jember
Jember, ........... ....
Vaselin flavum ad 100 g Telp. (0331) 567987
R/ Paracetamol ¼ tab
SERI II Jember, 29/12/2017
CTM ¼ tab
RESEP 1
Vit . C ¼ tab
R/ Aminophylin 50 mg
Mf cap dtd No XX KLINIK PRATAMA MEDIKA
Gliseril guaiakolat 30 mg
S. 3 dd 1 JL. GAJAH MADA 60 JEMBER
CTM 2 mg
Pro : Nanda . Dr. Yashinta Mf cap dtd No XX
S. 3 dd 1
KR : - SIP dokter (234/DU/2017) Jember, ........... ....
- Tgl R/ ( 29/12/2017) R/ Champora 0.100 g
Pro : Ny. Rani ( 21 th)
- Umur px ( 5 th) Mentholum 0.100 g
DM CTM (40 mg/hari) Acid boric 0.500 g
1 tab CTM = 2 mg MgO KR : SIP dr (
Talk aa ad 5 gr
RESEP 2 Mf. Pulv adsp SERI III
Sue RESEP 1
Dr. Gunawan Sp. KK
Jl. PB. Sudirman no 231 Jember Dr. Rahman Faruq
SIP. 2345/DK/2004 Jl. Ahmad Yani 207 Jember
Pro : Ilham ( 12 th) SIP. 363/2001/DU/2008
Jember, 28/11/2017 Telp. (0331) 123456
Jember, ........... ....
R/ Pasta lassari 10 g KR : SIP dokter (670/DU/2016)
Pro : Ny. Maya - tgl R/ (18/12/2017) R/ Ekstrak belladona 10 mg
- paraf dr Paracetamol 4 tab
KR : - paraf dokter - acc + 10% kec. Mentol dan champora SL qs
- Signa resep ( sue) PB : champora 100mg Mf pulv da in cap dtd No X
Note : - mentol 100mg
- da 5 g - acid boric 500 g + 10%
Pro : Tn Tomi
RESEP 2 RESEP 2 RESEP 2

Dr. RIZAL SAPUTRA Dr. Lilik Dr. Imam Marzuki

Jl. Pelita Harapan 12 Surabaya Jl. Semeru 2 Jember Jl. Nirwana 25 Jember
SIP : 943/DU/ 2015 SIP : 051/DU/2014 SIP : 258/DU/2017
Telp. (031) 2345678 Telp. (0331) 8768797 Telp. (0331) 8768797
Sby , ........... .... Jember, 20/12/2017

R/ Bentonit 0.5 g R/ Bedak magnesia 5g R/ Salep exeem basah 5g

ZnO adde Mf . d
Talcum aa 2g Sulfur precipitatum 0,300 g s.u.e
Gliserin Mf pulv adsp
Aqua aa 1.5 g s.u.e
Mf pasta
Sue Pro : Rahmad ( )
Pro : Andi
Pro : Rossa (17 th)
SERI IV SERI V SERI VI
RESEP 1 RESEP 1 RESEP 1
Dr. JONI Dr. Raisa Azzahra Dr. Amanda
Jl. Trunojoyo 5 Jember Jl. Mawar 25 Jember Jl. Manggar 121 jember
SIP : 987/DSK/ 2017 Telp. (0331) 4255678 SIP : 010/DSK/2015
Telp. (0331) 4255678 Telp. (0331) 8768797
Jember, 20/12/2017 R/ Rivanol 0,100 g
Aqua Rosae 1g
R/ Unguentum 2-4 10 g R/ Papaverin 1g
Adeps lanae 4g
Mf . Ung Ol. Mentapip 1 gt
ZnO 0,5 g
S. U. E Aqua ad 100 g
Vaselin album ad 10 g
Mf. Potio
Mf ungt
(da 5 g) S.bdd ½ cth
s.u.e
Pro : Dinda ( )
Pro : Diah ( )
Pro : Dion (10 th)
 RESEP 2
RESEP 2 Cap Dr. Munifah
apote
Dr. Koko Maroko k
Jl. Manggis 20 Patrang – Jember
Jl. Letjen Sutoyo 60 Jember SIP : 016/DU/2017
RESEP 2
SIP : 051/DU/2014
Telp. (0331) 8768797 Dr. Irwan Sumarwan R/ Balsam peru 0,100 g
Jember, 20/12/2017 Jl. KH. Hasyim Asyari 67 Jember Ol. Olivae 0,300 g
Mg. Carbonas 0,750 g
R/ Methampyron 250 mg Jember, 20/12/2017
Amylum 1,500 g
Diazepam 1 tab Talk ad 5g
R/ Metronidazol 1/3 tab
Mf. Pulv da in caps dtd No VIII Mf. Pulv adsp
Loperamid 1/3 tab
S. tdd s.u.e
Mf. Pulv dtd no XV
S. b dd pulv I
Pro : Jasmine ( )
Pro : An. Naura (7 th)
Pro : Febby
- da 6 -

SERI VII SERI VIII

SERI IX
RESEP 1 APOTEK ALQODIRI RESEP 1
JL. Manggar 139 Jember
RESEP 1
APA : Arinda S.Farm., Apt Dr. Edo Syahputra
Dr. Reza
SIPA : 01-01-2016 SIA 310885 Jl. PB. Sudirman 45 Jember
Jember, Jl. Cendrawasih 100 Jember
Telp. (0331) 8768797
COPY RESEP Telp. (0331) 4255789
Pro : Karyanto Umur : 12 th
Dokter : Ana marisa Tgl : 11-12-2017 R/ Ekstrak Hyosiami 0,025 g
R/ Ol. Olivae 5g
Methampyron 0,125 g
R/ Calamin 5 g PGA qs
Lactosa 0,062 g
Champora 0,5 Syr . Citri 5g
Bentonite 1% Mf. La. Pulv dtd No VIII
Aqua ad 50
Etanol 40% 10 ml S. prn pulv I
Mf potio
Aqua ad 100
Mf. Lotion S. hs. II C
Pro : Ulfa (9 th)
- did –
p.c.c paraf APA
Pro : Shanum ( 11 th)
 Dr. Dian Retno
Jl. Letjen Suprapto X No. 21A Jember
SIP : 234/ DU/ 2017
Jember, 20/12/2017

R/ Methampyron ¼ tab
GG ¼ tab
CTM ¼ tab
Mf. Caps dtd No XX

( da VIII)

Pro : Ashima ( 8 th)