OBAT DRIP OBAT DRIP OBAT DRIP

JAM.......................TANGGAL............................ JAM.......................TANGGAL............................ JAM.......................TANGGAL............................

BOTOL KE........................................................... BOTOL KE........................................................... BOTOL KE...........................................................
OBAT DRIP JUMLAH (MG) OBAT DRIP JUMLAH (MG) OBAT DRIP JUMLAH (MG)

OBAT DRIP OBAT DRIP OBAT DRIP

JAM.......................TANGGAL............................ JAM.......................TANGGAL............................ JAM.......................TANGGAL............................
BOTOL KE........................................................... BOTOL KE........................................................... BOTOL KE...........................................................
OBAT DRIP JUMLAH (MG) OBAT DRIP JUMLAH (MG) OBAT DRIP JUMLAH (MG)

OBAT DRIP OBAT DRIP OBAT DRIP

JAM.......................TANGGAL............................ JAM.......................TANGGAL............................ JAM.......................TANGGAL............................
BOTOL KE........................................................... BOTOL KE........................................................... BOTOL KE...........................................................
OBAT DRIP JUMLAH (MG) OBAT DRIP JUMLAH (MG) OBAT DRIP JUMLAH (MG)

OBAT DRIP OBAT DRIP OBAT DRIP

JAM.......................TANGGAL............................ JAM.......................TANGGAL............................ JAM.......................TANGGAL............................
BOTOL KE........................................................... BOTOL KE........................................................... BOTOL KE...........................................................
OBAT DRIP JUMLAH (MG) OBAT DRIP JUMLAH (MG) OBAT DRIP JUMLAH (MG)