Telp. 865644
Jl . Kalirungkut No. 20 Surabaya
APA = Susi Susilawati S. Farm.,Apt
COPY RESEP
R/ sanprima sirup
S. b.d.d cth II
___________ndet__________
R/ Paracetamol 150 mg
CTM Tab 1/3
Ambroksol Tab 1/3
Saccharum lactis q.s
m.f.Pulv. dtd. No. X
s. t.d.d I
____________det__________
P.C.C.