SOAL UPK RESEP

SERI I

Dr. Agnesia Miranti Dr. Rahardi

SIP. No. 65/SK/2355/XI/14 SIP. No. 78/SK/1234/XI/14
Jalan. Lingkaran timur 15 Tlp. 724152 Jalan. Persegi 18 Tlp. 232421
SUKABUMI SUKABUMI

1A 1B

R/ R/
Calamin 1% Potio Nigra 100ml
ZNO 2% Add pro cth
Champora 0,25 Codein Hcl 5mg
Talk ad 20
m.f potio
m.f pulv adsp S . t.d.d.I
S.U.E

Pro : Gumilang Pro : Antik

Dr. Julaeha Dr. Suparman

SIP. No. 440/SK/1234/XI/14 SIP. No. 264/SK/1252/XI/14
Jalan. Cibaraja 04 Tlp. 234782 Jalan. Cisaat 18 Tlp. 235421
SUKABUMI SUKABUMI

1C 1D

R/ R/
Rifampicin 300mg Chlorampenicol Palm 125mg
INH 100mg CMC Na 50mg
Pyridoxin Hcl 10mg Propylenglicol 1ml
Lactosum 100mg Sirup 1,5gr
Aquadest ad 5 ml
m.f. pulv. dtd.no.C
S I dd Pulv I Ac m.f. Suspensi
S Prn cth II

Detur XC da 75ml

Pro : virly
Pro : Fauzan (30kg) Alamat : Jl. Batu lingkar no. 24
 SOAL UPK RESEP

SERI II

Dr. Agnesia Dr. Rahardi

SIP. No. 440/SK/1234/XI/14 SIP. No. 78/SK/1234/XI/14
Jalan. Cibaraja 04 Tlp. 234782 Jalan. Persegi 18 Tlp. 232421
SUKABUMI SUKABUMI

2A 2B

R/ R/
Menthol 0,5 % Phenobarbital 0,15
Acid Salicyl 1% Acetaminophenum 3
Champora 0,5% SL qs
Talk ad 15
m.f pulv no x
Mds. Obat Gatal S . 4. d. d. pulv I

Pro : Selly
Pro : Galuh Umur : 8 tahun

Dr. Julaiha Dr. Suparman

SIP. No. 78/SK/1234/XI/14 SIP. No. 264/SK/1252/XI/14
Jalan. Persegi 18 Tlp. 232421 Jalan. Cisaat 18 Tlp. 235421
SUKABUMI SUKABUMI

2C 2D

R/ R/
Salep 4-8 20 Acid Salicyl 0,25
Add Amylum 5
Hidrocortison acetat 2,5% Ol. Rosae gtt III
Talcum Venet ad 20
Mds. ue
m.f. pulv adsp
S pulv adsp ue

Pro : Fauzan (30kg) Pro : raisya

Alamat : Jl. Batu lingkar no. 24
 SOAL UPK RESEP

SERI III

Dr. Agnesia Dr. Rahardi

SIP. No. 440/SK/1234/XI/14 SIP. No. 78/SK/1234/XI/14
Jalan. Cibaraja 04 Tlp. 234782 Jalan. Persegi 18 Tlp. 232421
SUKABUMI SUKABUMI

3A 3B

R/ R/
Spasmal ¾ As. Salisilat 0,5
Alukol 0,3 Talc 5
Amilum Manihot 5
m. f. caps. dtd. no x Etanol 90% ad 50ml
S 3 dd Cap I pc
Mds. Lotio

Pro : Agus Pro : Merry

BB : 35 kg Umur : 8 tahun

Dr. Julaiha Dr. Suparman

SIP. No. 78/SK/1234/XI/14 SIP. No. 264/SK/1252/XI/14
Jalan. Persegi 18 Tlp. 232421 Jalan. Cisaat 18 Tlp. 235421
SUKABUMI SUKABUMI

3C 3D

R/ R/
Champora 0,500 Menthol 2,5%
Acid Oleinic 0,500 Champora 1,0%
Ammon Liq ad 20 Acid Salicyl 2%
Talc ad 75
Mds. Liniment
Mds. Pulv adspers

da 1/5 pars

Pro : Ramon
Pro : Reza Alamat : Jl. Batu lingkar no. 24
 SOAL UPK RESEP

SERI IV

Dr. Agnesia Dr. Rahardi

SIP. No. 440/SK/1234/XI/14 SIP. No. 78/SK/1234/XI/14
Jalan. Cibaraja 04 Tlp. 234782 Jalan. Persegi 18 Tlp. 232421
SUKABUMI SUKABUMI

4A 4B

R/ R/
Potio nigra 60ml Menthol 0,2
Contin Ac. Salicyl 1
Syr thyme 10ml ZnO 20
CTM 40mg Talcum ad 100
Aminophillyn 800mg

mf potio Da 1/5 part

S 3. d. d. cth II

Pro : Tessa
BB : 8 th Pro : windi

Dr. Julaiha Dr. Suparman

SIP. No. 78/SK/1234/XI/14 SIP. No. 264/SK/1252/XI/14
Jalan. Persegi 18 Tlp. 232421 Jalan. Cisaat 18 Tlp. 235421
SUKABUMI SUKABUMI

4C 4D

R/ R/
Acetosal tab no. IV Salep 2 - 4 1
CTM 0,020 add
Cortison 1,0%
m.f. Pulv no X
S. Prn 3 dd I Mds. ue

Pro : Yulia
Pro : Dian (10 th)
 SOAL UPK RESEP

SERI V

Dr. Agnesia Dr. Rahardi

SIP. No. 440/SK/1234/XI/14 SIP. No. 78/SK/1234/XI/14
Jalan. Cibaraja 04 Tlp. 234782 Jalan. Persegi 18 Tlp. 232421
SUKABUMI SUKABUMI

5A 5B

R/ R/
Codein tab no. VIII
Salicylamid 1
Acidum Boricum Gutt. Auriculares 20ml Clhortrimeton 0,3

S 3 dd gtt II m.f pulv no X

S. prn 3 dd p I

Pro : Satrio Pro : Diaz (10 th)

Dr. Julaiha Dr. Suparman

SIP. No. 78/SK/1234/XI/14 SIP. No. 264/SK/1252/XI/14
Jalan. Persegi 18 Tlp. 232421 Jalan. Cisaat 18 Tlp. 235421
SUKABUMI SUKABUMI

5C 5D
R/
R/ Potio nigra 30ml
Salep Prednisolon 10 add
Gentamicyn 0,3% GG 0,120

Mds 3 dd ue mf potio
S Bila batuk . cth II

Pro : Tessa
Pro : Kania BB : 8 th
 SOAL UPK RESEP

SERI VI

Dr. Agnesia Dr. Rahardi

SIP. No. 440/SK/1234/XI/14 SIP. No. 78/SK/1234/XI/14
Jalan. Cibaraja 04 Tlp. 234782 Jalan. Persegi 18 Tlp. 232421
SUKABUMI SUKABUMI

6A 6B

R/ R/
Pyrazinamid 200mg
Ichtiyol 1% Rifampicin 100mg
ZnO 5% INH 100mg
As. Salicilat 3% Vit. B6 5mg
Talk ad 20
m. f. pulv . dtd. no X

S ue

Pro : Yuaza Pro : Diaz (10 th)

B.Badan : 35 kg

Dr. Suparman
Dr. Julaiha
SIP. No. 264/SK/1252/XI/14
SIP. No. 78/SK/1234/XI/14
Jalan. Cisaat 18 Tlp. 235421
Jalan. Persegi 18 Tlp. 232421
SUKABUMI
SUKABUMI
6D
6C
R/
OBH duplex 60ml
R/
Adde
Oxytetracyclin 2%
Ambroxol Hcl 0,12
Ichtamolum 2%
Vas. Flavum ad 10
m.f potio
S. Bila Batuk cth II
m. f. l.a. ungt
S. Salep Bisul

Pro : Juan
Pro : Ny. Raisya
 SOAL UPK RESEP

SERI VII

Dr. Agnesia Dr. Rahardi

SIP. No. 440/SK/1234/XI/14 SIP. No. 78/SK/1234/XI/14
Jalan. Cibaraja 04 Tlp. 234782 Jalan. Persegi 18 Tlp. 232421
SUKABUMI SUKABUMI

7A 7B

R/ R/
Ibuprofen 100mg/cth
Salep 4 – 8 20 Sorbitol sol 70% 10ml
Contin Sir. Simplex 10%
Hidrocortison Acetat 2,5% Aquadest ad 60ml

m.f. ungt m.f. potio

S obat gatal S 3 dd cth i

Pro : Yuaza (10 th) Pro : Yoan

Dr. Julaiha Dr. Suparman

SIP. No. 78/SK/1234/XI/14 SIP. No. 264/SK/1252/XI/14
Jalan. Persegi 18 Tlp. 232421 Jalan. Cisaat 18 Tlp. 235421
SUKABUMI SUKABUMI
7C 7D
R/
R/ Acid Salicyl 2%
Ibuprofen 0,100 Acid Benzoic 1,5%
Vit. C 0,050 Talcum 20
Thiamin Hcl 0,050
Coffein 0,03 Mds. Pulv adspers
m.f. pulv. dtd. No. X
S 3 dd I

Pro : Nn. Gea Pro : Helena

Umur : 21 th
 SOAL UPK RESEP

SERI VIII

Dr. Agnesia Dr. Rahardi

SIP. No. 440/SK/1234/XI/14 SIP. No. 78/SK/1234/XI/14
Jalan. Cibaraja 04 Tlp. 234782 Jalan. Persegi 18 Tlp. 232421
SUKABUMI SUKABUMI

8A 8B

R/ R/
Tetrasiklin Hcl 2% Difenhidramine Hcl 50 mg
Bezokain 3% Cofein 100 mg
Ungt simplek ad 15 Laktosa qs

Mds ue m.f. pulv. dtd no x

S 3 dd I

Pro : Yuaza Pro : An. Melisa (7 th)

Dr. Julaiha Dr. Suparman

SIP. No. 78/SK/1234/XI/14 SIP. No. 264/SK/1252/XI/14
Jalan. Persegi 18 Tlp. 232421 Jalan. Cisaat 18 Tlp. 235421
SUKABUMI SUKABUMI

8C 8D

R/ R/
Balsam Peru 1% Sir. Ottoprim 60ml
ZnO 5% Contin
As. Salicil 2% Papaverin Hcl 0,005/5ml
Talcum 20
m.f. pulv. adspers Mds. M et V cth I
S ue

Pro : Helena Pro : Bastian (5 tahun)

 SOAL UPK RESEP

SERI IX

Dr. Agnesia Dr. Rahardi

SIP. No. 440/SK/1234/XI/14 SIP. No. 78/SK/1234/XI/14
Jalan. Cibaraja 04 Tlp. 234782 Jalan. Persegi 18 Tlp. 232421
SUKABUMI SUKABUMI

9A 9B

R/ R/
Antistine 0,100 Menthol 3%
Benzocain 1% ZnO 10%
Champora 2%
Mf. Guttae auric 20ml Talcum ad 100
S 3 dd gtt II auric
Mf pulv adspers
S uc da ¼

Pro : Danisa Pro : An. Melisa (7 th)

Dr. Julaiha Dr. Suparman

SIP. No. 78/SK/1234/XI/14 SIP. No. 264/SK/1252/XI/14
Jalan. Persegi 18 Tlp. 232421 Jalan. Cisaat 18 Tlp. 235421
SUKABUMI SUKABUMI

9C 9D

R/ R/
Phenobarbital 0,15 Champora 2%
Pct 3 As. Benzolac 3%
SL qs Sulfur PP 5%
Cera alba 1,5
m. f. pulv no x
S 4 dd P I m.f ungt 20
d.s Salep gatal

Pro :Alya (8 th ) Pro : Damian

 SOAL UPK RESEP

SERI X

Dr. Agnesia Dr. Rahardi

SIP. No. 440/SK/1234/XI/14 SIP. No. 78/SK/1234/XI/14
Jalan. Cibaraja 04 Tlp. 234782 Jalan. Persegi 18 Tlp. 232421
SUKABUMI SUKABUMI

10A 10B

R/ R/
Calcii Carbon 5 Acidum Boricum Sol 3%
Pulv. Gummos 2%
Sir. Simplex 20 S ue (Tidak untuk cuci mata)
Aq. Dest ad 175

mf. Susp. da. 100cc

S 3 dd C PC

Pro : Yasmin Pro : An. Melisa (7 th)

Dr. Julaiha Dr. Suparman

SIP. No. 78/SK/1234/XI/14 SIP. No. 264/SK/1252/XI/14
Jalan. Persegi 18 Tlp. 232421 Jalan. Cisaat 18 Tlp. 235421
SUKABUMI SUKABUMI

10C 10D

R/ R/
Hidrcortison Acid 2,5% Amoxillin 250mg
Salep 2 – 4 ad 20 Luminal 1/3
Ambroxol 1/3
Mds. ue Ctm 2mg

m.f l.a pulv. dtd. No. IX

S 3 dd I

Pro :Alya (8 th ) Pro : Arina (10 th)