Dr. Salamoon SIP : 1289137/SIK/1990 Jl. Ciwidey 222 Bandung Tgl. trisulfa Ac. Citric Syr simplex Aqua ad M f potio 60 S tdd cth I-II 0,500 0.200 1,5 5 PUSKESMAS MARGAHAYU JL. KOPO SAYATI NO 223 NO. Tgl. Cosyr syr Adde Pro dos sing Luminal M f potio 60 S tdd cth I-II 60
NO.
R/
R/
0,1
Pro : ninik Alamat : Dr. Salamoon SIP : 1289137/SIK/1990 Jl. Ciwidey 222 Bandung Tgl.
Pro : ninik (5 th) Alamat : PUSKESMAS MARGAHAYU JL. KOPO SAYATI NO 223 NO. Tgl.
NO.
R/ chloramphenicol
CTM Pseudoefedrin HCL
M f potio 60 S tdd cth I Pro : ninik Alamat :
120 mg 1 mg 10 mg
R/ Parafin liq
PGA phenolphthalein Aqua ad m.f.emuls.100 S.vesp.C.II
Pro : ninik Alamat :
NO.
R/ Bedak keringat 50
Mds. Pulv ads Det 30 Pro : ninik Alamat :
R/
Dokter M. Salamoen Jl. Pasteur No. 31 Telp. 59710 Bandung SIP No. 03/KW/1987 NO. E Tgl. NO.
Dokter Haryanto Jl. sukajadi No. 11 Telp. 59710 Bandung SIP No. 08/KW/1988 E Tgl.
R/
tablet natrium subkarbonat No.I Adde pro dos sing Opii tinct. 0,250 Elaeo.sacch.MP q.s
20 20.000UI
Dr. Salamoon SIP : 1289137/SIK/1990 Jl. Ciwidey 222 Bandung NO. E Tgl. NO.
Tgl.
R/
75 mg No.VI 3
R/