dr. Dewi Anjarwati dr. Herman Sugiarto Sp.

PD
SIP. No. 376 / DKK-DN/II/2019 SIP. No. 046 / DKK-DN/II/29/2019
Jl. Ligu Tengah No. 1156 Bandung Jl. Lingga kencana No. 115 Bandung
Tlp. 022-777665 Tlp. 022-776665
N0.01 Bandung, 18 September 2023 N0.02 Bandung, 18 September 2023

R/Parasetamol 100 mg R/Phenobarbitalum 0,5

SL qs SL qs

m.f pulv. dtd no. VIII m.f pulv dtd no X

S. 3 dd 1 s.3 dd pulv 1

Pro : Tn Bahar Pro : Ny. suharti

Umur : 17 th Umur : 40 th
Alamat : Jl. Kenanga no. 5 Bandung Alamat : Jl. Ranting utara no. 5 Bandung

dr. Rio Hartanto dr. Susilo wibowo

SIP. No. 046 / DKK-DN/II/29/2019 SIP. No. 077/ DKK-DN/II/03/2019
Jl. sukma No. 120 Bandung Jl. sukma No. 120 Bandung
Tlp. 022-727665 Tlp. 022-727685
N0.03 Bandung, 18 September 2023 N0.04 Bandung, 18 September 2023

R/Dextro. Hbr 15 mg R/Dextrometorphan Hbr 15 mg

Parasetamol 1 tab Dexamethason 0,5 mg
CTM 1/2 tab CTM 1/2 tab
m.f pulv. Da in caps dtd no. VIII m.f pulv. da in cap no. VIII
S. Prn 3 dd Caps 1 S. 3 dd Caps 1
- ITER 2X - - ITER 2X –

Pro : Suharti Pro : Tn Bahar

Umur : 18 th Umur : 17 th
Alamat : Jl. yasmin no. 20 Bandung Alamat : Jl. Kenanga no. 5 Bandung