Date: 8 Dec 2023

MOHON DANA DAPAT LANGUNG DIBAYARKAN

KE REKENING BANK DI BAWAH INI:

BCA An. Surya Nugraha 146 188 0075

Senilai 265.500,-
 PURCHASE REQUEST (PR) FARMASI
No : PR/KIBM-BALI/FARMASI/2023120003 Pengajuan oleh:
Date : 07/12/2023 INTIBIOS LAB, KLINIK & FARMASI
Delivery : Regular - BALI -
Supplier : Apotek Adhi Guna Farma 2 Jl. Raya Puputan No 68X, Renon Denpasar Timur
Alamat : Jalan Mayjen Sutoyo No. 45 Denpasar
No Telepon : 081139015888
No Rekening BCA : 1461880075 (An. Surya Nugraha)

No. Nomor Katalog Nama Barang Kemasan Unit Qty Stock On Hand Note

1 NEW Pantoprazole Injeksi Box @ 1 Vial Box 10 0 Kebutuhan Klinik

TOTAL 10
Prepared By Verified By Verified By Approved By

apt. Retno Intan dr. IB Alit Raditya Jayaputra Maya Nurfajriah dr. Ida Bagus Darmawiguna
Head Ops. Medis /
Apoteker SPV Farmasi Branch Manager Klinik Bali
Dokter Umum
/ Ibu Eka Apotek Adhi Guna Frama 2