FORM LOGISTIK VAKSIN

Instansi :
Bulan : MEI
Tahun : 2017

Jumlah
Vaksin
No Nama Vaksin Nama Distributor No. Batch Tgl Expired
Diorder
(Perbulan)
1 2 3 4 5 6
1 BCG RAJAWALI NUSINDO 711816 12/31/2018 2 BOX @ 10 VIAL
2 CERVARIX APL AHPVA292AM 5/30/2018 9 VIAL

3 ENGERIX B JUNIOR APL AHBVC618AA 3/31/2019 15 VIAL

4 ENGERIX B ADULT APL AHBVC591EB 1/31/2019 2 VIAL

5 GARDASIL APL MO31131 3/15/2019 9 VIAL

6 HAVRIX JUNIOR APL AHAVB883AF 1/31/2018 15 VIAL

7 HEXAXIM APL MO1801M 1/31/2018 31 VIAL

8 HEXAXIM APL M71576V 2/28/2018 10 VIAL

9 PPDRT 23 INJ 1,5ML RAJAWALI NUSINDO 6500116 11/30/2017 1 VIAL

10 PREVENAR APL R91885 8/31/2019 55 VIAL

11 ROTARIX APL AROLB580AB 9/30/2018 45 VIAL

12 SYNFLORIX APL ASPNA788AF 3/31/2018 35 VIAL

13 THYPIM APL N1A424V 1/31/2019 10 VIAL

14 TETAGAM AAM 34645821B 1/1/2019 3 VIAL

15 VARILRIX APL A70CC936A 2/28/2018 20 VIAL

16 BOSTRIX APL AC37B225BN 9/30/2018 10 VIAL

17

18

19

20

21

Mengetahui Surabaya,
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