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    The document appears to be a form from Apotek Virlian, a pharmacy located on Jl. Raya Cilimus No. 250. It records patients' tea and spoon consumption before and after meals over multiple dates. The form includes the pharmacy address and contact information, and is signed by the pharmacist Yayan Daryanto.

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    The document appears to be a form from Apotek Virlian, a pharmacy located on Jl. Raya Cilimus No. 250. It records patients' tea and spoon consumption before and after meals over multiple dates. The form includes the pharmacy address and contact information, and is signed by the pharmacist Yayan Daryanto.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
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    11 views1 page

    Label 2

    Uploaded by

    idafarida
    The document appears to be a form from Apotek Virlian, a pharmacy located on Jl. Raya Cilimus No. 250. It records patients' tea and spoon consumption before and after meals over multiple dates. The form includes the pharmacy address and contact information, and is signed by the pharmacist Yayan Daryanto.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    PUSKESMAS JALAKSANA

    APOTEK VIRLIAN APOTEK VIRLIAN


    Jl. Raya Jalaksana no.158 Tlp.0232-874767
    ., Apt Jl. Raya Cilimus No. 250 Tlp.0232-615298 Jl. Raya Cilimus No. 250 Tlp.0232-615298
    APOTEKER YAYAN DARYANTO, S.Farm., Apt APOTEKER YAYAN DARYANTO, S.Farm., Apt
    SIPA: 503/IV.1/074 / Jamsarkes SIPA: 503/IV.1/074 / Jamsarkes

    NO.R/ Tgl.
    NO.R/ Tgl. NO.R/ Tgl.

    Sendok
    Teh Sendok Sendok
    Teh Teh

    Sehari ......................... X .............. Sendok Makan


    Sehari ......................... X .............. Sendok Makan Sehari ......................... X .............. Sendok Makan
    APOTEK VIRLIAN APOTEK VIRLIAN APOTEK VIRLIAN
    Jl. Raya Cilimus No. 250 Tlp.0232-615298 Jl. Raya Cilimus No. 250 Tlp.0232-615298 Jl. Raya Cilimus No. 250 Tlp.0232-615298
    APOTEKER YAYAN DARYANTO, S.Farm., Apt APOTEKER YAYAN DARYANTO, S.Farm., Apt APOTEKER YAYAN DARYANTO, S.Farm., Apt
    SEBELUM / SESUDAH
    SIPA: 503/IV.1/074 MAKAN
    / Jamsarkes SIPA: 503/IV.1/074 / Jamsarkes SIPA: 503/IV.1/074 / Jamsarkes
    SEBELUM / SESUDAH MAKAN SEBELUM / SESUDAH MAKAN

    NO.R/ Tgl. NO.R/ Tgl. NO.R/ Tgl.

    Sendok Sendok Sendok


    Teh Teh Teh

    Sehari ......................... X .............. Sendok Makan Sehari ......................... X .............. Sendok Makan Sehari ......................... X .............. Sendok Makan
    APOTEK VIRLIAN APOTEK VIRLIAN APOTEK VIRLIAN
    Jl. Raya Cilimus No. 250 Tlp.0232-615298 Jl. Raya Cilimus No. 250 Tlp.0232-615298 Jl. Raya Cilimus No. 250 Tlp.0232-615298
    APOTEKER YAYAN DARYANTO, S.Farm., Apt APOTEKER YAYAN DARYANTO, S.Farm., Apt APOTEKER YAYAN DARYANTO, S.Farm., Apt
    SIPA: 503/IV.1/074 / Jamsarkes SIPA: 503/IV.1/074 / Jamsarkes SIPA: 503/IV.1/074 / Jamsarkes
    SEBELUM / SESUDAH MAKAN SEBELUM / SESUDAH MAKAN SEBELUM / SESUDAH MAKAN

    NO.R/ Tgl. NO.R/ Tgl. NO.R/ Tgl.

    Sendok Sendok Sendok


    Teh Teh Teh

    Sehari ......................... X ..............


    APOTEK Sendok Makan
    VIRLIAN Sehari ......................... X ..............
    APOTEK Sendok Makan
    VIRLIAN Sehari ......................... X ..............
    APOTEK Sendok Makan
    VIRLIAN
    Jl. Raya Cilimus No. 250 Tlp.0232-615298 Jl. Raya Cilimus No. 250 Tlp.0232-615298 Jl. Raya Cilimus No. 250 Tlp.0232-615298
    APOTEKER YAYAN DARYANTO, S.Farm., Apt APOTEKER YAYAN DARYANTO, S.Farm., Apt APOTEKER YAYAN DARYANTO, S.Farm., Apt
    SIPA: 503/IV.1/074 / Jamsarkes SIPA: 503/IV.1/074 / Jamsarkes SIPA: 503/IV.1/074 / Jamsarkes
    SEBELUM / SESUDAH MAKAN SEBELUM / SESUDAH MAKAN SEBELUM / SESUDAH MAKAN

    NO.R/ Tgl. NO.R/ Tgl. NO.R/ Tgl.

    Sendok Sendok Sendok


    Teh Teh Teh

    Sehari ......................... X .............. Sendok Makan Sehari ......................... X .............. Sendok Makan Sehari ......................... X .............. Sendok Makan
    APOTEK VIRLIAN APOTEK VIRLIAN APOTEK VIRLIAN
    Jl. Raya Cilimus No. 250 Tlp.0232-615298 Jl. Raya Cilimus No. 250 Tlp.0232-615298 Jl. Raya Cilimus No. 250 Tlp.0232-615298
    APOTEKER YAYAN DARYANTO, S.Farm., Apt APOTEKER YAYAN DARYANTO, S.Farm., Apt APOTEKER YAYAN DARYANTO, S.Farm., Apt
    SIPA: 503/IV.1/074 / Jamsarkes SIPA: 503/IV.1/074 / Jamsarkes SIPA: 503/IV.1/074 / Jamsarkes
    SEBELUM / SESUDAH MAKAN SEBELUM / SESUDAH MAKAN SEBELUM / SESUDAH MAKAN

    NO.R/ Tgl. NO.R/ Tgl. NO.R/ Tgl.

    Sendok Sendok Sendok


    Teh Teh Teh

    Sehari .........................APOTEK
    X .............. Sendok Makan Sehari .........................APOTEK
    X .............. Sendok Makan Sehari .........................APOTEK
    X .............. Sendok Makan
    VIRLIAN VIRLIAN VIRLIAN
    Jl. Raya Cilimus No. 250 Tlp.0232-615298 Jl. Raya Cilimus No. 250 Tlp.0232-615298 Jl. Raya Cilimus No. 250 Tlp.0232-615298
    APOTEKER YAYAN DARYANTO, S.Farm., Apt APOTEKER YAYAN DARYANTO, S.Farm., Apt APOTEKER YAYAN DARYANTO, S.Farm., Apt
    SIPA: 503/IV.1/074 / Jamsarkes SIPA: 503/IV.1/074 / Jamsarkes SIPA: 503/IV.1/074 / Jamsarkes
    SEBELUM / SESUDAH MAKAN SEBELUM / SESUDAH MAKAN SEBELUM / SESUDAH MAKAN

    NO.R/ Tgl. NO.R/ Tgl. NO.R/ Tgl.

    Sendok Sendok Sendok


    Teh Teh Teh

    Sehari ......................... X .............. Sendok Makan Sehari ......................... X .............. Sendok Makan Sehari ......................... X .............. Sendok Makan
    APOTEK VIRLIAN APOTEK VIRLIAN APOTEK VIRLIAN
    Jl. Raya Cilimus No. 250 Tlp.0232-615298 Jl. Raya Cilimus No. 250 Tlp.0232-615298 Jl. Raya Cilimus No. 250 Tlp.0232-615298
    APOTEKER YAYAN DARYANTO, S.Farm., Apt APOTEKER YAYAN DARYANTO, S.Farm., Apt APOTEKER YAYAN DARYANTO, S.Farm., Apt
    SIPA: 503/IV.1/074 / Jamsarkes SIPA: 503/IV.1/074 / Jamsarkes SIPA: 503/IV.1/074 / Jamsarkes
    SEBELUM / SESUDAH MAKAN SEBELUM / SESUDAH MAKAN SEBELUM / SESUDAH MAKAN

    NO.R/ Tgl. NO.R/ Tgl. NO.R/ Tgl.

    Sendok Sendok Sendok


    Teh Teh Teh

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