PRAKTIK MANDIRI DOKTER

Dr. RIZKY FUTARI RENGGANA

Jl. Kp Sanding I, No.23, 004/002, Bj. Nangka, Gn. Putri, Kab. Bogor
Telp : 081283308246, E-mail : klinikrenggana@gmail.com

RESEP OBAT

Dokter : .......................................................................................................................
Pasien : .......................................................................................................................
Usia : ………………………………………………………………………......................
Berat Badan : ………………………………………………………………………......................
Alergi Obat : ……………………………………………………………………………………….

R/

Bogor, .........................

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FRM / URJ / 01