PENGAMBILAN OBAT PRB KIMIA FARMA

BULAN : MARET 2022

TANGGAL TANGGAL
NO NAMA NO BPJS TTD & NAMA KET
HABIS OBAT PENGAMBILAN
Ramirpil 10 mg 30
1 AGIL PRIAMBODO 0000147838241 Adalat oros 30
Concor 10 mg 30
Sansulin 1
2 AGUS DIYONO 0002273410574 Nitrokaf R 30
Metformin 850 mg 60
3 AGUS TRIYANI D 0001268342515 Metformin 500 mg 90
4 AMIYEM 0001268420005 Glimepirid 4 mg 30
Diltiazem 90
5 ANASTASIA HARTATI 0001816326371 Nitrokaf R 60
Candesartan 16 mg 30
BSP 5 mg 30
6 ASIH 0002461871171 Candersartan 16 mg 30
Adalat oros 30
Amlodipin 10 mg 30
7 DADI KARTINAH 0001273624479 BSP 5 mg 30
Gliquidone 90
8 DEWI SRI PALUPI 0000090097716 metformin 500mg 90
Tanapres 10 mg 30
9 EDHIE HASTUTI 0000089765021 Vit B12 30
Novomix 5
Candesartan 8 mg 30
10 ENDAH TRIHASTUTI Metformin 500 mg 90
Allopurinol 10 mg 30

Metformin 500 mg 30
Amlodipin 10 mg 30
11 ENDANG SRI W 0001526268518 BSP 5 mg 30
Candesartan 16 mg 30

LANTUS 1
Acarbose 50 mg 90
12 ENJEN 0001530725984 Herbesser 200 mg 30
Metformin 500 mg 90

13 ETIK HANDAYANI 0002034888546 Candesartan 8 mg 30

Candesartan 8 mg 30
14 FITRI ROOSTIYAHWATI 0001815760315 Metformin 500 mg 90
Glimepiride 2 mg 30

HUMALOG
Bsp 2,5 mg 30
15 HADI MULYANTO 0001799979388 Candesartan 16 mg 30
Adalat oros 30 mg
Spironolacton 25 mg 30

Glimepirid 1 mg 30
16 HENDRO NUFIANTO 0001531166815 Metformin 500 mg 90
Ramipril 5 mg 30

Metformin 500 mg 90
Amlodipin 10 mg 30
17 HENDRO PITOYO 0001439396087 Diovan 160 15
Miniaspi 30
Glimepirid 4 mg 30
18 KOMARIAH 0001524947512 Metformin 500 mg 60
19 LAGINEM 0001022299413
BSP 5 mg 30
20 LINA INDRIYANA 0001532968345 Amlodipin 10 mg 30
Candesartan 16 mg 30
21 LISTIANA DS 0000147838252 Symbicort 1
Risperidone 2 mg 60
22 MAMIK SUPARSI 0000569502977 THP 2 mg 60
 Amlodipin 5 mg 30
23 MARSONO 0000978031585 Miniaspi 30
Ramipril 10 mg 30
24 MARTIANA S S 0001441884756 Amlodipin 10 mg 30
Ramipril 10 mg 30
25 MM SUJATMI 0000089712865 Concor 10 mg 30
Amlodipin 10 mg 30

Meformin 500 mg 60
26 MUHAMMAD HATTA 0000091028788 Acarbose 50 mg 60
Amlodipin 10 mg 30

27 MUGIJEM 0001815628195
LANTUS 3
Amlodipin 10 mg 30
BSP 5 mg 30
28 MURTINI 0001421696496 Glimepiride 4 mg 30
Lisinopril 10 mg 30
ISDN 90

Amlodipin 10 mg 30
29 NGADIYEM 0001277309158 Lisinopril 10 mg 30
Amlodipin 5 mg 30
30 NINIK SUSILAWATI 0001874173419 Concor 2.5 mg 30
Nitrokaf R 60

Amlodipin 10 mg 30
Lisinopril 5 mg 30
31 PARDJIMAN 0000091039937 ISDN 30
Miniaspi 30

32 PARYANI 0001129874376
BSP 2,5 mg 30
33 PUJI RAHAYUNINGSIH 0001171829068 furosemid 30
candesartan 8 mg 30

Candesartan 8 mg 30
Amlodipin 10 mg 30
34 RA. ANICETHA MENIK 0000090914657 Vit B12 30
Bisoprolol 2,5 mg 30
Glimepiride 1 mg 30
35 RETMIYATI 0002276322434 Metformin 850 mg 60
Amlodipin 10 mg 30
36 RETNO SUBEKTI 0001481699384 Irbesartan 150 mg 30
Spironolacton 25 mg 30
Miniaspi 30
37 RIEN NURUL 0001794937195 Amlodipin 10 mg 30
Vit B 12 30
Amlodipin 10 mg 30
38 RUSDI 0001524914774 BSP 5 mg 30
Metformin 500 mg 90
Ramipril 10 mg 30
39 SAMSIKIN 0001441041445 Adalat oros 30
BSP 5mg 30
Symbicort 1
40 SARAH YAHUNI 0001809948205 Vit B1 30
Metformin 850 mg 60
41 SARDINEM 0002093997036 Gliquidon 90
Lisinopril 10 mg 30
LANTUS 4
42 SARSONO 0001525027601 Gliquidone 30
Amlodipin 10 mg 30
Gliquidone 30
43 SIH TAMI 0001310411755 Candesartan 30
BSP 5 30
HUMALOG 3
44 SISWANTI 0002269667406 Metformin 500 mg 30
45 SITI LESTARI 0001313166284 Amlodipin 5 mg 30
Metformin 500 mg 90
46 SOEPIYAH 0000089871243 Vit B1 30
Diamicron MR 30
47 SOEWARSONO 0000088711018 Candesartan 30
 Acarbose 50 mg 90
48 SRI LESTARI 0002596699236 Glimepiride 2 mg 30
Lisinopril 10 mg 30
49 SRI MARGIYATI 0001381842088 Amlodipin 10 mg 30
Candesartan 16 mg 30
50 SRI MULYANI 0001295839034 Nitrokaf R 30
Gliquidone 30
51 SRI PURWANTI 0001526137593 Metformin 500 mg 90
Gliquidon 30
Metformin 500 mg 30
52 SRI SUHARTI 0000089868756 Ramipril 10 mg 30
BSP 5 mg 30

Metformin 500 mg 90
BSP 5 mg 30
53 SRI SUHARTINI 0000092014119 Glimepirid 4 mg 30
Miniaspi 30
Galvus 50 mg 30

Metformin 500 mg 60
54 SRI SUMARNI 0002295086793 Gliquidone 90
55 SRI SUPADMI 0001306295919 Gliquidon 15

Miniaspi 30
BSP 5 mg 30
56 SUGENG SUPRIYONO 0000086921818 ISDN 90
Lisinopril 5 mg 30

57 SUHARNI 0000089961592
Candesarta 16 mg 30
58 SUHARTI 0001793765272 Amlodipin 10 mg 30
Miniaspi 30
Glimepirid 2 mg 30
59 SUKARMO 0001631350967 Metformin 500 mg 90
Amlodipin 5 mg 30
60 SUKIDI 000568070458 Miniaspi 30
Amlodipin 10 mg 30
61 SUKINEM 0001341315279 Ramipril 5 ng 30
62 SULASTRI HAMININGSIH 0001831760739 Amlodipin 5 mg 30
Gliquidon 90
63 SUMINEM 0001262335061 Candesartan 30
ISDN 90
Amlodipin 5 mg 30
64 SUMINI 001429715733 Irbesartan 300 mg 30
Amlodipin 5 mg 30
65 SUNARMI 0001328853273 ISDN 90
Candesartan 16 mg 30
66 SUNARSIH 0000089974719
67 SUPANTO 0000090916222 Irbesartan 300 mg 30
68 SUPARMAN 0001857767883 Amlodipin 5 mg 30
LEVEMIR 2
69 SUPARMANTO 0001341312614 glimepirid 3 mg 30
lisinopril 10 mg 30
Candesartan 16 mg 15
70 SUPARMI 0000641731331 Nitrokaf R 30
HCT 60

Glimepirid 3 mg 30
Metformin 500 mg 90
71 SUPARTINI 0002472654881 Acarbose 50 mg 90
Amlodipin 10 mg 30
Glimepirid 1 mg 30
72 SUPRAPTI 0000086959192 LANTUS 1
73 SURANI 00026998229643
74 SURATMANTO AGUS 0001152410387 Amlodipin 5 mg 30
Amlodipin 10 mg 30
75 SUWARNI 0002053485404 Candesartan 8 mg 30
 Miniaspi 30
Amlodipin 10 mg 30
76 SUWARTO 0000110928532 Metformin 500 mg 30
BSP 5 mg 30

77 SUYATNI 0001439375141 Amlodipin 10 mg 30

Concor 1,25 mg 30
78 SYAMSUL BACHRI 0001270506115 Candesartan 30
Nitrokaf R 60
Concor 2.5 mg 30
80 TARI 0001448242953 Amlodipin 5 mg 30
Spironolacton 25 mg 30

Perindopril 10 60
BSP 10 mg 30
81 TH SUKIYEM 0000088711029 Amlodipin 5 mg 30
Amlodipin 10 mg 30
BSP 5 mg 30

Candesartan 30
Concor 2.5 mg 30
82 UMI SOLEKAH 0001448176419 Glikazide 30
Herbesser 200 mg 30
BSP 5 mg 30
83 UMI SRI WAHYUNI 0001382219414 Valsartan 60 mg 30
84 WALIDI 0001795229054
Glimepirid 4 mg 30
85 WARSINI 0000089766224 metformin 500 mg 90
Amlodipin 5 mg 30
86 Y. ISWIYOTO 0000091158985 Metformin 500 mg 30
 LAPORAN PENGAMBILAN OBAT PRB KIMIA FARMA
BULAN : MARET 2022

NAMA KETERANGAN
NO NAMA NAMA OBAT KETERANGAN
PENYAKIT DIAMBIL TIDAK DIAMBIL
Ramirpil 10 mg 30
1 AGIL PRIAMBODO Adalat oros 30 HHD V
Concor 10 mg 30
Sansulin 1
2 AGUS DIYONO Nitrokaf R 30 Diabetes V
Metformin 850 mg 60
3 AGUS TRIYANI D Metformin 500 mg 90 Diabetes V 2 BULAN
4 AMIYEM Glimepirid 4 mg 30 Diabetes V
Diltiazem 90
5 ANASTASIA HARTATI Nitrokaf R 60 HHD V
Candesartan 16 mg 30
BSP 5 mg 30
6 ASIH Candersartan 16 mg 30 HHD V
Adalat oros 30
Amlodipin 10 mg 30
7 DADI KARTINAH BSP 5 mg 30 Hipertensi V

Gliquidone 90
8 DEWI SRI PALUPI metformin 500mg 90
Diabetes V 2 BULAN

Tanapres 10 mg 30
9 EDHIE HASTUTI Vit B12 30
HHD V

Novomix 5
Candesartan 8 mg 30
10 ENDAH TRIHASTUTI Metformin 500 mg 90
DM, Hipertensi V 1 BULAN
Allopurinol 10 mg 30

Metformin 500 mg 30
Amlodipin 10 mg 30
11 ENDANG SRI W BSP 5 mg 30 DM, Hipertensi V
Candesartan 16 mg 30

LANTUS 1
Acarbose 50 mg 90
12 ENJEN Herbesser 200 mg 30
Diabetes V
Metformin 500 mg 90

13 ETIK HANDAYANI Candesartan 8 mg 30 Hipertensi V

Candesartan 8 mg 30
14 FITRI ROOSTIYAHWATI Metformin 500 mg 90 DM, Hipertensi V
Glimepiride 2 mg 30

HUMALOG
Bsp 2,5 mg 30
15 HADI MULYANTO Candesartan 16 mg 30 DM, HHD V
Adalat oros 30 mg
Spironolacton 25 mg 30

Glimepirid 1 mg 30
16 HENDRO NUFIANTO Metformin 500 mg 90 DM, Hipertensi V
Ramipril 5 mg 30

Metformin 500 mg 90
Amlodipin 10 mg 30
17 HENDRO PITOYO Diovan 160 15
DM, Stroke V
Miniaspi 30
Glimepirid 4 mg 30
18 KOMARIAH Metformin 500 mg 60
Diabetes V

19 LAGINEM DM, HHD V

BSP 5 mg 30
20 LINA INDRIYANA Amlodipin 10 mg 30 Hipertensi V
Candesartan 16 mg 30
21 LISTIANA DS Symbicort 1 Asma V
Risperidone 2 mg 60
22 MAMIK SUPARSI THP 2 mg 60
Skizofrenia V

Amlodipin 5 mg 30
23 MARSONO Miniaspi 30 HHD V
Ramipril 10 mg 30
24 MARTIANA S S Amlodipin 10 mg 30 Hipertensi V
Ramipril 10 mg 30
25 MM SUJATMI Concor 10 mg 30 Hipertensi V
Amlodipin 10 mg 30
Bisoprolol 5 mg 30
27 MUGIJEM Metformin 500 mg 90
DM, HT V

LANTUS 3
Amlodipin 10 mg 30
BSP 5 mg 30
28 MURTINI Glimepiride 4 mg 30
DM, HHD V
Lisinopril 10 mg 30
ISDN 90
 Amlodipin 10 mg 30
29 NGADIYEM Lisinopril 10 mg 30
Hipertensi V 1 BULAN

Amlodipin 5 mg 30
30 NINIK SUSILAWATI Concor 2.5 mg 30 HHD V
Nitrokaf R 60

Amlodipin 10 mg 30
Lisinopril 5 mg 30
31 PARDJIMAN ISDN 30
HT, Stroke V 1 BULAN
Miniaspi 30

32 PARYANI Lisinopril 10 mg 30 HT V 1 BULAN

BSP 2,5 mg 30
33 PUJI RAHAYUNINGSIH furosemid 30 HHD V
candesartan 8 mg 30

Candesartan 8 mg 30
Amlodipin 10 mg 30
34 RA. ANICETHA MENIK Vit B12 30 Hipertensi V
Bisoprolol 2,5 mg 30
Glimepiride 1 mg 30
35 RETMIYATI Metformin 850 mg 60
Diabetes V

Amlodipin 10 mg 30
36 RETNO SUBEKTI Irbesartan 150 mg 30 Hipertensi V
Spironolacton 25 mg 30
Miniaspi 30
37 RIEN NURUL Amlodipin 10 mg 30 Stroke V
Vit B 12 30
Amlodipin 10 mg 30
38 RUSDI BSP 5 mg 30 Hipertensi V

Metformin 500 mg 90
Ramipril 10 mg 30
39 SAMSIKIN Adalat oros 30 DM, HHD V
BSP 5mg 30
Symbicort 1
40 SARAH YAHUNI Vit B1 30 Asma V

Metformin 850 mg 60
41 SARDINEM Gliquidon 90 DM, Hipertensi V
Lisinopril 10 mg 30
LANTUS 4
42 SARSONO Gliquidone 30 DM, HT V
Amlodipin 10 mg 30
Gliquidone 30
43 SIH TAMI Candesartan 30 Hipertensi V
BSP 5 30
HUMALOG 3
44 SISWANTI Metformin 500 mg 30
Diabetes V

45 SITI LESTARI Amlodipin 5 mg 30 Hipertensi V

Metformin 500 mg 90
46 SOEPIYAH Vit B1 30 Diabetes V
Diamicron MR 30
47 SOEWARSONO Candesartan 30 Hipertensi V
Acarbose 50 mg 90
48 SRI LESTARI Glimepiride 2 mg 30
Diabetes V

Lisinopril 10 mg 30
49 SRI MARGIYATI Amlodipin 10 mg 30
Hipertensi V

Candesartan 16 mg 30
50 SRI MULYANI Nitrokaf R 30
HHD V

Gliquidone 30
51 SRI PURWANTI Metformin 500 mg 90 Diabetes V

Gliquidon 30
Metformin 500 mg 30
52 SRI SUHARTI Ramipril 10 mg 30 DM, HT V
BSP 5 mg 30

Metformin 500 mg 90
BSP 5 mg 30
53 SRI SUHARTINI Glimepirid 4 mg 30 DM, Stroke V
Miniaspi 30
Galvus 50 mg 30

Metformin 500 mg 60
54 SRI SUMARNI Gliquidone 90
Diabetes V 1 BULAN

55 SRI SUPADMI Gliquidon 15 Diabetes V

Miniaspi 30
BSP 5 mg 30
56 SUGENG SUPRIYONO ISDN 90 Stroke V
Lisinopril 5 mg 30

57 SUHARNI V
Candesarta 16 mg 30
58 SUHARTI Amlodipin 10 mg 30 HHD, stroke V
Miniaspi 30
Glimepirid 2 mg 30
59 SUKARMO Metformin 500 mg 90 Diabetes V 1 BULAN
 Amlodipin 5 mg 30
60 SUKIDI Miniaspi 30
Stroke V

Amlodipin 10 mg 30
61 SUKINEM Ramipril 5 ng 30
Hipertensi V

62 SULASTRI HAMININGSIH Amlodipin 5 mg 30 Hipertensi V

Gliquidon 90
63 SUMINEM Candesartan 30 HHD V
ISDN 90
Amlodipin 5 mg 30
64 SUMINI Irbesartan 300 mg 30
Hipertensi V

Amlodipin 5 mg 30
65 SUNARMI ISDN 90 HHD V
Candesartan 16 mg 30
66 SUNARSIH V
67 SUPANTO Irbesartan 300 mg 30 Hipertensi V
68 SUPARMAN Amlodipin 5 mg 30 Hipertensi V
LEVEMIR 2
69 SUPARMANTO glimepirid 3 mg 30 DM, HT V
lisinopril 10 mg 30
Candesartan 16 mg 15 BUKU DIBAWA PASIEN
70 SUPARMI Nitrokaf R 30 HHD V U/ KONTROL
HCT 60

Glimepirid 3 mg 30
Metformin 500 mg 90
71 SUPARTINI Acarbose 50 mg 90
DM, HT V 2 BULAN
Amlodipin 10 mg 30
Glimepirid 1 mg 30
72 SUPRAPTI LANTUS 1
Diabetes V 1 BULAN

73 SURANI Symbicort 1 HHD, PPOK V 2 BULAN

74 SURATMANTO AGUS Amlodipin 5 mg 30 Hipertensi V
Amlodipin 10 mg 30
75 SUWARNI Candesartan 8 mg 30 Hipertensi V

Miniaspi 30
Amlodipin 10 mg 30
76 SUWARTO Metformin 500 mg 30 Stroke, DM V
BSP 5 mg 30

77 SUYATNI Amlodipin 10 mg 30 Hipertensi V

Concor 1,25 mg 30
78 SYAMSUL BACHRI Candesartan 30
Hipertensi V 2 BULAN

Nitrokaf R 60
Concor 2.5 mg 30
80 TARI Amlodipin 5 mg 30
HHD V
Spironolacton 25 mg 30
Perindopril 10 60
BSP 10 mg 30
81 TH SUKIYEM Amlodipin 5 mg 30 HHD V

Candesartan 30
Concor 2.5 mg 30
82 UMI SOLEKAH Glikazide 30
HHD V
Herbesser 200 mg 30
BSP 5 mg 30
83 UMI SRI WAHYUNI Valsartan 60 mg 30
Hipertensi V

84 WALIDI V
Glimepirid 4 mg 30
85 WARSINI metformin 500 mg 90
Diabetes V

Amlodipin 5 mg 30
86 Y. ISWIYOTO Metformin 500 mg 30
DM, HT V

Mengetahui , Karanganyar, ………………….

Direktur Klinik Pratama Pembuat Laporan
Griya Sehat

(dr. Agil Priambodo, Sp. KKLP, M. Biomed) ( )

 LAPORAN PENGAMBILAN OBAT PRB KIMIA FARMA
BULAN : APRIL 2022

NAMA KETERANGAN
NO NAMA NAMA OBAT PENYAKIT KETERANGAN
DIAMBIL TIDAK DIAMBIL
Ramirpil 10 mg 30
1 AGIL PRIAMBODO Adalat oros 30 HHD V
Concor 10 mg 30
Sansulin 1
2 AGUS DIYONO Nitrokaf R 30 Diabetes V
Metformin 850 mg 60
4 AMIYEM Glimepirid 4 mg 30 Diabetes V
Diltiazem 90
5 ANASTASIA HARTATI Nitrokaf R 60 HHD V
Candesartan 16 mg 30
BSP 5 mg 30
6 ASIH Candersartan 16 mg 30 HHD V
Adalat oros 30
Amlodipin 10 mg 30
7 DADI KARTINAH BSP 5 mg 30
Hipertensi V

Gliquidone 90
8 DEWI SRI PALUPI metformin 500mg 90
Diabetes V 3 BULAN

Tanapres 10 mg 30
9 EDHIE HASTUTI Vit B12 30
HHD V

Novomix 5
Candesartan 8 mg 30
10 ENDAH TRIHASTUTI Metformin 500 mg 90
DM, Hipertensi V
Allopurinol 10 mg 30

Metformin 500 mg 30
Amlodipin 10 mg 30
11 ENDANG SRI W BSP 5 mg 30
DM, Hipertensi V
Candesartan 16 mg 30

LANTUS 1
Acarbose 50 mg 90
12 ENJEN Herbesser 200 mg 30 Diabetes V
Metformin 500 mg 90

13 ETIK HANDAYANI Candesartan 8 mg 30 Hipertensi V

Candesartan 8 mg 30
14 FITRI ROOSTIYAHWATI Metformin 500 mg 90 DM, Hipertensi V
Glimepiride 2 mg 30

HUMALOG
Bsp 2,5 mg 30
15 HADI MULYANTO Candesartan 16 mg 30 DM, HHD V
Adalat oros 30 mg
Spironolacton 25 mg 30

Glimepirid 1 mg 30
16 HENDRO NUFIANTO Metformin 500 mg 90 DM, Hipertensi V
Ramipril 5 mg 30

Metformin 500 mg 90
Amlodipin 10 mg 30
17 HENDRO PITOYO Diovan 160 15 DM, Stroke V
Miniaspi 30
Glimepirid 4 mg 30
18 KOMARIAH Metformin 500 mg 60 Diabetes V

19 LAGINEM DM, HHD V

BSP 5 mg 30
20 LINA INDRIYANA Amlodipin 10 mg 30 Hipertensi V 1 BULAN
Candesartan 16 mg 30
21 LISTIANA DS Symbicort 1 Asma V
Risperidone 2 mg 60
22 MAMIK SUPARSI THP 2 mg 60
Skizofrenia V

Amlodipin 5 mg 30
23 MARSONO Miniaspi 30 HHD V
Ramipril 10 mg 30
24 MARTIANA S S Amlodipin 10 mg 30 Hipertensi V
Ramipril 10 mg 30
25 MM SUJATMI Concor 10 mg 30 Hipertensi V
Amlodipin 10 mg 30
Bisoprolol 5 mg 30
27 MUGIJEM Metformin 500 mg 90
DM, HT V
 LANTUS 3
Amlodipin 10 mg 30
BSP 5 mg 30
28 MURTINI Glimepiride 4 mg 30
DM, HHD V
Lisinopril 10 mg 30
ISDN 90

Amlodipin 10 mg 30
29 NGADIYEM Lisinopril 10 mg 30
Hipertensi V 1 BULAN

Amlodipin 5 mg 30
30 NINIK SUSILAWATI Concor 2.5 mg 30 HHD V
Nitrokaf R 60

Amlodipin 10 mg 30
Lisinopril 5 mg 30
31 PARDJIMAN ISDN 30
HT, Stroke V 2 BULAN
Miniaspi 30

32 PARYANI Lisinopril 10 mg 30 HT V
BSP 2,5 mg 30
33 PUJI RAHAYUNINGSIH furosemid 30 HHD V 1 BULAN
candesartan 8 mg 30

Candesartan 8 mg 30
Amlodipin 10 mg 30
34 RA. ANICETHA MENIK Vit B12 30
Hipertensi V
Bisoprolol 2,5 mg 30
Glimepiride 1 mg 30
35 RETMIYATI Metformin 850 mg 60
Diabetes V

Amlodipin 10 mg 30
36 RETNO SUBEKTI Irbesartan 150 mg 30 Hipertensi V
Spironolacton 25 mg 30
Miniaspi 30
37 RIEN NURUL Amlodipin 10 mg 30 Stroke V
Vit B 12 30
Amlodipin 10 mg 30
38 RUSDI BSP 5 mg 30
Hipertensi V

Metformin 500 mg 90
Ramipril 10 mg 30
39 SAMSIKIN Adalat oros 30 DM, HHD V
BSP 5mg 30
Symbicort 1
40 SARAH YAHUNI Vit B1 30 Asma V

Metformin 850 mg 60
41 SARDINEM Gliquidon 90 DM, Hipertensi V
Lisinopril 10 mg 30
LANTUS 4
42 SARSONO Gliquidone 30 DM, HT V
Amlodipin 10 mg 30
Gliquidone 30
43 SIH TAMI Candesartan 30 Hipertensi V
BSP 5 30
HUMALOG 3
44 SISWANTI Metformin 500 mg 30
Diabetes V

45 SITI LESTARI Amlodipin 5 mg 30 Hipertensi V 1 BULAN

Metformin 500 mg 90
46 SOEPIYAH Vit B1 30 Diabetes V
Diamicron MR 30
47 SOEWARSONO Candesartan 30 Hipertensi V
Acarbose 50 mg 90
48 SRI LESTARI Glimepiride 2 mg 30
Diabetes V 1 BULAN

Lisinopril 10 mg 30
49 SRI MARGIYATI Amlodipin 10 mg 30
Hipertensi V

Candesartan 16 mg 30
50 SRI MULYANI Nitrokaf R 30
HHD V

Gliquidone 30
51 SRI PURWANTI Metformin 500 mg 90 Diabetes V

Gliquidon 30
Metformin 500 mg 30
52 SRI SUHARTI Ramipril 10 mg 30 DM, HT V 1 BULAN
BSP 5 mg 30

Metformin 500 mg 90
BSP 5 mg 30
53 SRI SUHARTINI Glimepirid 4 mg 30 DM, Stroke V
Miniaspi 30
Galvus 50 mg 30

Metformin 500 mg 60
54 SRI SUMARNI Gliquidone 90
Diabetes V

55 SRI SUPADMI Gliquidon 15 Diabetes V

 Miniaspi 30
BSP 5 mg 30
56 SUGENG SUPRIYONO ISDN 90
Stroke V
Lisinopril 5 mg 30

57 SUHARNI V
Candesarta 16 mg 30
58 SUHARTI Amlodipin 10 mg 30 HHD, stroke V
Miniaspi 30
Glimepirid 2 mg 30
59 SUKARMO Metformin 500 mg 90
Diabetes V 1 BULAN

Amlodipin 5 mg 30
60 SUKIDI Miniaspi 30
Stroke V

Amlodipin 10 mg 30
61 SUKINEM Ramipril 5 ng 30
Hipertensi V 1 BULAN

62 SULASTRI HAMININGSIH Amlodipin 5 mg 30 Hipertensi V

Gliquidon 90
63 SUMINEM Candesartan 30 HHD V
ISDN 90
Amlodipin 5 mg 30
64 SUMINI Irbesartan 300 mg 30 Hipertensi V

Amlodipin 5 mg 30
65 SUNARMI ISDN 90 HHD V
Candesartan 16 mg 30
66 SUNARSIH V
67 SUPANTO Irbesartan 300 mg 30 Hipertensi V
68 SUPARMAN Amlodipin 5 mg 30 Hipertensi V
LEVEMIR 2
69 SUPARMANTO glimepirid 3 mg 30 DM, HT V
lisinopril 10 mg 30
Candesartan 16 mg 15
BUKU DIBAWA PASIEN
70 SUPARMI Nitrokaf R 30 HHD V
U/ KONTROL
HCT 60

Glimepirid 3 mg 30
Metformin 500 mg 90
71 SUPARTINI Acarbose 50 mg 90 DM, HT V PASIEN DI RUJUK KE RS
Amlodipin 10 mg 30
Glimepirid 1 mg 30
72 SUPRAPTI LANTUS 1
Diabetes V

73 SURANI Symbicort 1 HHD, PPOK V 3 BULAN

74 SURATMANTO AGUS Amlodipin 5 mg 30 Hipertensi V
Amlodipin 10 mg 30
75 SUWARNI Candesartan 8 mg 30
Hipertensi V

Miniaspi 30
Amlodipin 10 mg 30
76 SUWARTO Metformin 500 mg 30
Stroke, DM V
BSP 5 mg 30

77 SUYATNI Amlodipin 10 mg 30 Hipertensi V

Concor 1,25 mg 30
78 SYAMSUL BACHRI Candesartan 30
Hipertensi V DI RUJUK KE RS

Nitrokaf R 60
Concor 2.5 mg 30
80 TARI Amlodipin 5 mg 30 HHD V
Spironolacton 25 mg 30
Perindopril 10 60
BSP 10 mg 30
81 TH SUKIYEM Amlodipin 5 mg 30
HHD V

Candesartan 30
Concor 2.5 mg 30
82 UMI SOLEKAH Glikazide 30 HHD V
Herbesser 200 mg 30
BSP 5 mg 30
83 UMI SRI WAHYUNI Valsartan 60 mg 30 Hipertensi V

84 WALIDI V
Glimepirid 4 mg 30
85 WARSINI metformin 500 mg 90
Diabetes V

Amlodipin 5 mg 30
86 Y. ISWIYOTO Metformin 500 mg 30
DM, HT V

Mengetahui , Karanganyar, ………………….

Direktur Klinik Pratama Pembuat Laporan
Griya Sehat
(dr. Agil Priambodo, Sp. KKLP, M. Biomed) ( )
 LAPORAN PENGAMBILAN OBAT PRB KIMIA FARMA
BULAN : MEI 2022

NAMA KETERANGAN
NO NAMA NAMA OBAT PENYAKIT KETERANGAN
DIAMBIL TIDAK DIAMBIL
Ramirpil 10 mg 30
1 AGIL PRIAMBODO Adalat oros 30 HHD V
Concor 10 mg 30
Sansulin 1
2 AGUS DIYONO Nitrokaf R 30 Diabetes V
Metformin 850 mg 60
4 AMIYEM Glimepirid 4 mg 30 Diabetes V
Diltiazem 90
5 ANASTASIA HARTATI Nitrokaf R 60 HHD V
Candesartan 16 mg 30
BSP 5 mg 30
6 ASIH Candersartan 16 mg 30 HHD V
Adalat oros 30
Amlodipin 10 mg 30
7 DADI KARTINAH BSP 5 mg 30
Hipertensi V

Gliquidone 90
8 DEWI SRI PALUPI metformin 500mg 90
Diabetes V

Tanapres 10 mg 30
9 EDHIE HASTUTI Vit B12 30
HHD V

Novomix 5
Candesartan 8 mg 30
10 ENDAH TRIHASTUTI Metformin 500 mg 90
DM, Hipertensi V
Allopurinol 10 mg 30

Metformin 500 mg 30
Amlodipin 10 mg 30
11 ENDANG SRI W BSP 5 mg 30
DM, Hipertensi V
Candesartan 16 mg 30

LANTUS 1
Acarbose 50 mg 90
12 ENJEN Herbesser 200 mg 30 Diabetes V
Metformin 500 mg 90

13 ETIK HANDAYANI Candesartan 8 mg 30 Hipertensi V

Candesartan 8 mg 30
14 FITRI ROOSTIYAHWATI Metformin 500 mg 90 DM, Hipertensi V
Glimepiride 2 mg 30

HUMALOG
Bsp 2,5 mg 30
15 HADI MULYANTO Candesartan 16 mg 30 DM, HHD V 1 BULAN
Adalat oros 30 mg
Spironolacton 25 mg 30

Glimepirid 1 mg 30
16 HENDRO NUFIANTO Metformin 500 mg 90 DM, Hipertensi V
Ramipril 5 mg 30

Metformin 500 mg 90
Amlodipin 10 mg 30
17 HENDRO PITOYO Diovan 160 15 DM, Stroke V
Miniaspi 30
Glimepirid 4 mg 30
18 KOMARIAH Metformin 500 mg 60 Diabetes V

19 LAGINEM DM, HHD V

BSP 5 mg 30
20 LINA INDRIYANA Amlodipin 10 mg 30 Hipertensi V
Candesartan 16 mg 30
21 LISTIANA DS Symbicort 1 Asma V
Risperidone 2 mg 60
22 MAMIK SUPARSI THP 2 mg 60
Skizofrenia V BPJS NON AKTIF

Amlodipin 5 mg 30
23 MARSONO Miniaspi 30 HHD V
Ramipril 10 mg 30

24 MARTIANA S S Amlodipin 10 mg 30 Hipertensi V

Ramipril 10 mg 30
25 MM SUJATMI Concor 10 mg 30 Hipertensi V
Amlodipin 10 mg 30

Bisoprolol 5 mg 30
26 MUGIJEM Metformin 500 mg 90
DM, HT V
 Fenitoin 100 mg 60
27 MULYATIN Phenobarbital 30 mg 90 EPILEPSI V
vitamin B6 30 mg

LANTUS 3
Amlodipin 10 mg 30
BSP 5 mg 30
28 MURTINI Glimepiride 4 mg 30 DM, HHD V
Lisinopril 10 mg 30
ISDN 90

Amlodipin 10 mg 30
29 NGADIYEM Lisinopril 10 mg 30
Hipertensi V

Amlodipin 5 mg 30
30 NINIK SUSILAWATI Concor 2.5 mg 30 HHD V
Nitrokaf R 60

Amlodipin 10 mg 30
Lisinopril 5 mg 30
31 PARDJIMAN ISDN 30
HT, Stroke V 3 BULAN
Miniaspi 30

32 PARTINI Candesartan 8 mg 30 HT V
33 PARYANI Lisinopril 10 mg 30 HT V
BSP 2,5 mg 30
34 PUJI RAHAYUNINGSIH furosemid 30 HHD V 2 BULAN
candesartan 8 mg 30

Candesartan 8 mg 30
Amlodipin 10 mg 30
35 RA. ANICETHA MENIK Vit B12 30
Hipertensi V
Bisoprolol 2,5 mg 30
Glimepiride 1 mg 30
36 RETMIYATI Metformin 850 mg 60
Diabetes V

Amlodipin 10 mg 30
37 RETNO SUBEKTI Irbesartan 150 mg 30 Hipertensi V
Spironolacton 25 mg 30
Miniaspi 30
38 RIEN NURUL Amlodipin 10 mg 30 Stroke V
Vit B 12 30
Amlodipin 10 mg 30
39 RUSDI BSP 5 mg 30
Hipertensi V

Metformin 500 mg 90
Ramipril 10 mg 30
40 SAMSIKIN Adalat oros 30 DM, HHD V
BSP 5mg 30
Symbicort 1
41 SARAH YAHUNI Vit B1 30 Asma V

Metformin 850 mg 60
42 SARDINEM Gliquidon 90 DM, Hipertensi V
Lisinopril 10 mg 30
LANTUS 4
43 SARSONO Gliquidone 30 DM, HT V
Amlodipin 10 mg 30
Gliquidone 30
44 SIH TAMI Candesartan 30 Hipertensi V
BSP 5 30
HUMALOG 3
45 SISWANTI Metformin 500 mg 30
Diabetes V

46 SITI LESTARI Amlodipin 5 mg 30 Hipertensi V 1 BULAN

Metformin 500 mg 90
47 SOEPIYAH Vit B1 30 Diabetes V
Diamicron MR 30
48 SOEWARSONO Candesartan 30 Hipertensi V
Acarbose 50 mg 90
49 SRI LESTARI Glimepiride 2 mg 30
Diabetes V 2 BULAN

Lisinopril 10 mg 30
50 SRI MARGIYATI Amlodipin 10 mg 30
Hipertensi V

Candesartan 16 mg 30
51 SRI MULYANI Nitrokaf R 30
HHD V

Gliquidone 30
52 SRI PURWANTI Metformin 500 mg 90
Diabetes V

Gliquidon 30
Metformin 500 mg 30
53 SRI SUHARTI Ramipril 10 mg 30 DM, HT V 1 BULAN
BSP 5 mg 30

Metformin 500 mg 90
BSP 5 mg 30
54 SRI SUHARTINI Glimepirid 4 mg 30 DM, Stroke V
Miniaspi 30
Galvus 50 mg 30
 Metformin 500 mg 60
55 SRI SUMARNI Gliquidone 90
Diabetes V

56 SRI SUPADMI Gliquidon 15 Diabetes V

Miniaspi 30
BSP 5 mg 30
57 SUGENG SUPRIYONO ISDN 90
Stroke V
Lisinopril 5 mg 30

58 SUHARNI V
Candesarta 16 mg 30
59 SUHARTI Amlodipin 10 mg 30 HHD, stroke V
Miniaspi 30
Glimepirid 2 mg 30
60 SUKARMO Metformin 500 mg 90 Diabetes V

Amlodipin 5 mg 30
61 SUKIDI Miniaspi 30
Stroke V

Amlodipin 10 mg 30
62 SUKINEM Ramipril 5 ng 30
Hipertensi V

63 SULASTRI HAMININGSIH Amlodipin 5 mg 30 Hipertensi V

Gliquidon 90
64 SUMINEM Candesartan 30 HHD V
ISDN 90
Amlodipin 5 mg 30
65 SUMINI Irbesartan 300 mg 30
Hipertensi V

Amlodipin 5 mg 30
66 SUNARMI ISDN 90 HHD V
Candesartan 16 mg 30
67 SUNARSIH V
68 SUPANTO Irbesartan 300 mg 30 Hipertensi V
69 SUPARMAN Amlodipin 5 mg 30 Hipertensi V
LEVEMIR 2
70 SUPARMANTO glimepirid 3 mg 30 DM, HT V
lisinopril 10 mg 30
Candesartan 16 mg 15
BUKU DIBAWA PASIEN
71 SUPARMI Nitrokaf R 30 HHD V
U/ KONTROL
HCT 60

Glimepirid 3 mg 30
Metformin 500 mg 90
72 SUPARTINI Acarbose 50 mg 90
DM, HT V PASIEN DI RUJUK KE RS
Amlodipin 10 mg 30
Glimepirid 1 mg 30
73 SUPRAPTI LANTUS 1
Diabetes V

74 SURANI Symbicort 1 HHD, PPOK V 3 BULAN

75 SURATMANTO AGUS Amlodipin 5 mg 30 Hipertensi V
Amlodipin 10 mg 30
76 SUWARNI Candesartan 8 mg 30
Hipertensi V

Miniaspi 30
Amlodipin 10 mg 30
77 SUWARTO Metformin 500 mg 30
Stroke, DM V
BSP 5 mg 30

78 SUYATNI Amlodipin 10 mg 30 Hipertensi V 1 BULAN

Concor 1,25 mg 30
79 SYAMSUL BACHRI Candesartan 30
Hipertensi V DI RUJUK KE RS

Nitrokaf R 60
Concor 2.5 mg 30
81 TARI Amlodipin 5 mg 30
HHD V
Spironolacton 25 mg 30

Perindopril 10 60
82 TH SUKIYEM BSP 10 mg 30 HHD V
Amlodipin 5 mg 30

Lisinopril 10 mg 30
83 TUN WINARTI HCT 30
HT V

Candesartan 30
Concor 2.5 mg 30
84 UMI SOLEKAH Glikazide 30 HHD V
Herbesser 200 mg 30
BSP 5 mg 30
85 UMI SRI WAHYUNI Valsartan 60 mg 30
Hipertensi V

86 WALIDI V
Glimepirid 4 mg 30
87 WARSINI metformin 500 mg 90
Diabetes V 1 BULAN

Amlodipin 5 mg 30
88 Y. ISWIYOTO Metformin 500 mg 30
DM, HT V 1 BULAN
 Mengetahui , Karanganyar, ………………….
Direktur Klinik Pratama Pembuat Laporan
Griya Sehat

(dr. Agil Priambodo, Sp. KKLP, M. Biomed) ( )

 LAPORAN PENGAMBILAN OBAT PRB KIMIA FARMA
BULAN : MEI 2022

NAMA KETERANGAN
NO NAMA NAMA OBAT PENYAKIT KETERANGAN
DIAMBIL TIDAK DIAMBIL
Ramirpil 10 mg 30
1 AGIL PRIAMBODO Adalat oros 30 HHD V
Concor 10 mg 30
Sansulin 1
2 AGUS DIYONO Nitrokaf R 30 Diabetes V
Metformin 850 mg 60
4 AMIYEM Glimepirid 4 mg 30 Diabetes V
Diltiazem 90
5 ANASTASIA HARTATI Nitrokaf R 60 HHD V
Candesartan 16 mg 30
BSP 5 mg 30
6 ASIH Candersartan 16 mg 30 HHD V
Adalat oros 30
Amlodipin 10 mg 30
7 DADI KARTINAH BSP 5 mg 30
Hipertensi V

Gliquidone 90
8 DEWI SRI PALUPI metformin 500mg 90
Diabetes V

Tanapres 10 mg 30
9 EDHIE HASTUTI Vit B12 30
HHD V

Novomix 5
Candesartan 8 mg 30
10 ENDAH TRIHASTUTI Metformin 500 mg 90
DM, Hipertensi V
Allopurinol 10 mg 30

Metformin 500 mg 30
Amlodipin 10 mg 30
11 ENDANG SRI W BSP 5 mg 30
DM, Hipertensi V
Candesartan 16 mg 30

LANTUS 1
Acarbose 50 mg 90
12 ENJEN Herbesser 200 mg 30 Diabetes V
Metformin 500 mg 90

13 ETIK HANDAYANI Candesartan 8 mg 30 Hipertensi V

Candesartan 8 mg 30
14 FITRI ROOSTIYAHWATI Metformin 500 mg 90 DM, Hipertensi V
Glimepiride 2 mg 30

HUMALOG
Bsp 2,5 mg 30
15 HADI MULYANTO Candesartan 16 mg 30 DM, HHD V 1 BULAN
Adalat oros 30 mg
Spironolacton 25 mg 30

Glimepirid 1 mg 30
16 HENDRO NUFIANTO Metformin 500 mg 90 DM, Hipertensi V
Ramipril 5 mg 30

Metformin 500 mg 90
Amlodipin 10 mg 30
17 HENDRO PITOYO Diovan 160 15 DM, Stroke V
Miniaspi 30
Glimepirid 4 mg 30
18 KOMARIAH Metformin 500 mg 60 Diabetes V

19 LAGINEM DM, HHD V

BSP 5 mg 30
20 LINA INDRIYANA Amlodipin 10 mg 30 Hipertensi V
Candesartan 16 mg 30
21 LISTIANA DS Symbicort 1 Asma V
Risperidone 2 mg 60
22 MAMIK SUPARSI THP 2 mg 60
Skizofrenia V BPJS NON AKTIF

Amlodipin 5 mg 30
23 MARSONO Miniaspi 30 HHD V
Ramipril 10 mg 30

24 MARTIANA S S Amlodipin 10 mg 30 Hipertensi V

Ramipril 10 mg 30
25 MM SUJATMI Concor 10 mg 30 Hipertensi V
Amlodipin 10 mg 30

Bisoprolol 5 mg 30
26 MUGIJEM Metformin 500 mg 90
DM, HT V
 Fenitoin 100 mg 60
27 MULYATIN Phenobarbital 30 mg 90 EPILEPSI V
vitamin B6 30 mg

LANTUS 3
Amlodipin 10 mg 30
BSP 5 mg 30
28 MURTINI Glimepiride 4 mg 30 DM, HHD V
Lisinopril 10 mg 30
ISDN 90

Amlodipin 10 mg 30
29 NGADIYEM Lisinopril 10 mg 30
Hipertensi V

Amlodipin 5 mg 30
30 NINIK SUSILAWATI Concor 2.5 mg 30 HHD V
Nitrokaf R 60

Amlodipin 10 mg 30
Lisinopril 5 mg 30
31 PARDJIMAN ISDN 30
HT, Stroke V 3 BULAN
Miniaspi 30

32 PARTINI Candesartan 8 mg 30 HT V
33 PARYANI Lisinopril 10 mg 30 HT V
BSP 2,5 mg 30
34 PUJI RAHAYUNINGSIH furosemid 30 HHD V 2 BULAN
candesartan 8 mg 30

Candesartan 8 mg 30
Amlodipin 10 mg 30
35 RA. ANICETHA MENIK Vit B12 30
Hipertensi V
Bisoprolol 2,5 mg 30
Glimepiride 1 mg 30
36 RETMIYATI Metformin 850 mg 60
Diabetes V

Amlodipin 10 mg 30
37 RETNO SUBEKTI Irbesartan 150 mg 30 Hipertensi V
Spironolacton 25 mg 30
Miniaspi 30
38 RIEN NURUL Amlodipin 10 mg 30 Stroke V
Vit B 12 30
Amlodipin 10 mg 30
39 RUSDI BSP 5 mg 30
Hipertensi V

Metformin 500 mg 90
Ramipril 10 mg 30
40 SAMSIKIN Adalat oros 30 DM, HHD V
BSP 5mg 30
Symbicort 1
41 SARAH YAHUNI Vit B1 30 Asma V

Metformin 850 mg 60
42 SARDINEM Gliquidon 90 DM, Hipertensi V
Lisinopril 10 mg 30
LANTUS 4
43 SARSONO Gliquidone 30 DM, HT V
Amlodipin 10 mg 30
Gliquidone 30
44 SIH TAMI Candesartan 30 Hipertensi V
BSP 5 30
HUMALOG 3
45 SISWANTI Metformin 500 mg 30
Diabetes V

46 SITI LESTARI Amlodipin 5 mg 30 Hipertensi V 1 BULAN

Metformin 500 mg 90
47 SOEPIYAH Vit B1 30 Diabetes V
Diamicron MR 30
48 SOEWARSONO Candesartan 30 Hipertensi V
Acarbose 50 mg 90
49 SRI LESTARI Glimepiride 2 mg 30
Diabetes V 2 BULAN

Lisinopril 10 mg 30
50 SRI MARGIYATI Amlodipin 10 mg 30
Hipertensi V

Candesartan 16 mg 30
51 SRI MULYANI Nitrokaf R 30
HHD V

Gliquidone 30
52 SRI PURWANTI Metformin 500 mg 90
Diabetes V

Gliquidon 30
Metformin 500 mg 30
53 SRI SUHARTI Ramipril 10 mg 30 DM, HT V 1 BULAN
BSP 5 mg 30

Metformin 500 mg 90
BSP 5 mg 30
54 SRI SUHARTINI Glimepirid 4 mg 30 DM, Stroke V
Miniaspi 30
Galvus 50 mg 30
 Metformin 500 mg 60
55 SRI SUMARNI Gliquidone 90
Diabetes V

56 SRI SUPADMI Gliquidon 15 Diabetes V

Miniaspi 30
BSP 5 mg 30
57 SUGENG SUPRIYONO ISDN 90
Stroke V
Lisinopril 5 mg 30

58 SUHARNI V
Candesarta 16 mg 30
59 SUHARTI Amlodipin 10 mg 30 HHD, stroke V
Miniaspi 30
Glimepirid 2 mg 30
60 SUKARMO Metformin 500 mg 90 Diabetes V

Amlodipin 5 mg 30
61 SUKIDI Miniaspi 30
Stroke V

Amlodipin 10 mg 30
62 SUKINEM Ramipril 5 ng 30
Hipertensi V

63 SULASTRI HAMININGSIH Amlodipin 5 mg 30 Hipertensi V

Gliquidon 90
64 SUMINEM Candesartan 30 HHD V
ISDN 90
Amlodipin 5 mg 30
65 SUMINI Irbesartan 300 mg 30
Hipertensi V

Amlodipin 5 mg 30
66 SUNARMI ISDN 90 HHD V
Candesartan 16 mg 30
67 SUNARSIH V
68 SUPANTO Irbesartan 300 mg 30 Hipertensi V
69 SUPARMAN Amlodipin 5 mg 30 Hipertensi V
LEVEMIR 2
70 SUPARMANTO glimepirid 3 mg 30 DM, HT V
lisinopril 10 mg 30
Glimepirid 1 mg 30
73 SUPRAPTI LANTUS 1
Diabetes V

74 SURANI Symbicort 1 HHD, PPOK V 3 BULAN

75 SURATMANTO AGUS Amlodipin 5 mg 30 Hipertensi V
Amlodipin 10 mg 30
76 SUWARNI Candesartan 8 mg 30 Hipertensi V

Miniaspi 30
Amlodipin 10 mg 30
77 SUWARTO Metformin 500 mg 30 Stroke, DM V
BSP 5 mg 30

78 SUYATNI Amlodipin 10 mg 30 Hipertensi V 1 BULAN

Nitrokaf R 60
Concor 2.5 mg 30
81 TARI Amlodipin 5 mg 30
HHD V
Spironolacton 25 mg 30

Perindopril 10 60
82 TH SUKIYEM BSP 10 mg 30 HHD V
Amlodipin 5 mg 30

Lisinopril 10 mg 30
83 TUN WINARTI HCT 30
HT V

Candesartan 30
Concor 2.5 mg 30
84 UMI SOLEKAH Glikazide 30 HHD V
Herbesser 200 mg 30
BSP 5 mg 30
85 UMI SRI WAHYUNI Valsartan 60 mg 30 Hipertensi V

86 WALIDI V
Glimepirid 4 mg 30
87 WARSINI metformin 500 mg 90
Diabetes V 1 BULAN

Amlodipin 5 mg 30
88 Y. ISWIYOTO Metformin 500 mg 30
DM, HT V 1 BULAN

Mengetahui , Karanganyar, ………………….

Direktur Klinik Pratama Pembuat Laporan
Griya Sehat

(dr. Agil Priambodo, Sp. KKLP, M. Biomed) ( )

 LAPORAN PENGAMBILAN OBAT PRB KIMIA FARMA
BULAN : JUNI 2022

NAMA KETERANGAN
NO NAMA NAMA OBAT PENYAKIT KETERANGAN
DIAMBIL TIDAK DIAMBIL
Ramirpil 10 mg 30
1 AGIL PRIAMBODO Adalat oros 30 HHD V
Concor 10 mg 30
Sansulin 1
BUKU DIBAWA PASIEN
2 AGUS DIYONO Nitrokaf R 30 Diabetes V U/ KONTROL
Metformin 850 mg 60
4 AMIYEM Glimepirid 4 mg 30 Diabetes V
Diltiazem 90
5 ANASTASIA HARTATI Nitrokaf R 60 HHD V
Candesartan 16 mg 30
BSP 5 mg 30
6 ASIH Candersartan 16 mg 30 HHD V
Adalat oros 30
Amlodipin 10 mg 30
7 DADI KARTINAH BSP 5 mg 30
Hipertensi V

Gliquidone 90
8 DEWI SRI PALUPI metformin 500mg 90
Diabetes V

Tanapres 10 mg 30
9 EDHIE HASTUTI Vit B12 30
HHD V

Novomix 5
Candesartan 8 mg 30
10 ENDAH TRIHASTUTI Metformin 500 mg 90
DM, Hipertensi V
Allopurinol 10 mg 30

Metformin 500 mg 30
Amlodipin 10 mg 30
11 ENDANG SRI W BSP 5 mg 30
DM, Hipertensi V
Candesartan 16 mg 30

LANTUS 1
Acarbose 50 mg 90
12 ENJEN Herbesser 200 mg 30 Diabetes V
Metformin 500 mg 90

13 ETIK HANDAYANI Candesartan 8 mg 30 Hipertensi V

Candesartan 8 mg 30
14 FITRI ROOSTIYAHWATI Metformin 500 mg 90 DM, Hipertensi V
Glimepiride 2 mg 30

HUMALOG
Bsp 2,5 mg 30
15 HADI MULYANTO Candesartan 16 mg 30 DM, HHD V 2 BULAN
Adalat oros 30 mg
Spironolacton 25 mg 30

Glimepirid 1 mg 30
16 HENDRO NUFIANTO Metformin 500 mg 90 DM, Hipertensi V
Ramipril 5 mg 30

Metformin 500 mg 90
Amlodipin 10 mg 30
17 HENDRO PITOYO Diovan 160 15 DM, Stroke V
Miniaspi 30
Glimepirid 4 mg 30
18 KOMARIAH Metformin 500 mg 60 Diabetes V

19 LAGINEM DM, HHD V

BSP 5 mg 30
20 LINA INDRIYANA Amlodipin 10 mg 30 Hipertensi V
Candesartan 16 mg 30
21 LISTIANA DS Symbicort 1 Asma V
Risperidone 2 mg 60
22 MAMIK SUPARSI THP 2 mg 60
Skizofrenia V BPJS NON AKTIF

Amlodipin 5 mg 30
23 MARSONO Miniaspi 30 HHD V
Ramipril 10 mg 30

24 MARTIANA S S Amlodipin 10 mg 30 Hipertensi V

Ramipril 10 mg 30
25 MM SUJATMI Concor 10 mg 30 Hipertensi V
Amlodipin 10 mg 30

Bisoprolol 5 mg 30
26 MUGIJEM Metformin 500 mg 90
DM, HT V

Fenitoin 100 mg 60
27 MULYATIN Phenobarbital 30 mg 90 EPILEPSI V
vitamin B6 30 mg

LANTUS 3
Amlodipin 10 mg 30
BSP 5 mg 30
28 MURTINI Glimepiride 4 mg 30
DM, HHD V
Lisinopril 10 mg 30
ISDN 90

Amlodipin 10 mg 30
29 NGADIYEM Lisinopril 10 mg 30 Hipertensi V 1 BULAN
 Amlodipin 5 mg 30
30 NINIK SUSILAWATI Concor 2.5 mg 30 HHD V
Nitrokaf R 60

Amlodipin 10 mg 30
Lisinopril 5 mg 30
31 PARDJIMAN ISDN 30
HT, Stroke V 4 BULAN
Miniaspi 30

32 PARTINI Candesartan 8 mg 30 HT V
33 PARYANI Lisinopril 10 mg 30 HT V 1 BULAN
BSP 2,5 mg 30
34 PUJI RAHAYUNINGSIH furosemid 30 HHD V 2 BULAN
candesartan 8 mg 30

Candesartan 8 mg 30
Amlodipin 10 mg 30
35 RA. ANICETHA MENIK Vit B12 30
Hipertensi V
Bisoprolol 2,5 mg 30
Glimepiride 1 mg 30
36 RETMIYATI Metformin 850 mg 60
Diabetes V

Amlodipin 10 mg 30
37 RETNO SUBEKTI Irbesartan 150 mg 30 Hipertensi V
Spironolacton 25 mg 30
Miniaspi 30
38 RIEN NURUL Amlodipin 10 mg 30 Stroke V
Vit B 12 30
Amlodipin 10 mg 30
39 RUSDI BSP 5 mg 30
Hipertensi V

Metformin 500 mg 90
Ramipril 10 mg 30
40 SAMSIKIN Adalat oros 30 DM, HHD V
BSP 5mg 30
Symbicort 1
41 SARAH YAHUNI Vit B1 30 Asma V

Metformin 850 mg 60
42 SARDINEM Gliquidon 90 DM, Hipertensi V
Lisinopril 10 mg 30
LANTUS 4
43 SARSONO Gliquidone 30 DM, HT V
Amlodipin 10 mg 30
Gliquidone 30
44 SIH TAMI Candesartan 30 Hipertensi V
BSP 5 30
HUMALOG 3
45 SISWANTI Metformin 500 mg 30
Diabetes V

46 SITI LESTARI Amlodipin 5 mg 30 Hipertensi V 1 BULAN

Metformin 500 mg 90
47 SOEPIYAH Vit B1 30 Diabetes V
Diamicron MR 30
48 SOEWARSONO Candesartan 30 Hipertensi V
Acarbose 50 mg 90
49 SRI LESTARI Glimepiride 2 mg 30
Diabetes V 3 BULAN

Lisinopril 10 mg 30
50 SRI MARGIYATI Amlodipin 10 mg 30
Hipertensi V

Candesartan 16 mg 30
51 SRI MULYANI Nitrokaf R 30
HHD V

Gliquidone 30
52 SRI PURWANTI Metformin 500 mg 90
Diabetes V

Gliquidon 30
Metformin 500 mg 30
53 SRI SUHARTI Ramipril 10 mg 30 DM, HT V
BSP 5 mg 30

Metformin 500 mg 90
BSP 5 mg 30
54 SRI SUHARTINI Glimepirid 4 mg 30 DM, Stroke V
Miniaspi 30
Galvus 50 mg 30

Metformin 500 mg 60
55 SRI SUMARNI Gliquidone 90
Diabetes V

56 SRI SUPADMI Gliquidon 15 Diabetes V

Miniaspi 30
BSP 5 mg 30
57 SUGENG SUPRIYONO ISDN 90 Stroke V
Lisinopril 5 mg 30

58 SUHARNI V
Candesarta 16 mg 30
59 SUHARTI Amlodipin 10 mg 30 HHD, stroke V
Miniaspi 30
Glimepirid 2 mg 30
60 SUKARMO Metformin 500 mg 90 Diabetes V

Amlodipin 5 mg 30
61 SUKIDI Miniaspi 30
Stroke V

Amlodipin 10 mg 30
62 SUKINEM Ramipril 5 ng 30
Hipertensi V

63 SULASTRI HAMININGSIH Amlodipin 5 mg 30 Hipertensi V 1 BULAN

 Gliquidon 90
64 SUMINEM Candesartan 30 HHD V
ISDN 90
Amlodipin 5 mg 30
65 SUMINI Irbesartan 300 mg 30
Hipertensi V

Amlodipin 5 mg 30
66 SUNARMI ISDN 90 HHD V
Candesartan 16 mg 30
67 SUNARSIH V
68 SUPANTO Irbesartan 300 mg 30 Hipertensi V
69 SUPARMAN Amlodipin 5 mg 30 Hipertensi V
LEVEMIR 2
70 SUPARMANTO glimepirid 3 mg 30 DM, HT V
lisinopril 10 mg 30
Glimepirid 1 mg 30
71 SUPRAPTI LANTUS 1
Diabetes V

72 SURAMI HT V
73 SURANI Symbicort 1 HHD, PPOK V
74 SURATMANTO AGUS Amlodipin 5 mg 30 Hipertensi V
Amlodipin 10 mg 30
75 SUWARNI Candesartan 8 mg 30
Hipertensi V

Miniaspi 30
Amlodipin 10 mg 30
76 SUWARTO Metformin 500 mg 30 Stroke, DM V
BSP 5 mg 30

77 SUYATNI Amlodipin 10 mg 30 Hipertensi V 2 BULAN

Nitrokaf R 60
Concor 2.5 mg 30
80 TARI Amlodipin 5 mg 30 HHD V
Spironolacton 25 mg 30

Perindopril 10 60
81 TH SUKIYEM BSP 10 mg 30 HHD V
Amlodipin 5 mg 30

Lisinopril 10 mg 30
82 TUN WINARTI HCT 30
HT V

Candesartan 30
Concor 2.5 mg 30
83 UMI SOLEKAH Glikazide 30
HHD V
Herbesser 200 mg 30
BSP 5 mg 30
84 UMI SRI WAHYUNI Valsartan 60 mg 30
Hipertensi V

85 WALIDI V 1 BULAN
Glimepirid 4 mg 30
86 WARSINI metformin 500 mg 90 Diabetes V

Amlodipin 5 mg 30
87 Y. ISWIYOTO Metformin 500 mg 30
DM, HT V 2 BULAN

Mengetahui , Karanganyar, ………………….

Direktur Klinik Pratama Pembuat Laporan
Griya Sehat

(dr. Agil Priambodo, Sp. KKLP, M. Biomed) ( )

 LAPORAN PENGAMBILAN OBAT PRB KIMIA FARMA
BULAN : JULI 2022

NAMA KETERANGAN
NO NAMA NAMA OBAT PENYAKIT KETERANGAN
DIAMBIL TIDAK DIAMBIL
Ramirpil 10 mg 30
1 AGIL PRIAMBODO Adalat oros 30 HHD V
Concor 10 mg 30
Sansulin 1
BUKU DIBAWA PASIEN
2 AGUS DIYONO Nitrokaf R 30 Diabetes V U/ KONTROL
Metformin 850 mg 60
4 AMIYEM Glimepirid 4 mg 30 Diabetes V
Diltiazem 90
5 ANASTASIA HARTATI Nitrokaf R 60 HHD V
Candesartan 16 mg 30
BSP 5 mg 30
6 ASIH Candersartan 16 mg 30 HHD V
Adalat oros 30
Amlodipin 10 mg 30
7 DADI KARTINAH BSP 5 mg 30
Hipertensi V

Gliquidone 90
8 DEWI SRI PALUPI metformin 500mg 90
Diabetes V

Tanapres 10 mg 30
9 EDHIE HASTUTI Vit B12 30
HHD V

Novomix 5
Candesartan 8 mg 30
10 ENDAH TRIHASTUTI Metformin 500 mg 90
DM, Hipertensi V
Allopurinol 10 mg 30

Metformin 500 mg 30
Amlodipin 10 mg 30
11 ENDANG SRI W BSP 5 mg 30
DM, Hipertensi V
Candesartan 16 mg 30

LANTUS 1
Acarbose 50 mg 90
12 ENJEN Herbesser 200 mg 30 Diabetes V
Metformin 500 mg 90

13 ETIK HANDAYANI Candesartan 8 mg 30 Hipertensi V

Candesartan 8 mg 30
14 FITRI ROOSTIYAHWATI Metformin 500 mg 90 DM, Hipertensi V
Glimepiride 2 mg 30

HUMALOG
Bsp 2,5 mg 30
15 HADI MULYANTO Candesartan 16 mg 30 DM, HHD V
Adalat oros 30 mg
Spironolacton 25 mg 30

Glimepirid 1 mg 30
16 HENDRO NUFIANTO Metformin 500 mg 90 DM, Hipertensi V
Ramipril 5 mg 30

Metformin 500 mg 90
Amlodipin 10 mg 30
17 HENDRO PITOYO Diovan 160 15 DM, Stroke V
Miniaspi 30
Glimepirid 4 mg 30
18 KOMARIAH Metformin 500 mg 60 Diabetes V

19 LAGINEM DM, HHD V

BSP 5 mg 30
20 LINA INDRIYANA Amlodipin 10 mg 30 Hipertensi V
Candesartan 16 mg 30
21 LISTIANA DS Symbicort 1 Asma V
Risperidone 2 mg 60
22 MAMIK SUPARSI THP 2 mg 60
Skizofrenia V

Amlodipin 5 mg 30
23 MARSONO Miniaspi 30 HHD V
Ramipril 10 mg 30

24 MARTIANA S S Amlodipin 10 mg 30 Hipertensi V

Ramipril 10 mg 30
25 MM SUJATMI Concor 10 mg 30 Hipertensi V
Amlodipin 10 mg 30

Bisoprolol 5 mg 30
26 MUGIJEM Metformin 500 mg 90
DM, HT V
 Fenitoin 100 mg 60
27 MULYATIN Phenobarbital 30 mg 90 EPILEPSI V
vitamin B6 30 mg

LANTUS 3
Amlodipin 10 mg 30
BSP 5 mg 30
28 MURTINI Glimepiride 4 mg 30 DM, HHD V
Lisinopril 10 mg 30
ISDN 90

Amlodipin 10 mg 30
29 NGADIYEM Lisinopril 10 mg 30
Hipertensi V

Amlodipin 5 mg 30
30 NINIK SUSILAWATI Concor 2.5 mg 30 HHD V
Nitrokaf R 60

Amlodipin 10 mg 30
TIDAK DIAMBILKAN
Lisinopril 5 mg 30
31 PARDJIMAN ISDN 30
HT, Stroke V KRN 4 BULAN TIDAK
DIAMBIL
Miniaspi 30

32 PARTINI Candesartan 8 mg 30 HT V
33 PARYANI Lisinopril 10 mg 30 HT V
BSP 2,5 mg 30
34 PUJI RAHAYUNINGSIH furosemid 30 HHD V 2 BULAN
candesartan 8 mg 30

Candesartan 8 mg 30
Amlodipin 10 mg 30
35 RA. ANICETHA MENIK Vit B12 30
Hipertensi V
Bisoprolol 2,5 mg 30
Glimepiride 1 mg 30
36 RETMIYATI Metformin 850 mg 60
Diabetes V

Amlodipin 10 mg 30
37 RETNO SUBEKTI Irbesartan 150 mg 30 Hipertensi V
Spironolacton 25 mg 30
Miniaspi 30
38 RIEN NURUL Amlodipin 10 mg 30 Stroke V
Vit B 12 30
Amlodipin 10 mg 30
39 RUSDI BSP 5 mg 30
Hipertensi V

Metformin 500 mg 90
Ramipril 10 mg 30
40 SAMSIKIN Adalat oros 30 DM, HHD V
BSP 5mg 30
Symbicort 1
41 SARAH YAHUNI Vit B1 30 Asma V

Metformin 850 mg 60
42 SARDINEM Gliquidon 90 DM, Hipertensi V
Lisinopril 10 mg 30
LANTUS 4
43 SARSONO Gliquidone 30 DM, HT V
Amlodipin 10 mg 30
Gliquidone 30
44 SIH TAMI Candesartan 30 Hipertensi V
BSP 5 30
HUMALOG 3
45 SISWANTI Metformin 500 mg 30
Diabetes V

46 SITI LESTARI Amlodipin 5 mg 30 Hipertensi V 1 BULAN

Metformin 500 mg 90
47 SOEPIYAH Vit B1 30 Diabetes V
Diamicron MR 30
48 SOEWARSONO Candesartan 30 Hipertensi V
Acarbose 50 mg 90
49 SRI LESTARI Glimepiride 2 mg 30
Diabetes V 3 BULAN

Lisinopril 10 mg 30
50 SRI MARGIYATI Amlodipin 10 mg 30
Hipertensi V

Candesartan 16 mg 30
51 SRI MULYANI Nitrokaf R 30
HHD V

Gliquidone 30
52 SRI PURWANTI Metformin 500 mg 90
Diabetes V

Gliquidon 30
Metformin 500 mg 30
53 SRI SUHARTI Ramipril 10 mg 30 DM, HT V
BSP 5 mg 30

Metformin 500 mg 90
BSP 5 mg 30
54 SRI SUHARTINI Glimepirid 4 mg 30 DM, Stroke V
Miniaspi 30
Galvus 50 mg 30
 Metformin 500 mg 60
55 SRI SUMARNI Gliquidone 90
Diabetes V

56 SRI SUPADMI Gliquidon 15 Diabetes V

Miniaspi 30
BSP 5 mg 30
57 SUGENG SUPRIYONO ISDN 90
Stroke V 1 BULAN
Lisinopril 5 mg 30

58 SUHARNI V
Candesarta 16 mg 30
59 SUHARTI Amlodipin 10 mg 30 HHD, stroke V
Miniaspi 30
Glimepirid 2 mg 30
60 SUKARMO Metformin 500 mg 90 Diabetes V

Amlodipin 5 mg 30
61 SUKIDI Miniaspi 30
Stroke V

Amlodipin 10 mg 30
62 SUKINEM Ramipril 5 ng 30
Hipertensi V

63 SULASTRI HAMININGSIH Amlodipin 5 mg 30 Hipertensi V 2 BULAN

Gliquidon 90
64 SUMINEM Candesartan 30 HHD V
ISDN 90
Amlodipin 5 mg 30
65 SUMINI Irbesartan 300 mg 30
Hipertensi V

Amlodipin 5 mg 30
66 SUNARMI ISDN 90 HHD V
Candesartan 16 mg 30
67 SUNARSIH V
68 SUPANTO Irbesartan 300 mg 30 Hipertensi V
69 SUPARMAN Amlodipin 5 mg 30 Hipertensi V
LEVEMIR 2
70 SUPARMANTO glimepirid 3 mg 30 DM, HT V
lisinopril 10 mg 30
Glimepirid 1 mg 30
71 SUPRAPTI LANTUS 1
Diabetes V

72 SURAMI HT V
73 SURANI Symbicort 1 HHD, PPOK V
74 SURATMANTO AGUS Amlodipin 5 mg 30 Hipertensi V
Amlodipin 10 mg 30
75 SUWARNI Candesartan 8 mg 30 Hipertensi V

Miniaspi 30
Amlodipin 10 mg 30
76 SUWARTO Metformin 500 mg 30 Stroke, DM V
BSP 5 mg 30

77 SUYATNI Amlodipin 10 mg 30 Hipertensi V

Nitrokaf R 60
Concor 2.5 mg 30
80 TARI Amlodipin 5 mg 30
HHD V
Spironolacton 25 mg 30

Perindopril 10 60
81 TH SUKIYEM BSP 10 mg 30 HHD V
Amlodipin 5 mg 30

Lisinopril 10 mg 30
82 TUN WINARTI HCT 30
HT V 1 BULAN

Candesartan 30
Concor 2.5 mg 30
83 UMI SOLEKAH Glikazide 30 HHD V
Herbesser 200 mg 30
BSP 5 mg 30
84 UMI SRI WAHYUNI Valsartan 60 mg 30 Hipertensi V

85 WALIDI V
Glimepirid 4 mg 30
86 WARSINI metformin 500 mg 90
Diabetes V

Amlodipin 5 mg 30
87 Y. ISWIYOTO Metformin 500 mg 30
DM, HT V

Mengetahui , Karanganyar, ………………….

Direktur Klinik Pratama Pembuat Laporan
Griya Sehat
(dr. Agil Priambodo, Sp. KKLP, M. Biomed) ( )
 LAPORAN PENGAMBILAN OBAT PRB KIMIA FARMA
BULAN : AGUSTUS 2022

NAMA KETERANGAN
NO NAMA NAMA OBAT PENYAKIT KETERANGAN
DIAMBIL TIDAK DIAMBIL
Ramirpil 10 mg 30
1 AGIL PRIAMBODO Adalat oros 30 HHD V
Concor 10 mg 30
Sansulin 1
BUKU DIBAWA PASIEN
2 AGUS DIYONO Nitrokaf R 30 Diabetes V U/ KONTROL
Metformin 850 mg 60
4 AMIYEM Glimepirid 4 mg 30 Diabetes V
Diltiazem 90
5 ANASTASIA HARTATI Nitrokaf R 60 HHD V
Candesartan 16 mg 30
BSP 5 mg 30
6 ASIH Candersartan 16 mg 30 HHD V
Adalat oros 30
Amlodipin 10 mg 30
7 DADI KARTINAH BSP 5 mg 30
Hipertensi V

Gliquidone 90
8 DEWI SRI PALUPI metformin 500mg 90
Diabetes V

Tanapres 10 mg 30
9 EDHIE HASTUTI Vit B12 30
HHD V

Novomix 5
Candesartan 8 mg 30
10 ENDAH TRIHASTUTI Metformin 500 mg 90
DM, Hipertensi V
Allopurinol 10 mg 30

Metformin 500 mg 30
Amlodipin 10 mg 30
11 ENDANG SRI W BSP 5 mg 30
DM, Hipertensi V
Candesartan 16 mg 30

LANTUS 1
Acarbose 50 mg 90
12 ENJEN Herbesser 200 mg 30 Diabetes V
Metformin 500 mg 90

13 ETIK HANDAYANI Candesartan 8 mg 30 Hipertensi V

Candesartan 8 mg 30
14 FITRI ROOSTIYAHWATI Metformin 500 mg 90 DM, Hipertensi V
Glimepiride 2 mg 30

HUMALOG
Bsp 2,5 mg 30
15 HADI MULYANTO Candesartan 16 mg 30 DM, HHD V
Adalat oros 30 mg
Spironolacton 25 mg 30

Glimepirid 1 mg 30
16 HENDRO NUFIANTO Metformin 500 mg 90 DM, Hipertensi V
Ramipril 5 mg 30

Metformin 500 mg 90
Amlodipin 10 mg 30
17 HENDRO PITOYO Diovan 160 15 DM, Stroke V
Miniaspi 30
Glimepirid 4 mg 30
18 KOMARIAH Metformin 500 mg 60 Diabetes V

19 LAGINEM DM, HHD V

BSP 5 mg 30
20 LINA INDRIYANA Amlodipin 10 mg 30 Hipertensi V
Candesartan 16 mg 30
21 LISTIANA DS Symbicort 1 Asma V
Risperidone 2 mg 60
22 MAMIK SUPARSI THP 2 mg 60
Skizofrenia V

Amlodipin 5 mg 30
23 MARSONO Miniaspi 30 HHD V
Ramipril 10 mg 30

24 MARTIANA S S Amlodipin 10 mg 30 Hipertensi V

Ramipril 10 mg 30
25 MM SUJATMI Concor 10 mg 30 Hipertensi V
Amlodipin 10 mg 30

Bisoprolol 5 mg 30
26 MUGIJEM Metformin 500 mg 90
DM, HT V
 Fenitoin 100 mg 60
27 MULYATIN Phenobarbital 30 mg 90 EPILEPSI V
vitamin B6 30 mg

LANTUS 3
Amlodipin 10 mg 30
BSP 5 mg 30
28 MURTINI Glimepiride 4 mg 30 DM, HHD V
Lisinopril 10 mg 30
ISDN 90

Amlodipin 10 mg 30
29 NGADIYEM Lisinopril 10 mg 30
Hipertensi V

Amlodipin 5 mg 30
30 NINIK SUSILAWATI Concor 2.5 mg 30 HHD V
Nitrokaf R 60

Amlodipin 10 mg 30
TIDAK DIAMBILKAN
Lisinopril 5 mg 30
31 PARDJIMAN ISDN 30
HT, Stroke V KRN 4 BULAN TIDAK
DIAMBIL
Miniaspi 30

32 PARTINI Candesartan 8 mg 30 HT V
33 PARYANI Lisinopril 10 mg 30 HT V
BSP 2,5 mg 30 TIDAK DIAMBILKAN
34 PUJI RAHAYUNINGSIH furosemid 30 HHD V KRN 4 BULAN TIDAK
candesartan 8 mg 30 DIAMBIL

Candesartan 8 mg 30
Amlodipin 10 mg 30
35 RA. ANICETHA MENIK Vit B12 30
Hipertensi V
Bisoprolol 2,5 mg 30
Glimepiride 1 mg 30
36 RETMIYATI Metformin 850 mg 60
Diabetes V

Amlodipin 10 mg 30
37 RETNO SUBEKTI Irbesartan 150 mg 30 Hipertensi V
Spironolacton 25 mg 30
Miniaspi 30
38 RIEN NURUL Amlodipin 10 mg 30 Stroke V
Vit B 12 30
Amlodipin 10 mg 30
39 RUSDI BSP 5 mg 30
Hipertensi V

Metformin 500 mg 90
Ramipril 10 mg 30
40 SAMSIKIN Adalat oros 30 DM, HHD V
BSP 5mg 30
Symbicort 1
41 SARAH YAHUNI Vit B1 30 Asma V

Metformin 850 mg 60
42 SARDINEM Gliquidon 90 DM, Hipertensi V
Lisinopril 10 mg 30
LANTUS 4
43 SARSONO Gliquidone 30 DM, HT V
Amlodipin 10 mg 30
Gliquidone 30
44 SIH TAMI Candesartan 30 Hipertensi V
BSP 5 30
HUMALOG 3
45 SISWANTI Metformin 500 mg 30
Diabetes V

46 SITI LESTARI Amlodipin 5 mg 30 Hipertensi V 2 BULAN

Metformin 500 mg 90
47 SOEPIYAH Vit B1 30 Diabetes V
Diamicron MR 30
48 SOEWARSONO Candesartan 30 Hipertensi V
Acarbose 50 mg 90
49 SRI LESTARI Glimepiride 2 mg 30
Diabetes V

Lisinopril 10 mg 30
50 SRI MARGIYATI Amlodipin 10 mg 30
Hipertensi V

Candesartan 16 mg 30
51 SRI MULYANI Nitrokaf R 30
HHD V

Gliquidone 30
52 SRI PURWANTI Metformin 500 mg 90
Diabetes V

Gliquidon 30
Metformin 500 mg 30
53 SRI SUHARTI Ramipril 10 mg 30 DM, HT V
BSP 5 mg 30

Metformin 500 mg 90
BSP 5 mg 30
54 SRI SUHARTINI Glimepirid 4 mg 30 DM, Stroke V
Miniaspi 30
Galvus 50 mg 30
 Metformin 500 mg 60
55 SRI SUMARNI Gliquidone 90
Diabetes V

56 SRI SUPADMI Gliquidon 15 Diabetes V

Miniaspi 30
BSP 5 mg 30
57 SUGENG SUPRIYONO ISDN 90
Stroke V
Lisinopril 5 mg 30

58 SUHARNI V
Candesarta 16 mg 30
59 SUHARTI Amlodipin 10 mg 30 HHD, stroke V
Miniaspi 30
Glimepirid 2 mg 30
60 SUKARMO Metformin 500 mg 90 Diabetes V

Amlodipin 5 mg 30
61 SUKIDI Miniaspi 30
Stroke V

Amlodipin 10 mg 30
62 SUKINEM Ramipril 5 ng 30
Hipertensi V

63 SULASTRI HAMININGSIH Amlodipin 5 mg 30 Hipertensi V 2 BULAN

Gliquidon 90
64 SUMINEM Candesartan 30 HHD V
ISDN 90
Amlodipin 5 mg 30
65 SUMINI Irbesartan 300 mg 30
Hipertensi V

Amlodipin 5 mg 30
66 SUNARMI ISDN 90 HHD V
Candesartan 16 mg 30
67 SUNARSIH V
68 SUPANTO Irbesartan 300 mg 30 Hipertensi V
69 SUPARMAN Amlodipin 5 mg 30 Hipertensi V
LEVEMIR 2
70 SUPARMANTO glimepirid 3 mg 30 DM, HT V
lisinopril 10 mg 30
Glimepirid 1 mg 30
71 SUPRAPTI LANTUS 1
Diabetes V

72 SURAMI HT V
73 SURANI Symbicort 1 HHD, PPOK V
74 SURATMANTO AGUS Amlodipin 5 mg 30 Hipertensi V
Amlodipin 10 mg 30
75 SUWARNI Candesartan 8 mg 30 Hipertensi V

Miniaspi 30
Amlodipin 10 mg 30
76 SUWARTO Metformin 500 mg 30 Stroke, DM V
BSP 5 mg 30

77 SUYATNI Amlodipin 10 mg 30 Hipertensi V

Nitrokaf R 60
Concor 2.5 mg 30
80 TARI Amlodipin 5 mg 30
HHD V
Spironolacton 25 mg 30

Perindopril 10 60
81 TH SUKIYEM BSP 10 mg 30 HHD V
Amlodipin 5 mg 30

Lisinopril 10 mg 30
82 TUN WINARTI HCT 30
HT V

Candesartan 30
Concor 2.5 mg 30
83 UMI SOLEKAH Glikazide 30 HHD V
Herbesser 200 mg 30
BSP 5 mg 30
84 UMI SRI WAHYUNI Valsartan 60 mg 30 Hipertensi V

85 WALIDI V
Glimepirid 4 mg 30
86 WARSINI metformin 500 mg 90
Diabetes V

Amlodipin 5 mg 30
87 Y. ISWIYOTO Metformin 500 mg 30
DM, HT V

Mengetahui , Karanganyar, ………………….

Direktur Klinik Pratama Pembuat Laporan
Griya Sehat
(dr. Agil Priambodo, Sp. KKLP, M. Biomed) ( )