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SURAT PENGELUARAN BARANG

Outbound Report Form

No Document Effective Date


Form
D10082154 Rev AA 1-Jun-22

Delivered Form : Tanggal : Thursday, December 1, 2022


PT.Alere Health (Gudang) Nomor : 393/SPB/SI/XII/AH/2022
Komplek Pergudangan PT.Widya Sakti Kusuma Blok D-12A, No PO : 2211-403-P
Jl. Wahab Affan, Pondok Ungu, 17132 KOTA BEKASI, INDONESIA
Nama Driver :
No Polisi :
o
Shipping Address : Suhu Kendaraan : C
PT.Itama Ranoraya
MT.Haryono Square Lt.I unit 101 Jl.Otto Iskandardinata Raya No.390
Jakarta Timur 1333 0

No. SKU Dist SKU SAP Product Description Batch / Lot Expired Qty Remarks

1 11FK10 F11FK10PT SD Dengue IgG/M 25T 11ADG002AA 16-Nov-2023 30

Total 30

WH SPv
Distributor

( Taufik Rachman )
( )

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