APOTEK RISSA MEDIKA

Jl. SRI BANGUN RT.19

Apoteker : apt. Tri Debi Septiani Putri, S.Farm.
SIPA : 19980908/ SIPA 64.03/2023/2/177
SURAT PESANAN OBAT
Nomor SP : 00....../APT-RM/SPO/..../20....
Kepada Yth,
Nama PBF : FERTOMULIA
Alamat SAMARINDA
No. Nama Obat Satuan Jumlah Keterangan

1 ANTIMO 50 MG BOX 1
2 BETADINE FMININE HYGIENE 60 BTL 3
3 BETADINE GARGLE 100 ML BTL 3
4 BETADINE GARGLE 190 ML BTL 3
5 BEOPLACENTON GEL 15 GR TUBE 3
6 BODREX EXTRA BOX 3
7 BODREX F&B BERDAHAK PE 60ML BOX 2
8 BODREX F&B PE 60ML BTL 3
9 BODREX MIGRA TAB 25 STR BOX 3
10 BUSCOPAN PLUS TAB 100 BOX 2
11 BUSCOPAN TAB 100 BOX 3
12 CANDERIN 16 MG 30'S BOX 2
13 CATAFLAM 25 MG TAB 50'S BOX 3
Kota Bangun,
Apoteker Penanggungjawab Apotek

apt. Tri Debi Septiani Putri, S.Farm.

SIPA : 19980908/ SIPA 64.03/2023/2/177
 APOTEK RISSA MEDIKA
Jl. SRI BANGUN RT.19 KOTA BANGUN
Apoteker : apt. Tri Debi Septiani Putri, S.Farm.
SIPA : 19980908/ SIPA 64.03/2023/2/177
SURAT PESANAN OBAT OOT
Nomor SP : 00....../APT-RM/SPO/..../20....
Kepada Yth,
Nama PBF : FERTOMULIA
Alamat SAMARINDA
No. Nama Obat Satuan Jumlah Keterangan

1 KOMIX MINT G-FORMULA BOX 2

2 KONIDIN TAB BOX 2
3 MEXTRIL BOX 2
4 MIXAGRIF FLU BATUK25'S BOX 3
5 HISTIGO BOX 5
6 PROCOLD FLU & BATUK 24X6'S BOX 2
7 PROMEDEX 100 TAB INTERBAT BOX 3
8 PROMEDEX 60 ML INTERBAT BTL 3
9 SILADEX ATT 30 ML BTL 5
10 SILADEX ATT 60 ML BTL 5
11 SILADEX ATT 100 ML BTL 5
12 SILADEX DMP 30 ML BTL 5
13 SILADEX DMP 60 ML BTL 5
14 VICKS FORMULA 44 ANAK 27 ML BTL 5
15 VICKS FORMULA 44 ANAK 54 ML BTL 5
16 VICKS FORMULA 44 DWS 27 ML BTL 5
17 POLOFAR PLUS BOX 3
18 PRATIFAR 40 MG BOX 2
19 KALCINOL-N TUBE 3
20 MOLACORT 0,75 MG BOX 2
21 RHEMAFAR 4 MG BOX 5
22 RHEMAFAR 8 MG BOX 3
23 SCOPMA PLUS BOX 1
24 SELVIM 10 MG BOX 5
25 SELVIM 20 MG BOX 5
26 YUSIMOX TAB BOX 1
27 ACYCLOFIR TAB 400 MG BOX 1
28 AMBROXOL TAB BOX 3
29 AMPICILLIN BOX 3
30 BETAMETHASONE 5 GR TUBE 10
31 CAPTOPRIL 25 MG BOX 5
32 CAPTOPRIL 50 MG BOX 2
33 DESOXIMETHASONE 15 GR TUBE 5
34 DEXAMETHASON (HOLI) BOX 3
35 DIC. SODIUM 50 MG (FM) BOX 5
36 FLUNARIZINE 10 MG BOX 2
37 FLUNARIZINE 5 MG BOX 2
38 HYDROCORTISON CR 2,5% TUBE 5
39 METOCLOPERAMIDE 10 MG BOX 1
40 MOMETASONE 5 GR TUBE 5
41 PROPANOLOL 10 MG BOX 2
42 PROPYLTHIOURACIL (PTU) TAB 1 BOX
43 SALBUTAMOL 2 MG 2 BOX
44 SALBUTAMOL 4 MG 3 BOX Kota Bangun,
45 SPIRONOLACTONE 25 MG 1 BOX Apoteker Penanggungjawab Apotek
46 ISDN 3 BOX
47 SUPER TETRA 3 BOX
48 APOLAR CR 10 GR 3 TUBE
49 APOLAR N CR 10 GR 3 TUBE apt. Tri Debi Septiani Putri, S. Farm.
SIPA : 19980908/ SIPA 64.03/2023/2/177