RSUD TABANAN

Jl. Pahlawan No. 14 Tabanan, Bali 82113

Medical Prescription: PRO015

Patient Age Doctor Date
Suki Gianto 39 Tahun dr. Gde Somayana, Sp.PD- 06/09/2023 15:41:59
KGEH
Disease: TBC
Allow Dose Qty. Per Total
Sr.No Medicine Substitution Frequency Qty. Day Days Quantity Comment

1 ETHAMBUTOL True Take one in morning, noon 1.0 1.0 1.0 1.0 dihabiskan
500MG and evening.

Comment(If Any):
obat harus dihabiskan sebelum konsultasi kembali

Doctor’s Stamp/Signature

(0251) 8349305 info@brsutabanan.co.id http://www.brsutabanan.co.id

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