Purchase Order

Document No : PRO/137/231223/0013 Document Date : Dec 23, 2023 10:37 AM

To : MERAPI UTAMA Place Of Delivery : FARMASI REGULER

PHARMA,PT RS Hermina Karawang
JL Kawasan Industri SUKABUMI
Pulogadung, JL. Pulo Buaran JAWA BARAT
Raya No. 4, Blok III EE - Kav. Contact : Rima Nurhidayati/
No.1, Jakarta, 13930, RW.9, 085717058448
Jatinegara, Cakung, East
Jakarta City, Jakarta 13930
GAMBIR
DKI JAKARTA
Contact :JKT1-MERAPI
UTAMA PHARMA,/
02146821660
Document Status : CLOSED Approval Status : APPROVED
Ref Document No : Tax Code : 137PPN PEMBELIAN VAT

Sl.No. Description Quantity Unit Rate Amount Discount Total Amount

1 Sodium Chloride (NaCl) 0.9% Infus 40 Buah 6.913,00 276.520,00 0,00 306.937,20
Wida 500 ml
Gross Amount : 306.937,20

Total Tax Amount : 30.417,20

Payment Terms :
PO Advance Request Amount : 0
Net Amount (Rp) : 306.937,20
Terms And Conditions :
Remarks :
Terbilang Total Transaksi : Tiga Ratus Enam Ribu Sembilan Ratus Tiga Puluh Tujuh Rupiah
Amount in Words : Rupiah Three Hundred Six Thousand Nine Hundred Thirty Seven and Twenty Only

RS HERMINA KARAWANG

105809967
Authorized Signatory

Created By Yusi Mulyani Created Date Time Dec 23, 2023 10:37 AM
Approved By EVI OKTAVIA MARPAUNG Approved Date Time Dec 23, 2023 10:42 AM

Generated On 26/12/2023 05:58

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 Goods Receipt Note
GRN No GRN/137/231223/0014 GRN Date 23/12/2023
From MERAPI UTAMA PHARMA,PT To FARMASI REGULER
MERAPI UTAMA PHARMA,PT Rima Nurhidayati
JL. CILOSARI NO.23 CIKINI RS Hermina Karawang
GAMBIR SUKABUMI
DKI JAKARTA JAWA BARAT
INDONESIA INDONESIA
Phone: 3141906 Phone: 085717058448
Invoice No 23987438 Invoice Date 23/12/2023
Delivery Challan 23987438 Delivery Challan 23/12/2023
No. Date
Ref. Doc. No PRO/137/231223/0013
Approval Status APPROVED Document Status PENDING

S.No Item Batch Code Received Quantity Accepted Quantity UOM Rate (IDR) Amount DISC. MRP Tax Amount Total Amount
1 Sodium Chloride (NaCl) 0.9% A88K53A 40 40 Buah 6,913.00 276,520.00 0.00 9,822.00 30,417.20 306,937.20
Infus Wida 500 ml
Total (IDR) 276,520.00 0.00 30,417.20 306,937.20
Grand Total (IDR) 306,937.20
Terbilang Total : Tiga Ratus Enam Ribu Sembilan Ratus Tiga Puluh Tujuh Rupiah
Transaksi
Amount In Words : Rupiah Three Hundred Six Thousand Nine Hundred Thirty Seven and Twenty Only
Remarks : MERAPI UTAMA PHARMA,PT

105812201
Authorized Signatory

Generated On 26/12/2023 05:45

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Created By Yusi Mulyani Created Date Time Dec 23, 2023 11:06 AM
Approved By EVI OKTAVIA MARPAUNG Approved Date Time Dec 23, 2023 11:08 AM

Generated On 26/12/2023 05:45

Page 2 of 2