KWITANSI OBAT-OBATAN

RAWAT JALAN
Tgl & jam : 16/04/2019 No. Bill : 17002982
NAMA : AAN RUMIYANTO
NO MR : 293
UMUR/ SEX : 43 MALE
Dokter : Dr. ESTU RUDIKTYO, SP.JP
Perusahaan : BPJS KES
Pay Made :
No Nama Obat Qty Harga/Satuan
1 BISOPROLOL 15 1925
2 AMLODIPIN 10 1632
3 LANSOPRAZOLE 6 4054.05

JUMLAH
DISCOUNT
JUMLAH SETELAH DISCOUNT

SHIMA
SIGNATURED/ BILLED
BATAN
N
No. Bill : 17002982

JP

a/Satuan
Rp 28,875
Rp 16,320
Rp 24,324

Rp 69,519

Rp 69,519

SHIMA
NATURED/ BILLED
LAPORAN OBAT EX. DATE 2018
Bulan Januari - November 2018

NO NAMA OBAT JUMLAH SEDIAAN EX. DATE

1 VIOSTIN DS 53 TABLET
2 AZYTROMICIN 0.5G 6 VIAL Sep-18
3 FARTOLIN 2 INHALASI Nov-18
4 CEFEPIME 3 VIAL Jun-18
5 LIPOSIN SALEP 5 SALEP Jun-18
6 SEROQUEL 100 TABLET Feb-18
7 THIAMYCIN 3 SIRUP Mart-18
8 PALENTIN 1 SIRUP Mart-18
9 MATHOVIT 2 SIRUP Juni-18
10 INTERLAC 5 DROPS Mart-18
11 POLIDEMISIN 3 BOTOL Apr-18
12 INOTROP 1 AMPUL Juni-18
13 INDOP 1 AMPUL Mart-18
14 FLUBIO 4 VIAL Mart-18
15 ERLAMYCETIN 1 BOTOL Des-18
16 GLUVAS 1MG 10 TABLET Des-18
17 GLUVAS 2MG 6 TABLET Des-18
18 GLUVAS 3MG 50 TABLET Des-18
19 GLUVAS 4MG 45 TABLET Des-18
20 SULDOX 9 TABLET Feb-18
21 TEBOKAN SPESIAL 80MG 20 TABLET Sep-18
22 METRIX 2 TABLET
23 SALOFALK 19 TABLET Sep-18
24 WIAFLOX 4 TABLET
25 RILEVO 1 TABLET
26 VITAMAM 1 4 CAPS Mei-18
27 VITAMAM 2 12 CAPS Mei-18
28 VITAMAM 3 13 CAPS Mei-18
29 NYTEC 5 CAPS
30 VASCON 1 AMPUL Mei-18
31 LAMDA 1 AMPUL Mart-18
32 CARBAZOCHROME 2 AMPUL Sep-18
33 GAMET 3 AMPUL Mei-18
34 EPIDOSIN 2 AMPUL Nov-18
35 VALDIMEX 3 AMPUL Sep-18
36 ENTRAMIX 1 SUSU Sep-18
37 SGM LLM+ 1 SUSU Sep-18
38 SGM AMANDA 1 SUSU Sep-18

Note : Tanda Bukti Serah Terima Obat Expired Date

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