<table align="center" width="50%" border="0"cellpadding="2" cellspacing="2">

<tr>
<td align="center" colspan="5">
<big><big><big><span style="font-weight: bold;">
LAPORAN PEMAKAIAN PER RESEP
</span></big></big></big>
</td>
</tr>
</table>

<table class='tabel bayang' width='90%' border="1">

<tr class='row1' >
<td align='center'>No</td>
<td width="8%" align='center'>Tanggal</td>
<td >Pasien</td>
<td >No RM</td>
<td >Alamat</td>
<td >Lahir</td>
<td >Ruangan</td>
<td >Diagnosa</td>
<td width="40%" class="garis">
<table width='100%' border='1'>
<tr valign="top">
<td align="left">Nama</td>
<td width="10%">Jumlah</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>1</td>
<td align='left'>29-04-2024</td>
<td align='left'>ELIS ROSITA</td>
<td align='left'>034478</td>
<td align='left'>NGLEGOK RT 08 RW 03-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>1980-10-01</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
</td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>2</td>
<td align='left'>29-04-2024</td>
 <td align='left'>MINEM</td>
<td align='left'>034509</td>
<td align='left'>TEMPURAN 03/06-TEMPURAN-SAWOO-PONOROGO</td>
<td align='left'>1942-07-01</td>
<td align='left'>RAWAT INAP</td>
<td align='left'></td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Loratadin 10 mg </td>
<td width="10%" align="center">13</td>
</tr>
</table>
</td>
 </tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>3</td>
<td align='left'>29-04-2024</td>
<td align='left'>KAWIT</td>
<td align='left'>034494</td>
<td align='left'>RT 2 RW 4 -TEMPURAN-SAWOO-PONOROGO</td>
<td align='left'>1946-11-06</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>4</td>
<td align='left'>29-04-2024</td>
<td align='left'>SATRIA AGENG PRIHAMBODO</td>
<td align='left'>021182</td>
<td align='left'>DUSUN PAKEL, RT : 033,RW :006 PRAMBON</td>
<td align='left'>2010-11-30</td>
<td align='left'>UGD</td>
<td align='left'>L02</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Loratadin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>5</td>
<td align='left'>29-04-2024</td>
<td align='left'>MUHAMMAD DENY NUGROHO</td>
<td align='left'>034489</td>
<td align='left'>RT 17 RW 07 JAMBU</td>
<td align='left'>2009-12-30</td>
<td align='left'>UGD</td>
<td align='left'>Z48.0</td>
<td align='left'>
<table width='100%' border="1">
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>6</td>
<td align='left'>29-04-2024</td>
<td align='left'>PURNAWAN</td>
<td align='left'>032774</td>
<td align='left'>DUSUN MLOKO, RT : 055,RW :011 PRAMBON</td>
<td align='left'>1993-07-22</td>
 <td align='left'>UGD</td>
<td align='left'>Z48.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Allopurinol 100 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>7</td>
<td align='left'>29-04-2024</td>
<td align='left'>MURYONO</td>
<td align='left'>000650</td>
<td align='left'>DUSUN KRAJAN RT : 015 RW :004 NGLONGSOR</td>
<td align='left'>1954-08-12</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>8</td>
<td align='left'>29-04-2024</td>
<td align='left'>INDARWATI</td>
<td align='left'>034507</td>
<td align='left'>DSN GAJAH, RT : 007,RW :003 DUREN</td>
<td align='left'>1981-04-22</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Allopurinol 100 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
 <tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>9</td>
<td align='left'>29-04-2024</td>
<td align='left'>SUJIYO</td>
<td align='left'>015381</td>
<td align='left'>DSN ETAN KALI RT 020 RW 005 NGLONGSOR</td>
<td align='left'>1963-03-28</td>
<td align='left'>UGD</td>
<td align='left'>Z48.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Allopurinol 100 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>10</td>
<td align='left'>29-04-2024</td>
<td align='left'>ARSY SYAFAAT NURIL AKMAL</td>
<td align='left'>032622</td>
<td align='left'>DUSUN PAKEL, RT : 025,RW :005 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>2016-12-23</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">7</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>11</td>
<td align='left'>29-04-2024</td>
<td align='left'>EVA SETIANINGSIH</td>
<td align='left'>020033</td>
<td align='left'>DUSUN PONGGOK, RT : 20,RW :9 NGEPEH</td>
<td align='left'>2001-01-31</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>12</td>
<td align='left'>29-04-2024</td>
<td align='left'>SITI NURJANAH</td>
<td align='left'>034532</td>
<td align='left'>DSN.JARAKAN RT 23 / RW 05 DESA KARANGSOKO,TRENGGALEK.,
RT : 023,RW :005 -KARANGSOKO-TRENGGALEK-TRENGGALEK</td>
<td align='left'>1993-08-18</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>13</td>
<td align='left'>29-04-2024</td>
<td align='left'>HANDOYO</td>
<td align='left'>027453</td>
<td align='left'>DUSUN PONGGOK, RT : 20,RW :9 NGEPEH</td>
<td align='left'>1973-07-01</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
 </table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>14</td>
<td align='left'>29-04-2024</td>
<td align='left'>SAMUDJI</td>
<td align='left'>034477</td>
<td align='left'>RT 02 RW 05-TEMPURAN-SAWOO-PONOROGO</td>
<td align='left'>1962-06-30</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>15</td>
<td align='left'>29-04-2024</td>
<td align='left'>ISTIQAMAH</td>
<td align='left'>003983</td>
<td align='left'>RT 14 RW 4 GONDANG</td>
<td align='left'>1969-10-06</td>
<td align='left'>UGD</td>
<td align='left'>J45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Allopurinol 100 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>16</td>
<td align='left'>29-04-2024</td>
<td align='left'>VELLA REGINA PUTRI</td>
<td align='left'>034457</td>
<td align='left'>DUSUN MLOKO, RT : 56,RW :12 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>2011-05-14</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>B05.9</td>
 <td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>17</td>
<td align='left'>29-04-2024</td>
<td align='left'>DEWI MUSTIKA</td>
<td align='left'>034511</td>
<td align='left'>SOOKO, RT : 43,RW :9 PRAMBON</td>
<td align='left'>2005-03-25</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>18</td>
<td align='left'>29-04-2024</td>
<td align='left'>TUMISAH</td>
<td align='left'>009301</td>
<td align='left'>DUSUN KRAJAN, RT : 10,RW :3 -NGLONGSOR-TUGU-
TRENGGALEK</td>
<td align='left'>1945-05-10</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>19</td>
<td align='left'>29-04-2024</td>
<td align='left'>ZUMROTUL NASIKAH</td>
<td align='left'>000881</td>
<td align='left'>RT 18 RW 07-JAMBU-TUGU-TRENGGALEK</td>
 <td align='left'>2005-08-25</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>20</td>
<td align='left'>29-04-2024</td>
<td align='left'>RUBIYANTO</td>
<td align='left'>029804</td>
<td align='left'>ETAN KALI, RT : 21,RW :5 NGLONGSOR</td>
<td align='left'>1967-02-02</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Allopurinol 100 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>21</td>
<td align='left'>29-04-2024</td>
<td align='left'>MINEM</td>
<td align='left'>034509</td>
<td align='left'>TEMPURAN 03/06-TEMPURAN-SAWOO-PONOROGO</td>
<td align='left'>1942-07-01</td>
<td align='left'>RAWAT INAP</td>
<td align='left'></td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid 10 mg </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>22</td>
<td align='left'>29-04-2024</td>
<td align='left'>SUJIYO</td>
<td align='left'>015381</td>
<td align='left'>DSN ETAN KALI RT 020 RW 005 NGLONGSOR</td>
<td align='left'>1963-03-28</td>
<td align='left'>UGD</td>
<td align='left'>Z48.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ciprofloxacin 500 mg(13) </td>
<td width="10%" align="center">7</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>23</td>
<td align='left'>29-04-2024</td>
<td align='left'>RAFFASYA QIYAS IRAWAN</td>
<td align='left'>013049</td>
<td align='left'>DSN PONGGOK RT 024 RW 010 -NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2021-05-08</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R11</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
</td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>24</td>
<td align='left'>29-04-2024</td>
<td align='left'>MESIYEM</td>
 <td align='left'>007872</td>
<td align='left'>DUSUN SOOKO RT 049 RW 010 PRAMBON</td>
<td align='left'>1963-04-21</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metronidazole 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>25</td>
<td align='left'>29-04-2024</td>
<td align='left'>LAMIDI</td>
<td align='left'>000983</td>
<td align='left'>RT02 RW 01 GONDANG</td>
<td align='left'>1945-07-01</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Allopurinol 100 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>26</td>
<td align='left'>29-04-2024</td>
<td align='left'>DIMAS BAGUS SAPUTRA</td>
<td align='left'>034505</td>
<td align='left'>SOOKO, RT : 43,RW :9 PRAMBON</td>
<td align='left'>2014-05-01</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>27</td>
<td align='left'>29-04-2024</td>
 <td align='left'>SAMSUDIN</td>
<td align='left'>034510</td>
<td align='left'>RT 5 RW 2 WINONG WINONG</td>
<td align='left'>1969-04-29</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>28</td>
<td align='left'>29-04-2024</td>
<td align='left'>MUJIO</td>
<td align='left'>034456</td>
<td align='left'>RT 56 RW 12 DUSUN MLOKO PRAMBON</td>
<td align='left'>1975-07-11</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Allopurinol 100 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>29</td>
<td align='left'>28-04-2024</td>
<td align='left'>ELIS ROSITA</td>
<td align='left'>034478</td>
<td align='left'>NGLEGOK RT 08 RW 03-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>1980-10-01</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>30</td>
<td align='left'>28-04-2024</td>
<td align='left'>KAWIT</td>
<td align='left'>034494</td>
<td align='left'>RT 2 RW 4 -TEMPURAN-SAWOO-PONOROGO</td>
<td align='left'>1946-11-06</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>31</td>
<td align='left'>28-04-2024</td>
<td align='left'>ARSY SYAFAAT NURIL AKMAL</td>
<td align='left'>032622</td>
<td align='left'>DUSUN PAKEL, RT : 025,RW :005 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>2016-12-23</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50</td>
<td align='left'>
<table width='100%' border="1">
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>32</td>
<td align='left'>28-04-2024</td>
<td align='left'>RONAL SEPTIAN PRATANTO</td>
<td align='left'>007463</td>
<td align='left'>BANARAN RT 11-BANARAN-TUGU-TRENGGALEK</td>
<td align='left'>2006-09-22</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>33</td>
<td align='left'>28-04-2024</td>
<td align='left'>ISWANDI</td>
<td align='left'>018968</td>
 <td align='left'>DUSUN KALIPINGGIR, RT : 18,RW :5 -GONDANG-TUGU-
TRENGGALEK</td>
<td align='left'>1963-01-13</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>I49.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>34</td>
<td align='left'>28-04-2024</td>
<td align='left'>JARMI</td>
<td align='left'>015316</td>
<td align='left'>DUSUN KEBONSARI, RT : 27,RW :7 -GONDANG-TUGU-
TRENGGALEK</td>
<td align='left'>1950-04-13</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>35</td>
<td align='left'>28-04-2024</td>
<td align='left'>MUHAMMAD ARSYA HASYIM AL HANAN</td>
<td align='left'>029743</td>
<td align='left'>DUSUN GONDANG KIDUL RT 012 RW 003-GONDANG-TUGU-
TRENGGALEK</td>
<td align='left'>2023-01-28</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>B08.4</td>
<td align='left'>
<table width='100%' border="1">
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>36</td>
<td align='left'>28-04-2024</td>
<td align='left'>SAMUDJI</td>
<td align='left'>034477</td>
<td align='left'>RT 02 RW 05-TEMPURAN-SAWOO-PONOROGO</td>
 <td align='left'>1962-06-30</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>37</td>
<td align='left'>28-04-2024</td>
<td align='left'>VELLA REGINA PUTRI</td>
<td align='left'>034457</td>
<td align='left'>DUSUN MLOKO, RT : 56,RW :12 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>2011-05-14</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>B05.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>38</td>
<td align='left'>28-04-2024</td>
 <td align='left'>ELGA VINNO LERIAN</td>
<td align='left'>020325</td>
<td align='left'>DUSUN KRAJAN, RT : 14,RW :3 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>2001-01-19</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.22 </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>39</td>
<td align='left'>28-04-2024</td>
<td align='left'>TUMISAH</td>
<td align='left'>009301</td>
<td align='left'>DUSUN KRAJAN, RT : 10,RW :3 -NGLONGSOR-TUGU-
TRENGGALEK</td>
<td align='left'>1945-05-10</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>40</td>
<td align='left'>28-04-2024</td>
<td align='left'>ZUMROTUL NASIKAH</td>
<td align='left'>000881</td>
<td align='left'>RT 18 RW 07-JAMBU-TUGU-TRENGGALEK</td>
<td align='left'>2005-08-25</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>41</td>
<td align='left'>28-04-2024</td>
<td align='left'>RAFFASYA QIYAS IRAWAN</td>
<td align='left'>013049</td>
<td align='left'>DSN PONGGOK RT 024 RW 010 -NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2021-05-08</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R11</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
</td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>42</td>
<td align='left'>28-04-2024</td>
<td align='left'>SUJARMI</td>
<td align='left'>027325</td>
<td align='left'>RT5 SUKOREJO</td>
<td align='left'>1970-01-18</td>
<td align='left'>UGD</td>
<td align='left'>J45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Masker Nebulizer Dewasa(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>43</td>
<td align='left'>28-04-2024</td>
<td align='left'>ALHANAN NAJWAN HUMAYUN</td>
<td align='left'>032216</td>
<td align='left'>RT 21 RW 05 GONDANG</td>
<td align='left'>2023-07-03</td>
<td align='left'>UGD</td>
<td align='left'>L30</td>
<td align='left'>
<table width='100%' border="1">
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>44</td>
<td align='left'>28-04-2024</td>
<td align='left'>WIJIARSO</td>
<td align='left'>000162</td>
<td align='left'>DUSUN ETAN KALI RT 019 RW 005 NGLONGSOR</td>
<td align='left'>1979-12-22</td>
<td align='left'>UGD</td>
<td align='left'>R50.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
 </table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>45</td>
<td align='left'>28-04-2024</td>
<td align='left'>SUNAIDI</td>
<td align='left'>013947</td>
<td align='left'>RT 06 RW 01 GONDANG</td>
<td align='left'>1964-06-10</td>
<td align='left'>UGD</td>
<td align='left'>R33</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Allopurinol 100 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>46</td>
<td align='left'>28-04-2024</td>
<td align='left'>KLUMPUK</td>
<td align='left'>034476</td>
<td align='left'>DUSUN KRAJAN II, RT : 6,RW :3 BANARAN</td>
<td align='left'>1965-07-13</td>
<td align='left'>UGD</td>
<td align='left'>R51</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Allopurinol 100 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
 </td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>47</td>
<td align='left'>28-04-2024</td>
<td align='left'>MUJAIT</td>
<td align='left'>034275</td>
<td align='left'>DUSUN KASIHAN, RT : 28,RW :12 NGEPEH</td>
<td align='left'>1951-08-10</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Allopurinol 100 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>48</td>
<td align='left'>27-04-2024</td>
<td align='left'>WASIDI</td>
<td align='left'>034430</td>
<td align='left'>RT 05 RW 01-GONDANG-TUGU-TRENGGALEK</td>
<td align='left'>1955-12-04</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>H81</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>49</td>
<td align='left'>27-04-2024</td>
<td align='left'>KAWIT</td>
<td align='left'>034494</td>
<td align='left'>RT 2 RW 4 -TEMPURAN-SAWOO-PONOROGO</td>
<td align='left'>1946-11-06</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
 <td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>50</td>
<td align='left'>27-04-2024</td>
<td align='left'>BOIKEM</td>
<td align='left'>034472</td>
 <td align='left'>DUSUN SANGGRAHAN, RT : 3,RW :2 SUKOREJO</td>
<td align='left'>1940-12-31</td>
<td align='left'>UGD</td>
<td align='left'>I63.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>51</td>
<td align='left'>27-04-2024</td>
<td align='left'>MOCHAMMAD ARJUNA ASYRAFY KURNIAWAN</td>
<td align='left'>000795</td>
<td align='left'>RT 035 RW 006 PRAMBON</td>
<td align='left'>2011-10-21</td>
<td align='left'>UGD</td>
<td align='left'>D68.3</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
 <tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>52</td>
<td align='left'>27-04-2024</td>
<td align='left'>SUKIATI</td>
<td align='left'>034474</td>
<td align='left'>DSN GAJAH, RT : 017,RW :007 DUREN</td>
<td align='left'>1960-04-22</td>
<td align='left'>UGD</td>
<td align='left'>K29</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Allopurinol 100 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>53</td>
<td align='left'>27-04-2024</td>
<td align='left'>FADHLI NAILUL HUDA</td>
<td align='left'>026808</td>
<td align='left'>DESA GONDANG, RT : 25,RW :6 GONDANG</td>
<td align='left'>2012-05-16</td>
<td align='left'>UGD</td>
<td align='left'>R11</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
 <td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>54</td>
<td align='left'>27-04-2024</td>
<td align='left'>SUMARNO</td>
<td align='left'>034405</td>
<td align='left'>KRAJAN, RT : 23,RW :4 PRAMBON</td>
<td align='left'>1977-07-17</td>
<td align='left'>UGD</td>
<td align='left'>K29</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>55</td>
<td align='left'>27-04-2024</td>
<td align='left'>SUNARTI</td>
<td align='left'>003499</td>
<td align='left'>DSN MLOKO RT 057 RW 012 PRAMBON</td>
<td align='left'>1996-01-22</td>
<td align='left'>UGD</td>
<td align='left'>K02.9</td>
<td align='left'>
 <table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Allopurinol 100 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>56</td>
<td align='left'>27-04-2024</td>
<td align='left'>MISTIYAH</td>
<td align='left'>012188</td>
<td align='left'>DUSUN KRAJAN, RT : 16,RW :4 NGLONGSOR</td>
<td align='left'>1965-03-08</td>
<td align='left'>UGD</td>
<td align='left'>R05</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
 </table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>57</td>
<td align='left'>27-04-2024</td>
<td align='left'>ARSY SYAFAAT NURIL AKMAL</td>
<td align='left'>032622</td>
<td align='left'>DUSUN PAKEL, RT : 025,RW :005 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>2016-12-23</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>58</td>
<td align='left'>27-04-2024</td>
<td align='left'>RONAL SEPTIAN PRATANTO</td>
<td align='left'>007463</td>
<td align='left'>BANARAN RT 11-BANARAN-TUGU-TRENGGALEK</td>
<td align='left'>2006-09-22</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J06.9</td>
 <td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Loratadin 10 mg </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>59</td>
<td align='left'>27-04-2024</td>
<td align='left'>JARMI</td>
<td align='left'>015316</td>
<td align='left'>DUSUN KEBONSARI, RT : 27,RW :7 -GONDANG-TUGU-
TRENGGALEK</td>
<td align='left'>1950-04-13</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Loratadin 10 mg </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>60</td>
<td align='left'>27-04-2024</td>
<td align='left'>MUHAMMAD ARSYA HASYIM AL HANAN</td>
<td align='left'>029743</td>
<td align='left'>DUSUN GONDANG KIDUL RT 012 RW 003-GONDANG-TUGU-
TRENGGALEK</td>
<td align='left'>2023-01-28</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>B08.4</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Anak (PKD-2) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>61</td>
<td align='left'>27-04-2024</td>
<td align='left'>BOIKEM</td>
<td align='left'>034472</td>
<td align='left'>DUSUN SANGGRAHAN, RT : 3,RW :2 -SUKOREJO-TUGU-
TRENGGALEK</td>
<td align='left'>1940-12-31</td>
<td align='left'>RAWAT INAP</td>
 <td align='left'>I63.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>62</td>
<td align='left'>27-04-2024</td>
<td align='left'>RAFFASYA QIYAS IRAWAN</td>
<td align='left'>013049</td>
<td align='left'>DSN PONGGOK RT 024 RW 010 -NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2021-05-08</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R11</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Anak (PKD-2) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
</td>
 <td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>63</td>
<td align='left'>27-04-2024</td>
<td align='left'>AFIZA GHANIA ZEMA</td>
<td align='left'>030394</td>
<td align='left'>DSN KALIPINGGIR RT 020 RW 005 GONDANG</td>
<td align='left'>2020-04-24</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>64</td>
<td align='left'>27-04-2024</td>
<td align='left'>MAFAZA ADELIA RACHMAN</td>
<td align='left'>024867</td>
<td align='left'>DESA GONDANG RT 30 RW 07 GONDANG</td>
<td align='left'>2017-03-15</td>
<td align='left'>UGD</td>
<td align='left'>R11</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Loratadin 10 mg </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>65</td>
<td align='left'>27-04-2024</td>
<td align='left'>NURUL HIDAYAH</td>
<td align='left'>032292</td>
<td align='left'>DSN MOJO KIDUL RT : 021,RW :008 JAMBU</td>
<td align='left'>1984-04-24</td>
<td align='left'>UGD</td>
<td align='left'>J45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>66</td>
<td align='left'>26-04-2024</td>
<td align='left'>WASIDI</td>
<td align='left'>034430</td>
<td align='left'>RT 05 RW 01-GONDANG-TUGU-TRENGGALEK</td>
<td align='left'>1955-12-04</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>H81</td>
<td align='left'>
 <table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa(21) </td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>67</td>
<td align='left'>26-04-2024</td>
<td align='left'>SAMALI</td>
<td align='left'>034350</td>
<td align='left'>DUSUN KEBONSARI, RT : 30,RW :7 GONDANG</td>
<td align='left'>1952-11-15</td>
<td align='left'>UGD</td>
<td align='left'>N20.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
</td>
<td width="10%" align="center">9</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Hidrofil 16x16cm </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
URINE BAG steril </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Folley Catether No. 18 </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>68</td>
<td align='left'>26-04-2024</td>
<td align='left'>NUR CHOLISATEN</td>
<td align='left'>030759</td>
<td align='left'>DUSUN KEBONSARI, RT : 23,RW :6 GONDANG</td>
<td align='left'>1978-02-08</td>
<td align='left'>UGD</td>
<td align='left'>T62.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">11</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>69</td>
<td align='left'>26-04-2024</td>
<td align='left'>VELLA REGINA PUTRI</td>
<td align='left'>034457</td>
<td align='left'>DUSUN MLOKO, RT : 56,RW :12 PRAMBON</td>
<td align='left'>2011-05-14</td>
<td align='left'>UGD</td>
<td align='left'>K29</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Hidrofil 16x16cm </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">15</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>70</td>
 <td align='left'>26-04-2024</td>
<td align='left'>MUJIO</td>
<td align='left'>034456</td>
<td align='left'>RT 56 RW 12 DUSUN MLOKO PRAMBON</td>
<td align='left'>1975-07-11</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Loratadin 10 mg </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>71</td>
<td align='left'>26-04-2024</td>
<td align='left'>DEWI NUR AINIYAH</td>
<td align='left'>014228</td>
<td align='left'>DUSUN KEBONSARI, RT : 23,RW :6 GONDANG</td>
<td align='left'>2012-03-26</td>
<td align='left'>UGD</td>
<td align='left'>T62.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Hidrofil 16x16cm </td>
<td width="10%" align="center">4</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>72</td>
<td align='left'>26-04-2024</td>
<td align='left'>TONI AHMAD MAULANA ALFAREZI</td>
<td align='left'>002767</td>
<td align='left'>DUSUN SANGGRAHAN RT : 003 RW :002 SUKOREJO</td>
<td align='left'>2013-01-10</td>
<td align='left'>UGD</td>
<td align='left'>j45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>73</td>
<td align='left'>26-04-2024</td>
<td align='left'>PURNAWAN</td>
<td align='left'>032774</td>
 <td align='left'>DUSUN MLOKO, RT : 055,RW :011 PRAMBON</td>
<td align='left'>1993-07-22</td>
<td align='left'>UGD</td>
<td align='left'>T14</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>74</td>
<td align='left'>26-04-2024</td>
<td align='left'>RONAL SEPTIAN PRATANTO</td>
<td align='left'>007463</td>
<td align='left'>BANARAN RT 11-BANARAN-TUGU-TRENGGALEK</td>
<td align='left'>2006-09-22</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>75</td>
<td align='left'>26-04-2024</td>
<td align='left'>ELGA VINNO LERIAN</td>
<td align='left'>020325</td>
<td align='left'>DUSUN KRAJAN, RT : 14,RW :3 PRAMBON</td>
<td align='left'>2001-01-19</td>
<td align='left'>UGD</td>
<td align='left'>J00</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Loratadin 10 mg </td>
 <td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>76</td>
<td align='left'>26-04-2024</td>
<td align='left'>RAHMA NURFAIZAH</td>
<td align='left'>029285</td>
<td align='left'>RT 13 RW 05-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2012-09-09</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.1</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa(21) </td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>77</td>
<td align='left'>26-04-2024</td>
 <td align='left'>MUTILAH</td>
<td align='left'>015756</td>
<td align='left'>DUSUN GONDANG KIDUL, RT : 10,RW :2 -GONDANG-TUGU-
TRENGGALEK</td>
<td align='left'>1969-08-18</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa(21) </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>78</td>
<td align='left'>26-04-2024</td>
<td align='left'>MUJAIT</td>
<td align='left'>034275</td>
 <td align='left'>DUSUN KASIHAN, RT : 28,RW :12 NGEPEH</td>
<td align='left'>1951-08-10</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Hidrofil 16x16cm </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Loratadin 10 mg </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>79</td>
<td align='left'>26-04-2024</td>
<td align='left'>FAIZ RANGGA SAPUTRA</td>
<td align='left'>027109</td>
<td align='left'>DUSUN JUMOK, RT : 7,RW :3 TUMPUK</td>
<td align='left'>2013-02-14</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Loratadin 10 mg </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>80</td>
<td align='left'>26-04-2024</td>
<td align='left'>MOH.SYAFIQ</td>
<td align='left'>020077</td>
<td align='left'>RT41 RW 8 PRAMBON</td>
 <td align='left'>2017-04-10</td>
<td align='left'>UGD</td>
<td align='left'>R11</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>81</td>
<td align='left'>26-04-2024</td>
<td align='left'>MESINAH</td>
<td align='left'>000757</td>
<td align='left'>RT 20 RW 05-NGLONGSOR-TUGU-TRENGGALEK</td>
<td align='left'>1969-04-01</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
 <td align='left'>82</td>
<td align='left'>26-04-2024</td>
<td align='left'>SATRIA EKA ARI WIBOWO PUTRA</td>
<td align='left'>021581</td>
<td align='left'>DESA GONDANG, RT : 13,RW :3 GONDANG</td>
<td align='left'>2012-10-19</td>
<td align='left'>UGD</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Loratadin 10 mg </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>83</td>
<td align='left'>26-04-2024</td>
<td align='left'>SURANI</td>
<td align='left'>021444</td>
<td align='left'>DUSUN TENGGAR RT 002 RW 001 PRAMBON</td>
<td align='left'>1970-07-18</td>
<td align='left'>UGD</td>
<td align='left'>j45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
 <td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>84</td>
<td align='left'>26-04-2024</td>
<td align='left'>MUHAMMAD HIZAM OKTAFIANTO</td>
<td align='left'>032649</td>
<td align='left'>RT. 5 RW. 2 NGEPEH</td>
<td align='left'>2017-10-03</td>
<td align='left'>UGD</td>
<td align='left'>j45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>85</td>
<td align='left'>26-04-2024</td>
<td align='left'>SUYONO</td>
<td align='left'>034452</td>
<td align='left'>RT 23 RW 6 GONDANG</td>
<td align='left'>1968-04-26</td>
<td align='left'>UGD</td>
<td align='left'>J06.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
 <td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>86</td>
<td align='left'>26-04-2024</td>
<td align='left'>FATIMAH</td>
<td align='left'>000061</td>
<td align='left'>DUSUN BENGGLE RT 007 RW 003 WINONG</td>
<td align='left'>1951-09-13</td>
<td align='left'>UGD</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Loratadin 10 mg </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>87</td>
<td align='left'>25-04-2024</td>
<td align='left'>HANIF AKMAL YUGO RAMADANA</td>
<td align='left'>000641</td>
<td align='left'>DSN TAWANG RT : 001,RW :001 BANARAN</td>
<td align='left'>2015-06-26</td>
<td align='left'>UGD</td>
<td align='left'>J45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
<td width="10%" align="center">1</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kapas Pembalut 250 gram </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>88</td>
<td align='left'>25-04-2024</td>
<td align='left'>RAHMA NURFAIZAH</td>
<td align='left'>029285</td>
<td align='left'>RT 13 RW 05-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2012-09-09</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.1</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">3</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa(21) </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa(21) </td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>89</td>
<td align='left'>25-04-2024</td>
<td align='left'>MARRY NANLOHI</td>
<td align='left'>034407</td>
<td align='left'>RT 21 RW 7-MANISREJO-TAMAN-KOTA MADIUN</td>
<td align='left'>1958-11-22</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>H81.4</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Domperidon 10 mg </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>90</td>
<td align='left'>25-04-2024</td>
<td align='left'>YAMTI</td>
<td align='left'>000056</td>
<td align='left'>RT 05 RW 01-GONDANG-TUGU-TRENGGALEK</td>
<td align='left'>1954-07-11</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>I49.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Masker Oksigen Dewasa(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Nasal Canul Dewasa(21) </td>
<td width="10%" align="center">1</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>91</td>
<td align='left'>25-04-2024</td>
<td align='left'>WASIDI</td>
<td align='left'>034430</td>
<td align='left'>RT 05 RW 01-GONDANG-TUGU-TRENGGALEK</td>
<td align='left'>1955-12-04</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>H81</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Betahistine 6 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Simvastatin 10 mg (salut selaput) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Allopurinol 100 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Natrium Diklofenak (21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>92</td>
<td align='left'>25-04-2024</td>
<td align='left'>MUTILAH</td>
<td align='left'>015756</td>
<td align='left'>DUSUN GONDANG KIDUL, RT : 10,RW :2 -GONDANG-TUGU-
TRENGGALEK</td>
<td align='left'>1969-08-18</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metronidazole 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Atapulgit tab 600 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
 </td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>93</td>
<td align='left'>25-04-2024</td>
<td align='left'>MESINAH</td>
<td align='left'>000757</td>
<td align='left'>RT 20 RW 05-NGLONGSOR-TUGU-TRENGGALEK</td>
<td align='left'>1969-04-01</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>94</td>
<td align='left'>24-04-2024</td>
<td align='left'>NURHAYATI</td>
<td align='left'>034404</td>
<td align='left'>RT 24 RW 05 GONDANG</td>
<td align='left'>1979-05-11</td>
<td align='left'>UGD</td>
<td align='left'>K29.1</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>95</td>
<td align='left'>24-04-2024</td>
<td align='left'>SLAMET</td>
<td align='left'>001402</td>
<td align='left'>DUSUN SETONO, RT : 017,RW :004 GONDANG</td>
<td align='left'>1951-10-10</td>
<td align='left'>UGD</td>
<td align='left'>Z48.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
 <td align='left'>96</td>
<td align='left'>24-04-2024</td>
<td align='left'>SUMARNO</td>
<td align='left'>034405</td>
<td align='left'>KRAJAN, RT : 23,RW :4 PRAMBON</td>
<td align='left'>1977-07-17</td>
<td align='left'>UGD</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>97</td>
<td align='left'>24-04-2024</td>
<td align='left'>ERNI EKASARI</td>
<td align='left'>021731</td>
<td align='left'>DSN KEBONSARI RT : 024 RW :005 GONDANG</td>
<td align='left'>1998-05-26</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">6</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">62</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">24</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>98</td>
<td align='left'>24-04-2024</td>
<td align='left'>RAHMA NURFAIZAH</td>
<td align='left'>029285</td>
<td align='left'>RT 13 RW 05-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2012-09-09</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.1</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.22 </td>
<td width="10%" align="center">1</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>99</td>
<td align='left'>24-04-2024</td>
<td align='left'>SUKADI</td>
<td align='left'>032627</td>
<td align='left'>DUSUN PAKEL, RT : 34,RW :6
-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>1949-10-07</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Allopurinol 100 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metronidazole 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>100</td>
<td align='left'>24-04-2024</td>
<td align='left'>MARRY NANLOHI</td>
<td align='left'>034407</td>
<td align='left'>RT 21 RW 7-MANISREJO-TAMAN-KOTA MADIUN</td>
<td align='left'>1958-11-22</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>H81.4</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Betahistine 6 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>101</td>
<td align='left'>24-04-2024</td>
<td align='left'>KHANA AULIA ASSYIFA</td>
<td align='left'>027625</td>
 <td align='left'>DUSUN KRAJAN RT 003 RW 001-WINONG-TUGU-TRENGGALEK</td>
<td align='left'>2022-11-26</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R56</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Anak (PKD-2) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisilin Sirup Kering 125mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>102</td>
<td align='left'>24-04-2024</td>
<td align='left'>NOVELA ANGGI FATMARETA</td>
<td align='left'>034395</td>
<td align='left'>NGENTRONG RT 5 RW 1-NGENTRONG-KARANGAN-TRENGGALEK</td>
<td align='left'>2001-03-17</td>
 <td align='left'>RAWAT INAP</td>
<td align='left'>R55</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>103</td>
<td align='left'>24-04-2024</td>
<td align='left'>MUJILAN</td>
<td align='left'>031914</td>
<td align='left'>DUSUN PAKEL, RT : 033,RW :006 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>1951-07-01</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>I10</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>104</td>
<td align='left'>24-04-2024</td>
<td align='left'>MUHAMMAD RAMADHANI</td>
<td align='left'>026424</td>
<td align='left'>PRAMBON RT 56-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>2006-10-08</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A01.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kloramfenikol 250 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa(21) </td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>105</td>
<td align='left'>24-04-2024</td>
<td align='left'>AMINAH</td>
<td align='left'>016302</td>
<td align='left'>RT 17 RW 7-JAMBU-TUGU-TRENGGALEK</td>
<td align='left'>1950-07-01</td>
<td align='left'>RAWAT INAP</td>
 <td align='left'>J06.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa(21) </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>106</td>
<td align='left'>24-04-2024</td>
<td align='left'>KATENO</td>
<td align='left'>034393</td>
<td align='left'>TEMPURAN RT 02 RW 03-TEMPURAN-SAWOO-PONOROGO</td>
<td align='left'>1950-06-30</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa(21) </td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>107</td>
<td align='left'>24-04-2024</td>
<td align='left'>SURIP</td>
<td align='left'>034261</td>
<td align='left'>RT 02 RW 04-SAWOO-SAWOO-PONOROGO</td>
<td align='left'>1965-05-05</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>H81.4</td>
<td align='left'>
<table width='100%' border="1">
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Glimepiride 2 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metformin 850 mg </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Simvastatin 10 mg (salut selaput) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Betahistine 6 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">11</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa(21) </td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>108</td>
<td align='left'>24-04-2024</td>
<td align='left'>SLAMET</td>
<td align='left'>001402</td>
<td align='left'>DUSUN SETONO, RT : 017,RW :004 GONDANG</td>
<td align='left'>1951-10-10</td>
<td align='left'>UGD</td>
<td align='left'>Z48.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>109</td>
<td align='left'>24-04-2024</td>
<td align='left'>SUKATMI</td>
<td align='left'>034389</td>
<td align='left'>DUSUN KRAJAN, RT : 13,RW :4 -NGLONGSOR-TUGU-
TRENGGALEK</td>
<td align='left'>1945-12-31</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>H81.4</td>
<td align='left'>
 <table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Betahistine 6 mg </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa(21) </td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
 <td align='left'>110</td>
<td align='left'>24-04-2024</td>
<td align='left'>SUCIATI</td>
<td align='left'>034225</td>
<td align='left'>DSN KRAJAN RT 002 RW 001 GONDANG</td>
<td align='left'>1979-03-01</td>
<td align='left'>UGD</td>
<td align='left'>Z48</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>111</td>
<td align='left'>24-04-2024</td>
<td align='left'>MUHASIM</td>
<td align='left'>031249</td>
<td align='left'>DUSUN KEBON, RT : 033,RW :008 GONDANG</td>
<td align='left'>1950-06-12</td>
<td align='left'>UGD</td>
<td align='left'>N40</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">1</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>112</td>
<td align='left'>23-04-2024</td>
<td align='left'>SURANI</td>
<td align='left'>021444</td>
<td align='left'>DUSUN TENGGAR RT 002 RW 001 PRAMBON</td>
<td align='left'>1970-07-18</td>
<td align='left'>UGD</td>
<td align='left'>R06</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
 </td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>113</td>
<td align='left'>23-04-2024</td>
<td align='left'>SAMALI</td>
<td align='left'>034350</td>
<td align='left'>DUSUN KEBONSARI, RT : 30,RW :7 GONDANG</td>
<td align='left'>1952-11-15</td>
<td align='left'>UGD</td>
<td align='left'>N39</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
URINE BAG steril </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Folley Catether No. 16 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">4</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>114</td>
<td align='left'>23-04-2024</td>
<td align='left'>NIKEN NESA HERINESTI</td>
<td align='left'>033275</td>
<td align='left'>DSN MOJO KIDUL RT 023 RW 008 JAMBU</td>
<td align='left'>2007-12-07</td>
 <td align='left'>UGD</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">8</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>115</td>
<td align='left'>23-04-2024</td>
<td align='left'>MUTINI</td>
<td align='left'>011753</td>
<td align='left'>RT 010 RW - SUKOREJO</td>
<td align='left'>1958-09-01</td>
<td align='left'>UGD</td>
<td align='left'>J45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">6</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>116</td>
<td align='left'>23-04-2024</td>
<td align='left'>HARTATIK</td>
<td align='left'>019724</td>
<td align='left'>JAMBU, RT : 023,RW :008 JAMBU</td>
<td align='left'>1975-02-12</td>
<td align='left'>UGD</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Betamethasone krim 0,1% </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Allopurinol 100 mg </td>
<td width="10%" align="center">11</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>117</td>
<td align='left'>23-04-2024</td>
<td align='left'>LISA NUR KATIKA </td>
<td align='left'>001855</td>
 <td align='left'>DUSUN PAKEL, RT : 41,RW :8 PRAMBON</td>
<td align='left'>2007-04-04</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Atapulgit tab 600 mg </td>
<td width="10%" align="center">15</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Anak (PKD-2) </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>118</td>
<td align='left'>23-04-2024</td>
<td align='left'>TUKINI</td>
<td align='left'>021366</td>
<td align='left'>DUSUN JAMPI, RT : 005,RW :001 NGENTRONG</td>
<td align='left'>1962-01-17</td>
<td align='left'>UGD</td>
<td align='left'>R55</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>119</td>
<td align='left'>23-04-2024</td>
<td align='left'>NURUL KASANAH</td>
<td align='left'>012557</td>
<td align='left'>DUSUN KRAJAN, RT : 7,RW :2 SUMBER</td>
<td align='left'>1994-11-17</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R11</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Atapulgit tab 600 mg </td>
<td width="10%" align="center">15</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>120</td>
<td align='left'>23-04-2024</td>
<td align='left'>SUKADI</td>
<td align='left'>032627</td>
<td align='left'>DUSUN PAKEL, RT : 34,RW :6
-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>1949-10-07</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
 <table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Atapulgit tab 600 mg </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>121</td>
<td align='left'>23-04-2024</td>
<td align='left'>NOVELA ANGGI FATMARETA</td>
<td align='left'>034395</td>
<td align='left'>NGENTRONG RT 5 RW 1-NGENTRONG-KARANGAN-TRENGGALEK</td>
<td align='left'>2001-03-17</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R55</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Atapulgit tab 600 mg </td>
<td width="10%" align="center">15</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Anak (PKD-2) </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>122</td>
<td align='left'>23-04-2024</td>
<td align='left'>KATENO</td>
<td align='left'>034393</td>
<td align='left'>TEMPURAN RT 02 RW 03-TEMPURAN-SAWOO-PONOROGO</td>
<td align='left'>1950-06-30</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Atapulgit tab 600 mg </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>123</td>
<td align='left'>23-04-2024</td>
<td align='left'>MUJILAN</td>
<td align='left'>031914</td>
<td align='left'>DUSUN PAKEL, RT : 033,RW :006 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>1951-07-01</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>I10</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
 <td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>124</td>
<td align='left'>23-04-2024</td>
<td align='left'>MUHAMMAD RAMADHANI</td>
<td align='left'>026424</td>
<td align='left'>PRAMBON RT 56-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>2006-10-08</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A01.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Anak (PKD-2) </td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>125</td>
<td align='left'>23-04-2024</td>
<td align='left'>AMINAH</td>
<td align='left'>016302</td>
<td align='left'>RT 17 RW 7-JAMBU-TUGU-TRENGGALEK</td>
<td align='left'>1950-07-01</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J06.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>126</td>
<td align='left'>23-04-2024</td>
<td align='left'>SURIP</td>
<td align='left'>034261</td>
<td align='left'>RT 02 RW 04-SAWOO-SAWOO-PONOROGO</td>
<td align='left'>1965-05-05</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>H81.4</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>127</td>
<td align='left'>23-04-2024</td>
<td align='left'>TUKINI</td>
<td align='left'>021366</td>
<td align='left'>RT 05 RW 01 NGENTRONG</td>
<td align='left'>1962-01-17</td>
<td align='left'>UGD</td>
<td align='left'>R55</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>128</td>
<td align='left'>22-04-2024</td>
<td align='left'>MUHAMMAD RAMADHANI</td>
<td align='left'>026424</td>
 <td align='left'>PRAMBON RT 56-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>2006-10-08</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A01.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
 <td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kloramfenikol 250 mg </td>
<td width="10%" align="center">15</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>129</td>
<td align='left'>22-04-2024</td>
<td align='left'>SUCIATI</td>
<td align='left'>034225</td>
<td align='left'>DSN KRAJAN RT 002 RW 001 GONDANG</td>
<td align='left'>1979-03-01</td>
<td align='left'>UGD</td>
<td align='left'>Z48.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>130</td>
<td align='left'>22-04-2024</td>
 <td align='left'>NUR SUGIANTO</td>
<td align='left'>034083</td>
<td align='left'>DESA WINONG, RT : 8,RW :3 WINONG</td>
<td align='left'>1977-05-03</td>
<td align='left'>UGD</td>
<td align='left'>Z48.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>131</td>
<td align='left'>22-04-2024</td>
<td align='left'>AZKA RAYYAN ALFARIZKY</td>
<td align='left'>024965</td>
<td align='left'>RT 028 RW 007 GONDANG</td>
<td align='left'>2017-07-25</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>132</td>
<td align='left'>22-04-2024</td>
<td align='left'>TIRTA</td>
<td align='left'>014789</td>
<td align='left'>RT 19 RW 05 GONDANG</td>
<td align='left'>2020-08-27</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>133</td>
<td align='left'>22-04-2024</td>
<td align='left'>AISHA RAHMI NASYWA</td>
<td align='left'>004901</td>
<td align='left'>DUSUN KRAJAN, RT : 5,RW :3 SUKOREJO</td>
<td align='left'>2009-08-05</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>134</td>
<td align='left'>22-04-2024</td>
<td align='left'>MUHAMMAD RAMADHANI</td>
<td align='left'>026424</td>
<td align='left'>PRAMBON RT 56 PRAMBON</td>
<td align='left'>2006-10-08</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
 <td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>135</td>
<td align='left'>22-04-2024</td>
<td align='left'>MOCHAMMAD ARJUNA ASYRAFY KURNIAWAN</td>
<td align='left'>000795</td>
<td align='left'>RT 035 RW 006 PRAMBON</td>
<td align='left'>2011-10-21</td>
<td align='left'>UGD</td>
<td align='left'>D68.3</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>136</td>
<td align='left'>22-04-2024</td>
<td align='left'>MIFTAHATUL ROHMAH</td>
<td align='left'>034292</td>
<td align='left'>DUSUN SANGGRAHAN, RT : 3,RW :2 SUKOREJO</td>
<td align='left'>2000-07-15</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
 <td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>137</td>
<td align='left'>22-04-2024</td>
<td align='left'>SUMADJI</td>
<td align='left'>000150</td>
<td align='left'>DSN TENGGAR RT 006 RW 001 PRAMBON</td>
<td align='left'>1958-12-31</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>138</td>
<td align='left'>22-04-2024</td>
<td align='left'>WIDATUL HIMAWATI</td>
<td align='left'>034325</td>
<td align='left'>RT 14 RW 5 PANDEAN DONGKO PANDEAN</td>
<td align='left'>1994-04-24</td>
<td align='left'>UGD</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>139</td>
<td align='left'>22-04-2024</td>
<td align='left'>SUPRIYANTO</td>
<td align='left'>029490</td>
<td align='left'>PRAMBON RT 34 PRAMBON</td>
<td align='left'>1983-11-10</td>
 <td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>140</td>
<td align='left'>22-04-2024</td>
<td align='left'>JAMI</td>
<td align='left'>000151</td>
<td align='left'>DSN TENGGAR RT 006 RW 001 PRAMBON</td>
<td align='left'>1965-12-31</td>
<td align='left'>UGD</td>
<td align='left'>M13.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>141</td>
<td align='left'>22-04-2024</td>
<td align='left'>DIAN KURNIAWATI</td>
<td align='left'>013301</td>
<td align='left'>RT 57 PRAMBON</td>
<td align='left'>1997-12-20</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>142</td>
<td align='left'>22-04-2024</td>
<td align='left'>BELLVANIA JASMEEN PUTRI ARYONO</td>
<td align='left'>001251</td>
<td align='left'>RT 15 RW 03 PRAMBON</td>
<td align='left'>2020-10-13</td>
<td align='left'>UGD</td>
<td align='left'>R50.9</td>
<td align='left'>
<table width='100%' border="1">
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>143</td>
<td align='left'>22-04-2024</td>
<td align='left'>KATENO</td>
<td align='left'>034393</td>
<td align='left'>TEMPURAN RT 02 RW 03-TEMPURAN-SAWOO-PONOROGO</td>
<td align='left'>1950-06-30</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Atapulgit tab 600 mg </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>144</td>
<td align='left'>22-04-2024</td>
<td align='left'>MUJILAN</td>
<td align='left'>031914</td>
<td align='left'>DUSUN PAKEL, RT : 033,RW :006 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>1951-07-01</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>I10</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>145</td>
<td align='left'>22-04-2024</td>
<td align='left'>AMINAH</td>
<td align='left'>016302</td>
<td align='left'>RT 17 RW 7-JAMBU-TUGU-TRENGGALEK</td>
<td align='left'>1950-07-01</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J06.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>146</td>
<td align='left'>22-04-2024</td>
<td align='left'>SURIP</td>
<td align='left'>034261</td>
 <td align='left'>RT 02 RW 04-SAWOO-SAWOO-PONOROGO</td>
<td align='left'>1965-05-05</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>H81.4</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kloramfenikol 250 mg </td>
<td width="10%" align="center">7</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>147</td>
<td align='left'>22-04-2024</td>
<td align='left'>DEVITASARI</td>
<td align='left'>034264</td>
<td align='left'>NGLEGOK, RT : 11,RW :4 -NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2002-08-17</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Anak (PKD-2) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>148</td>
 <td align='left'>22-04-2024</td>
<td align='left'>MARSIDI</td>
<td align='left'>034099</td>
<td align='left'>NGLEGOK, RT : 11,RW :4 -NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>1957-11-24</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J03.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Anak (PKD-2) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>149</td>
<td align='left'>22-04-2024</td>
<td align='left'>HARTATIK</td>
<td align='left'>002387</td>
<td align='left'>RT 045 RW 009-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>1979-02-21</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
 <td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>150</td>
<td align='left'>22-04-2024</td>
<td align='left'>LISA NUR KATIKA </td>
<td align='left'>001855</td>
<td align='left'>DUSUN PAKEL, RT : 41,RW :8
-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>2007-04-04</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>151</td>
<td align='left'>22-04-2024</td>
<td align='left'>SUKADI</td>
<td align='left'>032627</td>
<td align='left'>DUSUN PAKEL, RT : 34,RW :6
-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>1949-10-07</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>152</td>
<td align='left'>21-04-2024</td>
<td align='left'>MARSIDI</td>
<td align='left'>034099</td>
<td align='left'>NGLEGOK, RT : 11,RW :4 -NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>1957-11-24</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J03.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Atapulgit tab 600 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
</td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>153</td>
<td align='left'>21-04-2024</td>
<td align='left'>AMINAH</td>
 <td align='left'>016302</td>
<td align='left'>RT 17 RW 7-JAMBU-TUGU-TRENGGALEK</td>
<td align='left'>1950-07-01</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J06.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Atapulgit tab 600 mg </td>
<td width="10%" align="center">15</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>154</td>
<td align='left'>21-04-2024</td>
<td align='left'>DEVITASARI</td>
<td align='left'>034264</td>
<td align='left'>NGLEGOK, RT : 11,RW :4 -NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2002-08-17</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.22 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
 <td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
</td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>155</td>
<td align='left'>21-04-2024</td>
<td align='left'>LISA NUR KATIKA </td>
<td align='left'>001855</td>
<td align='left'>DUSUN PAKEL, RT : 41,RW :8
-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>2007-04-04</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">8</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Atapulgit tab 600 mg </td>
<td width="10%" align="center">15</td>
</tr>
</table>
</td>
</tr>
 <tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>156</td>
<td align='left'>21-04-2024</td>
<td align='left'>SURIP</td>
<td align='left'>034261</td>
<td align='left'>RT 02 RW 04-SAWOO-SAWOO-PONOROGO</td>
<td align='left'>1965-05-05</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>H81.4</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.22 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Betahistine 6 mg </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Atapulgit tab 600 mg </td>
<td width="10%" align="center">15</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>157</td>
<td align='left'>21-04-2024</td>
<td align='left'>MUJILAN</td>
<td align='left'>031914</td>
<td align='left'>DUSUN PAKEL, RT : 33,RW :6
-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>1951-07-01</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>I10</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid 10 mg </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>158</td>
<td align='left'>21-04-2024</td>
<td align='left'>HARTATIK</td>
<td align='left'>002387</td>
<td align='left'>PRAMBON RT 45/9-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>1979-02-21</td>
 <td align='left'>RAWAT INAP</td>
<td align='left'>J45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
</td>
<td width="10%" align="center">20</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>159</td>
<td align='left'>21-04-2024</td>
<td align='left'>TUMINEM</td>
<td align='left'>002836</td>
<td align='left'>DESA WINONG RT 004 RW 002-WINONG-TUGU-TRENGGALEK</td>
<td align='left'>1940-12-30</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
</td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 5 mg </td>
<td width="10%" align="center">16</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>160</td>
<td align='left'>21-04-2024</td>
<td align='left'>MISBAH FEBRYAN ADHITAMA</td>
<td align='left'>002624</td>
<td align='left'>DSN KRAJAN I RT 011 RW
006-BANARAN-TUGU-TRENGGALEK</td>
<td align='left'>2018-02-12</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R11</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Anak (PKD-2) </td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>161</td>
<td align='left'>21-04-2024</td>
<td align='left'>TUKIRAN</td>
<td align='left'>034145</td>
<td align='left'>DSN GENDONG RT : 011,RW :005 SUKOREJO</td>
<td align='left'>1957-03-10</td>
<td align='left'>UGD</td>
<td align='left'>R39.1</td>
<td align='left'>
 <table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>162</td>
<td align='left'>21-04-2024</td>
<td align='left'>ANA PUSPITA SARI</td>
<td align='left'>029977</td>
<td align='left'>DSN KRAJAN RT 012 RW 003 NGLONGSOR</td>
<td align='left'>2017-12-22</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>163</td>
<td align='left'>21-04-2024</td>
<td align='left'>NOPITA PUTRI</td>
<td align='left'>034262</td>
<td align='left'>RT 41 RW 8 PRAMBON</td>
<td align='left'>2015-11-12</td>
<td align='left'>UGD</td>
<td align='left'>L20</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Masker Nebulizer Dewasa(21) </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
 </tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>164</td>
<td align='left'>20-04-2024</td>
<td align='left'>MARSIDI</td>
<td align='left'>034099</td>
<td align='left'>NGLEGOK, RT : 11,RW :4 -NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>1957-11-24</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J03.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
GOM(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>165</td>
<td align='left'>20-04-2024</td>
<td align='left'>HARTATIK</td>
<td align='left'>002387</td>
<td align='left'>PRAMBON RT 45/9-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>1979-02-21</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.22 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.22 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>166</td>
<td align='left'>20-04-2024</td>
<td align='left'>AGUS WAHYUDI</td>
<td align='left'>022726</td>
<td align='left'>RT 024 RW 005-GONDANG-TUGU-TRENGGALEK</td>
<td align='left'>1984-05-29</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>I25</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Nasal Canul Dewasa(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
 </tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>167</td>
<td align='left'>20-04-2024</td>
<td align='left'>SUWOTO</td>
<td align='left'>002225</td>
<td align='left'>DUSUN KALIPINGGIR, RT : 19,RW :5 -GONDANG-TUGU-
TRENGGALEK</td>
<td align='left'>1975-03-10</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>168</td>
<td align='left'>20-04-2024</td>
<td align='left'>BARNIANTO</td>
<td align='left'>023301</td>
<td align='left'>DSN NGLEGOK RT 019 RW 003-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>1972-08-17</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
 <table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
</td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Masker Nebulizer Dewasa(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>169</td>
<td align='left'>20-04-2024</td>
<td align='left'>SUNARTI</td>
<td align='left'>029087</td>
<td align='left'>NGLEGOK, RT :00 8,RW :003 -NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>1965-06-04</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>170</td>
<td align='left'>20-04-2024</td>
<td align='left'>TUKINI</td>
<td align='left'>021366</td>
<td align='left'>DUSUN JAMPI, RT : 5,RW :1 -NGENTRONG-KARANGAN-
TRENGGALEK</td>
<td align='left'>1962-01-17</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A01.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kloramfenikol 250 mg </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>171</td>
<td align='left'>20-04-2024</td>
<td align='left'>RISMA PUSPA N</td>
<td align='left'>034230</td>
<td align='left'>DUSUN KRAJAN, RT : 003,RW :001 -TEGAREN-TUGU-
TRENGGALEK</td>
<td align='left'>2001-11-16</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
 </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>172</td>
<td align='left'>20-04-2024</td>
<td align='left'>TUMINEM</td>
<td align='left'>002836</td>
<td align='left'>DESA WINONG RT 004 RW 002-WINONG-TUGU-TRENGGALEK</td>
<td align='left'>1940-12-30</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>173</td>
<td align='left'>20-04-2024</td>
<td align='left'>MISBAH FEBRYAN ADHITAMA</td>
<td align='left'>002624</td>
<td align='left'>DSN KRAJAN I RT 011 RW
006-BANARAN-TUGU-TRENGGALEK</td>
<td align='left'>2018-02-12</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R11</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">9</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>174</td>
<td align='left'>20-04-2024</td>
<td align='left'>SUKARIYATIN</td>
<td align='left'>034260</td>
<td align='left'>RT 04 RW 02 WINONG</td>
<td align='left'>1974-07-20</td>
<td align='left'>UGD</td>
<td align='left'>L29</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Amlodipin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>175</td>
<td align='left'>20-04-2024</td>
<td align='left'>DIAH PUSPITASARI</td>
<td align='left'>026231</td>
<td align='left'>DSN SELOMUNDING RT 004 RW 002 WINONG</td>
<td align='left'>1996-04-28</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>176</td>
<td align='left'>20-04-2024</td>
 <td align='left'>DWI LESTARI</td>
<td align='left'>032218</td>
<td align='left'>DUSUN KRAJAN RT 12 RW 03 NGLONGSOR</td>
<td align='left'>1993-02-21</td>
<td align='left'>UGD</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>177</td>
<td align='left'>20-04-2024</td>
<td align='left'>WINARSIH</td>
<td align='left'>034046</td>
<td align='left'>KEBONSARI, RT : 24,RW :5 GONDANG</td>
<td align='left'>1983-05-12</td>
<td align='left'>UGD</td>
<td align='left'>J45.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>178</td>
<td align='left'>20-04-2024</td>
<td align='left'>DEVIA INTAN VARADEA</td>
<td align='left'>034259</td>
<td align='left'>DUSUN KRAJAN II, RT : 5,RW :3 BANARAN</td>
<td align='left'>2006-06-03</td>
<td align='left'>UGD</td>
<td align='left'>J00</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>179</td>
<td align='left'>20-04-2024</td>
<td align='left'>HARDJO</td>
<td align='left'>000070</td>
<td align='left'>DUSUN KRAJAN RT 004 RW 001 GONDANG</td>
<td align='left'>1950-03-04</td>
<td align='left'>UGD</td>
<td align='left'>I15</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 5 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>180</td>
<td align='left'>20-04-2024</td>
<td align='left'>BUDI SANTOSO</td>
<td align='left'>034258</td>
<td align='left'>DUSUN PONGGOK, RT : 22,RW :9 NGEPEH</td>
<td align='left'>1998-08-29</td>
<td align='left'>UGD</td>
<td align='left'>J00</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>181</td>
<td align='left'>20-04-2024</td>
<td align='left'>SITI NUR SYAMSIYAH</td>
<td align='left'>026421</td>
<td align='left'>DESA KEBONSARI, RT : 28,RW :7 GONDANG</td>
<td align='left'>2010-10-12</td>
<td align='left'>UGD</td>
<td align='left'>J45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>182</td>
<td align='left'>20-04-2024</td>
<td align='left'>TUKIRAN</td>
<td align='left'>034145</td>
<td align='left'>DESA SUKOREJO, RT : 11,RW :5 SUKOREJO</td>
<td align='left'>1957-03-10</td>
<td align='left'>UGD</td>
<td align='left'>R33</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ciprofloxacin 500 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>183</td>
<td align='left'>20-04-2024</td>
<td align='left'>RYAN PRATAMA PUTRA</td>
<td align='left'>034257</td>
<td align='left'>RT 3 RW 6 BRANGBIJI SUMBAWA SUMBAWA BRANG BIJI</td>
<td align='left'>1992-12-07</td>
 <td align='left'>UGD</td>
<td align='left'>R51</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Vitamin B Kompleks </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>184</td>
<td align='left'>20-04-2024</td>
<td align='left'>HARTATIK</td>
<td align='left'>002387</td>
<td align='left'>PRAMBON RT 45 PRAMBON</td>
<td align='left'>1979-02-21</td>
<td align='left'>UGD</td>
<td align='left'>J45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
 <td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>185</td>
<td align='left'>19-04-2024</td>
<td align='left'>SUWOTO</td>
<td align='left'>002225</td>
<td align='left'>DUSUN KALIPINGGIR, RT : 19,RW :5 -GONDANG-TUGU-
TRENGGALEK</td>
<td align='left'>1975-03-10</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">4</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>186</td>
<td align='left'>19-04-2024</td>
<td align='left'>BARNIANTO</td>
<td align='left'>023301</td>
<td align='left'>DSN NGLEGOK RT 019 RW 003-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>1972-08-17</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>187</td>
<td align='left'>19-04-2024</td>
<td align='left'>SUNARTI</td>
<td align='left'>029087</td>
<td align='left'>NGLEGOK, RT :00 8,RW :003 -NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>1965-06-04</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
 <td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>188</td>
<td align='left'>19-04-2024</td>
<td align='left'>TUKINI</td>
<td align='left'>021366</td>
<td align='left'>DUSUN JAMPI, RT : 5,RW :1 -NGENTRONG-KARANGAN-
TRENGGALEK</td>
<td align='left'>1962-01-17</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A01.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>189</td>
<td align='left'>19-04-2024</td>
<td align='left'>RISMA PUSPA N</td>
<td align='left'>034230</td>
<td align='left'>DUSUN KRAJAN, RT : 003,RW :001 -TEGAREN-TUGU-
TRENGGALEK</td>
<td align='left'>2001-11-16</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
 </tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>190</td>
<td align='left'>19-04-2024</td>
<td align='left'>TUMINEM</td>
<td align='left'>002836</td>
<td align='left'>DESA WINONG RT 004 RW 002-WINONG-TUGU-TRENGGALEK</td>
<td align='left'>1940-12-30</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>191</td>
<td align='left'>19-04-2024</td>
<td align='left'>AISYAH SILMI AFIQA </td>
<td align='left'>024783</td>
<td align='left'>DSN SOOKO RT 044 RW 009 PRAMBON</td>
<td align='left'>2016-06-26</td>
<td align='left'>UGD</td>
<td align='left'>H61.2</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>192</td>
<td align='left'>19-04-2024</td>
<td align='left'>SULISTIYANI</td>
<td align='left'>024804</td>
<td align='left'>RT 016 RW 003 PRAMBON</td>
<td align='left'>1977-05-15</td>
<td align='left'>UGD</td>
<td align='left'>R00.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>193</td>
<td align='left'>19-04-2024</td>
<td align='left'>SUTRIMO</td>
<td align='left'>017195</td>
<td align='left'>DUSUN SOKO, RT : 49,RW :10 PRAMBON</td>
<td align='left'>1972-12-31</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>194</td>
<td align='left'>19-04-2024</td>
<td align='left'>MUNAH</td>
<td align='left'>012874</td>
<td align='left'>TUMPAK PELEM,SAWOO,PONOROGO-TUMPAK PELEM-SAWOO-
PONOROGO</td>
<td align='left'>1940-01-06</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Atapulgit tab 600 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>195</td>
<td align='left'>19-04-2024</td>
<td align='left'>HIKMA LUKIYA RAHMA</td>
<td align='left'>033505</td>
<td align='left'>DUSUN CORAH MULYO, RT : 004,RW :002 -NGLONGSOR-TUGU-
TRENGGALEK</td>
<td align='left'>2016-04-20</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A91</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>196</td>
<td align='left'>19-04-2024</td>
<td align='left'>SUPARNO</td>
<td align='left'>034158</td>
<td align='left'>RT 1 RW 3-TUMPAK PELEM-SAWOO-PONOROGO</td>
<td align='left'>1986-12-10</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A90</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>197</td>
<td align='left'>19-04-2024</td>
<td align='left'>FIRDA FAJRINA QURROTA AYUN</td>
<td align='left'>034132</td>
<td align='left'>PRAMBON RT 38/ RW 07-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>2022-03-09</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid 10 mg </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>198</td>
<td align='left'>19-04-2024</td>
<td align='left'>MARSIDI</td>
<td align='left'>034099</td>
<td align='left'>NGLEGOK, RT : 11,RW :4 -NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>1957-11-24</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J03.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
 </tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>199</td>
<td align='left'>19-04-2024</td>
<td align='left'>SLAMET</td>
<td align='left'>001402</td>
<td align='left'>DUSUN SETONO, RT : 017,RW :004 GONDANG</td>
<td align='left'>1951-10-10</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>200</td>
<td align='left'>19-04-2024</td>
<td align='left'>NURYANTO</td>
<td align='left'>031906</td>
<td align='left'>JAMPI, RT : 4,RW :1 NGENTRONG</td>
<td align='left'>1961-09-27</td>
<td align='left'>UGD</td>
<td align='left'>R33</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Folley Catether No. 18 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>201</td>
<td align='left'>19-04-2024</td>
<td align='left'>SUCIATI</td>
<td align='left'>034225</td>
<td align='left'>DSN KRAJAN RT 002 RW 001 GONDANG</td>
<td align='left'>1979-03-01</td>
<td align='left'>UGD</td>
<td align='left'>Z48.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>202</td>
<td align='left'>18-04-2024</td>
<td align='left'>BARNIANTO</td>
<td align='left'>023301</td>
<td align='left'>DSN NGLEGOK RT 019 RW 003-NGEPEH-TUGU-TRENGGALEK</td>
 <td align='left'>1972-08-17</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">30</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>203</td>
<td align='left'>18-04-2024</td>
<td align='left'>TUKINI</td>
<td align='left'>021366</td>
<td align='left'>DUSUN JAMPI, RT : 5,RW :1 -NGENTRONG-KARANGAN-
TRENGGALEK</td>
<td align='left'>1962-01-17</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A01.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metronidazole 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">30</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>204</td>
<td align='left'>18-04-2024</td>
<td align='left'>DIAH PUSPITASARI</td>
<td align='left'>026231</td>
<td align='left'>DSN SELOMUNDING RT 004 RW 002 WINONG</td>
<td align='left'>1996-04-28</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metronidazole 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>205</td>
<td align='left'>18-04-2024</td>
<td align='left'>MUYADI</td>
<td align='left'>034212</td>
<td align='left'>TENGGAR, RT : 7,RW :2 PRAMBON</td>
<td align='left'>1959-12-21</td>
<td align='left'>UGD</td>
<td align='left'>R50.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Metronidazole 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Natrium Diklofenak (21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>206</td>
<td align='left'>18-04-2024</td>
<td align='left'>SULASTRI</td>
<td align='left'>014840</td>
<td align='left'>DUSUN BENGGLE, RT : 11,RW :4 WINONG</td>
<td align='left'>1967-04-16</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Natrium Diklofenak (21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>207</td>
<td align='left'>18-04-2024</td>
<td align='left'>RENI EKA </td>
<td align='left'>034218</td>
<td align='left'>RT6 NGLONGSOR</td>
<td align='left'>2009-04-18</td>
<td align='left'>UGD</td>
<td align='left'>J00</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Natrium Diklofenak (21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>208</td>
<td align='left'>18-04-2024</td>
<td align='left'>DINAS BAGUS</td>
<td align='left'>034216</td>
<td align='left'>RT 6,RW 1 NGLONGSOR</td>
<td align='left'>2014-04-18</td>
<td align='left'>UGD</td>
<td align='left'>J00</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>209</td>
<td align='left'>18-04-2024</td>
<td align='left'>SUNARI</td>
<td align='left'>012913</td>
<td align='left'>DSN BENGGLE RT : 009,RW :003 WINONG</td>
<td align='left'>1956-09-20</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
 <td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Natrium Diklofenak (21) </td>
<td width="10%" align="center">9</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>210</td>
<td align='left'>18-04-2024</td>
<td align='left'>MUNAH</td>
<td align='left'>012874</td>
<td align='left'>TUMPAK PELEM,SAWOO,PONOROGO-TUMPAK PELEM-SAWOO-
PONOROGO</td>
<td align='left'>1940-01-06</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Atapulgit tab 600 mg </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>211</td>
<td align='left'>18-04-2024</td>
 <td align='left'>HIKMA LUKIYA RAHMA</td>
<td align='left'>033505</td>
<td align='left'>DUSUN CORAH MULYO, RT : 004,RW :002 -NGLONGSOR-TUGU-
TRENGGALEK</td>
<td align='left'>2016-04-20</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A91</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>212</td>
<td align='left'>18-04-2024</td>
<td align='left'>SUPARNO</td>
<td align='left'>034158</td>
 <td align='left'>RT 1 RW 3-TUMPAK PELEM-SAWOO-PONOROGO</td>
<td align='left'>1986-12-10</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A90</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid 10 mg </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
 </tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>213</td>
<td align='left'>18-04-2024</td>
<td align='left'>FIRDA FAJRINA QURROTA AYUN</td>
<td align='left'>034132</td>
<td align='left'>PRAMBON RT 38/ RW 07-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>2022-03-09</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid 10 mg </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>214</td>
<td align='left'>18-04-2024</td>
<td align='left'>LIA OKTAVIA</td>
<td align='left'>019593</td>
 <td align='left'>DUSUN PAKEL, RT : 39,RW :7 PRAMBON</td>
<td align='left'>2002-10-13</td>
<td align='left'>UGD</td>
<td align='left'>J00</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>215</td>
<td align='left'>18-04-2024</td>
<td align='left'>MEILINDA SUKMA PURWANINGTYAS</td>
<td align='left'>034176</td>
<td align='left'>DUSUN KRAJAN, RT : 8,RW :3 -NGLONGSOR-TUGU-
TRENGGALEK</td>
<td align='left'>1999-05-15</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>216</td>
<td align='left'>18-04-2024</td>
<td align='left'>ENDANG TEGOWATI</td>
<td align='left'>002275</td>
<td align='left'>DUSUN KEBON, RT : 20,RW :5
-GONDANG-TUGU-TRENGGALEK</td>
<td align='left'>1957-06-15</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>E16.2</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid 10 mg </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>217</td>
<td align='left'>18-04-2024</td>
<td align='left'>LEVINA MELODYA</td>
<td align='left'>034201</td>
<td align='left'>JL HAYAM WURUK, RT : 023,RW :005 NGANTRU</td>
<td align='left'>2008-10-28</td>
<td align='left'>UGD</td>
<td align='left'>R11</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>218</td>
<td align='left'>18-04-2024</td>
<td align='left'>SUYATI</td>
<td align='left'>034196</td>
<td align='left'>PRAMBON RT 40 RW 07 PRAMBON</td>
<td align='left'>1973-04-16</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>219</td>
<td align='left'>17-04-2024</td>
<td align='left'>KADIMIN</td>
<td align='left'>034161</td>
<td align='left'>RT 10 RW 03 DESA JOHO KECAMATAN PULE KABUPATEN
TRENGGALEK, RT : 10,RW :3 -JOHO-PULE-TRENGGALEK</td>
<td align='left'>1963-11-05</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J44</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">6</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Natrium Diklofenak (21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kloramfenikol 250 mg </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kapas Pembalut 250 gram </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>220</td>
<td align='left'>17-04-2024</td>
<td align='left'>TUKINI</td>
<td align='left'>021366</td>
<td align='left'>DUSUN JAMPI, RT : 5,RW :1 -NGENTRONG-KARANGAN-
TRENGGALEK</td>
<td align='left'>1962-01-17</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A01.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>221</td>
<td align='left'>17-04-2024</td>
<td align='left'>ARTIKA ISMO KUSUMA NINGSIH</td>
<td align='left'>031017</td>
<td align='left'>DUSUN PONGGOK, RT : 20,RW :9 NGEPEH</td>
<td align='left'>2009-10-01</td>
<td align='left'>UGD</td>
<td align='left'>J45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gentamicin SK(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
 </tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>222</td>
<td align='left'>17-04-2024</td>
<td align='left'>YUNITA PERMATASARI</td>
<td align='left'>021084</td>
<td align='left'>DSN KRAJAN, RT : 3,RW :1 TUMPUK</td>
<td align='left'>1999-06-03</td>
<td align='left'>UGD</td>
<td align='left'>A90</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Betamethasone krim 0,1% </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>223</td>
<td align='left'>17-04-2024</td>
<td align='left'>MUNAH</td>
<td align='left'>012874</td>
<td align='left'>TUMPAK PELEM,SAWOO,PONOROGO-TUMPAK PELEM-SAWOO-
PONOROGO</td>
<td align='left'>1940-01-06</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>224</td>
<td align='left'>17-04-2024</td>
<td align='left'>HIKMA LUKIYA RAHMA</td>
<td align='left'>033505</td>
<td align='left'>DUSUN CORAH MULYO, RT : 004,RW :002 -NGLONGSOR-TUGU-
TRENGGALEK</td>
<td align='left'>2016-04-20</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A91</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
 <tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>225</td>
<td align='left'>17-04-2024</td>
<td align='left'>SUPARNO</td>
<td align='left'>034158</td>
<td align='left'>RT 1 RW 3-TUMPAK PELEM-SAWOO-PONOROGO</td>
<td align='left'>1986-12-10</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A90</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid 10 mg </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>226</td>
<td align='left'>17-04-2024</td>
<td align='left'>FIRDA FAJRINA QURROTA AYUN</td>
<td align='left'>034132</td>
<td align='left'>PRAMBON RT 38/ RW 07-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>2022-03-09</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Metoklopramid 10 mg </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>227</td>
<td align='left'>17-04-2024</td>
<td align='left'>WIJI</td>
<td align='left'>034124</td>
<td align='left'>DUSUN MLOKO, RT : 55,RW :11 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>1963-07-16</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R11</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>228</td>
<td align='left'>17-04-2024</td>
<td align='left'>YUNITA PERMATASARI</td>
<td align='left'>021084</td>
<td align='left'>DSN KRAJAN, RT : 3,RW :1 -TUMPUK-TUGU-TRENGGALEK</td>
<td align='left'>1999-06-03</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>229</td>
<td align='left'>17-04-2024</td>
<td align='left'>MEILINDA SUKMA PURWANINGTYAS</td>
<td align='left'>034176</td>
<td align='left'>DUSUN KRAJAN, RT : 8,RW :3 -NGLONGSOR-TUGU-
TRENGGALEK</td>
<td align='left'>1999-05-15</td>
 <td align='left'>RAWAT INAP</td>
<td align='left'>R50</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>230</td>
<td align='left'>17-04-2024</td>
<td align='left'>ENDANG TEGOWATI</td>
<td align='left'>002275</td>
<td align='left'>DUSUN KEBON, RT : 20,RW :5
-GONDANG-TUGU-TRENGGALEK</td>
<td align='left'>1957-06-15</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>E16.2</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid 10 mg </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">6</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>231</td>
<td align='left'>17-04-2024</td>
<td align='left'>DHEFIN ALEXZO K</td>
<td align='left'>034195</td>
<td align='left'>RT 18 RW 8-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2021-04-10</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid 10 mg </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Atapulgit tab 600 mg </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
</td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>232</td>
<td align='left'>16-04-2024</td>
<td align='left'>KADIMIN</td>
<td align='left'>034161</td>
<td align='left'>RT 10 RW 03 DESA JOHO KECAMATAN PULE KABUPATEN
TRENGGALEK, RT : 10,RW :3 -JOHO-PULE-TRENGGALEK</td>
<td align='left'>1963-11-05</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J44</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Allopurinol 100 mg </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
</td>
<td width="10%" align="center">12</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ranitidin injeksi 25mg/ml </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>233</td>
<td align='left'>16-04-2024</td>
<td align='left'>TUKINI</td>
<td align='left'>021366</td>
<td align='left'>DUSUN JAMPI, RT : 5,RW :1 -NGENTRONG-KARANGAN-
TRENGGALEK</td>
<td align='left'>1962-01-17</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A01.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kloramfenikol 250 mg </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ranitidin injeksi 25mg/ml </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>234</td>
<td align='left'>16-04-2024</td>
<td align='left'>HIKMA LUKIYA RAHMA</td>
<td align='left'>033505</td>
<td align='left'>DUSUN CORAH MULYO, RT : 004,RW :002 NGLONGSOR</td>
<td align='left'>2016-04-20</td>
<td align='left'>UGD</td>
<td align='left'>A91</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Allopurinol 100 mg </td>
<td width="10%" align="center">20</td>
 </tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>235</td>
<td align='left'>16-04-2024</td>
<td align='left'>SURANI</td>
<td align='left'>021444</td>
<td align='left'>DUSUN TENGGAR RT 002 RW 001 PRAMBON</td>
<td align='left'>1970-07-18</td>
<td align='left'>UGD</td>
<td align='left'>J46</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>236</td>
<td align='left'>16-04-2024</td>
<td align='left'>DIAH PUSPITASARI</td>
<td align='left'>026231</td>
<td align='left'>DSN SELOMUNDING RT 004 RW 002 WINONG</td>
<td align='left'>1996-04-28</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">20</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>237</td>
<td align='left'>16-04-2024</td>
<td align='left'>WAHYU DWI NUR CAHYO</td>
<td align='left'>002119</td>
<td align='left'>DSN NGLEGOK, RT :009,RW :003 NGEPEH</td>
<td align='left'>2018-02-04</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisilin Sirup Kering 125mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>238</td>
<td align='left'>16-04-2024</td>
<td align='left'>KAYLA SALWA LATIFATUZ ZAHRA</td>
<td align='left'>034149</td>
<td align='left'>DUSUN KRAJAN, RT : 005,RW :002 TUMPUK</td>
<td align='left'>2009-04-19</td>
<td align='left'>UGD</td>
<td align='left'>j06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>239</td>
<td align='left'>16-04-2024</td>
<td align='left'>HIKMA LUKIYA RAHMA</td>
<td align='left'>033505</td>
<td align='left'>DUSUN CORAH MULYO, RT : 004,RW :002 -NGLONGSOR-TUGU-
TRENGGALEK</td>
<td align='left'>2016-04-20</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A91</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Anak (PKD-2) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>240</td>
<td align='left'>16-04-2024</td>
<td align='left'>KHAI BARRA BALINDRA</td>
<td align='left'>032021</td>
<td align='left'>DSN JAMPI RT 005 RW 001-NGENTRONG-KARANGAN-
TRENGGALEK</td>
<td align='left'>2022-07-28</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J20</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>241</td>
<td align='left'>16-04-2024</td>
<td align='left'>WIJI</td>
<td align='left'>034124</td>
<td align='left'>DUSUN MLOKO, RT : 55,RW :11 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>1963-07-16</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R11</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>242</td>
<td align='left'>16-04-2024</td>
<td align='left'>FIRDA FAJRINA QURROTA AYUN</td>
<td align='left'>034132</td>
<td align='left'>PRAMBON RT 38/ RW 07-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>2022-03-09</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>243</td>
<td align='left'>16-04-2024</td>
<td align='left'>KAYYSA LATIFA VEERUBY</td>
<td align='left'>021050</td>
<td align='left'>DUSUN KRAJAN, RT : 016,RW :003 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>2008-06-30</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A91</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>244</td>
<td align='left'>16-04-2024</td>
<td align='left'>RIKA WIDIANI</td>
<td align='left'>034119</td>
<td align='left'>DUSUN GEBANG, RT : 019,RW :007 -DUREN-TUGU-
TRENGGALEK</td>
 <td align='left'>1997-12-02</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R41.8</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ranitidin injeksi 25mg/ml </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>245</td>
<td align='left'>16-04-2024</td>
<td align='left'>ENDANG TEGOWATI</td>
<td align='left'>002275</td>
<td align='left'>DUSUN KEBON, RT : 20,RW :5
-GONDANG-TUGU-TRENGGALEK</td>
<td align='left'>1957-06-15</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>E16.2</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg(21) </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>246</td>
<td align='left'>16-04-2024</td>
<td align='left'>SUMIRAN</td>
<td align='left'>031019</td>
<td align='left'>RT 19 RW 7 JAMBU-JAMBU-TUGU-TRENGGALEK</td>
<td align='left'>1940-07-01</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J44</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>247</td>
<td align='left'>16-04-2024</td>
<td align='left'>DHEFIN ALEXZO K</td>
<td align='left'>034195</td>
<td align='left'>RT 18 RW 8-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2021-04-10</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid 10 mg </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Atapulgit tab 600 mg </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
</td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>248</td>
<td align='left'>16-04-2024</td>
<td align='left'>SUPARMAN</td>
<td align='left'>034153</td>
<td align='left'>BARUREJO RT 03 RW 03 GANDUSARI</td>
<td align='left'>1973-06-08</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>249</td>
<td align='left'>16-04-2024</td>
<td align='left'>SUMONO</td>
<td align='left'>034152</td>
 <td align='left'>LENGGOKSONO RT 08 RW 02 TIRTOYUDO</td>
<td align='left'>1972-02-21</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>250</td>
<td align='left'>16-04-2024</td>
<td align='left'>WINARSIH</td>
<td align='left'>034151</td>
<td align='left'>PURWODADI RT 22 RW 04 TIRTOYUDO</td>
<td align='left'>1976-03-12</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>251</td>
<td align='left'>15-04-2024</td>
<td align='left'>SULASTRI</td>
<td align='left'>034114</td>
<td align='left'>RT1 TEMPURAN</td>
<td align='left'>1979-07-17</td>
<td align='left'>UGD</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Vitamin B Kompleks </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ciprofloxacin 500 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
 </td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>252</td>
<td align='left'>15-04-2024</td>
<td align='left'>TUMINI</td>
<td align='left'>003834</td>
<td align='left'>RT 9 NGEPEH</td>
<td align='left'>1968-03-21</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>253</td>
<td align='left'>15-04-2024</td>
<td align='left'>DELLANO</td>
<td align='left'>034112</td>
<td align='left'>RT1 RW 1 DERMOSARI</td>
<td align='left'>2021-04-15</td>
<td align='left'>UGD</td>
<td align='left'>R50.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>254</td>
<td align='left'>15-04-2024</td>
<td align='left'>PURNOMO</td>
<td align='left'>034111</td>
<td align='left'>KRAJAN, RT : 22,RW :4 PRAMBON</td>
<td align='left'>1988-06-02</td>
<td align='left'>UGD</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>255</td>
<td align='left'>15-04-2024</td>
<td align='left'>SUMIRAN</td>
<td align='left'>031019</td>
<td align='left'>RT 19 RW 7 JAMBU-JAMBU-TUGU-TRENGGALEK</td>
<td align='left'>1940-07-01</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J44</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Nasal Canul Dewasa(21) </td>
<td width="10%" align="center">1</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>256</td>
<td align='left'>15-04-2024</td>
<td align='left'>WIJI</td>
<td align='left'>034124</td>
<td align='left'>DUSUN MLOKO, RT : 55,RW :11 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>1963-07-16</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R11</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">1</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>257</td>
<td align='left'>15-04-2024</td>
<td align='left'>KADIMIN</td>
<td align='left'>034161</td>
<td align='left'>RT 10 RW 03 DESA JOHO KECAMATAN PULE KABUPATEN
TRENGGALEK, RT : 10,RW :3 -JOHO-PULE-TRENGGALEK</td>
<td align='left'>1963-11-05</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J44</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Betahistine 6 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>258</td>
<td align='left'>15-04-2024</td>
<td align='left'>KHAI BARRA BALINDRA</td>
<td align='left'>032021</td>
<td align='left'>DSN JAMPI RT 005 RW 001-NGENTRONG-KARANGAN-
TRENGGALEK</td>
<td align='left'>2022-07-28</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J20</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>259</td>
<td align='left'>15-04-2024</td>
<td align='left'>MISIYAH</td>
<td align='left'>034115</td>
<td align='left'>DUSUN KRAJAN, RT : 6,RW :2 -SUMBER-KARANGAN-
TRENGGALEK</td>
<td align='left'>1958-10-10</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>E11.6</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.22 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Vitamin B Kompleks </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metformin 850 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>260</td>
<td align='left'>15-04-2024</td>
<td align='left'>ABRIZAM BRIAN</td>
<td align='left'>034144</td>
<td align='left'>PRAMBON RT /RW 43/ 09-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>2023-02-10</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J06</td>
<td align='left'>
 <table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Anak (PKD-2) </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>261</td>
<td align='left'>15-04-2024</td>
<td align='left'>ATIK MUNAWAROH</td>
<td align='left'>001745</td>
<td align='left'>DUSUN KEBONSARI RT : 023 RW :006 -GONDANG-TUGU-
TRENGGALEK</td>
 <td align='left'>1971-04-25</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Atapulgit tab 600 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metronidazole 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>262</td>
<td align='left'>15-04-2024</td>
<td align='left'>FIRDA FAJRINA QURROTA AYUN</td>
<td align='left'>034132</td>
<td align='left'>PRAMBON RT 38/ RW 07-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>2022-03-09</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Anak (PKD-2) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>263</td>
<td align='left'>15-04-2024</td>
<td align='left'>KAYYSA LATIFA VEERUBY</td>
<td align='left'>021050</td>
<td align='left'>DUSUN KRAJAN, RT : 016,RW :003 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>2008-06-30</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A91</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>264</td>
<td align='left'>15-04-2024</td>
<td align='left'>RIKA WIDIANI</td>
<td align='left'>034119</td>
<td align='left'>DUSUN GEBANG, RT : 019,RW :007 -DUREN-TUGU-
TRENGGALEK</td>
<td align='left'>1997-12-02</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R41.8</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>265</td>
<td align='left'>15-04-2024</td>
<td align='left'>JUPRI</td>
<td align='left'>034107</td>
<td align='left'>RT 12 RW 05. DS.PAKEL, KEC.PULE, KAB.TRENGGALEK, RT :
12,RW :5 -PAKEL-PULE-TRENGGALEK</td>
<td align='left'>1973-04-21</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K30</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
 </td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>266</td>
<td align='left'>15-04-2024</td>
<td align='left'>DHEFIN ALEXZO K</td>
<td align='left'>034195</td>
<td align='left'>RT 18 RW 8-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2021-04-10</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
</td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>267</td>
<td align='left'>15-04-2024</td>
<td align='left'>AZIZAH ZAFIRAH PUTRI UTAMI</td>
<td align='left'>034122</td>
<td align='left'>SANGGRAHAN, RT : 2,RW :1 SUKOREJO</td>
<td align='left'>2007-01-11</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ciprofloxacin 500 mg(21) </td>
<td width="10%" align="center">7</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>268</td>
<td align='left'>15-04-2024</td>
<td align='left'>MISNI</td>
<td align='left'>034121</td>
<td align='left'>DUSUN MLOKO, RT : 56,RW :12 PRAMBON</td>
<td align='left'>1945-12-31</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>269</td>
<td align='left'>15-04-2024</td>
<td align='left'>SUMIATIN</td>
<td align='left'>010147</td>
<td align='left'>DUSUN SETONO RT 015 RW 004 GONDANG</td>
<td align='left'>1957-12-31</td>
<td align='left'>UGD</td>
<td align='left'>I15</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg(21) </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Natrium Diklofenak (21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Vitamin B Kompleks </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">20</td>
 </tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>270</td>
<td align='left'>15-04-2024</td>
<td align='left'>KHUSNUL KHOTIMAH</td>
<td align='left'>025121</td>
<td align='left'>DUSUN KALIPINGGIR RT 020 RW 005 GONDANG</td>
<td align='left'>1972-11-21</td>
<td align='left'>UGD</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ciprofloxacin 500 mg(21) </td>
<td width="10%" align="center">7</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>271</td>
<td align='left'>15-04-2024</td>
<td align='left'>SOLEMAN</td>
<td align='left'>025431</td>
<td align='left'>RT 29 RW 07 GONDANG GONDANG</td>
<td align='left'>1950-08-26</td>
<td align='left'>UGD</td>
<td align='left'>R50.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>272</td>
<td align='left'>15-04-2024</td>
<td align='left'>ARIL DWI SAPUTRA</td>
<td align='left'>002160</td>
<td align='left'>KRAJAN, RT : 7,RW :2 NGEPEH</td>
<td align='left'>2015-05-27</td>
<td align='left'>UGD</td>
<td align='left'>R50.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>273</td>
<td align='left'>15-04-2024</td>
<td align='left'>SUPRAPTO</td>
<td align='left'>013469</td>
<td align='left'>GONDANG RT 04 RW 01 GONDANG</td>
<td align='left'>1970-02-23</td>
<td align='left'>UGD</td>
<td align='left'>R50</td>
<td align='left'>
<table width='100%' border="1">
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>274</td>
<td align='left'>15-04-2024</td>
 <td align='left'>SANIYAH</td>
<td align='left'>034136</td>
<td align='left'>BULUAGUNG RT 07 RW 03 BULUAGUNG</td>
<td align='left'>1949-09-07</td>
<td align='left'>UGD</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>275</td>
<td align='left'>15-04-2024</td>
<td align='left'>MUKIRAH</td>
<td align='left'>031537</td>
<td align='left'>DSN MOJO KIDUL RT : 021 RW :008 JAMBU</td>
<td align='left'>1964-11-11</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>276</td>
<td align='left'>15-04-2024</td>
<td align='left'>SUHADI</td>
<td align='left'>012240</td>
<td align='left'>KRAJAN, RT : 6,RW :2 NGEPEH</td>
<td align='left'>1950-12-31</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>277</td>
 <td align='left'>15-04-2024</td>
<td align='left'>ADINDA DWI MEIRIKA</td>
<td align='left'>017071</td>
<td align='left'>DUSUN ETAN KALI, RT : 25,RW :6 NGLONGSOR</td>
<td align='left'>2005-05-23</td>
<td align='left'>UGD</td>
<td align='left'>R50</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>278</td>
<td align='left'>15-04-2024</td>
<td align='left'>EKO WAHYU UTOMO</td>
<td align='left'>010735</td>
<td align='left'>DUSUN KRAJAN RT 004 RW 002 NGEPEH</td>
<td align='left'>2018-07-08</td>
<td align='left'>UGD</td>
<td align='left'>J00</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">4</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>279</td>
<td align='left'>15-04-2024</td>
<td align='left'>RASYA AL FATIH</td>
<td align='left'>034134</td>
<td align='left'>NGEPEH RT 28 RW 12 NGEPEH</td>
<td align='left'>2022-01-01</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
 <td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">4</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>280</td>
<td align='left'>15-04-2024</td>
<td align='left'>SUNYOTO</td>
<td align='left'>023207</td>
<td align='left'>PRAMBON RT 27/5 PRAMBON</td>
<td align='left'>1971-06-04</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>281</td>
<td align='left'>15-04-2024</td>
<td align='left'>SALMA DWI RAHMA</td>
<td align='left'>009841</td>
<td align='left'>DUSUN PAKEL, RT : 027,RW :005 PRAMBON</td>
<td align='left'>2015-03-29</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
 <table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>282</td>
<td align='left'>15-04-2024</td>
<td align='left'>HADI PRIYANTO</td>
<td align='left'>034123</td>
<td align='left'>DUSUN KALIPINGGIR, RT : 18,RW :5 GONDANG</td>
<td align='left'>1971-02-24</td>
<td align='left'>UGD</td>
<td align='left'>R14</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Bisakodil suppo 10 mg / STOLAX/DULCOLAX
</td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>283</td>
<td align='left'>15-04-2024</td>
<td align='left'>PUGUH PRAKOSO</td>
<td align='left'>007967</td>
<td align='left'>RT 2 RW 2 SUKOREJO</td>
<td align='left'>2000-11-18</td>
<td align='left'>UGD</td>
<td align='left'>R50.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Vitamin B Kompleks </td>
<td width="10%" align="center">4</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>284</td>
<td align='left'>15-04-2024</td>
<td align='left'>DAVID FAKSA WARDANA</td>
<td align='left'>034116</td>
<td align='left'>RT 6 GONDANG</td>
<td align='left'>2002-04-15</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>285</td>
<td align='left'>15-04-2024</td>
<td align='left'>ROZIKUL FADLI</td>
<td align='left'>034117</td>
<td align='left'>RT 6 GONDANG</td>
<td align='left'>2003-04-15</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>286</td>
<td align='left'>15-04-2024</td>
<td align='left'>YAYUK</td>
<td align='left'>034118</td>
<td align='left'>RT 9 SALAMREJO</td>
<td align='left'>1986-04-15</td>
<td align='left'>UGD</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>287</td>
<td align='left'>14-04-2024</td>
<td align='left'>REGA PRATAMA</td>
<td align='left'>002233</td>
<td align='left'>MLOKO, RT : 54,RW :11 PRAMBON</td>
<td align='left'>2015-10-30</td>
<td align='left'>UGD</td>
<td align='left'>R06.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">5</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Allopurinol 100 mg </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>288</td>
<td align='left'>14-04-2024</td>
<td align='left'>RIA ASTUTI ULANDARI</td>
<td align='left'>024048</td>
<td align='left'>RT 13 RW 3 NGENTRONG</td>
<td align='left'>1992-04-18</td>
<td align='left'>UGD</td>
<td align='left'>J45.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>289</td>
<td align='left'>14-04-2024</td>
<td align='left'>DIAH PUSPITASARI</td>
<td align='left'>026231</td>
<td align='left'>DSN SELOMUNDING RT 004 RW 002 WINONG</td>
<td align='left'>1996-04-28</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Allopurinol 100 mg </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>290</td>
<td align='left'>14-04-2024</td>
<td align='left'>KHAI BARRA BALINDRA</td>
<td align='left'>032021</td>
<td align='left'>DSN JAMPI RT 005 RW 001-NGENTRONG-KARANGAN-
TRENGGALEK</td>
<td align='left'>2022-07-28</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J20</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.22 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Anak (PKD-2) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ranitidin injeksi 25mg/ml </td>
<td width="10%" align="center">10</td>
 </tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>291</td>
<td align='left'>14-04-2024</td>
<td align='left'>CLARINTA MOZA AURELL</td>
<td align='left'>027155</td>
<td align='left'>DUSUN KRAJAN, RT : 4,RW :1 GONDANG</td>
<td align='left'>2008-06-14</td>
<td align='left'>UGD</td>
<td align='left'>R11</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Allopurinol 100 mg </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>292</td>
<td align='left'>14-04-2024</td>
<td align='left'>DHEFIN ALEXZO K</td>
<td align='left'>034195</td>
<td align='left'>RT 18 RW 8-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2021-04-10</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>293</td>
<td align='left'>14-04-2024</td>
<td align='left'>SUJIONO</td>
<td align='left'>017245</td>
<td align='left'>DSN KRAJAN, RT : 020,RW :004 PRAMBON</td>
 <td align='left'>1978-07-28</td>
<td align='left'>UGD</td>
<td align='left'>R51</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Allopurinol 100 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>294</td>
<td align='left'>14-04-2024</td>
<td align='left'>MISIYAH</td>
<td align='left'>034115</td>
<td align='left'>DUSUN KRAJAN, RT : 6,RW :2 -SUMBER-KARANGAN-
TRENGGALEK</td>
<td align='left'>1958-10-10</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>E11.6</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Vitamin B Kompleks </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ranitidin injeksi 25mg/ml </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>295</td>
<td align='left'>14-04-2024</td>
<td align='left'>ABRIZAM BRIAN</td>
<td align='left'>034144</td>
<td align='left'>PRAMBON RT /RW 43/ 09-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>2023-02-10</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J06</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Anak (PKD-2) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">2</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisilin Sirup Kering 125mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>296</td>
<td align='left'>14-04-2024</td>
<td align='left'>ATIK MUNAWAROH</td>
<td align='left'>001745</td>
<td align='left'>DUSUN KEBONSARI RT : 023 RW :006 -GONDANG-TUGU-
TRENGGALEK</td>
<td align='left'>1971-04-25</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metronidazole 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Atapulgit tab 600 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ranitidin injeksi 25mg/ml </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>297</td>
<td align='left'>14-04-2024</td>
<td align='left'>ALESA ALAYA NASIR</td>
<td align='left'>034092</td>
<td align='left'>DUSUN KRAJAN, RT : 16,RW :3 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>2017-03-18</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
 <td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ranitidin injeksi 25mg/ml </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>298</td>
<td align='left'>14-04-2024</td>
<td align='left'>WAKHIDATUN NUR RIANI</td>
<td align='left'>034103</td>
<td align='left'>DUSUN JAMPI, RT : 7,RW :2 -NGENTRONG-KARANGAN-
TRENGGALEK</td>
<td align='left'>1998-08-29</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">1</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ranitidin injeksi 25mg/ml </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>299</td>
<td align='left'>14-04-2024</td>
<td align='left'>MUYATUN</td>
<td align='left'>010559</td>
<td align='left'>DUSUN KRAJAN, RT : 4,RW :2
-TUMPUK-TUGU-TRENGGALEK</td>
<td align='left'>1945-12-30</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>G44</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ranitidin injeksi 25mg/ml </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>300</td>
<td align='left'>14-04-2024</td>
<td align='left'>KAYYSA LATIFA VEERUBY</td>
<td align='left'>021050</td>
<td align='left'>DUSUN KRAJAN, RT : 016,RW :003 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>2008-06-30</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A91</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>301</td>
<td align='left'>14-04-2024</td>
<td align='left'>JUPRI</td>
<td align='left'>034107</td>
<td align='left'>RT 12 RW 05. DS.PAKEL, KEC.PULE, KAB.TRENGGALEK, RT :
12,RW :5 -PAKEL-PULE-TRENGGALEK</td>
<td align='left'>1973-04-21</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K30</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
 <td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ranitidin injeksi 25mg/ml </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>302</td>
<td align='left'>14-04-2024</td>
<td align='left'>NADIO ADI ARYA SATYA</td>
<td align='left'>021842</td>
<td align='left'>RT 04 RW 02 NGLONGSOR</td>
<td align='left'>2022-09-17</td>
<td align='left'>UGD</td>
<td align='left'>R50</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
</table>
 </td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>303</td>
<td align='left'>14-04-2024</td>
<td align='left'>SINI</td>
<td align='left'>034109</td>
<td align='left'>SOOKO RT 44 RW 08 PRAMBON</td>
<td align='left'>1961-11-28</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>304</td>
<td align='left'>14-04-2024</td>
<td align='left'>WATINI</td>
<td align='left'>009543</td>
<td align='left'>DUSUN KEBONSARI, RT : 32,RW :8 GONDANG</td>
<td align='left'>1970-02-20</td>
<td align='left'>UGD</td>
<td align='left'>K12</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">4</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>305</td>
<td align='left'>14-04-2024</td>
<td align='left'>PRADANA PAMJI SAPUTRA</td>
<td align='left'>034108</td>
<td align='left'>DUSUN KRAJAN, RT : 5,RW :2 JATIPRAHU</td>
<td align='left'>2004-07-27</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Allopurinol 100 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>306</td>
<td align='left'>14-04-2024</td>
<td align='left'>RUDI</td>
<td align='left'>034155</td>
<td align='left'>RT 39 RW 7 GONDANG</td>
<td align='left'>1980-01-05</td>
<td align='left'>UGD</td>
<td align='left'>A05.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>307</td>
<td align='left'>14-04-2024</td>
<td align='left'>MARIYATI</td>
<td align='left'>010044</td>
<td align='left'>DUSUN KRAJAN, RT : 4,RW :1 GONDANG</td>
<td align='left'>1972-01-09</td>
<td align='left'>UGD</td>
<td align='left'>L20</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Allopurinol 100 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>308</td>
<td align='left'>14-04-2024</td>
<td align='left'>NOF RIYADI</td>
<td align='left'>006612</td>
<td align='left'>DUSUN PAKEL, RT : 26,RW :5 PRAMBON</td>
<td align='left'>1995-11-06</td>
<td align='left'>UGD</td>
<td align='left'>J02</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>309</td>
<td align='left'>14-04-2024</td>
<td align='left'>BAYU PUTRA KHARISMA</td>
<td align='left'>034154</td>
<td align='left'>DUSUN BENGGLE, RT : 11,RW :4 WINONG</td>
<td align='left'>2004-09-15</td>
<td align='left'>UGD</td>
<td align='left'>J02</td>
<td align='left'>
<table width='100%' border="1">
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Vitamin B Kompleks </td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>310</td>
<td align='left'>14-04-2024</td>
<td align='left'>RIA ASTUTI ULANDARI</td>
<td align='left'>024048</td>
<td align='left'>RT 13 RW 3 NGENTRONG</td>
<td align='left'>1992-04-18</td>
<td align='left'>UGD</td>
<td align='left'>R05</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Vitamin B Kompleks </td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>311</td>
<td align='left'>14-04-2024</td>
<td align='left'>SULASTRI</td>
<td align='left'>014840</td>
<td align='left'>DUSUN BENGGLE, RT : 11,RW :4 WINONG</td>
<td align='left'>1967-04-16</td>
<td align='left'>UGD</td>
<td align='left'>B37.2</td>
<td align='left'>
<table width='100%' border="1">
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>312</td>
<td align='left'>14-04-2024</td>
<td align='left'>SUMIRAN</td>
<td align='left'>031019</td>
<td align='left'>RT 19 RW 7 JAMBU JAMBU</td>
<td align='left'>1940-07-01</td>
<td align='left'>UGD</td>
<td align='left'>J45.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
 </tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>313</td>
<td align='left'>13-04-2024</td>
<td align='left'>YEDA FIRMANSYAH</td>
<td align='left'>000262</td>
<td align='left'>DUSUN JAMPI, RT : 6,RW :1 NGENTRONG</td>
<td align='left'>2010-07-02</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Betamethasone krim 0,1% </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>314</td>
<td align='left'>13-04-2024</td>
<td align='left'>ZASKIA AUDIA AL`ATIKA</td>
<td align='left'>034106</td>
<td align='left'>DUSUN KRAJAN, RT : 16,RW :3 PRAMBON</td>
<td align='left'>2007-07-02</td>
<td align='left'>UGD</td>
<td align='left'>J00</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>315</td>
<td align='left'>13-04-2024</td>
<td align='left'>WAHYU DWI NUR CAHYO</td>
<td align='left'>002119</td>
<td align='left'>DSN NGLEGOK, RT :009,RW :003 NGEPEH</td>
<td align='left'>2018-02-04</td>
<td align='left'>UGD</td>
<td align='left'>J00</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>316</td>
<td align='left'>13-04-2024</td>
<td align='left'>KHIRANI AULIA NURAZIZAH</td>
<td align='left'>022537</td>
<td align='left'>KRAJAN RT 2/1 NGEPEH</td>
<td align='left'>2008-12-16</td>
<td align='left'>UGD</td>
<td align='left'>K29</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>317</td>
<td align='left'>13-04-2024</td>
<td align='left'>SITI BATIAH</td>
<td align='left'>034105</td>
<td align='left'>WONOREJO RT4 RW1 PAPUA</td>
<td align='left'>1979-04-13</td>
<td align='left'>UGD</td>
<td align='left'>J00</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>318</td>
<td align='left'>13-04-2024</td>
<td align='left'>MUHAMMAD NURINDAFFA ALFATIH</td>
<td align='left'>027538</td>
<td align='left'>DUSUN TAMTU, RT : 21,RW :10 SUKOWETAN</td>
<td align='left'>2014-01-20</td>
<td align='left'>UGD</td>
<td align='left'>J00</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>319</td>
<td align='left'>13-04-2024</td>
<td align='left'>WAKHIDATUN NUR RIANI</td>
<td align='left'>034103</td>
<td align='left'>DUSUN JAMPI, RT : 7,RW :2 -NGENTRONG-KARANGAN-
TRENGGALEK</td>
<td align='left'>1998-08-29</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.22 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>320</td>
<td align='left'>13-04-2024</td>
<td align='left'>ALESA ALAYA NASIR</td>
<td align='left'>034092</td>
<td align='left'>DUSUN KRAJAN, RT : 16,RW :3 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>2017-03-18</td>
<td align='left'>RAWAT INAP</td>
 <td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Anak (PKD-2) </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>321</td>
<td align='left'>13-04-2024</td>
<td align='left'>HARTO</td>
 <td align='left'>025355</td>
<td align='left'>DUSUN KRAJAN, RT : 10,RW :3 -NGLONGSOR-TUGU-
TRENGGALEK</td>
<td align='left'>1967-02-12</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>322</td>
<td align='left'>13-04-2024</td>
<td align='left'>MUYATUN</td>
<td align='left'>010559</td>
<td align='left'>DUSUN KRAJAN, RT : 4,RW :2
-TUMPUK-TUGU-TRENGGALEK</td>
<td align='left'>1945-12-30</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>G44</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">8</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
 </table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>323</td>
<td align='left'>13-04-2024</td>
<td align='left'>KAYYSA LATIFA VEERUBY</td>
<td align='left'>021050</td>
<td align='left'>DUSUN KRAJAN, RT : 016,RW :003 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>2008-06-30</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A91</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida kombinasi tablet kunyah </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Anak (PKD-2) </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>324</td>
<td align='left'>13-04-2024</td>
<td align='left'>JUPRI</td>
<td align='left'>034107</td>
<td align='left'>RT 12 RW 05. DS.PAKEL, KEC.PULE, KAB.TRENGGALEK, RT :
12,RW :5 -PAKEL-PULE-TRENGGALEK</td>
<td align='left'>1973-04-21</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K30</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.22 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>325</td>
<td align='left'>12-04-2024</td>
<td align='left'>KAYYSA LATIFA VEERUBY</td>
<td align='left'>021050</td>
<td align='left'>DUSUN KRAJAN, RT : 016,RW :003 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>2008-06-30</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A91</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
 <td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>326</td>
<td align='left'>12-04-2024</td>
<td align='left'>MUYATUN</td>
<td align='left'>010559</td>
<td align='left'>DUSUN KRAJAN, RT : 4,RW :2
-TUMPUK-TUGU-TRENGGALEK</td>
<td align='left'>1945-12-30</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>G44</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Vitamin B Kompleks </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>327</td>
<td align='left'>12-04-2024</td>
<td align='left'>ALESA ALAYA NASIR</td>
<td align='left'>034092</td>
<td align='left'>DUSUN KRAJAN, RT : 16,RW :3 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>2017-03-18</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
 </tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>328</td>
<td align='left'>12-04-2024</td>
<td align='left'>SITI HELMIYATI LUTFIA</td>
<td align='left'>034094</td>
<td align='left'>DSN KRAJAN 01/09 MUMBULSARI</td>
<td align='left'>1981-11-26</td>
<td align='left'>UGD</td>
<td align='left'>R06.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>329</td>
<td align='left'>12-04-2024</td>
<td align='left'>MUHAMMAD ATHALLA ABISATYA ADANU</td>
<td align='left'>021258</td>
<td align='left'>RT 32 RW 08 GONDANG</td>
<td align='left'>2022-02-25</td>
<td align='left'>UGD</td>
<td align='left'>L30.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gentamicin SK(21) </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>330</td>
<td align='left'>12-04-2024</td>
<td align='left'>LAMIRAN</td>
<td align='left'>034093</td>
<td align='left'>DS SUKUN RT5 RW 11 MALANG SUKUN</td>
<td align='left'>1964-08-22</td>
<td align='left'>UGD</td>
<td align='left'>R50.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Vitamin B Kompleks </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gentamicin SK(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">7</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>331</td>
<td align='left'>12-04-2024</td>
<td align='left'>MISTI</td>
<td align='left'>005635</td>
<td align='left'>DSN GEBANG, RT : 019,RW :007
-DUREN-TUGU-TRENGGALEK</td>
<td align='left'>1968-12-09</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kloramfenikol 250 mg </td>
<td width="10%" align="center">15</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>332</td>
<td align='left'>12-04-2024</td>
<td align='left'>DAFFA DANIYAL</td>
<td align='left'>034053</td>
<td align='left'>RT 11 RW 4 NGEPEH-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2018-12-07</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>333</td>
<td align='left'>12-04-2024</td>
<td align='left'>MAHYA H</td>
<td align='left'>034091</td>
<td align='left'>JAMBU RT 18 RW7 PUCANGANAK JAMBU</td>
<td align='left'>2020-10-01</td>
<td align='left'>UGD</td>
<td align='left'>R11</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>334</td>
<td align='left'>12-04-2024</td>
<td align='left'>SUPRIYO</td>
<td align='left'>034090</td>
<td align='left'>DUSUN KRAJAN, RT : 4,RW :1 GONDANG</td>
<td align='left'>1974-08-06</td>
<td align='left'>UGD</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Gentamicin SK(21) </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>335</td>
<td align='left'>12-04-2024</td>
<td align='left'>FEBIANI</td>
<td align='left'>034089</td>
<td align='left'>CENGKONG RT12 RW 5 TAMANAN TAMANAN</td>
<td align='left'>2011-02-28</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>336</td>
<td align='left'>12-04-2024</td>
<td align='left'>MEYSA</td>
<td align='left'>034088</td>
<td align='left'>CENGKONG RT12 RW 5 TAMANAN TAMANAN</td>
<td align='left'>2012-05-20</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>337</td>
<td align='left'>12-04-2024</td>
<td align='left'>DIAH PUSPITASARI</td>
<td align='left'>026231</td>
<td align='left'>DSN SELOMUNDING RT 004 RW 002 WINONG</td>
<td align='left'>1996-04-28</td>
<td align='left'>UGD</td>
<td align='left'>Z39.1</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>338</td>
<td align='left'>12-04-2024</td>
<td align='left'>MUSONEP</td>
<td align='left'>034087</td>
<td align='left'>DUSUN PAKEL, RT : 155,RW :8 PRAMBON</td>
<td align='left'>1963-07-01</td>
<td align='left'>UGD</td>
<td align='left'>V90.0</td>
<td align='left'>
<table width='100%' border="1">
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>339</td>
<td align='left'>12-04-2024</td>
<td align='left'>SRIASIH</td>
<td align='left'>011893</td>
<td align='left'>DUSUN PAKEL, RT : 155,RW :8 PRAMBON</td>
<td align='left'>1969-07-01</td>
<td align='left'>UGD</td>
<td align='left'>R51</td>
<td align='left'>
<table width='100%' border="1">
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>340</td>
<td align='left'>12-04-2024</td>
<td align='left'>ASROBIAH</td>
<td align='left'>034086</td>
<td align='left'>RT 6 RW 1 DS GONDANG GONDANG</td>
<td align='left'>1984-03-05</td>
<td align='left'>UGD</td>
<td align='left'>R50.9</td>
<td align='left'>
<table width='100%' border="1">
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>341</td>
<td align='left'>12-04-2024</td>
<td align='left'>HARTO</td>
<td align='left'>025355</td>
<td align='left'>DUSUN KRAJAN, RT : 10,RW :3 -NGLONGSOR-TUGU-
TRENGGALEK</td>
<td align='left'>1967-02-12</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J06.9</td>
 <td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>342</td>
<td align='left'>12-04-2024</td>
<td align='left'>RETNO FEBRI ARIANTI</td>
<td align='left'>007268</td>
<td align='left'>RT 05 RW 02-WINONG-TUGU-TRENGGALEK</td>
<td align='left'>1998-02-14</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>343</td>
<td align='left'>11-04-2024</td>
<td align='left'>ALIFHA SYAQIA ZUHDA</td>
<td align='left'>034059</td>
<td align='left'>DESA SUKOREJO, RT : 11,RW :5 SUKOREJO</td>
<td align='left'>2014-10-21</td>
<td align='left'>UGD</td>
<td align='left'>J45</td>
<td align='left'>
 <table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>344</td>
<td align='left'>11-04-2024</td>
<td align='left'>GILANG EZA</td>
<td align='left'>034058</td>
<td align='left'>NGLONGSOR RT 07 RW 02 NGLONGSOR</td>
<td align='left'>2011-04-19</td>
<td align='left'>UGD</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>345</td>
<td align='left'>11-04-2024</td>
<td align='left'>MUHASIM</td>
<td align='left'>031249</td>
<td align='left'>DUSUN KEBON, RT : 33,RW :8 GONDANG</td>
<td align='left'>1950-06-12</td>
<td align='left'>UGD</td>
<td align='left'>R33</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Folley Catether No. 18 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
URINE BAG steril </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ciprofloxacin 500 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>346</td>
<td align='left'>11-04-2024</td>
<td align='left'>SURANI</td>
<td align='left'>021444</td>
<td align='left'>DUSUN TENGGAR RT 002 RW 001 PRAMBON</td>
<td align='left'>1970-07-18</td>
 <td align='left'>UGD</td>
<td align='left'>J45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
URINE BAG steril </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Folley Catether No. 18 </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>347</td>
<td align='left'>11-04-2024</td>
<td align='left'>MUTMAINNAH</td>
<td align='left'>006898</td>
<td align='left'>RT 15 RW 4 NGLONGSOR</td>
<td align='left'>1977-01-07</td>
<td align='left'>UGD</td>
<td align='left'>J10</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
 <td width="10%" align="center">18</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
URINE BAG steril </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Folley Catether No. 18 </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>348</td>
<td align='left'>11-04-2024</td>
<td align='left'>ZIDNA FAHMA MAZAYYA</td>
<td align='left'>004815</td>
<td align='left'>DUSUN KALIPINGGIR, RT : 018,RW :005 GONDANG</td>
<td align='left'>2016-09-12</td>
<td align='left'>UGD</td>
<td align='left'>J45.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>349</td>
 <td align='left'>11-04-2024</td>
<td align='left'>SUMARTIN</td>
<td align='left'>013909</td>
<td align='left'>PRAMBON RT 45 PRAMBON</td>
<td align='left'>1978-04-25</td>
<td align='left'>UGD</td>
<td align='left'>J45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>350</td>
<td align='left'>11-04-2024</td>
<td align='left'>MISTI</td>
<td align='left'>005635</td>
<td align='left'>DSN GEBANG, RT : 019,RW :007
-DUREN-TUGU-TRENGGALEK</td>
<td align='left'>1968-12-09</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
 <td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">9</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
</td>
<td width="10%" align="center">15</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>351</td>
<td align='left'>11-04-2024</td>
<td align='left'>DAFFA DANIYAL</td>
<td align='left'>034053</td>
<td align='left'>RT 11 RW 4 NGEPEH-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2018-12-07</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
 <td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
</td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infuset Anak(21) </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>352</td>
<td align='left'>11-04-2024</td>
<td align='left'>EDI PURWANTO</td>
<td align='left'>034080</td>
<td align='left'>RT 6 RW 4 GEMAHARJO</td>
<td align='left'>1993-10-19</td>
<td align='left'>UGD</td>
<td align='left'>R51</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
 </table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>353</td>
<td align='left'>11-04-2024</td>
<td align='left'>HARTO</td>
<td align='left'>025355</td>
<td align='left'>DUSUN KRAJAN, RT : 10,RW :3 -NGLONGSOR-TUGU-
TRENGGALEK</td>
<td align='left'>1967-02-12</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Glimepiride 2 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metformin 850 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>354</td>
<td align='left'>11-04-2024</td>
<td align='left'>SAMSURI</td>
<td align='left'>034096</td>
<td align='left'>DUSUN KALIPINGGIR, RT : 18,RW :5 -GONDANG-TUGU-
TRENGGALEK</td>
<td align='left'>1973-07-10</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">2</td>
</tr>
 </table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>355</td>
<td align='left'>11-04-2024</td>
<td align='left'>SOFI EL AZIS BADRIA TUZAMAN</td>
<td align='left'>000524</td>
<td align='left'>DUSUN NGLEGOK RT : 007 RW :003 NGEPEH</td>
<td align='left'>2011-01-11</td>
<td align='left'>UGD</td>
<td align='left'>I84.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
</td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>356</td>
<td align='left'>11-04-2024</td>
<td align='left'>SUPRIHATIN</td>
<td align='left'>008045</td>
<td align='left'>PRAMBON RT 25/5-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>1977-01-17</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>357</td>
<td align='left'>11-04-2024</td>
 <td align='left'>RETNO FEBRI ARIANTI</td>
<td align='left'>007268</td>
<td align='left'>RT 05 RW 02-WINONG-TUGU-TRENGGALEK</td>
<td align='left'>1998-02-14</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infuset Anak(21) </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>358</td>
<td align='left'>11-04-2024</td>
<td align='left'>MURTAMAH</td>
<td align='left'>016192</td>
<td align='left'>RT 29 RT 7 GONDANG</td>
<td align='left'>1957-11-10</td>
<td align='left'>UGD</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Atapulgit tab 600 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
</td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>359</td>
<td align='left'>11-04-2024</td>
<td align='left'>SITI FATIMAH</td>
<td align='left'>034078</td>
<td align='left'>RT 5 RW 5 SIDOMULYO</td>
<td align='left'>2003-03-18</td>
<td align='left'>UGD</td>
<td align='left'>J00</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>360</td>
<td align='left'>11-04-2024</td>
<td align='left'>DANI PUTRA SETYAWAN</td>
<td align='left'>029617</td>
<td align='left'>DUSUN KRAJAN RT : 007 RW :004 SUKOREJO</td>
<td align='left'>2009-10-11</td>
<td align='left'>UGD</td>
<td align='left'>R50</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>361</td>
<td align='left'>11-04-2024</td>
<td align='left'>UTINI</td>
<td align='left'>034077</td>
<td align='left'>DUSUN TAWING, RT : 015,RW :001 SENGON</td>
<td align='left'>1979-12-15</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>362</td>
<td align='left'>11-04-2024</td>
<td align='left'>ERES</td>
<td align='left'>034075</td>
<td align='left'>RT 3 RW 3 PUCANGAN</td>
<td align='left'>2019-04-25</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>363</td>
<td align='left'>11-04-2024</td>
<td align='left'>AZHIKRI DANIL MAULANA</td>
<td align='left'>034074</td>
<td align='left'>RT 9 RW 11 TUMPUK</td>
<td align='left'>2020-01-19</td>
<td align='left'>UGD</td>
<td align='left'>R50</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>364</td>
<td align='left'>11-04-2024</td>
<td align='left'>JUMROTUL MUKAROMAH</td>
<td align='left'>034073</td>
<td align='left'>RT 1 RW 1 MANGUHARJO</td>
<td align='left'>1987-09-02</td>
<td align='left'>UGD</td>
<td align='left'>J00</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>365</td>
<td align='left'>11-04-2024</td>
<td align='left'>MUKIRAH</td>
<td align='left'>031537</td>
<td align='left'>DSN MOJO KIDUL RT : 021 RW :008 JAMBU</td>
<td align='left'>1964-11-11</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>366</td>
<td align='left'>11-04-2024</td>
<td align='left'>RAZZAH YAZID NIZAM</td>
<td align='left'>034061</td>
<td align='left'>RT 02 RW 02 BUBUTAN</td>
<td align='left'>2021-03-08</td>
<td align='left'>UGD</td>
<td align='left'>R11</td>
 <td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>367</td>
<td align='left'>11-04-2024</td>
<td align='left'>ANJAR PRIANTI</td>
<td align='left'>001695</td>
<td align='left'>RT 36 RW 06 PRAMBON</td>
<td align='left'>1985-06-05</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>368</td>
<td align='left'>11-04-2024</td>
 <td align='left'>ZAKY BINTANG PUTRA PRATAMA</td>
<td align='left'>034060</td>
<td align='left'>DUSUN NGLONGAH, RT : 4,RW :1 SUMBERINGIN</td>
<td align='left'>2015-04-02</td>
<td align='left'>UGD</td>
<td align='left'>J45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>369</td>
<td align='left'>11-04-2024</td>
<td align='left'>DIAH PUSPITASARI</td>
<td align='left'>026231</td>
<td align='left'>DSN SELOMUNDING RT 004 RW 002 WINONG</td>
<td align='left'>1996-04-28</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">6</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>370</td>
<td align='left'>11-04-2024</td>
<td align='left'>NUR SUGIANTO</td>
<td align='left'>034083</td>
<td align='left'>DESA WINONG, RT : 8,RW :3 WINONG</td>
<td align='left'>1977-05-03</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>371</td>
<td align='left'>11-04-2024</td>
<td align='left'>MUHAMMAD FAHRI</td>
 <td align='left'>034085</td>
<td align='left'>WINONG RT 08 RW 03 WINONG</td>
<td align='left'>2014-06-25</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>372</td>
<td align='left'>11-04-2024</td>
<td align='left'>MARSELINA</td>
<td align='left'>034082</td>
<td align='left'>PERUM ASABRI. SUKOREJO RT 25 RW 06 KEC.TRENGGALEK
Sukorejo</td>
<td align='left'>2008-03-29</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">5</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>373</td>
<td align='left'>11-04-2024</td>
<td align='left'>TITIK INDRAWATI</td>
<td align='left'>034081</td>
<td align='left'>PERUM ASABRI. SUKOREJO RT 25 RW 06 Sukorejo</td>
<td align='left'>1963-08-21</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>374</td>
<td align='left'>10-04-2024</td>
<td align='left'>NIA KURNIAWATI</td>
 <td align='left'>010259</td>
<td align='left'>RT. 23 RW. 10 NGEPEH</td>
<td align='left'>1998-11-10</td>
<td align='left'>UGD</td>
<td align='left'>J10</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Betamethasone krim 0,1% </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>375</td>
<td align='left'>10-04-2024</td>
<td align='left'>IMAM SAFI`E R. PATIRAN</td>
<td align='left'>034057</td>
<td align='left'>PURWAHAB TONGGO RT 03 RW 00 FAK FAK SELATAN</td>
<td align='left'>2000-08-07</td>
<td align='left'>UGD</td>
<td align='left'>J10</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>376</td>
<td align='left'>10-04-2024</td>
<td align='left'>MISYATI</td>
<td align='left'>029960</td>
<td align='left'>DUSUN KEBONSARI, RT : 32,RW :8 GONDANG</td>
<td align='left'>1968-12-08</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Vitamin B Kompleks </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Anti Hemoroid kombinasi suppositoria
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>377</td>
<td align='left'>10-04-2024</td>
<td align='left'>RETNO FEBRI ARIANTI</td>
<td align='left'>007268</td>
<td align='left'>RT 05 RW 02-WINONG-TUGU-TRENGGALEK</td>
<td align='left'>1998-02-14</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metronidazole 500 mg </td>
<td width="10%" align="center">30</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>378</td>
<td align='left'>10-04-2024</td>
<td align='left'>DAFFA DANIYAL</td>
<td align='left'>034053</td>
<td align='left'>RT 11 RW 4 NGEPEH-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2018-12-07</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Anak (PKD-2) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
 <td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>379</td>
<td align='left'>10-04-2024</td>
<td align='left'>YUNI NUR</td>
<td align='left'>034056</td>
<td align='left'>JAMBU, RT : 010,RW :004 JAMBU</td>
<td align='left'>1999-06-16</td>
<td align='left'>UGD</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
 </td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>380</td>
<td align='left'>10-04-2024</td>
<td align='left'>MAKRUF</td>
<td align='left'>034055</td>
<td align='left'>GONDANG RT 34 GONDANG</td>
<td align='left'>1973-04-10</td>
<td align='left'>UGD</td>
<td align='left'>J06</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Vitamin B Kompleks </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>381</td>
<td align='left'>10-04-2024</td>
<td align='left'>NIA KURNIAWATI</td>
<td align='left'>010259</td>
<td align='left'>RT. 23 RW. 10 NGEPEH</td>
<td align='left'>1998-11-10</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>382</td>
<td align='left'>10-04-2024</td>
<td align='left'>MISYATI</td>
<td align='left'>029960</td>
<td align='left'>DUSUN KEBONSARI, RT : 32,RW :8 GONDANG</td>
<td align='left'>1968-12-08</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>383</td>
<td align='left'>10-04-2024</td>
<td align='left'>ALVINO DAFA</td>
<td align='left'>034054</td>
<td align='left'>GONDANG RT 18 RW 5 GONDANG</td>
<td align='left'>2020-05-19</td>
<td align='left'>UGD</td>
 <td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>384</td>
<td align='left'>10-04-2024</td>
<td align='left'>MISTI</td>
<td align='left'>005635</td>
<td align='left'>DSN GEBANG, RT : 019,RW :007
-DUREN-TUGU-TRENGGALEK</td>
<td align='left'>1968-12-09</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
 <td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">9</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
</td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Atapulgit tab 600 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>385</td>
<td align='left'>10-04-2024</td>
<td align='left'>HADI MULYONO</td>
<td align='left'>034038</td>
<td align='left'>DSN JOHO, RT : 008,RW :003 -PUCANGANAK-TUGU-
TRENGGALEK</td>
<td align='left'>1956-08-11</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R10.1</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>386</td>
<td align='left'>10-04-2024</td>
<td align='left'>SAMSURI</td>
<td align='left'>034096</td>
<td align='left'>DUSUN KALIPINGGIR, RT : 18,RW :5 -GONDANG-TUGU-
TRENGGALEK</td>
<td align='left'>1973-07-10</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>387</td>
<td align='left'>10-04-2024</td>
<td align='left'>SUPRIHATIN</td>
<td align='left'>008045</td>
<td align='left'>PRAMBON RT 25/5-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>1977-01-17</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>388</td>
<td align='left'>10-04-2024</td>
<td align='left'>ERZIO RAFAY PUTRA HARTONO</td>
<td align='left'>027097</td>
<td align='left'>RT 8 RW 4 TUMPUK</td>
<td align='left'>2019-06-18</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisilin Sirup Kering 125mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">4</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>389</td>
<td align='left'>10-04-2024</td>
<td align='left'>NURUL HIDAYAH</td>
<td align='left'>003250</td>
<td align='left'>PRAMBON RT 2/1 PRAMBON</td>
<td align='left'>1985-08-09</td>
<td align='left'>UGD</td>
 <td align='left'>J02</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>390</td>
<td align='left'>10-04-2024</td>
<td align='left'>GIZA DIAZ INDRIANI (1)</td>
<td align='left'>029374</td>
<td align='left'>DUSUN TAWANG RT :002 RW :001 BANARAN</td>
<td align='left'>2005-11-11</td>
<td align='left'>UGD</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>391</td>
<td align='left'>10-04-2024</td>
<td align='left'>SUKAR</td>
<td align='left'>025353</td>
<td align='left'>DSN ETAN KALI, RT : 024,RW :006 NGLONGSOR</td>
<td align='left'>1974-08-07</td>
<td align='left'>UGD</td>
<td align='left'>K29.7</td>
 <td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>392</td>
<td align='left'>10-04-2024</td>
<td align='left'>KATIRAN</td>
<td align='left'>003417</td>
<td align='left'>DUSUN PAKEL, RT : 39,RW :7 PRAMBON</td>
<td align='left'>1948-09-05</td>
<td align='left'>UGD</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>393</td>
<td align='left'>09-04-2024</td>
<td align='left'>ROHMAT RIZKI RISALDI</td>
 <td align='left'>002867</td>
<td align='left'>DSN TENGGAR RT 002 RW 001 PRAMBON</td>
<td align='left'>1996-07-01</td>
<td align='left'>UGD</td>
<td align='left'>G47.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Vitamin B Kompleks </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>394</td>
<td align='left'>09-04-2024</td>
<td align='left'>HADI MULYONO</td>
<td align='left'>034038</td>
<td align='left'>DSN JOHO, RT : 008,RW :003 PUCANGANAK</td>
<td align='left'>1956-08-11</td>
<td align='left'>UGD</td>
<td align='left'>N23</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
 </tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>395</td>
<td align='left'>09-04-2024</td>
<td align='left'>ARJUNA FARHAN KAMAL</td>
<td align='left'>005898</td>
<td align='left'>RT 13 NGLONGSOR</td>
<td align='left'>2014-12-21</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Nasal Canul Anak(21) </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>396</td>
<td align='left'>09-04-2024</td>
<td align='left'>SUNARTO</td>
<td align='left'>027471</td>
<td align='left'>RT 051 RW 010 PRAMBON</td>
<td align='left'>1970-11-01</td>
<td align='left'>UGD</td>
<td align='left'>N23</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Ibuprofen 400 mg </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">11</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>397</td>
<td align='left'>09-04-2024</td>
<td align='left'>WINARSIH</td>
<td align='left'>034046</td>
<td align='left'>KEBONSARI, RT : 24,RW :5 GONDANG</td>
<td align='left'>1983-05-12</td>
<td align='left'>UGD</td>
<td align='left'>J00</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>398</td>
<td align='left'>09-04-2024</td>
<td align='left'>HARDJO</td>
<td align='left'>000070</td>
<td align='left'>DUSUN KRAJAN RT 004 RW 001 GONDANG</td>
<td align='left'>1950-03-04</td>
<td align='left'>UGD</td>
<td align='left'>J00</td>
 <td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>399</td>
<td align='left'>09-04-2024</td>
<td align='left'>HADI MULYONO</td>
<td align='left'>034038</td>
<td align='left'>DSN JOHO, RT : 008,RW :003 -PUCANGANAK-TUGU-
TRENGGALEK</td>
<td align='left'>1956-08-11</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R10.1</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">4</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>400</td>
<td align='left'>09-04-2024</td>
<td align='left'>PRESTIONO</td>
<td align='left'>034034</td>
<td align='left'>RT 34 RW 6-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>1987-10-11</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kloramfenikol 250 mg </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>401</td>
<td align='left'>09-04-2024</td>
<td align='left'>JUMINA</td>
<td align='left'>032181</td>
<td align='left'>DUSUN MLOKO, RT : 58,RW :12 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>1984-05-10</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>G47.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>402</td>
<td align='left'>09-04-2024</td>
<td align='left'>JUMINA</td>
<td align='left'>032181</td>
<td align='left'>DUSUN MLOKO, RT : 58,RW :12 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>1984-05-10</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>G47.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">6</td>
</tr>
</table>
 </td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>403</td>
<td align='left'>09-04-2024</td>
<td align='left'>UMBAR</td>
<td align='left'>034045</td>
<td align='left'>PAKIS PAKIS</td>
<td align='left'>1964-03-20</td>
<td align='left'>UGD</td>
<td align='left'>J45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>404</td>
<td align='left'>09-04-2024</td>
<td align='left'>SUPARMI</td>
<td align='left'>034044</td>
<td align='left'>TEMPURAN TEMPURAN</td>
<td align='left'>1963-10-18</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ciprofloxacin 500 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Natrium Diklofenak (21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>405</td>
<td align='left'>09-04-2024</td>
<td align='left'>LUSIANA</td>
<td align='left'>034043</td>
 <td align='left'>TEMPURAN TEMPURAN</td>
<td align='left'>1994-07-28</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ciprofloxacin 500 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>406</td>
<td align='left'>09-04-2024</td>
<td align='left'>ADITYA RIZA NURHAMSAH</td>
<td align='left'>033825</td>
<td align='left'>DUSUN PONGGOK, RT : 024,RW :010 NGEPEH</td>
<td align='left'>2001-07-06</td>
<td align='left'>UGD</td>
<td align='left'>A01.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ciprofloxacin 500 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Nasal Canul Anak(21) </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
 <tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>407</td>
<td align='left'>09-04-2024</td>
<td align='left'>TUMIKAN</td>
<td align='left'>005867</td>
<td align='left'>PAKEL, RT : 38,RW :7 PRAMBON</td>
<td align='left'>1946-12-31</td>
<td align='left'>UGD</td>
<td align='left'>R51</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Natrium Diklofenak (21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>408</td>
<td align='left'>09-04-2024</td>
<td align='left'>AMELIA SANI</td>
<td align='left'>029629</td>
<td align='left'>WINONG RT 6 RW 02 WINONG</td>
<td align='left'>2022-09-30</td>
<td align='left'>UGD</td>
<td align='left'>R50.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
 </td>
<td width="10%" align="center">8</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>409</td>
<td align='left'>09-04-2024</td>
<td align='left'>RIZKI ABU SULTHON</td>
<td align='left'>004970</td>
<td align='left'>DUSUN KALIPINGGIR, RT : 19,RW :5 GONDANG</td>
<td align='left'>2002-01-01</td>
<td align='left'>UGD</td>
<td align='left'>J45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>410</td>
<td align='left'>09-04-2024</td>
<td align='left'>SEKARTAJI INDRAS SHANTI</td>
<td align='left'>004543</td>
<td align='left'>DSN KRAJAN RT 009 RW 003 NGLONGSOR</td>
<td align='left'>1975-06-23</td>
<td align='left'>UGD</td>
<td align='left'>I10</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg(21) </td>
 <td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asam Asetilsalisilat 80mg/MINIASPI </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Vitamin B Kompleks </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>411</td>
<td align='left'>09-04-2024</td>
<td align='left'>MUHAMMAD DANESH ERDOGAN</td>
<td align='left'>030070</td>
<td align='left'>RT 21 RW 10 SUKOWETAN</td>
<td align='left'>2022-03-23</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>412</td>
<td align='left'>09-04-2024</td>
<td align='left'>BINTI KOLIDAH</td>
<td align='left'>034040</td>
<td align='left'>RT 21 RW 10 SUKOWETAN</td>
<td align='left'>1993-09-27</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
 <table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>413</td>
<td align='left'>08-04-2024</td>
<td align='left'>ILHAM</td>
<td align='left'>022839</td>
<td align='left'>RT 8 NGLONGSOR</td>
<td align='left'>2014-01-28</td>
<td align='left'>UGD</td>
<td align='left'>J45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>414</td>
<td align='left'>08-04-2024</td>
<td align='left'>MUJI ANGGER SETYO</td>
<td align='left'>034036</td>
<td align='left'>RT 42 RW 07 PRAMBON</td>
<td align='left'>1986-12-11</td>
<td align='left'>UGD</td>
<td align='left'>J45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
 <td align='left'>415</td>
<td align='left'>08-04-2024</td>
<td align='left'>MOCHAMMAD ARJUNA ASYRAFY KURNIAWAN</td>
<td align='left'>000795</td>
<td align='left'>RT 035 RW 006 PRAMBON</td>
<td align='left'>2011-10-21</td>
<td align='left'>UGD</td>
<td align='left'>D68.3</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>416</td>
<td align='left'>08-04-2024</td>
<td align='left'>DEWI WULAN FEBRIANTI</td>
<td align='left'>005518</td>
<td align='left'>DUSUN ETAN KALI RT 022 RW 006 NGLONGSOR</td>
<td align='left'>2001-02-03</td>
<td align='left'>UGD</td>
<td align='left'>J45</td>
 <td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>417</td>
<td align='left'>08-04-2024</td>
<td align='left'>ST ROBIKAH</td>
<td align='left'>026824</td>
<td align='left'>RT 26 RW 6 GONDANG</td>
<td align='left'>1982-01-01</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>418</td>
<td align='left'>08-04-2024</td>
<td align='left'>TULUS</td>
<td align='left'>034030</td>
<td align='left'>RT 02 RW 02-TEMPURAN-SAWOO-PONOROGO</td>
<td align='left'>1940-06-30</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R07.4</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>419</td>
<td align='left'>08-04-2024</td>
<td align='left'>PRESTIONO</td>
<td align='left'>034034</td>
<td align='left'>RT 34 RW 6-PRAMBON-TUGU-TRENGGALEK</td>
 <td align='left'>1987-10-11</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>420</td>
<td align='left'>08-04-2024</td>
<td align='left'>RINGGA ERSHANDA SYANITRA MUKTI</td>
<td align='left'>034010</td>
<td align='left'>DUSUN KRAJAN, RT : 19,RW :3 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>2010-09-04</td>
 <td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>421</td>
<td align='left'>08-04-2024</td>
<td align='left'>DJEMIRAH</td>
<td align='left'>001723</td>
<td align='left'>RT 54 RW 11-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>1973-09-18</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>E11.6</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>422</td>
<td align='left'>08-04-2024</td>
<td align='left'>JUMINA</td>
<td align='left'>032181</td>
<td align='left'>DUSUN MLOKO, RT : 58,RW :12 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>1984-05-10</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>G47.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid 10 mg </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Vitamin B Kompleks </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>423</td>
<td align='left'>08-04-2024</td>
<td align='left'>AN. GHAISAN</td>
<td align='left'>034033</td>
<td align='left'>RT 03 RW 01 GONDANG</td>
<td align='left'>2020-11-13</td>
<td align='left'>UGD</td>
<td align='left'>R50</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Vitamin B Kompleks </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
 <tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>424</td>
<td align='left'>08-04-2024</td>
<td align='left'>MUKIRAH</td>
<td align='left'>031537</td>
<td align='left'>DSN MOJO KIDUL RT : 021 RW :008 JAMBU</td>
<td align='left'>1964-11-11</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>425</td>
<td align='left'>08-04-2024</td>
<td align='left'>SUMIATIN</td>
<td align='left'>010147</td>
<td align='left'>DUSUN SETONO RT 015 RW 004 GONDANG</td>
<td align='left'>1957-12-31</td>
<td align='left'>UGD</td>
<td align='left'>M79.1</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 5 mg </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Natrium Diklofenak (21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Vitamin B Kompleks </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>426</td>
<td align='left'>08-04-2024</td>
<td align='left'>FARENZA DINDA PRIMANDANTI</td>
<td align='left'>034032</td>
<td align='left'>RT 4 RW 2 PUCANGANAK</td>
<td align='left'>2010-03-15</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">11</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>427</td>
 <td align='left'>08-04-2024</td>
<td align='left'>BUCHORI</td>
<td align='left'>034031</td>
<td align='left'>RT 1 RW 2 NGUNUT</td>
<td align='left'>1979-04-25</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ciprofloxacin 500 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>428</td>
<td align='left'>08-04-2024</td>
<td align='left'>SRI ASTATIK</td>
<td align='left'>011896</td>
<td align='left'>RT 04 RW 01 GONDANG</td>
<td align='left'>1969-07-07</td>
<td align='left'>UGD</td>
<td align='left'>M79.1</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Natrium Diklofenak (21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Vitamin B Kompleks </td>
<td width="10%" align="center">10</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>429</td>
<td align='left'>08-04-2024</td>
<td align='left'>RIFKI RACHMAN</td>
<td align='left'>034029</td>
<td align='left'>RT 03 RW 01 SIDOREJO</td>
<td align='left'>1999-09-24</td>
<td align='left'>UGD</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>430</td>
<td align='left'>08-04-2024</td>
<td align='left'>SUBUR MUJIONO</td>
<td align='left'>034028</td>
<td align='left'>DUSUN PINGGIRSARI, RT : 11,RW :3 KARANGAN</td>
<td align='left'>1980-07-17</td>
<td align='left'>UGD</td>
<td align='left'>L30</td>
<td align='left'>
<table width='100%' border="1">
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hidrokortison Krim 2,5% </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Loratadin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>431</td>
<td align='left'>08-04-2024</td>
<td align='left'>EKO WAHYU UTOMO</td>
<td align='left'>010735</td>
<td align='left'>DUSUN KRAJAN RT 004 RW 002 NGEPEH</td>
<td align='left'>2018-07-08</td>
<td align='left'>UGD</td>
<td align='left'>L30</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Loratadin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>432</td>
<td align='left'>08-04-2024</td>
<td align='left'>ANJAR PRIANTI</td>
<td align='left'>001695</td>
<td align='left'>RT 36 RW 06 PRAMBON</td>
<td align='left'>1985-06-05</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>433</td>
<td align='left'>08-04-2024</td>
<td align='left'>SHAQUEENA ZEA ARISHA HUMAIRA</td>
<td align='left'>011227</td>
<td align='left'>DSN JUMOK RT 006 RW 003 TUMPUK</td>
<td align='left'>2020-05-01</td>
<td align='left'>UGD</td>
 <td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>434</td>
<td align='left'>07-04-2024</td>
<td align='left'>TSABITA FATIMA AZ ZAHRA</td>
<td align='left'>015805</td>
<td align='left'>DSN KALIPINGGIR RT 020 RW 005 GONDANG</td>
<td align='left'>2018-07-14</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>435</td>
<td align='left'>07-04-2024</td>
<td align='left'>ATIK IL HIDAYAH</td>
<td align='left'>024198</td>
<td align='left'>RT 20 RW 5 GONDANG</td>
<td align='left'>1996-02-19</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
 </tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>436</td>
<td align='left'>07-04-2024</td>
<td align='left'>SURANI</td>
<td align='left'>021444</td>
<td align='left'>DUSUN TENGGAR RT 002 RW 001 PRAMBON</td>
<td align='left'>1970-07-18</td>
<td align='left'>UGD</td>
<td align='left'>J45.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol cairan inhalasi 1mg/ml 0,1% / VENTOLIN NEBULES
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>437</td>
<td align='left'>07-04-2024</td>
<td align='left'>PUJI RAHAYUNINGSIH</td>
<td align='left'>008293</td>
<td align='left'>DUSUN KRAJAN, RT : 11,RW :3 NGLONGSOR</td>
<td align='left'>1970-10-10</td>
 <td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>438</td>
<td align='left'>07-04-2024</td>
<td align='left'>TULUS</td>
<td align='left'>034030</td>
<td align='left'>RT 02 RW 02-TEMPURAN-SAWOO-PONOROGO</td>
<td align='left'>1940-06-30</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R07.4</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
 <td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>439</td>
<td align='left'>07-04-2024</td>
<td align='left'>ADIFA ZARA WIJAYANTI</td>
<td align='left'>034025</td>
<td align='left'>NGLONGSOR 23/6 NGLONGSOR</td>
<td align='left'>2022-02-23</td>
<td align='left'>UGD</td>
<td align='left'>J45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>440</td>
<td align='left'>07-04-2024</td>
<td align='left'>RINGGA ERSHANDA SYANITRA MUKTI</td>
 <td align='left'>034010</td>
<td align='left'>DUSUN KRAJAN, RT : 19,RW :3 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>2010-09-04</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>441</td>
<td align='left'>07-04-2024</td>
<td align='left'>DJEMIRAH</td>
<td align='left'>001723</td>
<td align='left'>RT 54 RW 11-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>1973-09-18</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>E11.6</td>
<td align='left'>
<table width='100%' border="1">
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asam Asetilsalisilat 80mg/MINIASPI </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>442</td>
<td align='left'>07-04-2024</td>
<td align='left'>ADITYA RIZA NURHAMSAH</td>
<td align='left'>033825</td>
<td align='left'>DUSUN PONGGOK, RT : 024,RW :010 -NGEPEH-TUGU-
TRENGGALEK</td>
<td align='left'>2001-07-06</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
</td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Atapulgit tab 600 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>443</td>
<td align='left'>07-04-2024</td>
<td align='left'>TUMIKAN</td>
<td align='left'>005867</td>
<td align='left'>PAKEL, RT : 38,RW :7 -PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>1946-12-31</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asam Asetilsalisilat 80mg/MINIASPI </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
 <tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>444</td>
<td align='left'>07-04-2024</td>
<td align='left'>SUTRIATI</td>
<td align='left'>034008</td>
<td align='left'>RT 2 RW 2 NGLURUP SENDANG TULUNGAGUNG-NGLURUP-SENDANG-
TULUNGAGUNG</td>
<td align='left'>1976-12-27</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>G44</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asam Asetilsalisilat 80mg/MINIASPI </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>445</td>
<td align='left'>07-04-2024</td>
<td align='left'>ANDIKI BAGUS ARIANTO</td>
<td align='left'>021139</td>
<td align='left'>RT 3 RW 1-TUMPUK-TUGU-TRENGGALEK</td>
<td align='left'>2001-01-04</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>446</td>
<td align='left'>07-04-2024</td>
<td align='left'>SALWA NOPITA PUTRI</td>
<td align='left'>034026</td>
<td align='left'>BANARAN RT 9 RW 5 BANARAN</td>
<td align='left'>2001-04-06</td>
<td align='left'>UGD</td>
<td align='left'>L23.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hidrokortison Krim 2,5% </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>447</td>
<td align='left'>07-04-2024</td>
 <td align='left'>ERMANA `AYNUR KHALIFAH</td>
<td align='left'>016961</td>
<td align='left'>DSN NGLEGOK RT 011 RW 004-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2012-05-29</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A91</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Vitamin B Kompleks </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>448</td>
<td align='left'>07-04-2024</td>
<td align='left'>DALIA FITRI AGUSTIN</td>
<td align='left'>005176</td>
 <td align='left'>RT 01 RW 01 BANARAN</td>
<td align='left'>2014-08-16</td>
<td align='left'>UGD</td>
<td align='left'>A09.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
</td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisillin 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>449</td>
<td align='left'>06-04-2024</td>
<td align='left'>ERMANA `AYNUR KHALIFAH</td>
<td align='left'>016961</td>
<td align='left'>DSN NGLEGOK RT 011 RW 004-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2012-05-29</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A91</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>450</td>
<td align='left'>06-04-2024</td>
<td align='left'>RAFAEL DHEFIN AURELLIO</td>
<td align='left'>017823</td>
<td align='left'>RT 008 RW 003 NGLONGSOR</td>
<td align='left'>2016-05-07</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
 <td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>451</td>
<td align='left'>06-04-2024</td>
<td align='left'>FATHULLOH ULINNUHA</td>
<td align='left'>034024</td>
<td align='left'>RT 14 RW 04 GONDANG</td>
<td align='left'>2021-03-11</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 200 mg </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>452</td>
<td align='left'>06-04-2024</td>
<td align='left'>SHIFA FITRA HANIFA</td>
 <td align='left'>033987</td>
<td align='left'>RT 07-GONDANG-TUGU-TRENGGALEK</td>
<td align='left'>2016-06-23</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>453</td>
<td align='left'>06-04-2024</td>
<td align='left'>VENY APRILIANTI</td>
<td align='left'>034013</td>
<td align='left'>DSN JAMPI RT 004 RW 001-NGENTRONG-KARANGAN-
TRENGGALEK</td>
 <td align='left'>1997-04-06</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A90</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>454</td>
<td align='left'>06-04-2024</td>
<td align='left'>IKA PRIHARTATI</td>
<td align='left'>005581</td>
<td align='left'>RT 05 RW 02-SUMBER-KARANGAN-TRENGGALEK</td>
<td align='left'>2000-06-30</td>
<td align='left'>RAWAT INAP</td>
 <td align='left'>R50.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">7</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>455</td>
<td align='left'>06-04-2024</td>
<td align='left'>TULUS</td>
<td align='left'>034030</td>
<td align='left'>RT 02 RW 02-TEMPURAN-SAWOO-PONOROGO</td>
<td align='left'>1940-06-30</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R07.4</td>
<td align='left'>
 <table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Ranitidin injeksi 25mg/ml </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>456</td>
<td align='left'>06-04-2024</td>
<td align='left'>RINGGA ERSHANDA SYANITRA MUKTI</td>
<td align='left'>034010</td>
<td align='left'>DUSUN KRAJAN, RT : 19,RW :3 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>2010-09-04</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ranitidin injeksi 25mg/ml </td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>457</td>
<td align='left'>06-04-2024</td>
<td align='left'>WATINI</td>
<td align='left'>029383</td>
<td align='left'>DUSUN SOOKO, RT : 50,RW :10 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>1981-01-03</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">2</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>458</td>
<td align='left'>06-04-2024</td>
<td align='left'>DJEMIRAH</td>
<td align='left'>001723</td>
<td align='left'>RT 54 RW 11-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>1973-09-18</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>E11.6</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">7</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">8</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>459</td>
<td align='left'>06-04-2024</td>
<td align='left'>ADITYA RIZA NURHAMSAH</td>
<td align='left'>033825</td>
<td align='left'>DUSUN PONGGOK, RT : 024,RW :010 -NGEPEH-TUGU-
TRENGGALEK</td>
<td align='left'>2001-07-06</td>
 <td align='left'>RAWAT INAP</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>460</td>
<td align='left'>06-04-2024</td>
<td align='left'>SUTRIATI</td>
<td align='left'>034008</td>
<td align='left'>RT 2 RW 2 NGLURUP SENDANG TULUNGAGUNG-NGLURUP-SENDANG-
TULUNGAGUNG</td>
<td align='left'>1976-12-27</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>G44</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
 <td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>461</td>
<td align='left'>06-04-2024</td>
<td align='left'>TUMIKAN</td>
<td align='left'>005867</td>
<td align='left'>PAKEL, RT : 38,RW :7 -PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>1946-12-31</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Garam Oralit Kombinasi Serbuk (200 ml air)
</td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metformin 850 mg </td>
<td width="10%" align="center">4</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>462</td>
<td align='left'>06-04-2024</td>
<td align='left'>ANDIKI BAGUS ARIANTO</td>
<td align='left'>021139</td>
<td align='left'>RT 3 RW 1-TUMPUK-TUGU-TRENGGALEK</td>
<td align='left'>2001-01-04</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Siprofloksasin 500 mg (salut selaput)
</td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
 </tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>463</td>
<td align='left'>06-04-2024</td>
<td align='left'>FATHULLOH ULINNUHA RAJABI</td>
<td align='left'>010148</td>
<td align='left'>DUSUN SETONO RT 014 RW 004 GONDANG</td>
<td align='left'>2021-03-11</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Mess No.11 (21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>464</td>
<td align='left'>05-04-2024</td>
<td align='left'>ERMANA `AYNUR KHALIFAH</td>
<td align='left'>016961</td>
<td align='left'>DSN NGLEGOK RT 011 RW 004-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2012-05-29</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A91</td>
<td align='left'>
<table width='100%' border="1">
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.22 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gliseril Guaiyakolat 100 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>465</td>
<td align='left'>05-04-2024</td>
<td align='left'>WIWIK HANDAYANI </td>
<td align='left'>031018</td>
<td align='left'>NGEPEH 28/12-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>1982-04-12</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R11</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
HCT 25mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Furosemid injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Glimepiride 2 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metronidazole 500 mg </td>
<td width="10%" align="center">30</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ranitidin injeksi 25mg/ml </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>466</td>
<td align='left'>05-04-2024</td>
<td align='left'>SHIFA FITRA HANIFA</td>
<td align='left'>033987</td>
<td align='left'>RT 07-GONDANG-TUGU-TRENGGALEK</td>
<td align='left'>2016-06-23</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metronidazole 500 mg </td>
<td width="10%" align="center">30</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ranitidin injeksi 25mg/ml </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>467</td>
<td align='left'>05-04-2024</td>
<td align='left'>MOOZEY MELVIANO</td>
<td align='left'>033991</td>
<td align='left'>DOKO RT 43 RW 09-DOKO-NGASEM-KEDIRI</td>
<td align='left'>2021-08-30</td>
<td align='left'>RAWAT INAP</td>
 <td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Vitamin B Kompleks </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>468</td>
<td align='left'>05-04-2024</td>
<td align='left'>IKA PRIHARTATI</td>
<td align='left'>005581</td>
<td align='left'>RT 05 RW 02-SUMBER-KARANGAN-TRENGGALEK</td>
<td align='left'>2000-06-30</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.22 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Aqua Pro Injeksi </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ranitidin injeksi 25mg/ml </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>469</td>
<td align='left'>05-04-2024</td>
<td align='left'>WATINI</td>
<td align='left'>029383</td>
<td align='left'>DUSUN SOOKO, RT : 50,RW :10 -PRAMBON-TUGU-
TRENGGALEK</td>
<td align='left'>1981-01-03</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove L </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">7</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asam Asetilsalisilat 80mg/MINIASPI </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ranitidin injeksi 25mg/ml </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>470</td>
<td align='left'>05-04-2024</td>
<td align='left'>ADITYA RIZA NURHAMSAH</td>
<td align='left'>033825</td>
<td align='left'>DUSUN PONGGOK, RT : 024,RW :010 -NGEPEH-TUGU-
TRENGGALEK</td>
<td align='left'>2001-07-06</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">12</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>471</td>
<td align='left'>05-04-2024</td>
<td align='left'>SUTRIATI</td>
<td align='left'>034008</td>
<td align='left'>RT 2 RW 2 NGLURUP SENDANG TULUNGAGUNG-NGLURUP-SENDANG-
TULUNGAGUNG</td>
<td align='left'>1976-12-27</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>G44</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 10 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol 500 mg(21) </td>
<td width="10%" align="center">50</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ranitidin injeksi 25mg/ml </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>472</td>
<td align='left'>05-04-2024</td>
<td align='left'>MUKIRAH</td>
<td align='left'>031537</td>
<td align='left'>DSN MOJO KIDUL RT : 021 RW :008 JAMBU</td>
<td align='left'>1964-11-11</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">2</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Mess No.11 (21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>473</td>
<td align='left'>05-04-2024</td>
<td align='left'>IKA PRIHARTATI</td>
<td align='left'>005581</td>
<td align='left'>RT 05 RW 02 SUMBER</td>
<td align='left'>2000-06-30</td>
<td align='left'>UGD</td>
<td align='left'>R50.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>474</td>
<td align='left'>05-04-2024</td>
<td align='left'>ELVANO SAVIAN AL TEZZA</td>
<td align='left'>023404</td>
<td align='left'>DUSUN JAMPI, RT : 003,RW :001 NGENTRONG</td>
<td align='left'>2019-04-27</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kasa Pembalut Hidrofil 4mx15cm </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Antasida(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
 <td align='left'>475</td>
<td align='left'>04-04-2024</td>
<td align='left'>BELINDA NAIFAH SADINA MEI</td>
<td align='left'>024315</td>
<td align='left'>RT.28 RW.7 GONDANG</td>
<td align='left'>2010-05-16</td>
<td align='left'>UGD</td>
<td align='left'>L50.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Loratadin 10 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asiklovir krim </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>476</td>
<td align='left'>04-04-2024</td>
<td align='left'>PAWIT</td>
<td align='left'>033993</td>
<td align='left'>GONDANG GONDANG</td>
<td align='left'>1974-09-26</td>
<td align='left'>UGD</td>
<td align='left'>R50.1</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Vitamin B Kompleks </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Jarum Jahit(21) </td>
<td width="10%" align="center">3</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
plester non woven 5cm x 5m </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>477</td>
<td align='left'>04-04-2024</td>
<td align='left'>RAFASYA</td>
<td align='left'>032708</td>
<td align='left'>RT 30 RW 05 PRAMBON</td>
<td align='left'>2020-11-11</td>
<td align='left'>UGD</td>
<td align='left'>R50.1</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Domperidon 10 mg </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisilin Sirup Kering 125mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Nasal Canul Anak(21) </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>478</td>
<td align='left'>04-04-2024</td>
<td align='left'>SUKIYEM</td>
<td align='left'>033964</td>
<td align='left'>rt 2 rw 5-TEMPURAN-SAWOO-PONOROGO</td>
<td align='left'>1958-04-03</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>D64.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">2</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ranitidin injeksi 25mg/ml </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>479</td>
<td align='left'>04-04-2024</td>
<td align='left'>WIWIK HANDAYANI </td>
<td align='left'>031018</td>
<td align='left'>NGEPEH 28/12-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>1982-04-12</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R11</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">9</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ranitidin injeksi 25mg/ml </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>480</td>
<td align='left'>04-04-2024</td>
<td align='left'>SHIFA FITRA HANIFA</td>
<td align='left'>033987</td>
<td align='left'>RT 07-GONDANG-TUGU-TRENGGALEK</td>
<td align='left'>2016-06-23</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Deksamethasone injeksi 5mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ranitidin injeksi 25mg/ml </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>481</td>
<td align='left'>04-04-2024</td>
<td align='left'>MOOZEY MELVIANO</td>
<td align='left'>033991</td>
<td align='left'>DOKO RT 43 RW 09-DOKO-NGASEM-KEDIRI</td>
<td align='left'>2021-08-30</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
 <td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Maxter Exam Glove M </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ringer Laktat larutan infus (RL) </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>482</td>
<td align='left'>04-04-2024</td>
<td align='left'>ADITYA RIZA NURHAMSAH</td>
<td align='left'>033825</td>
<td align='left'>DUSUN PONGGOK, RT : 024,RW :010 -NGEPEH-TUGU-
TRENGGALEK</td>
<td align='left'>2001-07-06</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">2</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kloramfenikol 250 mg </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>483</td>
<td align='left'>04-04-2024</td>
<td align='left'>RIZKY DWI RAMADHANI</td>
<td align='left'>033945</td>
<td align='left'>DUSUN KRAJAN, RT : 15,RW :4 -NGLONGSOR-TUGU-
TRENGGALEK</td>
<td align='left'>2006-10-26</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>484</td>
<td align='left'>04-04-2024</td>
<td align='left'>FAHMI MUHAMAD ZAKARIA</td>
<td align='left'>033989</td>
<td align='left'>DUSUN SOKO, RT : 8,RW :2 -NGENTRONG-KARANGAN-
TRENGGALEK</td>
<td align='left'>2012-08-29</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A01.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisilin Sirup Kering 125mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>485</td>
<td align='left'>04-04-2024</td>
<td align='left'>SAMIYEM</td>
<td align='left'>009077</td>
<td align='left'>DSN KRAJAN RT 018 RW 003-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>1967-07-01</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>I10</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>486</td>
<td align='left'>04-04-2024</td>
<td align='left'>SAMIRAH</td>
<td align='left'>033941</td>
<td align='left'>RT 2-TEMPURAN-SAWOO-PONOROGO</td>
<td align='left'>1968-08-09</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Omeprazole 20 mg </td>
<td width="10%" align="center">6</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>487</td>
<td align='left'>04-04-2024</td>
<td align='left'>APRILIA NURMASARI</td>
<td align='left'>028057</td>
<td align='left'>NGEPEH-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2004-04-02</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>488</td>
<td align='left'>04-04-2024</td>
<td align='left'>AMELIA SUSANTI PUTRI</td>
<td align='left'>033944</td>
<td align='left'>NGLEGOK, RT : 9,RW :3 -NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2003-09-19</td>
<td align='left'>RAWAT INAP</td>
 <td align='left'>A01.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amoksisilin Sirup Kering 125mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>489</td>
<td align='left'>04-04-2024</td>
<td align='left'>SOLIKAH</td>
<td align='left'>015222</td>
<td align='left'>DUSUN GONDANG KIDUL RT : 011 RW :002 -GONDANG-TUGU-
TRENGGALEK</td>
<td align='left'>1971-02-25</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">1</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>490</td>
<td align='left'>04-04-2024</td>
<td align='left'>SUGIMAN</td>
<td align='left'>029934</td>
<td align='left'>DUSUN GEBANG RT : 017 RW :007 -DUREN-TUGU-
TRENGGALEK</td>
<td align='left'>1971-09-06</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid 10 mg </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>491</td>
<td align='left'>04-04-2024</td>
<td align='left'>PARJUKI</td>
<td align='left'>014034</td>
<td align='left'>KRAJAN, RT : 1,RW :1 -NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>1956-11-10</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
 <table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kloramfenikol 250 mg </td>
<td width="10%" align="center">20</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>492</td>
<td align='left'>04-04-2024</td>
<td align='left'>AINUR RIDWAN</td>
<td align='left'>033926</td>
<td align='left'>DUSUN KEDUNGSANGKAL, RT : 7,RW :3 -BULUAGUNG-KARANGAN-
TRENGGALEK</td>
<td align='left'>2004-01-05</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A90</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Vitamin B Kompleks </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>493</td>
<td align='left'>04-04-2024</td>
<td align='left'>DIFFANIA NASYWA VIOLLIN</td>
 <td align='left'>033976</td>
<td align='left'>DUSUN CORAH MULYO, RT : 005,RW :002 NGLONGSOR</td>
<td align='left'>2009-07-18</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Jarum Jahit(21) </td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>494</td>
<td align='left'>04-04-2024</td>
<td align='left'>YAHMI</td>
<td align='left'>033830</td>
<td align='left'>DSN KRAJAN II RT 007 RW 004 BANARAN</td>
<td align='left'>1977-01-10</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Jarum Jahit(21) </td>
<td width="10%" align="center">5</td>
</tr>
 </table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>495</td>
<td align='left'>04-04-2024</td>
<td align='left'>SULASTRI</td>
<td align='left'>029258</td>
<td align='left'>DUSUN KRAJAN, RT : 006,RW :001 GONDANG</td>
<td align='left'>1973-07-16</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Jarum Jahit(21) </td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>496</td>
<td align='left'>04-04-2024</td>
<td align='left'>RISKI MARLINO PUTRA</td>
<td align='left'>021058</td>
<td align='left'>DSN TAWANG, RT : 003,RW :002 BANARAN</td>
<td align='left'>2010-01-25</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Jarum Jahit(21) </td>
<td width="10%" align="center">3</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
plester non woven 5cm x 5m </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>497</td>
<td align='left'>03-04-2024</td>
<td align='left'>WIWIK HANDAYANI </td>
<td align='left'>031018</td>
<td align='left'>NGEPEH 28/12-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>1982-04-12</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R11</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.22 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid 10 mg </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metformin 850 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Betahistine 6 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>498</td>
<td align='left'>03-04-2024</td>
<td align='left'>RIZKY DWI RAMADHANI</td>
<td align='left'>033945</td>
<td align='left'>DUSUN KRAJAN, RT : 15,RW :4 -NGLONGSOR-TUGU-
TRENGGALEK</td>
<td align='left'>2006-10-26</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
 <tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>499</td>
<td align='left'>03-04-2024</td>
<td align='left'>SUKIYEM</td>
<td align='left'>033964</td>
<td align='left'>rt 2 rw 5-TEMPURAN-SAWOO-PONOROGO</td>
<td align='left'>1958-04-03</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>D64.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Betahistine 6 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.22 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>500</td>
<td align='left'>03-04-2024</td>
<td align='left'>MOOZEY MELVIANO</td>
<td align='left'>033991</td>
<td align='left'>DOKO RT 43 RW 09-DOKO-NGASEM-KEDIRI</td>
<td align='left'>2021-08-30</td>
<td align='left'>RAWAT INAP</td>
 <td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Anak (PKD-2) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Parasetamol Syrup 120mg/5ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Anak (PKD-2) </td>
<td width="10%" align="center">2</td>
</tr>
</table>
 </td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>501</td>
<td align='left'>03-04-2024</td>
<td align='left'>DIAH AYU RAHMAWATI</td>
<td align='left'>008496</td>
<td align='left'>DUSUN KRAJAN I, RT : 12,RW :6 BANARAN</td>
<td align='left'>2000-07-05</td>
<td align='left'>UGD</td>
<td align='left'>J45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>502</td>
<td align='left'>03-04-2024</td>
<td align='left'>MUSIYEM</td>
<td align='left'>032864</td>
<td align='left'>DUSUN PONGGOK, RT : 21,RW :10 -NGEPEH-TUGU-
TRENGGALEK</td>
<td align='left'>1941-10-31</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>E11</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Nasal Canul Dewasa(21) </td>
<td width="10%" align="center">1</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Masker N/R dewasa(21) </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>503</td>
<td align='left'>03-04-2024</td>
<td align='left'>PARJUKI</td>
<td align='left'>014034</td>
<td align='left'>KRAJAN, RT : 1,RW :1 -NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>1956-11-10</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>504</td>
<td align='left'>03-04-2024</td>
<td align='left'>FAHMI MUHAMAD ZAKARIA</td>
 <td align='left'>033989</td>
<td align='left'>DUSUN SOKO, RT : 8,RW :2 -NGENTRONG-KARANGAN-
TRENGGALEK</td>
<td align='left'>2012-08-29</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A01.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Anak (PKD-2) </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>505</td>
<td align='left'>03-04-2024</td>
<td align='left'>SAMIYEM</td>
<td align='left'>009077</td>
<td align='left'>DSN KRAJAN RT 018 RW 003-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>1967-07-01</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>I10</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ferro Fumarat 60mg + Asam Folat 0,4mg / TTD untuk ibu hamil
</td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
 <tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">4</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>506</td>
<td align='left'>03-04-2024</td>
<td align='left'>SAMIRAH</td>
<td align='left'>033941</td>
<td align='left'>RT 2-TEMPURAN-SAWOO-PONOROGO</td>
<td align='left'>1968-08-09</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">4</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>507</td>
<td align='left'>03-04-2024</td>
<td align='left'>APRILIA NURMASARI</td>
<td align='left'>028057</td>
<td align='left'>NGEPEH-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2004-04-02</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Anak (PKD-2) </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>508</td>
<td align='left'>03-04-2024</td>
<td align='left'>AMELIA SUSANTI PUTRI</td>
<td align='left'>033944</td>
<td align='left'>NGLEGOK, RT : 9,RW :3 -NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2003-09-19</td>
 <td align='left'>RAWAT INAP</td>
<td align='left'>A01.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Anak (PKD-2) </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>509</td>
<td align='left'>03-04-2024</td>
<td align='left'>SOLIKAH</td>
<td align='left'>015222</td>
<td align='left'>DUSUN GONDANG KIDUL RT : 011 RW :002 -GONDANG-TUGU-
TRENGGALEK</td>
<td align='left'>1971-02-25</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
 <td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>510</td>
<td align='left'>03-04-2024</td>
<td align='left'>SUGIMAN</td>
<td align='left'>029934</td>
<td align='left'>DUSUN GEBANG RT : 017 RW :007 -DUREN-TUGU-
TRENGGALEK</td>
<td align='left'>1971-09-06</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
 <td align='left'>511</td>
<td align='left'>03-04-2024</td>
<td align='left'>NURYATI</td>
<td align='left'>020737</td>
<td align='left'>RT. 19 RW. 7-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>1988-08-05</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>I10</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Dexametason 0,5 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>512</td>
<td align='left'>03-04-2024</td>
<td align='left'>TUMINI</td>
<td align='left'>010936</td>
<td align='left'>DUSUN SETONO RT 017 RW
004-GONDANG-TUGU-TRENGGALEK</td>
<td align='left'>1965-09-07</td>
<td align='left'>RAWAT INAP</td>
 <td align='left'>J45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Salbutamol tablet 2 mg(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>513</td>
<td align='left'>03-04-2024</td>
<td align='left'>AINUR RIDWAN</td>
<td align='left'>033926</td>
<td align='left'>DUSUN KEDUNGSANGKAL, RT : 7,RW :3 -BULUAGUNG-KARANGAN-
TRENGGALEK</td>
<td align='left'>2004-01-05</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A90</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
 <td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ciprofloxacin 500 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>514</td>
<td align='left'>02-04-2024</td>
<td align='left'>AINUR RIDWAN</td>
<td align='left'>033926</td>
<td align='left'>DUSUN KEDUNGSANGKAL, RT : 7,RW :3 -BULUAGUNG-KARANGAN-
TRENGGALEK</td>
<td align='left'>2004-01-05</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A90</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">6</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.18 </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>515</td>
<td align='left'>02-04-2024</td>
<td align='left'>APRILIA NURMASARI</td>
<td align='left'>028057</td>
<td align='left'>NGEPEH-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2004-04-02</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asetilsistein 200 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>516</td>
<td align='left'>02-04-2024</td>
<td align='left'>SAMIYEM</td>
<td align='left'>009077</td>
<td align='left'>DSN KRAJAN RT 018 RW 003-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>1967-07-01</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>I10</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Amlodipin 10 mg(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.18 </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>517</td>
<td align='left'>02-04-2024</td>
<td align='left'>AMELIA SUSANTI PUTRI</td>
<td align='left'>033944</td>
<td align='left'>NGLEGOK, RT : 9,RW :3 -NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>2003-09-19</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A01.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
 <td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kloramfenikol 250 mg </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>518</td>
<td align='left'>02-04-2024</td>
<td align='left'>NURYATI</td>
<td align='left'>020737</td>
<td align='left'>RT. 19 RW. 7-NGEPEH-TUGU-TRENGGALEK</td>
<td align='left'>1988-08-05</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>I10</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">2</td>
 </tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kaptopril 25 mg </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.18 </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>519</td>
<td align='left'>02-04-2024</td>
<td align='left'>MAR`UL FITRI</td>
<td align='left'>027161</td>
<td align='left'>DSN KEBONSARI, RT : 025,RW :006 GONDANG</td>
<td align='left'>1989-03-18</td>
<td align='left'>UGD</td>
<td align='left'>J00</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asiklovir krim </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Jarum Jahit(21) </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>520</td>
<td align='left'>02-04-2024</td>
<td align='left'>MUJIARTI</td>
<td align='left'>026292</td>
<td align='left'>PRAMBON RT 31/5-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>1968-01-09</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>521</td>
<td align='left'>02-04-2024</td>
<td align='left'>MUHAMMAD ALFAN SUNANUL KUSNA</td>
<td align='left'>029455</td>
<td align='left'>DUSUN KEBONSARI, RT : 026,RW :006 -GONDANG-TUGU-
TRENGGALEK</td>
<td align='left'>2010-02-02</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Asiklovir krim </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Nasal Canul Anak(21) </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>522</td>
<td align='left'>02-04-2024</td>
 <td align='left'>WINARSIH</td>
<td align='left'>002290</td>
<td align='left'>DUSUN KEBON RT : 034 RW :008 GONDANG</td>
<td align='left'>1970-01-01</td>
<td align='left'>UGD</td>
<td align='left'>J00</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">6</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gentamicin SK(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Jarum Jahit(21) </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>523</td>
<td align='left'>02-04-2024</td>
<td align='left'>TUSMINAH</td>
<td align='left'>013200</td>
<td align='left'>DUSUN KASIHAN RT: 025 RW :011 -NGEPEH-TUGU-
TRENGGALEK</td>
<td align='left'>1986-03-03</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>H81.4</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>524</td>
 <td align='left'>02-04-2024</td>
<td align='left'>RIZKY DWI RAMADHANI</td>
<td align='left'>033945</td>
<td align='left'>DUSUN KRAJAN, RT : 15,RW :4 -NGLONGSOR-TUGU-
TRENGGALEK</td>
<td align='left'>2006-10-26</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metronidazole 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>525</td>
<td align='left'>02-04-2024</td>
 <td align='left'>SUGIMAN</td>
<td align='left'>029934</td>
<td align='left'>DUSUN GEBANG RT : 017 RW :007 -DUREN-TUGU-
TRENGGALEK</td>
<td align='left'>1971-09-06</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metronidazole 500 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">6</td>
</tr>
</table>
 </td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>526</td>
<td align='left'>02-04-2024</td>
<td align='left'>FAHMI MUHAMAD ZAKARIA</td>
<td align='left'>033989</td>
<td align='left'>DUSUN SOKO, RT : 8,RW :2 -NGENTRONG-KARANGAN-
TRENGGALEK</td>
<td align='left'>2012-08-29</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A01.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.22 </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Kloramfenikol 250 mg </td>
<td width="10%" align="center">20</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Nasal Canul Anak(21) </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>527</td>
<td align='left'>02-04-2024</td>
<td align='left'>SAMIRAH</td>
<td align='left'>033941</td>
<td align='left'>RT 2-TEMPURAN-SAWOO-PONOROGO</td>
<td align='left'>1968-08-09</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>528</td>
<td align='left'>02-04-2024</td>
<td align='left'>SOLIKAH</td>
<td align='left'>015222</td>
<td align='left'>DUSUN GONDANG KIDUL RT : 011 RW :002 -GONDANG-TUGU-
TRENGGALEK</td>
<td align='left'>1971-02-25</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole serbuk injeksi 40mg/10ml </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">4</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
 <td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>529</td>
<td align='left'>02-04-2024</td>
<td align='left'>TUMINI</td>
<td align='left'>010936</td>
<td align='left'>DUSUN SETONO RT 017 RW
004-GONDANG-TUGU-TRENGGALEK</td>
<td align='left'>1965-09-07</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>J45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>530</td>
<td align='left'>02-04-2024</td>
<td align='left'>DENOK UMI ZAENAB</td>
<td align='left'>008350</td>
<td align='left'>DUSUN KEBON, RT : 34,RW :8 GONDANG</td>
<td align='left'>1970-12-11</td>
<td align='left'>UGD</td>
<td align='left'>R22.3</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Simvastatin 20 mg(21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Klorfeniramin Maleat 4 mg (CTM)(21) </td>
 <td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Natrium Diklofenak (21) </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Jarum Jahit(21) </td>
<td width="10%" align="center">5</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>531</td>
<td align='left'>02-04-2024</td>
<td align='left'>MOCHAMMAD ARJUNA ASYRAFY KURNIAWAN</td>
<td align='left'>000795</td>
<td align='left'>RT 035 RW 006 PRAMBON</td>
<td align='left'>2011-10-21</td>
<td align='left'>UGD</td>
<td align='left'>D68.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Gentamicin SK(21) </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Jarum Jahit(21) </td>
<td width="10%" align="center">5</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
plester non woven 5cm x 5m </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>532</td>
<td align='left'>01-04-2024</td>
<td align='left'>MUJIARTI</td>
 <td align='left'>026292</td>
<td align='left'>PRAMBON RT 31/5-PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>1968-01-09</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>K29.7</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Difenhidramin injeksi 10mg/ml (i.v./i.m.)
</td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>533</td>
<td align='left'>01-04-2024</td>
<td align='left'>RADITYA BIMA SAPUTRA</td>
<td align='left'>023828</td>
<td align='left'>RT 18 RW 7-DUREN-TUGU-TRENGGALEK</td>
<td align='left'>2021-02-18</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A09</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Anak (PKD-2) </td>
<td width="10%" align="center">1</td>
</tr>
 </table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>534</td>
<td align='left'>01-04-2024</td>
<td align='left'>SISWANTO</td>
<td align='left'>019633</td>
<td align='left'>DSN KRAJAN RT 024 RW 004 PRAMBON</td>
<td align='left'>1984-11-10</td>
<td align='left'>UGD</td>
<td align='left'>J06.9</td>
<td align='left'>
<table width='100%' border="1">
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>535</td>
<td align='left'>01-04-2024</td>
<td align='left'>MUHAMMAD ALFAN SUNANUL KUSNA</td>
<td align='left'>029455</td>
<td align='left'>DUSUN KEBONSARI, RT : 026,RW :006 -GONDANG-TUGU-
TRENGGALEK</td>
<td align='left'>2010-02-02</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>536</td>
<td align='left'>01-04-2024</td>
<td align='left'>TUMINI</td>
<td align='left'>010936</td>
<td align='left'>DUSUN SETONO RT 017 RW
004-GONDANG-TUGU-TRENGGALEK</td>
<td align='left'>1965-09-07</td>
 <td align='left'>RAWAT INAP</td>
<td align='left'>J45</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ampicillin injeksi(21) </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>537</td>
<td align='left'>01-04-2024</td>
<td align='left'>TUSMINAH</td>
<td align='left'>013200</td>
<td align='left'>DUSUN KASIHAN RT: 025 RW :011 -NGEPEH-TUGU-
TRENGGALEK</td>
<td align='left'>1986-03-03</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>H81.4</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.20 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Betahistine 6 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
 Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>538</td>
<td align='left'>01-04-2024</td>
<td align='left'>SUMARNO</td>
<td align='left'>002622</td>
<td align='left'>RT 11 RW 02-GONDANG-TUGU-TRENGGALEK</td>
<td align='left'>1978-06-06</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R57.0</td>
<td align='left'>
<table width='100%' border="1">
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>539</td>
<td align='left'>01-04-2024</td>
<td align='left'>AHMAD ALVIN NASRULLAH</td>
<td align='left'>006299</td>
<td align='left'>DUSUN GONDANG KIDUL RT : 009,RW :002 -GONDANG-TUGU-
TRENGGALEK</td>
<td align='left'>2008-07-15</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Omeprazole 20 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Piridoksin 10 mg (Vitamin B6) </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>540</td>
<td align='left'>01-04-2024</td>
<td align='left'>REITA SILVIA ZANADIVA</td>
<td align='left'>033906</td>
<td align='left'>TENGGAR, RT : 2,RW :1 -PRAMBON-TUGU-TRENGGALEK</td>
<td align='left'>2016-01-04</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>A90</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.24 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Metamizol / Norages injeksi(21) </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 5 ml </td>
<td width="10%" align="center">3</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa(21) </td>
<td width="10%" align="center">1</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>541</td>
<td align='left'>01-04-2024</td>
<td align='left'>NAUFAL AZKA FIKRI ROSYIDAN</td>
<td align='left'>009624</td>
<td align='left'>DSN CORAH MULYO RT 004 RW 002-NGLONGSOR-TUGU-
TRENGGALEK</td>
<td align='left'>2014-01-02</td>
<td align='left'>RAWAT INAP</td>
<td align='left'>R50.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Infusion Set Dewasa (NIPRO / OTSUKA/ONEMED)
</td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
I.V Catether No.22 </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Metoklopramid injeksi 10mg/ml </td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Hansplast </td>
<td width="10%" align="center">1</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Alat Suntik Sekali pakai 3 ml </td>
<td width="10%" align="center">3</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>542</td>
<td align='left'>01-04-2024</td>
<td align='left'>SHAQUEENA ZEA ARISHA HUMAIRA</td>
<td align='left'>011227</td>
<td align='left'>RT 06 RW 03 TUMPUK</td>
<td align='left'>2020-05-01</td>
<td align='left'>UGD</td>
<td align='left'>T14.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>543</td>
<td align='left'>01-04-2024</td>
<td align='left'>MUHAMMAD ALFAN SUNANUL KUSNA</td>
<td align='left'>029455</td>
<td align='left'>DUSUN KEBONSARI, RT : 026,RW :006 GONDANG</td>
<td align='left'>2010-02-02</td>
<td align='left'>UGD</td>
<td align='left'>R50.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
 <td align="left">
Atapulgit tab 600 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>544</td>
<td align='left'>01-04-2024</td>
<td align='left'>YAHMI</td>
<td align='left'>033830</td>
<td align='left'>DSN KRAJAN II RT 007 RW 004 BANARAN</td>
<td align='left'>1977-01-10</td>
<td align='left'>UGD</td>
<td align='left'>Z48.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">2</td>
</tr>
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>545</td>
<td align='left'>01-04-2024</td>
<td align='left'>HARYATUN</td>
<td align='left'>000247</td>
<td align='left'>RT 3 RW 1 NGENTRONG</td>
<td align='left'>1967-06-20</td>
<td align='left'>UGD</td>
<td align='left'>R51</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Ibuprofen 400 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>546</td>
<td align='left'>01-04-2024</td>
<td align='left'>RISKI MARLINO PUTRA</td>
<td align='left'>021058</td>
 <td align='left'>DSN TAWANG, RT : 003,RW :002 BANARAN</td>
<td align='left'>2010-01-25</td>
<td align='left'>UGD</td>
<td align='left'>Z48.0</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml (COMP.)
</td>
<td width="10%" align="center">2</td>
</tr>
</table>
</td>
</tr>
<tr style="background-color:#ECF0F1; border-bottom:1px;" valign="top">
<td align='left'>547</td>
<td align='left'>01-04-2024</td>
<td align='left'>REITA SILVIA ZANADIVA</td>
<td align='left'>033906</td>
<td align='left'>TENGGAR, RT : 2,RW :1 PRAMBON</td>
<td align='left'>2016-01-04</td>
<td align='left'>UGD</td>
<td align='left'>R50.9</td>
<td align='left'>
<table width='100%' border="1">
<tr style="background-color:#ECF0F1; border-
bottom:1px;" valign="top">
<td align="left">
Atapulgit tab 600 mg </td>
<td width="10%" align="center">10</td>
</tr>
</table>
</td>
</tr>
</table>