APOTEK APOTEKER NICKY

SIPA : 420/632/SIPA/DINKES/ASMAT/X/2021
APOTEK APOTEKER NICKY
SIPA : 420/632/SIPA/DINKES/ASMAT/X/2021
APOTEK APOTEKER NICKY
SIPA : 420/632/SIPA/DINKES/ASMAT/X/2021
STRA : 19891114/STRA-STFB/2013/233693 STRA : 19891114/STRA-STFB/2013/233693 STRA : 19891114/STRA-STFB/2013/233693
SIA : 420/491/SIA/DINKES/ASMAT/X/2021 SIA : 420/491/SIA/DINKES/ASMAT/X/2021 SIA : 420/491/SIA/DINKES/ASMAT/X/2021

JL. DOLOG KAMPUNG BIS AGATS, JL. DOLOG KAMPUNG BIS AGATS, JL. DOLOG KAMPUNG BIS AGATS,

NO. .......... AGATS, .................................. 20..... NO. .......... AGATS, .................................. 20..... NO. .......... AGATS, .................................. 20.....
Nama : ............................................. Tablet Nama : ............................................. Tablet Nama : ............................................. Tablet
Kaplet Kaplet Kaplet
x Kapsul x Kapsul x Kapsul
Bungkus Bungkus Bungkus
Pagi Siang Sore Malam Pagi Siang Sore Malam Pagi Siang Sore Malam
.................. ................... .................. ........................ .................. ................... .................. ........................ .................. ................... .................. ........................
SESUDAH / SETELAH / SAAT MAKAN SESUDAH / SETELAH / SAAT MAKAN SESUDAH / SETELAH / SAAT MAKAN

APOTEK APOTEKER NICKY

SIPA : 420/632/SIPA/DINKES/ASMAT/X/2021
APOTEK APOTEKER NICKY
SIPA : 420/632/SIPA/DINKES/ASMAT/X/2021
APOTEK APOTEKER NICKY
SIPA : 420/632/SIPA/DINKES/ASMAT/X/2021
STRA : 19891114/STRA-STFB/2013/233693 STRA : 19891114/STRA-STFB/2013/233693 STRA : 19891114/STRA-STFB/2013/233693
SIA : 420/491/SIA/DINKES/ASMAT/X/2021 SIA : 420/491/SIA/DINKES/ASMAT/X/2021 SIA : 420/491/SIA/DINKES/ASMAT/X/2021

JL. DOLOG KAMPUNG BIS AGATS, JL. DOLOG KAMPUNG BIS AGATS, JL. DOLOG KAMPUNG BIS AGATS,

NO. .......... AGATS, .................................. 20..... NO. .......... AGATS, .................................. 20..... NO. .......... AGATS, .................................. 20.....
Nama : ............................................. Tablet Nama : ............................................. Tablet Nama : ............................................. Tablet
Kaplet Kaplet Kaplet
x Kapsul x Kapsul x Kapsul
Bungkus Bungkus Bungkus
Pagi Siang Sore Malam Pagi Siang Sore Malam Pagi Siang Sore Malam
.................. ................... .................. ........................ .................. ................... .................. ........................ .................. ................... .................. ........................
SESUDAH / SETELAH / SAAT MAKAN SESUDAH / SETELAH / SAAT MAKAN SESUDAH / SETELAH / SAAT MAKAN

APOTEK APOTEKER NICKY

SIPA : 420/632/SIPA/DINKES/ASMAT/X/2021
APOTEK APOTEKER NICKY
SIPA : 420/632/SIPA/DINKES/ASMAT/X/2021
APOTEK APOTEKER NICKY
SIPA : 420/632/SIPA/DINKES/ASMAT/X/2021
STRA : 19891114/STRA-STFB/2013/233693 STRA : 19891114/STRA-STFB/2013/233693 STRA : 19891114/STRA-STFB/2013/233693
SIA : 420/491/SIA/DINKES/ASMAT/X/2021 SIA : 420/491/SIA/DINKES/ASMAT/X/2021 SIA : 420/491/SIA/DINKES/ASMAT/X/2021

JL. DOLOG KAMPUNG BIS AGATS, JL. DOLOG KAMPUNG BIS AGATS, JL. DOLOG KAMPUNG BIS AGATS,

NO. .......... AGATS, .................................. 20..... NO. .......... AGATS, .................................. 20..... NO. .......... AGATS, .................................. 20.....
Nama : ............................................. Tablet Nama : ............................................. Tablet Nama : ............................................. Tablet
Kaplet Kaplet Kaplet
x Kapsul x Kapsul x Kapsul
Bungkus Bungkus Bungkus
Pagi Siang Sore Malam Pagi Siang Sore Malam Pagi Siang Sore Malam
.................. ................... .................. ........................ .................. ................... .................. ........................ .................. ................... .................. ........................
SESUDAH / SETELAH / SAAT MAKAN SESUDAH / SETELAH / SAAT MAKAN SESUDAH / SETELAH / SAAT MAKAN

APOTEK APOTEKER NICKY

SIPA : 420/632/SIPA/DINKES/ASMAT/X/2021
APOTEK APOTEKER NICKY
SIPA : 420/632/SIPA/DINKES/ASMAT/X/2021
APOTEK APOTEKER NICKY
SIPA : 420/632/SIPA/DINKES/ASMAT/X/2021
STRA : 19891114/STRA-STFB/2013/233693 STRA : 19891114/STRA-STFB/2013/233693 STRA : 19891114/STRA-STFB/2013/233693
SIA : 420/491/SIA/DINKES/ASMAT/X/2021 SIA : 420/491/SIA/DINKES/ASMAT/X/2021 SIA : 420/491/SIA/DINKES/ASMAT/X/2021

JL. DOLOG KAMPUNG BIS AGATS, JL. DOLOG KAMPUNG BIS AGATS, JL. DOLOG KAMPUNG BIS AGATS,

NO. .......... AGATS, .................................. 20..... NO. .......... AGATS, .................................. 20..... NO. .......... AGATS, .................................. 20.....
Nama : ............................................. Tablet Nama : ............................................. Tablet Nama : ............................................. Tablet
Kaplet Kaplet Kaplet
x Kapsul x Kapsul x Kapsul
Bungkus Bungkus Bungkus
Pagi Siang Sore Malam Pagi Siang Sore Malam Pagi Siang Sore Malam
.................. ................... .................. ........................ .................. ................... .................. ........................ .................. ................... .................. ........................
SESUDAH / SETELAH / SAAT MAKAN SESUDAH / SETELAH / SAAT MAKAN SESUDAH / SETELAH / SAAT MAKAN

APOTEK APOTEKER NICKY

SIPA : 420/632/SIPA/DINKES/ASMAT/X/2021
APOTEK APOTEKER NICKY
SIPA : 420/632/SIPA/DINKES/ASMAT/X/2021
APOTEK APOTEKER NICKY
SIPA : 420/632/SIPA/DINKES/ASMAT/X/2021
STRA : 19891114/STRA-STFB/2013/233693 STRA : 19891114/STRA-STFB/2013/233693 STRA : 19891114/STRA-STFB/2013/233693
SIA : 420/491/SIA/DINKES/ASMAT/X/2021 SIA : 420/491/SIA/DINKES/ASMAT/X/2021 SIA : 420/491/SIA/DINKES/ASMAT/X/2021

JL. DOLOG KAMPUNG BIS AGATS, JL. DOLOG KAMPUNG BIS AGATS, JL. DOLOG KAMPUNG BIS AGATS,

NO. .......... AGATS, .................................. 20..... NO. .......... AGATS, .................................. 20..... NO. .......... AGATS, .................................. 20.....
Nama : ............................................. Tablet Nama : ............................................. Tablet Nama : ............................................. Tablet
Kaplet Kaplet Kaplet
x Kapsul x Kapsul x Kapsul
Bungkus Bungkus Bungkus
Pagi Siang Sore Malam Pagi Siang Sore Malam Pagi Siang Sore Malam
.................. ................... .................. ........................ .................. ................... .................. ........................ .................. ................... .................. ........................
SESUDAH / SETELAH / SAAT MAKAN SESUDAH / SETELAH / SAAT MAKAN SESUDAH / SETELAH / SAAT MAKAN

APOTEK APOTEKER NICKY

SIPA : 420/632/SIPA/DINKES/ASMAT/X/2021
APOTEK APOTEKER NICKY
SIPA : 420/632/SIPA/DINKES/ASMAT/X/2021
APOTEK APOTEKER NICKY
SIPA : 420/632/SIPA/DINKES/ASMAT/X/2021
STRA : 19891114/STRA-STFB/2013/233693 STRA : 19891114/STRA-STFB/2013/233693 STRA : 19891114/STRA-STFB/2013/233693
SIA : 420/491/SIA/DINKES/ASMAT/X/2021 SIA : 420/491/SIA/DINKES/ASMAT/X/2021 SIA : 420/491/SIA/DINKES/ASMAT/X/2021

JL. DOLOG KAMPUNG BIS AGATS, JL. DOLOG KAMPUNG BIS AGATS, JL. DOLOG KAMPUNG BIS AGATS,

NO. .......... AGATS, .................................. 20..... NO. .......... AGATS, .................................. 20..... NO. .......... AGATS, .................................. 20.....
Nama : ............................................. Tablet Nama : ............................................. Tablet Nama : ............................................. Tablet
Kaplet Kaplet Kaplet
x Kapsul x Kapsul x Kapsul
Bungkus Bungkus Bungkus
Pagi Siang Sore Malam Pagi Siang Sore Malam Pagi Siang Sore Malam
.................. ................... .................. ........................ .................. ................... .................. ........................ .................. ................... .................. ........................
SESUDAH / SETELAH / SAAT MAKAN SESUDAH / SETELAH / SAAT MAKAN SESUDAH / SETELAH / SAAT MAKAN