APOTIK AQILA FARMA

SIA : 003/8201/SIA/DPMPTSP-HB/2017, NPWP ; 86.600.163.9-943.000

JL.TRANS HALMAHERA DESA TONGUTE TERNATE ASAL KEC. IBU. KAB. HALMAHERA BARAT
NO HP ; 081543373194 N0 WA 081355666771

SURAT PESANAN
NOMOR : 013/AQILA/SP/3/2019

Kepada Yth :
PBF, PT MARKSON JAYA MEDIKA
DI TERNATE

NO NAMA BARANG UNIT JUMLAH KET

1 ASAM MEFENAMAT/ALTRAN BOX 30
2 CETIRIZIN TAB BOX 15
3 YUSIMOX SRP BTL 12
4 CFADROXIL SRP BTL 12
5 MADU TJ MURNI 150 GR BTL 24
6 MADU TJ MURNI 300 GR BTL 12
7 BABY COUGH SRP BTL 24
8 KETOKONAZOLE SALP TUBE 48
9 MYCONAZOLE SALP TUBE 50
10 KALPANAX CREAN TUBE 12
11 KALPANAX CAIR BTL 24
12 NEUROTROPIK E BOX 2
13 NEUROPIRON V BOX 3
14 ANDALAN 3 BULAN INJ BOX 4
15 DECADRIL SRP BTL 12
16 COTRIMOXAZOLE SRP BTL 24
17 TROMBOPHOP GELL TUBE 12
18 ADIDRIL/RECODRIL INJ VIAL/BTL 30
19 OBH COMBI ANAK BTL 24
20 HUFAGRIP PILEK (BIRU) BTL 12
21 HUFAGRIP FLU DAN BATUK (KUNING) BTL 24
22 HUFAGRIP SRP BATUK (HIJAU) BTL 24
23 CFADROXIL CAP.500 MG BOX 5
24 HANDSCOON ON (SARUNG TANGAN ) BOX 2
25 DEXAMETASONE INJ AMPUL 100
26 MYLANTA TAB BOX 2
27 KINA TAB BOX 2
28 CALADIN CAIR BTL 24
29 CTM PAK 5
30 PINTRACOL SRP LEMON/JERUK BTL 24
31 DULCOLAX TAB PAK 4
32 DISPO 5 CC BOX 2
33 INZA KEMASAN BARU BOX 4
34 MIXAGRIP FLU DAN BATUK BOX 3
35 INSTO TTS MATA BTL 48
36 KETOROLAC INJ AMPUL 30
37 MEFINAL TAB BOX 3
38 PONGSTAN TAB BOX 5
39 KONIDIN TAB BOX 5
40 ULTRACILIN SALP TUBE 36
41 NEO REMACIL TAB BOX 4
42 MYCORAL TAB BOX 4
43 GRIVING FORTE BOX 2
44 GRISEUFULVIN 500 MG BOX 4
45 PIROXICAM 20 MG BOX 10
46 NOSIB SALP POT 48
47 FOLAVIT TAB BOX 2
48 B.COMPLEX INJ VIAL/BTL 20
49 PLANOTAB TAB BOX 2
50 ANDALAN TAB BOX 3
51 B2 INJ AMPUL 100
52 DEXTEM PLUS BOX 30
53 PARAMEX TAB BOX 5
54 DUREX KONDOM DOZ 48
55 SUTRA @12 PCS BOX BOX 48
56 VOLTADEX 50 MG BOX 15
57 SALICYL SPIRTUS CAP GAJAH BTL 48
58 GLUCOPHAGE BOX 2
59 BODREX DEMAM PAK 5
60 SUTRA HITAM OK BOX 5
61 MINYAK KAPAK 3CC BTL 24
62 VITAMIN B1 IPI BTL 48
63 VITAMIN C IPI BTL 48
64 VITAMIN B6 IPI BTL 48
65 VITAMIN B COMPLEX IPI BTL 48

IBU, 14 MARET 2019

SUPRATMAN, S.SI, APT

ON JAYA MEDIKA
 PEMERINTAH KABUPATEN HALMAHERA BARAT
PUSKESMAS IBU
JL. TRANS HALMAHERA DESA TONGUTRE TERNATE ASAL KEC. IBU

SURAT PESANAN

NO NAMA BARANG UNIT JUMLAH KET

1 IBUPROPEN 400 MG TAB 2000
2 RL BTL 200
3 D5 BTL 100
4 NaCL BTL 100
5 MP4 TAB 2000
6 AMLODIPIN 5 MG TAB 1500
7 KETOROLAC INJ AMPUL 30
8 AS.TRANEKSAMAT INJ AMPUL 30
9 DIAZEPAM 2 MG TAB 2000
10 DIAZEPAM INJ AMPUL 30
11 PARACETAMOL TAB TAB 3000
12 AMBROXOL TAB TAB 3000
13 B.COMPLEX TAB 3000
14 CTM TAB 3000
15 AMOXILIN 500 MG TAB 2000
16 RANITIDIN TAB 2000
17 PIROXICAM 20 MG TAB 2000
18 MELOXICAM TAB 1500
19 DOMPERIDON TAB TAB 1000
20 ALLOPURINOL TAB 1500
21 BETAHISTIN TAB 2500
22 DIPENHIDRAMIN INJ VIAL/BTL 30
23 ANTASIDA SRP TAB 2000
24 PCT SRP BTL 100
25 AMOXILIN SRP BTL 100
26 STIK GULA NESCO BTL 25
27 STIK ASAM URAT NESCO BTL 25
28 STIK KOLESTEROL NESCO BTL 50
29 LIDOCAIN INJ AMPUL 90
30 HANDSCOON ON BOX 5
31 HANDSCOON STERIL PCS 200
32 COTRIMOXAZOLE SRP BTL 100
33 ORALITE PCS 300
34 GENTAMICIN SLP TUBE 96
35 OXITETRACIKLIN SLP MATA TUBE 100
36 OXITETRACIKLIN SALP KULIT TUBE 100
37 DISPOSIBLE 3 CC PCS 1000
38 INFUSET DEWASA PCS 200
39 KALAK TAB 3000
40 VIT.C TAB 2000
41 LIVRON B PLUS TAB 1500
42 SIMVASTATIN TAB 2000
43 DEXAMETASONE TAB 2000
44 KETOKONAZOLE SLP TUBE 96
45 MICONAZOLE SALP TUBE 96
46 LOPERAMIDE TAB 1000
47 HIDROCORTISONE SALP TUBE 96

MENGETAHUI : IBU, 15 MARET 2019

KEPALA PUSKESMAS IBU PENGELOLA OBAT

MERSIANA MONTOLALU, S.Kep.Ns SUPRATMAN, S.SI, APT

Nip:19710205 199003 2 002 NIP.198106172010011011