This document appears to be an order form or invoice from a pharmacy listing various medical products and quantities ordered. It includes over 270 line items of medications, medical supplies, and personal care products ordered from different suppliers.
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
0 ratings0% found this document useful (0 votes)
282 views66 pages
Form Permintaan Barang
This document appears to be an order form or invoice from a pharmacy listing various medical products and quantities ordered. It includes over 270 line items of medications, medical supplies, and personal care products ordered from different suppliers.
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
You are on page 1/ 66
APOTEK KIMIA FARMA PAGONGAN TEGAL
JL RAYA PAGONGAN KEC DUKUHTURI
NO ANEKA USAHA. PT QTY ORDER SATUAN
1 DR P ADULT DIAP SPECIAL L@8 2 BH 2 DR P ADULT DIAP SPECIAL M@10 2 BH 3 DR P ADULT DIAPERS BASIC L@8 1 BH 4 DR P ADULT DIAPERS BASIC M@10 1 BH APOTEK KIMIA FARMA PAGONGAN TEGAL JL RAYA PAGONGAN KEC DUKUHTURI
1 ABBOCATH T 16G 2 ABBOCATH T 18G 3 ABBOCATH T 20G 4 ABBOCATH T 22G 5 ABBOCATH T 24G 6 ALAT UKUR TINGGI BADAN 7 CELANA HERNIA M 8 CELANA HERNIA S 9 DISP NEEDLE 23 G TRM@100 10 DISP SYRINGE 3ML TRM@100 11 FOLLEY CATH. 2 WAY FR 14 RUSCH 12 HEARING AID AXVA OM 188 13 INDIKATOR UNIVERSAL 14 INFUS SET DEWASA TRM 15 KRUK KETIAK M GEA 16 KURSI RODA BAN MATI MAK(SS) 17 MASKER 3 PLY TIE ON HIJAU@50 18 MORTIR 10CM + STAMPER 19 MORTIR 13CM + STAMPER 20 ONEMED ALKOHOL 70% 100ML 21 ONEMED ALKOHOL 70% 300ML 22 ONEMED RIVANOL 0.1% 300ML 23 ONEMED THERMO DIGIT ONE ALPHA1 24 ONEMED TONGKAT+T.DUDUK/TRIPOT 25 ONEMED WWZ 26 PISPOT SODOK BIRU PLASTK B 27 PISPOT SODOK BIRU PLASTK BSR 28 RAK TABUNG REAKSI KAYU 29 RIVANOL 0.1% 300ML CITO 30 STATUR METER 31 STEEKPAN PLASTIK BESAR 32 THERMOMETER DIGITAL PRECISION 33 THERMOMETER DIGITAL SPR FUJITO 34 TIMBANGAN BADAN DIGITAL CAMRY 35 TIMBANGAN BADAN GEA 36 TIMBANGAN BADAN ONEMED 37 TONGKAT ORANG TUA LIPAT 38 TONGKAT ORANG TUA LIPAT FS927L 39 TONGKAT ORANG TUA LURUS 40 URINAL PLASTIK PRIA 41 URINAL PLASTIK WANITA 42 URINE BAG NON STERIL 43 WARM WATER ZAK APOTEK KIMIA FARMA PAGONGAN TEGAL JL RAYA PAGONGAN KEC DUKUHTURI
1 ALLETROL COMP ED 5ML 10 BIO ATP KPL@100 1 BOX 44 KAMILLOSAN OINT 10GR 1 TUBE 47 KOLKATRIOL 0.25MCG CAP@30 1 BOTOL APOTEK KIMIA FARMA . . . JL . . .
NO MARGA NUSANTARA JAYA QTY ORDER SATUAN
1 ANAKONIDIN OBH 60ML 2 ANAKONIDIN SYR 30ML 3 ANAKONIDIN SYR 60ML 4 BRAITO 0.5% EYE DROP 0.5ML@10 5 BRAITO 0.5% EYE DROP 5ML ORIG 6 BRAITO TEARS EYE DROP 5ML 7 CHOCO MANIA 90GR 8 CHOCO MANIA PEANUT 90GR 9 CHOCO MANIA RICH CHOCO 90GR 10 CHOCO MANIA RICH CHOCOLATE 90G 11 CHOCOMANIA CHOCO COCONUT 90GR 12 DIASWEET TAB@100 13 EVER E 250 CAP AMPLOP@6 14 EVER E 250MG CAP@12 15 FEMINAX TAB@200 16 FREZZA FLUORIDE 240ML 17 FREZZA KUMUR FLUORIDE 240ML 18 FREZZA KUMUR MINT 240ML 19 FREZZA KUMUR ORANGE MINT 120 20 FREZZA KUMUR ORANGE MINT 240 21 FREZZA KUMUR SPEARMINT 120ML 22 FREZZA KUMUR SPEARMINT 240ML 23 FROZZ MINT 24 FROZZ BLUEBERRY 25 FROZZ BLUEBERRY MINT 26 FROZZ CHERRY MINT 27 FROZZ ICE MINT EUCALYPTUS 28 FROZZ MINT 29 FROZZ ORANGE MINT 15GR 30 FROZZ RASA ICE MINT EUCALYPTUS 31 FROZZ TROPICAL MANGO 32 FUNGIDERM CR 5GR 33 FUNGIDERM CR 10GR 34 HERBADRINK KUNYIT ASAM SIRIH M 35 HERBADRINK KUNYIT ASAM@5 36 HERBADRINK SARI JAHE 22G SAC@5 37 HEXOS BARLEY MINT SACH 38 HEXOS LEMON MINT SACH 39 HEXOS MINT SACH 40 INZA TAB@200 41 JESSCOOL STRIP 42 KONICARE BABY DIAPER RASH CR60 43 KONICARE BABY LIQUID POWDER 44 KONICARE LOT KAYU PUTIH 60GR 45 KONICARE LOT TELON 60GR 46 KONICARE M TELON 30ML 47 KONICARE M TELON 60ML 48 KONICARE M TELON PLUS 60ML 49 KONICARE M TELON PLUS 125ML 50 KONICARE PEMBERSIH TANGAN 30ML 51 KONICARE PEMBERSIH TANGAN 60ML 52 KONICARE PENGURANG GATAL 30ML 53 KONICARE PENGURANG GATAL 60ML 54 KONIDIN MINT LOZ@6 HIJAU 55 KONIDIN STRONGMINT LOZ@6 MERAH 56 KONIDIN SYR 30ML 57 KONIDIN SYR 60ML 58 KONIDIN TAB@200 59 KONILIFE PROSMETO CAP@30 60 KONVERMEX 125MG/5ML SUSP 10ML 61 KONVERMEX 250MG TAB@50 62 KONVERMEX 250MG/5ML SUSP 10ML 63 MIGRAN TAB@100 64 NANO NANO PERMEN BELIMBING 65 NANO NANO PERMEN KULIT JERUK 66 NANO NANO PERMEN NOUGAT ORIGIN 67 NEO NAPACIN TAB@200 68 PARAMEX FLU & BATUK TAB@100 69 PARAMEX TAB@200 70 PROTECAL DEFENSE TUBE 71 PROTECAL EFF@10 TUBE 72 PROTECAL OSTEO TUBE 73 PROTECAL SOLID EFF TAB@10 TUBE 74 PROTECAL SOLID EFF@10 TUBE 75 PROTECAL SOLID STRIP 76 RENOVIT CAP@ 4 77 RENOVIT KPL@ 4 78 RENOVIT KPL@30 79 SILADEX COUGH & COLD SYR 30ML 80 SILADEX COUGH & COLD SYR 60ML 81 SILADEX M & E SYR 30ML 82 SILADEX M & E SYR 60ML 83 TERMOREX DROP 84 TERMOREX PLUS SYR 30ML 85 TERMOREX PLUS SYR 60ML 86 TERMOREX SYR 30ML 87 TERMOREX SYR 60ML 88 VIGEL 2 IN 1 125GR 89 VIGEL GEL 30GR 90 VIGEL GEL 60GR 91 VIRUGON CR 5GR APOTEK KIMIA FARMA PAGONGAN TEGAL JLRAYA PAGONGAN KECAMATAN DUKUHTURI
NO MERAPI UTAMA PHARMA PT. QTY ORDER SATUAN
1 BIOGOGUM CAP 3 CHARM BF EXTRA MAXI N WING 10P 6 BUAH 5 CHARM BF NIGHT WING 29CM 10P 3 BUAH 15 MAMYPOKO PANTS STANDAR L8 2 BUAH 17 MAMYPOKO PANTS STANDAR M9 2 BUAH 18 MAMYPOKO PANTS STANDAR XL7 2 BUAH APOTEK KIMIA FARMA . . . JL . . .
NO MEDISINDO BAHANA PT QTY ORDER SATUAN
1 FAMILY DR BPMS TD-3124 2 GLUCO DR AUTO STRIP@25 3 GLUCO DR BIO SENSOR AGM 2100 4 GLUCO DR LANCET AGL 28@200 5 GLUCO DR STRIP BIO SENSOR@25 6 GLUCO DR STRIP SPR SENSOR@25N 7 GLUCO DR STRIP SPR SENSOR@50N 8 GLUCO DR SUPER SENS AGM 2200 9 ROSSMAX DIGITAL THERMO TG 100 10 ROSSMAX QUTIE THERMO TG 380 APOTEK KIMIA FARMA PAGONGAN TEGAL JL RAYA PAGONGAN KEC DUKUHTURI
NO MENSA BINA SUKSES PT. QTY ORDER SATUAN
1 ACITRAL LIQ 120ML 5 ANLENE ACTIFIT 250GR COKLAT 2 DUS 6 ANLENE ACTIFIT 250GR VANILA 2 DUS 7 ANLENE GOLD 250GR COKLAT 2 DUS 9 ANLENE GOLD 250GR VANILA 2 DUS 13 APOLAR-N CR 10GR 1 TUBE 106 MADU TJ MURNI 150GR 6 BOTOL 110 MADU TJ SUPER 150GR 6 BOTOL 144 PROMEDEX SYR 60ML 12 FLASH 165 THEOBRON ELIX 100ML 1 FLASH 167 THIAMYCIN 1000MG KPL@50 1 BOX 189 ZOTER CR 5GR 3 TUBE APOTEK KIMIA FARMA . . . JL . . .
NO MILENIUM PHARMACON PT. QTY ORDER SATUAN
1 A-B VASK 5MG TAB@30 2 ALBOTHYL SOL CONC 5ML 3 ALBOTHYL SOL CONC 10ML 4 ALBOTHYL SOL CONC 10ML 5 AMADIAB 2MG TAB@50 6 AMADIAB 3MG TAB@50 7 APIALYS DROP 10ML 8 ARGESID 500MG KPL@100 9 BIOSTRUM SYR 100ML 10 CALIX SUSP 100ML 11 CALNIC CAP@30 12 CALNIC PLUS SYR 13 CALNIC PLUS SYR 100ML 14 CALNIC SYR 100ML 15 CEFILA DROP 30ML 16 CLORILEX 25MG TAB@50 17 DE-COUGH SYR 60ML 18 DHAVIT SYR 60ML 19 DOME 10MG TAB@30 20 ELGRAN 1MG TAB@50 21 ELOX CR 5GR 22 ELOX CR 10GR 23 EMIBION CAP@100 24 ENCEPHABOL FORTE TAB@100 25 ETHIGOBAL 500MCG CAP@50 26 EYEVIT TAB@30 27 FENATIC SUSP 60ML 28 FISHQUA CAP@30 29 FRUIT 18 JR TAB@30 30 FULADIC CR 5GR 31 FULADIC OINT 5GR 32 FUNGARES CR 5GR 33 FUNGARES CR 10GR 34 GALEPSI 300MG CAP@30 35 GASTRINAL TAB@100 36 GENICOL 500MG CAP@100 37 GOVAZOL 150MG CAP@3 38 GOVOTIL 2MG TAB@40 39 IMUNOS PLUS SYR 60ML 40 IMUNOS SYR 60ML 41 KANDISTATIN SUSP 12ML 42 LACOLDIN TAB@100 43 LACOPHEN 500MG CAP@100 44 LAPIBAL 250MCG CAP@100 45 LAPICEF 500MG CAP@100 46 LAPIFLOX 500MG TAB@30 47 LAPIMOX 500MG KPL@100 48 LAPISIV-T TAB@100 49 LAPISTAN 500MG TAB@100 50 LASAL 2MG CAP@100 51 LASAL 4MG CAP@100 52 LASAL EXP SYR 100ML 53 L-BIO SACH@30 54 L-CISIN 0.5MG TAB@30 55 L-CORE SACH@5 56 LEGIRON CAP@30 57 LODOMER 2MG TAB@100 58 LODOMER 5MG TAB@100 59 LORAN 10MG KPL@30 60 L-ZINC SYR 100ML 61 MAGANOL TAB@120 62 MAXTAN 500MG KPL@100 63 MECOLA FORTE KPL@30 64 MEIACT 200MG TAB@20 65 MESOL 4MG TAB@30 66 MESTAMOX 500MG TAB@100 67 MICROLAX ENEMA 5ML 68 MICROLAX ENEMA 5ML@1 69 MINOSEP GARGLE 0.1% 60ML 70 MINOSEP GARGLE 0.2% 60ML 71 MINOSEP GARGLE 0.2% 150ML 72 MINOSEP SOL 10ML 73 MINOSEP SOL 30ML 74 MORIS 100MG SUSP 100ML 75 MYORES 2MG TAB@100 76 NATTO-10 CPL@30 77 NERVA PLUS KPL@50 78 NEUCITI 500MG TAB@30 79 NEUROMED 5000 TAB@100 80 NORAGES SYR 60ML 81 NOURISH SKIN TAB@15 82 NOURISH SKIN TAB@30 83 NOURISH SKIN ULTIMATE TAB@15 84 NUFACE 0.025% CR 10GR 85 NUFACE 0.05% CR 10GR 86 NUTRIBREAST SOFTGEL @10 87 NUZIP 25MG TAB@50 88 OMEPROS CAP@30 89 OPTALVIT PLUS TAB@30 90 OSTEOKOM FORTE SACH@10 91 OSTEOKOM KPL@30 92 OVUTEST 93 OVUTEST SCOPE 94 OVUTEST STRIP 95 OXORIL SYR 60ML 96 POLYSILANE MAX BLUEBERY TAB@40 97 PONSAMIC 500MG TAB@100 98 PRO BABY CAP@30 99 PRO BABY TAB@12 100 PROCALMA CAP @30 101 PROCALMA LICAP@30 102 PROCELES TAB@50 103 PROCLOZAM 10MG TAB@100 104 PROGESIC 250MG/5ML SYR 60ML 105 PROGINA CARE FEMININ 100ML 106 PROHELIC CAP@30 107 PROLEPSI 300MG TAB@50 108 PRONEURON KPL@200 109 PRORIS 200MG TAB@50 110 PRORIS FORTE SYR 50ML 111 PRORIS FORTE SYR 60ML 112 PRORIS SYR 60ML 113 PROSINAL SYR 60ML 114 PUSPADROXILE 125MG SYR 60ML 115 REBAMID 100MG TAB@30 116 REFER STRETCH MARK CR 50GR 117 REJUVIT SOFTGEL @30 118 SAFE CARE AROMATHERAPY ROLL ON 119 SAFE CARE MKP ROLL ON 10ML 120 SENSITIF VIVO CLASSIC CONDOM@3 121 SENSITIF VIVO EXTRA CONDOM@3 122 SENSITIF VIVO PASSION CONDOM@3 123 SENSITIF VIVO PLEASUR CONDOM@3 124 SENSITIF VIVO ULTRA CONDOM@1 125 SIM-DHA SYR 100ML 126 SIMDROL 4MG TAB@100 127 SIRPLUS SYR 100ML JERUK 128 SIRPLUS SYR 100ML STRAWBERI 129 SISMAX SYR 120ML 130 SISMAX SYR 60ML 131 SIZORIL 25MG TAB@50 132 STELOSI 5MG TAB@100 133 STENIROL 4MG KPL@50 134 TB RIF SYR 120ML 135 TB VIT B6 SYR 120ML 136 TERANOL 10MG TAB@30 137 THECORT CR 5GR 138 THERMOLYTE DIET SUGAR@25 139 TINEURON 300MG CAP@30 140 TOFEDEX 25MG TAB@30 141 TYLONIC 100MG TAB@100 142 URSOLIC 250MG CAP@30 143 UTROGESTAN 200MG CAP@15 144 VENARON 300MG CAP@100 145 VIOQUIN 500MG KPL@30 146 VIOSTIN DS KPL@30 147 VIOSTIN DS KPL@50 148 VITACUR SYR 100ML 149 VOMISTOP 10MG FLASH TAB@30 150 VOXIN 500MG KPL@20 151 XANDA SYR 60ML 152 XIDANE CAP@30 153 ZEGREN 50MG TAB@100 154 ZIBRAMAX 500MG KPL@6 155 ZIRCUM KID SYR 156 ZUDEM 10MG TAB@30 APOTEK KIMIA FARMA . . . JL . . .
NO MITRA MEKAR UD QTY ORDER SATUAN
1 SIDO M TOLAK ANGIN + MADU 15ML 2 SIDO M TOLAK ANGIN CAIR ANA@12 3 SIDO M TOLAK ANGIN FLU CAIR@12 APOTEK KIMIA FARMA PAGONGAN TEGAL JLRAYA PAGONGAN KECAMATAN DUKUHTURI
NO PARIT PADANG GLOBAL, PT QTY ORDER SATUAN
1 ACCU-CHEK ACTIVE KIT/METER 6 ADEM SARI SACH@6 6 DUS 16 ASEPSO PLUS SOAP 80GR ORIGINAL 4 BUAH 158 OCU-V KPL@30 1 BOX 167 PRIMOLUT N 5MG TAB@30 1 BOX APOTEK KIMIA FARMA PAGONGAN TEGAL JL . . .