Form Pencatatan Narko Psiko.docx

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RSIA ABDHI FAMILI JL. Diponegoro No.05 Wringinrejo Gambiran Banyuwangi

PENCATATAN PSIKOTROPIKA JENIS PSIKOTROPIKA : ........................................................... No.

No. R/

Tanggal R/

Tanggal Penyerahan

Nama Pasien

Alamat Pasien

Nama Dokter

Alamat Dokter

Stok Awal

Pemasukan

Pengeluaran

Sisa

RSIA ABDHI FAMILI JL. Diponegoro No.05 Wringinrejo Gambiran Banyuwangi

PENCATATAN NARKOTIKA JENIS NARKOTIKA : .................................................................. No.

No. R/

Tanggal R/

Tanggal Penyerahan

Nama Pasien

Alamat Pasien

Nama Dokter

Alamat Dokter

Stok Awal

Pemasukan

Pengeluaran

Sisa

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