Format Bbk - 2016
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DINAS KESEHATAN KABUPATEN BANDUNG D
BUKTI BARANG KELUAR ( BBK )
NO : ...
Diserah
Pesanan dari : ......................................................................... Pesana
Tanggal :........................................................ No : 7 Tanggal
No Nama Barang Banyaknya Keterangan No
1
Ambroxol Syr 60 41
Ambroxol Tab !00 4
" Amlodipin 10 "00 4"
4 Amlodipin ! 1#0 44
! Amoxi$illin !00 !00 4!
6 Amoxi$illin !0 "00 46
% Amoxi$illin Syr %0 4%
# An&asid Syr 100 4#
' An&asid Tab 1!00 4'
10 (e&ason Salep 10 !011 )e*adroxil Syr 0 !1
1 )ap&opril 1+! 400 !
1" )ap&opril ! "00 !"
14 )T, 1!00 !4
1! )o&rimoxa-ole Syr 0 !!
16 )o&rimoxa-ole Deasa 1000 !6
1% Dexame&hasone Tab !00 !%
1# /ry&hromy$ine !0 00 !#
1' Domperidone Tab "00 !'
0 Ae&hanolm %0 1 2 6 60
1 Orali& 00 61
3en&amy$in S.. !0 6
" 3en&amy$in 5n. 0 6"
4 3libenklamid 00 64
! 3lkosa ! 40 6!
6 7ydro$or&isone S.. 10 66
% 5bpro*en 400 1!00 6%
# )hlorampheni$olm 00 6#
' )hlorampheni$olm S.,. 4 6'
"0 2ido$ain %0 %0
"1 ,y$ona-ole S.. !
" ,e&ronida-ole !00 400
"" 8i&amin Syr "0"4 8i&amin Tab 400
NO : 007!ANPK"I#0$%
Diserahkan kepada : Pera&atan
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"! Na&rim (i$arbona& 1000
"6 Na&rim Di$lo*ena$ 00
"% Na)l 5n*s 40
"# ,olagi& "00
"' O(7 "0
40 Pon*l Syr !
Arasari+ # ,ei 01!
9ang menyerahkan 9ang menerima 9ang m
.................................. ............................ .Sns
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
Pesanan dari : ......................................................................... Pesana
Tanggal :........................................................ No : $ Tanggal
No Nama Barang Banyaknya Keterangan No
1
Amoxi$yllin !00 mg "00 1
Dopler 3elly !
" oley )a&he&her No. 1# 10 "
4 5n*se& Deasa 0 4
! 5.8. )a&he&her No. 1# 0 !
6 ;7 O&o& 16 $m "0 %
# ,asker 100
' ,e&hergin 5n. 0
10 ,e&ronida-ole !00 mg 100
11 ,isopros&ol !0
1 ,l&i?i&amin Tab 00
1" Para$e&amol Tab 100
14 Plas&ik (esar
1! Sarng Tangan NS 400
16 Sarng Tangan S&eril !0
1% Tran*se& !
1# @mbilikal lem 0
NO : .001;ANPK"$#0$% NO : ...
Diserahkan kepada : P'NED Diserah
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1' @nderpad 0
0 @rine (ag 1
1
"
4
!
6
%
#
'
"0
"1
"""
"4
"!
"6
"%
"#
"'
40
Arasari+ .1" ;anari 016
9ang menyerahkan 9ang menerima 9ang m
Snsn Smirah (dn /is .Sns
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
Pesanan dari : ......................................................................... Pesana
Tanggal :........................................................ No : Tanggal
No Nama Barang Banyaknya Keterangan No
1 1
NO : .........*"PK"+#0$, NO : ...
Diserahkan kepada : P-.t- /arga-y- Diserah
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" "
4 4
! !
6 6
% %
# #
' '
10 10
11 11
1 1
1" 1"
14 14
1! 1!16 16
1% 1%
1# 1#
1' 1'
0 0
1 1
" "
4 4
! !
6 6
% %
# #
' '
"0 "0
"1 "1
" "
"" ""
"4 "4
"! "!
"6 "6
"% "%
"# "#
"' "'
40 40
Arasari+ # ,ei 01!
9ang menyerahkan 9ang menerima 9ang m
Snsn Smirah 2$iano .Sns
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
Pesanan dari : ......................................................................... Pesana
Tanggal :........................................................ No : % Tanggal
No Nama Barang Banyaknya Keterangan No
1
Ambroxol syr 10 1
Ambroxol &ab 100
" Amlodipin 10 60 "
4 Amoxi$yllin !00 "00 4
! Amoxi$yllin Syr 10 !
6 An&a$ida Syr 10 6
% An&a$ida Tab 00 %
# A$y$lo?ir S.. ! #
' (e&ason S.. " '
10 )ap&ropil 1+! 00 10
11 )o&rimoxa-ole Syr 10 11
1 )T, "00 1
1" Dexame&hasone Tab 00 1"14 Ae&hanolm %0 1 2 1 14
1! 3ly$eril 3aia$ola&e !00 1!
16 7ydro$or&isone S.. 10 16
1% 5n*se& Deasa 10 1%
1# 5.8. )a&he&her No. 1# ! 1#
1' )al$im 2a$&as !00 1'
0 asa S&eril 16 > 16 $m 0 0
1 )hlorampheni$olm S.,. ! 1
,e&hyl /rgome&rin 5n. 10
" ,$os /x&ra$&or ! "
4 ,l&i?i&amin Tab 100 4
! O(7 10 !
6 Oxy&e&ra$y$line S.. ! 6
% Oxy&e&ra$y$line S.,. ! %
# Oxy&osin 5n. 10 #
' Para$e&amol Tab 1000 '
NO : .........*"PK"+#0$, NO : ...
Diserahkan kepada : Po.ke.1e. /arga-y- Diserah
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"0 Para$e&amol Drop ! "0
"1 Para$e&amol Syr ! "1
" Ples&er 1 "
"" Pon*l Syr 10 ""
"4 Pralex Tab !0 "4
"! ani&idine Tab 00 "!
"6 inger 2ak&a& 5n*s 0 "6
"% Sarng Tangan NS 100 "%
"# errosi Sl*as "0 "#
"' @nderpad 10 "'
40 8i&amin ( )ompleks Tab 100
41 8i&amin ) !0 mg Tab !00
4 8i& mg>ml 5n. ! 9ang m
4" 8i&amin Syr
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Pesanan dari : ......................................................................... Pesana
Tanggal :........................................................ No : $0 Tanggal
No Nama Barang Banyaknya Keterangan No
1
Ambroxol &ab 1#00 41
Ambroxol syr 140 4
" Amlodipin 10mg 1!"0 4"
4 Amoxy$illin !00mg 6"00 44
! Amoxy$illin !0mg 4600 4!
6 Amoxy$illin syr "00 46
% An&algin !00mg %00 4%
# An&a$id syr 4%! 4#
' Chi&e*eld sk 1 4'
10 Ansol spp 0 !0
11 As ,e*enama& !00mg 00 !1
1 A$y$lo?ir sk 1! !
1" A-y&romi$in !00 100 !"
14 )ap&opr !mg 400 !4
1! )T, "00 !!
16 o&rim syr !!
1% o&rim D 00
1# Dexame& ""00
1' Dia- mg 00
0 /&hanol %0 100ml 60
1 enok &k 14
8i& &ab 100
" rosemid %0
4 3en&ian ?iole& "0
! 7alop 0.!mg 00
6 7idro sk 1%
% 5bp syr 600
# 5bp 400mg "00
' alk 1000
"0 ke&okona-ole 00
"1 loram*e !0mg 1400
" ,e&ro !00mg '00"" ,e&hyl pred !00
"4 ,l&i?i&amin kap 1600
"! Ni*edipin 100
"6 aominal syr #0
"% Oxy&e&ra sk #
"# Oxy&e&ra sm 6#
"' Para$e& &ab 1%#00
40 Para$e& drop !6
Arasari+ 0 ,ei 01!
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9ang menyerahkan 9ang menerima 9ang
Snsn Smirah Snsn .
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INAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
...........................................................................................................
kan kepada : ....................................................................................
n dari : ..............................................................................................
:..................................................................... No.................
Nama Barang Banyaknya Keteran
gan
Pon*l Tab 00
Omepra-ole "00
Oxy&e&ra$y$line S.. !
Ondanse&rone 5n. !0
Para$e&amol Drop 11
Para$e&amol Syr %!
Para$e&amol Tab "000
Prednisone ! 1000
ani&idine 1!0 1000
Salb&amol "00Salb&amol Nebli-er 0
inger 2ak&as 5n*s !00
8i& (1 5n 1
8i& ( )ompleks 100
oley )a&he&her No.1# %
5.8. )a&he&her No.1# 0
5.8. )a&he&her No. 0 !0
5.8. )a&he&her No. 0
5.8. )a&he&her No. 4 !0
asa 4 x 10 $m 100
asa 16 x 16 $m 1!0
,asker 00
Ples&er
Sarng Tangan NS , 400
Silk 60
Plas&ik e$il 0
7ipa*ix 10
Ondanse&ron 5n. !0
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Arasari+ ..# ,ei 01!
enyerahkan 9ang menerima
Smirah obby
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
n dari : ..............................................................................................
:.....................................................................
Nama Barang Banyaknya Keteran
gan
2idokain in 1"0
,asker 100
Sarng &angan NS S "00
Sarng &angan NS , 00
Ae&hanolm %0 1 2
3lkosa ! 5n*s 10
Spi& " ml 100
.00 ;ANPK"$#0$%
kan kepada : .P'L GIGI
No.**#
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Arasari+ ..1" ;anari 016
enyerahkan 9ang menerima
Smirah Dina
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
n dari : ..............................................................................................
:.....................................................................
Nama Barang Banyaknya Keterangan
Amlodipine 10 60
.............."PK"+#0$,
kan kepada : .P-.t- Baro.
No.**,
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Amoxi$yllin !00 00
Amoxi$yllin Syr !
An&asida Syr 10
An&algin !00 00
)ap&ropil 1+! 100
)ap&ropil ! 00
)T, 00
Dexame&hasone Tab "00
3li$eryl 3aia$ola&e !00
7ydro$hloro&hi-ide ! mg 100
5bpro*en 400 mg 00
)al$im 2a$&as !00 mg 00
)hlorampheni$ol S.,. !
,e&ronida-ole !00 100O(7 10
Orali& !
Para$e&amol Tab 400
Para$e&amol Syr !
Pon*l Syr 10
Pralex Tab !0
Salb&amol mg &ab !0
errosi Sl*as 0
8i&amin ) !0 mg 00
8i&amin Syr
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
n dari : ..............................................................................................
:.....................................................................
Nama Barang Banyaknya Keterangan
Ambroxol syr 10
Ambroxol &ab 100
Amoxi$yllin !0 100
Amoxi$yllin !00 "00
Amoxi$yllin Syr 10
An&a$ida Syr 10
An&a$ida Tab 00
An&algin !00 100
(e&ason S.. !
Na&rim (i$arbona& 00
)o&rimoxa-ole 4#0 mg 100
)o&rimoxa-ole Syr 10
)T, "00Dexame&hasone Tab 100
Ae&hanolm %0 1 2 1
3en&amy$in S.. !
3ly$eril 3aia$la&e !00
5bpro*en 400 mg 100
asa S&eril 16 > 16 $m 10
,e&hyil /rgome&rin 5n. !
,e&ronida-ole !00 mg 100
,l&i?i&amin Tab. 100
O(7 10
Oxy&er&asiklin S.. !
Oxy&osin 5n. !
Para$e&amol Tab "00
Para$e&amol Drop !
Para$e&amol Syr 0
Pon*l Syr 10
.............."PK"+#0$,
kan kepada : *Po.ke.1e. "ang-n !aya
No.**7
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Pralex Tab !0
ani&idine &ab 100
Salb&amol mg Tab !0
errosi Sl*a& 1!
8i&amin (1 Tab 1000
8i&amin ( )omplex Tab 400
8i&amin ) !0 mg Tab "00
8i&amin mg > ml 5n. 10
8i&amin Syr
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)o&rimoxa-ole Syr 10
)T, 00
Dexame&hasone Tab 00
3ly$eril 3aia$ola&e !00
7ydro$or&isone S.. 10
5bpro*en 400 mg 100
)al$im 2a$&as !00 mg !00
)hlorampheni$ol S.,. 10
,e&hyl /rgome&rin 5n. 10
,e&hyl /rgome&rin Tab !0
,e&ronida-ole !00 mg 100
,l&i?i&amin Tab 100
Ni*edipine 10 mg &ab !0
Nys&a&ine 8agina 0O(7 1!
Orali %!
Oxy&e&ra$y$line S.. !
Oxy&osin 5n. 10
Para$e&amol Tab 600
Para$e&amol Syr 0
Pon*l Syr 10
Pon*l Tab 100
ani&idine Tab 100
inger 2ak&as 5n*s 0
Salb&amol mg &ab !0
Salep 4 !
Sarng Tangan S&eril 10
errosi Sl*a& "0
8i&amin (1 Tab 1000
8i&amin ( )ompleks Tab 400
8i&amin ) !0 mg Tab "00
8i&amin mg > ml 5n. 10
8i&amin Syr
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n dari : ..............................................................................................
:.....................................................................
Nama Barang Banyaknya Keterangan
Piroxikam 600
(e&adine "00ml !
Pred "00
ani&idin &ab 00
Salb& mg #00
4 sk #
(iopl$en&on sk 10
Sim?as&a&in 100
)endo &m '4
8i& (1 &ab "000
Bink syr 100
8i& () &ab ""00
,asker !0
Polybag 7> 6,ar
Arasari+ ..0 ,ei 01!
No.*
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menyerahkan 9ang menerima
nsn Smirah Snsn
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : % A6PK"+I#0$,******************************************************* N' : ***
D.era8kan ke6a1a : **P-.t- /arga-y-****************************** D.era
Pesanan dari : ......................................................................... Pesana
Tanggal :........................................................ No : ....1 Tanggal
No Nama Barang Banyaknya Keterangan No
1 Al2oprinol 00 1
Ambroxol syr "0 " Ambroxol &ab 00 "
4 Amlodipin 10mg '0 4
! Amoxi$illin !00mg !00 !
6 Amoxi$illin !0mg 00 6
% Amoxi$illin syr 0 %
# An&a$id syr "0 #
' As me*e !00mg 00 '
10 A$y$lo?ir sk ! 10
11 )ap&opril 1.!mg 00 11
1 )ap&opril !mg 00 1
1" )T, !00 1"
14 )o&rim syr ! 14
1! )o&rim &ab 100 1!
16 Dexame& !00 16
1% 8i& 100 1%
1# rosemide !0 1#
1' 7idro sk 10 1'
0 ,e&ronida-ole !00mg 100 0
1 (i$na& 100 1
Ni*edipin !0
" Oxy&e&ra sk 10 "
4 Oxy&e&ra sm 10 4
! Para$e&amol #00 !
6 Piroxi$am 0mg 00 6
% (e&adine "00ml 1 %
# Pred 00 #
' ani&idin "00 '
"0 Salb& mg 100 "0
"1 4 sk 10 "1
" Sim?as&a&in !0 "
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"" )endo &m ! 33
"4 8i& () !00 34
"! ,asker !0 35
"6 assa 4x!$m 10
"% Plas&ik klip k 4 pak
Arasari+ ..! ;ni 01!
9ang menyerahkan 9ang menerima 9ang m
..Snsn Smirah 2$iano ....Sns
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : 7 A6PK"+I#0$,******************************************************* N' : ***
D.era8kan ke6a1a : **Po.ke.1e. /arga-y-************************ D.era
Pesanan dari : ......................................................................... Pesana
Tanggal :........................................................ No : ...." Tanggal
No Nama Barang Banyaknya Keterangan No
1 Amoxi$illin !00mg "00 1
,e&ronida-ole !00mg 100
" Para$e&amol 1000 "
4 As me*e !00mg 100 4
! An&a$id syr "0 !
6 ani&idin 100 6
% Bink &ab 100 %
# )T, 00
' alk !00
10 i?anol
11 Alkohol %0 100ml !
1 (e&adine "00ml 1
1" assa s&eril 16x16 1!
14 kapas !0mg 1
1! Oxy&e&ra sm !
16 7idro sk 10
1% Ambroxol syr 1!
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1# Abo$a&h no.1# !
1' Oxy&era sk !
0 @nderpad 10
1 Spi& 1ml 100
8i&alex &ab 100
" Sabn $air 1
4 Bink &ab 100
!
6
%
#
'
"0
"1
"
""
"4
"!
"6
Arasari+ ..! ;ni 01!
9ang menyerahkan 9ang menerima 9ang m
..Snsn Smirah (dn a&ih ....Sns
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : ,0 A6PK"+I#0$,******************************************************* NO : ....
D.era8kan ke6a1a : **Pera&atan******************************************* Diserah
Pesanan dari : ......................................................................... Pesana
Tanggal :........................................................ No : ....!........ Tanggal
No Nama Barang Banyaknya Keterangan No
1 Al2oprinol 100 41
Ambroxol syr !0 4
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" Ambroxol &ab "00 4"
4 Amlodipin 10mg "60 44
! Amoxi$illin !00mg 00 4!
6 Amoxi$illin !0mg "00 46
% Amoxi$illin syr !! 4%
# An&a$id syr 1!0 4#
' As me*e !00mg 600 4'
10 A$y$lo?ir sk ! !0
11 A$y$lo?ir &ab 100 !1
1 )ap&opril 1.!mg 00 !
1" $ap&opril !mg 100 !"
14 )T, 1000 !4
1! )o&rim syr 0 !!
16 )o&rim &ab !00 !6
1% Dexame& &ab #00 !%
1# Dia-epam re$&al ! !#
1' Dia-epam in "0 !'
0 enok &k 10 60
1 Alkohol %0 100ml 10 61
Orali& 100 6
" 7idro sk 0 6"4 alk !00mg !00
! loram*eni$ol !0mg 1000
6 Piroxi$am 0mg 00
% 2ido$ain in '0
# ,e&o$lorpram in 66
' ,e&ronida-ole !00mg 00
"0 8i&alex $ap 00
"1 ,e&hyl Ped 00
" (i$na& '00
"" Oxy&e&ra sk 4
"4 Oxy&era sm 10
"! Para$e& !00mg %00
"6 Piroxi$am 0mg 00
"% Omepra-ol &ab 60
"# (e&adine "00ml ""' ani&in &ab 1000
40 Bink syr !
Arasari+ ..6 ;ni 01!
9ang menyerahkan 9ang menerima 9ang m
-
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............................... ..................................... ....Sns
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : ,$ A6PK"+I#0$,******************************************************* N' : **
D.era8kan ke6a1a : **Pone1*********************************************** D.era
Pesanan dari : ......................................................................... Pesana
Tanggal :........................................................ No : ****%******** Tanggal
No Nama Barang Banyaknya Keterangan No
1 Amoxi$illin !00mg "00 1
As me*e !00mg 100
" S 100 "
4 ,e&hergin &ab 100 4
! ,e&ronida-ole !00mg 100 !
6 ,l&i?i&amin kaps 00 6
% Oxy&e&ra sm 10 %
# Para$e&amol !00mg !00 #' (e&adine "00ml '
10 2 in*s 0 10
11 er&as @S3 rol (2@D 11
1 Spi& 1ml 100 1
1" Spi& " ml 00 1"
14 )a&g& 4 (2@D 14
1! 5n*se& deasa 0 1!
16 58.$a&h No+1# 0 (2@D 16
1% 58.$a&h No+0 0 (2@D 1%
1# apas !0gr 1 1#
1' assa s&eril 16x16 "0 1'
0 ,asker 100 0
1 Sarng &angan s&eril %.! !0 (2@D 1
@nderpad 10
" Amlodipin 10mg "0 "
4 Spi& !0ml (2@D 4
! !
6
%
#
'
"0
-
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"1
"
""
"4
"!
"6
"%
"#
"'
40
Arasari+ ..6 ;ni 01!
9ang menyerahkan 9ang menerima 9ang m
..Snsn Smirah........... ...(dn /is.................. ....Sns
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : ,# A6PK"+I#0$,******************************************************* N' : **
D.era8kan ke6a1a : **P-.t- "ekar3aya******************************* D.era
Pesanan dari : ......................................................................... Pesana
Tanggal :........................................................ No : ****2******** Tanggal
No Nama Barang Banyaknya Keterangan No
1 Ambroxol syr 1! 1
Ambroxol &ab 100
" Amlodipin 10mg 60 "
4 Amoxi$illin !00mg 00 4
! Amoxi$illin !0mg 00 !
6 Amoxi$illin syr 10 6
% An&algin !00mg 100 %
# An&a$id syr 10 #
' As me*e !00mg 100 '
10 A$y$lo?ir sk ! 10
11 A$y$lo?ir &ab !0 11
1 )ap&opril 1.!mg 100 1
1" )ap&opril !mg 100 1"
14 )T, 100 14
1! o&rim syr 1! 1!
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16 o&rim &ab 100 16
1% Dexame& 00 1%
1# i?anol 1#
1' /&anol %0 100ml 1'
0 rosemid !0 0
1 Orali& 100 1
7idro sk 10
" alk !00mg !00 "
4 ,e&ro !00mg 100 4
! (i$na& 00 !
6 Ni*edipin !0
% Oba& diare syr 1!
# Para$e& !00mg 1000
' Pred 00
"0 ani& &ab 100
"1 Salb& mg 100
" )endo &m !
"" 8i& () !00
"4 loram*eni$ol syr 10
"!
"6"%
"#
"'
40
Arasari+ ..10 ;ni 01!
9ang menyerahkan 9ang menerima 9ang m
..Snsn Smirah........... ...(dn 7 esih.................. ....Sns
-
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : , A6PK"+I#0$,******************************************************* N' : *
D.era8kan ke6a1a : **Loket o4at**************************************** D.era
Pesanan dari : ......................................................................... Pesan
Tanggal :........................................................ No : ****$0**** Tangg
No Nama Barang Banyaknya Keterangan No
1 Ambroxol syr 100 41
Ambroxol &ab 100 4
" Aminop &ab 100 4"
4 Amlodipin 10mg "00 44
! Amoxi$illin !00mg !'006 Amoxi$illin syr 1!
% An&algin !00mg '00
# An&a$id syr "!
' /rgo&amin 100
10 8i& ) 000
11 As me*e 600
1 A$y$lo?ir sk 10
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1" A$y$lo?ir &ab 1!0
14 )ap&opril 1.! %00
1! )ap&opril ! !00
16 )T, "000
1% o&rim syr 100
1# ko&rim &ab "001' Dexame& "400
0 Dia-ep &ab 00
1 /ry&rom !0mg 400
8i& &ab 00
" ros &ab 100
4 Orall& "00
! 5SS 100
6 7)T 1000
% 7idro sk %'
# alk !00mg 000
' ,e&hergin &ab !0
"0 ,e&ro !00mg "00
"1 ,e&hyl pred "00
" Oxy&e&ra sk #1
"" Oxy&e&ra sm 60"4 Para$e& !00mg %000
"! Piroxi$am 600
"6 (e&adine "00ml
"% Pred &ab 600
"# ani& &ab "00
"' Salb& mg 600
40 Sim?as& &ab 1!0
Arasari+ ..1! ;ni 01!
9ang menyerahkan 9ang menerima 9ang
................................ .................................. ....Sn
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
******7 A6PK"+I#0$,
kan ke6a1a : ****P-.t- Baro.
n dari : ..............................................................................................
:..................................................................... No : ......................
Nama Barang Banyaknya Keteran
gan
Ambroxol syr 0
Ambroxol &ab 00Amlodipin 10mg 60
Amoxi$illin !00mg 100
An&a$id syr 0
As me*e !00mg 100
)ap&opril !mg 100
)o&rim syr 10
Dexame& 100
7idro sk !
Para$e& &ab 00
ani&idin &ab 100
)endo &m !
8i& () !00
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Arasari+ ...! ;ni 01!........................
nyerahkan 9ang menerima
n Smirah (dn 5nne..........
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
******2 A6PK"+I#0$,
kan ke6a1a : ****Po Gg
n dari : ..............................................................................................
:..................................................................... No : ...4...................
Nama Barang Banyaknya Keteran
gan
apas !0mg
Alkohol %0 100ml 10
(e&adine "00ml 1
Spi& "ml 100
2ido$ain in '0
,asker !0
Albo&hyl $ons& 1
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Arasari+ ...! ;ni 01!........................
nyerahkan 9ang menerima
n Smirah 2ina...................
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
.........................................................................................................
kan kepada : ...................................................................................
n dari : ..............................................................................................
:..................................................................... No : .....................
Nama Barang Banyaknya Keteran
gan
Salb&amol mg 00
4 sk !
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(iopla$en&on elly 10
8i& (1 in 100
)endo &m 10
8i& () %00
Spi& "ml 00
)a&g& 1" (2@D
5n*se& anak !0
5n*se& deasa 100
58.)a&h No.1# 0 (2@D
58.)a&h No.0 0 (2@D
58.)a&h No. 40 (2@D
58.)a&h No.4 40 (2@D
apas
assa glng 1
,asker !0
Silk 4 (2@D
2oma&lle 0
Plas&ik k ! pak (2@D
Plas&ik ( 1 pak (2@D
@rine bag 10 (2@D
Arasari+ ...6 ;ni 01!........................
nyerahkan 9ang menerima
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n Smirah obby
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
#A6PK"+I#0$,**************************************************************************
kan ke6a1a : ***Po.ke.1e. "ang-n3aya***************************************
n dari : ..............................................................................................
:..................................................................... No : *7******************
Nama Barang Banyaknya Keteran
gan
Ambroxol syr 0
Amoxi$illin !00mg 00
An&a$id syr 10
As me*e !00mg 100
S 0
)T, 00
/&anol %0 100ml !
Orali& 1007idro sk 10
,e&ro !00mg 100
Oxy&e&ra sm !
Para$e& !00mg 600
8i& (6 1000
ani& &ab 100
)endo &m !
8i& () "00
apas 1
assa 4x10 10
Abo$a&h no 1# !
)a&g& !
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Arasari+ ...10 ;ni 01!........................
nyerahkan 9ang menerima
n Smirah (dn 5mas........
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
9A6PK"+I#0$,**************************************************************************
kan ke6a1a : ***Po.ke.1e. "ekar3aya*****************************************
n dari : ..............................................................................................
:..................................................................... No : *5******************
Nama Barang Banyaknya Keteran
gan
Amoxi$illin !00mg "00
Para$e& !00mg 400
As me*e !00mg 100
An&a$id syr 1!
Bink &ab 100
8i& () !00
S 0
assa s&eril 16x16 10
alk !00mg !00
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Arasari+ ...10 ;ni 01!........................
nyerahkan 9ang menerima
n Smirah (dn 7 esih.......
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
***********************************************************************************************************
8kan ke6a1a : ********************************************************************************
n dari : ..............................................................................................
l :..................................................................... No : ******************
Nama Barang Banyaknya terangan
)endo &m 66
8i& (5 &ab %000
Bink syr !
8i& () "000
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Arasari+ ...1! ;ni 01!
enyerahkan 9ang menerima
sn Smirah Snsn Smirah
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : !-PK"+II#0$,****************************************** N' :
D.era8kan ke6a1a : **P-.t- /arga-y-***************** D.era
Pesanan dari : ........................................................... Pesan
Tanggal :............................................... No : .... Tangg
No Nama Barang Banyaknya Keterangan No
1 Al2oprinol 400 1
Ambroxol &ab !00
" Amlodipin 10mg 10 "
4 Amoxi$illin !00mg !00 4
! Amoxi$illin !0mg 00 !
6 Amoxi$illin syr 10 6
% An&a$id syr "0 %
# An&a$id &ab 400 #' As me*e !00mg 00 '
10 )ap&opril 1.!mg 00 10
11 )ap&opril !mg "00 11
1 )T, "00 1
1" )o&rim D &ab 100 1"
14 Dexame& 00 14
1! 3liben$lamide &ab 100 1!
16 7idro sk 0 16
1% loram*e !0mg 100 1%
1# ,e&hyl pred 4mg 100 1#
1' ,l&i?i&amin &ab 100 1'
0 Oxy&e&ra sm 10 0
1 Para$e&amol syr ! 1
Para$e&amol 1000
" Pred 00
4 ani&idin "00
! 8i& (5 &ab 1000
6 8i& () 1000
% assa 4x!$m 11
# Ples&er 1
' Sarng T NS No 2 100
"0 Sabn $air 1
"1 Plas&ik klip k # pak
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Arasari+ ..1" ;li 01!
9ang menyerahkan 9ang menerima 9ang
..Snsn Smirah 2$iano ....Sn
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : !-PK"+II#0$,******************************************* N' :
D.era8kan ke6a1a : **Po.ke.1e. /arga-y-******** D.era
Pesanan dari : ............................................................ Pesan
Tanggal :............................................... No : .... Tangg
No Nama Barang Banyaknya Keterangan No
1 Amoxi$illin !00mg "00 1
,e&ro !00mg 00
" Para$e&amol #00 "
4 Para$e&amol syr ! 4
! As ,e*e !00mg 00 !
6 An&a$id syr 0 6
% An&a$id &ab 1 %
# ani& &ab 100
' )T, "00
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10 Ambroxol &ab 00
11 Ni*edipin &ab "0
1 i?anol !
1" (e&adin "00ml 1
14 Alkohol "00ml "1! assa 16x16 1!
16 apas 1
1% Oxy&era Sm 10
1# 7idro Sk 10
1' 4 Sk !
0 Salb& mg !0
1 Neo in 10
(e&a Sk !" Amlodipin 10mg "0
4 @nderpad 10
! Spi& 1ml 100
6 3en&ian 8iole& !
% Sarng T NS No.2 100
# Albo&hyl $on$ 1
' Ples&er 1
Arasari+ ..1" ;li 01!
9ang menyerahkan 9ang menerima 9ang
..Snsn Smirah (dn a&ih ....Sn
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : !-PK"+II#0$,***************************************** NO : .
D.era8kan ke6a1a : **Pera&atan***************************** Disera
Pesanan dari : ............................................................ Pesan
Tanggal :............................................... No : ............ Tangg
No Nama Barang Banyaknya Keterangan No
1 Al2oprinol 00 41
Ambroxol &ab 1000 4
" Amlodipin 10mg "00 4"
4 Amoxi$illin !00mg 000 44
! Amoxi$illin !0mg 00 4!
6 Amoxi$illin syr !0 46
% An&a$id syr 1!0 4%
# An&a$id &ab 1000 4#
' As me*e !00mg 1000 4'
10 A$y$lo?ir sk 10 !0
11 A$y$lo?ir &ab 00 !1
1 (e&a Sk 1! !
1" $ap&opril !mg 00 !"
14 )o&rim syr 0 !4
1! )o&rim &ab %00 !!16 Domperidon &ab 100 !6
1% enok &k 4 !%
1# Alkohol %0 "00ml 10 !#
1' Orali& 100 !'
0 7idro sk 4 60
1 e&okona-ole &ab !0 61
loram*eni$ol !0mg 1100 6
" 2ido$ain in '0 6"
4 Oxy&era sm 1! 64
! Para$e& syr !0 6!
6 Para$e& !00mg !00
% Piroxi$am 0mg 00
# Omepra-ol &ab "0
' Albo&hyl $on$ 1
"0 (e&adine "00ml !"1 (e&adine "0ml !
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" ani&in &ab 1000
"" ani&in in 00
"4 Pred &ab 1000
"! Bink syr !
"6 inger 2ak&a& in* !00"% Salb& Neb 100
"# Salb& &ab mg 00
"' 4 Sk 10
40 (iopla$en&on ell 10
Arasari+ ..1" ;li 01!
9ang menyerahkan 9ang menerima 9ang
............................... ..................................... ....Sn
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : !-PK"+II#0$,************************************* N' : *
D.era8kan ke6a1a : **Pone1****************************** D.era
Pesanan dari : ...................................................... Pesan
Tanggal :............................................. No : ************ Tangg
No Nama Barang Banyaknya Keterangan No
1 Amoxi$illin !00mg "00 1
An&a$id &b 00
" As me*e !00mg 100 "
4 S !0 4
! ,e&hergin &ab 100 !
6 ,e&ro !00mg 00 6
% Para$e&amol !00mg 00 %
# (e&adine "00ml #
' 2 in*s 40 '
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10 Spi& "ml 100 10
11 Spi& ! ml 100 11
1 )a&g& 4 (2@D 1
1" 5n*se& deasa 0 1"
14 58.$a&h No+1# 0 (2@D 141! 58.$a&h No+0 0 (2@D 1!
16 assa s&eril 16x16 "0 16
1% ,asker 100 1%
1# Ples&er 1#
1' Sarng T NS , 00 (2@D 1'
0 Sarng T NS 2 100 (2@D 0
1 Sarng T s&eril %.! !0 (2@D 1
@nderpad 0 " Dopler ell "
4 Amlodipin 10mg 60 4
! @rine bag ! !
6
%
#
'
Arasari+ ..1" ;li 01!
9ang menyerahkan 9ang menerima 9ang
..Snsn Smirah........... ...(dn /is.................. ....Sn
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : !-PK"+II#0$,*************************************** N' : *
D.era8kan ke6a1a : **P-.t- "ekar3aya**************** D.era
Pesanan dari : ............................................................ Pesan
Tanggal :.............................................. No : ************ Tangg
No Nama Barang Banyaknya Keterangan No
1 Ambroxol &ab 00 1
Amlodipin 10mg 60
" Amoxi$illin !00mg 00 "
4 Amoxi$illin syr 0 4
! An&a$id syr 10 !
6 An&a$id &ab "00 6
% As me*e !00mg 100 %# )ap&opril 1.!mg 100 #
' )T, "00 '
10 Para$e& syr 0 10
11
1
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Arasari+ ..1" ;li 01!
9ang menyerahkan 9ang menerima 9ang
..Snsn Smirah........... ...(dn 7 esih.................. ....Sn
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : *********!-PK"+II#0$,*********************************** N' : *
D.era8kan ke6a1a : **Loket o4at********************** D.era
Pesanan dari : ........................................................ Pesan
Tanggal :........................................ No : ****$0**** Tangg
No Nama Barang Banyaknya Keterangan No
1 Allop "00 41
Ambroxol !00 4
" Amlodipin 1'0 4"
4 Amox !00mg "000 44
! Amox syr 110 4!
6 An&a$id syr !0 46
% An&a$id &ab 1100 4%
# /rgo&amin 100
' Ansol !0
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10 As me*e 1600
11 A$y$ sk 10
1 (e&a sk 100
1" )ap&op 1.! %00
14 )T, 40001! o&rim syr '0
16 o&rim D 600
1% /ry&rom !0 !00
1# /&anol %0 "00ml "
1' i?anol "
0 Orali& 100
1 3liben$lamid 100
7idro sk #0" e&ona-ol !0
4 loro $ap 600
! ,e&ro !00mg '00
6 Ni*edipin &ab 0
% aominal syr 10!
# Oxy&e&ra sm 1!
' Para$e& !00mg 10100
"0 Para$e& syr #%
"1 Pyran&el 100
" Piroxi$am %00
"" (e&adin "00ml 1
"4 (e&adin "0ml !
"! Pred &ab 16!0
"6 ani& &ab 100
"% Salb& 00"# 4 sk #
"' Sim?as&a&in 400
40 Te&ra !0mg 1000
Arasari+ ..% ;li 01!
9ang menyerahkan 9ang menerima 9ang
................................ .................................. ....Sn
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
!-PK"+II#0$,**********************************************
8kan ke6a1a : ****P-.t- Baro.******************************************************
n dari : ..............................................................................................
l :..................................................................... No : ................
Nama Barang Banyaknya Keteran
gan
Allop &ab 100
Ambroxol &ab "00
Amlodipin 10mg '0
Amoxi$illin !00mg 100
Amoxi$illin syr 10
An&a$id syr 0
An&a$id &ab 00
As ,e*e !00mg 100A$y$lo?ir sk !
o&rim D &ab 100
3en&ian 8iole& !
7idro Sk 10
loram*e !0mg 00
Para$e& syr !
Para$e& &ab !00
Piroxi$am 0mg 100
Prednison &ab 1!0
ani& &ab 100
8i& (5 &ab "00
Bink syr !
apas 1
,asker !0
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Arasari+ ... 1" ;li 01!.
enyerahkan 9ang menerima
sn Smirah (dn 5nne..........
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
!-PK"+II#0$,*********************************************
8kan ke6a1a : ****Po Gg*********************************
n dari : ..............................................................................................
l :..................................................................... No : .........
Nama Barang Banyaknya Keteran
gan
apas !0mg
Alkohol %0 "00ml 4
(e&adine "00ml 1
Spi& "ml 100
2ido$ain in '0
,asker !0
Al?ogyl
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Arasari+ ...1" ;li 01!..........
enyerahkan 9ang menerima
sn Smirah ................................
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
...........................................................................................................
kan kepada : ...................................................................................
n dari : ..............................................................................................
l :..................................................................... No : ................
Nama Barang Banyaknya Keteran
gan
Sim?as&a&in 100
8i& (5 &ab 1000
8i& () 1000
Spi& "ml "00
Spi& !ml 100
)anla D !
)anla A !
)a&g& 4 (2@D
)a&h No 1# % (2@D
5n*se& anak !0
5n*se& deasa !0
58.)a&h No.6 10 (2@D
58.)a&h No.0 0 (2@D
58.)a&h No. 0 (2@D
58.)a&h No.4 10 (2@Dapas !
kassa 4x10 !0
,asker "00
Ples&er #
Silk 0 (2@D
2oma&lle 0
Sabn $air 1
Plas&ik k 14 pak (2@D
Plas&ik ( pak (2@D
Sarng T s&eril %.! !0
-
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Arasari+ 1" ;li 01!..........
enyerahkan 9ang menerima
sn Smirah obby
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
* !-PK"+II#0$,*********************************************
8kan ke6a1a : ***Po.ke.1e. "ang-n3aya***************************************
n dari : ..............................................................................................
l :..................................................................... No : **************
Nama Barang Banyaknya Keteran
gan
Ambroxol &ab 00
Amoxi$illin !00mg "00
An&a$id syr 10
An&a$id &ab "00
8i& ) &ab 1000
As ,e*e !00mg 100
(e&a Sk !
)T, 00
,e&ro !00mg 100
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Ni*edipin &ab !0
Para$e& syr 0
Para$e& !00mg !00
ani& &ab 00
Salb& mg !04 Sk !
8i& () !00
Bink syr !
Spi& " ml 100
kassa 4x10 10
Ples&er 1
Sarng T NS , 100
Sabn $air 13en&ian 8iole& !
Neo in 10
2 "
Abo$a&h 1# !
,e&hergin in !
5n*se& D !
)a& g& !
Arasari+ .1" ;li 01!........
enyerahkan 9ang menerima
sn Smirah (dn 5mas........
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
* !-PK"+II#0$,*********************************************
8kan ke6a1a : ***Po.ke.1e. "ekar3aya*****************************************
n dari : ..............................................................................................
l :..................................................................... No : **************
Nama Barang Banyaknya Keterangan
Amoxi$illin !00mg "00
,e&ro !00mg 100
Para$e& syr 10
As me*e !00mg 100
An&a$id &ab 00
An&a$id syr 10
Bink syr !8i& (6 &ab 1000
Ambroxol &ab 100
S 0
Spi& " ml 100
Orali& 100
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Arasari+ .1" ;li 01!.........
enyerahkan 9ang menerima
sn Smirah (dn 7 esih.......
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
***********************************************************************************************************
8kan ke6a1a : ********************************************************************************
n dari : ..............................................................................................
l :..................................................................... No : ******************
Nama Barang Banyaknya Keteran
gan
8i&amin (5 &ab %00
T7 00
Bink syr 60
8i&amin () 1"00
Spi& "ml #00
Sabn $air
Plas&ik 6
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Arasari+ ...% ;li 01!.........
enyerahkan 9ang menerima
sn Smirah Snsn Smirah
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : %7 Ag.PK"+III#0$,*************************************** N' :
D.era8kan ke6a1a : **P-.t- /arga-y-***************** D.er
Pesanan dari : ........................................................... Pesan
Tanggal :............................................... No : ...." Tangg
No Nama Barang Banyaknya Keterangan No
1 Al2oprinol 100 1
Aminop &ab 100
" Amlodipin 10mg &ab 60 "
4 Amox !00mg &ab 400 4
! Amox !0mg &ab 100 !
6 Amox syr 0 6
% An&algin !oomg &ab 00 %
# An&a$id syr "0 #' Asam me*e !00mg 00 '
10 (e&ason sk 10 10
11 )ap&ro 1.!mg &ab 100 11
1 )ap&ro !mg &ab "00 1
1" )T, &ab 00 1"
14 enox &k 10 14
1! (i$na& &ab 100 1!
16 O(7 "0 16
1% Oxy&e&ra sk ! 1%
1# Para$e& syr 0 1#
1' Para$e& !00mg &ab 1000 1'
0 Piroxi$am 0mg 00 0
1 (e&hadin "00ml 1 1
ani& &ab 100
" Plas&ik ( 6 pak "
4 Plas&ik 1 pak 4
!
6
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Arasari+ ..6 Ags&s 01!
9ang menyerahkan 9ang menerima 9ang
..Snsn Smirah 2$iano ....Sn
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : 7$ Ag.PK"+II#0$,**************************************** N' :
D.era8kan ke6a1a : **Po.ke.1e. /arga-y-******** D.er
Pesanan dari : ............................................................ Pesan
Tanggal :............................................... No : E%E.... Tangg
No Nama Barang Banyaknya Keterangan No
1 Amoxi$illin !00mg "00
,e&ro !00mg 00
" Para$e&amol #00
4 Para$e&amol syr !
! As ,e*e !00mg 00
6 An&a$id &ab 00
% An&a$id syr !
# ani& &ab 00
' Bink syr !
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10 () &ab "00
11 8i& ) !0mg !00
1 )T, 00
1" )ap&op ! mg 100
14 Ni*edipin 10mg !01! alk !00mg !00
16 i?anol "
1% Alkohol %0 "00ml
1# (e&adin 1
1' assa 16>16 10
0 7idro sk 10
1 Salb& mg !0
Neo in 10" O(7 1!
4 (e&ason sk !
! @nderpad 10
6 Amlodipin 10mg 60
% Spi& 1ml 100
# Ples&er 1
'
Arasari+ ..6 Ags&s 01!
9ang menyerahkan 9ang menerima 9ang
..Snsn Smirah (dn a&ih ....Sn
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : %, Ag.PK"+III#0$,************************************** NO : .
D.era8kan ke6a1a : **Pera&atan***************************** Disera
Pesanan dari : ............................................................ Pesan
Tanggal :............................................... No : ........1.... Tangg
No Nama Barang Banyaknya Keterangan No
1 Al2oprinol 00 41
Ambroxol &ab !00 4
" Aminop 00mg &ab 100 4"
4 Amlodipin 10mg "00 44
! Amox !00mg !00 4!
6 Amox syr !! 46
% An&al !00mg 00 4%
# An&a$id syr 100 4#
' An&a$id &ab #00 4'
10 As me*e !00mg !00 !0
11 A$y$lo?ir sk 10 !1
1 A$y$lo?ir 400mg 00 !
1" (e&ason sk 1! !"
14 )ap&op ! 00 !4
1! )T, 600 !!16 o&rim syr ! !6
1% o&rim 4#0mg "00 !%
1# /ry&rom syr 10 !#
1' /ry&rom !0mg 100 !'
0 Domperindon &ab 100 60
1 Alkohol %0 "00ml 6 61
Orali& 100 6
" 3lkosa ! in* 40 6"
4 7)T !mg 00 64
! 7idro sk 4 6!
6 loram !0mg !00 66
% ,e&ro !00mg 100 6%
# (i$na& !00mg !00 6#
' Na$l in* 40 6'
"0 O(7 100 %0"1 O,B 0mg "0 %1
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" Para$e& syr !0 %
"" Para$e& !00mg !00 %"
"4 8i& (6 10mg 1000 %4
"! Piroxi$am 0mg 00
"6 (e&adin "0ml !"% (e&adin "00ml !
"# Prednison !mg 1000
"' ani& 1!0mg !00
40 Salb& mg 00
Arasari+ ..6 Ags&s 01!
9ang menyerahkan 9ang menerima 9ang
............................... ..................................... ....Sn
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : %% Ag.PK"+III#0$,******************************** N' : *
D.era8kan ke6a1a : **Pone1****************************** D.er
Pesanan dari : ...................................................... Pesan
Tanggal :............................................. No : ******#****** Tangg
No Nama Barang Banyaknya Keterangan No
1 Amoxi$illin !00mg "00 1
An&a$id syr 10
" As me*e !00mg 00 "
4 /&anol %0 1 &r 4
! Neo in 0 !
6 2idokain in "0 6
% ,e&hergin &ab 100 %
# ,&ehergin in 10 #
' ,e&ro !00mg 100 '
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10 Para$e& !00mg "00 10
11 (e&adin "00ml 11
1 inger lak&a& in* 0 1
1" Spi& "ml 100 1"
14 )a& g& 1 141! apas !0mg 1 1!
16 assa s&eril 16x16 60 16
1% ,asker 100 1%
1# Sarng T NS , 100 1#
1' Sarng T NS S 100 1'
0 Sarng T NS 2 100 0
1 Sarng T s&eril %.! !0 1
@nderpad 0 " @mbilikal klem 0 "
4 Dopler ell 4
! Amlodipin 10mg 60 !
6 @rine bag ! 6
% Plas&ik ( 1
# Oxy&osin in 100
Arasari+ ..6 Ags&s 01!
9ang menyerahkan 9ang menerima 9ang
..Snsn Smirah........... ...(dn /is.................. ....Sn
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : %5 Ag.PK"+III#0$,************************************ N' : *
D.era8kan ke6a1a : **P-.t- "ekar3aya**************** D.er
Pesanan dari : ............................................................ Pesan
Tanggal :.............................................. No : *******,***** Tangg
No Nama Barang Banyaknya Keterangan No
1 o&rim syr 0 1
7idro sk 10
" alk !00mg 00 "
4 ,e&ro !00mg &ab 100 4
! Para$e& syr 0 !
6 Pred !mg 00 6
% ani& 1!0mg 100 %# Sim?as 10mg 100 #
' Bink syr ! '
10
11
1
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Arasari+ ..10 Ags&s 01!
9ang menyerahkan 9ang menerima 9ang
..Snsn Smirah........... ...(dn 7 esih.................. ....Sn
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : ***79**Ag.PK"+III#0$,********************************* N' : *
D.era8kan ke6a1a : **Loket o4at********************** D.er
Pesanan dari : ........................................................ Pesan
Tanggal :........................................ No : ****5**** Tangg
No Nama Barang Banyaknya Keterangan No
1 Allop 600 41
Ambroxol 600 4
" Aminop &ab 100 4"
4 Amlodipin 10mg ''0 44
! Amox !00mg 600 4!
6 Amox syr 6! 46
% An&a$id syr %! 4%
# An&a$id &ab '00 4#
' As *ola& 1mg "00
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10 8i& ) !0mg 1000
11 As me*e !00mg 600
1 A$y$lo?ir sk 1!
1" (e&ason sk 40
14 )ap&op !mg 4001! )o&rim syr '!
16 )o&rim 4#0mg 00
1% Dia-epam mg 00
1# /&anol %0 1l& "
1' enox &k 14
0 Orali& 00
1 33 4#00
3liben$lamid 100" 7idro sk 1!%
4 alk !00mg #00
! loro !0mg !00
6 (i$na& &ab 400
% Ni*edip &ab %0
# Oxy&e&ra sm !
' O(7 "!
"0 Para$e& !00mg #'00
"1 Para$e& syr ""4
" 8i& (6 &ab 1%00
"" Piroxi$am 0mg !00
"4 Phenyl b&a- &ab %00
"! (e&adin "0ml 4
"6 Prednison &ab "600
"% ani& 1!0mg 1'00"# 4 sk '
"' 8i& (1 &ab 1"00
40 T7 TA( "00
Arasari+ ..1 Ags&s 01!
9ang menyerahkan 9ang menerima 9ang
................................ .................................. ....Sn
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
%2 Ag.PK"+III#0$,**********************************************
8kan ke6a1a : ****P-.t- Baro.******************************************************
n dari : ..............................................................................................
l :..................................................................... No : .......4.....
Nama Barang Banyaknya Keteran
gan
Allop &ab 100
Amlodipin 10mg '0
Amox !00mg 100
Amox syr 10
An&a$id syr 0
An&a$id &ab 100
8i& ) !0mg !00
As me*e !00mg 100)T, 100
o&rim syr 10
/&anol %0 "00ml 1
33 00
7)T !mg 00
7idro sk 10
O(7 0
Para$e& syr !
Para$e& !00mg !00
8i& (6 10mg "00
Piroxi$am 0mg 100
(e&adin "00ml 1
Prednison !mg 00
ani& 1!0mg 100
Salb& mg !0
8i& (1 !0mg 00
8i& () 100
Bink syr !
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Arasari+ ... 6 Ags&s 01!.
enyerahkan 9ang menerima
sn Smirah (dn 5nne..........
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
Ag.PK"+III#0$,*********************************************
8kan ke6a1a : **********************************************************
n dari : ..............................................................................................
l :..................................................................... No : .........
Nama Barang Banyaknya Keteran
gan
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Arasari+ ... Ags&s 01!..........
enyerahkan 9ang menerima
sn Smirah ...............Dina 3,.................
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
...........................................................................................................
kan kepada : ...................................................................................
n dari : ..............................................................................................
l :..................................................................... No : ................
Nama Barang Banyaknya Keteran
gan
inger 2ak&a& in* "00
4 sk 10
(iopla$en&on sk 10
Sim?as&a&in 10mg 100
)endo &m 10
8i& (1 !0mg 1000
8i& () #00
Spi& 1ml 00
Spi& "ml "00
Spi& !ml 100
Spi& 10ml 100
)a&g& 11
. )a&h 16 !
. )a&h 1# 10
5n*se& anak !05n*se& deasa 100
58.)a&h 1# 1!
58.)a&h 0 0
58.)a&h 4 "0
58.)a&h 6 0
apas !0mg !
assa 4>10 !0
assa 16>16 60
Ples&er %
Sarng &angan NS 2 100
Sarng &angan NS , 100
Sarng &angan s&eril % !0
Silk 10
@rin bag 10
Sabn $air 2oma&lle 0
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/&anol %0 "00ml
8i& k &ab 100
Neo in 10
7idro sk !
,e&ro !00mg 100O(7 10
Para$e& syr 0
Para$e& &ab !00
(e&adine "00ml 1
ani& 1!0mg 100
4 sk !
8i& () &ab 00
Bink syr !Spi& "ml 100
apas 1
assa 4>1! 10
@nderpad 10
Arasari+ .10 Ags&s 01!.....
enyerahkan 9ang menerima
sn Smirah (dn 5mas........
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
* 70 Ag.PK"+III#0$,******************************************
8kan ke6a1a : ***Po.ke.1e. "ekar3aya*****************************************
n dari : ..............................................................................................
l :..................................................................... No : ******%********
Nama Barang Banyaknya Keteran
gan
Para$e& !00mg !00
Para$e& syr 10
As me*e !00mg 100
An&a$id syr 10
Bink syr !
8i& (5 &ab !00
8i& () &ab "00O(7 10
Ni*edip 10mg "0
assa 16>16 10
Sarng &angan s&eril % 10
alk !00mg !00
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Arasari+ E1 Ags&s 01!..
enyerahkan 9ang menerima
sn Smirah Snsn Smirah
-
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : 7% Se6PK"I#0$,*************************************** N' :
D.era8kan ke6a1a : **P-.t- /arga-y-***************** D.er
Pesanan dari : ........................................................... Pesan
Tanggal :............................................... No : ....4...... Tangg
No Nama Barang Banyaknya Keterangan No
1 Allop 100mg &ab "00 1
Amlodipin 10mg &ab "0
" Amox !00mg &ab !00 "
4 Amox !0mg kap 00 4
! Amox syr 0 !
6 An&a$id syr "0 6
% An&a$id &ab "00 %
# Ansol spp 10 #' (e&ason sk 10 '
10 )ap&rop 1.!mg &ab "00 10
11 )ap&rop !mg &ab 00 11
1 )T, "00 1
1" )o&rim syr ! 1"
14 $o&rim ds &ab 100 14
1! 3liben$lamid &ab 100 1!
16 33 &ab 1000 16
1% 7idro sk 10 1%
1# O((7 syr "! 1#
1' Par$e& syr "0 1'
0 Para$e& !00mg &ab #00 0
1 Piroxi$am &ab 00 1
Pred &ab !00
" ani&idin &ab 00 "
4 Salb& mg &ab 100 4
! 4 sk ! !
6 Sim?as&a&in 10mg &ab 100 6
% 8i& (5 &ab 1000
# 8i& () &ab #00
' assa 4>10 10
"0 Sabn $air 1
"1 Bink syr 10" Plas&ik klip !
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Arasari+ ..14 Sep&ember 01!
9ang menyerahkan 9ang menerima 9ang
..Snsn Smirah 2$iano ....Sn
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : 20 Se6PK"I#0$,**************************************** N' :
D.era8kan ke6a1a : **Po.ke.1e. /arga-y-******** D.er
Pesanan dari : ............................................................ Pesan
Tanggal :............................................... No : E%E.... Tangg
No Nama Barang Banyaknya Keterangan No
1 Amox !00mg &ab "00 1
)o&rim ds &ab 100
" ,e&ro !00mg &ab 00 "
4 Para$e& !00mg &ab #00 4
! Para$e& syr ! !
6 An&a$id &ab 00 6
% An&a$id syr 0
# ani&idin &ab 100
' Bink syr 10
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10 Bink &ab 100
11 8i& (5 &ab !00
1 8i& (6 &ab 1000
1" 8i& () &ab 00
14 8i& ) !0mg &ab 10001! )T, "00
16 33 &ab !00
1% )ap&op 1.!mg &ab 00
1# 7)T !mg &ab 00
1' i?anol 4
0 Alkohol %0 1000ml 1
1 (e&adin "00ml 1
assa s&eril16>16 1!" apas 1
4 Oxy sm !
! 7idro sk 10
6 Salb&amol mg &ab 100
% O(7 syr 0
# (e&son sk 10
' @nderpad 10
"0 Sabn $air 1
"1 Sarng T NS no.2 100
Arasari+ ..14 Sep&ember 01!
9ang menyerahkan 9ang menerima 9ang
..Snsn Smirah (dn a&ih ....Sn
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : 79 Se6PK"I#0$,************************************** NO : .
D.era8kan ke6a1a : **Pera&atan************************* Disera
Pesanan dari : ............................................................ Pesan
Tanggal :............................................... No : .......1..... Tangg
No Nama Barang Banyaknya Keterangan No
1 Allop 100mg &ab 00 41
Amox !00mg &ab !00 4
" Amox !0mg kap !00 4"
4 Amox syr !0 44
! An&algin !00mg &ab 1000 4!
6 An&a$id syr 100 46
% An&a$id &ab #00 4%
# Ansol spp 10 4#
' 8i& ) !0mg &ab 1000 4'
10 As me*e !00mg &ab !00 !0
11 A$y$lo?ir sk 10 !1
1 A$y$lo?ir 400mg &ab 00 !
1" (e&ason sk 1! !"
14 )ap&op 1.!mg &ab 00 !4
1! )ap&op !mg &ab 00 !!16 )T, &ab 1000 !6
1% )o&rim syr 0 !%
1# )o&rim ds &ab !00 !#
1' Dia-epam re$&al ! !'
0 /&anol %0 1000ml % 60
1 enox &k ! 61
8i& &ab 100 6
" Orali& sak 100 6"
4 3en&ian ?iole& ! 64
! 3lkosa ! in* 40 6!
6 33 &ab 1000 66
% 7)T !mg &ab 00 6%
# 7idro sk 4 6#
' e&okona-ole &ab !0 6'
"0 loro !0mg kap !00 %0"1 2idokain in '0 %1
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" ,e&ro !00mg &ab 00 %
"" (i$na& !00mg &ab !00 %"
"4 Na$l in* 40 %4
"! O(7 syr 100
"6 Para$e& syr #0"% Para$e& !00mg &ab "000
"# Piroxi$am &ab 00
"' (e&adin "0ml !
40 (e&adin "00ml !
Arasari+ ..14 sep&ember 01!
9ang menyerahkan 9ang menerima 9ang
............................... ..................................... ....Sn
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : 7 Se6PK"I#0$,******************************** N' : *
D.era8kan ke6a1a : **Pone1****************************** D.er
Pesanan dari : ...................................................... Pesan
Tanggal :............................................. No : *******#***** Tangg
No Nama Barang Banyaknya Keterangan No
1 Amox !00mg &ab "00 1
An&a$id &ab 100
" /&anol %0 1000ml "
4 8i& Neo in 60 4
! 3liserin ! !
6 2idokain in "0 6
% ,e&hergin in 0 %
# ,e&ro !00mg &ab 00 #
' Oxy&e&ra sm ! '
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Arasari+ ..14 Sep&ember 01!
9ang menyerahkan 9ang menerima 9ang
..Snsn Smirah........... ...(dn 7 esih.................. ....Sn
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : **2#*Se6PK"I#0$,********************************* N' : *
D.era8kan ke6a1a : **Loket o4at********************** D.er
Pesanan dari : ........................................................ Pesan
Tanggal :........................................ No : ***$0**** Tangg
No Nama Barang Banyaknya Keterangan No
1 Allop !00 41
Ambroxol &ab !00 4
" Aminop &ab 400 4"
4 Amox !00mg "'00 44
! Amox !0mg 1000 4!
6 Amox syr 1#0 46
% An&al !00mg 400 4%
# An&a$id syr 1! 4#
' An&a$id &ab '00 4'
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10 Ansol spp 10 !0
11 8i& ) !0mg 4000 !1
1 As me*e !00mg 00 !
1" A$y$lo?ir sk 1! !"
14 (e&ason sk !0 !41! )ap& 1.!mg 100
16 )ap& !mg 1000
1% )T, !100
1# )o&rim syr 160
1' )o&rim Ds %00
0 /&anol %0 1000ml "
1 enok &k 1#
Orali& 600" 33 "!00
4 3liben 100
! 7)T 600
6 7idro sk #0
% alk &ab 100
# e&ona-ol 1!0
' loro !0mg 1!00
"0 ,e&ro !00mg 00
"1 (i$na& "00
" Oxy&e&ra sm 60
"" O(7 !00
"4 Para$e& &ab %'00
"! Para$e& syr ""6
"6 (6 &ab "000
"% Piroxi$am '00"# Pred &ab 600
"' ani& &ab 1400
40 4 sk "
Arasari+ .. Sep&ember 01!
9ang menyerahkan 9ang menerima 9ang
................................ .................................. ....Sn
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Arasari+ 14 Sep&ember 01!
enyerahkan 9ang menerima
sn Smirah (dn 5nne..........
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
7, Se6PK"I#0$,*********************************************
8kan ke6a1a : **********************************************************
n dari : ..............................................................................................
l :..................................................................... No : ....".....
Nama Barang Banyaknya Keteran
gan
Alkohol %0 1000ml
assa gl 1
Spi& 1ml 00
assa 4>10 0
Sarng T NS no., 00
-
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Arasari+ 14 Sep&ember 01!
enyerahkan 9ang menerima
sn Smirah ...............Dina 3,.................
-
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
...........................................................................................................
kan kepada : ...................................................................................
n dari : ..............................................................................................
l :..................................................................... No : ................
Nama Barang Banyaknya Keteran
gan
Pred &ab 1000
ani&idin &ab %00
Salb&amol mg &ab 00
Salb& neb 60
4 sk 6
Sim?as&a&in &ab 100
Te&ra !0mg kap 00
8i& (5 &ab 1000
8i& () &ab #00
Bink &ab 100
Spi& 1ml 00
Spi& "ml 00
Spi& !ml 100
Spi& 10ml 100
Abo$a& 1# 0Abo$a& 0 !0
Abo$a& 4 1!
Abo$a& 6 1!
apas 4
assa 4>10 !0
kassa s&eril 16>16 60
assa gl 1
,asker 00
ples&er 10
Sarng T NS S 100
Sarng T NS , "00
Sarng T NS 2 100
Silk 4#
Sabn $air "
8aselin sab 0Plas&ik #
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Plas&ik ( %
Scabimet sk 5
Metoclopramid inj 90
Arasari+ 14 Sep&ember 01!
enyerahkan 9ang menerima
sn Smirah obby
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
* 2$Se6PK"I#0$,******************************************
8kan ke6a1a : ***Po.ke.1e. "ang-n3aya***************************************
n dari : ..............................................................................................
l :..................................................................... No : *********5*****
Nama Barang Banyaknya Keteran
gan
Amox !00mg &ab "00
An&algin !00mg &ab 100
An&a$id syr 0
An&a$id &ab 00
(e&ason sk !
)ap&op !mg &ab 100
)T, &ab 00
$o&rim ds &ab 100
i?anol
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
* 75 Se6PK"I#0$,******************************************
8kan ke6a1a : ***Po.ke.1e. "ekar3aya*****************************************
n dari : ..............................................................................................
l :..................................................................... No : *****7*********
Nama Barang Banyaknya Keteran
gan
,e&ro !00mg &ab 100
Para$e& !00mg &ab !00
Para$e& syr 1!
An&a$id &ab 00
An&a$id syr 1!
8i& (5 &ab 00
O(7 syr !alk !00mg &ab 100
S$abime& sk
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Arasari+ .14 Sep&ember 01!
enyerahkan 9ang menerima
sn Smirah (dn 7 esih.......
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
***********************************************************************************************************
8kan ke6a1a : ********************************************************************************
n dari : ..............................................................................................
l :..................................................................... No : *********$0***
Nama Barang Banyaknya Keteran
gan
Sim?as& &ab "00
Te&ra !0mg "00
(1 &ab !"00
Bink syr 0
Bink &ab %00
() &ab 6!00
Spi& "ml 00
apas "
@ri& parame&er !00
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Plas&ik k 1%
Plas&ik b 111
A$&ren T3 1!
A$&ren oles 1!
A$&ren 3lkos %!
Arasari+ Sep&ember 01!
enyerahkan 9ang menerima
sn Smirah Snsn Smirah
-
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : 2%'ktPK"#0$,*************************************** N' :
D.era8kan ke6a1a : **P-.t- /arga-y-************* D.er
Pesanan dari : ........................................................... Pesan
Tanggal :............................................... No : ..4.. Tangg
No Nama Barang Banyaknya Keterangan No
1 Alloprinol 100mg "00 1
Amox !00mg 400
" Amox !0mg "00 "
4 Amox syr 0 4
! An&algin !00mg "00 !
6 An&a$id syr ! 6
% An&a$id &ab 400 %
# (e&ason sk 10 #' )ap&op 1.!mg "00 '
10 )ap&op !mg "00 10
11 )T, 00 11
1 )o&rim 4#0mg 100 1
1" 3liben$l &ab 100 1"
14 loro !0mg 100 14
1! Ni*edipin !0 1!
16 O(7 10 16
1% Para$e& syr 1! 1%
1# Para$e& !00mg 1000 1#
1' Piroxi$am 0mg 00 1'
0 4 sk ! 0
1 Plas&ik ! 1
" "
4 4
!
6
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Arasari+ ..! Ok&ober 01!
9ang menyerahkan 9ang menerima 9ang
..Snsn Smirah 2$iano ....Sn
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : 50'ktPK"#0$,**************************************** N' :
D.era8kan ke6a1a : **Po.ke.1e. /arga-y-*** D.er
Pesanan dari : ....................................................... Pesan
Tanggal :........................................... No : #EE.... Tangg
No Nama Barang Banyaknya Keterangan No
1 Amox !00mg "00 1
Amox syr !
" )o&rim ds &ab 100 "
4 )o&rim syr !
! ,e&ro !00mg 00
6 Para$e& !00mg '00
% Para$e& syr 1!
# An&a$id &ab 00
' An&a$id syr !
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10 ani& 00
11 Bink &ab 100
1 8i& (5 &ab !00
1" 8i& (6 &ab !00
14 8i& () 001! 8i& ) !0mg 1000
16 )T, "00
1% 33 &ab !00
1# )ap&op 1.!mg 100
1' )ap&op !mg 100
0 7)T !mg 00
1 alk !00mg !00
Orali& 100" (e&adin "00ml 1
4 assa 16>16 0
! apas 1
6 Oxy&ra sm 10
% 7idro sk 10
# A$y$lo?ir sk !
' ,e&hergin in !
"0 Oxy&osin in 10
"1 Neo in 10
" O(7 !
"" ,$os exp
"4 (e&ason sk !
"! @nderpad 10
"6 Spi& 1ml 100
"% ST non s&eril , 100"# Bink syr 10
"' an!la d"s 3
40
Arasari+ 1 Ok&ober 01!
9ang menyerahkan 9ang menerima 9ang
..Snsn Smirah (dn a&ih ....Sn
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : 29'ktPK"#0$,************************************** NO : .
D.era8kan ke6a1a : **Pera&atan***************************** Disera
Pesanan dari : ............................................................ Pesan
Tanggal :............................................... No : ....1........ Tangg
No Nama Barang Banyaknya Keterangan No
1 Alloprinol 100mg 00 41
Amox !00mg 000 4
" Amox !0mg !00 4"
4 Amox syr !0 44
! An&a$id syr 1!0 4!
6 An&a$id &ab #00 46
% A$y$lo?ir sk 10 4%
# 3liben$lamid 100 4#
' (e&ason sk 1! 4'
10 )ap&op 1.!mg 00 !0
11 )ap&op !mg 00 !1
1 )T, #00 !
1" o&rim syr 0 !"
14 o&rim 4#0mg !00 !4
1! Dia-epam re$& ! !!16 /ry&rom syr ! !6
1% Dimenhidrina& &ab 100 !%
1# /&anol %0 1000ml " !#
1' enok &k ! !'
0 8i& &ab 100 60
1 Orali& 100 61
38 10 6
" 3lkosa ! in* 0 6"
4 33 &ab 1000 64
! 7)T !mg 00 6!
6 7idro sk 4 66
% loro !0mg "00 6%
# ,e&ro !00mg 100 6#
' (i$na& &ab !00 6'
"0 Na$l in* 40 %0"1 O(7 100 %1
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" Oxy&e&ra sm 10 %
"" Para$e& syr 100 %"
"4 Para$e& !00mg !00 %4
"! Piroxi$am 0mg 00
"6 Po?idon "00ml "% Po?idon "0ml "
"# Pred !mg 1000
"' ani& &ab #00
40 Salb& mg 00
Arasari+ ..% Ok&ober 01!
9ang menyerahkan 9ang menerima 9ang
............................... ..................................... ....Sn
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : 2'ktPK"#0$,******************************** N' : *
D.era8kan ke6a1a : **Pone1****************************** D.er
Pesanan dari : ...................................................... Pesan
Tanggal :............................................. No : *****#******* Tangg
No Nama Barang Banyaknya Keterangan No
1 Amox !00mg 00 1
As ,e*e !00mg 100
" Spi& "ml 00 "
4 Spi& !ml 100 4
! 5n*se& ds 10 !
6 58 )a&h 1# 10 6
% ,asker !0 %
# ST non s&eril , 100 #
' ST non s&eril S 100 '
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10 @nderpad 10 10
11 @mbilikal klem ! 11
1 ;elly dopler 4 1
1" @rine bag ! 1"
14 Plas&ik ( " 141! Nela&hon )a&h 1 ! 1!
16 Pipa endo&rakeal .! 1 16
1% Pipa endo&rakeal ".0 1 1%
1# Pipa endo&rakeal ".! 1 1#
1' Pipa endo&rakeal 4.0 1 1'
0 )a&h penghisap ! 1 0
1 )a&h penghisap 6 1 1
)a&h penghisap # 1 " )a&h penghisap 10 1 "
4 )a&h penghisap 1 1 4
! )a&h penghisap 14 1 !
6 er&as lakms 1 6
% er&as saring 10 %
# er&as @S3 1 #
' S&ile& 4." 1 '
"0 )anla ds !
"1 )anla anak
" )a&h penghisap 1# 1
Arasari+ .! Ok&ober 01!
9ang menyerahkan 9ang menerima 9ang
..Snsn Smirah........... ...(dn /is.................. ....Sn
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10 )ap& 1.!mg 1"00
11 )ap& !mg 1"00
1 )T, !'00
1" o&rim syr 110
14 o&rim ds &ab "001! /ry&ro !0mg 400
16 Orali& "00
1% 38 !
1# 33 "000
1' 7)T 600
0 7idro sk #1
1 alk 1000
,e&ro !00mg 1000" (i$na& 00
4 Oxy&e&ra sm 6!
! O(7 ""!
6 Para$e& &ab '400
% Para$e& syr "14
# 8i& (6 "!00
' Pirox 0mg 1000
"0 Pred #00
"1 ani& 100
" Sim?as 10mg 00
"" 8i& (5 4000
"4 Bink syr 40
"! Bink &ab 600
"6 8i& () 1"00
"% Spi& "ml 00"# Plas&ik ( %4
"' Plas&ik 1"0
40 Obek glass 0
Arasari+ ..1! Ok&ober 01!
9ang menyerahkan 9ang menerima 9ang
................................ .................................. ....Sn
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
27'ktPK"#0$,**********************************************
8kan ke6a1a : ****P-.t- Baro.******************************************************
n dari : ..............................................................................................
l :..................................................................... No : ....!........
Nama Barang Banyaknya Keteran
gan
Alloprinol 100mg 100
Amox !00mg 00
Amox syr !
An&a$id syr 10
An&a$id &ab 100
(e&ason sk !
)T, "00
33 &ab !00Oxy&e&ra sm !
Para$e& syr 1!
Para$e& !00mg !00
8i& (6 &ab !00
Piroxi$am 0mg 100
Pred !mg 00
ani& &ab 100
4 sk !
8i& (5 &ab !00
8i& () &ab 00
Bink &ab 100
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Arasari+ ! Ok&ober 01!
enyerahkan 9ang menerima
sn Smirah (dn 5nne..........
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
2, 'ktPK"#0$,******************************************
8kan ke6a1a : ******Po Gg*************************************
n dari : ..............................................................................................
l :............................................ No : ..."......
Nama Barang Banyaknya Keteran
gan
Spi& "ml 100
Sarng &angan NS , 00
2idokain in 100
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Arasari+ ! Ok&ober 01!
enyerahkan 9ang menerima
sn Smirah ...............Dina 3,.................
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
...........................................................................................................
kan kepada : ...................................................................................
n dari : ..............................................................................................
l :..................................................................... No : ................
Nama Barang Banyaknya Keteran
gan
2 !00
4 sk !
Sim?as&a&in 10mg 100
8i& (5 &ab 1000
8i& () &ab #00
Bink &ab 100
Bink syr !
Spi& 1ml 00
Spi& "ml 00
Spi& !ml 100
5n*se& anak 0
58 )a&h 0 4%
58 )a&h %0
58 )a&h 4 6
58 )a&h 6 !0apas
assa 4>! 100
,asker 1!0
Ples&er 14
ST non s&eril 2 100
ST non s&eril , 100
Silk "6
Sabn $air
Plas&ik !
Plas&ik ( "
Sendok oba& 100
(is&ri !0
7ipa*ix %
;arm he$& kli& !
2idokain in 60Na& di$ !0mg "00
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,e&ro !00mg 100
(i$na& !00mg 00
O(7 10
Oxy&e&ra sm !
Para$e& syr 1!Para$e& !00mg !00
(e&adin "00ml 1
ani& 100
8i& () "00
Spi& "ml 100
apas 1
Ples&er ( 1
Sabn $air 1Neo in 10
Oxy&osin in 10
2 in*
,e&hergin in !
5n*se& D !
)a&g& !
ST s&eril % 10
Arasari+ .1 Ok&ober 01!
enyerahkan 9ang menerima
sn Smirah (dn 5mas........
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
* 25'ktPK"#0$,******************************************
8kan ke6a1a : ***Po.ke.1e. "ekar3aya*****************************************
n dari : ..............................................................................................
l :..................................................................... No : *****7*********
Nama Barang Banyaknya Keteran
gan
Amox !00mg 00
,e&ro !00mg 100
Para$e& syr 1!
An&a$id &ab 00
An&a$id syr 1!
ani& &ab 100
(i$na& !00mg 100Bink &ab 100
8i& &ab 100
)T, 100
O(7 10
33 !00
alk !00mg "00
/rgome&rin in 10
Oxy&osin in 10
Neo in 10
Orali& 100
Ples&er ( 1
Oxy&e&ra sm !
7idro sk !
4 sk !
ST s&eril % !
ST s&eril %.! !
-
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Arasari+ .1 Ok&ober 01!
enyerahkan 9ang menerima
sn Smirah (dn 7 esih.......
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
***********************************************************************************************************
8kan ke6a1a : ********************************************************************************
n dari : ..............................................................................................
l :..................................................................... No : ******************
Nama Barang Banyaknya Keteran
gan
Spiri&s 1000ml 10
Tip ning "
De$k glass "
Na& di$ !0mg %00
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Arasari+ 1! Ok&ober 01!
enyerahkan 9ang menerima
sn Smirah Snsn Smirah
-
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DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : No;PK"I#0$,***************************************** N' :
D.era8kan ke6a1a : **P-.t- /arga-y-******************** D.er
Pesanan dari : ........................................................... Pesan
Tanggal :............................................... No : .... Tangg
No Nama Barang Banyaknya Keterangan No
1 Alloprinol 100mg "00 1
Aminop &ab 100
" Amox !00mg !00 "
4 Amox !0mg "00 4
! Amox syr 0 !
6 An&a$id &ab !00 6
% 8i& ) &ab !00 %
# (e&a sk 1! #' )ap& 1.!mg 100 '
10 )ap& !mg "00 10
11 )T, "00 11
1 )o&rim syr ! 1
1" Dexa &ab "00 1"
14 3liben$ &ab 100 14
1! 7idro sk 10 1!
16 5bp 400mg "00 16
1% 8i&amin syr 0 1%
1# (i$na& &ab 100 1#
1' Na&rim di$klo* !0mg 100 1'
0 Ni*edip &ab !0 0
1 O(7 ! 1
Pon*l syr 1!
" Oxy&e&ra sm 10 "
4 Para$e& syr ! 4
! Para$e& !00mg 1000 !
6 8i& (6 &ab !00 6
% Pred &ab 00 %
# Salb& &ab 100
' 8i& (5 &ab 1000
"0 8i& () &ab !00
"1 ,asker !0" Ples&er 1
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"" Pon*l &ab 100
"4 Plas&ik ( "
"! Plas&ik 4
Arasari+ .14 No?ember 01!
9ang menyerahkan 9ang menerima 9ang
..Snsn Smirah 2$iano ....Sn
DINAS KESEHATAN KABUPATEN BANDUNG
BUKTI BARANG KELUAR ( BBK )
N' : No;PK"I#0$,************************************* N' :
D.era8kan ke6a1a : **Po.ke.1e. /arga-y- D.er
Pesanan dari : ....................................................... Pesan
Tanggal :........................................... No : EE.... Tangg
No Nama Barang Banyaknya Keterangan No
1 Amox !00mg "00 41
Amox syr ! 4
" o&rim syr ! 4"
4 ,e&ro !00mg 100 44
! Para$e& !00mg 1000
6 Para$e& syr !
% An&a$id &ab 00