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Green Manufacturing in Yakult

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Green manufacturing is a manufacturing measure that produces minimal waste and pollution. This is done through product and process design. With modifications to the production or manufacturing process of an organization, the entire process will release lesser toxic waste or use lesser energy. Green manufacturing addresses process redundancy, ergonomics, and cost implications due to faulty methods of producing goods (Balan, 2008). A good example of faulty methods of producing goods would be the mining of gold. The mining of gold involves the release of mercury from waste rock when it is exposed to normal temperatures because the evaporation point for mercury is a lot lower than normal metals (Engle MA, Gustin MS, Zhang H, 2001) Once in the atmosphere, it can be deposited in soils and waters, hence causing harm to the environment or the people who would later drink from the water. The Clinton White House defined green manufacturing as a process that reduces human and ecological tasks, enhances, cost effectiveness, improves process efficiency, and creates products and processes that are environmental friendly and benign (President, 1995). Having this stated, green manufacturing is a process that improves productivity, competitiveness, and profitability.
The benefits of having a green manufacturing process in an organization’s production are immeasurable. While it may be tough and expensive to implement a greener technology in a production, green technology would nevertheless save a lot of money for an organization. A good example of this would be the production of compact fluorescent lamp where it produces the same amount of visible light as an incandescent light bulb, it uses lesser energy while having a longer life time. This cost saving benefit has been taken by organizations to redesign their production process. Indeed, those organizations that have taken up green measures in their production process have enjoyed cost reductions. An impressive reduction of energy cost to up to 6 percent, cutting of facility costs by 7 percent, and reduction in logistic costs up to 7 percent have been achieved by various organizations (Fabricators and Manufacturers Association, 2011). In many cases, green manufacturing also reduces the carbon emissions that contribute to global warming whilst significantly lowering other chemicals that are hazardous to the environment (United States Department of Energy). The concern of global warming can never be ignored in the 21st century when the loss of floating ice is equivalent to 1.5 million Titanic-sized icebergs each year (ScienceDaily, 2010). This loss of floating ice in our ocean has caused sea level to rise quickly, hence causing archipelagoes such as Kirimati, a home to 92,500 people to sink gradually (Marks, 2006).
Current adoption of the green manufacturing process varies between organizations. Fujitsu built a next-generation Green Factory in Kuwana City, Mie Prefecture in April 2005 with various equipments and operations that offered various benefits (Fujitsu and the Environment - Environmental performance, 2005). The factory emits no hazardous chemicals to the atmosphere by recycling hydrofluoric and sulfuric acid, whilst having various new equipments installed to reduce carbon dioxide – a major cause of the current global warming issue. Subaru, the automobile manufacturer of Japan did not lag behind in the adoption of green manufacturing too. Subaru has taken major projects to reduce the emission of carbon dioxide in its process from 2006 – 2007 when the organization has successfully reduced 5,721 tons of carbon dioxide by installing air shut-off valves, reducing excess lighting and also lowering plant air pressure. The organization also reduced a whopping total of 6,000 gallon of oil in waste discharge and achieved a total of 79 percent of waste reduction in its operations (Easterday).
While the benefits for green manufacturing may be obvious, there are still various challenges faced by various organizations to adapt this measure. The high initial cost in adapting green manufacturing burdens most organizations hence many business owners are still reluctant in adapting this practice. Whilst green manufacturing is known to provide obvious cost cutting measures, the initiative to go green sometimes conflict the firm’s exisiting priorities (Lee, 2009). Nevertheless, the future of green manufacturing provides a better outlook. Better and more efficient machines in the future may make it easier for us to achieve energy savings and sustainability. Softwares could also be developed to examine characteristics of a material that might relate to a machine’s tool performance so the machine can be tuned to achieve best performance at maximum energy savings (Schelmatic, 2010).

Introduction
Company Background
Yakult has grown to become a world leader in probiotics and operate in 32 countries across five continents now. There is over 28 million people drink Yakult every day for good health. Yakult (Malaysia) Sdn Bhd is a wholly owned subsidiary of Yakult Honsha, Japan. Yakult has committed millions of ringgit to establish and operated a factory in Seremban, Negeri Sembilan on year 2004 and the head office in Glenmarie, Shah Alam. Since then, they also have opened branch offices in Johor Bahru, Melaka, Penang, Kuantan, Ipoh, Seremban and Kota Bharu. (YAKULT (M) SDN.BHD., 2010)Yakult (M) Sdn Bhd currently employs over 180 people throughout Malaysia. Their employees include production workers, sales consultants, customer service officers, administrative staff, managers and human resources personnel.
Philosophy
The Yakult philosophy is consists of preventive medicine emphasis should be placed on medicine that prevents illness, rather than on treating illness once it develops. A healthy intestine leads to a long life which human beings take in nutrition through their intestines. A healthy life for all define as making the intestines strong leads to healthy and long lives. The aim of probiotics is the use of beneficial bacteria that migrate to the intestine for the maintenance and promotion of good health. The corporate philosophy is contribute to the health and happiness of people around the world through the pursuit of excellence in life science in general and research and experience in microorganisms in particular. Refer to appendix-photo 10 as well. (Yakult Philosophy, 2010)
Principal activities and strategy
The Yakult that we drink in Malaysia is produced from high quality, carefully selected ingredients from around the world and packaged in technologically advanced local manufacturing facility, incorporating some of the latest food processing equipment. Hence, the overall production process can known as product focus. The products are producing in high volume and low variety within shortly period of time. On the other hand, their products are made to order. Nevertheless, it still keeps small volume of stocks to prevent the any accident occurs that cause delay to customers.
Besides that, they are implementing the corporate social responsibility like minimize pollution. The water contained residual materials and chemicals placed in the oxidation tanks shown in appendix photo 9. In order to diverse types of microorganisms and precise amount of chlorine sited into the tanks and digest the residual wastes. So, that can ensure the water purified before release into the drains.
The Yakult factory in Malaysia produces Yakult drinks for the customers of peninsular Malaysia and Sarawak, as well as for export to neighbouring countries like Singapore. Public whose are interesting and more understand Yakult, can get information by sign up for the factory tour. This service can also enhance the image of corporate brand. Yakult Malaysia determines new packaging for the products to compete with Vitagen drinks in domestic market. Therefore, it is obviously different to same brand at other nations, refer photo 11.
All Yakult products produced by the Yakult factory in Malaysia are certified Halal by the Department of Islamic Development Malaysia (JAKIM). The Yakult factory has been awarded the HACCP.Yakult is a high quality probiotics in the form of a cultured milk drink which contain the probiotic bacteria "Lactobacillus casei Shirota" (popularly known as the "Shirota strain") with over 30 billion in each bottle. It is scientifically proven to be strongest strains of beneficial bacteria which also free of preservatives, colourings and stabilizers.
Yakult drinks divided into two Yakult Ace and Yakult Ace Light in 80ml per bottle. Yakult Ace is the original version of Yakult cultured milk drink for the Malaysian market, which has a higher concentration of the beneficial Shirota strain and contains added nutrients such as calcium, niacin and vitamins B6, B12 and D. It is the one of full of vitamins that suits for everyone especially children. Yakult Ace Light cultured milk drink has the same high concentration of Shirota strain as Yakult Ace, 30 billion in each bottle, but with 50 percent less sugar and a lighter, less sweet taste. Therefore, it is free of fat, cholesterol, colourings, preservatives, conditioners, stabilizers, and more suits for elder people.

Content- Production Processes
The production process of fermented milk drink Yakult is concerned with transforming a range of inputs into outputs that are required by the market. Each machines are introduced by HACCP systems to ensure the company produce safe and reliable products, and comply with objectives of the ISO14001 standard that operations can be reduce the level of environmental impact. There are nineteen steps for the production process shown as following:

1. Mixing of Raw Ingredients
Firstly, for “Yakult Ace”, the skim milk powder, sugar and dextrose are mixed with filtered and sterilized water to make a sweet milky solution. Nevertheless, “Yakult Ace Light” will add least 50% sugar if compared with “Yakult Ace”.
2. Sterilization
Secondly, the sweet milky solution sterilized at a high temperature for a short time to destroy any bacteria that may be present. This process is called UHTST (Ultra Heat Treatment, Short Time). Then, the solution is transferred to a 6,000-litre fermentation tank via a closed system of pipes and valves.
3. Fermentation Tank
The live bacteria “Lactobacillus Casei Shirota” (by referring to appendix II photo 1) which is cultured and tested in the laboratory is added to tank. The temperature of the fermentation tank then reduced until the contents are at 37°C (body temperature). Next, the solution is ferment in the tank for 6-9 days or until the numbers of Lactobacillus Casei Shirota bacteria reach their ideal concentration.
4. Flavor Tank
After the solution, the citrus flavor is added to the concentrate (Yakult).
5. Storage Tank
Then, the flavored concentrate Yakult solution is transferred to a 12,000 liters storage tank (by referring appendix II photo 2), containing a chilled syrup solution. The tank is chilled to around 2°C.
6. Water Sterilizer
At the same time, water that contains any dissolved chlorides and chlorides are de-mineralized by a process called "reverse osmosis". After the water UV sterilized, it will store in a 25,000 liters holding tank before mix with the flavored concentrate Yakult.
7. Mixing Tank
The flavored concentrate Yakult is very full-bodied in this step. Therefore, the assembly line workers have to add sterilized water to reduce the deepness of Yakult. The concentrate is diluted with filtered, then sterile water at a ratio of 1:1.
8. Control Panel
From the seven steps mentioned, the machines are fully computerized and fully control the flow of production. For instance, different colored lights indicate which areas that need more attention. This control system can help to reduce human works. Therefore, help to reduce risk of infection by others bacteria toward Yakult.
9. Injection Blow Moulding Machine
In this step, the plastic bottles also produced in factory by using the material called “triple grade food polystyrene”. The injection blow-moulding machine functioned to produce 7,000 bottles per hour under its capacity.
10. Bottle Storage Tank
After that, the plastic bottles produced are stored in a large sterile bottle storage tank which able to store about 780,000 bottles. The bottles stored are enough for one week of production and bottling of Yakult.
11. Selector
Then, bottles drop down from the bottle storage tank into a large circular selector, which places the bottles in a standard position before fed onto the filling line.
12. Printing Station
After that, the bottles move along the conveyer belt to the printing station. By referring to Appendix II, photo 3, the name "Yakult" and labeling information are required by law, printed on the bottle in an instant-drying, red ink for “Yakult Ace” and blue ink for “Yakult Ace Light”.
13. Filling, Capping & Sealing Machine
After that, the bottles move along to the filling machine to fill with Yakult drinks. The filling machine has the capacity to fill in 36,000 bottles of Yakult per hour. After the bottles filled with Yakult, the completed products capped with a foil lid, printed with a use-by date, and transferred along the conveyor belt to the packaging facility.
14. Shrink-Wrap & Packaging Machine By referring to appendix II photo 4, the single bottles of Yakult sorted into groups of five and shrink-wrapped in polyethylene film (chemistry names). Then, Ten "five packs" are grouped together by packaging machine, wrapped again in polyethylene film, finally forming a "carton" of 50 Yakult bottles.
15. Finished Product
Finally, the packages of Yakult drinks produced and prepared for delivery.
16. Refrigeration Room
Then, the finished products transferred to a pallet, wrapped and stored at a temperature of 2-3°C while awaiting delivery to the stores. In order to make sure “Yakult” always fresh and deliver to customer, the products will not store in this refrigeration room over 2 days. Instead, they will sell or distribute the products to other places.
17. Selling and Distribution
Yakult Company has distributed their products and sells off at all hypermarkets, supermarkets, and sundry shop within west Malaysia. Moreover, restaurants like Sushi King and some hospitals provided Yakult products. Customers can enjoy fresh Yakult at home because Yakult Company has also recruit and hire Yakult Ladies to deliver the products within the certain housing areas, by referring to appendix II photo 7 and 8.
18. Hygiene
Yakult is a fermented milk drink, which contains a live bacterial culture. To maintain the high quality of Yakult, quality checker staff makes sure the strict hygiene standards in the production. By referring to appendix II photo 5, every employee must wearing apron, glove, chapeau, and respirator. Besides, quality checker also concern about the cleanliness of equipments all the time. Every tank must clean and disinfected every time after used.

19. Yakult Quality Assurance
Yakult maintains a comprehensive quality assurance program in order to maintain standards for personnel and factory hygiene, equipment cleaning, processing methods and parameters, and product handling. For this reason, samples are collected scientist (by referring to appendix II photo 6) for laboratory analysis throughout the production process to confirm that the products are always in the standard quality.
The testing involves more than 150 samples per production run. That means the test will conducted every hour from every steps of production to determine the number of bacteria “Lactobacillus Casei Shirota”, potential contaminants, microbiological quality, composition, acidity, physical attributes and taste. In addition, each bottle is inspected for undesirable markings and incorrect printing. Furthermore, Yakult Company from Japan will distribute technicians to repair and make some maintenance on the machinery every half year.
There are few problems identified from the present production process. In order to produce products with efficient, Yakult have been invested greater amount of capital to assembly those greater size of equipment. In addition, the equipments setup almost similar with the other Yakult factory which place at different regions. So, it can say that long term planning from the parent company of Yakult in Japan. There are all of high technology equipments that significance fixed cost to company before manufacture the products. Besides that, the equipments need to maintenance and check up within certain period of time, due to keep the quality of equipments.
The equipments can produce in high volume but low variety of Yakult drinks. The standardized products manufactured difficult to change because it will influence worldwide markets. It is also classify as inflexible production process. Moreover, the equipments in large size can manufacture much of products and also consume much of electric power. Hence, electric power can save costs and benefits to environment if the systems working by use from natural solar or wind power. However, Yakult Malaysia’s factory still has not utilized the natural electric power.

The whole transportation route of equipments consider very long and can divide into few of rooms. The production line consists of processing section and bottling section. Normally, the injection moulding machine never shut down because used for manufacture bottle in high quantity every day. There is extra add on bottle storage tank when peak sales seasons like New Year. There are various kind of equipments placed at bottling section and each of its direct and continuous working. If any equipment occur problem that will cause shortage on all line of equipments. Therefore, capacity planning must careful in order to fulfill the constraints. On the other hand, we anticipate the probably occur barriers when the process implement green manufacturing. The time consuming will be very high if changes on equipments and packaging of products. As the Yakult drinks must keep under cool temperature, the research and development team sure study many years and determine the packaging of products. The plastic bottles can be manufactured quickly and control the quality of fermented milk drink. There are huge project to restart or alter few of the production process. The packaging of finish goods changing not only affect to production department, and also selling and distribution department. In spite of the alternative of plastic bottles settle, will lead to face on another problem such as prices. Packaging of products also is a direct cost of goods before sell off to customers. Green manufacturing can be save time and the step of process therefore the costs of firm can be reduced. Then, customers can get low price on products or the firm can get more profits. On the other way round, green manufacturing can add on other steps to produce or extra labors in need. The prices of product will increase when the cost of manufacture increased. The firm has to consider the perception of customers and environment changes. The products finished by green manufacturing whether cater to most of the customers. For instance, customers willing to pay more purchase the green products. Purchasing power and awareness of environment protection still high by how many customers. Although behavior of customers can be influence and educate by advertisements or manufacturer, the firm also has to prepare enough capital and time to make changing decision. Otherwise, the firm may faces high risk to develop and continuous business.

6. Water sterilizer
Green Manufacturing Framework
19. Selling and distribution
18. Refrigeration room
17. Finished Product
16. Shrink-wrap, and packaging machine
8. Paperboard manufactured on a Fourdrinier Machine

9. Thin film of molten polyethylene is applied to paperboard

10. Waterproof paperboard is wound into a large roll

11. Forming and Bottom Sealing
12. Bottle storage tank
13. selector
14. Printing station
15. Filling, capping, and sealing machine
7. Mixing tank
4. Flavor tank
5. Storage tank
3. Fermentation tank

2. Sterilization
1. Mixing of raw ingredients

As opposed to the graph of the production process previously, three processes which are the control panel, hygiene, and Yakult Quality Assurance, have been intentionally left out in the graph of our green manufacturing process. This is because we will be discussing the addition of green manufacturing process in this section and not because we have deemed the previous three processes unnecessary in the implementation of the proposed green manufacturing process. Carton packaging has been around for centuries, dating as far back as 1908 when it was first found in commercial sale (History: The Alliance for Beverage Cartons and The Environment). According to a research by Institute for Energy and Environmental Research, carton packaging is also the most environmentally friendly form of packaging; cutting carbon dioxide emissions and fossil fuel consumption up to 60 percent compared to other forms of packaging (Stones, 2009). Due to the benefits of carton packaging and also the vast usage of it by various beverages in the world, it is plausible to replace plastic in the production of Yakult. Four new processes have been introduced to the current production process of Yakult in our attempt to create an environmentally friendly process for the organization. These four new processes will be replacing the usage of plastic bottles in the packaging of this cultured milk drink. Instead, the new manufacturing process will be using carton packaging which benefits the environment. These four new processes can be introduced to the current production process of Yakult simply by getting a couple of equipments and new materials. The organization needs to get a Fourdrinier machine which will be used to manufacture wood chips. These wood chips will then be grinded and shaped to a dried paperboard before being submitted to a few more processes to achieve a glossy and waterproof carton finish. Lastly, the finished carton will then be sealed and loaded onto the bottle storage tank.

Recommendation
Paperboard manufactured on a Fourdrinier Machine
In the new manufacturing process, the carton packaging will be replacing the usage of plastic bottles. Carton packaging is a type of paperboard, the process of making the carton of Yakult is begins with wood chips. Soften the wood chips by heating and bathing them in chemicals, then break them and make it become pulp. After that, bleach the pulp before remove the debris. Then, refine the pulp. Next, the refined pulp flows into the headbox of the Fourdrinier machine. After the process in the headbox, steam-heated cylinders will dry the paperboard.
Thin film of molten polyethylene is applied to paperboard
The dried paperboard is pulled through the rollers, the polyethylene clings to both sides of the paperboard in a thin film. There are several grades of polyethylene combined in the extruder, therefore the machine has lays down multiple layers. There are different tasks must be accomplished by the different layers, such as reducing moisture and oxygen penetration and aiding in essential oil retention.
Waterproof paperboard is wound into a large roll
The paperboard become waterproof after apply the thin film of molten polyethylene to paperboard. It is wound into a large roll and to be transported to the printing area.
Forming and bottom sealing
There is specialized machinery used to transform the blanks into open containers. The blanks are loaded a chute that lead to the forming machine, then the blanks are pulled by suction down onto forming mandrels.

Carton packaging communicates environmental friendliness. Paperboard is the only infinitely renewable packaging material because it comes from natural resources that can be continuously renewed. Paperboard of carton packaging is reused and recycled more than any other packaging material. The paperboard not only can be recycled, it also can be biodegraded, like the biodegradable plastic bag that widely used by most of the supermarket. Furthermore, the cost of this paperboard carton packaging is quite high, because it needs new machinery to produce. Moreover, the paperboard carton packaging can create recycle awareness. Normally people will throw the package into rubbish bin and neglect the importance of classification of recycle material. It is easy to remind people about recycle when they are holding the paperboard carton packaging. It is because most of the people thought that paper is the easiest to recycle, therefore they usually do the recycle for paper.

Conclusion In the future, Yakult may face the challenges of implementing the idea of green manufacturing. Green manufacturing management is not easy to carry out and may cost a lot to change their current manufacturing process to carton packaging. It is because changing the packaging need to have new machinery to carry out the new packaging. With the change of new machine, the cost of production will increase. After the implementation, the company should carry out a new marketing plan to boost the sales. Paperboard carton package’s most basic component is wood chips. Wood is a sustainable, renewable, environmentally responsible resource. Paper recycling is beneficial to business, our communities and environment. Yakult has taken the corporate social responsibilities as using paperboard carton packaging will not harm the environment since it is reusable. As Yakult having corporate social responsibilities, it enhances the image of the company and may influence the purchasing power and the loyalty level of consumer. In conclusion, the four new processes which are paperboard manufactured on a Fourdrinier Machine, thin film of molten polyethylene is applied to paperboard, and waterproof paperboard is wound into a large roll , and forming and bottom sealing have been introduced to the current production process of Yakult in our attempt to create an environmentally friendly product for the organization. The carton packaging communicates environmental friendliness because it comes from natural resources that can continuously renew. The company may faces challenge when started to apply the process but it can be overcome. Since there are benefits of carton packaging, it is plausible to replace plastic in the production of Yakult.

Reference 1. Balan, K. (2008). Introduction to Green Manufacturing. Wheelabrator Group. 2. Easterday, T. Lean, Green Automotive Manufacturing. The Industry Leader in Environmental Proceedings (pp. 6-12). Indiana: Subaru. 3. Engle MA, Gustin MS, Zhang H. (2001). Quantifying Natural Source Mercury Emissions from the Ivanhoe Mining Distric. Atmospheric Environment . 4. Fabricators and Manufacturers Association. (2011). Green Manufacturing Practices in America can Help Profits, Will Help Planet. Fabricators and Manufacturers Association.(2005). 5. Fujitsu and the Environment - Environmental performance. Fujitsu Group. 6. Lee, S. (2009). Getting serious about Green Manufacturing. Frost & Sullivan. 7. President, E. O. (1995). Bridge to a Sustainable Future. Executive Office of the President. 8. Schelmatic, T. (2010). Current Issues in Green Manufacturing. ThomasNetNews. 9. United States Department of Energy. Rebuilding after Disaster: Going Green from the Ground Up. United States Department of Energy. 10. YAKULT (M) SDN.BHD. (2010). Yakult Malaysia-General. Retrieved February 29, 2012, from http://www.yakult.com.my/html/yakult_my_general.html 11. Yakult Australia. (n.d.). Retrieved February 28, 2012, from http://www.yakult.com.au/resources/popups/pop_product03.htm 12. Yakult Corporate Japan. (31 March, 2007). PUTTING PROBIOTICS ON THE MAP-ANNUAL REPORT 2007( page 38). Retrieved 20 February, 2012, from Yakult/ Japan/English/AnnualReport2007: http://ir.yakult.co.jp/english/material/annual/pdf/ar2007.pdf 13. Yakult Philosophy. (2010). Retrieved February 29, 2012, from http://www.yakult.com.my/html/our_philosophy.html 14. Marks, K. (2006, October 25). World: NZ Herald. Retrieved March 3, 2012, from NZ Herald: http://www.nzherald.co.nz/world/news/article.cfm?c_id=2&objectid=10407508 15. ScienceDaily. (2010, April 28). Science News: Science Daily. Retrieved March 3, 2012, from Science Daily: http://www.sciencedaily.com/releases/2010/04/100428142258.htm

Appendix
Photo 1- Bacteria “Lactobacillus Casei Shirota”

Photo 2- Storage Tank

Photo 3- “Yakult Ace” and “Yakult Ace Light”

Photo 4- Single bottle of Yakult into group of five

Photo 5- Employee wearing apron, glove, chapeau and respirator

Photo 6- Scientist

Photo 7 and 8- Yakult Ladies

Photo 9- Oxidation tank

Photo 10- Philosophy

Photo 11- Packaging in other countries

--------------------------------------------
[ 2 ]. Hazard Analysis and Critical Control Points (HACCP) certification by Moody International since 2006.The HACCP system is a management tool that systematically identifies specific hazards and control measures to ensure the safety of food products. The system is recognized worldwide and accepted as an effective system for food safety.

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...No. Nama Perguruan Tinggi AKADEMI AKUNTANSI PGRI JEMBER Nama Pengusul Sisda Rizqi Rindang Sari Program Kegiatan Judul Kegiatan 1 PKMK KUE TART CAENIS ( CANTIK, ENAK DAN EKONOMIS) BERBAHAN DASAR TAPE 2 AKADEMI FARMASI KEBANGSAAN Nensi MAKASSAR AKADEMI KEBIDANAN CITRA MEDIKA SURAKARTA AKADEMI KEBIDANAN GIRI SATRIA HUSADA AKADEMI KEPERAWATAN KERTA CENDIKA SIDOARJO AKADEMI KEPERAWATAN KERTA CENDIKA SIDOARJO AKADEMI KEPERAWATAN KERTA CENDIKA SIDOARJO Putri Purnamasari PKMK LILIN SEHAT AROMA KURINDU PANCAKE GARCINIA MANGOSTANA ( PANCAKE KULIT MANGGIS ) 3 PKMK 4 Latifah Sulistyowati PKMK Pemanfaatan Potensi Jambu Mete secara Terpadu dan Pengolahannya sebagai Abon Karmelin (Karamel Bromelin) : Pelunak Aneka Jenis Daging Dari Limbah Nanas Yang Ramah Lingkungan, Higienis Dan Praktis PUDING“BALECI”( KERES) MAKANAN BERSERATANTI ASAM URAT 5 Achmad PKMK Zainunddin Zulfi 6 Dian Kartika Sari PKMK 7 Radita Sandia PKMK Selonot Sehat (S2) Diit untuk Penderita Diabetes 8 AKADEMI PEREKAM Agustina MEDIK & INFO KES Wulandari CITRA MEDIKA AKADEMI PEREKAM MEDIK & INFO KES Anton Sulistya CITRA MEDIKA AKADEMI PEREKAM Eka Mariyana MEDIK & INFO KES Safitri CITRA MEDIKA AKADEMI PEREKAM MEDIK & INFO KES Ferlina Hastuti CITRA MEDIKA AKADEMI PEREKAM Nindita Rin MEDIK & INFO KES Prasetyo D CITRA MEDIKA AKADEMI PEREKAM MEDIK & INFO KES Sri Rahayu CITRA MEDIKA AKADEMI PERIKANAN YOGYAKARTA PKMK Kasubi Wingko Kaya Akan Karbohidrat...

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