NAMA MUHAMMMAD ZACQY AR'FALY (18-57-33)

NO REGISTRAI J-IGD-20180620-014
KAMAR

TANGGAL KETERANGAN NO. NOTA STAFF

08-05-2018 BIAYA PENDAFTARAN J-ADM-1805-162783 SHINTIA
08-05-2018 MASA PERDARAHAN (BT) I-LAB-1805-590438 SRY
08-05-2018 GULA DARAH SEWAKTU I-LAB-1805-590438 SRY
08-05-2018 HEMATOKRIT I-LAB-1805-590438 SRY
08-05-2018 HEMOGLOBIN I-LAB-1805-590438 SRY
08-05-2018 MASA PEMBEKUAN (CT) I-LAB-1805-590438 SRY
08-05-2018 LEUKOSIT I-LAB-1805-590438 SRY
08-05-2018 TROMBOSIT I-LAB-1805-590438 SRY
09-05-2018 BLOOD SET TERUMO QTY 1.0 I-APTK-1805-590484 JIMMY
09-05-2018 OTSU WATER INJ 25ML (BPJS) QTY 1.0 I-APTK-1805-590484 JIMMY
09-05-2018 ASAM TRANEKSAMAT 500MG INJ (BPJS) QTY 4.0 I-APTK-1805-590484 JIMMY
09-05-2018 ALCOHOL SWAB (BPJS) QTY 10.0 I-APTK-1805-590484 JIMMY
09-05-2018 SELANG SUCTION 10 QTY 1.0 I-APTK-1805-590484 JIMMY
09-05-2018 ATROPIN SULFAT 0.25MG INJ (BPJS) QTY 1.0 I-APTK-1805-590484 JIMMY
09-05-2018 DEXAMETASON 5MG INJ (BPJS) QTY 4.0 I-APTK-1805-590484 JIMMY
09-05-2018 I.V CATH SURFLO PORT 20 (BPJS) QTY 1.0 I-APTK-1805-590484 JIMMY
09-05-2018 CEFOTAXIM 1G INJ (BPJS) QTY 3.0 I-APTK-1805-590484 JIMMY
09-05-2018 ONDANSETRON 4MG INJ (BPJS) QTY 1.0 I-APTK-1805-590484 JIMMY
09-05-2018 RANITIDIN INJ (BPJS) QTY 1.0 I-APTK-1805-590484 JIMMY
09-05-2018 SANTAGESIC 500MG INJ (BPJS) QTY 1.0 I-APTK-1805-590484 JIMMY
09-05-2018 SPUIT 3 CC (BPJS) QTY 5.0 I-APTK-1805-590484 JIMMY
09-05-2018 KETOROLAC 30MG INJ (BPJS) QTY 1.0 I-APTK-1805-590484 JIMMY
09-05-2018 PROTOFEN SUPP (BPJS) QTY 2.0 I-APTK-1805-590484 JIMMY
09-05-2018 SPUIT 5 CC (BPJS) QTY 5.0 I-APTK-1805-590484 JIMMY
09-05-2018 INFUSAN RL SP (BPJS) QTY 6.0 I-APTK-1805-590484 JIMMY
09-05-2018 SPUIT 1 CC (BPJS) QTY 1.0 I-APTK-1805-590484 JIMMY
09-05-2018 SPUIT 10 CC (BPJS) QTY 2.0 I-APTK-1805-590484 JIMMY
09-05-2018 NEOSTIGMIN HAMEIN INJ (BPJS) QTY 1.0 I-APTK-1805-590484 JIMMY
09-05-2018 SPALK ANAK QTY 1.0 I-APTK-1805-590484 JIMMY
09-05-2018 CARBAZOCHROME INJ (BPJS) QTY 2.0 I-APTK-1805-590485 JIMMY
09-05-2018 NATRIUM CHLORIDA 0.9% (BPJS) QTY 1.0 I-APTK-1805-590506 YAYA
09-05-2018 JASA ASKEP I-BGS-1805-590568 WULAN
09-05-2018 JASA ASKEP I-BGS-1805-590568 WULAN
09-05-2018 VISITE DR RUANGAN I-BGS-1805-590568 WULAN
09-05-2018 JASA INFUS DEWASA/ANAK I-BGS-1805-590568 WULAN
09-05-2018 PELAYANAN DASAR & ADMINISTRASI I-BGS-1805-590578 WULAN
09-05-2018 OTSU-NS 100 ML PIGGYBACK QTY 1.0 I-APTK-1805-590629 YAYA
09-05-2018 EPINEPRINE INJ (BPJS) QTY 1.0 I-APTK-1805-590629 YAYA
09-05-2018 CARBAZOCHROME INJ (BPJS) QTY 1.0 I-APTK-1805-590629 YAYA
09-05-2018 INFUSAN RL SP (BPJS) QTY 2.0 I-APTK-1805-590785 SAPPHIRE
09-05-2018 CEFOTAXIM 1G INJ (BPJS) QTY 2.0 I-APTK-1805-590785 SAPPHIRE
09-05-2018 KETOROLAC 30MG INJ (BPJS) QTY 3.0 I-APTK-1805-590785 SAPPHIRE
09-05-2018 ASAM TRANEKSAMAT 500MG INJ (BPJS) QTY 2.0 I-APTK-1805-590785 SAPPHIRE
09-05-2018 DEXAMETASON 5MG INJ (BPJS) QTY 3.0 I-APTK-1805-590785 SAPPHIRE
09-05-2018 RANITIDIN INJ (BPJS) QTY 2.0 I-APTK-1805-590785 SAPPHIRE
09-05-2018 SPUIT 3 CC (BPJS) QTY 8.0 I-APTK-1805-590785 SAPPHIRE
09-05-2018 SPUIT 5 CC (BPJS) QTY 4.0 I-APTK-1805-590785 SAPPHIRE
09-05-2018 OTSU WATER INJ 25ML (BPJS) QTY 1.0 I-APTK-1805-590785 SAPPHIRE
09-05-2018 ALCOHOL SWAB (BPJS) QTY 10.0 I-APTK-1805-590785 SAPPHIRE
09-05-2018 FENTANIL 0.05ML INJ (BPJS) QTY 1.0 I-APTK-1805-590810 RUBY
09-05-2018 RECOFOL N INJ QTY 1.0 I-APTK-1805-590810 RUBY
09-05-2018 ATROPIN SULFAT 0.25MG INJ (BPJS) QTY 1.0 I-APTK-1805-590810 RUBY
09-05-2018 NEOSTIGMIN HAMEIN INJ (BPJS) QTY 1.0 I-APTK-1805-590810 RUBY
10-05-2018 I.V CATH NO. 24 (BPJS) QTY 2.0 I-APTK-1805-591041 SAPPHIRE
10-05-2018 JASA ASKEP I-BGS-1805-591052 SHINTIA
10-05-2018 VISITE DR SPESIALIS I-BGS-1805-591052 SHINTIA
10-05-2018 CEFADROXIL 500MG CAP(BPJS) QTY 10.0 I-APTK-1805-591105 SAPPHIRE
10-05-2018 DEXAMETASON 0.5MG TAB (BPJS) QTY 10.0 I-APTK-1805-591105 SAPPHIRE
10-05-2018 PARACETAMOL 500MG TAB (BPJS) QTY 15.0 I-APTK-1805-591105 SAPPHIRE
10-05-2018 VISITE DR SPESIALIS I-BGS-1805-591186 NINI
10-05-2018 KELAS II-2-121 ANAK-1 - 2 HARI I-BGS-1805-591187 NINI
11-05-2018 PROSEDUR TONSIL & ADENOID (RINGAN)-ANASTESI-BGS-1805-591568 LIDIYA
11-05-2018 PROSEDUR TONSIL & ADENOID (RINGAN) I-BGS-1805-591568 LIDIYA
11-05-2018 BIAYA ADMINISTRASI I-BGS-1805-591569 LIDIYA
15-05-2018 BIAYA PENDAFTARAN J-ADM-1805-167088 ERIK
20-06-2018 BIAYA PENDAFTARAN J-ADM-1806-187474 NINI
KWITANSI JUMLAH
KPJ-1805-19401 Rp -
KPJ-1805-19401 Rp 30,000
KPJ-1805-19401 Rp 30,000
KPJ-1805-19401 Rp 27,500
KPJ-1805-19401 Rp 27,000
KPJ-1805-19401 Rp 30,000
KPJ-1805-19401 Rp 30,000
KPJ-1805-19401 Rp 27,000
KPJ-1805-19401 Rp 20,070
KPJ-1805-19401 Rp 3,432
KPJ-1805-19401 Rp 19,536
KPJ-1805-19401 Rp 1,584
KPJ-1805-19401 Rp 9,474
KPJ-1805-19401 Rp 1,672
KPJ-1805-19401 Rp 11,072
KPJ-1805-19401 Rp 19,272
KPJ-1805-19401 Rp 21,780
KPJ-1805-19401 Rp 4,501
KPJ-1805-19401 Rp 3,206
KPJ-1805-19401 Rp 7,395
KPJ-1805-19401 Rp 10,626
KPJ-1805-19401 Rp 6,001
KPJ-1805-19401 Rp 5,713
KPJ-1805-19401 Rp 12,936
KPJ-1805-19401 Rp 79,358
KPJ-1805-19401 Rp 2,957
KPJ-1805-19401 Rp 8,480
KPJ-1805-19401 Rp 10,100
KPJ-1805-19401 Rp 7,288
KPJ-1805-19401 Rp 28,322
KPJ-1805-19401 Rp 7,692
KPJ-1805-19401 Rp 150,000
KPJ-1805-19401 Rp 150,000
KPJ-1805-19401 Rp 40,000
KPJ-1805-19401 Rp 91,080
KPJ-1805-19401 Rp 18,000
KPJ-1805-19401 Rp 20,114
KPJ-1805-19401 Rp 7,665
KPJ-1805-19401 Rp 14,161
KPJ-1805-19401 Rp 26,453
KPJ-1805-19401 Rp 14,520
KPJ-1805-19401 Rp 18,002
KPJ-1805-19401 Rp 9,768
KPJ-1805-19401 Rp 8,304
KPJ-1805-19401 Rp 6,413
KPJ-1805-19401 Rp 17,002
KPJ-1805-19401 Rp 10,349
KPJ-1805-19401 Rp 3,432
KPJ-1805-19401 Rp 1,584
KPJ-1805-19401 Rp 49,920
KPJ-1805-19401 Rp 131,539
KPJ-1805-19401 Rp 1,672
KPJ-1805-19401 Rp 10,100
KPJ-1805-19401 Rp 20,053
KPJ-1805-19401 Rp 150,000
KPJ-1805-19401 Rp 125,000
KPJ-1805-19401 Rp 6,600
KPJ-1805-19401 Rp 1,822
KPJ-1805-19401 Rp 1,445
KPJ-1805-19401 Rp 125,000
KPJ-1805-19401 Rp 600,000
KPJ-1805-19401 Rp 355,168
KPJ-1805-19401 Rp1,775,840
KPJ-1805-19401 Rp 260,186
KPJ-1805-20363 Rp -
- Rp -
TOTAL Rp4,725,157
DEPOSIT Rp -
RETUR Rp -
SISA TAGIHAN Rp -