Kepada Yth. dr. TAUHID ISLAMY, Sp.OG.

USG BULAN APRIL 2013

No.
Tanggal
1.
01 04 2013
2.
01 04 2013
3.
01 04 2013
4.
01 04 2013
5.
01 04 2013
6.
01 04 2013
7.
01 04 2013
8.
01 04 2013
9.
01 04 2013
10.
01 04 2013
11.
01 04 2013
12.
01 04 2013
13.
01 04 2013
14.
01 04 2013
15.
01 04 2013
16.
01 04 2013
17.
01 04 2013
18.
01 04 2013
19.
01 04 2013

Nama Pasien
Ny. Fetty
Ny. Pipit
Ny. Yusma
Ny. Nining
Ny. Sudarwati
Ny. Dian
Ny. Triwiani
Ny. Ida
Ny. Yuni
Ny. Dian
Ny. Nina
Ny. Yessi
Ny. Wuni
Ny. Deny
Ny. Ferni
Ny. Dian
Ny. Winarti
Ny. Kholifah
Ny. Dian

20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.

02 04 2013
02 04 2013
02 04 2013
02 04 2013
02 04 2013
02 04 2013
02 04 2013
02 04 2013
02 04 2013
02 04 2013
02 04 2013
02 04 2013
02 04 2013
02 04 2013
02 04 2013
02 04 2013
02 04 2013

Ny. Eka Ayu

Ny. Yenny
Ny. Nuzul
Ny. Iswatik
Ny. Ardantri
Ny. Kristin
Ny. Putri
Ny. Neli
Ny. Bernadetta
Ny. Vita
Ny. Dian
Ny. Ana
Ny. Siti P
Ny. Rika
Ny. Titin
Ny. Dian
Ny. Yuniar

37.
38.
39.

08 04 2013
08 04 2013
08 04 2013

Ny. Novita
Ny. Supiyani
Ny. Titik

40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.

08 04 2013
08 04 2013
08 04 2013
08 04 2013
08 04 2013
08 04 2013
08 04 2013
08 04 2013
08 04 2013
08 04 2013
08 04 2013
08 04 2013

Ny. Ida
Ny. Diah
Ny. Rahma
Ny. Wilasti
Ny. Ria
Ny. Linawati
Ny. Anis
Ny. Suci Endah
Ny. Nunung
Ny. Anik
Ny. Winarti
Ny. Cindi

52.
53.
54.
55.

09 04 2013
09 04 2013
09 04 2013
09 04 2013

Ny. Yenny
Ny. Siti P
Ny. Ninik
Ny. Widya

Buku Baru

2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
Rp.
2032
2033
2034
2035

2036
2037

2038
2039
2040
2041

Nominal
Rp.
40.000
Rp.
70.000
Rp.
210.000
Rp.
40.000
Rp.
40.000
Rp.
40.000
Rp.
40.000
Rp.
40.000
Rp.
40.000
Rp.
40.000
Rp.
40.000
Rp.
40.000
Rp.
210.000
Rp.
40.000
Rp.
40.000
Rp.
40.000
Rp.
40.000
Rp.
40.000
Rp.
-

Keterangan
USG 2 D
Trans Vagina
USG 4 D
USG 2 D
Konsultasi
USG 2 D
USG 2 D
USG 2 D
USG 2 D
USG 2 D
Px Gynec
USG 2 D
USG 4 D
USG 2 D
Konsultasi
USG 2 D
USG 2 D
USG 2 D
-

Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.

40.000
40.000
40.000
40.000
40.000
40.000
40.000
GV
Rp.
40.000
Rp.
40.000
Rp.
40.000
Rp.
40.000
Rp.
40.000
Rp.
40.000
Rp.
40.000
Rp.
40.000

USG 2 D
GR
USG 2 D
USG 2 D
GR
USG 2 D
USG 2 D
USG 2 D

Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.

80.000
40.000
40.000
40.000
210.000
210.000
40.000
40.000
40.000
40.000
40.000
40.000
40.000
40.000
40.000

USG 2 D Gemelli
Px Gynec
Pap Smear
USG 2 D
USG 4 D
USG 4 D
USG 2 D
USG 2 D
USG 2 D
USG 2 D
USG 2 D
USG 2 D
USG 2 D
USG 2 D
USG 2 D

Rp.
Rp.
Rp.
Rp.

40.000
40.000
210.000

GR
USG 2 D
USG 2 D
USG 4 D

USG 2 D
USG 2 D
USG 2 D
USG 2 D
USG 2 D
USG 2 D
Konsultasi
USG 2 D

56.
57.
58.
59.
60.
61.
62.
63.
64.

09 04 2013
09 04 2013
09 04 2013
09 04 2013
09 04 2013
09 04 2013
09 04 2013
09 04 2013
09 04 2013

Ny. Ganes
Ny. Vidi
Ny. Rizka
Ny. Atokah
Ny. Nunung
Ny. Megawati
Ny. Sari Endah
Ny. Pipin
Ny. Anung

65.
66.
67.
68.
69.
70.
71.
72.
73.
74.
75.
76.

15 04 2013
15 04 2013
15 04 2013
15 04 2013
15 04 2013
15 04 2013
15 04 2013
15 04 2013
15 04 2013
15 04 2013
15 04 2013
15 04 2013

Ny. Evi
Ny. Yusma
Ny. Arik
Ny. Puji H
Ny. Ajeng
Ny. Santi
Ny. Nurul
Ny. Fitriani
Ny. Anisatul
Ny. Winarti
Ny. Verra
Ny. Fitriani

77.
78.
79.
80.
81.
82.

16 04 2013
16 04 2013
16 04 2013
16 04 2013
16 04 2013
16 04 2013

Ny. Yeny
Ny. Nina
Ny. Sri Rahayu
Ny. Dian
Ny. Ana
Ny. Nurul

83.
84.
85.
86.
87.
88.
89.
90.
91.
92.
93.

22 04 2013
22 04 2013
22 04 2013
22 04 2013
22 04 2013
22 04 2013
22 04 2013
22 04 2013
22 04 2013
22 04 2013
22 04 2013

Ny. Evi
Ny. Novita
Ny. Arik
Ny. Linawati
Ny. Yenni
Ny. Pratiwi
Ny. Nuzul
Ny. Murni
Ny. Anis
Ny. Lilis
Ny. Winarti

94.
95.
96.
97.
98.

23 04 2013
23 04 2013
23 04 2013
23 04 2013
23 04 2013

Ny. Pipin
Ny. Nur Halimah
Ny. Dian
Ny. Nuzul
Ny. Sri Indaryani

2052

99.

29 04 2013

Ny. Isma

2053

100.
101.
102.
103.
104.
105.
106.
107.
108.
109.
110.
111.
112.

29 04 2013
29 04 2013
29 04 2013
29 04 2013
29 04 2013
29 04 2013
29 04 2013
29 04 2013
29 04 2013
29 04 2013
29 04 2013
29 04 2013
29 04 2013

Ny. Arik
Ny. Yusma
Ny. Evi
Ny. Yenny
Ny. Yessi
Ny. Dwi Ferry
Ny. Anis
Ny. Dian
Ny. Yultri
Ny. Fitriani
Ny. Winarti
Ny. Sukartini
Ny. Mila

2042
2043

2044
2045
2046
2047
2048
2049

2050

2051

2054
2055
2056
2057

Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.

40.000
40.000
40.000
40.000
210.000
40.000
40.000
40.000
40.000

USG 2 D
USG 2 D
USG 2 D
USG 2 D
USG 4 D
USG 2 D
Konsultasi
USG 2 D
USG 2 D

Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.

40.000
40.000
40.000
40.000
40.000
40.000
40.000
40.000
40.000
40.000
40.000
40.000

Px Gynec
USG 2 D
USG 2 D
USG 2 D
USG 2 D
USG 2 D
USG 2 D
USG 2 D
USG 2 D
USG 2 D
USG 2 D
Px VT

Rp.
Rp.
Rp.
Rp.
Rp.
Rp.

40.000
40.000
40.000
40.000
40.000

GR
USG 2 D
USG 2 D
USG 2 D
USG 2 D
Konsultasi

Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.

40.000
80.000
40.000
40.000
40.000
40.000
40.000
40.000
40.000
40.000

Px Gynec
USG 2 D Gemelli
Konsultasi
USG 2 D
GR
USG 2 D
USG 2 D
Konsultasi
USG 2 D
USG 2 D
USG 2 D

Rp.
Rp.
Rp.
Rp.
Rp.

40.000
40.000
40.000
40.000
40.000

USG 2 D
USG 2 D
USG 2 D
GV
USG 2 D

Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.

40.000
40.000
40.000
40.000
40.000
40.000
40.000
40.000
40.000
40.000
40.000
40.000
40.000
40.000
40.000

USG 2 D
Px VT
Konsultasi
USG 2 D
Konsultasi
USG 2 D
USG 2 D
USG 2 D
USG 2 D
Konsultasi
GV
USG 2 D
USG 2 D
USG 2 D
USG 2 D

113.
114.
115.
116.
117.
118.
119.
120.
121.

29 04 2013
29 04 2013
29 04 2013
29 04 2013
29 04 2013
29 04 2013
29 04 2013
29 04 2013
29 04 2013

Jumlah

Dikurangi

Ny. Sofia
Ny. Triwiani
Ny. Linawati
Ny. Reni
Ny. Mei
Ny. Reni
Ny. Novi
Ny. Ana
Ny. Desi

Buku
USG 2 D
USG 2 D Gemelli
USG 4 D
Trans Vagina
Px Gynec
Px VT
Pap Smear
Konsultasi
GV
GR

Frestea
Cetak Sampul + Buku

2058
2059
2060
2061
2062

Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.

40.000
40.000
40.000
40.000
40.000
40.000
40.000
40.000

GR
USG 2 D
USG 2 D
USG 2 D
USG 2 D
USG 2 D
USG 2 D
USG 2 D
USG 2 D

43 x Rp.
86 x Rp.
2 x Rp.
6 x Rp.
1 x Rp.
4 x Rp.
2 x Rp.
1 x Rp.
10 x Rp.
3 x Rp.
6 x Rp.
Total

9.000
40.000
80.000
210.000
70.000
40.000
40.000
40.000
40.000
40.000
-

=
=
=
=
=
=
=
=
=
=
=
=

Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.
Rp.

387.000
3.440.000
160.000
1.260.000
70.000
160.000
80.000
40.000
400.000
120.000

6.117.000

120 x Rp.

2.500

=
=
=

Rp.
Rp.
Rp.

300.000
193.500
5.623.500

SIsa

Madiun, 08 Mei 2013

RSB AL HASANAH MADIUN

NY. ISTINI