RUMAH SAKIT METHODIST

Jl n.ahamri n No.1o5 Te]p.(061) 7369000

MEOAN

000941/19
KETTY TANADI (ooo2o636)
28 thn 0 bln
PANCING I LINGK IV MEDAN LABUHAN
Di rawat ooKTER IVAN 5.W.MMA, PHD,5P. AKP

G di tangani ol eh
Kete ran gan Qty Har9a T9'l Jam rgl ram fUMLAH DOKT ER

1 KAMAR E2 .2 3 396,000 15-04-19 16:00 18,04 - 19 10:OO 1,188,000

2 ,500
2 ,17 2
3 ADMINISTRASI 50,000
BIAYA PERAI'ATAN 300,000
5 CT SCAN RS DELI 950,000
384,000
LAB METHODIST 2,044,800
8 1,250,000
9 66,000
10 HONOR VISITE 3 300, oo0 900,000 IVAN S . W. NIMA, P
11 I]ONOR VISITE 1 375,000 375,000 RAMSI LUTAN, PR

TOTAL AIAYA 9. 680, 100

Te rbi'l ang:
sembilan luta Enam Ratus Delapan pul!h Ribu Tiga Ratus RUpTAH

Medan. 18 APRIL
 RUMAH SAKIT METHODIST
rl n. rhamri n No- 105 Te-l p. (O61) 7369OOO
MEDAN
TAN PASIEN
NAOI No. Re9: 000941/19

No. rarggal Quant i ty @Ha rga JUMLAH

390 780
1. 15 -04 19 MAsKER DISPO (BONDEO), @BOX IS 2

2. 15-04 19 I]ANDSCHOEN LATEX, ECERAN,ISI 1 608 2,433

3. 15 04 19 ALCOHOL SWAB, LEMAAR 2 LEMB/ 1,200 2 ,400

4. 15 04 19 POI PLASTIK 40 CC 1 1,200 1, 200

5. 15 04 19 1 SET / 15,600 15,600
6. 15-O4 1.9 VENFLON NO.22, BD 1 SEI / 36, O00 t6,000
/. 15 04 19 rv I000 1 9 ,434 9,418
8. 15-04 19 ID BAND (GELANG NAMA) 1
9. 15 04 19 SPUIT 3 ML, BD 2 sEr / 4,957 9,914
10. 15 04-19 CORTIDEX INJ, AMP 1 9,646 9,646
11. 15-04-19 I4ASKER DISPO (BONDED), GBOX IS 2 390 780
12. 15-04 19 HANDSCHOEN LATEX, ECERAN,ISI 1 608 2,433
13. 15 04 19 AQUABIDEST (OTsU WI), ATL, 25 1 BIL / 9,La7 9,747
14. 15 04 19 ALCOHOL SWAB, LEMBAR 2 LENIB/ 1, 200 2 ,400
15 - 15 04 19 AQUABIDEST (OTSU I'I), BTL, 25 BIL / I,aa7 t8,374
16. 15 04 19 INFUs SET ADULT (DEWASA) 1 sET / 12,O00 12 ,000
17. 15 04-19 5 PUIT 10 ML, BD 2 SEI / 7,456 t5 ,712
18. 15 04 19 5PUIT 3 ML, BD 3 SEI / 4,957 t4 ,877
19. 15 0,1 19 NEEDLE NO. 26 1 SEI / 1, 200 1,200
20. 15 04 19 CORTIOEX IN], AMP 3 9,646 28,940
21. 15 04 19 CEFTRIAXONE IN]. FLAC, 1GR 19,800 r9. 600
22. 15 04-19 METRONIDAZOLE INFUS, FLS, 5OO 1 57,600 57,600
23. 16-04-19 MASKER DISPO (BONOED), GBOX 1S 2 LBR / 390 7ao
24. a6-O4-19 HANOSCHOEN LATEX, ECERAN, ISI 1 3 LSR / 608 1,825
25. 16-04-19 ALCOHOL SWA3, LEMBAR 2 LEI4B / 1, 200 2,400
26. 16-04 19 I4ASKER DISPO (BONDED), GBOX 1S 2 LBR / 390 780
27. L6-04 79 HANDSCHOEN LATEX, ECERAN,ISI 1 608 2,433
28. 16 04 19 ALCOHOL swaB, L BA R Er.4 2 L EMB/ 1,200 2,400
29. 16 04 19 MASKER DISPO (AONOED), (4BOX 1S 2 L8R / 390 780
10. 16 04 19 HANDSCHOEN LATEX, ECERAN , IS1 1 LBR / 608 2,433
11. 16 04-19 ALCOHOL SWAB, LEMBAR 2 LET4B / 1, 200 2 ,400
12. 16 04 19 THROMBOPHOB GEL, TUBE, 2O GR 1 'tuBE / 78,408 78,408
ll. 16 04-19 NACL 0.9% OTSUKA (OT5U NS), FL 1 22,Oa1 22,Ot7
14. 16-04-19 5PUIT 5O I'IL (CATHETER TIP) 1 Pas / 68,640 68,640
15. 16 0.1- 19 METRONIDAZOLE INFU5, FLS , 5OO 2 57,600 115 ,200
16. 16 04-19 PANTOPRAZOLE, !N] , 40 MC 3 t34 ,412 4A4,438
37. 16-04-19 NEORAL SANDIi4MIJN 5O NIG, TAB 5 4?,952 239 ,760
38. 16-04-19 ILIADIN NASAL SPRAY O.O5%, CAN 1 STRI/ 81, 361 81 , 161
39. 16-04 19 AERTT]S, 012 10 IAB / la,952 119, 520
40. 16 04 19 CATAFLA,.4, TAB, 5O I.lG 10 8, 312 83 , t24
41. 16 04 19 OIGENTA CREAM 10 GR 1 TUBE/ LOg,440 109,440
42. 16 A4 19 CEFTRIAXONE IN], FLAC. 1 GR 2 19, 800 39,600
41. 16 04 19 CORTIOEX ]NJ, AI.4P 3 9,646 28,940
44. 16 04 19 AQUABIDEST (OISU-WI), BTL, 25 1 AIL / 9,447 9, 187
45. 16-04 19 SPUI I 10 ML, BD 5 sEr / 7 ,456 39,282
46. 16-04 19 SPUIT 3 ML, BD SEI / 4,957 19,828
47. 1,7-04-L9 MASKER DISPO (BONDED), @8OX IS 2 390 780
48. 17-04-19 HANDSCHOEN LATEX, ECERAN,ISI 1 3 608 1,825
49. t7 -44-19 ALCOHOL SWAB, LEMBAR 2 LEMB / 1, 200 2 ,400
50. 17-04-19 I4ASKER OISPO (BONOED), GBOX IS 2 390 780

Be rsambung ke ha'laman berikutnya

 RUMAH SAKIT METHODIST
rln.Thamrin No.105 Te'lp. (o61) 7369000
MEDAN

TAN PASIEN
NADI No. Req: 000941/19

No , Tanqga l @Harga JU14LAH

51. 17-04 19 HANDSCHOEN LATEX, ECERAN,ISI 1 2 608 1,216
52. L7 04 t9 PLANTACTD FORTE SUSP SYRUP, BT 1 B'tL / 42 ,768 42,764
53. 17 04 19 AZITHROMYCfN, KAPLET, 5OO MG 6 16 ,416 98,496
54. t7 04 t9 NEXIUM, TAB, 40 MG 6 29,910 179,460
55. 17 04 19 LAMESON, TAB, 16 MG 6 11, 8EO 71,280
56. 17 04 19 CLINDAMYCIN, TAB, 3OO I'4G 1,962 7 ,848

TOTAL BIAYA PEMAKAIAN OBAT. 2 ,472,500

Te rbi 'l ang:
Dua luta seRatus Tujuh Pu'luh oua Ribu Lima Ratus RUPTAH

Medan, 18 APRIL 2019

B aqi an Adm
 IAN ]ASA RUMAH SAKIT
IANAOI No. Reg: 000941/19
A1 ING I LINGK IV MEOAN LABI]HAN
28
04- 19 Jam:16 :00:00
'-04-19 Jam: 10 :00:00 H'l m:

Tanggal Quanti ty @Ha rq a di tangani ookte r

1. 15 04 19 JASA TINDA(AN IGD 1 66,000 66,000

2. 15-04 19 SCHEDEL/KEPALA 1 192 ,000 1,92,0oo rvAN 5.w, MMA, PHo, sP.
3. 15 -04 19 S I NU5 /NIAXl L LA/I\4,ANDI BULA 1 192 ,000 192 , OOO IVAN 5 . W, MP]A, PI]D , SP.
4. 15-04 19 1 120,000 12O, OOO IVAN 5.Il,. MMA, PHD, SP.
5. 15-04-19 1 60,000 60,000 rvaN 5.w.MMA, PHD,SP
6. 15-04 19 A L BUMIN 1 60,000 6O, OOO IVAN 5, W,I\4MA, PHD
'
SP,
7. 15-04 19 ALKALI PHOSPHATASE 1 80 ,400 80,4OO IVAN 5. W, MMA, PHD, SP.
8. 15 -04 19 SGOT 1 54,000 54 , OOO IVAN 5 . W. MMA, PHD SP.
'
9. 15 -04 19 SGPT 1 54,000 54.000 rvaN 5. w. r4t\4A, PHD, sP,
10. 15 04 19 1 80,400 80,400 rvaN 5.w.14MA, PHD, sP
11. 15-04 19 TOTAL AILIRI,IBIN 1 54,000 54,000 rvAN s, w. r.4MA, PHD,5P.
12- 15 04 L9 DTREK BILlRUBIN 1 54 ,000 54. OOO IVAN S.W, MMA, PHD,5P,
13. 15 04-19 MASA PEMBEKUAN 1 24,000 24, OOO IVAN S. W. MMA, PHD,5 P.
14. 15 04 19 MASA PENOARAHAN 1 24,OaO 24,000 rvaN s.lr. Ml\44, PHD,5P.
15. 15 04 19 1 54,000 54,000 rvAN s,lr.MMA, PHo, sP.
16. 15 04 19 CREATININ 1 54,000 54.000 rvAN s, w, rYlMA, PHD, sP.
17 . 15 04- 19 URINE RUTIN 1 48,000 48. OOO IVAN 5,W, MMA, PHD, SP,
18. 15 04 19 1 196,000 ]96. OOO IVAN S. W, MI4A, PI,]D, S P,
19. 15 04-19 1 42 .000 42 , 000 rvaN s . l,. MrYla, PHD , sP.
20. 15-04-19 HBAlC 1 112 ,000 132, oo0 rvAN s,t{.MMA, PHD, sP,
21. 15-04-19 I 1,250,000 1 , 2 50,000
22. L6-O4-19 AD14lNISTRASI 1 50,000 50,000
23. 15 04-19 G LOAUL I N 1 60,000 60,000 rvaN 5.w. MNla, PHo,5P.
24. 15-04-19 PT (INR) 1 264 ,000 264.000 rvaN s. \n. Mfra, PrD, sP.
25. 15-04 19 TS H5 1 330,000 330, ooo rvaN s. u/. Mi,la, PHD,5P.
26. 16 04 19 PENAMBAHAN FOTO 1 950,000 950,000
27. t7 04 79 BIAYA PERAWATAN 3 100, oo0 300,000
2E. 17 04 19 HONOR VISITE 3 300,000 900,000 rvAN s, w- irMA, PHD, sP.
29- a7 04 t9 HONOR VISITE 1 375 ,000 375,OOO RAI.,IS1 LUTAN, PROF. DR

TOTAL PEMAKAIAN JASA .,.,. 6,319,800