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  • Rs KH Abdurrahman Syamsuri: Keterangan/Details Jumlah (RP) Biaya Obat 707,840

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    This document is a record of medication purchases for a patient named Ahmad Asy'ari Yusuf from RS KH Abdurrahman Syamsuri Hospital. It lists the date, medication name, price and amount for multiple purchases totaling Rp. 707,840. It also includes a section listing returned medications and their refund amounts.

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    This document is a record of medication purchases for a patient named Ahmad Asy'ari Yusuf from RS KH Abdurrahman Syamsuri Hospital. It lists the date, medication name, price and amount for multiple purchases totaling Rp. 707,840. It also includes a section listing returned medications and their refund amounts.

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    12 views2 pages

    Rs KH Abdurrahman Syamsuri: Keterangan/Details Jumlah (RP) Biaya Obat 707,840

    Uploaded by

    rohmat
    This document is a record of medication purchases for a patient named Ahmad Asy'ari Yusuf from RS KH Abdurrahman Syamsuri Hospital. It lists the date, medication name, price and amount for multiple purchases totaling Rp. 707,840. It also includes a section listing returned medications and their refund amounts.

    Copyright:

    © All Rights Reserved
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    of 2

    RS KH ABDURRAHMAN SYAMSURI

    Jl. Raya Daendels, KM 74 Paciran


    Website : www.rs_arsy.com | Email. info@rs_arsy.com

    DATA PEMBELIAN OBAT

    NO RM : 02.61.35 REGISTER : 000.009.731.019


    NAMA : Ahmad Asy'ari Yusuf, An UMUR : 001T 08B 12H
    L/P : P JENIS : Asuransi Kesehatan
    ALAMAT : kemantren Kec. PACIRAN Kab. Lamongan PERUSAHAN : BPJS

    KETERANGAN/DETAILS JUMLAH (Rp)

    Biaya Obat 707,840

    Pembelian Obat
    19/04/2019 135,357
    JASA RESEP 1 @ Rp. 204 204
    INNOCATH 24 1 @ Rp. 26,400 26,400
    KAEN 1B INF 2 @ Rp. 12,537 25,074
    SANTAGESIK INJ 2 @ Rp. 12,312 24,624
    SPALK 15 CM X 5 CM 1 @ Rp. 11,583 11,583
    ALKOHOL SWAB 5 @ Rp. 231 1,155
    TREMENZA TAB 2 @ Rp. 1,981 3,962
    SALBUTAMOL 2 MG TAB 2 @ Rp. 109 218
    KERTAS PUYER 10 @ Rp. 206 2,060
    TINDAKAN PUYER/CAPSUL 10 @ Rp. 260 2,600
    CURCUMA PLUS SYR 1 @ Rp. 13,585 13,585
    SPUIT 10 CC TP 1 @ Rp. 1,904 1,904
    AQUADEST FOR INJ 1 @ Rp. 4,290 4,290
    INFUSET ANAK KIMSMED 1 @ Rp. 9,900 9,900
    SPUIT 3 CC ONEMED 3 @ Rp. 990 2,970
    RANITIDIN INJ-BP 2 @ Rp. 2,184 4,368
    ROVERTON 30 MG TAB-BP 2 @ Rp. 230 460
    19/04/2019 240,918
    JASA RESEP 1 @ Rp. 204 204
    VICILLIN-SX INJ 2 @ Rp. 117,260 234,520
    AQUADEST FOR INJ 1 @ Rp. 4,290 4,290
    SPUIT 10 CC TP 1 @ Rp. 1,904 1,904
    19/04/2019 197,216
    JASA RESEP 1 @ Rp. 204 204
    VELUTIN NEB 3 @ Rp. 16,016 48,048
    BISOLVON SOL 15 @ Rp. 442 6,630
    VICILLIN-SX INJ 1 @ Rp. 117,260 117,260
    KAEN 1B INF 2 @ Rp. 12,537 25,074
    19/04/2019 35,954
    JASA RESEP 1 @ Rp. 204 204
    SELANG NEBULE ANAK 1 @ Rp. 35,750 35,750
    20/04/2019 70,190
    JASA RESEP 1 @ Rp. 204 204
    KAEN 1B INF 2 @ Rp. 12,537 25,074
    SANTAGESIK INJ 1 @ Rp. 12,312 12,312

    22/04/2019 9:22:31 Page 1/2


    RS KH ABDURRAHMAN SYAMSURI
    Jl. Raya Daendels, KM 74 Paciran
    Website : www.rs_arsy.com | Email. info@rs_arsy.com

    DATA PEMBELIAN OBAT

    NO RM : 02.61.35 REGISTER : 000.009.731.019


    NAMA : Ahmad Asy'ari Yusuf, An UMUR : 001T 08B 12H
    L/P : P JENIS : Asuransi Kesehatan
    ALAMAT : kemantren Kec. PACIRAN Kab. Lamongan PERUSAHAN : BPJS

    KETERANGAN/DETAILS JUMLAH (Rp)

    ACRAN INJ 1 @ Rp. 29,058 29,058


    SPUIT 3 CC TP 1 @ Rp. 1,332 1,332
    BISOLVON SOL 5 @ Rp. 442 2,210
    20/04/2019 129,203
    JASA RESEP 1 @ Rp. 204 204
    CERINI DROP 1 @ Rp. 87,945 87,945
    SELANG NEBULE DEWASA 1 @ Rp. 35,750 35,750
    BISOLVON SOL 12 @ Rp. 442 5,304
    21/04/2019 10,357
    JASA RESEP 1 @ Rp. 204 204
    SPUIT 3 CC TERUMO 1 @ Rp. 7,293 7,293
    NEEDLE 25 TERUMO 1 @ Rp. 2,860 2,860
    21/04/2019 108,145
    JASA RESEP 1 @ Rp. 204 204
    STARMUNO SYR 1 @ Rp. 95,810 95,810
    TREMENZA TAB 3 @ Rp. 1,981 5,943
    OMEROXOL 30 MG TAB 3 @ Rp. 272 816
    SALBUTAMOL 2 MG TAB 2 @ Rp. 109 218
    MOLACORT 0,5 MG TAB 2 @ Rp. 247 494
    KERTAS PUYER 10 @ Rp. 206 2,060
    TINDAKAN PUYER/CAPSUL 10 @ Rp. 260 2,600
    Retur Obat
    KAEN 1B INF 1 21/04/2019 @ Rp. 12,537 12,537
    SANTAGESIK INJ 2 21/04/2019 @ Rp. 12,312 24,624
    RANITIDIN INJ-BP 1 21/04/2019 @ Rp. 2,184 2,184
    SPUIT 3 CC ONEMED 1 21/04/2019 @ Rp. 990 990
    VICILLIN-SX INJ 1 21/04/2019 @ Rp. 117,260 117,260
    VELUTIN NEB 2 21/04/2019 @ Rp. 16,016 32,032
    ACRAN INJ 1 21/04/2019 @ Rp. 29,058 29,058

    22/04/2019 9:22:31 Page 2/2

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