Provider EDC (Web Version) of Rsia. Sentosa Makassar [12387364] https://mobile.admedika.co.

id/edc/

Letter of Confirmation will be issue here

RSIA SENTOSA
Tel No: 0411-3612720
TID: 12387364 [RSIA SENTOSA MAKASSAR]
JL. JEND.SUDIRMAN 52,, MAKASSAR
======================================
Patient Name: ISABELLE AURORA SIANTURI
Principal Name: YULIANA
Card No.: 8000287101296065
Date of Birth: Apr-27-2018
Policy No: 680111001000
Payor Member ID: 0100010927304
===============DISCHARGE================

Reference ID : 84270622

PENGESAHAN & TAGIHAN

CHUBB
PT BANK CENTRAL ASIA. TBK
DIAG:Z27.1
SPES+OBAT 0
ALAT DENGAR 0
B.TEST DIAG 0
FISIOTHERAPI 0
UMUM+OBAT 65000
IMUNISASI 500000
JUM.BIAYA :1160000
JUM.DIBYR ASS:565000
DIBYR PASIEN:595000
EKSES BAYAR DI TEMPAT
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By: RSIA SENTOSA MAKASSAR (RSBSENT)

July 20, 2019, 6:56 pm

1 of 1 7/20/2019, 7:58 PM