DESCRIPTION

THERAPY 01

HLC

THERAPY 02

HLC

THERAPY 03
 HLC

THERAPY 04

HLC

THERAPY 05

HLC

THERAPY 06

HLC
THERAPY 07

HLC

THERAPY 08

HLC

THERAPY 09

HLC

THERAPY 10
 HLC

DESCRIPTION

SINGLE THERAPY
 HLC

SINGLE THERAPY

RS

SINGLE THERAPY

RS

SINGLE THERAPY

RS
SINGLE THERAPY

RS

SINGLE THERAPY

HLC

SINGLE THERAPY

HLC
PATIENT NAME :

MOBILE NO. :

RECEIPT NO. :

PAYMENT DATE :

PACKAGE :
 DATE

8/21/2019

8/21/2019

8/29/2019
8/29/2019

8/29/2019

8/29/2019

8/29/2019
8/29/2019

9/5/2019

9/5/2019

9/5/2019
9/5/2019

SUB TO

DATE

9/5/2019
9/5/2019

9/25/2019

9/25/2019

9/25/2019
9/25/2019

10/1/2019

10/1/2019

SUB TO
SUB TO
Tience Sumartini

0816 916 230

011/AB/VIII/2019

21 Aug 2019

10x
NAME PATIENT

TIENCE SUMARTINI

ADE AMRY

TIENCE SUMARTINI
TIENCE SUMARTINI

ADE AMRY

TIENCE SUMARTINI

TIENCE SUMARTINI
TIENCE SUMARTINI

ADE AMRY

ADE AMRY

ADE AMRY
 ADE AMRY

B TOTAL

NAME PATIENT

ADE AMRY
 ADE AMRY

ADE AMRY

ADE AMRY

TIENCE SUMARTINI
 TIENCE SUMARTINI

ADE AMRY

ADE AMRY

B TOTAL
B TOTAL
ACCE

PATIE
REMARKS

ACCESS BARS

ACCESS BARS

ACCESS BARS
ACCESS BARS

ACCESS BARS

QUALIFYING

QUALIFYING
 QUALIFYING

QUALIFYING

QUALIFYING

BINAURAL HYPERFOCUS
BINAURAL HYPERFOCUS

REMARKS

BINAURAL SUM 3 + 2
BINAURAL SUM 3 + 2

QUALIFYING

QUALIFYING

QUALIFYING
QUALIFYING

QUALIFYING

QUALIFYING
ACCESS BAR

PATIENT CAR
MARKS

CESS BARS

CESS BARS

CESS BARS
CESS BARS

CESS BARS

ALIFYING

ALIFYING
ALIFYING

ALIFYING

ALIFYING

L HYPERFOCUS
 L HYPERFOCUS

MARKS

RAL SUM 3 + 2
RAL SUM 3 + 2

ALIFYING

ALIFYING

ALIFYING
ALIFYING

ALIFYING

ALIFYING
SS BARS

NT CARD
AMOUNT

450

450

450
450

450

450

450
450

450

450

450
 450

4,500,00

AMOUNT

500
500

500

500

500
 500

500

500

3,500,00
3,500,00
S

D
MOUNT

450,000

450,000

450,000
450,000

450,000

450,000

450,000
450,000

450,000

450,000

450,000
 450,000

,500,000

MOUNT

500,000
500,000

500,000

500,000

500,000
 500,000

500,000

500,000

,500,000
,500,000