ie Y/ mf soph SURYAIISAN wun Sumy 092390594963, Ema auyansanz0L30gMaI. com smuine Nona + 202170377000329 Bangssiarar £00006, 1SOUST Teleranatan 2 Nove 2020 14:21:39 8.9 December 2020 19:38:31 (12 Har) NORM. 56007 Name Pasion £. ALBON SIALAH (SOT) ‘amot Pasion "-TANDUNG MEDAN, TARDUNG MEDAN, TAMBUSAT UTARA, ROXAU HULU fr. ue A, 5p. P (dew Syne ‘Fame Ret terol Aor Rese) : on00116, s01Ast + 000 20 300.00 Total Kamar Ina 3.000.000, can 8370 ewe {WStr DR UNUM ISOLASE s200 50 260.0 MIST OR SPESULS ISOLA sac 90 7.000 ISI OR SPESIALISISOLAS BY PHONE 000 50 "325.000 vow osc 10 190.000 oom mn000 10 20.000 [ASA MeDIS RUANG ISOLASI jaw 150 300.000 “etal Perawatan : 2.175.000 2.Pemersaon tw erate Umum 10 99750 9750 ima aa io 25000 5.00 ‘Tel Perko ab 124.750 ont a BHP : becom -c(-) : 1790 160 25.000 ‘POLLO KAPSUL 16760 200 335.600 2yCN TABLET 25006 () 20 200 ‘32.000 ‘RETTHROMYEI 500 TASH) Tides “30 0.095 aMITDIN TAB) Sea 200 ‘e480 MEMUCL TABLET (3 4050 200 1.000 ASTAPLLS TAB C) mas 240 237960 ACETYUCYSTEIN CAP NOVEL (aps) 2500 “40 10400 ANTIDINE IND HO (OBAT NON ORAL) 3500 AMIIDINE UP (OBAT NON CRAL) 3m 40 14.800 DMICLAV "TAB (OBAT ORAL) 20790 m0 sazi20 CERRAZOLE 20 MG CAP GEL (OBAT ORAL) mo “40 2.00 (CO AMONICLAY 625 MG TAS (Tale) ‘ i920 10.396 “otal bat & BHP: 1.981.651 [oral Obst Oars: LBAL651 Recep Palang cap Nove 2600 300 73.000 ‘Cerbame 200 AP NOVEL éao0 300 128.000 TANSOPRAZOLE CAP 10. a0 3n0 ‘2.000 ATRIUM DICLOFENAK 50 MG TAB 1200 150 18.00 “otal Resep Pang : 266.000 Tambahan Baya a RONTGEN OR ZLLDI, SPP 2x 20000 10 200.00 “Tea Tambatan : 29.000 Potongan Baya : TOTAL TAGIHAN fl 7.807401 Paw °° TAGIAN + PA 7.907401 Derostt 0 ses ° SIS PLUTANG 7.607401 Mengetahul ain Drear ase Pengaralan 0-12-2020 19:39:31 Cons IMAM SAKIT sta maa pobin oa taghan yong sum etaghian éaom prin aan taghan ker tal Spbis Bid alan chenttion