Daftar Pasien BiMC to Patra

BULAN MARET 2011

NAMAPASIEN
NO TGL Tn. Mhfud Ny. Mn Ny.Stnh Ny. Symsh Tn. Rjto Tn. Sgeng Ny. Ely
1 1/3/2011 1 1
2 2/3/2011 1
3 7/3/2011 1
4 9/3/2011
5 10/3/2011
6 11/3/2011
7 12/3/2011
8 14/3/2011 2 1
9 15/3/2011 1
10 16/3/2011 1
11 17/3/2011
12 19/3/2011
13 24/3/2011 1
14 25/3/2011
15 26/3/2011
16 28/3/2011 2 2
17 29/3/2011 1
18 30/03/2011
T O T A L
Tn. Slystio Tn. Swrso Tn. Sualwi PROGRAM TARIF
2 Rp 300,000
1 2 Rp 350,000
2 1 4 Rp 600,000
1 1 Rp 150,000
1 1 Rp 150,000
1 1 Rp 150,000
2 2 Rp 300,000
3 Rp 550,000
1 Rp 150,000
2 1 4 Rp 650,000
1 1 Rp 150,000
2 2 Rp 300,000
1 Rp 200,000
1 1 Rp 150,000
1 1 Rp 150,000
4 Rp 700,000
1 2 Rp 300,000
1 Rp 150,000
Rp 5,450,000
Daftar Pasien BiMC to Patra
BULAN APRIL 2011

N A M A P A S I E N
NO TGL Tn. Mhfud Ny. Mn Ny.Stnh Ny. Symsh Tn. Rjto Tn. Sgeng Ny. Ely Tn. Slystio
1 4/4/2011 2 2
2 5/4/2011 1
3 6/4/2011 2
4 11/4/2011 1
5 12/4/2011 1
6 13/04/2011 2
7 18/04/2011 2 2 1
8 19/04/11
9 20/04/11
10 23/04/11
11 25/04/11 1 2
12 26/04/11 1
13 27/04/11 2
14
15
16
17
18
T O T A L
Tn. Swrso Tn. Sualwi PROGRAM TARIF
Hydro/TW Rp 700,000
1 FT Rp 300,000
hydro dan TW Rp 350,000
hydro Rp 200,000
1 ft Rp 300,000
2 hydro/TW dan FT/TW Rp 650,000
hydro/TW dan FT Rp 850,000
1 FT Rp 150,000
1 FT Rp 150,000
2 TW/FT Rp 300,000
hydro/hydro/TW Rp 550,000
FT Rp 150,000
hydro dan TW Rp 350,000

Rp 5,000,000
Daftar Pasien BiMC to Patra
BULAN MEI 2011

N A M A P A S I E N
NO TGL Tn. Mhfud Ny. Mn Ny.Stnh Ny. Symsh Tn. Rjto Tn. Sgeng Ny. Ely
1 30/4/11
2 2/5/2011 2 2
3 3/5/2011 1
4 4/5/2011 2
5 7/5/2011
6 9/5/2011 2 2
7 10/5/2011 1
8 11/5/2011 1
9 14/5/11
10 16/5/11 2 2
11 18/5/11 2
12 21/5/11
13 23/5/11 2
14 25/5/11 1
15 30/5/11 1

9 12 2
M A P A S I E N
Tn. Slystio Tn. Swrso Tn. Achmad Tn. Skrma Tn. Sayuti Tn. Sualwi PROGRAM
1 FT
hydro dan TW
FT
1 hydro dan TW
1 1 TW/FT
hydro dan TW
FT
FT
2 FT dan TW
hydro dan TW
2 FT dan TW
2 1 FT dan TW/FT
1 hydro dan TW/hydro
1 hydro/TW
1 2 TW/FT/TW&FT

6 5 4
 TARIF
Rp 150,000
Rp 700,000
Rp 150,000
Rp 500,000
Rp 300,000
Rp 700,000
Rp 150,000
Rp 150,000 200
Rp 300,000
Rp 700,000
Rp 600,000 650
Rp 450,000
Rp 550,000
Rp 350,000
Rp 600,000

Rp 6,350,000 5.850.000
Daftar Pasien BiMC to Patra
BULAN JUNI 2011

N A M A P A S I E N
NO TGL Tn. Mhfud
Ny.Stnh Ny. Symsh Tn. Rjto Tn. Slystio Tn. Swrso Tn. Achmad
1 1/6/2011 2 2
2 2/6/2011 2
3 6/6/2011 1
4 8/6/2011 2 2
5 9/6/2011
6 11/6/2011
7 13/6/2011 2 1
8 15/6/2011 1
9 16/6/2011 1 2
10 18/6/2011
11 20/6/2011 2
12 21/6/11 1
13 25/6/11 1
14 27/6/2011 2

7 2 1 9 5
I E N
Aldjufri Tn. Skrma Tn. Sayuti PROGRAM TARIF
FT&TW/FT&TW Rp 600,000
FT&TW Rp 300,000
hydro Rp 200,000
1 FT&TW/FT&TW/hydro Rp 800,000
1 hydro Rp 200,000
1 FT Rp 150,000
hydro&TW/TW Rp 500,000
hydro Rp 200,000
FT/FT&TW Rp 450,000
1 FT Rp 150,000
hydro&TW Rp 350,000
1 FT/TW Rp 300,000
2 TW/FT&TW Rp 450,000
hydro&TW Rp 350,000

3 2 2
Rp 5,000,000
 DAFTAR PASIEN FISIOTERAPI BiMC Dikirim Ke Sasana Patra
BULAN JULI 2011
N A M A P A S I E N
NO TGL Tn. Mhfud Ny. Mn Ny.Stnh Ny. Symsh Tn. Rjto Tn. Slystio Tn. Swrso Tn. Achmad Aldjufri Tn. Skrma Tn. Sayuti Tn. Sualwi PROGRAM TARIF
1 30/6/2011 1 FT Rp 150,000
2 2/7/2011 1 TW Rp 150,000
3 4/7/2011 2 hydro&TW Rp 350,000
4 5/7/2011 1 TW Rp 150,000
5 7/7/2011 1 FT Rp 150,000
6 11/7/2011 2 FT&TW Rp 300,000
7 13/7/2011 1 hydro Rp 200,000
8 16/7/11 1 ft Rp 150,000
9 18/7/11 1 hydro Rp 200,000
10 19/7/11 1tw 2fttw 2fttw Rp 750,000
11 21/7/11 1ft 1ft Rp 300,000
12 25/7/11 2 hydro&tw Rp 350,000
13 26/7/11 2 hydro&tw Rp 350,000
14 28/7/11 1 ft Rp 150,000
5 4 2 1 2 1 1 Rp 3,700,000
 N A M A P A S I E N
NO TGL Ny.Stnh Ny. Symsh Tn. Rjto Tn. Slystio Tn. Swrso Tn. Achmad Aldjufri
1 1/8/2011 2 hydro tw
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
E N
Tn. Skrma Tn. Sayuti Tn. Sualwi PROGRAM TARIF
Rp 350,000