REKAPITULASI PASIEN

SISWA MAN CIAWIGEBANG / PONPES SALSABILA

PERIODE BULAN JANUARI - JUNI 2021

JUMLAH
NO TGL NO. RM NAMA UMUR KET.
KLAIM
JANUARI 2021
NIHIL

FEBRUARI 2021
NIHIL

MARET 2021
1 02/03/21 202103 6432 Furqon Maulana 16 25,000
2 11/03/21 202103 6560 Adam 17 25,000
3 18/03/21 202103 6650 Siva Aulia 17 25,000
4 19/03/21 202103 6663 Endang 17 25,000
5 25/03/21 202103 6735 Nabilah 15 25,000
6 27/03/21 202103 6772 Fitri Yana 17 25,000
7 27/03/21 202103 6774 Auradesinta 16 25,000
8 28/03/21 202103 6780 Ade Dwi M 17 25,000
9 28/03/21 202103 6783 Damara 17 25,000
10 28/03/21 202103 6784 Sinta Arta 15 25,000
11 30/03/21 202103 6804 Sindi Dea 17 25,000

APRIL 2021
1 03/04/21 202104 6859 Fajar A. 16 25,000
2 04/04/21 202104 6868 Ayilabibah 16 25,000
3 05/04/21 202104 6887 Syifa Nur F 17 25,000
4 06/04/21 202104 6893 Melia 34 25,000 Pengurus
5 06/04/21 202103 6703 Santi 16 25,000
6 06/04/21 202011 4821 Wildaningrum 16 25,000
7 06/04/21 202104 6901 Ratih 17 25,000
8 07/04/21 202104 6917 Nurwulansari 16 25,000
9 08/04/21 202104 6932 Susanti 17 25,000
10 08/04/21 202104 6939 Nailul 19 25,000
11 08/04/21 202104 6943 Azzam 16 25,000
12 08/04/21 202104 6944 Febiana 17 25,000
13 09/04/21 202104 6960 Risa Kamalia 16 25,000
14 10/04/21 202104 6964 Umi Nurlela 16 25,000
15 18/04/21 202104 7054 Wina 17 25,000
16 19/04/21 202104 7078 Ridwan 17 25,000
17 20/04/21 202104 7091 Sri Fatmawati 16 25,000
18 20/04/21 202104 7093 Jejen Jaenal 18 25,000
19 24/04/21 202104 7130 Ersa Mutiani 18 25,000
20 27/04/21 202104 7164 Syaeful Anan 17 25,000
21 29/04/21 202104 7186 Citra 16 25,000
22 29/04/21 202104 7188 Muhammad Iman 16 25,000

MEI 2021
1 24/05/21 202105 7549 Ainun Nisa 17 25,000
2 28/05/21 202105 7604 Ema 18 25,000
3 31/05/21 202009 4174 Sinta 14 25,000
4 31/05/21 202105 6894 Melia 34 25,000
5 31/05/21 202105 6943 Azam 16 25,000

JUNI 2021
1 01/06/21 202106 7637 Euis Nursela 17 25,000
2 03/06/21 202106 7658 Amelia 16 25,000
3 04/06/21 202104 6964 Umi Nurlela 16 25,000
4 04/06/21 202106 7671 Husna Yasiratul 17 25,000
5 05/06/21 202106 7684 Didin Rosidin 16 25,000
6 06/06/21 202104 6964 Umi Nurlela 16 25,000
7 06/06/21 202106 7701 Widanengsih 17 25,000
8 07/06/21 202106 7637 Euis Nursela 17 25,000
9 07/06/21 202106 7719 Abdurahman 16 25,000
10 08/06/21 202106 7725 Ega Abdul Gani 16 25,000
11 08/06/21 202104 6964 Umi Nurlela 16 25,000
12 08/06/21 202106 7726 Heri Sandi 16 25,000
13 09/06/21 202106 7054 Wina 17 25,000
14 10/06/21 202106 7747 Asyam Ruhul 17 25,000
15 10/06/21 202106 7748 Aura Desinta 16 25,000
16 13/06/21 202106 7771 Maymunah 17 25,000
17 16/06/21 202106 7846 Rajba 16 25,000

JUMLAH 1,375,000

Ciawigebang, 28 Juli 2021

YUSUF
 REKAPITULASI PASIEN
SISWA MAN CIAWIGEBANG / PONPES SALSABILA
PERIODE BULAN MEI - DESEMBER 2020

JUMLAH
NO TGL NO. RM NAMA UMUR KET.
KLAIM
MEI 2020
NIHIL

JUNI 2020
NIHIL

JULI 2020
1 17/07/20 202007 3378 Fatma amalia 18 25,000
2 18/07/20 202007 3388 Hasyam Ruhul 17 25,000
3 21/07/20 202007 3421 Razwa Ragba 15 25,000
4 23/07/20 202007 3442 Ratna 15 25,000
5 28/07/20 202007 3501 Euis 24 25,000 Pengurus

AGUSTUS 2020
1 04/08/20 202008 3595 Aril 17 25,000
2 04/08/20 202008 3597 Adinda Mutia 16 25,000
3 09/08/20 202008 3655 Widatun Nihayah 15 25,000
4 20/08/20 202008 3795 Ratna Anjani 15 25,000
5 21/08/20 202008 3802 Maulida 16 25,000
6 21/08/20 202008 3803 Putri A. 16 25,000
7 21/08/20 202008 3804 Een 15 25,000
8 23/08/20 202008 3825 Fatma Amalia 18 25,000
9 23/08/20 202008 3826 Vindi 15 25,000
10 26/08/20 202008 3865 Wahyunisa 18 25,000
11 26/08/20 202008 3869 Maiza 15 25,000
12 28/08/20 202008 3904 Adrian 18 25,000

SEPTEMBER 2020
1 01/09/20 202009 3424 Iin 15 25,000
2 03/09/20 202009 3995 Rasiman 18 25,000
3 05/09/20 202009 4021 Ninda 16 25,000
4 05/09/20 202009 4022 Kartini 16 25,000
5 08/09/20 202009 4070 Sri 14 25,000
6 08/09/20 202009 4074 Ima 16 25,000
7 08/09/20 202009 4075 Elsa 17 25,000
8 08/09/20 202009 4076 Anisa 16 25,000
9 11/09/20 202009 4132 Eka 17 25,000
10 11/09/20 202009 4133 Azam 15 25,000
11 14/09/20 202009 4153 Dini 15 25,000
12 15/09/20 202009 4174 Sinta 14 25,000
13 17/09/20 202009 4202 Rita 16 25,000
14 19/09/20 202009 4242 Indriyani 15 25,000
15 19/09/20 202009 4243 Rajba 15 25,000

OKTOBER 2020
1 06/10/20 202010 4463 Asyam Ruhul 17 25,000
2 09/10/20 202010 4510 Ralin 16 25,000
3 09/10/20 202010 4511 Ilyasa 16 25,000
4 10/10/20 202010 4514 Eeng 43 25,000 Pengurus
5 17/10/20 202010 4606 Firman 17 25,000
6 18/10/20 202002 1196 Kaissa 15 25,000
7 19/10/20 202010 4636 Sifa 17 25,000
8 23/10/20 202010 4693 Aliya 15 25,000
9 27/10/20 202010 4737 Awaludin 17 25,000
10 27/10/20 202010 4740 Gasal 17 25,000
11 29/10/20 202010 4759 Euis Nursela 17 25,000
12 30/10/20 202010 4774 Nada 17 25,000

NOVEMBER 2020
1 02/11/20 202011 4800 Ainul Fatin 15 25,000
2 02/11/20 202011 4812 Fitriyani 16 25,000
3 03/11/20 202011 4818 Nena Siti 16 25,000
4 03/11/20 202011 4821 Wildaningrum 16 25,000
5 03/11/20 202011 4822 Nurkholis 15 25,000
6 03/11/20 202002 0858 Saeful 16 25,000
7 04/11/20 202011 4848 Abdurahman 15 25,000
8 04/11/20 202011 4849 Ridwan 16 25,000
9 06/11/20 202011 4872 Fatma 18 25,000
10 06/11/20 202011 4873 Widanengsih 17 25,000
11 08/11/20 202011 4903 Rayhan 15 25,000
12 08/11/20 202011 4904 Euis Nurhasanah 24 25,000 Pengurus
13 09/11/20 202011 4929 Ayunda 16 25,000
14 11/11/20 202011 4953 Imel 15 25,000
15 11/11/20 202011 4965 Devi 16 25,000
16 12/11/20 202011 4982 Irma F. 17 25,000
17 13/11/20 202011 5000 Syifa 16 25,000
18 13/11/20 202011 5001 Intan Sintia 16 25,000
19 13/11/20 202011 5002 Ias Maskufah 16 25,000
20 16/11/20 202011 5045 Nina Nuriatifah 16 25,000
21 17/11/20 202007 3424 Iin 17 25,000
22 20/11/20 202011 5106 Reza Rafiani 15 25,000
23 20/11/20 202011 5123 Widianingsih 17 25,000
24 22/11/20 202011 5141 Alya Nurul 16 25,000
25 25/11/20 202011 5197 Siti Ainun 17 25,000
26 29/11/20 202011 5265 Syifa 17 25,000
27 29/11/20 202011 5272 Sri Bunga 15 25,000

DESEMBER 2020
1 03/12/20 202012 5334 Ahmad 17 25,000
2 07/12/20 202012 5383 Anisa 17 25,000

JUMLAH 1,825,000

Ciawigebang, Februari 2020