No Nama Umur Alamat Nama Ruangan Visite Jasa dokter Alat Tenun/ hari Kartu Status Adm oksigen

Alat Tenun/ hari Kartu Status Adm oksigen Obat Lab Infus Cairan Infus Maintenance Tindakan
Ruangan Pasien Obat Lab
1 ny teti 65 thn sukasirna marwah Rp 250,000 Rp 100,000 Rp 35,000 Rp 25,000 Rp 75,000 Rp 323,000 Rp 215,000 Rp 120,000 Rp 120,000 Rp 90,000 Rp 60,000
2 ny maryati 50 thn sukamaju shaffa Rp 250,000 Rp 150,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 333,000 Rp 170,000 Rp 120,000 Rp 60,000 Rp 100,000 Rp 50,000
3 an fadil 14 bln dunguswiru marwah Rp 125,000 Rp 50,000 Rp 35,000 Rp 25,000 Rp 75,000 Rp 208,000 Rp 170,000 Rp 120,000 Rp 40,000 Rp 80,000 Rp 50,000
4 an dika 12 thn perum galpak shaffa Rp 700,000 Rp 150,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 305,000 Rp 170,000 Rp 120,000 Rp 80,000 Rp 120,000 Rp 60,000
5 ny uun 59 thn kudang shaffa Rp 500,000 Rp 200,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 412,000 Rp 260,000 Rp 120,000 Rp 120,000 Rp 120,000 Rp 60,000
6 tn harun 75 thn cijolang marwah Rp 250,000 Rp 100,000 Rp 35,000 Rp 25,000 Rp 75,000 Rp 502,000 Rp 185,000 Rp 120,000 Rp 120,000 Rp 90,000 Rp 60,000
7 nn wulan 19 thn cipaku shaffa Rp 200,000 Rp 100,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 344,000 Rp 160,000 Rp 120,000 Rp 60,000 Rp 100,000 Rp 50,000
8 tn empan 63 thn cigawir marwah Rp 125,000 Rp 25,000 Rp 25,000 Rp 25,000 Rp 75,000 Rp 75,000 Rp 145,500 Rp 140,000 Rp 120,000 Rp 60,000 Rp 80,000 Rp 50,000
9 sdr rian 26 thn cinangsi shaffa Rp 500,000 Rp 250,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 507,500 Rp 340,000 Rp 100,000 Rp 120,000 Rp 120,000 Rp 60,000
10 sdr dodi 21 thn cibugel shaffa Rp 200,000 Rp 100,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 149,000 Rp 85,000 Rp 120,000 Rp 60,000 Rp 100,000 Rp 50,000
11 an nabil 4 thn neglasari marwah Rp 250,000 Rp 75,000 Rp 25,000 Rp 25,000 Rp 75,000 Rp 55,000 Rp 170,000 Rp 120,000 Rp 80,000 Rp 100,000 Rp 60,000
12 tn jaja 62 thn cirapuhan marwah Rp 375,000 Rp 125,000 Rp 25,000 Rp 25,000 Rp 75,000 Rp 228,000 Rp 170,000 Rp 120,000 Rp 180,000 Rp 120,000 Rp 70,000
13 an fadila 7 thn cijolang marwah Rp 250,000 Rp 100,000 Rp 35,000 Rp 35,000 Rp 75,000 Rp 278,000 Rp 85,000 Rp 120,000 Rp 80,000 Rp 90,000 Rp 60,000
14 tn ali 40 thn cibiuk shaffa Rp 250,000 Rp 50,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 213,000 Rp 130,000 Rp 120,000 Rp 60,000 Rp 100,000 Rp 50,000
15 ny nina 71 thn galpak shaffa Rp 200,000 Rp 50,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 87,500 Rp 90,000 Rp 185,000 Rp 120,000 Rp 60,000 Rp 80,000 Rp 50,000
16 tn ujang 62 thn godabaya shaffa/ma Rp 950,000 Rp 400,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 499,000 Rp 170,000 Rp 120,000 Rp 240,000 Rp 160,000 Rp 80,000
17 nn freti 18 thn pst kudang marwah Rp 125,000 Rp 75,000 Rp 35,000 Rp 25,000 Rp 75,000 Rp 24,000 Rp 130,000 Rp 120,000 Rp 60,000 Rp 80,000 Rp 50,000
18 an sarah 12 thn patrol marwah Rp 125,000 Rp 50,000 Rp 25,000 Rp 35,000 Rp 75,000 Rp 147,000 Rp 85,000 Rp 120,000 Rp 40,000 Rp 80,000 Rp 50,000
19 ny nenden 59 thn kersamanah shaffa Rp 1,050,000 Rp 300,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 803,000 Rp 130,000 Rp 240,000 Rp 180,000 Rp 140,000 Rp 70,000
20 tn nana 58 thn cibugeul shaffa Rp 750,000 Rp 350,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 840,000 Rp 255,000 Rp 120,000 Rp 180,000 Rp 140,000 Rp 70,000
21 ny iis 34 thn cimareme marwah Rp 125,000 Rp 50,000 Rp 35,000 Rp 35,000 Rp 75,000 Rp 375,000 Rp 210,000 Rp 120,000 Rp 60,000 Rp 80,000 Rp 60,000
22 an arhan 3 thn wedasari marwah Rp 365,000 Rp 175,000 Rp 35,000 Rp 25,000 Rp 75,000 Rp 386,500 Rp 170,000 Rp 120,000 Rp 120,000 Rp 120,000 Rp 70,000 Rp 210,000
23 ny tati 74 thn cigagade shaffa Rp 500,000 Rp 300,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 1,122,000 Rp 255,000 Rp 120,000 Rp 180,000 Rp 140,000 Rp 70,000
24 ny saojah 62 thn cikole shaffa Rp 600,000 Rp 350,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 1,162,000 Rp 170,000 Rp 120,000 Rp 180,000 Rp 120,000 Rp 70,000
25 tn ocid 80 thn sukamerang marwah Rp 375,000 Rp 125,000 Rp 35,000 Rp 25,000 Rp 75,000 Rp 50,000 Rp 425,000 Rp 230,000 Rp 240,000 Rp 180,000 Rp 120,000 Rp 70,000
26 by safira 8 bln ciwangi marwah Rp 375,000 Rp 150,000 Rp 35,000 Rp 25,000 Rp 75,000 Rp 191,000 Rp 130,000 Rp 120,000 Rp 120,000 Rp 100,000 Rp 70,000
27 an nazhan 8 thn cijolang shaffa Rp 1,000,000 Rp 350,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 539,000 Rp 425,000 Rp 240,000 Rp 120,000 Rp 160,000 Rp 80,000
28 tn wawan 56 thn pasir astana marwah Rp 125,000 Rp 25,000 Rp 25,000 Rp 35,000 Rp 75,000 Rp 150,000 Rp 291,000 Rp 130,000 Rp 120,000 Rp 60,000 Rp 80,000 Rp 50,000
29 ny hasanah 65 thn cigagade shaffa Rp 750,000 Rp 300,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 1,427,000 Rp 170,000 Rp 120,000 Rp 180,000 Rp 140,000 Rp 70,000
30 an aira 2 thn ciaro marwah Rp 125,000 Rp 50,000 Rp 35,000 Rp 25,000 Rp 75,000 Rp 357,000 Rp 170,000 Rp 120,000 Rp 40,000 Rp 80,000 Rp 50,000
31 ny ai herlina 46 thn tegal lame shaffa Rp 1,050,000 Rp 300,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 175,000 Rp 1,210,000 Rp - Rp 120,000 Rp 180,000 Rp 140,000 Rp -
32 tn. Anjar 31 thn cigadung shaffa Rp 800,000 Rp 350,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 1,900,000 Rp 170,000 Rp 120,000 Rp 240,000 Rp 160,000 Rp 80,000
33 ny iis 50 thn lame shaffa Rp 500,000 Rp 200,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 819,000 Rp 170,000 Rp 120,000 Rp 120,000 Rp 120,000 Rp 60,000
34 tn dadan 35 thn rancapanjang shaffa Rp 500,000 Rp 200,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 578,000 Rp 215,000 Rp 120,000 Rp 120,000 Rp 120,000 Rp 60,000 Rp 70,000
35 an m keenan 1 thn cirapuhan marwah Rp 125,000 Rp 100,000 Rp 35,000 Rp 25,000 Rp 75,000 Rp 108,000 Rp 85,000 Rp 120,000 Rp 40,000 Rp 80,000 Rp 50,000
36 tn h asep 65 thn situratu marwah Rp 250,000 Rp 100,000 Rp 35,000 Rp 25,000 Rp 75,000 Rp 256,000 Rp 85,000 Rp 120,000 Rp 120,000 Rp 80,000 Rp 50,000
37 ny siti jul 56 thn cikole shaffa Rp 200,000 Rp 150,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 175,000 Rp 395,000 Rp 170,000 Rp 120,000 Rp 60,000 Rp 100,000 Rp 50,000 Rp 140,000
38 an hafizh 5 thn cioray shaffa Rp 800,000 Rp 350,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 350,000 Rp 402,000 Rp 85,000 Rp 120,000 Rp 240,000 Rp 160,000 Rp 80,000 Rp 700,000
39 muqtada 16 thn perum kondang shaffa Rp 250,000 Rp 50,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 98,000 Rp 35,000 Rp 120,000 Rp 20,000 Rp 100,000 Rp 50,000
40 ny rina 32 thn limtim marwah Rp 125,000 Rp 75,000 Rp 35,000 Rp 25,000 Rp 75,000 Rp 182,000 Rp 130,000 Rp 120,000 Rp 60,000 Rp 80,000 Rp 50,000
41 ny maemunah 40 thn ciwangi marwah Rp 250,000 Rp 100,000 Rp 35,000 Rp 25,000 Rp 75,000 Rp 300,000 Rp 185,000 Rp 120,000 Rp 120,000 Rp 90,000 Rp 60,000
42 hj mahmudah 74 thn cihuma shaffa Rp 1,400,000 Rp 400,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 860,000 Rp 400,000 Rp 240,000 Rp 240,000 Rp 160,000 Rp 80,000
43 ny siti 74 thn cisalak marwah Rp 250,000 Rp 100,000 Rp 35,000 Rp 25,000 Rp 75,000 Rp 293,000 Rp 170,000 Rp 120,000 Rp 120,000 Rp 90,000 Rp 60,000
44 nn dewi 20 thn cibiuk marwah Rp 375,000 Rp 125,000 Rp 35,000 Rp 25,000 Rp 75,000 Rp 463,000 Rp 320,000 Rp 120,000 Rp 180,000 Rp 100,000 Rp 70,000
45 tn anwar 37 thn salam satu shaffa Rp 600,000 Rp 250,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 830,000 Rp 425,000 Rp 120,000 Rp 180,000 Rp 180,000 Rp 70,000
46 tn anggiana 29 thn nagreg marwah Rp 125,000 Rp 25,000 Rp 35,000 Rp 25,000 Rp 75,000 Rp 173,000 Rp 170,000 Rp 120,000 Rp 60,000 Rp 80,000 Rp 50,000
47 an akbar 3 thn leuwigoong shaffa Rp 750,000 Rp 250,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 250,000 Rp 300,000 Rp 120,000 Rp 120,000 Rp 140,000 Rp 70,000
48 an hasna 19 bln cibatu shaffa Rp 400,000 Rp 200,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 297,000 Rp - Rp 120,000 Rp 80,000 Rp 120,000 Rp -
49 ny cucu 50 thn selaawi marwah Rp 125,000 Rp 50,000 Rp 25,000 Rp 25,000 Rp 75,000 Rp 201,000 Rp 130,000 Rp 120,000 Rp 60,000 Rp 80,000 Rp 50,000
50 ny mira 42 thn sukamulya marwah Rp 250,000 Rp 125,000 Rp 25,000 Rp 35,000 Rp 75,000 Rp 530,000 Rp - Rp 120,000 Rp 120,000 Rp 90,000 Rp -
51 ny lina 40 thn leuwigoong shaffa Rp 600,000 Rp 300,000 Rp 25,000 Rp 35,000 Rp 100,000 Rp 525,000 Rp 395,000 Rp 120,000 Rp 180,000 Rp 140,000 Rp 70,000
52 ny iis 56 thn kersamanah shaffa Rp 400,000 Rp 150,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 257,000 Rp - Rp 120,000 Rp 120,000 Rp 120,000 Rp -
53 an malika 1,3 thn surabaya shaffa Rp 500,000 Rp 200,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 226,000 Rp 215,000 Rp 120,000 Rp 80,000 Rp 120,000 Rp 60,000
54 tn sudrajat 57 thn bunisari shaffa Rp 1,125,000 Rp 350,000 Rp 35,000 Rp 35,000 Rp 100,000 Rp 1,289,000 Rp 300,000 Rp 120,000 Rp 240,000 Rp 160,000 Rp 80,000 Rp 70,000
55 ny aas 42 thn baeud marwah Rp 250,000 Rp 100,000 Rp 35,000 Rp 25,000 Rp 75,000 Rp 746,000 Rp 165,000 Rp 120,000 Rp 120,000 Rp 90,000 Rp 60,000 Rp 70,000

Rp 23,765,000 Rp 9,275,000 Rp 1,845,000 Rp 1,725,000 Rp 4,875,000 Rp 1,062,500 Rp 25,869,500 Rp 9,785,000 Rp 7,060,000 Rp 6,460,000 Rp 6,130,000 Rp 3,130,000 Rp 1,260,000

Limbangan, 29 Maret 2022

Total maintenance obat + maintenance lab = Rp. 9.260.000

Apoteker penanggung jawab Pelapor

Ikhsan Hidayatuloh.,S.Si.,Apt Hasan Abdul Azis Zaelani A.md.Farm

Direktur Klinik AYMC

dr. Resi Hanawati