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BPJS KESEHATAN

JL LETJEN SUPRAPTO KAV 20 NO 14


RT:000, RW:000.
Kel:CEMPAKA PUTIH, Kec:Cempaka
Putih., INDONESIA
10510

To : Advice Date : 14 March 2022


Mr/Mrs. BPJS KESEHATAN - ASET DJS KC Advice No. : 202203141355528717
BARABAI
Page : 1
bnidirectbarabai@gmail.com

Full Debit Advice


We have debited your account for the following transaction :
Date : 14 March 2022
Transaction Type : Bulk Payment - LLG
Remitter Name : BPJS KESEHATAN - ASET DJS KC BARABAI
Remitter Account Number : *******436 (IDR)
KRAMAT
Transaction Amount : IDR 5,200,000.00
Remark : Puskesmas Tanjung Klaim RJTP & RI

Beneficiary Name : Bend Penerimaan BLUD Puskesmas Tanjung


Beneficiary Account Number : **********448 (IDR)
BPD Kalimantan Selatan,BPD Kalimantan Selatan,
Reference No. : 20220314100303258326
Remitter Reference No. : -
Beneficiary Reference No. : Puskesmas Tanjun

This advice is printed by computer and require no signature from bank officer

PT Bank Negara Indonesia (Persero) Tbk


Divisi Transactional Banking Services
Gedung Wisma 46 lt.3
Jl. Jend. Sudirman Kav.1
Jakarta 10220
Telp: +62-21-29946046
Fax: +62-21-5728874

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