DAFTAR PENDISTRIBUSIAN

AIR MUTIARA JAKARTA

DI RS.SINT CAROLUS
PT.Gracia Usaha Bersama
Jakarta
PERIODE : 01 - 15 Agustus 2018
UNIT / Jumlah HARGA Jumlah HARGA Jumlah HARGA
NO Galon Galon botol (600 JUMLAH
TGL.AMBIL (5Liter) Rp4,200 (19Liter) Rp8,400 ml) Rp2,000

1 Farmasi :
01/08/2018 0 0 5 42,000 0 0 42,000
04/08/2018 0 0 4 33,600 0 0 33,600
07/08/2018 0 0 5 42,000 0 0 42,000
09/08/2018 0 0 4 33,600 0 0 33,600
10/08/2018 0 0 2 16,800 0 0 16,800
13/08/2018 0 0 1 8,400 0 0 8,400
14/08/2018 0 0 2 16,800 0 0 16,800
15/08/2018 0 0 5 42,000 0 0 42,000
0 0 28 235,200 0 0 235,200

2 Guest House :
02/08/2018 0 0 4 33,600 0 0 33,600
04/08/2018 0 0 2 16,800 0 0 16,800
06/08/2018 0 0 3 25,200 0 0 25,200
08/08/2018 0 0 2 16,800 0 0 16,800
10/08/2018 0 0 3 25,200 0 0 25,200
13/08/2018 0 0 3 25,200 0 0 25,200
15/08/2018 0 0 2 16,800 0 0 16,800
0 0 19 159,600 0 0 159,600

3 URJ :
01/08/2018 0 0 8 67,200 0 0 67,200
03/08/2018 0 0 10 84,000 0 0 84,000
04/08/2018 0 0 11 92,400 0 0 92,400
06/08/2018 0 0 13 109,200 0 0 109,200
07/08/2018 0 0 10 84,000 0 0 84,000
08/08/2018 0 0 10 84,000 0 0 84,000
09/08/2018 0 0 6 50,400 0 0 50,400
10/08/2018 0 0 8 67,200 0 0 67,200
11/08/2018 0 0 6 50,400 0 0 50,400
13/08/2018 0 0 10 84,000 0 0 84,000
14/08/2018 0 0 12 100,800 0 0 100,800
15/08/2018 0 0 7 58,800 0 0 58,800
0 0 111 932,400 0 0 932,400

4 Ignatius :
01/08/2018 0 0 6 50,400 0 0 50,400
06/08/2018 0 0 9 75,600 0 0 75,600
08/08/2018 0 0 5 42,000 0 0 42,000
09/08/2018 0 0 5 42,000 0 0 42,000
10/08/2018 0 0 4 33,600 0 0 33,600
14/08/2018 0 0 5 42,000 0 0 42,000
0 0 34 285,600 0 0 285,600

5 UGD :
02/08/2018 0 0 8 67,200 0 0 67,200
04/08/2018 0 0 6 50,400 0 0 50,400
06/08/2018 0 0 6 50,400 0 0 50,400
07/08/2018 0 0 6 50,400 0 0 50,400
10/08/2018 0 0 8 67,200 0 0 67,200
14/08/2018 0 0 11 92,400 0 0 92,400
0 0 45 378,000 0 0 378,000
6 Fransiskus :
02/08/2018 0 0 7 58,800 0 0 58,800
04/08/2018 0 0 9 75,600 0 0 75,600
07/08/2018 0 0 9 75,600 0 0 75,600
09/08/2018 0 0 5 42,000 0 0 42,000
11/08/2018 0 0 11 92,400 0 0 92,400
15/08/2018 0 0 12 100,800 0 0 100,800
0 0 53 445,200 0 0 445,200

7 SDM :
02/08/2018 0 0 1 8,400 0 0 8,400
07/08/2018 0 0 1 8,400 0 0 8,400
0 0 2 16,800 0 0 16,800

8 Lukas :
01/08/2018 10 42,000 4 33,600 0 0 75,600
02/08/2018 8 33,600 0 0 0 0 33,600
03/08/2018 15 63,000 2 16,800 0 0 79,800
04/08/2018 15 63,000 3 25,200 0 0 88,200
06/08/2018 15 63,000 5 42,000 0 0 105,000
07/08/2018 15 63,000 0 0 0 0 63,000
08/08/2018 10 42,000 4 33,600 0 0 75,600
09/08/2018 10 42,000 3 25,200 0 0 67,200
10/08/2018 10 42,000 4 33,600 0 0 75,600
11/08/2018 11 46,200 0 0 0 0 46,200
13/08/2018 18 75,600 6 50,400 0 0 126,000
14/08/2018 12 50,400 2 16,800 0 0 67,200
15/08/2018 10 42,000 0 0 0 0 42,000
159 667,800 33 277,200 0 0 945,000

9 Pius :
02/08/2018 0 0 5 42,000 0 0 42,000
07/08/2018 0 0 5 42,000 0 0 42,000
13/08/2018 0 0 5 42,000 0 0 42,000
0 0 15 126,000 0 0 126,000

10 HD :
01/08/2018 0 0 3 25,200 0 0 25,200
03/08/2018 0 0 4 33,600 0 0 33,600
04/08/2018 0 0 2 16,800 0 0 16,800
06/08/2018 0 0 2 16,800 0 0 16,800
08/08/2018 0 0 3 25,200 0 0 25,200
11/08/2018 0 0 5 42,000 0 0 42,000
13/08/2018 0 0 2 16,800 0 0 16,800
15/08/2018 0 0 3 25,200 0 0 25,200
0 0 24 201,600 0 0 201,600

11 Laboratorium :
01/08/2018 0 0 2 16,800 0 0 16,800
03/08/2018 0 0 1 8,400 0 0 8,400
08/08/2018 0 0 2 16,800 0 0 16,800
15/08/2018 0 0 2 16,800 0 0 16,800
0 0 7 58,800 0 0 58,800
12 Asrama Lt.10 :
03/08/2018 0 0 2 16,800 0 0 16,800
06/08/2018 0 0 2 16,800 0 0 16,800
09/08/2018 0 0 2 16,800 0 0 16,800
11/08/2018 0 0 1 8,400 0 0 8,400
13/08/2018 0 0 1 8,400 0 0 8,400
0 0 8 67,200 0 0 67,200

13 Uji Kes:
02/08/2018 0 0 4 33,600 0 0 33,600
10/08/2018 0 0 4 33,600 0 0 33,600
0 0 8 67,200 0 0 67,200

14 Receptionist :
03/08/2018 0 0 4 33,600 0 0 33,600
09/08/2018 0 0 3 25,200 0 0 25,200
14/08/2018 0 0 3 25,200 0 0 25,200
0 0 10 84,000 0 0 84,000

15 Kamar Bedah:
02/08/2018 0 0 8 67,200 0 0 67,200
04/08/2018 0 0 5 42,000 0 0 42,000
07/08/2018 0 0 5 42,000 0 0 42,000
10/08/2018 0 0 6 50,400 0 0 50,400
14/08/2018 0 0 6 50,400 0 0 50,400
0 0 30 252,000 0 0 252,000
16 Gudang Farmasi :
06/08/2018 0 0 2 16,800 0 0 16,800
10/08/2018 0 0 2 16,800 0 0 16,800
0 0 4 33,600 0 0 33,600
17 Theresia :
03/08/2018 7 29,400 3 25,200 0 0 54,600
10/08/2018 0 0 4 33,600 0 0 33,600
11/08/2018 8 33,600 2 16,800 0 0 50,400
15 63,000 9 75,600 0 0 138,600

18 Daminanus :
02/08/2018 0 0 6 50,400 0 0 50,400
04/08/2018 0 0 5 42,000 0 0 42,000
06/08/2018 0 0 3 25,200 0 0 25,200
08/08/2018 0 0 4 33,600 0 0 33,600
10/08/2018 0 0 3 25,200 0 0 25,200
11/08/2018 0 0 5 42,000 0 0 42,000
13/08/2018 0 0 4 33,600 0 0 33,600
15/08/2018 0 0 6 50,400 0 0 50,400
0 0 36 302,400 0 0 302,400

19 Yohanes:
01/08/2018 16 67,200 0 0 0 0 67,200
07/08/2018 15 63,000 8 67,200 0 0 130,200
08/08/2018 7 29,400 0 0 0 0 29,400
09/08/2018 7 29,400 0 0 0 0 29,400
45 189,000 8 67,200 0 0 256,200
20 Elisabeth :
03/08/2018 13 54,600 5 42,000 0 0 96,600
06/08/2018 16 67,200 3 25,200 0 0 92,400
08/08/2018 17 71,400 3 25,200 0 0 96,600
11/08/2018 17 71,400 5 42,000 0 0 113,400
63 264,600 16 134,400 0 0 399,000

21 Humas :
02/08/2018 0 0 3 25,200 0 0 25,200
10/08/2018 0 0 3 25,200 0 0 25,200
0 0 6 50,400 0 0 50,400

22 Goretty :
02/08/2018 0 0 4 33,600 0 0 33,600
06/08/2018 0 0 3 25,200 0 0 25,200
08/08/2018 0 0 3 25,200 0 0 25,200
11/08/2018 0 0 3 25,200 0 0 25,200
0 0 13 109,200 0 0 109,200

23 Asrama Lt.07 :
03/08/2018 0 0 6 50,400 0 0 50,400
06/08/2018 0 0 7 58,800 0 0 58,800
09/08/2018 0 0 6 50,400 0 0 50,400
11/08/2018 0 0 4 33,600 0 0 33,600
13/08/2018 0 0 5 42,000 0 0 42,000
15/08/2018 0 0 4 33,600 0 0 33,600
0 0 32 268,800 0 0 268,800

24 Asrama Lt.08 :
03/08/2018 0 0 5 42,000 0 0 42,000
06/08/2018 0 0 4 33,600 0 0 33,600
09/08/2018 0 0 5 42,000 0 0 42,000
11/08/2018 0 0 3 25,200 0 0 25,200
13/08/2018 0 0 3 25,200 0 0 25,200
15/08/2018 0 0 3 25,200 0 0 25,200
0 0 23 193,200 0 0 193,200

25 Rehabilitasi Medik :
04/08/2018 0 0 2 16,800 0 0 16,800
08/08/2018 0 0 3 25,200 0 0 25,200
0 0 5 42,000 0 0 42,000

26 Komite Medik :
06/08/2018 0 0 6 50,400 0 0 50,400
0 0 6 50,400 0 0 50,400

27 Sekretariat :
02/08/2018 0 0 4 33,600 0 0 33,600
06/08/2018 0 0 6 50,400 0 0 50,400
08/08/2018 0 0 2 16,800 0 0 16,800
10/08/2018 0 0 5 42,000 0 0 42,000
13/08/2018 0 0 2 16,800 0 0 16,800
15/08/2018 0 0 3 25,200 0 0 25,200
0 0 22 184,800 0 0 184,800
28 Farmasi 24 Jam :
01/08/2018 0 0 3 25,200 0 0 25,200
04/08/2018 0 0 3 25,200 0 0 25,200
06/08/2018 0 0 2 16,800 0 0 16,800
08/08/2018 0 0 2 16,800 0 0 16,800
09/08/2018 0 0 2 16,800 0 0 16,800
11/08/2018 0 0 2 16,800 0 0 16,800
13/08/2018 0 0 2 16,800 0 0 16,800
15/08/2018 0 0 2 16,800 0 0 16,800
0 0 18 151,200 0 0 151,200

29 Maria :
01/08/2018 0 0 5 42,000 0 0 42,000
02/08/2018 0 0 4 33,600 0 0 33,600
03/08/2018 0 0 3 25,200 0 0 25,200
04/08/2018 0 0 4 33,600 0 0 33,600
06/08/2018 0 0 6 50,400 0 0 50,400
08/08/2018 0 0 3 25,200 0 0 25,200
09/08/2018 0 0 4 33,600 0 0 33,600
11/08/2018 0 0 4 33,600 0 0 33,600
14/08/2018 0 0 6 50,400 0 0 50,400
0 0 39 327,600 0 0 327,600

30 Carolus :
02/08/2018 20 84,000 6 50,400 0 0 134,400
04/08/2018 15 63,000 2 16,800 0 0 79,800
06/08/2018 25 105,000 5 42,000 0 0 147,000
08/08/2018 10 42,000 3 25,200 0 0 67,200
11/08/2018 20 84,000 6 50,400 0 0 134,400
13/08/2018 20 84,000 3 25,200 0 0 109,200
15/08/2018 20 84,000 2 16,800 0 0 100,800
130 546,000 27 226,800 0 0 772,800

31 Radiologi :
02/08/2018 0 0 3 25,200 0 0 25,200
04/08/2018 0 0 3 25,200 0 0 25,200
07/08/2018 0 0 3 25,200 0 0 25,200
08/08/2018 0 0 5 42,000 0 0 42,000
10/08/2018 0 0 2 16,800 0 0 16,800
13/08/2018 0 0 2 16,800 0 0 16,800
14/08/2018 0 0 3 25,200 0 0 25,200
0 0 21 176,400 0 0 176,400

32 Xaverius :
03/08/2018 0 0 5 42,000 0 0 42,000
06/08/2018 0 0 11 92,400 0 0 92,400
08/08/2018 0 0 5 42,000 0 0 42,000
09/08/2018 0 0 5 42,000 0 0 42,000
10/08/2018 0 0 4 33,600 0 0 33,600
13/08/2018 0 0 10 84,000 0 0 84,000
14/08/2018 0 0 3 25,200 0 0 25,200
15/08/2018 0 0 2 16,800 0 0 16,800
0 0 45 378,000 0 0 378,000
33 Yosef / Immanuel :
01/08/2018 1 4,200 3 25,200 0 0 29,400
03/08/2018 4 16,800 5 42,000 0 0 58,800
04/08/2018 3 12,600 2 16,800 0 0 29,400
06/08/2018 4 16,800 5 42,000 0 0 58,800
07/08/2018 4 16,800 4 33,600 0 0 50,400
08/08/2018 2 8,400 2 16,800 0 0 25,200
09/08/2018 2 8,400 4 33,600 0 0 42,000
10/08/2018 5 21,000 2 16,800 0 0 37,800
11/08/2018 4 16,800 5 42,000 0 0 58,800
13/08/2018 4 16,800 4 33,600 0 0 50,400
14/08/2018 6 25,200 4 33,600 0 0 58,800
15/08/2018 7 29,400 1 8,400 0 0 37,800
46 193,200 41 344,400 0 0 537,600

34 Lab Atas URJ :

06/08/2018 1 4,200 5 42,000 0 0 46,200
1 4,200 5 42,000 0 0 46,200

35 Information :
01/08/2018 0 0 4 33,600 0 0 33,600
02/08/2018 0 0 4 33,600 0 0 33,600
04/08/2018 0 0 4 33,600 0 0 33,600
06/08/2018 0 0 4 33,600 0 0 33,600
07/08/2018 0 0 2 16,800 0 0 16,800
08/08/2018 0 0 4 33,600 0 0 33,600
10/08/2018 0 0 4 33,600 0 0 33,600
11/08/2018 0 0 4 33,600 0 0 33,600
13/08/2018 0 0 4 33,600 0 0 33,600
14/08/2018 0 0 5 42,000 0 0 42,000
15/08/2018 0 0 2 16,800 0 0 16,800
0 0 41 344,400 0 0 344,400

36 Asrama Lt.09 :
13/08/2018 0 0 2 16,800 0 0 16,800
15/08/2018 0 0 2 16,800 0 0 16,800
0 0 4 33,600 0 0 33,600

37 Endoscopy :
04/08/2018 0 0 4 33,600 0 0 33,600
0 0 4 33,600 0 0 33,600

T O T A L ...……… 459 1,927,800 852 7,156,800 0 0 9,084,600

Jakarta, 29 Agustus 2018

 DAFTAR PENDISTRIBUSIAN
AIR MUTIARA JAKARTA
DI RS.SINT CAROLUS
PT.Gracia Usaha Bersama
Jakarta
PERIODE : 16-31 Agustus 2018
UNIT / Jumlah HARGA Jumlah HARGA Jumlah HARGA
NO Galon Galon botol (600 JUMLAH
TGL.AMBIL (5Liter) Rp4,200 (19Liter) Rp8,400 ml) Rp2,000

1 Farmasi :
16/08/2018 0 0 2 16,800 0 0 16,800
20/08/2018 0 0 2 16,800 0 0 16,800
21/08/2018 0 0 4 33,600 0 0 33,600
23/08/2018 0 0 4 33,600 0 0 33,600
27/08/2018 0 0 4 33,600 0 0 33,600
28/08/2018 0 0 2 16,800 0 0 16,800
29/08/2018 0 0 4 33,600 0 0 33,600
31/08/2018 0 0 4 33,600 0 0 33,600
0 0 26 218,400 0 0 218,400

2 Guest House :
18/08/2018 0 0 3 25,200 0 0 25,200
21/08/2018 0 0 4 33,600 0 0 33,600
23/08/2018 0 0 2 16,800 0 0 16,800
25/08/2018 0 0 1 8,400 0 0 8,400
30/08/2018 0 0 4 33,600 0 0 33,600
0 0 14 117,600 0 0 117,600

3 URJ :
16/08/2018 0 0 7 58,800 0 0 58,800
18/08/2018 0 0 12 100,800 0 0 100,800
21/08/2018 0 0 13 109,200 0 0 109,200
23/08/2018 0 0 15 126,000 0 0 126,000
24/08/2018 0 0 17 142,800 0 0 142,800
27/08/2018 0 0 16 134,400 0 0 134,400
28/08/2018 0 0 10 84,000 0 0 84,000
29/08/2018 0 0 10 84,000 0 0 84,000
30/08/2018 0 0 11 92,400 0 0 92,400
31/08/2018 0 0 10 84,000 0 0 84,000
0 0 121 1,016,400 0 0 1,016,400

4 Ignatius :
20/08/2018 0 0 7 58,800 0 0 58,800
23/08/2018 0 0 8 67,200 0 0 67,200
24/08/2018 0 0 4 33,600 0 0 33,600
27/08/2018 0 0 9 75,600 0 0 75,600
29/08/2018 0 0 4 33,600 0 0 33,600
0 0 32 268,800 0 0 268,800

5 UGD :
15/08/2018 0 0 5 42,000 0 0 42,000
18/08/2018 0 0 6 50,400 0 0 50,400
21/08/2018 0 0 5 42,000 0 0 42,000
23/08/2018 0 0 6 50,400 0 0 50,400
24/08/2018 0 0 6 50,400 0 0 50,400
28/08/2018 0 0 6 50,400 0 0 50,400
30/08/2018 0 0 6 50,400 0 0 50,400
0 0 40 336,000 0 0 336,000

6 Fransiskus :
16/08/2018 0 0 6 50,400 0 0 50,400
18/08/2018 0 0 8 67,200 0 0 67,200
 20/08/2018 2 8,400 5 42,000 0 0 50,400
23/08/2018 0 0 7 58,800 0 0 58,800
25/08/2018 0 0 5 42,000 0 0 42,000
27/08/2018 0 0 11 92,400 0 0 92,400
30/08/2018 2 8,400 7 58,800 0 0 67,200
4 16,800 49 411,600 0 0 428,400

7 SDM :
16/08/2018 0 0 1 8,400 0 0 8,400
0 0 1 8,400 0 0 8,400

8 Lukas :
16/08/2018 10 42,000 4 33,600 0 0 75,600
18/08/2018 17 71,400 4 33,600 0 0 105,000
20/08/2018 14 58,800 3 25,200 0 0 84,000
21/08/2018 8 33,600 1 8,400 0 0 42,000
23/08/2018 18 75,600 6 50,400 0 0 126,000
24/08/2018 13 54,600 2 16,800 0 0 71,400
25/08/2018 12 50,400 3 25,200 0 0 75,600
27/08/2018 20 84,000 5 42,000 0 0 126,000
29/08/2018 17 71,400 4 33,600 0 0 105,000
30/08/2018 12 50,400 0 0 0 0 50,400
31/08/2018 15 63,000 2 16,800 0 0 79,800
156 655,200 34 285,600 0 0 940,800

9 Pius :
20/08/2018 0 0 5 42,000 0 0 42,000
25/08/2018 0 0 4 33,600 0 0 33,600
29/08/2018 0 0 4 33,600 0 0 33,600
0 0 13 109,200 0 0 109,200

10 HD :
18/08/2018 0 0 4 33,600 0 0 33,600
23/08/2018 0 0 3 25,200 0 0 25,200
25/08/2018 0 0 3 25,200 0 0 25,200
27/08/2018 0 0 2 16,800 0 0 16,800
29/08/2018 0 0 3 25,200 0 0 25,200
31/08/2018 0 0 3 25,200 0 0 25,200
0 0 18 151,200 0 0 151,200

11 Laboratorium :
21/08/2018 0 0 2 16,800 0 0 16,800
24/08/2018 0 0 1 8,400 0 0 8,400
31/08/2018 0 0 2 16,800 0 0 16,800
0 0 5 42,000 0 0 42,000

12 Asrama Lt.10 :
18/08/2018 0 0 1 8,400 0 0 8,400
20/08/2018 0 0 2 16,800 0 0 16,800
23/08/2018 0 0 1 8,400 0 0 8,400
27/08/2018 0 0 1 8,400 0 0 8,400
30/08/2018 0 0 2 16,800 0 0 16,800
0 0 7 58,800 0 0 58,800

13 Uji Kes:
21/08/2018 0 0 4 33,600 0 0 33,600
30/08/2018 0 0 4 33,600 0 0 33,600
0 0 8 67,200 0 0 67,200

14 Receptionist :
21/08/2018 0 0 2 16,800 0 0 16,800
23/08/2018 0 0 4 33,600 0 0 33,600
24/08/2018 0 0 3 25,200 0 0 25,200
 30/08/2018 0 0 4 33,600 0 0 33,600
0 0 13 109,200 0 0 109,200

15 Kamar Bedah:
16/08/2018 0 0 5 42,000 0 0 42,000
23/08/2018 0 0 8 67,200 0 0 67,200
27/08/2018 0 0 7 58,800 0 0 58,800
31/08/2018 0 0 8 67,200 0 0 67,200
0 0 28 235,200 0 0 235,200

16 Theresia :
16/08/2018 6 25,200 3 25,200 0 0 50,400
21/08/2018 0 0 3 25,200 0 0 25,200
25/08/2018 10 42,000 2 16,800 0 0 58,800
27/08/2018 0 0 3 25,200 0 0 25,200
31/08/2018 10 42,000 5 42,000 0 0 84,000
26 109,200 16 134,400 0 0 243,600

17 UPI / Daminanus :
16/08/2018 0 0 3 25,200 0 0 25,200
18/08/2018 0 0 5 42,000 0 0 42,000
21/08/2018 0 0 4 33,600 0 0 33,600
25/08/2018 0 0 6 50,400 0 0 50,400
27/08/2018 0 0 5 42,000 0 0 42,000
28/08/2018 0 0 3 25,200 0 0 25,200
30/08/2018 0 0 6 50,400 0 0 50,400
0 0 32 268,800 0 0 268,800

18 Yohanes:
16/08/2018 17 71,400 5 42,000 0 0 113,400
23/08/2018 15 63,000 4 33,600 0 0 96,600
28/08/2018 15 63,000 5 42,000 0 0 105,000
47 197,400 14 117,600 0 0 315,000

19 Elisabeth :
16/08/2018 20 84,000 7 58,800 0 0 142,800
18/08/2018 8 33,600 2 16,800 0 0 50,400
20/08/2018 16 67,200 3 25,200 0 0 92,400
23/08/2018 11 46,200 3 25,200 0 0 71,400
27/08/2018 19 79,800 3 25,200 0 0 105,000
30/08/2018 5 21,000 4 33,600 0 0 54,600
79 331,800 22 184,800 0 0 516,600

20 Humas :
16/08/2018 0 0 5 42,000 0 0 42,000
21/08/2018 0 0 4 33,600 0 0 33,600
24/08/2018 0 0 2 16,800 0 0 16,800
30/08/2018 0 0 4 33,600 0 0 33,600
0 0 15 126,000 0 0 126,000

21 Goretty :
16/08/2018 0 0 5 42,000 0 0 42,000
18/08/2018 0 0 3 25,200 0 0 25,200
24/08/2018 0 0 4 33,600 0 0 33,600
28/08/2018 0 0 3 25,200 0 0 25,200
30/08/2018 0 0 3 25,200 0 0 25,200
0 0 18 151,200 0 0 151,200

22 Asrama Lt.07 :
18/08/2018 0 0 7 58,800 0 0 58,800
20/08/2018 0 0 5 42,000 0 0 42,000
23/08/2018 0 0 6 50,400 0 0 50,400
24/08/2018 0 0 4 33,600 0 0 33,600
 27/08/2018 0 0 7 58,800 0 0 58,800
30/08/2018 0 0 6 50,400 0 0 50,400
0 0 35 294,000 0 0 294,000

23 Asrama Lt.08 :
18/08/2018 0 0 5 42,000 0 0 42,000
20/08/2018 0 0 3 25,200 0 0 25,200
23/08/2018 0 0 5 42,000 0 0 42,000
27/08/2018 0 0 5 42,000 0 0 42,000
30/08/2018 0 0 4 33,600 0 0 33,600
0 0 22 184,800 0 0 184,800

24 Rehabilitasi Medik :
16/08/2018 0 0 2 16,800 0 0 16,800
23/08/2018 0 0 3 25,200 0 0 25,200
24/08/2018 0 0 3 25,200 0 0 25,200
28/08/2018 0 0 2 16,800 0 0 16,800
0 0 10 84,000 0 0 84,000

25 Komite Medik :
20/08/2018 0 0 5 42,000 0 0 42,000
0 0 5 42,000 0 0 42,000

26 Sekretariat :
18/08/2018 0 0 2 16,800 0 0 16,800
21/08/2018 1 4,200 0 0 0 0 4,200
23/08/2018 0 0 2 16,800 0 0 16,800
25/08/2018 0 0 3 25,200 0 0 25,200
28/08/2018 0 0 3 25,200 0 0 25,200
29/08/2018 0 0 1 8,400 0 0 8,400
30/08/2018 0 0 2 16,800 0 0 16,800
1 4,200 13 109,200 0 0 113,400

27 Farmasi 24 Jam :
16/08/2018 0 0 2 16,800 0 0 16,800
18/08/2018 0 0 3 25,200 0 0 25,200
20/08/2018 0 0 2 16,800 0 0 16,800
23/08/2018 0 0 3 25,200 0 0 25,200
25/08/2018 0 0 3 25,200 0 0 25,200
27/08/2018 0 0 2 16,800 0 0 16,800
29/08/2018 0 0 2 16,800 0 0 16,800
31/08/2018 0 0 4 33,600 0 0 33,600
0 0 21 176,400 0 0 176,400

28 Maria :
16/08/2018 0 0 3 25,200 0 0 25,200
18/08/2018 0 0 4 33,600 0 0 33,600
20/08/2018 0 0 5 42,000 0 0 42,000
23/08/2018 0 0 3 25,200 0 0 25,200
25/08/2018 0 0 5 42,000 0 0 42,000
27/08/2018 0 0 3 25,200 0 0 25,200
28/08/2018 0 0 2 16,800 0 0 16,800
29/08/2018 0 0 2 16,800 0 0 16,800
30/08/2018 0 0 4 33,600 0 0 33,600
31/08/2018 0 0 6 50,400 0 0 50,400
0 0 37 310,800 0 0 310,800

29 Carolus :
18/08/2018 20 84,000 4 33,600 0 0 117,600
21/08/2018 15 63,000 6 50,400 0 0 113,400
23/08/2018 15 63,000 3 25,200 0 0 88,200
25/08/2018 25 105,000 3 25,200 0 0 130,200
 28/08/2018 20 84,000 5 42,000 0 0 126,000
30/08/2018 20 84,000 3 25,200 0 0 109,200
31/08/2018 20 84,000 5 42,000 0 0 126,000
135 567,000 29 243,600 0 0 810,600

30 Radiologi :
16/08/2018 0 0 3 25,200 0 0 25,200
20/08/2018 0 0 3 25,200 0 0 25,200
23/08/2018 0 0 3 25,200 0 0 25,200
24/08/2018 0 0 2 16,800 0 0 16,800
25/08/2018 0 0 2 16,800 0 0 16,800
28/08/2018 0 0 2 16,800 0 0 16,800
29/08/2018 0 0 2 16,800 0 0 16,800
30/08/2018 0 0 2 16,800 0 0 16,800
0 0 19 159,600 0 0 159,600

31 Xaverius :
16/08/2018 0 0 3 25,200 0 0 25,200
18/08/2018 0 0 6 50,400 0 0 50,400
24/08/2018 0 0 5 42,000 0 0 42,000
25/08/2018 0 0 5 42,000 0 0 42,000
27/08/2018 0 0 3 25,200 0 0 25,200
31/08/2018 0 0 5 42,000 0 0 42,000
0 0 27 226,800 0 0 226,800

32 Yosef / Immanuel :
18/08/2018 8 33,600 6 50,400 0 0 84,000
20/08/2018 6 25,200 3 25,200 0 0 50,400
21/08/2018 4 16,800 5 42,000 0 0 58,800
23/08/2018 5 21,000 4 33,600 0 0 54,600
24/08/2018 3 12,600 5 42,000 0 0 54,600
25/08/2018 5 21,000 2 16,800 0 0 37,800
27/08/2018 9 37,800 5 42,000 0 0 79,800
28/08/2018 3 12,600 1 8,400 0 0 21,000
29/08/2018 6 25,200 1 8,400 0 0 33,600
30/08/2018 6 25,200 3 25,200 0 0 50,400
55 231,000 35 294,000 0 0 525,000

33 Stella Maris
27/08/2018 0 0 6 50,400 0 0 50,400
0 0 6 50,400 0 0 50,400

34 Information :
16/08/2018 0 0 4 33,600 0 0 33,600
18/08/2018 0 0 4 33,600 0 0 33,600
20/08/2018 0 0 5 42,000 0 0 42,000
21/08/2018 0 0 3 25,200 0 0 25,200
25/08/2018 0 0 4 33,600 0 0 33,600
27/08/2018 0 0 4 33,600 0 0 33,600
28/08/2018 0 0 4 33,600 0 0 33,600
29/08/2018 0 0 3 25,200 0 0 25,200
31/08/2018 0 0 4 33,600 0 0 33,600
0 0 35 294,000 0 0 294,000

35 Asrama Lt.09 :
18/08/2018 0 0 4 33,600 0 0 33,600
20/08/2018 0 0 2 16,800 0 0 16,800
23/08/2018 0 0 4 33,600 0 0 33,600
24/08/2018 0 0 4 33,600 0 0 33,600
27/08/2018 0 0 4 33,600 0 0 33,600
30/08/2018 0 0 4 33,600 0 0 33,600
0 0 22 184,800 0 0 184,800
T O T A L ...……… 503 2,112,600 842 7,072,800 0 0 9,185,400

Jakarta, 06 September 2018

 0 AIR MUTIARA KKUB JAKARTA
JLN. SALEMBA RAYA NO.41 JAKARTA PUSAT 10440
PHONE : 021-3900397- 021 3905396 / 3904441 EXT.2667

INVOICE

PERIODE : 01 - 15 Mei 2015

JUMLAH HARGA TOTAL DIBAYAR

TGL.INVOICE NAMA BARANG
gln/btl SATUAN (Rp)
5/19/2015 - AIR MUTIARA GALON 19LTR 514 7,500 3,855,000
- AIR MUTIARA GALON 5 LTR 1,001 3,750 3,753,750
- AIR MUTIARA BOTOL 600 ML - 2,000 -
T O T A L ..……. 7,608,750

Terbilang : # Tujuh Juta Enam Ratus Delapan Ribu Tujuh Ratus Lima Puluh Rupiah #

( Data Terlampir)

Jakarta, 19 Mei 2015

Hormat Kami,

V.Debbie Ruru SE
KA.Keuangan KKUBSC

Pembayaran Mohon Untuk Ditransfer ke Rekening

BANK BRI
An : KKUBSC QQ WU AMDK
KCP : Sint Carolus
No. Rekening : 1765-01-000010-56-5
No. NPWP : 01.762.809.0.023.000