Sp. ORS. SENTRAL YN Cs Te RENE CAL Oras Sr NO, #2 ATTA, CARTONS metre - ta LOAREZ (CRINCTAN BIAYA PERAWATAN PASIEN RAWAT INAP } We. Rag Fan; 2oDAoIESeA PRIGADI Narva Peden ADE ALETH Ho. Rah tied 06-44-62 ‘Umur/Gender 7 25 Tahun 3 Bulan EP RIA ‘Surdah teriona dari + ‘Alamat + DSN. MEXARSARI DS. BLANAKAN KEC. BLANAKAN-SBS | Keteranyan ee Yanyyat an Dumtah Rp | ‘SUA BU DIRK HER PERTAIN -BANGSAL Sermal Angyrek 305 KLS TIGA dari 05-20-23 jam09:35:33 24 06-10-23 pam 120404 = 2 Hari Re 200.000 290,000 Sub Total Palayanan 800,000 * SP RES ONTTAASD (TIND ON EM TRS HERES, BG ANOREE ARTHUR, OR 05-10-23 77900 en HBOS Paka BNE} EAT &/2NOREE THUR, OF as-10-23 10,500 Paar Irs Devas ANDREE ARTHUR, DR 05-10-23 31,250 Pararisaon Detter U6 ju SAREE ARTA, 352023 7.20 SIAYA REGISTRSS! BASEN 05-10-23 10,000 “bers Lenskes 051073 | 1070 81,120 *StkousDerh Sendo 25103 31200 LED 05-10-23 33,400 = Thorex 8° 05-20-23 115,200 ‘cub Total Pelayanian aa7,i20 + _Arioskan oTOMUTISDAR aA + AOH DARL RAWIAT HLA 05-10-23 19,000 Sub Total Pelayanari 20,00 * “PTUNDAK AN INAP B PERSSLINAN = Aces PERALATAN 8K 0510-23 13000 ~ HYGIENE PASIEN 85-10-23 = 1,537 + JaSa PERAWATAN: 05-10-23 22.000 = ALKESRANAP 2 HART (06-10-23 185,000 + ANQKAT INFUS aK DEAS 06-10-23 450 ~ Koneul dr spesiatis vie.teipon ACB.AL SUNGKAR, DR Sp FD (06-10-23 34125 stananiie Paes HE) 26103 130/500 + 10S PERAWATAN 06-10-23, 22,000 ‘Sab Fatal Petsyanan 234382 * ast ove ~ Visit Dakar Spesislis AQBAL SUNGH AR, DR.Sp.PO 05-10-23 73,500 se Jaga PODER 05-10-23 21,008 Si Total ebayaran 34,500 * PEVERICSAAN LABORA TORI Fees Aah OLAGIeOSTie Sub Total Pelayenian ESE DOKTER (FaRMMASL) ab Total Palayenan Catak tol : 05-10-23 Pukul: 12:05:42 WIB. User: MITHARANAP REKENING HOSPITAL MANAGEMENT SYSTEMel 2DAe 2 05-10-23 433,820 DHI523 382,600 = Rezes na RRIDE-OG o5-10- 84,600 = Reaag no PANZDSIIOTONEES 06-(0-23 263,700 Recep no RIUE-COOOIMESS 06-10-23 251,200 Recep 2 RRM E12 7500 Retr io RT2OZ-GRIRIGIOS Unt: Resep No, ANE-COUNITSD 06-10-23 2BI6 ‘Sub Total Balayanan, 2,057,213 * Total Biay2 Perawatan Rawat Inay 2.092.145 + mine Fea stan 5% 05-50-25 104557 Sans pacar - PRPBAYARAN YANG SUDA DILAKLKN PASI CERGURANGAN) = Uang ake /Penerbahen very mee KBIODIRE 95-10-23 00,000 ang tbs /Perendanan uy mute RAREST 05-16-23 539.800 —ang ke /Paranbshan wang maka 2022000007944 96-10-23 251200 Sub Total Peloyanan 7,491,600 * Sumish 2,197803.56 srg Mika 2,151, 500.00 TERBILANG : SATU SUTA EHAM 8(8U DUA RATUS EMBAD RUSIAH enyeaypa: Kefrerga asin Pasien/Peserta/istrianat “1, KurengBayar S0EteEseeeeese PN vas 0810-23 TRALERDIKA, (narra TUNGGAL PUTRI RANA < imaian Cia ote pene = isdn pads saat pulang dv beLir trac tiem fevien i, mae Shan tiean hems, (Cottak tn) : 06-10-23 Puls: 12:05:42 WI. Usor: MITHA RANAP REKENING HOSPITAL MANAGEMENT SYSTEMRS. SENFRAE MEDIKA A. RAYS. CIVALONG Sit NO: 42 JATISARY, KARAINC REKAPITULASI RESEP PERAWATAN | hase Wo Ragisveasi/Mk 20Q3AnD00504 jf — DORAEE Basa Fislex ADE ALL 1 ls [_e. tesep | Tenopst | Tome Oot a a |sawea-vonbees | os-30-25 | Fopanod Tah | heewiae | aaron | { Joe tag 305 rian imps | £7,228 suns | \ {apaeares { { 2.978 { asa | {soute 5 cc ( fe oane ze | } | cca aoa De Bansal alto aS acont i [srs rons ap i | i Bisse | [sevep-cosocer= [asia 25 Yapioen aye [ beemed | are 106 | | | Samand 500 ng Sah 3.00 Tablet ” am} | Jet tntussn Sone } zoortatech 26,387 } sums | |maxce Ser intur } abe mun yan vast} \ \ {Wentien 20 j doe taan rece | anaes \ {see cotau tp { { {rere | (ranea-tinanee ( oe-in-a? [eevecetae Sey Tey {atta | anor ane | { {F6 Troches Tab { a.oomabies! — a,c00 9,900 | | jet | boomer | eee | ener | i i Puecoite Int 2.00 ateeh B58 at,sse } Bb Infuran Aanhe | 2.00 Fiabeeh 20,700 20.780 | Histizs tab 2.00 Tablet! LEAP zo | \ spuis 3 cc L aloowe | ans) araeo { ss0 TOTAL Be { [tcc - rainnses | ote Tose ten 2p Tovar | eT | aes f ot tntssen dante 2.00 Flabo 25.907 | Stars i {Spuie 3 ce 00 bush 2,475 2475 | [ancora eee sige foray) sae zs | Blesige cab s.00reie} ram | eee | | 76 teacher Tab re | ies | \ fessine_ | )r20z3-c000024 { 06-10-22 | Topamol Ini 1-60 Vial | 291,631 | 281,932 | } | s+ roman op 252,800 ore jaa a oe papal na aa | } \cudanasatave tog Tab acces mast aoe teen Hinting. tab {3.00 tabder 1.472 wae | ' | Wotsdan s0Oay kb { -a.00 tabier ae sae ( | Pe corlatse i erence [ereoes-o0000s | O@ab22 |fetorsize Jong Tai t RC a | i sensed Zatue i 28,208 azo | Putealit Tat \ 24.563 24,582 oe as aeeS. RS . SENTRAL MEDIKA. a ay Tesh i aie sue 4 ee ee v } | REKAPITULASI RESEP PERAWATAN ners? | [ Total Resep/ubae Rp 3,057,713, ersren fph setae . o6-20 KOSETTAL YaNAGRENT@ ORS. SENTRAL MEDIKA RS evict me open Sst No Ragha/ Bo. 202340020575 /06-44621 ts PenerBsaun :1202300000010669 ‘Mama Fasten ADE AU,TN So" Brg Jawa | ¢ DRJEMMANUEL Sp.PK- Yatamin + Pria Bolter ANDREE ARTHUR DR vam 25 Th3ELOHe ‘Asal/pesamin. ae en away Jalan (#Jrona/PrawsD4 Alamat DSN. MEKARSARI DS ELANAKAN KEG. BLANAKAN‘SAG t Kab 2 gaet 2. TILAI NORMAL] SATUAN HASTE TES: Komis. 03 Oktaber 10:17:08 W1B | gua ) | _-MEMATOLOGILENGKAP a NOY ang { ee [oS rogwoa Fo Nena pans |. Metal Seemen Mesos Rematon, Trombosit “nce | KIMIA DARAH t | Ramis, 05 Oktober 10: . KARBONIORAT > CATATAN MOREETAG “UOAEEEIT YETEM ttn} / CAOORATORIM ~"> Laat Uodete Ragort 5 11/48/z0tE w