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OutPatient Invoice

COPY

Receipt No : OP-00000749
Reg No : 2401050010
MRN : OTC
Patients Name : KF FIRST CARE
Penjamin Bayar : Insurance
Instance : Kimia Farma - UPDS
Queue Recipe Number : 000

Description Qty Tot. Sblm Diskon Disc(%) Total

MEDICINES CHARGE :
Clindamycin 300mg@50 Gmer ( R00174455 ) 5 - 0,-
Microlax Enema 5ml@3 ( R00174455 ) 3 - 0,-
Subtotal : 0,-
Bill 0,-
Rounding 0,-
Total Bill 0,-
Payment :
Total Pay
Outstanding Amount 0,-

Receipt From : KF FIRST CARE


Amount ( Zero Rupiah)

BCA 375 801111111 Kota Jakarta Selatan / 05-01-2024, 14:22


PT Panca Medika Global
Thank You
Officer

Printed : 05-01-2024, 14:39 ( Rina )


- Payment is valid after being stamped by the cashier
- Purchased items cannot be exchanged or returned
- For taxable goods, VAT is included
Dr. dr. Fitriyadi, Sp.OG(K)
Jl. Panglima Polim III No.5, RT.3 / RW.3

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