R S L e s t a r i R a h a r j a

J l . S o e t o p o n o . 5
M a g e l a n g , J a w a Te n g a h , I n d o n e s i a
Te l p . ( 0 2 9 3 ) 3 6 2 2 2 5 / ( 0 2 9 3 ) 3 6 2 6 4 9
R I N C I A N

B I A Y A

1 5

N o .
N o .

: R I - 4 9 2
R M

N a m a

: 0 8 0 4 2 3

P a s i e n

: F A R R E L
C , A N

Y O N A T H A N

N a m a
P e n a n g g u n g
J a w a b

A l a m a t

: S a r a g a n I / 2 R t 3
B a n y u r o j o
M e r t o y u d a n ,

R w 9

B i a y a
1

S e w a

P e m e l i h a r a a n

K a m a r

D o k u m e n

4
5

2 0 1 6

: 1 6 0 5 2

P e l a y a n a n

: A N A K

T g l
K u n j u n g a n

: 1 2 M a r 2 0 1 6
M a r 2 0 1 6

C a r a

: U M U M

N o .

B a y a r

B i l l

J m l

P r a t a m a

M a r

N o .
R e g i s t e r

1 0 : 2 1

1 5

: _ _ _ _ _ / K U / _ _ _ _ _
/ _ _ _ _ _

B i a y a

S u b

T o t a l

7 2 5 , 0 0 0

2 , 1 7 5 , 0 0 0

2 1 7 , 5 0 0

2 1 7 , 5 0 0

5 5 , 0 0 0

5 5 , 0 0 0

O b a t

8 6 2 , 3 0 0

8 6 2 , 3 0 0

A L K E S

3 8 9 , 4 0 0

3 8 9 , 4 0 0

L a b o r a t o r i u m

1 1 1 , 0 0 0

1 1 1 , 0 0 0

J a s a

5 , 0 0 0

1 5 , 0 0 0

P e m a s a n g a n

8 0 , 0 0 0

8 0 , 0 0 0

P e r a w a t a n

3 0 , 0 0 0

6 0 , 0 0 0

F a s i l i t a s

1 0 %

M e d i s

P a r a m e d i k
I n f u s

I n f u s /

1 0 S u n t i k / T i n d i k .

T r a n f u s i

P a r a m e d i s

1 1 V i s i t e D o k t e r S p e s i a l i s
R a s y i d , d r . , S p . A )
1 2 P e m e r i k s a a n P o l i k l i n i k
R a s y i d , d r . , S p . A )

( I s n u
( I s n u

7 , 0 0 0

4 9 , 0 0 0

9 5 , 0 0 0

2 8 5 , 0 0 0

1 6 0 , 0 0 0

1 6 0 , 0 0 0

T e r b i l a n g :
S a t u J u t a E m p a t R a t u s L i m a P u l u h
S e m b i l a n R i b u D u a R a t u s R u p i a h

T o t a l

K e t e r a n g a n

B i a y a

4 , 4 5 9 , 2 0 0

K a r t u

U a n g
M u k a / D e p o s i t
A s u r a n s i

B a y a r

T u n a i

B a y a r

N o n

T u n a i

K u r a n g / K e l e b i h a n
P a s i e n / P e n a n g g u n g

J a w a b ,

_ _ _ _ _ _ _ _ _ _ _ _ _

3 , 0 0 0 , 0 0 0

P e t u g a s ,

D a n a n g

1 , 4 5 9 , 2 0 0
0
0