Pt. Inhe

RINCIAN BIAYA PERAWATAN KARYAWAN / KARYAWATI DAN ANGGOTA KELUARGA
PT. PML YANG BEROBAT DI RSUD H. HANAFIE MUARA BUNGO

BULAN TAGIHAN : JUNI 2010
UMUR TINDAKAN B I A Y A
DOKTER YG
NO. NAMA PASIEN JASA JASA
(THN) PELAYANAN JUMLAH O B H P MERAWAT
SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 Nanda Andalah A/D Musdarlin Karcis 7,500 3,750 3,750 Dr. Triolit
Sopir Operator Konsul 35,000 10,150 24,850 Dr. Triolit
Exo Serumen 28,000 14,000 5,600 8,400 Dr. Triolit
2 Irwan 25 Perwt. Bdh Kls II 1 Hr 56,000 15,600 21,800 18,600 Dr. Faisal
Kary. PHL Karcis & IGD 37,000 18,500 18,500 IGD
TNO Bdh 20,000 4,000 4,000 12,000 Dr. Faisal
3 Nanda Andalah A/D Musdarlin Karcis IGD 12,000 6,000 6,000 IGD
Sopir Operator TNO IGD 25,000 5,000 5,000 15,000 IGD
4 Erwin 26 Perwt. Pav B 3 Hr 630,000 294,000 126,000 210,000 Dr. Susi

Asst. PT PML Karcis & IGD 37,000 18,500 18,500 IGD
TNO Pav B 105,000 21,000 21,000 63,000 Dr. Susi
JUMLAH 992,500 410,500 183,400 398,600
Keterangan :
Jumlah 992,500
- Jasa Sarana 410,500
- O B H P 183,400
- Jasa Pelayanan 398,600
Mengetahui Muara Bungo, 26 Juli 2010

Direktur RSUD H. Hanafie Muara Bungo Pengelola Program
dr. Safaruddin, MPH S. M A N A L U.

NIP. 1967 0930 2002 12 1 001 NIP. 1963 06 08 1986 03 1 008
BULAN TAGIHAN : JULI 2010
DOKTER YG
SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 Musdarlin Karcis 7,500 3,750 3,750 Dr. Mardiah

Supir Manager Konsul 35,000 10,150 24,850 Dr. Mardiah
Labor 139,500 20,925 62,775 55,800 Dr. Mardiah
RO 98,000 11,760 44,100 42,140 Dr. Mardiah
2 Erwin 26 Thn Labor Tertinggal 150,500 22,575 67,725 60,200 Dr. Susi
JUMLAH 430,500 69,160 174,600 186,740
Keterangan :
Jumlah 430,500
- O B H P 174,600
Mengetahui Muara Bungo, 16 Agustus 2010


NIP. 1967 0930 2002 12 1 001 NIP. 1963 06 08 1986 03 1 008
BULAN TAGIHAN : AGUSTUS 2010
DOKTER YG
SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 Joi A/D Gibson Tanjung Perwt. Pav C 4 Hr 840,000 392,000 168,000 280,000 Dr. Harnadi
Asst Lapangan Labor 74,000 11,100 33,300 29,600 Dr. Harnadi
Karcis & IGD 37,000 18,500 18,500 IGD
TNO Pav C 140,000 28,000 28,000 84,000 Dr. Harnadi
2 Abd Rohim 42 Thn Perwt. INT Kls II 4 Hr 224,000 62,400 87,200 74,400 Dr. Susi
Operator PB SKU Labor 294,500 44,175 132,525 117,800 Dr. Susi
Karcis & IGD 37,000 18,500 18,500 IGD
TNO INT 20,000 4,000 4,000 12,000 Dr. Susi
3 H. Tambunan 33 Thn Perwt. INT Kls II 3 Hr 168,000 46,800 65,400 55,800 Dr. Susi
Sopir SKU H Labor 192,500 28,875 86,625 77,000 Dr. Susi
Karcis & IGD 37,000 18,500 18,500 IGD
TNO INT 40,000 8,000 8,000 24,000 Dr. Susi
JUMLAH 2,104,000 680,850 613,050 810,100
Keterangan :
Jumlah 2,104,000
- O B H P 613,050
Mengetahui Muara Bungo, 27 September 2010


NIP. 1967 0930 2002 12 1 001 NIP. 1963 06 08 1986 03 1 008
BULAN TAGIHAN : SEPTEMBER 2010
DOKTER YG
SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 A. Rohman 31 Perwt. INT Kls II 3 Hr 168,000 46,800 65,400 55,800 Dr. Taufan
Operator SKU PB Labor 242,500 36,375 109,125 97,000 Dr. Taufan
Karcis & IGD 37,000 18,500 18,500 Dr. Taufan
TNO INT 40,000 8,000 8,000 24,000 Dr. Taufan
2 Nanda A/D Musdarlin Karcis 7,500 3,750 3,750 Dr. Magdalena
3 H. Tambunan 32 Perwt. INT Kls II 3 Hr 168,000 46,800 65,400 55,800 Dr. Taufan
Operator SKU H Labor 229,500 34,425 103,275 91,800 Dr. Taufan
Karcis & IGD 37,000 18,500 18,500 Dr. Taufan
TNO INT 20,000 4,000 4,000 12,000 Dr. Taufan
JUMLAH 949,500 217,150 355,200 377,150
Keterangan :
Jumlah 949,500
- O B H P 355,200
Mengetahui Muara Bungo, 19 Oktober 2010


NIP. 1967 0930 2002 12 1 001 NIP. 1963 06 08 1986 03 1 008
BULAN TAGIHAN : OKTOBER 2010
DOKTER YG
SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 C. Br. Hutagaol 29 Karcis IGD 12,000 6,000 6,000 IGD

I/D H. Tambunan TNO IGD 25,000 5,000 5,000 15,000 IGD
2 Charles 30 Karcis IGD 12,000 6,000 6,000 IGD

Operator PHL TNO IGD 25,000 5,000 5,000 15,000 IGD
3 henny I/D Minto Perwt. INT Kls II 3 Hr 168,000 46,800 65,400 55,800 Dr. Susi
Operator PHL Labor 324,500 48,675 146,025 129,800 Dr. Susi
RO 70,000 8,400 31,500 30,100 Dr. Susi
EKG 70,000 14,000 35,000 21,000 Dr. Susi
Karcis & IGD 37,000 18,500 18,500 IGD
TNO INT 20,000 4,000 4,000 12,000 Dr. Susi
4 Musdarlin Karcis IGD 12,000 6,000 6,000 IGD

Sopir SKH U TNO IGD 25,000 5,000 5,000 15,000 IGD
5 Bambang 30 Karcis IGD 12,000 6,000 6,000 IGD

Mekanik SKU TNO IGD 25,000 5,000 5,000 15,000 IGD
JUMLAH 837,500 184,375 301,925 351,200
Keterangan :
Jumlah 837,500
- O B H P 301,925
Mengetahui Muara Bungo, 16 November 2010


NIP. 1967 0930 2002 12 1 001 NIP. 1963 06 08 1986 03 1 008
BULAN TAGIHAN : NOVEMBER 2010

(THN) PELAYANAN JUMLAH O B H P
SARANA PELAYANAN
1 2 3 4 5 6 7 8
1 Asnidar I/D Musdarlin Karcis 7,500 3,750 3,750

Sopir SKU H Premedikasi 25,000 3,125 12,500 9,375
2 Karmila I/D A Rikin Karcis 7,500 3,750 3,750

Operator Traktor PHL Konsul 35,000 10,150 24,850
3 H. Tambunan 33 Karcis 7,500 3,750 3,750

SKU Konsul 35,000 10,150 24,850
4 A. Rohman 42 Perwt. INT Kls II 6 Hr 336,000 93,600 130,800 111,600

Operator Labor 211,000 31,650 94,950 84,400
Karcis Poli 7,500 3,750 3,750
Konsul Poli 35,000 10,150 24,850
EKG Poli 45,000 9,000 22,500 13,500
TNO INT 40,000 8,000 8,000 24,000
5 Sudihati I/D Agus Sihotang Perwt. Obgyn Kls III 5 Hr 150,000 30,000 90,000 30,000
SuperVisi Op. Besar 940,000 423,000 235,000 282,000
TNO Obgyn 75,000 15,000 15,000 45,000
USG 43,000 8,600 21,500 12,900
Oksigen 20,000 20,000
Karcis 7,500 3,750 3,750
Konsul 35,000 10,150 24,850
JUMLAH 2,062,500 681,325 650,250 730,925
Keterangan :
Jumlah 2,062,500
- O B H P 650,250
Mengetahui Muara Bungo, 23 Desember 2010


NIP. 1967 0930 2002 12 1 001 NIP. 1963 06 08 1986 03 1 008
ARGA
DOKTER YG
MERAWAT
Dr. Elia
Dr. Elia
Dr. Tobroni
Dr. Susi
Dr. Mardiah
Dr. Mardiah
Dr. Susi
Dr. Susi
Dr. Tobroni
Dr. Susi
Dr. Susi
Dr. Susi
Dr. Marlis
Dr. Marlis
Dr. Marlis
Dr. Marlis
Dr. Marlis
Dr. Jerry
Dr. Marlis
ungo, 23 Desember 2010

engelola Program
. M A N A L U.
63 06 08 1986 03 1 008
BULAN TAGIHAN : DESEMBER 2010
DOKTER YG
SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 A. Sitorus 35 Karcis 7,500 3,750 3,750 Dr. Rumiyati

Operator TR SKU H Konsul 35,000 10,150 24,850 Dr. Taufan
2 H. Tambunan 33 Karcis 7,500 3,750 3,750 Dr. Jerry
3 Carles 35 Karcis 7,500 3,750 3,750 Dr. Rumiyati

Operator PHL Konsul 35,000 10,150 24,850 Dr. Taufan
4 Jahra Fitria A/D Bambang Karcis IGD 12,000 6,000 6,000 IGD
Mekanik TNO IGD 25,000 5,000 5,000 15,000 IGD
5 Gince BR H I/D H Tambunan Perwt. INT Kls II 3 Hr 168,000 46,800 65,400 55,800 Dr. Susi
Operator SKU H Labor 111,500 16,725 50,175 44,600 Dr. Susi
Karcis & IGD 37,000 18,500 18,500 IGD
TNO INT 40,000 8,000 8,000 24,000 Dr. Susi
JUMLAH 486,000 132,575 128,575 224,850
Keterangan :
Jumlah 486,000
- O B H P 128,575
Mengetahui Muara Bungo, 04 Febuari 2011


NIP. 1967 0930 2002 12 1 001 NIP. 1963 06 08 1986 03 1 008
BULAN TAGIHAN : JANUARI 2011
DOKTER YG
SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 Ny. Sukanti I/D Rahmadi Perwt. Obgyn Kls II 4 Hr 224,000 62,400 87,200 74,400 Dr. Zul
Mekanik SKU H Op. Besar 1,290,000 490,200 309,600 490,200 Dr. Zul
USG 72,000 14,400 36,000 21,600 Dr. Zul
Oksigen 12,000 12,000 Dr. Zul
Karcis & IGD 37,000 18,500 18,500 IGD
TNO Obgyn 60,000 12,000 12,000 36,000 Dr. Zul
2 By. Sukanti I/D Rahmadi Perwt. PRT 4 Hr 224,000 62,400 87,200 74,400 Dr. Harnadi
Mekanik SKU H Tind Dr. Anak Pada OPSC 101,000 101,000 Dr. Harnadi
Oksigen 20,000 20,000 Dr. Harnadi
Karcis 7,500 3,750 3,750 DSr. Magdalena
TNO PRT 80,000 16,000 16,000 48,000 Dr. Harnadi
3 H. Tambunan 33 Karcis 7,500 3,750 3,750 Dr. Mardiah

Operator SKU H Konsul 35,000 10,150 24,850 Dr. Mardiah
4 C. Hutagaol I/D H. Tambunan Karcis 7,500 3,750 3,750 Dr. Mardiah

Operator Konsul 35,000 10,150 24,850 Dr. Mardiah
5 A. Rohman 42 Perwt. INT Kls II 4 Hr 224,000 62,400 87,200 74,400 Dr. Taufan
Operator Traktor Labor 370,000 55,500 166,500 148,000 Dr. Taufan
EKG 70,000 14,000 35,000 21,000 Dr. Taufan
RO 70,000 8,400 31,500 30,100 Dr. Taufan
Karcis & IGD 37,000 18,500 18,500 IGD
TNO INT 40,000 8,000 8,000 24,000 Dr. Taufan
6 Putri A/D Tambunan Karcis 7,500 3,750 3,750 Dr. Magdalena
7 Dicky A/D Tambunan Karcis IGD 12,000 6,000 6,000 IGD

PHL TNO IGD 25,000 5,000 5,000 15,000 IGD
JUMLAH 3,068,000 889,000 913,200 1,265,800
Keterangan :
Jumlah 3,068,000
- O B H P 913,200
- Jasa Pelayanan 1,265,800
Mengetahui Muara Bungo, 29 Maret 2011


NIP. 1967 0930 2002 12 1 001 NIP. 1963 06 08 1986 03 1 008
Sr. Magdalena
BULAN TAGIHAN : FEBRUARI 2011
DOKTER YG
SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 Rafa A/D Musdarlin Karcis IGD 12,000 6,000 6,000 IGD

Sopir SKU H TNO IGD 25,000 5,000 5,000 15,000 IGD
2 Musdarlin 30 Karcis IGD 12,000 6,000 6,000 IGD

Sopir SKU H TNO IGD 25,000 5,000 5,000 15,000 IGD
Labor IGD 102,500 15,375 46,125 41,000 IGD
JUMLAH 176,500 37,375 56,125 83,000
Keterangan :
Jumlah 176,500
- O B H P 56,125


NIP. 1967 0930 2002 12 1 001 NIP. 1963 06 08 1986 03 1 008
BULAN TAGIHAN : MARET 2011
DOKTER YG
SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 Since Hutagaol I/D H.Tambunan Karcis Tind. IGD 37,000 18,500 18,500 IGD
Perwt.Obgyn Kls II 1 Hr 56,000 15,600 21,800 18,600 Dr. Marlis
Labor 31,500 4,725 14,175 12,600 Dr. Marlis
RO 72,000 8,640 32,400 30,960 Dr. Marlis
TNO 20,000 4,000 4,000 12,000 Dr. Marlis
2 Rosalina 29 Thn Karcis Tind. IGD 37,000 18,500 18,500 IGD

Perwt.Dalam Kls II 5 Hr 280,000 78,000 109,000 93,000 Dr. Haryuni
Labor 325,000 48,750 146,250 130,000 Dr. Haryuni
TNO 40,000 8,000 8,000 24,000 Dr. Haryuni
3 Desi Karcis IGD 12,000 6,000 6,000 IGD

TNO IGD 25,000 5,000 5,000 15,000 IGD
JUMLAH 935,500 215,715 340,625 379,160
Keterangan :
Jumlah 935,500
- O B H P 340,625


NIP. 1967 0930 2002 12 1 001 NIP. 1963 06 08 1986 03 1 008
BULAN TAGIHAN : APRIL 2011
DOKTER YG
SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 Nurparidah 29 Thn Perwt. Bdh Kls II 8 Hr 448,000 124,800 174,400 148,800 Dr. Faisal
PHL Lapangan Op. Besar 1,290,000 490,200 309,600 490,200 Dr. Faisal
Labor 234,500 35,175 105,525 93,800 Dr. Faisal
RO 72,000 8,640 32,400 30,960 Dr. Faisal
Perwt. ICU 2 Hr 770,000 422,000 70,000 278,000 Dr. Faisal
Oksigen ICU 150,000 150,000 Dr. Faisal
Karcis 7,500 3,750 3,750 Dr. Tobroni
Konsul 35,000 10,150 24,850 Dr. Faisal
TNO Bdh 160,000 32,000 32,000 96,000 Dr. Faisal
TNO ICU 450,000 90,000 90,000 270,000 Dr. Faisal
2 Iwan Kurniawan Karcis IGD 12,000 6,000 6,000 IGD

Opretor TNO IGD 25,000 5,000 5,000 15,000 IGD
Emergensi IGD 40,000 10,800 15,200 14,000 IGD
3 Putra Sinaga Karcis IGD 12,000 6,000 6,000 IGD

TNO IGD 25,000 5,000 5,000 15,000 IGD
4 Emiwati Perwt. Obgyn Kls II 3 Hr 168,000 46,800 65,400 55,800 Dr. Edwin
USG Obgyn 43,000 8,600 21,500 12,900 Dr. Edwin
Karcis 7,500 3,750 3,750 Dr. Melva
Konsul 35,000 10,150 24,850 Dr. Edwin
USG Poli 45,000 9,000 22,500 13,500 Dr. Edwin
TNO Obgyn 45,000 9,000 9,000 27,000 Dr. Edwin
5 Binsar Perwt. INT Kls II 10 Hr 560,000 156,000 218,000 186,000 Dr. Susi
Labor 237,500 35,625 106,875 95,000 Dr. Susi
Karcis 7,500 3,750 3,750 Dr. Rumiyati
Konsul 35,000 10,150 24,850 Dr. Susi
TNO INT 80,000 16,000 16,000 48,000 Dr. Susi
6 M. Oktaf Karcis IGD 12,000 6,000 6,000 IGD

Perawatan TNO IGD 25,000 5,000 5,000 15,000 IGD
7 Rafa Karcis 7,500 3,750 3,750 Dr. Megdalena

Konsul 35,000 10,150 24,850 Dr. Krisna
JUMLAH 5,074,000 1,583,240 1,453,400 2,037,360
Keterangan :
Jumlah 5,074,000
- Jasa Sarana 1,583,240
- O B H P 1,453,400


NIP. 1967 0930 2002 12 1 001 NIP. 1963 06 08 1986 03 1 008
BULAN TAGIHAN : MEI 2011
NO. NAMA PASIEN JASA JASA DOKTER YG MERAWAT
SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 Ulil 24 Thn Karcis 7,500 3,750 3,750 Dr. Mardiah

Mekanik SKU H Konsul 35,000 10,150 24,850 Dr. Mardiah
2 Julham Sinaga 30 Thn Karcis IGD 12,000 6,000 6,000 IGD

Krani Pembukuan SKU H TNO IGD 25,000 5,000 5,000 15,000 IGD
3 Musdarlin 33 Thn Karcis 7,500 3,750 3,750 Dr. Rumiyati

Driver Mobil Manager SKU H Konsul 35,000 10,150 24,850 Dr. Taufan
4 Andre Lubis Perwt. Bdh Kls II 2 Hr 112,000 31,200 43,600 37,200 Dr. Faisal
Mandor SKU H Labor 45,000 6,750 20,250 18,000 Dr. Faisal
RO 174,000 20,880 78,300 74,820 Dr. Faisal
Karcis 7,500 3,750 3,750 Dr. Tobroni
Konsul 35,000 10,150 24,850 Dr. Faisal
TNO Bdh 40,000 8,000 8,000 24,000 Dr. Faisal
5 Sutris 33 Thn Perwt. Irna Kls II 4 Hr 224,000 62,400 87,200 74,400 Dr. Mardiah
Traksi SKU H Labor 158,750 23,813 71,438 63,500 Dr. Mardiah
Karcis 7,500 3,750 3,750 Dr. Mardiah
Konsul 35,000 10,150 24,850 Dr. Mardiah
TNO Irna 80,000 16,000 16,000 48,000 Dr. Mardiah
6 H. Tambunan 33 Thn Perwt. INT Kls II 4 Hr 224,000 62,400 87,200 74,400 Dr. Susi
Karcis & IGD 37,000 18,500 18,500 IGD
TNO INT 40,000 8,000 8,000 24,000 Dr. Susi
7 Amon Sitorus 35 Thn Perwt. INT Kls II 5 Hr 280,000 78,000 109,000 93,000 Dr. Taufan
operator SKU H Labor 213,000 31,950 95,850 85,200 Dr. Taufan
Karcis & IGD 37,000 18,500 18,500 IGD
TNO INT 40,000 8,000 8,000 24,000 Dr. Taufan
8 Erno 32 Thn Perwt. INT Kls II 2 Hr 112,000 31,200 43,600 37,200 Dr. Susi
SKU H Akat Labor 229,500 34,425 103,275 91,800 Dr. Susi
Karcis & IGD 37,000 18,500 18,500 IGD
TNO INT 40,000 8,000 8,000 24,000 Dr. Susi
9 Okta A/D Triono Perwt. Anak Kls III 5 Hr 150,000 30,000 90,000 30,000 Dr. Harnadi
Peraeatan SKU Akat Labor 149,000 22,350 67,050 59,600 Dr. Harnadi
RO 45,000 5,400 20,250 19,350 Dr. Harnadi
ITD 200,000 30,000 130,000 40,000 Dr. Harnadi
Oksigen Anak 37,500 37,500 Dr. Harnadi
Karcis & IGD 37,000 18,500 18,500 IGD
TNO Anak 75,000 15,000 15,000 45,000 Dr. Harnadi
10 Latif A/D Triono Perwt. Anak Kls III 5 Hr 150,000 30,000 90,000 30,000 Dr. Harnadi
Peraeatan SKU Akat Labor 221,000 33,150 99,450 88,400 Dr. Harnadi
Karcis & IGD 37,000 18,500 18,500 IGD
11 Rafa A/D Musdarlin Karcis 7,500 3,750 3,750 Dr. Magdalena

Driver Mobil Manager Konsul 35,000 10,150 24,850 Dr. Krisna
12 Erza Gipahri A/D Awen Karcis 7,500 3,750 3,750 Dr. Magdalena
Mandor Ninit SKU H Konsul 35,000 10,150 24,850 Dr. Harnadi
13 Abdul Rahman 40 Thn Perwt. INT Kls II 10 Hr 560,000 156,000 218,000 186,000 Dr. Taufan 2X, Dr. Susi 8X
Operator SKU B Labor 210,000 31,500 94,500 84,000 Dr. Susi
RO 72,000 8,640 32,400 30,960 Dr. Susi
EKG 210,000 42,000 105,000 63,000 Dr. Susi
SARANA PELAYANAN
Karcis & IGD 37,000 18,500 18,500 IGD
TNO INT 80,000 16,000 16,000 48,000 Dr. Taufan 2X, Dr. Susi 8X
14 Suprihatin I/D Triono Perwt. INT Kls II 5 Hr 280,000 78,000 109,000 93,000 Dr. Susi
Perwt. SKU Akad Labor 248,500 37,275 111,825 99,400 Dr. Susi
Karcis & IGD 37,000 18,500 18,500 IGD
TNO INT 40,000 8,000 8,000 24,000 Dr. Susi
JUMLAH 5,669,250 1,257,933 2,191,788 2,219,530
Keterangan :
Jumlah 5,669,250
- O B H P 2,191,788


NIP. 1967 0930 2002 12 1 001 NIP. 1963 06 08 1986 03 1 008
SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 Andreas Subekti 23 Thn Karcis 7,500 3,750 3,750 Dr. Rumiyati

SKU H Konsul 35,000 10,150 24,850 Dr. Taufan
Labor 87,500 13,125 39,375 35,000 Dr. Taufan
2 Andreas Subekti 23 Thn Karcis 7,500 3,750 3,750 Dr. Rumiyati

3 Sutrisno 33 Thn Karcis 7,500 3,750 3,750 Dr. Mardiah

SKU H Konsul 35,000 10,150 24,850 Dr. Mardiah
4 Nasir Simanungkalit 23 Thn Karcis 7,500 3,750 3,750 Dr. Rumiyati

Labor 87,500 13,125 39,375 35,000 Dr. Taufan
5 Nasir Simanungkalit 23 Thn Karcis IGD 12,000 6,000 6,000 IGD

SKU H TNO IGD 25,000 5,000 5,000 15,000 IGD
6 Lilik Kurnianto 25 Thn Perwt. INT Kls II 3 Hr 168,000 46,800 65,400 55,800 Dr. Taufan
SKU B Labor 229,500 34,425 103,275 91,800 Dr. Taufan
Karcis & IGD 37,000 18,500 18,500 IGD
TNO INT 40,000 8,000 8,000 24,000 Dr. Taufan
7 Dina I/D Julham Sinaga Perwt. Obgyn Kls II 2 Hr 112,000 31,200 43,600 37,200 Dr. Marlis 1X, Dr. Husnul 1X
SKU H Labor 37,500 5,625 16,875 15,000 Dr. Marlis 1X, Dr. Husnul 1X
USG 72,000 14,400 36,000 21,600 Dr. Marlis 1X, Dr. Husnul 1X
Karcis & IGD 37,000 18,500 18,500 IGD
TNO Obgyn 40,000 8,000 8,000 24,000 Dr. Marlis 1X, Dr. Husnul 1X
8 Candra 24 Thn Perwt. INT Kls II 3 Hr 168,000 46,800 65,400 55,800 Dr. Taufan
SKU Labor 221,000 33,150 99,450 88,400 Dr. Taufan
Karcis & IGD 37,000 18,500 18,500 IGD
TNO INT 40,000 8,000 8,000 24,000 Dr. Taufan
9 Ulil 24 Thn RO Tertinggal 98,000 11,760 44,100 42,140 Dr. Mardiah
JUMLAH 1,719,000 396,510 581,850 740,640
Keterangan :
Jumlah 1,719,000
- O B H P 581,850


NIP. 1967 0930 2002 12 1 001 NIP. 1963 06 08 1986 03 1 008
DOKTER YG
SARANA PELAYANAN
1 2 3 4 5 6 7 8 9

SKU H Konsul 35,000 10,150 24,850 Dr. Mardiah
2 Saiful Antoni 30 Thn Karcis 7,500 3,750 3,750 Dr. Elia

Mekanik SKU H Premedikasi 25,000 3,125 12,500 9,375 Dr. Elia
3 Yulia I/D Saeli Karcis IGD 12,000 6,000 6,000 IGD

Driver SKU H TNO IGD 25,000 5,000 5,000 15,000 IGD
RO 98,000 11,760 44,100 42,140 IGD
4 Dina Lubis I/D Julham S Karcis IGD 12,000 6,000 6,000 IGD
Krani SKU H TNO IGD 25,000 5,000 5,000 15,000 IGD
5 Karmeyo 38 Thn Perwt. INT Kls II 7 Hr 392,000 109,200 152,600 130,200 Dr. Susi
SKU B Labor 261,000 39,150 117,450 104,400 Dr. Susi
Karcis & IGD 37,000 18,500 18,500 IGD
TNO INT 80,000 16,000 16,000 48,000 Dr. Susi
6 Agus Sugianto 22 Thn Perwt. INT Kls II 4 Hr 224,000 62,400 87,200 74,400 Dr. Susi
Karcis & IGD 37,000 18,500 18,500 IGD
Observasi IGD 70,000 18,900 26,600 24,500 IGD
TNO INT 60,000 12,000 12,000 36,000 Dr. Susi
7 Sugiarto 31 Thn Perwt. INT Kls II 6 Hr 336,000 93,600 130,800 111,600 Dr. Susi
Karcis & IGD 37,000 18,500 18,500 IGD
TNO INT 80,000 16,000 16,000 48,000 Dr. Susi
8 Eka Agustinah I/D Agus S Perwt. Obgyn Kls II 3 Hr 168,000 46,800 65,400 55,800 Dr. Husnul
SKU B Labor 251,000 37,650 112,950 100,400 Dr. Husnul
USG 72,000 14,400 36,000 21,600 Dr. Husnul
Karcis & IGD 37,000 18,500 18,500 IGD
TNO Obgyn 60,000 12,000 12,000 36,000 Dr. Husnul
9 Rudi Sinaga 27 Thn Perwt. INT Kls II 3 Hr 168,000 46,800 65,400 55,800 Dr. Susi
Mandor SKU H Labor 237,000 35,550 106,650 94,800 Dr. Susi
Karcis & IGD 37,000 18,500 18,500 IGD
TNO INT 40,000 8,000 8,000 24,000 Dr. Susi
10 Hotman Siahaan 31 Thn Perwt. INT Kls II 3 Hr 168,000 46,800 65,400 55,800 Dr. Susi
Operator PHL Labor 259,000 38,850 116,550 103,600 Dr. Susi
Karcis & IGD 37,000 18,500 18,500 IGD
TNO INT 40,000 8,000 8,000 24,000 Dr. Susi
11 Icha A/D Tarmizi Karcis 7,500 3,750 3,750 Dr. Jerry
12 Lidia A/D Tarmizi Karcis 7,500 3,750 3,750 Dr. Jerry
JUMLAH 3,984,000 915,235 1,461,900 1,606,865
Keterangan :
Jumlah 3,984,000
- O B H P 1,461,900


NIP. 1967 0930 2002 12 1 001 NIP. 1963 06 08 1986 03 1 008
DOKTER YG
SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 Ombar 21 Thn Karcis 7,500 3,750 3,750 Dr. Triolit

Mandor LC Konsul 35,000 10,150 24,850 Dr. Triolit
Op. Kecil 200,000 90,000 50,000 60,000 Dr. Triolit

Mekanik Konsul 35,000 10,150 24,850 Dr. Mardiah
3 Ahmad Bustami 30 Thn Perwt. INT Kls II 4 Hr 224,000 62,400 87,200 74,400 Dr. Taufan
Krani Labor 348,000 52,200 156,600 139,200 Dr. Taufan
Karcis & IGD 37,000 18,500 18,500 IGD
TNO INT 40,000 8,000 8,000 24,000 Dr. Taufan
4 Dahriman Tarigan 21 Thn Perwt. INT Kls II 4 Hr 224,000 62,400 87,200 74,400 Dr. Taufan
Pengawas Alat Berat Labor 267,000 40,050 120,150 106,800 Dr. Taufan
Karcis & IGD 37,000 18,500 18,500 IGD
TNO INT 40,000 8,000 8,000 24,000 Dr. Taufan
5 Radim 32 Thn Perwt. Bdh Kls II 8 Hr 448,000 124,800 174,400 148,800 Dr. Derry
Mandor Op. Besar 1,290,000 490,200 309,600 490,200 Dr. Derry
Labor 192,500 28,875 86,625 77,000 Dr. Derry
RO 72,000 8,640 32,400 30,960 Dr. Derry
Karcis & IGD 137,000 68,500 68,500 IGD
TNO Bdh 100,000 20,000 20,000 60,000 Dr. Derry
6 Dina Lubis I/D Julham S Karcis IGD 12,000 6,000 6,000 IGD
SKU H TNO IGD 50,000 10,000 10,000 30,000 IGD
7 Saiful Antoni 30 Thn Karcis IGD 12,000 6,000 6,000 IGD

Kepala Mekanik TNO IGD 25,000 5,000 5,000 15,000 IGD
8 Sari I/D Trisulo Perwt. INT Kls II 3 Hr 168,000 46,800 65,400 55,800 Dr. Susi
Perawatan Labor 222,000 33,300 99,900 88,800 Dr. Susi
Karcis & IGD 37,000 18,500 18,500 IGD
TNO INT 40,000 8,000 8,000 24,000 Dr. Susi
9 Heber Tambunan 34 Thn Perwt. INT Kls II 2 Hr 112,000 31,200 43,600 37,200 Dr. Susi
Karcis & IGD 37,000 18,500 18,500 IGD
TNO INT 20,000 4,000 4,000 12,000 Dr. Susi
10 Mulyadi 31 Thn Karcis IGD 12,000 6,000 6,000 IGD

Mekanik SKU H TNO IGD 25,000 5,000 5,000 15,000 IGD
11 Dika T A/D J Tambunan Karcis IGD 12,000 6,000 6,000 IGD

JUMLAH 4,787,500 1,373,715 1,492,725 1,921,060
Keterangan :
Jumlah 4,787,500
- O B H P 1,492,725


NIP. 1967 0930 2002 12 1 001 NIP. 1963 06 08 1986 03 1 008
DOKTER YG
SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 Torang Sitompul 23 Thn Karcis 7,500 3,750 3,750 Dr. Taufan

Mandor I SKU H Konsul 35,000 10,150 24,850 Dr. Taufan
Labor 111,500 16,725 50,175 44,600 Dr. Taufan
2 Radim Barus 31 Thn Karcis 7,500 3,750 3,750 Dr. Derry

Mandor Afd IV Konsul 35,000 10,150 24,850 Dr. Derry
GV & Aff Hecting 14,000 2,800 7,000 4,200 Dr. Derry

Konsul 35,000 10,150 24,850 Dr. Mardiah
4 Radim Barus 31 Thn Karcis IGD 12,000 6,000 6,000 IGD

Mandor Afd IV TNO IGD 25,000 5,000 5,000 15,000 IGD


7 Ayu Putri A/D Rahmadi Karcis IGD 12,000 6,000 6,000 IGD
8 Ngateno Karcis IGD 12,000 6,000 6,000 IGD

Mandor PHL TNO IGD 25,000 5,000 5,000 15,000 IGD
9 Janner Sihotang 40 Thn Karcis IGD 12,000 6,000 6,000 IGD

PHL TNO IGD 25,000 5,000 5,000 15,000 IGD
10 Jonnes Perwt. Bdh Kls II 7 Hr 392,000 109,200 152,600 130,200 Dr. Derry
PHL Konsul Dr. Armayani 66,500 66,500 Dr. Armayani
Op. Besar 2X 2,580,000 980,400 619,200 980,400 Dr. Derry
Labor 63,000 9,450 28,350 25,200 Dr. Derry
RO 180,000 21,600 81,000 77,400 Dr. Derry
Karcis IGD 12,000 6,000 6,000 IGD
TNO IGD 50,000 10,000 10,000 30,000 IGD
TNO Bdh 140,000 28,000 28,000 84,000 Dr. Derry
11 Heber Tanbunan 34 Thn Perwt. INT Kls II 4 Hr 224,000 62,400 87,200 74,400 Dr. Taufan
Karcis IGD 12,000 6,000 6,000 IGD
TNO IGD 25,000 5,000 5,000 15,000 IGD
EKG IGD 70,000 14,000 35,000 21,000 IGD
TNO INT 40,000 8,000 8,000 24,000 Dr. Taufan
12 Janer Sihotang Perwt. Bdh Kls II 8 Hr 448,000 124,800 174,400 148,800 Dr. Derry
PHL Konsul Dr Hendry 66,500 66,500 Dr. Hendry
Op. Besar 1,290,000 490,200 309,600 490,200 Dr. Derry
Labor 63,000 9,450 28,350 25,200 Dr. Derry
RO 90,000 10,800 40,500 38,700 Dr. Derry
Karcis IGD 12,000 6,000 6,000 IGD
TNO IGD 50,000 10,000 10,000 30,000 IGD
TNO Bdh 160,000 32,000 32,000 96,000 Dr. Derry
13 Rendo Perwt. Bdh Kls II 2 Hr 112,000 31,200 43,600 37,200 Dr. Armayani
PHL Labor 42,000 6,300 18,900 16,800 Dr. Armayani
RO 90,000 10,800 40,500 38,700 Dr. Armayani
Karcis IGD 12,000 6,000 6,000 IGD
TNO IGD 25,000 5,000 5,000 15,000 IGD
TNO Bdh 40,000 8,000 8,000 24,000 Dr. Armayani
14 Hendra Sitorus Perwt. Bdh Kls II 2 Hr 112,000 31,200 43,600 37,200 Dr. Armayani
RO 90,000 10,800 40,500 38,700 Dr. Armayani
Karcis IGD 12,000 6,000 6,000 IGD
DOKTER YG
SARANA PELAYANAN
TNO IGD 50,000 10,000 10,000 30,000 IGD
15 Rizki 24 Thn Perwt. Bdh Kls II 2 Hr 112,000 31,200 43,600 37,200 Dr. Armayani
RO 255,000 30,600 114,750 109,650 Dr. Armayani
Karcis IGD 12,000 6,000 6,000 IGD
TNO IGD 50,000 10,000 10,000 30,000 IGD
16 Hendrik Nainggolan Perwt. INT Kls II 2 Hr 112,000 31,200 43,600 37,200 Dr. Susi
Labor 192,500 28,875 86,625 77,000 Dr. Susi
Karcis IGD 12,000 6,000 6,000 IGD
TNO IGD 25,000 5,000 5,000 15,000 IGD
TNO INT 40,000 8,000 8,000 24,000 Dr. Susi
17 Saiful Antoni 30 Thn Labor Tertinggal 142,500 21,375 64,125 57,000 IGD
18 Mulyadi 31 Thn Labor Tertinggal 142,500 21,375 64,125 57,000 IGD
19 Jannes 23 Thn Karcis IGD 12,000 6,000 6,000 IGD

PHL TNO IGD 25,000 5,000 5,000 15,000 IGD


JUMLAH 8,675,500 2,488,700 2,550,050 3,636,750
Keterangan :
Jumlah 8,675,500 8,675,500
- O B H P 2,550,050
Mengetahui Muara Bungo, 29 Sept 2011


NIP. 1967 0930 2002 12 1 001 NIP. 1963 06 08 1986 03 1 008
DOKTER YG
SARANA PELAYANAN
1 2 3 4 5 6 7 8 9

Mekanik SKU H Konsul 35,000 10,150 24,850 Dr. Mardiah
2 Jannes sitohang 23 Thn Karcis 7,500 3,750 3,750 Dr. Jerry
3 Janner Sitohang 40 Thn Karcis 7,500 3,750 3,750 Dr. Jerry
4 Dodi Setiawan A/D Mulyadi Karcis 7,500 3,750 3,750 Dr. Jerry
5 Radim 31 Thn Karcis 7,500 3,750 3,750 Dr. Derry

Mandor SKU H Konsul 35,000 10,150 24,850 Dr. Derry
6 Radim 31 Thn Karcis 7,500 3,750 3,750 Dr. Derry

Mandor SKU H Konsul 35,000 10,150 24,850 Dr. Derry
RO 98,000 11,760 44,100 42,140 Dr. Derry
7 Anitia I/D Taliziso Perwt. Obgyn Kls II 3 Hr 168,000 46,800 65,400 55,800 Dr. Zul
Perawat PHL Labor 393,500 59,025 177,075 157,400 Dr. Zul
USG 72,000 14,400 36,000 21,600 Dr. Zul
Karcis IGD 12,000 6,000 6,000 IGD
TNO IGD 25,000 5,000 5,000 15,000 IGD
TNO Obgyn 40,000 8,000 8,000 24,000 Dr. Zul
Perwt. INT Kls II 4 Hr 224,000 62,400 87,200 74,400 Dr. Susi
TNO INT 40,000 8,000 8,000 24,000 Dr. Susi
8 Martua Munte 28 Thn Perwt. INT Kls II 3 Hr 168,000 46,800 65,400 55,800 Dr. Taufan
Tofografi Labor 237,000 35,550 106,650 94,800 Dr. Taufan
Karcis IGD 12,000 6,000 6,000 IGD
TNO IGD 25,000 5,000 5,000 15,000 IGD
TNO INT 60,000 12,000 12,000 36,000 Dr. Taufan
9 Ruth A/D Heber Tambunan Perwt. INT Kls II 3 Hr 168,000 46,800 65,400 55,800 Dr. Taufan
Karcis IGD 12,000 6,000 6,000 IGD
TNO IGD 25,000 5,000 5,000 15,000 IGD
TNO INT 40,000 8,000 8,000 24,000 Dr. Taufan
10 Leli I/D Aris Jega Perwt. INT Kls II 3 Hr 168,000 46,800 65,400 55,800 Dr. Taufan
PHL Labor 267,000 40,050 120,150 106,800 Dr. Taufan
Karcis IGD 12,000 6,000 6,000 IGD
TNO IGD 25,000 5,000 5,000 15,000 IGD
TNO INT 40,000 8,000 8,000 24,000 Dr. Taufan
11 Jonatan Pasaribu A/D Aprizal Perwt. Anak Kls II 2 Hr 112,000 31,200 43,600 37,200 Dr. Krisna
PHL Krani Afd Labor 33,000 4,950 14,850 13,200 Dr. Krisna
Karcis 7,500 3,750 3,750 Dr. Krisna
Konsul 35,000 10,150 24,850 Dr. Krisna
TNO Anak 40,000 8,000 8,000 24,000 Dr. Krisna
12 Ana I/D Aldi Tambunan Perwt. INT Kls II 4 Hr 224,000 62,400 87,200 74,400 Dr. Taufan
PHL Mandor Labor 272,000 40,800 122,400 108,800 Dr. Taufan
USG Dr. Zul 70,000 14,000 35,000 21,000 Dr. Zul
Konsul Dr. Zul 35,000 35,000 Dr. Zul
Karcis IGD 12,000 6,000 6,000 IGD
TNO IGD 25,000 5,000 5,000 15,000 IGD
TNO INT 40,000 8,000 8,000 24,000 Dr. Taufan
13 Jenner 40 Thn Karcis 7,500 3,750 3,750 Dr. Derry

PHL Konsul 35,000 10,150 24,850 Dr. Derry
DOKTER YG
SARANA PELAYANAN
14 Jenns 23 Thn Karcis 7,500 3,750 3,750 Dr. Derry
PHL Konsul 35,000 10,150 24,850 Dr. Derry
15 Jenner Sihotang 40 Thn Karcis IGD 12,000 6,000 6,000 IGD

PHL TNO IGD 25,000 5,000 5,000 15,000 IGD
JUMLAH 3,766,500 824,410 1,343,100 1,598,990
Keterangan :
Jumlah 3,766,500
- O B H P 1,343,100


NIP. 1967 0930 2002 12 1 001 NIP. 1963 06 08 1986 03 1 008
BULAN TAGIHAN : NOPEMBER 2011
DOKTER YG
SARANA PELAYANAN
1 2 3 4 5 6 7 8 9

SKU Mekanik Konsul 35,000 10,150 24,850 Dr. Mardiah
2 Radim Barus 31 Thn Karcis 7,500 3,750 3,750 Dr. Derry

Konsul 35,000 10,150 24,850 Dr. Derry
Buka Pen 780,000 343,200 156,000 280,800 Dr. Derry
RO 98,000 11,760 44,100 42,140 Dr. Derry
3 Janner Sihotang 40 Thn Perwt. Bdh Kls II 6 Hr 336,000 93,600 130,800 111,600 Dr. Derry
PHL Op. Khusus 1,500,000 600,000 300,000 600,000 Dr. Derry
Labor 193,000 28,950 86,850 77,200 Dr. Derry
RO 45,000 5,400 20,250 19,350 Dr. Derry
Karcis 7,500 3,750 3,750 Dr. Derry
Konsul 35,000 10,150 24,850 Dr. Derry
RO Poli 98,000 11,760 44,100 42,140 Dr. Derry
TNO Bdh 120,000 24,000 24,000 72,000 Dr. Derry
4 Aprizal Pasaribu 24 Thn Perwt. ICU 2 Hr 770,000 422,000 70,000 278,000 Dr. Taufan
PHL Krani Afd Labor 207,500 31,125 93,375 83,000 Dr. Taufan
RO 155,000 18,600 69,750 66,650 Dr. Taufan
TNO ICU 150,000 30,000 30,000 90,000 Dr. Taufan
Karcis IGD 12,000 6,000 6,000 IGD
TNO IGD 25,000 5,000 5,000 15,000 IGD
Perwt. INT Kls II 4 Hr 224,000 62,400 87,200 74,400 Dr. Taufan
Labor 55,000 8,250 24,750 22,000 Dr. Taufan
EKG 70,000 14,000 35,000 21,000 Dr. Taufan
RO 72,000 8,640 32,400 30,960 Dr. Taufan
TNO INT 40,000 8,000 8,000 24,000 Dr. Taufan
5 Setiawan A/D Trisulo Perwt. Anak Kls II 2 Hr 112,000 31,200 43,600 37,200 Dr. Krisna
SKU B Labor 82,000 12,300 36,900 32,800 Dr. Krisna
Karcis IGD 12,000 6,000 6,000 IGD
TNO IGD 25,000 5,000 5,000 15,000 IGD
6 Jennes 23 Thn Perwt. Bdh Kls II 3 Hr 168,000 46,800 65,400 55,800 Dr. Derry
PHL Op. Besar 1,290,000 490,200 309,600 490,200 Dr. Derry
Labor 221,000 33,150 99,450 88,400 Dr. Derry
Karcis IGD 12,000 6,000 6,000 IGD
TNO IGD 25,000 5,000 5,000 15,000 IGD
TNO Bdh 60,000 12,000 12,000 36,000 Dr. Derry
7 Mardiana 29 Thn Perwt. INT Kls II 6 Hr 336,000 93,600 130,800 111,600 Dr. Susi
PHL Labor 214,500 32,175 96,525 85,800 Dr. Susi
Karcis IGD 12,000 6,000 6,000 IGD
TNO IGD 25,000 5,000 5,000 15,000 IGD
TNO INT 60,000 12,000 12,000 36,000 Dr. Susi
8 Tukimin 32 Thn Perwt. INT Kls II 6 Hr 336,000 93,600 130,800 111,600 Dr. Taufan
PHL Afd III Labor 219,500 32,925 98,775 87,800 Dr. Taufan
RO 45,000 5,400 20,250 19,350 Dr. Taufan
Karcis IGD 12,000 6,000 6,000 IGD
TNO IGD 25,000 5,000 5,000 15,000 IGD
TNO INT 60,000 12,000 12,000 36,000 Dr. Taufan
9 Putra Sinaga 21 Thn Perwt. INT Kls II 6 Hr 336,000 93,600 130,800 111,600 Dr. Susi
SKU H Mandor Labor 223,500 33,525 100,575 89,400 Dr. Susi
Karcis IGD 12,000 6,000 6,000 IGD
TNO IGD 25,000 5,000 5,000 15,000 IGD
TNO INT 60,000 12,000 12,000 36,000 Dr. Susi
10 Urdin Siragih 32 Thn Perwt. INT Kls II 5 Hr 280,000 78,000 109,000 93,000 Dr. Susi
PHL Labor 359,000 53,850 161,550 143,600 Dr. Susi
Karcis IGD 12,000 6,000 6,000 IGD
DOKTER YG
SARANA PELAYANAN
TNO IGD 25,000 5,000 5,000 15,000 IGD
TNO INT 60,000 12,000 12,000 36,000 Dr. Susi
11 Nurfarida 29 Thn Perwt. INT Kls II 5 Hr 280,000 78,000 109,000 93,000 Dr. Susi
PHL Labor 311,500 46,725 140,175 124,600 Dr. Susi
Karcis IGD 12,000 6,000 6,000 IGD
TNO IGD 25,000 5,000 5,000 15,000 IGD
TNO INT 60,000 12,000 12,000 36,000 Dr. Susi
12 Cince I/D H. Tambunan Perwt. INT Kls II 5 Hr 280,000 78,000 109,000 93,000 Dr. Susi
SKU H Operator Labor 333,000 49,950 149,850 133,200 Dr. Susi
Karcis IGD 12,000 6,000 6,000 IGD
TNO IGD 25,000 5,000 5,000 15,000 IGD
TNO INT 60,000 12,000 12,000 36,000 Dr. Susi
13 Ny. Wulandari I/D Sahroin Perwt. Obgyn Kls II 2 Hr 112,000 31,200 43,600 37,200 Dr. Husnul
PHL Patus Patologis 425,000 191,250 42,500 191,250 Dr. Husnul
USG 72,000 14,400 36,000 21,600 Dr. Husnul
Karcis IGD 12,000 6,000 6,000 IGD
TNO IGD 25,000 5,000 5,000 15,000 IGD
TNO Obgyn 40,000 8,000 8,000 24,000 Dr. Husnul
14 By. Wulandari A/D Sahroin Perwt. PRT 8 Hr 800,000 336,000 256,000 208,000 Dr. Krisna
PHL Labor 61,500 9,225 27,675 24,600 Dr. Krisna
RO 72,000 8,640 32,400 30,960 Dr. Krisna
Oksigen 225,000 225,000 Dr. Krisna
Karcis 7,500 3,750 3,750 Dr. Krisna
TNO PRT 210,000 42,000 42,000 126,000 Dr. Krisna
15 Lilis A/D Aris Jega Perwt. Anak Kls II 3 Hr 168,000 46,800 65,400 55,800 Dr. Krisna
Karcis IGD 12,000 6,000 6,000 IGD
TNO IGD 50,000 10,000 10,000 30,000 IGD
16 Aprenja Nainggolan A/D Hendrik Perwt. Anak Kls II 4 Hr 224,000 62,400 87,200 74,400 Dr. Harnadi
Mandor PHL Labor 142,500 21,375 64,125 57,000 Dr. Harnadi
Karcis IGD 12,000 6,000 6,000 IGD
TNO IGD 25,000 5,000 5,000 15,000 IGD
17 Erza Guvahri A/D Awen Karcis IGD 12,000 6,000 6,000 IGD
Mandor I TNO IGD 25,000 5,000 5,000 15,000 IGD
18 Rudi Sinaga Perwt. Bdh Kls II 7 Hr 392,000 109,200 152,600 130,200 Dr. Derry
Mandor Afd I Op. Khusus 2X 3,000,000 1,200,000 600,000 1,200,000 Dr. Derry
Cito 150,000 150,000 Dr. Derry
Labor 215,000 32,250 96,750 86,000 Dr. Derry
RO 140,000 16,800 63,000 60,200 Dr. Derry
Karcis IGD 12,000 6,000 6,000 IGD
TNO IGD 50,000 10,000 10,000 30,000 IGD
Konsul Dr. Derry IGD 70,000 70,000 Dr. Derry
TNO Bdh 140,000 28,000 28,000 84,000 Dr. Derry
JUMLAH 18,302,500 5,591,675 5,368,875 7,341,950
Keterangan :
Jumlah 18,302,500
- O B H P 5,368,875


NIP. 1967 0930 2002 12 1 001 NIP. 1963 06 08 1986 03 1 008
DOKTER YG
NO. NAMA PASIEN JASA
(THN) PELAYANAN JUMLAH JASA SARANA O B H P MERAWAT
PELAYANAN
1 2 3 4 5 6 7 8 9
1 RUDI 20THN Karcis Rp 20,000 12,000 8,000 dr. taufan

KRANI KELILING Konsul Rp 40,000 24,000 16,000
2 URDIN SARAGIH 33THN Karcis Rp 20,000 12,000 8,000 dr. armayani

MANDOR Konsul Rp 40,000 24,000 16,000
Labor Rp 55,000 33,000 22,000
Ro Rp 176,000 105,600 70,400
3 ITA TANJUNG I/D J. TAMBUNAN Perwt. VK 1hr Rp 385,000 231,000 154,000 dr. edwin
SKU H Administrasi Rp 33,000 19,800 13,200
Pasang infus Rp 55,000 33,000 22,000
Pasang kateter Rp 38,500 23,100 15,400
Kuretase Rp 847,000 508,200 338,800
USG Rp 165,000 99,000 66,000
Oksigen Rp 75,000 75,000
Karcis IGD Rp 44,000 26,400 17,600
TNO IGD Rp 33,000 19,800 13,200
Perwt. Kebidanan kls II 1hr Rp 110,000 66,000 44,000
TNO Rp 19,800 11,880 7,920
4 CINCE 36THN Karcis Rp 20,000 12,000 8,000 drg. Elia gustin

DRIVER Premedikasi Rp 44,000 26,400 17,600
5 URDIN SARAGIH 33THN Perwt. Bedah kls II 3hr Rp 330,000 198,000 132,000 dr. armayani
Op. besar Rp 2,670,800 1,602,480 1,068,320
TNO Rp 59,400 35,640 23,760
Labor Rp 291,500 174,900 116,600
Karcis Rp 20,000 12,000 8,000 dr. haryuni
JUMLAH 5,608,500 3,320,100 75,000 2,213,400
Keterangan :
Jumlah 5,608,500
- O B H P 75,000
Mengetahui Muara Bungo, Juli 2013


NIP. 1967 0930 2002 12 1 001 NIP. 1963 06 08 1986 03 1 008
UMUR TINDAKAN B I A Y A DOKTER YG

SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 MARIANIS I/D ALIMAN Perwt. Dalam kls II 5hr Rp 880,000 528,000 352,000 dr. taufan 2x
PEMANEN Administrasi Rp 16,500 9,900 6,600 dr. melva 3x
TNO Rp 79,200 47,520 31,680
Labor Rp 59,400 35,640 23,760
EKG Rp 154,000 92,400 61,600
Ro Rp 176,000 105,600 70,400
Karcis IGD Rp 44,000 26,400 17,600
TNO IGD Rp 33,000 19,800 13,200
2 MARIANI S 25THN Karcis Rp 20,000 12,000 8,000 dr.triolit

PERAWAT Konsul Rp 40,000 24,000 16,000
4 CRISTIAN APRIYAN PASARIBU A/D APRKarcis IGD Rp 44,000 26,400 17,600 IGD
5 LUPRI 19THN Karcis Rp 20,000 12,000 8,000 dr. derry

PHL Labor Rp 253,000 151,800 101,200
Ro Rp 88,000 52,800 35,200
6 ROSMELINA TANJUNG Karcis Rp 20,000 12,000 8,000 dr. faisal

KRANI TRAKSI Konsul Rp 40,000 24,000 16,000
7 CINCE HUTAGAOL 35THN Karcis Rp 20,000 12,000 8,000 dr. edwin

DRIVER Konsul Rp 40,000 24,000 16,000
USG Rp 165,000 99,000 66,000
8 FITRIANI I/D MURYADI Karcis Rp 20,000 12,000 8,000 dr. zulkarnaen

MEKANIK Konsul Rp 40,000 24,000 16,000
USG Rp 165,000 99,000 66,000
9 TIKA PASARIBU I/D MECCO MENTAS S Karcis Rp 20,000 12,000 8,000 dr. zulkarnaen
MANDOR Konsul Rp 40,000 24,000 16,000
USG Rp 165,000 99,000 66,000
JUMLAH 2,642,100 1,585,260 - 1,056,840
Keterangan :
Jumlah 2,642,100
- O B H P -
Mengetahui Muara Bungo, Februaari 2014


NIP. 1967 0930 2002 12 1 001 NIP. 1963 06 08 1986 03 1 008
SARANA PELAYANAN
1 2 3 4 5 6 7 8
1 SERLI A/D AHMAD SAYUTI Perwt. Anak kls II 1hr Rp 110,000 66,000 44,000
TNO Rp 19,800 11,880 7,920
Labor Rp 140,800 84,480 56,320
Karcis IGD Rp 44,000 26,400 17,600
TNO IGD Rp 33,000 19,800 13,200
2 AZWAR 44THN Perwt. Bedah kls II 7hr Rp 770,000 462,000 308,000

KBK Administrasi Rp 16,500 9,900 6,600
Konsul dr. tulang Rp 13,200 7,920 5,280
Op. besar orif Rp 3,240,600 1,944,360 1,296,240
TNO Rp 59,400 35,640 23,760
Labor Rp 291,500 174,900 116,600
Ro Rp 352,000 211,200 140,800
Karcis IGD Rp 44,000 26,400 17,600
TNO IGD Rp 66,000 39,600 26,400
TE IGD Rp 275,000 165,000 110,000
3 J. SITOHANG Perwt. Bedah kls II 4hr Rp 440,000 264,000 176,000

PHL Administrasi Rp 16,500 9,900 6,600
Op. besar orif Rp 3,240,600 1,944,360 1,296,240
TNO Rp 59,400 35,640 23,760
Labor Rp 291,500 174,900 116,600
Ro Rp 176,000 105,600 70,400
4 VIRA DEASI F A/D MULYADI Karcis Rp 44,000 26,400 17,600

DRIVER Konsul Rp 33,000 19,800 13,200
USG Rp 165,000 99,000 66,000
5 J. SITOHANG 40THN Karcis Rp 44,000 26,400 17,600

HELPER ALAT Konsul Rp 33,000 19,800 13,200
6 JILDA DWI ANGGRAINI A/D WAHYUDI Karcis Rp 44,000 26,400 17,600

OPERATOR Konsul Rp 33,000 19,800 13,200
8 VIRA DEASI F A/D MULYADI Karcis Rp 44,000 26,400 17,600

DRIVER Konsul Rp 33,000 19,800 13,200
USG Rp 165,000 99,000 66,000
9 AZWAR 44THN Karcis Rp 44,000 26,400 17,600

KBT Konsul Rp 33,000 19,800 13,200
GV & AFF H Rp 44,000 26,400 17,600
10 TIKA PASARIBU I/D MESCO M. SITUMORANG Karcis Rp 44,000 26,400 17,600

MANDOR Konsul Rp 33,000 19,800 13,200
USG Rp 165,000 99,000 66,000
11 ERJAGIPAHRI A/D AWEN Karcis Rp 44,000 26,400 17,600

MANFOR 1 Konsul Rp 33,000 19,800 13,200
12 FEFI BR HUTAGAOL I/D J. SIMAMORA Perwt. VK 1hr Rp 385,000 231,000 154,000

Op. besar Rp 2,670,800 1,602,480 1,068,320
Pasang infus Rp 55,000 33,000 22,000
Doppler Rp 66,000 39,600 26,400
USG Rp 16,500 9,900 6,600
Karcis IGD Rp 44,000 26,400 17,600
TNO IGD Rp 33,000 19,800 13,200
Administrasi Rp 16,500 9,900 6,600
TNO Rp 99,000 59,400 39,600
BY. FEFI Perwt. Perinatology 8hr Rp 1,760,000 1,056,000 704,000
Administrasi Rp 66,000 39,600 26,400
Tind. Dr pd Op. SC Rp 267,850 160,710 107,140
Pasang infus Rp 165,000 99,000 66,000
Section Rp 44,000 26,400 17,600
Oksimetri Rp 150,000 90,000 60,000
By. Patologys Rp 385,000 231,000 154,000
Oksigen Rp 240,000 240,000
Labor Rp 102,300 61,380 40,920
Ro Rp 110,000 66,000 44,000
13 R. PURBA Perwt. Dalam kls II 5hr Rp 550,000 330,000 220,000

MANDOR 1 Administrasi Rp 16,500 9,900 6,600
TNO Rp 59,400 35,640 23,760
Labor Rp 782,100 469,260 312,840
Ro Rp 88,000 52,800 35,200
EKG Rp 77,000 46,200 30,800
Karcis IGD Rp 44,000 26,400 17,600
TNOIGD Rp 33,000 19,800 13,200
JUMLAH 19,741,750 11,701,050 240,000 7,800,700
Keterangan :
Jumlah 9,760,300
- O B H P -
Mengetahui Muara Bungo, Maret 2014


NIP. 1967 0930 2002 12 1 001 NIP. 1963 06 08 1986 03 1 008
WATAN KARYAWAN / KARYAWATI DAN ANGGOTA KELUARGA
NG BEROBAT DI RSUD H. HANAFIE MUARA BUNGO
DOKTER YG
MERAWAT
9
dr. harnadi
dr. faisal 2x
dr. derry 5x
dr. derry
dr. derry
dr. zulkarnaen
dr. derry
dr. triolit
dr. marlis
dr. derry
dr. edwin
dr. faisal
dr. zulkarnaen
dr. krisna
dr. taufan 2x
dr. faisal nst 3x
Muara Bungo, Maret 2014

Pengelola Program
S. M A N A L U.
NIP. 1963 06 08 1986 03 1 008

SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 NOVARIDA I/D URDIN SARAGIH Karcis Rp 20,000 12,000 8,000 dr. faisal
MANDOR Konsul Rp 40,000 24,000 16,000
2 AZWARA Karcis Rp 20,000 12,000 8,000 dr. derry

PHL Konsul Rp 40,000 24,000 16,000
GV & AFF H Rp 44,000 26,400 17,600
3 AGRISIA SIMAMORA A/D J. SIMAMORA Karcis Rp 20,000 12,000 8,000 dr. krisna
AFD. III Konsul Rp 40,000 24,000 16,000
4 J. SIHOTANG 40THN Karcis Rp 44,000 26,400 17,600 dr. derry

HELPER Konsul Rp 33,000 19,800 13,200
GV & AFF H Rp 44,000 26,400 17,600
5 TRI HANDAYANI I/D H. NAINGGOLAN Karcis Rp 44,000 26,400 17,600 dr. zulkarnaen
MANDOR Konsul Rp 33,000 19,800 13,200
USG Rp 165,000 99,000 66,000
6 F. HUTAGAOL I/D J. SIMAMORA Karcis Rp 44,000 26,400 17,600 dr. zulkarnaen

AFD. III Konsul Rp 33,000 19,800 13,200
USG Rp 165,000 99,000 66,000
7 PUTRI I/D SUPRI Karcis Rp 44,000 26,400 17,600 dr. edwin

DRIVER Konsul Rp 33,000 19,800 13,200
USG Rp 165,000 99,000 66,000
8 ROBET PURBA Perwt. Dalam kls II 4hr Rp 440,000 264,000 176,000 dr. venny
MANDOR I Administrasi Rp 16,500 9,900 6,600
TNO Rp 59,400 35,640 23,760
Labor Rp 550,000 330,000 220,000
Karcis IGD Rp 44,000 26,400 17,600
TNO IGD Rp 33,000 19,800 13,200
9 DESI SILABAN I/D F. SIREGAR Perwt. VK 1hr Rp 385,000 231,000 154,000 dr. zulkaarnaen
MANDOR Administrasi Rp 33,000 19,800 13,200
Op. besar Rp 2,670,800 1,602,480 1,068,320
Pasang infus Rp 55,000 33,000 22,000
Doppler Rp 22,000 13,200 8,800
Karcis IGD Rp 44,000 26,400 17,600
TNO IGD Rp 33,000 19,800 13,200
TNO Rp 59,400 35,640 23,760
BY. DESI Perwt. Perinatology 1hr Rp 220,000 132,000 88,000 dr. krisna
Administrasi Rp 33,000 19,800 13,200
Tind. Dr pd Op. SC Rp 230,230 138,138 92,092
Section Rp 22,000 13,200 8,800
Resusitasi Rp 385,000 231,000 154,000
Perwt. Rooming in 3hr Rp 330,000 198,000 132,000 dr. haryuni
TNO Rp 29,700 17,820 11,880
10 H. TAMBUNAN 37THN Karcis Rp 44,000 26,400 17,600 dr. derry

DRIVER DT Konsul Rp 33,000 19,800 13,200
Ro Rp 352,000 211,200 140,800
11 JONATHAN PASARIBU A/D AFRIZAL P Karcis IGD Rp 44,000 26,400 17,600 IGD
KRANI PEMBUKUAN TNO IGD Rp 33,000 19,800 13,200
JUMLAH 7,673,530 4,604,118 - 3,069,412
Keterangan :
Jumlah 7,673,530
- O B H P -
Mengetahui Muara Bungo, April 2014


NIP. 1967 0930 2002 12 1 001 NIP. 1963 06 08 1986 03 1 008
BULAN TAGIHAN : MEI 2014

SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 HABSAH 35THN Perwt. Bedah kls II 2hr Rp 220,000 132,000 88,000 dr. faisal 1x
Administrasi Rp 16,500 9,900 6,600 dr. rumiyati 1x
TNO Rp 39,600 23,760 15,840
Labor Rp 55,000 33,000 22,000
Karcis IGD Rp 44,000 26,400 17,600
TNO IGD Rp 33,000 19,800 13,200
Oksigen Rp 11,000 - 11,000 -
2 ANDARIAS SURBAKTI Perwt. Dalam kls II 6hr Rp 660,000 396,000 264,000 dr. taufan 2x
SKU H Administrasi Rp 16,500 9,900 6,600 dr. faisal nst 4x
TNO Rp 79,200 47,520 31,680
Labor Rp 347,000 208,200 138,800
Ro Rp 88,000 52,800 35,200
EKG Rp 77,000 46,200 30,800
Karcis IGD Rp 44,000 26,400 17,600
TNO IGD Rp 33,000 19,800 13,200
3 MISNAINI 46THN Perwt. Bedah kls II 2hr Rp 220,000 132,000 88,000 dr. faisal 1x
Administrasi Rp 16,500 9,900 6,600 dr. rumiyati 1x
TNO Rp 39,600 23,760 15,840
Labor Rp 235,000 141,000 94,000
Ro Rp 88,000 52,800 35,200
Karcis IGD Rp 44,000 26,400 17,600
TNO K IGD Rp 66,000 39,600 26,400
TNO S IGD Rp 55,000 33,000 22,000
Oksigen Rp 11,000 - 11,000 -
4 ANTONIUS MANIHURUK Karcis IGD Rp 44,000 26,400 17,600 IGD

MANDOR I AFD. III TNO IGD Rp 66,000 39,600 26,400
Labor Rp 188,100 112,860 75,240
Ro Rp 88,000 52,800 35,200
5 TIKA PASARIBU Karcis Rp 20,000 12,000 8,000 dr. husnul

MANDOR Konsul Rp 40,000 24,000 16,000
USG Rp 165,000 99,000 66,000
6 MIFTA A/D ARIF MUNANDAR Perwt. ICU 1hr Rp 440,000 264,000 176,000 dr. dewi
T. PANEN Administrasi Rp 33,000 19,800 13,200
Pasang monitor Rp 110,000 66,000 44,000
Pasang infus Rp 55,000 33,000 22,000
Pasang NGT Rp 66,000 39,600 26,400
Labor Rp 350,000 210,000 140,000
Oksigen Rp 66,000 - 66,000 -
Karcis IGD Rp 44,000 26,400 17,600
TNO IGD Rp 33,000 19,800 13,200
Oksigen Rp 10,000 - 10,000 -
Perwt. Anak kls II 2hr Rp 220,000 132,000 88,000
TNO Rp 39,600 23,760 15,840
7 MIKHA PUTIANI MALAU A/D R. MALAU Karcis Rp 20,000 12,000 8,000 dr. dewi
PETUGAS GUDANG Konsul Rp 40,000 24,000 16,000
8 C. HUTAGAOL I/D H. TAMBUNAN Karcis Rp 20,000 12,000 8,000 dr. edwin

DRIVER Konsul Rp 40,000 24,000 16,000
GV & AFF H Rp 27,500 16,500 11,000
JUMLAH 4,780,600 2,809,560 98,000 1,873,040
Keterangan :
Jumlah 4,780,600
- O B H P 98,000
Mengetahui Muara Bungo, September 2014

dr. Safaruddin, MPH LAILA MAKNUN, S.Sos

NIP. 1967 0930 2002 12 1 001

SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 KUAT 53THN Perwt. Dalam kls II 4hr Rp 440,000 264,000 176,000 dr. taufan
K. SEMPROT Administrasi Rp 16,500 9,900 6,600
TNO Rp 59,400 35,640 23,760
Labor Rp 495,000 297,000 198,000
EKG Rp 77,000 46,200 30,800
Karcis IGD Rp 44,000 26,400 17,600 dr. lena
TNO IGD Rp 66,000 39,600 26,400
2 DINALIA I/D RUSLI M Karcis Rp 20,000 12,000 8,000 dr. zulkarnaen

SKU H Konsul Rp 40,000 24,000 16,000
USG Rp 165,000 99,000 66,000
3 ANANDES NATANEAL A/D AMON SITORUS Karcis Rp 20,000 12,000 8,000 dr. harnadi
4 AGUS SITORUS 34THN Karcis Rp 20,000 12,000 8,000 dr. ramli

MANDOR Konsul Rp 40,000 24,000 16,000
Labor Rp 330,000 198,000 132,000
5 NURCICA I/D AMON SITORUS Karcis Rp 20,000 12,000 8,000 dr. triolit
JUMLAH 1,932,900 1,159,740 - 773,160
Keterangan :
Jumlah 1,932,900
- O B H P -


NIP. 1967 0930 2002 12 1 001

SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 Jefriansyah 34 Thn Perwt. Bedah Kls II 1 Hr Rp 110,000 66,000 44,000 Dr. Derry, Sp.OT
Panen PHL Adm Rp 16,500 9,900 6,600
TNO Rp 19,800 11,880 7,920
Labor Rp 298,100 178,860 119,240
RO Rp 110,000 66,000 44,000
Karcis IGD Rp 44,000 26,400 17,600
TNO IGD Rp 33,000 19,800 13,200
2 Aditya Tambunan A/D H. Tambunan Karcis IGD Rp 44,000 26,400 17,600 Dr. Melva
Driver Traksi TNO IGD Rp 33,000 19,800 13,200
3 Dinalia I/D Rusli Mendrofa Perwt. VK Rp 385,000 231,000 154,000 Dr. Marlis,Sp.OG
Afd II Adm Rp 33,000 19,800 13,200
Op. Besar Rp 2,760,000 1,656,000 1,104,000
Pasang Infus Rp 55,000 33,000 22,000
Cateter Rp 38,500 23,100 15,400
Doppler Rp 66,000 39,600 26,400
USG Rp 165,000 99,000 66,000
Oksigen Rp 132,000 - 132,000 -
Perwt. Kebidanan Kls II 5 Hr Rp 550,000 330,000 220,000 Dr. Krisna,SpA
Adm Rp 16,500 9,900 6,600
TNO 5X Rp 99,000 59,400 39,600
Karcis IGD Rp 44,000 26,400 17,600
TNO IGD Rp 33,000 19,800 13,200
3 By.Dinalia a/D Rusli Mendrofa Perwt. Kebidanan Kls II 4 Hr Rp 200,000 120,000 80,000 Dr. Krisna,SpA
Adm Rp 15,000 9,000 6,000
TNO Rp 134,000 80,400 53,600
JUMLAH 5,434,400 3,181,440 132,000 2,120,960
Keterangan :
Jumlah 5,434,400
- O B H P 132,000


NIP. 1967 0930 2002 12 1 001

SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 Saldi Karcis KIR Rp 20,000 12,000 8,000 Dr. Ummul

PHL Panen Labor Rp 253,000 151,800 101,200
RO Rp 88,000 52,800 35,200
2 Herman Mendropa Karcis KIR Rp 20,000 12,000 8,000 Dr. Ummul

RO Rp 88,000 52,800 35,200
3 Heni Karcis KIR Rp 20,000 12,000 8,000 Dr. Ummul

RO Rp 88,000 52,800 35,200
4 Oktavianus Karcis KIR Rp 20,000 12,000 8,000 Dr. Ummul

RO Rp 88,000 52,800 35,200
5 Yanto Karcis KIR Rp 20,000 12,000 8,000 Dr. Ummul

RO Rp 88,000 52,800 35,200
6 Charles Matondang Karcis KIR Rp 20,000 12,000 8,000 Dr. Ummul

RO Rp 88,000 52,800 35,200
7 Dimas Laia Karcis KIR Rp 20,000 12,000 8,000 Dr. Ummul

RO Rp 88,000 52,800 35,200
8 Sopani Halawa Karcis KIR Rp 20,000 12,000 8,000 Dr. Ummul

RO Rp 88,000 52,800 35,200
9 Fitri I/D Andry Lubis Karcis Rp 20,000 12,000 8,000 Dr. Susi, Sp.PD
Mandor I Afd IV Konsul Rp 40,000 24,000 16,000
RO BNO Rp 10,000 6,000 4,000
10 Eka Purnama Karcis IGD Rp 44,000 26,400 17,600 Dr. Haryuni

Traksi SKU H TNO IGD Rp 33,000 19,800 13,200
RO Rp 88,000 52,800 35,200
11 Yusuf Karcis IGD Rp 44,000 26,400 17,600 Dr. Melva

PHL Panen TE IGD Rp 150,000 90,000 60,000
12 Afuk Perwt. KU D Kls II 4 Hr Rp 440,000 264,000 176,000 Dr. Faisal, Sp.B

Mandor I Afd II KBK Adm Rp 16,500 9,900 6,600
TNO 3X Rp 59,400 35,640 23,760
Labor Rp 258,500 155,100 103,400
Karcis IGD Rp 44,000 26,400 17,600 Dr. Melva
TNO IGD Rp 66,000 39,600 26,400
TE IGD Rp 88,000 52,800 35,200
13 Aldo Cristiando Purba I/D Robet Purba Perwt. INT Kls II 8 Hr Rp 880,000 528,000 352,000 Dr. Taufan, Sp.PD 6X
Mandor I Afd IV KRL Adm Rp 16,500 9,900 6,600 Dr. Haryuni 2X
TNO 3X Rp 59,400 35,640 23,760
Labor Rp 110,000 66,000 44,000
RO Rp 88,000 52,800 35,200
Karcis IGD Rp 44,000 26,400 17,600 Dr. Magdalena
TNO IGD Rp 33,000 19,800 13,200
14 Masri Sitinjak I/D F Batubara Perwt. VK 1 Hr Rp 385,000 231,000 154,000 Dr. Rozi, Sp.OG
Mandor I Afd II KRL Adm Rp 33,000 19,800 13,200
Op. Besar Rp 2,670,800 1,602,480 1,068,320
Cito Rp 320,000 192,000 128,000
Pasang Infus Rp 55,000 33,000 22,000
Cateter Rp 38,500 23,100 15,400
Doppler 2X Rp 44,000 26,400 17,600
USG Rp 165,000 99,000 66,000
Karcis IGD Rp 44,000 26,400 17,600 Dr. Jerri
TNO IGD Rp 33,000 19,800 13,200
Perwt. KB Kls II 2 Hr Rp 220,000 132,000 88,000
Adm Rp 16,500 9,900 6,600
TNO 3X Rp 59,400 35,640 23,760
Perwt. KB Kls II 2 Hr(Bayi) Rp 110,000 66,000 44,000 Dr. Nengtis
Adm Rp 8,250 4,950 3,300
TNO 3X Rp 29,700 17,820 11,880
15 Heskiel Tambunan Perwt. Anak Kls II 1 Hr Rp 110,000 66,000 44,000 Dr. Dewi, Sp. A
Mekanik SKU H Adm Rp 16,500 9,900 6,600
TNO 1X Rp 19,800 11,880 7,920
Labor Rp 71,500 42,900 28,600
TNO IGD Rp 33,000 19,800 13,200
16 Benni Supardi Karcis Rp 20,000 12,000 8,000 Dr. Susi, Sp.PD

PHL Panen Konsul Rp 40,000 24,000 16,000
Labor Rp 291,500 174,900 116,600
SARANA PELAYANAN
EKG Rp 77,000 46,200 30,800
RO Rp 88,000 52,800 35,200
17 Pahotan Sitinjak Karcis Rp 20,000 12,000 8,000 Dr. Susi, Sp.PD

PHL Mandor Panen Konsul Rp 40,000 24,000 16,000
Labor Rp 291,500 174,900 116,600
EKG Rp 77,000 46,200 30,800
RO Rp 88,000 52,800 35,200
18 Suhardi PHL Panen Karcis Rp 20,000 12,000 8,000 Dr. Susi, Sp.PD
Konsul Rp 40,000 24,000 16,000
Labor Rp 291,500 174,900 116,600
EKG Rp 77,000 46,200 30,800
RO Rp 88,000 52,800 35,200
19 Ujang Sumarna Karcis Rp 20,000 12,000 8,000 Dr. Susi, Sp.PD

Labor Rp 291,500 174,900 116,600
EKG Rp 77,000 46,200 30,800
RO Rp 88,000 52,800 35,200
20 Jepriansyah Karcis Rp 20,000 12,000 8,000 Dr. Susi, Sp.PD

Labor Rp 291,500 174,900 116,600
EKG Rp 77,000 46,200 30,800
RO Rp 88,000 52,800 35,200
21 Ahmadi Karcis Rp 20,000 12,000 8,000 Dr. Susi, Sp.PD

Labor Rp 291,500 174,900 116,600
EKG Rp 77,000 46,200 30,800
RO Rp 88,000 52,800 35,200
JUMLAH 13,146,250 7,887,750 - 5,258,500
Keterangan :
Jumlah 13,146,250
- O B H P -


NIP. 1967 0930 2002 12 1 001
Dr. Taufan, Sp.PD 6X

SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 Bendri s Karcis Rp 20,000 12,000 8,000 Dr. Ummul

K. Panen Labor Rp 209,000 125,400 83,600
RO Rp 88,000 52,800 35,200
EKG Rp 77,000 46,200 30,800
2 Pahotan Sitinjak 24 Thn Karcis Rp 20,000 12,000 8,000 Dr. Ummul

K. Panen Labor Rp 209,000 125,400 83,600
RO Rp 88,000 52,800 35,200
EKG Rp 77,000 46,200 30,800
3 Ahmadi Karcis Rp 20,000 12,000 8,000 Dr. Ummul

K. Panen Labor Rp 209,000 125,400 83,600
RO Rp 88,000 52,800 35,200
EKG Rp 77,000 46,200 30,800
4 Jepriansyah Karcis Rp 20,000 12,000 8,000 Dr. Ummul

Pemanen Labor Rp 209,000 125,400 83,600
RO Rp 88,000 52,800 35,200
EKG Rp 77,000 46,200 30,800
5 Ujang Sumarna Karcis Rp 20,000 12,000 8,000 Dr. Ummul

Pemanen Labor Rp 209,000 125,400 83,600
RO Rp 88,000 52,800 35,200
EKG Rp 77,000 46,200 30,800
6 Suhardi Karcis Rp 20,000 12,000 8,000 Dr. Ummul

K. Panen Labor Rp 209,000 125,400 83,600
RO Rp 88,000 52,800 35,200
EKG Rp 77,000 46,200 30,800
7 Aditya Tambunan A/D H. Tambunan Perwt. Anak Kls II 2 Hr Rp 220,000 132,000 88,000 Dr. Krisna, Sp.A 1X
Driver Adm Rp 16,500 9,900 6,600 Dr. Nia 1X
TNO 2X Rp 39,600 23,760 15,840
Labor Rp 55,000 33,000 22,000
TNO IGD Rp 33,000 19,800 13,200
8 Efrina Perwt. Bedah Kls II 1 Hr Rp 110,000 66,000 44,000 Dr. Faisal, Sp.B
T. Pupuk Adm Rp 16,500 9,900 6,600
TNO 1X Rp 19,800 11,880 7,920
Labor Rp 55,000 33,000 22,000
RO Rp 110,000 66,000 44,000
TNO IGD Rp 33,000 19,800 13,200
9 Talif 65 Thn Perwt. Paru Kls II 2 Hr Rp 220,000 132,000 88,000 Dr. Mardiah, Sp.P
KBK Adm Rp 16,500 9,900 6,600
TNO 2X Rp 39,600 23,760 15,840
Labor Rp 250,800 150,480 100,320
RO Rp 88,000 52,800 35,200
Oksigen 2 Hr Rp 240,000 - 240,000 -
Karcis IGD Rp 44,000 26,400 17,600 Dr. Ummul
TNO IGD Rp 33,000 19,800 13,200
JUMLAH 4,092,300 2,311,380 240,000 1,540,920
Keterangan :
Jumlah 4,092,300
- O B H P 240,000
Mengetahui Muara Bungo, DESEMBER 2014


NIP. 1967 0930 2002 12 1 001

SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 Fakter Simatupang 26 Thn Karcis Rp 20,000 12,000 8,000 Dr. Ummul

Security Labor Rp 253,000 151,800 101,200
RO Rp 88,000 52,800 35,200
2 M. Adong 31 Thn Karcis Rp 20,000 12,000 8,000 Dr. Ummul

Danpos Labor Rp 253,000 151,800 101,200
RO Rp 88,000 52,800 35,200
3 Supardi 32 Thn Karcis Rp 20,000 12,000 8,000 Dr. Ummul

Security Labor Rp 253,000 151,800 101,200
RO Rp 88,000 52,800 35,200
4 Dodi Syaputra Siagian 23 Thn Karcis Rp 20,000 12,000 8,000 Dr. Ummul
Kasir Labor Rp 253,000 151,800 101,200
RO Rp 88,000 52,800 35,200
5 Mariani S 25 Thn Karcis Rp 20,000 12,000 8,000 Dr. Veny, Sp.PD

P. Klinik Konsul Rp 40,000 24,000 16,000
6 Arsas Karcis Rp 20,000 12,000 8,000 Dr. Susi, Sp.PD

PHL Konsul Rp 40,000 24,000 16,000
7 Bendri Karcis Rp 20,000 12,000 8,000 Dr. Susi, Sp.PD

PHL Konsul Rp 40,000 24,000 16,000
USG Rp 132,000 79,200 52,800
8 Rio A/D Sutris Perwt. Anak Kls II 4 Hr Rp 440,000 264,000 176,000 Dr. Dewi, Sp.A
Mekanik Adm Rp 16,500 9,900 6,600
TNO 4X Rp 79,200 47,520 31,680
Labor Rp 118,800 71,280 47,520
RO Rp 330,000 198,000 132,000
TNO IGD Rp 33,000 19,800 13,200
9 Mika Malau A/D R Malau Perwt. Anak Kls II 1 Hr Rp 110,000 66,000 44,000 Dr. Harnadi, Sp.A
Kantor Adm Rp 16,500 9,900 6,600
TNO 1X Rp 19,800 11,880 7,920
Labor Rp 71,500 42,900 28,600
Perwt. ICCU 1 Hr Rp 440,000 264,000 176,000
Adm Rp 33,000 19,800 13,200
Monitor Rp 110,000 66,000 44,000
Infus Rp 55,000 33,000 22,000
Infus Pump Rp 27,500 16,500 11,000
Oksimetri Rp 38,500 23,100 15,400
Oksigen Rp 75,000 - 75,000 -
TNO IGD Rp 33,000 19,800 13,200
10 Azwar 45 Thn Perwt. INT Kls II 7 Hr Rp 770,000 462,000 308,000 Dr. Veny, Sp.PD 6X
K. Panen Adm Rp 16,500 9,900 6,600 Dr. Haryuni 1X
TNO 3X Rp 59,400 35,640 23,760
Labor Rp 291,500 174,900 116,600
RO Rp 220,000 132,000 88,000
TNO IGD Rp 33,000 19,800 13,200
JUMLAH 5,325,700 3,150,420 75,000 2,100,280
Keterangan :
Jumlah 5,325,700
- O B H P 75,000
Mengetahui Muara Bungo, DESEMBER 2014


NIP. 1967 0930 2002 12 1 001
BULAN TAGIHAN : NOVEMBER 2014

SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 Mariano Sinaga 25 Thn Karcis Rp 20,000 12,000 8,000 Dr. Taufan, Sp.PD
SKU H Konsul Rp 40,000 24,000 16,000
2 Rio A/D Sutris Karcis Rp 20,000 12,000 8,000 Dr. Dewi, Sp.A
Mekanik Konsul Rp 40,000 24,000 16,000
Labor Rp 55,000 33,000 22,000
3 Calista Putri Siagian A/D Andi Siagian Perwt. Anak Kls II 1 Hr Rp 110,000 66,000 44,000 Dr. Krisna, Sp.A
Mandor SKU H Adm Rp 16,500 9,900 6,600
TNO 1X Rp 19,800 11,880 7,920
Labor Rp 55,000 33,000 22,000
TNO IGD Rp 33,000 19,800 13,200
4 Windores A/D Yaman Perwt. Anak Kls II 2 Hr Rp 220,000 132,000 88,000 Dr. Dewi, Sp.A
K. Panen Adm Rp 16,500 9,900 6,600 Dr. Nia
TNO 2X Rp 39,600 23,760 15,840
Labor Rp 71,500 42,900 28,600
TNO IGD Rp 33,000 19,800 13,200
5 Aprenza Nenggolan A/D H Nenggolan Perwt. Bedah Kls II 3 Hr Rp 330,000 198,000 132,000 Dr. Deri, Sp.OT
Mandor SKU H Adm Rp 16,500 9,900 6,600
Op. Orif Rp 3,240,600 1,944,360 1,296,240
TNO 3X Rp 59,400 35,640 23,760
Labor Rp 55,000 33,000 22,000
RO Rp 88,000 52,800 35,200
Karcis IGD Rp 44,000 26,400 17,600 Dr. Jerry
TNO IGD Rp 33,000 19,800 13,200
JUMLAH 4,744,400 2,846,640 - 1,897,760
Keterangan :
Jumlah 4,744,400
- O B H P -
Mengetahui Muara Bungo, Februari 2015


NIP. 1967 0930 2002 12 1 001

SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 A. Lubis 36 Thn Karcis Rp 20,000 12,000 8,000 Drg. Lasma

Mekanik Exo Dewasa Rp 50,000 30,000 20,000
2 Yanti 22 Thn Karcis Rp 20,000 12,000 8,000 Dr. Orthopedi,SP.OT

Afd I Konsul Rp 40,000 24,000 16,000
3 J Samosir 30 Thn Karcis IGD Rp 44,000 26,400 17,600 Dr. Melva

Afd III TNO IGD Rp 33,000 19,800 13,200
4 Yanti 22 Thn Perwt. Bedah Kls II 4 Hr Rp 440,000 264,000 176,000 Dr. Deri, Sp.OT 3X
Afd I Adm Rp 16,500 9,900 6,600 Dr. Syafrial 1X
Op. Orif Rp 3,240,600 1,944,360 1,296,240
TNO 3X Rp 59,400 35,640 23,760
Labor Rp 55,000 33,000 22,000
RO Rp 88,000 52,800 35,200
Karcis IGD Rp 44,000 26,400 17,600 Dr. Syahrial
TNO IGD Rp 33,000 19,800 13,200
5 Suhardi 27 Thn Perwt. Bedah Kls II 2 Hr Rp 220,000 132,000 88,000 Dr. Syahrial 1X
K Pemanen Adm Rp 16,500 9,900 6,600 Dr. Magdalena 1X
TNO 2X Rp 39,600 23,760 15,840
Labor Rp 228,800 137,280 91,520
RO Rp 396,000 237,600 158,400
TNO IGD 2X Rp 66,000 39,600 26,400
6 Eli Dasni 28 Thn Perwt. KU C 6 Hr Rp 1,650,000 990,000 660,000 Dr. Veny, Sp.PD
Afd II Adm Rp 16,500 9,900 6,600
TNO 3X Rp 75,900 45,540 30,360
Labor Rp 823,900 494,340 329,560
USG Rp 275,000 165,000 110,000
Karcis IGD Rp 44,000 26,400 17,600 Dr. Jery
TNO IGD Rp 33,000 19,800 13,200
7 Aka Dores Perwt. INT Kls II 5 Hr Rp 550,000 330,000 220,000 Dr. Ramli, Sp.S
Operator Genset Adm Rp 16,500 9,900 6,600
Visite Dr. Susi, Sp.PD 3X Rp 132,000 79,200 52,800 Dr. Susi, Sp.PD 3X
KAR Dr. Susi, Sp.PD Rp 13,200 7,920 5,280
TNO 3X Rp 59,400 35,640 23,760
Labor Rp 385,000 231,000 154,000
RO Rp 176,000 105,600 70,400
TNO IGD Rp 33,000 19,800 13,200
JUMLAH 9,521,800 5,713,080 - 3,808,720
Keterangan :
Jumlah 9,521,800
- O B H P -


NIP. 1967 0930 2002 12 1 001

SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 Arsas Karcis Rp 20,000 12,000 8,000 Dr. Ummul

Panen Labor Rp 407,000 244,200 162,800
RO Rp 88,000 52,800 35,200
2 Senang Hati 25 Thn Karcis IGD Rp 44,000 26,400 17,600 Dr. Jerri
K Until TNO IGD Rp 33,000 19,800 13,200
3 Aditya Tambunan A/D Tambunan Karcis IGD Rp 44,000 26,400 17,600 Dr. Jerri
Driver TNO IGD Rp 33,000 19,800 13,200
4 Yanti 22 Thn Perwt. Bedah Kls II 2 Hr Rp 220,000 132,000 88,000 Dr. Deri, Sp.OT
Afd I Adm Rp 16,500 9,900 6,600
Visite Dr. Heru, Sp.An Rp 44,000 26,400 17,600 Dr. Heru, Sp.An
Op. Remove Implant Rp 3,240,600 1,944,360 1,296,240
TNO 2X Rp 39,600 23,760 15,840
Labor Rp 55,000 33,000 22,000
Karcis Rp 20,000 12,000 8,000
Konsul Rp 40,000 24,000 16,000
5 Suhardi 27 Thn Perwt. Bedah Kls II 3 Hr Rp 330,000 198,000 132,000 Dr. Faisal, Sp.B 2X
Kary Panen Adm Rp 16,500 9,900 6,600 Dr. Magdalena 1X
TNO 3X Rp 59,400 35,640 23,760
Labor Rp 258,500 155,100 103,400
RO Rp 330,000 198,000 132,000
TNO IGD Rp 33,000 19,800 13,200
JUMLAH 5,416,100 3,249,660 - 2,166,440
Keterangan :
Jumlah 5,416,100
- O B H P -
Mengetahui Muara Bungo, 2015


NIP. 1967 0930 2002 12 1 001
DOKTER YG
NO. NAMA PASIEN
JASA MERAWAT
(THN) PELAYANAN JUMLAH JASA SARANA O B H P
PELAYANAN
1 2 3 4 5 6 7 8 9
1 Siti Harefa I/D Oktavianus 01-03-2016 Karcis Rp 20,000 12,000 8,000 Dr. Susi, Sp.PD
K. Panen Afd I Konsul Rp 40,000 24,000 16,000
2 Atika Sulistiani P I/D Mecco Mentos 19-01-2016 Karcis Rp 20,000 12,000 8,000 Dr. Veny, Sp.PD
Mandor Konsul Rp 40,000 24,000 16,000
3 Triyuwono 35 Thn 26-01-2016 Karcis Rp 20,000 12,000 8,000 Dr. Mardiah, Sp.P
SKU H Konsul Rp 40,000 24,000 16,000
4 Lopeli Dameyanti A/D C Matondang 27-01-2016 Karcis Rp 20,000 12,000 8,000 Dr. Krisna, Sp.A
Mandor Konsul Rp 40,000 24,000 16,000
- -
5 Muliadi 23-02-2016 Perwt. Bedah Kls II 2 Hr Rp 220,000 132,000 88,000 Dr. Faisal, Sp.B
K Panen Afd II 25-02-2016 Adm Rp 16,500 9,900 6,600
TNO 2X Rp 39,600 23,760 15,840
Labor Rp 228,800 137,280 91,520
USG Rp 200,000 120,000 80,000
TNO IGD Rp 33,000 19,800 13,200
- -
6 Trihandayani I/D Hendrik N 01-02-2016 Perwt. VK 1 Hr Rp 385,000 231,000 154,000 Dr. Husnul, Sp.OG
Mandor 01-02-2016 Adm Rp 33,000 19,800 13,200
Op. Sedang Rp 1,668,750 1,001,250 667,500
Cateter Rp 38,500 23,100 15,400
Infus Rp 55,000 33,000 22,000
Labor Rp 102,300 61,380 40,920
Karcis IGD Rp 44,000 26,400 17,600
TNO IGD Rp 33,000 19,800 13,200
01-02-2016 Perwt. KB Kls II 1 Hr Rp 110,000 66,000 44,000
02-02-2016 Adm Rp 16,500 9,900 6,600
TNO 1X Rp 19,800 11,880 7,920
-
7 Tunis 23 Thn 19-02-2016 Perwt. INT KLs II 1 Hr Rp 110,000 66,000 44,000 Dr. Taufan, Sp.PD
PHL 20-02-2016 Adm Rp 16,500 9,900 6,600
TNO 1X Rp 19,800 11,880 7,920
Labor Rp 206,800 124,080 82,720
TNO IGD Rp 33,000 19,800 13,200
-
8 Santi Nenggolan I/D Poniran Sitorus 09-02-2016 Perwt. Bedah Kls II 2 Hr Rp 220,000 132,000 88,000 Dr. Arianto, Sp.B
Operator 11-02-2016 Adm Rp 16,500 9,900 6,600
TNO 2X Rp 36,900 22,140 14,760
Labor Rp 258,500 155,100 103,400
USG Abdomen Rp 220,000 132,000 88,000
TNO IGD Rp 33,000 19,800 13,200
JUMLAH 4,786,750 2,872,050 - 1,914,700
Mengetahui Muara Bungo, 2016

dr. Safaruddin, MPH kresna Murti, S.Kom

NIP. 1967 0930 2002 12 1 001

SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 Joni Gultom Karcis Rp 20,000 12,000 8,000 Dr. Umul

Operator Jonder Labor Rp 418,000 250,800 167,200
RO Rp 80,000 48,000 32,000
2 Muhammad Zurni Karcis Rp 20,000 12,000 8,000 Dr. Umul

Sopir Labor Rp 418,000 250,800 167,200
RO Rp 80,000 48,000 32,000
3 Ngateno Karcis Rp 20,000 12,000 8,000 Dr. Umul

Mandor Civil Labor Rp 418,000 250,800 167,200
RO Rp 80,000 48,000 32,000
4 Aldi Tambunan Karcis Rp 20,000 12,000 8,000 Dr. Umul

RO Rp 80,000 48,000 32,000
5 Janner Sitohang Karcis Rp 20,000 12,000 8,000 Dr. Umul

Mandor Alat Berat Labor Rp 418,000 250,800 167,200
RO Rp 80,000 48,000 32,000
- -
6 Setio Utomo Karcis Rp 20,000 12,000 8,000 Dr. Umul
Mekanik Labor Rp 418,000 250,800 167,200
RO Rp 80,000 48,000 32,000
7 Ayu 23 Thn Karcis Rp 20,000 12,000 8,000 Dr. Umul

Krani Afd Labor Rp 418,000 250,800 167,200
RO Rp 80,000 48,000 32,000
8 Herdianti 21 Thn Karcis Rp 20,000 12,000 8,000 Dr. Umul

Krani Persinalia Labor Rp 418,000 250,800 167,200
RO Rp 80,000 48,000 32,000
9 Laksa Hartadi 23 Thn Karcis Rp 20,000 12,000 8,000 Dr. Umul

RO Rp 80,000 48,000 32,000
10 Nasib A Simanjuntak 27 Thn Karcis Rp 20,000 12,000 8,000 Dr. Umul

Mandor Panen Labor Rp 418,000 250,800 167,200
RO Rp 80,000 48,000 32,000
11 A. Riadul 29 Thn Karcis Rp 20,000 12,000 8,000 Dr. Umul

Mekanik Labor Rp 418,000 250,800 167,200
RO Rp 80,000 48,000 32,000
12 Nurlia 23 Thn Karcis Rp 20,000 12,000 8,000 Dr. Umul

RO Rp 80,000 48,000 32,000
13 Desima Tanjung 27 Thn Karcis Rp 20,000 12,000 8,000 Dr. Umul

RO Rp 80,000 48,000 32,000
14 Yosman 33 Thn Karcis Rp 20,000 12,000 8,000 Dr. Umul

Krani Adm Labor Rp 418,000 250,800 167,200
RO Rp 80,000 48,000 32,000
15 Soni Pasaribu 26 Thn Karcis Rp 20,000 12,000 8,000 Dr. Umul

RO Rp 80,000 48,000 32,000
16 Hotman Siahaan 33 Thn Karcis Rp 20,000 12,000 8,000 Dr. Umul

Operator Labor Rp 418,000 250,800 167,200
RO Rp 80,000 48,000 32,000
17 Cilisia Siagian A/D Andi Siagian Karcis Rp 20,000 12,000 8,000 Dr. Harnadi, Sp.A
Mandor Konsul Rp 40,000 24,000 16,000
18 Mariani Sinaga 25 Thn Karcis Rp 20,000 12,000 8,000 Dr. Veny, Sp.PD
Perawat SKU H Konsul Rp 40,000 24,000 16,000
19 Christian Aprian P A/D Aprizal P Karcis Rp 20,000 12,000 8,000 Dr. Triolit, Sp.THT
Krani Pembukuan Konsul Rp 40,000 24,000 16,000
Toilet Telinga Rp 44,000 26,400 17,600
20 Calista Siagian Andi Siagian Karcis Rp 20,000 12,000 8,000 Dr. Triolit, Sp.THT
Mandor Konsul Rp 40,000 24,000 16,000
Toilet Telinga 2X Rp 88,000 52,800 35,200
21 Leni Pasaribu A/D Soni Liston P Perwt. Anak Kls II 4 Hr Rp 440,000 264,000 176,000 Dr. Harnadi, Sp.A
Krani PHL Adm Rp 16,500 9,900 6,600
TNO 4X Rp 79,200 47,520 31,680
Labor Rp 55,000 33,000 22,000
TNO IGD Rp 33,000 19,800 13,200
Oksigen IGD Rp 11,000 11,000
SARANA PELAYANAN
22 Senang Hati 25 Thn Perwt. Bedah Kls II 4 Hr Rp 440,000 264,000 176,000 Dr. Faisal, Sp.B
K Until Adm Rp 16,500 9,900 6,600
TNO 3X Rp 59,400 35,640 23,760
Labor Rp 44,000 26,400 17,600
Karcis Rp 20,000 12,000 8,000
Konsul Rp 40,000 24,000 16,000
23 Yoga A/D Afuk Perwt. Anak Kls II 2 Hr Rp 220,000 132,000 88,000 Dr. Krisna, Sp.A
Mandor I Afd III Adm Rp 16,500 9,900 6,600
TNO 1X Rp 19,800 11,880 7,920
Labor Rp 135,300 81,180 54,120
TNO IGD Rp 33,000 19,800 13,200
24 Anandes N Sitorus Amon Sitrus Anak Kls II 2 Hr Rp 220,000 132,000 88,000 Dr. Krisna, SP.A
SKU H Adm Rp 16,500 9,900 6,600
TNO 2X Rp 39,600 23,760 15,840
Labor Rp 157,300 94,380 62,920
RO Rp 88,000 52,800 35,200
Karcis Rp 20,000 12,000 8,000
Konsul Rp 40,000 24,000 16,000
25 Winulyo Perwt. Mata & THT Kls II 5 Hr Rp 550,000 330,000 220,000 Dr. Veny, Sp.PD
Operator Adm Rp 16,500 9,900 6,600
TNO 3X Rp 59,400 35,640 23,760
Labor Rp 282,700 169,620 113,080
RO Rp 88,000 52,800 35,200
TNO IGD Rp 33,000 19,800 13,200
Perwt. INT Kls II 2 Hr Rp 220,000 132,000 88,000 Dr. Veny, Sp.PD
Adm Rp 16,500 9,900 6,600
TNO 1X Rp 19,800 11,880 7,920
Labor Rp 203,500 122,100 81,400
Oksigen INT Rp 150,000 150,000
Perwt. ICU 5 Hr Rp 2,200,000 1,320,000 880,000 Dr. Veny, SP.PD 4X
Adm Rp 33,000 19,800 13,200 Dr. Haryuni 1X
Visite Dr. Ramli, Sp.S 2X Rp 352,000 211,200 140,800 Dr. Ramli, Sp.S 2X
KAR Dr. Ramli, Sp.S Rp 88,000 52,800 35,200
Monitor 5X Rp 550,000 330,000 220,000
Infus Pump 5X Rp 137,500 82,500 55,000
Pasang Infus 1X Rp 55,000 33,000 22,000
Labor Rp 71,500 42,900 28,600
CT Scan Rp 1,100,000 660,000 440,000
Oksigen ICU Rp 264,000 264,000
Perwt. INT Kls II 15 Hr Rp 1,650,000 990,000 660,000 Dr. Veny, Sp.PD 14X
Adm 2X Rp 27,500 16,500 11,000 Dr. Haryuni 1X
Visite Dr. Ramli, Sp.S 15X Rp 660,000 396,000 264,000 Dr. Ramli, Sp.S 15X
TNO 3X Rp 39,600 23,760 15,840
Labor Rp 440,000 264,000 176,000
Fisioterapy Rp 627,000 376,200 250,800
JUMLAH 20,987,100 12,337,260 425,000 8,224,840
Keterangan :
Jumlah 20,987,100
- O B H P 425,000


NIP. 1967 0930 2002 12 1 001

SARANA PELAYANAN
1 2 3 4 5 6 7 8 9
1 Anandes S A/D Amon Sitorus Karcis Rp 20,000 12,000 8,000 Dr. Nia
2 M Rizki R A/D Sabar Karcis Rp 20,000 12,000 8,000 Dr. Faisal, Sp.B
K Panen Konsul Rp 40,000 24,000 16,000
3 Jefri 42 Thn Karcis IGD Rp 44,000 26,400 17,600 Dr. Melva

K Dongkel TNO IGD Rp 33,000 19,800 13,200
TE IGD Rp 165,000 99,000 66,000
4 Carli Sitorus A/D P Sitorus Perwt. Anak Kls II 1 Hr Rp 110,000 66,000 44,000 Dr. Nia
Operator Sonder Adm Rp 16,500 9,900 6,600
TNO Rp 19,800 11,880 7,920
Labor Rp 102,300 61,380 40,920
Karcis IGD Rp 44,000 26,400 17,600 Dr. Nengtis
TNO IGD Rp 33,000 19,800 13,200
5 Andika A/D Anto Perwt. Anak Kls II 1 Hr Rp 110,000 66,000 44,000 Dr. Nia
K Panen Adm Rp 16,500 9,900 6,600
TNO 1X Rp 19,800 11,880 7,920
Labor Rp 55,000 33,000 22,000
TNO IGD Rp 33,000 19,800 13,200
6 Marsandi A/D Yumin H Perwt. Anak Kls II 2 Hr Rp 220,000 132,000 88,000 Dr. Nia 2X
SKU H Adm Rp 16,500 9,900 6,600
TNO 2X Rp 39,600 23,760 15,840
Labor Rp 71,500 42,900 28,600
Karcis Rp 20,000 12,000 8,000
7 Neti Tindaon I/D T Tambunan Perwt. INT Kls II 4 Hr Rp 440,000 264,000 176,000 Dr. Taufan, Sp.PD
PHL Adm Rp 16,500 9,900 6,600
TNO 2X Rp 39,600 23,760 15,840
Labor Rp 482,900 289,740 193,160
EKG Rp 77,000 46,200 30,800
Oksigen INT Rp 150,000 150,000
TNO IGD Rp 33,000 19,800 13,200
8 Neti Tindaon I/D T Tambunan Perwt. INT Kls II 1 Hr Rp 110,000 66,000 44,000 Dr. Ramli, Sp.S
PHL Adm Rp 16,500 9,900 6,600
TNO 1X Rp 19,800 11,880 7,920
Labor Rp 430,100 258,060 172,040
RO Rp 500,000 300,000 200,000
Karcis Rp 20,000 12,000 8,000
Konsul Rp 40,000 24,000 16,000
9 Umiapsoh I/D Anwar Perwt. VK 1 Hr Rp 385,000 231,000 154,000 Dr. Husnul, Sp.OG
Kantor Adm Rp 33,000 19,800 13,200
Op. Besar Rp 2,670,800 1,602,480 1,068,320
Doppler 3X Rp 66,000 39,600 26,400
Cateter Rp 38,500 23,100 15,400
Infus Rp 55,000 33,000 22,000
TNO IGD Rp 33,000 19,800 13,200
Adm Rp 16,500 9,900 6,600
TNO 2X Rp 39,600 23,760 15,840
Perwt. PRT 1 Hr Rp 220,000 132,000 88,000 Dr. Krisna,SP.A
Adm Rp 33,000 19,800 13,200
Tind Dr. Anak Pada OPSC Rp 203,500 122,100 81,400
By Patologis Rp 385,000 231,000 154,000
Section Rp 22,000 13,200 8,800
JUMLAH 8,177,800 4,816,680 150,000 3,211,120
Keterangan :
Jumlah 8,177,800
- O B H P 150,000


NIP. 1967 0930 2002 12 1 001
TINDAKAN B I A Y A
DOKTER YG
NO. NAMA PASIEN
JASA JASA MERAWAT
PELAYANAN JUMLAH O B H P
SARANA PELAYANAN
1 2 4 5 6 7 8 9
1 Siti Harefa I/D Oktavianus Karcis Rp 20,000 12,000 8,000 Dr. Susi, Sp.PD
K. Panen Afd I Konsul Rp 40,000 24,000 16,000
2 Atika Sulistiani P I/D Mecco Mentos Karcis Rp 20,000 12,000 8,000 Dr. Veny, Sp.PD
Mandor Konsul Rp 40,000 24,000 16,000
3 Triyuwono 35 Thn Karcis Rp 20,000 12,000 8,000 Dr. Mardiah, Sp.P

SKU H Konsul Rp 40,000 24,000 16,000
4 Lopeli Dameyanti A/D C Matondang Karcis Rp 20,000 12,000 8,000 Dr. Krisna, Sp.A
Mandor Konsul Rp 40,000 24,000 16,000
- -
5 Muliadi Perwt. Bedah Kls II 2 Hr Rp 220,000 132,000 88,000 Dr. Faisal, Sp.B
K Panen Afd II Adm Rp 16,500 9,900 6,600
TNO 2X Rp 39,600 23,760 15,840
Labor Rp 228,800 137,280 91,520
USG Rp 200,000 120,000 80,000
TNO IGD Rp 33,000 19,800 13,200
- -
6 Trihandayani I/D Hendrik N Perwt. VK 1 Hr Rp 385,000 231,000 154,000 Dr. Husnul, Sp.OG
Mandor Adm Rp 33,000 19,800 13,200
Op. Sedang Rp 1,668,750 1,001,250 667,500
Cateter Rp 38,500 23,100 15,400
Infus Rp 55,000 33,000 22,000
Labor Rp 102,300 61,380 40,920
Karcis IGD Rp 44,000 26,400 17,600
TNO IGD Rp 33,000 19,800 13,200
Adm Rp 16,500 9,900 6,600
TNO 1X Rp 19,800 11,880 7,920
-
7 Tunis 23 Thn Perwt. INT KLs II 1 Hr Rp 110,000 66,000 44,000 Dr. Taufan, Sp.PD
PHL Adm Rp 16,500 9,900 6,600
TNO 1X Rp 19,800 11,880 7,920
Labor Rp 206,800 124,080 82,720
TNO IGD Rp 33,000 19,800 13,200
-
8 Santi Nenggolan I/D Poniran Sitorus Perwt. Bedah Kls II 2 Hr Rp 220,000 132,000 88,000 Dr. Arianto, Sp.B
Operator Adm Rp 16,500 9,900 6,600
TNO 2X Rp 36,900 22,140 14,760
Labor Rp 258,500 155,100 103,400
USG Abdomen Rp 220,000 132,000 88,000
TNO IGD Rp 33,000 19,800 13,200
JUMLAH 4,786,750 2,872,050 - 1,914,700
Keterangan :
Jumlah 4,786,750
- O B H P -
Muara Bungo, Pebruari 2016
Pengelola Program
kresna Murti, S.Kom

TINDAKAN B I A Y A
DOKTER YG
NO NAMA PASIEN JASA JASA
PELAYANAN JUMLAH O B H P MERAWAT
SARANA PELAYANAN
2 4 5 6 7 8 9
1 Herman Karcis Rp 20,000 Rp 12,000 8,000 Dr. Ramli, Sp.S

SKU H Konsul Rp 40,000 Rp 24,000 16,000
2 Herman Karcis Rp 20,000 Rp 12,000 8,000 Dr. Ramli, Sp.S

SKU H Konsul Rp 40,000 Rp 24,000 16,000
JUMLAH 120,000 72,000 - 48,000
Keterangan :
Jumlah 120,000
- O B H P -

dr. Safaruddin, MPH KRESNA MURTI, S.KOM

NIP. 1967 0930 2002 12 1 001
TINDAKAN B I A Y A
DOKTER YG
NO NAMA PASIEN JASA JASA
PELAYANAN JUMLAH O B H P MERAWAT
SARANA PELAYANAN
2 4 5 6 7 8 9
1 Herman Karcis Rp 20,000 Rp 12,000 8000 Dr. Ramli, Sp.S

Security Konsul Rp 40,000 Rp 24,000 16000
2 Jefriansyah Perwt. INT Kls II 4 Hr Rp 440,000 Rp 264,000 176000 Dr. Taufan, Sp.PD
K Panen Adm Rp 16,500 Rp 9,900 6600
Visite Dr.Taufan,Sp.PD 1X Rp 44,000 Rp 26,400 17600
KAR Dr. Ramli, Sp.S Rp 13,200 Rp 7,920 5280
TNO 2X Rp 39,600 Rp 23,760 15840
Labor Rp 228,800 Rp 137,280 91520
Karcis IGD Rp 44,000 Rp 26,400 17600
TNO IGD Rp 33,000 Rp 19,800 13200
JUMLAH 919,100 551,460 - 367,640
Keterangan :
Jumlah 919,100
- O B H P -
Mengetahui Muara Bungo, April 2016

Dr. SAFARUDDIN, MPH KRESNA MURTI, S.KOM

NIP. 1967 0930 2002 12 1 001
BULAN TAGIHAN : PEBRUARI 2018
TINDAKAN B I A Y A
DOKTER YG
NO NAMA PASIEN JASA MERAWAT
PELAYANAN JUMLAH JASA SARANA O B H P
PELAYANAN
2 4 5 6 7 8 9
1 AZKA ROMADHON Karcis Rp 20,000 Rp 12,000 8,000 dr.Lidia H,SpA

Konsul Rp 40,000 Rp 24,000 16,000
JUMLAH 60,000 36,000 - 24,000
Keterangan :
Jumlah 60,000
- O B H P -
Mengetahui Muara Bungo, PEBRUARI 2018

Kabid Pelayanan dan Penunjang Medik Pengelola Program
Dr. ONENG SOEKIRATEN KRESNA MURTI, S.KOM

NIP.19800920 200803 2 004
TINDAKAN B I A Y A
DOKTER YG
PELAYANAN
2 4 5 6 7 8 9
1 RISMAWATI Karcis IGD Rp 44,000 Rp 26,400 17,600 Dr. Rumiyati
JUMLAH 44,000 26,400 - 17,600
Keterangan :
Jumlah 44,000
- O B H P -
Mengetahui Muara Bungo, Desember 2017


NIP.19800920 200803 2 004
TINDAKAN B I A Y A
DOKTER YG
NO NAMA PASIEN JASA
PELAYANAN JUMLAH JASA SARANA O B H P MERAWAT
PELAYANAN
2 4 5 6 7 8 9
Perwtn Interne Kls II 1
1 ERNA PAJARANTI
Hr
Rp 110,000 Rp 66,000 44,000 Dr. Ramli,Sp.S
Adm Rp 16,500 Rp 9,900 6,600

TNO 3 X Rp 19,800 Rp 11,880 7,920
Lab Rp 517,000 Rp 310,200 206,800
Karcis & Tind. IGD Rp 77,000 Rp 46,200 30,800 Dr. Rumiyati
Rp - -
2 DIRGA AGUSTINO Perwtn Anak Kls II 1 Hr Rp 110,000 Rp 66,000 44,000 Dr. Dewi,Sp.A
Adm Rp 16,500 Rp 9,900 6,600

TNO 3 X Rp 19,800 Rp 11,880 7,920
Lab Rp 495,000 Rp 297,000 198,000
Rp - -
3 SITI MARYAM Perwtn K.Bersalin 1 Hr Rp 385,000 Rp 231,000 154,000 Dr. Husnul,Sp.OG
OP. Besar Rp 2,670,800 Rp 1,602,480 1,068,320
P.Infus Rp 55,000 Rp 33,000 22,000
Dopler 3x Rp 60,000 Rp 36,000 24,000
Cateter 1. Rp 38,500 Rp 23,100 15,400
TNO 1X Rp 35,000 Rp 21,000 14,000
USG Rp 150,000 Rp 90,000 60,000
Karcis + Tind. IGD Rp 77,000 Rp 46,200 30,800 Dr. Mahdalena
Rp - -
Perwtn Keb Kls III 3 Hr Rp 198,000 Rp 118,800 79,200
Adm Rp 16,500 Rp 9,900 6,600
TNO 3 X Rp 49,500 Rp 29,700 19,800
Rp - -
By. SITI MARYAM Perwtn Keb Kls III 3 Hr Rp 198,000 Rp 118,800 79,200 Dr. Lidia,Sp.A
Adm Rp 16,500 Rp 9,900 6,600

TNO 3X Rp 49,500 Rp 29,700 19,800
JUMLAH 5,380,900 3,228,540 - 2,152,360
Keterangan :
Jumlah 5,380,900
- O B H P -


NIP.19800920 200803 2 004
TINDAKAN B I A Y A
DOKTER YG
NO.
PELAYANAN
### 2 4 5 6 7 8 9
1 NIASTI Perwtn Interne Kls II 3 Hr Rp 330,000 Rp 198,000 - 132,000 Dr.Taufan,Sp.PD
Adm Rp 16,500 Rp 9,900 - 6,600
TNO 3 X Rp 59,400 Rp 35,640 - 23,760
Lab Rp 263,000 Rp 157,800 - 105,200
USG Rp 220,000 Rp 132,000 - 88,000
Konsultasi Gizi Rp 20,000 Rp 12,000 - 8,000
Karcis & Tind. IGD Rp 77,000 Rp 46,200 - 30,800
2 SITI MARYAM Perwtn IRNA PARU Kls II 4 Hr Rp 440,000 Rp 264,000 - 176,000 Dr. Mardiah,Sp.P
Adm Rp 16,500 Rp 9,900 - 6,600
TNO 4 X Rp 79,200 Rp 47,520 - 31,680
Nebulizer 4X Rp 176,000 Rp 105,600 - 70,400
LAB Rp 313,500 Rp 188,100 - 125,400
Oksigen 1 Hr Rp 120,000 Rp 72,000 - 48,000
3 WATIMAH Perwtn K.Bersalin 1 Hr Rp 385,000 Rp 231,000 - 154,000 Dr. Zul , Sp.OG
Adm Rp 33,000 Rp 19,800 - 13,200

Op. Besar Cyto Rp 1,814,230 Rp 1,088,538 - 725,692
P.Infus 1X Rp 50,000 Rp 30,000 - 20,000
P. Cateter 1X Rp 35,000 Rp 21,000 - 14,000
Dopler 1X Rp 22,000 Rp 13,200 - 8,800
USG Rp 150,000 Rp 90,000 - 60,000
Lab Rp 534,600 Rp 320,760 - 213,840
Perwtn Keb Kls III 3 Hr Rp 198,000 Rp 118,800 - 79,200
Adm Rp 16,500 Rp 9,900 - 6,600
TNO 3X Rp 49,500 Rp 29,700 - 19,800
JUMLAH 5,568,930 3,341,358 - 2,227,572
Keterangan :
Jumlah 5,568,930
- O B H P -
Mengetahui Muara Bungo, Juli 2018


NIP.19800920 200803 2 004
TINDAKAN B I A Y A
DOKTER YG
NO.
NO NAMA PASIEN JASA
PELAYANAN JUMLAH JASA SARANA O B H P MERAWAT
PELAYANAN
### 2 4 5 6 7 8 9
1 JELINA Perawatan anak kelas II 2 hari Rp 220,000 Rp 132,000 88,000 dr. Dewi, Sp. A
ANAK SOZISOKHI Administrasi Rp 16,500 Rp 9,900 6,600
Konsul antar spesialis Rp 13,200 Rp 7,920 5,280 Dr. Arifianto, Sp.B
Pasang kateter Rp 38,500 Rp 23,100 15,400
Karcis Rp 20,000 Rp 12,000 8,000
Konsul Rp 40,000 Rp 24,000 16,000
Labor Rp 187,000 Rp 112,200 74,800
RO Rp 220,000 Rp 132,000 88,000
Obat Rp 1,564,700 Rp 938,820 625,880
Perawatan zaal bedah II 3 hari Rp 330,000 Rp 198,000 132,000 Dr. Arifianto, Sp.B
Administrasi Rp 16,500 Rp 9,900 6,600
TNO kecil 2x Rp 39,600 Rp 23,760 15,840
2 ADITYA TAMBUNAN Karcis Rp 20,000 Rp 12,000 8,000 dr. Dewi , Sp. A
DRIVER Konsul Rp 40,000 Rp 24,000 16,000
3 LESTI OULI LAIA Karcis IGD Rp 44,000 Rp 26,400 17,600 dr. Rozi, Sp.OG
ISTRI SIMANUNGKALIT TNO IGD Rp 33,000 Rp 19,800 13,200
Perawatan kebidanan kls II 2 hari Rp 220,000 Rp 132,000 88,000
Admin Rp 16,500 Rp 9,900 6,600
TNO Kecil Rp 19,800 Rp 11,880 7,920

Perawatan VK Rp 385,000 Rp 231,000 154,000
Admin Rp 33,000 Rp 19,800 13,200

4 EVI TAMBUBOLON Karcis IGD Rp 44,000 Rp 26,400 17,600
ISTRI HERI TNO IGD Rp 33,000 Rp 19,800 13,200
Perawatan VK 1 hari Rp 385,000 Rp 231,000 154,000 dr. Krisna, Sp. A
admin Rp 33,000 Rp 19,800 13,200
Resusitasi Rp 385,000 Rp 231,000 154,000
Section Rp 22,000 Rp 13,200 8,800
5 EVI TAMBUBOLON Karcis IGD Rp 44,000 Rp 26,400 17,600 dr. Husnul, Sp.OG
ISTRI HERI TNO IGD Rp 33,000 Rp 19,800 13,200 dr. Melva
Perawatan kebidanan kelas II 2 hari Rp 220,000 Rp 132,000 88,000
admin Rp 16,500 Rp 9,900 6,600
TNO kecil Rp 19,800 Rp 11,880 7,920
EVI TAMBUBOLON Perawatan kamar bersalin 1 hR Rp 385,000 Rp 231,000 154,000
admin Rp 33,000 Rp 19,800 13,200
Infus Rp 55,000 Rp 33,000 22,000
Cateter Rp 38,500 Rp 23,100 15,400
Doppler Rp 66,000 Rp 39,600 26,400
Partus dengan panyulit Rp 990,000 Rp 594,000 396,000
JUMLAH 6,320,100 3,792,060 - 2,528,040
Keterangan :
Jumlah 6,320,100
- O B H P -
Mengetahui Muara Bungo, SEPTEMER 2017


NIP.19800920 200803 2 004
PT. INHEALT YANG BEROBAT DI RSUD H. HANAFIE MUARA BUNGO
TINDAKAN B I A Y A
DOKTER YG
NO NAMA PASIEN
JASA MERAWAT
PELAYANAN JUMLAH JASA SARANA OBHP
PELAYANAN
2 4 5 6 7 8 9
1 MUSDAR Karcis Rp 20,000 Rp 12,000
8,000 Dr. Tobroni,Sp.B
RM : 0144488 Konsul Rp 40,000 Rp 24,000 16,000
GV Rp 45,000 Rp 27,000
18,000
JUMLAH 105,000 63,000 - 42,000
Keterangan :
Jumlah 105,000
-OBHP -
Mengetahui Muara Bungo, Agustus 2018


NIP.19800920 200803 2 004
TINDAKAN B I A Y A
DOKTER YG
NO NAMA PASIEN
JASA MERAWAT
PELAYANAN
2 4 5 6 7 8 9
1 RANDI TRI OKTA S Karcis Rp 20,000 Rp 12,000 8,000 Dr. Hendry,Sp.M

RM : 0146220 Konsul Rp 40,000 Rp 24,000 16,000
Exo Alienum Cornea Rp 66,000 Rp 39,600 26,400
Funduskopi Rp 18,700 Rp 11,220 7,480
Visus Rp 11,000 Rp 6,600 4,400
Steak Retinoscopi Rp 30,250 Rp 18,150 12,100
Obat Rp 302,900 Rp 181,740 121,160
2 FATIH ABDULLAH Karcis Rp 20,000 Rp 12,000 8,000 Dr. Krisna,Sp.A

RM : 0146985 Konsul Rp 40,000 Rp 24,000 16,000
Obat Rp 481,600 Rp 288,960 192,640
3 MAYANG SARI Karcis Rp 20,000 Rp 12,000

8,000 Dr. Mardiah,Sp.P
RM: 20/09/2018 Konsul Rp 40,000 Rp 24,000 16,000
JUMLAH 1,090,450 654,270 - 436,180
Keterangan :
Jumlah 1,090,450
-OBHP -


NIP.19800920 200803 2 004
TINDAKAN B I A Y A
DOKTER YG
NO. NAMA PASIEN JASA MERAWAT
PELAYANAN
1 2 4 5 6 7 8
-
1 YUSMANIDAR Karcis Rp 20,000 Rp 12,000 Rp 8,000 Dr. Rozi,Sp.OG
Konsul Rp 40,000 Rp 24,000 Rp 16,000
USG Rp 150,000 Rp 90,000 Rp 60,000
JUMLAH Rp 210,000 126,000 - 84,000 -
Keterangan :
Jumlah 210,000
-OBHP -


NIP.19800920 200803 2 004
TINDAKAN B I A Y A
DOKTER YG
NO NAMA PASIEN
JASA MERAWAT
PELAYANAN
1 2 3 4 5 6 7 8
1 MUHAMMAD RIZKY Karcis Rp 20,000 Rp 12,000 8,000 Dr. Hendry,Sp.M
RM : 022638 Konsul Rp 40,000 Rp 24,000 16,000
Funduskopi Rp 18,700 Rp 11,220 7,480
Visus Rp 11,000 Rp 6,600 4,400
2 ENDRIZAL Karcis Rp 20,000 Rp 12,000 8,000 Dr. Hendry,Sp.M

RM: 038310 Konsul Rp 40,000 Rp 24,000 16,000
Funduskopi Rp 18,700 Rp 11,220 7,480
Visus Rp 11,000 Rp 6,600 4,400
JUMLAH 371,900 223,140 - 148,760
Keterangan :
Jumlah 371,900
-OBHP -


NIP.19800920 200803 2 004

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RINCIAN BIAYA PERAWATAN KARYAWAN / KARYAWATI DAN ANGGOTA KELUARGA

PT. PML YANG BEROBAT DI RSUD H. HANAFIE MUARA BUNGO

4 Erwin 26 Perwt. Pav B 3 Hr 630,000 294,000 126,000 210,000 Dr. Susi

JUMLAH 992,500 410,500 183,400 398,600

Mengetahui Muara Bungo, 26 Juli 2010

dr. Safaruddin, MPH S. M A N A L U.

1 Musdarlin Karcis 7,500 3,750 3,750 Dr. Mardiah

JUMLAH 430,500 69,160 174,600 186,740

Mengetahui Muara Bungo, 16 Agustus 2010

dr. Safaruddin, MPH S. M A N A L U.

JUMLAH 2,104,000 680,850 613,050 810,100

Mengetahui Muara Bungo, 27 September 2010

dr. Safaruddin, MPH S. M A N A L U.

2 Nanda A/D Musdarlin Karcis 7,500 3,750 3,750 Dr. Magdalena

JUMLAH 949,500 217,150 355,200 377,150

Mengetahui Muara Bungo, 19 Oktober 2010

dr. Safaruddin, MPH S. M A N A L U.

1 C. Br. Hutagaol 29 Karcis IGD 12,000 6,000 6,000 IGD

2 Charles 30 Karcis IGD 12,000 6,000 6,000 IGD

4 Musdarlin Karcis IGD 12,000 6,000 6,000 IGD

5 Bambang 30 Karcis IGD 12,000 6,000 6,000 IGD

JUMLAH 837,500 184,375 301,925 351,200

Mengetahui Muara Bungo, 16 November 2010

dr. Safaruddin, MPH S. M A N A L U.

NO. NAMA PASIEN JASA JASA

1 Asnidar I/D Musdarlin Karcis 7,500 3,750 3,750

2 Karmila I/D A Rikin Karcis 7,500 3,750 3,750

3 H. Tambunan 33 Karcis 7,500 3,750 3,750

4 A. Rohman 42 Perwt. INT Kls II 6 Hr 336,000 93,600 130,800 111,600

JUMLAH 2,062,500 681,325 650,250 730,925

Mengetahui Muara Bungo, 23 Desember 2010

dr. Safaruddin, MPH S. M A N A L U.

ungo, 23 Desember 2010

1 A. Sitorus 35 Karcis 7,500 3,750 3,750 Dr. Rumiyati

2 H. Tambunan 33 Karcis 7,500 3,750 3,750 Dr. Jerry

3 Carles 35 Karcis 7,500 3,750 3,750 Dr. Rumiyati

JUMLAH 486,000 132,575 128,575 224,850

Mengetahui Muara Bungo, 04 Febuari 2011

dr. Safaruddin, MPH S. M A N A L U.

3 H. Tambunan 33 Karcis 7,500 3,750 3,750 Dr. Mardiah

4 C. Hutagaol I/D H. Tambunan Karcis 7,500 3,750 3,750 Dr. Mardiah

6 Putri A/D Tambunan Karcis 7,500 3,750 3,750 Dr. Magdalena

7 Dicky A/D Tambunan Karcis IGD 12,000 6,000 6,000 IGD

JUMLAH 3,068,000 889,000 913,200 1,265,800

Mengetahui Muara Bungo, 29 Maret 2011

dr. Safaruddin, MPH S. M A N A L U.

1 Rafa A/D Musdarlin Karcis IGD 12,000 6,000 6,000 IGD

2 Musdarlin 30 Karcis IGD 12,000 6,000 6,000 IGD

JUMLAH 176,500 37,375 56,125 83,000

Mengetahui Muara Bungo, 29 Maret 2011

dr. Safaruddin, MPH S. M A N A L U.

2 Rosalina 29 Thn Karcis Tind. IGD 37,000 18,500 18,500 IGD

3 Desi Karcis IGD 12,000 6,000 6,000 IGD

JUMLAH 935,500 215,715 340,625 379,160

Mengetahui Muara Bungo, 29 Maret 2011

dr. Safaruddin, MPH S. M A N A L U.

2 Iwan Kurniawan Karcis IGD 12,000 6,000 6,000 IGD