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REKAPITULASI PENGAJUAN PEMBAYARAN BELANJA REGULER INSTALASI FARMASI TAHUN 2013

BULAN
NO NAMA DISTRIBUTOR Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13
1 APOTIK AMALIA - 80,906,829 - 15,339,816 15,155,526 33,878,751 42,617,284 25,920,630 - 24,939,316
2 APOTIK CAHAYA SEHAT - - - - - - - - - -
3 APOTIK KITA - 9,212,130 - - - 1,856,475 - - - -
4 CV. BHAKTI SEJAHTERA M 22,506,176 17,862,317 18,556,516 8,628,345 11,092,565 9,428,760 - - - 6,105,000
5 CV. SRI TIRTA JAYA - 53,891,200 - 54,015,500 - 64,101,400 - 28,770,500 36,826,900 31,570,000
6 PT. ANUGRAH ARGON M 55,878,227 332,196,447 65,024,241 134,113,196 162,937,393 124,231,771 149,464,189 136,566,263 125,162,877 171,991,751
7 PT. ANUGRAH PHARMINDO L 128,637,950 97,324,538 5,079,602 124,573,909 - 117,628,280 64,096,563 35,960,991 64,519,809 23,080,274
8 PT. BINA SAN PRIMA 67,086,523 42,420,041 27,533,990 43,542,874 53,482,897 55,423,677 68,308,354 69,509,254 61,264,891 46,258,652
9 PT. DOS NI ROHA - 106,004,418 60,731,940 78,888,826 142,168,400 228,919,231 102,471,440 163,468,087 76,901,671 249,814,223
10 PT. ENSEVAL PUTERA 192,495,428 372,494,500 167,458,220 223,485,189 247,911,809 185,169,891 269,791,108 252,351,511 141,443,341 316,229,744
11 PT. HOTAMA MEDIPHAR - 87,107,323 136,103,759 7,276,143 - - 7,612,721 - - -
12 PT. INDO FARMA GLOBAL M 24,312,545 27,058,171 10,693,777 4,426,667 17,803,537 24,657,840 20,014,051 - 42,068,843 2,575,210
13 PT. JUNGER PHARMA - 1,212,200 - - - - - - - -
14 PT. KEBAYORAN PHARMA - 138,023,220 82,755,653 91,174,440 - 85,673,847 52,834,069 67,453,217 23,357,950 12,615,381
15 PT. KIMIA FARMA 7,404,895 6,845,469 29,084,159 - 20,548,848 8,667,075 3,528,671 30,247,675 - 14,367,213
16 PT. MENSA BINA SUKSES 202,571,239 115,233,229 153,660,484 57,015,835 256,078,706 118,867,816 117,302,992 186,912,786 64,110,097 117,551,460
17 PT. MERAPI UTAMA PHARMA - 96,833,746 86,975,314 159,759,282 26,084,705 - 162,741,124 86,252,066 34,973,660 121,102,425
18 PT. MILLENIUM PHARMACON I 83,804,380 69,436,828 15,408,113 76,055,687 6,371,750 99,346,901 60,348,764 48,249,218 187,639,077 12,589,005
19 PT. PARAZELSUS - 35,121,974 - 27,185,125 4,514,400 14,747,915 - 1,944,982 3,223,000 2,699,950
20 PT. PARIT PADANG GLOBAL 9,239,192 18,553,634 - 21,711,471 - 12,914,215 11,256,199 13,756,681 9,865,981 6,620,127
21 PT. PENTA VALENT 31,390,487 170,217,854 118,173,169 142,261,706 48,037,632 - 180,283,893 63,435,747 49,721,376 59,812,640
22 PT. RAJAWALI NUSINDO - 76,747,661 41,830,005 56,416,320 44,684,252 55,507,503 26,419,424 52,730,280 - 71,284,757
23 PT. SAPTA SARI - 30,067,895 4,968,975 1,564,200 - 10,632,600 12,671,505 2,912,800 13,594,900 -
24 PT. SAWAH BESAR - 6,388,250 - - - - - - 3,245,000 -
25 PT. SINAR KENCANA - 12,651,430 - - - - - - - -
26 PT. TALANG GUGUN - - - - - - - - - -
27 PT. TEMPO - 24,935,652 - 13,627,500 - - 69,767,452 - 11,470,415 16,653,868
28 PT. ULICO PHARMA 59,278,230 - 98,340,550 41,057,500 54,191,500 - 59,578,200 48,492,400 99,431,200 42,609,600
29 PT. UNITED DICO CITAS 86,357,492 91,673,978 215,205,566 52,608,051 - 101,751,067 28,031,004 90,157,654 2,982,017 5,154,133
30 APOTIK ANUGRAH FARMA 7,700,000 - - -
TOTAL 970,962,764 2,120,420,934 1,337,584,033 1,434,727,582 1,118,763,920 1,353,405,015 1,509,139,007 1,405,092,742 1,051,803,005 1,355,624,729
Sudah di bayar LUNAS LUNAS LUNAS LUNAS LUNAS LUNAS LUNAS LUNAS LUNAS LUNAS
Kepala Instalasi Farmasi
RSUD H. Hanafie

Toni Dafiaputra, S.Farm, Apt


NIP. 19841023 200803 1 001

REKAPITULASI PENGAJUAN PEMBAYARAN BELANJA RUTIN INSTALASI FARMASI TAHUN 2013


BULAN
NO NAMA DISTRIBUTOR Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13
1 PT. HOTAMA MEDIPHAR 260,730,271 648,124,245 - 353,327,465 357,477,153 372,197,150 406,435,840 252,952,669 449,454,665 454,858,831
2 CV. SRI TIRTA JAYA 85,360,000 75,083,800 - 88,269,500 98,253,100 76,148,600 89,346,400 97,346,700 56,452,000 57,493,700
3 CV. SANTUN 2,750,000 2,750,000 - 5,500,000 2,750,000 - - - -
4 PT. DOS NI ROHA -
5 SINERGI PERSADA -
6 PT. ULICO -
7 PT. TRIMITRA PRATAMA 8,866,000 -
8 CV. TRIAS ANUGRAH M - - - 2,673,000
9 PT. MULYA HUSADA - - - 1,400,000
TOTAL 357,706,271 725,958,045 - 451,169,965 458,480,253 448,345,750 495,782,240 350,299,369 505,906,665 512,352,531

REKAPITULASI PENGAJUAN PEMBAYARAN BELANJA GAS MEDIS INSTALASI FARMASI TAHUN 2013
BULAN
NO NAMA DISTRIBUTOR Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13
1 PO. JUAN 34,314,500 34,875,500 35,997,500 26,928,000 39,644,000 41,420,500 44,599,500 41,794,500 42,355,500 42,355,500
2 PT. HOTAMA MEDIPHAR

39,207,667
Kepala Instalasi Farmasi
RSUD H. Hanafie

Toni Dafiaputra, S.Farm, Apt


NIP. 19841023 200803 1 001
### ### ### ### ### 1,843,171,265 ### ### ### 1,910,332,760
Nov-13 Dec-13 TOTAL
Belanja OBHP Reguler
- - 238,758,152
- - -
2,500,000,000
- - 11,068,605

Nominal
17,319,500 12,952,500 124,451,679
2,000,000,000
- 20,823,000 289,998,500
55,317,072 166,840,530 1,679,723,957
48,921,520 33,848,133 743,671,569
1,500,000,000
43,561,095 89,955,834 668,348,082
129,491,628 135,282,441 1,474,142,305 1,000,000,000
115,417,826 164,499,761 2,648,748,328
- - 238,099,946 500,000,000
15,499,671 20,202,243 209,312,555
- - 1,212,200 -
- 64,788,147 618,675,924 1 2 3 4 5 6 7 8 9 10 11 12
20,030,953 - 140,724,958
Bulan
- 310,232,534 1,699,537,178
33,475,896 133,587,922 941,786,140
90,306,811 13,209,089 762,765,623
- - 89,437,346 Chart Title
6,130,270 - 110,047,770
52,310,585 61,825,025 977,470,114
34,052,604 45,288,278 504,961,084
5,718,680 8,297,025 90,428,580 00
0,0
NOMINAL

00 00
- - 9,633,250
- - 12,651,430 00, 0,0
6 0 0
- - - 2, 0,0 ,00
40 00 0
- - 136,454,887 2, 0,0 ,00
- 75,429,200 578,408,380 20 00 0
2, 0,0 ,00
23,532,414 162,007,740 859,461,116 00 00 0
2, 0,0 ,00
80 00 0
Column O
691,086,525 1,519,069,402 15,859,979,658 1, 0,0 ,00
60 00 0
1, 0,0 ,00
Muara Bungo, Desember 2013 40 00 0
1, 0,0 ,00
20 00 0
1, 0,0 ,00
00 00 0
1, 0,0 ,00
80 000 00
0, ,0
60 000 00
0, ,0
40 00 -
2 0
2, 0,0 ,00
00 00 0
2, 0,0 ,00
80 00 0
Column O
1, 0,0 ,00
60 00 0
1, 0,0 ,00
40 00 0
1, 0,0 ,00
Kepala Ruangan Instalasi Farmasi
20 00 0
1, 0,0 ,00
00 00 0
1, 0,0 ,00
80 000 00
0, ,0
AYU TRESNAWATI 60 000 00
0, ,0
40 000 -
0, IA AT TA M YA M L A A A
AR M
A A A ES A N I S AL T O RI R A N O A AS A
20
H U N A N
AL EH KI RA J A O N DO RIM O ER PH AL RM RM RM KS RM O LS O B LE IND SA ES CA G U MP RM IT RM
M R T B A A A A C E A C FA
A A S T IK T E TA G IN N P I U DI O H H
N P E
F SU H A Z E G L VA US TA B N G U . T
E H O
K Y H IR R M L P P IA P M A A P H T P H
Nov-13 Dec-13 TOTAL T I HA PO J A I T H A AR SA O S AL M A G ER AN IM INA MA AR AR NG NT LI N SA WA R K NG P O DIC RA
O A A E H
R A P N A D V A M G R K B TA PH . P A E .
A T S A A L A I C D G
P S S E M . L
200,233,226 301,171,925 4,056,963,440 A C I . G R H BI T. NS TA AR UN YO PT SA U M PT AD T. P AW P T. SIN TA U E U
TI
K KT CV U RA T. P E O F . J BA E N PI IU T
P P AJ P T. T. PT. NIT AN
87,008,900 810,762,700 O A N P T. H O T A N I R P P U IK
BH . A UG P T. D P . KE M R
AR T. T. O T
AP V. PT AN P IN T PT. E LLE
M P P P
. P . M I . P
C . PT PT T. PT A
PT P PBF

287,242,126 301,171,925 4,867,726,140

Nov-13 Dec-13 TOTAL


43,945,000 42,262,000 470,492,000

Muara Bungo, Desember 2013


Kepala Ruangan Instalasi Farmasi

AYU TRESNAWATI
### ###
umn O
umn O

A
M
REKAPITULASI BELANJA REGULER INSTALASI FARMASI TAHUN 2014
BULAN
NO NAMA DISTRIBUTOR Jan-14 Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14
1 APOTIK AMALIA - 35,415,767 - 19,472,739 - - 36,694,471 - - -
2 APOTIK CAHAYA SEHAT - - - - - - - - - -
3 APOTIK KITA - - - - - - - - - -
4 PT. BHAKTI SEJAHTERA M - - 55,737,000 53,278,500 48,735,500 60,118,300 54,644,150 52,811,000 52,811,000 95,931,000
5 PT. DHEFEDA JANITRA - 51,056,500 - 21,175,000 - 36,487,000 23,336,500 23,336,500 - 11,280,500
6 PT. ANUGRAH ARGON M 143,879,362 140,726,095 78,309,989 162,430,833 391,670,416 142,461,289 174,671,163 283,226,166 122,238,467 235,820,750
7 PT. ANUGRAH PHARMINDO L 10,485,341 31,544,450 14,630,032 37,708,093 38,943,718 71,580,953 18,945,322 11,923,184 - 41,636,059
8 PT. BINA SAN PRIMA 53,841,761 71,604,184 2,487,760 62,328,934 134,890,083 29,305,559 - 37,025,038 - 80,969,010
9 PT. DOS NI ROHA 62,698,491 193,592,195 61,996,647 271,114,373 328,371,007 - 299,736,989 178,574,937 203,117,901 46,729,085
10 PT. ENSEVAL PUTERA 473,319,310 265,788,759 - 629,156,011 614,898,899 274,965,853 184,074,504 530,929,413 34,428,502 292,792,914
11 PT. HOTAMA MEDIPHAR - - - - - - - - - -
12 PT. INDO FARMA GLOBAL M - 4,990,883 41,022,835 13,533,987 21,449,206 56,419,003 - 41,884,417 11,108,955 23,964,078
13 PT. JUNGER PHARMA - - - - - - - - - -
14 PT. KEBAYORAN PHARMA - 32,830,085 - - 7,177,500 - - - - -
15 PT. KIMIA FARMA 3,819,964 16,157,169 - 30,717,321 16,083,545 80,475,354 56,531,291 27,609,808 8,797,316 100,181,914
16 PT. MENSA BINA SUKSES 104,901,583 127,214,643 175,948,411 348,972,749 289,356,426 - 375,076,241 202,071,771 173,976,770 221,431,216
17 PT. MERAPI UTAMA PHARMA - 109,548,376 24,215,291 50,693,995 127,392,335 44,586,139 - 103,681,337 66,054,918 97,418,715
18 PT. MILLENIUM PHARMACON I 111,624,304 83,770,453 - 69,505,002 200,607,155 51,134,586 - 115,902,707 115,925,707 27,816,113
19 PT. PARAZELSUS - - 24,060,649 - 16,115,432 4,304,628 - 3,073,950 - -
20 PT. PARIT PADANG GLOBAL 14,554,087 79,371,741 17,483,555 135,224,415 155,406,774 56,327,761 56,093,131 163,606,115 39,388,912 76,003,901
21 PT. PENTA VALENT - 98,037,305 - 30,503,401 38,678,576 42,044,226 - 55,797,507 44,427,997 35,695,589
22 PT. RAJAWALI NUSINDO - 43,941,566 58,228,647 70,033,042 45,102,538 39,577,186 - - 32,332,882 -
23 PT. SAPTA SARI 8,107,000 15,527,050 6,085,530 10,109,550 - 31,365,840 4,257,000 4,257,000 - 12,292,500
24 PT. SAWAH BESAR - - - - - - - - - -
25 PT. SINAR KENCANA - - - - - - - - - -
26 PT. TALANG GUGUN - - - - - - - - - -
27 PT. TEMPO - - 44,360,419 - - 8,582,985 - - - -
28 PT. ULICO PHARMA - 72,956,941 28,810,386 24,641,065 52,029,125 33,171,244 38,957,767 38,957,767 29,969,280 7,673,820
29 PT. UNITED DICO CITAS 43,357,822 72,320,028 34,583,053 108,962,339 100,669,188 - 58,027,056 218,300,719 6,073,676 100,999,433
30 PT. DWI MITRA PUTRA 2,217,089
TOTAL 1,030,589,025 1,546,394,190 667,960,204 2,149,561,349 2,627,577,423 1,062,907,906 1,381,045,585 2,092,969,336 940,652,283 1,510,853,686
Kepala Instalasi Farmasi
RSUD H. Hanafie
Toni Dafiaputra, S.Farm, Apt
NIP. 19841023 200803 1 001

REKAPITULASI BELANJA BHP RUTIN INSTALASI FARMASI TAHUN 2014


BULAN
NO NAMA DISTRIBUTOR Jan-14 Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14
1 PT. HOTAMA MEDIPHAR 430,108,672 495,647,578 359,962,313 468,440,018 338,115,488 471,517,887 196,757,900 442,644,389 155,993,937 234,368,851
2 PT. DHEFEDA JANITRA 160,421,800 179,605,800 121,728,750 80,099,800 47,183,400 79,833,490 65,843,800 117,276,500
3 PT. BHAKTI SEJAHTERA M 24,898,500 15,004,000
4 PT. DOS NI ROHA
5 pt. trimitra
6 PT. ULICO

TOTAL 590,530,472 520,546,078 539,568,113 590,168,768 418,215,288 518,701,287 276,591,390 442,644,389 236,841,737 351,645,351
PELUNASAN
RATA-RATA/ BULAN 473,338,479
Kepala Instalasi Farmasi 378,592,134
RSUD H. Hanafie

Toni Dafiaputra, S.Farm, Apt


NIP. 19841023 200803 1 001

REKAPITULASI BELANJA GAS MEDIS INSTALASI FARMASI TAHUN 2014


BULAN
NO NAMA DISTRIBUTOR Jan-14 Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14
1 PT. HOTAMA MEDIPHAR
2 PO. JUAN 45,160,500 43,758,000 44,319,000 45,534,500 52,860,500 48,059,000 37,860,500 41,888,000 38,425,500 40,859,500
RATA2 43,752,125
Kepala Instalasi Farmasi
RSUD H. Hanafie

Toni Dafiaputra, S.Farm, Apt


NIP. 19841023 200803 1 001

1,666,279,997 2,110,698,268 1,251,847,317 2,785,264,617 3,098,653,211 1,629,668,193 1,695,497,475 2,577,501,725 1,215,919,520 1,903,358,537
NJA REGULER INSTALASI FARMASI TAHUN 2014
BULAN
Nov-14 Dec-14 TOTAL
15,890,529 - 107,473,506
- - -
- - -
88,931,700 176,180,950 739,179,100
3,547,500 10,697,500 180,917,000
108,562,906 237,619,682 2,221,617,118
56,841,897 45,799,497 380,038,546
49,366,114 94,242,347 616,060,790
302,476,804 196,987,933 2,145,396,362
440,112,924 345,860,469 4,086,327,558
- - -
61,941,506 48,615,890 324,930,760
- - -
- - 40,007,585
52,738,674 34,856,698 427,969,054
219,073,140 314,847,920 2,552,870,870
81,507,400 116,723,861 821,822,367
98,104,503 87,715,154 962,105,684
64,804,695 13,109,030 125,468,384
87,569,597 89,987,719 971,017,708
60,430,195 59,332,220 464,947,016
45,248,980 31,204,955 365,669,796
9,333,500 10,557,250 111,892,220
- -
- - -
- - -
- - 52,943,404
25,684,930 4,840,000 357,692,325
147,737,589 183,057,699 1,074,088,602
- -
2,019,905,083 2,102,236,774 19,130,435,755

Muara Bungo, 2014


Kepala Ruangan Instalasi Farmasi

AYU TRESNAWATI
NIP 19660908 198803 2 002

JA BHP RUTIN INSTALASI FARMASI TAHUN 2014


BULAN
Nov-14 Dec-14 TOTAL
381,849,145 567,699,430 4,543,105,608
82,811,300 113,088,800 1,047,893,440
20,680,000 13,491,500 74,074,000

14,988,700

500,329,145 694,279,730 5,665,073,048

6,739,161,650
Muara Bungo, Desember 2014
Kepala Ruangan Instalasi Farmasi

AYU TRESNAWATI
NIP 19660908 198803 2 002

JA GAS MEDIS INSTALASI FARMASI TAHUN 2014


BULAN
Nov-14 Dec-14 TOTAL
-
41,046,500 45,254,000 525,025,500
Muara Bungo, Desember 2014
Kepala Ruangan Instalasi Farmasi

AYU TRESNAWATI
NIP 19660908 198803 2 002

2,561,280,728 2,841,770,504
REKAPITULASI TAGIHAN BELANJA INSTALAS
NAMA DISTRIBUTOR BULA
NO Jan-16 Feb-16 Mar-16 Apr-16 May-16
1 PT. ANUGRAH ARGON M
2 PT. ANUGRAH PHARMINDO L
3 PT. BHAKTI SEJAHTERA M
4 PT. BINA SAN PRIMA
5 PT. BIOMULTI MEDIKA
6 PT. CITRA PURNAMA S
7 PT. DOS NI ROHA
8 PT. DWI MITRA PUTRA
9 PT. ENSEVAL PUTERA
10 PT. HOTAMA MEDIPHAR
11 PT. INDO FARMA GLOBAL M
12 PT. JUNGER PHARMA
13 PT. KEBAYORAN PHARMA
14 PT. KIMIA FARMA
15 PT. MENSA BINA SUKSES
16 PT. MERAPI UTAMA PHARMA
17 PT. MILLENIUM PHARMACON I
18 PT. MITRA SEJATI MEDIKA
19 PT. MUARA NATIO P
20 PT. MUTIARA LABSAINS
21 PT. PARAZELSUS
22 PT. PARIT PADANG GLOBAL
23 PT. PENTA VALENT
PT. RAJAWALI NUSINDO
PT. SAPTA SARI
PT. SINAR KENCANA
PT. TALANG GUGUN
PT. TEMPO
PT. ULICO PHARMA
PT. UNITED DICO CITAS
REKAPITULASI BELANJA GAS MEDIS INSTALAS
BULAN
NO NAMA DISTRIBUTOR Jan-16 Feb-16 Mar-16 Apr-16 May-16
1 CV ANDALAS KARYA A I 27,500,000
2 PO. JUAN 64,845,000 58,311,000 69,597,000 61,341,500 69,492,500
99,000 99,000 99,000 104,500 104,500
655 589 703 587 665
Kepala Instalasi Farmasi
RSUD H. Hanafie 694.5833333333

Toni Dafiaputra, S.Farm, Apt


NIP. 19841023 200803 1 001
GIHAN BELANJA INSTALASI FARMASI TAHUN 2017
BULAN
Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16
ANJA GAS MEDIS INSTALASI FARMASI TAHUN 2016
BULAN
Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16

70,015,000 63,849,500 79,420,000 81,510,000 91,646,500 71,896,000 78,375,000


104,500 104,500 104,500 104,500 104,500 104,500 104,500
670 611 760 780 877 688 750
Tujuh puluh sembilan juta empat ratus dua puluh ribu rupiah Muara Bungo, Desember 2016
Kepala Ruangan Instalasi Farmasi

AYU TRESNAWATI
NIP 19660908 198803 2 002
TOTAL
TOTAL
27,500,000
860,299,000

8,335
ungo, Desember 2016
angan Instalasi Farmasi

60908 198803 2 002


LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTA
OBAT REGULER
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNG
09 Januari 2017
NO DISTRIBUTOR NO FACT TGL FACT JT. TEMPO NO.F STDR TAGIHAN
1 PT. UNITED DICO CITAS 3129 17/11/2016 08/12/2016 98830447 Rp 9,662,885
2 PT. UNITED DICO CITAS 3184 19/11/2016 10/12/2016 98830502 Rp 3,428,539
3 PT. UNITED DICO CITAS 2959 10/11/2016 01/12/2016 98830279 Rp 8,052,745
4 PT. UNITED DICO CITAS 3006 12/11/2016 03/12/2016 98830332 Rp 3,961,948
Rp 25,106,116
5 PT. MUTIARA LABSAINS 3014 07/11/2016 25/12/2016 70166772 Rp 7,085,809
6 PT. MUTIARA LABSAINS 3100 23/11/2016 10/01/2017 70166858 Rp 4,284,750
Rp 11,370,559
7 PT. BHAKTI SEJAHTERA M P493 03/11/2016 03/12/2016 Rp 2,378,775
8 PT. BHAKTI SEJAHTERA M P497 08/11/2016 08/12/2016 Rp 788,000
9 PT. BHAKTI SEJAHTERA M P521 28/11/2016 28/12/2016 Rp 8,697,550
10 PT. BHAKTI SEJAHTERA M P560 10/12/2016 09/01/2017 Rp 3,156,925
11 PT. BHAKTI SEJAHTERA M P571 19/12/2016 18/01/2017 Rp 2,107,900
Rp 17,129,150
12 PT. RAJAWALI NUSINDO 6905 10/11/2016 10/12/2016 71527224 Rp 564,937
13 PT. RAJAWALI NUSINDO 7469 29/11/2016 29/12/2016 71527225 Rp 519,391
14 PT. RAJAWALI NUSINDO 7375 25/11/2016 25/12/2016 71527686 Rp 389,542
15 PT. RAJAWALI NUSINDO 7374 25/11/2016 25/12/2016 71527685 Rp 164,988
16 PT. RAJAWALI NUSINDO 7373 25/11/2016 25/12/2016 71527684 Rp 443,073
17 PT. RAJAWALI NUSINDO 7372 25/11/2016 25/12/2016 71527683 Rp 2,152,812
18 PT. RAJAWALI NUSINDO 6916 10/11/2016 10/12/2016 71527235 Rp 1,204,115
19 PT. RAJAWALI NUSINDO 6915 10/11/2016 10/12/2016 71527234 Rp 2,444,718
20 PT. RAJAWALI NUSINDO 6914 10/11/2016 10/12/2016 71527233 Rp 5,151,156
21 PT. RAJAWALI NUSINDO 6913 10/11/2016 10/12/2016 71527232 Rp 324,601
22 PT. RAJAWALI NUSINDO 6910 10/11/2016 10/12/2016 71527229 Rp 179,989
Rp 13,539,321
23 PT. MERAPI UTAMA PHARMA 4356 23/11/2016 10/01/2017 07364058 Rp 1,795,960
24 PT. MERAPI UTAMA PHARMA 4440 25/11/2016 12/01/2017 07377530 Rp 32,517,805
25 PT. MERAPI UTAMA PHARMA 4447 25/11/2016 12/01/2017 07377534 Rp 12,262,068
26 PT. MERAPI UTAMA PHARMA 2844 24/10/2016 11/12/2016 13496510 Rp 2,204,012
27 PT. MERAPI UTAMA PHARMA 3493 07/11/2016 25/12/2016 13532321 Rp 1,235,781
Rp 50,015,626
28 PT. PARIT PADANG GLOBAL 5956 20/04/2016 11/05/2016 54348005 Rp 11,970,804
29 PT. PARIT PADANG GLOBAL 6607 07/12/2016 28/12/2016 54404672 Rp 784,060
30 PT. PARIT PADANG GLOBAL 6740 09/12/2016 30/12/2016 54414816 Rp 14,348,495
31 PT. PARIT PADANG GLOBAL 6393 02/12/2016 23/12/2016 54367110 Rp 853,726
32 PT. PARIT PADANG GLOBAL 6392 02/12/2016 23/12/2016 54387071 Rp 20,471,058
Rp 48,428,143
33 PT. KIMIA FARMA 0282 11/11/2016 02/12/2016 11631654 Rp 1,042,918
34 PT. KIMIA FARMA 2390 12/11/2016 03/12/2016 11631655 Rp 1,604,270
35 PT. KIMIA FARMA 3814 18/11/2016 09/12/2016 11642141 Rp 286,340
36 PT. KIMIA FARMA 3821 18/11/2016 09/12/2016 11642142 Rp 6,146,400
37 PT. KIMIA FARMA 9594 28/11/2016 19/12/2016 68735295 Rp 939,690
Rp 10,019,617
38 PT. ENSEVAL PUTERA 7793 30/11/2016 29/01/2017 18357082 Rp 3,256,320
39 PT. ENSEVAL PUTERA 7904 02/12/2016 31/01/2017 18176737 Rp 5,325,156
40 PT. ENSEVAL PUTERA 7995 02/12/2016 31/01/2017 18380262 Rp 14,425,128
41 PT. ENSEVAL PUTERA 1076 02/12/2016 01/01/2017 18371613 Rp 25,377,540
42 PT. ENSEVAL PUTERA 1079 02/12/2016 01/01/2017 18379974 Rp 2,377,431
43 PT. ENSEVAL PUTERA 6927 24/11/2016 24/12/2016 18275780 Rp 21,070,568
44 PT. ENSEVAL PUTERA 6938 24/11/2016 23/01/2017 18276848 Rp 4,257,867
45 PT. ENSEVAL PUTERA 7196 26/11/2016 25/01/2017 18301282 Rp 2,420,145
46 PT. ENSEVAL PUTERA 1032 24/11/2016 23/01/2017 18275594 Rp 3,019,472
47 PT. ENSEVAL PUTERA 1058 29/11/2016 28/01/2017 18329456 Rp 19,476,546
48 PT. ENSEVAL PUTERA 6138 17/11/2016 16/01/2017 18195557 Rp 14,740,033
49 PT. ENSEVAL PUTERA 8734 09/12/2016 07/02/2017 18454270 Rp 679,650
50 PT. ENSEVAL PUTERA 8740 09/12/2016 07/02/2017 18454980 Rp 30,455,954
51 PT. ENSEVAL PUTERA 8741 09/12/2016 07/02/2017 18454982 Rp 15,154,042
52 PT. ENSEVAL PUTERA 8954 13/12/2016 11/02/2017 18475287 Rp 1,263,263
53 PT. ENSEVAL PUTERA 1105 13/12/2016 11/02/2017 18475288 Rp 1,208,863
54 PT. ENSEVAL PUTERA 1106 09/12/2016 07/02/2017 18454075 Rp 1,986,218
55 PT. ENSEVAL PUTERA 1107 09/12/2016 07/02/2017 18195564 Rp 453,494
56 PT. ENSEVAL PUTERA 9233 15/12/2016 13/02/2017 18502608 Rp 1,642,643
57 PT. ENSEVAL PUTERA 9249 15/12/2016 13/02/2017 18503452 Rp 13,900,007
58 PT. ENSEVAL PUTERA 9545 17/12/2016 15/02/2017 18529146 Rp 1,410,340
59 PT. ENSEVAL PUTERA 9575 17/12/2016 15/02/2017 18530704 Rp 2,016,788
60 PT. ENSEVAL PUTERA 1118 14/12/2016 12/02/2017 18486148 Rp 1,015,006
61 PT. ENSEVAL PUTERA 1120 14/12/2016 12/02/2017 18486708 Rp 2,149,090
62 PT. ENSEVAL PUTERA 1127 15/12/2016 13/02/2017 18502783 Rp 1,053,510
63 PT. ENSEVAL PUTERA 1129 15/12/2016 13/02/2017 18502978 Rp 865,451
64 PT. ENSEVAL PUTERA 0738 27/12/2016 25/02/2017 18633200 Rp 1,673,614
65 PT. ENSEVAL PUTERA 0742 27/12/2016 25/02/2017 18633556 Rp 3,911,337
66 PT. ENSEVAL PUTERA 0814 27/12/2016 25/02/2017 18638164 Rp 18,718,054
Rp215,303,527
67 PT. MENSA BINA SUKSES 9772 19/11/2016 19/12/2016 04959702 Rp 1,305,220
68 PT. MENSA BINA SUKSES 6231 24/11/2016 24/12/2016 04985811 Rp 21,409,590
69 PT. MENSA BINA SUKSES 1048 24/11/2016 24/12/2016 04980704 Rp 8,666,816
70 PT. MENSA BINA SUKSES 9727 30/11/2016 30/12/2016 05028634 Rp 30,679,500
71 PT. MENSA BINA SUKSES 9731 30/11/2016 30/12/2016 05028638 Rp 43,090,549
72 PT. MENSA BINA SUKSES 9763 30/11/2016 30/12/2016 05028669 Rp 1,403,625
73 PT. MENSA BINA SUKSES 3713 01/12/2016 31/12/2016 05032595 Rp 2,120,213
74 PT. MENSA BINA SUKSES 5981 02/12/2016 01/01/2017 05034824 Rp 7,993,133
75 PT. MENSA BINA SUKSES 8612 02/12/2016 01/01/2017 05037429 Rp 3,873,203
76 PT. MENSA BINA SUKSES 1661 22/10/2016 21/11/2016 04813501 Rp 15,962,491
77 PT. MENSA BINA SUKSES 1908 26/10/2016 25/11/2016 04833455 Rp 2,944,534
78 PT. MENSA BINA SUKSES 2281 30/09/2016 30/10/2016 04695810 Rp 85,818
RETUR 9,875,250 Rp139,534,690
TOTAL

Mengetahui,
Kepala Instalasi Farmasi

TONI DAFIAPUTRA, S.FARM, APT


NIP.19841023 200803 1 001

LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTA


OBAT REGULER
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNG
25 Januari 2017
NO DISTRIBUTOR NO FACT TGL FACT JT. TEMPO NO.F STDR TAGIHAN
1 PT. SAPTA SARI 0454 10/11/2016 01/12/2016 75250521 2,008,173
2 PT. SAPTA SARI 1578 28/11/2016 19/12/2016 64541997 922,723
3 PT. SAPTA SARI 1842 02/12/2016 23/12/2016 64550888 1,356,197
4 PT. SAPTA SARI 2424 15/12/2016 05/01/2017 64565716 11,134,854
15,421,947
5 PT. DOS NI ROHA 5629 09/12/2016 08/01/2017 52030852 14,522,840
6 PT. DOS NI ROHA 5635 09/12/2016 08/01/2017 52030853 4,744,652
7 PT. DOS NI ROHA 5636 09/12/2016 08/01/2017 52030854 3,693,750
8 PT. DOS NI ROHA 6188 09/12/2016 08/01/2017 52030855 2,105,622
9 PT. DOS NI ROHA 0509 10/12/2016 09/01/2017 52031510 2,655,560
10 PT. DOS NI ROHA 8842 10/12/2016 09/01/2017 52031501 11,198,268
11 PT. DOS NI ROHA 8843 10/12/2016 09/01/2017 52031502 3,209,130
12 PT. DOS NI ROHA 6350 24/12/2016 23/01/2017 52069720 4,210,875
13 PT. DOS NI ROHA 6349 24/12/2016 23/01/2017 52069719 1,654,800
14 PT. DOS NI ROHA 6347 24/12/2016 23/01/2017 52069718 6,352,881
15 PT. DOS NI ROHA 8346 26/12/2016 25/01/2017 52069724 2,287,885
16 PT. DOS NI ROHA 3183 27/12/2016 26/01/2017 52073400 6,504,694
17 PT. DOS NI ROHA 3849 27/12/2016 26/01/2017 52073401 2,776,961
18 PT. DOS NI ROHA 4676 27/12/2016 26/01/2017 52073407 4,504,661
19 PT. DOS NI ROHA 5491 29/12/2016 28/01/2017 52079118 16,965,640
20 PT. DOS NI ROHA 5505 29/12/2016 28/01/2017 52079119 1,583,019
21 PT. DOS NI ROHA 5507 29/12/2016 28/01/2017 52079120 12,100,725
22 PT. DOS NI ROHA 5512 29/12/2016 28/01/2017 52079121 22,165,258
23 PT. DOS NI ROHA 1244 30/12/2016 29/01/2017 52092040 5,122,000
24 PT. DOS NI ROHA 6863 19/12/2016 18/01/2017 52053967 7,722,400
25 PT. DOS NI ROHA 6862 19/12/2016 18/01/2017 52053966 827,400
26 PT. DOS NI ROHA 6583 22/12/2016 21/01/2017 52062441 2,689,050
27 PT. DOS NI ROHA 6584 22/12/2016 21/01/2017 52062442 1,260,800
28 PT. DOS NI ROHA 6582 22/12/2016 21/01/2017 53062440 1,292,517
29 PT. DOS NI ROHA 0760 21/12/2016 20/01/2017 53062424 88,650
30 PT. DOS NI ROHA 9999 30/11/2016 30/12/2016 51975482 2,447,725
31 PT. DOS NI ROHA 9111 02/12/2016 01/01/2017 52018597 7,353,025
32 PT. DOS NI ROHA 9110 02/12/2016 01/01/2017 52018596 6,348,079
33 PT. DOS NI ROHA 6996 02/12/2016 01/01/2017 52018585 2,216,250
34 PT. DOS NI ROHA 3145 03/12/2016 02/01/2017 52018605 15,253,464
35 PT. DOS NI ROHA 8400 25/11/2016 25/12/2016 51960799 1,503,504
36 PT. DOS NI ROHA 7001 25/11/2016 25/12/2016 51960796 6,271,012
37 PT. DOS NI ROHA 7186 28/11/2016 28/12/2016 51966121 11,466,503
38 PT. DOS NI ROHA 4989 28/11/2016 28/12/2016 51966117 413,700
39 PT. DOS NI ROHA 4922 05/12/2016 04/01/2017 52020799 1,075,620
40 PT. DOS NI ROHA 6153 07/12/2016 06/01/2017 52025043 15,058,680
41 PT. DOS NI ROHA 4616 13/12/2016 12/01/2017 52034842 3,201,250
42 PT. DOS NI ROHA 4247 15/12/2016 14/01/2017 52040987 7,328,400
43 PT. DOS NI ROHA 4500 15/12/2016 14/01/2017 52040949 3,324,375
44 PT. DOS NI ROHA 4344 15/12/2016 14/01/2017 52040948 14,960,466
45 PT. DOS NI ROHA 5288 15/12/2016 14/01/2017 52040950 1,800,704
242,262,793
46 PT. ANUGRAH ARGON M 9973 15/12/2016 13/02/2017 58074511 1,790,909
47 PT. ANUGRAH ARGON M 0119 17/12/2016 15/02/2017 69269207 1,343,181
48 PT. ANUGRAH ARGON M 0117 17/12/2016 15/02/2017 69269205 7,038,613
49 PT. ANUGRAH ARGON M 0118 17/12/2016 15/02/2017 69269206 5,201,544
50 PT. ANUGRAH ARGON M 0120 17/12/2016 15/02/2017 69269208 2,903,780
51 PT. ANUGRAH ARGON M 9735 10/12/2016 08/02/2017 58058195 33,471,937
52 PT. ANUGRAH ARGON M 9736 10/12/2016 08/02/2017 58058196 2,275,350
53 PT. ANUGRAH ARGON M 9737 10/12/2016 08/02/2017 58058197 1,689,428
54 PT. ANUGRAH ARGON M 9971 15/12/2016 13/02/2017 58074509 32,016,705
55 PT. ANUGRAH ARGON M 8860 26/11/2016 25/01/2017 57991617 1,248,856
56 PT. ANUGRAH ARGON M 8861 26/11/2016 25/01/2017 57991618 2,349,977
57 PT. ANUGRAH ARGON M 9036 29/11/2016 28/01/2017 58003718 8,971,762
58 PT. ANUGRAH ARGON M 9313 02/12/2016 31/01/2017 58025235 25,242,094
59 PT. ANUGRAH ARGON M 9600 08/12/2016 06/02/2017 58048476 3,850,455
60 PT. ANUGRAH ARGON M 7749 08/11/2016 07/01/2017 57905471 1,182,000
130,576,592
61 PT. ULICO PHARMA 6033 19/12/2016 18/01/2017 11476033 5,396,799
62 PT. ULICO PHARMA 6034 30/12/2016 29/01/2017 11476034 3,698,159
9,094,958
63 PT. ENSEVAL PUTERA 9249 15/12/2016 13/02/2017 18503452 13,900,007
64 PT. ENSEVAL PUTERA 9575 17/12/2016 15/02/2017 18530704 2,016,788
65 PT. ENSEVAL PUTERA 1120 14/12/2016 12/02/2017 18486708 2,149,090
66 PT. ENSEVAL PUTERA 1129 15/12/2016 13/02/2017 18502978 865,451
67 PT. ENSEVAL PUTERA 0814 27/12/2016 25/02/2017 18638164 18,718,054
37,649,389
68 PT. BINA SAN PRIMA 0236 02/12/2016 01/01/2017 22542755 1,859,434
69 PT. BINA SAN PRIMA 1108 09/12/2016 08/01/2017 22543625 1,052,965
70 PT. BINA SAN PRIMA 1109 09/12/2016 08/01/2017 22543626 3,310,759
71 PT. BINA SAN PRIMA 1110 09/12/2016 08/01/2017 22543627 1,747,144
72 PT. BINA SAN PRIMA 1718 15/12/2016 14/01/2017 22543629 5,286,889
73 PT. BINA SAN PRIMA 1723 15/12/2016 14/01/2017 22543630 1,784,820
74 PT. BINA SAN PRIMA 3512 29/12/2016 28/01/2017 22546009 5,006,509
75 PT. BINA SAN PRIMA 3513 29/12/2016 28/01/2017 22546010 2,096,573
15,042,010
76 PT. INDO FARMA GLOBAL M 7180 07/11/2016 22/12/2016 93211045 8,240,154
77 PT. INDO FARMA GLOBAL M 7205 08/11/2016 23/12/2016 93211048 10,194,750
78 PT. INDO FARMA GLOBAL M 7215 08/11/2016 23/12/2016 93211049 4,622,480
79 PT. INDO FARMA GLOBAL M 7216 08/11/2016 23/12/2016 93211050 2,708,750
80 PT. INDO FARMA GLOBAL M 7261 10/11/2016 25/12/2016 93211055 3,415,980
81 PT. INDO FARMA GLOBAL M 7262 10/11/2016 25/12/2016 93211056 281,809
82 PT. INDO FARMA GLOBAL M 7338 14/11/2016 29/12/2016 93211064 1,235,190
83 PT. INDO FARMA GLOBAL M 7481 21/11/2016 05/01/2017 93211070 3,724,935
84 PT. INDO FARMA GLOBAL M 7483 21/11/2016 05/01/2017 93211071 1,847,208
85 PT. INDO FARMA GLOBAL M 7546 21/11/2016 05/01/2017 93211073 338,482
36,609,737
86 PT. PENTA VALENT 4389 02/12/2016 01/01/2017 90689035 2,900,234
87 PT. PENTA VALENT 4090 28/11/2016 28/12/2016 90671684 1,654,800
88 PT. PENTA VALENT 4091 28/11/2016 28/12/2016 90671685 12,025,357
89 PT. PENTA VALENT 4102 28/11/2016 28/12/2016 90671695 8,510,400
90 PT. PENTA VALENT 4174 29/11/2016 29/12/2016 90674762 3,137,225
28,228,016
91 PT. UNITED DICO CITAS 3596 03/12/2016 24/12/2016 98830899 9,773,775
92 PT. UNITED DICO CITAS 3595 03/12/2016 24/12/2016 98830898 7,058,756
93 PT. UNITED DICO CITAS 3567 02/12/2016 23/12/2016 98830870 3,961,948
94 PT. UNITED DICO CITAS 3759 09/12/2016 30/12/2016 98831058 33,511,918
95 PT. UNITED DICO CITAS 3788 10/12/2016 31/12/2016 98831081 5,070,780
96 PT. UNITED DICO CITAS 3870 15/12/2016 05/01/2017 98831168 5,928,469
97 PT. UNITED DICO CITAS 4080 22/12/2016 12/01/2017 98831375 3,961,948
98 PT. UNITED DICO CITAS 4081 22/12/2016 12/01/2017 98831376 2,160,844

99 PT. ANUGRAH PHARMINDO L 5853 08/12/2016 06/02/2017 40393266 2,679,594


100 PT. ANUGRAH PHARMINDO L 5388 02/12/2016 31/01/2017 40343814 893,198
101 PT. ANUGRAH PHARMINDO L 7419 24/12/2016 23/01/2017 40534767 2,183,784
102 PT. ANUGRAH PHARMINDO L 6491 15/12/2016 14/01/2017 40447424 273,314
103 PT. ANUGRAH PHARMINDO L 6494 15/12/2016 14/01/2017 40447425 12,520,702
104 PT. ANUGRAH PHARMINDO L 6588 16/12/2016 15/01/2017 40447426 1,288,640
105 PT. ANUGRAH PHARMINDO L 6680 17/12/2016 16/01/2017 40456905 3,477,320
106 PT. ANUGRAH PHARMINDO L 6653 17/12/2016 15/02/2017 40456904 778,150
107 PT. ANUGRAH PHARMINDO L 6659 17/12/2016 15/02/2017 40467583 144,525
24,239,227
108 PT. MERAPI UTAMA PHARMA 5402 16/12/2016 02/02/2017 07421106 4,552,916
109 PT. MERAPI UTAMA PHARMA 5401 16/12/2016 02/02/2017 07421105 4,467,271
110 PT. MERAPI UTAMA PHARMA 5541 19/12/2016 05/02/2017 07422145 8,643,375
111 PT. MERAPI UTAMA PHARMA 5123 09/12/2016 02/02/2017 07403181 84,621
112 PT. MERAPI UTAMA PHARMA 5217 13/12/2016 02/02/2017 07407630 761,592
113 PT. MERAPI UTAMA PHARMA 5529 19/12/2016 07/02/2017 07422143 2,327,831
114 PT. MERAPI UTAMA PHARMA 5549 19/12/2016 07/02/2017 07422147 22,613,827

115 PT. PENTA VALENT 5238 22/12/2016 21/01/2017 77422509 4,841,768


116 PT. PENTA VALENT 5356 27/12/2016 26/01/2017 77429794 1,379,000
117 PT. PENTA VALENT 5531 29/12/2016 28/01/2017 77436995 5,009,877

118 PT. MILLENIUM PHARMACON I 1634 19/10/2016 18/11/2016 17106031 6,694,921


119 PT. MILLENIUM PHARMACON I 1786 22/10/2016 21/11/2016 17114855 3,338,411
120 PT. MILLENIUM PHARMACON I 2012 27/10/2016 26/11/2016 17128614 1,977,388
121 PT. MILLENIUM PHARMACON I 2013 27/10/2016 26/11/2016 17128615 8,513,355
122 PT. MILLENIUM PHARMACON I 2350 03/11/2016 03/12/2016 17150696 4,334,000
123 PT. MILLENIUM PHARMACON I 4286 17/12/2016 16/01/2017 52784847 7,611,033
124 PT. MILLENIUM PHARMACON I 4288 23/12/2016 22/01/2017 52801293 4,617,188
125 PT. MILLENIUM PHARMACON I 3689 01/12/2016 31/12/2016 52747700 4,225,650
126 PT. MILLENIUM PHARMACON I 3738 02/12/2016 01/01/2017 52750222 5,365,233
127 PT. MILLENIUM PHARMACON I 3850 06/12/2016 05/01/2017 52757799 1,408,550
128 PT. MILLENIUM PHARMACON I 4006 10/12/2016 09/01/2017 52769231 23,736,284

Mengetahui,
Kepala Instalasi Farmasi

TONI DAFIAPUTRA, S.FARM, APT


NIP.19841023 200803 1 001

LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTA


BHP RUTIN
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNG
09 Januari 2017
NO DISTRIBUTOR NO FACT TGL FACT JT. TEMPO NO.F STDR TAGIHAN
1 PT. ENSEVAL PUTERA 1027 23/11/2016 18262586 3,999,593
2 PT. ENSEVAL PUTERA 5896 16/11/2016 18171688 1,137,675
3 PT. ENSEVAL PUTERA 6319 18/11/2016 18210211 15,421,656
4 PT. ENSEVAL PUTERA 3124 24/10/2016 17901348 349,675
5 PT. ENSEVAL PUTERA 3073 24/10/2016 17897332 14,531,628
6 PT. ENSEVAL PUTERA 1817 13/10/2016 17783201 19,089,421
7 PT. ENSEVAL PUTERA 2102 15/10/2016 17807845 14,312,050
8 PT. ENSEVAL PUTERA 0869 13/10/2016 17782566 1,015,006
9 PT. ENSEVAL PUTERA 7620 30/11/2016 18343334 8,334,171
78,190,875
10 PT. MITRA SEJATI MEDIKA 001/MSM 24/10/2016 94342766 16,971,695

11 PT. SAPTA SARI 0316 08/11/2016 75247143 4,970,310


12 PT. SAPTA SARI 1337 24/11/2016 83549862 4,970,310
13 PT. SAPTA SARI 1577 28/11/2016 64541998 323,129
10,263,749
14 PT. CITRA PURNAMA S 0027 22/11/2016 59278005 9,425,465
15 PT. CITRA PURNAMA S 0029 22/11/2016 59278007 1,231,250
16 PT. CITRA PURNAMA S 0030 26/11/2016 59278008 1,526,750
17 PT. CITRA PURNAMA S 0031 28/11/2016 59278009 1,576,000
18 PT. CITRA PURNAMA S 0032 30/11/2016 59278010 5,959,250
19 PT. CITRA PURNAMA S 0034 09/12/2016 59278012 1,083,500
20 PT. CITRA PURNAMA S 0037 16/12/2016 59278015 6,105,424
21 PT. CITRA PURNAMA S 0038 19/12/2016 59278016 8,618,750
22 PT. CITRA PURNAMA S 0039 19/12/2016 59278017 1,871,500
23 PT. CITRA PURNAMA S 0040 20/12/2016 59278018 2,364,000
24 PT. CITRA PURNAMA S 0042 29/12/2016 5,910,000
25 PT. CITRA PURNAMA S 0043 30/12/2016 2,058,158
47,730,047
26 PT. MUTIARA LABSAINS 3158 16/11/2016 70166916 1,182,000
27 PT. MUTIARA LABSAINS 3016 07/11/2016 70166774 1,773,000
28 PT. MUTIARA LABSAINS 3015 07/11/2016 70166773 502,350
29 PT. MUTIARA LABSAINS 3321 01/12/2016 05232383 7,717,475
30 PT. MUTIARA LABSAINS 3352 05/12/2016 05232415 581,150
31 PT. MUTIARA LABSAINS 0366 30/12/2016 1,970,000
13,725,975
32 PT. BIO MULTI MEDIKA 0199 24/11/2016 68434469 4,722,627
33 PT. BIO MULTI MEDIKA 0200 24/11/2016 68434470 32,084,208
34 PT. BIO MULTI MEDIKA 0202 30/11/2016 68434471 8,510,400
35 PT. BIO MULTI MEDIKA 0203 01/12/2016 68434472 16,252,500
36 PT. BIO MULTI MEDIKA 0205 06/12/2016 68434474 2,364,000
37 PT. BIO MULTI MEDIKA 0206 06/12/2016 68434475 6,553,098
38 PT. BIO MULTI MEDIKA 0208 08/12/2016 68434476 33,055,615
39 PT. BIO MULTI MEDIKA 0209 13/12/2016 76348089 2,925,450
40 PT. BIO MULTI MEDIKA 0210 17/12/2016 76348090 30,014,132
41 PT. BIO MULTI MEDIKA 0213 21/12/2016 80024124 34,453,330
42 PT. BIO MULTI MEDIKA 0212 20/12/2016 76348092 38,057,445
43 PT. BIO MULTI MEDIKA 0214 22/12/2016 80024125 30,312,390
44 PT. BIO MULTI MEDIKA 0215 23/12/2016 76348094 25,531,200
45 PT. BIO MULTI MEDIKA 0216 23/12/2016 80024127 3,634,650
268,471,045
46 PT. MENSA BINA SUKSES 9674 10/11/2016 04910313 2,267,864

47 PT. ANUGRAH ARGON M 7905 10/11/2016 57917047 3,378,857

48 CV RAFIN JAYA /INV-RJ/XI-16 06/12/2016 5,352,687

49 PT. AFINA SC 4759 23/11/2016 06423461 20,364,875

50 PT. BHAKTI SEJAHTERA M P487 01/11/2016 33,440,750


51 PT. BHAKTI SEJAHTERA M P494 03/11/2016 8,569,500
52 PT. BHAKTI SEJAHTERA M P501 11/11/2016 26,595,000
53 PT. BHAKTI SEJAHTERA M P522 28/11/2016 9,224,525
54 PT. BHAKTI SEJAHTERA M P528 30/11/2016 21,916,250
55 PT. BHAKTI SEJAHTERA M P533 05/12/2016 28,614,250
56 PT. BHAKTI SEJAHTERA M P561 11/12/2016 4,580,250
57 PT. BHAKTI SEJAHTERA M P570 19/12/2016 21,207,050

58 PT. MUARA NATIO P 15/11/2016 2,063,575


59 PT. MUARA NATIO P 15/11/2016 7,387,500
60 PT. MUARA NATIO P 15/11/2016 3,191,400
61 PT. MUARA NATIO P 15/11/2016 2,903,780
62 PT. MUARA NATIO P 15/11/2016 921,960

63 PT. BIO MULTI MEDIKA 0219 30/12/2016 32,765,040


64 PT. BIO MULTI MEDIKA 0218 30/12/2016 16,118,146
65 PT. BIO MULTI MEDIKA 0217 30/12/2016 9,751,500
66 PT. BIO MULTI MEDIKA 0220 30/12/2016 13,090,650

67 PT. HOTAMA MEDIPHAR 1474 23/12/2016 16,646,500

68 PT. SAPTA SARI 2105 09/12/2016 75247143 4,970,310

TOTAL

Mengetahui,
Kepala Instalasi Farmasi

TONI DAFIAPUTRA, S.FARM, APT


NIP.19841023 200803 1 001
SI SURAT PEMBAYARAN HUTANG

SUD H. HANAFIE MUARA BUNGO

PPN PPH SUB TOTAL TOTAL NO


Rp 981,004 Rp 147,151 Rp 10,791,039 1
Rp 348,075 Rp 52,211 Rp 3,828,825 2
Rp 817,538 Rp 122,631 Rp 8,992,913 3
Rp 402,228 Rp 60,334 Rp 4,424,510 4
Rp 2,548,844 Rp 382,327 Rp 28,037,287 5
Rp 70,166 Rp 10,525 Rp 7,166,500 6
Rp 435,000 Rp 65,250 Rp 4,785,000 7
Rp 505,166 Rp 75,775 Rp 11,951,500 8
Rp 241,500 Rp 36,225 Rp 2,656,500 9
Rp 80,000 Rp 12,000 Rp 880,000 10
Rp 883,000 Rp 132,450 Rp 9,713,000 11
Rp 320,500 Rp 48,075 Rp 3,525,500 12
Rp 214,000 Rp 32,100 Rp 2,354,000 13
Rp 1,739,000 Rp 260,850 Rp 19,129,000 14
Rp 57,354 Rp 8,603 Rp 630,894 15
Rp 52,730 Rp 7,910 Rp 580,030 16
Rp 39,547 Rp 5,932 Rp 435,022 17
Rp 16,750 Rp 2,513 Rp 184,250 18
Rp 44,982 Rp 6,747 Rp 494,802 19
Rp 218,560 Rp 32,784 Rp 2,404,155
Rp 122,245 Rp 18,337 Rp 1,344,697
Rp 248,195 Rp 37,229 Rp 2,730,142
Rp 522,960 Rp 78,444 Rp 5,752,560
Rp 32,954 Rp 4,943 Rp 362,499
Rp 18,273 Rp 2,741 Rp 201,003
Rp 1,374,550 Rp 206,183 Rp 15,120,054
Rp 182,331 Rp 27,350 Rp 2,005,641
Rp 3,301,300 Rp 495,195 Rp 36,314,300
Rp 1,244,880 Rp 186,732 Rp 13,693,680
Rp 223,758 Rp 33,564 Rp 2,461,333
Rp 125,460 Rp 18,819 Rp 1,380,060
Rp 5,077,729 Rp 761,659 Rp 55,855,014
Rp 1,215,310 Rp 182,297 Rp 13,368,410
Rp 79,600 Rp 11,940 Rp 875,600
Rp 1,456,700 Rp 218,505 Rp 16,023,700
Rp 86,673 Rp 13,001 Rp 953,400
Rp 2,078,280 Rp 311,742 Rp 22,861,080
Rp 4,916,563 Rp 737,484 Rp 54,082,190
Rp 105,880 Rp 15,882 Rp 1,164,680
Rp 162,870 Rp 24,431 Rp 1,791,570
Rp 29,070 Rp 4,361 Rp 319,770
Rp 624,000 Rp 93,600 Rp 6,864,000
Rp 95,400 Rp 14,310 Rp 1,049,400
Rp 1,017,220 Rp 152,583 Rp 11,189,420
Rp 330,591 Rp 49,589 Rp 3,636,500
Rp 540,625 Rp 81,094 Rp 5,946,875
Rp 1,464,480 Rp 219,672 Rp 16,109,280
Rp 2,576,400 Rp 386,460 Rp 28,340,400
Rp 241,364 Rp 36,205 Rp 2,654,999
Rp 2,139,144 Rp 320,872 Rp 23,530,584
Rp 432,271 Rp 64,841 Rp 4,754,978
Rp 245,700 Rp 36,855 Rp 2,702,700
Rp 306,545 Rp 45,982 Rp 3,371,999
Rp 1,977,314 Rp 296,597 Rp 21,750,457
Rp 1,496,450 Rp 224,468 Rp 16,460,950
Rp 69,000 Rp 10,350 Rp 759,000
Rp 3,091,975 Rp 463,796 Rp 34,011,725
Rp 1,538,481 Rp 230,772 Rp 16,923,296
Rp 128,250 Rp 19,238 Rp 1,410,750
Rp 122,727 Rp 18,409 Rp 1,349,999
Rp 201,646 Rp 30,247 Rp 2,218,111
Rp 46,040 Rp 6,906 Rp 506,440
Rp 166,766 Rp 25,015 Rp 1,834,424
Rp 1,411,168 Rp 211,675 Rp 15,522,851
Rp 143,182 Rp 21,477 Rp 1,574,999
Rp 204,750 Rp 30,713 Rp 2,252,250
Rp 103,046 Rp 15,457 Rp 1,133,509
Rp 218,182 Rp 32,727 Rp 2,399,999
Rp 106,955 Rp 16,043 Rp 1,176,509
Rp 87,863 Rp 13,179 Rp 966,493
Rp 169,910 Rp 25,487 Rp 1,869,010
Rp 397,090 Rp 59,564 Rp 4,367,990
Rp 1,900,310 Rp 285,047 Rp 20,903,410
Rp 21,858,226 Rp 3,278,734 Rp 240,440,487
Rp 132,510 Rp 19,876 Rp 1,457,606
Rp 2,173,562 Rp 326,034 Rp 23,909,187
Rp 879,880 Rp 131,982 Rp 9,678,678
Rp 3,114,670 Rp 467,201 Rp 34,261,370
Rp 4,374,675 Rp 656,201 Rp 48,121,425
Rp 142,500 Rp 21,375 Rp 1,567,500
Rp 215,250 Rp 32,288 Rp 2,367,750
Rp 811,486 Rp 121,723 Rp 8,926,341
Rp 393,219 Rp 58,983 Rp 4,325,404
Rp 1,620,557 Rp 243,084 Rp 17,826,132
Rp 298,937 Rp 44,841 Rp 3,288,312
Rp 8,712 Rp 1,307 Rp 95,837
Rp 14,165,958 Rp 2,124,894 Rp 155,825,542
Rp 591,630,494 Rp 591,630,494

Muara Bungo, 09 Januari 2017

AYU TRESNAWATI
NIP 19660908 198803 2 002

SI SURAT PEMBAYARAN HUTANG

SUD H. HANAFIE MUARA BUNGO

PPN PPH SUB TOTAL TOTAL NO


203,875 30,581 2,242,630 1
93,677 14,052 1,030,452 2
137,685 20,653 1,514,535 3
1,130,442 169,566 12,434,862 4
1,565,680 234,852 17,222,479 5
1,474,400 221,160 16,218,400 6
481,691 72,254 5,298,596 7
375,000 56,250 4,125,000 8
213,769 32,065 2,351,456 9
269,600 40,440 2,965,600 10
1,136,880 170,532 12,505,680 11
325,800 48,870 3,583,800 12
427,500 64,125 4,702,500 13
168,000 25,200 1,848,000 14
644,963 96,744 7,094,588
232,273 34,841 2,554,998
660,375 99,056 7,264,125
281,925 42,289 3,101,175
457,326 68,599 5,030,586
1,722,400 258,360 18,946,400
160,713 24,107 1,767,838
1,228,500 184,275 13,513,500
2,250,280 337,542 24,753,080
520,000 78,000 5,720,000
784,000 117,600 8,624,000
84,000 12,600 924,000
273,000 40,950 3,003,000
128,000 19,200 1,408,000
131,220 19,683 1,443,420
9,000 1,350 99,000
248,500 37,275 2,733,500
746,500 111,975 8,211,500
644,475 96,671 7,089,225
225,000 33,750 2,475,000
1,548,575 232,286 17,034,325
152,640 22,896 1,679,040
636,651 95,498 7,003,161
1,164,112 174,617 12,805,232
42,000 6,300 462,000
109,200 16,380 1,201,200
1,528,800 229,320 16,816,800
325,000 48,750 3,575,000
744,000 111,600 8,184,000
337,500 50,625 3,712,500
1,518,829 227,824 16,707,119
182,813 27,422 2,010,938
24,595,207 3,689,281 270,547,282
181,818 27,273 2,000,000
136,364 20,455 1,499,999
714,580 107,187 7,860,380
528,076 79,211 5,808,831
294,800 44,220 3,242,800
3,398,166 509,725 37,379,828
231,000 34,650 2,541,000
171,516 25,727 1,886,671
3,250,427 487,564 35,754,696
126,787 19,018 1,394,662
238,576 35,786 2,624,340
910,839 136,626 10,019,227
2,562,649 384,397 28,189,141
390,909 58,636 4,300,000
120,000 18,000 1,320,000
13,256,507 1,988,476 145,821,575
547,898 82,185 6,026,882
375,448 56,317 4,129,924
923,346 138,502 10,156,806
1,411,168 211,675 15,522,851
204,750 30,713 2,252,250
218,182 32,727 2,399,999
87,863 13,179 966,493
1,900,310 285,047 20,903,410
3,822,273 573,341 42,045,003
188,775 28,316 2,076,525
106,900 16,035 1,175,900
336,118 50,418 3,697,294
177,375 26,606 1,951,125
536,740 80,511 5,904,140
181,200 27,180 1,993,200
508,275 76,241 5,591,025
212,850 31,928 2,341,350
1,527,108 229,066 24,730,559
836,564 125,485 9,202,202
1,035,000 155,250 11,385,000
469,287 70,393 5,162,160
275,000 41,250 3,025,000
346,800 52,020 3,814,800
28,610 4,292 314,710
125,400 18,810 1,379,400
378,166 56,725 4,159,826
187,534 28,130 2,062,872
34,364 5,155 378,000
3,716,725 557,509 40,883,970
294,440 44,166 3,238,840
168,000 25,200 1,848,000
1,220,848 183,127 13,429,333
864,000 129,600 9,504,000
318,500 47,775 3,503,500
2,865,788 429,868 31,523,673
992,261 148,839 10,914,876
716,625 107,494 7,882,875
402,228 60,334 4,424,510
3,402,225 510,334 37,424,477
514,800 77,220 5,662,800
601,875 90,281 6,620,625
402,228 60,334 4,424,510
219,375 32,906 2,413,125
7,251,618 1,087,743 79,767,798
272,040 40,806 2,992,440
90,680 13,602 997,480
221,704 33,256 2,438,744
27,748 4,162 305,224
1,271,137 190,671 13,982,510
130,826 19,624 1,439,090
353,027 52,954 3,883,301
79,000 11,850 869,000
14,673 2,201 161,398
2,460,835 369,125 27,069,187
462,225 69,334 5,084,475
453,530 68,030 4,988,830
877,500 131,625 9,652,500
8,591 1,289 94,501
77,319 11,598 850,509
236,328 35,449 2,599,608
2,295,820 344,373 25,254,020
4,411,313 661,697 48,524,443
491,550 73,733 5,407,050
140,000 21,000 1,540,000
508,617 76,293 5,594,787
1,140,167 171,025 12,541,837
679,687 101,953 7,476,562
338,925 50,839 3,728,175
200,750 30,113 2,208,250
864,300 129,645 9,507,300
440,000 66,000 4,840,000
772,694 115,904 8,499,631
468,750 70,313 5,156,250
429,000 64,350 4,719,000
544,694 81,704 5,991,631
143,000 21,450 1,573,000
2,409,775 361,466 26,507,525
7,291,575 1,093,736 80,207,324

831,041,936 831,041,936

Muara Bungo, 25 Januari 2017

AYU TRESNAWATI
NIP 19660908 198803 2 002

SI SURAT PEMBAYARAN HUTANG

SUD H. HANAFIE MUARA BUNGO

PPN PPH SUB TOTAL TOTAL


406,050 60,908 4,466,551
115,500 17,325 1,270,500
1,565,650 234,848 17,222,154
35,500 5,325 390,500
1,475,292 221,294 16,228,214
1,938,012 290,702 21,318,135
1,453,000 217,950 15,983,000
103,046 15,457 1,133,509
846,109 126,916 9,307,196
7,938,160 1,190,724 87,319,759
1,723,015 258,452 18,953,162
18,953,162
504,600 75,690 5,550,600
504,600 75,690 5,550,600
32,805 4,921 360,855
1,042,005 156,301 11,462,055
956,900 143,535 10,525,900
125,000 18,750 1,375,000
155,000 23,250 1,705,000
160,000 24,000 1,760,000
605,000 90,750 6,655,000
110,000 16,500 1,210,000
619,840 92,976 6,818,240
875,000 131,250 9,625,000
190,000 28,500 2,090,000
240,000 36,000 2,640,000
600,000 90,000 6,600,000
208,950 31,343 2,298,450
4,845,690 726,854 53,302,590
120,000 18,000 1,320,000
180,000 27,000 1,980,000
51,000 7,650 561,000
783,500 117,525 8,618,500
59,000 8,850 649,000
200,000 30,000 2,200,000
1,393,500 209,025 15,328,500
479,455 71,918 5,274,000
3,257,280 488,592 35,830,080
864,000 129,600 9,504,000
1,650,000 247,500 18,150,000
240,000 36,000 2,640,000
665,289 99,793 7,318,180
3,355,900 503,385 36,914,900
297,000 44,550 3,267,000
3,047,120 457,068 33,518,320
3,497,800 524,670 38,475,800
3,863,700 579,555 42,500,700
3,077,400 461,610 33,851,400
2,592,000 388,800 28,512,000
369,000 55,350 4,059,000
27,255,944 4,088,392 299,815,380
230,240 34,536 2,532,640
2,532,640
343,031 51,455 3,773,343
3,773,343
543,420 81,513 5,977,620
5,977,620
2,067,500 310,125 22,742,500
22,742,500
3,395,000 509,250 37,345,000
870,000 130,500 9,570,000
2,700,000 405,000 29,700,000
936,500 140,475 10,301,500
2,225,000 333,750 24,475,000
2,905,000 435,750 31,955,000
465,000 69,750 5,115,000
2,153,000 322,950 23,683,000
172,144,500
209,500 31,425 2,304,500
750,000 112,500 8,250,000
324,000 48,600 3,564,000
294,800 44,220 3,242,800
93,600 14,040 1,029,600
18,390,900
3,326,400 498,960 36,590,400
1,636,360 245,454 17,999,960
990,000 148,500 10,890,000
1,329,000 199,350 14,619,000
80,099,360
1,690,000 253,500 18,590,000
18,590,000
504,600 75,690 5,550,600
5,550,600
815,982,909

Muara Bungo, 9 Januari 2017

AYU TRESNAWATI
NIP 19660908 198803 2 002
NAMA PERUSAHAAN JUMLAH HUTANG NO NAMA PERUSAHAAN
PT. BHAKTI SEJAHTERA M Rp 19,129,000 1 APOTIK CAHAYA SEHAT
PT. ENSEVAL PUTERA Rp 240,440,487 2 APOTIK KITA
PT. KIMIA FARMA Rp 11,189,420 3 PT. ANUGRAH ARGON M
PT. MENSA BINA SUKSES Rp 155,825,542 4 PT. ANUGRAH PHARMINDO L
PT. MERAPI UTAMA PHARMA Rp 55,855,014 5 PT. BHAKTI SEJAHTERA M
PT. MUTIARA LABSAINS Rp 11,951,500 6 PT. BINA SAN PRIMA
PT. PARIT PADANG GLOBAL Rp 54,082,190 7 PT. BIO MULTI MEDIKA
PT. RAJAWALI NUSINDO Rp 15,120,054 8 PT. DOS NI ROHA
PT. UNITED DICO CITAS Rp 28,037,287 9 PT. DWI MITRA PUTRA
Rp - 10 PT. ENSEVAL PUTERA
Rp - 11 PT. HOTAMA MEDIPHAR
Rp - 12 PT. INDO FARMA GLOBAL M
Rp - 13 PT. JUNGER PHARMA
Rp - 14 PT. KEBAYORAN PHARMA
Rp - 15 PT. KIMIA FARMA
Rp - 16 PT. MENSA BINA SUKSES
Rp - 17 PT. MERAPI UTAMA PHARMA
Rp - 18 PT. MILLENIUM PHARMACON I
Rp - 19 PT. MUTIARA LABSAINS
Rp - 20 PT. PARAZELSUS
Rp 591,630,494 21 PT. PARIT PADANG GLOBAL
22 PT. PENTA VALENT
23 PT. RAJAWALI NUSINDO
24 PT. SAPTA SARI
25 PT. SAWAH BESAR
26 PT. SINAR KENCANA
27 PT. TALANG GUGUN
28 PT. TEMPO
29 PT. ULICO PHARMA
30 PT. UNITED DICO CITAS

TOTAL
NAMA PERUSAHAAN JUMLAH HUTANG
PT. ANUGRAH ARGON M Rp 145,821,575
PT. ANUGRAH PHARMINDO L Rp 27,069,187
PT. BINA SAN PRIMA Rp 24,730,559
PT. DOS NI ROHA Rp 270,547,282
PT. ENSEVAL PUTERA Rp 42,045,003
PT. INDO FARMA GLOBAL M Rp 40,883,970
PT. MERAPI UTAMA PHARMA Rp 48,524,443
PT. MILLENIUM PHARMACON I Rp 80,207,324
PT. PENTA VALENT Rp 44,065,510
PT. SAPTA SARI Rp 17,222,479
PT. ULICO PHARMA Rp 10,156,806
PT. UNITED DICO CITAS Rp 79,767,798

Rp 831,041,936
JUMLAH HUTANG
Rp -
Rp -
Rp 145,821,575
Rp 27,069,187
Rp 19,129,000
Rp 24,730,559
Rp -
Rp 270,547,282
Rp -
Rp 282,485,490
Rp -
Rp 40,883,970
Rp -
Rp -
Rp 11,189,420
Rp 155,825,542
Rp 104,379,457
Rp 80,207,324
Rp 11,951,500
Rp -
Rp 54,082,190
Rp 44,065,510
Rp 15,120,054
Rp 17,222,479
Rp -
Rp -
Rp -
Rp -
Rp 10,156,806

Rp 1,314,867,345
LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG
OBAT REGULER
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
10 Februari 2017
NO DISTRIBUTOR NO FACT TGL FACT JT. TEMPO NO.F STDR TAGIHAN
1 PT. RAJAWALI NUSINDO 7560 02/12/2016 01/01/2017 71527866 Rp 681,664
2 PT. RAJAWALI NUSINDO 7559 02/12/2016 01/01/2017 71527865 Rp 4,501,111
3 PT. RAJAWALI NUSINDO 7755 09/12/2016 08/01/2017 71528060 Rp 610,336
4 PT. RAJAWALI NUSINDO 7790 13/12/2016 12/01/2017 71528095 Rp 329,975
5 PT. RAJAWALI NUSINDO 7828 14/12/2016 13/01/2017 71528133 Rp 1,497,200
6 PT. RAJAWALI NUSINDO 7839 15/12/2016 14/01/2017 71528144 Rp 1,713,900
7 PT. RAJAWALI NUSINDO 7837 15/12/2016 14/01/2017 71528142 Rp 2,626,401
8 PT. RAJAWALI NUSINDO 7840 15/12/2016 14/01/2017 71528145 Rp 1,176,714
9 PT. RAJAWALI NUSINDO 7986 21/12/2016 20/01/2017 59643209 Rp 2,189,300
10 PT. RAJAWALI NUSINDO 8120 29/12/2016 28/01/2017 71528422 Rp 1,076,438
11 PT. RAJAWALI NUSINDO 8217 29/12/2016 28/01/2017 59642186 Rp 361,315
12 PT. RAJAWALI NUSINDO 8210 30/12/2016 29/01/2017 59643179 Rp 501,767
13 PT. RAJAWALI NUSINDO 8209 31/12/2016 30/01/2017 59643178 Rp 11,397,959
14 PT. RAJAWALI NUSINDO 8240 01/01/2017 31/01/2017 59643209 Rp 3,648,834
Rp 32,312,914
15 PT. ANUGRAH ARGON M 9973 15/12/2016 13/02/2017 58074511 Rp 1,790,909
16 PT. ANUGRAH ARGON M 0119 17/12/2016 15/02/2017 69269207 Rp 1,343,181
17 PT. ANUGRAH ARGON M 0530 24/12/2016 22/02/2017 69301911 Rp 7,656,135
18 PT. ANUGRAH ARGON M 0671 27/12/2016 25/02/2017 69311121 Rp 896,350
19 PT. ANUGRAH ARGON M 0125 05/01/2017 06/03/2017 69811620 Rp 1,790,909
20 PT. ANUGRAH ARGON M 0310 10/01/2017 11/03/2017 69828628 Rp 17,268,480
21 PT. ANUGRAH ARGON M 0441 12/01/2017 13/03/2017 69839911 Rp 1,126,840
22 PT. ANUGRAH ARGON M 0442 12/01/2017 13/03/2017 69839912 Rp 9,050,217
23 PT. ANUGRAH ARGON M 0430 12/01/2017 13/03/2017 69839707 Rp 7,700,909
24 PT. ANUGRAH ARGON M 0564 14/01/2017 15/03/2017 69849578 Rp 10,349,865
25 PT. ANUGRAH ARGON M 0713 17/01/2017 18/03/2017 69859825 Rp 5,201,544
26 PT. ANUGRAH ARGON M 0861 17/01/2017 18/03/2017 69870985 Rp 8,390,071
27 PT. ANUGRAH ARGON M 0862 19/01/2017 20/03/2017 69870986 Rp 1,970,408
28 PT. ANUGRAH ARGON M 0863 19/01/2017 20/03/2017 69870987 Rp 12,221,430
29 PT. ANUGRAH ARGON M 0864 19/01/2017 20/03/2017 69870988 Rp 4,054,247
30 PT. ANUGRAH ARGON M 0860 19/01/2017 20/03/2017 69870984 Rp 3,117,076
Rp 93,928,572
31 PT. ANUGRAH PHARMINDO L 7110 22/12/2016 20/02/2017 40511559 Rp 2,865,444
32 PT. ANUGRAH PHARMINDO L 7650 27/12/2016 25/02/2017 40534770 Rp 1,786,396
33 PT. ANUGRAH PHARMINDO L 7921 29/12/2016 27/02/2017 40551931 Rp 6,816,653
34 PT. ANUGRAH PHARMINDO L 8583 07/01/2017 08/03/2017 05689160 Rp 1,880,454
35 PT. ANUGRAH PHARMINDO L 8997 12/01/2017 13/03/2017 05723172 Rp 1,878,198
36 PT. ANUGRAH PHARMINDO L 9010 12/01/2017 13/03/2017 05723173 Rp 2,679,594
37 PT. ANUGRAH PHARMINDO L 9053 12/01/2017 11/02/2017 05723175 Rp 4,543,544
38 PT. ANUGRAH PHARMINDO L 8788 10/01/2017 09/02/2017 05699218 Rp 6,043,341
39 PT. ANUGRAH PHARMINDO L 8859 10/01/2017 09/02/2017 05717366 Rp 7,812,823
40 PT. ANUGRAH PHARMINDO L 9040 12/01/2017 11/02/2017 05723174 Rp 1,566,150
Rp 37,872,596
41 PT. BINA SAN PRIMA 1132 11/01/2017 10/02/2017 86050679 Rp 407,987
42 PT. BINA SAN PRIMA 1133 11/01/2017 10/02/2017 86050680 Rp 2,298,695
43 PT. BINA SAN PRIMA 1134 11/01/2017 10/02/2017 86050681 Rp 232,953
RETUR 792,000 Rp 2,939,634
44 PT. MENSA BINA SUKSES 8398 09/12/2016 08/01/2017 05066762 Rp 6,483,642
45 PT. MENSA BINA SUKSES 8400 09/12/2016 08/01/2017 05066764 Rp 3,915,658
46 PT. MENSA BINA SUKSES 3703 17/12/2016 16/01/2017 05101591 Rp 5,895,225
47 PT. MENSA BINA SUKSES 2699 17/12/2016 16/01/2017 05100590 Rp 4,463,528
48 PT. MENSA BINA SUKSES 1622 15/12/2016 14/01/2017 05089634 Rp 17,309,504
49 PT. MENSA BINA SUKSES 7119 19/12/2016 18/01/2017 05104953 Rp 7,950,605
50 PT. MENSA BINA SUKSES 1255 24/12/2016 23/01/2017 05138599 Rp 4,255,200
51 PT. MENSA BINA SUKSES 1253 24/12/2016 23/01/2017 05138597 Rp 4,063,125
52 PT. MENSA BINA SUKSES 1267 27/12/2016 26/01/2017 05148464 Rp 3,042,235
53 PT. MENSA BINA SUKSES 8636 27/12/2016 26/01/2017 05145867 Rp 7,018,125
54 PT. MENSA BINA SUKSES 2315 29/12/2016 28/01/2017 84402400 Rp 1,263,263
Rp 65,660,108
55 PT. MILLENIUM PHARMACON I 4006 10/12/2016 09/01/2017 52769231 Rp 23,736,284
56 PT. MILLENIUM PHARMACON I 3850 06/12/2016 05/01/2017 52757799 Rp 1,408,550
57 PT. MILLENIUM PHARMACON I 3738 02/12/2016 01/01/2017 52750222 Rp 5,365,233
58 PT. MILLENIUM PHARMACON I 3689 01/12/2016 31/12/2016 52747700 Rp 4,225,650
59 PT. MILLENIUM PHARMACON I 4566 23/12/2016 22/01/2017 52801293 Rp 4,617,188
60 PT. MILLENIUM PHARMACON I 4286 17/12/2016 16/01/2017 52784847 Rp 7,611,033
61 PT. MILLENIUM PHARMACON I 2350 03/11/2016 03/12/2016 17150696 Rp 4,334,000
62 PT. MILLENIUM PHARMACON I 2013 27/10/2016 26/11/2016 17128615 Rp 8,513,355
63 PT. MILLENIUM PHARMACON I 2012 27/10/2016 26/11/2016 17128614 Rp 1,977,388
64 PT. MILLENIUM PHARMACON I 1786 22/10/2016 21/11/2016 17114855 Rp 3,338,411
65 PT. MILLENIUM PHARMACON I 1634 19/10/2016 18/11/2016 17106031 Rp 6,694,921
Rp 71,822,013
66 PT. MERAPI UTAMA PHARMA 4869 05/12/2016 22/01/2017 07399223 Rp 866,800
67 PT. MERAPI UTAMA PHARMA 4865 05/12/2016 22/01/2017 07399221 Rp 3,906,845
68 PT. MERAPI UTAMA PHARMA 4866 05/12/2016 22/01/2017 07399222 Rp 10,101,569
69 PT. MERAPI UTAMA PHARMA 4932 06/12/2016 23/01/2017 07399287 Rp 392,188
70 PT. MERAPI UTAMA PHARMA 5611 21/12/2016 07/02/2017 07425692 Rp 32,012,500
71 PT. MERAPI UTAMA PHARMA 6148 30/12/2016 16/02/2017 07437921 Rp 1,083,500
72 PT. MERAPI UTAMA PHARMA 0845 19/01/2017 08/03/2017 82951212 Rp 20,984,556
73 PT. MERAPI UTAMA PHARMA 0842 19/01/2017 08/03/2017 82951210 Rp 6,534,244
74 PT. MERAPI UTAMA PHARMA 0847 19/01/2017 08/03/2017 82951214 Rp 2,534,558
Rp 78,416,760
75 PT. KIMIA FARMA 7405 07/12/2016 28/12/2016 Rp 546,705
76 PT. KIMIA FARMA 0402 08/12/2016 29/12/2016 Rp 2,435,610
77 PT. KIMIA FARMA 4127 10/12/2016 31/12/2016 Rp 1,410,343
78 PT. KIMIA FARMA 5723 17/12/2016 07/01/2017 Rp 4,155,382
79 PT. KIMIA FARMA 1065 26/12/2016 16/01/2017 Rp 1,435,736
80 PT. KIMIA FARMA 4016 31/12/2016 21/01/2017 Rp 656,046
81 PT. KIMIA FARMA 5967 31/12/2016 21/01/2017 Rp 10,429,180
Rp 21,069,000
82 PT. SAPTA SARI 3311 29/12/2016 19/01/2017 64585598 Rp 983,838

83 PT. DOS NI ROHA 7186 28/11/2016 28/12/2016 51966121 Rp 11,466,503


84 PT. DOS NI ROHA 2031 05/01/2017 04/02/2017 92920506 Rp 2,369,725
85 PT. DOS NI ROHA 2030 05/01/2017 04/02/2017 92920505 Rp 449,160
86 PT. DOS NI ROHA 9309 09/01/2017 08/02/2017 92926921 Rp 5,122,000
87 PT. DOS NI ROHA 9311 09/01/2017 08/02/2017 92926922 Rp 5,282,063
88 PT. DOS NI ROHA 9312 09/01/2017 08/02/2017 92926923 Rp 5,763,629
89 PT. DOS NI ROHA 9433 09/01/2017 08/02/2017 92926924 Rp 9,653,000
90 PT. DOS NI ROHA 9436 09/01/2017 08/02/2017 92926925 Rp 2,604,094
91 PT. DOS NI ROHA 2855 10/01/2017 09/02/2017 92926926 Rp 2,679,200
92 PT. DOS NI ROHA 5350 12/01/2017 11/02/2017 92935653 Rp 2,206,400
93 PT. DOS NI ROHA 5352 12/01/2017 11/02/2017 92935654 Rp 2,761,079
94 PT. DOS NI ROHA 6026 14/01/2017 13/02/2017 92936677 Rp 724,960
95 PT. DOS NI ROHA 4452 14/01/2017 13/02/2017 92936670 Rp 20,050,660
96 PT. DOS NI ROHA 6036 14/01/2017 13/02/2017 92936679 Rp 1,773,000
97 PT. DOS NI ROHA 6696 19/01/2017 18/02/2017 92950173 Rp 5,181,100
98 PT. DOS NI ROHA 7505 19/01/2017 18/02/2017 92950175 Rp 8,766,697
99 PT. DOS NI ROHA 6963 19/01/2017 18/02/2017 92950174 Rp 3,572,595
100 PT. DOS NI ROHA 9825 20/01/2017 19/02/2017 92953263 Rp 3,209,130
Rp 93,634,994
101 PT. ULICO PHARMA 5315 10/01/2017 09/02/2017 03365315 Rp 2,056,680
102 PT. ULICO PHARMA 5316 13/01/2017 12/02/2017 03365316 Rp 394,000
103 PT. ULICO PHARMA 5317 19/01/2017 18/02/2017 03365317 Rp 3,450,439
Rp 5,901,119
104 PT. PARIT PADANG GLOBAL 7663 28/12/2016 18/01/2017 54491384 Rp 2,420,145
105 PT. PARIT PADANG GLOBAL 7450 24/12/2016 14/01/2017 54475231 Rp 17,945,206
106 PT. PARIT PADANG GLOBAL 7734 29/12/2016 19/01/2017 54497441 Rp 1,871,500
107 PT. PARIT PADANG GLOBAL 7669 28/12/2016 18/01/2017 54492019 Rp 3,605,100
108 PT. PARIT PADANG GLOBAL 7676 28/12/2016 18/01/2017 54492107 Rp 697,380
109 PT. PARIT PADANG GLOBAL 7060 17/12/2016 07/01/2017 54441976 Rp 1,216,475
110 PT. PARIT PADANG GLOBAL 6985 15/12/2016 05/01/2017 54434497 Rp 17,096,714
Rp 44,852,520
111 PT. INDO FARMA GLOBAL M 8087 20/12/2016 03/02/2017 Rp 3,653,976
112 PT. INDO FARMA GLOBAL M 8098 20/12/2016 03/02/2017 Rp 3,809,197
113 PT. INDO FARMA GLOBAL M 8109 20/12/2016 03/02/2017 Rp 2,302,438
114 PT. INDO FARMA GLOBAL M 8245 27/12/2016 10/02/2017 Rp 1,521,272
115 PT. INDO FARMA GLOBAL M 8246 27/12/2016 10/02/2017 Rp 6,456,675
116 PT. INDO FARMA GLOBAL M 8292 27/12/2016 10/02/2017 Rp 2,092,745
117 PT. INDO FARMA GLOBAL M 8406 29/12/2016 12/02/2017 Rp 904,409
Rp 20,740,712
118 PT. ENSEVAL PUTERA 1283 30/12/2016 28/02/2017 18681212 Rp 28,245,909
120 PT. ENSEVAL PUTERA 1170 27/12/2016 25/02/2017 18633335 Rp 13,474,800
121 PT. ENSEVAL PUTERA 1174 28/12/2016 26/02/2017 18646216 Rp 7,609,470
122 PT. ENSEVAL PUTERA 1187 30/12/2016 28/02/2017 18687805 Rp 1,716,193
123 PT. ENSEVAL PUTERA 0009 06/01/2017 07/03/2017 12782709 Rp 5,740,974
124 PT. ENSEVAL PUTERA 0610 09/01/2017 10/03/2017 12847432 Rp 20,639,404
125 PT. ENSEVAL PUTERA 0013 09/01/2017 10/03/2017 12846688 Rp 28,704,870
126 PT. ENSEVAL PUTERA 0014 09/01/2017 10/03/2017 12846684 Rp 1,006,490
127 PT. ENSEVAL PUTERA 0033 14/01/2017 15/03/2017 12915973 Rp 574,097
Rp107,712,208
TOTAL

Mengetahui,
Kepala Instalasi Farmasi

TONI DAFIAPUTRA, S.FARM, APT


NIP.19841023 200803 1 001

LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG


OBAT REGULER
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
01 Februari 2017
NO DISTRIBUTOR NO FACT TGL FACT JT. TEMPO NO.F STDR TAGIHAN
1 PT. BHAKTI SEJAHTERA M P487 01/11/2016 33,440,750
2 PT. BHAKTI SEJAHTERA M P494 03/11/2016 8,569,500
3 PT. BHAKTI SEJAHTERA M P501 11/11/2016 26,595,000
4 PT. BHAKTI SEJAHTERA M P522 28/11/2016 9,224,525
5 PT. BHAKTI SEJAHTERA M P528 30/11/2016 21,916,250
6 PT. BHAKTI SEJAHTERA M P533 05/12/2016 28,614,250
7 PT. BHAKTI SEJAHTERA M P561 11/12/2016 4,580,250
8 PT. BHAKTI SEJAHTERA M P570 19/12/2016 21,207,050
154,147,575
9 PT. MUARA NATIO P 9425 19/11/2016 51459425 2,063,575
10 PT. MUARA NATIO P 9426 03/12/2016 51459426 7,387,500
11 PT. MUARA NATIO P 9427 19/12/2016 51459427 3,191,400
12 PT. MUARA NATIO P 9428 21/12/2016 51459428 2,903,780
13 PT. MUARA NATIO P 9424 26/12/2016 51459424 921,960
14 PT. MUARA NATIO P 2501 13/01/2016 99872501 68,950,000
85,418,215
15 PT. SAPTA SARI 2105 09/12/2016 75247143 4,970,310
16 PT. SAPTA SARI 3111 27/12/2016 64581124 2,683,967
7,654,277
17 PT. BIO MULTI MEDIKA 0219 30/12/2016 80024130 32,765,040
18 PT. BIO MULTI MEDIKA 0218 30/12/2016 80024129 16,118,146
19 PT. BIO MULTI MEDIKA 0217 30/12/2016 80024128 9,751,500
20 PT. BIO MULTI MEDIKA 0220 30/12/2016 80024131 13,090,650
21 PT. BIO MULTI MEDIKA 0001 04/01/2016 01838891 5,296,148
22 PT. BIO MULTI MEDIKA 0003 06/01/2017 01838893 21,010,050
23 PT. BIO MULTI MEDIKA 0006 18/01/2017 01838894 22,162,500
24 PT. BIO MULTI MEDIKA 0007 19/01/2017 01838895 43,699,525
25 PT. BIO MULTI MEDIKA 0008 19/01/2017 01838896 1,290,350
26 PT. BIO MULTI MEDIKA 0009 20/01/2017 01838897 29,786,400
27 PT. BIO MULTI MEDIKA 0010 20/01/2017 01838898 11,820,000
206,790,309
28 PT. HOTAMA MEDIPHAR 1474 16/12/2016 11475946 16,646,500

29 PT. MUTIARA LABSAINS 3321 01/12/2016 05232383 7,717,475


30 PT. MUTIARA LABSAINS 3352 05/12/2016 05232415 581,150

31 PT. AFINA SC 4759 23/11/2016 06423461 20,364,875

32 PT. CITRA PURNAMA S 0042 29/12/2016 01880990 5,910,000


33 PT. CITRA PURNAMA S 0043 30/12/2016 01880991 2,058,158
34 PT. CITRA PURNAMA S 0001 11/01/2016 01880993 1,970,000
35 PT. CITRA PURNAMA S 0002 11/01/2016 01880994 2,925,450
36 PT. CITRA PURNAMA S 0003 12/01/2016 01880995 9,305,295
22,168,903
37 PT. ENSEVAL PUTERA 9233 15/12/2016 18502608 1,642,643
38 PT. ENSEVAL PUTERA 9545 17/12/2016 18529146 1,410,340
39 PT. ENSEVAL PUTERA 1118 14/12/2016 18486148 1,015,007
40 PT. ENSEVAL PUTERA 1127 15/12/2016 18502783 1,053,510
41 PT. ENSEVAL PUTERA 0738 27/12/2016 18633200 1,673,614
42 PT. ENSEVAL PUTERA 0742 27/12/2016 18633556 3,911,337
10,706,450
TOTAL

Mengetahui,
Kepala Instalasi Farmasi

TONI DAFIAPUTRA, S.FARM, APT


NIP.19841023 200803 1 001
RAN HUTANG

ARA BUNGO

PPN PPH SUB TOTAL TOTAL


Rp 69,204 Rp 10,381 Rp 761,249
Rp 456,966 Rp 68,545 Rp 5,026,621
Rp 61,963 Rp 9,294 Rp 681,593
Rp 33,500 Rp 5,025 Rp 368,500
Rp 152,000 Rp 22,800 Rp 1,672,000
Rp 174,000 Rp 26,100 Rp 1,914,000
Rp 266,640 Rp 39,996 Rp 2,933,037
Rp 119,463 Rp 17,920 Rp 1,314,097
Rp 222,264 Rp 33,340 Rp 2,444,904
Rp 109,283 Rp 16,392 Rp 1,202,114
Rp 36,682 Rp 5,502 Rp 403,499
Rp 50,941 Rp 7,641 Rp 560,349
Rp 1,157,153 Rp 173,573 Rp 12,728,685
Rp 370,440 Rp 55,566 Rp 4,074,840
Rp 3,280,499 Rp 492,075 Rp 36,085,488
Rp 181,818 Rp 27,273 Rp 2,000,000
Rp 136,364 Rp 20,455 Rp 1,499,999
Rp 777,273 Rp 116,591 Rp 8,549,999
Rp 91,000 Rp 13,650 Rp 1,001,000
Rp 181,818 Rp 27,273 Rp 2,000,000
Rp 1,753,145 Rp 262,972 Rp 19,284,597
Rp 114,400 Rp 17,160 Rp 1,258,400
Rp 918,804 Rp 137,821 Rp 10,106,841
Rp 781,818 Rp 117,273 Rp 8,600,000
Rp 1,050,748 Rp 157,612 Rp 11,558,225
Rp 528,076 Rp 79,211 Rp 5,808,831
Rp 851,784 Rp 127,768 Rp 9,369,622
Rp 200,041 Rp 30,006 Rp 2,200,456
Rp 1,240,754 Rp 186,113 Rp 13,648,298
Rp 411,599 Rp 61,740 Rp 4,527,585
Rp 316,454 Rp 47,468 Rp 3,480,999
Rp 9,535,896 Rp 1,430,384 Rp 104,894,852
Rp 290,908 Rp 43,636 Rp 3,199,988
Rp 181,360 Rp 27,204 Rp 1,994,960
Rp 692,046 Rp 103,807 Rp 7,612,506
Rp 190,909 Rp 28,636 Rp 2,099,999
Rp 190,680 Rp 28,602 Rp 2,097,480
Rp 272,040 Rp 40,806 Rp 2,992,440
Rp 461,273 Rp 69,191 Rp 5,074,008
Rp 613,537 Rp 92,031 Rp 6,748,909
Rp 793,180 Rp 118,977 Rp 8,724,980
Rp 159,000 Rp 23,850 Rp 1,749,000
Rp 3,844,934 Rp 576,740 Rp 42,294,270
Rp 41,420 Rp 6,213 Rp 455,620
Rp 233,370 Rp 35,006 Rp 2,567,070
Rp 23,650 Rp 3,548 Rp 260,150
Rp 298,440 Rp 44,766 Rp 3,282,840
Rp 658,238 Rp 98,736 Rp 7,240,615
Rp 397,529 Rp 59,629 Rp 4,372,816
Rp 598,500 Rp 89,775 Rp 6,583,500
Rp 453,150 Rp 67,973 Rp 4,984,650
Rp 1,757,310 Rp 263,597 Rp 19,330,410
Rp 807,168 Rp 121,075 Rp 8,878,848
Rp 432,000 Rp 64,800 Rp 4,752,000
Rp 412,500 Rp 61,875 Rp 4,537,500
Rp 308,856 Rp 46,328 Rp 3,397,420
Rp 712,500 Rp 106,875 Rp 7,837,500
Rp 128,250 Rp 19,238 Rp 1,410,750
Rp 6,666,001 Rp 999,900 Rp 73,326,009
Rp 2,409,775 Rp 361,466 Rp 26,507,525
Rp 143,000 Rp 21,450 Rp 1,573,000
Rp 544,694 Rp 81,704 Rp 5,991,631
Rp 429,000 Rp 64,350 Rp 4,719,000
Rp 468,750 Rp 70,313 Rp 5,156,250
Rp 772,694 Rp 115,904 Rp 8,499,631
Rp 440,000 Rp 66,000 Rp 4,840,000
Rp 864,300 Rp 129,645 Rp 9,507,300
Rp 200,750 Rp 30,113 Rp 2,208,250
Rp 338,925 Rp 50,839 Rp 3,728,175
Rp 679,687 Rp 101,953 Rp 7,476,562
Rp 7,291,575 Rp 1,093,736 Rp 80,207,324
Rp 88,000 Rp 13,200 Rp 968,000
Rp 396,634 Rp 59,495 Rp 4,362,974
Rp 1,025,540 Rp 153,831 Rp 11,280,940
Rp 39,816 Rp 5,972 Rp 437,976
Rp 3,250,000 Rp 487,500 Rp 35,750,000
Rp 110,000 Rp 16,500 Rp 1,210,000
Rp 2,130,412 Rp 319,562 Rp 23,434,530
Rp 663,375 Rp 99,506 Rp 7,297,125
Rp 257,316 Rp 38,597 Rp 2,830,471
Rp 7,961,092 Rp 1,194,164 Rp 87,572,016
Rp 55,503 Rp 8,325 Rp 610,533
Rp 247,270 Rp 37,091 Rp 2,719,970
Rp 143,182 Rp 21,477 Rp 1,575,002
Rp 421,866 Rp 63,280 Rp 4,640,528
Rp 145,760 Rp 21,864 Rp 1,603,360
Rp 66,604 Rp 9,991 Rp 732,640
Rp 1,058,800 Rp 158,820 Rp 11,646,800
Rp 2,138,985 Rp 320,848 Rp 23,528,833
Rp 99,882 Rp 14,982 Rp 1,098,702
Rp 1,098,702
Rp 1,164,112 Rp 174,617 Rp 12,805,232
Rp 240,581 Rp 36,087 Rp 2,646,393
Rp 45,600 Rp 6,840 Rp 501,600
Rp 520,000 Rp 78,000 Rp 5,720,000
Rp 536,250 Rp 80,438 Rp 5,898,750
Rp 585,140 Rp 87,771 Rp 6,436,540
Rp 980,000 Rp 147,000 Rp 10,780,000
Rp 264,375 Rp 39,656 Rp 2,908,125
Rp 272,000 Rp 40,800 Rp 2,992,000
Rp 224,000 Rp 33,600 Rp 2,464,000
Rp 280,313 Rp 42,047 Rp 3,083,438
Rp 73,600 Rp 11,040 Rp 809,600
Rp 2,035,600 Rp 305,340 Rp 22,391,600
Rp 180,000 Rp 27,000 Rp 1,980,000
Rp 526,000 Rp 78,900 Rp 5,786,000
Rp 890,020 Rp 133,503 Rp 9,790,220
Rp 362,700 Rp 54,405 Rp 3,989,700
Rp 325,800 Rp 48,870 Rp 3,583,800
Rp 9,506,091 Rp 1,425,914 Rp 104,566,998
Rp 208,800 Rp 31,320 Rp 2,296,800
Rp 40,000 Rp 6,000 Rp 440,000
Rp 350,298 Rp 52,545 Rp 3,853,282
Rp 599,098 Rp 89,865 Rp 6,590,082
Rp 245,700 Rp 36,855 Rp 2,702,700
Rp 1,821,848 Rp 273,277 Rp 20,040,332
Rp 190,000 Rp 28,500 Rp 2,090,000
Rp 366,000 Rp 54,900 Rp 4,026,000
Rp 70,800 Rp 10,620 Rp 778,800
Rp 123,500 Rp 18,525 Rp 1,358,500
Rp 1,735,707 Rp 260,356 Rp 19,092,777
Rp 4,553,555 Rp 683,033 Rp 50,089,109
Rp 370,962 Rp 55,644 Rp 4,080,582
Rp 386,721 Rp 58,008 Rp 4,253,926
Rp 233,750 Rp 35,063 Rp 2,571,250
Rp 154,444 Rp 23,167 Rp 1,698,883
Rp 655,500 Rp 98,325 Rp 7,210,500
Rp 212,461 Rp 31,869 Rp 2,337,075
Rp 91,818 Rp 13,773 Rp 1,010,000
Rp 2,105,656 Rp 315,848 Rp 23,162,216
Rp 2,867,605 Rp 430,141 Rp 31,543,655
Rp 1,368,000 Rp 205,200 Rp 15,048,000
Rp 772,535 Rp 115,880 Rp 8,497,885
Rp 174,233 Rp 26,135 Rp 1,916,561
Rp 582,840 Rp 87,426 Rp 6,411,240
Rp 2,095,371 Rp 314,306 Rp 23,049,081
Rp 2,914,200 Rp 437,130 Rp 32,056,200
Rp 102,182 Rp 15,327 Rp 1,123,999
Rp 58,284 Rp 8,743 Rp 641,124
Rp 10,935,250 Rp 1,640,287 Rp 120,287,745
Rp 756,986,484 Rp 756,986,484

Muara Bungo, 10 Februari 2017

AYU TRESNAWATI
NIP 19660908 198803 2 002

RAN HUTANG

ARA BUNGO

PPN PPH SUB TOTAL TOTAL


3,395,000 509,250 37,345,000
870,000 130,500 9,570,000
2,700,000 405,000 29,700,000
936,500 140,475 10,301,500
2,225,000 333,750 24,475,000
2,905,000 435,750 31,955,000
465,000 69,750 5,115,000
2,153,000 322,950 23,683,000
15,649,500 2,347,425 172,144,500
209,500 31,425 2,304,500
750,000 112,500 8,250,000
324,000 48,600 3,564,000
294,800 44,220 3,242,800
93,600 14,040 1,029,600
7,000,000 1,050,000 77,000,000
8,671,900 1,300,785 95,390,900
504,600 75,690 5,550,600
272,484 40,873 2,997,324
777,084 116,563 8,547,924
3,326,400 498,960 36,590,400
1,636,360 245,454 17,999,960
990,000 148,500 10,890,000
1,329,000 199,350 14,619,000
537,680 80,652 5,914,480
2,133,000 319,950 23,463,000
2,250,000 337,500 24,750,000
4,436,500 665,475 48,801,500
131,000 19,650 1,441,000
3,024,000 453,600 33,264,000
1,200,000 180,000 13,200,000
20,993,940 3,149,091 230,933,340
1,690,000 253,500 18,590,000
18,590,000
783,500 117,525 8,618,500
59,000 8,850 649,000
9,267,500
2,067,500 310,125 22,742,500
22,742,500
600,000 90,000 6,600,000
208,950 31,343 2,298,450
200,000 30,000 2,200,000
297,000 44,550 3,267,000
944,700 141,705 10,391,700
2,250,650 337,598 24,757,150
166,766 25,015 1,834,424
143,182 21,477 1,574,999
103,046 15,457 1,133,510
106,955 16,043 1,176,509
169,910 25,487 1,869,010
397,090 59,564 4,367,990
1,086,949 163,042 11,956,442
594,330,256 594,330,256

Muara Bungo, 1 Februari 2017


AYU TRESNAWATI
NIP 19660908 198803 2 002
LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG
OBAT REGULER
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
13 Maret 2017
NO DISTRIBUTOR NO FACT TGL FACT JT. TEMPO NO.F STDR TAGIHAN
1 PT. RAJAWALI NUSINDO 0147 10/01/2017 09/02/2017 03195005 1,839,943
2 PT. RAJAWALI NUSINDO 0156 10/01/2017 09/02/2017 03195014 1,867,881
3 PT. RAJAWALI NUSINDO 0160 11/01/2017 10/02/2017 03195018 1,713,900
4 PT. RAJAWALI NUSINDO 0161 11/01/2017 10/02/2017 03195019 1,298,409
5 PT. RAJAWALI NUSINDO 0372 20/01/2017 19/02/2017 03195219 344,901
6 PT. RAJAWALI NUSINDO 0544 30/01/2017 01/03/2017 03195390 6,814,764
7 PT. RAJAWALI NUSINDO 0545 30/01/2017 01/03/2017 03195391 72,976
8 PT. RAJAWALI NUSINDO 0546 30/01/2017 01/03/2017 03195392 1,079,591
9 PT. RAJAWALI NUSINDO 0547 30/01/2017 01/03/2017 03195393 886,500
10 PT. RAJAWALI NUSINDO 0581 31/01/2017 02/03/2017 03195426 1,477,500
11 PT. RAJAWALI NUSINDO 0588 31/01/2017 02/03/2017 03195433 3,648,834
12 PT. RAJAWALI NUSINDO 0601 01/02/2017 03/03/2017 03195442 1,666,620
13 PT. RAJAWALI NUSINDO 0649 03/02/2017 05/03/2017 03195490 1,599,190
14 PT. RAJAWALI NUSINDO 0661 03/02/2017 05/03/2017 03195501 1,618,747
25,929,758
15 PT. ANUGRAH ARGON M 0523 24/12/2016 22/02/2017 69301904 25,205,769
16 PT. ANUGRAH ARGON M 0589 26/12/2019 24/02/2020 69305349 27,465,614
17 PT. ANUGRAH ARGON M 0670 27/12/2019 25/02/2020 69311120 5,590,587
18 PT. ANUGRAH ARGON M 0672 27/12/2019 25/02/2020 69311122 1,833,946
19 PT. ANUGRAH ARGON M 0924 29/12/2017 27/02/2018 69329393 44,256,876
20 PT. ANUGRAH ARGON M 0124 05/01/2017 06/03/2017 69811619 2,497,714
21 PT. ANUGRAH ARGON M 1654 02/02/2017 03/04/2017 69935586 13,811,551
22 PT. ANUGRAH ARGON M 1655 02/02/2017 03/04/2017 69935587 4,485,881
23 PT. ANUGRAH ARGON M 1734 03/02/2017 04/04/2017 69940960 9,614,119
24 PT. ANUGRAH ARGON M 1735 03/02/2017 04/04/2017 69940961 3,975,137
25 PT. ANUGRAH ARGON M 1348 27/01/2017 28/03/2017 69909114 6,931,770
26 PT. ANUGRAH ARGON M 1349 27/01/2017 28/03/2017 69909115 11,609,475
27 PT. ANUGRAH ARGON M 1536 31/01/2017 01/04/2017 69924269 1,386,061
28 PT. ANUGRAH ARGON M 1002 21/01/2017 22/03/2017 69879978 3,959,358
29 PT. ANUGRAH ARGON M 1056 23/01/2017 24/03/2017 69884028 5,278,960
30 PT. ANUGRAH ARGON M 2017 09/02/2017 10/04/2017 69964879 447,726
31 PT. ANUGRAH ARGON M 2016 09/02/2017 10/04/2017 69964878 447,726
32 PT. ANUGRAH ARGON M 2023 09/02/2017 10/04/2017 69964885 17,727,336
33 PT. ANUGRAH ARGON M 1892 07/02/2017 08/04/2017 69953226 317,663
34 PT. ANUGRAH ARGON M 1893 07/02/2017 08/04/2017 69953227 249,771
35 PT. ANUGRAH ARGON M 2018 09/02/2017 10/04/2017 69964880 11,570,564
36 PT. ANUGRAH ARGON M 2019 09/02/2017 10/04/2017 69964881 6,318,775
37 PT. ANUGRAH ARGON M 2020 09/02/2017 10/04/2017 69964882 14,144,250
38 PT. ANUGRAH ARGON M 2021 09/02/2017 10/04/2017 69964883 886,500
RETUR 44,177,458 220,013,127
39 PT. PENTA VALENT 0386 12/01/2017 11/02/2017 83997931 2,523,816
40 PT. PENTA VALENT 1107 27/01/2017 26/02/2017 84032275 8,371,958
41 PT. PENTA VALENT 1180 30/01/2017 01/03/2017 84036029 24,038,814
42 PT. PENTA VALENT 1187 30/01/2017 01/03/2017 84036036 1,553,345
43 PT. PENTA VALENT 1234 31/01/2017 02/03/2017 84041094 1,403,625
44 PT. PENTA VALENT 1384 01/02/2017 03/03/2017 84047211 17,592,100
45 PT. PENTA VALENT 1206 31/01/2017 02/03/2017 84041066 2,836,800
46 PT. PENTA VALENT 1500 04/02/2017 06/03/2017 84051436 535,840
47 PT. PENTA VALENT 1688 08/02/2017 10/03/2017 84063361 18,690,868
48 PT. PENTA VALENT 1725 09/02/2017 11/03/2017 84064858 3,794,389
49 PT. PENTA VALENT 1739 09/02/2017 11/03/2017 84064562 4,321,688
50 PT. PENTA VALENT 1983 14/02/2017 16/03/2017 84075031 6,924,550
51 PT. PENTA VALENT 1984 14/02/2017 16/03/2017 84075032 13,292,329
52 PT. PENTA VALENT 1985 14/02/2017 16/03/2017 84075033 6,559,933
53 PT. PENTA VALENT 0760 20/01/2017 19/02/2017 84018390 945,600
54 PT. PENTA VALENT 0981 25/01/2017 24/02/2017 84028583 2,381,730
115,767,385
55 PT. ANUGRAH PHARMINDO L 0953 01/02/2017 03/03/2017 05886414 5,631,358
56 PT. ANUGRAH PHARMINDO L 1055 02/02/2017 03/04/2017 05886415 4,465,990
57 PT. ANUGRAH PHARMINDO L 0469 27/01/2017 26/02/2017 05838386 10,016,546
58 PT. ANUGRAH PHARMINDO L 1304 10/01/2017 09/02/2017 05918987 7,516,446
59 PT. ANUGRAH PHARMINDO L 1781 04/02/2017 06/03/2017 05947813 4,452,312
60 PT. ANUGRAH PHARMINDO L 2757 17/02/2017 19/03/2017 06011385 2,399,651
61 PT. ANUGRAH PHARMINDO L 1789 08/02/2017 10/03/2017 05957876 7,812,823
62 PT. ANUGRAH PHARMINDO L 2296 13/02/2017 14/04/2017 05969877 1,182,000
63 PT. ANUGRAH PHARMINDO L 2620 16/02/2017 17/04/2017 06011379 3,760,907
64 PT. ANUGRAH PHARMINDO L 2624 16/02/2017 17/04/2017 06011380 3,743,000
65 PT. ANUGRAH PHARMINDO L 2631 16/02/2017 17/04/2017 06011381 10,820,673
66 PT. ANUGRAH PHARMINDO L 2745 17/02/2017 18/04/2017 06011383 7,600,181
67 PT. ANUGRAH PHARMINDO L 2747 17/02/2017 18/04/2017 06011384 129,840
68 PT. ANUGRAH PHARMINDO L 1312 04/02/2017 05/04/2017 05918981 748,600
69 PT. ANUGRAH PHARMINDO L 1206 03/02/2017 04/04/2017 05918980 6,966,633
RETUR 2,615,800 77,246,959
70 PT. BINA SAN PRIMA 3039 27/01/2017 26/02/2017 86052574 1,549,799
71 PT. BINA SAN PRIMA 3038 27/01/2017 26/02/2017 86052573 2,974,700
72 PT. BINA SAN PRIMA 3040 27/01/2017 26/02/2017 86052575 3,658,290
73 PT. BINA SAN PRIMA 3481 31/01/2017 02/03/2017 86053014 3,310,759
74 PT. BINA SAN PRIMA 0208 02/02/2017 04/03/2017 86053341 538,992
75 PT. BINA SAN PRIMA 0209 02/02/2017 04/03/2017 86053342 2,226,100
76 PT. BINA SAN PRIMA 0885 08/02/2017 10/03/2017 86054014 1,300,397
77 PT. BINA SAN PRIMA 0886 08/02/2017 10/03/2017 86054015 5,522,698
78 PT. BINA SAN PRIMA 1622 14/02/2017 16/03/2017 86054748 5,043,890
79 PT. BINA SAN PRIMA 1623 14/02/2017 16/03/2017 86054749 4,047,956
80 PT. BINA SAN PRIMA 1624 14/02/2017 16/03/2017 86054750 17,284,682
47,458,262
81 PT. MENSA BINA SUKSES 2320 29/12/2016 28/01/2017 84402405 48,536,614
82 PT. MENSA BINA SUKSES 1249 24/12/2016 23/01/2017 05138593 25,218,463
83 PT. MENSA BINA SUKSES 1252 24/12/2016 23/01/2017 05138596 20,661,360
84 PT. MENSA BINA SUKSES 6195 29/12/2016 28/01/2017 05114007 4,063,125
85 PT. MENSA BINA SUKSES 4565 12/01/2017 11/02/2017 83227910 5,764,220
86 PT. MENSA BINA SUKSES 6286 14/01/2017 13/02/2017 83239498 4,414,329
87 PT. MENSA BINA SUKSES 8084 14/01/2017 13/02/2017 83241282 943,075
88 PT. MENSA BINA SUKSES 0035 19/01/2017 18/02/2017 83262895 8,992,065
89 PT. MENSA BINA SUKSES 6420 25/01/2017 24/02/2017 83288993 2,610,439
90 PT. MENSA BINA SUKSES 9923 31/01/2017 02/03/2017 83312091 5,243,699
91 PT. MENSA BINA SUKSES 8523 31/01/2017 02/03/2017 83320563 18,104,300
92 PT. MENSA BINA SUKSES 9840 31/01/2017 02/03/2017 83321860 6,011,578
93 PT. MENSA BINA SUKSES 0676 01/02/2017 03/03/2017 83332507 44,820,800
94 PT. MENSA BINA SUKSES 5234 02/02/2017 04/03/2017 83336992 5,895,225
95 PT. MENSA BINA SUKSES 7977 03/02/2017 05/03/2017 83339698 1,352,799
96 PT. MENSA BINA SUKSES 0044 19/01/2017 18/02/2017 83262904 6,405,696
RETUR 8,861,600 209,037,784
97 PT. MILLENIUM PHARMACON I 4127 14/12/2017 13/01/2018 52775762 1,539,063
98 PT. MILLENIUM PHARMACON I 4757 26/12/2017 25/01/2018 52813660 5,634,200
99 PT. MILLENIUM PHARMACON I 4853 29/12/2017 28/01/2018 52818114 14,079,713
100 PT. MILLENIUM PHARMACON I 0270 09/01/2017 08/02/2017 19061095 15,074,145
101 PT. MILLENIUM PHARMACON I 0271 09/01/2017 08/02/2017 19061096 11,268,400
102 PT. MILLENIUM PHARMACON I 0339 11/01/2017 10/02/2017 19067722 3,413,025
51,008,545
103 PT. MERAPI UTAMA PHARMA 6068 29/12/2016 15/02/2017 07436419 32,012,500
104 PT. MERAPI UTAMA PHARMA 0843 29/01/2017 18/03/2017 82951211 777,904
105 PT. MERAPI UTAMA PHARMA 0897 20/01/2017 09/03/2017 82953214 957,420
106 PT. MERAPI UTAMA PHARMA 1395 31/01/2017 20/03/2017 82970557 2,881,125
107 PT. MERAPI UTAMA PHARMA 1480 02/02/2017 22/03/2017 82982503 2,534,558
108 PT. MERAPI UTAMA PHARMA 1657 06/02/2017 26/03/2017 82986546 2,187,778
109 PT. MERAPI UTAMA PHARMA 1658 06/02/2017 26/03/2017 82986547 1,615,400
110 PT. MERAPI UTAMA PHARMA 1267 30/01/2017 19/03/2017 82969809 361,101
111 PT. MERAPI UTAMA PHARMA 1303 30/01/2017 19/03/2017 82969812 11,961,667
112 PT. MERAPI UTAMA PHARMA 1515 02/02/2017 22/03/2017 82982504 19,599,175
113 PT. MERAPI UTAMA PHARMA 1659 06/02/2017 26/03/2017 82986548 3,443,757
114 PT. MERAPI UTAMA PHARMA 1811 09/02/2017 29/03/2017 82988915 24,765,363
115 PT. MERAPI UTAMA PHARMA 1838 09/02/2017 29/03/2017 82988918 1,680,656
116 PT. MERAPI UTAMA PHARMA 1918 10/02/2017 30/03/2017 82989620 1,891,200
117 PT. MERAPI UTAMA PHARMA 1984 13/02/2017 02/04/2017 82989772 5,592,263
118 PT. MERAPI UTAMA PHARMA 2050 13/02/2017 02/04/2017 82989780 2,456,344
119 PT. MERAPI UTAMA PHARMA 1919 10/02/2017 30/03/2017 82989621 5,739,595
120 PT. MERAPI UTAMA PHARMA 2127 16/02/2017 05/04/2017 82997985 18,380,967
121 PT. MERAPI UTAMA PHARMA 2251 18/02/2017 07/04/2017 83003407 5,003,800
122 PT. MERAPI UTAMA PHARMA 2126 16/02/2017 05/04/2017 82997984 760,367
144,602,940
123 PT. DOS NI ROHA 7740 26/01/2017 25/02/2017 92971395 14,455,860
124 PT. DOS NI ROHA 3653 27/01/2017 26/02/2017 92976475 1,555,808
125 PT. DOS NI ROHA 3649 28/01/2017 27/02/2017 92976474 7,035,945
126 PT. DOS NI ROHA 3777 31/01/2017 02/03/2017 92982951 10,988,906
127 PT. DOS NI ROHA 2303 31/01/2017 02/03/2017 92982901 1,440,563
128 PT. DOS NI ROHA 2302 31/01/2017 02/03/2017 92982900 4,090,380
129 PT. DOS NI ROHA 7281 02/02/2017 04/03/2017 93028483 4,373,968
130 PT. DOS NI ROHA 5417 02/02/2017 04/03/2017 93034052 9,775,658
131 PT. DOS NI ROHA 6902 02/02/2017 04/03/2017 93028482 2,898,382
132 PT. DOS NI ROHA 7891 02/02/2017 04/03/2017 93028484 11,852,013
133 PT. DOS NI ROHA 5251 04/02/2017 06/03/2017 93034052 3,861,200
134 PT. DOS NI ROHA 4610 04/02/2017 06/03/2017 93034048 912,622
135 PT. DOS NI ROHA 8678 06/02/2017 08/03/2017 93034064 13,707,260
136 PT. DOS NI ROHA 5023 07/02/2017 09/03/2017 93037659 3,267,152
137 PT. DOS NI ROHA 1790 07/02/2017 09/03/2017 93037653 4,609,800
138 PT. DOS NI ROHA 1931 07/02/2017 09/03/2017 93037654 3,601,406
139 PT. DOS NI ROHA 9377 08/02/2017 10/03/2017 93037665 3,324,375
140 PT. DOS NI ROHA 9378 08/02/2017 10/03/2017 93037666 11,591,726
141 PT. DOS NI ROHA 9421 08/02/2017 10/03/2017 93037667 6,162,528
142 PT. DOS NI ROHA 3372 09/02/2017 11/03/2017 93046952 9,653,000
143 PT. DOS NI ROHA 3070 09/02/2017 11/03/2017 93046948 1,064,864
144 PT. DOS NI ROHA 4867 11/02/2017 13/03/2017 93046972 1,285,425
145 PT. DOS NI ROHA 3473 14/02/2017 16/03/2017 93056551 4,973,029
146 PT. DOS NI ROHA 3920 14/02/2017 16/03/2017 93056554 22,178,260
147 PT. DOS NI ROHA 3388 14/02/2017 16/03/2017 93056547 1,428,250
148 PT. DOS NI ROHA 3937 14/02/2017 16/03/2017 93056558 3,153,497
149 PT. DOS NI ROHA 3936 14/02/2017 16/03/2017 93056557 11,882,882
175,124,758
150 PT. BHAKTI SEJAHTERA M P001 04/01/2017 03/02/2017 3,378,550
151 PT. BHAKTI SEJAHTERA M P003 14/01/2017 13/02/2017 3,901,585
152 PT. BHAKTI SEJAHTERA M P015 20/01/2017 19/02/2017 2,299,975
153 PT. BHAKTI SEJAHTERA M P137 31/01/2017 02/03/2017 2,659,500
154 PT. BHAKTI SEJAHTERA M P229 04/02/2017 06/03/2017 4,255,200
155 PT. BHAKTI SEJAHTERA M P268 21/02/2017 23/03/2017 3,201,250
19,696,060
156 PT. PARIT PADANG GLOBAL 0706 24/01/2017 14/02/2017 26805505 345,735
157 PT. PARIT PADANG GLOBAL 0737 24/01/2017 14/02/2017 26808406 18,131,663
158 PT. PARIT PADANG GLOBAL 0849 26/01/2017 16/02/2017 26816073 354,994
159 PT. PARIT PADANG GLOBAL 0833 26/01/2017 16/02/2017 26815004 5,634,200
160 PT. PARIT PADANG GLOBAL 1282 03/02/2017 24/02/2017 26945094 1,276,021
161 PT. PARIT PADANG GLOBAL 1366 06/02/2017 27/02/2017 26949939 5,709,799
162 PT. PARIT PADANG GLOBAL 1518 08/02/2017 01/03/2017 26960922 18,861,174
163 PT. PARIT PADANG GLOBAL 1542 09/02/2017 02/03/2017 26964439 4,225,650
164 PT. PARIT PADANG GLOBAL 0697 24/01/2017 14/02/2017 26805367 19,234,686
165 PT. PARIT PADANG GLOBAL 0865 26/01/2017 16/02/2017 26816443 3,362,692
166 PT. PARIT PADANG GLOBAL 0866 26/01/2017 16/02/2017 26816649 3,840,909
167 PT. PARIT PADANG GLOBAL 1021 30/01/2017 20/02/2017 26826217 449,899
168 PT. PARIT PADANG GLOBAL 1025 30/01/2017 20/02/2017 26826349 23,149,864
169 PT. PARIT PADANG GLOBAL 1156 31/01/2017 21/02/2017 26837666 7,106,775
111,684,060
170 PT. MITRA SEJATI MEDIKA 022 04/01/2017 03/02/2017 47379172 32,323,809
32,323,809
171 PT. ENSEVAL PUTERA 1962 19/01/2017 20/03/2017 12972444 40,832,880
172 PT. ENSEVAL PUTERA 0055 19/01/2017 20/03/2017 12972846 1,692,417
173 PT. ENSEVAL PUTERA 3468 01/02/2017 02/04/2017 13119500 40,069,160
174 PT. ENSEVAL PUTERA 3474 01/02/2017 02/04/2017 13119871 4,772,325
175 PT. ENSEVAL PUTERA 0079 30/01/2017 31/03/2017 13080959 17,222,922
176 PT. ENSEVAL PUTERA 0085 31/01/2017 01/04/2017 13099384 40,186,818
177 PT. ENSEVAL PUTERA 0089 01/02/2017 02/04/2017 13121017 25,857,373
178 PT. ENSEVAL PUTERA 0090 01/02/2017 02/04/2017 13122027 6,419,065
179 PT. ENSEVAL PUTERA 2304 23/01/2017 24/03/2017 13004341 4,206,935
180 PT. ENSEVAL PUTERA 2935 27/01/2017 28/03/2017 13063095 403,850
181 PT. ENSEVAL PUTERA 2879 26/01/2017 27/03/2017 13055102 28,414,307
182 PT. ENSEVAL PUTERA 2878 26/01/2017 27/03/2017 13054595 27,585,723
183 PT. ENSEVAL PUTERA 2474 24/01/2017 25/03/2017 13020331 453,100
184 PT. ENSEVAL PUTERA 2269 23/01/2017 24/03/2017 13002306 1,024,400
239,141,274
185 PT. KIMIA FARMA 8387 17/01/2017 07/02/2017 45819317 852,025
186 PT. KIMIA FARMA 1353 20/01/2017 10/02/2017 45821133 940,183
187 PT. KIMIA FARMA 2682 21/01/2017 11/02/2017 45825363 4,018,101
188 PT. KIMIA FARMA 2696 21/01/2017 11/02/2017 45825364 889,948
189 PT. KIMIA FARMA 2289 26/01/2017 16/02/2017 45831976 5,496,300
190 PT. KIMIA FARMA 1936 11/02/2017 04/03/2017 45861396 26,596,709
38,793,265
191 PT. UNITED DICO CITAS 4560 03/02/2017 24/02/2017 29974851 804,423
192 PT. UNITED DICO CITAS 4603 03/02/2017 24/02/2017 29974852 4,921,921
193 PT. UNITED DICO CITAS 4288 29/12/2017 19/01/2018 98893301 22,816,010
194 PT. UNITED DICO CITAS 4294 29/12/2017 19/01/2018 98893307 3,961,948
32,504,302
195 PT. INDO FARMA GLOBAL M 0059 12/01/2017 26/02/2017 4,062,803
196 PT. INDO FARMA GLOBAL M 0060 12/01/2017 26/02/2017 715,110
4,777,913
197 PT. INDO FARMA GLOBAL M 0090 13/01/2017 27/02/2017 6,011,579
198 PT. INDO FARMA GLOBAL M 0142 16/01/2017 02/03/2017 1,853,672
199 PT. INDO FARMA GLOBAL M 0216 19/01/2017 05/03/2017 2,327,824
200 PT. INDO FARMA GLOBAL M 0306 25/01/2017 11/03/2017 91,694
201 PT. INDO FARMA GLOBAL M 0309 25/01/2017 11/03/2017 1,554,957
202 PT. INDO FARMA GLOBAL M 0410 01/02/2017 18/03/2017 1,365,210
203 PT. INDO FARMA GLOBAL M 0411 01/02/2017 18/03/2017 1,749,002
204 PT. INDO FARMA GLOBAL M 0506 03/02/2017 20/03/2017 2,708,750
17,662,686
205 PT. TEMPO 9629 20/02/2017 22/03/2017 17113382 6,447,273
206 PT. TEMPO 9575 20/02/2017 22/03/2017 17113389 14,215,341
207 PT. TEMPO 7135 25/01/2017 24/02/2017 16991718 8,083,268
208 PT. TEMPO 7136 25/01/2017 24/02/2017 16991717 4,351,909
33,097,791
TOTAL

Mengetahui,
Kepala Instalasi Farmasi

TONI DAFIAPUTRA, S.FARM, APT


NIP.19841023 200803 1 001

LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG


BHP RUTIN
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
01 Maret 2017
NO DISTRIBUTOR NO FACT TGL FACT JT. TEMPO NO.F STDR TAGIHAN
1 PT. BHAKTI SEJAHTERA M P002 04/01/2017 7,323,475
2 PT. BHAKTI SEJAHTERA M P004 17/01/2017 8,155,800
3 PT. BHAKTI SEJAHTERA M P016 20/01/2017 14,509,050
4 PT. BHAKTI SEJAHTERA M P138 31/01/2017 5,914,925
35,903,250
5 PT. ANUGRAH ARGON M 1656 02/02/2017 69935588 3,378,857

6 PT. MENSA BINA SUKSES 6127 10/01/2017 83219628 1,744,435


7 PT. MENSA BINA SUKSES 1451 11/01/2017 83224885 1,970,000
3,714,435
8 PT. MUARA NATIO P 2502 23/01/2017 99872502 1,042,309
9 PT. MUARA NATIO P 2503 08/02/2017 99872503 12,595,688
10 PT. MUARA NATIO P 2504 10/02/2017 99872504 16,621,875
30,259,872
11 PT. SAPTA SARI 4146 13/01/2017 98744659 1,656,770
12 PT. SAPTA SARI 4313 17/01/2017 98750942 3,313,540
13 PT. SAPTA SARI 5253 27/01/2017 98766418 538,549
14 PT. SAPTA SARI 5783 07/02/2017 98782564 5,587,905
retur 11,096,764
15 PT. HOTAMA MEDIPHAR 7177 25/01/2017 03367177 16,646,500

16 PT. MUTIARA LABSAINS 0125 16/01/2017 34826264 12,617,850


17 PT. MUTIARA LABSAINS 0195 23/01/2017 34826334 1,595,700
18 PT. MUTIARA LABSAINS 0207 23/01/2017 34826346 2,511,750
19 PT. MUTIARA LABSAINS 0283 31/01/2017 34826422 2,561,000
20 PT. MUTIARA LABSAINS 3651 23/12/2017 05232729 10,926,605
21 PT. MUTIARA LABSAINS 3382 23/12/2017 05232533 1,970,000
32,182,905
22 PT. AFINA SC 0310 25/01/2017 29314840 14,144,600

23 PT. CITRA PURNAMA S 0005 25/01/2017 01880990 2,659,500


24 PT. CITRA PURNAMA S 0006 31/01/2017 01880991 3,211,691
25 PT. CITRA PURNAMA S 0008 06/02/2017 01880993 4,629,500
26 PT. CITRA PURNAMA S 0009 13/02/2017 01880994 2,807,250
27 PT. CITRA PURNAMA S 0010 13/02/2017 01880995 935,750
28 PT. CITRA PURNAMA S 0011 14/02/2017 01880996 5,959,250
29 PT. CITRA PURNAMA S 0012 16/02/2017 01880997 1,182,000
30 PT. CITRA PURNAMA S 0013 17/02/2017 01880998 6,087,300
27,472,241
31 PT. BIO MULTI MEDIKA 0017 30/01/2017 01880999 32,765,040
32 PT. BIO MULTI MEDIKA 0018 02/02/2017 01880995 32,140,944
33 PT. BIO MULTI MEDIKA 0019 02/02/2017 01880996 3,792,250
34 PT. BIO MULTI MEDIKA 0023 07/02/2017 01880997 5,161,400
35 PT. BIO MULTI MEDIKA 0024 07/02/2017 01880998 3,743,000
36 PT. BIO MULTI MEDIKA 0025 07/02/2017 01880999 37,741,260
37 PT. BIO MULTI MEDIKA 0026 08/02/2017 01881000 11,357,050
38 PT. BIO MULTI MEDIKA 0028 10/02/2017 01881001 16,351,394
39 PT. BIO MULTI MEDIKA 0029 10/02/2017 01881002 4,895,450
40 PT. BIO MULTI MEDIKA 0031 14/02/2017 01881003 21,807,900
41 PT. BIO MULTI MEDIKA 0032 15/02/2017 01881004 31,290,791
42 PT. BIO MULTI MEDIKA 0033 15/02/2017 01880999 43,783,250
43 PT. BIO MULTI MEDIKA 0034 16/02/2017 01881000 43,838,410
44 PT. BIO MULTI MEDIKA 0035 16/02/2017 01881001 36,558,275
45 PT. BIO MULTI MEDIKA 0036 17/02/2017 01881002 30,308,450
46 PT. BIO MULTI MEDIKA 0038 18/02/2017 01881003 12,942,900
47 PT. BIO MULTI MEDIKA 0039 18/02/2017 01881004 25,531,200
48 PT. BIO MULTI MEDIKA 0040 20/02/2017 01881005 10,892,130
49 PT. BIO MULTI MEDIKA 0041 21/02/2017 01881006 38,524,532
50 PT. BIO MULTI MEDIKA 0042 21/02/2017 01881007 3,028,875
446,454,501
51 PT. ENSEVAL PUTERA 0732 27/12/2016 18632443 6,715,484
52 PT. ENSEVAL PUTERA 0733 27/12/2016 18632444 26,102,140
53 PT. ENSEVAL PUTERA 1168 27/12/2016 18631863 5,427,882
54 PT. ENSEVAL PUTERA 0777 10/01/2017 12863866 2,955,000
55 PT. ENSEVAL PUTERA 0049 29/01/2017 12962894 7,533,800
56 PT. ENSEVAL PUTERA 0742 23/01/2017 13002011 11,141,159
57 PT. ENSEVAL PUTERA 2283 23/01/2017 13003076 11,628,762
58 PT. ENSEVAL PUTERA 2472 24/01/2017 13020332 344,750
59 PT. ENSEVAL PUTERA 2483 24/01/2017 13021316 6,770,496
60 PT. ENSEVAL PUTERA 2833 26/01/2017 13051569 738,750
61 PT. ENSEVAL PUTERA 3399 31/01/2017 13108698 1,713,710
62 PT. ENSEVAL PUTERA 0094 02/02/2017 13134665 3,039,728
63 PT. ENSEVAL PUTERA 3677 03/01/2017 13140567 5,696,885
89,808,547
TOTAL

Mengetahui,
Kepala Instalasi Farmasi

TONI DAFIAPUTRA, S.FARM, APT


NIP.19841023 200803 1 001
MBAYARAN HUTANG

FIE MUARA BUNGO

PPN PPH SUB TOTAL TOTAL


186,796 28,019 2,054,759
189,633 28,445 2,085,959
174,000 26,100 1,914,000
131,818 19,773 1,450,000
35,015 5,252 385,169
691,854 103,778 7,610,396
7,409 1,111 81,496
109,603 16,440 1,205,635
90,000 13,500 990,000
150,000 22,500 1,650,000
370,440 55,566 4,074,840
169,200 25,380 1,861,200
162,354 24,353 1,785,898
164,340 24,651 1,807,738
2,632,463 394,869 28,957,090
2,558,961 383,844 28,148,574
2,788,387 418,258 30,672,259
567,572 85,136 6,243,295
186,187 27,928 2,048,062
4,493,084 673,963 49,423,922
253,575 38,036 2,789,325
1,402,188 210,328 15,424,067
455,419 68,313 5,009,613
976,053 146,408 10,736,580
403,567 60,535 4,439,239
703,733 105,560 7,741,063
1,178,627 176,794 12,964,896
140,717 21,108 1,547,885
401,965 60,295 4,421,618
535,935 80,390 5,895,285
45,454 6,818 499,999
45,454 6,818 499,999
1,799,730 269,959 19,797,025
32,250 4,838 354,750
25,357 3,804 278,932
1,174,677 176,201 12,921,442
641,500 96,225 7,056,500
1,435,964 215,395 15,795,609
90,000 13,500 990,000
22,336,358 3,350,454 245,699,939
256,225 38,434 2,818,475
849,945 127,492 9,349,395
2,440,489 366,073 26,845,376
157,700 23,655 1,734,700
142,500 21,375 1,567,500
1,786,000 267,900 19,646,000
288,000 43,200 3,168,000
54,400 8,160 598,400
1,897,550 284,633 20,873,050
385,217 57,783 4,237,389
438,750 65,813 4,826,250
703,000 105,450 7,733,000
1,349,475 202,421 14,844,225
665,983 99,897 7,325,814
96,000 14,400 1,056,000
241,800 36,270 2,659,800
11,753,034 1,762,955 129,283,374
571,711 85,757 6,288,826
453,400 68,010 4,987,400
1,016,908 152,536 11,185,990
763,091 114,464 8,394,001
452,011 67,802 4,972,125
243,619 36,543 2,679,813
793,180 118,977 8,724,980
120,000 18,000 1,320,000
381,818 57,273 4,199,998
380,000 57,000 4,180,000
1,098,545 164,782 12,084,000
771,592 115,739 8,487,512
13,182 1,977 144,999
76,000 11,400 836,000
707,272 106,091 7,779,996
7,842,331 1,176,350 86,265,640
157,340 23,601 1,730,740
302,000 45,300 3,322,000
371,400 55,710 4,085,400
336,118 50,418 3,697,294
54,720 8,208 601,920
226,000 33,900 2,486,000
132,020 19,803 1,452,220
560,680 84,102 6,167,480
512,070 76,811 5,632,770
410,960 61,644 4,520,560
1,754,790 263,219 19,302,690
4,818,098 722,715 52,999,074
4,927,575 739,136 54,203,325
2,560,250 384,038 28,162,750
2,097,600 314,640 23,073,600
412,500 61,875 4,537,500
585,200 87,780 6,437,200
448,155 67,223 4,929,707
95,744 14,362 1,053,180
912,900 136,935 10,041,900
265,019 39,753 2,915,211
532,355 79,853 5,855,907
1,838,000 275,700 20,218,000
610,312 91,547 6,713,437
4,550,335 682,550 50,053,685
598,500 89,775 6,583,500
137,340 20,601 1,510,740
650,324 97,549 7,153,569
21,222,110 3,183,317 233,443,211
156,250 23,438 1,718,750
572,000 85,800 6,292,000
1,429,412 214,412 15,723,537
1,530,370 229,556 16,834,070
1,144,000 171,600 12,584,000
346,500 51,975 3,811,500
5,178,532 776,780 56,963,857
3,250,000 487,500 35,750,000
78,975 11,846 868,725
97,200 14,580 1,069,200
292,500 43,875 3,217,500
257,316 38,597 2,830,471
222,109 33,316 2,443,204
164,000 24,600 1,804,000
36,660 5,499 403,260
1,214,382 182,157 13,358,207
1,989,764 298,465 21,887,404
349,620 52,443 3,845,820
2,514,250 377,138 27,656,750
170,625 25,594 1,876,875
192,000 28,800 2,112,000
567,742 85,161 6,245,167
249,375 37,406 2,743,125
582,700 87,405 6,409,700
1,866,088 279,913 20,526,968
508,000 76,200 5,588,000
77,195 11,579 849,141
14,680,502 2,202,075 161,485,517
1,467,600 220,140 16,143,600
157,950 23,693 1,737,450
714,309 107,146 7,857,401
1,115,625 167,344 12,271,875
146,250 21,938 1,608,750
415,267 62,290 4,567,937
444,058 66,609 4,884,634
992,453 148,868 10,916,978
294,252 44,138 3,236,772
1,203,250 180,488 13,235,750
392,000 58,800 4,312,000
92,652 13,898 1,019,172
1,391,600 208,740 15,307,600
331,691 49,754 3,648,596
468,000 70,200 5,148,000
365,625 54,844 4,021,875
337,500 50,625 3,712,500
1,176,825 176,524 12,945,075
625,637 93,846 6,882,011
980,000 147,000 10,780,000
108,108 16,216 1,189,188
130,500 19,575 1,435,500
504,876 75,731 5,553,636
2,251,600 337,740 24,767,600
145,000 21,750 1,595,000
320,152 48,023 3,521,672
1,206,384 180,958 13,270,224
17,779,163 2,666,874 195,570,796
343,000 51,450 3,773,000
396,100 59,415 4,357,100
233,500 35,025 2,568,500
270,000 40,500 2,970,000
432,000 64,800 4,752,000
325,000 48,750 3,575,000
1,999,600 299,940 21,995,600
35,100 5,265 386,100
1,840,778 276,117 20,248,558
36,040 5,406 396,440
572,000 85,800 6,292,000
129,545 19,432 1,424,998
579,675 86,951 6,376,425
1,914,840 287,226 21,063,240
429,000 64,350 4,719,000
1,952,760 292,914 21,480,360
341,390 51,209 3,755,290
389,940 58,491 4,289,340
45,675 6,851 502,425
2,350,240 352,536 25,852,640
721,500 108,225 7,936,500
11,338,483 1,700,772 124,723,316
3,281,605 492,241 36,097,655
3,281,605 492,241 36,097,655
4,145,470 621,821 45,600,170
171,819 25,773 1,890,009
4,067,935 610,190 44,747,285
484,500 72,675 5,329,500
1,748,520 262,278 19,233,720
4,079,880 611,982 44,878,680
2,625,114 393,767 28,876,254
651,682 97,752 7,168,499
427,100 64,065 4,698,100
41,000 6,150 451,000
2,884,701 432,705 31,731,713
2,800,581 420,087 30,806,391
46,000 6,900 506,000
104,000 15,600 1,144,000
24,278,302 3,641,745 267,061,321
86,500 12,975 951,500
95,450 14,318 1,049,950
407,929 61,189 4,487,219
90,350 13,553 993,850
558,000 83,700 6,138,000
2,700,174 405,026 29,701,909
3,938,403 590,760 43,322,428
81,667 12,250 898,340
499,687 74,953 5,496,562
2,316,346 347,452 25,479,808
402,228 60,334 4,424,510
3,299,929 494,989 36,299,220
412,467 61,870 4,537,140
72,600 10,890 798,600
485,067 72,760 5,335,740
610,313 91,547 6,713,438
188,190 28,229 2,070,090
236,327 35,449 2,599,600
9,309 1,396 102,399
157,864 23,680 1,736,500
138,600 20,790 1,524,600
177,564 26,635 1,953,200
275,000 41,250 3,025,000
1,793,166 268,975 19,724,827
654,545 98,182 7,200,000
1,443,182 216,477 15,875,000
820,636 123,095 9,027,000
441,818 66,273 4,860,000
3,360,182 504,027 36,962,000
1,782,190,605 1,782,190,605

Muara Bungo, 13 Maret 2017

AYU TRESNAWATI
NIP 19660908 198803 2 002

MBAYARAN HUTANG

FIE MUARA BUNGO

PPN PPH SUB TOTAL TOTAL


743,500 111,525 8,178,500
828,000 124,200 9,108,000
1,473,000 220,950 16,203,000
600,500 90,075 6,605,500
3,645,000 546,750 40,095,000
343,031 51,455 3,773,343
3,773,343
177,100 26,565 1,948,100
200,000 30,000 2,200,000
377,100 56,565 4,148,100
105,818 15,873 1,164,000
1,278,750 191,813 14,066,250
1,687,500 253,125 18,562,500
3,072,068 460,810 33,792,750
168,200 25,230 1,850,200
336,400 50,460 3,700,400
54,675 8,201 601,425
567,300 85,095 6,240,300
1,126,575 168,986 12,392,325
1,690,000 253,500 18,590,000
18,590,000
1,281,000 192,150 14,091,000
162,000 24,300 1,782,000
255,000 38,250 2,805,000
260,000 39,000 2,860,000
1,109,300 166,395 12,202,300
200,000 30,000 2,200,000
3,267,300 490,095 35,940,300
1,436,000 215,400 15,796,000
15,796,000
270,000 40,500 2,970,000
326,060 48,909 3,586,660
470,000 70,500 5,170,000
285,000 42,750 3,135,000
95,000 14,250 1,045,000
605,000 90,750 6,655,000
120,000 18,000 1,320,000
618,000 92,700 6,798,000
2,789,060 418,359 30,679,660
3,326,400 498,960 36,590,400
3,263,040 489,456 35,893,440
385,000 57,750 4,235,000
524,000 78,600 5,764,000
380,000 57,000 4,180,000
3,831,600 574,740 42,147,600
1,153,000 172,950 12,683,000
1,660,040 249,006 18,260,440
497,000 74,550 5,467,000
2,214,000 332,100 24,354,000
3,176,730 476,510 34,944,030
4,445,000 666,750 48,895,000
4,450,600 667,590 48,956,600
3,711,500 556,725 40,826,500
3,077,000 461,550 33,847,000
1,314,000 197,100 14,454,000
2,592,000 388,800 28,512,000
1,105,800 165,870 12,163,800
3,911,120 586,668 43,022,320
307,500 46,125 3,382,500
45,325,330 6,798,800 498,578,630
681,775 102,266 7,499,525
2,649,963 397,495 29,149,598
551,054 82,658 6,061,594
300,000 45,000 3,300,000
764,853 114,728 8,413,381
1,131,082 169,662 12,441,904
1,180,585 177,088 12,986,435
35,000 5,250 385,000
687,360 103,104 7,560,960
75,000 11,250 825,000
173,981 26,097 1,913,788
308,602 46,290 3,394,620
578,364 86,755 6,362,004
9,117,619 1,367,643 100,293,809
794,079,917 794,079,917

Muara Bungo, 1 Maret 2017

AYU TRESNAWATI
NIP 19660908 198803 2 002
LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG
OBAT REGULER
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
17 April 2017
NO DISTRIBUTOR NO FACT TGL.FACT JT. TEMPO NO.F STDR TAGIHAN
1 PT. RAJAWALI NUSINDO 0704 06/02/2017 08/03/2017 03195544 2,586,766
2 PT. RAJAWALI NUSINDO 0704 06/02/2017 08/03/2017 03195544 2,586,766
3 PT. RAJAWALI NUSINDO 0770 08/02/2017 10/03/2017 03195610 179,989
4 PT. RAJAWALI NUSINDO 0770 08/02/2017 10/03/2017 03195610 179,989
5 PT. RAJAWALI NUSINDO 0795 09/02/2017 11/03/2017 03195635 1,764,135
6 PT. RAJAWALI NUSINDO 0795 09/02/2017 11/03/2017 03195635 1,764,135
7 PT. RAJAWALI NUSINDO 0851 13/02/2017 15/03/2017 03195689 359,978
8 PT. RAJAWALI NUSINDO 0851 13/02/2017 15/03/2017 03195689 359,978
9 PT. RAJAWALI NUSINDO 0991 20/02/2017 22/03/2017 03195825 4,627,798
10 PT. RAJAWALI NUSINDO 0991 20/02/2017 22/03/2017 03195825 4,627,798
11 PT. RAJAWALI NUSINDO 1059 22/02/2017 24/03/2017 03195893 6,365,732
12 PT. RAJAWALI NUSINDO 1060 22/02/2017 24/03/2017 03195894 6,136,550
13 PT. RAJAWALI NUSINDO 1059 22/02/2017 24/03/2017 03195893 6,365,732
14 PT. RAJAWALI NUSINDO 1060 22/02/2017 24/03/2017 03195894 6,136,550
15 PT. RAJAWALI NUSINDO 1085 23/02/2017 25/03/2017 03195919 702,931
16 PT. RAJAWALI NUSINDO 1085 23/02/2017 25/03/2017 03195927 702,931
17 PT. RAJAWALI NUSINDO 1209 01/03/2017 31/03/2017 03196041 2,054,422
18 PT. RAJAWALI NUSINDO 1210 01/03/2017 31/03/2017 03196042 728,279
19 PT. RAJAWALI NUSINDO 1391 09/03/2017 08/04/2017 03196219 5,917,289
20 PT. RAJAWALI NUSINDO 1392 09/03/2017 08/04/2017 03196220 843,517
21 PT. RAJAWALI NUSINDO 1393 09/03/2017 08/04/2017 03196221 4,387,045
22 PT. RAJAWALI NUSINDO 1394 09/03/2017 08/04/2017 03196222 179,989
59,558,298
23 PT. ANUGRAH ARGON M 2525 18/02/2012 18/04/2012 70001864 687,629
24 PT. ANUGRAH ARGON M 2526 18/02/2012 18/04/2012 70001865 11,523,166
25 PT. ANUGRAH ARGON M 2527 18/02/2012 18/04/2012 70001866 1,126,840
26 PT. ANUGRAH ARGON M 2528 18/02/2012 18/04/2012 70001867 3,730,464
27 PT. ANUGRAH ARGON M 2590 20/02/2012 20/04/2012 70006601 9,429,135
28 PT. ANUGRAH ARGON M 2022 09/02/2017 10/04/2017 69964884 5,727,632
29 PT. ANUGRAH ARGON M 2318 14/02/2017 15/04/2017 69985763 11,124,344
30 PT. ANUGRAH ARGON M 2319 14/02/2017 15/04/2017 69985764 10,200,131
31 PT. ANUGRAH ARGON M 2320 14/02/2017 15/04/2017 69985765 6,120,078
32 PT. ANUGRAH ARGON M 2321 14/02/2017 15/04/2017 69985766 1,278,081
33 PT. ANUGRAH ARGON M 2322 14/02/2017 15/04/2017 69985767 11,963,586
34 PT. ANUGRAH ARGON M 2386 16/02/2017 17/04/2017 69991492 4,705,868
35 PT. ANUGRAH ARGON M 2393 16/02/2017 17/04/2017 69991647 3,895,226
36 PT. ANUGRAH ARGON M 2820 23/02/2017 24/04/2017 70024733 483,545
37 PT. ANUGRAH ARGON M 2812 23/02/2017 24/04/2017 70024725 6,603,256
38 PT. ANUGRAH ARGON M 2815 23/02/2017 24/04/2017 70024728 6,485,498
39 PT. ANUGRAH ARGON M 2816 23/02/2017 24/04/2017 70024729 4,353,700
40 PT. ANUGRAH ARGON M 2817 23/02/2017 24/04/2017 70024730 1,433,023
41 PT. ANUGRAH ARGON M 2818 23/02/2017 24/04/2017 70024731 13,647,101
42 PT. ANUGRAH ARGON M 2819 23/02/2017 24/04/2017 70024732 6,962,571
43 PT. ANUGRAH ARGON M 2879 24/02/2017 25/04/2017 70030289 1,170,180
44 PT. ANUGRAH ARGON M 2927 25/02/2017 26/04/2017 70035040 3,584,979
45 PT. ANUGRAH ARGON M 2929 25/02/2017 26/04/2017 70035042 2,974,700
46 PT. ANUGRAH ARGON M 2928 26/02/2017 27/04/2017 70035041 9,330,509
47 PT. ANUGRAH ARGON M 3123 28/02/2017 29/04/2017 70050066 655,473
48 PT. ANUGRAH ARGON M 3117 28/02/2017 29/04/2017 70050060 4,012,256
49 PT. ANUGRAH ARGON M 3118 28/02/2017 29/04/2017 70050061 10,351,392
50 PT. ANUGRAH ARGON M 3119 28/02/2017 29/04/2017 70050062 10,631,384
51 PT. ANUGRAH ARGON M 3120 28/02/2017 29/04/2017 70050063 1,888,883
52 PT. ANUGRAH ARGON M 3121 28/02/2017 29/04/2017 70050064 3,729,269
53 PT. ANUGRAH ARGON M 3122 28/02/2017 29/04/2017 70050065 537,383
54 PT. ANUGRAH ARGON M 3144 28/02/2017 29/04/2017 70050748 886,500
55 PT. ANUGRAH ARGON M 3311 03/03/2017 02/05/2017 70064209 14,520,892
56 PT. ANUGRAH ARGON M 3312 03/03/2017 02/05/2017 70064210 5,616,089
57 PT. ANUGRAH ARGON M 3315 03/03/2017 02/05/2017 70065062 6,268,735
58 PT. ANUGRAH ARGON M 3455 07/03/2017 06/05/2017 70075452 1,516,900
59 PT. ANUGRAH ARGON M 3456 07/03/2017 06/05/2017 70075453 1,253,785
60 PT. ANUGRAH ARGON M 3617 09/03/2017 08/05/2017 70087245 21,073,164
61 PT. ANUGRAH ARGON M 3620 09/03/2017 08/05/2017 70087248 4,029,545
62 PT. ANUGRAH ARGON M 3621 09/03/2017 08/05/2017 70087249 6,324,425
63 PT. ANUGRAH ARGON M 3623 09/03/2017 08/05/2017 70087251 4,184,396
64 PT. ANUGRAH ARGON M 3624 09/03/2017 08/05/2017 70087252 3,608,055
65 PT. ANUGRAH ARGON M 3681 10/03/2017 09/05/2017 70092342 1,791,356
66 PT. ANUGRAH ARGON M 3682 10/03/2017 09/05/2017 70092343 6,737,400
248,158,524
67 PT. PENTA VALENT 2160 17/02/2017 19/03/2017 84083229 2,021,220
68 PT. PENTA VALENT 2163 17/02/2017 19/03/2017 84083232 4,388,541
69 PT. PENTA VALENT 2284 21/02/2017 23/03/2017 84088899 7,673,150
70 PT. PENTA VALENT 2386 23/02/2017 25/03/2017 84094834 8,130,956
71 PT. PENTA VALENT 2409 23/02/2017 25/03/2017 84094855 1,279,023
72 PT. PENTA VALENT 2610 28/02/2017 30/03/2017 84108327 5,983,875
73 PT. PENTA VALENT 3026 09/03/2017 08/04/2017 84130279 5,943,908
35,420,673
74 PT. ANUGRAH PHARMINDO L 4385 02/02/2017 03/04/2017 06166294 1,027,178
75 PT. ANUGRAH PHARMINDO L 2196 13/02/2017 15/03/2017 05969875 722,627
76 PT. ANUGRAH PHARMINDO L 3935 01/03/2017 31/03/2017 06144028 9,373,222
77 PT. ANUGRAH PHARMINDO L 4384 07/03/2017 06/04/2017 06166293 348,331
78 PT. ANUGRAH PHARMINDO L 4427 07/03/2017 06/04/2017 06166298 468,860
79 PT. ANUGRAH PHARMINDO L 4446 07/03/2017 06/04/2017 06166299 4,566,854
80 PT. ANUGRAH PHARMINDO L 4615 08/03/2017 07/04/2017 06166300 3,032,069
RETUR 8,854,611 19,539,141
81 PT. BINA SAN PRIMA 0984 09/03/2017 08/04/2017 86057310 1,468,753
82 PT. BINA SAN PRIMA 0985 09/03/2017 08/04/2017 86057311 3,432,725
83 PT. BINA SAN PRIMA 1914 17/03/2017 16/04/2017 86058235 7,495,358
84 PT. BINA SAN PRIMA 1915 17/03/2017 16/04/2017 86058236 3,227,079
85 PT. BINA SAN PRIMA 2550 23/02/2017 25/03/2017 86055671 1,936,248
86 PT. BINA SAN PRIMA 2549 23/02/2017 25/03/2017 86055670 8,394,663
87 PT. BINA SAN PRIMA 3152 28/02/2017 30/03/2017 86056272 815,974
88 PT. BINA SAN PRIMA 3159 28/02/2017 30/03/2017 86056279 2,956,379
89 PT. BINA SAN PRIMA 3166 28/02/2017 30/03/2017 86056286 256,100
29,983,278
90 PT. MENSA BINA SUKSES 8975 29/12/2016 28/01/2017 05165900 3,128,384
91 PT. MENSA BINA SUKSES 7368 11/02/2017 13/03/2017 83378518 1,691,950
92 PT. MENSA BINA SUKSES 7369 11/02/2017 13/03/2017 83378519 15,222,781
93 PT. MENSA BINA SUKSES 9455 17/02/2017 19/03/2017 83400291 11,516,862
94 PT. MENSA BINA SUKSES 9452 17/02/2017 19/03/2017 83400288 12,056,893
95 PT. MENSA BINA SUKSES 9458 17/02/2017 19/03/2017 83400294 1,970,000
96 PT. MENSA BINA SUKSES 3250 22/02/2017 24/03/2017 748,117
97 PT. MENSA BINA SUKSES 7010 22/02/2017 24/03/2017 2,718,316
98 PT. MENSA BINA SUKSES 3666 23/02/2017 25/03/2017 41,157,092
99 PT. MENSA BINA SUKSES 3667 23/02/2017 25/03/2017 27,670,620
100 PT. MENSA BINA SUKSES 6599 27/02/2017 29/03/2017 28,311,855
101 PT. MENSA BINA SUKSES 1917 28/02/2017 30/03/2017 17,433,515
163,626,385
102 PT. MILLENIUM PHARMACON I 0489 13/01/2017 12/02/2017 19074448 11,268,400
11,268,400
103 PT. MERAPI UTAMA PHARMA 2140 16/02/2017 05/04/2017 82997986 1,440,563
104 PT. MERAPI UTAMA PHARMA 2423 22/02/2017 11/04/2017 83010890 933,780
105 PT. MERAPI UTAMA PHARMA 2594 25/02/2017 14/04/2017 83020326 528,305
106 PT. MERAPI UTAMA PHARMA 2585 25/02/2017 14/04/2017 83020324 5,592,263
107 PT. MERAPI UTAMA PHARMA 2648 27/02/2017 16/04/2017 83020469 12,805,000
108 PT. MERAPI UTAMA PHARMA 2740 28/02/2017 17/04/2017 83020671 4,897,913
109 PT. MERAPI UTAMA PHARMA 2863 03/03/2017 20/04/2017 83030815 5,739,595
110 PT. MERAPI UTAMA PHARMA 2864 03/03/2017 20/04/2017 83030816 1,387,964
111 PT. MERAPI UTAMA PHARMA 2865 03/03/2017 20/04/2017 83030817 2,896,491
112 PT. MERAPI UTAMA PHARMA 2862 03/03/2017 20/04/2017 83030814 506,911
113 PT. MERAPI UTAMA PHARMA 2898 03/03/2017 20/04/2017 83030822 7,350,563
114 PT. MERAPI UTAMA PHARMA 3119 08/03/2017 25/04/2017 83036480 19,671,474
63,750,821
115 PT. DOS NI ROHA 6660 27/02/2017 29/03/2017 93103253 208,881
116 PT. DOS NI ROHA 4823 28/02/2017 30/03/2017 93103788 22,178,260
117 PT. DOS NI ROHA 5567 28/02/2017 30/03/2017 93103815 2,758,000
118 PT. DOS NI ROHA 7436 28/02/2017 30/03/2017 93103829 290,129
119 PT. DOS NI ROHA 6370 28/02/2017 30/03/2017 93103826 17,913,210
120 PT. DOS NI ROHA 6369 28/02/2017 30/03/2017 93103825 8,956,605
121 PT. DOS NI ROHA 5109 28/02/2017 30/03/2017 93103798 1,997,580
122 PT. DOS NI ROHA 5038 02/03/2017 01/04/2017 93140474 6,648,750
123 PT. DOS NI ROHA 9434 03/03/2017 02/04/2017 93140480 5,145,394
124 PT. DOS NI ROHA 3275 17/02/2017 19/03/2017 93064567 2,240,875
125 PT. DOS NI ROHA 0698 18/02/2017 20/03/2017 93064591 1,229,280
126 PT. DOS NI ROHA 5398 20/02/2017 22/03/2017 93065373 7,880,000
127 PT. DOS NI ROHA 9529 23/02/2017 25/03/2017 93083427 14,849,860
128 PT. DOS NI ROHA 1908 23/02/2017 25/03/2017 93083436 165,480
129 PT. DOS NI ROHA 0281 23/02/2017 25/03/2017 93083435 3,398,250
130 PT. DOS NI ROHA 8890 24/02/2017 26/03/2017 93083459 6,785,173
131 PT. DOS NI ROHA 1967 23/02/2017 25/03/2017 93083441 19,471,604
140 PT. DOS NI ROHA 6251 27/02/2017 29/03/2017 93088848 4,018,800
126,136,130
141 PT. PARIT PADANG GLOBAL 1415 07/02/2017 28/02/2017 26954350 2,713,675
2,713,675
142 PT. SAPTA SARI 5990 09/02/2017 02/03/2017 98786283 Rp 2,881,125
143 PT. SAPTA SARI 5989 09/02/2017 02/03/2017 98786303 Rp 2,161,730
5,042,855
144 PT. ENSEVAL PUTERA 4307 08/02/2017 09/04/2017 13193412 23,696,760
145 PT. ENSEVAL PUTERA 4308 08/02/2017 09/04/2017 13193419 19,692,810
146 PT. ENSEVAL PUTERA 4442 09/02/2017 10/04/2017 13206969 2,442,800
147 PT. ENSEVAL PUTERA 4596 10/02/2017 11/04/2017 13220148 2,016,788
148 PT. ENSEVAL PUTERA 0103 08/02/2017 09/04/2017 13185130 1,692,417
149 PT. ENSEVAL PUTERA 0105 08/02/2017 09/04/2017 13193077 1,128,278
150 PT. ENSEVAL PUTERA 0139 14/02/2017 15/04/2017 13259658 7,833,095
151 PT. ENSEVAL PUTERA 5711 20/02/2017 21/04/2017 13314177 1,673,614
152 PT. ENSEVAL PUTERA 5386 17/02/2017 18/04/2017 13286944 496,440
153 PT. ENSEVAL PUTERA 5339 17/02/2017 18/04/2017 13282842 383,914
154 PT. ENSEVAL PUTERA 5213 16/02/2017 17/04/2017 13273476 1,410,343
155 PT. ENSEVAL PUTERA 5178 16/02/2017 17/04/2017 13269698 5,122,000
156 PT. ENSEVAL PUTERA 5098 14/02/2017 15/04/2017 13261392 13,101,854
157 PT. ENSEVAL PUTERA 0143 17/02/2017 18/04/2017 13283937 2,506,376
158 PT. ENSEVAL PUTERA 6132 23/02/2017 24/04/2017 13354248 11,619,799
159 PT. ENSEVAL PUTERA 6133 23/02/2017 24/04/2017 13354250 6,494,105
160 PT. ENSEVAL PUTERA 6137 23/02/2017 24/04/2017 13354240 17,792,351
161 PT. ENSEVAL PUTERA 6145 23/02/2017 24/04/2017 13354880 13,263,025
162 PT. ENSEVAL PUTERA 6173 23/02/2017 24/04/2017 13356821 463,196
163 PT. ENSEVAL PUTERA 6458 25/02/2017 26/04/2017 13387485 4,304,450
164 PT. ENSEVAL PUTERA 6528 25/02/2017 26/04/2017 13389827 1,414,854
165 PT. ENSEVAL PUTERA 0179 25/02/2017 26/04/2017 13386541 259,685
166 PT. ENSEVAL PUTERA 7791 09/03/2017 08/05/2017 13517927 5,560,128
167 PT. ENSEVAL PUTERA 7790 09/03/2017 08/05/2017 13517531 21,358,494
168 PT. ENSEVAL PUTERA 0231 09/03/2017 08/05/2017 13518635 15,477,931
169 PT. ENSEVAL PUTERA 0228 08/03/2017 07/05/2017 13505700 5,398,471
170 PT. ENSEVAL PUTERA 8140 11/03/2017 10/05/2017 13552010 837,250
171 PT. ENSEVAL PUTERA 6788 28/02/2017 29/04/2017 13419107 7,563,421
172 PT. ENSEVAL PUTERA 0194 28/02/2017 29/04/2017 13416558 17,797,019
173 PT. ENSEVAL PUTERA 0188 27/02/2017 28/04/2017 13399856 17,222,922
174 PT. ENSEVAL PUTERA 0195 28/02/2017 29/04/2017 13416867 30,140,114
175 PT. ENSEVAL PUTERA 0199 28/02/2017 29/04/2017 13419177 7,959,695
268,124,396
176 PT. ULICO PHARMA 5318 02/02/2017 04/03/2017 03365318 Rp 2,698,399
2,698,399
177 PT. KIMIA FARMA 3864 01/02/2017 22/02/2017 23,362,920
178 PT. KIMIA FARMA 5849 08/02/2017 01/03/2017 1,880,365
179 PT. KIMIA FARMA 6446 08/02/2017 01/03/2017 889,948
180 PT. KIMIA FARMA 9161 16/02/2017 09/03/2017 5,641,371
181 PT. KIMIA FARMA 0279 22/02/2017 15/03/2017 8,368,590
182 PT. KIMIA FARMA 2095 23/02/2017 16/03/2017 889,948
183 PT. KIMIA FARMA 6400 25/02/2017 18/03/2017 3,221,837
184 PT. KIMIA FARMA 0617 28/02/2017 21/03/2017 1,461,369
185 PT. KIMIA FARMA 1726 28/02/2017 21/03/2017 1,361,073
186 PT. KIMIA FARMA 2197 28/02/2017 21/03/2017 4,761,441
51,838,859
187 PT. UNITED DICO CITAS 5867 22/02/2017 15/03/2017 29976114 487,270
188 PT. UNITED DICO CITAS 5907 23/02/2017 16/03/2017 29976154 7,923,895
189 PT. UNITED DICO CITAS 5923 24/02/2017 17/03/2017 29976168 17,426,004
190 PT. UNITED DICO CITAS 5426 06/02/2017 27/02/2017 29975687 11,616,294
191 PT. UNITED DICO CITAS 5656 14/02/2017 07/03/2017 29975912 2,768,835
192 PT. UNITED DICO CITAS 5722 17/02/2017 10/03/2017 29975973 2,400,938
193 PT. UNITED DICO CITAS 5413 06/02/2017 27/02/2017 29975674 10,059,928
194 PT. UNITED DICO CITAS 4939 19/01/2017 09/02/2017 29975218 10,262,026
195 PT. UNITED DICO CITAS 5227 30/01/2017 20/02/2017 29975492 6,481,300
69,426,488
196 PT. INDO FARMA GLOBAL M 0794 16/02/2017 02/04/2017 6,068,536
197 PT. INDO FARMA GLOBAL M 0796 16/02/2017 02/04/2017 18,792,416
198 PT. INDO FARMA GLOBAL M 0837 17/02/2017 03/04/2017 6,011,579
199 PT. INDO FARMA GLOBAL M 0951 23/02/2017 09/04/2017 8,643,375
200 PT. INDO FARMA GLOBAL M 0952 23/02/2017 09/04/2017 2,068,717
201 PT. INDO FARMA GLOBAL M 0953 23/02/2017 09/04/2017 335,661
202 PT. INDO FARMA GLOBAL M 1000 27/02/2017 13/04/2017 3,201,250
203 PT. INDO FARMA GLOBAL M 1016 28/02/2017 14/04/2017 3,201,250
204 PT. INDO FARMA GLOBAL M 1047 28/02/2017 14/04/2017 4,329,775
205 PT. INDO FARMA GLOBAL M 1048 28/02/2017 14/04/2017 744,839
206 PT. INDO FARMA GLOBAL M 1051 28/02/2017 14/04/2017 4,993,448
207 PT. INDO FARMA GLOBAL M 0519 03/02/2017 20/03/2017 6,402,500
208 PT. INDO FARMA GLOBAL M 0061 12/01/2017 26/02/2017 3,191,400
67,984,745
209 PT. TEMPO 0155 24/02/2017 26/03/2017 17129464 7,253,182

TOTAL
Mengetahui,
Kepala Instalasi Farmasi

TONI DAFIAPUTRA, S.FARM, APT


NIP.19841023 200803 1 001

LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG


OBHP RUTIN
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
04 April 2017
NO DISTRIBUTOR NO FACT TGL.FACT JT. TEMPO NO.F STDR TAGIHAN
1 PT. BHAKTI SEJAHTERA M P230 04/02/2017 7,165,875
2 PT. BHAKTI SEJAHTERA M P231 09/02/2017 41,094,200
3 PT. BHAKTI SEJAHTERA M P256 21/02/2017 7,402,275
55,662,350
4 CV. RAFIN JAYA 0442 11/31/16 38936592 5,352,983

5 PT. BRATACO 0735 CASH 48839259 -

6 PT. MUARA NATIO P 2511 15/03/2017 99872511 36,321,875


7 PT. MUARA NATIO P 2508 11/02/2017 99872508 1,738,525
8 PT. MUARA NATIO P 2504 10/02/2017 99872504 16,621,875
9 PT. MUARA NATIO P 2506 20/02/2017 99872506 5,319,000
60,001,275
10 PT. SAPTA SARI 7298 28/02/2017 98821534 6,205,500
11 PT. SAPTA SARI 7336 28/02/2017 98820465 236,400
retur 6,441,900
12 PT. PARIT PADANG GLOBAL 1810 14/02/2017 26960604 2,420,145

13 PT. AFINA SC 0998 10/03/2017 44207661 20,980,500

14 PT. CITRA PURNAMA S 0015 24/02/2017 01881007 4,777,250


15 PT. CITRA PURNAMA S 0016 27/02/2017 01881008 2,068,500
16 PT. CITRA PURNAMA S 0017 01/03/2017 01881009 27,580,000
17 PT. CITRA PURNAMA S 0018 03/03/2017 01881010 11,081,250
18 PT. CITRA PURNAMA S 0019 03/03/2017 01881011 7,880,000
19 PT. CITRA PURNAMA S 0020 08/03/2017 01881012 1,871,500
20 PT. CITRA PURNAMA S 0021 08/03/2017 01881013 17,727,439
21 PT. CITRA PURNAMA S 0022 16/03/2017 01881014 3,989,250
76,975,189
22 PT. BIO MULTI MEDIKA 0046 27/02/2017 01838937 20,832,750
23 PT. BIO MULTI MEDIKA 0050 06/03/2017 01838940 5,880,450
24 PT. BIO MULTI MEDIKA 0051 09/03/2017 61690444 39,941,750
25 PT. BIO MULTI MEDIKA 0052 10/03/2017 61690445 6,855,600
26 PT. BIO MULTI MEDIKA 0053 11/03/2017 61690446 5,141,700
27 PT. BIO MULTI MEDIKA 0054 14/03/2017 61690451 7,357,950
28 PT. BIO MULTI MEDIKA 0055 14/03/2017 61690447 1,690,260
29 PT. BIO MULTI MEDIKA 0056 14/03/2017 61690448 25,326,714
30 PT. BIO MULTI MEDIKA 0057 15/03/2017 61690449 24,386,630
31 PT. BIO MULTI MEDIKA 0060 20/03/2017 61690452 18,469,932
32 PT. BIO MULTI MEDIKA 0061 20/03/2017 61690450 11,967,750
33 PT. BIO MULTI MEDIKA 0062 22/03/2017 61690453 29,786,400
197,637,886
34 PT. ENSEVAL PUTERA 8168 13/03/2017 13556289 1,410,343
35 PT. ENSEVAL PUTERA 8123 11/03/2017 13550770 1,190,865
36 PT. ENSEVAL PUTERA 0192 28/02/2017 13412173 1,986,218
37 PT. ENSEVAL PUTERA 0193 28/02/2017 13412496 1,015,006
38 PT. ENSEVAL PUTERA 5109 14/02/2017 13262334 8,943,130
39 PT. ENSEVAL PUTERA 0205 01/03/2017 13440983 3,392,263
40 PT. ENSEVAL PUTERA 6798 28/02/2017 13419995 16,889,962
41 PT. ENSEVAL PUTERA 6806 28/02/2017 13420409 6,770,496
42 PT. ENSEVAL PUTERA 8146 11/03/2017 13552273 4,297,796
45,896,079
43 PT. HOTAMA MEDIPHAR 7249 14/03/2017 03367249 9,062,000
44 PT. HOTAMA MEDIPHAR 7248 13/03/2017 03367248 24,625,000
33,687,000
TOTAL

Mengetahui,
Kepala Instalasi Farmasi

TONI DAFIAPUTRA, S.FARM, APT


NIP.19841023 200803 1 001
AYARAN HUTANG

MUARA BUNGO

PPN PPH SUB TOTAL TOTAL


262,616 39,392 2,888,774
262,616 39,392 2,888,774
18,273 2,741 201,003
18,273 2,741 201,003
179,100 26,865 1,970,100
179,100 26,865 1,970,100
36,546 5,482 402,006
36,546 5,482 402,006
469,827 70,474 5,168,099
469,827 70,474 5,168,099
646,267 96,940 7,108,939
623,000 93,450 6,853,000
646,267 96,940 7,108,939
623,000 93,450 6,853,000
71,364 10,705 784,999
71,364 10,705 784,999
208,571 31,286 2,294,278
73,937 11,091 813,307
600,740 90,111 6,608,140
85,636 12,845 941,999
445,385 66,808 4,899,238
18,273 2,741 201,003
6,046,528 906,979 66,511,805
69,810 10,472 767,910
1,169,865 175,480 12,868,510
114,400 17,160 1,258,400
378,727 56,809 4,166,000
957,273 143,591 10,529,999
581,485 87,223 6,396,340
1,129,375 169,406 12,423,125
1,035,546 155,332 11,391,009
621,328 93,199 6,834,605
129,754 19,463 1,427,299
1,214,577 182,187 13,360,350
477,753 71,663 5,255,284
395,454 59,318 4,349,999
49,091 7,364 539,999
670,381 100,557 7,374,195
658,426 98,764 7,242,688
442,000 66,300 4,862,000
145,485 21,823 1,600,330
1,385,492 207,824 15,240,417
706,860 106,029 7,775,460
118,800 17,820 1,306,800
363,957 54,594 4,003,530
302,000 45,300 3,322,000
947,260 142,089 10,419,858
66,545 9,982 732,000
407,336 61,100 4,480,692
1,050,903 157,635 11,559,930
1,079,328 161,899 11,872,612
191,765 28,765 2,109,412
378,606 56,791 4,164,666
54,557 8,183 600,123
90,000 13,500 990,000
1,474,202 221,130 16,216,225
570,161 85,524 6,271,775
636,420 95,463 7,000,618
154,000 23,100 1,694,000
127,288 19,093 1,400,166
2,139,408 320,911 23,533,483
409,091 61,364 4,499,999
642,074 96,311 7,062,810
424,812 63,722 4,672,930
366,300 54,945 4,029,300
181,864 27,280 2,000,499
684,000 102,600 7,524,000
25,193,759 3,779,064 277,131,347
205,200 30,780 2,257,200
445,537 66,831 4,900,909
779,000 116,850 8,569,000
825,478 123,822 9,080,255
129,850 19,478 1,428,350
607,500 91,125 6,682,500
603,442 90,516 6,637,867
3,596,007 539,401 39,556,081
104,282 15,642 1,147,102
73,363 11,004 806,995
951,596 142,739 10,467,558
35,364 5,305 388,999
47,600 7,140 523,600
463,640 69,546 5,100,040
307,824 46,174 3,386,067
1,983,669 297,550 21,820,361
149,112 22,367 1,640,232
348,500 52,275 3,833,500
760,950 114,143 8,370,450
327,622 49,143 3,603,845
196,573 29,486 2,162,307
852,250 127,838 9,374,750
82,840 12,426 911,240
300,140 45,021 3,301,540
26,000 3,900 286,000
3,043,988 456,598 33,483,864
317,602 47,640 3,493,627
171,772 25,766 1,889,487
1,545,460 231,819 17,000,060
1,169,225 175,384 12,861,470
1,224,050 183,608 13,464,550
200,000 30,000 2,200,000
75,951 11,393 835,461
275,971 41,396 3,035,683
4,178,385 626,758 45,962,235
2,809,200 421,380 30,901,200
2,874,300 431,145 31,617,300
1,769,900 265,485 19,468,900
16,611,816 2,491,772 182,729,973
1,144,000 171,600 12,584,000
1,144,000 171,600 12,584,000
146,250 21,938 1,608,750
94,800 14,220 1,042,800
53,635 8,045 589,985
567,742 85,161 6,245,167
1,300,000 195,000 14,300,000
497,250 74,588 5,469,750
582,700 87,405 6,409,700
140,910 21,137 1,550,010
294,060 44,109 3,234,660
51,463 7,719 566,094
746,250 111,938 8,208,750
1,997,104 299,566 21,968,144
6,472,165 970,825 71,193,810
21,206 3,181 233,268
2,251,600 337,740 24,767,600
280,000 42,000 3,080,000
29,455 4,418 324,002
1,818,600 272,790 20,004,600
909,300 136,395 10,002,300
202,800 30,420 2,230,800
675,000 101,250 7,425,000
522,375 78,356 5,746,125
227,500 34,125 2,502,500
124,800 18,720 1,372,800
800,000 120,000 8,800,000
1,507,600 226,140 16,583,600
16,800 2,520 184,800
345,000 51,750 3,795,000
688,850 103,328 7,577,350
1,976,813 296,522 21,744,938
408,000 61,200 4,488,000
12,805,698 1,920,855 140,862,683
275,500 41,325 3,030,500
275,500 41,325 3,030,500
Rp 292,500 Rp 43,875 Rp 3,217,500
Rp 219,465 Rp 32,920 Rp 2,414,115
511,965 76,795 5,631,615
2,405,762 360,864 26,463,387
1,999,270 299,891 21,991,970
248,000 37,200 2,728,000
204,750 30,713 2,252,250
171,819 25,773 1,890,009
114,546 17,182 1,260,006
795,238 119,286 8,747,619
169,910 25,487 1,869,010
50,400 7,560 554,400
38,976 5,846 428,736
143,182 21,477 1,575,002
520,000 78,000 5,720,000
1,330,137 199,521 14,631,512
254,454 38,168 2,798,999
1,179,675 176,951 12,976,425
659,300 98,895 7,252,300
1,806,330 270,950 19,869,630
1,346,500 201,975 14,811,500
47,025 7,054 517,275
437,000 65,550 4,807,000
143,640 21,546 1,580,040
26,364 3,955 290,004
564,480 84,672 6,209,280
2,168,375 325,256 23,852,125
1,571,364 235,705 17,284,999
548,068 82,210 6,028,749
85,000 12,750 935,000
767,860 115,179 8,446,460
1,806,804 271,021 19,874,844
1,748,520 262,278 19,233,720
3,059,910 458,987 33,659,010
808,091 121,214 8,888,999
27,220,751 4,083,113 299,428,260
Rp 273,949 Rp 41,092 Rp 3,013,441
273,949 41,092 3,013,441
2,371,870 355,781 26,090,570
190,900 28,635 2,099,900
90,350 13,553 993,850
572,728 85,909 6,300,008
849,603 127,440 9,345,633
90,350 13,553 993,850
327,090 49,064 3,597,990
148,362 22,254 1,631,986
138,180 20,727 1,519,980
483,395 72,509 5,317,345
5,262,828 789,424 57,891,112
49,469 7,420 544,159
804,456 120,668 8,849,020
1,769,137 265,371 19,460,512
1,179,319 176,898 12,972,511
281,100 42,165 3,092,100
243,750 36,563 2,681,250
1,021,312 153,197 11,234,437
1,041,830 156,275 11,460,130
658,000 98,700 7,238,000
7,048,374 1,057,256 77,532,119
616,095 92,414 6,777,045
1,907,859 286,179 20,986,454
610,313 91,547 6,713,438
877,500 131,625 9,652,500
210,022 31,503 2,310,242
34,077 5,112 374,850
325,000 48,750 3,575,000
325,000 48,750 3,575,000
439,571 65,936 4,835,282
75,618 11,343 831,800
506,949 76,042 5,576,439
650,000 97,500 7,150,000
324,000 48,600 3,564,000
6,902,005 1,035,301 75,922,050
736,364 110,455 8,100,000
8,100,000
1,376,423,021 1,376,423,021
Muara Bungo, 17 April 2017

AYU TRESNAWATI
NIP 19660908 198803 2 002

AYARAN HUTANG

MUARA BUNGO

PPN PPH SUB TOTAL TOTAL


727,500 109,125 8,002,500
4,172,000 625,800 45,892,000
751,500 112,725 8,266,500
5,651,000 847,650 62,161,000
543,450 81,518 5,977,950
5,977,950
- - -
-
3,687,500 553,125 40,562,500
176,500 26,475 1,941,500
1,687,500 253,125 18,562,500
540,000 81,000 5,940,000
6,091,500 913,725 67,006,500
630,000 94,500 6,930,000
24,000 3,600 264,000
654,000 98,100 7,194,000
245,700 36,855 2,702,700
2,702,700
2,130,000 319,500 23,430,000
23,430,000
485,000 72,750 5,335,000
210,000 31,500 2,310,000
2,800,000 420,000 30,800,000
1,125,000 168,750 12,375,000
800,000 120,000 8,800,000
190,000 28,500 2,090,000
1,799,740 269,961 19,797,140
405,000 60,750 4,455,000
7,814,740 1,172,211 85,962,140
2,115,000 317,250 23,265,000
597,000 89,550 6,567,000
4,055,000 608,250 44,605,000
696,000 104,400 7,656,000
522,000 78,300 5,742,000
747,000 112,050 8,217,000
171,600 25,740 1,887,600
2,571,240 385,686 28,283,640
2,475,800 371,370 27,233,800
1,875,120 281,268 20,626,320
1,215,000 182,250 13,365,000
3,024,000 453,600 33,264,000
20,064,760 3,009,714 220,712,360
143,182 21,477 1,575,002
120,900 18,135 1,329,900
201,646 30,247 2,218,111
103,046 15,457 1,133,509
907,932 136,190 9,987,252
344,392 51,659 3,788,314
1,714,717 257,208 18,861,887
687,360 103,104 7,560,960
436,324 65,449 4,799,569
4,659,500 698,925 51,254,504
920,000 138,000 10,120,000
2,500,000 375,000 27,500,000
3,420,000 513,000 37,620,000
564,021,154 564,021,154

Muara Bungo, 04 April 2017

AYU TRESNAWATI
NIP 19660908 198803 2 002
LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG
OBAT REGULER
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
17 Mei 2017
NO DISTRIBUTOR NO FACT TGL FACT JT. TEMPO NO.F STDR TAGIHAN
1 PT. ANUGRAH ARGON M 3870 14/03/2017 13/05/2017 70107143 3,206,175
2 PT. ANUGRAH ARGON M 3871 14/03/2017 13/05/2017 70107144 12,835,469
3 PT. ANUGRAH ARGON M 4007 16/03/2017 15/05/2017 70118644 10,603,076
4 PT. ANUGRAH ARGON M 4010 16/03/2017 15/05/2017 70118647 664,875
5 PT. ANUGRAH ARGON M 4011 16/03/2017 15/05/2017 70118648 2,955,614
6 PT. ANUGRAH ARGON M 4009 16/03/2017 15/05/2017 70118646 19,260,766
7 PT. ANUGRAH ARGON M 4008 16/03/2017 15/05/2017 70118645 13,081,056
8 PT. ANUGRAH ARGON M 4278 21/03/2017 20/05/2017 70139878 1,329,750
9 PT. ANUGRAH ARGON M 4568 27/03/2017 26/05/2017 70165419 689,500
10 PT. ANUGRAH ARGON M 4569 27/03/2017 26/05/2017 2,713,444
11 PT. ANUGRAH ARGON M 4570 27/03/2017 26/05/2017 70165421 2,105,692
12 PT. ANUGRAH ARGON M 4662 29/03/2017 28/05/2017 70172221 1,791,280
13 PT. ANUGRAH ARGON M 4801 31/03/2017 30/05/2017 70187399 13,504,350
14 PT. ANUGRAH ARGON M 4802 31/03/2017 30/05/2017 70187400 1,239,682
15 PT. ANUGRAH ARGON M 4803 31/03/2017 30/05/2017 70187401 2,498,318
16 PT. ANUGRAH ARGON M 4804 31/03/2017 30/05/2017 70187402 8,854,612
17 PT. ANUGRAH ARGON M 5001 04/04/2017 03/06/2017 70202304 7,636,979
18 PT. ANUGRAH ARGON M 5002 04/04/2017 03/06/2017 70202305 1,343,630
19 PT. ANUGRAH ARGON M 5003 04/04/2017 03/06/2017 70202306 2,012,946
20 PT. ANUGRAH ARGON M 5147 06/04/2017 05/06/2017 70213076 11,850,027
21 PT. ANUGRAH ARGON M 5148 06/04/2017 05/06/2017 70213077 5,690,070
22 PT. ANUGRAH ARGON M 5149 06/04/2017 05/06/2017 70213078 2,682,803
23 PT. ANUGRAH ARGON M 5150 06/04/2017 05/06/2017 70213079 1,816,876
24 PT. ANUGRAH ARGON M 5151 06/04/2017 05/06/2017 70213080 5,010,371
25 PT. ANUGRAH ARGON M 5233 07/04/2017 06/06/2017 70218515 4,534,670
26 PT. ANUGRAH ARGON M 5234 07/04/2017 06/06/2017 70218516 7,328,400
27 PT. ANUGRAH ARGON M 4281 21/03/2017 20/05/2017 70024729 21,227,926
28 PT. ANUGRAH ARGON M 4282 21/03/2017 20/05/2017 70139884 2,903,780
29 PT. ANUGRAH ARGON M 4400 23/03/2017 22/05/2017 70151693 5,870,477
30 PT. ANUGRAH ARGON M 4285 21/03/2017 20/05/2017 70139885 1,529,213
31 PT. ANUGRAH ARGON M 4283 21/03/2017 20/05/2017 70139883 4,012,257
32 PT. ANUGRAH ARGON M 4282 21/03/2017 20/05/2017 70139882 896,350
33 PT. ANUGRAH ARGON M 4066 17/03/2017 16/05/2017 70124715 3,864,469
34 PT. ANUGRAH ARGON M 4279 21/03/2017 20/05/2017 70139879 7,708,073
35 PT. ANUGRAH ARGON M 4280 21/03/2017 20/05/2017 70139880 5,068,286
200,321,262
36 PT. PENTA VALENT 3354 16/03/2017 15/04/2017 84145989 4,969,295
37 PT. PENTA VALENT 3355 16/03/2017 15/04/2017 84145990 620,550
38 PT. PENTA VALENT 3356 16/03/2017 15/04/2017 84145991 709,200
6,299,045
39 PT. ANUGRAH PHARMINDO L 6298 23/03/2017 22/05/2017 06307173 940,222
40 PT. ANUGRAH PHARMINDO L 6475 25/03/2017 24/05/2017 06317974 4,421,301
41 PT. ANUGRAH PHARMINDO L 6552 25/03/2017 24/04/2017 06317976 1,968,030
42 PT. ANUGRAH PHARMINDO L 6879 30/03/2017 29/05/2017 06362598 3,080,363
43 PT. ANUGRAH PHARMINDO L 7049 31/03/2017 30/04/2017 06144028 5,327,964
44 PT. ANUGRAH PHARMINDO L 7053 31/03/2017 30/04/2017 06367244 1,140,630
45 PT. ANUGRAH PHARMINDO L 4764 09/03/2017 08/04/2017 06194773 4,687,694
21,566,202
46 PT. BINA SAN PRIMA 2441 22/03/2017 21/04/2017 86058760 5,213,507
47 PT. BINA SAN PRIMA 2440 22/03/2017 21/04/2017 86058759 2,545,240
7,758,747
48 PT. BHAKTI SEJAHTERA M P318 01/03/2017 31/03/2017 4,634,425
49 PT. BHAKTI SEJAHTERA M P366 13/03/2017 12/04/2017 985,000
50 PT. BHAKTI SEJAHTERA M P397 14/03/2017 13/04/2017 4,269,975
51 PT. BHAKTI SEJAHTERA M P472 31/03/2017 30/04/2017 2,434,920
12,324,320
52 PT. MENSA BINA SUKSES 0863 03/03/2017 02/04/2017 83480671 2,255,933
53 PT. MENSA BINA SUKSES 6405 16/03/2017 15/04/2017 83545320 517,125
54 PT. MENSA BINA SUKSES 6406 16/03/2017 15/04/2017 83545321 6,011,578
55 PT. MENSA BINA SUKSES 6404 16/03/2017 15/04/2017 83545319 12,168,493
56 PT. MENSA BINA SUKSES 1766 17/03/2017 16/04/2017 83550637 1,970,000
57 PT. MENSA BINA SUKSES 2084 20/03/2017 19/04/2017 83560778 6,501,869
RETUR 6,027,000 29,424,998
58 PT. MILLENIUM PHARMACON I 2278 23/02/2017 25/03/2017 19182405 19,666,140
59 PT. MILLENIUM PHARMACON I 2320 24/02/2017 26/03/2017 19185578 7,042,750
60 PT. MILLENIUM PHARMACON I 2572 28/02/2017 30/03/2017 19202483 1,656,585
61 PT. MILLENIUM PHARMACON I 2797 07/03/2017 06/04/2017 19216591 9,141,304
62 PT. MILLENIUM PHARMACON I 3419 21/03/2017 20/04/2017 19249745 5,688,375
63 PT. MILLENIUM PHARMACON I 3271 17/03/2017 16/04/2017 19242218 9,013,095
64 PT. MILLENIUM PHARMACON I 3270 17/03/2017 16/04/2017 19242217 7,060,135
59,268,384
65 PT. MERAPI UTAMA PHARMA 3170 09/03/2017 26/04/2017 83042471 1,512,590
66 PT. MERAPI UTAMA PHARMA 3624 17/03/2017 04/05/2017 83055098 5,208,833
67 PT. MERAPI UTAMA PHARMA 3620 17/03/2017 04/05/2017 83042472 21,289,445
68 PT. MERAPI UTAMA PHARMA 4008 25/03/2017 12/05/2017 83072167 4,151,972
69 PT. MERAPI UTAMA PHARMA 4182 30/03/2017 17/05/2017 83088256 1,994,625
70 PT. MERAPI UTAMA PHARMA 4270 31/03/2017 18/05/2017 83088364 3,361,313
71 PT. MERAPI UTAMA PHARMA 4271 31/03/2017 18/05/2017 83088365 2,292,095
72 PT. MERAPI UTAMA PHARMA 4174 30/03/2017 17/05/2017 83088254 4,123,437
73 PT. MERAPI UTAMA PHARMA 4494 07/04/2017 25/05/2017 83101485 2,659,500
74 PT. MERAPI UTAMA PHARMA 4506 07/04/2017 25/05/2017 83101488 1,389,182
75 PT. MERAPI UTAMA PHARMA 4529 07/04/2017 25/05/2017 83101490 10,376,851
76 PT. MERAPI UTAMA PHARMA 4684 11/04/2017 29/05/2017 83106029 617,891
77 PT. MERAPI UTAMA PHARMA 4752 12/04/2017 30/05/2017 83108365 3,368,700
62,346,434
78 PT. DOS NI ROHA 6823 31/03/2017 30/04/2017 93231160 3,398,250
79 PT. DOS NI ROHA 0802 05/04/2017 05/05/2017 93266983 34,703,520
80 PT. DOS NI ROHA 1608 05/04/2017 05/05/2017 93266984 1,436,130
81 PT. DOS NI ROHA 6051 06/04/2017 06/05/2017 93266987 214,238
82 PT. DOS NI ROHA 7415 06/04/2017 06/05/2017 93266989 9,132,682
83 PT. DOS NI ROHA 9956 08/03/2017 07/04/2017 93150063 4,380,223
84 PT. DOS NI ROHA 9813 08/03/2017 07/04/2017 93150062 4,429,729
85 PT. DOS NI ROHA 8956 08/03/2017 07/04/2017 93150061 1,985,760
86 PT. DOS NI ROHA 8857 08/03/2017 07/04/2017 93150060 3,398,250
87 PT. DOS NI ROHA 1739 22/03/2017 21/04/2017 93193951 7,699,652
88 PT. DOS NI ROHA 9172 22/03/2017 21/04/2017 93193945 4,715,441
89 PT. DOS NI ROHA 3964 23/03/2017 22/04/2017 93193954 7,003,811
90 PT. DOS NI ROHA 9479 27/03/2017 26/04/2017 93208587 12,525,260
91 PT. DOS NI ROHA 5376 29/03/2017 28/04/2017 93208606 8,865,000
92 PT. DOS NI ROHA 1527 31/03/2017 30/04/2017 93231079 19,275,219
93 PT. DOS NI ROHA 1865 31/03/2017 30/04/2017 93231084 6,050,363
94 PT. DOS NI ROHA 3134 31/03/2017 30/04/2017 93231100 386,839
95 PT. DOS NI ROHA 3485 31/03/2017 30/04/2017 93231104 6,000,967
96 PT. DOS NI ROHA 3486 31/03/2017 30/04/2017 93231105 4,891,717
97 PT. DOS NI ROHA 5334 31/03/2017 30/04/2017 93231128 3,361,313
98 PT. DOS NI ROHA 8996 13/03/2017 12/04/2017 93169938 3,324,375
99 PT. DOS NI ROHA 1895 16/03/2017 15/04/2017 93175631 22,178,260
100 PT. DOS NI ROHA 4464 16/03/2017 15/04/2017 93175633 5,223,258
101 PT. DOS NI ROHA 9623 17/03/2017 16/04/2017 93175643 6,796,500
102 PT. DOS NI ROHA 9645 17/03/2017 16/04/2017 93175644 8,605,582
103 PT. DOS NI ROHA 9818 17/03/2017 16/04/2017 93175646 11,505,293
104 PT. DOS NI ROHA 1977 09/03/2017 08/04/2017 93154428 960,375
105 PT. DOS NI ROHA 1976 09/03/2017 08/04/2017 93154481 11,647,625
106 PT. DOS NI ROHA 1972 09/03/2017 08/04/2017 93154480 6,418,260
107 PT. DOS NI ROHA 6703 10/03/2017 09/04/2017 93154490 2,493,281
108 PT. DOS NI ROHA 9821 10/03/2017 09/04/2017 93154491 7,130,785
RETUR 6,132,500 230,137,957
109 PT. PARIT PADANG GLOBAL 4175 30/03/2017 20/04/2017 49345506 3,349,000
110 PT. PARIT PADANG GLOBAL 3110 10/03/2017 31/03/2017 49267705 354,600
111 PT. PARIT PADANG GLOBAL 3399 16/03/2017 06/04/2017 49290163 14,967,538
112 PT. PARIT PADANG GLOBAL 4416 03/04/2017 24/04/2017 49362289 14,149,525
113 PT. PARIT PADANG GLOBAL 3664 21/03/2017 11/04/2017 49308687 16,786,394
114 PT. PARIT PADANG GLOBAL 3716 22/03/2017 12/04/2017 49311849 5,752,045
115 PT. PARIT PADANG GLOBAL 3853 24/03/2017 14/04/2017 49323581 5,106,240
116 PT. PARIT PADANG GLOBAL 4238 31/03/2017 21/04/2017 49351270 680,544
117 PT. PARIT PADANG GLOBAL 4297 31/03/2017 21/04/2017 49354935 17,398,200
118 PT. PARIT PADANG GLOBAL 4406 03/04/2017 24/04/2017 49361957 8,421,750
119 PT. PARIT PADANG GLOBAL 1531 09/02/2017 02/03/2017 26963706 784,060
120 PT. PARIT PADANG GLOBAL 2949 07/03/2017 28/03/2017 49253435 2,245,800
121 PT. PARIT PADANG GLOBAL 2686 01/03/2017 22/03/2017 27047197 40,562,300
122 PT. PARIT PADANG GLOBAL 2536 28/02/2017 21/03/2017 27036570 5,634,200
123 PT. PARIT PADANG GLOBAL 2362 24/02/2017 17/03/2017 27021119 3,138,535
124 PT. PARIT PADANG GLOBAL 2298 23/02/2017 16/03/2017 27015710 35,684,533
125 PT. PARIT PADANG GLOBAL 2292 23/02/2017 16/03/2017 27015610 7,757,860
126 PT. PARIT PADANG GLOBAL 2197 21/02/2017 14/03/2017 27006873 2,817,100
127 PT. PARIT PADANG GLOBAL 1909 16/02/2017 09/03/2017 26987777 487,575
128 PT. PARIT PADANG GLOBAL 1924 16/02/2017 09/03/2017 26968694 10,187,139
129 PT. PARIT PADANG GLOBAL 2085 16/02/2017 09/03/2017 26998605 4,884,615
RETUR 577,500 201,149,552
130 PT. SAPTA SARI 8666 22/03/2017 12/04/2017 60261550 Rp 3,228,430
131 PT. SAPTA SARI 8660 22/03/2017 12/04/2017 60261556 Rp 1,527,057
132 PT. SAPTA SARI 8982 27/03/2017 17/04/2017 60268619 Rp 1,006,703
5,762,190
133 PT. ENSEVAL PUTERA 9256 21/03/2017 20/05/2017 13653295 834,019
134 PT. ENSEVAL PUTERA 9355 21/03/2017 20/05/2017 13660822 18,368,773
135 PT. ENSEVAL PUTERA 9364 21/03/2017 20/05/2017 13661130 14,819,079
136 PT. ENSEVAL PUTERA 9379 21/03/2017 20/05/2017 13661451 1,520,840
137 PT. ENSEVAL PUTERA 0282 21/03/2017 20/05/2017 13661744 12,320,110
138 PT. ENSEVAL PUTERA 8532 15/03/2017 14/05/2017 13589907 344,750
139 PT. ENSEVAL PUTERA 8664 16/03/2017 15/05/2017 13603880 20,759,121
140 PT. ENSEVAL PUTERA 8677 16/03/2017 15/05/2017 13605745 13,529,763
141 PT. ENSEVAL PUTERA 8736 16/03/2017 15/05/2017 13610561 383,914
142 PT. ENSEVAL PUTERA 0256 16/03/2017 15/05/2017 13605758 2,008,059
143 PT. ENSEVAL PUTERA 2230 13/04/2017 12/06/2017 06712933 22,227,018
144 PT. ENSEVAL PUTERA 2238 13/04/2017 12/06/2017 06713210 18,546,565
145 PT. ENSEVAL PUTERA 2247 13/04/2017 12/06/2017 06714678 3,309,600
146 PT. ENSEVAL PUTERA 2250 13/04/2017 12/06/2017 06714909 673,740
147 PT. ENSEVAL PUTERA 2509 15/04/2017 14/06/2017 06730354 1,255,875
148 PT. ENSEVAL PUTERA 0351 12/04/2017 11/06/2017 06699237 7,446,600
149 PT. ENSEVAL PUTERA 0356 13/04/2017 12/06/2017 06713566 13,481,067
150 PT. ENSEVAL PUTERA 0357 13/04/2017 12/06/2017 06715139 961,717
151 PT. ENSEVAL PUTERA 0412 30/03/2017 29/05/2017 13759852 21,424,735
152 PT. ENSEVAL PUTERA 0414 30/03/2017 29/05/2017 13760266 8,531,700
153 PT. ENSEVAL PUTERA 0416 30/03/2017 29/05/2017 13760272 17,892,525
154 PT. ENSEVAL PUTERA 0417 30/03/2017 29/05/2017 13760265 4,277,363
155 PT. ENSEVAL PUTERA 0324 04/04/2017 03/06/2017 13811334 34,432,547
156 PT. ENSEVAL PUTERA 7790 09/03/2017 08/05/2017 13517531 513,770
157 PT. ENSEVAL PUTERA 9891 25/03/2017 24/05/2017 13714697 2,122,281
158 PT. ENSEVAL PUTERA 0287 08/03/2017 07/05/2017 13671641 1,231,250
RETUR 2,886,175 243,216,779
159 PT. MITRA SEJATI MEDIKA 090 13/03/2017 12/04/2017 38407164 39,844,283
39,844,283
160 PT. KIMIA FARMA 2781 22/03/2017 12/04/2017 45930417 425,520
161 PT. KIMIA FARMA 7319 30/03/2017 20/04/2017 45944326 1,448,529
162 PT. KIMIA FARMA 0395 31/03/2017 21/04/2017 45946709 4,760,062
163 PT. KIMIA FARMA 5377 01/03/2017 22/03/2017 45897635 538,828
164 PT. KIMIA FARMA 6959 02/03/2017 23/03/2017 45897702 966,616
165 PT. KIMIA FARMA 9666 06/03/2017 27/03/2017 45900766 1,217,805
166 PT. KIMIA FARMA 7527 09/03/2017 30/03/2017 45907257 6,362,509
167 PT. KIMIA FARMA 7298 14/03/2017 04/04/2017 45916173 5,641,371
168 PT. KIMIA FARMA 1843 22/03/2017 12/04/2017 45930392 6,552,157
27,913,397
169 PT. UNITED DICO CITAS 6880 08/04/2017 29/04/2017 29976114 17,176,307
170 PT. UNITED DICO CITAS 6056 28/02/2017 21/03/2017 29976295 4,014,368
171 PT. UNITED DICO CITAS 6269 09/03/2017 30/03/2017 29976510 5,582,600
172 PT. UNITED DICO CITAS 6769 27/03/2017 17/04/2017 48585624 10,205,795
173 PT. UNITED DICO CITAS 6879 31/03/2017 21/04/2017 48585732 3,961,948
RETUR 643,500 40,941,017
174 PT. TEMPO 4422 05/04/2017 05/05/2017 17331490 3,331,091

TOTAL
Mengetahui,
Kepala Instalasi Farmasi

TONI DAFIAPUTRA, S.FARM, APT


NIP.19841023 200803 1 001

LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG


BHP RUTIN
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
04 Mei 2017
NO DISTRIBUTOR NO FACT TGL FACT JT. TEMPO NO.F STDR TAGIHAN
1 PT. BHAKTI SEJAHTERA M P367 13/03/2017 6,845,750
2 PT. BHAKTI SEJAHTERA M P398 18/03/2017 1,837,025
3 PT. BHAKTI SEJAHTERA M P471 24/03/2017 3,546,000
4 PT. BHAKTI SEJAHTERA M P474 31/03/2017 28,171,000
40,399,775
5 CV. RAFIN JAYA 0001 07/03/2017 38936591 -

6 PT. SAPTA SARI 8127 13/03/2017 98839218 3,725,270


7 PT. CITRA PURNAMA S 0023 29/03/2017 01881015 1,871,500
8 PT. CITRA PURNAMA S 0024 29/03/2017 01881016 4,787,100
9 PT. CITRA PURNAMA S 0025 03/04/2017 01881017 1,329,750
10 PT. CITRA PURNAMA S 0026 11/04/2017 01881018 3,181,550
11 PT. CITRA PURNAMA S 0027 12/04/2017 01881019 1,182,000
12 PT. CITRA PURNAMA S 0028 13/04/2017 01881020 13,200,576
13 PT. CITRA PURNAMA S 0029 18/04/2017 01881021 935,750
14 PT. CITRA PURNAMA S 0030 20/04/2017 01881022 3,782,400
33,995,896
15 PT. BIO MULTI MEDIKA 0066 27/03/2017 61690461 19,946,250
16 PT. BIO MULTI MEDIKA 0069 29/03/2017 61690462 12,319,198
17 PT. BIO MULTI MEDIKA 0070 30/03/2017 61690463 43,166,640
18 PT. BIO MULTI MEDIKA 0071 31/03/2017 61690464 42,289,005
19 PT. BIO MULTI MEDIKA 0072 01/04/2017 61690467 13,790,000
20 PT. BIO MULTI MEDIKA 0073 01/04/2017 61690468 17,730,000
21 PT. BIO MULTI MEDIKA 0074 03/04/2017 61690469 20,621,566
22 PT. BIO MULTI MEDIKA 0075 04/04/2017 61690470 32,505,000
23 PT. BIO MULTI MEDIKA 0076 06/04/2017 61690471 33,915,520
24 PT. BIO MULTI MEDIKA 0078 11/04/2017 61690472 10,785,750
25 PT. BIO MULTI MEDIKA 0082 19/04/2017 61690473 28,859,220
26 PT. BIO MULTI MEDIKA 0083 19/04/2017 61690474 8,208,990
27 PT. BIO MULTI MEDIKA 0086 21/04/2017 61690475 15,591,565
299,728,704
28 PT. ENSEVAL PUTERA 0193 28/02/2017 13412496 1,015,006
29 PT. ENSEVAL PUTERA 8796 17/03/2017 13619187 8,539,166
30 PT. ENSEVAL PUTERA 1942 11/04/2017 06682964 13,169,502
31 PT. ENSEVAL PUTERA 6798 28/02/2017 13419995 16,889,962
32 PT. ENSEVAL PUTERA 0347 11/04/2017 06682998 9,917,841
49,531,477
TOTAL

Mengetahui,
Kepala Instalasi Farmasi

TONI DAFIAPUTRA, S.FARM, APT


NIP.19841023 200803 1 001
AYARAN HUTANG

MUARA BUNGO

PPN PPH SUB TOTAL TOTAL


325,500 48,825 3,580,500
1,303,093 195,464 14,334,026
1,076,454 161,468 11,840,999
67,500 10,125 742,500
300,062 45,009 3,300,686
1,955,408 293,311 21,509,485
1,328,026 199,204 14,608,286
135,000 20,250 1,485,000
70,000 10,500 770,000
275,477 41,321 3,030,242
213,776 32,066 2,351,534
181,856 27,278 2,000,414
1,371,000 205,650 15,081,000
125,856 18,878 1,384,416
253,636 38,045 2,790,000
898,945 134,842 9,888,399
775,328 116,299 8,528,606
136,409 20,461 1,500,500
204,360 30,654 2,247,960
1,203,048 180,457 13,233,533
577,672 86,651 6,354,393
272,366 40,855 2,996,024
184,454 27,668 2,028,999 2,820,099
508,667 76,300 5,595,338
460,373 69,056 5,064,098
744,000 111,600 8,184,000
2,155,119 323,268 23,706,313
294,800 44,220 3,242,800
595,988 89,398 6,555,863
155,250 23,288 1,707,750
407,336 61,100 4,480,693
91,000 13,650 1,001,000
392,332 58,850 4,315,651
782,545 117,382 8,608,000
514,547 77,182 5,660,015
20,337,184 3,050,578 223,709,023
504,497 75,675 5,549,467
63,000 9,450 693,000
72,000 10,800 792,000
639,497 95,925 7,034,467
95,454 14,318 1,049,994
448,863 67,329 4,937,493
199,800 29,970 2,197,800
312,727 46,909 3,439,999
540,910 81,137 5,950,010
115,800 17,370 1,273,800
475,908 71,386 5,234,988
2,189,462 328,419 24,084,084
529,290 79,394 5,822,190
258,400 38,760 2,842,400
787,690 118,154 8,664,590
470,500 70,575 5,175,500
100,000 15,000 1,100,000
433,500 65,025 4,768,500
247,200 37,080 2,719,200
1,251,200 187,680 13,763,200
229,029 34,354 2,519,316
52,500 7,875 577,500
610,312 91,547 6,713,437
1,235,380 185,307 13,589,180
200,000 30,000 2,200,000
660,088 99,013 7,260,971
2,987,309 448,096 32,860,404
1,996,562 299,484 21,962,187
715,000 107,250 7,865,000
168,181 25,227 1,849,993
928,051 139,208 10,208,563
577,500 86,625 6,352,500
915,035 137,255 10,065,385
716,765 107,515 7,884,415
6,017,095 902,564 66,188,043
153,562 23,034 1,689,187
528,816 79,322 5,816,971
2,161,365 324,205 23,775,015
421,520 63,228 4,636,720
202,500 30,375 2,227,500
341,250 51,188 3,753,750
232,700 34,905 2,559,700
418,623 62,793 4,604,853
270,000 40,500 2,970,000
141,034 21,155 1,551,371
1,053,487 158,023 11,588,362
62,730 9,410 690,030
342,000 51,300 3,762,000
6,329,587 949,438 69,625,459
345,000 51,750 3,795,000
3,523,200 528,480 38,755,200
145,800 21,870 1,603,800
21,750 3,263 239,250
927,176 139,076 10,198,934
444,693 66,704 4,891,620
449,719 67,458 4,946,906
201,600 30,240 2,217,600
345,000 51,750 3,795,000
781,691 117,254 8,598,596
478,725 71,809 5,265,975
711,047 106,657 7,821,515
1,271,600 190,740 13,987,600
900,000 135,000 9,900,000
1,956,875 293,531 21,525,625
614,250 92,138 6,756,750
39,273 5,891 432,003
609,235 91,385 6,701,588
496,621 74,493 5,462,831
341,250 51,188 3,753,750
337,500 50,625 3,712,500
2,251,600 337,740 24,767,600
530,280 79,542 5,833,080
690,000 103,500 7,590,000
873,663 131,049 9,610,295
1,168,050 175,208 12,848,550
97,500 14,625 1,072,500
1,182,500 177,375 13,007,500
651,600 97,740 7,167,600
253,125 37,969 2,784,375
723,938 108,591 7,963,313
23,364,260 3,504,639 257,006,856
340,000 51,000 3,740,000
36,000 5,400 396,000
1,519,547 227,932 16,715,017
1,436,500 215,475 15,801,500
1,704,202 255,630 18,746,227
583,964 87,595 6,423,604
518,400 77,760 5,702,400
69,091 10,364 759,998
1,766,315 264,947 19,429,462
855,000 128,250 9,405,000
79,600 11,940 875,600
228,000 34,200 2,508,000
4,118,000 617,700 45,298,000
572,000 85,800 6,292,000
318,633 47,795 3,504,963
3,622,795 543,419 39,850,747
787,600 118,140 8,663,600
286,000 42,900 3,146,000
49,500 7,425 544,500
1,034,227 155,134 11,376,500
495,900 74,385 5,454,900
20,421,274 3,063,191 224,634,018
Rp 327,759 Rp 49,164 Rp 3,605,353
Rp 155,031 Rp 23,255 Rp 1,705,343
Rp 102,203 Rp 15,331 Rp 1,124,237
584,994 87,749 6,434,933
84,672 12,701 931,392
1,864,850 279,728 20,513,350
1,504,475 225,671 16,549,225
154,400 23,160 1,698,400
1,250,773 187,616 13,758,499
35,000 5,250 385,000
2,107,525 316,129 23,182,775
1,373,580 206,037 15,109,380
38,976 5,846 428,736
203,864 30,580 2,242,502
2,256,550 338,483 24,822,050
1,882,900 282,435 20,711,900
336,000 50,400 3,696,000
68,400 10,260 752,400
127,500 19,125 1,402,500
756,000 113,400 8,316,000
1,368,636 205,295 15,054,999
97,636 14,645 1,073,999
2,175,100 326,265 23,926,100
866,162 129,924 9,527,787
1,816,500 272,475 19,981,500
434,250 65,138 4,776,750
3,495,690 524,354 38,452,590
52,159 7,824 573,753
215,460 32,319 2,370,060
125,000 18,750 1,375,000
24,692,059 3,703,809 271,612,647
4,045,105 606,766 44,496,154
4,045,105 606,766 44,496,154
43,200 6,480 475,200
147,059 22,059 1,617,647
483,255 72,488 5,315,805
54,703 8,206 601,737
98,134 14,720 1,079,470
123,635 18,545 1,359,985
645,940 96,891 7,105,340
572,728 85,909 6,300,008
665,194 99,779 7,317,130
2,833,847 425,077 31,172,322
1,743,788 261,568 19,181,663
407,550 61,133 4,483,050
566,761 85,014 6,234,376
1,036,121 155,418 11,397,334
402,228 60,334 4,424,510
4,156,448 623,467 45,720,933
338,182 50,727 3,720,000
3,720,000
1,330,727,133 1,330,727,133
Muara Bungo, 17 Mei 2017

AYU TRESNAWATI
NIP 19660908 198803 2 002

AYARAN HUTANG

MUARA BUNGO

PPN PPH SUB TOTAL TOTAL


695,000 104,250 7,645,000
186,500 27,975 2,051,500
360,000 54,000 3,960,000
2,860,000 429,000 31,460,000
4,101,500 615,225 45,116,500
- - -
-
378,200 56,730 4,160,200
190,000 28,500 2,090,000
486,000 72,900 5,346,000
135,000 20,250 1,485,000
323,000 48,450 3,553,000
120,000 18,000 1,320,000
1,340,160 201,024 14,741,760
95,000 14,250 1,045,000
384,000 57,600 4,224,000
3,451,360 517,704 37,964,960
2,025,000 303,750 22,275,000
1,250,680 187,602 13,757,480
4,382,400 657,360 48,206,400
4,293,300 643,995 47,226,300
1,400,000 210,000 15,400,000
1,800,000 270,000 19,800,000
2,093,560 314,034 23,029,160
3,300,000 495,000 36,300,000
3,443,200 516,480 37,875,200
1,095,000 164,250 12,045,000
2,929,870 439,481 32,228,570
833,400 125,010 9,167,400
1,582,900 237,435 17,411,900
30,429,310 4,564,397 334,722,410
103,046 15,457 1,133,509
866,920 130,038 9,536,124
1,337,005 200,551 14,707,058
1,714,717 257,208 18,861,887
1,006,887 151,033 11,075,762
5,028,576 754,286 55,314,340
473,118,210

Muara Bungo, 04 Mei 2017

AYU TRESNAWATI
NIP 19660908 198803 2 002
LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG
OBAT REGULER
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
10 Juni 2017
NO DISTRIBUTOR NO FACT TGL FACT JT. TEMPO NO.F STDR TAGIHAN
1 PT. RAJAWALI NUSINDO 1561 16/03/2017 15/04/2017 03196388 7,240,923
2 PT. RAJAWALI NUSINDO 1562 16/03/2017 15/04/2017 03196389 3,648,834
3 PT. RAJAWALI NUSINDO 1564 16/03/2017 15/04/2017 03196391 1,724,510
4 PT. RAJAWALI NUSINDO 1565 16/03/2017 15/04/2017 03196392 131,990
5 PT. RAJAWALI NUSINDO 1566 16/03/2017 15/04/2017 03196393 678,695
6 PT. RAJAWALI NUSINDO 1691 22/03/2017 21/04/2017 03196516 5,140,986
7 PT. RAJAWALI NUSINDO 1738 23/03/2017 22/04/2017 03196563 318,608
8 PT. RAJAWALI NUSINDO 1918 31/03/2017 30/04/2017 03196741 293,235
9 PT. RAJAWALI NUSINDO 1969 06/04/1947 06/05/1947 03196791 356,480
10 PT. RAJAWALI NUSINDO 2009 07/04/1947 07/05/1947 03196829 5,479,142
11 PT. RAJAWALI NUSINDO 2010 07/04/1947 07/05/1947 03196830 3,742,102
12 PT. RAJAWALI NUSINDO 2183 13/04/1947 13/05/1947 56899640 1,116,183
13 PT. RAJAWALI NUSINDO 2250 18/04/1947 18/05/1947 56899705 174,047
14 PT. RAJAWALI NUSINDO 2253 18/04/1947 18/05/1947 56899708 1,961,151
15 PT. RAJAWALI NUSINDO 2284 20/04/1947 20/05/1947 56899739 419,965
16 PT. RAJAWALI NUSINDO 2369 25/04/1947 25/05/1947 56899818 5,432,364
17 PT. RAJAWALI NUSINDO 2368 25/04/1947 25/05/1947 56899817 2,801,824
18 PT. RAJAWALI NUSINDO 2415 27/04/1947 27/05/1947 56899863 501,767
19 PT. RAJAWALI NUSINDO 2416 27/04/1947 27/05/1947 56899864 240,882
20 PT. RAJAWALI NUSINDO 2417 27/04/1947 27/05/1947 56899865 1,687,738
43,091,425
21 PT. ANUGRAH ARGON M 5393 11/04/2017 10/06/2017 70230658 7,683,000
22 PT. ANUGRAH ARGON M 5394 11/04/2017 10/06/2017 70230659 896,350
23 PT. ANUGRAH ARGON M 9395 11/04/2017 10/06/2017 70230660 8,466,283
24 PT. ANUGRAH ARGON M 5545 13/04/2017 12/06/2017 70243320 7,620,374
25 PT. ANUGRAH ARGON M 5546 13/04/2017 12/06/2017 70243321 2,361,104
26 PT. ANUGRAH ARGON M 5550 13/04/2017 12/06/2017 70243325 2,687,975
27 PT. ANUGRAH ARGON M 5551 13/04/2017 12/06/2017 70243326 17,424,650
28 PT. ANUGRAH ARGON M 5556 13/04/2017 12/06/2017 70243480 5,708,523
29 PT. ANUGRAH ARGON M 5493 20/04/2017 19/06/2017 70259283 7,157,010
30 PT. ANUGRAH ARGON M 5778 18/04/2017 17/06/2017 70271290 6,533,340
31 PT. ANUGRAH ARGON M 5944 20/04/2017 19/06/2017 70271291 2,168,079
32 PT. ANUGRAH ARGON M 5946 20/04/2017 19/06/2017 70271293 758,450
33 PT. ANUGRAH ARGON M 5633 15/04/2017 14/06/2017 70247388 11,386,656
34 PT. ANUGRAH ARGON M 5634 15/04/2017 14/06/2017 70247389 4,853,908
35 PT. ANUGRAH ARGON M 5779 18/04/2017 17/06/2017 70259284 14,250,145
36 PT. ANUGRAH ARGON M 5782 19/04/2017 18/06/2017 70259287 3,025,181
37 PT. ANUGRAH ARGON M 5783 18/04/2017 17/06/2017 70259288 3,841,500
38 PT. ANUGRAH ARGON M 5784 18/04/2017 17/06/2017 70259289 1,130,948
39 PT. ANUGRAH ARGON M 6025 22/04/2017 21/06/2017 70281496 9,035,737
40 PT. ANUGRAH ARGON M 6026 22/04/2017 21/06/2017 70281497 1,203,490
41 PT. ANUGRAH ARGON M 6229 26/04/2017 25/06/2017 70294467 13,898,491
42 PT. ANUGRAH ARGON M 6230 26/04/2017 25/06/2017 70294468 15,858,202
43 PT. ANUGRAH ARGON M 6231 26/04/2017 25/06/2017 70294469 2,843,068
44 PT. ANUGRAH ARGON M 6232 26/04/2017 25/06/2017 70294470 725,334
45 PT. ANUGRAH ARGON M 6303 27/04/2017 26/06/2017 42335906 3,044,545
46 PT. ANUGRAH ARGON M 6304 27/04/2017 26/06/2017 42335907 6,967,457
161,529,801
47 PT. ANUGRAH PHARMINDO L 5166 14/03/2017 13/05/2017 06216055 1,198,804
48 PT. ANUGRAH PHARMINDO L 5152 14/03/2017 13/05/2017 06216054 6,163,858
49 PT. ANUGRAH PHARMINDO L 5142 13/03/2017 12/05/2017 06216053 116,723
50 PT. ANUGRAH PHARMINDO L 5066 13/03/2017 12/05/2017 06215630 2,677,407
51 PT. ANUGRAH PHARMINDO L 4828 10/03/2017 09/04/2017 06194776 3,438,812
52 PT. ANUGRAH PHARMINDO L 8846 17/04/2017 16/06/2017 96405513 2,838,234
53 PT. ANUGRAH PHARMINDO L 9195 20/04/2017 20/05/2017 96437204 4,506,598
54 PT. ANUGRAH PHARMINDO L 9984 27/04/2017 26/06/2017 96491079 812,172
55 PT. ANUGRAH PHARMINDO L 0158 28/04/2017 27/06/2017 96536560 3,916,360
25,668,967
56 PT. BINA SAN PRIMA 1545 15/04/2017 15/05/2017 86061348 2,634,284
57 PT. BINA SAN PRIMA 2541 25/04/2017 25/05/2017 88070558 2,199,210
58 PT. BINA SAN PRIMA 2542 25/04/2017 25/05/2017 88070559 3,227,079
59 PT. BINA SAN PRIMA 2543 25/04/2017 25/05/2017 88070560 1,223,961
60 PT. BINA SAN PRIMA 3053 28/04/2017 28/05/2017 88071066 1,238,145
61 PT. BINA SAN PRIMA 3054 28/04/2017 28/05/2017 88071067 1,429,038
RETUR 831,270 11,951,717
62 PT. MENSA BINA SUKSES 8161 31/03/2017 30/04/2017 83616107 7,298,850
63 PT. MENSA BINA SUKSES 8173 31/03/2017 30/04/2017 83616119 24,593,480
64 PT. MENSA BINA SUKSES 7203 31/03/2017 30/04/2017 83625011 11,986,958
65 PT. MENSA BINA SUKSES 7204 31/03/2017 30/04/2017 83625012 28,310,870
66 PT. MENSA BINA SUKSES 0037 31/03/2017 30/04/2017 83627812 6,335,028
67 PT. MENSA BINA SUKSES 0653 31/03/2017 30/04/2017 83628413 748,117
68 PT. MENSA BINA SUKSES 0248 31/03/2017 30/04/2017 83628013 1,193,081
69 PT. MENSA BINA SUKSES 5907 05/04/2017 05/05/2017 83643474 37,150,678
70 PT. MENSA BINA SUKSES 5804 07/04/2017 07/05/2017 83653185 1,885,783
71 PT. MENSA BINA SUKSES 4838 11/04/2017 11/05/2017 83671984 5,060,601
72 PT. MENSA BINA SUKSES 0224 13/04/2017 13/05/2017 83687112 23,440,538
73 PT. MENSA BINA SUKSES 3359 15/04/2017 15/05/2017 83690209 3,509,063
74 PT. MENSA BINA SUKSES 3361 15/04/2017 15/05/2017 83690211 2,621,849
75 PT. MENSA BINA SUKSES 3360 15/04/2017 15/05/2017 83690210 7,486,000
76 PT. MENSA BINA SUKSES 1975 18/04/2017 18/05/2017 83698730 4,678,750
166,299,644
77 PT. MILLENIUM PHARMACON I 3546 24/03/2017 23/04/2017 19264981 20,597,113
78 PT. MILLENIUM PHARMACON I 2894 08/03/2017 07/04/2017 19219972 7,668,127
79 PT. MILLENIUM PHARMACON I 3011 11/03/2017 10/04/2017 19228648 1,637,563
80 PT. MILLENIUM PHARMACON I 3012 11/03/2017 10/04/2017 19228649 5,634,200
35,537,002
81 PT. MERAPI UTAMA PHARMA 4837 15/04/2017 02/06/2017 83110656 1,267,279
82 PT. MERAPI UTAMA PHARMA 4940 17/04/2017 04/06/2017 83114794 8,211,157
83 PT. MERAPI UTAMA PHARMA 5104 20/04/2017 07/06/2017 83117871 9,668,662
84 PT. MERAPI UTAMA PHARMA 5141 20/04/2017 07/06/2017 83117875 1,188,463
85 PT. MERAPI UTAMA PHARMA 5152 20/04/2017 07/06/2017 83117876 1,680,656
86 PT. MERAPI UTAMA PHARMA 4838 15/04/2017 02/06/2017 83110657 2,737,414
87 PT. MERAPI UTAMA PHARMA 4679 11/04/2017 29/05/2017 83106028 20,038,052
88 PT. MERAPI UTAMA PHARMA 4494 07/04/2017 25/05/2017 83101485 2,659,500
89 PT. MERAPI UTAMA PHARMA 4506 07/04/2017 25/05/2017 83101488 1,389,182
90 PT. MERAPI UTAMA PHARMA 4529 07/04/2017 25/05/2017 83101490 10,376,851
91 PT. MERAPI UTAMA PHARMA 4684 11/04/2017 29/05/2017 83106029 617,891
92 PT. MERAPI UTAMA PHARMA 4752 12/04/2017 30/05/2017 83108365 3,368,700
93 PT. MERAPI UTAMA PHARMA 4876 15/04/2017 02/06/2017 83110660 5,983,875
RETUR 2,405,081 69,187,681
94 PT. DOS NI ROHA 9590 10/04/2017 10/05/2017 93293554 1,671,053
95 PT. DOS NI ROHA 5006 13/04/2017 13/05/2017 93288552 7,978,500
96 PT. DOS NI ROHA 5011 13/04/2017 13/05/2017 93288553 1,065,376
97 PT. DOS NI ROHA 3525 17/04/2017 17/05/2017 93293580 4,731,073
98 PT. DOS NI ROHA 7238 18/04/2017 18/05/2017 93297279 16,386,460
99 PT. DOS NI ROHA 0354 18/04/2017 18/05/2017 93297290 3,841,500
100 PT. DOS NI ROHA 0844 18/04/2017 18/05/2017 93297296 12,207,696
101 PT. DOS NI ROHA 9639 22/04/2017 22/05/2017 93150839 290,129
102 PT. DOS NI ROHA 0351 22/04/2017 22/05/2017 93145588 9,653,000
103 PT. DOS NI ROHA 5161 25/04/2017 25/05/2017 93155609 10,348,804
104 PT. DOS NI ROHA 1469 26/04/2017 26/05/2017 93155624 3,324,375
105 PT. DOS NI ROHA 1584 26/04/2017 26/05/2017 93155625 2,411,280
106 PT. DOS NI ROHA 1861 26/04/2017 26/05/2017 93155626 9,519,717
107 PT. DOS NI ROHA 2179 26/04/2017 26/05/2017 93155627 12,459,659
108 PT. DOS NI ROHA 5092 27/04/2017 27/05/2017 93165718 6,944,250
109 PT. DOS NI ROHA 3094 29/04/2017 29/05/2017 93166695 664,875
110 PT. DOS NI ROHA 3095 29/04/2017 29/05/2017 93166696 3,749,895
111 PT. DOS NI ROHA 6297 29/04/2017 29/05/2017 93166739 1,188,304
112 PT. DOS NI ROHA 6298 29/04/2017 29/05/2017 93166740 18,179,160
RETUR 2,150,035 126,615,106
113 PT. PARIT PADANG GLOBAL 3377 16/03/2017 06/04/2017 49288619 12,740,975
114 PT. PARIT PADANG GLOBAL 3043 09/03/2017 30/03/2017 49262216 12,272,697
115 PT. PARIT PADANG GLOBAL 4618 07/04/2017 28/04/2017 49377753 10,209,919
116 PT. PARIT PADANG GLOBAL 4873 12/04/2017 03/05/2017 49396625 4,840,290
117 PT. PARIT PADANG GLOBAL 5072 17/04/2017 08/05/2017 49410045 8,451,300
118 PT. PARIT PADANG GLOBAL 5145 18/04/2017 09/05/2017 49416230 21,014,236
119 PT. PARIT PADANG GLOBAL 4802 11/04/2017 02/05/2017 49391474 3,939,606
73,469,023
120 PT. ULICO PHARMA 0343 08/05/2017 07/06/2017 03365324 Rp 3,698,159
121 PT. ULICO PHARMA 0408 15/05/2017 14/06/2017 03365325 Rp 1,918,780
122 PT. ULICO PHARMA 0304 21/04/2017 21/05/2017 03365321 Rp 2,465,442
123 PT. ULICO PHARMA 0342 21/04/2017 21/05/2017 03365323 Rp 2,931,360
124 PT. ULICO PHARMA 0331 10/04/2017 10/05/2017 03365322 Rp 3,698,159
125 PT. ULICO PHARMA 0302 06/04/2017 06/05/2017 03365320 Rp 1,232,719
15,944,619
126 PT. ENSEVAL PUTERA 0374 18/04/2017 17/06/2017 06760766 3,237,639
127 PT. ENSEVAL PUTERA 0382 20/04/2017 19/06/2017 06785012 487,575
128 PT. ENSEVAL PUTERA 3302 21/04/2017 20/06/2017 06804589 1,255,875
129 PT. ENSEVAL PUTERA 3349 22/04/2017 21/06/2017 06810552 4,033,575
130 PT. ENSEVAL PUTERA 3859 27/04/2017 26/06/2017 06858728 24,766,840
131 PT. ENSEVAL PUTERA 3869 27/04/2017 26/06/2017 06859646 11,415,914
132 PT. ENSEVAL PUTERA 0396 27/04/2017 26/06/2017 06853399 22,765,320
133 PT. ENSEVAL PUTERA 0398 27/04/2017 26/06/2017 06854028 28,456,650
134 PT. ENSEVAL PUTERA 0404 27/04/2017 26/06/2017 06863120 3,049,022
135 PT. ENSEVAL PUTERA 1400 06/04/2017 05/06/2017 13843473 2,807,250
136 PT. ENSEVAL PUTERA 1401 06/04/2017 05/06/2017 13843477 12,539,050
137 PT. ENSEVAL PUTERA 1402 06/04/2017 05/06/2017 13843476 383,914
138 PT. ENSEVAL PUTERA 1415 06/04/2017 05/06/2017 13844077 18,780,503
139 PT. ENSEVAL PUTERA 0337 06/04/2017 05/06/2017 13845886 6,494,295
140 PT. ENSEVAL PUTERA 0433 05/05/2017 04/07/2017 06951332 9,336,442
141 PT. ENSEVAL PUTERA 4904 05/05/2017 04/07/2017 06952538 15,011,400
142 PT. ENSEVAL PUTERA 4901 05/05/2017 04/07/2017 06952223 836,807
143 PT. ENSEVAL PUTERA 4893 05/05/2017 04/07/2017 06951584 3,250,500
144 PT. ENSEVAL PUTERA 4886 05/05/2017 04/07/2017 06950991 5,820,365
145 PT. ENSEVAL PUTERA 4899 05/05/2017 04/07/2017 06951868 17,883,463
146 PT. ENSEVAL PUTERA 2759 18/04/2017 17/06/2017 06756111 14,955,255
147 PT. ENSEVAL PUTERA 2795 18/04/2017 17/06/2017 06758301 1,329,750
148 PT. ENSEVAL PUTERA 3129 20/04/2017 19/06/2017 06784967 3,073,200
149 PT. ENSEVAL PUTERA 3159 20/04/2017 19/06/2017 06788383 7,623,900
RETUR 1,896,297 219,594,503
150 PT. KIMIA FARMA 0612 29/04/2017 20/05/2017 45996261 20,141,267
151 PT. KIMIA FARMA 8959 26/04/2017 17/05/2017 45985609 3,506,141
152 PT. KIMIA FARMA 6719 29/04/2017 20/05/2017 45996195 507,182
153 PT. KIMIA FARMA 0813 17/04/2017 08/05/2017 45966494 2,185,961
154 PT. KIMIA FARMA 8540 29/04/2017 20/05/2017 45996235 2,820,685
155 PT. KIMIA FARMA 4245 28/04/2017 19/05/2017 45991671 428,042
156 PT. KIMIA FARMA 0558 21/04/2017 12/05/2017 45976858 591,236
157 PT. KIMIA FARMA 0778 17/04/2017 08/05/2017 45966492 6,181,663
158 PT. KIMIA FARMA 8430 15/04/2017 06/05/2017 45964141 1,235,781
159 PT. KIMIA FARMA 8075 10/04/2017 01/05/2017 45954720 3,221,837
40,819,795
160 PT. UNITED DICO CITAS 7389 19/04/2017 10/05/2017 48586232 7,723,815

161 PT. INDO FARMA GLOBAL M 1636 03/04/2017 18/05/2017 1,358,069


162 PT. INDO FARMA GLOBAL M 1568 03/04/2017 18/05/2017 4,270,259
163 PT. INDO FARMA GLOBAL M 1536 03/04/2017 18/05/2017 972,786
164 PT. INDO FARMA GLOBAL M 1537 03/04/2017 18/05/2017 6,402,500
165 PT. INDO FARMA GLOBAL M 1456 24/03/2017 08/05/2017 2,437,875
166 PT. INDO FARMA GLOBAL M 1374 27/03/2017 11/05/2017 6,216,828
167 PT. INDO FARMA GLOBAL M 1187 13/03/2017 27/04/2017 6,175,950
168 PT. INDO FARMA GLOBAL M 1114 06/03/2017 20/04/2017 4,689,032
169 PT. INDO FARMA GLOBAL M 1476 27/03/2017 11/05/2017 14,043,861
170 PT. INDO FARMA GLOBAL M 1458 27/03/2017 11/05/2017 1,667,292
171 PT. INDO FARMA GLOBAL M 1457 27/03/2017 11/05/2017 3,709,113
51,943,564
172 PT. TEMPO 7885 08/05/2017 07/06/2017 90229106 1,164,091
173 PT. TEMPO 6540 26/04/2017 26/05/2017 90167402 1,329,750
174 PT. TEMPO 6392 25/04/2017 25/05/2017 90162003 2,041,636
175 PT. TEMPO 1923 14/03/2017 13/04/2017 17217587 5,439,886
176 PT. TEMPO 1915 14/03/2017 13/04/2017 17217591 568,614
177 PT. TEMPO 1914 14/03/2017 13/04/2017 17217592 15,789,102
. 26,333,080
178 PT. SAPTA SARI 7848 08/03/2017 29/03/2017 98831516 Rp 2,067,116
179 PT. SAPTA SARI 0937 29/04/2017 20/05/2017 60323004 Rp 4,533,946
180 PT. SAPTA SARI 0944 29/04/2017 20/05/2017 60322942 Rp 1,473,806
8,074,868
TOTAL

Mengetahui,
Kepala Instalasi Farmasi

TONI DAFIAPUTRA, S.FARM, APT


NIP.19841023 200803 1 001

LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG


BHP RUTIN
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
02 Juni 2017
NO DISTRIBUTOR NO FACT TGL FACT JT. TEMPO NO.F STDR TAGIHAN
1 PT. BHAKTI SEJAHTERA M P536 11/04/2017 9,286,311
2 PT. BHAKTI SEJAHTERA M P575 20/04/2017 32,672,450
3 PT. BHAKTI SEJAHTERA M P016 25/04/2017 7,426,900
49,385,661
4 PT. BRATACO 0735 CASH 48839259 1,343,182

5 CV. RAFIN JAYA 0442 07/03/2017 38936591 5,352,983

6 PT. MUARA NATIO P 2530 12/05/2017 99872530 1,206,625


7 PT. MUARA NATIO P 2529 08/05/2017 99872529 9,091,550
8 PT. MUARA NATIO P 2520 03/05/2017 99872520 18,222,500
28,520,675
9 PT. SAPTA SARI 8985 27/03/2017 60268571 1,746,331
10 PT. SAPTA SARI 0936 29/04/2017 60323092 5,642,056
7,388,387
11 PT. MUTIARA LABSAINS 0427 14/02/2017 34826566 7,535,250
12 PT. MUTIARA LABSAINS 0614 02/03/2017 34826753 3,590,325
13 PT. MUTIARA LABSAINS 0936 30/03/2017 34827075 2,758,000
14 PT. MUTIARA LABSAINS 0984 04/04/2017 34827123 2,561,000
15 PT. MUTIARA LABSAINS 1029 07/04/2017 87280179 11,032,000
16 PT. MUTIARA LABSAINS 0936 10/04/2017 87280197 8,052,375
35,528,950
18 PT. AFINA SC 1596 28/04/2017 81924659 18,050,125

19 PT. BIO MULTI MEDIKA 0091 02/05/2017 61690487 2,240,875


20 PT. BIO MULTI MEDIKA 0092 04/05/2017 61690488 7,436,750
21 PT. BIO MULTI MEDIKA 0094 05/05/2017 61690489 29,397,325
22 PT. BIO MULTI MEDIKA 0095 06/05/2017 61690490 22,994,825
23 PT. BIO MULTI MEDIKA 0096 08/05/2017 61690491 11,424,030
24 PT. BIO MULTI MEDIKA 0097 09/05/2017 61690492 34,272,090
25 PT. BIO MULTI MEDIKA 0099 16/05/2017 61690493 17,730,000
26 PT. BIO MULTI MEDIKA 0104 20/05/2017 67844602 43,871,112
27 PT. BIO MULTI MEDIKA 0105 22/05/2017 67844603 41,794,929
28 PT. BIO MULTI MEDIKA 0106 22/05/2017 67844604 39,318,048
29 PT. BIO MULTI MEDIKA 0108 23/05/2017 67844605 16,587,400
30 PT. BIO MULTI MEDIKA 0109 23/05/2017 67844606 39,696,485
31 PT. BIO MULTI MEDIKA 0110 24/05/2017 67844607 42,235,815
32 PT. BIO MULTI MEDIKA 0111 24/05/2017 67844608 39,173,450
33 PT. BIO MULTI MEDIKA 0112 26/05/2017 67844609 25,718,350
34 PT. BIO MULTI MEDIKA 0113 26/05/2017 67844610 36,732,620
450,624,104
35 PT. CITRA PURNAMA S 0031 22/04/2017 01881023 2,206,400
36 PT. CITRA PURNAMA S 0032 25/04/2017 01881024 7,830,750
37 PT. CITRA PURNAMA S 0033 05/05/2017 01881025 8,312,908
38 PT. CITRA PURNAMA S 0034 15/05/2017 01881026 1,822,250
39 PT. CITRA PURNAMA S 0035 19/05/2017 01881027 9,869,700
40 PT. CITRA PURNAMA S 0036 19/05/2017 01881028 3,516,450
41 PT. CITRA PURNAMA S 0037 23/05/2017 01881029 4,432,500
37,990,958
42 PT. ENSEVAL PUTERA 0291 23/03/2017 13692585 1,543,298
43 PT. ENSEVAL PUTERA 9474 22/03/2017 13671850 10,871,715
44 PT. ENSEVAL PUTERA 0302 29/03/2017 13736692 2,648,291
45 PT. ENSEVAL PUTERA 0411 30/03/2017 13759847 13,366,556
46 PT. ENSEVAL PUTERA 2762 18/04/2017 06756502 13,283,592
47 PT. ENSEVAL PUTERA 2976 19/04/2017 06769307 1,508,705
48 PT. ENSEVAL PUTERA 3855 27/04/2017 06858479 977,834
49 PT. ENSEVAL PUTERA 4040 28/04/2017 06876613 3,911,337
50 PT. ENSEVAL PUTERA 4240 29/04/2017 06894869 884,335
51 PT. ENSEVAL PUTERA 4238 30/04/2017 06894878 2,014,587
51,010,249
52 PT. HOTAMA MEDIPHAR 0392 09/05/2017 69091435 24,625,000

TOTAL

Mengetahui,
Kepala Instalasi Farmasi

TONI DAFIAPUTRA, S.FARM, APT


NIP.19841023 200803 1 001
AYARAN HUTANG

MUARA BUNGO

PPN PPH SUB TOTAL TOTAL


735,119 110,268 8,086,310
370,440 55,566 4,074,840
175,077 26,262 1,925,849
13,400 2,010 147,400
68,903 10,335 757,933
521,928 78,289 5,741,203
32,346 4,852 355,806
29,770 4,466 327,470
36,191 5,429 398,099
556,258 83,439 6,118,839
379,909 56,986 4,178,997
113,318 16,998 1,246,499
17,670 2,650 194,367
199,102 29,865 2,190,118
42,636 6,395 468,996
551,509 82,726 6,066,599
284,449 42,667 3,128,940
50,941 7,641 560,349
24,455 3,668 269,005
171,344 25,702 1,884,784
4,374,764 656,215 48,122,403
780,000 117,000 8,580,000
91,000 13,650 1,001,000
859,521 128,928 9,454,732
773,642 116,046 8,510,062
239,706 35,956 2,636,766
272,891 40,934 3,001,799
1,769,000 265,350 19,459,000
579,545 86,932 6,375,000
726,600 108,990 7,992,600
663,283 99,492 7,296,116
220,110 33,016 2,421,205
77,000 11,550 847,000
1,156,006 173,401 12,716,063
492,783 73,917 5,420,608
1,446,715 217,007 15,913,868
307,125 46,069 3,378,375
390,000 58,500 4,290,000
114,817 17,223 1,262,988
917,334 137,600 10,090,671
122,182 18,327 1,343,999
1,411,014 211,652 15,521,157
1,609,970 241,495 17,709,667
288,636 43,295 3,175,000
73,638 11,046 810,018
309,091 46,364 3,399,999
707,356 106,103 7,780,917
16,398,965 2,459,845 180,388,610
121,706 18,256 1,338,766
625,772 93,866 6,883,496
11,850 1,778 130,350
271,818 40,773 2,989,998
349,118 52,368 3,840,298
288,146 43,222 3,169,601
457,523 68,628 5,032,749
82,454 12,368 906,994
397,600 59,640 4,373,600
2,605,987 390,898 28,665,852
267,440 40,116 2,941,840
223,270 33,491 2,455,970
327,622 49,143 3,603,845
124,260 18,639 1,366,860
125,700 18,855 1,382,700
145,080 21,762 1,595,880
1,213,372 182,006 13,347,095
741,000 111,150 8,151,000
2,496,800 374,520 27,464,800
1,216,950 182,543 13,386,450
2,874,200 431,130 31,616,200
643,150 96,473 7,074,650
75,951 11,393 835,461
121,125 18,169 1,332,375
3,771,642 565,746 41,488,067
191,450 28,718 2,105,950
513,767 77,065 5,651,433
2,379,750 356,963 26,177,250
356,250 53,438 3,918,750
266,178 39,927 2,927,953
760,000 114,000 8,360,000
475,000 71,250 5,225,000
16,883,213 2,532,482 185,715,339
2,091,077 313,662 23,001,852
778,490 116,774 8,563,390
166,250 24,938 1,828,750
572,000 85,800 6,292,000
3,607,817 541,173 39,685,992
128,658 19,299 1,415,235
833,620 125,043 9,169,820
981,590 147,239 10,797,490
120,656 18,098 1,327,218
170,625 25,594 1,876,875
277,910 41,687 3,057,010
2,034,320 305,148 22,377,520
270,000 40,500 2,970,000
141,034 21,155 1,551,371
1,053,487 158,023 11,588,362
62,730 9,410 690,030
342,000 51,300 3,762,000
607,500 91,125 6,682,500
7,024,130 1,053,620 77,265,431
169,650 25,448 1,866,150
810,000 121,500 8,910,000
108,160 16,224 1,189,760
480,312 72,047 5,283,432
1,663,600 249,540 18,299,600
390,000 58,500 4,290,000
1,239,360 185,904 13,632,960
29,455 4,418 324,002
980,000 147,000 10,780,000
1,050,640 157,596 11,557,040
337,500 50,625 3,712,500
244,800 36,720 2,692,800
966,469 144,970 10,631,156
1,264,940 189,741 13,914,340
705,000 105,750 7,755,000
67,500 10,125 742,500
380,700 57,105 4,187,700
120,640 18,096 1,327,040
1,845,600 276,840 20,301,600
12,854,325 1,928,149 141,397,580
1,293,500 194,025 14,228,500
1,245,959 186,894 13,705,550
1,036,540 155,481 11,401,940
491,400 73,710 5,405,400
858,000 128,700 9,438,000
2,133,425 320,014 23,467,675
399,960 59,994 4,399,560
7,458,784 1,118,818 82,046,625
Rp 375,448 Rp 56,317 Rp 4,129,924
Rp 194,800 Rp 29,220 Rp 2,142,800
Rp 250,299 Rp 37,545 Rp 2,753,285
Rp 297,600 Rp 44,640 Rp 3,273,600
Rp 375,448 Rp 56,317 Rp 4,129,924
Rp 125,149 Rp 18,772 Rp 1,376,641
1,618,743 242,811 17,806,174
328,694 49,304 3,615,638
49,500 7,425 544,500
127,500 19,125 1,402,500
409,500 61,425 4,504,500
2,514,400 377,160 27,658,400
1,158,976 173,846 12,748,736
2,311,200 346,680 25,423,200
2,889,000 433,350 31,779,000
309,545 46,432 3,404,999
285,000 42,750 3,135,000
1,273,000 190,950 14,003,000
38,976 5,846 428,736
1,906,650 285,998 20,973,150
659,319 98,898 7,252,512
947,862 142,179 10,426,484
1,524,000 228,600 16,764,000
84,955 12,743 934,505
330,000 49,500 3,630,000
590,900 88,635 6,499,900
1,815,580 272,337 19,971,380
1,518,300 227,745 16,701,300
135,000 20,250 1,485,000
312,000 46,800 3,432,000
774,000 116,100 8,514,000
22,293,858 3,344,079 245,232,440
2,044,799 306,720 22,492,786
355,953 53,393 3,915,487
51,491 7,724 566,396
221,925 33,289 2,441,175
286,364 42,955 3,150,004
43,456 6,518 478,016
60,024 9,004 660,264
627,580 94,137 6,903,380
125,460 18,819 1,380,060
327,090 49,064 3,597,990
4,144,142 621,621 45,585,558
784,144 117,622 8,625,580
8,625,580
137,875 20,681 1,516,625
433,529 65,029 4,768,817
98,760 14,814 1,086,360
650,000 97,500 7,150,000
247,500 37,125 2,722,500
631,150 94,673 6,942,650
627,000 94,050 6,897,000
476,044 71,407 5,236,482
1,425,773 213,866 15,683,500
169,268 25,390 1,861,950
376,560 56,484 4,142,157
5,273,458 791,019 58,008,041
118,182 17,727 1,300,000
135,000 20,250 1,485,000
207,273 31,091 2,280,000
552,273 82,841 6,075,000
57,727 8,659 635,000
1,602,955 240,443 17,632,500
2,673,409 401,011 29,407,500
Rp 209,859 Rp 31,479 Rp 2,308,454
Rp 460,299 Rp 69,045 Rp 5,063,290
Rp 149,625 Rp 22,444 Rp 1,645,875
819,784 122,968 9,017,619
1,210,317,839 1,210,317,839

Muara Bungo, 10 Juni 2017

AYU TRESNAWATI
NIP 19660908 198803 2 002

AYARAN HUTANG

MUARA BUNGO

PPN PPH SUB TOTAL TOTAL


942,773 141,416 10,370,500
3,317,000 497,550 36,487,000
754,000 113,100 8,294,000
5,013,773 752,066 55,151,500
136,364 20,455 1,500,000
1,500,000
543,450 81,518 5,977,950
5,977,950
122,500 18,375 1,347,500
923,000 138,450 10,153,000
1,850,000 277,500 20,350,000
2,895,500 434,325 31,850,500
177,292 26,594 1,950,217
572,798 85,920 6,300,773
750,090 112,514 8,250,990
765,000 114,750 8,415,000
364,500 54,675 4,009,500
280,000 42,000 3,080,000
260,000 39,000 2,860,000
1,120,000 168,000 12,320,000
817,500 122,625 8,992,500
3,607,000 541,050 39,677,000
1,832,500 274,875 20,157,500
20,157,500
227,500 34,125 2,502,500
755,000 113,250 8,305,000
2,984,500 447,675 32,829,500
2,334,500 350,175 25,679,500
1,159,800 173,970 12,757,800
3,479,400 521,910 38,273,400
1,800,000 270,000 19,800,000
4,453,920 668,088 48,993,120
4,243,140 636,471 46,674,540
3,991,680 598,752 43,908,480
1,684,000 252,600 18,524,000
4,030,100 604,515 44,331,100
4,287,900 643,185 47,166,900
3,977,000 596,550 43,747,000
2,611,000 391,650 28,721,000
3,729,200 559,380 41,021,200
45,748,640 6,862,296 503,235,040
224,000 33,600 2,464,000
795,000 119,250 8,745,000
843,950 126,593 9,283,450
185,000 27,750 2,035,000
1,002,000 150,300 11,022,000
357,000 53,550 3,927,000
450,000 67,500 4,950,000
3,856,950 578,543 42,426,450
156,680 23,502 1,723,480
1,103,727 165,559 12,141,002
268,862 40,329 2,957,482
1,357,011 203,552 14,927,118
1,348,588 202,288 14,834,468
153,168 22,975 1,684,848
99,272 14,891 1,091,997
397,090 59,564 4,367,990
89,780 13,467 987,582
204,527 30,679 2,249,793
5,178,705 776,806 56,965,760
2,500,000 375,000 27,500,000
27,500,000
792,692,690 792,692,690

Muara Bungo, 02 Juni 2017

AYU TRESNAWATI
NIP 19660908 198803 2 002
LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG
OBAT REGULER
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
10 Juli 2017
NO DISTRIBUTOR NO FACT TGL FACT JT. TEMPO NO.F STDR TAGIHAN
1 PT. MERAPI UTAMA PHARMA 5017 18/04/2017 05/06/2017 83115109 4,609,800
2 PT. MERAPI UTAMA PHARMA 5199 21/04/2017 08/06/2017 83118337 18,960,383
3 PT. MERAPI UTAMA PHARMA 5198 21/04/2017 08/06/2017 83118336 2,382,247
4 PT. MERAPI UTAMA PHARMA 5434 27/04/2017 14/06/2017 83137639 4,455,825
5 PT. MERAPI UTAMA PHARMA 5435 27/04/2017 14/06/2017 83137640 2,127,600
6 PT. MERAPI UTAMA PHARMA 5433 27/04/2017 14/06/2017 83137638 4,131,459
7 PT. MERAPI UTAMA PHARMA 5567 29/04/2017 16/06/2017 83138970 5,369,511
8 PT. MERAPI UTAMA PHARMA 5857 06/05/2017 23/06/2017 55727513 6,402,500
9 PT. MERAPI UTAMA PHARMA 5861 06/05/2017 23/06/2017 55727514 12,214,493
10 PT. MERAPI UTAMA PHARMA 5862 06/05/2017 23/06/2017 55727515 4,000,558
11 PT. MERAPI UTAMA PHARMA 5959 08/05/2017 25/06/2017 55729958 281,710
12 PT. MERAPI UTAMA PHARMA 6175 13/05/2017 30/06/2017 55736055 23,935,500
13 PT. MERAPI UTAMA PHARMA 6219 13/05/2017 30/06/2017 55736057 197,197
14 PT. MERAPI UTAMA PHARMA 6296 16/05/2017 03/07/2017 65021353 4,676,288
15 PT. MERAPI UTAMA PHARMA 6314 16/05/2017 03/07/2017 65021354 5,755,651
16 PT. MERAPI UTAMA PHARMA 6315 16/05/2017 03/07/2017 65021355 4,530,527
17 PT. MERAPI UTAMA PHARMA 6538 22/05/2017 09/07/2017 65032923 22,651,257
18 PT. MERAPI UTAMA PHARMA 6553 22/05/2017 09/07/2017 65032924 1,853,672
19 PT. MERAPI UTAMA PHARMA 6592 23/05/2017 10/07/2017 65034381 2,534,558
20 PT. MERAPI UTAMA PHARMA 6593 23/05/2017 10/07/2017 65034382 3,878,189
21 PT. MERAPI UTAMA PHARMA 6642 23/05/2017 10/07/2017 65034384 1,300,200
22 PT. MERAPI UTAMA PHARMA 6907 29/05/2017 16/07/2017 65042897 3,502,660
23 PT. MERAPI UTAMA PHARMA 6880 29/05/2017 16/07/2017 65042892 1,674,500
24 PT. MERAPI UTAMA PHARMA 6951 30/05/2017 17/07/2017 65047638 13,445,250
25 PT. MERAPI UTAMA PHARMA 6987 31/05/2017 18/07/2017 65051618 2,725,544
26 PT. MERAPI UTAMA PHARMA 7013 31/05/2017 18/07/2017 65051622 5,186,025
27 PT. MERAPI UTAMA PHARMA 7063 31/05/2017 18/07/2017 65051629 4,925,000
167,708,101
28 PT. TEMPO 9463 22/05/2017 21/06/2017 90293109 5,104,091
28 PT. TEMPO 1242 09/06/2017 09/07/2017 90381785 5,193,636
10,297,727
30 PT. KIMIA FARMA 1838 21/04/2017 12/05/2017 45976858 2,617,988
31 PT. KIMIA FARMA 9533 05/05/2017 26/05/2017 46004678 1,070,104
32 PT. KIMIA FARMA 9530 05/05/2017 26/05/2017 46004677 6,402,500
33 PT. KIMIA FARMA 0202 17/05/2017 07/06/2017 46025594 6,207,982
34 PT. KIMIA FARMA 3158 18/05/2017 08/06/2017 46027272 2,576,337
35 PT. KIMIA FARMA 5255 19/05/2017 09/06/2017 46028824 1,564,099
36 PT. KIMIA FARMA 5257 19/05/2017 09/06/2017 46028825 6,517,105
37 PT. KIMIA FARMA 3563 24/05/2017 14/06/2017 47911787 4,713,762
38 PT. KIMIA FARMA 5744 24/05/2017 14/06/2017 47911856 1,690,605
39 PT. KIMIA FARMA 5762 24/05/2017 14/06/2017 47911857 469,008
40 PT. KIMIA FARMA 1349 29/05/2017 19/06/2017 47917946 5,641,371
39,470,860
41 PT. BINA SAN PRIMA 0466 05/05/2017 04/06/2017 88071773 698,207
42 PT. BINA SAN PRIMA 0467 05/05/2017 04/06/2017 88071774 1,224,257
43 PT. BINA SAN PRIMA 1797 17/05/2017 16/06/2017 88073099 2,286,431
44 PT. BINA SAN PRIMA 1798 17/05/2017 16/06/2017 88073100 234,430
45 PT. BINA SAN PRIMA 1796 17/05/2017 16/06/2017 88073098 734,377
46 PT. BINA SAN PRIMA 3161 30/05/2017 29/06/2017 88074461 4,337,448
47 PT. BINA SAN PRIMA 3162 30/05/2017 29/06/2017 88074462 2,974,700
48 PT. BINA SAN PRIMA 3162 30/05/2017 29/06/2017 88074463 5,603,665
49 PT. BINA SAN PRIMA 3164 30/05/2017 29/06/2017 88074464 465,905
50 PT. BINA SAN PRIMA 3165 30/05/2017 29/06/2017 88074465 1,936,248
51 PT. BINA SAN PRIMA 3166 30/05/2017 29/06/2017 88074466 1,373,681
52 PT. BINA SAN PRIMA 0254 03/06/2017 03/07/2017 88074939 3,230,800
25,100,148
53 PT. ANUGRAH ARGON M 4066 17/03/2017 16/05/2017 70124715 3,864,468
54 PT. ANUGRAH ARGON M 4283 21/03/2017 20/05/2017 70139883 4,334,620
55 PT. ANUGRAH ARGON M 4280 21/03/2017 20/05/2017 70139880 5,068,285
56 PT. ANUGRAH ARGON M 4569 27/03/2017 26/05/2017 2,713,443
57 PT. ANUGRAH ARGON M 6547 02/05/2017 01/07/2017 42357901 13,819,089
58 PT. ANUGRAH ARGON M 6754 05/05/2017 04/07/2017 42374543 3,446,425
59 PT. ANUGRAH ARGON M 6755 05/05/2017 04/07/2017 42374544 5,288,906
60 PT. ANUGRAH ARGON M 6756 05/05/2017 04/07/2017 42374545 9,340,164
61 PT. ANUGRAH ARGON M 6915 09/05/2017 08/07/2017 42387312 6,151,235
62 PT. ANUGRAH ARGON M 6914 09/05/2017 08/07/2017 42387311 10,705,264
63 PT. ANUGRAH ARGON M 7154 13/05/2017 12/07/2017 42404422 878,620
64 PT. ANUGRAH ARGON M 7445 18/05/2017 17/07/2017 42427723 896,350
65 PT. ANUGRAH ARGON M 7446 18/05/2017 17/07/2017 42427724 784,131
66 PT. ANUGRAH ARGON M 7447 18/05/2017 17/07/2017 42427725 967,090
67 PT. ANUGRAH ARGON M 7448 18/05/2017 17/07/2017 42427726 8,460,510
68 PT. ANUGRAH ARGON M 7449 18/05/2017 17/07/2017 42427727 4,172,190
69 PT. ANUGRAH ARGON M 7546 20/05/2017 19/07/2017 42437956 1,406,580
70 PT. ANUGRAH ARGON M 7550 20/05/2017 19/07/2017 42437960 1,605,101
71 PT. ANUGRAH ARGON M 7551 20/05/2017 19/07/2017 42437961 1,745,868
72 PT. ANUGRAH ARGON M 7552 20/05/2017 19/07/2017 42437962 1,092,455
73 PT. ANUGRAH ARGON M 7553 20/05/2017 19/07/2017 42437963 6,962,571
74 PT. ANUGRAH ARGON M 7685 23/05/2017 22/07/2017 42449174 1,126,840
75 PT. ANUGRAH ARGON M 7686 23/05/2017 22/07/2017 42449175 2,265,463
76 PT. ANUGRAH ARGON M 7829 26/05/2017 25/07/2017 42461909 7,782,978
77 PT. ANUGRAH ARGON M 7830 26/05/2017 25/07/2017 42461910 8,856,011
78 PT. ANUGRAH ARGON M 7831 26/05/2017 25/07/2017 42461911 5,207,964
79 PT. ANUGRAH ARGON M 7832 26/05/2017 25/07/2017 42461912 13,738,956
80 PT. ANUGRAH ARGON M 7894 27/05/2017 26/07/2017 42467777 10,059,535
81 PT. ANUGRAH ARGON M 8071 30/05/2017 29/07/2017 42481511 6,702,476
82 PT. ANUGRAH ARGON M 8072 30/05/2017 29/07/2017 42481512 6,426,256
83 PT. ANUGRAH ARGON M 8073 30/05/2017 29/07/2017 42481513 6,878,528
84 PT. ANUGRAH ARGON M 8074 30/05/2017 29/07/2017 42481514 18,655,284
85 PT. ANUGRAH ARGON M 8075 30/05/2017 29/07/2017 42481515 371,435
86 PT. ANUGRAH ARGON M 8076 30/05/2017 29/07/2017 42481516 16,857,635
87 PT. ANUGRAH ARGON M 8077 30/05/2017 29/07/2017 42481517 6,317,790
88 PT. ANUGRAH ARGON M 8078 30/05/2017 29/07/2017 42481518 12,826,178
89 PT. ANUGRAH ARGON M 8147 31/05/2017 30/07/2017 42490383 16,084,434
90 PT. ANUGRAH ARGON M 8255 02/06/2017 01/08/2017 42498367 8,155,800
242,016,927
91 PT. ENSEVAL PUTERA 0436 05/05/2017 04/07/2017 06952569 7,519,131
92 PT. ENSEVAL PUTERA 5215 09/05/2017 08/07/2017 06984251 3,447,500
93 PT. ENSEVAL PUTERA 5586 10/05/2017 09/07/2017 07011790 2,462,500
94 PT. ENSEVAL PUTERA 0461 10/05/2017 09/07/2017 07011829 11,169,900
95 PT. ENSEVAL PUTERA 6237 16/05/2017 15/07/2017 07071777 4,752,625
96 PT. ENSEVAL PUTERA 6248 16/05/2017 15/07/2017 07072481 9,957,838
97 PT. ENSEVAL PUTERA 6253 16/05/2017 15/07/2017 07072705 17,937,392
98 PT. ENSEVAL PUTERA 6564 18/05/2017 17/07/2017 07101889 2,058,650
99 PT. ENSEVAL PUTERA 0501 20/05/2017 19/07/2017 07129598 447,732
100 PT. ENSEVAL PUTERA 0493 18/05/2017 17/07/2017 07101591 1,701,364
101 PT. ENSEVAL PUTERA 0482 16/05/2017 15/07/2017 07072143 1,728,137
102 PT. ENSEVAL PUTERA 6813 20/05/2017 19/07/2017 07126738 3,025,181
103 PT. ENSEVAL PUTERA 0521 29/05/2017 28/07/2017 07213476 2,865,455
104 PT. ENSEVAL PUTERA 0523 29/05/2017 28/07/2017 07216410 27,033,818
105 PT. ENSEVAL PUTERA 0524 29/05/2017 28/07/2017 07216699 18,496,823
106 PT. ENSEVAL PUTERA 8107 30/05/2017 29/07/2017 07237264 8,510,400
107 PT. ENSEVAL PUTERA 8106 30/05/2017 29/07/2017 07237266 10,269,364
108 PT. ENSEVAL PUTERA 8083 30/05/2017 29/07/2017 07235730 2,126,024
109 PT. ENSEVAL PUTERA 0530 30/05/2017 29/07/2017 07237777 882,986
110 PT. ENSEVAL PUTERA 8263 31/05/2017 30/07/2017 07254990 2,009,400
111 PT. ENSEVAL PUTERA 8191 31/05/2017 30/07/2017 07245889 325,050
112 PT. ENSEVAL PUTERA 8240 31/05/2017 30/07/2017 07251275 1,390,032
113 PT. ENSEVAL PUTERA 0535 31/05/2017 30/07/2017 07248232 4,762,142
114 PT. ENSEVAL PUTERA 0550 03/06/2017 02/08/2017 07285969 2,537,516
115 PT. ENSEVAL PUTERA 8606 03/06/2017 02/08/2017 07287766 1,255,875
148,672,832
116 PT. DOS NI ROHA 9177 02/05/2017 01/06/2017 93212296 11,081,250
117 PT. DOS NI ROHA 3464 05/05/2017 04/06/2017 93215012 4,770,662
118 PT. DOS NI ROHA 3465 05/05/2017 04/06/2017 93215013 15,074,019
119 PT. DOS NI ROHA 7842 06/05/2017 05/06/2017 93215016 2,048,800
120 PT. DOS NI ROHA 7843 06/05/2017 05/06/2017 93215017 12,945,825
121 PT. DOS NI ROHA 3710 09/05/2017 08/06/2017 93221673 38,998,120
122 PT. DOS NI ROHA 7284 09/05/2017 08/06/2017 93263793 1,339,600
123 PT. DOS NI ROHA 6975 12/05/2017 11/06/2017 93234400 1,970,000
124 PT. DOS NI ROHA 7102 12/05/2017 11/06/2017 93234401 9,377,200
125 PT. DOS NI ROHA 7104 12/05/2017 15/06/2017 93234402 4,801,875
126 PT. DOS NI ROHA 0666 16/05/2017 15/06/2017 93234428 377,165
127 PT. DOS NI ROHA 1370 16/05/2017 15/06/2017 93234429 1,130,288
128 PT. DOS NI ROHA 1372 16/05/2017 22/06/2017 93234430 4,161,231
129 PT. DOS NI ROHA 7600 23/05/2017 23/06/2017 93263800 4,157,094
130 PT. DOS NI ROHA 7672 24/05/2017 23/06/2017 93263804 8,955,497
131 PT. DOS NI ROHA 3027 24/05/2017 25/06/2017 93263810 12,963,684
132 PT. DOS NI ROHA 9212 26/05/2017 26/06/2017 93263816 5,540,625
133 PT. DOS NI ROHA 3619 27/05/2017 28/06/2017 93273377 5,540,625
134 PT. DOS NI ROHA 9113 29/05/2017 28/06/2017 93273386 31,963,250
135 PT. DOS NI ROHA 1355 29/05/2017 29/06/2017 93273393 3,969,550
136 PT. DOS NI ROHA 1376 30/05/2017 29/06/2017 93273394 8,374,377
137 PT. DOS NI ROHA 1380 30/05/2017 29/06/2017 93273395 5,051,573
138 PT. DOS NI ROHA 3178 30/05/2017 29/06/2017 93291245 543,720
139 PT. DOS NI ROHA 2371 30/05/2017 07/07/2017 93328306 14,395,184
140 PT. DOS NI ROHA 7728 07/06/2017 08/07/2017 93330510 8,956,605
141 PT. DOS NI ROHA 7729 08/06/2017 08/07/2017 93330511 6,550,250
142 PT. DOS NI ROHA 8072 08/06/2017 08/07/2017 93330512 2,636,230
143 PT. DOS NI ROHA 8734 08/06/2017 08/07/2017 93330513 5,162,019
144 PT. DOS NI ROHA 7632 08/06/2017 10/07/2017 93339386 42,347,120
145 PT. DOS NI ROHA 0689 10/06/2017 12/07/2017 93343286 689,500
146 PT. DOS NI ROHA 6197 12/06/2017 29/01/1900 93343291 2,801,094
278,674,030
148 PT. PENTA VALENT 6627 30/06/2017 28755742 13,227,971
149 PT. PENTA VALENT 6361 31/05/2017 30/06/2017 28737577 10,106,863
150 PT. PENTA VALENT 6402 23/05/2017 22/06/2017 28740094 3,390,863
RETUR 2,086,535 26,725,696
151 PT. INDO FARMA GLOBAL M 1798 12/04/2017 27/05/2017 7,798,245
152 PT. INDO FARMA GLOBAL M 1786 12/04/2017 27/05/2017 7,020,391
153 PT. INDO FARMA GLOBAL M 1670 05/04/2017 20/05/2017 7,707,401
22,526,037
154 PT. PARIT PADANG GLOBAL 5178 19/04/2017 10/05/2017 49419040 1,659,300
155 PT. PARIT PADANG GLOBAL 5710 29/04/2017 20/05/2017 49466157 18,685,450
156 PT. PARIT PADANG GLOBAL 5711 29/04/2017 20/05/2017 49466158 17,188,250
157 PT. PARIT PADANG GLOBAL 5712 29/04/2017 20/05/2017 49466159 10,244,000
158 PT. PARIT PADANG GLOBAL 7267 31/05/2017 21/06/2017 49581169 6,710,707
159 PT. PARIT PADANG GLOBAL 7359 31/05/2017 21/06/2017 49588739 6,067,600
160 PT. PARIT PADANG GLOBAL 7565 07/06/2017 28/06/2017 49606162 7,042,750
161 PT. PARIT PADANG GLOBAL 7568 07/06/2017 28/06/2017 49606269 4,728,000
162 PT. PARIT PADANG GLOBAL 7616 08/06/2017 29/06/2017 49610010 1,375,769
163 PT. PARIT PADANG GLOBAL 7621 08/06/2017 29/06/2017 49610168 23,463,035
164 PT. PARIT PADANG GLOBAL 7713 09/06/2017 30/06/2017 49617066 2,679,200
165 PT. PARIT PADANG GLOBAL 7769 10/06/2017 01/07/2017 49620466 14,419,454
166 PT. PARIT PADANG GLOBAL 7770 10/06/2017 01/07/2017 49620468 1,841,950
116,105,465
167 PT. ANUGRAH PHARMINDO L 4507 12/06/2017 12/07/2017 96897816 5,730,888
168 PT. ANUGRAH PHARMINDO L 4505 12/06/2017 12/07/2017 96897815 2,683,140
169 PT. ANUGRAH PHARMINDO L 4504 12/06/2017 12/07/2017 96872687 9,874,832
170 PT. ANUGRAH PHARMINDO L 4514 12/06/2017 12/07/2017 96897817 9,308,250
171 PT. ANUGRAH PHARMINDO L 4275 09/06/2017 08/08/2017 96885203 420,863
172 PT. ANUGRAH PHARMINDO L 4497 12/06/2017 11/08/2017 96872686 3,948,944
173 PT. ANUGRAH PHARMINDO L 4317 09/06/2017 08/08/2017 96885207 210,431
174 PT. ANUGRAH PHARMINDO L 4295 09/06/2017 08/08/2017 96853034 4,380,561
175 PT. ANUGRAH PHARMINDO L 4282 09/06/2017 08/08/2017 96885205 933,780
176 PT. ANUGRAH PHARMINDO L 4276 09/06/2017 08/08/2017 96885204 4,278,840
41,770,529
177 PT. MENSA BINA SUKSES 4307 21/04/2017 21/05/2017 22678471 18,768,805
178 PT. MENSA BINA SUKSES 1092 27/04/2017 27/05/2017 22704939 29,070,945
179 PT. MENSA BINA SUKSES 4377 28/04/2017 28/05/2017 22708164 6,891,690
180 PT. MENSA BINA SUKSES 5537 28/04/2017 28/05/2017 22709311 22,953,948
181 PT. MENSA BINA SUKSES 2730 29/04/2017 29/05/2017 22726249 3,509,063
182 PT. MENSA BINA SUKSES 5267 29/04/2017 29/05/2017 22728757 7,719,938
183 PT. MENSA BINA SUKSES 6818 05/05/2017 04/06/2017 22749986 3,102,750
184 PT. MENSA BINA SUKSES 9058 05/05/2017 04/06/2017 22752215 6,011,578
185 PT. MENSA BINA SUKSES 5784 05/05/2017 04/06/2017 22748965 18,222,327
RETUR 207,075 116,251,043
186 PT. UNITED DICO CITAS 7812 08/05/2017 29/05/2017 48586643 6,149,908
187 PT. UNITED DICO CITAS 7813 09/05/2017 30/05/2017 48586644 2,377,168
188 PT. UNITED DICO CITAS 7946 13/05/2017 03/06/2017 48586771 5,909,994
189 PT. UNITED DICO CITAS 8048 17/05/2017 07/06/2017 48586867 8,864,991
RETUR 2,252,250 23,302,061
TOTAL

Mengetahui,
Kepala Instalasi Farmasi
TONI DAFIAPUTRA, S.FARM, APT
NIP.19841023 200803 1 001

LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG


BHP RUTIN
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
02 Juli 2017
NO DISTRIBUTOR NO FACT TGL FACT JT. TEMPO NO.F STDR TAGIHAN
1 PT. MUARA NATIO P 2533 10/06/2017 10/07/2017 99872533 35,420,600
2 PT. MUARA NATIO P 2534 10/06/2017 10/07/2017 99872534 788,000
3 PT. MUARA NATIO P 2536 12/06/2017 12/07/2017 99872536 18,222,500
4 PT. MUARA NATIO P 2537 12/06/2017 12/07/2017 99872537 34,475,000
5 PT. MUARA NATIO P 2538 13/06/2017 13/07/2017 99872538 25,610,000
114,516,100
6 PT. CITRA PURNAMA S 0038 27/05/2017 26/06/2017 01881030 8,927,252
7 PT. CITRA PURNAMA S 0039 09/06/2017 09/07/2017 01881031 30,092,708
8 PT. CITRA PURNAMA S 0040 10/06/2017 10/07/2017 01881032 6,550,250
9 PT. CITRA PURNAMA S 0041 10/06/2017 10/07/2017 01881033 7,141,250
10 PT. CITRA PURNAMA S 0042 15/06/2017 15/07/2017 01881034 27,087,500
11 PT. CITRA PURNAMA S 0043 15/06/2017 15/07/2017 01881035 21,423,750
12 PT. CITRA PURNAMA S 0044 16/06/2017 16/07/2017 01881036 1,970,000
103,192,710
13 PT. BIO MULTI MEDIKA 0115 29/05/2017 28/06/2017 67844613 15,366,000
14 PT. BIO MULTI MEDIKA 0116 06/06/2017 06/07/2017 67844614 15,957,000
15 PT. BIO MULTI MEDIKA 0120 09/06/2017 09/07/2017 67844621 39,952,585
16 PT. BIO MULTI MEDIKA 0122 12/06/2017 12/07/2017 67844622 44,273,780
17 PT. BIO MULTI MEDIKA 0123 13/06/2017 13/07/2017 67844623 39,967,360
18 PT. BIO MULTI MEDIKA 0127 16/06/2017 16/07/2017 67844624 16,045,650
171,562,375
19 PT. BHAKTI SEJAHTERA M P711 18/05/2017 17/06/2017 6,717,700
20 PT. BHAKTI SEJAHTERA M P659 06/05/2017 05/06/2017 5,195,875
11,913,575
21 PT. ENSEVAL PUTERA 5122 08/05/2017 07/06/2017 06972452 24,109,944
22 PT. ENSEVAL PUTERA 0453 09/05/2017 08/06/2017 06988165 1,522,509
23 PT. ENSEVAL PUTERA 6243 16/05/2017 15/06/2017 07072129 9,390,695
24 PT. ENSEVAL PUTERA 6667 19/05/2017 18/06/2017 07113438 5,235,669
25 PT. ENSEVAL PUTERA 5871 13/05/2017 12/06/2017 07039543 1,673,614
26 PT. ENSEVAL PUTERA 0492 18/05/2017 17/06/2017 07098368 2,030,012
27 PT. ENSEVAL PUTERA 6796 20/05/2017 19/06/2017 07125495 3,447,500
28 PT. ENSEVAL PUTERA 6847 20/05/2017 19/06/2017 07129301 1,410,343
29 PT. ENSEVAL PUTERA 7055 23/05/2017 22/06/2017 07149448 3,447,500
30 PT. ENSEVAL PUTERA 7119 23/05/2017 22/06/2017 07154624 1,329,750
31 PT. ENSEVAL PUTERA 7144 23/05/2017 22/06/2017 07157294 3,295,121

Mengetahui,
Kepala Instalasi Farmasi
TONI DAFIAPUTRA, S.FARM, APT
NIP.19841023 200803 1 001
RAN HUTANG

ARA BUNGO

PPN PPH SUB TOTAL TOTAL


468,000 70,200 5,148,000
1,924,912 288,737 21,174,032
241,852 36,278 2,660,377
452,368 67,855 4,976,048
216,000 32,400 2,376,000
419,437 62,916 4,613,812
545,128 81,769 5,996,408
650,000 97,500 7,150,000
1,240,050 186,008 13,640,550
406,148 60,922 4,467,628
28,600 4,290 314,600
2,430,000 364,500 26,730,000
20,020 3,003 220,220
474,750 71,213 5,222,250
584,330 87,650 6,427,630
459,952 68,993 5,059,472
2,299,620 344,943 25,295,820
188,190 28,229 2,070,090
257,316 38,597 2,830,471
393,725 59,059 4,330,972
132,000 19,800 1,452,000
355,600 53,340 3,911,600
170,000 25,500 1,870,000
1,365,000 204,750 15,015,000
276,705 41,506 3,043,755
526,500 78,975 5,791,500
500,000 75,000 5,500,000
17,026,203 2,553,930 187,288,235
518,182 77,727 5,700,000
527,273 79,091 5,800,000
1,045,455 156,818 11,500,000
265,786 39,868 2,923,641
108,640 16,296 1,195,040
650,000 97,500 7,150,000
630,252 94,538 6,932,772
261,557 39,234 2,877,128
158,792 23,819 1,746,709
661,635 99,245 7,277,985
478,555 71,783 5,264,100
171,635 25,745 1,887,985
47,615 7,142 523,765
572,728 85,909 6,300,008
4,007,194 601,079 44,079,133
70,884 10,633 779,724
124,290 18,644 1,367,190
232,125 34,819 2,553,375
23,800 3,570 261,800
74,556 11,183 820,116
440,350 66,053 4,843,850
302,000 45,300 3,322,000
568,900 85,335 6,257,900
47,300 7,095 520,300
196,573 29,486 2,162,307
139,460 20,919 1,534,060
328,000 49,200 3,608,000
2,548,238 382,236 28,030,622
392,332 58,850 4,315,650
440,063 66,009 4,840,692
514,547 77,182 5,660,014
275,476 41,321 3,030,241
1,402,953 210,443 15,432,485
349,891 52,484 3,848,799
536,945 80,542 5,906,393
948,240 142,236 10,430,640
624,491 93,674 6,869,399
1,086,829 163,024 11,955,117
89,200 13,380 981,200
91,000 13,650 1,001,000
79,607 11,941 875,679
98,182 14,727 1,079,999
858,935 128,840 9,448,285
423,573 63,536 4,659,299
142,800 21,420 1,570,800
162,954 24,443 1,792,499
177,245 26,587 1,949,700
110,909 16,636 1,220,000
706,860 106,029 7,775,460
114,400 17,160 1,258,400
229,996 34,499 2,529,959
790,150 118,523 8,691,650
899,087 134,863 9,889,962
528,727 79,309 5,816,000
1,394,818 209,223 15,342,996
1,021,273 153,191 11,233,999
680,454 102,068 7,484,999
652,412 97,862 7,176,530
698,328 104,749 7,681,605
1,893,937 284,091 20,833,312
37,709 5,656 414,800
1,711,435 256,715 18,825,785
641,400 96,210 7,055,400
1,302,150 195,323 14,323,650
1,632,937 244,941 17,962,312
828,000 124,200 9,108,000
24,570,246 3,685,537 270,272,710
763,364 114,505 8,396,999
350,000 52,500 3,850,000
250,000 37,500 2,750,000
1,134,000 170,100 12,474,000
482,500 72,375 5,307,500
1,010,948 151,642 11,120,428
1,821,055 273,158 20,031,605
209,000 31,350 2,299,000
45,455 6,818 500,005
172,727 25,909 1,900,000
175,445 26,317 1,929,899
307,125 46,069 3,378,375
290,909 43,636 3,200,000
2,744,550 411,683 30,190,050
1,877,850 281,678 20,656,350
864,000 129,600 9,504,000
1,042,575 156,386 11,468,325
215,840 32,376 2,374,240
89,643 13,446 986,076
204,000 30,600 2,244,000
33,000 4,950 363,000
141,120 21,168 1,552,320
483,466 72,520 5,318,128
257,616 38,642 2,833,774
127,500 19,125 1,402,500
15,093,689 2,264,053 166,030,574
1,125,000 168,750 12,375,000
484,331 72,650 5,327,643
1,530,357 229,554 16,833,930
208,000 31,200 2,288,000
1,314,297 197,145 14,457,267
3,959,200 593,880 43,551,200
136,000 20,400 1,496,000
200,000 30,000 2,200,000
952,000 142,800 10,472,000
487,500 73,125 5,362,500
38,291 5,744 421,199
114,750 17,213 1,262,250
422,460 63,369 4,647,060
422,040 63,306 4,642,440
909,188 136,378 10,001,063
1,316,110 197,417 14,477,210
562,500 84,375 6,187,500
562,500 84,375 6,187,500
3,245,000 486,750 35,695,000
403,000 60,450 4,433,000
850,191 127,529 9,352,096
512,850 76,928 5,641,350
55,200 8,280 607,200
1,461,440 219,216 16,075,840
909,300 136,395 10,002,300
665,000 99,750 7,315,000
267,638 40,146 2,944,013
524,063 78,609 5,764,691
4,299,200 644,880 47,291,200
70,000 10,500 770,000
284,375 42,656 3,128,125
28,291,780 4,243,767 311,209,577
1,342,941 201,441 14,772,353
1,026,077 153,912 11,286,852
344,250 51,638 3,786,750
2,713,269 406,990 29,845,955
791,700 118,755 8,708,700
712,730 106,910 7,840,030
782,477 117,372 8,607,250
2,286,907 343,036 25,155,980
168,457 25,269 1,853,025
1,897,000 284,550 20,867,000
1,745,000 261,750 19,195,000
1,040,000 156,000 11,440,000
681,290 102,194 7,494,190
616,000 92,400 6,776,000
715,000 107,250 7,865,000
480,000 72,000 5,280,000
139,672 20,951 1,536,392
2,382,034 357,305 26,202,374
272,000 40,800 2,992,000
1,463,904 219,586 16,102,944
187,000 28,050 2,057,000
11,787,357 1,768,104 129,660,925
581,816 87,272 6,399,977
272,400 40,860 2,996,400
1,002,521 150,378 11,027,731
945,000 141,750 10,395,000
42,727 6,409 469,999
400,908 60,136 4,409,988
21,364 3,205 234,999
444,727 66,709 4,891,997
94,800 14,220 1,042,800
434,400 65,160 4,778,400
4,240,663 636,099 46,647,291
1,905,462 285,819 20,960,087
2,951,365 442,705 32,465,015
699,664 104,950 7,696,304
2,330,350 349,553 25,633,850
356,250 53,438 3,918,750
783,750 117,563 8,621,250
315,000 47,250 3,465,000
610,312 91,547 6,713,437
1,849,982 277,497 20,349,807
11,802,136 1,770,320 129,823,500
624,356 93,653 6,867,918
241,337 36,201 2,654,705
599,999 90,000 6,599,993
899,999 135,000 9,899,990
2,365,691 354,854 26,022,606
1,405,567,108 1,405,567,108

Muara Bungo, 10 Juli 2017


AYU TRESNAWATI
NIP 19660908 198803 2 002

RAN HUTANG

ARA BUNGO

PPN PPH SUB TOTAL TOTAL


3,596,000 539,400 39,556,000
80,000 12,000 880,000
1,850,000 277,500 20,350,000
3,500,000 525,000 38,500,000
2,600,000 390,000 28,600,000
11,626,000 1,743,900 127,886,000
906,320 135,948 9,969,520
3,055,097 458,265 33,606,070
665,000 99,750 7,315,000
725,000 108,750 7,975,000
2,750,000 412,500 30,250,000
2,175,000 326,250 23,925,000
200,000 30,000 2,200,000
10,476,417 1,571,463 115,240,590
1,560,000 234,000 17,160,000
1,620,000 243,000 17,820,000
4,056,100 608,415 44,617,100
4,494,800 674,220 49,442,800
4,057,600 608,640 44,633,600
1,629,000 244,350 17,919,000
17,417,500 2,612,625 191,592,500
682,000 102,300 7,502,000
527,500 79,125 5,802,500
1,209,500 181,425 13,304,500
2,447,710 367,157 26,924,810
154,569 23,185 1,700,264
953,370 143,006 10,487,070
531,540 79,731 5,846,940
169,910 25,487 1,869,010
206,093 30,914 2,267,019
350,000 52,500 3,850,000
143,182 21,477 1,575,002
350,000 52,500 3,850,000
135,000 20,250 1,485,000
334,530 50,180 3,679,830
63,534,945
511,558,535 511,558,535

Muara Bungo, 02 Juli 2017


AYU TRESNAWATI
NIP 19660908 198803 2 002
LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG
OBAT REGULER
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
10 Agustus 2017
NO DISTRIBUTOR NO FACT TGL.FACT JT. TEMPO NO.F STDR TAGIHAN
1 PT. ANUGRAH ARGON M 8605 08/06/2017 07/08/2017 42524916 9,523,159
2 PT. ANUGRAH ARGON M 8606 08/06/2017 07/08/2017 42524917 2,938,280
3 PT. ANUGRAH ARGON M 8607 08/06/2017 07/08/2017 42524918 17,952,968
4 PT. ANUGRAH ARGON M 8608 08/06/2017 07/08/2017 42524919 10,181,425
5 PT. ANUGRAH ARGON M 8609 08/06/2017 07/08/2017 42524920 2,942,643
6 PT. ANUGRAH ARGON M 9193 19/06/2017 18/08/2017 42575374 14,777,413
7 PT. ANUGRAH ARGON M 9194 19/06/2017 18/08/2017 42575375 12,843,730
8 PT. ANUGRAH ARGON M 9195 19/06/2017 18/08/2017 42575376 13,982,523
9 PT. ANUGRAH ARGON M 9196 19/06/2017 18/08/2017 42575377 5,705,299
10 PT. ANUGRAH ARGON M 9197 19/06/2017 18/08/2017 42575378 2,344,611
11 PT. ANUGRAH ARGON M 9291 20/06/2017 19/08/2017 42583277 9,453,045
102,645,096
12 PT. UNITED DICO CITAS 8219 22/05/2017 12/06/2017 48587032 7,227,189
13 PT. UNITED DICO CITAS 8282 24/05/2017 14/06/2017 48587089 1,584,779
14 PT. UNITED DICO CITAS 8283 24/05/2017 14/06/2017 48587090 12,724,969
15 PT. UNITED DICO CITAS 8325 26/05/2017 16/06/2017 48587130 1,728,675
16 PT. UNITED DICO CITAS 8457 30/05/2017 20/06/2017 48587250 3,961,948
17 PT. UNITED DICO CITAS 8530 31/05/2017 21/06/2017 48587326 5,421,316
18 PT. UNITED DICO CITAS 8654 07/06/2017 28/06/2017 48587449 1,758,225
19 PT. UNITED DICO CITAS 8947 19/06/2017 10/07/2017 48587740 23,464,361
57,871,461
20 PT. MENSA BINA SUKSES 8862 05/05/2017 04/06/2017 22752020 12,632,625
21 PT. MENSA BINA SUKSES 2209 10/05/2017 09/06/2017 22775015 6,375,910
22 PT. MENSA BINA SUKSES 2210 10/05/2017 09/06/2017 22775016 4,622,207
23 PT. MENSA BINA SUKSES 2634 22/05/2017 21/06/2017 22824846 5,443,196
24 PT. MENSA BINA SUKSES 2635 22/05/2017 21/06/2017 22824847 37,935,305
25 PT. MENSA BINA SUKSES 0199 24/05/2017 23/06/2017 22842118 14,401,193
26 PT. MENSA BINA SUKSES 8387 27/05/2017 26/06/2017 22850231 11,315,434
27 PT. MENSA BINA SUKSES 8380 27/05/2017 26/06/2017 22850224 2,302,438
28 PT. MENSA BINA SUKSES 8145 31/05/2017 30/06/2017 22889491 3,537,135
29 PT. MENSA BINA SUKSES 8143 31/05/2017 30/06/2017 22889489 16,974,505
30 PT. MENSA BINA SUKSES 8138 31/05/2017 30/06/2017 22889484 7,031,373
31 PT. MENSA BINA SUKSES 8125 31/05/2017 30/06/2017 22889471 3,537,135
32 PT. MENSA BINA SUKSES 8212 31/05/2017 30/06/2017 22889558 18,078,690
144,187,146
33 PT. ENSEVAL PUTERA 7302 24/05/2017 23/07/2017 07170680 2,462,500
34 PT. ENSEVAL PUTERA 7313 24/05/2017 23/07/2017 07170685 13,568,375
35 PT. ENSEVAL PUTERA 7314 24/05/2017 23/07/2017 07170690 11,162,020
36 PT. ENSEVAL PUTERA 7315 24/05/2017 23/07/2017 07170688 6,376,644
37 PT. ENSEVAL PUTERA 7318 24/05/2017 23/07/2017 07170686 1,600,133
38 PT. ENSEVAL PUTERA 7327 24/05/2017 23/07/2017 07172948 4,688,108
39 PT. ENSEVAL PUTERA 0515 24/05/2017 23/07/2017 07172599 5,330,014
40 PT. ENSEVAL PUTERA 9187 08/06/2017 07/08/2017 07340542 13,493,909
41 PT. ENSEVAL PUTERA 9190 08/06/2017 07/08/2017 07340858 16,262,843
42 PT. ENSEVAL PUTERA 9201 08/06/2017 07/08/2017 07342446 1,447,477
43 PT. ENSEVAL PUTERA 9274 09/06/2017 08/08/2017 07350691 17,730,000
44 PT. ENSEVAL PUTERA 9528 10/06/2017 09/08/2017 07368906 1,920,750
45 PT. ENSEVAL PUTERA 0563 06/06/2017 05/08/2017 07072481 8,536,995
46 PT. ENSEVAL PUTERA 0573 08/06/2017 07/08/2017 07342820 10,481,071
RETUR 786,885 115,060,837
47 PT. BINA SAN PRIMA 0933 10/06/2017 10/07/2017 88075617 1,546,943
48 PT. BINA SAN PRIMA 1448 15/06/2017 15/07/2017 88076123 755,200
49 PT. BINA SAN PRIMA 1682 17/06/2017 17/07/2017 88076357 3,087,246
50 PT. BINA SAN PRIMA 1683 17/06/2017 17/07/2017 88076358 12,188,981
51 PT. BINA SAN PRIMA 1684 17/06/2017 17/07/2017 88076359 1,344,616
18,922,985
52 PT. PARIT PADANG GLOBAL 6130 10/05/2017 31/05/2017 49500445 9,859,850
53 PT. PARIT PADANG GLOBAL 6192 12/05/2017 02/06/2017 49505433 30,617,642
54 PT. PARIT PADANG GLOBAL 6193 12/05/2017 02/06/2017 49505541 2,710,720
55 PT. PARIT PADANG GLOBAL 6219 13/05/2017 03/06/2017 49508481 1,342,782
56 PT. PARIT PADANG GLOBAL 6605 20/05/2017 10/06/2017 49538258 12,602,799
57 PT. PARIT PADANG GLOBAL 6606 20/05/2017 10/06/2017 49538259 4,225,650
58 PT. PARIT PADANG GLOBAL 6719 23/05/2017 13/06/2017 49547408 1,347,480
59 PT. PARIT PADANG GLOBAL 6701 23/05/2017 13/06/2017 49546036 2,817,100
60 PT. PARIT PADANG GLOBAL 6773 24/05/2017 14/06/2017 49553338 3,268,132
61 PT. PARIT PADANG GLOBAL 7144 30/05/2017 20/06/2017 49572866 19,750,058
62 PT. PARIT PADANG GLOBAL 7131 30/05/2017 20/06/2017 49572520 7,170,800
63 PT. PARIT PADANG GLOBAL 7155 30/05/2017 20/06/2017 49573387 35,223,108
64 PT. PARIT PADANG GLOBAL 7922 14/06/2017 05/07/2017 49634503 1,408,550
65 PT. PARIT PADANG GLOBAL 7923 14/06/2017 05/07/2017 49634505 9,253,090
66 PT. PARIT PADANG GLOBAL 8141 17/06/2017 08/07/2017 49648579 42,913,613
67 PT. PARIT PADANG GLOBAL 8239 20/06/2017 11/07/2017 49655890 6,994,779
68 PT. PARIT PADANG GLOBAL 8270 20/06/2017 11/07/2017 49656915 3,582,938
69 PT. PARIT PADANG GLOBAL 8275 20/06/2017 11/07/2017 49658132 3,582,938
70 PT. PARIT PADANG GLOBAL 8493 29/06/2017 20/07/2017 83487077 5,634,200
204,306,227
71 PT. MILLENIUM PHARMACON I 5022 27/04/2017 27/05/2017 30434602 4,937,214
72 PT. MILLENIUM PHARMACON I 5082 28/04/2017 28/05/2017 30439012 15,691,296
73 PT. MILLENIUM PHARMACON I 5083 28/04/2017 28/05/2017 30439013 23,332,926
74 PT. MILLENIUM PHARMACON I 5182 29/04/2017 29/05/2017 30445200 537,810
75 PT. MILLENIUM PHARMACON I 5190 29/04/2017 29/05/2017 30445208 4,974,743
76 PT. MILLENIUM PHARMACON I 5202 29/04/2017 29/05/2017 30445217 1,723,750
77 PT. MILLENIUM PHARMACON I 5823 16/05/2017 15/06/2017 30488272 5,702,411
78 PT. MILLENIUM PHARMACON I 6527 31/05/2017 30/06/2017 30533998 33,362,886
79 PT. MILLENIUM PHARMACON I 6538 31/05/2017 30/06/2017 30534009 7,032,900
RETUR 534,270 97,295,936
80 PT. PENTA VALENT 7240 13/06/2017 13/07/2017 28783278 8,796,296
81 PT. PENTA VALENT 7525 17/06/2017 17/07/2017 28792848 23,538,901
82 PT. PENTA VALENT 7617 20/06/2017 20/07/2017 28799753 15,582,552
83 PT. PENTA VALENT 7580 20/06/2017 20/07/2017 28796199 1,737,540
84 PT. PENTA VALENT 7618 20/06/2017 20/07/2017 28799754 5,567,367
85 PT. PENTA VALENT 7135 10/06/2017 10/07/2017 28777752 3,909,465
59,132,122
86 PT. INDO FARMA GLOBAL M 2229 22/05/2017 06/07/2017 2,437,875
87 PT. INDO FARMA GLOBAL M 2189 19/05/2017 03/07/2017 5,724,483
88 PT. INDO FARMA GLOBAL M 2190 19/05/2017 03/07/2017 2,428,115
89 PT. INDO FARMA GLOBAL M 2648 19/06/2017 03/08/2017 12,023,156
90 PT. INDO FARMA GLOBAL M 2644 17/06/2017 01/08/2017 2,642,916
91 PT. INDO FARMA GLOBAL M 2643 17/06/2017 01/08/2017 2,930,972
28,187,518
92 PT. RAJAWALI NUSINDO 3047 23/03/2017 22/04/2017 56900484 131,990
93 PT. RAJAWALI NUSINDO 3048 24/03/2017 23/04/2017 56900485 103,878
94 PT. RAJAWALI NUSINDO 3056 25/03/2017 24/04/2017 56900492 679,219
95 PT. RAJAWALI NUSINDO 2579 05/05/2017 04/06/2017 56900026 592,281
96 PT. RAJAWALI NUSINDO 2597 05/05/2017 04/06/2017 56900044 401,647
97 PT. RAJAWALI NUSINDO 2600 05/05/2017 04/06/2017 56900047 592,281
98 PT. RAJAWALI NUSINDO 2602 05/05/2017 04/06/2017 56900049 389,542
99 PT. RAJAWALI NUSINDO 2604 05/05/2017 04/06/2017 56900051 1,605,486
100 PT. RAJAWALI NUSINDO 2658 09/05/2017 08/06/2017 56900104 1,733,080
101 PT. RAJAWALI NUSINDO 2865 20/05/2017 19/06/2017 56900310 1,974,073
102 PT. RAJAWALI NUSINDO 2866 20/05/2017 19/06/2017 56900311 259,695
103 PT. RAJAWALI NUSINDO 2867 20/05/2017 19/06/2017 56900312 9,053,135
104 PT. RAJAWALI NUSINDO 2869 20/05/2017 19/06/2017 56900314 1,702,088
105 PT. RAJAWALI NUSINDO 3025 20/05/2017 19/06/2017 56900462 1,184,561
106 PT. RAJAWALI NUSINDO 3159 05/06/2017 05/07/2017 56900592 592,704
107 PT. RAJAWALI NUSINDO 3235 08/06/2017 08/07/2017 56900667 263,980
108 PT. RAJAWALI NUSINDO 3236 08/06/2017 08/07/2017 56900668 2,054,422
109 PT. RAJAWALI NUSINDO 3237 08/06/2017 08/07/2017 56900669 259,695
110 PT. RAJAWALI NUSINDO 3243 08/06/2017 08/07/2017 56900675 1,780,141
111 PT. RAJAWALI NUSINDO 3244 08/06/2017 08/07/2017 56900676 1,780,141
112 PT. RAJAWALI NUSINDO 3255 09/06/2017 09/07/2017 56900687 1,010,448
113 PT. RAJAWALI NUSINDO 3259 09/06/2017 09/07/2017 56900691 548,290
114 PT. RAJAWALI NUSINDO 3296 12/06/2017 12/07/2017 56900726 233,725
115 PT. RAJAWALI NUSINDO 3548 21/06/2017 21/07/2017 56900955 1,667,339
30,593,842
116 PT. BHAKTI SEJAHTERA M P535 11/04/2017 11/05/2017 1,910,900
117 PT. BHAKTI SEJAHTERA M P574 20/04/2017 20/05/2017 3,528,270
118 PT. BHAKTI SEJAHTERA M P600 25/04/2017 25/05/2017 1,741,480
119 PT. BHAKTI SEJAHTERA M P658 06/05/2017 05/06/2017 5,648,975
120 PT. BHAKTI SEJAHTERA M P710 18/05/2017 17/06/2017 1,822,250
14,651,875
121 PT. ANUGRAH PHARMINDO L 2860 25/05/2017 24/07/2017 96735975 11,233,485
122 PT. ANUGRAH PHARMINDO L 2672 24/05/2017 23/07/2017 96735971 21,286,756
123 PT. ANUGRAH PHARMINDO L 2368 22/05/2017 21/07/2017 96698940 778,150
124 PT. ANUGRAH PHARMINDO L 3137 29/05/2017 28/07/2017 96787830 401,880
125 PT. ANUGRAH PHARMINDO L 3092 29/05/2017 28/07/2017 96787828 1,902,843
126 PT. ANUGRAH PHARMINDO L 4719 13/06/2017 12/08/2017 96911605 2,337,133
127 PT. ANUGRAH PHARMINDO L 4735 14/06/2017 13/08/2017 96911607 579,180
128 PT. ANUGRAH PHARMINDO L 4755 14/06/2017 13/08/2017 96911608 5,169,016
129 PT. ANUGRAH PHARMINDO L 5249 19/06/2017 18/08/2017 96943555 1,326,795
130 PT. ANUGRAH PHARMINDO L 5263 19/06/2017 18/08/2017 96943557 1,083,500
131 PT. ANUGRAH PHARMINDO L 4653 13/06/2017 13/07/2017 96911602 496,440
132 PT. ANUGRAH PHARMINDO L 4696 13/06/2017 13/07/2017 96911604 7,812,823
133 PT. ANUGRAH PHARMINDO L 4721 13/06/2017 13/07/2017 96911606 2,679,594
134 PT. ANUGRAH PHARMINDO L 5267 19/06/2017 19/07/2017 96943558 3,896,660
135 PT. ANUGRAH PHARMINDO L 5307 19/06/2017 19/07/2017 96943561 1,620,916
136 PT. ANUGRAH PHARMINDO L 5356 19/06/2017 19/07/2017 96943562 1,932,176
64,537,347
137 PT. DOS NI ROHA 7705 31/05/2017 30/06/2017 93291173 16,604,490
138 PT. DOS NI ROHA 8509 31/05/2017 30/06/2017 93291193 5,223,258
139 PT. DOS NI ROHA 2834 31/05/2017 30/06/2017 93291240 21,726,391
140 PT. DOS NI ROHA 3179 31/05/2017 30/06/2017 93291246 2,936,531
141 PT. DOS NI ROHA 0867 22/05/2017 21/06/2017 93250328 11,145,078
142 PT. DOS NI ROHA 0868 22/05/2017 21/06/2017 93250329 39,667,920
143 PT. DOS NI ROHA 3367 22/05/2017 21/06/2017 93250330 3,741,110
144 PT. DOS NI ROHA 2405 30/05/2017 29/06/2017 93273396 2,048,800
145 PT. DOS NI ROHA 6308 17/06/2017 17/07/2017 93354823 5,329,904
146 PT. DOS NI ROHA 7144 17/06/2017 17/07/2017 93354824 5,612,776
147 PT. DOS NI ROHA 8316 19/06/2017 19/07/2017 93354861 6,885,150
148 PT. DOS NI ROHA 8332 19/06/2017 19/07/2017 93359863 3,841,500
149 PT. DOS NI ROHA 9412 19/06/2017 19/07/2017 93359877 13,707,260
150 PT. DOS NI ROHA 0154 19/06/2017 19/07/2017 93359878 5,326,801
151 PT. DOS NI ROHA 4088 20/06/2017 20/07/2017 93365524 1,937,556
152 PT. DOS NI ROHA 9262 16/06/2017 16/07/2017 93352283 66,727,840
153 PT. DOS NI ROHA 1746 16/06/2017 16/07/2017 93352286 5,448,281
217,910,646
154 PT. TEMPO 2631 20/06/2017 20/07/2017 90431493 3,626,591
155 PT. TEMPO 2625 20/06/2017 20/07/2017 90431492 2,361,045
5,987,636
156 PT. MERAPI UTAMA PHARMA 7681 17/06/2017 04/08/2017 65084187 8,055,330
157 PT. MERAPI UTAMA PHARMA 7706 18/06/2017 05/08/2017 65084191 1,267,279
158 PT. MERAPI UTAMA PHARMA 7751 19/06/2017 06/08/2017 65096791 1,263,263
159 PT. MERAPI UTAMA PHARMA 7820 19/06/2017 06/08/2017 65096797 1,994,625
160 PT. MERAPI UTAMA PHARMA 7880 20/06/2017 07/08/2017 65097379 3,457,350
161 PT. MERAPI UTAMA PHARMA 7953 21/06/2017 08/08/2017 65097886 2,392,073
162 PT. MERAPI UTAMA PHARMA 7707 17/06/2017 04/08/2017 65084192 9,025,555
163 PT. MERAPI UTAMA PHARMA 7719 17/06/2017 04/08/2017 65084193 2,743,698
164 PT. MERAPI UTAMA PHARMA 7874 20/06/2017 07/08/2017 65097377 19,207,500
165 PT. MERAPI UTAMA PHARMA 7259 07/06/2017 25/07/2017 65065314 9,106,818
166 PT. MERAPI UTAMA PHARMA 7260 07/06/2017 25/07/2017 65065315 22,158,757
167 PT. MERAPI UTAMA PHARMA 7466 13/06/2017 31/07/2017 65079868 1,680,656
168 PT. MERAPI UTAMA PHARMA 7297 08/06/2017 26/07/2017 65070901 4,321,688
169 PT. MERAPI UTAMA PHARMA 7369 09/06/2017 27/07/2017 65070956 3,063,744
89,738,334
170 PT. KIMIA FARMA 6596 29/06/2017 20/07/2017 47971995 11,163,202
171 PT. KIMIA FARMA 3407 19/06/2017 10/07/2017 47958719 2,081,883
172 PT. KIMIA FARMA 3405 19/06/2017 10/07/2017 47958718 11,579,493
173 PT. KIMIA FARMA 0911 17/06/2017 08/07/2017 49756461 960,375
174 PT. KIMIA FARMA 0191 17/06/2017 08/07/2017 49756432 2,069,327
175 PT. KIMIA FARMA 9134 16/06/2017 07/07/2017 47953756 12,805,000
176 PT. KIMIA FARMA 4789 10/06/2017 01/07/2017 47939847 2,435,610
177 PT. KIMIA FARMA 9114 08/06/2017 29/06/2017 47935490 2,069,327
178 PT. KIMIA FARMA 9110 08/06/2017 29/06/2017 47935488 2,871,514
179 PT. KIMIA FARMA 6088 07/06/2017 28/06/2017 47932751 3,443,757
180 PT. KIMIA FARMA 4939 06/06/2017 27/06/2017 47930940 7,617,904
181 PT. KIMIA FARMA 8667 03/06/2017 24/06/2017 47925296 2,684,864
182 PT. KIMIA FARMA 9916 21/06/2017 12/07/2017 47971907 841,727
62,623,983
TOTAL

Mengetahui,
Kepala Instalasi Farmasi

TONI DAFIAPUTRA, S.FARM, APT


NIP.19841023 200803 1 001

LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG


OBAT REGULER
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
12 Agustus 2017
NO DISTRIBUTOR NO FACT TGL.FACT JT. TEMPO NO.F STDR TAGIHAN
1 PT. MENSA BINA SUKSES 3550 19/06/2017 19/07/2017 22973841 5,363,364
2 PT. MENSA BINA SUKSES 4841 20/06/2017 20/07/2017 22975121 26,894,710
3 PT. MENSA BINA SUKSES 9375 21/06/2017 21/07/2017 22989461 10,901,519
4 PT. MENSA BINA SUKSES 9399 21/06/2017 21/07/2017 22989485 28,746,240
5 PT. MENSA BINA SUKSES 7380 30/06/2017 30/07/2017 23017148 2,386,163
74,291,996
6 PT. MUTIARA LABSAINS 1350 18/07/2017 17/08/2017 87280500 443,250

7 PT. BINA SAN PRIMA 0647 06/07/2017 05/08/2017 88077984 5,793,376


8 PT. BINA SAN PRIMA 0648 06/07/2017 05/08/2017 88077985 8,386,290
9 PT. BINA SAN PRIMA 0649 06/07/2017 05/08/2017 88077986 1,290,832
15,470,498
10 PT. ANUGRAH ARGON M 8761 12/06/2017 11/08/2017 42537830 15,030,844
11 PT. ANUGRAH ARGON M 8990 15/06/2017 14/08/2017 42559249 8,819,147
12 PT. ANUGRAH ARGON M 8991 15/06/2017 14/08/2017 42559250 413,700
13 PT. ANUGRAH ARGON M 8604 08/06/2017 07/08/2017 42524915 11,435,973
14 PT. ANUGRAH ARGON M 8462 06/06/2017 05/08/2017 42513072 1,075,620
36,775,284
15 PT. PENTA VALENT 8128 10/07/2017 09/08/2017 28832602 5,422,154
16 PT. PENTA VALENT 8129 10/07/2017 09/08/2017 28832603 7,930,481
17 PT. PENTA VALENT 7891 03/07/2017 02/08/2017 28818181 5,609,575
18 PT. PENTA VALENT 7982 05/07/2017 04/08/2017 28822092 2,393,550
21,355,760
19 PT. MERAPI UTAMA PHARMA 8629 13/07/2017 30/08/2017 65129235 1,680,656
20 PT. MERAPI UTAMA PHARMA 8121 30/06/2017 17/08/2017 65102604 2,304,900
21 PT. MERAPI UTAMA PHARMA 8604 13/07/2017 30/08/2017 65129230 5,983,875
22 PT. MERAPI UTAMA PHARMA 8610 13/07/2017 30/08/2017 65129232 5,181,593
15,151,024
23 PT. ENSEVAL PUTERA 0446 19/06/2017 18/08/2017 07454147 15,045,875
24 PT. ENSEVAL PUTERA 0455 19/06/2017 18/08/2017 07454420 16,903,831
25 PT. ENSEVAL PUTERA 0604 15/06/2017 14/08/2017 07414844 22,765,320
26 PT. ENSEVAL PUTERA 0621 19/06/2017 18/08/2017 07454152 5,298,305
60,013,331
TOTAL
Mengetahui,
Kepala Instalasi Farmasi

TONI DAFIAPUTRA, S.FARM, APT


NIP.19841023 200803 1 001
LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG
OBAT RUTIN
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
02 Agustus 2017
NO DISTRIBUTOR NO FACT TGL.FACT JT. TEMPO NO.F STDR TAGIHAN
1 PT. MUARA NATIO P 2548 14/07/2017 99872548 32,012,500
2 PT. MUARA NATIO P 2546 22/07/2017 99872546 19,207,500
3 PT. MUARA NATIO P 2547 24/07/2017 99872547 32,012,500
4 PT. MUARA NATIO P 2549 26/07/2017 99872549 2,413,250
85,645,750
5 PT. HOTAMA MEDIPHAR 1469 14/06/2017 69091469 24,625,000

6 PT. CITRA PURNAMA S 0045 10/07/2017 01881037 5,319,000


7 PT. CITRA PURNAMA S 0046 13/07/2017 01881038 3,910,450
8 PT. CITRA PURNAMA S 0047 17/07/2017 01881039 3,546,000
9 PT. CITRA PURNAMA S 0048 17/07/2017 01881040 13,482,188
26,257,638
10 PT. BHAKTI SEJAHTERA M P772 03/06/2017 11,280,713
11 PT. BHAKTI SEJAHTERA M P856 19/06/2017 7,076,240
18,356,953
12 PT. BIO MULTI MEDIKA 0128 19/06/2017 67844630 7,092,000
13 PT. BIO MULTI MEDIKA 0135 10/07/2017 67844634 10,932,515
14 PT. BIO MULTI MEDIKA 0138 13/07/2017 67844635 10,638,000
15 PT. BIO MULTI MEDIKA 0142 17/07/2017 67844636 4,235,500
16 PT. BIO MULTI MEDIKA 0144 21/07/2017 67844638 29,786,400
17 PT. BIO MULTI MEDIKA 0145 22/07/2017 67844637 4,925,000
67,609,415
18 PT. ENSEVAL PUTERA 8203 31/05/2017 07247019 16,451,726
19 PT. ENSEVAL PUTERA 8202 31/05/2017 07247022 6,928,293
20 PT. ENSEVAL PUTERA 0571 08/06/2017 07341147 3,972,436
21 PT. ENSEVAL PUTERA 8660 05/06/2017 07291634 3,385,248
22 PT. ENSEVAL PUTERA 9203 08/06/2017 07342447 30,386,023
23 PT. ENSEVAL PUTERA 9276 09/06/2017 07350680 3,911,337
65,035,063
24 PT. ANUGRAH ARGON M 9103 17/06/2017 42569661 1,013,655
25 PT. ANUGRAH ARGON M 9192 19/06/2017 42575373 4,422,650
26 PT. ANUGRAH ARGON M 9198 19/06/2017 42575379 1,540,540
27 PT. ANUGRAH ARGON M 9053 06/06/2017 42564634 1,689,428
8,666,273
28 PT. MUTIARA LABSAINS 0711 10/03/2017 34826850 11,068,445
29 PT. MUTIARA LABSAINS 1501 18/07/2017 87280651 22,069,418
30 PT. MUTIARA LABSAINS 1609 05/06/2017 87280759 15,600,743
48,738,606
TOTAL
Mengetahui,
Kepala Instalasi Farmasi

TONI DAFIAPUTRA, S.FARM, APT


NIP.19841023 200803 1 001
AYARAN HUTANG

MUARA BUNGO

PPN PPH SUB TOTAL TOTAL


966,818 145,023 10,635,000
298,303 44,745 3,281,328
1,822,636 273,395 20,049,000
1,033,647 155,047 11,370,119
298,745 44,812 3,286,200
1,500,245 225,037 16,502,695
1,303,932 195,590 14,343,252
1,419,545 212,932 15,615,000
579,218 86,883 6,371,400
238,032 35,705 2,618,347
959,700 143,955 10,556,700
10,420,822 1,563,123 114,629,041
733,725 110,059 8,070,972
160,891 24,134 1,769,804
1,291,875 193,781 14,210,625
175,500 26,325 1,930,500
402,228 60,334 4,424,510
550,387 82,558 6,054,262
178,500 26,775 1,963,500
2,382,169 357,325 26,203,855
5,875,275 881,291 64,628,028
1,282,500 192,375 14,107,500
647,301 97,095 7,120,306
469,260 70,389 5,161,856
552,609 82,891 6,078,696
3,851,300 577,695 42,364,300
1,462,050 219,308 16,082,550
1,148,775 172,316 12,636,525
233,750 35,063 2,571,250
359,100 53,865 3,950,100
1,723,300 258,495 18,956,300
713,845 107,077 7,852,295
359,100 53,865 3,950,100
1,835,400 275,310 20,189,400
14,638,289 2,195,743 161,021,178
250,000 37,500 2,750,000
1,377,500 206,625 15,152,500
1,133,200 169,980 12,465,200
647,375 97,106 7,121,125
162,450 24,368 1,786,950
475,950 71,393 5,235,450
541,118 81,168 5,952,300
1,369,940 205,491 15,069,340
1,651,050 247,658 18,161,550
146,952 22,043 1,616,472
1,800,000 270,000 19,800,000
195,000 29,250 2,145,000
866,700 130,005 9,533,700
1,064,068 159,610 11,704,749
11,681,303 1,752,195 128,494,336
157,050 23,558 1,727,550
76,670 11,501 843,370
313,426 47,014 3,447,686
1,237,460 185,619 13,612,060
136,509 20,476 1,501,602
1,921,115 288,167 21,132,268
1,001,000 150,150 11,011,000
3,108,390 466,259 34,192,290
275,200 41,280 3,027,200
136,323 20,448 1,499,553
1,279,472 191,921 14,074,192
429,000 64,350 4,719,000
136,800 20,520 1,504,800
286,000 42,900 3,146,000
331,790 49,769 3,649,691
2,005,082 300,762 22,055,902
728,000 109,200 8,008,000
3,575,950 536,393 39,335,450
143,000 21,450 1,573,000
939,400 140,910 10,333,400
4,356,712 653,507 47,923,832
710,130 106,519 7,811,428
363,750 54,563 4,001,250
363,750 54,563 4,001,250
572,000 85,800 6,292,000
20,741,749 3,111,262 228,159,238
501,240 75,186 5,513,640
1,593,025 238,954 17,523,275
2,368,825 355,324 26,057,075
54,600 8,190 600,600
505,050 75,758 5,555,550
175,000 26,250 1,925,000
578,925 86,839 6,368,175
3,387,095 508,064 37,258,045
714,000 107,100 7,854,000
9,877,760 1,481,664 108,655,360
893,025 133,954 9,823,275
2,389,736 358,460 26,287,098
1,581,985 237,298 17,401,835
176,400 26,460 1,940,400
565,215 84,782 6,217,364
396,900 59,535 4,365,900
6,003,261 900,489 66,035,872
247,500 37,125 2,722,500
581,166 87,175 6,392,824
246,509 36,976 2,711,600
1,220,625 183,094 13,426,875
268,316 40,247 2,951,480
297,561 44,634 3,273,167
2,861,677 429,252 31,478,446
13,400 2,010 147,400
10,546 1,582 116,006
68,956 10,343 758,519
60,130 9,020 661,430
40,776 6,116 448,540
60,130 9,020 661,430
39,547 5,932 435,022
162,994 24,449 1,792,929
175,947 26,392 1,935,419
200,413 30,062 2,204,548
26,365 3,955 290,015
919,100 137,865 10,110,100
172,801 25,920 1,900,809
120,260 18,039 1,322,860
60,173 9,026 661,903
26,800 4,020 294,800
208,571 31,286 2,294,278
26,365 3,955 290,015
180,725 27,109 1,987,975
180,725 27,109 1,987,975
102,584 15,388 1,128,419
55,664 8,350 612,304
23,728 3,559 261,013
169,273 25,391 1,862,003
3,105,974 465,896 34,165,712
194,000 29,100 2,134,000
358,200 53,730 3,940,200
176,800 26,520 1,944,800
573,500 86,025 6,308,500
185,000 27,750 2,035,000
1,487,500 223,125 16,362,500
1,140,455 171,068 12,545,009
2,161,092 324,164 23,772,012
79,000 11,850 869,000
40,800 6,120 448,800
193,182 28,977 2,125,002
237,272 35,591 2,609,996
58,800 8,820 646,800
524,773 78,716 5,772,505
134,700 20,205 1,481,700
110,000 16,500 1,210,000
50,400 7,560 554,400
793,180 118,977 8,724,980
272,040 40,806 2,992,440
395,600 59,340 4,351,600
164,560 24,684 1,810,160
196,160 29,424 2,157,760
6,552,015 982,802 72,072,164
1,685,735 252,860 18,543,085
530,280 79,542 5,833,080
2,205,725 330,859 24,262,975
298,125 44,719 3,279,375
1,131,480 169,722 12,446,280
4,027,200 604,080 44,299,200
379,808 56,971 4,177,889
208,000 31,200 2,288,000
541,107 81,166 5,952,177
569,825 85,474 6,268,075
699,000 104,850 7,689,000
390,000 58,500 4,290,000
1,391,600 208,740 15,307,600
540,792 81,119 5,948,712
196,706 29,506 2,163,768
6,774,400 1,016,160 74,518,400
553,125 82,969 6,084,375
22,122,908 3,318,436 243,351,991
368,182 55,227 4,050,000
239,700 35,955 2,636,700
607,882 91,182 6,686,700
817,800 122,670 8,995,800
128,658 19,299 1,415,235
128,250 19,238 1,410,750
202,500 30,375 2,227,500
351,000 52,650 3,861,000
242,850 36,428 2,671,350
916,300 137,445 10,079,300
278,548 41,782 3,064,028
1,950,000 292,500 21,450,000
924,550 138,683 10,170,050
2,249,620 337,443 24,745,820
170,625 25,594 1,876,875
438,750 65,813 4,826,250
311,040 46,656 3,421,440
9,110,491 1,366,574 100,215,398
1,133,320 169,998 12,466,520
211,359 31,704 2,324,946
1,175,583 176,337 12,931,413
97,500 14,625 1,072,500
210,084 31,513 2,310,924
1,300,000 195,000 14,300,000
247,270 37,091 2,719,970
210,084 31,513 2,310,924
291,524 43,729 3,206,767
349,620 52,443 3,845,820
773,391 116,009 8,507,304
272,575 40,886 2,998,325
85,455 12,818 940,000
6,357,765 953,665 69,935,413
1,467,023,645 1,467,023,645

Muara Bungo, 10 Agustus 2017

AYU TRESNAWATI
NIP 19660908 198803 2 002

AYARAN HUTANG

MUARA BUNGO

PPN PPH SUB TOTAL TOTAL


544,504 81,676 5,989,544
2,730,427 409,564 30,034,702
1,106,753 166,013 12,174,285
2,918,400 437,760 32,102,400
242,250 36,338 2,664,750
7,542,335 1,131,350 82,965,681
45,000 6,750 495,000
495,000
588,160 88,224 6,469,760
851,400 127,710 9,365,400
131,049 19,657 1,441,538
1,570,609 235,591 17,276,698
1,525,974 228,896 16,785,714
895,345 134,302 9,848,794
42,000 6,300 462,000
1,161,012 174,152 12,771,137
109,200 16,380 1,201,200
3,733,531 560,030 41,068,845
550,472 82,571 6,055,197
805,125 120,769 8,856,375
569,500 85,425 6,264,500
243,000 36,450 2,673,000
2,168,097 325,215 23,849,072
170,625 25,594 1,876,875
234,000 35,100 2,574,000
607,500 91,125 6,682,500
526,050 78,908 5,786,550
1,538,175 230,726 16,919,925
1,527,500 229,125 16,802,500
1,716,125 257,419 18,877,375
2,311,200 346,680 25,423,200
537,899 80,685 5,916,889
6,092,724 913,909 67,019,964
249,595,185 249,595,185
Muara Bungo, 12 Agustus 2017

AYU TRESNAWATI
NIP 19660908 198803 2 002
AYARAN HUTANG

MUARA BUNGO

PPN PPH SUB TOTAL TOTAL


3,250,000 487,500 35,750,000
1,950,000 292,500 21,450,000
3,250,000 487,500 35,750,000
245,000 36,750 2,695,000
8,695,000 1,304,250 95,645,000
2,500,000 375,000 27,500,000
27,500,000
540,000 81,000 5,940,000
397,000 59,550 4,367,000
360,000 54,000 3,960,000
1,368,750 205,313 15,056,250
2,665,750 399,863 29,323,250
1,145,250 171,788 12,597,750
718,400 107,760 7,902,400
1,863,650 279,548 20,500,150
720,000 108,000 7,920,000
1,109,900 166,485 12,208,900
1,080,000 162,000 11,880,000
430,000 64,500 4,730,000
3,024,000 453,600 33,264,000
500,000 75,000 5,500,000
6,863,900 1,029,585 75,502,900
1,670,226 250,534 18,372,486
703,380 105,507 7,737,180
403,293 60,494 4,436,223
343,680 51,552 3,780,480
3,084,875 462,731 33,933,630
397,090 59,564 4,367,990
6,602,544 990,382 72,627,989
102,909 15,436 1,132,000
449,000 67,350 4,939,000
156,400 23,460 1,720,400
171,516 25,727 1,886,671
879,825 131,974 9,678,071
1,123,700 168,555 12,360,700
2,240,550 336,083 24,646,050
1,583,832 237,575 17,422,150
4,948,082 742,212 54,428,900
385,206,260
Muara Bungo, 02 Agustus 2017

AYU TRESNAWATI
NIP 19660908 198803 2 002
LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG
OBAT REGULER
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
04 September 2017
NO DISTRIBUTOR NO FACT TGL.FACT JT. TEMPO NO.F STDR TAGIHAN
1 PT. DOS NI ROHA 1425 04/07/2017 03/08/2017 93416825 5,208,188
2 PT. DOS NI ROHA 1479 04/07/2017 03/08/2017 93416826 1,584,619
3 PT. DOS NI ROHA 6094 05/07/2017 04/08/2017 93416827 543,720
4 PT. DOS NI ROHA 6494 05/07/2017 04/08/2017 93416828 4,897,913
5 PT. DOS NI ROHA 6620 05/07/2017 04/08/2017 93416829 5,129,880
6 PT. DOS NI ROHA 7881 13/07/2017 12/08/2017 93447559 4,654,125
7 PT. DOS NI ROHA 6721 17/07/2017 16/08/2017 93447581 4,508,252
8 PT. DOS NI ROHA 6725 17/07/2017 16/08/2017 93447582 5,908,227
9 PT. DOS NI ROHA 6728 17/07/2017 16/08/2017 93447583 3,404,751
10 PT. DOS NI ROHA 0218 18/07/2017 17/08/2017 39447596 2,449,931
11 PT. DOS NI ROHA 2132 22/07/2017 21/08/2017 93457694 6,053,717
12 PT. DOS NI ROHA 2133 22/07/2017 21/08/2017 93457695 7,143,713
13 PT. DOS NI ROHA 2170 22/07/2017 21/08/2017 93457696 489,996
14 PT. DOS NI ROHA 2171 22/07/2017 21/08/2017 93457697 1,393,184
15 PT. DOS NI ROHA 2544 22/07/2017 21/08/2017 93457700 2,446,740
55,816,955
16 PT. ENSEVAL PUTERA 0663 04/07/2017 02/09/2017 07571207 3,662,409
17 PT. ENSEVAL PUTERA 1657 04/07/2017 02/09/2017 07571188 15,503,900
18 PT. ENSEVAL PUTERA 1656 04/07/2017 02/09/2017 07571187 7,280,135
19 PT. ENSEVAL PUTERA 1924 06/07/2017 04/09/2017 07596345 11,443,090
20 PT. ENSEVAL PUTERA 0671 06/07/2017 04/09/2017 07595767 1,678,976
21 PT. ENSEVAL PUTERA 0675 07/07/2017 05/09/2017 07609536 18,496,823
22 PT. ENSEVAL PUTERA 2181 10/07/2017 08/09/2017 07619680 3,930,150
23 PT. ENSEVAL PUTERA 0680 10/07/2017 08/09/2017 07619987 1,898,363
24 PT. ENSEVAL PUTERA 2729 13/07/2017 11/09/2017 07667955 771,994
25 PT. ENSEVAL PUTERA 2740 13/07/2017 11/09/2017 07669072 21,276,000
26 PT. ENSEVAL PUTERA 2741 13/07/2017 11/09/2017 07669073 5,305,703
27 PT. ENSEVAL PUTERA 2743 13/07/2017 11/09/2017 07669448 15,786,103
28 PT. ENSEVAL PUTERA 2745 13/07/2017 11/09/2017 07669446 12,802,463
29 PT. ENSEVAL PUTERA 0702 13/07/2017 11/09/2017 07669699 908,663
30 PT. ENSEVAL PUTERA 3215 17/07/2017 15/09/2017 28079847 4,017,458
31 PT. ENSEVAL PUTERA 0719 17/07/2017 15/09/2017 28079963 721,288
32 PT. ENSEVAL PUTERA 3976 22/07/2017 20/09/2017 28146194 12,156,594
33 PT. ENSEVAL PUTERA 3977 22/07/2017 20/09/2017 28146191 8,863,891
34 PT. ENSEVAL PUTERA 3981 22/07/2017 20/09/2017 28146485 1,255,875
35 PT. ENSEVAL PUTERA 0745 22/07/2017 20/09/2017 28146219 4,477,272
36 PT. ENSEVAL PUTERA 4059 24/07/2017 22/09/2017 28152414 2,304,900
37 PT. ENSEVAL PUTERA 4264 25/07/2017 23/09/2017 28169274 598,880
38 PT. ENSEVAL PUTERA 4268 25/07/2017 23/09/2017 28169730 1,182,000
39 PT. ENSEVAL PUTERA 0758 25/07/2017 23/09/2017 28169086 268,635
40 PT. ENSEVAL PUTERA 4623 27/07/2017 25/09/2017 28200406 10,240,306
41 PT. ENSEVAL PUTERA 4624 27/07/2017 25/09/2017 28200401 22,840,476
42 PT. ENSEVAL PUTERA 4627 27/07/2017 25/09/2017 28200811 17,143,925
43 PT. ENSEVAL PUTERA 0771 27/07/2017 25/09/2017 28201030 8,714,697
44 PT. ENSEVAL PUTERA 0772 28/07/2017 26/09/2017 28213367 671,589
45 PT. ENSEVAL PUTERA 0777 29/07/2017 27/09/2017 28226160 24,916,856
241,119,412
46 PT. ANUGRAH ARGON M 9771 06/07/2017 04/09/2017 42631265 2,572,462
47 PT. ANUGRAH ARGON M 9772 06/07/2017 04/09/2017 42631266 2,397,983
48 PT. ANUGRAH ARGON M 9773 06/07/2017 04/09/2017 42631267 1,176,196
49 PT. ANUGRAH ARGON M 9774 06/07/2017 04/09/2017 42672956 3,730,464
50 PT. ANUGRAH ARGON M 9850 07/07/2017 05/09/2017 42637578 3,049,918
51 PT. ANUGRAH ARGON M 9851 07/07/2017 05/09/2017 42637579 7,432,121
52 PT. ANUGRAH ARGON M 9852 07/07/2017 05/09/2017 42637580 8,663,568
53 PT. ANUGRAH ARGON M 9986 11/07/2017 09/09/2017 42651458 934,855
54 PT. ANUGRAH ARGON M 0045 12/07/2017 10/09/2017 42656354 2,417,781
55 PT. ANUGRAH ARGON M 0101 13/07/2017 11/09/2017 42663209 10,320,650
56 PT. ANUGRAH ARGON M 0102 13/07/2017 11/09/2017 42663210 7,277,628
57 PT. ANUGRAH ARGON M 0103 13/07/2017 11/09/2017 42663211 10,864,550
58 PT. ANUGRAH ARGON M 0104 13/07/2017 11/09/2017 42663212 560,075
59 PT. ANUGRAH ARGON M 0105 13/07/2017 11/09/2017 42663213 2,216,250
60 PT. ANUGRAH ARGON M 0106 13/07/2017 11/09/2017 42663214 15,879,633
61 PT. ANUGRAH ARGON M 0107 13/07/2017 11/09/2017 42663215 6,329,977
62 PT. ANUGRAH ARGON M 0243 15/07/2017 13/09/2017 42524921 2,304,900
63 PT. ANUGRAH ARGON M 0244 15/07/2017 13/09/2017 42672957 1,818,940
64 PT. ANUGRAH ARGON M 0245 15/07/2017 13/09/2017 3,662,230
65 PT. ANUGRAH ARGON M 0363 18/07/2017 16/09/2017 42683284 6,720,616
66 PT. ANUGRAH ARGON M 0364 18/07/2017 16/09/2017 42683285 6,962,571
67 PT. ANUGRAH ARGON M 0626 22/07/2017 20/09/2017 42705422 5,819,559
68 PT. ANUGRAH ARGON M 0627 22/07/2017 20/09/2017 42705423 5,941,619
69 PT. ANUGRAH ARGON M 0951 27/07/2017 25/09/2017 42730036 18,753,021
70 PT. ANUGRAH ARGON M 0954 27/07/2017 25/09/2017 42730039 12,048,250
71 PT. ANUGRAH ARGON M 0955 27/07/2017 25/09/2017 42730040 3,167,834
72 PT. ANUGRAH ARGON M 0956 27/07/2017 25/09/2017 42730041 3,044,545
73 PT. ANUGRAH ARGON M 0960 27/07/2017 25/09/2017 42730045 10,284,251
74 PT. ANUGRAH ARGON M 1011 28/07/2017 26/09/2017 42735455 3,202,481
75 PT. ANUGRAH ARGON M 1144 31/07/2017 29/09/2017 42747529 585,090
76 PT. ANUGRAH ARGON M 1145 31/07/2017 29/09/2017 42747530 3,516,450
173,656,465
77 PT. PARIT PADANG GLOBAL 8838 06/07/2017 27/07/2017 83509648 27,007,666
78 PT. PARIT PADANG GLOBAL 8932 07/07/2017 28/07/2017 83516463 1,604,023
79 PT. PARIT PADANG GLOBAL 8977 08/07/2017 29/07/2017 83519016 4,875,750
80 PT. PARIT PADANG GLOBAL 9085 12/07/2017 02/08/2017 83529267 1,397,345
81 PT. PARIT PADANG GLOBAL 9255 14/07/2017 04/08/2017 83541478 2,713,675
82 PT. PARIT PADANG GLOBAL 9315 17/07/2017 07/08/2017 83545696 19,719,700
83 PT. PARIT PADANG GLOBAL 9397 18/07/2017 08/08/2017 83550716 1,255,402
84 PT. PARIT PADANG GLOBAL 9600 21/07/2017 11/08/2017 83567654 2,009,400
85 PT. PARIT PADANG GLOBAL 9648 22/07/2017 12/08/2017 83571052 17,761,520
86 PT. PARIT PADANG GLOBAL 9855 27/07/2017 17/08/2017 83567464 9,245,801
87 PT. PARIT PADANG GLOBAL 9941 28/07/2017 18/08/2017 83593812 299,440
88 PT. PARIT PADANG GLOBAL 9952 28/07/2017 18/08/2017 83594138 10,902,177
98,791,899
89 PT. SAPTA SARI 3340 12/06/2017 03/07/2017 63704173 3,060,711
90 PT. SAPTA SARI 3353 12/06/2017 03/07/2017 63704261 3,841,746
6,902,457
91 PT. MERAPI UTAMA PHARMA 8340 07/07/2017 24/08/2017 65114918 5,805,466
92 PT. MERAPI UTAMA PHARMA 8341 07/07/2017 24/08/2017 65114919 3,349,000
93 PT. MERAPI UTAMA PHARMA 8342 07/07/2017 24/08/2017 65114920 3,469,909
94 PT. MERAPI UTAMA PHARMA 8357 07/07/2017 24/08/2017 65114923 4,257,091
95 PT. MERAPI UTAMA PHARMA 6839 13/07/2017 30/08/2017 65129236 19,207,500
96 PT. MERAPI UTAMA PHARMA 8860 18/07/2017 04/09/2017 65142373 3,509,063
97 PT. MERAPI UTAMA PHARMA 8861 18/07/2017 04/09/2017 65142374 1,891,200
98 PT. MERAPI UTAMA PHARMA 8862 18/07/2017 04/09/2017 65142375 8,093,745
99 PT. MERAPI UTAMA PHARMA 8946 20/07/2017 06/09/2017 65143966 2,208,863
100 PT. MERAPI UTAMA PHARMA 8949 20/07/2017 06/09/2017 65143968 842,175
101 PT. MERAPI UTAMA PHARMA 8947 20/07/2017 06/09/2017 65143967 10,467,595
RETUR 2,580,600 63,101,606
102 PT. UNITED DICO CITAS 9710 19/07/2017 09/08/2017 48588485 9,916,709
103 PT. UNITED DICO CITAS 9711 19/07/2017 09/08/2017 48588486 2,377,168
104 PT. UNITED DICO CITAS 9774 20/07/2017 10/08/2017 48588548 5,890,915
105 PT. UNITED DICO CITAS 9775 20/07/2017 10/08/2017 48588549 5,546,727
106 PT. UNITED DICO CITAS 9776 20/07/2017 10/08/2017 48588550 20,684,979
44,416,497
107 PT. MITRA SEJATI MEDIKA 001-I 12/07/2017 11/08/2017 80378723 44,299,064
108 PT. MITRA SEJATI MEDIKA 001-II 12/07/2017 11/08/2017 80378724 9,420,897
109 PT. MITRA SEJATI MEDIKA 001-III 12/07/2017 11/08/2017 80378725 36,155,483
89,875,444
110 PT. PENTA VALENT 8448 15/07/2017 14/08/2017 28843850 2,938,493
111 PT. PENTA VALENT 8449 15/07/2017 14/08/2017 28843851 5,222,531
112 PT. PENTA VALENT 8468 15/07/2017 14/08/2017 28843869 3,488,476
113 PT. PENTA VALENT 8469 15/07/2017 14/08/2017 28843870 2,367,448
114 PT. PENTA VALENT 8137 18/07/2017 17/08/2017 28873800 1,551,375
115 PT. PENTA VALENT 8768 22/07/2017 21/08/2017 28861681 8,385,502
116 PT. PENTA VALENT 8821 24/07/2017 23/08/2017 28864788 1,684,350
117 PT. PENTA VALENT 8830 24/07/2017 23/08/2017 28864797 2,554,598
118 PT. PENTA VALENT 8841 25/07/2017 24/08/2017 28867566 3,387,282
119 PT. PENTA VALENT 9022 27/07/2017 26/08/2017 28873796 1,449,649
33,029,703
120 PT. MENSA BINA SUKSES 3278 05/07/2017 04/08/2017 23032797 24,353,928
121 PT. MENSA BINA SUKSES 3279 05/07/2017 04/08/2017 23032798 12,054,332
122 PT. MENSA BINA SUKSES 5376 07/07/2017 06/08/2017 23044709 1,877,030
123 PT. MENSA BINA SUKSES 4657 07/07/2017 06/08/2017 23044000 2,339,375
124 PT. MENSA BINA SUKSES 0131 11/07/2017 10/08/2017 23059271 2,573,313
125 PT. MENSA BINA SUKSES 0128 11/07/2017 10/08/2017 23059268 486,590
43,684,567
126 PT. BINA SAN PRIMA 2209 19/07/2017 18/08/2017 88079540 290,575
127 PT. BINA SAN PRIMA 2210 19/07/2017 18/08/2017 88079541 3,924,240
128 PT. BINA SAN PRIMA 2391 21/07/2017 20/08/2017 88079721 567,360
129 PT. BINA SAN PRIMA 3389 29/07/2017 28/08/2017 88080720 734,377
130 PT. BINA SAN PRIMA 3390 29/07/2017 28/08/2017 88080721 7,327,809
131 PT. BINA SAN PRIMA 3391 29/07/2017 28/08/2017 88080722 6,363,100
RETUR 2,093,850 19,207,461
132 PT. TEMPO 5727 27/07/2017 26/08/2017 90571843 1,180,523
133 PT. TEMPO 5636 27/07/2017 26/08/2017 90571832 3,626,591
4,807,113
134 PT. ANUGRAH PHARMINDO L 6729 08/07/2017 06/09/2017 05738823 2,104,315
135 PT. ANUGRAH PHARMINDO L 6837 10/07/2017 08/09/2017 05748228 7,552,750
136 PT. ANUGRAH PHARMINDO L 7104 12/07/2017 11/08/2017 05782964 1,218,449
137 PT. ANUGRAH PHARMINDO L 8085 19/07/2017 17/09/2017 05849333 7,526,466
138 PT. ANUGRAH PHARMINDO L 8181 19/07/2017 17/09/2017 05849336 1,167,225
139 PT. ANUGRAH PHARMINDO L 8513 22/07/2017 20/09/2017 05868072 3,156,472
140 PT. ANUGRAH PHARMINDO L 8586 22/07/2017 20/09/2017 05878149 486,769
141 PT. ANUGRAH PHARMINDO L 8750 25/07/2017 23/09/2017 05901487 5,327,964
142 PT. ANUGRAH PHARMINDO L 9021 27/07/2017 25/09/2017 05912854 7,647,185
143 PT. ANUGRAH PHARMINDO L 9020 27/07/2017 25/09/2017 05912853 1,786,357
37,973,952
144 PT. MUTIARA LABSAINS 1462 19/05/2017 18/06/2017 87280612 4,728,000

145 PT. MILLENIUM PHARMACON I 7223 16/06/2017 16/07/2017 30576593 7,042,750


146 PT. MILLENIUM PHARMACON I 7278 19/06/2017 19/07/2017 30583219 2,817,100
9,859,850
147 PT. INDO FARMA GLOBAL M 2938 17/07/2017 31/08/2017 4,776,355
148 PT. INDO FARMA GLOBAL M 2802 06/07/2017 20/08/2017 876,837
149 PT. INDO FARMA GLOBAL M 2801 06/07/2017 20/08/2017 4,336,686
9,989,879
TOTAL
#NAME?

Mengetahui,
Kepala Instalasi Farmasi

TONI DAFIAPUTRA, S.FARM, APT


NIP.19841023 200803 1 001
LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG
OBHP RUTIN
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
10 September 2017
NO DISTRIBUTOR NO FACT 10/25/2016 JT. TEMPO NO.F STDR TAGIHAN
1 PT. MUARA NATIO P 2556 07/08/2017 06/09/2017 99872556 13,851,563
2 PT. MUARA NATIO P 2557 08/08/2017 07/09/2017 99872557 32,012,500
3 PT. MUARA NATIO P 2558 07/08/2017 06/09/2017 99872558 5,811,500
4 PT. MUARA NATIO P 2560 15/08/2017 14/09/2017 99872560 1,073,650
5 PT. MUARA NATIO P 2561 18/08/2017 17/09/2017 99872561 8,077,000
6 PT. MUARA NATIO P 2562 21/08/2017 20/09/2017 99872562 32,800,500
93,626,713
7 PT. CITRA PURNAMA S 0050 24/07/2017 23/08/2017 01881042 27,534,690
8 PT. CITRA PURNAMA S 0051 31/07/2017 30/08/2017 01881043 16,437,188
9 PT. CITRA PURNAMA S 0052 07/08/2017 06/09/2017 01881044 6,481,300
10 PT. CITRA PURNAMA S 0054 09/08/2017 08/09/2017 01881046 7,876,060
11 PT. CITRA PURNAMA S 0055 09/08/2017 08/09/2017 01881047 5,417,500
12 PT. CITRA PURNAMA S 0056 21/08/2017 20/09/2017 01881048 1,999,550
65,746,288
13 PT. BIO MULTI MEDIKA 0147 25/07/2017 24/08/2017 44329091 17,730,000
14 PT. BIO MULTI MEDIKA 0150 27/07/2017 26/08/2017 44329100 32,317,850
15 PT. BIO MULTI MEDIKA 0151 28/07/2017 27/08/2017 44329095 34,272,090
16 PT. BIO MULTI MEDIKA 0152 03/08/2017 02/09/2017 44329096 13,740,750
17 PT. BIO MULTI MEDIKA 0157 16/08/2017 15/09/2017 44329099 29,764,238
18 PT. BIO MULTI MEDIKA 0159 21/08/2017 20/09/2017 44329101 8,953,650
19 PT. BIO MULTI MEDIKA 0160 22/08/2017 21/09/2017 44329102 23,281,263
160,059,841
20 PT. AFINA SC 2746 07/08/2017 06/09/2017 52948620 19,761,563
21 PT. AFINA SC 2890 15/08/2017 14/09/2017 52948778 1,846,875
21,608,438
22 PT. ENSEVAL PUTERA 0705 13/07/2017 11/09/2017 07673190 9,336,442
23 PT. ENSEVAL PUTERA 0692 11/07/2017 09/09/2017 07644823 3,045,019
24 PT. ENSEVAL PUTERA 2879 14/07/2017 12/09/2017 07682900 14,708,256
25 PT. ENSEVAL PUTERA 2873 14/07/2017 12/09/2017 07682253 1,410,343
26 PT. ENSEVAL PUTERA 2871 14/07/2017 12/09/2017 07682254 6,319,497
27 PT. ENSEVAL PUTERA 2476 11/07/2017 09/09/2017 07641532 4,654,125
28 PT. ENSEVAL PUTERA 2774 13/07/2017 11/09/2017 07672448 650,100
29 PT. ENSEVAL PUTERA 9774 13/06/2017 12/08/2017 07391628 2,510,420
30 PT. ENSEVAL PUTERA 0247 16/06/2017 15/08/2017 07436119 2,339,375
31 PT. ENSEVAL PUTERA 0266 16/06/2017 15/08/2017 07438294 22,221,595
32 PT. ENSEVAL PUTERA 1792 05/07/2017 03/09/2017 07582960 10,076,747
33 PT. ENSEVAL PUTERA 1343 30/06/2017 29/08/2017 07541214 4,761,392
34 PT. ENSEVAL PUTERA 0779 29/07/2017 27/09/2017 28227716 2,537,516
35 PT. ENSEVAL PUTERA 4957 29/07/2017 27/09/2017 28227639 3,345,651
36 PT. ENSEVAL PUTERA 4616 27/07/2017 25/09/2017 28199897 4,891,628
37 PT. ENSEVAL PUTERA 4125 24/07/2017 22/09/2017 28156618 5,233,920
98,042,026
38 PT. DOS NI ROHA 7203 19/07/2017 18/08/2017 93451017 37,824,000
39 PT. DOS NI ROHA 1583 20/07/2017 19/08/2017 93451026 26,784,120
40 PT. DOS NI ROHA 6980 21/07/2017 20/08/2017 93451034 26,784,120
91,392,240
41 PT. BHAKTI SEJAHTERA M 0971 10/07/2017 2,605,325
42 PT. BHAKTI SEJAHTERA M 1064 28/08/2017 5,454,438
43 PT. BHAKTI SEJAHTERA M P972 10/07/2017 6,038,050
44 PT. BHAKTI SEJAHTERA M 1065 28/07/2017 2,423,100
16,520,913
45 PT. PARIT PADANG GLOBAL 8934 07/07/2017 28/07/2017 83516510 7,260,435
46 PT. PARIT PADANG GLOBAL 9316 17/07/2017 07/08/2017 83545697 6,177,920
13,438,355

#NAME?

Mengetahui,
Kepala Instalasi Farmasi

TONI DAFIAPUTRA, S.FARM, APT


NIP.19841023 200803 1 001
AYARAN HUTANG

MUARA BUNGO

PPN PPH SUB TOTAL TOTAL


528,750 79,313 5,816,250
160,875 24,131 1,769,625
55,200 8,280 607,200
497,250 74,588 5,469,750
520,800 78,120 5,728,800
472,500 70,875 5,197,500
457,691 68,654 5,034,596
599,820 89,973 6,598,020
345,660 51,849 3,802,260
248,724 37,309 2,735,964
614,591 92,189 6,760,496
725,250 108,788 7,977,750
49,746 7,462 547,204
141,440 21,216 1,555,840
248,400 37,260 2,732,400
5,666,696 850,004 62,333,655
371,818 55,773 4,090,000
1,574,000 236,100 17,314,000
739,100 110,865 8,130,100
1,161,735 174,260 12,779,085
170,454 25,568 1,874,999
1,877,850 281,678 20,656,350
399,000 59,850 4,389,000
192,727 28,909 2,119,999
78,375 11,756 862,125
2,160,000 324,000 23,760,000
538,650 80,798 5,925,150
1,602,650 240,398 17,629,150
1,299,742 194,961 14,297,167
92,250 13,838 1,014,750
407,864 61,180 4,486,501
73,227 10,984 805,499
1,234,172 185,126 13,575,892
899,887 134,983 9,898,762
127,500 19,125 1,402,500
454,545 68,182 4,999,999
234,000 35,100 2,574,000
60,800 9,120 668,800
120,000 18,000 1,320,000
27,273 4,091 299,999
1,039,625 155,944 11,435,875
2,318,830 347,825 25,507,130
1,740,500 261,075 19,145,500
884,741 132,711 9,732,149
68,182 10,227 749,998
2,529,630 379,445 27,825,930
24,479,128 3,671,869 269,270,409
261,164 39,175 2,872,800
243,450 36,518 2,677,950
119,411 17,912 1,313,518
378,727 56,809 4,166,000
309,636 46,445 3,406,000
754,530 113,180 8,299,830
879,550 131,933 9,675,051
94,909 14,236 1,044,000
245,460 36,819 2,700,060
1,047,782 157,167 11,525,599
738,845 110,827 8,127,300
1,103,000 165,450 12,133,000
56,860 8,529 625,464
225,000 33,750 2,475,000
1,612,145 241,822 17,733,600
642,637 96,396 7,069,010
234,000 35,100 2,574,000
184,664 27,700 2,031,304
371,800 55,770 4,089,800
682,296 102,344 7,505,256
706,860 106,029 7,775,460
590,818 88,623 6,499,000
603,210 90,482 6,635,310
1,903,860 285,579 20,942,460
1,223,173 183,476 13,454,899
321,608 48,241 3,537,683
309,091 46,364 3,399,999
1,044,086 156,613 11,484,950
325,125 48,769 3,576,375
59,400 8,910 653,400
357,000 53,550 3,927,000
17,630,098 2,644,515 193,931,078
2,741,895 411,284 30,160,845
162,845 24,427 1,791,295
495,000 74,250 5,445,000
141,862 21,279 1,560,487
275,500 41,325 3,030,500
2,002,000 300,300 22,022,000
127,452 19,118 1,401,972
204,000 30,600 2,244,000
1,803,200 270,480 19,835,200
938,660 140,799 10,325,260
30,400 4,560 334,400
1,106,820 166,023 12,175,020
10,029,634 1,504,445 110,325,979
310,732 46,610 3,418,053
390,025 58,504 4,290,275
700,757 105,114 7,708,328
589,387 88,408 6,483,262
340,000 51,000 3,740,000
352,275 52,841 3,875,025
432,192 64,829 4,754,112
1,950,000 292,500 21,450,000
356,250 53,438 3,918,750
192,000 28,800 2,112,000
821,700 123,255 9,038,700
224,250 33,638 2,466,750
85,500 12,825 940,500
1,062,700 159,405 11,689,700
6,406,254 960,938 70,468,799
1,006,772 151,016 11,074,497
241,337 36,201 2,654,705
598,062 89,709 6,578,687
563,119 84,468 6,194,314
2,099,998 315,000 23,099,976
4,509,289 676,393 49,602,179
4,497,367 674,605 49,471,036
956,436 143,465 10,520,799
3,670,607 550,591 40,376,681
9,124,411 1,368,662 100,368,516
298,324 44,749 3,281,566
530,206 79,531 5,832,268
354,160 53,124 3,895,760
240,350 36,053 2,643,850
157,500 23,625 1,732,500
851,320 127,698 9,364,520
171,000 25,650 1,881,000
259,350 38,903 2,852,850
343,887 51,583 3,782,752
147,172 22,076 1,618,897
3,353,269 502,990 36,885,963
2,472,480 370,872 27,197,280
1,223,790 183,569 13,461,690
190,561 28,584 2,096,176
237,500 35,625 2,612,500
261,250 39,188 2,873,750
49,400 7,410 543,400
4,434,981 665,247 48,784,796
29,500 4,425 324,500
398,400 59,760 4,382,400
57,600 8,640 633,600
74,556 11,183 820,116
743,940 111,591 8,183,340
646,000 96,900 7,106,000
1,949,996 292,499 21,449,956
119,850 17,978 1,318,350
368,182 55,227 4,050,000
488,032 73,205 5,368,350
213,636 32,045 2,349,996
766,777 115,016 8,434,543
123,700 18,555 1,360,705
764,108 114,616 8,405,191
118,500 17,775 1,303,500
320,454 48,068 3,524,994
49,418 7,413 543,600
540,910 81,137 5,950,010
776,364 116,455 8,540,004
181,356 27,203 1,994,916
3,855,224 578,284 42,407,459
480,000 72,000 5,280,000
5,280,000
715,000 107,250 7,865,000
286,000 42,900 3,146,000
1,001,000 150,150 11,011,000
484,909 72,736 5,334,001
89,019 13,353 979,209
440,273 66,041 4,843,000
1,014,201 152,130 11,156,210
1,046,352,677

Muara Bungo, 04 September 2017

AYU TRESNAWATI
NIP 19660908 198803 2 002
MBAYARAN HUTANG

FIE MUARA BUNGO

PPN PPH SUB TOTAL TOTAL


1,406,250 210,938 15,468,750
3,250,000 487,500 35,750,000
590,000 88,500 6,490,000
109,000 16,350 1,199,000
820,000 123,000 9,020,000
3,330,000 499,500 36,630,000
9,505,250 1,425,788 104,557,750
2,795,400 419,310 30,749,400
1,668,750 250,313 18,356,250
658,000 98,700 7,238,000
799,600 119,940 8,795,600
550,000 82,500 6,050,000
203,000 30,450 2,233,000
6,674,750 1,001,213 73,422,250
1,800,000 270,000 19,800,000
3,281,000 492,150 36,091,000
3,479,400 521,910 38,273,400
1,395,000 209,250 15,345,000
3,021,750 453,263 33,239,250
909,000 136,350 9,999,000
2,363,580 354,537 25,999,380
16,249,730 2,437,460 178,747,030
2,006,250 300,938 22,068,750
187,500 28,125 2,062,500
2,193,750 329,063 24,131,250
947,862 142,179 10,426,484
309,139 46,371 3,400,529
1,493,224 223,984 16,425,464
143,182 21,477 1,575,002
641,573 96,236 7,057,306
472,500 70,875 5,197,500
66,000 9,900 726,000
254,865 38,230 2,803,515
237,500 35,625 2,612,500
2,255,999 338,400 24,815,994
1,023,020 153,453 11,253,220
483,390 72,509 5,317,290
257,616 38,642 2,833,774
339,660 50,949 3,736,260
496,612 74,492 5,462,732
531,362 79,704 5,844,987
9,953,505 1,493,026 109,488,557
3,840,000 576,000 42,240,000
2,719,200 407,880 29,911,200
2,719,200 407,880 29,911,200
9,278,400 1,391,760 102,062,400
264,500 39,675 2,909,500
553,750 83,063 6,091,250
613,000 91,950 6,743,000
246,000 36,900 2,706,000
1,677,250 251,588 18,449,750
737,100 110,565 8,108,100
627,200 94,080 6,899,200
1,364,300 204,645 15,007,300
625,866,287 625,866,287

Muara Bungo, 10 September 2017

AYU TRESNAWATI
NIP 19660908 198803 2 002
LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG
OBAT DAN BAHAN HABIS PAKAI
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
04 Oktober 2017
NO DISTRIBUTOR KATEGORI NO FACT TGL.FACT JT. TEMPO NO.F STDR
1 PT. MERAPI UTAMA PHARMA OBAT REG 9267 26/07/2017 12/09/2017 65157138
2 PT. MERAPI UTAMA PHARMA OBAT REG 9331 28/07/2017 14/09/2017 65157822
3 PT. MERAPI UTAMA PHARMA OBAT REG 9341 28/07/2017 14/09/2017 65157825
4 PT. MERAPI UTAMA PHARMA OBAT REG 9342 28/07/2017 14/09/2017 65157826
5 PT. MERAPI UTAMA PHARMA OBAT REG 9343 28/07/2017 14/09/2017 65157827
6 PT. MERAPI UTAMA PHARMA OBAT REG 9449 31/07/2017 17/09/2017 65157950
7 PT. MERAPI UTAMA PHARMA OBAT REG 9758 07/08/2017 24/09/2017 84417157
8 PT. MERAPI UTAMA PHARMA OBAT REG 9734 07/08/2017 24/09/2017 84417154
9 PT. MERAPI UTAMA PHARMA OBAT REG 0011 14/08/2017 01/10/2017 84425300
10 PT. MERAPI UTAMA PHARMA OBAT REG 0154 16/08/2017 03/10/2017 84425446
11 PT. MERAPI UTAMA PHARMA OBAT REG 0155 16/08/2017 03/10/2017 84425447

12 PT. PENTA VALENT OBAT REG 9439 05/08/2017 04/09/2017 28896558


13 PT. PENTA VALENT OBAT REG 9447 05/08/2017 04/09/2017 28896566
14 PT. PENTA VALENT OBAT REG 9688 11/08/2017 10/09/2017 28910282
15 PT. PENTA VALENT OBAT REG 9689 11/08/2017 10/09/2017 28910283
16 PT. PENTA VALENT OBAT REG 9711 11/08/2017 10/09/2017 28910300

17 PT. ENSEVAL PUTERA OBAT REG 5872 05/08/2017 04/10/2017 28307310


18 PT. ENSEVAL PUTERA OBAT REG 0780 29/07/2017 27/09/2017 28229936
19 PT. ENSEVAL PUTERA OBAT REG 0794 01/08/2017 30/09/2017 28262136
20 PT. ENSEVAL PUTERA OBAT REG 6483 10/08/2017 09/10/2017 28362419
21 PT. ENSEVAL PUTERA OBAT REG 6484 10/08/2017 09/10/2017 28362424
22 PT. ENSEVAL PUTERA OBAT REG 6485 10/08/2017 09/10/2017 28362422
23 PT. ENSEVAL PUTERA OBAT REG 0835 10/08/2017 09/10/2017 28361978
RETUR 340,608
24 PT. MENSA BINA SUKSES OBAT REG 3031 18/07/2017 17/08/2017 23091788
25 PT. MENSA BINA SUKSES OBAT REG 7258 18/07/2017 17/08/2017 23095918
26 PT. MENSA BINA SUKSES OBAT REG 3030 18/07/2017 17/08/2017 23091787
27 PT. MENSA BINA SUKSES OBAT REG 7211 21/07/2017 20/08/2017 23115527
28 PT. MENSA BINA SUKSES OBAT REG 8045 26/07/2017 25/08/2017 23136020
29 PT. MENSA BINA SUKSES BHP UMUM 7017 27/07/2017 26/08/2017 23144860
30 PT. MENSA BINA SUKSES OBAT REG 1044 31/07/2017 30/08/2017 23168559
31 PT. MENSA BINA SUKSES OBAT REG 6188 02/08/2017 01/09/2017 23183497
32 PT. MENSA BINA SUKSES OBAT REG 0089 04/08/2017 03/09/2017 23197203
33 PT. MENSA BINA SUKSES OBAT REG 3011 05/08/2017 04/09/2017 23200096
34 PT. MENSA BINA SUKSES OBAT REG 3012 05/08/2017 04/09/2017 23200097
RETUR 1,943,425
35 PT. DOS NI ROHA OBAT REG 0675 25/07/2017 24/08/2017 93464482
36 PT. DOS NI ROHA OBAT REG 5820 26/07/2017 25/08/2017 93464493
37 PT. DOS NI ROHA OBAT REG 9823 27/07/2017 26/08/2017 93474162
38 PT. DOS NI ROHA OBAT REG 0827 27/07/2017 26/08/2017 93474169
39 PT. DOS NI ROHA OBAT REG 7168 31/07/2017 30/08/2017 93493986
40 PT. DOS NI ROHA OBAT REG 5108 04/08/2017 03/09/2017 93526322
41 PT. DOS NI ROHA OBAT REG 6150 04/08/2017 03/09/2017 93526325
42 PT. DOS NI ROHA OBAT REG 7674 05/08/2017 04/09/2017 93526991
43 PT. DOS NI ROHA OBAT REG 7676 05/08/2017 04/09/2017 93526992
44 PT. DOS NI ROHA OBAT REG 9464 05/08/2017 04/09/2017 93526993
45 PT. DOS NI ROHA OBAT REG 0022 07/08/2017 06/09/2017 93532127
LEBIH BAYAR
46 PT. UNITED DICO CITAS OBAT REG 0080 31/07/2017 21/08/2017 17080028
47 PT. UNITED DICO CITAS OBAT REG 0081 31/07/2017 21/08/2017 17080029
48 PT. UNITED DICO CITAS OBAT REG 0082 31/07/2017 21/08/2017 17080030
49 PT. UNITED DICO CITAS OBAT REG 0318 10/08/2017 31/08/2017 17080261
50 PT. UNITED DICO CITAS OBAT REG 0517 18/08/2017 08/09/2017 17080451
51 PT. UNITED DICO CITAS OBAT REG 0681 25/08/2017 15/09/2017 17080612

52 PT. BINA SAN PRIMA OBAT REG 1044 09/08/2017 08/09/2017 88081999
53 PT. BINA SAN PRIMA OBAT REG 2030 18/08/2017 17/09/2017 88082978
54 PT. BINA SAN PRIMA OBAT REG 2031 18/08/2017 17/09/2017 88082979
55 PT. BINA SAN PRIMA OBAT REG 2032 18/08/2017 17/09/2017 88082980
56 PT. BINA SAN PRIMA OBAT REG 2033 18/08/2017 17/09/2017 88082981
57 PT. BINA SAN PRIMA OBAT REG 3585 31/08/2017 30/09/2017 89978356
58 PT. BINA SAN PRIMA OBAT REG 0688 07/09/2017 07/10/2017 89979096
59 PT. BINA SAN PRIMA OBAT REG 0689 07/09/2017 07/10/2017 89979097
60 PT. BINA SAN PRIMA OBAT REG 0801 08/09/2017 08/10/2017 89979209

61 PT. RAJAWALI NUSINDO BHP UMUM 3453 19/06/2017 19/07/2017 56900860


62 PT. RAJAWALI NUSINDO OBAT REG 3636 05/07/2017 04/08/2017 56901064
63 PT. RAJAWALI NUSINDO OBAT REG 3643 05/07/2017 04/08/2017 56901071
64 PT. RAJAWALI NUSINDO OBAT REG 3669 06/07/2017 05/08/2017 56901097
65 PT. RAJAWALI NUSINDO BHP UMUM 3743 10/07/2017 09/08/2017 56901171
66 PT. RAJAWALI NUSINDO OBAT REG 3742 10/07/2017 09/08/2017 56901170
67 PT. RAJAWALI NUSINDO OBAT REG 3817 13/07/2017 12/08/2017 56901245
68 PT. RAJAWALI NUSINDO BHP UMUM 3836 14/07/2017 13/08/2017 56901264
69 PT. RAJAWALI NUSINDO OBAT REG 3859 15/07/2017 14/08/2017 56901285
70 PT. RAJAWALI NUSINDO OBAT REG 3644 15/07/2017 14/08/2017 56901072
71 PT. RAJAWALI NUSINDO BHP UMUM 3952 20/07/2017 19/08/2017 56900495
72 PT. RAJAWALI NUSINDO OBAT REG 3405 15/09/2017 15/10/2017 56900835

73 PT. MUARA NATIO P BHP UMUM 2564 23/08/2017 22/09/2017 99872564


74 PT. MUARA NATIO P BHP UMUM 2566 28/08/2017 27/09/2017 99872566
75 PT. MUARA NATIO P BHP UMUM 2571 30/08/2017 29/09/2017 99872571
76 PT. MUARA NATIO P LABOR 2573 30/08/2017 29/09/2017 99872573
77 PT. MUARA NATIO P BHP UMUM 2578 05/09/2017 05/10/2017 99872578
78 PT. MUARA NATIO P BHP UMUM 2574 06/09/2017 06/10/2017 99872574
79 PT. MUARA NATIO P RADIOLOGI 2575 06/09/2017 06/10/2017 99872575
80 PT. MUARA NATIO P BHP UMUM 2579 11/09/2017 11/10/2017 99872579
81 PT. MUARA NATIO P BHP UMUM 2580 12/09/2017 12/10/2017 99872580
82 PT. MUARA NATIO P RADIOLOGI 2581 13/09/2017 13/10/2017 99872581
83 PT. MUARA NATIO P RADIOLOGI 2582 15/09/2017 15/10/2017 99872582

84 PT. MUTIARA LABSAINS BHP UMUM 1902 10/07/2017 09/08/2017 87281052


85 PT. MUTIARA LABSAINS BHP UMUM 1861 18/07/2017 17/08/2017 87281011
86 PT. MUTIARA LABSAINS BHP UMUM 1980 18/07/2017 17/08/2017 87281130
87 PT. MUTIARA LABSAINS BHP UMUM 1997 18/07/2017 17/08/2017 87281147
88 PT. MUTIARA LABSAINS BHP UMUM 2257 10/08/2017 09/09/2017 30630695
89 PT. MUTIARA LABSAINS BHP UMUM 2349 18/08/2017 17/09/2017 30630787
90 PT. MUTIARA LABSAINS BHP UMUM 2554 06/09/2017 06/10/2017 30630992
91 PT. MUTIARA LABSAINS BHP UMUM 2570 07/09/2017 07/10/2017 30631008

92 PT. BHAKTI SEJAHTERA M LABOR 1241 28/08/2017 27/09/2017


93 PT. BHAKTI SEJAHTERA M BHP UMUM 1123 12/08/2017 11/09/2017

94 PT. SAPTA SARI OBAT REG 5557 24/07/2017 14/08/2017 63765110


95 PT. SAPTA SARI OBAT REG 5621 25/07/2017 15/08/2017 63767218
96 PT. SAPTA SARI OBAT REG 6382 07/08/2017 28/08/2017 63789788
97 PT. SAPTA SARI OBAT REG 7125 18/08/2017 08/09/2017 63808505
98 PT. SAPTA SARI OBAT REG 7166 19/08/2017 09/09/2017 63809063
99 PT. SAPTA SARI BHP UMUM 7965 31/08/2017 21/09/2017 63830159

100 PT. ULICO PHARMA OBAT REG 0591 21/08/2017 20/09/2017 67825658
101 PT. ULICO PHARMA LABOR 0611 30/08/2017 29/09/2017 67825659

102 PT. MEDICO VISI PHARMA BHP UMUM 006 07/09/2017 07/10/2017 91334258
103 PT. MEDICO VISI PHARMA LABOR 007 07/09/2017 07/10/2017 91334259
104 PT. MEDICO VISI PHARMA LABOR 008 07/09/2017 07/10/2017 91334260
105 PT. MEDICO VISI PHARMA LABOR 010 18/09/2017 18/10/2017 91334273
106 PT. MEDICO VISI PHARMA LABOR 011 18/09/2017 18/10/2017 91334274
107 PT. MEDICO VISI PHARMA LABOR 012 18/09/2017 18/10/2017 91334275

108 PT. CITRA PURNAMA S BHP UMUM 0057 28/08/2017 27/09/2017 99603773
109 PT. CITRA PURNAMA S LABOR 0059 30/08/2017 29/09/2017 99603774
110 PT. CITRA PURNAMA S LABOR 0060 02/09/2017 02/10/2017 99603775
111 PT. CITRA PURNAMA S LABOR 0061 06/09/2017 06/10/2017 99603776
112 PT. CITRA PURNAMA S LABOR 0062 06/09/2017 06/10/2017 99603777
113 PT. CITRA PURNAMA S LABOR 0063 06/09/2017 06/10/2017 99603778
114 PT. CITRA PURNAMA S BHP UMUM 0064 13/09/2017 13/10/2017 99603779
115 PT. CITRA PURNAMA S LABOR 0065 18/09/2017 18/10/2017 99603780
116 PT. CITRA PURNAMA S LABOR 0066 18/09/2017 18/10/2017 99603781
117 PT. CITRA PURNAMA S LABOR 0067 20/09/2017 20/10/2017 99603782
118 PT. CITRA PURNAMA S LABOR 0068 20/09/2017 20/10/2017 99603783
119 PT. CITRA PURNAMA S BHP UMUM 0069 22/09/2017 22/10/2017 99603784
120 PT. CITRA PURNAMA S BHP UMUM 0070 22/09/2017 22/10/2017 99603785

TOTAL

1 OBAT REG
2 BHP UMUM
3 LABOR
4 RADIOLOGI

TOTAL
JML FAKTUR 120

#NAME?

Mengetahui,
Kepala Instalasi Farmasi

TONI DAFIAPUTRA, S.FARM, APT


NIP.19841023 200803 1 001

LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG


OBAT DAN BAHAN HABIS PAKAI
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
24 Oktober 2017
NO DISTRIBUTOR KATEGORI NO FACT TGL.FACT JT. TEMPO NO.F STDR
1 PT. KIMIA FARMA OBAT REG 8267 06/07/2017 27/07/2017 47974649
2 PT. KIMIA FARMA BHP UMUM 3415 13/07/2017 03/08/2017 47986454
3 PT. KIMIA FARMA OBAT REG 3185 13/07/2017 03/08/2017 47995771
4 PT. KIMIA FARMA OBAT REG 5856 19/07/2017 09/08/2017 47998689
5 PT. KIMIA FARMA OBAT REG 8586 25/07/2017 15/08/2017 48010580
6 PT. KIMIA FARMA OBAT REG 8587 25/07/2017 15/08/2017 48010581
7 PT. KIMIA FARMA OBAT REG 0750 26/07/2017 16/08/2017 48012714
8 PT. KIMIA FARMA OBAT REG 1023 31/07/2017 21/08/2017 48023579
9 PT. KIMIA FARMA OBAT REG 2625 04/08/2017 25/08/2017
10 PT. KIMIA FARMA OBAT REG 2627 04/08/2017 25/08/2017
11 PT. KIMIA FARMA OBAT REG 7435 07/08/2017 28/08/2017
12 PT. KIMIA FARMA OBAT REG 2657 09/08/2017 30/08/2017
13 PT. KIMIA FARMA BHP UMUM 5789 10/08/2017 31/08/2017
14 PT. KIMIA FARMA OBAT REG 1813 14/08/2017 04/09/2017
15 PT. KIMIA FARMA BHP UMUM 8626 16/08/2017 06/09/2017
16 PT. KIMIA FARMA OBAT REG 1426 23/08/2017 13/09/2017
17 PT. KIMIA FARMA OBAT REG 9109 26/08/2017 16/09/2017
18 PT. KIMIA FARMA OBAT REG 9133 26/08/2017 16/09/2017
19 PT. KIMIA FARMA OBAT REG 2062 28/08/2017 18/09/2017
20 PT. KIMIA FARMA BHP UMUM 4960 29/08/2017 19/09/2017
21 PT. KIMIA FARMA OBAT REG 3283 31/08/2017 21/09/2017
22 PT. KIMIA FARMA BHP UMUM 3125 31/08/2017 21/09/2017
23 PT. KIMIA FARMA OBAT REG 3289 31/08/2017 21/09/2017

24 PT. MERAPI UTAMA PHARMA OBAT REG 9739 07/08/2017 24/09/2017 84417155
25 PT. MERAPI UTAMA PHARMA OBAT REG 0012 14/08/2017 01/10/2017 84425301
26 PT. MERAPI UTAMA PHARMA OBAT REG 0028 14/08/2017 01/10/2017 84425302
27 PT. MERAPI UTAMA PHARMA OBAT REG 0010 14/08/2017 01/10/2017 84425299
28 PT. MERAPI UTAMA PHARMA OBAT REG 0156 16/08/2017 03/10/2017 84425448
29 PT. MERAPI UTAMA PHARMA OBAT REG 0531 26/08/2017 13/10/2017 84440742
30 PT. MERAPI UTAMA PHARMA OBAT REG 0535 26/08/2017 13/10/2017 84440743

31 PT. PARIT PADANG GLOBAL OBAT REG 0317 05/08/2017 26/08/2017 83625537
32 PT. PARIT PADANG GLOBAL OBAT REG 0458 09/08/2017 30/08/2017 83637637
33 PT. PARIT PADANG GLOBAL OBAT REG 0450 09/08/2017 30/08/2017 83637320
34 PT. PARIT PADANG GLOBAL OBAT REG 0463 09/08/2017 30/08/2017 83638149
35 PT. PARIT PADANG GLOBAL OBAT REG 0781 16/08/2017 06/09/2017 83662303
36 PT. PARIT PADANG GLOBAL OBAT REG 0784 21/08/2017 11/09/2017 83662387
37 PT. PARIT PADANG GLOBAL OBAT REG 1191 24/08/2017 14/09/2017 83693262
38 PT. PARIT PADANG GLOBAL OBAT REG 1253 25/08/2017 15/09/2017 83698158
39 PT. PARIT PADANG GLOBAL OBAT REG 1231 25/08/2017 15/09/2017 83696613
40 PT. PARIT PADANG GLOBAL OBAT REG 1341 28/08/2017 18/09/2017 83705423
41 PT. PARIT PADANG GLOBAL OBAT REG 1523 31/08/2017 21/09/2017 83723125
42 PT. PARIT PADANG GLOBAL OBAT REG 1524 31/08/2017 21/09/2017 83723350
43 PT. PARIT PADANG GLOBAL OBAT REG 1525 31/08/2017 21/09/2017 83723351
44 PT. PARIT PADANG GLOBAL OBAT REG 1607 31/08/2017 21/09/2017 83728118
45 PT. PARIT PADANG GLOBAL OBAT REG 1623 02/09/2017 23/09/2017 83730975
46 PT. PARIT PADANG GLOBAL OBAT REG 1681 02/09/2017 23/09/2017 83733994
47 PT. PARIT PADANG GLOBAL OBAT REG 1835 07/09/2017 28/09/2017 83746294
48 PT. PARIT PADANG GLOBAL OBAT REG 1870 07/09/2017 28/09/2017 83747597
49 PT. PARIT PADANG GLOBAL OBAT REG 1989 09/09/2017 30/09/2017 83755766
50 PT. PARIT PADANG GLOBAL OBAT REG 2049 11/09/2017 02/10/2017 83759475

51 PT. ENSEVAL PUTERA LABOR 5230 31/07/2017 29/09/2017 28247285


52 PT. ENSEVAL PUTERA BHP UMUM 5867 05/08/2017 04/10/2017 28307013
53 PT. ENSEVAL PUTERA BHP UMUM 6579 11/08/2017 10/10/2017 28374335
54 PT. ENSEVAL PUTERA BHP UMUM 2747 14/08/2017 13/10/2017 28390567
55 PT. ENSEVAL PUTERA BHP UMUM 6963 15/08/2017 14/10/2017 28410620
56 PT. ENSEVAL PUTERA OBAT REG 7303 16/08/2017 15/10/2017 28432596
57 PT. ENSEVAL PUTERA OBAT REG 0866 16/08/2017 15/10/2017 28432994
58 PT. ENSEVAL PUTERA OBAT REG 8314 24/08/2017 23/10/2017 28514476
59 PT. ENSEVAL PUTERA OBAT REG 8315 24/08/2017 23/10/2017 28514475
60 PT. ENSEVAL PUTERA OBAT REG 8323 24/08/2017 23/10/2017 28515280
61 PT. ENSEVAL PUTERA OBAT REG 8335 24/08/2017 23/10/2017 28516180
62 PT. ENSEVAL PUTERA OBAT REG 8339 24/08/2017 23/10/2017 28516179
63 PT. ENSEVAL PUTERA OBAT REG 0897 24/08/2017 23/10/2017 28507403
64 PT. ENSEVAL PUTERA OBAT REG 0903 24/08/2017 23/10/2017 28515346
65 PT. ENSEVAL PUTERA OBAT REG 0904 24/08/2017 23/10/2017 28516212
66 PT. ENSEVAL PUTERA BHP UMUM 8510 25/08/2017 24/10/2017 28529367
67 PT. ENSEVAL PUTERA BHP UMUM 0923 29/08/2017 28/10/2017 28563707
68 PT. ENSEVAL PUTERA OBAT REG 0926 29/08/2017 28/10/2017 28565297
69 PT. ENSEVAL PUTERA OBAT REG 0929 29/08/2017 28/10/2017 28567106
70 PT. ENSEVAL PUTERA OBAT REG 9194 30/08/2017 29/10/2017 28585532
71 PT. ENSEVAL PUTERA OBAT REG 0937 30/08/2017 29/10/2017
72 PT. ENSEVAL PUTERA OBAT REG 0949 31/08/2017 30/10/2017 28608459
73 PT. ENSEVAL PUTERA BHP UMUM 0955 04/09/2017 03/11/2017 28629539
74 PT. ENSEVAL PUTERA BHP UMUM 9920 06/09/2017 05/11/2017 28653453
75 PT. ENSEVAL PUTERA BHP UMUM 9925 06/09/2017 05/11/2017 28653696
76 PT. ENSEVAL PUTERA OBAT REG 0190 07/09/2017 06/11/2017 28674541
77 PT. ENSEVAL PUTERA OBAT REG 0968 07/09/2017 06/11/2017 28667095
78 PT. ENSEVAL PUTERA OBAT REG 0976 07/09/2017 06/11/2017 28675587
79 PT. ENSEVAL PUTERA BHP UMUM 0500 11/09/2017 10/11/2017 28700179
80 PT. ENSEVAL PUTERA OBAT REG 0521 11/09/2017 10/11/2017 28701631
81 PT. ENSEVAL PUTERA OBAT REG 0528 11/09/2017 10/11/2017 28701971
82 PT. ENSEVAL PUTERA OBAT REG 0556 11/09/2017 10/11/2017 28704041
83 PT. ENSEVAL PUTERA OBAT REG 0995 12/09/2017 11/11/2017 28714483
84 PT. ENSEVAL PUTERA BHP UMUM 1029 13/09/2017 12/11/2017 28739414
85 PT. ENSEVAL PUTERA OBAT REG 1175 14/09/2017 13/11/2017 28752863
86 PT. ENSEVAL PUTERA OBAT REG 1187 14/09/2017 13/11/2017 28755246
87 PT. ENSEVAL PUTERA OBAT REG 1008 14/09/2017 13/11/2017 28755304
88 PT. ENSEVAL PUTERA LABOR 1376 15/09/2017 14/11/2017 28771646

89 PT. PENTA VALENT OBAT REG 0862 08/09/2017 08/10/2017 28974910


90 PT. PENTA VALENT OBAT REG 0858 08/09/2017 08/10/2017 28974906
91 PT. PENTA VALENT OBAT REG 0857 08/09/2017 08/10/2017 28974905
92 PT. PENTA VALENT OBAT REG 1129 14/09/2017 14/10/2017 28987539
93 PT. PENTA VALENT OBAT REG 1150 14/09/2017 14/10/2017 28987551
94 PT. PENTA VALENT OBAT REG 1241 16/09/2017 16/10/2017 28991424

95 PT. UNITED DICO CITAS OBAT REG 0843 31/08/2017 21/09/2017 17080764
96 PT. UNITED DICO CITAS OBAT REG 0939 06/09/2017 27/09/2017 17080858
97 PT. UNITED DICO CITAS OBAT REG 1015 08/09/2017 29/09/2017 17080933

98 PT. DOS NI ROHA BHP UMUM 0824 27/07/2017 26/08/2017 93474167


99 PT. DOS NI ROHA BHP UMUM 0116 15/08/2017 14/09/2017 93545268
100 PT. DOS NI ROHA BHP UMUM 0115 15/08/2017 14/09/2017 93545267
101 PT. DOS NI ROHA BHP UMUM 5483 16/08/2017 15/09/2017 93581497
102 PT. DOS NI ROHA OBAT REG 5496 16/08/2017 15/09/2017 93581500
103 PT. DOS NI ROHA OBAT REG 5499 16/08/2017 15/09/2017 93581501
104 PT. DOS NI ROHA OBAT REG 5514 16/08/2017 15/09/2017 93581503
105 PT. DOS NI ROHA OBAT REG 5502 16/08/2017 15/09/2017 93581502
106 PT. DOS NI ROHA OBAT REG 4781 19/08/2017 18/09/2017 93559210
107 PT. DOS NI ROHA BHP UMUM 2388 22/08/2017 21/09/2017 93559218
108 PT. DOS NI ROHA OBAT REG 4314 26/08/2017 25/09/2017 93575334
109 PT. DOS NI ROHA BHP UMUM 4315 26/08/2017 25/09/2017 93575335
110 PT. DOS NI ROHA OBAT REG 7469 30/08/2017 29/09/2017 93586123
111 PT. DOS NI ROHA BHP UMUM 7471 30/08/2017 29/09/2017 93586124
112 PT. DOS NI ROHA OBAT REG 8876 30/08/2017 29/09/2017 93586168
113 PT. DOS NI ROHA OBAT REG 8877 30/08/2017 29/09/2017 93586169
114 PT. DOS NI ROHA OBAT REG 8878 30/08/2017 29/09/2017 93586170
115 PT. DOS NI ROHA OBAT REG 8879 30/08/2017 29/09/2017 93586171
116 PT. DOS NI ROHA OBAT REG 8880 30/08/2017 29/09/2017 93586172
117 PT. DOS NI ROHA OBAT REG 8881 30/08/2017 29/09/2017 93586173
118 PT. DOS NI ROHA BHP UMUM 7467 30/08/2017 29/09/2017 93586122
119 PT. DOS NI ROHA OBAT REG 8424 31/08/2017 30/09/2017 93586268
120 PT. DOS NI ROHA OBAT REG 5873 07/09/2017 07/10/2017 93637995
121 PT. DOS NI ROHA BHP UMUM 5875 07/09/2017 07/10/2017 93637996
122 PT. DOS NI ROHA OBAT REG 2719 09/09/2017 09/10/2017 93638001
123 PT. DOS NI ROHA OBAT REG 2721 09/09/2017 09/10/2017 93638002
124 PT. DOS NI ROHA OBAT REG 3542 09/09/2017 09/10/2017 93638003
125 PT. DOS NI ROHA OBAT REG 3839 09/09/2017 09/10/2017 93638004
126 PT. DOS NI ROHA BHP UMUM 4813 11/09/2017 11/10/2017 93645153
127 PT. DOS NI ROHA OBAT REG 2177 12/09/2017 12/10/2017 93645212
128 PT. DOS NI ROHA OBAT REG 2178 12/09/2017 12/10/2017 93645213
129 PT. DOS NI ROHA BHP UMUM 5259 13/09/2017 13/10/2017 93645218

130 PT. ANUGRAH ARGON M OBAT REG 1606 08/08/2017 07/10/2017 42787021
131 PT. ANUGRAH ARGON M OBAT REG 1607 08/08/2017 07/10/2017 42787022
132 PT. ANUGRAH ARGON M OBAT REG 1609 08/08/2017 07/10/2017 42787024
133 PT. ANUGRAH ARGON M OBAT REG 1756 10/08/2017 09/10/2017 42799207
134 PT. ANUGRAH ARGON M OBAT REG 1757 10/08/2017 09/10/2017 42799208
135 PT. ANUGRAH ARGON M BHP UMUM 1758 10/08/2017 09/10/2017 42799209
136 PT. ANUGRAH ARGON M OBAT REG 1759 10/08/2017 09/10/2017 42799210
137 PT. ANUGRAH ARGON M OBAT REG 1889 12/08/2017 11/10/2017 42808909
138 PT. ANUGRAH ARGON M OBAT REG 1888 12/08/2017 11/10/2017 42808908
139 PT. ANUGRAH ARGON M OBAT REG 2135 18/08/2017 17/10/2017 42833130
140 PT. ANUGRAH ARGON M BHP UMUM 2134 18/08/2017 17/10/2017 42833129

141 PT. MENSA BINA SUKSES BHP UMUM 4085 09/08/2017 08/09/2017 63140519
142 PT. MENSA BINA SUKSES BHP UMUM 4100 09/08/2017 08/09/2017 63140534
143 PT. MENSA BINA SUKSES BHP UMUM 2926 11/08/2017 10/09/2017 63149212
144 PT. MENSA BINA SUKSES OBAT REG 6799 21/08/2017 20/09/2017 63192513
145 PT. MENSA BINA SUKSES OBAT REG 0663 23/08/2017 22/09/2017 63206149
146 PT. MENSA BINA SUKSES OBAT REG 0666 23/08/2017 22/09/2017 63206152

147 PT. BHAKTI SEJAHTERA M OBAT REG P771 03/06/2017 03/07/2017


148 PT. BHAKTI SEJAHTERA M OBAT REG P855 19/06/2017 19/07/2017
149 PT. BHAKTI SEJAHTERA M OBAT REG 1240 28/08/2017 27/09/2017
150 PT. BHAKTI SEJAHTERA M OBAT REG 1179 23/08/2017 22/09/2017
151 PT. BHAKTI SEJAHTERA M OBAT REG 1122 12/08/2017 11/09/2017

152 PT. PENTA VALENT OBAT REG 0154 23/08/2017 22/09/2017 28933835
153 PT. PENTA VALENT OBAT REG 0175 24/08/2017 23/09/2017 28937105

154 PT. RAJAWALI NUSINDO BHP UMUM 3581 03/07/2017 02/08/2017 56901009
155 PT. RAJAWALI NUSINDO BHP UMUM 4048 24/07/2017 23/08/2017 56901473
156 PT. RAJAWALI NUSINDO BHP UMUM 4061 24/07/2017 23/08/2017 56901486
157 PT. RAJAWALI NUSINDO OBAT REG 4082 25/07/2017 24/08/2017 66031745
158 PT. RAJAWALI NUSINDO OBAT REG 4137 26/07/2017 25/08/2017 66031798
159 PT. RAJAWALI NUSINDO BHP UMUM 4268 31/07/2017 30/08/2017 66031927

160 PT. MILLENIUM PHARMACON I OBAT REG 0184 07/06/2017 07/07/2017 30550964

TOTAL
#NAME?
1 OBAT REG 843,573,578
2 BHP UMUM 342,201,328
3 LABOR 14,171,520
4 RADIOLOGI -
1,199,946,426

TOTAL
JML FAKTUR 160

Mengetahui,
Kepala Instalasi Farmasi

TONI DAFIAPUTRA, S.FARM, APT


NIP.19841023 200803 1 001
SI SURAT PEMBAYARAN HUTANG
BAHAN HABIS PAKAI
SUD H. HANAFIE MUARA BUNGO

TAGIHAN PPN PPH SUB TOTAL TOTAL KATEGAORI


5,949,745 604,035 90,605 6,644,385 1
3,324,375 337,500 50,625 3,712,500 2
1,267,279 128,658 19,299 1,415,235 3
9,698,310 984,600 147,690 10,830,600 4
24,730,100 2,510,670 376,601 27,617,370
5,762,250 585,000 87,750 6,435,000
16,578,658 1,683,112 252,467 18,514,237
2,509,780 254,800 38,220 2,802,800
2,182,918 221,616 33,242 2,437,776
689,342 69,984 10,498 769,824
1,684,350 171,000 25,650 1,881,000
74,377,106 7,550,975 1,132,646 83,060,727
7,678,026 779,495 116,924 8,574,445
925,900 94,000 14,100 1,034,000
4,504,374 457,297 68,595 5,030,265
767,414 77,910 11,687 857,010
5,197,374 527,652 79,148 5,804,174
19,073,087 1,936,354 290,453 21,299,894
13,348,434 1,355,171 203,276 14,906,881
33,578,847 3,409,020 511,353 37,499,220
6,044,317 613,636 92,045 6,749,999
5,567,637 565,242 84,786 6,217,666
6,855,364 695,976 104,396 7,655,736
14,550,913 1,477,250 221,588 16,249,750
5,211,338 529,070 79,360 5,819,768
85,156,850 8,645,365 1,296,805 95,099,020
2,647,883 268,821 40,323 2,957,027
7,298,850 741,000 111,150 8,151,000
10,044,341 1,019,730 152,960 11,217,030
12,866,563 1,306,250 195,938 14,368,750
12,565,251 1,275,660 191,349 14,032,260
1,723,750 175,000 26,250 1,925,000
5,884,898 597,452 89,618 6,571,967
27,678,549 2,810,005 421,501 30,910,055
8,539,950 867,000 130,050 9,537,000
19,463,600 1,976,000 296,400 21,736,000
3,859,969 391,875 58,781 4,310,625
112,573,603 11,428,792 1,714,319 125,716,714
6,476,375 657,500 98,625 7,232,500
3,361,313 341,250 51,188 3,753,750
5,910,000 600,000 90,000 6,600,000
202,181 20,526 3,079 225,786
3,286,009 333,605 50,041 3,669,655
3,324,375 337,500 50,625 3,712,500
12,191,555 1,237,721 185,658 13,614,935
11,081,250 1,125,000 168,750 12,375,000
2,604,094 264,375 39,656 2,908,125
1,359,300 138,000 20,700 1,518,000
1,186,034 120,410 18,061 1,324,505
50,982,486 5,175,887 776,383 56,934,756
3,571,046 362,543 54,381 3,987,970
3,139,688 318,750 47,813 3,506,250
19,332,349 1,962,675 294,401 21,589,425
13,757,371 1,396,687 209,503 15,363,562
10,371,385 1,052,932 157,940 11,582,257
8,292,838 841,912 126,287 9,261,037
58,464,676 5,935,500 890,325 65,290,501
749,388 76,080 11,412 836,880
3,999,652 406,056 60,908 4,466,616
8,230,463 835,580 125,337 9,191,380
5,031,774 510,840 76,626 5,619,240
1,936,248 196,573 29,486 2,162,307
1,904,695 193,370 29,006 2,127,070
3,295,318 334,550 50,183 3,680,050
1,936,248 196,573 29,486 2,162,307
3,230,800 328,000 49,200 3,608,000
30,314,584 3,077,623 461,643 33,853,850
3,693,856 375,011 56,252 4,125,118
8,976,738 911,344 136,702 10,024,784
3,004,428 305,018 45,753 3,355,199
2,136,170 216,870 32,531 2,385,570
2,759,915 280,194 42,029 3,082,139
888,421 90,195 13,529 992,145
1,708,936 173,496 26,024 1,908,456
4,669,705 474,082 71,112 5,214,899
862,255 87,539 13,131 962,924
2,235,755 226,980 34,047 2,496,782
4,609,505 467,970 70,196 5,147,670
1,776,842 180,390 27,059 1,984,290
37,322,524 3,789,089 568,363 41,679,976
985,000 100,000 15,000 1,100,000
1,970,000 200,000 30,000 2,200,000
1,182,000 120,000 18,000 1,320,000
3,102,750 315,000 47,250 3,465,000
2,659,500 270,000 40,500 2,970,000
1,970,000 200,000 30,000 2,200,000
32,012,500 3,250,000 487,500 35,750,000
4,491,600 456,000 68,400 5,016,000
788,000 80,000 12,000 880,000
12,805,000 1,300,000 195,000 14,300,000
32,012,500 3,250,000 487,500 35,750,000
93,978,850 9,541,000 1,431,150 104,951,000
6,427,125 652,500 97,875 7,177,500
2,881,125 292,500 43,875 3,217,500
3,767,625 382,500 57,375 4,207,500
5,023,500 510,000 76,500 5,610,000
6,233,080 632,800 94,920 6,960,800
2,393,550 243,000 36,450 2,673,000
1,756,255 178,300 26,745 1,961,300
7,876,553 799,650 119,948 8,796,150
36,358,813 3,691,250 553,688 40,603,750
4,284,750 435,000 65,250 4,785,000
3,792,250 385,000 57,750 4,235,000
8,077,000 820,000 123,000 9,020,000
4,814,532 488,785 73,318 5,376,635
10,175,592 1,033,055 154,958 11,363,605
1,376,833 139,780 20,967 1,537,580
4,943,042 501,832 75,275 5,520,148
2,181,233 221,445 33,217 2,435,895
6,985,325 709,170 106,376 7,800,870
30,476,556 3,094,067 464,110 34,034,733
2,465,439 250,298 37,545 2,753,282
24,625,000 2,500,000 375,000 27,500,000
27,090,439 2,750,298 412,545 30,253,282
25,531,200 2,592,000 388,800 28,512,000
30,850,200 3,132,000 469,800 34,452,000
24,097,040 2,446,400 366,960 26,910,400
40,502,215 4,111,900 616,785 45,230,900
22,848,060 2,319,600 347,940 25,515,600
3,453,213 350,580 52,587 3,856,380
147,281,928 14,952,480 2,242,872 164,477,280
14,676,500 1,490,000 223,500 16,390,000
9,672,700 982,000 147,300 10,802,000
8,668,000 880,000 132,000 9,680,000
5,220,500 530,000 79,500 5,830,000
3,622,830 367,800 55,170 4,045,800
9,928,800 1,008,000 151,200 11,088,000
3,546,000 360,000 54,000 3,960,000
1,063,800 108,000 16,200 1,188,000
960,375 97,500 14,625 1,072,500
37,519,044 3,809,040 571,356 41,899,440
35,679,163 3,622,250 543,338 39,844,750
25,531,200 2,592,000 388,800 28,512,000
3,007,796 305,360 45,804 3,358,960
159,096,708 16,151,950 2,422,793 177,671,450
1,083,946,933 1,083,946,933

532,427,757
168,553,406
297,165,770
85,800,000

1,083,946,933

Muara Bungo, 04 Oktober 2017

AYU TRESNAWATI
NIP 19660908 198803 2 002

SI SURAT PEMBAYARAN HUTANG


BAHAN HABIS PAKAI
SUD H. HANAFIE MUARA BUNGO

TAGIHAN PPN PPH SUB TOTAL TOTAL


7,699,579 781,683 117,252 8,598,515
3,221,837 327,090 49,064 3,597,990
3,443,757 349,620 52,443 3,845,820
2,610,250 265,000 39,750 2,915,000
3,805,681 386,364 57,955 4,249,999
2,390,766 242,717 36,408 2,669,891
5,762,250 585,000 87,750 6,435,000
2,583,409 262,275 39,341 2,885,025
4,882,739 495,710 74,356 5,452,805
940,923 95,525 14,329 1,050,777
967,073 98,180 14,727 1,079,980
1,458,570 148,078 22,212 1,628,860
433,574 44,018 6,603 484,194
18,676,615 1,896,103 284,415 20,857,133
533,969 54,210 8,132 596,310
5,805,260 589,367 88,405 6,483,032
10,745,444 1,090,908 163,636 11,999,988
6,648,750 675,000 101,250 7,425,000
1,235,781 125,460 18,819 1,380,060
886,855 90,036 13,505 990,396
428,042 43,456 6,518 478,016
2,726,062 276,758 41,514 3,044,333
9,850,788 1,000,080 150,012 11,000,880
97,737,972 9,922,637 1,488,396 109,149,004
2,800,848 284,350 42,653 3,127,850
13,263,518 1,346,550 201,983 14,812,050
5,569,781 565,460 84,819 6,220,060
1,344,525 136,500 20,475 1,501,500
5,910,000 600,000 90,000 6,600,000
2,951,629 299,658 44,949 3,296,235
23,586,337 2,394,552 359,183 26,340,072
55,426,637 5,627,070 844,060 61,897,767
11,365,679 1,153,876 173,081 12,692,636
3,693,750 375,000 56,250 4,125,000
2,713,675 275,500 41,325 3,030,500
2,510,804 254,904 38,236 2,803,944
1,429,235 145,100 21,765 1,596,100
19,219,813 1,951,250 292,688 21,463,750
7,703,882 782,120 117,318 8,603,320
5,449,759 553,275 82,991 6,086,025
5,146,255 522,462 78,369 5,747,087
2,881,125 292,500 43,875 3,217,500
7,382,575 749,500 112,425 8,244,500
7,653,450 777,000 116,550 8,547,000
2,985,141 303,060 45,459 3,333,660
2,925,450 297,000 44,550 3,267,000
1,674,500 170,000 25,500 1,870,000
4,777,250 485,000 72,750 5,335,000
2,866,744 291,040 43,656 3,201,440
17,091,720 1,735,200 260,280 19,087,200
1,723,750 175,000 26,250 1,925,000
4,099,176 416,160 62,424 4,577,760
115,293,732 11,704,947 1,755,742 128,754,422
3,693,750 375,000 56,250 4,125,000
4,184,034 424,775 63,716 4,672,525
17,883,522 1,815,586 272,338 19,971,446
1,410,343 143,182 21,477 1,575,002
807,675 81,997 12,300 901,972
9,548,098 969,350 145,403 10,662,850
9,490,026 963,454 144,518 10,597,999
10,967,975 1,113,500 167,025 12,248,500
19,922,118 2,022,550 303,383 22,248,050
8,128,725 825,251 123,788 9,077,764
1,871,500 190,000 28,500 2,090,000
1,276,560 129,600 19,440 1,425,600
1,141,704 115,909 17,386 1,274,999
4,298,181 436,364 65,455 4,799,999
186,970 18,982 2,847 208,799
8,327,072 845,388 126,808 9,299,268
5,850,900 594,000 89,100 6,534,000
23,903,586 2,426,760 364,014 26,694,360
18,781,389 1,906,740 286,011 20,974,140
23,655,760 2,401,600 360,240 26,417,600
711,885 72,273 10,841 794,998
222,610 22,600 3,390 248,600
9,437,909 958,163 143,725 10,539,797
4,184,034 424,775 63,716 4,672,525
5,867,005 595,635 89,345 6,551,985
21,898,274 2,223,175 333,476 24,454,925
16,887,825 1,714,500 257,175 18,859,500
6,160,950 625,477 93,822 6,880,249
13,036,388 1,323,491 198,524 14,558,403
4,033,575 409,500 61,425 4,504,500
1,255,875 127,500 19,125 1,402,500
814,103 82,650 12,398 909,150
982,940 99,791 14,969 1,097,699
9,076,285 921,450 138,218 10,135,953
22,040,656 2,237,630 335,645 24,613,930
2,304,900 234,000 35,100 2,574,000
2,208,414 224,204 33,631 2,466,249
8,996,202 913,320 136,998 10,046,520
305,449,714 31,010,123 4,651,518 341,111,356
529,417 53,748 8,062 591,227
3,554,680 360,881 54,132 3,969,693
1,970,000 200,000 30,000 2,200,000
3,204,845 325,365 48,805 3,579,015
7,228,913 733,900 110,085 8,072,898
1,758,225 178,500 26,775 1,963,500
18,246,080 1,852,394 277,859 20,376,333
13,339,609 1,354,275 203,141 14,897,025
1,584,779 160,891 24,134 1,769,804
7,205,272 731,500 109,725 8,046,497
22,129,660 2,246,666 337,000 24,713,326
1,170,180 118,800 17,820 1,306,800
25,275,100 2,566,000 384,900 28,226,000
59,399,440 6,030,400 904,560 66,334,400
1,970,000 200,000 30,000 2,200,000
3,482,172 353,520 53,028 3,888,720
4,825,515 489,900 73,485 5,388,900
2,752,435 279,435 41,915 3,073,785
2,753,875 279,581 41,937 3,075,393
464,667 47,174 7,076 518,918
2,019,707 205,046 30,757 2,255,510
2,441,421 247,860 37,179 2,726,460
7,119,334 722,775 108,416 7,950,525
2,993,533 303,912 45,587 3,343,032
6,418,260 651,600 97,740 7,167,600
13,434,908 1,363,950 204,593 15,003,450
3,482,172 353,520 53,028 3,888,720
13,434,908 1,363,950 204,593 15,003,450
3,940,000 400,000 60,000 4,400,000
4,563,013 463,250 69,488 5,095,750
4,018,800 408,000 61,200 4,488,000
40,656,860 4,127,600 619,140 45,403,600
2,718,600 276,000 41,400 3,036,000
3,940,000 400,000 60,000 4,400,000
2,737,867 277,956 41,693 3,057,516
2,775,691 281,796 42,269 3,099,756
2,725,544 276,705 41,506 3,043,755
19,161,944 1,945,375 291,806 21,399,125
1,560,240 158,400 23,760 1,742,400
4,481,750 455,000 68,250 5,005,000
9,097,263 923,580 138,537 10,159,380
7,658,375 777,500 116,625 8,552,500
38,612,000 3,920,000 588,000 43,120,000
302,085,571 30,668,586 4,600,288 337,354,445
13,711,333 1,392,013 208,802 15,312,148
3,729,470 378,626 56,794 4,164,890
448,175 45,500 6,825 500,500
7,474,279 758,810 113,822 8,346,910
1,108,125 112,500 16,875 1,237,500
4,692,181 476,364 71,455 5,239,999
4,655,646 472,654 70,898 5,199,199
3,324,375 337,500 50,625 3,712,500
3,044,545 309,091 46,364 3,399,999
15,757,538 1,599,750 239,963 17,597,250
10,334,584 1,049,196 157,379 11,541,160
68,280,249 6,932,005 1,039,801 76,252,055
1,723,750 175,000 26,250 1,925,000
5,005,415 508,164 76,225 5,589,804
2,204,430 223,800 33,570 2,461,800
7,842,728 796,216 119,432 8,758,376
3,263,049 331,274 49,691 3,644,014
4,817,619 489,098 73,365 5,380,082
24,856,991 2,523,552 378,533 27,759,076
6,673,375 677,500 101,625 7,452,500
4,364,535 443,100 66,465 4,874,100
1,649,875 167,500 25,125 1,842,500
4,324,150 439,000 65,850 4,829,000
2,583,163 262,250 39,338 2,884,750
19,595,098 1,989,350 298,403 21,882,850
18,634,057 1,891,782 283,767 20,809,607
5,762,250 585,000 87,750 6,435,000
24,396,307 2,476,782 371,517 27,244,607
2,376,678 241,287 36,193 2,654,158
263,980 26,800 4,020 294,800
1,012,811 102,823 15,424 1,131,058
3,978,120 403,870 60,581 4,442,570
10,530,635 1,069,100 160,365 11,760,100
1,083,947 110,045 16,507 1,210,499
19,246,170 1,953,926 293,089 21,493,185
1,753,300 178,000 26,700 1,958,000
1,958,000
1,199,946,426 1,199,946,426

Muara Bungo, 24 Oktober 2017

AYU TRESNAWATI
NIP 19660908 198803 2 002
KATEGAORI
OBAT REG
BHP UMUM
LABOR
RADIOLOGI
LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG
OBAT DAN BAHAN HABIS PAKAI
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
02 November 2017
NO DISTRIBUTOR KATEGORI NO FACT TGL.FACT JT. TEMPO NO.F STDR
1 PT. ANUGRAH PHARMINDO L OBAT REG 0291 09/08/2017 08/10/2017 06028062
2 PT. ANUGRAH PHARMINDO L OBAT REG 0407 10/08/2017 09/10/2017 06038694
3 PT. ANUGRAH PHARMINDO L OBAT REG 0406 10/08/2017 09/10/2017 06038693
4 PT. ANUGRAH PHARMINDO L OBAT REG 0643 12/08/2017 11/10/2017 06056722
5 PT. ANUGRAH PHARMINDO L OBAT REG 1418 21/08/2017 20/10/2017 06144016
6 PT. ANUGRAH PHARMINDO L OBAT REG 3606 11/09/2017 10/11/2017 06298637
7 PT. ANUGRAH PHARMINDO L OBAT REG 3481 11/09/2017 10/11/2017 06298636
8 PT. ANUGRAH PHARMINDO L OBAT REG 3606 12/09/2017 11/11/2017 06310022
9 PT. ANUGRAH PHARMINDO L OBAT REG 4293 18/09/2017 18/10/2017 15019691

10 PT. SAPTA SARI BHP UMUM 8539 09/09/2017 30/09/2017 63830159

11 PT. ANUGRAH ARGON M OBAT REG 2196 19/08/2017 18/10/2017 42836968


12 PT. ANUGRAH ARGON M OBAT REG 2361 22/08/2017 21/10/2017 42849041
13 PT. ANUGRAH ARGON M OBAT REG 2493 24/08/2017 23/10/2017 42863239
14 PT. ANUGRAH ARGON M OBAT REG 2494 24/08/2017 23/10/2017 42863240
15 PT. ANUGRAH ARGON M OBAT REG 2495 24/08/2017 23/10/2017 42863241
16 PT. ANUGRAH ARGON M BHP UMUM 2625 26/08/2017 25/10/2017 42873122
17 PT. ANUGRAH ARGON M OBAT REG 2626 26/08/2017 25/10/2017 42873123
18 PT. ANUGRAH ARGON M OBAT REG 2773 29/08/2017 28/10/2017 71594490
19 PT. ANUGRAH ARGON M OBAT REG 2779 29/08/2017 28/10/2017 71594971
20 PT. ANUGRAH ARGON M OBAT REG 2850 30/08/2017 29/10/2017 71601020
21 PT. ANUGRAH ARGON M OBAT REG 2938 31/08/2017 30/10/2017 71610848
22 PT. ANUGRAH ARGON M OBAT REG 2939 31/08/2017 30/10/2017 71610849

23 PT. KIMIA FARMA OBAT REG 5928 04/09/2017 25/09/2017 48095621


24 PT. KIMIA FARMA OBAT REG 0424 09/09/2017 30/09/2017 48106733
25 PT. KIMIA FARMA BHP UMUM 2771 11/09/2017 02/10/2017 48110222
26 PT. KIMIA FARMA BHP UMUM 6353 12/09/2017 03/10/2017 48114278
27 PT. KIMIA FARMA OBAT REG 0927 14/09/2017 05/10/2017 48117705
28 PT. KIMIA FARMA OBAT REG 0931 14/09/2017 05/10/2017 48117706
29 PT. KIMIA FARMA OBAT REG 0158 19/09/2017 10/10/2017 48129827
30 PT. KIMIA FARMA OBAT REG 7133 22/09/2017 13/10/2017 19644974
31 PT. KIMIA FARMA OBAT REG 4472 26/09/2017 17/10/2017 19651663
32 PT. KIMIA FARMA OBAT REG 4925 26/09/2017 17/10/2017 19651666
33 PT. KIMIA FARMA BHP UMUM 5267 26/09/2017 17/10/2017 19651668
34 PT. KIMIA FARMA OBAT REG 6471 27/09/2017 18/10/2017 19652948
35 PT. KIMIA FARMA OBAT REG 7895 27/09/2017 18/10/2017 19652947

36 PT. MERAPI UTAMA PHARMA OBAT REG 1218 11/09/2017 29/10/2017 84480136
37 PT. MERAPI UTAMA PHARMA OBAT REG 1244 12/09/2017 30/10/2017 84480195
38 PT. MERAPI UTAMA PHARMA OBAT REG 1245 12/09/2017 30/10/2017 84480196
39 PT. MERAPI UTAMA PHARMA OBAT REG 1341 13/09/2017 31/10/2017 84480254
40 PT. MERAPI UTAMA PHARMA OBAT REG 1472 15/09/2017 02/11/2017 84480366

41 PT. ENSEVAL PUTERA OBAT REG 1108 03/09/2017 02/11/2017 28943173


42 PT. ENSEVAL PUTERA OBAT REG 2032 20/09/2017 19/11/2017 28825758
43 PT. ENSEVAL PUTERA OBAT REG 2034 20/09/2017 19/11/2017 28825757
44 PT. ENSEVAL PUTERA OBAT REG 1047 20/09/2017 19/11/2017 28826503
45 PT. ENSEVAL PUTERA OBAT REG 1064 23/09/2017 22/11/2017 28852651
46 PT. ENSEVAL PUTERA BHP UMUM 2537 26/09/2017 25/11/2017 28874640
47 PT. ENSEVAL PUTERA OBAT REG 2679 26/09/2017 25/11/2017 28883805
48 PT. ENSEVAL PUTERA OBAT REG 2702 26/09/2017 25/11/2017 28885203
49 PT. ENSEVAL PUTERA OBAT REG 1078 26/09/2017 25/11/2017 28883815
50 PT. ENSEVAL PUTERA BHP UMUM 3351 30/09/2017 29/11/2017 28945768
51 PT. ENSEVAL PUTERA OBAT REG 1106 30/09/2017 29/11/2017 28942785
52 PT. ENSEVAL PUTERA OBAT REG 1107 30/09/2017 29/11/2017 28943174
RETUR 3,887,730
53 PT. MENSA BINA SUKSES OBAT REG 7262 10/08/2017 09/09/2017 63143625
54 PT. MENSA BINA SUKSES OBAT REG 3124 16/08/2017 15/09/2017 63179006
55 PT. MENSA BINA SUKSES OBAT REG 3312 19/08/2017 18/09/2017 63189068
56 PT. MENSA BINA SUKSES OBAT REG 0664 23/08/2017 22/09/2017 63206150
57 PT. MENSA BINA SUKSES OBAT REG 8466 25/08/2017 24/09/2017 63223729
58 PT. MENSA BINA SUKSES OBAT REG 8691 28/08/2017 27/09/2017 63243664
59 PT. MENSA BINA SUKSES OBAT REG 0735 29/08/2017 28/09/2017 63245658
60 PT. MENSA BINA SUKSES OBAT REG 8686 31/08/2017 30/09/2017 63263291
RETUR 15,988,500
61 PT. PENTA VALENT OBAT REG 1741 28/09/2017 28/10/2017 29018233
62 PT. PENTA VALENT OBAT REG 1743 28/09/2017 28/10/2017 29018235
63 PT. PENTA VALENT OBAT REG 1776 29/09/2017 29/10/2017 20470060
64 PT. PENTA VALENT OBAT REG 1916 30/09/2017 30/10/2017 20474406
65 PT. PENTA VALENT OBAT REG 1932 30/09/2017 30/10/2017
66 PT. PENTA VALENT OBAT REG 1949 30/09/2017 30/10/2017

67 PT. RAJAWALI NUSINDO BHP UMUM 4339 04/08/2017 03/09/2017 66031996


68 PT. RAJAWALI NUSINDO BHP UMUM 4340 04/08/2017 03/09/2017 66031997
69 PT. RAJAWALI NUSINDO OBAT REG 4375 07/08/2017 06/09/2017 66032032
70 PT. RAJAWALI NUSINDO BHP UMUM 4376 07/08/2017 06/09/2017 66032033
71 PT. RAJAWALI NUSINDO OBAT REG 4682 21/08/2017 20/09/2017 66032332
72 PT. RAJAWALI NUSINDO OBAT REG 4683 21/08/2017 20/09/2017 66032333
73 PT. RAJAWALI NUSINDO OBAT REG 4743 23/08/2017 22/09/2017 66032391
74 PT. RAJAWALI NUSINDO OBAT REG 4744 23/08/2017 22/09/2017 66032392
75 PT. RAJAWALI NUSINDO BHP UMUM 5056 07/09/2017 07/10/2017 66032693
76 PT. RAJAWALI NUSINDO OBAT REG 5057 08/09/2017 08/10/2017 66032694
77 PT. RAJAWALI NUSINDO OBAT REG 5058 08/09/2017 08/10/2017 66032695
78 PT. RAJAWALI NUSINDO BHP UMUM 5059 08/09/2017 08/10/2017 66032696
79 PT. RAJAWALI NUSINDO OBAT REG 5066 08/09/2017 08/10/2017 66032702
80 PT. RAJAWALI NUSINDO OBAT REG 5067 08/09/2017 08/10/2017 66032703
81 PT. RAJAWALI NUSINDO OBAT REG 5086 09/09/2017 09/10/2017 66032721
82 PT. RAJAWALI NUSINDO OBAT REG 5190 15/09/2017 15/10/2017 66032824
83 PT. RAJAWALI NUSINDO OBAT REG 5189 15/09/2017 15/10/2017 66032823
84 PT. RAJAWALI NUSINDO BHP UMUM 5231 18/09/2017 18/10/2017 66032865
85 PT. RAJAWALI NUSINDO OBAT REG 5303 20/09/2017 20/10/2017 66032936
86 PT. RAJAWALI NUSINDO OBAT REG 5466 29/09/2017 29/10/2017 66033099
87 PT. RAJAWALI NUSINDO OBAT REG 5471 29/09/2017 29/10/2017 66033104

88 PT. PARIT PADANG GLOBAL OBAT REG 2126 13/09/2017 04/10/2017 83766753
89 PT. PARIT PADANG GLOBAL OBAT REG 2141 13/09/2017 04/10/2017 83767543
90 PT. PARIT PADANG GLOBAL OBAT REG 2142 13/09/2017 04/10/2017 83767643
91 PT. PARIT PADANG GLOBAL OBAT REG 2235 14/09/2017 05/10/2017 83773955
92 PT. PARIT PADANG GLOBAL OBAT REG 2264 15/09/2017 06/10/2017 83776715
93 PT. PARIT PADANG GLOBAL OBAT REG 2378 18/09/2017 09/10/2017 83786312
94 PT. PARIT PADANG GLOBAL OBAT REG 2408 19/09/2017 10/10/2017 83790362
95 PT. PARIT PADANG GLOBAL OBAT REG 2585 22/09/2017 13/10/2017 83801831

96 PT. ULICO PHARMA OBAT REG 4083 02/09/2017 02/10/2017 19374083

97 PT. DOS NI ROHA OBAT REG 7733 16/09/2017 16/10/2017 93653538


98 PT. DOS NI ROHA OBAT REG 5032 19/09/2017 19/10/2017 93662064
99 PT. DOS NI ROHA OBAT REG 7475 20/09/2017 20/10/2017 93662068
100 PT. DOS NI ROHA OBAT REG 7551 20/09/2017 20/10/2017 93662069
101 PT. DOS NI ROHA OBAT REG 7801 20/09/2017 20/10/2017 93665561
102 PT. DOS NI ROHA OBAT REG 1528 25/09/2017 25/10/2017 93665565

103 PT. CITRA PURNAMA S LABOR 0071 28/09/2017 28/10/2017 99603786


104 PT. CITRA PURNAMA S BHP UMUM 0072 03/10/2017 02/11/2017 99603788
105 PT. CITRA PURNAMA S BHP UMUM 0073 05/10/2017 04/11/2017 99603787
106 PT. CITRA PURNAMA S LABOR 0074 05/10/2017 04/11/2017 99603789
107 PT. CITRA PURNAMA S BHP UMUM 0075 07/10/2017 06/11/2017 99603790
108 PT. CITRA PURNAMA S LABOR 0076 10/10/2017 09/11/2017 99603791
109 PT. CITRA PURNAMA S LABOR 0077 12/10/2017 11/11/2017 99603792
110 PT. CITRA PURNAMA S LABOR 0078 13/10/2017 12/11/2017 50943115
111 PT. CITRA PURNAMA S BHP UMUM 0079 17/10/2017 16/11/2017 50943116
112 PT. CITRA PURNAMA S BHP UMUM 0080 20/10/2017 19/11/2017 50943117
113 PT. CITRA PURNAMA S LABOR 0081 21/10/2017 20/11/2017 50943118
114 PT. CITRA PURNAMA S LABOR 0082 21/10/2017 20/11/2017 50943119
115 PT. CITRA PURNAMA S BHP UMUM 0083 21/10/2017 20/11/2017 50943120
116 PT. CITRA PURNAMA S BHP UMUM 0084 23/10/2017 22/11/2017 50943121

117 PT. MUARA NATIO P BHP UMUM 2552 01/08/2017 31/08/2017 99872552
118 PT. MUARA NATIO P BHP UMUM 2595 19/09/2017 19/10/2017 99872595
119 PT. MUARA NATIO P RADIOLOGI 2584 02/10/2017 01/11/2017 99872584
120 PT. MUARA NATIO P LABOR 2587 06/10/2017 05/11/2017 99872587
121 PT. MUARA NATIO P BHP UMUM 2589 09/10/2017 08/11/2017 99872589
122 PT. MUARA NATIO P LABOR 2588 10/10/2017 09/11/2017 99872588
123 PT. MUARA NATIO P RADIOLOGI 2594 12/10/2017 11/11/2017 99872594
124 PT. MUARA NATIO P LABOR 2590 13/10/2017 12/11/2017 99872590
125 PT. MUARA NATIO P LABOR 2591 13/10/2017 12/11/2017 99872591
126 PT. MUARA NATIO P RADIOLOGI 2598 25/10/2017 24/11/2017 99872598

127 PT. MUTIARA LABSAINS BHP UMUM 2672 15/09/2017 15/10/2017 30631110
128 PT. MUTIARA LABSAINS BHP UMUM 2849 02/10/2017 01/11/2017 30631287
129 PT. MUTIARA LABSAINS BHP UMUM 2858 02/10/2017 01/11/2017 30631296
130 PT. MUTIARA LABSAINS BHP UMUM 2859 02/10/2017 01/11/2017 30631297
131 PT. MUTIARA LABSAINS BHP UMUM 2905 05/10/2017 04/11/2017 30631343
132 PT. MUTIARA LABSAINS BHP UMUM 2940 09/10/2017 08/11/2017 30631378
133 PT. MUTIARA LABSAINS BHP UMUM 2941 09/10/2017 08/11/2017 30631379
134 PT. MUTIARA LABSAINS BHP UMUM 2957 09/10/2017 08/11/2017 30631395
135 PT. MUTIARA LABSAINS BHP UMUM 2986 10/10/2017 09/11/2017 30631424
136 PT. MUTIARA LABSAINS BHP UMUM 3024 16/10/2017 15/11/2017 39579780
137 PT. MUTIARA LABSAINS BHP UMUM 3062 18/10/2017 17/11/2017 39579818
138 PT. MUTIARA LABSAINS BHP UMUM 3101 23/10/2017 22/11/2017 39579857
139 PT. MUTIARA LABSAINS BHP UMUM 3102 23/10/2017 22/11/2017 39579858
140 PT. MUTIARA LABSAINS BHP UMUM 3106 23/10/2017 22/11/2017 39579862
141 PT. MUTIARA LABSAINS LABOR 3137 25/10/2017 24/11/2017 39579893
142 PT. MUTIARA LABSAINS BHP UMUM 3138 25/10/2017 24/11/2017 39579894

143 PT. MEDICO VISI PHARMA LABOR 021 11/10/2017 10/11/2017 26368124
144 PT. MEDICO VISI PHARMA LABOR 022 13/10/2017 12/11/2017 26368125
145 PT. MEDICO VISI PHARMA LABOR 023 14/10/2017 13/11/2017 26368126
146 PT. MEDICO VISI PHARMA LABOR 025 18/10/2017 17/11/2017 26368127

147 PT. BHAKTI SEJAHTERA M BHP UMUM 1308 12/09/2017 12/10/2017


148 PT. BHAKTI SEJAHTERA M BHP UMUM 1307 12/08/2017 11/09/2017

1 OBAT REG
2 BHP UMUM
3 LABOR
4 RADIOLOGI

TOTAL
JML FAKTUR 146
#NAME?

Mengetahui,
Kepala Instalasi Farmasi

TONI DAFIAPUTRA, S.FARM, APT


NIP.19841023 200803 1 001

LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG


OBAT DAN BAHAN HABIS PAKAI
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
###
NO DISTRIBUTOR KATEGORI NO FACT TGL.FACT JT. TEMPO NO.F STDR
1 PT. ANUGRAH ARGON M OBAT REG 3354 08/09/2017 07/11/2017 71643688
2 PT. ANUGRAH ARGON M OBAT REG 3355 08/09/2017 07/11/2017 71643689
3 PT. ANUGRAH ARGON M OBAT REG 3531 12/09/2017 11/11/2017 71657535
4 PT. ANUGRAH ARGON M OBAT REG 3532 12/09/2017 11/11/2017 71657536
5 PT. ANUGRAH ARGON M OBAT REG 2504 12/09/2017 11/11/2017 71657537
6 PT. ANUGRAH ARGON M OBAT REG 3535 12/09/2017 11/11/2017 71657539
7 PT. ANUGRAH ARGON M OBAT REG 3675 14/09/2017 13/11/2017 71669720
8 PT. ANUGRAH ARGON M OBAT REG 3676 14/09/2017 13/11/2017 71669721
9 PT. ANUGRAH ARGON M OBAT REG 3677 14/09/2017 13/11/2017 71669722
10 PT. ANUGRAH ARGON M OBAT REG 3678 14/09/2017 13/11/2017 71669723
11 PT. ANUGRAH ARGON M OBAT REG 3801 16/09/2017 15/11/2017 71679018
12 PT. ANUGRAH ARGON M OBAT REG 3808 16/09/2017 15/11/2017 71679025
13 PT. ANUGRAH ARGON M OBAT REG 3942 19/09/2017 18/11/2017 71690265
14 PT. ANUGRAH ARGON M OBAT REG 3944 19/09/2017 18/11/2017 71690267
15 PT. ANUGRAH ARGON M OBAT REG 3945 19/09/2017 18/11/2017 71690268
16 PT. ANUGRAH ARGON M OBAT REG 4447 28/09/2017 27/11/2017 71733257
17 PT. ANUGRAH ARGON M OBAT REG 4448 28/09/2017 27/11/2017 71733258
18 PT. ANUGRAH ARGON M OBAT REG 4452 28/09/2017 27/11/2017 71733262
19 PT. ANUGRAH ARGON M OBAT REG 4453 28/09/2017 27/11/2017 71733263
20 PT. ANUGRAH ARGON M OBAT REG 4518 28/09/2017 27/11/2017 71740851
21 PT. ANUGRAH ARGON M OBAT REG 4591 30/09/2017 29/11/2017 71749692
22 PT. ANUGRAH ARGON M OBAT REG 4926 05/10/2017 04/12/2017 71771257
23 PT. ANUGRAH ARGON M OBAT REG 4927 05/10/2017 04/12/2017 71771258
24 PT. ANUGRAH ARGON M OBAT REG 4928 05/10/2017 04/12/2017 71771259
RETUR 20,270,800
25 PT. ANUGRAH PHARMINDO L OBAT REG 4796 22/09/2017 22/10/2017 06028059
26 PT. ANUGRAH PHARMINDO L OBAT REG 6058 04/10/2017 03/11/2017 06028062
27 PT. ANUGRAH PHARMINDO L OBAT REG 6490 10/10/2017 09/11/2017 15194964
28 PT. ANUGRAH PHARMINDO L OBAT REG 8494 26/10/2017 25/12/2017 15371036
29 PT. ANUGRAH PHARMINDO L OBAT REG 8859 30/10/2017 29/12/2017 15194966
30 PT. ANUGRAH PHARMINDO L OBAT REG 8494 30/10/2017 29/12/2017 15383288
31 PT. ANUGRAH PHARMINDO L OBAT REG 4860 23/09/2017 23/10/2017 15052833
32 PT. ANUGRAH PHARMINDO L OBAT REG 5494 28/09/2017 28/10/2017 15115885

33 PT. BHAKTI SEJAHTERA M OBAT REG 1377 26/09/2017 26/10/2017

34 PT. ENSEVAL PUTERA OBAT REG 1129 02/10/2017 01/12/2017 28962194


35 PT. ENSEVAL PUTERA BHP UMUM 3691 03/10/2017 02/12/2017 28970523
36 PT. ENSEVAL PUTERA OBAT REG 3890 04/10/2017 03/12/2017 28986608
37 PT. ENSEVAL PUTERA LABOR 3918 04/10/2017 03/12/2017 28988994
38 PT. ENSEVAL PUTERA OBAT REG 1150 05/10/2017 04/12/2017 29002688
39 PT. ENSEVAL PUTERA OBAT REG 4069 05/10/2017 04/12/2017 29003051
40 PT. ENSEVAL PUTERA OBAT REG 4071 05/10/2017 04/12/2017 29003392
41 PT. ENSEVAL PUTERA OBAT REG 4346 07/10/2017 06/12/2017 45729907
42 PT. ENSEVAL PUTERA OBAT REG 4469 10/10/2017 09/12/2017 29037529
43 PT. ENSEVAL PUTERA OBAT REG 4638 10/10/2017 09/12/2017 29049599
44 PT. ENSEVAL PUTERA OBAT REG 5004 12/10/2017 11/12/2017 29084523
45 PT. ENSEVAL PUTERA OBAT REG 1179 12/10/2017 11/12/2017 29083808
46 PT. ENSEVAL PUTERA OBAT REG 1180 12/10/2017 11/12/2017 29084542
47 PT. ENSEVAL PUTERA OBAT REG 5282 14/10/2017 13/12/2017 29108845
48 PT. ENSEVAL PUTERA OBAT REG 5488 17/10/2017 16/12/2017 45729897
49 PT. ENSEVAL PUTERA OBAT REG 5921 19/10/2017 18/12/2017 45766943
50 PT. ENSEVAL PUTERA OBAT REG 5922 19/10/2017 18/12/2017 45766944
51 PT. ENSEVAL PUTERA OBAT REG 1215 19/10/2017 18/12/2017 45763593
52 PT. ENSEVAL PUTERA OBAT REG 6069 20/10/2017 19/12/2017 45779330
53 PT. ENSEVAL PUTERA OBAT REG 1230 20/10/2017 19/12/2017 45779219
54 PT. ENSEVAL PUTERA BHP UMUM 6249 21/10/2017 20/12/2017 45792605
55 PT. ENSEVAL PUTERA BHP UMUM 1241 21/10/2017 20/12/2017 45792794
56 PT. ENSEVAL PUTERA OBAT REG 1242 21/10/2017 20/12/2017 45793055
57 PT. ENSEVAL PUTERA OBAT REG 1243 21/10/2017 20/12/2017 45793056
RETUR 14,724,354
58 PT. MENSA BINA SUKSES OBAT REG 9847 02/09/2017 02/10/2017 63274313
59 PT. MENSA BINA SUKSES BHP UMUM 9848 02/09/2017 02/10/2017 63274314
60 PT. MENSA BINA SUKSES BHP UMUM 9973 05/09/2017 05/10/2017 63284326
61 PT. MENSA BINA SUKSES OBAT REG 9972 05/09/2017 05/10/2017 63284325
62 PT. MENSA BINA SUKSES OBAT REG 8872 08/09/2017 08/10/2017 63302977
63 PT. MENSA BINA SUKSES OBAT REG 8870 08/09/2017 08/10/2017 63302975
64 PT. MENSA BINA SUKSES OBAT REG 2941 14/09/2017 14/10/2017 63336523
65 PT. MENSA BINA SUKSES OBAT REG 2940 14/09/2017 14/10/2017 63336522
66 PT. MENSA BINA SUKSES OBAT REG 2938 14/09/2017 14/10/2017 63336520
67 PT. MENSA BINA SUKSES OBAT REG 2939 14/09/2017 14/10/2017 63336521
68 PT. MENSA BINA SUKSES OBAT REG 7770 19/09/2017 19/10/2017 63351224
69 PT. MENSA BINA SUKSES OBAT REG 1787 20/09/2017 20/10/2017 63355189
70 PT. MENSA BINA SUKSES OBAT REG 1786 20/09/2017 20/10/2017 63355188
71 PT. MENSA BINA SUKSES OBAT REG 4473 22/09/2017 22/10/2017 63367741
72 PT. MENSA BINA SUKSES OBAT REG 4515 22/09/2017 22/10/2017 63367753
73 PT. MENSA BINA SUKSES BHP UMUM 8813 23/09/2017 23/10/2017 63371983
74 PT. MENSA BINA SUKSES OBAT REG 8811 23/09/2017 23/10/2017 63371981
75 PT. MENSA BINA SUKSES OBAT REG 6118 23/09/2017 23/10/2017 63389076
76 PT. MENSA BINA SUKSES OBAT REG 4353 28/09/2017 28/10/2017 63336530
77 PT. MENSA BINA SUKSES OBAT REG 4354 28/09/2017 28/10/2017 63397173
78 PT. MENSA BINA SUKSES OBAT REG 5940 30/09/2017 30/10/2017 63418437
RETUR 15,095,025
79 PT. TEMPO OBAT REG 2906 30/09/2017 30/10/2017 25121849
80 PT. TEMPO OBAT REG 2912 30/09/2017 30/10/2017 25121855
81 PT. TEMPO OBAT REG 2915 30/09/2017 30/10/2017 25121797
82 PT. TEMPO OBAT REG 2903 30/09/2017 30/10/2017 25121846

83 PT. PARIT PADANG GLOBAL OBAT REG 2797 27/09/2017 18/10/2017 83819835
84 PT. PARIT PADANG GLOBAL OBAT REG 2799 27/09/2017 18/10/2017 83819867
85 PT. PARIT PADANG GLOBAL OBAT REG 2837 28/09/2017 19/10/2017 83813450
86 PT. PARIT PADANG GLOBAL OBAT REG 2890 28/09/2017 19/10/2017 83827320
87 PT. PARIT PADANG GLOBAL OBAT REG 2772 29/09/2017 20/10/2017 83817114
88 PT. PARIT PADANG GLOBAL OBAT REG 2991 29/09/2017 20/10/2017 83833662
89 PT. PARIT PADANG GLOBAL OBAT REG 2977 29/09/2017 20/10/2017 83833306
90 PT. PARIT PADANG GLOBAL OBAT REG 3083 30/09/2017 21/10/2017 83840949
91 PT. PARIT PADANG GLOBAL OBAT REG 3220 03/10/2017 24/10/2017 83950271
92 PT. PARIT PADANG GLOBAL OBAT REG 3335 05/10/2017 26/10/2017 83859041
93 PT. PARIT PADANG GLOBAL OBAT REG 3475 09/10/2017 30/10/2017 83870131
94 PT. PARIT PADANG GLOBAL OBAT REG 3543 10/10/2017 31/10/2017 83876378
95 PT. PARIT PADANG GLOBAL OBAT REG 3659 12/10/2017 02/11/2017 83886306
96 PT. PARIT PADANG GLOBAL OBAT REG 3747 13/10/2017 03/11/2017 83890689
97 PT. PARIT PADANG GLOBAL OBAT REG 3751 14/10/2017 04/11/2017 83890914
98 PT. PARIT PADANG GLOBAL OBAT REG 3867 20/10/2017 10/11/2017 83919971

99 PT. TRI SAPTA JAYA OBAT REG 4526 11/07/2017 10/08/2017 54980105
100 PT. TRI SAPTA JAYA OBAT REG 4636 11/07/2017 10/08/2017 54981405
101 PT. TRI SAPTA JAYA OBAT REG 5706 24/07/2017 23/08/2017 54999132
102 PT. TRI SAPTA JAYA OBAT REG 5991 27/07/2017 26/08/2017 55003691
103 PT. TRI SAPTA JAYA OBAT REG 6793 05/08/2017 04/09/2017 83919973
104 PT. TRI SAPTA JAYA OBAT REG 7811 16/08/2017 15/09/2017 17282683
105 PT. TRI SAPTA JAYA OBAT REG 7889 19/09/2017 19/10/2017 17284599
106 PT. TRI SAPTA JAYA OBAT REG 5179 19/09/2017 19/10/2017 54990910
107 PT. BINA SAN PRIMA OBAT REG 3150 29/09/2017 29/10/2017 89981550
108 PT. BINA SAN PRIMA OBAT REG 3151 29/09/2017 29/10/2017 89981551
109 PT. BINA SAN PRIMA OBAT REG 3152 29/09/2017 29/10/2017 89981552
110 PT. BINA SAN PRIMA OBAT REG 1253 12/10/2017 11/11/2017 89983109
111 PT. BINA SAN PRIMA OBAT REG 2524 23/10/2017 22/11/2017 89984375
112 PT. BINA SAN PRIMA OBAT REG 2525 23/10/2017 22/11/2017 89984376
113 PT. BINA SAN PRIMA OBAT REG 2549 23/10/2017 22/11/2017 89984400
114 PT. BINA SAN PRIMA OBAT REG 2550 23/10/2017 22/11/2017 89984401
115 PT. BINA SAN PRIMA OBAT REG 2551 23/10/2017 22/11/2017 89984402
116 PT. BINA SAN PRIMA OBAT REG 2552 23/10/2017 22/11/2017 89984403
RETUR 513,337
117 PT. DOS NI ROHA OBAT REG 5087 30/09/2017 30/10/2017
118 PT. DOS NI ROHA OBAT REG 0365 05/10/2017 04/11/2017
119 PT. DOS NI ROHA BHP UMUM 9123 07/10/2017 06/11/2017
120 PT. DOS NI ROHA OBAT REG 1014 09/10/2017 08/11/2017
121 PT. DOS NI ROHA BHP UMUM 2508 09/10/2017 08/11/2017
122 PT. DOS NI ROHA OBAT REG 2509 09/10/2017 08/11/2017
123 PT. DOS NI ROHA BHP UMUM 2511 09/10/2017 08/11/2017
124 PT. DOS NI ROHA OBAT REG 4402 21/10/2017 20/11/2017 75016876
125 PT. DOS NI ROHA BHP UMUM 7622 23/10/2017 22/11/2017 75016878
126 PT. DOS NI ROHA OBAT REG 4285 26/10/2017 25/11/2017 75016892
127 PT. DOS NI ROHA OBAT REG 5655 13/10/2017 12/11/2017 75016893
128 PT. DOS NI ROHA OBAT REG 3997 28/10/2017 27/11/2017 75023027
129 PT. DOS NI ROHA BHP UMUM 8846 15/10/2017 14/11/2017 75023046
RETUR 3,667,356
130 PT. SAPTA SARI BHP UMUM 8153 05/09/2017 26/09/2017 63833310

131 PT. MERAPI UTAMA PHARMA OBAT REG 1994 26/09/2017 13/11/2017 84508760
132 PT. MERAPI UTAMA PHARMA OBAT REG 1987 26/09/2017 13/11/2017 84508759
133 PT. MERAPI UTAMA PHARMA OBAT REG 1986 26/09/2017 13/11/2017 84508758
134 PT. MERAPI UTAMA PHARMA OBAT REG 1997 26/09/2017 13/11/2017 84508761
135 PT. MERAPI UTAMA PHARMA OBAT REG 1999 26/09/2017 13/11/2017 84508762
136 PT. MERAPI UTAMA PHARMA OBAT REG 2173 30/09/2017 17/11/2017 84509015
137 PT. MERAPI UTAMA PHARMA OBAT REG 2875 17/10/2017 04/12/2017 84542960
138 PT. MERAPI UTAMA PHARMA OBAT REG 2770 14/10/2017 01/12/2017 84534393
139 PT. MERAPI UTAMA PHARMA OBAT REG 2770 13/10/2017 30/11/2017 84534310
140 PT. MERAPI UTAMA PHARMA OBAT REG 2466 07/10/2017 24/11/2017 84525973
141 PT. MERAPI UTAMA PHARMA OBAT REG 2401 05/10/2017 22/11/2017 84525706
142 PT. MERAPI UTAMA PHARMA OBAT REG 2776 14/10/2017 01/12/2017 84534394
143 PT. MERAPI UTAMA PHARMA OBAT REG 2403 05/10/2017 22/11/2017 84525708

144 PT. INDO FARMA GLOBAL M OBAT REG 3899 12/09/2017 27/10/2017
145 PT. INDO FARMA GLOBAL M OBAT REG 3900 12/09/2017 27/10/2017
146 PT. INDO FARMA GLOBAL M OBAT REG 4162 28/09/2017 12/11/2017
147 PT. INDO FARMA GLOBAL M OBAT REG 4163 28/09/2017 12/11/2017

148 PT. KIMIA FARMA OBAT REG 7504 07/10/2017 28/10/2017 19674612
149 PT. KIMIA FARMA OBAT REG 2275 05/10/2017 26/10/2017 19671539
150 PT. KIMIA FARMA OBAT REG 2271 05/10/2017 26/10/2017 19671538
151 PT. KIMIA FARMA OBAT REG 7506 07/10/2017 28/10/2017 19674613
152 PT. KIMIA FARMA OBAT REG 9991 12/10/2017 02/11/2017 19686898
153 PT. KIMIA FARMA BHP UMUM 1599 13/10/2017 03/11/2017 19689447
154 PT. KIMIA FARMA OBAT REG 0702 18/10/2017 08/11/2017 19697418
155 PT. KIMIA FARMA BHP UMUM 3263 18/10/2017 08/11/2017 19700169
156 PT. KIMIA FARMA OBAT REG 0679 21/10/2017 11/11/2017 19706397
157 PT. KIMIA FARMA OBAT REG 0455 21/10/2017 11/11/2017 19706400
158 PT. KIMIA FARMA BHP UMUM 6473 24/10/2017 14/11/2017 19712807
159 PT. KIMIA FARMA BHP UMUM 6475 24/10/2017 14/11/2017 19712808
160 PT. KIMIA FARMA OBAT REG 9113 30/10/2017 20/11/2017 19725014
161 PT. KIMIA FARMA OBAT REG 9111 30/10/2017 20/11/2017 19725013

162 PT. UNITED DICO CITAS OBAT REG 1527 28/09/2017 19/10/2017 17081429
163 PT. UNITED DICO CITAS OBAT REG 1584 29/09/2017 20/10/2017 17081458
164 PT. UNITED DICO CITAS OBAT REG 1585 29/09/2017 20/10/2017 17081459

TOTAL

1 OBAT REG
2 BHP UMUM
3 LABOR
4 RADIOLOGI

TOTAL
JML FAKTUR 164

#NAME?

Mengetahui,
Kepala Instalasi Farmasi

TONI DAFIAPUTRA, S.FARM, APT


NIP.19841023 200803 1 001
PT. ENSEVAL PUTERA OBAT REG 1120 30/09/2017 29/11/2017 28954251
SI SURAT PEMBAYARAN HUTANG
BAHAN HABIS PAKAI
SUD H. HANAFIE MUARA BUNGO

TAGIHAN PPN PPH SUB TOTAL TOTAL


6,496,514 659,545 98,932 7,254,990
778,150 79,000 11,850 869,000
4,208,629 427,272 64,091 4,699,992
10,007,580 1,015,998 152,400 11,175,978
4,465,892 453,390 68,009 4,987,290
482,256 48,960 7,344 538,560
1,167,225 118,500 17,775 1,303,500
2,543,093 258,182 38,727 2,840,002
2,317,311 235,260 35,289 2,587,860
32,466,649 3,296,107 494,416 36,257,172
1,746,331 177,292 26,594 1,950,217
1,950,217
10,106,100 1,026,000 153,900 11,286,000
2,109,870 214,200 32,130 2,356,200
12,135,791 1,232,060 184,809 13,552,660
2,975,007 302,031 45,305 3,322,343
5,985,396 607,654 91,148 6,684,199
8,476,871 860,596 129,089 9,466,556
1,344,525 136,500 20,475 1,501,500
4,680,996 475,228 71,284 5,227,508
6,816,648 692,045 103,807 7,612,500
1,605,370 162,982 24,447 1,792,799
8,270,060 839,600 125,940 9,235,600
3,966,676 402,708 60,406 4,429,791
68,473,310 6,951,605 1,042,741 76,467,656
6,402,500 650,000 97,500 7,150,000
1,832,248 186,015 27,902 2,046,165
4,138,655 420,168 63,025 4,621,848
3,495,010 354,823 53,224 3,903,057
6,402,500 650,000 97,500 7,150,000
428,042 43,456 6,518 478,016
12,805,000 1,300,000 195,000 14,300,000
3,140,709 318,854 47,828 3,507,391
988,625 100,368 15,055 1,104,048
6,402,500 650,000 97,500 7,150,000
2,069,327 210,084 31,513 2,310,924
2,122,675 215,500 32,325 2,370,500
4,654,125 472,500 70,875 5,197,500
54,881,916 5,571,768 835,765 61,289,449
7,830,750 795,000 119,250 8,745,000
1,680,656 170,625 25,594 1,876,875
2,501,776 253,987 38,098 2,793,862
6,887,514 699,240 104,886 7,691,640
1,961,245 199,111 29,867 2,190,223
20,861,942 2,117,964 317,695 23,297,600
19,350,522 1,964,520 294,678 21,609,720
9,444,655 958,848 143,827 10,547,330
18,628,049 1,891,172 283,676 20,802,897
2,642,933 268,318 40,248 2,951,499
1,428,250 145,000 21,750 1,595,000
472,726 47,992 7,199 527,917
339,825 34,500 5,175 379,500
542,735 55,100 8,265 606,100
2,171,476 220,454 33,068 2,424,999
5,171,250 525,000 78,750 5,775,000
26,847,653 2,725,650 408,848 29,982,150
19,065,956 1,935,630 290,345 21,291,930
106,106,029 10,772,186 1,615,828 118,494,042
9,778,588 992,750 148,913 10,920,250
18,161,036 1,843,760 276,564 20,281,360
12,117,963 1,230,250 184,538 13,532,750
1,448,541 147,060 22,059 1,617,660
13,289,522 1,349,190 202,379 14,841,090
2,559,769 259,875 38,981 2,858,625
3,649,425 370,500 55,575 4,075,500
3,128,385 317,603 47,640 3,493,628
64,133,227 6,510,988 976,648 71,620,863
19,758,411 2,005,930 300,890 22,065,230
2,736,626 277,830 41,675 3,056,130
709,200 72,000 10,800 792,000
6,016,873 610,850 91,628 6,719,350
4,674,071 474,525 71,179 5,219,775
1,777,925 180,500 27,075 1,985,500
35,673,105 3,621,635 543,245 39,837,985
1,776,842 180,390 27,059 1,984,290
933,940 94,816 14,222 1,042,979
1,027,211 104,285 15,643 1,147,139
425,323 43,180 6,477 474,980
2,759,915 280,194 42,029 3,082,139
898,320 91,200 13,680 1,003,200
10,957,239 1,112,410 166,862 12,236,510
239,444 24,309 3,646 267,399
519,391 52,730 7,910 580,030
3,735,764 379,265 56,890 4,171,919
933,940 94,816 14,222 1,042,979
259,695 26,365 3,955 290,015
501,767 50,941 7,641 560,349
7,001,735 710,836 106,625 7,819,196
1,027,211 104,285 15,643 1,147,139
2,586,766 262,616 39,392 2,888,774
1,776,842 180,390 27,059 1,984,290
9,319,592 946,151 141,923 10,407,666
3,679,887 373,593 56,039 4,109,519
1,724,510 175,077 26,262 1,925,849
3,237,496 328,680 49,302 3,615,478
55,322,829 5,616,531 842,480 61,781,839
13,464,950 1,367,000 205,050 15,037,000
2,820,458 286,341 42,951 3,149,750
443,250 45,000 6,750 495,000
19,641,885 1,994,100 299,115 21,935,100
465,413 47,250 7,088 519,750
2,866,744 291,040 43,656 3,201,440
3,313,169 336,362 50,454 3,699,986
17,070,740 1,733,070 259,961 19,063,770
60,086,608 6,100,163 915,024 67,101,796
3,698,159 375,448 56,317 4,129,924
4,129,924
3,472,125 352,500 52,875 3,877,500
868,031 88,125 13,219 969,375
3,194,591 324,324 48,649 3,567,564
1,639,040 166,400 24,960 1,830,400
4,705,471 477,713 71,657 5,254,841
14,412,520 1,463,200 219,480 16,095,200
28,291,779 2,872,262 430,839 31,594,880
2,836,800 288,000 43,200 3,168,000
3,265,275 331,500 49,725 3,646,500
5,319,000 540,000 81,000 5,940,000
11,672,250 1,185,000 177,750 13,035,000
23,403,600 2,376,000 356,400 26,136,000
1,034,250 105,000 15,750 1,155,000
10,756,200 1,092,000 163,800 12,012,000
1,912,378 194,150 29,123 2,135,650
3,546,000 360,000 54,000 3,960,000
31,933,700 3,242,000 486,300 35,662,000
19,975,800 2,028,000 304,200 22,308,000
19,846,174 2,014,840 302,226 22,163,240
3,546,000 360,000 54,000 3,960,000
2,038,950 207,000 31,050 2,277,000
141,086,377 14,323,490 2,148,524 157,558,390
788,000 80,000 12,000 880,000
985,000 100,000 15,000 1,100,000
44,226,500 4,490,000 673,500 49,390,000
28,244,875 2,867,500 430,125 31,542,500
2,955,000 300,000 45,000 3,300,000
5,306,688 538,750 80,813 5,926,250
12,805,000 1,300,000 195,000 14,300,000
18,222,500 1,850,000 277,500 20,350,000
16,868,125 1,712,500 256,875 18,837,500
27,087,500 2,750,000 412,500 30,250,000
157,489,188 15,988,750 2,398,313 175,876,250
2,038,950 207,000 31,050 2,277,000
13,072,920 1,327,200 199,080 14,599,200
5,058,960 513,600 77,040 5,649,600
5,843,020 593,200 88,980 6,525,200
1,567,135 159,100 23,865 1,750,100
1,182,000 120,000 18,000 1,320,000
4,207,920 427,200 64,080 4,699,200
2,610,743 265,050 39,758 2,915,550
2,155,180 218,800 32,820 2,406,800
2,925,450 297,000 44,550 3,267,000
288,605 29,300 4,395 322,300
5,736,955 582,432 87,365 6,406,752
2,725,938 276,745 41,512 3,044,195
2,152,225 218,500 32,775 2,403,500
971,210 98,600 14,790 1,084,600
10,204,600 1,036,000 155,400 11,396,000
62,741,811 6,369,727 955,459 70,066,997
5,614,500 570,000 85,500 6,270,000
44,427,440 4,510,400 676,560 49,614,400
43,621,710 4,428,600 664,290 48,714,600
19,936,400 2,024,000 303,600 22,264,000
113,600,050 11,533,000 1,729,950 126,863,000
2,265,500 230,000 34,500 2,530,000
5,807,068 589,550 88,433 6,485,050
8,072,568 819,550 122,933 9,015,050
1,133,203,110 1,133,203,110

550,487,944
208,194,426
280,580,740
93,940,000

1,133,203,110
Muara Bungo, 02 Nopember 2017

AYU TRESNAWATI
NIP 19660908 198803 2 002

SI SURAT PEMBAYARAN HUTANG


BAHAN HABIS PAKAI
SUD H. HANAFIE MUARA BUNGO

TAGIHAN PPN PPH SUB TOTAL TOTAL


3,378,857 343,031 51,455 3,773,343
5,966,017 605,687 90,853 6,662,557
7,979,578 810,109 121,516 8,911,204
2,624,040 266,400 39,960 2,930,400
6,060,221 615,251 92,288 6,767,759
4,862,317 493,636 74,045 5,429,999
3,634,650 369,000 55,350 4,059,000
4,799,854 487,295 73,094 5,360,243
3,679,245 373,527 56,029 4,108,802
6,962,571 706,860 106,029 7,775,460
1,705,840 173,182 25,977 1,904,999
2,813,160 285,600 42,840 3,141,600
2,491,065 252,900 37,935 2,781,900
4,663,080 473,409 71,011 5,207,500
856,704 86,975 13,046 956,725
11,404,734 1,157,841 173,676 12,736,251
7,897,518 801,778 120,267 8,819,563
1,242,873 126,180 18,927 1,387,980
466,729 47,384 7,108 521,220
8,325,713 845,250 126,788 9,297,750
1,662,188 168,750 25,313 1,856,250
10,679,143 1,084,177 162,627 11,925,947
2,975,007 302,031 45,305 3,322,343
2,131,002 216,345 32,452 2,379,799
109,262,105 11,092,599 1,663,890 122,018,594
10,324,608 1,048,184 157,228 11,530,019
2,991,406 303,696 45,554 3,340,656
561,450 57,000 8,550 627,000
1,578,240 160,227 24,034 1,762,502
2,543,093 258,182 38,727 2,840,002
1,326,795 134,700 20,205 1,481,700
456,685 46,364 6,955 510,004
4,465,990 453,400 68,010 4,987,400
24,248,267 2,461,753 369,263 27,079,283
3,201,250 325,000 48,750 3,575,000
3,575,000
3,310,360 336,077 50,412 3,696,849
4,574,734 464,440 69,666 5,108,840
1,085,470 110,200 16,530 1,212,200
9,750,614 989,910 148,487 10,889,010
2,820,681 286,364 42,955 3,149,999
17,505,765 1,777,235 266,585 19,549,585
19,266,600 1,956,000 293,400 21,516,000
837,250 85,000 12,750 935,000
5,920,859 601,102 90,165 6,612,127
5,951,370 604,200 90,630 6,646,200
18,608,226 1,889,160 283,374 20,780,760
3,759,565 381,682 57,252 4,198,499
1,522,272 154,545 23,182 1,699,999
3,025,181 307,125 46,069 3,378,375
4,865,900 494,000 74,100 5,434,000
14,464,252 1,468,452 220,268 16,152,972
16,398,034 1,664,775 249,716 18,312,525
2,112,825 214,500 32,175 2,359,500
1,892,264 192,108 28,816 2,113,188
4,253,409 431,818 64,773 4,750,000
5,447,247 553,020 82,953 6,083,220
11,741,430 1,192,023 178,804 13,112,257
2,901,250 294,543 44,181 3,239,975
532,712 54,082 8,112 594,907
162,548,270 16,502,362 2,475,354 181,525,987
13,297,008 1,349,950 202,493 14,849,450
1,723,750 175,000 26,250 1,925,000
1,723,750 175,000 26,250 1,925,000
5,243,699 532,355 79,853 5,855,907
1,462,725 148,500 22,275 1,633,500
12,913,350 1,311,000 196,650 14,421,000
14,007,931 1,422,125 213,319 15,643,375
565,144 57,375 8,606 631,125
3,144,120 319,200 47,880 3,511,200
748,117 75,951 11,393 835,461
2,621,849 266,178 39,927 2,927,953
5,123,231 520,125 78,019 5,721,375
1,462,725 148,500 22,275 1,633,500
11,266,430 1,143,800 171,570 12,581,800
22,340,096 2,268,030 340,205 24,948,330
6,869,055 697,366 104,605 7,671,026
2,947,613 299,250 44,888 3,291,750
3,383,900 343,543 51,531 3,778,975
8,030,213 815,250 122,288 8,967,750
2,694,960 273,600 41,040 3,009,600
2,718,316 275,971 41,396 3,035,683
124,287,981 12,618,069 1,892,710 138,798,760
1,773,000 180,000 27,000 1,980,000
443,250 45,000 6,750 495,000
3,626,591 368,182 55,227 4,050,000
9,947,605 1,009,909 151,486 11,109,000
15,790,445 1,603,091 240,464 17,634,000
6,836,196 694,030 104,105 7,634,330
12,085,950 1,227,000 184,050 13,497,000
2,340,360 237,600 35,640 2,613,600
3,313,169 336,362 50,454 3,699,986
14,919,269 1,514,647 227,197 16,661,113
1,969,776 199,977 29,997 2,199,750
4,713,052 478,482 71,772 5,263,307
4,875,750 495,000 74,250 5,445,000
8,683,563 881,580 132,237 9,697,380
22,312,811 2,265,260 339,789 24,917,860
4,554,837 462,420 69,363 5,086,620
8,150,757 827,488 124,123 9,102,368
13,841,220 1,405,200 210,780 15,457,200
732,426 74,358 11,154 817,938
1,561,426 158,520 23,778 1,743,724
14,485,016 1,470,560 220,584 16,176,160
125,375,578 12,728,485 1,909,273 140,013,336
9,163,258 930,280 139,542 10,233,080
7,756,875 787,500 118,125 8,662,500
3,073,200 312,000 46,800 3,432,000
16,713,480 1,696,800 254,520 18,664,800
17,006,055 1,726,503 258,975 18,991,533
1,741,086 176,760 26,514 1,944,360
3,213,563 326,250 48,938 3,588,750
17,198,100 1,746,000 261,900 19,206,000
75,865,616 7,702,093 1,155,314 84,723,023
1,019,968 103,550 15,533 1,139,050
6,988,575 709,500 106,425 7,804,500
559,086 56,760 8,514 624,360
3,354,516 340,560 51,084 3,746,160
1,043,115 105,900 15,885 1,164,900
1,063,771 107,997 16,200 1,187,968
863,353 87,650 13,148 964,150
6,709,032 681,120 102,168 7,492,320
1,936,248 196,573 29,486 2,162,307
4,768,582 484,120 72,618 5,325,320
28,306,245 2,873,730 431,060 31,611,035
3,913,898 397,350 59,603 4,370,850
2,570,850 261,000 39,150 2,871,000
12,347,960 1,253,600 188,040 13,789,600
4,986,563 506,250 75,938 5,568,750
28,919,600 2,936,000 440,400 32,296,000
1,475,136 149,760 22,464 1,647,360
29,944,000 3,040,000 456,000 33,440,000
2,991,938 303,750 45,563 3,341,250
14,845,920 1,507,200 226,080 16,579,200
2,718,600 276,000 41,400 3,036,000
2,295,050 233,000 34,950 2,563,000
1,576,000 160,000 24,000 1,760,000
3,792,250 385,000 57,750 4,235,000
112,377,764 11,408,910 1,711,337 125,498,010
5,238,993 531,877 79,782 5,850,652
5,850,652
145,071 14,728 2,209 162,008
9,231,420 937,200 140,580 10,309,200
3,313,294 336,375 50,456 3,700,125
648,253 65,812 9,872 723,937
638,649 64,837 9,726 713,212
5,762,250 585,000 87,750 6,435,000
4,264,065 432,900 64,935 4,761,900
11,161,281 1,133,125 169,969 12,464,375
1,013,823 102,926 15,439 1,132,188
4,266,953 433,193 64,979 4,765,125
7,504,609 761,889 114,283 8,380,782
991,624 100,672 15,101 1,107,397
27,268,129 2,768,338 415,251 30,451,718
76,209,420 7,736,997 1,160,550 85,106,967
4,548,218 461,748 69,262 5,079,228
15,281,380 1,551,409 232,711 17,065,501
14,883,690 1,511,035 226,655 16,621,380
1,065,143 108,136 16,220 1,189,500
35,778,432 3,632,328 544,849 39,955,609
5,220,500 530,000 79,500 5,830,000
2,069,327 210,084 31,513 2,310,924
3,140,709 318,854 47,828 3,507,391
4,231,028 429,546 64,432 4,725,006
3,212,883 326,181 48,927 3,587,991
3,140,709 318,854 47,828 3,507,391
321,031 32,592 4,889 358,512
925,140 93,923 14,088 1,033,151
644,722 65,454 9,818 719,994
6,402,500 650,000 97,500 7,150,000
3,140,709 318,854 47,828 3,507,391
4,138,655 420,168 63,025 4,621,848
460,980 46,800 7,020 514,800
1,241,996 126,091 18,914 1,387,001
38,290,890 3,887,400 583,110 42,761,400
16,912,204 1,716,975 257,546 18,886,725
2,377,168 241,337 36,201 2,654,705
4,321,688 438,750 65,813 4,826,250
23,611,059 2,397,062 359,559 26,367,680
1,072,519,336 1,072,519,336

906,944,750
154,685,576
10,889,010
-

1,072,519,336

Muara Bungo, 22 Nopember 2017

AYU TRESNAWATI
NIP 19660908 198803 2 002
3,304,226 335,454 50,318 3,689,999
LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG
OBAT DAN BAHAN HABIS PAKAI
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
02 Desember 2017
NO DISTRIBUTOR KATEGORI NO FACT TGL.FACT JT. TEMPO NO.F STDR
1 PT. ANUGRAH PHARMINDO L OBAT REG 7644 19/10/2017 18/12/2017 15537900
2 PT. ANUGRAH PHARMINDO L OBAT REG 8277 25/10/2017 24/12/2017 15338514
3 PT. ANUGRAH PHARMINDO L OBAT REG 8333 25/10/2017 24/12/2017 15338518
4 PT. ANUGRAH PHARMINDO L OBAT REG 8382 25/10/2017 24/12/2017 15338519
5 PT. ANUGRAH PHARMINDO L OBAT REG 8143 25/10/2017 24/12/2017 15338513
6 PT. ANUGRAH PHARMINDO L OBAT REG 0117 09/11/2017 08/01/2018 15476243
7 PT. ANUGRAH PHARMINDO L OBAT REG 0201 10/11/2017 10/12/2017 15486870
8 PT. ANUGRAH PHARMINDO L OBAT REG 0206 10/11/2017 10/12/2017 15486871
9 PT. ANUGRAH PHARMINDO L OBAT REG 0889 16/11/2017 15/01/2018 15537895

10 PT. ENSEVAL PUTERA BHP UMUM 1209 18/10/2017 17/12/2017 45753298


11 PT. ENSEVAL PUTERA BHP UMUM 6249 24/10/2017 23/12/2017 45810465
12 PT. ENSEVAL PUTERA OBAT REG 6898 26/10/2017 25/12/2017 45849906
13 PT. ENSEVAL PUTERA OBAT REG 6902 26/10/2017 25/12/2017 45850305
14 PT. ENSEVAL PUTERA LABOR 6905 26/10/2017 25/12/2017 45850650
15 PT. ENSEVAL PUTERA BHP UMUM 7039 27/10/2017 26/12/2017 45860993
16 PT. ENSEVAL PUTERA OBAT REG 7202 28/10/2017 27/12/2017 45876041
17 PT. ENSEVAL PUTERA OBAT REG 7212 28/10/2017 27/12/2017 45876718
18 PT. ENSEVAL PUTERA LABOR 7258 28/10/2017 27/12/2017 45877548
19 PT. ENSEVAL PUTERA OBAT REG 1291 28/10/2017 27/12/2017 45877423
20 PT. ENSEVAL PUTERA OBAT REG 7299 30/10/2017 29/12/2017 45882293
21 PT. ENSEVAL PUTERA OBAT REG 1299 30/10/2017 29/12/2017 45890689
22 PT. ENSEVAL PUTERA OBAT REG 1300 30/10/2017 29/12/2017 45891176
23 PT. ENSEVAL PUTERA OBAT REG 7721 31/10/2017 30/12/2017 45915982
24 PT. ENSEVAL PUTERA OBAT REG 1321 31/10/2017 30/12/2017 45916041
25 PT. ENSEVAL PUTERA OBAT REG 7837 01/11/2017 31/12/2017 45925660
26 PT. ENSEVAL PUTERA OBAT REG 7843 01/11/2017 31/12/2017 45925952
27 PT. ENSEVAL PUTERA OBAT REG 1327 01/11/2017 31/12/2017 45926043
28 PT. ENSEVAL PUTERA BHP UMUM 8304 06/11/2017 05/01/2018 45964721
29 PT. ENSEVAL PUTERA BHP UMUM 8388 07/11/2017 06/01/2018 45975552
30 PT. ENSEVAL PUTERA LABOR 8390 07/11/2017 06/01/2018 45975806
31 PT. ENSEVAL PUTERA LABOR 8434 07/11/2017 06/01/2018 45979833

32 PT. ANUGRAH ARGON M OBAT REG 5002 06/10/2017 05/12/2017 71777271


33 PT. ANUGRAH ARGON M OBAT REG 5333 12/10/2017 11/12/2017 71803505
34 PT. ANUGRAH ARGON M OBAT REG 5334 12/10/2017 11/12/2017 71803506
35 PT. ANUGRAH ARGON M OBAT REG 5335 12/10/2017 11/12/2017 71803507
36 PT. ANUGRAH ARGON M OBAT REG 5444 14/10/2017 13/12/2017 71812733
37 PT. ANUGRAH ARGON M OBAT REG 5445 14/10/2017 13/12/2017 71812734
38 PT. ANUGRAH ARGON M OBAT REG 5584 17/10/2017 16/12/2017 71824745
39 PT. ANUGRAH ARGON M OBAT REG 5585 17/10/2017 16/12/2017 71824746
40 PT. ANUGRAH ARGON M OBAT REG 5744 19/10/2017 18/12/2017 71836893
41 PT. ANUGRAH ARGON M BHP UMUM 5746 19/10/2017 18/12/2017 71836895
42 PT. ANUGRAH ARGON M OBAT REG 5748 19/10/2017 18/12/2017 71836896
43 PT. ANUGRAH ARGON M OBAT REG 6179 20/10/2017 19/12/2017 71873989
44 PT. ANUGRAH ARGON M OBAT REG 5878 21/10/2017 20/12/2017 71848405
45 PT. ANUGRAH ARGON M OBAT REG 6103 25/10/2017 24/12/2017 71866875
46 PT. ANUGRAH ARGON M OBAT REG 6181 26/10/2017 25/12/2017 71873991
47 PT. ANUGRAH ARGON M OBAT REG 6520 31/10/2017 30/12/2017 71905059
48 PT. ANUGRAH ARGON M OBAT REG 6524 31/10/2017 30/12/2017 71905305
49 PT. ANUGRAH ARGON M OBAT REG 6525 31/10/2017 30/12/2017 71905306
50 PT. ANUGRAH ARGON M OBAT REG 6821 06/11/2017 05/01/2018 71926056
51 PT. ANUGRAH ARGON M OBAT REG 6822 06/11/2017 05/01/2018 71926057
52 PT. ANUGRAH ARGON M OBAT REG 6823 06/11/2017 05/01/2018 71926058
53 PT. ANUGRAH ARGON M OBAT REG 7053 09/11/2017 08/01/2018 71945701
54 PT. ANUGRAH ARGON M BHP UMUM 7054 09/11/2017 08/01/2018 71945702
55 PT. ANUGRAH ARGON M OBAT REG 7055 09/11/2017 08/01/2018 71945703
56 PT. ANUGRAH ARGON M OBAT REG 7056 09/11/2017 08/01/2018 71945704
57 PT. ANUGRAH ARGON M OBAT REG 7057 09/11/2017 08/01/2018 71945705
58 PT. ANUGRAH ARGON M OBAT REG 7058 09/11/2017 08/01/2018 71945706

59 PT. MENSA BINA SUKSES OBAT REG 5610 05/10/2017 04/11/2017 63447805
60 PT. MENSA BINA SUKSES OBAT REG 1340 09/10/2017 08/11/2017 63463294
61 PT. MENSA BINA SUKSES OBAT REG 7746 12/10/2017 11/11/2017 63479456
62 PT. MENSA BINA SUKSES OBAT REG 2807 12/10/2017 11/11/2017 63484616
63 PT. MENSA BINA SUKSES OBAT REG 8706 27/10/2017 26/11/2017 63569174
64 PT. MENSA BINA SUKSES OBAT REG 8707 27/10/2017 26/11/2017 63569175
65 PT. MENSA BINA SUKSES OBAT REG 8708 27/10/2017 26/11/2017 63569176
66 PT. MENSA BINA SUKSES OBAT REG 2949 27/10/2017 26/11/2017 63573373
67 PT. MENSA BINA SUKSES OBAT REG 8780 30/10/2017 29/11/2017 63579126
68 PT. MENSA BINA SUKSES OBAT REG 0178 31/10/2017 30/11/2017 63600241
69 PT. MENSA BINA SUKSES OBAT REG 0180 31/10/2017 30/11/2017 63600243
70 PT. MENSA BINA SUKSES OBAT REG 0193 31/10/2017 30/11/2017 63600256
71 PT. MENSA BINA SUKSES OBAT REG 0182 31/10/2017 30/11/2017 63600245

72 PT. UNITED DICO CITAS OBAT REG 2287 27/10/2017 17/11/2017 17082166
73 PT. UNITED DICO CITAS OBAT REG 2288 27/10/2017 17/11/2017 17082167
74 PT. UNITED DICO CITAS OBAT REG 2384 31/10/2017 21/11/2017 17082260
75 PT. UNITED DICO CITAS OBAT REG 2403 31/10/2017 21/11/2017 17082280

76 PT. PARIT PADANG GLOBAL BHP UMUM 3992 23/10/2017 13/11/2017 83928109
77 PT. PARIT PADANG GLOBAL OBAT REG 3993 23/10/2017 13/11/2017 83928110
78 PT. PARIT PADANG GLOBAL OBAT REG 4022 24/10/2017 14/11/2017 83930750
79 PT. PARIT PADANG GLOBAL OBAT REG 4204 26/10/2017 16/11/2017 83943749
80 PT. PARIT PADANG GLOBAL OBAT REG 4249 27/10/2017 17/11/2017 83946568
81 PT. PARIT PADANG GLOBAL OBAT REG 4446 31/10/2017 21/11/2017 83959813
82 PT. PARIT PADANG GLOBAL OBAT REG 4582 31/10/2017 21/11/2017 83967006
83 PT. PARIT PADANG GLOBAL OBAT REG 4966 01/11/2017 22/11/2017 83992623

84 PT. MITRA SEJATI MEDIKA OBAT REG 218-I 12/07/2017 11/08/2017 64005603
85 PT. MITRA SEJATI MEDIKA OBAT REG 218-II 12/07/2017 11/08/2017 64005604

86 PT. PENTA VALENT OBAT REG 2917 24/10/2017 23/11/2017 20529498


87 PT. PENTA VALENT OBAT REG 3023 26/10/2017 25/11/2017 20536084
88 PT. PENTA VALENT OBAT REG 3024 26/10/2017 25/11/2017 20536085
89 PT. PENTA VALENT OBAT REG 3060 27/10/2017 26/11/2017 20538994
90 PT. PENTA VALENT OBAT REG 3061 27/10/2017 26/11/2017 20538995
91 PT. PENTA VALENT OBAT REG 2288 10/10/2017 09/11/2017 20496245
92 PT. PENTA VALENT OBAT REG 2337 11/10/2017 10/11/2017 20499848
93 PT. PENTA VALENT OBAT REG 2344 11/10/2017 10/11/2017 20499852
94 PT. PENTA VALENT OBAT REG 2382 12/10/2017 11/11/2017 20502713
95 PT. PENTA VALENT OBAT REG 2384 12/10/2017 11/11/2017 20502715
96 PT. PENTA VALENT OBAT REG 2542 16/10/2017 15/11/2017 20510806
97 PT. PENTA VALENT OBAT REG 3258 31/10/2017 30/11/2017 20549497
98 PT. PENTA VALENT OBAT REG 3460 04/11/2017 04/12/2017 20561273
99 PT. PENTA VALENT OBAT REG 3511 06/11/2017 06/12/2017 20563491
100 PT. PENTA VALENT OBAT REG 3512 06/11/2017 06/12/2017 20563492
101 PT. PENTA VALENT OBAT REG 3517 06/11/2017 06/12/2017 20563497
102 PT. PENTA VALENT OBAT REG 3616 09/11/2017 09/12/2017 20549502
RETUR 1,459,518
103 PT. TEMPO OBAT REG 6229 31/10/2017 30/11/2017 25121855
RETUR 6,637,500
104 PT. MUARA NATIO P RADIOLOGI 2600 27/10/2017 26/11/2017 99872600
105 PT. MUARA NATIO P RADIOLOGI 2601 30/10/2017 29/11/2017 99872601
106 PT. MUARA NATIO P BHP UMUM 2604 03/11/2017 03/12/2017 99872604
107 PT. MUARA NATIO P BHP UMUM 2606 07/11/2017 07/12/2017 99872606
108 PT. MUARA NATIO P BHP UMUM 2608 09/11/2017 09/12/2017 99872608
109 PT. MUARA NATIO P RADIOLOGI 2611 10/11/2017 10/12/2017 99872611
110 PT. MUARA NATIO P LABOR 2612 17/11/2017 17/12/2017 99872612
111 PT. MUARA NATIO P LABOR 2613 20/11/2017 20/12/2017 99872613

112 PT. CITRA PURNAMA S BHP UMUM 0085 26/10/2017 25/11/2017 50943122
113 PT. CITRA PURNAMA S LABOR 0086 26/10/2017 25/11/2017 50943123
114 PT. CITRA PURNAMA S LABOR 0087 30/10/2017 29/11/2017 50943124
115 PT. CITRA PURNAMA S BHP UMUM 0088 31/10/2017 30/11/2017 50943125
116 PT. CITRA PURNAMA S LABOR 0089 03/11/2017 03/12/2017 50943126
117 PT. CITRA PURNAMA S BHP UMUM 0090 03/11/2017 03/12/2017 50943127
118 PT. CITRA PURNAMA S LABOR 0091 08/11/2017 08/12/2017 50943128
119 PT. CITRA PURNAMA S LABOR 0092 13/11/2017 13/12/2017 50943129
120 PT. CITRA PURNAMA S BHP UMUM 0093 14/11/2017 14/12/2017 50943130
121 PT. CITRA PURNAMA S BHP UMUM 0094 14/11/2017 14/12/2017 50943131
122 PT. CITRA PURNAMA S BHP UMUM 0095 15/11/2017 15/12/2017 50943132
123 PT. CITRA PURNAMA S BHP UMUM 0096 16/11/2017 16/12/2017 50943133
124 PT. CITRA PURNAMA S BHP UMUM 0097 20/11/2017 20/12/2017 50943134
125 PT. CITRA PURNAMA S BHP UMUM 0098 21/11/2017 21/12/2017 92397087
126 PT. CITRA PURNAMA S BHP UMUM 0099 22/11/2017 22/12/2017 92397088

127 PT. MEDICO VISI PHARMA LABOR 039 31/10/2017 30/11/2017 52819227
128 PT. MEDICO VISI PHARMA LABOR 044 08/11/2017 08/12/2017 52819240
129 PT. MEDICO VISI PHARMA LABOR 045 09/11/2017 09/12/2017 52819241
130 PT. MEDICO VISI PHARMA LABOR 054 20/11/2017 20/12/2017 52819253
131 PT. MEDICO VISI PHARMA LABOR 058 23/11/2017 23/12/2017 52819254

132 PT. BHAKTI SEJAHTERA M BHP UMUM 1513 22/10/2017 21/11/2017

133 PT. RAJAWALI NUSINDO OBAT REG 5542 03/10/2017 02/11/2017 66033175
134 PT. RAJAWALI NUSINDO BHP UMUM 5545 03/10/2017 02/11/2017 66033178
135 PT. RAJAWALI NUSINDO BHP UMUM 6133 27/10/2017 26/11/2017 66154848
136 PT. RAJAWALI NUSINDO BHP UMUM 6134 27/10/2017 26/11/2017 66154849
137 PT. RAJAWALI NUSINDO BHP UMUM 6141 27/10/2017 26/11/2017 66154856
138 PT. RAJAWALI NUSINDO BHP UMUM 6142 27/10/2017 26/11/2017 66154857

139 PT. DOS NI ROHA OBAT REG 8511 23/10/2017 22/11/2017 75016880
140 PT. DOS NI ROHA OBAT REG 8512 23/10/2017 22/11/2017 75016881
141 PT. DOS NI ROHA BHP UMUM 8513 23/10/2017 22/11/2017 75016883
142 PT. DOS NI ROHA BHP UMUM 8515 23/10/2017 22/11/2017 75016883
143 PT. DOS NI ROHA OBAT REG 4789 31/10/2017 30/11/2017 75035698
144 PT. DOS NI ROHA OBAT REG 0701 31/10/2017 30/11/2017 75035777
145 PT. DOS NI ROHA OBAT REG 0700 31/10/2017 30/11/2017 75035776
146 PT. DOS NI ROHA OBAT REG 0699 31/10/2017 30/11/2017 75035775
147 PT. DOS NI ROHA OBAT REG 0287 31/10/2017 30/11/2017 75035751
148 PT. DOS NI ROHA OBAT REG 0286 31/10/2017 30/11/2017 75035750
149 PT. DOS NI ROHA OBAT REG 0285 31/10/2017 30/11/2017 75035749
150 PT. DOS NI ROHA OBAT REG 4790 31/10/2017 30/11/2017 75035699
151 PT. DOS NI ROHA OBAT REG 4788 31/10/2017 30/11/2017 75035697
152 PT. DOS NI ROHA OBAT REG 1836 04/11/2017 04/12/2017 75083985
153 PT. DOS NI ROHA OBAT REG 3155 06/11/2017 06/12/2017 75083987
154 PT. DOS NI ROHA OBAT REG 9060 07/11/2017 07/12/2017 75086354
155 PT. DOS NI ROHA BHP UMUM 9059 07/11/2017 07/12/2017 75086353
156 PT. DOS NI ROHA BHP UMUM 9058 07/11/2017 07/12/2017 75086352
157 PT. DOS NI ROHA BHP UMUM 9057 07/11/2017 07/12/2017 75086351
158 PT. DOS NI ROHA BHP UMUM 9151 09/11/2017 09/12/2017 75089420
159 PT. DOS NI ROHA OBAT REG 9149 09/11/2017 09/12/2017 75089419
160 PT. DOS NI ROHA OBAT REG 8719 09/11/2017 09/12/2017 75089417
161 PT. DOS NI ROHA OBAT REG 5189 14/11/2017 14/12/2017 75099761
162 PT. DOS NI ROHA OBAT REG 0209 15/11/2017 15/12/2017 75099766
163 PT. DOS NI ROHA BHP UMUM 0211 15/11/2017 15/12/2017 75099767

164 PT. MERAPI UTAMA PHARMA OBAT REG 3257 24/10/2017 11/12/2017 84563799
165 PT. MERAPI UTAMA PHARMA OBAT REG 3258 24/10/2017 11/12/2017 84563800
166 PT. MERAPI UTAMA PHARMA OBAT REG 3259 24/10/2017 11/12/2017 84563801
167 PT. MERAPI UTAMA PHARMA OBAT REG 3270 24/10/2017 11/12/2017 84563803
168 PT. MERAPI UTAMA PHARMA OBAT REG 3262 24/10/2017 11/12/2017 84563802
169 PT. MERAPI UTAMA PHARMA OBAT REG 3271 24/10/2017 11/12/2017 84563804
170 PT. MERAPI UTAMA PHARMA OBAT REG 3272 24/10/2017 11/12/2017 84563805
171 PT. MERAPI UTAMA PHARMA OBAT REG 3282 25/10/2017 12/12/2017 84564917
172 PT. MERAPI UTAMA PHARMA OBAT REG 3296 25/10/2017 12/12/2017 84564918
173 PT. MERAPI UTAMA PHARMA OBAT REG 3275 25/10/2017 12/12/2017 84564916
174 PT. MERAPI UTAMA PHARMA OBAT REG 3334 25/10/2017 12/12/2017 84564923
175 PT. MERAPI UTAMA PHARMA OBAT REG 3641 31/10/2017 18/12/2017 84572045
176 PT. MERAPI UTAMA PHARMA OBAT REG 3648 31/10/2017 18/12/2017 84564919

177 PT. INDO FARMA GLOBAL M OBAT REG 4364 09/10/2017 23/11/2017
178 PT. INDO FARMA GLOBAL M OBAT REG 4361 09/10/2017 23/11/2017
179 PT. INDO FARMA GLOBAL M OBAT REG 4430 12/10/2017 26/11/2017
180 PT. INDO FARMA GLOBAL M OBAT REG 4481 16/10/2017 30/11/2017
181 PT. INDO FARMA GLOBAL M OBAT REG 4809 31/10/2017 15/12/2017
182 PT. INDO FARMA GLOBAL M OBAT REG 4793 31/10/2017 15/12/2017
183 PT. INDO FARMA GLOBAL M OBAT REG 4792 31/10/2017 15/12/2017

184 PT. SAPTA SARI OBAT REG 1460 30/10/2017 20/11/2017 63917851
185 PT. SAPTA SARI OBAT REG 1461 30/10/2017 20/11/2017 63917852
186 PT. SAPTA SARI OBAT REG 1954 07/11/2017 28/11/2017 63930634
187 PT. SAPTA SARI OBAT REG 2009 08/11/2017 29/11/2017 63932490

TOTAL

1 OBAT REG
2 BHP UMUM
3 LABOR
4 RADIOLOGI

TOTAL
JML FAKTUR 187

#NAME?

Mengetahui,
Kepala Instalasi Farmasi
TONI DAFIAPUTRA, S.FARM, APT
NIP.19841023 200803 1 001

LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG


OBAT DAN BAHAN HABIS PAKAI
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
22 Desember 2017
NO DISTRIBUTOR KATEGORI NO FACT TGL.FACT JT. TEMPO NO.F STDR
1 PT. DOS NI ROHA OBAT REG 4840 18/11/2017 18/12/2017 75121610
2 PT. DOS NI ROHA BHP UMUM 2893 22/11/2017 22/12/2017 75121615
3 PT. DOS NI ROHA OBAT REG 9827 23/11/2017 23/12/2017 75124243

4 PT. ANUGRAH ARGON M OBAT REG 7535 14/11/2017 13/01/2018 71967915


5 PT. ANUGRAH ARGON M OBAT REG 7323 14/11/2017 13/01/2018 71967520
6 PT. ANUGRAH ARGON M OBAT REG 7319 14/11/2017 13/01/2018 71967516
7 PT. ANUGRAH ARGON M OBAT REG 7318 14/11/2017 13/01/2018 71967515
8 PT. ANUGRAH ARGON M OBAT REG 7520 16/11/2017 15/01/2018 71980800
9 PT. ANUGRAH ARGON M OBAT REG 7507 16/11/2017 15/01/2018 71980757
10 PT. ANUGRAH ARGON M OBAT REG 7506 16/11/2017 15/01/2018 71980756
11 PT. ANUGRAH ARGON M OBAT REG 7505 16/11/2017 15/01/2018 71980755
12 PT. ANUGRAH ARGON M OBAT REG 7504 16/11/2017 15/01/2018 71980754
13 PT. ANUGRAH ARGON M OBAT REG 7636 18/11/2017 17/01/2018 71990990
14 PT. ANUGRAH ARGON M OBAT REG 7637 18/11/2017 17/01/2018 71990991
15 PT. ANUGRAH ARGON M OBAT REG 7638 18/11/2017 17/01/2018 71990992
16 PT. ANUGRAH ARGON M OBAT REG 7639 18/11/2017 17/01/2018 71990993
17 PT. ANUGRAH ARGON M OBAT REG 7795 21/11/2017 20/01/2018 72003687
18 PT. ANUGRAH ARGON M OBAT REG 7922 23/11/2017 22/01/2018 72016343
19 PT. ANUGRAH ARGON M OBAT REG 7923 23/11/2017 22/01/2018 72016344
20 PT. ANUGRAH ARGON M OBAT REG 7924 23/11/2017 22/01/2018 72016345
21 PT. ANUGRAH ARGON M OBAT REG 7925 23/11/2017 22/01/2018 72016346

22 PT. BINA SAN PRIMA OBAT REG 0385 04/11/2017 04/12/2017 89985932
23 PT. BINA SAN PRIMA OBAT REG 0396 04/11/2017 04/12/2017 89985943
24 PT. BINA SAN PRIMA OBAT REG 0402 04/11/2017 04/12/2017 89985948
25 PT. BINA SAN PRIMA OBAT REG 0403 04/11/2017 04/12/2017 89985949
26 PT. BINA SAN PRIMA OBAT REG 0408 04/11/2017 04/12/2017 89985953
27 PT. BINA SAN PRIMA OBAT REG 1065 09/11/2017 09/12/2017 89986606
28 PT. BINA SAN PRIMA OBAT REG 1066 09/11/2017 09/12/2017 89986607
29 PT. BINA SAN PRIMA OBAT REG 1070 09/11/2017 09/12/2017 89986611
30 PT. BINA SAN PRIMA OBAT REG 1074 09/11/2017 09/12/2017 89986615
31 PT. BINA SAN PRIMA OBAT REG 2081 17/11/2017 17/12/2017 89987612
32 PT. BINA SAN PRIMA OBAT REG 2082 17/11/2017 17/12/2017 89987613
PT. BINA SAN PRIMA OBAT REG 3818 30/11/2017 30/12/2017 89989345
PT. BINA SAN PRIMA OBAT REG 3819 30/11/2017 30/12/2017 89989346

33 PT. INDO FARMA GLOBAL M OBAT REG 5116 17/11/2017 01/01/2018


34 PT. INDO FARMA GLOBAL M OBAT REG 5117 17/11/2017 01/01/2018
35 PT. INDO FARMA GLOBAL M OBAT REG 5235 24/11/2017 08/01/2018
36 PT. INDO FARMA GLOBAL M OBAT REG 5340 30/11/2017 14/01/2018
37 PT. INDO FARMA GLOBAL M OBAT REG 5341 30/11/2017 14/01/2018

38 PT. PARIT PADANG GLOBAL OBAT REG 2670 21/11/2017 12/12/2017 84045846
39 PT. PARIT PADANG GLOBAL OBAT REG 5532 18/11/2017 09/12/2017 84036907
40 PT. PARIT PADANG GLOBAL OBAT REG 5497 17/11/2017 08/12/2017 84034335
41 PT. PARIT PADANG GLOBAL OBAT REG 5399 16/11/2017 07/12/2017 84026849
42 PT. PARIT PADANG GLOBAL OBAT REG 5377 15/11/2017 06/12/2017 84023513
43 PT. PARIT PADANG GLOBAL OBAT REG 5370 15/11/2017 06/12/2017 84023274
44 PT. PARIT PADANG GLOBAL OBAT REG 5359 15/11/2017 06/12/2017 84023003
45 PT. PARIT PADANG GLOBAL OBAT REG 5248 14/11/2017 05/12/2017 84062726
46 PT. PARIT PADANG GLOBAL OBAT REG 5134 10/11/2017 01/12/2017 84006390
47 PT. PARIT PADANG GLOBAL OBAT REG 5127 10/11/2017 01/12/2017 84005803
48 PT. PARIT PADANG GLOBAL OBAT REG 5077 10/11/2017 01/12/2017 84003584
49 PT. PARIT PADANG GLOBAL OBAT REG 5813 23/11/2017 14/12/2017 84056691
50 PT. PARIT PADANG GLOBAL OBAT REG 5840 23/11/2017 14/12/2017 84058114
51 PT. PARIT PADANG GLOBAL OBAT REG 5883 24/11/2017 15/12/2017 84061174
52 PT. PARIT PADANG GLOBAL OBAT REG 5905 24/11/2017 15/12/2017 84062299
53 PT. PARIT PADANG GLOBAL OBAT REG 5917 24/11/2017 15/12/2017 84016197
54 PT. PARIT PADANG GLOBAL OBAT REG 5926 24/11/2017 15/12/2017 84063036
55 PT. PARIT PADANG GLOBAL OBAT REG 6031 27/11/2017 18/12/2017 84070199
56 PT. PARIT PADANG GLOBAL OBAT REG 6045 27/11/2017 18/12/2017 84071408
57 PT. PARIT PADANG GLOBAL OBAT REG 6292 30/11/2017 21/12/2017 84090081
58 PT. PARIT PADANG GLOBAL OBAT REG 6303 30/11/2017 21/12/2017 84090446
59 PT. PARIT PADANG GLOBAL OBAT REG 6533 06/12/2017 27/12/2017 84108017

49 PT. ENSEVAL PUTERA BHP UMUM 7942 02/11/2017 01/01/2018 45935881


50 PT. ENSEVAL PUTERA OBAT REG 8586 08/11/2017 07/01/2018 45989835
51 PT. ENSEVAL PUTERA OBAT REG 8808 09/11/2017 08/01/2018 46010641
52 PT. ENSEVAL PUTERA OBAT REG 1370 09/11/2017 08/01/2018 46010670
53 PT. ENSEVAL PUTERA OBAT REG 1371 09/11/2017 08/01/2018 46011028
54 PT. ENSEVAL PUTERA LABOR 9072 11/11/2017 10/01/2018 46032369
55 PT. ENSEVAL PUTERA BHP UMUM 9079 11/11/2017 10/01/2018 46032806
56 PT. ENSEVAL PUTERA OBAT REG 9357 14/11/2017 13/01/2018 46057842
57 PT. ENSEVAL PUTERA OBAT REG 9523 15/11/2017 14/01/2018 46069053
58 PT. ENSEVAL PUTERA OBAT REG 9561 15/11/2017 14/01/2018 46073535
59 PT. ENSEVAL PUTERA BHP UMUM 9575 15/11/2017 14/01/2018 46074024
60 PT. ENSEVAL PUTERA OBAT REG 1405 15/11/2017 14/01/2018 46069126
61 PT. ENSEVAL PUTERA OBAT REG 1415 16/11/2017 15/01/2018 46087983
62 PT. ENSEVAL PUTERA OBAT REG 0268 21/11/2017 20/01/2018 46139026
63 PT. ENSEVAL PUTERA OBAT REG 0612 23/11/2017 22/01/2018 46169654
64 PT. ENSEVAL PUTERA OBAT REG 0613 23/11/2017 22/01/2018 46169652
65 PT. ENSEVAL PUTERA BHP UMUM 1461 23/11/2017 22/01/2018 46169022
66 PT. ENSEVAL PUTERA OBAT REG 1463 23/11/2017 22/01/2018 46170674
67 PT. ENSEVAL PUTERA OBAT REG 1682 30/11/2017 29/01/2018 46256225
68 PT. ENSEVAL PUTERA OBAT REG 1675 30/11/2017 29/01/2018 46255907
69 PT. ENSEVAL PUTERA OBAT REG 1676 30/11/2017 29/01/2018 46255904
70 PT. ENSEVAL PUTERA BHP UMUM 1678 30/11/2017 29/01/2018 46255906
71 PT. ENSEVAL PUTERA BHP UMUM 1491 30/11/2017 29/01/2018 46248780
72 PT. ENSEVAL PUTERA BHP UMUM 1492 30/11/2017 29/01/2018 46248781
73 PT. ENSEVAL PUTERA OBAT REG 1499 30/11/2017 29/01/2018 46255942
74 PT. ENSEVAL PUTERA OBAT REG 1503 30/11/2017 29/01/2018 46256358
75 PT. ENSEVAL PUTERA BHP UMUM 2305 07/12/2017 05/02/2018 46316624
76 PT. ENSEVAL PUTERA BHP UMUM 1527 07/12/2017 05/02/2018 46326199
77 PT. ENSEVAL PUTERA OBAT REG 3022 12/12/2017 10/02/2018 46374737
78 PT. ENSEVAL PUTERA LABOR 3029 12/12/2017 10/02/2018 46375202
79 PT. ENSEVAL PUTERA LABOR 3030 12/12/2017 10/02/2018 46375249
80 PT. ENSEVAL PUTERA OBAT REG 3031 12/12/2017 10/02/2018 46375247
81 PT. ENSEVAL PUTERA OBAT REG 1566 12/12/2017 10/02/2018 46374924

82 PT. KIMIA FARMA BHP UMUM 8221 01/11/2017 22/11/2017 19733988


83 PT. KIMIA FARMA OBAT REG 7633 01/11/2017 22/11/2017 19733983
84 PT. KIMIA FARMA OBAT REG 4569 04/11/2017 25/11/2017 19739226
85 PT. KIMIA FARMA OBAT REG 4549 04/11/2017 25/11/2017 19739225
86 PT. KIMIA FARMA OBAT REG 1092 11/11/2017 02/12/2017 19754440
87 PT. KIMIA FARMA OBAT REG 7766 22/11/2017 13/12/2017 19781265
88 PT. KIMIA FARMA OBAT REG 4891 25/11/2017 16/12/2017 19787732
89 PT. KIMIA FARMA OBAT REG 6635 27/11/2017 18/12/2017 19791030
90 PT. KIMIA FARMA OBAT REG 7731 27/11/2017 18/12/2017 19791032

91 PT. RAJAWALI NUSINDO OBAT REG 6135 27/10/2017 26/11/2017 66154850


92 PT. RAJAWALI NUSINDO BHP UMUM 6536 27/10/2017 26/11/2017 66155241
93 PT. RAJAWALI NUSINDO BHP UMUM 6528 13/11/2017 13/12/2017 66155233
94 PT. RAJAWALI NUSINDO BHP UMUM 6542 14/11/2017 14/12/2017 66155247
95 PT. RAJAWALI NUSINDO BHP UMUM 6543 14/11/2017 14/12/2017 66155248
96 PT. RAJAWALI NUSINDO BHP UMUM 6648 16/11/2017 16/12/2017 66154852

97 PT. MENSA BINA SUKSES OBAT REG 0749 15/11/2017 15/12/2017 72047528
98 PT. MENSA BINA SUKSES OBAT REG 3182 20/11/2017 20/12/2017 72069694
99 PT. MENSA BINA SUKSES OBAT REG 3186 20/11/2017 20/12/2017 72069698
100 PT. MENSA BINA SUKSES OBAT REG 3193 20/11/2017 20/12/2017 72069705
101 PT. MENSA BINA SUKSES OBAT REG 3188 20/11/2017 20/12/2017 72069700
102 PT. MENSA BINA SUKSES OBAT REG 3187 20/11/2017 20/12/2017 72069699
103 PT. MENSA BINA SUKSES OBAT REG 3033 21/11/2017 21/12/2017 72079402
104 PT. MENSA BINA SUKSES OBAT REG 3035 21/11/2017 21/12/2017 72079404
105 PT. MENSA BINA SUKSES OBAT REG 5691 30/11/2017 30/12/2017 72131355
106 PT. MENSA BINA SUKSES OBAT REG 5689 30/11/2017 30/12/2017 72131353
107 PT. MENSA BINA SUKSES OBAT REG 5692 30/11/2017 30/12/2017 72131356
108 PT. MENSA BINA SUKSES OBAT REG 5695 30/11/2017 30/12/2017 72131359
109 PT. MENSA BINA SUKSES BHP UMUM 4238 30/11/2017 30/12/2017 72139753
110 PT. MENSA BINA SUKSES OBAT REG 5698 30/11/2017 30/12/2017 72131362

111 PT. MERAPI UTAMA PHARMA OBAT REG 4333 16/11/2017 03/01/2018 84606812
112 PT. MERAPI UTAMA PHARMA OBAT REG 4447 18/11/2017 05/01/2018 84606912
113 PT. MERAPI UTAMA PHARMA OBAT REG 4464 18/11/2017 05/01/2018 84606914
114 PT. MERAPI UTAMA PHARMA OBAT REG 4465 18/11/2017 05/01/2018 84606815
115 PT. MERAPI UTAMA PHARMA OBAT REG 4541 21/11/2017 08/01/2018 84611544
116 PT. MERAPI UTAMA PHARMA OBAT REG 4580 21/11/2017 08/01/2018 84611548
117 PT. MERAPI UTAMA PHARMA OBAT REG 4586 21/11/2017 08/01/2018 84611549
118 PT. MERAPI UTAMA PHARMA OBAT REG 4699 23/11/2017 10/01/2018 84619220
119 PT. MERAPI UTAMA PHARMA OBAT REG 4124 11/11/2017 29/12/2017 84593942
120 PT. MERAPI UTAMA PHARMA OBAT REG 3865 06/11/2017 24/12/2017 84582972
121 PT. MERAPI UTAMA PHARMA OBAT REG 3866 06/11/2017 24/12/2017 84582973
122 PT. MERAPI UTAMA PHARMA OBAT REG 4007 09/11/2017 27/12/2017 84592426
123 PT. MERAPI UTAMA PHARMA OBAT REG 4006 09/11/2017 27/12/2017 84592425
124 PT. MERAPI UTAMA PHARMA OBAT REG 4128 11/11/2017 29/12/2017 84593945
125 PT. MERAPI UTAMA PHARMA OBAT REG 4129 11/11/2017 29/12/2017 84593946
126 PT. MERAPI UTAMA PHARMA OBAT REG 4969 30/11/2017 17/01/2018 84635383
127 PT. MERAPI UTAMA PHARMA OBAT REG 5048 30/11/2017 17/01/2018 84635392
128 PT. MERAPI UTAMA PHARMA OBAT REG 5049 30/11/2017 17/01/2018 84635393
129 PT. MERAPI UTAMA PHARMA OBAT REG 4983 30/11/2017 17/01/2018 84635386
130 PT. MERAPI UTAMA PHARMA OBAT REG 5058 30/11/2017 17/01/2018 84635396

PT. MUTIARA LABSAINS BHP UMUM 3207 31/10/2017 30/11/2017 39579963


PT. MUTIARA LABSAINS BHP UMUM 3289 06/11/2017 06/12/2017 39580045
PT. MUTIARA LABSAINS BHP UMUM 3290 06/11/2017 06/12/2017 39580046
PT. MUTIARA LABSAINS BHP UMUM 3346 08/11/2017 08/12/2017 39580102
PT. MUTIARA LABSAINS BHP UMUM 3347 08/11/2017 08/12/2017 39580103
PT. MUTIARA LABSAINS BHP UMUM 3435 15/11/2017 15/12/2017 39580191
PT. MUTIARA LABSAINS BHP UMUM 3436 15/11/2017 15/12/2017 39580192
PT. MUTIARA LABSAINS BHP UMUM 3437 15/11/2017 15/12/2017 39580193
PT. MUTIARA LABSAINS BHP UMUM 3438 15/11/2017 15/12/2017 39580194

PT. PENTA VALENT OBAT REG 4538 29/11/2017 29/12/2017 20619985


PT. PENTA VALENT OBAT REG 4611 30/11/2017 30/12/2017 20624299
PT. PENTA VALENT OBAT REG 4687 30/11/2017 30/12/2017 20624374
PT. SAPTA SARI OBAT REG 2460 16/11/2017 07/12/2017 91786483

LAMPIRAN REKAPITULASI SURAT PEMBAYARAN HUTANG


OBAT DAN BAHAN HABIS PAKAI
INSTALASI FARMASI RSUD H. HANAFIE MUARA BUNGO
28 Desember 2017
NO DISTRIBUTOR KATEGORI NO FACT TGL.FACT JT. TEMPO NO.F STDR
1 PT. DOS NI ROHA (Re-print) BHP UMUM 0115 15/08/2017 14/09/2017 93545267

Mengetahui,
Kepala Instalasi Farmasi

TONI DAFIAPUTRA, S.FARM, APT


NIP.19841023 200803 1 001
SI SURAT PEMBAYARAN HUTANG
BAHAN HABIS PAKAI
SUD H. HANAFIE MUARA BUNGO

TAGIHAN PPN PPH SUB TOTAL TOTAL


3,911,386 397,095 59,564 4,368,045
7,095,585 720,364 108,055 7,924,004
2,699,794 274,091 41,114 3,014,998
2,552,041 259,090 38,864 2,849,995
6,560,100 666,000 99,900 7,326,000
2,543,093 258,182 38,727 2,840,002
4,465,990 453,400 68,010 4,987,400
1,850,539 187,872 28,181 2,066,592
8,909,768 904,545 135,682 9,949,995
40,588,296 4,120,639 618,096 45,327,031
2,785,293 282,771 42,416 3,110,479
5,171,250 525,000 78,750 5,775,000
13,993,895 1,420,700 213,105 15,627,700
18,119,075 1,839,500 275,925 20,234,500
19,157,364 1,944,910 291,737 21,394,010
1,981,497 201,167 30,175 2,212,839
1,112,026 112,896 16,934 1,241,856
4,702,144 477,375 71,606 5,251,125
6,691,302 679,320 101,898 7,472,520
985,000 100,000 15,000 1,100,000
2,122,281 215,460 32,319 2,370,060
24,533,888 2,490,750 373,613 27,398,250
29,879,483 3,033,450 455,018 33,367,950
2,275,350 231,000 34,650 2,541,000
1,056,413 107,250 16,088 1,179,750
15,071,534 1,530,105 229,516 16,831,155
4,435,455 450,300 67,545 4,953,300
15,916,704 1,615,909 242,386 17,774,999
9,928,850 1,008,005 151,201 11,088,056
2,510,420 254,865 38,230 2,803,515
738,750 75,000 11,250 825,000
3,333,240 338,400 50,760 3,722,400
186,501,211 18,934,133 2,840,120 208,275,464
5,445,326 552,825 82,924 6,081,075
9,929,695 1,008,091 151,214 11,088,999
13,701,080 1,390,973 208,646 15,300,698
2,313,898 234,913 35,237 2,584,048
3,769,841 382,725 57,409 4,209,975
859,635 87,273 13,091 959,999
1,343,181 136,364 20,455 1,499,999
2,109,870 214,200 32,130 2,356,200
7,748,189 786,618 117,993 8,652,800
11,867,602 1,204,833 180,725 13,253,160
5,502,506 558,630 83,795 6,144,930
10,456,939 1,061,618 159,243 11,677,800
1,462,725 148,500 22,275 1,633,500
611,775 62,109 9,316 683,200
14,275,585 1,449,298 217,395 15,942,278
14,803,762 1,502,920 225,438 16,532,120
1,540,540 156,400 23,460 1,720,400
3,156,531 320,460 48,069 3,525,060
5,288,906 536,945 80,542 5,906,392
9,775,648 992,452 148,868 10,916,967
3,378,857 343,031 51,455 3,773,343
1,809,938 183,750 27,563 2,021,250
12,871,807 1,306,782 196,017 14,374,607
3,139,620 318,743 47,811 3,506,175
8,729,339 886,227 132,934 9,748,500
2,843,068 288,636 43,295 3,175,000
3,083,641 313,060 46,959 3,443,660
161,819,503 16,428,376 2,464,256 180,712,135
19,973,115 2,027,727 304,159 22,305,002
3,275,125 332,500 49,875 3,657,500
6,818,754 692,259 103,839 7,614,852
23,485,454 2,384,310 357,647 26,227,410
21,225,026 2,154,825 323,224 23,703,075
7,708,063 782,544 117,382 8,607,989
2,194,088 222,750 33,413 2,450,250
1,305,219 132,510 19,876 1,457,605
521,262 52,920 7,938 582,120
10,695,623 1,085,850 162,878 11,944,350
8,385,551 851,325 127,699 9,364,575
7,438,596 755,187 113,278 8,307,062
8,875,589 901,075 135,161 9,911,825
121,901,464 12,375,783 1,856,367 136,133,615
8,864,991 899,999 135,000 9,899,990
21,117,685 2,143,927 321,589 23,583,202
7,923,895 804,456 120,668 8,849,020
6,424,909 652,275 97,841 7,175,025
44,331,480 4,500,658 675,099 49,507,237
1,575,821 159,982 23,997 1,759,800
1,220,711 123,930 18,590 1,363,230
935,011 94,925 14,239 1,044,175
21,254,330 2,157,800 323,670 23,735,800
4,472,515 454,062 68,109 4,994,687
25,119,864 2,550,240 382,536 28,052,640
20,143,250 2,045,000 306,750 22,495,000
6,690,622 679,251 101,888 7,471,761
81,412,124 8,265,190 1,239,779 90,917,093
23,894,512 2,425,839 363,876 26,684,227
28,381,531 2,881,374 432,206 31,695,111
52,276,044 5,307,213 796,082 58,379,338
3,679,960 373,600 56,040 4,109,600
8,122,160 824,585 123,688 9,070,432
6,887,120 699,200 104,880 7,691,200
2,605,224 264,490 39,673 2,909,387
4,705,838 477,750 71,663 5,255,250
12,312,500 1,250,000 187,500 13,750,000
4,619,650 469,000 70,350 5,159,000
8,384,813 851,250 127,688 9,363,750
3,190,728 323,932 48,590 3,563,249
6,766,541 686,958 103,044 7,556,543
12,977,375 1,317,500 197,625 14,492,500
1,116,524 113,353 17,003 1,246,880
3,797,975 385,581 57,837 4,241,393
8,470,508 859,950 128,993 9,459,450
4,033,575 409,500 61,425 4,504,500
2,178,131 221,130 33,170 2,432,430
5,647,005 573,300 85,995 6,306,300
99,495,624 10,101,079 1,515,162 111,111,864
6,662,182 676,364 101,455 7,440,000
7,440,000
7,387,500 750,000 112,500 8,250,000
7,092,000 720,000 108,000 7,920,000
3,693,750 375,000 56,250 4,125,000
1,871,500 190,000 28,500 2,090,000
5,023,500 510,000 76,500 5,610,000
32,012,500 3,250,000 487,500 35,750,000
22,999,750 2,335,000 350,250 25,685,000
4,001,563 406,250 60,938 4,468,750
84,082,063 8,536,250 1,280,438 93,898,750
1,073,650 109,000 16,350 1,199,000
2,659,008 269,950 40,493 2,969,450
1,516,900 154,000 23,100 1,694,000
6,402,500 650,000 97,500 7,150,000
21,670,000 2,200,000 330,000 24,200,000
14,715,900 1,494,000 224,100 16,434,000
17,459,125 1,772,500 265,875 19,497,500
19,659,024 1,995,840 299,376 21,954,240
9,751,500 990,000 148,500 10,890,000
3,644,500 370,000 55,500 4,070,000
1,379,000 140,000 21,000 1,540,000
4,137,000 420,000 63,000 4,620,000
3,503,645 355,700 53,355 3,912,700
12,145,050 1,233,000 184,950 13,563,000
17,635,145 1,790,370 268,556 19,694,070
137,351,946 13,944,360 2,091,654 153,387,960
18,591,875 1,887,500 283,125 20,762,500
34,272,090 3,479,400 521,910 38,273,400
22,848,060 2,319,600 347,940 25,515,600
16,759,775 1,701,500 255,225 18,716,500
12,839,475 1,303,500 195,525 14,338,500
105,311,275 10,691,500 1,603,725 117,606,500
2,068,500 210,000 31,500 2,310,000
2,310,000
10,826,046 1,099,091 164,864 12,090,001
3,689,693 374,588 56,188 4,120,469
1,536,502 155,990 23,399 1,715,890
2,574,273 261,348 39,202 2,874,823
1,563,149 158,695 23,804 1,745,649
3,735,764 379,265 56,890 4,171,919
23,925,427 2,428,977 364,347 26,718,751
777,411 78,925 11,839 868,175
2,561,000 260,000 39,000 2,860,000
14,995,640 1,522,400 228,360 16,746,400
28,604,400 2,904,000 435,600 31,944,000
17,966,400 1,824,000 273,600 20,064,000
1,229,280 124,800 18,720 1,372,800
4,018,800 408,000 61,200 4,488,000
5,223,258 530,280 79,542 5,833,080
8,211,206 833,625 125,044 9,169,875
2,604,094 264,375 39,656 2,908,125
4,876,086 495,034 74,255 5,445,375
8,902,430 903,800 135,570 9,941,800
960,375 97,500 14,625 1,072,500
1,220,711 123,930 18,590 1,363,230
855,343 86,837 13,026 955,205
2,817,100 286,000 42,900 3,146,000
11,536,320 1,171,200 175,680 12,883,200
10,468,580 1,062,800 159,420 11,690,800
24,664,400 2,504,000 375,600 27,544,000
23,324,800 2,368,000 355,200 26,048,000
11,279,284 1,145,105 171,766 12,596,155
264,104 26,813 4,022 294,938
14,547,418 1,476,895 221,534 16,245,847
16,163,850 1,641,000 246,150 18,051,000
13,317,200 1,352,000 202,800 14,872,000
231,389,489 23,491,319 3,523,698 258,404,505
5,225,548 530,512 79,577 5,835,637
1,477,500 150,000 22,500 1,650,000
5,319,000 540,000 81,000 5,940,000
1,267,279 128,658 19,299 1,415,235
666,175 67,632 10,145 743,952
18,715,000 1,900,000 285,000 20,900,000
2,501,900 254,000 38,100 2,794,000
842,175 85,500 12,825 940,500
584,844 59,375 8,906 653,125
3,761,026 381,830 57,275 4,200,130
5,967,654 605,853 90,878 6,664,385
4,352,006 441,828 66,274 4,860,108
16,646,500 1,690,000 253,500 18,590,000
67,326,605 6,835,188 1,025,278 75,187,072
1,583,179 160,729 24,109 1,768,017
889,186 90,273 13,541 993,000
1,312,727 133,272 19,991 1,465,990
11,596,136 1,177,273 176,591 12,950,000
6,626,363 672,727 100,909 7,399,999
154,091 15,644 2,347 172,081
1,427,019 144,875 21,731 1,593,625
23,588,701 2,394,792 359,219 26,342,712
10,580,496 1,074,162 161,124 11,815,782
429,834 43,638 6,546 480,018
2,328,449 236,391 35,459 2,600,298
913,095 92,700 13,905 1,019,700
14,251,874 1,446,891 217,034 15,915,798
1,657,575,825 1,657,575,825

1,046,224,079
307,942,376
251,489,370
51,920,000

1,657,575,825

Muara Bungo, 2 Desember 2017


AYU TRESNAWATI
NIP 19660908 198803 2 002

SI SURAT PEMBAYARAN HUTANG


BAHAN HABIS PAKAI
SUD H. HANAFIE MUARA BUNGO

TAGIHAN PPN PPH SUB TOTAL TOTAL


8,705,430 883,800 132,570 9,721,800
20,397,380 2,070,800 310,620 22,778,800
2,878,572 292,241 43,836 3,214,649
31,981,382 3,246,841 487,026 35,715,249
6,809,931 691,364 103,705 7,604,999
1,388,850 141,000 21,150 1,551,000
1,176,196 119,411 17,912 1,313,518
2,860,440 290,400 43,560 3,194,400
3,044,545 309,091 46,364 3,399,999
10,823,895 1,098,873 164,831 12,087,599
4,682,609 475,392 71,309 5,229,309
3,481,286 353,430 53,015 3,887,730
868,770 88,200 13,230 970,200
5,789,016 587,717 88,158 6,464,891
1,934,225 196,368 29,455 2,160,048
1,452,087 147,420 22,113 1,621,620
436,981 44,364 6,655 487,999
2,109,870 214,200 32,130 2,356,200
2,215,265 224,900 33,735 2,473,900
2,732,926 277,454 41,618 3,051,999
5,482,293 556,578 83,487 6,122,358
5,639,149 572,502 85,875 6,297,527
62,928,333 6,388,663 958,299 70,275,296
5,449,808 553,280 82,992 6,086,080
600,850 61,000 9,150 671,000
21,670 2,200 330 24,200
3,502,857 355,620 53,343 3,911,820
1,251,738 127,080 19,062 1,397,880
6,230,716 632,560 94,884 6,958,160
1,936,248 196,573 29,486 2,162,307
1,251,738 127,080 19,062 1,397,880
1,658,346 168,360 25,254 1,851,960
3,709,077 376,556 56,483 4,142,116
1,592,745 161,700 24,255 1,778,700
3,354,516 340,560 51,084 3,746,160
2,234,374 226,840 34,026 2,495,240
32,794,682 3,329,409 499,411 36,623,503
9,939,545 1,009,091 151,364 11,100,000
1,950,300 198,000 29,700 2,178,000
1,139,018 115,636 17,345 1,272,000
2,925,450 297,000 44,550 3,267,000
7,202,813 731,250 109,688 8,043,750
23,157,126 2,350,977 352,647 25,860,750
2,137,450 217,000 32,550 2,387,000
5,183,563 526,250 78,938 5,788,750
886,500 90,000 13,500 990,000
1,701,364 172,727 25,909 1,900,000
12,593,964 1,278,575 191,786 14,064,325
1,464,853 148,716 22,307 1,635,876
28,557,120 2,899,200 434,880 31,891,200
1,969,776 199,977 29,997 2,199,750
2,245,800 228,000 34,200 2,508,000
10,583,703 1,074,488 161,173 11,819,364
7,886,895 800,700 120,105 8,807,700
20,091,045 2,039,700 305,955 22,436,700
2,774,334 281,658 42,249 3,098,241
16,240,582 1,648,790 247,319 18,136,690
4,883,138 495,750 74,363 5,453,250
1,969,776 199,977 29,997 2,199,750
732,426 74,358 11,154 817,938
17,375,400 1,764,000 264,600 19,404,000
7,260,435 737,100 110,565 8,108,100
25,818,820 2,621,200 393,180 28,833,200
8,579,744 871,040 130,656 9,581,440
7,042,750 715,000 107,250 7,865,000
187,979,436 19,084,207 2,862,631 209,926,274
2,311,637 234,684 35,203 2,581,524
2,511,750 255,000 38,250 2,805,000
18,315,829 1,859,475 278,921 20,454,225
12,491,142 1,268,136 190,220 13,949,499
6,827,795 693,177 103,977 7,624,949
3,333,240 338,400 50,760 3,722,400
9,735,744 988,400 148,260 10,872,404
11,968,243 1,215,050 182,258 13,365,550
11,773,508 1,195,280 179,292 13,148,080
1,329,750 135,000 20,250 1,485,000
14,637,494 1,486,040 222,906 16,346,440
3,049,022 309,545 46,432 3,404,999
3,693,750 375,000 56,250 4,125,000
1,628,205 165,300 24,795 1,818,300
12,882,027 1,307,820 196,173 14,386,020
16,824,785 1,708,100 256,215 18,789,100
5,743,911 583,138 87,471 6,414,520
8,871,715 900,682 135,102 9,907,499
22,533,353 2,287,650 343,148 25,164,150
2,275,350 231,000 34,650 2,541,000
19,384,610 1,967,981 295,197 21,647,788
1,850,421 187,860 28,179 2,066,460
29,879,483 3,033,450 455,018 33,367,950
18,446,292 1,872,720 280,908 20,599,920
10,297,726 1,045,454 156,818 11,499,999
429,817 43,636 6,545 479,999
7,234,579 734,475 110,171 8,079,225
7,674,232 779,110 116,866 8,570,208
11,839,109 1,201,940 180,291 13,221,340
18,039,389 1,831,410 274,712 20,145,510
6,475,883 657,450 98,618 7,231,950
679,650 69,000 10,350 759,000
5,686,135 577,273 86,591 6,349,999
310,655,574 31,538,637 4,730,796 346,925,007
2,684,864 272,575 40,886 2,998,325
6,281,418 637,707 95,656 7,014,781
6,652,715 675,403 101,310 7,429,428
10,067,962 1,022,128 153,319 11,243,409
1,461,839 148,410 22,262 1,632,510
3,453,467 350,606 52,591 3,856,664
6,402,500 650,000 97,500 7,150,000
1,690,605 171,635 25,745 1,887,985
1,376,636 139,760 20,964 1,537,360
40,072,005 4,068,224 610,234 44,750,462
5,333,283 541,450 81,218 5,955,950
342,403 34,762 5,214 382,379
263,980 26,800 4,020 294,800
5,388,590 547,065 82,060 6,017,715
4,643,379 471,409 70,711 5,185,499
157,354 15,975 2,396 175,725
16,128,988 1,637,461 245,619 18,012,068
4,249,095 431,380 64,707 4,745,182
18,748,736 1,903,425 285,514 20,937,675
2,621,849 266,178 39,927 2,927,953
2,621,849 266,178 39,927 2,927,953
2,154,053 218,686 32,803 2,405,541
1,102,215 111,900 16,785 1,230,900
3,447,500 350,000 52,500 3,850,000
2,621,580 266,150 39,923 2,927,653
24,741,230 2,511,800 376,770 27,629,800
4,444,813 451,250 67,688 4,963,750
12,677,541 1,287,060 193,059 14,157,660
6,620,161 672,098 100,815 7,393,073
895,393 90,903 13,635 999,931
2,925,450 297,000 44,550 3,267,000
89,871,464 9,124,006 1,368,601 100,364,071
1,418,400 144,000 21,600 1,584,000
12,093,929 1,227,810 184,172 13,505,910
2,974,872 302,017 45,303 3,322,192
2,501,486 253,958 38,094 2,793,538
19,207,500 1,950,000 292,500 21,450,000
1,555,808 157,950 23,693 1,737,450
2,506,579 254,475 38,171 2,799,225
8,147,674 827,175 124,076 9,098,925
19,773,343 2,007,446 301,117 22,081,906
3,284,483 333,450 50,018 3,667,950
2,974,872 302,017 45,303 3,322,192
6,355,614 645,240 96,786 7,097,640
1,267,279 128,658 19,299 1,415,235
3,001,171 304,687 45,703 3,351,562
5,522,156 560,625 84,094 6,166,875
7,202,813 731,250 109,688 8,043,750
1,684,350 171,000 25,650 1,881,000
2,364,000 240,000 36,000 2,640,000
8,274,000 840,000 126,000 9,240,000
30,078,906 3,053,696 458,054 33,590,656
142,189,233 14,435,455 2,165,318 158,790,006
3,725,270 378,200 56,730 4,160,200
3,201,250 325,000 48,750 3,575,000
2,356,120 239,200 35,880 2,631,200
3,736,721 379,363 56,904 4,172,988
2,364,000 240,000 36,000 2,640,000
2,192,216 222,560 33,384 2,448,160
1,558,349 158,208 23,731 1,740,288
4,640,335 471,100 70,665 5,182,100
4,644,275 471,500 70,725 5,186,500
28,418,536 2,885,131 432,770 31,736,436
2,171,925 220,500 33,075 2,425,500
3,088,344 313,537 47,031 3,448,912
515,785 52,364 7,855 576,004
3,171,040 321,933 48,290 3,541,263

SI SURAT PEMBAYARAN HUTANG


BAHAN HABIS PAKAI
SUD H. HANAFIE MUARA BUNGO

TAGIHAN PPN PPH SUB TOTAL TOTAL


59,399,440 6,030,400 904,560 66,334,400
66,334,400

Muara Bungo, 28 Desember 2017

AYU TRESNAWATI
NIP 19660908 198803 2 002
REKAPITULASI TAGIHAN BELANJA INSTALAS
NAMA DISTRIBUTOR BULA
NO Jan-17 Feb-17 Mar-17 Apr-17 May-17
1 CV. RAFIN JAYA - - - 5,977,950 -
2 PT. AFINA SC 22,742,500 22,742,500 15,796,000 23,430,000 -
3 PT. ANUGRAH ARGON M 149,594,918 104,894,852 249,473,282 277,131,347 223,709,023
4 PT. ANUGRAH PHARMINDO L 27,069,187 42,294,270 86,265,640 21,820,361 24,084,084
5 PT. BHAKTI SEJAHTERA M 191,273,500 172,144,500 62,090,600 62,161,000 58,879,700
6 PT. BINA SAN PRIMA 24,730,559 3,282,840 52,999,074 33,483,864 8,664,590
7 PT. BIO MULTI MEDIKA 379,914,740 230,933,340 498,578,630 220,712,360 334,722,410
8 PT. BRATACO - - - - -
9 PT. CITRA PURNAMA S 53,302,590 24,757,150 30,679,660 85,962,140 33,804,760
10 PT. DOS NI ROHA 270,547,282 104,566,998 195,570,796 140,862,683 257,006,856
11 PT. ENSEVAL PUTERA 369,805,249 132,244,187 367,355,130 350,682,764 326,926,987
12 PT. HOTAMA MEDIPHAR 18,590,000 18,590,000 18,590,000 37,620,000 -
13 PT. INDO FARMA GLOBAL M 40,883,970 23,162,216 25,060,567 75,922,050 -
14 PT. KIMIA FARMA 11,189,420 23,528,833 43,322,428 57,891,112 31,172,322
15 PT. MEDICO VISI PHARMA - - - - -
16 PT. MENSA BINA SUKSES 158,358,182 73,326,009 237,591,311 182,729,973 32,860,404
17 PT. MERAPI UTAMA PHARMA 104,379,457 87,572,016 161,485,517 71,193,810 69,625,459
18 PT. MILLENIUM PHARMACON I 80,207,324 80,207,324 56,963,857 12,584,000 66,188,043
19 PT. MITRA SEJATI MEDIKA 18,953,162 - 36,097,655 - 44,496,154
20 PT. MUARA NATIO P 18,390,900 95,390,900 33,792,750 67,006,500 -
21 PT. MUTIARA LABSAINS 27,280,000 9,267,500 35,940,300 - -
22 PT. PARIT PADANG GLOBAL 54,082,190 50,089,109 124,723,316 5,733,200 224,634,018
23 PT. PENTA VALENT 44,065,510 - 129,283,374 39,556,081 7,034,467
24 PT. RAJAWALI NUSINDO 15,120,054 36,085,488 28,957,090 66,511,805 -
25 PT. SAPTA SARI 34,235,134 9,646,626 12,392,325 12,825,615 10,595,133
26 PT. TEMPO - - 36,962,000 8,100,000 3,720,000
27 PT. TRI SAPTA JAYA - - - - -
28 PT. ULICO PHARMA 10,156,806 6,590,082 - 3,013,441 -
29 PT. UNITED DICO CITAS 107,805,085 - 36,299,220 77,532,119 45,720,933

TOTAL 2,232,677,719 1,351,316,740 2,576,270,522 1,940,444,175 1,803,845,343


Kepala Instalasi Farmasi
RSUD H. Hanafie

Toni Dafiaputra, S.Farm, Apt


NIP. 19841023 200803 1 001

REKAPITULASI BELANJA GAS MEDIS INSTAL


BULA
NO NAMA DISTRIBUTOR
NO NAMA DISTRIBUTOR Jan-17 Feb-17 Mar-17 Apr-17 May-17
1 PT. JUAN 70,224,000 75,762,500 68,656,500 68,656,500 81,510,000
Harga/tabung 104,500 104,500 104,500 104,500 104,500
Jumlah Tabung 672 725 657 657 780
Kepala Instalasi Farmasi 728
RSUD H. Hanafie

Toni Dafiaputra, S.Farm, Apt


NIP. 19841023 200803 1 001

Transaksi Perusahaan
4,500,000,000

4,000,000,000

3,500,000,000

3,000,000,000

2,500,000,000

2,000,000,000

1,500,000,000 Trans

1,000,000,000

500,000,000

-
A C M L M A A O S A A R M A A ES A I A P S L T O RI
JAY A S N DO RA RI M DI K ATAC MA ROH TER PHA AL RM RM KS RM CON DI K TI O SAI N OBA LEN I ND SA
I N I N GO I N E P E R A I U I B FA A SU A A E A B GL VA S TA
R AF T. AF AR RM JAHT AN TI M T. B URN S N L P MED GLO I A I PH NA A PH RM TI M A N LA NG TA I NU SAP
. P AH HA SE A UL S P P DO EV A A A I M VI S B M HA EJA AR RA DA EN AL PT.
I
CV R P I N M A . S M K A A P S U IA P
U G H KT . B O
A
I
I I T P EN TA FA PT. I CO ENS I UT M RA T. M UT T PA PT. JAW
R T M R
A . A
N R
. A UG T. BH
PT T. B
PT
.C PT T. HO DO ED T. M RAP ENI U MI T P T. M ARI T.R
T
P AN P P P . IN . M P E I LL PT . P . P P
. PT PT .M PT
PT PT PT. M

Nilai Belanja
3,000,000,000

2,500,000,000

2,000,000,000
3,000,000,000

2,500,000,000

2,000,000,000

1,500,000,000

1,000,000,000

500,000,000

-
Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17
GIHAN BELANJA INSTALASI FARMASI TAHUN 2017
BULAN
Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17
5,977,950 - - - - - -
20,157,500 - - 24,131,250 - - -
180,388,610 270,272,710 165,375,957 193,931,078 76,252,055 198,486,250 250,987,431
28,665,852 46,647,291 72,072,164 42,407,459 - 63,336,455 45,327,031
55,151,500 13,304,500 36,862,650 18,449,750 30,902,850 12,590,050 2,310,000
13,347,095 28,030,622 38,408,966 21,449,956 33,853,850 31,611,035 36,623,503
503,235,040 191,592,500 75,502,900 178,747,030 - - -
1,500,000 - - - - - -
42,426,450 115,240,590 29,323,250 73,422,250 177,671,450 157,558,390 153,387,960
141,397,580 311,209,577 243,351,991 164,396,055 394,289,201 157,092,890 294,119,754
302,198,200 229,565,519 268,142,289 378,758,966 436,210,376 300,020,029 555,200,471
27,500,000 - 27,500,000 - - - -
58,008,041 25,155,980 31,478,446 11,156,210 - 39,955,609 52,203,462
45,585,558 44,079,133 69,935,413 - 109,149,004 104,050,849 44,750,462
- - - - 164,477,280 126,863,000 117,606,500
185,715,339 129,823,500 243,986,859 48,784,796 153,475,790 210,419,623 236,497,686
77,265,431 187,288,235 117,135,323 70,468,799 144,958,494 108,404,567 233,977,078
39,685,992 - 108,655,360 11,011,000 1,958,000 - -
- - - 100,368,516 - - 58,379,338
31,850,500 127,886,000 95,645,000 104,557,750 104,951,000 175,876,250 93,898,750
39,677,000 - 54,923,900 5,280,000 40,603,750 70,066,997 31,736,436
82,046,625 129,660,925 228,159,238 125,333,279 128,754,422 207,115,132 300,843,367
- 29,845,955 89,884,944 36,885,963 68,920,834 39,837,985 117,562,280
48,122,403 - 34,165,712 - 63,173,161 61,781,839 44,730,819
17,268,609 - - 7,708,328 34,034,733 7,800,869 19,457,061
29,407,500 11,500,000 6,686,700 5,368,350 - 17,634,000 7,440,000
- - - - - 84,723,023 -
17,806,174 - - - 30,253,282 4,129,924 -
8,625,580 26,022,606 64,628,028 49,602,179 90,003,827 26,367,680 49,507,237
- - -
### 1,917,125,643 2,101,825,090 ### 2,283,893,359 ### 2,746,546,626

Muara Bungo, 2017


Kepala Ruangan Instalasi Farmasi

AYU TRESNAWATI
NIP 19660908 198803 2 002

NJA GAS MEDIS INSTALASI FARMASI TAHUN 2017


BULAN
Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17
74,195,000 79,629,000 89,661,000
104,500 104,500 104,500 104,500 104,500 104,500 104,500
710 762 858

Muara Bungo, Desember 2017


Kepala Ruangan Instalasi Farmasi

AYU TRESNAWATI

Transaksi Perusahaan

AL NT DO RI
OB ALE SI N A SA
V T
TA NU SAP
N L T.I
A P
JAW

Nilai Belanja
Nilai Belanja

Oct-17 Nov-17 Dec-17


TOTAL Rata2/perusahaan

11,955,900 996,325
128,999,750 10,749,979
2,340,497,513 195,041,459
499,989,794 41,665,816
716,120,600 59,676,717
326,485,954 27,207,163
2,613,938,950 217,828,246
1,500,000 125,000
977,536,640 81,461,387
2,674,411,663 222,867,639
4,017,110,167 334,759,181
148,390,000 12,365,833
382,986,551 31,915,546
584,654,534 48,721,211
408,946,780 34,078,898
1,893,569,472 157,797,456
1,433,754,186 119,479,516
457,460,900 38,121,742
258,294,825 21,524,569
949,246,300 79,103,858
314,775,883 26,231,324
1,661,174,821 138,431,235
602,877,393 50,239,783
398,648,371 33,220,698
165,964,433 13,830,369
126,818,550 10,568,213
84,723,023 7,060,252
71,949,709 5,995,809
582,114,494 48,509,541

###

a Bungo, 2017
ngan Instalasi Farmasi

TRESNAWATI
0908 198803 2 002

TOTAL
TOTAL
379,753,000

ngo, Desember 2017


ngan Instalasi Farmasi

TRESNAWATI
NO TAHUN January February March April May June
1 2013 1,362,983,535 2,881,254,479 1,373,581,533 1,912,825,547 1,616,888,173 1,843,171,265
2 2014 1,666,279,997 2,110,698,268 1,251,847,317 2,785,264,617 3,098,653,211 1,629,668,193
3 2015 2,864,243,658 1,802,543,659 1,850,330,791 1,528,372,770 2,308,749,642 1,477,130,886
4 2016 1,699,209,811 1,028,823,008 1,341,765,147 1,509,554,116 1,654,788,907 1,527,623,187
5 2017 2,232,677,719 1,351,316,740 2,576,270,522 1,940,444,175 1,803,845,343 2,003,010,529
6 2018 1,794,215,228 3,941,016,176 1,990,911,006 1,646,483,978 1,942,660,190

4,500,000,000

4,000,000,000

3,500,000,000

3,000,000,000

2,500,000,000

2,000,000,000

1,500,000,000

1,000,000,000

500,000,000

-
January February March April May June July August September
July August September October November December TOTAL
2,049,520,747 1,797,186,611 1,600,065,170 1,910,332,760 1,022,273,651 1,862,503,327 21,232,586,798
1,695,497,475 2,577,501,725 1,215,919,520 1,903,358,537 2,561,280,728 2,841,770,504 25,337,740,092
1,808,372,532 1,698,817,450 1,810,925,014 2,593,107,041 2,062,130,036 1,609,432,425 23,414,155,904
1,650,740,341 1,689,159,090 1,434,701,223 1,795,527,859 1,361,692,998 2,018,310,012 18,711,895,699
1,917,125,643 2,101,825,090 1,672,218,964 2,283,893,359 2,205,722,446 2,746,546,626 24,834,897,156
11,315,286,578

tidak termasuk gas medis

2013
2014
2015
2016
2017
2018

July August September October November December


Rata2/bln
3,266,551,815
3,898,113,860
3,602,177,831
2,878,753,184
3,820,753,409
3,771,762,193

rmasuk gas medis

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