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<table width="400px">

<tr align="center">
<td colspan="8">LAPORAN Rekapan Pembayaran</td>
</tr>
<tr>
<td>PKM : CIMPAEUN</td>
</tr>
<tr>
<td>Periode : 2022-10-25 s.d 2022-10-25</td>
</tr>
<tr>
<td><b>No.</td>
<td><b>Tanggal</td>
<td><b>No. Registrasi</b></td>
<td><b> Nama</b></td>
<td><b>Jenis Kelamin</b></td>
<td><b>Jenis Pelayanan</td>
<td><b>Jumlah</b></td>
<td><b>Biaya</b></td>
<td><b>Puskesmas</b></td>
</tr>
</table>

<table>

<tr>
<td> 1</td>
<td> 2022-10-25 07:44:00 </td>
<td> 40210024913</td>
<td> MUHAMAD AL-KAHFI </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 2</td>
<td> 2022-10-25 07:48:00 </td>
<td> 40210027484</td>
<td> MUHAMAD FAZIAN MESIYANSYAH </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 3</td>
<td> 2022-10-25 14:02:00 </td>
<td> 40210027484</td>
<td> MUHAMAD FAZIAN MESIYANSYAH </td>
<td> Laki-laki </td>
<td> Injeksi </td>
<td> 1 </td>
<td> 5000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 4</td>
<td> 2022-10-25 07:58:00 </td>
<td> 40210027316</td>
<td> MARWIYAH </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 5</td>
<td> 2022-10-25 07:58:00 </td>
<td> 40210017557</td>
<td> HALIMAH SALVINA </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 6</td>
<td> 2022-10-25 07:59:00 </td>
<td> 40210017192</td>
<td> HELLIN </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 7</td>
<td> 2022-10-25 08:01:00 </td>
<td> 40210015228</td>
<td> RESQI ADITYA MAULANA </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 8</td>
<td> 2022-10-25 08:07:00 </td>
<td> 40210018616</td>
<td> AIDA FITRIYANI </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 9</td>
<td> 2022-10-25 08:09:00 </td>
<td> 40210027716</td>
<td> NADIRA SYIFA AZZAHRA </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 10</td>
<td> 2022-10-25 14:07:00 </td>
<td> 40210027716</td>
<td> NADIRA SYIFA AZZAHRA </td>
<td> Perempuan </td>
<td> Injeksi </td>
<td> 1 </td>
<td> 5000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 11</td>
<td> 2022-10-25 08:10:00 </td>
<td> 40210011166</td>
<td> ASKIA </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 12</td>
<td> 2022-10-25 08:11:00 </td>
<td> 40210025391</td>
<td> ARSYILA AYUDIA PUTRI </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 13</td>
<td> 2022-10-25 08:12:00 </td>
<td> 40210009341</td>
<td> NISAH </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 14</td>
<td> 2022-10-25 08:23:00 </td>
<td> 40210025685</td>
<td> MUHAMMAD NABIL </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 15</td>
<td> 2022-10-25 08:26:00 </td>
<td> 40210027710</td>
<td> SYAKILA PUTRI ALFATUNISA </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 16</td>
<td> 2022-10-25 13:58:00 </td>
<td> 40210027710</td>
<td> SYAKILA PUTRI ALFATUNISA </td>
<td> Perempuan </td>
<td> Injeksi </td>
<td> 1 </td>
<td> 5000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 17</td>
<td> 2022-10-25 08:28:00 </td>
<td> 40210013252</td>
<td> APRILIA TRI CAHYANI PUTRI </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 18</td>
<td> 2022-10-25 08:31:00 </td>
<td> 40210023699</td>
<td> MUHAMMAD MIRZA </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 19</td>
<td> 2022-10-25 08:38:00 </td>
<td> 40210020797</td>
<td> HERI SUSANTO </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 20</td>
<td> 2022-10-25 08:49:00 </td>
<td> 40210026170</td>
<td> NISA SUCI RAHAYU </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 21</td>
<td> 2022-10-25 08:51:00 </td>
<td> 40210016270</td>
<td> KAYLA OKTAVIA </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 22</td>
<td> 2022-10-25 08:52:00 </td>
<td> 40210026711</td>
<td> SHENA AILA VHARISHA </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 23</td>
<td> 2022-10-25 08:53:00 </td>
<td> 40210016091</td>
<td> ELA SALSIAH </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 24</td>
<td> 2022-10-25 08:56:00 </td>
<td> 40210002130</td>
<td> NADI </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 25</td>
<td> 2022-10-25 08:56:00 </td>
<td> 40210022316</td>
<td> KARTANA </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 26</td>
<td> 2022-10-25 09:02:00 </td>
<td> 40210027718</td>
<td> RAYA JESSICA ALI </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 27</td>
<td> 2022-10-25 09:08:00 </td>
<td> 40210023485</td>
<td> MUHAMMAD RAFASSYA SYAQIEL </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 28</td>
<td> 2022-10-25 09:10:00 </td>
<td> 40210022730</td>
<td> SITI AISAH </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 29</td>
<td> 2022-10-25 09:12:00 </td>
<td> 40210027719</td>
<td> AZZORA QEEIREN ARSYLA PUTRI </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 30</td>
<td> 2022-10-25 14:05:00 </td>
<td> 40210027719</td>
<td> AZZORA QEEIREN ARSYLA PUTRI </td>
<td> Perempuan </td>
<td> Injeksi </td>
<td> 1 </td>
<td> 5000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 31</td>
<td> 2022-10-25 09:16:00 </td>
<td> 40210022299</td>
<td> SALSABILAH NURJANAH </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 32</td>
<td> 2022-10-25 09:16:00 </td>
<td> 40210026480</td>
<td> MIA KURNIAWATI </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 33</td>
<td> 2022-10-25 09:22:00 </td>
<td> 40210024706</td>
<td> CUCU NURHOLIFAH </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 34</td>
<td> 2022-10-25 09:24:00 </td>
<td> 40210019882</td>
<td> UPI SUMANTI </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 35</td>
<td> 2022-10-25 09:28:00 </td>
<td> 40210005314</td>
<td> BUDI HARTONO </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 36</td>
<td> 2022-10-25 09:30:00 </td>
<td> 40210002683</td>
<td> YULIANA </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 37</td>
<td> 2022-10-25 09:32:00 </td>
<td> 40210027720</td>
<td> NAWIN SETIAWAN </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 38</td>
<td> 2022-10-25 09:34:00 </td>
<td> 40210018528</td>
<td> SHINTA ANGGRAENI NUR GHEA </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 39</td>
<td> 2022-10-25 09:35:00 </td>
<td> 40210003282</td>
<td> M. NOVAL </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 40</td>
<td> 2022-10-25 09:38:00 </td>
<td> 40210012698</td>
<td> MUHAMMAD FAHMI GOJALI </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 41</td>
<td> 2022-10-25 09:40:00 </td>
<td> 40210008090</td>
<td> SUKAMTO </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 42</td>
<td> 2022-10-25 09:41:00 </td>
<td> 40210022578</td>
<td> DIAN INDRIANI </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>

<tr>
<td> 43</td>
<td> 2022-10-25 09:47:00 </td>
<td> 40210027722</td>
<td> MUHAMAD RASYIQUL AL FATIH </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> CIMPAEUN</td>
</tr>
</table>
<br />
<br />
<br />

<table width="400px">
<tr align="center">
<td colspan="8">LAPORAN Rekapan Pembayaran Pelayanan Non
Kesehatan</td>
</tr>
<tr>
<td><b>No.</td>
<td><b>Tanggal</td>
<td><b> Nama</b></td>
<td><b>Nama Instansi</b></td>
<td><b>Jenis Pembayaran</b></td>
<td><b>Harga Satuan</b></td>
<td><b>Jumlah</b></td>
<td><b>Biaya</b></td>
<td><b>Puskesmas</b></td>
</tr>
</table>

<table>
</table>

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