Rekap Pendapatan Tahun 2018

LAPORAN PENDAPATAN FISIOTERAPI
Nama : Bpk Bambang Agus Mulyanto S.Ft

: Bpk Ambrosius Basuki S.ST.FT
Spesiali: Fisioterapi
Tarif :
No. Tanggal No Kartu Nama Pasien

1 1/2/2018 Lie Kiantoro S, Tn
2 1/2/2018 Sulianto Tedy Purnama, Tn
3 1/2/2018 Juliawati Laksmono, Ny
4 1/2/2018 Connie Wibisono, Ny
5 1/2/2018 Wibisono Hardjopranoto,Tn
6 1/2/2018 Miftahol Arifin, Tn
7 1/2/2018 Wanneke Mulyadi, Ny
8 1/3/2018 Alam, Tn
10 1/3/2018 Yan Christanto, Tn
11 1/3/2018 Bong Siu Ngiet, Ny
13 1/4/2018 Marta Ingelina, Ny
14 1/4/2018 Lily Susianti, Ny
16 1/4/2018 Maria Martini Ratna W, Ny
17 1/5/2018 Suhailah, Ny
18 1/5/2018 Alam, Tn
19 1/5/2018 Sugeng, Tn
22 1/5/2018 Lazarus Djojo, Tn
23 1/5/2018 Shirly Yunita Wijaya, Ny
24 1/8/2018 Atim Hadi Pangestu, Ny
28 1/9/2018 Sugeng, Tn
34 1/10/2018 Corryanti Suko, Ny
35 1/10/2018 Alam, Tn
36 1/10/2018 Mahmudah, Ny
40 1/12/2018 Alam, Tn
41 1/12/2018 Moedjiyo, Tn
43 1/13/2018 Christine Suliyah, Ny
44 1/13/2018 Corryanti Suko, Ny
46 1/13/2018 Bong Wong Irwan Saputra, Tn
49 1/15/2018 Siti M. Amin, Ny
50 1/15/2018 Alam, Tn
52 1/15/2018 Christine Oentari, Ny
53 1/15/2018 Merry, Ny
55 1/15/2018 Soeliatikno, Tn
56 1/15/2018 Yan Christanto, Tn
59 1/16/2018 Cecilia Adinda, Nn
60 1/17/2018 Gunawan, Tn
61 1/17/2018 Nanik Sutini, Ny
62 1/17/2018 Alam,Tn
72 1/19/2018 Alam, Tn
76 1/20/2018 Samsudin, Tn
79 1/20/2018 Totok Ismianto
80 1/22/2018 Edi, Tn
81 1/22/2018 Alam, Tn
86 1/23/2018 M. Johan Ansori, Tn
89 1/23/2018 Totok Ismianto
91 1/24/2018 Kasening
93 1/24/2018 Alam, Tn
95 1/24/2018 M. Johan Ansori, Tn
98 1/24/2018 F. Ritski Sugiarti, Ny
99 1/24/2018 Totok Ismianto, Tn
101 1/25/2018 Cecillia Adinda, Nn
102 1/25/2018 Lanny Oey Pie Lang, Ny
103 1/26/2018 Paulus Budiono, Tn
105 1/26/2018 Alam, Tn
111 1/29/2018 Gunawan, Tn
112 1/29/2018 Alam, Tn
113 1/29/2018 Yenny Andasari, Ny
115 1/29/2018 Lupita, Nn
116 1/29/2018 Liliana, Ny
117 1/30/2018 Paulus Budiono, Tn
120 1/30/2018 Sugeng, Tn
121 1/31/2018 Alam, Tn
124 1/31/2018 Enny Pandowo, Ny
Pendapatan yang diterima oleh dokter
Pendapatan yang diterima oleh Sanodoc
Surabaya,
Dibuat Oleh, Mengetahui,

Bulan Jan-18
Ruang :
Terapi Konsultasi (Rp)

SWD 1,5 , USD 1X, Exc R 1X Rp 250,000
SWD 1,5 , Exc Exstra B 1X Rp 270,000
SWD 1X, USD 1X, TENS 1X Rp 180,000
SWD 1X, USD 2X, EXC X 1X Rp 230,000
USD 1,5 , IFC 1X Rp 150,000
Exc B 1X Rp 150,000
SWD 1,5 X, USD 1X, TENS 1X Rp 210,000
USD 2X, Exc R 1X Rp 220,000
SWD 1X. USD 1X, Exc R 1X Rp 220,000
Exc B 1X Rp 150,000
SWD 1X, USD 2X, Exc B 1x Rp 330,000
USD 1,5 , IFC 1X Rp 150,000
SWD 1, USD 1, TENS 1, Exc R 1 Rp 280,000
SWD 1X, USD 1x Rp 120,000
Exc B 1X Rp 150,000
USD 1,5 , IFC 1X Rp 150,000
SWD 1X, USD 1X Rp 120,000
SWD 1X, USD 2X, Tens 1X, Exc B 1X Rp 390,000
SWD 1, USD 1, TENS 1, Exc R 1 Rp 280,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
SWD 1,5 , USD 1X, TENS 1X Rp 210,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
USD 1,5 , IFC 1X Rp 150,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
SWD 1X, USD 1X, Exc R 1X Rp 220,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
SWD 1X, USD 1X, TENS 1X, Exc X 1X Rp 230,000
USD 1,5 , IFC 1X Rp 150,000
SWD 1,5 , USD 1X, Exc X 1X Rp 200,000
Exc B 1X Rp 150,000
SWD 2X, USD 1X, TENS 1X, Exc R 1x Rp 340,000
SWD 1X, USD 1X, TENS 1X, Exc R 1X Rp 280,000
Exc B 1X Rp 150,000
SWD 1,5, Exc Exstra B 1X Rp 270,000
USD 1,5 , IFC 1X Rp 150,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
USD 1X, SWD 1,5X, TENS 1X Rp 210,000
Exc B 1X Rp 150,000
USD 1,5 , IFC 1X Rp 150,000
Exc B 1X Rp 150,000
Exc Exstra B 1X Rp 180,000
USD 1X, SWD 1,5X, TENS 1X Rp 210,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
Exc Exstra B 1X Rp 180,000
USD 1,5 , IFC 1X Rp 150,000
SWD 1,5 ,USD 1,5 Rp 180,000
SWD 1,5, USD 1X, TENS 1X Rp 210,000
SWD 1X. USD 1X, TENS 1X Rp 180,000
Exc B 1X Rp 150,000
USD 1,5 , IFC 1X Rp 150,000
Exc B 1X Rp 150,000
USD & SWD Rp 120,000
SWD 2X, USD 1X, TENS 1X, Exc R 1x Rp 340,000
Exc B 1X Rp 150,000
SWD 1,5x, USD 1X, Ecx X 1X Rp 200,000
USD 1,5 , IFC 1X Rp 150,000
SWD 1,5X, USD 1,5X, TENS 1,5X Rp 270,000
Exc B 1X Rp 150,000
SWD 1X, USD 2X, Tens 1x, Exc B 1x Rp 390,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
Exc Extra B 1x Rp 180,000
Rp 23,720,000
Rp 18,976,000
Rp 4,744,000
Diterima,
Spesialis : Fisioterapi
Tarif :

4 2/1/2018 Hiangsih Sugiarti, Ny
10 2/2/2018 Alam, Tn
13 2/5/2018 Siti M. Amin, Ny
14 2/5/2018 Alam,Tn
17 2/5/2018 Flora Indrayani, Ny
19 2/6/2018 Sulianto Tedy Purnama,Tn
21 2/7/2018 Alam, Tn
26 2/8/2018 Joko Supriyanto, Tn
30 2/9/2018 Joko Supriyanto, Tn
35 2/12/2018 Alam, Tn
38 2/12/2018 Suwandi, Tn
42 2/13/2018 Yudi Purnomo, Tn
43 2/13/2018 Saji Purnomo, Tn
44 2/14/2018 Alam, Tn
51 2/15/2018 Hunaifah Gunawan, Ny
52 2/15/2018 Ramli Muis, Tn
54 2/17/2018 Lupita, Nn
56 2/19/2018 Alam, Tn
61 2/20/2018 Hariyono Gunawan, Tn
63 2/21/2018 Gunawan, Tn
64 2/21/2018 Sugeng, Tn
65 2/21/2018 Alam, Tn
66 2/21/2018 Dian Andriani Hartanto, Ny
67 2/21/2018 Filia Indriyani, Nn
68 2/21/2018 Yuliana Gunawan, Ny
69 2/21/2018 Santoso Sastrowidjojo, Tn
70 2/21/2018 Fitri Ramadhani, Nn
73 2/22/2018 Kasening, Ny
76 2/22/2018 Filia Indriani, Nn
78 2/23/2018 Alam, Tn
85 2/24/2018 Sulastri, Ny
86 2/24/2018 Ledwina Chandra, Ny
89 2/26/2018 Sri Wuryani, Ny
92 2/26/2018 Alam, Tn
94 2/26/2018 A. Agung Hari Prasetyo, Tn
95 2/26/2018 Budi Santoso. S. Pd, Tn
108 2/28/2018 Alam, Tn
110 2/28/2018 Moedjiyo, Tn

Surabaya,

Bulan Feb-18
Ruang :

Exc B 1X Rp 150,000
Exc R 1X, USD 1X Rp 160,000
USD 1,5X, Exc X 1X Rp 140,000
SWD 1,5X, USD 1X, EXC X Rp 200,000
Exc Extra B 1X Rp 180,000
Exc B 1X Rp 150,000
SWD 1X. USD 1X Rp 120,000
Exc B 1X Rp 150,000
USD 1,5 X, IFC 1X Rp 150,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
USD 1,5 X, IFC 1X Rp 150,000
SWD 2X, USD 1,5X, TENS 1X Rp 270,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
USD 1,5 X, IFC 1X Rp 150,000
Exc B 1X Rp 150,000
SWD 1,5 ,USD 1,5 Rp 180,000
Exc B 1X Rp 150,000
USD 1,5 X, IFC 1X Rp 150,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
USD 1,5 X, IFC 1X Rp 150,000
Exc B 1X Rp 150,000
SWD 1X, USD 1X, TENS 1X, EXC R Rp 280,000
EXC B 1X Rp 150,000
USD 1,5 X, IFC 1X Rp 150,000
Exc B 1X Rp 150,000
SWD 1X, USD 1X, Exc B 1X Rp 270,000
SWD 1X, USD 1,5X, Tens 1X, Exc X 1x Rp 260,000
SWD 1X, USD 1,5 X Rp 150,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
USD 1,5 X, IFC 1X Rp 150,000
Exc B 1X Rp 150,000
SWD 2X, USD 1,5, Exc R 1X Rp 310,000
SWD 1X, USD 2X, Tens 1x, Exc B 1x Rp 390,000
Exc B 1X Rp 150,000
Exc B 1X, USD 1X Rp 210,000
SWD 1,5X, USD 2X, Tens 1X, Exc R 1X Rp 370,000
SWD 1,5X, USD 1,5X, Tens 1X Rp 240,000
Exc R 1X, USD 1X Rp 160,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
SWD 1,5X, Exc Extra B 1X Rp 270,000
SWD 1X, USD 1X, Tens 1X Rp 180,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
SWD 1X, USD 1X, TENS 1X, EXC X 1X Rp 230,000
USD 1,5X, SWD 1X Rp 150,000
Exc B 1X Rp 150,000
USD 1,5 X, IFC 1X Rp 150,000
USD 1,5X, SWD 1X, Exc X 1X Rp 200,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
USD 1,5 X, IFC 1X Rp 150,000
Rp 21,790,000
Rp 17,432,000
Rp 4,358,000
Diterima,
Nama: Bpk Bambang Agus Mulyanto S.Ft
Spesia: Fisioterapi
Tarif :

9 3/2/2018 Dian Andriani, Ny
12 3/2/2018 Budi Santoso, Tn
15 3/2/2018 Soegianto Juarsa, Tn
22 3/5/2018 Alam, Tn
23 3/5/2018 Nur Wachid, Tn
25 3/5/2018 Hindarto, Tn
27 3/6/2018 Hj. Laspuri
30 3/6/2018 Budi Santoso, S. Pd, Tn
34 3/7/2018 Alam, Tn
37 3/7/2018 Abdus Shomad, Tn
41 3/8/2018 Njoo Soegiharto, Tn
44 3/9/2018 Alam, Tn
45 3/9/2018 Njoo Soegiharto, Tn
47 3/10/2018 The Mei- Mei, Ny
50 3/12/2018 Alam,Tn
51 3/12/2018 The Mei Mei,Ny
52 3/12/2018 Wanneke Mulyadi,Ny
53 3/13/2018 Nur Wachid,Tn
54 3/13/2018 Santoso Sastrowidjojo,Tn
55 3/13/2018 Ni Made Indriawati,Dra
57 3/13/2018 Elvis Dwi Oktavianto, Tn
58 3/14/2018 Bong Wong Irwan Saputra,Tn
59 3/14/2018 Alam,Tn
63 3/14/2018 Yani Kumala, Ny
64 3/14/2018 The Mei-Mei, Ny
67 3/15/2018 Gunawan, Tn
68 3/15/2018 Sugiyanto, Tn
69 3/15/2018 Yani Kumala,Ny
73 3/16/2018 Alam,Tn
80 3/19/2018 Alam,Tn
81 3/19/2018 Agus Hebi Djuniantoro, Tn
84 3/19/2018 Sulianto Teddy Purnama, Tn
88 3/19/2018 David Agung Bayu, Tn
96 3/21/2018 Alam,Tn
97 3/21/2018 Agus Hebi Djuniantoro, Tn
101 3/21/2018 Lusiana Gunawan, Ny
104 3/22/2018 Samsudin, Tn
109 3/23/2018 Alam, Tn
116 3/24/2018 Lusiana Gunawan,Ny
117 3/24/2018 Budi Utomo Gunawan,Tn
118 3/24/2018 Samsudin,Tn
119 3/26/2018 Ramli Muis, Tn
124 3/26/2018 Wanneke Mulyadi,Ny
126 3/26/2018 Iwan Radius,Sdr
128 3/26/2018 Sri Wuryani,Ny
129 3/27/2018 Ramli Muis, Tn
133 3/27/2018 Shirly Yunita Wijaya,Ny
134 3/27/2018 Benediktus Dicky Rukmanto, Tn
135 3/28/2018 Juliawati Laksmono
136 3/28/2018 Ramli Muis, Tn
139 3/28/2018 Alam, Tn
142 3/28/2018 Liliana, Ny
145 3/28/2018 Moedjiyo,Tn
147 3/28/2018 Lily juliana,Ny
148 3/28/2018 F.Ritski Sugiarti,Ny
150 3/29/2018 Tjandrawati,Ny
151 3/29/2018 Iwan Radius,Sdr
153 3/29/2018 Filia Indriani,Nn

Surabaya,

Bulan Mar-18
Ruang :

Exc B 1X Rp 150,000
USD 1,5X, Exc R 1X Rp 190,000
Exc B 1X, USD1X Rp 210,000
USD 1,5 X, IFC 1X Rp 150,000
SDW 3X, USD 2X, TENS 1X Rp 360,000
Exc B 1X Rp 150,000
SWD 1,5X, Exc Extra B Rp 270,000
Exc B 1X Rp 150,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1X, USD 1X, Exr R 1X Rp 220,000
USD 1,5 X, IFC 1X Rp 150,000
Exc B 1X Rp 150,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SDW 1X, USD 1,5X, EXC R 1X Rp 250,000
USD 1,5X, Exc R 1X Rp 190,000
Exc R1X, USD 1X Rp 160,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1X Rp 150,000
EXC B 1X Rp 150,000
USD 1,5 X, IFC 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1,5X, USD 1X, TENS 1X, Exc R 1x Rp 310,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1X, USD 1X, TENS 1X, EXC R 1X Rp 280,000
USD 1,5 X, IFC 1X Rp 150,000
Exc B Rp 150,000
SWD 1X, USD 1X, Exc B 1x Rp 270,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
USD 1,5X, TENS 1X, EXC B 1X Rp 300,000
SWD 1,5X, USD 1X, TENS 1X, EXC R 1x Rp 310,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1X Rp 60,000
USD 1,5 X, IFC 1X Rp 150,000
IR 1X, USD 1,5X, TENS 1X, EXC B 1X Rp 330,000
SWD 1X Rp 60,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
USD 1,5 X, IFC 1X Rp 150,000
EXC Extra B 1X Rp 180,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1X USD 1,5 Rp 150,000
USD 1X, TENS 1X, EXC R 1X Rp 220,000
EXC B 1X Rp 150,000
USD 1,5 X, IFC 1X Rp 150,000
SWD 1X USD 1,5 Rp 150,000
USD 2x, SWD 1X, EXC X 1X Rp 230,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1X Rp 60,000
EXC B 1X Rp 150,000
SWD 2X, USD 1,5X, TENS 1X, Exc R 1X Rp 370,000
SWD 1X, USD 1,5X Rp 150,000
Rp 32,950,000
Rp 26,360,000
Rp 6,590,000
Diterima,
Tarif :

2 4/2/2018 Alam,Tn
5 4/2/2018 Yuniawati Rahmansyah, Ny
9 4/3/2018 The Mei - Mei, Ny
11 4/3/2018 Lily Juliana,Ny
15 4/4/2018 Alam,Tn
16 4/4/2018 Nanik Sutini,Ny
17 4/4/2018 Sari Asmajanti,Ny
21 4/4/2018 The Mei - Mei, Ny
22 4/5/2018 Lily Susianti,Ny
23 4/5/2018 Marta Ingelina,Ny
28 4/6/2018 Alam,Tn
29 4/6/2018 Enny Pandowo,Ny
34 4/6/2018 The Mei- Mei, Ny
36 4/6/2018 Michael Tjokrowardojo, Sdr
37 4/6/2018 Mathew Maximilion, Sdr
38 4/7/2018 Soegiharto,Tn
39 4/7/2018 The Mei- Mei, Ny
43 4/9/2018 Shirly Yunita
54 4/11/2018 Septian Dicky Putra Agung
59 4/11/2018 Soegianto Juarsa,Tn
62 4/11/2018 Filia Indriani,Nn
63 4/11/2018 Go Budi Hartono,Tn
67 4/12/2018 Soegianto Juarsa, Tn
68 4/12/2018 Achmad Zainul R
72 4/13/2018 Alam,Tn
74 4/13/2018 Sisilia,Ny
77 4/16/2018 Alam,Tn
79 4/16/2018 Budi Santoso S.Pd,Tn
81 4/16/2018 Oei Tjiauw May,Ny
82 4/17/2018 Susanti Alim Widjaja,Ny
88 4/18/2018 Juliawati Laksmono,Ny
89 4/18/2018 Hendro Siswanto,Tn
91 4/18/2018 Alam,Tn
95 4/18/2018 Eliarosa,Ny
100 4/19/2018 Lili Susianti, Ny
101 4/19/2018 Juliawati Laksmono,Ny
102 4/19/2018 Susanti Alim Widjaja,Ny
103 4/19/2018 Hendro Siswanto,Tn
109 4/21/2018 Suyati, Ny
112 4/23/2018 Gunawan, Tn
116 4/23/2018 A.Agung Hari Prasetyo,Tn
118 4/24/2018 Estri, Ny
121 4/24/2018 A.Agung Hari Prasetyo,Tn
124 4/25/2018 Alam, Tn
128 4/25/2018 A.Agung Hari Prasetyo, Tn
129 4/25/2018 Abdus Shomad,Tn
130 4/26/2018 Hendro Siswanto, Tn
138 4/27/2018 Alam,Tn
142 4/27/2018 Shirly Yunita,Ny
148 4/30/2018 Alam,Tn
151 4/30/2018 Estri,Ny

Surabaya,

Bulan
Ruang

EXC B 1X Rp 150,000
USD 1,5 X, IFC 1X Rp 150,000
EXC EXTRA B 1X, SWD 1,5X Rp 270,000
SWD 2X, USD 1,5, TENS 1X, Exc R 1X Rp 370,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
USD 1,5 X, IFC 1X Rp 150,000
EXC R 1X, USD 1X Rp 160,000
USD 2,5X Rp 150,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
EXC EXTRA B 1X Rp 180,000
USD 1,5 X, IFC 1X Rp 150,000
EXC B 1X Rp 150,000
USD 1,5 X, IFC 1X Rp 150,000
EXC B 1X Rp 150,000
EXC Exstra B 1X Rp 180,000
SWD 2X, USD 1,5, TENS 1X, Exc R 1X Rp 370,000
EXC R 1X Rp 100,000
EXC B 1X Rp 150,000
EXC B 1X, IFC 1X Rp 210,000
EXC Exstra B 1X Rp 180,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1,5X, USD 1,5X, TENS 1X Rp 240,000
SWD 2X, USD 1,5, TENS 1X Rp 270,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
EXC R 1X, USD 1,5X Rp 190,000
EXC R 1X, USD 2X Rp 220,000
EXC B 1X Rp 150,000
SWD 1,5 , USD 1X, TENS 1X Rp 210,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1X, USD 1X, Exc R 1 Rp 220,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1X, USD 1,5X, EXC R 1X Rp 250,000
EXC B 1X Rp 150,000
SWD 2X, USD 2 X Rp 240,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 2X, USD 2 X Rp 240,000
SWD 1X, USD 1,5 X, Exc R 1X Rp 250,000
Exc B 1X Rp 150,000
Exc B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1X, USD 1 X Rp 120,000
Rp 31,130,000
Rp 24,904,000
Rp 6,226,000
Diterima,
Apr-18
:
Tarif :

3 5/2/2018 Alam,Tn
6 5/3/2018 Tjandrwati,Ny
8 5/3/2018 Fitri Ramadhani, Nn
11 5/4/2018 Alam,Tn
18 5/5/2018 Erid Amaluddien, Tn
19 5/7/2018 Alam, Tn
21 5/8/2018 Tjandrawati, Ny
26 5/9/2018 Gunawan, Tn
27 5/9/2018 Alam,Tn
30 5/11/2018 Bambang Budi Waluyo, Tn
31 5/11/2018 Alam,Tn
34 5/12/2018 Niko Yanwar Pribadi, Tn
37 5/14/2018 Alam, Tn
40 5/14/2018 Yati Ilfiani Anggari, Ny
42 5/15/2018 Sugeng,Tn
53 5/17/2018 Sugeng,Tn
58 5/18/2018 Alam, Tn
59 5/18/2018 Sugeng,Tn
60 5/18/2018 Rahmad Harmoko, Tn
63 5/19/2018 Pram Nugraha Jayaparna, Tn
64 5/19/2018 Damayanti, Ny
68 5/21/2018 Alam, Tn
69 5/21/2018 Sugeng, Tn
74 5/22/2018 Olga Tanudjaja, Ny
76 5/23/2018 Alam,Tn
83 5/25/2018 Alam,Tn
89 5/26/2018 Hari Winarno,Tn
91 5/28/2018 Alam,Tn
92 5/28/2018 Sugeng,Tn
98 5/30/2018 Alam,Tn
100 5/30/2018 Sugeng,Tn
105 5/30/2018 Sri Ruhyati, Ny

Surabaya,

EXC B 1X Rp 150,000
SWD 1,5X, USD 1,5X, Tens 1X Rp 240,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1,5X, USD 1X, Exc R 1X Rp 250,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1X, USD 1 X Rp 120,000
EXC R 1X Rp 100,000
EXC B 1X Rp 150,000
SWD 1X, USD 1 X Rp 120,000
EXC R 1X Rp 100,000
EXC R 1X Rp 100,000
SWD 1X, USD 1 X Rp 120,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
EXC R 1X Rp 100,000
EXC R 1X Rp 100,000
USD 2X, SWD 1,5X Rp 210,000
EXC B 1X Rp 150,000
EXC R 1X Rp 100,000 ENI
EXC EXTRA B 1X, SWD 1,5X Rp 270,000 GO BUDI
USD 1,5x, TENS 1X Rp 150,000
EXC EXTRA B 1X 180,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
EXC EXTRA B 1X, USD 1,5X, TENS 1X Rp 330,000
SWD 1X Rp 60,000
SWD 1X Rp 60,000
EXC B 1X Rp 150,000
EXC R 1X Rp 100,000
EXC B 1X Rp 150,000
USD 1,5X, TENS 1X Rp 150,000
EXC R 1X Rp 100,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1X, USD 1 X Rp 120,000
EXC R 1X Rp 100,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
EXC R 1X Rp 100,000
SWD 1X, USD 1 X Rp 120,000
EXC R 1X Rp 100,000
EXC B 1X, TENS 1X Rp 210,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
USD 1,5X, TENS 1X Rp 150,000
EXC R 1X Rp 100,000
SWD 1X, USD 1 X Rp 120,000
EXC R 1X Rp 100,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1X, USD 1 X Rp 120,000
EXC R 1X Rp 100,000
Rp 19,530,000
Rp 15,624,000
Rp 3,906,000
Diterima,
Tarif :

1 6/2/2018 Gunawan,Tn
6 6/4/2018 Alam,Tn
7 6/4/2018 Bambang Budi Waluyo,Tn
8 6/4/2018 Sugeng,Tn
10 6/4/2018 Olga Tanudjaja,Ny
11 6/4/2018 Linda Natasia,Ny
13 6/5/2018 Inge Sodankh, Ny
17 6/5/2018 Sitompul,Ny
19 6/6/2018 Inge Sodakh, Ny
21 6/6/2018 Alam,Tn
26 6/7/2018 Inge Sondakh,Ny
27 6/7/2018 Septian Dicky Putra Agung,Tn
30 6/8/2018 Inge Sodankh, Ny
31 6/8/2018 Alam, Tn
36 6/8/2018 Ribut Setyawati, Ny
51 6/12/2018 Sugeng,Tn
59 6/13/2018 Vincentius A paulo,Tn
64 6/21/2018 Listanti Wijani,Ny
69 6/23/2018 Vincentius A paulo,Tn
71 6/23/2018 Adi Waluyo,Tn
76 6/25/2018 Alam,Tn
79 6/25/2018 Nurhuda, Tn
81 6/25/2018 Ennywati Tjandra, Ny
83 6/26/2018 Sugeng,Tn
88 6/27/2018 Hana Sipan, Ny
96 6/29/2018 Alam,Tn
101 6/29/2018 nanik enggawati, Ny
105 6/30/2018 Marta ingelina, Ny
107 6/30/2018 Sulianto Tedy Purnama

Surabaya,

Bulan
Ruang

SWD 1X, USD 1,5X, EXC R 1X Rp 250,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
EXC R 1X Rp 100,000
USD 1,5X, TENS 1X Rp 150,000
SWD 1,5X, EXC EXTRA B 1X Rp 270,000
Nebulizer/ chest 1 Rp 50,000
EXC R 1X Rp 100,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
EXC R 1X Rp 100,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
EXC R 1X Rp 100,000
USD 1,5X, TENS 1X Rp 150,000
EXC R 1X Rp 100,000
SWD 1X, USD 1,5X Rp 150,000
EXC B 1X Rp 150,000
EXC R 1X Rp 100,000
USD 1,5 X, IFC 1X Rp 150,000
SWD 1X, USD 1X, EXC R 1X Rp 220,000
SWD 1X, USD 1,5X Rp 150,000
USD 1,5X, EXC R 1X Rp 190,000
SWD 1X, USD 1,5X Rp 150,000
SWD 1X, USD 1,5X Rp 150,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
EXC R 1X Rp 100,000
SWD 1X, USD 1,5X Rp 150,000
SWD 1,5X, USD 1,5, TENS 1X Rp 240,000
EXC B 1x Rp 150,000
SWD 1X, USD 1,5X Rp 150,000
SWD 1,5X, USD 1,5, TENS 1X Rp 240,000
EXC R 1X Rp 100,000
SWD 1,5X, USD 1,5, TENS 1X Rp 240,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
EXC R 1X Rp 100,000
USD 1 X, EXC B 1X Rp 210,000
SWD 1,5 X, EXC. EXTRA B 1 X Rp 270,000
SWD 1 X ,USD 1 X Rp 120,000
Rp 19,110,000
Rp 15,288,000
Rp 3,822,000
Diterima,
Jun-18
:
Tarif :

1 7/2/2018 Alam,Tn
6 7/2/2018 Nanik Enggawati, Ny
9 7/3/2018 Sugeng,Tn
11 7/3/2018 Oscar Nehemia Julianto, Tn
16 7/4/2018 Jong Lie Jing, Ny
18 7/4/2018 Bong Wong Irwan Saputra
19 7/4/2018 Alam, Tn
29 7/5/2018 Madelia Marici Tarigan, Ny
30 7/5/2018 Indriati, Ny
31 7/6/2018 Alam,Tn
32 7/6/2018 Sugeng, Tn
39 7/6/2018 Sunarsih Santoso, Ny
43 7/7/2018 Medelia Marici Tarigan, Nn
44 7/9/2018 Bong Wong Irwan Saputra
45 7/9/2018 Alam, Tn
46 7/9/2018 Sulianto Tedy purnama,Tn
47 7/9/2018 Sunarsih Santoso, Ny
52 7/9/2018 Lie Pek Hwa,Ny
56 7/11/2018 sri wuryani, Ny
59 7/11/2018 Maria Irawati, Ny
60 7/12/2018 Wenny Siantini, Ny
64 7/12/2018 Lie Pek Hwa,Ny
68 7/13/2018 Alam, Tn
76 7/13/2018 Maria Irawati, Ny
79 7/16/2018 Alam, Tn
81 7/16/2018 Karto Raharjo , Tn
84 7/16/2018 Adi Waluyo, Tn
89 7/17/2018 Karto Raharjo , Tn
90 7/17/2018 Sugeng, Tn
95 7/18/2018 Alam, Tn
100 7/18/2018 Marsandi, Tn
103 7/19/2018 Ramli Muis, Tn
105 7/20/2018 Alam, Tn
106 7/20/2018 Gunawan, Tn
107 7/20/2018 Ramli Muis, Tn
108 7/20/2018 Sugeng, Tn
110 7/20/2018 Lina Setyawati, Ny
113 7/20/2018 Adi Waluyo, Tn
116 7/20/2018 Sugiarto Tjokrowardjo, Tn
121 7/23/2018 Alam, Tn
123 7/23/2018 Lidia Lasuwardi,Ny
124 7/23/2018 Sugeng, Ny
126 7/23/2018 Indriati, Ny
128 7/24/2018 Karto Raharjo, Tn
131 7/24/2018 Ismana,Tn
132 7/24/2018 Indriati, Ny
127 7/25/2018 Ismana, Tn
129 7/25/2018 Alam, Tn
130 7/25/2018 Sulianto Tedy Purnama, Ny
131 7/25/2018 Indriati, Ny
137 7/26/2018 Toyib, Tn
139 7/26/2018 Ismana, Tn
143 7/27/2018 Ismana, Tn
145 7/27/2018 Olly Gondo Wijoyo, Ny
147 7/27/2018 Adi Waluyo, Tn
148 7/28/2018 Karto Raharjo, Tn
149 7/28/2018 Toyib, Tn
152 7/28/2018 Ismana,Tn
154 7/30/2018 Toyib, Tn
156 7/30/2018 Alam, Tn
157 7/30/2018 Setyawati Uetomo, Ny
158 7/30/2018 Rachmad Harmoko, Tn
159 7/30/2018 Ismana, Tn
162 7/30/2018 Adi Waluyo, Tn
166 7/31/2018 Setyawati Oetomo,Ny
167 7/31/2018 Sri Ruhyati,Ny

Surabaya,

Bulan
Ruang

EXC B 1X Rp 150,000
SWD, 1,5X, EXC EXTRA B 1X Rp 270,000
SWD 1,5, USD 1,5, TENS 1 Rp 240,000
exc R 1X, Rp 100,000
USD 1,5X, EFC 1X Rp 150,000
EXC B 1X Rp 150,000
EXC R 1X, Rp 100,000
SWD 1X Rp 60,000
EXC extra B 1X Rp 180,000
SWD 1X, USD 1,5X Rp 150,000
SWD 1X Rp 60,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1,5, EXC EXTRA B Rp 270,000
USD 1X, EXC B 1X Rp 210,000
EXC R 1X, Rp 100,000
SWD 1X Rp 60,000
SWD 1X, USD 1,5X Rp 150,000
SWD 1,5X, USD 2X, TENS 1X Rp 270,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1X Rp 60,000
SWD 1,5, EXC EXTRA B Rp 270,000
DWD 1,5X, USD 2X, TENS 1X Rp 270,000
USD 1,5X, EFC 1X Rp 150,000
SWD 1X Rp 60,000
EXC R 1X, Rp 100,000
USD 1X, USD 1X,TENS 1X Rp 180,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1,5X, EXC Extra B Rp 270,000
SWD 1X, USD 1,5X Rp 150,000
USD 1,5X, EFC 1X, IR 1X Rp 180,000
EXC B 1X Rp 150,000
EXC R 1X Rp 100,000
SWD 1X, USD 1,5X Rp 150,000
SWD 1,5X, USD 1,5X, Extra R 1X Rp 280,000
EXC R 1X Rp 100,000
EXC B 1X Rp 150,000
SWD 1X, USD 1,5X Rp 150,000
EXC B 1X Rp 150,000
SWD 1X, USD 1,5X Rp 150,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1X, USD 1,5X Rp 150,000
SWD 2X, USD 1X , TENS 1X Rp 240,000
EXC B 1X Rp 150,000
SWD 1X, USD 1,5X, Tens 1X Rp 210,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1X, USD 1,5X Rp 150,000
EXC R 1X Rp 100,000
SWD 2X, USD 1X , TENS 1X Rp 240,000
EXC B 1X Rp 150,000
SWD 1X, USD 1,5X Rp 150,000
SWD 1X, USD 1,5X, TENS 1X, EXC X 1X Rp 260,000
USD 1,5X, EXC B 1X Rp 240,000
EXC B 1X Rp 150,000
USD 1X, TENS 1X, EXC B Rp 270,000
EXC B 1X Rp 150,000
SWD 1X, USD 1,5X Rp 150,000
EXC R 1X Rp 100,000
SWD 2X, USD 1X , TENS 1X, EXC X Rp 290,000
SWD 1,5 X, USD 1,5 X , TENS 1X, EXC X Rp 290,000
EXC B 1X Rp 150,000
SWD 1X,USD 1,5X TENS 1X Rp 210,000
EXC B 1X Rp 150,000
SWD 2X, USD 1,5X Rp 210,000
EXC R 1X Rp 100,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
EXC R 1X Rp 100,000
SWD 2X, USD 1,5X Rp 210,000
USD 1,5 X, EXC B 1X Rp 240,000
EXC X 1X Rp 50,000
SWD 2X, USD 1,5X Rp 210,000
EXC B 1X Rp 150,000
EXC R 1X Rp 100,000
EXC B 1X Rp 150,000
EXC X 1X Rp 50,000
SWD 1X, USD 1X, TENS 1X, Rp 180,000
EXC X 1X Rp 50,000
EXC B 1X Rp 150,000
IR 1X, USD 1,5X, TENS 1X Rp 180,000
USD 1X Rp 60,000
SWD 1,5X, USD 1X, TENS 1X, EXC X 1X Rp 230,000
EXC R 1X Rp 100,000
EXC B 1X,ES 2X Rp 270,000
SWD 1 USD 1, TENS 1 Rp 180,000
Rp 33,510,000
Rp 26,808,000
Rp 6,702,000
Diterima,
Jul-18
:
Tarif :

2 8/1/2018 Alam, Tn
3 8/1/2018 Karto Rahardjo, Tn
4 8/1/2018 Olga Tanudjaja, Tn
5 8/1/2018 Donny Tjahyono, Tn
6 8/1/2018 Ismana, Tn
7 8/1/2018 Setyawati Oetomo, Ny
8 8/1/2018 Olly Gondo Wijaya
11 8/1/2018 Ando Winoto, Tn
14 8/2/2018 Septian Dicky
15 8/2/2018 Olga Tanudjaja, Tn
16 8/2/2018 Donny Tjahyono
17 8/2/2018 Sulianto Teddy Purnomo
19 8/2/2018 Ismana, Tn
20 8/2/2018 Setyawati Uetomo, Ny
22 8/3/2018 Gunawan, Tn
23 8/3/2018 wenny Siantini, Ny
25 8/3/2018 Alam, Tn
26 8/3/2018 Toyib, Tn
30 8/3/2018 Natalia Hendrawati, Ny
31 8/3/2018 Ismana, tn
38 8/4/2018 Setyowati Oetomo, Ny
41 8/6/2018 Alam, Tn
43 8/6/2018 Olga Tanudjaja, ny
46 8/6/2018 Hendrawati Tjhim, Ny
47 8/6/2018 Sunarsih Santoso , Ny
48 8/6/2018 Ivan Susilowidjojo Young , Tn
52 8/7/2018 Ismana, Tn
55 8/7/2018 Listiyowati Waluyo, Ny
56 8/7/2018 Ivan Susilowidjojo Young , Tn
57 8/8/2018 Alam, Tn
63 8/8/2018 Ivan Susilowidjojo Young, Tn
64 8/8/2018 Chen Shun Chu, Ny
70 8/9/2018 Sri Rahayu, Ny
72 8/9/2018 Sherry, Nn
78 8/10/2018 Alam, Tn
81 8/10/2018 Hendrawati, Ny
85 8/11/2018 Oeij Hong Tiap, Ny
89 8/13/2018 Alam, Tn
91 8/13/2018 Abdus shomad, Tn
95 8/14/2018 Gunawan, Tn
99 8/14/2018 Sherry, Nn
102 8/15/2018 Asmiin, Ny
103 8/15/2018 Alam, Tn
108 8/15/2018 Juanda Kurniadi , Tn
113 8/16/2018 Sari Asmajanti, Ny
116 8/18/2018 Asmiin, Ny
117 8/18/2018 Sri Ruhyati,Ny
119 8/20/2018 Alam, Tn
123 8/20/2018 Endang Fitriyawati,Ny
124 8/20/2018 Hendrawati Tjhim, Ny
125 8/21/2018 Asmiin, Ny
126 8/21/2018 Septian Dicky Putra Agung, Tn
127 8/21/2018 David Agung Bayu Anggita, Tn
131 8/21/2018 Adi Waluyo, Tn
133 8/23/2018 Asmiin, Ny
135 8/23/2018 Handi Oentario Wijaya , Tn
136 8/24/2018 Asmiin, Ny
137 8/24/2018 Alam, Tn
139 8/24/2018 Sherry Young , Nn
143 8/27/2018 Alam, Tn
148 8/28/2018 Asmiin, Ny
150 8/28/2018 Sugeng, Ny
152 8/28/2018 Sherry, Nn
155 8/29/2018 Alam, Tn
162 8/30/2018 Asmiin, Ny
164 8/31/2018 Alam, Tn
167 8/31/2018 Aiden Matthew, An

Surabaya,

Bulan
Ruang

EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1X, USD 1X, TENS 1X EXC,X 1X Rp 230,000
EXC R 1X Rp 100,000
SWD 2X, USD 1,5X Rp 210,000
SWD 2X, USD 1,5X Rp 210,000
EXC XB 1X Rp 180,000
SWD 1,5X EXC B 1X Rp 270,000
SWD 2X, USD 1,5X Rp 210,000
SWD 1X,USD 1X, TENS 1X Rp 180,000
USD 1,5X, EXC B 1X Rp 240,000
USD 1X, TENS 1X Rp 120,000
EXC B 1X Rp 150,000
EXC 1 X Rp 50,000
SWD 1,5X EXC EXTRA B 1X Rp 270,000
SWD 1,5 X, USD 1 XTENS 1X, EXC X Rp 260,000
USD 2X Rp 120,000
SWD 2X, USD 1,5X Rp 210,000
EXC B 1X Rp 150,000
SWD 1X Rp 60,000
SWD 1X Rp 60,000
SWD 1X, USD 1X, TENS 1X, EXC X 1X, Rp 230,000
SWD 1X, USD1X, TENS 1X Rp 180,000
SWD 1X Rp 60,000
EXC B 1X Rp 150,000
SWD 2X, USD 1,5X Rp 210,000
SWD 1X Rp 60,000
USD 1 X, EXC B 1X Rp 210,000
EXC B 1X Rp 150,000
SWD 1X Rp 60,000
SWD 2X, USD 1,5X Rp 210,000
EXC B 1X Rp 150,000
SWD 2X, USD 1,5X Rp 210,000
SWD 1X Rp 60,000
SWD 1,5X, USD 1,5X, TENS 1,5 X Rp 270,000
batal batal
EXC B 1X Rp 150,000
SWD 1X Rp 60,000
EXC B 1X Rp 150,000
SWD 1X Rp 60,000
USD 1,5X, EXC B 1X Rp 240,000
SWD 2X Rp 120,000
SWD 1X Rp 60,000
SWD 2X, USD 1,5X Rp 210,000
EXC R 1X Rp 100,000
EXC B 1X Rp 150,000
SWD 1X Rp 60,000
EXC EXTRA B 1x Rp 180,000
SWD 1X Rp 60,000
EXC B 1X Rp 150,000
SWD 1X Rp 60,000
SWD 2 x , USD 1,5 x Rp 270,000
SWD 1 USD 1, TENS 1 Rp 180,000
EXC B 1X Rp 150,000
SWD 1X Rp 60,000
EXC B 1X Rp 150,000
SWD 1X Rp 60,000
SWD 1X Rp 60,000
SWD 1,5X, USD 1X Rp 150,000
SWD 1,5X, USD 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 2X, USD 1,5X Rp 210,000
EXC B 1X Rp 150,000
SWD 2X, USD 1,5X Rp 210,000
SWD 1,5X, USD 1X Rp 150,000
SWD 2X, USD 1,5X Rp 210,000
EXC B 1X Rp 150,000
SWD IX, USD 1X, TENS 1X, EXC R 1X Rp 280,000
SWD 2X, USD 1,5X Rp 210,000
SWD 1,5X, USD 1X Rp 150,000
SWD 2X, USD 1,5X Rp 210,000
EXC B 1X Rp 150,000
IR 1X, EXC R,1X Rp 130,000
SWD 2X, USD 1,5X Rp 210,000
Rp 31,120,000
Rp 24,896,000
Rp 6,224,000
Diterima,
Aug-18
:
Tarif :

4 9/3/2018 Asmiin, Ny
7 9/3/2018 Aiden Metthew , An
8 9/3/2018 Endang Yudhawati, Ny
9 9/3/2018 Antonius Ouny W , Tn
10 9/4/2018 Linda Purnamasari, Ny
12 9/4/2018 Handi Oentario Wijaya, Tn
13 9/4/2018 Chen, Shun Chu ,Ny
14 9/4/2018 Ivan Susilowidjojo , Tn
15 9/5/2018 Alam, Tn
17 9/5/2018 Olly Gondo Wijoyo , Ny
18 9/5/2018 Koeswanto Setiawan , Tn
19 9/5/2018 Bambang Budi Waluyo , Tn
21 9/5/2018 Aiden Metthew , An
24 9/6/2018 Asmiin, Ny
29 9/7/2018 Alam, Tn
35 9/7/2018 Indrawati Rustantinah, Ny
38 9/8/2018 Asmiin, Ny
43 9/10/2018 Alam, Tn
44 9/10/2018 Asmiin, Ny
51 9/12/2018 Asmiin, Ny
52 9/12/2018 Alam, Tn
63 9/14/2018 Ainia Hj , Ny
64 9/15/2018 Asmiin, Ny
68 9/15/2018 Yunita Dewi, Ny
69 9/15/2018 Tjong Fenny, Ny
72 9/17/2018 Alam, Tn
75 9/17/2018 Soedjoko , Tn
79 9/18/2018 Asmiin, Ny
81 9/19/2018 Liaw Rudy Wirawan , Tn
87 9/20/2018 Ainia Hj , Ny
89 9/21/2018 Alam, Tn
98 9/22/2018 Asmiin, Ny
104 9/24/2018 Alam, Tn
105 9/24/2018 Asmiin, Ny
110 9/24/2018 Ainia Hj , Ny
113 9/26/2018 Alam, Tn
115 9/26/2018 Koeswanto Setiawan, Tn
116 9/26/2018 Edith Wibisono, Ny
120 9/27/2018 Sitti Hidjrah.S.PD.M.PD
130 9/29/2018 Gunawan, Tn

Surabaya,

Bulan
Ruang

EXC Extra B 1X Rp 180,000
SWD 1X, USD 1,5X Rp 150,000
SWD 1X Rp 60,000
SWD 2X, USD 1,5X Rp 210,000
IR 1X, EXC R,1X Rp 130,000
SWD 1,5X, USD 1,5X Rp 180,000
SWD 1X, USD 1X, IFC 1X Rp 180,000
SWD 2X , USD 1X Rp 180,000
EXC B 1X Rp 150,000
IR 2X, USD 2 X , EXC R,1X Rp 280,000
EXC R 1X Rp 100,000
SWD 2X, USD 1,5X Rp 210,000
IR 1X, EXC R,1X Rp 130,000
SWD 1,5X, USD 1,5X Rp 180,000
SWD 1X, USD 1,5X Rp 150,000
IR 2X, USD 2 X , EXC R,1X Rp 280,000
SWD 2X, USD 1,5X Rp 210,000
EXC B 1X Rp 150,000
SWD 1,5X, USD 1,5X Rp 180,000
SWD 2X, USD 1,5X Rp 210,000
SWD 1X,USD 1X,EXC R,1X Rp 280,000
IR 2X, USD 2 X , EXC R,1X Rp 280,000
EXC R 1X Rp 100,000
SWD 1,5X, USD 1X Rp 150,000
IR 2X, USD 2 X , EXC R,1X Rp 280,000
EXC B 1X Rp 150,000
SWD 1,5X, USD 1X Rp 150,000
SWD 2X, USD 1,5X Rp 210,000
SWD 1,5X, USD 1,5X Rp 180,000
IR 2X, USD 2 X , EXC R,1X Rp 280,000
EXC R 1X Rp 100,000
SWD 1,5X, USD 1X Rp 150,000
SWD 1,5X, USD 1X Rp 150,000
SWD IX, USD 1X, TENS 1X, EXC R 1X Rp 280,000
SWD 1,5X, USD 1,5X Rp 180,000
USD 1,5X, EFC 1X, Rp 150,000
EXC R 1X Rp 100,000
SWD 2X, USD 1,5X Rp 210,000
SWD 1,5X, USD 1,5X Rp 180,000
SWD IX, USD 1X, EXC R 1X Rp 220,000
SWD 1,5X, USD 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1,5X, USD 2,5X, TENS 1X, EXC X Rp 350,000
SWD 1,5X, USD 1,5X Rp 180,000
SWD 2X, USD 1,5X Rp 210,000
EXC R 1X Rp 100,000
SWD 1,5X, USD 1X Rp 150,000
SWD 1X, USD 1X, TENS 1X, EXC R 1 X Rp 280,000
EXC B 1x Rp 150,000
USD 1,5X, EFC 1X, Rp 150,000
EXC R 1X Rp 100,000
SWD 2X, USD 1,5X Rp 210,000
SWD 1,5X, USD 1X Rp 150,000
EXC B 1x Rp 150,000
SWD 1,5X, USD 1X Rp 150,000
EXC B 1X Rp 150,000
IR 2X, USD 2 X , EXC R,1X Rp 280,000
SWD 2X, USD 1,5X Rp 210,000
USD 1,5X, EFC 1X, Rp 150,000
EXC B 1X Rp 150,000
IR 2X, USD 2 X , EXC R,1X Rp 280,000
SWD 1,5 X, USD 1,5, EXC R 1X Rp 280,000
SWD 1,5 X, USD 1,5, EXC R 1X Rp 280,000
IR 2X, USD 2 X , EXC R,1X Rp 280,000
USD 1,5X, EFC 1X, Rp 150,000
SWD 1,5 X, USD 1,5, EXC R 1X, TENS 1X Rp 340,000
USD 1X , EXC B 1X Rp 240,000
Rp 26,710,000
Rp 21,368,000
Rp 5,342,000
Diterima,
Sep-18
:
Tarif :

2 10/1/2018 Alam, Tn
4 10/1/2018 Abdus Shomad , Tn
6 10/1/2018 Ainia Hj. Ny
8 10/2/2018 Olly Gondowidjojo , Ny
9 10/2/2018 Wanneke Mulyadi , Ny
11 10/3/2018 Alam, Tn
12 10/3/2018 Aditya Bernhagi , sdr
16 10/4/2018 Petty Irawati, Ny
19 10/4/2018 Aditya Bernhagi , Sdr
21 10/4/2018 Mathew Maximilion , Sdr
22 10/5/2018 Alam, Tn
28 10/5/2018 Tony Iskandar, Ny
30 10/6/2018 Mathew Maximilion , Sdr
32 10/8/2018 Alam, Tn
36 10/8/2018 Ainia Hj. Ny
42 10/10/2018 Alam, Tn
45 10/10/2018 Liliana, Ny
47 10/10/2018 Tri Hari Sugiyanto, Tn
52 10/11/2018 Sari Asmajanti, Ny
53 10/11/2018 Sri Sudarsih, Ny
55 10/12/2018 Alam, Tn
57 10/12/2018 Adyta Bernhagi , Sdr
62 10/13/2018 sri ruhyati
63 10/15/2018 Alam, Tn
65 10/15/2018 Sigit Pamungkas , Tn
70 10/17/2018 Alam, Tn
72 10/17/2018 Yudhianto Kurniawan, Tn
76 10/17/2018 Sigit Pamungkas , Tn
78 10/18/2018 Dra EC. Astuti Tri Nugraheni, Ny
79 10/18/2018 Sri Wulun , Ny
81 10/19/2018 Alam, Tn
82 10/19/2018 Lenny Gunawan, Ny
84 10/19/2018 Henny Gunawan, Ny
91 10/22/2018 Alam, Tn
97 10/24/2018 Alam, Tn
99 10/24/2018 Lusyana, Ny
107 10/26/2018 Alam, Tn
115 10/27/2018 Nova Mayasari, Ny
118 10/27/2018 Sri Hutami, Ny
119 10/29/2018 Alam, Tn
122 10/29/2018 Suwarni, Ny
126 10/29/2018 Nova Mayasari, Nn
127 10/29/2018 Lamini , Ny
129 10/29/2018 Lusiana gunawan , Ny
131 10/30/2018 Suwarni, Ny
133 10/30/2018 Lamini , Ny
135 10/30/2018 Ambrita , Ny
138 10/31/2018 Gandhi Faile, Tn
140 10/31/2018 Alam, Tn
142 10/31/2018 Suwarni, Ny

Surabaya,

Bulan
Ruang

USD 1X, SWD 1X, TENS 1X Rp 180,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 2 X , USD 1,5 X Rp 210,000
SWD 1 X , USD 1 X , EXC R 1 X Rp 220,000
SWD 1,5X, EXC ETRA B 1X Rp 270,000
EXC B 1 X , ES 2 X Rp 270,000
USD 1,5X, EFC 1X, Rp 150,000
EXC B 1X Rp 150,000
SWD 1X Rp 60,000
USD 1,5X, EFC 1X, Rp 150,000

SWD 1X Rp 60,000
SWD 2 X , USD 1,5 X Rp 210,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1X Rp 60,000
EXC B 1 X , ES 2 X Rp 270,000
USD 1,5X, EFC 1X, Rp 150,000
SWD 2X, USD 1X. Rp 180,000
EXC B 1X Rp 150,000
SWD 1X Rp 60,000
SWD 2 X , USD 1,5 X Rp 210,000
SWD 2 X , USD 1 X , EXC x 1 X Rp 220,000
EXC B 1 X , ES 2 X Rp 270,000
SWD 1X Rp 60,000
USD 1,5X, EFC 1X, Rp 150,000
SWD 2 X , USD 1,5 X Rp 210,000
EXC B 1X Rp 150,000
SWD 1X Rp 60,000
USD 1,5X, EFC 1X, Rp 150,000
SWD 2 X , USD 1,5 X Rp 210,000
SWD 1X, EXC B 1X Rp 210,000
EXC B 1X Rp 150,000
SWD 2 X , USD 1,5 X Rp 210,000
EXC B 1X Rp 150,000
EXC B 1 X , ES 2 X Rp 270,000
SWD 1X Rp 60,000
USD 1,5X, EFC 1X, Rp 150,000
IR 2X, USD 2 X , EXC R,1X Rp 280,000
SWD 2 X , USD 1,5 X Rp 210,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 1 X , USD 1,5 X Rp 150,000
USD 1,5X, EFC 1X, Rp 150,000
SWD 1X Rp 60,000
EXC B 1X, ES 2X Rp 270,000
EXC B 1X Rp 150,000
SWD 1X Rp 60,000
USD 1,5X, IFC 1X, Rp 150,000
SWD 2 X , USD 1,5 X Rp 210,000
SWD 1X Rp 60,000
SWD 1 X , USD 1,5 X Rp 150,000
EXC B 1X Rp 150,000
SWD 2 X , USD 1,5 X Rp 210,000
EXC B 1X Rp 150,000
USD 2X, EXC R 1X Rp 220,000
USD 1,5X, IFC 1X Rp 150,000
IR 1X, USD 1,5 X , Tens 1x Rp 180,000
SWD 2 X , USD 1,5 X Rp 210,000
SWD 1,5X, USD 1,5X, TENS 1X, EXC X 1X Rp 290,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
SWD 2 X , USD 1,5 X Rp 210,000
USD 1,5X, IFC 1X Rp 150,000
EXC B 1X Rp 150,000
USD 1,5X, IFC 1X Rp 150,000
SWD 2X, USD 1,5X, TENS 1,5X Rp 300,000
IR 1X, USD 1,5 X , Tens 1x Rp 180,000
SWD 2 X , USD 1,5 X Rp 210,000
IR 1X, USD 1,5 X , Tens 1x Rp 180,000
SWD 2 X , USD 1,5 X Rp 210,000
EXC B 1X Rp 150,000
USD 1,5X, SWD 1,5X, TENS 1X, EXC X 1X Rp 290,000
EXC B 1 X , ES 2 X Rp 270,000
SWD 2X, USD 1,5X, TENS 1,5X Rp 300,000
USD 1,5X, IFC 1X Rp 150,000
IR 1X, USD 1,5 X , Tens 1x Rp 180,000
SWD 2 X , USD 1,5 X Rp 210,000
USD 1,5X, SWD 1,5X, TENS 1X, EXC X 1X Rp 290,000
SWD 1X, USD1X Rp 120,000
EXC R 1X Rp 100,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
USD 0,5X, SWD 1X, TENS 1X Rp 150,000
USD 1 x , Exercise R 1 X Rp 160,000
USD 1,5X, IFC 1X Rp 150,000
SWD 2 X , USD 1,5 X Rp 210,000
SWD 2 X , USD 1,5 X Rp 210,000
SWD 1,5 X, USD 1,5 X, TENS 1X Rp 240,000
EXC B 1X Rp 150,000
EXC B 1X Rp 150,000
EXC B 1 X , ES 2 X Rp 270,000
Rp 25,710,000
Rp 20,568,000
Rp 5,142,000
Diterima,
Oct-18
:
Tarif :

4 11/2/2018 Alam, Tn
6 11/2/2018 Naga Suwarna Tanumulya, Tn
13 11/5/2018 Alam, Tn
29 11/7/2018 Wibisono.h, Tn
39 11/9/2018 Alam, Tn
40 11/9/2018 Wibisono.h, Tn
46 11/12/2018 Petty Irawati, Ny
48 11/12/2018 Karen Elizabeth, Nn
53 11/13/2018 Wibisono H., Tn
59 11/14/2018 Alam, Tn
63 11/14/2018 Ribka Avie Alreta, Ny
64 11/14/2018 Ratna Ningsih,Ny
65 11/15/2018 Wibisono H., Tn
68 11/15/2018 Lupita, Nn
72 11/17/2018 Nova Mayasari,Nn
73 11/21/2018 Alam, Tn
78 11/22/2018 Sri Hutami, Ny
81 11/23/2018 Alam, Tn
82 11/23/2018 Rasuna Hj, Ny
85 11/23/2018 A.Agung Hari Prasetyo, Tn
92 11/25/2018 Alam, Tn
93 11/25/2018 Yomy Cahya
95 11/27/2018 Yomy Cahya Kurniawan, Tn
97 11/28/2018 Alam, Tn
100 11/28/2018 Andrian Chandra, Sdr
101 11/28/2018 Ribka Avie Alreta, Ny
107 11/29/2018 Sri Hutami, Ny
109 11/30/2018 Alam, Tn

Surabaya,

EXC B 1X Rp 150,000
EXC R 1X Rp 100,000
EXC B 1X Rp 150,000
SWD 1X, USD 1X, EXERCISE R 1X Rp 220,000
EXC B 1X, ES 1X Rp 210,000
EXC B 1X, ES 1X Rp 210,000
EXC B 1X Rp 150,000
EXC R 1X Rp 100,000
EXC B 1 X , ES 2 X Rp 270,000
SWD 2 X , USD 1,5 X Rp 210,000
SWD 2 X , USD 1,5 X Rp 210,000
EXC B 1X, ES 1X Rp 210,000
SWD 1 X, USD 1 X, TENS 1X , EXERCISE R 1X Rp 230,000
USD 1,5X, IFC 1X Rp 150,000
SWD 1,5 X, EXC EXTRA B 1X Rp 270,000
EXC B 1 X , ES 2 X Rp 270,000
SWD 2 X , USD 1,5 X Rp 210,000
EXC B 1X, ES 1X Rp 210,000
EXC B 1X Rp 150,000
SWD 1 X, USD 1 X, TENS 1X , EXERCISE R 1X Rp 230,000
SWD 2 X , USD 1,5 X Rp 210,000
SWD 1X, Nebulizer 1X Rp 110,000
USD 1,5X, IFC 1X Rp 150,000
SWD 1,5X , EXC EXTRA B 1X Rp 270,000
SWD 1X Rp 60,000
EXC B 1X Rp 150,000
SWD 1X Rp 60,000
SWD 1X Rp 60,000
EXC R 1X Rp 100,000
SWD 1X Rp 60,000
SWD 1X Rp 60,000
USD 1,5X, IFC 1X Rp 150,000
EXC B 1X Rp 150,000
EXC R 1X Rp 100,000
EXC B 1X Rp 150,000
SWD 2X, USD 2X, TENS 1,5X Rp 330,000
USD 1,5X, IFC 1X Rp 150,000
SWD 1X, USD 1X, EXC.R 1X Rp 220,000
SWD 1,5X , EXC EXTRA B 1X Rp 270,000
EXC B 1X Rp 150,000
SWD 1X Rp 60,000
SWD 1,5X, ExC EXTRA B Rp 270,000
SWD 1X Rp 60,000
EXC EXTRA B Rp 180,000
EXC B 1X Rp 150,000
SWD 1X Rp 60,000
SWD 1X Rp 60,000
SWD 1X, USD 1,5X Rp 150,000
SWD 1X Rp 60,000
SWD 1,5X, ExC EXTRA B Rp 270,000
SWD 1X Rp 60,000
EXC R 1X Rp 100,000
SWD 2X, USD 1,5X Rp 210,000
EXC B 1X Rp 150,000
SWD 1X Rp 60,000
SWD 2X, USD 1,5X Rp 210,000
Rp 20,470,000
Rp 16,376,000
Rp 4,094,000
Diterima,
Bulan Nov-18
Ruang :
Tarif :

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
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68
69
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71
72
73
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76
77
78
79
80
81
82
83
84
85
86
87
88
89

Surabaya,

Bulan
Ruang

Rp -
Rp -
Rp -
Diterima,
Dec-18
:

Rekap Pendapatan Tahun 2018

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LAPORAN PENDAPATAN FISIOTERAPI

Nama : Bpk Bambang Agus Mulyanto S.Ft

No. Tanggal No Kartu Nama Pasien

Dibuat Oleh, Mengetahui,

Terapi Konsultasi (Rp)

No. Tanggal No Kartu Nama Pasien

Pendapatan yang diterima oleh dokter

Dibuat Oleh, Mengetahui,

Terapi Konsultasi (Rp)

No. Tanggal No Kartu Nama Pasien

Pendapatan yang diterima oleh dokter

Dibuat Oleh, Mengetahui,

Terapi Konsultasi (Rp)

No. Tanggal No Kartu Nama Pasien

Pendapatan yang diterima oleh dokter

Dibuat Oleh, Mengetahui,

Terapi Konsultasi (Rp)

No. Tanggal No Kartu Nama Pasien

Pendapatan yang diterima oleh dokter

Dibuat Oleh, Mengetahui,

No. Tanggal No Kartu Nama Pasien

Pendapatan yang diterima oleh dokter

Dibuat Oleh, Mengetahui,

Terapi Konsultasi (Rp)

No. Tanggal No Kartu Nama Pasien

Pendapatan yang diterima oleh dokter

Dibuat Oleh, Mengetahui,

Terapi Konsultasi (Rp)

No. Tanggal No Kartu Nama Pasien

Pendapatan yang diterima oleh dokter

Dibuat Oleh, Mengetahui,

Terapi Konsultasi (Rp)

No. Tanggal No Kartu Nama Pasien

Pendapatan yang diterima oleh dokter

Dibuat Oleh, Mengetahui,

Terapi Konsultasi (Rp)

No. Tanggal No Kartu Nama Pasien

Pendapatan yang diterima oleh dokter

Dibuat Oleh, Mengetahui,

Terapi Konsultasi (Rp)

SWD 1,5X, EXC ETRA B 1X Rp 270,000

No. Tanggal No Kartu Nama Pasien

Pendapatan yang diterima oleh dokter

Dibuat Oleh, Mengetahui,

No. Tanggal No Kartu Nama Pasien

Pendapatan yang diterima oleh dokter

Dibuat Oleh, Mengetahui,

Terapi Konsultasi (Rp)

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