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TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP

KE TIM CASEMIX
JANUARI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
1 1 Kamis / 05-01-2023 15:01:30 AM2301050393 IRDAWATI KELAS BEDAH 514867 0304R0011222V006894 12/29/2022 1/1/2023
2 2 Kamis / 05-01-2023 15:01:15 AM2301050394 HAIL GHAISAN HAMIZAN Ruang Anak 454594 0304R0011222V007128 12/30/2022 1/1/2023
3 3 Kamis / 05-01-2023 15:01:54 AM2301050395 SHANUM AFRIOSA PUTRY Ruang Bayi (PERINATOLOGI) 573885 0304R0011222V007309 12/31/2022 1/1/2023
4 4 Kamis / 05-01-2023 15:01:05 AM2301050397 AENY NURUL FADILLA Ruang Ambun Suri Lantai 3 (Interne) 573575 0304R0011222V005995 12/26/2022 1/2/2023
5 5 Kamis / 05-01-2023 15:01:41 AM2301050401 ERWINSYAH Ruang Jantung 573779 0304R0011222V006987 12/29/2022 1/1/2023
6 6 Kamis / 05-01-2023 15:01:32 AM2301050403 BOBBY APRIALDI Ruang Jantung 573804 0304R0011222V007023 12/30/2022 1/1/2023
7 7 Kamis / 05-01-2023 15:01:32 AM2301050404 SUPRIJANTO Ruang Jantung 496130 0304R0011222V005782 12/26/2022 1/2/2023
8 8 Kamis / 05-01-2023 15:01:14 AM2301050405 RISWAN EFENDI Ruang Jantung 573791 0304R0011222V006998 12/29/2022 1/2/2023
9 9 Kamis / 05-01-2023 15:01:15 AM2301050407 DELWATI Ruang Kebidanan 471098 0304R0011222V007277 12/31/2022 1/1/2023
10 10 Kamis / 05-01-2023 15:01:48 AM2301050409 YENI ASTRIA SUSI Ruang Kebidanan 365159 0304R0011222V006680 12/28/2022 1/1/2023
11 11 Kamis / 05-01-2023 15:01:26 AM2301050410 SITI NURAINI Ruang Kebidanan 321617 0304R0011222V007320 12/31/2022 1/2/2023
12 12 Kamis / 05-01-2023 15:01:51 AM2301050412 FAUZIAH RAHMI Ruang Kebidanan 331926 0304R0011222V007276 12/31/2022 1/2/2023
13 13 Kamis / 05-01-2023 15:01:47 AM2301050414 NELMAWATI Ruang Cindua Mato 427179 0304R0011222V002709 12/13/2022 1/2/2023
14 14 Kamis / 05-01-2023 15:01:53 AM2301050423 AUDIASMAN, BA. Ruang Cindua Mato 127009 0304R0011222V003609 12/15/2022 1/2/2023
15 1 Jumat / 06-01-2023 10:01:15 AM2301060104 M FATHIR NAYAKA Ruang Anak 524160 0304R0010123V000319 1/2/2023 1/2/2023
16 2 Jumat / 06-01-2023 10:01:18 AM2301060108 BY. NY. TIOUZA SARAH A. S Ruang Bayi (PERINATOLOGI) 573605 0304R0011222V006325 12/27/2022 1/3/2023
17 3 Jumat / 06-01-2023 10:01:55 AM2301060109 BY. NY RETNAWATI Ruang Bayi (PERINATOLOGI) 573895 0304R0010123V000256 1/1/2023 1/2/2023
18 4 Jumat / 06-01-2023 10:01:22 AM2301060110 BAYI NYONYA TETEN PERMATA Y 1 Ruang Bayi (PERINATOLOGI) 573116 0304R0011222V003614 12/15/2022 1/2/2023
19 5 Jumat / 06-01-2023 10:01:59 AM2301060112 ZAID ALTHAFARIZQI PUTRA Ruang Anak 537578 0304R0010123V000030 1/1/2023 1/3/2023
20 6 Jumat / 06-01-2023 10:01:41 AM2301060115 SATRI GUSTIANA Ruang Cindua Mato 221972 0304R0011222V005750 12/25/2022 1/3/2023
21 7 Jumat / 06-01-2023 10:01:57 AM2301060120 ARNETI Ruang Ambun Suri Lantai 3 (Interne) 573721 0304R0011222V006677 12/28/2022 1/3/2023
22 8 Jumat / 06-01-2023 10:01:53 AM2301060122 ZULHENDRI Ruang Ambun Suri Lantai 3 (Interne) 573649 0304R0011222V006367 12/27/2022 1/2/2023
23 9 Jumat / 06-01-2023 10:01:14 AM2301060146 MURNI Ruang Ambun Suri Lantai 3 (Interne) 573604 0304R0011222V006057 12/27/2022 1/2/2023
24 10 Jumat / 06-01-2023 10:01:57 AM2301060149 SUARDI Ruang Ambun Suri Lantai 3 (Interne) 464412 0304R0010123V000017 1/1/2023 1/1/2023
25 11 Jumat / 06-01-2023 10:01:38 AM2301060153 TIASNA Ruang Ambun Suri Lantai 3 (Interne) 573595 0304R0011222V006025 12/26/2022 1/3/2023
26 12 Jumat / 06-01-2023 10:01:47 AM2301060162 CAMELIA Ruang Ambun Suri Lantai 3 (Interne) 417356 0304R0011222V006990 12/29/2022 1/3/2023
27 13 Jumat / 06-01-2023 10:01:05 AM2301060166 MARTINI Ruang Ambun Suri Lantai 3 (Interne) 573667 0304R0011222V006396 12/28/2022 1/3/2023
28 14 Jumat / 06-01-2023 10:01:43 AM2301060168 HENDRI Ruang Ambun Suri Lantai 3 (Interne) 543918 0304R0011222V006369 12/27/2022 1/2/2023
29 15 Jumat / 06-01-2023 10:01:52 AM2301060189 DEVI Ruang Ambun Suri Lantai 3 (Interne) 345120 0304R0011222V006612 12/27/2022 1/2/2023
30 16 Jumat / 06-01-2023 10:01:42 AM2301060194 IKBAL NOPRI Ruang Ambun Suri Lantai 3 (Interne) 573509 0304R0011222V005669 12/24/2022 1/2/2023
31 17 Jumat / 06-01-2023 10:01:30 AM2301060198 RINI BERLIANTI Ruang Jantung 320565 0304R0011222V006700 12/29/2022 1/3/2023
32 1 Senin / 09-01-2023 9:01:20 AM2301090085 shopia Ruang Kebidanan 573808 0304R0011222V007322 12/30/2022 1/2/2023
33 2 Senin / 09-01-2023 9:01:15 AM2301090087 KAS MELA SARI Ruang Kebidanan 573837 0304R0011222V007187 12/30/2022 1/3/2023
34 3 Senin / 09-01-2023 9:01:12 AM2301090089 RETNAWATI Ruang Kebidanan 443764 0304R0011222V007321 12/31/2022 1/3/2023
35 4 Senin / 09-01-2023 9:01:45 AM2301090090 DARMAYANTI Ruang Kebidanan 245347 0304R0010123V000668 1/1/2023 1/3/2023
36 5 Senin / 09-01-2023 9:01:58 AM2301090091 SYAFIRA AMALIYA Ruang ICU/ICCU 572028 0304R0011222V001720 12/8/2022 1/3/2023
37 6 Senin / 09-01-2023 9:01:08 AM2301090093 ERIATI Ruang Bedah 572495 0304R0011222V006924 12/29/2022 1/1/2023
38 7 Senin / 09-01-2023 9:01:02 AM2301090098 GIBRAN ALFAREZY Ruang Bedah 573102 0304R0011222V006240 12/27/2022 1/1/2023
39 8 Senin / 09-01-2023 9:01:58 AM2301090101 EFRIZAL Ruang Bedah 567759 0304R0011222V006863 12/29/2022 1/1/2023
40 9 Senin / 09-01-2023 9:01:22 AM2301090102 FAISAL Ruang Bedah 573725 0304R0011222V006698 12/28/2022 1/1/2023
41 10 Senin / 09-01-2023 9:01:24 AM2301090104 KHAIDIR Ruang Bedah 283065 0304R0011222V007252 12/30/2022 1/1/2023
42 11 Senin / 09-01-2023 9:01:59 AM2301090105 HERLIZA AGUSTIN Ruang Bedah 453034 0304R0011222V006618 12/28/2022 1/1/2023
43 12 Senin / 09-01-2023 9:01:46 AM2301090107 EMI AFNIDA KELAS BEDAH 477069 0304R0011222V006991 12/29/2022 1/1/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
JANUARI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
44 13 Senin / 09-01-2023 9:01:38 AM2301090109 ELLY Ruang Bedah 571097 0304R0010123V000012 1/1/2023 1/2/2023
45 14 Senin / 09-01-2023 9:01:09 AM2301090112 LUSI AGUSTI Ruang Bedah 572829 0304R0010123V000009 1/1/2023 1/2/2023
46 15 Senin / 09-01-2023 9:01:23 AM2301090114 SYAMSUIR KELAS BEDAH 559403 0304R0010123V000016 1/1/2023 1/2/2023
47 16 Senin / 09-01-2023 9:01:33 AM2301090118 HAMIDAH Ruang Bedah 573304 0304R0010123V000191 1/1/2023 1/2/2023
48 17 Senin / 09-01-2023 9:01:33 AM2301090121 JONI BENDRI Ruang Bedah 485257 0304R0011222V003998 12/18/2022 1/2/2023
49 18 Senin / 09-01-2023 9:01:52 AM2301090122 M.RIZAL Ruang Bedah 356765 0304R0010123V000008 1/1/2023 1/2/2023
50 19 Senin / 09-01-2023 9:01:56 AM2301090126 SLAMET HARDI Ruang Bedah 568743 0304R0011222V006992 12/29/2022 1/2/2023
51 20 Senin / 09-01-2023 9:01:49 AM2301090127 BUNGA RATNA DEWI Ruang Jantung 259054 0304R0010123V000351 1/2/2023 1/4/2023
52 21 Senin / 09-01-2023 9:01:45 AM2301090129 RITA SUSANTI Ruang Jantung 573977 0304R0010123V000352 1/2/2023 1/4/2023
53 22 Senin / 09-01-2023 9:01:13 AM2301090131 RENI AMELIA Ruang Ambun Suri Lantai 3 (Interne) 492308 0304R0010123V000041 1/1/2023 1/4/2023
54 23 Senin / 09-01-2023 9:01:11 AM2301090133 MUHAMMAD FADHIL Ruang Mata/THT/BEDAH MULUT 570102 0304R0010123V000298 1/2/2023 1/4/2023
55 24 Senin / 09-01-2023 10:01:04 AM2301090135 DEWI MAYA SARI Ruang Mata/THT/BEDAH MULUT 314535 0304R0010123V000316 1/2/2023 1/4/2023
56 25 Senin / 09-01-2023 10:01:53 AM2301090138 ANNISA DARUSSALAM Ruang Mata/THT/BEDAH MULUT 216427 0304R0010123V000317 1/2/2023 1/4/2023
57 26 Senin / 09-01-2023 10:01:24 AM2301090140 SYAHRAMA FATHAN MIRAFRI Ruang Mata/THT/BEDAH MULUT 574033 0304R0010123V000689 1/3/2023 1/4/2023
58 27 Senin / 09-01-2023 14:01:47 AM2301090462 YULIA DINDA ARISTA Ruang Kebidanan 16955 0304R0010123V000339 1/2/2023 1/4/2023
59 28 Senin / 09-01-2023 14:01:59 AM2301090463 MISKAH KHAIRANI Ruang Kebidanan 573386 0304R0011222V007293 12/31/2022 1/4/2023
60 29 Senin / 09-01-2023 15:01:35 AM2301090465 YUSNAINI SIDDIK Ruang Cindua Mato 335082 0304R0011222V006060 12/27/2022 1/5/2023
61 30 Senin / 09-01-2023 15:01:36 AM2301090466 DONI YUNARDI Ruang Ambun Suri Lantai 3 (Interne) 573801 0304R0011222V007021 12/30/2022 1/5/2023
62 31 Senin / 09-01-2023 15:01:38 AM2301090467 ERNAWATI Ruang Ambun Suri Lantai 3 (Interne) 470362 0304R0011222V003022 12/13/2022 1/4/2023
63 32 Senin / 09-01-2023 15:01:17 AM2301090468 DAMRIS Ruang Ambun Suri Lantai 3 (Interne) 574013 0304R0010123V000664 1/3/2023 1/4/2023
64 33 Senin / 09-01-2023 15:01:02 AM2301090469 YULIA FITRIYEN Ruang Ambun Suri Lantai 3 (Interne) 573898 0304R0010123V000036 1/1/2023 1/5/2023
65 34 Senin / 09-01-2023 15:01:01 AM2301090470 MIRDAWATI Ruang Ambun Suri Lantai 3 (Interne) 564528 0304R0011122V006462 11/28/2022 1/4/2023
66 35 Senin / 09-01-2023 15:01:47 AM2301090471 DONNY MIRAZEL Ruang Ambun Suri Lantai 3 (Interne) 573659 0304R0011222V007004 12/27/2022 1/5/2023
67 36 Senin / 09-01-2023 15:01:27 AM2301090472 SUWIRMAN Ruang Ambun Suri Lantai 3 (Interne) 573728 0304R0011222V006705 12/29/2022 1/5/2023
68 37 Senin / 09-01-2023 15:01:09 AM2301090473 NAIFAH Ruang Ambun Suri Lantai 3 (Interne) 542328 0304R0011222V006035 12/26/2022 1/5/2023
69 38 Senin / 09-01-2023 15:01:49 AM2301090474 BY. NY. NOVI YULIANI Ruang Bayi (PERINATOLOGI) 573662 0304R0011222V006960 12/27/2022 1/5/2023
70 39 Senin / 09-01-2023 15:01:40 AM2301090475 DANUAR Ruang Jantung 573925 0304R0010123V000331 1/2/2023 1/5/2023
71 40 Senin / 09-01-2023 15:01:27 AM2301090476 IRWAN Ruang Jantung 574019 0304R0010123V000657 1/3/2023 1/5/2023
72 41 Senin / 09-01-2023 15:01:09 AM2301090477 ELVI SOFIA Ruang Jantung 570765 0304R0010123V000344 1/2/2023 1/5/2023
73 42 Senin / 09-01-2023 15:01:12 AM2301090478 ZAMRIATY Ruang Jantung 573941 0304R0010123V000264 1/2/2023 1/5/2023
74 43 Senin / 09-01-2023 15:01:26 AM2301090479 MURHAN Ruang Jantung 573894 0304R0010123V000001 1/1/2023 1/5/2023
75 44 Senin / 09-01-2023 15:01:16 AM2301090480 KARDINA Ruang Mata/THT/BEDAH MULUT 570072 0304R0010123V000633 1/3/2023 1/5/2023
76 45 Senin / 09-01-2023 15:01:07 AM2301090481 HUMAIRA JENDAYA WIBOWO Ruang Anak 504078 0304R0010123V000940 1/4/2023 1/4/2023
77 46 Senin / 09-01-2023 15:01:46 AM2301090482 BY NY SHOPIA Ruang Bayi (PERINATOLOGI) 573843 0304R0011222V007326 12/30/2022 1/4/2023
78 47 Senin / 09-01-2023 15:01:56 AM2301090483 DESVIANTO Ruang Ambun Suri Lantai 3 (Interne) 372499 0304R0011222V006996 12/29/2022 1/4/2023
79 48 Senin / 09-01-2023 15:01:31 AM2301090484 FERA WATI Ruang Ambun Suri Lantai 3 (Interne) 337134 0304R0011222V006037 12/26/2022 1/2/2023
80 1 Selasa / 10-01-2023 10:01:45 AM2301100080 MUHAMMAD SAIF ARFAN Ruang Anak 548070 0304R0010123V000947 1/4/2023 1/5/2023
81 2 Selasa / 10-01-2023 10:01:27 AM2301100081 ABIL SHIDQI ALFAREZY Ruang Anak 569916 0304R0010123V000699 1/3/2023 1/6/2023
82 3 Selasa / 10-01-2023 10:01:09 AM2301100082 MEGI HERMAN Ruang Ambun Suri Lantai 3 (Interne) 543239 0304R0010123V000682 1/3/2023 1/6/2023
83 4 Selasa / 10-01-2023 10:01:01 AM2301100083 SYAFHEN RUSTAM Ruang Ambun Suri Lantai 3 (Interne) 346082 0304R0010123V000330 1/2/2023 1/6/2023
84 5 Selasa / 10-01-2023 10:01:10 AM2301100089 ASMIR Ruang Ambun Suri Lantai 3 (Interne) 573680 0304R0011222V006661 12/28/2022 1/4/2023
85 6 Selasa / 10-01-2023 11:01:04 AM2301100091 OKTA WILDA Ruang Kebidanan 573560 0304R0010123V000634 1/2/2023 1/6/2023
86 7 Selasa / 10-01-2023 11:01:00 AM2301100093 YENDRAWATI Ruang Kebidanan 573586 0304R0010123V000567 1/3/2023 1/6/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
JANUARI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
87 8 Selasa / 10-01-2023 11:01:45 AM2301100094 TIARA Ruang Kebidanan 570270 0304R0010123V000040 1/1/2023 1/6/2023
88 9 Selasa / 10-01-2023 11:01:37 AM2301100095 RODI HARTONO Ruang Jantung 574037 0304R0010123V000698 1/3/2023 1/6/2023
89 10 Selasa / 10-01-2023 11:01:59 AM2301100115 SUDIRMAN Ruang Jantung 574038 0304R0010123V000697 1/3/2023 1/6/2023
90 11 Selasa / 10-01-2023 11:01:54 AM2301100119 HARMON Ruang Jantung 254813 0304R0010123V000960 1/4/2023 1/6/2023
91 12 Selasa / 10-01-2023 11:01:39 AM2301100121 DARWANDI DARWIS Ruang Cindua Mato 573887 0304R0011222V007325 12/31/2022 1/6/2023
92 13 Selasa / 10-01-2023 11:01:55 AM2301100124 YUSNIDAR Ruang Cindua Mato 310549 0304R0010123V000900 1/4/2023 1/5/2023
93 14 Selasa / 10-01-2023 11:01:27 AM2301100131 YUNIDAR Ruang Cindua Mato 568862 0304R0011222V006836 12/29/2022 1/5/2023
94 15 Selasa / 10-01-2023 11:01:28 AM2301100134 AMNAWATI Ruang Kebidanan 572710 0304R0011222V007292 12/31/2022 1/4/2023
95 16 Selasa / 10-01-2023 11:01:08 AM2301100147 SYAMNELLI Ruang Bedah 429851 0304R0010123V000005 1/1/2023 1/4/2023
96 17 Selasa / 10-01-2023 11:01:59 AM2301100148 MARLIN Ruang Bedah 573390 0304R0011222V004998 12/21/2022 1/3/2023
97 18 Selasa / 10-01-2023 11:01:51 AM2301100150 MUNIR Ruang Bedah 573408 0304R0011222V005353 12/22/2022 1/3/2023
98 19 Selasa / 10-01-2023 11:01:05 AM2301100152 JANUAR IBRAHIM KELAS BEDAH 572286 0304R0010123V000015 1/1/2023 1/4/2023
99 20 Selasa / 10-01-2023 11:01:26 AM2301100153 HARLIS MAWATI Ruang Bedah 573432 0304R0010123V000334 1/2/2023 1/3/2023
100 21 Selasa / 10-01-2023 11:01:01 AM2301100159 EMRALIS Ruang Bedah 552810 0304R0010123V000332 1/2/2023 1/3/2023
101 22 Selasa / 10-01-2023 11:01:06 AM2301100162 ADI ROSMA Ruang Bedah 452608 0304R0010123V000665 1/3/2023 1/4/2023
102 23 Selasa / 10-01-2023 11:01:49 AM2301100164 TRESMY NOFERILA MARTA Ruang Bedah 396694 0304R0010123V000335 1/2/2023 1/4/2023
103 24 Selasa / 10-01-2023 11:01:42 AM2301100166 MERI SUSANTI Ruang Bedah 572825 0304R0011222V006674 12/28/2022 1/4/2023
104 25 Selasa / 10-01-2023 11:01:45 AM2301100182 ZULNOFRI Ruang Bedah 573778 0304R0011222V007233 12/30/2022 1/4/2023
105 26 Selasa / 10-01-2023 12:01:01 AM2301100190 NELFITA KELAS BEDAH 571356 0304R0010123V000667 1/3/2023 1/4/2023
106 27 Selasa / 10-01-2023 12:01:37 AM2301100191 VENI ROZA KELAS BEDAH 282484 0304R0010123V000532 1/3/2023 1/4/2023
107 28 Selasa / 10-01-2023 12:01:32 AM2301100193 YARNIS Ruang Bedah 549086 0304R0011222V006988 12/29/2022 1/4/2023
108 29 Selasa / 10-01-2023 12:01:08 AM2301100197 MARNI Ruang Bedah 573407 0304R0010123V000184 1/2/2023 1/3/2023
109 30 Selasa / 10-01-2023 12:01:56 AM2301100203 ANNISA MELISA Ruang Bedah 248801 0304R0010123V000325 1/2/2023 1/3/2023
110 31 Selasa / 10-01-2023 12:01:40 AM2301100210 BALKIS Ruang Bedah 569410 0304R0010123V000321 1/2/2023 1/3/2023
111 32 Selasa / 10-01-2023 12:01:47 AM2301100213 SULASTRI Ruang Bedah 563099 0304R0010123V000333 1/2/2023 1/3/2023
112 33 Selasa / 10-01-2023 12:01:33 AM2301100226 OOH Ruang Bedah 573215 0304R0011222V004032 12/19/2022 1/3/2023
113 34 Selasa / 10-01-2023 12:01:57 AM2301100230 RUSTAM EFENDI Ruang Bedah 571395 0304R0010123V000006 1/1/2023 1/3/2023
114 35 Selasa / 10-01-2023 12:01:40 AM2301100234 EFNARITA Ruang Mata/THT/BEDAH MULUT 573241 0304R0010123V000964 1/4/2023 1/6/2023
115 36 Selasa / 10-01-2023 12:01:45 AM2301100236 AQLAN ALMUZZAMMIL AFSA Ruang Mata/THT/BEDAH MULUT 569718 0304R0010123V000925 1/4/2023 1/6/2023
116 37 Selasa / 10-01-2023 14:01:22 AM2301100345 SURANI Ruang Mata/THT/BEDAH MULUT 328448 0304R0010123V000921 1/4/2023 1/6/2023
117 38 Selasa / 10-01-2023 14:01:26 AM2301100348 NURMI Ruang Mata/THT/BEDAH MULUT 411732 0304R0010123V000923 1/4/2023 1/6/2023
118 39 Selasa / 10-01-2023 14:01:07 AM2301100349 FANNY ZAHRATUL HAYATI KELAS BEDAH 573732 0304R0010123V000616 1/3/2023 1/6/2023
119 40 Selasa / 10-01-2023 15:01:08 AM2301100357 ALVIN KHAIRI ASSHIDIQIY Ruang Cindua Mato 573905 0304R0010123V000039 1/1/2023 1/4/2023
120 1 Rabu / 11-01-2023 11:01:00 AM2301110129 AHMAD Ruang Jantung 548185 0304R0011222V007250 12/30/2022 1/7/2023
121 2 Rabu / 11-01-2023 11:01:05 AM2301110133 ELLY MURTI Ruang Jantung 568717 0304R0010123V001247 1/5/2023 1/8/2023
122 3 Rabu / 11-01-2023 11:01:59 AM2301110137 ALI USMAN Ruang Jantung 573994 0304R0010123V000659 1/3/2023 1/8/2023
123 4 Rabu / 11-01-2023 11:01:32 AM2301110139 EZA DEWITA Ruang Kebidanan 574083 0304R0010123V000978 1/4/2023 1/6/2023
124 5 Rabu / 11-01-2023 11:01:11 AM2301110145 RAUDHATUL JANNAH Ruang Kebidanan 463344 0304R0010123V001367 1/5/2023 1/8/2023
125 6 Rabu / 11-01-2023 11:01:07 AM2301110148 ERNI Ruang Kebidanan 574215 0304R0010123V001720 1/7/2023 1/8/2023
126 7 Rabu / 11-01-2023 11:01:58 AM2301110152 JUWITA VEGONAS Ruang Kebidanan 508000 0304R0010123V001704 1/7/2023 1/8/2023
127 8 Rabu / 11-01-2023 11:01:04 AM2301110155 NELFI FITRIA Ruang Kebidanan 574099 0304R0010123V001007 1/5/2023 1/7/2023
128 9 Rabu / 11-01-2023 11:01:30 AM2301110159 SITI DAHLIA Ruang Kebidanan 574097 0304R0010123V001003 1/5/2023 1/7/2023
129 10 Rabu / 11-01-2023 11:01:16 AM2301110163 DEWI ISTIANA Ruang Kebidanan 386921 0304R0010123V001004 1/5/2023 1/7/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
JANUARI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
130 11 Rabu / 11-01-2023 11:01:02 AM2301110165 BETRI MARNITA Ruang Kebidanan 574067 0304R0010123V000943 1/4/2023 1/6/2023
131 12 Rabu / 11-01-2023 11:01:48 AM2301110170 SANTIA DENI Ruang Kebidanan 574135 0304R0010123V001355 1/5/2023 1/6/2023
132 13 Rabu / 11-01-2023 11:01:46 AM2301110173 SESMITA Ruang Kebidanan 574098 0304R0010123V001005 1/5/2023 1/6/2023
133 14 Rabu / 11-01-2023 11:01:37 AM2301110182 BY. NY RIKA DESRIANTI Ruang Bayi (PERINATOLOGI) 573287 0304R0011222V004617 12/20/2022 1/6/2023
134 15 Rabu / 11-01-2023 11:01:22 AM2301110186 BY NY DARMAYANTI Ruang Bayi (PERINATOLOGI) 573909 0304R0010123V000679 1/1/2023 1/6/2023
135 16 Rabu / 11-01-2023 11:01:10 AM2301110189 BY. NY. BETRI MARNITA Ruang Bayi (PERINATOLOGI) 574085 0304R0010123V001265 1/4/2023 1/8/2023
136 17 Rabu / 11-01-2023 11:01:58 AM2301110192 BAYI NYONYA DILA AULIA ALEM Ruang Bayi (PERINATOLOGI) 573878 0304R0011222V007302 12/31/2022 1/6/2023
137 18 Rabu / 11-01-2023 11:01:25 AM2301110197 KAHLIL GIBRAN Ruang Anak 567784 0304R0010123V000607 1/3/2023 1/9/2023
138 19 Rabu / 11-01-2023 11:01:39 AM2301110204 ATTHARAZKA ABILAL H Ruang Anak 549224 0304R0010123V001380 1/5/2023 1/7/2023
139 20 Rabu / 11-01-2023 11:01:33 AM2301110326 ABDUL HAFIZ Ruang Anak 574122 0304R0010123V001323 1/5/2023 1/8/2023
140 21 Rabu / 11-01-2023 13:01:23 AM2301110272 MUSLIM Ruang Cindua Mato 562495 0304R0010123V000338 1/2/2023 1/6/2023
141 22 Rabu / 11-01-2023 13:01:41 AM2301110273 ERMIATI Ruang Mata/THT/BEDAH MULUT 466410 0304R0010123V000673 1/3/2023 1/9/2023
142 23 Rabu / 11-01-2023 13:01:33 AM2301110274 ISMAIL SIREGAR Ruang ICU/ICCU 574221 0304R0010123V001729 1/7/2023 1/9/2023
143 24 Rabu / 11-01-2023 13:01:40 AM2301110275 SYAHRIZAL Ruang ICU/ICCU 574197 0304R0010123V001671 1/6/2023 1/8/2023
144 25 Rabu / 11-01-2023 14:01:04 AM2301110280 ISWANDY AYUB RuangICU/ICCU 573602 0304R0011222V006048 12/26/2022 1/6/2023
145 26 Rabu / 11-01-2023 14:01:06 AM2301110282 MUSLIM Ruang ICU/ICCU 574177 0304R0010123V001409 1/6/2023 1/6/2023
146 27 Rabu / 11-01-2023 14:01:03 AM2301110295 ALLISA QOTTRUNNADA ARIFAH Ruang Bedah 571182 0304R0010123V000007 1/1/2023 1/5/2023
147 28 Rabu / 11-01-2023 14:01:16 AM2301110298 YUSIRLON MASSA KELAS BEDAH 573098 0304R0010123V000234 1/2/2023 1/5/2023
148 29 Rabu / 11-01-2023 14:01:46 AM2301110300 ROSNA KELAS BEDAH 573727 0304R0011222V006707 12/29/2022 1/5/2023
149 30 Rabu / 11-01-2023 14:01:48 AM2301110301 IBNU FAJAR AL ZIQRI KELAS BEDAH 505210 0304R0010123V000022 12/1/2022 1/6/2023
150 31 Rabu / 11-01-2023 14:01:39 AM2301110304 ASRIL Ruang Bedah 568056 0304R0010123V000847 1/4/2023 1/5/2023
151 32 Rabu / 11-01-2023 14:01:34 AM2301110311 YULISA KHAIRANI Ruang Bedah 573943 0304R0010123V000678 1/3/2023 1/5/2023
152 33 Rabu / 11-01-2023 14:01:17 AM2301110312 ADEK FIRMANSYAH Ruang Bedah 573978 0304R0010123V000355 1/3/2023 1/5/2023
153 34 Rabu / 11-01-2023 14:01:07 AM2301110313 RISNAL Ruang Bedah 339484 0304R0011222V003945 12/17/2022 1/5/2023
154 35 Rabu / 11-01-2023 14:01:04 AM2301110315 KARIM Ruang Bedah 573877 0304R0011222V007328 12/31/2022 1/5/2023
155 36 Rabu / 11-01-2023 14:01:59 AM2301110316 RIZA NOVIA NETTA Ruang Bedah 561467 0304R0011222V007228 12/30/2022 1/5/2023
156 37 Rabu / 11-01-2023 15:01:04 AM2301110319 SOFYAN Ruang Bedah 285852 0304R0010123V000229 1/2/2023 1/5/2023
157 38 Rabu / 11-01-2023 15:01:22 AM2301110321 NASRUL Ruang Bedah 573880 0304R0011222V007311 12/31/2022 1/5/2023
158 1 Kamis / 12-01-2023 14:01:59 AM2301120282 LIDIA Ruang Jantung 574200 0304R0010123V001670 1/7/2023 1/10/2023
159 2 Kamis / 12-01-2023 14:01:50 AM2301120284 IRMAN BIN SAIR Ruang Jantung 574204 0304R0010123V001677 1/6/2023 1/10/2023
160 3 Kamis / 12-01-2023 14:01:33 AM2301120285 WARNITA Ruang Jantung 282105 0304R0010123V001754 1/8/2023 1/10/2023
161 4 Kamis / 12-01-2023 14:01:22 AM2301120287 AFRIZAL Ruang Jantung 574240 0304R0010123V001779 1/8/2023 1/10/2023
162 5 Kamis / 12-01-2023 14:01:46 AM2301120291 NURDIANIS Ruang Jantung 574222 0304R0010123V001976 1/2/2023 1/10/2023
163 6 Kamis / 12-01-2023 14:01:38 AM2301120292 YULHENDRA Ruang Ambun Suri Lantai 4 (Interne) 573657 0304R0011222V006379 12/27/2022 1/2/2023
164 7 Kamis / 12-01-2023 14:01:36 AM2301120294 ERNA Ruang Ambun Suri Lantai 4 (Interne) 570791 0304R0011222V005548 12/23/2022 1/2/2023
165 8 Kamis / 12-01-2023 14:01:20 AM2301120300 ASRIZAL Ruang Ambun Suri Lantai 4 (Interne) 573661 0304R0011222V006388 12/27/2022 1/2/2023
166 9 Kamis / 12-01-2023 14:01:03 AM2301120304 SURYA RAHMAT Ruang Ambun Suri Lantai 4 (Interne) 572714 0304R0011222V006016 12/26/2022 1/2/2023
167 10 Kamis / 12-01-2023 14:01:24 AM2301120306 NURUL AISYAH Ruang Ambun Suri Lantai 4 (Interne) 573882 0304R0011222V007307 12/31/2022 1/3/2023
168 11 Kamis / 12-01-2023 14:01:47 AM2301120309 SAPRIADI Ruang Ambun Suri Lantai 4 (Interne) 573805 0304R0011222V007026 12/30/2022 1/3/2023
169 12 Kamis / 12-01-2023 14:01:05 AM2301120311 YANTI. B Ruang Bedah 574150 0304R0010123V001780 1/8/2023 1/9/2023
170 13 Kamis / 12-01-2023 14:01:52 AM2301120314 MUHAMMAD YUNIL Ruang Bedah 573761 0304R0010123V001765 1/8/2023 1/9/2023
171 14 Kamis / 12-01-2023 14:01:37 AM2301120315 RUSLI Ruang Bedah 430107 0304R0010123V001352 1/5/2023 1/6/2023
172 15 Kamis / 12-01-2023 14:01:52 AM2301120317 HUSNIDAR Ruang Bedah 473448 0304R0010123V000954 1/4/2023 1/9/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
JANUARI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
173 16 Kamis / 12-01-2023 15:01:23 AM2301120322 MARNIS Ruang Bedah 505482 0304R0010123V000933 1/4/2023 1/9/2023
174 17 Kamis / 12-01-2023 15:01:00 AM2301120323 SULASTRI Ruang Ambun Suri Lantai 4 (Interne) 249276 0304R0011222V004007 12/18/2022 1/2/2023
175 18 Kamis / 12-01-2023 15:01:46 AM2301120324 MURNETI Ruang Bedah 573639 0304R0011222V001760 1/8/2023 1/9/2023
176 19 Kamis / 12-01-2023 15:01:05 AM2301120325 ASTRI IVO Ruang Bedah 567197 0304R0010123V001364 1/5/2023 1/9/2023
177 20 Kamis / 12-01-2023 15:01:46 AM2301120326 AMRIUS KELAS BEDAH 573466 0304R0010123V001759 1/8/2023 1/10/2023
178 21 Kamis / 12-01-2023 15:01:37 AM2301120328 NURWILIS KELAS BEDAH 573739 0304R0010123V002014 1/9/2023 1/10/2023
179 22 Kamis / 12-01-2023 15:01:57 AM2301120330 RIRIN MUTIARA SARY Ruang Kebidanan 530470 0304R0010123V001584 1/6/2023 1/9/2023
180 23 Kamis / 12-01-2023 15:01:12 AM2301120331 SHERLY DWIAGUSTIN Ruang Kebidanan 507068 0304R0010123V001748 1/7/2023 1/9/2023
181 24 Kamis / 12-01-2023 15:01:24 AM2301120334 DENIA ETRIANI Ruang Bedah 573976 0304R0010123V000350 1/3/2023 1/7/2023
182 25 Kamis / 12-01-2023 15:01:45 AM2301120343 MUHAMMAD DZAKI ELINDRA Ruang Bedah 329991 0304R0010123V000651 1/3/2023 1/7/2023
183 26 Kamis / 12-01-2023 15:01:32 AM2301120346 MASRIL HASAN KELAS BEDAH 401806 0304R0010123V001768 1/8/2023 1/9/2023
184 27 Kamis / 12-01-2023 15:01:40 AM2301120349 WELDA NINGSIH KELAS BEDAH 546649 0304R0010123V000680 1/3/2023 1/8/2023
185 28 Kamis / 12-01-2023 15:01:48 AM2301120353 YURNITA Ruang Bedah 573512 0304R0010123V000985 1/4/2023 1/8/2023
186 29 Kamis / 12-01-2023 15:01:28 AM2301120355 HANIFA Ruang Bedah 386516 0304R0010123V001400 1/5/2023 1/7/2023
187 30 Kamis / 12-01-2023 15:01:09 AM2301120358 ERNI Ruang Bedah 573142 0304R0010123V001251 1/5/2023 1/7/2023
188 31 Kamis / 12-01-2023 15:01:56 AM2301120362 ADIT SUWANDI KELAS BEDAH 556997 0304R0010123V000251 1/2/2023 1/7/2023
189 32 Kamis / 12-01-2023 15:01:36 AM2301120363 AISYILA QANITA PUTRI Ruang Bedah 573912 0304R0010123V000050 1/2/2023 1/7/2023
190 1 Jumat / 13-01-2023 7:01:59 AM2301130006 HARUSMI Ruang Bedah 317965 0304R0011222V006703 12/29/2022 1/7/2023
191 2 Jumat / 13-01-2023 7:01:02 AM2301130007 HELIN DESMIRIANTI KELAS BEDAH 574084 0304R0010123V000984 1/4/2023 1/6/2023
192 3 Jumat / 13-01-2023 8:01:03 AM2301130008 ZULYANTI KELAS BEDAH 573101 0304R0010123V001326 1/5/2023 1/6/2023
193 4 Jumat / 13-01-2023 8:01:41 AM2301130010 NUR RAHMAN Ruang Bedah 426637 0304R0010123V000976 1/4/2023 1/6/2023
194 5 Jumat / 13-01-2023 8:01:54 AM2301130013 AdMING OKTuRIZON Ruang Bedah 467780 0304R0010123V000010 1/1/2023 1/6/2023
195 6 Jumat / 13-01-2023 8:01:39 AM2301130014 ALNIS Ruang Bedah 393761 0304R0010123V000267 1/2/2023 1/6/2023
196 7 Jumat / 13-01-2023 8:01:00 AM2301130015 ZULFARIDA Ruang Bedah 573556 0304R0010123V000463 1/3/2023 1/5/2023
197 8 Jumat / 13-01-2023 8:01:37 AM2301130016 BUJANG Ruang Bedah 571721 0304R0010123V000594 1/3/2023 1/6/2023
198 9 Jumat / 13-01-2023 8:01:04 AM2301130017 SALIMUN Ruang Bedah 573269 0304R0010123V001002 1/5/2023 1/5/2023
199 10 Jumat / 13-01-2023 8:01:10 AM2301130018 SOFIA Ruang Ambun Suri Lantai 3 (Interne) 572817 0304R0011222V007236 12/30/2022 1/8/2023
200 11 Jumat / 13-01-2023 8:01:57 AM2301130019 MARTIUS Ruang Ambun Suri Lantai 3 (Interne) 574034 0304R0010123V000703 1/4/2023 1/4/2023
201 12 Jumat / 13-01-2023 8:01:44 AM2301130020 USMAN Ruang Ambun Suri Lantai 3 (Interne) 567231 0304R0010123V000949 1/4/2023 1/9/2023
202 13 Jumat / 13-01-2023 8:01:44 AM2301130021 BY NY MELISA RATNA SARI Ruang Bayi (PERINATOLOGI) 573911 0304R0010123V000662 1/2/2023 1/9/2023
203 14 Jumat / 13-01-2023 8:01:20 AM2301130022 HADIYYATUL ASHMA F Ruang Anak 302179 0304R0010123V001643 1/6/2023 1/10/2023
204 15 Jumat / 13-01-2023 8:01:17 AM2301130023 M. ATHARRAYYAN NAJWAN Ruang Anak 560699 0304R0010123V001750 1/8/2023 1/10/2023
205 16 Jumat / 13-01-2023 8:01:46 AM2301130026 GISEL SAKILLA NAJA Ruang Anak 531839 0304R0010123V002102 1/9/2023 1/9/2023
206 17 Jumat / 13-01-2023 8:01:47 AM2301130028 PRINCE RAYYANKA P Ruang Anak 520913 0304R0010123V001782 1/8/2023 1/9/2023
207 18 Jumat / 13-01-2023 8:01:51 AM2301130031 ZAL'AS NURBEN Ruang Mata/THT/BEDAH MULUT 403697 0304R0010123V002099 1/8/2023 1/10/2023
208 19 Jumat / 13-01-2023 8:01:36 AM2301130032 FARIZA Ruang Mata/THT/BEDAH MULUT 573197 0304R0011222V003979 12/18/2022 1/9/2023
209 20 Jumat / 13-01-2023 8:01:17 AM2301130033 NURAINI Ruang Ambun Suri Lantai 3 (Interne) 435803 0304R0011222V006692 12/28/2022 1/6/2023
210 21 Jumat / 13-01-2023 8:01:20 AM2301130036 JAULAN Ruang Ambun Suri Lantai 3 (Interne) 574041 0304R0010123V000938 1/4/2023 1/7/2023
211 22 Jumat / 13-01-2023 8:01:10 AM2301130037 SABRINAL ILHAM Ruang Ambun Suri Lantai 3 (Interne) 336732 0304R0010123V000013 1/1/2023 1/7/2023
212 23 Jumat / 13-01-2023 8:01:00 AM2301130038 RIK ALAN Ruang Ambun Suri Lantai 3 (Interne) 479832 0304R0010123V000328 1/2/2023 1/6/2023
213 24 Jumat / 13-01-2023 8:01:26 AM2301130040 SYAFRIZAL Ruang Ambun Suri Lantai 3 (Interne) 551276 0304R0010123V000941 1/4/2023 1/6/2023
214 25 Jumat / 13-01-2023 8:01:20 AM2301130045 ERWIN RITONGA Ruang Jantung 574094 0304R0010123V001000 1/5/2023 1/7/2023
215 26 Jumat / 13-01-2023 8:01:55 AM2301130047 YASMET Ruang Jantung 574069 0304R0010123V000963 1/4/2023 1/9/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
JANUARI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
216 27 Jumat / 13-01-2023 8:01:22 AM2301130049 MURNIATI Ruang Jantung 574202 0304R0010123V001679 1/6/2023 1/9/2023
217 28 Jumat / 13-01-2023 8:01:16 AM2301130051 DAHLAN Ruang Jantung 574175 0304R0010123V001403 1/6/2023 1/8/2023
218 29 Jumat / 13-01-2023 8:01:00 AM2301130052 ZULFAINER Ruang Jantung 574154 0304R0010123V001368 1/5/2023 1/8/2023
219 30 Jumat / 13-01-2023 9:01:10 AM2301130054 UPIK Ruang Jantung 536114 0304R0010123V000996 1/4/2023 1/7/2023
220 31 Jumat / 13-01-2023 9:01:27 AM2301130056 RIZAL Ruang Jantung 574128 0304R0010123V001374 1/5/2023 1/7/2023
221 32 Jumat / 13-01-2023 12:01:08 AM2301130246 YURNITA.A Ruang Paru 573525 0304R0011222V005700 12/24/2022 1/9/2023
222 33 Jumat / 13-01-2023 12:01:08 AM2301130250 KAHARUDDIN SIREGAR Ruang Paru 573541 0304R0011222V005746 12/25/2022 1/5/2023
223 34 Jumat / 13-01-2023 12:01:46 AM2301130258 HENDRIZAL Ruang Paru 573708 0304R0011222V006670 12/28/2022 1/4/2023
224 35 Jumat / 13-01-2023 12:01:24 AM2301130261 SARTIAN SUTNI Ruang Paru 573897 0304R0010123V000025 1/1/2023 1/1/2023
225 36 Jumat / 13-01-2023 12:01:10 AM2301130265 YUSRA EFENDI Ruang Paru 573797 0304R0011222V007016 12/29/2022 1/1/2023
226 37 Jumat / 13-01-2023 12:01:53 AM2301130268 RABBIL AINI Ruang Paru 573914 0304R0010123V000069 1/2/2023 1/2/2023
227 38 Jumat / 13-01-2023 12:01:14 AM2301130269 MUHAMMAD NUR Ruang Paru 573970 0304R0010123V000341 1/2/2023 1/3/2023
228 39 Jumat / 13-01-2023 12:01:13 AM2301130271 YARNIS Ruang Ambun Suri Lantai 4 (Interne) 568974 0304R0011222V006364 12/27/2022 1/9/2023
229 40 Jumat / 13-01-2023 12:01:26 AM2301130286 YULFITRI Ruang Ambun Suri Lantai 4 (Interne) 574047 0304R0010123V000937 1/4/2023 1/10/2023
230 41 Jumat / 13-01-2023 12:01:56 AM2301130287 RASMAWATI Ruang Ambun Suri Lantai 4 (Interne) 82633 0304R0010123V000974 1/4/2023 1/10/2023
231 42 Jumat / 13-01-2023 12:01:02 AM2301130288 AFRIDAWITA Ruang Ambun Suri Lantai 4 (Interne) 60960 0304R0010123V000320 1/2/2023 1/6/2023
232 43 Jumat / 13-01-2023 12:01:50 AM2301130289 FADILLAH SY Ruang Ambun Suri Lantai 4 (Interne) 494942 0304R0011222V006709 12/29/2022 1/4/2023
233 44 Jumat / 13-01-2023 12:01:41 AM2301130291 SYAMSIR KASAB Ruang Ambun Suri Lantai 4 (Interne) 462129 0304R0010123V000661 1/3/2023 1/9/2023
234 45 Jumat / 13-01-2023 12:01:10 AM2301130292 YANUAR Ruang Ambun Suri Lantai 4 (Interne) 572778 0304R0010123V000288 1/2/2023 1/6/2023
235 46 Jumat / 13-01-2023 12:01:23 AM2301130293 RAHMAD FAHRIZAL Ruang Ambun Suri Lantai 4 (Interne) 569363 0304R0011222V005850 12/26/2022 1/5/2023
236 47 Jumat / 13-01-2023 12:01:14 AM2301130295 SYAFRUDDIN HASAN Ruang Ambun Suri Lantai 4 (Interne) 92912 0304R0010123V000919 1/4/2023 1/6/2023
237 48 Jumat / 13-01-2023 12:01:39 AM2301130297 LISDAWATI Ruang Ambun Suri Lantai 4 (Interne) 571023 0304R0010123V000038 1/1/2023 1/5/2023
238 49 Jumat / 13-01-2023 12:01:30 AM2301130299 ELFI SEPTIMAR Ruang Ambun Suri Lantai 4 (Interne) 573875 0304R0011222V007300 12/31/2022 1/5/2023
239 50 Jumat / 13-01-2023 12:01:29 AM2301130300 MAIYULNI DESFIANTI Ruang Ambun Suri Lantai 4 (Interne) 286015 0304R0010123V000183 1/2/2023 1/4/2023
240 51 Jumat / 13-01-2023 12:01:56 AM2301130301 GUGI GUSTAMAN Ruang Ambun Suri Lantai 4 (Interne) 572658 0304R0011222V004000 12/18/2022 1/5/2023
241 52 Jumat / 13-01-2023 12:01:42 AM2301130309 RIZA PATI PURNAMA Ruang Mata/THT/BEDAH MULUT 346375 0304R0010123V002086 1/9/2023 1/11/2023
242 53 Jumat / 13-01-2023 12:01:52 AM2301130313 MAIYESTI Ruang Mata/THT/BEDAH MULUT 566349 0304R0010123V002090 1/9/2023 1/11/2023
243 54 Jumat / 13-01-2023 12:01:12 AM2301130318 MIRA NASIR Ruang Mata/THT/BEDAH MULUT 548753 0304R0010123V002106 1/9/2023 1/11/2023
244 55 Jumat / 13-01-2023 12:01:15 AM2301130341 ERMAYETI KELAS BEDAH 574100 0304R0010123V001006 1/5/2023 1/11/2023
245 56 Jumat / 13-01-2023 12:01:54 AM2301130344 M. AL HAFIZ Ruang Bedah 338070 0304R0010123V000980 1/4/2023 1/10/2023
246 57 Jumat / 13-01-2023 12:01:34 AM2301130347 TAUFIK HIDAYAT Ruang Bedah 573289 0304R0010123V001766 1/8/2023 1/10/2023
247 58 Jumat / 13-01-2023 12:01:14 AM2301130348 SAPARDI AGUS Ruang Bedah 574239 0304R0010123V001785 1/8/2023 1/10/2023
248 59 Jumat / 13-01-2023 12:01:58 AM2301130349 BENI ALAMSYAH Ruang Bedah 265101 0304R0010123V001795 1/8/2023 1/10/2023
249 60 Jumat / 13-01-2023 16:01:25 AM2301130451 PATMONO Ruang Jantung 565908 0304R0010123V002105 1/9/2023 1/11/2023
250 61 Jumat / 13-01-2023 16:01:19 AM2301130452 HISBER YULLER Ruang Jantung 574232 0304R0010123V001757 1/8/2023 1/11/2023
251 62 Jumat / 13-01-2023 16:01:56 AM2301130453 FATIZANOLO NDURU Ruang Jantung 574224 0304R0010123V001736 1/7/2023 1/11/2023
252 63 Jumat / 13-01-2023 16:01:33 AM2301130454 M FATHIR NAYAKA Ruang Anak 524160 0304R0010123V002460 1/10/2023 1/10/2023
253 64 Jumat / 13-01-2023 16:01:18 AM2301130455 BY. NY. SRI WAHYUNI Ruang Bayi (PERINATOLOGI) 572713 0304R0011222V001177 12/5/2022 1/10/2023
254 65 Jumat / 13-01-2023 16:01:36 AM2301130457 PRAMA YUKI Ruang Anak 430342 0304R0010123V001718 1/7/2023 1/11/2023
255 66 Jumat / 13-01-2023 16:01:24 AM2301130458 ASYFA SALSABILA HERMAWAN Ruang Anak 439803 0304R0010123V001728 1/7/2023 1/11/2023
256 67 Jumat / 13-01-2023 16:01:59 AM2301130460 FELISHA CORDELIA RAFANI Ruang Anak 574235 0304R0010123V001777 1/8/2023 1/11/2023
257 68 Jumat / 13-01-2023 16:01:37 AM2301130462 NAYAKA MIKAIL AFSHEEN Ruang Anak 569730 0304R0010123V001732 1/7/2023 1/11/2023
258 69 Jumat / 13-01-2023 16:01:15 AM2301130464 UMAR Ruang Cindua Mato 574176 0304R0010123V001407 1/6/2023 1/11/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
JANUARI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
259 70 Jumat / 13-01-2023 16:01:58 AM2301130466 ASLIMAR AMIN Ruang Cindua Mato 511266 0304R0010123V000993 1/4/2023 1/11/2023
260 71 Jumat / 13-01-2023 16:01:01 AM2301130467 HENDRA K Ruang Ambun Suri Lantai 3 (Interne) 556709 0304R0010123V001337 1/5/2023 1/7/2023
261 72 Jumat / 13-01-2023 16:01:42 AM2301130468 ASNIL BASRI Ruang Ambun Suri Lantai 3 (Interne) 566363 0304R0011222V006402 12/28/2022 1/9/2023
262 73 Jumat / 13-01-2023 16:01:27 AM2301130470 SUCI Ruang Ambun Suri Lantai 3 (Interne) 443856 0304R0010123V001650 1/6/2023 1/9/2023
263 74 Jumat / 13-01-2023 16:01:05 AM2301130472 TIRTA TARTI Ruang Ambun Suri Lantai 3 (Interne) 574156 0304R0010123V001384 1/5/2023 1/11/2023
264 75 Jumat / 13-01-2023 16:01:02 AM2301130473 BUSTAMAN Ruang Ambun Suri Lantai 3 (Interne) 574036 0304R0010123V000690 1/3/2023 1/11/2023
265 76 Jumat / 13-01-2023 16:01:36 AM2301130474 ERLIDA Ruang Ambun Suri Lantai 3 (Interne) 573869 0304R0011222V007327 12/30/2022 1/11/2023
266 77 Jumat / 13-01-2023 16:01:22 AM2301130475 KHAIRUL Ruang Ambun Suri Lantai 3 (Interne) 573261 0304R0010123V000569 1/3/2023 1/9/2023
267 78 Jumat / 13-01-2023 16:01:59 AM2301130476 LODI PUTRA Ruang Ambun Suri Lantai 3 (Interne) 393090 0304R0010123V001710 1/7/2023 1/10/2023
268 79 Jumat / 13-01-2023 16:01:13 AM2301130478 LISMAYATI Ruang Ambun Suri Lantai 3 (Interne) 358167 0304R0011222V007256 12/31/2022 1/10/2023
269 80 Jumat / 13-01-2023 16:01:50 AM2301130480 HENDRI Ruang Ambun Suri Lantai 3 (Interne) 487217 0304R0010123V001347 1/5/2023 1/7/2023
270 81 Jumat / 13-01-2023 16:01:42 AM2301130482 MIFTAHUL KHAIRA Ruang Ambun Suri Lantai 3 (Interne) 565827 0304R0010123V000956 1/4/2023 1/7/2023
271 82 Jumat / 13-01-2023 16:01:21 AM2301130483 SOFYAN Ruang Ambun Suri Lantai 3 (Interne) 568802 0304R0010123V000991 1/4/2023 1/7/2023
272 83 Jumat / 13-01-2023 16:01:58 AM2301130486 BAMBANG SAPUTRA Ruang Ambun Suri Lantai 3 (Interne) 565584 0304R0010123V001652 1/6/2023 1/7/2023
273 1 Senin / 16-01-2023 10:01:34 AM2301160181 ERMI YASTUTI Ruang Kebidanan 570326 0304R0010123V002052 1/9/2023 1/10/2023
274 2 Senin / 16-01-2023 10:01:56 AM2301160219 NENENG SRI RAHAYU Ruang Kebidanan 574258 0304R0010123V001803 1/8/2023 1/10/2023
275 3 Senin / 16-01-2023 10:01:21 AM2301160221 TIA HANDAYANI Ruang Kebidanan 574208 0304R0010123V001706 1/7/2023 1/10/2023
276 4 Senin / 16-01-2023 10:01:16 AM2301160224 LILI MARNI Ruang Kebidanan 573983 0304R0010123V000669 1/3/2023 1/10/2023
277 5 Senin / 16-01-2023 10:01:55 AM2301160226 YAMSASNI Ruang Kebidanan 501684 0304R0010123V001752 1/8/2023 1/10/2023
278 6 Senin / 16-01-2023 11:01:30 AM2301160310 SRI RAHMADANI Ruang Kebidanan 574220 0304R0010123V001726 1/7/2023 1/10/2023
279 7 Senin / 16-01-2023 12:01:54 AM2301160336 MASNIDAR Ruang Kebidanan 572085 0304R0010123V000675 1/3/2023 1/6/2023
280 8 Senin / 16-01-2023 12:01:48 AM2301160348 WAHYUNI AULIA PUTRI Ruang Kebidanan 574255 0304R0010123V001801 1/8/2023 1/10/2023
281 9 Senin / 16-01-2023 14:01:57 AM2301160414 NADIA ZULFA YUSMI Ruang Anak 272317 0304R0010123V002715 1/11/2023 1/11/2023
282 10 Senin / 16-01-2023 14:01:51 AM2301160415 KAIRAV SYAFIQ MARSAL Ruang Anak 541890 0304R0010123V002737 1/11/2023 1/11/2023
283 11 Senin / 16-01-2023 14:01:41 AM2301160416 SEPRI WENDRI Ruang Paru 380664 0304R0011222V007255 12/30/2022 1/4/2023
284 12 Senin / 16-01-2023 14:01:16 AM2301160417 ARMAN Ruang Paru 569943 0304R0010123V000329 1/2/2023 1/4/2023
285 13 Senin / 16-01-2023 14:01:25 AM2301160418 SYAWAL Ruang Paru 573058 0304R0011222V007234 12/30/2022 1/4/2023
286 14 Senin / 16-01-2023 14:01:50 AM2301160419 HERMAN Ruang Paru 480634 0304R0011222V007224 12/30/2022 1/4/2023
287 15 Senin / 16-01-2023 14:01:59 AM2301160420 ARSIL Ruang Paru 573685 0304R0010123V000027 1/1/2023 1/2/2023
288 16 Senin / 16-01-2023 14:01:38 AM2301160421 MASRI Ruang Paru 569594 0304R0011222V003885 12/17/2022 1/3/2023
289 17 Senin / 16-01-2023 14:01:47 AM2301160422 ALFITRA JONITRA Ruang Paru 570437 0304R0011222V006697 12/28/2022 1/4/2023
290 18 Senin / 16-01-2023 14:01:48 AM2301160423 MAWARDI Ruang Paru 434921 0304R0011222V007275 12/31/2022 1/2/2023
291 19 Senin / 16-01-2023 14:01:29 AM2301160424 AKMAL Ruang Paru 271146 0304R0011222V006906 12/28/2022 1/3/2023
292 20 Senin / 16-01-2023 14:01:57 AM2301160425 YURSIL DAMHURI Ruang Paru 573417 0304R0011222V005666 12/24/2022 1/3/2023
293 21 Senin / 16-01-2023 14:01:07 AM2301160426 ROSMA GUSMITA Ruang Ambun Suri Lantai 4 (Interne) 464806 0304R0010123V001658 1/6/2023 1/8/2023
294 22 Senin / 16-01-2023 14:01:56 AM2301160427 NOFRIANDI Ruang Ambun Suri Lantai 4 (Interne) 478248 0304R0010123V001661 1/6/2023 1/8/2023
295 23 Senin / 16-01-2023 14:01:48 AM2301160428 KEVIN ALVARIO FAWWAZ Ruang Paru 573321 0304R0010123V000337 1/2/2023 1/9/2023
296 24 Senin / 16-01-2023 14:01:44 AM2301160429 YULINAR Ruang Paru 573729 0304R0011222V006702 12/29/2022 1/9/2023
297 25 Senin / 16-01-2023 15:01:51 AM2301160430 NUSYIRWAN Ruang Mata/THT/BEDAH MULUT 562043 0304R0010123V002350 1/10/2023 1/12/2023
298 26 Senin / 16-01-2023 15:01:59 AM2301160432 ZAINATUL ELWANI Ruang Mata/THT/BEDAH MULUT 574046 0304R0010123V002447 1/10/2023 1/12/2023
299 27 Senin / 16-01-2023 15:01:15 AM2301160434 ASMAN CAN Ruang Ambun Suri Lantai 3 (Interne) 566774 0304R0010123V000970 1/4/2023 1/12/2023
300 28 Senin / 16-01-2023 15:01:59 AM2301160435 SAMSIAR Ruang Ambun Suri Lantai 3 (Interne) 574086 0304R0010123V000988 1/4/2023 1/11/2023
301 29 Senin / 16-01-2023 15:01:37 AM2301160436 ERNAWATI Ruang Ambun Suri Lantai 3 (Interne) 528762 0304R0010123V001722 1/7/2023 1/11/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
JANUARI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
302 30 Senin / 16-01-2023 15:01:12 AM2301160437 AMRIZAL Ruang Ambun Suri Lantai 3 (Interne) 405609 0304R0010123V001648 1/5/2023 1/11/2023
303 31 Senin / 16-01-2023 15:01:49 AM2301160438 RUKMINI Ruang Ambun Suri Lantai 3 (Interne) 551225 0304R0010123V001761 1/8/2023 1/11/2023
304 32 Senin / 16-01-2023 15:01:34 AM2301160439 NOVA RISMAN Ruang Ambun Suri Lantai 3 (Interne) 574035 0304R0010123V000704 1/3/2023 1/11/2023
305 33 Senin / 16-01-2023 15:01:10 AM2301160440 DAHLINI Ruang Ambun Suri Lantai 3 (Interne) 550045 0304R0010123V001709 1/7/2023 1/12/2023
306 34 Senin / 16-01-2023 15:01:51 AM2301160441 MILA MONA SARI Ruang Ambun Suri Lantai 3 (Interne) 378437 0304R0010123V001773 1/8/2023 1/11/2023
307 35 Senin / 16-01-2023 15:01:37 AM2301160442 MARLIS KELAS BEDAH 574114 0304R0010123V002627 1/11/2023 1/12/2023
308 36 Senin / 16-01-2023 15:01:50 AM2301160443 ADRIAS KELAS BEDAH 564482 0304R0010123V002488 1/10/2023 1/12/2023
309 37 Senin / 16-01-2023 15:01:34 AM2301160444 RADADIN KELAS BEDAH 562321 0304R0010123V002734 1/11/2023 1/12/2023
310 38 Senin / 16-01-2023 15:01:22 AM2301160445 NURLELA Ruang Bedah 569423 0304R0010123V002092 1/9/2023 1/11/2023
311 39 Senin / 16-01-2023 15:01:15 AM2301160446 SULASTRI Ruang Bedah 573443 0304R0011222V005364 12/22/2022 1/11/2023
312 40 Senin / 16-01-2023 15:01:45 AM2301160447 NOVRENSISTRI Ruang Bedah 570612 0304R0010123V001665 1/6/2023 1/11/2023
313 41 Senin / 16-01-2023 15:01:49 AM2301160448 AZWITA Ruang Bedah 499320 0304R0010123V001719 1/7/2023 1/10/2023
314 42 Senin / 16-01-2023 15:01:26 AM2301160449 RIMPI Ruang Bedah 455689 0304R0010123V001755 1/8/2023 1/11/2023
315 43 Senin / 16-01-2023 15:01:13 AM2301160450 ABIZAR Ruang Bedah 574174 0304R0010123V001405 1/6/2023 1/11/2023
316 44 Senin / 16-01-2023 15:01:00 AM2301160451 SURI Ruang Bedah 564508 0304R0011222V007017 12/29/2022 1/11/2023
317 45 Senin / 16-01-2023 15:01:44 AM2301160452 ASTINA WATI Ruang Bedah 574166 0304R0010123V001390 1/5/2023 1/11/2023
318 46 Senin / 16-01-2023 15:01:33 AM2301160453 SUPRIANI Ruang Bedah 464635 0304R0010123V002473 1/10/2023 1/11/2023
319 47 Senin / 16-01-2023 15:01:12 AM2301160454 ERIATI Ruang Bedah 572495 0304R0010123V002475 1/10/2023 1/11/2023
320 48 Senin / 16-01-2023 15:01:52 AM2301160455 SARDIN Ruang Jantung 574173 0304R0010123V001399 1/5/2023 1/12/2023
321 49 Senin / 16-01-2023 15:01:40 AM2301160456 HJ AMNIS Ruang Jantung 354176 0304R0010123V002104 1/9/2023 1/12/2023
322 50 Senin / 16-01-2023 15:01:29 AM2301160457 NOFRIANDI Ruang Jantung 574214 0304R0010123V002025 1/7/2023 1/12/2023
323 51 Senin / 16-01-2023 15:01:02 AM2301160458 FERDI ARIANTO Ruang Jantung 574327 0304R0010123V002124 1/9/2023 1/12/2023
324 52 Senin / 16-01-2023 15:01:48 AM2301160459 NELWATRI Ruang Jantung 271504 0304R0010123V002116 1/9/2023 1/12/2023
325 53 Senin / 16-01-2023 15:01:43 AM2301160460 SUMARDI Ruang Jantung 574333 0304R0010123V002468 1/10/2023 1/12/2023
326 54 Senin / 16-01-2023 15:01:21 AM2301160461 YENI DEVI YANTI Ruang Kebidanan 574228 0304R0010123V001738 1/7/2023 1/12/2023
327 55 Senin / 16-01-2023 15:01:15 AM2301160464 RAHMADONA Ruang Kebidanan 574329 0304R0010123V002132 1/10/2023 1/11/2023
328 56 Senin / 16-01-2023 15:01:43 AM2301160465 nelwida Ruang Kebidanan 574212 0304R0010123V001716 1/7/2023 1/11/2023
329 57 Senin / 16-01-2023 16:01:40 AM2301160467 HARNETI Ruang Kebidanan 573562 0304R0010123V001712 1/7/2023 1/11/2023
330 58 Senin / 16-01-2023 16:01:24 AM2301160468 AYU ENDRAWATI Ruang Kebidanan 471371 0304R0010123V002110 1/9/2023 1/11/2023
331 59 Senin / 16-01-2023 16:01:28 AM2301160469 WIWI RAMADANI Ruang Kebidanan 218540 0304R0010123V001809 1/9/2023 1/11/2023
332 60 Senin / 16-01-2023 16:01:07 AM2301160470 SUCI RAHMADHANI Ruang Kebidanan 574422 0304R0010123V002748 1/11/2023 1/12/2023
333 61 Senin / 16-01-2023 16:01:35 AM2301160471 HJ. CHAIRIAH Ruang Kebidanan 572219 0304R0010123V002476 1/10/2023 1/11/2023
334 62 Senin / 16-01-2023 16:01:25 AM2301160472 BERTINA SIMARMATA Ruang Kebidanan 536544 0304R0010123V002442 1/10/2023 1/11/2023
335 63 Senin / 16-01-2023 16:01:00 AM2301160473 AZINAR Ruang Kebidanan 573588 0304R0010123V001711 1/7/2023 1/11/2023
336 64 Senin / 16-01-2023 16:01:45 AM2301160474 ROSLAINI Ruang Cindua Mato 418326 0304R0010123V000671 1/2/2023 1/7/2023
337 1 Selasa / 17-01-2023 9:01:36 AM2301170047 JEFRIZAL Ruang Cindua Mato 74886 0304R0011222V007227 12/30/2022 1/12/2023
338 2 Selasa / 17-01-2023 9:01:38 AM2301170051 IRSAL TARMIZI Ruang Cindua Mato 574030 0304R0010123V000684 1/3/2023 1/12/2023
339 3 Selasa / 17-01-2023 9:01:25 AM2301170055 ERIZAL Ruang Cindua Mato 574223 0304R0010123V001727 1/7/2023 1/12/2023
340 4 Selasa / 17-01-2023 9:01:31 AM2301170058 NISWARDI NARWIS Ruang Cindua Mato 436417 0304R0010123V002131 1/9/2023 1/12/2023
341 5 Selasa / 17-01-2023 9:01:51 AM2301170060 AFRI YANTI Ruang Mata/THT/BEDAH MULUT 344843 0304R0010123V002471 1/10/2023 1/13/2023
342 6 Selasa / 17-01-2023 10:01:29 AM2301170063 LISA RAHAYU Ruang Mata/THT/BEDAH MULUT 538783 0304R0010123V002660 1/11/2023 1/13/2023
343 7 Selasa / 17-01-2023 10:01:50 AM2301170066 elsa triana sari Ruang Mata/THT/BEDAH MULUT 405039 0304R0010123V002634 1/11/2023 1/13/2023
344 8 Selasa / 17-01-2023 10:01:40 AM2301170068 LEKA Ruang Ambun Suri Lantai 3 (Interne) 574201 0304R0010123V001675 1/6/2023 1/12/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
JANUARI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
345 9 Selasa / 17-01-2023 10:01:29 AM2301170070 NELVANETI Ruang Ambun Suri Lantai 3 (Interne) 409992 0304R0010123V001753 1/8/2023 1/13/2023
346 10 Selasa / 17-01-2023 10:01:12 AM2301170072 ASEP MULYADI Ruang Ambun Suri Lantai 3 (Interne) 574078 0304R0010123V002035 1/9/2023 1/13/2023
347 11 Selasa / 17-01-2023 10:01:50 AM2301170074 YUSRIMAL Ruang Ambun Suri Lantai 3 (Interne) 574052 0304R0010123V001984 1/9/2023 1/13/2023
348 12 Selasa / 17-01-2023 10:01:25 AM2301170076 DEDI ATMAJAYA Ruang Jantung 574391 0304R0010123V002489 1/10/2023 1/13/2023
349 13 Selasa / 17-01-2023 10:01:44 AM2301170077 ASRIZAL Ruang Jantung 293386 0304R0010123V002018 1/9/2023 1/13/2023
350 14 Selasa / 17-01-2023 10:01:00 AM2301170079 jimmy mursailes Ruang Jantung 574397 0304R0010123V002586 1/10/2023 1/13/2023
351 15 Selasa / 17-01-2023 10:01:37 AM2301170109 NUR RAFIKAH Ruang ICU/ICCU 454516 0304R0010123V001811 1/9/2023 1/12/2023
352 16 Selasa / 17-01-2023 10:01:24 AM2301170111 MELDA FITRI YENI Ruang ICU/ICCU 573923 0304R0010123V000340 1/2/2023 1/12/2023
353 17 Selasa / 17-01-2023 10:01:10 AM2301170113 BY NY SYUKRITA Ruang Bayi (PERINATOLOGI) 572720 0304R0011222V001224 12/5/2022 1/13/2023
354 18 Selasa / 17-01-2023 10:01:55 AM2301170115 BY.NY.DONA WITRI 1 Ruang Bayi (PERINATOLOGI) 573345 0304R0011222V004954 12/21/2022 1/13/2023
355 19 Selasa / 17-01-2023 10:01:47 AM2301170129 BY.NY.SRI RAHMADANI Ruang Bayi (PERINATOLOGI) 574229 0304R0010123V002084 1/7/2023 1/13/2023
356 20 Selasa / 17-01-2023 10:01:32 AM2301170130 BY. NY. TIA HANDAYANI 1 Ruang Bayi (PERINATOLOGI) 574209 0304R0010123V002101 1/7/2023 1/13/2023
357 21 Selasa / 17-01-2023 10:01:27 AM2301170131 BY. NY. TIA HANDAYANI 2 Ruang Bayi (PERINATOLOGI) 574210 0304R0010123V002100 1/7/2023 1/13/2023
358 22 Selasa / 17-01-2023 10:01:19 AM2301170133 AMMAR LUTHFI ALBIRRU Ruang Anak 561729 0304R0010123V002066 1/9/2023 1/12/2023
359 23 Selasa / 17-01-2023 10:01:32 AM2301170137 FITRIA SUSANTI Ruang Kebidanan 239237 0304R0010123V002434 1/10/2023 1/13/2023
360 24 Selasa / 17-01-2023 10:01:57 AM2301170139 NATASHA AFDHOLA Ruang Kebidanan 565720 0304R0010123V003008 1/12/2023 1/13/2023
361 25 Selasa / 17-01-2023 11:01:35 AM2301170278 AENAH KELAS BEDAH 375279 0304R0010123V002397 1/10/2023 1/12/2023
362 26 Selasa / 17-01-2023 10:01:09 AM2301170145 MAWARDI Ruang Bedah 455369 0304R0010123V002497 1/10/2023 1/12/2023
363 27 Selasa / 17-01-2023 11:01:07 AM2301170155 EZI PUSPITA Ruang Bedah 571974 0304R0010123V001941 1/8/2023 1/12/2023
364 28 Selasa / 17-01-2023 11:01:51 AM2301170158 AZIZ MANDALA PUTRA Ruang Bedah 563996 0304R0010123V002093 1/9/2023 1/12/2023
365 29 Selasa / 17-01-2023 11:01:46 AM2301170164 WIDIAWATI Ruang Bedah 573424 0304R0010123V002386 1/10/2023 1/12/2023
366 30 Selasa / 17-01-2023 11:01:37 AM2301170167 RAPIT Ruang Bedah 573945 0304R0010123V002365 1/10/2023 1/12/2023
367 31 Selasa / 17-01-2023 11:01:31 AM2301170173 ELMARNIS Ruang Bedah 568314 0304R0010123V001767 1/8/2023 1/12/2023
368 32 Selasa / 17-01-2023 11:01:18 AM2301170175 ASDENIWATI Ruang Bedah 570324 0304R0010123V002625 1/11/2023 1/12/2023
369 33 Selasa / 17-01-2023 11:01:01 AM2301170177 AMRIL Ruang Bedah 564034 0304R0010123V001762 1/8/2023 1/12/2023
370 34 Selasa / 17-01-2023 11:01:47 AM2301170180 ROSDAWATI Ruang Bedah 570512 0304R0010123V002480 1/10/2023 1/12/2023
371 35 Selasa / 17-01-2023 11:01:52 AM2301170188 MARTINIS Ruang Bedah 550810 0304R0010123V002477 1/10/2023 1/12/2023
372 36 Selasa / 17-01-2023 11:01:11 AM2301170192 YETTRINI KELAS BEDAH 320459 0304R0010123V002474 1/10/2023 1/12/2023
373 37 Selasa / 17-01-2023 14:01:25 AM2301170386 YUSUF AHMADI Ruang Cindua Mato 398759 0304R0010123V002482 1/10/2023 1/16/2023
374 38 Selasa / 17-01-2023 14:01:03 AM2301170387 ABDURRAHMAN AZ ZUHAIRI RAMADHRuang Bayi (PERINATOLOGI) 574314 0304R0010123V002745 1/9/2023 1/14/2023
375 39 Selasa / 17-01-2023 14:01:47 AM2301170389 BY. NY. ELNI Ruang Bayi (PERINATOLOGI) 574430 0304R0010123V002753 1/11/2023 1/14/2023
376 40 Selasa / 17-01-2023 14:01:31 AM2301170390 BY. NY. RIRIN MUTIARA SARY Ruang Bayi (PERINATOLOGI) 574206 0304R0010123V002027 1/6/2023 1/15/2023
377 41 Selasa / 17-01-2023 14:01:12 AM2301170391 MUHAMMAD IBRAHIM Ruang Anak 490435 0304R0010123V002756 1/11/2023 1/15/2023
378 42 Selasa / 17-01-2023 14:01:46 AM2301170393 LINO MALIK ATHAYA Ruang Anak 574497 0304R0010123V003287 1/12/2023 1/15/2023
379 43 Selasa / 17-01-2023 14:01:34 AM2301170395 MOHAMMAD NABIL ZALMI Ruang Mata/THT/BEDAH MULUT 307670 0304R0010123V003146 1/12/2023 1/14/2023
380 44 Selasa / 17-01-2023 14:01:29 AM2301170396 NADIATUL JANNAH Ruang Mata/THT/BEDAH MULUT 574002 0304R0010123V003112 1/12/2023 1/14/2023
381 45 Selasa / 17-01-2023 14:01:23 AM2301170397 EDY SYOFYAN Ruang Mata/THT/BEDAH MULUT 498641 0304R0010123V002479 1/10/2023 1/14/2023
382 46 Selasa / 17-01-2023 14:01:58 AM2301170398 HENDRI Ruang Ambun Suri Lantai 3 (Interne) 487217 0304R0010123V002130 1/9/2023 1/13/2023
383 47 Selasa / 17-01-2023 14:01:42 AM2301170399 IRFAN PAISAL Ruang Ambun Suri Lantai 3 (Interne) 563244 0304R0010123V002739 1/11/2023 1/14/2023
384 48 Selasa / 17-01-2023 14:01:28 AM2301170400 HENDRA K Ruang Ambun Suri Lantai 3 (Interne) 556709 0304R0010123V002485 1/10/2023 1/13/2023
385 49 Selasa / 17-01-2023 14:01:28 AM2301170401 UNIS Ruang Ambun Suri Lantai 3 (Interne) 565645 0304R0011222V007232 12/30/2022 1/13/2023
386 50 Selasa / 17-01-2023 14:01:41 AM2301170402 HERMAN Ruang Ambun Suri Lantai 3 (Interne) 574323 0304R0010123V002111 1/9/2023 1/13/2023
387 51 Selasa / 17-01-2023 14:01:19 AM2301170403 SAFRIL SAH Ruang Ambun Suri Lantai 3 (Interne) 467026 0304R0010123V002640 1/11/2023 1/13/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
JANUARI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
388 52 Selasa / 17-01-2023 14:01:04 AM2301170404 ARSON GEMA Ruang Jantung 444529 0304R0010123V003415 1/13/2023 1/16/2023
389 53 Selasa / 17-01-2023 14:01:06 AM2301170406 SYAHBUDDIN Ruang Jantung 4933 0304R0010123V003055 1/11/2023 1/16/2023
390 54 Selasa / 17-01-2023 14:01:56 AM2301170407 DINA DESWITA Ruang Kebidanan 511253 0304R0010123V003157 1/12/2023 1/14/2023
391 55 Selasa / 17-01-2023 14:01:37 AM2301170408 GUSDI YANTI Ruang Kebidanan 574568 0304R0010123V003534 1/15/2023 1/16/2023
392 56 Selasa / 17-01-2023 14:01:16 AM2301170409 NAYLA AMALIA PRATAMI Ruang Kebidanan 574541 0304R0010123V003443 1/14/2023 1/16/2023
393 57 Selasa / 17-01-2023 14:01:51 AM2301170410 FITRIA Ruang Kebidanan 562389 0304R0010123V003485 1/14/2023 1/16/2023
394 58 Selasa / 17-01-2023 14:01:24 AM2301170411 RAHMI OKTAVIA Ruang Kebidanan 414660 0304R0010123V003182 1/13/2023 1/15/2023
395 59 Selasa / 17-01-2023 14:01:00 AM2301170413 RINDU OLGA ALPADIRA Ruang Kebidanan 498581 0304R0010123V003422 1/13/2023 1/15/2023
396 60 Selasa / 17-01-2023 14:01:34 AM2301170415 SUSILA MURNI Ruang Kebidanan 293879 0304R0010123V003368 1/12/2023 1/15/2023
397 61 Selasa / 17-01-2023 15:01:04 AM2301170442 ARYULIZON Ruang Jantung 2399 0304R0011222V007296 12/31/2022 1/3/2023
398 62 Selasa / 17-01-2023 15:01:12 AM2301170444 jusna dewi Ruang Jantung 574489 0304R0010123V003155 1/12/2023 1/16/2023
399 63 Selasa / 17-01-2023 15:01:50 AM2301170446 MISNIATI Ruang Jantung 574436 0304R0010123V002770 1/12/2023 1/14/2023
400 64 Selasa / 17-01-2023 15:01:42 AM2301170449 AZWAR Ruang Jantung 574483 0304R0010123V003139 1/12/2023 1/15/2023
401 65 Selasa / 17-01-2023 15:01:18 AM2301170451 BASRI Ruang Jantung 574493 0304R0010123V003161 1/12/2023 1/15/2023
402 66 Selasa / 17-01-2023 15:01:59 AM2301170453 MAWARLIS Ruang Jantung 181722 0304R0010123V003153 1/12/2023 1/16/2023
403 67 Selasa / 17-01-2023 15:01:41 AM2301170454 NOVIANTO Ruang Jantung 567590 0304R0010123V002744 1/11/2023 1/13/2023
404 1 Rabu / 18-01-2023 9:01:42 AM2301180075 SANTI KELAS BEDAH 573807 0304R0011222V007182 12/30/2022 1/16/2023
405 2 Rabu / 18-01-2023 9:01:45 AM2301180077 YONDI FITRA KELAS BEDAH 393149 0304R0010123V003536 1/15/2023 1/16/2023
406 3 Rabu / 18-01-2023 9:01:39 AM2301180079 SYAFRI KELAS BEDAH 353814 0304R0010123V003143 1/12/2023 1/13/2023
407 4 Rabu / 18-01-2023 9:01:30 AM2301180080 DEFI ANDRIANI Ruang Bedah 547142 0304R0010123V003148 1/12/2023 1/13/2023
408 5 Rabu / 18-01-2023 9:01:23 AM2301180081 EMELIA ZARMI Ruang Bedah 558205 0304R0010123V002741 1/11/2023 1/13/2023
409 6 Rabu / 18-01-2023 9:01:17 AM2301180082 SYAMSINAR Ruang Bedah 572680 0304R0010123V003135 1/12/2023 1/13/2023
410 7 Rabu / 18-01-2023 9:01:33 AM2301180089 FENI SUSANTI Ruang Bedah 574134 0304R0010123V003147 1/12/2023 1/13/2023
411 8 Rabu / 18-01-2023 9:01:31 AM2301180092 WINARNI Ruang Bedah 548384 0304R0010123V003122 1/12/2023 1/13/2023
412 9 Rabu / 18-01-2023 9:01:23 AM2301180098 SILVIA SARCE Ruang Bedah 428409 0304R0010123V002975 1/12/2023 1/14/2023
413 10 Rabu / 18-01-2023 9:01:52 AM2301180100 IRWANTO Ruang Bedah 574354 0304R0010123V002470 1/10/2023 1/14/2023
414 11 Rabu / 18-01-2023 9:01:05 AM2301180101 MUHAMMAD AL FAHRIZY Ruang Bedah 573359 0304R0010123V002467 1/10/2023 1/14/2023
415 12 Rabu / 18-01-2023 9:01:46 AM2301180103 HERMAN S Ruang Bedah 513361 0304R0010123V002469 1/10/2023 1/13/2023
416 13 Rabu / 18-01-2023 10:01:01 AM2301180106 BUDI WAHYONO Ruang Bedah 551255 0304R0010123V003126 1/12/2023 1/19/2023
417 14 Rabu / 18-01-2023 10:01:34 AM2301180108 ILHAM GHALIB AKBAR Ruang Anak 379734 0304R0010123V002767 1/11/2023 1/16/2023
418 15 Rabu / 18-01-2023 10:01:59 AM2301180112 HUMAIRA JENDAYA WIBOWO Ruang Anak 504078 0304R0010123V003907 1/16/2023 1/16/2023
419 16 Rabu / 18-01-2023 10:01:26 AM2301180113 BY NY SITI DAHLIA Ruang Bayi (PERINATOLOGI) 574103 0304R0010123V001504 1/5/2023 1/16/2023
420 17 Rabu / 18-01-2023 10:01:30 AM2301180120 GEVELY ARCAVOSKI Ruang Anak 568952 0304R0010123V000020 1/1/2023 1/17/2023
421 18 Rabu / 18-01-2023 10:01:11 AM2301180126 BY. NY ISRA MIRANTI Ruang Bayi (PERINATOLOGI) 572142 0304R0011122V004480 11/20/2022 1/16/2023
422 19 Rabu / 18-01-2023 10:01:03 AM2301180129 AMRIZAL Ruang Bedah 566885 0304R0010123V001747 1/7/2023 1/16/2023
423 20 Rabu / 18-01-2023 10:01:51 AM2301180131 FAUZAL AMRI Ruang Bedah 4538 0304R0010123V003538 1/15/2023 1/16/2023
424 21 Rabu / 18-01-2023 10:01:28 AM2301180132 NASRUL Ruang Bedah 573118 0304R0010123V003045 1/12/2023 1/16/2023
425 22 Rabu / 18-01-2023 10:01:25 AM2301180136 YUSRIL Ruang Bedah 524635 0304R0010123V002691 1/11/2023 1/16/2023
426 23 Rabu / 18-01-2023 10:01:28 AM2301180138 ENILWATI Ruang Bedah 562356 0304R0010123V003537 1/15/2023 1/16/2023
427 24 Rabu / 18-01-2023 10:01:36 AM2301180141 DEWI ANDRIKA Ruang Bedah 572560 0304R0010123V003532 1/15/2023 1/16/2023
428 25 Rabu / 18-01-2023 10:01:31 AM2301180147 FAISAL HAFIS KELAS BEDAH 571422 0304R0010123V003543 1/15/2023 1/17/2023
429 26 Rabu / 18-01-2023 10:01:06 AM2301180148 DELI MURNI KELAS BEDAH 574322 0304R0010123V002112 1/9/2023 1/16/2023
430 27 Rabu / 18-01-2023 10:01:38 AM2301180149 ZOELBAIDAH Ruang Ambun Suri Lantai 4 (Interne) 574020 0304R0010123V000677 1/3/2023 1/9/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
JANUARI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
431 28 Rabu / 18-01-2023 10:01:29 AM2301180150 HARDIUS Ruang Ambun Suri Lantai 4 (Interne) 573949 0304R0010123V000958 1/4/2023 1/11/2023
432 29 Rabu / 18-01-2023 10:01:06 AM2301180151 WISRI Ruang Ambun Suri Lantai 4 (Interne) 448110 0304R0010123V002122 1/9/2023 1/12/2023
433 30 Rabu / 18-01-2023 10:01:40 AM2301180152 MASMIR Ruang Ambun Suri Lantai 4 (Interne) 573334 0304R0011222V007242 12/30/2022 1/11/2023
434 31 Rabu / 18-01-2023 10:01:26 AM2301180165 BUJANG ST BATUAH Ruang Paru Ruang Paru 573730 0304R0011222V006714 12/29/2022 1/6/2023
435 32 Rabu / 18-01-2023 10:01:51 AM2301180166 JUSMANIAR Ruang Paru Ruang Paru 573876 0304R0011222V007298 12/31/2022 1/5/2023
436 33 Rabu / 18-01-2023 10:01:22 AM2301180167 TSANIA KHAIRIA Ruang Anak 519173 0304R0010123V003489 1/14/2023 1/17/2023
437 34 Rabu / 18-01-2023 11:01:02 AM2301180169 MARATUA SIHOMBING Ruang Ambun Suri Lantai 3 (Interne) 574405 0304R0010123V002743 1/11/2023 1/17/2023
438 35 Rabu / 18-01-2023 11:01:44 AM2301180170 DANDY FAHRUL Ruang Ambun Suri Lantai 3 (Interne) 492795 0304R0010123V003141 1/12/2023 1/17/2023
439 36 Rabu / 18-01-2023 11:01:02 AM2301180171 ERNAWATI Ruang Ambun Suri Lantai 3 (Interne) 421824 0304R0011222V004381 12/20/2022 1/16/2023
440 37 Rabu / 18-01-2023 11:01:01 AM2301180173 DARMIATI Ruang Ambun Suri Lantai 3 (Interne) 287117 0304R0010123V002486 1/10/2023 1/16/2023
441 38 Rabu / 18-01-2023 11:01:42 AM2301180174 ASNIDA Ruang Ambun Suri Lantai 3 (Interne) 574546 0304R0010123V003473 1/14/2023 1/17/2023
442 39 Rabu / 18-01-2023 11:01:26 AM2301180175 DASRIL Ruang Ambun Suri Lantai 3 (Interne) 574216 0304R0010123V001723 1/7/2023 1/17/2023
443 40 Rabu / 18-01-2023 11:01:41 AM2301180176 MARNO Ruang Ambun Suri Lantai 3 (Interne) 574328 0304R0010123V002129 1/9/2023 1/17/2023
444 41 Rabu / 18-01-2023 11:01:54 AM2301180177 SUHERMAN Ruang Ambun Suri Lantai 3 (Interne) 574398 0304R0010123V002504 1/10/2023 1/17/2023
445 42 Rabu / 18-01-2023 11:01:34 AM2301180220 HERU HERMONO Ruang Jantung 574580 0304R0010123V003566 1/15/2023 1/17/2023
446 43 Rabu / 18-01-2023 11:01:57 AM2301180233 AMRIZAL Ruang Jantung 574567 0304R0010123V003530 1/15/2023 1/17/2023
447 44 Rabu / 18-01-2023 11:01:52 AM2301180234 SAFRI Ruang Jantung 437849 0304R0010123V003399 1/13/2023 1/17/2023
448 45 Rabu / 18-01-2023 11:01:32 AM2301180235 NURSILIS Ruang Jantung 574544 0304R0010123V003470 1/14/2023 1/17/2023
449 46 Rabu / 18-01-2023 11:01:12 AM2301180237 YULIANA GUSVITA Ruang Kebidanan 574583 0304R0010123V003605 1/16/2023 1/17/2023
450 47 Rabu / 18-01-2023 11:01:48 AM2301180238 HARLIDA NUREFILS Ruang Kebidanan 574569 0304R0010123V003542 1/15/2023 1/17/2023
451 48 Rabu / 18-01-2023 11:01:23 AM2301180239 NADILA ANGGRAINI Ruang Kebidanan 483456 0304R0010123V003904 1/16/2023 1/17/2023
452 49 Rabu / 18-01-2023 11:01:03 AM2301180241 NIRA YUSPIKA Ruang Kebidanan 335047 0304R0010123V003570 1/15/2023 1/16/2023
453 50 Rabu / 18-01-2023 13:01:09 AM2301180284 FATIMAH AZZAHRA Ruang Mata/THT/BEDAH MULUT 566132 0304R0010123V003820 1/16/2023 1/18/2023
454 51 Rabu / 18-01-2023 13:01:18 AM2301180285 OSMIWATI Ruang Mata/THT/BEDAH MULUT 337058 0304R0010123V003898 1/16/2023 1/18/2023
455 52 Rabu / 18-01-2023 13:01:36 AM2301180286 ABID AQIL HARNANDO Ruang Mata/THT/BEDAH MULUT 551423 0304R0010123V003798 1/16/2023 1/18/2023
456 53 Rabu / 18-01-2023 13:01:16 AM2301180287 NOFIYANTI Ruang Mata/THT/BEDAH MULUT 566416 0304R0010123V003684 1/16/2023 1/18/2023
457 54 Rabu / 18-01-2023 13:01:44 AM2301180288 MUHAMMAD FANDRA Ruang Mata/THT/BEDAH MULUT 507088 0304R0010123V003785 1/16/2023 1/18/2023
458 55 Rabu / 18-01-2023 13:01:33 AM2301180289 RAIHAN AKBAR Ruang Anak 150415 0304R0010123V004279 1/17/2023 1/17/2023
459 56 Rabu / 18-01-2023 13:01:34 AM2301180290 BY. NY DEWI ROSALINA S Ruang Bayi (PERINATOLOGI) 574574 0304R0010123V003881 1/15/2023 1/18/2023
460 57 Rabu / 18-01-2023 13:01:52 AM2301180291 DJULIMAR Ruang Cindua Mato 412986 0304R0010123V003408 1/13/2023 1/18/2023
461 58 Rabu / 18-01-2023 13:01:32 AM2301180292 MONICA RAHMADANI Ruang Cindua Mato 292176 0304R0010123V003517 1/14/2023 1/17/2023
462 59 Rabu / 18-01-2023 13:01:07 AM2301180293 DEWI ROJIS Ruang Cindua Mato 369787 0304R0010123V003495 1/14/2023 1/17/2023
463 60 Rabu / 18-01-2023 13:01:27 AM2301180297 NUR ASNI Ruang Bedah 321636 0304R0010123V003650 1/16/2023 1/17/2023
464 61 Rabu / 18-01-2023 13:01:39 AM2301180299 JUSMANIAR Ruang Bedah 562353 0304R0010123V003910 1/16/2023 1/17/2023
465 62 Rabu / 18-01-2023 13:01:27 AM2301180301 ZULKHAEDAH Ruang Bedah 398683 0304R0010123V003903 1/16/2023 1/17/2023
466 63 Rabu / 18-01-2023 13:01:39 AM2301180303 ELMARNIS Ruang Bedah 568314 0304R0010123V003493 1/14/2023 1/17/2023
467 64 Rabu / 18-01-2023 13:01:27 AM2301180304 RAMANELIS Ruang Bedah 574480 0304R0010123V003803 1/16/2023 1/17/2023
468 65 Rabu / 18-01-2023 13:01:09 AM2301180306 RIRI AGUSTI KELAS BEDAH 563388 0304R0010123V003901 1/16/2023 1/17/2023
469 66 Rabu / 18-01-2023 13:01:25 AM2301180308 GUSNIATI KELAS BEDAH 454160 0304R0010123V003755 1/16/2023 1/17/2023
470 67 Rabu / 18-01-2023 15:01:41 AM2301180471 MUTIARA FEBRINA FRIANDES Ruang Cindua Mato 311186 0304R0010123V003775 1/16/2023 1/18/2023
471 68 Rabu / 18-01-2023 15:01:26 AM2301180472 FADHILA ALYA FITHRI Ruang Cindua Mato 574585 0304R0010123V003708 1/16/2023 1/18/2023
472 69 Rabu / 18-01-2023 15:01:27 AM2301180474 YUNFI SALMI Ruang Ambun Suri Lantai 3 (Interne) 574492 0304R0010123V003168 1/12/2023 1/16/2023
473 70 Rabu / 18-01-2023 16:01:00 AM2301180475 YUS Ruang Ambun Suri Lantai 3 (Interne) 567984 0304R0010123V000670 1/3/2023 1/13/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
JANUARI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
474 71 Rabu / 18-01-2023 16:01:40 AM2301180476 MARIA EMANUELA Ruang Ambun Suri Lantai 3 (Interne) 567518 0304R0010123V003899 1/16/2023 1/17/2023
475 72 Rabu / 18-01-2023 16:01:43 AM2301180477 YULIA FITRI Ruang ICU/ICCU 151136 0304R0010123V004282 1/17/2023 1/18/2023
476 73 Rabu / 18-01-2023 16:01:24 AM2301180478 IRMAN BIN SAIR Ruang Jantung 574204 0304R0010123V002759 1/11/2023 1/18/2023
477 74 Rabu / 18-01-2023 16:01:04 AM2301180479 RAJIF Ruang Jantung 574575 0304R0010123V003555 1/15/2023 1/18/2023
478 75 Rabu / 18-01-2023 16:01:47 AM2301180480 AMRI Ruang Jantung 574558 0304R0010123V003512 1/14/2023 1/18/2023
479 76 Rabu / 18-01-2023 16:01:23 AM2301180481 ARNIS Ruang Jantung 484192 0304R0010123V003412 1/13/2023 1/18/2023
480 1 Kamis / 19-01-2023 8:01:02 AM2301190051 RISFA MULYANI Ruang Kebidanan 518063 0304R0010123V004274 1/16/2023 1/18/2023
481 2 Kamis / 19-01-2023 8:01:42 AM2301190054 YUSNI Ruang Kebidanan 324694 0304R0010123V003739 1/16/2023 1/18/2023
482 3 Kamis / 19-01-2023 8:01:19 AM2301190058 DESRI YENNA Ruang Kebidanan 569108 0304R0010123V003136 1/12/2023 1/16/2023
483 4 Kamis / 19-01-2023 8:01:19 AM2301190060 MASNIDAR Ruang Kebidanan 572085 0304R0010123V003142 1/12/2023 1/15/2023
484 5 Kamis / 19-01-2023 8:01:12 AM2301190061 SRINANG HARTANTI Ruang Kebidanan 457206 0304R0010123V000620 1/3/2023 1/13/2023
485 6 Kamis / 19-01-2023 9:01:56 AM2301190083 SRI HARTATI KELAS BEDAH 299765 0304R0010123V001576 1/6/2023 1/18/2023
486 7 Kamis / 19-01-2023 12:01:12 AM2301190234 GILANG PRATAMA Ruang Mata/THT/BEDAH MULUT 573988 0304R0010123V004117 1/17/2023 1/19/2023
487 8 Kamis / 19-01-2023 12:01:21 AM2301190235 ATINIA GEA KELAS BEDAH 572277 0304R0010123V003540 1/15/2023 1/19/2023
488 9 Kamis / 19-01-2023 12:01:21 AM2301190237 TAHEN LUBIS Ruang Cindua Mato 363836 0304R0010123V003481 1/14/2023 1/19/2023
489 10 Kamis / 19-01-2023 14:01:45 AM2301190373 BY.NY.SRI MENTARI Ruang Bayi (PERINATOLOGI) 574547 0304R0010123V003888 1/14/2023 1/19/2023
490 11 Kamis / 19-01-2023 14:01:10 AM2301190375 BY NY DEWI ISTIANA Ruang Bayi (PERINATOLOGI) 574102 0304R0010123V001279 1/5/2023 1/18/2023
491 12 Kamis / 19-01-2023 14:01:05 AM2301190377 ASHEEQA ILFITRI ARIANZA Ruang Anak 574564 0304R0010123V003526 1/15/2023 1/19/2023
492 13 Kamis / 19-01-2023 14:01:54 AM2301190381 BY NY NATASHA AFDHOLA Ruang Bayi (PERINATOLOGI) 574487 0304R0010123V004550 1/17/2023 1/19/2023
493 14 Kamis / 19-01-2023 14:01:29 AM2301190383 SUBHAN Ruang Ambun Suri Lantai 3 (Interne) 574581 0304R0010123V003571 1/16/2023 1/19/2023
494 15 Kamis / 19-01-2023 14:01:12 AM2301190386 MUTRIATI Ruang Ambun Suri Lantai 3 (Interne) 520718 0304R0010123V003491 1/14/2023 1/19/2023
495 16 Kamis / 19-01-2023 14:01:36 AM2301190388 YULI ANTI Ruang Ambun Suri Lantai 3 (Interne) 524705 0304R0010123V003429 1/13/2023 1/19/2023
496 1 Jumat / 20-01-2023 10:01:24 AM2301200168 MESWADI HENDRA Ruang Jantung 574637 0304R0010123V003943 1/16/2023 1/19/2023
497 2 Jumat / 20-01-2023 10:01:10 AM2301200171 FAUZAN Ruang Jantung 443577 0304R0010123V001807 1/9/2023 1/19/2023
498 3 Jumat / 20-01-2023 10:01:51 AM2301200172 ROSNIMAR Ruang Jantung 155631 0304R0010123V003958 1/16/2023 1/19/2023
499 4 Jumat / 20-01-2023 10:01:27 AM2301200174 YULIMAR Ruang Jantung 74281 0304R0010123V003948 1/16/2023 1/19/2023
500 5 Jumat / 20-01-2023 10:01:05 AM2301200176 NASRIL Ruang Bedah 272600 0304R0010123V003556 1/15/2023 1/18/2023
501 6 Jumat / 20-01-2023 10:01:47 AM2301200177 MASRI Ruang Bedah 573985 0304R0010123V003913 1/15/2023 1/18/2023
502 7 Jumat / 20-01-2023 10:01:42 AM2301200182 jonnaidi Ruang Bedah 574198 0304R0010123V001663 1/6/2023 1/18/2023
503 8 Jumat / 20-01-2023 10:01:29 AM2301200214 ANIMAR Ruang Bedah 574433 0304R0010123V002768 1/11/2023 1/18/2023
504 9 Jumat / 20-01-2023 10:01:53 AM2301200216 AMRIL ANWAR KELAS BEDAH 462110 0304R0010123V004106 1/17/2023 1/18/2023
505 10 Jumat / 20-01-2023 10:01:48 AM2301200219 M AIRISYAN KELAS BEDAH 473011 0304R0010123V004268 1/17/2023 1/18/2023
506 11 Jumat / 20-01-2023 10:01:28 AM2301200220 RADHITA ANELIA Ruang Bedah 574554 0304R0010123V003502 1/14/2023 1/18/2023
507 12 Jumat / 20-01-2023 10:01:19 AM2301200224 JASMI Ruang Bedah 544333 0304R0010123V003535 1/15/2023 1/18/2023
508 13 Jumat / 20-01-2023 10:01:27 AM2301200228 LASMARNI Ruang Bedah 504640 0304R0010123V003872 1/16/2023 1/18/2023
509 14 Jumat / 20-01-2023 10:01:02 AM2301200231 AMELYA SAFUTRI Ruang Bedah 574313 0304R0010123V002114 1/9/2023 1/18/2023
510 15 Jumat / 20-01-2023 10:01:40 AM2301200233 AZWAR Ruang Bedah 475576 0304R0010123V003923 1/16/2023 1/18/2023
511 16 Jumat / 20-01-2023 10:01:45 AM2301200237 JARMAINI KELAS BEDAH 528445 0304R0010123V002710 1/11/2023 1/17/2023
512 17 Jumat / 20-01-2023 10:01:44 AM2301200240 YANTI SUSPITA Ruang Kebidanan 574321 0304R0010123V004278 1/17/2023 1/19/2023
513 18 Jumat / 20-01-2023 11:01:10 AM2301200265 UMMU KULTSUM Ruang Kebidanan 574727 0304R0010123V004574 1/18/2023 1/19/2023
514 19 Jumat / 20-01-2023 11:01:55 AM2301200267 DEWI ROSALINA SIMARMATA Ruang Kebidanan 495302 0304R0010123V003853 1/13/2023 1/19/2023
515 20 Jumat / 20-01-2023 11:01:07 AM2301200272 MARTAHI TIGOR OLOAN S Ruang Paru 572859 0304R0010123V001771 1/8/2023 1/12/2023
516 21 Jumat / 20-01-2023 11:01:39 AM2301200275 HANIFA Ruang Paru 573471 0304R0011222V005602 12/23/2022 1/13/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
JANUARI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
517 22 Jumat / 20-01-2023 11:01:54 AM2301200342 JONNY WERIS Ruang Paru 574252 0304R0010123V001805 1/8/2023 1/13/2023
518 23 Jumat / 20-01-2023 11:01:33 AM2301200344 YULFETRI Ruang Paru 574236 0304R0010123V001775 1/8/2023 1/13/2023
519 24 Jumat / 20-01-2023 11:01:53 AM2301200347 YETI IRAWATI Ruang Paru 572886 0304R0010123V002109 1/9/2023 1/11/2023
520 25 Jumat / 20-01-2023 11:01:31 AM2301200348 YULI YULIA Ruang Paru 567444 0304R0010123V000702 1/3/2023 1/12/2023
521 26 Jumat / 20-01-2023 11:01:09 AM2301200349 SAIN Ruang Paru 574157 0304R0010123V001382 1/5/2023 1/12/2023
522 27 Jumat / 20-01-2023 11:01:33 AM2301200351 YURNALIS Ruang Paru 564481 0304R0010123V000968 1/4/2023 1/10/2023
523 28 Jumat / 20-01-2023 11:01:25 AM2301200353 JAYUSMAN Ruang Paru 554109 0304R0010123V001649 1/6/2023 1/10/2023
524 29 Jumat / 20-01-2023 11:01:58 AM2301200356 JHON HENDRI Ruang Paru 574080 0304R0010123V000982 1/4/2023 1/9/2023
525 30 Jumat / 20-01-2023 11:01:38 AM2301200357 MARLIS Ruang Paru 393274 0304R0010123V000957 1/4/2023 1/9/2023
526 31 Jumat / 20-01-2023 11:01:15 AM2301200361 FATIMAH TU ZAHARA Ruang Paru 573980 0304R0010123V000357 1/3/2023 1/7/2023
527 32 Jumat / 20-01-2023 11:01:20 AM2301200365 YULISMAR Ruang Paru 567356 0304R0011222V006995 12/29/2022 1/9/2023
528 33 Jumat / 20-01-2023 11:01:03 AM2301200368 CHAIROEL BACHRI Ruang Paru 567183 0304R0010123V000638 1/3/2023 1/11/2023
529 34 Jumat / 20-01-2023 11:01:34 AM2301200369 SOFYAN Ruang Paru 550932 0304R0011222V006365 12/27/2022 1/6/2023
530 35 Jumat / 20-01-2023 16:01:36 AM2301200444 NAYLA RAHMADANI Ruang Anak 314437 0304R0010123V004540 1/17/2023 1/19/2023
531 36 Jumat / 20-01-2023 16:01:08 AM2301200445 LOLA ADHA Ruang Mata/THT/BEDAH MULUT 401709 0304R0010123V004531 1/18/2023 1/20/2023
532 37 Jumat / 20-01-2023 16:01:09 AM2301200447 NAZINDA AKSHITA Ruang Mata/THT/BEDAH MULUT 571703 0304R0010123V004489 1/18/2023 1/20/2023
533 38 Jumat / 20-01-2023 16:01:24 AM2301200448 AFNI WATI Ruang Mata/THT/BEDAH MULUT 310869 0304R0010123V004474 1/18/2023 1/20/2023
534 39 Jumat / 20-01-2023 16:01:12 AM2301200449 GUSNA YETTI Ruang ICU/ICCU 322897 0304R0010123V003506 1/14/2023 1/19/2023
535 40 Jumat / 20-01-2023 16:01:01 AM2301200450 IRAN HASIM SIREGAR Ruang Paru 572174 0304R0010123V003134 1/12/2023 1/14/2023
536 41 Jumat / 20-01-2023 16:01:41 AM2301200451 YUSRI SIDI BANDARO Ruang Paru 295600 0304R0010123V002499 1/10/2023 1/13/2023
537 42 Jumat / 20-01-2023 16:01:24 AM2301200452 SAHRIN NASUTION Ruang Paru 568718 0304R0010123V001774 1/8/2023 1/13/2023
538 43 Jumat / 20-01-2023 16:01:03 AM2301200453 SAFNI Ruang Paru 574093 0304R0010123V001001 1/4/2023 1/13/2023
539 44 Jumat / 20-01-2023 16:01:44 AM2301200454 AISHA DIVA MEDINA Ruang Cindua Mato 63669 0304R0010123V003511 1/14/2023 1/20/2023
540 45 Jumat / 20-01-2023 16:01:29 AM2301200455 H. NURSAL Ruang Cindua Mato 571743 0304R0010123V003396 1/13/2023 1/19/2023
541 46 Jumat / 20-01-2023 16:01:10 AM2301200456 HENGKI R Ruang Jantung 574636 0304R0010123V004280 1/16/2023 1/20/2023
542 47 Jumat / 20-01-2023 16:01:01 AM2301200457 DASMAWATI Ruang Jantung 563447 0304R0010123V004311 1/18/2023 1/20/2023
543 48 Jumat / 20-01-2023 16:01:43 AM2301200458 KAMSER Ruang Jantung 574698 0304R0010123V004552 1/18/2023 1/20/2023
544 49 Jumat / 20-01-2023 16:01:30 AM2301200459 ABDUL HAFIZ Ruang Anak 574122 0304R0010123V003551 1/15/2023 1/20/2023
545 50 Jumat / 20-01-2023 16:01:10 AM2301200460 SULASTRI Ruang Ambun Suri Lantai 3 (Interne) 249276 0304R0010123V002760 1/11/2023 1/15/2023
546 51 Jumat / 20-01-2023 16:01:21 AM2301200461 SYAHRIDAL Ruang Ambun Suri Lantai 3 (Interne) 517419 0304R0010123V004273 1/13/2023 1/20/2023
547 52 Jumat / 20-01-2023 16:01:43 AM2301200462 ARDI SIREGAR Ruang Ambun Suri Lantai 3 (Interne) 571323 0304R0010123V003876 1/16/2023 1/19/2023
548 53 Jumat / 20-01-2023 16:01:40 AM2301200463 ZUHERMI Ruang Kebidanan 568173 0304R0010123V004270 1/17/2023 1/19/2023
549 54 Jumat / 20-01-2023 16:01:39 AM2301200464 LAELA ANGRAINI Ruang Kebidanan 574713 0304R0010123V004560 1/18/2023 1/19/2023
550 55 Jumat / 20-01-2023 17:01:27 AM2301200465 PEBRI YUNI YUNANDA Ruang Ambun Suri Lantai 3 (Interne) 439352 0304R0010123V003950 1/16/2023 1/20/2023
551 1 Rabu / 25-01-2023 9:01:57 AM2301250070 JAMIARTI KELAS BEDAH 90899 0304R0010123V004562 1/18/2023 1/19/2023
552 2 Rabu / 25-01-2023 9:01:11 AM2301250072 HEFFI NETTI KELAS BEDAH 354813 0304R0010123V004405 1/18/2023 1/19/2023
553 3 Rabu / 25-01-2023 9:01:21 AM2301250073 ALI AKBAR KELAS BEDAH 386356 0304R0010123V004416 1/18/2023 1/19/2023
554 4 Rabu / 25-01-2023 9:01:19 AM2301250074 ASNAWATI KELAS BEDAH 543135 0304R0010123V004271 1/17/2023 1/19/2023
555 5 Rabu / 25-01-2023 9:01:27 AM2301250080 NURHASNAH KELAS BEDAH 574336 0304R0010123V004458 1/18/2023 1/19/2023
556 6 Rabu / 25-01-2023 9:01:29 AM2301250082 ERNI Ruang Bedah 573142 0304R0010123V004522 1/18/2023 1/19/2023
557 7 Rabu / 25-01-2023 9:01:51 AM2301250084 ASNIWATI Ruang Bedah 519214 0304R0010123V004555 1/18/2023 1/19/2023
558 8 Rabu / 25-01-2023 9:01:36 AM2301250085 HENDRA K Ruang Bedah 556709 0304R0010123V004295 1/17/2023 1/19/2023
559 9 Rabu / 25-01-2023 9:01:31 AM2301250086 RIKO UTAMA Ruang Bedah 574515 0304R0010123V004286 1/17/2023 1/19/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
JANUARI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
560 10 Rabu / 25-01-2023 9:01:46 AM2301250089 MASRIZAL Ruang Bedah 569861 0304R0010123V000936 1/4/2023 1/9/2023
561 11 Rabu / 25-01-2023 9:01:17 AM2301250091 ISPENDI Ruang Bedah 279645 0304R0010123V004281 1/17/2023 1/19/2023
562 12 Rabu / 25-01-2023 9:01:39 AM2301250092 RAJIBUL IHSAN Ruang Bedah 574561 0304R0010123V003520 1/14/2023 1/19/2023
563 13 Rabu / 25-01-2023 9:01:07 AM2301250094 EDO RANGGAYUNI KELAS BEDAH 573325 0304R0010123V002277 1/9/2023 1/20/2023
564 14 Rabu / 25-01-2023 9:01:50 AM2301250095 OCTA FAUZAN KELAS BEDAH 573046 0304R0010123V004538 1/18/2023 1/20/2023
565 15 Rabu / 25-01-2023 9:01:41 AM2301250096 MUHAMMAD FARHAN KELAS BEDAH 574635 0304R0010123V003937 1/16/2023 1/20/2023
566 16 Rabu / 25-01-2023 9:01:38 AM2301250099 HENDRA NOVRIADI KELAS BEDAH 574661 0304R0010123V004246 1/17/2023 1/20/2023
567 17 Rabu / 25-01-2023 10:01:43 AM2301250100 HENDRAWATI KELAS BEDAH 520439 0304R0010123V004081 1/17/2023 1/20/2023
568 1 Kamis / 26-01-2023 10:01:51 AM2301260251 GEFANDRA ALFARABI HAQQI Ruang Anak 574682 0304R0010123V004288 1/17/2023 1/22/2023
569 2 Kamis / 26-01-2023 10:01:11 AM2301260263 MUHAMMAD SAIF ARFAN Ruang Anak 548070 0304R0010123V005169 1/20/2023 1/21/2023
570 3 Kamis / 26-01-2023 10:01:18 AM2301260270 GISEL SAKILLA NAJA Ruang Anak 531839 0304R0010123V005166 1/20/2023 1/20/2023
571 4 Kamis / 26-01-2023 10:01:30 AM2301260307 NADIA ZULFA YUSMI Ruang Anak 272317 0304R0010123V005163 1/20/2023 1/20/2023
572 5 Kamis / 26-01-2023 10:01:09 AM2301260309 HENDRIKO Ruang Paru 574633 0304R0010123V003939 1/16/2023 1/17/2023
573 6 Kamis / 26-01-2023 10:01:38 AM2301260311 RIZAWATI M Ruang Paru 559598 0304R0010123V002765 1/11/2023 1/16/2023
574 7 Kamis / 26-01-2023 10:01:39 AM2301260318 JUNDI AHMAD Ruang Paru 572789 0304R0010123V002746 1/11/2023 1/16/2023
575 8 Kamis / 26-01-2023 10:01:14 AM2301260323 NURHANIFAH Ruang Paru 574500 0304R0010123V003178 1/13/2023 1/17/2023
576 9 Kamis / 26-01-2023 10:01:49 AM2301260333 JAUZI Ruang Paru 203044 0304R0010123V002125 1/9/2023 1/16/2023
577 10 Kamis / 26-01-2023 10:01:38 AM2301260335 IDRIS Ruang Paru 356769 0304R0010123V002742 1/11/2023 1/16/2023
578 11 Kamis / 26-01-2023 10:01:33 AM2301260338 IRMEN NOFRIS Ruang Paru 573849 0304R0010123V001386 1/5/2023 1/14/2023
579 12 Kamis / 26-01-2023 10:01:17 AM2301260341 SYAHRIL Ruang Paru 573979 0304R0010123V000356 1/3/2023 1/14/2023
580 13 Kamis / 26-01-2023 10:01:30 AM2301260350 DICKY HAFIDS Ruang Jantung 220213 0304R0010123V005245 1/21/2023 1/22/2023
581 14 Kamis / 26-01-2023 10:01:11 AM2301260351 WENDRIZAL Ruang Jantung 574776 0304R0010123V004910 1/19/2023 1/22/2023
582 15 Kamis / 26-01-2023 10:01:55 AM2301260352 TANWIR Ruang Jantung 574773 0304R0010123V004903 1/19/2023 1/21/2023
583 16 Kamis / 26-01-2023 10:01:18 AM2301260353 BATINAR Ruang Jantung 574687 0304R0010123V004305 1/18/2023 1/21/2023
584 17 Kamis / 26-01-2023 10:01:14 AM2301260355 FATMAH DEWI Ruang Jantung 574725 0304R0010123V004573 1/18/2023 1/23/2023
585 18 Kamis / 26-01-2023 10:01:44 AM2301260358 MIMI SUSANTI Ruang Cindua Mato 573234 0304R0010123V002867 1/12/2023 1/24/2023
586 19 Kamis / 26-01-2023 11:01:07 AM2301260440 AFNITA Ruang Ambun Suri Lantai 3 (Interne) 563534 0304R0010123V002771 1/12/2023 1/22/2023
587 20 Kamis / 26-01-2023 11:01:37 AM2301260446 MUN Ruang Ambun Suri Lantai 3 (Interne) 574779 0304R0010123V004928 1/20/2023 1/21/2023
588 21 Kamis / 26-01-2023 11:01:20 AM2301260448 MIFTAHUL KHAIRA Ruang Ambun Suri Lantai 3 (Interne) 565827 0304R0010123V003559 1/15/2023 1/20/2023
589 22 Kamis / 26-01-2023 11:01:00 AM2301260449 ASTUTI Ruang Ambun Suri Lantai 3 (Interne) 571313 0304R0010123V003175 1/12/2023 1/21/2023
590 23 Kamis / 26-01-2023 11:01:31 AM2301260452 ELMIATI Ruang Ambun Suri Lantai 3 (Interne) 574723 0304R0010123V004567 1/18/2023 1/19/2023
591 24 Kamis / 26-01-2023 11:01:41 AM2301260454 ZURNEDI Ruang Ambun Suri Lantai 3 (Interne) 574584 0304R0010123V003932 1/16/2023 1/20/2023
592 25 Kamis / 26-01-2023 11:01:01 AM2301260455 FIRDAUS AHMAD Ruang Ambun Suri Lantai 3 (Interne) 574432 0304R0010123V002764 1/11/2023 1/22/2023
593 26 Kamis / 26-01-2023 11:01:23 AM2301260459 LUMEK Ruang Ambun Suri Lantai 3 (Interne) 486193 0304R0010123V003438 1/14/2023 1/24/2023
594 27 Kamis / 26-01-2023 11:01:09 AM2301260460 SURYA RAHMAT Ruang Ambun Suri Lantai 3 (Interne) 572714 0304R0010123V002095 1/9/2023 1/20/2023
595 28 Kamis / 26-01-2023 11:01:25 AM2301260462 AGUSTARDI Ruang Ambun Suri Lantai 3 (Interne) 325275 0304R0010123V004276 1/17/2023 1/24/2023
596 29 Kamis / 26-01-2023 11:01:09 AM2301260463 BY NY MEGA SARI Ruang Bayi (PERINATOLOGI) 574804 0304R0010123V005175 1/20/2023 1/22/2023
597 30 Kamis / 26-01-2023 11:01:49 AM2301260464 BY NY NUR ARTI ANGGRAINI Ruang Bayi (PERINATOLOGI) 574749 0304R0010123V005164 1/19/2023 1/23/2023
598 31 Kamis / 26-01-2023 12:01:39 AM2301260465 BY.NY.MAHARANI SAPUTRI Ruang Bayi (PERINATOLOGI) 574578 0304R0010123V003931 1/16/2023 1/24/2023
599 32 Kamis / 26-01-2023 12:01:48 AM2301260471 BAYI NYONYA YULI MARNI Ruang Bayi (PERINATOLOGI) 574657 0304R0010123V004156 1/17/2023 1/24/2023
600 33 Kamis / 26-01-2023 12:01:18 AM2301260472 BY. NY. SYAM DWI AGISTA L Ruang Bayi (PERINATOLOGI) 574560 0304R0010123V003509 1/14/2023 1/23/2023
601 34 Kamis / 26-01-2023 12:01:19 AM2301260473 MERLIN HENRAYANI Ruang Kebidanan 574823 0304R0010123V005201 1/20/2023 1/23/2023
602 35 Kamis / 26-01-2023 12:01:46 AM2301260474 MARIATI Ruang Kebidanan 321232 0304R0010123V005273 1/22/2023 1/23/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
JANUARI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
603 36 Kamis / 26-01-2023 12:01:31 AM2301260475 MEGA SARI Ruang Kebidanan 439330 0304R0010123V005148 1/20/2023 1/22/2023
604 37 Kamis / 26-01-2023 12:01:13 AM2301260476 TIFFANY UTIMUA Ruang Kebidanan 574833 0304R0010123V005242 1/21/2023 1/23/2023
605 38 Kamis / 26-01-2023 12:01:27 AM2301260477 DENNY INDRIATY Ruang Kebidanan 574864 0304R0010123V005325 1/23/2023 1/24/2023
606 39 Kamis / 26-01-2023 12:01:15 AM2301260478 LAELA ANGRAINI Ruang Kebidanan 574713 0304R0010123V005270 1/22/2023 1/24/2023
607 40 Kamis / 26-01-2023 12:01:57 AM2301260479 ISTER FAHMI Ruang Kebidanan 452583 0304R0010123V004905 1/19/2023 1/21/2023
608 41 Kamis / 26-01-2023 12:01:47 AM2301260480 ROSMINA Ruang Kebidanan 574782 0304R0010123V004931 1/20/2023 1/22/2023
609 42 Kamis / 26-01-2023 12:01:34 AM2301260481 DONA NOFRIANI Ruang Kebidanan 574724 0304R0010123V004566 1/18/2023 1/22/2023
610 43 Kamis / 26-01-2023 12:01:16 AM2301260482 EMILIA TRUMIS SARI DEWI Ruang Kebidanan 156000 0304R0010123V004322 1/17/2023 1/20/2023
611 44 Kamis / 26-01-2023 13:01:52 AM2301260494 ALFIA NORA Ruang Kebidanan 572465 0304R0010123V003834 1/16/2023 1/20/2023
612 45 Kamis / 26-01-2023 13:01:22 AM2301260495 BUNGA ENJELI Ruang Kebidanan 521136 0304R0010123V004299 1/17/2023 1/20/2023
613 46 Kamis / 26-01-2023 13:01:19 AM2301260496 LENI RAMADAN Ruang Kebidanan 573592 0304R0010123V003544 1/16/2023 1/20/2023
614 47 Kamis / 26-01-2023 13:01:13 AM2301260497 WAHYUNI Ruang Kebidanan 458336 0304R0010123V004586 1/19/2023 1/20/2023
615 48 Kamis / 26-01-2023 13:01:53 AM2301260498 RAHMI OKTAVIA Ruang Kebidanan 414660 0304R0010123V004309 1/18/2023 1/20/2023
616 49 Kamis / 26-01-2023 13:01:29 AM2301260499 ZAHARA HASNI Ruang Cindua Mato 492666 0304R0010123V005178 1/20/2023 1/21/2023
617 50 Kamis / 26-01-2023 13:01:34 AM2301260500 SALMAN Ruang Cindua Mato 204637 0304R0010123V004554 1/18/2023 1/19/2023
618 51 Kamis / 26-01-2023 13:01:13 AM2301260501 MEDI KHAIRUL Ruang ICU/ICCU 574822 0304R0010123V005186 1/20/2023 1/23/2023
619 52 Kamis / 26-01-2023 13:01:39 AM2301260502 AGUSTINAR Ruang ICU/ICCU 574824 0304R0010123V005199 1/20/2023 1/24/2023
620 1 Senin / 30-01-2023 8:01:05 AM2301300033 VENI ROZA KELAS BEDAH 282484 0304R0010123V003548 1/15/2023 1/21/2023
621 2 Senin / 30-01-2023 8:01:17 AM2301300048 RIZA YULANDA Ruang Bedah 562130 0304R0010123V004275 1/17/2023 1/20/2023
622 3 Senin / 30-01-2023 8:01:07 AM2301300053 PURBA LUBIS Ruang Bedah 574646 0304R0010123V004244 1/17/2023 1/20/2023
623 4 Senin / 30-01-2023 8:01:01 AM2301300059 SAYUN Ruang Bedah 574551 0304R0010123V003498 1/14/2023 1/20/2023
624 5 Senin / 30-01-2023 9:01:37 AM2301300062 SYAFARUDIN Ruang Bedah 570113 0304R0010123V003791 1/14/2023 1/20/2023
625 6 Senin / 30-01-2023 9:01:48 AM2301300064 IRNAS Ruang Bedah 554241 0304R0010123V004203 1/17/2023 1/21/2023
626 7 Senin / 30-01-2023 9:01:25 AM2301300067 JAARMAL Ruang Bedah 292239 0304R0010123V004899 1/19/2023 1/22/2023
627 8 Senin / 30-01-2023 9:01:38 AM2301300068 MIMI ASRIANTI Ruang Bedah 557206 0304R0010123V004815 1/19/2023 1/23/2023
628 9 Senin / 30-01-2023 9:01:48 AM2301300075 SYAFRIDA KELAS BEDAH 558320 0304R0010123V004064 1/17/2023 1/23/2023
629 10 Senin / 30-01-2023 9:01:17 AM2301300081 JALMAN KELAS BEDAH 573736 0304R0010123V004035 1/17/2023 1/21/2023
630 11 Senin / 30-01-2023 9:01:30 AM2301300082 JOHNNI HARDI, SE Ruang Bedah 574595 0304R0010123V003921 1/16/2023 1/23/2023
631 12 Senin / 30-01-2023 9:01:22 AM2301300097 ERIC SAPUTRA Ruang Bedah 573574 0304R0011222V006015 12/26/2022 1/20/2023
632 13 Senin / 30-01-2023 9:01:59 AM2301300103 NANDA PRASETYA PUTRA Ruang Bedah 573614 0304R0010123V004885 1/19/2023 1/20/2023
633 14 Senin / 30-01-2023 9:01:09 AM2301300114 ARRASYID YUDIGA P KELAS BEDAH 199849 0304R0010123V004556 1/18/2023 1/23/2023
634 15 Senin / 30-01-2023 10:01:55 AM2301300122 MISTIAYATI KELAS BEDAH 574649 0304R0010123V004897 1/19/2023 1/20/2023
635 16 Senin / 30-01-2023 10:01:51 AM2301300125 MULYADI Ruang Bedah 573774 0304R0010123V003854 1/16/2023 1/19/2023
636 17 Senin / 30-01-2023 10:01:43 AM2301300126 ATMA DJALINUS Ruang Jantung 505886 0304R0010123V005229 1/21/2023 1/24/2023
637 18 Senin / 30-01-2023 10:01:49 AM2301300128 M FATHIR NAYAKA Ruang Anak 524160 0304R0010123V005451 1/24/2023 1/24/2023
638 19 Senin / 30-01-2023 10:01:26 AM2301300129 ILHAM GHALIB AKBAR Ruang Anak 379734 0304R0010123V004292 1/17/2023 1/24/2023
639 20 Senin / 30-01-2023 10:01:22 AM2301300130 IRDAWATI Ruang Mata/THT/BEDAH MULUT 573677 0304R0010123V005509 1/24/2023 1/25/2023
640 21 Senin / 30-01-2023 10:01:31 AM2301300135 KIKI SAFITRI Ruang Mata/THT/BEDAH MULUT 566888 0304R0010123V005346 1/23/2023 1/25/2023
641 22 Senin / 30-01-2023 10:01:24 AM2301300139 FARENZA RIDIA Ruang Mata/THT/BEDAH MULUT 573695 0304R0010123V005360 1/23/2023 1/25/2023
642 23 Senin / 30-01-2023 10:01:44 AM2301300143 RAHMITA NENGSIH Ruang Mata/THT/BEDAH MULUT 566645 0304R0010123V005349 1/23/2023 1/25/2023
643 24 Senin / 30-01-2023 10:01:23 AM2301300145 BY NY FEMEGA FEBRIA Ruang Bayi (PERINATOLOGI) 574840 0304R0010123V005938 1/22/2023 1/24/2023
644 25 Senin / 30-01-2023 10:01:57 AM2301300163 BY.NY.HARLIDA NUREFILS Ruang Bayi (PERINATOLOGI) 574573 0304R0010123V003915 1/15/2023 1/24/2023
645 26 Senin / 30-01-2023 10:01:50 AM2301300166 ASRUDDIN RKT Ruang Jantung 574827 0304R0010123V005231 1/21/2023 1/24/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
JANUARI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
646 27 Senin / 30-01-2023 10:01:12 AM2301300173 ASWIRMAN Ruang Jantung 574821 0304R0010123V005183 1/20/2023 1/24/2023
647 28 Senin / 30-01-2023 10:01:17 AM2301300184 HENDRI SAPUTRA Ruang Jantung 441123 0304R0010123V005257 1/22/2023 1/24/2023
648 29 Senin / 30-01-2023 10:01:32 AM2301300195 SUPRAPTO Ruang Jantung 574852 0304R0010123V005278 1/22/2023 1/24/2023
649 30 Senin / 30-01-2023 10:01:02 AM2301300196 ROKHANI Ruang Jantung 574850 0304R0010123V005276 1/22/2023 1/25/2023
650 31 Senin / 30-01-2023 10:01:05 AM2301300197 ISMAEL Ruang Jantung 574867 0304R0010123V005355 1/23/2023 1/25/2023
651 32 Senin / 30-01-2023 10:01:07 AM2301300199 FIRDAUS HANAFI Ruang Ambun Suri Lantai 3 (Interne) 574537 0304R0010123V003882 1/13/2023 1/24/2023
652 33 Senin / 30-01-2023 10:01:20 AM2301300207 DEFRITA Ruang Ambun Suri Lantai 3 (Interne) 389461 0304R0010123V003929 1/16/2023 1/25/2023
653 34 Senin / 30-01-2023 10:01:05 AM2301300211 AZIZAH Ruang Ambun Suri Lantai 3 (Interne) 402225 0304R0010123V001401 1/6/2023 1/25/2023
654 35 Senin / 30-01-2023 10:01:30 AM2301300214 NAZWAR Ruang Ambun Suri Lantai 3 (Interne) 574836 0304R0010123V005248 1/21/2023 1/22/2023
655 36 Senin / 30-01-2023 11:01:04 AM2301300215 ZUL HENDRI Ruang Ambun Suri Lantai 3 (Interne) 574245 0304R0010123V001784 1/8/2023 1/25/2023
656 37 Senin / 30-01-2023 11:01:13 AM2301300245 ALFI HENDRI Ruang Bedah 573954 0304R0010123V003176 1/13/2023 1/24/2023
657 38 Senin / 30-01-2023 11:01:06 AM2301300248 ULIL AMRI Ruang Bedah 562672 0304R0010123V004791 1/19/2023 1/24/2023
658 39 Senin / 30-01-2023 11:01:59 AM2301300249 SULASTRI Ruang Bedah 563099 0304R0010123V005331 1/23/2023 1/24/2023
659 40 Senin / 30-01-2023 11:01:34 AM2301300253 LUSI AGUSTI Ruang Bedah 572829 0304R0010123V005327 1/23/2023 1/24/2023
660 41 Senin / 30-01-2023 11:01:33 AM2301300254 RAPIT Ruang Bedah 573945 0304R0010123V005326 1/23/2023 1/24/2023
661 42 Senin / 30-01-2023 11:01:40 AM2301300255 WIDIAWATI Ruang Bedah 573424 0304R0010123V005323 1/23/2023 1/24/2023
662 43 Senin / 30-01-2023 11:01:22 AM2301300256 AZIZ KELAS BEDAH 573251 0304R0010123V005353 1/23/2023 1/25/2023
663 44 Senin / 30-01-2023 11:01:55 AM2301300268 ENDRIANI Ruang Bedah 573307 0304R0010123V005317 1/23/2023 1/24/2023
664 45 Senin / 30-01-2023 11:01:28 AM2301300269 SYAMSUIR KELAS BEDAH 559403 0304R0010123V005354 1/23/2023 1/24/2023
665 46 Senin / 30-01-2023 11:01:26 AM2301300270 NOFFITRIA ANGGRAINI KELAS BEDAH 574669 0304R0010123V005651 1/23/2023 1/24/2023
666 47 Senin / 30-01-2023 12:01:18 AM2301300275 NUR ARTI ANGGRAINI Ruang Kebidanan 504465 0304R0010123V004847 1/19/2023 1/20/2023
667 48 Senin / 30-01-2023 12:01:40 AM2301300276 ABELINA NATASYA Ruang Kebidanan 574819 0304R0010123V005188 1/20/2023 1/24/2023
668 49 Senin / 30-01-2023 12:01:23 AM2301300277 NESSIA FITRI Ruang Kebidanan 408296 0304R0010123V005483 1/24/2023 1/25/2023
669 50 Senin / 30-01-2023 12:01:10 AM2301300279 MUTHMAINNAH Ruang Kebidanan 415146 0304R0010123V005268 1/22/2023 1/24/2023
670 51 Senin / 30-01-2023 12:01:19 AM2301300280 KIKI RAHMADITHA Ruang Kebidanan 495883 0304R0010123V005261 1/22/2023 1/24/2023
671 52 Senin / 30-01-2023 12:01:19 AM2301300281 ROZI Ruang Kebidanan 476448 0304R0010123V005283 1/22/2023 1/25/2023
672 53 Senin / 30-01-2023 12:01:01 AM2301300282 YUNIDAR Ruang Kebidanan 568862 0304R0010123V005247 1/21/2023 1/24/2023
673 54 Senin / 30-01-2023 12:01:25 AM2301300286 MASDAR KELAS BEDAH 573163 0304R0010123V003560 1/15/2023 1/24/2023
674 1 Selasa / 31-01-2023 14:01:28 AM2301310395 ERIKA Ruang Ambun Suri Lantai 3 (Interne) 239110 0304R0010123V003964 1/17/2023 1/25/2023
675 2 Selasa / 31-01-2023 14:01:39 AM2301310397 RAIHAN AKBAR Ruang Anak 150415 0304R0010123V006029 1/25/2023 1/25/2023
676 3 Selasa / 31-01-2023 14:01:32 AM2301310400 NADIA RAHMI Ruang Mata/THT/BEDAH MULUT 569444 0304R0010123V005558 1/24/2023 1/26/2023
677 4 Selasa / 31-01-2023 14:01:08 AM2301310403 INDRA JAYA Ruang Jantung 574903 0304R0010123V005711 1/24/2023 1/26/2023
678 5 Selasa / 31-01-2023 14:01:34 AM2301310410 ROSMA HAKIM Ruang Jantung 574868 0304R0010123V005358 1/23/2023 1/26/2023
679 6 Selasa / 31-01-2023 14:01:32 AM2301310416 ARTINA Ruang Ambun Suri Lantai 4 (Interne) 561253 0304R0010123V003150 1/12/2023 1/25/2023
680 7 Selasa / 31-01-2023 14:01:22 AM2301310417 JUMIARTI Ruang Ambun Suri Lantai 4 (Interne) 574730 0304R0010123V004787 1/19/2023 1/25/2023
681 8 Selasa / 31-01-2023 14:01:08 AM2301310423 ROSMA GUSMITA Ruang Ambun Suri Lantai 4 (Interne) 464806 0304R0010123V005345 1/23/2023 1/25/2023
682 9 Selasa / 31-01-2023 15:01:53 AM2301310448 MUHAMMAD FEBRINO Ruang Paru 555162 0304R0010123V005180 1/17/2023 1/18/2023
683 10 Selasa / 31-01-2023 15:01:41 AM2301310450 RUSDAH Ruang Paru 437034 0304R0010123V003557 1/15/2023 1/19/2023
684 11 Selasa / 31-01-2023 15:01:48 AM2301310452 EDISON Ruang Paru 573798 0304R0011222V007018 12/29/2022 1/20/2023
685 12 Selasa / 31-01-2023 15:01:09 AM2301310453 MARDIATI Ruang Paru 574254 0304R0010123V001793 1/8/2023 1/14/2023
686 13 Selasa / 31-01-2023 15:01:17 AM2301310455 WIRDA Ruang Paru 574576 0304R0010123V003561 1/15/2023 1/16/2023
687 14 Selasa / 31-01-2023 15:01:03 AM2301310456 MARJOHAN Ruang Paru 574396 0304R0010123V002501 1/10/2023 1/17/2023
688 15 Selasa / 31-01-2023 15:01:51 AM2301310457 EMIDAWATI Ruang Paru 574491 0304R0010123V003158 1/12/2023 1/17/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
JANUARI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
689 16 Selasa / 31-01-2023 15:01:30 AM2301310458 ROHANA Ruang Paru 460609 0304R0010123V003166 1/12/2023 1/13/2023
690 17 Selasa / 31-01-2023 15:01:07 AM2301310460 NASA ASKAR MELIA Ruang Paru 574369 0304R0010123V002472 1/10/2023 1/13/2023
691 18 Selasa / 31-01-2023 15:01:44 AM2301310461 ARTATI Ruang Ambun Suri Lantai 4 (Interne) 398708 0304R0010123V003925 1/16/2023 1/20/2023
692 19 Selasa / 31-01-2023 15:01:21 AM2301310462 FATIMAH Ruang Ambun Suri Lantai 4 (Interne) 571117 0304R0010123V003789 1/16/2023 1/20/2023
693 20 Selasa / 31-01-2023 15:01:44 AM2301310464 AMRIN SUDDIN Ruang Ambun Suri Lantai 4 (Interne) 574634 0304R0010123V003935 1/16/2023 1/20/2023
694 21 Selasa / 31-01-2023 15:01:42 AM2301310465 ERNA Ruang Ambun Suri Lantai 4 (Interne) 570791 0304R0010123V003369 1/13/2023 1/22/2023
695 22 Selasa / 31-01-2023 15:01:45 AM2301310466 SURYA SAPUTRA Ruang Ambun Suri Lantai 4 (Interne) 441349 0304R0010123V003908 1/16/2023 1/19/2023
696 23 Selasa / 31-01-2023 15:01:20 AM2301310467 ZUMAR FITRI WELINDA Ruang Ambun Suri Lantai 4 (Interne) 566469 0304R0010123V003466 1/14/2023 1/17/2023
697 24 Selasa / 31-01-2023 15:01:05 AM2301310469 MARIA EMANUELA Ruang Ambun Suri Lantai 4 (Interne) 567518 0304R0010123V000066 1/2/2023 1/14/2023
698 25 Selasa / 31-01-2023 16:01:09 AM2301310470 ZARMAINI Ruang Ambun Suri Lantai 4 (Interne) 482440 0304R0010123V001392 1/5/2023 1/17/2023
699 26 Selasa / 31-01-2023 16:01:43 AM2301310472 ZULFAHMI Ruang Ambun Suri Lantai 4 (Interne) 574549 0304R0010123V003483 1/14/2023 1/18/2023
700 27 Selasa / 31-01-2023 16:01:02 AM2301310473 MUHAMMAD KADRI Ruang Ambun Suri Lantai 4 (Interne) 346745 0304R0010123V002750 1/11/2023 1/17/2023
701 28 Selasa / 31-01-2023 16:01:53 AM2301310474 RAHMAWATI Ruang Ambun Suri Lantai 4 (Interne) 519405 0304R0010123V003479 1/14/2023 1/16/2023
702 29 Selasa / 31-01-2023 16:01:51 AM2301310475 RINI MAIRIZA Ruang Ambun Suri Lantai 4 (Interne) 562478 0304R0010123V001802 1/8/2023 1/14/2023
703 30 Selasa / 31-01-2023 16:01:46 AM2301310476 ANWAR Ruang Ambun Suri Lantai 4 (Interne) 574331 0304R0010123V002134 1/10/2023 1/16/2023
704 31 Selasa / 31-01-2023 16:01:24 AM2301310477 HARTINI Ruang Ambun Suri Lantai 4 (Interne) 574088 0304R0010123V000990 1/4/2023 1/11/2023
705 32 Selasa / 31-01-2023 16:01:48 AM2301310478 ERNAWATI D Ruang Ambun Suri Lantai 4 (Interne) 430507 0304R0010123V001783 1/8/2023 1/13/2023
706 33 Selasa / 31-01-2023 16:01:38 AM2301310479 SRI RAHAYU Ruang Ambun Suri Lantai 4 (Interne) 573683 0304R0010123V000163 1/2/2023 1/13/2023
707 34 Selasa / 31-01-2023 16:01:25 AM2301310480 DESI ASRA ROZA Ruang Bedah 371951 0304R0010123V001697 1/7/2023 1/25/2023
708 35 Selasa / 31-01-2023 16:01:16 AM2301310481 HARLIS MAWATI Ruang Bedah 573432 0304R0010123V005682 1/24/2023 1/25/2023
709 36 Selasa / 31-01-2023 16:01:09 AM2301310482 HAMIDAH Ruang Bedah 573304 0304R0010123V005356 1/23/2023 1/25/2023
710 37 Selasa / 31-01-2023 16:01:57 AM2301310483 M.NASIR Ruang Bedah 574627 0304R0010123V005313 1/23/2023 1/25/2023
711 38 Selasa / 31-01-2023 16:01:33 AM2301310484 LASMARIA MANIK Ruang Bedah 574603 0304R0010123V005329 1/23/2023 1/25/2023
712 39 Selasa / 31-01-2023 16:01:24 AM2301310485 SYOFIANIS Ruang Bedah 574871 0304R0010123V005378 1/23/2023 1/25/2023
713 40 Selasa / 31-01-2023 16:01:01 AM2301310486 SAMSIMAR Ruang Kebidanan 378506 0304R0010123V005738 1/25/2023 1/26/2023
714 41 Selasa / 31-01-2023 16:01:37 AM2301310487 OMELYA IRAWAN Ruang Kebidanan 530954 0304R0010123V006051 1/25/2023 1/26/2023
715 42 Selasa / 31-01-2023 16:01:27 AM2301310488 CACA SUBRIYATI Ruang Kebidanan 520834 0304R0010123V006047 1/25/2023 1/26/2023
716 43 Selasa / 31-01-2023 16:01:54 AM2301310489 EFI ALIMA PAKPAHAN Ruang Kebidanan 574466 0304R0010123V005324 1/23/2023 1/26/2023
717 44 Selasa / 31-01-2023 16:01:49 AM2301310490 KHUSNUL FATIMAH Ruang Kebidanan 303623 0304R0010123V005191 1/20/2023 1/25/2023
718 45 Selasa / 31-01-2023 17:01:54 AM2301310491 BY NY WAHYUNI Ruang Bayi (PERINATOLOGI) 574769 0304R0010123V005172 1/19/2023 1/26/2023
719 46 Selasa / 31-01-2023 17:01:52 AM2301310492 BY NY ROSMINA Ruang Bayi (PERINATOLOGI) 574795 0304R0010123V005709 1/20/2023 1/26/2023
720 47 Selasa / 31-01-2023 17:01:13 AM2301310493 RAHMATUL ILMI Ruang Mata/THT/BEDAH MULUT 443536 0304R0010123V006035 1/25/2023 1/27/2023
721 48 Selasa / 31-01-2023 17:01:56 AM2301310494 NORA ELIDA Ruang Mata/THT/BEDAH MULUT 567004 0304R0010123V006030 1/25/2023 1/27/2023
722 49 Selasa / 31-01-2023 17:01:58 AM2301310495 ADRIANSYAH RAHMAD Ruang Mata/THT/BEDAH MULUT 573558 0304R0010123V005693 1/24/2023 1/27/2023
723 50 Selasa / 31-01-2023 17:01:42 AM2301310496 AFRIDA Ruang Jantung Ruang ICU/ICCU 574843 0304R0010123V005259 1/22/2023 1/27/2023
724 51 Selasa / 31-01-2023 17:01:42 AM2301310497 FAUZI HIDAYAT Ruang Jantung Ruang ICU/ICCU 574938 0304R0010123V005749 1/25/2023 1/27/2023
725 52 Selasa / 31-01-2023 17:01:25 AM2301310498 NABYLA KHARISMA SUHATMAN Ruang Cindua Mato 574973 0304R0010123V006050 1/25/2023 1/27/2023
726 1 Rabu / 01-02-2023 7:02:13 AM2302010007 AFDEL ULFADRI Ruang Cindua Mato 574946 0304R0010123V005925 1/25/2023 1/27/2023
727 2 Rabu / 01-02-2023 7:02:25 AM2302010009 KHALEED SAYRAS ARRAZI Ruang Anak 574858 0304R0010123V005573 1/22/2023 1/27/2023
728 3 Rabu / 01-02-2023 7:02:04 AM2302010014 NAFIDAL Ruang Ambun Suri Lantai 3 (Interne) 479688 0304R0010123V006045 1/25/2023 1/25/2023
729 4 Rabu / 01-02-2023 7:02:45 AM2302010015 NURANI Ruang Ambun Suri Lantai 3 (Interne) 539924 0304R0010123V003946 1/16/2023 1/26/2023
730 5 Rabu / 01-02-2023 8:02:27 AM2302010021 ASTUTI Ruang Ambun Suri Lantai 3 (Interne) 571313 0304R0010123V005371 1/23/2023 1/27/2023
731 6 Rabu / 01-02-2023 8:02:21 AM2302010043 SYAFHEN RUSTAM Ruang Ambun Suri Lantai 3 (Interne) 346082 0304R0010123V003467 1/14/2023 1/27/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
JANUARI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
732 7 Rabu / 01-02-2023 8:02:15 AM2302010046 SITI SYIFA Ruang Ambun Suri Lantai 3 (Interne) 346075 0304R0010123V005236 1/21/2023 1/27/2023
733 8 Rabu / 01-02-2023 8:02:01 AM2302010048 NURLAILI Ruang Ambun Suri Lantai 3 (Interne) 574847 0304R0010123V005266 1/22/2023 1/27/2023
734 9 Rabu / 01-02-2023 8:02:45 AM2302010049 FARIDA Ruang Ambun Suri Lantai 4 (Interne) 427712 0304R0010123V005368 1/23/2023 1/27/2023
735 10 Rabu / 01-02-2023 8:02:27 AM2302010050 BERTINA SIMARMATA Ruang Kebidanan 536544 0304R0010123V005713 1/24/2023 1/26/2023
736 11 Rabu / 01-02-2023 8:02:41 AM2302010055 WENI INDAH WULANDARI Ruang Kebidanan 361919 0304R0010123V006069 1/26/2023 1/27/2023
737 12 Rabu / 01-02-2023 8:02:45 AM2302010056 SARI PURWANINGSIH Ruang Kebidanan 574923 0304R0010123V005719 1/24/2023 1/27/2023
738 13 Rabu / 01-02-2023 8:02:34 AM2302010057 YULIA RISA SAPUTRI Ruang Kebidanan 227539 0304R0010123V004561 1/18/2023 1/21/2023
739 14 Rabu / 01-02-2023 9:02:47 AM2302010063 VUJA AMANDA Ruang Kebidanan 574934 0304R0010123V005746 1/25/2023 1/27/2023
740 15 Rabu / 01-02-2023 9:02:06 AM2302010079 ERY SILVIANTI Ruang Jantung 518682 0304R0010123V004557 1/18/2023 1/20/2023
741 16 Rabu / 01-02-2023 11:02:43 AM2302010154 SUHARTO Ruang Jantung 574956 0304R0010123V006027 1/25/2023 1/27/2023
742 17 Rabu / 01-02-2023 11:02:29 AM2302010158 HENDRA NOVRIADI KELAS BEDAH 574661 0304R0010123V006039 1/25/2023 1/26/2023
743 18 Rabu / 01-02-2023 11:02:29 AM2302010159 SALMAN KELAS BEDAH 568032 0304R0010123V005494 1/24/2023 1/27/2023
744 19 Rabu / 01-02-2023 11:02:29 AM2302010161 NELFITA KELAS BEDAH 571356 0304R0010123V005704 1/24/2023 1/26/2023
745 20 Rabu / 01-02-2023 11:02:51 AM2302010165 FAHRUL RAZIF KELAS BEDAH 554966 0304R0010123V005316 1/23/2023 1/26/2023
746 21 Rabu / 01-02-2023 12:02:47 AM2302010168 M. ABYAN SYAKIL KELAS BEDAH 553585 0304R0010123V005361 1/23/2023 1/26/2023
747 22 Rabu / 01-02-2023 12:02:11 AM2302010170 NOFRIDA KELAS BEDAH 39441 0304R0010123V005286 1/22/2023 1/26/2023
748 23 Rabu / 01-02-2023 12:02:55 AM2302010171 EMI AFNIDA KELAS BEDAH 477069 0304R0010123V005687 1/24/2023 1/26/2023
749 24 Rabu / 01-02-2023 12:02:45 AM2302010172 OSTINI KELAS BEDAH 537304 0304R0010123V005291 1/22/2023 1/26/2023
750 25 Rabu / 01-02-2023 12:02:22 AM2302010173 NURMAZIAR Ruang Bedah 545571 0304R0010123V006188 1/25/2023 1/26/2023
751 26 Rabu / 01-02-2023 12:02:01 AM2302010174 ELLY Ruang Bedah 571097 0304R0010123V005710 1/24/2023 1/26/2023
752 27 Rabu / 01-02-2023 12:02:46 AM2302010225 MAHYUDIN Ruang Bedah 572854 0304R0010123V005642 1/24/2023 1/26/2023
753 28 Rabu / 01-02-2023 12:02:03 AM2302010228 DWI ERAWATI Ruang Bedah 561014 0304R0010123V005598 1/23/2023 1/26/2023
754 29 Rabu / 01-02-2023 12:02:04 AM2302010230 GUSNIWATI KELAS BEDAH 526044 0304R0010123V005589 1/24/2023 1/27/2023
755 30 Rabu / 01-02-2023 12:02:15 AM2302010238 AINUL ADAWIYAH KELAS BEDAH 574598 0304R0010123V005321 1/23/2023 1/27/2023
756 31 Rabu / 01-02-2023 12:02:27 AM2302010240 RASUNI Ruang Bedah 573939 0304R0010123V003927 1/16/2023 1/26/2023
757 32 Rabu / 01-02-2023 12:02:38 AM2302010242 RIMA YETTI Ruang Bedah 574703 0304R0010123V005661 1/24/2023 1/26/2023
758 33 Rabu / 01-02-2023 12:02:56 AM2302010245 RISDA MAWATI PURBA Ruang Bedah 571401 0304R0010123V005725 1/24/2023 1/26/2023
759 34 Rabu / 01-02-2023 13:02:27 AM2302010251 SYAMSIDAR Ruang Bedah 574596 0304R0010123V003707 1/16/2023 1/26/2023
760 35 Rabu / 01-02-2023 13:02:42 AM2302010257 SILVIA JASMIATI Ruang Bedah 551114 0304R0010123V005706 1/24/2023 1/26/2023
761 36 Rabu / 01-02-2023 13:02:26 AM2302010261 ASNETTY KELAS BEDAH 459696 0304R0010123V005173 1/19/2023 1/27/2023
762 37 Rabu / 01-02-2023 13:02:16 AM2302010262 M. FIRDAUS Ruang Bedah 574837 0304R0010123V005545 1/21/2023 1/26/2023
763 38 Rabu / 01-02-2023 13:02:46 AM2302010264 MUSLIM Ruang Bedah 569630 0304R0010123V005243 1/21/2023 1/26/2023
764 39 Rabu / 01-02-2023 13:02:10 AM2302010265 YUL HENDRA Ruang Bedah 571282 0304R0010123V003525 1/14/2023 1/26/2023
765 40 Rabu / 01-02-2023 13:02:47 AM2302010266 ERDIZAL Ruang Mata/THT/BEDAH MULUT 542716 0304R0010123V006753 1/27/2023 1/30/2023
766 41 Rabu / 01-02-2023 13:02:28 AM2302010267 M. SALEH Ruang Mata/THT/BEDAH MULUT 570913 0304R0010123V006827 1/29/2023 1/30/2023
767 42 Rabu / 01-02-2023 16:02:24 AM2302010369 CORRYNA SYAHRIR MANAN Ruang Cindua Mato 557488 0304R0010123V005238 1/21/2023 1/27/2023
768 43 Rabu / 01-02-2023 16:02:12 AM2302010370 SAFRIDA Ruang Cindua Mato 532641 0304R0010123V006064 1/25/2023 1/30/2023
769 44 Rabu / 01-02-2023 16:02:19 AM2302010371 ZAHARA HASNI Ruang Cindua Mato 492666 0304R0010123V006823 1/29/2023 1/30/2023
770 45 Rabu / 01-02-2023 16:02:44 AM2302010372 darmawis Ruang Cindua Mato 418856 0304R0010123V004902 1/19/2023 1/27/2023
771 46 Rabu / 01-02-2023 16:02:38 AM2302010373 WIRDA Ruang Cindua Mato 574764 0304R0010123V004891 1/19/2023 1/24/2023
772 47 Rabu / 01-02-2023 16:02:08 AM2302010374 ALI MAZRA Ruang Cindua Mato 217183 0304R0010123V006061 1/25/2023 1/27/2023
773 48 Rabu / 01-02-2023 16:02:14 AM2302010375 ALI USMAN Ruang Cindua Mato 573994 0304R0010123V003905 1/16/2023 1/22/2023
774 49 Rabu / 01-02-2023 16:02:57 AM2302010376 ANWAR, SH Ruang Cindua Mato 552885 0304R0010123V005740 1/25/2023 1/29/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
JANUARI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
775 50 Rabu / 01-02-2023 16:02:02 AM2302010377 BY. NY DENNY INDRIATY Ruang Bayi (PERINATOLOGI) 574865 0304R0010123V006022 1/23/2023 1/27/2023
776 51 Rabu / 01-02-2023 16:02:43 AM2302010378 MUHAMMAD ABID ASHIM Ruang Ambun Suri Lantai 4 (Interne) 574683 0304R0010123V004898 1/17/2023 1/23/2023
777 52 Rabu / 01-02-2023 16:02:21 AM2302010379 ZULNEDI Ruang Cindua Mato 272115 0304R0010123V006478 1/26/2023 1/29/2023
778 53 Rabu / 01-02-2023 16:02:07 AM2302010380 SEPTIA MIZAR K Ruang Cindua Mato 365256 0304R0010123V006034 1/25/2023 1/30/2023
779 54 Rabu / 01-02-2023 16:02:54 AM2302010381 ELMI Ruang Cindua Mato 570144 0304R0010123V005263 1/22/2023 1/30/2023
780 55 Rabu / 01-02-2023 16:02:17 AM2302010382 ARSON GEMA Ruang Paru 444529 0304R0010123V004307 1/18/2023 1/23/2023
781 56 Rabu / 01-02-2023 16:02:49 AM2302010383 EVA ELIZA Ruang Paru 574390 0304R0010123V002487 1/10/2023 1/20/2023
782 57 Rabu / 01-02-2023 16:02:34 AM2302010384 ERU GUANDA Ruang Paru 574539 0304R0010123V003435 1/13/2023 1/19/2023
783 58 Rabu / 01-02-2023 16:02:18 AM2302010385 RUSDI Ruang Paru 420549 0304R0010123V003558 1/15/2023 1/19/2023
784 59 Rabu / 01-02-2023 16:02:56 AM2302010386 RIZAWATI M Ruang Paru 559598 0304R0010123V004926 1/20/2023 1/24/2023
785 60 Rabu / 01-02-2023 16:02:53 AM2302010387 FARHANDI HANAFI Ruang Paru 568752 0304R0010123V004169 1/17/2023 1/19/2023
786 61 Rabu / 01-02-2023 16:02:27 AM2302010388 ASRIL Ruang Paru 499393 0304R0010123V003468 1/14/2023 1/19/2023
787 62 Rabu / 01-02-2023 16:02:02 AM2302010389 WARLIS Ruang Paru 274424 0304R0010123V000686 1/3/2023 1/16/2023
788 63 Rabu / 01-02-2023 16:02:30 AM2302010390 ARSIL Ruang Paru 573685 0304R0010123V003398 1/13/2023 1/17/2023
789 64 Rabu / 01-02-2023 16:02:58 AM2302010391 LINDA Ruang Paru 447213 0304R0010123V002481 1/10/2023 1/15/2023
790 65 Rabu / 01-02-2023 16:02:20 AM2302010392 MINARSIH Ruang Paru 574289 0304R0010123V002096 1/9/2023 1/17/2023
791 66 Rabu / 01-02-2023 16:02:27 AM2302010393 ROSTINA Ruang Paru 574392 0304R0010123V002491 1/10/2023 1/17/2023
792 67 Rabu / 01-02-2023 16:02:54 AM2302010394 HERMAN Ruang Paru 480634 0304R0010123V003394 1/13/2023 1/17/2023
793 68 Rabu / 01-02-2023 16:02:37 AM2302010395 YERMA DEWITA Ruang Paru 574542 0304R0010123V003442 1/14/2023 1/19/2023
794 1 Jumat / 03-02-2023 10:02:10 AM2302030055 RATNA WILIS Ruang Ambun Suri Lantai 3 (Interne) 533853 0304R0010123V005074 1/19/2023 1/30/2023
795 2 Jumat / 03-02-2023 10:02:37 AM2302030058 ZULMISDAR Ruang Ambun Suri Lantai 3 (Interne) 574832 0304R0010123V005601 1/21/2023 1/28/2023
796 3 Jumat / 03-02-2023 10:02:19 AM2302030059 EVA FITRI YANI Ruang Jantung 510559 0304R0010123V005597 1/24/2023 1/29/2023
797 4 Jumat / 03-02-2023 10:02:51 AM2302030060 AMRIZAL Ruang Jantung 575097 0304R0010123V006784 1/28/2023 1/30/2023
798 5 Jumat / 03-02-2023 10:02:46 AM2302030062 LISNA Ruang Jantung 574995 0304R0010123V006070 1/26/2023 1/30/2023
799 6 Jumat / 03-02-2023 10:02:10 AM2302030063 EFENDI Ruang Jantung 572413 0304R0010123V005717 1/24/2023 1/28/2023
800 7 Jumat / 03-02-2023 10:02:01 AM2302030064 CHAIRUL Ruang Jantung 561691 0304R0010123V005459 1/22/2023 1/28/2023
801 8 Jumat / 03-02-2023 10:02:25 AM2302030065 IKHWAN Ruang Jantung 574993 0304R0010123V006067 1/25/2023 1/28/2023
802 9 Jumat / 03-02-2023 10:02:21 AM2302030079 SAFRI Ruang Jantung 437849 0304R0010123V006461 1/25/2023 1/28/2023
803 10 Jumat / 03-02-2023 10:02:03 AM2302030080 KARISMI Ruang Jantung 360213 0304R0010123V005621 1/24/2023 1/28/2023
804 11 Jumat / 03-02-2023 10:02:30 AM2302030081 DANIEL SITORUS Ruang Jantung 575055 0304R0010123V006505 1/27/2023 1/30/2023
805 12 Jumat / 03-02-2023 10:02:23 AM2302030086 RITA ASMAYANTI Ruang Jantung 574935 0304R0010123V005751 1/25/2023 1/28/2023
806 13 Jumat / 03-02-2023 10:02:05 AM2302030087 MARTINI Ruang Jantung 4480 0304R0010123V003957 1/16/2023 1/30/2023
807 14 Jumat / 03-02-2023 10:02:11 AM2302030094 SYAFRIL KELAS BEDAH 573753 0304R0010123V005901 1/25/2023 1/28/2023
808 15 Jumat / 03-02-2023 10:02:07 AM2302030097 WISRI KELAS BEDAH 448110 0304R0010123V006031 1/25/2023 1/26/2023
809 16 Jumat / 03-02-2023 10:02:30 AM2302030100 AFRISON KELAS BEDAH 554785 0304R0010123V006471 1/26/2023 1/27/2023
810 17 Jumat / 03-02-2023 10:02:16 AM2302030102 ZULYANTI KELAS BEDAH 573101 0304R0010123V006410 1/26/2023 1/27/2023
811 18 Jumat / 03-02-2023 10:02:59 AM2302030103 HELIN DESMIRIANTI KELAS BEDAH 574084 0304R0010123V006458 1/26/2023 1/27/2023
812 19 Jumat / 03-02-2023 10:02:42 AM2302030106 WELDA NINGSIH KELAS BEDAH 546649 0304R0010123V006463 1/26/2023 1/27/2023
813 20 Jumat / 03-02-2023 10:02:25 AM2302030107 IRMA LISA Ruang Kebidanan 495598 0304R0010123V006734 1/27/2023 1/28/2023
814 21 Jumat / 03-02-2023 10:02:00 AM2302030109 YULIVA FAHROZA Ruang Kebidanan 566726 0304R0010123V006480 1/26/2023 1/28/2023
815 22 Jumat / 03-02-2023 10:02:04 AM2302030110 rina sari Ruang Kebidanan 574881 0304R0010123V005720 1/24/2023 1/27/2023
816 23 Jumat / 03-02-2023 10:02:08 AM2302030111 LISA PURNAMA SARI Ruang Kebidanan 364481 0304R0010123V006367 1/26/2023 1/29/2023
817 24 Jumat / 03-02-2023 10:02:51 AM2302030112 REKA SUSANTI Ruang Kebidanan 574983 0304R0010123V006040 1/25/2023 1/27/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
JANUARI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
818 25 Jumat / 03-02-2023 10:02:27 AM2302030119 AMELIA FITRI Ruang Kebidanan 484054 0304R0010123V006783 1/27/2023 1/28/2023
819 26 Jumat / 03-02-2023 10:02:05 AM2302030121 SRI WAHYUNI Ruang Kebidanan 565486 0304R0010123V006043 1/25/2023 1/28/2023
820 27 Jumat / 03-02-2023 11:02:52 AM2302030126 LISNAWATI Ruang Kebidanan 574988 0304R0010123V006065 1/25/2023 1/27/2023
821 28 Jumat / 03-02-2023 11:02:31 AM2302030132 DEWI PERMATA BUNDA Ruang Kebidanan 428994 0304R0010123V006772 1/28/2023 1/29/2023
822 29 Jumat / 03-02-2023 11:02:34 AM2302030133 FITRIA Ruang Kebidanan 562389 0304R0010123V005196 1/20/2023 1/27/2023
823 30 Jumat / 03-02-2023 15:02:16 AM2302030325 INDAH WIDYASTUTI Ruang Kebidanan 575135 0304R0010123V007062 1/30/2023 1/31/2023
824 31 Jumat / 03-02-2023 15:02:58 AM2302030329 dewi kelana Ruang Kebidanan 575081 0304R0010123V006738 1/27/2023 1/28/2023
825 32 Jumat / 03-02-2023 15:02:38 AM2302030331 NORA ROMANDA Ruang Kebidanan 575105 0304R0010123V006800 1/29/2023 1/30/2023
826 33 Jumat / 03-02-2023 15:02:15 AM2302030333 ASRI YENTI Ruang Kebidanan 569450 0304R0010123V005373 1/23/2023 1/27/2023
827 34 Jumat / 03-02-2023 15:02:51 AM2302030335 TIARA Ruang Kebidanan 570270 0304R0010123V005365 1/23/2023 1/28/2023
828 35 Jumat / 03-02-2023 15:02:31 AM2302030337 MARLINA Ruang Kebidanan 368386 0304R0010123V006492 1/26/2023 1/30/2023
829 36 Jumat / 03-02-2023 15:02:02 AM2302030339 ERMAWATI Ruang Kebidanan 568477 0304R0010123V006459 1/26/2023 1/30/2023
830 37 Jumat / 03-02-2023 15:02:52 AM2302030342 FITRIA Ruang Kebidanan 562389 0304R0010123V006808 1/28/2023 1/30/2023
831 38 Jumat / 03-02-2023 15:02:16 AM2302030346 GUS ISMIARTI Ruang Cindua Mato 520795 0304R0010123V006018 1/25/2023 1/28/2023
832 39 Jumat / 03-02-2023 15:02:59 AM2302030348 FIRDA ELITA Ruang Cindua Mato 8456 0304R0010123V005593 1/24/2023 1/30/2023
833 40 Jumat / 03-02-2023 15:02:26 AM2302030353 GISEL SAKILLA NAJA Ruang Anak 531839 0304R0010123V007107 1/30/2023 1/30/2023
834 41 Jumat / 03-02-2023 15:02:45 AM2302030357 HUMAIRA JENDAYA WIBOWO Ruang Anak 504078 0304R0010123V007106 1/30/2023 1/30/2023
835 42 Jumat / 03-02-2023 15:02:26 AM2302030358 M. JONATHAN GUSTRIAFEL Ruang Ambun Suri Lantai 3 (Interne) 574994 0304R0010123V006181 1/26/2023 1/30/2023
836 43 Jumat / 03-02-2023 15:02:12 AM2302030359 BY. NY.KIKI RAHMADHITA Ruang Bayi (PERINATOLOGI) 574856 0304R0010123V005917 1/22/2023 1/30/2023
837 44 Jumat / 03-02-2023 15:02:51 AM2302030360 BY NY WENI INDAH W Ruang Bayi (PERINATOLOGI) 575008 0304R0010123V006467 1/26/2023 1/31/2023
838 45 Jumat / 03-02-2023 15:02:37 AM2302030361 JUHARNI Ruang Bedah 557138 0304R0010123V006475 1/26/2023 1/27/2023
839 46 Jumat / 03-02-2023 15:02:06 AM2302030365 OSNITA Ruang Bedah 574443 0304R0010123V006465 1/26/2023 1/27/2023
840 47 Jumat / 03-02-2023 15:02:24 AM2302030366 ASNA Ruang Bedah 573423 0304R0010123V005916 1/25/2023 1/28/2023
841 48 Jumat / 03-02-2023 15:02:48 AM2302030368 SYAFRIL Ruang Bedah 574924 0304R0010123V005727 1/24/2023 1/28/2023
842 49 Jumat / 03-02-2023 15:02:29 AM2302030373 HASAN Ruang Bedah 575053 0304R0010123V006507 1/27/2023 1/28/2023
843 50 Jumat / 03-02-2023 15:02:32 AM2302030375 BUDI SETIAWAN Ruang Bedah 571417 0304R0010123V005976 1/25/2023 1/26/2023
844 51 Jumat / 03-02-2023 15:02:41 AM2302030376 RINA NOVA YANTI Ruang Bedah 408225 0304R0010123V005638 1/24/2023 1/27/2023
845 52 Jumat / 03-02-2023 15:02:22 AM2302030383 ERNAWATI Ruang Bedah 571499 0304R0010123V005538 1/24/2023 1/28/2023
846 53 Jumat / 03-02-2023 15:02:01 AM2302030384 DESMA RIANTI Ruang Bedah 186699 0304R0010123V004927 1/20/2023 1/27/2023
847 54 Jumat / 03-02-2023 15:02:42 AM2302030386 IRWAN Ruang Bedah 575000 0304R0010123V006460 1/26/2023 1/27/2023
848 55 Jumat / 03-02-2023 15:02:21 AM2302030387 risman Ruang Bedah 299642 0304R0010123V006728 1/27/2023 1/28/2023
849 56 Jumat / 03-02-2023 15:02:55 AM2302030388 RUSLI Ruang Bedah 430107 0304R0010123V006164 1/26/2023 1/27/2023
850 57 Jumat / 03-02-2023 15:02:33 AM2302030391 SYAFRI YUSUF Ruang Jantung 97705 0304R0010123V006269 1/26/2023 1/31/2023
851 58 Jumat / 03-02-2023 16:02:52 AM2302030414 HAMDI Ruang Jantung 288673 0304R0010123V006806 1/28/2023 1/31/2023
852 59 Jumat / 03-02-2023 16:02:35 AM2302030415 ZAINAL ARIFIN Ruang Ambun Suri Lantai 3 (Interne) 356968 0304R0010123V006816 1/29/2023 1/29/2023
853 60 Jumat / 03-02-2023 16:02:12 AM2302030417 KALBI MAI RIZAL Ruang Ambun Suri Lantai 3 (Interne) 575096 0304R0010123V007122 1/28/2023 1/31/2023
854 61 Jumat / 03-02-2023 16:02:36 AM2302030419 ARLIS Ruang Ambun Suri Lantai 3 (Interne) 574933 0304R0010123V005744 1/25/2023 1/30/2023
855 62 Jumat / 03-02-2023 16:02:59 AM2302030420 DARMAWATI Ruang Ambun Suri Lantai 3 (Interne) 574928 0304R0010123V005733 1/24/2023 1/31/2023
856 63 Jumat / 03-02-2023 16:02:59 AM2302030423 RIBUAN SINAMBELA Ruang Ambun Suri Lantai 3 (Interne) 371516 0304R0010123V005215 1/21/2023 1/31/2023
857 64 Jumat / 03-02-2023 16:02:10 AM2302030425 NASMA Ruang Ambun Suri Lantai 3 (Interne) 428168 0304R0010123V006481 1/26/2023 1/29/2023
858 65 Jumat / 03-02-2023 16:02:04 AM2302030427 RIA DEVIANA Ruang Ambun Suri Lantai 3 (Interne) 574563 0304R0010123V003516 1/14/2023 1/26/2023
859 66 Jumat / 03-02-2023 16:02:42 AM2302030429 ACHRINAL Ruang Ambun Suri Lantai 3 (Interne) 572770 0304R0010123V005989 1/25/2023 1/28/2023
860 67 Jumat / 03-02-2023 16:02:24 AM2302030431 DODI EKA SAPUTRA Ruang Ambun Suri Lantai 3 (Interne) 574318 0304R0010123V006741 1/27/2023 1/28/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
JANUARI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
861 68 Jumat / 03-02-2023 16:02:50 AM2302030432 SYAFRI ST MUDO Ruang Ambun Suri Lantai 3 (Interne) 541363 0304R0010123V006508 1/27/2023 1/27/2023
862 69 Jumat / 03-02-2023 16:02:39 AM2302030433 AISYAH KELAS BEDAH 535962 0304R0010123V006053 1/25/2023 1/30/2023
863 70 Jumat / 03-02-2023 16:02:18 AM2302030434 ISWANDI MANSUR KELAS BEDAH 573147 0304R0010123V005328 1/23/2023 1/31/2023
864 71 Jumat / 03-02-2023 16:02:30 AM2302030437 EZWARDI KELAS BEDAH 574737 0304R0010123V006996 1/30/2023 1/31/2023
865 72 Jumat / 03-02-2023 16:02:20 AM2302030443 MUHAMMAD YAKUB Ruang Bedah 566961 0304R0010123V006387 1/26/2023 1/28/2023
866 73 Jumat / 03-02-2023 16:02:04 AM2302030445 AMRI Ruang Bedah 552653 0304R0010123V005193 1/20/2023 1/30/2023
867 74 Jumat / 03-02-2023 16:02:44 AM2302030446 LIZA WATI KELAS BEDAH 550150 0304R0010123V006733 1/27/2023 1/31/2023
868 75 Jumat / 03-02-2023 16:02:19 AM2302030447 WIRDA TISRIA Ruang Bedah 310835 0304R0010123V006504 1/27/2023 1/30/2023
869 76 Jumat / 03-02-2023 16:02:52 AM2302030449 RAHMAT AL FAJAR Ruang Bedah 566399 0304R0010123V006837 1/29/2023 1/30/2023
870 77 Jumat / 03-02-2023 16:02:30 AM2302030451 MUSLIM Ruang Bedah 572040 0304R0010123V006037 1/25/2023 1/30/2023
871 78 Jumat / 03-02-2023 16:02:33 AM2302030452 MUHARNIS Ruang Bedah 571760 0304R0010123V006818 1/29/2023 1/30/2023
872 79 Jumat / 03-02-2023 16:02:43 AM2302030453 ERMAN SURIADI Ruang Bedah 574986 0304R0010123V006057 1/25/2023 1/29/2023
873 80 Jumat / 03-02-2023 16:02:24 AM2302030454 FAJRILLA SANTIKA KELAS BEDAH 574735 0304R0010123V007104 1/30/2023 1/31/2023
874 81 Jumat / 03-02-2023 16:02:59 AM2302030455 NOFENDRI Ruang Bedah 573438 0304R0010123V006308 1/26/2023 1/29/2023
875 1 Senin / 06-02-2023 8:02:01 AM2302060025 ROSLAINI Ruang Ambun Suri Lantai 3 (Interne) 418326 0304R0010123V002103 1/8/2023 1/30/2023
876 2 Senin / 06-02-2023 8:02:02 AM2302060026 YUNALDI Ruang Ambun Suri Lantai 3 (Interne) 553356 0304R0010123V007391 1/31/2023 1/31/2023
877 3 Senin / 06-02-2023 8:02:27 AM2302060027 HARRY EKA PUTRA Ruang Cindua Mato 569528 0304R0010123V006836 1/29/2023 1/31/2023
878 4 Senin / 06-02-2023 8:02:20 AM2302060029 SEPRI WENDRI Ruang Paru 380664 0304R0010123V003863 1/15/2023 1/24/2023
879 5 Senin / 06-02-2023 8:02:56 AM2302060033 YUSRIZAL Ruang Paru 574225 0304R0010123V001735 1/7/2023 1/24/2023
880 6 Senin / 06-02-2023 8:02:24 AM2302060035 ZUNELDA Ruang Paru 26397 0304R0010123V004575 1/18/2023 1/20/2023
881 7 Senin / 06-02-2023 8:02:12 AM2302060036 NURHANIFAH Ruang Paru 574500 0304R0010123V004583 1/19/2023 1/21/2023
882 8 Senin / 06-02-2023 8:02:00 AM2302060037 WARNITA Ruang Paru 573258 0304R0010123V004553 1/18/2023 1/21/2023
883 9 Senin / 06-02-2023 8:02:11 AM2302060038 ARMAN Ruang Paru 569943 0304R0010123V003916 1/16/2023 1/19/2023
884 10 Senin / 06-02-2023 8:02:50 AM2302060039 ULIL AMRI Ruang Ambun Suri Lantai 4 (Interne) 575016 0304R0010123V006454 1/26/2023 1/30/2023
885 11 Senin / 06-02-2023 8:02:19 AM2302060040 JOHAN ARIFIN Ruang Ambun Suri Lantai 4 (Interne) 282495 0304R0010123V006499 1/26/2023 1/31/2023
886 12 Senin / 06-02-2023 8:02:34 AM2302060042 MAHYUDIN Ruang Ambun Suri Lantai 4 (Interne) 463608 0304R0010123V005714 1/20/2023 1/31/2023
887 13 Senin / 06-02-2023 8:02:24 AM2302060044 GUSNETTY, SH Ruang Ambun Suri Lantai 4 (Interne) 574218 0304R0010123V001725 1/7/2023 1/31/2023
888 14 Senin / 06-02-2023 8:02:33 AM2302060045 RAHMAD FAHRIZAL Ruang Ambun Suri Lantai 4 (Interne) 569363 0304R0010123V003293 1/13/2023 1/26/2023
889 15 Senin / 06-02-2023 8:02:22 AM2302060046 MARINI CHANDRA Ruang Ambun Suri Lantai 4 (Interne) 553594 0304R0010123V005359 1/23/2023 1/28/2023
890 16 Senin / 06-02-2023 8:02:33 AM2302060047 JIHAN RAMADHANA RISFIA Ruang Ambun Suri Lantai 4 (Interne) 574841 0304R0010123V005258 1/22/2023 1/27/2023
891 17 Senin / 06-02-2023 8:02:14 AM2302060049 ALI EFENDI Ruang Ambun Suri Lantai 4 (Interne) 285824 0304R0010123V005250 1/21/2023 1/26/2023
892 18 Senin / 06-02-2023 9:02:34 AM2302060055 ZULMUAR Ruang Ambun Suri Lantai 4 (Interne) 533553 0304R0010123V004547 1/18/2023 1/26/2023
893 19 Senin / 06-02-2023 9:02:28 AM2302060058 JONEIDI BA Ruang Ambun Suri Lantai 4 (Interne) 476805 0304R0010123V004924 1/19/2023 1/26/2023
894 20 Senin / 06-02-2023 9:02:33 AM2302060060 RINI MAIRIZA Ruang Ambun Suri Lantai 4 (Interne) 562478 0304R0010123V005362 1/23/2023 1/26/2023
895 21 Senin / 06-02-2023 9:02:09 AM2302060061 RISKY ACHTAR Ruang Ambun Suri Lantai 4 (Interne) 575117 0304R0010123V006811 1/29/2023 1/30/2023
896 22 Senin / 06-02-2023 9:02:01 AM2302060063 NOFRIANDI Ruang Ambun Suri Lantai 4 (Interne) 478248 0304R0010123V005298 1/23/2023 1/28/2023
897 23 Senin / 06-02-2023 9:02:44 AM2302060064 MASREL Ruang Ambun Suri Lantai 4 (Interne) 189017 0304R0010123V005387 1/24/2023 1/30/2023
898 24 Senin / 06-02-2023 9:02:31 AM2302060065 ISMARIYENI Ruang Ambun Suri Lantai 3 (Interne) 557462 0304R0010123V000972 1/4/2023 1/28/2023
899 25 Senin / 06-02-2023 9:02:01 AM2302060101 TITI SUSILAWATI Ruang Ambun Suri Lantai 3 (Interne) 574651 0304R0010123V004269 1/17/2023 1/28/2023
900 26 Senin / 06-02-2023 9:02:12 AM2302060103 IRMA FEBRIANI Ruang Kebidanan 575122 0304R0010123V006825 1/30/2023 1/31/2023
901 27 Senin / 06-02-2023 9:02:40 AM2302060105 GUSTINAR Ruang Kebidanan 565979 0304R0010123V006821 1/29/2023 1/31/2023
902 28 Senin / 06-02-2023 9:02:27 AM2302060110 SENIA YUNITA Ruang Kebidanan 574423 0304R0010123V005367 1/23/2023 1/31/2023
903 29 Senin / 06-02-2023 10:02:13 AM2302060114 ERMI YASTUTI Ruang Kebidanan 570326 0304R0010123V007047 1/30/2023 1/31/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
JANUARI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
904 30 Senin / 06-02-2023 10:02:57 AM2302060127 HAFNIZAR Ruang Ambun Suri Lantai 3 (Interne) 574996 0304R0010123V006071 1/26/2023 1/28/2023
905 31 Senin / 06-02-2023 10:02:33 AM2302060130 YUSRIZAL Ruang Ambun Suri Lantai 3 (Interne) 564313 0304R0010123V004914 1/19/2023 1/31/2023
906 32 Senin / 06-02-2023 10:02:15 AM2302060131 DIRMAN Ruang Bedah 574766 0304R0010123V004907 1/19/2023 1/30/2023
907 33 Senin / 06-02-2023 10:02:58 AM2302060132 EMRALIS Ruang Bedah 552810 0304R0010123V007113 1/30/2023 1/31/2023
908 34 Senin / 06-02-2023 10:02:00 AM2302060133 ARMON Ruang Bedah 571204 0304R0010123V006819 1/29/2023 1/31/2023
909 35 Senin / 06-02-2023 10:02:27 AM2302060134 ZULFAHMI WATI Ruang Bedah 562570 0304R0010123V005729 1/24/2023 1/31/2023
910 36 Senin / 06-02-2023 10:02:18 AM2302060136 AMELYA SAFUTRI Ruang Bedah 574313 0304R0010123V004925 1/20/2023 1/31/2023
911 37 Senin / 06-02-2023 10:02:31 AM2302060137 ELLIANA Ruang Bedah 573425 0304R0010123V006197 1/25/2023 1/31/2023
912 38 Senin / 06-02-2023 10:02:43 AM2302060140 ELVI YETNI Ruang Bedah 574590 0304R0010123V008457 1/26/2023 1/31/2023
913 39 Senin / 06-02-2023 10:02:42 AM2302060142 WELMI WANITA Ruang Bedah 575006 0304R0010123V006469 1/26/2023 1/30/2023
914 40 Senin / 06-02-2023 10:02:48 AM2302060148 NURSINA Ruang Bedah 288896 0304R0010123V006847 1/29/2023 1/31/2023
915 41 Senin / 06-02-2023 11:02:35 AM2302060182 MUZINI Ruang Paru 574728 0304R0010123V004578 1/18/2023 1/30/2023
916 42 Senin / 06-02-2023 11:02:18 AM2302060183 Muhammad YUNUS Ruang Paru 547682 0304R0010123V004558 1/18/2023 1/29/2023
917 43 Senin / 06-02-2023 11:02:46 AM2302060186 NELIWARTI Ruang Paru 575048 0304R0010123V006502 1/27/2023 1/29/2023
918 44 Senin / 06-02-2023 11:02:24 AM2302060187 KHAIRULLAH Ruang Paru 574775 0304R0010123V004986 1/20/2023 1/27/2023
919 45 Senin / 06-02-2023 11:02:14 AM2302060190 SYAHNIAR Ruang Paru 213700 0304R0010123V005296 1/22/2023 1/29/2023
920 46 Senin / 06-02-2023 11:02:52 AM2302060196 ARMAN Ruang Paru 569943 0304R0010123V005688 1/24/2023 1/31/2023
921 47 Senin / 06-02-2023 11:02:42 AM2302060199 JAYUSMAN Ruang Paru 554109 0304R0010123V006722 1/27/2023 1/31/2023
922 48 Senin / 06-02-2023 11:02:17 AM2302060200 DEDY SWANDI IR Ruang Paru 575119 0304R0010123V006815 1/29/2023 1/31/2023
923 49 Senin / 06-02-2023 11:02:09 AM2302060202 MUHAMMAD RASYID Ruang Paru 575045 0304R0010123V006474 1/26/2023 1/30/2023
924 50 Senin / 06-02-2023 11:02:12 AM2302060205 RUZIL Ruang Paru 575024 0304R0010123V006451 1/26/2023 1/30/2023
925 51 Senin / 06-02-2023 11:02:38 AM2302060208 FAUZAN Ruang Paru 443577 0304R0010123V004923 1/20/2023 1/24/2023
926 52 Senin / 06-02-2023 11:02:29 AM2302060213 YESSI MARLINA Ruang Paru 574771 0304R0010123V004906 1/19/2023 1/25/2023
927 53 Senin / 06-02-2023 11:02:52 AM2302060214 NURHAYATI Ruang Paru 572636 0304R0010123V004585 1/19/2023 1/25/2023
928 54 Senin / 06-02-2023 11:02:10 AM2302060234 SYAWAL Ruang Paru 573058 0304R0010123V005369 1/23/2023 1/25/2023
929 55 Senin / 06-02-2023 11:02:31 AM2302060235 SAHRUDDIN Ruang Paru 573084 0304R0010123V005230 1/21/2023 1/23/2023
930 56 Senin / 06-02-2023 11:02:33 AM2302060236 ARLEN SUTAN MARAJO Ruang Paru 504405 0304R0010123V004888 1/18/2023 1/24/2023
931 57 Senin / 06-02-2023 11:02:06 AM2302060237 RIO ANDIKA PUTRA Ruang Paru 574659 0304R0010123V004263 1/17/2023 1/24/2023
932 58 Senin / 06-02-2023 11:02:49 AM2302060238 EDIWAR Ruang Paru 574825 0304R0010123V005221 1/21/2023 1/26/2023
933 59 Senin / 06-02-2023 12:02:15 AM2302060242 FIDYA RENNY Ruang Paru 574704 0304R0010123V004889 1/19/2023 1/28/2023
934 60 Senin / 06-02-2023 12:02:18 AM2302060247 ABDUL LATIF Ruang Paru 455768 0304R0010123V006729 1/27/2023 1/31/2023
935 61 Senin / 06-02-2023 12:02:17 AM2302060253 SISWENDRI Ruang Paru 574873 0304R0010123V005382 1/23/2023 1/28/2023
936 62 Senin / 06-02-2023 12:02:08 AM2302060257 BUJANG ST BATUAH Ruang Paru 573730 0304R0010123V003574 1/16/2023 1/27/2023
937 63 Senin / 06-02-2023 12:02:42 AM2302060258 ERU GUANDA Ruang Paru 574539 0304R0010123V005722 1/24/2023 1/27/2023
938 64 Senin / 06-02-2023 12:02:07 AM2302060259 ENG MARCHEL Ruang Paru 277135 0304R0010123V005389 1/24/2023 1/27/2023
939 65 Senin / 06-02-2023 12:02:43 AM2302060261 MUSRIZAL Ruang Paru 574566 0304R0010123V003527 1/15/2023 1/27/2023
940 66 Senin / 06-02-2023 12:02:36 AM2302060263 AHSANUL FADHLI ILHAMI Ruang Paru 271668 0304R0010123V004565 1/18/2023 1/26/2023
941 67 Senin / 06-02-2023 12:02:15 AM2302060264 YERMA DEWITA Ruang Paru 574542 0304R0010123V005240 1/21/2023 1/27/2023
942 68 Senin / 06-02-2023 12:02:58 AM2302060265 ANDI SYAIFUL Ruang Ambun Suri Lantai 3 (Interne) 137473 0304R0010123V006747 1/27/2023 1/27/2023
943 69 Senin / 06-02-2023 12:02:07 AM2302060267 NURMI Ruang Ambun Suri Lantai 3 (Interne) 405324 0304R0010123V004168 1/17/2023 1/29/2023

LOKET Casemix
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
FEBRUARI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
599 18 Kamis / 02-03-2023 8:03:00 AM2303020054 YEFRI ROZA Ruang Ambun Suri Lantai 4 (Interne) 546527 0304R0010223V003706 2/15/2023 2/20/2023
600 19 Kamis / 02-03-2023 8:03:24 AM2303020056 ERNIWATI Ruang Ambun Suri Lantai 4 (Interne) 488455 0304R0010223V003432 2/11/2023 2/22/2023
601 20 Kamis / 02-03-2023 8:03:37 AM2303020058 GUSTI MUNAF Ruang Ambun Suri Lantai 4 (Interne) 524019 0304R0010223V004205 2/17/2023 2/22/2023
602 21 Kamis / 02-03-2023 8:03:16 AM2303020059 ZURYENI Ruang Ambun Suri Lantai 4 (Interne) 575698 0304R0010223V004183 2/17/2023 2/22/2023
603 22 Kamis / 02-03-2023 9:03:21 AM2303020102 M.ASYROF ISLAMAY Ruang Bedah 574105 0304R0010223V003772 2/16/2023 2/23/2023
604 23 Kamis / 02-03-2023 9:03:36 AM2303020103 TIRTA TARTI Ruang Bedah 574156 0304R0010223V004977 2/21/2023 2/23/2023
605 24 Kamis / 02-03-2023 9:03:25 AM2303020104 RADIUS Ruang Bedah 358749 0304R0010223V004784 2/20/2023 2/23/2023
606 25 Kamis / 02-03-2023 9:03:20 AM2303020105 SATRIO Ruang Bedah 575909 0304R0010223V004383 2/17/2023 2/22/2023
607 26 Kamis / 02-03-2023 9:03:35 AM2303020107 DEPRINDO WAHYUDI Ruang Bedah 562646 0304R0010223V003708 2/15/2023 2/18/2023
608 27 Kamis / 02-03-2023 10:03:39 AM2303020166 DARNIATI KELAS BEDAH 575843 0304R0010223V005224 2/22/2023 2/23/2023
609 28 Kamis / 02-03-2023 10:03:35 AM2303020168 DIAN JOVI ANDRIO KELAS BEDAH 498473 0304R0010223V005626 2/22/2023 2/24/2023
610 29 Kamis / 02-03-2023 10:03:58 AM2303020171 HANIMAR Ruang Jantung 285090 0304R0010223V005205 2/22/2023 2/24/2023
611 30 Kamis / 02-03-2023 10:03:30 AM2303020172 YUNAIDI Ruang Jantung 570558 0304R0010223V005352 2/22/2023 2/24/2023
612 31 Kamis / 02-03-2023 10:03:40 AM2303020487 IRWAN MATONDANG Ruang Jantung 573115 0304R0010223V005326 2/22/2023 2/24/2023
613 32 Kamis / 02-03-2023 10:03:45 AM2303020177 RIDWAN Ruang Jantung 576105 0304R0010223V005514 2/22/2023 2/24/2023
614 33 Kamis / 02-03-2023 10:03:24 AM2303020180 SULTANI Ruang Jantung 437681 0304R0010223V005232 2/21/2023 2/24/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
MARET 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
600 2 Jumat / 31-03-2023 8:03:22 AM2303310002 SUSI SUSANTI Ruang Kebidanan 496164 0304R0010323V004654 3/20/2023 3/21/2023
601 3 Jumat / 31-03-2023 8:03:28 AM2303310003 RANI FITRIA Ruang Kebidanan 404687 0304R0010323V004668 3/21/2023 3/22/2023
602 4 Jumat / 31-03-2023 8:03:12 AM2303310004 SILVIA RAMSI Ruang Kebidanan 360385 0304R0010323V004263 3/19/2023 3/20/2023
603 5 Jumat / 31-03-2023 8:03:58 AM2303310005 RESI WINDA SARI Ruang Kebidanan 569700 0304R0010323V004300 3/19/2023 3/21/2023
604 6 Jumat / 31-03-2023 8:03:53 AM2303310007 UTARI SILVIA PUTRI Ruang Kebidanan 561248 0304R0010323V005094 3/22/2023 3/23/2023
605 7 Jumat / 31-03-2023 8:03:55 AM2303310008 CICI FITRIA Ruang Kebidanan 201903 0304R0010323V004233 3/18/2023 3/20/2023
606 8 Jumat / 31-03-2023 8:03:42 AM2303310009 RANI ZAKIAH Ruang Kebidanan 573208 0304R0010323V005192 3/23/2023 3/25/2023
607 9 Jumat / 31-03-2023 8:03:26 AM2303310010 MELA YANTI Ruang Kebidanan 577343 0304R0010323V005190 3/23/2023 3/24/2023
608 10 Jumat / 31-03-2023 8:03:16 AM2303310011 ANITA SILVIA DEWI Ruang Kebidanan 359860 0304R0010323V004276 3/19/2023 3/20/2023
609 11 Jumat / 31-03-2023 8:03:30 AM2303310012 RINI SRI JUWITA Ruang Kebidanan 577420 0304R0010323V005625 3/25/2023 3/27/2023
610 12 Jumat / 31-03-2023 8:03:14 AM2303310013 TRI LOVITA Ruang Kebidanan 577428 0304R0010323V005649 3/25/2023 3/27/2023
611 13 Jumat / 31-03-2023 8:03:01 AM2303310014 RAHMADANI Ruang Kebidanan 577138 0304R0010323V004236 3/18/2023 3/20/2023
612 14 Jumat / 31-03-2023 8:03:42 AM2303310015 NURIAH Ruang Kebidanan 575603 0304R0010323V004237 3/18/2023 3/23/2023
613 15 Jumat / 31-03-2023 8:03:29 AM2303310016 NILLA ANNISYA WAHYUNI Ruang Kebidanan 290840 0304R0010323V005640 3/25/2023 3/27/2023
614 16 Jumat / 31-03-2023 8:03:52 AM2303310018 WIDYA INDRI YANTI Ruang Kebidanan 577144 0304R0010323V004249 3/18/2023 3/20/2023
615 17 Jumat / 31-03-2023 8:03:21 AM2303310022 SENIA YUNITA Ruang Kebidanan 574423 0304R0010323V004626 3/20/2023 3/22/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
APRIL 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
600 48 Senin / 08-05-2023 14:05:44 AM2305080330 BY. NY. FEBI WAHYUNI Ruang Bayi (PERINATOLOGI) 578412 0304R0010423V004076 4/22/2023 4/29/2023
601 49 Senin / 08-05-2023 14:05:55 AM2305080331 BY. NY DESI PRAMIDA SARI Ruang Bayi (PERINATOLOGI) 578517 0304R0010423V004350 4/25/2023 4/30/2023
602 50 Senin / 08-05-2023 14:05:59 AM2305080334 BY. NY. DENI ANGGRAINI S Ruang Bayi (PERINATOLOGI) 578426 0304R0010423V004061 4/23/2023 4/29/2023
603 51 Senin / 08-05-2023 14:05:09 AM2305080335 DIYAN DAMAYANTI Ruang Kebidanan 574760 0304R0010423V004200 4/25/2023 4/28/2023
604 52 Senin / 08-05-2023 14:05:22 AM2305080336 neci amelia Ruang Kebidanan 578606 0304R0010423V004471 4/26/2023 4/28/2023
605 53 Senin / 08-05-2023 14:05:35 AM2305080337 YULNA GUSTIA Ruang Kebidanan 578126 0304R0010423V003019 4/15/2023 4/18/2023
606 54 Senin / 08-05-2023 14:05:55 AM2305080338 ELIZA Ruang Kebidanan 478740 0304R0010423V004425 4/26/2023 4/29/2023
607 55 Senin / 08-05-2023 14:05:18 AM2305080341 CITRA AYU NOVIANI Ruang Kebidanan 578527 0304R0010423V004236 4/26/2023 4/27/2023
608 56 Senin / 08-05-2023 14:05:56 AM2305080344 TATIK SAPUTRI Ruang Kebidanan 247752 0304R0010423V004168 4/25/2023 4/27/2023
609 57 Senin / 08-05-2023 14:05:58 AM2305080346 RINA OKTAVIA Ruang Kebidanan 358673 0304R0010423V004462 4/25/2023 4/28/2023
610 58 Senin / 08-05-2023 14:05:54 AM2305080347 LUSI SANTIYANA Ruang Kebidanan 578508 0304R0010423V004207 4/25/2023 4/28/2023
611 59 Senin / 08-05-2023 14:05:28 AM2305080349 MUTIA Ruang Kebidanan 578531 0304R0010423V004307 4/26/2023 4/29/2023
612 60 Senin / 08-05-2023 14:05:33 AM2305080352 WAHYUNI Ruang Kebidanan 345968 0304R0010423V004237 4/26/2023 4/28/2023
613 61 Senin / 08-05-2023 15:05:13 AM2305080353 FEBI WAHYUNI Ruang Kebidanan 367654 0304R0010423V003951 4/22/2023 4/24/2023
614 62 Senin / 08-05-2023 15:05:16 AM2305080356 PERA ASMARA Ruang Kebidanan 578593 0304R0010423V004444 4/26/2023 4/29/2023
615 63 Senin / 08-05-2023 15:05:17 AM2305080359 YOLANDA RIZKI Ruang Kebidanan 578552 0304R0010423V004325 4/26/2023 4/28/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
MEI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
601 36 Rabu / 31-05-2023 15:05:52 AM2305310472 GUSTIMAR Ruang Ambun Suri Lantai 3 (Interne) 407807 0304R0010523V003652 5/15/2023 5/19/2023
602 37 Rabu / 31-05-2023 15:05:23 AM2305310474 YUSRI ROZA Ruang Ambun Suri Lantai 3 (Interne) 568775 0304R0010523V003320 5/12/2023 5/20/2023
603 38 Rabu / 31-05-2023 15:05:03 AM2305310475 MERIDA Ruang Ambun Suri Lantai 3 (Interne) 579441 0304R0010523V003365 5/13/2023 5/18/2023
604 39 Rabu / 31-05-2023 15:05:37 AM2305310476 SITI FATIMAH Ruang Ambun Suri Lantai 3 (Interne) 579336 0304R0010523V002596 5/11/2023 5/18/2023
605 40 Rabu / 31-05-2023 15:05:41 AM2305310477 YUDHI OKZIANANDA Ruang Ambun Suri Lantai 3 (Interne) 574131 0304R0010523V001637 5/8/2023 5/19/2023
606 41 Rabu / 31-05-2023 15:05:18 AM2305310478 AL MAINAR Ruang Ambun Suri Lantai 3 (Interne) 386374 0304R0010523V003434 5/14/2023 5/16/2023
607 42 Rabu / 31-05-2023 15:05:02 AM2305310479 HENDRI AZARI Ruang Ambun Suri Lantai 3 (Interne) 299431 0304R0010523V002309 5/9/2023 5/16/2023
608 43 Rabu / 31-05-2023 15:05:43 AM2305310481 NELDAWATI Ruang Ambun Suri Lantai 3 (Interne) 184833 0304R0010523V002295 5/9/2023 5/17/2023
609 44 Rabu / 31-05-2023 15:05:29 AM2305310482 SAFRIL SAH Ruang Ambun Suri Lantai 3 (Interne) 467026 0304R0010423V005088 4/28/2023 5/16/2023
610 45 Rabu / 31-05-2023 15:05:49 AM2305310483 JUNAIDI AMZA Ruang Cindua Mato 219523 0304R0010523V003481 5/15/2023 5/22/2023
611 46 Rabu / 31-05-2023 15:05:56 AM2305310484 HERMAN Ruang Cindua Mato 579451 0304R0010523V003375 5/13/2023 5/22/2023
612 47 Rabu / 31-05-2023 15:05:50 AM2305310485 JENDRA MUKHDA, SE Ruang Cindua Mato 370168 0304R0010523V002293 5/9/2023 5/22/2023
613 48 Rabu / 31-05-2023 15:05:03 AM2305310486 JAMARIS Ruang Cindua Mato 527971 0304R0010523V003689 5/15/2023 5/20/2023
614 49 Rabu / 31-05-2023 15:05:16 AM2305310487 YULMAILIS Ruang Cindua Mato 349463 0304R0010523V001514 5/6/2023 5/22/2023
615 50 Rabu / 31-05-2023 15:05:18 AM2306040016 WAHYUNI Ruang Cindua Mato 418348 0304R0010523V004775 5/20/2023 5/23/2023
616 51 Rabu / 31-05-2023 15:05:20 AM2306040017 NAUFAL ABIYYU IKHLIL Ruang Ambun Suri Lantai 4 (Interne) 576494 0304R0010523V001190 5/4/2023 5/10/2023
TANDA TERIMA SETORAN BERKAS TAGIHAN PASIEN RAWAT INAP
KE TIM CASEMIX
JUNI 2023
Hari/ Tanggal Setor Tanggal Rawatan
No Nama pasien Ruangan No.MR SEP
ALL Hari waktu No invoice Masuk Pulang
601
602
603
604
605
606
607
608
609
610
611
612
613
614
615
616

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