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PERDANA MEDICA

JL.RAYA MUDING NO. 2C, MUDING KAJA


JL.RAYA TIBUNGSARI NO.2C , KWANJI
JL. RAYA PENYALIN NO.8, TABANAN

TELP : 087734146933/03618975042 EMAIL : klinikperdanamedica@gmail.com

RECEIPT

Name : VIRAN Register No. : 27/IX/2022/PM/001


Date : 27/09/2022 MR No. :
Sex : Male Doctor : dr. Teguh Adi Partama
Address : Bali Bustle Co Working & Co Living

No. Item Details Sub Total


1 Consultation & Visite Fee Rp. 750.000
2 Injection Fee Rp. 250.000
3 Verorab (Rabies) Vaccines 1 vial Rp. 1.000.000

Total : Rp. 2.000.000


Payment :
Cash : Rp. 2.000.000
Bank Transfer :

Patient/Family Admin

VIRAN I Gede Sukma Okta Perdana, S. Ak, SH,


MH

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