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  • Medical Claim Form 20240521073859

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    Mica
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    Medical_Claim_Form_20240521073859

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    1 views1 page

    Medical Claim Form 20240521073859

    Uploaded by

    Mica

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 1

    PT ADARO INDONESIA

    MEDICAL CLAIM
    Employee Name HADI SYUHARA
    Personnel Number 12010011
    Employee Subgroup SUPERINTENDENT
    Position RESOURCE & RSRVE MOD SECT
    Personnel Area KALIMANTAN

    Claim Document Claim Type Billing Patient Billing Dr. ID GL Claim


    Date No Date No. Amount
    21.05.2024 0000114283 OUTPATIENT 19.05.2024 668,781

    Requested by Approved by

    HADI SYUHARA Human Resource

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