RSU DR.

ABDUL RADJAK PURWA

STATEMENT OF ACCOUNT

Case ID : 2158354

MR ID : 478644
Patient Name : RUSWANTO , TN
Intake Date : 19-Jun-2024 9:42

Closed Date : 22-Jun-2024 13:41

Company Name : SUMI RUBBER INDONESIA, PT (DUNLOP)

Description

ADMINISTRATION

ADMINISTRATION IP
JASA PELAYANAN

JADE

RUANG JADE
VISITE DOKTER SPESIALIS
VISITE DOKTER UMUM
GANTI BALUTAN (GV)

LAB
DARAH LENGKAP
MASA PERDARAHAN
MASA PEMBEKUAN
GOL DARAH ABO-RHESUS
HBSAG
GLUKOSA SEWAKTU

OR
OPERATOR Try Sutrisno Rahantan, dr, Sp.B
ANESTHESI Siti Harniati, dr., SpAn.
ASSISTEN Perawat OK
KAMAR
O2 / JAM
OPERATOR Try Sutrisno Rahantan, dr, Sp.B

PATOLOGI ANATOMI
ADJAK PURWAKARTA

T OF ACCOUNT

Qty Charge

1
1

3
3
3
1

1
1
1
1
1
1

1
1
1
1
1
1
20-Jun-24 PA A(JARINGAN KECIL) < 3 CM

PHARMACY

RL 500 ML INFUS
INFUSET MAKRO TERUMO
THREE WAY
ABOCATH NO 20
OMZ INJ
RATIVOL 30 MG INJ
ALKOHOL SWAB 2 PLY
TERFACEF INJ
METRONIDAZOLE 500 MG / 100 ML INFUS
PLASMINEX 5 ML INJ
SPUIT 10 CC
SPUIT 3 CC
SPUIT 5 CC
ALKOHOL SWAB 2 PLY

OBAT PULANG
22-Jun-24 SPORETIK 200 MG CAPSUL
22-Jun-24 VOXIB TABLET
22-Jun-24 LAPRAZ CAPSUL

PHARMACY DEPO

OK
20-Jun-24 REGIVELL 20 MG / 4 ML INJ
20-Jun-24 SPINAL NEEDLE NO 25
20-Jun-24 B-PROTOFEN 100 MG SUPP
20-Jun-24 APRON WHITE BARASCODE
20-Jun-24 H2O2 50% 800 ML
20-Jun-24 FLATE NETRAL KABEL
20-Jun-24 CHROMIC 2-0 HR 27
20-Jun-24 NACL 500 ML INFUS
20-Jun-24 WI 500 ML (AQUA PRO INJECTION)
20-Jun-24 ALKOHOL 70% 1000 ML
20-Jun-24 POVIDON IODINE 1000 ML
20-Jun-24 HANDSCONE STERIL NO 6,5
20-Jun-24 HANDSCONE STERIL NO 7
20-Jun-24 HANDSCONE STERIL NO 7,5
20-Jun-24 HANDSCONE STERIL NO 8
20-Jun-24 KASA TAMPON X RAY 10 CM X 7.5 CM
20-Jun-24 BISTURI NO 10
20-Jun-24 LOMATULLE / CUTICEL CLASSIC 10X10
20-Jun-24 SPUIT 10 CC
20-Jun-24 SPUIT 5 CC
20-Jun-24 MASKER DISPOSIBLE EARLOOP
20-Jun-24 HYPAFIX 10 X 5 METER
20-Jun-24 HANDSCONE NON STERIL UKURAN M
20-Jun-24 TOPI OPERASI DOKTER ( SURGEON )
20-Jun-24 COUTER PEN (PISAU COUTER)
20-Jun-24 NASAL CANNUL DEWASA
RANAP LT V JADE
 1

15
1
1
1
3
6
5
6
9
6
10
3
3
3

10
10
10

1
1
2
1
10
1
1
1
20
50
100
1
1
1
1
3
1
1
1
1
3
0
10
3
1
1
19-Jun-24 BAHAN HABIS PAKAI KECIL
19-Jun-24 HANDSCONE NON STERIL UKURAN S
19-Jun-24 MASKER DISPOSIBLE EARLOOP
20-Jun-24 MASKER DISPOSIBLE EARLOOP
20-Jun-24 HANDSCONE NON STERIL UKURAN S
20-Jun-24 PISAU CUKUR
21-Jun-24 MASKER DISPOSIBLE EARLOOP
21-Jun-24 HANDSCONE NON STERIL UKURAN S
UGD
19-Jun-24 BAHAN HABIS PAKAI KECIL
19-Jun-24 MASKER DISPOSIBLE EARLOOP
19-Jun-24 HANDSCONE NON STERIL UKURAN M
19-Jun-24 ALKOHOL SWAB 2 PLY

RADIOLOGY

19-Jun-24 THORAX FOTO Ema Setiyowati, dr,Sp.R

UGD

KONSULTASI DOKTER UGD

PASANG INFUS DEWASA

Total Payment

Total Charge

To be paid

Print By : drlita Page -1 of 1

 1
7
6
4
4
1
2
2

1
1
2
2

Total Charge :

0.00

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06/25/2024 13:50:06