RAWAT JA
1 28-08-2013 Pagi Nn - -
2 28-08-2013 Pagi Apt Sahabat - -
3 28-08-2013 Pagi Nuraidah hj 5,000 80,000
4 28-08-2013 Pagi Yayan - -
5 28-08-2013 Pagi Damanhuri - -
1 28-08-2013 Sore Nn - -
2 28-08-2013 Sore Nurlaela 5,000 70,000
3 28-08-2013 Sore Nancy Arianti 5,000 250,000
4 28-08-2013 Sore Ica Julia 5,000 70,000
5 28-08-2013 Sore Esih 5,000 70,000
6 28-08-2013 Sore Edward 5,000 70,000
7 28-08-2013 Sore Abdurachman 5,000 70,000
8 28-08-2013 Sore Dodo Jimirianto 5,000 70,000
9 28-08-2013 Sore Nn - -
10 28-08-2013 Sore Devi 5,000 70,000
11 28-08-2013 Sore Dede hj 5,000 70,000
12 28-08-2013 Sore Iis tim 5,000 70,000
13 28-08-2013 Sore Nurmala 5,000 70,000
14 28-08-2013 Sore Iis Sumiati 5,000 70,000
15 28-08-2013 Sore Barni 5,000 70,000
16 28-08-2013 Sore Wati 5,000 70,000
17 28-08-2013 Sore Uun Sunarsih 5,000 70,000
18 28-08-2013 Sore Khoeriyah hj - -
19 28-08-2013 Sore Neng Rosti 5,000 70,000
20 28-08-2013 Sore Budi Supriadi 5,000 70,000
21 28-08-2013 Sore Asep popo 5,000 70,000
22 28-08-2013 Sore Nn - -
80,000 1,120,000
1 31-08-2013 Pagi Insi - -
2 31-08-2013 Pagi Siti Nurasri 5,000 70,000
1 31-08-2013 Sore Nn - -
2 31-08-2013 Sore Tan - -
3 31-08-2013 Sore Yano Susilo 5,000 70,000
10,000 140,000
1 1/9/2013 Pagi Nn -
2 1/9/2013 Pagi Nn - -
0 0
105,000 1,480,000
75,000 1,050,000
65,000 910,000
30,000 420,000
90,000 1,260,000
50,000 620,000
1 9/9/2013 Pagi Reni 5,000 70,000
2 9/9/2013 Pagi Mulina 5,000 70,000
3 9/9/2013 Pagi Arif Darma - -
4 9/9/2013 Pagi Eros - -
1 9/9/2013 Sore Munir 5,000 70,000
2 9/9/2013 Sore Rinrin 5,000 70,000
3 9/9/2013 Sore Jaya 5,000 70,000
4 9/9/2013 Sore Putri Zahra 5,000 70,000
5 9/9/2013 Sore Agus Komarudin 5,000 70,000
6 9/9/2013 Sore Sopia 5,000 70,000
7 9/9/2013 Sore Pupu 5,000 70,000
8 9/9/2013 Sore D Najdmudin - -
9 9/9/2013 Sore Eti 5,000 70,000
10 9/9/2013 Sore Heli 5,000 70,000
11 9/9/2013 Sore Herlin 5,000 70,000
12 9/9/2013 Sore Hen Hen 5,000 70,000
13 9/9/2013 Sore Nunung 5,000 70,000
14 9/9/2013 Sore Sutisna 5,000 70,000
15 9/9/2013 Sore Nn - -
16 9/9/2013 Sore Alfarozian 5,000 30,000
17 9/9/2013 Sore Anjar 5,000 70,000
18 9/9/2013 Sore Ajudin 5,000 70,000
90,000 1,220,000
70,000 980,000
1 22-09-2013 Pagi Nn - -
2 22-09-2013 Sore Ayu 5,000 50,000
1 24-09-2013 Pagi Nn - -
2 24-09-2013 Pagi Ai Aisyah 5,000 70,000
3 24-09-20013 Pagi Ela 5,000 70,000
4 24-09-2013 Pagi Fitri 5,000 70,000
1 24-09-2013 Sore Hendra - -
2 24-09-2013 Sore Nn - -
3 24-09-2013 Sore Ahmad 5,000 30,000
4 24-09-2013 Sore Fatimah 5,000 70,000
5 24-09-2013 Sore Fatimah - -
6 24-09-2013 Sore Jubaedah 5,000 70,000
7 24-09-2013 Sore Sutantio 5,000 70,000
8 24-09-2013 Sore Enung 5,000 70,000
9 24-09-2013 Sore Nn - -
10 24-09-2013 Sore Rodiah 5,000 70,000
11 24-09-2013 Sore A Harun 5,000 70,000
12 24-09-2013 Sore Ai Aisyah - -
13 24-09-2013 Sore Indah 5,000 70,000
14 24-09-2013 Sore Hendra - -
15 24-09-2013 Sore Zein 5,000 70,000
ORAN PERHARI KLINIK PERMATA
RAWAT JALAN
- 277,500 - ### -
- 246,500 - ### -
- - - ### -
20,000 - - ### -
- 143,900 - ### -
- 161,000 - ### -
- 233,000 - ### -
- 182,700 - ### -
- 69,000 - ### -
- 411,800 - ### -
- 316,500 - ### -
- 124,000 - ### -
- 326,200 - ### -
- 272,000 - ### -
- 404,700 - ### -
- 80,500 - ### -
20,000 26,500 - ### -
40,000 3,275,800
- - 160,000 - -
- 128,000 - ### -
- 200,500 - ### -
20,000 149,200 - ### -
- 184,500 - ### -
- 85,600 - ### -
- - - ### -
- - - ### -
- - - ### -
- 166,900 - ### -
- 109,000 - ### -
- 318,700 - ### -
1,342,400 160,000
- 132,800 - ### -
100,000 81,000
- 34,800 - ### -
- 41,000 - ### -
- 99,200 - ### -
- 290,000 - ### -
- 196,300 - ### -
20,000 200,900 - ### -
- 400 - ### -
- 4,800 - ### -
- 125,500 - ### -
- 54,000 - ### -
- 11,300 - ### -
- 632,800 - ### -
- 204,600 - ### -
120,000 2,109,400 -
- - 141,000 - -
- 132,000 - ### -
- 124,500 - ### -
- 388,000 - ### 40,000
- 7,100 - ### -
20,000 42,200 - ### -
- 240,200 - ### -
- 97,300 - ### -
- 252,700 - ### -
20,000 138,700 - ### -
- 179,000 - ### -
- 12,900 - ### -
25,000 314,600 100,000 - -
- 184,500 - ### -
- 247,400 105,000 - -
- 151,500 - ### -
- 14,500 - ### -
- - 300,000 - -
20,000 233,500 - ### -
- 272,200 - ### -
- 201,700 - ### -
60,000 178,000 - ### -
122,000
20,000 185,500 - ### -
- 165,700 - ### -
- 115,600 - ### -
20,000 319,000 - ### -
- 106,700 - ### -
- - - ### -
111,500 - ### -
0 199,500 90,000 - -
0 - - 60,000 -
0 194,500 - ### -
0 25,800 - ### -
0 - - ### -
- 673,000 - ### -
- - 60,000 - -
- 364,900 - ### -
20,000 199,000 - ### -
- 64,000 - ### 20,000
- 226,700 - ### -
- 2,400 - ### -
- 107,500 - ### -
- 189,200 - ### -
- - 300,000 - -
- - 60,000 - -
- 10,400 - ### -
- 56,000 - ### -
100,000 169,900 218,000 - -
- 254,200 - ### -
- - - ### 70,000
- - - ### -
- - - ###
- - - ### -
- 13,500 - ### -
100,000 99,000 - ### 75,000
- 54,000 - ### -
- 47,500 - ### -
- 144,200 - ### -
- 199,100 - ### -
20,000 450,100 - ### -
20,000 - - ### -
20,000 33,900 - ### -
- 89,000 - ### -
- 217,400 - ### -
- 107,200 - ### -
60,000 596,000 - ### -
- 2,500 - ### -
- 8,000 - ### -
- - - ### -
- 170,000 - ### -
- 183,500 - ### -
- 121,200 - ### -
- - - ### 70,000
- 19,000 - ### -
- 222,500 - 60,000 -
20,000 253,500 - ### -
- 230,400 - ### -
- 27,500 - ### 70,000
- 192,600 - ### -
- - 135,000 - -
- 174,600 - ### -
- 88,000 - ### -
- 296,200 - ### -
- 24,000 - ### -
- 180,000 - ### -
- - - ### -
- 13,400 - ### -
- 62,200 - ### -
332,000
42000 62,000
- 376,000 - ### -
- 158,200 - ### -
- - 300,000 - -
- 179,400 145,000 - -
- - 270,000 - -
- 130,900 - ### -
- 126,300 - ### -
- 505,000 460,000 - -
- 183,200 - 60,000 -
- 338,000 - ### -
- 285,500 - ### -
- 104,000 - ### -
- - - ### -
- 168,400 - ### -
- - - ### -
- 75,200 300,000 - -
- 126,000 - ### -
- 6,000 - ### -
- - 300,000 - -
- 333,200 - ### -
- 183,000 - ### -
- 166,400 - ### -
- 176,200 - ### -
- 190,000 - 70,000 -
- 121,800 - ### -
- 145,000 - ### -
- 260,000 235,000 - -
- - - ### -
- 151,800 - ### -
20,000 597,100 - ### -
- 106,000 - ### -
20,000 203,400 - ### -
- 10,000 - ### -
- 620,000 - ### -
- 185,400 - ### -
- 153,200 - ### -
- 108,900 - ### -
20,000 - - ### -
- 69,200 - ### -
- 125,000 - ### -
- 58,600 - ### -
- 87,000 300,000 - -
- 442,200 - ### -
- 134,600 - ### -
- 159,000 - ### -
- 58,000 - ### -
- 47,500 - ### 50,000
- 182,500 - 60,000 20,000
- 10,000 - ### -
- 251,000 - ### -
- - 300,000 - -
- 112,200 - ### -
20,000 114,600 - ### -
- 168,500 - ### 50,000
- 122,000 - 60,000 -
- 126,000 - ### -
- 89,000 - ### -
- 204,800 205,000 - -
- 146,200 - ### -
- 151,300 300,000 - -
- 10,000 - ### -
- - 220,000 - -
- 2,000 - ### -
- 116,300 300,000 - -
100,000 240,600 287,000 - -
- 157,000 - 60,000 -
- 118,500 - 120,000 -
- 272,200 - ### -
- 63,800 205,000 - -
- 118,200 - ### -
- 139,200 - ### -
- 130,000 - ### -
- 111,700 - ### -
- 55,300 - ### -
- 129,400 105,000 - -
- 3,000 - ### -
- - 160,000 - -
- - 300,000 - -
- 39,000 - ### -
- 146,800 - ### -
- 80,200 - ### -
- 83,100 - ### -
- 136,000 - ### 30,000
- 67,500 - ### 30,000
- 116,800 20,000 - -
- 10,000 - ### -
- - 20,000 - -
- 361,000 - ### -
- 10,000 - ### -
- 205,000 - ### -
- 42,500 - ### -
- 165,600 - ### -
- 130,600 - 60,000 -
- 93,700 105,000 - -
- 166,100 - ### -
- - 300,000 - -
- 11,700 - ### -
- 46,000 - ### -
- 40,000 - ### -
- 400,500 - ### -
- 157,200 - ### -
- 257,000 - ### -
94,200 - ### -
- 2,000 - ### -
- 97,700 - ### -
- 168,400 - ### -
1,534,500 405,000 0 0
- 152,000 - ### -
- 248,500 413,000 - -
- - 300,000 - -
- 103,500 - ### -
- 118,000 142,000
- 62,200 405,000 - -
- 258,100 - -
- - - ### -
- - - ### -
- 174,000 - ### -
- 140,000 - ### 30,000
- - 132,000 - -
20,000 226,200 - ### -
- 31,000 - ### 50,000
- 174,000 - ### -
- 298,200 - ### -
- - - ### -
20,000 74,000 - ### -
- 13,000 - ### -
- 30,000 - ### -
20,000 - - ### -
- 226,500 - ### -
- - 145,000 - -
- - 15,000 - -
- 171,400 - ### -
- 197,000 - ### -
- 180,000 - ### -
- 286,000 - ### -
- 30,600 - ### -
- 129,700 175,000 - -
- - 300,000 - -
- 138,500 - ### -
- 33,100 - ### -
- 255,800 - ### -
- 210,600 300,000 - -
- 138,700 - ### -
- 194,100 - ### -
- 97,100 - ### -
- 106,200 - ### -
- 360,000 - 60,000 -
- 219,500 - ### -
- 134,800 - ### -
- - 158,000 - -
- 167,000 105,000 - -
- 2,500 - ### -
- 20,000 - ### -
- 152,000 - ### -
20,000 275,600 - ### -
- 73,200 - ### -
60,000 121,500 - ### -
20,000 102,400 - ### -
- 167,600 - 120,000 -
- 157,200 - ### -
263,000
- - - ### -
- 134,000 - ### -
- 141,200 - ### -
- 92,000 - ### -
- 64,000 - ### -
- 34,000 - ### -
- - 300,000 - -
- 3,000 - ### -
- 185,000 - ### 35,000
- 98,000 - ### -
- 86,200 - ### -
- 130,000 - ### -
- 129,500 - ### -
- 219,300 - ### -
60,000 183,600 142,000 60,000 -
- 62,200 - ### -
100,000 82,000 162,000 180,000 -
604,000
- - - ### -
20,000 133,200 - ### 20,000
- 115,000 - ### -
- 293,200 105,000 - -
40,000 193,000 187,000 130,000 -
- 69,400 - ### 30,000
10,000 5,000 - ### -
- 8,400 - ### -
- - 300,000 - -
- 123,500 - ### -
- - - ### -
- - - ### -
- 145,000 - ### -
- 529,200 - ### -
- 124,000 260,000 - -
- 118,200 - ### -
- 159,000 - ### -
20,000 327,000 300,000 - -
- - - ### -
- 98,000 - ### -
60,000 68,600 - ### -
- 82,000 300,000 - -
- 150,000 - 60,000 -
- 211,000 - ### -
- 10,000 - ### -
- 132,600 195,000 - 20,000
- 7,500 - ### -
1,647,000
10,000 - - ### -
- 98,000 - ### -
20,000 263,600 - ### -
- 100,000 - ### -
- 25,500 - ### -
- 73,000 - ### -
- 170,000 - ### -
- 142,400 105,000 - -
- 161,200 - ### -
10,000 - - ### -
- 39,600 155,000 60,000 -
- 20,000 - ### -
260,000
- 20,000 - ### -
- 85,000 - ### -
- 16,500 - ### -
- 24,000 - ### -
- 49,200 155,000 60,000 -
- 2,400 - ### -
- 125,800 - ### -
- 3,000 - ### -
- - - 120,000 -
15,000 10,000 - ### -
- 32,200 - ### -
155,000
- 114,200 - ### 20,000
- 60,400 - ### 20,000
- 175,600 105,000 - -
- 25,500 - ### -
- 109,400 - ### -
- 261,800 - ### -
- 356,000 - ### -
- 178,500 - ### -
- 180,200 - ### -
- 314,000 - ### -
20,000 386,100 - ### -
- 129,000 - ### -
- 297,000 - ### -
- - - ### -
- 36,200 - ### -
20,000 236,200 - ### -
20,000 354,800 - ### -
- 334,700 377,000 - -
482,000
- 435,000 - ### -
- - 20,000 - -
- 70,800 - ### -
20,000 208,500 - ### -
- 55,500 300,000 - -
- 89,200 - ### -
- 237,400 - ### -
150,000 113,000 - ### -
- 182,200 - ### -
25,000 25,600 - ### -
- 74,500 315,000 - -
- 206,200 - ### -
- 23,000 - ### -
- 19,000 - ### -
- 56,300 - ### -
635,000
- - 105,000 - -
- - 100,000 - -
- - - ### -
- - - ### -
- 139,200 - 60,000 -
- 664,000 185,000 - -
- 146,000 - ### -
- 112,600 - ### -
- - - ### -
20,000 267,700 - ### -
- 205,000 - ### -
- 66,500 - ### 70,000
- 231,000 - ### -
- 175,000 - ### -
- 91,600 - ### -
- 446,000 - ### -
20,000 482,000 - ### -
- 186,000 - ### -
- 707,600 - ### -
- 348,000 - ### -
151,000
- 151,000 - ### -
390,000
- 167,000 - ### -
- 6,000 - ### -
- - - ### -
- - - ### -
- 110,200 300,000 - -
20,000 633,600 - ### -
- 105,000 - ### -
- 165,000 - ### -
- - 260,000 - -
- 151,500 - ### -
- - - ### -
- 245,000 - ### -
- 99,200 - ### -
- 52,000 - ### -
- 30,000 - ### -
- - 300,000 - -
- 19,500 - ### -
- - - 60,000 -
- - 285,000 - -
- 105,000 - ### -
- 22,800 - ### -
- 15,600 - ### -
- 188,000 - ### -
- 43,000 - ### -
- 159,000 - ### -
- 112,700 - ### -
- - 275,000 - -
- 72,000 - ### -
15,000 - - ### -
- 158,200 260,000 - -
- 180,100 - ### -
- 89,200 - ### -
- - 147,000 - -
- 27,000 - ### -
- - - ### -
- 344,000 - ### -
30,000 25,600 - ### -
- 278,000 - ### -
- 346,000 - ### -
- 552,000 - ### -
- 357,000 - ### -
- - - ###
- 11,000 - ### -
- 102,500 - ### -
- 10,000 - ### -
- 25,000 - ### -
- 10,000 - ### -
- 168,400 - ### -
- 13,000 - ### -
- 276,000 112,000 - -
- - 60,000 - -
- 80,300 - ### -
163,500 - ### -
- 146,000 - ### -
- 227,000 50,000 - -
- 91,200 - ### -
- 300,000 - ### -
- 104,000 - ### -
- 25,000 - ### -
- - 300,000 - -
- - - ### -
- 340,800 - ### -
- 922,000 430,000 - -
- - - ### -
- 354,200 - ### -
- 261,000 - ### -
- - 300,000 - -
- - - ### -
20,000 46,800 - ### -
20,000 355,000 270,000 - -
15,000 - - ### -
60,000 174,000 - 60,000 -
- 5,500 - ### -
- 177,800 - ### -
20,000 - - ### -
- 100,000 - ### -
- - - ### -
- 16,000 - ### -
- 140,200 - ### -
- - 300,000 - -
170,000 177,600 - ### -
- 16,000 - ### -
- 156,600 116,000 - -
- 83,400 300,000 - -
- 110,700 - ### -
- - 300,000 - -
- 10,800 - ### -
- - - ### -
- 222,000 - ### -
- 155,200 - ### -
- 374,400 - ### -
- 168,800 395,000 - -
- 80,200 300,000 - -
- 4,000 - ### -
- 130,000 - ### 20,000
60,000 172,400 - ### -
- 254,000 - ### -
- 113,000 - ### -
- 188,000 - ### -
- 116,000 - ### -
TOTAL
No Nama Pasien
352,500
321,500 1 Viddy
75,000 2 Ina Rustiana
95,000 3 Irni Heryani
218,900 4 Hermala
236,000 5 Nunuh
308,000 6 D Najmudin
257,700 7 Astia Nuralip
144,000 8 Enung
486,800 9 Tan Eng Nio
391,500 10 Nunuh
199,000 11 Kusnadi
401,200 Bebby Syaqila
347,000 Berliana
479,700 Nurjanah
155,500
121,500
4,590,800
160,000
203,000
275,500
244,200
259,500
160,600
75,000
75,000
75,000
241,900
184,000
393,700
2,347,400
207,800
256,000
34,800
116,000
174,200
365,000
271,300
295,900
400
4,800
200,500
129,000
86,300
707,800
279,600
3,129,400
141,000
207,000
199,500
423,000
7,100
137,200
315,200
172,300
327,700
233,700
254,000
12,900
519,600
2,950,200
259,500
427,400
226,500
14,500
300,000
328,500
347,200
276,700
313,000
197,000
280,500
240,700
190,600
414,000
181,700
75,000
186,500
364,500
135,000
269,500
100,800
75,000
5,204,100
748,000
60,000
439,900
294,000
119,000
301,700
1,962,600
237,100
135,000
203,200
41,700
300,000
75,000
169,000
172,200
224,200
224,200
292,000
190,000
147,000
207,000
179,800
435,200
338,800
275,300
356,000
213,000
272,900
10,000
15,600
4,714,200
647,000
210,000
366,500
15,500
75,000
380,200
830,500
487,700
25,000
225,000
3,262,400
2,400
107,500
274,200
300,000
60,000
10,400
131,000
742,900
329,200
5,000
75,000
75,000
75,000
13,500
199,000
129,000
122,500
219,200
274,100
545,100
95,000
128,900
89,000
292,400
182,200
731,000
2,500
5,211,000
16,500
13,800 1,043,300
300,000
413,000
300,000
5,500
315,000
452,000
60,000 2,941,900
687,000
238,200
276,700
75,000
611,400
221,100
3,985,200
8,000
75,000
245,000
183,500
121,200 632,700
5,000
94,000
357,500
348,500
305,400
32,500
267,600
135,000 2,908,900
249,600
163,000
371,200
24,000
255,000
75,000
88,400
137,200
3,541,600
20,000
75,000 95,000
22,000
150,000 387,000
215,000
482,000
42,000
60,000 102,000
102,000
451,000
233,200
375,000 1,728,600
399,400
270,000
205,900
201,300
1,040,000
318,200
413,000
285,500
104,000
75,000
243,400
75,000
450,200
126,000
6,000
300,000
408,200
258,000 5,337,300
241,400
251,200
335,000
201,800
225,000 426,800
7,492,700
495,000
75,000
226,800 1,488,900
692,100
181,000
298,400
85,000
695,000
260,400
228,200
183,900
95,000
144,200
200,000 3,408,900
58,600
462,000
517,200
4,897,800
209,600 1,207,600
234,000
133,000
72,500
297,500
10,000
251,000
300,000
187,200
209,600
193,500
257,000
201,000
89,000
484,800 2,679,600
221,200
526,300
10,000
3,887,200
220,000
2,000
491,300
702,600
292,000
313,500 2,712,400
347,200
343,800 2,492,400
2,712,400
193,200
214,200
205,000
186,700 1,701,800
130,300
309,400
3,000
160,000
300,000
114,000
221,800
155,200
158,100
181,000
112,500
211,800
10,000
20,000 2,534,100
436,000
10,000
280,000
117,500
240,600
265,600
4,235,900
273,700
241,100
300,000 814,800
11,700
81,000
75,000
475,500
232,200 1,376,600
332,000
169,200
2,000
172,700 418,100
243,400
2,609,500
227,000
736,500
300,000 1,367,000
103,500
335,000
542,200
333,100
75,000
75,000
249,000
185,000
132,000
321,200
56,000
249,000
373,200
75,000
169,000
13,000 3,644,200
65,000
95,000
301,500
5,011,200 5,011,200
145,000
15,000
246,400
272,000
255,000
361,000
30,600 1,704,700
379,700
300,000
213,500
108,100
330,800
585,600
213,700
269,100
172,100 3,088,600
181,200
495,000
219,500
4,793,300
134,800
158,000 639,800
347,000
2,500
2,000
227,000
370,600
108,200
256,500
197,400
362,600 1,759,000
232,200
2,398,800
75,000
209,000
216,200
167,000
667,200
99,000
69,000
300,000
3,000
225,000
173,000
161,200
205,000
129,500
294,300
520,600 2,840,800
62,200
599,000
3,508,000
75,000
208,200
190,000
473,200
625,000 1,709,200
114,400
15,000
8,400
300,000
198,500
75,000
75,000
220,000
604,200
459,000
193,200
234,000
722,000
75,000
98,000
163,600
457,000 4,845,600
285,000
286,000
10,000
382,600
7,500
6,554,800
15,000
98,000
358,600
175,000
100,500
73,000 805,100
245,000
322,400
236,200 803,600
15,000
289,600
55,000 359,600
70,000
190,000
16,500
59,000
299,200
2,400
125,800 765,900
3,000
120,000
60,000
70,200 250,200
169,200
115,400
355,600
25,500
184,400
336,800 1,186,900
431,000
253,500
255,200
389,000
481,100
204,000
372,000
75,000
71,200
331,200
449,800
786,700 4,099,700
5,286,600
510,000
20,000
105,800 635,800
303,500
430,500
164,200
312,400
338,000
257,200
85,600
464,500
281,200
58,000
54,000
91,300 2,840,400
3,476,200
105,000
100,000
75,000
75,000
274,200 629,200
924,000
221,000
187,600
75,000
362,700
280,000
71,500
306,000
250,000
166,600
521,000
577,000
261,000
782,600
423,000
226,000
151,000 5,786,000
6,415,200
242,000
61,000 303,000
35,000
75,000
485,200
728,600
140,000
240,000 1,703,800
2,006,800
260,000
226,500
75,000
320,000
174,200
52,000
65,000
300,000
19,500
60,000
285,000
105,000
22,800
15,600
188,000
43,000
234,000
187,700
275,000
147,000
50,000
493,200
255,100
164,200
182,000
62,000
75,000
419,000
90,600
353,000
721,000
627,000
432,000
11,000
157,500
45,000
60,000
45,000
243,400
13,000
463,000
60,000
155,300
238,500
221,000
352,000
166,200
375,000
179,000
60,000 2,676,400
300,000
75,000
415,800
1,427,000
75,000
429,200
336,000
375,000
75,000
141,800
720,000
50,000
369,000
5,500
252,800
95,000
175,000
75,000
16,000
215,200
300,000
422,600 6,345,900
9,022,300
16,000
347,600
458,400
185,700 1,007,700
300,000
10,800
35,000
297,000
155,200
449,400
638,800
455,200
4,000
185,000
307,400
254,000
188,000
188,000
191,000 3,658,800
4,666,500
Rawat Jalan
Tgl Masuk Tgl Keluar Rawat Inap
Adm Dokter
19-08-2013 23-08-2013 5,000 70,000 600,000
24-08-2013 26-08-2013 0 0 700,000
28-08-2013 29-08-2013 5,000 70,000 400,000
27-08-2013 30-08-2013 5,000 70,000 1,300,000
29-08-2013 31-08-2013 5,000 70,000 500,000
30-08-2013 1/9/2013 5,000 70,000 500,000
30-08-2013 2/9/2013 5,000 70,000 700,000
2/9/2013 4/9/2013 10,000 100,000 537,500
28-08-2013 8/9/2013 5,000 70,000 4,025,000
6/9/2013 10/9/2013 - - 1,207,500
11/9/2013 Observasi 5,000 70,000 107,500
11/9/2013 12/9/2013 - - 500,000
10/9/2013 12/9/2013 - - 687,500
12/9/2013 14-09-2013 5,000 70,000
Laporan Klinik Permata
Rawat Inap
Visite Dokter
Obat Laboratorium Radiologi
Visite Via Telp
50,000 15,000 1,576,000 345,000 -
### - 750,400 92,000 -
### - 1,147,500 452,000 66,000
- - 1,841,600 300,000 -
### - 1,247,300 297,000 -
### - 1,029,000 205,000 -
### - 1,319,800 280,000 -
120,000 - 856,000 358,000 -
### - 7,567,900 538,000 72,000
- - 3,287,500 178,000 -
### - 94,300 20,000 -
### - 1,130,800 316,000 -
### - 1,173,400 502,000 -
3,883,000
AKHP Tindakan Total Disc
100,000
LAPORAN KASIR
Tanggal 16 Februari 2016 Sore Rj Sore
Pengeluaran
Total Rp 161,500
Penerima Kasir
Rp 161,500
KLINIK PERMATA
Jl.RA Kosasih No.112 Telp (0266) 219188
Sudah Di Terima Dari : Elis Siti Hati.Ny
Usia : 71 Tahun
Ruangan : Sahai VIP 2
DEPOSIT Rp 11,314,000
11,314,000
11,314,000
: 47 Tahun
: 12/02/2016
Rp. 57,000
Rp. 1,750,000
Rp. 500,000
Rp. 125,000
Rp. 3,415,484
Rp. -
Rp. 415,700
Rp. 110,000
Rp. 344,450
Rp. 6,717,634
Rp. 582,754
Rp. 7,300,388
Rp. -
Rp. 7,300,388
Kasir
LABORATORIUM
KLINIK RAWAT INAP PERMATA
Jl. RA Kosasih No.112 Telp (0266) 219188
Tanggal Masuk : 12-02-2016 Umur
Nama Pasien : Seri Rahayu.Ny
Ruang Rawat : Ranah 2/kls 1
Tanggal Pemeriksaan :
Hematologi Rutin
Total
Sukabumi,16 Febuari 2016
M
ERMATA
47 Tahun
14-02-2016
Rp 68,800
Rp 68,800
KLINIK RAWAT INAP PERMATA
RADIOLOGI
Tanggal : 28 Januari 2016
Nama Pasien : Yeti Nurhayati.Ny
Umur : 41 Tahun
Jenis Pemeriksaan :
Abdomen 3 Posisi Rp 286,000
Total Rp 286,000
Sukabumi,31 Januari 2016
ATA
286,000
286,000
ari 2016
RINCIAN BIAYA AKHP + BHP RAWAT INAP
KLINIK RAWAT INAP PERMATA
Jl.RA Kosasih (Ciaul) No.112 Sukabumi
TOTAL
Sukabumi,16 Febuari 2016
AT INAP
ATA
47 Tahun
12/02/2016
Rp 60,000
Rp 15,000
Rp 10,000
Rp 10,000
Rp 15,000
Rp 110,000
bumi,16 Febuari 2016
RINCIAN BIAYA OBAT RAWAT INAP
KLINIK RAWAT INAP PERMATA
No. RM : 0000-0203
Nama Pasien : Nur Azizah.Ny
Ruang Rawat : Sahai VIP 2
Tanggal Nama Obat Qty
08/03/2015 dextrose 100cc 1
08/03/2015 RL 500ml 1
08/03/2015 terfacef 1
08/03/2015 Ranitidin 1
08/03/2015 ondansentron inj 1
08/03/2015 Pumpisel 1
08/03/2015 trixim200mg 6
08/03/2015 redusec 10
08/03/2015 mucosta 10
AYA OBAT RAWAT INAP
WAT INAP PERMATA
Usia : 36 Thn
Harga Total
Rp 20,100 Rp 20,100
Rp 25,148 Rp 25,148
Rp 281,800 Rp 281,800
Rp 4,500 Rp 4,500
Rp 7,000 Rp 7,000
Rp 179,600 Rp 179,600
Rp 28,875 Rp 173,250
Rp 2,000 Rp 20,000
Rp 5,800 Rp 58,000
Total Rp 769,398
RINCIAN BIAYA OBAT RAWAT INAP
KLINIK RAWAT INAP PERMATA
Jln RA.Kosasih (Ciaul) No.112 Sukabumi
No. RM : 0000-7842 Umur :
Nama Pasien : Seri Rahayu.Ny Tanggal Masuk :
Ruang Rawat : Ranah 2/kls 1
Tanggal Nama Obat Qty Harga
16-02-2016 Trixim 200 5 Rp 29,333
16-02-2016 Tamezol 6 Rp 3,045
16-02-2016 Mucosta 10 Rp 5,887
16-02-2016 Spasmomen 10 Rp 8,729
Total
Sukabumi,16 Februari 2016
INAP
ATA
i
47 Tahun
12/02/2016
Total
Rp 146,665
Rp 18,270
Rp 58,870
Rp 87,290
Rp 311,095
16 Februari 2016
07/05/-19830
09/11/-25306
11/18/-30782
01/24/29279
04/03/23803
06/10/18327
08/16/12851
dr.S um a ryo no ( 6 x Rp.70.000)
10/23/7375
Ra na h 1(6 x Rp.215.000)
12/30/1899
::
48 Tahun
28/12/2015
: : : : : : : : : : : :
Ranah 1/kls 2
Konsul
Operasi
Rawat
Visite
R
: awat
Sedang
Farmasi
Inap
Laboratorium
Dokter
jalan
AKHP
T
Ranpa
USG
adiologi
/ Obat
Tindakan
Sisa
Administrasi
Total
+Anastesi
Total
yang
BHP
Deposite
Transaksi
harus dibayar
Ruang Rawat
01/24/29279
02/27/26541
04/03/23803
05/06/21065
06/10/18327
07/13/15589
08/16/12851
09/19/10113 dr.Yus ra D e wita ,S p.P D ( 4 x Rp.80.000)
10/23/7375
::
22 Tahun
03/01/2016
: : : : : : : : : : :
Ranah 1/kls 2
Konsul
Rawat
rawat
Visite
: FTarmasi
indakan
Inap
Dokter
jalan
Laboratorium
RAKHP
adiologi
/ Obat
Operasi
TSisa
Administrasi
indakan
Total
+Total
BHP
yang
Deposite
Transaksi
harus dibayar
Ruang Rawat
RINCIAN BIAYA RAWAT INAP
KLINIK PERMATA
JL.RA Kosasih No. 112 Sukabumi
Telp (0266) 219188 .Fax (0266) 6247781
No Rm : 0000-7866
Nama Pasien : Ijah.Ny
Ruang Rawat : Ranah 1/kls 2
Konsul rawat jalan :
Rawat Inap :
Visite Dokter :
:
Farmasi / Obat :
Radiologi :
Laboratorium :
AKHP+BHP :
Tindakan :
Total
Administrasi
Total Transaksi
Deposite
Sisa yang harus dibayar
IAN BIAYA RAWAT INAP
KLINIK PERMATA
.RA Kosasih No. 112 Sukabumi
0266) 219188 .Fax (0266) 6247781
Umur : 45 Tahun
Tanggal Masuk : 15/02/2016
Total Rp 369,000
Sukabumi,16 Febuari 2016
KLINIK PERMATA
Radiologi
Tanggal Pemeriksaan : 16/02/2016
Nama Pasien : Susanto,Sdr
Umur : 25 Tahun
Jenis Pemeriksaan :
Thorax AP/PA
Total
Sukabumi,16 Januari 2016
Rp 80,000
Rp 80,000
Januari 2016
RINCIAN BIAYA AKHP+BHP RAWAT INAP
KLINIK PERMATA
No Rm : 0000-7866 Umur : 45 Tahun
Nama Pasien : Ijah.Ny Tanggal Masuk : 15/02/2016
Ruang Rawat : Ranah 1/kls 2
KIT mandi 1 Rp 100,000 Rp 100,000
Total Rp 100,000
Sukabumi,16 Februari 2016
KLINIK PERMATA
Jl. RA.Kosasih No.112 Telp (0266) 219188
Tarif Radiologi
No Jenis Pemeriksaan
RJ/Kls II Kls I
Pemeriksaan Non Kontras
1 Thorax
a. Thorax AP/PA Rp 70,000 Rp 75,000
b. Thorax AP/PA + Lateral Rp 121,000 Rp 132,000
c. Top Lordotik Rp 55,000 Rp 60,000
2 BNO
a. Abdomen Polos / BNO Rp 80,000 Rp 85,000
b. Abdomen 2 Posisi Rp 143,000 Rp 156,000
c. Abdomen 3 Posisi Rp 220,000 Rp 250,000
3 Extremitas
a. Extremitas Atas Rp 75,000 Rp 80,000
b. Extremitas Bawah Rp 77,000 Rp 85,000
4 Schedel
a. Schedel AP & Lateral Rp 99,000 Rp 108,000
b. SPN Waters Rp 77,000 Rp 84,000
c. SPN Waters & Cadwell Rp 143,000 Rp 156,000
d. SPN Waters,Cadwell & Lateral Rp 220,000 Rp 240,000
e. Mandibula Rp 88,000 Rp 96,000
f. Cavum Orbita Rp 88,000 Rp 96,000
g. TMJ 1 Rp 99,000 Rp 108,000
h. TMJ 2 Rp 176,000 Rp 192,000
i. Maxilla/Arcus Zigomaticum Rp 88,000 Rp 96,000
j. Mastoid 2 Posisi Rp 110,000 Rp 120,000
k. Mastoid 4 Posisi Rp 198,000 Rp 216,000
l. Sella Turcica 1 Posisi Rp 77,000 Rp 84,000
m. Sella Turcica 2 Posisi Rp 132,000 Rp 144,000
n. Os Nasal Rp 88,000 Rp 96,000
5 Columna Vertebralis
a. Cervikal AP + Lateral Rp 110,000 Rp 120,000
b. Cervikal AP,Lateral & Oblique Rp 165,000 Rp 180,000
c. Thoracal AP & Lateral Rp 165,000 Rp 180,000
d. Thoracolumbal AP & Lateral Rp 220,000 Rp 240,000
e. Lumbosacral AP & Lateral Rp 150,000 Rp 165,000
f. Stermum PA + Oblique Rp 94,000 Rp 102,000
g. Sacrum / Coxxigis AP + Lateral Rp 138,000 Rp 150,000
6 Pelvis
a. Coxae dex + sin AP Rp 77,000 Rp 84,000
b. Coxae dex + sin AP + Lateral Rp 132,000 Rp 144,000
c. Coxae dex / sin AP Lateral Rp 132,000 Rp 144,000
d. Pelvis AP Rp 83,000 Rp 90,000
e. Pelvis AP + Lateral Rp 154,000 Rp 168,000
7 Bone Survey
a. Bone Survey A Rp 418,000 Rp 456,000
b. Bone Survey B Rp 528,000 Rp 576,000
8 Artresiani Rp 110,000 Rp 120,000
TA
219188
adiologi
VIP
Rp 80,000
Rp 143,000
Rp 65,000
Rp 95,000
Rp 169,000
Rp 275,000
Rp 90,000
Rp 95,000
Rp 117,000
Rp 91,000
Rp 169,000
Rp 260,000
Rp 104,000
Rp 104,000
Rp 117,000
Rp 208,000
Rp 104,000
Rp 130,000
Rp 234,000
Rp 91,000
Rp 156,000
Rp 104,000
Rp 130,000
Rp 195,000
Rp 195,000
Rp 260,000
Rp 175,000
Rp 111,000
Rp 163,000
Rp 91,000
Rp 156,000
Rp 156,000
Rp 98,000
Rp 182,000
Rp 494,000
Rp 624,000
Rp 130,000
KLINIK RAWAT INAP PERMATA KWITANSI
JL.RA. Kosasih (ciaul) no.112 Sukabumi Tanggal Pelayanan :
Telp: (0266) 219188 Nomor Kwitansi :
Fax: (0266) 6247781 Nomor RM :
53 Tahun
Sahai VIP 1
pat ribu
Admin
KLINIK PERMATA
Jl.RA Kosasih No.112 Telp (0266) 219188
KWITANSI PEMBAYARAN RAWAT INAP
No.
Sudah terima dari : Tn. Ruswan
Banyaknya uang : Dua Juta delapan ratus dua puluh dua ribu rupiah
Untuk pembayaran : Rawat inap a/n Tn. Ruswan Tanggal 08/12/2014 s/d 10/12/2014
10 Desember 2014
enerima
TANGGAL HARGA HARI
16/07/2015 Rp 45,000 KAMIS
18/01/2016 Rp 50,000 Senin
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
KLINIK PERMATA
Fisiterapi
Jl. RA Kosasih No.112 Telp (0266) 219188
Tanggal Masuk : 21/12/2015
Nama Pasien : Hj.Lastiah.Ny Umur : 46 Tahun
Jenis Pemeriksaan 23/12/2015
IRR Rp 39,000
Tens Rp 52,000
US Rp 52,000
Exc Rp 130,000
Total Rp 273,000
Sukabumi, Desember 2015