NO NAMA ALAMAT NO. SPM / NIK TANGGAL DIAGNOSA/TINDAKAN PARAF L P MASUK TINDAKAN BIAYA 1 Niart 44 Sambakat 403/42/435.325.117.2017 26-07-2017 Thorax PA Rp 40,000 Rp 40,000 2 Nawiya 26 Sambakat 430/40/435.425.117.2017 27-07-2017 Thorax PA Rp 40,000 Rp 40,000 3 Madiya 48 Sawah Sumur 470/73/435.426/04/2017 01-08-2017 Water's Rp 40,000 Rp 40,000 4 Arifin 62 Laok jang-jang 405/110/455.425.112/2017 09-08-2017 Thorax PA Rp 40,000 Rp 40,000 5 Aulia Faradila 11 Arjasa 405/25/435.425.101/2017 15-08-2017 Cranium Rp 80,000 Rp 80,000
TOTAL Rp 240,000 Rp 240,000
Arjasa, 25 Agustus 2017
Kepala UPT. Puskesmas Arjasa Penanggung Radiologi
H. D. MUSAID, S. Kep. Ners Ifa dewi susanti A. Md. Rad