Nama Perusahaan / BU : spbu 3446314 cibentang

No Virtual Account : 8888890001110012 (BNI)

: 8888890001110012 (BRI)
: 8988890001110012 (MANDIRI)

DAFTAR IURAN JKN BPJS KESEHATAN

IURAN KELAS PERA

No NIK Nama Tgl Lahir 4.0% 0.5% TOTAL KELAS I
UPAH
PERSH KARYAWAN PST
1 ani kuswardini 03-051988 1,025,000 41,000 5,125 46,125 0
2 asriah permana 6/8/1991 1,025,000 41,000 5,125 46,125 0
3 bustomi aripin 17-02-1991 1,025,000 41,000 5,125 46,125 0
4 cecep hernawan 30-04-1984 1,025,000 41,000 5,125 46,125 0
5 dodi miswar 14-08-1986 1,025,000 41,000 5,125 46,125
6 feri irawan 4/6/1973 1,025,000 41,000 5,125 46,125
7 gugi guntoro 8/12/1992 1,025,000 41,000 5,125 46,125
8 herdin 30-06-1990 1,025,000 41,000 5,125 46,125
9 heryanto 9/12/1990 1,025,000 41,000 5,125 46,125
10 jaedin 5/1/1989 1,025,000 41,000 5,125 46,125
11 marikin 14-02-1976 1,025,000 41,000 5,125 46,125
12 roni mustofa 3/6/1991 1,025,000 41,000 5,125 46,125
13 rudi herdiana 11/6/1985 1,025,000 41,000 5,125 46,125
14 sukirno 15-03-1947 1,025,000 41,000 5,125 46,125
15 unan gunawan 8/11/1953 1,025,000 41,000 5,125 46,125
16 yadi setiadi 5/1/1989 1,025,000 41,000 5,125 46,125
17 yana suryana 21-03-1981 1,025,000 41,000 5,125 46,125
18 rina marlina 1,025,000 41,000 5,125 46,125
19 elin 1,025,000 41,000 5,125 46,125
20 tambahan tomy 10,250
21 tambahan tomy 10,250
22 tambahan yadi 10,250
23 tambahan yadi 10,250
24 tambahan roni 10,250
25 tambahan roni 10,250
26 tambahan ani 10,250
27 tambahan ani 10,250
19,475,000 779,000 97,375 958,375 -

Jumlah Peserta
Jumlah keluarga
Iuran JKN - BPJS Kesehatan Bulan desember 2014 Rp 958,375
BPJS KESEHATAN

KELAS PERAWATAN
KELAS I KELAS II
KLG PST KLG
0
0
0
0

- - -

-
Nama Perusahaan / BU : spbu 3446314 cibentang
No Virtual Account : 8888890001110012 (BNI)
: 8888890001110012 (BRI)
: 8988890001110012 (MANDIRI)

DAFTAR IURAN JKN BPJS KESEHATAN

IURAN KELAS PERA

No NIK Nama Tgl Lahir 4.0% 0.5% TOTAL KELAS I
UPAH
PERSH KARYAWAN PST
1 ani kuswardini 03-051988 1,025,000 41,000 5,125 46,125 0
2 asriah permana 6/8/1991 1,025,000 41,000 5,125 46,125 0
3 bustomi aripin 17-02-1991 1,025,000 41,000 5,125 46,125 0
4 cecep hernawan 30-04-1984 1,025,000 41,000 5,125 46,125 0
5 dodi miswar 14-08-1986 1,025,000 41,000 5,125 46,125
6 feri irawan 4/6/1973 1,025,000 41,000 5,125 46,125
7 gugi guntoro 8/12/1992 1,025,000 41,000 5,125 46,125
8 herdin 30-06-1990 1,025,000 41,000 5,125 46,125
9 heryanto 9/12/1990 1,025,000 41,000 5,125 46,125
10 jaedin 5/1/1989 1,025,000 41,000 5,125 46,125
11 marikin 14-02-1976 1,025,000 41,000 5,125 46,125
12 roni mustofa 3/6/1991 1,025,000 41,000 5,125 46,125
13 rudi herdiana 11/6/1985 1,025,000 41,000 5,125 46,125
14 sukirno 15-03-1947 1,025,000 41,000 5,125 46,125
15 unan gunawan 8/11/1953 1,025,000 41,000 5,125 46,125
16 yadi setiadi 5/1/1989 1,025,000 41,000 5,125 46,125
17 yana suryana 21-03-1981 1,025,000 41,000 5,125 46,125
18 rina marlina 1,025,000 41,000 5,125 46,125
19 elin 1,025,000 41,000 5,125 46,125
20 tambahan tomy 10,250
21 tambahan tomy 10,250
22 tambahan yadi 10,250
23 tambahan yadi 10,250
24 tambahan roni 10,250
25 tambahan roni 10,250
26 tambahan ani 10,250
27 tambahan ani 10,250
28 - - -
19,475,000 779,000 97,375 958,375 -

Jumlah Peserta -
Jumlah keluarga -
Iuran JKN - BPJS Kesehatan Bulan november 2014 Rp 958,375

Rp 19,168
Rp 977,543
Rp 1,273,653
BPJS KESEHATAN

KELAS PERAWATAN
KELAS I KELAS II
KLG PST KLG
0 1 3
0 1
0 1 2
0 1 2
1 2
1 2
1
1 1
1 2
1 2
1 2
1 2
1
1
1 3
1 1
1

- 16 21

-
Nama Perusahaan / BU : spbu 3446314 cibentang
No Virtual Account : 8888890001110012 (BNI)
: 8888890001110012 (BRI)
: 8988890001110012 (MANDIRI)

DAFTAR IURAN JKN BPJS KESEHATAN

IURAN KELAS PERA

No NIK Nama Tgl Lahir 4.0% 0.5% TOTAL KELAS I
UPAH
PERSH KARYAWAN PST
1 ani kuswardini 03-051988 1,025,000 41,000 5,125 46,125 0
2 asriah permana 6/8/1991 1,025,000 41,000 5,125 46,125 0
3 bustomi aripin 17-02-1991 1,025,000 41,000 5,125 46,125 0
4 cecep hernawan 30-04-1984 1,025,000 41,000 5,125 46,125 0
5 dodi miswar 14-08-1986 1,025,000 41,000 5,125 46,125
6 feri irawan 4/6/1973 1,025,000 41,000 5,125 46,125
7 gugi guntoro 8/12/1992 1,025,000 41,000 5,125 46,125
8 herdin 30-06-1990 1,025,000 41,000 5,125 46,125
9 heryanto 9/12/1990 1,025,000 41,000 5,125 46,125
10 jaedin 5/1/1989 1,025,000 41,000 5,125 46,125
11 marikin 14-02-1976 1,025,000 41,000 5,125 46,125
12 roni mustofa 3/6/1991 1,025,000 41,000 5,125 46,125
13 rudi herdiana 11/6/1985 1,025,000 41,000 5,125 46,125
14 sukirno 15-03-1947 1,025,000 41,000 5,125 46,125
15 unan gunawan 8/11/1953 1,025,000 41,000 5,125 46,125
16 yadi setiadi 5/1/1989 1,025,000 41,000 5,125 46,125
17 ratiman 1,025,000 41,000 5,125 46,125
18 susi 1,025,000 41,000 5,125 46,125
19 yana suryana 21-03-1981 1,025,000 41,000 5,125 46,125
20 jujun junaedi 1,025,000 41,000 5,125 46,125
21 rina marlina 1,025,000 41,000 5,125 46,125
22 elin 1,025,000 41,000 5,125 46,125
20 tambahan tomy 10,250
21 tambahan tomy 10,250
22 tambahan yadi 10,250
23 tambahan yadi 10,250
24 tambahan roni 10,250
25 tambahan roni 10,250
24 tambahan ani 10,250
25 tambahan ani 10,250
23 - - 21,935
22,550,000 902,000 112,750 1,118,685 -

Jumlah Peserta -
Jumlah keluarga -
Iuran JKN - BPJS Kesehatan Bulan oktober 2014 Rp 1,118,685
RAN JKN BPJS KESEHATAN

KELAS PERAWATAN
KELAS I KELAS II
KLG PST KLG
0
0
0
0

- - -
Nama Perusahaan / BU : spbu 3446314 cibentang
No Virtual Account : 8888890001110012 (BNI)
: 8888890001110012 (BRI)
: 8988890001110012 (MANDIRI)

DAFTAR IURAN JKN BPJS KESEHATAN

IURAN KELAS PERA

No NIK Nama Tgl Lahir 4.0% 0.5% TOTAL KELAS I
UPAH
PERSH KARYAWAN PST
1 ani kuswardini 03-051988 1,025,000 41,000 5,125 46,125 0
2 asriah permana 6/8/1991 1,025,000 41,000 5,125 46,125 0
3 bustomi aripin 17-02-1991 1,025,000 41,000 5,125 46,125 0
4 cecep hernawan 30-04-1984 1,025,000 41,000 5,125 46,125 0
5 dodi miswar 14-08-1986 1,025,000 41,000 5,125 46,125
6 feri irawan 4/6/1973 1,025,000 41,000 5,125 46,125
7 gugi guntoro 8/12/1992 1,025,000 41,000 5,125 46,125
8 herdin 30-06-1990 1,025,000 41,000 5,125 46,125
9 heryanto 9/12/1990 1,025,000 41,000 5,125 46,125
10 jaedin 5/1/1989 1,025,000 41,000 5,125 46,125
11 marikin 14-02-1976 1,025,000 41,000 5,125 46,125
12 roni mustofa 3/6/1991 1,025,000 41,000 5,125 46,125
13 rudi herdiana 11/6/1985 1,025,000 41,000 5,125 46,125
14 sukirno 15-03-1947 1,025,000 41,000 5,125 46,125
15 unan gunawan 8/11/1953 1,025,000 41,000 5,125 46,125
16 yadi setiadi 5/1/1989 1,025,000 41,000 5,125 46,125
17 ratiman 1,025,000 41,000 5,125 46,125
18 susi 1,025,000 41,000 5,125 46,125
19 yana suryana 21-03-1981 1,025,000 41,000 5,125 46,125
20 jujun junaedi 1,025,000 41,000 5,125 46,125
21 rina marlina 1,025,000 41,000 5,125 46,125
22 elin 1,025,000 41,000 5,125 46,125
23 - - -
22,550,000 902,000 112,750 1,014,750 -

Jumlah Peserta -
Jumlah keluarga -
Iuran JKN - BPJS Kesehatan Bulan september 2014 Rp 1,014,750
RAN JKN BPJS KESEHATAN

KELAS PERAWATAN
KELAS I KELAS II
KLG PST KLG
0
0
0
0

- - -
Nama Perusahaan / BU : spbu 3446314 cibentang
No Virtual Account : 8888890001110012 (BNI)
: 8888890001110012 (BRI)
: 8988890001110012 (MANDIRI)

DAFTAR IURAN JKN BPJS KESEHATAN

IURAN KELAS PERA

No NIK Nama Tgl Lahir 4.0% 0.5% TOTAL KELAS I
UPAH
PERSH KARYAWAN PST
1 ani kuswardini 03-051988 1,025,000 41,000 5,125 46,125
2 asriah permana 6/8/1991 1,025,000 41,000 5,125 46,125
3 bustomi aripin 17-02-1991 1,025,000 41,000 5,125 46,125
4 cecep hernawan 30-04-1984 1,025,000 41,000 5,125 46,125
5 dodi miswar 14-08-1986 1,025,000 41,000 5,125 46,125
6 feri irawan 4/6/1973 1,025,000 41,000 5,125 46,125
7 gugi guntoro 8/12/1992 1,025,000 41,000 5,125 46,125
8 herdin 30-06-1990 1,025,000 41,000 5,125 46,125
9 heryanto 9/12/1990 1,025,000 41,000 5,125 46,125
10 jaedin 5/1/1989 1,025,000 41,000 5,125 46,125
11 marikin 14-02-1976 1,025,000 41,000 5,125 46,125
12 roni mustofa 3/6/1991 1,025,000 41,000 5,125 46,125
13 rudi herdiana 11/6/1985 1,025,000 41,000 5,125 46,125
14 sukirno 15-03-1947 1,025,000 41,000 5,125 46,125
15 unan gunawan 8/11/1953 1,025,000 41,000 5,125 46,125
16 yadi setiadi 5/1/1989 1,025,000 41,000 5,125 46,125
17 ratiman 1,025,000 41,000 5,125 46,125
18 susi 1,025,000 41,000 5,125 46,125
19 yana suryana 21-03-1981 1,025,000 41,000 5,125 46,125
20 jujun junaedi 1,025,000 41,000 5,125 46,125
21 rina marlina 1,025,000 41,000 5,125 46,125
22 elin 1,025,000 41,000 5,125 46,125
23 - - -
22,550,000 902,000 112,750 1,014,750 -

Jumlah Peserta -
Jumlah keluarga -
Iuran JKN - BPJS Kesehatan Bulan agustus 2014 Rp 1,014,750
RAN JKN BPJS KESEHATAN

KELAS PERAWATAN
KELAS I KELAS II
KLG PST KLG

- - -
Nama Perusahaan / BU : spbu 3446314 cibentang
No Virtual Account : 8888890001110012 (BNI)
: 8888890001110012 (BRI)
: 8988890001110012 (MANDIRI)

DAFTAR IURAN JKN BPJS KESEHATAN

IURAN KELAS PERA

No NIK Nama Tgl Lahir 4.0% 0.5% TOTAL KELAS I
UPAH
PERSH KARYAWAN PST
1 ani kuswardini 03-051988 1,025,000 41,000 5,125 46,125
2 asriah permana 6/8/1991 1,025,000 41,000 5,125 46,125
3 bustomi aripin 17-02-1991 1,025,000 41,000 5,125 46,125
4 cecep hernawan 30-04-1984 1,025,000 41,000 5,125 46,125
5 dodi miswar 14-08-1986 1,025,000 41,000 5,125 46,125
6 feri irawan 4/6/1973 1,025,000 41,000 5,125 46,125
7 gugi guntoro 8/12/1992 1,025,000 41,000 5,125 46,125
8 herdin 30-06-1990 1,025,000 41,000 5,125 46,125
9 heryanto 9/12/1990 1,025,000 41,000 5,125 46,125
10 jaedin 5/1/1989 1,025,000 41,000 5,125 46,125
11 marikin 14-02-1976 1,025,000 41,000 5,125 46,125
12 roni mustofa 3/6/1991 1,025,000 41,000 5,125 46,125
13 rudi herdiana 11/6/1985 1,025,000 41,000 5,125 46,125
14 sukirno 15-03-1947 1,025,000 41,000 5,125 46,125
15 unan gunawan 8/11/1953 1,025,000 41,000 5,125 46,125
16 yadi setiadi 5/1/1989 1,025,000 41,000 5,125 46,125
17 ratiman 1,025,000 41,000 5,125 46,125
18 susi 1,025,000 41,000 5,125 46,125
19 yana suryana 21-03-1981 1,025,000 41,000 5,125 46,125
20 jujun junaedi 1,025,000 41,000 5,125 46,125
21 rina marlina 1,025,000 41,000 5,125 46,125
22 elin 1,025,000 41,000 5,125 46,125
22,550,000 902,000 112,750 1,014,750 -

Jumlah Peserta #REF!

Jumlah keluarga #REF!
Iuran JKN - BPJS Kesehatan Bulan juli 2014 Rp 1,014,750
RAN JKN BPJS KESEHATAN

KELAS PERAWATAN
KELAS I KELAS II
KLG PST KLG

- - -
Nama Perusahaan / BU : spbu 3446314 cibentang
No Virtual Account : 8888890001110012 (BNI)
: 8888890001110012 (BRI)
: 8988890001110012 (MANDIRI)

DAFTAR IURAN JKN BPJS KESEHATAN

IURAN KELAS PERA

No NIK Nama Tgl Lahir 4.0% 0.5% TOTAL KELAS I
UPAH
PERSH KARYAWAN PST
1 ani kuswardini 03-051988 1,025,000 41,000 5,125 46,125 0
2 asriah permana 6/8/1991 1,025,000 41,000 5,125 46,125 0
3 bustomi aripin 17-02-1991 1,025,000 41,000 5,125 46,125 0
4 cecep hernawan 30-04-1984 1,025,000 41,000 5,125 46,125 0
5 dodi miswar 14-08-1986 1,025,000 41,000 5,125 46,125
6 feri irawan 4/6/1973 1,025,000 41,000 5,125 46,125
7 gugi guntoro 8/12/1992 1,025,000 41,000 5,125 46,125
8 herdin 30-06-1990 1,025,000 41,000 5,125 46,125
9 heryanto 9/12/1990 1,025,000 41,000 5,125 46,125
10 jaedin 5/1/1989 1,025,000 41,000 5,125 46,125
11 marikin 14-02-1976 1,025,000 41,000 5,125 46,125
12 roni mustofa 3/6/1991 1,025,000 41,000 5,125 46,125
13 rudi herdiana 11/6/1985 1,025,000 41,000 5,125 46,125
14 sukirno 15-03-1947 1,025,000 41,000 5,125 46,125
15 unan gunawan 8/11/1953 1,025,000 41,000 5,125 46,125
16 yadi setiadi 5/1/1989 1,025,000 41,000 5,125 46,125
17 ratiman 1,025,000 41,000 5,125 46,125
18 susi 1,025,000 41,000 5,125 46,125
19 yana suryana 21-03-1981 1,025,000 41,000 5,125 46,125
20 jujun junaedi 1,025,000 41,000 5,125 46,125
22 elin 1,025,000 41,000 5,125 46,125
23 rina 1,025,000 41,000 5,125 46,125
22,550,000 902,000 112,750 1,014,750 -

Jumlah Peserta -
Jumlah keluarga -
Iuran JKN - BPJS Kesehatan Bulan juni 2014 Rp 1,014,750
RAN JKN BPJS KESEHATAN

KELAS PERAWATAN
KELAS I KELAS II
KLG PST KLG

- - -
Nama Perusahaan / BU : spbu 3446314 cibentang
No Virtual Account : 8888890001110012 (BNI)
: 8888890001110012 (BRI)
: 8988890001110012 (MANDIRI)

DAFTAR IURAN JKN BPJS KESEHATAN

IURAN KELAS PERA

No NIK Nama Tgl Lahir 4.0% 0.5% TOTAL KELAS I
UPAH
PERSH KARYAWAN PST
1 ani kuswardini 03-051988 1,025,000 41,000 5,125 46,125 0
2 asriah permana 6/8/1991 1,025,000 41,000 5,125 46,125 0
3 bustomi aripin 17-02-1991 1,025,000 41,000 5,125 46,125 0
4 cecep hernawan 30-04-1984 1,025,000 41,000 5,125 46,125 0
5 dodi miswar 14-08-1986 1,025,000 41,000 5,125 46,125
6 feri irawan 4/6/1973 1,025,000 41,000 5,125 46,125
7 gugi guntoro 8/12/1992 1,025,000 41,000 5,125 46,125
8 herdin 30-06-1990 1,025,000 41,000 5,125 46,125
9 heryanto 9/12/1990 1,025,000 41,000 5,125 46,125
10 jaedin 5/1/1989 1,025,000 41,000 5,125 46,125
11 marikin 14-02-1976 1,025,000 41,000 5,125 46,125
12 roni mustofa 3/6/1991 1,025,000 41,000 5,125 46,125
13 rudi herdiana 11/6/1985 1,025,000 41,000 5,125 46,125
14 sukirno 15-03-1947 1,025,000 41,000 5,125 46,125
15 unan gunawan 8/11/1953 1,025,000 41,000 5,125 46,125
16 yadi setiadi 5/1/1989 1,025,000 41,000 5,125 46,125
17 ratiman 1,025,000 41,000 5,125 46,125
18 susi 1,025,000 41,000 5,125 46,125
19 yana suryana 21-03-1981 1,025,000 41,000 5,125 46,125
20 jujun junaedi 1,025,000 41,000 5,125 46,125
21 rina marlina 1,025,000 41,000 5,125 46,125
1,025,001 41,000 5,125 46,125
denda 2 % 20,295
22,550,001 902,000 112,750 1,035,045 -

Jumlah Peserta -
Jumlah keluarga -
Iuran JKN - BPJS Kesehatan Bulan mei 2014 Rp 1,035,045
RAN JKN BPJS KESEHATAN

KELAS PERAWATAN
KELAS I KELAS II
KLG PST KLG

- - -
Nama Perusahaan / BU : spbu 3446314 cibentang
No Virtual Account : 8888890001110012 (BNI)
: 8888890001110012 (BRI)
: 8988890001110012 (MANDIRI)

DAFTAR IURAN JKN BPJS KESEHATAN

IURAN KELAS PERA

No NIK Nama Tgl Lahir 4.0% 0.5% TOTAL KELAS I
UPAH
PERSH KARYAWAN PST
1 ani kuswardini 03-051988 1,025,000 41,000 5,125 46,125
2 asriah permana 6/8/1991 1,025,000 41,000 5,125 46,125
3 bustomi aripin 17-02-1991 1,025,000 41,000 5,125 46,125
4 cecep hernawan 30-04-1984 1,025,000 41,000 5,125 46,125
5 dodi miswar 14-08-1986 1,025,000 41,000 5,125 46,125
6 feri irawan 4/6/1973 1,025,000 41,000 5,125 46,125
7 gugi guntoro 8/12/1992 1,025,000 41,000 5,125 46,125
8 herdin 30-06-1990 1,025,000 41,000 5,125 46,125
9 heryanto 9/12/1990 1,025,000 41,000 5,125 46,125
10 jaedin 5/1/1989 1,025,000 41,000 5,125 46,125
11 marikin 14-02-1976 1,025,000 41,000 5,125 46,125
12 roni mustofa 3/6/1991 1,025,000 41,000 5,125 46,125
13 rudi herdiana 11/6/1985 1,025,000 41,000 5,125 46,125
14 sukirno 15-03-1947 1,025,000 41,000 5,125 46,125
15 unan gunawan 8/11/1953 1,025,000 41,000 5,125 46,125
16 yadi setiadi 5/1/1989 1,025,000 41,000 5,125 46,125
17 ratiman 1,025,000 41,000 5,125 46,125
18 susi 1,025,000 41,000 5,125 46,125
19 yana suryana 21-03-1981 1,025,000 41,000 5,125 46,125
20 jujun junaedi 1,025,000 41,000 5,125 46,125
21 1,025,000 41,000 5,125 46,125
22 1,025,000 41,000 5,125 46,125

22,550,000 902,000 112,750 1,014,750 -

Jumlah Peserta -
Jumlah keluarga -
Iuran JKN - BPJS Kesehatan Bulan april 2014 Rp 1,014,750

Rp -
0
RAN JKN BPJS KESEHATAN

KELAS PERAWATAN
KELAS I KELAS II
KLG PST KLG

- - -
Nama Perusahaan / BU : spbu 3446314 cibentang
No Virtual Account : 8888890001110012 (BNI)
: 8888890001110012 (BRI)
: 8988890001110012 (MANDIRI)

DAFTAR IURAN JKN BPJS KESEHATAN

IURAN KELAS PERA

No NIK Nama Tgl Lahir 4.0% 0.5% TOTAL KELAS I
UPAH
PERSH KARYAWAN PST
1 ani kuswardini 03-051988 1,025,000 41,000 5,125 46,125 0
2 asriah permana 6/8/1991 1,025,000 41,000 5,125 46,125 0
3 bustomi aripin 17-02-1991 1,025,000 41,000 5,125 46,125 0
4 cecep hernawan 30-04-1984 1,025,000 41,000 5,125 46,125 0
5 heryati 1,025,000 41,000 5,125 46,125
6 dodi miswar 14-08-1986 1,025,000 41,000 5,125 46,125
7 feri irawan 4/6/1973 1,025,000 41,000 5,125 46,125
8 gugi guntoro 8/12/1992 1,025,000 41,000 5,125 46,125
9 herdin 30-06-1990 1,025,000 41,000 5,125 46,125
10 heryanto 9/12/1990 1,025,000 41,000 5,125 46,125
11 jaedin 5/1/1989 1,025,000 41,000 5,125 46,125
12 marikin 14-02-1976 1,025,000 41,000 5,125 46,125
13 roni mustofa 3/6/1991 1,025,000 41,000 5,125 46,125
14 anisa solihat 1,025,000 41,000 5,125 46,125
15 rudi herdiana 11/6/1985 1,025,000 41,000 5,125 46,125
16 sukirno 15-03-1947 1,025,000 41,000 5,125 46,125
17 unan gunawan 8/11/1953 1,025,000 41,000 5,125 46,125
18 yadi setiadi 5/1/1989 1,025,000 41,000 5,125 46,125
19 ratiman 1,025,001 41,000 5,125 46,125
20 susi 1,025,002 41,000 5,125 46,125
21 yana suryana 21-03-1981 1,025,003 41,000 5,125 46,125
22 mirayati 1,025,004 41,000 5,125 46,125
23 jujun junaedi 1,025,005 41,000 5,125 46,125 -
23,575,015 943,001 117,875 1,060,876 -

Jumlah Peserta -
Jumlah keluarga -
Iuran JKN - BPJS Kesehatan Bulan maret 2014 Rp 1,060,876
RAN JKN BPJS KESEHATAN

KELAS PERAWATAN
KELAS I KELAS II
KLG PST KLG

- - -
- - -
Nama Perusahaan / BU : spbu 3446314 cibentang
No Virtual Account : 8888890001110012 (BNI)
: 8888890001110012 (BRI)
: 8988890001110012 (MANDIRI)

DAFTAR IURAN JKN BPJS KESEHATAN

IURAN KELAS PERA

No NIK Nama Tgl Lahir 4.0% 0.5% TOTAL KELAS I
UPAH
PERSH KARYAWAN PST
1 ani kuswardini 03-051988 1,025,000 41,000 5,125 46,125
2 asriah permana 6/8/1991 1,025,000 41,000 5,125 46,125
3 bustomi aripin 17-02-1991 1,025,000 41,000 5,125 46,125
4 cecep hernawan 30-04-1984 1,025,000 41,000 5,125 46,125
5 heryati 1,025,000 41,000 5,125 46,125
6 dodi miswar 14-08-1986 1,025,000 41,000 5,125 46,125
7 feri irawan 4/6/1973 1,025,000 41,000 5,125 46,125
8 gugi guntoro 8/12/1992 1,025,000 41,000 5,125 46,125
9 herdin 30-06-1990 1,025,000 41,000 5,125 46,125
10 heryanto 9/12/1990 1,025,000 41,000 5,125 46,125
11 jaedin 5/1/1989 1,025,000 41,000 5,125 46,125
12 marikin 14-02-1976 1,025,000 41,000 5,125 46,125
13 roni mustofa 3/6/1991 1,025,000 41,000 5,125 46,125
14 anisa solihat 1,025,000 41,000 5,125 46,125
15 rudi herdiana 11/6/1985 1,025,000 41,000 5,125 46,125
16 sukirno 15-03-1947 1,025,000 41,000 5,125 46,125
17 unan gunawan 8/11/1953 1,025,000 41,000 5,125 46,125
18 yadi setiadi 5/1/1989 1,025,000 41,000 5,125 46,125
19 ratiman 1,025,001 41,000 5,125 46,125
20 susi 1,025,002 41,000 5,125 46,125
21 yana suryana 21-03-1981 1,025,003 41,000 5,125 46,125
22 mirayati 1,025,004 41,000 5,125 46,125
23 jujun junaedi 1,025,005 41,000 5,125 46,125 -
23,575,015 943,001 117,875 1,060,876 -

Jumlah Peserta -
Jumlah keluarga -
Iuran JKN - BPJS Kesehatan Bulan februari 2014 Rp 1,060,876
RAN JKN BPJS KESEHATAN

KELAS PERAWATAN
KELAS I KELAS II
KLG PST KLG

- - -
- - -
Nama Perusahaan / BU : spbu 3446314 cibentang
No Virtual Account : 8888890001110012 (BNI)
: 8888890001110012 (BRI)
: 8988890001110012 (MANDIRI)

DAFTAR IURAN JKN BPJS KESEHATAN

IURAN KELAS PERA

No NIK Nama Tgl Lahir 4.0% 0.5% TOTAL KELAS I
UPAH
PERSH KARYAWAN PST
1 ani kuswardini 03-051988 1,025,000 41,000 5,125 46,125 0
2 asriah permana 6/8/1991 1,025,000 41,000 5,125 46,125 0
3 bustomi aripin 17-02-1991 1,025,000 41,000 5,125 46,125 0
4 cecep hernawan 30-04-1984 1,025,000 41,000 5,125 46,125 0
5 heryati 1,025,000 41,000 5,125 46,125
6 dodi miswar 14-08-1986 1,025,000 41,000 5,125 46,125
7 feri irawan 4/6/1973 1,025,000 41,000 5,125 46,125
8 gugi guntoro 8/12/1992 1,025,000 41,000 5,125 46,125
9 herdin 30-06-1990 1,025,000 41,000 5,125 46,125
10 heryanto 9/12/1990 1,025,000 41,000 5,125 46,125
11 jaedin 5/1/1989 1,025,000 41,000 5,125 46,125
12 marikin 14-02-1976 1,025,000 41,000 5,125 46,125
13 roni mustofa 3/6/1991 1,025,000 41,000 5,125 46,125
14 anisa solihat 1,025,000 41,000 5,125 46,125
15 rudi herdiana 11/6/1985 1,025,000 41,000 5,125 46,125
16 sukirno 15-03-1947 1,025,000 41,000 5,125 46,125
17 unan gunawan 8/11/1953 1,025,000 41,000 5,125 46,125
18 yadi setiadi 5/1/1989 1,025,000 41,000 5,125 46,125
19 ratiman 1,025,001 41,000 5,125 46,125
20 susi 1,025,002 41,000 5,125 46,125
21 yana suryana 21-03-1981 1,025,003 41,000 5,125 46,125
22 mirayati 1,025,004 41,000 5,125 46,125
23 jujun junaedi 1,025,005 41,000 5,125 46,125 -
23,575,015 943,001 117,875 1,060,876 -

Jumlah Peserta -
Jumlah keluarga -
Iuran JKN - BPJS Kesehatan Bulan JANUARI 2014 Rp 1,060,876
RAN JKN BPJS KESEHATAN

KELAS PERAWATAN
KELAS I KELAS II
KLG PST KLG

- - -