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Nama Nama Harga

No. Waktu No. Reg NRM Tindakan Tindakan Jumlah Total


Dokter Pasien
Rp. Rp.
9-Jul-18 dr. Nani
1. Zumaroh ANIK 2082746 931334 INSISI au
270,232.00 270,232.00
Rp. Rp.
25-Jul-18 dr. AGOES
2. 2084534 931859 DC 1
Hartono SETIONO SHOCK 215,292.00 215,292.00
dr. Goliat Rp. Rp.
3. 26-Jul-18 Victor FREDY 2084763 931901 EKSTRAKS 1
I KUKU
Emanuel 151,525.00 151,525.00
PASANG Rp. Rp.
10-Jul-18 dr. Yenny SUTRISN
4. 2083096 931473 TAMPON 1
Haryono O, TN HIDUNG 147,264.00 147,264.00
WINDI FIKSASI Rp. Rp.
7-Jul-18 Zumaroh RAHMA
dr. Nani
5. NUARINA 2082771 931371 PLESTER 1
LEBAR
WATI
116,058.00 116,058.00
Rp. Rp.
1-Jul-18 dr. SAIFUL
6. 2082126 931173 IRIGASI 1
Hartono MUCHLIS MATA 99,375.00 99,375.00
dr. Rp. Rp.
7. 3-Jul-18 Artamty BOKIR 2082263 931221 HEACTIN 1
G > 10
Sastry A 79,249.00 79,249.00
Rp. Rp.
5-Jul-18 dr. Nani ALVI
8. 2082573 931309 HEACTIN 1
Zumaroh SAHRIN G > 10 79,249.00 79,249.00
Rp. Rp.
17-Jul-18 dr. Nani YULIANIN 2083813
9. 931670 HEACTIN 1
Zumaroh GSIH G > 10 79,249.00 79,249.00
NUR Rp. Rp.
10. 16-Jul-18 dr.
Hartono RAIHAN, 2083673 931639 SUCTION 1
MUH. 79,154.00 79,154.00

Yenny BY.NY.SITI Rp. Rp.


11. 22-Jul-18 dr.
Haryono NUR 2084242 931792 SUCTION 1
NIKMAH 79,154.00 79,154.00
RAWAT Rp. Rp.
12. 3-Jul-18 dr.
Hartono PANDI 2082386 931253 LUKA 1
BESAR 75,618.00 75,618.00
RAWAT Rp. Rp.
5-Jul-18 dr. Nani ALVI
13. 2082573 931309 LUKA 1
Zumaroh SAHRIN BESAR 75,618.00 75,618.00
RAWAT Rp. Rp.
8-Jul-18 dr. Nani
14. Zumaroh WARNADI 2082820 917244 LUKA 1
BESAR 75,618.00 75,618.00
RAWAT Rp. Rp.
8-Jul-18 dr. Nani
15. Zumaroh SUNOTO 2082826 924169 LUKA 1
BESAR 75,618.00 75,618.00
RAWAT Rp. Rp.
17-Jul-18 dr. Nani YULIANIN 2083813
16. 931670 LUKA 1
Zumaroh GSIH BESAR 75,618.00 75,618.00
RAWAT Rp. Rp.
17. 26-Jul-18 dr.
Hartono TAYUK 2084718 931896 LUKA 1
BESAR 75,618.00 75,618.00
dr. Goliat ARIE RAWAT Rp. Rp.
18. 29-Jul-18 Victor WICAKSO 2084975 927160 LUKA 0
Emanuel NO BESAR 0 75,618.00
RAWAT Rp. Rp.
19. 30-Jul-18 dr.
Hartono KAMISAH 2085119 932005 LUKA 0
BESAR 0 75,618.00
dr. Goliat AGUSTIN PASANG Rp. Rp.
20. 1-Jul-18 Victor A 2082096 931163 INFUS 1
Emanuel ROHANI DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
21. 1-Jul-18 dr.
Hartono MARIYATI 2082087 931158 INFUS 1
DEWASA 71,723.00 71,723.00
dr. Goliat SITI PASANG Rp. Rp.
22. 1-Jul-18 Victor 2082094 931069 INFUS 1
Emanuel ANIFAH DEWASA 71,723.00 71,723.00
dr. Goliat MUDI PASANG Rp. Rp.
23. 1-Jul-18 Victor HARTON 2082101 931167 INFUS 1
Emanuel O DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
24. 1-Jul-18 Victor DARWITO 2082102 931168 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
25. 1-Jul-18 Victor DARNI 2082100 931166 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
ABIMANY
dr. PASANG Rp. Rp.
U
26. 1-Jul-18 Artamty ARKANA 2082106 97823 INFUS 1
Sastry A ANAK
FARID
71,723.00 71,723.00
dr. PASANG Rp. Rp.
27. 1-Jul-18 Artamty LASADJI 2082111 914717 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. Goliat SARJI PASANG Rp. Rp.
28. 1-Jul-18 Victor 2082113 85610 INFUS 1
Emanuel GUNO DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
29. 1-Jul-18 Victor MOLAN 2082114 931169 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
dr. Goliat KUSNING, PASANG Rp. Rp.
30. 1-Jul-18 Victor 2082115 84994 INFUS 1
Emanuel HJ DEWASA
dr. Goliat KUSNING, PASANG
30. 1-Jul-18 Victor 2082115 84994 INFUS 1
Emanuel HJ DEWASA 71,723.00 71,723.00
dr. Goliat MEY NUR PASANG Rp. Rp.
31. 1-Jul-18 Victor 2082117 917719 INFUS 1
Emanuel AZIZAH DEWASA 71,723.00 71,723.00
dr. Goliat AGUS PASANG Rp. Rp.
32. 1-Jul-18 Victor 2082119 931171 INFUS 1
Emanuel PUJIONO DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
33. 1-Jul-18 Victor LANTIP 2082122 931172 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
dr. Goliat GIO PASANG Rp. Rp.
34. 1-Jul-18 Victor 2082124 905682 INFUS 1
Emanuel FIPTIAN ANAK 71,723.00 71,723.00
TEGUH PASANG Rp. Rp.
35. 1-Jul-18 dr.
Hartono SLAMET 2082127 931174 INFUS 1
WIDODO DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
36. 2-Jul-18 dr.
Hartono MARJO 2082138 931175 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
2-Jul-18 dr. Nani
37. Zumaroh WINDA 2082146 931178 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
2-Jul-18 dr. Nani SUWARNI 2082162
38. 931183 INFUS 1
Zumaroh ,NY DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
2-Jul-18 dr. Nani
39. Zumaroh DARSAM 2082169 61805 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
2-Jul-18 dr. Nani
40. Zumaroh RUKMINI 2082181 77582 INFUS 1
DEWASA 71,723.00 71,723.00

Nani SANTI PASANG Rp. Rp.


41. 2-Jul-18 dr.
Zumaroh RATNASA 2082188 931192 INFUS 1
RI DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
2-Jul-18 dr. Yenny
42. Haryono TARMI 2082193 901182 INFUS 1
DEWASA 71,723.00 71,723.00

Nani MASROYA PASANG Rp. Rp.


43. 2-Jul-18 dr.
Zumaroh NA/RSM 2082201 76 INFUS 1
M DEWASA 71,723.00 71,723.00

Nani HADI PASANG Rp. Rp.


44. 2-Jul-18 dr.
Zumaroh PRAYITN 2082204 931195 INFUS 1
O DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
2-Jul-18 dr. Nani NYAMINA 2082217
45. 931200 INFUS 1
Zumaroh H DEWASA
PASANG
2-Jul-18 dr. Nani NYAMINA 2082217
45. 931200 INFUS 1
Zumaroh H DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
46. 2-Jul-18 Ferryzal SUWITO 2082210 920782 INFUS 1
O.M., DEWASA
Sp.OT.
71,723.00 71,723.00
PASANG Rp. Rp.
2-Jul-18 dr. Yenny
47. Haryono SUPARTIN 2082232 931206 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
2-Jul-18 dr. Nani LASMUNT 2082224
48. 931203 INFUS 1
Zumaroh IK DEWASA 71,723.00 71,723.00

Yenny AMALIA PASANG Rp. Rp.


49. 2-Jul-18 dr.
Haryono MULYA 2082235 931207 INFUS 1
SAPUTRI DEWASA 71,723.00 71,723.00

DHANUR
Yenny ENDRA PASANG Rp. Rp.
50. 2-Jul-18 dr.
Haryono ARYO 2082250 931212 INFUS 1
MAHEND ANAK
RA
71,723.00 71,723.00
PASANG Rp. Rp.
2-Jul-18 dr. Yenny ARIFIN
51. Haryono SUSANTO 2082251 931213 INFUS 1
DEWASA 71,723.00 71,723.00

RAHMAT PASANG Rp. Rp.


2-Jul-18 Haryono YUSUF
dr. Yenny
52. KUSUMA 2082253 931014 INFUS 1
DEWASA
WARDANI
71,723.00 71,723.00
PASANG Rp. Rp.
2-Jul-18 dr. Yenny HARIANT
53. 2082256 931215 INFUS 1
Haryono O DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
54. 2-Jul-18 Artamty SAMIAN 2082260 931218 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. ANDYS PASANG Rp. Rp.
55. 2-Jul-18 Artamty YOGA 2082261 931219 INFUS 1
Sastry A ARDIKA DEWASA 71,723.00 71,723.00
dr. FAIQ AL PASANG Rp. Rp.
56. 3-Jul-18 Artamty FAHMI, 2082297 931225 INFUS 1
Sastry A MUH ANAK 71,723.00 71,723.00
dr. PASANG Rp. Rp.
57. 3-Jul-18 Artamty NAIM 2082298 931226 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
IFRA PASANG Rp. Rp.
3-Jul-18 Haryono MIKAYLA
dr. Yenny
58. 2082303 931227 INFUS 1
RAMADH ANAK
ANI
IFRA PASANG
3-Jul-18 Haryono MIKAYLA
dr. Yenny
58. 2082303 931227 INFUS 1
RAMADH ANAK
ANI
71,723.00 71,723.00
PASANG Rp. Rp.
3-Jul-18 dr. Yenny
59. Haryono TUMAJI 2082304 931228 INFUS 1
DEWASA 71,723.00 71,723.00
ANDRIYA PASANG Rp. Rp.
3-Jul-18 Haryono N
dr. Yenny
60. 2082334 921985 INFUS 1
KRISTIYO DEWASA
NI
71,723.00 71,723.00
PASANG Rp. Rp.
3-Jul-18 dr. Yenny
61. Haryono TUMIRAH 2082341 931240 INFUS 1
DEWASA 71,723.00 71,723.00

Yenny SITI PASANG Rp. Rp.


62. 3-Jul-18 dr.
Haryono MUNAFIA 2082312 101018 INFUS 1
H DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
3-Jul-18 dr. Nani
63. Zumaroh SUDARTI 2082354 901489 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
3-Jul-18 dr. Yenny
64. Haryono KASWATI 2082365 931248 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
65. 3-Jul-18 dr.
Hartono PANDI 2082386 931253 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
66. 3-Jul-18 dr.
Hartono CANCOKO 2082387 79079 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
3-Jul-18 dr. IIS
67. 2082389 931254 INFUS 1
Hartono ARISKA DEWASA 71,723.00 71,723.00
DUROTUL PASANG Rp. Rp.
3-Jul-18 Hartono HUSNA
dr.
68. 2082392 931255 INFUS 1
VITA DEWASA
SANTICA
71,723.00 71,723.00
dr. Goliat SUYUFI,M PASANG Rp. Rp.
69. 3-Jul-18 Victor UCHAMA 2082395 931256 INFUS 1
Emanuel D DEWASA 71,723.00 71,723.00
dr. Goliat RUSMAN PASANG Rp. Rp.
70. 4-Jul-18 Victor 2082409 931257 INFUS 1
Emanuel AJI DEWASA 71,723.00 71,723.00
dr. LILIK PASANG Rp. Rp.
71. 4-Jul-18 Artamty SETYOWA 2082434 38391 INFUS 1
Sastry A TI DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
IMAM
72. 4-Jul-18 Artamty 2082433 931265 INFUS 1
ROZIQIN
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
73. 4-Jul-18 Artamty KADIR 2082438 931267 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
YUDHA
74. 4-Jul-18 Artamty EBIYANTO 2082443 927511 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
75. 4-Jul-18 Artamty SULASIH 2082466 931271 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
GISELA
dr. PASANG Rp. Rp.
DWI
76. 4-Jul-18 Artamty 2082470 931272 INFUS 1
OKTAVIA
Sastry A ANAK
NI
71,723.00 71,723.00
dr. PASANG Rp. Rp.
77. 4-Jul-18 Artamty SRIAH 2082474 909814 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. TRI PASANG Rp. Rp.
78. 4-Jul-18 Artamty MARGIAN 2082476 931273 INFUS 1
Sastry A I, NY DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
MURDIO
79. 4-Jul-18 Artamty 2082452 80659 INFUS 1
NO
Sastry A DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
4-Jul-18 dr. Yenny KUNTIRA
80. 2082486 931278 INFUS 1
Haryono H DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
4-Jul-18 dr. Yenny
81. Haryono PASIRAN 2082489 29317 INFUS 1
DEWASA 71,723.00 71,723.00
SHERLY PASANG Rp. Rp.
4-Jul-18 Haryono YANIAR
dr. Yenny
82. 2082494 916521 INFUS 1
CHANDR DEWASA
A
71,723.00 71,723.00

Yenny KANA PASANG Rp. Rp.


83. 4-Jul-18 dr.
Haryono FATHIN 2082495 931280 INFUS 1
ROBIHAH ANAK 71,723.00 71,723.00
dr. Goliat DIANITA PASANG Rp. Rp.
84. 4-Jul-18 Victor KRISTIAN 2082503 99921 INFUS 1
Emanuel NINGSIH DEWASA 71,723.00 71,723.00
dr. Goliat DARMIYA PASANG Rp. Rp.
85. 4-Jul-18 Victor 2082504 931284 INFUS 1
Emanuel TI DEWASA 71,723.00 71,723.00
JIHAN
dr. Goliat PASANG Rp. Rp.
ARRIFA
86. 4-Jul-18 Victor MAWADD 2082505 931182 INFUS 1
Emanuel DEWASA
AH
71,723.00 71,723.00
WINANDI
dr. Goliat PASANG Rp. Rp.
KA
87. 5-Jul-18 Victor KUMAYA 2082517 918013 INFUS 1
Emanuel ANAK
NG JATI
71,723.00 71,723.00
dr. Goliat SITI PASANG Rp. Rp.
88. 5-Jul-18 Victor JARIYATU 2082519 931287 INFUS 1
Emanuel N DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
89. 5-Jul-18 Victor SUCIPTO 2082520 931288 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
dr. Goliat MUTIATU PASANG Rp. Rp.
90. 5-Jul-18 Victor 2082522 926993 INFUS 1
Emanuel N DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
5-Jul-18 dr. Nani
91. Zumaroh NASORI 2082536 931292 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
5-Jul-18 dr. Nani
92. Zumaroh SUKARNO 2082523 931290 INFUS 1
DEWASA 71,723.00 71,723.00

Nani ALDEFAN PASANG Rp. Rp.


93. 5-Jul-18 dr.
Zumaroh YFARANISA
OKTA 2082554 931300 INFUS 1
ANAK
71,723.00 71,723.00

Nani ZAENAL PASANG Rp. Rp.


94. 5-Jul-18 dr.
Zumaroh ABIDIN,M 2082559 931142 INFUS 1
OH DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
5-Jul-18 dr. Nani ALVI
95. 2082573 931309 INFUS 1
Zumaroh SAHRIN DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
5-Jul-18 dr. Nani AZAM AL- 2082562
96. 931303 INFUS 1
Zumaroh HABSYI DEWASA 71,723.00 71,723.00

Nani PUTRI PASANG Rp. Rp.


97. 5-Jul-18 dr.
Zumaroh WIDAYAN 2082568 931307 INFUS 1
TI ANAK 71,723.00 71,723.00
ALYA PASANG Rp. Rp.
5-Jul-18 Zumaroh NAUFA
dr. Nani
98. 2082581 107058 INFUS 1
FARZANI, ANAK
AN
71,723.00 71,723.00
PASANG Rp. Rp.
5-Jul-18 dr. Nani
99. Zumaroh SRIPAH 2082601 931317 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
5-Jul-18 dr. Nani KASBULL
100. 2082605 926458 INFUS 1
Zumaroh AH S,H DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
101. 5-Jul-18 Artamty MUDRON 2082614 931318 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
102. 5-Jul-18 Artamty ROHLI 2082626 927283 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
103. 5-Jul-18 Artamty DEMES 2082628 85449 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
104. 5-Jul-18 Artamty SAMIRAH 2082631 909463 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
105. 5-Jul-18 Artamty JAELANI 2082638 931324 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. ST ZAHRA PASANG Rp. Rp.
106. 5-Jul-18 Artamty ABIDATU 2082641 919189 INFUS 1
Sastry A N NAJWA DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
107. 5-Jul-18 Artamty SLAMET 2082642 931326 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
5-Jul-18 dr. Yenny SUKOWA
108. 2082643 931327 INFUS 1
Haryono RNO DEWASA 71,723.00 71,723.00

GERRA
Yenny AYU PASANG Rp. Rp.
109. 5-Jul-18 dr.
Haryono KUSUMA 2082644 913744 INFUS 1
WARDHA DEWASA
NI
71,723.00 71,723.00
PASANG Rp. Rp.
6-Jul-18 dr. Yenny SOFFAN,
110. 2082646 931329 INFUS 1
Haryono M DEWASA 71,723.00 71,723.00
UMROTU PASANG Rp. Rp.
6-Jul-18 Haryono LCHHOIRIY 2082647
dr. Yenny
111. 931330 INFUS 1
ANAK
YAH
71,723.00 71,723.00
dr. ENDANG PASANG Rp. Rp.
112. 6-Jul-18 Artamty POERMIH 2082663 80248 INFUS 1
Sastry A ARSIH DEWASA 71,723.00 71,723.00

AZAHRA
dr. ZAINA PASANG Rp. Rp.
113. 6-Jul-18 Artamty ADI 2082670 931335 INFUS 1
Sastry A NINGRU ANAK
M
71,723.00 71,723.00
dr. PASANG Rp. Rp.
114. 6-Jul-18 Artamty DARMAJI 2082677 931194 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. RENALDY PASANG Rp. Rp.
115. 6-Jul-18 Artamty ARDIAN 2082678 931337 INFUS 1
Sastry A SAPUTRA ANAK 71,723.00 71,723.00
dr. SULIS PASANG Rp. Rp.
116. 6-Jul-18 Artamty SETYONI 2082682 931340 INFUS 1
Sastry A NGSIH DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
SUBRAHI
117. 6-Jul-18 Artamty 2082693 931344 INFUS 1
M
Sastry A DEWASA 71,723.00 71,723.00
dr. GIBRAN PASANG Rp. Rp.
118. 6-Jul-18 Artamty ALFATIH, 2082696 931345 INFUS 1
Sastry A MUH ANAK 71,723.00 71,723.00
dr. PASANG Rp. Rp.
119. 6-Jul-18 Artamty KARSILAN 2082704 907653 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
6-Jul-18 dr. Nani NUR
120. 2082721 931353 INFUS 1
Zumaroh HIDAYAH DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
6-Jul-18 dr. Nani INDRI
121. 2082723 931355 INFUS 1
Zumaroh JATUN R DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
6-Jul-18 dr. Nani
122. Zumaroh KASPAN 2082726 931357 INFUS 1
DEWASA 71,723.00 71,723.00
ALMEIRA PASANG Rp. Rp.
6-Jul-18 Zumaroh FITRIA
dr. Nani
123. HADITAM 2082727 931358 INFUS 1
ANAK
A
71,723.00 71,723.00
PASANG Rp. Rp.
6-Jul-18 dr. Nani
124. Zumaroh SUMAR 2082732 931359 INFUS 1
DEWASA 71,723.00 71,723.00

Nani UCIK PASANG Rp. Rp.


125. 6-Jul-18 dr.
Zumaroh NURHIDA 2082728 915749 INFUS 1
YATI DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
6-Jul-18 dr. Nani ABDUL
126. 2082733 931360 INFUS 1
Zumaroh WAHAB DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
6-Jul-18 dr. Nani
127. Zumaroh SAKIRAH 2082736 931363 INFUS 1
DEWASA 71,723.00 71,723.00
dr. Goliat DIGYO PASANG Rp. Rp.
128. 6-Jul-18 Victor 2082739 929777 INFUS 1
Emanuel WINARSO DEWASA
dr. Goliat DIGYO PASANG
128. 6-Jul-18 Victor 2082739 929777 INFUS 1
Emanuel WINARSO DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
129. 7-Jul-18 Victor LASMI,NY 2082740 910296 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
DZAKY PASANG Rp. Rp.
7-Jul-18 Zumaroh FAEYZA
dr. Nani
130. 2082753 917862 INFUS 1
ANGGAR ANAK
A
71,723.00 71,723.00

Nani HAYDAR PASANG Rp. Rp.


131. 7-Jul-18 dr.
Zumaroh FAHMY 2082760 931368 INFUS 1
HAKIM ANAK 71,723.00 71,723.00
PASANG Rp. Rp.
7-Jul-18 dr. Nani
132. Zumaroh LASRI 2082768 931369 INFUS 1
DEWASA 71,723.00 71,723.00
CHARMEL PASANG Rp. Rp.
7-Jul-18 Zumaroh LYA
dr. Nani
133. ANGELIN 2082769 931370 INFUS 1
ANAK
E WILLIS
71,723.00 71,723.00
PRAJNA PASANG Rp. Rp.
7-Jul-18 Zumaroh PARAMIT
dr. Nani
134. 2082770 920478 INFUS 1
A TRI ANAK
ALISA
71,723.00 71,723.00
dr. Goliat JEVIA PASANG Rp. Rp.
135. 7-Jul-18 Victor 2082778 931373 INFUS 1
Emanuel SAFITRI DEWASA 71,723.00 71,723.00
dr. Goliat KHOIRUL PASANG Rp. Rp.
136. 7-Jul-18 Victor SETIAWA 2082779 931374 INFUS 1
Emanuel N ANAK 71,723.00 71,723.00
dr. Goliat SURIPAH, PASANG Rp. Rp.
137. 7-Jul-18 Victor 2082784 900005 INFUS 1
Emanuel NY DEWASA 71,723.00 71,723.00

Ratna MARITA PASANG Rp. Rp.


138. 7-Jul-18 dr.
Ernawat DWI 2082791 931381 INFUS 1
NURLAILI DEWASA 71,723.00 71,723.00
dr. Goliat LULUS PASANG Rp. Rp.
139. 7-Jul-18 Victor 2082794 931377 INFUS 1
Emanuel PAMUJI DEWASA 71,723.00 71,723.00

CHINTAM
dr. Goliat I PASANG Rp. Rp.
140. 7-Jul-18 Victor MUTIARA 2082795 931383 INFUS 1
Emanuel RACHMA DEWASA
PUTRI
71,723.00 71,723.00
dr. Goliat ADI PASANG Rp. Rp.
141. 8-Jul-18 Victor WAHYU 2082797 931385 INFUS 1
Emanuel SAPUTRA ANAK 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
142. 8-Jul-18 Victor MUINAH 2082799 931387 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00

MAULIDA
Yenny TSALISA PASANG Rp. Rp.
143. 8-Jul-18 dr.
Haryono RAHMA 2082800 73857 INFUS 1
NUR AL ANAK
HUSNA
71,723.00 71,723.00
PASANG Rp. Rp.
8-Jul-18 dr. Yenny
144. Haryono LANTIP 2082802 931389 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
8-Jul-18 dr. Yenny
145. Haryono WINARTI 2082803 931390 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
8-Jul-18 dr. Yenny
146. Haryono SUDARNI 2082804 931341 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
8-Jul-18 dr. Yenny
147. Haryono MALIKIN 2082805 931391 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
8-Jul-18 dr. Yenny
148. Haryono TOMO 2082810 915224 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
8-Jul-18 dr. Yenny
149. Haryono SAMIRAH 2082813 931393 INFUS 1
DEWASA 71,723.00 71,723.00
ANINDYA PASANG Rp. Rp.
8-Jul-18 Haryono AYU
dr. Yenny
150. PRAMUSI 2082814 922867 INFUS 1
ANAK
TA
71,723.00 71,723.00

Yenny FEDRIKA PASANG Rp. Rp.


151. 8-Jul-18 dr.
Haryono SUSANAV 2082812 913176 INFUS 1
I ANDARI DEWASA
71,723.00 71,723.00

FARREL PASANG Rp. Rp.


8-Jul-18 Zumaroh OKTAVIA
dr. Nani
152. 2082817 931395 INFUS 1
N ANAK
SANTOSO
71,723.00 71,723.00

Nani SUGENG PASANG Rp. Rp.


153. 8-Jul-18 dr.
Zumaroh RUDIANT 2082818 931396 INFUS 1
O DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
8-Jul-18 dr. Nani
154. Zumaroh WARNADI 2082820 917244 INFUS 1
DEWASA 71,723.00 71,723.00
Nani IBNU ALI PASANG Rp. Rp.
155. 8-Jul-18 dr. MUSTAJJ 2082819 907399 INFUS 1
Zumaroh AB ANAK 71,723.00 71,723.00
PASANG Rp. Rp.
8-Jul-18 dr. Nani MINARO
156. 2082821 931397 INFUS 1
Zumaroh HMA DEWASA 71,723.00 71,723.00

Nani RAFI PASANG Rp. Rp.


157. 8-Jul-18 dr.
Zumaroh SAIFUDIN 2082822 931398 INFUS 1
,MOCH ANAK 71,723.00 71,723.00
PASANG Rp. Rp.
8-Jul-18 dr. Nani
158. Zumaroh KASIYADI 2082824 931400 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
8-Jul-18 dr. Nani SUHARTI
159. 2082827 104002 INFUS 1
Zumaroh NIK DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
8-Jul-18 dr. Nani
160. Zumaroh SUNOTO 2082826 924169 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
8-Jul-18 dr. Nani MADANU 2082829
161. 903683 INFUS 1
Zumaroh N DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
8-Jul-18 dr. Nani TARU
162. 2082831 931399 INFUS 1
Zumaroh WIJAYA DEWASA 71,723.00 71,723.00
DHANIEL PASANG Rp. Rp.
163. 8-Jul-18 dr.
Hartono BAYU 2082833 931403 INFUS 1
IRAWAN DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
8-Jul-18 dr. DIANTINI
164. 2082834 931404 INFUS 1
Hartono K DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
165. 9-Jul-18 dr.
Hartono KASNIR 2082836 931406 INFUS 1
DEWASA 71,723.00 71,723.00
HANIF PASANG Rp. Rp.
9-Jul-18 Hartono AHZHA,M
dr.
166. UHAMM 2082847 928615 INFUS 1
ANAK
AD
71,723.00 71,723.00
PASANG Rp. Rp.
9-Jul-18 dr. KHAFID
167. 2082849 931407 INFUS 1
Hartono ASNAIN DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
168. 9-Jul-18 dr.
Hartono WARAS 2082853 931408 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
9-Jul-18 dr. AIO
169. 2082856 931409 INFUS 1
Hartono ARASI ANAK
PASANG
9-Jul-18 dr. AIO
169. 2082856 931409 INFUS 1
Hartono ARASI ANAK 71,723.00 71,723.00
PASANG Rp. Rp.
9-Jul-18 dr. Nani MUSRIPA
170. 2082903 904014 INFUS 1
Zumaroh H DEWASA 71,723.00 71,723.00

NIKITA
Nani WHELAN PASANG Rp. Rp.
171. 9-Jul-18 dr.
Zumaroh DA 2082891 917993 INFUS 1
WIJAYANT ANAK
I
71,723.00 71,723.00
PASANG Rp. Rp.
9-Jul-18 dr. Nani
172. Zumaroh GARIYAH 2082905 931425 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
9-Jul-18 dr. Nani
173. Zumaroh LIMJIATI 2082908 931427 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
9-Jul-18 dr. Nani HARIYANT 2082912
174. 931215 INFUS 1
Zumaroh O DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
9-Jul-18 dr. Yenny
175. Haryono TORAN 2082927 64042 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
9-Jul-18 dr. Yenny
176. Haryono KATREMI 2082929 929170 INFUS 1
DEWASA 71,723.00 71,723.00

Yenny NAJWA PASANG Rp. Rp.


177. 9-Jul-18 dr.
Haryono KHAIRA 2082937 931436 INFUS 1
WILDHA ANAK 71,723.00 71,723.00
PASANG Rp. Rp.
9-Jul-18 dr. Yenny
178. Haryono TARSIH 2082938 931437 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
9-Jul-18 dr. Yenny
179. Haryono KASBU 2082941 78230 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
9-Jul-18 dr. Yenny
180. Haryono MASJUKI 2082944 919356 INFUS 1
DEWASA 71,723.00 71,723.00

Yenny SITI PASANG Rp. Rp.


181. 9-Jul-18 dr.
Haryono ZULAIKO 2082943 931438 INFUS 1
H ANAK 71,723.00 71,723.00

Yenny WIDARTI PASANG Rp. Rp.


182. 9-Jul-18 dr.
Haryono JANUARI 2082947 931440 INFUS 1
NINGSIH DEWASA 71,723.00 71,723.00
RENY PASANG Rp. Rp.
9-Jul-18 Haryono VISILIA
dr. Yenny
183. 2082953 931441 INFUS 1
SALAMO DEWASA
NY
RENY PASANG
9-Jul-18 Haryono VISILIA
dr. Yenny
183. 2082953 931441 INFUS 1
SALAMO DEWASA
NY
71,723.00 71,723.00
PASANG Rp. Rp.
9-Jul-18 dr. Yenny
184. Haryono TUMIRAH 2082954 931240 INFUS 1
DEWASA 71,723.00 71,723.00
dr. RENATA PASANG Rp. Rp.
185. 9-Jul-18 Artamty LYAN 2082955 34866 INFUS 1
Sastry A NOVIA ANAK 71,723.00 71,723.00
dr. SAMUEL PASANG Rp. Rp.
186. 9-Jul-18 Artamty LYANNOV 2082956 89089 INFUS 1
Sastry A E ANAK 71,723.00 71,723.00
YUDHISTI
dr. PASANG Rp. Rp.
187. 9-Jul-18 Artamty RA 2082957 921123 INFUS 1
HARFIAN
Sastry A DEWASA
O PUTRA
71,723.00 71,723.00
AGUNG
dr. PASANG Rp. Rp.
ADI
188. 10-Jul-18 Artamty 2082970 931442 INFUS 1
PRASETY
Sastry A DEWASA
O
71,723.00 71,723.00
dr. VIZRAL PASANG Rp. Rp.
189. 10-Jul-18 Artamty SATRIA 2082971 911444 INFUS 1
Sastry A PUTRA DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
190. 10-Jul-18 Artamty KARMINI 2082974 63247 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
191. 10-Jul-18 Artamty ZAENI 2082975 931443 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
192. 10-Jul-18 dr.
Hartono SUKADI 2083001 931447 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
193. 10-Jul-18 dr.
Hartono SURIYAH 2083009 931450 INFUS 1
DEWASA 71,723.00 71,723.00
KRISTINA PASANG Rp. Rp.
194. 10-Jul-18 dr.
Hartono NURHAYA 2083033 913252 INFUS 1
TI DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
10-Jul-18 dr. NYAMINA 2083035
195. 931200 INFUS 1
Hartono H DEWASA 71,723.00 71,723.00
RINI PASANG Rp. Rp.
196. 10-Jul-18 dr.
Hartono WAHYUNI 2083054 2078 INFUS 1
/RSMM DEWASA 71,723.00 71,723.00

Yenny AZURA PASANG Rp. Rp.


197. 10-Jul-18 dr.
Haryono MAFAZA 2083078 931467 INFUS 1
FIKRI ANAK 71,723.00 71,723.00
PASANG Rp. Rp.
10-Jul-18 dr. Yenny
198. Haryono KARJONO 2083080 931468 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
10-Jul-18 dr. Yenny LASMINT
199. 2083083 931102 INFUS 1
Haryono O, TN DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
10-Jul-18 dr. Yenny
200. Haryono SUMIRAH 2083088 931470 INFUS 1
DEWASA 71,723.00 71,723.00
QUTHBI PASANG Rp. Rp.
10-Jul-18 Haryono UWAYS
dr. Yenny
201. 2083089 931471 INFUS 1
SYIHAB, ANAK
AHMAD
71,723.00 71,723.00
PASANG Rp. Rp.
10-Jul-18 dr. Yenny SUTRISN
202. 2083096 931473 INFUS 1
Haryono O, TN DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
10-Jul-18 dr. Yenny
203. Haryono SUKIMAH 2083099 931474 INFUS 1
DEWASA 71,723.00 71,723.00
dr. Goliat SOFIA PASANG Rp. Rp.
204. 10-Jul-18 Victor 2083105 70087 INFUS 1
Emanuel SEGAF DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
205. 10-Jul-18 Victor SUMIJAH 2083107 931478 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
dr. Goliat ENI NUR PASANG Rp. Rp.
206. 11-Jul-18 Victor 2083104 931472 INFUS 1
Emanuel FARIDAH DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
207. 11-Jul-18 Victor SUPARMI 2083103 26851 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
208. 11-Jul-18 Victor SUPARMI 2083103 26851 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00

FAUQI
dr. Goliat ALQOHAR PASANG Rp. Rp.
209. 11-Jul-18 Victor , 2083111 931480 INFUS 1
Emanuel MOHAM DEWASA
AD
71,723.00 71,723.00

dr. Goliat RAVI PASANG Rp. Rp.


210. 11-Jul-18 Victor PUTERA 2083112 922920 INFUS 1
Emanuel PRASETYA DEWASA
71,723.00 71,723.00
WAN PASANG Rp. Rp.
11-Jul-18 Haryono SAHIRA
dr. Yenny
211. 2083127 915313 INFUS 1
PUTRI ANAK
ARINA
71,723.00 71,723.00
PASANG Rp. Rp.
11-Jul-18 dr. Yenny
212. Haryono KUHARI 2083156 931490 INFUS 1
DEWASA 71,723.00 71,723.00

NIZAR
TSAQIF PASANG Rp. Rp.
11-Jul-18 Hartono AL
dr.
213. FATIH,MU 2083172 931495 INFUS 1
ANAK
HAMMA
D
71,723.00 71,723.00
PASANG Rp. Rp.
11-Jul-18 dr. SUPRIYAD 2083186
214. 900511 INFUS 1
Hartono I DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
11-Jul-18 dr. Nani
215. Zumaroh SURI 2083190 931500 INFUS 1
DEWASA 71,723.00 71,723.00

Yenny ALKHALIF PASANG Rp. Rp.


216. 11-Jul-18 dr.
Haryono IRAFAN
MAUZA 2083199 925675 INFUS 1
ANAK 71,723.00 71,723.00
PASANG Rp. Rp.
11-Jul-18 dr. Yenny KUSNAN,
217. 2083203 911166 INFUS 1
Haryono M DEWASA 71,723.00 71,723.00
ROIIQOH PASANG Rp. Rp.
11-Jul-18 Hartono HABIBAT
dr.
218. 2083209 72057 INFUS 1
UL ASMA DEWASA
ALIFAH
71,723.00 71,723.00
AZRINA PASANG Rp. Rp.
219. 11-Jul-18 dr.
Hartono LAVENIA 2083210 931506 INFUS 1
SHAZFA ANAK 71,723.00 71,723.00
JEFRI PASANG Rp. Rp.
220. 11-Jul-18 dr.
Hartono HERIANT 2083214 931507 INFUS 1
O, MUH DEWASA 71,723.00 71,723.00

ABHAN
MAULAN PASANG Rp. Rp.
11-Jul-18 Hartono A
dr.
221. 2083215 105537 INFUS 1
ADHYAST ANAK
HA
BUKHORI
71,723.00 71,723.00
dr. PASANG Rp. Rp.
222. 12-Jul-18 Artamty DURAJI 2083226 931510 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
HARMOK
223. 12-Jul-18 Artamty 2083229 931511 INFUS 1
O
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
224. 12-Jul-18 Artamty SODJO 2083230 931483 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00

dr. AULIA PASANG Rp. Rp.


225. 12-Jul-18 Artamty RAFA ARI 2083236 931513 INFUS 1
Sastry A PRATAMA ANAK
71,723.00 71,723.00
dr. PASANG Rp. Rp.
SRI
226. 12-Jul-18 Artamty 2083239 65659 INFUS 1
HARUMI
Sastry A DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
12-Jul-18 dr. Yenny
227. Haryono SUYATNO 2083247 931516 INFUS 1
DEWASA 71,723.00 71,723.00

Yenny EARLITA PASANG Rp. Rp.


228. 12-Jul-18 dr.
Haryono SALSABIL 2083285 907589 INFUS 1
A ANAK 71,723.00 71,723.00

Yenny DIANITA PASANG Rp. Rp.


229. 12-Jul-18 dr.
Haryono KRISTIAN 2083313 99921 INFUS 1
NINGSIH DEWASA 71,723.00 71,723.00
TEGUH PASANG Rp. Rp.
12-Jul-18 Haryono IBNU
dr. Yenny
230. 2083320 34066 INFUS 1
SUNGKO DEWASA
WO
71,723.00 71,723.00
PASANG Rp. Rp.
12-Jul-18 dr. Yenny
231. Haryono DAMPUN 2083317 931529 INFUS 1
DEWASA 71,723.00 71,723.00

Yenny DANIYAH PASANG Rp. Rp.


232. 12-Jul-18 dr.
Haryono RIHADAT 2083338 931532 INFUS 1
UL AISY DEWASA 71,723.00 71,723.00

Yenny YOGI PASANG Rp. Rp.


233. 12-Jul-18 dr.
Haryono WAHYU 2083336 36581 INFUS 1
PRATAMA DEWASA
71,723.00 71,723.00

Yenny LUCKY PASANG Rp. Rp.


234. 12-Jul-18 dr.
Haryono ANGGAR 2083356 108128 INFUS 1
A,M ANAK 71,723.00 71,723.00
BENY PASANG Rp. Rp.
12-Jul-18 Haryono WAHYU
dr. Yenny
235. 2083286 931524 INFUS 1
IRAWAN, DEWASA
MOCH.
71,723.00 71,723.00
PASANG Rp. Rp.
12-Jul-18 dr. Yenny
236. Haryono DARGO 2083357 931279 INFUS 1
DEWASA
PASANG
12-Jul-18 dr. Yenny
236. Haryono DARGO 2083357 931279 INFUS 1
DEWASA 71,723.00 71,723.00

Yenny PIPIT PASANG Rp. Rp.


237. 12-Jul-18 dr.
Haryono YULIARI 2083359 68253 INFUS 1
ALIVIA DEWASA 71,723.00 71,723.00
DINDA PASANG Rp. Rp.
12-Jul-18 Haryono PUTRI
dr. Yenny
238. 2083353 931538 INFUS 1
RAMADH DEWASA
ANI
71,723.00 71,723.00
RAISA PASANG Rp. Rp.
12-Jul-18 Hartono AZIRAH
dr.
239. 2083361 931539 INFUS 1
RAMADH ANAK
ANI
71,723.00 71,723.00
JEREMY PASANG Rp. Rp.
12-Jul-18 Hartono GLEVINO
dr.
240. 2083364 105516 INFUS 1
KARSTEN
LIN ANAK
71,723.00 71,723.00
HERMINA PASANG Rp. Rp.
12-Jul-18 Hartono H
dr.
241. FEBRIANT 2083368 931542 INFUS 1
DEWASA
Y
71,723.00 71,723.00
PASANG Rp. Rp.
242. 12-Jul-18 dr.
Hartono BASRI 2083369 931543 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
12-Jul-18 dr. WARSILA
243. 2083371 107216 INFUS 1
Hartono H DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
12-Jul-18 dr. MUNTOLI 2083373
244. 931545 INFUS 1
Hartono B DEWASA 71,723.00 71,723.00
ANUGRA PASANG Rp. Rp.
245. 12-Jul-18 dr.
Hartono H EKA 2083374 69014 INFUS 1
ALFEYCO ANAK 71,723.00 71,723.00
SYAUQIL PASANG Rp. Rp.
13-Jul-18 Hartono ISMA
dr.
246. ASSYAFIIY 2083370 931544 INFUS 1
ANAK
AH
71,723.00 71,723.00
RISKI PASANG Rp. Rp.
13-Jul-18 Hartono DIKA
dr.
247. 2083379 40039 INFUS 1
ARMADA ANAK
NI
71,723.00 71,723.00
HAFIZH PASANG Rp. Rp.
13-Jul-18 Hartono MUZAKY,
dr.
248. 2083378 931547 INFUS 1
MUHAM ANAK
MAD
71,723.00 71,723.00
PASANG Rp. Rp.
249. 13-Jul-18 dr.
Hartono SAJI 2083388 931548 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
13-Jul-18 dr. JOYO
250. 2083403 904546 INFUS 1
Hartono ADI,H DEWASA 71,723.00 71,723.00
dr. AISYAH PASANG Rp. Rp.
251. 13-Jul-18 Artamty NUHA 2083436 931556 INFUS 1
Sastry A ZAHIRA ANAK 71,723.00 71,723.00
dr. PASANG Rp. Rp.
NUR YULI 2083438
252. 13-Jul-18 Artamty 931557 INFUS 1
ASTITI
Sastry A DEWASA 71,723.00 71,723.00
dr. SITI PASANG Rp. Rp.
253. 13-Jul-18 Artamty MARDIYA 2083440 930843 INFUS 1
Sastry A H DEWASA 71,723.00 71,723.00
dr. SITI PASANG Rp. Rp.
254. 13-Jul-18 Artamty KHASANA 2083443 931558 INFUS 1
Sastry A H DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
255. 13-Jul-18 Artamty SUMARJI 2083448 931561 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
256. 13-Jul-18 Artamty ZAENAB 2083449 931562 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
CALYSTA
dr. PASANG Rp. Rp.
QUEENIZ 2083450
257. 13-Jul-18 Artamty 921638 INFUS 1
A
Sastry A ANAK
ROHMAN
71,723.00 71,723.00
dr. PASANG Rp. Rp.
258. 13-Jul-18 Artamty ROHLI 2083452 927283 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
13-Jul-18 dr. Yenny
259. Haryono MASUD 2083458 931565 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
13-Jul-18 dr. Yenny BOECHOR 2083459
260. 47813 INFUS 1
Haryono I/RSMM DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
13-Jul-18 dr. Yenny
261. Haryono HENDUN 2083396 930959 INFUS 1
DEWASA 71,723.00 71,723.00
AFZAR PASANG Rp. Rp.
13-Jul-18 Haryono HAZIQ
dr. Yenny
262. ALFARIDZ 2083471 924185 INFUS 1
ANAK
Y,AHMAD
71,723.00 71,723.00
Yenny NUR PASANG Rp. Rp.
263. 13-Jul-18 dr.
Haryono SHOLICA 2083473 930480 INFUS 1
H DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
13-Jul-18 dr. Yenny
264. Haryono PASRI 2083474 931568 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
13-Jul-18 dr. Yenny
265. Haryono LAMIJAH 2083475 931378 INFUS 1
DEWASA 71,723.00 71,723.00
dr. Goliat ZAINUL PASANG Rp. Rp.
266. 13-Jul-18 Victor 2083477 931570 INFUS 1
Emanuel ABIDIN DEWASA 71,723.00 71,723.00
ANGGAR
dr. Goliat PASANG Rp. Rp.
ROSARIA
267. 14-Jul-18 Victor 2083479 78535 INFUS 1
PUTRI
Emanuel DEWI DEWASA
71,723.00 71,723.00
dr. Goliat DARWOT PASANG Rp. Rp.
268. 14-Jul-18 Victor 2083476 72779 INFUS 1
Emanuel O DEWASA 71,723.00 71,723.00
dr. Goliat JULIANA PASANG Rp. Rp.
269. 14-Jul-18 Victor 2083482 931573 INFUS 1
Emanuel PUTRI DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
14-Jul-18 dr. Yenny DAFFA,M
270. 2083487 931575 INFUS 1
Haryono OCH ANAK 71,723.00 71,723.00
PASANG Rp. Rp.
14-Jul-18 dr. Yenny WASRIAT
271. 2083488 931576 INFUS 1
Haryono UN DEWASA 71,723.00 71,723.00

RAVI PASANG Rp. Rp.


272. 14-Jul-18 dr. PUTERA 2083496 922920 INFUS 1
Hartono PRASETYA ANAK
71,723.00 71,723.00
IDA PASANG Rp. Rp.
273. 14-Jul-18 dr.
Hartono LUPITA 2083500 931581 INFUS 1
SARI DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
14-Jul-18 dr. ROZIMI,A
274. 2083503 931582 INFUS 1
Hartono CHMAD DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
275. 14-Jul-18 Victor RUSNO 2083504 931583 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
276. 14-Jul-18 Victor TASRAM 2083510 931585 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
277. 14-Jul-18 Victor MUCHLIS 2083511 931586 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
dr. Goliat MUSTAIN, PASANG Rp. Rp.
278. 14-Jul-18 Victor 2083453 106469 INFUS 1
Emanuel TN DEWASA 71,723.00 71,723.00
dr. Goliat DHIMAS PASANG Rp. Rp.
279. 14-Jul-18 Victor AKBAR 2083514 95332 INFUS 1
Emanuel ARIYADI ANAK 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
280. 14-Jul-18 Victor KARTINI 2083513 931587 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
dr. Goliat DYAH AYU PASANG Rp. Rp.
281. 14-Jul-18 Victor 2083517 931589 INFUS 1
Emanuel SAFITRI DEWASA 71,723.00 71,723.00
dr. Goliat NOFI PASANG Rp. Rp.
282. 14-Jul-18 Victor ANDIK 2083518 915598 INFUS 1
Emanuel SUSANTO DEWASA 71,723.00 71,723.00
dr. DIVIA PASANG Rp. Rp.
283. 14-Jul-18 Artamty CHILA 2083521 931592 INFUS 1
Sastry A ASYIFA ANAK 71,723.00 71,723.00
dr. PASANG Rp. Rp.
RINA
284. 15-Jul-18 Artamty 2083522 931593 INFUS 1
WATI
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
285. 15-Jul-18 Artamty WITO 2083524 931595 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
286. 15-Jul-18 Artamty MASIJAH 2083526 931596 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
287. 15-Jul-18 dr.
Hartono SUPRAT 2083530 931599 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
288. 15-Jul-18 dr.
Hartono PARCIM 2083531 931600 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
289. 15-Jul-18 dr.
Hartono KACUNG 2083533 931602 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
15-Jul-18 dr. IMAM
290. 2083536 931603 INFUS 1
Hartono SYAFI'I DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
291. 15-Jul-18 dr.
Hartono RUKMI 2083537 931604 INFUS 1
DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
292. 15-Jul-18 Victor SALEKAH 2083544 927868 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
293. 15-Jul-18 Victor SALEKAH 2083544 927868 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
294. 15-Jul-18 Victor LASRUN 2083548 925071 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
dr. DARJITO PASANG Rp. Rp.
295. 15-Jul-18 Artamty HADI 2083551 931609 INFUS 1
Sastry A SUCIPTO DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
296. 16-Jul-18 Victor SARILAH 2083550 931608 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
PEGGI
dr. PASANG Rp. Rp.
ARIE
297. 16-Jul-18 Artamty 2083552 931610 INFUS 1
ZULIA
Sastry A DEWASA
AZIZ
71,723.00 71,723.00
MARDIKA
dr. PASANG Rp. Rp.
DIAN
298. 16-Jul-18 Artamty NINGRU 2083554 931498 INFUS 1
Sastry A DEWASA
M
71,723.00 71,723.00
PASANG Rp. Rp.
16-Jul-18 dr. Yenny
299. Haryono TARSINI 2083582 88240 INFUS 1
DEWASA 71,723.00 71,723.00
NAUFAL PASANG Rp. Rp.
16-Jul-18 Haryono SYAMIL
dr. Yenny
300. 2083591 931614 INFUS 1
ADZ ANAK
DZAKY W
71,723.00 71,723.00

Yenny LUTHFIA PASANG Rp. Rp.


301. 16-Jul-18 dr.
Haryono LEYLA 2083597 931616 INFUS 1
NASHIWA ANAK
71,723.00 71,723.00
PASANG Rp. Rp.
16-Jul-18 dr. Yenny
302. Haryono BASTAM 2083610 921489 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
16-Jul-18 dr. Yenny
303. Haryono ASRIATIN 2083613 88759 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
16-Jul-18 dr. Yenny
304. Haryono ANTO 2083640 931628 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
16-Jul-18 dr. Yenny
305. Haryono SUPARMI 2083646 931631 INFUS 1
DEWASA
PASANG
16-Jul-18 dr. Yenny
305. Haryono SUPARMI 2083646 931631 INFUS 1
DEWASA 71,723.00 71,723.00
dr. Goliat NABILLA PASANG Rp. Rp.
306. 16-Jul-18 Victor AMEERA 2083663 925561 INFUS 1
Emanuel H ANAK 71,723.00 71,723.00
dr. Goliat TURJIMA PASANG Rp. Rp.
307. 16-Jul-18 Victor 2083667 931635 INFUS 1
Emanuel N DEWASA 71,723.00 71,723.00
ADHITAM
dr. Goliat PASANG Rp. Rp.
A ELVAN 2083670
308. 16-Jul-18 Victor 931637 INFUS 1
SYAHREZ
Emanuel ANAK
A
71,723.00 71,723.00
NUR PASANG Rp. Rp.
309. 16-Jul-18 dr.
Hartono RAIHAN, 2083673 931639 INFUS 1
MUH. DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
310. 17-Jul-18 dr.
Hartono SAMHADI 2083674 920067 INFUS 1
DEWASA 71,723.00 71,723.00

NAJMA PASANG Rp. Rp.


17-Jul-18 Hartono YUKE
dr.
311. 2083695 931640 INFUS 1
FISKA ANAK
PRATAMA
71,723.00 71,723.00
PASANG Rp. Rp.
17-Jul-18 dr. KUSNAN,
312. 2083696 911166 INFUS 1
Hartono M DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
17-Jul-18 dr. WILDAN
313. 2083707 914458 INFUS 1
Hartono FAIQ, M ANAK 71,723.00 71,723.00
PASANG Rp. Rp.
17-Jul-18 dr. Yenny CAHYANA
314. Haryono , AHMAD 2083728 931645 INFUS 1
ANAK 71,723.00 71,723.00

Yenny SITI PASANG Rp. Rp.


315. 17-Jul-18 dr.
Haryono ISTIKOMA 2083737 931641 INFUS 1
H DEWASA 71,723.00 71,723.00

Yenny ATTHAR PASANG Rp. Rp.


316. 17-Jul-18 dr.
Haryono GIO 2083746 931648 INFUS 1
VALENSIA ANAK
71,723.00 71,723.00
PASANG Rp. Rp.
17-Jul-18 dr. Yenny
317. Haryono SUNOTO 2083717 924169 INFUS 1
DEWASA 71,723.00 71,723.00
IKVAN PASANG Rp. Rp.
17-Jul-18 Haryono HADI
dr. Yenny
318. 2083758 912337 INFUS 1
PRASETY DEWASA
O
71,723.00 71,723.00
PASANG Rp. Rp.
17-Jul-18 dr. Yenny SUHARSO 2083765
319. 931654 INFUS 1
Haryono NO DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
17-Jul-18 dr. Yenny
320. Haryono SAENI 2083773 931657 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
17-Jul-18 dr. Nani AHSAN
321. 2083780 908407 INFUS 1
Zumaroh ALWI ANAK 71,723.00 71,723.00

Nani ENI PASANG Rp. Rp.


322. 17-Jul-18 dr.
Zumaroh SUSWAN 2083784 931660 INFUS 1
TI DEWASA 71,723.00 71,723.00

Nani NAUFALI PASANG Rp. Rp.


323. 17-Jul-18 dr.
Zumaroh NO 2083793 931663 INFUS 1
ATHAYA ANAK 71,723.00 71,723.00
PASANG Rp. Rp.
17-Jul-18 dr. Nani
324. Zumaroh MASHUDI 2083789 931662 INFUS 1
DEWASA 71,723.00 71,723.00

Nani KARSANI PASANG Rp. Rp.


325. 17-Jul-18 dr.
Zumaroh EDI 2083797 95655 INFUS 1
WIBOWO DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
17-Jul-18 dr. Nani RUKMIYA
326. 2083807 931669 INFUS 1
Zumaroh TUN DEWASA 71,723.00 71,723.00

Nani YUSUF PASANG Rp. Rp.


327. 17-Jul-18 dr.
Zumaroh ROMADH 2083802 105681 INFUS 1
ON,MOH ANAK 71,723.00 71,723.00

ANDREE
Nani NICO PASANG Rp. Rp.
328. 17-Jul-18 dr.
Zumaroh AUSHAF, 2083809 67315 INFUS 1
MUHAM ANAK
MAD
71,723.00 71,723.00

Nani FADHIL PASANG Rp. Rp.


329. 17-Jul-18 dr.
Zumaroh ABDILLAH 2083812 915074 INFUS 1
,MUH ANAK 71,723.00 71,723.00
dr. PASANG Rp. Rp.
SULISWA
330. 17-Jul-18 Artamty 2083820 931675 INFUS 1
NTO
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
PURNOM 2083819
331. 17-Jul-18 Artamty 900871 INFUS 1
O
Sastry A DEWASA 71,723.00 71,723.00
SHANDY
DWISAKS
dr. PASANG Rp. Rp.
ANA
332. 17-Jul-18 Artamty 2083817 931674 INFUS 1
ADITYA
Sastry A DEWASA
CANDRAK
USUMA
71,723.00 71,723.00
dr. PASANG Rp. Rp.
ADAM
333. 17-Jul-18 Artamty 2083816 931673 INFUS 1
RAHMAN
Sastry A DEWASA 71,723.00 71,723.00
dr. RIRIN PASANG Rp. Rp.
334. 18-Jul-18 Artamty AMBARW 2083833 920460 INFUS 1
Sastry A ATI DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
335. 18-Jul-18 Artamty DARSIPAH 2083832 927232 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. ERICK PASANG Rp. Rp.
336. 18-Jul-18 Artamty FEBRIANS 2083834 931678 INFUS 1
Sastry A YAH DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
337. 18-Jul-18 dr.
Hartono SAMIN 2083855 931685 INFUS 1
DEWASA 71,723.00 71,723.00

NAZRIL PASANG Rp. Rp.


338. 18-Jul-18 dr.
Hartono ILHAM 2083864 931689 INFUS 1
PRASTIYO ANAK
71,723.00 71,723.00
PASANG Rp. Rp.
18-Jul-18 dr. KASMINA 2083871
339. 931680 INFUS 1
Hartono H DEWASA 71,723.00 71,723.00
MISHEL PASANG Rp. Rp.
18-Jul-18 Hartono SALSA
dr.
340. 2083890 931695 INFUS 1
OKTAQUE ANAK
EN
71,723.00 71,723.00
PASANG Rp. Rp.
18-Jul-18 dr. KHOIRUL
341. 2083899 931703 INFUS 1
Hartono IKHSAN DEWASA 71,723.00 71,723.00

ALDHI
Yenny ATHARRA PASANG Rp. Rp.
342. 18-Jul-18 dr.
Haryono IHAN 2083901 931706 INFUS 1
KASYAFA DEWASA
NI
71,723.00 71,723.00
PASANG Rp. Rp.
18-Jul-18 dr. Yenny
343. Haryono KASIYATI 2083905 105378 INFUS 1
DEWASA 71,723.00 71,723.00
ULFA PASANG Rp. Rp.
18-Jul-18 Haryono MIMA
dr. Yenny
344. FIMAULID 2083910 931709 INFUS 1
DEWASA
YA
71,723.00 71,723.00
PASANG Rp. Rp.
18-Jul-18 dr. Yenny
345. Haryono KARMILA 2083912 931711 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
18-Jul-18 dr. Yenny MUSTAIN, 2083913
346. 931712 INFUS 1
Haryono MOH DEWASA 71,723.00 71,723.00

Yenny ARKA PASANG Rp. Rp.


347. 18-Jul-18 dr.
Haryono DWI 2083916 931714 INFUS 1
CAHYA DEWASA 71,723.00 71,723.00
ACHMAD PASANG Rp. Rp.
348. 18-Jul-18 Haryono HAFIZ
dr. Yenny 2083917 931715 INFUS 1
NUR DEWASA
RIFKY
71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
349. 18-Jul-18 Victor KASMIN 2083920 931718 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
dr. Goliat WAGIMA PASANG Rp. Rp.
350. 19-Jul-18 Victor 2083943 90206 INFUS 1
Emanuel N DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
19-Jul-18 dr. Yenny
351. Haryono SOMI 2083951 931721 INFUS 1
DEWASA 71,723.00 71,723.00

Yenny FATAH, PASANG Rp. Rp.


352. 19-Jul-18 dr.
Haryono MUHAM 2083956 931724 INFUS 1
MAD DEWASA 71,723.00 71,723.00
dr. Goliat KARDIMA PASANG Rp. Rp.
353. 19-Jul-18 Victor 2083921 931719 INFUS 1
Emanuel H DEWASA 71,723.00 71,723.00
dr. Goliat HENI PASANG Rp. Rp.
354. 19-Jul-18 Victor ULANDAR 2083940 102250 INFUS 1
Emanuel I DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
19-Jul-18 dr. Yenny
355. Haryono KAMSIH 2083960 931727 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
19-Jul-18 dr. Yenny
356. Haryono KARSONO 2083971 931730 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
19-Jul-18 dr. Yenny SITI
357. 2083979 931731 INFUS 1
Haryono FATIMAH DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
19-Jul-18 dr. Nani ALI
358. 2083985 931732 INFUS 1
Zumaroh SODIKIN DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
19-Jul-18 dr. Nani
359. Zumaroh SAKHUR 2083993 929916 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
19-Jul-18 dr. Nani SITI NUR
360. 2084002 931734 INFUS 1
Zumaroh KHOLIFA DEWASA 71,723.00 71,723.00

Nani NOVIA PASANG Rp. Rp.


361. 19-Jul-18 dr.
Zumaroh RATNA 2084006 930418 INFUS 1
JUWITA DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
SURATMA 2084034
362. 19-Jul-18 Artamty 931736 INFUS 1
N
Sastry A DEWASA 71,723.00 71,723.00

BIYANTAR
dr. PASANG Rp. Rp.
A AYOEM 2084040
363. 19-Jul-18 Artamty 931740 INFUS 1
RUMBAK
Sastry A ANAK
A
71,723.00 71,723.00
dr. BRILLIA PASANG Rp. Rp.
364. 19-Jul-18 Artamty HENING 2084046 931741 INFUS 1
Sastry A MAS DEWASA 71,723.00 71,723.00
dr. YAYUK PASANG Rp. Rp.
365. 19-Jul-18 Artamty SETYAWA 2084047 921332 INFUS 1
Sastry A TI DEWASA 71,723.00 71,723.00
dr. ABDULLA PASANG Rp. Rp.
366. 19-Jul-18 Artamty H 2084048 931742 INFUS 1
Sastry A ABIDZAR ANAK 71,723.00 71,723.00
RAGIL PASANG Rp. Rp.
367. 19-Jul-18 dr.
Hartono SEPTI 2084051 904119 INFUS 1
ANDITA ANAK 71,723.00 71,723.00
AZZAMI PASANG Rp. Rp.
368. 19-Jul-18 dr.
Hartono SYAUQI 2084052 920321 INFUS 1
SINA ANAK 71,723.00 71,723.00
WAHYU PASANG Rp. Rp.
20-Jul-18 Hartono ADI
dr.
369. 2084054 22221 INFUS 1
PRASETY DEWASA
O
71,723.00 71,723.00
PASANG Rp. Rp.
20-Jul-18 dr. MARDIYA 2084055
370. 931744 INFUS 1
Hartono NTO DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
20-Jul-18 dr. RUSDIAN
371. 2084068 931745 INFUS 1
Hartono TO DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
20-Jul-18 dr. HANDOY
372. 2084080 931748 INFUS 1
Hartono O DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
373. 20-Jul-18 Artamty RASIPAN 2084108 79516 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
GEISYA PASANG Rp. Rp.
20-Jul-18 Hartono MAULIDA
dr.
374. DZIRGAM 2084143 926541 INFUS 1
ANAK
A DIARTA
71,723.00 71,723.00
PASANG Rp. Rp.
375. 20-Jul-18 dr.
Hartono BINTORO 2084101 931752 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
20-Jul-18 dr. SITI
376. 2084145 931762 INFUS 1
Hartono ASTUTIK DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
377. 20-Jul-18 dr.
Hartono RADI 2084146 928175 INFUS 1
DEWASA 71,723.00 71,723.00

IKA PASANG Rp. Rp.


378. 20-Jul-18 dr.
Hartono NURLIDYA 2084150 930105 INFUS 1
NINGSIH DEWASA
71,723.00 71,723.00

RAISHA
AZKADIN PASANG Rp. Rp.
379. 20-Jul-18 dr.
Hartono A 2084154 911991 INFUS 1
MUADZA ANAK
H
71,723.00 71,723.00
RAISYA PASANG Rp. Rp.
380. 20-Jul-18 dr.
Hartono PUTRI 2084157 931765 INFUS 1
CAHYANI ANAK 71,723.00 71,723.00
PASANG Rp. Rp.
20-Jul-18 dr. MAFTUKI
381. 2084158 931766 INFUS 1
Hartono N, MOCH DEWASA 71,723.00 71,723.00

ANGGA
dr. Goliat APRILIA PASANG Rp. Rp.
382. 20-Jul-18 Victor DWI 2084162 107405 INFUS 1
Emanuel CAHYANI DEWASA
NGTYAS
71,723.00 71,723.00
dr. Goliat RIRIN PASANG Rp. Rp.
383. 20-Jul-18 Victor AMBARW 2084160 920460 INFUS 1
Emanuel ATI DEWASA 71,723.00 71,723.00
HAFIDZ PASANG Rp. Rp.
21-Jul-18 Haryono ALWI
dr. Yenny AL
384. AZZA,MU 2084183 931769 INFUS 1
ANAK
H.
HAFIDZ PASANG
21-Jul-18 Haryono ALWI
dr. Yenny AL
384. AZZA,MU 2084183 931769 INFUS 1
ANAK
H.
71,723.00 71,723.00
PASANG Rp. Rp.
21-Jul-18 dr. Yenny
385. Haryono SAWIT 2084188 931773 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
21-Jul-18 dr. Yenny
386. Haryono NISWATI 2084189 931774 INFUS 1
DEWASA 71,723.00 71,723.00

Yenny ARVIN,M PASANG Rp. Rp.


387. 21-Jul-18 dr.
Haryono UHAMM 2084186 931772 INFUS 1
AD ANAK 71,723.00 71,723.00
PASANG Rp. Rp.
21-Jul-18 dr. Nani NGASMA
388. 2084201 923319 INFUS 1
Zumaroh N DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
389. 21-Jul-18 Victor SALAMAH 2084202 931776 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
dr. Goliat TRI PASANG Rp. Rp.
390. 21-Jul-18 Victor MULYO 2084203 931777 INFUS 1
Emanuel UTOMO DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
391. 21-Jul-18 Victor NIKKAH 2084206 64368 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
dr. Goliat SRI PASANG Rp. Rp.
392. 21-Jul-18 Victor 2084207 926233 INFUS 1
Emanuel RAHAYU DEWASA 71,723.00 71,723.00
dr. Goliat KASMON PASANG Rp. Rp.
393. 21-Jul-18 Victor 2084212 900550 INFUS 1
Emanuel O DEWASA 71,723.00 71,723.00
SUWADA
dr. Goliat PASANG Rp. Rp.
NA JAFIS
394. 21-Jul-18 Victor 2084214 904212 INFUS 1
KUSTARA
Emanuel DEWASA
HARJA
71,723.00 71,723.00
dr. PASANG Rp. Rp.
IMAM
395. 21-Jul-18 Artamty 2084216 930270 INFUS 1
HANAFI
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
396. 22-Jul-18 Artamty RUSMIATI 2084218 931782 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
ALI
397. 22-Jul-18 Artamty ROHMAN 2084221 931785 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
22-Jul-18 dr. Nani
398. Zumaroh NOTO 2084223 929028 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
22-Jul-18 dr. Nani
399. Zumaroh KUNTARI 2084227 931786 INFUS 1
DEWASA 71,723.00 71,723.00
RAYMON PASANG Rp. Rp.
22-Jul-18 Zumaroh D
dr. Nani AGOES
400. 2084228 84139 INFUS 1
IVANDER ANAK
ILYASA
71,723.00 71,723.00

Nani DENI PASANG Rp. Rp.


401. 22-Jul-18 dr.
Zumaroh SETIAWA 2084230 931787 INFUS 1
N ANAK 71,723.00 71,723.00
PASANG Rp. Rp.
22-Jul-18 dr. Nani SUMARLI
402. 2084233 78496 INFUS 1
Zumaroh K DEWASA 71,723.00 71,723.00

SILVY
Nani PUTRI PASANG Rp. Rp.
403. 22-Jul-18 dr.
Zumaroh ARDHIYA 2084234 931790 INFUS 1
NTI ANAK
SANTOSO
71,723.00 71,723.00
PASANG Rp. Rp.
22-Jul-18 dr. Nani
404. Zumaroh WASRI 2084235 931791 INFUS 1
DEWASA 71,723.00 71,723.00
CHRISTIN PASANG Rp. Rp.
22-Jul-18 Haryono DIAH
dr. Yenny
405. MARDIYA 2084239 909934 INFUS 1
DEWASA
NI
71,723.00 71,723.00

Yenny RUDI PASANG Rp. Rp.


406. 22-Jul-18 dr.
Haryono UTOMO/ 2084240 81145 INFUS 1
RSMM DEWASA 71,723.00 71,723.00
KEANU PASANG Rp. Rp.
22-Jul-18 Haryono ALBAIHA
dr. Yenny
407. 2084241 929395 INFUS 1
QI ANAK
SUKISNO
71,723.00 71,723.00

Yenny BY.NY.SITI PASANG Rp. Rp.


408. 22-Jul-18 dr.
Haryono NUR 2084242 931792 INFUS 1
NIKMAH ANAK 71,723.00 71,723.00
PASANG Rp. Rp.
22-Jul-18 dr. Yenny
409. Haryono GIMAH 2084244 931793 INFUS 1
DEWASA 71,723.00 71,723.00

ENGGAR PASANG Rp. Rp.


410. 22-Jul-18 dr.
Hartono RIZKY 2084245 913216 INFUS 1
PURBOYO ANAK
71,723.00 71,723.00
CHANIF PASANG Rp. Rp.
22-Jul-18 Hartono RASYHID
dr.
411. INDRAWA 2084249 927874 INFUS 1
ANAK
N
71,723.00 71,723.00
PASANG Rp. Rp.
23-Jul-18 dr. FATMAW
412. 2084250 931796 INFUS 1
Hartono ATI DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
413. 23-Jul-18 Artamty MUKAJI 2084269 931801 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
414. 23-Jul-18 Artamty SUKIJAH 2084277 931802 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
KASMI/RS 2084288
415. 23-Jul-18 Artamty 10582 INFUS 1
Sastry A MM DEWASA 71,723.00 71,723.00
dr. RASYA PASANG Rp. Rp.
416. 23-Jul-18 Artamty ZUNNUR 2084300 931805 INFUS 1
Sastry A AIN ZILMI ANAK 71,723.00 71,723.00
dr. PASANG Rp. Rp.
RATIH
417. 23-Jul-18 Artamty 2084286 925249 INFUS 1
RIASTUTI
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
418. 23-Jul-18 Artamty TOMO 2084305 931807 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
SUMIYATI 2084307
419. 23-Jul-18 Artamty 68478 INFUS 1
,NY
Sastry A DEWASA 71,723.00 71,723.00
MUHIBU
dr. PASANG Rp. Rp.
R ROYYAN 2084308
420. 23-Jul-18 Artamty 931809 INFUS 1
AS
Sastry A DEWASA
SUDKANI
71,723.00 71,723.00
ROBBI
dr. PASANG Rp. Rp.
AHSIN
421. 23-Jul-18 Artamty 2084310 914495 INFUS 1
KHULUQI
Sastry A ANAK
AHMAD
71,723.00 71,723.00
dr. PASANG Rp. Rp.
422. 23-Jul-18 Artamty SUKINAH 2084319 931812 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
423. 23-Jul-18 Artamty JOYO PIN 2084322 931813 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. QARINA PASANG Rp. Rp.
424. 23-Jul-18 Artamty AULIA 2084327 931815 INFUS 1
Sastry A LESTARI ANAK 71,723.00 71,723.00
PASANG Rp. Rp.
23-Jul-18 dr. Yenny AZIF
425. 2084350 931824 INFUS 1
Haryono FAHMI DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
23-Jul-18 dr. Yenny
426. Haryono RASIM 2084253 105784 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
23-Jul-18 dr. Yenny DINUL
427. 2084364 931829 INFUS 1
Haryono AQLI ANAK 71,723.00 71,723.00
PASANG Rp. Rp.
23-Jul-18 dr. Yenny AINUN
428. 2084365 931830 INFUS 1
Haryono NAJIB DEWASA 71,723.00 71,723.00
KHAFILUD PASANG Rp. Rp.
23-Jul-18 Hartono DIN
dr.
429. 2084367 931831 INFUS 1
YUDHA
TAMA ANAK
71,723.00 71,723.00
WIDA PASANG Rp. Rp.
430. 23-Jul-18 dr.
Hartono WATI 2084368 914703 INFUS 1
NINGSIH DEWASA 71,723.00 71,723.00
NOVIA PASANG Rp. Rp.
23-Jul-18 Hartono RUSDIAN
dr.
431. 2084372 931833 INFUS 1
A DEWASA
PAHLEVI
71,723.00 71,723.00
PASANG Rp. Rp.
23-Jul-18 dr. ASMORO
432. 2084370 931832 INFUS 1
Hartono KANDIK DEWASA 71,723.00 71,723.00
RIFAYA PASANG Rp. Rp.
23-Jul-18 Hartono NOUREN
dr.
433. 2084369 930627 INFUS 1
DWI ANAK
FALISHA
71,723.00 71,723.00
PASANG Rp. Rp.
434. 24-Jul-18 dr.
Hartono SARNO 2084390 931834 INFUS 1
DEWASA 71,723.00 71,723.00

RACHMA
NDA PASANG Rp. Rp.
24-Jul-18 Hartono AS'AD
dr.
435. 2084391 931835 INFUS 1
YATIM ANAK
UBAIDILL
AH
71,723.00 71,723.00
dr. PASANG Rp. Rp.
436. 24-Jul-18 Artamty SAMIJAH 2084428 931841 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. ERWIN PASANG Rp. Rp.
437. 24-Jul-18 Artamty SULIS TYA 2084458 931845 INFUS 1
Sastry A NINGSEH DEWASA 71,723.00 71,723.00
RAJHIB EL
dr. PASANG Rp. Rp.
MUDDIN, 2084464
438. 24-Jul-18 Artamty 81936 INFUS 1
MUCHAM
Sastry A DEWASA
MAD
71,723.00 71,723.00
dr. PASANG Rp. Rp.
439. 24-Jul-18 Artamty MISRI 2084468 54848 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
UDI
440. 24-Jul-18 Artamty 2084481 931847 INFUS 1
WALUYO
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
KUSPARTI 2084478
441. 24-Jul-18 Artamty 20606 INFUS 1
NI
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
442. 24-Jul-18 Artamty SUWANDI 2084484 931843 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
24-Jul-18 dr. Yenny SUDARN
443. 2084507 931851 INFUS 1
Haryono O DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
24-Jul-18 dr. Yenny
444. Haryono SAKRIM 2084510 931852 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
24-Jul-18 dr. Yenny
445. Haryono WARTI 2084516 931853 INFUS 1
DEWASA 71,723.00 71,723.00

Yenny RIZKY PASANG Rp. Rp.


446. 24-Jul-18 dr.
Haryono CANDRA 2084518 916099 INFUS 1
P,MUH DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
447. 24-Jul-18 dr.
Hartono HASANAH 2084523 931856 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
448. 24-Jul-18 dr.
Hartono KASIRAN 2084525 931857 INFUS 1
DEWASA 71,723.00 71,723.00
ENDRO PASANG Rp. Rp.
449. 25-Jul-18 dr.
Hartono CAHYON 2084526 931858 INFUS 1
O DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
450. 25-Jul-18 dr.
Hartono SUBANDI 2084535 931860 INFUS 1
DEWASA 71,723.00 71,723.00

Yenny DHYFA PASANG Rp. Rp.


451. 25-Jul-18 dr.
Haryono ADHARA 2084550 107123 INFUS 1
F.R, AN ANAK 71,723.00 71,723.00
FARREL PASANG Rp. Rp.
25-Jul-18 Haryono RADIKA
dr. Yenny
452. 2084553 59585 INFUS 1
RAMADH ANAK
AN
71,723.00 71,723.00
PASANG Rp. Rp.
25-Jul-18 dr. Yenny
453. Haryono TASMI 2084562 931861 INFUS 1
DEWASA 71,723.00 71,723.00
RAFKA PASANG Rp. Rp.
25-Jul-18 Haryono ADITYA
dr. Yenny
454. 2084566 925191 INFUS 1
ALIM ANAK
TAMAM
71,723.00 71,723.00
PASANG Rp. Rp.
25-Jul-18 dr. Yenny VICA
455. 2084569 931848 INFUS 1
Haryono HARUNA DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
25-Jul-18 dr. Yenny FACHRI
456. 2084571 56401 INFUS 1
Haryono R.MUH. ANAK 71,723.00 71,723.00

Yenny ANDIKA PASANG Rp. Rp.


457. 25-Jul-18 dr.
Haryono BAGASKA 2084583 27922 INFUS 1
RA.E ANAK 71,723.00 71,723.00
RIFKI PASANG Rp. Rp.
25-Jul-18 Haryono ADIT
dr. Yenny
458. ARDIANSY 2084612 931868 INFUS 1
DEWASA
AH
71,723.00 71,723.00
SITI
dr. Goliat PASANG Rp. Rp.
DJULAEC
459. 25-Jul-18 Victor 2084625 10112 INFUS 1
HA/RSM
Emanuel DEWASA
M
71,723.00 71,723.00
dr. Goliat TIARA PASANG Rp. Rp.
460. 25-Jul-18 Victor NADIA 2084630 931874 INFUS 1
Emanuel PUTRI ANAK 71,723.00 71,723.00
dr. Goliat PATMISA PASANG Rp. Rp.
461. 25-Jul-18 Victor 2084632 69340 INFUS 1
Emanuel RI DEWASA 71,723.00 71,723.00
AGUNG
dr. Goliat PASANG Rp. Rp.
GILANG
462. 25-Jul-18 Victor TRITANAY 2084637 931875 INFUS 1
Emanuel ANAK
A
71,723.00 71,723.00
dr. Goliat JIHAN PASANG Rp. Rp.
463. 25-Jul-18 Victor QIANITA 2084638 931876 INFUS 1
Emanuel NAJIYA ANAK 71,723.00 71,723.00
dr. Goliat ALI PASANG Rp. Rp.
464. 25-Jul-18 Victor SAIFUDDI 2084641 87814 INFUS 1
Emanuel N, MOH DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
465. 25-Jul-18 Victor USMAN 2084642 78984 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
AQILAH
dr. PASANG Rp. Rp.
NAJWA
466. 25-Jul-18 Artamty 2084643 100017 INFUS 1
NURUL
Sastry A ANAK
JANNAH
71,723.00 71,723.00
dr. PASANG Rp. Rp.
467. 25-Jul-18 Artamty SAIDO 2084644 911649 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
MUZAKI,
468. 26-Jul-18 Artamty 2084646 74735 INFUS 1
AHMAD
Sastry A ANAK 71,723.00 71,723.00

NAFILA PASANG Rp. Rp.


469. 26-Jul-18 dr.
Hartono TRIA 2084685 931884 INFUS 1
BELFANIA ANAK
71,723.00 71,723.00
PASANG Rp. Rp.
470. 26-Jul-18 dr.
Hartono MARTINI 2084687 917149 INFUS 1
DEWASA 71,723.00 71,723.00
YAHYA PASANG Rp. Rp.
471. 26-Jul-18 dr.
Hartono ARDIANSY 2084693 931885 INFUS 1
AH ANAK 71,723.00 71,723.00
PASANG Rp. Rp.
472. 26-Jul-18 dr.
Hartono LASMO 2084704 11756 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
473. 26-Jul-18 dr.
Hartono SULASTRI 2084705 70830 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
474. 26-Jul-18 dr.
Hartono TAYUK 2084718 931896 INFUS 1
DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
475. 26-Jul-18 Victor KASDI 2084759 931900 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
476. 26-Jul-18 Victor SUYADI 2084741 930902 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
477. 26-Jul-18 Victor SUNOTO 2084745 924169 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
dr. Goliat SALSABIL PASANG Rp. Rp.
478. 26-Jul-18 Victor A SHAFA 2084762 100609 INFUS 1
Emanuel AZZAHRA ANAK 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
479. 26-Jul-18 Victor WARTI 2084768 931902 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
HANU
dr. Goliat PASANG Rp. Rp.
MORO AJI 2084769
480. 26-Jul-18 Victor 931904 INFUS 1
TISNO
Emanuel DEWASA
PUTRO
71,723.00 71,723.00

dr. Goliat DWIOIS PASANG Rp. Rp.


481. 26-Jul-18 Victor A'INUR 2084772 107414 INFUS 1
Emanuel FAATIHAH ANAK
71,723.00 71,723.00
PASANG Rp. Rp.
482. 27-Jul-18 dr.
Hartono DJUPRI 2084778 925756 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
483. 27-Jul-18 dr.
Hartono SUKARJI 2084789 106944 INFUS 1
DEWASA 71,723.00 71,723.00

Yenny RINJANI PASANG Rp. Rp.


484. 27-Jul-18 dr.
Haryono PUTRI 2084810 105694 INFUS 1
ARAFAH ANAK 71,723.00 71,723.00
PASANG Rp. Rp.
27-Jul-18 dr. Yenny
485. Haryono SAWI 2084833 931908 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
27-Jul-18 dr. Yenny WARSILA
486. 2084834 931916 INFUS 1
Haryono N DEWASA 71,723.00 71,723.00

Yenny ARUM PASANG Rp. Rp.


487. 27-Jul-18 dr.
Haryono RAHMAN 2084848 924869 INFUS 1
A DEWASA 71,723.00 71,723.00

Yenny RENDI PASANG Rp. Rp.


488. 27-Jul-18 dr.
Haryono PRASETY 2084842 931920 INFUS 1
O VICKI ANAK 71,723.00 71,723.00
PASANG Rp. Rp.
489. 27-Jul-18 dr.
Hartono SUPATMI 2084806 918511 INFUS 1
DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
GUNORES 2084864
490. 27-Jul-18 Artamty 931923 INFUS 1
O
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
491. 27-Jul-18 Artamty NOVI 2084868 931925 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
LAMSRIYA 2084871
492. 27-Jul-18 Artamty 931928 INFUS 1
TI
Sastry A DEWASA 71,723.00 71,723.00
CANDRIK
dr. PASANG Rp. Rp.
A AFLAH
493. 27-Jul-18 Artamty 2084874 931929 INFUS 1
AMANUL
Sastry A ANAK
LOH
71,723.00 71,723.00
ROHMAD
dr. PASANG Rp. Rp.
DWI
494. 27-Jul-18 Artamty 2084876 931930 INFUS 1
FAJAR
Sastry A ANAK
PUTRA
71,723.00 71,723.00
MALAKH
dr. PASANG Rp. Rp.
JOY
495. 27-Jul-18 Artamty 2084877 104824 INFUS 1
BARAK
Sastry A DEWASA
SUCIPTO
71,723.00 71,723.00
dr. LILIK PASANG Rp. Rp.
496. 27-Jul-18 Artamty MASFUFA 2084879 904874 INFUS 1
Sastry A TUN DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
WAHYU
497. 27-Jul-18 Artamty 2084880 931932 INFUS 1
UTOMO
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
498. 27-Jul-18 Artamty SUWARTI 2084882 931934 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
MAULAN
499. 27-Jul-18 Artamty 2084883 931935 INFUS 1
A
Sastry A DEWASA 71,723.00 71,723.00
dr. MIMI PASANG Rp. Rp.
500. 27-Jul-18 Artamty WAHIDA 2084884 931936 INFUS 1
Sastry A H DEWASA 71,723.00 71,723.00
dr. Goliat WARSINA PASANG Rp. Rp.
501. 27-Jul-18 Victor 2084886 931938 INFUS 1
Emanuel H DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
502. 28-Jul-18 Victor JUWARI 2084901 924193 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00

DEVAN
AZKA PASANG Rp. Rp.
503. 28-Jul-18 dr.
Hartono PUTRA 2084915 931942 INFUS 1
NOVEND ANAK
RA
71,723.00 71,723.00
PASANG Rp. Rp.
28-Jul-18 dr. FIRMANS
504. Hartono YAH,MOH 2084908 60670 INFUS 1
DEWASA 71,723.00 71,723.00
PASANG Rp. Rp.
28-Jul-18 dr. Yenny
505. Haryono RASEMI 2084928 83721 INFUS 1
DEWASA 71,723.00 71,723.00
TUTIK PASANG Rp. Rp.
506. 28-Jul-18 dr.
Hartono AGUSTIN 2084929 24440 INFUS 1
A DEWASA 71,723.00 71,723.00
dr. WIWIN PASANG Rp. Rp.
507. 28-Jul-18 Artamty PRIYO 2084934 931948 INFUS 1
Sastry A UTOMO DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
TASMINA
508. 28-Jul-18 Artamty 2084936 931949 INFUS 1
H
Sastry A DEWASA 71,723.00 71,723.00
AINUR
dr. PASANG Rp. Rp.
RAHMAN
509. 28-Jul-18 Artamty 2084938 931951 INFUS 1
MIRZA
Sastry A ANAK
ATTARIQ
71,723.00 71,723.00
dr. PASANG Rp. Rp.
ADJI DWI
510. 28-Jul-18 Artamty 2084940 66167 INFUS 1
Sastry A CIPTA T.K DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
511. 28-Jul-18 Artamty MULYANI 2084941 931698 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
dr. SRI PASANG Rp. Rp.
512. 28-Jul-18 Artamty WAHYUNI 2084942 931952 INFUS 1
Sastry A HERTUTI DEWASA 71,723.00 71,723.00
dr. PASANG Rp. Rp.
SUNTIYAT 2084946
513. 28-Jul-18 Artamty 931954 INFUS 1
IN
Sastry A DEWASA 71,723.00 71,723.00
dr. CELLO PASANG Rp. Rp.
514. 28-Jul-18 Artamty SYARIEF 2084948 931955 INFUS 1
Sastry A ADHA ANAK 71,723.00 71,723.00
dr. PASANG Rp. Rp.
515. 28-Jul-18 Artamty WARTIK 2084949 931956 INFUS 1
Sastry A DEWASA 71,723.00 71,723.00
ROBERTO PASANG Rp. Rp.
516. 28-Jul-18 dr.
Hartono AURELIO 2084952 21491 INFUS 1
SEBER ANAK 71,723.00 71,723.00
MUFID PASANG Rp. Rp.
28-Jul-18 Hartono ADONIA
dr.
517. 2084955 926608 INFUS 1
NAJMA ANAK
ORLIN
71,723.00 71,723.00
HADI PASANG Rp. Rp.
518. 29-Jul-18 dr.
Hartono PRAYITN 2084956 931195 INFUS 1
O DEWASA 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
519. 29-Jul-18 Victor SUMINAH 2084960 918912 INFUS 1
Emanuel DEWASA 71,723.00 71,723.00
dr. Goliat GRIZEL PASANG Rp. Rp.
520. 29-Jul-18 Victor ARCELI 2084963 928047 INFUS 1
Emanuel SUSANTO ANAK 71,723.00 71,723.00
dr. Goliat PASANG Rp. Rp.
521. 29-Jul-18 Victor JIDIN 2084968 931963 INFUS 0
Emanuel DEWASA 0 71,723.00
dr. Goliat PASANG Rp. Rp.
522. 29-Jul-18 Victor SUNARTI 2084971 931446 INFUS 0
Emanuel DEWASA 0 71,723.00
SAKHA
dr. Goliat PASANG Rp. Rp.
GIBRAN
523. 29-Jul-18 Victor 2084972 931965 INFUS 0
RAMDHA
Emanuel ANAK
NSAH, A
0 71,723.00
dr. Goliat JIHAN PASANG Rp. Rp.
524. 29-Jul-18 Victor EKA FUA 2084974 900987 INFUS 0
Emanuel DAH ANAK 0 71,723.00
dr. Goliat ARIE PASANG Rp. Rp.
525. 29-Jul-18 Victor WICAKSO 2084975 927160 INFUS 0
Emanuel NO DEWASA 0 71,723.00
FAHRI
dr. Goliat PASANG Rp. Rp.
HUSAIN
526. 29-Jul-18 Victor 2084976 904966 INFUS 0
MAULAN
Emanuel ANAK
A,MOH
0 71,723.00
dr. Goliat LILIANA,N PASANG Rp. Rp.
527. 29-Jul-18 Victor 2084977 931967 INFUS 0
Emanuel Y DEWASA 0 71,723.00
dr. Goliat AZRINA PASANG Rp. Rp.
528. 29-Jul-18 Victor LAVENIA 2084978 931506 INFUS 0
Emanuel SHAZFA DEWASA 0 71,723.00
RAVIEL PASANG Rp. Rp.
29-Jul-18 Zumaroh HITO
dr. Nani
529. 2084984 931971 INFUS 0
PUTRA ANAK
AHMAD
0 71,723.00
dr. Goliat SRI PASANG Rp. Rp.
530. 29-Jul-18 Victor WINDART 2084983 931970 INFUS 0
Emanuel I DEWASA 0 71,723.00
PASANG Rp. Rp.
29-Jul-18 dr. Nani INDASAH
531. 2084986 931973 INFUS 0
Zumaroh RR DEWASA 0 71,723.00
PASANG Rp. Rp.
30-Jul-18 dr. Nani
532. Zumaroh ANJURI 2084987 927621 INFUS 0
DEWASA 0 71,723.00

Nani REZHADIT PASANG Rp. Rp.


533. 30-Jul-18 dr.
Zumaroh YA TARIQ 2084988 78258 INFUS 0
AZAM ANAK
Nani REZHADIT PASANG
533. 30-Jul-18 dr.
Zumaroh YA TARIQ 2084988 78258 INFUS 0
AZAM ANAK
0 71,723.00
PASANG Rp. Rp.
30-Jul-18 dr. Nani
534. Zumaroh TUMISO 2085004 931974 INFUS 0
DEWASA 0 71,723.00

Nani YAYUK PASANG Rp. Rp.


535. 30-Jul-18 dr.
Zumaroh SETYAWA 2085007 921332 INFUS 0
TI DEWASA 0 71,723.00
PASANG Rp. Rp.
30-Jul-18 dr. Nani NUR
536. 2085006 931975 INFUS 0
Zumaroh KHOZIN DEWASA 0 71,723.00
PASANG Rp. Rp.
30-Jul-18 dr. Yenny PARSINA
537. 2085035 931982 INFUS 0
Haryono H DEWASA 0 71,723.00
AYU PASANG Rp. Rp.
538. 30-Jul-18 Haryono RACHMA
dr. Yenny 2085053 931989 INFUS 0
NIA DEWASA
ULFAH
0 71,723.00
PASANG Rp. Rp.
30-Jul-18 dr. Yenny ALFIANA
539. 2085057 931990 INFUS 0
Haryono NUR AINI ANAK 0 71,723.00

Yenny KASDAR PASANG Rp. Rp.


540. 30-Jul-18 dr.
Haryono DJUWITA, 2085070 67392 INFUS 0
NY DEWASA 0 71,723.00
PASANG Rp. Rp.
541. 30-Jul-18 dr.
Hartono KUHARI 2085071 931490 INFUS 0
DEWASA 0 71,723.00
PASANG Rp. Rp.
542. 30-Jul-18 dr.
Hartono PARWATI 2085076 924682 INFUS 0
DEWASA 0 71,723.00

YUSUF
EKA PASANG Rp. Rp.
30-Jul-18 Hartono ARDIANSY
dr.
543. AH,MOC 2085097 61507 INFUS 0
ANAK
HAMMA
D
0 71,723.00
PASANG Rp. Rp.
544. 30-Jul-18 dr.
Hartono RASTUM 2085107 4159 INFUS 0
DEWASA 0 71,723.00
PUGUH PASANG Rp. Rp.
30-Jul-18 Hartono BUDI
dr.
545. SANTOSO 2085109 932001 INFUS 0
DEWASA
,IR
0 71,723.00
KUSNUL PASANG Rp. Rp.
30-Jul-18 Hartono HIDAYATI
dr.
546. 2085103 931998 INFUS 0
NUR DEWASA
ALIYAH
KUSNUL PASANG
30-Jul-18 Hartono HIDAYATI
dr.
546. 2085103 931998 INFUS 0
NUR DEWASA
ALIYAH
0 71,723.00
JOKO PASANG Rp. Rp.
547. 30-Jul-18 dr.
Hartono WAHYUH 2085110 32777 INFUS 0
ONO DEWASA 0 71,723.00
dr. PASANG Rp. Rp.
548. 30-Jul-18 Hartono
Margono, SUKRAN 2085114 932003 INFUS 0
DEWASA
Sp.Rad.
0 71,723.00
PASANG Rp. Rp.
549. 30-Jul-18 dr.
Hartono SUNTARI 2085115 920744 INFUS 0
DEWASA 0 71,723.00
PASANG Rp. Rp.
550. 30-Jul-18 dr.
Hartono KAMISAH 2085119 932005 INFUS 0
DEWASA 0 71,723.00
RAMA PASANG Rp. Rp.
30-Jul-18 Hartono ADI
dr.
551. 2085124 30792 INFUS 0
NUGROH DEWASA
O
0 71,723.00
PASANG Rp. Rp.
552. 30-Jul-18 dr.
Hartono NURIKAH 2085121 932007 INFUS 0
DEWASA 0 71,723.00
dr. Goliat PASANG Rp. Rp.
553. 31-Jul-18 Victor SUCIATI 2085145 932013 INFUS 0
Emanuel DEWASA 0 71,723.00
dr. Goliat PASANG Rp. Rp.
554. 31-Jul-18 Victor MARTINI 2085146 917149 INFUS 0
Emanuel DEWASA 0 71,723.00
PASANG Rp. Rp.
31-Jul-18 dr. Yenny EKA
555. 2085162 932014 INFUS 0
Haryono YULIANA DEWASA 0 71,723.00
Rp. Rp.
556. 1-Jul-18 dr. 931158 EKG
Hartono MARIYATI 2082087 1
MANUAL 71,121.00 71,121.00
dr. Goliat MUDI Rp. Rp.
557. 1-Jul-18 Victor HARTON 2082101 931167 EKG 1
MANUAL
Emanuel O 71,121.00 71,121.00
dr. Goliat Rp. Rp.
558. 1-Jul-18 Victor DARNI 2082100 931166 EKG 1
MANUAL
Emanuel 71,121.00 71,121.00
dr. Rp. Rp.
559. 1-Jul-18 Artamty LASADJI 2082111 914717 EKG 1
MANUAL
Sastry A 71,121.00 71,121.00
dr. Goliat SARJI Rp. Rp.
560. 1-Jul-18 Victor 2082113 85610 EKG 1
Emanuel GUNO MANUAL
71,121.00 71,121.00
dr. Goliat Rp. Rp.
561. 1-Jul-18 Victor MOLAN 2082114 931169 EKG 1
MANUAL
Emanuel 71,121.00 71,121.00
dr. Goliat KUSNING, Rp. Rp.
562. 1-Jul-18 Victor 2082115 84994 EKG 1
Emanuel HJ MANUAL
71,121.00 71,121.00
dr. Goliat Rp. Rp.
563. 1-Jul-18 Victor LANTIP 2082122 931172 EKG 1
MANUAL
Emanuel 71,121.00 71,121.00
Rp. Rp.
2-Jul-18 dr. Nani SUWARNI 2082162
564. 931183 EKG 1
Zumaroh ,NY MANUAL 71,121.00 71,121.00
Rp. Rp.
565. 2-Jul-18 dr. Nani 61805 EKG
Zumaroh DARSAM 2082169 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
2-Jul-18 dr. Nani
566. 77582 EKG
Zumaroh RUKMINI 2082181 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
2-Jul-18 dr. Yenny
567. 901182 EKG
Haryono TARMI 2082193 1
MANUAL 71,121.00 71,121.00

Nani MASROYA Rp. Rp.


568. 2-Jul-18 dr. 76 EKG
Zumaroh NA/RSM 2082201 1
MANUAL
M 71,121.00 71,121.00

Nani HADI Rp. Rp.


569. 2-Jul-18 dr. 931195 EKG
Zumaroh PRAYITN 2082204 1
MANUAL
O 71,121.00 71,121.00
Rp. Rp.
2-Jul-18 dr. Nani NYAMINA 2082217
570. 931200 EKG 1
Zumaroh H MANUAL 71,121.00 71,121.00
dr.
Rp. Rp.
571. 2-Jul-18 Ferryzal SUWITO 2082210 920782 EKG 1
O.M., MANUAL
Sp.OT.
71,121.00 71,121.00
Rp. Rp.
2-Jul-18 dr. Yenny SUPARTIN 2082232
572. 931206 EKG 1
Haryono MANUAL 71,121.00 71,121.00
Rp. Rp.
2-Jul-18 dr. Nani LASMUNT 2082224
573. 931203 EKG 1
Zumaroh IK MANUAL 71,121.00 71,121.00

Rp. Rp.
2-Jul-18 dr. Yenny ARIFIN
574. 931213 EKG
Haryono SUSANTO 2082251 1
MONITOR
71,121.00 71,121.00
Rp. Rp.
2-Jul-18 dr. Yenny
575. 929170 EKG
Haryono KATREMI 2082249 1
MANUAL 71,121.00 71,121.00

Rp. Rp.
2-Jul-18 dr. Yenny
576. 929170 EKG
Haryono KATREMI 2082249 1
MONITOR
71,121.00 71,121.00
Rp. Rp.
2-Jul-18 dr. Yenny HARIANT
577. 2082256 931215 EKG 1
Haryono O MANUAL 71,121.00 71,121.00
dr. Rp. Rp.
578. 2-Jul-18 Artamty SAMIAN 2082260 931218 EKG 1
MANUAL
Sastry A
dr.
578. 2-Jul-18 Artamty SAMIAN 2082260 931218 EKG 1
MANUAL
Sastry A 71,121.00 71,121.00
DWI
Rp. Rp.
3-Jul-18 Haryono WAHYU
dr. Yenny
579. 2082353 931242 EKG 1
NUR MANUAL
AANG
71,121.00 71,121.00
dr. Goliat SUYUFI,M Rp. Rp.
580. 3-Jul-18 Victor UCHAMA 2082395 931256 EKG 1
MANUAL
Emanuel D 71,121.00 71,121.00
dr. Goliat RUSMAN Rp. Rp.
581. 4-Jul-18 Victor 2082409 931257 EKG 1
Emanuel AJI MANUAL
71,121.00 71,121.00
dr. LILIK Rp. Rp.
582. 4-Jul-18 Artamty SETYOWA 2082434 38391 EKG 1
MANUAL
Sastry A TI 71,121.00 71,121.00
dr. Rp. Rp.
583. 4-Jul-18 Artamty SRIAH 2082474 909814 EKG 1
MANUAL
Sastry A 71,121.00 71,121.00
dr. TRI Rp. Rp.
584. 4-Jul-18 Artamty MARGIAN 2082476 931273 EKG 1
MANUAL
Sastry A I, NY 71,121.00 71,121.00
Rp. Rp.
4-Jul-18 dr. Yenny KUNTIRA
585. 2082486 931278 EKG 1
Haryono H MANUAL 71,121.00 71,121.00
dr. Goliat Rp. Rp.
586. 5-Jul-18 Victor SUCIPTO 2082520 931288 EKG 1
MANUAL
Emanuel 71,121.00 71,121.00
dr. Goliat MUTIATU Rp. Rp.
587. 5-Jul-18 Victor 2082522 926993 EKG 1
Emanuel N MANUAL
71,121.00 71,121.00
Rp. Rp.
5-Jul-18 dr. Nani
588. 931317 EKG
Zumaroh SRIPAH 2082601 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
5-Jul-18 dr. Nani
589. 931317 EKG
Zumaroh SRIPAH 2082601 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
5-Jul-18 dr. Nani KASBULL
590. Zumaroh AH S,H 2082605 926458 EKG
MANUAL 71,121.00 1
71,121.00
dr. Rp. Rp.
591. 5-Jul-18 Artamty MUDRON 2082614 931318 EKG 1
MANUAL
Sastry A 71,121.00 71,121.00
dr. Rp. Rp.
592. 5-Jul-18 Artamty ROHLI 2082626 927283 EKG 1
MANUAL
Sastry A 71,121.00 71,121.00
dr. Rp. Rp.
593. 5-Jul-18 Artamty DEMES 2082628 85449 EKG 1
MANUAL
Sastry A 71,121.00 71,121.00
dr. Rp. Rp.
594. 5-Jul-18 Artamty SAMIRAH 2082631 909463 EKG 1
MANUAL
Sastry A
dr.
594. 5-Jul-18 Artamty SAMIRAH 2082631 909463 EKG 1
MANUAL
Sastry A 71,121.00 71,121.00
Rp. Rp.
6-Jul-18 dr. Yenny SOFFAN,
595. 2082646 931329 EKG 1
Haryono M MANUAL 71,121.00 71,121.00
dr. ENDANG Rp. Rp.
596. 6-Jul-18 Artamty POERMIH 2082663 80248 EKG 1
MANUAL
Sastry A ARSIH 71,121.00 71,121.00
dr. Rp. Rp.
597. 6-Jul-18 Artamty DARMAJI 2082677 931194 EKG 1
MANUAL
Sastry A 71,121.00 71,121.00
dr. SULIS Rp. Rp.
598. 6-Jul-18 Artamty SETYONI 2082682 931340 EKG 1
MANUAL
Sastry A NGSIH 71,121.00 71,121.00
dr. Rp. Rp.
599. 6-Jul-18 Artamty KARSILAN 2082704 907653 EKG 1
MANUAL
Sastry A 71,121.00 71,121.00
Rp. Rp.
6-Jul-18 dr. Nani INDRI
600. 2082723 931355 EKG 1
Zumaroh JATUN R MANUAL 71,121.00 71,121.00
Rp. Rp.
6-Jul-18 dr. Nani
601. 87191 EKG
Zumaroh KARSIMIN 2082729 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
6-Jul-18 dr. Nani ABDUL
602. 2082733 931360 EKG 1
Zumaroh WAHAB MANUAL 71,121.00 71,121.00
Rp. Rp.
6-Jul-18 dr. Nani
603. 931363 EKG
Zumaroh SAKIRAH 2082736 1
MANUAL 71,121.00 71,121.00
dr. Goliat DIGYO Rp. Rp.
604. 6-Jul-18 Victor 2082739 929777 EKG 1
Emanuel WINARSO MANUAL
71,121.00 71,121.00
dr. Goliat Rp. Rp.
605. 7-Jul-18 Victor LASMI,NY 2082740 910296 EKG 1
MANUAL
Emanuel 71,121.00 71,121.00
Rp. Rp.
7-Jul-18 dr. Nani LASRI
606. 2082768 931369 EKG 1
Zumaroh MANUAL 71,121.00 71,121.00
dr. Goliat SURIPAH, Rp. Rp.
607. 7-Jul-18 Victor 2082784 900005 EKG 1
Emanuel NY MANUAL
71,121.00 71,121.00
dr. Goliat Rp. Rp.
608. 8-Jul-18 Victor MUINAH 2082799 931387 EKG 1
MANUAL
Emanuel 71,121.00 71,121.00
Rp. Rp.
8-Jul-18 dr. Yenny
609. 931389 EKG
Haryono LANTIP 2082802 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
8-Jul-18 dr. Yenny
610. 931390 EKG
Haryono WINARTI 2082803 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
8-Jul-18 dr. Yenny
611. 931341 EKG
Haryono SUDARNI 2082804 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
8-Jul-18 dr. Yenny
612. 915224 EKG
Haryono TOMO 2082810 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
8-Jul-18 dr. Yenny
613. 931393 EKG
Haryono SAMIRAH 2082813 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
8-Jul-18 dr. Nani
614. 917244 EKG
Zumaroh WARNADI 2082820 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
8-Jul-18 dr. Nani SUHARTI
615. 2082827 104002 EKG 1
Zumaroh NIK MANUAL 71,121.00 71,121.00
Rp. Rp.
8-Jul-18 dr. DIANTINI
616. 2082834 931404 EKG 1
Hartono K MANUAL 71,121.00 71,121.00

Rp. Rp.
8-Jul-18 dr. DIANTINI
617. 2082834 931404 EKG 1
Hartono K MONITOR
71,121.00 71,121.00
Rp. Rp.
618. 9-Jul-18 dr. 931406 EKG
Hartono KASNIR 2082836 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
619. 9-Jul-18 dr. 931408 EKG
Hartono WARAS 2082853 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
9-Jul-18 dr. Nani
620. 931425 EKG
Zumaroh GARIYAH 2082905 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
9-Jul-18 dr. Nani HARIYANT 2082912
621. 931215 EKG 1
Zumaroh O MANUAL 71,121.00 71,121.00
Rp. Rp.
9-Jul-18 dr. Yenny
622. 64042 EKG
Haryono TORAN 2082927 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
9-Jul-18 dr. Yenny
623. 931437 EKG
Haryono TARSIH 2082938 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
9-Jul-18 dr. Yenny
624. 78230 EKG
Haryono KASBU 2082941 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
9-Jul-18 dr. Yenny
625. 919356 EKG
Haryono MASJUKI 2082944 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
9-Jul-18 dr. Yenny
626. 931240 EKG
Haryono TUMIRAH 2082954 1
MANUAL 71,121.00 71,121.00
dr. Rp. Rp.
627. 10-Jul-18 Artamty KARMINI 2082974 63247 EKG 1
MANUAL
Sastry A 71,121.00 71,121.00
Rp. Rp.
628. 10-Jul-18 dr.
Hartono SUKADI 2083001 931447 EKG
MANUAL 1
71,121.00 71,121.00
Rp. Rp.
10-Jul-18 dr. Yenny
629. 931468 EKG
Haryono KARJONO 2083080 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
10-Jul-18 dr. Yenny LASMINT
630. 2083083 931102 EKG 1
Haryono O, TN MANUAL 71,121.00 71,121.00
Rp. Rp.
10-Jul-18 dr. Yenny
631. 931470 EKG
Haryono SUMIRAH 2083088 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
10-Jul-18 dr. Yenny SUTRISN
632. 2083096 931473 EKG 1
Haryono O, TN MANUAL 71,121.00 71,121.00
Rp. Rp.
10-Jul-18 dr. Yenny
633. 931474 EKG
Haryono SUKIMAH 2083099 1
MANUAL 71,121.00 71,121.00
dr. Goliat Rp. Rp.
634. 10-Jul-18 Victor SUMIJAH 2083107 931478 EKG 1
MANUAL
Emanuel 71,121.00 71,121.00
dr. Goliat Rp. Rp.
635. 11-Jul-18 Victor SUPARMI 2083103 26851 EKG 1
MANUAL
Emanuel 71,121.00 71,121.00
Rp. Rp.
11-Jul-18 dr. Yenny
636. 931490 EKG
Haryono KUHARI 2083156 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
11-Jul-18 dr. SUPRIYAD 2083186
637. 900511 EKG 1
Hartono I MANUAL 71,121.00 71,121.00
Rp. Rp.
11-Jul-18 dr. Nani
638. 931500 EKG
Zumaroh SURI 2083190 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
11-Jul-18 dr. Yenny KUSNAN,
639. 2083203 911166 EKG 1
Haryono M MANUAL 71,121.00 71,121.00
dr. Rp. Rp.
640. 12-Jul-18 Artamty SODJO 2083230 931483 EKG 1
MANUAL
Sastry A 71,121.00 71,121.00
dr. Rp. Rp.
SRI
641. 12-Jul-18 Artamty 2083239 65659 EKG 1
HARUMI MANUAL
Sastry A 71,121.00 71,121.00
Rp. Rp.
12-Jul-18 dr. Yenny
642. 931516 EKG
Haryono SUYATNO 2083247 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
643. 12-Jul-18 dr. 931543 EKG
Hartono BASRI 2083369 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
644. 13-Jul-18 dr. 931548 EKG
Hartono SAJI 2083388 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
13-Jul-18 dr. JOYO
645. 2083403 904546 EKG 1
Hartono ADI,H MANUAL 71,121.00 71,121.00
dr. SITI Rp. Rp.
646. 13-Jul-18 Artamty MARDIYA 2083440 930843 EKG 1
MANUAL
Sastry A H 71,121.00 71,121.00
Rp. Rp.
13-Jul-18 dr. Yenny
647. 931565 EKG
Haryono MASUD 2083458 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
13-Jul-18 dr. Yenny
648. 930959 EKG
Haryono HENDUN 2083396 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
13-Jul-18 dr. Yenny
649. 931568 EKG
Haryono PASRI 2083474 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
13-Jul-18 dr. Yenny
650. 931378 EKG
Haryono LAMIJAH 2083475 1
MANUAL 71,121.00 71,121.00
dr. Goliat Rp. Rp.
651. 13-Jul-18 Victor RASIDIN 2083478 931571 EKG 1
MANUAL
Emanuel 71,121.00 71,121.00
dr. Goliat DARWOT Rp. Rp.
652. 14-Jul-18 Victor 2083476 72779 EKG 1
Emanuel O MANUAL
71,121.00 71,121.00
dr. Goliat JULIANA Rp. Rp.
653. 14-Jul-18 Victor 2083482 931573 EKG 1
Emanuel PUTRI MANUAL
71,121.00 71,121.00
Rp. Rp.
14-Jul-18 dr. Yenny WASRIAT
654. 2083488 931576 EKG 1
Haryono UN MANUAL 71,121.00 71,121.00
dr. Goliat Rp. Rp.
655. 14-Jul-18 Victor RUSNO 2083504 931583 EKG 1
MANUAL
Emanuel 71,121.00 71,121.00
dr. Goliat Rp. Rp.
656. 14-Jul-18 Victor TASRAM 2083510 931585 EKG 1
MANUAL
Emanuel 71,121.00 71,121.00
dr. Goliat Rp. Rp.
657. 14-Jul-18 Victor MUCHLIS 2083511 931586 EKG 1
MANUAL
Emanuel 71,121.00 71,121.00
dr. Goliat MUSTAIN, Rp. Rp.
658. 14-Jul-18 Victor 2083453 106469 EKG 1
Emanuel TN MANUAL
71,121.00 71,121.00
dr. Goliat Rp. Rp.
659. 15-Jul-18 Victor SALEKAH 2083544 927868 EKG 1
MANUAL
Emanuel 71,121.00 71,121.00
dr. Goliat Rp. Rp.
660. 15-Jul-18 Victor LASRUN 2083548 925071 EKG 1
MANUAL
Emanuel 71,121.00 71,121.00
Rp. Rp.
16-Jul-18 dr. Yenny
661. 88240 EKG
Haryono TARSINI 2083582 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
16-Jul-18 dr. Yenny
662. 921489 EKG
Haryono BASTAM 2083610 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
16-Jul-18 dr. Yenny
663. 88759 EKG
Haryono ASRIATIN 2083613 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
16-Jul-18 dr. Yenny ANTO
664. 2083640 931628 EKG 1
Haryono MANUAL 71,121.00 71,121.00
dr. Goliat SITI Rp. Rp.
665. 16-Jul-18 Victor 2083656 30755 EKG 1
Emanuel KHOLIFAH MANUAL
71,121.00 71,121.00
dr. Goliat TURJIMA Rp. Rp.
666. 16-Jul-18 Victor 2083667 931635 EKG 1
Emanuel N MANUAL
71,121.00 71,121.00
NUR Rp. Rp.
667. 16-Jul-18 dr. 931639 EKG
Hartono RAIHAN, 2083673 1
MONITOR
MUH. 71,121.00 71,121.00
Rp. Rp.
668. 17-Jul-18 dr. 920067 EKG
Hartono SAMHADI 2083674 1
MANUAL 71,121.00 71,121.00

Yenny SITI Rp. Rp.


669. 17-Jul-18 dr. 931641 EKG
Haryono ISTIKOMA 2083737 1
MANUAL
H 71,121.00 71,121.00
Rp. Rp.
17-Jul-18 dr. Yenny SUHARSO 2083765
670. 931654 EKG 1
Haryono NO MANUAL 71,121.00 71,121.00
Rp. Rp.
17-Jul-18 dr. Nani RUKMIYA
671. 2083807 931669 EKG 1
Zumaroh TUN MANUAL 71,121.00 71,121.00
dr. Rp. Rp.
PURNOM 2083819
672. 17-Jul-18 Artamty 900871 EKG 1
O MANUAL
Sastry A 71,121.00 71,121.00
dr. Rp. Rp.
673. 18-Jul-18 Artamty DARSIPAH 2083832 927232 EKG 1
MANUAL
Sastry A 71,121.00 71,121.00
Rp. Rp.
674. 18-Jul-18 dr. 931685 EKG
Hartono SAMIN 2083855 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
18-Jul-18 dr. KASMINA 2083871
675. 931680 EKG 1
Hartono H MANUAL 71,121.00 71,121.00
Rp. Rp.
676. 18-Jul-18 dr. Yenny 105378 EKG
Haryono KASIYATI 2083905 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
18-Jul-18 dr. Yenny
677. 931711 EKG
Haryono KARMILA 2083912 1
MANUAL 71,121.00 71,121.00
dr. Goliat Rp. Rp.
678. 18-Jul-18 Victor KASMIN 2083920 931718 EKG 1
MONITOR
Emanuel 71,121.00 71,121.00

Yenny FATAH, Rp. Rp.


679. 19-Jul-18 dr. 931724 EKG
Haryono MUHAM 2083956 1
MANUAL
MAD 71,121.00 71,121.00
dr. Goliat HENI Rp. Rp.
680. 19-Jul-18 Victor ULANDAR 2083940 102250 EKG 1
MANUAL
Emanuel I 71,121.00 71,121.00
Rp. Rp.
19-Jul-18 dr. Yenny
681. 931727 EKG
Haryono KAMSIH 2083960 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
19-Jul-18 dr. Yenny KARSONO 2083971
682. 931730 EKG 1
Haryono MANUAL 71,121.00 71,121.00
Rp. Rp.
19-Jul-18 dr. Yenny SITI
683. 2083979 931731 EKG 1
Haryono FATIMAH MANUAL 71,121.00 71,121.00
Rp. Rp.
19-Jul-18 dr. Nani ALI
684. 2083985 931732 EKG 1
Zumaroh SODIKIN MANUAL 71,121.00 71,121.00
Rp. Rp.
19-Jul-18 dr. Nani
685. 929916 EKG
Zumaroh SAKHUR 2083993 1
MANUAL 71,121.00 71,121.00

Nani NOVIA Rp. Rp.


686. 19-Jul-18 dr. 930418 EKG
Zumaroh RATNA 2084006 1
MANUAL
JUWITA 71,121.00 71,121.00
dr. Rp. Rp.
SURATMA 2084034
687. 19-Jul-18 Artamty 931736 EKG 1
N MANUAL
Sastry A 71,121.00 71,121.00
dr. BRILLIA Rp. Rp.
688. 19-Jul-18 Artamty HENING 2084046 931741 EKG 1
MANUAL
Sastry A MAS
dr. BRILLIA
688. 19-Jul-18 Artamty HENING 2084046 931741 EKG 1
MANUAL
Sastry A MAS 71,121.00 71,121.00

Rp. Rp.
20-Jul-18 dr. RUSDIAN
689. 2084068 931745 EKG 1
Hartono TO MONITOR
71,121.00 71,121.00
Rp. Rp.
20-Jul-18 dr. HANDOY
690. 2084080 931748 EKG 1
Hartono O MANUAL 71,121.00 71,121.00
dr. Rp. Rp.
691. 20-Jul-18 Artamty RASIPAN 2084108 79516 EKG 1
MANUAL
Sastry A 71,121.00 71,121.00
Rp. Rp.
692. 20-Jul-18 dr. 931752 EKG
Hartono BINTORO 2084101 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
693. 20-Jul-18 dr. SITI 2084145 931762 EKG 1
Hartono ASTUTIK MANUAL 71,121.00 71,121.00
Rp. Rp.
694. 20-Jul-18 dr. 928175 EKG
Hartono RADI 2084146 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
21-Jul-18 dr. Yenny
695. 931773 EKG
Haryono SAWIT 2084188 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
21-Jul-18 dr. Yenny
696. 931774 EKG
Haryono NISWATI 2084189 1
MANUAL 71,121.00 71,121.00
dr. Goliat Rp. Rp.
697. 21-Jul-18 Victor SALAMAH 2084202 931776 EKG 1
MONITOR
Emanuel 71,121.00 71,121.00
dr. Goliat TRI Rp. Rp.
698. 21-Jul-18 Victor MULYO 2084203 931777 EKG 1
MONITOR
Emanuel UTOMO 71,121.00 71,121.00
dr. Goliat SRI Rp. Rp.
699. 21-Jul-18 Victor 2084207 926233 EKG 1
Emanuel RAHAYU MANUAL
71,121.00 71,121.00
dr. Rp. Rp.
IMAM
700. 21-Jul-18 Artamty 2084216 930270 EKG 1
HANAFI MONITOR
Sastry A 71,121.00 71,121.00
dr. Rp. Rp.
701. 22-Jul-18 Artamty RUSMIATI 2084218 931782 EKG 1
MONITOR
Sastry A 71,121.00 71,121.00
dr. Rp. Rp.
ALI
702. 22-Jul-18 Artamty 931785 EKG
ROHMAN 2084221 1
MANUAL
Sastry A 71,121.00 71,121.00

Rp. Rp.
22-Jul-18 dr. Nani
703. 929028 EKG
Zumaroh NOTO 2084223 1
MONITOR
71,121.00 71,121.00
Rp. Rp.
22-Jul-18 dr. Nani
704. 931786 EKG
Zumaroh KUNTARI 2084227 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
22-Jul-18 dr. Nani
705. 931791 EKG
Zumaroh WASRI 2084235 1
MANUAL 71,121.00 71,121.00
CHRISTIN
Rp. Rp.
22-Jul-18 Haryono DIAH
dr. Yenny
706. 909934 EKG
MARDIYA 2084239 1
MANUAL
NI
71,121.00 71,121.00
Rp. Rp.
23-Jul-18 dr. FATMAW
707. 2084250 931796 EKG 1
Hartono ATI MANUAL 71,121.00 71,121.00
dr. Rp. Rp.
708. 23-Jul-18 Artamty MUKAJI 2084269 931801 EKG 1
MANUAL
Sastry A 71,121.00 71,121.00
dr. Rp. Rp.
709. 23-Jul-18 Artamty SUKIJAH 2084277 931802 EKG 1
MANUAL
Sastry A 71,121.00 71,121.00
dr. Rp. Rp.
KASMI/RS 2084288
710. 23-Jul-18 Artamty 10582 EKG 1
MM MANUAL
Sastry A 71,121.00 71,121.00
dr. Rp. Rp.
SUMIYATI 2084307
711. 23-Jul-18 Artamty 68478 EKG 1
,NY MANUAL
Sastry A 71,121.00 71,121.00
dr. Rp. Rp.
712. 23-Jul-18 Artamty SUKINAH 2084319 931812 EKG 1
MANUAL
Sastry A 71,121.00 71,121.00
Rp. Rp.
23-Jul-18 dr. Yenny AZIF
713. 2084350 931824 EKG 1
Haryono FAHMI MANUAL 71,121.00 71,121.00
Rp. Rp.
23-Jul-18 dr. Yenny AINUN
714. 2084365 931830 EKG 1
Haryono NAJIB MANUAL 71,121.00 71,121.00
WIDA Rp. Rp.
715. 23-Jul-18 dr. 914703 EKG
Hartono WATI 2084368 1
MANUAL
NINGSIH 71,121.00 71,121.00

Rp. Rp.
716. 24-Jul-18 dr. 931834 EKG
Hartono SARNO 2084390 1
MONITOR
71,121.00 71,121.00
dr. ERWIN Rp. Rp.
717. 24-Jul-18 Artamty SULIS TYA 2084458 931845 EKG 1
MANUAL
Sastry A NINGSEH 71,121.00 71,121.00
dr. Rp. Rp.
718. 24-Jul-18 Artamty MISRI 2084468 54848 EKG 1
MANUAL
Sastry A 71,121.00 71,121.00
dr. Rp. Rp.
719. 24-Jul-18 Artamty MISRI 2084468 54848 EKG 1
MONITOR
Sastry A 71,121.00 71,121.00
Rp. Rp.
24-Jul-18 dr. Yenny
720. 931850 EKG
Haryono NURHADI 2084503 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
24-Jul-18 dr. Yenny SUDARN
721. 2084507 931851 EKG 1
Haryono O MANUAL 71,121.00 71,121.00
Rp. Rp.
24-Jul-18 dr. Yenny
722. 931853 EKG
Haryono WARTI 2084516 1
MANUAL
24-Jul-18 dr. Yenny
722. 931853 EKG
Haryono WARTI 2084516 1
MANUAL 71,121.00 71,121.00

Yenny RIZKY Rp. Rp.


723. 24-Jul-18 dr. 916099 EKG
Haryono CANDRA 2084518 1
MANUAL
P,MUH 71,121.00 71,121.00
Rp. Rp.
724. 24-Jul-18 dr. 931857 EKG
Hartono KASIRAN 2084525 1
MANUAL 71,121.00 71,121.00
ENDRO Rp. Rp.
725. 25-Jul-18 dr. 931858 EKG
Hartono CAHYON 2084526 1
MANUAL
O 71,121.00 71,121.00
Rp. Rp.
25-Jul-18 dr. Yenny
726. 931861 EKG
Haryono TASMI 2084562 1
MANUAL 71,121.00 71,121.00
dr. Goliat PATMISA Rp. Rp.
727. 25-Jul-18 Victor 2084632 69340 EKG 1
Emanuel RI MANUAL
71,121.00 71,121.00
dr. Rp. Rp.
728. 25-Jul-18 Artamty SAIDO 2084644 911649 EKG 1
MANUAL
Sastry A 71,121.00 71,121.00
Rp. Rp.
729. 26-Jul-18 dr. 70830 EKG
Hartono SULASTRI 2084705 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
730. 26-Jul-18 dr. 11756 EKG
Hartono LASMO 2084704 1
MANUAL 71,121.00 71,121.00
dr. Goliat Rp. Rp.
731. 26-Jul-18 Victor SUYADI 2084741 930902 EKG 1
MANUAL
Emanuel 71,121.00 71,121.00
dr. Goliat Rp. Rp.
732. 26-Jul-18 Victor KASDI 2084759 931900 EKG 1
MANUAL
Emanuel 71,121.00 71,121.00
HANU
dr. Goliat Rp. Rp.
MORO AJI 2084769
733. 26-Jul-18 Victor 931904 EKG 1
TISNO MANUAL
Emanuel PUTRO
71,121.00 71,121.00
dr. Rp. Rp.
GUNORES 2084864
734. 27-Jul-18 Artamty 931923 EKG 1
O MANUAL
Sastry A 71,121.00 71,121.00
dr. Rp. Rp.
LAMSRIYA 2084871
735. 27-Jul-18 Artamty 931928 EKG 1
TI MANUAL
Sastry A 71,121.00 71,121.00
dr. Rp. Rp.
736. 27-Jul-18 Artamty SUWARTI 2084882 931934 EKG 1
MANUAL
Sastry A 71,121.00 71,121.00
dr. Goliat Rp. Rp.
737. 28-Jul-18 Victor JUWARI 2084901 924193 EKG 1
MANUAL
Emanuel 71,121.00 71,121.00
Rp. Rp.
738. 28-Jul-18 dr. 931946 EKG
Hartono DARSIN 2084926 1
MANUAL 71,121.00 71,121.00
Rp. Rp.
28-Jul-18 dr. Yenny
739. 83721 EKG
Haryono RASEMI 2084928 1
MANUAL 71,121.00 71,121.00
TUTIK Rp. Rp.
740. 28-Jul-18 dr. 24440 EKG
Hartono AGUSTIN 2084929 1
MANUAL
A 71,121.00 71,121.00
dr. Rp. Rp.
TASMINA
741. 28-Jul-18 Artamty 2084936 931949 EKG 1
H MANUAL
Sastry A 71,121.00 71,121.00
dr. Rp. Rp.
742. 28-Jul-18 Artamty MULYANI 2084941 931698 EKG 1
MANUAL
Sastry A 71,121.00 71,121.00
HADI Rp. Rp.
743. 29-Jul-18 dr. 931195 EKG
Hartono PRAYITN 2084956 1
MANUAL
O 71,121.00 71,121.00
dr. Goliat Rp. Rp.
744. 29-Jul-18 Victor SUMINAH 2084960 918912 EKG 1
MANUAL
Emanuel 71,121.00 71,121.00
dr. Goliat Rp. Rp.
745. 29-Jul-18 Victor JIDIN 2084968 931963 EKG 0
MANUAL
Emanuel 0 71,121.00
dr. Goliat Rp. Rp.
746. 29-Jul-18 Victor SUNARTI 2084971 931446 EKG 0
MANUAL
Emanuel 0 71,121.00
Rp. Rp.
29-Jul-18 dr. Nani INDASAH
747. 2084986 931973 EKG 0
Zumaroh RR MANUAL 0 71,121.00
Rp. Rp.
30-Jul-18 dr. Nani
748. 931974 EKG
Zumaroh TUMISO 2085004 0
MANUAL 0 71,121.00
Rp. Rp.
30-Jul-18 dr. Nani NUR
749. 2085006 931975 EKG 0
Zumaroh KHOZIN MANUAL 0 71,121.00

Rp. Rp.
30-Jul-18 dr. Yenny PARSINA
750. 2085035 931982 EKG 0
Haryono H MONITOR
0 71,121.00

Yenny KASDAR Rp. Rp.


751. 30-Jul-18 dr. 67392 EKG
Haryono DJUWITA, 2085070 0
MONITOR
NY 0 71,121.00

Rp. Rp.
752. 30-Jul-18 dr. 931490 EKG
Hartono KUHARI 2085071 0
MONITOR
0 71,121.00
Rp. Rp.
753. 30-Jul-18 dr. 4159 EKG
Hartono RASTUM 2085107 0
MANUAL 0 71,121.00
PUGUH
Rp. Rp.
30-Jul-18 Hartono BUDI
dr.
754. 932001 EKG
SANTOSO 2085109 0
MANUAL
,IR
0 71,121.00
dr.
Rp. Rp.
755. 30-Jul-18 Hartono 932003 EKG
Margono, SUKRAN 2085114 0
MANUAL
Sp.Rad.
0 71,121.00
Rp. Rp.
756. 30-Jul-18 dr. 920744 EKG
Hartono SUNTARI 2085115 0
MANUAL 0 71,121.00
Rp. Rp.
757. 30-Jul-18 dr. 932005 EKG
Hartono KAMISAH 2085119 0
MANUAL 0 71,121.00
Rp. Rp.
30-Jul-18 dr. KASMIJA
758. 2085120 932006 EKG 0
Hartono N MANUAL 0 71,121.00
Rp. Rp.
759. 30-Jul-18 dr. 932007 EKG
Hartono NURIKAH 2085121 0
MANUAL 0 71,121.00
Rp. Rp.
20-Jul-18 dr. RUSDIAN
760. 2084068 931745 RJP 1
Hartono TO DEWASA 70,761.00 70,761.00
Rp. Rp.
761. 20-Jul-18 dr. RUSDIAN 2084068 931745 RJP 1
Hartono TO DEWASA 70,761.00 70,761.00
Rp. Rp.
4-Jul-18 dr. Yenny
762. 29317 HEACTIN
Haryono PASIRAN 2082489 1
G3-6 65,591.00 65,591.00
dr. Goliat BUDI Rp. Rp.
763. 4-Jul-18 Victor SETYO 2082502 931283 HEACTIN 1
G3-6
Emanuel FEBRI 65,591.00 65,591.00
Rp. Rp.
764. 11-Jul-18 dr. 931497 HEACTIN
Hartono SUYONO 2083176 1
G 7 - 10 65,591.00 65,591.00
Rp. Rp.
17-Jul-18 dr. Nani IMRON
765. 2083798 931665 HEACTIN 1
Zumaroh ASTAIN G<3 65,591.00 65,591.00
dr. AGUS Rp. Rp.
766. 22-Jul-18 Artamty BUDI 2084219 931783 HEACTIN 1
G<3
Sastry A HARTO 65,591.00 65,591.00
Rp. Rp.
27-Jul-18 dr. Yenny WARSILA
767. 2084834 931916 HEACTIN 1
Haryono N G<3 65,591.00 65,591.00
JOKO Rp. Rp.
768. 30-Jul-18 dr. 32777 HEACTIN
Hartono WAHYUH 2085110 0
G3-6
ONO 0 65,591.00
dr. PASANG Rp. Rp.
ALI
769. 22-Jul-18 Artamty ROHMAN 2084221 931785 NGT 1
Sastry A DEWASA 64,732.00 64,732.00
dr. PASANG Rp. Rp.
770. 25-Jul-18 Artamty SAIDO 2084644 911649 NGT 1
Sastry A DEWASA 64,732.00 64,732.00
dr. Goliat HABIBUL RAWAT Rp. Rp.
771. 1-Jul-18 Victor 2082095 931162 LUKA 1
Emanuel ANSORI SEDANG 63,980.00 63,980.00
RAWAT Rp. Rp.
2-Jul-18 dr. Nani
772. Zumaroh DARSAM 2082169 61805 LUKA 1
SEDANG 63,980.00 63,980.00
dr. RAWAT Rp. Rp.
773. 2-Jul-18 Artamty SAMIAN 2082260 931218 LUKA 1
Sastry A SEDANG 63,980.00 63,980.00
dr. RAWAT Rp. Rp.
774. 3-Jul-18 Artamty BOKIR 2082263 931221 LUKA 1
Sastry A SEDANG 63,980.00 63,980.00
RAWAT Rp. Rp.
9-Jul-18 dr. Nani
775. Zumaroh ANIK 2082746 931334 LUKA 1
SEDANG 63,980.00 63,980.00
RAWAT Rp. Rp.
12-Jul-18 dr. Yenny
776. Haryono DAMPUN 2083317 931529 LUKA 1
SEDANG 63,980.00 63,980.00
RAWAT Rp. Rp.
777. 14-Jul-18 dr.
Hartono RUSNO 2083504 931583 LUKA 1
SEDANG 63,980.00 63,980.00
RAWAT Rp. Rp.
16-Jul-18 dr. Yenny
778. Haryono ANTO 2083640 931628 LUKA 1
SEDANG 63,980.00 63,980.00
RAWAT Rp. Rp.
20-Jul-18 dr. MAFTUKI
779. 2084158 931766 LUKA 1
Hartono N, MOCH SEDANG 63,980.00 63,980.00
dr. Goliat RAWAT Rp. Rp.
780. 21-Jul-18 Victor SARIPAN 2084211 931779 LUKA 1
Emanuel SEDANG 63,980.00 63,980.00
MARDIKA RAWAT Rp. Rp.
26-Jul-18 Haryono DIAN
dr. Yenny
781. NINGRU 2084734 931498 LUKA 1
SEDANG
M
63,980.00 63,980.00

PASANG
dr. Goliat SITI KATETER Rp. Rp.
782. 1-Jul-18 Victor 2082094 931069 ANAK 1
Emanuel ANIFAH DAN
DEWASA
59,398.00 59,398.00

PASANG
KATETER Rp. Rp.
2-Jul-18 dr. Nani LASMUNT 2082224
783. 931203 ANAK 1
Zumaroh IK DAN
DEWASA
59,398.00 59,398.00

PASANG
KATETER Rp. Rp.
2-Jul-18 dr. Yenny
784. Haryono KATREMI 2082249 929170 ANAK 1
DAN
DEWASA
59,398.00 59,398.00
PASANG
dr. KATETER Rp. Rp.
MURDIO
785. 4-Jul-18 Artamty 2082452 80659 ANAK 1
NO
Sastry A DAN
DEWASA
59,398.00 59,398.00

PASANG
dr. KATETER Rp. Rp.
786. 6-Jul-18 Artamty DARMAJI 2082677 931194 ANAK 1
Sastry A DAN
DEWASA
59,398.00 59,398.00

PASANG
KATETER Rp. Rp.
10-Jul-18 dr. Yenny
787. Haryono SUKIMAH 2083099 931474 ANAK 1
DAN
DEWASA
59,398.00 59,398.00

PASANG
dr. Goliat KATETER Rp. Rp.
788. 16-Jul-18 Victor SARILAH 2083550 931608 ANAK 1
Emanuel DAN
DEWASA
59,398.00 59,398.00

PASANG
Yenny NUR KATETER Rp. Rp.
789. 17-Jul-18 dr.
Haryono RAIHAN, 2083673 931639 ANAK 1
MUH. DAN
DEWASA
59,398.00 59,398.00

PASANG
KATETER Rp. Rp.
17-Jul-18 dr. Nani AHSAN
790. 2083780 908407 ANAK 1
Zumaroh ALWI DAN
DEWASA
59,398.00 59,398.00

PASANG
dr. Goliat SRI KATETER Rp. Rp.
791. 21-Jul-18 Victor 2084207 926233 ANAK 1
Emanuel RAHAYU DAN
DEWASA
59,398.00 59,398.00

PASANG
dr. KATETER Rp. Rp.
ALI
792. 22-Jul-18 Artamty ROHMAN 2084221 931785 ANAK 1
Sastry A DAN
DEWASA
59,398.00 59,398.00
dr. Goliat AFF Rp. Rp.
793. 21-Jul-18 Victor SARIPAN 2084211 931779 HEACTIN 1
Emanuel G 7 - 10 59,343.00 59,343.00
OBSERVA
dr. PASIEN Rp. Rp.
794. 1-Jul-18 Artamty LASADJI 2082111 914717 SI 1
RESIKO
Sastry A TINGGI
56,375.00 56,375.00

OBSERVA
dr. Goliat CAIRAN Rp. Rp.
795. 1-Jul-18 Victor MOLAN 2082114 931169 SI 1
ELEKTROL
Emanuel IT
56,375.00 56,375.00
OBSERVA
dr. Goliat KUSNING, PASIEN Rp. Rp.
796. 1-Jul-18 Victor 2082115 84994 SI 1
Emanuel HJ RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
797. 2-Jul-18 dr. Nani NYAMINA 2082217 931200 SI PASIEN Rp. 1
Rp.
Zumaroh H RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
2-Jul-18 dr. Yenny
798. 931206 SI
Haryono SUPARTIN 2082232 1
RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
2-Jul-18 dr. Nani LASMUNT 2082224
799. 931203 SI 1
Zumaroh IK RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
2-Jul-18 dr. Yenny
800. 929170 SI
Haryono KATREMI 2082249 1
RESIKO
TINGGI
56,375.00 56,375.00
AFF Rp. Rp.
801. 3-Jul-18 dr.
Hartono PANDI 2082386 931253 HEACTIN 1
G > 10 56,375.00 56,375.00
dr. AFF Rp. Rp.
IMAM
802. 4-Jul-18 Artamty 2082433 931265 HEACTIN 1
ROZIQIN
Sastry A G > 10 56,375.00 56,375.00
OBSERVA
dr. MURDIO PASIEN Rp. Rp.
803. 4-Jul-18 Artamty 2082452 80659 SI 1
NO RESIKO
Sastry A TINGGI
56,375.00 56,375.00
OBSERVA
dr. ENDANG PASIEN Rp. Rp.
804. 6-Jul-18 Artamty POERMIH 2082663 80248 SI 1
RESIKO
Sastry A ARSIH TINGGI
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
6-Jul-18 dr. Nani
805. 931357 SI
Zumaroh KASPAN 2082726 1
RESIKO
TINGGI
56,375.00 56,375.00
ALMEIRA OBSERVA
PASIEN Rp. Rp.
6-Jul-18 Zumaroh FITRIA
dr. Nani
806. 931358 SI
HADITAM 2082727 1
RESIKO
A TINGGI
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
6-Jul-18 dr. Nani ABDUL
807. 2082733 931360 SI 1
Zumaroh WAHAB RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
8-Jul-18 dr. Yenny
808. 931393 SI
Haryono SAMIRAH 2082813 1
RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
8-Jul-18 dr. Nani SUHARTI
809. 2082827 104002 SI 1
Zumaroh NIK RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
8-Jul-18 dr. Nani
810. 924169 SI
Zumaroh SUNOTO 2082826 1
RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
8-Jul-18 dr. DIANTINI
811. 2082834 931404 SI 1
Hartono K RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
9-Jul-18 dr. Nani MUSRIPA
812. 2082903 904014 SI 1
Zumaroh H RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
9-Jul-18 dr. AIO
813. 2082856 931409 SI 1
Hartono ARASI RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
9-Jul-18 dr. Yenny
814. 78230 SI
Haryono KASBU 2082941 1
RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
9-Jul-18 dr. Yenny
815. 919356 SI
Haryono MASJUKI 2082944 1
RESIKO
TINGGI
56,375.00 56,375.00
RAWAT
AGUNG
dr. LUKA Rp. Rp.
ADI
816. 10-Jul-18 Artamty 2082970 931442 GANGGR 1
PRASETY
Sastry A EN
O SEDANG
56,375.00 56,375.00
OBSERVA
RINI Rp. Rp.
817. 10-Jul-18 dr. 2078 SI
Hartono WAHYUNI 2083054 1
BALANCE
/RSMM CAIRAN
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
10-Jul-18 dr. Yenny SUTRISN
818. 2083096 931473 SI 1
Haryono O, TN RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
819. 11-Jul-18 dr. Yenny 931490 SI PASIEN Rp. Rp.
Haryono KUHARI 2083156 1
RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
11-Jul-18 dr. Nani
820. 931500 SI
Zumaroh SURI 2083190 1
RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
12-Jul-18 dr. Yenny
821. 931529 SI
Haryono DAMPUN 2083317 1
RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
Yenny PIPIT PASIEN Rp. Rp.
822. 12-Jul-18 dr. 68253 SI
Haryono YULIARI 2083359 1
RESIKO
ALIVIA TINGGI
56,375.00 56,375.00
OBSERVA
dr. SITI
PASIEN Rp. Rp.
823. 13-Jul-18 Artamty MARDIYA 2083440 930843 SI 1
RESIKO
Sastry A H TINGGI
56,375.00 56,375.00
CALYSTA OBSERVA
dr. QUEENIZ 2083450 PASIEN Rp. Rp.
824. 13-Jul-18 Artamty 921638 SI 1
A RESIKO
Sastry A ROHMAN TINGGI
56,375.00 56,375.00
OBSERVA
dr. PASIEN Rp. Rp.
825. 13-Jul-18 Artamty ROHLI 2083452 927283 SI 1
RESIKO
Sastry A TINGGI
56,375.00 56,375.00
OBSERVA
BY.NY.WI PASIEN Rp. Rp.
826. 14-Jul-18 dr. 931580 SI
Hartono NDA 2083499 1
RESIKO
KRISTIANI TINGGI
56,375.00 56,375.00
OBSERVA
dr. Goliat MUSTAIN, PASIEN Rp. Rp.
827. 14-Jul-18 Victor 2083453 106469 SI 1
Emanuel TN RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
dr. Goliat PASIEN Rp. Rp.
828. 14-Jul-18 Victor MUCHLIS 2083511 931586 SI 1
RESIKO
Emanuel TINGGI
56,375.00 56,375.00
OBSERVA
dr. Goliat PASIEN Rp. Rp.
829. 15-Jul-18 Victor SALEKAH 2083544 927868 SI 1
RESIKO
Emanuel TINGGI
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
16-Jul-18 dr. Yenny
830. 88759 SI
Haryono ASRIATIN 2083613 1
RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
dr. Goliat TURJIMA PASIEN Rp. Rp.
831. 16-Jul-18 Victor 2083667 931635 SI 1
Emanuel N RESIKO
TINGGI
56,375.00 56,375.00
ADHITAM OBSERVA
dr. Goliat A ELVAN 2083670 PASIEN Rp. Rp.
832. 16-Jul-18 Victor 931637 SI 1
SYAHREZ RESIKO
Emanuel A TINGGI
56,375.00 56,375.00
OBSERVA
NUR PASIEN Rp. Rp.
833. 17-Jul-18 dr. 931639 SI
Hartono RAIHAN, 2083673 1
RESIKO
MUH. TINGGI
56,375.00 56,375.00
PASANG Rp. Rp.
17-Jul-18 dr. Nani AHSAN
834. 2083780 908407 CERVICAL 1
Zumaroh ALWI COLAR 56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
17-Jul-18 dr. Nani AHSAN
835. Zumaroh ALWI 2083780 908407 SI
RESIKO 1
TINGGI
56,375.00 56,375.00

OBSERVA
Nani ENI CAIRAN Rp. Rp.
836. 17-Jul-18 dr. 931660 SI
Zumaroh SUSWAN 2083784 1
ELEKTROL
TI IT
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
837. 18-Jul-18 dr. 931684 SI
Hartono BIANTO 2083852 1
RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
RIZAL PASIEN Rp. Rp.
838. 18-Jul-18 dr. 931692 SI
Hartono RAMADH 2083877 1
RESIKO
AN, MOH TINGGI
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
18-Jul-18 dr. Yenny
839. 105378 SI
Haryono KASIYATI 2083905 1
RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
18-Jul-18 dr. Yenny
840. 931711 SI
Haryono KARMILA 2083912 1
RESIKO
TINGGI
56,375.00 56,375.00

OBSERVA
CAIRAN Rp. Rp.
18-Jul-18 dr. Yenny MUSTAIN, 2083913
841. 931712 SI 1
Haryono MOH ELEKTROL
IT
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
19-Jul-18 dr. Nani SITI NUR
842. 2084002 931734 SI 1
Zumaroh KHOLIFA RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
dr. SURATMA 2084034 PASIEN Rp. Rp.
843. 19-Jul-18 Artamty 931736 SI 1
N RESIKO
Sastry A TINGGI
56,375.00 56,375.00

BIYANTAR OBSERVA
dr. A AYOEM 2084040 PASIEN Rp. Rp.
844. 19-Jul-18 Artamty 931740 SI 1
RUMBAK RESIKO
Sastry A A TINGGI
56,375.00 56,375.00
OBSERVA
dr. YAYUK PASIEN Rp. Rp.
845. 19-Jul-18 Artamty SETYAWA 2084047 921332 SI 1
RESIKO
Sastry A TI TINGGI
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
20-Jul-18 dr. RUSDIAN
846. 2084068 931745 SI 1
Hartono TO RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
Yenny ARVIN,M PASIEN Rp. Rp.
847. 21-Jul-18 dr. 931772 SI
Haryono UHAMM 2084186 1
RESIKO
AD TINGGI
56,375.00 56,375.00
OBSERVA
Yenny RUDI PASIEN Rp. Rp.
848. 22-Jul-18 dr. 81145 SI
Haryono UTOMO/ 2084240 1
RESIKO
RSMM TINGGI
OBSERVA
Yenny RUDI
22-Jul-18 dr. 81145 SI PASIEN
848. Haryono UTOMO/ 2084240 1
RESIKO
RSMM TINGGI
56,375.00 56,375.00
OBSERVA
Yenny BY.NY.SITI PASIEN Rp. Rp.
849. 22-Jul-18 dr. 931792 SI
Haryono NUR 2084242 1
RESIKO
NIKMAH TINGGI
56,375.00 56,375.00
OBSERVA
dr. PASIEN Rp. Rp.
850. 23-Jul-18 Artamty SUKINAH 2084319 931812 SI 1
RESIKO
Sastry A TINGGI
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
851. 24-Jul-18 dr. 931834 SI
Hartono SARNO 2084390 1
RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
dr.
852. 24-Jul-18 Artamty MISRI 2084468 54848 SI PASIEN Rp. 1
Rp.
RESIKO
Sastry A TINGGI
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
24-Jul-18 dr. Yenny
853. 931850 SI
Haryono NURHADI 2084503 1
RESIKO
TINGGI
56,375.00 56,375.00
OBSERVA
PASIEN Rp. Rp.
854. 24-Jul-18 dr. 931856 SI
Hartono HASANAH 2084523 1
RESIKO
TINGGI
56,375.00 56,375.00
dr. Rp. Rp.
855. 25-Jul-18 Artamty SAIDO 2084644 911649 SONDE 1
Sastry A 56,375.00 56,375.00

RAWAT
LUKA
FARIS Rp. Rp.
856. 26-Jul-18 dr. 931893 COMBUS
Hartono ARDIANSY 2084708 1
TIO
AH GRADE II
BESAR
56,375.00 56,375.00
OBSERVA
dr. Goliat EKA PASIEN Rp. Rp.
857. 26-Jul-18 Victor VIVILIA 2084767 931903 SI 1
RESIKO
Emanuel SUVITA TINGGI
56,375.00 56,375.00
OBSERVA
dr. PASIEN Rp. Rp.
858. 27-Jul-18 Artamty NOVI 2084868 931925 SI 1
RESIKO
Sastry A TINGGI
56,375.00 56,375.00
OBSERVA
dr. LAMSRIYA 2084871 PASIEN Rp. Rp.
859. 27-Jul-18 Artamty 931928 SI 1
TI RESIKO
Sastry A TINGGI
OBSERVA
dr. LAMSRIYA 2084871 931928 SI PASIEN
859. 27-Jul-18 Artamty 1
TI RESIKO
Sastry A TINGGI
56,375.00 56,375.00
MALAKH OBSERVA
dr. Rp. Rp.
JOY
860. 27-Jul-18 Artamty 2084877 104824 SI 1
BARAK BALANCE
Sastry A SUCIPTO CAIRAN
56,375.00 56,375.00
OBSERVA
dr. PASIEN Rp. Rp.
861. 27-Jul-18 Artamty SUWARTI 2084882 931934 SI 1
RESIKO
Sastry A TINGGI
56,375.00 56,375.00
OBSERVA
dr. MIMI PASIEN Rp. Rp.
862. 27-Jul-18 Artamty WAHIDA 2084884 931936 SI 1
RESIKO
Sastry A H TINGGI
56,375.00 56,375.00
dr. Goliat ABDUL AFF Rp. Rp.
863. 29-Jul-18 Victor LATIF 2084964 931961 HEACTIN 1
Emanuel HUSAINI G > 10 56,375.00 56,375.00
OBSERVA
dr. Goliat PASIEN Rp. Rp.
864. 29-Jul-18 Victor JIDIN 2084968 931963 SI 0
RESIKO
Emanuel TINGGI
0 56,375.00
OBSERVA
dr. Goliat LILIANA,N Rp. Rp.
865. 29-Jul-18 Victor 2084977 931967 SI 0
Emanuel Y BALANCE
CAIRAN
0 56,375.00
OBSERVA
dr. Goliat AZRINA PASIEN Rp. Rp.
866. 29-Jul-18 Victor LAVENIA 2084978 931506 SI 0
RESIKO
Emanuel SHAZFA TINGGI
0 56,375.00
PUGUH OBSERVA
PASIEN Rp. Rp.
30-Jul-18 Hartono BUDI
dr.
867. 2085109 932001 SI 0
SANTOSO RESIKO
,IR TINGGI
0 56,375.00
dr. OBSERVA
PASIEN Rp. Rp.
868. 30-Jul-18 Hartono 932003 SI
Margono, SUKRAN 2085114 0
RESIKO
Sp.Rad. TINGGI
0 56,375.00
OBSERVA
PASIEN Rp. Rp.
869. 30-Jul-18 dr. 920744 SI
Hartono SUNTARI 2085115 0
RESIKO
TINGGI
0 56,375.00
OBSERVA
PASIEN Rp. Rp.
30-Jul-18 dr. KASMIJA
870. 2085120 932006 SI 0
Hartono N RESIKO
TINGGI
0 56,375.00
RAMA OBSERVA
PASIEN Rp. Rp.
30-Jul-18 Hartono ADI
dr.
871. 2085124 30792 SI 0
NUGROH RESIKO
O TINGGI
0 56,375.00
OBSERVA
dr. Goliat SARJI Rp. Rp.
872. 1-Jul-18 Victor 2082113 85610 SI 1
Emanuel GUNO PASIEN/H
R
52,714.00 52,714.00
OBSERVA
TEGUH Rp. Rp.
873. 1-Jul-18 dr. 931174 SI
Hartono SLAMET 2082127 1
PASIEN/H
WIDODO R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
2-Jul-18 dr. Nani
874. 931178 SI
Zumaroh WINDA 2082146 1
PASIEN/H
R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
2-Jul-18 dr. Nani SUWARNI 2082162
875. 931183 SI 1
Zumaroh ,NY PASIEN/H
R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
2-Jul-18 dr. Nani
876. 61805 SI
Zumaroh DARSAM 2082169 1
PASIEN/H
R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
2-Jul-18 dr. Nani
877. 77582 SI
Zumaroh RUKMINI 2082181 1
PASIEN/H
R
52,714.00 52,714.00
OBSERVA
Nani SANTI Rp. Rp.
878. 2-Jul-18 dr. RATNASA 2082188 931192 SI 1
Zumaroh RI PASIEN/H
R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
2-Jul-18 dr. Yenny
879. 901182 SI
Haryono TARMI 2082193 1
PASIEN/H
R
52,714.00 52,714.00
OBSERVA
Nani MASROYA Rp. Rp.
880. 2-Jul-18 dr. 76 SI
Zumaroh NA/RSM 2082201 1
PASIEN/H
M R
52,714.00 52,714.00
OBSERVA
Nani HADI Rp. Rp.
881. 2-Jul-18 dr. 931195 SI
Zumaroh PRAYITN 2082204 1
PASIEN/H
O R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
882. 3-Jul-18 dr. 79079 SI
Hartono CANCOKO 2082387 1
PASIEN/H
R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
3-Jul-18 dr. IIS
883. 2082389 931254 SI 1
Hartono ARISKA PASIEN/H
R
52,714.00 52,714.00
DUROTUL OBSERVA
Rp. Rp.
3-Jul-18 Hartono HUSNA
dr.
884. 2082392 931255 SI 1
VITA PASIEN/H
SANTICA R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
4-Jul-18 dr. Yenny KUNTIRA
885. 2082486 931278 SI 1
Haryono H PASIEN/H
R
52,714.00 52,714.00
OBSERVA
Yenny KANA Rp. Rp.
886. 4-Jul-18 dr. 931280 SI
Haryono FATHIN 2082495 1
PASIEN/H
ROBIHAH R
52,714.00 52,714.00
OBSERVA
dr. Goliat MUTIATU Rp. Rp.
887. 5-Jul-18 Victor 2082522 926993 SI 1
Emanuel N PASIEN/H
R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
5-Jul-18 dr. Nani
888. 931292 SI
Zumaroh NASORI 2082536 1
PASIEN/H
R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
5-Jul-18 dr. Nani ALVI
889. 2082573 931309 SI 1
Zumaroh SAHRIN PASIEN/H
R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
5-Jul-18 dr. Nani AZAM AL- 2082562
890. 931303 SI 1
Zumaroh HABSYI PASIEN/H
R
52,714.00 52,714.00
OBSERVA
Nani PUTRI Rp. Rp.
891. 5-Jul-18 dr. 931307 SI
Zumaroh WIDAYAN 2082568 1
PASIEN/H
TI R
52,714.00 52,714.00
ALYA OBSERVA
Rp. Rp.
5-Jul-18 Zumaroh NAUFA
dr. Nani
892. 2082581 107058 SI 1
FARZANI, PASIEN/H
AN R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
5-Jul-18 dr. Nani
893. 931317 SI
Zumaroh SRIPAH 2082601 1
PASIEN/H
R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
5-Jul-18 dr. Nani KASBULL
894. 2082605 926458 SI 1
Zumaroh AH S,H PASIEN/H
R
52,714.00 52,714.00
OBSERVA
dr. Rp. Rp.
895. 5-Jul-18 Artamty JAELANI 2082638 931324 SI 1
PASIEN/H
Sastry A R
52,714.00 52,714.00
OBSERVA
dr. RENALDY Rp. Rp.
896. 6-Jul-18 Artamty ARDIAN 2082678 931337 SI 1
PASIEN/H
Sastry A SAPUTRA R
52,714.00 52,714.00
OBSERVA
dr. Rp. Rp.
897. 6-Jul-18 Artamty KARSILAN 2082704 907653 SI 1
PASIEN/H
Sastry A R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
6-Jul-18 dr. Nani INDRI
898. 2082723 931355 SI 1
Zumaroh JATUN R PASIEN/H
R
52,714.00 52,714.00
OBSERVA
dr. Goliat DIGYO Rp. Rp.
899. 6-Jul-18 Victor 2082739 929777 SI 1
Emanuel WINARSO PASIEN/H
R
52,714.00 52,714.00
OBSERVA
dr. Goliat Rp. Rp.
900. 7-Jul-18 Victor LASMI,NY 2082740 910296 SI 1
PASIEN/H
Emanuel R
52,714.00 52,714.00
OBSERVA
DHANIEL Rp. Rp.
901. 8-Jul-18 dr. 931403 SI
Hartono BAYU 2082833 1
PASIEN/H
IRAWAN R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
902. 9-Jul-18 dr. 931406 SI
Hartono KASNIR 2082836 1
PASIEN/H
R
52,714.00 52,714.00
OBSERVA
KHUSNUL Rp. Rp.
903. 9-Jul-18 dr. 924586 SI
Hartono KHOTIMA 2082846 1
PASIEN/H
H R
52,714.00 52,714.00
HANIF OBSERVA
Rp. Rp.
9-Jul-18 Hartono AHZHA,M
dr.
904. 928615 SI
UHAMM 2082847 1
PASIEN/H
AD R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
9-Jul-18 dr. Yenny
905. 64042 SI
Haryono TORAN 2082927 1
PASIEN/H
R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
9-Jul-18 dr. Yenny
906. 929170 SI
Haryono KATREMI 2082929 1
PASIEN/H
R
52,714.00 52,714.00
OBSERVA
Yenny NAJWA Rp. Rp.
907. 9-Jul-18 dr. 931436 SI
Haryono KHAIRA 2082937 1
PASIEN/H
WILDHA R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
9-Jul-18 dr. Yenny
908. 931437 SI
Haryono TARSIH 2082938 1
PASIEN/H
R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
10-Jul-18 dr. Yenny LASMINT
909. 2083083 931102 SI 1
Haryono O, TN PASIEN/H
R
52,714.00 52,714.00
OBSERVA
dr. Goliat DESY Rp. Rp.
910. 10-Jul-18 Victor KURNIAW 2083109 931479 SI 1
PASIEN/H
Emanuel ATI R
52,714.00 52,714.00
OBSERVA
dr. Goliat NANIK Rp. Rp.
911. 10-Jul-18 Victor YULIANTI 2083108 930365 SI 1
PASIEN/H
Emanuel S R
52,714.00 52,714.00
OBSERVA
dr. Goliat Rp. Rp.
912. 10-Jul-18 Victor SUMIJAH 2083107 931478 SI 1
PASIEN/H
Emanuel R
52,714.00 52,714.00
NURUL OBSERVA
dr. Goliat Rp. Rp.
SITI
913. 11-Jul-18 Victor 2083106 931477 SI 1
OKTAVIA PASIEN/H
Emanuel NI R
52,714.00 52,714.00
OBSERVA
dr. Goliat ENI NUR Rp. Rp.
914. 10-Jul-18 Victor 2083104 931472 SI 1
Emanuel FARIDAH PASIEN/H
R
52,714.00 52,714.00
OBSERVA
dr. Goliat Rp. Rp.
915. 11-Jul-18 Victor SUPARMI 2083103 26851 SI 1
PASIEN/H
Emanuel R
52,714.00 52,714.00

FAUQI OBSERVA
dr. Goliat ALQOHAR Rp. Rp.
916. 11-Jul-18 Victor , 2083111 931480 SI 1
PASIEN/H
Emanuel MOHAM R
AD
52,714.00 52,714.00
OBSERVA
dr. Goliat RAVI Rp. Rp.
917. 11-Jul-18 Victor PUTERA 2083112 922920 SI 1
PASIEN/H
Emanuel PRASETYA R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
918. 11-Jul-18 dr. Yenny KUSNAN, 2083203 911166 SI 1
Haryono M PASIEN/H
R
52,714.00 52,714.00
ROIIQOH OBSERVA
Rp. Rp.
11-Jul-18 Hartono HABIBAT
dr.
919. 2083209 72057 SI 1
UL ASMA PASIEN/H
ALIFAH R
52,714.00 52,714.00
OBSERVA
AZRINA Rp. Rp.
920. 11-Jul-18 dr. 931506 SI
Hartono LAVENIA 2083210 1
PASIEN/H
SHAZFA R
52,714.00 52,714.00

ABHAN
MAULAN OBSERVA
Rp. Rp.
11-Jul-18 Hartono A
dr.
921. 2083215 105537 SI 1
ADHYAST PASIEN/H
HA R
BUKHORI
52,714.00 52,714.00
OBSERVA
dr. Rp. Rp.
922. 12-Jul-18 Artamty DURAJI 2083226 931510 SI
PASIEN/H 1
Sastry A R
52,714.00 52,714.00
OBSERVA
dr. Goliat DHIMAS Rp. Rp.
923. 14-Jul-18 Victor AKBAR 2083514 95332 SI 1
PASIEN/H
Emanuel ARIYADI R
52,714.00 52,714.00
SRI OBSERVA
dr. Goliat Rp. Rp.
WAHYUNI 2083520
924. 14-Jul-18 Victor 931591 SI 1
INDAH PASIEN/H
Emanuel SARI R
52,714.00 52,714.00
OBSERVA
dr. Goliat Rp. Rp.
925. 15-Jul-18 Victor LASRUN 2083548 925071 SI 1
PASIEN/H
Emanuel R
52,714.00 52,714.00
OBSERVA
dr. DARJITO Rp. Rp.
926. 15-Jul-18 Artamty HADI 2083551 931609 SI 1
PASIEN/H
Sastry A SUCIPTO R
52,714.00 52,714.00
OBSERVA
dr. Goliat Rp. Rp.
927. 16-Jul-18 Victor SARILAH 2083550 931608 SI 1
PASIEN/H
Emanuel R
52,714.00 52,714.00
PEGGI OBSERVA
dr. Rp. Rp.
ARIE
928. 16-Jul-18 Artamty 2083552 931610 SI 1
ZULIA PASIEN/H
Sastry A AZIZ R
52,714.00 52,714.00

RIZKHA OBSERVA
dr. DIAH Rp. Rp.
929. 17-Jul-18 Artamty PUSPITA 2083818 906919 SI 1
PASIEN/H
Sastry A NINGRU R
M
52,714.00 52,714.00
OBSERVA
dr. Rp. Rp.
SULISWA
930. 17-Jul-18 Artamty 2083820 931675 SI 1
NTO PASIEN/H
Sastry A R
52,714.00 52,714.00
OBSERVA
dr. Rp. Rp.
PURNOM 2083819
931. 17-Jul-18 Artamty 900871 SI 1
O PASIEN/H
Sastry A R
52,714.00 52,714.00

SHANDY
DWISAKS OBSERVA
dr. Rp. Rp.
ANA
932. 17-Jul-18 Artamty 2083817 931674 SI 1
ADITYA PASIEN/H
Sastry A CANDRAK R
USUMA
52,714.00 52,714.00
OBSERVA
dr. Rp. Rp.
ADAM
933. 17-Jul-18 Artamty 2083816 931673 SI 1
RAHMAN PASIEN/H
Sastry A R
52,714.00 52,714.00
OBSERVA
Nani FADHIL Rp. Rp.
934. 17-Jul-18 dr. 915074 SI
Zumaroh ABDILLAH 2083812 1
PASIEN/H
,MUH R
52,714.00 52,714.00
ANDREE OBSERVA
Nani NICO Rp. Rp.
935. 17-Jul-18 dr. 67315 SI
Zumaroh AUSHAF, 2083809 1
PASIEN/H
MUHAM R
MAD
52,714.00 52,714.00
OBSERVA
Nani YUSUF Rp. Rp.
936. 17-Jul-18 dr. 105681 SI
Zumaroh ROMADH 2083802 1
PASIEN/H
ON,MOH R
52,714.00 52,714.00
OBSERVA
dr. Rp. Rp.
937. 18-Jul-18 Artamty DARSIPAH 2083832 927232 SI 1
PASIEN/H
Sastry A R
52,714.00 52,714.00
OBSERVA
dr. ERICK Rp. Rp.
938. 18-Jul-18 Artamty FEBRIANS 2083834 931678 SI 1
PASIEN/H
Sastry A YAH R
52,714.00 52,714.00
MISHEL OBSERVA
Rp. Rp.
18-Jul-18 Hartono SALSA
dr.
939. 931695 SI
OKTAQUE 2083890 1
PASIEN/H
EN R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
18-Jul-18 dr. KHOIRUL
940. 2083899 931703 SI 1
Hartono IKHSAN PASIEN/H
R
52,714.00 52,714.00
OBSERVA
Yenny BY.NY.SITI Rp. Rp.
941. 18-Jul-18 dr. 931707 SI
Haryono MAHMU 2083903 1
PASIEN/H
DLOTIN R
52,714.00 52,714.00
ULFA OBSERVA
Rp. Rp.
18-Jul-18 Haryono MIMA
dr. Yenny
942. 931709 SI
FIMAULID 2083910 1
PASIEN/H
YA R
52,714.00 52,714.00
OBSERVA
RAISYA Rp. Rp.
943. 20-Jul-18 dr. 931765 SI
Hartono PUTRI 2084157 1
PASIEN/H
CAHYANI R
52,714.00 52,714.00
SUWADA OBSERVA
dr. Goliat Rp. Rp.
NA JAFIS
944. 21-Jul-18 Victor 2084214 904212 SI 1
KUSTARA PASIEN/H
Emanuel HARJA R
52,714.00 52,714.00
OBSERVA
dr. Rp. Rp.
IMAM
945. 21-Jul-18 Artamty 2084216 930270 SI 1
HANAFI PASIEN/H
Sastry A R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
22-Jul-18 dr. Nani
946. 931786 SI
Zumaroh KUNTARI 2084227 1
PASIEN/H
R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
22-Jul-18 dr. Nani SUMARLI
947. 2084233 78496 SI 1
Zumaroh K PASIEN/H
R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
22-Jul-18 dr. Nani
948. 931791 SI
Zumaroh WASRI 2084235 1
PASIEN/H
R
52,714.00 52,714.00
CHANIF OBSERVA
Rp. Rp.
22-Jul-18 Hartono RASYHID
dr.
949. 927874 SI
INDRAWA 2084249 1
PASIEN/H
N R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
23-Jul-18 dr. FATMAW
950. 2084250 931796 SI 1
Hartono ATI PASIEN/H
R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
23-Jul-18 dr. Yenny
951. 105784 SI
Haryono RASIM 2084253 1
PASIEN/H
R
52,714.00 52,714.00
NOVIA OBSERVA
Rp. Rp.
23-Jul-18 Hartono RUSDIAN
dr.
952. 2084372 931833 SI 1
A PASIEN/H
PAHLEVI R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
23-Jul-18 dr. ASMORO
953. 2084370 931832 SI 1
Hartono KANDIK PASIEN/H
R
52,714.00 52,714.00
RIFAYA OBSERVA
Rp. Rp.
23-Jul-18 Hartono NOUREN
dr.
954. 2084369 930627 SI 1
DWI PASIEN/H
FALISHA R
52,714.00 52,714.00
OBSERVA
WIDA Rp. Rp.
955. 23-Jul-18 dr. 914703 SI
Hartono WATI 2084368 1
PASIEN/H
NINGSIH R
52,714.00 52,714.00

RACHMA
NDA OBSERVA
Rp. Rp.
24-Jul-18 Hartono AS'AD
dr.
956. 2084391 931835 SI 1
YATIM PASIEN/H
UBAIDILL R
AH
NDA OBSERVA
24-Jul-18 Hartono AS'AD
dr.
956. 2084391 931835 SI 1
YATIM PASIEN/H
UBAIDILL R
AH
52,714.00 52,714.00
OBSERVA
dr. Rp. Rp.
KUSPARTI 2084478
957. 24-Jul-18 Artamty 20606 SI 1
NI PASIEN/H
Sastry A R
52,714.00 52,714.00
OBSERVA
Rp. Rp.
958. 24-Jul-18 dr. 931857 SI
Hartono KASIRAN 2084525 1
PASIEN/H
R
52,714.00 52,714.00
AQILAH OBSERVA
dr. Rp. Rp.
NAJWA
959. 25-Jul-18 Artamty 2084643 100017 SI 1
NURUL PASIEN/H
Sastry A JANNAH R
52,714.00 52,714.00
OBSERVA
dr. Rp. Rp.
960. 26-Jul-18 Artamty NURHIDA 2084668 931878 SI 1
YATI PASIEN/H
Sastry A R
52,714.00 52,714.00
CANDRIK OBSERVA
dr. Rp. Rp.
A AFLAH
961. 27-Jul-18 Artamty 2084874 931929 SI 1
AMANUL PASIEN/H
Sastry A LOH R
52,714.00 52,714.00
OBSERVA
dr. Rp. Rp.
WAHYU
962. 27-Jul-18 Artamty 2084880 931932 SI 1
UTOMO PASIEN/H
Sastry A R
52,714.00 52,714.00
OBSERVA
dr. Rp. Rp.
MAULAN
963. 27-Jul-18 Artamty 2084883 931935 SI 1
A PASIEN/H
Sastry A R
52,714.00 52,714.00
OBSERVA
dr. Goliat WARSINA Rp. Rp.
964. 27-Jul-18 Victor 2084886 931938 SI 1
Emanuel H PASIEN/H
R
52,714.00 52,714.00
OBSERVA
dr. Goliat Rp. Rp.
965. 28-Jul-18 Victor JUWARI 2084901 924193 SI 1
PASIEN/H
Emanuel R
52,714.00 52,714.00
RAVIEL OBSERVA
Rp. Rp.
29-Jul-18 Zumaroh HITO
dr. Nani
966. 2084984 931971 SI 0
PUTRA PASIEN/H
AHMAD R
0 52,714.00
OBSERVA
dr. Goliat SRI Rp. Rp.
967. 29-Jul-18 Victor WINDART 2084983 931970 SI 0
PASIEN/H
Emanuel I R
0 52,714.00
OBSERVA
Rp. Rp.
29-Jul-18 dr. Nani INDASAH
968. 2084986 931973 SI 0
Zumaroh RR PASIEN/H
R
0 52,714.00
OBSERVA
Rp. Rp.
30-Jul-18 dr. Nani
969. 927621 SI
Zumaroh ANJURI 2084987 0
PASIEN/H
R
0 52,714.00
OBSERVA
Nani REZHADIT Rp. Rp.
970. 30-Jul-18 dr. 78258 SI
Zumaroh YA TARIQ 2084988 0
PASIEN/H
AZAM R
0 52,714.00
OBSERVA
Rp. Rp.
30-Jul-18 dr. Nani
971. 931974 SI
Zumaroh TUMISO 2085004 0
PASIEN/H
R
0 52,714.00
OBSERVA
Rp. Rp.
30-Jul-18 dr. Nani NUR
972. 2085006 931975 SI 0
Zumaroh KHOZIN PASIEN/H
R
0 52,714.00

YUSUF
EKA OBSERVA
Rp. Rp.
30-Jul-18 Hartono ARDIANSY
dr.
973. 61507 SI
AH,MOC 2085097 0
PASIEN/H
HAMMA R
D
0 52,714.00
OBSERVA
Rp. Rp.
974. 30-Jul-18 dr. 4159 SI
Hartono RASTUM 2085107 0
PASIEN/H
R
0 52,714.00
dr. Goliat LILIK ASUHAN Rp. Rp.
975. 1-Jul-18 Victor FARIDATI 2082097 910867 KEPERAW 1
Emanuel N ATAN 50,000.00 50,000.00
dr. Goliat HABIBUL ASUHAN Rp. Rp.
976. 1-Jul-18 Victor 2082095 931162 KEPERAW 1
Emanuel ANSORI ATAN 50,000.00 50,000.00

dr. Goliat BAGAS ASUHAN Rp. Rp.


977. 1-Jul-18 Victor ADITYA 2082098 931164 KEPERAW 1
Emanuel PRATAMA ATAN
50,000.00 50,000.00
dr. LILIK ASUHAN Rp. Rp.
978. 1-Jul-18 Artamty FARIDATI 2082104 910867 KEPERAW 1
Sastry A N ATAN 50,000.00 50,000.00
dr. NURMA ASUHAN Rp. Rp.
979. 1-Jul-18 Artamty MUFARID 2082107 923831 KEPERAW 1
Sastry A A ATAN
dr. NURMA ASUHAN
979. 1-Jul-18 Artamty MUFARID 2082107 923831 KEPERAW 1
Sastry A A ATAN 50,000.00 50,000.00
ASUHAN Rp. Rp.
1-Jul-18 dr. SAIFUL
980. 2082126 931173 KEPERAW 1
Hartono MUCHLIS ATAN 50,000.00 50,000.00
ASUHAN Rp. Rp.
2-Jul-18 dr. Yenny
981. Haryono FATIMA 2082252 931214 KEPERAW 1
ATAN 50,000.00 50,000.00
dr. Goliat SITI ASUHAN Rp. Rp.
982. 7-Jul-18 Victor RONDIYA 2082757 931367 KEPERAW 1
Emanuel H ATAN 50,000.00 50,000.00
WINDI ASUHAN Rp. Rp.
983. 7-Jul-18 Zumaroh RAHMA
dr. Nani
NUARINA 2082771 931371 KEPERAW 1
ATAN
WATI
50,000.00 50,000.00
dr. Goliat YESSI ASUHAN Rp. Rp.
984. 7-Jul-18 Victor PHARLES 2082787 931380 KEPERAW 1
Emanuel TINE ATAN 50,000.00 50,000.00
dr. Goliat ZAINUL ASUHAN Rp. Rp.
985. 8-Jul-18 Victor 2082798 931386 KEPERAW 1
Emanuel ARIFIN ATAN 50,000.00 50,000.00

FARREL ASUHAN Rp. Rp.


8-Jul-18 Zumaroh OKTAVIA
dr. Nani
986. 2082817 931395 KEPERAW 1
N ATAN
SANTOSO
50,000.00 50,000.00
ASUHAN Rp. Rp.
987. 10-Jul-18 dr.
Hartono PRIYANTO 2083069 931465 KEPERAW 1
ATAN 50,000.00 50,000.00
ASUHAN Rp. Rp.
11-Jul-18 dr. Yenny ALI
988. 2083098 15656 KEPERAW 1
Haryono AGUNG ATAN 50,000.00 50,000.00
SULTHAN
dr. ASUHAN Rp. Rp.
ANOM
989. 11-Jul-18 Artamty PUJANGG 2083216 931508 KEPERAW 1
Sastry A ATAN
A ALAM
50,000.00 50,000.00

dr. AULIA ASUHAN Rp. Rp.


990. 12-Jul-18 Artamty RAFA ARI 2083236 931513 KEPERAW 1
Sastry A PRATAMA ATAN
50,000.00 50,000.00
TEGUH ASUHAN Rp. Rp.
12-Jul-18 Haryono IBNU
dr. Yenny
991. 2083305 34066 KEPERAW 1
SUNGKO ATAN
WO
50,000.00 50,000.00

Yenny PIPIT ASUHAN Rp. Rp.


992. 12-Jul-18 dr.
Haryono YULIARI 2083359 68253 KEPERAW 1
ALIVIA ATAN
Yenny PIPIT ASUHAN
992. 12-Jul-18 dr.
Haryono YULIARI 2083359 68253 KEPERAW 1
ALIVIA ATAN 50,000.00 50,000.00
dr. Goliat DIANA ASUHAN Rp. Rp.
993. 14-Jul-18 Victor MAYASAR 2083480 931572 KEPERAW 1
Emanuel I ATAN 50,000.00 50,000.00
dr. ASUHAN Rp. Rp.
994. 15-Jul-18 Artamty INDAH 2083527 931597 KEPERAW 1
Sastry A ATAN 50,000.00 50,000.00
dr. ASUHAN Rp. Rp.
995. 15-Jul-18 Artamty SARTI 2083528 931598 KEPERAW 1
Sastry A ATAN 50,000.00 50,000.00
WULAN ASUHAN Rp. Rp.
996. 15-Jul-18 Hartono EKA
dr.
NURJANA 2083532 931601 KEPERAW 1
ATAN
H
50,000.00 50,000.00
dr. Goliat ASUHAN Rp. Rp.
997. 16-Jul-18 Victor SARILAH 2083550 931608 KEPERAW 1
Emanuel ATAN 50,000.00 50,000.00
ASUHAN Rp. Rp.
16-Jul-18 dr. Yenny LIAN NUR 2083623
998. 906782 KEPERAW 1
Haryono AFIFAH ATAN 50,000.00 50,000.00
dr. Goliat SITI ASUHAN Rp. Rp.
999. 16-Jul-18 Victor 2083656 30755 KEPERAW 1
Emanuel KHOLIFAH ATAN 50,000.00 50,000.00
ALYA ASUHAN Rp. Rp.
17-Jul-18 Hartono NABILA
dr.
1000. 2083681 914296 KEPERAW 1
DAMAYA ATAN
NTI
50,000.00 50,000.00
RATNA ASUHAN Rp. Rp.
17-Jul-18 Haryono DWI
dr. Yenny
1001. SETYORIN 2083770 81758 KEPERAW 1
ATAN
I
50,000.00 50,000.00
ASUHAN Rp. Rp.
17-Jul-18 dr. Nani IMRON
1002. 2083798 931665 KEPERAW 1
Zumaroh ASTAIN ATAN 50,000.00 50,000.00

Nani SLAMET ASUHAN Rp. Rp.


1003. 17-Jul-18 dr.
Zumaroh OPERA 2083795 931664 KEPERAW 1
SIAGA ATAN 50,000.00 50,000.00
ASUHAN Rp. Rp.
1004. 18-Jul-18 dr.
Hartono BIANTO 2083852 931684 KEPERAW 1
ATAN 50,000.00 50,000.00
RIZAL ASUHAN Rp. Rp.
1005. 18-Jul-18 dr.
Hartono RAMADH 2083877 931692 KEPERAW 1
AN, MOH ATAN 50,000.00 50,000.00
NUR AZIZ ASUHAN Rp. Rp.
1006. 20-Jul-18 dr.
Hartono ANDRIAW 2084076 924791 KEPERAW 1
AN,MUH ATAN
50,000.00 50,000.00
dr. Goliat DWI ASUHAN Rp. Rp.
1007. 21-Jul-18 Victor INDRA 2084170 40479 KEPERAW 1
Emanuel YUNIARTI ATAN 50,000.00 50,000.00
dr. Goliat ASUHAN Rp. Rp.
1008. 21-Jul-18 Victor SARIPAN 2084211 931779 KEPERAW 1
Emanuel ATAN 50,000.00 50,000.00
dr. ASUHAN Rp. Rp.
LESTARI
1009. 21-Jul-18 Artamty 2084215 931780 KEPERAW 1
NINGSIH
Sastry A ATAN 50,000.00 50,000.00
dr. ASUHAN Rp. Rp.
1010. 21-Jul-18 Artamty SUGIONO 2084217 931781 KEPERAW 1
Sastry A ATAN 50,000.00 50,000.00
dr. AGUS ASUHAN Rp. Rp.
1011. 22-Jul-18 Artamty BUDI 2084219 931783 KEPERAW 1
Sastry A HARTO ATAN 50,000.00 50,000.00
dr. TARMI ASUHAN Rp. Rp.
1012. 22-Jul-18 Artamty ADI 2084220 931784 KEPERAW 1
Sastry A ASTUTIK ATAN 50,000.00 50,000.00

Nani NAUFAL ASUHAN Rp. Rp.


1013. 22-Jul-18 dr.
Zumaroh AQIL DWI 2084231 931789 KEPERAW 1
SAPUTRA ATAN 50,000.00 50,000.00

Yenny RUDI ASUHAN Rp. Rp.


1014. 22-Jul-18 dr.
Haryono UTOMO/ 2084240 81145 KEPERAW 1
RSMM ATAN 50,000.00 50,000.00
ASUHAN Rp. Rp.
22-Jul-18 dr. Yenny
1015. Haryono GIMAH 2084244 931793 KEPERAW 1
ATAN 50,000.00 50,000.00
ASUHAN Rp. Rp.
23-Jul-18 dr. Nani FAHMI
1016. 2084264 931800 KEPERAW 1
Zumaroh DAWUD ATAN 50,000.00 50,000.00

FATHAN
dr. DWI ASUHAN Rp. Rp.
1017. 23-Jul-18 Artamty PRAMAN 2084321 917038 KEPERAW 1
Sastry A A AL ATAN
RAZZAQ
50,000.00 50,000.00
YUSUF ASUHAN Rp. Rp.
23-Jul-18 Haryono BINTANG
dr. Yenny
1018. MAHARDI 2084366 79781 KEPERAW 1
ATAN
KA
50,000.00 50,000.00
ASUHAN Rp. Rp.
25-Jul-18 dr. AGOES
1019. 2084534 931859 KEPERAW 1
Hartono SETIONO ATAN
ASUHAN
25-Jul-18 dr. AGOES
1019. 2084534 931859 KEPERAW 1
Hartono SETIONO ATAN 50,000.00 50,000.00
ASUHAN Rp. Rp.
25-Jul-18 dr. Yenny
1020. Haryono SUKISWO 2084620 931871 KEPERAW 1
ATAN 50,000.00 50,000.00
dr. Goliat ASUHAN Rp. Rp.
1021. 25-Jul-18 Victor MARIYAM 2084623 931872 KEPERAW 1
Emanuel ATAN 50,000.00 50,000.00
ASUHAN Rp. Rp.
27-Jul-18 dr. NAZIIHA
1022. Hartono FANDYA A 2084790 73032 KEPERAW 1
ATAN 50,000.00 50,000.00
dr. Goliat MASLACH ASUHAN Rp. Rp.
1023. 28-Jul-18 Victor 2084888 931939 KEPERAW 1
Emanuel ATUN ATAN 50,000.00 50,000.00
dr. Goliat DANIL ASUHAN Rp. Rp.
1024. 28-Jul-18 Victor PUTRA 2084902 925704 KEPERAW 1
Emanuel RAHARJO ATAN 50,000.00 50,000.00
NANIK ASUHAN Rp. Rp.
28-Jul-18 Hartono DWI
dr.
1025. NURYANT 2084954 931957 KEPERAW 1
ATAN
I
50,000.00 50,000.00
dr. Goliat ASUHAN Rp. Rp.
1026. 29-Jul-18 Victor TRISNO 2084959 931959 KEPERAW 1
Emanuel ATAN 50,000.00 50,000.00
dr. Goliat ABDUL ASUHAN Rp. Rp.
1027. 29-Jul-18 Victor LATIF 2084964 931961 KEPERAW 1
Emanuel HUSAINI ATAN 50,000.00 50,000.00

dr. Goliat BAMBAN ASUHAN Rp. Rp.


1028. 29-Jul-18 Victor G 2084966 931962 KEPERAW 1
Emanuel BUDIONO ATAN
50,000.00 50,000.00
dr. Goliat UCIK ASUHAN Rp. Rp.
1029. 29-Jul-18 Victor 2084970 931964 KEPERAW 0
Emanuel FITRIA ATAN 0 50,000.00
dr. Goliat LAILANI ASUHAN Rp. Rp.
1030. 29-Jul-18 Victor 2084980 77162 KEPERAW 0
Emanuel CETTA R ATAN 0 50,000.00
ASUHAN Rp. Rp.
30-Jul-18 dr. EVI NUR
1031. 2085108 932000 KEPERAW 0
Hartono AFIFAH ATAN 0 50,000.00
DINDA ASUHAN Rp. Rp.
1032. 31-Jul-18 dr.
Hartono PUJA 2085116 932004 KEPERAW 0
NURAENI ATAN 0 50,000.00

dr. Goliat BAGAS RAWAT Rp. Rp.


1033. 1-Jul-18 Victor ADITYA 2082098 931164 LUKA 1
Emanuel PRATAMA KECIL
dr. Goliat BAGAS RAWAT
1033. 1-Jul-18 Victor ADITYA 2082098 931164 LUKA 1
Emanuel PRATAMA KECIL
46,822.00 46,822.00
dr. Goliat RAWAT Rp. Rp.
1034. 1-Jul-18 Victor PRAPTO 2082118 931170 LUKA 1
Emanuel KECIL 46,822.00 46,822.00

Yenny KANTI RAWAT Rp. Rp.


1035. 2-Jul-18 dr.
Haryono WAHYU 2082257 931216 LUKA 1
PRAHESTI KECIL 46,822.00 46,822.00
dr. SURYA,M RAWAT Rp. Rp.
1036. 3-Jul-18 Artamty UHAMM 2082290 931223 LUKA 1
Sastry A AD KECIL 46,822.00 46,822.00
dr. RAWAT Rp. Rp.
IMAM
1037. 4-Jul-18 Artamty 2082433 931265 LUKA 1
ROZIQIN
Sastry A KECIL 46,822.00 46,822.00
RAWAT Rp. Rp.
4-Jul-18 dr. Yenny
1038. Haryono PASIRAN 2082489 29317 LUKA 1
KECIL 46,822.00 46,822.00
dr. Goliat RAWAT Rp. Rp.
1039. 7-Jul-18 Victor SUTARNO 2082790 931382 LUKA 1
Emanuel KECIL 46,822.00 46,822.00
dr. Goliat ZAINUL RAWAT Rp. Rp.
1040. 8-Jul-18 Victor 2082798 931386 LUKA 1
Emanuel ARIFIN KECIL 46,822.00 46,822.00
RAWAT Rp. Rp.
8-Jul-18 dr. Nani TARU
1041. 2082823 931399 LUKA 1
Zumaroh WIJAYA KECIL 46,822.00 46,822.00
RAWAT Rp. Rp.
8-Jul-18 dr. Nani TARU
1042. 2082831 931399 LUKA 1
Zumaroh WIJAYA KECIL 46,822.00 46,822.00
RAWAT Rp. Rp.
1043. 9-Jul-18 dr.
Hartono WARAS 2082853 931408 LUKA 1
KECIL 46,822.00 46,822.00
RAWAT Rp. Rp.
9-Jul-18 dr. Nani
1044. Zumaroh JADMIKO 2082895 931401 LUKA 1
KECIL 46,822.00 46,822.00
RAWAT Rp. Rp.
1045. 11-Jul-18 dr.
Hartono SUYONO 2083176 931497 LUKA 1
KECIL 46,822.00 46,822.00
dr. RAWAT Rp. Rp.
1046. 13-Jul-18 Artamty SUMARJI 2083448 931561 LUKA 1
Sastry A KECIL 46,822.00 46,822.00
dr. RAWAT Rp. Rp.
1047. 15-Jul-18 Artamty MASIJAH 2083526 931596 LUKA 1
Sastry A KECIL 46,822.00 46,822.00
dr. RAWAT Rp. Rp.
1048. 15-Jul-18 Artamty INDAH 2083527 931597 LUKA 1
Sastry A KECIL
dr. RAWAT
1048. 15-Jul-18 Artamty INDAH 2083527 931597 LUKA 1
Sastry A KECIL 46,822.00 46,822.00
dr. RAWAT Rp. Rp.
1049. 15-Jul-18 Artamty SARTI 2083528 931598 LUKA 1
Sastry A KECIL 46,822.00 46,822.00
RAWAT Rp. Rp.
1050. 15-Jul-18 dr.
Hartono PARCIM 2083531 931600 LUKA 1
KECIL 46,822.00 46,822.00
NUR RAWAT Rp. Rp.
1051. 17-Jul-18 dr.
Hartono RAIHAN, 2083673 931639 LUKA 1
MUH. KECIL 46,822.00 46,822.00
RAWAT Rp. Rp.
17-Jul-18 dr. Yenny
1052. Haryono SAENI 2083773 931657 LUKA 1
KECIL 46,822.00 46,822.00
RAWAT Rp. Rp.
1053. 18-Jul-18 dr.
Hartono BIANTO 2083852 931684 LUKA 1
KECIL 46,822.00 46,822.00
RIZAL RAWAT Rp. Rp.
1054. 18-Jul-18 dr.
Hartono RAMADH 2083877 931692 LUKA 1
AN, MOH KECIL 46,822.00 46,822.00

Nani SITI RAWAT Rp. Rp.


1055. 19-Jul-18 dr.
Zumaroh NURQOLI 2084002 931734 LUKA 1
FAH KECIL 46,822.00 46,822.00
dr. AGUS RAWAT Rp. Rp.
1056. 22-Jul-18 Artamty BUDI 2084219 931783 LUKA 1
Sastry A HARTO KECIL 46,822.00 46,822.00
dr. TARMI RAWAT Rp. Rp.
1057. 22-Jul-18 Artamty ADI 2084220 931784 LUKA 1
Sastry A ASTUTIK KECIL 46,822.00 46,822.00

Nani DENI RAWAT Rp. Rp.


1058. 22-Jul-18 dr.
Zumaroh SETIAWA 2084230 931787 LUKA 1
N KECIL 46,822.00 46,822.00

Nani NAUFAL RAWAT Rp. Rp.


1059. 22-Jul-18 dr.
Zumaroh AQIL DWI 2084231 931789 LUKA 1
SAPUTRA KECIL 46,822.00 46,822.00
RAWAT Rp. Rp.
22-Jul-18 dr. Nani SUMARLI
1060. 2084233 78496 LUKA 1
Zumaroh K KECIL 46,822.00 46,822.00

SILVY
Nani PUTRI RAWAT Rp. Rp.
1061. 22-Jul-18 dr.
Zumaroh ARDHIYA 2084234 931790 LUKA 1
NTI KECIL
SANTOSO
46,822.00 46,822.00
RAWAT Rp. Rp.
23-Jul-18 dr. Nani FAHMI
1062. 2084264 931800 LUKA 1
Zumaroh DAWUD KECIL
RAWAT
23-Jul-18 dr. Nani FAHMI
1062. 2084264 931800 LUKA 1
Zumaroh DAWUD KECIL 46,822.00 46,822.00
dr. RAWAT Rp. Rp.
SUMIYATI 2084307
1063. 23-Jul-18 Artamty 68478 LUKA 1
,NY
Sastry A KECIL 46,822.00 46,822.00
RAWAT Rp. Rp.
24-Jul-18 dr. Yenny
1064. Haryono SAKRIM 2084510 931852 LUKA 1
KECIL 46,822.00 46,822.00
RAWAT Rp. Rp.
25-Jul-18 dr. Yenny
1065. Haryono SUKISWO 2084620 931871 LUKA 1
KECIL 46,822.00 46,822.00
dr. Goliat RAWAT Rp. Rp.
1066. 25-Jul-18 Victor MARIYAM 2084623 931872 LUKA 1
Emanuel KECIL 46,822.00 46,822.00
RAWAT Rp. Rp.
27-Jul-18 dr. Yenny IMAM
1067. 2084825 931913 LUKA 1
Haryono SAFI'I KECIL 46,822.00 46,822.00
RAWAT Rp. Rp.
27-Jul-18 dr. Yenny WARSILA
1068. 2084834 931916 LUKA 1
Haryono N KECIL 46,822.00 46,822.00
dr. WIWIN RAWAT Rp. Rp.
1069. 28-Jul-18 Artamty PRIYO 2084934 931948 LUKA 1
Sastry A UTOMO KECIL 46,822.00 46,822.00
dr. Goliat RAWAT Rp. Rp.
1070. 29-Jul-18 Victor TRISNO 2084959 931959 LUKA 1
Emanuel KECIL 46,822.00 46,822.00
dr. Goliat JUWARIY RAWAT Rp. Rp.
1071. 29-Jul-18 Victor 2084961 931960 LUKA 1
Emanuel AH KECIL 46,822.00 46,822.00
dr. Goliat ABDUL RAWAT Rp. Rp.
1072. 29-Jul-18 Victor LATIF 2084964 931961 LUKA 1
Emanuel HUSAINI KECIL 46,822.00 46,822.00
RAWAT Rp. Rp.
30-Jul-18 dr. EVI NUR
1073. 2085108 932000 LUKA 0
Hartono AFIFAH KECIL 0 46,822.00
JOKO RAWAT Rp. Rp.
1074. 30-Jul-18 dr.
Hartono WAHYUH 2085110 32777 LUKA 0
ONO KECIL 0 46,822.00
dr. Goliat MARSINA RAWAT Rp. Rp.
1075. 30-Jul-18 Victor 2085127 932010 LUKA 0
Emanuel H KECIL 0 46,822.00
dr. Goliat SARJI Rp. Rp.
1076. 1-Jul-18 Victor 2082113 85610 GDA 1
Emanuel GUNO 43,326.00 43,326.00
dr. Goliat Rp. Rp.
1077. 1-Jul-18 Victor MOLAN 2082114 931169 GDA 1
Emanuel
dr. Goliat
1077. 1-Jul-18 Victor MOLAN 2082114 931169 GDA 1
Emanuel 43,326.00 43,326.00
Rp. Rp.
2-Jul-18 dr. Nani SUWARNI 2082162
1078. 931183 GDA 1
Zumaroh ,NY 43,326.00 43,326.00
Rp. Rp.
2-Jul-18 dr. Nani
1079. Zumaroh DARSAM 2082169 61805 GDA 1
43,326.00 43,326.00
Rp. Rp.
2-Jul-18 dr. Nani
1080. Zumaroh RUKMINI 2082181 77582 GDA 1
43,326.00 43,326.00
Rp. Rp.
2-Jul-18 dr. Yenny
1081. Haryono TARMI 2082193 901182 GDA 1
43,326.00 43,326.00
Rp. Rp.
2-Jul-18 dr. Nani NYAMINA 2082217
1082. 931200 GDA 1
Zumaroh H 43,326.00 43,326.00
Rp. Rp.
1083. 2-Jul-18 dr. Yenny
Haryono KATREMI 2082249 929170 GDA 1
43,326.00 43,326.00
Rp. Rp.
2-Jul-18 dr. Yenny ARIFIN
1084. Haryono SUSANTO 2082251 931213 GDA 1
43,326.00 43,326.00
dr. Rp. Rp.
1085. 2-Jul-18 Artamty SAMIAN 2082260 931218 GDA 1
Sastry A 43,326.00 43,326.00
dr. Rp. Rp.
YUDHA
1086. 4-Jul-18 Artamty EBIYANTO 2082443 927511 GDA 1
Sastry A 43,326.00 43,326.00
Rp. Rp.
5-Jul-18 dr. Nani
1087. Zumaroh SRIPAH 2082601 931317 GDA 1
43,326.00 43,326.00
Rp. Rp.
6-Jul-18 dr. Nani NUR
1088. 2082721 931353 GDA 1
Zumaroh HIDAYAH 43,326.00 43,326.00
Rp. Rp.
6-Jul-18 dr. Nani
1089. Zumaroh KASPAN 2082726 931357 GDA 1
43,326.00 43,326.00
Rp. Rp.
6-Jul-18 dr. Nani ABDUL
1090. 2082733 931360 GDA 1
Zumaroh WAHAB 43,326.00 43,326.00
Rp. Rp.
6-Jul-18 dr. Nani SAKIRAH
1091. 2082736 931363 GDA 1
Zumaroh 43,326.00 43,326.00
dr. Goliat Rp. Rp.
1092. 7-Jul-18 Victor LASMI,NY 2082740 910296 GDA 1
Emanuel 43,326.00 43,326.00
Rp. Rp.
8-Jul-18 dr. Yenny
1093. Haryono TOMO 2082810 915224 GDA 1
43,326.00 43,326.00
Rp. Rp.
8-Jul-18 dr. Nani
1094. Zumaroh WARNADI 2082820 917244 GDA 1
43,326.00 43,326.00
Rp. Rp.
8-Jul-18 dr. Nani SUHARTI
1095. 2082827 104002 GDA 1
Zumaroh NIK 43,326.00 43,326.00
Rp. Rp.
8-Jul-18 dr. Nani
1096. Zumaroh SUNOTO 2082826 924169 GDA 1
43,326.00 43,326.00
Rp. Rp.
8-Jul-18 dr. DIANTINI
1097. 2082834 931404 GDA 1
Hartono K 43,326.00 43,326.00
Rp. Rp.
1098. 9-Jul-18 dr.
Hartono KASNIR 2082836 931406 GDA 1
1098. 9-Jul-18 dr.
Hartono KASNIR 2082836 931406 GDA 1
43,326.00 43,326.00
Rp. Rp.
1099. 9-Jul-18 dr.
Hartono WARAS 2082853 931408 GDA 1
43,326.00 43,326.00
Rp. Rp.
9-Jul-18 dr. Nani
1100. Zumaroh GARIYAH 2082905 931425 GDA 1
43,326.00 43,326.00
Rp. Rp.
9-Jul-18 dr. Yenny
1101. Haryono TORAN 2082927 64042 GDA 1
43,326.00 43,326.00
Rp. Rp.
9-Jul-18 dr. Yenny
1102. Haryono TARSIH 2082938 931437 GDA 1
43,326.00 43,326.00
Rp. Rp.
9-Jul-18 dr. Yenny
1103. Haryono TUMIRAH 2082954 931240 GDA 1
43,326.00 43,326.00
Rp. Rp.
1104. 10-Jul-18 dr.
Hartono SURIYAH 2083009 931450 GDA 1
43,326.00 43,326.00
Rp. Rp.
10-Jul-18 dr. Yenny
1105. Haryono KARJONO 2083080 931468 GDA 1
43,326.00 43,326.00
Rp. Rp.
10-Jul-18 dr. Yenny SUTRISN
1106. 2083096 931473 GDA 1
Haryono O, TN 43,326.00 43,326.00
dr. Goliat Rp. Rp.
1107. 10-Jul-18 Victor SUMIJAH 2083107 931478 GDA 1
Emanuel 43,326.00 43,326.00
Rp. Rp.
11-Jul-18 dr. Yenny
1108. Haryono KUHARI 2083156 931490 GDA 1
43,326.00 43,326.00
Rp. Rp.
11-Jul-18 dr. Nani
1109. Zumaroh SURI 2083190 931500 GDA 1
43,326.00 43,326.00
Rp. Rp.
1110. 12-Jul-18 dr.
Hartono BASRI 2083369 931543 GDA 1
43,326.00 43,326.00
Rp. Rp.
13-Jul-18 dr. JOYO
1111. 2083403 904546 GDA 1
Hartono ADI,H 43,326.00 43,326.00
dr. SITI Rp. Rp.
1112. 13-Jul-18 Artamty MARDIYA 2083440 930843 GDA 1
Sastry A H 43,326.00 43,326.00
dr. Rp. Rp.
1113. 13-Jul-18 Artamty ROHLI 2083452 927283 GDA 1
Sastry A 43,326.00 43,326.00
Rp. Rp.
13-Jul-18 dr. Yenny
1114. Haryono HENDUN 2083396 930959 GDA 1
43,326.00 43,326.00
dr. Rp. Rp.
RINA
1115. 15-Jul-18 Artamty 2083522 931593 GDA 1
WATI
Sastry A 43,326.00 43,326.00
Rp. Rp.
16-Jul-18 dr. Yenny
1116. Haryono ASRIATIN 2083613 88759 GDA 1
43,326.00 43,326.00
Rp. Rp.
17-Jul-18 dr. Yenny SUHARSO 2083765
1117. 931654 GDA 1
Haryono NO 43,326.00 43,326.00
Rp. Rp.
17-Jul-18 dr. Yenny
1118. Haryono SAENI 2083773 931657 GDA 1
43,326.00 43,326.00
Rp. Rp.
17-Jul-18 dr. Nani AHSAN
1119. 2083780 908407 GDA 1
Zumaroh ALWI 43,326.00 43,326.00
Rp. Rp.
18-Jul-18 dr. Yenny MUSTAIN, 2083913
1120. 931712 GDA 1
Haryono MOH 43,326.00 43,326.00
Rp. Rp.
19-Jul-18 dr. Yenny
1121. Haryono SOMI 2083951 931721 GDA 1
43,326.00 43,326.00

Yenny FATAH, Rp. Rp.


1122. 19-Jul-18 dr.
Haryono MUHAM 2083956 931724 GDA 1
MAD 43,326.00 43,326.00
Rp. Rp.
19-Jul-18 dr. Yenny
1123. Haryono KAMSIH 2083960 931727 GDA 1
43,326.00 43,326.00
Rp. Rp.
1124. 19-Jul-18 dr. Yenny
Haryono KARSONO 2083971 931730 GDA 1
43,326.00 43,326.00
Rp. Rp.
19-Jul-18 dr. Nani
1125. Zumaroh SAKHUR 2083993 929916 GDA 1
43,326.00 43,326.00
dr. Rp. Rp.
SURATMA 2084034
1126. 19-Jul-18 Artamty 931736 GDA 1
N
Sastry A 43,326.00 43,326.00
dr. Rp. Rp.
1127. 20-Jul-18 Artamty RASIPAN 2084108 79516 GDA 1
Sastry A 43,326.00 43,326.00
Rp. Rp.
21-Jul-18 dr. Yenny
1128. Haryono NISWATI 2084189 931774 GDA 1
43,326.00 43,326.00
Rp. Rp.
21-Jul-18 dr. Yenny
1129. Haryono SAWIT 2084188 931773 GDA 1
43,326.00 43,326.00
dr. Goliat Rp. Rp.
1130. 21-Jul-18 Victor NIKKAH 2084206 64368 GDA 1
Emanuel 43,326.00 43,326.00
dr. Goliat SRI Rp. Rp.
1131. 21-Jul-18 Victor 2084207 926233 GDA 1
Emanuel RAHAYU 43,326.00 43,326.00
dr. Rp. Rp.
IMAM
1132. 21-Jul-18 Artamty 2084216 930270 GDA 1
HANAFI
Sastry A 43,326.00 43,326.00
dr. Rp. Rp.
IMAM
1133. 21-Jul-18 Artamty 2084216 930270 GDA 1
HANAFI
Sastry A 43,326.00 43,326.00
Rp. Rp.
23-Jul-18 dr. FATMAW
1134. 2084250 931796 GDA 1
Hartono ATI 43,326.00 43,326.00
dr. Rp. Rp.
1135. 23-Jul-18 Artamty MUKAJI 2084269 931801 GDA 1
Sastry A 43,326.00 43,326.00
dr. Rp. Rp.
SUMIYATI 2084307
1136. 23-Jul-18 Artamty 68478 GDA 1
,NY
Sastry A 43,326.00 43,326.00
dr. Rp. Rp.
1137. 24-Jul-18 Artamty MISRI 2084468 54848 GDA 1
Sastry A 43,326.00 43,326.00

Yenny RIZKY Rp. Rp.


1138. 24-Jul-18 dr.
Haryono CANDRA 2084518 916099 GDA 1
P,MUH 43,326.00 43,326.00
Rp. Rp.
1139. 24-Jul-18 dr.
Hartono KASIRAN 2084525 931857 GDA 1
43,326.00 43,326.00
ENDRO Rp. Rp.
1140. 25-Jul-18 dr.
Hartono CAHYON 2084526 931858 GDA 1
O 43,326.00 43,326.00
Rp. Rp.
1141. 25-Jul-18 dr.
Hartono SUBANDI 2084535 931860 GDA 1
43,326.00 43,326.00
Rp. Rp.
25-Jul-18 dr. Yenny
1142. Haryono TASMI 2084562 931861 GDA 1
43,326.00 43,326.00
dr. Rp. Rp.
1143. 25-Jul-18 Artamty SAIDO 2084644 911649 GDA 1
Sastry A 43,326.00 43,326.00
Rp. Rp.
1144. 26-Jul-18 dr.
Hartono SULASTRI 2084705 70830 GDA 1
43,326.00 43,326.00
Rp. Rp.
1145. 27-Jul-18 dr.
Hartono SUKARJI 2084789 106944 GDA 1
43,326.00 43,326.00
dr. Rp. Rp.
GUNORES 2084864
1146. 27-Jul-18 Artamty 931923 GDA 1
O
Sastry A 43,326.00 43,326.00
dr. Rp. Rp.
LAMSRIYA 2084871
1147. 27-Jul-18 Artamty 931928 GDA 1
TI
Sastry A 43,326.00 43,326.00
Rp. Rp.
28-Jul-18 dr. Yenny
1148. Haryono RASEMI 2084928 83721 GDA 1
43,326.00 43,326.00
TUTIK Rp. Rp.
1149. 28-Jul-18 dr.
Hartono AGUSTIN 2084929 24440 GDA 1
A 43,326.00 43,326.00
dr. WIWIN Rp. Rp.
1150. 28-Jul-18 Artamty PRIYO 2084934 931948 GDA 1
Sastry A UTOMO 43,326.00 43,326.00
dr. WIWIN Rp. Rp.
1151. 28-Jul-18 Artamty PRIYO 2084934 931948 GDA 1
Sastry A UTOMO 43,326.00 43,326.00
dr. Rp. Rp.
TASMINA
1152. 28-Jul-18 Artamty 2084936 931949 GDA 1
H
Sastry A 43,326.00 43,326.00
HADI Rp. Rp.
1153. 29-Jul-18 dr.
Hartono PRAYITN 2084956 931195 GDA 1
O 43,326.00 43,326.00
dr. Goliat Rp. Rp.
1154. 29-Jul-18 Victor SUMINAH 2084960 918912 GDA 1
Emanuel 43,326.00 43,326.00
dr. Goliat Rp. Rp.
1155. 29-Jul-18 Victor JIDIN 2084968 931963 GDA 0
Emanuel 0 43,326.00
dr. Goliat Rp. Rp.
1156. 29-Jul-18 Victor SUNARTI 2084971 931446 GDA 0
Emanuel 0 43,326.00
Rp. Rp.
1157. 30-Jul-18 dr.
Hartono KUHARI 2085071 931490 GDA 0
0 43,326.00
Rp. Rp.
1158. 30-Jul-18 dr.
Hartono KAMISAH 2085119 932005 GDA 0
0 43,326.00

dr. Goliat BAGAS AFF Rp. Rp.


1159. 1-Jul-18 Victor ADITYA 2082098 931164 HEACTIN 1
Emanuel PRATAMA G<3
42,185.00 42,185.00
AFF Rp. Rp.
9-Jul-18 dr. Nani
1160. Zumaroh JADMIKO 2082895 931401 HEACTIN 1
G3-6 42,185.00 42,185.00
AFF Rp. Rp.
1161. 15-Jul-18 dr.
Hartono PARCIM 2083531 931600 HEACTIN 1
G<3 42,185.00 42,185.00
AFF Rp. Rp.
1162. 18-Jul-18 dr.
Hartono BIANTO 2083852 931684 HEACTIN 1
G<3 42,185.00 42,185.00
RIZAL AFF Rp. Rp.
1163. 18-Jul-18 dr.
Hartono RAMADH 2083877 931692 HEACTIN 1
AN, MOH G3-6 42,185.00 42,185.00
AFF Rp. Rp.
1164. 22-Jul-18 dr.
Hartono TARSO 2084248 931795 HEACTIN 1
G3-6 42,185.00 42,185.00
dr. Goliat AFF Rp. Rp.
1165. 29-Jul-18 Victor TRISNO 2084959 931959 HEACTIN 1
Emanuel G3-6 42,185.00 42,185.00
dr. Goliat JUWARIY AFF Rp. Rp.
1166. 29-Jul-18 Victor 2084961 931960 HEACTIN 1
Emanuel AH G3-6 42,185.00 42,185.00

MEMBERI
dr. Goliat GIO KAN Rp. Rp.
1167. 1-Jul-18 Victor 2082124 905682 OBAT 1
Emanuel FIPTIAN SUPPOSIT
ORIA
42,033.00 42,033.00
INJEKSI IV Rp. Rp.
3-Jul-18 dr. Yenny
1168. Haryono TUMIRAH 2082341 931240 LANGSUN 1
G
42,033.00 42,033.00
Rp. Rp.
4-Jul-18 dr. Yenny
1169. 29317 INJEKSI
Haryono PASIRAN 2082489 1
SC 42,033.00 42,033.00

dr. Goliat INJEKSI IV Rp. Rp.


1170. 5-Jul-18 Victor TARMU 2082516 931286 LANGSUN 1
Emanuel G
42,033.00 42,033.00

MEMBERI
KAN Rp. Rp.
5-Jul-18 dr. Nani
1171. Zumaroh NASORI 2082536 931292 OBAT 1
SUPPOSIT
ORIA
42,033.00 42,033.00

MEMBERI
dr. FURQON KAN Rp. Rp.
1172. 6-Jul-18 Artamty AMIRUD 2082702 931346 OBAT 1
Sastry A DIN,MUH SUPPOSIT
ORIA
42,033.00 42,033.00

dr. Goliat DIGYO INJEKSI IV Rp. Rp.


1173. 6-Jul-18 Victor 2082739 929777 LANGSUN 1
Emanuel WINARSO G
42,033.00 42,033.00

dr. Goliat INJEKSI IV Rp. Rp.


1174. 7-Jul-18 Victor LASMI,NY 2082740 910296 LANGSUN 1
Emanuel G
42,033.00 42,033.00

DHANIEL INJEKSI IV Rp. Rp.


1175. 8-Jul-18 dr. BAYU 2082833 931403 LANGSUN 1
Hartono IRAWAN G
42,033.00 42,033.00

INJEKSI IV Rp. Rp.


8-Jul-18 dr. DIANTINI
1176. 2082834 931404 LANGSUN 1
Hartono K G
42,033.00 42,033.00

INJEKSI IV Rp. Rp.


1177. 9-Jul-18 dr.
Hartono KASNIR 2082836 931406 LANGSUN 1
G
42,033.00 42,033.00
Rp. Rp.
9-Jul-18 dr. Yenny
1178. 78230 INJEKSI
Haryono KASBU 2082941 1
SC 42,033.00 42,033.00
Rp. Rp.
10-Jul-18 dr. Yenny SUTRISN
1179. 2083096 931473 INJEKSI 1
Haryono O, TN SC 42,033.00 42,033.00
dr. Goliat SOFIA INJEKSI IV Rp. Rp.
1180. 10-Jul-18 Victor 2083105 70087 LANGSUN 1
Emanuel SEGAF G
42,033.00 42,033.00

dr. Goliat RAVI INJEKSI IV Rp. Rp.


1181. 11-Jul-18 Victor PUTERA 2083112 922920 LANGSUN 1
Emanuel PRASETYA G
42,033.00 42,033.00
dr. SITI Rp. Rp.
1182. 13-Jul-18 Artamty MARDIYA 2083440 930843 INJEKSI 1
SC
Sastry A H 42,033.00 42,033.00
dr. Rp. Rp.
1183. 13-Jul-18 Artamty ZAENAB 2083449 931562 INJEKSI 1
SC
Sastry A 42,033.00 42,033.00
Rp. Rp.
1184. 13-Jul-18 dr. Yenny
Haryono HENDUN 2083396 930959 INJEKSI IC 1
42,033.00 42,033.00
Rp. Rp.
13-Jul-18 dr. Yenny
1185. 931568 INJEKSI
Haryono PASRI 2083474 1
SC 42,033.00 42,033.00
ANGGAR
dr. Goliat INJEKSI IV Rp. Rp.
ROSARIA
1186. 14-Jul-18 Victor 2083479 78535 LANGSUN 1
PUTRI
Emanuel G
DEWI
42,033.00 42,033.00

dr. Goliat DHIMAS INJEKSI IV Rp. Rp.


1187. 14-Jul-18 Victor AKBAR 2083514 95332 LANGSUN 1
Emanuel ARIYADI G
42,033.00 42,033.00
dr. Rp. Rp.
RINA
1188. 15-Jul-18 Artamty 2083522 931593 INJEKSI 1
WATI SC
Sastry A 42,033.00 42,033.00

dr. INJEKSI IV Rp. Rp.


1189. 15-Jul-18 Artamty MASIJAH 2083526 931596 LANGSUN 1
Sastry A G
42,033.00 42,033.00

dr. Goliat INJEKSI IV Rp. Rp.


1190. 15-Jul-18 Victor SHOLIKIN 2083545 931606 LANGSUN 1
Emanuel G
42,033.00 42,033.00

dr. Goliat INJEKSI IV Rp. Rp.


1191. 15-Jul-18 Victor LASRUN 2083548 925071 LANGSUN 1
Emanuel G
42,033.00 42,033.00
ALYA INJEKSI IV Rp. Rp.
17-Jul-18 Hartono NABILA
dr.
1192. 2083681 914296 LANGSUN 1
DAMAYA G
NTI
42,033.00 42,033.00
Nani YUSUF INJEKSI IV Rp. Rp.
1193. 17-Jul-18 dr.
Zumaroh ROMADH 2083802 105681 LANGSUN 1
ON,MOH G
42,033.00 42,033.00

dr. INJEKSI IV Rp. Rp.


SULISWA
1194. 17-Jul-18 Artamty 2083820 931675 LANGSUN 1
NTO
Sastry A G
42,033.00 42,033.00

dr. INJEKSI IV Rp. Rp.


PURNOM 2083819
1195. 17-Jul-18 Artamty 900871 LANGSUN 1
O
Sastry A G
42,033.00 42,033.00

SHANDY
DWISAKS
dr. INJEKSI IV Rp. Rp.
1196. 17-Jul-18 Artamty ANA 2083817 931674 LANGSUN 1
ADITYA
Sastry A G
CANDRAK
USUMA
42,033.00 42,033.00
Rp. Rp.
20-Jul-18 dr. RUSDIAN
1197. 2084068 931745 INJEKSI 1
Hartono TO SC 42,033.00 42,033.00

dr. Goliat DWI INJEKSI IV Rp. Rp.


1198. 21-Jul-18 Victor INDRA 2084170 40479 LANGSUN 1
Emanuel YUNIARTI G
42,033.00 42,033.00

MEMBERI
dr. Goliat TRI KAN Rp. Rp.
1199. 21-Jul-18 Victor MULYO 2084203 931777 OBAT 1
Emanuel UTOMO SUPPOSIT
ORIA
42,033.00 42,033.00

MEMBERI
dr. Goliat KASMON KAN Rp. Rp.
1200. 21-Jul-18 Victor 2084212 900550 OBAT 1
Emanuel O SUPPOSIT
ORIA
42,033.00 42,033.00

dr. INJEKSI IV Rp. Rp.


SUMIYATI 2084307
1201. 23-Jul-18 Artamty 68478 LANGSUN 1
,NY
Sastry A G
42,033.00 42,033.00

MEMBERI
KAN Rp. Rp.
23-Jul-18 dr. Yenny AINUN
1202. 2084365 931830 OBAT 1
Haryono NAJIB SUPPOSIT
ORIA
42,033.00 42,033.00
NOVIA INJEKSI IV Rp. Rp.
23-Jul-18 Hartono RUSDIAN
dr.
1203. 2084372 931833 LANGSUN 1
A G
PAHLEVI
42,033.00 42,033.00
RIFAYA INJEKSI IV Rp. Rp.
23-Jul-18 Hartono NOUREN
dr.
1204. 2084369 930627 LANGSUN 1
DWI G
FALISHA
42,033.00 42,033.00

MEMBERI
KAN Rp. Rp.
1205. 24-Jul-18 dr.
Hartono SARTIK 2084373 19534 OBAT 1
SUPPOSIT
ORIA
42,033.00 42,033.00

INJEKSI IV Rp. Rp.


1206. 24-Jul-18 dr.
Hartono SARNO 2084390 931834 LANGSUN 1
G
42,033.00 42,033.00

RACHMA
NDA INJEKSI IV Rp. Rp.
24-Jul-18 Hartono AS'AD
dr.
1207. 2084391 931835 LANGSUN 1
YATIM G
UBAIDILL
AH
42,033.00 42,033.00

MEMBERI
dr. KAN Rp. Rp.
UDI
1208. 24-Jul-18 Artamty 2084481 931847 OBAT 1
WALUYO
Sastry A SUPPOSIT
ORIA
42,033.00 42,033.00

MEMBERI
KAN Rp. Rp.
1209. 25-Jul-18 dr.
Hartono SUBANDI 2084535 931860 OBAT 1
SUPPOSIT
ORIA
42,033.00 42,033.00

MEMBERI
AGUNG
dr. Goliat KAN Rp. Rp.
GILANG
1210. 25-Jul-18 Victor TRITANAY 2084637 931875 OBAT 1
Emanuel SUPPOSIT
A ORIA
42,033.00 42,033.00
Rp. Rp.
1211. 27-Jul-18 dr. 918511 INJEKSI
Hartono SUPATMI 2084806 1
SC 42,033.00 42,033.00

MEMBERI
dr. Goliat SUNTIASI KAN Rp. Rp.
1212. 29-Jul-18 Victor 2084979 931968 OBAT 0
Emanuel H SUPPOSIT
ORIA
0 42,033.00
INJEKSI IV Rp. Rp.
29-Jul-18 dr. Nani INDASAH
1213. 2084986 931973 LANGSUN 0
Zumaroh RR G
0 42,033.00

INJEKSI IV Rp. Rp.


30-Jul-18 dr. Nani
1214. Zumaroh ANJURI 2084987 927621 LANGSUN 0
G
0 42,033.00

Nani REZHADIT INJEKSI IV Rp. Rp.


1215. 30-Jul-18 dr.
Zumaroh YA TARIQ 2084988 78258 LANGSUN 0
AZAM G
0 42,033.00
OBSERVA
dr. Goliat MEY NUR Rp. Rp.
1216. 1-Jul-18 Victor 2082117 917719 SI 1
Emanuel AZIZAH THERMO
REGULASI
39,216.00 39,216.00

Rp. Rp.
2-Jul-18 dr. Yenny
1217. 929170 SATURASI
Haryono KATREMI 2082249 1
OKSIGEN
39,216.00 39,216.00
Rp. Rp.
3-Jul-18 dr. Nani
1218. 901489 PASANG
Zumaroh SUDARTI 2082354 1
SPALK 39,216.00 39,216.00

Rp. Rp.
4-Jul-18 dr. Yenny KUNTIRA
1219. 2082486 931278 SATURASI 1
Haryono H OKSIGEN
39,216.00 39,216.00
dr. Rp. Rp.
1220. 5-Jul-18 Artamty ROHLI 2082626 927283 SATURASI 1
OKSIGEN
Sastry A 39,216.00 39,216.00
dr. Rp. Rp.
1221. 5-Jul-18 Artamty SAMIRAH 2082631 909463 SATURASI 1
OKSIGEN
Sastry A 39,216.00 39,216.00
OBSERVA
dr. ST ZAHRA Rp. Rp.
1222. 5-Jul-18 Artamty ABIDATU 2082641 919189 SI 1
THERMO
Sastry A N NAJWA REGULASI
39,216.00 39,216.00
OBSERVA
Rp. Rp.
6-Jul-18 dr. Nani NUR
1223. 2082721 931353 SI 1
Zumaroh HIDAYAH THERMO
REGULASI
39,216.00 39,216.00

Rp. Rp.
6-Jul-18 dr. Nani INDRI
1224. 2082723 931355 SATURASI 1
Zumaroh JATUN R OKSIGEN
39,216.00 39,216.00
dr. Goliat DIGYO Rp. Rp.
1225. 6-Jul-18 Victor 2082739 929777 SATURASI 1
Emanuel WINARSO OKSIGEN
39,216.00 39,216.00
OBSERVA
dr. Goliat KHOIRUL Rp. Rp.
1226. 7-Jul-18 Victor SETIAWA 2082779 931374 SI 1
THERMO
Emanuel N REGULASI
39,216.00 39,216.00

Yenny FEDRIKA Rp. Rp.


1227. 8-Jul-18 dr. 913176 SATURASI
Haryono SUSANAV 2082812 1
OKSIGEN
I ANDARI
39,216.00 39,216.00
OBSERVA
Nani RAFI Rp. Rp.
1228. 8-Jul-18 dr. 931398 SI
Zumaroh SAIFUDIN 2082822 1
THERMO
,MOCH REGULASI
39,216.00 39,216.00

Rp. Rp.
8-Jul-18 dr. DIANTINI
1229. 2082834 931404 SATURASI 1
Hartono K OKSIGEN
39,216.00 39,216.00

Rp. Rp.
1230. 9-Jul-18 dr. 931406 SATURASI
Hartono KASNIR 2082836 1
OKSIGEN
39,216.00 39,216.00

NIKITA OBSERVA
Nani WHELAN Rp. Rp.
1231. 9-Jul-18 dr. 917993 SI
Zumaroh DA 2082891 1
THERMO
WIJAYANT REGULASI
I
39,216.00 39,216.00

Rp. Rp.
10-Jul-18 dr. Yenny
1232. 931468 SATURASI
Haryono KARJONO 2083080 1
OKSIGEN
39,216.00 39,216.00
QUTHBI OBSERVA
Rp. Rp.
10-Jul-18 Haryono UWAYS
dr. Yenny
1233. 2083089 931471 SI 1
SYIHAB, THERMO
AHMAD REGULASI
39,216.00 39,216.00
dr. Goliat MERISYE Rp. Rp.
1234. 10-Jul-18 Victor 2083110 915138 SATURASI 1
Emanuel BARIANTI OKSIGEN
39,216.00 39,216.00

Rp. Rp.
11-Jul-18 dr. Yenny
1235. 931490 SATURASI
Haryono KUHARI 2083156 1
OKSIGEN
39,216.00 39,216.00

NIZAR
TSAQIF OBSERVA
Rp. Rp.
11-Jul-18 Hartono AL
dr.
1236. 931495 SI
FATIH,MU 2083172 1
THERMO
HAMMA REGULASI
D
39,216.00 39,216.00

Yenny LUCKY Rp. Rp.


1237. 12-Jul-18 dr. 108128 SATURASI
Haryono ANGGAR 2083356 1
OKSIGEN
A,M 39,216.00 39,216.00
OBSERVA
Yenny LUCKY Rp. Rp.
1238. 12-Jul-18 dr. 108128 SI
Haryono ANGGAR 2083356 1
THERMO
A,M REGULASI
39,216.00 39,216.00

Yenny LUCKY Rp. Rp.


1239. 12-Jul-18 dr. 108128 SATURASI
Haryono ANGGAR 2083356 1
OKSIGEN
A,M 39,216.00 39,216.00
RAISA OBSERVA
Rp. Rp.
12-Jul-18 Hartono AZIRAH
dr.
1240. 2083361 931539 SI 1
RAMADH THERMO
ANI REGULASI
39,216.00 39,216.00

Rp. Rp.
1241. 12-Jul-18 dr. 931543 SATURASI
Hartono BASRI 2083369 1
OKSIGEN
39,216.00 39,216.00
SYAUQIL OBSERVA
Rp. Rp.
13-Jul-18 Hartono ISMA
dr.
1242. 931544 SI
ASSYAFIIY 2083370 1
THERMO
AH REGULASI
39,216.00 39,216.00
dr. SITI Rp. Rp.
1243. 13-Jul-18 Artamty KHASANA 2083443 931558 PASANG 1
SPALK
Sastry A H 39,216.00 39,216.00
dr. SITI Rp. Rp.
1244. 13-Jul-18 Artamty MARDIYA 2083440 930843 SATURASI 1
OKSIGEN
Sastry A H 39,216.00 39,216.00
OBSERVA
Rp. Rp.
13-Jul-18 dr. Yenny
1245. 931568 SI
Haryono PASRI 2083474 1
THERMO
REGULASI
39,216.00 39,216.00
Rp. Rp.
1246. 14-Jul-18 dr. 931583 PASANG
Hartono RUSNO 2083504 1
SPALK 39,216.00 39,216.00
dr. Goliat Rp. Rp.
1247. 14-Jul-18 Victor MUCHLIS 2083511 931586 SATURASI 1
OKSIGEN
Emanuel 39,216.00 39,216.00
dr. Goliat MUSTAIN, Rp. Rp.
1248. 14-Jul-18 Victor 2083453 106469 SATURASI 1
Emanuel TN OKSIGEN
39,216.00 39,216.00
dr. Rp. Rp.
1249. 15-Jul-18 Artamty MASIJAH 2083526 931596 PASANG 1
SPALK
Sastry A 39,216.00 39,216.00
dr. Goliat Rp. Rp.
1250. 15-Jul-18 Victor LASRUN 2083548 925071 SATURASI 1
OKSIGEN
Emanuel 39,216.00 39,216.00
dr. Goliat Rp. Rp.
1251. 16-Jul-18 Victor SARILAH 2083550 931608 SATURASI 1
OKSIGEN
Emanuel 39,216.00 39,216.00
Rp. Rp.
16-Jul-18 dr. Yenny
1252. 88240 SATURASI
Haryono TARSINI 2083582 1
OKSIGEN
39,216.00 39,216.00
NAUFAL
Rp. Rp.
16-Jul-18 Haryono SYAMIL
dr. Yenny
1253. 2083591 931614 SATURASI 1
ADZ OKSIGEN
DZAKY W
39,216.00 39,216.00

Rp. Rp.
16-Jul-18 dr. Yenny
1254. 88759 SATURASI
Haryono ASRIATIN 2083613 1
OKSIGEN
39,216.00 39,216.00
Rp. Rp.
16-Jul-18 dr. Yenny
1255. 931628 PASANG
Haryono ANTO 2083640 1
SPALK 39,216.00 39,216.00

Yenny SITI Rp. Rp.


1256. 17-Jul-18 dr. 931641 SATURASI
Haryono ISTIKOMA 2083737 1
OKSIGEN
H 39,216.00 39,216.00
dr. ERICK Rp. Rp.
1257. 18-Jul-18 Artamty FEBRIANS 2083834 931678 SATURASI 1
OKSIGEN
Sastry A YAH 39,216.00 39,216.00
Rp. Rp.
1258. 18-Jul-18 dr. 931685 PASANG
Hartono SAMIN 2083855 1
SPALK 39,216.00 39,216.00

ALDHI OBSERVA
Yenny ATHARRA Rp. Rp.
1259. 18-Jul-18 dr. 931706 SI
Haryono IHAN 2083901 1
THERMO
KASYAFA REGULASI
NI
39,216.00 39,216.00

Rp. Rp.
18-Jul-18 dr. Yenny
1260. 105378 SATURASI
Haryono KASIYATI 2083905 1
OKSIGEN
39,216.00 39,216.00

Rp. Rp.
18-Jul-18 dr. Yenny
1261. 931711 SATURASI
Haryono KARMILA 2083912 1
OKSIGEN
39,216.00 39,216.00
OBSERVA
Yenny ARKA Rp. Rp.
1262. 18-Jul-18 dr.
Haryono DWI 2083916 931714 SI
THERMO 1
CAHYA REGULASI
39,216.00 39,216.00
ACHMAD OBSERVA
Rp. Rp.
18-Jul-18 Haryono HAFIZ
dr. Yenny
1263. 2083917 931715 SI 1
NUR THERMO
RIFKY REGULASI
39,216.00 39,216.00

Rp. Rp.
19-Jul-18 dr. Yenny
1264. 931730 SATURASI
Haryono KARSONO 2083971 1
OKSIGEN
39,216.00 39,216.00
RAWAT
LUKA
Rp. Rp.
19-Jul-18 dr. Yenny
1265. 931730 COMBUS
Haryono KARSONO 2083971 1
TIO
GRADE I
SEDANG
39,216.00 39,216.00

Rp. Rp.
19-Jul-18 dr. Yenny SITI
1266. 2083979 931731 SATURASI 1
Haryono FATIMAH OKSIGEN
39,216.00 39,216.00
OBSERVA
dr. ABDULLA Rp. Rp.
1267. 19-Jul-18 Artamty H 2084048 931742 SI 1
THERMO
Sastry A ABIDZAR REGULASI
39,216.00 39,216.00
GEISYA OBSERVA
Rp. Rp.
1268. 20-Jul-18 Hartono MAULIDA
dr. 926541 SI
DZIRGAM 2084143 1
THERMO
A DIARTA REGULASI
39,216.00 39,216.00
Rp. Rp.
20-Jul-18 dr. MAFTUKI
1269. 2084158 931766 PASANG 1
Hartono N, MOCH SPALK 39,216.00 39,216.00

ANGGA OBSERVA
dr. Goliat APRILIA Rp. Rp.
1270. 20-Jul-18 Victor DWI 2084162 107405 SI 1
THERMO
Emanuel CAHYANI REGULASI
NGTYAS
39,216.00 39,216.00
dr. Rp. Rp.
IMAM
1271. 21-Jul-18 Artamty 2084216 930270 SATURASI 1
HANAFI OKSIGEN
Sastry A 39,216.00 39,216.00

Nani DENI Rp. Rp.


1272. 22-Jul-18 dr. 931787 PASANG
Zumaroh SETIAWA 2084230 1
SPALK
N 39,216.00 39,216.00

Rp. Rp.
23-Jul-18 dr. FATMAW
1273. 2084250 931796 SATURASI 1
Hartono ATI OKSIGEN
39,216.00 39,216.00

Rp. Rp.
23-Jul-18 dr. ASMORO
1274. 2084370 931832 SATURASI 1
Hartono KANDIK OKSIGEN
39,216.00 39,216.00

Rp. Rp.
1275. 24-Jul-18 dr. 931834 SATURASI
Hartono SARNO 2084390 1
OKSIGEN
39,216.00 39,216.00

RACHMA
NDA
Rp. Rp.
24-Jul-18 Hartono AS'AD
dr.
1276. 2084391 931835 PASANG 1
YATIM SPALK
UBAIDILL
AH
39,216.00 39,216.00
RIFKI
Rp. Rp.
25-Jul-18 Haryono ADIT
dr. Yenny
1277. 931868 PASANG
ARDIANSY 2084612 1
SPALK
AH
39,216.00 39,216.00
OBSERVA
dr. Rp. Rp.
MUZAKI,
1278. 26-Jul-18 Artamty 2084646 74735 SI 1
AHMAD THERMO
Sastry A REGULASI
39,216.00 39,216.00
dr. Rp. Rp.
GUNORES 2084864
1279. 27-Jul-18 Artamty 931923 SATURASI 1
O OKSIGEN
Sastry A 39,216.00 39,216.00

DEVAN
AZKA Rp. Rp.
1280. 28-Jul-18 dr. 931942 PASANG
Hartono PUTRA 2084915 1
SPALK
NOVEND
RA
39,216.00 39,216.00
OBSERVA
dr. CELLO Rp. Rp.
1281. 28-Jul-18 Artamty SYARIEF 2084948 931955 SI 1
THERMO
Sastry A ADHA REGULASI
39,216.00 39,216.00

Rp. Rp.
29-Jul-18 dr. Nani INDASAH
1282. 2084986 931973 SATURASI 0
Zumaroh RR OKSIGEN
0 39,216.00

Rp. Rp.
30-Jul-18 dr. Nani
1283. 927621 SATURASI
Zumaroh ANJURI 2084987 0
OKSIGEN
0 39,216.00

Rp. Rp.
30-Jul-18 dr. Nani
1284. 931974 SATURASI
Zumaroh TUMISO 2085004 0
OKSIGEN
0 39,216.00

Rp. Rp.
30-Jul-18 dr. Nani NUR
1285. 2085005 931975 SATURASI 0
Zumaroh KHOZIN OKSIGEN
0 39,216.00

Rp. Rp.
30-Jul-18 dr. Nani NUR
1286. 2085006 931975 SATURASI 0
Zumaroh KHOZIN OKSIGEN
0 39,216.00
OBSERVA
Rp. Rp.
30-Jul-18 dr. Yenny ALFIANA
1287. 2085057 931990 SI 0
Haryono NUR AINI THERMO
REGULASI
0 39,216.00
dr. Goliat AGUSTIN Rp. Rp.
1288. 1-Jul-18 Victor A 2082096 931163 TRANSFE 1
R PASIEN
Emanuel ROHANI 26,516.00 26,516.00
Rp. Rp.
1289. 1-Jul-18 dr. 931158 TRANSFE
Hartono MARIYATI 2082087 1
R PASIEN 26,516.00 26,516.00
dr. Goliat SITI Rp. Rp.
1290. 1-Jul-18 Victor 2082094 931069 TRANSFE 1
Emanuel ANIFAH R PASIEN
26,516.00 26,516.00
dr. Goliat MUDI Rp. Rp.
1291. 1-Jul-18 Victor HARTON 2082101 931167 TRANSFE 1
R PASIEN
Emanuel O 26,516.00 26,516.00
dr. Goliat Rp. Rp.
1292. 1-Jul-18 Victor DARWITO 2082102 931168 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
dr. Goliat Rp. Rp.
1293. 1-Jul-18 Victor DARNI 2082100 931166 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
ABIMANY
dr. Rp. Rp.
U
1294. 1-Jul-18 Artamty 97823 TRANSFE
ARKANA 2082106 1
R PASIEN
Sastry A FARID
26,516.00 26,516.00
dr. HAPPY Rp. Rp.
1295. 1-Jul-18 Artamty DESTRIAN 2082108 926539 TRANSFE 1
R PASIEN
Sastry A A 26,516.00 26,516.00
dr. Rp. Rp.
1296. 1-Jul-18 Artamty LASADJI 2082111 914717 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. Goliat SARJI Rp. Rp.
1297. 1-Jul-18 Victor 2082113 85610 TRANSFE 1
Emanuel GUNO R PASIEN
26,516.00 26,516.00
dr. Goliat Rp. Rp.
1298. 1-Jul-18 Victor MOLAN 2082114 931169 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
dr. Goliat KUSNING, Rp. Rp.
1299. 1-Jul-18 Victor 2082115 84994 TRANSFE 1
Emanuel HJ R PASIEN
26,516.00 26,516.00
dr. Goliat MEY NUR Rp. Rp.
1300. 1-Jul-18 Victor 2082117 917719 TRANSFE 1
Emanuel AZIZAH R PASIEN
26,516.00 26,516.00
dr. Goliat AGUS Rp. Rp.
1301. 1-Jul-18 Victor 2082119 931171 TRANSFE 1
Emanuel PUJIONO R PASIEN
26,516.00 26,516.00
dr. Goliat Rp. Rp.
1302. 1-Jul-18 Victor LANTIP 2082122 931172 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
FEBRIANI
dr. Goliat Rp. Rp.
TA DINA
1303. 1-Jul-18 Victor 2082123 917167 TRANSFE 1
MISTIAN R PASIEN
Emanuel A
26,516.00 26,516.00
dr. Goliat GIO Rp. Rp.
1304. 1-Jul-18 Victor 2082124 905682 TRANSFE 1
Emanuel FIPTIAN R PASIEN
26,516.00 26,516.00
TEGUH Rp. Rp.
1305. 1-Jul-18 dr. 931174 TRANSFE
Hartono SLAMET 2082127 1
R PASIEN
WIDODO 26,516.00 26,516.00
Rp. Rp.
1306. 2-Jul-18 dr. 931175 TRANSFE
Hartono MARJO 2082138 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
2-Jul-18 dr. Nani
1307. 931178 TRANSFE
Zumaroh WINDA 2082146 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
2-Jul-18 dr. Nani SUWARNI 2082162
1308. 931183 TRANSFE 1
Zumaroh ,NY R PASIEN 26,516.00 26,516.00
Rp. Rp.
2-Jul-18 dr. Nani
1309. 77582 TRANSFE
Zumaroh RUKMINI 2082181 1
R PASIEN 26,516.00 26,516.00

Nani SANTI Rp. Rp.


1310. 2-Jul-18 dr. 931192 TRANSFE
Zumaroh RATNASA 2082188 1
R PASIEN
RI 26,516.00 26,516.00
Rp. Rp.
2-Jul-18 dr. Yenny
1311. 901182 TRANSFE
Haryono TARMI 2082193 1
R PASIEN 26,516.00 26,516.00

Nani MASROYA Rp. Rp.


1312. 2-Jul-18 dr. 76 TRANSFE
Zumaroh NA/RSM 2082201 1
R PASIEN
M 26,516.00 26,516.00

Nani HADI Rp. Rp.


1313. 2-Jul-18 dr. 931195 TRANSFE
Zumaroh PRAYITN 2082204 1
R PASIEN
O 26,516.00 26,516.00
Rp. Rp.
2-Jul-18 dr. Nani NYAMINA 2082217
1314. 931200 TRANSFE 1
Zumaroh H R PASIEN 26,516.00 26,516.00
dr.
Rp. Rp.
1315. 2-Jul-18 Ferryzal SUWITO 2082210 920782 TRANSFE 1
O.M., R PASIEN
Sp.OT.
26,516.00 26,516.00
Rp. Rp.
2-Jul-18 dr. Yenny
1316. 931206 TRANSFE
Haryono SUPARTIN 2082232 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
2-Jul-18 dr. Nani LASMUNT 2082224
1317. 931203 TRANSFE 1
Zumaroh IK R PASIEN 26,516.00 26,516.00

Yenny AMALIA Rp. Rp.


1318. 2-Jul-18 dr. 931207 TRANSFE
Haryono MULYA 2082235 1
R PASIEN
SAPUTRI 26,516.00 26,516.00
Rp. Rp.
2-Jul-18 dr. Yenny
1319. 929170 TRANSFE
Haryono KATREMI 2082249 1
R PASIEN 26,516.00 26,516.00

DHANUR
Yenny ENDRA Rp. Rp.
1320. 2-Jul-18 dr. 931212 TRANSFE
Haryono ARYO 2082250 1
R PASIEN
MAHEND
RA
26,516.00 26,516.00
Rp. Rp.
2-Jul-18 dr. Yenny ARIFIN
1321. 931213 TRANSFE
Haryono SUSANTO 2082251 1
R PASIEN 26,516.00 26,516.00

RAHMAT
Rp. Rp.
2-Jul-18 Haryono YUSUF
dr. Yenny
1322. 931014 TRANSFE
KUSUMA 2082253 1
R PASIEN
WARDANI
26,516.00 26,516.00
Rp. Rp.
2-Jul-18 dr. Yenny HARIANT
1323. 2082256 931215 TRANSFE 1
Haryono O R PASIEN 26,516.00 26,516.00
dr. Rp. Rp.
1324. 2-Jul-18 Artamty SAMIAN 2082260 931218 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. ANDYS Rp. Rp.
1325. 2-Jul-18 Artamty YOGA 2082261 931219 TRANSFE 1
R PASIEN
Sastry A ARDIKA 26,516.00 26,516.00
dr. Rp. Rp.
1326. 3-Jul-18 Artamty KUSRIPAH 2082262 931220 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. FAIQ AL Rp. Rp.
1327. 3-Jul-18 Artamty FAHMI, 2082297 931225 TRANSFE 1
R PASIEN
Sastry A MUH 26,516.00 26,516.00
dr. Rp. Rp.
1328. 3-Jul-18 Artamty NAIM 2082298 931226 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
IFRA
Rp. Rp.
3-Jul-18 Haryono MIKAYLA
dr. Yenny
1329. 2082303 931227 TRANSFE 1
RAMADH R PASIEN
ANI
26,516.00 26,516.00
Rp. Rp.
3-Jul-18 dr. Yenny
1330. 931228 TRANSFE
Haryono TUMAJI 2082304 1
R PASIEN 26,516.00 26,516.00
ANDRIYA
Rp. Rp.
3-Jul-18 Haryono N
dr. Yenny
1331. 2082334 921985 TRANSFE 1
KRISTIYO R PASIEN
NI
26,516.00 26,516.00
Rp. Rp.
3-Jul-18 dr. Yenny
1332. 931240 TRANSFE
Haryono TUMIRAH 2082341 1
R PASIEN 26,516.00 26,516.00

Yenny SITI Rp. Rp.


1333. 3-Jul-18 dr. 101018 TRANSFE
Haryono MUNAFIA 2082312 1
R PASIEN
H 26,516.00 26,516.00
Rp. Rp.
3-Jul-18 dr. Yenny
1334. 931248 TRANSFE
Haryono KASWATI 2082365 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
1335. 3-Jul-18 dr. 931253 TRANSFE
Hartono PANDI 2082386 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
1336. 3-Jul-18 dr. 79079 TRANSFE
Hartono CANCOKO 2082387 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
3-Jul-18 dr. IIS
1337. 2082389 931254 TRANSFE 1
Hartono ARISKA R PASIEN 26,516.00 26,516.00
DUROTUL
Rp. Rp.
3-Jul-18 Hartono HUSNA
dr.
1338. 2082392 931255 TRANSFE 1
VITA R PASIEN
SANTICA
26,516.00 26,516.00
dr. Goliat SUYUFI,M Rp. Rp.
1339. 3-Jul-18 Victor UCHAMA 2082395 931256 TRANSFE 1
R PASIEN
Emanuel D 26,516.00 26,516.00
dr. Goliat RUSMAN Rp. Rp.
1340. 4-Jul-18 Victor 2082409 931257 TRANSFE 1
Emanuel AJI R PASIEN
26,516.00 26,516.00
dr. LILIK Rp. Rp.
1341. 4-Jul-18 Artamty SETYOWA 2082434 38391 TRANSFE 1
R PASIEN
Sastry A TI 26,516.00 26,516.00
dr. Rp. Rp.
IMAM
1342. 4-Jul-18 Artamty 2082433 931265 TRANSFE 1
ROZIQIN R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
1343. 4-Jul-18 Artamty KADIR 2082438 931267 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
YUDHA
1344. 4-Jul-18 Artamty 927511 TRANSFE
EBIYANTO 2082443 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
1345. 4-Jul-18 Artamty SULASIH 2082466 931271 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
GISELA
dr. Rp. Rp.
DWI
1346. 4-Jul-18 Artamty 2082470 931272 TRANSFE 1
OKTAVIA R PASIEN
Sastry A NI
26,516.00 26,516.00
dr. Rp. Rp.
1347. 4-Jul-18 Artamty SRIAH 2082474 909814 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. TRI Rp. Rp.
1348. 4-Jul-18 Artamty MARGIAN 2082476 931273 TRANSFE 1
R PASIEN
Sastry A I, NY 26,516.00 26,516.00
Rp. Rp.
4-Jul-18 dr. Yenny
1349. 931277 TRANSFE
Haryono RAMINI 2082483 1
R PASIEN 26,516.00 26,516.00
dr. Rp. Rp.
MURDIO
1350. 4-Jul-18 Artamty 2082452 80659 TRANSFE 1
NO R PASIEN
Sastry A 26,516.00 26,516.00
Rp. Rp.
4-Jul-18 dr. Yenny
1351. 29317 TRANSFE
Haryono PASIRAN 2082489 1
R PASIEN 26,516.00 26,516.00
SHERLY
Rp. Rp.
4-Jul-18 Haryono YANIAR
dr. Yenny
1352. 2082494 916521 TRANSFE 1
CHANDR R PASIEN
A
26,516.00 26,516.00

Yenny KANA Rp. Rp.


1353. 4-Jul-18 dr. 931280 TRANSFE
Haryono FATHIN 2082495 1
R PASIEN
ROBIHAH 26,516.00 26,516.00
dr. Goliat DIANITA Rp. Rp.
1354. 4-Jul-18 Victor KRISTIAN 2082503 99921 TRANSFE 1
R PASIEN
Emanuel NINGSIH 26,516.00 26,516.00
dr. Goliat DARMIYA Rp. Rp.
1355. 4-Jul-18 Victor 2082504 931284 TRANSFE 1
Emanuel TI R PASIEN
26,516.00 26,516.00
JIHAN
dr. Goliat Rp. Rp.
1356. 4-Jul-18 Victor ARRIFA 931182 TRANSFE
MAWADD 2082505 1
R PASIEN
Emanuel AH
26,516.00 26,516.00
WINANDI
dr. Goliat Rp. Rp.
KA
1357. 5-Jul-18 Victor 918013 TRANSFE
KUMAYA 2082517 1
R PASIEN
Emanuel NG JATI
26,516.00 26,516.00
dr. Goliat SITI Rp. Rp.
1358. 5-Jul-18 Victor JARIYATU 2082519 931287 TRANSFE 1
R PASIEN
Emanuel N 26,516.00 26,516.00
ROHMAT
dr. Goliat Rp. Rp.
UL
1359. 5-Jul-18 Victor 918874 TRANSFE
ISLAMIYA 2082518 1
R PASIEN
Emanuel H SAFITRI
26,516.00 26,516.00
dr. Goliat Rp. Rp.
1360. 5-Jul-18 Victor SUCIPTO 2082520 931288 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
dr. Goliat SUSILOW Rp. Rp.
1361. 5-Jul-18 Victor 2082521 931289 TRANSFE 1
Emanuel ATI R PASIEN
26,516.00 26,516.00
dr. Goliat MUTIATU Rp. Rp.
1362. 5-Jul-18 Victor 2082522 926993 TRANSFE 1
Emanuel N R PASIEN
26,516.00 26,516.00
Rp. Rp.
5-Jul-18 dr. Nani
1363. 931292 TRANSFE
Zumaroh NASORI 2082536 1
R PASIEN 26,516.00 26,516.00
DEVI
Rp. Rp.
5-Jul-18 Zumaroh SAHROVA
dr. Nani
1364. 2082550 931298 TRANSFE 1
TUL R PASIEN
UMROCH
26,516.00 26,516.00
Rp. Rp.
5-Jul-18 dr. Nani
1365. 931290 TRANSFE
Zumaroh SUKARNO 2082523 1
R PASIEN 26,516.00 26,516.00
Nani ALDEFAN Rp. Rp.
1366. 5-Jul-18 dr. 931300 TRANSFE
Zumaroh YFARANISA
OKTA 2082554 1
R PASIEN
26,516.00 26,516.00

Nani ZAENAL Rp. Rp.


1367. 5-Jul-18 dr. 931142 TRANSFE
Zumaroh ABIDIN,M 2082559 1
R PASIEN
OH 26,516.00 26,516.00
Rp. Rp.
5-Jul-18 dr. Nani ALVI
1368. 2082573 931309 TRANSFE 1
Zumaroh SAHRIN R PASIEN 26,516.00 26,516.00
Rp. Rp.
5-Jul-18 dr. Nani AZAM AL- 2082562
1369. 931303 TRANSFE 1
Zumaroh HABSYI R PASIEN 26,516.00 26,516.00

Nani PUTRI Rp. Rp.


1370. 5-Jul-18 dr. 931307 TRANSFE
Zumaroh WIDAYAN 2082568 1
R PASIEN
TI 26,516.00 26,516.00
ALYA
Rp. Rp.
5-Jul-18 Zumaroh NAUFA
dr. Nani
1371. 2082581 107058 TRANSFE 1
FARZANI, R PASIEN
AN
26,516.00 26,516.00
Rp. Rp.
5-Jul-18 dr. Nani
1372. 931317 TRANSFE
Zumaroh SRIPAH 2082601 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
5-Jul-18 dr. Nani
1373. 931317 TRANSFE
Zumaroh SRIPAH 2082601 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
5-Jul-18 dr. Nani KASBULL
1374. 2082605 926458 TRANSFE 1
Zumaroh AH S,H R PASIEN 26,516.00 26,516.00
A'YUN
Rp. Rp.
5-Jul-18 Zumaroh LULUK
dr. Nani
1375. 921314 TRANSFE
NURHASA 2082607 1
R PASIEN
NAH
26,516.00 26,516.00
dr. Rp. Rp.
1376. 5-Jul-18 Artamty MUDRON 2082614 931318 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
1377. 5-Jul-18 Artamty ROHLI 2082626 927283 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
1378. 5-Jul-18 Artamty DEMES 2082628 85449 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
1379. 5-Jul-18 Artamty SAMIRAH 2082631 909463 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
1380. 5-Jul-18 Artamty JAELANI 2082638 931324 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. ST ZAHRA Rp. Rp.
1381. 5-Jul-18 Artamty ABIDATU 2082641 919189 TRANSFE 1
R PASIEN
Sastry A N NAJWA
dr. ST ZAHRA
1381. 5-Jul-18 Artamty ABIDATU 2082641 919189 TRANSFE 1
R PASIEN
Sastry A N NAJWA 26,516.00 26,516.00
dr. Rp. Rp.
1382. 5-Jul-18 Artamty SLAMET 2082642 931326 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
Rp. Rp.
5-Jul-18 dr. Yenny SUKOWA
1383. 2082643 931327 TRANSFE 1
Haryono RNO R PASIEN 26,516.00 26,516.00

GERRA
Yenny AYU Rp. Rp.
1384. 5-Jul-18 dr. 913744 TRANSFE
Haryono KUSUMA 2082644 1
R PASIEN
WARDHA
NI
26,516.00 26,516.00
Rp. Rp.
1385. 6-Jul-18 dr. Yenny SOFFAN, 2082646 931329 TRANSFE 1
Haryono M R PASIEN 26,516.00 26,516.00
UMROTU
Rp. Rp.
1386. 6-Jul-18 Haryono LCHHOIRIY 2082647
dr. Yenny 931330 TRANSFE 1
R PASIEN
YAH
26,516.00 26,516.00
dr. ENDANG Rp. Rp.
1387. 6-Jul-18 Artamty POERMIH 2082663 80248 TRANSFE 1
R PASIEN
Sastry A ARSIH 26,516.00 26,516.00

AZAHRA
dr. ZAINA Rp. Rp.
1388. 6-Jul-18 Artamty ADI 2082670 931335 TRANSFE 1
R PASIEN
Sastry A NINGRU
M
26,516.00 26,516.00
dr. Rp. Rp.
1389. 6-Jul-18 Artamty DARMAJI 2082677 931194 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. RENALDY Rp. Rp.
1390. 6-Jul-18 Artamty ARDIAN 2082678 931337 TRANSFE 1
R PASIEN
Sastry A SAPUTRA 26,516.00 26,516.00
dr. SULIS Rp. Rp.
1391. 6-Jul-18 Artamty SETYONI 2082682 931340 TRANSFE 1
R PASIEN
Sastry A NGSIH 26,516.00 26,516.00
dr. YAUMI Rp. Rp.
1392. 6-Jul-18 Artamty SOLIKHA 2082688 931302 TRANSFE 1
R PASIEN
Sastry A H 26,516.00 26,516.00
dr. Rp. Rp.
SUBRAHI
1393. 6-Jul-18 Artamty 2082693 931344 TRANSFE 1
M R PASIEN
Sastry A 26,516.00 26,516.00
dr. GIBRAN Rp. Rp.
1394. 6-Jul-18 Artamty ALFATIH, 2082696 931345 TRANSFE 1
R PASIEN
Sastry A MUH 26,516.00 26,516.00
dr. FURQON Rp. Rp.
1395. 6-Jul-18 Artamty AMIRUD 2082702 931346 TRANSFE 1
R PASIEN
Sastry A DIN,MUH
dr. FURQON
1395. 6-Jul-18 Artamty AMIRUD 2082702 931346 TRANSFE 1
R PASIEN
Sastry A DIN,MUH 26,516.00 26,516.00
dr. Rp. Rp.
1396. 6-Jul-18 Artamty KARSILAN 2082704 907653 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
Rp. Rp.
6-Jul-18 dr. Nani ERISTIATI
1397. 2082716 931350 TRANSFE 1
Zumaroh NUR IFA R PASIEN 26,516.00 26,516.00
Rp. Rp.
6-Jul-18 dr. Nani NUR
1398. 2082721 931353 TRANSFE 1
Zumaroh HIDAYAH R PASIEN 26,516.00 26,516.00
Rp. Rp.
6-Jul-18 dr. Nani INDRI
1399. 2082723 931355 TRANSFE 1
Zumaroh JATUN R R PASIEN 26,516.00 26,516.00
Rp. Rp.
6-Jul-18 dr. Nani
1400. 931357 TRANSFE
Zumaroh KASPAN 2082726 1
R PASIEN 26,516.00 26,516.00
ALMEIRA
Rp. Rp.
6-Jul-18 Zumaroh FITRIA
dr. Nani
1401. 931358 TRANSFE
HADITAM 2082727 1
R PASIEN
A
26,516.00 26,516.00
Rp. Rp.
6-Jul-18 dr. Nani
1402. 931359 TRANSFE
Zumaroh SUMAR 2082732 1
R PASIEN 26,516.00 26,516.00

Nani UCIK Rp. Rp.


1403. 6-Jul-18 dr. 915749 TRANSFE
Zumaroh NURHIDA 2082728 1
R PASIEN
YATI 26,516.00 26,516.00
Rp. Rp.
6-Jul-18 dr. Nani ABDUL
1404. 2082733 931360 TRANSFE 1
Zumaroh WAHAB R PASIEN 26,516.00 26,516.00
Rp. Rp.
6-Jul-18 dr. Nani
1405. 931363 TRANSFE
Zumaroh SAKIRAH 2082736 1
R PASIEN 26,516.00 26,516.00
dr. Goliat DIGYO Rp. Rp.
1406. 6-Jul-18 Victor 2082739 929777 TRANSFE 1
Emanuel WINARSO R PASIEN
26,516.00 26,516.00
dr. Goliat Rp. Rp.
1407. 7-Jul-18 Victor LASMI,NY 2082740 910296 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
dr. Goliat Rp. Rp.
1408. 7-Jul-18 Victor YULIANI 2082747 931366 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00

Nani SITI Rp. Rp.


1409. 7-Jul-18 dr. 931367 TRANSFE
Zumaroh RONDIYA 2082748 1
R PASIEN
H 26,516.00 26,516.00
DZAKY
Rp. Rp.
7-Jul-18 Zumaroh FAEYZA
dr. Nani
1410. 2082753 917862 TRANSFE 1
ANGGAR R PASIEN
A
26,516.00 26,516.00

Nani HAYDAR Rp. Rp.


1411. 7-Jul-18 dr. 931368 TRANSFE
Zumaroh FAHMY 2082760 1
R PASIEN
HAKIM 26,516.00 26,516.00
dr. Goliat SITI Rp. Rp.
1412. 7-Jul-18 Victor RONDIYA 2082757 931367 TRANSFE 1
R PASIEN
Emanuel H 26,516.00 26,516.00
Rp. Rp.
7-Jul-18 dr. Nani
1413. 931369 TRANSFE
Zumaroh LASRI 2082768 1
R PASIEN 26,516.00 26,516.00
CHARMEL
Rp. Rp.
7-Jul-18 Zumaroh LYA
dr. Nani
1414. 931370 TRANSFE
ANGELIN 2082769 1
R PASIEN
E WILLIS
26,516.00 26,516.00
PRAJNA
Rp. Rp.
7-Jul-18 Zumaroh PARAMIT
dr. Nani
1415. 2082770 920478 TRANSFE 1
A TRI R PASIEN
ALISA
26,516.00 26,516.00
dr. Goliat JEVIA Rp. Rp.
1416. 7-Jul-18 Victor 2082778 931373 TRANSFE 1
Emanuel SAFITRI R PASIEN
26,516.00 26,516.00
dr. Goliat KHOIRUL Rp. Rp.
1417. 7-Jul-18 Victor SETIAWA 2082779 931374 TRANSFE 1
R PASIEN
Emanuel N 26,516.00 26,516.00
dr. Goliat SURIPAH, Rp. Rp.
1418. 7-Jul-18 Victor 2082784 900005 TRANSFE 1
Emanuel NY R PASIEN
26,516.00 26,516.00

Ratna MARITA Rp. Rp.


1419. 7-Jul-18 dr. 931381 TRANSFE
Ernawat DWI 2082791 1
R PASIEN
NURLAILI 26,516.00 26,516.00
dr. Goliat LULUS Rp. Rp.
1420. 7-Jul-18 Victor 2082794 931377 TRANSFE 1
Emanuel PAMUJI R PASIEN
26,516.00 26,516.00

CHINTAM
dr. Goliat I Rp. Rp.
1421. 7-Jul-18 Victor MUTIARA 2082795 931383 TRANSFE 1
R PASIEN
Emanuel RACHMA
PUTRI
26,516.00 26,516.00
dr. Goliat ADI Rp. Rp.
1422. 8-Jul-18 Victor WAHYU 2082797 931385 TRANSFE 1
R PASIEN
Emanuel SAPUTRA 26,516.00 26,516.00
dr. Goliat Rp. Rp.
1423. 8-Jul-18 Victor MUINAH 2082799 931387 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00

MAULIDA
Yenny TSALISA Rp. Rp.
1424. 8-Jul-18 dr. 73857 TRANSFE
Haryono RAHMA 2082800 1
R PASIEN
NUR AL
HUSNA
26,516.00 26,516.00
Rp. Rp.
8-Jul-18 dr. Yenny SARI
1425. 2082801 931388 TRANSFE 1
Haryono MULIA R PASIEN
8-Jul-18 dr. Yenny SARI
1425. 2082801 931388 TRANSFE 1
Haryono MULIA R PASIEN 26,516.00 26,516.00
Rp. Rp.
8-Jul-18 dr. Yenny
1426. 931389 TRANSFE
Haryono LANTIP 2082802 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
8-Jul-18 dr. Yenny
1427. 931390 TRANSFE
Haryono WINARTI 2082803 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
8-Jul-18 dr. Yenny
1428. 931341 TRANSFE
Haryono SUDARNI 2082804 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
8-Jul-18 dr. Yenny
1429. 931391 TRANSFE
Haryono MALIKIN 2082805 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
8-Jul-18 dr. Yenny
1430. 53360 TRANSFE
Haryono TATIK 2082806 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
1431. 8-Jul-18 dr. Yenny 915224 TRANSFE
Haryono TOMO 2082810 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
8-Jul-18 dr. Yenny
1432. 931393 TRANSFE
Haryono SAMIRAH 2082813 1
R PASIEN 26,516.00 26,516.00
ANINDYA
Rp. Rp.
8-Jul-18 Haryono AYU
dr. Yenny
1433. 922867 TRANSFE
PRAMUSI 2082814 1
R PASIEN
TA
26,516.00 26,516.00

Yenny FEDRIKA Rp. Rp.


1434. 8-Jul-18 dr. 913176 TRANSFE
Haryono SUSANAV 2082812 1
R PASIEN
I ANDARI
26,516.00 26,516.00

FARREL
Rp. Rp.
8-Jul-18 Zumaroh OKTAVIA
dr. Nani
1435. 2082817 931395 TRANSFE 1
N R PASIEN
SANTOSO
26,516.00 26,516.00

Nani SUGENG Rp. Rp.


1436. 8-Jul-18 dr. 931396 TRANSFE
Zumaroh RUDIANT 2082818 1
R PASIEN
O 26,516.00 26,516.00
Rp. Rp.
8-Jul-18 dr. Nani
1437. 917244 TRANSFE
Zumaroh WARNADI 2082820 1
R PASIEN 26,516.00 26,516.00

Nani IBNU ALI Rp. Rp.


1438. 8-Jul-18 dr. MUSTAJJ 2082819 907399 TRANSFE 1
Zumaroh AB R PASIEN
26,516.00 26,516.00
Rp. Rp.
8-Jul-18 dr. Nani MINARO
1439. 2082821 931397 TRANSFE 1
Zumaroh HMA R PASIEN 26,516.00 26,516.00

Nani RAFI Rp. Rp.


1440. 8-Jul-18 dr. 931398 TRANSFE
Zumaroh SAIFUDIN 2082822 1
R PASIEN
,MOCH 26,516.00 26,516.00
Rp. Rp.
8-Jul-18 dr. Nani
1441. 931400 TRANSFE
Zumaroh KASIYADI 2082824 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
8-Jul-18 dr. Nani SUHARTI
1442. 2082827 104002 TRANSFE 1
Zumaroh NIK R PASIEN 26,516.00 26,516.00
Rp. Rp.
8-Jul-18 dr. Nani
1443. 924169 TRANSFE
Zumaroh SUNOTO 2082826 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
8-Jul-18 dr. Nani MADANU 2082829
1444. 903683 TRANSFE 1
Zumaroh N R PASIEN 26,516.00 26,516.00
Rp. Rp.
8-Jul-18 dr. Nani DEBIE
1445. 2082832 931402 TRANSFE 1
Zumaroh MARIA R PASIEN 26,516.00 26,516.00
Rp. Rp.
8-Jul-18 dr. Nani TARU
1446. 2082831 931399 TRANSFE 1
Zumaroh WIJAYA R PASIEN 26,516.00 26,516.00
DHANIEL Rp. Rp.
1447. 8-Jul-18 dr. 931403 TRANSFE
Hartono BAYU 2082833 1
R PASIEN
IRAWAN 26,516.00 26,516.00
Rp. Rp.
1448. 8-Jul-18 dr. DIANTINI 2082834 931404 TRANSFE 1
Hartono K R PASIEN 26,516.00 26,516.00
Rp. Rp.
1449. 9-Jul-18 dr. 931406 TRANSFE
Hartono KASNIR 2082836 1
R PASIEN 26,516.00 26,516.00
KHUSNUL Rp. Rp.
1450. 9-Jul-18 dr. 924586 TRANSFE
Hartono KHOTIMA 2082846 1
R PASIEN
H 26,516.00 26,516.00
HANIF
Rp. Rp.
9-Jul-18 Hartono AHZHA,M
dr.
1451. 928615 TRANSFE
UHAMM 2082847 1
R PASIEN
AD
26,516.00 26,516.00
Rp. Rp.
9-Jul-18 dr. KHAFID
1452. 2082849 931407 TRANSFE 1
Hartono ASNAIN R PASIEN 26,516.00 26,516.00
Rp. Rp.
1453. 9-Jul-18 dr. 931408 TRANSFE
Hartono WARAS 2082853 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
9-Jul-18 dr. AIO
1454. 2082856 931409 TRANSFE 1
Hartono ARASI R PASIEN 26,516.00 26,516.00
Rp. Rp.
9-Jul-18 dr. Nani
1455. 931414 TRANSFE
Zumaroh PUJIATI 2082872 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
9-Jul-18 dr. Nani MUSRIPA
1456. 2082903 904014 TRANSFE 1
Zumaroh H R PASIEN 26,516.00 26,516.00

NIKITA
Nani WHELAN Rp. Rp.
1457. 9-Jul-18 dr. 917993 TRANSFE
Zumaroh DA 2082891 1
R PASIEN
WIJAYANT
I
26,516.00 26,516.00
Rp. Rp.
9-Jul-18 dr. Nani
1458. 931425 TRANSFE
Zumaroh GARIYAH 2082905 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
9-Jul-18 dr. Nani
1459. 931427 TRANSFE
Zumaroh LIMJIATI 2082908 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
9-Jul-18 dr. Nani HARIYANT 2082912
1460. 931215 TRANSFE 1
Zumaroh O R PASIEN 26,516.00 26,516.00
Rp. Rp.
9-Jul-18 dr. Yenny
1461. 64042 TRANSFE
Haryono TORAN 2082927 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
9-Jul-18 dr. Yenny
1462. 929170 TRANSFE
Haryono KATREMI 2082929 1
R PASIEN 26,516.00 26,516.00

Yenny NAJWA Rp. Rp.


1463. 9-Jul-18 dr. 931436 TRANSFE
Haryono KHAIRA 2082937 1
R PASIEN
WILDHA 26,516.00 26,516.00
Rp. Rp.
9-Jul-18 dr. Yenny
1464. 931437 TRANSFE
Haryono TARSIH 2082938 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
9-Jul-18 dr. Yenny
1465. 78230 TRANSFE
Haryono KASBU 2082941 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
9-Jul-18 dr. Yenny
1466. 919356 TRANSFE
Haryono MASJUKI 2082944 1
R PASIEN 26,516.00 26,516.00

Yenny SITI Rp. Rp.


1467. 9-Jul-18 dr. 931438 TRANSFE
Haryono ZULAIKO 2082943 1
R PASIEN
H 26,516.00 26,516.00

Yenny WIDARTI Rp. Rp.


1468. 9-Jul-18 dr. 931440 TRANSFE
Haryono JANUARI 2082947 1
R PASIEN
NINGSIH 26,516.00 26,516.00
RENY
Rp. Rp.
9-Jul-18 Haryono VISILIA
dr. Yenny
1469. 2082953 931441 TRANSFE 1
SALAMO R PASIEN
NY
26,516.00 26,516.00
Rp. Rp.
9-Jul-18 dr. Yenny
1470. 931240 TRANSFE
Haryono TUMIRAH 2082954 1
R PASIEN 26,516.00 26,516.00
dr. RENATA Rp. Rp.
1471. 9-Jul-18 Artamty LYAN 2082955 34866 TRANSFE 1
R PASIEN
Sastry A NOVIA 26,516.00 26,516.00
dr. SAMUEL Rp. Rp.
1472. 9-Jul-18 Artamty LYANNOV 2082956 89089 TRANSFE 1
R PASIEN
Sastry A E 26,516.00 26,516.00
YUDHISTI
dr. Rp. Rp.
RA
1473. 9-Jul-18 Artamty 2082957 921123 TRANSFE 1
HARFIAN R PASIEN
Sastry A O PUTRA
26,516.00 26,516.00
AGUNG
dr. Rp. Rp.
ADI
1474. 10-Jul-18 Artamty 2082970 931442 TRANSFE 1
PRASETY R PASIEN
Sastry A O
26,516.00 26,516.00
dr. VIZRAL Rp. Rp.
1475. 10-Jul-18 Artamty SATRIA 2082971 911444 TRANSFE 1
R PASIEN
Sastry A PUTRA 26,516.00 26,516.00
dr. Rp. Rp.
1476. 10-Jul-18 Artamty KARMINI 2082974 63247 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
1477. 10-Jul-18 Artamty ZAENI 2082975 931443 TRANSFE 1
R PASIEN
Sastry A
dr.
1477. 10-Jul-18 Artamty ZAENI 2082975 931443 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00

Ratna MARITA Rp. Rp.


1478. 10-Jul-18 dr. 931381 TRANSFE
Ernawat DWI 2082994 1
R PASIEN
NURLAILI 26,516.00 26,516.00
Rp. Rp.
1479. 10-Jul-18 dr. 931447 TRANSFE
Hartono SUKADI 2083001 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
1480. 10-Jul-18 dr. 931450 TRANSFE
Hartono SURIYAH 2083009 1
R PASIEN 26,516.00 26,516.00
KRISTINA Rp. Rp.
1481. 10-Jul-18 dr. 913252 TRANSFE
Hartono NURHAYA 2083033 1
R PASIEN
TI 26,516.00 26,516.00
Rp. Rp.
1482. 10-Jul-18 dr. NYAMINA 2083035 931200 TRANSFE 1
Hartono H R PASIEN 26,516.00 26,516.00

Yenny AZURA Rp. Rp.


1483. 10-Jul-18 dr. 931467 TRANSFE
Haryono MAFAZA 2083078 1
FIKRI R PASIEN
26,516.00 26,516.00
Rp. Rp.
10-Jul-18 dr. Yenny
1484. 931468 TRANSFE
Haryono KARJONO 2083080 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
10-Jul-18 dr. Yenny LASMINT
1485. 2083083 931102 TRANSFE 1
Haryono O, TN R PASIEN 26,516.00 26,516.00
Rp. Rp.
10-Jul-18 dr. Yenny
1486. 931470 TRANSFE
Haryono SUMIRAH 2083088 1
R PASIEN 26,516.00 26,516.00
QUTHBI
Rp. Rp.
10-Jul-18 Haryono UWAYS
dr. Yenny
1487. 2083089 931471 TRANSFE 1
SYIHAB, R PASIEN
AHMAD
26,516.00 26,516.00
Rp. Rp.
10-Jul-18 dr. Yenny
1488. 931474 TRANSFE
Haryono SUKIMAH 2083099 1
R PASIEN 26,516.00 26,516.00
dr. Goliat DESY Rp. Rp.
1489. 10-Jul-18 Victor KURNIAW 2083109 931479 TRANSFE 1
R PASIEN
Emanuel ATI 26,516.00 26,516.00
dr. Goliat NANIK Rp. Rp.
1490. 10-Jul-18 Victor YULIANTI 2083108 930365 TRANSFE 1
R PASIEN
Emanuel S 26,516.00 26,516.00
dr. Goliat Rp. Rp.
1491. 10-Jul-18 Victor SUMIJAH 2083107 931478 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
NURUL
dr. Goliat Rp. Rp.
SITI
1492. 11-Jul-18 Victor 2083106 931477 TRANSFE 1
OKTAVIA R PASIEN
Emanuel NI
26,516.00 26,516.00
dr. Goliat ENI NUR Rp. Rp.
1493. 11-Jul-18 Victor 2083104 931472 TRANSFE 1
Emanuel FARIDAH R PASIEN
26,516.00 26,516.00
FAUQI
dr. Goliat ALQOHAR Rp. Rp.
1494. 11-Jul-18 Victor , 2083111 931480 TRANSFE 1
R PASIEN
Emanuel MOHAM
AD
26,516.00 26,516.00

dr. Goliat RAVI Rp. Rp.


1495. 11-Jul-18 Victor PUTERA 2083112 922920 TRANSFE 1
R PASIEN
Emanuel PRASETYA
26,516.00 26,516.00
WAN
Rp. Rp.
11-Jul-18 Haryono SAHIRA
dr. Yenny
1496. 2083127 915313 TRANSFE 1
PUTRI R PASIEN
ARINA
26,516.00 26,516.00
Rp. Rp.
11-Jul-18 dr. Yenny
1497. 931490 TRANSFE
Haryono KUHARI 2083156 1
R PASIEN 26,516.00 26,516.00
EVA
Rp. Rp.
11-Jul-18 Haryono SUNITI
dr. Yenny
1498. 930132 TRANSFE
DARMAW 2083159 1
R PASIEN
IATI
26,516.00 26,516.00
Rp. Rp.
11-Jul-18 dr. SARMILA
1499. 2083167 931492 TRANSFE 1
Hartono H R PASIEN 26,516.00 26,516.00

NIZAR
TSAQIF
Rp. Rp.
11-Jul-18 Hartono AL
dr.
1500. 931495 TRANSFE
FATIH,MU 2083172 1
R PASIEN
HAMMA
D
26,516.00 26,516.00
Rp. Rp.
11-Jul-18 dr. SUPRIYAD 2083186
1501. 900511 TRANSFE 1
Hartono I R PASIEN 26,516.00 26,516.00
Rp. Rp.
11-Jul-18 dr. Nani SURI
1502. 2083190 931500 TRANSFE 1
Zumaroh R PASIEN 26,516.00 26,516.00

Yenny ALKHALIF Rp. Rp.


1503. 11-Jul-18 dr. 925675 TRANSFE
Haryono IRAFAN
MAUZA 2083199 1
R PASIEN
26,516.00 26,516.00
Rp. Rp.
11-Jul-18 dr. Yenny KUSNAN,
1504. 2083203 911166 TRANSFE 1
Haryono M R PASIEN 26,516.00 26,516.00
ROIIQOH
Rp. Rp.
11-Jul-18 Hartono HABIBAT
dr.
1505. 2083209 72057 TRANSFE 1
UL ASMA R PASIEN
ALIFAH
26,516.00 26,516.00
AZRINA Rp. Rp.
1506. 11-Jul-18 dr. 931506 TRANSFE
Hartono LAVENIA 2083210 1
R PASIEN
SHAZFA 26,516.00 26,516.00
JEFRI Rp. Rp.
1507. 11-Jul-18 dr. 931507 TRANSFE
Hartono HERIANT 2083214 1
R PASIEN
O, MUH
JEFRI
1507. 11-Jul-18 dr. 931507 TRANSFE
Hartono HERIANT 2083214 1
R PASIEN
O, MUH 26,516.00 26,516.00

ABHAN
MAULAN
Rp. Rp.
11-Jul-18 Hartono A
dr.
1508. 2083215 105537 TRANSFE 1
ADHYAST R PASIEN
HA
BUKHORI
26,516.00 26,516.00
dr. Rp. Rp.
1509. 12-Jul-18 Artamty DURAJI 2083226 931510 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
HARMOK
1510. 12-Jul-18 Artamty 2083229 931511 TRANSFE 1
O R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
1511. 12-Jul-18 Artamty SODJO 2083230 931483 TRANSFE 1
Sastry A R PASIEN
26,516.00 26,516.00

dr. AULIA Rp. Rp.


1512. 12-Jul-18 Artamty RAFA ARI 2083236 931513 TRANSFE 1
R PASIEN
Sastry A PRATAMA
26,516.00 26,516.00
dr. Rp. Rp.
SRI
1513. 12-Jul-18 Artamty 2083239 65659 TRANSFE 1
HARUMI R PASIEN
Sastry A 26,516.00 26,516.00
Rp. Rp.
12-Jul-18 dr. Yenny
1514. 931516 TRANSFE
Haryono SUYATNO 2083247 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
12-Jul-18 dr. Nani ERLIN
1515. 2083265 69917 TRANSFE 1
Zumaroh PUTRI P R PASIEN 26,516.00 26,516.00

Yenny EARLITA Rp. Rp.


1516. 12-Jul-18 dr. 907589 TRANSFE
Haryono SALSABIL 2083285 1
R PASIEN
A 26,516.00 26,516.00

Yenny DIANITA Rp. Rp.


1517. 12-Jul-18 dr. 99921 TRANSFE
Haryono KRISTIAN 2083313 1
R PASIEN
NINGSIH 26,516.00 26,516.00
TEGUH
Rp. Rp.
12-Jul-18 Haryono IBNU
dr. Yenny
1518. 2083320 34066 TRANSFE 1
SUNGKO R PASIEN
WO
26,516.00 26,516.00
Rp. Rp.
12-Jul-18 dr. Yenny
1519. 931529 TRANSFE
Haryono DAMPUN 2083317 1
R PASIEN 26,516.00 26,516.00

Yenny DANIYAH Rp. Rp.


1520. 12-Jul-18 dr. 931532 TRANSFE
Haryono RIHADAT 2083338 1
R PASIEN
UL AISY 26,516.00 26,516.00

Yenny YOGI Rp. Rp.


1521. 12-Jul-18 dr. 36581 TRANSFE
Haryono WAHYU 2083336 1
R PASIEN
PRATAMA
Yenny YOGI
1521. 12-Jul-18 dr. 36581 TRANSFE
Haryono WAHYU 2083336 1
R PASIEN
PRATAMA
26,516.00 26,516.00

Yenny LUCKY Rp. Rp.


1522. 12-Jul-18 dr. 108128 TRANSFE
Haryono ANGGAR 2083356 1
R PASIEN
A,M 26,516.00 26,516.00
BENY
Rp. Rp.
12-Jul-18 Haryono WAHYU
dr. Yenny
1523. 2083286 931524 TRANSFE 1
IRAWAN, R PASIEN
MOCH.
26,516.00 26,516.00

Yenny CATUR Rp. Rp.


1524. 12-Jul-18 dr. 931536 TRANSFE
Haryono WULAND 2083347 1
R PASIEN
ARI 26,516.00 26,516.00
Rp. Rp.
1525. 12-Jul-18 dr. Yenny 931279 TRANSFE
Haryono DARGO 2083357 1
R PASIEN 26,516.00 26,516.00
DINDA
Rp. Rp.
1526. 12-Jul-18 Haryono PUTRI
dr. Yenny 2083353 931538 TRANSFE 1
RAMADH R PASIEN
ANI
26,516.00 26,516.00
RAISA
Rp. Rp.
12-Jul-18 Hartono AZIRAH
dr.
1527. 2083361 931539 TRANSFE 1
RAMADH R PASIEN
ANI
26,516.00 26,516.00
JEREMY
Rp. Rp.
12-Jul-18 Hartono GLEVINO
dr.
1528. 2083364 105516 TRANSFE 1
KARSTEN R PASIEN
LIN
26,516.00 26,516.00
HERMINA
Rp. Rp.
12-Jul-18 Hartono H
dr.
1529. 931542 TRANSFE
FEBRIANT 2083368 1
R PASIEN
Y
26,516.00 26,516.00
Rp. Rp.
1530. 12-Jul-18 dr. BASRI 2083369 931543 TRANSFE 1
Hartono R PASIEN 26,516.00 26,516.00
Rp. Rp.
12-Jul-18 dr. WARSILA
1531. 2083371 107216 TRANSFE 1
Hartono H R PASIEN 26,516.00 26,516.00
Rp. Rp.
12-Jul-18 dr. MUNTOLI 2083373
1532. 931545 TRANSFE 1
Hartono B R PASIEN 26,516.00 26,516.00
ANUGRA Rp. Rp.
1533. 12-Jul-18 dr. 69014 TRANSFE
Hartono H EKA 2083374 1
R PASIEN
ALFEYCO 26,516.00 26,516.00
SYAUQIL
Rp. Rp.
13-Jul-18 Hartono ISMA
dr.
1534. 931544 TRANSFE
ASSYAFIIY 2083370 1
R PASIEN
AH
26,516.00 26,516.00
RISKI
Rp. Rp.
13-Jul-18 Hartono DIKA
dr.
1535. 2083379 40039 TRANSFE 1
ARMADA R PASIEN
NI
RISKI
13-Jul-18 Hartono DIKA
dr.
1535. 2083379 40039 TRANSFE 1
ARMADA R PASIEN
NI
26,516.00 26,516.00
HAFIZH
Rp. Rp.
13-Jul-18 Hartono MUZAKY,
dr.
1536. 2083378 931547 TRANSFE 1
MUHAM R PASIEN
MAD
26,516.00 26,516.00
Rp. Rp.
1537. 13-Jul-18 dr. 931548 TRANSFE
Hartono SAJI 2083388 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
13-Jul-18 dr. JOYO
1538. 2083403 904546 TRANSFE 1
Hartono ADI,H R PASIEN 26,516.00 26,516.00
dr. Rp. Rp.
LIA NUR
1539. 13-Jul-18 Artamty 2083413 931551 TRANSFE 1
ENI R PASIEN
Sastry A 26,516.00 26,516.00
dr. AISYAH Rp. Rp.
1540. 13-Jul-18 Artamty NUHA 2083436 931556 TRANSFE 1
R PASIEN
Sastry A ZAHIRA 26,516.00 26,516.00
dr. Rp. Rp.
NUR YULI 2083438
1541. 13-Jul-18 Artamty 931557 TRANSFE 1
ASTITI R PASIEN
Sastry A 26,516.00 26,516.00
dr. SITI Rp. Rp.
1542. 13-Jul-18 Artamty KHASANA 2083443 931558 TRANSFE 1
R PASIEN
Sastry A H 26,516.00 26,516.00
dr. SITI Rp. Rp.
1543. 13-Jul-18 Artamty MARDIYA 2083440 930843 TRANSFE 1
R PASIEN
Sastry A H 26,516.00 26,516.00
dr. Rp. Rp.
1544. 13-Jul-18 Artamty SUMARJI 2083448 931561 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
1545. 13-Jul-18 Artamty ZAENAB 2083449 931562 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
CALYSTA
dr. Rp. Rp.
QUEENIZ 2083450
1546. 13-Jul-18 Artamty 921638 TRANSFE 1
A R PASIEN
Sastry A ROHMAN
26,516.00 26,516.00
dr. Rp. Rp.
1547. 13-Jul-18 Artamty ROHLI 2083452 927283 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
Rp. Rp.
13-Jul-18 dr. Yenny
1548. 931565 TRANSFE
Haryono MASUD 2083458 1
R PASIEN 26,516.00 26,516.00
AFZAR
Rp. Rp.
13-Jul-18 Haryono HAZIQ
dr. Yenny
1549. 924185 TRANSFE
ALFARIDZ 2083471 1
R PASIEN
Y,AHMAD
26,516.00 26,516.00

Yenny NUR Rp. Rp.


1550. 13-Jul-18 dr. 930480 TRANSFE
Haryono SHOLICA 2083473 1
R PASIEN
H
Yenny NUR
1550. 13-Jul-18 dr. 930480 TRANSFE
Haryono SHOLICA 2083473 1
R PASIEN
H 26,516.00 26,516.00
Rp. Rp.
13-Jul-18 dr. Yenny
1551. 931568 TRANSFE
Haryono PASRI 2083474 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
13-Jul-18 dr. Yenny
1552. 931378 TRANSFE
Haryono LAMIJAH 2083475 1
R PASIEN 26,516.00 26,516.00
dr. Goliat ZAINUL Rp. Rp.
1553. 13-Jul-18 Victor 2083477 931570 TRANSFE 1
Emanuel ABIDIN R PASIEN
26,516.00 26,516.00
dr. Goliat Rp. Rp.
1554. 13-Jul-18 Victor RASIDIN 2083478 931571 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
ANGGAR
dr. Goliat Rp. Rp.
ROSARIA
1555. 14-Jul-18 Victor 2083479 78535 TRANSFE 1
PUTRI R PASIEN
Emanuel DEWI
26,516.00 26,516.00
dr. Goliat JULIANA Rp. Rp.
1556. 14-Jul-18 Victor 2083482 931573 TRANSFE 1
Emanuel PUTRI R PASIEN
26,516.00 26,516.00
dr. Goliat SITI Rp. Rp.
1557. 14-Jul-18 Victor 2083483 931574 TRANSFE 1
Emanuel ZULAIKAH R PASIEN
26,516.00 26,516.00
Rp. Rp.
14-Jul-18 dr. Yenny DAFFA,M
1558. 2083487 931575 TRANSFE 1
Haryono OCH R PASIEN 26,516.00 26,516.00
Rp. Rp.
14-Jul-18 dr. Yenny WASRIAT
1559. 2083488 931576 TRANSFE 1
Haryono UN R PASIEN 26,516.00 26,516.00

RAVI Rp. Rp.


1560. 14-Jul-18 dr. 922920 TRANSFE
Hartono PUTERA 2083496 1
R PASIEN
PRASETYA
26,516.00 26,516.00

BY.NY.WI Rp. Rp.


1561. 14-Jul-18 dr. 931580 TRANSFE
Hartono NDA 2083499 1
R PASIEN
KRISTIANI
26,516.00 26,516.00
IDA Rp. Rp.
1562. 14-Jul-18 dr. 931581 TRANSFE
Hartono LUPITA 2083500 1
R PASIEN
SARI 26,516.00 26,516.00
Rp. Rp.
14-Jul-18 dr. ROZIMI,A
1563. 2083503 931582 TRANSFE 1
Hartono CHMAD R PASIEN 26,516.00 26,516.00
dr. Goliat Rp. Rp.
1564. 14-Jul-18 Victor RUSNO 2083504 931583 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
dr. Goliat Rp. Rp.
1565. 14-Jul-18 Victor TASRAM 2083510 931585 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
dr. Goliat Rp. Rp.
1566. 14-Jul-18 Victor MUCHLIS 2083511 931586 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
dr. Goliat MUSTAIN, Rp. Rp.
1567. 14-Jul-18 Victor 2083453 106469 TRANSFE 1
Emanuel TN R PASIEN
26,516.00 26,516.00
dr. Goliat DHIMAS Rp. Rp.
1568. 14-Jul-18 Victor AKBAR 2083514 95332 TRANSFE 1
R PASIEN
Emanuel ARIYADI 26,516.00 26,516.00
dr. Goliat Rp. Rp.
1569. 14-Jul-18 Victor KARTINI 2083513 931587 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
dr. Goliat DYAH AYU Rp. Rp.
1570. 14-Jul-18 Victor 2083517 931589 TRANSFE 1
Emanuel SAFITRI R PASIEN
26,516.00 26,516.00
SRI
dr. Goliat Rp. Rp.
WAHYUNI 2083520
1571. 14-Jul-18 Victor 931591 TRANSFE 1
INDAH R PASIEN
Emanuel SARI
26,516.00 26,516.00
dr. Goliat NOFI Rp. Rp.
1572. 14-Jul-18 Victor ANDIK 2083518 915598 TRANSFE 1
R PASIEN
Emanuel SUSANTO 26,516.00 26,516.00
dr. DIVIA Rp. Rp.
1573. 14-Jul-18 Artamty CHILA 2083521 931592 TRANSFE 1
R PASIEN
Sastry A ASYIFA 26,516.00 26,516.00
dr. Rp. Rp.
RINA
1574. 15-Jul-18 Artamty 2083522 931593 TRANSFE 1
WATI R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
1575. 15-Jul-18 Artamty WITO 2083524 931595 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
1576. 15-Jul-18 Artamty MASIJAH 2083526 931596 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
Rp. Rp.
1577. 15-Jul-18 dr. 931599 TRANSFE
Hartono SUPRAT 2083530 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
1578. 15-Jul-18 dr. 931600 TRANSFE
Hartono PARCIM 2083531 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
1579. 15-Jul-18 dr. 931602 TRANSFE
Hartono KACUNG 2083533 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
15-Jul-18 dr. IMAM
1580. 2083536 931603 TRANSFE 1
Hartono SYAFI'I R PASIEN 26,516.00 26,516.00
Rp. Rp.
1581. 15-Jul-18 dr. 931604 TRANSFE
Hartono RUKMI 2083537 1
R PASIEN 26,516.00 26,516.00
dr. Goliat Rp. Rp.
1582. 15-Jul-18 Victor SALEKAH 2083544 927868 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
dr. Goliat Rp. Rp.
1583. 15-Jul-18 Victor LASRUN 2083548 925071 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
dr. Goliat SRI Rp. Rp.
1584. 15-Jul-18 Victor 2083549 930897 TRANSFE 1
Emanuel WAHYUNI R PASIEN
26,516.00 26,516.00
dr. DARJITO Rp. Rp.
1585. 15-Jul-18 Artamty HADI 2083551 931609 TRANSFE 1
R PASIEN
Sastry A SUCIPTO 26,516.00 26,516.00
dr. Goliat Rp. Rp.
1586. 16-Jul-18 Victor SARILAH 2083550 931608 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
PEGGI
dr. Rp. Rp.
ARIE
1587. 16-Jul-18 Artamty 2083552 931610 TRANSFE 1
ZULIA R PASIEN
Sastry A AZIZ
26,516.00 26,516.00
MARDIKA
dr. Rp. Rp.
DIAN
1588. 16-Jul-18 Artamty 931498 TRANSFE
NINGRU 2083554 1
R PASIEN
Sastry A M
26,516.00 26,516.00
Rp. Rp.
16-Jul-18 dr. Yenny
1589. 88240 TRANSFE
Haryono TARSINI 2083582 1
R PASIEN 26,516.00 26,516.00
NAUFAL
Rp. Rp.
16-Jul-18 Haryono SYAMIL
dr. Yenny
1590. 2083591 931614 TRANSFE 1
ADZ R PASIEN
DZAKY W
26,516.00 26,516.00

LUTHFIA Rp. Rp.


16-Jul-18 dr. Yenny LEYLA
1591. 931616 TRANSFE
Haryono NASHIWA 2083597 1
R PASIEN
26,516.00 26,516.00
Rp. Rp.
16-Jul-18 dr. Yenny
1592. 921489 TRANSFE
Haryono BASTAM 2083610 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
16-Jul-18 dr. Yenny
1593. 88759 TRANSFE
Haryono ASRIATIN 2083613 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
16-Jul-18 dr. Yenny
1594. 931628 TRANSFE
Haryono ANTO 2083640 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
16-Jul-18 dr. Yenny
1595. 931631 TRANSFE
Haryono SUPARMI 2083646 1
R PASIEN 26,516.00 26,516.00
dr. Goliat NABILLA Rp. Rp.
1596. 16-Jul-18 Victor AMEERA 2083663 925561 TRANSFE 1
R PASIEN
Emanuel H 26,516.00 26,516.00
dr. Goliat TURJIMA Rp. Rp.
1597. 16-Jul-18 Victor 2083667 931635 TRANSFE 1
Emanuel N R PASIEN
26,516.00 26,516.00
ADHITAM
dr. Goliat Rp. Rp.
A ELVAN 2083670
1598. 16-Jul-18 Victor 931637 TRANSFE 1
SYAHREZ R PASIEN
Emanuel A
26,516.00 26,516.00
Rp. Rp.
1599. 17-Jul-18 dr. 920067 TRANSFE
Hartono SAMHADI 2083674 1
R PASIEN 26,516.00 26,516.00

NAJMA
Rp. Rp.
17-Jul-18 Hartono YUKE
dr.
1600. 2083695 931640 TRANSFE 1
FISKA R PASIEN
PRATAMA
26,516.00 26,516.00
Rp. Rp.
1601. 17-Jul-18 dr. KUSNAN, 2083696 911166 TRANSFE 1
Hartono M R PASIEN 26,516.00 26,516.00
NUR Rp. Rp.
1602. 17-Jul-18 dr. 931639 TRANSFE
Hartono RAIHAN, 2083673 1
R PASIEN
MUH. 26,516.00 26,516.00
SITI Rp. Rp.
1603. 17-Jul-18 dr. 930488 TRANSFE
Hartono FATONAH 2083701 1
R PASIEN
, NY 26,516.00 26,516.00
Rp. Rp.
17-Jul-18 dr. WILDAN
1604. 2083707 914458 TRANSFE 1
Hartono FAIQ, M R PASIEN 26,516.00 26,516.00

Rp. Rp.
17-Jul-18 dr. Yenny CAHYANA
1605. 931645 TRANSFE
Haryono , AHMAD 2083728 1
R PASIEN
26,516.00 26,516.00

Yenny SITI Rp. Rp.


1606. 17-Jul-18 dr. 931641 TRANSFE
Haryono ISTIKOMA 2083737 1
R PASIEN
H 26,516.00 26,516.00
AGNES
Rp. Rp.
17-Jul-18 Haryono CRISTY
dr. Yenny
1607. 2083752 931632 TRANSFE 1
MARGAR R PASIEN
ETHA
26,516.00 26,516.00

Yenny ATTHAR Rp. Rp.


1608. 17-Jul-18 dr. 931648 TRANSFE
Haryono GIO 2083746 1
R PASIEN
VALENSIA
26,516.00 26,516.00
Rp. Rp.
17-Jul-18 dr. Yenny
1609. 924169 TRANSFE
Haryono SUNOTO 2083717 1
R PASIEN 26,516.00 26,516.00
IKVAN
Rp. Rp.
17-Jul-18 Haryono HADI
dr. Yenny
1610. 2083758 912337 TRANSFE 1
PRASETY R PASIEN
O
26,516.00 26,516.00
Rp. Rp.
17-Jul-18 dr. Yenny SUHARSO 2083765
1611. 931654 TRANSFE 1
Haryono NO R PASIEN
17-Jul-18 dr. Yenny SUHARSO 2083765
1611. 931654 TRANSFE 1
Haryono NO R PASIEN 26,516.00 26,516.00
RATNA
Rp. Rp.
17-Jul-18 Haryono DWI
dr. Yenny
1612. 81758 TRANSFE
SETYORIN 2083770 1
R PASIEN
I
26,516.00 26,516.00
Rp. Rp.
17-Jul-18 dr. Yenny
1613. 931657 TRANSFE
Haryono SAENI 2083773 1
R PASIEN 26,516.00 26,516.00

Nani ENI Rp. Rp.


1614. 17-Jul-18 dr. 931660 TRANSFE
Zumaroh SUSWAN 2083784 1
R PASIEN
TI 26,516.00 26,516.00

Nani NAUFALI Rp. Rp.


1615. 17-Jul-18 dr. 931663 TRANSFE
Zumaroh NO 2083793 1
R PASIEN
ATHAYA 26,516.00 26,516.00
Rp. Rp.
17-Jul-18 dr. Nani
1616. 931662 TRANSFE
Zumaroh MASHUDI 2083789 1
R PASIEN 26,516.00 26,516.00

Nani KARSANI Rp. Rp.


1617. 17-Jul-18 dr. 95655 TRANSFE
Zumaroh EDI 2083797 1
R PASIEN
WIBOWO 26,516.00 26,516.00
Rp. Rp.
17-Jul-18 dr. Nani RUKMIYA
1618. 2083807 931669 TRANSFE 1
Zumaroh TUN R PASIEN 26,516.00 26,516.00

Nani YUSUF Rp. Rp.


1619. 17-Jul-18 dr. 105681 TRANSFE
Zumaroh ROMADH 2083802 1
R PASIEN
ON,MOH 26,516.00 26,516.00

ANDREE
Nani NICO Rp. Rp.
1620. 17-Jul-18 dr. 67315 TRANSFE
Zumaroh AUSHAF, 2083809 1
R PASIEN
MUHAM
MAD
26,516.00 26,516.00
Rp. Rp.
17-Jul-18 dr. Nani RUBI
1621. 2083814 931671 TRANSFE 1
Zumaroh MAE R PASIEN 26,516.00 26,516.00

Nani FADHIL Rp. Rp.


1622. 17-Jul-18 dr. 915074 TRANSFE
Zumaroh ABDILLAH 2083812 1
R PASIEN
,MUH 26,516.00 26,516.00

RIZKHA
dr. DIAH Rp. Rp.
1623. 17-Jul-18 Artamty PUSPITA 2083818 906919 TRANSFE 1
R PASIEN
Sastry A NINGRU
M
26,516.00 26,516.00
dr. Rp. Rp.
SULISWA
1624. 17-Jul-18 Artamty 2083820 931675 TRANSFE 1
NTO R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
PURNOM 2083819
1625. 17-Jul-18 Artamty 900871 TRANSFE 1
O R PASIEN
Sastry A 26,516.00 26,516.00
SHANDY
DWISAKS
dr. Rp. Rp.
ANA
1626. 17-Jul-18 Artamty 2083817 931674 TRANSFE 1
ADITYA R PASIEN
Sastry A CANDRAK
USUMA
26,516.00 26,516.00
dr. Rp. Rp.
ADAM
1627. 17-Jul-18 Artamty 2083816 931673 TRANSFE 1
RAHMAN R PASIEN
Sastry A 26,516.00 26,516.00
dr. RIRIN Rp. Rp.
1628. 18-Jul-18 Artamty AMBARW 2083833 920460 TRANSFE 1
R PASIEN
Sastry A ATI 26,516.00 26,516.00
dr. Rp. Rp.
1629. 18-Jul-18 Artamty DARSIPAH 2083832 927232 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
1630. 18-Jul-18 Artamty ROKIAH 2083830 931676 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. ERICK Rp. Rp.
1631. 18-Jul-18 Artamty FEBRIANS 2083834 931678 TRANSFE 1
R PASIEN
Sastry A YAH 26,516.00 26,516.00
Rp. Rp.
1632. 18-Jul-18 dr. 931685 TRANSFE
Hartono SAMIN 2083855 1
R PASIEN 26,516.00 26,516.00

NAZRIL Rp. Rp.


1633. 18-Jul-18 dr. 931689 TRANSFE
Hartono ILHAM 2083864 1
R PASIEN
PRASTIYO
26,516.00 26,516.00
Rp. Rp.
18-Jul-18 dr. KASMINA 2083871
1634. 931680 TRANSFE 1
Hartono H R PASIEN 26,516.00 26,516.00
MISHEL
Rp. Rp.
18-Jul-18 Hartono SALSA
dr.
1635. 931695 TRANSFE
OKTAQUE 2083890 1
R PASIEN
EN
26,516.00 26,516.00
NUNUK Rp. Rp.
1636. 18-Jul-18 dr. 931699 TRANSFE
Hartono FITRIANI 2083894 1
R PASIEN
GSIH 26,516.00 26,516.00
Rp. Rp.
18-Jul-18 dr. KHOIRUL
1637. 2083899 931703 TRANSFE 1
Hartono IKHSAN R PASIEN 26,516.00 26,516.00

ALDHI
Yenny ATHARRA Rp. Rp.
1638. 18-Jul-18 dr. 931706 TRANSFE
Haryono IHAN 2083901 1
R PASIEN
KASYAFA
NI
26,516.00 26,516.00
Yenny BY.NY.SITI Rp. Rp.
1639. 18-Jul-18 dr. 931707 TRANSFE
Haryono MAHMU 2083903 1
R PASIEN
DLOTIN
26,516.00 26,516.00
Rp. Rp.
18-Jul-18 dr. Yenny
1640. 105378 TRANSFE
Haryono KASIYATI 2083905 1
R PASIEN 26,516.00 26,516.00
ULFA
Rp. Rp.
18-Jul-18 Haryono MIMA
dr. Yenny
1641. 931709 TRANSFE
FIMAULID 2083910 1
R PASIEN
YA
26,516.00 26,516.00
Rp. Rp.
18-Jul-18 dr. Yenny
1642. 931711 TRANSFE
Haryono KARMILA 2083912 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
18-Jul-18 dr. Yenny MUSTAIN, 2083913
1643. 931712 TRANSFE 1
Haryono MOH R PASIEN 26,516.00 26,516.00

Yenny ARKA Rp. Rp.


1644. 18-Jul-18 dr. 931714 TRANSFE
Haryono DWI 2083916 1
R PASIEN
CAHYA 26,516.00 26,516.00
ACHMAD
Rp. Rp.
18-Jul-18 Haryono HAFIZ
dr. Yenny
1645. 2083917 931715 TRANSFE 1
NUR R PASIEN
RIFKY
26,516.00 26,516.00

SHAFA
dr. Goliat DINA Rp. Rp.
1646. 18-Jul-18 Victor HAYUNIN 2083919 931717 TRANSFE 1
R PASIEN
Emanuel G
MENTARI
26,516.00 26,516.00
dr. Goliat Rp. Rp.
1647. 18-Jul-18 Victor KASMIN 2083920 931718 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
dr. Goliat WAGIMA Rp. Rp.
1648. 19-Jul-18 Victor 2083943 90206 TRANSFE 1
Emanuel N R PASIEN
26,516.00 26,516.00
Rp. Rp.
19-Jul-18 dr. Yenny
1649. Haryono SOMI 2083951 931721 TRANSFE
R PASIEN 26,516.00 1
26,516.00

Yenny FATAH, Rp. Rp.


1650. 19-Jul-18 dr. 931724 TRANSFE
Haryono MUHAM 2083956 1
R PASIEN
MAD 26,516.00 26,516.00
dr. Goliat KARDIMA Rp. Rp.
1651. 19-Jul-18 Victor 2083921 931719 TRANSFE 1
Emanuel H R PASIEN
26,516.00 26,516.00
dr. Goliat HENI Rp. Rp.
1652. 19-Jul-18 Victor ULANDAR 2083940 102250 TRANSFE 1
R PASIEN
Emanuel I 26,516.00 26,516.00
Rp. Rp.
19-Jul-18 dr. Yenny
1653. 931727 TRANSFE
Haryono KAMSIH 2083960 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
19-Jul-18 dr. Yenny
1654. 931730 TRANSFE
Haryono KARSONO 2083971 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
19-Jul-18 dr. Yenny SITI
1655. 2083979 931731 TRANSFE 1
Haryono FATIMAH R PASIEN 26,516.00 26,516.00
Rp. Rp.
19-Jul-18 dr. Nani ALI
1656. 2083985 931732 TRANSFE 1
Zumaroh SODIKIN R PASIEN 26,516.00 26,516.00
Rp. Rp.
19-Jul-18 dr. Nani
1657. 929916 TRANSFE
Zumaroh SAKHUR 2083993 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
19-Jul-18 dr. Nani SITI NUR
1658. 2084002 931734 TRANSFE 1
Zumaroh KHOLIFA R PASIEN 26,516.00 26,516.00

Nani NOVIA Rp. Rp.


1659. 19-Jul-18 dr. 930418 TRANSFE
Zumaroh RATNA 2084006 1
R PASIEN
JUWITA 26,516.00 26,516.00
dr. Rp. Rp.
SURATMA 2084034
1660. 19-Jul-18 Artamty 931736 TRANSFE 1
Sastry A N R PASIEN
26,516.00 26,516.00
dr. Rp. Rp.
1661. 19-Jul-18 Artamty RIDWAN 2084035 931737 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00

BIYANTAR
dr. Rp. Rp.
A AYOEM 2084040
1662. 19-Jul-18 Artamty 931740 TRANSFE 1
RUMBAK R PASIEN
Sastry A A
26,516.00 26,516.00
dr. BRILLIA Rp. Rp.
1663. 19-Jul-18 Artamty HENING 2084046 931741 TRANSFE 1
R PASIEN
Sastry A MAS 26,516.00 26,516.00
dr. YAYUK Rp. Rp.
1664. 19-Jul-18 Artamty SETYAWA 2084047 921332 TRANSFE 1
R PASIEN
Sastry A TI 26,516.00 26,516.00
dr. ABDULLA Rp. Rp.
1665. 19-Jul-18 Artamty H 2084048 931742 TRANSFE 1
R PASIEN
Sastry A ABIDZAR 26,516.00 26,516.00
RAGIL Rp. Rp.
1666. 19-Jul-18 dr. 904119 TRANSFE
Hartono SEPTI 2084051 1
R PASIEN
ANDITA 26,516.00 26,516.00
AZZAMI Rp. Rp.
1667. 19-Jul-18 dr. 920321 TRANSFE
Hartono SYAUQI 2084052 1
R PASIEN
SINA 26,516.00 26,516.00
HIMMAT Rp. Rp.
1668. 19-Jul-18 dr. 931743 TRANSFE
Hartono UL 2084053 1
R PASIEN
FITRIYAH 26,516.00 26,516.00
WAHYU
Rp. Rp.
20-Jul-18 Hartono ADI
dr.
1669. 2084054 22221 TRANSFE 1
PRASETY R PASIEN
O
WAHYU
20-Jul-18 Hartono ADI
dr.
1669. 2084054 22221 TRANSFE 1
PRASETY R PASIEN
O
26,516.00 26,516.00
Rp. Rp.
20-Jul-18 dr. MARDIYA 2084055
1670. 931744 TRANSFE 1
Hartono NTO R PASIEN 26,516.00 26,516.00
Rp. Rp.
20-Jul-18 dr. RUSDIAN
1671. 2084068 931745 TRANSFE 1
Hartono TO R PASIEN 26,516.00 26,516.00
Rp. Rp.
20-Jul-18 dr. HANDOY
1672. 2084080 931748 TRANSFE 1
Hartono O R PASIEN 26,516.00 26,516.00
dr. Rp. Rp.
1673. 20-Jul-18 Artamty RASIPAN 2084108 79516 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
GEISYA
Rp. Rp.
1674. 20-Jul-18 Hartono MAULIDA
dr. 926541 TRANSFE
DZIRGAM 2084143 1
R PASIEN
A DIARTA
26,516.00 26,516.00
Rp. Rp.
1675. 20-Jul-18 dr. 931752 TRANSFE
Hartono BINTORO 2084101 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
20-Jul-18 dr. SITI
1676. 2084145 931762 TRANSFE 1
Hartono ASTUTIK R PASIEN 26,516.00 26,516.00
Rp. Rp.
1677. 20-Jul-18 dr. 928175 TRANSFE
Hartono RADI 2084146 1
R PASIEN 26,516.00 26,516.00

IKA Rp. Rp.


1678. 20-Jul-18 dr. 930105 TRANSFE
Hartono NURLIDYA 2084150 1
R PASIEN
NINGSIH
26,516.00 26,516.00
YEKTI Rp. Rp.
1679. 20-Jul-18 dr. 48255 TRANSFE
Hartono SULISTIYA 2084153 1
R PASIEN
NI 26,516.00 26,516.00

RAISHA
AZKADIN Rp. Rp.
1680. 20-Jul-18 dr. 911991 TRANSFE
Hartono A 2084154 1
R PASIEN
MUADZA
H
26,516.00 26,516.00
Rp. Rp.
20-Jul-18 dr. GENDUK
1681. Hartono ELISTIANI 2084156 931720 TRANSFE
R PASIEN 26,516.00 1
26,516.00
RAISYA Rp. Rp.
1682. 20-Jul-18 dr. 931765 TRANSFE
Hartono PUTRI 2084157 1
R PASIEN
CAHYANI 26,516.00 26,516.00
Rp. Rp.
20-Jul-18 dr. MAFTUKI
1683. 2084158 931766 TRANSFE 1
Hartono N, MOCH R PASIEN 26,516.00 26,516.00

ANGGA
dr. Goliat APRILIA Rp. Rp.
1684. 20-Jul-18 Victor DWI 2084162 107405 TRANSFE 1
R PASIEN
Emanuel CAHYANI
NGTYAS
26,516.00 26,516.00
dr. Goliat RIRIN Rp. Rp.
1685. 20-Jul-18 Victor AMBARW 2084160 920460 TRANSFE 1
R PASIEN
Emanuel ATI 26,516.00 26,516.00
HAFIDZ
Rp. Rp.
21-Jul-18 Haryono ALWI
dr. Yenny AL
1686. 931769 TRANSFE
AZZA,MU 2084183 1
R PASIEN
H.
26,516.00 26,516.00
Rp. Rp.
21-Jul-18 dr. Yenny
1687. 931773 TRANSFE
Haryono SAWIT 2084188 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
21-Jul-18 dr. Yenny
1688. 931774 TRANSFE
Haryono NISWATI 2084189 1
R PASIEN 26,516.00 26,516.00

Yenny ARVIN,M Rp. Rp.


1689. 21-Jul-18 dr. 931772 TRANSFE
Haryono UHAMM 2084186 1
R PASIEN
AD 26,516.00 26,516.00
Rp. Rp.
1690. 21-Jul-18 dr. Nani NGASMA 2084201 923319 TRANSFE 1
Zumaroh N R PASIEN 26,516.00 26,516.00
dr. Goliat Rp. Rp.
1691. 21-Jul-18 Victor SALAMAH 2084202 931776 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
dr. Goliat TRI Rp. Rp.
1692. 21-Jul-18 Victor MULYO 2084203 931777 TRANSFE 1
R PASIEN
Emanuel UTOMO 26,516.00 26,516.00
dr. Goliat Rp. Rp.
1693. 21-Jul-18 Victor NIKKAH 2084206 64368 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
dr. Goliat SRI Rp. Rp.
1694. 21-Jul-18 Victor 2084207 926233 TRANSFE 1
Emanuel RAHAYU R PASIEN
26,516.00 26,516.00
dr. Goliat KASMON Rp. Rp.
1695. 21-Jul-18 Victor 2084212 900550 TRANSFE 1
Emanuel O R PASIEN
26,516.00 26,516.00
SUWADA
dr. Goliat Rp. Rp.
NA JAFIS
1696. 21-Jul-18 Victor KUSTARA 2084214 904212 TRANSFE
R PASIEN 1
Emanuel HARJA
26,516.00 26,516.00
dr. Rp. Rp.
IMAM
1697. 21-Jul-18 Artamty 2084216 930270 TRANSFE 1
HANAFI R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
1698. 22-Jul-18 Artamty RUSMIATI 2084218 931782 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
ALI
1699. 22-Jul-18 Artamty 931785 TRANSFE
ROHMAN 2084221 1
R PASIEN
Sastry A 26,516.00 26,516.00
Rp. Rp.
22-Jul-18 dr. Nani
1700. 929028 TRANSFE
Zumaroh NOTO 2084223 1
R PASIEN
22-Jul-18 dr. Nani
1700. 929028 TRANSFE
Zumaroh NOTO 2084223 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
22-Jul-18 dr. Nani
1701. 931786 TRANSFE
Zumaroh KUNTARI 2084227 1
R PASIEN 26,516.00 26,516.00
RAYMON
Rp. Rp.
22-Jul-18 Zumaroh D
dr. Nani AGOES
1702. 2084228 84139 TRANSFE 1
IVANDER R PASIEN
ILYASA
26,516.00 26,516.00

Nani DENI Rp. Rp.


1703. 22-Jul-18 dr. 931787 TRANSFE
Zumaroh SETIAWA 2084230 1
R PASIEN
N 26,516.00 26,516.00
Rp. Rp.
22-Jul-18 dr. Nani SUMARLI
1704. 2084233 78496 TRANSFE 1
Zumaroh K R PASIEN 26,516.00 26,516.00

SILVY
1705. 22-Jul-18 dr. Nani PUTRI 931790 TRANSFE
Rp. Rp.
Zumaroh ARDHIYA 2084234 1
R PASIEN
NTI
SANTOSO
26,516.00 26,516.00
Rp. Rp.
22-Jul-18 dr. Nani
1706. 931791 TRANSFE
Zumaroh WASRI 2084235 1
R PASIEN 26,516.00 26,516.00
CHRISTIN
Rp. Rp.
22-Jul-18 Haryono DIAH
dr. Yenny
1707. 909934 TRANSFE
MARDIYA 2084239 1
R PASIEN
NI
26,516.00 26,516.00
KEANU
Rp. Rp.
22-Jul-18 Haryono ALBAIHA
dr. Yenny
1708. 2084241 929395 TRANSFE 1
QI R PASIEN
SUKISNO
26,516.00 26,516.00

Yenny BY.NY.SITI Rp. Rp.


1709. 22-Jul-18 dr. 931792 TRANSFE
Haryono NUR 2084242 1
R PASIEN
NIKMAH 26,516.00 26,516.00

ENGGAR Rp. Rp.


1710. 22-Jul-18 dr.
Hartono RIZKY 2084245 913216 TRANSFE
R PASIEN 1
PURBOYO
26,516.00 26,516.00
CHANIF
Rp. Rp.
22-Jul-18 Hartono RASYHID
dr.
1711. 927874 TRANSFE
INDRAWA 2084249 1
R PASIEN
N
26,516.00 26,516.00
Rp. Rp.
23-Jul-18 dr. FATMAW
1712. 2084250 931796 TRANSFE 1
Hartono ATI R PASIEN 26,516.00 26,516.00
dr. Rp. Rp.
1713. 23-Jul-18 Artamty MUKAJI 2084269 931801 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
1714. 23-Jul-18 Artamty SUKIJAH 2084277 931802 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
KASMI/RS 2084288
1715. 23-Jul-18 Artamty 10582 TRANSFE 1
MM R PASIEN
Sastry A 26,516.00 26,516.00
dr. RASYA Rp. Rp.
1716. 23-Jul-18 Artamty ZUNNUR 2084300 931805 TRANSFE 1
R PASIEN
Sastry A AIN ZILMI 26,516.00 26,516.00
dr. Rp. Rp.
RATIH
1717. 23-Jul-18 Artamty 2084286 925249 TRANSFE 1
RIASTUTI R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
1718. 23-Jul-18 Artamty TOMO 2084305 931807 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
SUMIYATI 2084307
1719. 23-Jul-18 Artamty 68478 TRANSFE 1
,NY R PASIEN
Sastry A 26,516.00 26,516.00
MUHIBU
dr. Rp. Rp.
R ROYYAN 2084308
1720. 23-Jul-18 Artamty 931809 TRANSFE 1
AS R PASIEN
Sastry A SUDKANI
26,516.00 26,516.00
ROBBI
dr. Rp. Rp.
AHSIN
1721. 23-Jul-18 Artamty 2084310 914495 TRANSFE 1
KHULUQI R PASIEN
Sastry A AHMAD
26,516.00 26,516.00
dr. Rp. Rp.
1722. 23-Jul-18 Artamty JOYO PIN 2084322 931813 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. QARINA Rp. Rp.
1723. 23-Jul-18 Artamty AULIA 2084327 931815 TRANSFE 1
R PASIEN
Sastry A LESTARI 26,516.00 26,516.00
dr. MEGA Rp. Rp.
1724. 23-Jul-18 Artamty OKTAVIA 2084339 931820 TRANSFE 1
R PASIEN
Sastry A NI 26,516.00 26,516.00
Rp. Rp.
23-Jul-18 dr. Yenny AZIF
1725. 2084350 931824 TRANSFE 1
Haryono FAHMI R PASIEN 26,516.00 26,516.00
Rp. Rp.
23-Jul-18 dr. Yenny
1726. 105784 TRANSFE
Haryono RASIM 2084253 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
23-Jul-18 dr. Yenny DINUL
1727. 2084364 931829 TRANSFE 1
Haryono AQLI R PASIEN 26,516.00 26,516.00
Rp. Rp.
23-Jul-18 dr. Yenny AINUN
1728. 2084365 931830 TRANSFE 1
Haryono NAJIB R PASIEN 26,516.00 26,516.00
KHAFILUD
Rp. Rp.
23-Jul-18 Hartono DIN
dr.
1729. 2084367 931831 TRANSFE 1
YUDHA R PASIEN
TAMA
26,516.00 26,516.00
WIDA Rp. Rp.
1730. 23-Jul-18 dr. 914703 TRANSFE
Hartono WATI 2084368 1
R PASIEN
NINGSIH 26,516.00 26,516.00
NOVIA
Rp. Rp.
23-Jul-18 Hartono RUSDIAN
dr.
1731. 2084372 931833 TRANSFE 1
A R PASIEN
PAHLEVI
26,516.00 26,516.00
Rp. Rp.
1732. 23-Jul-18 dr. ASMORO 2084370 931832 TRANSFE 1
Hartono KANDIK R PASIEN 26,516.00 26,516.00
RIFAYA
Rp. Rp.
1733. 23-Jul-18 Hartono NOUREN
dr. 2084369 930627 TRANSFE 1
DWI R PASIEN
FALISHA
26,516.00 26,516.00

RACHMA
NDA
Rp. Rp.
24-Jul-18 Hartono AS'AD
dr.
1734. 2084391 931835 TRANSFE 1
YATIM R PASIEN
UBAIDILL
AH
26,516.00 26,516.00
dr. Rp. Rp.
1735. 24-Jul-18 Artamty SAMIJAH 2084428 931841 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. ERWIN Rp. Rp.
1736. 24-Jul-18 Artamty SULIS TYA 2084458 931845 TRANSFE 1
R PASIEN
Sastry A NINGSEH 26,516.00 26,516.00
RAJHIB EL
dr. Rp. Rp.
MUDDIN, 2084464
1737. 24-Jul-18 Artamty 81936 TRANSFE 1
MUCHAM R PASIEN
Sastry A MAD
26,516.00 26,516.00
dr. Rp. Rp.
1738. 24-Jul-18 Artamty MISRI 2084468 54848 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
UDI
1739. 24-Jul-18 Artamty 2084481 931847 TRANSFE 1
WALUYO R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
KUSPARTI 2084478
1740. 24-Jul-18 Artamty 20606 TRANSFE 1
NI R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
1741. 24-Jul-18 Artamty SUWANDI 2084484 931843 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
Rp. Rp.
24-Jul-18 dr. Yenny SUDARN
1742. 2084507 931851 TRANSFE 1
Haryono O R PASIEN 26,516.00 26,516.00
Rp. Rp.
24-Jul-18 dr. Yenny
1743. 931853 TRANSFE
Haryono WARTI 2084516 1
R PASIEN 26,516.00 26,516.00

Yenny RIZKY Rp. Rp.


1744. 24-Jul-18 dr. 916099 TRANSFE
Haryono CANDRA 2084518 1
R PASIEN
P,MUH 26,516.00 26,516.00
Rp. Rp.
1745. 24-Jul-18 dr. 931856 TRANSFE
Hartono HASANAH 2084523 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
1746. 24-Jul-18 dr. 931857 TRANSFE
Hartono KASIRAN 2084525 1
R PASIEN 26,516.00 26,516.00
ENDRO Rp. Rp.
1747. 25-Jul-18 dr. 931858 TRANSFE
Hartono CAHYON 2084526 1
R PASIEN
O 26,516.00 26,516.00
Rp. Rp.
1748. 25-Jul-18 dr. 931860 TRANSFE
Hartono SUBANDI 2084535 1
R PASIEN 26,516.00 26,516.00

Yenny DHYFA Rp. Rp.


1749. 25-Jul-18 dr. 107123 TRANSFE
Haryono ADHARA 2084550 1
R PASIEN
F.R, AN 26,516.00 26,516.00
FARREL
Rp. Rp.
25-Jul-18 Haryono RADIKA
dr. Yenny
1750. 2084553 59585 TRANSFE 1
RAMADH R PASIEN
AN
26,516.00 26,516.00
Rp. Rp.
25-Jul-18 dr. Yenny
1751. 931861 TRANSFE
Haryono TASMI 2084562 1
R PASIEN 26,516.00 26,516.00
RAFKA
Rp. Rp.
25-Jul-18 Haryono ADITYA
dr. Yenny
1752. 2084566 925191 TRANSFE 1
ALIM R PASIEN
TAMAM
26,516.00 26,516.00
Rp. Rp.
25-Jul-18 dr. Yenny VICA
1753. 2084569 931848 TRANSFE 1
Haryono HARUNA R PASIEN 26,516.00 26,516.00
Rp. Rp.
25-Jul-18 dr. Yenny FACHRI
1754. 2084571 56401 TRANSFE 1
Haryono R.MUH. R PASIEN 26,516.00 26,516.00

Yenny ANDIKA Rp. Rp.


1755. 25-Jul-18 dr. 27922 TRANSFE
Haryono BAGASKA 2084583 1
R PASIEN
RA.E 26,516.00 26,516.00
RIFKI
Rp. Rp.
25-Jul-18 Haryono ADIT
dr. Yenny
1756. 931868 TRANSFE
ARDIANSY 2084612 1
R PASIEN
AH
26,516.00 26,516.00
SITI
dr. Goliat Rp. Rp.
DJULAEC
1757. 25-Jul-18 Victor 2084625 10112 TRANSFE 1
HA/RSM R PASIEN
Emanuel M
26,516.00 26,516.00
dr. Goliat TIARA Rp. Rp.
1758. 25-Jul-18 Victor NADIA 2084630 931874 TRANSFE 1
R PASIEN
Emanuel PUTRI 26,516.00 26,516.00
dr. Goliat PATMISA Rp. Rp.
1759. 25-Jul-18 Victor 2084632 69340 TRANSFE 1
Emanuel RI R PASIEN
26,516.00 26,516.00
AGUNG
dr. Goliat Rp. Rp.
GILANG
1760. 25-Jul-18 Victor 931875 TRANSFE
TRITANAY 2084637 1
R PASIEN
Emanuel A
26,516.00 26,516.00
dr. Goliat JIHAN Rp. Rp.
1761. 25-Jul-18 Victor QIANITA 2084638 931876 TRANSFE 1
R PASIEN
Emanuel NAJIYA 26,516.00 26,516.00
dr. Goliat ALI Rp. Rp.
1762. 25-Jul-18 Victor SAIFUDDI 2084641 87814 TRANSFE 1
Emanuel N, MOH R PASIEN
26,516.00 26,516.00
dr. Goliat Rp. Rp.
1763. 25-Jul-18 Victor USMAN 2084642 78984 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
ENDAH
dr. Goliat Rp. Rp.
FITRIASIH 2084634
1764. 25-Jul-18 Victor 906401 TRANSFE 1
ANGGRAE R PASIEN
Emanuel NY
26,516.00 26,516.00
AQILAH
dr. Rp. Rp.
NAJWA
1765. 25-Jul-18 Artamty 2084643 100017 TRANSFE 1
NURUL R PASIEN
Sastry A JANNAH
26,516.00 26,516.00
dr. Rp. Rp.
1766. 25-Jul-18 Artamty SAIDO 2084644 911649 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
MUZAKI,
1767. 26-Jul-18 Artamty 2084646 74735 TRANSFE 1
AHMAD R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
NURHIDA 2084668
1768. 26-Jul-18 Artamty 931878 TRANSFE 1
YATI R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
WINARSI
1769. 26-Jul-18 Artamty 2084670 931879 TRANSFE 1
H R PASIEN
Sastry A 26,516.00 26,516.00

NAFILA Rp. Rp.


1770. 26-Jul-18 dr. 931884 TRANSFE
Hartono TRIA 2084685 1
R PASIEN
BELFANIA
26,516.00 26,516.00
Rp. Rp.
1771. 26-Jul-18 dr. 917149 TRANSFE
Hartono MARTINI 2084687 1
R PASIEN 26,516.00 26,516.00
YAHYA Rp. Rp.
1772. 26-Jul-18 dr. 931885 TRANSFE
Hartono ARDIANSY 2084693 1
R PASIEN
AH 26,516.00 26,516.00
Rp. Rp.
1773. 26-Jul-18 dr. 11756 TRANSFE
Hartono LASMO 2084704 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
1774. 26-Jul-18 dr. 70830 TRANSFE
Hartono SULASTRI 2084705 1
R PASIEN 26,516.00 26,516.00
FARIS Rp. Rp.
1775. 26-Jul-18 dr. 931893 TRANSFE
Hartono ARDIANSY 2084708 1
R PASIEN
AH 26,516.00 26,516.00
Rp. Rp.
1776. 26-Jul-18 dr. 931896 TRANSFE
Hartono TAYUK 2084718 1
R PASIEN 26,516.00 26,516.00
dr. Goliat Rp. Rp.
1777. 26-Jul-18 Victor KASDI 2084759 931900 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
dr. Goliat Rp. Rp.
1778. 26-Jul-18 Victor SUYADI 2084741 930902 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
dr. Goliat Rp. Rp.
1779. 26-Jul-18 Victor SUNOTO 2084745 924169 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
dr. Goliat SALSABIL Rp. Rp.
1780. 26-Jul-18 Victor A SHAFA 2084762 100609 TRANSFE 1
R PASIEN
Emanuel AZZAHRA 26,516.00 26,516.00
dr. Goliat Rp. Rp.
1781. 26-Jul-18 Victor WARTI 2084768 931902 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
HANU
dr. Goliat Rp. Rp.
MORO AJI 2084769
1782. 26-Jul-18 Victor 931904 TRANSFE 1
TISNO R PASIEN
Emanuel PUTRO
26,516.00 26,516.00

dr. Goliat DWIOIS Rp. Rp.


1783. 26-Jul-18 Victor A'INUR 2084772 107414 TRANSFE
R PASIEN 1
Emanuel FAATIHAH
26,516.00 26,516.00
Rp. Rp.
1784. 27-Jul-18 dr. 925756 TRANSFE
Hartono DJUPRI 2084778 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
1785. 27-Jul-18 dr. 106944 TRANSFE
Hartono SUKARJI 2084789 1
R PASIEN 26,516.00 26,516.00

Yenny RINJANI Rp. Rp.


1786. 27-Jul-18 dr. 105694 TRANSFE
Haryono PUTRI 2084810 1
R PASIEN
ARAFAH 26,516.00 26,516.00
Rp. Rp.
27-Jul-18 dr. Yenny
1787. 931908 TRANSFE
Haryono SAWI 2084833 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
27-Jul-18 dr. Yenny WARSILA
1788. 2084834 931916 TRANSFE 1
Haryono N R PASIEN
27-Jul-18 dr. Yenny WARSILA
1788. 2084834 931916 TRANSFE 1
Haryono N R PASIEN 26,516.00 26,516.00

Yenny ARUM Rp. Rp.


1789. 27-Jul-18 dr. 924869 TRANSFE
Haryono RAHMAN 2084848 1
R PASIEN
A 26,516.00 26,516.00

Yenny RENDI Rp. Rp.


1790. 27-Jul-18 dr. 931920 TRANSFE
Haryono PRASETY 2084842 1
R PASIEN
O VICKI 26,516.00 26,516.00
Rp. Rp.
1791. 27-Jul-18 dr. 918511 TRANSFE
Hartono SUPATMI 2084806 1
R PASIEN 26,516.00 26,516.00
dr. Rp. Rp.
GUNORES 2084864
1792. 27-Jul-18 Artamty 931923 TRANSFE 1
O R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
1793. 27-Jul-18 Artamty NOVI 2084868 931925 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
LAMSRIYA 2084871
1794. 27-Jul-18 Artamty 931928 TRANSFE 1
TI R PASIEN
Sastry A 26,516.00 26,516.00
CANDRIK
dr. Rp. Rp.
A AFLAH
1795. 27-Jul-18 Artamty 2084874 931929 TRANSFE 1
AMANUL R PASIEN
Sastry A LOH
26,516.00 26,516.00
ROHMAD
dr. Rp. Rp.
DWI
1796. 27-Jul-18 Artamty 2084876 931930 TRANSFE 1
FAJAR R PASIEN
Sastry A PUTRA
26,516.00 26,516.00
MALAKH
dr. Rp. Rp.
JOY
1797. 27-Jul-18 Artamty 2084877 104824 TRANSFE 1
BARAK R PASIEN
Sastry A SUCIPTO
26,516.00 26,516.00
dr. LILIK Rp. Rp.
1798. 27-Jul-18 Artamty MASFUFA 2084879 904874 TRANSFE 1
R PASIEN
Sastry A TUN 26,516.00 26,516.00
dr. Rp. Rp.
WAHYU
1799. 27-Jul-18 Artamty 2084880 931932 TRANSFE 1
UTOMO R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
1800. 27-Jul-18 Artamty SUWARTI 2084882 931934 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
MAULAN
1801. 27-Jul-18 Artamty 2084883 931935 TRANSFE 1
A R PASIEN
Sastry A 26,516.00 26,516.00
dr. MIMI Rp. Rp.
1802. 27-Jul-18 Artamty WAHIDA 2084884 931936 TRANSFE 1
R PASIEN
Sastry A H 26,516.00 26,516.00
dr. Goliat WARSINA Rp. Rp.
1803. 27-Jul-18 Victor 2084886 931938 TRANSFE 1
Emanuel H R PASIEN
26,516.00 26,516.00
dr. Goliat Rp. Rp.
1804. 28-Jul-18 Victor JUWARI 2084901 924193 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00

DEVAN
AZKA Rp. Rp.
1805. 28-Jul-18 dr. 931942 TRANSFE
Hartono PUTRA 2084915 1
R PASIEN
NOVEND
RA
26,516.00 26,516.00

Rp. Rp.
28-Jul-18 dr. FIRMANS
1806. 60670 TRANSFE
Hartono YAH,MOH 2084908 1
R PASIEN
26,516.00 26,516.00
Rp. Rp.
1807. 28-Jul-18 dr. 931946 TRANSFE
Hartono DARSIN 2084926 1
R PASIEN 26,516.00 26,516.00
Rp. Rp.
28-Jul-18 dr. Yenny
1808. 83721 TRANSFE
Haryono RASEMI 2084928 1
R PASIEN 26,516.00 26,516.00
TUTIK Rp. Rp.
1809. 28-Jul-18 dr. 24440 TRANSFE
Hartono AGUSTIN 2084929 1
R PASIEN
A 26,516.00 26,516.00
dr. WIWIN Rp. Rp.
1810. 28-Jul-18 Artamty PRIYO 2084934 931948 TRANSFE 1
R PASIEN
Sastry A UTOMO 26,516.00 26,516.00
dr. Rp. Rp.
TASMINA
1811. 28-Jul-18 Artamty 2084936 931949 TRANSFE 1
H R PASIEN
Sastry A 26,516.00 26,516.00
AINUR
dr. Rp. Rp.
RAHMAN
1812. 28-Jul-18 Artamty 2084938 931951 TRANSFE 1
MIRZA R PASIEN
Sastry A ATTARIQ
26,516.00 26,516.00
dr. Rp. Rp.
ADJI DWI
1813. 28-Jul-18 Artamty 2084940 66167 TRANSFE 1
CIPTA T.K R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
1814. 28-Jul-18 Artamty MULYANI 2084941 931698 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
dr. SRI Rp. Rp.
1815. 28-Jul-18 Artamty WAHYUNI 2084942 931952 TRANSFE 1
R PASIEN
Sastry A HERTUTI 26,516.00 26,516.00
dr. Rp. Rp.
SUNTIYAT 2084946
1816. 28-Jul-18 Artamty 931954 TRANSFE 1
IN R PASIEN
Sastry A 26,516.00 26,516.00
dr. Rp. Rp.
1817. 28-Jul-18 Artamty WARTIK 2084949 931956 TRANSFE 1
R PASIEN
Sastry A
dr.
1817. 28-Jul-18 Artamty WARTIK 2084949 931956 TRANSFE 1
R PASIEN
Sastry A 26,516.00 26,516.00
ROBERTO Rp. Rp.
1818. 28-Jul-18 dr. 21491 TRANSFE
Hartono AURELIO 2084952 1
R PASIEN
SEBER 26,516.00 26,516.00
NANIK
Rp. Rp.
28-Jul-18 Hartono DWI
dr.
1819. 931957 TRANSFE
NURYANT 2084954 1
R PASIEN
I
26,516.00 26,516.00
MUFID
Rp. Rp.
28-Jul-18 Hartono ADONIA
dr.
1820. 2084955 926608 TRANSFE 1
NAJMA R PASIEN
ORLIN
26,516.00 26,516.00
HADI Rp. Rp.
1821. 29-Jul-18 dr. 931195 TRANSFE
Hartono PRAYITN 2084956 1
R PASIEN
O 26,516.00 26,516.00
dr. Goliat Rp. Rp.
1822. 29-Jul-18 Victor SUMINAH 2084960 918912 TRANSFE 1
R PASIEN
Emanuel 26,516.00 26,516.00
dr. Goliat GRIZEL Rp. Rp.
1823. 29-Jul-18 Victor ARCELI 2084963 928047 TRANSFE 1
R PASIEN
Emanuel SUSANTO 26,516.00 26,516.00
dr. Goliat Rp. Rp.
1824. 29-Jul-18 Victor JIDIN 2084968 931963 TRANSFE 0
R PASIEN
Emanuel 0 26,516.00
dr. Goliat Rp. Rp.
1825. 29-Jul-18 Victor SUNARTI 2084971 931446 TRANSFE 0
R PASIEN
Emanuel 0 26,516.00
SAKHA
dr. Goliat Rp. Rp.
GIBRAN
1826. 29-Jul-18 Victor 2084972 931965 TRANSFE 0
RAMDHA R PASIEN
Emanuel NSAH, A
0 26,516.00
dr. Goliat MEI Rp. Rp.
1827. 29-Jul-18 Victor MEGAWA 2084973 931352 TRANSFE 0
R PASIEN
Emanuel TI 0 26,516.00
dr. Goliat JIHAN Rp. Rp.
1828. 29-Jul-18 Victor EKA FUA 2084974 900987 TRANSFE 0
R PASIEN
Emanuel DAH 0 26,516.00
dr. Goliat ARIE Rp. Rp.
1829. 29-Jul-18 Victor WICAKSO 2084975 927160 TRANSFE 0
R PASIEN
Emanuel NO 0 26,516.00
dr. Goliat LILIANA,N Rp. Rp.
1830. 29-Jul-18 Victor 2084977 931967 TRANSFE 0
Emanuel Y R PASIEN
0 26,516.00
FAHRI
dr. Goliat Rp. Rp.
HUSAIN
1831. 29-Jul-18 Victor 2084976 904966 TRANSFE 0
MAULAN R PASIEN
Emanuel A,MOH
0 26,516.00
dr. Goliat AZRINA Rp. Rp.
1832. 29-Jul-18 Victor LAVENIA 2084978 931506 TRANSFE 0
R PASIEN
Emanuel SHAZFA 0 26,516.00
dr. Goliat SUNTIASI Rp. Rp.
1833. 29-Jul-18 Victor 2084979 931968 TRANSFE 0
Emanuel H R PASIEN
0 26,516.00
dr. Goliat RATNA Rp. Rp.
1834. 29-Jul-18 Victor 2084982 931924 TRANSFE 0
Emanuel ZUNITA R PASIEN
0 26,516.00
RAVIEL
Rp. Rp.
1835. 29-Jul-18 Zumaroh HITO
dr. Nani 2084984 931971 TRANSFE 0
PUTRA R PASIEN
AHMAD
0 26,516.00
dr. Goliat SRI Rp. Rp.
1836. 29-Jul-18 Victor WINDART 2084983 931970 TRANSFE 0
R PASIEN
Emanuel I 0 26,516.00
Rp. Rp.
29-Jul-18 dr. Nani INDASAH
1837. 2084986 931973 TRANSFE 0
Zumaroh RR R PASIEN 0 26,516.00
Rp. Rp.
30-Jul-18 dr. Nani
1838. 927621 TRANSFE
Zumaroh ANJURI 2084987 0
R PASIEN 0 26,516.00

Nani REZHADIT Rp. Rp.


1839. 30-Jul-18 dr. 78258 TRANSFE
Zumaroh YA TARIQ 2084988 0
R PASIEN
AZAM
0 26,516.00
Rp. Rp.
30-Jul-18 dr. Nani
1840. 931974 TRANSFE
Zumaroh TUMISO 2085004 0
R PASIEN 0 26,516.00

Nani YAYUK Rp. Rp.


1841. 30-Jul-18 dr. 921332 TRANSFE
Zumaroh SETYAWA 2085007 0
R PASIEN
TI 0 26,516.00
Rp. Rp.
30-Jul-18 dr. Nani NUR
1842. 2085006 931975 TRANSFE 0
Zumaroh KHOZIN R PASIEN 0 26,516.00

Yenny SALVITO Rp. Rp.


1843. 30-Jul-18 dr. 911324 TRANSFE
Haryono AZENIA 2085020 0
R PASIEN
PRANAJA 0 26,516.00
Rp. Rp.
30-Jul-18 dr. Yenny PARSINA
1844. 2085035 931982 TRANSFE 0
Haryono H R PASIEN 0 26,516.00
AYU
Rp. Rp.
30-Jul-18 Haryono RACHMA
dr. Yenny
1845. 2085053 931989 TRANSFE 0
NIA R PASIEN
ULFAH
0 26,516.00
Rp. Rp.
30-Jul-18 dr. Yenny ALFIANA
1846. 2085057 931990 TRANSFE 0
Haryono NUR AINI R PASIEN
30-Jul-18 dr. Yenny ALFIANA
1846. 2085057 931990 TRANSFE 0
Haryono NUR AINI R PASIEN 0 26,516.00

Yenny KASDAR Rp. Rp.


1847. 30-Jul-18 dr. 67392 TRANSFE
Haryono DJUWITA, 2085070 0
R PASIEN
NY 0 26,516.00
Rp. Rp.
1848. 30-Jul-18 dr. 931490 TRANSFE
Hartono KUHARI 2085071 0
R PASIEN 0 26,516.00
Rp. Rp.
1849. 30-Jul-18 dr. 924682 TRANSFE
Hartono PARWATI 2085076 0
R PASIEN 0 26,516.00
FATIMAH
Rp. Rp.
30-Jul-18 Hartono MAYA
dr.
1850. 931996 TRANSFE
RATNAWA 2085094 0
R PASIEN
TI
0 26,516.00

YUSUF
EKA
Rp. Rp.
1851. 30-Jul-18 Hartono ARDIANSY
dr. 61507 TRANSFE
AH,MOC 2085097 0
R PASIEN
HAMMA
D
0 26,516.00
Rp. Rp.
1852. 30-Jul-18 dr. 4159 TRANSFE
Hartono RASTUM 2085107 0
R PASIEN 0 26,516.00
PUGUH
Rp. Rp.
30-Jul-18 Hartono BUDI
dr.
1853. 932001 TRANSFE
SANTOSO 2085109 0
R PASIEN
,IR
0 26,516.00
KUSNUL
Rp. Rp.
30-Jul-18 Hartono HIDAYATI
dr.
1854. 2085103 931998 TRANSFE 0
NUR R PASIEN
ALIYAH
0 26,516.00
Rp. Rp.
30-Jul-18 dr. MARIAH
1855. 2085106 81288 TRANSFE 0
Hartono ULFAH R PASIEN 0 26,516.00
JOKO Rp. Rp.
1856. 30-Jul-18 dr. 32777 TRANSFE
Hartono WAHYUH 2085110 0
R PASIEN
ONO 0 26,516.00
dr.
Rp. Rp.
1857. 30-Jul-18 Hartono 932003 TRANSFE
Margono, SUKRAN 2085114 0
R PASIEN
Sp.Rad.
0 26,516.00
Rp. Rp.
1858. 30-Jul-18 dr. 920744 TRANSFE
Hartono SUNTARI 2085115 0
R PASIEN 0 26,516.00
Rp. Rp.
1859. 30-Jul-18 dr. 932005 TRANSFE
Hartono KAMISAH 2085119 0
R PASIEN 0 26,516.00
Rp. Rp.
30-Jul-18 dr. KASMIJA
1860. 2085120 932006 TRANSFE 0
Hartono N R PASIEN 0 26,516.00
RAMA
Rp. Rp.
30-Jul-18 Hartono ADI
dr.
1861. 2085124 30792 TRANSFE 0
NUGROH R PASIEN
O
0 26,516.00
Rp. Rp.
1862. 30-Jul-18 dr. 932007 TRANSFE
Hartono NURIKAH 2085121 0
R PASIEN 0 26,516.00
WIWIT
Rp. Rp.
30-Jul-18 Hartono WINDA
dr.
1863. 2085125 932009 TRANSFE 0
RATNASA R PASIEN
RI
0 26,516.00
dr. Goliat Rp. Rp.
1864. 31-Jul-18 Victor SUCIATI 2085145 932013 TRANSFE 0
R PASIEN
Emanuel 0 26,516.00
dr. Goliat Rp. Rp.
1865. 31-Jul-18 Victor MARTINI 2085146 917149 TRANSFE 0
Emanuel R PASIEN
0 26,516.00
Rp. Rp.
31-Jul-18 dr. Yenny EKA
1866. 2085162 932014 TRANSFE 0
Haryono YULIANA R PASIEN 0 26,516.00

AFF
KATETER Rp. Rp.
12-Jul-18 dr. Yenny
1867. Haryono DAMPUN 2083317 931529 ANAK 1
DAN
DEWASA
24,947.00 24,947.00
INJEKSI IV
dr. Goliat AGUSTIN Rp. Rp.
1868. 1-Jul-18 Victor A 2082096 931163 TIDAK 1
LANGSUN
Emanuel ROHANI G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
1869. 1-Jul-18 dr. 931158 TIDAK
Hartono MARIYATI 2082087 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat SITI Rp. Rp.
1870. 1-Jul-18 Victor 2082094 931069 TIDAK 1
Emanuel ANIFAH LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat MUDI Rp. Rp.
1871. 1-Jul-18 Victor HARTON 2082101 931167 TIDAK 1
LANGSUN
Emanuel O G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat Rp. Rp.
1872. 1-Jul-18 Victor DARWITO 2082102 931168 TIDAK 1
LANGSUN
Emanuel G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat Rp. Rp.
1873. 1-Jul-18 Victor DARNI 2082100 931166 TIDAK 1
LANGSUN
Emanuel G
24,875.00 24,875.00
ABIMANY INJEKSI IV
dr. Rp. Rp.
U
1874. 1-Jul-18 Artamty 97823 TIDAK
ARKANA 2082106 1
LANGSUN
Sastry A FARID G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
1875. 1-Jul-18 Artamty LASADJI 2082111 914717 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat SARJI Rp. Rp.
1876. 1-Jul-18 Victor 2082113 85610 TIDAK 1
Emanuel GUNO LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat Rp. Rp.
1877. 1-Jul-18 Victor MOLAN 2082114 931169 TIDAK 1
LANGSUN
Emanuel G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat KUSNING, Rp. Rp.
1878. 1-Jul-18 Victor 2082115 84994 TIDAK 1
Emanuel HJ LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat MEY NUR Rp. Rp.
1879. 1-Jul-18 Victor 2082117 917719 TIDAK 1
Emanuel AZIZAH LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat AGUS Rp. Rp.
1880. 1-Jul-18 Victor 2082119 931171 TIDAK 1
Emanuel PUJIONO LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat Rp. Rp.
1881. 1-Jul-18 Victor LANTIP 2082122 931172 TIDAK 1
LANGSUN
Emanuel G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat GIO Rp. Rp.
1882. 1-Jul-18 Victor 2082124 905682 TIDAK 1
Emanuel FIPTIAN LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
TEGUH Rp. Rp.
1883. 1-Jul-18 dr. 931174 TIDAK
Hartono SLAMET 2082127 1
LANGSUN
WIDODO G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
1884. 2-Jul-18 dr. 931175 TIDAK
Hartono MARJO 2082138 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2-Jul-18 dr. Nani
1885. 931178 TIDAK
Zumaroh WINDA 2082146 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2-Jul-18 dr. Nani SUWARNI 2082162
1886. 931183 TIDAK 1
Zumaroh ,NY LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2-Jul-18 dr. Nani
1887. 61805 TIDAK
Zumaroh DARSAM 2082169 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2-Jul-18 dr. Nani
1888. 77582 TIDAK
Zumaroh RUKMINI 2082181 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Nani SANTI Rp. Rp.
1889. 2-Jul-18 dr. 931192 TIDAK
Zumaroh RATNASA 2082188 1
LANGSUN
RI G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2-Jul-18 dr. Yenny
1890. 901182 TIDAK
Haryono TARMI 2082193 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Nani MASROYA Rp. Rp.
1891. 2-Jul-18 dr. NA/RSM 2082201 76 TIDAK 1
Zumaroh M LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Nani HADI Rp. Rp.
1892. 2-Jul-18 dr. 931195 TIDAK
Zumaroh PRAYITN 2082204 1
LANGSUN
O G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2-Jul-18 dr. Nani NYAMINA 2082217
1893. 931200 TIDAK 1
Zumaroh H LANGSUN
G
24,875.00 24,875.00
dr. INJEKSI IV
Rp. Rp.
1894. 2-Jul-18 Ferryzal SUWITO 2082210 920782 TIDAK 1
O.M., LANGSUN
Sp.OT. G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2-Jul-18 dr. Yenny
1895. 931206 TIDAK
Haryono SUPARTIN 2082232 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2-Jul-18 dr. Nani LASMUNT 2082224
1896. 931203 TIDAK 1
Zumaroh IK LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Yenny AMALIA Rp. Rp.
1897. 2-Jul-18 dr. 931207 TIDAK
Haryono MULYA 2082235 1
LANGSUN
SAPUTRI G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2-Jul-18 dr. Yenny
1898. 929170 TIDAK
Haryono KATREMI 2082249 1
LANGSUN
G
24,875.00 24,875.00

DHANUR INJEKSI IV
Yenny ENDRA Rp. Rp.
1899. 2-Jul-18 dr. 931212 TIDAK
Haryono ARYO 2082250 1
LANGSUN
MAHEND G
RA
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2-Jul-18 dr. Yenny ARIFIN
1900. 931213 TIDAK
Haryono SUSANTO 2082251 1
LANGSUN
G
24,875.00 24,875.00

RAHMAT INJEKSI IV
Rp. Rp.
2-Jul-18 Haryono YUSUF
dr. Yenny
1901. 931014 TIDAK
KUSUMA 2082253 1
LANGSUN
WARDANI G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2-Jul-18 dr. Yenny HARIANT
1902. 2082256 931215 TIDAK 1
Haryono O LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
1903. 2-Jul-18 Artamty SAMIAN 2082260 931218 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
dr. ANDYS Rp. Rp.
1904. 2-Jul-18 Artamty YOGA 2082261 931219 TIDAK 1
LANGSUN
Sastry A ARDIKA G
24,875.00 24,875.00
INJEKSI IV
dr. FAIQ AL Rp. Rp.
1905. 3-Jul-18 Artamty FAHMI, 2082297 931225 TIDAK 1
LANGSUN
Sastry A MUH G
INJEKSI IV
dr. FAIQ AL
1905. 3-Jul-18 Artamty FAHMI, 2082297 931225 TIDAK 1
LANGSUN
Sastry A MUH G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
1906. 3-Jul-18 Artamty NAIM 2082298 931226 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
IFRA INJEKSI IV
Rp. Rp.
3-Jul-18 Haryono MIKAYLA
dr. Yenny
1907. 2082303 931227 TIDAK 1
RAMADH LANGSUN
ANI G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
3-Jul-18 dr. Yenny
1908. 931228 TIDAK
Haryono TUMAJI 2082304 1
LANGSUN
G
24,875.00 24,875.00
ANDRIYA INJEKSI IV
Rp. Rp.
1909. 3-Jul-18 Haryono N
dr. Yenny 2082334 921985 TIDAK 1
KRISTIYO LANGSUN
NI G
24,875.00 24,875.00
INJEKSI IV
Yenny SITI Rp. Rp.
1910. 3-Jul-18 dr. 101018 TIDAK
Haryono MUNAFIA 2082312 1
LANGSUN
H G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
3-Jul-18 dr. Yenny
1911. 931248 TIDAK
Haryono KASWATI 2082365 1
LANGSUN
G
24,875.00 24,875.00
DWI INJEKSI IV
Rp. Rp.
3-Jul-18 Haryono WAHYU
dr. Yenny
1912. 2082353 931242 TIDAK 1
NUR LANGSUN
AANG G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
1913. 3-Jul-18 dr. 931253 TIDAK
Hartono PANDI 2082386 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
1914. 3-Jul-18 dr. 79079 TIDAK
Hartono CANCOKO 2082387 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
3-Jul-18 dr. IIS
1915. 2082389 931254 TIDAK 1
Hartono ARISKA LANGSUN
G
24,875.00 24,875.00
DUROTUL INJEKSI IV
Rp. Rp.
3-Jul-18 Hartono HUSNA
dr.
1916. 2082392 931255 TIDAK 1
VITA LANGSUN
SANTICA G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat SUYUFI,M Rp. Rp.
1917. 3-Jul-18 Victor UCHAMA 2082395 931256 TIDAK 1
LANGSUN
Emanuel D G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat RUSMAN Rp. Rp.
1918. 4-Jul-18 Victor 2082409 931257 TIDAK 1
Emanuel AJI LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. LILIK Rp. Rp.
1919. 4-Jul-18 Artamty SETYOWA 2082434 38391 TIDAK 1
LANGSUN
Sastry A TI G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
IMAM
1920. 4-Jul-18 Artamty 2082433 931265 TIDAK 1
ROZIQIN LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
1921. 4-Jul-18 Artamty KADIR 2082438 931267 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
YUDHA
1922. 4-Jul-18 Artamty 927511 TIDAK
EBIYANTO 2082443 1
LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
1923. 4-Jul-18 Artamty SULASIH 2082466 931271 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
GISELA INJEKSI IV
dr. Rp. Rp.
DWI
1924. 4-Jul-18 Artamty 2082470 931272 TIDAK 1
OKTAVIA LANGSUN
Sastry A NI G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
1925. 4-Jul-18 Artamty SRIAH 2082474 909814 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
dr. TRI Rp. Rp.
1926. 4-Jul-18 Artamty MARGIAN 2082476 931273 TIDAK 1
LANGSUN
Sastry A I, NY G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
MURDIO
1927. 4-Jul-18 Artamty 2082452 80659 TIDAK 1
NO LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
4-Jul-18 dr. Yenny KUNTIRA
1928. 2082486 931278 TIDAK 1
Haryono H LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
4-Jul-18 dr. Yenny
1929. 29317 TIDAK
Haryono PASIRAN 2082489 1
LANGSUN
G
24,875.00 24,875.00
SHERLY INJEKSI IV
Rp. Rp.
4-Jul-18 Haryono YANIAR
dr. Yenny
1930. 2082494 916521 TIDAK 1
CHANDR LANGSUN
A G
24,875.00 24,875.00
INJEKSI IV
Yenny KANA Rp. Rp.
1931. 4-Jul-18 dr. 931280 TIDAK
Haryono FATHIN 2082495 1
LANGSUN
ROBIHAH G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat BUDI Rp. Rp.
1932. 4-Jul-18 Victor SETYO 2082502 931283 TIDAK 1
LANGSUN
Emanuel FEBRI G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat DIANITA Rp. Rp.
1933. 4-Jul-18 Victor KRISTIAN 2082503 99921 TIDAK 1
LANGSUN
Emanuel NINGSIH G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat DARMIYA Rp. Rp.
1934. 4-Jul-18 Victor 2082504 931284 TIDAK 1
Emanuel TI LANGSUN
G
24,875.00 24,875.00
JIHAN INJEKSI IV
dr. Goliat Rp. Rp.
ARRIFA
1935. 4-Jul-18 Victor 2082505 931182 TIDAK 1
MAWADD LANGSUN
Emanuel AH G
24,875.00 24,875.00
WINANDI INJEKSI IV
dr. Goliat Rp. Rp.
KA
1936. 5-Jul-18 Victor 918013 TIDAK
KUMAYA 2082517 1
LANGSUN
Emanuel NG JATI G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat Rp. Rp.
1937. 5-Jul-18 Victor SUCIPTO 2082520 931288 TIDAK 1
LANGSUN
Emanuel G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat MUTIATU Rp. Rp.
1938. 5-Jul-18 Victor 2082522 926993 TIDAK 1
Emanuel N LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
5-Jul-18 dr. Nani
1939. 931292 TIDAK
Zumaroh NASORI 2082536 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
5-Jul-18 dr. Nani
1940. 931290 TIDAK
Zumaroh SUKARNO 2082523 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Nani ALDEFAN Rp. Rp.
1941. 5-Jul-18 dr. 931300 TIDAK
Zumaroh YFARANISA
OKTA 2082554 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Nani ZAENAL Rp. Rp.
1942. 5-Jul-18 dr. 931142 TIDAK
Zumaroh ABIDIN,M 2082559 1
LANGSUN
OH G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
5-Jul-18 dr. Nani ALVI
1943. 2082573 931309 TIDAK 1
Zumaroh SAHRIN LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
5-Jul-18 dr. Nani AZAM AL- 2082562
1944. 931303 TIDAK 1
Zumaroh HABSYI LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Nani PUTRI Rp. Rp.
1945. 5-Jul-18 dr. 931307 TIDAK
Zumaroh WIDAYAN 2082568 1
LANGSUN
TI G
24,875.00 24,875.00
ALYA INJEKSI IV
Rp. Rp.
5-Jul-18 Zumaroh NAUFA
dr. Nani
1946. 2082581 107058 TIDAK 1
FARZANI, LANGSUN
AN G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
5-Jul-18 dr. Nani
1947. 931317 TIDAK
Zumaroh SRIPAH 2082601 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
5-Jul-18 dr. Nani KASBULL
1948. 2082605 926458 TIDAK 1
Zumaroh AH S,H LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
1949. 5-Jul-18 Artamty MUDRON 2082614 931318 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
1950. 5-Jul-18 Artamty ROHLI 2082626 927283 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
1951. 5-Jul-18 Artamty DEMES 2082628 85449 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
1952. 5-Jul-18 Artamty SAMIRAH 2082631 909463 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
1953. 5-Jul-18 Artamty JAELANI 2082638 931324 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
dr. ST ZAHRA Rp. Rp.
1954. 5-Jul-18 Artamty ABIDATU 2082641 919189 TIDAK 1
LANGSUN
Sastry A N NAJWA G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
1955. 5-Jul-18 Artamty SLAMET 2082642 931326 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
5-Jul-18 dr. Yenny SUKOWA
1956. 2082643 931327 TIDAK 1
Haryono RNO LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
6-Jul-18 dr. Yenny SOFFAN,
1957. 2082646 931329 TIDAK 1
Haryono M LANGSUN
G
24,875.00 24,875.00
UMROTU INJEKSI IV
Rp. Rp.
6-Jul-18 Haryono LCHHOIRIY 2082647
dr. Yenny
1958. 931330 TIDAK 1
LANGSUN
YAH G
24,875.00 24,875.00
INJEKSI IV
dr. ENDANG Rp. Rp.
1959. 6-Jul-18 Artamty POERMIH 2082663 80248 TIDAK 1
LANGSUN
Sastry A ARSIH G
24,875.00 24,875.00

AZAHRA INJEKSI IV
dr. ZAINA Rp. Rp.
1960. 6-Jul-18 Artamty ADI 2082670 931335 TIDAK 1
LANGSUN
Sastry A NINGRU G
M
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
1961. 6-Jul-18 Artamty DARMAJI 2082677 931194 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
dr. RENALDY Rp. Rp.
1962. 6-Jul-18 Artamty ARDIAN 2082678 931337 TIDAK 1
LANGSUN
Sastry A SAPUTRA G
24,875.00 24,875.00
INJEKSI IV
dr. SULIS Rp. Rp.
1963. 6-Jul-18 Artamty SETYONI 2082682 931340 TIDAK 1
LANGSUN
Sastry A NGSIH G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
SUBRAHI
1964. 6-Jul-18 Artamty 2082693 931344 TIDAK 1
M LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
dr. GIBRAN Rp. Rp.
1965. 6-Jul-18 Artamty ALFATIH, 2082696 931345 TIDAK 1
LANGSUN
Sastry A MUH G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
1966. 6-Jul-18 Artamty KARSILAN 2082704 907653 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
6-Jul-18 dr. Nani NUR
1967. 2082721 931353 TIDAK 1
Zumaroh HIDAYAH LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
6-Jul-18 dr. Nani INDRI
1968. 2082723 931355 TIDAK 1
Zumaroh JATUN R LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
6-Jul-18 dr. Nani
1969. 931357 TIDAK
Zumaroh KASPAN 2082726 1
LANGSUN
G
24,875.00 24,875.00
ALMEIRA INJEKSI IV
Rp. Rp.
6-Jul-18 Zumaroh FITRIA
dr. Nani
1970. 931358 TIDAK
HADITAM 2082727 1
LANGSUN
A G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
6-Jul-18 dr. Nani
1971. 931359 TIDAK
Zumaroh SUMAR 2082732 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
6-Jul-18 dr. Nani ABDUL
1972. 2082733 931360 TIDAK 1
Zumaroh WAHAB LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
6-Jul-18 dr. Nani
1973. 931363 TIDAK
Zumaroh SAKIRAH 2082736 1
LANGSUN
G
24,875.00 24,875.00
DZAKY INJEKSI IV
Rp. Rp.
7-Jul-18 Zumaroh FAEYZA
dr. Nani
1974. 2082753 917862 TIDAK 1
ANGGAR LANGSUN
A G
24,875.00 24,875.00
INJEKSI IV
Nani HAYDAR Rp. Rp.
1975. 7-Jul-18 dr. 931368 TIDAK
Zumaroh FAHMY 2082760 1
LANGSUN
HAKIM G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
7-Jul-18 dr. Nani
1976. 931369 TIDAK
Zumaroh LASRI 2082768 1
LANGSUN
G
24,875.00 24,875.00
CHARMEL INJEKSI IV
Rp. Rp.
7-Jul-18 Zumaroh LYA
dr. Nani
1977. 931370 TIDAK
ANGELIN 2082769 1
LANGSUN
E WILLIS G
24,875.00 24,875.00
PRAJNA INJEKSI IV
Rp. Rp.
7-Jul-18 Zumaroh PARAMIT
dr. Nani
1978. 2082770 920478 TIDAK 1
A TRI LANGSUN
ALISA G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat JEVIA Rp. Rp.
1979. 7-Jul-18 Victor 2082778 931373 TIDAK 1
Emanuel SAFITRI LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat KHOIRUL Rp. Rp.
1980. 7-Jul-18 Victor SETIAWA 2082779 931374 TIDAK 1
LANGSUN
Emanuel N G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat SURIPAH, Rp. Rp.
1981. 7-Jul-18 Victor 2082784 900005 TIDAK 1
Emanuel NY LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Ratna MARITA Rp. Rp.
1982. 7-Jul-18 dr. 931381 TIDAK
Ernawat DWI 2082791 1
LANGSUN
NURLAILI G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat LULUS Rp. Rp.
1983. 7-Jul-18 Victor 2082794 931377 TIDAK 1
Emanuel PAMUJI LANGSUN
G
24,875.00 24,875.00

CHINTAM INJEKSI IV
dr. Goliat I Rp. Rp.
1984. 7-Jul-18 Victor MUTIARA 2082795 931383 TIDAK 1
LANGSUN
Emanuel RACHMA G
PUTRI
24,875.00 24,875.00
INJEKSI IV
dr. Goliat ADI Rp. Rp.
1985. 8-Jul-18 Victor WAHYU 2082797 931385 TIDAK 1
LANGSUN
Emanuel SAPUTRA G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat Rp. Rp.
1986. 8-Jul-18 Victor MUINAH 2082799 931387 TIDAK 1
LANGSUN
Emanuel G
24,875.00 24,875.00

MAULIDA INJEKSI IV
Yenny TSALISA Rp. Rp.
1987. 8-Jul-18 dr. 73857 TIDAK
Haryono RAHMA 2082800 1
LANGSUN
NUR AL G
HUSNA
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
8-Jul-18 dr. Yenny
1988. 931389 TIDAK
Haryono LANTIP 2082802 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
8-Jul-18 dr. Yenny
1989. 931390 TIDAK
Haryono WINARTI 2082803 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
8-Jul-18 dr. Yenny
1990. 931341 TIDAK
Haryono SUDARNI 2082804 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
8-Jul-18 dr. Yenny
1991. 931391 TIDAK
Haryono MALIKIN 2082805 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
8-Jul-18 dr. Yenny
1992. 915224 TIDAK
Haryono TOMO 2082810 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
8-Jul-18 dr. Yenny
1993. 931393 TIDAK
Haryono SAMIRAH 2082813 1
LANGSUN
G
INJEKSI IV
8-Jul-18 dr. Yenny
1993. 931393 TIDAK
Haryono SAMIRAH 2082813 1
LANGSUN
G
24,875.00 24,875.00
ANINDYA INJEKSI IV
Rp. Rp.
8-Jul-18 Haryono AYU
dr. Yenny
1994. 922867 TIDAK
PRAMUSI 2082814 1
LANGSUN
TA G
24,875.00 24,875.00
INJEKSI IV
Yenny FEDRIKA Rp. Rp.
1995. 8-Jul-18 dr. 913176 TIDAK
Haryono SUSANAV 2082812 1
LANGSUN
I ANDARI G
24,875.00 24,875.00
INJEKSI IV
Nani SUGENG Rp. Rp.
1996. 8-Jul-18 dr. 931396 TIDAK
Zumaroh RUDIANT 2082818 1
LANGSUN
O G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
1997. 8-Jul-18 dr. Nani 917244 TIDAK
Zumaroh WARNADI 2082820 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Nani IBNU ALI Rp. Rp.
1998. 8-Jul-18 dr. MUSTAJJ 2082819 907399 TIDAK 1
Zumaroh AB LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
8-Jul-18 dr. Nani MINARO
1999. 2082821 931397 TIDAK 1
Zumaroh HMA LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Nani RAFI Rp. Rp.
2000. 8-Jul-18 dr. 931398 TIDAK
Zumaroh SAIFUDIN 2082822 1
LANGSUN
,MOCH G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
8-Jul-18 dr. Nani
2001. 931400 TIDAK
Zumaroh KASIYADI 2082824 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
8-Jul-18 dr. Nani SUHARTI
2002. 2082827 104002 TIDAK 1
Zumaroh NIK LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
8-Jul-18 dr. Nani
2003. 924169 TIDAK
Zumaroh SUNOTO 2082826 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
8-Jul-18 dr. Nani MADANU 2082829
2004. 903683 TIDAK 1
Zumaroh N LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
8-Jul-18 dr. Nani TARU
2005. 2082831 931399 TIDAK 1
Zumaroh WIJAYA LANGSUN
G
24,875.00 24,875.00
HANIF INJEKSI IV
Rp. Rp.
9-Jul-18 Hartono AHZHA,M
dr.
2006. 928615 TIDAK
UHAMM 2082847 1
LANGSUN
AD G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
9-Jul-18 dr. AIO
2007. 2082856 931409 TIDAK 1
Hartono ARASI LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
9-Jul-18 dr. Nani MUSRIPA
2008. 2082903 904014 TIDAK 1
Zumaroh H LANGSUN
G
24,875.00 24,875.00

NIKITA INJEKSI IV
Nani WHELAN Rp. Rp.
2009. 9-Jul-18 dr. 917993 TIDAK
Zumaroh DA 2082891 1
LANGSUN
WIJAYANT G
I
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
9-Jul-18 dr. Nani
2010. 931425 TIDAK
Zumaroh GARIYAH 2082905 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
9-Jul-18 dr. Nani
2011. 931427 TIDAK
Zumaroh LIMJIATI 2082908 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
9-Jul-18 dr. Nani HARIYANT 2082912
2012. 931215 TIDAK 1
Zumaroh O LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
9-Jul-18 dr. Yenny
2013. 64042 TIDAK
Haryono TORAN 2082927 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
9-Jul-18 dr. Yenny
2014. 929170 TIDAK
Haryono KATREMI 2082929 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Yenny NAJWA Rp. Rp.
2015. 9-Jul-18 dr. 931436 TIDAK
Haryono KHAIRA 2082937 1
LANGSUN
WILDHA G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
9-Jul-18 dr. Yenny
2016. 931437 TIDAK
Haryono TARSIH 2082938 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
9-Jul-18 dr. Yenny
2017. 78230 TIDAK
Haryono KASBU 2082941 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
9-Jul-18 dr. Yenny
2018. 919356 TIDAK
Haryono MASJUKI 2082944 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Yenny SITI Rp. Rp.
2019. 9-Jul-18 dr. 931438 TIDAK
Haryono ZULAIKO 2082943 1
LANGSUN
H G
24,875.00 24,875.00
INJEKSI IV
Yenny WIDARTI Rp. Rp.
2020. 9-Jul-18 dr. 931440 TIDAK
Haryono JANUARI 2082947 1
LANGSUN
NINGSIH G
24,875.00 24,875.00
RENY INJEKSI IV
Rp. Rp.
9-Jul-18 Haryono VISILIA
dr. Yenny
2021. 2082953 931441 TIDAK 1
SALAMO LANGSUN
NY G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
9-Jul-18 dr. Yenny
2022. 931240 TIDAK
Haryono TUMIRAH 2082954 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. RENATA Rp. Rp.
2023. 9-Jul-18 Artamty LYAN 2082955 34866 TIDAK 1
LANGSUN
Sastry A NOVIA G
24,875.00 24,875.00
INJEKSI IV
dr. SAMUEL Rp. Rp.
2024. 9-Jul-18 Artamty LYANNOV 2082956 89089 TIDAK 1
LANGSUN
Sastry A E G
24,875.00 24,875.00
YUDHISTI INJEKSI IV
dr. Rp. Rp.
RA
2025. 9-Jul-18 Artamty 2082957 921123 TIDAK 1
HARFIAN LANGSUN
Sastry A O PUTRA G
24,875.00 24,875.00
AGUNG INJEKSI IV
dr. Rp. Rp.
ADI
2026. 10-Jul-18 Artamty 2082970 931442 TIDAK 1
PRASETY LANGSUN
Sastry A O G
24,875.00 24,875.00
INJEKSI IV
dr. VIZRAL Rp. Rp.
2027. 10-Jul-18 Artamty SATRIA 2082971 911444 TIDAK 1
LANGSUN
Sastry A PUTRA G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
2028. 10-Jul-18 Artamty KARMINI 2082974 63247 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
2029. 10-Jul-18 Artamty ZAENI 2082975 931443 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2030. 10-Jul-18 dr. 931447 TIDAK
Hartono SUKADI 2083001 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2031. 10-Jul-18 dr. 931450 TIDAK
Hartono SURIYAH 2083009 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
KRISTINA Rp. Rp.
2032. 10-Jul-18 dr. 913252 TIDAK
Hartono NURHAYA 2083033 1
LANGSUN
TI G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
10-Jul-18 dr. NYAMINA 2083035
2033. 931200 TIDAK 1
Hartono H LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
RINI Rp. Rp.
2034. 10-Jul-18 dr. WAHYUNI 2083054 2078 TIDAK 1
Hartono /RSMM LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Yenny AZURA Rp. Rp.
2035. 10-Jul-18 dr. 931467 TIDAK
Haryono MAFAZA 2083078 1
LANGSUN
FIKRI G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
10-Jul-18 dr. Yenny
2036. 931468 TIDAK
Haryono KARJONO 2083080 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
10-Jul-18 dr. Yenny
2037. 931470 TIDAK
Haryono SUMIRAH 2083088 1
LANGSUN
G
24,875.00 24,875.00
QUTHBI INJEKSI IV
Rp. Rp.
10-Jul-18 Haryono UWAYS
dr. Yenny
2038. 2083089 931471 TIDAK 1
SYIHAB, LANGSUN
AHMAD G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
10-Jul-18 dr. Yenny SUTRISN
2039. 2083096 931473 TIDAK 1
Haryono O, TN LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
10-Jul-18 dr. Yenny
2040. 931474 TIDAK
Haryono SUKIMAH 2083099 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat Rp. Rp.
2041. 10-Jul-18 Victor SUMIJAH 2083107 931478 TIDAK 1
LANGSUN
Emanuel G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat ENI NUR Rp. Rp.
2042. 11-Jul-18 Victor 2083104 931472 TIDAK 1
Emanuel FARIDAH LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat Rp. Rp.
2043. 11-Jul-18 Victor SUPARMI 2083103 26851 TIDAK 1
LANGSUN
Emanuel G
24,875.00 24,875.00

FAUQI INJEKSI IV
dr. Goliat ALQOHAR Rp. Rp.
2044. 11-Jul-18 Victor , 2083111 931480 TIDAK 1
LANGSUN
Emanuel MOHAM G
AD
24,875.00 24,875.00
WAN INJEKSI IV
Rp. Rp.
11-Jul-18 Haryono SAHIRA
dr. Yenny
2045. 2083127 915313 TIDAK 1
PUTRI LANGSUN
ARINA G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
11-Jul-18 dr. Yenny
2046. 931490 TIDAK
Haryono KUHARI 2083156 1
LANGSUN
G
24,875.00 24,875.00

NIZAR
TSAQIF INJEKSI IV
Rp. Rp.
11-Jul-18 Hartono AL
dr.
2047. 931495 TIDAK
FATIH,MU 2083172 1
LANGSUN
HAMMA G
D
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
11-Jul-18 dr. SUPRIYAD 2083186
2048. 900511 TIDAK 1
Hartono I LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
11-Jul-18 dr. Nani
2049. 931500 TIDAK
Zumaroh SURI 2083190 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Yenny ALKHALIF Rp. Rp.
2050. 11-Jul-18 dr. 925675 TIDAK
Haryono IRAFAN
MAUZA 2083199 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
11-Jul-18 dr. Yenny KUSNAN,
2051. 2083203 911166 TIDAK 1
Haryono M LANGSUN
G
24,875.00 24,875.00
ROIIQOH INJEKSI IV
Rp. Rp.
11-Jul-18 Hartono HABIBAT
dr.
2052. 2083209 72057 TIDAK 1
UL ASMA LANGSUN
ALIFAH G
24,875.00 24,875.00
INJEKSI IV
AZRINA Rp. Rp.
2053. 11-Jul-18 dr. 931506 TIDAK
Hartono LAVENIA 2083210 1
LANGSUN
SHAZFA G
24,875.00 24,875.00
INJEKSI IV
JEFRI Rp. Rp.
2054. 11-Jul-18 dr. 931507 TIDAK
Hartono HERIANT 2083214 1
LANGSUN
O, MUH G
24,875.00 24,875.00

ABHAN
MAULAN INJEKSI IV
Rp. Rp.
11-Jul-18 Hartono A
dr.
2055. 2083215 105537 TIDAK 1
ADHYAST LANGSUN
HA G
BUKHORI
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
2056. 12-Jul-18 Artamty DURAJI 2083226 931510 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
HARMOK
2057. 12-Jul-18 Artamty 2083229 931511 TIDAK 1
O LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
2058. 12-Jul-18 Artamty SODJO 2083230 931483 TIDAK 1
LANGSUN
Sastry A G
INJEKSI IV
dr.
2058. 12-Jul-18 Artamty SODJO 2083230 931483 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
SRI
2059. 12-Jul-18 Artamty 2083239 65659 TIDAK 1
HARUMI LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
12-Jul-18 dr. Yenny
2060. 931516 TIDAK
Haryono SUYATNO 2083247 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Yenny EARLITA Rp. Rp.
2061. 12-Jul-18 dr. 907589 TIDAK
Haryono SALSABIL 2083285 1
LANGSUN
A G
24,875.00 24,875.00
TEGUH INJEKSI IV
Rp. Rp.
2062. 12-Jul-18 Haryono IBNU
dr. Yenny 2083320 34066 TIDAK 1
SUNGKO LANGSUN
WO G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
12-Jul-18 dr. Yenny
2063. 931529 TIDAK
Haryono DAMPUN 2083317 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Yenny DANIYAH Rp. Rp.
2064. 12-Jul-18 dr. 931532 TIDAK
Haryono RIHADAT 2083338 1
LANGSUN
UL AISY G
24,875.00 24,875.00
INJEKSI IV
Yenny YOGI Rp. Rp.
2065. 12-Jul-18 dr. 36581 TIDAK
Haryono WAHYU 2083336 1
LANGSUN
PRATAMA G
24,875.00 24,875.00
INJEKSI IV
LUCKY Rp. Rp.
12-Jul-18 dr. Yenny ANGGAR
2066. 2083356 108128 TIDAK 1
Haryono A,M LANGSUN
G
24,875.00 24,875.00
BENY INJEKSI IV
Rp. Rp.
12-Jul-18 Haryono WAHYU
dr. Yenny
2067. 2083286 931524 TIDAK 1
IRAWAN, LANGSUN
MOCH. G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
12-Jul-18 dr. Yenny
2068. 931279 TIDAK
Haryono DARGO 2083357 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Yenny PIPIT Rp. Rp.
2069. 12-Jul-18 dr. 68253 TIDAK
Haryono YULIARI 2083359 1
LANGSUN
ALIVIA G
24,875.00 24,875.00
DINDA INJEKSI IV
Rp. Rp.
12-Jul-18 Haryono PUTRI
dr. Yenny
2070. 2083353 931538 TIDAK 1
RAMADH LANGSUN
ANI G
24,875.00 24,875.00
RAISA INJEKSI IV
Rp. Rp.
12-Jul-18 Hartono AZIRAH
dr.
2071. 2083361 931539 TIDAK 1
RAMADH LANGSUN
ANI G
24,875.00 24,875.00
JEREMY INJEKSI IV
Rp. Rp.
12-Jul-18 Hartono GLEVINO
dr.
2072. 2083364 105516 TIDAK 1
KARSTEN LANGSUN
LIN G
24,875.00 24,875.00
HERMINA INJEKSI IV
Rp. Rp.
12-Jul-18 Hartono H
dr.
2073. 931542 TIDAK
FEBRIANT 2083368 1
LANGSUN
Y G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2074. 12-Jul-18 dr. 931543 TIDAK
Hartono BASRI 2083369 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
12-Jul-18 dr. WARSILA
2075. 2083371 107216 TIDAK 1
Hartono H LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
12-Jul-18 dr. MUNTOLI 2083373
2076. 931545 TIDAK 1
Hartono B LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
ANUGRA Rp. Rp.
2077. 12-Jul-18 dr. H EKA 2083374 69014 TIDAK 1
Hartono ALFEYCO LANGSUN
G
24,875.00 24,875.00
SYAUQIL INJEKSI IV
Rp. Rp.
13-Jul-18 Hartono ISMA
dr.
2078. 931544 TIDAK
ASSYAFIIY 2083370 1
LANGSUN
AH G
24,875.00 24,875.00
RISKI INJEKSI IV
Rp. Rp.
13-Jul-18 Hartono DIKA
dr.
2079. 2083379 40039 TIDAK 1
ARMADA LANGSUN
NI G
24,875.00 24,875.00
HAFIZH INJEKSI IV
Rp. Rp.
13-Jul-18 Hartono MUZAKY,
dr.
2080. 2083378 931547 TIDAK 1
MUHAM LANGSUN
MAD G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2081. 13-Jul-18 dr. 931548 TIDAK
Hartono SAJI 2083388 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
13-Jul-18 dr. JOYO
2082. 2083403 904546 TIDAK 1
Hartono ADI,H LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. AISYAH Rp. Rp.
2083. 13-Jul-18 Artamty NUHA 2083436 931556 TIDAK 1
LANGSUN
Sastry A ZAHIRA G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
NUR YULI 2083438
2084. 13-Jul-18 Artamty 931557 TIDAK 1
ASTITI LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
dr. SITI Rp. Rp.
2085. 13-Jul-18 Artamty MARDIYA 2083440 930843 TIDAK 1
LANGSUN
Sastry A H G
24,875.00 24,875.00
INJEKSI IV
dr. SITI Rp. Rp.
2086. 13-Jul-18 Artamty KHASANA 2083443 931558 TIDAK 1
LANGSUN
Sastry A H G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
2087. 13-Jul-18 Artamty SUMARJI 2083448 931561 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
2088. 13-Jul-18 Artamty ZAENAB 2083449 931562 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
CALYSTA INJEKSI IV
dr. Rp. Rp.
QUEENIZ 2083450
2089. 13-Jul-18 Artamty 921638 TIDAK 1
A LANGSUN
Sastry A ROHMAN G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
2090. 13-Jul-18 Artamty ROHLI 2083452 927283 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
13-Jul-18 dr. Yenny
2091. 931565 TIDAK
Haryono MASUD 2083458 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
13-Jul-18 dr. Yenny BOECHOR 2083459
2092. 47813 TIDAK 1
Haryono I/RSMM LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
13-Jul-18 dr. Yenny
2093. 930959 TIDAK
Haryono HENDUN 2083396 1
LANGSUN
G
24,875.00 24,875.00
AFZAR INJEKSI IV
Rp. Rp.
13-Jul-18 Haryono HAZIQ
dr. Yenny
2094. 924185 TIDAK
ALFARIDZ 2083471 1
LANGSUN
Y,AHMAD G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
13-Jul-18 dr. Yenny
2095. 931568 TIDAK
Haryono PASRI 2083474 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Yenny NUR Rp. Rp.
2096. 13-Jul-18 dr. 930480 TIDAK
Haryono SHOLICA 2083473 1
LANGSUN
H G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
13-Jul-18 dr. Yenny
2097. 931378 TIDAK
Haryono LAMIJAH 2083475 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat ZAINUL Rp. Rp.
2098. 13-Jul-18 Victor 2083477 931570 TIDAK 1
Emanuel ABIDIN LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat Rp. Rp.
2099. 13-Jul-18 Victor RASIDIN 2083478 931571 TIDAK 1
LANGSUN
Emanuel G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat DARWOT Rp. Rp.
2100. 14-Jul-18 Victor 2083476 72779 TIDAK 1
Emanuel O LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat JULIANA Rp. Rp.
2101. 14-Jul-18 Victor 2083482 931573 TIDAK 1
Emanuel PUTRI LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
14-Jul-18 dr. Yenny DAFFA,M
2102. 2083487 931575 TIDAK 1
Haryono OCH LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
14-Jul-18 dr. Yenny WASRIAT
2103. 2083488 931576 TIDAK 1
Haryono UN LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
RAVI Rp. Rp.
2104. 14-Jul-18 dr. 922920 TIDAK
Hartono PUTERA 2083496 1
LANGSUN
PRASETYA G
24,875.00 24,875.00
INJEKSI IV
IDA Rp. Rp.
2105. 14-Jul-18 dr. 931581 TIDAK
Hartono LUPITA 2083500 1
LANGSUN
SARI G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
14-Jul-18 dr. ROZIMI,A
2106. 2083503 931582 TIDAK 1
Hartono CHMAD LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat Rp. Rp.
2107. 14-Jul-18 Victor RUSNO 2083504 931583 TIDAK 1
LANGSUN
Emanuel G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat Rp. Rp.
2108. 14-Jul-18 Victor TASRAM 2083510 931585 TIDAK 1
LANGSUN
Emanuel G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat Rp. Rp.
2109. 14-Jul-18 Victor MUCHLIS 2083511 931586 TIDAK 1
LANGSUN
Emanuel G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat Rp. Rp.
2110. 14-Jul-18 Victor KARTINI 2083513 931587 TIDAK 1
LANGSUN
Emanuel G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat DYAH AYU Rp. Rp.
2111. 14-Jul-18 Victor 2083517 931589 TIDAK 1
Emanuel SAFITRI LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat NOFI Rp. Rp.
2112. 14-Jul-18 Victor ANDIK 2083518 915598 TIDAK 1
LANGSUN
Emanuel SUSANTO G
24,875.00 24,875.00
INJEKSI IV
dr. DIVIA Rp. Rp.
2113. 14-Jul-18 Artamty CHILA 2083521 931592 TIDAK 1
LANGSUN
Sastry A ASYIFA G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
RINA
2114. 15-Jul-18 Artamty 2083522 931593 TIDAK 1
WATI LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
2115. 15-Jul-18 Artamty WITO 2083524 931595 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2116. 15-Jul-18 dr. 931599 TIDAK
Hartono SUPRAT 2083530 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2117. 15-Jul-18 dr. 931600 TIDAK
Hartono PARCIM 2083531 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2118. 15-Jul-18 dr. 931602 TIDAK
Hartono KACUNG 2083533 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
15-Jul-18 dr. IMAM
2119. 2083536 931603 TIDAK 1
Hartono SYAFI'I LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2120. 15-Jul-18 dr. 931604 TIDAK
Hartono RUKMI 2083537 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat Rp. Rp.
2121. 15-Jul-18 Victor SALEKAH 2083544 927868 TIDAK 1
LANGSUN
Emanuel G
24,875.00 24,875.00
INJEKSI IV
dr. DARJITO Rp. Rp.
2122. 15-Jul-18 Artamty HADI 2083551 931609 TIDAK 1
LANGSUN
Sastry A SUCIPTO G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat Rp. Rp.
2123. 16-Jul-18 Victor SARILAH 2083550 931608 TIDAK 1
LANGSUN
Emanuel G
24,875.00 24,875.00
PEGGI INJEKSI IV
dr. Rp. Rp.
ARIE
2124. 16-Jul-18 Artamty 2083552 931610 TIDAK 1
ZULIA LANGSUN
Sastry A AZIZ G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
16-Jul-18 dr. Yenny
2125. 88240 TIDAK
Haryono TARSINI 2083582 1
LANGSUN
G
24,875.00 24,875.00
NAUFAL INJEKSI IV
Rp. Rp.
16-Jul-18 Haryono SYAMIL
dr. Yenny
2126. 2083591 931614 TIDAK 1
ADZ LANGSUN
DZAKY W G
24,875.00 24,875.00
INJEKSI IV
Yenny LUTHFIA Rp. Rp.
2127. 16-Jul-18 dr. 931616 TIDAK
Haryono LEYLA 2083597 1
LANGSUN
NASHIWA G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
16-Jul-18 dr. Yenny
2128. 921489 TIDAK
Haryono BASTAM 2083610 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
16-Jul-18 dr. Yenny
2129. 88759 TIDAK
Haryono ASRIATIN 2083613 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
16-Jul-18 dr. Yenny
2130. 931628 TIDAK
Haryono ANTO 2083640 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
16-Jul-18 dr. Yenny
2131. 931631 TIDAK
Haryono SUPARMI 2083646 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat NABILLA Rp. Rp.
2132. 16-Jul-18 Victor AMEERA 2083663 925561 TIDAK 1
LANGSUN
Emanuel H G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat TURJIMA Rp. Rp.
2133. 16-Jul-18 Victor 2083667 931635 TIDAK 1
Emanuel N LANGSUN
G
24,875.00 24,875.00
ADHITAM INJEKSI IV
dr. Goliat Rp. Rp.
A ELVAN 2083670
2134. 16-Jul-18 Victor 931637 TIDAK 1
SYAHREZ LANGSUN
Emanuel A G
24,875.00 24,875.00
INJEKSI IV
NUR Rp. Rp.
2135. 16-Jul-18 dr. 931639 TIDAK
Hartono RAIHAN, 2083673 1
LANGSUN
MUH. G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2136. 17-Jul-18 dr. 920067 TIDAK
Hartono SAMHADI 2083674 1
LANGSUN
G
24,875.00 24,875.00

NAJMA INJEKSI IV
Rp. Rp.
17-Jul-18 Hartono YUKE
dr.
2137. 2083695 931640 TIDAK 1
FISKA LANGSUN
PRATAMA G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
17-Jul-18 dr. KUSNAN,
2138. 2083696 911166 TIDAK 1
Hartono M LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2139. 17-Jul-18 dr. WILDAN 2083707 914458 TIDAK 1
Hartono FAIQ, M LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
17-Jul-18 dr. Yenny CAHYANA
2140. 931645 TIDAK
Haryono , AHMAD 2083728 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Yenny SITI Rp. Rp.
2141. 17-Jul-18 dr. 931641 TIDAK
Haryono ISTIKOMA 2083737 1
LANGSUN
H G
24,875.00 24,875.00
INJEKSI IV
Yenny ATTHAR Rp. Rp.
2142. 17-Jul-18 dr. 931648 TIDAK
Haryono GIO 2083746 1
LANGSUN
VALENSIA G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
17-Jul-18 dr. Yenny
2143. 924169 TIDAK
Haryono SUNOTO 2083717 1
LANGSUN
G
24,875.00 24,875.00
IKVAN INJEKSI IV
Rp. Rp.
17-Jul-18 Haryono HADI
dr. Yenny
2144. 2083758 912337 TIDAK 1
PRASETY LANGSUN
O G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
17-Jul-18 dr. Yenny SUHARSO 2083765
2145. 931654 TIDAK 1
Haryono NO LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
17-Jul-18 dr. Yenny
2146. 931657 TIDAK
Haryono SAENI 2083773 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
17-Jul-18 dr. Nani AHSAN
2147. 2083780 908407 TIDAK 1
Zumaroh ALWI LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Nani ENI Rp. Rp.
2148. 17-Jul-18 dr. 931660 TIDAK
Zumaroh SUSWAN 2083784 1
LANGSUN
TI G
24,875.00 24,875.00
INJEKSI IV
Nani NAUFALI Rp. Rp.
2149. 17-Jul-18 dr. 931663 TIDAK
Zumaroh NO 2083793 1
LANGSUN
ATHAYA G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
17-Jul-18 dr. Nani
2150. 931662 TIDAK
Zumaroh MASHUDI 2083789 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Nani KARSANI Rp. Rp.
2151. 17-Jul-18 dr. 95655 TIDAK
Zumaroh EDI 2083797 1
LANGSUN
WIBOWO G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
17-Jul-18 dr. Nani RUKMIYA
2152. 2083807 931669 TIDAK 1
Zumaroh TUN LANGSUN
G
24,875.00 24,875.00

ANDREE INJEKSI IV
Nani NICO Rp. Rp.
2153. 17-Jul-18 dr. 67315 TIDAK
Zumaroh AUSHAF, 2083809 1
LANGSUN
MUHAM G
MAD
24,875.00 24,875.00
INJEKSI IV
FADHIL Rp. Rp.
17-Jul-18 dr. Nani ABDILLAH 2083812
2154. 915074 TIDAK 1
Zumaroh ,MUH LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
ADAM
2155. 17-Jul-18 Artamty 2083816 931673 TIDAK 1
RAHMAN LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
2156. 18-Jul-18 Artamty DARSIPAH 2083832 927232 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
dr. ERICK Rp. Rp.
2157. 18-Jul-18 Artamty FEBRIANS 2083834 931678 TIDAK 1
LANGSUN
Sastry A YAH G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2158. 18-Jul-18 dr. 931685 TIDAK
Hartono SAMIN 2083855 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
NAZRIL Rp. Rp.
2159. 18-Jul-18 dr. 931689 TIDAK
Hartono ILHAM 2083864 1
LANGSUN
PRASTIYO G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
18-Jul-18 dr. KASMINA 2083871
2160. 931680 TIDAK 1
Hartono H LANGSUN
G
24,875.00 24,875.00
MISHEL INJEKSI IV
Rp. Rp.
18-Jul-18 Hartono SALSA
dr.
2161. 931695 TIDAK
OKTAQUE 2083890 1
LANGSUN
EN G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
18-Jul-18 dr. KHOIRUL
2162. 2083899 931703 TIDAK 1
Hartono IKHSAN LANGSUN
G
24,875.00 24,875.00

ALDHI INJEKSI IV
Yenny ATHARRA Rp. Rp.
2163. 18-Jul-18 dr. 931706 TIDAK
Haryono IHAN 2083901 1
LANGSUN
KASYAFA G
NI
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
18-Jul-18 dr. Yenny
2164. 105378 TIDAK
Haryono KASIYATI 2083905 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
18-Jul-18 dr. Yenny
2165. 931711 TIDAK
Haryono KARMILA 2083912 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
18-Jul-18 dr. Yenny MUSTAIN, 2083913
2166. 931712 TIDAK 1
Haryono MOH LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Yenny ARKA Rp. Rp.
2167. 18-Jul-18 dr. 931714 TIDAK
Haryono DWI 2083916 1
LANGSUN
CAHYA G
24,875.00 24,875.00
ACHMAD INJEKSI IV
Rp. Rp.
18-Jul-18 Haryono HAFIZ
dr. Yenny
2168. 2083917 931715 TIDAK 1
NUR LANGSUN
RIFKY G
24,875.00 24,875.00
SHAFA INJEKSI IV
dr. Goliat DINA Rp. Rp.
2169. 18-Jul-18 Victor HAYUNIN 2083919 931717 TIDAK 1
LANGSUN
Emanuel G G
MENTARI
24,875.00 24,875.00
INJEKSI IV
dr. Goliat Rp. Rp.
2170. 18-Jul-18 Victor KASMIN 2083920 931718 TIDAK 1
LANGSUN
Emanuel G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
19-Jul-18 dr. Yenny
2171. 931721 TIDAK
Haryono SOMI 2083951 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
2172. 19-Jul-18 dr. Yenny FATAH, 931724 TIDAK
Rp. Rp.
Haryono MUHAM 2083956 1
LANGSUN
MAD G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat KARDIMA Rp. Rp.
2173. 19-Jul-18 Victor 2083921 931719 TIDAK 1
Emanuel H LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. Goliat HENI Rp. Rp.
2174. 19-Jul-18 Victor ULANDAR 2083940 102250 TIDAK 1
LANGSUN
Emanuel I G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
19-Jul-18 dr. Yenny
2175. 931727 TIDAK
Haryono KAMSIH 2083960 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
19-Jul-18 dr. Yenny
2176. 931730 TIDAK
Haryono KARSONO 2083971 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
19-Jul-18 dr. Nani ALI
2177. 2083985 931732 TIDAK 1
Zumaroh SODIKIN LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
19-Jul-18 dr. Nani
2178. 929916 TIDAK
Zumaroh SAKHUR 2083993 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
19-Jul-18 dr. Nani SITI NUR
2179. 2084002 931734 TIDAK 1
Zumaroh KHOLIFA LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Nani NOVIA Rp. Rp.
2180. 19-Jul-18 dr. 930418 TIDAK
Zumaroh RATNA 2084006 1
LANGSUN
JUWITA G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
SURATMA 2084034
2181. 19-Jul-18 Artamty 931736 TIDAK 1
N LANGSUN
Sastry A G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
2182. 19-Jul-18 Artamty RIDWAN 2084035 931737 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00

BIYANTAR INJEKSI IV
dr. Rp. Rp.
A AYOEM 2084040
2183. 19-Jul-18 Artamty 931740 TIDAK 1
Sastry A RUMBAK LANGSUN
A G
24,875.00 24,875.00
INJEKSI IV
dr. BRILLIA Rp. Rp.
2184. 19-Jul-18 Artamty HENING 2084046 931741 TIDAK 1
LANGSUN
Sastry A MAS G
24,875.00 24,875.00
INJEKSI IV
dr. ABDULLA Rp. Rp.
2185. 19-Jul-18 Artamty H 2084048 931742 TIDAK 1
LANGSUN
Sastry A ABIDZAR G
24,875.00 24,875.00
INJEKSI IV
RAGIL Rp. Rp.
2186. 19-Jul-18 dr. 904119 TIDAK
Hartono SEPTI 2084051 1
LANGSUN
ANDITA G
24,875.00 24,875.00
INJEKSI IV
AZZAMI Rp. Rp.
2187. 19-Jul-18 dr. 920321 TIDAK
Hartono SYAUQI 2084052 1
LANGSUN
SINA G
24,875.00 24,875.00
WAHYU INJEKSI IV
Rp. Rp.
20-Jul-18 Hartono ADI
dr.
2188. 2084054 22221 TIDAK 1
PRASETY LANGSUN
O G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
20-Jul-18 dr. MARDIYA 2084055
2189. 931744 TIDAK 1
Hartono NTO LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
20-Jul-18 dr. RUSDIAN
2190. 2084068 931745 TIDAK 1
Hartono TO LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
dr. Rp. Rp.
2191. 20-Jul-18 Artamty RASIPAN 2084108 79516 TIDAK 1
LANGSUN
Sastry A G
24,875.00 24,875.00
GEISYA INJEKSI IV
Rp. Rp.
20-Jul-18 Hartono MAULIDA
dr.
2192. 926541 TIDAK
DZIRGAM 2084143 1
LANGSUN
A DIARTA G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2193. 20-Jul-18 dr. 931752 TIDAK
Hartono BINTORO 2084101 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
20-Jul-18 dr. SITI
2194. 2084145 931762 TIDAK 1
Hartono ASTUTIK LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
2195. 20-Jul-18 dr. 928175 TIDAK
Hartono RADI 2084146 1
LANGSUN
G
24,875.00 24,875.00
INJEKSI IV
IKA Rp. Rp.
2196. 20-Jul-18 dr. 930105 TIDAK
Hartono NURLIDYA 2084150 1
LANGSUN
NINGSIH G
24,875.00 24,875.00

RAISHA INJEKSI IV
AZKADIN Rp. Rp.
2197. 20-Jul-18 dr. 911991 TIDAK
Hartono A 2084154 1
LANGSUN
MUADZA G
H
24,875.00 24,875.00
INJEKSI IV
RAISYA Rp. Rp.
2198. 20-Jul-18 dr. 931765 TIDAK
Hartono PUTRI 2084157 1
LANGSUN
CAHYANI G
24,875.00 24,875.00
INJEKSI IV
Rp. Rp.
20-Jul-18 dr. MAFTUKI
2199. 2084158 931766 TIDAK 1
Hartono N, MOCH LANGSUN
G
24,875.00 24,875.00

ANGGA INJEKSI IV
dr. Goliat APRILIA Rp. Rp.
2200. 20-Jul-18 Victor DWI 2084162 107405 TIDAK 1
LANGSUN
Emanuel CAHYANI G
NGTYAS
24,875.00 24,875.00
HAFIDZ INJEKSI IV
Rp. Rp.
21-Jul-18 Haryono ALWI
dr. Yenny AL
2201. 931769 TIDAK
AZZA,MU 2084183 1
LANGSUN
H. G
HAFIDZ INJEKSI IV