TAGIHAN BIAYA KESEHATAN AL MA'UNAH

APOTEK
No TANGGAL NAMA
NOMOR RESEPNAMA OBAT Σ NOMINAL

1 ### Tn.Damar R/102P Rp 14,000

2 ### Syarifah Fadlun Confident XL 1 Rp 40,000

3 ### Fatkhi Gabapentin 10 Rp 43,000

Zahra (Kak Ipah) R/141P Rp 43,000

4 ###

Ali At Thamimy Concor 2,5 10 Rp 60,600

5 ### Hb.Abdurrachman R/159P Rp 23,000

Syarifah Fadlun Confident XL 1 Rp 40,000

An.Nuriyah
6 ###
Tn.Damar R/163P Rp 13,000

7 ### Hb.Abdurrachman
Tn.Jayadi Hepatin 10 Rp 54,000
B6 60 Rp 12,000
8 ###
Fatimah Bamgetol 60 Rp 118,800
Kutoin 60 Rp 81,500
Choirun Nisya' R/013P Rp 81,000
An.Kamila R/014P Rp 79,000
9 ###
Ny.Fina R/023P Rp 53,000
Rokhim R/024P Rp 64,000
Stimuno 10 Rp 25,000
10 ### Fitria Al Hadad Panadol Biru 10 Rp 7,500
Omeprazole 10 Rp 4,000
11 ### Syarifah Fadlun Confident XL 1 Rp 40,000
12 ### Maria Ulfa R/038 Rp 21,000
Total Apotek Rp 917,400
L MA'UNAH
KLINIK
TOTAL BIAYA
Jenis Tindakan Nominal
Konsul Rp 15,000
Rp 59,000
Nebulizer Rp 30,000
Rp 40,000
Rp 43,000
Konsul Rp 15,000
Chol Rp 25,000 Rp 93,000
AU Rp 10,000
Rp 60,600
Konsul Rp 15,000
GDA Rp 10,000
Rp 113,000
AU Rp 10,000
Ekstrasi Kuku Rp 55,000
Rp 40,000
Cabut Gigi Rp 50,000 Rp 50,000
Konsul Rp 15,000
Rp 58,000
Nebulizer Rp 30,000
Rawat Luka Rp 25,000 Rp 25,000
Rp 54,000

Rp 212,300

Konsul Rp 15,000 Rp 96,000

Konsul Rp 15,000 Rp 94,000
Konsul Rp 15,000 Rp 68,000
Konsul Rp 15,000 Rp 79,000

Rp 36,500

Rp 40,000
Konsul Rp 15,000 Rp 36,000
Total Klinik Rp 380,000 Rp 1,297,400
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK
No TANGGAL NAMA
NOMOR RESEPNAMA OBAT Σ NOMINAL

1 ### Tn.Damar R/102P Rp 14,000

2 ### Syarifah Fadlun Confident XL 1 Rp 40,000

3 ### Fatkhi Gabapentin 10 Rp 43,000

Zahra (Kak Ipah) R/141P Rp 43,000

4 ###

Ali At Thamimy Concor 2,5 10 Rp 60,600

5 ### Hb.Abdurrachman R/159P Rp 23,000

Syarifah Fadlun Confident XL 1 Rp 40,000

An.Nuriyah
6 ###
Tn.Damar R/163P Rp 13,000

7 ### Hb.Abdurrachman
Tn.Jayadi Hepatin 10 Rp 54,000
B6 60 Rp 12,000
8 ###
Fatimah Bamgetol 60 Rp 118,800
Kutoin 60 Rp 81,500
Choirun Nisya' R/013P Rp 81,000
An.Kamila R/014P Rp 79,000
9 ###
Ny.Fina R/023P Rp 53,000
Rokhim R/024P Rp 64,000
Stimuno 10 Rp 25,000
10 ### Fitria Al Hadad Panadol Biru 10 Rp 7,500
Omeprazole 10 Rp 4,000
11 ### Syarifah Fadlun Confident XL 1 Rp 40,000
12 ### Maria Ulfa R/038 Rp 21,000
Total Apotek Rp 917,400
L MA'UNAH
KLINIK
TOTAL BIAYA
Jenis Tindakan Nominal
Konsul Rp 15,000
Rp 59,000
Nebulizer Rp 30,000
Rp 40,000
Rp 43,000
Konsul Rp 15,000
Chol Rp 25,000 Rp 93,000
AU Rp 10,000
Rp 60,600
Konsul Rp 15,000
GDA Rp 10,000
Rp 113,000
AU Rp 10,000
Ekstrasi Kuku Rp 55,000
Rp 40,000
Cabut Gigi Rp 50,000 Rp 50,000
Konsul Rp 15,000
Rp 58,000
Nebulizer Rp 30,000
Rawat Luka Rp 25,000 Rp 25,000
Rp 54,000

Rp 212,300

Konsul Rp 15,000 Rp 96,000

Konsul Rp 15,000 Rp 94,000
Konsul Rp 15,000 Rp 68,000
Konsul Rp 15,000 Rp 79,000

Rp 36,500

Rp 40,000
Konsul Rp 15,000 Rp 36,000
Total Klinik Rp 380,000 Rp 1,297,400
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK KLINIK
No TANGGAL NAMA
NOMOR RESEPNAMA OBAT Σ NOMINAL Jenis Tindakan Nominal
Konsul Rp 15,000
1 ### Tn.Damar R/057P Rp 11,000
Nebulizer Rp 30,000
Cek GDA 1 Rp 10,000
Zainab Al Habsy
2 ### Dextral 10 Rp 5,000
An.Nuriyah Cabut Gigi Rp 50,000
Rouf R/35B Rp 68,000 Konsul Rp 15,000
3 ###
Hb.Anis R/131M Rp 194,000 Konsul Rp 15,000
Konsul Rp 15,000
4 ### Tn.Maruki R/36B Rp 22,000 GDA Rp 10,000
AU Rp 10,000
5 ### Syarifah Fadlun Confident XL 1 Rp 40,000
6 ### Tn.Anis R/153P Rp 53,000 Konsul Rp 15,000
7 ### Ali At Thamimy Concor 2,5 10 Rp 60,600
8 ### P.Jayadi Hepatin 10 Rp 51,750
Syarifah Fadlun Confident XL 1 Rp 40,000
9 ###
An.Bambang Depaken Syr 1 Rp 171,000
Nebulizer Rp 30,000
10 ### Tn.Damar
Oksigen Rp 60,000
Konsul Rp 15,000
11 ### Tn.Damar R/191P Rp 11,000
Nebulizer Rp 30,000
Omeprazole 10 Rp 4,500
12 ### Fitria Al Hadad
Syimuno 20 Rp 49,000
Total Apotek Rp 790,850 Total Klinik Rp 310,000
TOTAL BIAYA

Rp 56,000

Rp 15,000

Rp 50,000
Rp 83,000
Rp 209,000

Rp 57,000

Rp 40,000
Rp 68,000
Rp 60,600
Rp 51,750
Rp 40,000
Rp 171,000

Rp 90,000

Rp 56,000

Rp 53,500

Rp 1,100,850
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK KLINIK
No TANGGAL NAMA TOTAL BIAYA
NOMOR RESEP NAMA OBAT Σ NOMINAL Jenis Tindakan Nominal
Rokhim R/16P Rp 52,000 Konsul Rp 15,000 Rp 67,000
1 ###
Mb.Nisya' R/22P Rp 12,000 Konsul Rp 15,000 Rp 27,000
3 ### Sulaiman R/29P Rp 9,000 Rp 9,000
### Ali At Thamimi Concor 2.5 10 Rp 61,510 Rp 60,510
4
Syarifah Fadlun Confident XL 1 Rp 40,000 Rp 40,000
Temulawak kecil 3 Rp 15,000
5 ### Maunah Rp 23,000
Paseo 1 Rp 8,000
### Tn.Jayadi Hepatin 10 Rp 51,730 Rp 51,730
6 Zahra (Kak Ipah) R/146M Rp 73,000 Konsul Rp 15,000 Rp 88,000
An.Ainun R/72P Rp 85,000 Konsul Rp 15,000 Rp 100,000
7 ### Tn.Jamal R/96P Rp 23,000 Rp 23,000
8 ### Tn.Jamal R/107P Rp 175,000 Rp 175,000
Tn.Fuad R/147M Rp 142,000 Rp 142,000
Konsul Rp 15,000
9 ### Tn.Maruki R/118P Rp 11,000 Rp 36,000
GDA Rp 10,000
Karimah R/117P Rp 12,000 Rp 12,000
10 ### Syarifah Fadlun Confident XL 1 Rp 40,000 Rp 40,000
Hb.Anis Aeris 15 Rp 157,080 Rp 157,080
11 ###
M.Umar R/139P Rp 60,000 Konsul Rp 15,000 Rp 75,000
Omeprazole 20 Rp 8,080
12 ### Fitria Al Hadad Rp 57,080
Stimuno Cap 2 Rp 49,000
Kutoin 60 Rp 81,420
13 ### Fatimah Vit B6 60 Rp 12,060 Rp 152,880
Bamgetol 30 Rp 59,400
Bagus S R/179P Rp 19,000 Konsul Rp 15,000 Rp 34,000
14 ###
Shidiq R/181P Rp 40,000 Konsul Rp 15,000 Rp 55,000
Methil 4 10 Rp 4,360
15 ### Tn.Jamal Retapyl 10 Rp 24,670 Rp 154,030
Berotec 1 Rp 125,000
16 ### Tn.Jayadi Hepatin 10 Rp 51,730 Rp 51,730
Total Apotek Rp 1,502,040 Total Klinik Rp 130,000 Rp 1,631,040
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK KLINIK
No TANGGAL NAMA TOTAL BIAYA
NOMOR RESEP NAMA OBAT Σ NOMINAL Jenis Tindakan Nominal
1 ### M.Taron Gunawan As.Mef 10 Rp 2,000 Rawat Luka Rp 25,000 Rp 27,000
Konsul Rp 15,000
2 ### Richu R/011P Rp 20,000 Rp 60,000
Injek Rp 25,000
3 ### Syarifah Fadlun Confident XL 1 Rp 40,000 Rp 40,000
SKS Rp 20,000
Richu Rp 24,000 Rp 59,000
4 ### Konsul Rp 15,000
Fatimah Bamgetol 30 Rp 59,400 Rp 59,400
Syarifah Fadlun Confident XL 1 Rp 40,000 Rp 40,000
Asetil 10 Rp 10,890
5 ### Tn.Jamal Retapil 10 Rp 24,670 Rp 160,560
Birotec 1 Rp 125,000
An.Karimah R/068P Rp 6,000 Rp 6,000
6 ### Ali At Thamimi Concor 2 10 Rp 60,510 Rp 60,510
7 ### Tn.Jayadi Hepatin 10 Rp 51,730 Rp 51,730
8 ### Syarifah Fadlun Confident XL 1 Rp 40,000 Rp 40,000
9 ### An.Kamila R/151P Rp 81,000 Rp 15,000 Rp 96,000
Methil 4 10 Rp 4,360
Tn.Jamal Berotec 1 Rp 125,000 Rp 154,030
10 ###
Retapil 10 Rp 24,670
An.Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
Omeprazole 10 Rp 4,040
Fitria Al Hadad Panadol Biru 1 Rp 7,880 Rp 36,420
Stimuno 1 Rp 24,500
11 ### KSR 6 Rp 19,830
Tn.Umar Candesartan 10 Rp 33,000 Rp 105,830
Glauseta 10 Rp 53,000
Ustdz Luluk Lasik 40 10 Rp 54,600 Rp 54,600
Total Apotek Rp 1,107,080 Total Klinik Rp 115,000 Rp 1,222,080
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK KLINIK
No TANGGAL NAMA TOTAL BIAYA
NOMOR RESEPNAMA OBAT Σ NOMINAL Jenis Tindakan Nominal
T.Komposit Rp 120,000
Rozi R/015P Rp 7,000 Rp 177,000
1 ### Devitalasi Rp 50,000
An.Ainun R/016P Rp 85,000 Konsul Rp 15,000 Rp 100,000
2 ### Syarifah Fadlun Confident L 1 Rp 42,000 Rp 42,000
Ali At Thamimi Concor 2 20 Rp 121,020 Rp 121,020
Berotec 1 Rp 125,000
Tn.Jamal Retapil 10 Rp 23,570 Rp 159,460
Asetil 10 Rp 10,890
3 ### Tn.Fuad R/036P Rp 258,390 Rp 258,390
Home Visite Rp 35,000
Ibu Darsih Rp 60,000
Rawat Luka Rp 25,000
Konsul Rp 15,000
Tn.Maruki R/053P Rp 17,000 Rp 52,000
Cek GDA (2) Rp 20,000
Sakinah Al Habsy Metformin 50 Rp 10,000 Rp 10,000
4 ###
Tn.Basori R/062P Rp 52,000 Konsul Rp 15,000 Rp 67,000
Konsul Rp 15,000
5 ### Devi R/071P Rp 44,000 Rp 79,000
Surat Rp 20,000
Konsul Rp 15,000
Hb.Abdullah R/157M Rp 43,000 Cek Chol Rp 25,000 Rp 113,000
Nebulizer Rp 30,000
6 ###
Hb.Anis Aerius 15 Rp 140,025 Rp 140,025
Home Visite Rp 35,000
Darsih Rp 60,000
Rawat Luka Rp 25,000
Fina R/106P Rp 56,000 Konsul Rp 15,000 Rp 71,000
7 ### Tn.Arifin R/093P Rp 16,000 Konsul Rp 15,000 Rp 31,000
Hb.Anis R/159M Rp 124,000 Konsul Rp 15,000 Rp 139,000
8 ### Syarifah Fadlun Confident XL 1 Rp 40,000 Rp 40,000
Konsul Rp 15,000
9 ### Tn.Maruki R/135P Rp 19,000 Cek GDA Rp 10,000 Rp 54,000
9 ### Tn.Maruki R/135P Rp 19,000 Rp 54,000
Cek AU Rp 10,000
Konsul Rp 15,000
9 ### Mayani R/085B Rp 16,000 Rp 56,000
Cek Chol Rp 25,000
Kutoin 60 Rp 81,420
10 ### Fatimah Liconam 60 Rp 3,000 Rp 203,220
Bamgetol 60 Rp 118,800
Rozi Devitalasi Rp 20,000 Rp 20,000
11 ###
Admuji R/164M Rp 53,000 Rp 53,000
Total Apotek Rp 1,506,115 Total Klinik Rp 600,000 Rp 2,106,115

Klinik Apotek
No.REK BCA 0891264193 0891111125
A/n Hasan Alwi Z. Hadi
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK
No TANGGAL NAMA
NOMOR RESEPNAMA OBAT Σ NOMINAL
1 ### Richu R/175P Rp 17,000
2 ### Syarifah Fadlun Confident XL 1 Rp 40,000

3 ### Kholiq R/017P Rp 7,000

4 ### An.Rizqi R/043P Rp 21,000

Syarifah Fadlun Confident XL 1 Rp 40,000
An.Bambang Depaken Syr 1 Rp 171,000
5 ###
Rochim R/059P Rp 46,000
Mb.Nisa' R/010B Rp 77,000

Tn.Maruki R/065P Rp 36,000

Decolgen 8 Rp 3,504
6 ### Fitria Al Hadad Lansoprazol 20 Rp 23,780
Amox 10 Rp 3,500
An.Kamila R/068P Rp 21,000

Khitan + Uang Saku

Syarifah Fadlun Confident 1 Rp 40,000

Ali At Thamimi Concor 10 Rp 60,510
7 ### Suyuti U/ Tukang Sinom 3 Rp 15,000

Darsih R/124P Rp 7,000

8 ### Bagus R/140P Rp 80,000

Total Apotek Rp 709,294

No.REK BCA
A/n
AL MA'UNAH
KLINIK
TOTAL BIAYA
Jenis Tindakan Nominal
Konsul Rp 15,000 Rp 32,000
Rp 40,000
Konsul Rp 15,000
Rp 97,000
Cross Rp 75,000
Konsul Rp 15,000 Rp 36,000
Rp 40,000
Rp 171,000
Konsul Rp 15,000 Rp 61,000
Konsul Rp 15,000 Rp 92,000
Konsul Rp 15,000
Cek GDA Rp 10,000 Rp 86,000
Cek Chol Rp 25,000

Rp 30,784

Konsul Rp 15,000 Rp 36,000

Sirkumsisi Rp 200,000
Rp 400,000
Uang Saku Rp 200,000
Rp 40,000
Rp 60,510
Rp 15,000
Konsul Rp 15,000
Rp 47,000
Rawat Luka Rp 25,000
Konsul Rp 15,000 Rp 95,000
Total Klinik Rp 670,000 Rp 1,379,294

Klinik Apotek
0891264193 0891111125
Hasan Alwi Z. Hadi
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK KLINIK
No TANGGAL NAMA TOTAL BIAYA
NOMOR RESEP NAMA OBAT Σ NOMINAL Jenis Tindakan Nominal
Maulidia R/168P Rp 10,180 Rp 10,180
1 ### Hb.Anis Bangilan R/173M Rp 463,256 Konsul Rp 15,000 Rp 478,256
Ali At Thamimi Concor 1 Rp 60,510 Rp 60,510
2 ### Syarifah Fadlun Confident 1 Rp 40,000 Rp 40,000
Konsul Rp 15,000
Safina R/006P Rp 49,090 Rp 84,090
Surat Rp 20,000
3 ###
Bu Diana R/007P Rp 6,090 Konsul Rp 15,000 Rp 21,090
Dafri R/176M Rp 116,919 Konsul Rp 15,000 Rp 131,919
4 ### Tn.Fuad R/009P Rp 265,650 Rp 265,650
An.Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
Ultra BD 5 Rp 15,000
5 ###
Ust. Said NovoMix 3 Rp 450,000 Rp 477,360
Amlodipin 5mg 30 Rp 12,360
6 ### Syarifah Fadlun Confident 1 Rp 40,000 Rp 40,000
Omeprazole 10 Rp 4,040
7 ### Fitria Al Hadad Panadol Biru 2 Rp 16,200 Rp 69,240
Stimuno 2 Rp 49,000
Kutoin 60 Rp 81,420
Fatimah Vit B6 60 Rp 12,000 Rp 212,220
8 ###
Bamgetol 60 Rp 118,800
An.Karimah R/086P Rp 12,764 Rp 12,764
Laili At Thamimi R/087P Rp 41,040 Rp 41,040
9 ### Konsul Rp 15,000
Zahra (Kak Ipah) R/109P Rp 19,070 Rp 59,070
Injeksi Rp 25,000
Total Apotek Rp 2,054,389 Total Klinik Rp 120,000 Rp 2,174,389

Klinik Apotek
No.REK BCA 0891264193 0891111125
A/n Hasan Alwi Z. Hadi
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK KLINIK
No TANGGAL NAMA TOTAL BIAYA
NOMOR RESEP NAMA OBAT Σ NOMINAL Jenis Tindakan Nominal
Konsul Rp 15,000
Bu Diana R/119P Rp 16,190 Rp 51,190
1 ### Surat Rp 20,000
Bagus S R/122P 1 Rp 23,690 Konsul Rp 15,000 Rp 38,690
2 ### Syarifah Fadlun Confident 1 Rp 40,000 Rp 40,000
3 ### Khitan + Uang Saku Sirkumsisi Rp 200,000 Rp 200,000
4 ### An.Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
5 ### Kak Mira R/198P Rp 50,916 Konsul Rp 15,000 Rp 65,916
Ali At Thamimi Concor 10 Rp 60,510 Rp 60,510
Syarifah Fadlun Confident 1 Rp 40,000 Rp 40,000
6 ### An.Rizqi R/022P Rp 28,650 Konsul Rp 15,000 Rp 43,650
Mb.Nisa R/023P Rp 12,700 Konsul Rp 15,000 Rp 27,700
Mb.Fina R/024 Rp 29,660 Konsul Rp 15,000 Rp 44,660
7 ### Khitan + Uang Saku Rp 200,000 Rp 200,000
8 ### Khitan + Uang Saku Rp 200,000 Rp 200,000
9 ### Khitan + Uang Saku Rp 200,000 Rp 200,000
Konsul Rp 15,000
Hb.Abdullah R/036P Rp 25,350 Cek AU Rp 10,000 Rp 75,350
10 ###
Cek Chol Rp 25,000
Maria Ulfa R/044P Rp 41,300 Cabut Gigi Rp 100,000 Rp 141,300
Fitria Al Hadad R/037B Rp 10,620 Rp 10,620
Tn.Fuad R/057P Rp 267,180 Rp 267,180
11 ### Ali At Thamimi R/059P Rp 78,095 Rp 78,095
Omeprazole 10 Rp 4,040
Fitria Al Hadad Rp 29,240
Stimuno 1 Rp 25,200
Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
An.Ainun R/070P Rp 17,950 Konsul Rp 15,000 Rp 32,950
Mb.Nisa R/072P Rp 28,270 Konsul Rp 15,000 Rp 43,270
12 ###
Mostafa R/079P Rp 14,330 Konsul Rp 15,000 Rp 29,330
Khitan + Uang Saku Rp 200,000 Rp 200,000
Khitan + Uang Saku Rp 200,000 Rp 200,000
Konsul Rp 15,000
13 ### Aditya Kukuh R/081P Rp 49,730 Rp 84,730
Surat Rp 20,000
14 ### An.Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
15 ### Ny.Indah R/110P Rp 39,652 Homevisite Rp 50,000 Rp 89,652
Allopurinol 10 Rp 3,960
Muhammad Habsy Meloxicam 10 Rp 5,330 Rp 21,510
Neurosanbe 10 Rp 12,220
16 ###
Konsul Rp 15,000
Tn.Maruki R/117P Rp 16,000 GDA Rp 10,000 Rp 51,000
AU Rp 10,000
17 ### Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
Abd. Rouf R/146P Rp 77,484 Konsul Rp 15,000 Rp 92,484
18 ###
Mb.Nisa R/147P Rp 24,234 Konsul Rp 15,000 Rp 39,234
19 ### Miranda R/160P Rp 41,496 Konsul Rp 15,000 Rp 56,496
Hb.Anis Aerius 15 Rp 140,025 Rp 140,025
20 ###
Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
Total Apotek Rp 1,692,782 Total Klinik Rp 1,670,000 Rp 3,362,782

Klinik Apotek
No.REK BCA 0891264193 0891111125
A/n Hasan Alwi Z. Hadi
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK KLINIK
No TANGGAL NAMA TOTAL BIAYA
NOMOR RESEPNAMA OBAT Σ NOMINAL Jenis Tindakan Nominal
Ali At Thamimi Concor Rp 60,510 Rp 60,510
Kutoin 60 Rp 81,420
1 ###
Fatimah Vit B6 60 Rp 12,000 Rp 212,220
Bamgetol 60 Rp 118,800
2 ### An.Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
AU Rp 10,000
3 ### Mayani R/028P Rp 8,350 Rp 33,350
Konsul Rp 15,000
Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
4 ###
Mayani Thyrozol 10 Rp 13,130 Rp 13,130
Ali At Thamimi Concor 10 Rp 60,510 Rp 60,510
5 ### Tn.Fuad R/094P Rp 267,180 Rp 267,180
Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
Dafri R/114P Rp 20,160 Konsul Rp 15,000 Rp 35,160
Konsul Rp 15,000
6 ### Cek AU Rp 10,000
Hb.Abdullah R/111P Rp 33,910 Rp 93,910
Cek Chol Rp 25,000
Cek GDA Rp 10,000
Nuriyah (An.Budin) Cabut Gigi Rp 50,000 Rp 50,000
Hb.Anis R/018M Rp 265,465 Konsul Rp 15,000 Rp 280,465
Konsul Rp 15,000
7 ###
Cek Chol Rp 25,000
Tn.Maruki R/126P Rp 36,260 Rp 136,260
Cek GDA Rp 10,000
Injeksi Rp 50,000
Seretic Rp 186,900
8 ### Hb.Anis Rp 245,200
Iliadin Spray Rp 58,300
9 ### Syarifah Fadlun Confident Rp 42,000 Rp 42,000
Taslim R/165P Rp 10,750 Konsul Rp 15,000 Rp 25,750

10 ###
 Dafri R/024M Rp 89,078 Konsul Rp 15,000 Rp 104,078
10 ###
Aini R/167P Rp 65,140 Konsul Rp 15,000 Rp 80,140
Mayani Konsul Rp 15,000 Rp 15,000
Konsul Rp 15,000
Zahra Kak Ipah R/176P Rp 69,500 GDA Rp 10,000 Rp 119,500
11 ###
Chol Rp 25,000
An.Karimah R/173P Rp 71,014 Rp 71,014
12 ### Suyuti Pocari 2 Rp 11,000 Rp 11,000
13 ### Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
14 ### Mayani R/003P Rp 11,800 Medikasi Rp 50,000 Rp 61,800
An.Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
Safiq Muslim R/019P Rp 29,250 Konsul Rp 15,000 Rp 44,250
###
Sanilal Fahri R/018P Rp 28,650 Konsul Rp 15,000 Rp 43,650
15
An.Kamila R/021P Rp 32,150 Konsul Rp 15,000 Rp 47,150
### Laili At Thamimi R/035P Rp 31,460 Konsul Rp 15,000 Rp 46,460
### Syarifah Fadlun Rp 42,000 Rp 42,000
16 ### Khitan Gratis Rp 800,000 Rp 800,000
17 ### Khitan Gratis Rp 200,000 Rp 200,000
Total Apotek Rp 2,224,687 Total Klinik Rp 1,485,000 Rp 3,709,687

Klinik Apotek
No.REK BCA 0891264193 0891111125
A/n Hasan Alwi Z. Hadi
 TAGIHAN BIAYA KESEHATAN AL MA'UN
APOTEK
No TANGGAL NAMA
NOMOR RESEPNAMA OBAT Σ
R/047P
1 ### M. Munir Cek AU
Cek Chol
Bamgetol 60
2 ### Fatimah Vit B6 60
Kutoin 60
Syarifah Fadlun Confident 1
3 ###
Tn.Fuad R/067P
Mayani Thyrozol 10
4 ### Ali At Thamimi Concor 10
An.Bambang Depaken Syr 1
Khitan Gratis
5 ###
Khitan Gratis
6 ### Mayani Thyrozol 30
Total Apotek
EHATAN AL MA'UNAH
OTEK KLINIK
TOTAL BIAYA
NOMINAL Jenis Tindakan Nominal
Rp 264,265 Rp 264,265
Rp 10,000
Rp 35,000
Rp 25,000
Rp 118,800
Rp 12,000 Rp 212,220
Rp 81,420
Rp 42,000 Rp 42,000
Rp 267,180 Rp 267,180
Rp 13,130 Rp 13,130
Rp 60,510 Rp 60,510
Rp 171,000 Rp 171,000
Rp 200,000 Rp 200,000
Rp 200,000 Rp 200,000
Rp 39,390 Rp 39,390
Rp 1,104,695 Total Klinik Rp 400,000 Rp 1,504,695

Klinik Apotek
No.REK BCA 0891264193 0891111125
A/n Hasan Alwi Z. Hadi
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK KLINIK
No TANGGAL NAMA TOTAL BIAYA
NOMOR RESEPNAMA OBAT Σ NOMINAL Jenis Tindakan Nominal
Hb. Anis Aerius 15 Rp 146,475 Rp 146,475
1 ### An.Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
Ali At Thamimi Concor 10 Rp 60,510 Rp 60,510
Ali At Thamimi Concor 10 Rp 60,510 Rp 60,510
Konsul Rp 15,000
2 ### Hb. Abdullah R/185P Rp 45,410 Nebul Rp 30,000 Rp 100,410
GDA Rp 10,000
F. Rochim R/186P Rp 39,120 Konsul Rp 15,000 Rp 54,120
Tn.Fuad R/197P Rp 267,180 Rp 267,180
Rp 36,600 Konsul Rp 15,000
3 ###
Tn.Maruki R/199P GDA Rp 10,000 Rp 96,600
Cholestrol Rp 25,000
AU Rp 10,000
Total Apotek Rp 851,805 Total Klinik Rp 105,000 Rp 956,805

Apotek Klinik
No.REK BCA 0891111125 0891334515
A/n Hadi Hasan Alwi Z.
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK KLINIK
No TANGGAL NAMA TOTAL BIAYA
NOMOR RESEPNAMA OBAT Σ NOMINAL Jenis Tindakan Nominal
Konsul Rp 15,000
1 ### Dafri Rp 50,000
Ambil Serumen Rp 35,000
2 ### Ali At Thamimi Concor 10 Rp 60,510 Rp 60,510
Dafri R/026P Rp 13,200 Konsul Rp 15,000 Rp 28,200
Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
3 ### Kutoin 60 Rp 81,420
Fatimah Vit B6 60 Rp 12,000 Rp 212,220
Bamgetol 60 Rp 118,800
Konsul Rp 15,000
4 ### Bahanan (Panitia) R/053P Rp 14,000 Rp 54,000
Rawat Luka Rp 25,000
Dafri R/058P Rp 35,760 Konsul Rp 15,000 Rp 50,760
5 ### Aditya (Bu Din) R/066P Rp 66,308 Konsul Rp 15,000 Rp 81,308
Richu R R/071P Rp 65,778 Konsul Rp 15,000 Rp 80,778
R/076P Rp 3,360 Rp 3,360
6 ### Mayani
R/079P Rp 10,600 Konsul Rp 15,000 Rp 25,600
Omeprazole 20 Rp 8,080
Fitria Al Hadad Rp 58,480
Stimuno 2 Rp 50,400
Mayani Thyrozol 20 Rp 26,260 Rp 26,260
Konsul Rp 15,000
7 ### Admuji R/104P Rp 7,200 Rawat Luka Rp 25,000 Rp 67,200
Surat Rp 20,000
Khitan Gratis Sirkumsisi Rp 200,000
Khitan Gratis Sirkumsisi Rp 200,000 Rp 600,000
Khitan Gratis Sirkumsisi Rp 200,000
An. Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
8 ###
Suyadi R/112P Rp 48,100 Konsul Rp 15,000 Rp 63,100
Maruki R/108P Rp 39,250 Konsul Rp 15,000 Rp 54,250
Richu R Medikasi Rp 50,000 Rp 50,000
9 ### C Nisya Medikasi Rp 50,000 Rp 50,000
9 ###
Maria U Tumpac Rp 100,000 Rp 100,000
10 ### Maria U R/144P Rp 23,576 Konsul Rp 15,000 Rp 38,576
11 ### Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
Konsul Rp 15,000
Mustofa R/048P Rp 17,980 Rp 107,980
12 ### Rawat Luka Rp 75,000
Ali At Thamimi Concor 1 Rp 60,510 Rp 60,510
13 ### Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
14 ### An. Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
Konsul Rp 20,000
Mayani R/152P Rp 32,300 Cek Chol Rp 25,000 Rp 87,300
Cek GDA Rp 10,000
Konsul Rp 20,000
13 ###
Hb.Abdullah R/154P Rp 90,060 Cek Chol Rp 25,000 Rp 145,060
Cek GDA Rp 10,000
Konsul Rp 20,000
Mustofa R/155P Rp 26,680 Rp 96,680
Rawat Luka Rp 50,000
14 ### C Nisya R/181P Rp 44,758 Konsul Rp 20,000 Rp 64,758
Konsul Rp 20,000
15 ### Tn. Maruki R/011P Rp 97,200 Rp 127,200
Cek GDA Rp 10,000
16 ### Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
Total Apotek Rp 1,606,090 Total Klinik Rp 1,390,000 Rp 2,996,090

Apotek Klinik
No.REK BCA 0891111125 0891334515
A/n Hadi Hasan Alwi Z.
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK KLINIK
No TANGGAL NAMA TOTAL BIAYA
NOMOR RESEPNAMA OBAT Σ NOMINAL Jenis Tindakan Nominal
1 ### Tn. Fuad R/061P Rp 267,180 Rp 267,180
Ali At Thamimi Concor 10 Rp 60,510 Rp 60,510
2 ###
Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
An. Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
3 ###
F Rokhim R/021P Rp 49,790 Konsul Rp 20,000 Rp 69,790
Konsul Rp 20,000
4 ### C Nisya R/055M Rp 69,445 Rp 109,445
Surat Rp 20,000
Konsul Rp 20,000
5 ### Mustofa R/072P Rp 10,300 Rp 190,300
Rawat Luka Rp 160,000
Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
6 ### Ali At Thamimi Concor 9 Rp 54,459 Rp 54,459
C Nisya R/112P Rp 30,360 Konsul Rp 20,000 Rp 50,360
Konsul Rp 20,000
7 ### Mustofa R/117P Rp 393,660 NDK Rp 75,000 Rp 568,660
RLB Rp 80,000
Richu R R/173P Rp 43,268 Konsul Rp 20,000 Rp 63,268
Konsul Rp 20,000
8 ### Tn.Damar R/165P Rp 20,380 Nebul Rp 41,000 Rp 99,380
Injeksi Rp 18,000
Hb. Anis Aerius 10 Rp 97,650 Rp 97,650
An. Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
9 ###
Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
Teh Pucuk 6 Rp 18,000
11 ### Suyuti Rp 28,000
Sinom 2 Rp 10,000
12 ### Sarimuna Confident 1 Rp 42,000 Rp 42,000
13 ### Hb. Abdullah R/070P Rp 93,060 Konsul Rp 20,000 Rp 113,060
Mayani Thyrozol 30 Rp 39,390 Rp 39,390
14 ### Aerius 15 Rp 146,475
Hb.Anis Rp 276,475
Iliadin Spray 2 Rp 130,000
Sarimuna Confident M 2 Rp 84,000 Rp 84,000
Ardium 23 Rp 193,821
15 ###
Hb.Anis Asam Tranex 14 Rp 25,914 Rp 429,135
Ultraproct 12 Rp 209,400
Hb.Anis Ultraproct 1bx Rp 104,700 Rp 104,700
16 ###
Ali At Thamimi Concor 15 Rp 90,765 Rp 90,765
Kutoin 60 Rp 80,420
Fatimah Vit B6 60 Rp 13,000 Rp 212,220
17 ###
Bamgetol 60 Rp 118,800
An. Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
18 ### Hb.Anis Berotec 1 Rp 125,000 Rp 125,000
19 ### Tn.Fuad R/162P Rp 267,180 Rp 267,180
Total Apotek Rp 3,527,927 Total Klinik Rp 554,000 Rp 4,081,927

Apotek Klinik
No.REK BCA 0891111125 0891334515
A/n Hadi Hasan Alwi Z.
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK KLINIK
No TANGGAL NAMA TOTAL BIAYA
NOMOR RESEPNAMA OBAT Σ NOMINAL Jenis Tindakan Nominal
Miranda R/151B Rp 102,146 Konsul Rp 20,000 Rp 122,146
1 ###
Tn. Dafri R/049P Rp 50,496 Konsul Rp 20,000 Rp 70,496
Konsul Rp 20,000
2 ### Tn. Maruki R/107P Rp 89,940 Rp 134,940
Cek Chol Rp 25,000
3 ### Bu Diana R/163P Rp 51,336 Konsul Rp 20,000 Rp 71,336
Ali At Thamimi Concor 5 Rp 30,255 Rp 30,255
4 ###
F Rokhim R/193P Rp 27,780 Konsul Rp 20,000 Rp 47,780
Konsul Rp 20,000
Mayani Rp 17,770 Cek AU Rp 10,000 Rp 72,770
5 ###
Cek Chol Rp 25,000
Mama Ena Cek Chol 1 Rp 25,000 Rp 25,000
6 ### Miranda R/017P Rp 28,140 Konsul Rp 20,000 Rp 48,140
Tn. Sa'i R/ Rp 83,100 Rp 83,100
7 ### Konsul Rp 20,000
Maria Ulfa R/044P Rp 34,652 Rp 79,652
Cek Chol Rp 25,000
C Nisya Medikasi Rp 50,000 Rp 50,000
8 ###
Tn.Maruki R/067P Rp 91,620 Konsul Rp 20,000 Rp 111,620
An. Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
9 ###
Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
Ali At Thamimi Concor 10 Rp 60,510 Rp 60,510
10 ### Tn. Fuad R/114P Rp 267,180 Rp 267,180
Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
11 ### C Nisya Medikasi Rp 50,000 Rp 50,000
12 ### Mayani R/143P Rp 26,244 Konsul Rp 20,000 Rp 46,244
13 ### Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
Tn.Dafri R/026P Rp 17,250 Konsul Rp 20,000 Rp 37,250
Konsul Rp 20,000
14 ###
Tn. Maruki R/027P Rp 33,150 Cek GDA Rp 10,000 Rp 88,150
Cek Chol Rp 25,000
Konsul Rp 20,000
15 ### Ustad Asrori R/048P Rp 21,005 Rp 51,005
Cek GDA Rp 10,000
Ali At Thamimi Concor 10 Rp 60,510 Rp 60,510
Omeprazole 20 Rp 8,080
16 ###
Fitria Al Hadad Panadol Biru 10 Rp 8,100 Rp 66,580
Stimuno 2 Rp 50,400
17 ### Mayani Thyrozol 10 Rp 13,130 Rp 13,130
18 ### Tn. Fuad R/ Rp 267,850 Rp 267,850
19 ### Tn.Dafri R/096P Rp 25,460 Konsul Rp 20,000 Rp 45,460
Aerius 10 Rp 97,650
Hb.Anis Rp 284,550
20 ### Seretic 1 Rp 186,900
20 ###
Hb.Anis R/073M Rp 128,950 Konsul Rp 20,000 Rp 148,950
Al Maunah Tissu 1 Rp 16,500 Rp 16,500
21 ### Konsul Rp 20,000
Bu Sutiah R/138P Rp 18,228 Rp 68,228
Rawat Luka Rp 30,000
Syarifah Fadlun Confident Rp 42,000 Rp 42,000
22 ###
Tn. Dafri R/166P Rp 8,980 Konsul Rp 20,000 Rp 28,980
Konsul Rp 20,000 Rp 3,276,012
Mayani R/177P Rp 19,320 Injeksi Rp 21,000 Rp 105,320 Rp 6,486,549
23 ###
Cek Lengkap Rp 45,000 Rp 1,324,890
Bu Sutiah R/179P Rp 1,820 Konsul Rp 20,000 Rp 21,820 Rp 729,883
Kutoin 60 Rp 81,420 Rp 11,817,334
Fatimah Vit b6 60 Rp 118,800 Rp 212,220
24 ###
Bamgetol 60 Rp 12,000
Bu Sutiah R/011P Rp 3,080 Konsul Rp 20,000 Rp 23,080
25 ### Mayani Thyrozol 20 Rp 26,260 Rp 26,260
Total Apotek Rp 2,550,012 Total Klinik Rp 726,000 Rp 3,276,012

Apotek Klinik
No.REK BCA 0891111125 0891334515
A/n Hadi Hasan Alwi Z.
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK KLINIK
No TANGGAL NAMA TOTAL BIAYA
NOMOR RESEPNAMA OBAT Σ NOMINAL Jenis Tindakan Nominal
1 ### Yudi R/097P Rp 51,496 Konsul Rp 20,000 Rp 71,496
Tn. Dafri R/194P Rp 37,650 Konsul Rp 20,000 Rp 57,650
2 ###
Tn. Pipin (supir) R/195P Rp 17,350 Konsul Rp 20,000 Rp 37,350
An. Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
2 ###
Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
3 ### Tn.Dafri R/058P Rp 122,800 Konsul Rp 20,000 Rp 142,800
Maria Ulfa R101P Rp 42,156 Konsul Rp 20,000 Rp 62,156
4 ###
Reni R/102P Rp 10,000 Konsul Rp 20,000 Rp 30,000
5 ### Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
Ali At Thamimi Concor 10 Rp 60,510 Rp 60,510
Konsul Rp 20,000
6 ###
Hb. Abdullah R/082M Rp 48,920 Cek Lengkap Rp 45,000 Rp 155,920
Nebul Rp 42,000
Konsul Rp 20,000
Tn.Dafri R/157P Rp 10,232 Rp 72,232
Nebul Rp 42,000
7 ###
Cek Chol Rp 25,000
Mayani R/158P Rp 5,670 Rp 50,670
Konsul Rp 20,000
An. Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
Konsul Rp 20,000
8 ###
Konsul Ortho Rp 35,000
Ujik Siswanto Rp 185,000
RLS Rp 55,000
Nekrotomi K Rp 75,000
Konsul Rp 20,000
Tn. Maruki R/013P Rp 36,300 Rp 66,300
9 ### Cek GDA Rp 10,000
Ujik Siswanto R/025P Rp 43,400 Konsul Rp 20,000 Rp 63,400
Suyuti Matcha Milk 2 Rp 16,000 Rp 16,000
10 ### RLS Rp 55,000
Ujik Siswanto Rp 75,000
Konsul Rp 20,000
11 ### Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
Mayani Thyrozol 20 Rp 26,260 Rp 26,260
Ali At Thamimi Concor 10 Rp 60,510 Rp 60,510
12 ### Omeprazole 20 Rp 8,080
Fitria Al Hadad Panadol Biru 10 Rp 8,100 Rp 66,580
Stimuno 2 Rp 50,400
13 ### Mayani R/103P Rp 15,000 Konsul Rp 20,000 Rp 35,000
14 ### Tn. Damar Berotec 1 Rp 125,000 Rp 125,000
15 ### Fauzia R/088M Rp 61,520 Konsul Rp 20,000 Rp 81,520
Konsul Rp 20,000
16 ### Ujik Siswanto R/159P Rp 35,370 Rawat Luka Rp 55,000 Rp 120,370
Cek GDA Rp 10,000
Bu Suriyati R/170P Rp 84,250 Konsul Rp 20,000 Rp 104,250
17 ###
An. Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
18 ### M.Ishaq Sanoskin 1 Rp 365,000 Rp 365,000
19 ### Mayani Konsul Rp 20,000 Rp 20,000
Ali At Thamimi Concor 1 Rp 60,510 Rp 60,510
20 ###
Mayani R/080P Rp 9,320 Konsul Rp 20,000 Rp 29,320
Total Apotek Rp 2,092,804 Total Klinik Rp 829,000 Rp 2,921,804

Apotek Klinik
No.REK BCA 0891111125 0891334515
A/n Hadi Hasan Alwi Z.
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK KLINIK
No TANGGAL NAMA TOTAL BIAYA
NOMOR RESEPNAMA OBAT Σ NOMINAL Jenis Tindakan Nominal
Tn.Fuad R/088P Rp 534,200 Rp 534,200
1 ###
Syarifah Fadlun Confident Rp 42,000 Rp 42,000
Konsul Rp 20,000
Cek Chol Rp 25,000
2 ### Tn.Maruki R/118P Rp 47,225 Rp 112,225
Cek GDA Rp 10,000
Cek AU Rp 10,000
An. Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
Mayani Thyrozol 20 Rp 26,260 Rp 26,260
3 ### Nuriyah (an. Budin) R/136P Rp 74,810 Konsul Rp 20,000 Rp 94,810
Konsul Rp 20,000
Tn.Damar Jalal R/140P Rp 28,725 Rp 90,725
Nebul Rp 42,000
Homevisit Rp 50,000
4 ### Ust.Husni R/080B Rp 74,625 Rp 141,625
Injeksi Rp 17,000
5 ### Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
6 ### Ali At Thamimi Concor 10 Rp 60,510 Rp 60,510
7 ### Mayani R/064P Rp 6,920 Konsul Rp 20,000 Rp 26,920
Mayani R/069P Rp 55,200 Konsul Rp 20,000 Rp 75,200
8 ###
Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
9 ### Mayani R/079P Rp 18,350 Konsul Rp 20,000 Rp 38,350
10 ### Fatkhur Rokhim R/103P Rp 75,392 Konsul Rp 20,000 Rp 95,392
Omeprazole 20 Rp 8,080
11 ### Fitria Al Hadad Panadol Biru 10 Rp 8,100 Rp 66,580
Stimuno 2 Rp 50,400
Konsul Rp 20,000
12 ### Tn.Damar Jalal R/119P Rp 12,340 Rp 74,340
Nebul Rp 42,000
13 ### Mayani R/139P Rp 16,850 Konsul Rp 20,000 Rp 36,850
Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
Konsul Rp 20,000
Abd Rouf R/147P Rp 81,304 Rp 146,304
14 ### Cek Lengkap Rp 45,000
Cipro 10 Rp 4,000
Acc Ust.Husni Rp 108,700
Ultraproct N 1 Rp 104,700
15 ### Mayani Thyrozol 20 Rp 26,260 Rp 26,260
16 ### An. Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
Konsul Rp 20,000
17 ### Supiyah R/181P Rp 37,950 RLS Rp 55,000 Rp 122,950
Cek GDA Rp 10,000
Konsul Rp 20,000
Tn. Maruki R/182P Rp 67,440 Rp 97,440
Cek GDA Rp 10,000
18 ### Nadia R/183P Rp 14,365 Konsul Rp 20,000 Rp 34,365
Konsul Rp 20,000
Tn. Damar R/193P Rp 13,440 Rp 75,440
Nebul Rp 42,000
19 ### Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
20 ### Tn.Damar Jalal Berotec Spray 1 Rp 125,000 Rp 125,000
Total Apotek Rp 2,124,446 Total Klinik Rp 638,000 Rp 2,762,446

Apotek Klinik
No.REK BCA 0891111125 0891334515
A/n Hadi Hasan Alwi Z.
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK KLINIK
No TANGGAL NAMA TOTAL BIAYA
NOMOR RESEP NAMA OBAT Σ NOMINAL Jenis Tindakan Nominal
Mayani R/019P Rp 7,910 Konsul Rp 20,000 Rp 27,910
Mayani R/021P Rp 34,000 Tumpac Rp 50,000 Rp 84,000
1 ### Kutoin 60 Rp 81,420
Fatimah Bamgetol 60 Rp 12,000 Rp 212,220
Vit B6 60 Rp 118,800
2 ### An. Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
Mayani Thyrozol 20 Rp 24,300 Rp 24,300
Simvas 20 10 Rp 4,300
3 ###
Hb.Muhammad Cipro 10 Rp 3,660 Rp 11,300
Allo 300 10 Rp 3,340
4 ### Hb.Abdullah R/040P Rp 6,860 Konsul Rp 20,000 Rp 26,860
Madu Extragra 625 1 Rp 90,000
5 ### Acc. Suyuti Rp 120,000
Jinten Bubuk 1 Rp 30,000
6 ### Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
Dafri R/069P Rp 10,600 Konsul Rp 20,000 Rp 30,600
Mujayanah R/075P Rp 8,100 Konsul Rp 20,000 Rp 28,100
7 ###
Konsul Rp 20,000
Tn. Damar R/076P Rp 7,760 Rp 69,760
Nebul Rp 42,000
8 ### C Nisa R/127B Rp 10,870 Konsul Rp 20,000 Rp 30,870
Suyuti Coolant 2 Rp 10,800 Rp 10,800
Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
9 ### An. Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
Konsul Rp 20,000
Supiyah R/50P Rp 37,430 Rp 67,430
Cek GDA Rp 10,000
Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
10 ###
Ali At Thamimi Concor 10 Rp 60,500 Rp 60,500
11 ### Tn. A Fauzi R/007M Rp 240,400 Rp 240,400
Konsul Rp 20,000
12 ### Mayani R/190P Rp 5,100 Rp 50,100
Cek Chol Rp 25,000
An. Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
13 ###
Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
Acc. Suyuti Aspilet 10 Rp 6,300 Rp 6,300
14 ###
M. Safrijal R/ Rp 18,800 Konsul Rp 20,000 Rp 38,800
Konsul Rp 20,000
Azizah Salum R/005P Rp 18,000 Heacting Rp 70,000 Rp 118,000
15 ###
Cek GDA Rp 10,000
Ahmad Fauzi R/ Rp 4,000 Konsul Rp 20,000 Rp 24,000
Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
16 ### Lanso 20 Rp 24,000
Fitria Al Hadad Rp 40,000
Panadol Biru 20 Rp 16,000
Total Apotek Rp 1,618,250 Total Klinik Rp 427,000 Rp 2,045,250
 Apotek Klinik
No.REK BCA 0891111125 0891334515
A/n Hadi Hasan Alwi Z.
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK KLINIK
No TANGGAL NAMA TOTAL BIAYA
NOMOR RESEP NAMA OBAT Σ NOMINAL Jenis Tindakan Nominal
Mayani Thyrozol 30 Rp 39,400 Rp 39,400
Vit B6 60 Rp 12,000
1 ###
Fatimah Kutoin 60 Rp 66,800 Rp 197,600
Bamgetol 60 Rp 118,800
2 ### Azizah Salum R/ Rp 7,300 Konsul Rp 20,000 Rp 27,300
Konsul Rp 20,000
Azizah Salum R/ Rp 14,300 Rp 59,300
Angkat Jahitan Rp 25,000
Cek Chol Rp 25,000
3 ###
Maruki R/ Rp 46,900 Cek GDA Rp 10,000 Rp 101,900
Konsul Rp 20,000
Taufik Satpam R Rp 13,000 Konsul Rp 20,000 Rp 33,000
An. Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
4 ###
Ali At Thamimi Concor 10 Rp 60,600 Rp 60,600
5 ### Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
6 ### Abd. Rouf R/ Rp 18,100 Konsul Rp 20,000 Rp 38,100
Syarifah Fadlun Confident 1 Rp 42,000 Rp 42,000
7 ###
Tn. Damar Berotec 1 Rp 125,000 Rp 125,000
Dafri R/ Rp 24,300 Konsul Rp 20,000 Rp 44,300
9 ### Jamal R/ Rp 41,700 Konsul Rp 20,000 Rp 61,700
Rony R/ Rp 15,400 Konsul Rp 20,000 Rp 35,400
F Rochim R/ Rp 30,400 Konsul Rp 20,000 Rp 50,400
10 ###
Dafri R/ Rp 73,800 Konsul Rp 20,000 Rp 93,800
11 ### Ali At Thamimi Concor 10 Rp 61,000 Rp 61,000
Diana R/ Rp 58,500 Konsul Rp 20,000 Rp 78,500
12 ###
F Rochim R/ Rp 24,900 Konsul Rp 20,000 Rp 44,900
Syarifah Fadlun Confident 1 Rp 45,700 Rp 45,700
13 ### Nebul Rp 41,000
Basori R/ Rp 25,200 Rp 86,200
Konsul Rp 20,000
14 ### Mayani R/ Rp 45,900 Rp 45,900
15 ### Azril Irsya (Nisa') R/ Rp 22,400 Konsul Rp 20,000 Rp 42,400
Ali At Thamimi Concor 10 Rp 61,000 Rp 61,000
An. Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
Konsul Rp 20,000
16 ### Maruki R/ 45800 Cek GDA Rp 10,000 Rp 85,800
Cek AU Rp 10,000
Cek Chol Rp 25,000
Mayani R/ Rp 24,300 Rp 69,300
Konsul Rp 20,000
Tn.Fuad R/ Rp 272,600 Rp 272,600
17 ###
Syarifah Fadlun Confident 1 Rp 45,700 Rp 45,700
Total Apotek Rp 1,866,800 Total Klinik Rp 466,000 Rp 2,332,800

Apotek Klinik
No.REK BCA 0891111125 0891334515
A/n Hadi Hasan Alwi Z.
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK
No TANGGAL NAMA
NOMOR RESEPNAMA OBAT Σ NOMINAL
Bamgetol 60 Rp 118,800
Fatimah Kutoin 60 Rp 66,700
Vit B12 60 Rp 12,000
1 ###
Omz 20 Rp 10,000
Fitria Al Hadad Stimuno 2 Rp 44,600
Panadol Biru 20 Rp 18,000

M.Ishaq R/ Rp 11,900
2 ###
An. Bambang Depaken Syr 1 Rp 171,000
3 ### Pak Eko R/ Rp 26,900
4 ### M. Sai R/ Rp 81,900
Omz 20 Rp 8,100
5 ### Fitria Al Hadad
Panadol Biru 10 Rp 8,100
Syarifah Fadlun Confident 1 Rp 45,700
Hb.Muhammad Ultraproct N 5 Rp 103,700

6 ### Mayani R/ Rp 17,700

Maruki R/ Rp 39,300

7 ### Supiyah R/ Rp 51,500

8 ### C Nisa R/ Rp 29,100

9 ### Fatimah Zahro R/ Rp 6,300

Syarifah Fadlun Confident 1 Rp 45,700

Fitria Al Hadad Stimuno 2 Rp 44,600
10 ### Cetirizin 10 Rp 5,000
Hb.Anis Grafalin 4 10 Rp 2,000
Grathazone 10 Rp 2,000
An. Bambang Depaken Syr 1 Rp 171,000
Ali At Thamimi Concor 10 Rp 61,000

11 ### Lilik Hikmah R/ Rp 25,700

Ali At Thamimi R/ Rp 25,500

Dewi Chumairah R/ Rp 24,300
12 ### Richu R/ Rp 93,700
13 ### Najuwa R/ Rp 27,800
Total Apotek Rp 1,399,600
No.REK BCA
A/n
AL MA'UNAH
KLINIK
TOTAL BIAYA
Jenis Tindakan Nominal

Rp 197,500

Rp 72,600

Konsul Rp 20,000
Rp 86,900
RLS Rp 55,000
Rp 171,000
Konsul Rp 20,000 Rp 46,900
Konsul Rp 20,000 Rp 101,900

Rp 16,200

Rp 45,700
Rp 103,700
Konsul Rp 20,000
Cek Chol Rp 25,000
Rp 82,700
Cek AU Rp 10,000
Cek GDA Rp 10,000
Konsul Rp 20,000
Rp 69,300
Cek GDA Rp 10,000
Konsul Rp 20,000
Cek GDA Rp 10,000 Rp 136,500
RLS Rp 55,000
Konsul Rp 20,000 Rp 49,100
Konsul Rp 20,000
Rp 67,300
Nebul Rp 41,000
Rp 45,700
Rp 44,600

Rp 9,000

Rp 171,000
Rp 61,000
Konsul Rp 20,000
Rp 90,700
Cek Lengkap Rp 45,000
Konsul Rp 20,000 Rp 45,500
Konsul Rp 20,000 Rp 44,300
Konsul Rp 20,000 Rp 113,700
Konsul Rp 20,000 Rp 47,800
Total Klinik Rp 521,000 Rp 1,920,600
 Apotek Klinik
0891111125 0891334515
Hadi Hasan Alwi Z.
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK KLINIK
No TANGGAL NAMA TOTAL BIAYA
NOMOR RESEPNAMA OBAT Σ NOMINAL Jenis Tindakan Nominal
1 ### Syarifah Fadlun Confident M 1 Rp 41,200 Rp 41,200
2 ### Maunah Santri Botol 4 Rp 8,000 Rp 8,000
Konsul Rp 20,000
3 ### Maruki R/ Cek Chol Rp 25,000 Rp 55,000
Cek GDA Rp 10,000
Omz 10 Rp 5,000
Fitria Al Hadad Rp 56,800
4 ### Stimuno 20 Rp 51,800
Miftahul Jannah R/ Rp 23,200 Konsul Rp 20,000 Rp 43,200
Ali At Thamimi Concor 10 Rp 61,000 Rp 61,000
5 ### Hb.Anis Aerius 15 Rp 141,500 Rp 141,500
Richu R/ Rp 27,100 Konsul Rp 20,000 Rp 47,100
6 ### An. Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
7 ### Nuriyatul Ilmi R/ Rp 28,800 Konsul Rp 20,000 Rp 48,800
8 ### Solim R/ Rp 16,000 Konsul Rp 20,000 Rp 36,000
Maunah Sinom 2 Rp 10,000 Rp 10,000
9 ###
Ratna K R/ Rp 75,800 Konsul Rp 20,000 Rp 95,800
10 ### M. Nadif R/ Rp 34,400 Konsul Rp 20,000 Rp 54,400
Konsul Rp 20,000 Rp 58,600
11 ### Nur Rohma R/ Rp 38,600
Injeksi Rp 21,100 Rp 21,100
Seretic 1 Rp 227,000
Hb.Anis Rp 368,500
12 ### Aerius 15 Rp 141,500
Marwah (an.Ratna) R/ Rp 51,100 Konsul Rp 20,000 Rp 71,100
Syarifah Fadlun Confident 2 Rp 91,400 Rp 91,400
13 ###
Richu Rp 68,300 Konsul Rp 20,000 Rp 88,300
Total Apotek Rp 1,312,700 Total Klinik Rp 256,100 Rp 1,568,800

Apotek Klinik
No.REK BCA 0891111125 0891334515
A/n Hadi Hasan Alwi Z.
### Belum
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK KLINIK
No TANGGAL NAMA TOTAL BIAYA
NOMOR RESEP NAMA OBAT Σ NOMINAL Jenis Tindakan Nominal
1 ### Jauhari Hikam R/ Rp 7,700 Khitan Rp 300,000 Rp 307,700
2 ### M. Ari Arlansah R/ Rp 7,700 Khitan Rp 300,000 Rp 307,700
Konsul Rp 20,000
Mayani R/ Rp 19,000 Rp 64,000
3 ### Cek Chol Rp 25,000
Bayi Rahmatul R/ Rp 231,000 Rp 231,000
Neurobion + 10 Rp 32,300
Ondan 8 10 Rp 20,000
4 ### Kak Ipah Rp 180,500
Sucralfate Syr 1 Rp 79,900
Urso 250 10 Rp 48,300
Bamgetol 60 Rp 94,700
Fatimah Kutoin 60 Rp 66,800 Rp 173,500
Vit B6 60 Rp 12,000
5 ###
An. Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
Konsul Rp 20,000
Jamal Rp 20,700 Rp 61,800
Injeksi Rp 21,100
Berotec 1 Rp 125,000
Jamal Damar Rp 148,600
Retaphyl Sr 10 Rp 23,600
6 ### M. Abdullah R/ Rp 5,000 Konsul Rp 20,000 Rp 25,000
Alwi Al Idrus Rp 10,800 Khitan Rp 320,000 Rp 330,800
F Rochim R/ Rp 58,700 Konsul Rp 20,000 Rp 78,700
7 ### Ratna R/ Rp 51,700 Konsul Rp 20,000 Rp 71,700
Sucralfate Syr 1 Rp 79,900
Habbatus Kurma 1 Rp 60,000
Urso 250 10 Rp 48,300
Kak Ipah Rp 280,500
SKM HMS 1 Rp 40,000
8 ### Neurobion + 10 Rp 32,300
Ondan 8 10 Rp 20,000
Nova Bin Abd Said R/ Rp 16,500 Konsul Rp 20,000 Rp 36,500
Hariyati R/ Rp 73,700 Konsul Rp 20,000 Rp 93,700
Zahra Kak Ipah R/ Rp 67,500 Konsul Rp 20,000 Rp 87,500
Ronny R/ Rp 9,600 Rp 9,600
Ust.Husni R/ Rp 26,000 Rp 26,000
9 ###
An.Abdullah Hasan R/ Rp 78,300 Rp 78,300
An. Ust Husni R/ Rp 12,500 Rp 12,500
Sucralfate Syr 1 Rp 79,900
Urso 250 10 Rp 48,300
10 ### Kak Ipah SKM HMS 1 Rp 40,000 Rp 220,500
Neurobion + 10 Rp 32,300
Ondan 8 10 Rp 20,000
11 ### Fuad R/ Rp 289,700 Konsul Rp 20,000 Rp 309,700
12 ### An. Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
Mayani R/ Rp 115,500 Rp 115,500
13 ###
Ronny R/ Rp 3,500 Rp 3,500
Stimuno 2 Rp 43,600
Fitria Al Hadad Rp 51,700
Omz 20 Rp 8,100
14 ###
Maryam Sanmag 10 Rp 12,000 Rp 12,000
An.Kamila R/ Rp 108,200 Konsul Rp 20,000 Rp 128,200
Ghiyas Rp 9,700 Khitan Rp 320,000 Rp 329,700
15 ###
Ronny Gigi Rp 150,000 Rp 150,000
16 ### Bahanan R/ Rp 31,600 Konsul Rp 20,000 Rp 51,600
Fuad R/ Rp 344,600 Konsul Rp 20,000 Rp 364,600
An. Bambang Depaken Syr 1 Rp 171,000 Rp 171,000
Domperidon 10 Rp 3,800
17 ### Lanso 10 Rp 9,500
Kak Ipah Sucralfate Syr 1 Rp 79,900 Rp 186,500
Urso 250 10 Rp 48,300
SKM HMS 1 Rp 45,000
18 ### Hb. Anis R/ Rp 263,200 Rp 263,200
Bamgetol 60 Rp 99,500
Fatimah Kutoin 60 Rp 69,800 Rp 189,300
Vit B6 60 Rp 20,000

19 ###
 Konsul Rp 20,000
19 ###
Tn.Maruki R/ Rp 28,500 Cek GDA Rp 10,000 Rp 68,500
Cek AU Rp 10,000
Ratna R/ Rp 36,000 Konsul Rp 20,000 Rp 56,000
An.Haryo(Ratna) R/ Rp 73,700 Konsul Rp 20,000 Rp 93,700
Pak Jamal R/ Rp 10,300 Rp 10,300
20 ### Kak Ipah PCT 10 Rp 2,000 Rp 2,000
Ali Atthamimi Concor 10 Rp 61,000 Rp 61,000
M.Iqbal R/ Rp 9,700 Khitan Rp 300,000 Rp 309,700
21 ###
M. Zainal Ikhwan R/ Rp 9,700 Khitan Rp 300,000 Rp 309,700
An. Kamila R/ Rp 58,800 Rp 58,800
22 ###
An. Abdullah Hasan Rp 117,000 Rp 117,000
Total Apotek Rp 3,941,300 Total Klinik Rp 1,156,100 Rp 5,097,400

Apotek Klinik
No.REK BCA 0891111125 0891334515
A/n Hadi Hasan Alwi Z.
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK
No TANGGAL NAMA
NOMOR RESEP NAMA OBAT Σ NOMINAL
1 ### Kak Ipah Urso 250 20 Rp 96,600
2 ### Kak Ipah Urso 250 10 Rp 48,300
Domperidon 10 Rp 3,800
Lanso 20 Rp 19,000
3 ### Kak Ipah Sucralfate Syr 1 Rp 79,900
SKM HMS 1 Rp 45,000
Allo 300 10 Rp 4,600
Neurobion + 10 Rp 32,300
Kak Ipah Ondan 8 10 Rp 20,000
4 ###
Urso 250 10 Rp 48,300
Tn.Sutoyo
Syarifah Fadlun Confident 4 Rp 182,800
5 ###
Maryam R/ Rp 16,000
Taslim R/ Rp 13,000
Irham R/ Rp 16,000
6 ### Ronny R/ Rp 8,700

Jamal Damar R/ Rp 14,000

7 ### An. Bambang Depaken Syr 1 Rp 171,000

F Rochim R/ Rp 89,000

Musdalifah R/ Rp 68,200
8 Friday, May 03, 2019

Ali Bin Husein R/ Rp 55,400

Zahra Kak Ipah R/ Rp 44,400
Ali Atthamimi Concor 10 Rp 65,900
9 ### Nurul Maslikha R/ Rp 14,600
Achmad R/ Rp 33,300
10 ### Zahra Kak Ipah R/ Rp 32,000
Ronny R/ Rp 13,200
11 ###
Marwah Permatasari R/ Rp 54,600
12 ### Admuji R/ Rp 20,200
12 ### Muhammad Habsy R/ Rp 18,100
Sucralfate Syr 1 Rp 80,000
SKM HMS 1 Rp 45,000
Neurobion + 10 Rp 32,300
13 ### Kak Ipah Domperidon 10 Rp 3,800
PCT 10 Rp 2,000
Lanso 20 Rp 19,000
Urso 250 20 Rp 96,600
Ali Atthamimi Concor 10 Rp 65,900
14 ### Kakak Ust Hadi Mefinal 10 Rp 18,000
14 ###
P. Taslim R/ Rp 15,100

15 ### Tn. Maruki R/ Rp 22,400

Miftakkhul Jannah R/ Rp 26,300

16 ###
Ali Atthamimi Concor 10 Rp 65,900
An. Bambang Depaken Syr 1 Rp 171,000
Bamgetol 60 Rp 94,700
17 ###
An. Fatimah Kutoin 60 Rp 66,800
Vit B6 60 Rp 12,000
Lanso 10 Rp 9,500
Neurobion + 10 Rp 32,300
18 ### Kak Ipah Ondan 8 12 Rp 28,500
Sucralfate Syr 1 Rp 79,900
Urso 250 10 Rp 48,200

Suyuti R/ Rp 113,400
19 Friday, May 24, 2019

Fuad
20 ### M. Khoiron R/ Rp 22,000
Total Apotek Rp 2,331,100

No.REK BCA
A/n
MA'UNAH
KLINIK
TOTAL BIAYA
Jenis Tindakan Nominal
Rp 96,600
Rp 48,300

Rp 152,300

Rp 100,600

Surat Sehat Rp 25,000 Rp 25,000

Rp 182,800
Konsul Rp 20,000 Rp 36,000
Konsul Rp 20,000 Rp 33,000
Rp 16,000
Gigi Rp 50,000 Rp 58,700
Konsul Rp 20,000 Rp 34,000
Nebul Rp 30,000 Rp 30,000
Rp 171,000
Konsul Rp 20,000 Rp 109,000
Konsul Rp 20,000
Cek GDA Rp 10,000 Rp 153,200
Rawat Luka Rp 55,000
Konsul Rp 20,000 Rp 75,400
Konsul Rp 20,000 Rp 64,400
Rp 65,900
Konsul Rp 20,000 Rp 34,600
Konsul Rp 20,000 Rp 53,300
Konsul Rp 20,000 Rp 52,000
Konsul Rp 20,000 Rp 33,200
Konsul Rp 20,000 Rp 74,600
Konsul Rp 20,000 Rp 40,200
Konsul Rp 20,000 Rp 38,100

Rp 278,700

Rp 65,900
Rp 18,000
 Rp 15,100
Konsul Rp 20,000
Rp 52,400
Cek GDA Rp 10,000
Konsul Rp 20,000 Rp 46,300
Rp 65,900
Rp 171,000

Rp 173,500

Rp 198,400

Konsul Rp 20,000
Nebul Rp 41,100 Rp 188,600
Injeksi Rp 14,100
Konsul Rp 20,000 Rp 20,000
Konsul Rp 20,000 Rp 42,000
Total Klinik Rp 615,200 Rp 2,946,300

Apotek Klinik
0891111125 0891334515
Hadi Hasan Alwi Z.
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK KLINIK
No TANGGAL NAMA
NOMOR RESEP NAMA OBAT Σ NOMINAL Jenis Tindakan
1 ### Marwah Fitria Alhadad R/ Rp 148,900
2 ### Syarifah Fadlun Confident 2 Rp 91,400
Omz 30 Rp 12,200
3 ### Fitria Al Hadad Panadol Biru 30 Rp 25,500
Stimuno 3 Rp 79,500
Cek Chol
Diana
Cek AU
Konsul
Ronny R/ Rp 20,700
4 ### Injeksi
Cek AU
Zahra R/ Rp 267,100 Cek Chol
Konsul
5 ### Ali Atthamimi Concor 10 Rp 65,900
Sucralfate Syr 1 Rp 17,000
Neurobion + 10 Rp 32,300
Kak Ipah
Ondan 8 12 Rp 28,500
6 ###
Lanso 20 Rp 16,000
Ust.Husni R/ Rp 13,900
Tn. Fuad R/ Rp 342,800
Syarifah Fadlun Confident 5 Rp 223,000
7 ###
Ny.Maryam R/ Rp 53,800
P.Jamal Supir Neurodex Rp 7,000
Konsul
8 ###
Zahra R/ Rp 88,100 Cek AU
Cek GDA
Cek GDA
Tn. Maruki R/ Rp 44,000
9 ### Konsul
Ali Atthamimi Concor 10 Rp 65,900
10 ### An.Bambang Depaken Syr 1 Rp 171,000
Genta Sk 2 Rp 8,200
Loratadin 10 Rp 3,000
11 ### Fatimah acc Ust.Husni
Peditox 2 Rp 14,600
PCT 10 Rp 2,000
Urso 250 10 Rp 48,300
Panadol Biru 10 Rp 8,500
Lanso 10 Rp 11,200
12 ### Kak Ipah
Ondan 8 6 Rp 14,200
Sucralfate Syr 1 Rp 79,900
Nystatin Drop 1 Rp 24,500
Maunah Suyuti Sinom 2 Rp 10,000
Nuriyah Fajriyah Gigi
13 ###
Aditya Kukuh Surat Sehat
Nuriyatul Ilmi R/ Rp 16,200 Konsul
Novamox 10 Rp 4,300
14 ### Kak Ipah Fg Troches 10 Rp 14,300
Panadol Biru 10 Rp 8,500
Decolgen 4 Rp 2,000

15 ### Kak Ipah

 Urso 250 10 Rp 48,300
Sucralfate Syr 1 Rp 79,900
15 ### Kak Ipah Neozep F 8 Rp 4,300
Lanso 10 Rp 11,200
PCT 10 Rp 2,000
Ondan 4 10 Rp 11,000
Berotec 1 Rp 125,000
16 ### Tn. Jamal Damar
Retaphyl Sr 10 Rp 23,600
M Wildan R/ Rp 9,700 Sirkumsisi
Syaifudin Nizam R/ Rp 9,700 Sirkumsisi
17 ### M. Nazril Ilham R/ Rp 9,700 Sirkumsisi
M. Fakhri R/ Rp 9,700 Sirkumsisi
M. Midkhom R/ Rp 9,700 Sirkumsisi
Sirkumsisi
Sulton Naji R/ Rp 24,900
Konsul
18 ### Ali Atthamimi Concor 10 Rp 65,900
Kak Ipah Lipitor 20 10 Rp 239,300
An. Bambang Depaken Syr 1 Rp 171,000
Bamgetol 60 Rp 94,700
Fatimah Kraton Kutoin 60 Rp 62,700
19 ###
Vit B6 60 Rp 24,000
Kak Ipah Cendo Genta 1 Rp 40,700
Total Apotek Rp 2,883,200 Total Klinik

Apotek
No.REK BCA 0891111125
A/n Hadi
AH
KLINIK
TOTAL BIAYA
Nominal
Rp 148,900
Rp 91,400

Rp 117,200

Rp 25,000
Rp 35,000
Rp 10,000
Rp 20,000
Rp 50,700
Rp 10,000
Rp 10,000
Rp 25,000 Rp 322,100
Rp 20,000
Rp 65,900

Rp 93,800

Rp 13,900
Rp 342,800
Rp 223,000
Rp 53,800
Rp 7,000
Rp 20,000
Rp 10,000 Rp 128,100
Rp 10,000
Rp 10,000
Rp 74,000
Rp 20,000
Rp 65,900
Rp 171,000

Rp 27,800

Rp 186,600

Rp 10,000
Rp 50,000 Rp 50,000
Rp 25,000 Rp 25,000
Rp 20,000 Rp 36,200

Rp 27,100

Rp 158,700
 Rp 158,700

Rp 148,600

Rp 300,000 Rp 309,700
Rp 300,000 Rp 309,700
Rp 300,000 Rp 309,700
Rp 300,000 Rp 309,700
Rp 300,000 Rp 309,700
Rp 300,000
Rp 344,900
Rp 20,000
Rp 65,900
Rp 239,300
Rp 171,000

Rp 181,400

Rp 40,700
Rp 2,105,000 Rp 4,988,200

Klinik
0891334515
Hasan Alwi Z.
 TAGIHAN BIAYA KESEHATAN AL MA'UN
APOTEK
No TANGGAL NAMA
NOMOR RESEP NAMA OBAT Σ
M. Rohmatulloh R/

1 ### Supiyah R/

Tn. Fuad R/
Sucralfate Syr 1
Panadol Biru 10
Kak Ipah Urso 250 10
2 ###
Decadryl Syr 1
Lanso 10
Zahra R/

3 ### Abd. Rouf

R/

4 ### Suyuti R/

5 ### Tn. Maruki R/

Ali Atthamimi Concor 10

Abd. Rouf R/
6 ###
Supiyah R/

An. Bambang Depaken Syr 1

Sucralfate Syr 1
Panadol Biru 10
7 ### Supertetra 6
Kak Ipah
Urso 250 10
Lanso 10
Ondan 8 6
Sucralfate Syr 1
Lipitor 40 6
Ondan 8 6
11 ### Kak Ipah Urso 250 10
Lanso 10
Allo 300 10
Panadol Biru 10
12 ### Tn. Fuad

13 ### Tn. Fuad R/

13 ### Tn. Fuad R/

14 ### Ali Atthamimi Concor 10

15 ### Kak Ipah R/
Sucralfate Syr Mepro 1
Lipitor 40 10
16 ### Kak Ipah Lanso 10
Piroxicam 10
Urso 250 10
Furosemid 10
19 ### Kak Ipah
Omepros 30
Berotec 1
Tn. Jamal
Retaphyl Sr 10
20 ### Richu Ridho R/

Fauzi R/

21 ### Tn. Fuad R/

22 ### A. Fahri R/
Ali Atthamimi Concor 10
23 ### Ronny R/
M. Abdillah Bafaqih R/
Lanso 10
Ondan 8 10
24 ### Kak Ipah
Sucralfate Syr 1
Urso 250 10
Total Apotek
ATAN AL MA'UNAH
K KLINIK
TOTAL BIAYA
NOMINAL Jenis Tindakan Nominal
Rp 31,800 Konsul Rp 20,000 Rp 51,800
Konsul Rp 20,000
Rp 21,700 Rp 71,700
RLK Rp 30,000
Rp 484,200 Rp 484,200
Rp 79,900
Rp 7,900
Rp 48,300 Rp 161,300
Rp 14,100
Rp 11,100
Rp 271,500 Konsul Rp 20,000 Rp 291,500
Cek Chol Rp 25,000 Rp 25,000
Rp 43,300 Konsul Rp 20,000 Rp 63,300
Konsul Rp 20,000
Rp 61,400
Nebul Rp 41,400
Konsul Rp 20,000
Rp 37,700 Rp 67,700
Cek GDA Rp 10,000
Rp 65,900 Rp 65,900
Rp 15,200 Konsul Rp 20,000 Rp 35,200
Konsul Rp 20,000
Rp 21,600 Cek GDA Rp 10,000 Rp 81,600
RLK Rp 30,000
Rp 169,400 Rp 169,400
Rp 79,900
Rp 8,000
Rp 7,000
Rp 165,800
Rp 48,300
Rp 8,500
Rp 14,100
Rp 79,900
Rp 140,600
Rp 14,200
Rp 48,300 Rp 302,700
Rp 8,500
Rp 3,400
Rp 7,800
Konsul Rp 20,000 Rp 20,000
Konsul Rp 20,000

Rp 44,300 Rp 125,300
 Injeksi Rp 21,000
Rp 44,300 Rp 125,300
RLK Rp 30,000
Cek GDA Rp 10,000
Rp 65,900 Rp 65,900
Rp 152,800 Rp 152,800
Rp 22,000
Rp 241,500
Rp 8,600 Rp 322,200
Rp 1,800
Rp 48,300
Rp 1,500
Rp 133,100
Rp 131,600
Rp 124,500
Rp 148,100
Rp 23,600
Rp 3,600 Konsul Rp 20,000 Rp 23,600
Konsul Rp 20,000
Rp 11,500 Rp 52,500
Injeksi Rp 21,000
Rp 294,300 Rp 294,300
Rp 10,200 Sirkumsisi Rp 300,000 Rp 310,200
Rp 65,900 Rp 65,900
Rp 5,200 Rp 5,200
Rp 16,200 Konsul Rp 20,000 Rp 36,200
Rp 8,500
Rp 12,700
Rp 149,400
Rp 79,900
Rp 48,300
Rp 3,756,700 Total Klinik Rp 1,053,400 Rp 4,810,100

Apotek Klinik
No.REK BCA 0891111125 0891334515
A/n Hadi Hasan Alwi Z.
Lunas
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK KLINIK
TOTAL
No TANGGAL NAMA
NO RESEP NAMA OBAT Σ NOMINAL Jenis Tindakan Nominal BIAYA

Lailatul Luthfiah R/ Rp 67,300 Konsul Rp 20,000 Rp 87,300

Konsul Rp 20,000
1 ### Tn. Maruki R/ Rp 29,600 Cek GDA Rp 10,000 Rp 69,600
Cek AU Rp 10,000
An. Bambang Depaken Syr Rp 169,400 Rp 169,400
2 ### Zahra R/ Rp 270,000 Konsul Rp 20,000 Rp 290,000
3 ### Ratna R/ Rp 49,000 Konsul Rp 20,000 Rp 69,000
4 ### Zahra R/ Rp 26,400 Konsul Rp 20,000 Rp 46,400
Kak Ipah Lipitor 40 10 Rp 237,300 Rp 237,300
Ali Atthamimi Concor 10 Rp 65,600 Rp 65,600
Konsul Rp 20,000
M. Taslim R/ Rp 17,400 Rp 47,400
Injeksi Rp 10,000
5 ### Konsul Rp 20,000
Ulil Azmi R/ Rp 41,600 Rp 80,800
Injeksi Rp 19,200
Kak Ipah Rp 258,600 Rp 258,600
Maria Ulfa Poli Gigi Rp 50,000 Rp 50,000
6 ###
Richu Ridho Poli Gigi Rp 50,000 Rp 50,000
An. Bambang Depaken Syr 1 Rp 169,400 Rp 169,400
7 ###
Kak Ipah Rp 163,700 Rp 163,700
Fuad Konsul Rp 20,000 Rp 20,000
8 ###
Abdul Rouf Konsul Rp 20,000 Rp 20,000
9 ### Ali Atthamimi Concor 10 Rp 65,600 Rp 65,600
Choirun Nisya' R/ Rp 62,800 Konsul Rp 20,000 Rp 82,800
Kak Ipah Rp 419,100 Rp 419,100
10 ###
Tn. Jamal Rp 148,100 Rp 148,100
Syf Fadlun Rp 115,000 Rp 115,000
### An. Bambang Rp 170,700 Rp 170,700
### Zahra Rp 29,400 Rp 65,000 Rp 94,400
Tn. Maruki Rp 26,200 Rp 26,200
11 ###
11 ###
Joko Tukang Rp 4,000 Rp 4,000
Kak Ipah Rp 301,700 Rp 301,700
12 ###
Abdillah Bafagih Rp 9,500 Konsul Rp 20,000 Rp 29,500
Ali Atthamimi Concor 10 Rp 65,900 Rp 65,900
13 ###
Jamal Rp 15,100 Rp 15,100
14 ### Kak Ipah Rp 374,800 Rp 374,800
Fatimah Rp 181,400 Rp 181,400
Rp -
Total Apotek Rp 3,554,600 Total Klinik Rp 434,200 Rp 3,988,800

Apotek Klinik
No.REK BCA 0891111125 0891334515
A/n Hadi Hasan Alwi Z.
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK KLINIK
No TANGGAL NAMA NAMA Jenis TOTAL BIAYA
NO RESEP
OBAT Σ NOMINAL
Tindakan
Nominal
1 ### Syf Fadlun Rp 127,600 Rp - Rp 127,600
2 ### P. Bambang Rp 170,700 Rp - Rp 170,700
3 ### Tn Maruki Rp 27,700 Rp 30,000 Rp 57,700
### Ust Husni Rp 3,400 Rp - Rp 3,400
### Ali Attamimi Rp 65,900 Rp - Rp 65,900
### Kak Ipah Rp 120,700 Rp - Rp 120,700
4 ### Ratna Rp 61,000 Rp 20,000 Rp 81,000
5 ### Abdul Hadi Khasan Rp 9,600 Rp 320,000 Rp 329,600
6 ### Anis Al Habsyi Rp - Rp 65,000 Rp 65,000
7 ### Kak Ipah Rp 290,500 Rp 65,000 Rp 355,500
### Kak Ipah Rp 154,900 Rp - Rp 154,900
8 ### Ust Husni Rp 24,200 Rp 20,000 Rp 44,200
### Marwah Rp 45,500 Rp - Rp 45,500
9 ### Ali Attamimi Rp 65,900 Rp - Rp 65,900
### Suyuti Rp 15,000 Rp - Rp 15,000
10 ### Ust Husni Rp 8,400 Rp - Rp 8,400
### An. Bambang Rp 170,700 Rp - Rp 170,700
### Kak Ipah Rp 443,300 Rp - Rp 443,300
11 ### An. Kamila Rp 46,500 Rp 20,000 Rp 66,500
12 ### Zahra Rp 327,300 Rp 65,000 Rp 392,300
### Muhammad Habsyi Rp 8,100 Rp - Rp 8,100
### Fatimah Kraton Rp 14,500 Rp - Rp 14,500
### Syf Fadlun Rp 127,600 Rp - Rp 127,600
### M Anis Rp 9,800 Rp 320,000 Rp 329,800
### M Syafi'i Rp 9,800 Rp 320,000 Rp 329,800
### Tn Maruki Rp 23,400 Rp 30,000 Rp 53,400
### Achmad Azhar Rp 9,300 Rp 320,000 Rp 329,300
### M. Kholili Rp 9,300 Rp 320,000 Rp 329,300
### Rachmad K Rp 9,300 Rp 320,000 Rp 329,300
### M Ilham R Rp 12,300 Rp 320,000 Rp 332,300
### M. Fitrah F Rp 9,300 Rp 320,000 Rp 329,300
### Saikhu Rp 19,800 Rp 100,000 Rp 119,800
### Rofi' Rp 123,500 Rp 20,000 Rp 143,500
### Ali Attamimi Rp 65,900 Rp - Rp 65,900
### Anisah Putri Rp 2,000 Rp 50,000 Rp 52,000
### Rp 15,000 Rp - Rp 15,000
### Zahra Rp 39,900 Rp 65,000 Rp 104,900
### An Bambang Rp 170,700 Rp - Rp 170,700
### P. Jamal Rp 12,300 Rp - Rp 12,300
### Damar/Tn Jamal Rp 148,100 Rp - Rp 148,100
### Ronny Rp 3,400 Rp - Rp 3,400
### Richu Ridho Rizky Rp 65,700 Rp 150,000 Rp 215,700
### Kamila Aulia Rp 18,000 Rp 20,000 Rp 38,000

Total Apotek Rp 3,105,800 Total Klinik Rp 3,280,000 Rp 6,385,800

Apotek Klinik
No.REK BCA 0891111125 0891334515
A/n Hadi Hasan Alwi Z.
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK
No TANGGAL NAMA
NO RESEP NAMA OBAT Σ
1 ### Ali Attamimi

Hb Anis

2 ### M Rifqi
Amanda
An Bambang
Zahra
### Zahra
2 ### M Ridho
3 ### Aditya Kukuh
Zahra
### Bu Supiah
4 ### Zahra
M Ibrahim
5 ### M Rizky
Khurotul A'yun
6 ### Abdullah
### An Bambang
Hb Anis
7 ### Ahmad Ajis
Tn Maruki
Zahra
8 ###
M. Rifki
Zahra
9 ### Muamar

Ahmad Suyuthi
10 ### Ahmad Suyuthi
Zahra
11 ### Zahra
12 ### Bu Supiah
13 ###
14
###
Leli Bidan
15 ### Zahra
16 ### Zahra
Total Apotek
HATAN AL MA'UNAH
TEK KLINIK
TOTAL BIAYA
NOMINAL Jenis Tindakan Nominal
Rp 66,000 Rp - Rp 66,000
Rp 85,600 Rp - Rp 85,600
Rp 11,000 Rp - Rp 11,000
Rp 179,800 Rp 179,800
Rp 31,500 Rp 20,000 Rp 51,500
Rp 38,500 Rp 20,000 Rp 58,500
Rp 176,400 Rp 176,400
Rp 64,000 Rp 64,000
Rp 80,100 Rp 80,100
Rp 9,600 Rp 320,000 Rp 329,600
Rp - Rp 25,000 Rp 25,000
Rp 330,500 Rp 330,500
Rp 79,900 Rp 79,900
Rp 71,900 Rp 65,000 Rp 136,900
Rp 6,800 Rp 320,000 Rp 326,800
Rp 8,900 Rp 320,000 Rp 328,900
Rp 116,500 Rp - Rp 116,500
Rp 17,000 Rp 20,000 Rp 37,000
Rp 176,400 Rp 176,400
Rp 35,900 Rp 35,900
Rp 9,500 Rp 320,000 Rp 329,500
Rp 16,700 Rp 20,000 Rp 36,700
Rp 65,700 Rp 20,000 Rp 85,700
Rp 7,800 Rp 320,000 Rp 327,800
Rp 391,000 Rp 391,000
Rp 20,900 Rp 30,000 Rp 50,900
Rp 46,100 Rp 46,100
Rp 25,700 Rp 20,000 Rp 45,700
Rp 6,600 Rp 61,000 Rp 67,600
Rp 793,900 Rp 793,900
Rp - Rp 55,000 Rp 55,000
Rp 20,900 Rp 20,900
Rp 143,300 Rp 143,300
Rp 49,700 Rp 49,700
Rp 83,600 Rp 83,600
Rp 433,800 Rp 433,800
Rp 440,200 Rp 440,200
Rp 4,141,700 Total Klinik Rp 1,956,000 Rp 6,097,700

Apotek Klinik
No.REK BCA 0891111125 0891334515
A/n Hadi Hasan Alwi Z.
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK
No TANGGAL NAMA NAMA
NO RESEP
OBAT Σ
### Tn Maruki
Alfia
Ratna K
### Zahra
Hb Anis
Zahra
### Zahra
### Zahra
### Siti Rohma
Alfia
Zahra
Ali Attamimi
### Zahra
Tn Jamal
Syfh Fadlun
### Zahra
### Abdul Haq
### Zahra
An Bambang
Zahra
### Alfia
Ulil Hikmah
Zahra
Fatimah ust Husni
### Zahra
Ali Zaenal Abidin
Nur Salim
### Lailatul Luthfiah
Zahra
Ali Attamimi
### Zahra
### Dian Ningrum
Zahra
Fitria Al Haddad
### Anisa
Safira
Anisa
### Khumaiyah
Zahra
### Maryam
### Anisa
 Nur Salim
### Zahra
An Bambang
Syfh Fadlun
### Khumaiyah
Nur Salim
Zahra
Hb Ahmad Alhabsy
### Fitriyah Al Haddad
Sarmidi
Sukirno
M Alhabsy
Nur Hasyim
### Dzulkifli
Zahra
Zahra
Suyuti
### Zahra
Fatimah
### Zahra
Zahra
Zahra Cek Lab 250000
Ust hadi pinjem u 200000

Total Apotek
HATAN AL MA'UNAH
EK KLINIK
Jenis TOTAL BIAYA
NOMINAL Nominal
Tindakan
Rp 34,900 Rp 20,000 Rp 54,900
Rp 23,100 Rp 50,000 Rp 73,100
Rp 103,400 Rp 20,000 Rp 123,400
Rp 50,036 Rp 185,000 Rp 235,036
Rp 29,700
Rp 7,000
Rp - Rp 50,000 Rp 50,000
Rp 23,600
Rp 35,000 Rp 84,600 Rp 119,600
Rp 36,700 Rp 121,600 Rp 158,300
Rp - Rp 65,000 Rp 65,000
Rp 65,200
Rp 22,500
Rp 138,600
Rp 94,500
Rp 47,600
Rp 20,800 Rp 20,000 Rp 40,800
Rp 164,100
Rp 170,700
Rp 28,000
Rp 44,800 Rp 100,000 Rp 144,800
Rp 20,700 Rp 130,000 Rp 150,700
Rp 339,000 Rp 20,000 Rp 359,000
Rp 36,900 Rp - Rp 36,900
Rp 67,200 Rp - Rp 67,200
Rp 40,600 Rp 20,000 Rp 60,600
Rp 9,700 Rp 145,000 Rp 154,700
Rp 24,800 Rp 42,000 Rp 66,800
Rp 29,400 Rp - Rp 29,400
Rp 65,200 Rp - Rp 65,200
Rp 179,200 Rp 186,700 Rp 365,900
Rp 109,400 Rp 20,000 Rp 129,400
Rp 42,500 Rp - Rp 42,500
Rp 67,200 Rp - Rp 67,200
Rp - Rp 85,000 Rp 85,000
Rp 60,200 Rp 25,000 Rp 85,200
Rp - Rp 75,000 Rp 75,000
Rp 16,100 Rp 39,600 Rp 55,700
Rp 478,000 Rp 20,000 Rp 498,000
Rp 64,100 Rp - Rp 64,100
Rp 16,800 Rp 50,000 Rp 66,800
Rp 35,100 Rp 50,000 Rp 85,100
Rp 128,700 Rp - Rp 128,700
Rp 170,700 Rp - Rp 170,700
Rp 87,200 Rp - Rp 87,200
Rp - Rp 39,600 Rp 39,600
Rp - Rp 45,000 Rp 45,000
Rp 5,800 Rp - Rp 5,800
Rp 2,100 Rp - Rp 2,100
Rp 25,900 Rp 20,000 Rp 45,900
Rp 76,300 Rp 60,000 Rp 136,300
Rp 33,000 Rp 20,000 Rp 53,000
Rp 19,100 Rp 20,000 Rp 39,100
Rp 16,700 Rp 20,000 Rp 36,700
Rp - Rp 100,000 Rp 100,000
Rp 469,700 Rp 20,000 Rp 489,700
Rp 53,600 Rp - Rp 53,600
Rp 15,000 Rp - Rp 15,000
Rp - Rp 225,700 Rp 225,700
Rp 166,500
Rp 43,100 Rp - Rp 43,100
Rp 12,700 Rp - Rp 12,700
Rp 450,000 Rp 450,000
Rp -
Rp -
Rp -
Rp -
Rp 4,168,436 Total Klinik Rp 2,644,800 Rp 5,855,236

Apotek Klinik
No.REK BCA 0891111125 0891334515
A/n Hadi Hasan Alwi Z.
 TAGIHAN BIAYA KESEHATAN AL MA'UNAH
APOTEK
No TANGGAL NAMA NO NAMA
RESEP OBAT Σ NOMINAL
### Dewi Chumairoh Rp 51,100
Khodijah Alaydrus Rp 21,300
### Tn Maruki Rp 145,000
### Rofi'atut Tamami Rp -
### Zahra Rp 82,200
### Zahra Rp 65,200
### Zahra Rp 201,000
An Bambang Rp 170,700
### ust nur hadi Rp 66,300
### Ahmad Al Habsy Rp 12,400
Friday, March 06, 2020 Zahra Rp 72,500
Zahra Rp 85,500
Ali Attamimi Rp 30,100
### Admuji Rp 127,100
Syrf Fadlun Rp 95,600
Rony Rp 100,600
### Damar Rp 138,600
### Zahra Rp 84,300
### Zahra Rp 51,000
ust husni Rp 133,200
Friday, March 13, 2020 Rofi'atut Tamami Rp -
Alfia Rp 147,200
### M Abdillah Rp 48,100
M Abdullah Rp 47,000
M Faiz Rp 13,900
Basori Rp 68,700
An Bambang Rp 170,700
### Salsabila Putri R Rp 141,600
Zahra Rp 681,300
Syrf Fadlun Rp 51,000
Ali Attamimi Rp 30,100
### Saneri Rp 114,300
Khotimatul Rp 42,500
### Muhammad Rp 142,600
Zahra Rp 139,400
Zahra Rp 113,600
### Zahra Rp 47,500
Hb Anis Rp 65,100
Friday, March 20, 2020 Much Iqbal cicilan I Rp -
M dzulkifli Rp -
Zahra Rp 191,500
 ### Ali Hasan Rp 73,800
### Zahra Rp 129,700
Zahra Rp 41,000
### Zahra Rp 343,000
Zahra Rp 336,100
An Bambang Rp 170,700
HB Shaleh Rp 628,700
### Alfia Rp 32,700
Abdullah Rp 360,000
Kak Fit Rp 65,100
Friday, March 27, 2020 Zahra Rp 51,400
Syrf Fadlun Rp 51,000
Hb Anis Rp 52,300
### Richu Rp 11,500
An Pak Jamal Rp 10,800
### Anisa Rp 181,500
Jamal Damar Rp 138,600
### ustad nur hadi Rp 59,200

Total Apotek Rp 6,726,900

No.REK BCA
A/n
N AL MA'UNAH
KLINIK
Jenis TOTAL BIAYA
Nominal
Tindakan
Rp 20,000 Rp 71,100
Rp 20,000 Rp 41,300
Rp 30,000 Rp 175,000
Rp 15,000 Rp 15,000
Rp - Rp 82,200
Rp - Rp 65,200
Rp 65,000 Rp 266,000
Rp - Rp 170,700
Rp - Rp 66,300
Rp - Rp 12,400
Rp 77,000 Rp 149,500
Rp - Rp 85,500
Rp - Rp 30,100
Rp 20,000 Rp 147,100
Rp - Rp 95,600
Rp - Rp 100,600
Rp - Rp 138,600
Rp - Rp 84,300
Rp - Rp 51,000
Rp - Rp 133,200
Rp 15,000 Rp 15,000
Rp 20,000 Rp 167,200
Rp 20,000 Rp 68,100
Rp 50,000 Rp 97,000
Rp 20,000 Rp 33,900
Rp 20,000 Rp 88,700
Rp - Rp 170,700
Rp 20,000 Rp 161,600
Rp - Rp 681,300
Rp - Rp 51,000
Rp - Rp 30,100
Rp 20,000 Rp 134,300
Rp - Rp 42,500
Rp 20,000 Rp 162,600
Rp 20,000 Rp 159,400
Rp - Rp 113,600
Rp - Rp 47,500
Rp - Rp 65,100
Rp 600,000 Rp 600,000
Rp 175,000 Rp 175,000
Rp - Rp 191,500
 Rp 20,000 Rp 93,800
Rp 65,000 Rp 194,700
Rp - Rp 41,000
Rp - Rp 343,000
Rp - Rp 336,100
Rp - Rp 170,700
Rp - Rp 628,700
Rp 20,000 Rp 52,700
Rp - Rp 360,000
Rp - Rp 65,100
Rp - Rp 51,400
Rp - Rp 51,000
Rp - Rp 52,300
Rp 42,000 Rp 53,500
Rp - Rp 10,800
Rp - Rp 181,500
Rp - Rp 138,600
Rp - Rp 59,200
Rp -
Rp -
Rp -
Total Klinik Rp 1,394,000 Rp 8,120,900

Apotek Klinik
0891111125 0891334515
Hadi Hasan Alwi Z.