KLINIK MIAN MEDICAL CENTER
Jl. Raya Kresek Balaraja Kp. Caringin Ds. Saga
Balaraja, Kab. Tangerang 15610 Telp. (021) 5951142
DATA-DATA PASIEN BEROBAT BULAN JANUARI 2022
PONDOK PESANTREN INSAN PRATAMA
NO | TANGGAL | NAMAPASIEN | KELAS | TINDAKAN | DIAGNOSA | HARGA USTADZ/
| USTADZAH
1_| 10/01/22 | An. MArkan A | =| Scabies | Rp 50,000. | Ustadzah silvi
2 ‘An, Aail <0 | Dermatitis | Rp 50,000. | Ustadz Ridwan
Abdilah |
3 | 11/01/22 | An. Nayara vu : IsPA | Rp50,000. | Ustadzah
Khariyah
4 Tn. ALL = [Gea [Rp 50,000. | Ustadz Al
5 | 12/01/22 [an ZufarM. | Xi - Scabies | Rp 50,000.__| Ustadz idwan
6 | 15/01/22 | Nn. Putri | - Konjungtivi | Rp 50,000. Ustadzah
| tis Fajriah
7 ‘An. Rio a : Gastritis_| Rp50,000.__| Ustadz isan
8 | 19/01/22 [An.ZamarB. |X! =| Hematoma | Rp 50,000. | Ustadz san
9 | 21/01/22 | An. Musyafa - Konseling | Rp 20,000. | Ustadz isan
p10 [| An. Parisa 7 = Konseling | Rp 20,000. Ustadz Irsan
11 | 26/01/22 | An. Acila xi - Faringitis | Rp 50,000. | Ustadzan
| Amina
12 | 28/01/22 | An. Zidkeri x : edema _| Rp 50,000. | Ustadz Ridwan
13 | 29/01/22 | Ny. Neneng : Ispa__| Rp50,000.__| Ustadzan Devi
14 ‘An. Akhtar vi - Ispa__| Rp 50,000.__| Ustadz fidwan
15 | 31/01/22 | An. Multazam | Vil - Ve | Rp 50,000. | Ustadz Aziz
16 ‘An. Zibril ik Dermatitis | Rp 50,000. | Ustadz Aziz
7 ‘An. Huwaidi | 1x - Dermatitis | Rp 50,000. | Ustadz Aziz
18 ‘An. Dafa ik : Dermatitis | Rp 50,000. | Ustadz Aziz
19 ‘An. Alvin vu Scabies | Rp50,000.__| Ustadz Aziz
20 ‘An. Abid vi - Dermatitis | Rp'50,000.__| Ustadz Aziz
2 ‘An, Dzikri i - GEA | Rp 50,000. | Ustadz isan
Maula
TOTALKLINIK MIAN MEDICAL CENTER
Jl. Raya Kresek Balaraja Kp. Caringin Ds. Saga
Balaraja, Kab. Tangerang 15610 Telp. (021) 5951142
INVOICE
Kepada Yth
Pimpinan Pondok Pesantren Insan Pratama
Di
Tempat
NO | NAMAKEGIATAN | _JUMLAH BIAYA TOTAL
1_| Berobat 19 orang | @50,000/orang _ | Rp 950,000.
2__| Konseling 2orang @20,000./orang | Rp 40,000. _
Rp 990,000.
Pembayaran untuk invoice ini mohon ditransfer ke rekening :
Bank BCA Cab Tangerang
Atas Nama: Linda Mirawati
No Rek :6042020377
‘Tangerang, 01 Februari 2022