Jasa Tindakan Sept

REPORT JASA DOKTER / FEE MEDIS
PERIODE 2022-09-01 sampai 2022-09-30
No Keterangan Tarif Qty

ABDUL HAFID, AMD.KEP
1 GDA STIK Rp 5,000.00 1
2 GDA STIK Rp 5,000.00 1
3 PELEPASAN KATETER Rp 15,000.00 1
4 NEBULIZER Rp 10,000.00 1
5 PELEPASAN INFUS DEWASA Rp 10,000.00 1
10 BPJS NEBULIZER Rp 10,000.00 1
23 PEMASANGAN DAN PELEPASAN INFUS DEWASA Rp 20,000.00 1
42 GDA STIK Rp 5,000.00 1
44 GDA STIK Rp 5,000.00 1
46 PELEPASAN INFUS ANAK Rp 10,000.00 1
47 PEMASANGAN DAN PELEPASAN INFUS ANAK Rp 25,000.00 1
68 GDA STIK Rp 5,000.00 1
TOTAL
ADE BELA SUKMA, S.KEP.NS
3 GDA STIK Rp 5,000.00 1
4 RAWAT JENASAH Rp 50,000.00 1
20 GDA STIK Rp 5,000.00 1
22 GDA STIK Rp 5,000.00 1
23 BPJS PEMASANGANDAN PELEPASAN INFUS DEWASA Rp 20,000.00 1
TOTAL
AHLI GIZI
1 PELAYANAN GIZI KELAS II Rp 45,000.00 1
2 PELAYANAN GIZI VIP Rp 45,000.00 1
3 PELAYANAN GIZI MAKANAN TAMBAHAN 2 Rp 10,000.00 1
21 PELAYANAN GIZI KELAS 1 Rp 45,000.00 1
578 JASA KONSULTASI GIZI RANAP Rp 5,000.00 1
TOTAL
AHMAD RIDWAN, S.KEP.NS
1 GDA STIK Rp 5,000.00 1
2 GDA STIK Rp 5,000.00 1
3 GDA STIK Rp 5,000.00 1
4 GDA STIK Rp 5,000.00 1
15 GDA STIK Rp 5,000.00 1
23 GDA STIK Rp 5,000.00 1
40 PEMASANGAN KATETER Rp 15,000.00 1
41 PELEPASAN KATETER Rp 15,000.00 1
55 RAWAT LUKA RINGAN Rp 20,000.00 1
56 BPJS GDA STIK Rp 5,000.00 1
57 GDA STIK Rp 5,000.00 1
58 GDA STIK Rp 5,000.00 1
TOTAL
SEWA ALAT KLINIK
1 SEWA ALAT EKG/ECG Rp 50,000.00 1
3 SEWA ALAT NEBULEZER Rp 10,000.00 1
26 PEMAKAIAN OKSIGEN KURANG DARI 2000 LITER Rp 105,000.00 1
40 SEWA ALAT GDA STIK Rp 5,000.00 1
163 PEMAKAIAN TABUNG OKSIGIN Rp 125,000.00 1
178 NEBULIZER Rp 10,000.00 1
210 JASA EKG/ECG Rp 25,000.00 1
211 NEBULIZER Rp 10,000.00 1
221 NEBULIZER Rp 10,000.00 1
229 NEBULIZER Rp 10,000.00 1
TOTAL
ANA WILDANI, S.TR.KEB
1 ANC RANAP Rp 20,000 1
2 JASA BIDAN ANC RANAP Rp 15,000 1
3 JASA BIDAN KB SUNTIK 1 BULAN Rp 5,000 1
4 KB SUNTIK 1 BULAN CYCLO/ANDALAN Rp 7,500 1
TOTAL
BAGUS ROBBY FITRIANTO,S.KEP.NS
1 JASA PERAWAT UGD BPJS Rp 10,000.00 1
2 GDA STIK Rp 5,000.00 1
7 GDA STIK Rp 5,000.00 1
TOTAL
BENI EKA WULANDARI, AMD.KEB
1 BPJS NON KAPITASI ANC RANAP Rp 2,000.00 1
2 JASA BIDAN BPJS NON KAPITASI ANC RANAP Rp 3,000.00 1
5 BPJS PERAWATAN BAYI BARU LAHIR NORMAL Rp 50,000.00 1
6 BKIA BPJS Rp 1,000.00 1
7 JASA BIDAN BPJS NON KAPITASI KB SUNTIK 3 BULAN Rp 5,000.00 1
8 BPJS NON KAPITASI KB SUNTIK 3 BULAN Rp 9,000.00 1
10 JASA BIDAN KB SUNTIK 3 BULAN Rp 5,000.00 1
11 BKIA UMUM Rp 5,000.00 1
12 ANC BIDAN Rp 20,000.00 1
13 JASA BIDAN ANC BIDAN Rp 15,000.00 1
14 JASA RESEP RJ Rp 2,000.00 1
TOTAL
BIDAN JAGA
1 BPJS JASA OBSERVASI Rp 10,000.00 2
2 JASA OBSERVASI PERSALINAN Rp 40,000.00 2
3 OBSERVASI PERSALINAN Rp 60,000.00 2
4 GIZI UNTUK PERSALINAN Rp 45,000.00 1
5 HEATCHING DERAJAT II Rp 150,000.00 1
6 PEMASANGAN INFUS PERSALINAN Rp 20,000.00 1
7 JASA MANUAL PLASENTA TANPA PERTOLONGAN PERSALINAN Rp 300,000.00 1
8 MANUAL PLASENTA TANPA PERTOLONGAN PERSALINAN Rp 450,000.00 1
9 JASA PERAWATAN BAYI BARU LAHIR NORMAL Rp 40,000.00 1
10 PERAWATAN BAYI BARU LAHIR NORMAL Rp 60,000.00 1
11 JASA DOKUMENTASI FOTO NEWBORN Rp 100,000.00 1
12 BPJS JASA OBSERVASI Rp 10,000.00 1
13 GIZI UNTUK PERSALINAN Rp 45,000.00 1
14 PEMASANGAN INFUS PERSALINAN Rp 20,000.00 1
15 SEWA AMBULANCE PERSALINAN WILAYAH JEMBER Rp 250,000.00 1
16 BPJS KAPITASI ANC BIDAN Rp 7,000.00 1
18 BPJS JASA OBSERVASI PERSALINAN Rp 10,000.00 1
20 JASA BIDAN VT RANAP Rp 10,000.00 1
21 VT RANAP Rp 15,000.00 1
TOTAL
DANA FATHURROHMAN, AMD.KEP
1 GDA STIK Rp 5,000.00 1
7 BPJS EKG/ECG Rp 25,000.00 1
12 BPJS EKG/ECG Rp 25,000.00 1
13 JASA EKG/ECG Rp 25,000.00 1
15 HEATCHING 1-5 Rp 30,000.00 1
16 RAWAT LUKA SEDANG Rp 35,000.00 1
21 BPJS RAWAT LUKA RINGAN Rp 10,000.00 1
TOTAL
DEVITA SINGGIH R, S.KEP.NS
1 GDA STIK Rp 5,000 1
3 NEBULIZER Rp 10,000 1
15 EKG/ECG Rp 25,000 1
17 RAWAT JENASAH Rp 50,000 1
21 RAWAT JENASAH Rp 50,000 1
22 HEATCHING 1-5 Rp 30,000 1
23 HEACTCHING (PENAMBAHAN >5) Rp 5,000 5
24 RAWAT LUKA RINGAN Rp 20,000 1
25 HEATCHING 1-5 Rp 30,000 1
26 HEACTCHING (PENAMBAHAN >5) Rp 5,000 3
TOTAL
dr. BUDIONO
1 VISITE DOKTER VIP Rp 100,000.0 1
2 BPJS VISITE DOKTER Rp 10,000.0 1
12 VISITE DOKTER KLS II & UGD Rp 60,000.0 1
22 VISITE DOKTER KELAS 1 Rp 75,000.0 1
35 PASIEN UMUM RJ Rp 35,000.0 1
41 PASIEN BPJS RJ Rp 4,000.0 1
TOTAL
dr. FAHMI
TOTAL
dr. IVAN
TOTAL
dr. KUKUH HADI TRI WIBOWO
TOTAL
dr. MOHAMMAD HISYAM RIFQI
694 BEDAH MINOR NERVUS Rp 150,000.00 1
TOTAL
dr. YEDI
1 VISITE DOKTER VIP 100000 1
TOTAL
dr.TIWI
TOTAL
Drg. RUDI
2 PERIKSA GIGI Rp 15,000.00 1
4 SKALING PER RAHANG 1 RA/RB Rp 100,000.00 1
7 PENCABUTAN GIGI TETAP Rp 100,000.00 1
24 BPJS KONSELING Rp 7,000.00 1
26 KONSELING GIGI Rp 25,000.00 1
28 PENCABUTAN GIGI SUSU CHLORETIL Rp 50,000.00 1
30 BPJS KONSELING Rp 7,000.00 1
32 PENCABUTAN GIGI SUSU CITOJECT Rp 75,000.00 1
49 PENCABUTAN GIGI SUSU CHLORETIL Rp 50,000.00 1
TOTAL
Drg. YANI
1 PASIEN BPJS RJ 4000 1
TOTAL
EVI KOMALASARI, AMD.KEP
6 EKG/ECG Rp 25,000.00 1
8 EKG/ECG Rp 25,000.00 1
21 GDA STIK Rp 5,000.00 1
22 EKG/ECG Rp 25,000.00 1
27 GDA STIK Rp 5,000.00 1
28 GDA STIK Rp 5,000.00 1
29 GDA STIK Rp 5,000.00 1
39 GDA STIK Rp 5,000.00 1
40 GDA STIK Rp 5,000.00 1
TOTAL
FAKHRUSY SYAKIRIN, S.KEP.NS
2 NEBULIZER 10000 1
3 RAWAT LUKA RINGAN 20000 2
4 PELEPASAN INFUS DEWASA 10000 1
5 NEBULIZER 10000 1
9 NEBULIZER 10000 1
10 NEBULIZER 10000 1
15 PELEPASAN KATETER 15000 1
17 PEMASANGAN KATETER 15000 1
19 BPJS JASA PERAWAT RUANGAN 10000 1
20 BPJS JASA PERAWAT RUANGAN 10000 1
22 HEATCHING 1-5 30000 1
23 HEACTCHING (PENAMBAHAN >5) 5000 7
26 RAWAT LUKA SEDANG 35000 1
TOTAL
GUNAWAN PRASETYO, S.KEP.NS
1 GDA STIK Rp 5,000.00 1
7 EKG/ECG Rp 25,000.00 1
38 BPJS JASA PERAWAT RUANGAN Rp 10,000.00 1
41 GDA STIK Rp 5,000.00 1
TOTAL
HANY INDAH LESTARI, A.MD.KEB
1 JASA BIDAN ANC RANAP Rp 15,000.00 1
2 ANC RANAP Rp 20,000.00 1
3 ANC RANAP Rp 20,000.00 1
5 VT RANAP Rp 15,000.00 1
6 JASA BIDAN VT RANAP Rp 10,000.00 1
10 KB SUNTIK 1 BULAN CYCLO/ANDALAN Rp 7,500.00 1
12 JASA BIDAN BPJS KAPITASI ANC BIDAN Rp 2,000.00 1
13 JASA BIDAN PELEPASAN IMPLAN Rp 40,000.00 1
14 BAYI SEHAT (KN) Rp 20,000.00 1
15 JASA BIDAN BAYI SEHAT (KN) Rp 15,000.00 1
16 JASA BIDAN PNC BIDAN Rp 15,000.00 1
19 JASA BIDAN KONSELING Rp 10,000.00 1
20 KONSELING BKIA Rp 15,000.00 1
22 BPJS NON KAPITASI PELEPASAN IMPLAN Rp 40,000.00 1
23 JASA BIDAN BPJS NON KAPITASI PELEPASAN IMPLAN Rp 39,000.00 1
24 ANC BIDAN Rp 20,000.00 1
26 JASA BIDAN PEMASANGAN IUD Rp 40,000.00 1
31 BPJS NON KAPITASI PELEPASAN IMPLAN Rp 40,000.00 1
32 JASA BIDAN BPJS NON KAPITASI PELEPASAN IMPLAN Rp 39,000.00 1
TOTAL
IFA MARIA ULFA, AMD.KEB
3 BPJS PERTOLONGAN PERSALINAN NORMAL Rp 300,000.00 1
4 BPJS HEACTING DERAJAT 1 Rp 50,000.00 1
5 JASA BIDAN VT RALAN Rp 10,000.00 1
6 VT RALAN Rp 15,000.00 1
15 GDA STIK Rp 5,000.00 1
TOTAL
IRFAN FIRMANSYAH, S.KEP.NS
6 GDA STIK Rp 5,000.00 2
24 GDA STIK Rp 5,000.00 1
25 GDA STIK Rp 5,000.00 1
TOTAL
JULITA SARI P, AMD.KEB
1 ANC RANAP Rp 20,000.00 1
6 ANC RANAP Rp 20,000.00 1
TOTAL
LENNY LESTI DIRGANTARI, S.ST
TOTAL
M. ALAM KUSUMA ATMAJA,S.KEP.NS
3 GDA STIK Rp 5,000.00 1
25 RAWAT JENASAH Rp 50,000.00 1
28 GDA STIK Rp 5,000.00 1
TOTAL
MEIKE JUWITA SARI, STR.KEB
3 ANC RANAP Rp 20,000.00 1
8 KB SUNTIK 3 BULAN ANDALAN Rp 8,300.00 1
TOTAL
NUR IMAMAH, A.MD.KEB
2 BPJS PERAWATAN BAYI BARU LAHIR NORMAL Rp 50,000.00 1
3 BPJS PERTOLONGAN PERSALINAN NORMAL Rp 300,000.00 1
TOTAL
O2
4 BPJS PEMAKAIAN OKSIGEN NASAL Rp 2,500.00 1
5 BPJS PEMAKAIAN OKSIGEN KURANG DARI 500 LITER Rp 30,000.00 1
TOTAL
PERAWAT RANAP
1 JASA PERAWAT RUANGAN KELAS 1 Rp 75,000.0 1
9 JASA PERAWAT RUANGAN KELAS VIP Rp 75,000.0 1
21 JASA PERAWAT RUANGAN KELAS II & UGD Rp 50,000.0 1
TOTAL
PERAWAT UGD
1 JASA PERAWAT UGD Rp 75,000.00 1
TOTAL
SANEX FEBRIAN, AMD.KEP
3 GDA STIK Rp 5,000.00 1
4 GDA STIK Rp 5,000.00 1
10 GDA STIK Rp 5,000.00 1
11 GDA STIK Rp 5,000.00 1
20 JASA EKG/ECG Rp 25,000.00 1
23 RAWAT LUKA SEDANG Rp 35,000.00 1
TOTAL
SITI MAISYAROH, AMD.KEP
9 GDA STIK Rp 5,000.00 1
17 GDA STIK Rp 5,000.00 1
33 GDA STIK Rp 5,000.00 1
43 GDA STIK Rp 5,000.00 1
TOTAL
SULISTYANINGSIH, AMD.KEB
3 OBSERVASI PERSALINAN Rp 60,000.00 1
4 GDA STIK Rp 5,000.00 1
5 JASA OBSERVASI PERSALINAN Rp 40,000.00 1
6 GDA STIK Rp 5,000.00 1
7 JASA PEMASANGAN INFUS PERSALINAN Rp 10,000.00 1
16 GDA STIK Rp 5,000.00 1
18 KB SUNTIK 3 BULAN ANDALAN Rp 8,300.00 1
60 GDA STIK Rp 5,000.00 1
61 GDA STIK Rp 5,000.00 1
65 GDA STIK Rp 5,000.00 1
66 GDA STIK Rp 5,000.00 1
TER / FEE MEDIS
DOKTER ALL
Total Jasa Nama Pasien
Rp 5,000.00 SUNARSIH / B IM
Rp 15,000.00 ABDUR ROHMAN
Rp 10,000.00 JAUHAROTUL MAKIYAH
Rp 10,000.00 SUNAMI / B. TIN
Rp 10,000.00 KIANA TALISHA SHEENAZ ARIFIN
Rp 10,000.00 MARYATI
Rp 10,000.00 INDANI AINUN FAJRIA
Rp 10,000.00 HANIAH
Rp 10,000.00 AHMAD FATAH ALJABBARUL ILHAM
Rp 10,000.00 LATIFA
Rp 10,000.00 MADINATUS SAYYIDAH
Rp 10,000.00 MUHAMMAD ABIM BERDIAN
Rp 10,000.00 MUHAMMAD SYAHRUL HUDA
Rp 10,000.00 MAT KADIR
Rp 10,000.00 MUHAMMAD NIZAM FAKHRIL ARIF
Rp 10,000.00 MUHAMMAD MALKA AL KAHFI
Rp 10,000.00 AZIZAH / ASIZEH
Rp 10,000.00 AHMAD IZUL ISLAM
Rp 10,000.00 ANA NUR LAILA LATIFAH
Rp 10,000.00 SAMINA / BUK FITRI
Rp 20,000.00 HOSZAIMAH
Rp 10,000.00 PRAYOGI SURYA RAMADHAN
Rp 10,000.00 AHMAD BAIRI
Rp 10,000.00 SAMI / HJ. ABDUL HADI
Rp 10,000.00 SITI NURAINI
Rp 10,000.00 AHMAD RIDHO ARMANDO
Rp 10,000.00 ALEEYA NUR RAMADINA PUTRI
Rp 10,000.00 AHMAD ZIYAD ZIDQIL
Rp 10,000.00 MATRAJI
Rp 20,000.00 MUHENA
Rp 10,000.00 MAIMUNA
Rp 10,000.00 HAMDAN HAKIKI
Rp 10,000.00 SAHARUDIN
Rp 10,000.00 RESTU ALIF FIRMANSYAH
Rp 5,000.00 ZAINULLAH
Rp 5,000.00 LAJI / PAK MUKHLIS
Rp 10,000.00 MUSLIHANI
Rp 10,000.00 ALFI KAMILA RAMADHANI DARMAWAN
Rp 25,000.00 MUHAMMAD BALUQIA ARKA
Rp 10,000.00 AULIYA RAMADHANI
Rp 10,000.00 IDEH / B. SU
Rp 10,000.00 YULIANA SETIA PUTRI
Rp 10,000.00 ARSO
Rp 10,000.00 RANIA RAHMEDIA RUMAISYAH
Rp 10,000.00 FATAN BUSYRA SYAHREZA
Rp 10,000.00 WAHYUDI
Rp 10,000.00 EKA WAHYU NOVI ANTINI
Rp 10,000.00 HUMAIRA ALIFA NAJMA ALFATUNNISA
Rp 10,000.00 PAENA / IBU SU
Rp 10,000.00 ABU ASAN
Rp 10,000.00 MUHAMMAD AQHAR FIDANISA
Rp 10,000.00 PA
Rp 10,000.00 MOHAMMAD MIRZA AL-FARIZI
Rp 10,000.00 LIA AGUSTIN
Rp 10,000.00 NIZAR MUSTAKFIRI ASROR
Rp 5,000.00 SAHRIYAH / IBU MUHYIT
Rp 10,000.00 LAILI HIDAYAH
Rp 10,000.00 IFTAH SALSABILA
Rp 10,000.00 IBROHIM
Rp 10,000.00 ASIFA NAURATUL HASANAH
Rp 10,000.00 DAFIT ANDIKA
Rp 10,000.00 NIBA / IBU NADI
Rp 10,000.00 AHMAT HORI
Rp 25,000.00 AHMAD NAZRIL ALFAREZI
Rp 10,000.00 JAUSIRIYANTO
Rp 10,000.00 DJUMARI
Rp 10,000.00 RUDI HARTONO
Rp 850,000.00
Rp 10,000.00 MAÙN
Rp 10,000.00 MAÙN
Rp 10,000.00 REYNAN RAJENDRA HANDIKA
Rp 10,000.00 LATIFA
Rp 10,000.00 AHMAD ARIS RAMADHAN
Rp 10,000.00 ALFIYATUL HASANAH
Rp 10,000.00 JUNAIDI
Rp 10,000.00 BADRUL ULUM / P. AGA
Rp 10,000.00 HALIMATUS SA`DIYAH
Rp 10,000.00 ENTIN KUSTINI
Rp 10,000.00 TUNGGASWATI
Rp 5,000.00 MUHENA
Rp 10,000.00 MUHENA
Rp 10,000.00 PAÌ / P YUL
Rp 10,000.00 MOH FIKRI
Rp 10,000.00 SARMANI
Rp 10,000.00 MUSTIRAH / BU MUS
Rp 10,000.00 TUTIK SITI ROHMAH
Rp 10,000.00 MARDI
Rp 10,000.00 GALIH RAMADHAN MUBAROK
Rp 10,000.00 MOH RIFKI HASAN
Rp 10,000.00 MUHAMMAD DIRGA ALKANTARA
Rp 10,000.00 ELDINAR SHAKIRA
580000
Rp 45,000.00 HANIAH
Rp 45,000.00 HOLIFATUL HASANAH
Rp 45,000.00 SUNARTO
Rp 45,000.00 NURSASI
Rp 45,000.00 MUHAMMAD BAKIR
Rp 45,000.00 AMARI
Rp 45,000.00 AMARI
Rp 45,000.00 UMAR FARIKI
Rp 45,000.00 ADELIA FITRI
Rp 45,000.00 ALIFIA CAHYANI
Rp 45,000.00 ALI AKBAR HASYIMI
Rp 45,000.00 RAKA TAMA
Rp 45,000.00 DIA AINUN NISA
Rp 45,000.00 SAMSUL ARIFIN
Rp 45,000.00 TRIANA RAHMADANI
Rp 45,000.00 RETNO AYU NINGTIAS
Rp 45,000.00 SYAROFAH NELLI AGUSTINA
Rp 45,000.00 RIYA FANDU WINATA
Rp 45,000.00 MUS / P HENI
Rp 45,000.00 AIRIN MAUFIROH
Rp 45,000.00 NIWI
Rp 45,000.00 NIWI
Rp 45,000.00 NIWI
Rp 45,000.00 NURUL HASANAH
Rp 45,000.00 ILMIATI
Rp 45,000.00 MUHAMMAD NAFLI
Rp 45,000.00 ARBIAN MAULANA YUSUF
Rp 45,000.00 ANA NAJMA ZAHIRA
Rp 45,000.00 JUMAATI
Rp 45,000.00 ALLAYA ZILAILI HAFIZA
Rp 45,000.00 EVANANI ZEHIROH
Rp 45,000.00 KUSDIANTO
Rp 45,000.00 JUPRI
Rp 45,000.00 JUPRI
Rp 45,000.00 MAISUNA / BU HALIL
Rp 45,000.00 KHANZA ANINDIA SYAHROTUL AINI
Rp 45,000.00 BUNAMA/B.MUR
Rp 45,000.00 NOFITA AYU CANDRA
Rp 45,000.00 IFAN FAUZI
Rp 45,000.00 IMAM WAHDI
Rp 45,000.00 FIKRI RAMADHANI
Rp 45,000.00 MUHENA
Rp 45,000.00 MUHENA
Rp 45,000.00 MUHENA
Rp 15,000.00 MUHENA
Rp 15,000.00 MUHENA
Rp 45,000.00 MUHENA
Rp 15,000.00 MUHENA
Rp 45,000.00 MUHENA
Rp 15,000.00 MUHENA
Rp 45,000.00 MUSLIHATI
Rp 45,000.00 RIDWAN / BAPAK NAFISA
Rp 45,000.00 MASNIA JULITA SARI
Rp 45,000.00 AHMADIYEK / AHMAD DIYAK / BAPAK EP
Rp 45,000.00 YUS SUDARSO
Rp 45,000.00 PUTRI SYIFA BILUNA
Rp 45,000.00 AYIB FARIDA
Rp 45,000.00 NAYLA SALSABILA AZZAHRA
Rp 45,000.00 SRIYANI
Rp 45,000.00 PAÌ / P YUL
Rp 45,000.00 PAÌ / P YUL
Rp 15,000.00 PAÌ / P YUL
Rp 45,000.00 PAÌ / P YUL
Rp 15,000.00 PAÌ / P YUL
Rp 45,000.00 PAÌ / P YUL
Rp 15,000.00 PAÌ / P YUL
Rp 45,000.00 KARISMA
Rp 45,000.00 RAKESYA CAMILIA PUTRI
Rp 45,000.00 NIKMATUN / BU HER
Rp 45,000.00 NY. IIM IKA N
Rp 45,000.00 NISFI AMALIA. N
Rp 45,000.00 IDEH / B. SU
Rp 45,000.00 IDEH / B. SU
Rp 45,000.00 IDEH / B. SU
Rp 45,000.00 IDEH / B. SU
Rp 45,000.00 IDEH / B. SU
Rp 45,000.00 IDEH / B. SU
Rp 45,000.00 ARSO
Rp 45,000.00 ARSO
Rp 45,000.00 ARSO
Rp 45,000.00 ARSO
Rp 45,000.00 JUHAIRIA / B IN
Rp 45,000.00 YUSUF
Rp 45,000.00 YUSUF
Rp 45,000.00 YUSUF
Rp 45,000.00 M. RIJALUDDIN
Rp 45,000.00 MULAGI
Rp 45,000.00 MULAGI
Rp 45,000.00 MULAGI
Rp 45,000.00 MULAGI
Rp 45,000.00 MARDI
Rp 45,000.00 MARDI
Rp 45,000.00 MARDI
Rp 45,000.00 SURYATI
Rp 45,000.00 EVI KOMALASARI
Rp 45,000.00 SITI FATIMATUS ZAHRA
Rp 45,000.00 JALAL / PAK SULFA
Rp 45,000.00 MELISA ISTIANA
Rp 45,000.00 MISNADI
Rp 45,000.00 AHMADUN / P INDRA
Rp 45,000.00 SAMSUL
Rp 45,000.00 SAMSUL
Rp 45,000.00 SAMSUL
Rp 45,000.00 SAMSUL
Rp 45,000.00 SAMSUL
Rp 45,000.00 SAMSUL
Rp 45,000.00 SINTA DWI PUTRI
Rp 45,000.00 ARSO
Rp 45,000.00 ARSO
Rp 45,000.00 ARSO
Rp 45,000.00 ARSO
Rp 45,000.00 ARSO
Rp 45,000.00 KHOFIFAH NURUL WAHWUNI
Rp 45,000.00 ASYATI
Rp 15,000.00 ASYATI
Rp 45,000.00 ASYATI
Rp 15,000.00 ASYATI
Rp 45,000.00 ASYATI
Rp 45,000.00 ASYATI
Rp 15,000.00 ASYATI
Rp 45,000.00 MAT ROSI
Rp 45,000.00 MARWATI
Rp 45,000.00 ABD MUKIT
Rp 45,000.00 ARUMI MAULIDA ATMAJA
Rp 45,000.00 SITI AMINAH
Rp 45,000.00 RAHMAT HIDAYATULLAH SABIQUL FADLI
Rp 45,000.00 HALIMA / IBU YOGA
Rp 45,000.00 PA
Rp 45,000.00 PA
Rp 45,000.00 PA
Rp 45,000.00 SAIFUL
Rp 45,000.00 SAIFUL
Rp 45,000.00 SAIFUL
Rp 45,000.00 CHAISYA PUTRI FIRMANSYAH
Rp 45,000.00 AISYAH NUR KAMILA
Rp 45,000.00 ZAINUDIN
Rp 45,000.00 SATIJE / BU MUARIS
Rp 45,000.00 LINDA ALITA WULANDARI
Rp 45,000.00 HENDRIK BACHTIAR
Rp 45,000.00 ALVIN MAULANA HAMZAH
Rp 45,000.00 SYAILA AINUR SAFANA
Rp 45,000.00 HERMANTO
Rp 45,000.00 SITI FATIMAZ ZAHROTUL ALIYAH
Rp 45,000.00 INDAH FARHATIN
Rp 45,000.00 SUTIYANI
Rp 45,000.00 SUNARYA
Rp 45,000.00 INDAY YATI
Rp 45,000.00 SUDIYANTO H FAISOL
Rp 45,000.00 SUHAIRIYA
Rp 45,000.00 MAULANA RAIKA ZAHRA
Rp 45,000.00 TOSAN
Rp 45,000.00 TOSAN
Rp 45,000.00 TOSAN
Rp 45,000.00 TOSAN
Rp 45,000.00 TOSAN
Rp 45,000.00 TOSAN
Rp 45,000.00 SELIN AULIA
Rp 45,000.00 ASRI
Rp 15,000.00 ASRI
Rp 45,000.00 ASRI
Rp 15,000.00 ASRI
Rp 45,000.00 HOZZAIMAH
Rp 45,000.00 ANANDA SHERIN AZKAYRA
Rp 45,000.00 ALFINO
Rp 45,000.00 ALFINO
Rp 45,000.00 ALFINO
Rp 45,000.00 ALFINO
Rp 45,000.00 ALFINO
Rp 45,000.00 NISMA / B. SUPAR
Rp 45,000.00 ABDUL AZIZ / BAPAK YUL
Rp 45,000.00 TONI / IBU TIK
Rp 45,000.00 KURNIAWAN BUDI SANTOSO
Rp 31,545,000.00
Rp 5,000.00 SANAN
Rp 10,000.00 NOVILATUL LAILA
Rp 10,000.00 DEVI FERNANDA
Rp 10,000.00 LATIFA
Rp 10,000.00 LATIFA
Rp 10,000.00 AMARI
Rp 10,000.00 MUHENA
Rp 10,000.00 MUHENA
Rp 10,000.00 MUHENA
Rp 10,000.00 MUHENA
Rp 5,000.00 MAIMUNA
Rp 10,000.00 YUSUF
Rp 10,000.00 SAMSUL
Rp 10,000.00 ASRI
Rp 20,000.00 JENIS SRI AYU
Rp 5,000.00 SANA
Rp 5,000.00 SUKATMIATIN
Rp 5,000.00 BADRIYA
Rp 605,000.00
Rp 50,000.00 JUMIATI
Rp 10,000.00 LATIFA
Rp 10,000.00 LATIFA
Rp 10,000.00 LATIFA
Rp 10,000.00 LATIFA
Rp 10,000.00 LATIFA
Rp 10,000.00 LATIFA
Rp 10,000.00 LATIFA
Rp 10,000.00 AMARI
Rp 5,000.00 MUHENA
Rp 5,000.00 MUHENA
Rp 5,000.00 MUHENA
Rp 10,000.00 MUHENA
Rp 5,000.00 MUHENA
Rp 10,000.00 MUHENA
Rp 5,000.00 MUHENA
Rp 10,000.00 MUHENA
Rp 10,000.00 MUHENA
Rp 5,000.00 MUHENA
Rp 10,000.00 MUHENA
Rp 10,000.00 MUHENA
Rp 5,000.00 MAIMUNA
Rp 5,000.00 PAÌ / P YUL
Rp 10,000.00 YUSUF
Rp 10,000.00 YUSUF
Rp 10,000.00 YUSUF
Rp 10,000.00 YUSUF
Rp 10,000.00 YUSUF
Rp 5,000.00 MULAGI
Rp 10,000.00 TOSAN
Rp 5,000.00 MISKATI / HJ. AISYAH
Rp 5,000.00 MARYATI
Rp 25,000.00 SLAMET / PAK SELA
Rp 10,000.00 MUHAMMAD ZIDEN
Rp 10,000.00 SITI ARMELIA KHAIRUNNISA
Rp 10,000.00 MUHAMMAD HAIDARUL IKBAR
Rp 10,000.00 MASI / B. SINAP
Rp 5,000.00 SEI
Rp 5,000.00 ZAHROTUL KAMILAH
Rp 10,000.00 ASAN
Rp 10,000.00 SIA
Rp 10,000.00 SIA
Rp 10,000.00 AULIA NUR ZAHRA
Rp 10,000.00 MOH ALIFUL MAKLUF
Rp 10,000.00 HALIMA
Rp 5,000.00 SANA
Rp 10,000.00 DULAMI
Rp 10,000.00 SITI NAILATUL ROHMAH
Rp 10,000.00 MUHAMMAD AL FAHRI
Rp 5,000.00 BADRIYA
Rp 10,000.00 ABDUR ROHIM
Rp 10,000.00 MISRAN
Rp 2,520,000.00
Rp 20,000 TRIANA RAHMADANI

Rp 15,000 TRIANA RAHMADANI
Rp 5,000 PAIJEM
Rp 7,500 PAIJEM
Rp 47,500

Rp 5,000.00 BUYATI
Rp 5,000.00 BUYATI
Rp 5,000.00 AHMAD GUNAWAR
Rp 20,000.00 MUHAMMAD IMRON
Rp 15,000.00 AHMAD / HAJI AHMAD
Rp 5,000.00 H. ALPAN
Rp 5,000.00 SHOLEHA
Rp 10,000.00 SUNARMI
Rp 10,000.00 HARBABUN / HAJI ABDUL HADI
Rp 5,000.00 SUDARMADI HASAN
Rp 5,000.00 ATMANI
Rp 5,000.00 TOREJO
Rp 10,000.00 ABRIZAM FATAN A.
Rp 10,000.00 SUTIJA / HAJJAH LATIFA
Rp 15,000.00 SUMAR / BAPAK SAIFUL
Rp 10,000.00 SUYANI / IBU LUT
Rp 150,000.00

Rp 1,000.00 NAILUL HIDAYATUL FITRI
Rp 5,000.00 MAISYATUL MUNAWAROH
Rp 5,000.00 SULISTIYOWATI
Rp 122,000.00
Rp 20,000.00 NOVIALIS ANGGRAINI

Rp 80,000.00 SUÀIBAH
Rp 10,000.00 DEVI HIDAYATULLAH
Rp 10,000.00 INDRI VERALIAWATI
Rp 9,000.00 MISWATI NINGSIH
Rp 5,000.00 MISWATI NINGSIH
Rp 1,778,000.00
Rp 10,000.00 YUSUF
Rp 25,000.00 MARDI
Rp 10,000.00 ALIFAH ELSAFA
Rp 20,000.00 REYFALDI ARDIANSYAH
Rp 10,000.00 ADAM
Rp 15,000.00 AMSIH/ P SUTIK
Rp 515,000.00
Rp 5,000.00 MUHENA
Rp 5,000.00 PAÌ / P YUL
Rp 5,000.00 MULAGI
Rp 5,000.00 INA / IBU BUYAMI
Rp 25,000.00 SUNARDI
Rp 10,000.00 ASAN
Rp 50,000.00 MAULANA MALIK IBRAHIM
Rp 30,000.00 SAHUR
Rp 25,000.00 SAHUR
Rp 20,000.00 SAHUR
Rp 30,000.00 ABDUL AZIS
Rp 10,000.00 MISRAN
Rp 535,000.00
Rp 100,000.00 MUHAMMAD FADIL BAHTIAR

Rp 10,000.00 NIWI
Rp 10,000.00 JUPRI
Rp 10,000.00 JUPRI
Rp 100,000.00 PAÌ / P YUL
Rp 10,000.00 SAIFUL
Rp 30,000.00 SELAMET RIYADI
Rp 30,000.00 MUHAMMAD IRFANI
Rp 30,000.00 RAMILA
Rp 30,000.00 TURYATI/ BU SELFI
Rp 30,000.00 SITI AMINAH/B.HJ.HAMINA
Rp 30,000.00 LILIS PUTRI NOVIA SARI
Rp 3,000.00 JUHRIYAH
Rp 3,000.00 KUSYADI
Rp 3,000.00 LUTFI / BAPAK WAFIQ
Rp 30,000.00 AZLAN SAUQILLAH SUWOTO
Rp 30,000.00 ASMA/ PAK SIPUL
Rp 30,000.00 NABILA IZZA AFKARINA
Rp 3,000.00 AININDA ZELDA
Rp 30,000.00 MUARIP
Rp 3,000.00 SULISTYANINGSIH
Rp 3,000.00 MUHAMMAD ZAIDAN EL HAFIZH
Rp 30,000.00 MISKADI
Rp 30,000.00 LATIFATUL JANNAH
Rp 3,000.00 EKA CINTIYA FEBRIANTI
Rp 30,000.00 MUHAMMAD HAFIDI
Rp 30,000.00 FATIMA
Rp 30,000.00 INTAN KURNIA FEBRIANTI
Rp 30,000.00 SUGIANTO
Rp 30,000.00 NAURA RAMADHANI
Rp 30,000.00 HJ. NURYATI/NURYATI
Rp 30,000.00 ASAN
Rp 30,000.00 SHELIN
Rp 30,000.00 HAFIZH ZAKI MUBAROK
Rp 3,000.00 DEVITA SINGGIH RAHAJENG
Rp 3,000.00 MUANI
Rp 3,000.00 DIDIK NOR HADI
Rp 3,000.00 PAIDA
Rp 3,000.00 MUHAMMAD ISBAT GAUTAMA
Rp 30,000.00 MAMLUATUL HASANAH
Rp 30,000.00 MUHAMMAD FAHREZI
Rp 30,000.00 HAFIZH ZAKI MUBAROK
Rp 3,000.00 MUHAMMAD FEBIAN GAUTAMA
Rp 30,000.00 PAÌ / P YUL
Rp 30,000.00 JENIS SRI AYU
Rp 30,000.00 HALIMA
Rp 30,000.00 BERYL HAMIZAN KASYAFANI
Rp 30,000.00 HASAN
Rp 3,000.00 ZAINAL ARIFIN
Rp 3,000.00 SUMINA
Rp 30,000.00 ATI / BU TOHANI
Rp 30,000.00 SALMAN / P. YUNI
Rp 3,000.00 MUHAMMAD AUFA RAMADHANI
Rp 3,000.00 HAVID
Rp 3,000.00 MOHAMMAD ADAM IZZ RAYYAN
Rp 3,000.00 JULITA SARI P
Rp 3,000.00 AHMAD SYAMSUL ARIFIN
Rp 3,000.00 NAINI
Rp 30,000.00 SUTIK / B.HIKMAH
Rp 30,000.00 TOHARI/ P TOTOK
Rp 30,000.00 HILMAN GABRIEL ABDILAH
Rp 3,000.00 SANA
Rp 3,000.00 SUKIMAN/P.LIN
Rp 3,000.00 ENI MARDIANA
Rp 3,000.00 SUCIPTO
Rp 3,000.00 LADY VIRGINA JASMIN
Rp 3,000.00 AFDIAR ROSIQI PRABAWANA
Rp 30,000.00 MUHAMMAD KANZI
Rp 3,000.00 MISBAH
Rp 30,000.00 AHDAN RAKA
Rp 30,000.00 MUHAMMAD ADAM RAMADAN
Rp 30,000.00 MUHAMMAD FAIZZAQI
Rp 30,000.00 SYARIF HIDAYAT
Rp 30,000.00 INDAH AYU PRATIWI
Rp 30,000.00 MUYATI
Rp 30,000.00 SUTIRA / B. MASKURI
Rp 3,000.00 MOCH. GIBRAN RAZIQ AR -RIDWAN
Rp 3,000.00 KEISYA NAFISAH AR. R
Rp 3,000.00 LILIS SUSILOWATI
Rp 3,000.00 JUMARIYA
Rp 3,000.00 MARHAWI
Rp 3,000.00 MAULANA ALVARO RISQI
Rp 30,000.00 SAHNAN
Rp 30,000.00 FARIDATUL HASANAH
Rp 30,000.00 ERFAATIN
Rp 30,000.00 ASIA / B. TILA
Rp 30,000.00 BADRIYA
Rp 30,000.00 IMROÀTUL HASANAH
Rp 3,000.00 BAGAS KAFFA AZ ZIKRI
Rp 3,000.00 IMRON HIDAYAT
Rp 3,000.00 ZEINIYAH / B. HOS
Rp 3,000.00 SUKUR
Rp 3,000.00 GUNAWAN PRASETYO
Rp 30,000.00 HENDRA FARIADI
Rp 3,115,000.00
Rp 75,000.00 AFGATHA ZAHY PRANATA

Rp 100,000.00 AINIATUL JANNAH
Rp 10,000.00 JUPRI
Rp 75,000.00 MUHENA
Rp 10,000.00 IDEH / B. SU
Rp 10,000.00 ARSO
Rp 10,000.00 SAMSUL
Rp 10,000.00 ARSO
Rp 10,000.00 PA
Rp 10,000.00 SAIFUL
Rp 30,000.00 ANANDA CECE AZRILA
Rp 3,000.00 TN. DIN /P. HORI
Rp 30,000.00 YUSRA AINUN MAHYA
Rp 30,000.00 HATIPA / BU DI
Rp 2,458,000.00

Rp 100,000.00 ZAHROTUL FIKRI ANNABILA
Rp 10,000.00 HANIAH
Rp 10,000.00 HANIAH
Rp 30,000.00 HJ. SUJUD
Rp 30,000.00 GIUNIA LAVANYA KANEISHIA
Rp 30,000.00 EKA BUDI PRASETIA
Rp 30,000.00 MISNU
Rp 30,000.00 BUNASIR
Rp 30,000.00 BAWON RAHARTO
Rp 3,000.00 LULUK FITRIANI
Rp 3,000.00 NAFISATUL MUHIMMAH
Rp 3,000.00 KHAIRINA SELVIA ANGGRAINI
Rp 3,000.00 ACHAMD ASRORI
Rp 3,000.00 ROMLA
Rp 3,000.00 RAKA FEBRIAN PUTRA
Rp 3,000.00 MARIA ULFA
Rp 3,000.00 URIFAH
Rp 3,000.00 ARSITA
Rp 3,000.00 ACH JUNAIDI NOER
Rp 3,000.00 WIYANT0 / P, FIKA
Rp 30,000.00 ADIMAS WAHYU MAULANA
Rp 10,000.00 JA`FAR
Rp 30,000.00 INDAH AYU PRATIWI
Rp 30,000.00 AZKYA KAYLA ALMARA
Rp 30,000.00 MUHAMMAD IRFANI
Rp 30,000.00 TUPA / B. NURUL
Rp 30,000.00 KURDI
Rp 30,000.00 ABDULLAH HANIF
Rp 3,000.00 JUPRI
Rp 30,000.00 ELSA SAFIKA AULIA
Rp 30,000.00 HABIBAH
Rp 30,000.00 NAJWA AL QOMARIAH
Rp 30,000.00 ASALINA AZZAHRA RAIKA
Rp 30,000.00 KASYATI
Rp 30,000.00 DESI AMELIA PUTRI
Rp 30,000.00 ADELIA SYARIF KOMALA HIDAYAH
Rp 30,000.00 ANISAH ISMATUL ALIYAH
Rp 30,000.00 MUSLIHATIN
Rp 30,000.00 MISKADI
Rp 30,000.00 MURBIATI / BUK DUL AZIS
Rp 30,000.00 SUDIYEH
Rp 30,000.00 KAINDRA BAHTIAR PANDU WIJAYA
Rp 30,000.00 ABDUL HADI
Rp 30,000.00 MAWARDI
Rp 30,000.00 SEI
Rp 30,000.00 YUNI ARLISATIANI
Rp 30,000.00 SUMARDI
Rp 30,000.00 SAFARA MAULIDIA SALAMAH
Rp 30,000.00 MUHAMMAD TALUM
Rp 30,000.00 ARYATI/ B MUNIB
Rp 30,000.00 FATIMAH SYAKILA KAIRINA
Rp 30,000.00 NAYLA AZ-ZAHRO SALSABILA
Rp 30,000.00 ZAHRA FADILA MUMTAZA
Rp 3,000.00 ARYA NOFAIS PRATAMA
Rp 3,000.00 HERI SUPARMAN
Rp 3,000.00 SITI NURJANNAH
Rp 3,000.00 J. TUKADI
Rp 3,000.00 KINA AH
Rp 3,000.00 HADI SUSANTO
Rp 30,000.00 ASMARO
Rp 30,000.00 AISYAH RABIATUL HUSNI
Rp 30,000.00 EFENDI PRADANA
Rp 3,000.00 AZKHANA AINUN MAHYA
Rp 3,000.00 DIDIK NOR HADI
Rp 30,000.00 BELQESYA AZZAHRA KHUMAIRA
Rp 30,000.00 SITTI ROHAYU / IBU MIKI
Rp 3,000.00 WAQIATUL HASANAH
Rp 3,000.00 A ZULKARNAIN ALI
Rp 30,000.00 SUWARDI / BAPAK UNIK
Rp 3,000.00 AHMAD AFIN
Rp 2,727,000.00
Rp 60,000.00 SANAN
Rp 100,000.00 WARDAH DZULQOIDAH M
Rp 60,000.00 ABRAHAM ABDUL MALIK
Rp 10,000.00 FITRIYATUL HASANAH
Rp 10,000.00 PERI / P. EKA
Rp 10,000.00 PERI / P. EKA
Rp 10,000.00 PERI / P. EKA
Rp 75,000.00 MAÙN
Rp 75,000.00 MAÙN
Rp 75,000.00 MAÙN
Rp 75,000.00 MAÙN
Rp 10,000.00 NANANG HADI SYAIFULLAH
Rp 10,000.00 SITI NUR MUFIDAH NINGTIAS
Rp 60,000.00 TUYAMI
Rp 10,000.00 MOH ROBIT UBAIDILLAH
Rp 10,000.00 IMAM BUHARI
Rp 10,000.00 RISTA SAFIRA
Rp 30,000.00 ALISHA SABYA PUTRI WINDAYU
Rp 100,000.00 AURA ZAHRO
Rp 10,000.00 HANIAH
Rp 10,000.00 HANIAH
Rp 100,000.00 LATIFA
Rp 10,000.00 AMARI
Rp 10,000.00 AMARI
Rp 10,000.00 AMARI
Rp 10,000.00 NIWI
Rp 10,000.00 NIWI
Rp 75,000.00 MUHENA
Rp 75,000.00 MUHENA
Rp 75,000.00 MUHENA
Rp 10,000.00 IDEH / B. SU
Rp 10,000.00 IDEH / B. SU
Rp 10,000.00 IDEH / B. SU
Rp 60,000.00 MULAGI
Rp 60,000.00 MULAGI
Rp 10,000.00 SAMSUL
Rp 10,000.00 SAMSUL
Rp 10,000.00 ARSO
Rp 10,000.00 ASYATI
Rp 10,000.00 PA
Rp 10,000.00 PA
Rp 10,000.00 SAIFUL
Rp 10,000.00 SAIFUL
Rp 10,000.00 SAIFUL
Rp 60,000.00 INA / IBU BUYAMI
Rp 10,000.00 TOSAN
Rp 10,000.00 TOSAN
Rp 10,000.00 TOSAN
Rp 10,000.00 TOSAN
Rp 10,000.00 ALFINO
Rp 10,000.00 ALFINO
Rp 10,000.00 ALFINO
Rp 10,000.00 ALFINO
Rp 30,000.00 SLAMET RIYADI
Rp 30,000.00 MUHAMMAD AL MALIK
Rp 30,000.00 SONI HERMAWAN
Rp 3,000.00 WIDADAH
Rp 3,000.00 SUPARTO
Rp 3,000.00 FITRIA MEGA WULANDARI
Rp 30,000.00 NIHAN / BAPAK SUM
Rp 30,000.00 TAUFIK JOYO SAPUTRO
Rp 3,000.00 BAHASIS
Rp 3,000.00 HENNY SAPARINGGA
Rp 3,000.00 SUPA I / BAPAK EVA
Rp 3,000.00 NAINI
Rp 30,000.00 ONI FITRIYANTI
Rp 30,000.00 MIYATI / IBU LIA
Rp 30,000.00 MAÙN
Rp 30,000.00 SAYATI/ B ATAN
Rp 30,000.00 SITI AISYAH AZZAHRA RASYIDA
Rp 3,000.00 REISYA APRILIA PUTRI
Rp 30,000.00 NGATINEM / B. JUP
Rp 30,000.00 H. ALPAN
Rp 30,000.00 ROHATI
Rp 3,000.00 IIN MAFTUHAH
Rp 3,000.00 SUHARTADI
Rp 30,000.00 YUNITA
Rp 3,000.00 MUHAMMAD WILDAN TSAQIF
Rp 3,000.00 SHOLEHA
Rp 30,000.00 SHANUM IKBAR RUZ ZAMAN
Rp 3,000.00 RAFANDA QALESYA PUTRI EFENDI
Rp 3,000.00 YAYUK PUJI LESTARI
Rp 30,000.00 FEBY FARADILA
Rp 30,000.00 YULIATIK
Rp 3,000.00 MUHSINATIN
Rp 30,000.00 DIMAS FIRDAUZEN
Rp 3,000.00 IFA YULIANTI
Rp 3,000.00 ANDINI RIZQI MELIANA HERMANTO
Rp 3,000.00 HABIYEH
Rp 3,000.00 BADARUDIN
Rp 30,000.00 LINDA YULIATIN
Rp 30,000.00 SUTIYA
Rp 3,000.00 LAVANYA DIYA TAJ RUMI
Rp 3,000.00 MISRAWI / HAJI HOLIK
Rp 30,000.00 AHMAD LUKMAN HADI
Rp 30,000.00 MISYATUN
Rp 30,000.00 ORLIN
Rp 30,000.00 HARBABUN / HAJI ABDUL HADI
Rp 30,000.00 ASEP/PAK SUBAIRI
Rp 30,000.00 MUHAMMAD AFKAR NURDIANSYAH PRADIPTA
Rp 30,000.00 AURELIA PUTRI IZZAHANIFA
Rp 30,000.00 MUHAMMAD ROIS
Rp 30,000.00 FADILATUL HASANAH
Rp 30,000.00 MUHAMMAD ADNAN ZIO SYAHPUTRA
Rp 30,000.00 ZARINA NAVEN TAHERA
Rp 3,000.00 KEVIN MAULANA
Rp 3,000.00 SAYFUL BARI
Rp 3,000.00 MURYAMA
Rp 30,000.00 AHMAD FAWAID
Rp 30,000.00 KHADIJAH HAURA AZKIYA
Rp 30,000.00 ANDI PRAYITNO
Rp 30,000.00 NARMI / IBU JULI
Rp 30,000.00 SUAJI / IBU HAR
Rp 30,000.00 MUSDALIFAH
Rp 30,000.00 IIS UFAYANA
Rp 30,000.00 NUR AININ GHITA SALSABILLA
Rp 30,000.00 SUYANI
Rp 3,000.00 SRI HARTINI
Rp 3,000.00 SUPAIDA
Rp 3,000.00 NORHASANAH
Rp 3,000.00 LILIS SUSILOWATI
Rp 3,000.00 VANESA
Rp 3,000.00 YUNI FIRDAUSI NUZULA
Rp 30,000.00 SAMSUL
Rp 30,000.00 DASUKI / BAPAK HOLIK
Rp 30,000.00 NAURA AGUSTIN
Rp 30,000.00 MUHAMMAD BIMA PRASETYO
Rp 30,000.00 HENDRA FARIADI
Rp 3,000.00 CHIKA PRICILIA PUTRI
Rp 3,000.00 MUHAMMAD AZ ZHAHIR. R
Rp 3,000.00 KEISHA ARSYFA WAFIYAH
Rp 3,000.00 FATIMAH AR RIZQIA ZHAHIRA
Rp 3,000.00 F. MUFED
Rp 3,000.00 F. MUFED
Rp 30,000.00 AINIYATUL KARIMAH
Rp 30,000.00 MAURA SEPTI ANDINI
Rp 30,000.00 MERI ANANDA
Rp 30,000.00 ITA RESITA
Rp 30,000.00 ADIFA ASALINA MAHFIN
Rp 30,000.00 SONY PRATAMA
Rp 30,000.00 TOYAMA
Rp 30,000.00 MAUFIROH
Rp 30,000.00 HARTOKO
Rp 30,000.00 ULFATUS SHOLIHAH
Rp 3,000.00 WIRYANI / IBU ERFAN
Rp 3,000.00 SURAMI
Rp 30,000.00 MOH HEDI
Rp 3,000.00 FITRIA MEGA WULANDARI
Rp 30,000.00 SUMARTI / B. DIAH
Rp 30,000.00 ZAHRA FADILA MUMTAZA
Rp 3,000.00 ATMANI
Rp 30,000.00 BAYU AJI
Rp 30,000.00 ANDINI FAHMA ELIYA ZANNUBA
Rp 30,000.00 SUDARSO
Rp 3,000.00 SUPRIYADI
Rp 30,000.00 ABRIZAM FATAN A.
Rp 30,000.00 KHALID UMAR FATHAN
Rp 30,000.00 CANTIKA DEWI
Rp 30,000.00 SUTOMO
Rp 30,000.00 IMRON ROFIKI
Rp 30,000.00 SAHUR
Rp 3,000.00 LAVANYA DIYA TAJ RUMI
Rp 30,000.00 SAFITRI WULANDARI
Rp 3,000.00 MEIKE JUWITA SARI
Rp 30,000.00 ALEA AGHNIA SALSABILA
Rp 30,000.00 ADAM
Rp 30,000.00 TRILA DEWI ANTIKA
Rp 30,000.00 BOYZEROUN PRABOWO
Rp 30,000.00 NURLAILINDA
Rp 30,000.00 KEISYA NUR AZIZAH
Rp 30,000.00 MISNA
Rp 30,000.00 ELDINAR SHAKIRA
Rp 30,000.00 QIAS AKBAR ALFAWAID
Rp 30,000.00 MUHAMMAD ALI FIKRIANSYAH
Rp 30,000.00 MUHAMMAD SAMRONI
Rp 30,000.00 JUMA A
Rp 30,000.00 NAILUL AMANI
Rp 30,000.00 MUHAMMAD TALUM
Rp 3,000.00 SUTIJA / HAJJAH LATIFA
Rp 30,000.00 RIZHA DANIEL ARVAN
Rp 3,000.00 MISBAKHUL ADI CANDRA
Rp 3,000.00 MUHAMMAD FADILATUR ROHMAN
Rp 3,000.00 DWI NAUVAL ZAKARIA
Rp 3,000.00 SUARNO / BAPAK MOL
Rp 3,000.00 MOHAMMAD KHAFIL BASRI
Rp 3,000.00 SAINAP
Rp 30,000.00 TALITA KAMILA RAMADHANI
Rp 30,000.00 FAWAIDURRAHMAN
Rp 30,000.00 MUHAMMAD DAFFA YUSUF
Rp 30,000.00 VIRENDRA ISKIAN. A
Rp 30,000.00 FATIMAH / BU SIYEH
Rp 30,000.00 SAHUR
Rp 30,000.00 NABILA NAFASA
Rp 30,000.00 SULIHA / B. MUSEN
Rp 3,000.00 SULASTRI
Rp 3,000.00 SUBUR SUHERMAN
Rp 3,000.00 AHMAD WAKIT
Rp 30,000.00 SUNAMI / IBU SUKIR
Rp 3,000.00 ANA WILDANI
Rp 30,000.00 BUNGKOS / BAPAK HOIRIYEH
Rp 30,000.00 LISA
Rp 3,000.00 MAIMONA
Rp 3,000.00 FATIMATUS SUHRO
Rp 30,000.00 ITA ASTUTIK
Rp 3,000.00 ROHATI
Rp 3,000.00 MUHAMMAD AUFA RAMADHANI
Rp 3,000.00 RISMA OLIVIA
Rp 3,000.00 ZASKIA SHEVA SABILA
Rp 3,000.00 FRISTIKA MIRA WIDIYANTI
Rp 3,000.00 ASIS / BAPAK IN
Rp 3,000.00 KINA AH
Rp 3,000.00 UMAR SODIQ PRANOTO
Rp 3,000.00 YUNI FIRDAUSI NUZULA
Rp 3,000.00 SRI WATININGSIH
Rp 30,000.00 FARA AZZAHRA
Rp 3,000.00 BAGUS ROBBY FITRIANTO
Rp 3,000.00 WIDI ASTUTIK
Rp 30,000.00 MUHAMMAD ANGGA SAPUTRA
Rp 3,000.00 FIRMAN HAIDAR ABDUS S.
Rp 3,000.00 MUHAMMAD AFIL ARDIANSYAH
Rp 30,000.00 MOH. DAVI SABTIAN
Rp 30,000.00 SAHUR
Rp 3,000.00 JIBRAN DZAKA DWI SAMTA
Rp 30,000.00 REYHAN
Rp 30,000.00 RIYADI
Rp 30,000.00 KEYLA HANIS SAUFA
Rp 30,000.00 ANINDITA KEISYA AZZAHRA
Rp 3,000.00 ELVINA NURIL MAULIDAH
Rp 30,000.00 MOHAMMAD HOIRUL F
Rp 30,000.00 NAWANG TASBIHA
Rp 30,000.00 UNTUNG MARTA LEGAWA
Rp 30,000.00 NAJWA AL QOMARIAH
Rp 30,000.00 KUSTINI / IBU WAHYU
Rp 30,000.00 MUHAMMAD RAKA
Rp 3,000.00 RANIA ALMAHYRA MECCA
Rp 30,000.00 AURA SELA ROZANA
Rp 30,000.00 ISLAMIAH ALIYA PUTRI
Rp 30,000.00 ARKA WIRAYUDA RAKSONO
Rp 30,000.00 ARSYILA ROMEZA FARZANA
15801000
Rp 75,000.00 AHMAD AZZZAMIRU ADITYA NAHROWI

Rp 100,000.00 MUHAMMAD RADITYA SAPUTRA
Rp 60,000.00 SANAN
Rp 75,000.00 ASWAR / PAK KUS
Rp 60,000.00 MUHAMMAD AZKA ALFARISKI
Rp 60,000.00 TUYAMI
Rp 60,000.00 TUYAMI
Rp 10,000.00 NAGITA SEVINA PUTRI ELFAS
Rp 60,000.00 SUWARNA
Rp 75,000.00 ERNAWATI
Rp 10,000.00 AMARI
Rp 75,000.00 MUHENA
Rp 100,000.00 PAÌ / P YUL
Rp 100,000.00 PAÌ / P YUL
Rp 100,000.00 PAÌ / P YUL
Rp 10,000.00 IDEH / B. SU
Rp 10,000.00 ARSO
Rp 10,000.00 ARSO
Rp 10,000.00 YUSUF
Rp 10,000.00 YUSUF
Rp 10,000.00 YUSUF
Rp 10,000.00 JUMAR
Rp 10,000.00 JUMAR
Rp 10,000.00 MARDI
Rp 10,000.00 MARDI
Rp 10,000.00 MARDI
Rp 10,000.00 SAMSUL
Rp 10,000.00 ARSO
Rp 10,000.00 ASYATI
Rp 10,000.00 ASYATI
Rp 60,000.00 RISKIYAH
Rp 10,000.00 TOSAN
Rp 75,000.00 ASRI
Rp 75,000.00 ASRI
Rp 30,000.00 SUPYANI/B,AGUS
Rp 30,000.00 MUNAYAH
Rp 30,000.00 ASOKA JUNA PUTRA
Rp 30,000.00 BUYATI
Rp 30,000.00 AINEIL AZIZAH
Rp 30,000.00 MUHAMMAD DAFA IBNU H
Rp 3,000.00 MUHAMMAD BERYL ZAHRAN
Rp 3,000.00 AHMAD GUNAWAR
Rp 30,000.00 SUPYATI
Rp 30,000.00 MUHAMMAD IMRON
Rp 30,000.00 SUKARTINI
Rp 30,000.00 NESYA FEBRIKA SETIAWAN
Rp 30,000.00 ALISATUS SAKINAH
Rp 30,000.00 LASMINI
Rp 30,000.00 MUHAMMAD GUFRON
Rp 30,000.00 SUPANDIAH
Rp 30,000.00 AHMAD SUKRON ROFIKI
Rp 30,000.00 SUNYOTO
Rp 3,000.00 MISNAYAN / P. MAR
Rp 3,000.00 LUTFI / BAPAK WAFIQ
Rp 30,000.00 AFIFAH
Rp 3,000.00 MURATI / B. LIS
Rp 30,000.00 NINO / PAK SUK
Rp 30,000.00 SAKRUMI
Rp 3,000.00 VANESSA ANGELITA
Rp 3,000.00 MUSHOLLINAH
Rp 3,000.00 BUYATI / B. AL
Rp 30,000.00 SURAKMO
Rp 30,000.00 JUHAIRIYAH
Rp 30,000.00 AINUN NADIFA
Rp 30,000.00 SUAMI
Rp 30,000.00 SABU
Rp 30,000.00 JEFRIAN DEBI RIFKIANTO
Rp 30,000.00 MUHAMMAD HAIKAL ASSEGAF
Rp 3,000.00 DIAN KHUMAIROH
Rp 30,000.00 MEYRITA HANIFATUL NUR AZIZAH
Rp 30,000.00 FENI NUR IRIANTI
Rp 3,000.00 AHMAD SALEH // IFA MARIA ULFA
Rp 3,000.00 JAMALLUDDIN
Rp 3,000.00 RAHMATUL HS
Rp 30,000.00 SELVI EVA
Rp 30,000.00 YURANTI
Rp 30,000.00 NARMI / B. NURSIDI
Rp 30,000.00 MUNAÌ / P. FAHMI
Rp 30,000.00 AMMA/B.TRIS
Rp 30,000.00 IMSIATI / B. FAHMIL
Rp 30,000.00 ASIA / B. TILA
Rp 30,000.00 AHMAD ILMAN BACHTIAR
Rp 30,000.00 UMI FADHILA
Rp 30,000.00 ANDRIK SUSANTO
Rp 30,000.00 HOTIJA / SEY
Rp 30,000.00 JURI / P. YUL
Rp 3,000.00 IMAM ROFIKI
Rp 30,000.00 MUHAMMAD RAKA
Rp 30,000.00 PUTRI DWI AJENG
Rp 3,000.00 FIKRI SIDDIQI
Rp 3,000.00 LINTANG ALFINA DEWI
Rp 3,000.00 SUBUR SUHERMAN
Rp 3,000.00 ASNIA
Rp 3,000.00 UNTUNG SLAMET
Rp 30,000.00 JUMZAINATUN
Rp 3,000.00 RINA YONIASTI
Rp 30,000.00 SAID
Rp 3,000.00 MUHAMMAD IFAN
Rp 3,000.00 FAYYOLA QONITA ZAHRA AULIA
Rp 30,000.00 AINUN WIDIYA HERNANDA
Rp 30,000.00 MAT ASUS
Rp 3,000.00 YUNI TRI
Rp 3,000.00 SUPARTILA
Rp 30,000.00 SELVI ANGGRIANI
Rp 30,000.00 BAHROSI/ H LUTFI
Rp 30,000.00 AIRA SAFA
Rp 30,000.00 NUR ISKANDAR
Rp 30,000.00 RUSTI/B.EN
Rp 3,000.00 MUHAMMAD ABDUL FAQIH
Rp 3,000.00 FERI IRAWAN
Rp 3,000.00 SURYADI
Rp 3,000.00 KEYSIFA MAHDA / VIA
Rp 30,000.00 SUPIYA / BU PON
Rp 3,000.00 SITI NURJANNAH
Rp 30,000.00 HAFIZ FIRDAUS ALI
Rp 3,000.00 ADELIA SEPTIA PUTRI
Rp 3,000.00 YULIANI
Rp 30,000.00 ASBULLAH
Rp 30,000.00 AURELIA LUTFIA SEPTIANI
Rp 3,000.00 BABUR ROHMAH
Rp 30,000.00 DIAN NOVITA DINASARI ATNAWATI
Rp 3,000.00 SUGENG PRAYOGO
Rp 30,000.00 AGUSTINA / B. AISYAH
Rp 30,000.00 YENI TIRTA DIANA PUTRI
Rp 30,000.00 AMIRUL HASAN
Rp 3,000.00 BRIAN ADHYASTA AFRIANDI
Rp 3,000.00 DEDI AFRIANDI
Rp 30,000.00 DIMA / BU SUKRI
Rp 3,000.00 HERLINA / BU AYU
Rp 30,000.00 SHELIN
Rp 30,000.00 MUHAMMAD LAIS
Rp 30,000.00 NY. HJ. MAFTUHAH
Rp 30,000.00 ARSY HILMA NUR RAISA
Rp 30,000.00 H JAZULI
Rp 30,000.00 BURAWI / P. MIS
Rp 30,000.00 SIFHA NASYA ANINDITA
Rp 30,000.00 JUMAÀTI
Rp 30,000.00 ARSYILA ZAHWA ALTAFUNISA
Rp 30,000.00 IMAM WAHYUDI
Rp 3,000.00 ARDITA FEBRIYANTI
Rp 30,000.00 TITIN HARYANTI
Rp 3,000.00 ALI WAFI
Rp 30,000.00 KHADIJAH HAURA AZKIYA
Rp 30,000.00 JUMANI
Rp 30,000.00 MUHAMMAD ABRIZAM REYNAN
Rp 30,000.00 MUNAJIB/ BAPAK RIRIN
Rp 30,000.00 AHMAD AZAIN ALFATIHIL ASYROF
Rp 30,000.00 MAULIDIA SAFIRA
Rp 30,000.00 ALVARES
Rp 3,000.00 ADEEVA ZIVANA PUTRI WIDODO
Rp 3,000.00 YADIMA
Rp 30,000.00 MUHAMMAD MUKRI
Rp 30,000.00 FINA DAMAYANTI
Rp 3,000.00 AULIA PASHA NADIRA
Rp 30,000.00 SONI HERMAWAN
Rp 30,000.00 MUNIRI/ PAK MUS
Rp 3,000.00 ZULFATUL MAUFIROH
Rp 30,000.00 MUHAMMAD SURAWI
Rp 3,000.00 MURYAMA
Rp 3,000.00 BASIRAH
Rp 3,000.00 AHMAD ADRI HASAN
Rp 3,000.00 FATMAWATI
Rp 30,000.00 ASNI / BU IB
Rp 30,000.00 BIKDIN / PAK RAHMAT
Rp 30,000.00 BOBBY INDRA
Rp 30,000.00 NINDI
Rp 30,000.00 NUNUNG AFIFAH
Rp 3,000.00 GUNAWAN PRASETYO
Rp 3,000.00 HASAN / BAPAK EDI
Rp 30,000.00 MEDINA ZAKIYATUN NUFUS
Rp 30,000.00 FATHULLAH
Rp 30,000.00 FIRA AULIA DEWI
Rp 3,000.00 ZAHRA DIYARI JENNATI
Rp 3,000.00 MUSHOLLINAH
Rp 30,000.00 ANDI
Rp 3,000.00 ROFI FATONI
Rp 30,000.00 MUHAMMAD SHAKEIL NIZAMA PUTRA
Rp 30,000.00 MUHAMMAD BAYU SAPUTRA
Rp 30,000.00 MUHAMMAD HASAN
Rp 3,000.00 ALVARENDRA RUNAKO ADIDARMA
Rp 3,000.00 LATHIFAH
Rp 30,000.00 MUHAMMAD RAHMAD DANI
Rp 3,000.00 AKHMAD ZAINI
Rp 3,000.00 FARIDA
Rp 3,000.00 SUCIK
Rp 30,000.00 IZZATUL ALIYAH
Rp 30,000.00 SAINAL
Rp 30,000.00 ALMIRA ZAKIYA ALTAFUNISA
Rp 30,000.00 ENI SULIKA
Rp 30,000.00 SIA
Rp 30,000.00 WAWAN HARDIANTO
Rp 3,000.00 SUNARTI
Rp 30,000.00 MAIMUNAH
Rp 30,000.00 JUMADI / PAK EVA
Rp 3,000.00 ARSY EKA PUTRI SETIAWAN
Rp 3,000.00 ZAINAL ANSORI
Rp 30,000.00 BURIYA / IBU MISYANA
Rp 30,000.00 MAISUN
Rp 30,000.00 NUR AZIZAH
Rp 3,000.00 WONGSO / P. NOVI
Rp 30,000.00 ROHEMAH
Rp 30,000.00 MOH. GIBRAN ARFAN ALHUSAIN
Rp 30,000.00 KAIYIMAH
Rp 3,000.00 HALIMATUS SAKDIYAH
Rp 3,000.00 SITI MUNIRAH
Rp 3,000.00 MOCH SUHDI
Rp 3,000.00 PANDI
Rp 3,000.00 JOSO
Rp 3,000.00 YULI NABILA AMALIA
Rp 3,000.00 ABDUL HAFID
Rp 3,000.00 ARYANI/ B MISEH
Rp 30,000.00 YENI TIRTA DIANA PUTRI
Rp 30,000.00 SUKRON
Rp 3,000.00 AGUS SUSANTO
Rp 30,000.00 SUCIK SUSIANA
Rp 30,000.00 DINARA ZAHIRA AZALIYA
Rp 30,000.00 SOFIATUN HASANAH
Rp 30,000.00 KAILA ZAHRA
Rp 30,000.00 DIMA / BU SUKRI
Rp 30,000.00 HARTONO
Rp 30,000.00 DAFINA NUR RAMADINA
Rp 30,000.00 ANDI
Rp 30,000.00 KUSTINI / BUK HERI
Rp 3,000.00 RAISYA MARATIN
Rp 3,000.00 SAKTIMAN / P. PUT
Rp 30,000.00 ARKA ZIKRILA
Rp 30,000.00 DAHNI
Rp 30,000.00 ALIFAH ELSAFA
Rp 30,000.00 IRMA NURMAYANTI
Rp 3,000.00 MUHAMMAD SULTAN FATTAH HADINATA
Rp 30,000.00 INTAN PUTRI FADILA
Rp 30,000.00 M. AZKA ZIO ITKON
Rp 30,000.00 M. HARRUN AR RASYID
Rp 30,000.00 UMYANI / BUK HAJAH TOHIR
Rp 3,000.00 NY. NIWATI
Rp 30,000.00 LISTIANA ROMADHOYANTI
Rp 3,000.00 LULUK FITRIANI
Rp 3,000.00 MUHAMMAD SULTAN FATTAH HADINATA
Rp 30,000.00 DIMAS FEBRIAN
Rp 30,000.00 AJIS/P.YUS
Rp 30,000.00 MUHAMMAD DAFA IBNU H
Rp 30,000.00 SEPTANIA DEVINA
Rp 30,000.00 SUYITNO
Rp 30,000.00 FENDI ARDIANSYAH
Rp 30,000.00 ANDINI RIHADATUL AISYI
Rp 30,000.00 INDRA MULYADI
Rp 30,000.00 BETY HARIANI
Rp 3,000.00 MUTIMMATUL ULUM
Rp 3,000.00 AGHNIA KHALWA AYU WIJAYA
Rp 3,000.00 MIMMA AMALIA
Rp 3,000.00 SENIMAN
Rp 3,000.00 SUMINA
Rp 3,000.00 ASIA
Rp 3,000.00 RAFANDA QALESYA PUTRI EFENDI
Rp 30,000.00 HOLIFAH / B. FINA
Rp 30,000.00 JA`FAROH
Rp 30,000.00 JUMAAH / BU IKE
Rp 30,000.00 ARPADI / B SUTEMA
Rp 30,000.00 M RIJO / PAK SISKA
Rp 30,000.00 MISYATI / BUK TI
Rp 30,000.00 SULIMAN
Rp 30,000.00 NASIA / BU SUNAMI
Rp 30,000.00 ICA MAULIDIYAH
Rp 30,000.00 MUHAMMAD ZIDAN ZAKI
Rp 30,000.00 BADRIATUS SHOLIHATIN
Rp 30,000.00 ALMIRA HIZA NARAYA
Rp 30,000.00 RAISYA AZKYA FITRIA ROBIT
Rp 30,000.00 RESTU BUDI PRASETYO
Rp 30,000.00 ARIFIYANTO
Rp 30,000.00 MUSRIFAH
Rp 30,000.00 HOLIFAH
Rp 3,000.00 AHMAD SUBHAN HADI
Rp 30,000.00 JUNAINI ALFIAH
Rp 30,000.00 SUMIATI
Rp 30,000.00 AKMA/ B KARIM
Rp 30,000.00 SENAMI / B SUNA
Rp 30,000.00 MUHAMMAD ZHIAN AL GHAAZIY
Rp 30,000.00 RENZY AFFELLIA AL-HAKIM
Rp 30,000.00 ALDI PRATAMA
Rp 3,000.00 BURANI
Rp 30,000.00 MISYATI NINGSIH
Rp 30,000.00 AFIFAH
Rp 3,000.00 SUYONO / PAK WAFAQ
Rp 3,000.00 AGHNIA KHALWA AYU WIJAYA
Rp 30,000.00 OMAR
Rp 30,000.00 JAFAR SAHWAN FIRDAUS
Rp 30,000.00 SITI SAADATUL AZIZAH
Rp 30,000.00 M. NUR SULTAN AL FARIZI
Rp 30,000.00 ZAFIR AHMAD RAMADHAN
Rp 30,000.00 NOR HOTIM
Rp 30,000.00 SENI
Rp 30,000.00 WARDATUL HASANAH
Rp 30,000.00 IMAM FATONI
Rp 30,000.00 AFANDI FIRDATAMA
Rp 30,000.00 NURHALIMAH
Rp 3,000.00 FERI IRAWAN
Rp 30,000.00 SILVI MASQIROH
Rp 3,000.00 HIMAS LAILATUL ERVANIAH
Rp 3,000.00 ABRIZAM FARIKI AULADI
Rp 30,000.00 HAJI SAMSUL ARIFIN
Rp 30,000.00 MUHAMMAD RAFFA AZKA PUTRA
Rp 30,000.00 ASÀD / P. MISTARI
Rp 30,000.00 SUAIBAH
Rp 30,000.00 MUHAMMAD RAFA
Rp 30,000.00 FADLAN ALFARISI
Rp 3,000.00 SENIMAN
Rp 3,000.00 QONITA AZZAHRA BILGINA / GINA
Rp 3,000.00 INDAH SETYOWATI
Rp 3,000.00 FAIQOTUL HIMMAH
Rp 3,000.00 PATWARI / BAPAK FATHOL
Rp 3,000.00 ROMLA
Rp 30,000.00 DULAMI
Rp 3,000.00 ADILAH AZKA LABIBA
Rp 30,000.00 MUJIONO
Rp 30,000.00 IMAM WAHYUDI
Rp 3,000.00 M. JOHNY. A
Rp 30,000.00 KAINDRA BAHTIAR PANDU WIJAYA
Rp 30,000.00 MUHAMMAD ROBIT BAIFILLAH
Rp 3,000.00 DARSAN
Rp 3,000.00 DALISA AZKIA KAURIN
Rp 30,000.00 TUTIK ASYATUN/ B TUTIK
Rp 3,000.00 RAKA FEBRIAN PUTRA
Rp 3,000.00 YUNI TRI
Rp 3,000.00 MUHAMMAD ISBAT GAUTAMA
Rp 30,000.00 IRAWATI KHOTIMAH
Rp 30,000.00 ALBERT ADRIAN K
Rp 30,000.00 WAHYUNINGSIH
Rp 30,000.00 NAILUL AMANI
Rp 30,000.00 ASYIFA PUTRI AURA ZASKIA
Rp 30,000.00 MIRZA DAMARA
Rp 3,000.00 MUHAMMAD APRILIAN RISKI SAHBANA
Rp 30,000.00 AUDRI VIRSILIA ROSA
Rp 30,000.00 MISRAN
Rp 3,000.00 HAVID
Rp 3,000.00 SAHRI
Rp 3,000.00 SUSYATI/ IBU SUCIP
Rp 3,000.00 ALFIANDRA ARIFIN
Rp 25,786,000.00
100000 AINIATUL JANNAH

100000
Rp 60,000.00 TUYAMI
Rp 10,000.00 HANIAH
Rp 10,000.00 AMARI
Rp 10,000.00 JUPRI
Rp 75,000.00 MUHENA
Rp 10,000.00 IDEH / B. SU
Rp 10,000.00 ARSO
Rp 60,000.00 MULAGI
Rp 60,000.00 MULAGI
Rp 10,000.00 MARDI
Rp 10,000.00 SAMSUL
Rp 10,000.00 SAMSUL
Rp 10,000.00 ARSO
Rp 10,000.00 ARSO
Rp 10,000.00 ASYATI
Rp 10,000.00 TOSAN
Rp 10,000.00 ALFINO
Rp 10,000.00 ALFINO
Rp 30,000.00 HELYATUN
Rp 3,000.00 TITIN SULISTIYOWATI
Rp 30,000.00 PUTRI NUR AISYAH
Rp 30,000.00 HER / BAPAK AGUS
Rp 30,000.00 TASYA ALFATUNNISA
Rp 30,000.00 NARTO
Rp 30,000.00 MISYA
Rp 3,000.00 SITI HOIRIYAH
Rp 3,000.00 SUNARTO H.S
Rp 3,000.00 MUHAMMAD ADI HARJA AJI PRATAMA
Rp 3,000.00 PATWARI / BAPAK FATHOL
Rp 30,000.00 HARYONO TOYO
Rp 30,000.00 DHINA/ BUK HAJAH MAIMONA
Rp 30,000.00 ISWANTO
Rp 30,000.00 MUHAMMAD CLAZYA
Rp 30,000.00 JUMALIA
Rp 30,000.00 KUSTINI / IBU WAHYU
Rp 30,000.00 FELA PUJI ASTUTIK
Rp 30,000.00 ASMUI
Rp 30,000.00 VIA DWI SAFITRI
Rp 30,000.00 BUKADIN
Rp 3,000.00 DARSAN
Rp 3,000.00 AHMAD SYAMSUL ARIFIN
Rp 3,000.00 NAINI
Rp 3,000.00 SAHRA/ P SAMSUL
Rp 3,000.00 WAKIAH
Rp 30,000.00 SUNARMI / HJ AZIZAH
Rp 30,000.00 RIFATUL HASANAH
Rp 30,000.00 MUHAMMAD FAISAL ARIF
Rp 3,000.00 BY. IRSYAD MAUZA AULIAN
Rp 3,000.00 BENI EKA WULANDARI
Rp 3,000.00 ANA WILDANI
Rp 3,000.00 SUHADAK
Rp 3,000.00 ENI PUJIATI
Rp 3,000.00 MOHAMMAD ALDEBARAN. S
Rp 3,000.00 BUDIH
Rp 3,000.00 AKHMAD ZAINI
Rp 3,000.00 SUSYATI/ IBU SUCIP
Rp 30,000.00 M. KEVIN ARDIANSYAH
Rp 30,000.00 MUHAMMAD RAFA AGATHA
Rp 30,000.00 A. MISBAHUL MUNIR
Rp 30,000.00 MUHAMMAD GIBRAN
Rp 30,000.00 MUHAMMAD MUFASIR ALFARISI
Rp 30,000.00 MUHAMMAD MUHLIS
Rp 30,000.00 DEDY SUROSO
Rp 30,000.00 SUPAMI
Rp 30,000.00 SUMIATI BU RIO
Rp 30,000.00 SARIFATUL AULIA
Rp 30,000.00 SAWATI/ B. SELI
Rp 30,000.00 SATURUDI
Rp 30,000.00 MOCHAMMAD ALI GUFRON
Rp 30,000.00 FARAH ADINDA
Rp 30,000.00 ZAKIYA BELIA PUTRI KURNAIN
Rp 30,000.00 MUHAMMAD WILDAN FAHRI
Rp 3,000.00 MAIMONA
Rp 30,000.00 FATIMA
Rp 3,000.00 IBNU FAQIH
Rp 3,000.00 FARAH MAULIDIA
Rp 30,000.00 AJENG PUTRI BILQIS GHUFRONIA
Rp 30,000.00 BENDOT SUBROTO
Rp 30,000.00 AURA SELA ROZANA
Rp 30,000.00 MATJURI / MADJURI / P. DI / P. DHI
Rp 3,000.00 MUHAMMAD ARSYA ALFAUZI
Rp 3,000.00 SYADDAD MANAF AHKELL RASYID
Rp 3,000.00 TITIN SULISTIYOWATI
Rp 3,000.00 TOREJO
Rp 3,000.00 SUNITO / BAPAK HAI
Rp 30,000.00 MURYATI
Rp 30,000.00 SOLIHIN / P. DIDIK
Rp 30,000.00 MUHAMMAD ZAINUDIN SOLEH
Rp 30,000.00 PANUT DIONO
Rp 3,000.00 SUHADAK
Rp 30,000.00 FAUZAN
Rp 30,000.00 HAJJAH. SITI SHOFIAH
Rp 30,000.00 BEWI/P SADI
Rp 30,000.00 SITI MAIMUNA
Rp 30,000.00 MOHAMMAD DENI ORLANDO
Rp 30,000.00 ABDUR ROFIQ
Rp 30,000.00 JUPRI
Rp 30,000.00 AUFAL MAROM
Rp 30,000.00 SONI PRANATA
Rp 30,000.00 MUHAMAMD ELDIS WIRATA
Rp 30,000.00 ROHMAWATI
Rp 30,000.00 ATIKA ZAHRA LATIFAH
Rp 30,000.00 IBNAINI KURNIA AZIZAH
Rp 30,000.00 ARINAL AFROH
Rp 30,000.00 QORI
Rp 30,000.00 HERLIN / B. NAFIS
Rp 30,000.00 DEDI ROFIKI
Rp 30,000.00 MUYATI
Rp 30,000.00 WULANDARI
Rp 30,000.00 MISJELI
Rp 30,000.00 AISYATUL QORIAH
Rp 30,000.00 MARTI/B.SAYONO
Rp 30,000.00 IIN JANUARTI
Rp 30,000.00 IMRONI / IBU ABIM
Rp 30,000.00 DEDI ROFIKI
Rp 3,000.00 MUHAMMAD AFIL ARDIANSYAH
Rp 3,000.00 MURATI / B. LIS
Rp 30,000.00 NY. HALIMATUS SA`DIYAH
Rp 3,000.00 YATIMA
Rp 30,000.00 MURBIATI / BUK DUL AZIS
Rp 30,000.00 AHMAD SEHU
Rp 30,000.00 NADIROH
Rp 30,000.00 M ROBIT RAISAL HAQ
Rp 3,000.00 MEIKE JUWITA SARI
Rp 3,000.00 IDEH / B. SU
Rp 30,000.00 SAINI
Rp 30,000.00 SUPRIANTO
Rp 30,000.00 SUYANI / IBU LUT
Rp 30,000.00 PUTRI AMALIA SARI
Rp 30,000.00 ANDIKA RADIT PRATAMA
Rp 30,000.00 DIAN GAFUR
Rp 30,000.00 MUHAMMAD MUKRI
Rp 3,000.00 JUMIATI
Rp 3,000.00 M. IFAN HASBIYALLAH
Rp 30,000.00 MUHAMMAD ZAKI MUBAROK
Rp 3,000.00 AMELIA SYARIF KOMALA HIDAYAH
Rp 3,000.00 KEISHA ARSYFA WAFIYAH
Rp 3,000.00 ELI ERNAWATI
Rp 3,000.00 AHMAD BAIDHOWI
Rp 30,000.00 KHUSNUL HOTIMAH
Rp 30,000.00 ADAM
Rp 3,000.00 ASIS / BAPAK IN
Rp 3,000.00 HASAN / BAPAK EDI
Rp 3,000.00 NUR IMAMAH
Rp 3,000.00 JUHAIRIYAH
Rp 30,000.00 SUWARDI / BAPAK UNIK
Rp 3,000.00 MAHRUS ALI
Rp 30,000.00 JUMANTO
Rp 30,000.00 ATIKA SARI
Rp 30,000.00 RAFIF ZAHRAN
Rp 30,000.00 SARNI
Rp 30,000.00 SUPIYATI/ BUK DIAN
Rp 30,000.00 ZAIDANI ROYHAINATUL AINI
Rp 30,000.00 NAURA SALSABILA PUTRI
Rp 30,000.00 HERLIN / B. NAFIS
Rp 30,000.00 MUHAMMAD DAFA AL RIFQI
Rp 30,000.00 ABDUL HADI
Rp 30,000.00 SITI NAWARUO
Rp 30,000.00 UMI ANITA ZAHROH
Rp 30,000.00 TIMO/P. RUDI
Rp 30,000.00 QISYA AQILA FARZANA
Rp 3,000.00 IRA SYAHARANI
Rp 3,000.00 LATHIFAH
Rp 30,000.00 MURTINI / IBU WAHYUNI
Rp 30,000.00 M. BAKRI
Rp 30,000.00 FEBY ASKA QISTHI AULIA
Rp 30,000.00 FADIA AFKARINA
Rp 3,000.00 AHMAD FAUZAN NURRUDIN
Rp 3,000.00 FATIMAH
Rp 3,000.00 NINIK SUBAKTINI
Rp 8,502,000.00

Rp 30,000.00 NURUL HIKMAH
Rp 30,000.00 M. IRVAN BAIDILLAH
Rp 100,000.00 M. IRVAN BAIDILLAH
Rp 30,000.00 YUNITA MARIA ULFA
Rp 30,000.00 ALDI AFLATUL AFSAN
Rp 30,000.00 KRISTINA
Rp 200,000.00 KRISTINA
Rp 30,000.00 NURUDDIN
Rp 30,000.00 NUR FADILLAH
Rp 3,000.00 WAQIATUL HASANAH
Rp 3,000.00 SELVYA NANDA DWI KARTIKO
Rp 3,000.00 REISYA APRILIA PUTRI
Rp 30,000.00 SULIS KURNIAWATI
Rp 25,000.00 SULIS KURNIAWATI
Rp 30,000.00 NATASYA
Rp 50,000.00 NATASYA
Rp 30,000.00 AYUNINDIYA KEIZHA AZZAHRA
Rp 75,000.00 AYUNINDIYA KEIZHA AZZAHRA
Rp 3,000.00 RUHANIYAH
Rp 3,000.00 MOH ROIKHAN BAIDHAWI
Rp 3,000.00 WIDADAH
Rp 30,000.00 ROZANA ELIMANI
Rp 100,000.00 ROZANA ELIMANI
Rp 3,000.00 ROHATI
Rp 3,000.00 MURYAMA
Rp 15,000.00 WIDADAH
Rp 15,000.00 MURYAMA
Rp 30,000.00 RAIHANATU AMBAR ZAHIRATUS SYITA
Rp 3,000.00 IMAM ROFIKI / BAPAK FIKI
Rp 30,000.00 HADARI / BAPAK DENDI
Rp 100,000.00 HADARI / BAPAK DENDI
1592000
3000 WIDADAH
3000
Rp 10,000.00 TUYAMI
Rp 10,000.00 LATIFA
Rp 5,000.00 MUHENA
Rp 5,000.00 MUHENA
Rp 5,000.00 MUHENA
Rp 10,000.00 TOSAN
Rp 10,000.00 TOSAN
Rp 5,000.00 MARYATI
Rp 445,000.00

Rp 10,000.00 MAÙN
Rp 20,000.00 SAYATI/ B ATAN
Rp 10,000.00 NURAHMATIN
Rp 10,000.00 HALIMA
Rp 30,000.00 ADAM
Rp 35,000.00 ADAM
Rp 35,000.00 SUAIBAH
Rp 10,000.00 DULAMI
Rp 495,000.00
Rp 20,000.00 LATIFA
Rp 10,000.00 YUSUF
Rp 10,000.00 YUSUF
Rp 10,000.00 YUSUF
Rp 10,000.00 MULAGI
Rp 10,000.00 ALFINO
Rp 520,000.00

Rp 7,000.00 HAFIDATUL KOMARIYAH
Rp 2,000.00 HAFIDATUL KOMARIYAH
Rp 40,000.00 HOTIMATUL ROHMAH
Rp 20,000.00 M. SEPTA AQUILAN PUTRA RENALDI
Rp 15,000.00 M. SEPTA AQUILAN PUTRA RENALDI
Rp 40,000.00 MARIYANA
Rp 30,000.00 TANTI MAISARO
Rp 40,000.00 WAGINI
Rp 40,000.00 HOSAIMAH
Rp 39,000.00 HOSAIMAH
Rp 20,000.00 UNZILATIR ROHMA
Rp 15,000.00 UNZILATIR ROHMA
Rp 40,000.00 RISTA ANGGRAENI FIRANTI
Rp 40,000.00 RISTA ANGGRAENI FIRANTI
Rp 3,000.00 RIFKATUL AISYAH
Rp 40,000.00 SAROVA
Rp 39,000.00 SAROVA
Rp 631,500.00

Rp 7,000.00 SOFIYAH
Rp 2,000.00 SOFIYAH
Rp 9,000.00 MAIMUNA
Rp 5,000.00 MAIMUNA
Rp 9,000.00 RIRIN
Rp 5,000.00 RIRIN
Rp 9,000.00 MISYATI / B.TATIK
Rp 5,000.00 MISYATI / B.TATIK
Rp 5,000.00 UNTUNG MARTA LEGAWA
Rp 436,000.00

Rp 10,000.00 MAÙN
Rp 10,000.00 LATIFA
Rp 20,000.00 AMARI
Rp 10,000.00 JUPRI
Rp 5,000.00 MUHENA
Rp 5,000.00 MUHENA
Rp 10,000.00 MUHENA
Rp 415,000.00

Rp 7,000.00 IGHFIRLINA YAUMIL AKHDA
Rp 2,000.00 IGHFIRLINA YAUMIL AKHDA
Rp 5,000.00 FITRIA
Rp 7,500.00 FITRIA
Rp 9,000.00 SITI MUTMAINAH
Rp 5,000.00 SITI MUTMAINAH
Rp 7,500.00 IDA /B.RETA
Rp 5,000.00 IDA /B.RETA
Rp 5,000.00 ARKY MARSHA NURLITASARI
Rp 9,000.00 ARKY MARSHA NURLITASARI
Rp 9,000.00 FITRIATUL HASANAH
Rp 5,000.00 FITRIATUL HASANAH
Rp 149,000.00

Rp 5,000.00 SANAN
Rp 5,000.00 SANAN
Rp 5,000.00 MAÙN
Rp 5,000.00 MAÙN
Rp 5,000.00 MAÙN
Rp 5,000.00 TUYAMI
Rp 5,000.00 TUYAMI
Rp 45,000.00 TUYAMI
Rp 5,000.00 TUYAMI
Rp 5,000.00 TUYAMI
Rp 5,000.00 SUWARNA
Rp 5,000.00 MARYATI
Rp 5,000.00 MARYATI
Rp 5,000.00 MARYATI
Rp 5,000.00 MARYATI
Rp 5,000.00 LATIFA
Rp 5,000.00 LATIFA
Rp 45,000.00 LATIFA
Rp 15,000.00 LATIFA
Rp 5,000.00 LATIFA
Rp 5,000.00 SUNARTO
Rp 5,000.00 SUNARTO
Rp 5,000.00 SUNARTO
Rp 5,000.00 JUMAATI
Rp 5,000.00 JUMAATI
Rp 5,000.00 MATRAJI
Rp 5,000.00 MATRAJI
Rp 5,000.00 MATRAJI
Rp 5,000.00 MUHENA
Rp 5,000.00 MUHENA
Rp 5,000.00 MUHENA
Rp 5,000.00 MUHENA
Rp 5,000.00 MUHENA
Rp 5,000.00 MAIMUNA
Rp 5,000.00 MAIMUNA
Rp 5,000.00 MAIMUNA
Rp 5,000.00 MAIMUNA
Rp 5,000.00 MAIMUNA
Rp 5,000.00 MAIMUNA
Rp 5,000.00 PAÌ / P YUL
Rp 5,000.00 PAÌ / P YUL
Rp 5,000.00 PAÌ / P YUL
Rp 5,000.00 KARISMA
Rp 5,000.00 KARISMA
Rp 5,000.00 KARISMA
Rp 5,000.00 YUSUF
Rp 5,000.00 YUSUF
Rp 5,000.00 ASYATI
Rp 5,000.00 ASYATI
Rp 5,000.00 ASYATI
Rp 5,000.00 MARWATI
Rp 5,000.00 IBROHIM
Rp 5,000.00 IBROHIM
Rp 5,000.00 IBROHIM
Rp 5,000.00 ASRI
Rp 5,000.00 ASRI
Rp 5,000.00 DJUMARI
Rp 5,000.00 DJUMARI
Rp 5,000.00 DJUMARI
Rp 5,000.00 DJUMARI
Rp 5,000.00 DJUMARI
Rp 11,550,000.00
Rp 10,000 FITRIYATUL HASANAH

Rp 20,000 FITRIYATUL HASANAH
Rp 5,000 SUNARSIH / B IM
Rp 10,000 LATIFA
Rp 10,000 SUNARTO
Rp 20,000 AMARI
Rp 10,000 AHMAD IZUL ISLAM
Rp 20,000 ANA NUR LAILA LATIFAH
Rp 10,000 SAMSUL ARIFIN
Rp 10,000 HOSZAIMAH
Rp 10,000 SYAROFAH NELLI AGUSTINA
Rp 10,000 AHMAD BAIRI
Rp 10,000 AHMAD BAIRI
Rp 10,000 MUS / P HENI
Rp 10,000 SAMI / HJ. ABDUL HADI
Rp 20,000 BUNAMA/B.MUR
Rp 10,000 MAIMUNA
Rp 10,000 NAYLA SALSABILA AZZAHRA
Rp 10,000 RAKESYA CAMILIA PUTRI
Rp 10,000 RAKESYA CAMILIA PUTRI
Rp 10,000 NIKMATUN / BU HER
Rp 10,000 YUSUF
Rp 10,000 GALIH RAMADHAN MUBAROK
Rp 10,000 CHAISYA PUTRI FIRMANSYAH
Rp 50,000 INA / IBU BUYAMI
Rp 10,000 HENDRIK BACHTIAR
Rp 20,000 SYAILA AINUR SAFANA
Rp 5,000 SAHRIYAH / IBU MUHYIT
Rp 10,000 SUNARYA
Rp 20,000 INDAY YATI
Rp 10,000 DJUMARI
Rp 10,000 KURNIAWAN BUDI SANTOSO
Rp 410,000.00

Rp 5,000.00 MAISAROH
Rp 8,300.00 MAISAROH
Rp 53,300.00

Rp 360,000.00
Rp 105,000.00 AMARI
Rp 105,000.00 MULAGI
Rp 272,500.00

Rp 50,000.00 SANAN
Rp 50,000.00 SANAN
Rp 10,000.00 PERI / P. EKA
Rp 10,000.00 PERI / P. EKA
Rp 10,000.00 PERI / P. EKA
Rp 75,000.00 MAÙN
Rp 75,000.00 MAÙN
Rp 75,000.00 MAÙN
Rp 75,000.00 MAÙN
Rp 50,000.00 TUYAMI
Rp 50,000.00 TUYAMI
Rp 50,000.00 TUYAMI
Rp 50,000.00 TUYAMI
Rp 10,000.00 HANIAH
Rp 10,000.00 HANIAH
Rp 10,000.00 HANIAH
Rp 10,000.00 HANIAH
Rp 75,000.00 LATIFA
Rp 75,000.00 LATIFA
Rp 75,000.00 LATIFA
Rp 10,000.00 AMARI
Rp 10,000.00 AMARI
Rp 10,000.00 AMARI
Rp 10,000.00 AMARI
Rp 10,000.00 NIWI
Rp 10,000.00 NIWI
Rp 10,000.00 JUPRI
Rp 10,000.00 JUPRI
Rp 10,000.00 JUPRI
Rp 10,000.00 JUPRI
Rp 75,000.00 MUHENA
Rp 75,000.00 MUHENA
Rp 75,000.00 MUHENA
Rp 75,000.00 MUHENA
Rp 75,000.00 MUHENA
Rp 75,000.00 MUHENA
Rp 75,000.00 PAÌ / P YUL
Rp 75,000.00 PAÌ / P YUL
Rp 75,000.00 PAÌ / P YUL
Rp 75,000.00 PAÌ / P YUL
Rp 10,000.00 IDEH / B. SU
Rp 10,000.00 IDEH / B. SU
Rp 10,000.00 IDEH / B. SU
Rp 10,000.00 IDEH / B. SU
Rp 10,000.00 IDEH / B. SU
Rp 10,000.00 IDEH / B. SU
Rp 10,000.00 ARSO
Rp 10,000.00 ARSO
Rp 10,000.00 YUSUF
Rp 10,000.00 YUSUF
Rp 10,000.00 YUSUF
Rp 50,000.00 MULAGI
Rp 50,000.00 MULAGI
Rp 50,000.00 MULAGI
Rp 10,000.00 MARDI
Rp 10,000.00 MARDI
Rp 10,000.00 MARDI
Rp 10,000.00 SAMSUL
Rp 10,000.00 SAMSUL
Rp 10,000.00 SAMSUL
Rp 10,000.00 SAMSUL
Rp 10,000.00 SAMSUL
Rp 10,000.00 ARSO
Rp 10,000.00 ARSO
Rp 10,000.00 ARSO
Rp 10,000.00 ARSO
Rp 10,000.00 ARSO
Rp 10,000.00 ASYATI
Rp 10,000.00 PA
Rp 10,000.00 PA
Rp 10,000.00 SAIFUL
Rp 10,000.00 SAIFUL
Rp 10,000.00 TOSAN
Rp 10,000.00 TOSAN
Rp 10,000.00 TOSAN
Rp 10,000.00 TOSAN
Rp 10,000.00 TOSAN
Rp 10,000.00 TOSAN
Rp 75,000.00 ASRI
Rp 75,000.00 ASRI
Rp 10,000.00 ALFINO
Rp 10,000.00 ALFINO
Rp 10,000.00 ALFINO
Rp 10,000.00 ALFINO
Rp 31,395,000.00

Rp 75,000.00 SANAN
Rp 10,000.00 PERI / P. EKA
Rp 75,000.00 MAÙN
Rp 75,000.00 TUYAMI
Rp 75,000.00 LATIFA
Rp 10,000.00 AMARI
Rp 10,000.00 NIWI
Rp 10,000.00 JUPRI
Rp 75,000.00 MUHENA
Rp 75,000.00 PAÌ / P YUL
Rp 10,000.00 IDEH / B. SU
Rp 10,000.00 ARSO
Rp 10,000.00 ARSO
Rp 10,000.00 ARSO
Rp 10,000.00 JUMAR
Rp 10,000.00 JUMAR
Rp 75,000.00 MULAGI
Rp 10,000.00 MARDI
Rp 10,000.00 SAMSUL
Rp 10,000.00 ARSO
Rp 10,000.00 ASYATI
Rp 10,000.00 ASYATI
Rp 10,000.00 ASYATI
Rp 10,000.00 PA
Rp 10,000.00 PA
Rp 10,000.00 SAIFUL
Rp 10,000.00 SAIFUL
Rp 10,000.00 SAIFUL
Rp 10,000.00 TOSAN
Rp 75,000.00 ASRI
Rp 10,000.00 ALFINO
Rp 10,000.00 ALFINO
Rp 10,000.00 ALFINO
Rp 10,000.00 JA`FAR
Rp 75,000.00 FARAH SAKINA
Rp 10,000.00 FARAH SAKINA
Rp 10,320,000.00

Rp 5,000.00 SUWARNA
Rp 5,000.00 LATIFA
Rp 10,000.00 AMARI
Rp 5,000.00 SRIYANI
Rp 35,000.00 ONI FITRIYANTI
Rp 10,000.00 SITI AMINAH/B.HJ.HAMINA
Rp 10,000.00 MUHAMMAD MUFASIR ALFARISI
Rp 20,000.00 SAHUR
Rp 475,000.00
Rp 10,000.00 PERI / P. EKA

Rp 10,000.00 MAÙN
Rp 5,000.00 NURSASI
Rp 10,000.00 NIWI
Rp 5,000.00 MUHENA
Rp 10,000.00 MUHENA
Rp 10,000.00 YUSUF
Rp 10,000.00 YUSUF
505000
Rp 10,000.00 MAÙN
Rp 10,000.00 MAÙN
Rp 10,000.00 AMARI
Rp 5,000.00 ROMLAH ARIFIN
Rp 8,300.00 ROMLAH ARIFIN
Rp 9,000.00 JUMAANI
Rp 5,000.00 JUMAANI
Rp 5,000.00 MARYANI
Rp 9,000.00 MARYANI
Rp 10,000.00 ARSO
Rp 10,000.00 ASYATI
Rp 5,000.00 SEI
1 NEBULIZER 10000 1 10000 MAÙN
2 NEBULIZER 10000 1 10000 MAÙN
4 OBSERVASI PERSALINAN 60000 1 60000 INDRI VERALIAWATI
5 GDA STIK 5000 1 5000 SUNARSIH / B IM
5 JASA OBSERVASI PERSALINAN 40000 1 40000 INDRI VERALIAWATI
6 GDA STIK 5000 1 5000 SUNARSIH / B IM
7 JASA PEMASANGAN INFUS PERSALINAN 10000 1 10000 INDRI VERALIAWATI
8 PELEPASAN INFUS DEWASA 10000 1 10000 ZAHROTUL FIKRI ANNABILA
9 PELEPASAN INFUS DEWASA 10000 1 10000 AURA ZAHRO
10 PELEPASAN INFUS DEWASA 10000 1 10000 AHMAD FATAH ALJABBARUL
11 NEBULIZER 10000 1 10000 MAT KADIR
12 PELEPASAN INFUS DEWASA 10000 1 10000 AMARI
13 PELEPASAN INFUS DEWASA 10000 1 10000 TRIANA RAHMADANI
14 PELEPASAN INFUS DEWASA 10000 1 10000 RETNO AYU NINGTIAS
15 BPJS NEBULIZER 10000 1 10000 AHMAD ARIS RAMADHAN
16 GDA STIK 5000 1 5000 SAMI / HJ. ABDUL HADI
16 JASA BIDAN KB SUNTIK 3 BULAN 5000 1 5000 ROMLAH ARIFIN
17 KB SUNTIK 3 BULAN ANDALAN 8300 1 8300 ROMLAH ARIFIN
17 NEBULIZER 10000 1 10000 SAMI / HJ. ABDUL HADI
18 PELEPASAN INFUS DEWASA 10000 1 10000 NOFITA AYU CANDRA
19 NEBULIZER 10000 1 10000 AHMAD ZIYAD ZIDQIL
20 BPJS NON KAPITASI KB SUNTIK 3 BULAN 9000 1 9000 JUMAANI
20 NEBULIZER 10000 1 10000 AHMAD ZIYAD ZIDQIL
21 JASA BIDAN KB SUNTIK 3 BULAN 5000 1 5000 JUMAANI
21 PELEPASAN INFUS ANAK 10000 1 10000 AHMAD ZIYAD ZIDQIL
22 PELEPASAN INFUS ANAK 10000 1 10000 FIKRI RAMADHANI
23 JASA BIDAN BPJS NON KAPITASI KB SUNTIK 3 BULAN 5000 1 5000 HIMAS LAILATUL ERVANIAH
23 NEBULIZER 10000 1 10000 MATRAJI
24 BPJS NON KAPITASI KB SUNTIK 3 BULAN 9000 1 9000 HIMAS LAILATUL ERVANIAH
24 PELEPASAN INFUS DEWASA 10000 1 10000 MATRAJI
25 PELEPASAN INFUS DEWASA 10000 1 10000 MUSLIHATI
26 JASA BIDAN KB SUNTIK 3 BULAN 5000 1 5000 MARYANI
26 NEBULIZER 10000 1 10000 ZAINULLAH
27 BPJS NON KAPITASI KB SUNTIK 3 BULAN 9000 1 9000 MARYANI
27 NEBULIZER 10000 1 10000 ZAINULLAH
28 PELEPASAN INFUS DEWASA 10000 1 10000 AHMADIYEK / AHMAD DIYA
29 PELEPASAN INFUS DEWASA 10000 1 10000 YUS SUDARSO
30 NEBULIZER 10000 1 10000 MAIMUNA
31 NEBULIZER 10000 5 50000 MUSLIHANI
32 PEMASANGAN DAN PELEPASAN INFUS ANAK 25000 1 25000 SITI FATIMATUS ZAHRA
33 NEBULIZER 10000 1 10000 FATAN BUSYRA SYAHREZA
34 PELEPASAN INFUS ANAK 10000 1 10000 FATAN BUSYRA SYAHREZA
35 PELEPASAN INFUS DEWASA 10000 1 10000 AHMADUN / P INDRA
36 PELEPASAN INFUS DEWASA 10000 1 10000 SINTA DWI PUTRI
37 PELEPASAN INFUS DEWASA 10000 1 10000 ARSO
38 NEBULIZER 10000 1 10000 ABU ASAN
42 PELEPASAN INFUS DEWASA 10000 1 10000 ASYATI
43 NEBULIZER 10000 1 10000 MUHAMMAD DIRGA ALKAN
44 NEBULIZER 10000 1 10000 MUHAMMAD DIRGA ALKAN
45 NEBULIZER 10000 1 10000 MUHAMMAD AQHAR FIDAN
46 NEBULIZER 10000 1 10000 MUHAMMAD AQHAR FIDAN
47 PELEPASAN INFUS ANAK 10000 1 10000 MUHAMMAD AQHAR FIDAN
48 PELEPASAN INFUS DEWASA 10000 1 10000 HALIMA / IBU YOGA
49 PELEPASAN INFUS DEWASA 10000 1 10000 HERMANTO
50 NEBULIZER 10000 1 10000 NIZAR MUSTAKFIRI ASROR
51 PELEPASAN INFUS DEWASA 10000 1 10000 SITI FATIMAZ ZAHROTUL ALI
52 GDA STIK 5000 1 5000 HOZZAIMAH
53 GDA STIK 5000 1 5000 HOZZAIMAH
54 NEBULIZER 10000 1 10000 DJUMARI
55 NEBULIZER 10000 1 10000 DJUMARI
56 PEMASANGAN DAN PELEPASAN INFUS DEWASA 20000 1 20000 ABDUL AZIZ / BAPAK YUL
57 GDA STIK 5000 1 5000 SEI
58 GDA STIK 5000 1 5000 ZAHROTUL KAMILAH
59 NEBULIZER 10000 1 10000 ABDUR ROHIM
6 PEMASANGAN INFUS PERSALINAN 10000 1 10000 INDRI VERALIAWATI
TOTAL 375300
TOTAL 610000
YULI NABILA AMALIA, AMD.KEP
YUNI FIRDAUSI NUSULA, A.MD.AK
INDRI VERALIAWATI
SUNARSIH / B IM
INDRI VERALIAWATI
SUNARSIH / B IM
INDRI VERALIAWATI
ZAHROTUL FIKRI ANNABILA
AURA ZAHRO
AHMAD FATAH ALJABBARUL ILHAM
MAT KADIR
TRIANA RAHMADANI
RETNO AYU NINGTIAS
AHMAD ARIS RAMADHAN
SAMI / HJ. ABDUL HADI
ROMLAH ARIFIN
ROMLAH ARIFIN
SAMI / HJ. ABDUL HADI
NOFITA AYU CANDRA
AHMAD ZIYAD ZIDQIL
AHMAD ZIYAD ZIDQIL
AHMAD ZIYAD ZIDQIL

FIKRI RAMADHANI
HIMAS LAILATUL ERVANIAH
HIMAS LAILATUL ERVANIAH
MUSLIHATI
ZAINULLAH
ZAINULLAH
AHMADIYEK / AHMAD DIYAK / BAPAK EP
YUS SUDARSO
MAIMUNA
MUSLIHANI
SITI FATIMATUS ZAHRA
FATAN BUSYRA SYAHREZA
FATAN BUSYRA SYAHREZA
AHMADUN / P INDRA
SINTA DWI PUTRI
ABU ASAN
ABU ASAN
ABU ASAN
ABU ASAN
MUHAMMAD DIRGA ALKANTARA

MUHAMMAD DIRGA ALKANTARA
MUHAMMAD AQHAR FIDANISA
HALIMA / IBU YOGA
HERMANTO
NIZAR MUSTAKFIRI ASROR
SITI FATIMAZ ZAHROTUL ALIYAH
HOZZAIMAH
HOZZAIMAH
ABDUL AZIZ / BAPAK YUL
ZAHROTUL KAMILAH
ABDUR ROHIM
INDRI VERALIAWATI
70 PEMAKAIAN 125000 1 0 SUNARSIH / B IM
86 PEMAKAIAN 125000 1 0 ABDUR ROHMAN
No Keterangan Tarif Total
QtyJasa Dokter / Nama
Fee Medis
Pasien
ABDUL HAFID, AMD.KEP
SEWA ALAT 5000 1 5000 SUNARSIH / B IM
SEWA ALAT 10000 1 10000 JAUHAROTUL MAKIYAH
SEWA ALAT 10000 1 10000 KIANA TALISHA SHEENAZ ARIFIN
SEWA ALAT 10000 1 10000 MARYATI
ADE BELA SUKMA, S.KEP.NS
2 SEWA ALAT 10000 1 10000 MAÙN
4 SEWA ALAT 5000 1 5000 SUNARSIH / B IM
8 SEWA ALAT 10000 1 10000 JAUHAROTUL MAKIYAH
11 SEWA ALAT 10000 1 10000 KIANA TALISHA SHEENAZ ARIFIN
13 SEWA ALAT 10000 1 10000 REYNAN RAJENDRA HANDIKA
AHMAD RIDWAN, S.KEP.NS
2 SEWA ALAT 5000 1 5000 SANAN
BAGUS ROBBY FITRIANTO,S.KEP.NS
5 SEWA ALAT 5000 1 5000 AHMAD GUNAWAR
8 SEWA ALAT 5000 1 5000 H. ALPAN
11 SEWA ALAT 5000 1 5000 SHOLEHA
12 SEWA ALAT 10000 1 10000 SUNARMI
15 SEWA ALAT 10000 1 10000 HARBABUN / HAJI ABDUL HADI
16 SEWA ALAT 5000 1 5000 SUDARMADI HASAN
19 SEWA ALAT 5000 1 5000 ATMANI
20 SEWA ALAT 5000 1 5000 TOREJO
23 SEWA ALAT 10000 1 10000 ABRIZAM FATAN A.
24 SEWA ALAT 10000 1 10000 SUTIJA / HAJJAH LATIFA
28 SEWA ALAT 10000 1 10000 SUYANI / IBU LUT
DANA FATHURROHMAN, AMD.KEP
2 SEWA ALAT 10000 1 10000 MARYATI
4 SEWA ALAT 50000 1 50000 HALIMATUS SA`DIYAH
5 SEWA ALAT 50000 1 50000 MARDI
6 SEWA ALAT 10000 1 10000 ALIFAH ELSAFA
DEVITA SINGGIH R, S.KEP.NS
1 SEWA ALAT 10000 1 10000 MAÙN
19 SEWA ALAT 50000 1 50000 SUNARDI
272 SEWA ALAT 10000 1 10000 FATIMAH SYAKILA KAIRINA

dr.Moh.Hisyam Rifqi
SEWA ALAT EKG/ECG
SEWA ALAT EKG/ECG
SEWA ALAT NEBULEZER
SEWA AMBULANCE PERSALINAN WILAYAH JEMBER
SEWA ALAT NEBULEZER

SEWA ALAT NEBULEZER
SEWA ALAT NEBULEZER
FAKHRUSY SYAKIRIN, S.KEP.NS

6 SEWA ALAT 10000 1 10000 MAÙN
8 SEWA ALAT 10000 1 10000 MOH ALIFUL MAKLUF
11 SEWA ALAT 10000 1 10000 NURAHMATIN
IFA MARIA ULFA, AMD.KEB
16 SEWA ALAT ### 1 ### UNTUNG MARTA LEGAWA
IRFAN FIRMANSYAH, S.KEP.NS
4 SEWA ALAT ### 1 ### MAÙN
8 SEWA ALAT ### 2 ### ABDUR ROHMAN
11 SEWA ALAT ### 1 ### MARYATI
M. ALAM KUSUMA ATMAJA,S.KEP.NS

2 SEWA ALAT 10000 1 10000 FITRIYATUL HASANAH
30 SEWA ALAT 5000 1 5000 SAHRIYAH / IBU MUHYIT

229 SEWA ALAT 5000 1 5000 NURSASI
502 SEWA ALAT 5000 1 5000 SRIYANI
4 SEWA ALAT 10000 1 10000 AHMAD AZZZAMIRU ADITYA NAHROWI
45 SEWA ALAT 10000 1 10000 MAÙN
48 SEWA ALAT 10000 1 10000 MAÙN
52 SEWA ALAT 10000 1 10000 MAÙN
53 SEWA ALAT 10000 1 10000 MAÙN
55 SEWA ALAT 10000 1 10000 MAÙN
137 SEWA ALAT 10000 1 10000 RISTA SAFIRA
161 SEWA ALAT 10000 1 10000 INDANI AINUN FAJRIA
199 SEWA ALAT 10000 1 10000 AHMAD FATAH ALJABBARUL ILHAM
377 SEWA ALAT 10000 1 10000 TUNGGASWATI
728 SEWA AMBU 250000 1 250000 RISKIYAH
SEWA ALAT 50000 1 50000 TOSAN

SEWA ALAT 5000 1 5000 MUHENA
SEWA ALAT 5000 1 5000 MUHENA
SEWA ALAT 5000 1 5000 SUDIYANTO H FAISOL
SEWA ALAT 10000 1 10000 JUMIATI
SEWA ALAT 10000 1 10000 SUPYANI/B,AGUS
SEWA ALAT 10000 1 10000 AISYAH RABIATUL HUSNI
SEWA ALAT 10000 1 10000 ELDINAR SHAKIRA
SEWA ALAT 50000 1 50000 RISKIYAH

SEWA ALAT 5000 1 5000 SUWARNA
SEWA ALAT 5000 1 5000 LATIFA
SEWA ALAT 5000 1 5000 SAMI / HJ. ABDUL HADI
SEWA ALAT 5000 1 5000 IFAN FAUZI
SEWA ALAT 5000 1 5000 SRIYANI
SEWA ALAT 10000 1 10000 AMARI
SEWA ALAT 10000 1 10000 ADELIA FITRI
SEWA ALAT 10000 1 10000 ADELIA FITRI
SEWA ALAT 10000 1 10000 AHMAD ZIYAD ZIDQIL
SEWA ALAT 10000 1 10000 MAIMUNA
SEWA ALAT 10000 1 10000 MUSLIHANI
SEWA ALAT 10000 1 10000 DJUMARI
SEWA ALAT 10000 1 10000 MUNAYAH
SEWA ALAT 10000 1 10000 SITI AMINAH/B.HJ.HAMINA
SEWA ALAT 10000 1 10000 MUHAMMAD MUFASIR ALFARISI
SEWA ALAT 10000 1 10000 MARIA ULFA
13 SEWA ALAT 5000 1 5000 NURSASI

2 SEWA ALAT 10000 1 10000 MAÙN
10 SEWA ALAT 10000 1 10000 INDANI AINUN FAJRIA

SEWA ALAT 10000 1 10000 MAÙN
SEWA AMBU200000 1 200000 INDRI VERALIAWATI
2 JASA PERAWAT UGD Rp 75,000.00 1 Rp 75,000.00 MARYATI
4 JASA PERAWAT UGD Rp 75,000.00 1 Rp 75,000.00 REYNAN RAJENDRA HANDIKA
6 JASA PERAWAT UGD BPJS Rp 10,000.00 1 Rp 10,000.00 ALIFIA CAHYANI
8 JASA PERAWAT UGD Rp 75,000.00 1 Rp 75,000.00 ALLAYA ZILAILI HAFIZA
9 JASA PERAWAT UGD BPJS Rp 10,000.00 1 Rp 10,000.00 YUSUF
11 JASA PERAWAT UGD BPJS Rp 10,000.00 1 Rp 10,000.00 MARDI
11 JASA PERAWAT UGD Rp 75,000 1 Rp 75,000.00 INA / IBU BUYAMI
16 JASA PERAWAT UGD BPJS Rp 10,000 1 Rp 10,000.00 JA`FAR
15 PELAYANAN GIZI KELAS II Rp 45,000.0 2 Rp 90,000.00 JUPRI
20 JASA KONSULTASI GIZI RAN Rp 5,000.0 1 Rp 5,000.00 PUTRI SYIFA BILUNA
23 JASA PERAWAT RUANGAN KRp 75,000.0 1 Rp 75,000.00 KARISMA
25 PELAYANAN GIZI MAKANA Rp 15,000.0 1 Rp 15,000.00 MAT ROSI
26 JASA KONSULTASI GIZI RAN Rp 5,000.0 1 Rp 5,000.00 MAT ROSI
29 BPJS NEBULIZER Rp 10,000.0 1 Rp 10,000.00 SITI AMINAH
30 SEWA ALAT NEBULEZER Rp 10,000.0 1 Rp 10,000.00 SITI AMINAH
32 PELAYANAN GIZI KELAS II Rp 45,000.0 1 Rp 45,000.00 SAIFUL
7 JASA PERAWAT RUANGAN KE Rp 50,000.00 1 Rp 50,000.00 AINIATUL JANNAH
20 PELEPASAN INFUS DEWASA Rp 10,000.00 1 Rp 10,000.00 SAMI / HJ. ABDUL HADI
29 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 MAISUNA / BU HALIL
30 JASA KONSULTASI GIZI RAN Rp 5,000.00 2 Rp 10,000.00 MAISUNA / BU HALIL
72 BPJS PELEPASAN KATETER Rp 15,000.00 1 Rp 15,000.00 TN. DIN /P. HORI
4 JASA KONSULTASI GIZI RAN Rp 5,000.00 1 Rp 5,000.00 NOVILATUL LAILA
6 JASA BIDAN ANC RANAP Rp 15,000.00 1 Rp 15,000.00 ZAHROTUL FIKRI ANNABILA
7 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 ZAHROTUL FIKRI ANNABILA
9 PELAYANAN GIZI MAKANA Rp 10,000.00 1 Rp 10,000.00 ZAHROTUL FIKRI ANNABILA
12 JASA KONSULTASI GIZI RAN Rp 5,000.00 1 Rp 5,000.00 ZAHROTUL FIKRI ANNABILA
17 BPJS JASA PERAWAT RUAN Rp 10,000.00 1 Rp 10,000.00 HANIAH
18 JASA PERAWAT UGD BPJS Rp 10,000.00 1 Rp 10,000.00 HANIAH
19 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 HANIAH
21 JASA PERAWAT UGD Rp 75,000.00 1 Rp 75,000.00 MADINATUS SAYYIDAH
23 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 MADINATUS SAYYIDAH
24 JASA PERAWAT RUANGAN KRp 75,000.00 1 Rp 75,000.00 MADINATUS SAYYIDAH
30 JASA KONSULTASI GIZI RAN Rp 5,000.00 1 Rp 5,000.00 GALIH RAMADHAN MUBAROK
31 NEBULIZER Rp 10,000.00 2 Rp 20,000.00 GALIH RAMADHAN MUBAROK
32 SEWA ALAT NEBULEZER Rp 10,000.00 2 Rp 20,000.00 GALIH RAMADHAN MUBAROK
34 JASA PERAWAT RUANGAN KE Rp 50,000.00 1 Rp 50,000.00 ABU ASAN
90 NEBULIZER Rp 10,000.00 1 Rp 10,000.00 FATIMAH SYAKILA KAIRINA
138 BPJS VISITE DOKTER Rp 10,000.00 1 Rp 10,000.00 ENTIN KUSTINI
139 NEBULIZER Rp 10,000.00 1 Rp 10,000.00 ENTIN KUSTINI
140 SEWA ALAT NEBULEZER Rp 10,000.00 1 Rp 10,000.00 ENTIN KUSTINI
143 JASA KONSULTASI GIZI RAN Rp 5,000.00 1 Rp 5,000.00 KHANZA ANINDIA SYAHROTUL AINI
244 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 SAIFUL
261 RJP DEWASA Rp 35,000.00 1 Rp 35,000.00 INA / IBU BUYAMI
463 HEATCHING 1-5 Rp 30,000.00 1 Rp 30,000.00 ADAM
464 HEACTCHING (PENAMBAHA Rp 5,000.00 3 Rp 15,000.00 ADAM
1 JASA PERAWAT UGD 75000 1 Rp 75,000.00 MUHAMMAD ABIM BERDIAN
1 PELAYANAN GIZI KELAS 1 Rp 45,000.00 1 Rp 45,000.00 AHMAD AZZZAMIRU ADITYA NAHROWI
8 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 MUHAMMAD RADITYA SAPUTRA
10 PELAYANAN GIZI MAKANA Rp 10,000.00 1 Rp 10,000.00 MUHAMMAD RADITYA SAPUTRA
4 PEMAKAIAN OKSIGEN MAS Rp 5,000.00 1 Rp 5,000.00 MARYATI
14 PELAYANAN GIZI MAKANA Rp 10,000.00 1 Rp 10,000.00 MUHAMMAD RADITYA SAPUTRA
19 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 MUHAMMAD FADIL BAHTIAR
20 PELAYANAN GIZI MAKANA Rp 10,000.00 1 Rp 10,000.00 MUHAMMAD FADIL BAHTIAR
33 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 SANAN
35 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 SANAN
37 PELAYANAN GIZI MAKANA Rp 15,000.00 1 Rp 15,000.00 WARDAH DZULQOIDAH M
38 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 WARDAH DZULQOIDAH M
40 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 WARDAH DZULQOIDAH M
41 PELAYANAN GIZI MAKANA Rp 15,000.00 1 Rp 15,000.00 WARDAH DZULQOIDAH M
43 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 ABRAHAM ABDUL MALIK
49 PELAYANAN GIZI KELAS 1 Rp 45,000.00 1 Rp 45,000.00 ASWAR / PAK KUS
52 PELAYANAN GIZI MAKANA Rp 15,000.00 1 Rp 15,000.00 ASWAR / PAK KUS
54 PELAYANAN GIZI MAKANA Rp 15,000.00 1 Rp 15,000.00 ASWAR / PAK KUS
56 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 FITRIYATUL HASANAH
60 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 PERI / P. EKA
63 PELAYANAN GIZI KELAS 1 Rp 45,000.00 1 Rp 45,000.00 MAÙN
66 PELAYANAN GIZI MAKANA Rp 15,000.00 1 Rp 15,000.00 MAÙN
73 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 SUNARSIH / B IM
76 PELAYANAN GIZI MAKANA Rp 15,000.00 1 Rp 15,000.00 SUNARSIH / B IM
81 PELAYANAN GIZI MAKANA Rp 15,000.00 1 Rp 15,000.00 SUNARSIH / B IM
85 PELAYANAN GIZI MAKANA Rp 15,000.00 1 Rp 15,000.00 NANANG HADI SYAIFULLAH
86 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 NANANG HADI SYAIFULLAH
93 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 ABDULLAH HANIF
95 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 ABDULLAH HANIF
96 PELAYANAN GIZI MAKANA Rp 10,000.00 1 Rp 10,000.00 ABDULLAH HANIF
98 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 ABDUR ROHMAN
99 PELAYANAN GIZI MAKANA Rp 15,000.00 1 Rp 15,000.00 ABDUR ROHMAN
100 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 ABDUR ROHMAN
101 PELAYANAN GIZI KELAS 1 Rp 45,000.00 1 Rp 45,000.00 JAUHAROTUL MAKIYAH
104 PELAYANAN GIZI MAKANA Rp 15,000.00 1 Rp 15,000.00 JAUHAROTUL MAKIYAH
111 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 SITI NUR MUFIDAH NINGTIAS
114 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 SUNAMI / B. TIN
120 PELAYANAN GIZI KELAS 1 Rp 45,000.00 1 Rp 45,000.00 KIANA TALISHA SHEENAZ ARIFIN
127 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 MUHAMMAD AZKA ALFARISKI
129 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 MUHAMMAD AZKA ALFARISKI
133 PELAYANAN GIZI KELAS 1 Rp 45,000.00 1 Rp 45,000.00 NOVIALIS ANGGRAINI
134 PELAYANAN GIZI KELAS 1 Rp 45,000.00 1 Rp 45,000.00 NOVIALIS ANGGRAINI
135 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 TUYAMI
143 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 NAGITA SEVINA PUTRI ELFAS
144 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 NAGITA SEVINA PUTRI ELFAS
145 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 MOH ROBIT UBAIDILLAH
147 PELAYANAN GIZI KELAS 1 Rp 45,000.00 1 Rp 45,000.00 MOH ROBIT UBAIDILLAH
150 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 SUWARNA
151 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 SUWARNA
153 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 JUMIATI
157 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 IMAM BUHARI
163 PELAYANAN GIZI KELAS 1 Rp 45,000.00 1 Rp 45,000.00 AFGATHA ZAHY PRANATA
164 PELAYANAN GIZI KELAS 1 Rp 45,000.00 1 Rp 45,000.00 AFGATHA ZAHY PRANATA
166 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 RISTA SAFIRA
169 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 ALISHA SABYA PUTRI WINDAYU
174 PELAYANAN GIZI MAKANA Rp 10,000.00 1 Rp 10,000.00 ALISHA SABYA PUTRI WINDAYU
180 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 MARYATI
189 PELAYANAN GIZI KELAS 1 Rp 45,000.00 1 Rp 45,000.00 INDANI AINUN FAJRIA
196 PELAYANAN GIZI KELAS 1 Rp 45,000.00 1 Rp 45,000.00 NOVILATUL LAILA
202 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 REYNAN RAJENDRA HANDIKA
204 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 REYNAN RAJENDRA HANDIKA
206 PELAYANAN GIZI MAKANA Rp 10,000.00 1 Rp 10,000.00 REYNAN RAJENDRA HANDIKA
207 PELAYANAN GIZI MAKANA Rp 10,000.00 1 Rp 10,000.00 REYNAN RAJENDRA HANDIKA
209 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 DEVI FERNANDA
213 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 AINIATUL JANNAH
214 PELAYANAN GIZI MAKANA Rp 10,000.00 1 Rp 10,000.00 AINIATUL JANNAH
221 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 AINIATUL JANNAH
226 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 ERNAWATI
228 PELAYANAN GIZI KELAS 1 Rp 45,000.00 1 Rp 45,000.00 ERNAWATI
230 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 AURA ZAHRO
231 PELAYANAN GIZI MAKANA Rp 10,000.00 1 Rp 10,000.00 AURA ZAHRO
243 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 AHMAD FATAH ALJABBARUL ILHAM
244 PELAYANAN GIZI KELAS 1 Rp 45,000.00 1 Rp 45,000.00 AHMAD FATAH ALJABBARUL ILHAM
253 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 LATIFA
256 PELAYANAN GIZI MAKANA Rp 15,000.00 1 Rp 15,000.00 LATIFA
261 PELAYANAN GIZI MAKANA Rp 15,000.00 1 Rp 15,000.00 LATIFA
265 PELAYANAN GIZI MAKANA Rp 10,000.00 1 Rp 10,000.00 MADINATUS SAYYIDAH
274 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 MUHAMMAD ABIM BERDIAN
275 PELAYANAN GIZI MAKANA Rp 10,000.00 1 Rp 10,000.00 MUHAMMAD ABIM BERDIAN
283 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 MUHAMMAD SYAHRUL HUDA
289 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 HOLIFATUL HASANAH
291 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 HOLIFATUL HASANAH
292 PELAYANAN GIZI MAKANA Rp 10,000.00 1 Rp 10,000.00 HOLIFATUL HASANAH
294 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 SUNARTO
300 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 NURSASI
304 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 MAT KADIR
306 PELAYANAN GIZI MAKANA Rp 15,000.00 1 Rp 15,000.00 MAT KADIR
309 PELAYANAN GIZI MAKANA Rp 15,000.00 1 Rp 15,000.00 MAT KADIR
314 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 AMARI
319 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 UMAR FARIKI
320 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 UMAR FARIKI
321 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 AZIZAH / ASIZEH
325 PELAYANAN GIZI KELAS 1 Rp 45,000.00 1 Rp 45,000.00 RAKA TAMA
332 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 SULISTYANINGSIH
336 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 SAMSUL ARIFIN
337 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 SAMSUL ARIFIN
341 PELAYANAN GIZI KELAS 1 Rp 45,000.00 1 Rp 45,000.00 HOSZAIMAH
342 PELAYANAN GIZI MAKANA Rp 15,000.00 1 Rp 15,000.00 HOSZAIMAH
344 PELAYANAN GIZI MAKANA Rp 15,000.00 1 Rp 15,000.00 HOSZAIMAH
347 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 AHMAD ARIS RAMADHAN
352 PELAYANAN GIZI UGD Rp 45,000.00 1 Rp 45,000.00 ALFIYATUL HASANAH
353 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 ALFIYATUL HASANAH
355 PELAYANAN GIZI MAKANA Rp 10,000.00 1 Rp 10,000.00 ALFIYATUL HASANAH
395 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 EVANANI ZEHIROH
422 PELAYANAN GIZI KELAS 1 Rp 45,000.00 1 Rp 45,000.00 MUHENA
423 PELAYANAN GIZI MAKANA Rp 15,000.00 1 Rp 15,000.00 MUHENA
467 PELAYANAN GIZI MAKANA Rp 15,000.00 1 Rp 15,000.00 MUSLIHANI
468 PELAYANAN GIZI KELAS 1 Rp 45,000.00 1 Rp 45,000.00 MUSLIHANI
473 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 ALFI KAMILA RAMADHANI DARMAWAN
474 PELAYANAN GIZI MAKANA Rp 10,000.00 1 Rp 10,000.00 ALFI KAMILA RAMADHANI DARMAWAN
493 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 SITI FATIMATUS ZAHRA
540 PELAYANAN GIZI MAKANA Rp 15,000.00 1 Rp 15,000.00 MELISA ISTIANA
546 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 ZAINUDIN
559 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 SUTIYANI
564 PELAYANAN GIZI VIP Rp 45,000.00 1 Rp 45,000.00 LAILI HIDAYAH
565 PELAYANAN GIZI MAKANA Rp 15,000.00 1 Rp 15,000.00 LAILI HIDAYAH
586 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 NIBA / IBU NADI
586 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 NIBA / IBU NADI
621 PELAYANAN GIZI UGD Rp 45,000.00 1 Rp 45,000.00 JA`FAR
622 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 FARAH SAKINA
623 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 NISFI AMALIA. N
624 PELAYANAN GIZI KELAS II Rp 45,000.00 1 Rp 45,000.00 NISFI AMALIA. N
6 PELEPASAN INFUS ANAK Rp 10,000.0 1 Rp 10,000.00 AHMAD AZZZAMIRU ADITYA NAHROWI
7 NEBULIZER Rp 10,000.0 1 Rp 10,000.00 AHMAD AZZZAMIRU ADITYA NAHROWI
14 PELEPASAN INFUS DEWASA Rp 10,000.0 1 Rp 10,000.00 MUHAMMAD RADITYA SAPUTRA
20 PELEPASAN INFUS ANAK Rp 10,000.0 1 Rp 10,000.00 MUHAMMAD FADIL BAHTIAR
41 NEBULIZER Rp 10,000.0 1 Rp 10,000.00 MAÙN
50 GDA STIK Rp 5,000.0 1 Rp 5,000.00 SUNARSIH / B IM
51 JASA PERAWAT RUANGAN KRp 75,000.0 1 Rp 75,000.00 SUNARSIH / B IM
56 PEMASANGAN DAN PELEPA Rp 20,000.0 1 Rp 20,000.00 SUNARSIH / B IM
58 PELEPASAN INFUS DEWASA Rp 10,000.0 1 Rp 10,000.00 SUNARSIH / B IM
63 PELEPASAN INFUS DEWASA Rp 10,000.0 1 Rp 10,000.00 NANANG HADI SYAIFULLAH
68 PELEPASAN INFUS DEWASA Rp 10,000.0 1 Rp 10,000.00 ABDUR ROHMAN
71 NEBULIZER Rp 10,000.0 1 Rp 10,000.00 JAUHAROTUL MAKIYAH
87 PELEPASAN INFUS ANAK Rp 10,000.0 1 Rp 10,000.00 KIANA TALISHA SHEENAZ ARIFIN
116 NEBULIZER Rp 10,000.0 1 Rp 10,000.00 RISTA SAFIRA
124 NEBULIZER Rp 10,000.0 1 Rp 10,000.00 MARYATI
137 NEBULIZER Rp 10,000.0 1 Rp 10,000.00 INDANI AINUN FAJRIA
149 NEBULIZER Rp 10,000.0 1 Rp 10,000.00 REYNAN RAJENDRA HANDIKA
150 NEBULIZER Rp 10,000.0 1 Rp 10,000.00 REYNAN RAJENDRA HANDIKA
174 BPJS NEBULIZER Rp 10,000.0 1 Rp 10,000.00 AHMAD FATAH ALJABBARUL ILHAM
179 NEBULIZER Rp 10,000.0 1 Rp 10,000.00 LATIFA
203 GDA STIK Rp 5,000.0 1 Rp 5,000.00 NURSASI
257 PELEPASAN INFUS DEWASA Rp 10,000.0 1 Rp 10,000.00 SULISTYANINGSIH
391 NEBULIZER Rp 10,000.0 2 Rp 20,000.00 AHMAD ZIYAD ZIDQIL
393 NEBULIZER Rp 10,000.0 1 Rp 10,000.00 AHMAD ZIYAD ZIDQIL
425 PELEPASAN INFUS DEWASA Rp 10,000.0 1 Rp 10,000.00 RIDWAN / BAPAK NAFISA
6 PELEPASAN INFUS ANAK Rp 10,000.0 1 Rp 10,000.00 AHMAD AZZZAMIRU ADITYA NAHROWI
596 BPJS VISITE DOKTER Rp 10,000.0 1 Rp 10,000.00 AHMADUN / P INDRA
630 BPJS NEBULIZER Rp 10,000.0 1 Rp 10,000.00 MUHAMMAD DIRGA ALKANTARA
661 PELEPASAN INFUS DEWASA Rp 10,000.0 1 Rp 10,000.00 SAIFUL
790 PELEPASAN INFUS ANAK Rp 10,000.0 1 Rp 10,000.00 ANANDA SHERIN AZKAYRA
797 NEBULIZER Rp 10,000.0 1 Rp 10,000.00 NISMA / B. SUPAR
798 NEBULIZER Rp 10,000.0 4 Rp 40,000.00 NISMA / B. SUPAR
249 GDA STIK Rp 5,000.00 1 Rp 5,000.00 SUDIYANTO H FAISOL
250 NGT Rp 25,000.00 1 Rp 25,000.00 SUDIYANTO H FAISOL
22 PELEPASAN INFUS DEWASA Rp 10,000.00 1 Rp 10,000.00 NAGITA SEVINA PUTRI ELFAS
473 BPJS GDA STIK Rp 5,000.0 1 Rp 5,000.00 SRIYANI
27 NEBULIZER Rp 10,000.00 1 Rp 10,000.00 JUMIATI
260 BPJS EKG/ECG Rp 25,000.00 1 Rp 25,000.00 TOSAN
277 RAWAT LUKA RINGAN Rp 20,000.00 1 Rp 20,000.00 NIHAN / BAPAK SUM
278 NEBULIZER Rp 10,000.00 1 Rp 10,000.00 SUPYANI/B,AGUS
287 NEBULIZER Rp 10,000.00 1 Rp 10,000.00 AISYAH RABIATUL HUSNI
YAHROTUL AINI
U ADITYA NAHROWI
U ADITYA NAHROWI
U ADITYA NAHROWI
U ADITYA NAHROWI
TYA SAPUTRA
TYA SAPUTRA
TYA SAPUTRA
TYA SAPUTRA
TYA SAPUTRA
TYA SAPUTRA
TYA SAPUTRA
ENAZ ARIFIN
ENAZ ARIFIN
ENAZ ARIFIN
ENAZ ARIFIN
RI WINDAYU
RI WINDAYU
RI WINDAYU
RI WINDAYU
RI WINDAYU
RI WINDAYU
RI WINDAYU
ABBARUL ILHAM
ABBARUL ILHAM
ABBARUL ILHAM
ABBARUL ILHAM
ABBARUL ILHAM
DHANI DARMAWAN
DHANI DARMAWAN
U ADITYA NAHROWI
U ADITYA NAHROWI
U ADITYA NAHROWI
TYA SAPUTRA
ENAZ ARIFIN
ABBARUL ILHAM
U ADITYA NAHROWI
U ADITYA NAHROWI
U ADITYA NAHROWI
A ALKANTARA

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REPORT JASA DOKTER / FEE MEDIS

PERIODE 2022-09-01 sampai 2022-09-30

No Keterangan Tarif Qty

Total Jasa Nama Pasien

Rp 20,000 TRIANA RAHMADANI

Rp 10,000.00 MUHAMMAD BALUQIA ARKA

Rp 2,000.00 ANA NUR LAILA LATIFAH

Rp 20,000.00 NOVIALIS ANGGRAINI

Rp 100,000.00 MUHAMMAD FADIL BAHTIAR

Rp 75,000.00 AFGATHA ZAHY PRANATA

Rp 100,000.00 ABDUR ROHMAN

Rp 75,000.00 AHMAD AZZZAMIRU ADITYA NAHROWI

100000 AINIATUL JANNAH

Rp 30,000.00 AHMAD SUKRON ROFIKI

Rp 10,000.00 ADELIA FITRI

Rp 15,000.00 ZAHROTUL FIKRI ANNABILA

Rp 2,000.00 DEVI FERNANDA

Rp 10,000.00 WARDAH DZULQOIDAH M

Rp 20,000.00 ZAHROTUL FIKRI ANNABILA

Rp 5,000.00 AHMAD AZZZAMIRU ADITYA NAHROWI

Rp 10,000 FITRIYATUL HASANAH

Rp 2,000.00 ANA NUR LAILA LATIFAH

Rp 10,000.00 RIYA FANDU WINATA

Rp 75,000.00 AHMAD AZZZAMIRU ADITYA NAHROWI

Rp 75,000.00 AHMAD AZZZAMIRU ADITYA NAHROWI

Rp 25,000.00 KIANA TALISHA SHEENAZ ARIFIN

Rp 10,000.00 PERI / P. EKA

AHMAD ZIYAD ZIDQIL

AHMAD ZIYAD ZIDQIL

HIMAS LAILATUL ERVANIAH

MUHAMMAD DIRGA ALKANTARA

ABDUL AZIZ / BAPAK YUL

272 SEWA ALAT 10000 1 10000 FATIMAH SYAKILA KAIRINA

SEWA ALAT NEBULEZER

FAKHRUSY SYAKIRIN, S.KEP.NS

M. ALAM KUSUMA ATMAJA,S.KEP.NS

59 SEWA ALAT 5000 1 5000 SUNARSIH / B IM

SEWA ALAT 50000 1 50000 TOSAN

SEWA ALAT 50000 1 50000 RISKIYAH

13 SEWA ALAT 5000 1 5000 NURSASI

SEWA ALAT 5000 1 5000 SUNARSIH / B IM

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