PEMERIKSAAN PASIEN RS SURYA MEDIKA BULAN DESEMBER 2022

NO TANGGAL NO RM NAMA ALAMAT PEMERIKSAAN TARIF LOKET TOTAL

1 12/6/2022 191628 MAESARAH GANG KASWARI ELEKTROLIT 220,000 17,000 237000

2 12/6/2022 193996 BATIAH UTAN ELEKTROLIT 220,000 17,000 237000
12/6/2022 191628 MAESARAH GANG KASWARI ELEKTROLIT 220,000 17,000 237000
3 12/7/2022 191628 MAESARAH GANG KASWARI C TROPONIN 222,000 17,000 239000
4 12/9/2022 141482 HARTATI KUSUMA O ENDOKRIN 611,500 17,000 628500
5 12/12/2022 194242 EKODJATI JAWA BARAT HBA1C 196,500 17,000 213500
6 12/12/2022 194241 SALEHA ALAS ELEKTROLIT, KREATININ , UREUM 296,000 17,000 313000
7 12/13/2022 123669 NURZAENAB HADI KEBAYAN ELEKTROLIT 220,000 17,000 237000
8 12/14/2022 044921 SITI ALU BRANG BARA ELEKTROLIT 220,000 17,000 237000
9 12/14/2022 185831 SULTAN IBRAHIM SEKETENG ELEKTROLIT 220,000 17,000 237000
10 12/15/2022 194276 SRIADI ALAS BARAT ENDOKRIN 611,500 17,000 628500
11 12/17/2022 001224 JUADI SUMBAWA ENDOKRIN 611,500 17,000 628500
12 12/18/2022 122479 A CANDRA GUNAWAN LAB BADAS ELEKTROLIT 220,000 17,000 237000
13 12/21/2022 091191 SYAFRUDDIN SEKETENG ALBUMIN, ELEKTROLIT 258,000 17,000 275000
14 12/22/2022 105509 NURLAILA ROPANG ENDOKRIN 611,500 17,000 628500
15 12/22/2022 024485 TIRA RIDAYANTI BUKIT PERMAI ENDOKRIN 611,500 17,000 628500
16 12/24/2022 194726 SUNARTO LAB SUMBAWA ELEKTROLIT 220,000 17,000 237000
17 12/25/2022 194726 SUNARTO LAB SUMBAWA C TROPONIN 222,000 17,000 239000
20 12/27/2022 162159 DITA RAKITA SUMBAWA ENDOKRIN 611,500 17,000 628500
18 12/28/2022 075017 SRI BANIN SAMAPUIN ELEKTROLIT 220,000 17,000 237000
19 12/28/2022 194726 SUNARTO LAB SUMBAWA ELEKTROLIT 220,000 17,000 237000
20 12/29/2022 194911 MARIANA BRANG ENE ENDOKRIN 611,500 17,000 628500
21 12/30/2022 194943 SITI NAJMAH KP BUGIS ELEKTROLIT 220,000 17,000 237000
22 12/30/2022 190700 IR DANI JATNIKA DL, GDS 141,500 17,000 158500
23 12/30/2022 070343 NURHAYATI PLAMPANG BGA 402,000 17,000 419000

Total 8438500 425000 8863500

Mengetahui
Kepala Ruangan laboratorium
Hj. SALWA.S.ST
PEMERIKSAAN PASIEN RS SURYA MEDIKA BULAN JANUARI 2023

NO TANGGAL NO RM NAMA ALAMAT PEMERIKSAAN TARIF LOKET TOTAL

1 1/3/2023 195068 PUTRI NIFTAH D DUSUN HIJRAH LAPE ELEKTROLIT 220,000 17,000 237000
2 1/4/2023 195106 MARIYANI LABUHAN SUMBAWA ENDOKRIN 611,500 17,000 628500
3 1/7/2023 163482 RAMLI MS BRANG BARA ENDOKRIN 611,500 17,000 628500
4 1/12/2023 195427 EDO MOYO UTARA ELEKTROLIT 220,000 17,000 237000
5 1/12/2023 195436 ALFIAN DUSUN LAB JONTAL ELEKTROLIT 220,000 17,000 237000
6 1/13/2023 033167 SAHABUDDIN DUSUN BAJO -LAB BAJO ALBUMIN 38,000 17,000 55000
7 1/15/2023 045128 ENDANG MURTININGSSEKETENG ELEKTROLIT 220,000 17,000 237000
8 1/16/2023 129812 RIZKI DINA DUSUN SANTONG ALAS ENDOKRIN 611,500 17,000 628500
9 1/17/2023 120861 SHIFAH FAIZAH SUMBAWA REMATOID FAKTOR 62,500 17,000 79500
10 1/17/2023 099038 ISNAINI POTO ENDOKRIN 611,500 17,000 628500
11 1/20/2023 195705 MUHAMMAD RAFKA BARU TAHAN ELEKTROLIT 220,000 17,000 237000
12 1/22/2023 192510 NURFITRIA LARAS SATLABUHAN BURUNG - BUER ENDOKRIN 611,500 17,000 628500
13 1/24/2023 195883 WLDA GUSTIANINGSI BERARE ENDOKRIN 611,500 17,000 628500
14 1/25/2023 195943 KARNILASARI KARANG GORENG ENDOKRIN 611,500 17,000 628500
15 1/28/2023 196066 RAHMAWATI MOYO MEKAR ELEKTROLIT 220,000 17,000 237000
16 1/30/2023 030776 AINY FITRIAH SUMBAWA ENDOKRIN 611,500 17,000 628500
17 1/30/2023 196144 SUTIHAT EMPANG ENDOKRIN 611,500 17,000 628500
18 1/31/2023 033758 MUHAMMAD B JEMADUSUN SETE ATAS ELEKTROLIT 220,000 17,000 237000
19 1/31/2023 061074 HAJJI ENDOKRIN 611,500 17,000 628500

TOTAL 7755500 323000 8078500

Mengetahui
Kepala Ruangan laboratorium
Hj. SALWA.S.ST
PEMERIKSAAN PENUNJANG PASIEN RS SURYA MEDIKA BULAN FEBRUARI 2023

NO TANGGAL NO RM NAMA ALAMAT PEMERIKSAAN TARIF LOKET TOTAL

1 2/1/2023 196247 BY NY KARNILASARI BRANG BARA ENDOKRIN 611,500 17,000 628500
2 2/3/2023 123979 DWI PURMALASARI PANTO DAENG ALBUMIN 38,000 17,000 55000
3 2/6/2023 100491 OVIYANTI KP PADAK PT, APTT, INR 439,000 17,000 456000
4 2/7/2023 `050344 SITI MASITA SUMBAWA ENDOKRIN 611,500 17,000 628500
5 2/7/2023 111018 FIONI IRAMALDA KEBAYAN PT, APTT, INR, ALBUMIN 477,000 17,000 494000
6 2/7/2023 185523 LESTARI SERING ATAS ENDOKRIN 611,500 17,000 628500
7 2/9/2023 196598 FN DISKA AP SUMBAWA PT, APTT, INR 439,000 17,000 456000
8 2/10/2023 194236 ABDUL HARIS SEBEWE GDS, ALBUMIN, ELEKTROLIT 297,500 17,000 314500
9 2/11/2023 182555 FERIYANTO SUMBAWA ELEKTROLIT 220,000 17,000 237000
10 2/11/2023 138737 YENI KUS ENDANG BUGIS PT, APTT, INR, ALBUMIN 477,000 17,000 494000
11 2/12/2023 196676 EMI FITRIANI ALAS BARAT PT, APTT, INR 439,000 17,000 456000
12 2/12/2023 196681 NINING KEBAYAN PT, APTT, INR 439,000 17,000 456000
13 2/14/2023 `084520 NELIARTI UNTER IWES PT, APTT, INR 439,000 17,000 456000
14 2/14/2023 196753 HABIDATUL UNTER IWES PT, APTT, INR 439,000 17,000 456000
15 2/14/2023 196759 ZULHIDAYAT LAB BADAS NS1 224,000 17,000 241000
16 2/15/2023 196190 SUDIRMAN LAB SUMBAWA BILIRUBIN TOTAL, DIREK, INDIRECT 114,000 17,000 131000
17 2/16/2023 182696 SUSILAWATI BUIN PANDAN PT, APTT, INR 439,000 17,000 456000
18 2/17/2023 173851 RIA QOMRATUL UNTER IWES ELEKTROLIT 220,000 17,000 237000
19 2/17/2023 196869 SITI SALEH BUER ELEKTROLIT 220,000 17,000 237000
20 2/17/2023 196859 FATMAWATI SUMBAWA PT, APTT, INR 439,000 17,000 456000
21 2/18/2023 196881 SRI ASTUTI KARANG ORONG PT, APTT, INR 439,000 17,000 456000
22 2/20/2023 116828 DWI FITRI H SEBEWE PT, APTT, INR 439,000 17,000 456000
23 2/21/2023 126865 IFA SARIFATIA BUGIS PT, APTT, INR 439,000 17,000 456000
24 2/21/2023 103554 MELY APRIANI DUSUN PASIR HBA1C 196,500 17,000 213500
25 2/21/2023 174920 SRI ASTUTI ALAS ELEKTROLIT 220,000 17,000 237000
26 2/26/2023 005007 SULAS TINA BTN KARANG DIMA ELEKTROLIT 220,000 17,000 237000

TOTAL 9,587,500 442,000 10,029,500

Sumbawa, 2 Maret 2023

Kepala Ruangan laboratorium
HJ SALWA, S.ST
PEMERIKSAAN PENUNJANG PASIEN RS SURYA MEDIKA BULAN MARET 2023

NO TANGGAL NO RM NAMA ALAMAT

1 3/1/2023 197323 DATIA WAHAB DUSUN PASIR
2 3/2/2023 20762 AMINOLLAH LEMPEH
3 3/6/2023 143336 IPAN NURYANDI LOPOK
4 3/7/2023 `012902 SITI JAHORA KP BUGIS
5 3/12/2023 197680 BASRI PANTO DAENG
6 3/12/2023 26068 DIAN ARMINI BRANG BIJI
7 3/20/2023 129812 RIZKI DINA FITRIYAH DUSUN SANTONG ALAS
8 3/21/2023 192510 NUR PITRIA LARASATI BUER
9 3/24/2023 198140 ACMADIN HZ LAB BADAS
4/25/2023 193482 RAMLI PANTO DAENG
10 3/26/2023 198140 ACMADIN HZ LAB BADAS
11 3/27/2023 198248 A AZIZ SUMBAWA
12 3/31/2023 198931 MUHAMMAD SALEH BRANG BIJI
13 3/31/2023 114673 NGAKAN MADE SUMBAWA
14 3/31/2023 198434 NURU LAB BADAS
15 3/31/2023 198433 ABDUL KADIR LAB SANGORA
16 3/31/2023 198433 ABDUL KADIR LAB SANGORA
 PEMERIKSAAN TARIF LOKET TOTAL
ELEKTROLIT 611,500 17,000 628500
ELEKTROLIT 220,000 17,000 237000
ELEKTROLIT 220,000 17,000 237000
ELEKTROLIT 220,000 17,000 237000
ELEKTROLIT 220,000 17,000 237000
ALBUMIN, ELEKTROLIT 258,000 17,000 275000
ENDOKRIN 611,500 17,000 628500
ENDOKRIN 611,500 17,000 628500
ELEKTROLIT 220,000 17,000 237000
ENDOKRIN 611,500 17,000 628500
ELEKTROLIT 220,000 17,000 237000
ELEKTROLIT 220,000 17,000 237000
UREUM, KRAETININE 56,000 17,000 73,000
UREUM, KRAETININE, ELEKTROLIT 296,000 17,000
BILIRUBIN TOTAL, DIREK, INDIRECT, ALBUMIN,HCV 239,000 17,000 256000
ELEKTROLIT 220,000 17,000 237000
UREUM, KRAETININE 56,000 17,000 73,000

TOTAL 5,111,000 289,000 5,400,000

Sumbawa, 2 Maret 2023

Kepala Ruangan laboratorium

HJ SALWA, S.ST
PEMERIKSAAN PENUNJANG PASIEN RS SURYA MEDIKA BULAN MEI 2023

NO TANGGAL NO RM NAMA ALAMAT

1 5/3/2023 199615 RUSMIATI LEMPEH
2 5/6/2023 199733 I YOMAN GUMBREK DSN KAUMAN LAB SUMBAWA
3 5/6/2023 104447 SALMA DUSUN POTO
4 5/6/2023 110823 YUVIAN V JLN ASAHAN
5 5/7/2023 117452 DITA PUTRI L KERATO UNTER IWES
6 5/9/2023 `013905 DIAN ARMINI A RACHMAN MUCHTAR
7 5/11/2023 124895 ADRIANA NIJANG
8 5/11/2023 `084693 SABARUDDIN SEKETENG
9 5/12/2023 175769 JON ARIFIN PERNEK
4/25/2023 193482 RAMLI PANTO DAENG
10 3/26/2023 198140 ACMADIN HZ LAB BADAS
11 3/27/2023 198248 A AZIZ SUMBAWA
12 3/31/2023 198931 MUHAMMAD SALEH BRANG BIJI
13 3/31/2023 114673 NGAKAN MADE SUMBAWA
14 3/31/2023 198434 NURU LAB BADAS
15 3/31/2023 198433 ABDUL KADIR LAB SANGORA
16 3/31/2023 198433 ABDUL KADIR LAB SANGORA
 PEMERIKSAAN TARIF LOKET TOTAL
ELEKTROLIT 220,000 17,000 237000
ELEKTROLIT 220,000 17,000 237000
ELEKTROLIT 220,000 17,000 237000
ELEKTROLIT 220,000 17,000 237000
ELEKTROLIT 220,000 17,000 237000
ELEKTROLIT 220,000 17,000 237000
ENDOKRIN 611,500 17,000 628500
ALBUMIN, UREUM, KREATININE 114,000 17,000 131000
ELEKTROLIT 220,000 17,000 237000
ENDOKRIN 611,500 17,000 628500
ELEKTROLIT 220,000 17,000 237000
ELEKTROLIT 220,000 17,000 237000
UREUM, KRAETININE 56,000 17,000 73,000
UREUM, KRAETININE, ELEKTROLIT 296,000 17,000
BILIRUBIN TOTAL, DIREK, INDIRECT, ALBUMIN,HCV 239,000 17,000 256000
ELEKTROLIT 220,000 17,000 237000
UREUM, KRAETININE 56,000 17,000 73,000

TOTAL 4,184,000 289,000 4,473,000

Sumbawa, 2 Maret 2023

Kepala Ruangan laboratorium

HJ SALWA, S.ST