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PEMERINTAH KABUPATEN ACEH TENGAH

DINAS KESEHATAN
UPTD PUSKESMAS BIES
Jln. Takengon Angkup Desa Simpang Uning Niken Kec. Bies 24561

KWITANSI
NO :

Sudah terima dari :.............................................................................................


ELIMINATING TB IN INDONESIA
Banyaknya uang :.............................................................................................
Rp 175.000 (Seratus Tujuh Puluh Lima Ribu Rupiah)

Untuk Pembayaran :.............................................................................................


Biaya Packing Sampel Specimen / Dahak Suspek TB SO
Bulan : Agustus
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Jumlah Pasien :7
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1. Ibrahim Tanggal 8/3/2023
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2. Tukijah Tanggal 8/3/2023
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3. Sulastri Tanggal 8/3/2023
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4. Faisal Abda'u Tanggal 8/4/2023
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5. Tria Junita Tanggal 8/4/2023
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6. Merlin Susi AndrianTanggal 8/5/2023
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7. Sikman Tanggal 8/6/2023
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Bies, 05 September 2023


Mengetahui Yang Menerima
Kepala Puskesmas Bies Petugas TB Puskesmas Bies

dr. Gustina Fitri M.K.M Desi susanti Amd.Keb


Nip.19800817 201412 2 001 Nip. 19881229 201705 2 002

Bies, 03 Agustus 2023


Mengetahui Yang Menerima
Kepala Puskesmas Bies Petugas TB Puskesmas Bies
dr. Gustina Fitri M.K.M Desi susanti Amd.Keb
Nip.19800817 201412 2 001 Nip. 19881229 201705 2 002

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