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PEMERINTAH KABUPATEN BLITARRUMAH SAKIT UMUM DAERAH"NGUDI WALUYO" WLINGIJalan Dokter Sucipto Nomor 5 Beru Wlingi Blitar |
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| No. Invoice | TRX-20260212-0002 |
| Periode Layanan | January 2026 |
| Unit Layanan | MIKROBIOLOGI |
| NO | TANGGAL | NO. MR | NAMA PASIEN | LAYANAN | TARIF (Rp.) |
|---|---|---|---|---|---|
| 1 | 06/01/26 | 372581 | SULENI | Kultur Darah | 675.000 |
| 2 | 08/01/26 | 372709 | SUYADI | Kultur Darah | 675.000 |
| 3 | 15/01/26 | 373102 | RONY CANDRA GUNAWAN | Kultur Pus | 520.000 |
| 4 | 17/01/26 | 373151 | PONIRAH | Kultur Urine | 520.000 |
| 5 | 27/01/26 | 373647 | SULASTRI | Kultur Darah | 675.000 |
| 6 | 30/01/26 | 373787 | ANDY CAHYONO | Kultur Pus | 520.000 |
| 7 | 13/01/26 | 372992 | SIGIT NURDIANSYAH | Kultur Pus | 520.000 |
| 8 | 03/01/26 | 372429 | DARSUYANTO | Kultur Darah | 675.000 |
| TOTAL TAGIHAN | Rp 4.780.000 | ||||
Mengetahui,
DIREKTUR
dr. ENDAH WORO UTAMI, MMRS
NIP. 19720202 200212 2 004
KABAG KEUANGAN
ADI WIDODO, SE
NIP. 19680718 200701 1 017
Wlingi, 11 April 2026
BENDAHARA PENERIMA
IKA SRI MUHARTI, S.Sos
NIP. 19780111 200701 2 012