 |
PEMERINTAH KABUPATEN BLITARRUMAH SAKIT UMUM DAERAH"NGUDI WALUYO" WLINGIJalan Dokter Sucipto Nomor 5 Beru Wlingi Blitar |
 |
Ditagihkan Kepada:
RSUD Srengat
Jl. Raya Dandong, Dandong, Kec. Srengat, Kabupaten Blitar
| No. Invoice | TRX-20260411-0001 |
| Periode Layanan | February 2026 |
| Unit Layanan | MIKROBIOLOGI |
| NO | TANGGAL | NO. MR | NAMA PASIEN | LAYANAN | TARIF (Rp.) |
|---|---|---|---|---|---|
| 1 | 02/02/26 | 373917 | KARYATI | Kultur Pus | 520.000 |
| 2 | 03/02/26 | 373968 | SUAHRTI | Kultur Sputum | 520.000 |
| 3 | 06/02/26 | 374113 | MESILAH | Kultur Sputum | 520.000 |
| 4 | 06/02/26 | 374114 | UMI ASRIAH | Kultur Sputum | 520.000 |
| 5 | 06/02/26 | 374115 | YATUN | Kultur Sputum | 520.000 |
| 6 | 07/02/26 | 374173 | SUMADI | Kultur Sputum | 520.000 |
| 7 | 10/02/26 | 374337 | MUKHAYANI | Kultur Sputum | 520.000 |
| 8 | 11/02/26 | 374404 | AMIN | Kultur Sputum | 520.000 |
| 9 | 11/02/26 | 374402 | MURANTI | Kultur Sputum | 520.000 |
| 10 | 11/02/26 | 374405 | GINAH | Kultur Sputum | 520.000 |
| 11 | 12/02/26 | 374457 | RETRO FITRIANI | Kultur Sputum | 520.000 |
| 12 | 16/02/26 | 374615 | SUTIAH | Kultur Sputum | 520.000 |
| 13 | 17/02/26 | 374654 | NININ TRI RAHAYU | Kultur Sputum | 520.000 |
| 14 | 21/02/26 | 374919 | DIAN IRIANTIK | Kultur Sputum | 520.000 |
| 15 | 23/02/26 | 374997 | SUMINEM | Kultur Sputum | 520.000 |
| 16 | 23/02/26 | 374998 | SUPIYAH | Kultur Sputum | 520.000 |
| 17 | 24/02/26 | 375140 | KATEMIN | Kultur Sputum | 520.000 |
| 18 | 26/02/26 | 375156 | ROPINGI | Kultur Sputum | 520.000 |
| TOTAL TAGIHAN | Rp 9.360.000 | ||||
Terbilang:
"Sembilan Juta Tiga Ratus Enam Puluh Ribu Rupiah"
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