coba
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coba programTRANSCRIPT
Kepada:Yth.Hj.Amalia
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi02/06/14 6090K053F USG KANDUNGAN 80,000 16,000 Total 80,000 16,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bpk.H.Amat
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi13/06/14 6512K475F USG 240,000 48,00020/06/14 6734K697F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,25029/06/14 7077K040F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,250 Total 400,000 88,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Asnawati
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi16/06/14 6599K562F Gula Darah Acak 15,000 3,750 S G O T 20,000 5,000 S G P T 20,000 5,000 Urea 20,000 5,000 Kreatinin 20,000 5,00026/06/14 6953K916F Darah Lengkap Elektrik 55,000 13,750 S G O T 20,000 5,000 S G P T 20,000 5,000 Hbs Ag (Elisa) 90,000 18,000 Anti HBs Titer 105,000 21,000 URINE LENGKAP 25,000 6,250 Total 410,000 92,750
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bp.A.Basuki
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi10/06/14 6402K365F S G O T 20,000 5,000 S G P T 20,000 5,000 Hbs Ag (Elisa) 90,000 18,00016/06/14 6583K546F ECG 60,000 12,000 Total 190,000 40,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bdn Astutik
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi07/06/14 6280K243F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,250 Total 80,000 20,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr Arif M.F
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi06/06/14 6251K214F BOF 65,000 13,00023/06/14 6845K808F Bilirubin Direk 22,000 5,500 Bilirubin Total 22,000 5,500 S G O T 20,000 5,000 S G P T 20,000 5,000 Alkali Phospatase 48,000 12,000 AFP 170,000 34,000 USG 240,000 48,00023/06/14 6850K813F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,250 Total 687,000 148,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bdn Ana Susanti
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi03/06/14 6144K107F Darah Lengkap Elektrik 55,000 13,75005/06/14 6210K173F PAP Smear 90,000 13,50007/06/14 6303K266F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,25007/06/14 6306K269F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,25008/06/14 6311K274F VDRL 50,000 10,00008/06/14 6312K275F VDRL 50,000 10,00008/06/14 6313K276F PAP Smear 90,000 13,50009/06/14 6379K342F Darah Lengkap Elektrik 55,000 13,750 URINE LENGKAP 25,000 6,25009/06/14 6380K343F Thorax PA 65,000 13,00022/06/14 6789K752F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,250 Total 720,000 153,750
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bdn Astrid
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi25/06/14 6930K893F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,250 Total 80,000 20,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bpk.Aldino
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi05/06/14 6195K158F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,25019/06/14 6731K694F USG 240,000 48,000 Total 320,000 68,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Agung Cahyono
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi02/06/14 6058K021F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,250 S G O T 20,000 5,000 S G P T 20,000 5,00006/06/14 6243K206F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,25011/06/14 6455K418F Darah Lengkap Elektrik 55,000 13,750 S G O T 20,000 5,000 S G P T 20,000 5,000 WIDAL 25,000 6,25016/06/14 6580K543F Darah Lengkap Elektrik 55,000 13,750 S G O T 20,000 5,000 S G P T 20,000 5,000 WIDAL 25,000 6,25020/06/14 6733K696F Darah Lengkap Elektrik 55,000 13,750 Gula Darah Acak 15,000 3,750 Urea 20,000 5,000 Kreatinin 20,000 5,000 S G O T 20,000 5,000 S G P T 20,000 5,00021/06/14 6780K743F S G O T 20,000 5,000 S G P T 20,000 5,000 Hbs Ag (Elisa) 90,000 18,00024/06/14 6866K829F Darah Lengkap Elektrik 55,000 13,750 Urea 20,000 5,000 Kreatinin 20,000 5,000
S G O T 20,000 5,000 S G P T 20,000 5,000 Total 855,000 209,250
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bpk.Agus Setia.B
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi17/06/14 6641K604F Thorax PA 65,000 13,000 Total 65,000 13,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Ny.Ailul
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi04/06/14 6180K143F USG KANDUNGAN 80,000 16,000 Total 80,000 16,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Alek
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi11/06/14 6454K417F USG 240,000 48,00013/06/14 6507K470F Urea 20,000 5,000 Kreatinin 20,000 5,000 Asam Urat 20,000 5,000 CEA 170,000 34,000 AFP 170,000 34,000 TOTAL PSA 210,000 42,000 Free PSA 290,000 58,000 Acid Phosphatase 380,000 76,000 Ca 15 - 3 260,000 52,00025/06/14 6942K905F USG 240,000 48,000 Total 2,020,000 407,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Amining Wati
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi04/06/14 6162K125F Darah Lengkap Elektrik 55,000 13,750 S G O T 20,000 5,000 S G P T 20,000 5,000 WIDAL 25,000 6,25024/06/14 6895K858F USG 240,000 48,000 Total 360,000 78,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Ny.Anita Fauziyah
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi07/06/14 6301K264F Darah Lengkap Elektrik 55,000 13,750 Gula Darah Acak 15,000 3,750 S G O T 20,000 5,000 S G P T 20,000 5,000 Urea 20,000 5,000 Kreatinin 20,000 5,000 Asam Urat 20,000 5,00018/06/14 6677K640F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,250 S G O T 20,000 5,000 S G P T 20,000 5,000 Urea 20,000 5,000 Kreatinin 20,000 5,000 Total 330,000 82,500
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bdn.Ardiniwati
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi09/06/14 6347K310F Darah Lengkap Elektrik 55,000 13,750 GOL.DARAH RHESUS 20,000 5,000 Gula Darah Acak 15,000 3,750 Urea 20,000 5,000 Kreatinin 20,000 5,000 Asam Urat 20,000 5,000 Kreatinin Clearance 90,000 18,000 URINE LENGKAP 25,000 6,250 Total 265,000 61,750
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bpk.H.Asfiyak
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi23/06/14 6820K783F Gula Darah Puasa 15,000 3,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 Kreatinin 20,000 5,000 Asam Urat 20,000 5,000 Kreatinin Clearance 90,000 18,000 S G O T 20,000 5,000 S G P T 20,000 5,000 Total 234,000 54,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Amalis
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi06/06/14 6254K217F Thorax PA 65,000 13,00007/06/14 6288K251F Thorax PA 65,000 13,00016/06/14 6574K537F Thorax PA 65,000 13,00025/06/14 6915K878F Pelvis 65,000 13,000 Total 260,000 52,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bp.Cucut A.
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi10/06/14 6397K360F Elbow AP/LAT SINISTRA 100,000 20,000 Total 100,000 20,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bpk.Catur Ahmadani
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi23/06/14 6818K781F Thorax PA 65,000 13,000 S G O T 20,000 5,000 S G P T 20,000 5,00030/06/14 7120K083F Thorax PA 65,000 13,000 ECG 60,000 12,000 Total 230,000 48,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Ny.CICIK
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi02/06/14 6059K022F Thorax PA 65,000 13,000 Total 65,000 13,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Diana
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi19/06/14 6695K658F Gula Darah Puasa 15,000 3,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 Asam Urat 20,000 5,000 URINE LENGKAP 25,000 6,250 Total 109,000 27,250
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Dr.H.M.DAWAM WAHAB
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi02/06/14 6063K026F Gula Darah Puasa 15,000 3,750 Gula Darah 2 jam PP 15,000 3,75009/06/14 6368K331F URINE LENGKAP 25,000 6,25016/06/14 6611K574F Gula Darah Acak 15,000 3,750 Genu Ap/Lat Sinistra 100,000 20,00027/06/14 7019K982F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,250 URINE LENGKAP 25,000 6,250 Total 275,000 63,750
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Dwi Purnomo Sidhi
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi17/06/14 6626K589F Darah Lengkap Elektrik 55,000 13,750 Gula Darah Puasa 15,000 3,750 Gula Darah 2 jam PP 15,000 3,750 Urea 20,000 5,000 Kreatinin 20,000 5,000 Asam Urat 20,000 5,000 S G O T 20,000 5,000 S G P T 20,000 5,000 ECG 60,000 12,000 Thorax PA 65,000 13,000 Total 310,000 71,250
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Didik
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi16/06/14 6586K549F ECG 60,000 12,00019/06/14 6724K687F USG 240,000 48,00021/06/14 6775K738F Thorax PA 65,000 13,000 Total 365,000 73,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Drg.Darmawan,M.Kes
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi13/06/14 6501K464F Dental 55,000 11,00030/06/14 7111K074F Dental 55,000 11,000 Total 110,000 22,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Deby Kartika H
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi23/06/14 6835K798F Thorax PA 65,000 13,000 Total 65,000 13,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Dian .P
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi23/06/14 6853K816F USG MAMMAE 160,000 32,00027/06/14 7020K983F USG 240,000 48,000 Total 400,000 80,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Dyah Ayu R.P
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi28/06/14 7060K023F USG 240,000 48,000 Total 240,000 48,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Ny.Evi Susanti
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi30/06/14 7093K056F Thorax PA 65,000 13,000 Total 65,000 13,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Elizabeth
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi10/06/14 6414K377F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,250 Total 80,000 20,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bdn.Erli
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi02/06/14 6078K041F Hemoglobin 10,000 2,500 Protein 7,000 1,750 Reduksi 7,000 1,750 Total 24,000 6,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bdn.Eni Farida
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi17/06/14 6638K601F PAP Smear 90,000 13,50026/06/14 6964K927F PAP Smear 90,000 13,500 Total 180,000 27,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Evilinda P
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi03/06/14 6129K092F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,25003/06/14 6135K098F Gula Darah Acak 15,000 3,75004/06/14 6159K122F Gula Darah Puasa 15,000 3,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 HDL-Cholesterol 22,000 5,500 LDL-Cholesterol 22,000 5,500 Asam Urat 20,000 5,00018/06/14 6668K631F Gula Darah Acak 15,000 3,750 Kholesterol 27,000 6,750 Asam Urat 20,000 5,000 Total 285,000 71,250
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Elizza H
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi07/06/14 6271K234F WIDAL 25,000 6,250 URINE LENGKAP 25,000 6,25011/06/14 6441K404F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,250 Total 130,000 32,500
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.EKO B
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi30/06/14 7103K066F Thorax PA 65,000 13,000 Total 65,000 13,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.drg.Esti
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi23/06/14 6830K793F Dental 55,000 11,000 Total 55,000 11,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bdn.Fatmawati
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi21/06/14 6769K732F PAP Smear 90,000 13,500 Total 90,000 13,500
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Ny.Farida
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi07/06/14 6281K244F Genu Ap/Lat Dextra 100,000 20,00017/06/14 6634K597F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,25019/06/14 6705K668F Darah Lengkap Elektrik 55,000 13,75028/06/14 7033K996F Genu Ap/Lat Dextra 100,000 20,000 Genu Ap/Lat Sinistra 100,000 20,000 Total 435,000 93,750
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bdn.Feni A Riyanto
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi03/06/14 6121K084F PAP Smear 90,000 13,50003/06/14 6143K106F USG 240,000 48,00028/06/14 7063K026F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,250 Total 410,000 81,500
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bdn.Feti Ningsih
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi09/06/14 6363K326F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,250 Total 80,000 20,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bp.Gunawan.
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi13/06/14 6503K466F Wrist Ap/Lat Dextra 100,000 20,000 Total 100,000 20,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.T.A Hadi Kusumo
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi14/06/14 6521K484F Darah Lengkap Elektrik 55,000 13,750 Gula Darah Puasa 15,000 3,750 Gula Darah 2 jam PP 15,000 3,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 LDL-Cholesterol 22,000 5,500 S G O T 20,000 5,000 S G P T 20,000 5,000 Urea 20,000 5,000 Kreatinin 20,000 5,000 Asam Urat 20,000 5,000 URINE LENGKAP 25,000 6,250 Total 281,000 70,250
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Hadig F. Sp.PD
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi02/06/14 6061K024F Gula Darah Acak 15,000 3,750 Kholesterol 27,000 6,750 S G O T 20,000 5,000 S G P T 20,000 5,000 Urea 20,000 5,000 Kreatinin 20,000 5,000 Asam Urat 20,000 5,000 Thorax PA 65,000 13,000 ECG 60,000 12,000 URINE LENGKAP 25,000 6,25003/06/14 6128K091F Gula Darah Acak 15,000 3,75004/06/14 6170K133F Gula Darah Acak 15,000 3,75005/06/14 6198K161F Thorax PA 65,000 13,000 Gula Darah Acak 15,000 3,75007/06/14 6279K242F Gula Darah Puasa 15,000 3,750 Gula Darah 2 jam PP 15,000 3,75009/06/14 6348K311F Gula Darah Acak 15,000 3,750 Thorax PA 65,000 13,00009/06/14 6349K312F Urea 20,000 5,000 Kreatinin 20,000 5,00009/06/14 6351K314F Gula Darah Acak 15,000 3,75010/06/14 6390K353F Genu Ap/Lat Sinistra 100,000 20,00010/06/14 6407K370F Gula Darah Acak 15,000 3,75010/06/14 6410K373F Gula Darah Acak 15,000 3,75011/06/14 6422K385F Gula Darah Acak 15,000 3,750 Thorax PA 65,000 13,000
11/06/14 6424K387F Gula Darah Acak 15,000 3,75011/06/14 6450K413F Thorax PA 65,000 13,00011/06/14 6456K419F Thorax PA 65,000 13,00012/06/14 6472K435F Gula Darah Acak 15,000 3,750 Kholesterol 27,000 6,75012/06/14 6477K440F Thorax PA 65,000 13,00014/06/14 6536K499F Free T4 195,000 39,00014/06/14 6553K516F ANA (EIA) 325,000 65,000 0 016/06/14 6584K547F Gula Darah Acak 15,000 3,75016/06/14 6589K552F Gula Darah Acak 15,000 3,75016/06/14 6595K558F HIV Titer 350,000 35,00017/06/14 6629K592F Free T4 195,000 39,00019/06/14 6713K676F Gula Darah Acak 15,000 3,75019/06/14 6714K677F Gula Darah Acak 15,000 3,75019/06/14 6725K688F Antebrachii AP/LAT Sinistra 100,000 20,00020/06/14 6738K701F Gula Darah Acak 15,000 3,75020/06/14 6744K707F Thorax PA 65,000 13,00020/06/14 6745K708F Gula Darah Acak 15,000 3,75020/06/14 6750K713F Thorax PA 65,000 13,00020/06/14 6751K714F Gula Darah Acak 15,000 3,750 Kholesterol 27,000 6,750 Asam Urat 20,000 5,00021/06/14 6772K735F Thorax PA 65,000 13,00021/06/14 6774K737F Gula Darah Acak 15,000 3,75021/06/14 6777K740F Gula Darah Acak 15,000 3,75022/06/14 6805K768F Gula Darah Acak 15,000 3,75023/06/14 6815K778F Gula Darah Acak 15,000 3,75023/06/14 6839K802F Gula Darah Acak 15,000 3,75024/06/14 6868K831F Gula Darah Puasa 15,000 3,750
Gula Darah 2 jam PP 15,000 3,75025/06/14 6905K868F Gula Darah Acak 15,000 3,75025/06/14 6912K875F Thorax PA 65,000 13,00025/06/14 6914K877F Gula Darah Acak 15,000 3,75026/06/14 6966K929F Gula Darah Acak 15,000 3,75026/06/14 6971K934F Darah Lengkap Elektrik 55,000 13,750 Gula Darah Acak 15,000 3,75026/06/14 6989K952F Thorax PA 65,000 13,00026/06/14 6990K953F Gula Darah Acak 15,000 3,75027/06/14 7004K967F Gula Darah Acak 15,000 3,75027/06/14 7006K969F Thorax PA 65,000 13,00028/06/14 7036K999F URINE LENGKAP 25,000 6,25029/06/14 7084K047F BOF 65,000 13,000 Total 3,076,000 622,250
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Harjo Santoso
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi02/06/14 6065K028F Darah Lengkap Elektrik 55,000 13,750 Thorax PA 65,000 13,00002/06/14 6098K061F Darah Lengkap Elektrik 55,000 13,750 Thorax PA 65,000 13,00003/06/14 6108K071F Gula Darah Puasa 15,000 3,750 Gula Darah 2 jam PP 15,000 3,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 HDL-Cholesterol 22,000 5,500 LDL-Cholesterol 22,000 5,500 Asam Urat 20,000 5,000 ECG 60,000 12,00004/06/14 6161K124F Darah Lengkap Elektrik 55,000 13,750 Bilirubin Direk 22,000 5,500 Bilirubin Total 22,000 5,500 S G O T 20,000 5,000 S G P T 20,000 5,000 Alkali Phospatase 48,000 12,00004/06/14 6167K130F Darah Lengkap Elektrik 55,000 13,750 Bilirubin Direk 22,000 5,500 Bilirubin Total 22,000 5,500 S G O T 20,000 5,000 S G P T 20,000 5,000 Alkali Phospatase 48,000 12,00005/06/14 6212K175F Darah Lengkap Elektrik 55,000 13,750 Bilirubin Direk 22,000 5,500
Bilirubin Total 22,000 5,500 S G O T 20,000 5,000 S G P T 20,000 5,000 Gula Darah Acak 15,000 3,750 WIDAL 25,000 6,250 URINE LENGKAP 25,000 6,25012/06/14 6479K442F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,25013/06/14 6500K463F Darah Lengkap Elektrik 55,000 13,750 Urea 20,000 5,000 Kreatinin 20,000 5,000 Asam Urat 20,000 5,000 URINE LENGKAP 25,000 6,250 BOF 65,000 13,00016/06/14 6600K563F Darah Lengkap Elektrik 55,000 13,750 Thorax PA 65,000 13,00016/06/14 6613K576F Darah Lengkap Elektrik 55,000 13,750 Thorax PA 65,000 13,00017/06/14 6624K587F Darah Lengkap Elektrik 55,000 13,750 ECG 60,000 12,000 Thorax PA 65,000 13,00018/06/14 6673K636F Darah Lengkap Elektrik 55,000 13,750 Thorax PA 65,000 13,00019/06/14 6699K662F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,250 URINE LENGKAP 25,000 6,25019/06/14 6722K685F Darah Lengkap Elektrik 55,000 13,750 URINE LENGKAP 25,000 6,250 USG 240,000 48,00020/06/14 6740K703F Pedis Ap / Lat Sinistra 100,000 20,000
24/06/14 6860K823F Darah Lengkap Elektrik 55,000 13,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 HDL-Cholesterol 22,000 5,500 LDL-Cholesterol 22,000 5,500 Urea 20,000 5,000 Kreatinin 20,000 5,000 Asam Urat 20,000 5,000 URINE LENGKAP 25,000 6,250 ECG 60,000 12,00025/06/14 6911K874F Gula Darah Puasa 15,000 3,750 Gula Darah 2 jam PP 15,000 3,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 HDL-Cholesterol 22,000 5,500 LDL-Cholesterol 22,000 5,500 S G O T 20,000 5,000 S G P T 20,000 5,000 Bilirubin Direk 22,000 5,500 Bilirubin Total 22,000 5,50025/06/14 6928K891F Darah Lengkap Elektrik 55,000 13,750 Bilirubin Direk 22,000 5,500 Bilirubin Total 22,000 5,500 S G O T 20,000 5,000 S G P T 20,000 5,000 WIDAL 25,000 6,250 URINE LENGKAP 25,000 6,25027/06/14 6998K961F Darah Lengkap Elektrik 55,000 13,750 Gula Darah Puasa 15,000 3,750 Gula Darah 2 jam PP 15,000 3,750
ECG 60,000 12,00028/06/14 7050K013F Gula Darah Puasa 15,000 3,750 Gula Darah 2 jam PP 15,000 3,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 HDL-Cholesterol 22,000 5,500 LDL-Cholesterol 22,000 5,500 Asam Urat 20,000 5,000 Total 3,348,000 785,250
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.A Hary Irawan
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi20/06/14 6759K722F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,25030/06/14 7116K079F Pedis AP/lat Dextra 100,000 20,00030/06/14 7119K082F USG 240,000 48,000 Total 420,000 88,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Heri
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi03/06/14 6126K089F S G O T 20,000 5,000 S G P T 20,000 5,000 Bilirubin Direk 22,000 5,500 Bilirubin Total 22,000 5,500 Total 84,000 21,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bpk.Haryo 2
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi25/06/14 6926K889F Gula Darah Acak 15,000 3,750 Kholesterol 27,000 6,750 Asam Urat 20,000 5,00025/06/14 6939K902F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,250 Total 142,000 35,500
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bdn.Hasanah
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi08/06/14 6314K277F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,25014/06/14 6552K515F USG KANDUNGAN 80,000 16,000 Total 160,000 36,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bpk.Hasta
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi05/06/14 6208K171F Gula Darah Acak 15,000 3,750 Total 15,000 3,750
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.M.Iza
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi04/06/14 6177K140F Gula Darah Puasa 15,000 3,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 HDL-Cholesterol 22,000 5,500 LDL-Cholesterol 22,000 5,500 Urea 20,000 5,000 Kreatinin 20,000 5,000 Asam Urat 20,000 5,000 S G O T 20,000 5,000 S G P T 20,000 5,00018/06/14 6665K628F Thorax PA 65,000 13,00018/06/14 6669K632F Thorax PA 65,000 13,00026/06/14 6948K911F Gula Darah Puasa 15,000 3,750 Gula Darah 2 jam PP 15,000 3,750 Kholesterol 27,000 6,750 Asam Urat 20,000 5,000 Total 415,000 97,250
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Indah Nur Amalia
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi05/06/14 6213K176F Gula Darah Acak 15,000 3,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 Asam Urat 20,000 5,000 Total 84,000 21,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.H.Isnu P.
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi30/06/14 7094K057F Elbow AP/LAT DEXTRA 100,000 20,000 Total 100,000 20,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Ny.Ike Verawati
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi30/06/14 7098K061F Gula Darah Puasa 15,000 3,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 HDL-Cholesterol 22,000 5,500 LDL-Cholesterol 22,000 5,500 Rasio Kholesterol Total/HDL 40,000 10,000 S G O T 20,000 5,000 S G P T 20,000 5,000 Urea 20,000 5,000 Kreatinin 20,000 5,000 Asam Urat 20,000 5,000 Thorax PA 65,000 13,000 ECG 60,000 12,000 USG 240,000 48,000 Total 613,000 135,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bdn.Ita Ariani
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi04/06/14 6160K123F Hemoglobin 10,000 2,500 GOL.DARAH RHESUS 20,000 5,000 Protein 7,000 1,750 Reduksi 7,000 1,75010/06/14 6405K368F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,250 S G O T 20,000 5,000 S G P T 20,000 5,00021/06/14 6786K749F S G O T 20,000 5,000 S G P T 20,000 5,000 Urea 20,000 5,000 Kreatinin 20,000 5,000 Total 244,000 61,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Imam Sp.OG
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi11/06/14 6426K389F IgG Anti Toxoplasma 170,000 34,000 IgM anti Toxoplasma 170,000 34,000 Total 340,000 68,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bdn.Indana Zulfa
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi14/06/14 6543K506F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,25021/06/14 6770K733F Pelvis 65,000 13,000 Total 145,000 33,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Ny.Indri Amd.Kep
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi28/06/14 7046K009F Darah Lengkap Elektrik 55,000 13,750 TIBC 75,000 15,000 Serum Iron 68,000 13,600 Total 198,000 42,350
Diterima Tgl:............
Oleh:.............
Kepada:Yth.drg.Ika Dista R
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi06/06/14 6260K223F Dental 55,000 11,00010/06/14 6400K363F Dental 55,000 11,00017/06/14 6636K599F Dental 55,000 11,000 Total 165,000 33,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Ny.Ineke
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi27/06/14 7008K971F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,250 Total 80,000 20,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Inensa KH
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi28/06/14 7047K010F Darah Lengkap Elektrik 55,000 13,750 Total 55,000 13,750
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bdn.Ita Sugiarti
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi07/06/14 6304K267F USG UPPER 160,000 32,00008/06/14 6329K292F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,250 S G O T 20,000 5,000 S G P T 20,000 5,000 Urea 20,000 5,000 Kreatinin 20,000 5,000 Total 320,000 72,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Julius Sutedja K
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi25/06/14 6938K901F Darah Lengkap Elektrik 55,000 13,750 URINE LENGKAP 25,000 6,25026/06/14 6982K945F Darah Lengkap Elektrik 55,000 13,750 URINE LENGKAP 25,000 6,250 Total 160,000 40,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Jeanny Maurine S
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi10/06/14 6384K347F Darah Lengkap Elektrik 55,000 13,750 WIDAL 25,000 6,25010/06/14 6411K374F Hemoglobin 10,000 2,500 Urea 20,000 5,000 Kreatinin 20,000 5,000 Asam Urat 20,000 5,000 Kalium 45,000 9,000 Natrium 45,000 9,000 Khlorida 45,000 9,000 CKMB 106,000 21,200 ECG 60,000 12,000 Total 451,000 97,700
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.J.Gustam
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi17/06/14 6650K613F USG 240,000 48,000 Total 240,000 48,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Ny.Juanik .PRG
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi30/06/14 7118K081F Dental 55,000 11,000 Total 55,000 11,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bdn.Ny Kuryati
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi02/06/14 6092K055F ECG 60,000 12,000 USG LOWER 160,000 32,000 0 0 Total 220,000 44,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Bdn.Kartika
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi05/06/14 6211K174F USG KANDUNGAN 80,000 16,00025/06/14 6937K900F Hemoglobin 10,000 2,500 USG KANDUNGAN 80,000 16,000 Total 170,000 34,500
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Kajian PKM Krian
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi03/06/14 6109K072F Darah Lengkap Elektrik 55,000 13,750 Gula Darah Puasa 15,000 3,750 Gula Darah 2 jam PP 15,000 3,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 HDL-Cholesterol 22,000 5,500 LDL-Cholesterol 22,000 5,500 S G O T 20,000 5,000 S G P T 20,000 5,000 Urea 20,000 5,000 Kreatinin 20,000 5,000 Asam Urat 20,000 5,000 URINE LENGKAP 25,000 6,250 ECG 60,000 12,000 Thorax PA 65,000 13,000 Plano Test 18,000 4,50003/06/14 6110K073F Darah Lengkap Elektrik 55,000 13,750 Gula Darah Puasa 15,000 3,750 Gula Darah 2 jam PP 15,000 3,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 HDL-Cholesterol 22,000 5,500 LDL-Cholesterol 22,000 5,500 S G O T 20,000 5,000 S G P T 20,000 5,000 Urea 20,000 5,000
Kreatinin 20,000 5,000 Asam Urat 20,000 5,000 URINE LENGKAP 25,000 6,250 Thorax PA 65,000 13,000 ECG 60,000 12,00003/06/14 6111K074F Darah Lengkap Elektrik 55,000 13,750 GOL.DARAH RHESUS 20,000 5,000 Gula Darah Puasa 15,000 3,750 Gula Darah 2 jam PP 15,000 3,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 HDL-Cholesterol 22,000 5,500 LDL-Cholesterol 22,000 5,500 S G O T 20,000 5,000 S G P T 20,000 5,000 Urea 20,000 5,000 Kreatinin 20,000 5,000 Asam Urat 20,000 5,000 URINE LENGKAP 25,000 6,250 Thorax PA 65,000 13,000 ECG 60,000 12,00004/06/14 6176K139F Darah Lengkap Elektrik 55,000 13,750 GOL.DARAH RHESUS 20,000 5,000 Gula Darah Puasa 15,000 3,750 Gula Darah 2 jam PP 15,000 3,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 HDL-Cholesterol 22,000 5,500 LDL-Cholesterol 22,000 5,500 S G O T 20,000 5,000
S G P T 20,000 5,000 Urea 20,000 5,000 Kreatinin 20,000 5,000 Asam Urat 20,000 5,000 URINE LENGKAP 25,000 6,250 Thorax PA 65,000 13,000 ECG 60,000 12,00011/06/14 6430K393F Darah Lengkap Elektrik 55,000 13,750 URINE LENGKAP 25,000 6,250 ECG 60,000 12,00014/06/14 6538K501F Darah Lengkap Elektrik 55,000 13,750 Gula Darah Puasa 15,000 3,750 Gula Darah 2 jam PP 15,000 3,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 HDL-Cholesterol 22,000 5,500 LDL-Cholesterol 22,000 5,500 URINE LENGKAP 25,000 6,250 Plano Test 18,000 4,500 Thorax PA 65,000 13,000 ECG 60,000 12,00014/06/14 6539K502F Darah Lengkap Elektrik 55,000 13,750 GOL.DARAH RHESUS 20,000 5,000 Gula Darah Puasa 15,000 3,750 Gula Darah 2 jam PP 15,000 3,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 HDL-Cholesterol 22,000 5,500 LDL-Cholesterol 22,000 5,500 URINE LENGKAP 25,000 6,250
Thorax PA 65,000 13,000 ECG 60,000 12,00018/06/14 6666K629F Darah Lengkap Elektrik 55,000 13,750 Gula Darah Puasa 15,000 3,750 Gula Darah 2 jam PP 15,000 3,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 HDL-Cholesterol 22,000 5,500 LDL-Cholesterol 22,000 5,500 URINE LENGKAP 25,000 6,250 Thorax PA 65,000 13,000 ECG 60,000 12,00018/06/14 6667K630F Darah Lengkap Elektrik 55,000 13,750 Gula Darah Puasa 15,000 3,750 Gula Darah 2 jam PP 15,000 3,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 HDL-Cholesterol 22,000 5,500 LDL-Cholesterol 22,000 5,500 Plano Test 18,000 4,500 URINE LENGKAP 25,000 6,250 Thorax PA 65,000 13,000 ECG 60,000 12,00023/06/14 6813K776F Darah Lengkap Elektrik 55,000 13,750 Gula Darah Puasa 15,000 3,750 Gula Darah 2 jam PP 15,000 3,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 HDL-Cholesterol 22,000 5,500 LDL-Cholesterol 22,000 5,500
Asam Urat 20,000 5,000 Plano Test 18,000 4,500 URINE LENGKAP 25,000 6,250 ECG 60,000 12,000 Thorax PA 65,000 13,00023/06/14 6817K780F Darah Lengkap Elektrik 55,000 13,750 Gula Darah Puasa 15,000 3,750 Gula Darah 2 jam PP 15,000 3,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 HDL-Cholesterol 22,000 5,500 LDL-Cholesterol 22,000 5,500 Asam Urat 20,000 5,000 URINE LENGKAP 25,000 6,250 Thorax PA 65,000 13,000 ECG 60,000 12,00023/06/14 6831K794F Darah Lengkap Elektrik 55,000 13,750 Gula Darah Puasa 15,000 3,750 Gula Darah 2 jam PP 15,000 3,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 HDL-Cholesterol 22,000 5,500 LDL-Cholesterol 22,000 5,500 Asam Urat 20,000 5,000 URINE LENGKAP 25,000 6,250 Plano Test 18,000 4,500 ECG 60,000 12,000 Thorax PA 65,000 13,00026/06/14 6968K931F Gula Darah Puasa 15,000 3,750 Gula Darah 2 jam PP 15,000 3,750
Asam Urat 20,000 5,000 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 HDL-Cholesterol 22,000 5,500 LDL-Cholesterol 22,000 5,500 URINE LENGKAP 25,000 6,250 ECG 60,000 12,000 Thorax PA 65,000 13,00026/06/14 6969K932F Darah Lengkap Elektrik 55,000 13,750 Gula Darah Puasa 15,000 3,750 Gula Darah 2 jam PP 15,000 3,750 Asam Urat 20,000 5,000 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 HDL-Cholesterol 22,000 5,500 LDL-Cholesterol 22,000 5,500 URINE LENGKAP 25,000 6,250 Plano Test 18,000 4,500 Thorax PA 65,000 13,000 ECG 60,000 12,00030/06/14 7104K067F Darah Lengkap Elektrik 55,000 13,750 Gula Darah Puasa 15,000 3,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 HDL-Cholesterol 22,000 5,500 LDL-Cholesterol 22,000 5,500 Asam Urat 20,000 5,000 URINE LENGKAP 25,000 6,250 ECG 60,000 12,000 Thorax PA 65,000 13,000
30/06/14 7105K068F Darah Lengkap Elektrik 55,000 13,750 Gula Darah Puasa 15,000 3,750 Gula Darah 2 jam PP 15,000 3,750 Kholesterol 27,000 6,750 Trigliserida 22,000 5,500 HDL-Cholesterol 22,000 5,500 LDL-Cholesterol 22,000 5,500 Asam Urat 20,000 5,000 Plano Test 18,000 4,500 URINE LENGKAP 25,000 6,250 ECG 60,000 12,000 Thorax PA 65,000 13,000 Total 5,716,000 1,332,250
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Kriswanto
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi17/06/14 6649K612F Thorax PA 65,000 13,00020/06/14 6737K700F Thorax PA 65,000 13,00023/06/14 6808K771F Thorax PA 65,000 13,00024/06/14 6881K844F Thorax PA 65,000 13,00029/06/14 7081K044F Thorax PA 65,000 13,000 Total 325,000 65,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Ny.Kurnia Andiyani
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi02/06/14 6073K036F Wrist Ap/Lat Dextra 100,000 20,000 Total 100,000 20,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.dr.Lukito Pribadi
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi12/06/14 6470K433F Darah Lengkap Elektrik 55,000 13,750 Bilirubin Direk 22,000 5,500 Bilirubin Total 22,000 5,500 Thorax PA 65,000 13,00016/06/14 6604K567F Darah Lengkap Elektrik 55,000 13,750 Gula Darah Acak 15,000 3,750 Kholesterol 27,000 6,750 S G O T 20,000 5,000 S G P T 20,000 5,000 Urea 20,000 5,000 Kreatinin 20,000 5,000 Asam Urat 20,000 5,00030/06/14 7121K084F Thorax PA 65,000 13,000 Total 426,000 100,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.NY.Lailil M
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi16/06/14 6603K566F Darah Lengkap Elektrik 55,000 13,750 Total 55,000 13,750
Diterima Tgl:............
Oleh:.............
Kepada:Yth.LAB PKM Krian
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi26/06/14 6962K925F Hbs Ag (Elisa) 90,000 18,000 Total 90,000 18,000
Diterima Tgl:............
Oleh:.............
Kepada:Yth.Drg.Laila Fitriyah
Tanggal- NoKwitansi Test Medis---------------------- ---Harga --Komisi23/06/14 6814K777F Dental 55,000 11,000 Total 55,000 11,000
Diterima Tgl:............
Oleh:.............
