Contoh Kwitansi Pkm.docx
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Jl. Merdeka No. 02 Sumber Rejo Kecamatan Waway Karya 34376
SUMBER REJO
UPTD PUSKESMAS RAWAT INAP
DINAS KESEHATAN KABUPATEN LAMPUNG TIMUR
No : ................... KWITANSI PUSKESMAS RAWAT INAP SUMBER REJO
Sudah terima dari Uang sejumlah Untuk pembayaran
: ................................................................................................................. : ................................................................................................................. : ................................................................................................................. ................................................................................................................. Pro : ............................................... No. MR : ........................................
Rp. ..................................... Sumber Rejo, ....................................... Petugas Jaga
Terima dari
(...........................) (...........................)
(...........................)
SUMBER REJO
UPTD PUSKESMAS RAWAT INAP
DINAS KESEHATAN KABUPATEN LAMPUNG TIMUR
No : ................... KWITANSI PUSKESMAS RAWAT INAP SUMBER REJO
Sudah terima dari Uang sejumlah Untuk pembayaran
: ................................................................................................................. : ................................................................................................................. : ................................................................................................................. ................................................................................................................. Pro : ............................................... No. MR : ........................................
Rp. ..................................... Sumber Rejo, ....................................... Petugas Jaga
Terima dari
(...........................) (...........................)
(...........................)
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