Klaim Tagihan

Uploaded by: dewi
0
0

October 2019
PDF

This document was uploaded by user and they confirmed that they have the permission to share it. If you are author or own the copyright of this book, please report to us by using this DMCA report form. Report DMCA

Overview

Download & View Klaim Tagihan as PDF for free.

More details

Words: 31
Pages: 2

Preview
Full text

NO

1

NAMA PASIEN

XXX

NAMA DOKTER

NAMA APOTEK

TGL RESEP

XX

XX

XX

GRAND TOTAL (Rp)

TGL KUITA HARGA HARGA KUITANSI YG TERBAYA R XX

XX

KETERANGAN

XX

XX XX