Surat Tagihan Pengemasan Suspek Tb Ke Gf.docx

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KOP PUSKESMAS Nomor Sifat Lampiran Perihal

: : : :

445/ 1 (satu) bendel Tagihan Biaya Pengemasan Spesimen

Temanggung,

Kepada Yth : PPO GF – TB JAWA TENGAH Dinas Kesehatan Prov. Jateng Jl. Piere Tendean No 24 Kantor GF_TB Lantai IV Semarang

Dengan Hormat, Bersama ini kami tagihkan biaya pengemasan spesimen untuk pemeriksaan TCM suspek TBC/TB-RO Puskesmas.........................pada bulan Juli 2018. Sebesar Terbilang

2018

: Rp. 125.000,: Seratus dua puluh lima ribu rupiah

Dengan perincian sebagaimana terlampir Demikian atas perhatian dan kerja samanya yang baik disampaikan terimakasih.

........................, 2 Agustus 2018 Kepala Puskesmas..................

...................................... NIP....................

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