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    Enero Refer. Aprovad

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    Monica Salas Laveriano
    This document is a report of approved transportation services for patient transfers from the Ucayali DISA for January 2016. It includes 7 transfers, listing the patient's name, age, contract number, date of transfer, origin facility, destination facility, and costs for passage, per diems, fuel, food and total. The total cost for all transfers was 8,687.10 Soles.

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    © All Rights Reserved
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    Enero Refer. Aprovad

    Uploaded by

    Monica Salas Laveriano
    19 views1 page
    This document is a report of approved transportation services for patient transfers from the Ucayali DISA for January 2016. It includes 7 transfers, listing the patient's name, age, contract number, date of transfer, origin facility, destination facility, and costs for passage, per diems, fuel, food and total. The total cost for all transfers was 8,687.10 Soles.

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    SEPELIO ENERO APROBADO

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    This document is a report of approved transportation services for patient transfers from the Ucayali DISA for January 2016. It includes 7 transfers, listing the patient's name, age, contract number, date of transfer, origin facility, destination facility, and costs for passage, per diems, fuel, food and total. The total cost for all transfers was 8,687.10 Soles.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    19 views1 page

    Enero Refer. Aprovad

    Uploaded by

    Monica Salas Laveriano
    This document is a report of approved transportation services for patient transfers from the Ucayali DISA for January 2016. It includes 7 transfers, listing the patient's name, age, contract number, date of transfer, origin facility, destination facility, and costs for passage, per diems, fuel, food and total. The total cost for all transfers was 8,687.10 Soles.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    REPORTE DE SERVICIOS POR TRASLADO APROBADO CERRADO

    COMPONENTE: SUBSIDIADO

    Periodo Calendario: ENERO/2016

    DISA: 340 DISA UCAYALI


    Fecha de Impresion : 15/04/2016 01:38:34p.m.

    NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

    0950 REGION UCAYALI - SALUD


    1 340-15-01804324 MELENDEZ PACAYA MELITA 40 340-2-80443093 30/10/2015 250401A201 250101A101 1,755.00 320.00 0.00 0.00 2,075.00
    2 340-15-00883456 NAVARRO RODRIGUEZ ESAU 6 340-2-62294206 22/09/2015 250101A325 250101A101 0.00 0.00 275.00 0.00 275.00
    3 340-15-00885841 RODRIGUEZ PUTAPAÑA JUSTO PASTOR 56 340-2-00120176 25/09/2015 250101A341 250101A101 0.00 112.00 275.00 0.00 387.00
    4 340-15-01957408 TELLO CANALES MOISES 45 340-2-42024165 20/10/2015 250204A301 250101A101 4,580.00 320.00 0.00 0.00 4,900.00
    5 340-15-00885822 VARGAS MARICHY WILTA 75 340-2-21147040 17/09/2015 250104A201 250101A101 0.00 0.00 274.00 0.00 274.00
    6 340-15-01808792 VASQUEZ GUEVARA PATRICIA 19 340-2-61379641 02/10/2015 250101A341 250101A101 0.00 112.00 275.00 0.00 387.00
    7 340-15-00673870 VASQUEZ VELA PAULO PAUL 0 340-E-27428918 14/10/2015 250106A325 250105A101 0.00 0.00 389.10 0.00 389.10

    8,687.10

    Total: general: 6,335.00 864.00 1,488.10 0.00 8,687.10

    Elaborado por OIE-SIS Página 1 de 1

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