LAPORAN DETAIL PEMERIKSAAN LABORATORIUM YANG DIRUJUK

Lab. Rujukan : LAB MARTEN INDEY

Tanggal : 01/05/2022 s/d 31/05/2022

Page -1 of 1

No. Tanggal No. Bukti Nama Pasien Pemeriksaan Harga

1 01/05/2022 Z22050100001 GERSON GARING TN Albumin 48,000.00

2 01/05/2022 Z22050100002 FRANS SANADI TN Ureum Darah 96,000.00
Kreatinin Darah
3 04/05/2022 Z22050400003 MARTHINA L BOKKO NY #Albumin 48,000.00
4 04/05/2022 Z22050400005 LEONARD H SETIAWAN Albumin 48,000.00
5 05/05/2022 Z22050500002 FRANS SANADI TN Albumin 48,000.00
6 05/05/2022 Z22050500005 VALENTINA ANNA C NY #Albumin 48,000.00
7 05/05/2022 Z22050500006 YOHANES BALYO TN Cholesterol HDL 112,000.00
Cholesterol LDL
8 05/05/2022 Z22050500007 ZAKIAH HALWA AZZAHRA BY #Bilirubin Direk 144,000.00
#Bilirubin Total
Bilirubin Indirek
9 06/05/2022 Z22050600005 IRPHAN JHORDY W TN #Bilirubin Total 96,000.00
#Bilirubin Direk
10 06/05/2022 Z22050600006 ZIKRI H WIBOWO AN Bilirubin Total 192,000.00
Bilirubin Direk
Bilirubin Indirek
Albumin
11 06/05/2022 Z22050600011 ZAVIER MALIK AL HAKIM BY Bilirubin Total 96,000.00
Bilirubin Direk
12 06/05/2022 Z22050600013 MANZO REVIN T H BY #Bilirubin Total 96,000.00
#Bilirubin Direk
13 07/05/2022 Z22050700004 GERSON GARING TN Albumin 48,000.00
14 07/05/2022 Z22050700006 TIARA ASTRIANA NY Albumin 48,000.00
15 08/05/2022 Z22050800004 TIARA ASTRIANA NY Albumin 48,000.00
16 08/05/2022 Z22050800005 MUNFARIDA BY NY #Bilirubin Direk 96,000.00
#Bilirubin Total
17 08/05/2022 Z22050800006 MANZO REVIN T H BY #Bilirubin Total 96,000.00
#Bilirubin Direk
18 09/05/2022 Z22050900001 VALENTINA ANNA C NY #Albumin 48,000.00
19 09/05/2022 Z22050900002 Y ISRAEL WAMUAR TN Cholesterol LDL 56,000.00
20 09/05/2022 Z22050900007 BY NY NURBAYA Albumin 48,000.00
21 11/05/2022 Z22051100002 ALOYSIUS J FERNANDES TN #Bilirubin Total 96,000.00
#Bilirubin Direk
22 11/05/2022 Z22051100003 DRS DEKY A RUMAROPEN TN #Albumin 48,000.00
23 11/05/2022 Z22051100004 EVA WULANDARI BY NY #Bilirubin Total 96,000.00
#Bilirubin Direk
24 11/05/2022 Z22051100005 MUNFARIDA BY NY #Bilirubin Total 96,000.00
#Bilirubin Direk
25 11/05/2022 Z22051100007 YOHANES HARIYANTO TN #Albumin 144,000.00
#Bilirubin Total
 #Bilirubin Direk
26 12/05/2022 Z22051200006 TIARA ASTRIANA NY Albumin 48,000.00
27 12/05/2022 Z22051200008 WAKANOMO NY #Bilirubin Direk 96,000.00
#Bilirubin Total
28 12/05/2022 Z22051200010 ALFA A A RUMBEKWAAN BY Bilirubin Total 216,000.00
Bilirubin Direk
29 14/05/2022 Z22051400001 ESTHER I LUMANGKUN NY #Albumin 48,000.00
30 14/05/2022 Z22051400002 DIANDRA AYUDHISA BY Bilirubin Total 96,000.00
Bilirubin Direk
31 15/05/2022 Z22051500001 CHRESTIAN MANUPUTTY TN #Albumin 48,000.00
32 16/05/2022 Z22051600006 HARUN SANUSI TN #Ureum Darah 96,000.00
#Kreatinin Darah
33 16/05/2022 Z22051600008 ENGELBERTUS IKIKITARO TN SGOT 208,000.00
SGPT
Ureum Darah
Kreatinin Darah
34 16/05/2022 Z22051600009 APRILIA CARLOS BY NY #Bilirubin Total 96,000.00
#Bilirubin Direk
35 16/05/2022 Z22051600010 REZZA BY NY #Bilirubin Direk 96,000.00
#Bilirubin Total
36 17/05/2022 Z22051700003 HARUN KAITAM TN Ureum Darah 352,002.00
Kreatinin Darah
Albumin
Bilirubin Total
Bilirubin Direk
SGOT
SGPT
37 17/05/2022 Z22051700005 JERKIUS SAIBA TN SGOT 392,000.00
SGPT
Trigliserida
Cholesterol Total
Ureum Darah
Kreatinin Darah
Asam Urat Darah
38 17/05/2022 Z22051700007 HERDOMINA ISIR NY SGOT 392,000.00
SGPT
Trigliserida
Cholesterol Total
Ureum Darah
Kreatinin Darah
Asam Urat Darah
39 17/05/2022 Z22051700008 MUSA DOWANSIBA TN SGOT 392,000.00
SGPT
Trigliserida
Cholesterol Total
Ureum Darah
Kreatinin Darah
Asam Urat Darah
40 17/05/2022 Z22051700010 DEMIANUS E RUMPAIDUS TN SGOT 392,000.00
SGPT
Trigliserida
Cholesterol Total
Ureum Darah
Kreatinin Darah
 Asam Urat Darah
41 17/05/2022 Z22051700013 NATALLEN J DIRK TN SGOT 504,000.00
SGPT
Trigliserida
Cholesterol Total
Cholesterol HDL
Cholesterol LDL
Ureum Darah
Kreatinin Darah
Asam Urat Darah
42 17/05/2022 Z22051700014 YURTHINUS MANDACAN TN SGOT 392,000.00
SGPT
Trigliserida
Cholesterol Total
Ureum Darah
Kreatinin Darah
Asam Urat Darah
43 17/05/2022 Z22051700016 ERICK SKENLY NUSTELU TN SGOT 392,000.00
SGPT
Trigliserida
Cholesterol Total
Ureum Darah
Kreatinin Darah
Asam Urat Darah
44 17/05/2022 Z22051700017 FERINANDUS BAUNIK TN Asam Urat Darah 554,000.00
Cholesterol HDL
Cholesterol LDL
Cholesterol Total
45 17/05/2022 Z22051700019 AGUSTINUS R KAMBUAYA TN Trigliserida 392,000.00
Cholesterol Total
Ureum Darah
Kreatinin Darah
Asam Urat Darah
SGOT
SGPT
46 17/05/2022 Z22051700021 DR AWALUDDIN IDRIS TN Ureum Darah 208,000.00
Kreatinin Darah
SGOT
SGPT
Total Rujukan 7,450,002.00