| No. | No. Nota | No. Billing | No. RM | Nama Pasien | Nama Dokter | Kode Item | Nama Item | Harga | Jumlah | Total Harga | Status Eksekusi | Lokasi Eksekusi |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | REF2026072300748 | BIL2026072300918 | MR000012 | test-22072026 | Leonysa | A02 | Biaya Pendaftaran Rawat Jalan | 50.000 | 1 | 50.000 | BELUM | |
| 2 | REF2026072300748 | BIL2026072300918 | MR000012 | test-22072026 | Leonysa | A03 | Biaya Kartu Pasien | 20.000 | 1 | 20.000 | BELUM | |
| 3 | REF2026072300748 | BIL2026072300918 | MR000012 | test-22072026 | Leonysa | D000134 | Dokter Spesialis 75k | 75.000 | 1 | 75.000 | BELUM |