<table width="400px">

<tr align="center">
<td colspan="8">LAPORAN Rekapan Pembayaran</td>
</tr>
<tr>
<td>PKM : SAWANGAN</td>
</tr>
<tr>
<td>Periode : 2019-11-16 s.d 2019-11-16</td>
</tr>
<tr>
<td><b>No.</td>
<td><b>Tanggal</td>
<td><b>No. Registrasi</b></td>
<td><b> Nama</b></td>
<td><b>Jenis Kelamin</b></td>
<td><b>Jenis Pelayanan</td>
<td><b>Jumlah</b></td>
<td><b>Biaya</b></td>
<td><b>Puskesmas</b></td>
</tr>
</table>

<table>

<tr>
<td> 1</td>
<td> 2019-11-16 07:36:00 </td>
<td> 10201070598</td>
<td> ALDI JEFRIYANDI </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 2</td>
<td> 2019-11-16 07:39:00 </td>
<td> 10201028848</td>
<td> SUINAH IRIYANTI </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 3</td>
<td> 2019-11-16 07:46:00 </td>
<td> 1020111208</td>
<td> SRI RUSTARI </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
 <td> SAWANGAN</td>
</tr>

<tr>
<td> 4</td>
<td> 2019-11-16 07:50:00 </td>
<td> 10201062221</td>
<td> RAHMAT HIDAYAT </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 5</td>
<td> 2019-11-16 10:10:00 </td>
<td> 10201062221</td>
<td> RAHMAT HIDAYAT </td>
<td> Laki-laki </td>
<td> Open Boor </td>
<td> 1 </td>
<td> 5000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 6</td>
<td> 2019-11-16 10:10:00 </td>
<td> 10201062221</td>
<td> RAHMAT HIDAYAT </td>
<td> Laki-laki </td>
<td> Penambalan Tetap Satu Gigi Susu Atau Gigi Tetap Dengan (GIC) </td>
<td> 1 </td>
<td> 15000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 7</td>
<td> 2019-11-16 10:10:00 </td>
<td> 10201062221</td>
<td> RAHMAT HIDAYAT </td>
<td> Laki-laki </td>
<td> Perawatan Gigi (pulpa Dan Atau Saluran Akar) </td>
<td> 1 </td>
<td> 5000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 8</td>
<td> 2019-11-16 07:57:00 </td>
<td> 10201053490</td>
<td> INDAH MUTIA SARI </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
 <td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 9</td>
<td> 2019-11-16 09:37:00 </td>
<td> 10201053490</td>
<td> INDAH MUTIA SARI </td>
<td> Perempuan </td>
<td> Hematologi Rutin </td>
<td> 1 </td>
<td> 25000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 10</td>
<td> 2019-11-16 09:37:00 </td>
<td> 10201053490</td>
<td> INDAH MUTIA SARI </td>
<td> Perempuan </td>
<td> Laju Endap Darah </td>
<td> 1 </td>
<td> 5000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 11</td>
<td> 2019-11-16 09:37:00 </td>
<td> 10201053490</td>
<td> INDAH MUTIA SARI </td>
<td> Perempuan </td>
<td> Widal </td>
<td> 1 </td>
<td> 20000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 12</td>
<td> 2019-11-16 08:02:00 </td>
<td> 10201073665</td>
<td> ROBIYATUL ULYA </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 13</td>
<td> 2019-11-16 08:12:00 </td>
<td> 10201073667</td>
<td> GISELA AMANDA </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
 <td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 14</td>
<td> 2019-11-16 09:34:00 </td>
<td> 10201073667</td>
<td> GISELA AMANDA </td>
<td> Perempuan </td>
<td> Surat Keterangan Sehat (termasuk Tes Ichihara)/Orang </td>
<td> 1 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 15</td>
<td> 2019-11-16 08:17:00 </td>
<td> 10201059951</td>
<td> MUH RAFISKI ALFARIZI </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 16</td>
<td> 2019-11-16 08:18:00 </td>
<td> 10201073668</td>
<td> FARIHA ARDINI ROSYADI </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 17</td>
<td> 2019-11-16 08:19:00 </td>
<td> 10201060479</td>
<td> AZQIARA </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 18</td>
<td> 2019-11-16 08:21:00 </td>
<td> 1020121335</td>
<td> SOMIATUN HASANAH </td>
<td> Perempuan </td>
 <td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 19</td>
<td> 2019-11-16 10:25:00 </td>
<td> 1020121335</td>
<td> SOMIATUN HASANAH </td>
<td> Perempuan </td>
<td> Open Boor </td>
<td> 1 </td>
<td> 5000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 20</td>
<td> 2019-11-16 10:25:00 </td>
<td> 1020121335</td>
<td> SOMIATUN HASANAH </td>
<td> Perempuan </td>
<td> Perawatan Gigi (pulpa Dan Atau Saluran Akar) </td>
<td> 1 </td>
<td> 5000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 21</td>
<td> 2019-11-16 10:28:00 </td>
<td> 1020121335</td>
<td> SOMIATUN HASANAH </td>
<td> Perempuan </td>
<td> Penambalan Sementara Satu Gigi Susu Atau Gigi Tetap </td>
<td> 1 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 22</td>
<td> 2019-11-16 08:23:00 </td>
<td> 1020124092</td>
<td> YUYUN </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 23</td>
<td> 2019-11-16 08:24:00 </td>
<td> 10201060305</td>
<td> BIMA SAKA ALKALI YULIYANTO </td>
 <td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 24</td>
<td> 2019-11-16 08:24:00 </td>
<td> 10201065217</td>
<td> BAMBANG YULYANTO </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 25</td>
<td> 2019-11-16 11:28:00 </td>
<td> 10201065217</td>
<td> BAMBANG YULYANTO </td>
<td> Laki-laki </td>
<td> Open Boor </td>
<td> 2 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 26</td>
<td> 2019-11-16 11:29:00 </td>
<td> 10201065217</td>
<td> BAMBANG YULYANTO </td>
<td> Laki-laki </td>
<td> Perawatan Gigi (pulpa Dan Atau Saluran Akar) </td>
<td> 1 </td>
<td> 5000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 27</td>
<td> 2019-11-16 11:29:00 </td>
<td> 10201065217</td>
<td> BAMBANG YULYANTO </td>
<td> Laki-laki </td>
<td> Penambalan Tetap Satu Gigi Susu Atau Gigi Tetap Dengan (GIC) </td>
<td> 1 </td>
<td> 15000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 28</td>
<td> 2019-11-16 11:29:00 </td>
<td> 10201065217</td>
 <td> BAMBANG YULYANTO </td>
<td> Laki-laki </td>
<td> Penambalan Sementara Satu Gigi Susu Atau Gigi Tetap </td>
<td> 1 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 29</td>
<td> 2019-11-16 08:25:00 </td>
<td> 1020121336</td>
<td> PRAMOEDYA ERLANGGA DHARMA ATMADJA </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 30</td>
<td> 2019-11-16 10:03:00 </td>
<td> 1020121336</td>
<td> PRAMOEDYA ERLANGGA DHARMA ATMADJA </td>
<td> Laki-laki </td>
<td> Pembersihan Karang Gigi Per Regio </td>
<td> 1 </td>
<td> 15000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 31</td>
<td> 2019-11-16 10:04:00 </td>
<td> 1020121336</td>
<td> PRAMOEDYA ERLANGGA DHARMA ATMADJA </td>
<td> Laki-laki </td>
<td> Pencabutan Satu Gigi Tanpa Suntikan </td>
<td> 2 </td>
<td> 30000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 32</td>
<td> 2019-11-16 12:33:00 </td>
<td> 1020121336</td>
<td> PRAMOEDYA ERLANGGA DHARMA ATMADJA </td>
<td> Laki-laki </td>
<td> Pembersihan Karang Gigi Per Regio </td>
<td> 2 </td>
<td> 30000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 33</td>
<td> 2019-11-16 08:32:00 </td>
 <td> 10201069357</td>
<td> KHAIRA CAHYANA SAPUTRI </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 34</td>
<td> 2019-11-16 10:21:00 </td>
<td> 10201069357</td>
<td> KHAIRA CAHYANA SAPUTRI </td>
<td> Perempuan </td>
<td> Pencabutan Satu Gigi Tanpa Suntikan </td>
<td> 1 </td>
<td> 15000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 35</td>
<td> 2019-11-16 08:36:00 </td>
<td> 10201066495</td>
<td> AL AYUBHIE AGUSTIAN </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 36</td>
<td> 2019-11-16 10:50:00 </td>
<td> 10201066495</td>
<td> AL AYUBHIE AGUSTIAN </td>
<td> Laki-laki </td>
<td> Pencabutan Satu Gigi Tanpa Suntikan </td>
<td> 2 </td>
<td> 30000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 37</td>
<td> 2019-11-16 08:39:00 </td>
<td> 10201051726</td>
<td> ERITA SURYANTI </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 38</td>
 <td> 2019-11-16 10:59:00 </td>
<td> 10201051726</td>
<td> ERITA SURYANTI </td>
<td> Perempuan </td>
<td> Perawatan Gigi (pulpa Dan Atau Saluran Akar) </td>
<td> 1 </td>
<td> 5000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 39</td>
<td> 2019-11-16 10:58:00 </td>
<td> 10201051726</td>
<td> ERITA SURYANTI </td>
<td> Perempuan </td>
<td> Open Boor </td>
<td> 1 </td>
<td> 5000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 40</td>
<td> 2019-11-16 11:00:00 </td>
<td> 10201051726</td>
<td> ERITA SURYANTI </td>
<td> Perempuan </td>
<td> Penambalan Tetap Satu Gigi Susu Atau Gigi Tetap Dengan (GIC) </td>
<td> 1 </td>
<td> 15000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 41</td>
<td> 2019-11-16 08:42:00 </td>
<td> 10201064664</td>
<td> MUHAMAD MUNDHOFAR </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 42</td>
<td> 2019-11-16 10:01:00 </td>
<td> 10201064664</td>
<td> MUHAMAD MUNDHOFAR </td>
<td> Laki-laki </td>
<td> Hematologi Rutin </td>
<td> 1 </td>
<td> 25000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
 <td> 43</td>
<td> 2019-11-16 08:44:00 </td>
<td> 10201073670</td>
<td> MUH JURIAN </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 44</td>
<td> 2019-11-16 12:39:00 </td>
<td> 10201073670</td>
<td> MUH JURIAN </td>
<td> Laki-laki </td>
<td> Open Boor </td>
<td> 1 </td>
<td> 5000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 45</td>
<td> 2019-11-16 12:39:00 </td>
<td> 10201073670</td>
<td> MUH JURIAN </td>
<td> Laki-laki </td>
<td> Perawatan Gigi (pulpa Dan Atau Saluran Akar) </td>
<td> 1 </td>
<td> 5000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 46</td>
<td> 2019-11-16 08:46:00 </td>
<td> 10201058025</td>
<td> BRIGITA LARASATI PURNOMOHADI </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 47</td>
<td> 2019-11-16 11:10:00 </td>
<td> 10201058025</td>
<td> BRIGITA LARASATI PURNOMOHADI </td>
<td> Perempuan </td>
<td> Pencabutan Satu Gigi Tanpa Suntikan </td>
<td> 1 </td>
<td> 15000 </td>
<td> SAWANGAN</td>
</tr>
<tr>
<td> 48</td>
<td> 2019-11-16 08:54:00 </td>
<td> 10201073672</td>
<td> DADAH FARIDA </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 49</td>
<td> 2019-11-16 09:35:00 </td>
<td> 10201073672</td>
<td> DADAH FARIDA </td>
<td> Perempuan </td>
<td> Pemeriksaan Hbsag </td>
<td> 1 </td>
<td> 20000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 50</td>
<td> 2019-11-16 09:35:00 </td>
<td> 10201073672</td>
<td> DADAH FARIDA </td>
<td> Perempuan </td>
<td> Golongan Darah + Rhesus </td>
<td> 1 </td>
<td> 8000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 51</td>
<td> 2019-11-16 09:35:00 </td>
<td> 10201073672</td>
<td> DADAH FARIDA </td>
<td> Perempuan </td>
<td> Vdlr </td>
<td> 1 </td>
<td> 25000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 52</td>
<td> 2019-11-16 09:35:00 </td>
<td> 10201073672</td>
<td> DADAH FARIDA </td>
<td> Perempuan </td>
<td> Hematologi Rutin </td>
<td> 1 </td>
<td> 25000 </td>
<td> SAWANGAN</td>
</tr>
<tr>
<td> 53</td>
<td> 2019-11-16 09:35:00 </td>
<td> 10201073672</td>
<td> DADAH FARIDA </td>
<td> Perempuan </td>
<td> Urine Rutin </td>
<td> 1 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 54</td>
<td> 2019-11-16 09:35:00 </td>
<td> 10201073672</td>
<td> DADAH FARIDA </td>
<td> Perempuan </td>
<td> Sedimen </td>
<td> 1 </td>
<td> 5000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 55</td>
<td> 2019-11-16 09:17:00 </td>
<td> 10201067660</td>
<td> PUTRI ZULAIKHA </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 56</td>
<td> 2019-11-16 10:00:00 </td>
<td> 10201067660</td>
<td> PUTRI ZULAIKHA </td>
<td> Perempuan </td>
<td> Hematologi Rutin </td>
<td> 1 </td>
<td> 25000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 57</td>
<td> 2019-11-16 10:00:00 </td>
<td> 10201067660</td>
<td> PUTRI ZULAIKHA </td>
<td> Perempuan </td>
<td> Laju Endap Darah </td>
<td> 1 </td>
<td> 5000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 58</td>
<td> 2019-11-16 09:30:00 </td>
<td> 10201073676</td>
<td> MUH SALAHUDIN </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 59</td>
<td> 2019-11-16 09:36:00 </td>
<td> 10201066368</td>
<td> KELVIN MAHESA </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 60</td>
<td> 2019-11-16 09:50:00 </td>
<td> 10201073678</td>
<td> MUHAMAD DAFFA AL MUMTAZ </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 61</td>
<td> 2019-11-16 10:01:00 </td>
<td> 10201073680</td>
<td> AILA TUWIAM </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 62</td>
<td> 2019-11-16 10:13:00 </td>
<td> 1020123720</td>
<td> ALIFATUR ROFIKA </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
 <td> SAWANGAN</td>
</tr>

<tr>
<td> 63</td>
<td> 2019-11-16 10:20:00 </td>
<td> 102016988</td>
<td> NURYANTI </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 64</td>
<td> 2019-11-16 10:37:00 </td>
<td> 10201043147</td>
<td> TRIANNY KRISTIANY </td>
<td> Perempuan </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 65</td>
<td> 2019-11-16 10:38:00 </td>
<td> 10201024081</td>
<td> MUROBBIR RIZKI NAZAL </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 66</td>
<td> 2019-11-16 11:06:00 </td>
<td> 10201070660</td>
<td> MULYADI </td>
<td> Laki-laki </td>
<td> Pelayanan Pagi </td>
<td> 1 </td>
<td> 2000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 67</td>
<td> 2019-11-16 14:32:00 </td>
<td> 1020111225</td>
<td> DARTO MURDIANTO </td>
<td> Laki-laki </td>
<td> Pelayanan Sore </td>
<td> 1 </td>
 <td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 68</td>
<td> 2019-11-16 14:55:00 </td>
<td> 10201059306</td>
<td> ABD HALIM </td>
<td> Laki-laki </td>
<td> Pelayanan Sore </td>
<td> 1 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 69</td>
<td> 2019-11-16 14:56:00 </td>
<td> 10201030630</td>
<td> RAFLI DARMAWAN </td>
<td> Laki-laki </td>
<td> Pelayanan Sore </td>
<td> 1 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 70</td>
<td> 2019-11-16 15:02:00 </td>
<td> 10201055321</td>
<td> ADELIA </td>
<td> Perempuan </td>
<td> Pelayanan Sore </td>
<td> 1 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 71</td>
<td> 2019-11-16 15:12:00 </td>
<td> 10201067083</td>
<td> DENI ISWANTO </td>
<td> Laki-laki </td>
<td> Pelayanan Sore </td>
<td> 1 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 72</td>
<td> 2019-11-16 15:16:00 </td>
<td> 10201073684</td>
<td> TIA OKTAVIANI </td>
<td> Perempuan </td>
<td> Pelayanan Sore </td>
 <td> 1 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 73</td>
<td> 2019-11-16 15:36:00 </td>
<td> 10201067919</td>
<td> MUH NAZRIEL HAKIM </td>
<td> Laki-laki </td>
<td> Pelayanan Sore </td>
<td> 1 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 74</td>
<td> 2019-11-16 15:41:00 </td>
<td> 10201073686</td>
<td> DEVAN DWI PUTRA </td>
<td> Laki-laki </td>
<td> Pelayanan Sore </td>
<td> 1 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 75</td>
<td> 2019-11-16 15:53:00 </td>
<td> 10201073687</td>
<td> ABDILLAH ABQORI AGAM </td>
<td> Laki-laki </td>
<td> Pelayanan Sore </td>
<td> 1 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 76</td>
<td> 2019-11-16 15:56:00 </td>
<td> 10201044299</td>
<td> DINI RAHMA HASANAH </td>
<td> Perempuan </td>
<td> Pelayanan Sore </td>
<td> 1 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 77</td>
<td> 2019-11-16 16:00:00 </td>
<td> 10201068221</td>
<td> MULYANTI </td>
<td> Perempuan </td>
 <td> Pelayanan Sore </td>
<td> 1 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 78</td>
<td> 2019-11-16 16:09:00 </td>
<td> 10201058985</td>
<td> ADAM FIRDAUS </td>
<td> Laki-laki </td>
<td> Pelayanan Sore </td>
<td> 1 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 79</td>
<td> 2019-11-16 16:18:00 </td>
<td> 10201073688</td>
<td> NOVI OKTAVIA </td>
<td> Perempuan </td>
<td> Pelayanan Sore </td>
<td> 1 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 80</td>
<td> 2019-11-16 16:31:00 </td>
<td> 10201032803</td>
<td> REKRIAN KIARENDRA </td>
<td> Laki-laki </td>
<td> Pelayanan Sore </td>
<td> 1 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 81</td>
<td> 2019-11-16 16:40:00 </td>
<td> 10201073689</td>
<td> KHANZA MAWLA SYANUM </td>
<td> Perempuan </td>
<td> Pelayanan Sore </td>
<td> 1 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 82</td>
<td> 2019-11-16 17:10:00 </td>
<td> 10201054201</td>
<td> ARYA RIZIEQ </td>
 <td> Laki-laki </td>
<td> Pelayanan Sore </td>
<td> 1 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 83</td>
<td> 2019-11-16 17:32:00 </td>
<td> 10201029274</td>
<td> YUSRIANI TAHIR MAKAWARO </td>
<td> Perempuan </td>
<td> Pelayanan Sore </td>
<td> 1 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 84</td>
<td> 2019-11-16 17:38:00 </td>
<td> 10201029274</td>
<td> YUSRIANI TAHIR MAKAWARO </td>
<td> Perempuan </td>
<td> Surat Keterangan Sehat (termasuk Tes Ichihara)/Orang </td>
<td> 1 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 85</td>
<td> 2019-11-16 17:35:00 </td>
<td> 10201040212</td>
<td> FAUZAN AIDHA RACHMAN </td>
<td> Laki-laki </td>
<td> Pelayanan Sore </td>
<td> 1 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>

<tr>
<td> 86</td>
<td> 2019-11-16 17:39:00 </td>
<td> 10201040212</td>
<td> FAUZAN AIDHA RACHMAN </td>
<td> Laki-laki </td>
<td> Surat Keterangan Sehat (termasuk Tes Ichihara)/Orang </td>
<td> 1 </td>
<td> 10000 </td>
<td> SAWANGAN</td>
</tr>
</table>
<br />
<br />
<br />
<table width="400px">
<tr align="center">
<td colspan="8">LAPORAN Rekapan Pembayaran Pelayanan Non
Kesehatan</td>
</tr>
<tr>
<td><b>No.</td>
<td><b>Tanggal</td>
<td><b> Nama</b></td>
<td><b>Nama Instansi</b></td>
<td><b>Jenis Pembayaran</b></td>
<td><b>Harga Satuan</b></td>
<td><b>Jumlah</b></td>
<td><b>Biaya</b></td>
<td><b>Puskesmas</b></td>
</tr>
</table>

<table>
</table>