5479
5479 |
| Nama | : | ........................................... |
| Jabatan | : | ........................................... |
| Instansi | : | ........................................... |
| NPSN | : | ........................................... |
| Alamat | : | ........................................... |
| : | ........................................... | |
| Nomor Telepon | : | ........................................... |
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| Sumber Dana | : | ........................................... |
| Janji Bayar | : | ........................................... |
| Tanggal Kirim | : | ........................................... |
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| No | Kode Barang | Nama Barang | Harga | Jumlah | Sub Total |
| TOTAL | |||||
*)Harga sudah termasuk pajak, dan biaya ongkos kirim.
*)Barang bisa diretur maks. 30 hari sejak penerimaan.
| Klaten, 07 Januari 2025 | |
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