Kunjungan Sakit Juni 2022

TANGGAL
NO NO KUNJUNGAN TANGGAL ENTRI NO KARTU

PELAYANAN
4 133011010622P000 30-06-2022 30-06-2022 0000686536874

766 00:00 08:29
11 133011010622P000 30-06-2022 30-06-2022 0000727643092

775 00:00 08:53
12 133011010622P000 30-06-2022 30-06-2022 0001038947861

784 00:00 09:46
27 133011010622P000 29-06-2022 29-06-2022 0000674775922

737 00:00 10:02
37 133011010622P000 29-06-2022 29-06-2022 0000687073386

735 00:00 09:46
133011010622P000 29-06-2022 29-06-2022
729 00:00 08:58
43 0001038960246
64 133011010622P000 28-06-2022 28-06-2022 0000686583101

688 00:00 10:25
65 133011010622P000 28-06-2022 28-06-2022 0000686594654

678 00:00 09:04
88 133011010622P000 28-06-2022 28-06-2022 0001703803678
704 00:00 11:50
102 133011010622P000 28-06-2022 01-07-2022 0002178845199

798 00:00 10:17
110 133011010622P000 28-06-2022 28-06-2022 0002804401855

683 00:00 09:24
111 133011010622P000 28-06-2022 28-06-2022 0002843037303

689 00:00 10:57
133011010622P000 28-06-2022 28-06-2022
687 00:00 09:55
116 0003104832058
133011010622P000 28-06-2022 28-06-2022

119 684 00:00 09:46 0003129263436
121 133011010622P000 27-06-2022 27-06-2022 0000685734423

649 00:00 11:12
133011010622P000 27-06-2022 27-06-2022

124 641 00:00 10:17 0000686718167
133 133011010622P000 27-06-2022 27-06-2022 0000687043236

646 00:00 10:55
140 133011010622P000 27-06-2022 27-06-2022 0000687228952
634 00:00 08:56
144 133011010622P000 27-06-2022 27-06-2022 0000687409121
631 00:00 08:17
156 133011010622P000 27-06-2022 27-06-2022 0001703814456
648 00:00 11:07
162 133011010622P000 27-06-2022 27-06-2022 0002288547988

647 00:00 11:00
133011010622P000 27-06-2022 27-06-2022

636 00:00 09:23
175 0003137845781
177 133011010622P000 24-06-2022 24-06-2022 0000685733714

584 00:00 10:30
213 133011010622P000 23-06-2022 23-06-2022 0000159506403
538 00:00 13:07
223 133011010622P000 23-06-2022 23-06-2022 0000686818978
534 00:00 10:35
229 133011010622P000 23-06-2022 23-06-2022 0000691709714
532 00:00 10:28
231 133011010622P000 23-06-2022 23-06-2022 0001382628429
524 00:00 09:24
133011010622P000 23-06-2022 23-06-2022
516 00:00 08:20
232 0001470086379
244 133011010622P000 23-06-2022 23-06-2022 0002733886451

529 00:00 10:09
245 133011010622P000 23-06-2022 23-06-2022 0002804194855

512 00:00 08:01
246 133011010622P000 23-06-2022 23-06-2022 0002804198556
513 00:00 08:10
247 133011010622P000 23-06-2022 23-06-2022 0002804199851
522 00:00 09:13
258 133011010622P000 22-06-2022 22-06-2022 0000686612799

485 00:00 08:18
260 133011010622P000 22-06-2022 22-06-2022 0000687134586
495 00:00 09:51
270 133011010622P000 22-06-2022 22-06-2022 0001404015557
500 00:00 10:51
288 133011010622P000 22-06-2022 23-06-2022 0003268548358

514 00:00 08:14
289 133011010622P000 22-06-2022 23-06-2022 0003268548404

515 00:00 08:17
292 133011010622P000 21-06-2022 21-06-2022 0000685761489

441 00:00 09:07
294 133011010622P000 21-06-2022 21-06-2022 0000686359157
439 00:00 08:56
302 133011010622P000 21-06-2022 21-06-2022 0000686921444

442 00:00 09:12
307 133011010622P000 21-06-2022 21-06-2022 0000687386542
440 00:00 09:01
327 133011010622P000 21-06-2022 21-06-2022 0002860574062
466 00:00 10:41
331 133011010622P000 20-06-2022 20-06-2022 0000089180559
403 00:00 09:30
339 133011010622P000 20-06-2022 20-06-2022 0000686235227

398 00:00 08:46
341 133011010622P000 20-06-2022 20-06-2022 0000686585507
404 00:00 09:35
347 133011010622P000 20-06-2022 20-06-2022 0000686937745
416 00:00 11:06
367 133011010622P000 20-06-2022 20-06-2022 0002157826138
413 00:00 10:49
371 133011010622P000 20-06-2022 20-06-2022 0002234643625
405 00:00 09:45
372 133011010622P000 20-06-2022 20-06-2022 0002278590715

417 00:00 11:12
378 133011010622P000 20-06-2022 20-06-2022 0002804188601

412 00:00 10:43
384 133011010622P000 20-06-2022 20-06-2022 0002857522601
394 00:00 08:25
385 133011010622P000 20-06-2022 20-06-2022 0002873812847

411 00:00 10:28
427 133011010622P000 17-06-2022 17-06-2022 0001038962316
358 00:00 09:42
428 0001543852078
133011010622P000 17-06-2022 17-06-2022

354 00:00 08:40
433 133011010622P000 17-06-2022 17-06-2022 0001703818416

356 00:00 09:32
448 133011010622P000 16-06-2022 16-06-2022 0000686841445

335 00:00 09:54
457 133011010622P000 16-06-2022 16-06-2022 0000775088234

311 00:00 08:26
458 133011010622P000 16-06-2022 16-06-2022 0001038951213
343 00:00 10:22
460 133011010622P000 16-06-2022 16-06-2022 0001275446687

328 00:00 09:32
465 133011010622P000 16-06-2022 16-06-2022 0002064824008
325 00:00 09:14
476 133011010622P000 16-06-2022 16-06-2022 0003090529653
346 00:00 10:37
478 133011010622P000 15-06-2022 15-06-2022 0000685497295
303 00:00 09:57
479 133011010622P000 15-06-2022 15-06-2022 0000685979425

300 00:00 09:43
133011010622P000 15-06-2022 15-06-2022
289 00:00 08:19
483 0000686819452
485 0000687295091
133011010622P000 15-06-2022 15-06-2022

293 00:00 08:37
486 133011010622P000 15-06-2022 15-06-2022 0001038952056

309 00:00 13:42
133011010622P000 15-06-2022 15-06-2022

302 00:00 09:52
487 0001261693045
499 133011010622P000 15-06-2022 15-06-2022 0002804199671

305 00:00 11:14
527 133011010622P000 14-06-2022 14-06-2022 0001968400844

264 00:00 09:07
535 133011010622P000 14-06-2022 14-06-2022 0002755051233
262 00:00 08:38
539 133011010622P000 14-06-2022 14-06-2022 0002804195529
260 00:00 08:19
544 133011010622P000 14-06-2022 14-06-2022 0003069311567
261 00:00 08:38
546 133011010622P000 13-06-2022 13-06-2022 0000089347509

246 00:00 10:06
133011010622P000 13-06-2022 13-06-2022
241 00:00 08:47
548 0000114481438
563 133011010622P000 13-06-2022 13-06-2022 0000686935517

243 00:00 08:57
568 133011010622P000 13-06-2022 13-06-2022 0000687641668
240 00:00 08:40
576 133011010622P000 13-06-2022 13-06-2022 0002157819671
239 00:00 08:12
133011010622P000 13-06-2022 13-06-2022
242 00:00 08:51
586 0002843039406
588 133011010622P000 13-06-2022 13-06-2022 0002875678323

247 00:00 10:55
612 133011010622P000 06-09-2022 09-06-2022 0000686601112
194 09:14
613 133011010622P000 06-09-2022 09-06-2022 0000686608661

196 09:53
620 133011010622P000 06-09-2022 09-06-2022 0001038960202
193 08:56
623 133011010622P000 06-09-2022 09-06-2022 0001883374143
201 10:59
133011010622P000 09-06-2022
192 08:33
629 06-09-2022 0002261795207
133011010622P000 09-06-2022
204 11:05
637 06-09-2022 0003094773941
638 133011010622P000 06-09-2022 09-06-2022 0003134547213
191 08:28
649 133011010622P000 06-08-2022 08-06-2022 0001516148122

141 08:51
662 133011010622P000 06-08-2022 08-06-2022 0003003193855
142 08:54
671 133011010622P000 06-07-2022 07-06-2022 0000686830228
110 08:40
673 133011010622P000 06-07-2022 07-06-2022 0000687077662
113 09:03
678 133011010622P000 06-07-2022 07-06-2022 0001038947635

134 11:06
679 133011010622P000 06-07-2022 07-06-2022 0001038958571
127 10:10
684 133011010622P000 06-07-2022 07-06-2022 0001701943479
114 09:08
133011010622P000 07-06-2022
115 09:36
689 06-07-2022 0002179103286
690 133011010622P000 06-07-2022 07-06-2022 0002260574627

109 08:27
704 06-06-2022 0000113398187
133011010622P000 06-06-2022
074 08:35
706 133011010622P000 06-06-2022 06-06-2022 0000685491456

073 08:28
711 133011010622P000 06-06-2022 06-06-2022 0000686490849
072 07:34
713 133011010622P000 06-06-2022 06-06-2022 0000686501335
075 08:49
133011010622P000 06-06-2022
077 09:04
718 06-06-2022 0000687170924
133011010622P000 06-06-2022
076 08:51
721 06-06-2022 0000687463402
729 133011010622P000 06-06-2022 06-06-2022 0001703801441

078 09:08
734 133011010622P000 06-06-2022 06-06-2022 0001878998523

081 09:14
739 133011010622P000 06-06-2022 06-06-2022 0002307920499
100 10:03
747 133011010622P000 06-06-2022 06-06-2022 0002970802743

080 09:13
759 133011010622P000 06-03-2022 03-06-2022 0000114308414
049 09:10
771 133011010622P000 06-03-2022 03-06-2022 0000691555184
053 09:44
133011010622P000 03-06-2022
052 09:29
772 06-03-2022 0001038948388
780 133011010622P000 06-03-2022 03-06-2022 0002455480113

051 09:24
781 133011010622P000 06-03-2022 03-06-2022 0002505878616

048 08:44
784 133011010622P000 06-03-2022 03-06-2022 0002873633602
047 08:30
786 133011010622P000 06-03-2022 03-06-2022 0003059946077
050 09:18
803 133011010622P000 06-02-2022 02-06-2022 0000687625626
016 09:46
808 133011010622P000 06-02-2022 02-06-2022 0001038961563
008 09:16
809 133011010622P000 06-02-2022 02-06-2022 0001401338294
024 10:26
810 133011010622P000 06-02-2022 02-06-2022 0001405141795
014 09:34
812 133011010622P000 06-02-2022 02-06-2022 0001691872716

025 10:28
813 133011010622P000 06-02-2022 02-06-2022 0001703402109
020 10:01
815 133011010622P000 06-02-2022 02-06-2022 0001703801092
015 09:44
818 06-02-2022 0001890065349
133011010622P000 02-06-2022
005 08:46
830 133011010622P000 06-02-2022 02-06-2022 0002681455904

033 11:16
831 133011010622P000 06-02-2022 02-06-2022 0002681457849

002 08:30
843 133011010622P000 06-02-2022 02-06-2022 0003075868517
007 09:10
JENIS STATUS
NAMA PESERTA JENIS PESERTA DIAGNOSA PRB PROLANIS
KELAMIN PULANG
DWI YUNI ASTUTIK P PBI (APBN) Other and unspecified Rujuk Vertikal Hipertensi
right bundle-branch
block
LILIK ARIFAH P PBI (APBN) Supervision of other Rujuk Vertikal

high-risk pregnancies
SUHAR L PBI (APBN) Cerebral infarction, Rujuk Vertikal

unspecified
SIAMI P PBI (APBN) Other chronic Rujuk Vertikal

obstructive pulmonary
disease
DEWI AMBARWATI P PBI Benign neoplasm of Rujuk Vertikal

breast
Chronic obstructive
pulmonary disease,
unspecified
SLAMIN L PBI (APBN) Rujuk Vertikal
AHMAD FAREL LEONARDI L PBI (APBN) Other hypertrophic Rujuk Vertikal

disorders of skin
FITRIA. P PBI (APBN) Nummular dermatitis Rujuk Vertikal
MAULIDATUL HASANAH P PBI Tuberculosis of other Rujuk Vertikal

specified organs
AHMAD FAREL LEONARDI L PBI Other hypertrophic Rujuk Vertikal

disorders of skin
HARTIN P PEKERJA Supervision of other Rujuk Vertikal

MANDIRI high-risk pregnancies
YUYUN WAHYUNINGSIH P PBI Ganglion Rujuk Vertikal
PEKERJA Mechanical
MANDIRI complication of other
urinary devices and
EDY DJATMIKO L implants Rujuk Vertikal
PEKERJA Systemic lupus

ERWIN SRI ASTUTIK P MANDIRI erythematosus, Rujuk Vertikal
unspecified
SITI MAISAROH P PBI (APBN) Bipolar affective Rujuk Vertikal

disorder, current
episode severe
depression without
psychotic symptoms
PBI Other disorders of Diabetes Mellitus

RUKMIYATI P conjunctiva Rujuk Vertikal Hipertensi
SLAMET MUJIONO L PBI (APBN) Chronic rhinitis Rujuk Vertikal
DIAN LESTARI P PBI (APBN) Benign neoplasm of Rujuk Vertikal

breast
AKH JUMADI L PBI Gastro-oesophageal Rujuk Vertikal
reflux disease
RICO IRAWAN PRATAMA L PBI (APBN) Respiratory disorder, Rujuk Vertikal
unspecified
YULIATIN P PEKERJA Supervision of other Rujuk Vertikal

MANDIRI high-risk pregnancies
PEKERJA Visual impairment

MANDIRI including blindness
(binocular or
MOHAMAD ICHSAN H L monocular) Rujuk Vertikal
ACHMAD SUBEKTI L PBI (APBN) Special epileptic Rujuk Vertikal

syndromes
NUR AMALA P PBI Heart failure Rujuk Vertikal
TUTIK RAUTI P PBI (APBN) Benign neoplasm of Rujuk Vertikal

breast
SAIFUR ROHMAN L PEKERJA Abscess of liver Rujuk Vertikal
MANDIRI
SUWARNO L PEKERJA Heart failure Rujuk Vertikal
MANDIRI
Human
immunodeficiency
virus [HIV] disease
resulting in infectious
MUHAMMAD ABDUL AZIZ L PBI (APBD) and parasitic diseases Rujuk Vertikal
SLAMET BUDI L PBI (APBN) Other chronic Rujuk Vertikal

disease
SUTIYEH P PBI (APBN) Senile cataract Rujuk Vertikal
HARI HUSEN L PBI (APBN) Hyperplasia of prostate Rujuk Vertikal
SIHAB BANDIDO L PBI (APBN) Stroke, not specified as Rujuk Vertikal

haemorrhage or
infarction
MUSRIFAH P PBI (APBN) Senile cataract Rujuk Vertikal
JUARIYAH P PBI (APBN) Presence of intraocular Rujuk Vertikal

lens
ANGGI NOVELASARI P PBI Supervision of other Rujuk Vertikal
JEVANO ZAKI WIDODO L PEKERJA Feeding difficulties and Rujuk Vertikal

MANDIRI mismanagement
JUAN ZAKI WIDODO L PEKERJA Feeding difficulties and Rujuk Vertikal

MANDIRI mismanagement
HAMDATUNNISA P PBI (APBN) Epilepsy Rujuk Vertikal
SAMA'I L PBI Other chronic Rujuk Vertikal

disease
SAUDAH P PBI (APBN) Unqualified visual loss, Rujuk Vertikal

both eyes
MUHAMAD L PBI (APBN) Heart failure Rujuk Vertikal
SAUDA P PBI (APBN) Unqualified visual loss, Rujuk Vertikal

both eyes
SUNGKEMING TIAS MAMI P VETERAN Sacroiliitis, not Rujuk Vertikal
elsewhere classified
SEMININGSIH P PBI Congestive heart Rujuk Vertikal

failure
ALWI L PBI (APBN) Senile cataract Rujuk Vertikal Hipertensi
SITI HANIFAH P PBI (APBN) Asthma Rujuk Vertikal
SITI AISYAH P PBI (APBD) Pre-eclampsia, Rujuk Vertikal

unspecified
SUROSO L PBI (APBN) Pleural effusion, not Rujuk Vertikal
BUNI P PEKERJA Other and unspecified Rujuk Vertikal

MANDIRI right bundle-branch
block
RIKA MAWARSARI P PBI (APBN) Prolonged pregnancy Rujuk Vertikal
WAHYU PUTRI P PBI (APBN) Other specified acute Rujuk Vertikal

ROMADHANI viral hepatitis
SURA'I L PEKERJA Heart failure Rujuk Vertikal

MANDIRI
ROHMATUL MAWANAH P PBI (APBN) Supervision of other Rujuk Vertikal
SUMAIDAH P Chronic obstructive Rujuk Vertikal

pulmonary disease with
acute exacerbation,
PEKERJA unspecified
MANDIRI
KARNI ALIFAH HJ P PBI (APBN) Other chronic Rujuk Vertikal

disease
JONI ISKANDAR L PBI (APBN) Chronic renal failure, Rujuk Vertikal

unspecified
JUMAIYA P PBI (APBN) Senile cataract Rujuk Vertikal
INDAH NUR IMANIAH P PBI (APBN) Supervision of other Rujuk Vertikal

ANY SULISTYOWATI P PEKERJA Heart failure Rujuk Vertikal

MANDIRI
MOHAMMAD ALFIN L PBI Other aplastic anaemias Rujuk Vertikal
ROMADHONA
ALIVIA SALSABILA P PEKERJA Acute bronchitis, Rujuk Vertikal
MANDIRI unspecified
FIRMANSYAH L PBI (APBN) Acute and transient Rujuk Vertikal
psychotic disorders
SAI L PBI Corneal ulcer Rujuk Vertikal
Chronic obstructive
pulmonary disease,
unspecified
ASNAN L PBI (APBN) Rujuk Vertikal Hipertensi
SUGIWANTORO L PBI (APBN) Injury of extensor Rujuk Vertikal
muscle and tendon of
other finger at wrist
and hand level
SITI HOTIMAH P PBI (APBN) Sacroiliitis, not Rujuk Vertikal

PEKERJA Insulin-dependent Diabetes Mellitus

MANDIRI diabetes mellitus with
KASRIATI P ophthalmic Rujuk Vertikal
complications
IMAM WARSITO L PBI (APBN) Cerebral infarction, Rujuk Vertikal

unspecified
M. SOLEH L PEKERJA Nasal polyp, Rujuk Vertikal

MANDIRI unspecified
SAROPA P PEKERJA Lesion of sciatic nerve Rujuk Vertikal
MANDIRI
SUMIRAH P PBI (APBN) Heart failure Rujuk Vertikal
TRYNA JIHAN MISHA AL P PBI Convulsions, not Rujuk Vertikal

PRANOWO elsewhere classified
SUMIJAH P PENERIMA Polyarthrosis Rujuk Vertikal

PENSIUN PNS
Non-insulin-dependent
diabetes mellitus with
ophthalmic
KASIYAMI P PNS DAERAH complications Rujuk Vertikal
UMIATI P PBI (APBN) Senile cataract Rujuk Vertikal
SUKESI P PBI (APBN) Polyarthrosis Rujuk Vertikal
CHOIRUL ANAM L PBI (APBD) Schizophrenia Rujuk Vertikal
Chronic obstructive
pulmonary disease,
unspecified
SANA P PBI (APBN) Rujuk Vertikal
DESY YEYEN SETIYOWATI P PEKERJA Astigmatism Rujuk Vertikal

MANDIRI
KHOLIFAH P PBI (APBN) Acute viral hepatitis, Rujuk Vertikal
unspecified
HERIYA P PBI (APBN) Glaucoma Rujuk Vertikal
FAUZIAH AMIN P PBI (APBN) Senile incipient Rujuk Vertikal

cataract
HAMSUN L PBI (APBD) Other and unspecified Rujuk Vertikal
cirrhosis of liver
PEGAWAI Chronic obstructive

SWASTA pulmonary disease,
unspecified
AHMAD HERU SUSANTO L Rujuk Vertikal
PBI Congenital absence,

atresia and stenosis of
anus without fistula
NAYYARA KAYLA SAFITRI P Rujuk Vertikal
MILA ROSA P PEKERJA Thyrotoxicosis with Rujuk Vertikal
MANDIRI diffuse goitre
AISYAH FEBI PUTRI P PEGAWAI Chalazion Rujuk Vertikal

PERMANA SWASTA
ROHMAN L PBI Senile cataract, Rujuk Vertikal
unspecified
SEDIYEH P PBI (APBN) Heart failure Rujuk Vertikal
KARTINI P PBI (APBN) Stroke, not specified as Rujuk Vertikal

haemorrhage or
infarction
SAWI L PBI Hyperplasia of prostate Rujuk Vertikal
HOSNIYATI P PBI (APBN) Hypertensive heart Rujuk Vertikal

disease
IWAN KRISDIANTO L PBI Senile cataract Rujuk Vertikal
Hepatomegaly with
splenomegaly, not
DJUMA'ATI P PBI (APBN) Rujuk Vertikal
MILA NUR DAHLIA P PEGAWAI Diabetes mellitus in Rujuk Vertikal

SWASTA pregnancy, unspecified
FAHMI REZA AMRULLAH L Other benign neoplasm Rujuk Vertikal

of connective and other
soft tissue of head, face
PEKERJA and neck
MANDIRI
LILIS CAHYATI P PBI (APBN) Schizophrenia Rujuk Vertikal
NUR ANNISA MAJID P PBI Prolonged pregnancy Rujuk Vertikal
MUHAMMAD REZA L PBI (APBN) Epilepsy Rujuk Vertikal
Respiratory
tuberculosis,
bacteriologically and
MUNAJI L PBI (APBN) histologically Rujuk Vertikal
confirmed
PBI Chronic obstructive

pulmonary disease,
unspecified
TAHER L Rujuk Vertikal
NGATMINAH P PBI (APBD) Other and unspecified Rujuk Vertikal

cirrhosis of liver
DUKUT SUTIYONO L PBI Heart failure Rujuk Vertikal
SUTIKNO L PEKERJA Chronic renal failure, Rujuk Vertikal

MANDIRI unspecified
KASERI L PBI (APBN) Hyperplasia of prostate Rujuk Vertikal
SUHARTOYO L PENERIMA Fracture of shaft of Rujuk Vertikal

PENSIUN PNS tibia
SITI NURKHOLILA P PBI (APBN) Supervision of other Rujuk Vertikal
Chronic obstructive
pulmonary disease,
unspecified
MAAT P L PBI (APBN) Rujuk Vertikal
PUGUH L PEKERJA Chronic renal failure, Rujuk Vertikal

MANDIRI unspecified
ABDUL ABAS L PBI (APBN) Total (external) Rujuk Vertikal

ophthalmoplegia
MATTOSAN L PEKERJA Angina pectoris, Rujuk Vertikal
MANDIRI unspecified
NURSANI P PBI (APBN) Atrial fibrillation and Rujuk Vertikal
flutter
TUMIN L PBI Senile cataract Rujuk Vertikal
SUWARSI P PBI (APBN) Heart failure Rujuk Vertikal
SAWI WANTO L PBI (APBD) Spinal enthesopathy Rujuk Vertikal
SUPARNO L PBI Chronic renal failure, Rujuk Vertikal

unspecified
IKA PURWANTI P PEKERJA Pre-eclampsia, Rujuk Vertikal

MANDIRI unspecified
YENI TITIK SUTANTI P PEGAWAI Pleural condition, Rujuk Vertikal
SWASTA unspecified
ANY WIDIYASTUTI P PBI (APBD) Pre-eclampsia, Rujuk Vertikal
unspecified
DAHRIYAH P Non-insulin-dependent Rujuk Vertikal
diabetes mellitus with
PEKERJA neurological
complications Diabetes Mellitus
MANDIRI
TAHAL L PBI (APBD) Infection due to other Rujuk Vertikal

mycobacteria
DIYAN ARIFIYANTO L PBI (APBD) Schizophrenia Rujuk Vertikal
RAHMATULLAH L PEGAWAI Lactose intolerance Rujuk Vertikal

DANUARTA SWASTA
ICD-X POLI RS
145.1 AJNTUNG DAN PEMBULUH DARAH JATIROTO
Z35.8 OBGYN JATIROTO
163.9 SARAF JATIROTO
J44 PARU JATIROTO
D24 BEDAH JATIROTO
J44.6 PARU JATIROTO
L91.8 BEDAH JATIROTO
L30.0 KULIT KELAMIN JATIROTO
A18.8 PARU JATIROTO
L91.8 BEDAH JATIROTO
M67.4 BEDAH JATIROTO
T83.1 UROLOGI JATIROTO
M32.9 PENYAKIT DALAM JATIROTO
F31.4 JIWA WIJAYA KUSUMA
H11 MATA JATIROTO
J31.0 PARU JATIROTO
D24 BEDAH JATIROTO
K21 PENYAKIT DALAM JATIROTO

J98.9 ANAK JATIROTO
H54 MATA WIJAYA KUSUMA
G40.5 SARAF JATIROTO
I50 PENYAKIT DALAM JATIROTO
D24 BEDAH JATIROTO
K75.0 PENYAKIT DALAM JATIROTO
I50 JANTUNG DAN PEMBULUH DARAH JATIROTO
A15 PENYAKIT DALAM HARYOTO LUMAJANG
J44 PARU JATIROTO
H25 MATA JATIROTO
N40 UROLOGI HARYOTO LUMAJANG
I64 SARAF HARYOTO LUMAJANG
H25 MATA JATIROTO
Z96.1 MATA JATIROTO
R63.3 ANAK JATIROTO
R63.3 ANAK JATIROTO
G40 SARAF JATIROTO
J44 PARU JATIROTO
H54.3 MATA JATIROTO
H54 MATA JATIROTO

M46.1 SARAF JATIROTO
I50.0 JANTUNG DAN PEMBULUH DARAH JATIROTO
425 MATA WIJAYA KUSUMA
J45 PARU JATIROTO
O14.9 OBGYN JATIROTO
J90 PARU JATIROTO
I45.1 JANTUNG DAN PEMBULUH DARAH JATIROTO
O48 OBGYN JATIROTO
B17.8 PENYAKIT DALAM JATIROTO
I50 JANTUNG DAN PEMBULUH DARAH WIJAYA KUSUMA
J44.1 PARU JATIROTO
J44 PARU JATIROTO
N18.9 PENYAKIT DALAM JATIROTO
H25 MATA JATIROTO
D61 ANAK HARYOTO LUMAJANG
J20.9 ANAK JATIROTO
F23 JIWA JATIROTO
H16.0 MATA JATIROTO
J44.9 PARU JATIROTO

S66.3 ORTHOPEDI JATIROTO
M46.1 SARAF JATIROTO
E10.3 PENYAKIT DALAM JATIROTO
I63.9 SARAF JATIROTO
J33.9 THT-KL JATIROTO
G57.0 SARAF JATIROTO
R56 ANAK JATIROTO
M15 PENYAKIT DALAM JATIROTO
M15 ORTHOPEDI JATIROTO
F20 JIWA JATIROTO
J44.9 PARU JATIROTO
H52.2 MATA JATIROTO
B17.9 PENYAKIT DALAM JATIROTO
H40 MATA JATIROTO
H25.0 MATA JATIROTO
K74.6 PENYAKIT DALAM WIJAYA KUSUMA
J44.9 PARU JATIROTO
Q42.3 BEDAH ANAK SOEBANDI JEMBER

H00.1 MATA JATIROTO
H25.9 MATA JATIROTO
I64 SARAF JATIROTO
N40 UROLOGI JATIROTO
R16.2 PENYAKIT DALAM JATIROTO
D21.0 THT-L HARYOTO LUMAJANG
F20 JIWA JATIROTO
O48 OBGYN JATIROTO
G40 ANAK JATIROTO
A15 PARU JATIROTO
J44.9 PARU JATIROTO
K74.6 PENYAKIT DALAM JATIROTO
N18.9 HEMODIALISA HARYOTO LUMAJANG
N40 UROLOGI BHAYANGKARA KUMAJANG
S82.2 ORTHOPEDI JATIROTO

J44.1 PARU JATIROTO
N18.9 HEMODIALISA HARYOTO LUMAJANG
J49.3 MATA WIJAYA KUSUMA
I20.9 JANTUNG DAN PEMBULUH DARAH BHAYANGKARA LUMAJANG
H25 MAYA WIJAYA KUSUSMA
M46 SARAF JATIROTO
N18.9 HEMODIALISASI HARYOTO LUMAJANG
J94.9 PARU JATIROTO
E11.4 SARAF JATIROTO
A31 KULIT KELAMIN JATIROTO
F20 JIWA JATIROTO
E73 ANAK JATIROTO

Kantor Cabang : JEMBER - 1310
FKTP : JATIROTO - 13301101
TANGGAL TANGGAL JENIS
NO NO KUNJUNGAN PELAYANAN ENTRI NO KARTU NAMA PESERTA KELAMIN
1 133011010622P000 30-06-2022 30-06-2022 0000674661306 SLAMET ROZA ZAKARIYA L

787 00:00 09:56
2 133011010622P000 30-06-2022 30-06-2022 0000674771422 WARI SIYATUL JENNAH P

786 00:00 09:53
3 133011010622P000 30-06-2022 02-07-2022 0000686464479 HADIYANTI ROSIDA P

818 00:00 07:04
4 133011010622P000 30-06-2022 30-06-2022 0000686536874 DWI YUNI ASTUTIK P

766 00:00 08:29
5 133011010622P000 30-06-2022 30-06-2022 0000686570848 UMI KALSUM P
783 00:00 09:36
6 133011010622P000 30-06-2022 02-07-2022 0000686872168 QOIMATUR ROHMI P
817 00:00 06:57
133011010622P000 30-06-2022 30-06-2022

7 780 00:00 09:20 0000687132371 KULSUM P
8 133011010622P000 30-06-2022 01-07-2022 0000687216069 SULIYATI P

795 00:00 08:54
9 133011010622P000 30-06-2022 30-06-2022 0000687631689 SINEM P

785 00:00 09:51
10 133011010622P000 30-06-2022 30-06-2022 0000687703408 SUNARSIATI P
788 00:00 09:58
11 133011010622P000 30-06-2022 30-06-2022 0000727643092 LILIK ARIFAH P

775 00:00 08:53
12 133011010622P000 30-06-2022 30-06-2022 0001038947861 SUHAR L

784 00:00 09:46
13 133011010622P000 30-06-2022 30-06-2022 0001038951549 MAULANA ZAKARIAH L

790 00:00 12:19
133011010622P000 30-06-2022 30-06-2022

14 777 00:00 09:00 0001038952089 DUMAH P
133011010622P000 30-06-2022 30-06-2022

15 779 00:00 09:14 0001038956501 ENDANG SRI RAHAYU P
16 133011010622P000 30-06-2022 30-06-2022 0001038963622 ROMLAH P

767 00:00 08:38
17 133011010622P000 30-06-2022 30-06-2022 0001703795826 KARUNIA P
774 00:00 08:51
STATUS
JENIS PESERTA DIAGNOSA PULANG PRB PROLANIS
PBI (APBN) Schizophrenia Berobat Jalan
PBI (APBD) Acute nasopharyngitis [common Berobat Jalan

cold]
- Pregnancy examination and test Berobat Jalan
PBI (APBN) Other and unspecified right Rujuk Vertikal Hipertensi

bundle-branch block
PBI (APBN) Acute nasopharyngitis [common Berobat Jalan
cold]
Acute upper respiratory infections

PBI (APBN) of multiple and unspecified sites Berobat Jalan
PBI (APBN) Essential (primary) hypertension Berobat Jalan
PBI (APBN) Essential (primary) hypertension Berobat Jalan Diabetes Mellitus
PBI (APBN) Allergic contact dermatitis Berobat Jalan
PBI (APBN) Supervision of other high-risk Rujuk Vertikal

pregnancies
PBI (APBN) Cerebral infarction, unspecified Rujuk Vertikal
PBI (APBN) Periapical abscess without sinus Berobat Jalan
Acute upper respiratory infections Diabetes Mellitus

Other soft tissue disorders, not

PBI (APBN) elsewhere classified Berobat Jalan

cold]
18 133011010622P000 30-06-2022 30-06-2022 0001703804848 MUHAMMAD BACHTIAR ALI L

776 00:00 08:55
19 133011010622P000 30-06-2022 30-06-2022 0002157385015 HARRY SUBAGIJO L

782 00:00 09:23
133011010622P000 30-06-2022 02-07-2022

20 821 00:00 12:37 0002160026842 SUMMAH P
21 133011010622P000 30-06-2022 30-06-2022 0002204254315 AZIZAH ZAHRA TRIANOVA P

778 00:00 09:04
22 133011010622P000 30-06-2022 30-06-2022 0002251244619 ABIDAH KHOIRIYAH MUKI P

789 00:00 10:27
23 133011010622P000 30-06-2022 04-07-2022 0002732040663 MISTINA P
839 00:00 09:10
24 133011010622P000 30-06-2022 02-07-2022 0002804401855 HARTIN P

816 00:00 06:53
25 133011010622P000 30-06-2022 30-06-2022 0003261867862 ALI MURTADHO L
781 00:00 09:23

739 00:00 11:01
27 133011010622P000 29-06-2022 29-06-2022 0000674775922 SIAMI P
737 00:00 10:02
28 133011010622P000 29-06-2022 04-07-2022 0000685592706 MISNAYAH P

844 00:00 11:23
133011010622P000 29-06-2022 29-06-2022

29 738 00:00 10:56 0000686194413 RIASIH P
133011010622P000 29-06-2022 29-06-2022

30 742 00:00 13:53 0000686340156 MARIYEH P
31 133011010622P000 29-06-2022 29-06-2022 0000686746045 SUAMA P

747 00:00 14:07
32 133011010622P000 29-06-2022 04-07-2022 0000686818978 TUTIK RAUTI P
843 00:00 11:21
33 133011010622P000 29-06-2022 29-06-2022 0000686850636 NANIK P

730 00:00 09:05
34 133011010622P000 29-06-2022 29-06-2022 0000686947263 SUSIATI P
736 00:00 09:59
35 133011010622P000 29-06-2022 29-06-2022 0000687039399 SITI RUKAYYAH P

725 00:00 08:44
STATUS
PEGAWAI SWASTA Acute nasopharyngitis [common Berobat Jalan

cold]
PBI (APBN) Essential (primary) hypertension Berobat Jalan Hipertensi
Transient cerebral ischaemic

- attack, unspecified Sembuh
- Acute nasopharyngitis [common Berobat Jalan

cold]

cold]
- Typhoid and paratyphoid fevers Sembuh
PEKERJA MANDIRI Pregnancy examination and test Berobat Jalan
PEKERJA MANDIRI Anodontia Berobat Jalan
PBI (APBN) Other chronic obstructive Berobat Jalan

pulmonary disease
PBI (APBN) Other chronic obstructive Rujuk Vertikal
pulmonary disease
PBI (APBN) Toxic effect of contact with Berobat Jalan

venomous animals
Neoplasm of uncertain or unknown

PBI (APBN) behaviour of male genital organs Berobat Jalan

- elsewhere classified Berobat Jalan
PBI (APBN) Headache Berobat Jalan
PBI (APBN) Non-insulin-dependent diabetes Berobat Jalan

mellitus
PBI (APBN) Conjunctivitis Berobat Jalan

36 133011010622P000 29-06-2022 01-07-2022 0000687068739 SURYO L

793 00:00 08:39
37 133011010622P000 29-06-2022 29-06-2022 0000687073386 DEWI AMBARWATI P

735 00:00 09:46
38 133011010622P000 29-06-2022 29-06-2022 0000687190432 TIARA YOGI APRILIA P

744 00:00 13:59
39 133011010622P000 29-06-2022 29-06-2022 0000687363737 ASLAM L

723 00:00 08:37
40 133011010622P000 29-06-2022 02-07-2022 0000687381928 YULINDA ANGGRAENI P
820 00:00 12:26
133011010622P000 29-06-2022 29-06-2022
41 726 00:00 08:47 0001038946127 MOH ALIK SANDRO L
133011010622P000 29-06-2022 29-06-2022

42 741 00:00 13:50 0001038947668 ASAN L
133011010622P000 29-06-2022 29-06-2022

43 729 00:00 08:58 0001038960246 SLAMIN L
44 133011010622P000 29-06-2022 29-06-2022 0001703609256 RISA ALFIANA P

743 00:00 13:56
45 133011010622P000 29-06-2022 29-06-2022 0001703796096 MOHAMAD DARWIS SHARUL L

745 00:00 14:02 ANWAR
133011010622P000 29-06-2022 29-06-2022
46 724 00:00 08:40 0001703800844 ROMLAH P
47 133011010622P000 29-06-2022 29-06-2022 0002157825892 JETIM L

728 00:00 08:52
48 133011010622P000 29-06-2022 29-06-2022 0002160633352 YUYUN SULISTIANI P
746 00:00 14:04
49 133011010622P000 29-06-2022 04-07-2022 0002433760986 SIGIT PRATOMO L

842 00:00 11:20
50 133011010622P000 29-06-2022 29-06-2022 0002443995393 IKA RAHAYU P

749 00:00 14:12
51 133011010622P000 29-06-2022 02-07-2022 0002622432047 MUHAMMAD RAKA DWI L

819 00:00 11:50 SYAPUTRA
133011010622P000 29-06-2022 29-06-2022
52 748 00:00 14:09 0002681150207 SAODAH P
STATUS
- Diarrhoea and gastroenteritis of Sembuh

presumed infectious origin
- Benign neoplasm of breast Rujuk Vertikal
PEGAWAI SWASTA Fever of other and unknown origin Berobat Jalan
PBI (APBN) Urinary tract infection, site not Berobat Jalan

specified
PEGAWAI SWASTA Dyspepsia Sembuh


Chronic obstructive pulmonary

PBI (APBN) disease, unspecified Rujuk Vertikal
PBI (APBD) Allergic contact dermatitis Berobat Jalan
PBI (APBD) Fever, unspecified Berobat Jalan

PBI (APBD) Otalgia and effusion of ear Berobat Jalan
PEGAWAI SWASTA Other surgical follow-up care Berobat Jalan
PBI (APBN) Typhoid fever Sembuh

PBI (APBD) of multiple and unspecified sites Berobat Jalan
53 133011010622P000 29-06-2022 29-06-2022 0002804181489 MOCH DOFIR L

727 00:00 08:49
133011010622P000 29-06-2022 29-06-2022

54 750 00:00 14:14 0002804200402 SLAMET BUDIONO L
55 133011010622P000 29-06-2022 02-07-2022 0003085133095 SITI HOLIFAH P

822 00:00 12:48
56 133011010622P000 28-06-2022 28-06-2022 0000099986038 IKA LESTARI FATMAWATI P
686 00:00 09:51
133011010622P000 28-06-2022 28-06-2022

57 706 00:00 13:07 0000113499999 TUTIK WINARNI P
58 133011010622P000 28-06-2022 28-06-2022 0000170110258 NUR HAYATI P

695 00:00 11:20
133011010622P000 28-06-2022 28-06-2022

59 677 00:00 08:43 0000685593821 BAMBANG ROESMANTO L
60 133011010622P000 28-06-2022 30-06-2022 0000685604193 RUMIATI P

791 00:00 13:45
61 133011010622P000 28-06-2022 02-07-2022 0000685713126 ZUMROTUL HABIBAH P
812 00:00 06:28
62 133011010622P000 28-06-2022 28-06-2022 0000685775452 KHOLFIYAH P

713 00:00 13:47
63 133011010622P000 28-06-2022 28-06-2022 0000686274941 MULYATI P
710 00:00 13:35
64 133011010622P000 28-06-2022 28-06-2022 0000686583101 AHMAD FAREL LEONARDI L

688 00:00 10:25
65 133011010622P000 28-06-2022 28-06-2022 0000686594654 FITRIA. P
678 00:00 09:04
66 133011010622P000 28-06-2022 02-07-2022 0000686600403 SITI AMINA P

810 00:00 06:25
67 133011010622P000 28-06-2022 28-06-2022 0000686727652 IRIANTI P
722 00:00 14:36
68 133011010622P000 28-06-2022 02-07-2022 0000686873654 SITI NURFADILA P

814 00:00 06:33
133011010622P000 28-06-2022 28-06-2022
69 682 00:00 09:23 0000686919519 HUSNUL KHOTIMAH P
STATUS

PNS DAERAH Contraceptive management Berobat Jalan

PENERIMA PENSIUN Acute nasopharyngitis [common Berobat Jalan

PNS cold]

- Fever of other and unknown origin Sembuh
PBI (APBN) Pregnancy examination and test Berobat Jalan
- Essential (primary) hypertension Berobat Jalan Hipertensi
- Gastritis and duodenitis Berobat Jalan Diabetes Mellitus
PBI (APBN) Other hypertrophic disorders of Rujuk Vertikal

skin
PBI (APBN) Nummular dermatitis Rujuk Vertikal
- Essential (primary) hypertension Berobat Jalan

133011010622P000 28-06-2022 28-06-2022

70 717 00:00 14:32 0000687058683 SAMAT L
71 133011010622P000 28-06-2022 02-07-2022 0000687062632 NIMAWATI P

813 00:00 06:31
72 133011010622P000 28-06-2022 28-06-2022 0000687062643 SUMRATI P

708 00:00 13:08
73 0000687095864 FIRMAN L
133011010622P000 28-06-2022 28-06-2022
676 00:00 08:38
133011010622P000 28-06-2022 28-06-2022

74 690 00:00 11:00 0000687100915 MENIK HANDAYANI P
75 133011010622P000 28-06-2022 28-06-2022 0000687155152 SUWANI P

714 00:00 13:58
133011010622P000 28-06-2022 28-06-2022

76 712 00:00 13:40 0000687200826 SURIP P
77 133011010622P000 28-06-2022 28-06-2022 0000687903963 PANGAT L

675 00:00 08:35
78 133011010622P000 28-06-2022 28-06-2022 0000694115087 AWIT NURAINI P
681 00:00 09:21
79 133011010622P000 28-06-2022 30-06-2022 0000828850983 MELAN L

792 00:00 14:02
80 0001038954655 ROKAYAH P
133011010622P000 28-06-2022 01-07-2022
796 00:00 09:00
81 133011010622P000 28-06-2022 28-06-2022 0001038959998 SITI ISMIYATI P

679 00:00 09:10
82 133011010622P000 28-06-2022 28-06-2022 0001038961337 SITI HALIMA P
694 00:00 11:18
83 133011010622P000 28-06-2022 28-06-2022 0001341465107 M SUKRI L

711 00:00 13:38
84 133011010622P000 28-06-2022 28-06-2022 0001341469539 TRISNI P
716 00:00 14:32
85 133011010622P000 28-06-2022 01-07-2022 0001382628429 SUWARNO L
800 00:00 14:51
STATUS

- of multiple and unspecified sites Berobat Jalan Hipertensi
- General counselling and advice on Berobat Jalan

contraception
- Other headache syndromes Berobat Jalan
KEPALA DESA DAN Acute upper respiratory infections Berobat Jalan

PERANGKAT DESA of multiple and unspecified sites

- Myalgia Berobat Jalan Diabetes Mellitus

PBI (APBN) Contraceptive management Berobat Jalan
- Acute renal failure, unspecified Sembuh


cold]
PEKERJA MANDIRI Chronic periodontitis Berobat Jalan

133011010622P000 28-06-2022 28-06-2022

86 705 00:00 13:06 0001405141378 SUPARIANTO L
133011010622P000 28-06-2022 28-06-2022

87 715 00:00 14:31 0001537869036 SATIMA P
88 133011010622P000 28-06-2022 28-06-2022 0001703803678 MAULIDATUL HASANAH P

704 00:00 11:50
89 133011010622P000 28-06-2022 28-06-2022 0001703803678 MAULIDATUL HASANAH P
699 00:00 11:36
90 133011010622P000 28-06-2022 01-07-2022 0001703807436 ALFIA KARIMATUL MA'RIFA P
799 00:00 14:49
133011010622P000 28-06-2022 04-07-2022
91 845 00:00 11:28 0001703809697 PITONO L
92 133011010622P000 28-06-2022 28-06-2022 0001703809721 APRILIA WULANDARI P

701 00:00 11:41
93 133011010622P000 28-06-2022 28-06-2022 0001703813422 MUHAMMAD AKBAR L

680 00:00 09:17
94 133011010622P000 28-06-2022 28-06-2022 0001703813747 FARHAN MAULANA L
700 00:00 11:38
95 133011010622P000 28-06-2022 28-06-2022 0001720222751 ERIS MEI DIASTUTIK P

718 00:00 14:34
96 133011010622P000 28-06-2022 28-06-2022 0001885080262 ALFIA ROHMA WATI P
703 00:00 11:47
97 133011010622P000 28-06-2022 28-06-2022 0002157826217 BUNARMI P

697 00:00 11:30
98 133011010622P000 28-06-2022 28-06-2022 0002157826331 PARIYEM P
696 00:00 11:26
133011010622P000 28-06-2022 28-06-2022

99 691 00:00 11:04 0002157826601 PAIMA P
100 133011010622P000 28-06-2022 28-06-2022 0002157830998 SUPARMAN L

698 00:00 11:33
101 133011010622P000 28-06-2022 28-06-2022 0002178844852 SIYAMA P

719 00:00 14:35
102 133011010622P000 28-06-2022 01-07-2022 0002178845199 AHMAD FAREL LEONARDI L
798 00:00 10:17
103 133011010622P000 28-06-2022 01-07-2022 0002308022381 AL MUKTAFI BILLAH L
794 00:00 08:48
STATUS


- Tuberculosis of other specified Rujuk Vertikal

organs
cold]
PBI (APBN) Pulpitis Berobat Jalan


cold]

cold]

cold]

cold]

PBI (APBD) Gastritis and duodenitis Berobat Jalan
- Other hypertrophic disorders of Rujuk Vertikal

skin
104 133011010622P000 28-06-2022 01-07-2022 0002455480664 AZZAHRA ASYILA RAHMA P

801 00:00 14:53
105 133011010622P000 28-06-2022 28-06-2022 0002482108165 JUMARI L

702 00:00 11:44
133011010622P000 28-06-2022 28-06-2022

106 721 00:00 14:36 0002804180365 BIRTO L
133011010622P000 28-06-2022 28-06-2022

107 707 00:00 13:07 0002804194146 MATDULLAH L
133011010622P000 28-06-2022 28-06-2022

108 692 00:00 11:07 0002804195013 LILIK AGUSTIN P
109 133011010622P000 28-06-2022 28-06-2022 0002804195046 ADELLIA GALIH PRAMESWARI P

693 00:00 11:13
110 133011010622P000 28-06-2022 28-06-2022 0002804401855 HARTIN P
683 00:00 09:24
111 133011010622P000 28-06-2022 28-06-2022 0002843037303 YUYUN WAHYUNINGSIH P

689 00:00 10:57
133011010622P000 28-06-2022 28-06-2022
112 720 00:00 14:35 0002843039373 SUNARTI P
113 133011010622P000 28-06-2022 28-06-2022 0003003193855 ROHMAN L

709 00:00 13:09
114 133011010622P000 28-06-2022 02-07-2022 0003059599241 HOFIFAH P
815 00:00 06:46
115 133011010622P000 28-06-2022 02-07-2022 0003080237343 MOHAMMAD RIKI RAMADANI L

809 00:00 06:20
133011010622P000 28-06-2022 28-06-2022
116 687 00:00 09:55 0003104832058 EDY DJATMIKO L
117 133011010622P000 28-06-2022 28-06-2022 0003104832306 RUMIJAH P

685 00:00 09:47
118 133011010622P000 28-06-2022 02-07-2022 0003111606595 MOCHAMMAD ARRASYA L
811 00:00 06:27 RAMADHAN
133011010622P000 28-06-2022 28-06-2022
119 684 00:00 09:46 0003129263436 ERWIN SRI ASTUTIK P
120 133011010622P000 27-06-2022 27-06-2022 0000101055418 TARMUDJI L

655 00:00 13:47
STATUS

mellitus


- of multiple and unspecified sites Berobat Jalan

PEKERJA MANDIRI Supervision of other high-risk Rujuk Vertikal

pregnancies
- Ganglion Rujuk Vertikal

PEKERJA MANDIRI Acute nasopharyngitis [common Berobat Jalan

cold]
PEKERJA MANDIRI Mechanical complication of other
urinary devices and implants Rujuk Vertikal
PEKERJA MANDIRI Pulpitis Berobat Jalan

cold]
PEKERJA MANDIRI Systemic lupus erythematosus,
unspecified Rujuk Vertikal
PENERIMA PENSIUN Essential (primary) hypertension Berobat Jalan

TNI
121 133011010622P000 27-06-2022 27-06-2022 0000685734423 SITI MAISAROH P

649 00:00 11:12
122 133011010622P000 27-06-2022 27-06-2022 0000686162845 HUSNIA P

670 00:00 14:31
123 133011010622P000 27-06-2022 02-07-2022 0000686356896 AINA LAILATUL QODARIYAH P

808 00:00 06:17
133011010622P000 27-06-2022 27-06-2022

124 641 00:00 10:17 0000686718167 RUKMIYATI P
133011010622P000 27-06-2022 27-06-2022

125 664 00:00 14:16 0000686719642 LAYLA RACHMAD P
126 133011010622P000 27-06-2022 04-07-2022 0000686818978 TUTIK RAUTI P

841 00:00 11:03
127 133011010622P000 27-06-2022 02-07-2022 0000686836146 LUSIANA P

804 00:00 06:02
128 133011010622P000 27-06-2022 29-06-2022 0000686850906 MUHAMAT ABDUL AZIZ L

733 00:00 09:31
129 133011010622P000 27-06-2022 27-06-2022 0000686850906 MUHAMAT ABDUL AZIZ L

645 00:00 10:48
130 133011010622P000 27-06-2022 27-06-2022 0000686907887 ANI LESTARI P

663 00:00 14:13
131 133011010622P000 27-06-2022 27-06-2022 0000686921444 SAUDAH P
642 00:00 10:36
132 133011010622P000 27-06-2022 27-06-2022 0000687036519 SUMIK P

654 00:00 13:45
133 133011010622P000 27-06-2022 27-06-2022 0000687043236 SLAMET MUJIONO L
646 00:00 10:55
134 133011010622P000 27-06-2022 27-06-2022 0000687044441 SHERLY OKTAVIA P

668 00:00 14:25
133011010622P000 27-06-2022 27-06-2022
135 667 00:00 14:23 0000687045431 UMI KULSUM P
136 133011010622P000 27-06-2022 27-06-2022 0000687057761 PRAYOGA ARIS TANTONO L

673 00:00 14:39
137 133011010622P000 27-06-2022 27-06-2022 0000687078426 AYU RIZKA TANIA P
653 00:00 12:16
STATUS
PBI (APBN) Bipolar affective disorder, current Rujuk Vertikal

episode severe depression without
psychotic symptoms
PBI (APBN) Non-insulin-dependent diabetes Berobat Jalan Diabetes Mellitus

mellitus
Other disorders of conjunctiva Diabetes Mellitus

- Rujuk Vertikal Hipertensi

PBI (APBN) Other surgical follow-up care Berobat Jalan
- Postpartum care and examination Berobat Jalan
PBI (APBN) Dengue fever [classical dengue] Sembuh
PBI (APBN) Fever, unspecified Berobat Jalan
PBI (APBN) Bell's palsy Berobat Jalan
PBI (APBN) Chronic rhinitis Rujuk Vertikal

cold]
PBI (APBN) Chronic periodontitis Berobat Jalan

138 133011010622P000 27-06-2022 27-06-2022 0000687109329 FITRIYA P

644 00:00 10:45
139 133011010622P000 27-06-2022 27-06-2022 0000687223765 AHMAD HISAM HUDIN L

674 00:00 14:42
140 133011010622P000 27-06-2022 27-06-2022 0000687228952 DIAN LESTARI P

634 00:00 08:56
141 133011010622P000 27-06-2022 27-06-2022 0000687277484 MUDJIYO L

659 00:00 14:00
142 133011010622P000 27-06-2022 27-06-2022 0000687277585 SITI SUPIYAH P
658 00:00 13:57
143 133011010622P000 27-06-2022 27-06-2022 0000687396453 SU'ADIYAH P
638 00:00 09:44
144 133011010622P000 27-06-2022 27-06-2022 0000687409121 AKH JUMADI L

631 00:00 08:17
145 133011010622P000 27-06-2022 27-06-2022 0000687825281 SUPAEDAH P
657 00:00 13:54
146 133011010622P000 27-06-2022 27-06-2022 0001401337089 JOKO DWI LAKSONO L

652 00:00 12:11
133011010622P000 27-06-2022 27-06-2022
147 662 00:00 14:11 0001405141705 SRI WARYATI / WARIK P
148 133011010622P000 27-06-2022 02-07-2022 0001478058928 RIFANA P

806 00:00 06:06
149 133011010622P000 27-06-2022 27-06-2022 0001703402109 YENI TITIK SUTANTI P

666 00:00 14:21
150 133011010622P000 27-06-2022 27-06-2022 0001703609201 KHILWA MAFAZA P

665 00:00 14:18
151 133011010622P000 27-06-2022 27-06-2022 0001703801575 ACHMAD RIDWAN L

650 00:00 11:58
133011010622P000 27-06-2022 27-06-2022
152 661 00:00 14:08 0001703807932 LIWON L
153 133011010622P000 27-06-2022 27-06-2022 0001703807943 MICKY WAHYU ROBBIYANSA L

660 00:00 14:06
154 133011010622P000 27-06-2022 27-06-2022 0001703811789 NAHATI P
669 00:00 14:28
155 133011010622P000 27-06-2022 27-06-2022 0001703812847 TEMU KINANTHI P
639 00:00 10:08
156 133011010622P000 27-06-2022 27-06-2022 0001703814456 RICO IRAWAN PRATAMA L
648 00:00 11:07
STATUS
PBI (APBN) Urinary tract infection, site not Berobat Jalan

specified
PBI (APBN) Benign neoplasm of breast Rujuk Vertikal
- Heart failure Berobat Jalan
- Gastro-oesophageal reflux disease Rujuk Vertikal
PBI (APBD) Pulpitis Berobat Jalan

PEGAWAI SWASTA Postpartum care and examination Berobat Jalan
PEGAWAI SWASTA Essential (primary) hypertension Berobat Jalan
PBI (APBD) Scabies Berobat Jalan
PBI (APBD) Periapical abscess without sinus Berobat Jalan

PBI (APBD) elsewhere classified Berobat Jalan

cold]
PBI (APBD) Essential (primary) hypertension Berobat Jalan Hipertensi
PBI (APBN) Respiratory disorder, unspecified Rujuk Vertikal

157 133011010622P000 27-06-2022 27-06-2022 0001917853187 NANANG KOSIM P

651 00:00 12:08
133011010622P000 27-06-2022 27-06-2022

158 656 00:00 13:51 0001961392612 SITI WACHDA PD P
159 133011010622P000 27-06-2022 27-06-2022 0002157830853 IBNU ABAS NURBAID L

640 00:00 10:10
160 133011010622P000 27-06-2022 27-06-2022 0002157836782 ASMA P
671 00:00 14:35
161 133011010622P000 27-06-2022 27-06-2022 0002234644402 INDRIK PONIYATI P

672 00:00 14:37
162 133011010622P000 27-06-2022 27-06-2022 0002288547988 YULIATIN P
647 00:00 11:00
163 133011010622P000 27-06-2022 29-06-2022 0002524109141 HESTI NOVITA SARI P

740 00:00 11:36
133011010622P000 27-06-2022 27-06-2022
164 635 00:00 09:18 0002696688832 SUMIATI P
165 133011010622P000 27-06-2022 02-07-2022 0002843039373 SUNARTI P

803 00:00 05:57
166 133011010622P000 27-06-2022 27-06-2022 0002843039384 DITHA FIRMA NARTIANA P

637 00:00 09:30
167 133011010622P000 27-06-2022 29-06-2022 0002843087433 MARTI P
732 00:00 09:24
168 133011010622P000 27-06-2022 02-07-2022 0002843116749 HALIMATUS SADIYAH P

805 00:00 06:04
169 0002922274449 SAQINA ANNAIRA P
133011010622P000 27-06-2022 29-06-2022
731 00:00 09:16
170 133011010622P000 27-06-2022 29-06-2022 0003000769165 PUTRI DWI SALSABILA P

734 00:00 09:43
171 133011010622P000 27-06-2022 27-06-2022 0003070631889 NETI P
632 00:00 08:35
172 133011010622P000 27-06-2022 02-07-2022 0003082557688 FRINO AKBAR ADYATAMA L

807 00:00 06:16
133011010622P000 27-06-2022 27-06-2022
173 643 00:00 10:40 0003118804929 JUNAEDI L
STATUS
PBI (APBN) Anodontia Berobat Jalan
PEKERJA MANDIRI Complications and

ill-defined descriptions of heart Berobat Jalan
disease
PBI (APBD) Conjunctivitis Berobat Jalan
PBI (APBD) Essential (primary) hypertension Berobat Jalan Diabetes Mellitus
PEKERJA MANDIRI Supervision of other high-risk Rujuk Vertikal

pregnancies
- Dengue fever [classical dengue] Sembuh
PEKERJA MANDIRI Acute upper respiratory infections Diabetes Mellitus

of multiple and unspecified sites Berobat Jalan
- General counselling and advice on Berobat Jalan

contraception
PBI (APBN) Gastritis and duodenitis Berobat Jalan
- Other disorders of urinary system Sembuh
PBI (APBN) General counselling and advice on Berobat Jalan

contraception
- Acute bronchitis Sembuh
PBI (APBD) Essential (primary) hypertension Berobat Jalan

cold]
PEKERJA MANDIRI Acute upper respiratory infections
174 133011010622P000 27-06-2022 02-07-2022 0003118805537 CHOIRUNNISAK NOVI RAHAYU P

802 00:00 05:53
133011010622P000 27-06-2022 27-06-2022

175 636 00:00 09:23 0003137845781 MOHAMAD ICHSAN H L
133011010622P000 24-06-2022 24-06-2022

177 133011010622P000 24-06-2022 24-06-2022 0000685733714 ACHMAD SUBEKTI L

584 00:00 10:30
178 133011010622P000 24-06-2022 24-06-2022 0000685742938 DEWI MASITA P
573 00:00 09:45
179 133011010622P000 24-06-2022 24-06-2022 0000686132223 INTAN PERMATASARI P
576 00:00 10:01
180 133011010622P000 24-06-2022 24-06-2022 0000686246174 HAFIT FATAHIN L

574 00:00 09:50
181 0000686606984 AHMAT ALFARISI L

133011010622P000 24-06-2022 24-06-2022
578 00:00 10:07
182 133011010622P000 24-06-2022 24-06-2022 0000686921444 SAUDAH P

575 00:00 09:58
183 133011010622P000 24-06-2022 24-06-2022 0000687124822 ITA WULANDARI P

581 00:00 10:19
133011010622P000 24-06-2022 24-06-2022
184 579 00:00 10:10 0000687442544 ABDU RASMAN L
185 133011010622P000 24-06-2022 24-06-2022 0000687554379 JOKO HANDOYO KUSUMO L

591 00:00 12:00
186 133011010622P000 24-06-2022 24-06-2022 0000687564472 SITI MAISUM P
592 00:00 12:05
187 133011010622P000 24-06-2022 24-06-2022 0000687920602 MOCJ NASIHHA ANIN L

589 00:00 11:54
188 133011010622P000 24-06-2022 24-06-2022 0000687920916 MOCH ZARKASIH NUR L
590 00:00 11:58
189 133011010622P000 24-06-2022 24-06-2022 0000693247511 RIA FATMAWATI P

625 00:00 18:30
190 133011010622P000 24-06-2022 03-07-2022 0001478058928 RIFANA P
838 00:00 10:43
STATUS

cold]
PEKERJA MANDIRI Visual impairment including

blindness (binocular or monocular) Rujuk Vertikal

PBI (APBN) Special epileptic syndromes Rujuk Vertikal
PBI (APBN) Atopic dermatitis Berobat Jalan
- Diarrhoea and gastroenteritis of Berobat Jalan

PBI (APBN) Bell's palsy Berobat Jalan

- Periapical abscess without sinus Berobat Jalan
PBI (APBN) Diseases of pulp and periapical Berobat Jalan

tissues

tissues
tissues
PEGAWAI SWASTA Single spontaneous delivery Sembuh

133011010622P000 24-06-2022 24-06-2022

191 586 00:00 10:37 0001481690452 MUFARROKHAH P
192 133011010622P000 24-06-2022 24-06-2022 0001703609212 BALOK ROHMAN MUSTAKIM L

577 00:00 10:04
193 133011010622P000 24-06-2022 24-06-2022 0001703802958 HAYU MAULANI P

582 00:00 10:23
194 133011010622P000 24-06-2022 24-06-2022 0001703804589 SILVIA NUR SOLEHANA P
623 00:00 18:27
195 133011010622P000 24-06-2022 24-06-2022 0001703808461 SRI TUTIK P

567 00:00 09:10
133011010622P000 24-06-2022 24-06-2022 SILVIA DWI REGINA PUTRI
196 583 00:00 10:26 0001703808483 P
197 133011010622P000 24-06-2022 24-06-2022 0001703818945 WAGIMAN L

571 00:00 09:37
198 133011010622P000 24-06-2022 24-06-2022 0002068435067 gading candra kanta daniswara L

554 00:00 08:39
199 133011010622P000 24-06-2022 24-06-2022 0002121261568 KHUSNUL KHOTIMAH P

622 00:00 18:25

560 00:00 08:54
201 133011010622P000 24-06-2022 26-06-2022 0002157825464 ANISA MAGHFIROH P
630 00:00 08:08
133011010622P000 24-06-2022 26-06-2022 MUHAMMAD GALANG ADHA

202 629 00:00 08:02 0002157828129 PRATAMA L
133011010622P000 24-06-2022 24-06-2022

203 580 00:00 10:16 0002179103297 MOCHAMMAD ARIFIN L
133011010622P000 24-06-2022 24-06-2022

204 585 00:00 10:33 0002381455473 HUSNUL KHOTIMAH P
205 133011010622P000 24-06-2022 24-06-2022 0002765855463 VENI EVI LIA P

587 00:00 11:48
206 133011010622P000 24-06-2022 24-06-2022 0002765855676 AURA SENJA SALSABILA P
588 00:00 11:51
133011010622P000 24-06-2022 24-06-2022

207 572 00:00 09:42 0003070411187 SURATI P
STATUS

PBI (APBN) Heart failure, unspecified Berobat Jalan
PBI (APBD) Cytomegaloviral disease Berobat Jalan
PBI (APBD) Pregnancy examination and test Berobat Jalan
PBI (APBD) Heart failure Berobat Jalan

PBI (APBD) Non-insulin-dependent diabetes Berobat Jalan

mellitus
PEKERJA MANDIRI Diseases of pulp and periapical Berobat Jalan

tissues
PBI (APBN) Fever of other and unknown origin Sembuh

- of multiple and unspecified sites Sembuh


PEKERJA MANDIRI Disturbances in tooth eruption Berobat Jalan

133011010622P000 24-06-2022 24-06-2022

208 558 00:00 08:46 0003070413753 SITI NUR HOLIFAH P

624 00:00 18:29
210 133011010622P000 24-06-2022 24-06-2022 0003123572095 MUHAMMAD IQBAL MAULANA L

621 00:00 18:24
211 133011010622P000 24-06-2022 24-06-2022 0003273390729 abil shidqi arifin L
626 00:00 18:31
212 133011010622P000 23-06-2022 24-06-2022 0000114308414 SUHARTOYO L

569 00:00 09:15
213 133011010622P000 23-06-2022 23-06-2022 0000159506403 NUR AMALA P
538 00:00 13:07

545 00:00 13:33
215 133011010622P000 23-06-2022 23-06-2022 0000685586665 MOCHAMAD SOKIB L
526 00:00 09:50
216 133011010622P000 23-06-2022 24-06-2022 0000685719145 SITI MAISARO P

619 00:00 18:21
133011010622P000 23-06-2022 23-06-2022
217 535 00:00 10:40 0000686335116 RINA WATININGSIH P
218 133011010622P000 23-06-2022 24-06-2022 0000686397688 ALDA FIATUL ROHMA P

617 00:00 18:17
219 133011010622P000 23-06-2022 23-06-2022 0000686667868 SALMA P

517 00:00 08:37
220 133011010622P000 23-06-2022 23-06-2022 0000686675518 AL WASILATUL HIJAH P
536 00:00 10:46
221 133011010622P000 23-06-2022 23-06-2022 0000686721879 SAMAN L

540 00:00 13:22
222 133011010622P000 23-06-2022 23-06-2022 0000686813321 M ILHAM L
537 00:00 12:05
223 133011010622P000 23-06-2022 23-06-2022 0000686818978 TUTIK RAUTI P

534 00:00 10:35
224 133011010622P000 23-06-2022 23-06-2022 0000686932389 SUKARSIH P
543 00:00 13:27
133011010622P000 23-06-2022 23-06-2022
225 539 00:00 13:16 0000687132371 KULSUM P
STATUS


cold]

cold]
cold]
PENERIMA PENSIUN Fracture of shaft of tibia , open Berobat Jalan

PNS
- Heart failure Rujuk Vertikal

cold]

PBI (APBN) Depressive episode Berobat Jalan
PBI (APBN) Acute pharyngitis Berobat Jalan
- Conjunctivitis Berobat Jalan
- Pulpitis Berobat Jalan
PBI (APBN) Benign neoplasm of breast Rujuk Vertikal

226 133011010622P000 23-06-2022 24-06-2022 0000687283571 BELQIS WULIDA RAMADANI P

618 00:00 18:19
227 133011010622P000 23-06-2022 23-06-2022 0000687295181 NGATPIATI P

525 00:00 09:41
228 133011010622P000 23-06-2022 23-06-2022 0000687337312 ISTI NOVA SAROH P

530 00:00 10:13
229 133011010622P000 23-06-2022 23-06-2022 0000691709714 SAIFUR ROHMAN L

532 00:00 10:28
230 133011010622P000 23-06-2022 23-06-2022 0001038953406 ANITA SUDARMAYANTI P
528 00:00 10:04
231 133011010622P000 23-06-2022 23-06-2022 0001382628429 SUWARNO L
524 00:00 09:24
133011010622P000 23-06-2022 23-06-2022

516 00:00 08:20
232 0001470086379 MUHAMMAD ABDUL AZIZ L
133011010622P000 23-06-2022 23-06-2022 MUHAMMAD AHSAN KAFABIHI

233 541 00:00 13:25 0001703797918 L
234 133011010622P000 23-06-2022 23-06-2022 0001703800034 ROMLI L

521 00:00 09:03
235 133011010622P000 23-06-2022 24-06-2022 0001703815367 WINDI AYU FEBRIYANTI P

615 00:00 18:14
236 133011010622P000 23-06-2022 23-06-2022 0001785372658 RAMDHAN DWI WIJAYA L
523 00:00 09:18
237 133011010622P000 23-06-2022 23-06-2022 0001838052202 MURTINI P

518 00:00 08:45
238 133011010622P000 23-06-2022 25-06-2022 0002156902784 HANDAYANI P
627 00:00 09:45
239 133011010622P000 23-06-2022 23-06-2022 0002161525239 DIANA PRIHATININGSIH P

519 00:00 08:49
240 133011010622P000 23-06-2022 23-06-2022 0002251628019 SUPARJO RAHMAT L
520 00:00 09:00
241 133011010622P000 23-06-2022 24-06-2022 0002616354459 MAULANA AL GHAZALI P

620 00:00 18:22 SANJAYA
242 133011010622P000 23-06-2022 23-06-2022 0002681455509 RUDY AHMAD RASYID L
544 00:00 13:28
243 133011010622P000 23-06-2022 23-06-2022 0002681455522 EKA CHANDRA CAHAYA L

542 00:00 13:27
STATUS
PBI (APBN) Otalgia and effusion of ear Berobat Jalan
PEKERJA MANDIRI Abscess of liver Rujuk Vertikal
PEKERJA MANDIRI Heart failure Rujuk Vertikal
Human immunodeficiency virus

[HIV] disease resulting in
PBI (APBD) infectious and parasitic diseases Rujuk Vertikal

PEKERJA MANDIRI Other headache syndromes Berobat Jalan
PBI (APBN) Excessive vomiting in pregnancy Sembuh
PEKERJA MANDIRI Non-insulin-dependent diabetes Berobat Jalan Diabetes Mellitus

mellitus

cold]
PBI (APBD) Atopic dermatitis Berobat Jalan

244 133011010622P000 23-06-2022 23-06-2022 0002733886451 SLAMET BUDI L

529 00:00 10:09
245 133011010622P000 23-06-2022 23-06-2022 0002804194855 SUTIYEH P

512 00:00 08:01
246 133011010622P000 23-06-2022 23-06-2022 0002804198556 HARI HUSEN L

513 00:00 08:10
247 133011010622P000 23-06-2022 23-06-2022 0002804199851 SIHAB BANDIDO L

522 00:00 09:13
248 0002843037819 SUPIYAH P
133011010622P000 23-06-2022 23-06-2022
527 00:00 09:58
249 133011010622P000 23-06-2022 24-06-2022 0002944694417 NAZILATUS SYARIFAH P

616 00:00 18:15
250 133011010622P000 22-06-2022 24-06-2022 0000113662574 VISTA CLAUDIA SARI P

612 00:00 17:52
133011010622P000 22-06-2022 22-06-2022
251 496 00:00 10:12 0000685542014 IIN WIDYAWATI P
133011010622P000 22-06-2022 23-06-2022

252 552 00:00 14:01 0000685734074 SARI P
253 133011010622P000 22-06-2022 23-06-2022 0000685751905 SULIHA P

550 00:00 13:53
254 133011010622P000 22-06-2022 24-06-2022 0000686118778 SRI UMIL DALIKUN P
610 00:00 17:50

836 00:00 10:29
256 133011010622P000 22-06-2022 22-06-2022 0000686483561 FERDI KURNIAWAN L
498 00:00 10:44
257 133011010622P000 22-06-2022 22-06-2022 0000686591291 RENY SUPRIATININGSIH P

505 00:00 11:38
258 133011010622P000 22-06-2022 22-06-2022 0000686612799 MUSRIFAH P
485 00:00 08:18
259 133011010622P000 22-06-2022 03-07-2022 0000686836146 LUSIANA P

837 00:00 10:37
260 133011010622P000 22-06-2022 22-06-2022 0000687134586 JUARIYAH P
495 00:00 09:51
261 133011010622P000 22-06-2022 22-06-2022 0000687228952 DIAN LESTARI P

487 00:00 08:56
STATUS

pulmonary disease
PBI (APBN) Senile cataract Rujuk Vertikal
PBI (APBN) Hyperplasia of prostate Rujuk Vertikal
PBI (APBN) Stroke, not specified as Rujuk Vertikal

haemorrhage or infarction
PBI (APBN) Diarrhoea and gastroenteritis of Berobat Jalan

cold]


- Single spontaneous delivery Sembuh

cold]
PBI (APBN) Presence of intraocular lens Rujuk Vertikal
PBI (APBN) Malignant neoplasm of breast Berobat Jalan

262 133011010622P000 22-06-2022 22-06-2022 0000687440125 RACHMANSYAH L

510 00:00 15:05
263 133011010622P000 22-06-2022 22-06-2022 0000687442004 RINA YULIANA SARI P

509 00:00 12:28
264 133011010622P000 22-06-2022 22-06-2022 0000687523522 DENI TRI WILUJENG P

492 00:00 09:27
265 133011010622P000 22-06-2022 23-06-2022 0000687625626 TUMIN L

548 00:00 13:47
266 133011010622P000 22-06-2022 23-06-2022 0000687625896 ALIYAH P
549 00:00 13:50
133011010622P000 22-06-2022 22-06-2022
267 497 00:00 10:35 0001038957535 JUMAATI P
268 133011010622P000 22-06-2022 23-06-2022 0001123961016 INNEKE RAHMAWATI P

551 00:00 13:57
269 133011010622P000 22-06-2022 22-06-2022 0001401336584 SULASMANTO L
489 00:00 09:11
270 133011010622P000 22-06-2022 22-06-2022 0001404015557 ANGGI NOVELASARI P

500 00:00 10:51
133011010622P000 22-06-2022 22-06-2022
504 00:00 11:26
271 0001425245038 SUMIASIH RAHAYU P
272 133011010622P000 22-06-2022 24-06-2022 0001478058928 RIFANA P

611 00:00 17:51
273 133011010622P000 22-06-2022 23-06-2022 0001703797119 RIZKA LISA UMAROH P

553 00:00 14:04
274 133011010622P000 22-06-2022 22-06-2022 0001703807976 JUMNA P
499 00:00 10:46
275 133011010622P000 22-06-2022 22-06-2022 0001703815806 SITI IFATUS SHOLEHA P

506 00:00 11:55
276 133011010622P000 22-06-2022 22-06-2022 0001732487591 SUYANTO L
503 00:00 11:09
277 133011010622P000 22-06-2022 22-06-2022 0001732487602 IMMA YULIANI P

502 00:00 11:05
278 133011010622P000 22-06-2022 25-06-2022 0001995838648 SITI AMINAH P
628 00:00 09:51
279 133011010622P000 22-06-2022 22-06-2022 0002157825339 MAT JURI L

494 00:00 09:47
STATUS

cold]
PBI (APBN) Other headache syndromes Berobat Jalan
- Myalgia Berobat Jalan
- Acute nasopharyngitis [common Berobat Jalan Hipertensi

cold]
Other benign neoplasms of
PBI (APBN) connective and other soft tissue Berobat Jalan
- Suppurative and unspecified otitis Berobat Jalan

media
- Supervision of other high-risk Rujuk Vertikal

pregnancies
PEGAWAI Other soft tissue disorders, not
PEMERINTAH elsewhere classified
DENGAN PERJANJIAN Berobat Jalan
KERJA
PEGAWAI SWASTA Pregnancy examination and test Berobat Jalan

cold]

cold]
PEKERJA MANDIRI Pulpitis Berobat Jalan
PEKERJA MANDIRI Periapical abscess without sinus Berobat Jalan
- Nausea and vomiting Sembuh

280 133011010622P000 22-06-2022 22-06-2022 0002157825341 KASIYATI P

507 00:00 12:05
281 133011010622P000 22-06-2022 22-06-2022 0002161524903 SUPATMAH P

501 00:00 10:57
282 133011010622P000 22-06-2022 24-06-2022 0002200750075 NAURA KANAHAYA PRASETYA P

593 00:00 12:26
283 133011010622P000 22-06-2022 24-06-2022 0002310178634 INDRIANI TRI ASTUTI P

614 00:00 18:12
284 133011010622P000 22-06-2022 22-06-2022 0002505883026 NOVITA INDAYANI P
508 00:00 12:09
285 133011010622P000 22-06-2022 27-06-2022 0002620276749 SUMARTINI P
633 00:00 08:52
286 133011010622P000 22-06-2022 24-06-2022 0002804195474 ASTRID PITALOKA P

613 00:00 17:54
287 133011010622P000 22-06-2022 22-06-2022 0002804197915 ASIYAH P
493 00:00 09:39
288 133011010622P000 22-06-2022 23-06-2022 0003268548358 JEVANO ZAKI WIDODO L

514 00:00 08:14
289 133011010622P000 22-06-2022 23-06-2022 0003268548404 JUAN ZAKI WIDODO L
515 00:00 08:17
290 133011010622P000 21-06-2022 03-07-2022 0000113463472 ASIYAH P

835 00:00 10:22
291 133011010622P000 21-06-2022 21-06-2022 0000113790126 PUJI ASTUTIK P
461 00:00 10:19
292 133011010622P000 21-06-2022 21-06-2022 0000685761489 HAMDATUNNISA P

441 00:00 09:07
293 133011010622P000 21-06-2022 21-06-2022 0000686213199 SENEMAN L
454 00:00 10:05
294 133011010622P000 21-06-2022 21-06-2022 0000686359157 SAMA'I L

439 00:00 08:56
295 133011010622P000 21-06-2022 21-06-2022 0000686545503 MOCH ASMUI L

473 00:00 14:09
133011010622P000 21-06-2022 21-06-2022

296 453 00:00 10:01 0000686594654 FITRIA. P
297 133011010622P000 21-06-2022 21-06-2022 0000686596836 ANDRI NUR CHOLIS L

467 00:00 10:43
298 133011010622P000 21-06-2022 21-06-2022 0000686808202 SUWARNI P
474 00:00 14:13
STATUS
- Dengue haemorrhagic fever Sembuh
PEGAWAI SWASTA Contraceptive management Berobat Jalan

mellitus
PEKERJA MANDIRI Feeding difficulties and Rujuk Vertikal

mismanagement
PEKERJA MANDIRI Feeding difficulties and Rujuk Vertikal
mismanagement
PNS DAERAH Essential (primary) hypertension Berobat Jalan
PBI (APBN) Epilepsy Rujuk Vertikal
- Other chronic obstructive Rujuk Vertikal

pulmonary disease


299 133011010622P000 21-06-2022 23-06-2022 0000686810079 YULIANTI P

547 00:00 13:42
300 133011010622P000 21-06-2022 24-06-2022 0000686837013 NUR FATIMATUZ ZAHRO P

609 00:00 17:48
301 133011010622P000 21-06-2022 21-06-2022 0000686842097 SITI HOTIJAH P

455 00:00 10:07
302 133011010622P000 21-06-2022 21-06-2022 0000686921444 SAUDAH P

442 00:00 09:12
303 133011010622P000 21-06-2022 21-06-2022 0000687157751 SUMARNI P
457 00:00 10:11
304 133011010622P000 21-06-2022 21-06-2022 0000687192895 HANIFAH P
472 00:00 14:01
305 133011010622P000 21-06-2022 21-06-2022 0000687379419 MUHAMMAD UMAR ROSYID L

476 00:00 14:25
306 133011010622P000 21-06-2022 21-06-2022 0000687380804 MARIA ULFANIA P
475 00:00 14:21
307 133011010622P000 21-06-2022 21-06-2022 0000687386542 MUHAMAD L

440 00:00 09:01
308 133011010622P000 21-06-2022 21-06-2022 0000687396453 SU'ADIYAH P
438 00:00 08:50
309 133011010622P000 21-06-2022 21-06-2022 0000687422294 DERNIAWAN ARDIANSYAH L

464 00:00 10:24 PRATAMA
310 133011010622P000 21-06-2022 21-06-2022 0001703799988 MUHAMMAD RIFKI L
478 00:00 14:32
311 133011010622P000 21-06-2022 21-06-2022 0001703801676 LILIK SULIYATI P

462 00:00 10:21
312 133011010622P000 21-06-2022 21-06-2022 0001703817459 MUHAMMAD SULTAN L
465 00:00 10:25
133011010622P000 21-06-2022 21-06-2022

313 456 00:00 10:09 0001785363513 NURHASANAH P
314 133011010622P000 21-06-2022 21-06-2022 0001785374008 LINTANG WIDIASARI P

459 00:00 10:16
315 133011010622P000 21-06-2022 21-06-2022 0001796906024 LAILIYAH P
469 00:00 10:51
316 133011010622P000 21-06-2022 21-06-2022 0002157830998 SUPARMAN L

470 00:00 10:54
317 133011010622P000 21-06-2022 23-06-2022 0002158453449 SUGIARDI L
531 00:00 10:18
STATUS
PBI (APBN) Unqualified visual loss, both eyes Rujuk Vertikal

mellitus

mellitus
PBI (APBN) Heart failure Rujuk Vertikal
- Congestive heart failure Berobat Jalan
PBI (APBD) Gastritis and duodenitis Berobat Jalan
PBI (APBD) Anodontia Berobat Jalan

- Essential (primary) hypertension Berobat Jalan Hipertensi

318 133011010622P000 21-06-2022 24-06-2022 0002288547988 YULIATIN P

606 00:00 17:42
319 133011010622P000 21-06-2022 21-06-2022 0002437593309 SUSIATI P

468 00:00 10:48
320 133011010622P000 21-06-2022 21-06-2022 0002681473184 ALIN MAS ADAH P

463 00:00 10:22
321 133011010622P000 21-06-2022 24-06-2022 0002737884745 AHMAD VIKO NUR RAHMAN L

608 00:00 17:45
322 133011010622P000 21-06-2022 24-06-2022 0002765191781 SULTAN RAMADHANA L
607 00:00 17:43
323 133011010622P000 21-06-2022 21-06-2022 0002804194978 REZA ARIF NUR RAHMAN L
479 00:00 14:35
324 133011010622P000 21-06-2022 23-06-2022 0002804196532 PAIMAN L

546 00:00 13:39
325 133011010622P000 21-06-2022 24-06-2022 0002804196532 PAIMAN L
568 00:00 09:12
326 133011010622P000 21-06-2022 21-06-2022 0002804200839 ARIN KUSMIRIANI P

471 00:00 10:59
327 133011010622P000 21-06-2022 21-06-2022 0002860574062 SAUDA P
466 00:00 10:41

460 00:00 10:18
133011010622P000 21-06-2022 21-06-2022 MUHAMAD FAISAL ROZAQ
329 458 00:00 10:14 0003059071119 L
330 133011010622P000 21-06-2022 21-06-2022 0003255517045 MEGA YULIANTIKA P

477 00:00 14:28 PRAMESWARI
331 133011010622P000 20-06-2022 20-06-2022 0000089180559 SUNGKEMING TIAS MAMI P

403 00:00 09:30
133011010622P000 20-06-2022 21-06-2022
332 451 00:00 09:54 0000113653585 M NURHAFID L
333 133011010622P000 20-06-2022 24-06-2022 0000114308414 SUHARTOYO L

563 00:00 09:01
133011010622P000 20-06-2022 20-06-2022
335 133011010622P000 20-06-2022 21-06-2022 0000686129499 KARMILA P

443 00:00 09:18
STATUS

mellitus

cold]
cold]
cold]
PBI (APBN) Cellulitis Berobat Jalan
PBI (APBN) Unqualified visual loss, both eyes Rujuk Vertikal
PEGAWAI SWASTA Acute upper respiratory infections

PEGAWAI SWASTA Gastritis, unspecified Berobat Jalan
VETERAN Sacroiliitis, not elsewhere Rujuk Vertikal

classified

PNS
- Typhoid fever Berobat Jalan

133011010622P000 20-06-2022 20-06-2022

336 414 00:00 10:51 0000686157783 NANIK YULIANTI P
337 133011010622P000 20-06-2022 20-06-2022 0000686158593 RUDI AGUSTINO L

415 00:00 11:06
338 133011010622P000 20-06-2022 21-06-2022 0000686229941 AMI P

444 00:00 09:22
339 133011010622P000 20-06-2022 20-06-2022 0000686235227 SEMININGSIH P
398 00:00 08:46
340 133011010622P000 20-06-2022 21-06-2022 0000686241911 DENIS KUSUMA WIJAYA L

428 00:00 08:15
341 133011010622P000 20-06-2022 20-06-2022 0000686585507 ALWI L
404 00:00 09:35
342 0000686594676 TISKA DIAN FAIRUS P

133011010622P000 20-06-2022 24-06-2022
557 00:00 08:46
343 133011010622P000 20-06-2022 24-06-2022 0000686603698 NURIATUS SHOLEHAH P

603 00:00 17:36
344 133011010622P000 20-06-2022 21-06-2022 0000686810079 YULIANTI P

435 00:00 08:29
345 133011010622P000 20-06-2022 20-06-2022 0000686813455 YATIMININGSIH P
402 00:00 09:11
346 133011010622P000 20-06-2022 24-06-2022 0000686927136 SUMIATI P

565 00:00 09:05
347 133011010622P000 20-06-2022 20-06-2022 0000686937745 SITI HANIFAH P

416 00:00 11:06
348 133011010622P000 20-06-2022 20-06-2022 0000687050684 UMIATI P

401 00:00 09:06
349 133011010622P000 20-06-2022 21-06-2022 0000687134226 SULISTIYOWATI P

429 00:00 08:16
350 133011010622P000 20-06-2022 20-06-2022 0000687173049 BUAMAH P
418 00:00 11:22
351 133011010622P000 20-06-2022 01-07-2022 0000687341957 FAISOL L

797 00:00 09:39
352 133011010622P000 20-06-2022 21-06-2022 0000687385866 SATUNI P
448 00:00 09:37
133011010622P000 20-06-2022 20-06-2022

353 420 00:00 11:54 0000687602384 NAVILA PUTRI NAZWA P
STATUS

- Congestive heart failure Rujuk Vertikal

cold]
PBI (APBN) Senile cataract Rujuk Vertikal Hipertensi

- Gastritis and duodenitis Berobat Jalan
PBI (APBN) Asthma Rujuk Vertikal
PEGAWAI SWASTA Acute periodontitis Berobat Jalan
PBI (APBN) Atopic dermatitis Berobat Jalan

cold]

354 133011010622P000 20-06-2022 24-06-2022 0000687602384 NAVILA PUTRI NAZWA P

564 00:00 09:03
355 133011010622P000 20-06-2022 21-06-2022 0000687920589 ACHMAD MARZUKI NAJIB L

424 00:00 08:10
356 133011010622P000 20-06-2022 21-06-2022 0001038961642 FATMA ZAMRA P

427 00:00 08:15
357 133011010622P000 20-06-2022 20-06-2022 0001304820797 TAMINA P

396 00:00 08:35
358 133011010622P000 20-06-2022 22-06-2022 0001401337225 ANDRIANI NIFERA P
486 00:00 08:43
359 133011010622P000 20-06-2022 21-06-2022 0001405141547 SUMIATI P
425 00:00 08:10
133011010622P000 20-06-2022 21-06-2022

360 434 00:00 08:26 0001405141705 SRI WARYATI / WARIK P
361 133011010622P000 20-06-2022 21-06-2022 0001703612147 HARYANA P

449 00:00 09:41
133011010622P000 20-06-2022 21-06-2022

362 422 00:00 07:55 0001703799494 SUKATNO L
133011010622P000 20-06-2022 20-06-2022

363 421 00:00 12:09 0001703799505 SRIYANI P
133011010622P000 20-06-2022 21-06-2022

364 423 00:00 07:58 0001703799527 SULTAN MUHRATKAN L
365 133011010622P000 20-06-2022 21-06-2022 0001703800113 REDITA INTAN PRATIWI P

426 00:00 08:13
366 133011010622P000 20-06-2022 21-06-2022 0002127144328 SITI MAIMUNAH P
432 00:00 08:22
367 133011010622P000 20-06-2022 20-06-2022 0002157826138 SITI AISYAH P

413 00:00 10:49
133011010622P000 20-06-2022 20-06-2022

368 395 00:00 08:31 0002157831055 NGADIONO L
369 133011010622P000 20-06-2022 21-06-2022 0002161889122 ERNI DWI YANTI P

433 00:00 08:22
370 133011010622P000 20-06-2022 24-06-2022 0002205061738 FAUZIYAH P

601 00:00 17:30
STATUS
PEKERJA MANDIRI Essential (primary) hypertension Berobat Jalan Hipertensi
- Nausea and vomiting Sembuh

mellitus


cold]
Unknown and unspecified causes

PBI (APBD) of morbidity Berobat Jalan


PBI (APBD) of morbidity Berobat Jalan
PBI (APBD) Chronic periodontitis Berobat Jalan
PBI (APBD) Pre-eclampsia, unspecified Rujuk Vertikal

PBI (APBD) Headache Berobat Jalan

371 133011010622P000 20-06-2022 20-06-2022 0002234643625 SUROSO L

405 00:00 09:45
372 133011010622P000 20-06-2022 20-06-2022 0002278590715 BUNI P

417 00:00 11:12
373 133011010622P000 20-06-2022 20-06-2022 0002423225608 SUPARMI P

419 00:00 11:38
133011010622P000 20-06-2022 21-06-2022

374 446 00:00 09:30 0002482108165 JUMARI L
133011010622P000 20-06-2022 20-06-2022

375 397 00:00 08:42 0002681473983 LILIK KADARWATI P
376 133011010622P000 20-06-2022 21-06-2022 0002804181491 SITI ASIYAH P

437 00:00 08:47
377 133011010622P000 20-06-2022 21-06-2022 0002804183447 SARMINI P

430 00:00 08:18
378 133011010622P000 20-06-2022 20-06-2022 0002804188601 RIKA MAWARSARI P

412 00:00 10:43
379 133011010622P000 20-06-2022 21-06-2022 0002804192335 MOHAMMAD ABDURROHMAN L

431 00:00 08:19
380 133011010622P000 20-06-2022 20-06-2022 0002804194697 MUHAMMAD SHOLEHUDIN L

400 00:00 09:01
133011010622P000 20-06-2022 24-06-2022
381 602 00:00 17:34 0002843039373 SUNARTI P
382 133011010622P000 20-06-2022 21-06-2022 0002843039384 DITHA FIRMA NARTIANA P

450 00:00 09:44
383 133011010622P000 20-06-2022 21-06-2022 0002843042692 SATUWI L
436 00:00 08:45
384 133011010622P000 20-06-2022 20-06-2022 0002857522601 WAHYU PUTRI ROMADHANI P

394 00:00 08:25
385 133011010622P000 20-06-2022 20-06-2022 0002873812847 SURA'I L
411 00:00 10:28
386 133011010622P000 20-06-2022 21-06-2022 0003000765609 ADITIYA AINUN RAHMAN L

445 00:00 09:26
133011010622P000 20-06-2022 21-06-2022

387 452 00:00 09:57 0003051745705 ALLIYA GUSNIA HIDAYATI P
STATUS
PBI (APBN) Pleural effusion, not elsewhere Rujuk Vertikal

classified
PEKERJA MANDIRI Other and unspecified right Rujuk Vertikal

bundle-branch block
PBI (APBN) Gastritis, unspecified Berobat Jalan


PBI (APBN) Prolonged pregnancy Rujuk Vertikal
Other specified noninflammatory

- disorders of vagina Berobat Jalan
PBI (APBN) Dyspepsia Berobat Jalan
PBI (APBN) Other specified acute viral hepatitis Rujuk Vertikal


388 133011010622P000 20-06-2022 24-06-2022 0003051745705 ALLIYA GUSNIA HIDAYATI P

566 00:00 09:07

604 00:00 17:38
390 133011010622P000 20-06-2022 24-06-2022 0003088424226 SUNDARI P

605 00:00 17:40
391 133011010622P000 20-06-2022 21-06-2022 0003104832058 EDY DJATMIKO L

447 00:00 09:33
392 133011010622P000 19-06-2022 21-06-2022 0002416316692 MEGA AGUSTIN P
480 00:00 22:20
393 133011010622P000 19-06-2022 23-06-2022 0002765679232 AHMAD RIZAL MUZAKKI L
533 00:00 10:29
133011010622P000 18-06-2022 29-06-2022

394 765 00:00 15:26 0000685728641 SAMINAH P
395 133011010622P000 18-06-2022 29-06-2022 0000685893879 SAYUTI P

762 00:00 15:24
133011010622P000 18-06-2022 29-06-2022

396 764 00:00 15:25 0000686174253 KUSTINI P
133011010622P000 18-06-2022 22-06-2022

397 490 00:00 09:13 0000686203222 MUHAMMAD LUTFI HAKIM L
133011010622P000 18-06-2022 29-06-2022

398 756 00:00 15:21 0000686492471 ISA P
399 133011010622P000 18-06-2022 21-06-2022 0000686967625 SU`INA P

482 00:00 22:45
400 133011010622P000 18-06-2022 29-06-2022 0000686980989 JUMA'IYAH P
753 00:00 15:19
401 133011010622P000 18-06-2022 29-06-2022 0000686985952 SUPARTI P

760 00:00 15:23
133011010622P000 18-06-2022 29-06-2022

402 759 00:00 15:22 0000687244779 MISRI P
403 133011010622P000 18-06-2022 22-06-2022 0000687396453 SU'ADIYAH P

491 00:00 09:16
133011010622P000 18-06-2022 29-06-2022

404 763 00:00 15:25 0000687451678 MARIAMA P
STATUS
PEKERJA MANDIRI Corns and callosities Berobat Jalan

cold]
PEKERJA MANDIRI Nasal polyp, unspecified Berobat Jalan
PEGAWAI SWASTA Gastritis and duodenitis Sembuh

PBI (APBN) Other diseases of hard tissues of Berobat Jalan

teeth



Other soft tissue disorders, not Diabetes Mellitus


405 133011010622P000 18-06-2022 29-06-2022 0001703808617 ANDI PROYOGI L

755 00:00 15:20
133011010622P000 18-06-2022 29-06-2022

406 758 00:00 15:22 0001703811273 SAYU P
407 133011010622P000 18-06-2022 23-06-2022 0002121244795 HALIMAH P

511 00:00 06:33
133011010622P000 18-06-2022 29-06-2022
408 754 00:00 15:20 0002157825284 SAMSURI HALIM L
409 133011010622P000 18-06-2022 29-06-2022 0002381455124 SIANI P

761 00:00 15:23
410 133011010622P000 18-06-2022 29-06-2022 0002381455214 MUNIK P
752 00:00 15:19
411 133011010622P000 18-06-2022 22-06-2022 0002381455473 HUSNUL KHOTIMAH P

488 00:00 09:11
412 133011010622P000 18-06-2022 21-06-2022 0002804180242 AHMAD NABIL UBAIDILLAH L

481 00:00 22:37
133011010622P000 18-06-2022 29-06-2022

413 751 00:00 15:18 0002804197037 SUSIYATI P
133011010622P000 18-06-2022 29-06-2022

414 757 00:00 15:21 0003051745637 SULAEHA HJ P
133011010622P000 17-06-2022 30-06-2022

415 772 00:00 08:44 0000685824671 TRI WAHYU HANDAYANI P
416 133011010622P000 17-06-2022 17-06-2022 0000686400581 SUGIATI P

357 00:00 09:38
417 133011010622P000 17-06-2022 17-06-2022 0000686587318 KARTIKA CANDRA DEWI P
363 00:00 14:47
418 133011010622P000 17-06-2022 19-06-2022 0000686713476 SALAMUN L
378 00:00 09:04
133011010622P000 17-06-2022 17-06-2022
419 368 00:00 15:18 0000686749162 RUSDI L
133011010622P000 17-06-2022 17-06-2022

420 366 00:00 15:06 0000686755989 NUR AZIZAH P
STATUS


- Non-insulin-dependent diabetes Berobat Jalan

mellitus

mellitus



PBI (APBN) elsewhere classified Berobat Jalan Hipertensi
- Heart failure Berobat Jalan
- Bronchitis, not specified as acute Berobat Jalan

or chronic
- Non-insulin-dependent diabetes Sembuh
mellitus

133011010622P000 17-06-2022 17-06-2022

421 355 00:00 09:24 0000686927136 SUMIATI P
133011010622P000 17-06-2022 30-06-2022

422 773 00:00 08:45 0000687100915 MENIK HANDAYANI P
423 133011010622P000 17-06-2022 19-06-2022 0000687306093 AMAL L

380 00:00 09:32
133011010622P000 17-06-2022 30-06-2022
424 771 00:00 08:43 0000687442544 ABDU RASMAN L
425 133011010622P000 17-06-2022 17-06-2022 0000687564472 SITI MAISUM P

361 00:00 13:34
133011010622P000 17-06-2022 17-06-2022
426 369 00:00 15:28 0001038961528 VERy ZAKARIA L
427 133011010622P000 17-06-2022 17-06-2022 0001038962316 ROHMATUL MAWANAH P

358 00:00 09:42
428 0001543852078 SUMAIDAH P

133011010622P000 17-06-2022 17-06-2022
354 00:00 08:40
429 133011010622P000 17-06-2022 17-06-2022 0001703779481 SRI ISWATI P

370 00:00 15:36
430 133011010622P000 17-06-2022 17-06-2022 0001703800844 ROMLAH P

365 00:00 14:59
431 133011010622P000 17-06-2022 17-06-2022 0001703809214 MOCHAMMAD RUSLI L
371 00:00 15:48
432 133011010622P000 17-06-2022 17-06-2022 0001703815795 MISTURI L

364 00:00 14:53
433 133011010622P000 17-06-2022 17-06-2022 0001703818416 KARNI ALIFAH HJ P
356 00:00 09:32
434 133011010622P000 17-06-2022 17-06-2022 0002157822459 NANIK SULASTRI P

360 00:00 13:32
435 133011010622P000 17-06-2022 24-06-2022 0002158453664 NUR HALIMAH P

599 00:00 17:27
436 133011010622P000 17-06-2022 17-06-2022 0002804186968 MUHAMMAD ARIF L

367 00:00 15:14 FIRMANSYAH
437 133011010622P000 17-06-2022 17-06-2022 0002804200661 BUSARI P
362 00:00 14:41
STATUS
Other benign neoplasms of

PBI (APBN) connective and other soft tissue Berobat Jalan

- Essential (primary) hypertension Sembuh



pregnancies
Chronic obstructive pulmonary Rujuk Vertikal

disease with acute exacerbation,
PEKERJA MANDIRI unspecified

cold]

pulmonary disease
PBI (APBD) General counselling and advice on Berobat Jalan

contraception

cold]
438 133011010622P000 17-06-2022 24-06-2022 0003000777759 FARADIBA NAILA FEBRADIKA P

600 00:00 17:29
439 133011010622P000 16-06-2022 24-06-2022 0000114308414 SUHARTOYO L

562 00:00 08:58
133011010622P000 16-06-2022 30-06-2022

440 769 00:00 08:41 0000685503685 ASMARI L
441 133011010622P000 16-06-2022 16-06-2022 0000685555345 DANI HARDONO L

342 00:00 10:19
442 133011010622P000 16-06-2022 16-06-2022 0000685556493 ASRI MURWANI P

327 00:00 09:25
443 133011010622P000 16-06-2022 24-06-2022 0000686490175 LAILYA SAKINA P
598 00:00 17:25
444 133011010622P000 16-06-2022 16-06-2022 0000686496633 MISNARI P

351 00:00 14:06
445 133011010622P000 16-06-2022 24-06-2022 0000686514982 SIYA P
561 00:00 08:54
446 133011010622P000 16-06-2022 16-06-2022 0000686692293 FITRIANINGSIH P

345 00:00 10:37
447 133011010622P000 16-06-2022 16-06-2022 0000686697737 NINING NURHAYATI P
334 00:00 09:51
448 133011010622P000 16-06-2022 16-06-2022 0000686841445 JONI ISKANDAR L

335 00:00 09:54
449 133011010622P000 16-06-2022 17-06-2022 0000686871922 MILA P

359 00:00 10:01
133011010622P000 16-06-2022 16-06-2022

450 349 00:00 13:41 0000687394269 MISRI P
451 133011010622P000 16-06-2022 16-06-2022 0000687426298 NINIS SETYO IKAWATI P

323 00:00 09:10
452 133011010622P000 16-06-2022 16-06-2022 0000687567532 YULIATI P
332 00:00 09:46
133011010622P000 16-06-2022 16-06-2022

453 348 00:00 13:38 0000687808337 SUTINA P
454 133011010622P000 16-06-2022 16-06-2022 0000687903963 PANGAT L

326 00:00 09:20
455 133011010622P000 16-06-2022 24-06-2022 0000691555184 SITI NURKHOLILA P

595 00:00 17:18
STATUS

cold]

PNS

PBI (APBN) Necrosis of pulp Berobat Jalan
PBI (APBN) Asthma Berobat Jalan
- Dyspepsia Berobat Jalan
PBI (APBN) Chronic renal failure, unspecified Rujuk Vertikal
- Contraceptive management Berobat Jalan


PBI (APBN) Unspecified renal colic Berobat Jalan
PBI (APBN) General counselling and advice on Berobat Jalan

contraception
133011010622P000 16-06-2022 24-06-2022

456 594 00:00 17:15 0000691942364 CICIK WIRAWATI P
457 133011010622P000 16-06-2022 16-06-2022 0000775088234 JUMAIYA P

311 00:00 08:26
458 133011010622P000 16-06-2022 16-06-2022 0001038951213 INDAH NUR IMANIAH P

343 00:00 10:22
459 133011010622P000 16-06-2022 16-06-2022 0001123961016 INNEKE RAHMAWATI P
329 00:00 09:35
460 133011010622P000 16-06-2022 16-06-2022 0001275446687 ANY SULISTYOWATI P

328 00:00 09:32
461 133011010622P000 16-06-2022 16-06-2022 0001703611405 HOSI L
322 00:00 09:05
462 133011010622P000 16-06-2022 16-06-2022 0001703801676 LILIK SULIYATI P

350 00:00 13:58
463 133011010622P000 16-06-2022 16-06-2022 0001703809495 ENI PURWANTI P
347 00:00 10:40
464 133011010622P000 16-06-2022 16-06-2022 0001703809642 TUMIRAH P

330 00:00 09:40
465 133011010622P000 16-06-2022 16-06-2022 0002064824008 MOHAMMAD ALFIN L
325 00:00 09:14 ROMADHONA

770 00:00 08:42
467 133011010622P000 16-06-2022 16-06-2022 0002161889234 RENDY RAMADANI L

331 00:00 09:43
468 0002288615725 ANGGITA PRATIWI P

133011010622P000 16-06-2022 19-06-2022
379 00:00 09:15
133011010622P000 16-06-2022 17-06-2022

469 372 00:00 16:09 0002765855676 AURA SENJA SALSABILA P
470 133011010622P000 16-06-2022 16-06-2022 0002766191725 EDY ISMANTO L

344 00:00 10:32
471 133011010622P000 16-06-2022 16-06-2022 0002804192335 MOHAMMAD ABDURROHMAN L

352 00:00 14:10
472 133011010622P000 16-06-2022 24-06-2022 0002804194833 WINDA WIJAYANTI P
596 00:00 17:20
STATUS
Other specified noninflammatory

PBI (APBN) disorders of vagina Berobat Jalan Hipertensi

pregnancies
- Suppurative and unspecified otitis Berobat Jalan
media

cold]
PBI (APBD) Acute periodontitis Berobat Jalan
PBI (APBD) Non-insulin-dependent diabetes Berobat Jalan Diabetes Mellitus

mellitus
- Other aplastic anaemias Rujuk Vertikal
PBI (APBD) Acute pharyngitis Berobat Jalan


KEPALA DESA DAN Caries of dentine Berobat Jalan

PERANGKAT DESA

473 133011010622P000 16-06-2022 21-06-2022 0002881581592 AZKA MAULANA PRASETYA L

483 00:00 22:53
474 133011010622P000 16-06-2022 16-06-2022 0003070413753 SITI NUR HOLIFAH P

338 00:00 10:03
475 133011010622P000 16-06-2022 03-07-2022 0003088424226 SUNDARI P

833 00:00 10:05
476 133011010622P000 16-06-2022 16-06-2022 0003090529653 ALIVIA SALSABILA P

346 00:00 10:37
477 133011010622P000 16-06-2022 24-06-2022 0003272812299 BAYI NYONYA HOTIMAH P
597 00:00 17:24
478 133011010622P000 15-06-2022 15-06-2022 0000685497295 FIRMANSYAH L
303 00:00 09:57
479 133011010622P000 15-06-2022 15-06-2022 0000685979425 SAI L

300 00:00 09:43
480 133011010622P000 15-06-2022 16-06-2022 0000686161091 SITI UMANIK P
310 00:00 08:23
133011010622P000 15-06-2022 15-06-2022

481 304 00:00 10:12 0000686161686 ACHMAD RI'FAD FAISAL L
482 133011010622P000 15-06-2022 30-06-2022 0000686194413 RIASIH P

768 00:00 08:39
133011010622P000 15-06-2022 15-06-2022

483 289 00:00 08:19 0000686819452 ASNAN L
484 133011010622P000 15-06-2022 16-06-2022 0000686952764 SITI AMINAH FARADIBA P

353 00:00 16:11 HALIMATUS S
485 0000687295091 SUGIWANTORO L
133011010622P000 15-06-2022 15-06-2022
293 00:00 08:37
486 133011010622P000 15-06-2022 15-06-2022 0001038952056 SITI HOTIMAH P

309 00:00 13:42
133011010622P000 15-06-2022 15-06-2022
487 302 00:00 09:52 0001261693045 KASRIATI P
133011010622P000 15-06-2022 16-06-2022

488 314 00:00 08:33 0001540210487 SHAUQYA AL AYYUBI P

389 00:00 15:48
STATUS

cold]
PEKERJA MANDIRI Acute bronchitis, unspecified Rujuk Vertikal

cold]
PBI (APBN) Acute and transient psychotic Rujuk Vertikal
disorders
- Corneal ulcer Rujuk Vertikal

PBI (APBN) Epilepsy Berobat Jalan

PBI (APBN) disease, unspecified Rujuk Vertikal Hipertensi
PBI (APBN) Injury of extensor muscle and Rujuk Vertikal

tendon of other finger at wrist and
hand level
PBI (APBN) Sacroiliitis, not elsewhere Rujuk Vertikal

classified
PEKERJA MANDIRI Insulin-dependent diabetes mellitus Diabetes Mellitus
with ophthalmic complications Rujuk Vertikal



318 00:00 08:43
133011010622P000 15-06-2022 16-06-2022

491 313 00:00 08:32 0001824885865 ROHIL RUSLI ALFAIJI L
492 133011010622P000 15-06-2022 16-06-2022 0001859435212 JUMAENI P

316 00:00 08:39
493 133011010622P000 15-06-2022 19-06-2022 0002157826138 SITI AISYAH P
392 00:00 15:53
494 133011010622P000 15-06-2022 15-06-2022 0002259475479 LAMIYATI P

307 00:00 12:05
495 133011010622P000 15-06-2022 19-06-2022 0002490191212 ELISA CHOTHIMIA TIA P
390 00:00 15:50 ERINTHA
496 133011010622P000 15-06-2022 16-06-2022 0002505881913 JUMAATI P

315 00:00 08:37
497 133011010622P000 15-06-2022 16-06-2022 0002733886451 SLAMET BUDI L
317 00:00 08:41
498 133011010622P000 15-06-2022 19-06-2022 0002770622717 ILLHAM RAMDAN MAULANA L

393 00:00 15:54
499 133011010622P000 15-06-2022 15-06-2022 0002804199671 IMAM WARSITO L
305 00:00 11:14
500 133011010622P000 15-06-2022 16-06-2022 0002804199851 SIHAB BANDIDO L

312 00:00 08:29
501 133011010622P000 15-06-2022 15-06-2022 0002867929637 AHMAD HEFNI HUMAIDY L

308 00:00 12:08 AZHARY
502 133011010622P000 15-06-2022 19-06-2022 0002901018802 MUHAMMAD FAHRI AZMI AL L

391 00:00 15:52 HAFIDZ
503 133011010622P000 15-06-2022 15-06-2022 0003070631889 NETI P

296 00:00 09:08
504 133011010622P000 15-06-2022 21-06-2022 0003088007548 MUHAMMAD FADHIL L
484 00:00 23:02 ABDILLAH
133011010622P000 14-06-2022 16-06-2022

505 339 00:00 10:06 0000685751859 SELAMET L
506 133011010622P000 14-06-2022 16-06-2022 0000685751905 SULIHA P

337 00:00 09:58
507 133011010622P000 14-06-2022 14-06-2022 0000685876184 ULA PRISTIAWATI P
269 00:00 09:26
STATUS

cold]

PEKERJA MANDIRI Abdominal and pelvic pain Berobat Jalan
PBI (APBD) Pregnancy examination and test Berobat Jalan
PEGAWAI SWASTA Pulpitis Berobat Jalan

cold]
PBI (APBN) Fever of other and unknown origin Berobat Jalan

cold]
PBI (APBN) Cerebral infarction, unspecified Rujuk Vertikal

cold]


133011010622P000 14-06-2022 20-06-2022

508 408 00:00 10:14 0000686077435 SUMIARSIH MAHLIFA P
509 133011010622P000 14-06-2022 15-06-2022 0000686874396 SULAEMAN L

292 00:00 08:30
510 133011010622P000 14-06-2022 20-06-2022 0000687036519 SUMIK P

410 00:00 10:25
511 133011010622P000 14-06-2022 24-06-2022 0000687044441 SHERLY OKTAVIA P
559 00:00 08:51
512 133011010622P000 14-06-2022 19-06-2022 0000687047859 YULIATIN P

383 00:00 15:26
513 133011010622P000 14-06-2022 15-06-2022 0000687324723 MAULIDIAH MUSDALIFAH P
294 00:00 08:38
514 133011010622P000 14-06-2022 16-06-2022 0000687340866 JINGGA PRISCILLA M P

340 00:00 10:09
133011010622P000 14-06-2022 19-06-2022
515 384 00:00 15:29 0000687375437 FARIDA P
516 133011010622P000 14-06-2022 16-06-2022 0000687757206 AMNA P

341 00:00 10:14
517 133011010622P000 14-06-2022 03-07-2022 0000687848275 DIANA DEWI KARTIKASARI P

830 00:00 09:34
133011010622P000 14-06-2022 15-06-2022 KIMBERLY RARA SAHRONI
295 00:00 08:44
518 0001038959605 P
519 133011010622P000 14-06-2022 14-06-2022 0001314888603 NAJWA WIKA AULIA P

284 00:00 12:01
520 133011010622P000 14-06-2022 16-06-2022 0001430014961 SRI BUDI RAHAYU P
324 00:00 09:11
521 133011010622P000 14-06-2022 16-06-2022 0001703800045 SUMIYATI P

336 00:00 09:56
522 133011010622P000 14-06-2022 19-06-2022 0001703801125 IKA NUR FARIDA P
388 00:00 15:46
523 133011010622P000 14-06-2022 14-06-2022 0001703811587 RAMA AMIRTA L

283 00:00 11:55
524 133011010622P000 14-06-2022 14-06-2022 0001703815828 FITRI HANDAYANI P
263 00:00 09:04
STATUS

PBI (APBN) Contusion of finger(s) with Berobat Jalan

damage to nail
Excessive and frequent

- menstruation with irregular cycle Berobat Jalan
- Dyspepsia Sembuh
PEGAWAI Acute upper respiratory infections

PEMERINTAH of multiple and unspecified sites
DENGAN PERJANJIAN Berobat Jalan
KERJA
- Anodontia Berobat Jalan
PEKERJA MANDIRI Essential (primary) hypertension Berobat Jalan Diabetes Mellitus
PBI (APBD) Non-insulin-dependent diabetes Berobat Jalan Diabetes Mellitus

mellitus
PBI (APBD) Caries of dentine Berobat Jalan

133011010622P000 14-06-2022 15-06-2022

525 290 00:00 08:26 0001703818989 NGATEMI P
526 133011010622P000 14-06-2022 16-06-2022 0001856280385 RINI SUSILOWATI P

319 00:00 08:47
527 133011010622P000 14-06-2022 14-06-2022 0001968400844 M. SOLEH L

264 00:00 09:07
528 133011010622P000 14-06-2022 15-06-2022 0002157822764 AYLA PUTRI NUROFIK P
297 00:00 09:19
529 133011010622P000 14-06-2022 16-06-2022 0002157822764 AYLA PUTRI NUROFIK P

333 00:00 09:49
530 133011010622P000 14-06-2022 15-06-2022 0002157826645 SITI ROMLAH P
291 00:00 08:28
531 133011010622P000 14-06-2022 16-06-2022 0002179102408 WAGINTEN P

320 00:00 08:55
532 133011010622P000 14-06-2022 14-06-2022 0002179102656 SILVI TRI MUSTIKA DEWI P
288 00:00 12:17
533 133011010622P000 14-06-2022 20-06-2022 0002204254315 AZIZAH ZAHRA TRIANOVA P

407 00:00 10:12
534 133011010622P000 14-06-2022 20-06-2022 0002630159188 ILHAM ALAMSYAH L
409 00:00 10:22
535 133011010622P000 14-06-2022 14-06-2022 0002755051233 SAROPA P

262 00:00 08:38
536 133011010622P000 14-06-2022 14-06-2022 0002804179544 MEILINDA PUTRI KRISTIANI P

287 00:00 12:15
537 133011010622P000 14-06-2022 16-06-2022 0002804188072 MUHAMMAD SHOLEH L

321 00:00 09:00
538 133011010622P000 14-06-2022 19-06-2022 0002804188601 RIKA MAWARSARI P

385 00:00 15:31
539 133011010622P000 14-06-2022 14-06-2022 0002804195529 SUMIRAH P
260 00:00 08:19
540 133011010622P000 14-06-2022 14-06-2022 0002804200817 HOMSATUN MUTMAINAH P

286 00:00 12:10
541 133011010622P000 14-06-2022 14-06-2022 0002914083303 BAMESWARA AL-KHALIFI L
285 00:00 12:06 PRIYANTO
542 133011010622P000 14-06-2022 19-06-2022 0002974809666 FARIZKI RAMADHAN L

382 00:00 15:24
STATUS

PEGAWAI SWASTA Gastritis and duodenitis Berobat Jalan
PEKERJA MANDIRI Nasal polyp, unspecified Rujuk Vertikal
- Bronchitis, not specified as acute Sembuh

or chronic
cold]

cold]
PEKERJA MANDIRI Lesion of sciatic nerve Rujuk Vertikal

cold]
- Periapical abscess without sinus Berobat Jalan

cold]
543 133011010622P000 14-06-2022 19-06-2022 0003000767106 ARRAYAN MIKAIL ALFAHREZI L

386 00:00 15:36
544 133011010622P000 14-06-2022 14-06-2022 0003069311567 TRYNA JIHAN MISHA AL P

261 00:00 08:38 PRANOWO
545 133011010622P000 14-06-2022 19-06-2022 0003273314769 BAYI NYONYA IKA NUR P

387 00:00 15:44 FARIDA
546 133011010622P000 13-06-2022 13-06-2022 0000089347509 SUMIJAH P

246 00:00 10:06
547 133011010622P000 13-06-2022 13-06-2022 0000101055418 TARMUDJI L
254 00:00 14:02
133011010622P000 13-06-2022 13-06-2022
548 241 00:00 08:47 0000114481438 KASIYAMI P
549 133011010622P000 13-06-2022 13-06-2022 0000156661187 SUTRISNO L

245 00:00 09:27
550 133011010622P000 13-06-2022 13-06-2022 0000685468383 PARTI ANJAR P
244 00:00 09:24
133011010622P000 13-06-2022 14-06-2022

551 265 00:00 09:20 0000685503685 ASMARI L
133011010622P000 13-06-2022 14-06-2022

552 270 00:00 09:27 0000685520482 LISTIANA P
133011010622P000 13-06-2022 20-06-2022

554 133011010622P000 13-06-2022 14-06-2022 0000685731971 SUHARYANTO L

274 00:00 09:38
133011010622P000 13-06-2022 14-06-2022
555 271 00:00 09:30 0000686123447 SUKARDI L
556 133011010622P000 13-06-2022 13-06-2022 0000686194413 RIASIH P

257 00:00 14:17
557 133011010622P000 13-06-2022 19-06-2022 0000686227768 RISMA AMBARWATI P
376 00:00 07:12
558 133011010622P000 13-06-2022 04-07-2022 0000686237692 MURDIANA P
846 00:00 11:51

381 00:00 15:20
STATUS

- Convulsions, not elsewhere Rujuk Vertikal

classified
- Liveborn infants according to place Berobat Jalan

of birth
PENERIMA PENSIUN Polyarthrosis Rujuk Vertikal

PNS
PENERIMA PENSIUN Chronic periodontitis Berobat Jalan
TNI
Non-insulin-dependent diabetes
PNS DAERAH mellitus with ophthalmic Rujuk Vertikal
complications
PENERIMA PENSIUN Heart failure Berobat Jalan

PNS
PBI (APBN) Congestive heart failure Berobat Jalan Hipertensi




PBI (APBN) Epilepsy Berobat Jalan
- Chronic periodontitis Berobat Jalan

560 133011010622P000 13-06-2022 19-06-2022 0000686641026 AMI P

375 00:00 07:11
561 133011010622P000 13-06-2022 14-06-2022 0000686818978 TUTIK RAUTI P

282 00:00 10:14
562 133011010622P000 13-06-2022 24-06-2022 0000686927136 SUMIATI P

556 00:00 08:45
563 133011010622P000 13-06-2022 13-06-2022 0000686935517 UMIATI P

243 00:00 08:57
564 133011010622P000 13-06-2022 14-06-2022 0000686945272 SUMIATI P
277 00:00 09:48
565 133011010622P000 13-06-2022 13-06-2022 0000686962293 MURI P
258 00:00 14:20
566 133011010622P000 13-06-2022 04-07-2022 0000687109329 FITRIYA P

840 00:00 10:17
567 133011010622P000 13-06-2022 13-06-2022 0000687422294 DERNIAWAN ARDIANSYAH L
256 00:00 14:06 PRATAMA
568 133011010622P000 13-06-2022 13-06-2022 0000687641668 SUKESI P

240 00:00 08:40
569 133011010622P000 13-06-2022 13-06-2022 0000687920589 ACHMAD MARZUKI NAJIB L
252 00:00 13:56
133011010622P000 13-06-2022 14-06-2022

570 276 00:00 09:44 0000687948355 SAMSUL HIDAYAT L
133011010622P000 13-06-2022 14-06-2022

571 281 00:00 10:07 0001154752165 MUHAMMAD QUFRON L
572 133011010622P000 13-06-2022 14-06-2022 0001226940041 SUDARTIK P

279 00:00 09:59
573 133011010622P000 13-06-2022 14-06-2022 0001703806593 SUNARSIH P

280 00:00 10:05
133011010622P000 13-06-2022 13-06-2022
574 250 00:00 11:30 0001703810845 YENI ERAWATI P
133011010622P000 13-06-2022 14-06-2022

575 275 00:00 09:42 0002121244694 IIS NURHALISA L
576 133011010622P000 13-06-2022 13-06-2022 0002157819671 CHOIRUL ANAM L

239 00:00 08:12
STATUS
PBI (APBN) Polyarthrosis Rujuk Vertikal


PENERIMA PENSIUN Non-insulin-dependent diabetes Berobat Jalan

TNI mellitus


PBI (APBD) Schizophrenia Rujuk Vertikal

133011010622P000 13-06-2022 13-06-2022

577 259 00:00 14:51 0002157826331 PARIYEM P
578 133011010622P000 13-06-2022 14-06-2022 0002161524813 SUPINI P

273 00:00 09:34
579 133011010622P000 13-06-2022 13-06-2022 0002259475479 LAMIYATI P

253 00:00 13:59
133011010622P000 13-06-2022 14-06-2022
580 278 00:00 09:54 0002269379788 AMINAH CANDRA KASIH P
581 133011010622P000 13-06-2022 14-06-2022 0002269380058 DESCA RIO ADITYA L

272 00:00 09:31
133011010622P000 13-06-2022 14-06-2022
582 266 00:00 09:22 0002475399521 AN'IM HOLILULLOH L
133011010622P000 13-06-2022 14-06-2022

583 267 00:00 09:23 0002681473184 ALIN MAS ADAH P
133011010622P000 13-06-2022 13-06-2022 MOCHAMMAD RAMADHAN

584 249 00:00 11:23 0002804187429 FATUR ROHMAN L
585 133011010622P000 13-06-2022 14-06-2022 0002804198141 MOCHAMAD JUNAEDI L

268 00:00 09:25
133011010622P000 13-06-2022 13-06-2022

586 242 00:00 08:51 0002843039406 SANA P
587 133011010622P000 13-06-2022 13-06-2022 0002843041689 SUPARMAN L

248 00:00 11:20
588 133011010622P000 13-06-2022 13-06-2022 0002875678323 DESY YEYEN SETIYOWATI P
247 00:00 10:55
589 133011010622P000 13-06-2022 19-06-2022 0002916747707 MUHAMMAD HUSEIN RAYYAN L

374 00:00 07:09 AS SHOLEH
590 133011010622P000 13-06-2022 13-06-2022 0003065348632 NOVITASARI P
255 00:00 14:04

377 00:00 07:14
592 133011010622P000 13-06-2022 13-06-2022 0003115483571 NURNATI P

251 00:00 11:37
STATUS

PEKERJA MANDIRI Other soft tissue disorders, not

elsewhere classified Berobat Jalan

cold]



cold]

PEKERJA MANDIRI Astigmatism Rujuk Vertikal
- Otalgia and effusion of ear Berobat Jalan
PEGAWAI SWASTA Necrosis of pulp Berobat Jalan
PEGAWAI SWASTA Diarrhoea and gastroenteritis of Berobat Jalan



834 10:15 ERINTHA
133011010622P000 10-06-2022
594 231 06-10-2022 11:15 0000686239694 SURIEH P
595 133011010622P000 06-10-2022 10-06-2022 0000686247074 SITI NUR FADILAH P

213 10:09
596 133011010622P000 06-10-2022 10-06-2022 0000686519357 SUNARJI L
229 11:05
133011010622P000 15-06-2022
597 298 06-10-2022 09:24 0000687267472 SITI MAHMUDA P
598 133011010622P000 06-10-2022 10-06-2022 0000687406228 YULIS SETYOWATI P

207 08:24
599 133011010622P000 06-10-2022 10-06-2022 0000687576745 MISNAYAH P

230 11:13
600 133011010622P000 06-10-2022 10-06-2022 0001038961642 FATMA ZAMRA P

220 10:27
601 133011010622P000 06-10-2022 19-06-2022 0002158452202 NURUL QOMARIYAH P

373 07:06
602 133011010622P000 06-10-2022 10-06-2022 0002161888828 MUSLIMIN L

235 12:59
603 133011010622P000 06-10-2022 12-06-2022 0002520134886 BUNAWI L
237 08:45
133011010622P000 15-06-2022 MAULANA AHMAD

604 306 06-10-2022 11:33 0002804183537 NASRULLOH L
605 133011010622P000 06-10-2022 10-06-2022 0002804189477 LISA SUNIATI P

234 12:56
133011010622P000 10-06-2022
606 232 06-10-2022 11:41 0002843038361 SUMIATI P
133011010622P000 10-06-2022
607 233 06-10-2022 12:53 0003051745637 SULAEHA HJ P
608 133011010622P000 06-09-2022 10-06-2022 0000674771422 WARI SIYATUL JENNAH P

228 11:00
609 133011010622P000 06-09-2022 09-06-2022 0000686293479 RINI SETYOWATI P

203 11:04
STATUS

Contraceptive management Diabetes Mellitus

PBI (APBN) Berobat Jalan Hipertensi
PBI (APBN) Heart failure Berobat Jalan
PBI (APBD) Atopic dermatitis Berobat Jalan Hipertensi




133011010622P000 10-06-2022
610 219 06-09-2022 10:26 0000686550431 ASIYAH P
611 133011010622P000 06-09-2022 10-06-2022 0000686555954 JUHANA P

222 10:33
612 133011010622P000 06-09-2022 09-06-2022 0000686601112 KHOLIFAH P

194 09:14
613 133011010622P000 06-09-2022 09-06-2022 0000686608661 HERIYA P
196 09:53
614 133011010622P000 06-09-2022 10-06-2022 0000686709011 SUBATI P

221 10:30
615 133011010622P000 06-09-2022 10-06-2022 0000686719585 RAHAYU P
218 10:20
616 06-09-2022 0000686934819 MOCH AINUL YAKIN L

133011010622P000 10-06-2022
210 10:01
617 133011010622P000 06-09-2022 03-07-2022 0000687944226 LINDA P

829 09:31
618 133011010622P000 06-09-2022 03-07-2022 0000727643092 LILIK ARIFAH P

824 09:24
619 133011010622P000 06-09-2022 10-06-2022 0001038956501 ENDANG SRI RAHAYU P
227 10:56
620 133011010622P000 06-09-2022 09-06-2022 0001038960202 FAUZIAH AMIN P

193 08:56
621 133011010622P000 06-09-2022 10-06-2022 0001703795679 SITI PARTI P

214 10:10
622 133011010622P000 06-09-2022 03-07-2022 0001703805017 RATNAWATI P

826 09:27
623 133011010622P000 06-09-2022 09-06-2022 0001883374143 HAMSUN L

201 10:59
624 133011010622P000 06-09-2022 10-06-2022 0001883374582 ULFA MUSRIFA P
224 10:39
133011010622P000 10-06-2022
625 211 06-09-2022 10:04 0002157831055 NGADIONO L
626 133011010622P000 06-09-2022 10-06-2022 0002157831066 JUMAINA P

212 10:07
STATUS

PBI (APBN) of morbidity Berobat Jalan
PBI (APBN) Acute viral hepatitis, unspecified Rujuk Vertikal
PBI (APBN) Glaucoma Rujuk Vertikal
- Bronchitis, not specified as acute Berobat Jalan Hipertensi

or chronic
PBI (APBN) Suppurative and unspecified otitis Berobat Jalan
media

PBI (APBN) Senile incipient cataract Rujuk Vertikal
PBI (APBD) Other and unspecified cirrhosis of Rujuk Vertikal

liver


133011010622P000 10-06-2022
627 225 06-09-2022 10:45 0002204254315 AZIZAH ZAHRA TRIANOVA P
628 133011010622P000 06-09-2022 10-06-2022 0002219173198 ADINDA DWI PERMATA SARI P

226 10:52
133011010622P000 09-06-2022
629 192 06-09-2022 08:33 0002261795207 AHMAD HERU SUSANTO L
630 133011010622P000 06-09-2022 10-06-2022 0002503612157 MOCHAMAD YUSUF MAULANA L

215 10:12
631 133011010622P000 06-09-2022 10-06-2022 0002611781987 SABIRUN L
216 10:14
632 133011010622P000 06-09-2022 03-07-2022 0002765698042 SAYYIDAH AISYATUL P
827 09:28 HUMAIRA
633 06-09-2022 0002766191725 EDY ISMANTO L

133011010622P000 09-06-2022
200 10:51
634 133011010622P000 06-09-2022 10-06-2022 0002804181491 SITI ASIYAH P

223 10:37
635 133011010622P000 06-09-2022 10-06-2022 0002804181873 ASMANAH P

217 10:16
636 133011010622P000 06-09-2022 03-07-2022 0003047714368 DEA DWI MEILINDAWATI P

828 09:29
133011010622P000 09-06-2022
637 204 06-09-2022 11:05 0003094773941 NAYYARA KAYLA SAFITRI P
638 133011010622P000 06-09-2022 09-06-2022 0003134547213 MILA ROSA P

191 08:28
639 133011010622P000 06-09-2022 03-07-2022 0003263813662 BAYI NYONYA SUCIK DWI P
825 09:26 NARTI
133011010622P000 08-06-2022
640 145 06-08-2022 10:09 0000685733714 ACHMAD SUBEKTI L
641 133011010622P000 06-08-2022 10-06-2022 0000686612204 AGUS TRIMAWAN L

209 09:17
642 133011010622P000 06-08-2022 08-06-2022 0000686889911 SULASTRI P

143 10:04
643 133011010622P000 06-08-2022 09-06-2022 0000686928295 ERNI INDRIYANI P
189 06:27
STATUS

PEGAWAI SWASTA Chronic obstructive pulmonary

disease, unspecified Rujuk Vertikal
PEGAWAI SWASTA Atopic dermatitis Berobat Jalan

cold]
KEPALA DESA DAN Fracture of tooth Berobat Jalan

PERANGKAT DESA
Congenital absence, atresia and

- stenosis of anus without fistula Rujuk Vertikal
PEKERJA MANDIRI Thyrotoxicosis with diffuse goitre Rujuk Vertikal

cold]

- Vertigo of central origin Sembuh

133011010622P000 08-06-2022
644 146 06-08-2022 10:10 0000687073386 DEWI AMBARWATI P
133011010622P000 08-06-2022
645 155 06-08-2022 10:21 0000687078819 SARIMAH P
646 133011010622P000 06-08-2022 08-06-2022 0000687576745 MISNAYAH P

144 10:05
133011010622P000 08-06-2022
647 154 06-08-2022 10:21 0001038960527 NUR HOFIFAH P
648 133011010622P000 06-08-2022 08-06-2022 0001038961517 YUNIANI P

152 10:18
649 133011010622P000 06-08-2022 08-06-2022 0001516148122 AISYAH FEBI PUTRI PERMANA P
141 08:51
650 133011010622P000 06-08-2022 08-06-2022 0001703801013 JOEANA P
151 10:14
651 133011010622P000 06-08-2022 08-06-2022 0001703812779 SUBANDI L

150 10:14
652 133011010622P000 06-08-2022 08-06-2022 0002157826768 SATIMAH P
148 10:12
653 133011010622P000 06-08-2022 09-06-2022 0002157830684 LASMI ASIH P

187 06:24
832 09:55
655 133011010622P000 06-08-2022 08-06-2022 0002161525263 GUNTUR WICAKSONO L

149 10:12
656 133011010622P000 06-08-2022 08-06-2022 0002161889098 ELIYA P
147 10:11
133011010622P000 12-06-2022
657 238 06-08-2022 20:14 0002269379788 AMINAH CANDRA KASIH P

188 06:26 ERINTHA
659 133011010622P000 06-08-2022 08-06-2022 0002503127338 FILIN WAHYUDI L

153 10:19
660 133011010622P000 06-08-2022 09-06-2022 0002748688312 MUHAMMAD FATIH IMAMI L
186 06:23
661 133011010622P000 06-08-2022 09-06-2022 0002922604031 AFKAR NURDIANSYAH L
190 06:29 PRADIPTA
STATUS



PEGAWAI SWASTA Chalazion Rujuk Vertikal
PEKERJA MANDIRI Other soft tissue disorders, not


cold]
cold]
662 133011010622P000 06-08-2022 08-06-2022 0003003193855 ROHMAN L

142 08:54
663 133011010622P000 06-08-2022 24-06-2022 0003011756973 LILIK PURWANINGSIH P

570 09:17
664 133011010622P000 06-08-2022 08-06-2022 0003046867042 AGUSTIN NINGSIH, HJ P

140 08:38
665 133011010622P000 06-08-2022 09-06-2022 0003088769117 ARIFKA NUR VARISHA P

199 10:46
666 133011010622P000 06-08-2022 11-06-2022 0003115483571 NURNATI P
236 08:35
667 133011010622P000 06-07-2022 07-06-2022 0000685731971 SUHARYANTO L
116 09:43
133011010622P000 07-06-2022
668 121 06-07-2022 10:02 0000686213199 SENEMAN L
669 133011010622P000 06-07-2022 07-06-2022 0000686536288 AMI P

111 08:42
133011010622P000 07-06-2022
670 117 06-07-2022 09:44 0000686590075 ERNAWATI P
671 133011010622P000 06-07-2022 07-06-2022 0000686830228 SEDIYEH P

110 08:40
672 133011010622P000 06-07-2022 09-06-2022 0000686858679 SITI MARYAMA P
183 06:16
673 133011010622P000 06-07-2022 07-06-2022 0000687077662 KARTINI P

113 09:03
674 133011010622P000 06-07-2022 07-06-2022 0000687124124 SUHADI L
119 09:46
133011010622P000 07-06-2022
675 123 06-07-2022 10:04 0000687219232 SUKATEMI RATNASARI P
676 133011010622P000 06-07-2022 07-06-2022 0000687865814 HANIMA P

128 10:11
677 133011010622P000 06-07-2022 07-06-2022 0000687975761 PONISIH P

126 10:07
678 133011010622P000 06-07-2022 07-06-2022 0001038947635 SAWI L
134 11:06
679 133011010622P000 06-07-2022 07-06-2022 0001038958571 HOSNIYATI P

127 10:10
STATUS
- Senile cataract, unspecified Rujuk Vertikal
- Headache Berobat Jalan
PEKERJA MANDIRI Malignant neoplasm of breast, Berobat Jalan

unspecified
PBI (APBN) Schizophrenia Sembuh


PBI (APBN) Stroke, not specified as Rujuk Vertikal

haemorrhage or infarction

- Hyperplasia of prostate Rujuk Vertikal
PBI (APBN) Hypertensive heart disease Rujuk Vertikal

680 133011010622P000 06-07-2022 07-06-2022 0001275444314 BAMBANG SOEGIHARTO L

122 10:03
133011010622P000 07-06-2022 SRIYANI BT HERMAN ABDUL

681 133 06-07-2022 10:24 0001401336729 PAMI P
682 133011010622P000 06-07-2022 09-06-2022 0001478058928 RIFANA P

181 06:13
683 133011010622P000 06-07-2022 07-06-2022 0001585556695 FITRI ARIANI P
120 09:46
684 133011010622P000 06-07-2022 07-06-2022 0001701943479 IWAN KRISDIANTO L

114 09:08
133011010622P000 07-06-2022
685 125 06-07-2022 10:06 0001703610461 TRI RIDHO ERFINALIS L

137 13:59
687 133011010622P000 06-07-2022 09-06-2022 0001851406481 LAILATUL FATIKA ROHMA P

185 06:21
688 133011010622P000 06-07-2022 09-06-2022 0002157819445 ZHAHROTUL LAILI FARHATI P

202 11:01
133011010622P000 07-06-2022
689 115 06-07-2022 09:36 0002179103286 DJUMA'ATI P
690 133011010622P000 06-07-2022 07-06-2022 0002260574627 MILA NUR DAHLIA P

109 08:27
691 133011010622P000 06-07-2022 07-06-2022 0002426996171 AULIA MUTIARA PUTRI P

136 13:55
133011010622P000 07-06-2022 ABRORUL ARKA REAL HAQIQI
692 124 06-07-2022 10:05 0002441590086 L
693 133011010622P000 06-07-2022 07-06-2022 0002500596606 TIWEK SUPRAPTI P

132 10:14
694 133011010622P000 06-07-2022 09-06-2022 0002613790552 LUTFIAH AZQIRA PUTRI P

182 06:15
695 133011010622P000 06-07-2022 09-06-2022 0002616354459 MAULANA AL GHAZALI P

184 06:18 SANJAYA
133011010622P000 07-06-2022
696 112 06-07-2022 08:54 0002804183414 ARSINEM P
STATUS
PEKERJA MANDIRI Essential (primary) hypertension Berobat Jalan Diabetes Mellitus

PBI (APBN) Gastritis, unspecified Berobat Jalan
- Senile cataract Rujuk Vertikal

PEGAWAI SWASTA Anodontia Berobat Jalan
Hepatomegaly with splenomegaly,

PBI (APBN) not elsewhere classified Rujuk Vertikal
PEGAWAI SWASTA Diabetes mellitus in pregnancy, Rujuk Vertikal

unspecified


cold]
PEGAWAI SWASTA Allergic contact dermatitis Berobat Jalan

133011010622P000 07-06-2022
697 130 06-07-2022 10:12 0002804186619 SUDARMANINGSIH P
133011010622P000 07-06-2022 ABEL INTAN SARGIAN DAEP

698 131 06-07-2022 10:13 0002804186621 P
133011010622P000 07-06-2022
699 129 06-07-2022 10:12 0002804192998 SRI MULYANTI P
700 06-07-2022 0002804197915 ASIYAH P

133011010622P000 10-06-2022
208 09:08
701 133011010622P000 06-07-2022 07-06-2022 0002867929637 AHMAD HEFNI HUMAIDY L

135 13:53 AZHARY
133011010622P000 07-06-2022
702 118 06-07-2022 09:45 0002970786431 SIANI P
703 133011010622P000 06-07-2022 09-06-2022 0003123572095 MUHAMMAD IQBAL MAULANA L

180 06:12
704 06-06-2022 0000113398187 FAHMI REZA AMRULLAH L

133011010622P000 06-06-2022
074 08:35
133011010622P000 06-06-2022
705 095 06-06-2022 09:36 0000113653585 M NURHAFID L
706 133011010622P000 06-06-2022 06-06-2022 0000685491456 LILIS CAHYATI P

073 08:28
133011010622P000 06-06-2022
707 084 06-06-2022 09:18 0000685593821 BAMBANG ROESMANTO L
708 133011010622P000 06-06-2022 06-06-2022 0000686142674 ELLY SUMIANI P

083 09:17
133011010622P000 06-06-2022
709 104 06-06-2022 10:37 0000686247298 ANGGI PUTRI AGUSTIN P
133011010622P000 15-06-2022
710 299 06-06-2022 09:36 0000686340156 MARIYEH P
711 133011010622P000 06-06-2022 06-06-2022 0000686490849 NUR ANNISA MAJID P

072 07:34
STATUS



PBI (APBN) Diarrhoea and gastroenteritis of Sembuh

Diabetes Mellitus


cold]
Other benign neoplasm of Rujuk Vertikal

connective and other soft tissue of
PEKERJA MANDIRI head, face and neck

PBI (APBN) Schizophrenia Rujuk Vertikal



- Prolonged pregnancy Rujuk Vertikal

712 133011010622P000 06-06-2022 06-06-2022 0000686500582 VINA WULANDARI P

092 09:34
713 133011010622P000 06-06-2022 06-06-2022 0000686501335 MUHAMMAD REZA L

075 08:49
714 133011010622P000 06-06-2022 08-06-2022 0000686556156 LATIFA P

157 15:06
133011010622P000 06-06-2022
715 086 06-06-2022 09:20 0000686841838 MARGI L
133011010622P000 06-06-2022
716 085 06-06-2022 09:19 0000687078573 LEGIMA P
717 133011010622P000 06-06-2022 06-06-2022 0000687104133 KINANTI RAHAYU P

091 09:28
133011010622P000 06-06-2022
718 077 06-06-2022 09:04 0000687170924 MUNAJI L
133011010622P000 06-06-2022
719 101 06-06-2022 10:34 0000687327355 RIZKIYEKA NOVIANSYAH L
720 133011010622P000 06-06-2022 09-06-2022 0000687381478 RIKA INDRIYANI P

177 06:07
133011010622P000 06-06-2022
721 076 06-06-2022 08:51 0000687463402 TAHER L
722 133011010622P000 06-06-2022 15-06-2022 0000687463694 SULIHA P

301 09:51
723 133011010622P000 06-06-2022 06-06-2022 0001038959493 SRI ASTUTI P

094 09:35
133011010622P000 06-06-2022
724 089 06-06-2022 09:22 0001038959998 SITI ISMIYATI P
725 133011010622P000 06-06-2022 06-06-2022 0001038963802 SITI USWATUN HASANAH P

096 09:37
726 133011010622P000 06-06-2022 06-06-2022 0001304820797 TAMINA P

079 09:12
133011010622P000 06-06-2022
727 097 06-06-2022 09:37 0001405141705 SRI WARYATI / WARIK P

173 06:01
STATUS
PBI (APBN) Epilepsy Rujuk Vertikal


Respiratory tuberculosis,
PBI (APBN) bacteriologically and histologically Rujuk Vertikal
confirmed


- disease, unspecified Rujuk Vertikal

mellitus

cold]
PEKERJA MANDIRI Essential (primary) hypertension Berobat Jalan Hipertensi


cold]
729 133011010622P000 06-06-2022 06-06-2022 0001703801441 NGATMINAH P

078 09:08
133011010622P000 06-06-2022
730 103 06-06-2022 10:36 0001703801676 LILIK SULIYATI P
133011010622P000 06-06-2022
731 102 06-06-2022 10:35 0001703801698 EVELYN AINUN MAHYA P
732 133011010622P000 06-06-2022 06-06-2022 0001703809124 NUR HOSEN L

090 09:25
733 133011010622P000 06-06-2022 06-06-2022 0001842514784 LILIS YULIASTARI P
099 09:59
734 133011010622P000 06-06-2022 06-06-2022 0001878998523 DUKUT SUTIYONO L
081 09:14
735 133011010622P000 06-06-2022 09-06-2022 0002089919351 SEPTI novita sari P

198 10:37
736 133011010622P000 06-06-2022 06-06-2022 0002155149955 AMINAH P

098 09:45
737 133011010622P000 06-06-2022 08-06-2022 0002157820514 AFTON ZADID AL MUROBBY L

159 15:12
738 133011010622P000 06-06-2022 06-06-2022 0002161525061 ANI SUDARYANTI P

088 09:22
739 133011010622P000 06-06-2022 06-06-2022 0002307920499 SUTIKNO L
100 10:03
740 133011010622P000 06-06-2022 09-06-2022 0002461028826 MUHAMMAD ARFIYAN ALFA L

171 05:58 DANI
741 133011010622P000 06-06-2022 09-06-2022 0002505883588 SAFITRI L
176 06:06
742 133011010622P000 06-06-2022 07-06-2022 0002763824231 MUHAMMAD GHOFUR L

139 15:44 RAMADHAN
133011010622P000 06-06-2022 JESSIKA APRILIA WORO PUTRI
743 082 06-06-2022 09:17 0002774816212 P
744 133011010622P000 06-06-2022 09-06-2022 0002804184314 AYU WANDANI P

175 06:04
745 133011010622P000 06-06-2022 08-06-2022 0002804199851 SIHAB BANDIDO L
158 15:07
746 133011010622P000 06-06-2022 09-06-2022 0002900561229 AZZAM MATLUBUN NAJAH L

174 06:03 ABIYU
STATUS
PBI (APBD) Other and unspecified cirrhosis of Rujuk Vertikal

liver


- Heart failure Rujuk Vertikal
- Dengue fever [classical dengue] Sembuh
PBI (APBD) Anodontia Berobat Jalan
PEKERJA MANDIRI Chronic renal failure, unspecified Rujuk Vertikal

cold]
PEGAWAI SWASTA Other nutritional anaemias Sembuh


cold]
747 133011010622P000 06-06-2022 06-06-2022 0002970802743 KASERI L

080 09:13
748 133011010622P000 06-06-2022 06-06-2022 0002974809677 RIDA WINARSIH P

087 09:21
749 133011010622P000 06-06-2022 08-06-2022 0003065348632 NOVITASARI P

156 14:57
750 133011010622P000 06-06-2022 09-06-2022 0003065917522 RAZKA AKBAR ALFAIJI L

172 06:00
751 133011010622P000 06-06-2022 09-06-2022 0003081648363 LAURA ALISKHA P
178 06:08 RAMADHANIA
752 133011010622P000 06-06-2022 09-06-2022 0003111606595 MOCHAMMAD ARRASYA L
179 06:10 RAMADHAN
133011010622P000 06-06-2022
753 093 06-06-2022 09:35 0003113269097 RIYAMAH P
754 133011010622P000 06-05-2022 06-06-2022 0001703804422 HENDRIK MARIYONO L

105 13:38
755 133011010622P000 06-05-2022 09-06-2022 0002220402677 SANATI P

197 10:02
756 06-05-2022 0003062489466 L
133011010622P000 09-06-2022 MUHAMMAD RAFKA
195 09:51 MAULANA
757 133011010622P000 06-04-2022 03-07-2022 0000687484304 HANIYAH P

831 09:47
133011010622P000 07-06-2022
138 15:38
758 06-04-2022 0002844768385 SLAMET RIYADI L
759 133011010622P000 06-03-2022 03-06-2022 0000114308414 SUHARTOYO L

049 09:10
133011010622P000 03-06-2022
760 062 06-03-2022 13:21 0000685734074 SARI P
133011010622P000 03-06-2022
761 059 06-03-2022 13:06 0000685824671 TRI WAHYU HANDAYANI P
762 133011010622P000 06-03-2022 03-06-2022 0000686552905 SARIMO L

055 12:55
STATUS
PBI (APBN) Hyperplasia of prostate Rujuk Vertikal

cold]

cold]
cold]
cold]

- Fever with chills Berobat Jalan
PBI (APBN) Typhoid and paratyphoid fevers Sembuh

Human immunodeficiency virus

[HIV] disease resulting in
- infectious and parasitic diseases Sembuh
PENERIMA PENSIUN Fracture of shaft of tibia Rujuk Vertikal

PNS


PBI (APBN) elsewhere classified Berobat Jalan Hipertensi
- Asthma Berobat Jalan

763 133011010622P000 06-03-2022 03-06-2022 0000686627201 BUANI P

069 13:38
764 133011010622P000 06-03-2022 03-06-2022 0000686975703 HARIANTO L

058 13:03
765 133011010622P000 06-03-2022 03-06-2022 0000687065051 MURTALAM L

065 13:29
766 133011010622P000 06-03-2022 03-06-2022 0000687118612 LASIM L

060 13:12
767 133011010622P000 06-03-2022 03-06-2022 0000687375437 FARIDA P
054 12:53
768 133011010622P000 06-03-2022 03-06-2022 0000687442544 ABDU RASMAN L
061 13:19
133011010622P000 03-06-2022
769 067 06-03-2022 13:34 0000687825281 SUPAEDAH P
770 133011010622P000 06-03-2022 03-06-2022 0000687826001 INDAH DWI PUJI ASTUTIK P

068 13:36
771 133011010622P000 06-03-2022 03-06-2022 0000691555184 SITI NURKHOLILA P

053 09:44
133011010622P000 03-06-2022
772 052 06-03-2022 09:29 0001038948388 MAAT P L
773 133011010622P000 06-03-2022 09-06-2022 0001703800113 REDITA INTAN PRATIWI P

205 11:10
774 133011010622P000 06-03-2022 03-06-2022 0001703801687 FABIANSYAH PRATAMA L

066 13:32
206 11:16
776 133011010622P000 06-03-2022 03-06-2022 0001832887034 SUMITO BARDY L

070 13:39
777 133011010622P000 06-03-2022 03-06-2022 0002121262266 NI'A P
064 13:27

168 05:51
779 133011010622P000 06-03-2022 03-06-2022 0002178845109 RIZKI AYU WULANDARI P
057 13:01
780 133011010622P000 06-03-2022 03-06-2022 0002455480113 PUGUH L
051 09:24
781 133011010622P000 06-03-2022 03-06-2022 0002505878616 ABDUL ABAS L
048 08:44
STATUS
PBI (APBN) Acute nasopharyngitis [common Berobat Jalan Diabetes Mellitus

cold]
- Paralytic strabismus Berobat Jalan


pregnancies
PBI (APBD) Chronic periodontitis Berobat Jalan
PEGAWAI SWASTA Disturbances in tooth eruption Berobat Jalan
PNS DAERAH Essential (primary) hypertension Berobat Jalan
PEKERJA MANDIRI Chronic renal failure, unspecified Rujuk Vertikal
PBI (APBN) Total (external) ophthalmoplegia Rujuk Vertikal

782 133011010622P000 06-03-2022 03-06-2022 0002585454333 ALI WAFI ANDRIAN L

063 13:25
783 133011010622P000 06-03-2022 03-06-2022 0002682102611 DWI APRILLIA P

056 12:59
784 133011010622P000 06-03-2022 03-06-2022 0002873633602 MATTOSAN L

047 08:30

170 05:56
786 133011010622P000 06-03-2022 03-06-2022 0003059946077 NURSANI P
050 09:18
787 133011010622P000 06-03-2022 09-06-2022 0003262223351 ELFATHAN DZAKIR L
169 05:53
788 133011010622P000 06-02-2022 02-06-2022 0000113773678 MULYADI DRS L

041 11:51
133011010622P000 02-06-2022
789 017 06-02-2022 09:50 0000685463973 LATIFAH P
790 133011010622P000 06-02-2022 02-06-2022 0000685838327 MUHAMMAD RIZKI PRATAMA L

013 09:33
133011010622P000 02-06-2022
791 022 06-02-2022 10:16 0000686077435 SUMIARSIH MAHLIFA P
792 133011010622P000 06-02-2022 02-06-2022 0000686161945 DHEAFANI ARTIKA SARI P

046 14:48
793 133011010622P000 06-02-2022 02-06-2022 0000686262126 DWI YULI HILDA PRASTIWI P

039 11:43
794 133011010622P000 06-02-2022 09-06-2022 0000686335116 RINA WATININGSIH P
162 05:36
795 133011010622P000 06-02-2022 02-06-2022 0000686463524 ON MUGIONO L

042 11:54
796 133011010622P000 06-02-2022 03-07-2022 0000686891024 ERLINDA P
823 09:21
797 133011010622P000 06-02-2022 02-06-2022 0000686895412 NASRIFATIN P

044 12:00
133011010622P000 02-06-2022
798 040 06-02-2022 11:45 0000687086482 NURAINI P
STATUS
PBI (APBN) Scabies Berobat Jalan

cold]
PEKERJA MANDIRI Angina pectoris, unspecified Rujuk Vertikal

cold]
PBI (APBN) Atrial fibrillation and flutter Rujuk Vertikal

cold]
PNS DAERAH Chronic periodontitis Berobat Jalan

- Open wound of toe(s) without Berobat Jalan

damage to nail

799 133011010622P000 06-02-2022 06-06-2022 0000687299578 MAIL L

106 16:37
800 133011010622P000 06-02-2022 06-06-2022 0000687307702 MUSRIFAH P

108 16:51
801 06-02-2022 0000687351183 P

133011010622P000 02-06-2022
NINING KHOIRUN ASROFA
019 09:55
802 133011010622P000 06-02-2022 02-06-2022 0000687409121 AKH JUMADI L

004 08:40
803 133011010622P000 06-02-2022 02-06-2022 0000687625626 TUMIN L
016 09:46
804 133011010622P000 06-02-2022 02-06-2022 0000687625896 ALIYAH P
030 11:00
805 133011010622P000 06-02-2022 02-06-2022 0000688511272 ROSITA P

045 13:38
806 133011010622P000 06-02-2022 02-06-2022 0000691942364 CICIK WIRAWATI P
029 10:50
133011010622P000 02-06-2022
807 018 06-02-2022 09:52 0001038955634 MISPARIASIH P
808 133011010622P000 06-02-2022 02-06-2022 0001038961563 SUWARSI P

008 09:16
809 133011010622P000 06-02-2022 02-06-2022 0001401338294 SAWI WANTO L

024 10:26
810 133011010622P000 06-02-2022 02-06-2022 0001405141795 SUPARNO L

014 09:34
811 133011010622P000 06-02-2022 02-06-2022 0001540337398 SITI AISAH P

001 08:26
812 133011010622P000 06-02-2022 02-06-2022 0001691872716 IKA PURWANTI P

025 10:28
813 133011010622P000 06-02-2022 02-06-2022 0001703402109 YENI TITIK SUTANTI P
020 10:01
814 133011010622P000 06-02-2022 02-06-2022 0001703798842 LAYLATUL LUTVIA P

036 11:29
815 133011010622P000 06-02-2022 02-06-2022 0001703801092 ANY WIDIYASTUTI P
015 09:44
STATUS

PBI (APBN) Dengue haemorrhagic fever Sembuh
PBI (APBN) Hyperuricaemia without signs of Berobat Jalan

inflammatory arthritis and
tophaceous disease
- Gastritis and duodenitis Berobat Jalan
- Senile cataract Rujuk Vertikal
Essential (primary) hypertension Diabetes Mellitus

- Berobat Jalan Hipertensi
PBI (APBD) Spinal enthesopathy Rujuk Vertikal
- Chronic renal failure, unspecified Rujuk Vertikal
PEGAWAI BUMN Contraceptive management Berobat Jalan
PEKERJA MANDIRI Pre-eclampsia, unspecified Rujuk Vertikal
PEGAWAI SWASTA Pleural condition, unspecified Rujuk Vertikal
PBI (APBD) Pre-eclampsia, unspecified Rujuk Vertikal

816 133011010622P000 06-02-2022 02-06-2022 0001703809124 NUR HOSEN L

021 10:13
817 133011010622P000 06-02-2022 09-06-2022 0001703818866 RIRIN LIANA P

165 05:42
818 06-02-2022 0001890065349 DAHRIYAH P

133011010622P000 02-06-2022
005 08:46
819 133011010622P000 06-02-2022 02-06-2022 0001959559301 ARIANI SETYA PUTRI P

026 10:29
133011010622P000 02-06-2022
820 038 06-02-2022 11:40 0002157369254 RIZMA PUTRI YURISYAH P

003 08:36
822 133011010622P000 06-02-2022 02-06-2022 0002161525184 ARSHYLA KAMILA PUTRI P

012 09:29
823 133011010622P000 06-02-2022 02-06-2022 0002179102724 MISNA P
006 09:08
133011010622P000 02-06-2022
824 034 06-02-2022 11:22 0002179103736 USWATUN HASANAH P
825 133011010622P000 06-02-2022 02-06-2022 0002307920499 SUTIKNO L

028 10:39
826 133011010622P000 06-02-2022 02-06-2022 0002420313783 ILHAM RAHMATULLAH L
035 11:26
827 133011010622P000 06-02-2022 09-06-2022 0002420317754 IBRAHIM RAHMATULLAH L

166 05:44
828 133011010622P000 06-02-2022 02-06-2022 0002443995393 IKA RAHAYU P
027 10:35
133011010622P000 02-06-2022
829 023 06-02-2022 10:20 0002482108165 JUMARI L
830 133011010622P000 06-02-2022 02-06-2022 0002681455904 TAHAL L

033 11:16
831 133011010622P000 06-02-2022 02-06-2022 0002681457849 DIYAN ARIFIYANTO L

002 08:30
133011010622P000 02-06-2022
832 009 06-02-2022 09:20 0002696688832 SUMIATI P
STATUS
Non-insulin-dependent diabetes Rujuk Vertikal

mellitus with neurological
PEKERJA MANDIRI complications Diabetes Mellitus
PEKERJA MANDIRI Non-insulin-dependent diabetes Berobat Jalan

mellitus
PBI (APBD) Fever of other and unknown origin Berobat Jalan

PBI (APBN) of morbidity Berobat Jalan
PEKERJA MANDIRI Conjunctivitis Berobat Jalan

cold]

PBI (APBD) Infection due to other Rujuk Vertikal

mycobacteria
PBI (APBD) Schizophrenia Rujuk Vertikal
PEKERJA MANDIRI Other soft tissue disorders, not Diabetes Mellitus

833 133011010622P000 06-02-2022 02-06-2022 0002735143738 MUHAMMAD HENDRA WIJAYA L

011 09:26
834 133011010622P000 06-02-2022 02-06-2022 0002774816177 FIRMAN MUTAWAKKIL L

032 11:12 HAMZAH
835 133011010622P000 06-02-2022 09-06-2022 0002804181287 HIDAYATUL HIKMAH P

164 05:41
133011010622P000 02-06-2022
836 031 06-02-2022 11:07 0002843042905 ROCHMAN L
837 133011010622P000 06-02-2022 06-06-2022 0002860574218 IKAWATI P

107 16:44
838 133011010622P000 06-02-2022 02-06-2022 0002876662721 RUKAYAH P
037 11:37
839 133011010622P000 06-02-2022 09-06-2022 0002891997584 SUCI TRI AYU P

161 05:34 CAHYANINGTIAS
840 133011010622P000 06-02-2022 02-06-2022 0003065348632 NOVITASARI P
043 11:56
841 133011010622P000 06-02-2022 02-06-2022 0003070411187 SURATI P

010 09:23
842 133011010622P000 06-02-2022 09-06-2022 0003073803693 M DANIYAL ABDAN L
167 05:47
843 133011010622P000 06-02-2022 02-06-2022 0003075868517 RAHMATULLAH DANUARTA L

007 09:10

160 05:32
845 133011010622P000 06-02-2022 09-06-2022 0003270240404 ATHA HAFIZH ALFAREZI L

163 05:38
846 133011010622P000 06-01-2022 03-06-2022 0000686552905 SARIMO L

071 13:55
STATUS

cold]
PEKERJA MANDIRI Schizophrenia Berobat Jalan

PEKERJA MANDIRI Essential (primary) hypertension Berobat Jalan

cold]
PEGAWAI SWASTA Lactose intolerance Rujuk Vertikal

cold]

cold]

Kunjungan Sakit Juni 2022

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TANGGAL

NO NO KUNJUNGAN TANGGAL ENTRI NO KARTU

4 133011010622P000 30-06-2022 30-06-2022 0000686536874

11 133011010622P000 30-06-2022 30-06-2022 0000727643092

12 133011010622P000 30-06-2022 30-06-2022 0001038947861

27 133011010622P000 29-06-2022 29-06-2022 0000674775922

37 133011010622P000 29-06-2022 29-06-2022 0000687073386

64 133011010622P000 28-06-2022 28-06-2022 0000686583101

65 133011010622P000 28-06-2022 28-06-2022 0000686594654

102 133011010622P000 28-06-2022 01-07-2022 0002178845199

110 133011010622P000 28-06-2022 28-06-2022 0002804401855

111 133011010622P000 28-06-2022 28-06-2022 0002843037303

133011010622P000 28-06-2022 28-06-2022

121 133011010622P000 27-06-2022 27-06-2022 0000685734423

133011010622P000 27-06-2022 27-06-2022

133 133011010622P000 27-06-2022 27-06-2022 0000687043236

162 133011010622P000 27-06-2022 27-06-2022 0002288547988

133011010622P000 27-06-2022 27-06-2022

177 133011010622P000 24-06-2022 24-06-2022 0000685733714

244 133011010622P000 23-06-2022 23-06-2022 0002733886451

245 133011010622P000 23-06-2022 23-06-2022 0002804194855

258 133011010622P000 22-06-2022 22-06-2022 0000686612799

288 133011010622P000 22-06-2022 23-06-2022 0003268548358

289 133011010622P000 22-06-2022 23-06-2022 0003268548404

292 133011010622P000 21-06-2022 21-06-2022 0000685761489

302 133011010622P000 21-06-2022 21-06-2022 0000686921444

339 133011010622P000 20-06-2022 20-06-2022 0000686235227

372 133011010622P000 20-06-2022 20-06-2022 0002278590715

378 133011010622P000 20-06-2022 20-06-2022 0002804188601

385 133011010622P000 20-06-2022 20-06-2022 0002873812847

133011010622P000 17-06-2022 17-06-2022

433 133011010622P000 17-06-2022 17-06-2022 0001703818416

448 133011010622P000 16-06-2022 16-06-2022 0000686841445

457 133011010622P000 16-06-2022 16-06-2022 0000775088234

460 133011010622P000 16-06-2022 16-06-2022 0001275446687

479 133011010622P000 15-06-2022 15-06-2022 0000685979425

133011010622P000 15-06-2022 15-06-2022

486 133011010622P000 15-06-2022 15-06-2022 0001038952056

133011010622P000 15-06-2022 15-06-2022

499 133011010622P000 15-06-2022 15-06-2022 0002804199671

527 133011010622P000 14-06-2022 14-06-2022 0001968400844

546 133011010622P000 13-06-2022 13-06-2022 0000089347509

563 133011010622P000 13-06-2022 13-06-2022 0000686935517

588 133011010622P000 13-06-2022 13-06-2022 0002875678323

613 133011010622P000 06-09-2022 09-06-2022 0000686608661

649 133011010622P000 06-08-2022 08-06-2022 0001516148122

678 133011010622P000 06-07-2022 07-06-2022 0001038947635

690 133011010622P000 06-07-2022 07-06-2022 0002260574627

704 06-06-2022 0000113398187

706 133011010622P000 06-06-2022 06-06-2022 0000685491456

729 133011010622P000 06-06-2022 06-06-2022 0001703801441

734 133011010622P000 06-06-2022 06-06-2022 0001878998523

747 133011010622P000 06-06-2022 06-06-2022 0002970802743

780 133011010622P000 06-03-2022 03-06-2022 0002455480113

781 133011010622P000 06-03-2022 03-06-2022 0002505878616

812 133011010622P000 06-02-2022 02-06-2022 0001691872716

830 133011010622P000 06-02-2022 02-06-2022 0002681455904

831 133011010622P000 06-02-2022 02-06-2022 0002681457849

LILIK ARIFAH P PBI (APBN) Supervision of other Rujuk Vertikal

SUHAR L PBI (APBN) Cerebral infarction, Rujuk Vertikal