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Bulan : 01 Januari 2014

Daftar Kunjungan Peserta bpjs/ askes/ jamkesmas/ jampersal


No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJUK CETAK
1 1/30/2014 423641204 ITI Unspecified injury of lower leg YA
persalinan
2 1/30/2014 423701763 AHMAD GHOZALI Acute tonsillitis, unspecified YA
askes
3 1/30/2014 424331188 AAH Dermatitis, unspecified TIDAK

4 1/30/2014 424616872 ITING Dermatitis, unspecified TIDAK

5 1/30/2014 424661703 DIDIN MUHIDIN Paratyphoid fever, unspecified YA

6 1/30/2014 1266108816 ALIT rukilah Myalgia YA

7 1/30/2014 1267111539 TETI SUHAETI Comp follow abortion and ectopic and molar preg unspec act partus YA

8 1/29/2014 423097569 AYAT Asthma, unspecified TIDAK

9 1/29/2014 423665043 ROHMAN Asthma, unspecified TIDAK

10 1/29/2014 423738134 ENUR Scabies TIDAK

11 1/29/2014 423739438 ASEP P Scabies TIDAK

12 1/29/2014 423793721 NURHAYATI Single spontaneous delivery, unspecified YA

13 1/29/2014 424311039 ENUNG Fever, unspecified TIDAK

14 1/29/2014 424315462 ADE SOPIAH Dermatitis, unspecified TIDAK

15 1/29/2014 424494729 SITI NURAENI Acute upper respiratory infection, unspecified TIDAK

16 1/29/2014 1266228538 WARJO Asthma, unspecified TIDAK

17 1/28/2014 423000314 IHAH Low back pain TIDAK


No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJUK CETAK
persalinan
18 1/28/2014 423695766 ANA Asthma, unspecified YA
askes
19 1/28/2014 423843085 OJAH Essential (primary) hypertension TIDAK

20 1/28/2014 424207732 EMPUNG Gastritis, unspecified TIDAK

21 1/28/2014 424285626 TINI Acute upper respiratory infection, unspecified TIDAK

22 1/28/2014 424286853 NISA Acute upper respiratory infection, unspecified TIDAK

23 1/28/2014 424290633 ISAH Asthma, unspecified TIDAK

24 1/27/2014 69879903 ENI KARTINI Low back pain YA

25 1/27/2014 411873939 EUIS Acute laryngopharyngitis TIDAK

26 1/27/2014 422681646 TINO Other disorders of nervous system, not elsewhere classified YA

27 1/27/2014 422909864 YAYAH Moderate pre-eclampsia YA

28 1/27/2014 422999627 IMAR Unspecified diabetes mellitus without complications YA

29 1/27/2014 423236913 WIWIN Dermatitis, unspecified TIDAK

30 1/27/2014 423662365 IMAS Gastritis, unspecified TIDAK

31 1/27/2014 423671769 PIAH Rheumatism, unspecified TIDAK

32 1/27/2014 423943795 UIS Influenza with oth resp manifestation virus not identified TIDAK

33 1/27/2014 424101418 EEM Unspecified diabetes mellitus without complications YA

34 1/27/2014 424330481 CAHYA Typhoid fever TIDAK

35 1/27/2014 424330536 DIAN Acute upper respiratory infection, unspecified TIDAK

36 1/27/2014 424342372 YAYAT Conjunctivitis, unspecified TIDAK

37 1/27/2014 424371813 ILOT Low back pain YA


No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJUK CETAK
persalinan
38 1/27/2014 424564367 ROKAYAH Gastritis, unspecified TIDAK
askes
39 1/27/2014 424654986 AMAH PATIMAH Gastritis, unspecified TIDAK

40 1/27/2014 424656527 ASEP M Disease of jaws, unspecified TIDAK

41 1/26/2014 422770498 YUYUN Diarrhoea and gastroenteritis of presumed infectious origin TIDAK

42 1/26/2014 423947834 KOMARIYAH Single spontaneous delivery, unspecified TIDAK

43 1/25/2014 423436408 IMA Gastritis, unspecified TIDAK

44 1/24/2014 422848754 ENYAT Diarrhoea and gastroenteritis of presumed infectious origin TIDAK

45 1/24/2014 423517601 HILMAN Epilepsy, unspecified TIDAK

46 1/24/2014 423862209 CECEP Influenza with oth resp manifestation virus not identified TIDAK

47 1/23/2014 69037211 YANI RAHMAYANI Gastritis, unspecified TIDAK

48 1/23/2014 69879453 BAISUDIN Influenza with oth resp manifestation virus not identified TIDAK

49 1/23/2014 423104714 ABDUL MAJID Influenza with oth resp manifestation virus not identified TIDAK

50 1/23/2014 423339816 UNDANG Typhoid fever YA

51 1/23/2014 424293704 AI YUNINGSIH Gastritis, unspecified TIDAK

52 1/23/2014 424329895 DEWI Influenza with oth resp manifestation virus not identified TIDAK

53 1/23/2014 424361272 INDI Other specified diseases of upper respiratory tract TIDAK

54 1/23/2014 1004325502 MALA Hypertensive heart disease with (congestive) heart failure TIDAK

55 1/23/2014 1004325546 UMUN Rheumatism, unspecified TIDAK

56 1/23/2014 1266107286 icha fatmawati Single spontaneous delivery, unspecified TIDAK

57 1/22/2014 69353504 AYI SUMIYATI Acute upper respiratory infection, unspecified TIDAK
No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJUK CETAK
persalinan
58 1/22/2014 69669459 YAHYA HIDAYAT Influenza with oth resp manifestation virus not identified TIDAK
askes
59 1/22/2014 422508205 NOPI Typhoid fever TIDAK

60 1/22/2014 422600275 JALIL Essential (primary) hypertension TIDAK

61 1/22/2014 423237756 WULAN Scabies TIDAK

62 1/22/2014 423441909 PIAH Gastritis, unspecified TIDAK

63 1/22/2014 423612832 SITI Unspecified acute lower respiratory infection TIDAK

64 1/22/2014 423694541 TATI Gastritis, unspecified TIDAK

65 1/22/2014 423694708 ARIP RAHMAN Acute upper respiratory infection, unspecified TIDAK

66 1/22/2014 423759947 UCUP Myalgia TIDAK

67 1/22/2014 424103477 ENI Influenza with oth resp manifestation virus not identified TIDAK

68 1/22/2014 424335745 MOCH IRFAN Other specified diseases of upper respiratory tract TIDAK

69 1/22/2014 1004324501 DODO Gastritis, unspecified TIDAK

70 1/21/2014 422669024 HENI Conjunctivitis, unspecified TIDAK

71 1/21/2014 422728503 AEP Influenza with oth resp manifestation virus not identified TIDAK

72 1/21/2014 423440616 ELSA Other specified diseases of upper respiratory tract TIDAK

73 1/21/2014 423645243 DANDI Epilepsy, unspecified YA

74 1/21/2014 423754255 OCIH Rheumatism, unspecified TIDAK

75 1/21/2014 423831216 EMAR Acute upper respiratory infection, unspecified TIDAK

76 1/21/2014 423832577 SITI LISNAWATI Gastritis, unspecified TIDAK

77 1/21/2014 423972652 MULYANA Diarrhoea and gastroenteritis of presumed infectious origin TIDAK
No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJUK CETAK
persalinan
78 1/21/2014 424053404 KOKOM Influenza with oth resp manifestation virus not identified TIDAK
askes
79 1/21/2014 424293309 II RUSTANDI Essential (primary) hypertension TIDAK

80 1/20/2014 423236913 WIWIN Acute cystitis TIDAK

81 1/20/2014 423517601 HILMAN Epilepsy, unspecified TIDAK

82 1/20/2014 423599152 DIKRI Cutaneous abscess, furuncle and carbuncle, unspecified TIDAK

83 1/20/2014 423664244 ARI ANGGARA Angina pectoris, unspecified YA

84 1/20/2014 423665043 ROHMAN Gastroduodenitis, unspecified TIDAK

85 1/20/2014 423744028 ASIH Keratitis, unspecified TIDAK

86 1/20/2014 423965079 JAMILAH Gastritis, unspecified TIDAK

87 1/20/2014 423965507 WIWIN Gastritis, unspecified TIDAK

88 1/20/2014 424021746 ADE SOLIHIN Hyperplasia of prostate YA

89 1/20/2014 424043594 ADAH Diarrhoea and gastroenteritis of presumed infectious origin TIDAK

90 1/20/2014 424114255 YUYUN Angina pectoris, unspecified YA

91 1/20/2014 1004324556 CICIN Angina pectoris, unspecified YA

92 1/20/2014 1004324782 HOLILAH Rheumatism, unspecified TIDAK

93 1/18/2014 422647481 ADE EMAR Other and unspec diseases of pulp and periapical tissues TIDAK

94 1/18/2014 422705248 DIDIN Acute sinusitis, unspecified TIDAK

95 1/18/2014 423097705 DEDE Diarrhoea and gastroenteritis of presumed infectious origin TIDAK

96 1/18/2014 423210881 DEDE Neuralgia and neuritis, unspecified TIDAK

97 1/18/2014 423428905 DEDE IDA Gastritis, unspecified TIDAK


No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJUK CETAK
persalinan
98 1/18/2014 424189462 HENI MARWATI Dermatitis, unspecified TIDAK
askes
99 1/18/2014 424351675 ENDANG Paratyphoid fever, unspecified TIDAK

100 1/18/2014 424646234 PITRI N Dermatitis, unspecified TIDAK

101 1/17/2014 423408532 DIAH Rheumatism, unspecified TIDAK

102 1/17/2014 423410951 ADE Dermatitis, unspecified TIDAK

103 1/17/2014 423423033 NAIN Acute amoebic dysentery TIDAK

104 1/17/2014 423680466 IRIN Rheumatism, unspecified TIDAK

105 1/17/2014 424225642 KAKAY Other specified diseases of upper respiratory tract TIDAK

106 1/17/2014 424311039 ENUNG Dermatitis, unspecified TIDAK

107 1/17/2014 424315462 ADE SOPIAH Scabies TIDAK

108 1/17/2014 424399634 SUMIATI Dermatitis, unspecified TIDAK

109 1/16/2014 68997565 DJUBAEDAH Gastroduodenitis, unspecified TIDAK

110 1/16/2014 422972065 ASEP ANOM Rheumatism, unspecified TIDAK

111 1/16/2014 423076487 ITA ROSITA Influenza with oth resp manifestation virus not identified TIDAK

112 1/16/2014 423611469 NINA Acute upper respiratory infection, unspecified TIDAK

113 1/16/2014 423614349 TUSUF Fever, unspecified TIDAK

114 1/16/2014 423738134 ENUR Dermatitis, unspecified TIDAK

115 1/16/2014 423739438 ASEP P Dermatitis, unspecified TIDAK

116 1/16/2014 423816849 ASUM Other and unspec diseases of pulp and periapical tissues TIDAK

117 1/15/2014 69669459 YAHYA HIDAYAT Acute upper respiratory infection, unspecified TIDAK
No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJUK CETAK
persalinan
118 1/15/2014 422782762 IHAT SOLIHAT Unspecified contact dermatitis, unspecified cause TIDAK
askes
119 1/15/2014 423055607 WENSISLAUS W Conjunctivitis, unspecified TIDAK

120 1/15/2014 423236362 ENUNG Dermatitis, unspecified TIDAK

121 1/15/2014 423314267 YAYAN Gastritis, unspecified TIDAK

122 1/15/2014 423890313 ELSA Scabies TIDAK

123 1/15/2014 423923861 UNDANG MASUM Diarrhoea and gastroenteritis of presumed infectious origin TIDAK

124 1/15/2014 424101058 AHMAD HIDAYAT Acute upper respiratory infection, unspecified TIDAK

125 1/13/2014 423019293 ADE R Ascariasis, unspecified TIDAK

126 1/13/2014 423119621 INUN Ascariasis, unspecified TIDAK

127 1/13/2014 423462069 AA ABDUL KOHAR Acute upper respiratory infection, unspecified TIDAK

128 1/13/2014 423729595 UWIN Gastritis, unspecified TIDAK

129 1/13/2014 423816581 AGUS Paratyphoid fever, unspecified TIDAK

130 1/13/2014 423865822 YATI Single spontaneous delivery, unspecified TIDAK

131 1/13/2014 423902103 HAYATI Gastritis, unspecified TIDAK

132 1/13/2014 423967566 MASITOH Diarrhoea and gastroenteritis of presumed infectious origin TIDAK

133 1/13/2014 424077434 ADE LILIS Typhoid fever TIDAK

134 1/13/2014 424097908 TETEH YATI Acute upper respiratory infection, unspecified TIDAK

135 1/13/2014 424146385 ASRI Influenza with oth resp manifestation virus not identified TIDAK

136 1/13/2014 424290633 ISAH Conjunctivitis, unspecified TIDAK

137 1/13/2014 424324541 DINDIN Acute upper respiratory infection, unspecified TIDAK
No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJUK CETAK
persalinan
138 1/13/2014 424338603 LENI Acute tonsillitis, unspecified TIDAK
askes
139 1/13/2014 1004322802 UUN Acute amoebic dysentery TIDAK

140 1/13/2014 1004323318 ARIP Dermatitis, unspecified TIDAK

141 1/11/2014 423188109 CUCUM Myalgia TIDAK

142 1/11/2014 423188482 AGUS Scabies TIDAK

143 1/11/2014 423761793 RATNA Conjunctivitis, unspecified TIDAK

144 1/11/2014 423816186 MIMIH Disorder of eye and adnexa, unspecified TIDAK

145 1/11/2014 424088818 NIA Rheumatism, unspecified TIDAK

146 1/11/2014 424101475 IMAM MAULANA Acute upper respiratory infection, unspecified TIDAK

147 1/10/2014 422705248 DIDIN Influenza with oth resp manifestation virus not identified TIDAK

148 1/10/2014 422996163 EEN Rheumatism, unspecified TIDAK

149 1/10/2014 422997693 CEPI Paragonimiasis TIDAK

150 1/10/2014 423402693 RIPA Paragonimiasis TIDAK

151 1/10/2014 423611469 NINA Hypertensive heart disease with (congestive) heart failure TIDAK

152 1/10/2014 423614384 RAPI Diarrhoea and gastroenteritis of presumed infectious origin TIDAK

153 1/10/2014 423770196 UUD Myalgia TIDAK

154 1/10/2014 424087874 ELSYA Gastric ulcer, acute with haemorrhage TIDAK

155 1/10/2014 424101418 EEM Dermatitis, unspecified TIDAK

156 1/10/2014 424154801 IYON Rheumatism, unspecified TIDAK

157 1/10/2014 424293309 II RUSTANDI Paranoid schizophrenia TIDAK


No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJUK CETAK
persalinan
158 1/9/2014 423517601 HILMAN Locl-rel(foc)(part)idiop epilep/ epilptic syn seiz locl ons TIDAK
askes
159 1/9/2014 424061177 WINARTI Unspecified contact dermatitis, unspecified cause TIDAK

160 1/9/2014 424135236 RINA Nummular dermatitis TIDAK

161 1/9/2014 424173868 PATIMAH Rheumatism, unspecified TIDAK

162 1/9/2014 1004325546 UMUN Hypertensive heart disease with (congestive) heart failure TIDAK

163 1/8/2014 423622214 EVI Y Rheumatism, unspecified TIDAK

164 1/8/2014 423928495 IMAS Rheumatism, unspecified TIDAK

165 1/8/2014 424101418 EEM Dermatitis, unspecified TIDAK

166 1/8/2014 424276446 ADE Gastric ulcer, acute with haemorrhage TIDAK

167 1/8/2014 1004324501 DODO Rheumatism, unspecified TIDAK

168 1/7/2014 422791132 SOFIA Cutaneous abscess, furuncle and carbuncle of face TIDAK

169 1/7/2014 423157364 MAMAH Urethral abscess TIDAK

170 1/7/2014 423505473 JUMAENI Influenza with pneumonia, virus not identified TIDAK

171 1/7/2014 423611469 NINA Hypertension, stage I TIDAK

172 1/7/2014 423614057 AAN Disorder of skin and subcutaneous tissue, unspecified TIDAK

173 1/7/2014 423614103 NENAH Gastritis, unspecified TIDAK

174 1/7/2014 423614384 RAPI Acute laryngopharyngitis TIDAK

175 1/7/2014 424333653 RISITA Nummular dermatitis TIDAK

176 1/6/2014 423426306 ADE ARIAH Essential (primary) hypertension TIDAK

177 1/6/2014 423517814 SALWA Acute upper respiratory infection, unspecified TIDAK
No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJUK CETAK
persalinan
178 1/6/2014 423552914 EUIS ANI Other acute gastritis TIDAK
askes
179 1/6/2014 423819944 ROJAK Influenza with oth resp manifestation virus not identified TIDAK

180 1/6/2014 423941444 ENDAN Dermatitis, unspecified TIDAK

181 1/6/2014 423943132 SORAYA Diarrhoea and gastroenteritis of presumed infectious origin TIDAK

182 1/6/2014 424002431 ASEP Diarrhoea and gastroenteritis of presumed infectious origin TIDAK

183 1/6/2014 424101418 EEM Dermatitis, unspecified TIDAK

184 1/6/2014 424232684 DZIKRI Acute tonsillitis, unspecified TIDAK

185 1/6/2014 424305911 RAISAL RAHMANIA Influenza with oth resp manifest influenza virus identified TIDAK

186 1/6/2014 424305944 SAHRUL AJI M Cutaneous abscess, furuncle and carbuncle of face TIDAK

187 1/4/2014 423006118 AOH Periodontal disease, unspecified TIDAK

188 1/4/2014 423390824 ADE J Dermatitis, unspecified TIDAK

189 1/4/2014 423392027 AGI Dermatitis, unspecified TIDAK

190 1/4/2014 423634994 DULOH Dermatitis, unspecified TIDAK

191 1/4/2014 424101418 EEM Dermatitis, unspecified TIDAK

192 1/4/2014 424346005 TITI Neuralgia and neuritis, unspecified TIDAK

193 1/4/2014 424370259 SOBAR Acute upper respiratory infection, unspecified TIDAK

194 1/4/2014 424645154 DADAN Acute upper respiratory infection, unspecified TIDAK

195 1/4/2014 1004325502 MALA Acute upper respiratory infection, unspecified TIDAK

196 1/3/2014 423048003 YUDI AWAN Bronchitis, not specified as acute or chronic TIDAK

197 1/3/2014 423182799 JAMJAM Cutaneous strongyloidiasis TIDAK


No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJUK CETAK
persalinan
198 1/3/2014 423411851 ATING Conjunctivitis, unspecified TIDAK
askes
199 1/3/2014 423517601 HILMAN Locl-rel(foc)(part)idiop epilep/ epilptic syn seiz locl ons TIDAK

200 1/3/2014 423738134 ENUR Gnathostomiasis TIDAK

201 1/3/2014 423739438 ASEP P Gnathostomiasis TIDAK

202 1/3/2014 423816895 IIS Acute myocardial infarction, unspecified TIDAK

203 1/3/2014 423942952 UKAS Myalgia TIDAK

204 1/2/2014 69190446 SUKI Rheumatism, unspecified TIDAK

205 1/2/2014 69879633 SILPI LATIPAH Acute cystitis TIDAK

206 1/2/2014 422600275 JALIL Hypertension, stage I TIDAK

207 1/2/2014 423436386 WULANDARI Influenza with pneumonia, virus not identified TIDAK

208 1/2/2014 423862018 AI DEWI Myalgia TIDAK

209 1/2/2014 423958408 SETIAWAN Scabies TIDAK

210 1/2/2014 423967768 DENMI Cutaneous abscess, furuncle and carbuncle of face TIDAK

211 1/2/2014 423968444 SOPIANA Scabies TIDAK

212 1/2/2014 424101418 EEM Dermatitis, unspecified TIDAK

213 1/2/2014 424133651 ADE LINDA Gastric ulcer, acute with haemorrhage TIDAK

214 1/2/2014 424134369 NIRA Nummular dermatitis TIDAK

215 1/2/2014 424223188 LUTFI Acute amoebic dysentery TIDAK

216 1/2/2014 424259987 ODAH Rheumatism, unspecified TIDAK

217 1/2/2014 424268008 IIS Streptococcal pharyngitis TIDAK

218 1/2/2014 424510143 LILIS Duodenal ulcer, acute with perforation TIDAK

219 1/2/2014 424598848 IKOH Hypertensive heart disease with (congestive) heart failure TIDAK
Daftar Kunjungan Peserta bpjs/ askes/ jamkesmas/
Puskesmas
jampersal
: Sukahurip
Bulan : Januari 2014
Jumlah Kunjungan : 220
Jumlah Yang dirujuk : 19

No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DermatGastritScabieAsthmaRheuma


Acute Influe DiarrhTyphoi
1 1/30/2014 423641204 ITI Unspecified injury of lower leg

2 1/30/2014 423701763 AHMAD GHOZALI Acute tonsillitis, unspecified


3 1/30/2014 424331188 AAH Dermatitis, unspecified 1
4 1/30/2014 424616872 ITING Dermatitis, unspecified 1
5 1/30/2014 424661703 DIDIN MUHIDIN Paratyphoid fever, unspecified
6 1/30/2014 1266108816 ALIT rukilah Myalgia
7 1/30/2014 1267111539 TETI SUHAETI Comp follow abortion and ectopic and molar preg
8 1/29/2014 423097569 AYAT Asthma, unspecified 1
9 1/29/2014 423665043 ROHMAN Asthma, unspecified 1
10 1/29/2014 423738134 ENUR Scabies 1
11 1/29/2014 423739438 ASEP P Scabies 1
12 1/29/2014 423793721 NURHAYATI Single spontaneous delivery, unspecified
13 1/29/2014 424311039 ENUNG Fever, unspecified
14 1/29/2014 424315462 ADE SOPIAH Dermatitis, unspecified 1
15 1/29/2014 424494729 SITI NURAENI Acute upper respiratory infection, unspecified 1
16 1/29/2014 1266228538 WARJO Asthma, unspecified 1
17 1/28/2014 423000314 IHAH Low back pain
18 1/28/2014 423695766 ANA Asthma, unspecified 1
19 1/28/2014 423843085 OJAH Essential (primary) hypertension
20 1/28/2014 424207732 EMPUNG Gastritis, unspecified 1
21 1/28/2014 424285626 TINI Acute upper respiratory infection, unspecified 1
22 1/28/2014 424286853 NISA Acute upper respiratory infection, unspecified 1
23 1/28/2014 424290633 ISAH Asthma, unspecified 1
24 1/27/2014 69879903 ENI KARTINI Low back pain
25 1/27/2014 411873939 EUIS Acute laryngopharyngitis
26 1/27/2014 422681646 TINO Other disorders of nervous system, not elsewhere c
27 1/27/2014 422909864 YAYAH Moderate pre-eclampsia
28 1/27/2014 422999627 IMAR Unspecified diabetes mellitus without complicatio
29 1/27/2014 423236913 WIWIN Dermatitis, unspecified 1
30 1/27/2014 423662365 IMAS Gastritis, unspecified 1
31 1/27/2014 423671769 PIAH Rheumatism, unspecified 1
32 1/27/2014 423943795 UIS Influenza with oth resp manifestation virus not ide 1
33 1/27/2014 424054089 RINI Hypotension, unspecified
34 1/27/2014 424101418 EEM Unspecified diabetes mellitus without complicatio
35 1/27/2014 424330481 CAHYA Typhoid fever 1
36 1/27/2014 424330536 DIAN Acute upper respiratory infection, unspecified 1
37 1/27/2014 424342372 YAYAT Conjunctivitis, unspecified
38 1/27/2014 424371813 ILOT Low back pain
39 1/27/2014 424564367 ROKAYAH Gastritis, unspecified 1
40 1/27/2014 424654986 AMAH PATIMAH Gastritis, unspecified 1
41 1/27/2014 424656527 ASEP M Disease of jaws, unspecified
42 1/26/2014 422770498 YUYUN Diarrhoea and gastroenteritis of presumed infectio 1
43 1/26/2014 423947834 KOMARIYAH Single spontaneous delivery, unspecified
44 1/25/2014 423436408 IMA Gastritis, unspecified 1
45 1/24/2014 422848754 ENYAT Diarrhoea and gastroenteritis of presumed infectio 1
46 1/24/2014 423517601 HILMAN Epilepsy, unspecified
47 1/24/2014 423862209 CECEP Influenza with oth resp manifestation virus not ide 1
48 1/23/2014 69037211 YANI RAHMAYANI Gastritis, unspecified 1
49 1/23/2014 69879453 BAISUDIN Influenza with oth resp manifestation virus not ide 1
50 1/23/2014 423104714 ABDUL MAJID Influenza with oth resp manifestation virus not ide 1
No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA
51 1/23/2014 423339816 UNDANG Typhoid fever 1
52 1/23/2014 424293704 AI YUNINGSIH Gastritis, unspecified 1
53 1/23/2014 424329895 DEWI Influenza with oth resp manifestation virus not ide 1
54 1/23/2014 424361272 INDI Other specified diseases of upper respiratory tract
55 1/23/2014 1004325502 MALA Hypertensive heart disease with (congestive) heart
56 1/23/2014 1004325546 UMUN Rheumatism, unspecified 1
57 1/23/2014 1266107286 icha fatmawati Single spontaneous delivery, unspecified
58 1/22/2014 69353504 AYI SUMIYATI Acute upper respiratory infection, unspecified 1
59 1/22/2014 69669459 YAHYA HIDAYAT Influenza with oth resp manifestation virus not ide 1
60 1/22/2014 422508205 NOPI Typhoid fever 1
61 1/22/2014 422600275 JALIL Essential (primary) hypertension
62 1/22/2014 423237756 WULAN Scabies 1
63 1/22/2014 423441909 PIAH Gastritis, unspecified 1
64 1/22/2014 423612832 SITI Unspecified acute lower respiratory infection
65 1/22/2014 423694541 TATI Gastritis, unspecified 1
66 1/22/2014 423694708 ARIP RAHMAN Acute upper respiratory infection, unspecified 1
67 1/22/2014 423759947 UCUP Myalgia
68 1/22/2014 424103477 ENI Influenza with oth resp manifestation virus not ide 1
69 1/22/2014 424335745 MOCH IRFAN Other specified diseases of upper respiratory tract
70 1/22/2014 1004324501 DODO Gastritis, unspecified 1
71 1/21/2014 422669024 HENI Conjunctivitis, unspecified
72 1/21/2014 422728503 AEP Influenza with oth resp manifestation virus not ide 1
73 1/21/2014 423440616 ELSA Other specified diseases of upper respiratory tract
74 1/21/2014 423645243 DANDI Epilepsy, unspecified
75 1/21/2014 423754255 OCIH Rheumatism, unspecified 1
76 1/21/2014 423831216 EMAR Acute upper respiratory infection, unspecified 1
77 1/21/2014 423832577 SITI LISNAWATI Gastritis, unspecified 1
78 1/21/2014 423972652 MULYANA Diarrhoea and gastroenteritis of presumed infectio 1
79 1/21/2014 424053404 KOKOM Influenza with oth resp manifestation virus not ide 1
80 1/21/2014 424293309 II RUSTANDI Essential (primary) hypertension
81 1/20/2014 423236913 WIWIN Acute cystitis
82 1/20/2014 423517601 HILMAN Epilepsy, unspecified
83 1/20/2014 423599152 DIKRI Cutaneous abscess, furuncle and carbuncle, unspec
84 1/20/2014 423664244 ARI ANGGARA Angina pectoris, unspecified
85 1/20/2014 423665043 ROHMAN Gastroduodenitis, unspecified
86 1/20/2014 423744028 ASIH Keratitis, unspecified
87 1/20/2014 423965079 JAMILAH Gastritis, unspecified 1
88 1/20/2014 423965507 WIWIN Gastritis, unspecified 1
89 1/20/2014 424021746 ADE SOLIHIN Hyperplasia of prostate
90 1/20/2014 424043594 ADAH Diarrhoea and gastroenteritis of presumed infectio 1
91 1/20/2014 424114255 YUYUN Angina pectoris, unspecified
92 1/20/2014 1004324556 CICIN Angina pectoris, unspecified
93 1/20/2014 1004324782 HOLILAH Rheumatism, unspecified 1
94 1/18/2014 422647481 ADE EMAR Other and unspec diseases of pulp and periapical t
95 1/18/2014 422705248 DIDIN Acute sinusitis, unspecified
96 1/18/2014 423097705 DEDE Diarrhoea and gastroenteritis of presumed infectio 1
97 1/18/2014 423210881 DEDE Neuralgia and neuritis, unspecified
98 1/18/2014 423428905 DEDE IDA Gastritis, unspecified 1
99 1/18/2014 424189462 HENI MARWATI Dermatitis, unspecified 1
100 1/18/2014 424351675 ENDANG Paratyphoid fever, unspecified
101 1/18/2014 424646234 PITRI N Dermatitis, unspecified 1
102 1/17/2014 423408532 DIAH Rheumatism, unspecified 1
103 1/17/2014 423410951 ADE Dermatitis, unspecified 1
104 1/17/2014 423423033 NAIN Acute amoebic dysentery

No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA


105 1/17/2014 423680466 IRIN Rheumatism, unspecified 1
106 1/17/2014 424225642 KAKAY Other specified diseases of upper respiratory tract
107 1/17/2014 424311039 ENUNG Dermatitis, unspecified 1
108 1/17/2014 424315462 ADE SOPIAH Scabies 1
109 1/17/2014 424399634 SUMIATI Dermatitis, unspecified 1
110 1/16/2014 68997565 DJUBAEDAH Gastroduodenitis, unspecified
111 1/16/2014 422972065 ASEP ANOM Rheumatism, unspecified 1
112 1/16/2014 423076487 ITA ROSITA Influenza with oth resp manifestation virus not ide 1
113 1/16/2014 423611469 NINA Acute upper respiratory infection, unspecified 1
114 1/16/2014 423614349 TUSUF Fever, unspecified
115 1/16/2014 423738134 ENUR Dermatitis, unspecified 1
116 1/16/2014 423739438 ASEP P Dermatitis, unspecified 1
117 1/16/2014 423816849 ASUM Other and unspec diseases of pulp and periapical t
118 1/15/2014 69669459 YAHYA HIDAYAT Acute upper respiratory infection, unspecified 1
119 1/15/2014 422782762 IHAT SOLIHAT Unspecified contact dermatitis, unspecified cause
120 1/15/2014 423055607 WENSISLAUS W Conjunctivitis, unspecified
121 1/15/2014 423236362 ENUNG Dermatitis, unspecified 1
122 1/15/2014 423314267 YAYAN Gastritis, unspecified 1
123 1/15/2014 423890313 ELSA Scabies 1
124 1/15/2014 423923861 UNDANG MASUM Diarrhoea and gastroenteritis of presumed infectio 1
125 1/15/2014 424101058 AHMAD HIDAYAT Acute upper respiratory infection, unspecified 1
126 1/13/2014 423019293 ADE R Ascariasis, unspecified
127 1/13/2014 423119621 INUN Ascariasis, unspecified
128 1/13/2014 423462069 AA ABDUL KOHAR Acute upper respiratory infection, unspecified 1
129 1/13/2014 423729595 UWIN Gastritis, unspecified 1
130 1/13/2014 423816581 AGUS Paratyphoid fever, unspecified
131 1/13/2014 423865822 YATI Single spontaneous delivery, unspecified
132 1/13/2014 423902103 HAYATI Gastritis, unspecified 1
133 1/13/2014 423967566 MASITOH Diarrhoea and gastroenteritis of presumed infectio 1
134 1/13/2014 424077434 ADE LILIS Typhoid fever 1
135 1/13/2014 424097908 TETEH YATI Acute upper respiratory infection, unspecified 1
136 1/13/2014 424146385 ASRI Influenza with oth resp manifestation virus not ide 1
137 1/13/2014 424290633 ISAH Conjunctivitis, unspecified
138 1/13/2014 424324541 DINDIN Acute upper respiratory infection, unspecified 1
139 1/13/2014 424338603 LENI Acute tonsillitis, unspecified
140 1/13/2014 1004322802 UUN Acute amoebic dysentery
141 1/13/2014 1004323318 ARIP Dermatitis, unspecified 1
142 1/11/2014 423188109 CUCUM Myalgia
143 1/11/2014 423188482 AGUS Scabies 1
144 1/11/2014 423761793 RATNA Conjunctivitis, unspecified
145 1/11/2014 423816186 MIMIH Disorder of eye and adnexa, unspecified
146 1/11/2014 424088818 NIA Rheumatism, unspecified 1
147 1/11/2014 424101475 IMAM MAULANA Acute upper respiratory infection, unspecified 1
148 1/10/2014 422705248 DIDIN Influenza with oth resp manifestation virus not ide 1
149 1/10/2014 422996163 EEN Rheumatism, unspecified 1
150 1/10/2014 422997693 CEPI Paragonimiasis
151 1/10/2014 423402693 RIPA Paragonimiasis
152 1/10/2014 423611469 NINA Hypertensive heart disease with (congestive) heart
153 1/10/2014 423614384 RAPI Diarrhoea and gastroenteritis of presumed infectio 1
154 1/10/2014 423770196 UUD Myalgia
155 1/10/2014 424087874 ELSYA Gastric ulcer, acute with haemorrhage
156 1/10/2014 424101418 EEM Dermatitis, unspecified 1
157 1/10/2014 424154801 IYON Rheumatism, unspecified 1
158 1/10/2014 424293309 II RUSTANDI Paranoid schizophrenia

No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA


159 1/9/2014 423517601 HILMAN Locl-rel(foc)(part)idiop epilep/ epilptic syn seiz locl
160 1/9/2014 424061177 WINARTI Unspecified contact dermatitis, unspecified cause
161 1/9/2014 424135236 RINA Nummular dermatitis
162 1/9/2014 424173868 PATIMAH Rheumatism, unspecified 1
163 1/9/2014 1004325546 UMUN Hypertensive heart disease with (congestive) heart
164 1/8/2014 423622214 EVI Y Rheumatism, unspecified 1
165 1/8/2014 423928495 IMAS Rheumatism, unspecified 1
166 1/8/2014 424101418 EEM Dermatitis, unspecified 1
167 1/8/2014 424276446 ADE Gastric ulcer, acute with haemorrhage
168 1/8/2014 1004324501 DODO Rheumatism, unspecified 1
169 1/7/2014 422791132 SOFIA Cutaneous abscess, furuncle and carbuncle of face
170 1/7/2014 423157364 MAMAH Urethral abscess
171 1/7/2014 423505473 JUMAENI Influenza with pneumonia, virus not identified 1
172 1/7/2014 423611469 NINA Hypertension, stage I
173 1/7/2014 423614057 AAN Disorder of skin and subcutaneous tissue, unspecif
174 1/7/2014 423614103 NENAH Gastritis, unspecified 1
175 1/7/2014 423614384 RAPI Acute laryngopharyngitis
176 1/7/2014 424333653 RISITA Nummular dermatitis
177 1/6/2014 423426306 ADE ARIAH Essential (primary) hypertension
178 1/6/2014 423517814 SALWA Acute upper respiratory infection, unspecified 1
179 1/6/2014 423552914 EUIS ANI Other acute gastritis
180 1/6/2014 423819944 ROJAK Influenza with oth resp manifestation virus not ide 1
181 1/6/2014 423941444 ENDAN Dermatitis, unspecified 1
182 1/6/2014 423943132 SORAYA Diarrhoea and gastroenteritis of presumed infectio 1
183 1/6/2014 424002431 ASEP Diarrhoea and gastroenteritis of presumed infectio 1
184 1/6/2014 424101418 EEM Dermatitis, unspecified 1
185 1/6/2014 424232684 DZIKRI Acute tonsillitis, unspecified
186 1/6/2014 424305911 RAISAL RAHMANIA Influenza with oth resp manifest influenza virus ide 1
187 1/6/2014 424305944 SAHRUL AJI M Cutaneous abscess, furuncle and carbuncle of face
188 1/4/2014 423006118 AOH Periodontal disease, unspecified
189 1/4/2014 423390824 ADE J Dermatitis, unspecified 1
190 1/4/2014 423392027 AGI Dermatitis, unspecified 1
191 1/4/2014 423634994 DULOH Dermatitis, unspecified 1
192 1/4/2014 424101418 EEM Dermatitis, unspecified 1
193 1/4/2014 424346005 TITI Neuralgia and neuritis, unspecified
194 1/4/2014 424370259 SOBAR Acute upper respiratory infection, unspecified 1
195 1/4/2014 424645154 DADAN Acute upper respiratory infection, unspecified 1
196 1/4/2014 1004325502 MALA Acute upper respiratory infection, unspecified 1
197 1/3/2014 423048003 YUDI AWAN Bronchitis, not specified as acute or chronic
198 1/3/2014 423182799 JAMJAM Cutaneous strongyloidiasis
199 1/3/2014 423411851 ATING Conjunctivitis, unspecified
200 1/3/2014 423517601 HILMAN Locl-rel(foc)(part)idiop epilep/ epilptic syn seiz locl
201 1/3/2014 423738134 ENUR Gnathostomiasis
202 1/3/2014 423739438 ASEP P Gnathostomiasis
203 1/3/2014 423816895 IIS Acute myocardial infarction, unspecified
204 1/3/2014 423942952 UKAS Myalgia
205 1/2/2014 69190446 SUKI Rheumatism, unspecified 1
206 1/2/2014 69879633 SILPI LATIPAH Acute cystitis
207 1/2/2014 422600275 JALIL Hypertension, stage I
208 1/2/2014 423436386 WULANDARI Influenza with pneumonia, virus not identified 1
209 1/2/2014 423862018 AI DEWI Myalgia
210 1/2/2014 423958408 SETIAWAN Scabies 1
211 1/2/2014 423967768 DENMI Cutaneous abscess, furuncle and carbuncle of face
212 1/2/2014 423968444 SOPIANA Scabies 1

No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA


213 1/2/2014 424101418 EEM Dermatitis, unspecified 1
214 1/2/2014 424133651 ADE LINDA Gastric ulcer, acute with haemorrhage
215 1/2/2014 424134369 NIRA Nummular dermatitis
216 1/2/2014 424223188 LUTFI Acute amoebic dysentery
217 1/2/2014 424259987 ODAH Rheumatism, unspecified 1
218 1/2/2014 424268008 IIS Streptococcal pharyngitis
219 1/2/2014 424510143 LILIS Duodenal ulcer, acute with perforation
220 1/2/2014 424598848 IKOH Hypertensive heart disease with (congestive) heart
22 18 8 5 16 18 16 10 4
1 2 3 4 5 6 7 8 9
EssentMyalgiAcute tFever, Conjunc
UnspecNummul
GnathoOther CutaneSingle spontaneous delivery, unspecified

1
1

1
1

1
1

1
1

1
1
1

1
1

1
1

1
8 6 5 2 6 2 3 2 4 4 3
10 11 12 13 14 15 16 17 18 19 20
Daftar Kunjungan Peserta bpjs/ askes/
Puskesmas
jamkesmas/ jampersal
: Sukahurip
Bulan : Februari 2014
Jumlah Kunjungan : 261
Jumlah Yang dirujuk : 39

No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DermGastScabAsthRheuAcutInfl Diar TyphEsseMyalAcute


FeveConjOtheGastOthe
1 2/28/2014 423951041 YANI Disorder of skin and subcutaneou
2 2/28/2014 423982991 HERI Dermatitis, unspecified 1
3 2/28/2014 424060233 IIN Rheumatism, unspecified 1
4 2/28/2014 424202949 IKA Typhoid fever 1
5 2/27/2014 411864366 ANDIKA Influenza with oth resp manifesta 1
6 2/27/2014 423855876 ENUNG Gastritis, unspecified 1
7 2/27/2014 423974305 M RAMDAN Unilateral or unspecified inguin
8 2/27/2014 424114255 YUYUN Heart failure, unspecified
9 2/27/2014 424131186 YUYU YUNIANTI Acute upper respiratory infectio 1
10 2/27/2014 424132795 SRI H Acute upper respiratory infectio 1
11 2/27/2014 424290082 DIAH Rheumatism, unspecified 1
12 2/27/2014 424489252 USEP Dermatitis, unspecified 1
13 2/27/2014 1004328718 AJUM Influenza with oth resp manifesta 1
14 2/26/2014 423665111 KOMARIAH Dental caries, unspecified
15 2/26/2014 424030847 SIFA Otitis media, unspecified
16 2/26/2014 424402885 RASID Typhoid fever 1
17 2/26/2014 424615072 CIDAH Influenza with oth resp manifesta 1
18 2/26/2014 424617197 HILDA Acute upper respiratory infectio 1
19 2/26/2014 424617434 TANIA Acute upper respiratory infectio 1
20 2/26/2014 1266228538 WARJO Influenza with oth resp manifesta 1
21 2/26/2014 1275706372 EMPUN Other specified nontoxic goitre
22 2/25/2014 69266327 KOMAR Rheumatism, unspecified 1
23 2/25/2014 423611458 YADI Rheumatism, unspecified 1
24 2/25/2014 423614349 TUSUF Disorder of skin and subcutaneou
25 2/25/2014 423908177 AGUS Conjunctivitis, unspecified 1
26 2/25/2014 423925784 OOM Rheumatism, unspecified 1
27 2/25/2014 424077434 ADE LILIS Acute upper respiratory infectio 1
28 2/25/2014 424333596 ATING Rheumatism, unspecified 1
29 2/25/2014 424333653 RISITA Dermatitis, unspecified 1
30 2/25/2014 424609378 AGNI Acute upper respiratory infectio 1
31 2/25/2014 1262938094 rifail rajab Hypospadias, penile
32 2/25/2014 1273630151 acip Asthma, unspecified 1
33 2/24/2014 69088263 RIDWAN NUR ALAM Dermatitis, unspecified 1
34 2/24/2014 422953266 YAYA Retention of urine
35 2/24/2014 422981368 ETI Inflammation of eyelid, unspecif
36 2/24/2014 423033478 HAJAR Dental caries, unspecified
37 2/24/2014 423033794 SULISTIANI Influenza with oth resp manifesta 1
38 2/24/2014 423119621 INUN Rheumatism, unspecified 1
39 2/24/2014 423120328 YUDI Dermatitis, unspecified 1
40 2/24/2014 423440943 CIKA Acute pharyngitis, unspecified
41 2/24/2014 423482826 ELIS SUPRIATIN Paratyphoid fever, unspecified
42 2/24/2014 423482905 DONI Unspecified acute lower respirat
43 2/24/2014 423622664 EEN Epilepsy, unspecified
44 2/24/2014 423786824 ARIP Acute upper respiratory infectio 1
45 2/24/2014 423862209 CECEP Acute myocardial infarction, uns
46 2/24/2014 424097908 TETEH YATI Essential (primary) hypertension 1
47 2/24/2014 424338671 MUHAMMAD EGEL MDental caries, unspecified
48 2/24/2014 424583032 POPONG Dermatitis, unspecified 1
49 2/24/2014 1256080623 IKA Single spontaneous delivery, uns
No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA

50 2/24/2014 1267777146 elisa laila sari h Epilepsy, unspecified


51 2/24/2014 1270401625 NUNUR NURHAYATI Other abortion, incomplete, comp
52 2/22/2014 423326294 M RIDWAN Acute upper respiratory infectio 1
53 2/22/2014 423339816 UNDANG Disease of jaws, unspecified
54 2/22/2014 423341392 SITI ISMA NP Other specified general symptom
55 2/22/2014 423655907 ETI Low back pain
56 2/22/2014 423804497 NURHAYATI Acute upper respiratory infectio 1
57 2/22/2014 423942952 UKAS Influenza with oth resp manifesta 1
58 2/22/2014 424351124 DEDE ROHAYATI Typhoid fever 1
59 2/22/2014 424644568 JAJA Asthma, unspecified 1
60 2/21/2014 422869724 ILHAM Fever, unspecified 1
61 2/21/2014 423236913 WIWIN Dermatitis, unspecified 1
62 2/21/2014 423428859 MOMON Scabies 1
63 2/21/2014 423429243 ENTIT Unspecified contact dermatitis,
64 2/21/2014 423739438 ASEP P Diarrhoea and gastroenteritis of 1
65 2/21/2014 423791638 IMMA S Dermatitis, unspecified 1
66 2/21/2014 424146385 ASRI Influenza with oth resp manifesta 1
67 2/21/2014 424189462 HENI MARWATI Disorder of skin and subcutaneou
68 2/21/2014 424324541 DINDIN Low back pain
69 2/21/2014 424609378 AGNI Typhoid fever 1
70 2/21/2014 1004325862 IDAH Acute upper respiratory infectio 1
71 2/21/2014 1274394508 oki hermawan Acute appendicitis, unspecified
72 2/20/2014 422698871 NURUL Influenza with oth resp manifesta 1
73 2/20/2014 422699995 RIF SADIYAH Other and unspec diseases of pul 1
74 2/20/2014 423460361 ANGGUN Acute upper respiratory infectio 1
75 2/20/2014 423609581 IRFAN Other acute sinusitis
76 2/20/2014 423927606 SRI Dermatitis, unspecified 1
77 2/20/2014 424288989 PIKRI Acute upper respiratory infectio 1
78 2/20/2014 424290633 ISAH Dermatitis, unspecified 1
79 2/20/2014 424661703 DIDIN MUHIDIN Disorder of skin and subcutaneou
80 2/20/2014 1270353284 TRI YUDI APRIYONO Angina pectoris, unspecified
81 2/19/2014 68997565 DJUBAEDAH Bronchopneumonia, unspecified
82 2/19/2014 422645556 IID Other and unspec diseases of pul 1
83 2/19/2014 422950779 NURHAYATI Disorder of teeth and supporting
84 2/19/2014 423237756 WULAN Scabies 1
85 2/19/2014 423467932 YATI Essential (primary) hypertension 1
86 2/19/2014 423625869 CUCU Dental caries, unspecified
87 2/19/2014 423672344 RIDA Bronchopneumonia, unspecified
88 2/19/2014 424390116 RESTI Acute upper respiratory infectio 1
89 2/19/2014 424504945 DEWI Essential (primary) hypertension 1
90 2/19/2014 424506778 WINA Acute upper respiratory infectio 1
91 2/19/2014 424655559 NEGRESI Bronchopneumonia, unspecified
92 2/19/2014 1261627198 SITI NURHAYATI Tuberculosis of lung, confirmed
93 2/18/2014 422946898 ENAH Rheumatism, unspecified 1
94 2/18/2014 423000314 IHAH Essential (primary) hypertension 1
95 2/18/2014 423149714 PARHAN Acute upper respiratory infectio 1
96 2/18/2014 423389013 SALEH Rheumatism, unspecified 1
97 2/18/2014 423645243 DANDI Epilepsy, unspecified
98 2/18/2014 423670004 NAI Influenza with oth resp manifesta 1
99 2/18/2014 423965507 WIWIN Essential (primary) hypertension 1
100 2/18/2014 424029835 PIPIH Acute upper respiratory infectio 1
101 2/18/2014 424031769 AISYAH Acute upper respiratory infectio 1
102 2/18/2014 424609378 AGNI Typhoid fever 1
103 2/18/2014 1004324556 CICIN Angina pectoris, unspecified

No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA


104 2/18/2014 1266228538 WARJO Asthma, unspecified 1
105 2/17/2014 422912305 ADAY Cutaneous abscess, furuncle and
106 2/17/2014 423104714 ABDUL MAJID Gastritis, unspecified 1
107 2/17/2014 423188109 CUCUM Conjunctivitis, unspecified 1
108 2/17/2014 423541438 WANDA Acute upper respiratory infectio 1
109 2/17/2014 423665043 ROHMAN Asthma, unspecified 1
110 2/17/2014 423708726 ATENG Cutaneous abscess, furuncle and
111 2/17/2014 424159097 SITI Conjunctivitis, unspecified 1
112 2/17/2014 424259987 ODAH Rheumatism, unspecified 1
113 2/17/2014 424338603 LENI Rheumatism, unspecified 1
114 2/17/2014 1266099276 BABA BAHRUDIN Tb lung without mention of bact
115 2/15/2014 69393519 BANA SIHABUDIN Gastritis, unspecified 1
116 2/15/2014 423033478 HAJAR Dental caries, unspecified
117 2/15/2014 423098897 RIPALDI Fever, unspecified 1
118 2/15/2014 423248894 WARIAH Acute amoebic dysentery
119 2/15/2014 423541901 ONI Acute upper respiratory infectio 1
120 2/15/2014 423599152 DIKRI Typhoid fever 1
121 2/15/2014 423685899 TITIN Influenza with oth resp manifesta 1
122 2/15/2014 424038677 RITA Influenza with oth resp manifesta 1
123 2/15/2014 424315833 VINA Gest [pregnancy-induced] hypert
124 2/15/2014 424330481 CAHYA Dermatitis, unspecified 1
125 2/15/2014 424583032 POPONG Dermatitis, unspecified 1
126 2/14/2014 423097569 AYAT Acute upper respiratory infectio 1
127 2/14/2014 423156341 ELIS HOLISOH Dermatitis, unspecified 1
128 2/14/2014 423423033 NAIN Acute upper respiratory infectio 1
129 2/14/2014 423449054 ENUNG Essential (primary) hypertension 1
130 2/14/2014 423475356 BIBAH Gastritis, unspecified 1
131 2/14/2014 424030847 SIFA Dermatitis, unspecified 1
132 2/14/2014 424131186 YUYU YUNIANTI Acute upper respiratory infectio 1
133 2/14/2014 424307373 AAH Gastritis, unspecified 1
134 2/14/2014 424641317 JUJUN JUNAEDI Scabies 1
135 2/14/2014 1004323836 OTANG Rheumatism, unspecified 1
136 2/14/2014 1270353284 TRI YUDI APRIYONO Angina pectoris with document
137 2/14/2014 1272367956 lina julianti Long labour, unspecified
138 2/13/2014 196057675 TJATJIH MINTARSIH Mechanical complication of intr
139 2/13/2014 423063494 YULIA Cellulitis, unspecified
140 2/13/2014 423188087 ISHAK Cutaneous abscess, furuncle and
141 2/13/2014 423739438 ASEP P Scabies 1
142 2/13/2014 423827122 RIJAL Amoebiasis, unspecified
143 2/13/2014 423832768 ANDIKA Influenza with oth resp manifesta 1
144 2/13/2014 423862806 RUSLI Acute amoebic dysentery
145 2/13/2014 424309904 DEWI Rotaviral enteritis
146 2/13/2014 424309937 AYU Typhoid fever 1
147 2/13/2014 424399634 SUMIATI Cutaneous abscess, furuncle and
148 2/13/2014 1262969054 I MULYANA Men & behav dis multiple/psycho
149 2/13/2014 1271549305 ADE NURLATIPAH Maternal care for transverse and
150 2/12/2014 423636568 DEDE SUDIN Paratyphoid fever, unspecified
151 2/12/2014 423843085 OJAH Essential (primary) hypertension 1
152 2/12/2014 424159209 EEN Cellulitis, unspecified
153 2/12/2014 424189462 HENI MARWATI Acute cystitis
154 2/12/2014 424352338 ABDUL BASIT Arthritis, unspecified
155 2/12/2014 424424046 DALPA Influenza with oth resp manifesta 1
156 2/12/2014 424574853 PAHRI Scabies 1
157 2/12/2014 424609378 AGNI Cellulitis of finger and toe

No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA


158 2/12/2014 1273679087 EUTIK Single spontaneous delivery, uns
159 2/11/2014 69181301 ACAH Essential (primary) hypertension 1
160 2/11/2014 423104714 ABDUL MAJID Essential (primary) hypertension 1
161 2/11/2014 423466356 DENDI Cellulitis, unspecified
162 2/11/2014 423656886 KAROM Rheumatism, unspecified 1
163 2/11/2014 423705172 LISEP Acute tonsillitis, unspecified 1
164 2/11/2014 423756033 HUDAIFAH Acute upper respiratory infectio 1
165 2/11/2014 423811934 PITRI Diarrhoea and gastroenteritis of 1
166 2/11/2014 423842591 NUNUNG Chronic ischaemic heart disease,
167 2/11/2014 424103477 ENI Myalgia 1
168 2/11/2014 424104311 DARWIS Acute upper respiratory infectio 1
169 2/11/2014 424166872 LUTFI Paratyphoid fever, unspecified
170 2/11/2014 424292016 AYI BABA Unspecified haemorrhoids witho
171 2/11/2014 1004325546 UMUN Essential (primary) hypertension 1
172 2/11/2014 1266228538 WARJO Asthma, unspecified 1
173 2/10/2014 411865828 DEDE AISAH Gastritis, unspecified 1
174 2/10/2014 423329218 JUJU Follicular cyst of ovary
175 2/10/2014 423411851 ATING Gastritis, unspecified 1
176 2/10/2014 423623272 BANDI Acute upper respiratory infectio 1
177 2/10/2014 423738134 ENUR Dermatitis, unspecified 1
178 2/10/2014 423739438 ASEP P Scabies 1
179 2/10/2014 423768521 ENUNG Gastritis, unspecified 1
180 2/10/2014 423768802 SERLI Gastritis, unspecified 1
181 2/10/2014 423923861 UNDANG MASUM Other and unspec diseases of pul 1
182 2/10/2014 424056249 TRIA Acute upper respiratory infectio 1
183 2/10/2014 424169482 LILIS Acute cystitis
184 2/10/2014 424333596 ATING Asthma, unspecified 1
185 2/10/2014 424335418 AIDAH Vomiting associated with other
186 2/10/2014 424490343 CECEP H Paratyphoid fever, unspecified
187 2/10/2014 424570454 FIRDA AULIA Dental caries, unspecified
188 2/10/2014 424637605 TRIYANA Acute tonsillitis, unspecified 1
189 2/8/2014 423236913 WIWIN Scabies 1
190 2/8/2014 423237756 WULAN Scabies 1
191 2/8/2014 423611469 NINA Periodontal disease, unspecified
192 2/8/2014 423751072 ATANG Typhoid fever 1
193 2/8/2014 424114255 YUYUN Other and unspecified disorders 1
194 2/8/2014 424402648 ADE WAWANG Typhoid fever 1
195 2/8/2014 424578205 ENTAR Paratyphoid fever, unspecified
196 2/8/2014 424609378 AGNI Scabies 1
197 2/8/2014 1266298086 muhammad ihsan f Unspecified acute lower respirat
198 2/7/2014 421954457 FIKRI Acute tonsillitis, unspecified 1
199 2/7/2014 423716769 ALIT Fever, unspecified 1
200 2/7/2014 423718233 IIS ROHAYATI Gastritis, unspecified 1
201 2/7/2014 423816895 IIS Rheumatism, unspecified 1
202 2/7/2014 423893068 SAEPUL Acute upper respiratory infectio 1
203 2/7/2014 423893103 EMPAT Essential (primary) hypertension 1
204 2/7/2014 423986073 AI TATAT Cutaneous abscess, furuncle and
205 2/7/2014 1004323318 ARIP Cutaneous abscess, furuncle and
206 2/7/2014 1267803022 IVAN Disorder of eye and adnexa, uns
207 2/6/2014 422980468 SAHAL Disease of jaws, unspecified
208 2/6/2014 423697533 OMAN Fever, unspecified 1
209 2/6/2014 424131186 YUYU YUNIANTI Acute upper respiratory infectio 1
210 2/6/2014 424324541 DINDIN Disorder of skin and subcutaneou

No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA


211 2/6/2014 424347827 GINA Paratyphoid fever, unspecified
212 2/6/2014 424490218 AI POPON Hypotension, unspecified
213 2/6/2014 1004322802 UUN Essential (primary) hypertension 1
214 2/6/2014 1004324782 HOLILAH Essential (primary) hypertension 1
215 2/6/2014 1261627198 SITI NURHAYATI Other and unspecified disorders 1
216 2/5/2014 423033794 SULISTIANI Unspecified acute lower respirat
217 2/5/2014 423652127 PITRI Dermatitis, unspecified 1
218 2/5/2014 423968444 SOPIANA Disorder of skin and subcutaneou
219 2/5/2014 424008641 HASANAH Cutaneous abscess, furuncle and
220 2/5/2014 424054181 RIAN Acute upper respiratory infectio 1
221 2/5/2014 424184117 RANI Acute pharyngitis, unspecified
222 2/5/2014 424402648 ADE WAWANG Acute upper respiratory infectio 1
223 2/5/2014 424570184 PATIMAH Dental caries, unspecified
224 2/5/2014 424637605 TRIYANA Acute upper respiratory infectio 1
225 2/5/2014 1004324501 DODO Essential (primary) hypertension 1
226 2/4/2014 423175689 IHAT Dental caries, unspecified
227 2/4/2014 423593875 ELIS Acute upper respiratory infectio 1
228 2/4/2014 423618039 ENDANG Low back pain
229 2/4/2014 423665043 ROHMAN Asthma, unspecified 1
230 2/4/2014 423697702 TASIH Fever, unspecified 1
231 2/4/2014 424077434 ADE LILIS Gastritis, unspecified 1
232 2/4/2014 424286302 SOBAN Cutaneous abscess, furuncle and
233 2/4/2014 424331188 AAH Myalgia 1
234 2/4/2014 424333596 ATING Myalgia 1
235 2/4/2014 424340548 AI MASKANAH Scabies 1
236 2/4/2014 424553624 HILDA Disorder of skin and subcutaneou
237 2/4/2014 424616872 ITING Essential (primary) hypertension 1
238 2/3/2014 69069284 EULIS FARIDA Dental caries, unspecified
239 2/3/2014 411902278 IRAN Dermatitis, unspecified 1
240 2/3/2014 422655131 ONOH Chronic ischaemic heart disease,
241 2/3/2014 423137878 NUR AISYAH Other and unspec diseases of pul 1
242 2/3/2014 423436408 IMA Acute cystitis
243 2/3/2014 423553217 IJANG ACEP Fever, unspecified 1
244 2/3/2014 423566774 DUDUNG Thalassaemia, unspecified
245 2/3/2014 423650474 CICIH SETIANSIH Dental caries, unspecified
246 2/3/2014 423942682 AGIS Unspecified acute lower respirat
247 2/3/2014 423943132 SORAYA Gastroduodenitis, unspecified 1
248 2/3/2014 424021746 ADE SOLIHIN Hyperplasia of prostate
249 2/3/2014 424054181 RIAN Influenza with oth resp manifesta 1
250 2/3/2014 424071404 NURLELA Fever, unspecified 1
251 2/3/2014 424570296 AI NURJANAH Other subarachnoid haemorrha
252 2/3/2014 424684091 ISMA Other disorders of nervous syste
253 2/3/2014 1004323882 INTAN Dermatitis, unspecified 1
254 2/1/2014 69181301 ACAH Essential (primary) hypertension 1
255 2/1/2014 69880195 FARIHAT Dermatitis, unspecified 1
256 2/1/2014 423182676 ANI Acute pharyngitis, unspecified
257 2/1/2014 423187874 ANA Gastroduodenitis, unspecified 1
258 2/1/2014 423327082 RINI HESTI Scabies 1
259 2/1/2014 424061177 WINARTI Influenza with oth resp manifesta 1
260 2/1/2014 424335363 OYON Gastroduodenitis, unspecified 1
261 2/1/2014 424365941 ADI Scabies 1
19 11 12 7 14 32 15 2 9 16 3 3 7 3 4 3 2
DisoDentCutaneous abscess, furuncle and carbuncle, unspecified
1

1
1

1
1

1
1
1
1

1
1

1
7 9 8
Daftar Kunjungan Peserta bpjs/ askes/ jamkesmas/
Puskesmas
jampersal
: Sukahurip
Bulan : Maret 2014
Jumlah Kunjungan : 266
Jumlah Yang dirujuk : 28

No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA Derma


GastrScabiAsth RheuAcuteInflu DiarrFeverEssenMyal
1 3/29/2014 423973675 MIRA Gastritis, unspecified 1
2 3/29/2014 424570454 FIRDA AULIA Acute tonsillitis, unspecified
3 3/29/2014 424570994 AHMAD G Acute tonsillitis, unspecified
4 3/29/2014 424572208 A KHOIRUL U Acute tonsillitis, unspecified
5 3/28/2014 423033478 HAJAR Acute tonsillitis, unspecified
6 3/28/2014 423148599 NUNUNG Diarrhoea and gastroenteritis of presumed infectious 1
7 3/28/2014 423742252 NITA SAKILA Acute tonsillitis, unspecified
8 3/28/2014 423853604 RENDI Influenza with oth resp manifestation virus not identi 1
9 3/28/2014 424109889 ATI Acute pharyngitis, unspecified
10 3/28/2014 424110025 IRHAM Other specified general symptoms and signs
11 3/28/2014 424293309 II RUSTANDI Schizophrenia, unspecified
12 3/28/2014 424309904 DEWI Diarrhoea and gastroenteritis of presumed infectious 1
13 3/28/2014 1004326503 WILDAN Acute tonsillitis, unspecified
14 3/28/2014 1004326615 AWANAH Acute tonsillitis, unspecified
15 3/27/2014 69266327 KOMAR Acute upper respiratory infection, unspecified 1
16 3/27/2014 424259987 ODAH Rheumatism, unspecified 1
17 3/26/2014 423635174 ALNAH Essential (primary) hypertension 1
18 3/26/2014 423740687 ATIKAH Other specified general symptoms and signs
19 3/26/2014 424289755 WIDANINGSIH Gastritis, unspecified 1
20 3/26/2014 424329895 DEWI Scabies 1
21 3/26/2014 424330481 CAHYA Acute serous otitis media
22 3/26/2014 1266228538 WARJO Asthma, unspecified 1
23 3/25/2014 422744488 HENI Gastritis, unspecified 1
24 3/25/2014 422936695 IAH Acute upper respiratory infection, unspecified 1
25 3/25/2014 422937448 FITRI Dermatitis, unspecified 1
26 3/25/2014 423149714 PARHAN Acute tonsillitis, unspecified
27 3/25/2014 423459314 AI NENI Gastritis, unspecified 1
28 3/25/2014 423460361 ANGGUN Pneumonia, unspecified
29 3/25/2014 423687418 ANDRI Dermatitis, unspecified 1
30 3/25/2014 423852658 ENGKOS Diarrhoea and gastroenteritis of presumed infectious 1
31 3/25/2014 423878826 NELI Disorder of skin and subcutaneous tissue, unspecifie
32 3/25/2014 424510143 LILIS Essential (primary) hypertension 1
33 3/25/2014 1004328718 AJUM Arthritis, unspecified
34 3/24/2014 69551188 ADE ATIKAH Myalgia 1
35 3/24/2014 207680163 IN IN KHAZANAH Acute upper respiratory infection, unspecified 1
36 3/24/2014 422600275 JALIL Gastritis, unspecified 1
37 3/24/2014 422944929 AACEP Acute amoebic dysentery
38 3/24/2014 423134515 DAYAT HIDAYAT Dermatitis, unspecified 1
39 3/24/2014 423183328 ANANDA Disorder of skin and subcutaneous tissue, unspecifie
40 3/24/2014 423662365 IMAS Acute serous otitis media
41 3/24/2014 423665043 ROHMAN Asthma, unspecified 1
42 3/24/2014 423665111 KOMARIAH Acute suppurative otitis media
43 3/24/2014 423771636 AHMAD Acute tonsillitis, unspecified
44 3/24/2014 424400218 SAEPUL MILAH Diarrhoea and gastroenteritis of presumed infectious 1
45 3/24/2014 424570994 AHMAD G Acute tonsillitis, unspecified
46 3/24/2014 424603642 MIMI Gastritis, unspecified 1
47 3/24/2014 1004325546 UMUN Myalgia 1
48 3/24/2014 1004328292 ENTAR Injury of eye and orbit, unspecified
49 3/24/2014 1277290078 iyah Other and unspecified disorders of circulatory syste
No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA
50 3/24/2014 1278297448 EJI A Heart failure, unspecified
51 3/24/2014 1284487852 RISYANTO Unilateral or unspecified inguinal hernia, without ob
52 3/23/2014 422955099 EUIS YUNINGSIH Influenza with oth resp manifestation virus not identi 1
53 3/22/2014 422996163 EEN Rheumatism, unspecified 1
54 3/22/2014 422998806 CACA Acute tonsillitis, unspecified
55 3/22/2014 423132917 OHAN Gastritis, unspecified 1
56 3/22/2014 423178672 ABUN Cutaneous abscess, furuncle and carbuncle, unspecif
57 3/22/2014 423481961 ODAH Cutaneous abscess, furuncle and carbuncle, unspecif
58 3/22/2014 423650474 CICIH SETIANSIH Influenza with oth resp manifestation virus not identi 1
59 3/22/2014 423716769 ALIT Myalgia 1
60 3/22/2014 423806466 NURAENI Dental caries, unspecified
61 3/22/2014 423861816 ELIS Other and unspec diseases of pulp and periapical tis
62 3/22/2014 424109889 ATI Cutaneous abscess, furuncle and carbuncle, unspecif
63 3/22/2014 424110025 IRHAM Gastritis, unspecified 1
64 3/22/2014 424319319 EUTIK Gastritis, unspecified 1
65 3/22/2014 424390116 RESTI Acute amoebic dysentery
66 3/22/2014 424574853 PAHRI Rheumatism, unspecified 1
67 3/22/2014 1004325761 OYOH Gastritis, unspecified 1
68 3/22/2014 1285868079 mohamad rehan Glaucoma, unspecified
69 3/21/2014 422957553 AGNI Disorder of skin and subcutaneous tissue, unspecifie
70 3/21/2014 423175937 AAS Essential (primary) hypertension 1
71 3/21/2014 423431199 CECEP Scabies 1
72 3/21/2014 423728199 ENAH Peptic ulcer, unspec as acute or chronic w'out haemo
73 3/21/2014 423729202 ELIS Dermatitis, unspecified 1
74 3/21/2014 423797591 YATI Acute upper respiratory infection, unspecified 1
75 3/21/2014 423974305 M RAMDAN Acute upper respiratory infection, unspecified 1
76 3/21/2014 424250109 IDAH Fever, unspecified 1
77 3/21/2014 424645907 ENUR N Gastritis, unspecified 1
78 3/21/2014 424646234 PITRI N Dermatitis, unspecified 1
79 3/20/2014 422758956 ROHILAH Gastritis, unspecified 1
80 3/20/2014 423088018 SUMARNA Rheumatism, unspecified 1
81 3/20/2014 423175937 AAS Essential (primary) hypertension 1
82 3/20/2014 423177906 PULDAN Acute serous otitis media
83 3/20/2014 424088818 NIA Developmental odontogenic cysts
84 3/20/2014 424103477 ENI Rheumatism, unspecified 1
85 3/20/2014 424104311 DARWIS Disease of jaws, unspecified
86 3/20/2014 424656527 ASEP M Cutaneous abscess, furuncle and carbuncle, unspecif
87 3/20/2014 1004325502 MALA Rheumatism, unspecified 1
88 3/20/2014 1256410348 DEDE Follicular cyst of ovary
89 3/19/2014 423006118 AOH Gastritis, unspecified 1
90 3/19/2014 423429243 ENTIT Dermatitis, unspecified 1
91 3/19/2014 423624723 ATANG SETIAWAN Dermatitis, unspecified 1
92 3/19/2014 424131186 YUYU YUNIANTI Acute upper respiratory infection, unspecified 1
93 3/19/2014 424132795 SRI H Gastritis, unspecified 1
94 3/19/2014 424412673 SITI ROMLAH Conjunctivitis, unspecified
95 3/19/2014 424583032 POPONG Rheumatism, unspecified 1
96 3/19/2014 1261627198 SITI NURHAYATI Nephrotic syndrome, minor glomerular abnormality
97 3/18/2014 423106931 ADE Other and unspec diseases of pulp and periapical tis
98 3/18/2014 423817288 NANIH Influenza with oth resp manifestation virus not identi 1
99 3/18/2014 423865822 YATI Diarrhoea and gastroenteritis of presumed infectious 1
100 3/18/2014 424101418 EEM Other and unspecified disorders of circulatory syste
101 3/18/2014 424361349 ROROH Acute upper respiratory infection, unspecified 1
102 3/18/2014 424363961 AGUS Dermatitis, unspecified 1
103 3/18/2014 424365941 ADI Disorder of skin and subcutaneous tissue, unspecifie
No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA
104 3/18/2014 424366132 NUNUR Acute upper respiratory infection, unspecified 1
105 3/18/2014 424371813 ILOT Rheumatism, unspecified 1
106 3/17/2014 422666998 YATI Cutaneous abscess, furuncle and carbuncle, unspecif
107 3/17/2014 422850554 ENDAN Other and unspec diseases of pulp and periapical tis
108 3/17/2014 423248905 IMAS Essential (primary) hypertension 1
109 3/17/2014 423249726 ILAN Acute upper respiratory infection, unspecified 1
110 3/17/2014 423465142 EEM Acute upper respiratory infection, unspecified 1
111 3/17/2014 423568473 ANDI Essential (primary) hypertension 1
112 3/17/2014 423701763 AHMAD GHOZALI Tb lung without mention of bact or histological conf
113 3/17/2014 423750914 SITI SOPA Gastritis, unspecified 1
114 3/17/2014 423770758 OOM Vomiting of pregnancy, unspecified
115 3/17/2014 424159209 EEN Rheumatism, unspecified 1
116 3/17/2014 424211512 ANAH Cutaneous abscess, furuncle and carbuncle, unspecif
117 3/17/2014 424233595 KANAH Rheumatism, unspecified 1
118 3/17/2014 424333416 MENAH Gastroduodenitis, unspecified
119 3/17/2014 1266228538 WARJO Asthma, unspecified 1
120 3/17/2014 1275706372 EMPUN Other specified nontoxic goitre
121 3/16/2014 423977422 EMAN Arthritis, unspecified
122 3/15/2014 69880195 FARIHAT Diarrhoea and gastroenteritis of presumed infectious 1
123 3/15/2014 422506495 ENDANG W Disease of upper respiratory tract, unspecified 1
124 3/15/2014 423611469 NINA Acute upper respiratory infection, unspecified 1
125 3/15/2014 423614349 TUSUF Dermatitis, unspecified 1
126 3/15/2014 423843085 OJAH Gastritis, unspecified 1
127 3/15/2014 424087852 DWI Gastritis, unspecified 1
128 3/15/2014 424647775 YONO Scabies 1
129 3/14/2014 422820055 OOM Hypotension, unspecified
130 3/14/2014 422820999 HASANAH Amoebiasis, unspecified
131 3/14/2014 424506497 WANDA Dermatitis, unspecified 1
132 3/14/2014 424506778 WINA Dermatitis, unspecified 1
133 3/14/2014 424646234 PITRI N Unspecified contact dermatitis, unspecified cause
134 3/13/2014 422506203 MUCH ARDABILI Acute appendicitis, unspecified
135 3/13/2014 422742194 WULAN Acute pharyngitis, unspecified
136 3/13/2014 423248905 IMAS Essential (primary) hypertension 1
137 3/13/2014 423248938 ENGKAR Acute upper respiratory infection, unspecified 1
138 3/13/2014 423396134 SITI Other and unspec diseases of pulp and periapical tis
139 3/13/2014 423428859 MOMON Dermatitis, unspecified 1
140 3/13/2014 423532168 JUJU Gastroduodenitis, unspecified
141 3/13/2014 423532866 AI SOPIAH Dermatitis, unspecified 1
142 3/13/2014 423738134 ENUR Dermatitis, unspecified 1
143 3/13/2014 424245543 YANI Degenerative and vascular disorders of ear
144 3/13/2014 424250109 IDAH Medical abortion, incomplete, complicated by genital
145 3/13/2014 424348413 NANI Mechanical complication of intrauterine contracepti
146 3/13/2014 424439651 ISAH Diarrhoea and gastroenteritis of presumed infectious 1
147 3/13/2014 424576326 ANISA Other specified general symptoms and signs
148 3/12/2014 69181301 ACAH Essential (primary) hypertension 1
149 3/12/2014 423104714 ABDUL MAJID Essential (primary) hypertension 1
150 3/12/2014 423412683 DADAH Gastritis, unspecified 1
151 3/12/2014 423445296 KANDI Acute pharyngitis, unspecified
152 3/12/2014 424211512 ANAH Acute upper respiratory infection, unspecified 1
153 3/12/2014 424290633 ISAH Gastritis, unspecified 1
154 3/12/2014 424402648 ADE WAWANG Influenza with oth resp manifestation virus not identi 1
155 3/12/2014 424609378 AGNI Acute upper respiratory infection, unspecified 1
156 3/12/2014 1004323386 H MAMUN Essential (primary) hypertension 1
157 3/11/2014 423148599 NUNUNG Other specified general symptoms and signs

No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA


158 3/11/2014 423460473 M RAMDAN Fever, unspecified 1
159 3/11/2014 423465142 EEM Abdominal pregnancy
160 3/11/2014 423618039 ENDANG Rheumatism, unspecified 1
161 3/11/2014 423622539 M RIZKY Cutaneous abscess, furuncle and carbuncle, unspecif
162 3/11/2014 423622664 EEN Epilepsy, unspecified
163 3/11/2014 424088818 NIA Influenza with oth resp manifestation virus not identi 1
164 3/11/2014 424207732 EMPUNG Acute upper respiratory infection, unspecified 1
165 3/11/2014 424242472 M OTIH Gastritis, unspecified 1
166 3/11/2014 424330536 DIAN Influenza with oth resp manifestation virus not identi 1
167 3/11/2014 424370259 SOBAR Neoplasm of uncertain or unknown behaviour, unspe
168 3/11/2014 424655111 ULFAH SARIFAH Rheumatism, unspecified 1
169 3/11/2014 1004324556 CICIN Rheumatism, unspecified 1
170 3/11/2014 1004326413 ROSIH Essential (primary) hypertension 1
171 3/11/2014 1266718228 andra hanan Unspecified contact dermatitis, unspecified cause
172 3/10/2014 69880116 EULIS KARWATI . Gastritis, unspecified 1
173 3/10/2014 422936695 IAH Rheumatism, unspecified 1
174 3/10/2014 422937448 FITRI Influenza with oth resp manifestation virus not identi 1
175 3/10/2014 423119474 UUM Rheumatism, unspecified 1
176 3/10/2014 423120328 YUDI Disorder of skin and subcutaneous tissue, unspecifie
177 3/10/2014 423156341 ELIS HOLISOH Acute upper respiratory infection, unspecified 1
178 3/10/2014 423426306 ADE ARIAH Gastritis, unspecified 1
179 3/10/2014 423521684 ITA Acute upper respiratory infection, unspecified 1
180 3/10/2014 423818054 AKIM Influenza with oth resp manifestation virus not identi 1
181 3/10/2014 423842591 NUNUNG Chronic ischaemic heart disease, unspecified 1
182 3/10/2014 424335418 AIDAH Rheumatism, unspecified 1
183 3/10/2014 424338603 LENI Other and unspec diseases of pulp and periapical tis
184 3/10/2014 424408566 SILVA SIDIK Influenza with oth resp manifestation virus not identi 1
185 3/10/2014 424410131 DINI NURUL AULIA Fever, unspecified 1
186 3/10/2014 424490343 CECEP H Acute upper respiratory infection, unspecified 1
187 3/10/2014 424617197 HILDA Acute upper respiratory infection, unspecified 1
188 3/10/2014 424684091 ISMA Other disorders of nervous system, not elsewhere cla
189 3/10/2014 1266228538 WARJO Asthma, unspecified 1
190 3/10/2014 1278297448 EJI A Acute upper respiratory infection, unspecified 1
191 3/9/2014 1278884755 ENCAR Arthritis, unspecified
192 3/8/2014 69880195 FARIHAT Influenza with oth resp manifestation virus not identi 1
193 3/8/2014 423827122 RIJAL Diarrhoea and gastroenteritis of presumed infectious 1
194 3/8/2014 423889896 DIAT Diarrhoea and gastroenteritis of presumed infectious 1
195 3/8/2014 424015953 UU TAI Paratyphoid fever, unspecified
196 3/8/2014 424131186 YUYU YUNIANTI Asthma, unspecified 1
197 3/8/2014 1266298086 muhammad ihsan f Tuberculosis of lung, confirmed by unspecified mean
198 3/8/2014 1270353284 TRI YUDI APRIYONO Diarrhoea and gastroenteritis of presumed infectious 1
199 3/7/2014 69088263 RIDWAN NUR ALAM Dermatitis, unspecified 1
200 3/7/2014 69266327 KOMAR Essential (primary) hypertension 1
201 3/7/2014 422977173 DINI Other specified diseases of upper respiratory tract
202 3/7/2014 423156341 ELIS HOLISOH Acute pharyngitis, unspecified
203 3/7/2014 423602987 IYAH Rheumatism, unspecified 1
204 3/7/2014 423908177 AGUS Conjunctivitis, unspecified
205 3/7/2014 424002431 ASEP Otitis media, unspecified
206 3/7/2014 424307373 AAH Dermatitis, unspecified 1
207 3/7/2014 424353227 KAYAH Acute upper respiratory infection, unspecified 1
208 3/7/2014 424634387 ROHMAT Dental caries, unspecified
209 3/7/2014 1081593134 ASTRI APRILIANTI Influenza with oth resp manifestation virus not identi 1
210 3/6/2014 422743757 ANING Gastritis, unspecified 1
211 3/6/2014 424165645 MAHRON Conjunctivitis, unspecified

No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA


212 3/6/2014 424346005 TITI Rheumatism, unspecified 1
213 3/6/2014 424408566 SILVA SIDIK Gastritis, unspecified 1
214 3/6/2014 424412673 SITI ROMLAH Scabies 1
215 3/6/2014 424647775 YONO Dermatitis, unspecified 1
216 3/6/2014 1279665922 NURHASANAH Premature rupture of membranes, unspecified 1
217 3/5/2014 69181301 ACAH Acute upper respiratory infection, unspecified 1
218 3/5/2014 422943704 AGUNG Acute upper respiratory infection, unspecified 1
219 3/5/2014 423085656 MITA Cutaneous abscess, furuncle and carbuncle, unspecif
220 3/5/2014 423187582 CICIN Rheumatism, unspecified 1
221 3/5/2014 423187828 JIHAN M Acute upper respiratory infection, unspecified 1
222 3/5/2014 423187874 ANA Acute upper respiratory infection, unspecified 1
223 3/5/2014 423762221 EMAY Other and unspec diseases of pulp and periapical tis
224 3/5/2014 423933647 ADE SYARIPUDIN Acute upper respiratory infection, unspecified 1
225 3/5/2014 424262002 DIDI Asthma, unspecified 1
226 3/5/2014 1276460379 ALI SADIKIN Degenerative and vascular disorders of ear
227 3/4/2014 411865828 DEDE AISAH Disease of jaws, unspecified
228 3/4/2014 423424438 YUNINGSIH Disorder of skin and subcutaneous tissue, unspecifie
229 3/4/2014 423506125 CICIH Acute upper respiratory infection, unspecified 1
230 3/4/2014 423665043 ROHMAN Asthma, unspecified 1
231 3/4/2014 423715601 RIFKI Other and unspec diseases of pulp and periapical tis
232 3/4/2014 423716769 ALIT Rheumatism, unspecified 1
233 3/4/2014 424056249 TRIA Influenza with oth resp manifestation virus not identi 1
234 3/4/2014 424101418 EEM Gastritis, unspecified 1
235 3/4/2014 424234091 UNDIH Erythema intertrigo
236 3/4/2014 424657899 YAYAN Cutaneous abscess, furuncle and carbuncle, unspecif
237 3/4/2014 431981616 YUNI NURAENI Other and unspec diseases of pulp and periapical tis
238 3/4/2014 1004325546 UMUN Essential (primary) hypertension 1
239 3/4/2014 1266228538 WARJO Dermatitis, unspecified 1
240 3/4/2014 1268612583 ZAENAL MUHAMAD Epilepsy, unspecified
241 3/4/2014 1278858789 asep hasanudin Influenza with oth resp manifestation virus not identi 1
242 3/3/2014 69881163 TATI NURYATI Essential (primary) hypertension 1
243 3/3/2014 422780725 SOLIHIN Dental caries, unspecified
244 3/3/2014 423115953 SITI AMINAH Gastritis, unspecified 1
245 3/3/2014 423179155 SARIP HIDAYAT Unspecified acute lower respiratory infection
246 3/3/2014 423378112 IRES Arthritis, unspecified
247 3/3/2014 423428859 MOMON Dermatitis, unspecified 1
248 3/3/2014 423460473 M RAMDAN Unspecified acute lower respiratory infection
249 3/3/2014 423566774 DUDUNG Thalassaemia, unspecified
250 3/3/2014 423639483 EMAN Asthma, unspecified 1
251 3/3/2014 424078108 DADAH Acute upper respiratory infection, unspecified 1
252 3/3/2014 424103477 ENI Rheumatism, unspecified 1
253 3/3/2014 424131186 YUYU YUNIANTI Acute upper respiratory infection, unspecified 1
254 3/3/2014 424207732 EMPUNG Rheumatism, unspecified 1
255 3/3/2014 424319319 EUTIK Fever, unspecified 1
256 3/3/2014 424342923 RIZAL Acute upper respiratory infection, unspecified 1
257 3/3/2014 424400218 SAEPUL MILAH Acute tonsillitis, unspecified
258 3/3/2014 1004323847 ETI Other and unspec diseases of pulp and periapical tis
259 3/3/2014 1267811414 muhamad aldi suhendPneumonia, unspecified
260 3/1/2014 423055787 NIA Pneumonia, unspecified
261 3/1/2014 423390655 AI SAADAH Other specified general symptoms and signs
262 3/1/2014 423475356 BIBAH Dermatitis, unspecified 1
263 3/1/2014 424104311 DARWIS Acute upper respiratory infection, unspecified 1
264 3/1/2014 424290633 ISAH Asthma, unspecified 1

No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA


265 3/1/2014 424570184 PATIMAH Acute upper respiratory infection, unspecified 1
266 3/1/2014 424609378 AGNI Unspecified acute lower respiratory infection
AcuteOtherConjuOtherUnspe
OtherDisorDentaCutaneous abscess, furuncle and carbuncle, unspecified

1
1
1
1

1
1

1
1

1
1

1
1
1

1
1
1

1
1

1
1

1
1

1
1

1
1

1
1
Daftar Kunjungan Peserta bpjs/ askes/ jamkesmas/ jampersal
Puskesmas : Sukahurip
Bulan : April 2014
Jumlah Kunjungan : 247
Jumlah Yang dirujuk : 26
1 2 3 4
No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJU CETAK Dermat
Asthma
RheumFever,
1 4/30/2014 423423033 NAIN Gastric ulcer, unspec as acute or chronic w'out TIDAK
2 4/30/2014 423618039 ENDANG Acute upper respiratory infection, unspecified TIDAK
3 4/30/2014 423622539 M RIZKY Dermatitis, unspecified TIDAK 1
4 4/30/2014 423645243 DANDI Epilepsy, unspecified YA 1
5 4/30/2014 423655547 ENUR Developmental odontogenic cysts TIDAK
6 4/30/2014 423731452 ROKAYAH Gastric ulcer, unspec as acute or chronic w'out TIDAK
7 4/30/2014 423859026 ELIT SA'ADAH Other abortion, incomplete, complicated by genit
YA 1
8 4/30/2014 424107404 ADITYA Other and unspec diseases of pulp and periapicaTIDAK
9 4/30/2014 424202949 IKA Rheumatism, unspecified TIDAK 1
10 4/30/2014 1004324501 DODO Hypertension (HPN) TIDAK
11 4/30/2014 1256876684 MUHAMAD RESHA Unilateral or unspecified inguinal hernia, witho YA 1
12 4/29/2014 69669459 YAHYA HIDAYAT Typhoid fever TIDAK
13 4/29/2014 69669461 NENIH Hypertension (HPN) TIDAK
14 4/29/2014 69879497 CUCU ROHAYATI Hypertension (HPN) TIDAK
15 4/29/2014 423556604 OJO Acute haemorrhagic gastritis TIDAK
16 4/29/2014 423566774 DUDUNG Thalassaemia, unspecified YA 1
17 4/29/2014 423695979 MAMAN Gastric ulcer, unspec as acute or chronic w'out TIDAK
18 4/29/2014 423966295 ERWIN Unilateral or unspecified inguinal hernia, witho YA 1
19 4/28/2014 423129609 SANDI Neuralgia and neuritis, unspecified TIDAK
20 4/28/2014 423129789 INDI Diarrhoea and gastroenteritis of presumed infecTIDAK
21 4/28/2014 424167243 SANI Conjunctivitis, unspecified TIDAK
22 4/28/2014 424290791 ADE FITRI Cutaneous abscess, furuncle and carbuncle, unsTIDAK
23 4/28/2014 424383142 IIS Rheumatism, unspecified TIDAK 1
24 4/28/2014 424516612 KARYATI Acute upper respiratory infection, unspecified TIDAK
25 4/28/2014 424528571 AI CARIAH Rheumatism, unspecified TIDAK 1
26 4/28/2014 1266228538 WARJO Asthma, unspecified TIDAK 1
27 4/26/2014 422946898 ENAH Rheumatism, unspecified TIDAK 1
28 4/26/2014 423187863 TIRAH Long labour, unspecified YA 1
29 4/26/2014 423611469 NINA Essential (primary) hypertension TIDAK
30 4/26/2014 423842591 NUNUNG Premature rupture of membranes, unspecified YA 1
31 4/26/2014 423915333 YATI Asthma, unspecified TIDAK 1
32 4/26/2014 424133651 ADE LINDA Acute amoebic dysentery TIDAK
33 4/26/2014 424135236 RINA Cutaneous abscess, furuncle and carbuncle, unsTIDAK
34 4/26/2014 424286853 NISA Dermatitis, unspecified TIDAK 1
35 4/25/2014 422699995 RIF SADIYAH Other and unspec diseases of pulp and periapicaTIDAK
36 4/25/2014 423671769 PIAH Rheumatism, unspecified TIDAK 1
37 4/25/2014 424082722 AHMAD RESTU Scabies TIDAK
38 4/25/2014 424176974 RATNA Scabies TIDAK
39 4/25/2014 424370259 SOBAR Gastritis, unspecified YA 1
40 4/25/2014 424371677 AAH Essential (primary) hypertension TIDAK
41 4/25/2014 1300020557 IMAS Ectopic pregnancy, unspecified YA 1
42 4/24/2014 423288731 ADE SARIPAH Acute upper respiratory infection, unspecified TIDAK
43 4/24/2014 423289686 ADAH Hypertension (HPN) TIDAK
44 4/24/2014 423290788 RIZKI Dental caries, unspecified TIDAK
45 4/24/2014 423716376 KAMILA Acute upper respiratory infection, unspecified TIDAK
46 4/24/2014 423855876 ENUNG Gastric ulcer, unspec as acute or chronic w'out TIDAK
47 4/24/2014 424054089 RINI Acute upper respiratory infection, unspecified TIDAK
48 4/24/2014 424077434 ADE LILIS Dental caries, unspecified TIDAK
49 4/24/2014 1285868079 mohamad rehan Glaucoma, unspecified YA 1
50 4/24/2014 1297056273 ADE YANA Unspecified injury of wrist and hand YA 1
51 4/24/2014 1298992127 JULAEHA Disorder of eye and adnexa, unspecified YA 1
No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJU CETAK

52 4/23/2014 423033478 HAJAR Other and unspec diseases of pulp and periapicaTIDAK
53 4/23/2014 423200463 MUMU Acute upper respiratory infection, unspecified TIDAK
54 4/23/2014 423319397 SITI ROHIMAH Medical abortion, incomplete, complicated by gen
YA 1
55 4/23/2014 423468325 DEDE PARIDA Nausea and vomiting TIDAK
56 4/23/2014 423678982 ITA Medical abortion, incomplete, complicated by gen
YA 1
57 4/23/2014 424043594 ADAH Diarrhoea and gastroenteritis of presumed infecTIDAK
58 4/22/2014 69088263 RIDWAN NUR ALAM Dermatitis, unspecified TIDAK 1
59 4/22/2014 423120328 YUDI Scabies TIDAK
60 4/22/2014 423811934 PITRI Diarrhoea and gastroenteritis of presumed infecTIDAK
61 4/22/2014 423837584 YANTI Single spontaneous delivery, unspecified TIDAK
62 4/22/2014 423862209 CECEP Influenza with pneumonia, virus not identified TIDAK
63 4/22/2014 1266228538 WARJO Asthma, unspecified TIDAK 1
64 4/22/2014 1296948712 sobirin Unspecified severe protein-energy malnutrition YA 1
65 4/21/2014 423050139 OMAN Gastritis, unspecified TIDAK
66 4/21/2014 423426734 JAELANI Fever, unspecified TIDAK 1
67 4/21/2014 423740564 IDUN Rheumatism, unspecified TIDAK 1
68 4/21/2014 423966295 ERWIN Unilateral or unspecified inguinal hernia, witho TIDAK
69 4/21/2014 424350505 NABILA Acute upper respiratory infection, unspecified TIDAK
70 4/21/2014 424438143 ENA Rheumatism, unspecified TIDAK 1
71 4/21/2014 424634354 KURNIA Cutaneous abscess, furuncle and carbuncle, unsTIDAK
72 4/21/2014 1004324501 DODO Rheumatism, unspecified TIDAK 1
73 4/21/2014 1256739568 HILDA MAULIDA Other and unspecified disorders of circulatory YA 1
74 4/21/2014 1256954038 JAJANG Schizophrenia, unspecified YA 1
75 4/21/2014 1273630151 acip Predominantly allergic asthma TIDAK
76 4/19/2014 422820999 HASANAH Diarrhoea and gastroenteritis of presumed infecTIDAK
77 4/19/2014 423440943 CIKA Influenza with pneumonia, virus not identified TIDAK
78 4/19/2014 423619312 YOYOH Essential (primary) hypertension TIDAK
79 4/19/2014 423650474 CICIH SETIANSIH Rheumatism, unspecified TIDAK 1
80 4/19/2014 423729099 AIP Dermatitis, unspecified TIDAK 1
81 4/19/2014 423782594 ASEP Acute pharyngitis, unspecified TIDAK
82 4/19/2014 423806466 NURAENI Other and unspec diseases of pulp and periapicaTIDAK
83 4/19/2014 423808097 IMAS Gastritis, unspecified TIDAK
84 4/19/2014 423945257 CUCUM Rheumatism, unspecified TIDAK 1
85 4/19/2014 424335745 MOCH IRFAN Ascariasis, unspecified TIDAK
86 4/19/2014 424379114 RANGGA Typhoid fever TIDAK
87 4/19/2014 424503257 PIAN Other and unspecified disorders of circulatory YA 1
88 4/19/2014 1004324782 HOLILAH Dermatitis, unspecified TIDAK 1
89 4/17/2014 69266327 KOMAR Acute haemorrhagic gastritis TIDAK
90 4/17/2014 423084802 SITI Acute upper respiratory infection, unspecified TIDAK
91 4/17/2014 423681491 IROS Exfoliation of teeth due to systemic causes TIDAK
92 4/17/2014 423682492 NUR AISAH Gastric ulcer, unspec as acute or chronic w'out TIDAK
93 4/17/2014 424030847 SIFA Dermatitis, unspecified TIDAK 1
94 4/17/2014 424038677 RITA Influenza with pneumonia, virus not identified TIDAK
95 4/17/2014 424490152 IMAN SARIP H Acute upper respiratory infection, unspecified TIDAK
96 4/17/2014 424503257 PIAN Gastritis, unspecified TIDAK
97 4/17/2014 424523665 AMAD Gastric ulcer, unspec as acute or chronic w'out TIDAK
98 4/17/2014 424575729 ROSITA Acute pharyngitis, unspecified TIDAK
99 4/17/2014 1004323847 ETI Rheumatism, unspecified TIDAK 1
100 4/16/2014 423614057 AAN Pyogenic granuloma TIDAK
101 4/16/2014 423834568 OOM Dermatitis, unspecified TIDAK 1
102 4/16/2014 423837371 IJAH Acute haemorrhagic gastritis TIDAK
103 4/16/2014 424061177 WINARTI Allergic contact dermatitis due to metals TIDAK
104 4/16/2014 424101418 EEM Acquired pure red cell aplasia, unspecified YA 1
105 4/16/2014 424285626 TINI Gastritis, unspecified TIDAK
106 4/16/2014 1267770543 AYI BADRUL MUNIR Epilepsy, unspecified YA 1
107 4/15/2014 423186096 YAYAH Essential (primary) hypertension TIDAK
108 4/15/2014 423622664 EEN Cerebrovascular disease, unspecified YA 1
No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJU CETAK

109 4/15/2014 423754806 SITI KOMARIAH Diarrhoea and gastroenteritis of presumed infecTIDAK
110 4/15/2014 424131186 YUYU YUNIANTI Other specified general symptoms and signs TIDAK
111 4/15/2014 424132852 NONO H Cutaneous abscess, furuncle and carbuncle, unsTIDAK
112 4/15/2014 424159097 SITI Conjunctivitis, unspecified TIDAK
113 4/15/2014 424348841 NUNUR Influenza with oth resp manifestation virus not iTIDAK
114 4/15/2014 424550068 ETI Nausea and vomiting TIDAK
115 4/15/2014 1004324556 CICIN Angina pectoris, unspecified YA 1
116 4/15/2014 1256897687 MUHAMMAD NUR ARS
Cerebrovascular disease, unspecified YA 1
117 4/15/2014 1262938094 rifail rajab Acute upper respiratory infection, unspecified TIDAK
118 4/14/2014 423012216 YUSEP Scabies TIDAK
119 4/14/2014 423192723 ROHMAT Other and unspec diseases of pulp and periapicaTIDAK
120 4/14/2014 423321197 SITI DINA Eclampsia, unspecified as to time period YA 1
121 4/14/2014 423663669 EMIT Acute upper respiratory infection, unspecified TIDAK
122 4/14/2014 423666639 HABIB ULFAH Dermatitis, unspecified TIDAK 1
123 4/14/2014 423697533 OMAN Rheumatism, unspecified TIDAK 1
124 4/14/2014 423889896 DIAT Nausea and vomiting TIDAK
125 4/14/2014 423919776 AOS Unilateral or unspecified inguinal hernia, witho TIDAK
126 4/14/2014 423947755 ROVI Dermatitis, unspecified TIDAK 1
127 4/14/2014 424018541 ENUNG SOLIHAT Conjunctivitis, unspecified TIDAK
128 4/14/2014 424021116 MIFTAH FAUZI Asthma, unspecified TIDAK 1
129 4/14/2014 424207732 EMPUNG Essential (primary) hypertension TIDAK
130 4/14/2014 424361349 ROROH Essential (primary) hypertension TIDAK
131 4/14/2014 1004325546 UMUN Myalgia TIDAK
132 4/14/2014 1272367956 lina julianti Acute tonsillitis, unspecified TIDAK
133 4/12/2014 423012093 DEDI Scabies TIDAK
134 4/12/2014 423330625 MANAH CACAH Cutaneous abscess, furuncle and carbuncle, unsTIDAK
135 4/12/2014 423710447 SITI AISAH Paratyphoid fever, unspecified TIDAK
136 4/12/2014 423800212 HENI ROHAENI Rheumatism, unspecified TIDAK 1
137 4/12/2014 424209543 ILHAM YASIR Acute tonsillitis, unspecified TIDAK
138 4/12/2014 424490343 CECEP H Influenza with pneumonia, virus not identified TIDAK
139 4/12/2014 424658823 WINA NINGSIH Influenza with pneumonia, virus not identified TIDAK
140 4/12/2014 424660961 NAWAP FAJAR AKBARAcute upper respiratory infection, unspecified TIDAK
141 4/12/2014 1004322802 UUN Diarrhoea and gastroenteritis of presumed infecTIDAK
142 4/12/2014 1294021348 SIDIK WAHYUDIN Impetigo [any organism] [any site] YA 1
143 4/11/2014 69088263 RIDWAN NUR ALAM Dermatitis, unspecified TIDAK 1
144 4/11/2014 69816914 ENTIN GARNIATIN Gastritis, unspecified TIDAK
145 4/11/2014 423098831 RUDI Acute upper respiratory infection, unspecified TIDAK
146 4/11/2014 423446376 NINDI Influenza with oth resp manifestation virus not iTIDAK
147 4/11/2014 423506125 CICIH Rheumatism, unspecified TIDAK 1
148 4/11/2014 423692425 AINUN SOPIAH Dental caries, unspecified TIDAK
149 4/11/2014 423822464 EROSMAWATI Single spontaneous delivery, unspecified TIDAK
150 4/11/2014 424103501 RIZAL Influenza with oth resp manifestation virus not iTIDAK
151 4/11/2014 424290633 ISAH Scabies TIDAK
152 4/11/2014 424290791 ADE FITRI Gastritis, unspecified TIDAK
153 4/11/2014 424350505 NABILA Acute upper respiratory infection, unspecified TIDAK
154 4/11/2014 424616872 ITING Myalgia TIDAK
155 4/11/2014 1266228538 WARJO Scabies TIDAK
156 4/10/2014 422705248 DIDIN Amoebiasis, unspecified TIDAK
157 4/10/2014 423119621 INUN Rheumatism, unspecified TIDAK 1
158 4/10/2014 423122681 DINI Acute pharyngitis, unspecified TIDAK
159 4/10/2014 423396909 IKA Disorder of skin and subcutaneous tissue, unspeTIDAK
160 4/10/2014 423609524 SAODAH Acute upper respiratory infection, unspecified TIDAK
161 4/10/2014 423744028 ASIH Cutaneous abscess, furuncle and carbuncle, unsTIDAK
162 4/10/2014 423888952 UU RUKMANA Paratyphoid fever, unspecified TIDAK
163 4/10/2014 424166848 HABIBAH Acute tonsillitis, unspecified TIDAK
164 4/10/2014 424176974 RATNA Dermatitis, unspecified TIDAK 1
165 4/10/2014 424335418 AIDAH Myalgia TIDAK

No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJU CETAK

166 4/10/2014 424553624 HILDA Acute upper respiratory infection, unspecified TIDAK
167 4/10/2014 424647999 DEDE LUKMAN Gastritis, unspecified TIDAK
168 4/8/2014 423157318 ENDANG Dermatitis, unspecified TIDAK 1
169 4/8/2014 423475356 BIBAH Acute tonsillitis, unspecified TIDAK
170 4/8/2014 423651339 ITA Gastritis, unspecified TIDAK
171 4/8/2014 423652195 ENUR Scabies TIDAK
172 4/8/2014 424011047 SANTI Influenza with pneumonia, virus not identified TIDAK
173 4/8/2014 424011328 RESYA Acute upper respiratory infection, unspecified TIDAK
174 4/8/2014 424075228 SOPIAH Acute upper respiratory infection, unspecified TIDAK
175 4/8/2014 424293309 II RUSTANDI Schizophrenia, unspecified TIDAK
176 4/8/2014 424331188 AAH Dermatitis, unspecified TIDAK 1
177 4/8/2014 1004325502 MALA Essential (primary) hypertension TIDAK
178 4/8/2014 1004325827 ANI Acute upper respiratory infection, unspecified TIDAK
179 4/7/2014 69037211 YANI RAHMAYANI Chronic ischaemic heart disease, unspecified YA 1
180 4/7/2014 69880116 EULIS KARWATI . Fever, unspecified TIDAK 1
181 4/7/2014 422669024 HENI Other and unspec diseases of pulp and periapicaTIDAK
182 4/7/2014 423440943 CIKA Diarrhoea and gastroenteritis of presumed infecTIDAK
183 4/7/2014 423665043 ROHMAN Asthma, unspecified TIDAK 1
184 4/7/2014 423687396 DODI Dermatitis, unspecified TIDAK 1
185 4/7/2014 423739438 ASEP P Scabies TIDAK
186 4/7/2014 423815894 ILASIFA Gastritis, unspecified TIDAK
187 4/7/2014 423965079 JAMILAH Pyogenic granuloma TIDAK
188 4/7/2014 424088043 NURHASANAH Acute upper respiratory infection, unspecified TIDAK
189 4/7/2014 424159209 EEN Rheumatism, unspecified TIDAK 1
190 4/7/2014 424244878 ENDAH Acute upper respiratory infection, unspecified TIDAK
191 4/7/2014 424319319 EUTIK Acute upper respiratory infection, unspecified TIDAK
192 4/7/2014 424528571 AI CARIAH Influenza with oth resp manifestation virus not iTIDAK
193 4/7/2014 1004325761 OYOH Rheumatism, unspecified TIDAK 1
194 4/7/2014 1266228538 WARJO Asthma, unspecified TIDAK 1
195 4/5/2014 422598115 EROS R Acute upper respiratory infection, unspecified TIDAK
196 4/5/2014 423740564 IDUN Rheumatism, unspecified TIDAK 1
197 4/5/2014 423740687 ATIKAH Influenza with oth resp manifestation virus not iTIDAK
198 4/5/2014 423973675 MIRA Essential (primary) hypertension TIDAK
199 4/5/2014 423974305 M RAMDAN Dental caries, unspecified TIDAK
200 4/5/2014 424250109 IDAH Influenza with oth resp manifestation virus not iTIDAK
201 4/5/2014 424572704 LATIPAH Other specified general symptoms and signs TIDAK
202 4/5/2014 424574853 PAHRI Cutaneous abscess, furuncle and carbuncle, unsTIDAK
203 4/5/2014 424583032 POPONG Dermatitis, unspecified TIDAK 1
204 4/5/2014 424584123 SITI Cutaneous abscess, furuncle and carbuncle, unsTIDAK
205 4/5/2014 1278183014 AYI ALAWIYAH Rheumatism, unspecified TIDAK 1
206 4/4/2014 422666998 YATI Acute pharyngitis, unspecified TIDAK
207 4/4/2014 423240175 JELI RAHMAYANI Acute upper respiratory infection, unspecified TIDAK
208 4/4/2014 423671804 ANIS ANISAH Acute upper respiratory infection, unspecified TIDAK
209 4/4/2014 423687418 ANDRI Acute upper respiratory infection, unspecified TIDAK
210 4/4/2014 423817288 NANIH Gastric ulcer, unspec as acute or chronic w'out TIDAK
211 4/4/2014 423843085 OJAH Rheumatism, unspecified TIDAK 1
212 4/4/2014 424103477 ENI Rheumatism, unspecified TIDAK 1
213 4/4/2014 424202949 IKA Acute tonsillitis, unspecified TIDAK
214 4/4/2014 424220354 MIA Dermatitis, unspecified TIDAK 1
215 4/4/2014 424634139 TATI Influenza with pneumonia, virus not identified TIDAK
216 4/4/2014 1272367956 lina julianti Dermatitis, unspecified TIDAK 1
217 4/3/2014 422850554 ENDAN Pyogenic granuloma TIDAK
218 4/3/2014 423077422 AMAR Myalgia TIDAK
219 4/3/2014 423445634 RIVAL Acute upper respiratory infection, unspecified TIDAK
220 4/3/2014 423663669 EMIT Acute pharyngitis, unspecified TIDAK
221 4/3/2014 423784056 MIRA Paratyphoid fever, unspecified TIDAK
222 4/3/2014 423804497 NURHAYATI Paratyphoid fever, unspecified TIDAK

No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJU CETAK

223 4/3/2014 423847157 OOS Acute cystitis TIDAK


224 4/3/2014 424338603 LENI Rheumatism, unspecified TIDAK 1
225 4/2/2014 206660507 AI SITI MARYAM Developmental (nonodontogenic) cysts of oral r TIDAK
226 4/2/2014 423339816 UNDANG Acute cystitis TIDAK
227 4/2/2014 423395425 DADIN Other specified general symptoms and signs TIDAK
228 4/2/2014 423436408 IMA Gastric ulcer, unspec as acute or chronic w'out TIDAK
229 4/2/2014 423704305 AHMAD Dermatitis, unspecified TIDAK 1
230 4/2/2014 423943795 UIS Influenza with pneumonia, virus not identified TIDAK
231 4/2/2014 424400354 AISYAH Acute tonsillitis, unspecified TIDAK
232 4/2/2014 424490286 RISMAN Acute haemorrhagic gastritis TIDAK
233 4/2/2014 424637605 TRIYANA Fever, unspecified TIDAK 1
234 4/1/2014 422770498 YUYUN Influenza with pneumonia, virus not identified TIDAK
235 4/1/2014 423000314 IHAH Rheumatism, unspecified TIDAK 1
236 4/1/2014 423458482 IIM Predominantly allergic asthma TIDAK
237 4/1/2014 423571948 LISDA AMELIA Fever, unspecified TIDAK 1
238 4/1/2014 423663669 EMIT Acute upper respiratory infection, unspecified TIDAK
239 4/1/2014 424088043 NURHASANAH Fever, unspecified TIDAK 1
240 4/1/2014 424110352 IRMAN Fever, unspecified TIDAK 1
241 4/1/2014 424207732 EMPUNG Essential (primary) hypertension TIDAK
242 4/1/2014 424322728 SUSI Diarrhoea and gastroenteritis of presumed infecTIDAK
243 4/1/2014 424338603 LENI Dental caries, unspecified TIDAK
244 4/1/2014 424402648 ADE WAWANG Disorder of skin and subcutaneous tissue, unspeTIDAK
245 4/1/2014 1004328718 AJUM Diarrhoea and gastroenteritis of presumed infecTIDAK
246 4/1/2014 1266228538 WARJO Asthma, unspecified TIDAK 1
247 4/1/2014 1278297448 EJI A Influenza with oth resp manifestation virus not iTIDAK
26 18 7 23 6
5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
DiarrhDentalCutaneScabieInflue GastriEssentAcute GastriOther Acute DisordAcute Acute ParatyOther and unspec diseases of pulp and periapical tissues
1
1

1
1
1
1

1
1
1
1
1
1
1

1
1
1
1

1
1
1

1
1
1

1
1

1
1
1
1
1

1
1

1
1
1

1
1

1
1
1
1

1
1
1
1
1

1
1
1

1
1
1
1
1
1

1
1
1
1
1
1
1
1

1
1
1
1
1
1

1
1

1
1

1
1

1
1
1

1
1
1
1
1
1

1
1
1
1
1

1
1
1
1
1

1
1

1
1
1

1
1
1
1
1

1
9 5 8 9 16 8 9 26 10 2 4 4 5 6 4 6
Daftar Kunjungan Peserta bpjs/ askes/ jamkesmas/
jampersal
Puskesmas : Sukahurip
Bulan : Mei 2014
Jumlah Kunjungan : 265
Jumlah Yang dirujuk : 34

No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJUK CETAK

1 5/31/2014 411865828 DEDE AISAH Typhoid fever TIDAK


2 5/31/2014 423033478 HAJAR Rheumatism, unspecified TIDAK
3 5/31/2014 423033794 SULISTIANI Dermatitis, unspecified TIDAK
4 5/31/2014 423647763 ANI Benign neoplasm of unspecified site YA 1
5 5/31/2014 424077434 ADE LILIS Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perforati TIDAK
6 5/31/2014 424234517 RUHIAT Polyarthritis, unspecified TIDAK
7 5/31/2014 424236284 SITI AISYAH Scabies TIDAK
8 5/31/2014 424565447 ENENG Gastric ulcer, acute with haemorrhage TIDAK
9 5/31/2014 424617434 TANIA Acute upper respiratory infection, unspecified TIDAK
10 5/31/2014 1257648298 ETI Long labour, unspecified YA 1
11 5/30/2014 422960433 NISA NS Cutaneous abscess, furuncle and carbuncle, unspecified TIDAK
12 5/30/2014 423321377 SITI MASPUPAH Labour and delivery complicated by fetal heart rate anomaly YA 1
13 5/30/2014 424121411 ADE HASANAH Acute suppurative otitis media YA 1
14 5/30/2014 424293309 II RUSTANDI Schizophrenia, unspecified TIDAK
15 5/30/2014 424573468 IYAM Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perforati TIDAK
16 5/30/2014 1004325502 MALA Bronchopneumonia, unspecified TIDAK
17 5/29/2014 423934907 TITA Single spontaneous delivery, unspecified TIDAK
18 5/28/2014 422957553 AGNI Scabies TIDAK
19 5/28/2014 423566774 DUDUNG Other thalassaemias YA 1
20 5/28/2014 423619312 YOYOH Hypertension (HPN) TIDAK
21 5/28/2014 423755414 YATI Other abortion, incomplete, complicated by genital tract and pelvic infec YA 1
22 5/28/2014 423972652 MULYANA Other and unspec diseases of pulp and periapical tissues TIDAK
23 5/28/2014 424039408 CICIH Single spontaneous delivery, unspecified TIDAK
24 5/28/2014 424077434 ADE LILIS Bronchopneumonia, unspecified TIDAK
25 5/28/2014 424330481 CAHYA Influenza with oth resp manifestation virus not identified TIDAK
26 5/28/2014 424330536 DIAN Asthma, unspecified TIDAK
27 5/28/2014 424389475 FITRI Scabies TIDAK
28 5/28/2014 1266228538 WARJO Asthma, unspecified TIDAK
29 5/26/2014 423379359 ASEP GAOS Scabies TIDAK
30 5/26/2014 423424416 HENDI Diarrhoea and gastroenteritis of presumed infectious origin TIDAK
31 5/26/2014 423482905 DONI Acute upper respiratory infection, unspecified TIDAK
32 5/26/2014 423689848 ADE YUSUP Acute upper respiratory infection, unspecified TIDAK
33 5/26/2014 423729595 UWIN Other and unspec diseases of pulp and periapical tissues TIDAK
34 5/26/2014 423804431 NURDIN Rheumatism, unspecified TIDAK
35 5/26/2014 424087852 DWI Rheumatism, unspecified TIDAK
36 5/26/2014 424333653 RISITA Dermatitis, unspecified TIDAK
37 5/26/2014 424439651 ISAH Rheumatism, unspecified TIDAK
38 5/26/2014 1004324556 CICIN Other and unspecified disorders of circulatory system YA 1
39 5/26/2014 1284206062 IIM ROHIMAH Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perforati TIDAK
40 5/26/2014 1305897917 rizal muhammad mauTb lung without mention of bact or histological confirm YA 1
41 5/26/2014 1310906452 iyay yulintiani Disorder of refraction, unspecified YA 1
42 5/25/2014 423651429 DEVIRA Acute upper respiratory infection, unspecified TIDAK
43 5/24/2014 69266327 KOMAR Hypertension (HPN) TIDAK
44 5/24/2014 423794722 SIFA Scabies TIDAK
45 5/24/2014 423795791 NINA Developmental odontogenic cysts TIDAK
46 5/24/2014 1257420475 SAHRINI Moderate protein-energy malnutrition YA 1
47 5/23/2014 69685514 A SYAMBAS Hypertension (HPN) TIDAK
48 5/23/2014 422695754 UMU Polyarthritis, unspecified TIDAK
49 5/23/2014 423055787 NIA Cellulitis, unspecified TIDAK
50 5/23/2014 423215111 EUIS Pyogenic granuloma TIDAK
No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJUK CETAK

51 5/23/2014 423231355 ICIN Calculus of kidney TIDAK


52 5/23/2014 423883001 ANI SURYANI Dental caries, unspecified TIDAK
53 5/23/2014 1184681406 WIDANENGSIH INDRACystitis, unspecified TIDAK
54 5/23/2014 1285868079 mohamad rehan Glaucoma, unspecified YA 1
55 5/22/2014 68997565 DJUBAEDAH Developmental odontogenic cysts TIDAK
56 5/22/2014 422876981 IMAS Single spontaneous delivery, unspecified TIDAK
57 5/22/2014 423088018 SUMARNA Typhoid fever TIDAK
58 5/22/2014 423214312 MIRNA Cutaneous abscess, furuncle and carbuncle of face TIDAK
59 5/22/2014 423241896 IJANG KAMALUDIN Influenza with pneumonia, virus not identified TIDAK
60 5/22/2014 423326698 DEDE SOPIAH Dizziness and giddiness TIDAK
61 5/22/2014 423843085 OJAH Acute haemorrhagic gastritis TIDAK
62 5/22/2014 423873685 MI'AH Gastric ulcer, acute with haemorrhage TIDAK
63 5/22/2014 424077928 FITRI Cutaneous abscess, furuncle and carbuncle of face TIDAK
64 5/22/2014 424290082 DIAH Impacted teeth TIDAK
65 5/22/2014 424299554 SUSI Acute haemorrhagic gastritis TIDAK
66 5/22/2014 424583032 POPONG Dermatitis, unspecified TIDAK
67 5/22/2014 424608434 HALIMAH Gastric ulcer, acute with haemorrhage TIDAK
68 5/22/2014 424646234 PITRI N Dermatitis, unspecified YA 1
69 5/22/2014 1266228538 WARJO Asthma, unspecified TIDAK
70 5/21/2014 423003172 ELSA Gastric ulcer, acute with haemorrhage TIDAK
71 5/21/2014 423450369 EPUL Conjunctivitis, unspecified TIDAK
72 5/21/2014 423740687 ATIKAH Gastric ulcer, acute with haemorrhage TIDAK
73 5/21/2014 423742252 NITA SAKILA Bronchopneumonia, unspecified TIDAK
74 5/21/2014 424212906 YONI Disorder of eye and adnexa, unspecified YA 1
75 5/21/2014 424244878 ENDAH Influenza with pneumonia, virus not identified TIDAK
76 5/21/2014 424335418 AIDAH Developmental odontogenic cysts TIDAK
77 5/21/2014 1004325862 IDAH Gastric ulcer, acute with haemorrhage TIDAK
78 5/21/2014 1311239406 wildan alamsyah Interstitial pulmonary disease, unspecified YA 1
79 5/20/2014 423000314 IHAH Hypertension (HPN) TIDAK
80 5/20/2014 423211421 MIMIN MUNAROH Acute haemorrhagic gastritis TIDAK
81 5/20/2014 423686722 RIKI S Pyogenic granuloma TIDAK
82 5/20/2014 423695518 OOM Essential (primary) hypertension TIDAK
83 5/20/2014 423744028 ASIH Cutaneous abscess, furuncle and carbuncle, unspecified TIDAK
84 5/20/2014 424104311 DARWIS Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perforati TIDAK
85 5/20/2014 424290633 ISAH Dermatitis, unspecified TIDAK
86 5/20/2014 424515611 INDRA Influenza with pneumonia, virus not identified TIDAK
87 5/20/2014 424645907 ENUR N Scabies TIDAK
88 5/20/2014 424715951 SITI AISYAH Shigellosis due to shigella dysenteriae TIDAK
89 5/19/2014 68997565 DJUBAEDAH Rheumatism, unspecified TIDAK
90 5/19/2014 423129789 INDI Cutaneous abscess, furuncle and carbuncle, unspecified TIDAK
91 5/19/2014 423484828 AHMAD Acute renal failure with tubular necrosis TIDAK
92 5/19/2014 423515845 IDIN Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perforati TIDAK
93 5/19/2014 423541438 WANDA Dermatitis, unspecified TIDAK
94 5/19/2014 423577822 JAJANG S Unspecified haemorrhoids without complication YA 1
95 5/19/2014 423594303 AAM Spontaneous abortion, complete or unspecified, without complication YA 1
96 5/19/2014 424055327 SANAH Dermatitis, unspecified TIDAK
97 5/19/2014 424121411 ADE HASANAH Unspecified injury of head YA 1
98 5/19/2014 424131186 YUYU YUNIANTI Tb lung without mention of bact or histological confirm YA 1
99 5/19/2014 424516239 WISNU Acute upper respiratory infection, unspecified TIDAK
100 5/19/2014 424516612 KARYATI Dermatitis, unspecified TIDAK
101 5/19/2014 424526185 NENENG NURLIAH Dizziness and giddiness TIDAK
102 5/19/2014 424570184 PATIMAH Rheumatism, unspecified TIDAK
103 5/19/2014 1004324501 DODO Rheumatism, unspecified TIDAK
104 5/19/2014 1004325761 OYOH Dermatitis, unspecified TIDAK
105 5/19/2014 1257330892 H. idang BUSROL KARCalculus of urinary tract in other diseases ec YA 1
106 5/19/2014 1267811414 muhamad aldi suhendBronchitis, not specified as acute or chronic YA 1
No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJUK CETAK

107 5/18/2014 423094904 SANTI Single spontaneous delivery, unspecified TIDAK


108 5/17/2014 69181301 ACAH Rheumatism, unspecified TIDAK
109 5/17/2014 423314267 YAYAN Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perforati TIDAK
110 5/17/2014 423623801 AMAH Influenza with pneumonia, virus not identified TIDAK
111 5/17/2014 423625869 CUCU Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perforati TIDAK
112 5/17/2014 424647775 YONO Other and unspec diseases of pulp and periapical tissues TIDAK
113 5/17/2014 424655111 ULFAH SARIFAH Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perforati TIDAK
114 5/17/2014 1272367956 lina julianti Influenza with pneumonia, virus not identified TIDAK
115 5/16/2014 422691489 ENTIN Acute upper respiratory infection, unspecified TIDAK
116 5/16/2014 423329218 JUJU Neuralgia and neuritis, unspecified TIDAK
117 5/16/2014 423390903 JILAH Rheumatism, unspecified TIDAK
118 5/16/2014 423517814 SALWA Dental caries, unspecified TIDAK
119 5/16/2014 423650474 CICIH SETIANSIH Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perforati TIDAK
120 5/16/2014 423701763 AHMAD GHOZALI Acute tonsillitis, unspecified YA 1
121 5/16/2014 423754806 SITI KOMARIAH Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perforati TIDAK
122 5/16/2014 423942952 UKAS Myalgia TIDAK
123 5/16/2014 424157512 ABDUL ROJAK Scabies TIDAK
124 5/16/2014 424338603 LENI Rheumatism, unspecified TIDAK
125 5/16/2014 424369113 AAH Dermatitis, unspecified TIDAK
126 5/16/2014 424374671 WIBI AL FAUZAN Acute upper respiratory infection, unspecified TIDAK
127 5/16/2014 1004323386 H MAMUN Calculus of urinary tract in other diseases ec TIDAK
128 5/16/2014 1262938094 rifail rajab Scabies TIDAK
129 5/16/2014 1278297448 EJI A Acute upper respiratory infection, unspecified TIDAK
130 5/14/2014 422909864 YAYAH Diarrhoea and gastroenteritis of presumed infectious origin TIDAK
131 5/14/2014 423120328 YUDI Acute upper respiratory infection, unspecified TIDAK
132 5/14/2014 423504674 MARYATI Influenza with pneumonia, virus not identified TIDAK
133 5/14/2014 423504718 FIRLI Acute upper respiratory infection, unspecified TIDAK
134 5/14/2014 423816849 ASUM Pulpitis TIDAK
135 5/14/2014 424320096 ADE Dermatitis, unspecified TIDAK
136 5/14/2014 424320647 JAJAT Scabies TIDAK
137 5/14/2014 424394785 ALIS Acute upper respiratory infection, unspecified TIDAK
138 5/14/2014 424506497 WANDA Dermatitis, unspecified TIDAK
139 5/14/2014 1266228538 WARJO Predominantly allergic asthma TIDAK
140 5/13/2014 69073198 ZAENAL ARIPIN Chronic ischaemic heart disease, unspecified TIDAK
141 5/13/2014 411865828 DEDE AISAH Acute upper respiratory infection, unspecified TIDAK
142 5/13/2014 422848754 ENYAT Diarrhoea and gastroenteritis of presumed infectious origin TIDAK
143 5/13/2014 423137878 NUR AISYAH Dermatitis, unspecified TIDAK
144 5/13/2014 423187582 CICIN Rheumatism, unspecified TIDAK
145 5/13/2014 423424438 YUNINGSIH Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perforati TIDAK
146 5/13/2014 423653681 SITI Diarrhoea and gastroenteritis of presumed infectious origin TIDAK
147 5/13/2014 423665043 ROHMAN Asthma, unspecified TIDAK
148 5/13/2014 424131186 YUYU YUNIANTI Acute upper respiratory infection, unspecified TIDAK
149 5/13/2014 424154801 IYON Dermatitis, unspecified TIDAK
150 5/13/2014 424370259 SOBAR Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perforati TIDAK
151 5/13/2014 424708367 IPAH Other abortion, incomplete, complicated by genital tract and pelvic infec YA 1
152 5/13/2014 1004323847 ETI Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perforati TIDAK
153 5/13/2014 1004324556 CICIN Other and unspecified disorders of circulatory system YA 1
154 5/13/2014 1004325524 IYAH Developmental odontogenic cysts TIDAK
155 5/13/2014 1004325546 UMUN Essential (primary) hypertension TIDAK
156 5/13/2014 1081593134 ASTRI APRILIANTI Acute upper respiratory infection, unspecified TIDAK
157 5/13/2014 1257331792 YANI HERYANI Other immediate postpartum haemorrhage YA 1
158 5/13/2014 1305605597 solih gupron Other and unspecified disorders of circulatory system YA 1
159 5/12/2014 69138167 OIH YOPHI Acute upper respiratory infection, unspecified TIDAK
160 5/12/2014 69880116 EULIS KARWATI . Rheumatism, unspecified TIDAK
161 5/12/2014 423211871 INDRA JAYA Cutaneous abscess, furuncle and carbuncle, unspecified TIDAK
162 5/12/2014 423428905 DEDE IDA Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perforati TIDAK

No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJUK CETAK

163 5/12/2014 423445634 RIVAL Acute upper respiratory infection, unspecified TIDAK
164 5/12/2014 423694359 ENGKUS Amoebiasis, unspecified TIDAK
165 5/12/2014 423865822 YATI Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perforati TIDAK
166 5/12/2014 424390645 RIAN Dental caries, unspecified TIDAK
167 5/12/2014 424438143 ENA Hypertension (HPN) TIDAK
168 5/10/2014 423517601 HILMAN Influenza with pneumonia, virus not identified TIDAK
169 5/10/2014 423662365 IMAS Typhoid fever TIDAK
170 5/10/2014 423704305 AHMAD Cardiovascular syphilis TIDAK
171 5/10/2014 423808839 OMAH Dental caries, unspecified TIDAK
172 5/10/2014 423809943 AI RESTI Influenza with pneumonia, virus not identified TIDAK
173 5/10/2014 424414697 YUNI A Acute suppurative otitis media TIDAK
174 5/9/2014 69069284 EULIS FARIDA Fever, unspecified TIDAK
175 5/9/2014 69880195 FARIHAT Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perforati TIDAK
176 5/9/2014 423040509 MASITOH Rheumatism, unspecified TIDAK
177 5/9/2014 423041815 HENI Hypothermia not assoc with low environmental temperature TIDAK
178 5/9/2014 423041872 PURNAMA Dermatitis, unspecified TIDAK
179 5/9/2014 423475356 BIBAH Rheumatism, unspecified TIDAK
180 5/9/2014 423770196 UUD Polyarthritis, unspecified TIDAK
181 5/9/2014 423837371 IJAH Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perforati TIDAK
182 5/9/2014 424002431 ASEP Acute haemorrhagic gastritis TIDAK
183 5/9/2014 424333653 RISITA Dermatitis, unspecified TIDAK
184 5/9/2014 424360293 JUBAEDAH Rheumatism, unspecified TIDAK
185 5/9/2014 424645154 DADAN Cellulitis of finger and toe TIDAK
186 5/9/2014 1004324286 ANI Predominantly allergic asthma TIDAK
187 5/9/2014 1270353284 TRI YUDI APRIYONO Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perforati TIDAK
188 5/9/2014 1278297448 EJI A Heart failure, unspecified YA 1
189 5/8/2014 69360581 HADANIAH Influenza with pneumonia, virus not identified TIDAK
190 5/8/2014 422742194 WULAN Acute pharyngitis, unspecified TIDAK
191 5/8/2014 422977173 DINI Other and unspec diseases of pulp and periapical tissues TIDAK
192 5/8/2014 423000314 IHAH Hypertension (HPN) TIDAK
193 5/8/2014 423187582 CICIN Hypertension (HPN) TIDAK
194 5/8/2014 423650474 CICIH SETIANSIH Acute upper respiratory infection, unspecified TIDAK
195 5/8/2014 423921835 AI SITI ROSITA Long labour, unspecified YA 1
196 5/8/2014 424107527 SALSABILA Dermatitis, unspecified TIDAK
197 5/8/2014 424176761 ROHAYATI Decubitus ulcer TIDAK
198 5/8/2014 424368933 DADI Hypothermia not assoc with low environmental temperature TIDAK
199 5/8/2014 424490343 CECEP H Acute upper respiratory infection, unspecified TIDAK
200 5/8/2014 1305170245 AYdeCICAH Angina pectoris, unspecified YA 1
201 5/8/2014 1306540348 KARWATI Single spontaneous delivery, unspecified TIDAK
202 5/7/2014 422965113 RIDWAN Other appendicitis YA 1
203 5/7/2014 423033478 HAJAR Other and unspec diseases of pulp and periapical tissues TIDAK
204 5/7/2014 423245564 HERI Tb intrathoracic lymph node without bact or hist confirm YA 1
205 5/7/2014 423444914 TITA Idiopathic hypotension TIDAK
206 5/7/2014 423622664 EEN Cerebrovascular disease, unspecified YA 1
207 5/7/2014 424077434 ADE LILIS Other and unspec diseases of pulp and periapical tissues TIDAK
208 5/7/2014 424097908 TETEH YATI Gastric ulcer, acute with haemorrhage TIDAK
209 5/7/2014 424165645 MAHRON Conjunctivitis, unspecified TIDAK
210 5/7/2014 424503257 PIAN Other and unspecified disorders of circulatory system YA 1
211 5/7/2014 1004322802 UUN Acute haemorrhagic gastritis TIDAK
212 5/7/2014 1266228538 WARJO Predominantly allergic asthma TIDAK
213 5/6/2014 423419218 NURJAMAN Diarrhoea and gastroenteritis of presumed infectious origin TIDAK
214 5/6/2014 423717502 JENI ANGGRAENI Scabies TIDAK
215 5/6/2014 423729595 UWIN Dental caries, unspecified TIDAK
216 5/6/2014 423839349 REDI S Dermatitis, unspecified TIDAK
217 5/6/2014 423914859 TRI BUKTI Scabies TIDAK
218 5/6/2014 424290633 ISAH Dermatitis, unspecified TIDAK

No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJUK CETAK

219 5/6/2014 424290791 ADE FITRI Gastric ulcer, acute with haemorrhage TIDAK
220 5/6/2014 424608434 HALIMAH Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perforati TIDAK
221 5/6/2014 424609378 AGNI Influenza with pneumonia, virus not identified TIDAK
222 5/6/2014 424654986 AMAH PATIMAH Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perforati TIDAK
223 5/5/2014 422747289 ISOH Dermatitis, unspecified TIDAK
224 5/5/2014 422748516 ADE AISYAH Scabies TIDAK
225 5/5/2014 422782762 IHAT SOLIHAT Allergic contact dermatitis due to metals TIDAK
226 5/5/2014 423245564 HERI Tb lung without mention of bact or histological confirm YA 1
227 5/5/2014 423475615 SITI ZAKARIAH Pneumonia, unspecified TIDAK
228 5/5/2014 423599027 ENENG Other and unspec diseases of pulp and periapical tissues TIDAK
229 5/5/2014 423651429 DEVIRA Influenza with pneumonia, virus not identified TIDAK
230 5/5/2014 423663669 EMIT Hypertension (HPN) TIDAK
231 5/5/2014 423685899 TITIN Dermatitis, unspecified TIDAK
232 5/5/2014 423694541 TATI Gastritis, unspecified TIDAK
233 5/5/2014 423965924 RONI Typhoid fever TIDAK
234 5/5/2014 423966148 AGIS Acute upper respiratory infection, unspecified TIDAK
235 5/5/2014 423966532 SANDRI Acute upper respiratory infection, unspecified TIDAK
236 5/5/2014 423989818 HENI Single spontaneous delivery, unspecified TIDAK
237 5/5/2014 424207732 EMPUNG Conjunctivitis, unspecified TIDAK
238 5/5/2014 424244878 ENDAH Fever, unspecified TIDAK
239 5/5/2014 424246667 RULI Acute upper respiratory infection, unspecified TIDAK
240 5/5/2014 424439651 ISAH Rheumatism, unspecified TIDAK
241 5/5/2014 424587824 ENYU Asthma, unspecified TIDAK
242 5/5/2014 1004325761 OYOH Essential (primary) hypertension TIDAK
243 5/5/2014 1004325862 IDAH Dermatitis, unspecified TIDAK
244 5/5/2014 1261627198 SITI NURHAYATI Resp tb unspec without mention of bact or hist confirm YA 1
245 5/3/2014 423504718 FIRLI Acute upper respiratory infection, unspecified TIDAK
246 5/3/2014 423614103 NENAH Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perforati TIDAK
247 5/3/2014 424246612 DERINI Dermatitis, unspecified TIDAK
248 5/2/2014 69360579 ABDALOH Pneumonia, unspecified TIDAK
249 5/2/2014 422770498 YUYUN Influenza with pneumonia, virus not identified TIDAK
250 5/2/2014 423080932 WIDI YULIA Dermatitis, unspecified TIDAK
251 5/2/2014 423122523 YANTI Gastritis, unspecified TIDAK
252 5/2/2014 423653005 ENCI Scabies TIDAK
253 5/2/2014 423890267 DENDI Acute upper respiratory infection, unspecified TIDAK
254 5/2/2014 424055327 SANAH Dental caries, unspecified TIDAK
255 5/2/2014 424176761 ROHAYATI Dermatitis, unspecified TIDAK
256 5/2/2014 424221355 EDI Scabies TIDAK
257 5/2/2014 424290791 ADE FITRI Gastritis, unspecified TIDAK
258 5/2/2014 424331188 AAH Essential (primary) hypertension TIDAK
259 5/2/2014 424348975 AI ROPAH Anogenital herpesviral infection, unspecified TIDAK
260 5/2/2014 424516869 AI WINA Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perforati TIDAK
261 5/2/2014 424585833 MAMAD Scabies TIDAK
262 5/2/2014 424609378 AGNI Pneumonia, unspecified TIDAK
263 5/2/2014 1262938094 rifail rajab Acute upper respiratory infection, unspecified TIDAK
264 5/2/2014 1266228538 WARJO Asthma, unspecified TIDAK
265 5/1/2014 423252088 HAJAR Single spontaneous delivery, unspecified TIDAK
34
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

DermRheuScabAsthInfl Diar GastAcutDentEsseGastDeveCutaGastTyphConjSingAcutOtheOther and unspecified disorders of circulatory system


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25 16 15 6 13 5 22 24 6 4 3 4 6 8 6 3 7 5 6 3
Daftar Kunjungan Peserta bpjs/ askes/ jamkesmas/ jampersal
Puskesmas : Sukahurip
Bulan : Juni 2014
Jumlah Kunjungan : 233
Jumlah Yang dirujuk : 40

No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJUK

1 6/30/2014 411865828 DEDE AISAH Influenza with oth resp manifestation virus not identified TIDAK
2 6/30/2014 423157836 IRON BURHANUDIN Chronic ischaemic heart disease, unspecified YA
3 6/30/2014 423432876 YATI Developmental odontogenic cysts TIDAK
4 6/30/2014 424286302 SOBAN Cutaneous abscess, furuncle and carbuncle of face TIDAK
5 6/30/2014 1266228538 WARJO Asthma, unspecified TIDAK
6 6/30/2014 1278297448 EJI A Fever, unspecified TIDAK
7 6/29/2014 423200035 IDOH Single spontaneous delivery, unspecified TIDAK
8 6/28/2014 423432033 HASANAH Malignant neoplasm, intestinal tract, part unspecified YA
9 6/28/2014 423843085 OJAH Gastritis, unspecified TIDAK
10 6/28/2014 424077928 FITRI Scabies TIDAK
11 6/28/2014 424078108 DADAH Dental caries, unspecified TIDAK
12 6/28/2014 424097908 TETEH YATI Hypertension (HPN) TIDAK
13 6/28/2014 424405708 SITI KOMSAH Gastritis, unspecified TIDAK
14 6/28/2014 1004324501 DODO Hypertension (HPN) TIDAK
15 6/28/2014 1004324782 HOLILAH Dermatitis, unspecified TIDAK
16 6/27/2014 423037304 ABDUL Dental caries, unspecified TIDAK
17 6/27/2014 423211421 MIMIN MUNAROH Other and unspec diseases of pulp and periapical tissues TIDAK
18 6/27/2014 423611469 NINA Hypertension (HPN) TIDAK
19 6/27/2014 424088818 NIA Rheumatism, unspecified TIDAK
20 6/27/2014 424359922 YETI Postcoital and contact bleeding YA
21 6/26/2014 422976508 ISAH Typhoid fever TIDAK
22 6/26/2014 423728199 ENAH Rheumatism, unspecified TIDAK
23 6/26/2014 424293309 II RUSTANDI Schizophrenia, unspecified TIDAK
24 6/26/2014 424526185 NENENG NURLIAH Single spontaneous delivery, unspecified TIDAK
25 6/26/2014 424658979 DINI YULIANI Single spontaneous delivery, unspecified TIDAK
26 6/26/2014 1324074723 dede rohayati Typhoid fever YA
27 6/25/2014 69266327 KOMAR Hypertension (HPN) TIDAK
28 6/25/2014 422933365 EUIS Gastritis, unspecified TIDAK
29 6/25/2014 423077422 AMAR Rheumatism, unspecified TIDAK
30 6/25/2014 423773987 SITA Mumps without complication YA
31 6/25/2014 423966892 ONENG Bronchopneumonia, unspecified TIDAK
32 6/25/2014 423997626 SALSA Dental caries, unspecified TIDAK
33 6/25/2014 424146194 ELIS Gastritis, unspecified TIDAK
34 6/25/2014 424262935 TITIM Single spontaneous delivery, unspecified TIDAK
35 6/25/2014 1311239406 wildan alamsyah Interstitial pulmonary disease, unspecified YA
36 6/25/2014 1326144543 oom aningsih Malignant neoplasm, myometrium YA
37 6/24/2014 68997554 ASENG Hypertension (HPN) TIDAK
38 6/24/2014 422705248 DIDIN Acute amoebic dysentery TIDAK
39 6/24/2014 423525881 HABIB Epilepsy, unspecified YA
40 6/24/2014 423622664 EEN Cerebrovascular disease, unspecified YA
41 6/24/2014 423865822 YATI Influenza with pneumonia, virus not identified TIDAK
42 6/24/2014 423965924 RONI Disorder of refraction, unspecified YA
43 6/24/2014 424101475 IMAM MAULANA Acute upper respiratory infection, unspecified TIDAK
44 6/24/2014 424414765 AIRA RAISA KIRANI Scabies TIDAK
45 6/24/2014 424644568 JAJA Acute upper respiratory infection, unspecified TIDAK
46 6/24/2014 1262644479 ENUNG Rheumatism, unspecified TIDAK
47 6/23/2014 423060243 DINA Neuralgia and neuritis, unspecified TIDAK
48 6/23/2014 423129609 SANDI Diarrhoea and gastroenteritis of presumed infectious origin TIDAK
49 6/23/2014 423129789 INDI Ascariasis, unspecified TIDAK
50 6/23/2014 423566774 DUDUNG Other thalassaemias YA
51 6/23/2014 423816581 AGUS Paratyphoid fever, unspecified TIDAK
No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJUK

52 6/23/2014 424402648 ADE WAWANG Urinary calculus, unspecified TIDAK


53 6/23/2014 424572704 LATIPAH Gastritis, unspecified TIDAK
54 6/23/2014 424643152 ASID Influenza with oth resp manifestation virus not identified TIDAK
55 6/23/2014 1004326255 YATI ANA Rheumatism, unspecified TIDAK
56 6/23/2014 1262938094 rifail rajab Dermatitis, unspecified TIDAK
57 6/23/2014 1266228538 WARJO Asthma, unspecified TIDAK
58 6/21/2014 422647481 ADE EMAR Dental caries, unspecified TIDAK
59 6/21/2014 423740687 ATIKAH Gastritis, unspecified TIDAK
60 6/21/2014 1004324501 DODO Hypertension (HPN) TIDAK
61 6/20/2014 69266327 KOMAR Gastritis, unspecified TIDAK
62 6/20/2014 423521684 ITA Typhoid fever TIDAK
63 6/20/2014 423541438 WANDA Fever, unspecified TIDAK
64 6/20/2014 423663669 EMIT Rheumatism, unspecified TIDAK
65 6/20/2014 423664119 ROHMAH Single spontaneous delivery, unspecified TIDAK
66 6/20/2014 423666639 HABIB ULFAH Acute upper respiratory infection, unspecified TIDAK
67 6/20/2014 423759947 UCUP Arthritis, unspecified TIDAK
68 6/20/2014 424333653 RISITA Gastritis, unspecified TIDAK
69 6/20/2014 1081593134 ASTRI APRILIANTI Fever, unspecified TIDAK
70 6/20/2014 1257387557 WILDA Single spontaneous delivery, unspecified TIDAK
71 6/19/2014 422977792 LIA Acute upper respiratory infection, unspecified TIDAK
72 6/19/2014 423525881 HABIB Epilepsy, unspecified YA
73 6/19/2014 423816186 MIMIH Disorder of eye and adnexa, unspecified TIDAK
74 6/19/2014 424307373 AAH Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perfora TIDAK
75 6/19/2014 424609378 AGNI Typhoid fever TIDAK
76 6/19/2014 424647775 YONO Scabies TIDAK
77 6/19/2014 424682919 PURKON Unspecified injury of head YA
78 6/19/2014 1004325761 OYOH Conjunctivitis, unspecified TIDAK
79 6/19/2014 1256954038 JAJANG Depressive episode, unspecified YA
80 6/19/2014 1324074723 dede rohayati Typhoid fever YA
81 6/19/2014 1324383884 A. SUTARMAN Stroke, not specified as haemorrhage or infarction YA
82 6/18/2014 69120753 HARYS SURYADY Dermatitis, unspecified TIDAK
83 6/18/2014 69353504 AYI SUMIYATI Paratyphoid fever, unspecified YA
84 6/18/2014 69881163 TATI NURYATI Dermatitis, unspecified TIDAK
85 6/18/2014 423215111 EUIS Disorder of skin and subcutaneous tissue, unspecified TIDAK
86 6/18/2014 423362283 ENTIN Gastritis, unspecified TIDAK
87 6/18/2014 423366423 YOGA Dermatitis, unspecified TIDAK
88 6/18/2014 423504674 MARYATI Scabies TIDAK
89 6/18/2014 423504718 FIRLI Acute upper respiratory infection, unspecified TIDAK
90 6/18/2014 423748732 EULIS Acute upper respiratory infection, unspecified TIDAK
91 6/18/2014 423759598 DEDE Rheumatism, unspecified TIDAK
92 6/18/2014 423760702 REGINA Acute upper respiratory infection, unspecified TIDAK
93 6/18/2014 423819944 ROJAK Influenza with oth resp manifestation virus not identified TIDAK
94 6/18/2014 424286302 SOBAN Cutaneous abscess, furuncle and carbuncle of face YA
95 6/18/2014 424302557 DEDE HADIDAH Single spontaneous delivery, unspecified TIDAK
96 6/18/2014 424528571 AI CARIAH Conjunctivitis, unspecified TIDAK
97 6/18/2014 424552702 ETI Conjunctivitis, unspecified TIDAK
98 6/18/2014 1261627198 SITI NURHAYATI Resp tb unspec without mention of bact or hist confirm YA
99 6/18/2014 1262938094 rifail rajab Acute upper respiratory infection, unspecified TIDAK
100 6/18/2014 1285868079 mohamad rehan Glaucoma, unspecified YA
101 6/18/2014 1323556075 naura nur alfia Other preterm infants YA
102 6/17/2014 69353504 AYI SUMIYATI Paratyphoid fever, unspecified YA
103 6/17/2014 411906385 E SITI PATIMAH Bronchopneumonia, unspecified TIDAK
104 6/17/2014 422728503 AEP Influenza with pneumonia, virus not identified TIDAK
105 6/17/2014 424704058 MUMIN ALIYUDIN Acute upper respiratory infection, unspecified TIDAK
106 6/17/2014 1311790781 pitri Tb lung confirm sputum microscopy with or without culture YA
107 6/16/2014 69181301 ACAH Acute upper respiratory infection, unspecified TIDAK
108 6/16/2014 422909864 YAYAH Gastritis, unspecified TIDAK
No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJUK

109 6/16/2014 422943682 OGI Acute upper respiratory infection, unspecified TIDAK
110 6/16/2014 422943704 AGUNG Other and unspec diseases of pulp and periapical tissues TIDAK
111 6/16/2014 423432033 HASANAH Malignant neoplasm, intestinal tract, part unspecified YA
112 6/16/2014 423827122 RIJAL Diarrhoea and gastroenteritis of presumed infectious origin TIDAK
113 6/16/2014 423836559 HAFID Disorder of skin and subcutaneous tissue, unspecified TIDAK
114 6/16/2014 423837371 IJAH Gastritis, unspecified TIDAK
115 6/16/2014 423841432 ESAH Influenza with pneumonia, virus not identified TIDAK
116 6/16/2014 423955809 DEWI Diarrhoea and gastroenteritis of presumed infectious origin TIDAK
117 6/16/2014 423975047 FARHAN Cutaneous abscess, furuncle and carbuncle, unspecified TIDAK
118 6/16/2014 424121411 ADE HASANAH Other disorders of nervous system, not elsewhere classified YA
119 6/16/2014 424207732 EMPUNG Rheumatism, unspecified TIDAK
120 6/16/2014 424290633 ISAH Dermatitis, unspecified TIDAK
121 6/16/2014 424438143 ENA Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perfora TIDAK
122 6/16/2014 424654986 AMAH PATIMAH Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perfora TIDAK
123 6/16/2014 1004324286 ANI Acute upper respiratory infection, unspecified TIDAK
124 6/16/2014 1004325546 UMUN Rheumatism, unspecified TIDAK
125 6/16/2014 1266228538 WARJO Asthma, unspecified TIDAK
126 6/14/2014 423622214 EVI Y Gastric ulcer, acute with haemorrhage TIDAK
127 6/14/2014 423982732 IMAS Paratyphoid fever, unspecified TIDAK
128 6/14/2014 423992272 RATNA Gastritis, unspecified TIDAK
129 6/14/2014 424054089 RINI Acute upper respiratory infection, unspecified TIDAK
130 6/14/2014 424331188 AAH Rheumatism, unspecified TIDAK
6/14/2014 424616872 ITING Essential (primary) hypertension TIDAK
132 6/14/2014 424666844 ENOB Hydronephrosis with ureteropelvic junction obstruction TIDAK
133 6/13/2014 422955099 EUIS YUNINGSIH Influenza with oth resp manifestation virus not identified TIDAK
134 6/13/2014 423193735 DIAH Acute upper respiratory infection, unspecified TIDAK
135 6/13/2014 423236362 ENUNG Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perfora TIDAK
136 6/13/2014 423517601 HILMAN Fever, unspecified TIDAK
137 6/13/2014 423671769 PIAH Dermatitis, unspecified TIDAK
138 6/13/2014 424378372 RIDWAN Conjunctivitis, unspecified TIDAK
139 6/13/2014 1004325862 IDAH Acute upper respiratory infection, unspecified TIDAK
140 6/13/2014 1303580812 AI ROHIMAH Long labour, unspecified YA
141 6/12/2014 69138167 OIH YOPHI Acute upper respiratory infection, unspecified TIDAK
142 6/12/2014 422820527 ENYI Herpesviral vesicular dermatitis TIDAK
143 6/12/2014 423440943 CIKA Acute tonsillitis, unspecified TIDAK
144 6/12/2014 423446376 NINDI Influenza with pneumonia, influenza virus identified TIDAK
145 6/12/2014 423857002 IIN Tb lung confirm sputum microscopy with or without culture YA
146 6/12/2014 424054181 RIAN Influenza with pneumonia, virus not identified TIDAK
147 6/12/2014 424185412 ATIH Gest [pregnancy-induced] hypertens without sig proteinuria YA
148 6/12/2014 424760692 MANAH Fracture of foot, unspecified YA
149 6/12/2014 1004328718 AJUM Influenza with oth resp manifestation virus not identified TIDAK
150 6/11/2014 423248905 IMAS Acute upper respiratory infection, unspecified TIDAK
151 6/11/2014 423982732 IMAS Acute pansinusitis TIDAK
152 6/11/2014 424335418 AIDAH Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perfora TIDAK
153 6/11/2014 424376504 DEDE Influenza with pneumonia, influenza virus identified TIDAK
154 6/11/2014 424377437 ANDI Paratyphoid fever, unspecified TIDAK
155 6/11/2014 1004328202 ENEH Asthma, unspecified TIDAK
156 6/11/2014 1276485388 leni halimah Single spontaneous delivery, unspecified TIDAK
157 6/10/2014 422868273 NURJANAH Influenza with pneumonia, virus not identified TIDAK
158 6/10/2014 423187582 CICIN Dermatitis, unspecified TIDAK
159 6/10/2014 423435475 NABIL Scabies TIDAK
160 6/10/2014 423436241 NELA Acute upper respiratory infection, unspecified TIDAK
161 6/10/2014 423545038 HABIBAH Acute upper respiratory infection, unspecified TIDAK
162 6/10/2014 423657088 GILANG Acute upper respiratory infection, unspecified TIDAK
163 6/10/2014 423685899 TITIN Rheumatism, unspecified TIDAK
164 6/10/2014 423686913 TIK-TIK Hypertension (HPN) TIDAK
165 6/10/2014 423843085 OJAH Acute haemorrhagic gastritis TIDAK

No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJUK

166 6/10/2014 423946912 NINA Single stillbirth YA


167 6/10/2014 424060233 IIN Rheumatism, unspecified TIDAK
168 6/10/2014 424310681 TIO Fever, unspecified TIDAK
169 6/10/2014 424490218 AI POPON Disorder of teeth and supporting structures, unspecified TIDAK
170 6/10/2014 1276485388 leni halimah Single spontaneous delivery, unspecified TIDAK
171 6/9/2014 423182676 ANI Acute pharyngitis, unspecified TIDAK
172 6/9/2014 424002014 UCUN Malignant neoplasm, vulva, unspecified YA
173 6/9/2014 424053369 KIKIN Influenza with pneumonia, virus not identified TIDAK
174 6/9/2014 424568349 UBADILAH Typhoid fever YA
175 6/9/2014 1266228538 WARJO Asthma, unspecified TIDAK
176 6/9/2014 1284206062 IIM ROHIMAH Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perfora TIDAK
177 6/8/2014 424400354 AISYAH Single spontaneous delivery, unspecified TIDAK
178 6/7/2014 69069284 EULIS FARIDA Gastritis, unspecified TIDAK
179 6/7/2014 69181301 ACAH Rheumatism, unspecified TIDAK
180 6/7/2014 411906385 E SITI PATIMAH Rheumatism, unspecified TIDAK
181 6/7/2014 422933365 EUIS Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perfora TIDAK
182 6/7/2014 423532168 JUJU Typhoid fever TIDAK
183 6/7/2014 423661037 ENUR HAYATI Diarrhoea and gastroenteritis of presumed infectious origin TIDAK
184 6/7/2014 423951041 YANI Disorder of skin and subcutaneous tissue, unspecified TIDAK
185 6/6/2014 422743757 ANING Gastritis, unspecified TIDAK
186 6/6/2014 422981368 ETI Acute haemorrhagic gastritis TIDAK
187 6/6/2014 423248905 IMAS Rheumatism, unspecified TIDAK
188 6/6/2014 423631203 ROKAYAH Labour and delivery complicated by fetal stress, unspecified YA
189 6/6/2014 423663669 EMIT Rheumatism, unspecified TIDAK
190 6/6/2014 423689027 NURASIAH Single spontaneous delivery, unspecified TIDAK
191 6/6/2014 423989008 IRI Neoplasm of uncertain or unknown behaviour, unspecified YA
192 6/6/2014 424045293 EROS Severe pre-eclampsia YA
193 6/6/2014 424056249 TRIA Acute upper respiratory infection, unspecified TIDAK
194 6/6/2014 424439651 ISAH Gastroduodenitis, unspecified TIDAK
195 6/6/2014 424616523 YAZID Acute upper respiratory infection, unspecified TIDAK
196 6/6/2014 1315497925 didin komarudin Hypertension (HPN) TIDAK
197 6/5/2014 423475356 BIBAH Rheumatism, unspecified TIDAK
198 6/5/2014 423865822 YATI Gastritis, unspecified TIDAK
199 6/5/2014 424131186 YUYU YUNIANTI Tuberculosis of lung, confirmed by unspecified means TIDAK
200 6/5/2014 424365941 ADI Cutaneous abscess, furuncle and carbuncle, unspecified TIDAK
201 6/5/2014 424366942 ADE WILI Acute upper respiratory infection, unspecified TIDAK
202 6/5/2014 1278858789 asep hasanudin Influenza with oth resp manifestation virus not identified TIDAK
203 6/4/2014 422698149 ASRI Other abortion, incomplete, complicated by genital tract and pelvic inf YA
204 6/4/2014 423410027 AI Gestational oedema YA
205 6/4/2014 423665043 ROHMAN Asthma, unspecified TIDAK
206 6/4/2014 423762221 EMAY Dental caries, unspecified TIDAK
207 6/4/2014 424202949 IKA Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perfora TIDAK
208 6/4/2014 424331188 AAH Hypertension (HPN) TIDAK
209 6/4/2014 424645907 ENUR N Dermatitis, unspecified TIDAK
210 6/3/2014 423034828 DEDE KUSMIATI Acute tonsillitis, unspecified TIDAK
211 6/3/2014 423035649 BELA Neuralgia and neuritis, unspecified TIDAK
212 6/3/2014 423036371 DINDA Disorder of teeth and supporting structures, unspecified TIDAK
213 6/3/2014 423037304 ABDUL Scabies TIDAK
214 6/3/2014 423193735 DIAH Conjunctivitis, unspecified TIDAK
215 6/3/2014 423517814 SALWA Acute upper respiratory infection, unspecified TIDAK
216 6/3/2014 423611469 NINA Gastric ulcer, unspec as acute or chronic w'out haemorrhage or perfora TIDAK
217 6/3/2014 423740564 IDUN Rheumatism, unspecified TIDAK
218 6/3/2014 423837257 DEDE Developmental odontogenic cysts TIDAK
219 6/3/2014 423861816 ELIS Diarrhoea and gastroenteritis of presumed infectious origin TIDAK
220 6/3/2014 424189462 HENI MARWATI Cutaneous abscess, furuncle and carbuncle, unspecified TIDAK
221 6/2/2014 422744488 HENI Gastritis, unspecified TIDAK
222 6/2/2014 422980468 SAHAL Diarrhoea and gastroenteritis of presumed infectious origin TIDAK

No TANGGAL No. KARTU NAMA PESERTA DIAGNOSA DI RUJUK

223 6/2/2014 423029766 RENI Neoplasm of uncertain or unknown behaviour, unspecified YA


224 6/2/2014 423033478 HAJAR Dental caries, unspecified TIDAK
225 6/2/2014 423424293 ANEU Dermatitis, unspecified TIDAK
226 6/2/2014 423662894 SITI AMINAH Rheumatism, unspecified TIDAK
227 6/2/2014 423695766 ANA Asthma, unspecified YA
228 6/2/2014 423878826 NELI Disorder of skin and subcutaneous tissue, unspecified TIDAK
229 6/2/2014 424103477 ENI Myalgia TIDAK
230 6/2/2014 424109889 ATI Schizophrenia, unspecified TIDAK
231 6/2/2014 424526185 NENENG NURLIAH Acute upper respiratory infection, unspecified TIDAK
232 6/2/2014 424647775 YONO Scabies TIDAK
233 6/2/2014 1256675275 HJ IIM Other disorders of nervous system, not elsewhere classified YA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
DermRheuScabAsthInfl GastDiar AcutDentAcutGastFeveCutaParaTyphConjSingDisoOtheHypertension (HPN)
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1 1
1
1
1
1

1
1
1
1
1
1

1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1

1
1
1
1
1
1
1 1
1
1
1 1
1
1
1
1
1
1
1
1
1
1
1 1
1
1
1
1
1
1
1
1 1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1

1
1
1 1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1

1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1

1
1
1
1
1 1
1

1
1
1
40 10 19 7 7 14 10 6 25 6 2 16 5 5 5 7 5 11 4 2 9
kode
1 Dermatitis, unspecified l30.9 Dermatitis lain, tidak spesifik (eksema)
Penyakit infeksi saluran pernapasan atas akut tidak
2 Acute upper respiratory infection, unspecified J06.9 spesifik

3 Gastritis, unspecified k29.7 Tukak lambung

4 Rheumatism, unspecified M79.0 Reumatisme tidak spesifik

5 Influenza with oth resp manifestation virus not identified J111 Influensa

6 Diarrhoea and gastroenteritis of presumed infectious origin A090 Diare dan gastroenteritis

7 Scabies B86 Skabies

8 Essential (primary) hypertension I10 Hipertensi primer (esensial)

9 Myalgia M79.1 Myalgia

10 Conjunctivitis, unspecified H109 Konjungtivitis

11 Asthma, unspecified J45.9 Asthma

12 Acute tonsillitis, unspecified J03.9 Tonsilitis akuta

Penyakit saluran pernapasan bagian atas lainnya


13 Other specified diseases of upper respiratory tract J398
14 Cutaneous abscess, furuncle and carbuncle of face L020 Abses, furunkel, karbunkel kutan

15 Typhoid fever A010 Demam typoid

16 Nummular dermatitis L300 Dermatitis lain, tidak spesifik (eksema)

17 Single spontaneous delivery, unspecified o809 Persalinan tunggal spontan

18 Fever, unspecified R509 Demam yang tidak diketahui sebebnya

19 Unspecified diabetes mellitus without complications E149 Diabetes melitus tidak sfesifik

20 Gnathostomiasis B831 Gnathostomiasis


Penyakit infeksi saluran pernapasan atas akut tidak
1 Acute upper respiratory infection, unspecified J06.9 spesifik

2 Dermatitis, unspecified l30.9 Dermatitis lain, tidak spesifik (eksema)

3 Essential (primary) hypertension I10 Hipertensi primer (esensial)

4 Influenza with oth resp manifestation virus not identified J111 Influensa

5 Rheumatism, unspecified M79.0 Reumatisme tidak spesifik

6 Scabies B86 Skabies

7 Gastritis, unspecified k29.7 Tukak lambung

8 Typhoid fever A010 Demam typoid

9 Dental caries, unspecified k029 Karies Gigi

10 Cutaneous abscess, furuncle and carbuncle, unspecified L029 Abses, furunkel, karbunkel kutan

11 Asthma, unspecified J45.9 Asthma

12 Fever, unspecified R509 Demam yang tidak diketahui sebebnya

13 Disorder of skin and subcutaneous tissue, unspecified l989 Gangguan lain pada kulit dan jaringan subkutan yang ti
14 Other and unspec diseases of pulp and periapical tissues k049 Penyakit pulpa dan jaringan periapikal
15 Myalgia M79.1 Myalgia

16 Acute tonsillitis, unspecified J03.9 Tonsilitis akuta

17 Conjunctivitis, unspecified H109 Konjungtivitis

18 Gastroduodenitis, unspecified k299 Gastroduodenitis tidak spesifik


19 Other and unspecified disorders of circulatory system i99 Penyakit pembuluh darah lain tidak spesifik
20 Diarrhoea and gastroenteritis of presumed infectious origin A090 Diare dan gastroenteritis
Penyakit infeksi saluran pernapasan atas akut tidak
1 Acute upper respiratory infection, unspecified J06.9 spesifik

2 Gastritis, unspecified k29.7 Tukak lambung

3 Rheumatism, unspecified M79.0 Reumatisme tidak spesifik

4 Dermatitis, unspecified l30.9 Dermatitis lain, tidak spesifik (eksema)

5 Influenza with oth resp manifestation virus not identified J111 Influensa
6 Essential (primary) hypertension I10 Hipertensi primer (esensial)

7 Acute tonsillitis, unspecified J03.9 Tonsilitis akuta

8 Diarrhoea and gastroenteritis of presumed infectious origin A090 Diare dan gastroenteritis

9 Asthma, unspecified J45.9 Asthma

10 Other and unspec diseases of pulp and periapical tissues k049 Penyakit pulpa dan jaringan periapikal
11 Cutaneous abscess, furuncle and carbuncle, unspecified L029 Abses, furunkel, karbunkel kutan

12 Disorder of skin and subcutaneous tissue, unspecified l989 Gangguan lain pada kulit dan jaringan subkutan yang ti
13 Other specified general symptoms and signs R688 Gejala dan tanda umum lainnya
14 Scabies B86 Skabies

15 Fever, unspecified R509 Demam yang tidak diketahui sebebnya

16 Unspecified acute lower respiratory infection J229 Faringitis akuta

17 Myalgia M79.1 Myalgia

18 Conjunctivitis, unspecified H109 Konjungtivitis

19 Dental caries, unspecified k029 Karies Gigi

20 Other and unspecified disorders of circulatory system i99 Penyakit pembuluh darah lain tidak spesifik
Penyakit infeksi saluran pernapasan atas akut tidak
1 Acute upper respiratory infection, unspecified J06.9 spesifik

2 Rheumatism, unspecified M79.0 Reumatisme tidak spesifik

3 Dermatitis, unspecified l30.9 Dermatitis lain, tidak spesifik (eksema)

4 Influenza with oth resp manifestation virus not identified J111 Influensa

5 Essential (primary) hypertension I10 Hipertensi primer (esensial)

6 Gastritis, unspecified k29.7 Tukak lambung

7 Diarrhoea and gastroenteritis of presumed infectious origin A090 Diare dan gastroenteritis

8 Scabies B86 Skabies

9 Cutaneous abscess, furuncle and carbuncle, unspecified L029 Abses, furunkel, karbunkel kutan
Penyakit gusi, jaringan periodental dan tulang
10 Gastric ulcer, unspec as acute or chronic w'out haemorrhage or pe K256 alveolar

11 Asthma, unspecified J45.9 Asthma

12 Acute tonsillitis, unspecified J03.9 Tonsilitis akuta

13 Fever, unspecified R509 Demam yang tidak diketahui sebebnya

14 Other and unspec diseases of pulp and periapical tissues k049 Penyakit pulpa dan jaringan periapikal
15 Dental caries, unspecified k029 Karies Gigi

16 Acute pharyngitis, unspecified J029 Faringitis akuta

17 Acute haemorrhagic gastritis K290 Acute haemorrhagic gastritis


18 Disorder of skin and subcutaneous tissue, unspecified L989 Gangguan lain pada kulit dan jaringan subkutan yang ti
19 Paratyphoid fever, unspecified A014 Demam paratifoid tidak sfesisik
20 Other specified general symptoms and signs R688 Gejala dan tanda umum lainnya
1 Dermatitis, unspecified l30.9 Dermatitis lain, tidak spesifik (eksema)
Penyakit infeksi saluran pernapasan atas akut tidak
8 Acute upper respiratory infection, unspecified J06.9 spesifik
Penyakit gusi, jaringan periodental dan tulang
7 Gastric ulcer, unspec as acute or chronic w'out haemorrhage or pe K256 alveolar

2 Rheumatism, unspecified M79.0 Reumatisme tidak spesifik

3 Scabies B86 Skabies

5 Influenza with pneumonia, virus not identified J111 Influensa

Essential (primary) hypertension I10 Hipertensi primer (esensial)

14 Gastric ulcer, acute with haemorrhage K250 Gastric ulcer, acute with haemorrhage
17 Single spontaneous delivery, unspecified o809 Persalinan tunggal spontan

15 Typhoid fever A010 Demam typoid

13 Cutaneous abscess, furuncle and carbuncle, unspecified L029 Abses, furunkel, karbunkel kutan
4 Asthma, unspecified J45.9 Asthma

9 Dental caries, unspecified k029 Karies Gigi

19 Other and unspec diseases of pulp and periapical tissues k049 Penyakit pulpa dan jaringan periapikal
6 Diarrhoea and gastroenteritis of presumed infectious origin A090 Diare dan gastroenteritis

18 Acute haemorrhagic gastritis K290 Acute haemorrhagic gastritis


Developmental odontogenic cysts K929 Penyakit sistem pncernaan tidak spesifik

Gastritis, unspecified k29.7 Tukak lambung

16 Conjunctivitis, unspecified H109 Konjungtivitis

20 Other and unspecified disorders of circulatory system i99 Penyakit pembuluh darah lain tidak spesifik

Penyakit infeksi saluran pernapasan atas akut tidak


1 Acute upper respiratory infection, unspecified J06.9 spesifik

2 Rheumatism, unspecified M79.0 Reumatisme tidak spesifik

3 Gastritis, unspecified k29.7 Tukak lambung

4 Influenza with pneumonia, virus not identified J111 Influensa

5 Single spontaneous delivery, unspecified o809 Persalinan tunggal spontan


Penyakit gusi, jaringan periodental dan tulang
6 Gastric ulcer, unspec as acute or chronic w'out haemorrhage or pe K256 alveolar

7 Dermatitis, unspecified l30.9 Dermatitis lain, tidak spesifik (eksema)

8 Hypertension (HPN) i109 Hypertensi


9 Scabies B86 Skabies

10 Asthma, unspecified J45.9 Asthma

11 Typhoid fever A010 Demam typoid

12 Diarrhoea and gastroenteritis of presumed infectious origin A090 Diare dan gastroenteritis

13 Dental caries, unspecified k029 Karies Gigi

14 Fever, unspecified A010 Demam typoid

15 Cutaneous abscess, furuncle and carbuncle, unspecified L029 Abses, furunkel, karbunkel kutan

16 Paratyphoid fever, unspecified A014 Demam paratifoid tidak sfesisik


17 Conjunctivitis, unspecified H109 Konjungtivitis

18 Disorder of skin and subcutaneous tissue, unspecified L989 Gangguan lain pada kulit dan jaringan subkutan yang ti
19 Acute haemorrhagic gastritis K290 Acute haemorrhagic gastritis
Other and unspec diseases of pulp and periapical tissues k049 Penyakit pulpa dan jaringan periapikal

Dermatitis, unspecified l30.9 Dermatitis lain, tidak spesifik (eksema)

Rheumatism, unspecified M79.0 Reumatisme tidak spesifik

Scabies B86 Skabies

Asthma, unspecified J45.9 Asthma

Influenza with pneumonia, virus not identified J111 Influensa


Penyakit gusi, jaringan periodental dan tulang
Gastric ulcer, unspec as acute or chronic w'out haemorrhage or pe K256 alveolar

Diarrhoea and gastroenteritis of presumed infectious origin A090 Diare dan gastroenteritis
Penyakit infeksi saluran pernapasan atas akut tidak
Acute upper respiratory infection, unspecified J06.9 spesifik

Dental caries, unspecified k029 Karies Gigi

Acute haemorrhagic gastritis K290 Acute haemorrhagic gastritis


Gastritis, unspecified k29.7 Tukak lambung

Fever, unspecified A010 Demam typoid

Cutaneous abscess, furuncle and carbuncle, unspecified L029 Abses, furunkel, karbunkel kutan
Paratyphoid fever, unspecified A014 Demam paratifoid tidak sfesisik
Typhoid fever A010 Demam typoid

Conjunctivitis, unspecified H109 Konjungtivitis

Single spontaneous delivery, unspecified o809 Persalinan tunggal spontan

Disorder of skin and subcutaneous tissue, unspecified L989 Gangguan lain pada kulit dan jaringan subkutan yang ti
Other and unspec diseases of pulp and periapical tissues k049 Penyakit pulpa dan jaringan periapikal
Hypertension (HPN) i109 Hypertensi
jumlah rangking
22 21

18 18
18 18
16 16
16 16
10 15
8 13
8 13
6 11
6 11
5 9
5 9

4 6
4 6
4 6
3 4
3 4
2 1
2 1
2 1

32 20
19 18
16 17
15 16
14 15
12 14
11 13
9 11
9 11
8 10
7 7
7 7
7 7
4 6
3 2
3 2
3 2
3 2
2 1
2 1

35 20
26 19
22 18
20 17
14 15
14 15
12 14
10 13
9 10
9 10
9 10
6 9
5 8
4 5
4 5
4 5
3 2
3 2
3 2
2 1

26 #VALUE!
23 #VALUE!
18 17
16 16
13
10 14
9 12
9 12
8 10

8 10
7 9
6 6
6 6
6 6
5 4
5 4
4 1
4 1
4 1
2 #VALUE!
25 20

24 19

22 18
16 17
15 16
13 15
12 14
8 13
7 12
6 7
6 7
6 7
6 7
6 7
5 5
5 5
4 4
3 1
3 1
3 1

25 1
19 2
16 3
14 4
11 5

10 6
10 6
9 8
7 9
7 9
7 9
6 12
6 12
5 14
5 14
5 14
5 14
4 18
3 19
2 20

10 6
19 2
7 9
7 9
14 4

10 6
6 12

25 1
6 12
3 19
16 3
5 14
5 14
5 14
7 9
5 14
11 5
4 18
2 20
9 8
0
Daftar Kunjungan Peserta BPJS/ Askes/ Jamkesmas/ Jam
Puskesmas : Sukahurip
Bulan : Juli 2014
Jumlah Kunjungan : 175
Jumlah Yang dirujuk : 39

No TANGGAL No. KARTU NAMA PESERTA

1 25/07/2014 423744028 ASIH


2 24/07/2014 423618039 ENDANG
3 24/07/2014 423889896 DIAT
4 24/07/2014 423974305 M RAMDAN
5 24/07/2014 424636716 ROSITA FUJIANTI
6 24/07/2014 1387044246 idah
7 23/07/2014 422791132 SOFIA
8 23/07/2014 423255791 AI RINI
9 23/07/2014 424159097 SITI
10 23/07/2014 424655706 REPI
11 23/07/2014 1004322767 YAYAH
12 23/07/2014 1004324782 HOLILAH
13 23/07/2014 1259439895 ENTING
14 22/07/2014 423650474 CICIH SETIANSIH
15 22/07/2014 423770196 UUD
16 22/07/2014 423974428 HERI
17 22/07/2014 423975047 FARHAN
18 22/07/2014 424207732 EMPUNG
19 22/07/2014 424338603 LENI
20 22/07/2014 1278297448 EJI A
21 21/07/2014 422904789 DIDAH
22 21/07/2014 423434799 ISAH
23 21/07/2014 423506777 RAHMA D
24 21/07/2014 423689927 NURHAYATI
25 21/07/2014 423903407 MIMIN
26 21/07/2014 424101475 IMAM MAULANA
27 21/07/2014 424390116 RESTI
28 21/07/2014 1004322802 UUN
29 21/07/2014 1004325546 UMUN
30 21/07/2014 1257648298 ETI
31 21/07/2014 1266228538 WARJO
32 19/07/2014 423037304 ABDUL
33 19/07/2014 423241896 IJANG KAMALUDIN
34 19/07/2014 423614349 TUSUF
35 19/07/2014 424630056 NURHLIMAH
36 19/07/2014 424636716 ROSITA FUJIANTI
37 19/07/2014 1004325862 IDAH
38 18/07/2014 69181301 ACAH
39 18/07/2014 423463825 ANNISA
40 18/07/2014 423484479 ATAR
41 18/07/2014 423485291 NURLELA
42 18/07/2014 423671804 ANIS ANISAH
43 18/07/2014 423947834 KOMARIYAH
44 18/07/2014 423974305 M RAMDAN
45 18/07/2014 424045293 EROS
46 18/07/2014 1257254504 AI SULASTRI
47 18/07/2014 1267809017 HENDAR HERDIANA
48 18/07/2014 1267811414 Muhamad Aldi Suhendar
49 18/07/2014 1284487852 RISYANTO
50 17/07/2014 422666998 YATI

No TANGGAL No. KARTU NAMA PESERTA

51 17/07/2014 422695754 UMU

52 17/07/2014 423329218 JUJU

53 17/07/2014 423817288 NANIH

54 16/07/2014 69880116 EULIS KARWATI .

55 16/07/2014 422782762 IHAT SOLIHAT

56 16/07/2014 423060243 DINA

57 16/07/2014 423541438 WANDA

58 16/07/2014 423865822 YATI

59 16/07/2014 423967566 MASITOH

60 16/07/2014 1259235821 HAMIDAH

61 15/07/2014 69669459 YAHYA HIDAYAT

62 15/07/2014 69669461 NENIH

63 15/07/2014 422950779 NURHAYATI

64 15/07/2014 423248905 IMAS

65 15/07/2014 423249232 PIAN


66 15/07/2014 423566774 DUDUNG

67 15/07/2014 423843085 OJAH

68 15/07/2014 1004324501 DODO

69 15/07/2014 1261627198 SITI NURHAYATI

70 15/07/2014 1383270107 IPIN ARIPIN

71 14/07/2014 69138167 OIH YOPHI

72 14/07/2014 423035324 HANIFAH

73 14/07/2014 423129609 SANDI

74 14/07/2014 423740687 ATIKAH

75 14/07/2014 424276604 ALISA

76 14/07/2014 424331065 LALA

77 14/07/2014 424379114 RANGGA

78 14/07/2014 424405708 SITI KOMSAH

79 14/07/2014 424409354 RIJAL PAUZI

80 14/07/2014 424616872 ITING

81 14/07/2014 424644568 JAJA

82 14/07/2014 1256739568 HILDA MAULIDA

83 14/07/2014 1259141242 IMAS MUNAWAROH

84 14/07/2014 1266228538 WARJO

85 14/07/2014 1284206062 IIM ROHIMAH

86 14/07/2014 1298967535 agus rizal mubarok

87 13/07/2014 424276604 ALISA

88 12/7/2014 423428905 DEDE IDA

89 12/7/2014 423521346 MIMIH

90 12/7/2014 423664119 ROHMAH

91 12/7/2014 423678982 ITA

92 12/7/2014 424101475 IMAM MAULANA

93 12/7/2014 424165645 MAHRON

94 12/7/2014 1272855194 neng sovi sukmawati

95 11/7/2014 69181301 ACAH

96 11/7/2014 69353504 AYI SUMIYATI

97 11/7/2014 423397359 M ILHAM

98 11/7/2014 423861816 ELIS

99 11/7/2014 423891314 MIFTAHUL ANWAR

100 11/7/2014 1257739773 RENI

101 10/7/2014 423329218 JUJU

102 10/7/2014 423622664 EEN

103 10/7/2014 1081436635 MARYATI

104 10/7/2014 1258907354 ROFIATUL ADAWIAH


No TANGGAL No. KARTU NAMA PESERTA

105 10/7/2014 1262644479 ENUNG

106 10/7/2014 1298967535 agus rizal mubarok

107 10/7/2014 1382038479 dedi kurniadi

108 10/7/2014 1382039594 nina fitriani

109 9/7/2014 422744488 HENI

110 9/7/2014 423097569 AYAT


111 9/7/2014 423855876 ENUNG

112 8/7/2014 422743757 ANING

113 8/7/2014 423412683 DADAH

114 8/7/2014 423665043 ROHMAN

115 8/7/2014 423742252 NITA SAKILA

116 7/7/2014 422728503 AEP

117 7/7/2014 423517814 SALWA

118 7/7/2014 423697702 TASIH

119 7/7/2014 423759947 UCUP

120 7/7/2014 423834568 OOM

121 7/7/2014 423836559 HAFID

122 7/7/2014 423837371 IJAH

123 7/7/2014 423916323 JAJANG FIRMAN

124 7/7/2014 1004328448 IRUS

125 7/7/2014 1263633423 GRISTI MAULIDIA AROPAH

6 7/7/2014 1270353284 TRI YUDI APRIYONO


127 7/7/2014 1305605597 solih gupron

128 6/7/2014 422799254 ADE

129 6/7/2014 423992272 RATNA

130 6/7/2014 1311100312 ELA

131 5/7/2014 423455207 RISPAN

132 5/7/2014 423663669 EMIT

133 5/7/2014 423822464 EROSMAWATI

134 5/7/2014 423951041 YANI


135 5/7/2014 424101475 IMAM MAULANA

136 5/7/2014 424490152 IMAN SARIP H

137 5/7/2014 1258805823 ENTIN MARTINI

138 5/7/2014 1258807847 YANI ROHAENI

139 5/7/2014 1297056273 ADE YANA

140 5/7/2014 1298967535 agus rizal mubarok

141 4/7/2014 68985101 YANI ANDRIANI

142 4/7/2014 423249221 ACIH

143 4/7/2014 423339816 UNDANG

144 4/7/2014 423762221 EMAY

145 4/7/2014 423768521 ENUNG

146 4/7/2014 423768802 SERLI

147 4/7/2014 424490218 AI POPON

148 3/7/2014 423614057 AAN

149 3/7/2014 423729595 UWIN

150 3/7/2014 423869949 AI ROHIMAH

51 3/7/2014 1262644479 ENUNG

152 3/7/2014 1262938094 rifail rajab

153 3/7/2014 1273630151 acip

154 3/7/2014 1278297448 EJI A

155 2/7/2014 422551811 MIMIN

156 2/7/2014 423682492 NUR AISAH

157 2/7/2014 423695766 ANA

158 2/7/2014 423699164 MULYADI

No TANGGAL No. KARTU NAMA PESERTA

59 2/7/2014 424121411 ADE HASANAH

160 2/7/2014 424132795 SRI H

161 2/7/2014 424314393 JUJU JUBAEDAH

162 2/7/2014 424335418 AIDAH

163 1/7/2014 69880116 EULIS KARWATI .

164 1/7/2014 423326294 M RIDWAN

165 1/7/2014 423358389 HISNA


166 1/7/2014 423541438 WANDA

167 1/7/2014 423559945 LILIT

168 1/7/2014 423560395 RISMAYANTI

169 1/7/2014 423692425 AINUN SOPIAH

170 1/7/2014 423935673 LILIS SAPITRI

171 1/7/2014 424103477 ENI

172 1/7/2014 424104311 DARWIS

173 1/7/2014 424657989 TITIN

174 1/7/2014 424660746 SILVI

175 1/7/2014 1273630151 acip


jungan Peserta BPJS/ Askes/ Jamkesmas/ Jampersal

DIAGNOSA DI RUJUK
TIDAK
Cutaneous abscess, furuncle and carbuncle, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Influenza with pneumonia, virus not identified
TIDAK
Scabies
TIDAK
Acute haemorrhagic gastritis
YA
Gastritis, unspecified
TIDAK
Influenza with pneumonia, virus not identified
TIDAK
Disease of jaws, unspecified
TIDAK
Bacterial foodborne intoxication, unspecified
TIDAK
Acute upper respiratory infection, unspecified
YA
Acute cystitis
TIDAK
Dermatitis, unspecified
YA
Malignant neoplasm, breast, unspecified
TIDAK
Diarrhoea and gastroenteritis of presumed infectious origin
TIDAK
Arthritis, unspecified
TIDAK
Dermatitis, unspecified
TIDAK
Other specified diseases of upper respiratory tract
TIDAK
Hypertension (HPN)
TIDAK
Other and unspec diseases of pulp and periapical tissues
TIDAK
Other and unspec diseases of pulp and periapical tissues
TIDAK
Hypertension (HPN)
TIDAK
Disorder of skin and subcutaneous tissue, unspecified
TIDAK
Dental caries, unspecified
YA
Other immediate postpartum haemorrhage
TIDAK
Fever, unspecified
Gastritis, unspecified TIDAK
Unspecified contact dermatitis, unspecified cause TIDAK
Hypertension (HPN) TIDAK
Hypertension (HPN) TIDAK
Acute upper respiratory infection, unspecified TIDAK
Asthma, unspecified TIDAK
Scabies TIDAK
Influenza with pneumonia, virus not identified TIDAK
Dermatitis, unspecified TIDAK
Disorder of skin and subcutaneous tissue, unspecified TIDAK
Influenza with pneumonia, virus not identified TIDAK
Dermatitis, unspecified TIDAK
Rheumatism, unspecified TIDAK
Disorder of eye and adnexa, unspecified TIDAK
Acute upper respiratory infection, unspecified TIDAK
Hypotension, unspecified TIDAK
Acute upper respiratory infection, unspecified TIDAK
Gastritis, unspecified TIDAK
Paratyphoid fever, unspecified TIDAK
Severe pre-eclampsia YA
Myalgia TIDAK
Calculus of urinary tract in other diseases ec YA
Bronchitis, not specified as acute or chronic YA
Unilateral or unspecified femoral hernia, without obstruction or gangrene YA
Acute pharyngitis, unspecified TIDAK

DIAGNOSA DI RUJUK
TIDAK
Gastritis, unspecified
YA
Single spontaneous delivery, unspecified
TIDAK
Gastritis, unspecified
TIDAK
Influenza with pneumonia, virus not identified
TIDAK
Cystitis, unspecified
TIDAK
Single spontaneous delivery, unspecified
TIDAK
Rheumatism, unspecified
TIDAK
Diarrhoea and gastroenteritis of presumed infectious origin
TIDAK
Diarrhoea and gastroenteritis of presumed infectious origin
YA
Neonatal jaundice, unspecified
TIDAK
Rheumatism, unspecified
TIDAK
Conjunctivitis, unspecified
TIDAK
Rheumatism, unspecified
TIDAK
Rheumatism, unspecified
TIDAK
Disorder of teeth and supporting structures, unspecified
YA
Other thalassaemias
TIDAK
Scabies
TIDAK
Rheumatism, unspecified
YA
Resp tb unspec without mention of bact or hist confirm
YA
Unspecified injury of lower leg
TIDAK
Influenza with pneumonia, virus not identified
TIDAK
Single spontaneous delivery, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Single spontaneous delivery, unspecified
TIDAK
Gastritis, unspecified
TIDAK
Gastritis, unspecified
TIDAK
Rheumatism, unspecified
TIDAK
Cutaneous abscess, furuncle and carbuncle, unspecified
TIDAK
Conjunctivitis, unspecified
TIDAK
Gastritis, unspecified
YA
Epilepsy, unspecified
YA
Prolonged pregnancy
TIDAK
Asthma, unspecified
TIDAK
Gastritis, unspecified
TIDAK
Other and unspec diseases of pulp and periapical tissues
TIDAK
Single spontaneous delivery, unspecified
TIDAK
Influenza with pneumonia, virus not identified
TIDAK
Gastritis, unspecified
TIDAK
Influenza with pneumonia, virus not identified
TIDAK
Paratyphoid fever, unspecified
TIDAK
Diarrhoea and gastroenteritis of presumed infectious origin
TIDAK
Allergic contact dermatitis due to metals
YA
Premature rupture of membranes, unspecified
TIDAK
Rheumatism, unspecified
YA
Gastritis, unspecified
TIDAK
Scabies
TIDAK
Other and unspec diseases of pulp and periapical tissues
YA
Bilateral inguinal hernia, with obstruction, without gangrene
YA
Tuberculosis of lung, bacteriologically & histolog'y neg
TIDAK
Rheumatism, unspecified
YA
Cerebrovascular disease, unspecified
TIDAK
Gastritis, unspecified
YA
Gastritis, unspecified
DIAGNOSA DI RUJUK
TIDAK
Bronchopneumonia, unspecified
YA
Bilateral inguinal hernia, with obstruction, without gangrene
YA
Heart failure, unspecified
YA
Angina pectoris, unspecified
TIDAK
Gastric ulcer, chronic without haemorrhage or perforation
TIDAK
Asthma, unspecified
Diarrhoea and gastroenteritis of presumed infectious origin TIDAK

Unspecified abortion, incomplete, complicated by genital tract and pelvic infection YA


TIDAK
Alcoholic gastritis
TIDAK
Asthma, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Diarrhoea and gastroenteritis of presumed infectious origin
TIDAK
Dermatitis, unspecified
TIDAK
Rheumatism, unspecified
TIDAK
Influenza with pneumonia, virus not identified
TIDAK
Rheumatism, unspecified
TIDAK
Dermatitis, unspecified
TIDAK
Gastritis, unspecified
TIDAK
Scabies
TIDAK
Scabies
YA
Asthma, unspecified
TIDAK
Rheumatism, unspecified
Other and unspecified disorders of circulatory system YA

Unspecified abortion, incomplete, complicated by genital tract and pelvic infection YA


YA
Prolonged pregnancy
YA
Other immediate postpartum haemorrhage
TIDAK
Disorder of eye and adnexa, unspecified
TIDAK
Gastritis, unspecified
TIDAK
Fever, unspecified
TIDAK
Disorder of skin and subcutaneous tissue, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Dermatitis, unspecified
YA
Other immediate postpartum haemorrhage
YA
Antepartum haemorrhage, unspecified
YA
Fracture of foot, unspecified
YA
Unilateral or unspecified inguinal hernia, without obstruction or gangrene
TIDAK
Dermatitis, unspecified
TIDAK
Gastritis, unspecified
TIDAK
Other and unspec diseases of pulp and periapical tissues
TIDAK
Other and unspec diseases of pulp and periapical tissues
TIDAK
Gastritis, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Acute tonsillitis, unspecified
TIDAK
Myalgia
TIDAK
Typhoid fever
YA
Prolonged pregnancy
TIDAK
Rheumatism, unspecified
TIDAK
Scabies
TIDAK
Asthma, unspecified
YA
Heart failure, unspecified
TIDAK
Single spontaneous delivery, unspecified
TIDAK
Rheumatism, unspecified
YA
Asthma, unspecified
TIDAK
Scabies

DIAGNOSA DI RUJUK
YA
Acute suppurative otitis media
TIDAK
Acute tonsillitis, unspecified
YA
Other immediate postpartum haemorrhage
TIDAK
Gastritis, unspecified
TIDAK
Rheumatism, unspecified
TIDAK
Unspecified acute lower respiratory infection
TIDAK
Dermatitis, unspecified
TIDAK
Influenza with pneumonia, virus not identified
TIDAK
Conjunctivitis, unspecified
TIDAK
Conjunctivitis, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Gastritis, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Gastritis, unspecified
TIDAK
Disorder of skin and subcutaneous tissue, unspecified
TIDAK
Scabies
TIDAK
Asthma, unspecified
Daftar Kunjungan Peserta BPJS/ Askes/ Jamkesmas/ Jamper
Puskesmas : Sukahurip
Bulan : Agustus 2014
Jumlah Kunjungan : 237
Jumlah Yang dirujuk : 61

No TANGGAL No. KARTU NAMA PESERTA

1 30/08/2014 69611681 TATI KARTISAH


2 30/08/2014 423237756 WULAN
3 30/08/2014 423517601 HILMAN
4 30/08/2014 423704406 KOMALASARI
5 30/08/2014 424189462 HENI MARWATI
6 30/08/2014 424335363 OYON
7 30/08/2014 1262938094 rifail rajab
8 30/08/2014 1311239406 wildan alamsyah
9 30/08/2014 1428328135 yani nuraeni
10 29/08/2014 423035324 HANIFAH
11 29/08/2014 423204186 SARI
12 29/08/2014 423822464 EROSMAWATI
13 29/08/2014 424029835 PIPIH
14 29/08/2014 424244878 ENDAH
15 28/08/2014 69360579 ABDALOH
16 28/08/2014 423966295 ERWIN
17 28/08/2014 423981088 MASITOH
18 28/08/2014 424087929 JANA
19 28/08/2014 424350055 IIP
20 28/08/2014 1004322767 YAYAH
21 28/08/2014 1004322802 UUN
22 28/08/2014 1004324556 CICIN
23 28/08/2014 1257648298 ETI
24 28/08/2014 1428592116 euis tati
25 28/08/2014 1428715225 imas
27/08/2014 69880994 AEP SAEPUROHMAN
27 27/08/2014 423241896 IJANG KAMALUDIN
28 27/08/2014 423390903 JILAH
29 27/08/2014 423391893 YAYANG
30 27/08/2014 423428905 DEDE IDA
31 27/08/2014 423817288 NANIH
32 27/08/2014 423858047 AEP
33 27/08/2014 424053369 KIKIN
34 27/08/2014 424570184 PATIMAH
35 27/08/2014 424594168 ENUNG
36 27/08/2014 1004323386 H MAMUN
37 27/08/2014 1262938094 rifail rajab
38 27/08/2014 1266228538 WARJO
39 26/08/2014 422705248 DIDIN
40 26/08/2014 423712675 IIS
41 26/08/2014 423714969 DEWI
42 26/08/2014 423738134 ENUR
43 26/08/2014 423889367 DE ROSIH
44 26/08/2014 1004325546 UMUN
45 26/08/2014 1004327559 ENGKAN
46 25/08/2014 423236913 WIWIN
47 25/08/2014 423401681 AI NURHAYATI
No TANGGAL No. KARTU NAMA PESERTA
48 25/08/2014 423665111 KOMARIAH
49 25/08/2014 423740564 IDUN
50 25/08/2014 423853604 RENDI
51 25/08/2014 424067962 ITA
52 25/08/2014 424370259 SOBAR
53 25/08/2014 424390116 RESTI
54 25/08/2014 424515611 INDRA
55 25/08/2014 424576449 SIPA
56 25/08/2014 1004325761 OYOH
57 25/08/2014 1004327559 ENGKAN
58 23/08/2014 422789218 CECEP
59 23/08/2014 423120328 YUDI
60 23/08/2014 423122681 DINI
61 23/08/2014 423248905 IMAS
62 23/08/2014 423692425 AINUN SOPIAH
63 23/08/2014 423942952 UKAS
64 23/08/2014 424054089 RINI
65 23/08/2014 424088043 NURHASANAH
66 23/08/2014 424189462 HENI MARWATI
67 23/08/2014 424307373 AAH
68 23/08/2014 424341764 HENI
69 23/08/2014 1004323285 APIT
70 23/08/2014 1004323296 EMPOR
71 23/08/2014 1004326885 SOPIAH
72 22/08/2014 69880195 FARIHAT
73 22/08/2014 423456219 ASEP
74 22/08/2014 424053404 KOKOM
75 22/08/2014 424056249 TRIA
76 22/08/2014 424207732 EMPUNG
77 22/08/2014 424290633 ISAH
78 22/08/2014 424331065 LALA
79 22/08/2014 424490218 AI POPON
80 22/08/2014 1004325862 IDAH
81 22/08/2014 1257542932 ENA SUMPENA
82 22/08/2014 1266228538 WARJO
83 21/08/2014 422743757 ANING
84 21/08/2014 423426734 JAELANI
85 21/08/2014 424390116 RESTI
86 21/08/2014 424489252 USEP
87 21/08/2014 1004325546 UMUN
88 21/08/2014 1256410348 DEDE
89 20/08/2014 69181301 ACAH
90 20/08/2014 69669461 NENIH
91 20/08/2014 423460473 M RAMDAN
92 20/08/2014 423663669 EMIT
93 20/08/2014 423811934 PITRI
94 20/08/2014 424644568 JAJA
95 20/08/2014 1257542932 ENA SUMPENA
96 20/08/2014 1422462363 imas
97 19/08/2014 422979401 IDANG
98 19/08/2014 423181967 IMIK
99 19/08/2014 423456219 ASEP
100 19/08/2014 423521346 MIMIH
101 19/08/2014 423525881 HABIB
102 19/08/2014 423545038 HABIBAH
No TANGGAL No. KARTU NAMA PESERTA
103 19/08/2014 423817852 JALIL
104 19/08/2014 424324541 DINDIN
105 19/08/2014 424594168 ENUNG
106 19/08/2014 424594664 AI N
107 19/08/2014 424595171 MULTI
108 19/08/2014 1260736345 ENAH
109 19/08/2014 1284206062 IIM ROHIMAH
110 18/08/2014 422791132 SOFIA
111 18/08/2014 423731452 ROKAYAH
112 18/08/2014 424159209 EEN
113 18/08/2014 424258931 ITOH
114 18/08/2014 424365355 YUNANI
115 18/08/2014 424503257 PIAN
116 18/08/2014 424608434 HALIMAH
117 18/08/2014 1004324231 USUP
118 18/08/2014 1004327155 AWAT
119 17/08/2014 424490218 AI POPON
120 17/08/2014 1261627198 SITI NURHAYATI
121 16/08/2014 423326294 M RIDWAN
122 16/08/2014 423326698 DEDE SOPIAH
123 16/08/2014 423661037 ENUR HAYATI
124 16/08/2014 423662894 SITI AMINAH
125 16/08/2014 423699952 JAJANG
126 16/08/2014 423787735 ANWAR
127 16/08/2014 424616872 ITING
128 16/08/2014 1266298086 muhammad ihsan f
129 15/08/2014 423516194 ATIK
130 15/08/2014 424159097 SITI
131 15/08/2014 1422750633 cucu
132 14/08/2014 423650474 CICIH SETIANSIH
133 14/08/2014 1298967535 agus rizal mubarok
134 14/08/2014 1384379379 uu sumiati
135 14/08/2014 1422536207 rini
136 13/08/2014 69880116 EULIS KARWATI .
137 13/08/2014 422698149 ASRI
138 13/08/2014 423965799 IDAS
139 13/08/2014 424072978 SITI
140 13/08/2014 1257202449 AHMAD MUHAMAD
141 13/08/2014 1262938094 rifail rajab
142 13/08/2014 1310533198 imas pupah
143 13/08/2014 1387044246 idah
144 12/8/2014 423011777 AMELIA
145 12/8/2014 423506125 CICIH
146 12/8/2014 423622664 EEN
147 12/8/2014 1004325546 UMUN
148 12/8/2014 1266108816 ALIT rukilah
149 12/8/2014 1278297448 EJI A
150 11/8/2014 423254733 DENI
151 11/8/2014 423566774 DUDUNG
152 11/8/2014 423935234 SANDI
153 11/8/2014 424054089 RINI
154 11/8/2014 1004326885 SOPIAH
155 11/8/2014 1259409958 SAMAN FARIZI
156 11/8/2014 1307149301 d vira ana natasa
157 9/8/2014 423048003 YUDI AWAN
No TANGGAL No. KARTU NAMA PESERTA
158 9/8/2014 423464141 SALWA
159 9/8/2014 423541901 ONI
160 9/8/2014 423661037 ENUR HAYATI
161 9/8/2014 423740687 ATIKAH
162 9/8/2014 423742252 NITA SAKILA
163 9/8/2014 424077434 ADE LILIS
164 9/8/2014 424260347 SUSANTI
165 9/8/2014 424552702 ETI
166 9/8/2014 424655111 ULFAH SARIFAH
167 9/8/2014 1258340545 DEDE NURHAYATI
168 8/8/2014 423108011 M HARDIANSAH
169 8/8/2014 423193735 DIAH
170 8/8/2014 424061177 WINARTI
171 8/8/2014 424575742 IHAT
172 8/8/2014 1297058578 BIBAH
173 8/8/2014 1321354001 SAADAH
174 7/8/2014 69669459 YAHYA HIDAYAT
175 7/8/2014 423838001 IPOK
176 7/8/2014 423839349 REDI S
177 7/8/2014 424290633 ISAH
178 7/8/2014 424290791 ADE FITRI
179 7/8/2014 424310681 TIO
180 7/8/2014 424608434 HALIMAH
181 7/8/2014 1278884755 ENCAR
182 7/8/2014 1305605597 solih gupron
183 7/8/2014 1387044246 idah
184 6/8/2014 423504674 MARYATI
185 6/8/2014 423504718 FIRLI
186 6/8/2014 423611469 NINA
187 6/8/2014 423619312 YOYOH
188 6/8/2014 423740564 IDUN
189 6/8/2014 423859026 ELIT SA'ADAH
190 6/8/2014 424038677 RITA
191 6/8/2014 424655111 ULFAH SARIFAH
192 6/8/2014 1257739773 RENI
193 6/8/2014 1389123404 aas
194 5/8/2014 69181301 ACAH
195 5/8/2014 69611681 TATI KARTISAH
196 5/8/2014 423423033 NAIN
197 5/8/2014 423424293 ANEU
198 5/8/2014 423456219 ASEP
199 5/8/2014 423460473 M RAMDAN
200 5/8/2014 423665043 ROHMAN
201 5/8/2014 423699491 OYO
202 5/8/2014 424516239 WISNU
203 5/8/2014 424636716 ROSITA FUJIANTI
204 5/8/2014 424637605 TRIYANA
205 5/8/2014 1284206062 IIM ROHIMAH
206 5/8/2014 1312441323 riska paujiah
207 4/8/2014 422904789 DIDAH
208 4/8/2014 423129565 AGIT
209 4/8/2014 423129789 INDI
210 4/8/2014 423192014 PIROH
211 4/8/2014 423304288 EGI
212 4/8/2014 423410962 ELI
No TANGGAL No. KARTU NAMA PESERTA
213 4/8/2014 423413155 RITA
214 4/8/2014 423413831 NIKI
215 4/8/2014 423496372 SANTI
216 4/8/2014 423525881 HABIB
217 4/8/2014 423771636 AHMAD
218 4/8/2014 423940836 ABDUL HALIM
219 4/8/2014 423940948 BADRI TAMAM
220 4/8/2014 424054089 RINI
221 4/8/2014 424490218 AI POPON
222 4/8/2014 424617434 TANIA
223 4/8/2014 1257254504 AI SULASTRI
224 4/8/2014 1257941068 SITI AISAH
225 4/8/2014 1259491724 ADE LUKMAN
6 4/8/2014 1262938094 rifail rajab
227 4/8/2014 1266228538 WARJO
228 4/8/2014 1278884755 ENCAR
rizal muhammad
229 4/8/2014 1305897917 maulana
230 4/8/2014 1310533198 imas pupah
muhammad alya
231 4/8/2014 1318761101 robby islam
232 2/8/2014 69881332 SUKIMIN SARIFULOH
233 2/8/2014 423187582 CICIN
234 2/8/2014 423663669 EMIT
235 2/8/2014 1004326661 DEKI
236 2/8/2014 1384379379 uu sumiati
237 1/8/2014 422551811 MIMIN
ungan Peserta BPJS/ Askes/ Jamkesmas/ Jampersal

DIAGNOSA DI RUJUK
YA
Cataract, unspecified
TIDAK
Simple chronic bronchitis
TIDAK
Diarrhoea and gastroenteritis of presumed infectious origin
Influenza with pneumonia, virus not identified TIDAK
Dermatitis, unspecified TIDAK
Unilateral or unspecified inguinal hernia, without obstruction or gangrene YA
Acute upper respiratory infection, unspecified TIDAK
Interstitial pulmonary disease, unspecified YA
Other abortion, incomplete, complicated by genital tract and pelvic infection YA
Gastritis, unspecified TIDAK
Benign neoplasm of unspecified site YA
Diarrhoea and gastroenteritis of presumed infectious origin TIDAK
Corros multi reg at least one corros of third deg mentioned TIDAK
Hypertension (HPN) TIDAK
Cutaneous abscess, furuncle and carbuncle, unspecified TIDAK
Chronic ischaemic heart disease, unspecified YA
Benign neoplasm of unspecified site YA
Fever, unspecified TIDAK
Dental caries, unspecified TIDAK
Rheumatism, unspecified TIDAK
Neuralgia and neuritis, unspecified TIDAK
Chronic ischaemic heart disease, unspecified YA
Neuralgia and neuritis, unspecified TIDAK
Other disorders of nervous system, not elsewhere classified YA
Labour and delivery complicated by fetal stress, unspecified YA
Thyrotoxicosis, unspecified YA
Polyarthritis, unspecified TIDAK
Scabies TIDAK
Scabies TIDAK
Influenza with pneumonia, virus not identified TIDAK
Gastritis, unspecified TIDAK
Glaucoma, unspecified YA
Myalgia TIDAK
Unilateral or unspecified inguinal hernia, without obstruction or gangrene TIDAK
Disorder of skin and subcutaneous tissue, unspecified TIDAK
Rheumatism, unspecified TIDAK
Hypospadias, unspecified YA
Asthma, unspecified TIDAK
Acute amoebic dysentery TIDAK
Gastritis, unspecified TIDAK
Gastritis, unspecified TIDAK
Diarrhoea and gastroenteritis of presumed infectious origin TIDAK
Rheumatism, unspecified TIDAK
Rheumatism, unspecified TIDAK
Gastritis, unspecified TIDAK
Rheumatism, unspecified TIDAK
Gastritis, unspecified TIDAK
DIAGNOSA DI RUJUK
Rheumatism, unspecified TIDAK
Acute upper respiratory infection, unspecified TIDAK
Acute upper respiratory infection, unspecified TIDAK
Gastritis, unspecified TIDAK
Unilateral or unspecified inguinal hernia, without obstruction or gangrene YA
Cutaneous abscess, furuncle and carbuncle, unspecified TIDAK
Fever, unspecified TIDAK
Acute amoebic dysentery TIDAK
Rheumatism, unspecified TIDAK
Dental caries, unspecified TIDAK
Influenza with pneumonia, virus not identified TIDAK
Scabies TIDAK
Conjunctivitis, unspecified TIDAK
Rheumatism, unspecified TIDAK
Influenza with pneumonia, virus not identified TIDAK
Myalgia TIDAK
Long labour, unspecified YA
Dental caries, unspecified TIDAK
Dermatitis, unspecified TIDAK
Gastritis, unspecified TIDAK
Prolonged pregnancy YA
Developmental odontogenic cysts TIDAK
Chronic ischaemic heart disease, unspecified YA
Rheumatism, unspecified TIDAK
Gastritis, unspecified TIDAK
Hypertension (HPN) TIDAK
Hypertension (HPN) TIDAK
Bronchopneumonia, unspecified TIDAK
Hypertension (HPN) TIDAK
Conjunctivitis, unspecified TIDAK
Acute upper respiratory infection, unspecified TIDAK
Acute upper respiratory infection, unspecified TIDAK
Scabies TIDAK
Myalgia TIDAK
Asthma, unspecified TIDAK
Diarrhoea and gastroenteritis of presumed infectious origin TIDAK
Dermatitis, unspecified TIDAK
Dermatitis, unspecified TIDAK
Unspecified parasitic disease TIDAK
Hypertension (HPN) TIDAK
Other and unspecified ovarian cysts YA
Hypertension (HPN) TIDAK
Hypertension (HPN) TIDAK
Acute upper respiratory infection, unspecified TIDAK
Myalgia TIDAK
Acute amoebic dysentery TIDAK
Cataract, unspecified YA
Umbilical hernia without obstruction or gangrene YA
Schizophrenia, unspecified YA
Cutaneous abscess, furuncle and carbuncle, unspecified TIDAK
Dermatitis, unspecified TIDAK
Hypertension (HPN) TIDAK
Hypertension (HPN) TIDAK
Epilepsy, unspecified YA
Conjunctivitis, unspecified TIDAK
DIAGNOSA DI RUJUK
Other and unspec diseases of pulp and periapical tissues TIDAK
Dermatitis, unspecified TIDAK
Scabies TIDAK
Scabies TIDAK
Dermatitis, unspecified TIDAK
Malignant neoplasm, breast, unspecified YA
Conjunctivitis, unspecified TIDAK
Influenza with pneumonia, virus not identified TIDAK
Ascites YA
Myalgia TIDAK
Scabies TIDAK
Nephrotic syndrome, minor glomerular abnormality YA
Other and unspecified disorders of circulatory system YA
Dermatitis, unspecified TIDAK
Disorder of eye and adnexa, unspecified YA
Dermatitis, unspecified TIDAK
Acute upper respiratory infection, unspecified TIDAK
Resp tb unspec without mention of bact or hist confirm YA
Cutaneous abscess, furuncle and carbuncle, unspecified TIDAK
Dental caries, unspecified TIDAK
Rheumatism, unspecified TIDAK
Dermatitis, unspecified TIDAK
Cutaneous abscess, furuncle and carbuncle, unspecified YA
Streptococcal pharyngitis TIDAK
Other and unspec diseases of pulp and periapical tissues TIDAK
Tuberculosis of lung, confirmed by unspecified means YA
Dental caries, unspecified TIDAK
Allergic contact dermatitis, unspecified cause TIDAK
Delay/ exces haem follow abort and ectop and molar preg YA
Diarrhoea and gastroenteritis of presumed infectious origin TIDAK
Unilateral or unspecified inguinal hernia, without obstruction or gangrene YA
Cutaneous abscess, furuncle and carbuncle, unspecified YA
Abnormality of forces of labour, unspecified YA
Fever, unspecified TIDAK
Other and unspecified ovarian cysts YA
Cystitis, unspecified TIDAK
Cutaneous abscess, furuncle and carbuncle, unspecified TIDAK
Chronic ischaemic heart disease, unspecified YA
Other hypospadias YA
Unspecified haemorrhoids without complication YA
Ascites YA
Gastritis, unspecified TIDAK
Hypertension (HPN) TIDAK
Cerebrovascular disease, unspecified YA
Hypertension (HPN) TIDAK
Other local lupus erythematosus YA
Heart failure, unspecified YA
Pyogenic granuloma TIDAK
Other thalassaemias YA
Pyogenic granuloma TIDAK
Supervision of other normal pregnancy TIDAK
Gastritis, unspecified TIDAK
Disorder of eye and adnexa, unspecified YA
Influenza with pneumonia, virus not identified TIDAK
Acute pharyngitis, unspecified TIDAK
DIAGNOSA DI RUJUK
Pyogenic granuloma TIDAK
Diarrhoea and gastroenteritis of presumed infectious origin TIDAK
Hydronephrosis with ureteropelvic junction obstruction TIDAK
Acute upper respiratory infection, unspecified TIDAK
Typhoid fever TIDAK
Gastritis, unspecified TIDAK
Premature rupture of membranes, unspecified YA
Acute upper respiratory infection, unspecified TIDAK
Acute upper respiratory infection, unspecified TIDAK
Premature rupture of membranes, unspecified YA
Cutaneous abscess, furuncle and carbuncle, unspecified TIDAK
Diarrhoea and gastroenteritis of presumed infectious origin TIDAK
Diarrhoea and gastroenteritis of presumed infectious origin TIDAK
Stroke, not specified as haemorrhage or infarction YA
Unspecified diabetes mellitus without complications YA
Typhoid fever YA
Rheumatism, unspecified TIDAK
Influenza with oth resp manifestation virus not identified TIDAK
Influenza with oth resp manifestation virus not identified TIDAK
Scabies TIDAK
Typhoid fever TIDAK
Fever, unspecified TIDAK
Dermatitis, unspecified TIDAK
Other and unspec diseases of pulp and periapical tissues TIDAK
Other and unspecified disorders of circulatory system YA
Gastritis, unspecified YA
Scabies TIDAK
Influenza with oth resp manifestation virus not identified TIDAK
Gastritis, unspecified TIDAK
Acute upper respiratory infection, unspecified TIDAK
Gastritis, unspecified TIDAK
Spontaneous abortion, complete or unspecified, without complication YA
Influenza with pneumonia, virus not identified TIDAK
Influenza with pneumonia, virus not identified TIDAK
Tb lung without mention of bact or histological confirm YA
Slow fetal growth, unspecified YA
Hypertension (HPN) TIDAK
Cataract, unspecified YA
Rheumatism, unspecified TIDAK
Long labour, unspecified TIDAK
Migraine, unspecified TIDAK
Diarrhoea and gastroenteritis of presumed infectious origin TIDAK
Asthma, unspecified TIDAK
Hypertension (HPN) TIDAK
Influenza with pneumonia, virus not identified TIDAK
Peptic ulcer, unspec as acute or chronic w'out haemorrhage or perforation TIDAK
Fever, unspecified TIDAK
Influenza with pneumonia, virus not identified TIDAK
Scabies TIDAK
Pyogenic granuloma TIDAK
Gastritis, unspecified TIDAK
Other and unspec diseases of pulp and periapical tissues TIDAK
Periodontal disease, unspecified TIDAK
Gastritis, unspecified TIDAK
Gastritis, unspecified TIDAK
DIAGNOSA DI RUJUK
Scabies TIDAK
Ascariasis, unspecified TIDAK
Supervision of other normal pregnancy TIDAK
Epilepsy, unspecified YA
Scabies TIDAK
Other and unspec diseases of pulp and periapical tissues TIDAK
Unspecified acute lower respiratory infection TIDAK
Supervision of other normal pregnancy TIDAK
Influenza with pneumonia, virus not identified TIDAK
Paratyphoid fever, unspecified TIDAK
Supervision of other normal pregnancy TIDAK
Other disorders of nervous system, not elsewhere classified YA
Nasal polyp, unspecified YA
Disorder of skin and subcutaneous tissue, unspecified TIDAK
Asthma, unspecified TIDAK
Nephrotic syndrome, minor glomerular abnormality YA
YA
Acute upper respiratory infection, unspecified
Conjunctivitis, unspecified TIDAK
TIDAK
Gastritis, unspecified
TIDAK
Acute upper respiratory infection, unspecified
Typhoid fever TIDAK
Acute haemorrhagic gastritis TIDAK
Hypertension (HPN) TIDAK
Malignant neoplasm, breast, unspecified YA
Gastritis, unspecified TIDAK
Daftar Kunjungan Peserta BPJS/ Askes/ Jamkesmas/ Jamper
Puskesmas : Sukahurip
Bulan : September 2014
Jumlah Kunjungan : 220
Jumlah Yang dirujuk : 41

No TANGGAL No. KARTU NAMA PESERTA

1 30/09/2014 422977173 DINI


2 30/09/2014 423070839 BUDIONO
3 30/09/2014 423071526 SUCI KOMALASARI
4 30/09/2014 423179155 SARIP HIDAYAT
5 30/09/2014 423188109 CUCUM
6 30/09/2014 423705172 LISEP
7 30/09/2014 424567315 OON
8 30/09/2014 424714059 YULIA NINGSIH
9 30/09/2014 1298967535 Agus Rizal Mubarok

10 29/09/2014 411865828 DEDE AISAH


11 29/09/2014 423248905 IMAS
12 29/09/2014 423599152 DIKRI
13 29/09/2014 423608782 RESA
14 29/09/2014 423694359 ENGKUS
15 29/09/2014 423739438 ASEP P
16 29/09/2014 423831216 EMAR
17 29/09/2014 423966295 ERWIN
18 29/09/2014 424511436 RESNI
19 29/09/2014 424644568 JAJA
20 29/09/2014 1004323836 OTANG
21 29/09/2014 1004324231 USUP
22 29/09/2014 1262898549 NUNUNG FARTINI
23 27/09/2014 422758956 ROHILAH
24 27/09/2014 424291059 EMAH
25 27/09/2014 424299352 YUNI
26 27/09/2014 424316812 KOKOM
27 27/09/2014 424317576 TINA
28 27/09/2014 1435200175 alit
29 26/09/2014 423011946 ADAH
30 26/09/2014 423012328 AI SANTI
31 25/09/2014 422770498 YUYUN
32 25/09/2014 423077422 AMAR
No TANGGAL No. KARTU NAMA PESERTA

33 25/09/2014 423341392 SITI ISMA NP


34 25/09/2014 423423033 NAIN
35 25/09/2014 423464027 AI ZAKIAH
36 25/09/2014 423566774 DUDUNG
37 25/09/2014 423817288 NANIH
38 25/09/2014 424656911 RISTI DAMAYANTI
39 25/09/2014 1004323296 EMPOR
40 25/09/2014 1326144543 oom aningsih
41 25/09/2014 1441571984 muhamad dzaki zahrul hak
42 24/09/2014 69353504 AYI SUMIYATI
43 24/09/2014 423187582 CICIN
44 24/09/2014 423390824 ADE J
45 24/09/2014 423446376 NINDI
46 24/09/2014 423739438 ASEP P
47 24/09/2014 423773987 SITA
48 24/09/2014 423775877 AMAT RAHMAT
49 24/09/2014 423843085 OJAH
50 24/09/2014 423965079 JAMILAH
51 24/09/2014 423974305 M RAMDAN
52 24/09/2014 1004327561 DIDA RAHMASARI
53 23/09/2014 423424416 HENDI
54 23/09/2014 423697533 OMAN
55 23/09/2014 424272543 SUMIATI
56 23/09/2014 424408566 SILVA SIDIK
57 23/09/2014 1266228538 WARJO
58 23/09/2014 1337314757 POPON
59 22/09/2014 69069284 EULIS FARIDA
60 22/09/2014 422848754 ENYAT
61 22/09/2014 423245564 HERI
62 22/09/2014 423314267 YAYAN
63 22/09/2014 423426734 JAELANI
64 22/09/2014 423611469 NINA
65 22/09/2014 423718233 IIS ROHAYATI
66 22/09/2014 423837371 IJAH
67 22/09/2014 423853604 RENDI
68 22/09/2014 423933783 INA
No TANGGAL No. KARTU NAMA PESERTA

69 22/09/2014 423974305 M RAMDAN


70 22/09/2014 424053404 KOKOM
71 22/09/2014 424310951 TETE
72 22/09/2014 424338603 LENI
73 22/09/2014 424660746 SILVI
74 22/09/2014 1278297448 EJI A
75 22/09/2014 1326267955 H. SOPIYAN
76 20/09/2014 423975047 FARHAN
77 20/09/2014 424088818 NIA
78 20/09/2014 1004326885 SOPIAH
79 19/09/2014 422820999 HASANAH
80 19/09/2014 422937966 ANAH
81 19/09/2014 422938473 YUSUF
82 19/09/2014 422991101 ETI
83 19/09/2014 423156341 ELIS HOLISOH
84 19/09/2014 423392949 ADE NANI
85 19/09/2014 423395289 HILMI ABDUL A
86 19/09/2014 423395436 AULIA
87 19/09/2014 423836559 HAFID
88 19/09/2014 424310951 TETE
89 19/09/2014 424341639 SITI NAZWA
90 19/09/2014 424635974 TUTI SRININGSIH
91 19/09/2014 424636931 LILIS MARINI
92 19/09/2014 424637245 SIDIK FARHAN
93 19/09/2014 424637605 TRIYANA
94 19/09/2014 1257739773 RENI
95 18/09/2014 423279393 RUSTANDI
96 18/09/2014 423744028 ASIH
97 18/09/2014 423967599 ROHMAT
98 18/09/2014 424562444 RIKA
99 18/09/2014 1004324782 HOLILAH
100 18/09/2014 1318761101 muhammad alya robby islam
101 17/09/2014 422921711 USMAN IRPAN FADILAH
102 17/09/2014 422921992 DEDE MUH RAMDANI
103 17/09/2014 422945199 ANDRI
104 17/09/2014 423619312 YOYOH
No TANGGAL No. KARTU NAMA PESERTA

105 17/09/2014 423740687 ATIKAH


106 17/09/2014 423804497 NURHAYATI
107 17/09/2014 423806174 SELI
108 17/09/2014 423865822 YATI
109 17/09/2014 423981088 MASITOH
110 17/09/2014 424056249 TRIA
111 17/09/2014 1004325546 UMUN
112 17/09/2014 1335824335 IYEP
113 17/09/2014 1432689401 ulul azmi
114 16/09/2014 68997554 ASENG
115 16/09/2014 422741226 YANI
116 16/09/2014 422909864 YAYAH
117 16/09/2014 422936695 IAH
118 16/09/2014 422937382 DUDIH
119 16/09/2014 423611469 NINA
120 16/09/2014 423760702 REGINA
121 16/09/2014 424335363 OYON
122 16/09/2014 1285008028 WAWAN DARMAWAN
123 16/09/2014 1286693493 kamil abdilah mughni
124 15/09/2014 423212916 ANDRI JAYA
125 15/09/2014 423657281 ILOH
126 15/09/2014 423731452 ROKAYAH
127 15/09/2014 423811934 PITRI
128 15/09/2014 423854008 NESPIN
129 15/09/2014 424618795 IJIB
130 15/09/2014 1435200175 alit
131 15/09/2014 1436135591 rifky maulana

132 13/09/2014 69181301 ACAH


133 13/09/2014 69880116 EULIS KARWATI .
134 13/09/2014 424335418 AIDAH
135 13/09/2014 424567315 OON
136 13/09/2014 1004324782 HOLILAH
137 13/09/2014 1383270107 IPIN ARIPIN
138 12/9/2014 69669459 YAHYA HIDAYAT
139 12/9/2014 69669461 NENIH
140 12/9/2014 422765289 EKI
No TANGGAL No. KARTU NAMA PESERTA

141 12/9/2014 423619312 YOYOH


142 12/9/2014 423754255 OCIH
143 12/9/2014 424118046 SUPRIATNA
144 12/9/2014 424131186 YUYU YUNIANTI
145 12/9/2014 424552871 TITIN
146 12/9/2014 1004323285 APIT
147 12/9/2014 1004326615 AWANAH
148 12/9/2014 1422462363 imas
149 11/9/2014 423123276 TITI
150 11/9/2014 423609581 IRFAN
151 11/9/2014 423665111 KOMARIAH
152 11/9/2014 423817852 JALIL
153 11/9/2014 423823375 SAHRUL
154 11/9/2014 424647775 YONO
155 11/9/2014 1004327144 MIMAN
156 11/9/2014 1298967535 agus rizal mubarok

157 10/9/2014 423064844 ANA


158 10/9/2014 424515611 INDRA
159 9/9/2014 69360581 HADANIAH
160 9/9/2014 423619312 YOYOH
161 9/9/2014 423889367 DE ROSIH
162 9/9/2014 423962087 SOLIHIN
163 9/9/2014 423962537 IMAS
164 9/9/2014 424088043 NURHASANAH
165 9/9/2014 424115864 TONAH
166 9/9/2014 1258907354 ROFIATUL ADAWIAH
167 8/9/2014 423050139 OMAN
168 8/9/2014 423191946 CICI
169 8/9/2014 423192014 PIROH
170 8/9/2014 423375153 SOLEH
171 8/9/2014 423566774 DUDUNG
172 8/9/2014 423860411 ANDRIAN
173 8/9/2014 424103477 ENI
174 8/9/2014 424283207 IBAH
175 8/9/2014 424508174 UNASIH
176 8/9/2014 1256277339 MUDIN JK
No TANGGAL No. KARTU NAMA PESERTA

177 8/9/2014 1266228538 WARJO


178 8/9/2014 1335460195 ABDUL LATIF FAUZI
179 6/9/2014 423204186 SARI
180 6/9/2014 423665043 ROHMAN
181 6/9/2014 424251707 ABDUL KOHAR
182 5/9/2014 423678982 ITA
183 5/9/2014 423728199 ENAH
184 5/9/2014 423731226 JAJANG
185 5/9/2014 1273630151 acip
186 5/9/2014 1312441323 riska paujiah
187 4/9/2014 422797083 ENJAH
188 4/9/2014 423571948 LISDA AMELIA
189 4/9/2014 423995286 JIAHN
190 4/9/2014 424215191 JUBAEDAH
191 4/9/2014 424333653 RISITA
192 4/9/2014 424517523 RONI

193 3/9/2014 68985101 YANI ANDRIANI


194 3/9/2014 422513008 PIYAH
195 3/9/2014 422826682 KARTIKA
196 3/9/2014 423525881 HABIB
197 3/9/2014 423664119 ROHMAH
198 3/9/2014 423934593 NAIN
199 3/9/2014 424054089 RINI
200 3/9/2014 424155532 IYA
201 3/9/2014 424660746 SILVI
202 3/9/2014 1432689401 ulul azmi
203 2/9/2014 69181301 ACAH
204 2/9/2014 423260458 EULIS
205 2/9/2014 423622664 EEN
206 2/9/2014 423625869 CUCU
207 2/9/2014 423670004 NAI
208 2/9/2014 423740564 IDUN
209 2/9/2014 423853604 RENDI
210 2/9/2014 424184117 RANI
211 1/9/2014 423704305 AHMAD
212 1/9/2014 424185232 UBAN
No TANGGAL No. KARTU NAMA PESERTA

213 1/9/2014 424283207 IBAH


214 1/9/2014 424490218 AI POPON
215 1/9/2014 424692191 PATIMAH
216 1/9/2014 424693528 AHMAD
217 1/9/2014 1004324501 DODO
218 1/9/2014 1266228538 WARJO
219 1/9/2014 1336262354 UHA
220 1/9/2014 1387044246 idah
Peserta BPJS/ Askes/ Jamkesmas/ Jampersal

DIAGNOSA DI RUJUK
TIDAK
Dermatitis, unspecified
TIDAK
Pyogenic granuloma
TIDAK
Dermatitis, unspecified
TIDAK
Dermatitis, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Hypertension (HPN)
TIDAK
Acute upper respiratory infection, unspecified
Unilateral or unspecified inguinal hernia, without obstruction or YA
gangrene
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Rheumatism, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Scabies
TIDAK
Pyogenic granuloma
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Rheumatism, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Typhoid fever
YA
Cataract, unspecified
TIDAK
Rheumatism, unspecified
YA
Disorder of eye and adnexa, unspecified
TIDAK
Hypothermia not assoc with low environmental temperature
TIDAK
Gastritis, unspecified
TIDAK
Hypertension (HPN)
TIDAK
Cutaneous abscess, furuncle and carbuncle, unspecified
TIDAK
Rheumatism, unspecified
TIDAK
Other and unspec diseases of pulp and periapical tissues
YA
Other tetanus
TIDAK
Dermatitis, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Influenza with pneumonia, virus not identified
TIDAK
Myalgia
DIAGNOSA DI RUJUK
TIDAK
Conjunctivitis, unspecified
TIDAK
Hypertension (HPN)
TIDAK
Acute upper respiratory infection, unspecified
YA
Other thalassaemias
TIDAK
Gastritis, unspecified
TIDAK
Influenza with pneumonia, virus not identified
YA
Other and unspecified disorders of circulatory system
YA
Leiomyoma of uterus, unspecified
YA
Neonatal jaundice associated with preterm delivery
YA
Benign neoplasm, kidney
TIDAK
Dermatitis, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Scabies
YA
Benign neoplasm of unspecified site
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Rheumatism, unspecified
TIDAK
Influenza with pneumonia, virus not identified
TIDAK
Conjunctivitis, unspecified
TIDAK
Fever, unspecified
TIDAK
Diarrhoea and gastroenteritis of presumed infectious origin
TIDAK
Influenza with pneumonia, virus not identified
YA
Unspecified visual loss
TIDAK
Gastritis, unspecified
TIDAK
Asthma, unspecified
YA
Acute pharyngitis, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Gastritis, unspecified
YA
Tb intrathoracic lymph node without bact or hist confirm
TIDAK
Polyarthritis, unspecified
TIDAK
Dermatitis, unspecified
TIDAK
Cutaneous abscess, furuncle and carbuncle, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Gastritis, unspecified
TIDAK
Fever, unspecified
YA
Asthma, unspecified
DIAGNOSA DI RUJUK
TIDAK
Typhoid fever
TIDAK
Rheumatism, unspecified
TIDAK
Hypertension (HPN)
TIDAK
Gastritis, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Acute upper respiratory infection, unspecified
YA
Chronic ischaemic heart disease, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Influenza with pneumonia, virus not identified
TIDAK
Conjunctivitis, unspecified
TIDAK
Myalgia
TIDAK
Gastritis, unspecified
TIDAK
Disorder of skin and subcutaneous tissue, unspecified
YA
Long labour, unspecified
TIDAK
Rheumatism, unspecified
TIDAK
Scabies
TIDAK
Scabies
TIDAK
Scabies
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Hypertension (HPN)
TIDAK
Scabies
TIDAK
Influenza with pneumonia, virus not identified
TIDAK
Influenza with pneumonia, virus not identified
TIDAK
Influenza with pneumonia, virus not identified
TIDAK
Influenza with pneumonia, virus not identified
YA
Tb lung without mention of bact or histological confirm
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Conjunctivitis, unspecified
TIDAK
Neuralgia and neuritis, unspecified
YA
Secondary malignant neoplasm of skin
TIDAK
Gastritis, unspecified
TIDAK
Cutaneous abscess, furuncle and carbuncle, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Dermatitis, unspecified
YA
Depressive episode, unspecified
YA
Asthma, unspecified
DIAGNOSA DI RUJUK
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Scabies
TIDAK
Scabies
TIDAK
Acute upper respiratory infection, unspecified
YA
Pyogenic granuloma
TIDAK
Influenza with pneumonia, virus not identified
TIDAK
Hypertension (HPN)
TIDAK
Influenza with pneumonia, virus not identified
YA
Constitutional aplastic anaemia
TIDAK
Hypertension (HPN)
TIDAK
Diarrhoea and gastroenteritis of presumed infectious origin
TIDAK
Gastritis, unspecified
TIDAK
Rheumatism, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Gastritis, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Gastritis, unspecified
YA
Heart failure, unspecified
YA
Fracture of foot, unspecified
TIDAK
Cutaneous abscess, furuncle and carbuncle, unspecified
TIDAK
Disorder of skin and subcutaneous tissue, unspecified
YA
Nephrotic syndrome, minor glomerular abnormality
TIDAK
Diarrhoea and gastroenteritis of presumed infectious origin
TIDAK
Acute upper respiratory infection, unspecified
YA
Atrophy of prostate
YA
Cutaneous abscess, furuncle and carbuncle, unspecified
Unilateral or unspecified inguinal hernia, without obstruction or YA
gangrene
TIDAK
Hypertension (HPN)
TIDAK
Gastritis, unspecified
TIDAK
Cystitis, unspecified
TIDAK
Hypertension (HPN)
TIDAK
Hypertension (HPN)
TIDAK
Allergic contact dermatitis, unspecified cause
TIDAK
Rheumatism, unspecified
TIDAK
Dermatitis, unspecified
TIDAK
Other and unspec diseases of pulp and periapical tissues
DIAGNOSA DI RUJUK
YA
Hypertension (HPN)
TIDAK
Myalgia
YA
Depressive episode, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Urinary calculus, unspecified
YA
Unspecified injury of wrist and hand
TIDAK
Rheumatism, unspecified
YA
Schizophrenia, unspecified
TIDAK
Rheumatism, unspecified
TIDAK
Cutaneous abscess, furuncle and carbuncle, unspecified
TIDAK
Unspecified renal colic
TIDAK
Acute pharyngitis, unspecified
TIDAK
Gastritis, unspecified
TIDAK
Dermatitis, unspecified
TIDAK
Otitis externa, unspecified
Unilateral or unspecified inguinal hernia, without obstruction or YA
gangrene
TIDAK
Cutaneous abscess, furuncle and carbuncle, unspecified
TIDAK
Scabies
TIDAK
Rheumatism, unspecified
TIDAK
Asthma, unspecified
TIDAK
Hypertension (HPN)
TIDAK
Paratyphoid fever, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Influenza with pneumonia, virus not identified
TIDAK
Hypertension (HPN)
TIDAK
Influenza with pneumonia, virus not identified
TIDAK
Asthma, unspecified
TIDAK
Asthma, unspecified
TIDAK
Rheumatism, unspecified
TIDAK
Myalgia
YA
Thalassaemia trait
YA
Acute upper respiratory infection, unspecified
TIDAK
Rheumatism, unspecified
YA
Hypertension (HPN)
TIDAK
Migraine, unspecified
YA
Acute renal failure, unspecified
DIAGNOSA DI RUJUK
TIDAK
Asthma, unspecified
YA
Aplastic anaemia, unspecified
TIDAK
Gastritis, unspecified
TIDAK
Asthma, unspecified
TIDAK
Pyogenic granuloma
TIDAK
Gastritis, unspecified
TIDAK
Hypertension (HPN)
TIDAK
Scabies
TIDAK
Asthma, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Amoebiasis, unspecified
TIDAK
Dermatitis, unspecified
TIDAK
Scabies
TIDAK
Diarrhoea and gastroenteritis of presumed infectious origin
TIDAK
Influenza with pneumonia, virus not identified
Gastric ulcer, unspec as acute or chronic w'out haemorrhage or TIDAK
perforation
TIDAK
Scabies
TIDAK
Hypertension (HPN)
TIDAK
Diarrhoea and gastroenteritis of presumed infectious origin
YA
Epilepsy, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Rheumatism, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Gastritis, unspecified
TIDAK
Scabies
TIDAK
Acute pharyngitis, unspecified
TIDAK
Rheumatism, unspecified
TIDAK
Rheumatism, unspecified
YA
Cerebrovascular disease, unspecified
TIDAK
Idiopathic hypotension
TIDAK
Hypertension (HPN)
TIDAK
Hypertension (HPN)
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Disorder of skin and subcutaneous tissue, unspecified
TIDAK
Pyogenic granuloma
TIDAK
Disorder of skin and subcutaneous tissue, unspecified
DIAGNOSA DI RUJUK
YA
Hypertension (HPN)
TIDAK
Neuralgia and neuritis, unspecified
TIDAK
Gastritis, unspecified
TIDAK
Acute upper respiratory infection, unspecified
TIDAK
Rheumatism, unspecified
TIDAK
Asthma, unspecified
TIDAK
Myalgia
TIDAK
Influenza with pneumonia, virus not identified

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