REGISTER PASIEN POLI UMUM

NO UMUR KUNJUNGAN
NO NO. BPJS NAMA PASIEN Alamat/Rt LAKI- PEREM DALAM LUAR
KARTU
LAKI PUAN BARU LAMA BARU LAMA
10 April 2017
1 0001373587896 maria mardiani 47 40 1
2 0002198886579 shanaz 9 6 1
3 0002063610044 reza aprialdi 64 26 1
4 0000903137589 heny 43 37 1
5 syukran makmun pramuka 3 38
6 0000902672864 hardiyanto 6 13 1
7 0002231636578 alfian.s 49 19 1
8 001925280202 farida aws 32 1
9 0000120879628 muhammad lutfi Rt.19 13 1
10 0000902946161 richo 3 16 1
11 0001141267533 kurniawan 9 26 1
12 0001313991731 shalomita bumi spj 7 1
13 0000902754257 alfinus 13 18 1
14 0000903708742 baso 3 42 1
15 0000903703162 duyah 2 39 1
16 0000903702611 ardi odin 2 40 1
17 0000902920015 m.richie perdana 2 6 1
18 0000902919622 idawati 26 26 1
19 0000902924943 siti aisyah 27 13 1
20 0001167132328 ina mutmaina 7 32 1
21 0000902776037 hiskia brolin 26 7 1
22 0001925287288 kinanti indah 17 9 1
23 0002039247192 fadel 29 16 1
24 0002231636534 triana 4 39 1
25 0002235946228 muhammad nur hasyim 9 9 1
26 0001546777822 ahmad hadi.u 2 8 1
27 0002210235164 orlin.f 2 5 1
28 0000903092422 amir 27 43 1
29 0001546777809 hendro umbara 2 40 1
30 0001195546522 adji achmad 3 14 1
31 0000209783733 jalasi 10 34 1
32 Susiyani rt.10 29 1
33 maylinda winda smp 27 12 1
34 Haikal 28 7 1
35 fahrul.r 26 38 1
36 arifin 2 33 1
37 cindi 13 16 1
38 normas 5 29 1
39 achmad kariyanto 5 25 1
40 krisdayanti 1 29 1
41 sugiarti 26 42 1
42 muhamad nasrullah 14 21 1
43 sukiman 2 23 1
44 jamiah perjuangan 1 20 1
17 15 8 3

11 April 2017
1 0001553581282 JONAEDI LORONG ABADI 25 1
2 I156 0001925287839 SALASIAH 43 42 1
3 R387 0001066496174 RAHMAN 4 33 1
4 A888 0000903807044 INDRIYANI 27 9 1
5 Y14 0002057133598 LEONARD NISYEN 2 27 1
6 A 0000900574751 ARIATI YAKUB 13 17 1
 7 S173 0001925289415 SUMARTIN 44 39 1
8 S3 000090296269 SANIAH 2 35 1
9 B390 0002086387931 JENI 28 16 1
10 S620 0000902981756 PRASETYO 26 15 1
11 R31 0002040530951 ZAELANI HAZARD 1 7 1
12 L114 0002219414769 LA DIRIA 10 27
13 Y366 0000903741017 YUDI PRAMUDITA 54 35 1
14 H326 0002231599781 LAWAHIT 10 6 1
15 H513 0000120913266 KARYATI 2 43 1
16 H513 0000120909249 RAGHIB KARHANI 2 12 1
17 A536 0002216042831 MUHAMAD NASRULLAH 45 9 1
18 M 0000962036144 MAS ULANG M.YAMIN 41 1
19 A 0000899976003 AFSOLINA WATI 2 22 1
20 A469 0000120539801 YASMIN BENGKURING 12 1
21 Y361 0002221106297 M.ROYAN PAKU MERAH 6 1
22 K 0001549799379 KHAIRUL.A 23 23 1
23 A235 AHMAD FAHRI 13 7 1
24 I113 MANDALA 12 7 1
25 A235 RUSMAH 13 37 1
26 H68 LATIFAH PESANTREN 10 1
27 J31 NURUL CAHYA 61 44 1
28 A AJMIKO 8 18 1
8 14 3 2

12 April 2017
1 0000901551194 maimunah 13 19 1
2 F2 0001548424372 m.yusuf 15 7 1
3 0000147945622 irma ningsih 28 33 1
4 S483 0001156177866 dionisius.v 2 27 1
5 N 0000121707808 nur dewi r pramuka 2 20 1
 6 S86 0001435982264 fauzan.p 18 14 1
7 S485 0001868411608 sartika nurshalah 9 22 1
8 D465 0002211544648 darwis 26 25 1
9 0001613798807 derrby didan 6 14 1
10 A179 0001066498738 andik sunarji w.hasyim 34 1
11 M307 0002084619745 fandy setiawan 1 21 1
12 S121 0000902697849 sambima 25 16 1
13 B18 0000903749714 tawiah 45 42 1
14 H466 0002217437302 resky 33 8 1
15 B18 0000903751942 dian fadila 45 9 1
16 B18 0000903751413 dheo tri saputra 73 18 1
17 Y259 0000903156838 bagus julianto 13 8 1
18 J505 0002070994959 rahmawati 25 32 1
19 A267 0001925285095 mastiah 10 33 1
20 D457 imam kurniawan 7 24 1
21 D457 rahmad lesmana 79 32 1
22 A ayuni lestari pramuka 17 22 1
23 L171 lasuru 5 36 1
24 N42 sella ramadian 54 6 1
25 victorio.s sli 37 1
26 S senofri 1 21 1
27 M mardiana 30 16 1
28 meti rasmini pramuka 1 20 1
29 S1017 nur istiqomah 1 23 1
30 H64 heroeddin abdillah 6 40 1
31 F123 arya 51 13 1
32 D457 m.husein anggur 20 1
13 8 10 1

13 april 2017
 1 W101 0001066499662 dahliansyah 10 33 1
2 N345 0002233805955 komang rani 39 13 1
3 H355 0002060837471 rian pratama 8 9 1
4 I77 0002231636578 alfian syahrul 49 18 1
5 A433 0001066499087 siti mardiyah 10 21 1
6 W38 0001959446081 wiwin 37 33 1
7 A1123 0000903092422 amir 27 43 1
8 I 0000897093404 iska sapari 1 22 1
9 S2468 0002086904889 aulia rahman 1 21 1
10 A48 0002198558946 ahmad yasin 1 27 1
11 J186 0000904689663 teguh 39 10 1
12 K482 0000120879628 muhamad lutfi 19 13 1
13 R376 0001925307584 farhan ibnu 42 13 1
14 K156 0000904063498 siti aisyah 5 43 1
15 M1359 m.hasmi 29 7 1
16 M377 0001808630537 m.reza 5 16 1
17 R31 0002040530951 ZAELANI HAZARD 1 7 1
18 S144 0002198301535 sinta 39 14 1
19 H267 0001546777822 ahmad hadi.u 2 7 1
20 L245 0001925288379 noor aida 26 39 1
21 L245 0001925306357 lalu fairuz 26 5 1
22 L245 0001925306368 lalu fawwaz 26 7 1
23 R467 0000120263095 ratih nurjanah 25 20 1
24 S478 0002232500815 marlina 6 25 1
25 R10 0000903093996 kholifah 3 40 1
26 R874 0002231721472 iti iriyani 25 33 1
27 D16 0000903763642 hamdani 45 7 1
28 S473 0001925280426 suparno 64 40 1
29 0002016456752 prahastara 11 29 1
30 M424 0002076061588 desty wi 27 18 1
31 T16 0000902754257 alfinus 13 17 1
32 H380 0002215766316 eni.s 7 29 1
33 D457 0002005593186 lisa 32 27 1
34 K156 0000904064409 m.imam 5 9 1
35 D457 0002005593175 alfredo 23 26 1
36 N144 normas 5 28 1
37 olyvia teko merdeka 22 1
38 onissimus l g.lingaai 24 1
39 S santa 13 18 1
40 a232 yudhi alfian belibis 29 1
41 santa 13 19 1
42 S643 sunarsih 25 36 1
43 B bambang 2 22 1
44 Y yosep 13 24 1
45 D457 abdul choliq 36 29 1
10 20 7 8

15 April 2017
1 L114 0002219414769 la diria 10 28 1
2 S568 0001967576411 amelia kusuma 2 20 1
3 A565 0002093792455 rohani 28 42 1
4 K 0001549799379 khaairul agusliansyah 23 23 1
5 S12 0000903665531 wati 9 39 1
6 S2616 0001066510293 hatnawiyah 39 43 1
7 A249 0002195129755 nur halimah 51 39 1
8 A249 0002195129961 aska 6 6 1
9 I59 0000119652085 samuel 4 11 1
10 A926 0000902809203 m.tuarif 25 19 1
11 A48 0002198559115 umayan 1 38 1
12 R318 0000903137589 heny 43 36 1
13 B168 0001484104296 indah 7 32 1
14 A204 0002093477714 putri nurul 39 9 1
15 0000752051777 winarsih 3 31 1
16 Y12 0001186269478 m.raihan 1 5 1
17 E33 0001646416664 gozy zahid 8 9 1
18 A700 0002225494888 abdul azam 29 6 1
19 P38 000090380888 m.yusuf 19 8 1
20 H67 0002209596388 isnawati 50 32
21 B244 0000903710788 ida murdiana 3 7 1
22 0001826730382 dario feroz 6 7 1
23 S1500 0001925304524 ruspinah 20 26 1
24 0002083725652 nopi susanti padat karya 23 1
25 puji rahayu 33 24 1
26 R437 0001547444654 esti insiah 37 25 1
27 0002217437076 hamka 45 33 1
28 0000119825796 suhartanto 73 43 1
29 B168 0001484102597 rudiansyah 28 32 1
30 S1342 0000903784803 saidah.l 37 7 1
31 S121 0000902696589 sulastri 25 44 1
32 P297 0002197367907 nurul hidayah 2 25 1
33 A190 0001621746472 amiruddin 66 33 1
34 0000902719541 feiby liya 26 9 1
35 S141 0000903867772 trisumarsih 3 39 1
36 0002217437144 erni 23 31 1
37 A235 fahmi 13 12 1
38 J153 syahfia 10 11 1
39 M588 intan 1 21 1
40 A232 m.amir 7 32 1
41 N najla syakura s.durian 12 1
42 M1435 recca faddillah 8 8 1
43 A594 najwa abul hasan 13 1
44 A926 akbar ramadhan 25 5 1
45 N novianti pm.noor 21 1
46 shireen marina 7 9 1
12 21 3 9

17 April 2017
1 B29 0001301874941 budi hartono 26 42 1
2 D129 0001925274475 dwi widyastoto 48 44 1
3 M37 0000120777063 siti nurhayati 4 19 1
4 A156 0000120866163 fasqiyullah 48 17 1
5 H267 0001546777822 ahmad hadi.u 2 7 1
6 H267 0001546777809 hendro umbara 2 40 1
7 N473 0000902946093 sela wahyuni 12 15 1
8 B29 0002196419692 m.fathir 26 5 1
9 N473 0000902945878 nurhayati 12 24 1
10 A491 0002068929584 apridin l 26 43 1
11 J13 0001925287312 jope 21 40 1
12 T 0000902334155 triapsah pm.noor 20 1
13 0001800036033 christin 5 30 1
14 A 0001638549516 nurlaila 3 31 1
15 K156 0000904064409 m.imam 5 10 1
16 0001840226613 jakaria 29 27 1
17 A897 0001613163328 abd.rahman 1 42 1
18 A893 0002045982194 fitria rahman perjuangan 1 7 1
19 R490 0001386129723 yesha.a 68 10 1
20 C17 0000904027048 rusmini 3 42 1
21 A263 0000903702611 ardi odin 2 40 1
22 M474 0000120289781 eka suriana 22 41 1
23 R177 0001925287288 kinanti indah 17 10 1
24 R437 0001547444654 esti insiah 39 25 1
25 J468 0000903550544 juraidah 45 30 1
26 M 0002201089566 muhamad indra 6 10 1
27 M475 0002046477172 muh.ajan hari 1 30 1
28 A263 0000903703162 diyah 2 38 1
29 S473 0001925280426 suparno 64 40 1
30 0002202717183 mahdalena 13 39 1
31 okta mansa 26 19 1
32 B186 0000902921602 m.novian 2 17 1
33 S168 0002079169514 ayuni fillah 8 19 1
34 0001898717938 titra wena 10 19 1
35 0000734487129 siti nur faizatul perjuangan 4 19 1
36 A491 0002068930664 hanawati 26 39 1
37 H137 0002076274102 tina sagita 2 40 1
38 R rina 21 15 1
39 H799 raphagl efraim 1 5 1
40 R ratih ovia perjuangan 3 24 1
41 puspitasari slada 32 1
42 djefri deny 80 43 1
43 rasni pramuka 13 20 1
44 L236 wiwin arif 39 12 1
45 A60 holiyah 27 37 1
46 R A agis 2 10 1
47 N194 normas 5 29 1
48 A ajmika 8 19 1
49 H harum widyastuti 12 21 1
50 fahrul 22 26 1
51 mirnawati 22 24 1
52 R rivaido gg.hardani 5 1
53 L80 nisa mudalifah 9 5 1
54 A ammalia 1 21 1
55 D dwiyanti 15 10 1
56 A azizah bella 19 19 1
57 kristoferus 13 21 1
58 R53 wahyu eka 2 26 1
59 R53 lililay tenggarong 39 1
60 D457 rosmawati 1 41 1
61 D457 rahmad 1 39 1
62 D457 joy briyan 52 24 1
26 17 13 6

18 April 2017
1 S253 0002200000136 agus setio 8 25 1
2 F200 0002084965165 fesa atma.w 15 31 1
3 S473 0001925280426 suparno 64 40 1
4 A120 0002073173185 nur syifa 28 10 1
5 A1387 0000902578713 masturi 37 42 1
6 A184 0001925288572 yani maryani 29 30 1
7 A586 0001457822046 rifqi ammar 8 9 1
8 B186 0000902021391 arif rusbandi 2 20 1
9 D 0001874561488 debbie artha 17 24 1
10 D58 0000205362685 irawati 10 35 1
11 G488 0000120796029 juhairiyah 6 40 1
12 H474 0000902035449 sella melatih 24 13 1
13 I44 0001742110021 irmayani 6 41 1
14 I44 0001742110053 septiani 56 18 1
15 I45 0000903852234 rio andhika 22 10 1
16 J 0001553581282 JONAEDI l.abadi 25 1
17 J450 0000902812847 linda 6 6 1
18 K133 0002224938442 endah.y 42 26 1
19 K133 0002224938813 raka ramadhan 42 9 1
20 M1552 0001928354545 mahmud al chusairi 7 34 1
21 M69 0000903447314 alisa 39 10 1
22 R135 0000120305597 riadi 53 42 1
23 R135 0000120305586 dhyani nastiti 53 40 1
24 R488 0000120796031 juhan rusydina 6 13 1
25 S235 0002084158383 imam 5 18 1
26 S458 0000903891767 kasiani 12 33 1
27 S506 0002077922507 amelia 24 6 1
28 S96 0000903115282 m.prayuda 4 18 1
29 W166 0000903907732 wino supandi 4 11 1
30 W210 0001925303927 muhamad rifai 24 18 1
31 Y34 0001723867187 normaiyah 4 40 1
32 0000899726117 kristina 3 21 1
33 0000903215632 m.hasbullah pesantren 13 1
34 0002068430545 dian syahfani jl.piano 40 1
35 0002068431513 RR.muninggar jl.piano 40 1
36 0002225048455 fatonah 23 6 1
37 0001810790087 andira oktaviana perjuangan 17 1
38 A151 shireen marina 7 8 1
39 D13 wijaya 25 10 1
40 H708 harianto aan 4 34 1
41 J30 rahmadani 27 6 1
42 S83 supriyatin 1 38 1
43 W57 sena 34 9 1
44 W57 warso enggah 44 42 1
45 Y yuris 1 19 1
46 iis ayu ariska 30 19 1
47 alfin nur bahar juanda 9 23 1
19 13 13 2

19 April 2017
1 B479 0001925278897 ludy 12 31 1
 2 M1106 0000902957815 m.fahriyansah 5 8 1
3 M1784 0001925280178 sri hindiyani 52 38 1
4 I87 0001647522011 keyvin keyla 26 8 1
5 H452 0001549401838 yohana sinaga perjuangan 3 19 1
6 S237 0001609989535 aisyah nurrahman 40 6 1
7 H497 0001637638402 harry agung 11 39 1
8 R437 0001547444654 esti insiah 37 25 1
9 B144 0000897545867 yulia yulianti 3 35 1
10 S763 0000903777671 halimah 1 36 1
11 R343 0000962657256 mardina 27 30 1
12 A1097 0002096374904 desi.m 51 19 1
13 D443 0000005240057 reinhart.s 3 22 1
14 Y366 0000903742187 fatir 54 10 1
15 G12 0001902947152 nalari prahara 8 21 1
16 K164 0001724674601 irpan 55 31 1
17 B186 0000902921391 arif rusbandi 2 20 1
18 F 0001874421246 felysa santika 2 21 1
19 tri feni 55 19 1
20 R rabiatul a elang 20 1
21 V vivi corniah 26 33 1
22 M477 m.zhavict.w 2 5 1
23 S2138 suyani 26 35 1
24 mutmainah kh.dewantara 21 1
25 A122 erlina 54 20 1
26 A235 ahmad fahri 13 8 1
27 A235 fahmi 13 12 1
28 A235 rusmah 13 38 1
29 A232 m.octa jossy juanda 15 1
12 7 9 1
 20 April 2017
1 L161 0000120231268 lorens bringin 8 20 1
2 W175 0001800639999 waldi samuel swandi 20 1
3 G20 0001925296964 adi triangoro 39 22 1
4 P314 0002091901656 pohni 10 35 1
5 L46 0001186281652 siti halimah 10 37 1
6 F29 0000902754988 walingu 9 37 1
7 R485 0001868716192 riza aribawati 37 21 1
8 M3 000209429339 erni ningsih 26 36 1
9 K99 0000120291502 supartini 22 39 1
10 K99 0000202019264 atika 22 6 1
11 S366 0001791272823 sugeng jamaludin 19 31 1
12 K66 0001611068264 warsilah 12 20 1
13 S568 0001967576411 amelia kusuma 2 20 1
14 E16 0000903100836 dahlia sesilia 17 6 1
15 A491 0002068929584 apridin l 26 43 1
16 W 0001283724123 wasil fadhilah 6 21 1
17 M345 0002067748525 dimas saputra 2 16 1
18 B405 0002070461632 diniya amelia 1 6 1
19 B405 0002070459009 m.fatur rahman 1 6 1
20 J132 0001837793373 nita permata 5 16 1
21 I367 0000120426491 ahdan 1 14 1
22 S1010 0000903652637 gufron 12 6 1
23 0000120866782 sukarsono p.karya 41 1
24 A346 Ramadhani aulia.r 1 25 1
25 M maria barek 4 23 1
26 M54 hanifah 43 5 1
27 S484 irmayanti 8 26 1
28 W483 windhika charisma 9 23 1
29 R23 rudiansyah 3 39 1
30 F101 laudia 27 10 1
31 N482 meliyana 2 9 1
32 A asep diki ahim 2 20 1
33 marna ria 16 22 1
34 H harianto 5 34 1
35 H411 hana samuel 61 9 1
36 S162 anasyah nuralifah 8 9 1
37 S101 suratman 1 41 1
38 N narius M.YAMIN 22 1
39 S15 nurul avni 9 20 1
13 14 11 1

21 April 2017
1 K157 0001442236781 krista verawati 1 32 1
2 J288 0001925289551 siti madina 47 43 1
3 S173 0001925289415 sumartin 44 39 1
4 B29 0001301874941 budi hartono 26 42 1
5 B186 0000902921398 arif rusbandi 2 20 1
6 H120 0001066511169 hadi winarno 5 41 1
7 0000898729435 susilawati g.lingai 15 1
8 T40 0000903938376 siti ramlah 29 38 1
9 0001253993916 ika rosita pramuka 2 19 1
10 0000123276609 risna fitria 25 24 1
11 M330 0000902773203 dewi megawati ery suparjan 20 1
12 I177 0002202170297 lusiana 29 6 1
13 J311 0000122179375 septiani 5 29 1
14 A1267 0002204598385 sari 4 23 1
15 A117 0000903277855 lerin 26 42 1
16 B498 0001080886667 budiansyah 27 30 1
17 Y361 0002221106297 m.royan reyhan bengkuring 5 1
18 Y361 0002221103338 indah herlina bengkuring 38 1
19 trivina 20 25 1
20 S1321 jumiati 37 30 1
21 a2188 timur samsu 13 12 1
22 A2188 hatik 13 40 1
23 S95 wahyuni y 2 36 1
24 farasati swandi 22 1
25 argopi 5 19 1
26 asriana merdeka 24 1
10 7 7 2

SABTU, 22 APRIL 2017

1 I499 0001825504031 IRFANSYAH REINALDI M. YAMIN 44 1

2 F275 FEBRI PRADIPKA padat karya 27 1
3 A888 0000903807044 INDRIYANI RT.27 10 1
4 R10 0000903093996 KHOLIFAH TEPIAN 3 41 1
5 W30 0000120905605 NUGROHO ARIF RT.2 26 1
6 H67 0002209596388 ISMAWATI PM. NOOR 31 1
7 D457 EKO HADI PURNOMO LEMPAKE 27 1
8 D457 MOH. ISMAIL LEMPAKE 29 1
9 D457 RIA IRIANI MANGKUPALAS 32 1
10 J JESY PERJUANGAN 20 1
11 K353 0000120446425 SRI WAHTUNIDIA AWS 41 1
12 M.524 SELLY FEBRIANI RT.1 16 1
13 A700 0002225494664 ABDUL HAMID RT.5 6 1
14 A700 0002225494607 ABDUL MALIK RT.5 10 1 1
15 S9 0001871920912 SUMARSONO RT.25 41 1
16 S1869 0000902941525 PARAMITHA RT.1 9 1
17 H886 000113876456 HIDAYAT SOLIHIN AWS 40 1
18 E 0001823884413 ERNI SURIANI PRAMUKA 21 1
19 L114 0001798921991 WA ODE NURISA KARYA BARYU 33 1
20 SUHADI AWS 25 1
21 W166 0000903907732 WINO SUPANDI BT. CERMIN 12 1
22 N144 NORMAS PERUM TVRI 29 1
23 U137 FAHRUL RONI PM NOOR 23 1
24 ANISA RT. 13 9 1
25 R 0000903662493 ROSANCI PEMUDA 35 1
26 J JANWARDI AWS 32 1
4 20 0 3
25 April 2017
1 D457 Masrudin Jl. Kakap RT 24 29 1
2 D457 0001819933413 Alfian Rokhmansyah Jl. suwandi 28 1
3 Hasanah Jl. AWS 22 1
4 0000203353299 Ibau Danil perumahan Solong 34 1
5 M374 0000903858625 Nur Azkra RT.39 12 1
6 L99 0002089313818 Maulidan Bachtiar AWS gg. 4 6 1
7 S72 0000903670795 Marta Gresia RT. 8 7 1
8 B169 0001460518661 Septiani nastiti SPMA 31 1
9 Ansar syahrir RT.27 27 1
10 F 0002041394826 Fajar Dwi Prihantoro pramuka 5 23 1
11 S Supardiansyah Jl. Perjuangan 21 1
12 M. Suhadi AWS. 6 25 1
13 I68 Putu Rohaniah Dayak Punan 24 1
14 S1869 0000922941525 Paramitha RT.1 9 1
15 Z476 0002233448583 Syammsinar Batu Besaung 38 1
16 m139 0001925288212 Desy Arisandi Bengkuring 44 1
17 M139 0001925306346 M. Medi Vierzean Bengkuring 21 1
18 D 0001635830706 Desi Rahmawati M. Yamin 25 1
19 L332 Evi Karya Baru 8 1
20 U137 Fahrul Roni PM. Noor 23 1
21 N8 000106649752 agus Supriadi RT.9 35 1
22 D58 0002032232859 Nazril Akmal Karya Baru 6 1
23 R Rani Saskia. N RT. 2 17 1
24 y100 0000899905364 Melyana Djo R RT. 2 31 1
25 I59 0000119652085 Samuel Roberth Trepian 12 1
26 A195 0002197375266 Alissa RT.20 5 1
27 A244 Salmiah RT. 33 38 1
28 N490 Mahfirah RT. 04 38 1
29 S41 0002079696216 Deny Kurniawan RT. 46 23 1
30 S2536 0001066505409 Ahmad Rijik Bt. Cermin 7 1
31 S2563 0001066505398 M. Rehan Bt. Cermin 11 1
32 H150 0002218355526 Haryono Rt. 51 30 1
33 B341 0002073153936 Zahra Rt. 10 10 1
34 S503 0001066504353 Sutrisno Rt.25 43 1
35 A Arief Wiyanto Rt. 8 19 1
36 R35 0001307246578 Rudiansyah Rt. 06 42 1
37 P472 Puji Rahayu Rt. 33 25 1
38 R501 0000902955519 Gery Pradana Rt.54 12 1
39 M70 M. Arifin Rt. 2 31 1
40 I Ivan Fernando Rt. 01 29 1
41 Papa Syabenne Rt. 11 22 1
42 A Ade Adriana Rt. 39 22 1
43 D239 0000174034877 M. Raffi Rt.26 10 1
44 Y361 0002221106297 M. Royan Rt. 58 6 1
45 H 0001815621862 Hesti Widiastuti Rt. 26 23 1
46 T329 0002090317882 Chandra Kirana Rt. 01 6 1
47 T329 0002090317713 Dwi Sri Ramania Rt. 01 10 1
48 R 0002086457141 Rina Sriatun Rt. 06 42 1
49 S1521 0002196043312 M. Taufik Rt. 12 10 1
50 W30 0000120905605 Nugroho Rt. 02 26 1
51 M412 0000903080351 Darwati Rt. 05 42 1
52 A1072 0002063223966 Lutfi Abdillah Rt. 05 14 1
53 B159 0001858384539 Ahmad Yusuf Rt. 03 6 1
15 23 6 9

26 APRIL 217
1 H Hendri RT. 50 33 1
2 R 0000123275081 Rasidi Com SPP 44 1
3 F206 0001154895715 Andi Hasdiana Gg.Unggul 44 1
4 S494 0000902751243 Rinda Antika Kesehatan 28 1
5 S280 0002080028283 Siti Kusliyanti Wolter monginsidi 37 1
6 S280 0002080028507 Bisma Maulana Ihsan Wolter monginsidi 9 1
7 R504 0002213688453 Risda Febrianti w.hasyim 54 15 1
8 R504 0002213688622 Ria Desinta w.hasyim 54 14 1
9 A500 0002071879211 Junias perjuangan 3 rt 2 12 1
10 S1024 0000902300354 Ahmad Husni Sempaja ujung 05 7 1
11 S285 0009021044694 Asria Sempaja ujung 06 32 1
12 Y115 0001724283235 Yusman Berambai 59 37 1
13 D419 0002228522973 Kenstaivisen Ringrood 01 21 1
14 H 0002238992875 Hendri Mardianata Loajanan Rt. 13 21 1
15 K164 0001724674601 Irfan Rt. 05 35 1
16 A1356 0001066504757 Siti Nufus Rt. 02 10 1
17 A135 0001925298821 Ahmad Fauzi Rt. 03 43 1
18 L11 0001925289674 Juliadi Rt.10 36 1
19 S411 0000902831231 Risna Rt. 26 32 1
20 S411 0000902831984 M.Alif Solong Durian 11 1
21 P Putri Wahyuni Rt. 06 22 1
22 S Suprianto Wagiman MP Nugroho 67 1
23 Y Yuni Ayu Musita AWS 27 1
24 J Januardi AWS 22 1
25 Y Yosiana Pramuka 07 29 1
26 H346 Erna Rt.12 35 1
27 H346 Maita Rt.12 9 1
28 D Dewi Mustika Rt. 30 21 1
29 P9 Putri Rt. 24 12 1
30 J175 Frencelia Juwita Rt. 18 25 1
6 9 6 9

27 April 2017

1 H 0001553531332 Hendri RT.50 22 1

2 L236 Rahmad Fitri Wicaksono RT. 39 24 1
3 Yuni Ayu Musita AWS 27 1
4 K 000121723211 Kurnia Sari Dasy RT.7 19 1
5 H.199 0000011641871 Helda Pandianagan RT.29 21 1
6 R Rositawati RT.14 21 1
7 S Silwanus Gn. Lingai 32 1
8 I202 0002084239945 Siti Masrah RT.20 25 1
9 E39 0002089697231 Amelia Grezy Novia RT.11 18 1
10 L495 001727395907 Liang chen Ni Rt. 7 19 1
11 D13 0000169349084 Usmayanti Rt. 25 42 1
12 A.655 0001190730339 Fayza RT. 60 15 1
13 Y Yadi AWS 37 1
14 F75 Wahyuni RT.13 30 1
15 N.144 Normas RT.5 29 1
16 S1500 0001925304502 M. Nur Zidane Ramadhan RT.64 7 1
17 M 0001205054471 M. Setiyawan RT. 11 36 1
18 H44 0000120527019 Evi setyowati RT.13 37 1
19 M Mariyanti Juanda 21 1
20 H.936 Rahmad RT.1 12 1
21 H550 0002202717183 Mahdalena RT.13 40 1
5 14 1 1
 28 april 2017
1 R427 0000903672977 masliyah 27 40 1
2 H355 0002060837471 rian pratama 8 9 1
3 S527 0001925309417 norliana 36 18 1
4 S1699 0002220942396 ewing radinda 13 9 1
5 M1200 0001676259448 muhammad untung 28 35 1
6 0001259363226 fuad maaruf 25 33 1
7 198 0002223023332 irliani 5 36 1
8 0002223023771 amelia 5 9 1
9 W64 0001266596302 juwita intan 5 26 1
10 M1254 0000902802701 muslimin 12 41 1
11 A509 0000166789361 yati 1 43 1
12 R3 0000120923144 nur anisa 19 19 1
13 R508 0002208125068 nayla salsabila 50 11 1
14 G211 0002054038735 gatot ismantoko 12 39 1
15 U158 0002222715025 veronica rosalina 1 19 1
16 D419 0002228521678 dikson boas 1 43 1
17 0001736648425 veronika 1 37 1
18 0002241043942 aditya 17 6 1
19 F80 0001925285049 martanama 69 39 1
20 N79 0002082273366 faris ahmad 54 40 1
21 N473 0000902946093 sela wahyuni 12 12 1
22 F179 0002082278338 mulyani 1 40 1
23 H199 0000011641871 Helda Pandianagan 29 21 1
24 S225 0000903436806 arga riski 54 9 1
25 C59 0000208190158 safira nue pakis 4 5 1
26 M276 saprudin 54 37 1
27 59 triswanto 93 44 1
28 D457 rhoni supriyanto 2 37 1
29 D457 rhena oktaviani 2 37 1
30 gita lestari perjuangan7 20 1
31 janwardi 30 22 1
32 lili chermita perjuangan7 23 1
33 fanuel adriel p.tepian 8 1
34 nor maria 7 20 1
35 lamisih 13 39 1
8 12 10 5

29 april 2017
1 F 0002041394826 Fajar Dwi Prihantoro pramuka 5 22 1
2 A260 0001066597761 rina 28 28 1
3 A260 0001066497772 zidni 28 8 1
4 S493 0002219219188 wati 23 41 1
5 A260 0001066497759 anto 28 34 1
6 parman 8 37 1
7 0001457814521 amirul hadi 8 14 1
8 E39 0002089697073 yosi 11 16 1
9 L99 0002089313818 Maulidan Bachtiar 2 5 1
10 C496 0001727327327 chong kai jian 8 20 1
11 I493 0002065877122 mardiana 12 34 1
12 B38 0002227883793 muhamad anwar 16 29 1
13 R10 0000903093996 kholifah 3 40 1
14 D494 dendi 47 6 1
15 I570 0000120911826 iwan muhamad ramdan 1 41 1
16 0000896665883 delyanus pramuka6 25 1
17 I131 0002223442023 naila raudhatul 7 10 1
18 I131 0002223441461 wiwi astuti 28 38 1
19 S95 wahyuni y 2 36 1
20 R53 ananda 5 32 1
21 abdul wahab 1 8 1
22 H438 0002224855056 syahaznani 24 24 1
23 Y5 0001867663337 marselo 13 8 1
24 F267 0002042064279 ira despitasari 14 30 1
25 A2146 0002229930369 m.yunus 18 10 1
26 D457 0000903156328 jumaah 8 29 1
27 D457 0000120474538 andi rajib 8 30 1
28 M497 mery patmawati 25 21 1
29 A127 anggi karisna 33 15 1
30 A127 0000903659725 rostiawati 45 38 1
31 R753 0001775791631 penny fajarwati 17 33 1
32 erma nur afriani 3 26 1
8 14 8 2
 JAMINAN
KESEHATAN
DIAGNOSA KETERANGAN
BPJS/KIS UMUM

1 f20.9 AHM
1 R29 anak/smc
1 K64.2 bedah/smc
1 K30 interna/smc
1 i10 jantung/aws
1 G409 saraf/smc
1 D14 THT/smc
1 B230
1 L239
1 D23.11
1 S61
1 T109
1 T109
1 J00
1 i10/B35
1 B35
1 J00
1 J00
1 L239
1 M79.1
1 B269
1 H659/J00
1 H542
1 J45.9
1 C85.9
1 T109
1 H609
1 T109
1 M791
1 B019
1 M79.1
1 B230
1 B09
1 j00
1 J00
1 J00
1 K297
1 T109
1 B09
1 J02
1 J00/R42
1 B059
1 R42/K30
1 K30
31 13 rujukam : B:7

1 K30 interna/smc
1 I249 jantung/aws
1 R042 PARU/SMC
1 G409 saraf/smc
1 G409 saraf/smc
1 H542 SMEC
1 E11
1 R51
1 K30
1 G43
1 L50.0
1 H61.2
1 K64.2
1 JOO
1 I10
1 I84.9/K69
1 Z41.2
1 I10/K30
1 L239
1 K30/A09
1 R11
1 L04
1 B86
1 J00
1 B86
1 J00
1 JOO/K30
1 K30
22 6 Rujukan : 6

1 L239
1 J02
1 H11.0
1 A09
1 M79.1/R42/K30
1 J00
1 K64.0/R42
1 M79.1
1 L84
1 L239/E78.5
1 H10.9
1 J00
1 J00
1 J00
1 J00
1 J02
1 J00
1 A168
1 M79.1
1 B230
1 B230
1 T109
1 J00
1 J00
1 J00
1 J03
1 B269
1 K30
1 N61
1 I10/M79.1
1 B35
1 B230
19 13 rujukan : -
1 F20.9 AHM
1 H542 BKMOM
1 G409 saraf/smc
1 D14 THT/smc
1 J00
1 B35
1 T109
1 K30
1 J02
1 L239
1 J00
1 Z00
1 B35
1 M79.1
1 H659/J00
1 A09
1 L50.0
1 B109
1 T109
1 A09
1 A09/J00
1 A09
1 L239
1 R51
1 I10
1 Z34
1 J00
1 AAA
1 K30
1 K30/J00
1 L84
1 H00.0
1 B230
1 L239
1 B230
1 T109
1 B269
1 J02
1 B269
1 B230
1 B269
1 J03
1 B019/L239
1 J00/K30
1 B230
35 10 rujukan : B: 4

1 H61.2 THT/SMC
1 D649
1 I10
1 Z00
1 K30/I10
1 I10/K64
1 J00
1 J00
1 J00/L239
1 J00
1 B86
1 K30
1 R42
1 J03
1 O02.0
1 J03
1 J02
1 J03/K30
1 B269
1 I10/J459
1 B35
1 L01
1 N76
1 H00.0
1 B269
1 K30
1 J00
1 Z00
1 J00
1 J00
1 J00
1 L028
1 M79.1
1 J00
1 M79.1
1 R42
1 B019
1 J00
1 J00
1 J00
1 L028
1 J00
1 K30
1 J00
 1 Z00
1 J00
36 10 rujukan : B :1

1 I659 jantung/aws
1 I628 orto/aws
1 B07
1 J00
1 T109
1 G439
1 J00/K297
1 J00
1 J00
1 L028
1 F20.9
1 H659
1 J03
1 J00
1 L239
1 J02
1 Z00
1 J00
1 J00
1 J00
1 L509
1 H110
1 H659
1 AAA
1 J00
1 J00
1 B019
1 I10
1 AAA
1 I10
1 B019
1 B019
1 K359
1 J00
1 N39
1 G439
1 G43.9/B35
1 J00
1 A090
1 G439
1 B230
1 B230
1 H660
1 B359/W54
1 G439
1 H10.9
1 T109
1 K30
1 R42
1 Z00
1 Z00
1 K30
1 J00
1 A090
1 J00
1 J00
 1 B019
1 B230
1 B230
1 B230
1 B230
1 B230
37 25 rujukan : 2

1 F20.9 AHM
1 I10/E11 jantung/aws
1 J20.9 PARU/SMC
1 J00
1 B353
1 L50
1 J02
1 B019
1 J00
1 J00
1 G439
1 J02
1 Z00
1 M791
1 J00
1 Z00
1 A010
1 H00.0
1 L02
1 B019
1 J00
1 Z00
1 Z00
1 J00
1 J00
1 Z00
1 J00
1 H609
1 T019
1 Z48
1 J02
1 J03
1 B359
1 Z00
1 Z00
1 M791
1 K30
1 J00
1 L239
1 H609
1 J45.9
1 B019
1 J00
1 K297
1 R50
1 J00
1 J00
37 10 rujukan : 3

1 F20.9 AHM
1 D56.9 anak/smc
1 H93.1/H652 THT/SMC
1 J02
1 J02
1 J02
1 J02
1 J02
1 J459
1 K297
1 I10
1 K297
1 J02
1 J00
1 Z00
1 N39/L239
1 B019
1 Z00
1 J00
1 Z00
1 L239
1 L589
1 G439
1 Z00
1 B269
1 B86
1 B019
1 L02
1 B230
18 11 rujukan : 3
1 B169 interna/smc
1 S069 SMEC
1 H521
1 Z00
1 H109/K30
1 J459
1 R51
1 E11.9
1 J00
1 J00
1 L239
1 K297
1 J00/K297
1 J00
1 L028
1 J02
1 S628
1 H019/J00
1 L02
1 N609
1 B350
1 J00
1 Z00
1 A150
1 J00
1 J02
1 A09
1 T019
1 A162
1 Z00
 1 J00
1 Z00
1 B269
1 K297
1 J00
1 H00.0
1 K297
1 K590
1 J00
23 16 rujukan : 2

1 F20.9 AHM
1 C509 bedah onk/aws
1 E11.9 interna/smc
1 R51 saraf/smc
1 B019
1 E118
1 K108
1 M791
1 K297
1 T634
1 K297
1 J00
1 M79
1 B269
1 K297/I10
1 J02
1 K30
1 J00
 1 J00
1 L239
1 J45.9
1 R51
1 I10/R42
1 K359
1 J03
1 L239
18 8 rujukan : B: 4

1 L.65.9 P. KULIT AWS

1 T019 POLI BEDAH SMC
1 G409 SMC
1 I10 SMC
1 L.239
1 J.45.9
1 B230
1 B230
1 B230
1 B019
1 R42/B356
1 K297
1 J00
J00
1 Z00
1 J00
1 E11
1 J02
1 K297
1 T019
1 T019
1 T019
1 A150
1 J00
1 J45.9
1 T019
16 9 rujukan:4

1 B230
1 B230
1 J00
1 B169/J209
H521
J00
1 J00
1 J00
1 K30
1 M79
1 J02
1 T019
1 N946
1 J00
1 R42
1 L239
A09
1 J02
1 A162
1 A.150
1 J459/A162
1 J03
1 K30
1 E78
1 L239
1 J02
1 N791
1 I10/ J459
1 A09
1 Z00
1 B019
1 J00
1 B359
1 J02 / I10
1 R22
1 M791
1 L028
1 K30
1 H109
1 A150
1 Varicella
1 R42
1 J00
1 B059
1 F209
1 H61.2
1 B369
1 I10
1 J00
1 L509
1 J02
1 A090
1 J00
35 15

1 J00
1 AAA
1 B269
1 M791
1 I10
1 L028
1 K30
1 H946
1 J00
1 K040
1 D34
1 J459
1 B359
1 H262/E109
1 N309
1 H261
1 H521
1 F20
1 H000/L028
1 J00
Z.00
1 E.79
1 N.700
1 T019
1 J02
1 H109
1 H109
 1 R50
1 J00
1 K30
20 9

1 J00
1 F.20
1 Z.00
1 N. 309
1 J.02
1 R.42
1 T019
1 K30
1 B059
1 A09
1 K022
1 T019
1 K359
1 K30
1 T019
1 T12
1 R42
1 G409
K30
1 B019
1 i10/J00
12 8 0
1 I249 jantung/aws
1 G409 saraf/smc
1 G409 saraf/smc
1 H109
1 M791
1 J00
1 J00/K30
1 A198
1 R52
1 J00
1 R42
1 L028
1 L239
1 J02
1 J00
1 L028/B359
1 H521
1 K30
1 J03
1 J03
1 K30
1 I10/M791
1 B359
1 J00
1 K30
1 A188
1 E11/J02/T81
1 B230
1 J00/B230
1 R42
 1 T019
1 J00
1 L028
1 A09
1 B359
25 10 rujukan : 3

1 S93 orto/dirga
1 J00
1 J00
1 I10
1 J00
1 Z00
1 J02
1 K30
1 J00
1 J00
1 L028
1 Z00
1 I10/K30
1 J00
1 R42/T81
1 A09
1 L239
1 M791
1 J00/H109
1 B230
1 J00
1 K30
1 T019
1 J00
1 B269
1 B230
1 B230
1 K30
1 Z00
1 K30
1 J00
1 A09
24 8 rujukan : B :1
 NO UMUR KUNJUNGAN
NO NO. BPJS NAMA PASIEN Alamat/Rt LAKI- PEREM DALAM
KARTU
LAKI PUAN BARULAMA
10 April 2017
1 0001373587896 maria mardiani 47 40
2 0002198886579 shanaz 9 6 x
3 0002063610044 reza aprialdi 64 26 x
4 0000903137589 heny 43 37 x
5 syukran makmun pramuka 3 38
6 0000902672864 hardiyanto 6 13
7 0002231636578 alfian.s 49 19 x

11 April 2017
1 0001553581282 JONAEDI LORONG ABADI25 X
2 I156 0001925287839 SALASIAH 43 42 X
3 R387 0001066496174 RAHMAN 4 33
4 A888 0000903807044 INDRIYANI 27 9 X
5 Y14 0002057133598 LEONARD NISYE 2 27 X
6 A 0000900574751 ARIATI YAKUB 13 17 X

13 April 2017
1 W101 0001066499662 dahliansyah 10 33 x
2 N345 0002233805955 komang rani 39 13 x
3 H355 0002060837471 rian pratama 8 9 x
4 I77 0002231636578 alfian syahrul 49 18 x

15 April 2017
1 L114 0002219414769 la diria 10 28 x

17 April 2017
1 B29 0001301874941 budi hartono 26 42
2 D129 0001925274475 dwi widyastoto 48 44 x

18 April 2017
1 S253 0002200000136 agus setio 8 25 x
2 F200 0002084965165 fesa atma.w 15 31 x
3 S473 0001925280426 suparno 64 40 x

19 April 2017
1 B479 0001925278897 ludy 12 31 x
2 M1106 0000902957815 m.fahriyansah 5 8 x
3 M1784 0001925280178 sri hindiyani 52 38 x
 JAMINAN
KUNJUNGAN
KESEHATAN KETERANGA
LUAR DIAGNOSA
BPJS/KIS UMUM N
BARULAMA

x x f20.9 AHM
x R29 anak/smc
x K64.2 bedah/smc
x K30 interna/smc
x i10 jantung/aws
x x G409 saraf/smc
x D14 THT/smc

X K30 interna/smc
X I249 jantung/aws
X X R042 PARU/SMC
X G409 saraf/smc
X G409 saraf/smc
X H542 SMEC

x F20.9 AHM
x H542 BKMOM
x G409 saraf/smc
x D14 THT/smc

x H61.2 THT/SMC

x x I659 jantung/aws
x I628 orto/aws

x F20.9 AHM
x I10/E11 jantung/aws
x J20.9 PARU/SMC

x F20.9 AHM
x D56.9 anak/smc
x H93.1/H652 THT/SMC
 MINGGU 1
BPJS UMUM
KUNJUNGAN 86 55
RUJUKAN 17 -

MINGGU 2
BPJS UMUM
KUNJUNGAN 143 52
RUJUKAN 18 -

MINGGU 3
BPJS UMUM RUJUKAN
SENIN 37 25 2
SELASA 37 10 3
RABU 18 11 3
KAMIS 23 16 2
JUMAT 18 8 4
SABTU 16 9 4
TOTAL 149 79 18

MINGGU 4
BPJS UMUM RUJUKAN
SENIN
SELASA 35 15 7
RABU 20 9 5
KAMIS 12 8 5
JUMAT 25 10 3
SABTU 24 8 1
TOTAL 116 50 21
 BULANAN
BPJS UMUM RUJUKAN
MINGGU 1 86 55 17
MINGGU 2 143 52 18
MINGGU 3 149 79 18
MINGGU 4 116 50 21
TOTAL 494 236 74