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DAFTAR KLAIM KUNJUNGAN SEHAT

PUSKESMAS BATURITI I 5/antapan


PROPINSI : BALI BULAN : Agustus TAHUN 2017 7/apuan
KABUPATEN : TABANAN PUSKESMAS BATURITI I 8/angseri
14/btrit
KEPESERTAAN UMUR 15/bangli
NO NAMA PASIEN NO KARTU SKP NO.TLP.
TANGGAL KUNJUNGAN TENSI/ND PELAYANAN
PBI ASKES JKN LK PR 16/batuny 34
DAFTAR KLAIM KUNJUNGAN SEHAT
PUSKESMAS BATURITI I
PROPINSI : BALI BULAN : Agustus TAHUN 2017
KABUPATEN : TABANAN PUSKESMAS BATURITI I

KEPESERTAAN UMUR
NO NAMA PASIEN NO KARTU SKP NO.TLP. TANGGAL KUNJUNGAN TENSI/ND PELAYANAN
PBI ASKES JKN LK PR
1 NI KADEK NOVIA BUDIANAWATI 2198817674 12/11/2003 4/10/2017
2 NI NYOMAN TRISNA SEPTIANI 2198817977 29/09/2006
I KETUT BAGUS SATRIA DARMA
3 SASTRA 2198818361 14/09/2014

4 I WAYAN PICA 2198812419 31/12/1936


5 NI WAYAN MIASIH 2198812713 31/12/1938
6 SITI HALIMAH.G 141431927 5/9/1953 Sehat
7 I GUSTI PUTU TUSAN 141460964 8/9/1941 Sehat
8 NI NYOMAN MANIS 141460975 7/1/1945 Sehat
9 SUARTIKA PANDIA I GST KT 141478503 12/31/1940
10 I NYM. SUMADI 141184203 12/31/1958
11 NI KETUT YOGA ARI PURNAMAWATI 141188286 12/14/1979
12 I MADE SUARSANA 141193247 12/31/1952
13 NI MADE SENTER 141193258 12/31/1955
14 NI NYOMAN SRI ANGGRENI 141403116 1/2/1968
15 I KT. ARNAWA 141425043 12/31/1947
16 I KT. PENDRA 141425493 12/31/1951
17 KUSUMAYADI 2227796605 29/05/1995
18 HANIFAN 2227800598 6/9/1994
19 ILYAS TAMIMI 2221224524 24/02/1989
20 HASNA ZUKHRUFI TAMIMI 2221225053 24/12/2011
21 SABARIYAH 2221226122 9/8/1990
22 HAFIZ RASYIQ TAMIMI 2221226684 2/12/2016
23 CAHYATI HARISKA 2219024733 17/04/1998
24 shohibul miftah 2214005488 12/6/1988
25 nunik puspita wat 2214005703 17/01/1994
26 SABARUDIN 2214778094 5/3/1976
27 SRI RAHAYU 2214778116 3/3/1979
28 AHMAD RODI SALMANSYAH 2214778127 4/4/2001
29 OLYA KAMILA 2214778151 11/11/2005
30 RISTAM SAHWADI 2208062046 28/09/1990
31 INDAH AYU LESTARI 2208062395 5/8/1993
32 BOBBY TATA MAHARDIKA 2126569228 15/08/2013
33 SAL-SABILA 2126569239 28/03/2011
34 H ABU HANIFAH 2196607228 31/12/1951
35 HJ RAKMAN 2196607983 31/10/1953
36 MUALIMAH 2105146855 20/11/1992
37 SARWISYAH 2105146866 31/12/1957
38 ADHITIA ZAQI TRI FAUZI WAFI 2105146945 12/3/2008
39 MUH NAJIB MA SUN 2105146989 11/7/2007
40 DYAN MEININGSASI SISWOYO PUTRI 141182469 5/21/1979
41 SITI FATIMAH HANUM 141185834 1/29/1980
42 ABD QOHAR BAHARUDDIN 141319236 9/9/1992
43 DARWISAH GURU 141377207 12/31/1929
44 BUKHORI 141385678 3/10/1973
45 BAYI NABILA 2126569195 21/09/2013
46 CAHAYA 2126569206 15/04/2011
47 BOBBY TATA MAHARDIKA 2126569228 15/08/2013
48 SAL-SABILA 2126569239 28/03/2011
49 H ABU HANIFAH 2196607228 31/12/1951
50 HJ RAKMAN 2196607983 31/10/1953
51 AMANULLAH AHMAD 2105149994 31/08/1972
52 SADDAH 2105150038 31/12/1966
53 MOH ALFARIZI 2105150051 9/5/2012
54 WASIAH 2105149803 5/11/1979
55 MUNAKIF 2105149893 1/12/1957
56 MUHAMMAD IVAN MAGHANI 2105148554 7/6/2010
57 DIDIK RUBIYANTO 2105148565 28/11/1974
58 AHMAD DZIKWAN AVI CENNA 2105148352 23/02/2012
59 MARJUKI 2105148069 31/12/1953
60 IDAH FARIDAH 2105148082 31/12/1974
61 RIJAL HANAPI 2105148126 5/1/2014
62 TAHKIA AFIFAH 2105146822 15/07/2012
63 NAHRAH 2105149959 31/12/1960
64 LUQUIANA HALUWA 2105149961 7/5/1991
65 JUMAIDI 2105149678 3/5/1993

66 MUHAMMAD FADHLAN ABDUL GHANI 2105148947 20/03/2013

67 DANI ANWAR 2105148971 1/2/2013


68 I WAYAN SUKADA 2214775844 19/07/1976
69 NI LUH EKA YULIATI 2214775912 25/07/1984

70
I PANDE PUTU DEVA JULIAWAN PUTRA 2214777519 4/7/2009
71 NI KADEK PANDE PUTRI MARLINA 2214777554 27/03/2014
72 I KOMANG BUDIARTA 2105149836 25/03/2011
73 NI NYOMAN KARSI 2105149882 31/12/1934
74 IDA AYU KETUT SARI 2105149904 31/12/1940
75 DESAK MADE ARIASIH 2105149915 13/09/1984
76 I PUTUN DEDI JUNIARTA 2105149926 3/5/2005
77 I WAYAN SUWITA 2105149599 9/6/1974
78 NI KETUT MUDANI 2105149623 31/12/1972
79 NI KETUT SUTRININGSIH 2105149634 28/06/2009
80 I GD. SENTANA 141182649 12/31/1956
81 NI NYOMAN NGENTIG 141182651 12/31/1959
82 I KETUT JEDY UMBARA 141182662 6/24/1999
83 IDA AYU NYOMAN SURYANI 141185283 1/20/1970
84 I DEWA MADE WARKA 141294183 12/31/1954
85 GST. AYU KT. MAHYUNI 141294205 12/31/1958
86 NI NENGAH ARIMURTI 141306153 3/23/1965
87 IR. GEDE SUDHIYASA 141306164 11/5/1960
88 I MADE ADHI DHARMA PARAYANA 141306186 3/17/1994
89 DEWA MADE DWI INDRAWAN 2105149689 30/06/1997
90 NI WAYAN JUMU 2105149691 31/12/1962
91 NI KOMANG RAPRIYASTINI 2105149724 23/04/2014
92 I MADE ADI ARTAWAN 2105149735 5/9/1994
93 I WAYAN ARTANADI 2105149757 12/10/1999
94 NI KADEK TAMAN 2105149421 21/07/1980
95 NI MADE SENIASIH 2105149432 5/3/1975
96 NENGAH SUSI NINGSIH 2105149443 23/06/1997
97 IDA AYU PUTU RAKA 2105149476 28/09/1960
98 NI LUH NITA RESTITIANI 2105149566 8/4/2000
I WAYAN AGUS ADITYA PRATAMA ADI 2105149577
99 SAPUTRA 9/2/2009

100 NI LUH RENASIH 2105149195 4/8/1975


101 I MADE ARDIKA 2105148363 9/9/1993
102 NI WAYAN KUMPUL 2105148374 1/7/1963
103 NI WAYAN METASARI 2105148003 10/5/1992
104 NI KADEK SUARSINI 2105148036 13/05/1980
105 NI KETUT BEYOD 2105148071 31/12/1935
106 NI LUH SRI ASIH 2105148104 16/12/1973
107 IDA AYU MADE PUTRI ANTARI 2105148115 11/4/2000
108 I GEDE AGUS SANDIRA PRATAMA 2105146877 13/12/1997
109 NI PUTU LASMINI 2105146899 7/12/1977
110 LUH PUTU SUTRISNHA DEWI 2105146912 16/11/2001
111 NI NYOMAN REROD 2105146923 31/12/1947
112 I KADEK AGUS DEDI SAPUTRA 2105149239 19/12/2009
113 NI MADE SUWINI 2105149241 15/12/1975
114 NI KADEK SUTAMI 2105149296 21/12/1967
115 DEWA PUTU SELAMET 2105148993 4/5/1965
116 NI NYOMAN SANIASIH 2105149059 31/12/1964
117 N IKETUT TERIMIN 2105149094 31/12/1958
118 I NYOMAN LIPET 2105149116 31/12/1960
119 I MADE KUYUNDRA 2105149127 1/1/1967
120 I NYOMAN TURUN 2105149149 12/12/1960
121 I NYOMAN KARI 2105149184 2/3/1934
122 IDA BAGUS PUTU ASTAWA 2105148791 31/12/1957
123 I WAYAN SUMARYANA 2105148745 6/7/1992
I KOMANG ADNYANA ARIMBAWA
124 PRADIPA 2105148418 8/8/2005

125 I PUTU DARMA WIRANATA 2105148442 12/10/2006


126 NI PUTU ARMINI 2105148464 31/12/1965
127 I WAYAN ARDI SUMANTRA 2105148227 29/07/1996
128 I KADEK AGUS SILA YASA 2105148238 4/8/2009
129 NI MADE DERNI 2105148249 31/12/1970
130 NI LUH SERI REINI 2105148587 2/4/1978
131 NI NYOMAN SRI ANINGSIH 2105148284 22/08/2006
132 I WAYAN SUTAMA 2105148328 15/08/1974
133 NI MADE RIKSA 2105148802 31/12/1960
134 I KADEK MERTA DIPAYANA 2105148813 25/08/2006
135 NI WAYAN CIRIANI 2105148879 31/12/1970
136 NI NYOMAN SINAR 2105148622 31/12/1967
137 I KETUT TARIK 2105148633 31/12/1957
138 I MADE AWIDYA NANTA 2209808507 18/09/2008
139 I WAYAN SANTIARTA 2105149825 2/12/1986
140 I WAYAN RESEP 2105149858 20/12/1949
141 NI PUTU KARTIKA W 2105149937 6/8/2011
142 NI KETUT MUNDEL 2105149645 30/12/1958
143 I MADE SUARDIKA 2105149779 5/4/1978
144 I WAYAN YASA 2105149397 5/7/1976
145 NI PUTU ARINAYANTI 2105149555 10/4/2008
146 I WAYAN GUNAWAN 2105149307 17/08/1988
147 I KETUT BAYU 2105149061 28/08/2013
148 I KETUT CANDRA 2105149151 4/9/1967
149 I PUTU ARTADANA 2105148824 27/02/1997
150 NI KETUT NUETRI 2105148835 27/11/2012
151 I KADEK SOMAYADNYANA 2105148396 19/03/1997
152 NI LUH SOKA HITA 0000819021418 1/1/2003
153 NI KADEK SUTRIANI 819022454 11/1/2005
154 I NYOMAN NIRKA 819012543 7/1/1976
155 NI WAYAN SRIANI 819012598 12/1/1977
156 I PUTU PUTRA SANJAYA 819013364 12/1/1998
157 KADE ARDIKAYASA 819013689 2/1/2004
158 KOMANG RADIKA PUTRA 819014668 10/1/2008
159 NI MADE BANCUK 819015851 12/1/1939
160 I NYOMAN KARYA 818995498 7/1/1977
161 NI KOMANG WARDANI 818995792 1/1/1984
162 NI PUTU DIAN ANTARINI 818996084 12/1/2000
163 NI KADEK VIRA YULIAPRATIWI 818997276 2/1/2004
164 I NYOMAN PUJA ARTANA,S.SOS 164159223 8/12/1962
165 NI GUSTI AYU DEWI ASTINI 164159864 4/30/1971
166 NI WAYAN LONDRI 2105148194 1/7/1977
167 NI NYOMAN SUKRIANI 2105146888 1/6/1977
168 I KETUT SUDIARSA 2105146967 13/08/1985
169 NI WAYAN SUGIANI 141197073 9/19/1959
170 IDA BAGUS RAI 142043196 1/2/1961
171 IDA AYU KETUT UTARI 142043207 12/31/1962
172 I MADE SIMPEN 819945944 12/1/1960
173 NI WAYAN SOPAK 819946034 12/1/1962
174 I KADEK MULIANA 819946438 7/1/1991
175 I KOMANG WIRAWAN 819946708 10/1/1996
176 I MADE NUARTA 819073629 6/1/1999
177 NI KOMANG ASTI PRADNYA WATI 819073899 8/1/2005
178 I NYOMAN GALIH 819074619 12/1/1934
179 I WAYAN SUKANADA 819044482 12/1/1954
180 NI KETUT KERTI 819044932 10/1/1955
181 I KOMANG BUDAARTA 819045674 9/1/1988
182 NI KADEK NUWETRI 819045933 11/1/1994
183 NI NYOMAN SUNITRI 819046855 6/1/2000
184 NI KADEK AYU LESTARI 819054753 11/1/2006
185 I MADE SUARDIKA 819038395 4/1/1978
186 NI WAYAN SUNIASIH 819039159 6/1/1982
187 NI LUH KARTINI 819020395 4/1/1984
188 I WAYAN DWI ARTAYASA 819938665 6/1/1995
189 I KETUT GANTOS ARSANA 819938531 3/1/1958
190 NI MADE OKARINI 819938384 1/1/1986
191 I MADE SUARSANA 819938261 8/1/1980
192 I MADE SELAMET 819094511 12/1/1969
193 NI NYOMAN PENI 819094792 12/1/1963
194 NI KADEK DWI TARI 819094994 1/1/1992
195 I MADE BAKAT 819070165 4/1/1972
196 NI KETUT SUKARNI 819070593 3/1/1980
197 NI KETUT LINTIA ARISMA 2217224687 27/12/1995
198 I PUTU JUNI ARTA YASA 2209806909 21/06/2016
199 I KADEK DEWA PRATAMA 2126569241 28/04/2013
200 NI PUTU MULIA DEWI 2126569252 15/03/2011
201 I KADEK MERTA 2126569217 17/03/2014
202 I KADEK DEWA PRATAMA 2126569241 28/04/2013
203 NI PUTU MULIA DEWI 2126569252 15/03/2011
204 NI KETUT DORA 2105150016 8/1/2006
205 LUH SUDIANI 2105150027 13/12/1969
206 I NYOMAN RAPET 2105150049 31/12/1950
207 I MADE KERTIASA 2105149847 15/10/1996
208 NI NYOMAN SARI 2105149871 31/12/1970
209 NI MADE NYANDRI 2105149948 19/12/1965
210 NI NYOMAN MANIS 2105149612 4/10/1987
211 I MADE SEMARA DARMA 2105149667 10/1/2011
212 I KETUT DIARSA 2105149408 5/2/1996
213 I KADEK AGUS DEVA ARTAWAN 2105149465 13/05/2013
269 I WAYAN MUDIARTA 819077016 7/1/1995
270 I KOMANG MURA MARDI KARIANA 819951298 7/1/2006
271 I KOMANG SOKLAT 819951388 12/1/1983
272 I WAYAN BUDIARTA 819951715 8/1/1988
273 I WAYAN KANIA 819951974 5/1/1972
274 NI NYOMAN SAYANG 819952007 12/1/1981
275 I NYOMAN MARDIANA 819952031 12/1/1993
276 NI PUTU DIAHMAYANTI 819952108 3/1/2001
277 I MADE SUJA 819951153 12/1/1966
278 I NYOMAN OSEK 819935594 12/1/1956
279 NI WAYAN ORDI 819936066 12/1/1965
280 NI KOMANG AGUSTIANI 819936832 8/1/1999
281 I WAYAN SUTAMA 819935098 12/1/1993
282 I KADEK SEMARA PUTRA 819935212 8/1/2003
283 I KOMANG PUTRA ARDANA 819934187 12/1/2004
284 I NYOMAN WIDANA 819934312 12/1/1973
285 NI WAYAN MIRTA 819934749 12/1/1976
286 I WAYAN SUWASTIKA 819932916 12/1/1966
287 NI KETUT SARIANI 819932995 12/1/1970
288 I KADEK SUMERTA YASA 2105148914 27/12/2005
289 NI KETUT NUMBRUG 2105148958 31/08/1965
290 NI NYOMAN WARTINI 2105148982 31/12/1969
291 I WAYAN SELEG 2105148677 14/12/1942
292 I MADE SIARTA 2105148688 30/12/1972
293 NI WAYAN WASTRI 2105148655 31/12/1940
294 NI KETUT SURI 2105148712 17/07/1985
295 I MADE BAWE 2105148723 30/12/1955
296 NI WAYAN MARTINI 2105148756 12/1/1969
297 I KOMANG JERI SAPUTRA 2105148486 31/12/2000
298 NI WAYAN SRI ARTINI 2105148497 11/5/1998
299 NI NYOMAN PEJI 2105148519 31/12/1945
300 I KETUT DARMA YASA 2105148532 25/04/2010
301 I WAYAN PASTI 2105148205 25/12/1964
302 NI WAYAN ARTINI 2105148216 30/12/1980
303 NI WAYAN SRI HANDAYANI 2105148058 6/8/1985
304 NI MADE SUARTINI 2105146833 19/11/1992
305 NI KADEK AYU STIADEWI 2105146901 29/05/2007
306 I WAYAN ARTAWAN 2105146934 5/7/1983
307 I NYOMAN SUMA ADI PUTRA 2105146978 14/10/2009
308 I GUSTI NYOMAN SUITERA 141192415 12/28/1964
309 NI KETUT RASTITI 141402982 12/27/1969
310 I NYOMAN SUTA, s.sos 141402993 10/26/1964
311 KOMANG ANGGA ANTIKA 141403015 12/1/1995
312 NGAKAN NJOMAN RAKA 141438126 12/31/1952
313 DESAK NYOMAN SUPAMI 141438137 12/31/1955
314 NI NYOMAN PRAMI 819951254 12/1/1971
315 I KADEK DITE YASA 2105148262 27/05/2003
316 I KOMANG ARTHA WIGUNA 2105148295 14/04/2009
317 I MADE RADI 2105148306 30/10/1965
318 NI KADEK SETIA DEWI 2105148317 21/06/2005
319 NI MADE SUJENI 2105148339 29/12/1967
320 I NYOMAN KARIASA 2105148014 1/7/1975
321 NI KOMANG WIDIANTI 2105148025 14/04/1997
322 NI WAYAN WIDIANI 2105148385 31/12/1979
323 NI KADEK SUKARMIASIH 2105148047 6/8/1976
324 I NENGAH SANTI 2105149814 31/12/1971
325 NI WAYAN LOKA 2105149601 31/12/1934
326 NI LUH TAMAN 2105149656 15/10/1978
327 I NYOMAN TIKA 2105149702 31/12/1972
328 I WAYAN RASTANA 2105149768 31/12/1999
329 NI PUTU DANIYANTI 2105149781 6/9/1998
330 I PUTU WIDI ARTANA 2105149533 18/03/2008
331 NI WAYAN SUKERNI 2105149544 31/12/1966
332 NI WAYAN SUITI 2105149353 1/7/1962
333 I WAYAN SUBRATA 2105149004 2/9/1972
334 I NYOMAN SARA 2105149015 10/12/1992
335 I NYOMAN PASEK 2105149072 31/12/1950
336 I MADE SUDARMA 2105149138 1/7/2000
337 I MADE DARMA YOGA 2105148846 19/05/2000
338 I WAYAN AGUS ARTA WIGUNA 2105148857 13/10/2012
339 I NYOMAN REDANA 2105148925 10/12/1994
340 I PUTU DIPRANATA 2105148936 10/6/2014
341 NI NYOMAN SIPI 819937124 12/1/1977
342 NI KADEK ELY ARIANI 819937271 11/1/1999
343 I NYOMAN KORNI 819083474 12/1/1932
344 NI NYOMAN SUSUN 819084273 12/1/1935
345 I KETUT SUARNAYA 819084339 12/1/1965
346 I WAYAN SUTAMIANA 819064888 12/1/1972
347 NI PUTU PURNI 819064978 12/1/1972
348 I WAYAN ARTADANA 819065226 2/1/1997
349 I KADEK DIRGANTARA 819065362 5/1/2006
350 I WAYAN SUBRATA 819039407 3/1/1972
351 NI WAYAN PUTRI SUASTINI 819039622 12/1/1983
352 I PUTU SUARDI 819040307 8/1/2000
353 I KADEK JANUARA 819041141 1/1/2005
354 I NYOMAN TIKA 819006513 12/1/1986
355 NI KADEK SUDIASIH 819006647 12/1/1990
356 NI PUTU RESTIANI 819007209 12/1/2010
357 I NYOMAN REDANA 819008054 12/1/1994
358 I GEDE ARTA 819008829 12/1/1997
359 NI LUH IRAYANI 819008897 12/1/2003
360 MADE GATRA 352054574 2/3/1963
361 KETUT DARTI 352054809 7/13/1963
362 NYOMAN ANGGREINI 352055068 3/10/1997
363 I KADEK SUBA 2105148969 31/12/1995
364 I KADEK SUBRATA 2105148598 31/12/1978
365 I PUTU DARMAYASA 2105148611 17/07/1999
366 NI WAYAN SUTIASMINI 2105148666 20/06/1986
367 I MADE SEDANA MIYASA 2105148701 4/1/2002
368 NI WAYAN SARINADI 2105148789 24/04/1977
369 I MADE BUDI ARTA 2105148407 22/09/2001
370 NI WAYAN SERI PARNITI 2105148431 31/12/1972
371 I WAYAN WISNA 2105148521 31/12/1960
372 NI MADE KORNI 2105148576 31/12/1943
373 I KETUT SRI ADNYANA 2105148251 15/05/2004
374 I NENGAH NURIASTA 2105148273 31/12/1972
375 NI KADE RESTINI 2105148341 21/06/2009
376 I NYOMAN BAGIANA 2105147992 31/12/1977
377 KETUT TIRTA ADITYA 2105148093 12/4/2012
378 NI KADEK SUMADANIASIH 2105146844 25/05/1993
379 I WAYAN KARTIKA 2105146956 11/1/1990
380 NI KETUT RESTITIASIH 819938013 12/1/2010
381 I NENGAH SANTI 819937056 12/1/1970
5/antapan
7/apuan
8/angseri
14/btrit
15/bangli
16/batuny 34
candikuning 1

ck 2
kembang merta
batusesa
bukit catu
pemuteran
DAFTAR KLAIM KUNJUNGAN SEHAT
PUSKESMAS BATURITI I
PROPINSI : BALI
KABUPATEN : TABANAN

NO NAMA PASIEN NO KARTU SKP NO.TLP.

NI PUTU AYU DEWI ADNYANI 0002235111963 20/03/2016

BAYI NI WAYAN DARTI 0002230899693 2/3/2017


I NYOMAN ARIAWAN 0002221636004 29/09/1991
NI KADEK SARIANI 0002221636926 12/12/1992

I PUTU EGHA DANANTYA DIPA 0002217909868 17/07/2015

I PUTU SUADI WICAKSANA 0002213071479 10/5/2013


PUTRA
I WAYAN SANTIKA 00002213071097 29/03/1983
DESI AMANAH 0002213071198 17/12/1988
I KETUT DARMA 0002210042057 31/12/1956
NI NYOMAN SEKEN 0002210042294 31/12/1960
I GDE KENZIE RADEVA 0002208697378 11/12/2015

NI LUH MADE DEVIANA PUTRI 0002209017677 14/06/2014

I MADE NGENJIL 0002203012451 23/12/1950


NI KETUT SERIASIH 0002203013676 23/12/1953
I KETUT BAGIARTA 0002203014058 14/12/1977
made yunita dewi 0002205614981 10/12/1985
I PUTU ARNAYA 0000142620298 6/19/1978
NI KETUT DARMIANI 0000142620309 10/20/1983
NI LUH PT INDAH PUTRI L. 0000142620311 4/11/2007
PRABUDI 0000142514188 9/15/1963
ANIK MULYATI 0000142514199 7/22/1964
SASTRO PITUTUR 0000142514201 8/18/1995
ANGGA SALIRO 0000142514212 7/22/1998
TJERUG I WAJAN 0000142473688 12/31/1928
SAMBA I NYOMAN 0000142460796 12/31/1927
R. SURADI 0000142446778 1/1/1940
R. SUTARKA 0000142446789 12/31/1926
MORIS NANG 0000142433289 12/31/1926
KEREB I WAJAN 0000142418755 1/1/1940
DANA NANG 0000142378885 12/31/1927
AMPERIG I MADE 0000142374341 12/31/1929
ABDUL KADIR 0000142373171 1/1/1940
I MADE GEDE DIRGHA
SASTRAWAN 0000172704137 9/7/1998
NI KETUT SILIASIH 0000172701551 2/18/1968
KOMANG SUKARINI 0000162367896 10/10/1969
NI LUH MARTA AGUSTINI 0000162367929 8/27/1996
I MADE JAMURTA 0000148474855 6/25/1963
NI WAYAN SUPADMI 0000148474866 12/31/1965
KETUT MITHA ERAWATI 0000148474877 4/7/1992
I PUTU YOGA ADIGUNA 0000148474888 9/28/1999
I KETUT GUNADA 0000143177771 12/31/1960
NI MADE SUKARMINIATI 0000143177782 6/17/1967
I WAYAN PUJA 0000143151017 12/31/1954
NI NYM. RIYASMI 0000143151028 12/31/1957
I GUSTI MADE MURDANA 0000142661226 12/31/1956
SI MADE MERTA NADI 0000142661237 12/31/1958
I WAYAN KEBAYAN 0000142721853 12/31/1952
I MADE LANIA ATMAJA 0000141513298 12/31/1960
NYOMAN SUAMBA 0000141513952 1/20/1958
WANENG I NJOMAN 0000142187207 12/31/1929

PUTU TRILILA PURNAMAYASA 0000142351514 8/22/1994


HERRY SASMITO UTOMO 0000211047906 7/6/1993

DESAK AYU MADE PRADNYA


ISWARI 0000210540881 12/16/1994
NI MADE BUDIANI 0000209670276 12/11/1971

I MADE SUKADI ARTA ADI


PUTRA 0000209670579 8/24/1996
NI MADE PARMI 0000209400298 12/31/1935
NI NYOMAN SINAH 0000209089214 12/31/1938

I MADE SUKADI ARTA ADI


PUTRA 0000209670579 8/24/1996
NI MADE BUDIANI 0000209670276 12/11/1971
NI NYOMAN SINAH 0000209089214 12/31/1938
NI MADE PARMI 0000209400298 12/31/1935
I GD NYM AMBARA YASA 0000200934955 3/13/2001
ARYANTHA SUATHAMA 0000201411843 3/2/1994
DAKA GUSTI GEDE 0000198689163 12/31/1929
I NYOMAN SUWETJA 0000198690748 12/31/1930
RENDEM 0000198804418 12/31/1929

GUBUG I MADE / MUKA PAN 0000198818998 12/31/1928


BIN I KETUT 0000198819224 12/31/1929
RAMBIN I KETUT 0000198819595 12/31/1929
RUNTA PAN 0000199113941 12/31/1926
NI PUTU SUTARIYANI 0000198114039 7/8/2007
I MADE SUTAWIGUNA 0000198114118 11/22/2008
GENTEH I WAYAN 0000197546297 12/31/1928
NI MADE WIDIANTARI 0000196676919 4/19/1981

NI GUSTI AYU AGUNG RAI,


S.PD 0000195054581 1/7/1987
I MADE MERTA 0000194288512 7/5/1971
AYU KADEK DEWI ADNYANI 0000194287061 2/13/1978
NI KETUT KERTI ASIH 0000173286685 12/31/1960
I KETUT SUDARSANA 0000172703981 5/2/1964
NI NYOMAN DESY SUPRAPTI 0002220214588 19/12/1993
BELA KINASIH 0002197224617 3/2/2008
I KETUT SUYASA 0000141275351 3/14/1966
NI WY MINDRAWATI 0000141275362 3/31/1971
MAHARANI 0000141275384 12/27/2001
NI NYOMAN WIRATI 0000141441625 12/31/1950
I MD. PATRU 0000141183786 12/31/1961
NI KT. SUKRI 0000141183797 12/31/1962
NI NYM DESY SUPRAPTI 0000141183808 12/19/1993
I WAYAN TAPAK 0000141184585 12/31/1958
NI MADE SUGI 0000141184596 12/31/1958

I WAYAN SUDANA 0000141834047 12/31/1962


NI MD. SUMIANI 0000141834058 12/30/1963
NI MADE NILAWATI 0000141834071 12/26/1992
NI GUSTI KETUT RAI 0000141844026 9/30/1962
I WAYAN REGEP 0002228052385 31/12/1952
I KADEK PANDE ARTHA 0002221194699 25/07/2005
MUGRAHA
I MADE SUJANA 0002221195296 1/12/1960
I WAYAN SUDIARTA 0002222106153 6/12/1986
NI NENGAH ARIANI 0002222106502 5/6/1993
I PUTU BAGUS SEDANA 0002222106772 25/01/2013
PUTRA
I WAYAN SUTAMA 0002222107097 31/12/1945
NI WAYAN SINGID 0002222107378 10/1/1951

KOMANG TRISKA VIORENTINA 0002218483743 13/09/1997

GEDE JOSE YUDHA PRAWIRA 0002218484349 4/6/2012


PETER ALEXANDER FRITZ 0002220649648 3/12/1958
MICHAEL PAUL FREDRICK 0002220650818 2/5/1970
DEUTSCH
I GEDE PANDE RIADNYA 0002221193057 25/02/1979
NI WAYAN SEKARIATI 0002221193698 28/07/1980
I PUTU PANDE DIKA 0002221194161 3/5/1999
MUGRAHA
NI KETUT KENDRI 0002211787372 7/3/1969
MADE ARIAWAN 0000141513759 8/27/1963
NI WAYAN SUJIANI 0000141513761 7/31/1968

I GD NGR WAHYU PRAPANCA


KRISNA, A.MD.AK 0000206521108 3/5/1988
NI KETUT WIJI 0000207406833 12/31/1962

I GD MD KISKENDA BHADRIKA 0000203886088 5/4/2010


SUMARNA 0000197407078 8/16/1968
EKA JALA BUDIASIH 0000197407146 1/9/1998

NI KT MUTIARA SURYA DEWI 0000197407203 2/27/2006


PUTU KSAMAWAN 0000196022968 8/20/1983

NI L. GEDE PANDE
HARISNAYANTI 0000196022979 7/27/1984

PANDE BAGUS ARIESTYAWAN 0000196022981 3/27/2003

NI LUH KOMPYANG BUDIASIH 0000195634664 1/25/1972

NI PUTU GEK RATIH


DAMAYANTI 0000195634765 4/9/1994
KMNG KARUNIA DEWI 0000195634877 3/7/2003
NI MADE MIRAHANI 0000174366797 9/24/1984

NI luh putu SANDRA


SARASWATI 0000174490525 5/29/2004
I KETUT SUDIRTA 0000172704633 7/6/1960

I GD NGURAH ALIT ANDITA


DIRTA YOGA 0000172704971 3/12/1995
NI WAYAN DIASMINIATI 0000172702945 1/29/1968
RADJIN I WAJAN 0000142447386 1/1/1940
AGUNG WAHYU 0002211787708 10/10/1997
NI MADE LILA RATIH 0002212761835 28/11/2016
SWANDEWI
NI WAYAN SARI 0002209235692 31/12/1965
I WAYAN SUHENDRA 0002209238943 15/12/1986
NI WAYAN OKTAVIANI 0002209239843 9/10/1989
I PUTU NALA HARADEA 0002209240607 6/9/2009
I KETUT LETID 0002209242734 7/6/1949
NI MADE LUSIN 0002209243375 4/2/1944
I MADE DHARMA SEMARA 0002203374262 9/6/2016
PUTRA

NI PUTU AYU OKTAVYANA 0002126569094 6/10/2011


SWANDEWI PUTRI

NI KOMANG TRI PUSPITA 0002126569105 25/02/2011


DAMAYANTI

NI LUH KETUT NARISMA 0002126569149 6/6/2012


JENITA
I WAYAN YOGI PRANATA 0002107225449 26/11/1990
I GEDE KUSUMA MERTA 0002107225462 3/1/1995
MUSTIKA

I GEDE NGURAH DELAN ARTA 0002107225473 1/5/1993


PRATAMA
NI PUTU SUPARINI 0000141402666 12/18/1984

I WYN ADI NARADHIPA PAJRA 0000141402677 12/12/2002

I MADE GIRI 0000141402688 12/31/1968


NI WYN. SUNI 0000141402699 12/19/1963
NI WAYAN NITIASIH 0000141403149 10/16/1976
I GD MD SUASTAWA,SH 0000141403151 7/18/1969
NI PT PRISTHA DEWI Y 0000141403162 5/24/1999
I KETUT CAKERA 0000141423838 6/2/1946
I NYM. PEPEK 0000141467139 12/31/1940
NI NYM. SUCIATI 0000141476657 12/31/1953
i nyoman riata 0000141477131 12/31/1941
NI MD. LETID 0000141477142 12/31/1947
SUARKA I GD NYM 0000141478424 12/31/1942
KEMUDAWATI NI LUH 0000141478435 12/31/1942
NYOMAN
I NYOMAN GEDE SUBAWA 0000141193754 12/31/1949
I KETUT DARMAWA 0002107225528 31/12/1975
I PUTU MERTA YASA 0002107225539 7/12/1998
NI LUH DE RINI 0002107225541 3/10/2001
ANTIKADARMAWATI
I MADE SURYA NEGARA 0002106151683 25/06/1968
NI WAYAN ASTINI 0000141196691 12/31/1953
I WAYAN RENGKA 0000141277533 12/31/1961
NI WAYAN SUKAASIH 0000141277544 3/6/1965
NI MD SINTHYA KUSUMA A. 0000141277566 2/5/1997
I GEDE PUTU KARPANA 0000141288579 3/3/1964
I GEDE WAYAN KISMAYA 0000141288625 3/22/1971
I WAYAN DARMA 0000141300843 12/31/1962
NI KETUT SUKASIH 0000141300854 12/31/1967
I MADE OKA ADI SAPUTRA 0000141300876 4/8/1997
I MADE BUDIARTAYASA 0000141311079 6/17/1970
I W MERTHA AYA 0000141313331 10/15/1962
NI KT. YASMINI 0000141313342 12/10/1962
NI MADE DEWI SOMAYATI 0000141313353 12/13/1993
NI NYOMAN LUWIH 0000141333197 12/31/1935
I MADE KERTAYASA 0000141386275 6/23/1982
I MADE MUDIADANA 0000141386286 6/20/1983
I KETUT SUADA 0000141402655 5/10/1979
I DEWA MADE SUWITA 0002229986384 17/04/1962
DESAK MADE DARMINI 0002229986542 31/12/1965

DEWA NYOMAN MERTA YASA 0002229986834 15/04/1989

DESAK PUTU GENDRI 0002229987148 31/12/1960


I MADE MERTA 0002224766665 23/04/1958
NI MADE SUMIASIH 0002224767418 23/05/1960
I MADE SUBRATA 0002224767677 24/11/1988
NI NYOMAN TOKYONG 0002224768127 22/12/1928
NI KOMANG SRI DIANTARI 0002211663723 14/03/1994

NI PUTU DEWI ANDINI PUTRI 0002126272015 17/05/2011

NI MADE SURADI 0000141185654


I PUTU SUARDITA 0000141185665
I MADE JULIO SAPUTRA 0000141185687
I GST KT NGURAH 0000141188556
I KETUT SUGITRA 0000141192729
I MADE SUTAMA 0000141193416
NI KADE SUDIARI 0000141193427

MADE ARY SUKMA PRADITHA 0000141193449

I NYOMAN MARDIANA 0000141193888


NI MADE SURYA ADNYANI 0000141193912
I NYOMAN MERTA 0000141193923
NI KAKE SUDIARI 0000141195554

NI LUH made DEWI ARI PUTRI 0000141195813


NGAKAN NYOMAN PATRA 0000141281368
DESAK NYOMAN SEKARINI 0000141281379
DESAK PUTU SUDARMINI 0000141281381
DSK MD RESI KEDISAN 0000141281392
I MD PURDJI 0000141299144
NI LUH PT WARDIYATI 0000141299155
I WAYAN SIRKA 0000141395275
NI MADE MUKRI 0000141395286
DR DAVID 0000141402532
NI MADE DEWI PURNIATI 0000141402543

MIHAIMANATIN MEI'XIE N.W 0000141402554

NI PUTU PANDE DESIANTARI 0002126569116 15/12/2011

NI KOMANG TRI ATSARI 0002126569138 30/12/2013


I MADE MASNAJAYA 0000141311125 12/31/1957
I NYOMAN SUSWILA 0000141513524 12/31/1955
NI MADE SARINI 0000141513535 12/30/1958
PUTU RISAWAN 0000141525483 12/24/1978

MD HARI SEDANA PRASETYA 0000210557114 1/23/2002


NI PUTU PURNAMA DEWI 0000207756832 3/3/1988
NI PUTU TATALIA REGINA 0000207756854 6/30/2010
NI PUTU PURNAMA DEWI 0000207756832 3/3/1988
NI PUTU TATALIA REGINA 0000207756854 6/30/2010
PUTU ADI SENA PRASETYA 0000194041438 4/18/1994
NI KT NURANI PARIYATI 0000172599467 2/2/1968
I PUTU ADI SURYA SUSANTA 0000164491637 11/21/2008
I KETUT SANTIKA YASA 0000164491896 6/14/1972
I MADE WARGINA 0000141513434 10/11/1968
NI WAYAN SUWINIASIH 0000141513445 1/3/1974

NI WYN ASIH PUTRI WARGINA 0000141513456 4/12/1995

NI MD SANTI DEWI WARGINA 0000141513467 4/24/1998


I NYOMAN SUTARMA 0002216284121 7/7/1977
NI WAYAN SUTARIANI 0002216284953 18/04/1978
NI LUH CINTA ANJANI 0002216285256 12/4/2010
NI MADE HANINDIA ANJANI 0002216285605 26/12/2014
NI KETUT GASI 0002216285921 4/12/1952
I PUTU SATYA ANGGRADIKA 0002217719305 16/11/2004
LUH NYOMAN DIDIK TRI 0002211130348 13/09/1994
UTAMI

NI MADE SINTYA MAHARANI 0002217720453 14/09/2006

I NYOMAN AGASTYA 0002217721702 24/02/2016


MAHAPUTRA
I MADE TANA 0002212640313 31/12/1941
NI LUH MADE SIULAN 0002212641854 31/12/1949
I KETUT RASNAWA YADNYA 0002209853259 4/8/1961
NI WAYAN RESINAWA 0002209855476 11/1/1969
I WAYAN SUMERTHA 0002211126039 25/12/1964
NI NYOMAN SUKARTINI 0002211126862 1/1/1969
I KETUT SUDERI ARTA 0002107225484 13/06/1968
NI MADE SUMIATI 0002107225495 12/2/1970
KADEK BELLA RAGITA 0002107225506 17/04/1995
I PUTU ANGGI PRATAMA 0002107225517 9/8/1993
I KETUT THISNA YASA 0000141192764 12/31/1952
NI MD. TISNAWATI 0000141192775 12/31/1957
NI WAYAN SULASIH 0000141197139 8/3/1974
I PUTU INDRA YUDISTIRA 0000141271885 2/8/1982
I KETUT KARTANA 0000141296095 12/31/1960
NI KETUT WINDI 0000141296106 12/31/1959
I WAYAN SUAR SUTANTA 0000141301462 12/31/1962
NI KETUT MIRIANI 0000141301473 12/31/1962
I KETUT SUMAREDANA 0000141324502 12/31/1964
I MADE CARTA 0000141403555 10/7/1973
NI WAYAN RUSMINI 0000141403566 1/11/1977
NI LUH NITA WULANDARI 0000141403577 1/22/1996
TRIKA YADNYA I WYN 0000141479357 12/31/1939
SUTARI NI KETUT 0000141479368 12/31/1945
I KETUT DAGING ADNYANA 0000141494679 8/15/1954
NI MADE LASTRINI 0000141494681 12/31/1959
DAFTAR KLAIM KUNJUNGAN SEHAT
PUSKESMAS BATURITI I
BULAN : Agustus TAHUN 2017
PUSKESMAS BATURITI I

KEPESERTAAN UMUR
TANGGAL KUNJUNGAN TENSI/ND PELAYANAN
PBI ASKES JKN LK PR

7/10/2017

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baturiti
abianluang

pacung
pekarangan
abang

bangah
DAFTAR KLAIM KUNJUNGAN SEHAT
PUSKESMAS BATURITI I
PROPINSI : BALI
KABUPATEN : TABANAN

NO NAMA PASIEN NO KARTU SKP NO.TLP. TANGGAL KUNJUNGAN


I PT PRADNYAN LES
10 WINARYA 141489371 6/26/2008 16-10-2017
11 I KETUT BUDIASA 0002214774358 4/7/1970 16-10-2017
12 NI PUTU SUMIARTI 0002214774437 4/8/1970 16-10-2017
13 NUSRI 0002205898738 4/9/1970 16-10-2017
14 USNAH 0002205899717 4/10/1970 16-10-2017
15 ARI NORMANSAH 0002205900911 4/11/1970 16-10-2017
NI KADEK NOVIA
16 BUDIANAWATI 0002198817674 12/11/2003 16-10-2017
17 I MADE SUARTA 0002105150005 31/12/1960 16-10-2017
18 NI WAYAN SRIASIH 0002198813793 4/14/1970 16-10-2017
19 I NYOMAN PASEK BUDIARTA 0002198816144 4/15/1970 16-10-2017
20 NI PUTU SULISTYAWATI 0002198817156 4/16/1970 16-10-2017
21 NI WYN. KENI 0000141425504 12/31/1951 16-10-2017
22 I KT. WIRATMAJA 0000141426279 12/31/1956 16-10-2017
25 I PUTU PUJA ANTARA 0002105149869 20/11/2013 16-10-2017
26 NI NYOMAN MULIATI 0002105149274 31/12/1959 16-10-2017
27 I PUTU MARDIKA WIJAYA 0002105149285 28/06/1984 16-10-2017
28 NI WAYAN JUNI ARTINI 0002105149331 27/06/1993 16-10-2017
29 I GEDE RAMA KUSUMA 0002105148868 27/03/2008 16-10-2017
30 NI KETUT SEKARINI 0002105148453 10/1/1969 16-10-2017
31 I MADE CAKRA CENDANA 0002105148508 24/05/1996 16-10-2017
88 JAVASZ PARTAYA AL GHOZIY 0002105149983 1/8/2006 9/10/2017
89 ALMAY DAFFA ALBANNA 0002105149713 6/12/2004 9/10/2017
90 RIZKI KAPASILLAH 0002105149746 22/10/2007 9/10/2017
91 MARIAH 0002105149419 30/09/1963 9/10/2017
92 INAYATUL FAIRIYAH 0002105149487 29/09/2005 9/10/2017
93 MIRNA WATI 0002105149511 30/06/2013 9/10/2017
94 AGUS MUJIONO 0002105148609 19/08/1998 9/10/2017
95 WAHIDAH 0002105148644 31/12/1975 9/10/2017
MUHAMMAD GILANG
96 ADRIAN 0002105148699 3/5/2002 9/10/2017
97 MUHAMAD HAERUSSAKIRIN 0002105148767 31/12/1986 9/10/2017
98 JULFAHRI 0002105148778 16/03/2010 9/10/2017
99 RAHIMIN 0002105148734 31/12/1958 9/10/2017
100 SUNIATI 0002105148429 31/12/1960 9/10/2017
101 MASIDAH 0002105148475 20/04/1989 9/10/2017
102 MITANINGSIH 0002105148543 28/12/1976 9/10/2017
104 PITRIAH JULIANI 0002105149206 31/12/1986 9/10/2017
105 ADMAH 0002105149228 25/12/1960 9/10/2017
106 HIDAYATULLOH 0002105149252 7/2/1988 9/10/2017
107 REZA THAULANI 0002105149318 22/08/2007 9/10/2017
108 RIRIN RIANA 0002105149329 20/11/1993 9/10/2017
109 JAILANI 0002105149375 30/12/1984 9/10/2017
110 MARDIYANAH 0002105149386 9/8/1984 9/10/2017
111 SAIDUDDIN 0002105149037 10/4/1966 9/10/2017
112 DIDIT RYAI AR-RASYID 0002105149083 14/06/2011 9/10/2017
113 RABI'AH 0002105148892 31/12/1963 9/10/2017
114 BAYU FAJAR RASIDIN 0002105148903 29/09/2007 9/10/2017
I KOMANG BUDAYASA 0000819025615 2/1/1999 21-10-2017
I MADE RADI 0000819017638 12/1/1955 21-10-2017
NI KETUT MURDA 0000819017763 12/1/1957 21-10-2017
I WAYAN BUDIANA 0000819017965 12/1/1979 21-10-2017
NI WAYAN WARNITI 0000819018494 7/1/1980 21-10-2017
NI LUH EKA LESTARI 0000819019102 7/1/2000 21-10-2017
NI KADEK TRIA DEWI 0000819019157 6/1/2005 21-10-2017
I KETUT 0000819019247 4/1/2010 21-10-2017
I KADEK SWAKA PUTRA 0000819019956 9/1/1982 21-10-2017
NI KADEK SUKERNI 0000819020035 3/1/1985 21-10-2017
GEDE ARDANA YASA 0000819020158 1/1/2008 21-10-2017
I WAYAN DARTA 0000819003778 12/1/1964 21-10-2017
I WAYAN BUDIASA 0000819004138 4/1/1990 21-10-2017
I MADE BUDIARTA 0000819004228 12/1/1995 21-10-2017
I GEDE SUTANA 0000818989334 8/1/1975 21-10-2017
NI NYOMAN BUDAWATI 0000818989773 8/1/1987 21-10-2017
NI LUH PUTU JULIANTI 0000818990537 7/1/2003 21-10-2017
NI NYOMAN ARINI 0002105149498 10/11/1980 21-10-2017

NI WAYAN DEWI INDRAWATI 0002105149509 9/5/1997 21-10-2017

I WAYAN MERTA 0002105149522 7/1/1995 21-10-2017


NI KOMANG SUKENI 0002105149217 27/12/1980 21-10-2017
I KETUT ADI UTAMA 0002105149263 10/5/1975 21-10-2017
NI KADEK DWI ULANDARI 0002105149342 7/1/2000 21-10-2017
NI MADE WATI 0002105149364 14/07/1978 21-10-2017
NI LUH SRI ARTINI 0002105149026 17/08/2007 21-10-2017
NI WAYAN DEGDEG 0002105149048 30/12/1952 21-10-2017
I KADEK AGUS PRATAMA 0002105149105 6/2/2014 21-10-2017
NI NYOMAN SUKEMI 0002105149162 10/3/1982 21-10-2017
I NYOMAN RAKA 0002105149173 1/7/1959 21-10-2017
I PUTU WIDIANA 0002105148881 22/05/2002 21-10-2017
NI KD MULIARSI 0000819077556 5/1/2000 21-10-2017
I MADE KARTANA 0000819027729 12/1/1972 21-10-2017
NI WAYAN SARINI 0000819027944 12/1/1972 21-10-2017
I KOMANG SULANDRA 0000819029237 3/1/2001 21-10-2017
I NYOMAN PUSER 0000819023679 12/1/1960 21-10-2017
NI NYOMAN NITI 0000819023725 12/1/1963 21-10-2017
I KETUT SU 0000819023782 2/1/2005 21-10-2017
I KOMANG SUKAYASA 0000819023848 3/1/1992 21-10-2017
NI KADEK SUMI ASIH 0000819023883 6/1/1995 21-10-2017
I NENGAH GENAH 0000819024333 12/1/1966 21-10-2017
NI WAYAN TAMI 0000819024456 12/1/1970 21-10-2017
I MADE SANTIKA 0000819025492 12/1/1993 21-10-2017
I WAYAN JULIARTANA 0000819933401 12/1/1991 21-10-2017
I KADEK CAKRA CENDANA 0000819933851 12/1/1992 21-10-2017
NI NENGAH NUMBRUG 0000819095872 12/1/1963 21-10-2017
NI KETUT SARI 0000819096096 12/1/1994 21-10-2017
I WAYAN MERTA 0000819096456 12/1/1996 21-10-2017
I NYOMAN DARSANA 0000819087906 8/1/1985 21-10-2017
I MADE PASEK 0000819075892 12/1/1973 21-10-2017
NI WAYAN DARMI 0000819075982 12/1/1975 21-10-2017
I KADEK MERTI YASA 0000819076228 3/1/1996 21-10-2017
I NYOMAN SUKADANA 0000819076454 8/1/1972 21-10-2017
NI LUH SARIANI 0000819076702 3/1/1980 21-10-2017
NGAN SEHAT
TURITI I 5/antapan
BULAN : Agustus TAHUN 2017 7/apuan
PUSKESMAS BATURITI I 8/angseri
14/btrit
KEPESERTAAN UMUR 15/bangli
TENSI/ND PELAYANAN
PBI ASKES JKN LK PR 16/batuny 34
·√ 9 ck 1
√ 47
47
47
47
47
14
57
47
47
47
66
61
4
58
33
24
9
48
21
11 ck2
13
10
54
12
4
19
42
15
31
7
59
57
28
41
31
57
29
10
24
33
33
51
6
54
10
18 bukit catu
62
60
38
37
17
12
7
35
32
9
53
27
22
42
30
14
37

20

22
37
42
17
39
10
65
3
35
58
15
17
45
45
16
57
54
12
25
22
51
47
24
26
25
54
23
21
32
44
42
21
45
37
DAFTAR KLAIM KUNJUNGAN SEHAT
PUSKESMAS BATURITI I
PROPINSI : BALI
KABUPATEN : TABANAN

NO NAMA PASIEN NO KARTU SKP NO.TLP.

1 I MADE ADIK SUARNA 0002223732903 13/09/1985


2 I WAYAN BIRTA 0002223736413 31/12/1955
3 NI MADE MEKARTINI 0002223736481 31/12/1962
4 NI KETUT ARIANTI 0002206645885 31/12/1970
5 I MADE OKI DIANTARA 0002206646403 9/5/1996
6 I NYOMAN NGANDRA 0002206645119 10/12/1968
7 NI MADE WIWIK SURYADEWI 0002200987359 7/4/1985
8 I WAYAN WINAYA 0002200988024 14/07/1973

9
NI LUH MIRAH PURNAMA PUTRI 0002200988507 16/02/2003
10 NI MADE DWI ADINDA PUTRI 0002200989881 27/08/2005

11 I KOMANG KRISNA BARRI


PERDANA 0002200991409 20/11/2013
12 NI MADE WIWIK SURYADEWI 0002200987359 7/4/1985
13 I WAYAN WINAYA 0002200988024 14/07/1973

14
NI LUH MIRAH PURNAMA PUTRI 0002200988507 16/02/2003
15 NI MADE DWI ADINDA PUTRI 0002200989881 27/08/2005

16 I KOMANG KRISNA BARRI


PERDANA 0002200991409 20/11/2013

17
I KADEK AGUS DWIK MAS DIKA 0002106797714 5/9/2004

18 NI LUH MADE SRI NATHA LINA,


S.PD 0000193311753 9/27/1978
19 NI NYOMAN SIPONGNINGSIH 0000148469354 7/1/1963
20 I KETUT CAKRA 0000148469343 12/31/1959
21 GEDE HARTAWAN 0000147109037 11/8/1975
22 LAKSMI BHINDARWATY H. C 0000147109048 1/22/1974
23 I MADE SUNANTRA YASA 0000141735587 5/15/1972
24 NI KADEK BUDI ARINI 0000819921879 12/1/1984
25 GEDE DIANA PUTRA 0000819921969 12/1/2001
26 I KETUT SUDARSANA 0000819921565 4/1/1976
27 NI KETUT LONDRI 0000209514745 12/31/1950
28 NI KETUT LONDRI 0000209514745 12/31/1950
29 NI NYOMAN SURIM 0000200305168 12/31/1952
30 I NYOMAN SUANDA 0000195046569 12/1/1951
31 I NYOMAN WIANA 0002106797624 2/12/1978

32 I PUTU ESA PRADNYA


SAMADHAYA 0002106797635 2/9/1993
33 NI MADE DWI CAHYANI 0002106797646 4/4/1992

34 NI PUTU AYU SRI PRADNYA


SWARI 0002106797657 16/07/2013
35 NI KETUT MURDI 0002106797668 17/12/1974
36 I MADE MANDI 0002106797679 8/12/1973
37 I MADE MAS MEIDITYA PUTRA 0002106797681 31/05/2002
38 I WAYAN SUSENA MANTARA 0002106797692 6/6/1970
39 NI NYOMAN SRI KARTINI 0002106797703 8/8/1972
40 I KETUT DARTAYASA 0000141166056 12/31/1956
41 NI NYM. LATRININGSIH 0000141166067 12/31/1959
42 I KETUT ENTEG 0000141192459 12/31/1960
43 I MD ERY SUSASTRAWAN 0000141192472 3/7/1998
44 I MADE MENDRA 0000141192922 12/31/1964
45 NI NYOMAN WARNI 0000141192933 12/31/1965
46 I MADE WIDIARSA 0000141193539 1/1/1964
47 NI NYM. WERDIASIH 0000141193541 7/24/1964
48 I NYOMAN GATRA 0000141193719 12/31/1963
49 NI MADE SEKARINI 0000141193721 12/15/1967
51 HANDE HENDRAWAN 0000141193743 10/21/1994
52 IDA BAGUS PT ARDANA 0000141195453 12/31/1954
53 NI NYOMAN SULIASIH 0000141196522 6/3/1954
54 I KATUT SOMARATHA 0000141196533 12/31/1954
55 I KETUT SOMARATHA 0000141296534 3/18/1952
56 NI NYM. SULIASIH 0000141296545 6/3/1954
57 I MADE REMPON 0000141320158 12/31/1964
58 NI MADE PASTINI 0000141403048 4/25/1968
59 I MADE TASTRA 0000141403059 12/31/1954
60 LUH GEDE VERA YUNIARI 0000141403061 6/17/1999
61 I NYM SEREGEG,A.MA.PD 0000141430364 12/31/1947
62 NI LUH WAYAN MASNING 0000141430375 12/31/1952
63 IDA AYU KETUT RATIH 0000141437136 12/31/1953
64 I KT. SUKANATA 0000141463225 12/31/1941
65 NI LUH KT. KENDERI 0000141463236 12/31/1943
66 LESEG NI KT 0000141472089 12/31/1940
67 I WAYAN SUARTANA YASA 0000141481236 11/24/1960
68 NI KT SURATINI 0000141481247 11/28/1970
69 DODY GUSVIANTARA 0000141481269 9/18/1997
70 MANDRA I WAJAN 0000141354246 12/31/1926
71 NI MD. MANGKRUG 0000141354257 12/31/1934
72 NI SAYU KETUT RAI 0002231592254 31/12/1950
73 I NYOMAN LASIA 0002206305101 15/12/1951
74 NI KETUT TANGI 0002206305909 17/09/1972
75 I WAYAN SUPARKA 0002206306405 17/11/1980
76 I NYOMAN BUDIARTA 0002206306901 2/11/1990
77 I KETUT SUARDANA 0002206307799 7/4/1992
78 I MADE MERTA DANA 0002127964037 3/11/1986
79 NI PUTU DIA PRAMAN DARI 0002127964048 10/6/2008
80 I MADE KEDUANA 0002127964059 5/8/1970
81 I MADE MERTA DANA 0002127964037 3/11/1986
82 NI PUTU DIA PRAMAN DARI 0002127964048 10/6/2008
83 I MADE KEDUANA 0002127964059 5/8/1970
84 I MADE MERTA DANA 0002105345799 12/6/1986
85 NI KETUT SUARDANA 0002105345801 31/12/1971
86 I GUSTI NGURAH SUTEJA 0000141192358 12/9/1954
87 GUSTI AYU GEDONG 0000141192369 12/31/1960
88 IDA AYU NYOMAN GAYATRI 0000141195284 12/31/1962
89 I GST. PUTU DANA 0000141195295 12/31/1958
90 IDA BAGUS ANOM 0000141195317 12/31/1954
91 NI MADE PARTINI 0000141311439 3/6/1974
92 NI PUTU LIARTINI 0000141526394 1/8/1962
93 NI GUSTI NYOMAN WIRYATI 0000210216104 12/31/1954
94 I GST MADE SUMADIYOGA 0000163658608 7/15/1967
95 GST AYU PUTU ARDABA KORY 0000163658878 7/27/1995
96 GST AYU MADE ARDABA DEWI 0000163659205 3/27/2001

97
I GUSTI NGURAH BAGUS KATON 0000148467071 10/23/1980

98 GST AYU NGR JELANTIK


ARUMDAPTA PUTRI 0000148467082 4/2/2004

99 I GUSTI NGURAH BAGUS WISNU


JELANTIK 0000148467093 6/20/2008
100 I KETUT ARSANA 0000143151153 12/31/1962
101 NI KADEK SUARTHINI 0000143151175 9/26/1994
102 I MADE TOPOK 0002203242017 31/12/1932
103 NI MADE LUGET 0002203247474 31/12/1937
104 I KADEK SATYA PRATAMA 0002125936989 8/5/2012
105 I WAYAN REKEN BSC 0000123532492 8/31/1943
106 NI GST AYU MADE SUAMI 0000141195442 11/8/1958
107 IDA BAGUS PUTU ARDANA 0000141166484 12/31/1954
108 I MADE SUNATHA 0000141265258 8/15/1957
109 LUH LASMIN 0000141265269 12/31/1960
110 NI NENGAH RUWINING 0000141306309 11/27/1958
111
112 KETUT SEJIANA 0000141498584 8/20/1953
113 NI KOMANG KURNIA DEWI 0000819926054 7/1/2007
114 I KETUT DARMA YASA 0000819926133 11/1/2009
115 I MADE SELAMET 0000819925266 4/1/1976
116
117 NI MADE PUTRIANI 0000819925929 12/1/1975

118 IDA BAGUS PUTU ASTHINA


PUTRA 0000196080985 11/28/1982
119 IDA AYU PUTU EVIK ERNAYATI 0000196081187 7/20/1988

120 IDA BAGUS GEDE BISMA


WEDAKARNA 0000196081299 5/22/2009
121 NI WAYAN KERTI 0000193825078 12/31/1958
122 NI WAYAN METRI 0000141536711 11/7/1967
123 NI NYM DITA INDAH SARI 0000141536722 10/8/1997
124 I KT YOGA MAUSADI MULYA 0000141536733 5/6/2000
125 I WAYAN SUADNYANA 0000141875122 7/31/1959
126 NI NYOMAN LEPUS 0000819925209 12/1/1938
127 I PUTU PENDIT SUDIRA 0000819923714 11/1/1990
128 I KADEK PENDIT SUANTARA 0000819923804 11/1/1997
129 NI KETUT SUDIASIH 0000819923073 1/1/1969
130 I NYOMAN LODRA ANTARA 0000819922858 7/1/1965
131 NI KETUT WARNI 0000819921519 12/1/1934
132 I KETUT GINA 0000819921328 12/1/1930
133 I KETUT SANDITA YASA 0000819920057 7/1/1976
134 NI LUH GEDE SANTI DEWI 0000819920147 2/1/1986

135 I WAYAN DYAUS CANDRA


WANGSA 0000819920283 5/1/2006

136 I KADEK ABIRAMA SAMBUDA


DHARMA SATYA 0000819920338 7/1/2008
137 I MADE NEKA 0000819920722 12/1/1953
138 I KADEK REVAN SATYA A 0000819919809 3/1/2011
139 NI NYOMAN BESOG 0000208217531 12/31/1930
140 NI NYOMAN BESOG 0000208217531 12/31/1930
141 NI KETUT SUMBEREG 0000168547059 12/31/1934
142 NI MD. TANEK 0000168538026 12/31/1932
143 SONOG I MADE 0000160964662 12/31/1929
144 SANDERI I NYN 0000142461191 12/31/1927
145 REDING I WAYAN 0000142451313 12/31/1927
146 I WAYAN SUBAGIARTA 00002229593984 15/07/1985
147 NI WAYAN SUKARMI 00002229594243 1/1/1983
148 NI LUH PUTU RISA MAHAYANI 00002229594557 28/09/2008
149 NI MADE SISTA ANDREANI 00002229594862 30/10/2010
150 I MADE PETRA 00002229595751 31/12/1960
151 NI NYOMAN REKA 00002229596065 31/12/1965
152 I KETUT PINTU 00002213562879 31/12/1964
153 NI KETUT MADURIASIH 00002213563329 30/03/1969
154 A A RAKA PUTRA 00002198111725 1/2/1958
155 NI KETUT SULI 00002198112085 2/10/1962
156 NI WAYAN WERA 00002198112614 8/10/1943
157 KOMANG SADU GUNAWAN 00002125936978 15/05/2013
158 A A RAKA PUTRA 00002198111725 1/2/1958
159 NI KETUT SULI 00002198112085 2/10/1962
160 NI WAYAN WERA 00002198112614 8/10/1943
161 NI WAYAN LOSIN 00002105345812 3/5/1958
162 A A KETUT SUDIRA 0000141191831 12/31/1958
163 I GST NGR PUTRA ARYANA 0000141191853 2/28/1995
164 I WAYAN GIRINATHA 0000141194452 6/6/1960
165 NI LUH MADE SUARIANI 0000141194474 1/27/1994
166 NI GUSTI PUTU SUKERTI 0000141195521 1/15/1964
167 NI MADE ARTINI 0000141195881 12/31/1958
168 I WAYAN MURYA 0000141195892 12/31/1960
169 NI NYOMAN NITAWATI 0000141196419 12/31/1965
170 I MADE KAWITRA 0000141275676 3/13/1956
171 NI MADE SARTINI 0000141275687 12/31/1960
172 LUH NYOMAN ASTRI 0000141303497 12/31/1963
173 GINA I KETUT 0000141345292 12/31/1929
174 NI KETUT WARNI 0000141345303 12/31/1928
175 NI WAYAN PADMINI 0000141403173 11/5/1969
176 I MADE DILA SUDARTA 0000141403184 5/1/1965
177 I GEDE ADI GUNA 0000141403195 3/28/1996
178 made adiarta sudarta 0000141403206 12/8/1998
179 I NYM. SUWETJA 0000141431591 12/31/1936
180 NI MD RECI 0000141431602 12/31/1936
DAFTAR KLAIM KUNJUNGAN SEHAT
PUSKESMAS BATURITI I
BULAN : Agustus TAHUN 2017
PUSKESMAS BATURITI I

KEPESERTAAN UMUR
TANGGAL KUNJUNGAN TENSI/ND PELAYANAN
PBI ASKES JKN LK PR
10/10/2017 √ 32
10/10/2017 √ 62
10/10/2017 √ 55
10/10/2017 √ 47
10/10/2017 √ 21
10/10/2017 √ 49
10/10/2017 √ 32
10/10/2017 √ 44

10/10/2017 √ 14

10/10/2017 √ 12

10/10/2017 √ 4

10/10/2017 √ 32
10/10/2017 √ 44

10/10/2017 √ 14

10/10/2017 √ 12

10/10/2017 √ 4

10/10/2017 √ 13

10/10/2017 √ 39

10/10/2017 √ 54
10/10/2017 √ 58
10/10/2017 √ 42
10/10/2017 √ 43
10/10/2017 √ 45
10/10/2017 √ 33
10/10/2017 √ 16
10/10/2017 √ 41
10/10/2017 √ 67
10/10/2017 √ 67
10/10/2017 √ 65
10/10/2017 √ 66
10/10/2017 √ 39

10/10/2017 √ 24

10/10/2017 √ 25

10/10/2017 √ 4

10/10/2017 √ 43
10/10/2017 √ 44
10/10/2017 √ 15
10/10/2017 √ 47
10/10/2017 √ 45
10/10/2017 √ 61
10/10/2017 √ 58
10/10/2017 √ 57
10/10/2017 √ 19
10/10/2017 √ 53
10/10/2017 √ 52
10/10/2017 √ 53
10/10/2017 √ 53
10/10/2017 √ 54
10/10/2017 √ 50
10/10/2017 √ 22
10/10/2017 63
10/10/2017 63
10/10/2017 63
10/10/2017 65
10/10/2017 63
10/10/2017 53
10/10/2017 49
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017

10/10/2017

10/10/2017

10/10/2017

10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017

10/10/2017

10/10/2017

10/10/2017

10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017

10/10/2017

10/10/2017

10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
10/10/2017
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